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HomeMy WebLinkAboutBLD-23-003049 ' 12/9/22,3:34 PM Mail-Sears,Tim-Outlook 4 Summer St Sears, Tim <tsears@yarmouth.ma.us> ((Sea I i -i)7/c? -- Fri 12/9/2022 3:33 PM To: info@capitalcons.com <info@capitalcons.com> David, I have reviewed your application and there are some items needed. �1. This property is operating as a motel and requires a commercial permit application 2. The plans show the railing height at 36 inches, 42 inches are required http://www.yarmouth.ma.us/DocumentCenter/View/1451/Commercial-Building-Application?bidld= Please submit these items for review This email is considered a written denial of your permit application per Section 105.3.1 of the Massachusetts State Building Code. Section 105.3.2 states in part that "an application for a permit for any proposed work shall be deemed to have been abandoned 180 days after the date of filing, unless such application has been pursued in good faith" You may appeal this denial to the Building Code Appeals Board in accordance with M.G.L. c. 143 §100, within 45 days of this notice. Timothy Sears COO Deputy Building Commissioner Town of Yarmouth 508-398-2231 Ext. 1259 maiito:tsearsjyarmouth.ma.us https://outlook.office.com/mail/sentitems/id/AAQkADE3MDQ5NWZmLTkOYzItNDIwNi1 iMDQxLWNkMGQyNmE4NzE5NAAQAEcv7kIRAO9NhfjFME0jL... 1/1 °tat ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department 1146 Route 28, South Yarmouth,MA 02664-4492 AllI 508-398-2231 ext. 1261 Fax 508-398-0836 •'R'' Massachusetts State Building Code,780 CMR Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: 6th..r23-()b3D`1 i Date Applied: -R E G E I V E D Building Official(Print Name) Signature DalDEC 0 2 2022 SECTION 1:SITE INFORMATION — 1.1 roperty Address: 1.2 Assessors Map&Parcel Numbers ByVit DING DEPARTMENT LiOrnrn.e r . _ 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) i Ck X'S` Front Yard Side Yards Rear Yard Required I Provided Required Provided Required Provided 1.6 Water Supply: (Ivf.G.L G.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: Outside Flood Zone? — Municipal❑ On site disposal system 0 Check if yes0 SECTION 2: PROPERTY OWNERSHIP` 2.1 Owner'of,Record: E-11111_.F'_ s-e,'3 `armcx n I(Y �S oci Name(Print) City,State,ZIP ,lS,x,r-von-e( c1-.. ( 315-(o MV.e.eas5C14 yicuncx)•C No.and Street Telephone Email Adtlfess SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building G}'Owner-Occupied 0 I Repairs(s) ❑ Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other G" pecify: Brief Description of Proposed Work2:r G L 100 . -e f r SECTION 4: ESTIMATED CONSTRUCTION COSTS. . Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 29 (51 2 1. Building Permit Fee:$ -Indicate how fee is determined: I_, El Standard City/Town Application Fee 2.Electrical $ (rj 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ ( .) 2. Other Fees: $ 4.Mechanical (HVAC) $ 0 List: t?1 O .66 tik ll Lil 5.Mechanical (Fire $ `1 . Total All Fees: Suppression) ( $ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ 2 9 012 0 Paid in Full O Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CC10.7L13 kt 2.4 ,t,\I 18 q'c OS lr 1tA-Z. License Number Expiration Date Name of CSL Holder (4 T:wri^`� 54- List CSL Type(see below) v No,and Street Jl Type Description Crt ` 1�G n ice, �\202 I u I Unrestricted(Buildings up to 35,000 cu.ft.) 9 V GLJ R Restricted 1&2 Family Dwelling City/Town,State,ZIP 1v1 Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances (oC-)Sct-122s- 1Yt•C(C 'rkt ecn5.eCinn, I Insulation _ Telephone Email address D_ Demolition 5 2 Registered//Hoo�me Improvement Contractor(HIC) t�'Cl 1 G (t {U + (Y ) ��2 L�� 2 HIC Registration Number Expiratio Date HIC ompany Name or H C Registrant Name No.and Sreetri r o-F-"' I r Fo63 t?t-h'- ors-c_ -, Car/4W) h(A C202-1 U � P1_' � Email address City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes 19------ No ❑ . SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDINGPERMIT I,as Owner of the subject property,hereby authorize' iC( 44C(Ql+� n►kv /eap'rkd (GrliiiuuC-iic r1 to act on my behalf, ' all matters relative to work authorized by this building permit application. ..02i ,GL. 1► /15/2Z P mt Owner's Name(Electronic Signature) Date SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true d accurate to the best of my knowledge and understanding. -'--- / 11/45122-- rin s or Authorized Agent's ame(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.bov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics, decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" oI- TOWN OF YARMOUTH 6 " BUILDING DEPARTMENT �` MN� ?�. �a 1146 Route 28, South Yarmouth,MA 02664 S08-398-2231 ext. 1261 HOMEOWNER LICENSE EXEMPTION PLEASE PRINT: DATE: C'I JOB LOCATION: S I )111rn.e r s,4)\ ma4v MA- ()2(61 NAME STREET AD RESS SECTION OF TOWN "HOMEOWNER" �i�,QA��ctsseis (5g )315-< 'i0 — lv l,Ar — NAME HOME PHONE WORK PHONE PRESENT MAILNG ADDRESS _Savnne_ (gooJe.._— CITY OR TOWN STAlt, ZIP CODE The current exemption for `Homeowner' was extended to include owner—occupied dwellings of one or two units and to allow such homeowners to engage an individual for hire who does not possess a license,provided that such homeowner shall act as supervisor. (State Building Code Section 110 R5.1.3.1) Definition of Homeowner: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is or is intended to be, a one or two family attached or detached structure assessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner;such"homeowner"shall submit to the building official,on a form acceptable to the building official,that he/she shall be responsible for all such work performed under the building permit. (Section 110 R5.1.3.1) The undersigned `homeowner' assumes responsibility for compliance with the State Building Code and other applicable codes,by-laws, rules and regulations. The undersigned 'homeowner' certifies that he / she understands the Town of Yarmouth Building Department minimum inspection procedures and requirements and that he / she will comply with said procedures and requirements. HOMEOWNER"S SIGNATURE A, APPROVAL OF BUILDING OFFICIAL INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch.142. Yes No If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent h:homeownrlicexemp §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-223!I ext.-1261 Fax 508-398-0836 Office of the Building Commissioner BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Ch. 40, §54 and 780 CMR- Section 105.3.1. #4. I hereby certify that the debris resulting from the proposed work/demolition to be conducted at LI Summer * a mU - 020 Work ddress Is to be disposed of oat the following location: v hav,� 3l �a p � Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. -‘22_ igna e o pplication ate Permit No. The Commonwealth of Massachusetts t Department of Industrial Accidents 1 Congress Street, Suite 100 i t Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information PIease Print Legibly Name (Business/Organization/Individual): I �LJ��f�UCtCXI Address: 35 q Ur ripikzc City/State/Zip: (bn}on ML)s<, 02021 Phone #: (-)--)31q-122,s Are you an employer?Check the appropriate box: Type of project (required): I. am a employer with I® employees(full and/or part-time).* 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. ❑Rem delinruction any capacity.[No workers'comp. insurance required.] 8• ❑ eoeling 3.0 I am a homeowner doing all work myself. (No workers'comp. insurance required.]t 9. Demolition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 ❑ Building addition ensure that ail contractors either have workers'compensation insurance or are sole ]1. Electrical repairs or additions proprietors with no employees. 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 12'❑Plumbing repairs or additions These sub-contractors have employees and have workers'comp.insurance.) 13.0�,R�,00f—repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. t 4•Ly-�'����r 152,§1(4),and we have no employees.(No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. f am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Li j Policy or Self-ins.Lic,l#: W C223t.5(0 Dd.u4 aGs 2_ Expiration Date: \. ) v 23 L Job Site Address: I ,% rn Attach a copy of the workers' compensation policy declaration page(showing tthetpolicy n tuber and xpirat�datJ)��� Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the.pains.aj d penalties of per' that the information provided above is true and correct. Sienature: Date: Phone T: Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License • Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector b. Other Contact Person: Phone#: ACo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) L.. 09/15/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jennifer DeRubeis NAME: Stanton Insurance Agency Inc. PHONE (781)893-3200 FAX (781)893-7516 (A/C,No,Ext): (A/C,No): 230 Second Ave#105 AD RIESS: Jderubeis@stantonins.com INSURER(S)AFFORDING COVERAGE NAIC# Waltham MA 02451 INSURER A: RPS-Nautilus Insurance Co. INSURED INSURERS: Arbella Protection Ins Co 41360 Capital Construction Contracting Inc INSURER C: RPS-Evanston Insurance Co. 354 Turnpike St INSURER D: INSURER E: Canton MA 02021 INSURER F: COVERAGES CERTIFICATE NUMBER: Master 22-23 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE IN$D WVD POLICY NUMBER (MM/DD/YYYY j) (MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ 50,000 MED EXP(Any one person) $ 10,000 A NN1263725 05/12/2022 05/12/2023 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X 78: LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Employee Benefits $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED 5/ SCHEDULED 1020069668 12/09/2021 12/09/2022 BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS X HIRED Ne NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY _ AUTOS ONLY (Per accident) $ ANCPL $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 C X EXCESS LIAB CLAIMS-MADE MKLV1EUL103416 05/12/2022 05/12/2023 AGGREGATE $ 1,000,000 DED RETENTION$ 10000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Boston ACCORDANCE WITH THE POLICY PROVISIONS. 1 City Hall Plaza AUTHORIZED REPRESENTATIVE Boston MA 02201 1 Cl QP� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD _ ) ® DATE(MM/DD/YYYY) A D CERTIFICATE OF LIABILITY INSURANCE 01/11/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jennifer DeRubeis Stanton Insurance Agency Inc. PHONE (781)893-3200 FAX (A/C, (781)893-7516 IA/C,No,Extl: ( ) 230 Second Ave#105 EMAIL : jderubeis@stantonins.com DDREINSURER(S)AFFORDING COVERAGE NAIC# Waltham MA 02451 INSURER A: RPS-Nautilus Insurance Co. INSURED INSURER B: Arbella Protection Ins Co 41360 Capital Construction Contracting Inc INSURER C: RPS-Evanston Insurance Co. 3 Norwood St INSURER D: Liberty Mutual Group INSURER E Dorchester MA 02122 INSURER F: COVERAGES CERTIFICATE NUMBER: 21-22 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. SR ADDL SUBR POLICY EFF POLICY EXP IN LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDJYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED 50,000 CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 A NN1263725 05/12/2021 05/12/2022 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- LOC PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY JECT Employee Benefits $ OTHER: AUTOMOBILE LIABILITY COa aBINEDt)SINGLE LIMIT $ 1,000,000 (EcANY AUTO BODILY INJURY(Per person) $ B OWNED 'y/ SCHEDULED 1020069668 12/09/2021 12/09/2022 BODILY INJURY(Per accident) $ AUTOS ONLY /� AUTOS XHIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) ANCPL $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000, - 000 C EXCESS LIAB CLAIMS-MADE EZXS3050232 05/12/2021 05/12/2022 AGGREGATE $ 1,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- STATUTE ER AND EMPLOYERS'LIABILITY Y/N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A WC231 S600872052 01/10/2022 01/10/2023 E.L.EACH ACCIDENT $ D (Mandatory in N ER EXCLUDED? 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Capital Construction 354 Turnpike St AUTHORIZED REPRESENTATIVE Canton MA 02021 9144 d'� 1 UU/ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ocowv o >•-iT> z rn < --IwEla q 0 0 8 > 1-4 o am c)En t•••••;o o X = 0 0 > A° Z 0 (i) ,„""0 M* Ocz'53,> A14zr- x.74 c - g• (0 0 .:...0 0 2 < 4 6 A ,._ 1 > 7Kz M1.7 CI)-I ' -;•;; ''.1 " A-t 9. ri 0 Z .,... Z -I 51 0 0 N' 0 2 - --1 i — 0 rrs C 0 -I 7J a E. t 2iM cr, .7 1 g rD .,. . a cn 2 — 33 c; = '-'• E - , - 3 o 0 ol S. ----,'-. 2--._ 04 itNa a o 'c. E z z ,t) ' 4 III .-• 0 -;•-• 1 ,,... 111111 0 ill ca-co?c73 ilk tovirl...„.., # -H- I 1111 1;1;11011 gilItti 114 ,1 Ia. .4,--(msomp Patti ± a ,,tlEttpitt, ,._g. -0' (31 1 .----0 0.z - a 1 1 r. . . ...< 0 i 1 . z 6 2,0 0 e gy , i '''', I, .7,1 it I al 1 60 ;35 cr-‘ \ 3.9 k, — CO ,,,,, ...... ttri m: 0 ....,. ...." t . 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SCE¢H • Sf ti CatrCBomm. 8- THE FOUNDATION SHOWN IS 0.6' BELOW THE HIGH POINT IN SUMMER STREET. •. A$ tr .641/P",c,./. t CO -oeoO 03 ott 50g-362-4541 ja '1 a"4S rmo sae 3a2-aeaa SOo, , �NZ• OF Moss, o� ARNE y-�t ' down cape engineering, inc. tie o o3A� `,� CIVIL ENGINEERS No. ��. LAND SURVEYORS (w.�! jrr 939'main st. yarmouth, ma 02675 _ j/1Z -- — DATE REG. LAND SURVEYOR. { JOB #99-346 ! ....r.......„.„ . -fflumilIM ill , $ fir"'' .w ha t O -Pligito < wo _ . : 2 17» ,,is 01 PJ ,�LANE: _ f LL11 -LP OTz i '(fig o ij"il kgslo0,l l§215.i '$o m5s1onJ a >� . e �^' �l - 3 1 1 fig'• � „,: Wit, 41l a g _ Y p .� t _---,41453W11.-1- 7N 41. -A5'" ' ' alliM t p+� , .:00 '0. g 1 7 -- t- ..-A 11"` 0000 ik - 't Nei! g \-?1; lk :\ 8 "''. -1' A: alleill: 0 "..znt"`"•••S ILIT+ w i g1 r ,_ ' tr? 0 4141ge k m -IL- pr pt ty snag g 40111 t:. --, _ -15' C a I -1 14, _______ e '11 j a g .. e ' ii g XI 0 0 \\.I -I,. i E ' ipiiiier, ,,,. 0 6) 12 ' 3 rm .164 3. 3,..-. i II iip."''' 1-s:wporci-- :\ '-'..-'-6:2.ct' %., c, .,9:0 - cA* 0 w A 8§ , g © ' 1 ti 1 A W N `\ t� u� � e 0 � na /n �� -\ rt N i.' n I IV to f k t 1 p'e TOWN * I TH ° • 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 Telephone(508)398-2231 Ext. 1292-Fax(508)398-0836 IKING'S HIGHWAY HISTORIC DISTRICT *CRAriliFrgg V E • p 5 2022 APPLICATION FOR h Pg104,) h CERTIFICATE OF EXEMPTION DEC C 7 v22 ULD KINGS HIGHWAY 111711.-151-NfG DE PA RfktIE 14T Application is hereby made for the issuance of a Certificate of Exemption under Secti. 43p and 7 of Chapter 470 f Acts of 1973, as amended, for the proposed work as described below and on plans, w ngs, or p o ograp s accompanying this application. Type or print legibly: Address of proposed work: I mlEP ST RI-0uA Po RT Map/Lot# Owner(s):M1 LEO Ch cstm S Phone#: g 3 75 0 Sci All applications must be submitted by owner or accompanied by letter from owner approving submittal of application. Mailing address: 1367k, -3 7) YARi1100 To ro tz,--r, 0 -At 7 B Year built: Email: 5 1: rt t) ct.f.—CoLrEecr e, Preferred notification method: \0 Phone Email .1)1 LIY1f) ,AgehliCentractor: cii ei TA (oS1UTiOJ fYP3 'Phone#: 7 8 1 7,27 3957 Mailing Address: 3 5 11- -rq gr4 et # 30 T3 c J ro i ('Y)A 0 0 ) Email: (..e Cc ( it4cons R (in D Preferred notification mejhod: a-Phone Email Description of Proposed Work(Additional pages may be attached if necessantl: 1)LCK e L14 CS:. to tit\J CK OF eiRoPLRTY, rRg,v I 0,4 ..7)6ck kg-i\I & OVc S D ft r got) To WA LK THS- C A os'31.-1 CkS TH i PL.41 S 711 g 0 TH EA a. 2cA,zE is nt,16- rxilsg)t-A. Filo)t)E-s THr itzt) Pt NRL— t I-1- (3'6 e LE, sf 5E t.. A Twc c'Ho-ros', Signed(Owner or agent): 1\1: ' Date: 2 51 2 ° > Owner/contractor/agent is aware that a permit may be required from the Building Department.(Check other departments,also.) > This certificate is good for one year from approval date or upon date of expiration of Building Permit,whichever date shall be later. For Committee use only: Date: IA ).›. /Approved Approved with changiii mo ** Amount gOi Reason for denial: 0 5 NZ2 Cash/CK#: Cast') YARMOu t Rcvd by: /./ Date Signed: I2'1 51t92 Signed: z-;14-ceP14 erv,2 ) APPLICATION# 0-e V52017 " r{j TOWN OF YARMOUTH +i.**- -') � / HEALTH DEPARTMENT ''' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET i To be completed "j)Applicant. Building Site Location: LI SmM-P-,r- Si-. \ r'Wrr _ Y`(TAr- 0(.2(0.1 J Proposed Improvement Jt\dia G\& v r)() -}\2 ktck- "he_ V`rv1 e, On Z" '-�Iour. -3 '` r--, ; _ ( ) C6 o tec -t---Q ..►rss Applicant V%c \Afa)LJSrn r'b-\ / C lytli5AC 1r G-tio(1 Tei. No..1p�a�3�c1-�2?� Address: 354 IUc►"p Sir C5t n mot- Q2U21 Date Filed:`-4-1S Z **lfyou would like e-mail notification of sign off please provide e-mail address: Infa0dAVA-CdCWn5. CC'✓-�/l ---- __ Owner Name:l,-4,‘V-C., 14 e 1 Cs3e13 Owner Address: `l&mover S . \a�''t'nOt�n I(�(1Ar' 02AD� Owner Tel. No.:b0`6),2)-43 -U Q RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e.. Requirements For Septage Disposal and other Public Health Activities. Please submit three (3) copies of plans, to include: (1.) Site Plan showing existing buildings, water line location, and septic system location; (2.) Floor plan labeling ALL rooms within building (all existing and proposed) - Note: Floor plans not required for decks, sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY: (/)f),-\__..7,4-- DATE:' ( )/ 5V� -- -- PLEASE NOTE COMMENTS/CONDITIONS:IO - ' 1CFJr /7� \ (r e.-c _ Scl, ,,'l ,i \--.-/"! t. C v't Se lft L TA ACC 5` CERTIFIED PL O T PLAN PREPARED FOR: �w� DOUG HEYWOOD av 4 SUMMER STREET LOCATION : c4 YARMO UTHPOR T, MA Oh 1 PARCEL 93 Gj 0'L' 98.991t SQ. FT. SCALE: 1" = 60' DATE: JUNE 21, 2000 M /o REFERENCE : ASSESS. MAP 122 PCL 93 \NN . (41 i I HEREBY CERTIFY THAT THE STRUCTURE ( 7P. HIGH\P�. �ti f ! SHOWN ON THIS PLAN IS LOCATED ON THE: GROUND AS SHOWN HEREON. ~-.-. c` =rHXC E It E • :i r--i v ~}'P f J 20,et ev. ti6 coxcyomm. 8• eY6,. THE FOUNDATION SHOWN IS 0.8' BELOW THE HIGH POINT IN SUMMER STREET. !g. ZZOZ e 0 330 tr el o A Ot . ec 0 of o y *c �� .A Aq,p` • Ica 0. �r sm-35z-{sc, M. jgs�,,,. OF MASSti�y f�505 � soa, o ARNE H. � down cape engineering, inc. 1 O.I ,L.A ,' _ S ::. No. ` �-. ,, , _ CIVIL ENGINEERS �'*r.C::. ' LAND SURVEYORS . .. 939 main st. yarmouth, ma 02675 _ .ZJ1z L__ DATE REG. LAND SURVEYORJOB #99-346