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HomeMy WebLinkAboutBLDR-23-12937 ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department 'y... 1146 Route 28, South Yarmouth,MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836 < . Massachusetts State Building Code,780 CMR `e Building Permit Application To Construct, Repair, Renovate Or Demolish _ a One-or Two-Family Dwelling _RECEIV D This Section For Official Use Only • ---- Building Permit Number: B 417--2 , -/7.vl,'37 Date Applied. OCT-Q 3 20.3� y Building Official Signature BUIWINJUEf ARTMENT SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers jot Lt iCzt.to IAA. 5.. Yea-rs4 Oki 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 BuildingSetbacks(ft){ ) ' .C1'. --//7(9 Front Yard Side Yards Rear Yard Required I Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public Private 0 Zone: Outside Flood Zone? Check if ye Municipal 0 On site disposal system D"l SECTION 2: PROPERTY OWNERSHIP' O1Owner'of Record: e� Mentc `i,`co S . L tZ V1A- ()a&& Name(Print) City,State,ZIP K (CPA 0 L.v'. No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction Existing Building 0 I Owner-Occupied k 1 Repairs(s) 0 Alteration(s) 0 I Addition Demolition 0 Accessory Bldg. 0 Number of Units 1 Other 0 Specify: P fY: Brief D cription of Proposed Work2: Q v; a dcfib� a Vk (oac4.. d-e ( Ij} . t,,t'I(,L root c .Q..(c. SECTION 4:ESTIMATED CONSTRUCTION COSTS. Item Estimated Costs: (Labor and Materials) Official Use Only 1.Building S 6 .-O©O ' 1. Building Permit Fee:$li ` ; Indicate how fee is determined: 2.Electrical $ IQ Standard City/Town Application Fee 000 0 Total Project Cost3(kem 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ /l Lb C -i4.Mechanical (HVAC) $ List: `I f?� 5.Mechanical (Fire • Suppression) $ Total All Fees:$ 6.Total Project Cost: $ Check No. Check Amount: Cash Amount: 7�600 ❑Paid in Full a Outstanding Balance Due: (t7O — SECTION 5: CONSTRUCTION SERVICES 5,1 Construction Supervisor License(CSL) Pa -r►�1C a cvtos Cc— C 8er o Llat 14a6( Name of CSL Holder License Number Expi ation Date P © e O X 3`{ List CSL Type(see below) U No,and Street 1 Type j Description YCl f VKO UI V� PO('� M I4 d a j� 7 U I Unrestricted(Buildings up to 35,000 cu.R) City/Town,State,ZIP 1 R I Restricted 1&2 Family Dwelling lVI Masonry RC I Roofing Covering WS Window and Siding I Insulation 7 714,3S3-CoBSa pair,a s bs.79 a .C"'o' SF Solid Fuel Burning Appliances Telephone T`Ji ez �t"� Email aedress D ' Demolition . 5.2 Registered Home Improvement Contractor(MC) lo c_tL:ja S. II4ceb5 1Y HIC Company Name or HIC Registrant Name HIC Registration Number E pira on Date �q and Street eG�, `C t.c-06S @ YR.�100. Z0.xlm 0011', P l 44" 4247� 77Y--3 'der" U 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 ❑ No ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. .fie. of - d o D cy /, rozr,i Print 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 th' pli Lion i e and accurate to the best of my knowledge and understanding. Print Owner's or Aut orized Agent's Name(Electronic Signature) /4/y/XD r3 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.sov/oca Information on the Construction Supervisor License can be found at www.mass.aov/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.) Number of ftreplaces Habitable room count Number of bathrooms Number of bedrooms Type of heating system Number of half/baths Type of cooling system Number of decks/porches Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-22311 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 L( Wrk Address Is to be disposed of oat the following location: ei\(\A_ Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. /6DA-0-d-2 Signature of A plication ate Permit No. Property Location:4 KELP LN MAP ID:25/22/l i Bldg Name: State Use:1012 Vision ID:801 Account#801 Bldg#: 1 of 1 Sec#: 1 of 1 Card 1 of 1 Print Date:08/31/2017 13:07 CIVR28NTOWNER TOPO. UTILITIES _, ,STRTIROAD LOCATION CURRENTtSSESSMENT SERGIO RtBtERT F 1 Level 2 Public Water 1 Paned 2 Suburban Description Code Appraised Value I Assessed Value at 4KELP LN 6 Septic RESIDNTL 1012 283,800 283,800 815 — RES LAND 1012 206,600 206,600 YARMOUTH,MA SOUTH YARMOUTH,MA 02664 SUPPLEMENTAL DATA Additional Owners: Other ID: 14/J002//1 VOTE Y MISC 161 VOTE DATE 02/0212013 CHANGES ADD PP FY 16 MG PRIVATE Ri KELP LN•SY BETTERMENT 1 VISION PLAN NUMBE1694B•G ZIP CODE 2664 G1S ID:M_306709_822203 ASSOC P1D# Total 490,400 490,4001 RECORD OF OWNERSHIP 1 BK•VO1JPAGE SALE DATE ql u vli j SALE PRICE V.C. PREVIOUS ASSESSMENTS(HISTORY) $ERGIO ROBERT F I 29646/210 05/13/2016 Q I 470,250 Yr. Code Assessed Value Yr. Code Assessed Value Yr. Code Assessed Value HICKEY DEAN J ' 28060/17 03/31/2014 Q I 550,000 2018 1012 283 t 12017 1012 283,800 0161012 279,500; IACCARINO CARL A 1 2388/39 08/24/1976 I 2018 1012 206,60020171012 206,600 161012 359,000 AACCARINO CARL A I 0 Total:I 490.10. Total:, 490400! Told: 638,500 EXEMPTIONS OTHER ASSESSMENTS I This signature acknowledges a visit by a Data Collector or Assessor fear Type Description Amount Code Description Number Amount 'Comm.Int. APPRAISED VALUE SUMMARY Total: Appraised Bldg.Value(Card) 277,6001 ASSESSING NEIGHBORHOOD Appraised XF(B)Value(Bldg) 6,2001 NBH&SL'B NMI)Name i. Street Index Name Tracing Batch !Appraised OB(L)Value(Bldg) 0 0070/A Appraised Land Value(Bldg) 206,600E NOTES Special Land Value 0 ATURAL 1/6 E/A Total Appraised Parcel Value 490 0 Valuation Method: C KITCHENS 200.10%SHAPE Adjustment: 0 OR SALE 711/13 Net Total Appraised Parcel Value 490,061 BUILDING PERMIT RECORD VISIT/CHANGE HISTORY Puma ID Issue Date Ape Descriptton Amount6 Imp,Date Comp. Date Comp. Comments Date Tv 01.754 ! 05/01/2001 RS ResidentialID IS CL ParlxrselResult i. 998571 09118/1990 '� 100 ; 01/01/2002 REROOF 05/23/2016 CW CL 1,250 1 + REPLACING 01/01/2014 01 1 BH CY CYCLICAL 2014 07/01/2013 BH 01 Measur+IVla 07/01/2013 BH 02 Measur+2Yisit»IthClot 07/23/2004 GM 00 Measur+LKted 1 I ( LAND LINE VALUATION SECTION B Lae i boo Unit I, Acre C. ST. I Code Description 7rre D Front input' Units Price Factor SpecUsSpecial Pricing SAdj i I OCEAN FRONT A,, Disc F ar Ids Ad/, Notes-Adi Use Snee ak Fad Adi.Unit Price land Value A 11,326 SF 7.771.0000 7 LOON 0.850060 1.60 3.0OXIS ACCESS TOWAT WFIIIIVF1l 1.73 18.24 206,600 Total Card Land Oak 016 AC Parcel Total LandArea:b.26 AC Total Laki Value 206,61 Property Location:4 KELP LN MAP ID:25/22//l Bldg Name: State Use:1012 Vision ID:801 Account#801 Bldg 4: I of I Sec If: 1 of 1 Card 1 of 1 Print Date:08/31/ 1713:0? CONSTRUCTION DETAIL CONSTRUCTION DETAIL(CONTINUED) Element Cd. Ch, Description Element Cd. CA. Description$yIe 07 1 odern/Contemp I Model 01 Residential ;Grade 05 Average+20 Stones 2 Stories Occupancy i I MIXED USE Exterior Wall 1 06 Eoard&Batten Code Description Percentage Exterior Wall 2 10 Above Average 1012 OCEAN FRONT ' 100 KW 26 oof Structure 03 !Gable/Hip cof Cover 03 hIF G1slCmp 16 tenor Wall 1 06 at Wd Panel , BAS tenor Wall 2 COST/MARKET VALUATION i tenor Fir 1 14 Carpet Adj,Base Rate: 114,08 16 23 41 aterior Flr 2 1 334,935 Meat Fuel 04 Electric Net Other Adj: 12,100,00 Heat Type 07lectr Basebrd Replace Cost 347 035 EAF g Type 01 None 21 1975 17 BAS 17 FUS 21 BAS 21 tT otal Bedrooms 04 4 Bedrooms pep Code A eta![khans 3 Remodel Rating "23 13 11 oral Half Baths 0 Year Remodeled F1 36 5 2 eta!Xtra Fixes Dep% 20 17 55 5 S FOP Dial Rooms Functional Obsinc 0 ath Style 02 Await Obslne 0 CTH 5 'when Style 02 odern Cost Trend Factor BAS 101010 Condition 36 5 j Complete Overall%Cond 60 Apprais Val 07480 Do`A Ovr Dep Ow Comment Misc Imp Ovr Misc Imp Ovr Comment t Cost to Cure Ovr Cost to Cure Ovr Comment OR-OUTBUILDING&YARD ITEMS(L)I XF BUILDING EXTRA FEATURES(B) 1 4 Code ` Descnpnon 'Sub'Sub Descrtpt AM Units Unit Price Yr Gale DP RI Cnd end Apr Value t � .,, FPL3 2 STORY CH 8 1 — I ,soo.00 995 I 100 2,208 KIT EXTRA TUTU B 1 $00.00 1995 I 100 4,9@0 r f 1 IVILDINGSUB•AREA SUMMARY SECTION Code 1 Description Living Area Gross Area EB:Area Unit Cost ,Undeprec.Value AS First Floor Cathedral Clng Attic,Expansion, 1,793 1,793 1,793 114 t�; . 0 D 0 Finished 137 391 I37 39.97 15,629, . . P'OP Porch,Open,Finished 0 80 16 22.82 1,82E Upper Story,Finished 861 861 861 114.08 98,222 ST Utility,Storage,Unfinished 0 100 45 51.34 � ' 'WOK 0 8 ► 84 5 - » ' Deck,Wood 11A1 9 '� "�` : -';„'--5;,,:,,', * Tit.Gray i.ivll ease Area:, 2.791 4.865 2936 ,, -, ,,, r 347433 -,.. To Whom it May Concern, August 4, 2023 I, Domenic D'Amico, give Pat Jacobs, permission to work at my home located at 4 Kelp Lane Yarmouth Mass. Sign , Domenic D'Amico • 12--, The Commonwealth of Massachusetts r"—v �0 Department of Industrial Accidents H - \" 1 Congress Street, Suite 100 VIM '�•=. Boston, MA 02114-2017 www.mass.gov/dicz Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. An Iicant Information Name (Business/Organiaatiort/Ind%viduat): D 1 � S Please Print Leath! Address: P 0. d OK L{L( City/State/Zip. y ®o(�,t P r 4 o l Oaip 7S Phone 4: 17�{-35-3—Co 0,SA Are you an employer?Check the appropriate box: 1•0 I am a employer with employeesType of project(required): (full and/or part-time).'' am a sole proprietor or partnership7. II l New construction P and have no employees working any capacity.[No workers'comp.insurance required.] tn for m_in S. KRemodeling . 3.0 I am a homeowner doing all work myself.(No workers'comp.insurance required.)r 9. 0 Demolition 4.i I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 ❑ Building addition ensure that all contractors either have workers'compensation insurance or are sole ILO Electrical repairs or additions proprietors with no employees. 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 1? Roofr Plumbing repairs or additions These sub-contractors have employees and have workers'comp. insurance.t 13.E]Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§I(4),and we have no employees.[No workers'comp,insurance required.] I 14. Graben ':any applicant that checks box I must also till out the section below showing their workers'compensation policy information. Homeowner who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors 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. o I am an employer that is providing workers'compensation insurance for nzy employees. Below is the polio,and job site information. insurance Company Name: Policy=or Self-ins.Lie.#: Expiration Date: Job Site Address: Attach a copy of the workers' compensation policy declaration page(showing thetpolicy number and expiration date). Failure to secure coverage as required under\'1GL c. 152, 2'•� is � and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORT;violation ORDER lan by afine of up to$250.00 day against the violator.A co • of this statement maybe forwarded to the Office of Investigations S—oance a coverage verification. copy of the DIA for insurance I do hereby certify a -r th air and penalties of perjuty that the Information provided above is true Signature: and correct Phony 77 _6 Date: 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): ar I.Boar of Health ?. Suilding I.Barr. Department 3. City/Town Clerk 4.Electrical Inspector 5, Plumbing Inspector Contact Person: Phone Ai: THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Individual Registration Expiration 165888 05/14/2024 PATRICK JACOBS D/B/A P.JACOBS CUSTOM CARPENTRY AND REMODELING PATRICK JACOBS 28 M.-UTTER DR. GG DENNIS,MA 02638 Undersecretary Commonwealth a'Massachusetts Division of Occupational Licensure Board of Building Re ulations and Standards o Consti »ISsrvisor 4, CS-081040 ;cps es:04/04/2024 PATRICK H JACOBS 28 WHITTIER/DRIVE ', DENNIS MA U)638 ter' ,)��` 1 Commissioner dog A. Z164. �ua� N �< a � \ n D t .n'' s s rti)(` ss . co ■ '+It ram _tp .* '7i4 `asp,. _. S . Z N m 0 0 0 EH- r ro NN il I (1 N 0420'5 -E 90.0 ' 11 nr N TDB II�IMir: oom Ilt I` gfl'' x * OWo 8:-:r 'Q Z 8p #kg- t7 %,,Q-I mmHg. f yµ 0 N m ,- z 0tnN x t..." N-O .-.� n t 1 ZA i I U Ir.a SE_S 1�t t i mm t t 1 1 O x 9� v` 9O (n .00' n ,l6'LS 3 „05,OZ.LO S N D ms, o m XI a A 3ARAa 1f17iMtiNN`d71M`dd m o n Rl O ao—4 o = tv _Z A �ZD c O -U Z('i� "I Oat > m O a)�nyZ y Zf oo� rrt mom g+o m m D O o�� zo� tm O O N _ Z O Z -,� mn N mO m Z Z _t O c oo z °Na0x -fin A D Z Z oe �� D�k' o `' m` ID �' rn N =Dm N _.t ^-4Z 6 D pq`_NNA,_ o rTi r t f�1 u ,rn o 0 0 1 wrcttr ors { �' Pi nZof T. v4" "ZM O r 2 D D vmm Z p Z -P N) z A➢* n m D 0 Z UYOE3 NO3N Sl13NWd O O ,v1 Z m G) D > (� r W MAR Z Z N v 3FIN3AV M3(AV3S O .` ' Substantial Improvement W� '����eet for FUood�X ^n Construction �� ,_ reconstruction, rehabilitation,addition,Or other improvements, and repair of damage from any cause) Propertyc T� owne _ *\ ` T-)^ Address: 4 ���� Permit No.: ' Location: Description of improvements: CL 10�( 0-f- an xI If ratio is 50 percent or greater(Substantial Improvement),entire structure including the existing building must be elevated to the base flood elevation (BFE)and all other aspects brought into compliance. Important Notes: 1. Review cost estimates toensure that all appropriate costs are included n,excluded. 2 Ifa residential pre-FIRM building is determined tobe substantially improved. it must be elevated toov above the BFE �a /mn~vo/oenna|pn++|Rmbuilding�aubo�nbaUyimpmved.b must bna|evn&�or dry flondpmo�dto�eBFE. ' a. Proposals to repair damage from any cause must be analyzed using the formula shown above. 4. Any proposed improvements or repairs to a post-FIRM building must be evaluated to ensure that the improvements or repairs comply with«nodp|ain management regulations and to ensure that the improvements or repairs do not K aspect cn the building that vvou|dmake�non�ompUont. a »'ony 5. Alterations to and repairs of designated historic structures may be granted a variance or be exempt under the b�� ti | m/vmvemenzonnn�on)pmvidod the work v�||not pna�udeoonUnuoddeoignaUonaoa^h/�nhcoUuoture` au n o S. Any costs associated with directly correcting haa|1h,sanitary, and mafe�code�o|ationo may be oxduda-"from the cost of improvement. The violation �� onmuhavebeonoffinia||yci8*dphor8zaubmionionnfthnpannhappUcation. Determination completed by: Date' � 4 .01, ,,F" ,` TOWN N OFYARMOUTH a( ;,1 BUILDING DEPARTMENT �;;.....;� 1146 Route 28, South Yarmouth, MA 02664 °'��. ; Telephone 508-398-2231 ext. 1261 Fax 508-398-0836 Contractor's Affidavit: Substantial Improvement or Repair of Substantial Damage Property Address:- Li ` L, S. ,rw o i 01C4 o 6(1 Parcel ID Number: a'S cp-D-- Owner`s Name: �nm2wt L D' i( 0 Contractor: Pck. c.11 O S Contractor's License Number: C_ — 0 8 k.01-(0 Date of Contractor's Estimate: lO , -' 'a-(73-3 I hereby attest that I have personally inspected the building located at the above-referenced address by the nature and extent of the work requested by the owner, including all improvements, rehabilitation, remodeling, repairs, additions, and any other form of improvement. At the request of the owner, I have prepared a cost estimate for all of the improvement work requested by the owner and the cost estimate includes, at a minimum, the cost elements identified by the Town of Yarmouth that are appropriate for the nature of the work. If the work is repair of damage, I have prepared a cost estimate to repair the building to its pre-damage condition. I acknowledge that if, during the course of construction, the owner requests more work or modification of the work described in the application, that a revised cost estimate must be provided to the Town of Yarmouth, which will re-evaluate its comparison of the cost of work to the market value of the building to determine if the work is substantial improvement. Such re- evaluation may require revision of the permit and may require revision of the permit and may subject the property to additional requirements. I also understand that I am subject to enforcement action and/or fines if inspection of the property reveals that I have made or authorized repairs or improvements that if inspection of the property reveals that I have made or authorized repairs or improvements that were not included in the description of work and the cost estimate for that work that were basis for issuance of a permit. Contractor's Signature Date: Notarized: TOWNOFOF-YARMOUTH 1146 Route 28, kliinettouth, MA 02664 508-398-2231 e - 1 ax$08-398-0836 Office of the BuildingT o" issioner FINAL COST AFFIDVIT FOR WORK IN FEMA FLOOD ZONE To the Building Commissioner, In accordance with 780 CMR Section 109 of the Massachusetts State Building Code, the total estimated cost of construction, including all related costs* of the building at and constructed, reconstructed, altered,repaired, or extended under building permit no. amounts to $ 77 p pv I, Pa.-c-c\`'Z LSQ.c 6 o S. ,being referred to as the owner/agent identified below,do solemnly swear that the statements made herein are strictly true, correct and made in good faith *Related construction costs include all work done with or concurrently with the work contemplated by the building permit including construction, reconstruction, repairs, demolition, HVAC work, etc. Furnishings and portable equipment are not part of the total construction costs. Signature of owner/agent Notary Public Signature My Commission Expires Notary Seal: �� TOWN OF YARMOUTH Rc)fig' BUILDING DEPARTMENT ,�`,MAT G:..SE%1ti 1146 Route 28, South Yarmouth, MA 02664 Telephone 508-398-2231 ext. 1261 Fax 508-398-0836 Owner's Affidavit: Substantial Improvement or Repair of Substantial Damage Property Address: Li y Lin. S lac- k VI 64- Parcel ID Number: as-- arZ Owner's Name: DO tv�,p,v,i c �}I'I�t,i CO Owner's Address/Phone: "1 V--eA,p [ . .S. yeLrykoatt , m Contractor: e,-(-„,,,(c. ` .„3,„ Contractor's License Number: C.S. — () 3 I,0L{0 Date of contractor's Estimate: lO a ea-7 I hereby attest that the description included in the permit application for work on the existing building all improvements, rehabilitation, remodeling, repairs, additions, and other forms of improvement. I further attest that I requested the above-identified contractor to prepare a cost estimate for all of the work, including the contractor's overhead and profit. I acknowledge that if, during the course of construction, I decided to add more work or to modify the work described, that the Town of Yarmouth will re-evaluate its comparison of the cost of work to the market value of the building to determine if the work is substantial improvement. Such r - evaluation may require revision of the permit and may subject the property to additional requirements. e I also understand that I am subject to enforcement action and/or fines if inspection of the property that I have or authorized repairs or improvements that were not included in the description of work, d the cost estimate for that work that were basis for issuance of a permit. Owner's Signature: Date: Notarized: