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HomeMy WebLinkAboutBLDR-23-11061 ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department 1146 Route 28, South Yarmouth,MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836 s�' r M111 '1 Massachusetts State Building Code,780 CMR ,te Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: F ,I >j2—2 3-1100( Date Applied: 1;r� 9frLc f—'__ "�1- Building Official(Print Name) Signa a Date SECTION 1:SITE INFORMATION 1.1)k 110 Address U pu / 1.2 As s Map&Parcel Numbers v/ 1.1 a Is this an a(epted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 3. i/ ' ckeiteS 0 Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) 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: f Public Zone: _ Outside Flood Zone? pdisposaly �/ Private❑ Check if yes❑ Municipal 0 On site system SECTION 2: PROPERTY OWNERSHIP' 2.1 eI' I Re pr1: k t � 2 Ole j� Name( rint ,- ty,State, 1P .0 ft 4 Via, i O s 6 ,vy �`� + fry kO kc.ocl , n sr -- : o.and Street Telephone Email Addiess SECTION 3:DESCRIPTION OF PROPOSED WORK-(check all that apply) New Construction 0 I Existing Building"Owner-Occupied i13"Repairs(s) 0 Alteration(s) 12"Addition 0 Demolition ❑ Accessory Bldg. 0 Number of Units Other 0 Specify: BriefDescription of Pro sed Work': C +01 at( ' catz -( e to CYI I-J LaofirL SECTION 4:ESTIMATED CONSTRUCTION COSTS. • Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 3000 , 00 1. Building Permit Fee:SIT__Indicate how fee is determined: 111 Standard City/Town Application Fee 2.Electrical $ s ❑Total Project Cost (Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: (Q 0 . LID tu513 5.Mechanical (Fire $ Suppression) Total All Fees:$ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ ❑Paid in Full 161 Outstanding Balance Due: P SECTION 5: CONSTRUCTION SERVICES 5.1 Construction p isor License(CSL) WSJ �j f License Number Expiration Date Nam f C L older /,, / �'-{ f /,1 of List CSL Type(see below)(h1k 1 (l tC j� No,and eet Type Description 4� , //I4 J ;; (C-z U Unrestricted(Buildings up to 35,000 Cu.ft.) City/To n,State 11�1 R Restricted lea Family Dwelling M Masonry W / _ (/�I f • RC J Roofing Covering /� 71 f ,/ ', �J WS Window and Siding it. 7J }7( C t v atie e0 .__ SIF SoInsulation Fuel Burning Appliances Telephone Email address D J Demolition . 5.2 Registered,Hwle Improvement Contractor(HIC) (c59[) ` H Registration Number xpi tion Date HI .N e or IC/Want Name 'r W r140002114,0613 (101i- Email address City/T wn,State,ZIP Telephone SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(N�I.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 Issuanc the building permit. Signed Affidavit Attached? Yes No .0 . SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRAC OR APPLIE F UILDING PERMIT I,as Owner of the subject property,hereby authorize to on my behalf,in all matters relative to work authorized by this building permit application. ' } W2/A 3 Pr 0 e ame(Elec onic 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 conta. ed in this ation is true and accurate to the best of my lmowledge and understanding. 4fltPrint Owner's or Authorized Agent's Name ElectronicSignature) r( Date NOTES: I. 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.zov/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" §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1261 Fax 508-398-0836 Office of the Building Commissio';er • 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 ed at fiai,(0#7 - U/f;1 UJ V '�Jconduct Address Is to be disposed of oat the following location: C jjU y►� '< 564,YL—, p � � Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. 6/i3 Signature of Application e Permit No. 11. • '� The Commonwealth of Massachusetts �*=--ii, Department of IndustrialAccidents E Aii 1 Congress Street,Suite 100 .;� Boston,MA 02114-2017 SY•'�. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FI ED WITH T ERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Org 'zation/Individual): . it l Address: //6— City/State/Zip: LC j' j / Phone#:�- b VG -- rO/U Are you an emplo r?Cheek the app priate box: Type of project gaited): I.E f a employer with employees(full and/or part-time).* 7. 1�I construction 2 am a sole proprietor or partnership and have no employees working for me in 8. em a . odelin any capacity.[Itio workers'comp.insurance required.] � 3.D I am a homeowner doing all work myself.[No workers'comp.insurance required.]r 9. ❑Demolition 4.{:l I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Ell Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp. insurance.: 1. •❑P. epairs/ 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. I4. Other h�'K 152,§I(4).and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box At 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. :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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy 4 or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). 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 imprisonm- .s 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. - cop; of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify t po/i' ,.ains and penalties of perjury drat the information provided abo a is rue and correct. Ir Signature: Date: 6 e) '2_ Phone T:(Dii-- J F--- D//f 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 6.Other Contact Person: Phone ff: Commonwealth of Massachusetts flgf Division of Occupational Li Standards e goacd of Building Re ulationsf andnd Standards Constotivisor CS-082931 6ipires:03/13/2024 ADAM LATE . I 15 PAYSON ATH :4I.llnl WEST YARMO JTFl• J • -Ore �r��� �1f Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Individual Re istr 'on Exni_ r_tion • 157390 09/27/2023 ADAM LABONTE D/B/A FULL HOUSE ttOME IMPROVEMENT ADAM LABONTE 15 PAYSON PATH WEST YARMOUTH,MA 02673 G(rl`°"'olC ��Gfo�°k' Undersecretary ESM-104 •A 2 \ LOCUS INFORMATION rR 4 N CURRENT OWNER: CRAIG 8 NICOLE WRITTEN r� -e- EDGE OF SALT.MARSH CHASE GARDEN CREEK TITLE REFERENCE: CERTIFICATE 174609 �?^ ESM-103 ��s..®.._.�.._..�.—.. / / /i 'y PLAN REFERENCE: LAND COURT 31551 D.SH 2 \.- `ESM-9-02"' — -_ BRAY FARM ASSESSORS MAP: 150 / AL // LOCUS ROAD NORTH PARCEL: 41 ALL AllNOTTINGHAM ROAD 64' RESIDENTAL ZONE: R-40 \e // ,�a�, 9SF' SETBACKS FRONT 30' 'v SIDE 20° ,,.-.' - Vrd3'c REAR 20' MINIMUM LOT SIZE: 40,000 S.F. /I `— — — _ _ --- `/- SgruCk fr EXISTING LOT SIZE: 151,366t S.F. IL ' LOCUS MAP ROgD NOT TO SCALE ZONE II: NO :plc ryP�' VEGETATED IlrM7 WETLANDS I CERTIFY TO THE BEST OF MY GROUNDWATER PROFESSIONAL KNOWLEDGE. INFORMATION OVERLAY DISTRICT:. NONE 6' - AND BELIEF THAT THE LOT CORNERS, DIMENSIONS AND SETBACKS TO THE '�9 1— f FLOOD ZONE "X' STRUCTURE AS DETERMINED BY 25001C0577 J \ / INSTRUMENT SURVEY AND AS SHOWN ON JULY 16,2014 —— — THIS PLAN ARE CORRECT. . No.38039 \11i , WF-4 j _ _ WF_2 jO C?.-� i,id,Amy NEW POOL '_,' ' jALL `ti< ROFESSIONAL LAND SURVEYOR DATE HOUSE ra--- - - -- -./WF-3Sck FOUNDATION - 'i.. \. 14'x24' �4 t/ ~� —�., .,9 tip ' ,j..— PLOT PLAN 5.� o, — WITH Cr i -- --- „ \edit. „, NEW x"t ' � y. POOL HOUSE 0ao 9 ,.. 0p -� 4kPROPOSED '\.. o0 ° 00000•'. "o—' SEPTIC TANK .- o 0. 00 S .A5 ` V FOUNDATION a •OaOo jw 0. za °p° ' _�-- -40 Rvanckation Loole,lon ApGrove.:1 \•:`OF RO• B °' 00.0 0. \ /a /A/� a i FOOD Q T \ f.r oo'o � °•aoa• LOT 41 1 7 1„.`\ POOL aRoo�-CRAIG 4,NICOLE-wt4T9m1- _..1 .-.__»._.. fA .._ � I♦F- ...�. ...._..._....__.._.._._,. ` _- oe" 0000; ASSESSORS MAP 150 t \ .'�' \ 1 °° •°00• PARCEL 41 j�� °, „........_.-..w-.a_,.. IN \ a -° 151,366*S.F. j� LOT 34 \ 0 /SOD OF N� \ �°‹,,,,...0 p:- 2 _�� YARMOUTH PORT JASSPHES O SHEM G15INI _ �°ao __ ��-` MASSACHUSETTS ASSESSORS MAP,50 '� \ 00 °ao;�'�.. i" PARCEL 40.1 , j \ 00 e _ _ ° 1��I BENCHMARK (BARNSTABLE COUNTY) i'i f`s_ .G_ `„ �l> e� \ TOP OF CONCRETE TOP OF LEACHING �� / � �f�r�\ 2r.o .� BOUND El 24.07. CHAMBERS CHI `�1\i�iz` r.�e. - -- BOUND 1929 DATUM BY DESIGN PLAN ",` � � a .i♦.*/ DECEMBER 16, 2014 �� �.� �� POP. , EXISTING ��. _.ya A'P0.GOLA/ RAISED �\ i !l1/llr%Illll.J'r _ l PAAo N N ��`_l? Zs \\� .'\sue\.1 REVISIONS: \ �' 1 �C -��� \ �"'+�s M0. DATE DESC. a\\ \ ! \ 4,7 4_ DECK FND — ISTI - — N fir.. EXISTING _ *o N .7.11. 2 STORY `r� PREPARED FOR: DWELLING FIRST FL 41.5 CRAIG & NICOLE WHITEN sa \�� P.O. BOX 1210 �� r So. YARMOUTH, MA 02664 whitterOUTH, cod.net - © / ' (508) 790-0615 „ , .0_ % / LOT 42 349 Route 28 s / Nis- West Yarmouth, Massachusetts /__� W DENNIS do CAROL STILL 02673 I / 'z� h ASSESSORS ARCEL 43.1 950 508 778 8919 .I:, +�\ --' .: / © 2014 The 85C Gaup,Inc -� \\?4 — \ SCALE 1"=30 * / 0 3.75 7.5 15 .m+ Np 1 R-EC EPIEDI 0 15 30 60 fnr PROJ. MGR.: CRAIG FIELD T��A,^�^ �. `1g37 / P 16 '�r VV VV AM FIELD: P. HAGIST I -- - Op/I'r \' S7?q?4p n�i_evr CALL./DESIGN: K. HEALY / -` '` V` (40, AA Nr -'S3' FN1. DOH I ` DRAWN: P. HAGIST ttyOF) _.. CHECK: CRAIG FIELD `��OF p4, �r `205:6i' DWG. NO: 52307/-06173 SHEET Rae- .DWG JOB. NO: 4-8173.01