No preview available
HomeMy WebLinkAbout1069 Great IslandTOWN OF YARMOUTH � o p" 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451 Telephone (508) 398-2231 Ext.1292 Fax (508) 398-0836 YARMOUTH HISTORICAL COMMISSION NOTICE OF INTENT TO DEMOLISH A HISTORIC BUILDING To be submitted to the YHC along with Demolition Permit Application Date of Application: aI ,2.od-0 Building Address: Assessor's Map # r x_��srarcel v i a Demolition: (circle one): Partial Total Year built: /& J Reaqullding is Considered Historic (check all that apply): Over 75 Years Old Located in the South Yarmouth/Bass River National Register Historic District Listed on National Register of Historic Places Resource for historic listings: Massachusetts Cultural Resource Information System: www.mhc-macris.net Owner: IA--*e-l:i I Address: City/Town: State:AT Zip Code: e:�7�Z Phone#: (,� Z Cell# Email. Signature: Date: AgentlContractor: 7,41 Address: }� ' Cityffown: , jrjfl,o j State: 14d Zip Coder Phone#: Cell# f -7., 3 Email: ra &L 5 Signature: Date: �I Reason fo olition request: Description of structure to be demolished: Please include with application: • Color photographs of all sides of the structure being proposed for demolition • Map showing location of property • History of the building/property (if known) • Assessor's Map Field Card Updated MV ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department 1146 Route 28, South Yannouth, MA 02664-4492 508-398-2231 ext, 1251 Fax 508-398-0836 Massachusetts State Building Code, 780 CMR Building Permit Application To Const;wct, Repair, Renovate Or Demolish a One- or Two -Family Dwelling Building Perrnit Number: This Section For Official Use Date Applied: f3' Building Official (Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Pro erty ddre t ; p f 1.2 Assessors Ma & Parcel Numbers V��C 1.1 a Is this An accepted street? yes no Map Number Parcel Number 1.3 Zanin Ini'ormadow 1.4 Pro er Dimensions: T� Zoning District Proposed Use Lot Area (sq ft) � Frontage(f(%) 1.5 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (lvt.G.L c. 40 §§54) 1-7 Fl od Zane In ormafion: 1.8 Sewage Disposal System: Public El Private l� Zone: Outside Flood Zone? Check if yes❑ Municipal p On site disposal system SECTION 2:.PROPERTY OWNERSFTTPt 2.1 Owner' of Racord., City, State ZIP - " - ' -.- No. and Street TelephoneE—mailAdcrccss SECTION 3: DESCRIPTION OF PROPOSED WORD= (check all that apply) New Con structio ❑ Existing Building ❑ Owner -Occupied ❑ irs(s) ❑ Alteration(s) ❑ Addition ❑ Repa Demolition Accessary Bldg. ❑ Number of Units. Other 1] Specify; 13riefDe4criptiQn cifProposed Work2: 1 /7,o SYi iY,, x- - —, -t SECTION d: ESTIMATED CONSTRUCTION COSTS . 'De,1-1Q a„ Item Estimated Costs: (Labor and Materials) Official'Use Only 1. Building $ 1. StAding Permit Fee: $ Indicate how fee is determined: 2. Electrical $ ❑ Standard City/Town Application Fee ❑ Total Project Cost' ()Item 6) x multiplier x 3. Plumbing $ �. Other Fees: S 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire Su ression) Total All Fees: $ 6. Total Project Cost: Check No. Check Amount: Cash Amount: ❑ Paid in Full 0 Outstanding Balance Due: SECTION 5. CONSTRUCTION SERVICES 5.1 Construction Supervisor License (CSL) (/1 i Name of CSI, older No. and tract City/Town, State, zrp License umber ran List CSI. Type (see below) -- 4 Tele hone Errrai] address 5.2 e�gisst�tered o e Improvement Contractor (RTC) Nlfl.� I an e or HIC R ' anrN �— 2 1 Type Description U j ilnrestricted (Buildin1supto33,000cu. R Restricted l&2 Family Dwelling N1 Masonry _ RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances u �2/� . -,. HIC Registration Number Empiration mail address SECTION 6: WORRERS' 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 ...... —'. q No ........... El SECTION 7a: OWNTR AUTHORIZATION TO BE CON2LETI;D W1=IEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERINM 1, as Owner of the subject property, hereby authorize 7 ! . /l/� J �/�j�k� to act on my behalf, in all matters relative to work authorized by this building permit application. Print Owner's Name (Electronic Signature) ✓� Date SECTION 7b: OWNERr OR AUTHORIZED AGENT D'ECLARATIOIN By entering my name below, I hereby attest under the pains and penalties of peijuty that all of the information contained in th pplication is and accurate to the best of my knowledge and understanding. Print er's or Authorized Agen#'s Name (Electronic Signature) Date I. An Owner who obtains a building permit to do his/her mAm work, or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor (HIC) Program), will Dior have access to the arbitration program or guaranty fund under M.G.L. c. 142A. Other important information on the MC Program can be found at www.mass.aov/oca Information on the Construction Supervisor License can be found at Mw.mass.eov/dns 2. When substantial work is plar,.rled, 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 I lafi tiol"11.21.41K,"I SA)MOLI lit.%tscArH$:CrTr OIU44411 iakpMnr I!aaLS9a.:?:I F.[ Ilv. I a� lfotl iMat7f. YARMOUTH HISTORICAL COMMISSION NOTICE OF INTENT TO DEMOLISH A HISTORIC BUILDING To be *uMr Gtd b the Y#C slang wtul Cemesuon Parma App3keuon Dala Of Applwahon: � [Denfo6llon (cveh noel: PiHud Wal �� Slaving Address: � �IL v Assessors Map w'=2 Am�el Y Y. 6u18t Realms Building Is Considered Htsiodu ImIma all that apply): �F Over 76 Ygay Old ^Located In the Bouth YamlouiNBass River National Register Hielertc OISIrki Llsled w National Register of HIM& Wets llftb efor Aikrc i0c pa Itafaulft GAurat lltaav,e 111ortnthon SYarm w&—w—tmAm ndd Phew NtdUtle with appina6pn: • Galor gwtpgrsWes o1 as sides df ete swdwe 6e[n9 WdPeted lax dampsson ' Mop SNYWV iacsllon of pm mty • "listdY Oahe Iwddogfpropeft Cd known) • Aseeasals!Asp Reid Card K 7.k1 iC7 ekr 4sp"tQ1elCetNradar (lRt.7 f �N„ erldz'Rr — ,— I CH�aykay T s1iG`f70p f: woeYiRS• C()"eNl Al OCtI!11A71Ce A3iIPAVEP fN•c-I. r. lst. y tsC19Y . wclnra Ccu.;xautue[alvrwnaf8da.ii aewdtrorpW,e+ad a4mimed.frtW tlw ofddava wiu+sn:kio &admYi state hr.mu afkebalGetpgre aFa'lsatme. Falsvemateryia arle.dA[SGK[Atn-6�d7 Yr........._it lfe........♦5 LuOwmafde ryyecf pr°P4'1', 1>+RhYaa�a�e / ��K,(y<JIJI "�fi$i/'���r�� �Im•rfm ry 6drl(uaL'merararNrrinrwed +AM�6•ddi. "'�'�^-L W-CM4 7!; OA At7C1FOA1Za o A('ItiY' A E C7a,SwT10.1' g1'ra[amE ey'>vo.beler,l Meehyaryer rtdarthe pay tffi pcaafm b( rmeked6 ,-!paaW arettae.r W b. Fmy lmowkdpaecl rruiatmo afarmrdm 'r A's^dmtApsl'atdwelELmrte ewarr� - `•Z/✓'ri`1 Drr IltCar a w�artsL n71 aR(have axrp r dti v}arrim Q3afmrWoe "fthWL"I4ZtO&.rwWW ilnratioA ow the HiC Fnpam tea he iwedra T QAnf mErrep'ai wrath=RtrsirLkeae tap as fem{el�g,, Yotal fear r.a (q, a.) G—Bros m N. �'�^^—Owweiwmm& wit hevaleyw tfetaalrrckf 'ima6fsafErepprel �� 8161k611 raps wcf y®hco[b.wywan—J`^---"�— N�rrat6.#sara 'fYWsfhctliaensam�'�^ N�aw a[410e�e •.�� m •�• N OOOOn as p00 0o n nC � ro a°o° wt��• � � x � � A 'T"'��� o � p7R� nyi Ada ;40 Z� O NOC. � 10 �j y ❑ 000 oob o � b �• 7y 0 71'., U U F`+� n � A kQCD O c y w 00�0 O O NNAN N0000y C�Mh a ep m Qa z - oesn� D A t-15 •!} � ' C N N � y G} A Cq � rjIR n NNNp � day a o y I 5 o: c b Q 1�000 O .�'. r�s pt• � w A� � ��om0 ..aOC O 1=4 �NNNNO '� E2� NNN +�DOr�n rC+tb Vi W W '� A. G. Q. O. �•o OOC .�,• Ilk Ulth ci C o� m N m � ❑ ~ m C m b O 000 N t4 4 A• ❑' C A ,,, W a co ~ V C 7nw"oo o��o� � = oot4-, �'Q C y b Q AAA ".Otl o � 000 � m �y n dtQ n MC � N N N ep C O w H ti ;r 4 w "'y►i N N A O vAo N CN7i = N 0 o f'] a o a o 0 o a o00 a w a N "I L" Ch N N O O0r dGdn E'r m rD ta Q C CD o N _ � m a h Op�05 Lb tJ rA vi O w A r V 12 OC�1C17� C dtv�n oa Cr o hl o o .mr ,may — CQn a ,a. 6 Q 9. ep n o n ' h r4 a p C �000004 Koo> 0cCn vo b r°w °--+A2x� o Rj n n e, oc rn n El Ea W'2 ao o �• '� o o fir'EL en,n \O mot 0042Cae� %, rn �000 'wf]Foo?ayOO pm � $y � wwwww� n a n~ o o S °O w (] yb n T=1 ay th 4 N alp i-+ w �. � W p W N o o o �oU IS so A r } ►T€�. 1 r i R „e= smi I q Irmbilk