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Home My WebLink AboutBLD-22-007504 N.(e. ds 1-4- ‘frhu-rscect , 1,00in,- Office Use Only RECEIVED permit# Amount 35112 JUN 29 2022 Permit expires 180 days from issue date BUILIji •-•.' . By: BC,1)-got-66 r/561/4 EXPRESS SHED PE ' A ' * A ON TOWN OF YARMOLITH Yarmouth Building Department 1146 Route 28 South Yarmouth. MA 02664 (508) 398-2231 Ext. 1261 CONSTRUCTION ADDRESS: 6)C Mar/A M4 1 rt S T 1, S A, ,,,a „,,n 0.24 4 y t..7 owNER:TxxiGtm:__k-viek,, ,--- ca,„,,p661 4 6 AJ,Aet 14.,du 5 7-i, Syen4444 5-Dg-o/g0 -- agao NAME I PRESENT ADDRESS TEL, 14 CONTRACTOR:PI NI -c-' 6the16,0e.- vs( Vt,ill CtS— .2-51 a u-iLe 4.. Afrin.e irel2 ,fog.--- ;AO o v NAME MAILING ADDRESS OR ki 1 cf, /to 4 TEL# yeidential Commercial Est.Cost of Construction$ 1.--;00 0 a e t Home Improvement Contractor Lie.# /3,2 flf-- Construction Supervisor Lie.# 0 -73 Bkr. Workman's Compensation Insurance: (check one) I am the homeowner I am the sole proprietor I have Worker's Compensation Insurance Insurance Company Name: Worker's Comp. Policy# SHED INFORMATION New I Size L 0 x W 10 x H 1 Corner Lot: Yes No Per Town of Yarmouth Zoultut Br-Law See 203.5 Note E: Side and rear yzird setbacks Ibr accessory buildings containing one hundred fifty(150)square feet or less and single story, shall he six (6)feet in all districts, but in no case shall said accessory buildings be built closer than twelve (12)feet to any other building on an,kliacein parcel. All sheds are required to be located thirty( 90 feetfrom any front lot line Replace existing* Size L x W x H *The debris will be disposed of at: Location of Facility I declare under penalties of perjury that the statements herein contained are true and correct to the best of my knowledge and belief I understand that any false answer(s) will be just cause for denial or revocation of my license and for prosecution under M.G.L.Ch.268,Section I. Applicant's Signature: ____ j Date- "Owners Signature(or attachment) Date: - Approved By: Date. 6"---. .--.?t_ Building Official des i ) — EMAII,ADDRES — Zoning District: Historical District: Yes No Flood Plain Zone: Yes No Water Resource Protection District: Within 100 ft.of Wetlands:*** Yes No Yes No ***Note:Conservation review required if within 100 ft. of Wetlands 3/22 . a. , ' ,• :7,;(24 —COCk/IV,760.°7 ''. „4 ,to ''. a Office of Consumer Affairs and.111(u;inessategu1ation •-• te, - ) 10 Park Pi, , - Suite 5170 Boston, Massac,„ , etts 02116 - • ea.. Home Improvemeflticz.,evie tor Registratiort, . . - Commonwealth of Massachusetts ngRceusgp4atatitoionnasi Uancds nstlre Board Standards peivfisRi°uni 1(17f Occupational Colstructio\irtrni4iiisivio &2 Family McO. RATH POST& SEAM CO. . =-:"_ 1-= JAMES MoGRATH , iit ..=...._=„1 _____ ,,, CSFA-073865 4/7,--,-- 259 QUEEN ANNE RD. .,, ,, ----e- 6pires:03/14/2024 HARWCH,MA 02646- JAMES R MIRAg ti,,i,„ ---..,...+-,......,..., 0- 204 CRANVI Fara/ VT. ,...,4 1,, BREWSTERi.°,,5 4.„. .. ,. .. • • i It'l., ' ,' V) ; . *T011VC10:3*. ' Commissioner d,4fto K ?fitalid.to.... ., , .. Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation Registration: 132935 MCGRATH POST&BEAM CO. Expiration. 10/30/2022 D/B/A PINE HARBOR WOOD PRODUCTS 259 QUEEN ANNE RD. HARWICH,MA 02645 - — Update Address and Return Card. ; 1 Office of consumer Affairs S EitiebleSS Regulation HOME IMPROVEMENT CONTRACTOR Registretkin valid for Individual use only TYPE:Corporation before the expiration date. it found return to: 8.00.000 ni$01011-011 Office of Consumer Affairs and Business Regulation 132935 10/30/2022 1000 Washington Street-Suite 710 , MCGRATH POST&BEAM CO Boston MA 02118 D/B/A PINE HARBOR WOOD PRODUCTS JAMES R.MCGPIATH 1ii 259 OUEEN ANNE RD. `. ,f„.•,...-r 4,7,17r-e404' . _ — -- N.ilrZrrtrut signature HARWICH,MA 02645 Undersecretary The Commonwealth of Massachusetts =E — , Department of industrial Accidents 1 Congress Street, Suite 100 • L "' Boston, MA 02114-201711111v.'row Workers' www.rnass.gov/dia �Sw� R Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): DO t.( t c - ,4 ro;R Q ( (_ Address: (p p � v2U M(U/ -free1 City/State/Zip:,S64 VkivtourtiOa_ 074(1 Phone #: S76 2YO 6 �oC Are you an employer?Check the appropriate box: Type of project(required): LE I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 3.0 I am a homeowner doing all work myself.[No workers'comp_insurance required.]r 9. El Demolition 10 [] Building addition 4.2 I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions • proprietors with no employees. - 12.Q Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. I3. Roof repairs These sub-contractors have employees and have workers'comp.insurance.: f 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other trl t t(/l5 Cze 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. I.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: (,(�l��c ;re 6v10 .ef.S' f Policy#or Self-ins.Lic. #: 16G— i)--V02 q0-2 14 Expiration Date: '`U- (y < 1 7 d2 Z Job Site Address: (A A) // ..i Q27' City/State/Zip:(c7 C %1'l , Q C22/ Attach a copy of the workers' compensation policy declaration page(showing the policy number a 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 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 DR for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true'and correct. Signaturla; ' -.Cc 17i'l Date: y U� Phone#: t� 1 � � — O0r1 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#: PLOT PLAN FOR LOT # (pC ! 1 l Indicate locetko arage Addiriawr w h °r accessory building Sewerageines disposal: (cesspool.) 6 Well or 1 rtio _41 ex I cam.. I I in- Abutter's /, Name 1 Abutter's Name Lot* If this is a REAR YARD ,`,•1�� Lot# corner lot, l ' I L I ( If e is a . write in Y i ft. corner lot, name of street, t,(� j�� write in f �' - name of street_ incC.< . •ct• . H "; SIDE ARD HOUSE SIDE YARD 17 C\ : S� 'SSE4et. T BAD � • 4 „ -1L 1 .. 1 •4:Y ft. frontage) rTh (NAME OF STREET) / N. Supplitvi by