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HomeMy WebLinkAboutBLDR-24-378 application RCE VED O TWO FAMILY ONLY-BUILDING PERMIT JUL 15 2024 Town of Yarmouth Building Department pF-Y ## 1146 Route 28, South Yarmouth,MA 02664-4492p i� - BUIL DING DEPARTMENT 508-398-2231 ext. 1261 Fax 508-398-0836 eY _ — — Massachusetts State Building Code,780 CMR E x ' Building Permit Application To Construct, Repair, Renovate Or Demolish -4,,,,,,_ HE_,,�� a One-or Two-Family Dwelling R-0Ross• • This Section For Official Use Only Building Permit Number: `J L.b --24 -''7g"" Date Applied: Building Official(Print Name) Signature Date SECTION 1:} SITE INFORMATION Address: tie (.) �16'/3 1.2 Assessors Map&Parcel Numbers 1.1a Is this an accepted street?yos---"" 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) Front Yard Side Yards Rear Yard Required 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: / Zone: Outside Flood Zone? Public Private 0 Check if yes❑ Municipal 0 On site disposal system 0 n�12 SECTION 2: PROPERTY OWNERSHIP' r,t 1 Owned'of Record: u� L/ q! /1 0, / '}3 �jc�rbr� �� ��ti� (7�J" Name(Print) v Ci ,State,ZIP Sal Qcres #\ 3e - -2 -2001 No.and Street Te ephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORD(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: B ' f Description of Proposed Work': va N(,O tf 2 Pk I fta✓ ci {�.1 .� to �� "A- fa ckal t otr J la re./ Lk) tv‘C(©CA) SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 5O 660•dv 1. Building Permit Fee:$ Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ 0 Total Project Costa(Item x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees:$ //''''�K.— Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ Jt/I 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CSS1- 5^732 Jt7/ S i-k( License Number Expiration Date Ngswe of CSL boy- � ' • b List CSL Type(see below) No.and Street ' ( Type Description `O n f ce 1C A�} 0 2 f (1 U Unrestricted(Buildings up to 35,000 cu.ft.) 'V`�' l/15�t �`��I , R Restricted 1&2 Family Dwelling City/Town,State,ZIP • M Masonry _.n] RC Roofing Covering WS Window and Siding V 1 ^ _ ,f ,h.�b , I (�� SF Solid Fuel Burning Appliances :..�fiU'� (�`�C''`lr (,� ►V Vt (�I �' I Insulation Telephone ail address D 2Demolition 5.2 a istered ome (H��I r l 1 J 0 çrovementontractor 2 S6 HIC Registration Number Expiration Date N .and ° h� 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 ,� 0 No 0 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 C Dt 10CN 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: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 and accurate to the best of my knowledge and understanding. Print Owner's or Authorized Agent's Name(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.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dp' 2. When substantial work is planned,pr v' a the information below: Total floor area(sq.ft.) 1 10 (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" -og Yeke-N TOWN OF YARMOUTH 3 Office of the Building Commissioner r�- - _ kr:�1 1146 Route 28, South Yarmouth, MA 02664 �[;aCC 4A. „RpORAtEO 508-398-2231 ext. 1260 Fax. 508-398-0836 DEMOLITION DEBRIS DISPOSAL APPLICATION Pursuant to M.G.L. c.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 Scl \c 1 S i\v�- f 0)"' Itt- Work Address t.A.vt-R Is to be disposed of at the following location: X eSS Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, §150A. /61a Y Signature of Applicant Date Permit No. \. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 'i Lafayette City Center / 2 Avenue de Lafayette, Boston,MA 02111-1750 `' r www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): CC1 \e_ �CI R CD L i (dais fs e O C l e l l` LL C~ Q1 - � � \ Address. � � � � Gj�t�(�c,[� �' c� // � y / r City/State/Zip: 0(2--L `1 3 Phone#: Q `—3C�d 'A, S* Are you an employer?Check the appropriate bo • Type of project(required): 1.❑ I am a employer with 4. am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9._Erfuilding addition [No workers' comp.insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.111 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no 13.❑Other 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. :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: g rc-1 de ri 1SC...Li (' l/ Policy#or Self-in. Lic.#: Expiration Date: Job Site Address:s.Q J +`n CrC 5 Ro Q City/State/Zip: / mol "' w 02 6.43 • Attach a copy of the workers' compensation policy declaration page(showing the policy numbe and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that 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 ins and penalties of perjury that the information provided ab ve is true nd correct. Signature: `� ((� Date: ( -�(f Phone#: 71 — 3"V — �,L sm Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: A�o® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/15/2024 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 Joanne Ainswoth NAME: BRYDEN&SULLIVAN INSURANCE AGENCY INC (A/C No.Ext): (508)775-6060 FAXNo): ainsworth@brydenandsulhvan.com SS b denandsullivan.com ADDRE : J 88 FALMOUTH RD INSURER(S)AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURER A: TRAVELERS PROPERTY CAS CO OF AM 25674 INSURED INSURER B CAPE COD PRO BUILDERS&REMODELING LLC INSURER C: INSURER D: 299 RTE 28 INSURER E: WEST YARMOUTH MA 02673 INSURER F: COVERAGES CERTIFICATE NUMBER: 1026506 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP W LIMITS LTR INSD VD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ _ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER OOTH STATUTE AND EMPLOYERS'LIABILITY — ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 100,000 A OFFICER/MEMBEREXCLUDED? N/A N/A N/A 7PJUBOW70160723 09/21/2023 09/21/2024 — (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage- Coverage Verification Search tool at www.mass.gov/Iwd/workers-compensation/investigations/. 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. Town of Yarmouth 1146 Main St. AUTHORIZED REPRESENTATIVE S Yarmouth MA 02664 Daniel M.Crowley,CPCU,Vice President—Residual Market—WCRIBMA I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Friday, July 12, 2024 To Whom It May Concern I give Cape Cod ProBuilders permission to obtain any and all permits required for the construction of a bedroom addition, up to 10'x14', at my property at 39 Acres Ave West Yarmouth, MA. Thank you arbara Coakley 774-277-2001 Property Location 39 ACRES AVE Map ID 23/199/// Bldg Name State Use 1010 Vision ID 2379 Account# 2379 Bldg# 1 Sec# 1 of 1 Card# 1 of 1 Print Date 9/14/2023 CONSTRUCTION DETAIL CONSTRUCTION DETAIL(CONTINUED) p Element Cd Description I Element Cd Description Style: 01 Ranch • UST Model 01 Residential Grade: 04 Average+10 8 Stories: 1 1 Story Occupancy 1 CONDO DATA Exterior Wall 1 14 Wood Shingle Parcel Id ICI Owne 0.0 12 Exterior Wall 2 jB IS 12 Roof Structure: 03 Gable/Hip Adjust Type Code Description Factor% BAS Roof Cover 03 Asph/F Gls/Cmp Condo Fir Interior Wall 1 05 Drywall/Sheet Condo Unit Interior Wall 2 COST/MARKET VALUATION Interior Fir 1 12 Hardwood 1 1 Interior Fir 2 Building Value New 263,598 Heat Fuel 03 Gas Heat Type: 02 Floor/Wall Fur AC Type: 03 Central Year Built 1951 Total Bedrooms 02 2 Bedrooms Effective Year Built 24 Total Bthrms: 1 Depreciation Code E 25 Total Half Baths 0 Remodel Rating Total Xtra Fixtrs Year Remodeled Total Rooms: 0 Depreciation% 12 • • Bath Style: 03 Modern Functional Obsol 0 t4 1 TrendExt.Comment Factorn1 1 I Condition Condition Percent Good 88 RCNLD 232,000 Dep%Ovr 36 Dep Ovr Comment Misc Imp Ovr ;, ° Misc Imp Ovr Comment CosttoCureOvr ° Cost to Cure Ovr Comment OB-OUTBUILDING&YARD ITEMS(L)/XF-BUILDING EXTRA FEATURES(B) ,rL Code Description LIB Units Unit Price Yr Blt Cond.Cd %Gd Grade Grade Adj. Appr.Value "`' OOS OPEN OUT S B 1 0.00 1975 88 0.00 0 a i.. . $d. M4 , ,. BUILDING SUE-AREA SUMMARY SECTION Code Description Living Area Floor Area Eff Area Unit Cost Undeprec Value 2 BAS First Floor 636 636 636 388.21 246,904 , UST Utility,Storage,Unfinished 0 96 43 173.89 16,693 16' ,. ._ ,4,, _ ,. , ,., iforr....:4t 1,......:::1:70 „4:11," Ttl Gross Liv/Lease Area 636 732 679 263,597 —.-' ` Property Location 39 ACRES AVE Map ID 23/199/// Bldg Name State Use 1010 Vision ID 2379 Account# 2379 Bldg# 1 Sec# 1 of 1 Card# 1 of 1 Print Date 9/14/2023 CURRENT OWNER TOPO UTILITIES STRT/ROAD LOCATION CURRENT ASSESSMENT I COAKLEY BARBARA 1 Level 2 1 Paved 2 Suburban Description _ Code Assessed Assessed i 815 6 Septic RESIDNTL 1010 232,000 232,000 4 Gas RES LAND 1010 230,700 230,700 305 BLACKSTONE ST SUPPLEMEV AL DATA YARMOUTH,MA Alt Prcl ID 19/W 028/// VOTE BLACKSTONE MA 01504 MISC 120 VOTE DATE SEWER P PRIVATE BETTERMENTS VISION PLAN # 362 ZIP CODE 2673: GIS ID M_305677_822339 Assoc Pid# Total 462,700 462,700 RECORD OF OWNERSHIP BK-VOUPAGE SALE DATE Cr/U V/I SALE PRICE VC PREVIOUS ASSESSMENTS(HISTORY COAKLEY BARBARA 33617 264 12-28-2020 Q I 355,000 00 _Year_ Code Assessed Year Code Assessed V i Year Code Assessed CAMBAL GEOFFREY S 30777 0059 09-21-2017 U I 140,000 10 2024 1010 232,000 2023 1010 211,100 2022 1010 171,000 JUMES JAMES 28021 0188 03-07-2014 U I 112,000 1H 1010 230,700 1010 186,200 1010 166,600 THOMAS MARILYN M PERS REP 28021 0187 03-07-2014 U I 100 1 F THOMAS JOSEPH J 1085 0269 08-02-1960 I 0 Total 462,700 Total 397,300 Total' 337,600 EXEMPTIONS OTHER ASSESSMENTS This signature acknowledges a visit by a Data Collector or Assessor Year Code Description Amount Code Description Number Amount Comm Int APPRAISED VALUE SUMMARY Total 0.00 Appraised Bldg.Value(Card) 232,000 ASSESSING NEIGHBORHOOD Appraised Xf(B)Value(Bldg) 0 Nbhd Nbhd Name B Tracing Batch Appraised Ob(B)Value(Bldg) 0 0060 NOTES Appraised Land Value(Bldg) 230,700 WHITE E/E I/P Special Land Value 0 PTO/NV(COND) Total Appraised Parcel Value 462,700 Valuation Method C BP18:REAR OF HOME IS EXPOSED;HOUSE IS UNDER DEMO;STOP WORK ORDER-SAME 2020 Total Appraised Parcel Value 462,700 BUILDING PERMIT RECORD VISIT/CHANGE HISTORY Permit Id Issue Date _ Type i Description Amount lisp Date %Comp Date Comp Comments Date Id Type_ Is Cd Purpost/Result 18-001641 09-20-2017 AL Alterations 8,500 05-18-2021 100 12-31-2020 Repairs:Strip and re-roof 8 sq 08-08-2022 BC CL Cyclical 05-18-2021 KM BP Building Permit 04-07-2020 WD 54 Field Review 02-05-2019 KM 02 BP Building Permit 02-06-2018 BH 01 BP Building Permit 05-19-2016 BH CL Cyclical 01-01-2014 BH 01 1 CY CYCLICAL 2014 LAND:INE VALUATION SECTION B Use Code Description Zone Land Type Land Units Unit Price Size Adj Site Index Cond. Nbhd. Nbhd.Adj Notes Location Adjustment Adj Unit P Land Value 1 ' 1010 SINGLE FAM M i 10,454 SF 13.70 1.00000 5 1.00 i 0060 1.400 i WF10 1.0000 22.06 230,700 Total Card Land Units' 10,454 SFI Parcel Total Land Area10.24 I I I I I Total LandValue 230,700 • CiA ---(--- 4,...\ , ..--r 4.-i---- CI\ / i S V U ,....... ... ...., /, q ray R: _aeaue�_..o , ...;. .‹p , . \\\; 3, i 7 IC:IS i T.__ , f1 ........„, ,......,1) ,) C . . • . . I c ii �T� I a V 4.0 U t" ""' - a I �C 01.,,,„4.-s :i..,1,......S. .. - _ . , . . Vi 1 $ < c "► ... {fie' t'i.iif i4;l1 ;zgi.rs 4 r} .fir fin "0411 ' 1 `e i �3 S JIll! r y�• a " 4 r iil el , .>04 i.e• . . .^ 1.-•.,,,...., .4 M Cam 43) H ca g . . • 's ,.1 „ l N " 4 ,rip • 1 - , , 1'4."s".;''... ' ' +. ) .4 '°A.,. ,t.- ... 2 Ei.. 4 � z o 3 a It tc 4KN .�tt sue'