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HomeMy WebLinkAboutBLDR-24-48P() W . ;�i2 -7 t. & TWO FAMILY ONLY- BUILDING PERMIT II Town of Yarmouth Building Department 1146 Route 28, South Yarmouth, MA 02664-4492�✓O1 _ �= 508-398-2231 ext. 1261 Fax 508-398-0836 Massachusetts State Building Code, r: [ 780 CMR 4O=,$q, Ri ern it Application To Construct, Repair, Renovate Or Demolish s pC N�zl a One- or Two -Family Dwelling o '63" \' R�'ORATr Eo ,� sv 3� This Section For Official Use Only Building Permit Number: ELL b Date Applied: Building Official (Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: Aria U.:hjS Wfl 1.2 Assessors Map & Parcel Numbers Map Number Parcel Number 1.1 a Is this an accepted street? yes no 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 Required Provided EProvided 1.6 Water Supply: (M.G.L c. 40, §54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public ❑ Private ❑ Zone: _ Outsidc Flood Zone? Check ifyes❑ Municipal ❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner' of Record: 7 3 Name (Print) City. State. ZI -/D gefle-M %r No. and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK (check all that apply) New Construction ❑ Existing Building ❑ Owner -Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work'-: l I CA r0o yer �' S SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Labor and Materials Official Use Onl Y 1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee ❑ Total Project Cost' (Item 6) x multiplier x 2. Electrical $ 3. Plumbing 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Total All Fees: $ Check No. Check Amount: Cash Amount: Suppression) 6. Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License (CSL) ��qq 4r/p �j'� Sm/?A t✓}��� � 2 License Number Expiration Date List CSL Type (see below) V Name ol'CSL Hold r �r Q Tye Description No. and St re t � i /, 'O� ��.� a e,57 /a, rj�/�•1¢� ►'Vy Unrestricted (Buildings u to 35.000 cu. ft.) R Restricted 1&2 FamilyDwelling City/Town. State, ZIP M Masonry RC Roofing Covering WS Window and Siding 6-0g_7 SF Solid Fuel Burning Appliances I Insulation Telephone Email address I D I Demolition 5.2 Registered Home Improvement Contractor (HIC) 44 D�,f� HIC Registration Number F.xpir tion Date )lh (g)sa,2AV.SC;d'"''' - H C,�pany HI R egi� nt OU No. aryj t eet � p i{1f l 1 ��j 2 / ;� / it /``T//own, State, ZIP 11 �/�10 % TelephoneV-�7 Email address 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 01 I, as Owner of the subject property, hereby authorize to act on my behalf, in all matters relative to work auth by this building permit application. All 4 Y/JV C 1 0 — 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: 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.gov/oca Information on the Construction Supervisor License can be found at www.mass.Qov/dns 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" The Commonwealth of Massachusetts Department oflndustrialAccidents I Congress Street, Suite 100 Boston, MA 02114-2017 °� s�•� www.mass.gov/din «Yorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERIMITTING AUTHORITY. Applicant Information Please Print 1 Name (Business/Organization/Individual): Address: a—) 1-3 City/State/Zip: Phone r: - -2, e Tn A ) --.), 2 Are yo an employer? Check the appropriate box: I. I am a employer with employees (full and/or art -time .* p } 2 u I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] - 3.(7 1 am a homeowner doing a!I work myself. [No workers' comp. insurance required.] t 4 ❑ 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 proprietors with no employees. 5 ❑ 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.: 67 We are a corporation and its officers have exercised their right of exemption per ,NIGL c. 152, § 1(4), and we have no employees [No workers' comp. insurance required.] Type of project (required): 7. ❑ New construction S. Remodeling 9. ❑ Demolition 10 Building addition 11.E] Electrical repairs or additions 12.0 Plumbing repairs or additions 13. 7 Roof repairs 14. [] Other -• 1-rr••-- •- ••••-• �••1 — ,., ,,,,,,, ,,,,, L,,, our. me section oeiow 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 Cnat 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 ant an employer that is providin; workers' compensation insurance for my employees. Below is the policy and job site information. j Insurance Company Name: ��� �`(,( CJ Policy A or Self -ins. Lic. �: 1! ' (P—C—Q a 1�'QALJ 4 Expiration Date: Job Site Address:_ I�rbLA_ JLA S PC-, --h 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 1MGL c. 152, §25A is a criminal violation punishable by a fine up to S1,500.00 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 DIA for insurance coverage verification. I do hereby certYIider the pains andpenalties of perjury that the information provided above is true and correct. 360 b Official use only. Do not write in this area, to be completed by city or town official. City or Town: Issuing Authority (circle one): 1. Board of Health 2. Building Department 6. Other Contact Person: Perm it/License 3. City/Town Clerk 4. Electrical Inspector i. Plumbing Inspector ft Phone #: g TOWN OF YARMOUTH .. Office of the Building Commissioner 1146 Route 28, South Yarmouth, MA 02664 APOpA1E0 , 508-398-2231 ext. 1260 Fax 508-398-0836 DATE: JOB LOCATION: HOMEOWNER HOMEOWNER LICENSE EXEMPTION NAME STREET ADDRESS NAME HOME PHONE PRESENT MAILING ADDRESS CITY Y OR TOWN Definition of Homeowner ON OF TOWN WORK PHONE STATE ZIP CODE Person(s) who owns aparcel ofland on which he or s resides or intends to reside, on which there is or is intended to be, a one or two family attached or detached stru Lure accessory to such use and'orfarm structures. A person who constructs more than one home in a two-year riod shall not be considered a homeowner. Any homeowner performing work for which building permit is required shall be exempt from the licensing provisions oJ780 CMR I10.RS, provided th t ifa homeowner engages a person(s) for hire to do such work, then such homeowner shall act as supervisor. is exception shall not apply to the field erection of manufactured buildings constructed pursuant to 780 C R 110.R3 I procedures and requirements HOMEOWNER"S SIGNA b TOWN OF YARMOUTH Office of the Building Commissioner �,...«.;y 1146 Route 28 South Yarmouth MA 02664 4_ ti,' ;R�ORATE' 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. Work Address Is to bedisposed of at the following location: r6;1 Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 1 11, § 150A. Signature of Applicant Permit No. Date ACC)RDr. CERTIFICATE OF LIABILITY INSURANCE 06/18 DATE 06/18/2024 24 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION I -INSURANCE GROUP INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 799 GORHAM ST HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR LOWELL, MA 01852 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURED MA SOLUTIONS & CARPENTRY INC 28 ARBUSTUS PATH WEST YARMOUTH, MA 02673 Cf)VFRAP,F3 'INSURERS AFFORDING COVERAGE INSURERA: THE BURLINGTON INS NAIC # INSURERB: AIM MUTUAL INS CO - ----- ---1 INSURER C: INSURERD: I INSURER F. I 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 i POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD'l7 POLICYNUMBER POLICY EFFECTIVE i POLITY EXPIRATION E (MMIDDrYY) LIMITS A GENERALLWBILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR I 318BOO6830 03/22/2024 03/22/2025 EACH OCCURRENCE $ $ $ $ 1,000,000' 100,000� 5,000 1,000,C00j DAMAGE MED EXP (Any one person) P PERSONAL &ADV INJURY �J -- § 2,000,000: GENERALAGGREGATE GEN'LAGGREGATELIMIT APPLIES PER: POLICY PRO n LOC PRODUCTS-COMP/OPAGG $ 2,000,0001 I AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) I $ ALLOWNEDAUTOS - SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS -- I NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTYDAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY -EA ACCIDENT § I ANY AUTO OTHERTHAN EAA—C-C-� S AUTOONLY: AGG $ ---- EXCESS/UMBRELLALIABILITY I OCCUR C CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ � is DEDUCTIBLE I $ I RETENTION $ WORKERS COMPENSATION AND B EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE VWC10060257212024A 03/22/2024 03/22/2025 OFFICER/MEMBEREXCLUDEp? Ifyas, describe under SPECIAL PROVISIONS below OTHER WC STATU- OTH-1$ ER — LE*L.EACHACCIDENT $ 1,000,000i E.L. DISEASE -EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ __ 1 ,000,06C I 1 DESCRIPTION OF OPERATIONS J LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS i General Liability: for regular and usual jobs. Worker's Compensation: MA employees only. I I CERTIFICATE HOLDER CANCELLATION 3 Wharleson + Keila Nascimento 28 Arbutus Path West Yarmouth, MA 02673 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAI ION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTLN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS 0:, AUTHORIZED REPRESENTATIVE TO ACORD 25 (2001/08) ©ACORD CORPORATION 1961-15 z O Q J _O LL O W Q C) 1 V N w Q H U) Z ' � i_ w W O Q � LL O� w O w Z LL LL LLO w m U O LL JLL w } U) O LLJ C) U W 06 Q 2 W w of z z >- m m Q U J Q= LL OUT LL Z w z 0= Oozo0 W dct LL .19 a� U w HU ) 2 W Ow H O N. E i W rn,c Q F c m LL Q@o. 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Transaction Code: HTL-YARMOUTH-MA-US-12164650 City Hall Systems Secure Payment Portal © 2024 Copyright: City Hall Systems, Inc. We're Online! How may I help you toda... Ihttps://epos.cityhallsystems.com/process 1/1 --64- — EXISTING CONTOUR x 60.98 EXISTING SPOT GRADE., SOIL LOG —W— EXISTING WATER SVC. >� -- EXISTING GAS SERVICE DATE: JUNE 29. 2021 —9N.'IS— OVERHEAD WIRES 4.d SOIL EVALUATOR: PETER McENTEE SE 1542 TEST P� nx �w, ���7J WITNESS: PHIL RENAUD HEALTH AGENT �• BENCHMARK far '°•v� ELEV. . TP DEPTH t 4 `iyy 100.5 A D" LEGEND t SANDY LOAM IOYR 4/2 99.4 7^ B LOAMY SAN PERC. lOYR 5/8� BOTT. 26" Pptak vtlW for REPAIR OF SEPTIC SYSTO.,� 97.5 36" QN", due to State and Local septic variu C h 8aard of Health review and approvrll is required ° may future additionstrenovotionslelteratione a sa*W facilities and/or strocturnidwelling. COARSE SAND q =' Yarmoulh Houlth peparintrut 2 m APPROVED 91.9 90.5 ADJ.DJ. GIN GW STDG. OW Q 103" REDOX 7.5YR 5/8 120" f 90.0 126" � /�{y � AAS /]Q/%2 PERC RATE <2 MIN/IN. "B" HORIZON � O NO GROUNDWATER ENCOUNTERED 99,00 K 99.68 ��99.62' �� •4iq�� 5. W 36: Bxi A. 99.7%\ j PK 00.00 100 L�('1 PK SET •,., c\\J 99.95 x O s Yo (C l 100.47 y 0 (� of n n A �J „ SET 100, A� 100.34TP Y z:SO ::DRI, AY ,: ;... 100.55 O 100 92 100.58 % 100.49 x 1 9.' 100.56 DECK k 0 ?8 do F =1O1.Ot_ EL=101.74 F �Z, -x 98.51 \ INSTALL 40 MIL POLY LINER 5' OUTSIDE S.A.S. x 99.27 TOP OF LINER, EL-97.6 BOTTOM OF LINER, EL.�95.1 98.5 O /'K S EXISTING S.A.S. PARTIAL STRIPOUT & PARTIAL ABANDONMENT UNSUITABLE SOILS ASSOCIATED WITH EXISTTNG S.A.S. GO PROPOSED S.A.S. 7 LC-6 UNITS SURROUNDED 4' OF STONE ON SIDES & 2• ON ENDS EXISTING SEPTIC TANK 2-COMPARTMENT TOP OF TANK, EL=99.33 INV.(OUT), EL.=98.00t ���177D2021 JUL 0HEALT OWNER OF RECORD NASCIMENTO, KEILA NASCIMENTO, WHARLESON 28 ARBUTUS PATH r� WEST YARMOUTH, MA 02673 MAP ID" 40-29 PROPOSED SEPTIC SYSTEM UPGRADE PLAN 28&30 ARBUTUS PATH, WEST YARMOUTH MA Prepared for: DiBuono Sewer & Drain, 35 Content Ln, Cotuit, MA 02536 Engineering by: SCALE DRAWN JOB. NO. A / Fnetinccrinn W-1- T - t "�P.T.M. I 11A-1)1 TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1261 Fax 508-398-0836 Office of the Building Commissioner SECOND NOTICE of VIOLATION Keila & Wharleson Nascimento 10 Hemeon Drive West Yarmouth MA 02673 August 23, 2024 RE: 28 Arbutus Path — Addition - without permit and illegal camper in front yard Dear Mr.& Mrs. Nascimento; This letter constitutes a second notice of violation along with a illegal camper in front of your residents. The Building Dept. has noticed that you add an addition to the side of your home. This requires a building permit Building, electrical, permits are required. Your new contractor has not come in to take over the application, you're still in violation. R105.1 Required. It shall be unlawful to construct, reconstruct, alter, repair, remove or demolish a building or structure; or to change the use or occupancy of a building or structure; or to install or alter any equipment for which provision is made or the installation of which is regulated by this code without first filing a written application with the building official and obtaining the required permit. Failure to comply with the MA State Building code 780CMR is subject to fines and penalties as prescribed in MGL CH 143 section 94A. Each day constitutes a new violation. This is a violation of the Town of Yarmouth Zoning Bylaws: 401.1 Camping and Recreational Equipment. 401.1.1 At no time shall parked or stored camping and recreational equipment be occupied or used, fir living, sleeping or housekeeping purposes. 401.1.2 If camping or recreational equipment is parked or stored outside of'a garage, it shall be parked or stored to the rear of the front building line of the lot, except for loading and unloading. You are hereby ordered to abate or correct said violations within seven (7) days. Failure to do so may result in criminal / civil complaints being filed against you. You may be subject to fines as prescribed by pertinent laws and regulations. You also have the right to appeal against this decision with the Zoning Board of Appeals. You are subject to daily fines of up to three hundred dollars for this violation 101.3 Penalties. Any person violating any of the provisions of this bylaws shall be fined not more than three hundred ($300.00) for each offense. Each day that such violation continues shall constitute separate offense You are hereby ordered to abate and or correct said violations or seek relief from the Zoning Board of Appeals as allowed by MGL Ch. 40a §7 & § 15.You are required to respond within 7 days of receiving this letter. You also have the right to appeal this decision with the Zoning Board of Appeals within 30 days of this letter. You are required to respond within 7 days. Questions regarding this matter may be directed to this department. Very truly Brad Inkley Local Inspector Town of Yarmouth CERTWFI n' nnnii (n) Qr:r%=IE ru flornestic Mail Only m m7ra - ir O Mail Fee�rzlrvices & Fees (check box, add ❑ Return Receipt (hardcopy) ` a� Q ❑ Return Receipt (electronic) h- ❑ Certified Mail Restrict,C�6\ fl_I ❑ Adult Signature,a�\e0��e On� Lr) El Adult Sign>'- Postago a `/ \�� � Total Po; re- o $ Sent To\Qj IT' ------------- -- Street andflpt. r, ao-------------------------------------------------- ------ LfI City, State. ZlP+4�'