HomeMy WebLinkAboutBLDR-24-429 n. bol ' /&J/. z
7--73 iv ONE & TWO FAMILY ONLY-BUILDING PERMIT
Town of Yarmouth Building Department o..--.4.`Yq
% 4 ,
1146 Route 28, South Yarmouth,MA 02664-4492 r 1 to
i 'aj 16 ZQ2 508-398-2231 ext. 1261 Fax 508-398-0836 lO —�
� .t�,H
1 Massachusetts State Building Code,780 CMR :0 ,�
77 c,, ::r_.PAP BU&Yi Permit Application To Construct, Repair, Renovate Or Demolish \<4,00RPURpTEc obY9i
a One-or Two-Family Dwelling This Section For Official Use Only
Building Permit Number: bf24y--cf27 Date Applied:
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Address: 1.2 Assessors Map&Parcel Numbers
� G LJ
1.1a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zp,ix Ipformation: 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
3 0 35PF /5 Pr 2 U 0SFT
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public Private 0 Zone: Outside Flood Zone?Check if yesj< Municipal 0 On site disposal system
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of ec
e(Print) City,Sta f e,,ZIP
/�4IC-ooll) �x-2 501410 60g7 C)t!.1.4*LVC. 134v1 W ,".,;
No.and Street Telephone Email Address 6?, e '1..
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition lk
Demolition ❑ Accessory Bldg. 0 Number of Units 1 Other 0 Specify:
Brief Desc 'pt f Proposed Work': ,,[,/ (.....2 iIt—0A.)7 jevJc lj co- 7U
6 .4X 3 -
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Lab° and Materials)
1.Building $ el60, 00 1. Building Permit Fee:$ Indicate how fee is determined:
0 Standard City/Town Application Fee
2.Electrical $ 0 Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $ ,/ 1 i/-F/i ^ji ,
4.Mechanical (HVAC) $ List: iJ v �1� l�
5.Mechanical (Fire $
Suppression) Total All Fees: $
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
No.and Street 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 ❑ 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
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 .== ate to the best of my knowledge and understanding.
TOIA- #44#0.7/,__ A/ Wi/6/02
i t Owner's or Authorized Agent's Nam♦ ronic 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/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"
, The Commonwealth of Massachusetts
a Department of Industrial Accidents
91 s
=l l`, Office of Investigations
Lafayette City Center
2 Avenue de Lafayette, Boston,MA qi„
02111-1750
www.mass.gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): 0 L4- 4-• 64vitsoki
Address: '3O l ei 01_ ./2..2)
City/State/Zip:( lesT y/1 0�11/v 14 04 hone #: 50 r 2 U�' '.5/
h Ek theappropriate
Are you an employer? C e pp opriate box: Type of project(required):
1.0 I am a employer with 4. ❑ I am a general contractor and I
employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction
2.VI I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. 0 Demolition
workingfor me in anycapacity. employees and have workers'
p �' 9. p Building addition
[No workers' comp. insurance comp. insurance.$
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.0 I am a homeowner doing all work officers have exercised their 11.❑ 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
employees. [No workers' 13.❑ Other
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:
Policy#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 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 t ify under the pains and penalties of perjuty that the information provided above is true and correct.
Signature: l'i Date: (1 / J/�ic=2-'
Phone#: 5o0 • 02a o 605/
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):
10Board of Health 20 Building Department 30City/Town Clerk 4.0 Electrical Inspector 50Plumbing
Inspector 6.0Other
Contact Person: Phone#:
TOWN OF YARMOUTH
g YA„ Office of the Building Commissioner
1146 Route 28, South Yarmouth, MA 02664
.- % 508-398-2231 ext. 1260 Fax 508-398-0836
!"fz.::=Ai EC fib--
HOMEOWNER LICENSE EXEMPTION
DATE: 08 / / in.24
JOB LOCATION:
NAME , STREET ADDRESS SECTION O TOWN
HOMEOWNER 7O1 /4.- 4 .J'g-V,2&o/V 5t8Z, go p- /
NAME HOME PHONE /f,� WORK PHONE
PRESE T MAILING ADDRESS �0 tl ' '`�l`E ob Lb `
C OR TOWN STATE ZIP CODE
Definition of Homeowner:
Person(s)who owns aparcel of land on which he or she resides or intends to reside,on which there is or is intended
to be, a one or two family attached or detached structure accessory to such use and/orfarm structures. A person
who constructs more than one home in a two-year period shall not be considered a homeowner.
Any homeowner performing work for which a building permit is required shall be exempt from the licensing
provisions of780 CMR 110.R5,provided that if a homeowner engages a person(s)for hire to do such work, then
such homeowner shall act as supervisor. This exception shall not apply to the field erection of manufactured
buildings constructed pursuant to 780 CMR 110.R3
The undersigned 'homeowner' assumes responsibility for compliance with the State Building Code and other
applicable codes,by-laws,rules and regnlationsand certifies that he or she understands the Town of Yarmouth
Building Department minimum inspection procedures and requirements and that he or she will comply with said
procedures and requirements.
HOMEOWNER"S SIGNATURE '
.g Y9 , TOWN OF YARMOUTH
4. - �, Office of the Building Commissioner
° =�,q 1146 Route 28, South Yarmouth, MA 02664
r`~,,RPOFA.E• .. /
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. /O aA) Of7lig atTIf b e c ° 4 -64-
Work Address
Is to be disposed of at the following location: - °+4I)uTi/
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, §150A.
Signature of Applicant Date
Permit No.
v.,. .........-,_1 \
...k. s„.,
NNN .
.,...„.
I .
7 .
i
• ir$
.---.
t .
•
±1
1 ,
/I
Q
l'-(:),i X ': ' •
-4-
/ 'I .
(5\ ,
cri
1
i
1
,...........
_....
=II I i I
iN \....
!
1 1 .
1 . !
I., ..•
....,...,- .
ii
1 t
d I
.,
••,
I: 1 / .''... ':****Nnr'''''....,,,,..,.........„.....,.......
,
.' .I N.. ,..... .,
i -'.... ,....,
i" 1 .... .
t i .
, .
.......,
'''''.,.• --,„,,
-..,s
...
,....,
',.. -..
--. .
.r- _
-........._ I (1 .46.1.{.1 1 , _ . • -----„.., N„,....„
•N„
ft
1 '
. r 1
.N.
1 ' IlLik I r ,
/
1
-
4......1
t'll ....-......,,,,
1,,,, —10 lk:'''''.: r•-""........
III ?•:„5„..,, 4A1 1..,:j
---......,
t4 --I
,....-1-1 '.-.......,
,,.
t 11'" r
1:Yr e7Se v-l§r
c't
CIO
NT
L
es,
.14
1
• CC)
10
I .4 4
gammorsimmairoraw.-A,,
ii
r;
b
Property Location 30 MARIGOLD RD Map ID 37/121/// Bldg Name State Use 1010
Vision ID 5462 Account# 5462 Bldg# 1 Sec# 1 of 1 Card# 1 of 1 Print Date 9/15/2023
CONSTRUCTION DETAIL, CONSTRUCTION DETAIL(CONTINUED) _
Element Cd Description Element Cd Description
Style: 04 Cape Cod FBM
Model 01 Residential (716 sf)
Grade: 03 Average UBM
Stories: 1.5 1 1/2 Stories (100 sf)
Occupancy 1 CONDO DATA
Exterior Wall 1 26 Aluminum Sidng Parcel Id ICI Owne 0.0
Exterior Wall 2 IB IS
Roof Structure: 03 Gable/Hip Adjust Type _ Code Description Factor%
Roof Cover 03 Asph/F GIs/Cmp Condo Fir
Interior Wall 1 05 Drywall/Sheet Condo Unit
Interior Wall 2 07 K PINE/A WD COST I MARKET VALUATIOl�( BAS
Interior Fir 1 12 Hardwood
Interior Fir 2 Building Value New 486,987
16
Heat Fuel 03 Gas P- —-
Heat Type: 05 Hot Water PTO
AC Type: 01 None Year Built 1950 917
Total Bedrooms 04 4 Bedrooms Effective Year Built 18 3 23
Total Bthrms: 2 Depreciation Code A FGR . .. FHS
Total Half Baths 0 Remodel Rating BAS BAS
Total Xtra Fixtrs Year Remodeled
Total Rooms: Depreciation% 33 13
Functional Obsol 0 23 23
Bath Style: 02 Average 20
Kitchen Style: 02 Modern Ext.Comment 0
23
Trend Factor 1
Condition PTO 6
Condition% 18 17 34
Percent Good 67
RCNLD 326,300
Dep%Ovr
Dep Ovr Comment
Misc Imp Ovr ,
Misc Imp Ovr Comment #' . ; ' ¢
Cost to Cure Ovr f ;, `.
Cost to Cure Ovr Comment
OB-OUTBUILDING&YARD ITEMS(L)I XF-BUILDING EXTRA FEATURES(B) k .". `� .
Code Description L/B Units Unit Price Yr Blt Cond.Cd %Gd Grade Grade Adj. Appr.Value ,:. - ;5 ._ `,` I
FPL2 1.5 STORY C B 1 2500.00 1983 67 0.00 1,700 ' _ ,�,
FPO EXTRA FPL O B 1 800.00 1983 67 0.00 500
EOS Encl Outs Shw B 1 0.00 1983 67 0.00 0 .
#•
JJ�f
BUILDING SUE-AREA SUMMARY SECTION L# J,' .. , •. 1 '
Code Description Living Area Floor Area Eff Area Unit Cost Undeprec Value J
BAS First Floor 1,353 1,353 1,353 212.61 287 661 :. .
FBM Basement,Finished 0 716 322 95.62 68,460 : "r
FGR Garage 0 414 166 85.25 35 2931
FHS Half Story,Finished 391 782 391 106.31 83 131
PTO Patio 0 309 15 10.32 3,189
UBM Basement, Unfinished 0 100 20 42.52 4 252
Ttl Gross Liv/Lease Area 1,744 3,674 2,267 481,986 _ � `:
1 f Bk 18324 P 325 1898'6
03--.16-2004 a 02 Lt 1 0
DECLARATION OF HOMESTEAD
KNOW ALL MEN BY THESE PRESENTS that We, Timothy J. Davidson and Julia A.
Davidson of 30 Marigold Road, West Yarmouth as the owner of real estate by deed from
Peter J. Gilmore and Lisa C. Gilmore recorded with the Barnstable County Registry of Deeds
in Book 16344 Page 73 as an owners thereof and being entitled to an estate of homestead in
the land and buildings hereinafter described, do hereby declare that we own,possess and
occupy said premises as a residence and homestead to wit:
The land with the buildings thereon situated in Yarmouth(West),Barnstable County,
Massachusetts, being shown as LOTS 63, 64 and 65 as shown on a plan of land entitled,
"Hyannis Gardens" dated January 1926 and recorded in the Barnstable County Registry of
Deeds in Plan Book 16, Page 75.
Said lots are further bounded and described as follows:
NORTHWESTERLY by Marigold Road, there measuring one hundred fifty (150.00)
feet;
NORTHEASTERLY by Lot 66, there measuring ninety (90.00) feet;
SOUTHEASTERLY by Lots 44, 45 and 46, there measuring one hundred fifty (150.00)
feet;
SOUTHWESTERLY by Lot 62,there measuring ninety(90.00) feet.
Property Address:30 Marigold Road,West Yarmouth,MA 02673
This Declaration of Homestead is filed under the provisions of M.G.L.A. c. 188, Section 1 as
amended.
HAYES&HAYES
ATTORNEYS-AT-LAW,P.C.
23 EAST MAIN STREET
P.O.BOX 2155
HYANNIS,MA 02601-2155
(508)775-0080