HomeMy WebLinkAboutBSHD-25-85- .40 f
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0 _ 44 SEP 15 2025 Perrnix751't0-X-155"
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�'c .. 3 By Permit expires IRO days from issue date
EXPRESS SHED PERMIT APPLICATION
TOWN OF YARMOUTH
Yarmouth Bagdhg Department
1146 Route 28
South Yarmouth,MA 02664
/� %(508)�398-2231 Ext. 1261 i I
cortsumucnort ADDRESS: II / vl141 C ;vim \AIM0a/k (c- f --t CilL ,a
OWNER: Si- ec. ,Atf ez:.: l l 8 A t c0 et;,.e, 02 a 3 _- `r'- t! y
NAME PRESENT ADDRESS TEL#
CONTRACTOR: eihe— q.;.-b=1" 3)4., Yr lho.4r` gel NI.Oil:s COS — 771 "S'G,7
NAME MAILING ADDRESS TEL
EMAIL: .S. c.1'etiv e- c.1e'l• - 1\e-
ARe.ifleotial n C _ Est- Cost of Construction c I/ t)
Home Icorrovemeut Courrietor I ie.t# f g , S�J Caastreetinu Sup isor i_ic.. ( S r A — O 5
SHED INFORMATION
t tl
New / Site L 1 i 14- I o a II (z 7 Corner Lot Yes 1C _ No
Per Town of Yarmouth Zoning By-Law Sec 203.5 Note E:
Side and rear yard setbacks for accessory buildings containing one hundred.fifty(150)square feet or less and single story,
shall be 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 adjacent parcel. All sheds are required to be located thirty(30)feet from anyfront lot line
( t
Replace eaisfing* 17 See I.. /0 It Fr x H 7,
*The debris will be disposed Drat_ ; S y (�.;-2 z r� nn q. .�I S r�: c k
`" aeatise er F .
t doclaw under penalties of perjury that the st'ati.-rnos1s herein contained an true and WITCO to the best of my knowledge and belief. I understand that any false answers)
will be just cause tIw denial er revocation ati• of no-lice aril x p^.: :.Pied under M GI,Ch.26#,Baer I.
,Appl;raot's Signature- D1te: Q / /I
Owners Signature(.r attachment) A.._.----'.-- Date: / L s/ 0--C-
Approved By: Date:
Building Ofbcial(ardesigteee)
Zoning District:
Historical District:trict_ Yes No
"Conserv-ation ret iea•will be required if shed is placed within t 00ft of
wetland.200ft from ti.ac4taiL or located-within a flood moe5
to 24
The Con omvealth of Massachusetts
_.?k Department of Industrial Accidents
n= ' -1 Congress Stree;suite 100 •
-.s, '� Boston,MA 02114-201 y •
s.
Workers'Compensation Insurance Affidavit Bu lddera/Coatractors/ElettrklaWPlumbers.
TO BE fILED WITH THE PERMITTING AUTHORITY.
Aool taut Informatio4 t b
Name Business/Orgaarzatioo/Idividual):VS,-
LC.e
Address:2.S.ct C1vacim -
City/State/Zip: a V11.102 S Phone#:$'o$ - t{3 0 ..Z U4
Are as ampieym'Cheek Me appropriate beet
1.( t ire a employer web ?yin of project{required)
employees(fun and/or part-time),• • 7.UNew construction
2❑Ianesole proprietor or pastaea6ip and have=employes wetting for sn&Li; :
any capacity-(No workers'comp.insure.=required.] 8.0 Remodeling
3.01 am a homeowner doing ail work myself(No oaten'gyp.immurerequired], 9..❑Demolition
(❑lam a homeowner and will be hiringcpnarton to conduct all work re my property t will it)❑Building addition
enure Mot all wmra=s either have workers'compensation imurence or are sole 11.0 Electrical repairs or additions
Proprietors with no employees.
12.❑Plumbing repairs or additions
$Q!�soh-cacureorors lave de I have eventhevs elets'co p. m the attached sheet 13.0Roof repairs
employees and have omelets'wrap.ktaaart=.:
b.❑We am a corporation and in otfiars have exorcised their right ottxemptioo per MOL e. 14.QOther
Ida,f 1(4),and we hove no employees.(No workers'comp iawaarnte requited.]
'Any applicant tun ehxly hos Y1 must also fill our the r
f Haneeweers who submit this affidavit seniors doing art e babas/mooing t nod their victims'a coon es mat information.
anim
:Contractors that cheek this box must embed additional duet thoas work and tam him outride u., its mat submit a new affidavitthose
indicating nub.
e provide
the came of mp spbicy rag be and acne whether or as Anse tatitles have
�°�°a�ff�"> uva emPioyecs.ebe3'mmt Povida their workers'comp.po(ieymwba
am an employer dud a providing workers'compensation Wawa cefor np esapfoyeec Below Is the
injorarahoa policy anQJobsae
Insurance Company Name: � lGtS,lre, \ �Pj� ��r�wlq\( ► kf+15..
Policy!{orSelf-ins.Lic.4: CC'—loon— o124j?02s.Expiration Date:2.12$ 126'
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 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$250.00 a
day against the violator.A copy of this cot forwarded to the Office of Investigations of the DIA for insurance
coverage verification. nvesti S
f doin hoe es. cent,'
the am yaw ajperfury then the information provided aabov/e is true and correct
Signature: Date: 7'/f 0/t.6--
Phone#: cO 'e {3 b—?
Official use only.Do not write In this area,to be completed by city or togas official
City or Town: Permit/License it
Authority(circle one):
I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact F°erson:
Phone#:
•
PLOT PLAN
I la
FOR LOT i
lists ate Location of gauge or accessory y bnrlding
Additions with dashed lines
Sawarags dispose/�/ �� {cI)
Ego
Sell is
I •S 1 G J 1 P V�►(I�y
II
I Clot' I s `i -a- rear) 1 Q
.4 Cart.
6 �
1 ---, Abutters 5{� Jr�
Name
r I i C Lot* !l5
(e
If this is a REAR LARD •_ .. _ If this is a
car lot, corner to
write in G rt. write in k
name of sheet; f , name of street.
I . a
ce L u;1� I
id
id
SIDE YARD S E YARD
•
HOUSE •
,r
- ; • as
" l
...,
•
SILT BACK '
i A
I
•
(lot.....i .........ft. )
•
♦ 1 /
♦ / (NAME OF STREET)
n C
.........-k/t1,771 /1,Avt-4---
SIC(1 r1L.,, ! L r e J
•
5--Ofroe 'ea',111/0.0011142614444(44t'
44. -.
_ k 3 , �•• Office of Consumer A an • . •
t l���h1� lOYg %
,.` �: 1 0 park Plaza-- Suite 5170 0
} • Boston, etta 02116 •
Hozne It roveane e• 777 . - •i Resistrationt. . .
•
• . ilk ___.. ^T ___ Commonwealth of Massachusetts
• _ -t4� __=- ► Division of Occupational Licensure
MC TH POSTS BEAM CO. El ` __ Board of Building Regulations and Standards
{ r - : _` Constructi�oyiT 'uper�f 1 & 2 Family
JAMES CH. MA 45. . i _ ' ___- CSFA-073865 •11;
pines: 03I14I2026
S _ ._ __— JAMES R z
•y 204 CRANVI RD
=?► _- � ,�: . BREWSTER MA ' k
Commissioner .S-.e ifac, �
O
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affaiis^and Business Regulation
1000 Washing .$tr t - Suite 710
Boston ssaciausetts-02i 18
Home improvemer t ' egistration
i.• '7'4! •sir"---- i--
-I '"'t ` -. Type: Corporation
MCGRATH POST& BEAM CORPORATION I =>. •--I --- -� anon: 132935
D/B/A PINE HARBOR WOOD PROD. ';:i 3"» .; � ti0n' 10I3012026
259 QUEEN ANNE RD.
;;A 7- --
HARWICH, MA 02645 i,� `ire-'�.' �; Z. •
. :1 _• r
L L. %.'-
i �•
. , _ •,
r.'a� re i r.
4 r'
ma,,,.... Update Address and Return Card.
THE COMMONWEALTH OF MASSACHUSETTS
OBI**o9 Consumer'Metre A Business Regulation
HOME IMPROVEMENT! CONTRACTORtbr� xpi Registration valid for Individual return
use only before the
apkatloe data. if found return to:
Offtae of Consumer , • • •. : i . s RaguIstIon
132935 - -,j„ Boston MA a -Stir 7f 0
MCGRATH POST 8 BEAM CORPORATION 7f
DIEM.PINE HARBOR WOppjPROO. /q
Irl
JAMES R. MCGRATH ". ' _ ' Y / l
259 QUEEN ANNE RD_ • J: F &z.
HARWICH• MA 02645 .; - - - .
`. Undersecretary t id without aiglte