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HomeMy WebLinkAboutBLDR-25-582 application/plans ilkONE & TWO FAMILY ONLY- BUILDING PERMIT ___ D i 0 8 � � Town of Yarmouth Building Department pF Y`��� 1146 Route 28, South Yarmouth,MA 02664-4492 G �Z 3 1111V0508-398-2231 ext. 1261 Fax 508-398-0836 C H Massachusetts State Building Code,780 CMR 1� �,4 Building Permit Application To Construct,Repair, Renovate Or Demolish 'ti A4 RPORATE. a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date Applied: Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Prope Address:`` Afi1 (1; 2 Assessors Map& Parcel Numbers 1.1 a Is this an accepted street?yes X no Are 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 Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'o Record: S'Autfi Ywrou& \T Name(Print) City,State,ZIP No yKe45,4 euvg. ,I ci L 7 i-e6(0- 9I ` 1-cn` the S7S7 givuo . coit• No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction Cl Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) ffi Addition 0 Demolition 0 Accessory Bldg. 0 umber of Units Other 0 Sp cify:B 'ef De criptio of P posed Work': 41 01 - y�\ l u n^ ip (O S 5 u. 0 A (c_ �) i'1 0 0 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ J)ppu 1. Building Permit Fee:$ 5.S ilidicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ 60 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ ,i2Ut) 2. Other Fees: $ 4. Mechanical (HVAC) $ 1f OO List: 5. Mechanical (Fire $ Suppressio0 _ Total All Fees:$ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ ) 1A 0 0 Paid in Full 0 Outstanding Balance Due: 1 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 Registere Home I rov�went Contractor(HIC) I' 17 _eV,HOME.(ne.. C > ►l Lit, HIC Registration Number Ex ' on Date HI C p Name or I egis t i j 40()fr.in__S-7C7tqpia 1).eak\ andet ixf kA Pa—,10- O�,. 73'/err ,r �9 Email address C ty/Town,State,ZIP Telephone) nev I 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 Issu nce 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:OWNERS 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/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 ==...0_ Department of Industrial Accidents _-o —` Office of Investigations -•mil' 1 , Lafayette City Center . 11%_. 2 Avenue de Lafayette, Boston,MA 02111-1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): I 0 Mil. V . .)t) .-,,..,r e Address: ac-) t\,r.1(.SGv,A 0...0\iQ_ e C\ E.- City/State/Zip: 1 GJC MO U ►1 ')U ft Phone#: N l 'q sxp--(,;( q_ I Are you an employer? Check the appropriate box: Type of project(required): 1.❑ 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.❑ 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. ❑ Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.yzI am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *My applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 1.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 o the DIA for insurance coverage verification. 1 do hereby c :fy under the ain and penalties of perjury that the information provided above s true and correct. Signature: Date: '7 o5 Phone#: 78k— 6W' 40& l I 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 31:City/Town Clerk 4.0 Electrical Inspector 51=1Plumbing Inspector 6.0Other Contact Person: Phone#: zog Y: a TOWN OF YARMOUTH rat Office of the Building Commissioner _� ;= 1146 Route 28, South Yarmouth, MA 02664 .CpRpppAtEO`, 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 22 rr r suiting from?the proposed w rk/demo ition to be conducted at. qt 1�, .� � L l P(.��., iaavv,A O&F Work Address a r . \) Is tobedisposed°fat the following location: ( CAM) ,\ 0 U'D ,ISci C1 COtU EoreSV a A t 1,I Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chap r 111, §150A. Iz f ignature of!Applicant Date Permit No. TOWN OF YARMOUTH ���og Y� 411,18 Office of the Building Commissioner [ l3� 1146 Route 28, South Yarmouth, MA 02664 o �� 508-398-2231 ext. 1260 Fax 508-398-0836 A9 , HOMEOWNER LICENSE EXEMPTION DATE: 1.18/XLC JOB LOCATION: I /.101YRkS1-1;:ati4-- 30 f!� , a ' (,'G L YR; 2'lPie � Cam. � 0/4 NAME / STREET APPARESS SECTION OF TOWN HOMEOWNER I vvyks roft". G'( NAME HOME PHONE WORK P ONE PRE NT ING ADDRESS P.voy�( Ave (((` C vi� PEA ')a- A oa67 CITY OROWN 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 regulations,and certifies that he or she understands the Town of Yarmouth Building Department minimum inspectio procedures and requirements and that he or she will comply with said procedures and requirements. HOMEOWNER"S SIGNATURE 12/5/25,9:54 AM _\ / �,XtC \ uest bath perspective 2.jpg 4 � N euu gAt 1 " ;," ti ‘ k41 X If 1 CO 0 0 C e/t(r G a t)(\\ IN)1 kl— N cvj \ACt\c kA)aik ��� 3z E)Q- I < ' i r �tp, 0,)(c, ,,,,,,, - ------ e)<(c5 ‘0 u,, 'OAP tk) iN eji0 4104Ma-I IA el /•). 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Side '' �4 limidi rII' ExistingPart�ngStopJ:0.40 �l� (typ ca y re o ed) Interior ' Interior ��w�iJ Existing Inside Stop � .-4, 1 View of Side Jamb View of Side Jamb 1.Existing Opening Height Existing Stool Head Jamb Head Jamb Al MUM View of Head Jamb View of Head Jamb 11 Existing IntenorTrim �) 1� i_ 2.Existing �' Existing Sill Head lamb 1, Head lamb Allill,, A<� Sill Angie iiI b�7� �j� �. Interior i � all Vertical Sectioni ', wJ Interior II �.� _ 111 Existing Intenor Trim (�� Existing Inside Stop . - sh 3.Existing Opening Width iftilliftol _ Existing Parting Stop all / /III(typically removed) Srool Existing Exterior Stop /�r�� 4� =��lamb Extstin Exterior Trim �'�/I�r pp.♦N i/ !many'./ Intenor 4.1.17 Intenor Horizontal Section View of Sill IK--a r^=` View of Sill 0 Stool Stool Sill Angle Details Scale 3"(76)= 1'-0"(305)—1:4 Select a sill angle that most closely matches your existing sill angle. Windows with a smaller sill angle will have a larger maximum height. o m x x x m m m 0 0 0 = H Existing Window Sill y Existing Window Sill N Existing Window Sill 5°to 10°Angle ;$ 11°to 15°Angle J 0°to 4°Angle �. _A. s16I - " ---- (27) (1s> Exterior -- Interior Existing Wall Existing Wall Existing Wall , f I, 1, 0°Sill 8°Sill 14°Sill •Details are for illustration only and are not intended to represent product installation methods or materials.Refer to product installation guides at andersenwindows.com. •Refer to andersenwindows.conr/measure for detailed instructions on how to properly measure for insert windows. •Dimensions in parentheses are in millimeters. 2025-26 400 Series Product Guide Page 1 of 3 400 SERIES TILT-WASH INSERT WINDOWS ANDERSEN •t�'' WINDOWS i DOORS Details for Tilt-Wash Double-Hung Insert Window Scale 1 1/2"(38)= 1'-0"(305)—1:8 31/a"(83) I I Lid Wij II l Existing Stop %•. P Removed -81 Andersen' AndersenTilt-Wash Exterior 1r � Transom Insert Stop Cover 4i Window Andersen"Tilt-Wash Head oo Transom Insert Window i; 6 m A IA I v O MeeUn Rail 1 11111111rj4 l .� _l-.IMF AA(1) Height ms� . -•...`�1= Sill Angle Options: 1 _� ~ -7/I�� 14'8°0° Andersen Exterior 1 • Jamb Clear Opg.Width Jamb Stop Cove 14° .I 3/is"(5) Unit Width 3/i6"(5) Min.' Min.' Existing Opening Width i SIH Horizontal Section Vertical Section Details for Tilt-Wash Picture Insert Windows 31/4,(83) Scale 1 1/2"(38)= 1'-0"(305)—1:8 I i " ''III Existing . . ' Parting Stop Removed Andersen'Tilt-Wash Ira.„7 fir Andersen' �� IE1 Andersen Tilt-Wash Picture Insert Window mi Exterior "�■ Picture Insert Window �' �� Stop Cover �._ orr mom IIIL:-� L ►. �I R' 1" III .7w 1iIIii1 C" Head —I�r � �� taaaaaaralara Sill Angle Options: r5 M ` AMA Andersen 14°8°O° �II,C.�In Exterior � MEN Jamb 'Clear Opg.Width Jamb Stop Cover �A 3hs'(5) Unit Width 3hs"(5) ��II 1 Min' Min.' 11W_AillailiIExisting Opening Width Sill Horizontal Section Vertical Section •tight-colored areas are parts included with window.Dark-colored areas are additional Andersen'parts required to complete window assembly as shown. •Details are for illustration only and are not intended to represent product installation methods or materials.Refer to product installation guides at andersenwindows.com. •Dimensions in parentheses are in millimeters. 'Refer to andersenwindows.com/measure for detailed instructions on how to properly measure for insert windows. 2025-26 400 Series Product Guide Page 2 of 3 400 SERIES TILT-WASH INSERT WINDOWS ■ ANDERSEN WINDOWS t DOORS Details for Tilt-Wash Transom Insert Windows Scale 1 1/2"(38)= 1'-0"(305)—1:8 31/4"(83) 1 1 f0i1 �1 Existing c MINI' ' Parting Stop \7 'Ili/=, Removed - Andersen'Tilt Wash Andersen" '� r TransominsertWindow El ��w Andersen lilt-Wash Exterior Transom Insert A A Stop Cover F� Window I II111Ms 11 m FI" 1 I� • /1 (83)31/4" Head Pi s a � � — ���� ' Andersen 1111NOW Exterior ~ice-- i Jamb Clear Opg.Width Jamb Stop Cover 3/is"(5) Unit Width 3/16"(5) Min.' Min.' Existing Opening Width livilil Sill Horizontal Section Vertical Section •Light-colored areas are parts included with window.Dark-colored areas are additional Andersen'parts required to complete window assembly as shown. •Details are for illustration only and are not intended to represent product installation methods or materials.Refer to product installation guides at andersenwindows.com. •Dimensions in parentheses are in millimeters. •Refer to andersenwindows.com/measure for detailed instructions on how to property measure for insert windows. 2025-26 400 Series Product Guide Page 3 of 3 -m 11 ;•1t,1 11l,1.4 I I II III I I U I'111 i t:1:,1 1 I 1:.' II• 1 1•ii 1•�. r l' III Ill 1,4 ai: :tiai.�i;I.; ti;ly�ili:i i!'6;ly14ll'iii I .I ' Ei;; �i''�' 'hN. 1E11 1II! 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