HomeMy WebLinkAboutBLDR-25-422 ONE & TWO FAMILY ONLY- BUILDING PERMIT
Town of Yarmouth Building Department pF �q
1146 Route 28, South Yarmouth,MA 02664-4492
508-398-2231 ext. 1261 Fax 508-398-0836 �� '- d ��
Massachusetts State Building Code,780 CMR N E
Building Permit Application To Construct, Repair,Renovate Or Demolish 4ti. e,."`""_�b,4
O7Po RATED
a One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: /3/J f_ $� Date Applied:
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
23 West Woods Village,Yarmouth Port,MA 02675 142/4/23W// 103572
1.1 a Is this an accepted street?yes x no Map Number Parcel Number
1.3 Zoning Information: 1.4 Promoty Dimensions:
a 3A.
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
A t) /0 daV
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public II Private 0 _Zone: Outside Flood Zone? Municipal 0 On site disposal system
Check if yesE
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Stephen 8 Jill Albright Yarmouth Port,MA 02675
Name(Print) City,State,ZIP
23 West Woods Village 508-916-1617 salbri91@aol.com
aol.com
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building❑ Owner-Occupied 0 Repairs(s) i Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units 1 Other 0 Specify:
Brief Description of Proposed Work':Replace existing deck boards on deck.Replace existing railings.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $5,000 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees: $
Check No. Check Amount: Cash Amount:6.Total Project Cost: $5000 0 Paid in Full 0 Outstandi T ile4V E
JAEP 19 2025 I
NG DEPARTME
By
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
N/A 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.)
City/Town,own,State,ZIP R Restricted 1&2 Family Dwelling
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 Contract C)
N/A HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant N e
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 0 No
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 N/A
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 ap ication is tru d acc to t best of my knowledge and understanding.
9/15/25
Print Owner' Authori d Agent's ame(Ele.i'nic 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.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 °"e
Type of cooling system Enclosed Open xx
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
The Commonwealth of Massachusetts
_a Department of Industrial Accidents
=: is Office of Investigations
Lafayette City Center
2 Avenue de Lafayette, Boston,MA 02111-1750
�' 'S• www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Stephen Albright
Address:23 West Woods Village
City/State/Zip:Yarmouth Port, MA 02675 Phone #: 508-916-1617
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
workingfor me in anycapacity. employees and have workers'
P h' 9. ❑ Building 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 11.0 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.]
*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: N/A
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 certify and t e pains pen ties perjury that the information provided above is true and correct.
S nature: Date: 9/15/25
Phone#: 508-916-1617
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 20 Building Department 3,❑City/Town Clerk 4.0 Electrical Inspector 5EIPlumbing
Inspector 6.0Other
Contact Person: Phone#:
TOWN OF YARMOUTH
�� o q Office of the Building Commissioner
4� :. _ 0, 1146 Route 28, South Yarmouth, MA 02664
508-398-2231 ext. 1260 Fax 508-398-0836
aCOgPORAt£0 ,
HOMEOWNER LICENSE EXEMPTION
DATE: 9/15/25
JOB LOCATION: 23 West Woods Village, Yarmouth Port, MA 02675
NAME STREET ADDRESS SECTION OF TOWN
HOMEOWNER Stephen Albright 508-916-1617
NAME HOME PHONE WORK PHONE
PRESENT MAILING ADDRESS 23 West Woods Village
Yarmouth Port MA 02675
CITY OR TOWN STATE ZIP CODE
Definition of Homeowner:
Person(s)who owns a parcel 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 inspection procedures and requirements and that he or she will comply with said
procedures and requirements.
HOMEOWNER"S SIGNATURE
wog � TOWN OF YARMOUTH
Ar
�? Office of the Building Commissioner
1146 Route 28, South Yarmouth, MA 02664
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.23 West Woods Village Yarmouth Port,MA 02675
Work Address
Is to be disposed of at the following location: Town Transfer Station
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111,§150A.
9/15/25
• nature of Applic Date
Permit No.
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I spfitu
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more
of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if
necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of
insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the
members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy, please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant
that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current
policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or
town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
Lafayette City Center, 2 Avenue de Lafayette
Boston, MA 02111-1750
Tel. (617) 727-4900 or 1-877-MASSAFE
Fax (617) 727-7749
Revised 7-2019
www.mass.govidia
QUITCLAIM DEED
We, DARIN A. PERRI and JOY A. BOUCHER,TRUSTEES, of the HERBERT M.
BONNEY, II, 1994 REVOCABLE TRUST u/d/t dated August 15, 1994, as amended
January 25,2006, Abstract of Trust recorded as Doc.No.1,026,E8 and further amended
on November 16,2023,Abstract of Trust recorded in Doc. No 1,491,670 with a mailing
address of 23 West Woods,Yarmouth Port,Massachusetts 02675,
in consideration of FOUR HUNDRED NINETY-NINE THOUSAND NINE
HUNDRED and 00/100 DOLLARS($499,900.00)PAID,
GRANT TO.
STEPHEN A. ALBRIGHT and JILL A. ALBRIGHT, TRUSTEES, of the STEPHEN
ALBRIGHT AND JILL ALBRIGHT REVOCABLE LIVING TRUST u/d/t dated October
14,2020, with a mailing address now of 23 West Woods,Yarmouth Port,Massachusetts
02675,
with QUITCLAIM COVENANTS
The"Unit"known as Unit No.23W,having an address of 23 West Woods,Yarmouth,
Massachusetts, in Building No. 73, in a condominium known as Kings Way and
established pursuant to Massachusetts General Laws, Chapter 183A, as amended by
Master Deed dated July 31, 1987 and registered on October 15, 1987, with Barnstable
District of the Land Court as Document No. 441932, as amended under Master
Condominium Certificate of Title No.C-240(hereinafter the"Master Deed"),and situated
on Kings Circuit in Yarmouth, Barnstable County, Massachusetts, together with an
undivided percentage interest appertaining to said Unit in the common areas and facilities
of said Condominium and together with the rights,if any,to exclusive use of the common
areas and facilities of said Condominium as more fully set forth in the aforesaid Master
Deed and the Unit Deed and the unit plan.
Together with the benefit of,and subject to,the easements,restrictions,conditions,rights
and obligations set forth or referred to in said Master Deed. Unit Deed and provisions of
the Kings Way Condominium Trust dated July 31,1987,and filed with said District of the
Land Court as Document No.441933,its by-laws and Rules and Regulations,recorded
with said Registry of Deeds,as the same may from time to time be amended by instruments
of record.
Grantors hereby release any and all right of Homestead in said premises and certifies
under pains and penalties of perjury that there are no other persons entitled to
protection of the Homestead Act.
We, DARIN A. PERRI and JOY A. BOUCHER, as TRUSTEES, of the HERBERT M.
BONNEY, II, 1994 REVOCABLE TRUST u/d/t dated August 15, 1994, as amended
January 25, 2006, do hereby certify that we are the sole Trustees of said Trust; that said
Trust has not been amended,revoked or terminated and the Trust remains in full force and
effect; that all beneficiaries are of full legal age and are competent: that all beneficiaries
have authorized and directed us to execute this Deed conveying the above described
premises to STEPHEN A. ALBRIGHT and JILL A. ALBRIGHT, TRUSTEES, of the
STEPHEN ALBRIGHT AND JILL ALBRIGHT REVOCABLE LIVING TRUST for
consideration paid in the amount of$499,900.00; that in accordance with the provisions
contained in said Trust, we have full power and authority to execute this Deed on behalf
of the Trust; and that the above described premises is not our principal residence or the
principal residence of any other person.
For Grantor's title, see Deed in Certificate of Title No. C240-23W, Document No. 713091,
as recorded in the Barnstable County Registry of Deeds District of the Land Court.
Property Address 23 West Woods, Unit 23W,Yarmouth Port, MA 02675
EXECUTED a a spied ' strunent under the pains and penalties of perjury this
day of Pe44n e- , 2025.
* 444.1i
di
D in A. Perri, Trustee
Herbert M. Bonney 111994 Revocable Trust
COMMONWEALTH OF MASSACHUSETTS
Barnstable, ss.
On this c.)7 day of ..ef4,19py- 2025, before me, the undersigned notary
public, personally appeared Darin A. Perri, Trustee aforesaid, proved to me through
satisfactory evidence of identification, which was J, - v . -%' , to be the person
whose name is signed on the preceding or attached document, and acknowledged to me
that he signed it freely and voluntarily, for the purpose stated, and who swore or affirmed
to me that the contents of the attached document are truthful and accurate to the best of
his knowledge, and that he has the authority to act in that capacit .
4
4.1k19:.‘"71,p • • 6,1. My Commission Expires:
it 1 )1 •
x
*yi1tASE ..
q,,�P�UBt.o
,
EXECUTED a scaled instrument under the pains and penalties of perjury this
day of d-m,tii-Qi/ , 2025. hJ A. oucher,Trustee
/74(C224/Z C/a/
Herbert M. Bonney 111994 Revocable Trust
COMMONWEALTH of MASSACHUSETTS
Barnstable, ss.
On this day of -f)fi =eW\\907 , 2025, before me, the undersigned notary
public, personally appeared Joy A. Boucher, Trustee aforesaid, proved to me through
satisfactory evidence of identification, which was k1 kl ( (c_fill , to be the
person whose name is signed on the preceding or attached document, and acknowledged
to me that she signed it freely and voluntarily, for the purpose stated, and who swore or
affirmed to me that the contents of the attached document are truthful and accurate to the
best of her knowledge, and that she has the authority to act in t at capacity.
K 4,-----1_,) ..
Notary Public:
My Commission Expires:
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