The URL can be used to link to this page

Home My WebLink AboutBLDX-26-722 application RECEIVED Office Use Only Atriv&V Permit#x' .d, JUL L 02 2026 , - _ice�]. I{ Amount 51) MATTACMIESL `\�CORPORAtE��b�` BUILDING DEPARTMENT -- Lay ....'.._�..__.-__ EXPRESS BUILDING PERMIT APPLICATION TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 �/ (508) 398-2231 Ext. 1261 CONSTRUCTION ADDRESS: 7 6 � 1 .., C�k c S L A v J) I ) D OWNER: Ov S C_ S0 NAME PRESENT ADDRESS TEL. # CONTRACTOR: m Ia 2 i` 13K NAME MAILING ADDRESS TEL.# EMAIL: /"' l Rvl3 r / F & /, C 1-04 •C U ►+/� C'Residential J Commercial Est.Cost of Construction$ Homeowner is Applicant? Yes No Home Improvement Contractor Lic.# Construction Supervisor Lic.# C S`C'(> S I ``f Gf WORK TO BE PERFORMED Tent Duration (Fire Retardant Certificate required) Wood Stove Siding: #of Squares Replacement windows:# C L.i D C- R Replacement doors: # Roofing: #of Squares Insulation KE/L t /?�- Temporary Mobile Home Temporary Construction Trailer Demolition—Interior only *Demolition Raze Structure Solar System ESS System Chimney Fence *Please submit utility disconnect letters for electric& gas—structures over 75 years old require historical review *The debris will be disposed of at: d/I 1 kit u v'f N L r\- 11- . L.(— Location of Facility I declare under penalties of perjury that the statements herein contained are true and correct to the best of my knowledge and belief. I understand that any false answer(s) will be just cause for denial or revocation of my license and for prosecution under M.G.L.Ch.268,Section I. I�� W Applicant's Signature:_ VA-- _ Date: 1 12. / 2 (i Owners Signature(or attachment) Date: Approved By: Date: Building Official(or designee) Rev 6/24 ),_.0.) ; CAsa GE.te_ RA- Rub. ?ekc-- c). artiC vcUr tee- cvT i Cd c. � v c k sv 40.)L,v.t.„ (- \.( i9� - 1z� JAKE ROONEY'S DINNER SPECIALS Today's Soup:TOMATO BASIL APPETIZERS ENTREES APPY SAMPLER 20 STEAK TIP WEDGE SALAD N 18 Mozzarella sticks,cheddar bacon potato skins,Asian spring rolls and chicken wings BAKED SEA SCALLOPS 30 SEAFOOD STEW 18 Served as a casserole with rice and vegetable Top Notch Delicious&Satisfying.Shrimp, BBQ RIBS DINNER 25 Scallops,Haddock&Little Neck Clams steamed in a Fennel Saffron broth Fall off the bone tender bbq ribs with cote slaw, french fries,and onion rings FRIED CALAMARI 15 BOILED LOBSTER DINNER 38 Flash fried with banana peppers and served with Marinas Fresh lobster dinner with cote slaw,drawn butter and charred lemon 75 CENT WINGS 10 WINGS FOR$7.50 DONNY'S FAMOUS SMASIBORGER 18 Fresh crispy chicken wings tossed in your The best smashburger on the Cape-YOU decide! favorite sauce On grilled sourdough with cheddar cheese, caramelized onions,bacon and special sauCe. ROONEY'S LITTLE NECKS 25 Served with fries Sauteed Littlenecks w/Roasted Red Peppers,Caramelized Onion&Italian SURF•N-TURF 38 Sausage in garlic butter &wine 6 oz filet mignon w/3 stuffed shrimp. Served with mashed potato&vegetable over lobster sauce MAC-N-CHEESE FLATBREAD 14 Just like it sounds Drink special:Peachy white sangria 10 Homemade Brownie Sundae,Warm Toffee Bundt Cake,Key Lime Pie, Dubai Chocolate Cake,Homemade Apple Crisp,plain or a la mode *Please advise your server if anyone in your party has a food allergy Aar"' �.s J s_ per MASSACHUSETTS DRIVER'S .�=�yus.„ LICENSE :;A Mi,,,s, . . ' a !!r „�—r.'" MBER ' '` ` . 7/16/2024 92468 0. �1 r ��o� `` � ;_�:I0412029 3 DOB. • 08104)1957 t; e 9 . t2 REST 9a END L 3, NONE NONE ,,"1 s 2MA'KP I 7'< = c ..818 •HADYEEST DR E SO TH YARMOUTH, MA 02664-1831 • 18 EYES BRO /1 15 SEX M 16HGT 6O-Q1�� 08 j57 �/ (1\ / 5 0D 07/17/2024 Rev 021�y2016 ! • 0 - • * em on rac or Registration Card Reco troraut v4otrd ke ate typ. orsfr lets;'na fitkpeAtooft data.: Typ.: loll tygludl , Staftsbar 1?6512 Expiration:04$22/1O/'! ,. Issued to: * a MARK RUBY BUitiNGO 6,REMODLE3NG MARK RUBY ^-•,. _ - Mark P Ruby 18 SHADY REST'DR. 1 f 1. Y rf,I7;ice,. SOUTi4 +`ARMOUTH,MA 02664 onii. c � 4> Retr,.satsaes Lad�r R. O its " 1 f 50"4 4gg.340ff 0no,1144006,MA 02110 2012 Undersecretary Commonwealth of Massachusetts litklyr Division of Occupational Licensure un Board of Building g Re ulations and Standards H Cott orntiAtp$rviS o y CS-065149 ,1 ` pires: 08/04/2027 : 5, MARK RUBIf� .F ��; ' 4. , 18 SHADY R T ; p S YARMOUT 1k' 4719Ij v CI F Commissioner —c,L_Z0,..-- The Commonwealth of Massachusetts rt Department oflndustrialAccidents WNW-5 Office of Investigations ' Lafayette City Center 2 Avenue de Lafayette,Boston,MA 02111-1750 .�F www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): P , Z V [ t,A3 y — Address: l g c/'f'i o y ?�s S I (( Q. '.,y il vl'1 City/State/Zip: Phone#: S v —?? I K 3—2— Are you an employer?Check the appropriate box: r 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. am a sole proprietor or partner- listed on the attached sheet. 7. Er-Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp.insurance. t 9. ID Building addition required.] 5.❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑I am a homeowner doingall 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. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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 cernfy under the pains/and penalties of peijury that the information provided above is true and correct. Signature: l t/"— \ """ Date: 7 (2 I. Phone#: 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): 11:1Board of Health 21:1 Building Department 30City/Town Clerk 4.0 Electrical Inspector 50Plumbing Inspector 6.0Other Contact Person: Phone#: