HomeMy WebLinkAboutBSHD-26-75- YA�A,' k
RECEIVEDi
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t,�� ' O�} It
}�a 20263 d Permit#tSSH� -75
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Amount�'ti 'b+° BUIL ARTMENT i 1
�`Q,��''PORAT ED :� By
.,,; _,,' _ _ _ j _:Permit expires 180 days from 1
issue date
EXPRESS SHED PERMIT APPLICATION
TOWN OF YARMOUTH
Yarmouth Building Department
1146 Route 28
South Yarmouth, MA 02664
(508) 398-2231 Ext. 1261
CONSTRUCTION ADDRESS: 25 Grove St. West Yarmouth, MA 02673
OWNER: Charles Paul Garabo JR 908-581-7110
NAME PRESENT ADDRESS TEL. #
CONTRACTOR: Pine Harbor Wood Products 326 Yarmouth Rd. Hyannis, MA 02601 508-771-5007
NAME MAILING ADDRESS TEL.#
EMAIL:kimgarabo@yahoo.com
D Residential 0 Commercial 0 Est.Cost of Construction$7,000
Home Improvement Contractor Lic.#132935 Exp 10-30-26 Construction Supervisor Lic.#CS FA073865
SHED INFORMATION
New X Size L14 x W 8 x H 10ft 9in Corner Lot: Yes No X
Per Town of Yarmouth Zoning Br-Law Sec 203.5 Note E:
Side and rear yard setbacks for accessory buildings containing one hundred fitty(150)square,feet or less and single story.
shall be six (6)feet in all districts, but in no case shall said accessory buildings he built closer than twelve (1')feet to any
other building on an adjacent parcel. All sheds are required to he located thirty (30)feet from any front lot line
Replace existing* No Size L x IT- x H
*The debris will be disposedofat: 259 Queen AnneRd Harwich, Rd. 02645
Location of Facility
I declare under penalties of perjury that the statements her in contained are true and corr the best of my knowledge and belief. I understand that any false answer(s)
will be just cause for denial or revocation of m se d p on under . .L.Ch.268,Section I.
Applicant's Signature: Date: 08-01-26
Owners Signature(orattachmen Date:08-01-26
Approved By: Date
Building Official(or designee)
Zoning District:
Historical District: 0 Yes ❑ No
**Conservation review will be required if shed is placed within 100ft of
wetland,200ft from riverfront,or located within a flood zone**
624
The Commonwealth of Massaclutseitt
Department of IndlLstria1 Accidmts
" rn 1 Congncs S et, Sidle 100
Briton,Mi 02114-2017
Wwwsmass.gov/dia
awl:
Workers'Compnss€tiou Iaauraace Ai8dtevic:Buildtrel+CanbractotItctritaa�lp'l�bera.
TO BE FILED WITH THE PERMIT'YING AUTHORITY.
e�oolicant b ftlrmjtioa l sc Print L.&biy
Name(Busine$s/C7rSenizatioMnttividual): � T�Q�1� (' 9 'll� iL Q
Address: ?- fr
City/StateIzip4+(S Y'�t.1 'c C1'Z, +�" Phone#: ?5'C) L.3 b r c
Are as ampterer'!t'ieelr apprnpdate tteL
-^��ernptaytts(toll and/or Type of project(required}:
i. lam a eaployce with 6 pit-tire). 7! g New Construction
2.Q tam a sole toppneeot of pwtnaship and have no employees wakol1 for in Oi i g. Remodel
any tapatrty_(We wooers'comp.cnn,�requimd.J 4" r 8
hcmeoavrscr doing all wtutc rayseif (Na w r ej 'comp.itwhsarre regafed.J t '.,[�Detttolition
am at xnco*wt wd will bo kain*egwacors oe conduct all woo#on coy pmpaty. i will 10[ Building addition
soon that alt eoaoacton eitl�r lava Muck zs'compensation in:rarance or we sole 11.9 Electrical repairs or additions
p►opnetocs watt no ermployees.
12.Q Pi ter�1�.��aa r~;i:��r:�or additions
59 1 am a grneretl contractor and I haver hard the tu wntractots lifted on the amacled sheet
These have employees and lava workers'comp.in>urnot.: 13,Q�s�of repairs
6.9 We tin a carporadoct and its office have exercised their right of exemption per MGL c. t't.90her
152.$1(4),end uv hove no employees.(We workers'camp,iaatrrattee requited.]
'My applicant that cleeb Dot 51 moor also fill out the section below showing their workers'wmpcnsapgt Policy information.
t Homeowners who submit this affidavit indicating they arc doing all work and area hire amide contractors mist odnrdt a newaWdsvh bsdieating ouch
t osuactors that check this box helot tnhed an additional altar sowing the name otthe tractors turd pris whether at not those ertti4aa have
employees. lithe sub oart4wcmrs Davt cmpiyces they mint prvvida their workers'gyp,policy number.
I em an enq foyer that is providing workers'conrpensaUon Insurance jar hay ersi Rloyeer Below Is the policy and Job site
irajornradtorr,
lrtsurance Company Name: Qjpl�(i�
Policy#or Self-ins.Lic-$1: CC Qo— 12 T 9 2(Y Expiration Date:`L 7
Job Site Address: City/State/Zip:
Attach a copy of the workers'compensation policy declarstion page(showing the policy naalber sad expiration date).
Failure to secure coverage as required raider MGL c. 152,¢2SA is a criminal violation punishable by a fine u➢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 3250.00 a
day against the violator.A copy of this state art . . forwarded to the Office oft westigafions of the DLA for insurance
coverage verification, /
I do hereby cmify • ---- _ ... ..
''� �r'1' ., ,��o P�r�'tJi+rt this infonaaaQioh provtaitat tbovr t`s three creed terrace
$zanaPre: ! _jitatei
Phones: � q3 b " 7, L
Official use orris. Do tot write ha this area,to be conppieted by city or town official -
City or Town: PermWLkaasc ii
huthtp Authority(circle one): _
I,Bo:rd of Health 2.Btaildiag Department 3.CitylTawn C`Icrir 4.Ekctricai Insptttr3r S.Piumbiag irupsetor 6.UMer
Cttatrtct Peraaa: ${�:
PLOT PLAN�
FOR LOT t /2 v
Indicate location of garage or accessccry building
Additions with dashed lines
Sew� erags disposal (cesspool)
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Abutter's Q '
Name I Abutter's
Lot# I Name
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corner lot, If this is a
write in R. corner lot,
name of street. write in
` 4p PT name of street.
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SIDE YARD
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SET BACK
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(lot it. frontage) ,
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