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Home My WebLink AboutBSHD-26-78 application RECEIVED11 -4rY., t--- Office Use Only �-x c AUG 10 2026 1 Q y ' r 1 Permitit to- co --/iil 2G�j co,,, �„ '�`k{ BUILD E TMENT Amount 3S co la ',, f% By Permit expires 180 days from 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: 27 Hunters Circle OWNER: William R. Bowen Sr. 27 Hunters Circle W. Yarmouth 02673 (508)775-7962 NAME PRESENT ADDRESS TEL. # CONTRACTOR: None NAME MAILING ADDRESS TEL.# EMAIL wiflambowenl oud.net (iTt rb�� ►il u i/. G»J) 51 Residential 0 Commercial ' Est.Cost of Construction$ 3,000 Home Improvement Contractor Lic.# N/A Construction Supervisor Lic.# N/A SHED INFORMATION New Yes Size L 10 x W 8 x H 9 Corner Lot:Yes No X 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 any front lot line Replace existing* No Size L x W x H *The debris will be disposed of at: 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 r evocation of my license and for prosecution �under M.G.L.J Ch.268,Section 1. Applicant's Signature:j �tJe 1 ,r `A Q '1 �C.! Date: 8/10/2026 Owners Signature(or attachment) 0,..#J4„a j /X n �l 1 l) t Date: 8/10/2026 Approved By: L ` l� Date: Building Official(or designee) Zoning District: Historical District: Yes ❑ No **Conservation review will be required if shed is placed within 100ft of wetland,200ft from riverfront,or located within a flood zone** 6/24 " The Commonwealth of Massachusetts Department of Industrial Accidents ,- Office of Investigations =l Lafayette City Center r` 2 Avenue de Lafayette, Boston,MA 02111-1750 ,�/ www mass.gov/dia M-('ter-' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): William Bowen Sr Address: 27 Hunters Circle City/State/Zip: W. Yarmouth, MA 02673 Phone#:(508)775-7962 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. 0 I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. El New construction 2.El 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.$ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.II 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.j *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. :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 of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature:�" Date: 8/10/2026 Phone#: (508)775-7962 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 31:City/Town Clerk 4.❑Electrical Inspector 5Elumbing I Inspector 6.0Other PLOT PLAN FOR LOT * 3997 Addition'sIndicate location of garage with dashed or X building Seweragepceal (cesspool) fa Well 1g 3996 1 LUKE I CARLETON TRS I____ �_ (irit 100 ..ft, _. — _ la 'ca°z? 1 •Z- ._._. Abutter's >15' I Abutter's Name I Name Lot# ,t j Lot# If this is a • REAR YARD If this is a corner lot, 7' O- S-0 40 corner lot, Q ft. write in write name onfstreet. 4——�'•` Q'SyO S� , -I ,�0 f name of street. te 5 1 E Ti 4 t I- D SIDE YARD Cr) HOUSE SID8 YARD „-, cc a 15 —,.ETit. (> 20 • W oI . � � o • ry I • v CI3997 C• 5 cc SET BACQ[ WILLIAM BOWEN SR co• in O ._ O • H W . 20 ° 4 ...... ..ft. z i ° -0. • • (kit 100 ft. ) / HUNTERS CIRCLE / (NAME OF STREET) TOWN OF YARMOUTH / Infarmadtn h GIS/ASSESSORS RECORDS