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Home My WebLink AboutBSHD-26-100 application i g' YAK— —1'4\• Office Use Only O-' s' 1 Permit# ��- i i 3S.t� Amount N' if.PORATE b y .rt�' 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: 11 Hole in One Dr., S. Yarmouth, 02664 OWNER: Michael Murray, 11 Hole in One Dr., 774-212-9724 NAME PRESENT ADDRESS TEL. # CONTRACTOR: N/A NAME MAILING ADDRESS TEL.# EMAIL:mikemurrayonthecape@outlook.com 00 D Residential ❑Commercial ❑ Est.Cost of Construction$ CS Home Improvement Contractor lie.# Construction Supervisor Lie.# SHED INFORMATION New Yes Size L 14 x W 8 x H 7 Corner Lot: Yes No/11111, Per Town of Yarmouth Zonin.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 anvfront lot line Replace existing* No Size L x W x H *The debris will be disposed of at: —TO Location of Facili I declare under penalties of perjury that the statements herein contained are true and co,ect to the best of my knowledge and belief. I understand that any false answer(s) will be just cause for denial or revoc ion of Jjmy license and for prosecution under M. .L.Ch.268,Section 1. Applicant's Signature: 144.I,. Li, twl Date: 9/30/2026 Owners Signature(or attachment) h(........)t,J 1/t.a --- Date: 9/30/2026 Approved By: V Date: Building Official(or designee) Zoning District: ECE ! - D # Historical District: ❑ Yes No // **Conservation review will be required if shed is placed within 100ft of OC 0 8 2026 wetland,200ft from riverfront,or located within a flood zone** 6/24 BUILDING D A ENT By The Commonwealth of Massachusetts Department of Industrial Accidents S ir# Office of Investigations I"ILafayette City Center 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): f /E\ Address: City/State/Zip: Phone #: Are you an employer? Check the appropriate box: Type of project (required): I.❑ 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. 0 onstruction listed on the attached sheet. 7. ❑ Remodeling 2.❑ I am a sole proprietor or partner- 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 3.1=1 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. Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13. ther 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: 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 undere the pains and penalties of perjury that the information provided above is true and correct. Signature: AA 1 IL) � tn.---� / Date: 9/30/2026 Phone#: 774-212-9724 V 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 503lumbing Inspector 6.00ther Contact Person: Phone#: PLOT PLAN FOR LOY Y Indicate 7acaticu of garage or accessory building Additions with dashed ,lines Sewerageer dispo (catalpa].) ES'Well !� I / I I (kit I I0-0 _ — —— rear) Abutters _ Col I Name w Abutter's Lot# 3� Lot# Name L _ _ If this is a \REAR YARD comer lot, If this is a write in corner lot, name of street. A ft. write in 1.` name of street. 8 ' 8 v 4 I SIDE YARD `— g� NOOSE SIDE YARD • ( SET• ( BACK • • • .(, ft. • 1 1 (lot I to ft. frontage) ,• �/ 1i 4c)it. I OM- �r (NAME OF STREET) —/_\7 Taf -matirn Supplied by Kt, cV•ai l'V1 to f('a) C OWV\Q f.), ..v.1,vu i �—' t..►V uHui I4.j I / LU f / CD REGISTRY BARNSTABLE -y CC nADEED BOOK/PAGE 231 ! 0/328 BASED UPON DOCUuENTATIQN PROMED, REQUIRED uEASUR£-UENTS WERE LIAQE OF THE FRONTAGE AND BUILDING(5) SHOWN ON PUW BOOK/PI�W 23/ 5 r•—+DOS MORTGAGE INSPECTION PLAN, IN OUR JUDGEuENT ALL Vt518LE ,�EASEMENTS ARE SHOWN AND THERE ARE NO v►OUITIONS OF ZONINGREQUIREMENTS REGARDING STRUCTURES TO PROPERTY UNE QFFSET5WE CERTIFY THAT THE BURSA.G(S) ARE NOT WITHIN THE (UNLESS OTHERWISE NOTED IN DRAWING BELOW), 5PEGtA1 FLOOD ►{�j�Rp � S� HUO w1P; NOTE: NOT DEFINED ARE ABOVEGROUND POOLS, DRIVEWAYS, ORsHE05 rtrrTH NO FOUNDATIONS, Tw5 IS A WORTCAGE INSPECTION y /y 5 91 J bro 4 7- 16— 14 PLAN; NOT AN INSTRUMENT SURVEY. DO NOT USE TO ERECT FENCES, OTHER BQUNO,RY STRUCTURES, OR TO PLANT SHRUBS. ,r� '� ��LOCATION QF THE STRt1CTt1RE(5} SHOWN HEREON t5 EfTHfR rNtri)Cijs ��••.7 � "`fir Ft000 tiZ RD ZONE HAS BEEN OETERUINED DY SCALE AND C uPLLA ICF Willi LOCAL ZONING FOR PROPERTY UNE OFFSET 4 4�`'�1l `'' S IS NOT NEC£ss�tiLY ACCURATE, UNTIL OEFlNRIVE PLANS ARE RACDON EQUIREMENTS. OR 15 EXEMPT FROu VIOLATION ENFORCEMENT •:;ola ISSUED Err HUG AND/OR A vERTTC�ALL CONTROL SURVEY is ERwISE NOTED. THG CERTIFICATION IS NON—TSRA F'EEC. RAUBLE sNLETHE PERFORUED, PRECISE ELEVATIONS CANNOT BE DETERUINED. oTHABOVE CERTIFICATIONS ARE U.'►D£ WITH THE PROVISION THAT THE INFORLIATION PROVIDED I$ ACCURATE AND THAT THE UEASUREIAENTS USED ARE ACCURATELY LOCATED IN RELATION 70 THE PROPERTr LINES. CERTIFIED TO: MICHAEL W. MURRAY N88'49'10"E ;.,, 2 �!- t . HOLE IN ONE r v, s,4ti, ,t -• DRIVE '* -7 + r a" r 1 (x( ` '" .4L i'�'ty x'�,r,,. ., 0.?. �•9 ' �' fit ri'r Yid x. i g ,i ,,41:' w i. +.- ,, i q 4.:: *`tt„f 'ski:i, +n. '..i'f i .+R v , , , ;z ' } :'04f 14-: 10,tt ° g ri is a- + 'd. il.2b`T; fs•atZhi4 ntViC-,- r f' ' s X 5 4 sd. '� as ` �� ...-, "' .*��,z?�,Iji3- '.�'-s��er,e�4 r 'p1 �c � ? .�. } 0 ,if�`� tad t ;, t t' j. 'l t 45 r#", . rrK.�S .> , , /�� 7� sz. y fiery .dam ' .• "1'• ' �,Z'.t .. '# ! • # , S , r °#...1t.'! k ?.�+L' „„ .. ..,.., r S1 ,,,.4',41 Yk o z:: ..1,t ;boo ` . `y, i' ? a•u !4• v_,1 7 J �' • � ,� obi - ,.. A {pi ry4x ' � q rV Yard} W 0 I., 5itl 7 a 3, .?: ° � "..: _ i 5 rri q -"+ �p� ;_ a rie ,r T L ',+t. J: . { {pis ril �.ia xa rY�� sy 4-S-t ? y�y rct I.J ea' -` p+'Kira +'mas t}. . ,z.lR(, f ri. 'ti s. a!'i ar f� fir Za 3 „4. YY TT7711E. ,_ • Y S 88'49'10" W 1 k ` ) REQUESTING OFFICE: GRAEBER, DAVIS do CAIVTWELL„ P.C. REQUESTED BY: DRAWN BY:DA CHECKED BY: