HomeMy WebLinkAboutBSHD-26-102 application 4 Y'a 4 Office Use Only
( y 'Permits 3S It7-aco-103\
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�••� -issue date
EXPRESS SHED PERMIT APPLICATION
TOWN OF YARMOUTH
Yarmouth Building Department
1146 Route 28
South Yarmouth,MA 02664
�7 (508)398-2231 Ext. 1261
CONSTRUCTION ADDRESS:/O/ rls‘n\e."•
OWNER:E Liz A6c n4 &i EKE /? R4.4, r %/%-if.moi 611`f 7/c37.2'.
NAME PRESENT A• yS ^ L t/ . �/y
CONTRACTOR\At.k4k W'� t'��c g `%)„ e t n 1{�ZI2 )(LJ 1 .(�J�-,
,8i BkteM,A8€.C.Ioud,Ctn
EMAIL:
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it �� 0 Commercial�} E Est.Cost of Construction S Li-(l�pf�. �t Q
Home Improvement Contractor lie# / 3•9 `35 Construction Supervisor LieNe5cA ' 01.XJro3
/ SHED INFORMATION �/
New/ Size L g a W tv i H Corner Lot:Yes No !�
Per limn of Yarmouth Zoning RP-Law See 203.5 Note E:
Side and rear yard setbacks fOr accessory buildings cotataitring one hundred filly(150)square feet or less and single.slum-.
.shall he.sir(h)feel in all districts.but in no case shall.said accessory buildings be hnili closer than twelve(12)fret to any
other building on an adjacent parcel.All sheds arc required to he located shirty 130)feet from antjront lot line
Replace existing*_ Size L F�//��x W x H `n^�n` \11 n^.
'The debris will be disposed Mat: cg,00k Ox�een Ac\,i `t+�,c\-,
Location of Facility
I decline under penalties Mate statemens heron contained me true and correct to the best of my knowledge and belief I udashnd that any false answer(s)
will be just cause for f my license and for prosecution wider M.GL.at.268,Section 1.
Applicant's Signature: - - _. Dew: 9 • la• u
Owners SignatureMr ) Date: q�///eta
Atwro•od By: tit,-
Buildng Official(or designee) - -
Zoning District:
Historical District f/Ys ❑ No
"Conservation review will be required if shed is placed within 100ft of
waland,200ft from riverfront,or located within a flood zone"
6.24
The Commonwealth of Massachusetts
i=�i Department oflnrdwstr�al AceJdtnts
•
=_r.!R_=,y 1 GongaStree4 Suite 100
:$- ' Boston, MA 02114-2017
•
` www.mass.gov/tfia
Workers'Compens.stIon Insurance Affidavit Builders/+ContractorafEiectriciasalPlumbera.
TO BE FILED WJTR THE PERMITTING AUTHORITY.
AooIi f tioa
re Print Lertbly
Name(Business/Orgsnizaton/Individuat): i 1 ii%A r( IZRIC 1a4 LL C.
Address: ZS 9 (w9or,N"N' Mil
city/stateizipA'f Gy i & k 47.64 y Phone*: g'eL$ " C'3 0 ":CS M
ArE;folt sa employer?Cheek es appropriate btu:
I. r am a employer with?. =Moyers(full md/or . • Type of project(repaired):
_ oe"�'e1 7.'JNew construction i
2.Q I non a sole prapricsor otpw eeabip sod lave itedbS�+week.0 g far nx 1ri:�' 8. 0 Remodelingt
mY cap sty. o trotters'comp.uuttraoa
3I am a hamsoweher doing eU+wet myself 1Mo wexktes'aoesA cuat:secce tepuireef)t 9.,0 Demolition
4.Q I sera s houieow»asd wh71 be►eves eoreesscaacs m eondues dl want m my prapvty T.
wolf 10❑Building addition
ennae rfnr atl cwetrsixoes tit5.r hers wntloses' itmraoee or are unto 11-0 Electrical repairs or additions
praptiewc$with oo employees.
S�I am,gems!contractor and t have lived the12.❑Pi utnbing repairs or additions
Thesehave sub-contractors listed on the almched sheet
employes and have workers'comp.insurance: 13.❑Roof repairs
6.0 We are a corporation and its officers hove eaetristd tun right of exemption per Mort ¢ lit.❑Other
152,f 1(4),andwv leave no employees.Po meters comp.eatitraaeY required]
1
!Any applicant that cheeks boat.,most dao 5H ow the section below showing their workers'compensation policy information y�,�;�,�;��t Homrowness who submit this affidavit indicating they are doing all wort and then hire outside contractors mist st�pit a new affidavit hsdicatin8 such 1Con*ractoss that check this box must ameba'in atidthroal sheet showing aia name of the tub-contractors and stele whether or not those entities have
cmpioyea. If the ootY hart employees s[,they nut . ids thou melon'comp.policy,number.
I am an employer that fs providing workers'compensation ttsarance for wry employees Below it the policy amf job she
information
Insurance Company Name: h p,,,
Policy#or Self-ins. Lie.#: 'CC oo-- 12 4 20 Expiration�:� � V11�
Job Site Address: City/State/Zip:
Attach a copy of the workers'compensation polity declaration page(showing the policy member and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable bye 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 S2S0.00 a
day against the violator.A copy of this forwarded to the Office of Investigations of the D1A for insurance
coverage verification.
I do hereby eery w the a/perjury ekes the itrjonnosion provided
d ma
above is&see d correct ^
Dare. 7 1(a r f,1
Phone#: co 3' --- /3 0 -4
Official rue only. Do nos'write its this mrevs,to be cv rplrred by cloy or novas qv-trial
City or Town: Permit/License# _
fanning Authority(circle one):
1. Board of Health 2.Building Department 3. City/Toi n Clerk 4. Electrical Inspector 5. Piumbiog Inspector
t;.Other_
Co[ u1ttePerson: Phone#: i
NOTE: This sketch was drawn for mortgage inspection
derstood purposesthatIfan only and is not to be recorded, or cons[rueu as a
Instrument survey,it should be further un instrument survey Is accomplished at a later
date we will not be responsible for any changes that occur.This mortgage inspection is based upon
technical standards as adopted by the Massachusetts Association of Land Surveyors and Civil Engineers Inc.
LOT 2
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CERTt F r1=Tj \
To FcEMri,1G � LANGLOI S
MORTGAGE INSPECTION SKETCH
OF PROPi�RT1
owned by i at
r Count
: 11 - Y.M
Book ScaleNo Page No ?ate.ate — —
L.C.Cert.No._t Zy
In m --�
y professional opinion the building and � �'�
lot lines shown on this plan are approximately
located on the r FZOBE
they have °onfolm ground as shown hereon and that µ
Laws of the ��° ofe diAensional Zoning
at the time of nstruction. Y kMo uTN i 7Na•3433
On this date \V4:41,Vrethat to the best of my know) certity
as shown does not fall �y �the belief the parcel :UR'
shown on the FEMA/F1A National Flood Flood Plain as
Program Maps dated lnsurar Co 4MU 1
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PLOT PLAN
FOR LOT i
Indicate location of garage or accessory building
Additions with dashed lines ------Sew age dispose/ (cesspool) 69
»
I
ft. rear)
Abutters ( Abutters
Name i Name
Lot* Lot
If this is a REAR YARD If this is a
corner lot corner lot,
write in ft. write in
name of street name of street.
t
SIDE YARD SIDE YARD
HOUSE
a-----Igo
•
•
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SET RACE
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(lot ft. frontage)
i Jo? I h(L�iL L u .
INANE OF STREET)
/ Ihfsmatiott
/ Supplied by
Commonwealth of Massachusetts
Division of Occupational Licensure Construction Supervisor 1&2 Family
�.
Board of Building Regulations and Standards
frn
Constructic uperVis 1 & 2 Family, _
CSFA-073865 �; glcpires: 03/14/2028
JAMES R M( RATN ,,
204 CRANVI RD ..I sb'
BREWSTER 0 1 2
?c', O 1:
-UI.Lddii>> Failure to possess a cannot edition of the Massachusetts State
Commissioner Building Code is cause for revocation of this license.
_ DEL/ :„ Contact OPSI:(617)727-3200 or visit www.mass.govldpllopsi
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washingtoj$tr -Suite 710
BostonL4Aaseadausetts-02118
Home ImQrOver ftt. oi`_ egisiration
5Pp
Mr t^"="i i �i..
.•!". Twig Corporation
MCGRATH POST a BEAM CORPORATION 0,+'f �• �' ,, low/5
D/BJA PINE HARBOR MMDOD PROD. ;:5 ^-�_�� 10AQ/m26
259 QUEEN ANNE RD. 4".--;•. .• r-1
HARWICH.MA 02645 '
Upda4 Address and Ronan Cana.
TNc COMMONWEAITN OF FAASSACNOSTTS
trill**of Gamesome-Palma&Busaanoa Regulation Registration valk for
HOW Il P110yE�r, bldmom usa only Won rho
TTIE:e4riAtiOrI ACTOR s�os al two./i mom to-
OMloa d Consumer A RagulaHon
lEa00 �o
: w a -Iwo 710
t3?935 -' �pyp�4026 g Horton,
on,WA a
MCGRATH POST A BEAM CORPORAT ON
:::: '
out
259 OUEEN ANNE RO. ]aaro F .�!ilt �nHARWICH,MA 02645 �
E;
ii-v‘ 0111v(- 1) . L)\;;442
tel.(508)362-4541
939 main street rt 6a
yarmouth port
1‘1
mass 02675
down cape engineering, Inc
land court civil engineers&land surveyors Daniel A.
• R.G G.Ojala onsalves P.E.,PP.E.RLA.L.S.,S.E.
surveys
structural design Riellyp
• H.OJ. jFerala aru{ayri P.E.,P.L.S.
,Daniel• igra , S.E.ellyp T.Tonial,E.I.T.,S.E.
,
site planning September 10, 2026
sewage system Elizabeth Burke
designs
6 Hilda Street
Quincy, MA 02169
inspections Re: 12 Thrush Trail, Yarmouth Port
permits Dear Elizabeth,
As requested, below is an estimate for surveying services associated with the preparation of a
plot plan for a proposed shed.
The following work is expected:
Phase I
• Research for plans and deeds of record
• Instrument topographic/control survey, location of relevant significant site features
• Computations/analysis of survey data
• Prepare existing conditions base site plan for your planning/design
hase I: $1295.00 Q caeo -76 cbD
Existing septic system would be shown based on the as-built plan assumed on file at the Health
Department; the quote does not include subsurface confirmation of location and/or suitability of
the system components for any proposed work. We are assuming that NO septic system design
work/modifications will be required.
Phase II
• Revise base site plan to show proposed shed
• Prints for permitting
Phase I1 is hourly; approximately 2- 3 hrs expected at$185.00/hour
(depending on scope/extent of construction)
Burke Page 1 of 2
w
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r �v
II
{'r
•
Phase Ill
• Shed As-built Certification (field location/plot plan)
• Prints as required/requested
Phase IV: $850.00
Additional work requested/required beyond that listed above, such as but not limited to plan
revisions requested by client or town,construction and/or property line stakings, additional
certifications, etc. would be billed hourly at$185.00/hour. Pricing honored for 90 days.
This proposal is not contingent on the findings of any board or agency.
The deliverable products of this work are the project paper plans, forms and data submitted to
the owner and public agencies. Down Cape Engineering reserves exclusive rights to all other
materials accumulated or produced during prosecution of the project work. All plans and data
submitted are for the exclusive use of this single project, and are not to be used for any other
project or purpose without further compensation and the express written consent of Down Cape
Engineering, Inc.
If you would like to proceed, please sign below and return along with a retainer payment of
$900.00 to authorize work. Balance due upon completion of each phase. Invoices due within 30
days. Don't hesitate to contact us with any questions.
Very truly yours,
Daniel A. Ojala, PE, PLS
President
DAO/sbo
944 Zb?6,
Acknowledged a a d signatur Date
ELIZABETH A BURKE 11-84 53-8529/2113 1378
6 HILDA ST, 9/7/476/-
PAYQJINCY,MA 02169 DATE
TO 1J CLD 086Z/ I $
THE ORDF 0
bode ftwidrec' ico 8
DOLLARS �---
ujacy Union
QUIN AC2,l9 Burke Page 2 of 2
MEMO f / C'� J IP
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