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HomeMy WebLinkAboutBuilding Permits BackfileAPPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 lislnli (PLEASE PRINT IN INK OR TYPE To the Inspector of Wires: By this al work described below. Location (Street & Nu Owner or Tenant (OFFICE USE ONLY) (Rev. 9/05) BY Fee: $ 7y ` �] 2 2 4.:ZOQ] PERMIT NO. �% /, J Date: / -29,e O �tIIdetSigaed4ves notice of his or her intention to perform the electrical %ems . - /�esvlctr��s LSNTelenhnneNn Owner's Address v �= Is this permit in conjunction with a building permit? N�Yes Q No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts OverheadQ Undgrd 0 No. of Meters New Service Number of Feeders and Amps / Volts Overheadc] Undgrd C3 No. of Meters Location and Nature of Proposed electrical Work: Completion ofthe followine table may be waived by the Inspector of Wires No. of Recessed Luminaires No. of Ceil.-Sus . Paddle Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above In- Swimming Pool gmd. gmd. No. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection an Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat mp Totals: um er — — Tons — — K — — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW P g Local Municipal Connection Other No. of Dryers Heating Appliances KW cur $eNo. of Devices or Equivalent j No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hng: dromassa a Bathtubs Y g No. of Motors Total HP Telecommunications Wiri No. of Devices or uivalent Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND OTHER (Specify:) (Expiration Date) Estimated Value of lec ' al Work: (When required by municipal policy.) Work to Start: �J Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under e p ' s and FIRM NAME: Licensee: 2SoZ, ��c„�1�Y Sigm (If applicable, enter "exempt" in the lice- senumber .) AddrPcc• /� � �Ten7 n gn this application is true and complete. / LIC. NO. LIC. NO. Bus. -TeTNo.: _ 279 Y .QS-9 Alt. Tel. No.: 72 *Security System Contractor License required for this work; if applicable, enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) owner ❑ owner's agent. Q Owner/Agent Signature Telephone DEPARTMENT OF PUBLIC SAFETY S - LICENSE Numbei,,SS CO 000046 Birthdatg01l0511955 i.. xpires2�1l05/2609 Tr. no: 127.0 S-E c`ote;�-SEASJDE ALARMS INC _ ROBERT K BOUGH ER' L j 1255 ROUTE 28 ���� S YARMOUTH, X6 Commissioner y APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 (OFFICE USE ONLY) (Rev. 9/05) I (PLEASi To the Ir work de,, Location Owner o Owner's Is this pc Purpose Existing New Service Amps / Volts Overheadc] Undgrd CJ Number of Feeders and Ampacity. Location and Nat= of Work: No. of Meters d�� .. f- mnv ho wmvod by thn /n cnortnr No. of Recessed Luminaires No. of Ceil.-Sus . Paddle Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Abovet--� n- SwimmingPool grind, LJ tnd. No. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No, of Switches No. of Gas Burners No. o Detection an Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: um er — — Tons _I — K K — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Local Connection Other No. of Dryers Heating Appliances KW $ecurNo.tof Devices or Equivalent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wirin : No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or uivalent Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by a owner, no permit for the performance of electrical work may be issued unless the licensee provides 1 proof of liability insurance including "comp] ed operation" coverage or its substantial equivalent. a un ersi tied certifies that su7;Plo n �Y force, and has exhibited proof of same to a permit issuing office. n CHECK ONE: INSURANCE BOND OTHER (Specify:) L� ��l'I O yt (Expiration Dat9 Estimated Value of Electrical Work: V (When required by municipal policy.) Work to Start: o % Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the p i and pe hies of 1 jury, at the information on this ap lication is true and complete. ,lJ -� FIRM NAME: � cJ �i�? P��/ Q IC. NO. P7` Licensee:_ (If applicable Addresses IC. NO. Bus. Tel. No.: /. p T Alt. Tel. No.: tj *Security System Contractor License required for this work; if applicablVenter the license number here: --i OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature nQ below, I hereby waive this requirement. I am the (check one) owner Q owner's agent. Q �Y> Owner/Agent Signature Telephone IS a I, oF r TOWN OFYARMOUTH Building Department BUILDING 61 - (508) 398-2231 ext.2 PERMIT NO �: FB07.612_ � -_ -_ - - - PERMIT ., ISSUE DATE : _ 11/6/20QQ _ ; PROPOSED US r - - - - - - ' JOB WEATHER CARD APPLICANT Richard Desmarais PERMIT TO Alterations ' AT (LOCATION) 100010CRESCENT CT ZONING DISTRICT R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK LOT SIZE .69 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 remove ebsbng roof to construct 2nd floor for two bedrooms and full bath, repave partitions on 1st floor to REMARKS construct stairway to new 2nd floor as per plans dated 10/30/06. AREA (SO FT) EST COST ($ $100,000.00 PERMIT FEE ($) $325.00 OWNER IJOSEPH T JURGENSEN BUILDING DEPT BY ADDRESS 100010 CRESCENT CT South Yarmouth I MA 102664 INSPECTION RECORD CONTRACTOR LICENSE 049883 Desmarais, Richard 115 Old Townhouse Road South Yarmouth MA 02664 5083940052 PHONE 16083946587 FIELD COPY 5. 1 Note ProgressMAE - i oV'YgR,� ONE & TWO FAMILY ONLY - BUILDING PERMIT $ APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING 0 - — C Town of Yarmouth Building Department CA „ATTMC„EES 3 1146 Route 28 • Yarmouth, MA 02664-4492 �,.,..... •* Tel: (508) 398-2231 x261 •Fax: (508) 398-0836 • Office Use Only Planning Board Information Assessors Department Information: Permit NoNn Date Plan Type Ma Cot Permit FeEndorsement Date Z 6 ii�� ecording Date New Deposit RDatjo n No. 1.4 Property Dimensions: Net Due $�� �iQ ther Lot Area (sf) Frontage (ft) Lot Coverage This Section for Office Use Only Buildinq PerTim e . I Date Issued: Signature: �'Q . ?�- oeg- Certificate of Occupancy is is not required Building Official Date Section 1 - Site Information I Use Group: R-4 Type: 5-B 1.1 Property Address: 1.2 Zoning Information: Zoning District Proposed Use S 1.3 Building Setbacks (ft) Front Yard I Side Yards Rear Yard Required Provided Required Provided ui0 0 Tr(Rid 1.4 Water Supply (M.G.L c. 40. S 54) Public Private 1.5 Flood Zon Zone: Information: r Com BFE: 16 s: NOV 0 s 2006 Section 2 - Property Ownership/Authorized Agent -19 2.1 Owner of R cord: w Name (print) Mailing Address ,�a7`G� rr,•• Signature � Telephone 5 3 A6 T 2.2 Authfrrized AjG�f- OCrrlA l 4j57 Use, Zit:�, a W4 s D sL Name(prin MailingAddre ? �\01 Si nature Telephone -Fax `�- . ^�o Section 3 - Construction Services 3.1 Licensed Construction Supervisor: \\� %� \\� �. v"� Applicable ❑ 7� /1Q1cC QGCl �� (fVS /�C \\ .Sow a P m 6lFn i License Number Address Expiration Date Stignat e ' Telephone621y 3.2 Registered Home Improvement Contractor: Company Na a G Not Applicable ❑ Ad'dres/s�/S ?(�J(ULVGjv(�kv �( SrClj 6y�0U n,11� fN' �O/1s 1Lt vrC� S W b 3 Q2� —DOS-2 Signature Telephone LicenseN�be Expiration Date ,-3 Q —QEyn 1 of 2 OVER Section 4 - Workers' Compensation Insurance Affidavit (M.G.L."c. 152 S 259 (6)' Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial o issuance of the building permit. Signed Affidavit Attached Yes .......... No .......... Section 5 - Description of Proposed Work (check all applicable) New Construction ❑ No. of Bedrooms --� No. of Bathrooms Existing Bldg. ❑ Repair(s) ❑ Alterations ❑ Addition Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: FAYF/G•S 7� /qpm 0 LJ e D yv 1,rs/2e,l O GcJ 1Lv ) d A1,4C4/ Costs' Section 6 - Estimated Construction Item Estimated Cost (Dollars) to be Check Below Conservation -Commission Filing (if applicable) Old Kings Highway & Historical Commission approval (if applicable) completed by permit applicant 1. Building 2. Electrical ? 3. Plumbing / Gas , OU 4. Mechanical (HVAC) (� , o 5. Fire Protection vi 6. Total = (1 + 2 + 3 + 4 + 5) 7. Total Square Ft. (new houses & addRions) 3 Section 7a = Owner Authorization'- To be Completed When Owner's Wnt or Contr `tor Applies for Building Permit I, as owner of the subject property hereby authorize 7YC 2f"C s Q'GC/�S liie� C. ,' to act on my behalf, in all matters relative to work authorized by this building permit application. Signature o ner Date Section7b - Owner/Authorized Agent Declaration I, �tC"'/C l� �- �� fiGL.�S' as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print name 06 ign ure of Owner/Agent Date 9-15-99 2 of 2 a oF..ygR� �yZ®0 PLEASE PRINT: TOWN OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM Job Location: l t/ Number Owner of Property: Construction Supervisor: Address: Licensed Designee: (If other than Supervisor) i�' <9 c7,il % Name 2.15 Responsibility of each license holder: -1"- 0����� 1^ License No. ?Z Village (/ Phone No. License No. 2.15.1 The license holder shall be fully and completely responsible for all work for which he is supervising. He shall be responsible for seeing that all work is done pursuant to the state building code and the drawings as approved by the building official. - 2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of building and structures only pursuant to the state building code and all other applicable laws of the commonwealth, even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any violations which are covered by the building permit. 2.15.4 Any licensee who shall willfullyviolate subsections 2.15.1, 2.15.2 or 2.15.3 or any other section of these rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of license by the board. 2.16 All -building. permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. - I . I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance withsection109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building official. INSURANCE COVERAGE: I have a current liabi ' nsurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by C apter 1 of t Mass. General Laws, and that my signature on this permit application waives this requirement. 1yJA Check one: Signature of Owner or Owner's Agent l Owner ❑ Agent Signature: Building Official Approval: For Office Use Only Permit No. Date TOWN OF YARMOUTH AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142A requires that the `reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition or construction of an addition to any pre-existing owner -occupied building containing at least one but not more than four dwelling units or structures which are adjacent to such residence or building' be done by registered contractors, with certain exceptions, along with other requirements. Type of Work: C (, (.0 tt l RlXI/ Est. Cost ^//TO r d Address of Work AD Owner Name: e Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under $1,000 Building not owner occupied Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. Signed under penalties of perjury: I hereby apply for ;apermit 7:7 as the nt of the owner: /n q� 4 / [/,�[/ Date ontractor Name Registration No. A Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name The Commonwealth ofMassaehusetts Department of Industrial Accidents _ Office of Investigations 600 Washington Street Boston, MA 02111 www mass.gov/dia Workers'.Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / 77 Please Print/Legibly Name (Business/Organization/Individual): �j( 4t/(� �(Q�/Y1 /LG`Q�S f�(/��L�`' l—� L •C Address: Cif , /T � � Phone # 59 J/ (;e Are yo n employer? Check the appropriate box: 03 I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time)." have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. t ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t These sub -contractors have workers' comp. insurance. 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New constmction 7. Epta odeling . El ui '. m dingg a addition 10. E!5eofical repairs or additions 11. lum ' repairs or additions 12. oof repairs 13.❑ Other Any applicant that checks box # t must also fill out the section below showing then 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 their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Policy # or Self -ins. Lic. Job Site Address:D Cr45 064-�- Expiration Date: Attach a copy of the workers' compensation policy declaration page (showing the policy number and 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 certif -agder ti;e p5bMiand penalties of perjury that the information provided above is true and correct: 5,�2 Ofeial use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License #_ Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the Issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall _ enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self -insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple pemtitllicense applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia BUILDING TOWN OF Y A R M O U T H ELECTRICAL GAS 1146ROUTE28 SOUTHYARMOUTH MASSACHUSETTS02664-4451 Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 PLUMBING SIGNS BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the idebris resulting /from ythe proposed work/demolition to be conducted ate%lV ��°Sl ��i T amz _/ Work Address is to be disposed of at the following location: Seem 8-C,�"ZC , Vern, R33 - 6:�(0o Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. VONNz I/ i/. �I. Applicant Permit No. —149 —0 Date . YARMOUTH FIRE & RESCUE Commercial Building Permit Sign Off Project Name Jurgensen Address 10 Crescent Court Contact Name Richard Desmarais Tel. No. 508-394-0052 YES NO NA Subject Regulation Access for Fire Apparatus 527 CMR 25.02 x Building Numbers MGL Chapter 148 sec 59 Flammable gas/liquid storage 527 CMR 14.03 Fire Lanes 527 CMR 10.03(10) Service Stations 527 CMR 5 & 9 Hazardous Materials Storage 527 CMR 25.08 Kitchen Exhaust Systems 780 CMR, 527 CMR 10.03(8) _Extinguishers -527_CMR_1.0.02, Chapter_148-sec 28 x Fire Alarm Systems/CO detection 780 CMR, Chapter 148, 527 CMR 24,CMR 31 LPG Storage Chapter 148 sec 9,10,28 & 527 CMR 6 Pesticide Storage 527 CMR 37 Sprinkler Systems 780 CMR & Chapter 148 sec 26 A -I _ _Storage inside/outside Buildings 527 CMR 10.03(5) Upholstery 527 CMR 29 Trash Containers 527 CMR 10.04 & 34 Any Hazard to the Public Chapter 148 sec 28 Curtains, Draperies, Blinds 527 CMR 21 ----Plan'ReviewedBy.` Capt o ertKellher- ---Date:-16 g - -- Copy for Applicant 0 Copy to Building Department llSJ Copy to Fire Prevention TOWN OF YARMOUTH WATER DEPARTMENT 99 Buck Island Road West Yarmouth, MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET Bldg. Site Location: C%"1°�se pe6/ �C i�%Map #_ Lot #: os Proposed Improvement: j,'?PA(11) 0b4-L S / Applicant,//' �/� /� o s �� �-�if �lii /�� G, e-- Address: Tel. #:'�� 5� ZV5',2—Date Filed: �7 ,e-6' RESIDENTIAL AND / OR COMMERCIAL BUILDING Water Department: Determines Compliance of Water Availability and or Existing Location. Engineering Department: Determines Compliance for Parking and Drainage Conservation Commission Determines Compliance to Wetlands Acts; i.e. If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Ocean, Bogs, Bays, Marshland, Etc... Health Department Determines Compliance to Stat and town Regulations' i.e., Requirements for Septage Disposal and other Public Health Activities. Fire Department: Detern)Jes Compliance to State and Town Requirements for Personal Safety/, Property Protection; i.e. Smoke Detectors, Sprinkler Systems, Etc... REVIEWED BY WATER DIVI N: signature date PLEASE NOTE: COMMENTS: bF.Y�Ro TOWN OF YARMOUTH {oA y HEALTH DEPARTMENT • MATTA M [f PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant. Building Site Location:�eepo!,2 CGUj,- Map No. Lot No.:!F!�f Proposed Improvement: ]1 P I PC Applicant: -s L &24, f Tel. No.: Address: N **Ifyou would like e-mail notification of sign off, please provide e-mail address: Owner Name: Filed: /d "l% 06 Owner Address:1D CG'e,5 Cc°I 7L a�2 dY 7' Owner Tel. No.: -3 - ' W RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Please submit four (4) copies of plans, to include: (1.) Site Plan showing existing buildings, water line location, and septic system location; (2.) Floor plan labeling ALL rooms within building (all existing and proposed) — Note. Floor plans not required for decks, sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY: L DATE: 10117,b- PLEASE NOTE COMMENTS/CONDITIONS: , C+c�n� �Xvy. C.ASe c � 7aw.,. �� C 1�-e�✓owe w�c �.� S 7w �� 6CjAVcr jYc1 rrl TOWN OF YARMOUTH Building Department _ Town Hall e Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-07-184 Applicant Name: Richard Desmarais Applicant Phone: 5083940052 Building Location: 00010 CRESCENT CT Owner's Name: JOSEPH T JURGENSEN Owner's Addres 00010 CRESCENT CT South Yarmouth MA 02664 ' Owner's Telephone: (508) 394-6587 REVIEWED B 1. WAI 2. ENGI 3. CONS \d 4. HEALI 5. BUILDI 6. FIRE DEPARTMENT: PLEASE NOTE COMMENTS: ,„ _ (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $25.00 Payment Type: Cash ChkNo.: 0 Net Owed: ($25.00) Application Date: 10/18/2006 Issue Date: Expiration Date Comments: Map/Lot: 034.269 remove existing roof to construct 2nd floor for two bedrooms and full bath, remove partitions on 1st floor to construct stairway to new 2nd floor ZONING /` MPROVED ice_ l�.�y/e.) <: � DATE: DATE: DATE: DATE: DATE: DATE: N/A: N/A: N/A: N/A: N/A: N/A: RECEIPT OF COPY: SIGNATURE OF APPLICANT: \ DATE: �?y9, /0 �s �o Date Printed: 10/23/2006 c r Richard Desmarais Builder 115 Old Town House Rd. South Yarmouth MA, 02664 MA Lic. # 049883 Phone: 508-394-0052 Fax: 508-760-1264 Memo TO. Yarmouth Building Department From Richard Desmarais cc: Date: November 12.006. R . 10 Crescent Court Construction Cost of Project: $ 91,000.00 1. Demolition: $ 8,000.00 2. Framing: $ 25,000.00 3. Electric: $12,000.00 4. Plumbing: $15,000.00 5. Heating: $10,000.00 6. Interior Finish: $16,000.00 7. Interior and Exterior Painting: $ 5,000.00 0 Page 1 Total: $ 91,000.00 D E C E I y E Nov 0,12006 BUILDING DEPT. ltv-o-- e��q-4-70, JURGENSEN BARBARA L TRS 8121 DISTRICT RESIDENTIAL OPEN SPACE COMMERCIAL INDUSTRIAL .TOTAL VALUATION REAL ESTATE TAX DUE BY NOV.16,2006 1st PAYMENT DUE BY - MAY 01,2007 2nd PAYMENT 5.89 5.89 5. 89 5.69 I 546,000 3, 312.92 PROPERTY DESCRIPTION REAL ESTATE VALUES DESC. — cuss — VALUATION RES. /CDMM. �EXFMPTION DESCRIPTION Class Code 101 ACRE 128 Map 0. 26 Lot 9. 6 Deed `Book .,. .. D109 �Deed Page. 177 Deed Date 08/07/2006 - LAND BLDG ,. 1 1 .. 336,, 90. 209,10 TAX CPA TAX TOTAL DUE AMOUNT NOW DUE 1,607.97I 48.24 ----------- 1,656.21 1,656.21 1, 607.97 48.24I ----------- 1,656.21I __— TOTAL TAXABLE VALUATION •546,000 — '— ToTA% ASSESSMENTS — SP AL A$S-ES�NTS TOTAL TAX AND ASSESSMENTS 3,312.42 PROPERTY LOCATION 10 CRESCENT CT Ba;ad on assessments as of January 1,2UU6 your Real Estate Tax for the tlscal year Deglnning July 1, [uuo ana enuing June ov, <vur on the parcel of real estate is described above. SCHOLARSHIP FUND Dear Neighbor. Your contributions over the last 10 years have raised over $200,000.00 to assist 265 Yarmouth students with their college expenses. On behalf of those students, thank you for your generosity. We ask that you consider contributing to this year's Yarmouth Scholarship Fund by indicating the amount of your contribution in the space provided below and returning the middle portion of this tax bill to the Collector's Office Scholarship Committee. VOLUNTARY CONTRIBUTION $2.00 $5.00 _$10.00 _$Other Please indicate the appropriate amount and enclose a SEPARATE check to the Town of Yarmouth. PAY ON-LINE a WWW.YARMOUTH.MA.US ABATEMENT APPLICATIONS ARE DUE IN THE OFFICE HOURS: ASSESSOR'S OFFICE BY NOV. 16, 2006. �MONDAY - FRIDAY 8:30 AM - 1:30 PM COLLECTORS 508-398-2231 EXT. 233 ASSESSORS 508-398-2231 EXT. 222 VISIT OUR WEB SITE AT yarmouth.ma.us SHIRLEY A. SPRAGUE, TOWN COLLECTOR Interest at the rate of 14% per annum will accrue on overdue payments from the bill issue date until the payment is made. s 034. 269OLLECTOR'S COPY -RETURN WITH YOUR PAYMENT BY: 1111612006 E YARMOUTH /COLLECTOR1150RMOUTH, MA 02664NG SERVICE REQUESTED 11I1612006 8121 1,656.21 If your address has changed, correct it below. - - - - Please indicate amount enclosed. Do not send cash. _ _ Make check or money order payable to: ******MIXED AADC 015 15161 JURGENSEN BARBARA L TRS TOWN YARMOUT OFFICE, OF THE TOWN COLLECTOR BARBARA L JURGENSEN LIVING TRUST P.O. BOX 1150 H�I;S>i-DZNE �m P.D.,8ox a-�3 SOUTH YARMOUTH, MA 02664-7150 zMed A1+ II IIII II 11111 IIIIIIIIIII1I/III1IIII I11111 F1111II1111111111I111 O ;46�v IIIIII IIIIII III III IIIIIIIIII IIIII111111II II 1111111 I 11111111111 (:DOCRESCENT CT *01070018121------ 000165621* This form aooroved by the Commissioner of Revenue. (c 2WA Municinal Mnnanament Assnciatas Inc All RInMc RPCPrvPA Property Location: 10 CRESCENT CT MAP ID: 34/ 269/ / / ether m: 7,9/ znnv / / Bide A 1 Card 1 of 1 Print Date: 10/27/200611:33 V �✓ " ' CURRENT OWNER RGENSEN, JOSEPH T GENSEN, BARBARA B II L &DALE COUNTRY CLUB 9 PINE TRAIL ARMEL, NY 10512 UTILITIES el as STRTJROAD aved LOCATION uburban CURRENT Description Code ASSESSMENT A raised Value Assessed Value 815 YARMOUTH, MA TTOPO. blic Wate: Peptic LAND IDNTL IDNTL 1010 1010 1010 281,000 192,000 800 281,000 192,000 800 SUPPLEMENTAL DATA Account # 053M00 Subdivision 180 Photo Ward VISION LAN NUMBER 474B IS ID: 4919 Tatall 473,800 473,800 RECORD OF OWNERSHIP URGENSEN, JOSEPH T JURGENSEN, JOSEPH T BK-VOUPAGE 541543 SALE DATE 12/27/1991 12/27/1991 qla Q v/i SALE I I PRICE 175,000 .C. 1N Yr. I Code PREVIOUS I Assessed Value Yr. ASSESSMENTS Code (HIS Assessed Value Yr. 1) Code I Assessed Value 2006 2006 1010 1010 281,000 192,000 2006 2006 1010 1010 222,200 181,200 Z005 2005 1010 1010 222,200 181,200 2006 1010 800 Total. 473 00 Total: 403 400 Total: 403 00 EXEMPTIONS OTHER ASSESSMENTS This signature acknowledges a visit by a Data Collector or Assessor Year I TypelDescription Amount Code Description Number Amount Comm, Int. APPRAISED VALUE SUMMARY Appraised Bldg. Value (Card) Appraised XF (B) Value (Bldg) Appraised OB (L) Value (Bldg) Appraised Land Value (Bldg) Special Land Value 190,200 180000 281,000 Total: NOTES NATURAL ING POND VIEW Total Appraised Card Value 473,800 Total Appraised Parcel Value 473,800 Valuation Method: Cost/Market Valuation et Total Appraised Parcel Value 473,800 BUILDING PERMIT RECORD VISIT/CHANGE HISTORY Permit ID 06-302 02-761 998104 Issue Date 9/1l2005 3/12/2002 2/24/1994 Tvve AC RS Description ccessory Stru esidential Amount 2,500 60,000 5,000 Insp. Date V10/2003 6/15/1995 % Conw. 100 100 Date Comp. BX12 1/1/2003 REMODEL 1/1/1995 DECK Comments SHED KITCHEN, Date 11/30/2005 1LI5/2003 4/10/2003 6/15/1995 ID I Cd. GM JB GM RD 00 02 01 01 Pu ose/Result easur+Listed easun r+2Visit - Info Ca easur+lVisit easur+lVisit LAND LINE VALUATION SECTION B# I 1 1 Use Code 1010 1010 I Description SINGLE FAM SINGLE FAM Zone D [Frontagel [Frontage Depth Units 40,000.00 036 SF AC Unit Price 3A3 15,000.00 I L Factor 1.85 ISS S.I. I 7 7 C. Factor 1.10 0.10 Nbad. 0070 0070 Ad'. I 1.00 1.00 rOPO Notes- Ad 1S ecial Pricing Ad. Unit Price 7•00 2,850.00 Land Value 280,000 1,000 Total Card land Units 128 AC Parcel Total La—Area:j 1.28 ACI Total Land Valu 281,000 Property Location: 10 CRESCENT CT Vision ID: 4919 co Element Cd Ch Descrip & AC MAP ID: 34/ 269/ / / Other ID: 29/ Z001/ / / itories I I Story 3ccupancy 01 CeilingfWall oom&TYms 3xterior Wall 14 Wood Shingle Common Wall 2 Wall Height Ioof Structure 03 able/Hip toof Cover 03 sph/F Gls/Cmp CONDO/MOBILE HOME DATA Interior Wall 1 05 all/Sheet Element Code Oescription Factor 2 Interior Floor 1 2 ardwood omplex Floor Ad ' 2 4 t Location nit cation Heating Fuel Heating Type 3 5 as of Water um( of Units AC Type 1 one Number of Levels Ownership Bedrooms 3 Bedrooms COST/MARKET VALUATION Bathrooms Bathrooms nadj. Base Rate 105.00 Total Rooms Size Adj. Factor 0.98718 Bath Type 02 Modern Grade (Q) Index 1.06 Kitchen Style D3 uxorious Adj. Base Rate 109.87 Bldg. Value New 234,792 ear Built 1978 ff. Year Built 1983 mil Physcl Dep 19 uncnlObslnc on Obslnc jpecl. Cond. Cade pecl Cond %a 0 0 MIXED USE 1010 INGLE FAM 100 veran prec. Bldg Value 190 200 OB-OUTBUILDING & YARD ITEMS(L)I_XF-BUILDING EXTRA FEATURES(B) Code I Description UB I Units I Unit Price r. Cnd Apr. Value FPLl PIREPLACE 1 ST B 1 2,200.00 1983 1 100 1,800 EOS Foci Outs Shwr B 1 0.00 1983 1 100 0 SHDI FHED FRAME L 96 8.00 2005 0 100 800 BAS itst Floor CAN anopy SFB Lftse, Sen i-I URB p3asement, U WDK Deck. Wood A 1 Card 1 of 1 Print Date: 10/27/200611 REScheck Software Version 3.7.3 li Inspection Checklist C( Date: Oa/23106 Ceilings: ❑ Ceiling 1: Flat Ceiling or Scissor Truss, R-30.0 cavity insulation Comments: Above -Grade Walls: ❑ Wall 1: Wood Frame,16' o.c., R-13.0 cavity Insulation Comments: ❑ Band Joists (1 st fl): Wood Frame,16" o.c., R-13.0 cavity insulation Comments: Windows: ❑ Window 1: Vinyl Frame:Double Pane with Low-E, U-factor. 0.330 For windows without labeled U-factors, describe features: #Panes — Frame Type Thermal Break? — Yes _ No Comments: Floors: ❑ Floor 1: All -Wood Joistlfruss:Over Unconditioned Space, R-19.0 cavity insulation Comments: Heating and Cooling Equipment: ❑ Boiler 1: Gas-Flred Steam: 90 AFUE or higher Make and Model Number. Air Leakage: ❑ Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. ❑ When installed In the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the Inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, In accordance with Standard ASTM E 283, with no more than 2.0 dm (0.944 Us) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 Ibs/112 pressure difference and shall be labeled. Vapor Retarder. ❑ Required on the wamhaniMnter side of all non -vented framed ceilings, wails, and floors. Materials Identification: ❑ Materials and equipment must be identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. ❑ Insulation R-values, glazing Udactors, and heating equipment efficiency must be dearly marked on the building plans or specifications. Duct Insulation: ❑ Duds shall be insulated per Table J4.4.7.1. Duct Construction: ❑ All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to Richard Desmarais Builder Page 2 of the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. ❑ The HVAC system must provide a means for balancing air and water systems. Temperature Controls: ❑ Thermostats are required for each separate WAC system. A manual or automatic means to partially restrict or shut off the heating and/or coding Input to each zone or floor shall be provided. Heating and Cooling Equipment Sizing: ❑ Rated output capacity of the heatingr000ling system Is not greater than 125% of the design load as specified in Sections 780CMR 1310 and AA Circulating Hot Water Systems: ❑ Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: ❑ All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from nondepletable sources. Pod pumps require a time clock. Heating and Cooling Piping Insulation: ❑ HVAC piping conveying fluids above 120 degrees F or chilled fluids below 55 degrees F must be insulated to the levels in Table 2. Richard Desmarais Builder Page 3 of 4 Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Non -Circulating Runouts Circulating Mains and Runouts Heated Water Temperature (*EL Up to P Up to 1.25' 1.5'to 2.0' Over 2' 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pip as Insulation Thickness in Inches by Pipe Sizes Fluid Temp. Piping System Types Range ff) 2' Runouts 1' and Less 125' to 2.0' 2.5' to 4' Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.0 1.0 1.5 1.5 2.0 Steam Condensate (for feed water) Any Cooling Systems Chilled Water, Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD: (Building Department Use Only) Richard Desmarais Builder Page 4 of 4 THE M FILE COPY Z 0 SGA 27 � •1A LO I' % 4.0 0 ` .29•15 tl� 1yl LOT G 'f; f{a' G1 ,A. LOT CRE•SC'6.N7a 200. 00 I N112.20 15 L = 22. 00' -Zk G3GC�GOMGD WOR �T C��yy��IIFO A 0 ALL TOWN OCT 1 7 2006 BAND R I b HEALTH DEPT. Y H WATER DEPT / T RES ZO>vE'• "R-Z5" Thie h10R'1•GAGE INSPECTION Bell) Useoonly f'1.h(1D ZONE -All" i0W?{: 5O_ REGISTRY U�'INER:-51111?4&LCIJ- s 5— — -- — — DEED REF --Ctf. Wla — -- —BUYER. J0 Ef 1L T._.e_1L1Rl ARA 8 lir.FOE glv— •— — DATE' -1z11%91 — — _ PLAN REF. -k C`3�Z6�1 _ — SCALE 1 = 50 1 HEREBY CERTIFY TO 2�Sfll1� l�.Ts;A.O SIIti_ N.G._ SHOWNON T1{IS FLAiI IS LOCATED Off THE HATHE 13UI VING �`�` 01 � YA\NEE SURVEY DAuI CONSLLTAN'1'S SHORN AND THAT ITS POSITION Dots CONFORMs �. TO THE ZONING LAW SETPACK REQUIREMENTS OF lilt'.VErnrHEW = 1e3 ROUTE 149 TON1l OF iArlAIOL'I1� __-•-- -AND MAT 140.32290 s uAit57o1 S MILLS. MA 029/ IT DOES ------ LIE W1711111 Tilt SPECIAL FL(Inl) HAZARD � "TF,I: 4211-0055 APEA 4� g}{OWN ON 711E }I U.U. MAP DATED.G.li�11Q__ �`J��CS11''s FAR: 420-5553 iu1' - - 250015 U '6 q vo �i �- _ - 1 HIS PLA 1i A i RO4 AN I tUufN 7-71 Ol'? ru r- 9Ci►itA L - --- SURVEY. Mot 70 01; USLD_[9I2_F&K�$ �.'�r��C=•ten S. �, 1iJ C�_r=SCE: r' Cr c�h r-t' ;d cc � li,� 4,-r�i �r ^s � tg►�D rZ�� o w� i XvSr/t �. I 911"tve-P 0 Row T<o.4 \, Z x JIC e � AA LoT / z\, �� ID y P iu4TE \ �R6�FNT ,d'wr CouR7 -ELLVATION OF TOP OF FOUNDATION ROAD GRAUP, st 8 .3' DICK MoNFAU A330C . 618 Main Street Went Yarmouth e j�klou . THOMAs E. l:i '.i.:Y CO. I AND SURVi'l :IRS 346 LONG POND DRIVE. SOUTH YARMOUTH, MASS. 02664 CERTIFIED PLOT PLAN LOCATioN ..YArIAouth, SCALE . ". 6Q.. DATe . VAY. 7, . 1973 PLAN REFERENCE .B@Sn6, Lot �f1 Ojl, Igrl4. Gmur:t. IAR ri�,©4 gpte..mb©r. 196.6..... . . 1�Orcflr ,GCr�,ineeriRES. G2>"R.. .. . I CERTIFY THAT THE... Z'Q(IN��1'iC�Pd$I�o�vr� ON - THIS PLAN IS LOCATED ON TM Cili UNI") AS SHOWN 1HEREOtJI -J I NQO"SQ28 F. •zt. Q -LOT SSA 27 �J) J .SC THE 1,07' CO UR7' 2U0. UO NQ2'29 I .L L = 22.00' LOT G -N EE@EDMEL 1NOR' §7 C FoFJA TO ALL T1AI BYLAWS AN RE ULATMS OCT 1 7 ZOOS /ADAT HEALTH DEPT. ARMO H WATER DEPT Rm� MORTGAGE INSPECTION fLnnn zoN& All" Benit__(f�e O"1T REGIS"TRY 01'1NER: _SN1R�F�L' r �•�s_s _ __ - - DEED REF 60710- - __ _UUYFR. JOSEFILT._,e-BARUABA A DATE- 101-01--0 - - - = PLAN REF. -k C`_-d�4- - - SC'ALE:1 = SU F'T. 1 HEREBY CERTIFY TO 1-YSIL'JU-FJ3:A v--Mv- _THAT THE BUILDING °` *, YANKEE SURVEY SHOWN on THIS FLAIL IS LOCATED Off TIIE GROUIID AS vAUL CONSULTANTS SHOWN AND THAT ITS PO°ITIQN VOF.S CONFORM A. TO TIIE ZONING LAW SETBACK REQUIREMEMS OF TIIF M THEW _ 14.1 ROUTE 149 TOMN OF LA AIOL'II� _-_--- -AND MAT 140.32M • UAM70KN UILLQ. MA 0204 IT DOES ------ LIE WITHM TIM SFECIAL FI.on1) IIAZARD � � T � � � TEI: 4211-0055 AREA A; SHOWN ON 71IE 11 U.U. VAF 11ATFD-G,�J11�IQ__ `f�� S 'S FAX: 420-5553 a .Io n � , 1 HIS rLA WADE A F RIMM AN ! IUUFN 7771 orr, cili r=hO'Dii7{r-vw, ! ------- SURv7Y_ 110T TO BE 11M FOR FENCE$_ LLS.. PJ jc� Pc, 5 t-- _� &;,bl�v vn 6r".�,zoo oe. D,�fir Al ox—S tw)- C'LoSE� 1 iD C roc ; 4. S/-Io n tzXfSrltiG- I 1 TAJE Poly • ! 1 Z7 ` `�� • •'� Its}, T.tA e 10 e 1VIVATF /9A .00 -ELEVATION OF TOP OF FOUNDATION - ROAD (}RAJA. t 8.3' DICK McNfiMLY A9�0C . 618 lS-in Street ',•least, Y_C.r`wautil, �'",.J.tJCJ . f"E ITIONLER �C:rr THOMA'i E. CO. I AND SUR'✓::1 .IRS 346 LONG POND DRIVE SOUTH YARMOUTH, MASS. 02664 CERTIFIED PLOT PLAN LOCATION ..YArU1QQth, SCALE ..1_ 60i. . OATS . V;,Y. 7, . 197.3 PLAN REFERENCE .Bfii21Q Lot . �f 1 O11 . . Ur)4. raurt. KPLA 1f33.92)@� ..... . Yi;kQ4 Eftttiembor. 2?., .196.6.. ... . I,Orce.r .E;n_gippprtng. Corp . .. . 1 CERTIFY THAT THE... Z''.OUYMITIONSH01'JN ON - THIS PLAN IS LOCATED ON THE* C-POUTIO AS SHOWN HI-REON, DATE `��/ ? i/��;; o ,�, ✓ ��i�`�; ,,, _Y OF r TOWN OF YARMOUTH Building Department BUILDING �+ _ - - - - _ - _ _ - (508) 398 2231 ext.261 PERMIT NO 8-06-302 _ s� --- ISSUE DATE ;_ _9/1/2005- . ; PROPOSED USE _ _ _ _ _ _ _ _ _ -_ PERMIT APPLICANT ,Pine Harbor Wood Pds. JOB WEATHER CARD _ _ _ _ _ _ ------------ PERMIT TO ;Accessory Structure; AT (LOCATION) ZONING DISTRIC R-25 Bldg. Type: Residential 100010CRESCENT CT SUBDIVISION MAP LOT BLOCK 1034 269 BUILDING IS TO BE• CONST TYPE 5-B USE GROUP R•3 LOT SIZE SHED 8 X 12 REMARKS AREA (SO FT) EST COST ($ $2,500.00 PERMIT FEE ($) OWNER IJOSEPH T JURGENSEN BUILDING DEPT BY ADDRESS 100010 CRESCENT CT SOUTH YARMOUTH I MA 102664 CONTRACTOR LICENSE 073865 a ,James ue n Anne Road 11 Hann MA 02645 5084302800 INSPECTION RECORD FIELD COPY C SHEDS LESS THAN 150 SO. FT. SHALL BE PLACED A MINIMUM OF 30 FEET FROM THE FRONT LOT LINE AND A MINIMUM OF 6 FEET FROM SIDES AND REAR LOT LINES. plank 0 Fes rlratit espisa 6 moetbe am lbaw"L EXPRESS BUILDING PERMIT APPLICATION TOWN OF YARMOU M Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 Fart. 261 /D 6'.e°CSC. T /+yt-,D /riDy CON51RUC1IONADDRE9S: C s ASSESSOR'S D*XX HrATION: : :3 q- Panrei: (off owN>�lt: J�A� ¢�B � �2C�SE,./ %� f v►c a.z3 S'�Y�no vr�-� w At OIL - �tiUlALr,56 TEA T--Vg— J°lRaMes" ❑ cammem at Pat Cast of Ca nk"m t -ZSbb Ilamehaprovematcr- trumA %3y93Sr c=*wfmswwv!swU%i CsS 07384S wahnan's Campe mboa h maooc (Cho* me) 0 I am the homeowner 0 Ism the sale pmprie i6 ba--ve//wo�dwes Campwsw iosnrmoe hneaa m camp" / I//I E-A 1 ektU Jy m E �EfSY_a • wader's Camp• Policyf LvC G %a % k d v WORK To IN ZZRFQWn o Ted (Fa. Retadest CaHaase Wedwo Dutotlm wood store sw. V s" 0 sidaw s of sgeaa O Rap6camat wbdowe # s_ J 0 Replec@med don Rse: A 0 "oe 0 of squaw i44. M t h 4 _ UM*gald&aalaee Oping ws ofozbft root vnw w , wd be d pnW afab Lecedm of Fece7Yy r 1", ' eadr Pew the edtemeob both codeiwd ae trw eed oared to gn bed fy 1peod ruwia bejsecaw fa OwIdodaMod ht mY Sls otnmiy llLG.L eh 26k sectim 1. ARAcmt'ssWmtwc Deter 9��Jpls� onaaesipdwv(or dhcboeet) Ddc Appr*YW e r v v nwe bnVt 0fikW (a dea0ne) ZMM District tQ -? I FLAwwd Datrit ❑ Ya 0/No Water Raoaee Ptcwu ❑ Ya Flood Plsin Zanc ❑ Ya Gob Wehin 100 a ofwdbnds: "a 0 No SEP 0 I 2005 C4)-•11 3MI SHEDS LESS THAN 150 SO. FT. SHALL M BE PLACED A MINIMUM OF 30 FEET FROM THE FRONT LOT LINE AND A PLOT PLAN MINIMUM OF 6 FEET FROM SIDES AND t REAR LOT LINES. butbor's ame ot # this is a =ner lot, sate in name street W FOR LOT # k9licate locatLon of garage or ,building Addittons with dashed jtM -------------------- Well go Sewerage disposal (cesspool) 40 SIDE YARD GAD G REAR YARD (lat....a UO C2�s 1/7- (NAME OF STREET) Information 0 SIDE YARD At Ns Loo if cc W. na b st, O�e eOWNnOWWea449 0/ '�'11XdWze& Board of BuildiNcalce, Regulations One Ashburton m 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Bitthdate: 03/14/1970 Number: CS 073865 1 Expires: 03/14/2006 Restricted To: 1G JAMES R MCGRATH 204 CRANVIEW RD BREWSTER, MA 02631 Tr. no. 19218 Keep top-r4 receipt andchanpe of• addrm notiftcation. Board of Buildin .Re lat4ons and Standards. One Ashburton Place Room 1301 kwn Boston. Massachusetts 0.2108 Home ImmovemeaCContractor Registration �-7_7. =_ _= Registratidn, 132935� :✓i ' _- (7r -Type: -Private-Corporation Expiration` 1013120D6 ,.ice•_-�:1. . . McGRATH POST & BEAM CO. :.r� _ zK`-,; �.. JAMES MCGRATH"., 259 QUEEN ANNE RD. HARWICH, MA 02645 Update Address and return card Mark reason for change rs-t o SOM-04/04-0Io1216 Address Renewal Employment Lost G Dee PODrvm0lucralGi o�./i�aaeuaiarel4 Board of Building Replatidas and Standards A LII HOME IMF ROVEMENT CONTRACTOR Rapistratlon--.t�2935 . E?�plfai�on 10412008 ' Piiy to Corporatlon !Dee . -:l •. ;__: McGRATH POST & BEAK O' JAMES MoGRATii'.. ti f•:. , 259 QUEEN ANNE RI): ��—,{y�c.✓ HARWICH, MA02645 Administrator License or registration valid for Individul use only before the expiration date. If found -return to: . Board of Bulldinj Regulations and Standards One Asbburton Place Rm 1301 Boston, Ma. 02108 Nd vend mNLwn� e:wwsb.w ----- ITT IT IF 1!3 � •' j� �� � � !` ,• �_ '! � _ ! I I � •�,u, 1. ,; i San w,/m=1zG �+ - yr ZxA, PAv r, s 24-pAc-- .� 4!r G'i fb 0.stS j 7 f�t_�.7cop p j•-W- tlt ED4P cr,n`t�C— _ I YA�r . I io a j OFFICE MEETING NOTES p ) ADDRESS: �(' �.a� C��z�—T DATE: Names of Attendees: c Zoning District: Z Flood Zone: Meeting Topic: _ ? 7 3 re r�T A 4C:F7- 14 407- 1?611Vice0 IL 4 47� 1mo4 .00 C ou R 7- 'ELEVATION OF TOP OF FOUNDATION ROAD GRAop, YL 8-3' DICK 1-1014FAU A330C 6113 ll,%ln Street ,eAt Yartuouth, TiONER: THONIA-i E. Vj I AND 34r LONCsloNo DnfYF SOUTH YARMOUTIJ, 6o4,,jS. CERTIFIED PLOT PLAN LOCATIO.64 . XArjnqLjth SCALC . .. 60.. ')AT[:. L"Y. 7s .,197.3 PLAN REFCnEr4CC .4�11TIS. )LqL./A I M-nTIFY THAT THE ON - THIS PLAN IS WCATF0 ON Til" U14o"Inin AS !mC)v-jtj jj- REON DATF e x", I.FG. Department of lndustrid Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www massgov/dia Workers' Compeusation Insurance Affidavit: Builders/Contractors/Eleplricp p 4ni .T ►b orih Name(8usiness/Orgmization/individual):, i 1 r • _ I1.r Are you an employer? Checkthe• appropriate box: 1. El I am a employer with 4. 0 I am a general contractor and I to ees (full and/or part-time). Have hired the sub -contractors y li red n the attached sheet. t 2. ❑ I am a sole proprietor or Partner- ship and have no employees working for me in. any capacity. (No workers' comp: insurance required.) 3. E I am a homeowner doing all work myself. (No workers' comp. insurance required.] t s o These sub -contractors have Workers' comp. insurance. ❑ We are a corporation and its officershave exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. Demolition 9. ❑ Building addition. 10.❑ Electrical repairs or additions 11.E Plumbing repairs or additions 12.❑ Roof repairs 13.El Oilier *Any applicant that checks box # 1 must also fill out the section below showing their workers' wmPensatiori policy infomation , t Homeowi irs wYho submit this affdavit uidicatmg-they-are doing all work and then hire outside contractors must submit a new affidavit indicating suck tcontractors thaf check this box must attached an additional sheet showing the name of the sabramtmctofs and their woikera' comp. policy information: I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. � n Insb,ranee Company Name:nm fzi034 r) m 'A e 19sa)cc l ;(' Expiration Date:: 0-7— Policy # or Self -ins. Lia #: c e ni S.,1a City/State/Zip: Job. Site Address: 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/qr one-year itriprisonmcnt, as well as civil penalties in the form of a STOP WORK ORDER anal a fine of up to $250.00 a day against the violator. Ee advised1hat a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c rti under the p pena o erj t at the information provided above is true and correct Si ature: Date: Phone #: O1Jteial use only. Do not write in this area, to be completed by city or town official. City or Town: permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person• Phone Properly Location 6 CRESCENT CT Vision M 4919 MAP ID: 34/ 269/ / / Other ID: 29/ Z001/ l 1 #: 1 Card 1 of I Print Date: 07/07/2004 1 Cc Element Cd. Ch. Descr,r Style/ Type P8 1 Fidud Ranch ies I Story ipancy riot Wall 1 4 0od Shingle 2 f Structure ble/Hip f Cover 3 ph/F Gis/O for Wall 1 rywaWSheet 2 rior Floor 1 2 ood 2 4 arW ting Fuel 3 ting Type of Water Type 1 one rooms Bedrooms :rooms Bathrooms al Rooms h Type ;hen Style OB-OUTBUILDING & YARD "ode I Descri lion FPLl �IREPLAC'E1ST B EOS PEncl Outs Shwr B Element & AC to Type Common Wall all Height loor Adj Jnit Location Vumber of Units Vumber of Levels Y. Ownership OST/MARKET VALUE Base Rate 105.00 j. Fads 0.98718 Q) Index 1.00 se Rate 103.65 alue New 221,5M uih 1978 [BaR ar Built 1983 hyscl pep 19 Maine bslnc ond. Codeond %l 0 0 % Cond. 81 . Bldg Value 179,400 (L) I XF-BUILDING EXTRA FEAT Unit Price I Yr. I D Rt I %Cn 1 2,200.00 1983 1 100 1 0.00 1983 1 100 1 1 BAS Irst Floor 1,464 1,464 1,464 103.65 151,744 CAN Canopy 0 32 6 19.43 622 SFB ale Semi -Finished 0 672 403 62.16 41,771 URB asement, Unfinished, Raised 0 720 216 31.10 22,389 WDK ,a ck, Wood 0 480 48 1037 4,975 Property Location 6 CRESCENT CT Vlrion ID: 4919 MAPID. 34/ 269/ / / Other ID: 29/ Z001/ / / Bldg #: 1 Card 1 of 1 Print Date: 07/07/2004 11:13 CURRENT OWNER TOPO. UTILITIES 9IRTIROAD LOCATION CURRENT ASSESSMENT JUPGENSEN, JOSEPH T GENSEN, BARBARA HILL & DALE COUNTRY CLUB ARMEL NY 10512 213tiburban Description Code 4ppraised Value Assessed Value 81S YARMOUTH, MA S LAND SIDNTL 1010 1010 222,200 181.200 222,200 181,200 SUPPLEMENTAL DATA Account # 0533400 Subdivision ISO Photo Ward ct IS ID: ISION Total 403,4N 403,4W RECORD OF OWNERSHIP BSVOL/PAGE ULE DATE Wlu v/i ALE PRICE V.0 PREVIOUSASSESSMENTS(HISTORY) JURGENSEN, JOSEPH T 12/27/1991 Q I 175,000 1N Yr. odel Assessed Value Yr. Code I Assessed Value Yr. Code Assessed Value 003 003 1010 1010 105,400 106,300 002 002 1010 1010 105,400 106,300 001 001 1010 1010 105,400 106,300 Total 211700 Total: 211700 Total: 211700 EXEMP77ONS OTHER ASSESSMENTS his signature acknowledges a visit by a Data Collector or Assesso Year TwelDescription Amount Code Description Number Amount Comm.Int. APPRAISED VALUE SUMMARY Appraised Bldg. Value (Card) Appraised XF (B) Value (Bldg) Appraised OB (L) Value (Bldg) Appraised Land Value (Bldg) Special Land Value Total Appraised Card Value Total Appraised Parcel Value Valuation Method: 179AN 1,800 0 222,200 403,400 403,400 Cost/Market Valuation Total• NOTES NATURAL I/VG 0180 et Total Appraised Parcel Value 403,400 BUILDING PERMIT RECORD VISIT/CHANGEHISTORY PermitID Issue Date Type Description Amount Ins .Date %Com . DateCom . Comments Date ID Cd. Purpose/Result 02-761 998104 3/12/2002 2/24/1994 RS Residential 60,000 5,000 4/10/2003 6/15/1995 100 100 1/1/2003 REMODELIUTCHEP 1/1/1995 DECK 4/10/2003 6/I5/1995 GM 01 RD 01 easur+IVisit MeasurFlVisit LAND LINE VALUATIONSECTION # Use Code Description Zone D wage Depth Units Unit Price 1. Factor S.I. C.Factor Nbad. Ad'. Notes-AtalPricing Adi.UnitPriee Land Value 1 1 1010 1010 SINGLE FAM SINGLE FAM 40,000.00 036 SF AC 2.71 15,000.00 1.85 1.85 7 7 1.10 0.10 0070 0070 1.00 1.00 rOPO 5.53 2,850.00 221,200 1,000 Total Card Land Unb 1.28 C Parcel Total Land Area: 1.28 AC i Total land V—d4 1 222 200 hiss ,.Zug • O:.H:.. IaLmd:: , ...: ..:.. :... y � _ 6 �ALL� ai►per, =1 O I II I I I I I I II II II 16• I I I I I 116• I I I I I I 12 I II I I II id I I II NOTE: ffiSTINO CENTEN PARTITION I9 ISSUMID TO BE I BEIRINO WILL. IP NOT I .a I,y y ii•+ THIM 11 7/8•560 P 16.00 JOISTS MOST BE °i I INSTILLED. E� II I I II I113 1 R2 II II II II II II II IO I I I I I I I 6 9/16- I I I I I I I I 61/6• II II II II II II I I i I I I I I I Rai I I I I I I I - aal-lt ----- ------- Hdl-lt 1--3' 6• RINGER LIST - Hin6son Strong -Tie COMPARY, I134.6 Plot ID Qty Product Label Top Nails Pace Nails Member Nails Notes H1 2 IUS2.37/11.88 10-11[10 H2 1 IUT9 S-10d 2-N10 (5) R3 1 IUT9 8-NIO 2-N10 Hanger Hotest (5) Backer Blxks Required BEAVER LIST Plot ID Length Product Plies Qty Rdl 6' 3 1/2- z 11 7/8. 2.0E Parallax PSL 1 2 e n 22' 6• JOIST AND BETE LIST 1CCESSORIES LIST Plot ID Length Product Plies Qty plot ID Length Product Plies Qty u 26' 11 7/8- TJI 230 joist 1 17 Rol Is, 1 1/4- z 11 7/8. 1.3E TisberStraad LSL 1 3 12 14, 11 7/8- Til 230 joist 1 2 Bbl 1' 1- not Backer Blocks 1 2 Fl 4' 1 3/6- z 11 7/8. 1.9E Ricrollam LVL 1 1 Shl 4' z 8' 23/32• Pawls (24- Span Rating) 1 20 P1 26' 3 1/2- z 11 7/8. 2.0E parallax PSL 1 2 Rv, Rig Board CREATED BY Bid -Cape Ones Centers Po Box 1618 665 RTE 131 South Dennis, W 02660 508-398-6071 P1Ee 508-398-4559 JOB COMMENTS RICH DESBIRRIS JORGENSEN RENOVATION 10 CRESCENT COURT BASH RIVEN Y LEVEL NOTES Pile Sews JURGENSEN.JOB Level Nave 2ND FLOOR Plottede 8/9/2006 12162 Design Status$ 211D FLOOR .... 8/9/2006 12:13 ROOT......... 8/9/2006 11858 3xms Level design time indicated above Provide assurance for Proper level stacking. Design Dethodologyt 10 Floor Irea Loading Ise 40Pef Live Load and 12 Dot Dead Load N-,t— Joist Deflections L/480 Live Load L/260 Total Load TJ-Pro Rating Informtione weighted kverages 61 Lovett Ratings 60 Highest Ratingt 61 Glued a Nailed Decking is Required Direct Upliod Ceiling of 5/8- gypsum is Required 1 E 6 Strapping is Required Floor Deckings 23/32- Panels (26- Span Rating) Normal O.C. Spacing - 16-• -Unlass acted otherwise Layout Scale: 114" = 1' SYMBOL Lam x Note from Operator O Point Load Lim Load Use Load ODetail Callout Label (See Prawt's Pocket Guide) ., . . Hd-t Header, and -t indicates quantity of 23t_ trimmers required. at ands L Required Dearing Length in inches LJ (Adequate bearing has been provided if bearing length is not indicated.) Page 1 of 2 FOR THE TJ-XPERT WARRANTY SEE FRAMER'S POCKET GUIDE TJ.XpeMt 6.42 (f693) C6A2 D6.42 S6.42 P6A2 - I I