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HomeMy WebLinkAboutBuilding PermitsPERMIT 378 6/16/97 6/16/97 LOT Z58 (I O'Loughlin, Mike 230 Weir Road Yarmouthport, MA 02675 Strip & re -roof (same color) $1,200.00 SHEET 104 �7 1' P TYPE OR PRINT CLEARLY MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY /Zf0 u.7/ O T MA DATE /D PERMIT # JOBSITE ADDRESS 1935 l ad OWNER'SNAMEleB OWNER ADDRESS TEL d •� 21 FAX OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL NEW: ❑ RENOVATION: ❑ REPLACEMENT: PLANS SUBMITTED: YES ❑ NO[:] FIXTURES 1 FLOOR-+ BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICEr6olLfef DEDICATED SPECIAL WASTE SYSTEM DEDICATED GASIOIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM I DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOORIAREADRAIN -- INTERCEPTOR INTER KITCHEN SINK Cr7 LAVATORY 1AL=10 ROOF DRAIN bo— SHOWER STALL nitri 0 SERVICE I MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER 1 I INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES 0 NO ❑ IF YOU CHECKED YES. PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Q OTHER TYPE OF INDEMNITY ❑ BOND ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHEC ONE ONL : 0 N [1/40 ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the detalls and information I have submitted or entered regarding this application are true and a rate t the bast i cnowledge and that all plumbing work and Installations performed under the permit Issued for this application will be In compliance P rti ent r on of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME STEPHEN A. WINSLOW LICENSE # 12298 SIGNATURE MPQ JP❑ CORPORATIONQ# 3281C PARTNERSHIP❑#OLLC❑#0 COMPANY NAME I EF WINSLOW PLUMBING & HEATING I ADDRESS rjFEARDON CIRCLE CITY F66TH YARMOUTH I STATE ® ZIP 102664 TEL 508-394-7778 FAX 508 394 8256 CELL 0 EMAIL I accountspayable@efWnslow.com P/,q -5�-8760 ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ i ^ PERMIT # PLAN REVIEW NOTES FINAL INSPECTION NOTES irws4-L dGC T o• r� TOWN OF YARMOUTH Building Department BUILDING (508) 398 2231 ext.1261 PERMIT NO B-11:So6 . _ PERMIT �+ ISSUE DATE ; _ 12J3012010_ ; PROPOSED USA% 1 APPLICANT ,Rise Engineering ...... • ........ . JOB WEATHER CARD PERMIT TO Misctnsulation ' AT (LOCATION) 10230WEIR RD ZONING DISTRIC R-40 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 1116.57 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R.9 LOT SIZE install Insulation In ebsting home REMARKS AREA (SO FT) EST COST ($ OWNER Christina Fletcher ADDRESS 10230 WEIR RD Yamrouth Port I MA 102675 PERMIT FEE ($) $35.00 BUILDING DEPT BY INSPECTION RECORD CONTRACTOR LICENSE 100459 Nerstheimer, Erik 1341 Elmwood Avenue Cranston RI 02910 8007843700 PHONE 15083759885 FIELD COPY Date I _ Note Progress - Corrections and Remarks I Inspector I Mace use umy • .�• moo; - - Permit # �/ , � 9 l 1 F= S u lissue Permit expires 6 months from wTTwcn,(�y`date. EXPRESS BUILDING PERMIT APPLICATION . TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 Erxt. 1261 CONSTRUCTION ADDRESS: __ 2'�n W P-I r 12L1CiCI ASSESSOR'S INFORMATION: Map: Parcel: OWNER: _Chris�'no, Fla-rhpr srfm� NAME PRL.SF T ADDRESS • EL # CONTRACTOR:RISE Engineering 1341 Elmwood Avenue, Cranston RI 02910 (401)784-3700 NAME- MAIIING ADDRESS 7I'1-# WResidential Commercial Esc Cost of Construction $_ YD ?/• DD Home Improvement Contractor Lic. # 100459 -Construction Supervisor Lic. # 120979 Workman's Compensation Insurance: (check one) I am the homeowner I am the sole proprietorM have Worker's Compensation insurance Insurance Company Name: The Preston Ai encv Worker's Comp. Policy# WC2-Z11-259874-019 WORK TO BE PERFORMED 'Pent (I ire Retardant Certificate attacttod) Duration Wood SLOVe she -- ':Siding: # of Squares Replacernentwindows: # Replacement doors: x Re -roof. # of Squares () Stripping old shingles* () going over layers of existing roof _. Old Kings Highway/HisLoric District W Install Insulation -in existing home (see attached contract) Roofrng/Siding(Like for Me) *The debt is will be disposed of at: Location of facility I declare under penalties of perjury th a star • w h Wntain' . e true and correct to the best of my knowledge and Wief. I understand that any false answers) will be just cause for ticnial or rev on of icen d for pr (Cuuon under MG.L Ch. 268, Section 1. Applicant's Signature: Date:=�1 r'i� lin Erik Nerstheimer for RIS Engineering Owuas Signafwe (or attachment) Date: ApptovW By: t Date: Building Official (or designee) t Zoning District: Historical District: Yok No Flood Plain Zone. Yes' l�9DL Water Resourc Protection District: Within IOQ ft.of Wetlands: 1 Y•No No L RISE ENGINEERING Federal 1000641406629 RI Contractor Roalstration No of" A division of Thidsch Engineering MA Contractor Registration No 120979 1 _ CT Contractor Registration No 620120 1341 Elmwood Avenue, Cranston, RI 02910 1 (401)73"700 FAx(401)78"710 CONTRACT Page RI S E THIS rrTHEurnsar iMOSMESAM An THE CUITOMEn FORMNAS ENGINEERING DESCRIBED BELOW CUSTOMER _ PHONE DATE CINaIS Christina Fletcher (508)375-9885 07r2=010 111362 SSRWA sTRW SLUNG STREET 230 Weir Road 230 Weir L� SEavloa CnT.STATE.TIF SLUNG CITY. VATE.r1 ui Yarmouthport, MA 02675 Yarmouthport, MA 0267 F. L I' JOB DESCRIPTION RISE Engineering will provide labor and materials to seal areas of your home against wasteful, excess air . This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a wallUlUrlavelmratr— excharige and indoor air quality. Materials to be used to seal your home can include caulks, foams, weatherstripping and other products. Primary area for sealing include air leakage to attics, basements and other unheated areas (windows am not generally addressed) Ibis work will be performed at the rate of SM per man per hour, which includes materials and testing. 24 man hours. $1,594.00 RISE Engineering will provide labor and materials to install a -6' layer of R-19 Class I Cellulose added to 288 square feet of attic kneewall floor space. $298.00 RISE Engineering will provide labor and materials to install 2.25' R-10 semi -rigid fiberglass board insulation to 288 square feet of kneewall area $777.60 RISE Engineering will provide labor and materials to install a 8' layer of R-30 Class 1 Cellulose added to 306 square feet of open attic space. $336.60 RISE Engineering will provide labor and materials to insulate the back of 2 existing knawall access hatches) with 2.5' rigid fiberglass board insulation, and seal the edge of the hatch with weatherstripping. $170.00 RISE Engineering will provide labor and materials to make a temporary access to an attic area through the foci[ The opening will be closed with materials similar to those existing. Roofing will be scaled properly when insulation work is complete. $75.00 RISE Engineering will remove 360 square feet of batt style insulation from the kneewall slope area $234.00 RISE Engineering will provide labor and materials to install Class I Cellulose insulation to 468 square fat of platter ceiling located below a heated floor area, by drilling holes in the ceiling thorn blow. Holes drilled will be plugged. Plugs will be sparkled and left in a relatively smooth condition. Finish sanding and touch-up Priming/painting will be the cwtnmces responsibility. (Drilling plaster creates dust. We will attempt to isolate the area affected by this dust and make reasonable efforts to dealt up plaster dust resulting from the work. However, it is I RISE ENGINEERING Federal ID M 05-MS629 RI Contractor Registration No $196 A division of Thltlsth Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 ii 1341 Elmwood Avenue, Cranston, RI 02910 i_ (401)7843700 FAX (401) 784-3710 CONTRACT Page 2 RI S E wroLNG ce RM A D ENTEREDOME aeTTVEEN K AS ENGURERaa AND tHE CUSTOMER FOR WORK AS ENGINEERING DEse"'EDBELM CUSTOMER PHONE DATE CSMSS Christina Fletcher (508)375-9885 07R82010 111362 SERVICE STREET BILLING STREET 230 Weir Road 230 Weir SERWE CRY.STAMZP OLLM Off. STAMMP Yarmouthport, MA 02675 Yarmouthport, MA 02675 JOB DESCRIPTION likely that some film of dust will remain.) $819.00 RISE Engineering will provide labor and materials to incorporate heating pipes in your kneewall within the thermal boundary of your home. $528.00 RISE Engineering will apply all Applicable, eligible incentives to this contract You will be billed only the Net amount. Currently, for au sealing measures, the Cape light Compact offers a 100E/S incentive. -SI,584.00 RISE Engineering will apply all applicable, eligible incentives to this Contract You will be billed only the Net amount Currently, for eligible measures, the Cape Light Compact offers 75% incentive, not to exceed S2,000 per Wander year. -$2,000.00 ONE AGREE HEREBY TO FURNM SERVICES - COMPLETE 94 ACCORDANCE WRH ABOVE I PECIFIcATIONS, FOR THE SUM OF ***One Thousand Two Hundred Twenty -Eight & 201100 Dollars ;1,228.20 UPON ANLDISPECTI NANDAPPROVALaVRISEENGNICERNO.CUSTOMERAGREESTOPANTAMOUNTDURINrw INTEREST OF+%Re1asCHARGEDMONTHLY ONANY UNPAID BALANCE AFTER IN DAn SEE REVERSE FOR WoRTANT WORM►TION ON GUARANTEES, RXMM OF RROMIKK SOPAULNG. AND CONTRACTOR ASGMTRATIOK DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SP ES ox ®eaNATUAs-AraE cwTorEaAccEiiANCE 10—/ -7' ' 10 NOTE: THIS COrrTRACT MAY e[ wnloRAwH aY IM IF NOT ErECItiED YR71IEI DATE Or ACCEPTANCE THIS 3 6 ACCEPTANCE OF CONTRACT -THE ABOVE PRICES, SPECU'"TIONS AND COMMMMS ARE iATMPAOT'ORY TO US AND AM HRM" ACCEPTED. YOU ARE AUTHOPRID TO DO THE WORK DAYS. AS SPECr1ED. PAYMENT IMI.L k MADE AS OUTLAW MOVE ploz i The Commonwealth ofhlassaehuseas Department of Industrial Accidents • Office of Investigations 600 Washington Street Boston, llfass. 02111 www.ntass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Orgnnization/Individual):_RISE Engineering a division of Thielsrh Engin�g Address: 1341 Elmwood Avenue City/State/Zip: Cranston, RI 02910 Phone#: (401)784-3700 or 1-806-422-5365 Are you an employer? Check the appropriate box: L N I am an 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. ship and have no employees These sub -contractors have working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. $ required] 5.0 We are a corporation and its 3. ❑ I am a homeowner doing all work officers have exercised their myself [No workers' comp. right of exemption perm MGL insurance required] t c.152, § 1(4), and we have no employees. [no workers' comp, insurance required.] Type of project (required): 6. 0 New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12. ❑ Roof repairs 13. X Other Insulate "Any applicant that checks box Ml must also fill out the section below showing their workers' compensation policy information. tllomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contactors that check this box must attach an additional sheet showing the name of the sub -contractors sod state whether or not those entities have employees. It 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: The Preston Agency Policy # or Self -ins. Lic. #: 3730961-00 Expiration Date: 1 / 1 / 11 Job Site Address: Z92D IA.(.2l lZ, /Zd City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the poIi4 number and expiration (date). Failure to secure*coverage as required under Section 25a of MGL 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 $250.00 a.day against violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby cert und�heXins enaIties ofperju y that the information provided above is true and. correct. _Print Name: Erik Nerstheimer Phone #(401)784 3700 or 1 800 4 7 5469 exrM Official use only Do not write in this area to be coinpleted by city or town official City or Town: Permit/license #: Issuing•Authority (circle one): 1.Board of Heath 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6.Other Contact person: Phone # ACORD , CERTIFICATE OF LIABILITY, INSURANCE OPID 47 THIEL-1 The Preston Agency, Inc. 1350 Division Rd -Suite 303' PO Box 81D East Greenwich RI 02819-0810 Phone:401-886-8000 Fax:401-885-1700 Thielsch Engineering, Inc Thielsch Group Inc. Hi Tech R6alty Inc. 195 Crances Avenue Cranston RI-02910 RINIFG THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 3/10 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW INSURERS AFFORDING COVERAGE NAIL ## INSURER A; Zurich -American Ins Co. B45lREA B: b.nle.n eu.onL.. 6 MJ.DISIty Z RERc North American Capacity INSURER O: Hartford Insurance Com an INSURER E' 1T[ POLICIES OF INylMNCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING AN'T REOUIRE ENT• TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO W ION THIS CERTIFICATE MAY BE ISSUED OR WIT PERTAIN. THE INSIFTAAICE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONWQNS OF SUCH POLICIES. AGGREGATE LMTITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAWS. I LTR NSA TYPE OF INSURANCE ►DUGYMUMBEfl FOCI DATE (MMlDDM' DATE IMMlD LIMITS— A GENERAL X LIABLTY COMMERCIALGETERALLIABILITY CLAIMS MADE XQ OCCUR 3730962-00 04/01/10 01/01/11 EACH OCCURRENCE S1,000,000 PREMISES (Es cC sma $300,000 MED EXP Lkwwe pvsml $10 , 000 PERSONAL I ADV NARY 51,000,000 GENERAL AGGREGATE s 2 , 000 , 000 GEMI AGGREGATE LOATAPPLIES PER: POLICY F1 PJERcT LOC AUTOMOBILE LIABLfTY PRODUCTS• COW1OP AGG' $2,000,000 Emp Ben. 1 , 000 , 000 A X ANY AUTO 3730963-00 04/01/10 01/01/11 (EssMBINEO ecidelX) SINGLE LMIT $2,000,000 ALL OWNED AUTOS BODILY 114ARY IPr pmaon) i SO[IXAEDAUTOS WRED.WTOS NUN-OWWO AUTOS BODILY II•L1RY (P.T ACTJd.14) . i PROPERTY DAMAGE IP.F.CCid.fn s GARAGE LIABILITY ANY AUTO ' ^w6 ONLY• EA ACCIDENT i OTHER THAN EAAf.0 AUTO ONLY. AGG i s . B EXCE SSIUMBRELLA LIABILITY X I OCCUR F_� CLAIMSmAOE UID3 9263637-00 04/01/10 01/01/11 EACH OCCURRENCE 410,000,000 AGGREGATE s 10 000,000 i RDEDUCTIBLE X RETENTION 110,000 S s A WORKERS COMPENSATION AND EMPLOYERs'LIABLTY ANY PROPRIETORIPARTNERAFXECUm °FIK, 065A be UrR EXCLUDED? If ya. d.acfiD. IFdM SPECIAL PROVISIONS bel" 3730961-00 04 0 /VE 1/10 01./01/11 X TORY LIMITS lu,EP. E.LEACHACCIOENT i 1,000,000 E.L. DISEASE • EA EMPLOYEE 11,000,000 E.L. DISEASE -PdJCY LIMIT i 1,000,000 OTHER C D Professional Liab Leased/Rented Eqp DVL000026800 02WTTTD5678 04101/10 09/O1/10 04/01/11 04/01/11 Prof Liab 2,000,000 Equipment 100,000 DESCRIP I ION OF OPERATION gI IOCAT10N5 VEHICLES EXCLUSIONS ADDED BY ENOOR SEMENT SPEC PRO IONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXP1gATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WAITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO 00 $D SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY HIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESE IV ACORD 25(2001/08) QACORD CORPORATION 1988 _ `��Ofce o onsumer aan`ess egu anon 10 Park Plaza - Suite 5170 Boston, sachusetts 02116 Home Improve=ontractor Registration THIELSCH ENGINEERING ERIK NERSTHEIMER 1341 ELMWOOD AVE. CRANSTON, RI 02910 ovscAl a 5ou-04104-GIm21e 0 ei s moo !!.4 ✓lfaaeac%uaeQ3 Office of Consumer Affairs & Butiness Regulation OME IMPROVEMENT CONTRACTOR Registration79 Type: Expira s 1122Supplement Card THIELSCH ENC j� E 0 ERIK NERSTHE) 1341 ELMWOOD CRANSTON, RI C 49�—s--y Undersecretary Registration: 120979 Type: Supplement Card Expiration: 325/2012 date Address and return card. h1ark reason for change. LiAddress ❑Renewal ❑Employment ❑Lost Card License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, AAA 02116 Not valid without signature r arc I OT 1 The Official Website of the Executive Office of Public Safety and Security (FOPS) Mass.Gov Home Public Safety Department of Public Safety Licensee Complaints License Type Construction Supervisor License A 100459 Restriction WS,IC Name Erik Nerstheimer City, State, Zip North Scituate, Rl, 02857 Expiration Date 3/28/2012 Status Current No complaints found for Back To Search this Licensee. Board of Building Regulations and Stand;i HOME PROVE/EENT CONTRACTOR Registr Hp:, 20979 7u1'{� ` 3i2512010 =; +. `{ =+Type _- ,PPieme6l Card . l i �. IELSCH ENGIj9E,EE?I IK NERSTHEI68'R,-•= i1 ELMWOOD•AY �fi, ANSTON,Rl02910 Administi:�iior •.�`kra Uense or relistration valid for individid use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 a.F.uslau, AJa. 02108 — — Not valid without signs##Te http://db.state.ma.us/dps/licdetails.asp?txtSearchLN=CSLI 00459 NAT-24531-1 SUBDIV %z""E "�'"-- LOT SIZ ARC (Su r r ) OWNER ADDRESS p►iONE Date TOWN OF YARMOUTH Building Department (508) 398-2231 ext.261 PERMIT NO 0..... PROPOSED USE PERMIT ISSUE DATE :_11/10/?005_; ' JOB WEATHER CARD APPLICANT Andrew 8� Christina Fle r PERMIT TO MiscJwood stove ' BUILDING DEPT BY INSPECTION RECORD FIELD COPY to Progress - Corrections and Remarks Inspector er.�ttt - C.I. L-T . _U:f..:r::EMM:l, is recurred or the ins.dlatton of any solid fuel burning aaaiiance. The building nermr -ano ins.:�__erl are limited to the stove insmiation and not to the stove c; ,ristrucoon. Stove New - Nib Used �. lyre:racaan; %Z�DiANT C:rc_laurc :.. .Ial.,...:....irer t L i :a. No. Nai..2Wr'.:•e! No. 3(ij2 Ccilar size u1.Tiensi.;r:: e:Crt 2� L rwnC:h 14 WIG:.1 r =`Y A. New c;isltnC �frSTINb �. Cize t::t:e area) 1 X 11 C. C:rer a_c:ianc_s atm-.64ed to flue (Numaer and flue stzel ... -. -1 - t Uanu!a .:rer—r.=e and type) -MhAr c.:.lascnrylUned t-i^OD line., Un:irec —Rue \ ttlz.•manuuCur.r1 ei;^:(re?e:•^- _ - s; L J n�eT �}P£G �xrst/Nb 6W 131?icK (NY141 2_77ccr d r pe t I titx 2 u::i. I 'L �t I - 1 �jq OX 1 CI M N E ciEiG: ; i 12t M41i. l8'' 1111N. Ask ;.:;a.:r/a:s- 1 lt� lZPdSe9 fl 1... : .5" Sire?er:O.:.a::-T.I C:azrancss arc vizil Frctet «cn isee s:cve irs;eilazcn G2aran::3s =-.) ". y;.e _ ::o:f c.—Cole^_ter r:Gvtcec li�ARTH f NOT WEAR 1,hit f 1 i�9,vTEL ivlcc y,��� ycp3�fi •c g st • O. y ~+ti.xn• i m pin, NOV I ,0 ;2005 igI BUILDING PERMIT APPLICATION TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 Ext. 261 CONSTRUCTIONADDRESS: 230 WaR go ots" Usia Oal j ramitr� . Gay Permit expires 6 montha Qom ASSESSOR'S INFORMATION: Map: Parcel: OWNER: 23bylac, q)yARtAwran- Sod -37�- NAIv¢ PRESENT ADDRESS TEL. N 4 Residential ❑ Commercial ESL Cost of Construction s / U ' _ Home Improvement Contractor UQ # Cortstnution Supervisor Uc. # W 's Compensation Insurance: (check one) I am the homeowner ❑ I am the sole proprietor ❑ I have Worker's Compensation Insurance insurance Company Name: Worker's Comp. PolicyN WORK 'O BE PERFORMED ❑ Tent (Fire Retardant Certificate attached) Duration WDO,D X7-OVE ❑ Siding: N ofSquares ❑ Repluement windows: N ❑ Replacement door: N 17 Re -roof r of Squares () Stripping old shingles$ () going over layers of existing roof *The debris will be disposed of at: Location of Facility I declare under penalties of perjury that the statcn=ts herein contained are true and correct to the best of my knowledge and belie[ 1 understand that any false answer(s) will be just cause for di4& n of my license and far prosecution under MO L Ch. 268, Sedan L Applicant'sSignamre: Date: 11— 9 w GS OwnersSignature Approved Hy D&W Budding Official (car designee) Zoning Distric / Historical District: 17 Yes ❑ No Water Rqource Protection District: kk Yes 0 No Flood Plain Zone: Yes 1/No Within ldfL of Well �f Yes 0 No 3/01 fro djv. ...ar.n ", . Cf TOWN OF YARMOUTH Building Department BUILDING (508) 398-2231 ext.261 - W(3 PERMIT NO B-05-339, . ISSUE DATE 8110/2004 _: PROPOSED USE _ .. _ _ . _ .. PERMIT APPLICANT ;mall"Hopkins : "" ""' JOB WEATHER CARD -- -- ........... --• - PERMIT TO Alterations AT (LOCATION) 100230WEIR RD ZONING DISTRIC R-40 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 1116.57 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE O CONTRACTOR demolish & replace existing 12 x 16 deck as per plans dated 09102104. REMARKS AREA (SO FT) EST COST ($ $8,900.00 PERMIT FEE ($) $48.00 OWNER IChris Fletcher BUILDING DEPT BY ADDRESS 100230WEIRRD Yarmouthport 7777TiTA 102675 INSPECTION RECORD LICENSE 084916 Hopkins, Niall POB 231 South Yarmouth MA 02664 5083944986 FIELD COPY Date , I Note Progress - Corrections and Remarks I Inspector wil W 40 . This Section for Office Use Only Building P r ber. Date Issued: Signatur _ Bu g Official �Z Date Certificate of Occupancy is is not required Section 1 -Site Information I Use Group: R-4 Type: 5-B 1.1 Property Address: 1 1.2 Zoning Information: T V Zoning District Proposed Use 1.3 Building Setbacks (it) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided IIA Water Supply (M.G.L. c. 40. S 54) Public Private 1.5 Flood Zone Information: Comments: Zone: BFE: Section 2 -Property Ownership/Authorized Agent 2.1y�Owner of ecord: /1 ►�j Name Signs ure (� p r Maili g Address Telephone 2.2 Authorized Ag nt: 0S 509 SP Telephone 1' 1 1 r, � `" • 1055,k Q I Mailiny Ad ress ► SEp 10 2004 4qST Fax Name ( Signature Section 3 - Construction Services 3.1 Licensed Construction Supervisor: I �� L' �yt 111 Not Applicable ❑ L ii AUG 2 6 20 License Num er 02 Addres JI pUtl hl'Av "- - Expiration to CS I Signature Telephone 8 a 3.2 Registere ome Improvement Contractor: Company Name '. Not Applicable ❑ License Number Address /f ;? 6 Signature I �� ��� Telephone Expiration Date n 0 20 X0b5 VVU 1 of 2 OVER Section 4 • Workers' Compensation Insurance Affidavit (M.G.L. c. 152 S 25C (6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure_ to provide this affidavit will result in the denial of the 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 Spdgy: '`�•� Brief Description of Proposed Work:to �.. 4- &vl!yj2 0 Ap \ 0 C� D ` Costs Section 6 - Estimated Construction Item Estimated Cost (Dollars) to be Check Below ❑ Conservation -Commission Filing (if applicable) / Old Kings Highway & Historical r Commission approval (if applicable) com feted by permit applicant 1. Building 5Y C100 2. Electrical 3. Plumbing / Gas 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) 7. Total Square Ft. (new houses & additions) Section 7a - Owner Authorization - To be Completed When Owner's Agent or Contractor Applies for Building Permit I , as owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. ignature of weer Date Section 7b - Owner/Authorized �Agent t—Declaration 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 g IB o� Signature er/Agent Date qMq 9-15-99 2of 2 Oi AR,} 2 3 c O H TOWN OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: n 30 Job Location: ' Number Owner of Property: —f Construction Supervisor: IV 1110 Name Address: Licensed Designee: (If other than Supervisor) 231 4� !� Name 2.15 Responsibility of each license holder: (:,S c License No. Village License No. Phone 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 wilifullyviolate 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 have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 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 c rrent iability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes No ❑ If you have checked M, please 'ndi to the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'SNCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 15E ass. General taws, and that my signature on this permit application waives this requirement. Check one: % / m Owner ❑ Agent Signature: ' Building Official Approval: Fr - 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: I)erA_ Address of Workm9 *1^ Owner Name: I t I 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 a permit as the agent of the owner: I� 12o562 Date Contract& Name Registration No. Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: r— Date Owner Name or The Commonwealth of Massachusetts Department of Industrial accidents exceof/aYestlptffess 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit 0 1 am a sole proprietor and ha%e no one ttorkine in any capacity 5 am an employer pro%iding workers' compensation for my employees working on this job. I am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below who halve the follo%%in_ %corkers' compensation polices: Failure to secure coverage as required under Section 25A of MGL 152 eaa lead to the imposition of eri=iW penalties of a floe up to 111,500.00 and/or one years' Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fiat of 5100.00 a day against me. 1 understood that a copy of this state%16sy be forwarded to the Office of Investigations of the DU for coverage verificatloa. _ I I do hereby ce she pains and penalties of perjury that the information provided above is true SignatureM t Date a Print name official use only do not %rite in this area to be completed by city or town official city or town: YARMOUTIJ _ permittlicense 0 nBuilding Department ❑Licensing Board ❑ check if immediate response is required 261. ❑Selectmen's Once (508) 398-2231 mot, ❑llcalth Department contact person: phone M; _ _ nOther Ironed 191 P1AI Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their enaplu%ees. As quoted from the "law-, an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An e►►►phr ver 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 o%%ner 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 iepair'work on such dwelling house or un the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. NIG1_ chapter 15_ section `5 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. Additionall%. neither the common%ealth nor any of its political subdivision's shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha% e been presented to the contracting authoritc. Applicants Please till in the workers' compensation affidavit completely. by checking the box that applies to your situation and supply ing company names, address and phone numbers as all affidavits 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. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the aMdavit 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. The affdavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of investigations would like to thank you in advance for you 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 If IMStlo:le0t 600 Washington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone #: (617) 7274900 ext. 406, 409 or 375 TOWN OF YARMOUTH 1146ROUTE28 SOUTH YARNIOUTH hIASSACHUSETTS02664.4451 Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT BUILDING ELECTRICAL GAS PLUMBING SIGNS Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the propo ed work/demolition to be `p conducted at 21KJl�J1 Work Address �{ T— Qisto be disposed of at the following location: ` , "I Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Pcrmit No. OF �, TOWN OF YARMOUTH ? j Building Department +( Town Hall ." Yarmouth, MA 02664 (508) 398-2231 ext.261 BUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-140 Applicant Name: Niall Hopkins Applicant Phone: 5083944986 Building Location: 00230 WEIR RD Owner's Name: Chris Fletcher Owner's Addres 00230 WEIR RD Yarmouthport MA 02675 Owner's Telephone: (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $25.00 Payment Type: Check ChkNo.: 169 Net Owed: ($25.00) Application Date: 8/26/2004 Issue Date: Expiration Date Comments: Map/Lot: 116.57 demolish & replace existing 12 x 16 deck ZONING APPROVED r RE IEWED BY: WATER DEPARTMENT: DATE: N/A: ENGINEERING DEPARTMENT: DATE: N/A: �2 ONSERVATION: DATE: N/A: /4EALTH DEPARTMENT: DATE: N/A: 5. BUILDING DEPARTMENT: DATE: N/A: 6. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 8/27/2004 Property Location: 230 WEIR RD AMP ID: 116/ 57/ / / Vision ID. 14931 Other ID: 104/ Z0581 / / Bldg M 1 Card I of 1 Print Date: 08/26/200415 CONSTRUCTION DETAIL SKETCH Element Cd ICIL I Description Commercial Data Elements tyle/Type ape Cod Element Cd ICIL I Description awe_ :rior Wall 1 2 if Structure if Cover rior Wall 1 2 rior Floor 1 2 ling Fuel ling Type Type Rooms Type en Style 1 1010 EOS XnclOutsSh, VDDK PAT1 ATIO-AVG Story ine/Soft Wood it of Water one Bedrooms 1/2 Bathrms EAF ttic, Expansion, Finished FGR &rage FSP orch, Screen, Finished SFB Ise, Semi -Finished WDK eckWood B L L Common Wall 91 Height it Adj Location fiber of Units sber of Levels nvncrship COSTIMARKET VALU. dj. Base Rate 100.00 Adj. Factor 1.01379 Ie (ty Index 096 Base Rate 9732 rValue New 182,086 r Built 1980 Year Built 1982 d Physcl Dep 20 ud Obslnc 0 a Obslnc 0 :L Cond. Code :1 Cond % rall % Cond. 80 rec. Bldg Value 145,700 1982 1 "0 1980 3.57 100 1980 536 100 s 281 J 7-4 o NT i Property Location: 230 WEIR RD AMP ID: 116/ 57/ / / 17cian ID: 14931 Other ID: 104/ ZO58/ / / Bldg If. I Card I of I Print Date. 08/26/2004 15:08 CURRENTOIVNER TOPO. UTILITIES STRTJROAD LOCATION CURRENTASSESSMENT ARDILLO, CIiR1STLYA 0 WEIR RD TII ARSIOUPORT,111A 02675iEEH Additional Owners: Description Code Appraised Value Assessed Value 815 YARMOUTH, AM LAND IDNTL IDNTL 1010 1010 1010 128,000 147,700 300 128,000 147,700 300 SUPPLEAfENTAL DATA Account# 1519700 Subdivision 360 ard ct IS ID: VISION Total 276,0001 276,000 RECORD OF OWNERSHIP BK-VOUPAGE SALE DATE q1q yr SALE PRICE V.0 PREVIOUSASSESSMENTS (HIS RI) CARDILLO. CHRISTINA LOUGIiLIN,NOREENAt LOUG11LIN Ai1CIIAEL W 14147/ 342 13739/ 96 08/17/2001 04/18/2001 Q U I I 260,000 1 0 00 1F Assessed Value Yr. Code Assessed Value Yr. Code Assessed Value 12�0031010 58.100 91,600 300 002 002 2002 1010 1010 1010 58,100 91,600 300 2001 001 001 1010 10I0 1010 58,100 91,600 300 Total. 150 00oi Total: 150,000 Total: 150 000 EXEMPTIONS OTHER ASSESSMENTS This signature acknowledges a visit by a Data Collector or Assessor Year TIpelDescription Amount Code Description Number Amount Comm. Inc APPRAISED VALUESUAIALMY Appraised Bldg. Value (Card) Appraised XF (B) Value (Bldg) AppraisedOB (L) Value (Bldg) Appraised Land Value (Bldg) Special Land Value Total Appraised Card Value Total Appraised Parcel Value Valuation Method: 145,700 21000 300 128,000 276,000 276,000 Cost/Market Valuation Total.- NOTES 8 ROOMS SPL3-WEDMG POND 0360 et Total Appraised Parcel Value 276,000 BUILDING PERAHT RECORD VISIT/CHANGE HISTORY Permit ID is Date Tire Description Amount Insp. Date %Comp. Date Comp. Comments Date ID Cit. I Purpo.selResull 378 6/16/1997 RS Residential 1,200 too REROOF 6/7/1996 RD 01 IeasurtlVisit LAND LINE VALUATIONSECTION BH Use Code Description Zone D Frontarel Depth Units I Unit Price I. Factor S.I. I C. Factor Nbad I Ad . I Notes- Ad7S cial Pricing Ad. Unit Price Land 1'alue 1 1010 SINGLE FA31 30,927.60 SF 339 135 5 090 0050 1.00 FOPO 4.14 128,000 Total Card Land Units 30,92&00 SFI Parcel Total Land Area 30.928 SFI Total Land Valu 128,000 5 fob �\ 0i41 _5opt Axe I I lye x I �L zX 1- L�x 1O P uP� -6ftea foists % 00 cQ,iep, Uj.e ledt vmis TOWN OF YARMOUTH REVIEWED FOR BUILDING AND ZONING jtD�COM I- �1NCE ERT ORS,OR QM�00 N P �41�V HE J�iEP ' N ROIL} j HJTY ' $`g IL ' COMPLIANCE. x 4' 1 , (--C�aw ,I n 110U�\t?. �\fs1 A- w SUILbINGOFFICIAL �C t �to F�ou�e �e► p i'G�i1wSF ?�� 'E-' o,� Cen4e 36 io t:,,� 6� '" FILE COPY TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BUILDING PERMIT Temp Permit No.: Applicant Name: Applicant Phone: Building Location: Owner's Name: Owner's Addres Owner's Telephone: TRANSMITTAL T-05-140 Niall Hopkins 5083944986 00230 WEIR RD Chris Fletcher 00230 WEIR RD Yarmouthport MA 02675 REVIEWED BY: 1. WATER DEPARTMENT: 2. ENGINEERING DEPARTMENT: 4. HEALTH DEPARTMENT: 5. BUILDING DEPARTMENT: 6 FIRE DEPARTMENT (OFFICE USE ONLY Recorded By: IC Permit Fee: $0.00 Deposit Rec: $25.00 Payment Type: Check ChkNo.: 169 Net Owed: ($25.00) Application Date: 8/26/2004 Issue Date: Expiration Date Comments: Map/Lot: 116.57 demolish & replace existing 12 x 16 deck DATE: N/A: DATE: N/A: DATE: —Q N/A: DATE: N/A: DATE: N/A: DATE* WA• >1 PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 8/27/2004 vperty Location: 230 W EIK RU HAPID., 116157111 sion /D., 14931 Other ID: 1041 ZO58/ / / Bldg N. 1 Card I of 1 Print Date: 08/26/2004 15 CONSTRUCTION DETAIL _ - SKETCH Element Cd Ch Description C mmercial Data Elemr Lis [ qld Type ape Cod Element Cd Ch Deswiption tones 1 Story ccupancy 0 xtcrior Wall 1 1 Clapboard 2 oofStructure abletllip oof Cover 3 sphtFGls/Cm1 lerior Wall 1 S rywalVSbeet 2 acrior Floor 1 Ine/Soft Wood 2 eating Fuel 2 it eating Type is lot Water CType H ione edroorns M Bedrooms athrooms .S 1 1/2 Bathrms :)W Rooms ath Type itchen Style . "- - . VD-1/US 0U Lf/I/YVB ZAK"I1CD7J( Code DrrcN Lion 1/8 Units FPL2 .SSTORYCHIM B 1 EOS ocl Outs Shwr B 1 VDDK L 12C PATI ATIO-AVG L 23C BUILDING Code Description 1 BAS ^irstFloor EAF \[tic, Espaesioo, Finished FGR ■rage FSP orth,Screen, Finished SFB [e, Semi -Finished WDK eck, Wood all Height CONDI Element omplcx Adj nit location umber of Units umber of Levels .Ownership COST nadj. Base Rate ize Adj. Factor rade (ty Index dj. Base Rate Idg. Value New ear Built tT Year Built rml Physcl Dep uncnl Obslnc Obslnc peel. Cond. Code ped Cond % erall % Cond. . Bldg Value 1980 1980 281 100.00 1.01379 0.% 9732 182,(" 1990 1982 20 0 0 80 145,700 100 100 100 711 Cost Unde ree. Value 97.32 98,094. 34.10 31.921 3t1.89 18,194, 2433 4.671 r r/e 0+4jT Gc/F_ BIZ 42) c�1(i e CoYAS� RUrjLxofj tax 6 2004 `�1 BYE 1.9 MM' I Axlf zx q- cl to V 1 60 dvl�-Cl 5 OF TOWN OF YARMOUTH Building Department Town Hall ." Yarmouth, MA 02664 (508) 398-2231 ext.261 BUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-140 Applicant Name: Niall Hopkins Applicant Phone: 5083944986 Building Location: 00230 WEIR RD Owner's Name: Chris Fletcher Owner's Addres 00230 WEIR RD Yarmouthport MA 02675 Owner's Telephone: REVIEWED BY: 1,.WATER DEPARTMENT: 2. ENGINEERING DEPARTMV-1. I . (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $25.00 Payment Type: Check ChkNo.: 169 Net Owed: ($25.00) Application Date: 8/26/2004 Issue Date: Expiration Date Comments: Map/Lot: 116.57 demolish & replace existing 12 x 16 deck DATE:7/ p7i N/A: If DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: DATE: N/A: 5. BUILDING DEPARTMENT: DATE: N/A: 6. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 8/27/2004 RE C E I V E r •operty Locaflon: 23U WEIR IW hfAP ID: 116/ 571 / l sloe /D.1493I Other ID: 104/ Z058/ / / Bldg N: 1 Card I of 1 Print Die. 8I26/200.4 15 CONSTRUCTIONDBTAIL SKETCH Element Cd CIL Description Commercial Data Elements is I tyld Type Cape Cod Element Cd Ch. Description cat do AC rameType lodcl , l 3 Residential Average NDKrade 16 Yarmouth Water Dept. aths/Plumbmg SP :Dries Story ccupancy 0 7ing/Wall 12 1 ooms/Prtns xtcrior Wall 1 1 Clapboard /• Common Wall 16 2 Mail Height ED S 26 oof Structure able/Hip oofCover ksphlFGIs/Cmp CONDO/AfOBILE HOME DATA FB derior Wall 1 2 S rywalUSheet Element Code Description Factor mplcx r Adj iterior Floor 1 9 Ine/Soft Wood 8 1 2 nit Location eating Fuel eating Type 2 S oil 11olWatcr umber of Units 26 C Type H None =her of Levels FGR 26 36 Ownership 36 o athr athroomu S Bedrooms 1 1/2 Batbrms COST/AfARXET VALUATION nadj. Base Rau 100.00 8 1 �tal Rooms ize Adj. Factor 1.01379 3rada (Q) Index 0.96 ath Type itchcn Style kdj. Bans Rau 9732 296 Idg.ValueNew IM086 r car Built rf Year Built 1980 1982 /� U AJT //Z �D rml Physcl Dep 20 AfLXED USE uncnl Obslnc Obsinc pec1 Conde Code 0 0 1010 INGLE FAFI I00 pecl Cond /• erall %Cord. 80 rec. Bldg Value 14S,700 OBOUTBUILDING A YARD ITMIS(L)/XF-BUILDINGEXTRA FEATURES(B) Code Description LIB I Units I Unit Price I Yr. I D Rt Wnd A Value FP12 SSTORYC111M B 1 2,500.00 1982 1 100 2,000 EOS od Outs Sbwr B 1 0.00 1982 I 100 0 14 DDK L I20 4.001980 3.57 100 100 PATI ATI0.AVG L 280 2501980 S36 100 200 + BUILDING Code Description I BAS -irsl Floor EAF kttic, Expansion, Finished FGR ;&rage FSP lorrh. Screen, Finished SFB lisp, Semi -Finished WDK leek. Wood EGT/ON Area Unit Cost Unde ree. Value 1.008 9732 98,09 328 34.10 3192 187 38.89 I8,19 48 2433 4,67 281 58.43 ' 2734 `•q TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398.2231 exL261 BUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-140 Applicant Name: Niall Hopkins Applicant Phone: 5083944986 Building Location: 00230 WEIR RD Owner's Name: Chris Fletcher Owner's Addres 00230 WEIR RD Yarmouthport MA 02675 i Owner's Telephone: REVIEWED BY: 1. WATER DEPARTMENT: 2. ENGINEERING DEPARTMENT: (OFFICE USE ONLY Recorded By: IC Permit Fee: $0.00 Deposit Rec: $25.00 Payment Type: Check ChkNo.: 169 Net Owed: ($25.00) Application Date: 8/26/2004 Issue Date: Expiration Date Comments: Map/Lot: 116.57 demolish & replace existing 12 x 16 deck DATE: DATE: AUG 2 7 2004 N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: DATE: 3/ N/A: 5. BUILDING DEPARTMENT: V DATE: N/A: 6. FIRE DEPARTMENT: DATE: N/A: COMMENTS: RECEIPT OF COPY: PLEASE NOTE SIGNATURE OF APPLICANT: DATE: Date Printed: 8/27/2004 •operty Location: 230 W LIK KU AIAP ID: 116/ 57/ / / slon ID. 14931 Other ID: 104/ T.058/ / / Bldg N. 1 Card 1 of 1 Mnl Date: 0=6/2004 15 CONSTRUCTION DETAIL SKETCH Element I Cd 1C)LI Description Coimerrial Data Elements tyld Type P4 I apt Cod Element Cd jCk I Description tones , ccupancy xterior Wall 1 2 oof Structure oof Cover terior Wall 1 2 lerior Floor 1 2 eating Fuel eating Type C Type edrooms aduooms xal Rooms nth Type itchen Style . A/ 1010 FANGLEFAM OB-UUTBUTA Code Drscri FPIL2 SSFORYali EOS ad Outs Shwr DK PATI ATIO-AVG Story ne/Soft Wood a lot Water one Bedrooms 1 112 Bathrms Bull Code Description BAS vrsl Floor EAF tde, Expaasioa, Finished FGR &rage FSP orch, Screen, Finished SFB lse,Seml-Finished WDK eck, Wood ommon Wall I Height CON] umber of Units umber of Lcvcis /a Ownership COST/JII nadj. Base Rate ize Adj. Factor rade(Q)Index dj. Base Rate Idg Value New ear Built Year Built mil Physcl Dep uncnl Obslnc n Obslnc prCL Cond. Code peel Cond °/. I00 erall % Cond. rec. Bldg Value D ITEMS(L) /XF-BUILDING] /B unity Unit Price Yr. B 1 2,500.00 1982 B 1 0.00 1982 L 120 4.00 1990 L 290 2S0 1980 DAT�auor 100.00 1.01379 0.96 97.32 182,086 1990 1982 20 0 0 80 145,700 too 100 100 pit Cost Undr rec. Vah 97.32 9811 34.10 31; 38.89 18, 24.33 4� ea/, ON r fob F\echvuR ----� >µ � I .i ly�xis I A+ e4 1 S f i s I zx '- 4 ly1 soon ' )Ov` 4 -,�oicit �►�llwsro►'. �'� oil Cute 36„ �� ,���16� vw � i r h E u? � 1 V AUG 2 6 004 U BUILD", Sri. By_ �C oli ctl-t�e P, jt ,Ce,5 Gw,.v,&c i�le� $,'� oq,�. �M"Ufts one" I&AMOUL." °"""" Old King's Highway Regional Historic District Cornmittee in the Town of Yarmouth for a CERTIFICATE OF APPROPRIATENESS Application is hereby made in triplicate, for the issuance of a Certificate of Appropriateness under of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as descSection 6 ribed beerSand on plans, drawings or photographs accompanying this application for. CHECK CATEGORIES THAT APPLY• 1. Exterior Building Construction : M New Building p Addition p Alton .tion '03 FEB-13 AM 9:20 lod"-tetypeofWdding: O House D Garage Q Commercial ta Other 2. Exterior Painting: 17 3. Sigas or Billboards: 0 Nc%v Sign 0 Existing Sign E3 Repainting existing sign 4. Structure~ p Fence p Wall' p Flagpole 13 Other TITE OR PRLYT LEGIBLY DATE_ _ I Z ^- F" O Z ADDRESS OF PROPOSED WORK 05M el( PA ASSESSORS MAP NO. j f ^ OWNER Q"rst''^''d6r Ic'C ASSESSORS LOTNO._ HOME ADDRESS 2_-11b tAe%( P1 TELEPHONE NO. E0t 375 1 065 AGENT OR CON IRACTOR�aI�, SDr�r 9,ne� S TELEPHONE NO 3q IqO O ADDRESS 9-35 Grejr WaSIrerry V4L X soytn DenV3 ,M� 02c.G,n vyl�7 pYrnu.��-- 111 USE ATTACHED SHEET IN PACKET FOR ABUTTING OWNERS yl �l , �UT}I co;'riolmaa.1 materia K als to V be used In case of signsneccssar, give locations of existing signs and proposed locations of nevv signs. (Attach additional sheet, if y> 0 x l 2 liven F (t3n Sh c.A Sara\ 4 ti-to o otA t�D )_jV rwAt ?hr^t�m an ro_v� n Space below line for Committee use only. Received by OKHC Date — CertificaI'tte is LL2 Check BYL —AL-- APPROVED DISAPPROVED a/ 103 M.0 13 IWORTANT: If Certificate is approved, approval is subject to thM day appeal period provided in the Act. O Please return to: Yarmouth OKHC District Committee Yarmouth To«n Hall, 1146 Route 28, S. Yarmouth, MA 02664 00ftft ,2 i qo3 SPECIFICATION SHEET (YARMOUTH OKHC) Please fill out the form in its entirety providing color chips where necessary. INDICATE LANDSCAPING, EXTERIOR LIGHTING do ELECTRIC METER ON SITE PLANS FOR NEIV I[ousm 17 PROPERTY ADDRESS: = 403 FEB 13m3:21 FOUNDATION (18" MAX. EXPOSED): ONCRET THER DRIVEW ,: (1jflNE WALKWAY: Sftqt t4 OAV, STEPS (INDICA 1EMEOTHER Dmp SIDING TYPE &MATERIAL: 6WVrUrypntB� b0?lo�9r�NC� COLOR:16*w� CHIMNEY (INDICATE UCCO/WOODFACED) COLOR. ROOF MATERIAL: PITCH (7/12 N.) COLOR: MAX EXP. MI `fc ( fc WE WINDOWS (GRILLES REQUIRED) -INDICATE SIZES N T LISTED ON ELEVATIONS: DOORS (INDICATE SIZES AND STYLE IF NOT LISTED ON ELEVATIONS): COLOR: TRIM: (ALL WINDOWS & DOORS TRIMMED WITH 1X4 / 1XS) COLOR: MATERIAL OF TRIM: 00 , VINYL, ALUMINUM X 5)X `1X(O� SHUTTERS (WOOD/VINIQANELED/LOUVERED) N one COLOR: GUTTERS (WOOD/ALUMINUM): NOVA COLOR: GARAGE DOORS: SIZE & STYLE:* None COLOR: STORM WINDOWS & DOORS: COLOR: (INDICATE SIZES IF. NOT LISTED ON ELVATIONS) SKYLIGHTS: TYPE/SIZE: N o..e COLOR: DECK: SIZE & MATERIAL: Math COLOR: FENCING (MAX. HEIGHT 6'): STYLE: COLOR: (SHOW LAYOUT & RUNNING FOOTAGE ON SITE PLAN 4 to os RETAINING WALL: (P.T. OR FIELDSTONE -CONCRETE INAPPROPRIATE) (SHOW LAYOUT & RUNNING FOOTAGE ON SITE PLAN 11;;;•.' ' t,, ;;J SIGNS: (indicate size, style, colors) N005 COLOR: SIGN POST: (indicate size, style, color)jJaC COLOR: ADDITIONAL INFORMATION: REV. 12/01 SHEDS LESS THAN 150 SQ. F7. SHALL PLOT PLAN 6E PLACED A MINIMUM OF 30 FEET D A FROM THE FRONT LOT LINE AN MINIMUM OF 6 FEET FROM REAR LOT I SIDES AND NES. rOR LOT # Indicate location of Additions with dashed files or accessory building ---- Sewerage d-isposal (cesspool) ®- ------- --- Well y - 1 (lot ................ rear) uttor's me t# this is a lox lZ REAR YARD lot, '- 70 1 in name ;S'HED-•--....1,,,,ft street . - SIDE YARD //�� SIDE YARD 0 -"! --- FTo SET BACK ...45. .ft. (lot..................ft. frontage) WAME UP' b1 t1r�1') Information Supplied by Yi�iP;1UiH CO': .i ��.J .✓, J J/ ...J '03 FEB 13 AM 9:22 E: 4j 1 S (D v Abuttorts Name Lot # If this is corner Ic ' write in ' name of other street. '03 FEB 13� 9:22 :.: Cl _ .. a/ 013 1_ Stt �03 FEB 13 PH 9:22 3avolo/a 5 10'•O� Itr9 03 FER13 ate 9:22 0 �103. FEB 13 aM 9:22 J al-o" R SDC-- ©. l� �— C.7 �Q.m1 U UJ O z to � f - COAM ronwcatth of maaaa�stf! Official Uu Only o`e7�wrp-'�.%:it i ..-A PCrrmtNo. Jati service! Occupancy and Fee Checked 9. BOARD OF FIRE PREVENTION'REGULATIONS v.1/07] bleak "`.. -t :4 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (IvlE , 52.7,CMR 12.00 .. . (PLEASEPRINTININKOR EALLIN_ FORMATION Date: Cityor Town of: To the Inspector of Wires: By this application the undersign6d gives notice of his or her intention to perform the electrical work described below. Location (Street & Nu b r) CtA c) Owner or Tenant 'L" Telephone No.50Y-. ,?.322 I Owner's Address - - Sii'.4 Is this permit in conjunction with a buildln permit? Jes ❑ No eo�;"._(Check Appropriate Box) I� Purpose of Building�e S 1C1&,of ` UtilityAuthorization No.' Existing Service Amps / Volts i..Overhead ❑ U_ndgrd ❑ ::x;No. of Meters New Service ''Amps `/ Volts ,Overhead ❑ z:Undgrd ❑ ' '-No. ofMeters Number of Feeders and Ampaeity r� Location and Nature of Proposed Electrical Work: - ,.. •: n - r..r r.r . ! rr r" . m6r.....,,, he ."shred by the Inmeetor el Wires. No. of Recessed Luminaires No. of Ceil.-S addle Fans ". 7 �Pr ) '= rao. o u:: «.: '. •. . Total Transformers KVA No. of Luminalre Outlets No. of Hot Tubs Generators .. „ — :..:_ KVA 'r No. of Luminaires : t • Aboven- Swimming Pool d. ❑ d. ❑Bette o. o mergency Lighting Units t" No. of Receptacle Outlets .. .._ No. of Oil Burner _, a<:"• FIRE ALARMS No. of Zones u' - No. of Switches .. No. of Gas Burners_ _ .:,:, .:,;:.�•�? �; ":":: o. of Detection an yTnitiatin Devices No. of Ranges _-- -.. _ : _:... No. of Air Cond. _- -:Tons '- _ = No, of AleittnE Devices :...... . No. of Waste Disposers eat ump Totals: um er ors o. oSelf-Contained_ Detection/Alerting Devices I I I No. of Dishwashers S ace/Area Heating KW _ P g Local ❑municipal❑ �� Connection No. of Dryers rY Heating Appliances MV ecunty :" Na of Devices or Equivalent o. of Water KW Heaters o. o o. o Signs Ballasts Data Wring: No. otDevices or E uivaglent No. Hydromassage Bathtubs No. of Motors Total HP a Na of Devices onr E uivalent OTHER aaacn aaairtonai aerau p acsa ca, ar as rsgrurcu uy .,r'.,.W. w ,• •• Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start . Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue 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 R BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and.conVii—Ie FIRM NAME: /V5Lytk3 PLUm , , y 14fqT1 eo G LIC. NOA I i Z?3 Licensee: %/CfivigLLf-c3t_i4><� Signatur C.No...3o%sc79� (lfapplicable, enter "exempt" in the license monber line)But. Tel. No ��V�'gfU 7771 Address: F •=5.2i'wau C to-c-L£ Sr,, r�,�r��Ji'rotuV4/if#U21Lil Alt. Tel. No.: *per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. 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 aeent. Owner/Agent PERMIT FEE: $ Signature Telephone No. • s t...'.�' +.fir. x:.+s .`•y.rY i ti 1: nrF �4 The Commonwealth ofMassachusetts Department to en Office of Investigations - 600 Washington Street Boston, MA 02111 www.mvssgov/dca Workers' Compensation Insurance Affidavit: Builders!Contractors/Electricians/Plumbers Applicant Information `""'''Please Print Leeiblv Name (Business/Organization/Individual): F 1 ur-001.10,A.� a4a �4nts • y113 : .'YI Address: City/State/Zip: yArvwwo k1N `MA Phone M ' 50 $- 314 lyAre ou an employer? Check the app I am a employer with �_ `` employees (full and/or part-time).' 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. ❑ 1 am a homeowner doing all work myself. [No workers' comp. - insurance required.] t - ropriatebox: — ..:.._ �.,�..._::.... 4. ❑ lam a general contractor and I have hired the sub -contractors; listed on the attached sheet. These sub -contractors have employees and have, workers' r: -- ... comp. p insurance.: - .- 5. [J 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 woikers' comp. insurance reawred.l ij Type of project (required): 6. New construction on ❑ Remodeling 8. ❑ Demolition .3 9. ❑ Building addition i `-10.❑ Electrical repairs nor additions I1.❑ Plumbing repairs,�r additions - ail :12 ❑ Roofrcpam —13 ❑ Other •L.]i 1L Sill.. r� a• ., I a ♦err 1:✓. �r1:�^�� 'My applicant that checks box Ml must also fill out the section below showing their workers' compensation policy iinnfoirnatlon t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors rmtsk submita riewiff�davit indiutmg suefi: IC Antractors that check this box must attached an additional sheet showing the name of the sub -contractors and auto whether ornot those entities _ --Y 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 Polley and fob site Information. ...�._. . __ _....-. _ x.•_ _ Insurance Company Name: An -ow HAvai ::[v►SVranCe. \ e •�. n� ' `I Policy # or Self -ins. Me. #: 1705 A Expiration Date: 015 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 2L54mf MGL c.152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-yearimprisonmen well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.0 lator. Be vised t At a copy of this statement may be forwarded to the Office of Investigati of the DIA for ce covers a veri ation. I do hereby certify u patio and penalqetw6jperjury that the informadon provided above is true and correct Phone#• 5138. 394-7I2Q Official 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 Wpector 6.Other Contact Person: Phone #: • 12r=14 SlipGen - Portal Hone Town of Yarmouth Template [Building Dept] Slipsheet Identifier [sg13278] Document Category Building Permits Map -Block Number 116.57 Street Number 0230 Street Name WEIR RD Department Building Parcel ID 14931 Backfile Batch Scan No Document? Additional Naming Info Index Operator Operator, Yarmscan Date - Time 2014-12-22 - 09:58 httpJAaserfichel2/S1ipGerJ 1/1