Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Building Permits
0 Z tu W N > c N � a W CD 0 z � W o N J H In . l.orntrtonw.a� of ///aJJac�.t�J - �- `�.parlrn.nE of �ir. Jiroic.! BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. Occupancy and Fee Checked ev. 1/071 aeave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to beperfotmed in accordance with the Massachusetts Electrical Code(WC)• 527 CMR 12,00 SA SE PRINT IN INK. OR ALL INFORN TION) Date: City or Town of: TAQ U To the Insp Ctor to Wires: this application the undersignv�ea notice of his or her intetbon, o performrthe electrical work described belowti cation (Street & Number) k,0 71n v ' — er or TenantS Yl Telephone No./VIE Q er's Address is m this permit In conjunction with a bui ding permit? Yes ❑ No (Cheek Appropriate Bo:) Purpose of Building e \ n Utility Authorization No. W Existing Service Amps / Volts Overhead ❑. Undgrd ❑ No. of Meters New Service Amps / _ Volts Overhead ❑ Undgrd ❑ No. of Meters Nuinber of Feeders and Ampacity , Locyt(oIr and Nature om posed ElecMcal Work: TIC,-� �� ��� n_�_ r_.r__ _r.L- ! 1I....•J.... i../.1........ A. wniw,4 AV tA. /nenierer of Wbr-r No. of Recessed Luminaires No. of CeiL-Susp. (Paddle) Fans O. or Total Transformers KVA No. of Luminalre Outlets ------------ No. of Hot Tubs Generators KVA No. of Luminaires Above Swimming Pool rnd. ❑ n- d. ❑ o, ot Emergency 141ghung Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. ofSwitches No. of Gas Burners o. of Detection an Initiating Devices No. of Ranges No. of Air Cond. Tons Z No. of Alerting Devices of Waste Disposers P ump TrearrNo. Totals: um er ons et oSelf-Containedin Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW' municipali Local ❑ Connection ❑ r No. of Dryers Heating Appliances KW See my ystems: No. of Devices or Equivalent o. of Water KW Heaters o. o o• o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. H'dromatsa d'Bathtubs y g No.ofMotors Total HP Telecommunications NofDeis rung No. of Devices or Equivalent OTHER: nasal QaalaarWl ucr"u .f ----- I .. .. ^. Estimated Value o c 'cal Work: (When required by municipal policy.) Work to Start: inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE C VERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "cgmpleted operation" coverage or its substantial equivalent. The undersigned certifies that such rA erage is in force; and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE . BOND ❑ OTHER [I (Specify-) I cer*, ur ' " " 'tat the information on this application is true and complet ry v FIRM NAl WAYNE SCHMlDT LIC. NO.: 336 ELECTRICIAN 222 WILLIMANTIC DRIVE Si nature LIC. NO.: Licensee: g tljapplicab7 (50 MARSTMILLS, 02648 Bus. Tel. No.- =j 17/ (508) 428.7747 47 Addresr. 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 agent Owner/Agent PERMIT FEE: $ Signature Telephone No. FRIEDLINE & CARTER ADJUSTMENT, INC. 436 Main Street, P. O. Box 338 Hyannis, Massachusetts 02601 Tel. (508) 771-3232 FAX (508) 790-2344 TO: (4uilding Commissioner or Inspector of Buildings ( ) Board of Health or Board of Selectmen ( ) Fire Department TOWN OF Yarmouth TOWN HALL ,MA RE: Insured: MORIN, David & Linda Property Address: 69 Union Street Yarmouthport, MA Policy Number. 0803725 Type of Loss: Water Date of Loss: 2/212006 File #: 104187 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. General Laws, Chapter 143, Section 6 to be applicable. If any notice under MGL, Ch. 139, Sec. 313 is appropriate, please direct it to the attention of this writer and include a reference to the captioned insured, location, policy number, date of loss and file number. On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by First Class Mail. N. LAGUE Adjuster 2/252006 G sAv " Location OEC 31 Z003 U isls 3� tQ iJhro New ❑ Renovation ❑ Plans Submitted Yes ❑ No ❑ APPLICATION FOR PERMIT TO DO GASFITTING (OFFICE USE ONLY) By 4C, �1 Fee: $ 00/' PERMIT NO. G Date / z - 31- .�y_yd' 1 ,9\�2 T(`Ge Name V %'t D r1' n� Type of Occupancy l M Replacement Ef;- N i� 0f y U LU Z YES�� v7 2 Uf y oC 0 F- F z J Cn UJI a �' Z Z o JulCn f l I O w O O a ►x- w w a JLr t I ''j0 m W. y c� v u� ul x 0 W a¢ o p> w_ D �GW W N Z W W J 2 F= Q= Z F cc W M W V. Q O> W �' 1= F V W 0 !n f. W x 4Ql y o a x 3 c g a a� o U.3 > SUB-BSMT. BASEMENT / 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) n /i Installing Company Name 1c Gk Address D t7 14, M4 Business Telephone �Z o Name of Licensed Plumber or Gasfitter 22 Check One: ❑ Corp. ❑ Partnership — irm/Company INSURANCE COVERAGE: Check Qne I have a current liability insurance policy or its substantial equivalent. Yes n No ❑ If you have checked yes, please indicat the type of 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 Chapter 142 of the Mass. General laws, and that my signature on this permit application waives this requirement. Check One: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and Information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Signat re of Licensed Plumber or Gasfitter t-c1�388 . License Number TYPE LICENSE: 0 Plumber ❑ Gasfitter aster ❑ doumeyman /A 1! 1( 3 of Cq ou MW % T APPLICATION FOR PERMIT TO DO PLUMBING SOFFICE USE ONLY) By / �! Fee: $ PERMIT NO. Oct/ Building ut AT: Location �� �i h t dK �j<<'e�� - Date Owner's && r � /U Name : Type of Occupancy New 9�� Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No ❑ l ye`/Z71 z S' Cn N y 0 X Fa- > frf / W Y J cn Q V Q N Z (7 N N Z y WCM F W X 2 f' Vl O W Z Z Z n• CO w W Z o ¢ (p Z cc a. M 0 . w O w a 3 °� a rn ¢ o cU. W�ttcu3e M� I W> x� 1- 3 O S°Nz o O p v~izzwW O U 3Yg mc000 g 3°x►a- N a�ca3o°cmo gr UU.. SUB-BSMT. BASEMENT 1ST FLOOR 2NDFLOOR / r 3RD FLOOR (PRINT OR TYPE) !!-- Installing Company Name �^�[/��fC2 Di is PV` Iq Address S10 03 ka-(`d n M 19L Check One: ❑ Corp. ❑ Partnership cnzit, ,0e'%/57• CYF`rm/Company Business Telephone Name of Licensed Plumber I ak 4g —r/ INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent. Check One: Yes LS3' No ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. A liability insurance policy Q' Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance voerage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Signature or Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) In above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be incompliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Check on Owner ❑ Agent ❑ --� Signa a of Licensed Plumber License Number Type: Master Journeyman 0 F/y/o N 001* SEPTIC SYSTEM o LOCATION FROM INSTALLER'S CARD l3S 0 FENCE EXIST. / DWELL CONCRETE FOUND AT10X j �or TOWN OF YARMOUTH WELL EASEMENT JOB # 88-313 PL 0 T PLAN SHOWING EXISTING FOUNDATION AND A PROPOSED POOL FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT ONLY LOCATION : 69 UNION STREET YARMOUTHPORT, MA SCALE : 1" = 50' DATE : AUGUST 1, 2003 REFERENCE LOT 3 PB 378 PG 59 1 HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. a" 508-392- 541 rm soe 362-OW dawn cape engineering, inc. CIVM ENGINEERS rsNn StMMYORS DATE lain sL yamiouth, ma 026M PREPARED FOR: DARIN a<00�HOFl�ss90 o TIMOTHY COVELL o No.38035 y ROR os r TOWN OF YARMOUTH Building Department BUILDING (508) 398-2231 ext.261 '- PERMIT NO PERMIT B-04-115 e ISSUE DATE ; - - 7/25/03 - - ; PROPOSED USE ' APPLICANT David v•-8 Lin•daor••Mo•in --------------- Pi 0 WEATHER CARD ............ ADDRESS 00069 UNION ST PERMIT TO Addition --------------------- ------------ AT (LOCATION) 00069UNION ST ZONING DISTRIC R 40 Bldg. Type: Residential SUBDIVISION MAP LOT BLOC 1 t5.59 LOT SIZE O BUILDING IS TO BE: CONST TYPE 5•B USE GROUP R-4 two car garage addition with master bedroom & bath, utiltyroom, mudroom , covered porch as REMARK per plans dated 06/27/03. AREA (SO FT) EST COST ($ $88 OWNER JDAVID B MORIN ADDRESS 00069 UNION ST Yarmouthport MA 102675 PERMIT FEE ($) BUILDING DEPT BY INSPECTION RECORD CONTRACTOR LICENSE 0 I FIELD COPY .:Note Progress Opp Fame A To ��IJ� OF •�rqR a I so{A y '� / �• `h M�iTACMIst ONE & TWO FAMILY ONLY - BUILDING PERMIT APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING Town of Yarmouth Building Department ' 1146 Route 28 - Yarmouth, MA 02664-4492 Tel: (508) 398-2231 x261 - Fax: (508) 398-2365 .w�&V-F.4-" rj Office Use Only ; ' Permit NoDatB� •-- ; c�11 D 'Deposit Rec d $�5D° Dat Net Due $ ` xrfy�' ' planning Board Information an Type . ` Endorsement0afe ' Rec6rd(np Date i Plan No Assessors Department information r s IUav t Old a New 1:4 Property Dimensions i. Lot Area (sQ J, 3o i Frontage (ft). Lot Coverage i { Omer This 'Section for Off Ida, Use On Buildin Peimif Number. ;Date' issued: ° ; Signature Building Otfiaal ; Date ". Certificate of Occupancy +`'` , ; ; is Is not _ _required Section•1,=5i a lnfomlation' Use Group: R-4 Type: 5-B 1.1 Property Address: rirt _ 1.2 Zoning Inform'a)tion: n Zoning District Proposed Use 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 50 4- 1.4 or Supply (M.O.L. c. 40. S 54) ublic Private 1:5 1 Flood Zone Infomiatlon " Comments s : ; " Zone ie' CrBFE''''^; 1 Section 2 '-' Property,Ownership/AuthorizedAgent 2.1 Owner of Record: ' Name (print) Mailing Address Signature y, , i��` Telephone J`J` QQ3 2.2 Authorized Agent:ul- Name(print) J qD6({ Mailing A ress Signature Te ephone Section:3'- C 3.1 Licensed C ) D 1 ^ I/ Not Applicable ❑ J U L G o tuu 5 License Number Address By Expiration Date Signature Telephone 3.2 Registered Horne, Improvement Contractor' Company Name OWNERS PULLING THEIR OWN PERidITS OR DEALING WiTH UNREGISTERED CONTRACTORS FOR APPLt• WIP uroir 14^RX 89 N9T HAZE Not Applicable ❑ License Number Address ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. Signature Telephone Expiration Date 7-i-99 1of2 OVER 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. Si ned Affidavit Attached Yes No New Construction I�J No. of Bedrooms I I No. of Bathrooms Existing Bldg. ❑ IRepair(s) ❑ IAlterations ❑ Addition Accessory Bldg. ❑ Type Demolition Other Specify: Brief scri tion of Prppposed ork: ✓l CA(t ► i p)J sSectlori i3 = Bstimafed,'Coristtitction%Costs' Item Estimated Cost (Dollars) to be c mpleted by permit applicant 1. Building 40 • a 2. Electrical . eb 3. Plumbing / Gas Z oao . CA 4. Mechanical (HVAC) 4D 5. Fire Protection if 4 taw. cp 6.Total=(1 +2+3+4+5) V W AV •orb 7. Total Square Ft. (new h=w 3 additions) a Sq FT. 616. I I Check Below I d3 Conservation -Commission Fling (if applicable) Old Kings Highway ri Historical Commission approval (if applicable) 3�y 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. Signature of owner T Date , 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 AA Signatu of Owner/Agent Date •t 9- r5-99 2 of 2 TOWN OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION* SUPERVISOR FORM PLEASE PRINT: ,job Location: • , Number ; Street Village Owner of Property: ' Construction Supervisor: Name License No. Phone No. Address: Licensed Designee: (If other than Supervisor) Name License No. 2.15 Responsibility of each license holder. 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.AalI be responsible.to supervise the construction, reconstruction, alteration, repair, removal or demolitiorinvolving 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 hblder 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 Anylicenseewho shall willfully violate subsections 2.15.1,2.15.2 or 2.15.3 or anyother 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 Bolder 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 understandmy 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 current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes ❑ No ❑ If you have checked yam, 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 Chapter 152 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent Signature: Building Official Approval: 4� For Office Use Only Permit No. Date TOWN OF YARMOUTH AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MOL 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: —f%t/� f^ Est. Cost 600. Address of Work Owner Name: / ' Date of Permit Application: dJ 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 PERMITS OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLI- CABLE HONE IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL r.142A. 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 ppl for a permit as the agent of the owner: Date Contractor Name Registration No. Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: 11513 Date Owner Name /I The Commonwealth of Massachusetts Department of Industrial Accidents #Nev0//9YOS1/OsdasS 600 Washington Street Boston, Mass 02111 Workers' Compensation Insurance Affidavit Ai • i 47 .../ lam a homeowner performing all work myself. I am a sole proprietor =ad have no one working in any capacity O lam an employer pro%iding workers' compensation for my employees working on this job. com�an,y o�me• addres • city: phone N• insurince co noliev 0 1 am a sole proprietor. general contractor, or homeowner (circle one) and have hired the contractors listed below eho have the following workers' compensation polices: company phone N• policy 0 -- incur-ince co Faiture to secure coverage as required under Section 25A of h1GL 152 eaa lead to the imposition of criminal penalties of a Due up to S1,SNJDQ and/or one years' Imprisonment as well as civil penaldes In the form of a STOP WORK ORDER and ra fine of SI00.00 a day against me. I understand that a copy of this statement may be forwarded to the Ogee of investigations of the DU for coverage verification. 1 do hereby cerb. f t ftthe pains and penattles• ojperjuty that the information provided above is true and correct Print name Phone 0 r Official use only do not write in this srta to be completed by city or town official city or town: YARMODT$ check if Immediate response is required permitAleense 0 nBuilding Department ClLlccnsing Board 261 ❑Selectmen's Office Health Department tcnft% ion,"31 eat contact person: phone 0: _ nOther Information and Instructions T Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. 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 enrplt�rer is defined as an individual. partnership, association. corporation or other legal entity, or any two or more of the foregoing enea�aed 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 tilt grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. NIGL chapter 1521 section 25 also states that every state or local licensing agency shall withhold the issuance or rcncival of a license or permit to operate a business or to construct buildings in the commonwealth for any .who has not produced acceptable evidence of compliance with the insurance coverage required. applicant Additionall%. 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 ha%e been presented to the contracting authority. Applicants Please till in the workers compensation affidavit completely, by checking the box that applies to your situation and supplying 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 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. The affidavits 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 OCC of hros110auses 600 Washington Street Boston, Ma. 02111 fax N: (617) 727-7749 phone 9: (617) 7274900 eat. 406, 409•or 375 TOWN OF YARMOUTH BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 260 PLEASE PRINT: DATE: JOB LOCATION: "HOMEOWNER" NAME PRESENT MAILING HOMEOWNER LICENSE EXEMPTION STREET ADDRESS SECTION OF TOWN WORK PHONE CITY OR TOWN STATE ZIP CODE The current exemption for `Homeowner' was extended to include owner — occuQed dwellings of one or two units and to allow such homeowners to engage an individual for hire who does not possess a license, provided that such homeowner all act as supervisor. (State Building Code Section 108.3.5.1) Definition of Homeowner. Persons) who owns a parcel of land on which he / she resides or intends to reside, on which there is or is intended to be, a one or two family attached or detached structure assessory to such use and / or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner, such "homeowner" shall submit to the building official, on a form acceptable to the building official, that he / she shall be responsible for alisuch workerformed under the building permit. (Section 108.3.5.1) The undersigned `homeowner' assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and regulations. The undersigned `homeowner' certifies that he / she understands the Town of Yarmouth Building Department minimum inspection procedures and requirements and that he / she will comply with said procedures and requirements. %,'� OWNERS PULLING THEIR OWN PERMITS OR DEALING HOMEOWNER"S SIGNATURE / /2� 2 - APPROVAL OF BUILDING OFFICIAL WITH UNREGISTERED CONTRACTORS FOR APPLI- CABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL C.142A. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch.142. 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 Cbapt 2 o;the Mass. General Laws and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent ❑ h:homeowftdke=P TOWN OF YARMOUTH 1146ROUTE28 SOUTHYARMOUTH MASSACHUSETTS02664-4451 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 th�e�debriiss�res/u�.11tiing/ffrrom,t�he proposed work/demolition to be conducted at (�V, ow-?� Work Address is to be disposed of at the following location: ��rky Cal �1 Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Signature of Applicant Date Permit No. butbor's ame of # . this is a :)rner lot, rite in name street. a� b 4 PLOT PLAN FOR LOT # Indicate location of garage or accessory building Additions with dashed lines -------------------- Sewerage disposal (cesspool) Well f8 I Ia6t................ ft. rear) SIDE YARD FT_ I, 4 REAR YARD HOUSE Q SET BACK I SIDE YARD 0------FT0 (lot .................. ft. frontage) (NAME OF STREET) Information Supplied by Abuttor' Name Lot # If this corner write i name of a other street. MARK NORTH POINT. TONVIN OF YAR«OL•TM BM DING DEPARTMENT r P'"N REV� & BL�DING PERNUT APPUCATTON REyEEW HOB tilap i ram: D2te of h iiat ew::_G%?- 16 3 dal Dom: NOTES: ��0 / #pD/T D/YE �oowA�T/an CV/,u0ecu Y eov e& ✓itn t3 Oiv �o n r.t K ¢s ReDi..r sZ/r-CA,C//4* #AY4LC,rm,) /LauKD �1CR/MtLrc.c IIHPe c w0 7WO" ' t/vcc ,uNOrr..�s•tor Dr �Sy/r�ras a+r r!s s/t� F. e � GYPSu.,. g W/µDaa`SrN /%%S !3A'V01454- TAGurt! W007- b'E �l11 P�ILs-D . IG .+ a ... . • _ D3 P 1.: A.rJ r �. `•rr. i c�e prcposed _ _ ... _ .. ' ._�..razs a aSpe�P�saa �'�-thtZcRr�g $o�3•af.. — o-� auitdhg code Denial (if zp mble) •+ oor •., TOWN OF YARMOUTH Fof _ Building Department = Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT APPLICATION RECEIPT Temp Permit No.: T-03-592 Applicant Name: David & Linda Morin Location: 00069 , UNION ST Owner's Name: DAVID B MORIN Owner's Addres 00069 UNION ST Yarmouthport I MA 02675 Owner's Telephone: (508) 362-4397 (OFFICE USE ONLY Recorded By. Ic Permit Fee: $0.00 Deposit Rec: $25.00 Payment Type: Check ChkNo.: 2035 Net Owed: ($25.00) Application Date: 6/12/03 Issue Date: Expiration Date Comments: two car garage addition with master bedroom & bath, utiltyroom, mudroom , covered porch ZONING APPROVED -W a3AO?lddd DNINOZ This is NOT a building permit. Application subject to plan review. Contact Building Department for permit status. Official Building Permit will be issued upon plan review completion, approval, and complete payment of Net Owed on Permit Fee. OWNERS PULLING THEIR OWN PERMITS OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLI- CABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL t:144A. Date Printed: 6/20/03 oq'v'9R,S � wwtf SSK d Building Site Location: TOWN OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET No: —&,Lot No: a The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. RESH)ENTIAL 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, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. ..................................................................................................................................................... REVIEWED BY: / �1. WATER DEPARTMENT: V DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: CONSERVATION: V' DATE: N/A Imo. HEALTH DEPARTMENT: V-4' DATE: N/A: INDUSTRIAL AND/OR COMMERCIAL PERMITS S. WIRING INSPECTOR: DATE: N/A: 6. PLUMBING INSPECTOR: DATE: N/A: 7. FIRE DEPARTMENT. DATE: N/A: COMMENTS: RECEIPT OF COPY: PLEASE NOTE SIGNATURE OF APPLICANT: DATE: White copy - Building Dept - Pink copy - Water Dept - Ydlow Copy - Heal* Dept - Pink Copy - Engkmaing Dept - Goldenrod - Fire DeptAComQvation Building Site Location: y TOWN OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET No _ZZ No: a Address: sXX Te1.No.: 3G o? 1-1397 Date Filed: �1 / The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. 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, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Eta .......................................... -------- lea ............ --......................................................................... REVIEWED BY: 1. 'WATER DEPAR"IMENT,-,c DATE � N/A: 2. . ENGINEERING DEPARTMENT: DATE: N/A: 3. ; CONSERVATION: DATE: N/A ` 4. HEALTH DEPARTMENT: DATE: N/A: INDUSTRIAL AND/OR COMMERCIAL PERMITS 3. WIRING INSPECTOR DATE: N/A: 6. PLUMBING INSPECTOR DATE: N/A: 7. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: White co" - BufldiB DML - Pink copy - Water Dept - Ydtow Copy - Haft Dept. - Pi* Copy - Engirwering D� - Goldenrod - Fie UeptfiConscrn im . . I U r JOB # 88-313 PL 0 T PLAN SHOWING A PROPOSED ADDITION AND A PROPOSED POOL FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT ONLY LOCATION : 69 UNION STREET YARMOUTHPORT, MA PREPARED FOR: SCALE : 1" = 50' DATE : JUNE 9, 2003 REFERENCE : LOT 3 PB 378 PC 59 DAWD- M.ORIN I HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. offae sae-sez-+s41 sae Fez-veeo down cape engineerutg, inc. CTVII. M r-=Ms tr►ND SURVEYORS 939 main SL yartnouth. ma 02675 DATE �37 rrao �' H. it },• is COVELL �• Wo. JaO 5 REG. ND 'SURVEYOR 4 -_w S&7 Building Site Location: TOWN OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET No: _&.5 __Lot No: a The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. �FSIDENTTAL 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, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal ................................ -...................................................................................................... Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. REVIEWED BY: 1. WATER DEPARTMENT: DATE: N/A: NIA: 4. HEALTH DEPARTMENT: DATE: N/A INDUSTRIAL AND/OR COMMERCIAL PERMITS S. WIRING INSPECTOR DATE: N/A: 6. PLUMBING INSPECTOR DATE: N/A: 7. FIRE DEPARTMENT DATE: N/A COMMENTS: RECEIPT OF COPY: PLEASE NOTE SIGNATURE OF APPLICANT: DATE: White eOry-BuDdmgDept - Pink copy - Water Dept - Yeflow Co" - Haft Dept. - PmkCopy-Ett�Dept. ��lireDep ,i+�!qC'— —N1 PL 0 T PLAN SHOWING A PROPOSED AND A PROPOSED POOL FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT ONLY LOCATION : 69 UNION STREET YARMOUTHPORT, MA SCALE : 1" = 50' DATE : JUNE 9, 2003 JOB # 88-313 ADDITION PREPARED FOR: REFERENCE : LOT 3 PB 378 PG 59 DAWD-_MORIN I HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. at =7382-4541 to xe Sex -OM down cope engineering, me. CIVII. ENGMEERS LAND SURVEYORS 939 nain al. yamrouth, ma 02675 DATE V [ �• Ti'.�OTH't H. }. C04•FLL• � 'z h'ii.:,9D35 y' r Al REG. AND SURVEYOR .0 .YaR� /-�3 TOWN OF YARMOUTH BUILDING DEPARTMENT O H ��, n •�t BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET Building Site Location: Map No: // S Lot No: a The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. 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, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements r For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. ................................................ -.................................................................................................... REVIEWED BY: 1. WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: i 3. 1 CONSER' 4. HEALTH 3. WIRING INSPECTOR DATE: N/A: 6. PLUMBING INSPECTOR: DATE: 7. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: White copy -Building Dept- Pink copy - Water Dept. - Yellow Copy -Health Dept. - Pink Copy- Engineering Dept - Goldenrod - Fire DeWConmvation PL 0 T PLAN SHOWING A PROPOSED AND A PROPOSED POOL FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT ONLY LOCATION : 69 UNION STREET YARMOUTHPORT, MA SCALE : 1" = 50' DATE : JUNE 9, 2003 JOB # 88-313 ADDITION PREPARED FOR: REFERENCE : LOT 3 PB 378 PG 59 DA I HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. ar sor362-4541 I r� son 362—aseo down cape engineering, inc. civ>z. ENGINEERS t.nlan SURVEYORS 939 main sL yamroulh, ma 02675 DATE VI r •ARIN NOFIIgssc TIMOTHY s E f{ COVELL oNo.38035� LAND "" Y R PROPERTY ADDRESS: ALCULATION FOR PERMIT C a�Xa-s= s9p� /b X 3, 17iC2= 3� Gat �t xas' 37,C3� / s'l 5T TYPE OF ROOM ETC 9105 T/ HUUI i wn I. ALTERATIONS BATH BED ROOM CERTIFICATE OF OCCUPANCY COMPUTER ROOM ! DECK OPEN DECK WITH ROOF DEMOLITION, - DEN DINING ROOM FAMILY ROOM FIREPLACE FOUNDATION ONLY. - GARAGE NO. OF BAYS (�) GREAT ROOM LAUNDRY ROOM LAUNDRY ROOM LIVING ROOM MUD ROOM OFFICE PORCH CLOSED PORCH OPEN REROOFING SHED STORAGE AREA SUN ROOM HEATED SUN ROOM UNHEATED SWIMMING POOL ABOVE GRi SWIMMING POOL INGROUND WINDOW REPLACEMENT 6rx 1 i 3'�y PL 0 T PLAN SHOWING A PROPOSED AND A PROPOSED POOL FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT ONLY LOCATION : 69 UNION STREET YARMOUTHPORT, MA SCALE : 1" = 50' DATE : JUNE 9, 2003 JOB # 88-313 ADDITION PREPARED FOR: REFERENCE : LOT 3 PB 378 PG 59 DAVI 1 HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. off 50e-362-+541 fax We M-4w Down cape engineering, Inc. CIVII. ENaniEERS LAND SURVEYORS 939 mein sL yammth. ma 02675 ORIN FL COVELL No.3803° p ' �. off. oo. � /TOWN OF /YARMOUTH WELL EASEMENT I L�1 ._. I T, S� SEPTIC SYSTEM 0 LOCATION FROM 0. INSTALLER'S CARD o� PROP. o ADDITION .y0 01 POSED OOL .o FENCE PL 0 T PLAN SHOWING A PROPOSED AND A PROPOSED POOL FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT ONLY LOCATION : 69 UNION STREET YARMOUTHPORT, MA SCALE : 1" = 50' DATE : JUNE 9, 2003 REFERENCE LOT 3 PB 378 PG 59 l 1 HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. c" soe Q sae-xz-4541 as2-9=ew down cape engineering, tac. c>vu. ENCEN=RS LAND SURVEYORS 939 main sL yarmouth. ma 02675 JOB # 88-313 ADDITION PREPARED FOR: YARMOUTH Old King's Highway Regional Historic District CotnmT&WN! CLERK in the Town of Yarmouth for a M HAY 15 Alt 9- 23 A' PA' CERTIFICATE OF APPROPRIATENESS RECEIVED Application is hereby made in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on Plans, drawings or photographs accompanying this application for. CHECK CATEGORIES THAT APPLY: 1. Exterior Bin7ding C ElNew�lding Addition p AlterationMica ' e1YPeofbuflA�ar House N�Gatage 0 CommecCial p Otber_ IAX;i1CLt►'} �.�t%rl�4lnPi I(�1(I 1c�7 y 2. Exterior Piiinting p 3. Signs or.Billboardt r NewSiga D Existing Sign'' -a Repainting edsting sign 4. Stnxtum,E Fence-; p Wi&-- 11 Flagpok�:! CIf Othct— TYPE OR PRLWT LEGIBLY DATE ADDRESS OF PROPOSED WORK 6 A MAP NO. / S OWNER_ �� ID + LIMDA /� Q Z/N ASSESSORS LOT NO._ t HOME ADDRESS 64 �N LC!►J STREET �tin+f�R , TELEPHONE NO._Y Z —q- q % AGENT OR CONTRACTOR TELEPHONE NO ADDRESS USE ATTACHED SHEET IN PACKET FOR ABUTTING OWNERS DETAILED DESCRIPTION OF PROPOSED WORK Give all particulars of work to be done including materials to be used. In case of signs, give locations of edsting signs and proposed locations of new signs. (Attach additional sheet, if necessary). N EWZ CA-P. GEC—' AYD ML D2oot-t AD-D 77ZCW NCZo GA 6L6=- A'r2ML-1. s "G0;u`>tawS C >m i rzonr,-o CZi ts��� Moos& New 1k3G20uN)j 700L Wrnl Faa.iCL s; edl`O >;� Space below line for Committee use only, 0 w ner'C a i Ior-A ent Received by OKHC Date n0 3 This cafe ' ` () Date 5 V Check #Aq 1 By ----Pr, APPROVED 13 tOtRT rC te is approve approval is subject to the 10 day appeal period provided in the Act. DISAPPROVED p Please return to: Yarmouth OKITC District Committee Yarmouth Toun Hall.1146 Route 28, S. Yarmouth, MA 02664 IZJ ■ lTt SPECIFICATION SHEET (YARMOUTH OKH lV RM Please fill out the form in its entirety providing�n� i T '4ere necessary. INDICATE PLANS FOR NEII'AOUSES LANDSCAPING, EXTERIOR LIGHTING & ELECTRIC bTM 7m) uw 1.1 w ^ I, 7 FOUNDATION (18" MAX EXPOSED): CONCRE DRIVEWAY: WALKWAY: STEPS (INDICATFCEMENT�: —� SIDING TYPE & MATERIAL: (A)• (f COLOR: (�/L CHIMNEY (INDICATE BRICIUSTUCCO/WOODFACED) COLOR ROOF MATERIAL: / kr-(f 1R67-PITCH (7/12 MIN.) MA-TCµ C )CIS?• COLOR M,+-C(� MAX EXP. tExt is WINDOWS (GRILLES REQUIRED) —(WOO" ^- INDICATE SIZES IF NOT LISTED ON ELEVATION h s'D E25 esa �i . N . W H i r=- U tNy L C4A-P ZU MA-iZd+ tEKi eS?. 5t7d5- DOORS (WOOD95L riitt(INDICATE SIZES IF NOT LISTED ON ELEVATIONS): Z X G 8 COLOR: q UTE S7E L=?- D TRIM: (ALL WINDOWS & DOORS TRMAED WITH 1X4 / IX5) /'�I/t'1Gff. lSr : COLOR: 0) I{ / TL MATERIAL OF TRIM: D IIdYL. ALUtvmRM SHUTTERS (WOO GUTTERS mow(g'W�M ct GARAGE DOORS: SIZE & STYLE: rj t0'k l 10" STORM WINDOWS & DOORS: (INDICATE SIZES IF NOT LISTED ON ELVATIONS) SKYLIGHTS: TYPEISU E: WOOD DECK: SIZE: G. t(5"x lab to MAk) m y WOOD FENCING (MAX HEIGHT 67: STYLE: (SHOW LAYOUT & RUNNING FOOTAGE ON SITE PLAN) RETAINING WALL: STONE —CONCRETE INAPPROPRI (SHOW LAYOUT & RUNNING FOOTAGE ON SITE PLAN) SIGNS: (indicate size, style, colors) COLOR605516,fw ao COLOR: Wtf 17Z- COLOR:rt,,�' . COLOR 1J I -tom COLOR COLOR Mk7ZVJ-r- COLOR 1 SIGN POST: (indicate size, style, color) COLOR � Jo ADDITIONAL INFORMATION: REV. 12/02 43 MAD 4T LpimbscP►p" /Pl0r PLAt YARMOUTH qiZz/03 TOWN CLE�� ;. oti 1m3 HAY i z AEI ED •gc iL L 13 P 4 :05 a 1fiENw� .i� y�, 1 OWN CLEHK y. 1 1' -9a1r d N!'` �ro •ti' APPRO V E Lb LOT 7/ C) / !gS Do. �. X r �BMou H P�- OKHRHpM1�EE you«va.T,e.r %--% 4A* Ago%m -CAE gjet %% prT o p U"1=94 # 88-313 CERTIFIED PLOT PLAN LOCATION : UNION STREET YARMOUTH SCALE : 1' = 50' DATE : 1210518B PREPARED FOR: . REFERENCE : L- 3 PB 378 PG 59 I HEREBY CERTIFY THAT THE STRUCTURE DAVID MORIN SHOWN ON THIS PLAN IS LOCATED ON THE _ GROUND AS SHOWN HEREON. OF dCHN c o m EL1VEE N down cape engineering CIVIL ENGINEERS Inc. N0,33E02 c LAND SURVEYORS als 8PS A RTE 6A - YARMOUTN, MASS. DATE REG. t YARMOUTH ' TOWN CLERK 1103 MAY 15 AN 9* 24 �n . ,...-, RECEIVED All Cape Fence P.O. Box 318 South Dennis, MA 02860 3-A0?8 1 780 CMR. STATE BOARD OF BUILDING REGULATIONS AND STANDARDS THE MASSACHUSETTS STATE BUILDING CODE Manual Trade -Off Worksheet BnilderName /l/y �aG1N Date Permit it '• Checked By BuilderAddras I Site Address rag WIMAT YAjZwoaW ZIA Zone)Z12 ❑13 ❑14 Date 1 Submitted By Phone - PROPOSED REQUIRED f•eilm¢s Skvti¢fits and Floors Over Outside Air ,. aeQu'ved Ittsuluton z HaArea U-Value ev It -Value U•Vatue UA •b1e16.:?fi) UA �abk Q I�k 13 aQ� Qz>Area 1 `0 z5, Z 6.21.) • a0 . Floor Orc Outside Ak fe abk 16JJa1 fe Walls. Windows: and Doors : Tact A= -t • Destaf'eton •• Irwlattom It -valve • U-Value z ILsS Ara r •UA 1"it°d U•Valve .zArea UA 1:5 Z ---• 91.3 l - l l�o. 14 rrr.Vbk1622b.ad) J Wittdowf -- -- offa3+ 'v'9 F97; (NFRC or Table 11-%Jb) srl&t Glass Doors (NFKC orTableJI.SJs) R' fY . . TOW Am Floor and Foundations losid an Immladoalt- zAreaor , "Ired _ . _ -_ .._•.� .rant... •.d....... Arta O.V.toe it OS-141-2 -LA +7e 1 • Tora1 7�.7 OR Rega fired UA G e. sotttmm ofComplis=The proposed *Oft desipt rr cmftd m +AdJuAed Am d•e...rnu 4 rowrtranr trJrJr dr 6.p�trJ+� rIr'�O°a . .nd odic ealeuladoru wbmima vrbh the k ton. Rtgalrid CA Si�Jt� Ccx�t� �D7ucr �'A•y ��[GN z7�a3 B.nelraDerl;rrrr Company Name Dart 0 J.- yr` IN 76022 780 CMR- Sixth Edition . 2R0/98 (Effective 3/1)'8) 4. ENERGY CONSERVATION APPL;CATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS - - - 780 CMR Appendix J (effective 3/1/98) Applicant Name; �� %�'v Site Address: NlelJ 5i RE! Z— . Applicant Address: ( l/yiD� Cityrrown: Qc�7}( )i2i'; Y �a - Use Group: AN. p7,6 7 DateofApplication: Applicant Phone: Applicant Signature: Compliance Path (check one): Prescriptive Package (Limited to 1-or2-family wood frame. buildings heated with fossil fuels only) Package (A Through KK from Table.152.lb): Heating Degree Days (HDDj$) from Table J52.1a: (For items d. through i, fill in. all values that apply from Table 15.2.1 b:) a. Gross Wall Area sq.ft E Wall R-value R- b. Glazing Area' sq.ft. g. Floor R-value R- . c. Glaring % (too x b a) "�• h. Basement wall R __.. _. d. Glazing U-iralue U- ' 1. Slab Perimeter R-, e. Ceiling R-value. R- j., Heating AFUE Component Performance: "Manual Trade -Of" (Limited to Snood or metal framed bpildings only) Climate Zone (from Figure J622) Zone 12 {] Zone 13 Zone 14 Attach Trade-off Worksheet from Appendikland N AC Trade -Off r'orksheet. if applicable] HASeheck Software Attach Compliance Report and Inspection Checklist printouts. Systems Analysis OR 0 Renewable Energy Sources Attach Mass Registered Architect or Engineer Analysis ALTERNATIVE FOR ADDITIONS ONLY: a. Gross Wail +Ceiling Area sq.ft. b. Glazing Area' sq.ft. c. Glazing % (100 x b+•a) % ADDMON with Glazing % (a) up to 40% may use 780 CMR Table J1.123.1 below: htAXlM1UM U-value MINIMUM R-Values Fenestration I Ceiling Wall I Basement Wall Slab Perimeter. Depth 0.39 1 R-37 R.t3 I R-19 I R-10 R-10.4 R O "SUNROOM" addition (greater than 40% glazing -to -wall stud ceiling gross area) Attach "Consumer Information Form" from 780 CMit Appendix B. Official's Name: ORcial's Signature: Application Approved Denied Date of Approval/Denial: Reason(s) for Denial: (provide additional details as needed on back side) \Glazing Area may be either Rough Opening or Unit d'unemlons. BARS o6nV92 Massachusetts Department of En dromneMal Protectlan Town of Yarmouth Wetland By -Law Bureau of Resource Protection — Wetlands Chapter 143 WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 p ' General Information From: YARMOUTH con armimCommisslon 1. Applicant David Morin Name ofhaw M pgRemst 69 Union Street Mai7inpAMM YnrmnnthPnrt G1y/ro»n MA 92675 SW 40 code 2 Property Owner. SAME AS ABOVE Name offteryowvrifdif "- hmoppik" MarnoAddmr GTy/rown 3. Title and Final Revision Date of Plans and Other Documents: Certified Plot Plan at 69 Union St., Yarmouth, MA Sbte aCode 1 Determination \ Pursuant to the authority of M.G.L c.131, §40, the YARMOUTH Coiue ww commiwm has considered your Request for a Determination of Applicability, with its supporting documentation, and has made the following Determination regarding: 69 Union Street SVWAd&en YarmouthPort 02675 cay/ro" Lp code 103 C3 AssessoaMaAft Pem"t R V. 1 P Massachnsefts Department of Environmental Protection Town of yarmoath Wetiand By -Law Bureau of Resource Protectlon — Wetlands Chapter 143 WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Determination (cont.) The following Determination(s) istare applicable to the :3 proposed site and/or project relative to the Wetlands Protection Act and Regulations: Positive Determination Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of Conditions (issued following submittal of a Notice of Intent or Abbreviated Notice of Intent) has been received from the issuing authority (i.e., conservation commission or the Department of Environmental Protection). M 1. The area described on the plan(s) referenced above, which includes all or part of the area described in the Request, is an area subject to protection under the Act. Therefore, any removing, filling, dredging, or altering of that area requires the filing of a Notice of Intent 0 2. The delineations of the boundaries of the resource areas listed directly below, described on the plan($) referenced above, which includes all or part of the area described in the Request, are confirmed as accurate: Therefore, the resource area boundaries confirmed in this Determination are binding as to all decisions rendered pursuant to the Wetlands Protection Act and its regulations regarding such boundaries for as long as this Determina- tion is valid. However, the boundaries of resource areas not listed directly above are = confirmed by this Determina- bon, regardless of whether such boundaries are contained on the plans attached to this Determination or to the Request for Determination. ::3 3. The work described on plan(s) and document(s) referenced above, which includes all or part of the work described in the Request, is within an area subject to protection under the Act and will remove, fig. dredge, or after that area. Therefore, said work requires the filing of a Notice of Intent. 4. The work described on plan(s) and document(s) referenced above, which includes all or part of the work described in the Request, is within the Buffer Zone and w48 after an Area subject to protection under the Act. Therefore, said work requires the filing of a Notice of Intent. S. The area and/or work described on plan(s) and document(s) referenced above, which Includes all or part of the work described in the Request, is subject to review and approval by Nrme olA�widD�ldY pursuant to the following wetlands law, bylaw, or ordinance (name and citation of law). ❑ 6. The following area and/or work, if any, is subject to municipal bylaw but 1M subject to the Massachusetts Wetlands Protection Act: G 7. If a Notice of Intent is filed for the work in the Riverfront Area described on plans and documents referenced above, which includes all or part of the work described in the Request, the applicant must consider the following alternatives (Refer to the Wetlands Regulations at 10.58(4)c. for more information about the scope of aftemative requirements) : G Alternatives limited to the lot on which the project is located. ❑ Atematives limited to the lot on which the project is located, the subdivided lots, and any adjacent lots formerly or presently owned by the same owner. C Ahematives limited to the original parcel on which the project is located, the subdivided parcels, any adjacent parcels, and any other land which can reasonably be obtained within the municipality. Ahematives extend to any sites which can reasonably be obtained within the appropriate region of the state. MauachawfCs Department of EMMAIMerltal Protectlon Town of Yarmouth Wetland By -Law Bureau of Resource Protectlon — Wetlands Chapter 143 WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G. L. c. 131, §40 U Determination (cont.) Negative Determination Note: No further action under the Wetlands Protection Act Is required by the applicant However, if the Department of Environmental Protection Is requested to Issue a Supersed- ing Determination of Applicability, work may not proceed on this project unless the Department fails to act on such request within 35 days of the date the request is post- marked for certified mail or hand delivered to the Depart- ment. Work may then proceed at the owner's risk only upon notice to the Department and to the conservation commission. Requirements for requests for Superseding Determinations are listed at the end of this document ❑ 1. The area described in the Request is not an area subject to protection under the Act or the Buffer Zone. G 2. The work described in the Request is within an area subject to protection under the Act, but will not remove, fig, dredge, or after that area Therefore, said work does not require the filing of a Notice of Intent. X 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but will not after an Area subject to protection under the Act Therefore, said work does not require the fling of a Notice of Intent 4. The work described In the Request is not within an Area subject to protection under the Act (including the Butter Zone). Therefore, said work does not require the firing of a Notice of Intent, unless and urtbl said work afters an Area subject to protection under the Act. :3 5. The area described in the Request is subject to protection under the Act Since the work described therein meets the requirements for the following exemption, as specified in the Act and regulations, no Notice of Intent is required: EMWAC&Y ❑ 6. The area and/or work described in the Request is not subject to review and approval by N&M ofMumdAVY pursuant to a municipal wetlands law, ordinance, or bylaw, (name and citation of bylaw). Authorization This Determination must be si ned f th This Determination Is Issued to the applicant and delivered as follows: ❑ by hand delivery on Dale }ill by certified mail, return receipt requested on April 25, 00 Dale This Determination is valid for three years from the date of Issuance (except Determinations for Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. g by a majorrty o e conservation commission. A copy must be sent to the appropriate Department of Environmental Protection regional office (see appendix A) and the property owner (if different from the applicant). 4-25-00 D2.+e • D�E P Massachusetts Department of Enivlrenmental Protect/on Town of Yarmouth wetland By-it.aw Bureau of Resource Protection — Wetlands Chapter 143 WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protectlon Act M.G.L. c. 131, §40 U Appeals The applicant, owner, any person aggrieved by this Determina- tion, any owner of land abutting the land upon which the proposed work is to be done, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate Department of Environmental Protection Regional Office to issue a Superseding Determina- tion of Applicability. The request must be made by certified mail or hand delivery to the Department, with the appropriate fling fee and Fee Transmittal Form (see Appendb(E: Request for Departmental Action Fee Transmittal Form) as provided in 310 CMR 10.03(7) within ten business days from the date of Issuance of this Determination. A copy of the request shall at the same time be sent by certified mail or hand delivery to the conservation commission and to the applicant If he/she is not the appellant. The request shall state clearly and concisely the objections to the Determination which is being appealed. To the extent that the Determination is based on a municipal bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has no appellate jurisdiction. 103-c3 • � Z3X8 / rTaawvsT�e.r . \S 4.4' / J,gs 0 4BovE 'TAE' "te 1U r r 0 o F.t�►�low1 ST2t!mTh CERTIFIED PLOT PLAN LOCATION : UNION STREET YARMOUTH SCALE : 1" = 50' DATE : 12/05/88 REFERENCE : L- 3 PB 37B PG 59 I HEREBY CERTIFY' THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. I down cape engineering inc. CIVIL ENGINEERS LAND SURVEYORS RTE 6A - YARMOUTH. MASS. DATE PREPARED FOR: DA VID MORIN ,e OF }� JCHt3 fo t cELME 18B-313 THE COMMONWEALTH OF MASSACHUSETTS TOWN OF YARMOUTH OCCUPANCY PERMIT 207 No....................... . "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until 9 certificate of occupancy has been -issued by the Building, Inspector." G —3 ,,�,�f� sz /' Issued to y . �r y�Ad ress:.�.9�!�!.. !t/X.+ f ....J ..t..... Wiring Inspect ...... O.. ..... � 1; .....Jnspection Date....... ..... Plumbing Insp o ...... . ..... f . !k! � .... Inspection Date %..-..;:2 .-..... .......... Fire Departmen . (�'. y. ...... ....................Inspection Date... �.-+�A.'........j Building Inspector .......... .. .......... ................................Inspection Date....l�.��'l....... .. 3`0AR'�..OF... HE .TH.....,J .......................Inspection Date ...1 THIS PERMIT WILL NOT BE VALI , ANSHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN%j REQUIREMENTS. Date:....�...©.R................ Building Inspector................................................................... --- ------�� - Rio,✓ fit•- -- -- o� --Q�-�r�--------- .- ND Y zx3S AP rLmn ,ol T M N fLO/ I caNTIr4AUS eLOCxINc TLmQ JCI I I I 1 , I I I I I , 1 1 6 z x rNnca f , 1 11 AC" �. Ts e i__ac g. TAGGCR£D)' STA Z` CAP FL �I ` I i [AP PLAT D=TAIL 1 Or ....V2' d 10.T 3 c/Z STEEL C0.uw � l TO rOOTING, OR CONTINI= V rOa TING 4 6�Tt:3 I _x�xD_— (D Y('leY,¢Yl � AtW 1 M T D JUN 2 3 4— t / + N RA NQTFS AND MATERIAL , 1. Structural Steep ASTM A7 i, Grade 50, shop painted w/ rust Inhibitive paint. 2 Anchor Bolts, ASTM A510 (Galvanized for exposure to moisture), 3'PW din. expansion -type x 6' min. embedment, 3 All workmanshlp to conform with American Institute of Steel Construction and Massachusetts State Building Code Latest Edition requirements. 4. All welds to be E70xx electrodes. Shop weld cap and base plates to columns. 5 Coordinate all dimenslons with Architectural Drawings, and field verify _! wnere required. �� Ala C. I TUDOR No. 34774 STEEL BEARS CONNECTIONS TO T R FRAMING MICHELE C. TUDOR, P.E. � Consulting Structural Engineer 123 Cottonwood Lane Centerville, MAssochusetts 02632 0j Y,[,Wir _rg h Gi fsL�h�"j Drawn By: MCT Date: F 1 g i r e S K — l Checked By: Scale: none File Name: Project No.: a 891SE' BC CALL® 2002 DESIGN REPORT - US Double 1 3/4" x 91/2" VERSA-LAM(g) 3100 SP Job Name - LINDA & DAVID MORIN Address - 69 UNION STREET City, State, Zip - YARMOUTHPORT, MA Customer - Code reports - ICBO 5512, BOCA 98-52, SBCCI 9852 Friday, June 13, 200315:25 File Name - D Morin.BCC : RB01 Description - PORCH Specifier - Designer - Joe Madera Company - SHEPLEY WOOD PRODUCTS Misc - '1_10 12 StandardLoad - 30 PSF 115 PSF TriWa 03-06-00 05-06-00 05.04-00 05-08-00 BO B1 B2 B3 259 Ibs LL 685 Ibs LL 685 lbs LL 259 Ibs LL 137 Ibs DL 368 Ibs DL 368 Ibs DL 137 Ibs DL Total Horizontal Length-16-04-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Live Dead Trib. Dur. S Standard Unf.Area Load Left 00-00-00 16-04-00 30 PSF 15 PSF 03-06-00 115 Member Type: - Roof Beam Number of Spans - 3 Controls Summary Left Cantilever - No Control Type Value % Allowable Duration Loadcase Span Location Right Cantilever - No Moment 544 ft-Ibs 3.4% @ 115% 7 2 - Right End Shear 264 lbs 3.6% @ 115% 4 1 -Left Slope 0/12 Cont Shear 426 lbs 5.8% @ 115% 7 3 - Left Tributary 03-06-00 Total Deflection U14211 (0.005") 1.3% 4 1 Repetitive n/a Live Deflection L/20197 (0.003") 1.2% 4 1 Construction Type n/a Total Neg. Defl. -0.002" 0.3% 4 2 Max. Defl. 0.005" (Limit: 11 0.5% 4 1 Live Load 30 PSF Span/Depth 6.9 1 Dead Load 15 PSF Part Load 0 PSF Duration 115 NOTES: Design meets Code minimum (U180) Total load deflection criteria. Disclosure Design meets Code minimum (L1240) Live load deflection criteria. The completeness and accuracy of Design meets arbitrary (1") Maximum load deflection criteria. the input must be verified by anyone Minimum bearing length for BO is 1-1/2". who would rely on the output as Minimum bearing length for B1 is 3". evidence of suitability for a Minimum bearing length for B2 is 3". particular application. The output Minimum bearing length for B3 is 1-1/2". above is based upon building code -accepted design properties Entered/Displayed Horizontal Span Length(s) = Clear Span + 1/2 min. end bearing + 1/2 intermediate bearing and analysis methods. Installation Member Slope = 0, consider drainage. of BOISE engineered wood products must be in accordance with the current Installation Guide and the applicable building codes. To obtain an Installation Guide or if you have any questions, please call (800)232-0788 before beginning product installation. BC CALCO, BC FRAMER®, BCI®, BC RIM BOARDTM, BC OSB RIM BOARDTM, BOISE GLULAMTM, VERSA -LAM®, VERSA -RIM®, VERSA -RIM PLUS®, VERSA-STRANDTM, VERSA -STUD®, ALLJOISTO and AJSTM are registered trademarks of Boise Cascade Corporation. Page 1 of 1 n4 z 911-r* tnommonweaR of MamacLefft Official Use Only cc��rParlrnrnt `..tircc77 r Jrnn rvicu Permit No. �/� , ` 0 6 _ .1Jo Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/071 leave blank APPLICATION FOR PERMIT TO PERFORM ELE CAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (ME� Fes- (PLEASE PRINT IN INK OR TYPE ALL INFORMA TION) Date: Augustwro; City or Town of: YARMOUTH To the Inspect l'I "IMP. III By this application the undersigned gives notice of his or her intention to perform the electric ork escn L; n. Location (Street & Number)69 UNION STREET Owner or Tenant JUSTIN & JENNIFER ENDRES ip 08)_2$0- 090 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ✓❑ (Check Appropriate Box) Purpose of Building RESIDENTIAL Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: INSTALL SECURITY SYSTEM PLEASE FAX PERMIT AND PERMIT# BACK TO US AT: 508 398-5666. THANK YOU rmmnla/inn ntthn mh/s.i ha tha /nenortn-n!1{'i•ee U O rL W z O No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans o. of ota Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ n- ❑ rnd. grnd. o. o 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. o eteng D an Initiating Devices No. of Ranges No. of Air Cond. Toot No. of Alerting Devices No. of Waste Disposers eat Pump Totals: um_. er ors_].IZW No. of Self-Conta`tne Detect ion/Alert in g Devices — No. of Dishwashers Space/Area Heating KW Local ❑ Nlluniclpa [I Other Connection No. of Dryers Heating Appliances KW Security ystems: No. of Devices or Equivalent 4 o. o eaters KW tera. Heaterst o o. o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP a ecommunicattons Vtrmg: No. of Devices or E uivalent OTHER: 215.00 Attach additional detail if desired, or as required by the Inspector of Wires. 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 Q BOND ❑ OTHER ❑ (Specify:) I cerilfy, under the pains and penaltles of perjury, that the information on this application is true and complete M NAIVE: Cape Cod Alarm Co.. Inc. LIC. NO.: 1592 ticensee: GENE CORMIER Signature LIC. NO.: e �1 afapplicable. enter -exempt " in the license number line.) Bus. Tel. No.! 508 398=6316 CaAddress: 204 OLD TOWNHOUSE ROAD WEST YARMOUTH. MA 02673 Alt. Tel. No.: 800 468-8300 Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. SS CO 000248 M OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hme the liability insurance coverage normally `required by law. By my signature below, I hereby waive this requirement. 1 am the (check one owner owner's agent. Owner/Agent PERMIT FEE. S 45.00 Signature Telephone No. The Commonwealth of Massachusetts 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 Please Print Leuibly Name (Business/Organization/Individual): CAPE COD ALARM CO., INC. Address: 204 OLD TOWNHOUSE ROAD City/State/Zip: WEST YARMOUTH, MA 02673 Phone #: (508) 398-6316 Are you an employer? Check the appropriate box: I. El I am a employer with 30 4. ❑ I am a general contractor and I 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. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and 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' comm. insurance reouired.l Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t I lomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that Is providing workers' compensation Insurance for my employees. Below is the policy mid Job site information. Insurance Company Name: Associated Employers Ins., Co. Policy # or Self -ins. Lic. #: 5006433012008 Expiration Date: September 1, 2009 Job Site Address:69 UNION STREET City/Statc/Zip:YARMOUTH PORT I Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Sienature ate: August 25, 2009 Phone #: (508) 398-6316 Official use only. Do not write in this area, to be completed by city or town ofciaL 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 _ 11 Contact Person: Phone #: 11 1201I2014 SlipGen - Portal Home Town of Yarmouth Template [Building Dept] ■ Slipsheet Identifier [sg14912] Document Category Building Permits Map -Block Number 115.59 Street Number 0069 Street Name UNION ST Department Building Parcel ID 14657 Backfile Batch Scan No Document? Additional Naming Info Index Operator Operator, Yarmscan Date - Time 2014-12-31 - 11:54 httpJAaserfiche121SlipGenl 1/1