HomeMy WebLinkAboutBuilding PermitsFee>?.13d.-.0.......
THE COMMONWEALTH OF MASSACHUSETTS
TOWN OF YARMOUTH
OCCUPANCY PERMIT
96
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 �ce� ificapte of
occupancy has been issued by the Building Inspector.
Issued to:
Address:
Wiring Insct ............ .,.............Inspection Date. l!z..: 2 -t.,
%.............
Plumbing Insp - f Inspection Date..,l.��,HFire Department...... . ................Inspection Date...............
Building Inspector..... . .......:. K?"'"``zC"........Inspection Date%i:.............g..............
Assessors...................................................................................Inspection Date.........................................
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED
BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOW REQUIREMENTS.
i
Date:.... /�.��..:.��........... Building Inspect P...:�,........................................
op r TOWN OF YARMOUTH Building Department BUILDING
_ _ . _ .. _ . (508) 398-2231 ext.1261
+- PERMIT NO B-12.197 - PERMIT
r ISSUE DATE 8/15/2Qj1 . ; PROPOSED USE ;
APPLICANT Allen- eaoi............. ..... ' JOB WEATHER CARD
PERMIT TO AlterraUons...
AT (LOCATION) 10062SEMIN0LE DR 1ZONIX6 DISTRICT R-40 Bldg. Type: ResldenUal
SUBDIVISION MAP LOT BLOCK 1118.99 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-3
LOT SIZE
siding 2.5 squares
REMARKS
AREA (SO FT) EST COST ($ $1,900.00 PERMIT FEE ($) $35.00
OWNER IMCDOWELL, JAMES L BUILDING DEPT BY
ADDRESS 22 Rising Ridge Road
Upper Saddle River NJ
INSPECTION RECORD
Date Note Progress - Corrections and Remarks
CONTRACTOR
LICENSE 15579
Bent, Allen
48 Winsome Road
South Yarmouth MA 02664
5083947709
PHONE 12019214490
FIELD COPY
Inspector
A
is
It
RECEIVED
AUG 1 5 2011
Or -
EXPRESS BUILDING PERMIT APPLICATION
TOWN OF YARMOUTH
Yarmouth Building Department
1146 Route 28
South Yarmouth, MA 02664
(508) 398-2231 Ext. 1261
CONSTRUCTION ADDRFSSt
ASSESSOR'S INFORMATION:
units use uuty
Fee s
Pamlt expires 6 monou from
Map: Parcel:
OWNER: 1i G �0l 92/ Yq?o
.y
NA�MiE PRESENT ADDRESS . EL 0
1l 12,
n< U ���{ i
.000NTRACTOR:
NAb1E MAII.WO ADDRESS 207
Residendal Conun= al 0 Est. Cost of Construction
Itome Improvement Contractor Lie. N l fJ 5�2
Construction Supervisor Lk.
Workman's Compensation Insurance:
1 am the homeowner i am the sole otJf� 1 have Worker's Compensation Insurance
Insurance Company Name Worker's Comp. PolicyN
WORK TO BE PERFORNIFID
❑ Tent (Fire Rdardaat Cuttlkam attached) WORK
stove
-� �� g� n n n n Shin
�Sldlag: N or Syuores 2 fo _ f'` y�}' a Gc�ss-,� ��n`'�.(d�QtepLscemrnt windows: N
O Replacement door- S
0 Electrical Pormit M
❑ Re -roof: N of Squares
( ) Strlppins old shinglea•
`The debris will be disposed of at:
❑ Insulation
() going over --- L—layers of exlatins roof Old Kings Higbway/Filstorio District
s
RooMySldlog (like for iJke)
1 dative under pcnaltles of perjury that the s herein contalood am true and cared to the best of will be just cause for deelal or rcr oya�� n11 In1se and belkf. 1 uadentand that any false answap)
prosonrtbn under M.O.L C3.268. Sectbo 1.
Applicant's Slyract= �/�jJ//Jj� /�y -
Ownersgnature (or Sis(tachasenl)i�I%ZQJ �rData
Dsls:
Approval By: Date
Building Oflkial (or daipsee)
Zoning District_ <� Yy
Historical District: Yi No Flood Plain Zone: Yes
Water Resour Protection District: Within IW rt, of Wetlands:
X No yti(' No
3,01
The Consmonwealth Opfauachusetts
Department oflndnstWAccidents
gpice ojlnveshkadons
600 Washington Street
Bostons MA 02111
Workers' Compensation Insurance AMdavi�BulldeyCoatractor$Mectrlclans/Plumbers
aQcaat intormaHon
Name
Are you as employer? Check the appr
1. ❑ 1 am a employer with
2. 0employees (flrll and/or puwtime)-•
1 am a sole proprietor or partner.
ship and have no employees
wod ntg for me in any capacity.
[No workers' comp, insurance
requtred:j
3.[31 am a homeowner doing all work
Myself [No workers' comp.
3a.13 insurance required.) t
Iamahomeowner
general contractor ( tsartto N4)
Phone #:
Type olpro jeet (required):
6. ❑ New construction
7. JURernodeliag
B. ❑ Demolition
9. ❑ Building addition
1013Electrical repairs or additions
-11.13Phmbing repairs or addidons
12.E3 Roof repairs
11[3 Other
;�' aPPUeaat that chaeb boat NI swat a4o all out ttfe saetloa below showda [
;Any
who ru6mit thin Otdwit iodicadn wovnwdett
tCaatraesep ant ehaek thin bavt mur �'r' d0i" a ag wadt and Am bau outiid, h as
eatplorew, Utha won harms d addidaeal shoat showioa sans ortha whoa d t a °^� arltdarit ia$ndng stack
CO4 r. thgr snot povids rhtdr waken' cowl 1 uaatbw. adb wMthw want thcaa eadd a have
aim a�
4. ❑ I am a general contractor and I
have hired ft subcontractors
listed listed on rite attached sheet,
These sub -contractors have
employees and have workers'
comp, insurancat
s• We are a corporation and its
officers have exercised their
right of exemption per MOL
C. I52, 11(4), and we have no
employees. [No workers'
co
il
lnjonrratfoh,��-- ........ p,vv f`l wrontera' coarptarwlow b"Manee or
j my em pro» Betort► b �P�J owr/off ails
Insurance Company Nor=
Policy M or Self -ins. Lie. H:
Job Site Address-
Expiradon Data:
Attach a copy of the workers$ compeassyoa City/Stat mp.
Failure to secure covers as p°�' deelarstloa pep (can le of the polity number and eapsradon date).
g° under Section 25A o(MOL a 132 can lead to the impoaidoq elcriminal
tine up to 31,s00.1>D and/or one-year imprisonment, as well as civil Peaaltia of a
o[up to $2JO.A0 a day against the violator. 8e advised that a copy
o o� ;a in the loon of a STOP WORK ORDER and a fine
Igvatlpdogs of the DfA for insurance coverage verification tateOent may be forwarded to the Office of
0/pedwJ►that the bvoraaatfow p abar�tLrtrwa�corratx
MR
OQfctet rtas onljt Do Hof wilts in this arcs, to ha, compk" bl cltJr or fbwra e,Qfc/aL
City or Towg:
Issuing authors Permlt/L tense
4 (circle age)t
1. Board of He81111 2. Buildln n
& Other g epartment J. Cl1y/1'ow4 Clark a, Electrical Inspector S. Plumbing Inspector
Contact Person:
Phoas a:
Information and InstructionshoM a
deaerd Lava obapw 152 N°P� 1°b& ������mo imdw � ��t dwir of WM
manussttaet r thie sts% es copkya is defned
WE' 9YO7
a Nei � a wrtttaw."
agrees �P sparsdam at odw iepl w*9 at my two of more
As �p b det;sed es was indtridss� is Siam gobvielk And �� � ` of s dscsassd twat �
oftbsl6eep�*Wsfadh►idirlassedl► ato �wssrriA.tMrsV► tbsat a °yes
avant a &maw bssae bares eat moe■ fast three apertmads at woek as atsei da"ellbr{ b0■e■
d o bd t �°mt &u - - an l aot tsa0w of ss� a ""yawl be lk - 2 r be s em�r7��
at � isles � May strM w leeol tleeuslos� s!■'sy st<sn wttlbetd l!e tsesosss w
Mc cbsPls 1s7.12iG6I r spst■r a budges w is clausal bsiYaM t• t!s eemseu+se■o er arq
remwd d s flees w Pry Of coeheJt
pprast,rr. tus.et It t++:2L* 1 � oc ss with dw tom•
enter too 07� the psbsssaw■ °tpebat� ra�f Yam''"
regWemdor o[ ttois abegasr bsre bees pMMEMENNEEM d
Ap�s■ts ettydnit twmipislaM� � ebec� the boat.. tttet apply r yow ,sieraliou
Fuson old dw wmbsee' « number(,) 210" with tbdt eedaeaw
IN(s) nonds)a maken() pbsss (Liu?) will oe wpblgee odl w doedo
asessesef� � Cozad" (LLQ ar Lhww L1sb.JY1► tf w LLC or Lttt dow bars
rosmbses eeee PMUM r we ad � r `� w°rled %ftp v e be d h dw*W
be aebmittad le � �'�
englopsk s peWy to rage ; � MIS to sla u+ rite eb. sftliar& Ds 'b°n{d�
Aaddalt for ea-rmdbs mt tbs pit aft tioseee is helotsK
UM sutrtmd r do dtfr 7'■n° 0s�sads■s r.�.,us{ tb. taw at itya. er. narie+le abd■ Isw erco
tadsasW A«�a me the smbr itetsd bell+..�■d abo.Yasrr .heir
m" pass% ohm"
alf td Deprtmn! t
CNY w •taws omd•U ,� >�evsssasd 6w peatridsd i apse. d the halos
please be sue that the smda it is.owlet sod prielad bes to coetad you' do
oft! s8fdsrit !be g i s r eel arts b the mmbbladw wbt k wW bo uwd sso rel�as °0 � e�rit
pigs.. be ON a ell is td p.rmiWauss�� is say td*e■ yeeq need only wrtr m toeedoae lu�y or
u.d.t •tab su. Adilt sd' &S aFgbod b a� off owm any be peo+►+ded r t!•
_ tbst bs baeu owdally atsa>♦ed at marloed by �f me be;Td out ear&
� " A s/! of the sttlydstrit I. as Ne he ti�trsr Perth, as ttee■aea. A eew.mdarit V"K"
Wttw o bems�av eel ae eitiss is obattai e o sloes s pewit mt nlaMd For sq beebw ar cammosefal
ae r ttraet tearw ete.) "M Pens is , = regdrd r complete� emdtrit:
(Le. a do{ Noeess paleg d adrson ex your coopsrudou sad dould yas hate say qt dkw*
MENNEN
1?is Otltea at faresdWb■s weeY lib r tbslt you
plesw ds eel bedlsss r yfre ns a C&L
ctt. oep.+ttss�, > U&Phom sed eta emebert
Tits Commoawesltb of Mans
pepwanat of Wdt odd Aceldeab
own of hw"dg%&2S
6w w»data sale
gostoar h(A 02111
Tel. # 61-1-121 � 90O W � r- VI•NfA93AFB
ttsrised 11.22a16 WWW.rttat-SOY/&
l� 61
Liu
L
ths from
EXPRESS BUILDING PERMIT APPLICATION
TOWN OF YARMOUTH
Yarmouth Building Department
1146 Route 28
South Yarmouth, MA 02664
(508) 398-2231 Ext. 1261
CONSTRUCTION ADDRESS: (n,2 /y! / N D !c —PR f o S
ASSESSOR'S INFORMATION:
Map:
OWNER:
CONTRACTOR:
Residential Commercial
"tom
Parcel:
O Q1ar NY
TEL #6161 sai q4is6 t
ADDRESS T1- #
❑ Est. Cost of Construction S
Ilome Improvement Contractor LIc. # l G � ~ Construction Supervisor Lie. #
Workman's Compensation Insurance: (chee ney—�'
I am the homeowner am the sole proprietor 1 have Worker's Compensation Insurance
Insurance Company Name: Worker's Comp. Policy#
WORK TO BE PERFORMED ,
❑ Tent (F'ue R�Yardaat Crstilkate attacltcd)
❑ Wood Stove Shed
❑Sldins: NofSyuuxa 0
❑ Electrical Permit # ❑ Replaceneat doom. # Xcovemrnt windows: #
❑ Re -roof: #orSquam
() Stripping old shinsks•
'The debris will be disposed of at:
O Insu6ulon
() going over layers of alsdng roof
Wcyrlon of Facility
❑ Old Kings Highwayallswric District
Roonng/Slding (Uke for Uke)
1 declare under peoples of perjury that the statertenn heroin conwlned will be Just cause for denial a revone true and correct to the best of my Mewl dge and belief. I understand that any false aaswer(s)
i2 a oA y d Uon under M.G.L. (X 268. Smdon 1.
Applicant's Signature
Dare: In --/ Y
Owners Signature (or s(tacbmenl) Q�
Data: -
Approved Ily: Dam
Building Official (or designee)
Zoning DGtrkt—LL —0
Historical District V� No Flood Plain Zone: Yes
Water Rao Protection
))District Within 100 M of Wetlands:
Ybs` No Y14— No
I
111
The Commonweal* OfMossachusetts
Department oflndmtrial Accidents
00ee ofbrvesdgadons
600 Washington Street
Boston, ,NA 02111
Workers' Compensation Insurance A d viat.-]3uliders/Contractors/ElecMcians/Piumbers
11lcant Information
Name
Are yosi as employer? Check the a
1 1-1 I ppropriate bo::
am a employer with 4. 0 I am a general contractor d I
2.� employees (Rill and/or part-time). •
I am a sole proprietor or partner.
ship and have no employees
working for me in any capacity.
[No workers, comp, insurance
relud:l
3.[31 am a homeowner doing all work
myself. [No workers' comp.
U.131 Mumma acting as a
general contractor (refer to M4)
have hired the subcontractors
listed on the attached sheet
These sub -contractors have
employees and have workers'
comp. insurance,=
s• ❑ We are a corporation and its
officers have exercised their
right of exemption per MOL
C. 132, 41(4), and we have no
employees. [No workers'
Comn
_ �RU
Type of proieet (required):
6. ❑ New construction
7. ,Remodeling
S. ❑ Demolition
9. ❑ Building addition
10.13 Electrical repairs or additions
11.[] Plwnbing repairsor addition,
12.0 Roof repaira
13.0Other U I
'Any zppUcwA that Cheeks tn�tt[anCe I [ tuns NI must W o QII out da recdos below
tCoomeawom as dt who rAtnit"atndarlt tadicatin doily a!(wak OW then
rhea h� ,mad
ehaCk d" boa mur i ' aro md& ilouey iatbrmaelaa
cmployeaa. Ittm sib 000tneyors ha addiBwd rheas ahowioa 16a oama of �ha>v�ha aW MW =SIM bn* aww w at not Vir �n such.
! as a......r ....mm�� .r ,- -- Yam, dray oeuat Pro" dfeir waken• ComP6 POUq aumbar. thoaa CUddaa baw
-•----r••••r•narvvrRtA'COM►pensedonlnfrglpnc�
lnjorMwtlott j" +nJ eMrployset Below is A*Pd 1Y and jab stet
Insurance Company Name:_ .
Policy 0 or Self -ins. Lis N:
Job Site AddresExpiration Data:
s:
Attach 4 copy of the workers' compeo,ayos City/StatelZip:
Failure to secure covers as p°' deelaratlos page (showing the Polley number and expiration date).
ge re under Section 2JA of MOL c. 132 can lead to the imposition ofCriminalfine up to $1.500.00 and/or one-year imprisonment, as well as civil Penalties of a
oflnvuP t 3250.00 a day against the violator. Be advised that a copy of 'es is the form of a STOP WORK ORDER and a fine
gations Of DIA for insurance coverage verification tatement may be forwarded to the Ofslce of
-v ••• •yam ...wr lne akAw aJPelary fkat 1Are lnjorareeiow
S� t — P OwRllilx/OndComa It
O.Ofehal ass onhc
City or Town:
Do not tarp& h, t,,b area, da he co wpk*d by city or to am ol%1elaL
Issuing authors Perralt/License 0
61.0
Board of Ilea! h( 2. Building Department 3. City/Tows Clerk 4. Electrical Inspector 3. Plu
mbing Inspector
Contact Person:
Phone p;
Information and Instructions
�, c� L:we cbapeer l!2 � rmplaf�+ �p"� '� ,mCO �',� � o
p,u,�a, t is No�"► "is defined •• ��► Paws
ae Ora al a wnteta"
� ��� corpaado�a or athdr � e�h►s or aef r1° og osoge
A. en/igs is defined a. "� mod" i' mi i.chdh�{ the � o[a d.oewd sot 68
o � � ' eaeoeiedott at a � wb. �widee thw*# - then oc r i m o(dw
Cocaowat of'e darnllhts ho.ee �"� °0t m0g'thea tbeae �tmaor come,- at n rr wak of Mb d� bound
dwelft bourn d another wbw att>pMye not � �meTt employment be deswed eo b. ea mm pls�w
at as the gt or bnildMfl � ebell wtthWW to � of
ll2. �uc(6)' dtet w� dealt s Meal •/siey Ireg W
MechsPW do 21to O� ar e. aaetroet � �/� arenM r"ok w
al of a• ticwe partelt erwe h nag my a[ fee poll" wbd��'MA
el
2"dC w o bee � ststee "Nnhber the eommoawe� with the �
Ate
. M" cbeP� 1 orpub6M work until aeeept ble nvidews o[
ate
Cabot Imy coshes floe the pad to the codmft et.baebf w EMNEW
op dtla cbepeer btw bes pdeeealed
AppYea.b I _ ' bComo1 cha>�i the boxed the applf"Yaw alendoa dada U
Plane td oot the d � e"= (,w �p� ((LLLV) wit! �Myae)Of
odW &m the
10
tow". Llabil� e: (LLC) a Lhdted Ltabi" WWMM Ira LLC or LLF does hew
a eae*f
�mbaea as ��dr a not & an d�� that thin a aaf � to d Depastond cc Udwerm do"
L
w'pMyn► VW amd"
a Pow d cmdmmdm d �aeee ea.a,� Ain e...d+ e8 alp u+ dais tl..m�.
be tedmb a delCiVar'"" the the a�piieedm ex the penur11 y � obddi.. walodd.�
fadetaW Aaldd.le` _ Rena ya heed ati 4 � numbs Ihrd We 5.!>�towted °°mp�in aboeY aaldr t!laig
... m ooliny. PMan the Depedemdet awe MEMME—
ne IMS 0 1210b
h Mad grits d legibly. floe Depattrwat lone F -- a sp'0' at the bottos
P1aae bn en that the al * �°' ' bee to caatad yom teped� the
at the an wit me yaa to 0 out be the �nombb dhet MA will used f1fu aee mabw is sddfd^ M app�"
P a s ba nee to en d the p«eft—M nay d� 2� and o.ly =be* am aEederit ledleaetee caeg*e/
W adm � (U� =" "Job SW A"SnV P a mubmd bf the clef Q'ancy tm ftag�rtiI i on d e ar
towW A aff 0166 amdwtt td hee bes oodoy t�4ed w � A ww amdevit mad be NMi out eaJ
appiiael r peon[ that a vaW taboo f ag a Iffis A" ae pamb ant whMd w anf bneioa' a � v"N"
h, r z***rd m coe;kn bete amdwit
(�. dog Ilnan Of Pff"* en bum kr'an ode.) said P� should yor Mvn nay °O�
.,fe (3010 of toadgedos would 13* to d mlt you, Is advmee 6. y.. cooper d.
pleaae de we ha ftW r 51" w a caL
WEENNOWN�rtr Depatmoed't oddtae� alephow mad t><a meats:
To C oqmftcd of uNLot e
d b
apta of rST"dpdde+S
600 Wm6i 0W 8ftd
Boston &fA 02111
Tel.10 611-721-4900 ext 406 of 1-a77-&'ASSAF8
Fax Al 617-IV-7749
Itsvised 11.22-46 WwtifMo Lpy/dIg
l
YARMOUTH OLD KING'S HIGHWAY REGIONAL HISTORIC
DISTRICT COMMITTEE
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Phone (508) 398-2231 Ext.1292 -- Fax (508) 398-0836
Colleen McLaughlin, Office Administrator (cmclaughlin@yarmouth.maus)
CERTIFICATE OF APPROPRIATENESS APPLICATION
Application is hereby made in quadruplicate for the Issuance of a Certificate of Appropriateness (C/A) under Section
6 of Chapter 460, Acts of 1973 as amended, for proposed work as described below and on plans, drawings,
photographs, and other supplemental information accompanying this application.
Check All Categories That Apply,
1) Exterior Building Construction: New Building Addition _Alterations Reroof
Indicate type of Building: Commercial _X Residential Garage _Shed _Other.
2) Exterior Painting: Siding Shutter Doors Roof Other
3) Signs/Billboards: New Sign Existing Sign Change ' - 5) RV'Pi-1110E W1V'v 1f
4) Miscellaneous Structures: Fence Wall Flagpole Pool Other.
Tyne or print lealbly:
Address of proposed work: V, P Map/Lot #
n Phone q:
Mailing address: 2 K / -i uz C: �id 4 /� C/ (� n/J�p�•�� /�- -+�— �;V r
Email: Preferred notification' method: f+w
_QUS Mail Email
Agent/contractor. :T, fit lei eop Phone 1i: _S 2a 103V41 27o(7
Mailing Address:
Email: 4 1 /-preferred notification method: (ri;--NUS Mail Email
Description of Proposed Work•
Signed (Owner or agent):
Owner/contractor/agent Is aware that a permit is required from the Building Departmer
If application Is approved, approval Is subject to a 10-day appeal period required by thi
This certificate Is good for one year from approval date or upon date of expiration of Bt
All new construction will be subject to inspection by OKH. OKH-approved plans MUST
For Committee use only:
Recelved y KH:
Date:
CashRcvd b heclL#:
Rcvd by:
Date signed:
Approved
Reason for denial:
Signed:
RECEIVED
MAY 10 2011
YARMOUTH
..11 ,.... ..._.....
on -site for
C` 3 H
Date: :!5 -14 •— //
r
hall be later.
Irarninp IBnal inspections.
11
ten<a1 Denied
iWAY
YARMOUTH OLD KINGS HIGHWAY REGIONAL HISTORIC
DISTRICT COMMITTEE
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Phone (508) 398-2231 Ext. 1292 -- Fax (508) 398-0836
Colleen McLaughlin, Office Administrator (cmclaughlin®yarmouth.ma.us)
STATEMENT OF UNDERSTANDING
As property owner/contractor/agent for construction at (, a- JQm; nr))e bi4ye.
Map/Lot , C/A # _1 I— A 0IDR approved on
In accordance with the Guidelines to the Act,"Sec. E1., only minor changes
may be approved by the Committee without the filing of a new application
and the holding of a new hearing. Minor changes or alterations would
include such matters as altering a single window or door or a minor change
of color which could be made without a detrimental impact to the overall
appearance of the project. All alterations by amendment or otherwise will
require the local Committee's approval."
Before or after work has begun on a project approved by the Old King's Highway
Committee, a request for a minor change must be submitted to the Committee in
writing. Approval shall be obtained before incorporating the change into the project.
For more than one revision to previously approved plans, a new Certificate of
Appropriateness must be filed and approval voted by the Committee before
incorporating the changes Into the project. Failure to do so will result in the Building
Department issuing a stop -work order or delaying issuance of an Occupancy Permit or
final inspection approval.
Filing a Certificate of Appropriateness for revised plans after work on the changes has
been undertaken will also result in having to pay a doubled filing fee of $50.00.
I have read and understand the above statements.
Date: /,/I / 1 Signed: GI _zq
(Owner/contractor/agent)
Date: L/'/ / / I Signed:
(Chairman, Old g's Highway Committee)
HAOKHC12010 APPUCATION FORMS\STATEMENT OF
Updated 9110110
docAPPROVED
I
I JUN 14 2011
YARMOUTH
10I.D KINGS HIGHWAY
YARMOUTH OKH SPECIFICATION SHEET
Address:_ "� 74 �� •^vr �s �(� I
������ c/AN: P- Aato
FOUNDATION: Material
Exposure (Not to exceed 1 ir)
DRIVEWAY MATERIAL: WALKWAY MATERIAL:
STEPS: Material: Color: Railing: Color.
CHIMNEY. Material/Color
GUTTERS: Material Color.
ROOF: Material: Pitch (7/12 min.): Height to Ridge: Color.
SIDING: Material: Front:
Color: Front:
Sides & Rear. PAINT CHIPS
Sides & Rear.
TRIM: All windows and doors to be trimmed with 1x4 or 1x5. (Circle one).
Trim material: Color.
DOORS: Material: Color.
Indicate alzea/styies if not Ilsted/shown on elevations:
STORM DOORS: Material. Style:
Color.
GARAGE DOORS: Material. Style: Color.
WINDOWS: City. 14 Material:
Color: A --a
Grilles (required)- Pattern: Type.
Indicate window styles and sizes if not Ilsted/shown on elevations. `� Ir/iiuuJ�s
STORM WINDOWS: Sty. Material: Color
Indicate style and sizes it not listed /shown on elevations
SHUTTERS: _Wood _,Vinyl _Paneled _Louvered Color.
SKYLIGHTS: Type: Size: Color.
DECK: Material: Size: Color
Railing matedal/Style: Color
FENCES (Max. Hslght tYy RETAINING WALLS. Material:
Style/Height Color
(Show running footage 8 location on plot plan.)
UTILITY METERSlHVAC UNITS: Location: Screening:
EXTERIOR LIGHTS: Oty Style: Location:
Color.
Additional Information:
RECEIVED
MAY 10 2011
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YARMOUTH L -.-___J i
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styles LW ELIDouble Hung Casement Pleture Awning Designer Shapes Hopper Rolling Patio Door
(17
'Designer shape styles not available with High Performance Package. SPF not available on patio doors, and SunClean coating available on standard We patio doors only.
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Contoured GBG (Grids Between Glass) Simulated Divided Lites (SDL) Decorative Pencil Bar Grids
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Color -matched grids are positioned between For an even more dramatic and upscale look, LJtirizes brasstone or brushed nickel grid bars
the two pieces of glass, allowing for easy choose the SDL grid system. SDL utilizes a between the glass. Incorporates Glass Accents
cleaning. pewter in -glass grid with vinyl grids applied on for added elegance. Note: Glass Accents not
both the interior and exterior. available with HP Triple Glazing Package.
locks & lifts
The Tribute features a low profile sash lock
to complement its sleek design. For added
convenience when operating the window,
Integral or applied lift handles on the lower
sash are available,
exterior casing
To enhance the beauty of your Tribute
window, Harvey also offers maintenance -
free vinyl exterior casing for new construction
applications. The factory -applied casing with
fusion -welded comers eliminates the need
for exterior caulking and produces a clean,
upscale look.
4
Brasstone Brushed Nickel Oil -Rubbed
Bronze
Low -profile Sash Lock Integral Lift Handle Optional flnlshes for locks and applied lift handles
(standard white) (white only) (not pictured)
1 X3 flat with picture frame
1 x3 flat with sill nose
908 picture frame
908 with sill nose
exterior colors WhfteInteriorwith27exteriorcoloroptlons'
Harvey Bronze
Harvey Almond
Forest Green
Clay
Sandstone
Sandalwood
Leaf Green
Amazon Green
Grey
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CM
Cranberry
Black
Cashmere
Burgundy
The Red
Old World Blue
Sable
Universal Brown
LLLJ-
Ivory
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Wicker
Buff
Wedgewood
Ivy Green
Backwood
Bronze
Silver Metallic
Copper
'Note: Information subject to change, all representations of colors and/or finishes are mechanically reproduced and may vary from the actual product
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ON
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, (MEQ, 527 CMR 12.00
3? ..9 (OFFICE USE ONLY)
= TOWN -'YAR UTH y
00 Fee:
e { 1 3 OU5 I PERMIT NO. C
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: 3 O
To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical
work described below.
Location (Street
Owner or Tenant
62- �Qmino(e- it& t
Is this permit in conjunction with a building permit? Yes ❑No (Check Appropriate Box)
Purpose of Building S> 10 I oo e!'1 RIU . Utility Authorization No.
o
\ Existing Service Amps �ZG LWO Volts Overhead Undgrd Q No. of Meters
~New Service Amps / Volts Overhead❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity.
Location and Nature of Proposed electrical
Suo
Cmmnlerinn at the fnllnH,inv table may he waived by the In.merinr of tint
No. of Total
No. of Recessed Fixtures
N% !2M[l - sp-Maddle) Fans
Transformers KVA
No. of Liphting Outlets
No. of Hot Tubs
Generators KVA
Above n-
❑ Q. ❑
No. o Emergency Lighting
No. of Lighting Fixtures
SwimmingPool md.
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
o. oT Detection an
Initiating Devices
Total
No. of Ranges
No. of Air Cond. Tons
No. of Alerting Devices
No. of Waste Disposers
Heat mp
Totals:
um er
ons
—
— —
No. of Self -Contained
Detection/AlertingDevices
No. of Dishwashers
Space/Area Heating KW
Municipal
Local ❑ Connection Other
No. of Dryers
Heating Appliances KW
SecuroitSDetvmicse:s or Equipvalent
No. of Water
No. of No. of
Data Winng:
Heaters KW
Signs Ballasts
No. of Devices or Equivalent
Wiring:
PTelecommunicationso. H dromassa c Bathtubs
y g
No. of Motors Total HP
No. of Devices or Equivalent
Attach additional detail if desired, or as required by the Inspector of Wires.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee provides
proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in
force, and has exhibited proof of sam tot permit issuing office.
CHECK ONE: INSURANCE BOND[3 OTHER (Specify:)
(Expiration Date)
Estimated Value of Illectfiral Work: (When required by municipal policy.)
Work to Start: 3 O Inspections to be requested in accordance with MEC Rule 10, and upon completion.
I certify,
FIRM N
(If applicaltle, enter "exgtnptI,•the
AAdd— --•� �Z , 0IN C. Sn k,
of
vZ tCU Signature,
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does'n
below, I hereby waive this requirement. I am the (check one) owner
Owner/Agent
ion on this application is true and compl h
LIC. NO.
LIC. NO.
Bus. Tel. No.4O
:n S Alt. Tel. No.: •36 6
have the liability insurance coverage normally required by law. By my signature
owner's agent. ❑
Signature
[Rev. 0 M]
Telephone No.
RE -INSPECTIONS
.<, S ov
S ii1i 2 RE -INSPECTION - $30.00
pPR 1 A 2005 J 3RD RE -INSPECTION - $40.00
GUlLD1;::i UcPT.
ALL OTHER RE -INSPECTIONS - $40.00
I
DATE: y /k G
DATE RECALL:Y / OS
0
ISSUED �A ��
TO: �.c—f'zP c z XO G 4G i
REASON FOR RE-
BUILDING DEPT.: 3 -_6 S- �y=
OCCUPANCY PERMIT:
PLUMBING PERMIT:
GAS:
ELECTRICAL:
FIRE DEPARTMENT:
��1 cpl�py
I-
Liu
1.) THUS PLAN IS VALID ONLY IF IT IS STAMPED AND SIGNED
IN RED. THIS OFFICE ASSUMES NO RESPONSIBILITY FOR
INFORMATION CONTAINED ON COPIES WHICH DO NOT HAVE
ORIGINAL STAMPS AND SIGNATURES IN RED.
AS -BUILT
R. J O'Heam, P.L. S., R. S.
35 Route 134, Swan River Plaxq Unit Z
Soutli Oenniv Afa, OR660
I CERTIFY TO McCARTHY CONSTRUCTION CO.
AND TO THE TOWN OF YARMOUTH BUILDING INSPECTOR
THAT TO THE BEST OF MY INFORMATJON, KNOWLEDGE
AND BELIEF, THE S7RUC7URE SHOWN ON THIS PLAN
HAS BEEN LOCATED ON THE GROUND AS INDICA7FD
AND THAT IT IS LOCATED IN FLOOD ZONE C PER
FLOOD INSURANCE RATE MAP DA7FD .TUNE 17 1986
REG.
LAND SURVEYOR
" PLOT PL14N
OCATOM
LOT 100. If 6,9, S'L'1LIMOLL' DR.
YARWOU hr, M,4.
ASSESSORS &4f 116 PARCEL 99
►"' N0" 1019R
Zvi" OF Mes
RICHARD s
DAM- JAN. 14, 2005
o� tiG s
i. McCARTHY
o O'HEARN
NO. 27871 � SCALE. 9„ � ,o • 1 /N = 30 FT
Da Or. R. 01H.
SHEET l OF i
V
APPLICATION FOR PERMIT TO DO GASFITTING
TOWN OF YARM H (OFFICE USE ONLY)
p 0 g By Fee: $ dir' c
(L�
JUL 2 8 2005 PERMIT NO. ' d
BUILDING DEPT. Date JI QL—
Buil pg Owner's
AT. Loca I e r. Name St M IM S O O (a.r c It
New ❑
Plans Submitted
Renovation ❑
Yes❑ NoM
Type of Occupancy r-CSI CI '
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1ST FLOOR
2ND FLOOR
3RD FLOOR
(PRINT OR TYPE)
Installing Company Name -Jack I6n c
Address 3`1 movtomal 2d'
� •\/arm '
Check One:
❑ Corp.
❑ Partnership
Qr-Firm/Company
Business Telephone 3 q Li -DL9 & ,� -t
Name of Licensed Plumber or Gasfitter JC4CK Kta ne
INSURANCE COVERAGE:
Check One
have a current liability insurance policy or Its substantial equivalent. Yes ❑ No ❑
If you have checked yes, please indicate the type of coverage by checking the appropriate box.
A liability insurance policy Vi_ 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.
S' nature of Licensed
Plumber or Gasfitter
as 7rS�
License Number
TYPE LICENSE:
Plumber C&asfitter 0 Master AIourneyman
TOWN OF YARMOUTH
E C E o W E 0
JUL 2 S 2005
DEP;;�e
APPLICATION FOR PERMIT TO DO PLUMBING
(OFfI� E USE ONLY)
By 7 ,
Fee: $
PERMIT NO.
Date 7u I V Ak20 O ci
Building Owner's �rt� IncDoWfII
AT. Location 6 A t 2 Dr- Name
§/— Po V-+
If Type of Occupancy Pesld evr + I G
New ❑ Renovation ❑ Replacement l&
Plans Submitted Yes ❑ No 9—
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1ST FLOOR
2ND FLOOR
tit
3RD FLOOR
(PRINT OR TYPE)
Installing Company Name TackcKo n-c
Check One:
❑ Corp.
Address 2G M o 0 o en a u R dl - ❑ Partnership
S %V& rtm C& Firm/Company
Business Telephone 39 H '19 a"Y- Name of Licensed Plumber
INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes ❑ No ❑
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
A liability insurance policy X. 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.
Signature ofOwnerorOwner'sAgent
1 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.
Check on Owner ❑ Agent ❑
ignature of Licensed
Plumber
aa9J-3-
License Number
Type: Master[] Journeyman
. 7-
or r
TOWN OF YARMOUTH
Building Department
BUILDING
011,11
(508) 398-2231 ext.261
,
PERMIT NO B05 845 --_
ISSUE DATE :_ _1/3/2005- _KPROP..p
_ _ _ _ _
APPLICANT ,MikeMcCall .''"PERMIT
JOB WEATHER CARD
PERMITTO Addftlor
AT (LOCATION)
00062SEMINOLE DR
G DISTRIC R-40
Bldg. Type: Reskfential
SUBDIVISION MAP LOT BLOCK 1118.99 BUILDING IS TO BE: CONST TYPE 5•B USE GROUP R 4
LOT SIZE O
construct 15 x 15 three season sunroom , deck as per plans dated 11124104.
REMARKS
AREA (SO FT) EST COST ($ $20,000.00 PERMIT FEE ($)
OWNER IJAMES L MCDOWELL BUILDING DEPT BY
ADDRESS 100062 SEMINOLE DR
Yannouthport I MA 102675
INSPECTION RECORD
50.00
CONTRACTOR
LICENSE 058633
McCarthy, Mike
POB 52
West Dennis MA 02670
5082806964
FIELD COPY
Note Progress.-
cam
s�►
-�
It
=13454 lit WE
`.
10
This Section for Office Use Only
Bjiildinq Perm' u ber:
Date Issued:
Signature:
Building 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:
J e C,
1.2 Zoning Info ation:
�
Zoning District Proposed Use
1.3 Building Setbacks (it)
Front Yard
Side Yards
Rear Yard
Required
Provided
Required
Provided
Required
Provided
[B+-
111 +-
1.4 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
2.1 Owner of Record:
Sit-, HLla. .V
Name (print)
Signature
Mailing Address
Te one
2.2 Authorized Agent:
c
Name ( 'yt)
Sig ature Telephone
0 3 20v > S. w. 0-u 70
Mailing ddress
DEFT.
By l 1 ax
qU
Section 3 - Construction Services
3.1 Licensed Construction Supervisor:
A
M
Not Applicable ❑
P.V• Dom,_ �� U•/JiCn.ya�1H.
O,�Ly� , r.
License Number
i
cu
Address
KKK
o , -�_ l
Expiration Date
Signatute Telephone
3.2 Registered Home Improvement Contractor:
Company Name
G. S .
O a
Not Applicable ❑
149S74
License u ber
Addres
Sign ture
/
Telephone
Expiration Date
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
jo to provide this affidavit will result in the denia f the issuance of the building permit.
I fined Affidavit Attached Yes ......... No ..........
Section 5 - Description of Proposed Work (check all applic
New Construction I No. of Bedrooms No. of Batl
Existing Bldg. ❑ Repair(s) ❑ I Alterations ❑ I Addition
Accessory Bldg. ❑ Type
Demolition
Other Specify:
Brief Description of Proposed Work3��gy)
7L I �)
Section 6 - Estimated Construction Costs
Item Estimated Cost (Dollars) to be
completed by permit applicant
1. Building
)!"a
2. Electrical
3�do
3. Plumbing / Gas
pup
4. Mechanical (HVAC)
—
5. Fire Protection
6.Total=(1+2+3+4+5)
ad,
7. Total Square Ft. (new houses & addAlons)
Owner's
I,
- Owner Authorization - To be Completed Wt
lent or Contractor Applies for Buildinq Permit
hereby authorize
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner
Check Below
ItQ Conservation -Commission Fling
(if applicable)
a/CId Kings Highway & Historical
Commission approval
(if applicable)
, as owner of the subject property
Section 7b - Owner/Authorized Agent Declaration
I
to act on
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 nam
Signature of Owner/Agent
9- f5-99
2of 2
b It lak
Date
SO
PLEASE PRIM.
job Location:_
TOWN .0.F YA.R.M O U
B JI•LD,ING'DhPAR.TMENT
CONSTk-U;CTI'O.-X,.'S-UPERVIS'O''R
Number
Owner of Property:_
Construction Supervisor: 1,71 ter
Name
Address: —
Street.
O� 63
License No.
TH
FORM
Y-P, f-
Village
Licensed Designee:
(If other than Supervisor) *;Name License No.
2.15 Responsibility of eachlicetise;hplder:
Phone No.
2.15.1 The license holder shall be fully and'coriipletely responsible for, all work for which he is supervising.
He shall be responsible fox.seeiag :th4t'ali work:is done pursuant to the state building code and the drawings
as approved by the building off cfat, ' i
2.15.2 The license holder shall be responsible'•tb supervise the construction, reconstruction, alteration,
repair, removal or demolition involving the structural -elements of building and structures only pursuant to
the state building code and all other applicable..laws of•the commonwealth, even though he, the license
holder, is not the permit holder but only a subcontractor or contractor to the permit holder.
2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any
violations which are covered by the building permit.
2.15.4 Any licensee who shall willfullyviolate subsections 2.15.1, 2:15.2 or 2.15.3 or 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 sueh',Iicensee-is no:longer supervising said persons, the work shall immediately
cease until a successor .licerise: Iholder' is substitut6d.on the records of the -building department•
2.17 The license holder shall be.responsr1516fpr:rcquesting'all required.ihspections. Failure to do so may
be deemed a violation of the permtt,•.contil[ions':'
I have read and understand my responsibilities.under• the rules and regulations for licensing construction
supervisors in accordance with section 109J.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 iability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152
Yes lsd No ❑
It 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 havr< the insurance coverage required by
Chapter Vof
�General Laws, and that my signature on this permit application waives this requirement.
Check one:
Signatu a of Owner or Owner's Agent Owner ❑ Agent 12/
Signature:
Building Official Approval:
The Commonwealth'ofMassachusetts
Department of Industrial Accidents
ONCO o//nest/ffids®s
600-Washington Street
Boston, Mass. 02111
`Z1� Workers' Compensation Insurance Affidavit
A nnlicant information: P7eascFRiPTR�dsb3tr
Iocntinn' SN.MinfjIe • ►ill
ciLs T. r rn -.) h phone!! Cck)adu GSC4
0 1 am a homeowner pertormtpg all work myself.
0 1 am. a sole'proprietor anal have no one working in any capacity
O lam an employer pro%iding.w•orkers' compensation for my employees working'on this job.
Lam" am a'sole proprietor. zeneral contractor. or homeowner (circle one) and have hired the contractors listed below
the followin_ %vorktrs' compensation polices:
commix rime A4- E 1�cnS
.•�,�}..��.ir}�A '
/ "7 • _ phone q: _
� 1.
WLJ
I.
Failure insecure coverage as required under Section 25A of MGL 152 can lead to the imposition of crimitsal penalties of aline op to S1,M 00,
one years' Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a floe of S100.00 a day against me. I understand
copy of this statement maybe forwarded to the Office of f avcstigatiom of the DIA for coverage verification. .
do -hereby certif
Si
thel.6ins and penallies of perjury that the information provided above is true and correct
S
Print name / lit �t%�F�-i Phonek�S')7�aG76v
4fici3l use only do not write in this area to be completed by city or town official
city or town: YARMOUT$
o check if immediate response is required
ptrmit/licensc it nDuilding Department
❑Licensing Board
261 OSelectmcn's Ofbcr
frnu% 39ti 2231 011ealthUtpartmeni
contact person: phone ii; _ _ ext • _OOther.
Information and. Instructions . '.
Massachusetts General Laws chapter I52 section 25 requires all employers to provide workers' compensation for tt
elttplo%ees- As quoted from the -law-, an employee is defined as every person in the service of another under anv
contract of hire, express -or implied. oral or written.
An entpl( trer is defined as an individual. partnership, association: corporation or other legal entity, or any t►►•o or mo
the foregoing ennaeed 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 if
owner of a dwelling house having not more than three apartments and who resides therein. or the'occupant of the
d►►elling house of another who employs persons to do maintenance , construction or repair work on such dwelling he
or un the _rounds or building appurtenant thereto shall not because of such employment be deemed to bean emplo%e
1GL cltapteP 15= section 25 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 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 ofthis chapter h
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 compan% 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: Plea;
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned tc
the Department by;mail or FAX unless other arrangements have been made.
The Office ofTnvestrgations would like to thank you in advance for you cooperation and should you have any question!
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
On ®l 10VOSt1350003
600 Washington Street
Boston, Ma. 02111
fax 9: (617) 727-7749
phone 9: (617) 727-4900 cat. 406, 401) or 375
TOWN OF YARMO U "I'H BUILDINGELECTRIQ
1146ROUTE28 SOUTH YARMOUTH MASSACHUSETTS02664-4451 GAS
Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 PLUMBING
SIGNS
BUILDING DEPARTMENT
DEMOLITION DEBRIS DISPOSAL AFFIDAVIT
Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5,
I hereby certify that the debris resulting from the proposed work/demolition to be
conducted at 632 ScM:.tk
Work Address
is to be disposed of at the following location:
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.
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: ��� Scy,. e m. Est. Cost 'ao,"
Address of Work 0r_
Owner Name: 7 i th
Date of Permit Application: hdl ld,
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:
Idddy I AC-r,_f-I., )o5s7L
Date Contractor Name Registration No.
•'
Notwithstanding the above notice, I hereby apply for a permit as the owner of the above
property:
Date
Owner Name
uo
TOWN OF YARMOUTH
Building Department
Town Hall
Yarmouth, MA 02664
(508) 398-2231 exL261
BUILDING PERMIT
TRANSMITTAL
Temp Permit No.:
T-05-269
Applicant Name:
Mike McCarthy
Applicant Phone:
5082806964
Building Location:
00062 SEMINOLE DR
Owner's Name:
JAMES L MCDOWELL
Owner's Addres
00062 SEMINOLE DR
Yarmouthport MA 02675
r
Owner's Telephone:
(OFFICE USE ONLY
Recorded By:
IC
Permit Fee:
$0.00
Deposit Rec:
$25.00
Payment Type:
Check ChkNo.: 158
Net Owed:
($25.00)
Application Date:
11 /9/2004
Issue Date:
Expiration Date
Comments: Map/Lot: 116.99
construct three season sunroom , deck
ZONING APPROVED
REVIEWED BY:
VI'WATER DEPARTMENT:
22.. ENGINEERING DEPARTMENT:
X. CONSERVATION:
I/. HEALTH DEPARTMENT:
5. BUILDING DEPARTMENT:
6. FIRE DEPARTMENT:
COMMENTS:
DATE:
DATE:
DATE:
DATE:
DATE:
DATE:
PLEASE NOTE
N/A:
N/A:
WA:
N/A:
N/A:
N/A:
RECEIPT OF COPY:
SIGNATURE OF APPLICANT:
DATE:
Date Printed: 11/16/2004
✓ifsnx
Yoaa.�nosuc.salG4✓llydu.i.t6i
Board of Building Regulations and Standards
a HOME IMPROVEMENT CONTRACTOR
Registration: 109576
Expiration: 9/21=6
Type: Individual
MICHAEL J MCCARTHY
MICHAEL MCCARTHY -
6 Ringly Ln. rz.
S.Dennis, MA 02670 Administrator
13
License or registration valid for individul use only
before the expiration date. If found return to:
Board of Building Regulations and Standards
Out Ashburton Place Run 1301
Boston, Ala. 02108
Not valid without signature
BARD OF BUILDING REGULATION8
JL0
License: CONSTRUCTION SUPERVISOR
Number.CS 058633
Birdulate: 00011966
ExpUue: W1012006 Tr. no: 3776.0
Restrfdbd: 00
MICHAEL J MCCARTHY
PO BOX 52
W DENNIS, MA 02570
0
CERT/F/ED PL OT PLPM ;�SoVELEROAC 2'
LOCATION: PARmou7H F ONT/ NG LOT.
SCA LE:. /" = 30 c DATE= �o - 4-'79 h �6LE'V• /7. 9
REFERENCE: BEING LOT z9 AS
SHOWN ON A PLAN RECORDED N .TUnJ, /9f�
/ THE 8ARNSTABLE covNTy DAT
REGISTRY OF DEEDS PLAN BOOK .;A
289 PAGE 48
I HEREBY CERr•/FY TNA,T THE FOUNDATIO
SHOWN ON TH/S PLAN /S LOCATED ON
THE GROUND AS SHOWN HEREoN AND
THAT /T % OES ' CONFORM TO THE
BUILDING SETBACK REQU'IRE"cjvTS OF.
THE TOWN Y/
OF 9je:140W7W
i
9EOR9E LOW AND CO.
Y A RM o v rH PoRr l,
N
REG..LAND•T11 EYOR
v
i
" TOWN OF YARMOUTH
Building Department
Town Hall
Yarmouth, MA 02664
(508) 398-2231 exU61
BUILDING PERMIT
TRANSMITTAL
Temp Permit No.:
T-05-269
Applicant Name:
Mike McCarthy
Applicant Phone:
5082806964
Building Location:
00062 SEMINOLE DR
Owner's Name:
JAMES L MCDOWELL
Owner's Addres
00062 SEMINOLE DR
Yarmouthport MA 02675
Owner's Telephone:
(OFFICE USE ONLY
Recorded By:
Ic
Permit Fee:
$0.00
Deposit Rec:
$25.00
Payment Type:
Check ChkNo.: 158
Net Owed:
($25.00)
Application Date: 11/9/2004
Issue Date:
Expiration Date
comments: MapiLot: 110.ya
construct three season sunroom , deck
REVIEWED BY:
1. WATER DEPARTMENT:
DATE:
N/A:
2. ENGINEERING DEPARTMENT:
DATE:
N/A:
L 3. CONSERVATION: �,
DATE: 1i%
N/A:
4. HEALTH DEPARTMENT:
DATE:
N/A:
5. BUILDING DEPARTMENT:
DATE:
N/A:
6. FIRE DEPARTMENT:
DATE:
WA:
PLEASE NOTE
COMMENTS:
RECEIPT OF COPY:
SIGNATURE OF APPLICANT:
DATE:
Data Printed: 11/16/2004
a r TOWN OF YARMOUTH
Building Department
Town Hall
Yarmouth, MA 02664
(508) 398-2231 ext261
BUILDING PERMIT
TRANSMITTAL
Temp Permit No.:
T-05-269
Applicant Name:
Mike McCarthy
Applicant Phone:
5082806964
Building Location:
00062 SEMINOLE DR
Owner's Name:
JAMES L MCDOWELL
Owner's Addres
00062 SEMINOLE DR
Yarmouthport MA 02675
Owner's Telephone:
REVIEWED BY:
1. WATER DEPARTMENT: _
2. ENGINEERING DEPARTMENT:
3. CONSERVATION:
4. HEALTH DEPARTMENT:
5. BUILDING DEPARTMENT:
6. FIRE DEPARTMENT:
COMMENTS:
RECEIPT OF COPY:
(OFFICE USE ONLY
Recorded By.
IC
Permit Fee:
$0.00
Deposit Rec:
$25.00
Payment Type:
Check ChkNo.: 158
Net Owed:
($25.00)
Application Date:
11/9/2004
Issue Date:
Expiration Date
PLEASE NOTE
SIGNATURE OF APPLICANT:
Comments: Map/Lot: 116.99
construct three season sunroom , deck
DATE: / 1A9,164N/A:
DATE: N/A:
DATE: N/A:
DATE: N/A:
DATE: N/A:
DATE: WA:
DATE:
Date Printed: 11/16/2004
TOWN OF YARMOUTH
Building Department
Town Hall
Yarmouth, NIA 026U
(W8) 398-2231 exL261
BUILDING PERMIT
TRANSMITTAL
Temp Permit No.: T-05-269
Applicant Name:
Applicant Phone:
Building Location:
Owner's Name:
Mike McCarthy
5082806964
00062 SEMINOLE DR
JAMES L MCDOW ELL
Owner's Addres 00062 SEMINOLE DR
Yarmouthport MA 02675
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.: 158
Net Owed:
($25.00)
Application Date: 11 /9/2004
Issue Date:
Expiration Date
Comments: Map/Lot: 116.99
construct three season sunroom , deck
G3 � 5 '1 C✓� rz
DATE: N/A:
DATE: N/A:
3. CONSERVATION: I DATE: WA:
4. HEALTH DEPARTMENT: DATE: r� N/A:
5. BUILDING DEPARTMEN DATE: N/A:
6. FIRE DEPARTMENT: DATE: WA:
COMMENTS:
RECEIPT OF COPY:
PLEASE NOTE
SIGNATURE OF APPLICANT:
DATE:
Date Printed: 11/16/2004
I 5 OEM" U
9& m?A a Mw"Ve
MAMA Old King's ITighway Regional historic District Committee �/
c
in the Tows of Yarmouth fora r/
CERTIFICATE OF APPROPRIATENESS
� /
Application is hereby made in triplicate, for the issuance of a Certificate of 4
of Chapter 470, Acts and Resolves of Massachusetts 1973 for work as described
under Section
, Proposed work as described below and on
plans, drawings or photographs accompanying this application for.
CHECK CATEGORIES THAT APPLY:
1. Exterior Building Construction: Q
4Peofbu;ldin&
New Building 14ddition
Q Alterationwicate
8
—i
Q Horse
l] Garage 11 commercial
o Other
C
2. Exterior Painting: Q
v
j"]
3. Signs or Billboards Q New Sign
Q Existrtimg Sign Q Repainting existing sign r(-•t
a
O
4. Structure Q Fence Q Wall
Q Flagpole Q Other
Z
z,—
i—
—1
InTE OR FRI.YT LEGIBLY
DATE
ADDRESS OF PROPOSED WORK
/
6 �t n1,.� Ic12r._ASSESSORS
MAP NO.
II
OWNER T n�. , M p
lI
ASSESSORS LOT NO. 5 5
HOME ADDRESS-, L Q,��;,
�:SZ r j
TELEPHONE NO.
0(rc. t
�il/c�'Ou
AGENT OR
NO SZt u-Gst:y
r
ADDRESS_Q�.
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 existing sips and proposed locations of new signs. (Attach additional shoot, if
11ccC ry)-
A.
on
Signed
ow
Space below line for Committee use only /-w-Contractor-Agcrit
Received by OKHC
Date]
Chock Y
By_ '�i7aT
APPROVED Q
DISAPPROVED Q
EWPORTANT.
Please return to:
Itrrr
If Certificate is approved, approval is subject to the 10 day appeal period
provided in the Act "'•«�,q��.
Yarmouth OKHC District Committee
Yarmouth Town Hall, 1146 Route 28, S. Yarmouth, MA 02664
Y.0 Iq / ? *>
AMENDMENTS
DATE D C/A #
2.
I
4.
1 agree to the above
Owner/Agent olo�j.
Signature
V-m
n
.00
M
rn
pPPn,JED
OKIVChaknian
Signature
'1
• SPECIFICATION SHEET (YARMOUTH OKHC)
Please fill out the form in its entirety providing color chips where
necessary. INDICATE LANDSCAPING, EXTERIOR LIGHTING & ELECTRIC METER ON SITE
PLANS FOR NEW HOUSE.
/. n
ADDRESS: 2 � M i rw1 C
6 /i
FOUNDATION (18• MAX. EXPOSED): CONmETE/mm DRIVEWAY:
WALKWAY: STEPS (INDICATE BRICK/CEMENT/OTHER): ree>s,• n 4-er.1 9 A tc
SIDING TYPE & MATERIAL: W k.Ic &,0,r
CHIMNEY (INDICATE BRICK/STUCCO/WOODFACED)
ROOF MATERIAL: 4 (1.11- PITCH (7/12 MIN.)
MAX. EXP.
WINDOWS (GRILLES REQUIRED)—(WOOD/OTHER) U4c,,
INDICATE SIZES IF NOT LISTED ON ELEVATIONS:
DOORS (WOOD/OTHER)
(RJDICATE SIZES AND STYLE IF NOT LISTED ON ELEVATIONS):
wbt-� Tu N- 6061s - :k.
ayY6 -3
COLOR: k(� ,,, I
COLOR:
COLOR: ih,"
tA41r-S
COLOR: uI ,.A.'k
TRIM: (ALL WINDOWS & DOORS TRUAMED WITH 1X4 / IX5) CO4QR �;+c
MATERIAL OF TRIM: C�D,�)INYL, ALUMINUM m m S-
SHUTTERS (WOOD/VINYL) (PANELED/LOUVERED) b; i* Z �
GUTTERS (WOOD/ALUMINUM: �OL2P-- r-
GARAGE DOORS: SIZE & STYLE: LC9t- _
STORM WINDOWS & DOORS: COL& -
(INDICATE S12ES IF NOT LISTED ON ELVATIONS)
SKYLIGHTS: TYPEISIZE: Z) " VS 361, COLOR
WOOD DECK: SIZE: �',X IS ,Press�'� .�c9 41 e�-k, COLOR
erb}r„ S
WOOD FENCING (MAX. HEIGHT6): STYLE: COLOR: -
(SHOW LAYOUT & RUNNING FOOTAGE ON SITE PLAN)
RETAINING WALL: (P.T. OR FIELDSTONE —CONCRETE INAPPROPRIATE)
(SHOW LAYOUT & RUNNING FOOTAGE ON SITE PLAN) `4 n,:•.:,,
SIGNS: (indicate size, style, colors) — COLOR:
SIGN POST: (indicate size, style, color)
f y CO3:1lfllj
0
ADDMONA
INFORMATI SRO
V'
REV. 12/02 •��� 17•
At
4i
'o �7
J
too
<Ivo Zoo /vFc,
pG
29
44• 9
- --_ �� �7
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rC
-t
I�
�f�
• V
r^
�/O, pU•
�Q
IW
CERTIFIED PLOT PLAAJ
LOCATION: YA�eMOU7H
SCALE.'. /•'=30• DATE.
REFERENCE: BEING LOT e-9 AS
SHOWN ON A PLAN RECORDED
/N THE SARNSTABLE COUNTY
REGISTRY OF DEEDS PLAN BOOK
289 PAGE 46
I HEREBY CERTIFY THAT THE FOUNDATION
SHOWN ON 7-I4I.5 PLAN IS LOCATED ON
THE GROUND AS SHOWN HEREON AND
THAT /T ,I6 OES' CONFORM TO THE
SILL eL EV. IS 2
Af3ovE ROAD
F ONT/ NG LOT.
DAT
REG. ,LAND•.5:(! EYOR
Y
N... N."
BUILDING SETBACK REQUIREMENTS OF
THE TOWN OF Vt9.CMO Cr7?Y '
9EOR9E LOW AND CO.
YARMOU-rHPOR-T, MASS.
177
N
.! ..
• ADDRESS
LOT NO.:
OWNERS NAME:
SEWAGE PERMIT NO.: NEW: REPAIR:
DATE ISSUED: DATE INSTALLED:
INSTALLERS NAME:
4 INSTALLATION OF:
I
II, WATER TABLE: 08'lprVa. INSPECTION $���
DRAWING OF INSTALLATION ON REVERS IISI E:
1
9 Aa d v.✓wt . IDS c C e AD L
� li«=try ICU 3
ae y
bc �l3
I
�t k -
CERT/F/ED PLOT PLAA/ ;so ELEROAC Z,
LOCATION: MoeMouTH F ONTI NG LOT.
SCALE.. /" = 30' DATE: WELE-V. /7. 9' .
REFERENCE- BEING LOT Z9AS
SHOWN ON A PLAN RECORDED .TyoLJ Y, /979
/N THE SARNSTASLE COV"7TY DAT
REGISTRY OF DEEDS PLAA1 BOOK .
289 PACE 48
/ NEREBY CERTIFY THAT THE FOUNDATION REG. ,LAN0•.'S`... EYOR
SHOWN ON THIS PLAN /S LOCATED ON +•
THE GROUND AS SHOWN HEREON AND
THAT /T /) pe-s • CONFORM TO THE
BUILDING SETBACK REQU'I REA#CA1TS OF
THE TOWN OF Vgje40CJ7H
9EOR5rE LOW AND CO.
YARM c urHPoRr, MAss,
_.
j
P3,01SE-
f
BC CAME) 2003 DESIGN REPORT - US Friday, October 01, 2004 09:15
Triple 1 3/4" x 11 7/8" VERSA-LAM(g) 3100 SP File Name: BC CALC Project: RB01
Job Name: McDowell Residence Description: Structural Ridge
Address: 62 Seminole Rd Specifier.
City, State, Zip: Yarmouth, Ma Designer. Bill Campbell
Customer. Mike McCarthy Company: Shepley Wood Products
Code reports: ICBO 5512, NER 629 Misc:
�0
12
General Data
Version:
US Imperial
Member Type:
Roof Beam
Number of Spans:
1
Left Cantilever.
No
Right Cantilever.
No
Slope:
0/12
Tributary:
07-06-00
Live Load:
30 psf
Dead Load:
15 psf
Partition Load:
0 psf
Duration:
115
Disclosure
The completeness and accuracy of
the input must be verified by anyone
who would rely on the output as
evidence of suitability for a
particular application. The output
above is based upon building
code -accepted design properties
and analysis methods. Installation
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 CALC®, BC FRAMER®, BCIO,
BC RIM BOARDTm. BC OSB RIM
BOARDTm, BOISE GLULAMTm,
VERSA -LAMS, VERSA -RIM®,
VERSA -RIM PLUS®,
VERSA-STRANDT"',
VERSA -STUD®, ALLJOISTO and
AJSTL are trademarks of
Boise Cascade Corporation.
Total Horizontal Length - 15-Wo
Load Summary
ID Description Load Type Ref. Start End Type
S Standard Load Unf. Area Left 00-00-00 15-04-00 Live
Dead
Controls Summary
Control Type Value
Moment
10434 ft-Ibs
Neg. Moment
0 ft-Ibs
End Shear
2371tbs
Total Load Defl.
U611 (0.301m)
Live Load Defl.
U963 (0.191
Max Defl.
0.301"
% Allowable Duration
28.4% 115%
n/a 100%
17.1% 115%
29.5%
24.9%
30.1 %
Value Trib. Dur.
30 psf 07-06-00 115%
15 psf 07-06-00 90%
Load Case Span Location
2 1- Internal
1- Left
1
1
1
Notes
Design meets Code minimum (U180) Total load deflection criteria.
Design meets Code minimum (1-/240) Live bad deflection criteria.
Design meets arbitrary (1*) Maximum load deflection criteria.
Minimum bearing length for BO is 1-12".
Minimum bearing length for B1 is 1-12".
Member Slope = 0, consider drainage.
Entered/Displayed Horizontal Span Length(s) = Clear Span + 12 min. end bearing + 12 intermediate bearing
Connection Diagram
Consult project design professional of record or BOISE technical representative for connection design
Bolts are assumed to be Grade 5 or higher.
Member has no side loads.
Connectors are: 12 in. Staggered Through Bolt
a=2"
b = 2-12"
c=4"
d = 24"
Page 1 of 1
139iSE- BC CALC® 2003 DESIGN REPORT - US Friday, October 01, 2004 09:16
Double 1 3/4" x 71/4" VERSA -LAM® 3100 SP File Name: BC CALC Project: FB01
Job Name: McDowell Residence Description: Header over door
Address: 62 Seminole Rd Specifier.
City, State, Zip: Yarmouth, Ma Designer. Bill Campbell
Customer. Mike McCarthy Company: Shepley Wood Products
Code reports: ICBO 5512, NER 629 Misc:
General Data
Version:
US Imperial
Member Type:
Floor Beam
Number of Spans:
1
Left Cantilever.
No
Right Cantilever.
No
Slope:
0112
Tributary:
01-00-00
Live Load:
40 psf
Dead Load:
10 psf
Partition Load:
0 psf
Duration:
100
Disclosure
The completeness and accuracy of
the input must be verified by anyone
who would rely on the output as
evidence of suitability for a
particular application. The output
above is based upon building
code -accepted design properties
and analysis methods. Installation
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 CALC®, BC FRAMER®, BCIO.
BC RIM BOARDT", BC OSB RIM
BOARD7°, BOISE GLULAMTm,
VERSA -LAM®, VERSA -RIM®,
VERSA -RIM PLUS®,
VERSA-STRANDT",
VERSA -STUD®, ALLJOISTO and
AJST" are trademarks of
Boise Cascade Corporation.
Load Summary
ID Description Load Type Ref. Start End
S Standard Load Unf. Area Left 00-00-00 06-06-00
1 Gable wall Unf. Lin.
2 RB01 Conc. Pt
Controls Summary
Control Type
Value
Moment
5045 ft-Ibs
Neg. Moment
0 ft-Ibs
End Shear
1672 Ibs
Total Load Deft.
L/548 (0.142")
Live Load Deft.
U928 (0.084")
Max Deft.
0.142"
Left 00-00-00 06-06-M
Left 03-03-00 03-03-00
Type
Value
Trib.
Dur.
Live
40 psf
01-00-00
100%
Dead
10 psf
01-00-00
90%
Live
0 plf
n/a
90%
Dead
60 plf
n/a
90%
Live
1728lbs
Na
115%
Dead
997lbs
n/a
90%
%. Allowable Duration
52.4% 115%
n/a 100%
29.6% 115%
43.8%
38.8%
14.2%
Load Case Span Location
3 1 - Internal
3 1 -Left
3 •1
3 1
3 1
Notes
Design meets Code minimum (L/240) Total load deflection criteria.
Design meets Code minimum (L/360) Live load deflection criteria.
Design meets arbitrary (1") Maximum load deflection criteria.
Minimum bearing length for BO is 1-1/27.
Minimum bearing length for Bt is 1-1/2".
Entered/Displayed Horizontal Span Length(s) = Clear Span + 1/2 min. end bearing + 1/2 intermediate bearing
Connection Diagram
Consult project design professional of record or BOISE technical representative for connection design
Member has no side loads.
Concentrated loads are not considered in side load analysis.
Connectors are: 16d Sinker Nails
a=2"
b=3"
c = 1-5/8"
d=12"
Page 1 of 1
slN�o,v — f 7-19a t34✓44 — t VA
of . TOWN OF YARMOUTH Building Department
BUILDING
+ ......... (508) 398-2231 ext.1261
PERMIT NO �.B-'�1.151�.'
PROPOSED USE
' PERMIT
M ISSUE DATE ;...... 01. _ ; ........
APPLICANT AilenBent
JOB WEATHER CARD
AT (LOCATION) 10062SEMINOLE DR ZO DI
SUBDIVISION MAP LOT BLOCK 1116.99 BUILDING IS TO BE:
LOT SIZE
15 replacement windows
REMARKS
PERMIT TO Alterations
ICT R-40 Bldg. Type: Residentlai
CONST TYPE 5-B USEGROUP R-3
AREA (SO FT) EST COST ($ I$9,000.00 PERMIT FEE ($) $40.00
OWNER IMCDOWELL, JAMES L BUILDING DEPT BY
ADDRESS 122 Rising Ridge road
Upper Saddle River NJ
CONTRACTOR
LICENSE 15579
Bent, Allen
48 Winsome Road
South Yarmouth MA 02664
5083947709 -
PHONE 12019214490
INSPECTION RECORD FIELD COPY
Date Note Progress - Corrections and Remarks Insaector
0
2111/2015 SlipGen - Portal Hone
.� Town of Yarmouth
' Template [Building Dept]
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Slipsheet Identifier [sg19642]
Document Category Building Permits
Map -Block Number 116.99
Street Number
0062
Street Name
SEMINOLE DR
Department
Building
Parcel ID
14901
Backfile Batch Scan
No
Document?
Additional Naming Info
Index Operator
Operator, Yarmscan
Date - Time
2015-02-11 - 11:27
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