HomeMy WebLinkAboutBuilding Permitso' r� TOWN OF YARMOUTH Building Department BUILDING
-,
(508) 398-2231 ext.261
PERMIT NO B47-922 _ PERMIT
•. ISSUE DATE ; • 1/23/2007 _ ; PROPOSED USE .. _ . _
APPLICANT stani . iehne� " " " ' " " ' ' ' ' ' ' ' ' ' ' ' JOB WEATHER CARD
•-- -•---•...............
PERMIT TO Alterations
AT (LOCATION) 0314NORTH DENNIS RD ZONING DISTRIC R-40 Bldg. Type: Residential
SUBDIVISION MAP LOT BLOCK 1127.16 BUILDING IS TO BE: CONST TYPE 5 B USE GROUP R-4
LOT SIZE
remove ebsting slider to construct dog house for gas fireplace, install two casement window ori%ach
REMARKS side of dog house as per plans submitted 01/23107.
AREA (SO FT) EST COST ($ 1PERMIT FEE ($) $75.00
OWNER 1HARDING. ROBERT L BUILDING DEPT BY
ADDRESS 1POBOX737
Yarmouth Port MA 102675
PHONE
CONTRACTOR
LICENSE 016860
Lehner, Stanley
POB 991
East Dennis , MA 02641
5083850087
INSPECTION RECORD FIELD COPY
Date Note Progress - Corrections and Remarks Inspector
I V—L A 77 i.
3d
F oF'YgR ONE & TWO FAMILY ONLY - BUILDING PERMIT
o APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
p ,y Town of Yarmouth Building Departinent
F--TT^C-g , 1146 Route 28 • Yarmouth, NIA 02664-4492
Tel: (508) 398-2231 x261 • Fax: (508) 398-0836
Office Use Only
Permit No 16 Date/
Permit Fee $ Z5, e zd
Deposit Rec'd. $ Date
Net Due $
Planning Board Information
ype
ording D Date
Recording Date
Plan No.
Other
Assessors Department Information:
M Lot
New
1.4 Property Dimensions:
Lot Area (sf) Frontage (ft) Lot Coverage
This Section for Office Use Only
Buildind Permit Number:
Date Issued:
Signature: �o �l'
Certificate f ccupancy
is Is of L d
iic
B�ill�dmg Official Date
Section 1 - Site Information
I Use Group: R-4 Type: 5-B
1.1 Property Address:
3Jy .•t/ ��.dyis . oga
1.2 Zoning Informati oy:
�
Zoning District Proposed Use
1.3 Bullding Setbacks fit)
Front Yard
Side Yards
Rear Yard
Required
Provided
Required
Provided
Required
Provided
1.4 Water Supply (M.O.L. c. 40. S 54)
Public Private
1.5 Flood Zone Information: Comments:
Zone: BFE:
Section 2 - Prooertv Ownership/Authorized Aaent
2.1 Ow r of Record.
70o e,eF
'Pa0. 'ox 73y
Name (print)
- Mailing Address
i
Signa re lephone
Fax E-mail
2.2 Authorize Agent:
Si -&I r /j/ LeH.I/t�
�
�o UVX / �, �%rc%c/is •�y. oAZGf//
Name (print)
g' Mailing Address
Signature Telephone
Fax E-mail
Section 3 - Construction Services
3.1 Licensed Construction Supervisor:
License Number
0J4ItGO
,99 �l7 it Oz
Address% von Y/
Expiration Date
Ba /o aces
Signat a J/ Telephone Fax E-mail
it T i 1��J-3J3=04 . , "IP.r-yGp�
) IAddres9"), C), 46?"oa
Date
n
Telephone Fax
1of2
,IW//, eG ewr1l
OVER
Section 4 - Workers' Compensation Insurance Affidavit (M.G.L c. 152 S 25C (6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure
to provide this affidavit will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes .......... No ..........
Section 5 - Description of Proposed Work (check all applicable)
New Construction I No. of Bedrooms No. of Bathrooms
Existing Bldg. ❑ Repair(s) ❑ Alterations ❑ Addition ❑
Accessory Bldg. ❑ Type
Demolition
her Specify:
F
Brief Description� Pf 1rW�k
�pl7 rc�/v z L'.d rE'-.r��`!/t'✓ �p I ✓ • L' ..rJ,(//
a vS�
Costs
Estimated Cost (Dollars) to be Check Below
completed by permit applicant
Se o ❑ Conservation -Commission Filing
(if applicable)
Old Kings Highway & Historical
Commission approval
(if applicable)
To be Completed When
for Building Permit
Section 6 - Estimated Construction
Item
1. Building
2. Electrical
3. Plumbing / Gas
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5)
7. Total Square Ft. (new houses 3 additions)
Section 7a - Owner Authorization -
Owner's Agent or Contractor Applies
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 Date
Section 7b - Owner/Authorized Agent Declaration
I, , 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
Signature of Owner Agent Date
i
9-15-99
2of 2
TOWN OF YARMOUTH
BUILDING DEPARTMENT
CONSTRUCTION SUPERVISOR FORM
PLEASE PRINT:
job Location: `3
Owner of Property: _
Fa
xr_ Street
Construction Supervisor:
";K .GEya/F"r 014
License No.
Village
Address: x'Q l-oX "/ ,�,yrwy/.' �� eue;Kl
Licensed Designee:
(If other than Supervisor)
Name
2.15 Responsibility of each license holder:
License No.
.�df ooc
Phone No.
2.15.1 The license holder shall be fully and completely responsible for all work for which he is supervising.
He shall be responsible for seeing that all work is done pursuant to the state building code and the drawings
as approved by the building official.
2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration,
repair, removal or demolition involving the structural elements of building and structures only pursuant to
the state building code and all other applicable laws of the commonwealth, even though he, the license
holder, is not the permit holder but only a subcontractor or contractor to the permit holder.
2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any
violations which are covered by the building permit.
2.15.4 Any licensee who shall willfully violate subsections 2.15.1, 2.15.2 or 2.15.3 or any other section of these
rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of
license by the board.
2.16 All building permit applications shall contain the name, signature and license number of the
construction supervisor who is to supervise those persons engaged in construction, reconstruction,
alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and
regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately
cease until a successor license holder is substituted on the records of the building department.
2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may
be deemed a violation of the permit conditions.
I have read and understand my responsibilities under the rules and regulations for licensing construction
supervisors in accordance with section 109.1.1 of the state building code. I understand the construction
inspection procedures and the specific inspection as called for by the building official.
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152
Yes 1�1 No ❑
If you have checked ygu, 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 1°3 of tha Mass. GeneAl Laws_, and that my signature on this permit application waives this requirement.
�.. Check one:
Signature of Owner/qf Owners Agent
Owner ❑ Agent 0
Signature: Building Official Approval:
For Office Use Only
Permit No.
Date TOWN OF YARMOUTH
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGL c. 142A requires that the `reconstruction, alteration, renovation, repair, modernization, conversion,
improvement, removal, demolition or construction of an addition to any pre-existing owner -occupied
building containing at least one but not more than four dwelling units or structures which are adjacent to
such residence or building' be done by registered contractors, with certain exceptions, along with other
requirements.
Type of Work: 45�'s- �,jlm -(Al ``/) Est. Cost ¢lid%
Address of Work J'/ZO //* Z?6faV1 s ��
Owner Name: Dd
Date of Permit Application:
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under $1,000
Building not owner occupied
Owner pulling oTcrmit
Other (specify) O�Y�'�OYmlC
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:
av
Date Contractor Name Registration No.
At
Notwithstanding the above notice, I hereby apply for a permit as the owner of the above
property:
Date
Owner Name
The Commonwealth ofAlassachusetts
Department of Industrial Accidents
Office of Investigations
' 600 Washington Street
Boston, DIA 02111
wwrv.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information ( Please Print Legibly
Name(Business/Organization/Individual): !J�VAII/ri
Address:1�
City/State/Zip: ,Z ti�F1/1 1/ lVi 49 3P9 Phone #: J ede_'Jfe'r' DO��
Are you an employer? Check the appropriate box:
L ❑ I am a employer with 4. ❑ I am a general contractor and I
employees (full and/or part-time)."
2. N I am a sole proprietor or partner-
ship and have no employees
working for me in any capacity.
[No workers' comp. insurance
required.]
3. ❑ 1 am a homeowner doing all work
myself. [No workers' comp.
insurance required.] t
have hired the sub -contractors
listed on the attached sheet.
These sub -contractors have
employees and have workers'
comp. insurance.t
5. ❑ We are a corporation and its
officers have exercised their
right of exemption per MGL
c. 152, § 1(4), and we have no
employees. [No workers'
comp. insurance required.]
Type of project (required):
6. ❑ New construction
7. Q 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 workcrs' compensation policy information.
t Ilorneowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have
employees. If the subcontractors have employees, they must provide their workers' comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company
Policy # or Self -ins. Lic. #: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 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
Investieations of the DIA for insurance coverage verification.
I do Isereby certify under the pains and ppalties ofperjury that the information provided above is true and correct.
Di, .fJ-y- o a
use only. Do not
City or Town:
area, to be completed by city or town officiaL
Permit/License #
i- atp_a ad'
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone #:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more
of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if
necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of
insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the
members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy, please call the Department at the number listed below. Self -insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant
that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current
policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or
town). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone and fax number:
The Commonwealth of Massachusetts .
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax # 617-727-7749
Revised 11-22-06
www.mass.gov/dia
Ll
TOWN OF YARMOUTH
1146 ROUTE 28 SOUTH YARNIOUTH MASSACHUSETTS 026641I451
Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365
BUILDING DEPARTMENT
DEMOLITION DEBRIS DISPOSAL AFFIDAVIT
BUILDING
ELECTRICAL
GAS
PLUMBING
SIGNS
Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5,
I hereby certify that the debris resulting from the proposed work/demolition to be
conducted at 3/:z v 67e2/zx/ '� ra
Work Address
is to be disposed of at the following location- 4*eo9
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, Section 150A.
Si tatur of Applicant
Permit No.
Date
TOWN OF YARMOUTH
BUILDING DEPARTMENT
1146 Route 28, South Yarmouth, MA 02664
508-398-2231 ext. 261 Fax 508-398-0836
BUILDING PERMIT APPLICATION REGULATORY APPROVALS NOTICE
Address of Proposed Work: .?/Y if/ •oe.V.11%s Ae
Scope of Proposed Work: -1
-.,Ie evi�ddt/1
,dgwmiNc arcs/r.
Date: i- a-?- am
o✓c � rve 4r1'dZ7e, feA/a6e w,,14 7-weC��Jc��'1c'y�
o tdiv X .P �'17 Ar-P
i:d�D.e� •i'AsYol.�Yv
Based on the scope of work described above, the applicant is required to obtain approvals/sign-
offs from the following departments as checked -off below:
Health Dept. — Town Hall Phone No. 508-398-2231 ext. 241
Conservation Comm.— Town Hall Phone No. 508-398-2231 ext. 288
Water Dept.— 99 Buck Island Rd. phone no. 508-771-7921
Old Kings Hwy. Hist. Comm.— Town Hall phone no. 508-398-2231 ext. 292
Engineering Dept. —Town Hall phone no. 508-398-2231 ext. 250
Fire Dept.—Capt. Kelleher, 96 Old Main St. So. Yarm. Phone no. 508-398-2212
Other
Appropriate plans and/or application shall be provided to each of the departments checked -off
above. Each of these regulatory authorities has their own requirements outside the jurisdiction of
the Building Department. All applicable approvals shall be obtained prior to submitting a
building permit application to the Building Dept.
Thank you for cooperation.
Receipt Acknowledgement:
00
Applicant's
0?,3-add
Date
� J� t�rnor �✓ll�,G�aa
Board of Building Regulations and Standards License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration: 127820 Board of Building Regulations and Standards
Expiration: 1/11/2009 Tr# 126181 One Ashburton Place Rm 1301
Type: Individual Boston, Ma. 02108
STANLEY H. LEHNER
STANLEY LEHNER
28 Highcrest Avgnue
E. Dennis, MA 02641
i
Administrator Not vallid with t signature
k% �orn�nanuroal!/ a�✓i�a>,ac%wen3
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Number: CS 016860
Birthdate: 02/10/1935
Expires: 02/1072008 Tr. no: 16854
RFstricted: 00
STANLEYH LEHNER- I
PO BOX 991 DR C I
E DENNIS, MA 02641,._
Commissioner
I
Old King's Highway Regional Historic District CommiMwork83
RECEIVED
in the Town of Yarmouth for a
06
CERTIFICATE OF APPROPRIATENESS
Application Is hereby made in triplicate, for the issuance of a Certificate of Ad�Y
Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 19739 for proposed descn e
below and on plans, drawings or photographs accompanying this application for:
CHECK CATEGORIES THAT APPLY:
1. Exterior Building Construetion: 0 New Building 0 Addition e Altcratioa
Indicate typeotbuilding: .%House ❑Garage UCommercial Mother RJ=VIG VED. , tR2 M
2. Exterior Painting: 0 I �, �jUP
3. Signs or Billboards: Q New Sizo n Existing Sign CI Repainting existing sign JAN 11 2001
4. Structure: 0 Fcace U Wall 0 Flagpole M Other TOWN CLERK
SOUTH YARMOUTH, +1A
7�PEORPRI1yTLEGIBLY AA1B /4
ADDRESS OF PROPOSED WORK -31V iv 2:y%V,7'S ,Ca ASSESSORS MAP NO. /02
OWNER •(o2�iE'T // oC��'il/�i ASSESSORS LOT NO. I(A.
HOME ADDRESS �� ?C�y > -�=q — TELEPHONE NO. lalP— 2-57v--$aS�j
i' •�.t"i�/GunY .�o.�i
AGENT OR CONTRACTOR_ f r'*VleCr 7.0. 1 e // IS—,p TELEPHONE NO Sod-�'�.> ✓ 00��
ADDRESS J. $ak Qq/ ,c��,lrri' Z)WlxllS /% .
,, �_ZIPCODE O .2 6fF/
USE ATTACHED SHEET IN PACKET FOR ABUTTING OWNERS
DETAILED DESCRIPTION OF PROPOSED WORK: Give all parlictdars ojwak to be dons Including nmterials to
be used In care ojsigre, give locations ojexlsting sivu and proposed locations ojnew signs, (Atueh additional sheet, if
necessary). C' C o 3E' OFC St�'r11'vCo C'GNsS �JO�' ig�,�q �.CJsrq��
QyTtllbc&Z C74/
_..
Signed Date %02 OG
• Owner-ContrieWir Agent is aware that a Permit H required from the Building
Department.
• All new construction will be subject to inspection by OKH Ins �c L R O V E D
Date /_ a � 4; Thb Certificate is h by ate / v 0 H
Cheeky 1
APPROVED 0 IMPORTANT. If Certificate is a roved, • roval is subject to the
Period provided inpthe Act. Dp 10 day appeal
DISAPPROVED M PLEME RETURN TO: Yarmouth OKHC District Committee
Yarmouth Town Hall, 1146 Routc Zit, S. Yatmoutti, %fA 02664
W
SPECIFICATION SHEET (YARMOUTH OKHC)
• Provide color chips where necessary and attach
• On Site Plan for New House: Indicate landscaping, exterior lighting and electric meter
ADDRESS: 11A.ir4141is e
FOUNDATION (18" MAX. EXPOSED): ONCRE OTHER DRIVEWAY:
WALKWAY: STEPS (INDICATE BRICK/CEMENT/OTHER):
SIDING TYPE & MATERIAL: 4/11-1 -VE t arc9•I' S-`firs COLOR:
CHIMNEY (INDICATE BRICK/STUCCO/WOODFACED) COLOR:
ROOF MATERIAL: PITCH �AXIIalm. 4
MxN) gyp, C4 , /IJCOLOR:
WINDOWSnt�
(GRILLES REQUIRED) (WOOD/OTHER)�Ilpedf--`41',COLOR: 4/h'10
(INDICATE SIZES IF NOT LISTED ON ELEVATIONS): � wA','-v
DOORS (WOOD/OTHER)
(INDICATE SIZES AND STYLE 1F NOT LISTED ON ELEVATIONS):
TRIM: (ALL WINDOWS & DOORS TRIMMED WITH IX4 / 1X5)
MATERIAL OF TRIM: (WOOD, VINYL, ALUMINUM)
SHUTTERS (WOODIVINYL) (PANELED/LOUVERED)
GUTTERS (WOOD/ALUMINUM):
GARAGE DOORS: SIZE & STYLE:
STORM WINDOWS & DOORS:
(INDICATE SIZES IF NOT LISTED ON ELVATIONS)
SKYLIGHTS: TYPE/slzE:
WOOD DECK: SIZE:
WOOD FENCING (MAX. HEIGHT 6'): STYLE:
(SHOW LAYOUT & RUNNING FOOTAGE ON SITE PLAN)
RETAINING WALL: (P.T. OR FIELDSTONE - CONCRETE
(SHOW LAYOUT & RUNNING FOOTAGE ON SITE PLAN)
SIGNS: (indicate size, style, colors)
SIGN POST: (indicate size, style, color)
Rcvn of,
COLOR:
COLOR:IrIXIYr
COLOR:
COLOR:
COLOR:
COLOR:
COLOR:
COLOR:
COLOR:
ED
JAN 112007
YARMni1Tu PR:
Page 2 of 2
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APPROVED
JAN 112007
YARMOUTH
KING'S HIGI
12/19/2006
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APPROVED
[JAN 112007
YARMOUTH
Mr) KING'S HIGHWAY
715�40'0 &
12/19/2006
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PROPOSAL 144
TO:
STANLEY H. LEHNER
P.O. Box 991 E. Dennis, Ma 02641
Phone 508-385-0087 Fax MASS. H.I.C. EG. 0227820 J687
Mass. Construction Supervisor Lie. #016860
Shlehner@msn.com
Robert Harding
P O Box 737
Yarmouth Port, mA. 02675
256-5050 ( �"%r27/2006
%^o1O1tennis Road
Yarmouth Port, HA-
0
hersufm3t apoGlleaGons and astlmates for -
Removal of rear living room exterior wall with sliding patio door. Reframe to house two (2)
Andersen casement window units, series 400 C155 white on exterior and natural on interior.
White screens and stone color hardware. Exterior casing of 1 x 5 Pine, preprimed to be
applied. Interior casings to match existing.
Studding, 2 x 6 16" on center
Sheathing, 1/211 Exterior CD plywood
Siding, White Cedar shingles, extra clear grade with exposure of approximately 5".
Insulation, R-13 fiberglass with kraft. rimed.
Wall covering, 1/2" sheetrock, taped and sanded smooth, p
Electrical, relocate existing.
Remove all construction debris from job site upon completion.
F6uY'rtTof� nflir5��%{� het��rd��r�dl rf0��9!9 in accordance with the above specifwations, for the sum of: 4, 070. 00
•� 6 i 'rtTou dollars (i )' -
P3eposymtotbe made . follows:. ..... .............................. $2035.00
Balance upon completion.................................$2035.00
ai material is guaranteed to be as specitied. All work to be completed in a professional
manner aomrding to standard practices. Any anerabon or deviation from move Specifics- Authorized /L
inn& kwoh ng extra costs wW be executed onty upon written ordors, and wig become an Signature
extra Charge over and above the eebmete. wl agreements contingent upon strikes. accidents
or delays beyond our col 0 .Owner to carry ire, tomedo, and other necessary insurance. Note: This proposal may be
Our workers are fully covered by Workers Canpensamm insurance. withdrawn by us if not accepted within
Acceptance of Proposal— The above prices, speoifkanons and
ooridibons are sabslactory and are hereby accepted. You are authorized to do the work Signature
as specified. Payment will be )utli deb e.
Date of Acceptance: I V&—O&
30 days.
N
TOWN OR YAPJ;OUTH
DATE July .iU.
APPLICANT JaMec McGrath/ Pine Harbor SL1edS ADDR
PERMIT TO shed (_) STORY
(TYPE OF IMPROVEMENT) NO.
BUILDING nC1)I�A�T. � _v3 _lov 7hbAl z ,
(PROPOSED USE)
NUMBER OF
DWELLING UNITS
314 North
Dennis Road.
ZONING
AT (LOCATION)
YP 02675
DISTRICT P40
(NO.)
(STREET)
e
BETWEEN
AND
m
m
)CROSS STREET)
(CROSS STREET)
am
127/16
LOT
SUBDIVISION
LOT BLOCK.
SIZE
^wr^
U
O
BUILDING IS TO BE
FT. WIDE BY
FT. LONG BY
FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
0
O
Z
Z
TO TYPE 5B
USE GROUP- R11
BASEMENT WALLS OR
FOUNDATION
¢
(TYPE)
O
REMARKS: 10 X 12 rhvd
- a ubiQct to
zoning b,tiilaws
AREA OR PERMIT
VOLUME ESTIMATED COST $ 3200.00 FEE $ 2.D_ 00
(CUBIC/SQUARE FEET)
OWNER Robert Harding DEP
ADDRESS- 314 North Dennis Road, YP 02675 BYILD'Y%y
INSPECTION RECORD
DATE I NOTE PROGRESS - CORRECTIONS AND REMARKS I INSPECTOR
t,
of uce t�.e Only
The Commonwealth of Massachusetts
Deportment of Public Safcty
Occupancy 6 Fee lTecked
• BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 12:00 3/90 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All cork to be performed In accordance with the Mascachuserts Electrical Code. 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
City or Town of thAelwuk TO. the Ins p r of
The undersigned applies for a permit to
top/e�rfo'r/m/*the electrical work describe low!
Location (Street & Number) A P - /Y AJA �EM1G& -QA
Owner or
Owner's
L/F P r..•L,.. C-AA. ^J - I Ru ("_.0 / / I
Is this permit in conjunction with a building permit: Yes R No ❑ (Check Appropriate Box
Purpose of Building fJ/htT 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 /D/ADleA rl-alyir�.L widfNC s7,iP74g�
No. of Lighting Outlets
No. of Hot Tubs
Total
No. of Transformers KVA
No. of Lighting Fixtures
SwimmingAbove In -
Pool grnd. ❑ grnd. ❑
Generators ICVA
No. of Receptacle Outlets
No. of Oil Burners
No. of Emergency Lighting
Battery Units
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS No. of Zones
No. of Detection and
Iotal
No. of Ranges _
No. of Air Cord. tons
Initiating Devices
No. of Sounding Devices
No. of Disposals
ta
No. of Hpuemats TTtas Tol
KW
N
Detection/Sf Self oundingeDevices
Local ❑ Municipal ❑ Other
Connection
No. of Dishwashers
Space/Area Heating KW
No. of Dryers - �►
Heating Devi KW
8
No. of Water Heaters KW
No, of o, o
Si ns Ballasts
Low Voltage
Wirin
No. Hydro Massage Tubs
No. of Motors Total HP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial
equivalent. YES NO [] I have submitted valid proof of same to this office. YESM NO ❑
If you have chec ed YES, please indicate the type of coverage by checking the appropri to box.
INSURANCE DQ BOND ❑ OTHER ❑ (Please Specify) 99
xpiration ate
Estimated Value of Electrical Work S % �-
Work to Start .2 9 Inspection Date Requested( ugh - ina1
Signed under the penalties of erjury:
FIRM NA (;, LIC. N0.
ME
Licensee 1?j6,ejvAeJ f. .1A04 Signature LIC. NO._gff�_ AP_
Alt. Tel. No.�Z-.�j�1pQ
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage err is sub-
stantial equivalent as required by Massachusetts General wsTa , and that my signature on this permit
application waives this requirement. Owner Agent (Please check one) .
Telephone No. PERMIT FEE S
Signature of Owner or Agent
_14
The Commonwealth of Massachusetts
Department of Industrial Accidents
emca allayestllaiil ss
600 Washington Street
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
Applicant information: //�� / Pfease�Rllt71'TedtbTR
name•
locatio
Cgt%* i !i e N y phone 0
0 1 am a homeowner performing all work myself.
Vf I am a sole proprietor and ha%e no one working in am• capacity
0 I am an employer pro%iding workers' compensation for my employees working on this job.
insurance co policy t!
0 I am a sole proprietor.:eneral contractor. or homeowner (circle one) and have hired the contractors listed below who have
the following worker' compensation polices:
Failure to secure coverage as required under Section 2SA of MGL I32 us lead to the imposition of erimi "penalties of A fine op to S1.500.oa Aadlor
one years' Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 11I00.00 a day against me. I Understand that a
copy of this statement may be forwarded to the OMce of investigations of the DIA for coverage verification.
I do hereby certify under the pains andpena/lties of perjury that the information provided above is true and correct.
Signature�&di-
_� . �,.,, A 2� Date - /9- 9/ i
Print name 3�JeZAR I Phone N 4Q?- V-57 S—
official use only do not %rite in this area to be completed by city or town official
city or town.• YARMOUM
0 check if immediate response is required
contact person:
permitAicense 0 nBuilding Department
pldcensing Board
261 OSeltctmen's Office
pHealth Department
phone #; _ (508) 398-2231 eatriOther
0nncd 3.95 P1A1
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
entplo%ees. As quoted from the "law", an employee is defined as every person in the service of another under am
contract of hire, express or implied, oral or written.
An enrplt trer is defined as an individual. partnership. association, corporation or other legal entity, or any two or more of
tlae foregoing engaged in a joint enterprise. and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual , partnership. association or other legal entity, employing employees. However the
oavnei of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
d%%ellin�house of another %%ho employs persons to do maintenance , construction or repair work on such dwelling house
or on the ;,_rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.
%IGI_ chapter 152 section =: 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 commom"ealth norany 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
suppling 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
1111ce of Ilmst 1298os
600 Washington Street
Boston Ma. 02111
fax 0: (617) 727-7749
phone #: (617) 7274900 ext. 406, 409 or 375
WIRE INSPECTOR'S DEPARTMENT
YARMOUTH TOWN HALL
SOUTH YARMOUTH, MASS. 02664
145
Fee
Date
Name of Job
Name of Electrician
Location
wyr.w � n:flae AOnl _
P The Commonwealth of Massachusetts r.rate No.aJ
"L Department of Public Softly
Oee.ryner a Faa o,.e►ta
BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 1Z00 3/90 (tea.e slant)
�'
"� APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed In accordance with the Massachusetts Electrical Code. 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFOPIlATION)
City or Tow of //f /zmo 47W
The undersigned applies for a permit to perform the elect
Location (Street e
Owner or
Owner's
FIC
Date 3// 9/98
To. the Ins r of/}1;mitts:
work describe lowp
.rJINiS / Penn 1 n Inn
Is this permit in conjunction with a building permit: Yes R No ❑ (Check Appropriate Box)
Purpose of Building 12,es/ �) -e<j < L Utility Authorization NO.
Existing Service /O d Amps //J /o?,,?d Volts Overhead 0 Undgrd:0 No. of Meters_
New Service. Amps / Volts Overbead ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No.
of Lighting Outlets
a
No. of Hot Iubs
No. of Iransformers TK„Al
No.
of Lighting Fixtures
Swimmin Pool Above In
grnd. ❑ grnd. ❑
Generators KVA
No.
of Receptacle Outlets S
No. of Oil Burners
No. Emergency Lighting
Batter Units
No.
of Switch Outlets
No. of Gas Burners
FIRE ALA W No. of Zones Z
NIn of Detection and
InofDevices
No. of Sounding Devices
No. of Self Contained
Detection/Sounding Devices
Local rM Municipal [:]Other
Connection
No. of Ranges
No. of Air Cond. Ttons
No. of Disposals
No. of H�ts TTtag To VW
No. of Dishwashers
S ace/Area Heating
P
No. of Dryers
Heating Devices KW
No.
of Water Heaters
1W
No. of
Signsf Ballasts
uirinoltage bYz /ls• � Z
`J
No.
Hydro Massage Tubs
No. of Motors Total HP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
I have a current Liabill.ty Insurance Policy including Completed Operations Coverage or its substantial
equivalent. YES ❑ NO U I have submitted valid proof of same to this office. YES ❑ NO ❑.
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify)
xpiration ate
Estimated Value of Electtrriical Work S
Work to Start3 . O /Co Inspection Date Requesteds Rough Final
Signed under the penalties of perjury:
OWNER'S INSURANCE WAIVER: I am aware that the Licensee
stantial equivalent as required by Massachusetts Genera
application waives thif/requirement. Owner Agent
Alt. Tel. No.
ave the insurance coverage or is sub -
chat my signature on this permit
check one) .
Telephone No. a %6 —/ ;lS/Z PERMIT FEE �S
WIRE INSPECTOR'S DEPARTMENT
YARMOUTH TOWN HALL
SOUTH YARMOUTH, MASS. 02664
252
Fee
Location
ri
°r'Y'Ue
3; o
TOWN OF YARMOUTH
RICHARD B. GRAHAM
INSPECTOR OF SIGNS
SEALER OF WEIGHTS & MEASURES
ASSISTANT BUILDING INSPECTOR
OFFICE TEL. 398-2231
EAT. 261
FAX 390-2365 1 146 ROUTE 28
SOUTH YARMOUTH, MA 02684
TOWN OF YARMOUTH
Application for a Permit to Build
UPON FINAL APPROVAL 0-4-o?. -1 V
FEE MUST ACCOMPANY THIS APPLICATION.
A „,
The undersigned hereby applies for a permit to build
according to the following specifications
1. Name of property owner f
Address RO .a e
11q
0 fC Few r
No.
LOT 2
DATE
Tel.S
2.Name ofArchitect (if any) _/¢K)e,0 i%sac YFCi}.xP Si A,4f q,:risr Tel, 72Z'-6a4a
3. Name of builder 040su'2c
4. License No.
Tel.
dress _Sv/%ti-eS% I*�;zoj mr►
5. Name of Mason Address
6. License No.
Z Construction address
Tel.
8. Date of subdivision Approval piaii
9. Private dwelling Estimated Cost `gyp
10. Multifamily ❑ /O iaJ
11. Commercial ❑ G��w�.erGioz
12.Other ❑
13. No. of stories 0
14. Foundation — Full ❑ Half ❑ Crawl4 Slab ❑
15. Materials — Wood » Cement ❑ Other ❑
16. Type of heat — Oil ❑ GasX1 Electric ❑ Other ❑
17. Garage —1 ❑ 2 ❑
18. Swimming pool - Size
19. Storage shed — Size
zone G Zone ct - 9y
DO NOT WRITE IN THIS SPACE
G�ii�-tom` /o-oo Type of room I No.
-- -,
/'7�4
a -/a
• ?-s
-'a, s�
Kitchen
Dining Rm.
Living Rm.
Bed Rm.
Bath
Deck
port
Family Rm.
Sun room
Garage
Shed
20. Stove — Wood ❑ Coal ❑ 1 1 Alterations
21. Size of lot: No. of feet front ��`1 f No. of feet rear P?S2 rt No. of feet deep s°d t
22. Size of building. No. of feet front e--3S No. of feet side -21— No. of feet rear 3S
23. Distance from nearest building: Front 'J A Ft. side 14d Ft. side -:20 O Rear
24. Distance back from line or street From rear lot line 300 1 Sideline /od t
25. H.I.C.R. No.
LOT RELEASED BY
PLANNING BOARD
Date
Signature /QZ7� --
Address 0 �N S
a/e/sV . ass
BUILDING PERMIT APPLICATION SIGN OFF
., y
APPLICANT: BUILDING PERMIT #:
ADDRESS: j-� 'Tr /Je e-f'eu m o ELE. NO.:74f/-2. 'J63G DATE FILED: S
BLDG. SITE LOCATION: 34Y A)o bewA/'s MAP#: /I LOT#: 7-2-
THE FOLLOWING INFORMATION OUTLINES THE PROCEDURAL STEPS REQUIRED TO OBTAIN A PERMIT TO BUILD,
ALTER, OR ADD TO A STRUCTURE WITHIN THE TOWN OF YARMOUTH. THE BUILDING DEPARTMENT WILL DETER-
MINE COMPLIANCE TO THE FOLLOWING (A) ZONING REQUIREMENTS (B) HISTORICAL DISTRICTS (C) FLOOD
PLAINS ZONING. THE BUILDING DEPARTMENT WILL BE RESPONSIBLE FOR ASSISTING THE APPLICANT THOUGH
THE FOLLOWING DEPARTMENTS:
WATER DEPARTMENT:
ENGINEERING DEPARTMENT:
CONSERVATION COMMISSION:
HEALTH DEPARTMENT:
FIRE DEPARTMENT:
RESIDENTIAL AND/OR COMMERCIAL BUILDING
DETERMINES COMPLIANCE OF WATER AVAILABILITY.
DETERMINES COMPLIANCE FOR PARKING AND DRAINAGE.
DETERMINES COMPLIANCE TO WETLANDS ACTS, I.E.: IF LOT(S) BORDER ANY
TYPE OF WETLANDS, STREAMS, PONDS, RIVERS, OCEANS, BOGS, BAYS, HARSH
LAND, ETC.
DETERMINES COMPLIANCE TO STATE AND TOWN REGULATIONS, I.E.: REQUIRE-
MENTS FOR SEPTAGE DISPOSAL AND OTHER PUBLIC HEALTH ACTIVITIES.
DETERMINES COMPLIANCE TO STATE AND TOWN REQUIREMENTS FOR PERSONAL
SAFETY, PROPERTY PROTECTION, I.E., SMOKE DETECTORS, SPRINKLER SYSTEMS,
ETC.
THE FOLLOWING DEPARTMENTS MUST SIGN OFF,
ISSUING THE REQUIRED BUILDING PERMIT:
REVIEWED BY:
1. WATER DEPARTMENT
2. ENGINEERING DEPARTMENT:
3. CONSERVATION:
4. HEALTH DEPARTMENT
INDUSTRIAL
IN THE RESPECTIVE ORDER, PRIOR TO BUILDING INSPECTOR
DATE: S- 8 • g8 N/A:
DATE: N/A:
DATE: N/A:
DATE: - - ;r N/A:
COMMERCIAL PERMITS
5.
WIRING INSPECTOR:
DATE:
N/A:
6.
PLUMBING INSPECTOR:
DATE:
N/A:
7.
FIRE DEPARTMENT:
DATE:
N/A:
PLEASE NOTE
ALL STUMPS AND/OR BRUSH MUST BE DISPOSED OF AT AN APPROVED SITE.
DISPOSAL SITE MUST BE SUBMITTED TO THE BUILDING DEPARTMENT PRIOR
A SIGNED RECEIPT FROM THE
TO ISSUANCE OF THE BUILDING
BLH 89
TOWN OF YARMOUTH
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE
JOB LOCATION 3 jq AJv D-ex o/S Rd
"HOMEOWNER" jhOU 14NNk'0J [. iw4Xl c,,XA4-4J
NAME HOME PHC
PRESENT MAILING ADDRESS 5�6 P,R1-e
CITY
STATE
SECT
PHONE
ale' 6
THE CURRENT EXEMPTION FOR "HOMEOWNER" WAS EXTENDED TO INCLUDE OWNER -
OCCUPIED 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 SHALL ACT AS SUPERVISOR. (STATE BUILDING CODE SEC-
109.1.1)
DEFINITION OF HOMEOWNER:
PERSON(S) 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 STRUCTURES 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 ALL SUCH WORK PERFORMED UNDER THE
BUILDING PERMIT. (SECTION 109.1.1)
THE UNDERSIGNED 'HOMEOWNER" ASSUMES RESPONSIBILITY FOR COMPLIANCE WITH THE
STATE BUILDING CODE AND OTHER APPLICABLE CODES, BY-LAWS, RULES AND REGU-
LATIONS.
THE UNDERSIGNED "HOMEOWNER" CERTIFIES THAT HE/SHE UNDERSTANDS THE TOWN OF
YARMOUTH BUILDING DEPARTMENT MINIMUM INSPECTION PROCEDURES AND REQUIRE-
MENTS AND THAT HE/SHE WILL COMPLY WITH SAID PROCEDURES AND REQUIREMENTS.
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFCICIAL
INSURANCE COVERAGE:
I have a current liability Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes O No 0
If you have checked Yes. please Indicate the type coverage by checking the appropriate box.
A liability Insurance policy 0 Other type of Indemnity 0 Bond 0
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 142 o the Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
Owners Agent O
is ature of Owner nr (?unnr e e ,e, e
The Commonwealth of Massachusetts
Department of Industrial Accidents
emceollolresdIZOis
600 Washington Street
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
A(Iniicant information: PleascPRII�71'Tetlibhr
name .JaL1.J ,y,VyPJ G.toalgicc� Ci�/¢�tH.V
locations F0 603.0, 5'T
e5 1 am a homeowner performing all work myself.
I am a sole proprietor zrd have no one %%orkine in any capacity
0 1 am an employer pro%iding workers' compensation for my employees working on this job.
egmnw name•
address:
city.* — — phone q
I am a sole proprietor. general contractor, r homeowner rcle one) and have hired the contractors listed below who have
the follow ing %%orker:ompensation polices:
company names
eery • Phone q:
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition occrisiaal penalties of a flat op to 51,500.00 sad/or
one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a flat otS100.00 a day against me. I naderstand that a
copy of this statement may be forwarded to the Office of Investigations of the DU for coverage verification.
I do hereby certify under
pains and penalties ojperjuty that the informadon provided above is true and eorred.
n-.�-�- / / Date�9�'
Printnamu-��ou �NWsN L-2V,0V -ad 04;f '!}-4LJ PhoncM%S-/—QLE-4134
official use only do not write in this area to be completed by city or town official
city or town: YARMOUTIJ _ permitAicense 0 []Building Dcpartmcat
❑1.1ceosiog Board
❑ check if immediate response is required 261 ❑Selectmen's Office
Health Department
contact person: phone «:_ i508� 398-2231 eat. ❑riOther
irc.ned 3.95 PJA)
Information and Instructions
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 emplorer is defined as an individual, partnership, association. corporation or other legal entity, or any two or more of
the foregoing engaged in a joint enterprise. and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual . partnership. association or other legal entity, employing employees. However the
o%%ner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance . construction or repair work on such dwelling house
or on the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.
%lGI_ chapter I: _ section =: also states that every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required.
Additionally, neither the commom%ealth 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
stipplyin;_ 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
MCC of IerIS1111 8113
600 Washington Street
Boston, Ma. 02111
fax #: (617) 727-7749
phone #: (617) 7274900 ext. 406, 409 or 375
.. ' Suggested Affidavit for Home Improvement Contractor Permit Application
For once use only NAME OF CITY/rOWN
Ptrmlt No.
Date
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGLe 14ZArequires that the "reconstruction, alteration, renovation, repair, modernization, conversion, inprovement, removal, demolition,
or construction of an addition to any preexisting owner -occupied building contain ineat least one but not more than four dwelling units....or
to structures which are adjacent to such residence or building" be done by registered contractors. with certain exceptions, along with other
requirements,
Type of Work: 01d rTin j-j A-JJ F,w i Po/_,c 4 Est. Cost /o oo a
`��/ / too .3/� /too, be,.s,.,�S �d )'A/Z t(47 � Ioo<T
Owner Name: 1,0
Date of Permit Application:
I hereby certify that:
L
Registration is not required for the following rcason(s):
_Work excluded by law
_Job under S1,000
Building not owner•occupicd
Owner pulling own permit
_Other (specify)
Notice is hereby given that:
,-CA-0 -/Oj
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:
Date Contractor Name Registration No.
W
Notwithstanding the above notice, hereby apply for a permit as the owner of the above property:
s 9 X
Date Owner Name
I
Abuttor's
Name 2.
Lot # COWL a
�I c�
go GV eA
If this is a
corner lot,
write in name
of street.
a
10
R
IL
PLOT PLAN
Z
FOR LOT # 7-
mAP nq
Indicate location of garage or accessory building
Additions with dashed lines • --------------------
Sewerage disposal (cesspool)
Well
MARK NORTH POINT
74ti � I
(lot................ft. rear) I
(lot .................. ft. frontage)
(NAME OF STREET)
Information `
Supplied by ti-I/6( L.4,U1
33 014 M )q/.:j s;
5'0. Yigl-r•a47'1
Abuttor's
Name
Lot # T2.3
., Gj41=C%/?
If this is
corner lo-
write in
name of
i, other
street.
XI
i
THE COMMONWEALTH OF MASSACHUSETTS 1. EN.'i<r1Pr'
MASSACHUSEITS
J,
�Fr#ifict><#>L of (1�nmplittnce a
THIS IS TO CERTIFY, that the On -site Sewage Disposal System ins t ed ( ) or rr ,ir d replaced ( ) on
at J 1t `� �V� �T� �� �� tb has been constructed in
accordance w th the pr vi ions of Title 5 and the for Disposal System Construction Permit No. _�� dated
—//— y . Use of this system is conditioned on compliance with the provisions set forth below:
The issuance of this certificate shall not be construed as a guarantee that the system will function as aestgnea. t nu
Certificate expires on
DATE 'T Inspector
,
M£Ccheck COMPLIANCE REPORT
1995 Model Energy Code
MECcheck Software Version 2.0
CITY: Hyannis
STATE: Massachusetts
HDD: 5973
CONSTRUCTION TYPE: Single Family
DATE: 5-8-1998
DATE OF PLANS:
TITLE:
COMPLIANCE: PASSES
Required UA = 255
Your Home = 238
Permit #
Checked by/Date
Area or
Insul
Sheath
Glazing/Door
-------------------------------------------------------------------------------
Perimeter
R-Value
R-Value
U-Value
UA
CEILINGS
1050
38.0
0.0
31
WALLS: Wood Frame, 16" O.C.
1250
13.0
3.0
89
GLAZING: Windows or Doors
94
0.400
38
DOORS
108
0.350
38
FLOORS: Over Unconditioned Space
-------------------------------------------------------------------------------
892
19.0
42
COMPLIANCE STATEMENT: The proposed building design represented in these
documents is consistent with the building plans, specifications, and other
calculations submitted with the permit application. The proposed building
has been designed to meet the requirements of the 1995 CABO Model Energy Code.
Builder/Designer Date
Tabu J5.2.2b (continued)
Prnrripdro Patka;ta for Ono aad Two -Family Rcsldaatial DnIIdlap lioaaod wilt Fouil Fatly
MAXIM Uhl
MINIhl Uhl
0uuas
auxins
cz ai
Wall Floor 8,a�
Slab
Hcsaai/Coolias
Anal (K)
U-valud
R•vilucj
R-valua' R.valucj Wall
Ptn==
Egwp== ===cr'
Par�arc
R-valu?
R-valuc�
Ml to 6500 Ilmdag Depn DaTe
Q
Iri.
0.40
38m—n-
19 10
6
Normil
R
Iri.
U2
3019
10
6
Ncr�sl
S
IZ•A
U0
3119
10
6
i5 AFVE
T
13Y.
0.36
3125
WA
NIA
Norz=sl
U
ISA
0.46
3819
10
6
Nome!
V
1SA
0.44
3125
WA
NIA
Es AFUE
a
ISY.
am
3019
10
6 I
L3 AFIJE
IEYi
M32
3825
WA
NIA
Normil
LAA
A"
0.42
3125
NIA
NIA
Norral
IEY.
0.42
3819
10
6
90AFUE
IEY.
0-50
30
19 19 10
6
90AFUE
1. ADDRESS OF PROPERTY: 31 y ND/4? fly
2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: _ -14%-4
3. SQUARE FOOTAGE OF ALL GLAZING:
4. % GLAZING AREA (#3 DIVIDED BY #2):
S. SELECT PACKAGE (Q — AA - see chart above):
NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS
ARE AVAILABLE. ASK US FOR THIS INFORMATION.
BUILDrNG INSPECTOR APPROVAL:
YES NO:
q-fomu-680303a
ENERGY CONSERVATION APPLICATION FORM
FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION
Applicant Name: en rd vrra
Applicant Address: 3t!i Ab. neNN/s RrJ.
M&RA14hpat i
Applicant Phone:
Compliance Path (check one):
Site Address: 31U &A PeA,AJJs I84.
City/Town: z
Use Group:
Date of Application:
Applicant Signature:
❑ Prescriptive Package (Limited to 1- or 2-family wood frame buildings heated with fossil fuels only)
Package (A through KK): Heating Degree Days Base 65 (HDD65) from Table J5.2.1a: $-921
(For items d. through i., fill in all values that apply from Table JS 2.lb:)
a. Gross Wall Area q.ft f. Wall R-value R- 076
b. Glazing R.O. Area Paz sq.ft. g. Floor R-value R- ,Qlli
c. Glazing % (100 x b+a) f 2 °/u h. Basement wall R-
d. Glazing U-value U_ you i. Slab Perimeter R-
e. Ceiling R-value R- 1? j. Heating AFUE
Component Performance: "Manual Trade -Off' (Limited to wood or metal framed buildings only)
Climate Zone (from Figure J6.2.2) C3 Zone 12 ❑ Zone 13 ❑ Zone 14
Attach Trade -Off Norksheet from Appendix J, [and HVAC Trade -Off Worksheet, if applicable]
JU ALIScheck Software
Attach Compliance Report and Inspection Checklist printouts.
Systems Analysis OR ❑ Renewable Energy Sources
Attach Mass Registered Architect or Engineer Analysis
Official's Name: Official's Signature:
Application Approved Date of Approval:
Application Denied ❑ Date of Denial:
Reason(s) for Denial:
(provide more details, if needed, on opposite side)
MRS 01r.9s
1§\1
lip CO
Cape Cod Insulation, Inc.
455 Yarmouth Rd.
Hyannis, Ma. 02601
(508) 775-1214 (800) 696-6611
Fax (508) 778-5735
Building Inspector
Town of Yarmouth
Dear Forest or Bill,
Mr. Curran asked me to do the metcheck sheet for his home on 314 No.
Dennis Rd. He asked me to mail it to you.
` <V1-"r'.[rr 'i..'7:niNc:M:..y.-4...�•uT tall-
Old King's Highway Regional Historic District Con mittee
in the Town of Yarmouth for a APPROVED
�•r YARMOUTH COMMITTEE
~i CERTIFICATE OF APPROPRIATENESS j OKHRD
Application is hereby made in triplicate, for the issuance of a Certificate of Appropriateness_wlceet gnksf.- —
Chapter 470, Acts and Resolves of Massachusetts,1973, for proposed work as described below and -on plans,• e
drawings or photographs accompanying this application for:
CHECK CATEGORIES THAT APPLY:
�/ Friw
1. Exterior Building Construction: ❑ New Building ER Addition I( Alteration r' ti
Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Other.
2. Exterior Painting. 0( — -
r*'; a .,
3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting existing sign
cn ,.. �J
4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other
(Please read other side for the check list for explanations and requirements)
TYPE OR PRINT LEGIBLY DATE 3 I 4
ADDRESS OF PROPOSED WORK 31 N N, VCftW Rd . ASSESSORS MAP _
OWNER(contrAcf)John ►f etimo►t swJ Leonard Catrraaa ASSESSORSLOTNO.�_
HOME ADDRESS PO y„r S Morfo ni M A OS - TELEPHONE NO. ZR - S6 ?!6
0 g
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any
public street or way. (Use attached sheet included with the packet)
AGENT OR CONTRACTORRX06 6550CINM5 A904ITBCTS TELEPHONENO.508-67%8.god O
r
ADDRESS Zia CAMP ST, dMir 6 HVANNUo W OF-461
DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8, other side),
including materials to be used. If specifications do not accompany plans. In case of signs, give bastions of existing signs and ,tom
proposed locations of new signs. (Attach additional sheet, if necessary). NG`U/ jem er t l a rcA O h fro wt v / 14
gatio Ito! add; jiax over for cks&t vAtd for fat cede ctAP«KLMCe, A./ew
add ifio-H fo ✓tOLI- -b 1*9,0rore /h'CPior /440W.f as 3 becfecc.n
reSkletn6e• lovii 5(iarh' 9IcLrs ci6orr erne[ A A'td0&U a/�?ra7'iottS.
''�--- -Space below line for Committee use onlybelow line for Committee use only.
Received by H.D.C.
Date I'. t This Certi ietel
Signed mi./aeIttl
Owner -Contractor- nt
Time i l- I ; I 1 �/ 0--4— / • _)o
gy
APPROVED ❑ IMPORTANT: If Certificate is approved, appoval is subject to the 10 day appeal period provided
In the Act.
DISAPPROVED ❑ Pease return to: Yarmouth OKHC DistrictCommittee
Yarmouth Town Hall, 1146 Route 28, S. Yarmouth, MA 02664
SPECIFICATION SHEET (Yarmouth OKHC) - submit 3 copies
NAME OF• OWN4R(S) : John hanxoa aAAJ LPenavd Cuyvan LAD
. FOUNDATION (18" max. exp.):
STEPS (indicate brick/cement/other)
SIDING TYPE: 1K, VjOe Ceoiav SAlk? i4 5,
CONCRET OTHER
6opd Au rnvt s �o yc i, gvoocl cleckl':;ig
c�
SIIexlo COLOR: i71
un
CHIMNEY (indicate brick/stucco/woodfaced)
APHOW e:u, cklyvtnp� t9 6t ►-,�rtcof��d. = '
ROOF nMATERIAL: PITCH (7/12min.) ?�j2 COLOR: Mai-e-A
19v ka i4- MAX . EXP.. _��� `' V ,PJX46 %n
(•uea K%44LJ u r000(�
b/k&kol /
ENDOWS (grilles required) --Indicate sizes if not listed on elevations:
(p l/Q Woodc�oc�bl� hc.9 W 1x y c x-tio+r cas,ky s ,
DOORS (indicate sizes if not listed on elevations: COLOR..r.44#- ; 8rick
6' "el B' ' A"'0Z A wood soy It s / V1it 9 q,b-ss doo✓s -�p WA e A. 1240.
TRIM: (all windows & doors trimmed C f lx5) COLOR: C,t/At go. 1
SHUTTERS (wood/Cinyl_;': P/�(
GUTTERS (wood/aluminum) : vl on e-
�^
GARAGE DOORS: SIZE & STYLE:
STORM WINDOWS & DOORS: Along
(Indicate sizes if not listed on e
SKYLIGHTS: TYPE/SIZE: PV*O&%4-
COLOR:
COLOR:
NppROVED Y)rrl,)
YARMOUIVICOMM111EE COLOR:
CORD
- - = COLOR:
Aef^`
160wokip
DECK: SIZE & MATERIAL: P-_r� � � COLOR:
FENCING (max. ht. 6'): STCOLOR:
(Show layout & running footage on site plan.)
RETAINING WALL: (P.T. or fieldstone --concrete inappropriate)
(Show layout & running footage on site plan.) h.crr.t-
ADDITIONAL INFORMATION:
`1ekt,,,c_ A`W
o 'F
bl R ck.
NOTES: Attach color chips. Indicate landscaping, exterior lighting ;
electric meter on site plans for new houses..
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APPROVED
YARMOUTH COMMITTEE
OKHRD
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APPROVED Ck
YARMOUTH COMMITTEE
OKHRD
----------
,
u
A� mill
tv
05"3 APR -9
APPROVED
YARMOUTH commam
OKHRD
310 CMR 10.99
Forrh 2
4b
Commonwealth
z�
z of Massachusetts
• i
..tip
DEP File Na.
(To be prwiaW by DEP)
City Town YARMOUTH
Aaplicant CURRAN/HANNON
Determination of Applicability
Massachusetts Wetlands Protection Act, G.L. c.131, §40
and the Town of Yarmouth Wetland Bylaw
From Town of Yarmouth Conservation Commission Issuing Authority
ToLeonard Curran/John Hannon
(Name of person making request)
Address 41 Center St., YarmouthPort
same
(Name of property owner)
Address Game
This determination is issued and delivered as follows:
f3 by hand delivery to person making reauest on June 19, 1998 (date)
-T4 by certified mail, return receipt requested on . (date)
Pursuant to the authority of G.L c. 131, §40. the Town of Yarmouth Conservation Commission
has considered your request for a Determination of Applicability and its supporting documentation, and has
made the following determination (check whichever is applicable):
�tion• Street Address 314 North Dennis Road, YarmouthPort , MA
,..:t Number. Lot T2
1. 17 The area described below, which includes all/part of the area described in your 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.
2. C The work described below, which includes alVpart of the work described in your request, is within
an Area Subject to Protection Under the Act and will remove, fill, dredge or alter that area. There•
fore. said work requires the filing of a Notice of Intent.
Effective
2.1
3. O The work described below, which includes all/part of the work described in your request, is within
the Buffer Zone as defined in the regulations, and will alter an Area Subject to Protection Under
the Act. Therefore, said work requires the filing of a Notice of Intent.
This Determination is negative:
1. O The area described in your request is not an Area Subject to Protection Under the Act.
2. O The work described in your request is within an Area Subject to Protection Under the Act, but will
not remove, fill, dredge, or alter that area. Therefore, said work does not require the filing of a
Notice of Intent.
3. X The work described in your request is within the Buffer Zone, as defined in the regulations, but will
not alter an Area Subject to Protection Under the Act. Therefore, said work does not require the
filing of a Notice of Intent.
4. O The area described in your request is Subject to Protection Under the Act, but since the work
described therein meets the requirements for the following exemption,as specified in the Act and
the regulations, no Notice of Intent is required:
Issued by TOWN OF YARM UTH Conservation Commission
This Determination must be signed by a majority of the Conservation Commission.
On this �� day of �JU/�� 19 9 r before me
personally appeared. P e7AC R� , to me known to be the
person described in, and who executed, the foregoing instrument, and acknowledged that hershe executed
the same as is; her fro � nd`�
Notary Public My commission expires
This Determination does not relieve trio applicant from complying with all other applicable leoeral, state or local statutes. ordinances,
by-laws or regulations. This Determination shall be valid for three years form the date of issuance.
The applicant, the owner. any person aggrieved by this Determination, any owner of land abutting trio land upon which the proposed work
is to be done. at any ten residents of the city or town in which such land is located, are hereby notillso of their right to reouesl the Department
of Environmental Protection to issue a superseding Determination of Applrcabilny, providing the request is made by certiLeo trail or hand
delivery to the. Department. with the appropriate filing fee and Fee Transmittal Form as provided in 310 CMR 10.03(7) within ten days from
the date of mu once of this Determination. A copy of the request shall at the same time be sent by artif ied mail or viand delivery to the
Conservation Commission and the applicant.
2-2A
SPECIFICATION SHEET (Yarmouth ORHC) - submit 3 copies
NAIAE OF OWNER (S )
FOUNDATION (18" max. exp.}:
(�CO�NCRET OTHER
STEPS (indicate brick/cement/other) ;i-on'/ /u4rA z s ooaroi, weal o%ck'-h
SIDING TYPE: %A woe ce-dow Sili'hy !e S, r`eX/O, na,�rcra /, COLOR:
CHIMNEY (indicate •brick/stucco /woodfaced)
. ;vna// enc. CA)4,nay fo 4a6 re4,tof/ec(.
ROOF MATERIAL: PITCH (7/12min.) 7//Z
6vhQ1f MAX. EXP. _coif
c
2: _.y
r:i COLQR: °�Y}(a*k.A
WINDOWS (grilles required) --Indicate sizes if not listed oa,el rations:
w V4 /X y exltiiaj caslkf S', •
Wood c✓ou.bl� hua,9 n
,�ront�' Doey t
DOORS (indicate sizes if not listed on elevations: = COLOR: Xf444#• - BYIck
6"amef 8'' -AwAwood 5�le 56L/4k9 ?,Etssoloors -�W/ v;4L �d
TRIM: (all windows & doors trimmed lx4/lx5)
SHUTTERS (wood/ inyl
GUTTERS (wood/aluminum) : Hon�G?��....._.. �k
COLOR: Cc/A, &
COLOR: b/RGA,
COLOR:
GARAGE DOORS: SIZE & STYLE: MOM-- l ' AppROVED COLOR:
i 1ARMOUTH COMMITTEE
STORM WINDOWS & DOORS: OKHRD COLOR:
(Indicate sizes if not listed on` elevations.)
SKYLIGHTS: TYPE/SIZE: rL,� COLOR:
1 C
I
DECK: SIZE & MATERIAL: ��.t� � 0 V) COLOR:
1b
FENCING (max. ht . V) : STYLE: ^OU-P%A' COLOR:
(Show layout & running footage on site plan.)
RETAINING WALL: (P.T. or fieldstone --concrete inappropriate)
(Show layout & running footage on site plan.)
ADDITIONAL INFORMATION:
o f mall 4 YK&I eA aid
ax r }7t,S
NOTES: Attach color chips. Indicate landscaping, exterior lighting &
electric meter on site plans for new houses.
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•�( jr {)� TTT �1:. � ���(�g < �. i�4[ , 1 may,• )
/.f �t� j �y/.i7 .. - r O'er{:' 1 i► y�i
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y �•iJI '• Jj •^ }y yrt ."yy _ _ ��,..�i.d, aa! '�1�: b{l 1.-..i _ •• i �.. t
I"j��j2yi:' .MiWt i't��(�µY(liiJ�ly��iyiRB�*iBS�ij��Y�+yr.�i`o22i+a.+.Ai' - . i�I y}-153�>:�'" . ♦ (�:
� tI yd�,.OMe���.V)I}a�S-w�yti �� .i1 Llrl� S: s� �h .3 M •i t.1.�:ei�L. ��le'SL •!�• i- •�-
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YARMOUTH COMMITTEE i
OKHRD
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APPROVED
YARMOUTH comMITTEE
OKHRD
('t'rn:tir.•.:.,ltis::=�.,--yCs�=%�v+�..stce :r
' • ABUTTING OWNERS FOR MAP LOT 7'L Y�w
• t (Note: Mailing address may not be abutting lot address.)
MAP��,LOT tI?-2 ABUTTER RIC�tard �• G�9eh wartti
MAP L LOT J q1
-ABUTTER,
P,o 8oX 15,51 Ya.ynloyttiport M A oZi67S
p /sCLIMe oC✓ntV- a.S j22.
MAPJLI_LOTABUTTER )Wtrf anJ Ju.Jr*�h 64r[iv. .�
$ MercMahf' Ave ,ya�n�out�t�M/} oZ675'
MAP liq LOT,-1"eq ABUTTER rxedeyeck avil May-f6g, 01504
2Z Mevchant Ave yavmovtlport AAA O?K7
MAP_jLj LOT r5l ABUTTER Vw1j ,_: -' And KO-Aleem Fabe1e
I�3 ��lfleton T�CI ,Morris Play T 1UJ o7gso
MAPJ_& _LOT e ABUTTER Jose ar,J 9li?AbefA Rut 5CL8CAe z
1qq Lakeeresf Tr- NSNI tedaeville 6A 3lo6J
MAP (rt LOT _ ABUTTER 5VC1yk Yookeks
MAP1I_LOT fyS ABUTTER
iEdwavd Donne1/H qG Al tnczrett-Aahaka
MAP LOT ABUTTER oT Yase uo of A
APPROVED n
YARMOUTH COMMITTEE
OKHRD
'10.'tiiMS.i a►Y J(rJG.4.if::w
ABUTTING OWNERS FOR MAP liq LOT TZ 114(D'�
(Note: Mailing address may not be abutting lot address.)
A
MAP B& LOT J2Z ABUTTER ffLAard 45• 6c9en wart
P,D 8oX ASS. �ccyrnoutltoovt M A oZ�75
MAPlff__LOT J q1 AB
MAP1ILOT -rZ-S
)I
obcrt anJ Ju.dr-
caneV- cts c12Z
8• Me echanl-' Ave, yarrxoutl�;Mi4 oZ67S
MAP1LLOT 1"24 ABUTTER J jrf erFck nm j Mloyf�a, 0150v1
22 Meg-ctiani" Ave V vaaovtfiAo►-t M14 02,675
MAP J% LOT Tj 1 ABUTTER
1N3 LWteton 1V Movris Plain s, W J 07450
MAP _LOT7� ABUTTER Jose as,d e-lizabetti Rai fahc e z
119 bkkecresf Vw, NE, IIII;/ledgeville G� 3/o6J
MAP_LtL LOTI2� ABUTTER 5VCIVk YoKkers
�f6 MeyckaNtA✓ep Ygym0ojAQo►-rt M& 02675
MAPJI_Y•LOT_f45
MAPJ_L_LOT lJ`L
Lamd across
N . 1)emhi5 12d-
ABUTTER 4% EJWat'
ABUTTER
164 McrAaKt Av e
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OKHRD
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MASSACHUSETT& UNIFORM APpI.ICATION FOR PERMIT TO DO G�SEITTING
Wrinl or Type),
TOWN OF YARMOUTH, MA 02664 Date3 / 19 / Permit # /v
Balding Locatio r/ 1)�P.c,r.'i S�d�Owner•S Name �'' � 0 ��-i' �'' C-a•o �%
A/� /�U ce7 �)'•" )/c Type CCU
/ -t'.) ��-Qic►.�'G•
Pt.
New ❑ , Renovation Replacement ❑ Plans Submitted ' Yesp No 02
D Yla 1A
9 1998 J H W U G 2 /•/
C p. < >' .= Z O r W
o W< Q c a�
�6 m W 6 W W h N 6 C tl ( •
BY N C N CI O W = YI W < C O p>
W 2 C W F F• S
V ~ W J ~_ ~ f' Y N :m 2 O ~ W O UNI S 2 < W < C
�.• < W> C W D < C<< O O W C O bi F
C 'S O 0 S a o 3 O tl J Cl C Y p 6 P O
SUB-BSMT. � i •f'
.c 13ASEMEt1T
1STFLOOR
2NO FLOOR
I i ti
"..�• .f�'
4TH FLOOR
STH FLOOR. I
i •' i I i
7THFLOOR
8TH FLOOR
Installing Company NameCheck one: ! Certifij
tate
Address 11 • ► i } "• ; ' 13 Corporation
0 Partnership
Business Telephone /I O FkWCO.
Name of Licensed Plumber or G F"itt � h N " '-r- ► #
as er , , /L
p
INSURANCE COVERAGE:r
' I have a current liability, Insurgpce ,Qolicy of Its substantial equivalent which meets the requirements of MGL Ch 142 + °
,,Yes.O; :No t ,• '_,.,, I ';
1 c
It you have checkedyg• piease Indicate the type coverage by checking the appropriate box.
i!. , :�:.r r..., it t •f, �''w�, °-. t ;' rF V;. I r'I , ;♦ Y`,•
° A liability, insurance policy 0 Other type of Indemnity, 0 , --Bond.O
50W�N1,ER'S'.114SURANCE'WAIVER:,lam aware thatthe IlcensCedoes not'have,the.insurance coverage required byef 142 of the Mass General �wswand that my signature -on this permit application valves this requirement +'
i ? ° Check one.
Owners Agent
ur4 OIL Owner or Owner's Agent
♦ o er a ,,.•..rrf ,�°L^. ,.::, ,' `i:h i...ra .e :.:fit .' -ll. 1 L:'':. •'a
i I hereby certify that all of the details an Information I have ;ubmitted for entered) In above application are true end accurate to the best of mY,
knowled a and that all plumbing work d Installations performed under tho pernut Issued for this applicatio will be in compliance with all ,
!; DeNnen p ovtsloru of the htassaehu to State Gas Code and Chapter 142 of the It era] Law r:
T of Ucense
°Yr rrieNjourneyrfm
Urft rf t'� 7+ . -0 C-eenze U r
Mast r U se NumBti(��;, !
w r. AP / L 1 1
i . r Il''., R� i.. .',:.•,,r ti y . .y r ' . r` e a ' 1 p r� - . -}ri f ,i .� .. C.
FINAL INSPECTION
BELOW FOR OFFICE USE ONLY
SKETCHES
FEE
NO.�L��-
APPLICATION FOR PERMIT TO DO GASFITTING
NAME 1 TYPE OF BUILDING
LOCATION OF BUILDING
Aj
PLUMBER OR GASFITTER
LI C. NO.
PERMIT GRA`NT'; . 9
DATE v / 19
GAS INSPECTOR
PROGRESS INSPECTION
f
Town of Yarmouth
GAS PERMIT
Office of the Gas
This is to Certify that
has permission to
for
in building
No. 170
I
in accordance with an application on file in this office, and subject to the provisions of the
Ordinances relating to the Gas Code in the Town of Yarmouth.
Fee $
!�`/� Gas Inspector
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or Type)
TOWN OF YARMOUTH, MA 026,,6r4 ,/Date (� 19— C Permit # '
BuildingLocation �34 Nd�T1f be',u41oS Owner's Name
I`�l� Ivio ct f / Po ZType of Occupancy,
Renovation Replacement ❑ Plans Submitted: Yes ❑ No ❑
FIXTURES )�v 7 A -/
�F�E�J�i�fiJ�F��E
`�s�■����n�s�■■���i
Installing Company Name
Address I k I (;—>
Ili )C�- p ;Sc
Business Telephone bl—f
Name of Licensed Plumber
Check one:
❑ Corporation
❑ Partnership
❑ hrm/Co.
Certificate
INSURANCE COVERAGE:
I have a current liability Insuppee 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
Chapter 142 of the Mass. eneral Laws, and that my signature on this permit application waives this requirement.
Check one:
�r Owner ❑ Agentx_
Si re of Owner or Owner's !went
certify that all of the details and Information I have submitted (or entered) m above appucauon are uve ana accurate to the ocu of my
ge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all
t provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
I
Type of License: Master[]
G Journeyman>(
k.,)cense Number—
BELOW FOR OFFICE USE ONLY
PROGRESS INSPECTIONS
FINAL INSPECTIONS SKETCHES
FEE
a NO. -/-
APPLICATION FOR PERMIT TO DO PLUMBING
rld-a- 42 d:)z=;l C —
NAME A TYPE OF BUILDFING; c/
/Ga t.L lzot.crS As �c+rucc%
LOCATION OF BUILDING
PLUMBER
PERMIT GRANT
DATE441
I
PLUMBING INSPECTOR
Ordinances relatir to the State Plumbing Code in the Town of Yarmouth.
Fee $' .
Plumbing Inspector
PERMIT 728 11/12/97
11/12/97
LOT T-2
Roberts, Roger
314 No. Dennis Road
Yarmouthport, MA 02675
Existing house ---interior remodel only.
$10,000.00
SHEET 114
PERMIT 435 6/23/98
LOT T2 p
6/23/98
Hannon, John
314 No. Dennis Road
Yarmouthport, MA 02675
Extend one bedroom & bathrm. $10,000.0
SHEET 114
PERMIT 498 8/14/97
P 8/14/97
LOT T2 ' 0%
Roberts, Roger
314 No. Dennis Road
Yarmouthport, MA 02675
Strip & re -roof $2,000.00
SHEET 114
ft
51SM15
SlipGen- Portal Hone
Document Category
Map -Block Number
Street Number
Street Name
Department
Parcel ID
Backfile Batch Scan
Document?
Additional Naming Info
Index Operator
Date - Time
Town of Yarmouth
Template [Building Dept]
Slipsheet Identifier [sg24666]
Building Permits
127.16
0314
NORTH DENNIS RD
Building
15984
0fel
Operator, Yarmscan
2015-05-05 - 11:19
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