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HomeMy WebLinkAboutBuilding PermitsNOTES: 1. ELEVATION FROM RM 9 (NGVD)_ I 2. FLOODZONE AS EL 6 & C (HOUSE IS IN C? �FIRM_250015-0002 D. REV._ 7/2/92 3. ASSESSORS MAP 101 PARCEL 164 4. ZONING: R-40 (FRONT: 30', SIDE, 20') 5. ROOF RUN—OFF TO BE DIRECTED TO DRYWELLS EXIST. DWELL. BULKHEAD DETAIL 1"= 15' LOCATION MAP NTS KEY: C GUY WIRE TRANSECT ''O.> UTIL POLE t4 Q� ( �: TREE + ,fp '•,F _ TRANSECT i7 PARCEL 163 u S Io LIGHT POST BLUE ROCK HEIGHTS -''ems _ TRANSECTr u•-+4z - + 11.2 SPOT ELEV. ASSOC. 4D _..-►_3s 'J 107 102 +9.4 ft J=-179 .o 1st STORY SCREENED tii _ k y PORCH W/1 CK OVER r�uw�ri i FLOODZONE EL 6 (TOP COASTAL BANK) tit � i i 1 1 i tIJ.7 #l� *i' LOT 23 �i1zs •fiza *44 DRIVE/PARKING WOODCHIPS 11 i .F11.4 i +Iu cmas ,•... -- EXIST +1z4 i�I '.LACE • �, ,.Ftz'l� p►tss ' Ila EXIST. ST .'EXIST. SEPTIC *!U LEACHING AREA (APPROX. AREA) '•`Fly 1�, 73 •Ogll�� 4 off. 508-362-4541 fax 508-362-9880 e�C/F Pq lF fNNa down cape engineering, inc. ROCk CIVIL ENGINEERS ROgD LAND SURVEYORS BENCHMARK 939 main St. yarmouth, ma 02675 CATCH BASIN ELEV 10.8' 94-310 +101 12" TREE DECK 2 STORY EXIST. DWELLING PARCEL 164 0.69 AC I 0 k PARCEL 165 PATRICIA J. CEDERIC GRENIER TR ARNE H. OJALA, PE, PLS a)5_ s3 DATE �- PROP. 6.3'x 5.3' BULKHEAD (SEE DETAIL ABOVE) PROP. SUNROOM SITE PLAN OF #200 BLUE ROCK ROAD IN THE TOWN OF: (SOUTH) YARMO UTH PREPARED FOR: MARK UPPENDAHL 30 0 30 60 90 SCALE: 1" 30 DATE: DECEMBER 19. 2001 REV. 1/14/03 (SH) Town of Yarmouth No. 338 PLUMBING PERMIT Office of the Plumbing Ipspector, South Y outh 19 � at This is to Certify th has permission to for in building on c2OD " L6211 122 _ in accordance with an application on file in this office, and subject to the provisions of the Ordinances relating to the State Plumbing Code in the Town of Yarmouth. Fee $- F/X Plumbing Inspector 04e Crommnnweuli4 of Malifiar4jaslm Utpartnunt of Iiubl(c $ufeg BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 I ii Office Use Only Permit No. &13 Occupancy 6 Fee CheckiiT peeve blank) EAPPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Massachusetts Electrical Code, 527 CM 12:0 (PLEASE PRINT IN INK OR TYPE ALL FORMATION) Date City or Town of—� �.nl\1 To the Ili cto es: 11 The undersigned applies or a permit to erform t e electrical work des ribed below. JUN 4 Location (Street 6 Number) tool 19.�9 Owner or Tenant Tel. No. Owner's Address I aY _. Is this permit in conjunction with a building permit: Yeb No ❑ (Check Appropriate Box) Purpose of Building 0P l- A fA-<.0 Utility Authorization No. Existing Service Amps —==t— Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service �^ Amps _J Volts Overhead ❑ Undgmd ❑ No. of Meters Number of Feeders and Ampacity location and Nature of Proposed Electrical Worker No. of Lighting Outlets No. of Hot Tlrba No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool In- ❑ omd. LJ grad. Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Bumei Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and No. of Ranges No. of Air Cond. Total tons Initiating Devices No. of Disposals No of Heat Total Total Pumps Tons KW No. of Sounding Devices . No. of Sell Contained No. of Dishwashers Space/Area Heating KW DetecWNSounding Devices Lpal ocal❑ ection ❑ Omer No. of Dryers Heating Devices KW CoConnectin No. of No. of* Low Voltage No. of Water Heaters KW Signs Billasts Wiring No. Hydro Massage Tutu No. of Motors Total HP OTHER: . INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability insurance Policy includ. Ing Po ted Operations Coverage or Its substantial equivalent. YES d NO D 1 have submitted valid proof of same to the Office. YES IM . NO P It you have checked YES, please indicate the type of'coverage by checking the appropriate box. nn INSURANCE N BIOND D OTHER O (Please Specify) 9-- 94--t9 CEstimated Value of Electrical work S (Expiration Date) Work to Start Inspection Date Requested: Rough Final Signed under the Penalties of Perjy(n( FIRM NAME 1 C. NO. A I Q04� Licensee _7O P n 6' � d f2 i Ciq f; Signature _ h01{ . UUC. Address I ZZ i✓IC11CtY) r'12. rl� litl/LI 11rK. �. VL�121'17L!L1.Tt1 A Bus. Tat. No. .7 �T•�, ` 1 { - Alt. Tel. No. /)SC — OWNER'S INSURANCE WAIVER: 1 am aware that th4 Lice" does not have the Insurance coverage or Its substantial equivalent as re• quined by Massachusetts General Laws, and that my signature on Ws permit application waives this requirement. Owner Agent (Please check ore) Telephone No. PERMIT FEE S (Signature of Owner or Agenq Notify Inspector for rough and/or final Inspection. Pemdt must be obtained before commencing arty. and all work in compliance with G.I.C. tat A al: apple; a- ble laws 3 ordinances Is required and understood. xd796 633 WIRE INSPECTOR'S DEPARTMENT YARMOUTH TOWN HALL SOUTH YARMOUTH, MASS. 02664 Fee 30 tob Date Name of Job 1 i �%�� ilk WA Yi�e" Name of Electrician Location TOWN OF YARMOUTH Building Department (5u8) 398-2 3� . PERMIT NO B-03-1113I _ ISSUE DATE 613/03 ; PROPOSED t E APPLICANT -'MARK S UPPENDAHL ADDRESS :00200 BLUE ROCK RD BUILDING PERMIT JOB WEATHER CARD .... PERMITTO Alterations SUBDIVISION MAP LOT BLOC 1101.164 / BUILDING IS TO BE USE GROUP R4 LOT SIZE CONST TYPE 5-B CONTR'S LICENSE 0 replace 2 story pillared covered front entry with one story entry as per plans dated 06/02103. REMARK CONTR'S NAM AREA (SO FT) EST COST ($ $1,000.00 PERMIT FEE ($) $35.00 OWNE MARK S UPPENDAHL ADDRESS 100200 BLUE ROCK RD BUILDING DEPT BY INSPECTION RECORD Date Note Progress - Corrections and Remarks _-4 FIELD COPY M '� ONE & TWO FAMILY ONLY - BUILDING PERMIT . APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING Town ol'larinouth Building Deparllncnl. 1146 Route 28 • Yarmouth, MA 02664-4-192 Tel: (508) 398-2231 x261 • Fax: (508) 398-2365 Office Use Only ermt No.Late Planning Board Information : lan Type AssessorsDepattment Information Map } Lot c Ma P; Lot [eprmiltiFee?� Endorsement Date DteostRec'd nrewRecorsLng 14 Property Dimensions $ aJ-pate% p /' Y'-i Net Due Plan No = $ �Dr k Ottter :Lot Area. (sf) +`' Frontage ((t) _Lot Coverage• Section forOffice Use Onl , . ;,=' Buildin :P r It Numbe .. Date Issued:: Signat Z.,. a _ Certificate of Occupancy , BuildingI ': • Official Date + rs is not ` "regtured Section 1'- Site Information`; Use Group: R-4 T e: 5-B 1.1 Property Address: 1.2 Zoning Information: /� �/ /j A gl e K �C Aq/% .y o Zoning District Proposed Use 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard equired Provided Required Provided Required Provided 30 F1.4Water 3ia Lv z � Supply (M.G.L. c. 40. S 541 1 5 Flood Zone Intormati Commentsblic t/ Private one:; Section 2 - Property Ownership/Atthoried-Agent 2.1 of Record: �Owner Name (print) Mailing Address Signature Telephone 2.2 Authorized Agent: D Name (print) Mailing Address JUN l✓ Signature Telephone Section 3 -'Construction Services 3.1 Licensed Construction Supervisor: Not Applicable ❑ 2 2003 License Number Address 1 c 5�/ ds� Expiration Date Signature Telephone 3.2 Registered Home Improvement; Contracto—rol Company Name Not Applicable ❑ Address License Number Signature Telephone Expiration Date o - at - an of z rillco r . 1.: 7 Sectloriw.. yVofkers' Conipensa"tion Ins urance Aff(iiavit'(rN G L c # 152'S"2';G a)l 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 .......... Sectloi%5"It "Dotion!of Pfdpgsed VlCork"((hTTR alTppficatifej New Construction ❑ No. of Bedrooms No. of Bathrooms Existing Bldg. ® Repair(s) ❑ Alterations f Additlon ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: a I �' _4ory reillara cohere 4y"o en4 Fla-f e to u CO-f eD Estimated Cost (Dollars) to be Check Below Sectioi=sfirnate8' onsifuctioii"Cost`s Item completed by permit applicant boo ❑ Conservation -Commission Fling (if applicable) ❑ Old Kings Highway R Historical - Commission approval (if applicable) C0 is bL Cb teteti WIftiM, 1. Building 2. Electrical 3. Plumbing / Gas 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) 7. Total Square FL (new houses 8 addtions) Sect16p 7A�X Ow h 0 A Ih6H26tid-f 1 ,P" ['F ' `Y.YrF Ji Qwrie['s`Agent or, Cohractor dppi�os?%r _ 'M1 I," yi L-b�•iSi pn, • Buildingpermit ;, r 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 Seotion76�=�jDwi'e/r7 ufiiolnz)e'tl"'g nTDecIdiration; 1, Owne /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. _�l/'Y Print name -o`eaa ,Z Signature of Owner/Agent %—I Date 0--y;4`n TOWN 'OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION' SUPERVISOR FORM PLEASE PRINT: ,)ob'Location: Number : Street Village Owner of Property: Constriction Supervisor: Name License No. Phone No. Address: Licensed Designee: (If other than Supervisor) Name License No. 2.15 Responsibility of each license holder: 2.15.1 The license holder shall be fully and completely responsible for all work for which he is supervising. He shall be responsible f'or 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 allother 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 %vitl .section 109-1.1.of the state building code. I understand the construction inspection procedures and:the specific inspection as called for by the building official. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes ❑ No ❑ If you have checked 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 152 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Owner ❑ Agent Q 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: Est. Cost / ddress of Work Owner Name: Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under $1,000 Building not owner occupied _ Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. Signed under penalties ofpcdury: I hereby apply for a permit as the agent of the owner: Date Contractor Name R' Registration No. Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name l 2 �\ The Commonwealth of Massachusetts Department of Industrial Accidents ©///6D 01/L9/DSl/jl�L'r7®S 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit s a t M111F.111111 J BC 1►11fya r�►. S- cit%- phone # 4 1 am a homeowner performing all work myself. O 1 am a sole proprietor and have no one working in any capacity O 1 am an employer pro%iding workers' compensation for my employees working on this job. company name: address: — city- phone #: insurince to, policy # 1 am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below who have the followin_ workerscompensation polices: compan n'me' adr cs• — city. phone #: insurance co policy # Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal peaaitica of fine op to S1.500.00 andlot one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I onderstaad that a copy of this statement may be forwarded to the OMce of Investigations of the DtA for coverage verification. I do -hereby certify under the paint andpena/ties of perjury that the information provided above is true and coned Print name Phone N I fficial use only do not write in this area to be completed by city or town official city or town: YARMOUTIJ i7 check if immediate response is required contact person: -5-117,7/o 3 permitAicenst # nBuilding Department ❑Licensing Board 261 ❑Selectmen's Office pHealth Department phone #: _ (508) 398-2231 eat. n01her Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their erttpluy ees. As quoted from the "la%v", an employee is defined as every person in the service of another under ant contract of hire, express or implied, oral or written. An enrphnver 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 . &elling 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. NIGL chapter 1=2 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 prolfuced acceptable evidence of compliance with the insurance covers a tired__ Additionally. neither the com `. n?�ofits-pe3ktrcal subd isrons s a 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 fill in the workers compensation affidavit completely. by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The to the city or town that the application for the permit or license is being requested. affidavit should be returned 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 affdavits may be returned to the Department by mail or FAX unless other arrangements have been made: The Office of'Investigations would like to thank you in advance for you cooperation and should you have any questions'. please do not hesitate to give us a call. The Department's address, to fax num The Commonwealth of Massachusetts Department of Industrial Accidents ®fllt:e of 1218SHUME13 600 Washington Street Boston, Ma. 02111 fax 9: (617) 727-7749- phone 9: (617) 7274900 eat. 406, 409 or 375 41 PLEASE PRINT: DATE: JOB LOCATION• TOWN OF 'YARMOUTH BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 260 HOMEOWNER LICENSE EXEMPTION .7-00 Ae 4d� .s y NAME10 STREET ADDRESS SECTION OF TOWN "HOMEOWNER" 176 c/ 7-10 4 NAME HOME PHONE WORK PHONE PRESENT MAILING ADDRESS <- — e CITY OR TOWN STATE ZIP CODE 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 Section 108.3.5.1) Definition of Homeowner. Persons) who owns a parcel of land on which he / she resides or intends to reside, on which there is or is intended to be, a one or two family attached or detached structure assessory to such use and / or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner; such "homeowner" shall submit to the building official, on a form acceptable to the building official, that he / she shall be responsible I all such work pefoormed under the building hermit. (Section 108.3.5.1) The undersigned 'homeowner' assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and regulations. The undersigned 'homeowner' certifies that he / she understands the Town of Yarmouth Building Department minimum inspection procedures and requirements and that he / she will comply with said procedures and requirements. APPROVAL OF BUILDING OFFICIAL INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL CIL 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. General Laws and that my signature on this permit application waives this requirement. Check one: Signature of Owner d wner's Agent Owner Agent ❑ h1omeowarlicexemp TOWN OF YARMOUTH 1146ROUTE28 SOUTHYARMOUTH MASSACHUSETTS02664-4451 Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT BUILDING ELECTRICAL, GAS PLUMBING SIGNS Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at RILW S' Y ZZI&y Work Address is to be disposed of at the following location:m�S��y' Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Signature of ticant Permit No. z, O Da e 0 �M EASTr-40 FOYER PORTICO ow 1 4 ///, m m " LIVING RM =-G- ,s r TOWN OF YARMOUTH d` Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 exL261 BBUILDING PERMIT APPLICATION RECEIPT Temp Permit No.: T-03-523 Applicant Name: Mark Uppendahi Location: 00200 BLUE ROCK RD Owner's Name: MARK S UPPENDAHL Owner's Addres 00200 BLUE ROCK RD South Yarmou MA 02664 Owner's Telephone: (508) 394-1764 (OFFICE USE ONLY Recorded By. Ic Permit Fee: $0.00 Deposit Rec: $25.00 Payment Type: Check ChkNo.: 4521 Net Owed: ($25.00) Application Date: 5/27/03 Issue Date: Expiration Date , Comments: /Q replace 2 story pillared covered front entry with one story entry This Is NOT a building permit. Application subject to plan review. Contact Building Department for permit status. Official Building Permit will be issued upon plan review completion, approval, and complete payment of Net Owed on Permit Fee. Date Printed: 5129/03 1 1 RM EDOS„ o FOYER n F-ICST"G LIVING RM - ex Is -If. Y r al-45 1 �M �� FOYER PROPOSEEDD POIZTIGO E)CST"G LIVINO RM =-V 31 +4.2 CT ND - +3.5 -2.3 �(,a_ I - . 32- +3.9 + k y 98 1. BANK - 's-q•-_ TOp--- V, I DECK 14A asT 2 STORY EXIST. DWELLING CAGE Ul/, 1 PROP. PORTICO -Z is PA L 164 ,a 0.69 AC + k� 26p p0 � � 1 1st STORY SCREE PORCH W/DECK WALL - - EXIST BRICK PATIO (REMOVE) act �W �- 0' PROP. SUNROOM PARCEL 165 PATRICIA J. CEDERIC GRENIER TR OF #2( � 3�� �5 ti • A 4 NOTES: 1. ELEVATION FROM RM 9 (NGVD) 2. FL006ZONE A5 EL 6 & C (HOUSE IS IN C) (FIRM 250015-0002 D, REV. 7/2/92) 3. ASSESSORS MAP 101 PARCEL 164 4. ZONING: R-40 (FRONT: 30', SIDE, 20') 5. ROOF RUN—OFF TO BE DIRECTED TO DRYWELLS KEY: C GUY WIRE `Cli UTIL POLE {'J TREE Vo LIGHT POST + 11.2 SPOT ELEV. PARCEL 163 BLUE ROCK HEIGHTS ASSOC. DRIVE/PARKING WOoODCHIPS TRMiSECT ass u �.Ar a>• + u TRMSE T �i 'P +Iu rem a .a PROP. GAR AoanoN •- ; rli� /LOT 23 p off. 5M-362-4541 fax 508-362-9880 down cape engineering, ine. CIVIL ENGINEERS LAND SURVEYORS 939 main st. yarmouth, ma 02676 13 4? �a 4 7 �r�. uz ROC/` HT 1'6 RID BENCHMARK CATCH BASIN ELEV 10.a an SEPTIC 11 :ACHING AREA (APPROX ARE EXIST GARAGE EXIST. ST 12' TREE (e)a ARNE H. N P .a TRANSECT / 24-+42 tot STORY SCREENED PORCH W/OECK OVER DECK 2 STORY EXIST. DWELLING N 217 PORTICO r@ PARCEL 164 '. r 0.69 AC PARCEL 165 PATRICIA J. CEDERIC GRENIER TR 19, 2�01 DATE LOCATION MAP NTS 49, S �opi`F FLOODZCNE EL 6 (TOP COASTAL BANK) O. E1aST. ROCK QWALL —EMSTBRICK u1j (PATIO PROP. SUHROOM SITE PLAN OF #200 BLUE ROCK ROAD IN THE TOWN OR (SOUTH) . YARMO UTH PREPARED FOR: MARK UPPENDAHL 30 0 30 60 90 ZZI SCALE: 1' 30' DATE: DECEMBER 19. 2001 • ' TOWN OF YARMOUTH Building Department BUILDING '- �•. PERMIT NO-8-03-854 -' ISSUE DATE ...418/03... ; (508) ss8 22�91 ext.2 PROPOSED U ' PERMIT APPLICANT: MarkUppendahl ADDRESS '00200 BLUE ROCK RD JOB WEATHER CARD PERMIT TO Addition AT (LOCATION) 100200 BLUE ROCK RD ZONING DISTRIC R-40 SUBDIVISION MAP LOT BLOC 1101.164 BUILDING IS TO BE USE GROUP R-4 LOT SIZE CONST TYPE 5-B CONTR'S LICENSE addition: sunroom/tamilyroom as per plans dated 04/02/03. REMARK CONTR'S NAM AREA (SO FT) EST COST ($ $30,000.00 PERMIT FEE ($) $150.00 OWNE MARK S UPPENDAHL ADDRESS 100200 BLUE ROCK RD BUILDING DEPT BY South Yarmouth 02664 71 . INSPECTION RECORD FIELD COPY Date Note Progress - Corrections and Remarks Inspector • 3 a O $�2 -0 /o d d/C of YqR Mom y �� • MATTAC.t 5 ONE & TWO FAMILY ONLY - BUILDING PERMIT APPLICATION TO CONSTRUCT, REPAY., RENOVATE OR DEMOUSH A ONE OR TWO FAMILY DWELLING Town of Yarmouth Builchng Department e iice �7TN%Ow 1146 Route 28 • Yarmouth, MA 02664-4492 FAX sd,F 3 3G3� Tel: (508) 398-2231 x261 • Fax: (508) 398-0836 ( Office Use Onfy ;,(, Planning Board Information Assessors Department Information Date'' 'J Plan Type " Ma of }; ap Lot Permit No.H� Permit Fee:/Soy Endorsement Date O/d, New Deposit Rec'dj� Date Recording Date '}, 1 4 Property Dimensions 10 } .. -4 1 t 1 n, 1 Net Due s /a $i Otherlot Area ,(so . Frontage(ft) , , .-'Lot Coverage . This Section for Office Use Only Building Permit umber: °: - Date Issued: Certificate of Occupancy Signature: Building Official, to ' is'' Is not required + : •, Section"l - Si Information Use Group: R-4 Type: 5-B 1.1 Property Address: 1.2 Zoning Information: B/U" �aa� /Z yo Zoning District Proposed Use S• krW-6 w7 1t . 14 Duo (o 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Re uired Provided Require Provided dr o7Q' I A Water Supply (M.G.L. e. 40. S 54) 1.5 Flood Zone Information Commegts .1 .` Public ✓ Private Zone:°-Fz .. BFE,. Section 2 = Property Ownershi /Authorized Agent 2.1 Owner of Record: rr lbw ida 4 l Name (print) Mailing Address /7A ^� Signature Telephone 2.2 Authorized Agent: Name (print) Mailing Address Signature Telephone -- Section 3'- Construction Services 3.1 Licensed Construction Supervisor. �, u p V U �I'� Not Applicable ❑ S.nl UUU License Number Address � ` Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor. Company Name OWNERS PULLING THEIR OWN PERMITS OR IsE dXpplicable ❑ WITH UNREGISTERED CONTRACTORS FOR APPLI- Ci ' se Number eABLE HOME .vnyvurnTr.onnw N Address ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL t:142A. Expiration Date Signature Telephone 1 of 2 OVER Section 4 = Workers' Compensation Insurance Affidavit (IVIAL. 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 tfie 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 la Accessory Bldg. ❑ Type Demolition. Other Specify: Brief Description of Proposed Work: _ Costs Estimated Cost (Dollars) to be Check Below completed by permit applicant A-S O00 ❑ Conservation -Commission Filing 000 (if applicable) 00 J ❑ Old Kings Highway & Historical Commission approval 3 D DO J (if applicable) U 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 6 addrdom) Section 7a - Owner Authorization -To Owner's Agent or ContractorApplies (, 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 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 � zo�d3 Signature of Owner/Agent Date 9-15-99 2 of 2' TOWN OF 0 YARMOUTH •o,)y c....rZ,s BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRIM. Job Location: Number Street Village Owner of Property: Construction Supervisor: Name License No. • Phone No. Address: Licensed Designee: (If other than Supervisor) Name License No. 2.15 Responsibility of each license holder: 2.15.1 The license holder shall be fully and completely responsible for all work for which he is supervising. He shall he 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 willftilly 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, reconstntction, 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 workshall 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 ❑ 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 152 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or owner's Agent Owner U Agent Signature: Iuilding 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: &o% Est. Cost Address of Work Zn;� flu 0 Owner Name: Date of Permit Application: V_?D 113 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under $1,000 Building not owner occupied _ Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMITS OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLI- CABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A. OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: 3 zoo Date Owner Name The Commonwealth of Massachusetts Department of Industrial Accidents exciffWnesU N&M 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit G.Il.• phone 0 ka 1 am a homeowner performing all work myself. p l am a sole proprietor and have no one working in any capacity O 1 am an employer pro%iding workers' compensation for my employees working on this job. LQEU gym• name: addre s- cit) phone No inst r� Ice co Policy N C] I am a sole proprietor. General contractor. or homeowner (circle one) and have hired the contractors listed below who hay e the following workers' compensation polices: phone N• Failure to secure coverage as required under Section 25A of MGL 152 can lad to the Imposition of criminal penalties of s flue op to S1.S00.00 and/or one years' Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a not of $100.00 a day against me. 1 understood that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do -hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Print name Phoned official use only do not write in this area to be completed by city or town official city or town: YARMOUTH O check if immediate response is required permitAicenst 0 riBuilding Department ❑Licensiog Board 261 OSelectmen's Ogee pHealtb Department (508) 398-2231 eat phone 0; _ r901her contact person: Information and Instructions Massachusetts General Laws chapter I52 section 25 requires all emplovers to provide workers' compensation fortheir entpluy ees. As quoted from the ••la%►•", an employee is defined as every person in the service of another under any contract of hire, express or implied. oral or written. An emphover 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. %IGL chapter 1 section also states that every state or local licensing agencv 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 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 hae been presented to the contracting authority. Applicants Please till in the workers compensation affidavit completely. by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial accidents. Should you have anv 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 affdavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address, telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of 11111 ast19303®a 600 Washington Street Boston, Ma. 02111 fax N: (617) 727-7749 phone #: (617) 7274900 ext. 406, 409 or 375 of Y9R TOWN OF YARMOUTH BUILDING DEPARTMENT ° x 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 260 HOMEOWNER LICENSE EXEMPTION PLEASE PRINT: DATE: c3f7 JOB LOCATION: yI-✓�eu-j 016G`/ . NAME' STREET ADDRESS SECTION OF TOWN "HOMEOWNER" .Set 1w t NAME HOME PHONE WORK PHONE PRESENT MAILING ADDRESS 5z� Q - CITY OR TOWN STATE ZIP CODE 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 Section 108.3.5.1) 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 structure assessory to such use and / or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner; such "homeowner" shall submit to the building official, on a form acceptable to the building official, that he / she shall be responsible for all such work performed under the building hermit- (Section 108.3.5.1) The undersigned 'homeowner' assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and regulations. The undersigned 'homeowner' certifies that he / she understands the Town of Yarmouth Building Department minimum inspection procedures and requirements and that he / she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch.142. Yes ❑ No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ hhomeowarlicc=p TOWN OF YARMOUTH 1146ROUTE28 SOUTHYARMOUTH 'MASSACHUSETTS02664-4451 Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT BUILDING ELECTRICAL GAS PLUMBING SIGNS Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at �0 151t, �d A 5,/d roi 7dl, In� Oz-&6o y Work Address is to be disposed of at the following location: • f �� �w l Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. ge Signatur Applicant Permit No. � Zo b Date uto) f TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398.2231 ext.261 BBUILDING PERMIT APPLICATION RECEIPT Temp Permit No. Applicant Name: Location: Owner's Name: T-03-400 Mark Uppendahl 00200 BLUE ROCK RD MARK S UPPENDAHL (OFFICE USE ONLY Recorded By: IC Permit Fee: $0.00 Deposit Rec: $25.00 Payment Type: Check ChkNo.: 4472 Net Owed: ($25.00) Application Date: 3/20/03 Issue Date: Expiration Date Comments: / 0 / 116 addition: sunroom/familyroom Owner's Addres 00200 BLUE ROCK RD South Yarmou� MA 02664 CONING APPROVED. Owner's Telephone: (508) 394-1764� This is NOT a building permit. Application subject to plan review. Contact Building Department for permit status. Official Building Permit will be Issued upon plan review completion, approval, and complete payment of Net Owed on Permit Fee. OWNERS PULLING THEIR OWN PERMITS OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLI- CABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL r.142A. Date Printed: 3129/03 TOWN OF YARMOUTH BUILDING DEPARTMENT ADDRESS: gav ?L Map / Lot: /a Date of Initial Re view: : Other. Inspector. u—,41L i APPLICATION REVIEW NOTES SY r NOTES: 15100 /4//, ?o y (J,v D BiL /► pvi PrL S'v/�P.�/�.t s E�lQit61%1 r.�- ro2 i%���. L"Na�.e 5reci- [34-s4nc0> ; CL�#4rZfi`rrc. RT FiAe- l3ox rN/N r 8�z ' rtov, off._ P,,f Sr/�T F�� Cw -3sr w�.•ao�..s I cc a sS ffor SHo w /y i) liGOvrO l7i�Tn Fe,t FX�sTiKc Q4 NC... liE+frJvc �y57Krn i Zoning Denial (ifapplicable): Section 10432„ Para Chazige, Eztensi� Alie:aiion (pra e�sting. nonconforming) The primed _.. _ _..__.._ ..... requites a Spacial Permit front the 7g Bosdvf tlppeals Other --.-- Building Code Denial (ifappEcable) Kca.11-01 Building Site Location: Proposed Improvement: Address: TOWN OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET No: zO Lot No• 6Y Filed: 3 ZO D The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. RESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT: Determines Compliance of Water Availability and or existing location. ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage. CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. REVIEWED BY: 1. WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: DATE: N/A: INDUMIAL AND/OR COMMERCIAL PERMITS S. WMING INSPECTOR: DATE: N/A: 6. PLUMBING INSPECTOR: DATE: N/A: 7. FIRE DEPARTMENT: DATE: N/A: COMMENTS: RECENT OF COPY: PLEASE NOTE SIGNATURE OF APPLICANT: DATE: White copy - BuWmg DepL - Pick spy - Wabw DWc - Yd1ow Copy - Irahh Dcp - Pwk Copy - Engin=4 DcpL - Goldcmod - Fire Dept/Cousaystion .. .�7y M J._• Building Site Location: Proposed Improvement: Address: , ..I •,p�^mod n"`: :{l1 .t -, �,, .:p,.o ...1,�a�,. .✓. .. ... .. .. �.r 7n.. `,,.6..�r:.�Y :`a:a+'J.../.,.. TOWN OF.YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET �LMap No: Lot No: Al el Filed: 3 T 6 The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. WATER DEPARTMENT: ENGINEERING DEPARTMENT: _ CONSERVATION COMMISSION: HEALTH DEPARTMENT: FIRE DEPARTMENT: RESIDENTIAL AND/OR COMMERCIAL BUILDING Determines Compliance of Water Availability and or existing location. 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, Marshland, Etc Determines Compliance to State and Town Regulations; i.e., Requirements 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. -----------------------------------------------------------------------------------------------------------------------------------. REVIEWED BY: 1. WATER DEPARTMENT: L r �t OlL� DATE:-3-3�N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION:- DATE: N/A 4. HEALTH DEPARTMENT: DATE: N/A: INDUSTRIAL AND/OR COMMERCIAL PF.RMM 5. WIRING INSPECTOR: DATE: N/A: 6. PLUMBING INSPECTOR: DATE: N/A: 7. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Whit copy - Buddmg DcpL - Pink wpy - Wow Dcpt. - Ydlow Copy - Hdth DcpL - Pick Copy - Enginc r DTL - Gdk -Fite Q ..�. ..-w....�a..w a..�W�.rt4. ir..w.7•�+scs.v.a y`.r...,r.-. .. �+reL+M+�i�i.�4rr+;:iWH�rwwie 4J�.F_�.,.p..,-u �.rn-.r'.y..,.:.r .w.a.v..:: �.s�.w....: Building Site Location: Proposed Improvement: Address: qo�) TOWN OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET No Z0 Lot No: /u/ Filed: 3 a The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. RESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT: Determines Compliance of Water Availability and or existing location. ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage. CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. *1J 1A.'J"73'F 1. WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: 4. HEALTH DEPART S. WRUNG INSPECTOR: DATE: 6. PLUMBING INSPECTOR: DATE: N/A: 7. FIRE DEPARTMENT. DATE: N/A: COMMENTS: RECEIPT OF COPY: PLEASE NOTE SIGNATURE OF APPLICANT: DATE: Wbite copy - Baddmg DRY - Pink copy - Water DTL - Ydlow Copy - Haab Dept. - Pick Copy - En6inc� D� - Gold=W - Fire Dc0K=scv& im • o%� .� •` ;TKn Sf/ �� Building Site Location: Proposed Improvement: t�7�1-1cL'v rl.. L10f) TOWN OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET No: %O Lot No:16 �/ Address: e, Tel.No. 7y, Date Filed: 3 7G O The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. WATER DEPARTMENT: Determines Compliance of Water Availability and or existing location. ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage. CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands; Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. REVIEWED BY: 1. WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING 4. HEALTH DEPARTMENT jja 1 I I I a u.0 N/A: S. WIRING INSPECTOR: DATE: N/A 6. PLUMBING INSPECTOR DATE: N/A 7. FIRE DEPARTMENT: DATE: N/A: COMMENTS: RECEIPT OF COPY: PLEASE NOTE SIGNATURE OF APPLICANT: DATE: Wn; C0py-BuIdmBDcpL - P; kcM-W&WDept - Yd1owCopy-1kzMDcpt - Pi&Copy- �aDCPL --F6oDepUCoocins0og -P ropertl' Location: 200 BLUE ROCK RD ALLP ID: 101/ 164/ / / t ision 1v: 13654 Other ID: 90/ X023/ / / Bldg #: 1 Card 1 of 1 Print Date: 04/04/2003 M CURRENT01171ER TOPO. UTILITIES ISTREIROAD I LOGITION CURR&WASSESSIIEW - TENDAIU , AL4RK S PENDAIIL,JOANhi BLtiE ROCK RD R'ARNIOUTILMA02664 Descrr non Code WrraisedMihie Assessed Value d15 }�1R110UT11, 2ESLA.VD SIDNTL -sue /Q = 1013 1013 3�• 211900 6,60 190 211.900 196,600 SUPPLE91FWAL DATA Account 4 1392400 ubd ision 241 Ward ISID: VISIC Total 408400 408,500 RECORD OFOWNF.RS1I11' BK-1 nUPAGF. SALE. DATE /u tq SALE, PRICF. :C PRF,I7OU.SA.SSF MENTS(IM5 R} TPPENDAIIL,NURKS 0 Yr. ICode I Assessed Value Yr. Code Assessedt'ahie Yr. Code Assessed: 2003 OOJ 1013 1013 211900 196,600 1002 002 1013 1013 211,900 196,600 001 001 1013 1013 Teral• 408,90) Total: 408 00 Total• EXE11PTIONS OTIIF,RASSM31EATS This signature acknowledges a sisit ly a Data Collector or As Year - T �scrtnon Ammon Code Desctinon Number Amount Comm.Int. --T APPRAISED JALUESU.ILILIRY Appraised Bldg. Value (Card) Appraised XF (B) Value (Bldg) OB (L) Value (Bldg) Appraised Appraised Land Value (Bldg) Special Land Value Total Appraised Card Value Total Appraised Parcel Value Valuation Method:. Cost/Market Total.. NOTES 4 SALE 394-3200 10 RMS INCL 1 L\ FBJI 0241 et Total Appraised Parcel Value BUILDING PERVIT RECORD 17S1TICHANGF. HISTORY Permit ID IsrneDare Tire Descn non Amount Inr. .Date %Camp, Date comp. Comments Date ID Cd. PurpowRej 375 6/11199.) RS Residenthtl 10,000 2/10/2000 100 1/1I2000 >,DDITION 2/1012000 7/26/1995 G\t RD 01 10 lemurflVldt NImufIArSnt L LAND LINE. 1 ALUATION SECTION X Use Code Description Zone D ronra a D¢ th Units Untt Price 1. Factor S.I. C. Factor Nbad. Ad'. Notes. Ad p ecial PncinA Ad'. Unit Price Land t i 1 1013 SFR WATER 30,056.40 SF 1.58 1.65 6 2.70 0060 1.00 00-10% DR\GE ES\INT 7.05 Total Card Land Units 1 30,056.001 SF I Parcel Total Land Area: 1 30.056 SF Total Land 1 alu Won: 200 BLUE ROCK RD MPID: 1011164111 -°D �� Other ID: 90/ X023/ / / Bldg #: 1 Card 1 of 1 Print Date. 04/04/2003 08 CONSTRUGTrov DETAIL, SKETCH Element Co. KA Description Commercial Data Elements FUS ' 'tvIe/Type 13 'olonial Element Co. Ch. Description feat & AC ludel 1 lesidendw BAS We 5 Iverage+20 7rameType WDK UBM ' FSP 28 torus Moviesths"Flumbmg cupancy 0 etlmg'1Vall is 12 30 oonlv?rhrs xterior Wall 1 4 Food Shingle ,'n Common Wall 12 2 9 IrickVeneer Vail Height t oofStructure 13 blenlip 3 14 BA oofCover UphIFGLVCmp 14 CONDOM OBILEHOME DATA 4 eriorWall 1 15 r)wa1L'Sheet WDK 'lement ode Description actor nterior Floor 1 2 lardwood 37 FUS 8 BAS 2 26 loor Imo. 2 'nit Location FBM 4 [eating Fuel Icating Type 3 5 lot Water umber of Units 'umber 12 14 14 C Type 1 ;one of Levels OP o Ownership cbooms i Bed roorro COS T/.1/ARAET 1 ALUATION throoms 1.5 112 Bathma 7 17 nadj. Base Rate ize Adj. Factor 60.00 0.90201 otal Rooms 0 0 Rooms ath Type 2 lodern 3vuk (Q) Index 117 4 FGR 2 itchen Style 2 lodern j. Base Rate 6&73 Mg. Value New 269,490 24 ear Built 1%2 Year Built 1972 rml Physcl Dep 28 �uncnlObshrc onObslnc peel. Cold. Code 3pec,Cond% 0 0 MI\F.DUSE 1013 1110 [FRIVATER -crall ! o Cond. 72 Bldg Value 194,000 O&OUTBUILDIAG& 1:1R 1 115)/,V'F-BUILDI.VGEVTRIFIATURFV(B) Code Description l/If Umtr Unirpnce I Yr. I Dr RI I e01.Cnd I Arr. T"211-600000 FPL3 SrORYCIIIMi 13 1 2.800.00 1972 1 100 FPO URA FPL OPEN B 1 800.00 1972 1 100 FBM cement, Fhdshed FGR ;arage FOP orch, Open, Finished FSP lorch. Screen, Finished FUS Ipper Story, Finished UBN1 Imement, Unfinished RDl+ k, Wood 1.568 11568 1,568 6&73 0 364 164 30.97 0 576 230 27.44 0 96 19 13.60 0 228 57 17.18 I'm 1.568 1,569 68.73 0 1,204 241 13.76 0 744 74 &84 107,769 11.272 1SM08 1,306 3.919 107,769 16 564 5,086 i HOME * LAND 667A Main Street Route 6A REALTY Dennis, 02638 Telephone: (50508) 385.1331 Fax: (508) 385.3637 M5-� ��AK of � 1 G @C 0T �r9AR 2 7%zQ 03 D I� • a. i j ENGINEEKING 107 euaamcn "Nu w oxs i FIELD REPORTMORKSNEET Project No: P03-ay Sheet. No: J_ 01 2— GENERAL DESCRIPTION Designer - Don I. Meyer 394-5296 Owner - Mark Uppendahl Narrative: Add 1 Story Family Room to 1-1/2 Story Wood Frame _____- Location_ 200 Blue Rock Road, South Yarmouth, MA 1� 1 Construction: 211x 4" o.c. Platform Frame w/ Stick -burl Roof >�12003 ------------- Full Height Concrete Foundation ��— J SPECIAL CONSIDERATIONS I Use Group(s): R-4 (Residential) 1 Family ------------- Construction Type: 5B (unprotected) - note separation below ------------------ Misc or Comments: o Plan and Layout Reviews ----------------- o Design Requirements and Support Needs Beams, Columns, Details & Notes o Certify DESIGN CONSIDERATIONS Soil Data: - Site Plan or Boring Log available: NO ---------- Preparer of plan or log: Direct Observation: YES; P98-17 from CC Atlas - Qsm; Glacial Till, Sand & Silts Description: USCS = SP ( ) SBC Class = = 8 Specifics: Br(allow) = _2,500 lb/sq ft w/ 10% width increase Fire Data: Standard 1/2" GWB through -out Loads SBC Location Basement 1st Floor 2nd Floor Attic Balconys/Stairs Partitions: 2x4/6 Snow - m <= 7/12 for all Wind - Ref Pres = worst +/- = -.7 #/sq ft Dur Note 50 1.0 Concrete 40 1.0 30 1.0 0 1.0 non -Expand 100 1.0 10 1.0 Wall Parts. 25 1.15 Zone - I _ 21 Zone - 3 -15 1.33 EXP - B/C Loadings I 1st Floor 2nd Floor Attic Roof ------------------------------ -------- ------------------------ LIVE LOAD 1 40 36 0 25 --------------------------------- ------------------------ DEAD LOADS I 13 13 4 8 i 2"x 10" Joists, 1/2" GWB, 2"x 10" Rafters cca;ca=e caaasaca acc=aaaaa aaaaaaa aascaa=caaaca=�saa=La DESIGN TOTAL I 55 45 5 35 w/ round I w/ 5% on DL NET UPLIFT = not checked; Provide Simpson Products P82-FRW-7 Ila 1. ENGINEERING FIELD REPORTMORKSHEET Project No: P63-08 Sheet No: 7-of I iGENERAL DESCRIPTION Designer - Don I. Meyer 394-5296 Owner - Mark Uppendahl Narrative: Add 1 Story Family Room to 1-1/2 Story Wood Frame Location: 200 Blue Rock Road, South Yarmouth, MA DESIGN LAYOUTS Floor Beam; 3.5"x 9.5" TJ-W ParalLam w/ E = 2.Ox 10(6) PSI Wul = 281/2 x (30+15) + 8x 12 + 25 Wul = 755 lb/lf 1 span = 111.0" ea max. Mmax = 11,420 ft-lb Fbreq = 2,602 PSI Fbavail = 21900 PSI DELmax .47" (@ 85%) DELact,= .49" for 3.5x9.5 OK for use -- no reductions required Gable Beam; 3.5"x 14" TJ-W ParalLam w/ E = 2.Ox 10(6) PSI Wul =8x12+25 Wul = 125 lb/lf 1 span = 20' 0" ea max. {I1.lPOT�or, Pt = 4,150 lb @ 1010" Mmax = 26,175 ft-lb ��VLV-� Fbreq = 2,747 PSI Fbavail = 2,900 PSI DEL.max = 1.00" DELact .94" for 3.5x14 0 OK for use -- no reductions required o D House Column; 3.5"x 3.5" PSL w/ E = 1.8x 10(6) PSI Pmax @ Post = 41150 lbs Leff = 71 6" w/o blocki Fc(perp)req = 339 PSI F'c(perp)avail = 593 P! OK for use (no reductions) Wall Columns; 3.5"x 3.5" PSL w/ E = 1.8x 10(6) PSI Pmax @ Post = 3,325 lbs Leff = 71 6" w/o blocki Fc(perp)req = 271 PSI F'c(perp)avail = 593 P! OK for use (no reductions) Set bottom of posts tight to wall plates. Solid block to the foundation sill plates or main girt beam w/ 3.5" PSL stub columns installed snugly Attach ParalLam beams to PSL posts w/ Simpson LCE4 post caps. Nail outer existing band joist to 3.5xl4 ParalLam w/ 2 rows of 12d/16d nails @ 16" o/c staggered T&B 'S = 13.2 )N43 n W) L4 lo'26ge"� S L - �b•Z )tip Tpvaxr SL 11*!`t' � 1 bb !(W/ OS%,. "ncstrh� �Acf •`� QK . �� Fy��•12- L = )6.8 10.1 IJd ovcsw�► fZ��ao.¢� �r Jaat-= 1 `i.2 < IL. Z.� y� P82-FRW-7 PHILBROOK ENGINEERING 107 BEACH STREET Project: UPPENDAHL Addition DENNIS, MA 02638 Project No: P03-08 1-508-385-8682 Date: 12 March 2003 DESIGN LAYOUTS -- -- ------ ----��--------_ -- 91 Floor Beam; 3.5"x 9.5" TJ-W ParalLam flush framed to existing 92 Posts; 3.5"x 3.5" TJ-W 1.8e PSL column. Attach to ParalLam beams w/ Simpson LCE4 post caps #3 Existing 2"z 10" floor joists. Flush frame to ParalLam using Simpson LUS28 hangers. This is a cut and snug fit assembly #4 Beam Hanger; Simpson THD410 face mount hanger #5 Gable Beam; 3.5"z 14" TJ-W ParalLam held tight to existing gable wall and up flush w/ existing ceiling #6 Band Joist -Gable Beam Nailing; 2 rows of 12d/16d nails @ 16" c/o o/c staggered, binding the band joist segments along the bottom of the 3.511x 14" ParalUm. This supports the gable end wall 97 Double 2"x 10" box w/ 1/2" CDX flitch to create header beam 98 Box Header Hanger; Simpson LUS48 face mount hanger PHILBROOK ENGINEERING 107 BEACH`STREET Project: UPPENDAHL Addition DENNIS, MA­02638 'Project.No: P03-08 1-508-385-8682 Date: .14 March.2003 DESIGN LAYOUTS -cs- -------n -- #4 Beam Hanger; Simpson HWI410 top flange hanger. Weld top flanges to beam top flange. Weld bottom of bucket to beam bottom flange 95 Gable Beam;-W10x17:w/ 2"x 10" ripped -to -fit side ledgers. Gun or bolt thru.w/.1/24;.dia. bolts stagger spaced 16" o/c 96 Band Joist -Gable Beam Nailing; 2 rows of 12d/16d nails @ 16" c/o o/a staggered, binding the band joist'segments to the inside of the packed W10x17 beam. This supports the gable end wall 4r4 t Flush Floor Beam waawn(m&05S,�;'ter 3112" x 9112" 2.0E Parallarn® PSL 2 u`m 111e s7 Pagel BVinevasiorrIA12 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED F-- Elm 0 i 11. Product Diagram Is conceptual. ol`ADS: Analysis is for a Header (Flush Beare) Member. Tributary Load Width:14' Prirnary Load Group - Residential - Sleeping Areas (pst): 30.0 Live at 100 % duration,15.0 Dead Vertical Loads: Type Class Live Dead Location Application Commend Unifonn(plf) Floor(1.00) 0.0 100.0 0 To l l' Adds To SUPPORTS: Input Bearing Vertical Reactions Ply Depth Nailing Detail Width Length (Ibs) Depth UvdDeadNplMrrotal 1 Wood column 3.50' 3.50' 2284117421014026 WA WA WA LI: Bbd&g 2 T'mbersband LSL 3.5W Hanger 2336 / 1782 / 014118 1 9.5U' WA H1: Face Mound Beam Hanger . -See TJ SPECIFIERS / BUILDERS GUIDE for deta(s): L1: Blo d ,Ht: Face Mound Hanger Other 1 Ply 1 114.1.3E TmberStrand® LSL None HANGERS: Simpson Strong -Tie® Connectors Support Model Slope Skew Reverse Top Flange Top Flange Support Wood Flanges Offset Slope Specks 2 FaceMount Hangar HHUS410 0112 0 No WA WA WA -Naliwg forSupport 2 Face: 30•t 0d , Top WA Member.10-10d DESIGN CONTROLS: Maximum Design Control Control location Shear (lbs) 39M 3316 6428 Passed (52%) RL end Span 1 urder Floor loading Mornerd (Ft-Lbs) 10284 10284 13057 Passed (79%) MID Span 1 under Floor loading Live Load Dell (in) 0.254 0.264 Passed (U499) MID Span 1 under Floor loading Total Load Den (in) 0.447 0.527 Passed (LJ283) MID Span 1 under Floor loading -Deflection Crdam STANDARD(LL_U480,TL•L/240). -Brad g(Lu): AN compression edges (top and bottom) must be braced at 2' 8' ado unless detailed otherwise. Proper attactmerd and powlionug of lateral bracing is required to achieve member 9904. PROJECT INFORMATION: UPPENDAHL Project No: P03 38 200 Shia Road Road South Yarmouth, MA OPERATOR INFORMATION: T. Vamum Philbrook Ph@xook Engineering 107 Beady Sheet Demis. MA 02638.1825 Phone: 508,VS- 82 Fax :50841851682 WarnPhd@AoLcom Copyright 0 2002 hi I" Joist, a Weyerhaeuser Business Parallams end yimberStrandm are registered trdamerks of Irma Joist. Simpson Strong-21eS Corwectors is a registered trademark of Simpson Strang-yis Company, Inc. #nL' 4r4 Flush Floor Beam Tlasernam 6.05 Serial NAi=45= 3112" x 9112" 2.0E ParallarnO PSL �i ErQlmV.' a'n s12 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED ADDITIONAL NOTES: -IMPORTANTI The analysis presented is output from software developed by Trus Joist MI. TJ warrants the stung of its products by this sdbhwa wit be accomplished in accordance with TJ product design item and code accepted design values The specific product application. Mput design loads, and stated dimensions have been provided by the software user'. This output has not been reviewed by a TJ Associate. -Not an products are readily available. Check with your supplier or TJ technical representative for product availability. -THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY. PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Alowable Stress Design methodology was used for Building Code BOCA analyzing the TJ Distribution product fisted above. m PROJECT INFORMATION. UPPENDAHL Pr*d No: P03-08 200 Blue Road Road Seth Yamauth, MA OPERATOR INFORMATION: T. Vamuun Philbrook Ph ilbrook Engineering 107 Beach Street Dennis, MA 02638.1826 Phone:508.385.8682 Fax :508-385Z682 TVamPhhl@AoLoom Copyright 0 2002 by true Joist, a Weyerhaeuser Busiwss Perallems and TimberStrande are registered trdamarke of True Joist. Simpson Strong-TSe* Connectors is a registered trademark of Simpson Strang -Tie Company, Inc. ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS 780 CNIR Appendix J (effective 3/1/98) ,_Apjj�a t Addr�S. n911 n _509f/—/7b�1 (check one): Site Address: lie Rd City/I own: V Use Group: _ Date of Application: Applicant Signature: C] Pti criptive Package (Limited to 1- or 2-family wood frame buildings heated with fossil fuels only) Package (A through KK from Table J5.2.1b): Heating Degree Days (HDD63) from Table J5.2.1a: (For items d. through i., fill in all values that apply from Table J5.2.lb:) a. Gross Wall Area sq.ft E Wall R-value R- b. Glazing Area' sq.ft. c. Glazing%(100xb+a) d. Glazing U-value U- ~' e. Ceiling R-value R- g. Floor R-value R- h. Basement wall R- i. Slab Perimeter R- J. Heating AFUE C] Component Performance: "Manual Trade -Off' (Limited to wood or metal framed buildings only) Climate Zone (from Figure J6.2.2) C] Zone 12 [] Zone 13 C] Zone 14 Attach Trade -Off Worksheel from Appendix J, [and HVAC Trade -Off Workrheel, if applicable) C] MAScheck Software Attach Compliance Report and Inspection Checklist printouts. C] Systems Analysis OR [] Renewable Energy Sources Attach Mass Registered Architect or Engineer Analysis ALTERNATIVE FOR ADDITIONS ONLY: a. Gross Wall + Ceiling Area :66-0 q.R. b. Glazing Area' /i sq.ft. c. Glazing % (100 x b + a) 3r Pd ADDITION with Glazing % (c.) up to 40% may use 780 CMR Table J 1.1.2.3.1 below: MAXIMUM U-value I MINIMUM R-values Fenestration I Ceiling Will Floor Basement Wall I Slab Perlmeter, Depth 0.39 1 R-37 R-13 R-19 R-10 I R-10, 4 It C] "SUNROOM" addition (greater than 40% glazing -to -wall and ceiling gross area) Attach "Consumer Information Form" from 780 CMR Appendix B. Official's Name: Official's Signature: Application Approved [] Denied [] Date of Approval/Denial: Reasons) for Denial: (provide additional details as needed on back side) ' Glazing Area may be either Rough Opening or Unit dimensions. BORE 06117/98 , or FILED WITH TOWN CLERK: PETITION NO: HEARING DATE: PETITIONER: PROPERTY: TOWN OF YARMOUTH BOARD OF APPEALSYARmOUTH DECISION-T0\Ni\j, r;�-ERK H3729 January 23, 2002 January 10, 2002 Mark S. Uppendahl 7m2 pi 23 P11 3 56 RECENtl� 200 Blue Rock'Road, South Yarmouth `Map: 10I'Parcel:164, (90/X23) Zoning District: R40 J-L'�' MEMBERS PRESENT AND VOTING: David Reid, Chairman, John Richards, Joseph Sarnosky, Diane Moudouris, Richard St. George. It appearing that notice of said hearing has been given by sending notice thereof to the petitioner and all those owners of property deemed by the Board to be affected thereby, and to the public by posting notice of the hearing and published in The Register, the hearing was opened and held on the date stated above. The property in question is a .69 acre residential lot, in an R40 zone, currently improved with a single family home. The homeowner proposes to extend the existing attached garage, in order to create a work shop/storage area for their personal use. The petitioner represents that the existing home and garage were constructed in (approximately) 1962, as shown on the plans filed with the Board. They wish to have a workshop area within the existing garage, and propose to extend it out, adding 16' x 22.5'. It would remain a two (2) car garage, for their household use. The existing structure extends to within 14.1' of the side (northerly) lot line. The proposed addition will come within 9.3' of the same side line. The petitioner represents that he can not maintain the existing set back because of the angle of the existing house and garage, and their plan to continue to use a portion of the existing garage for the vehicles. The adjoining parcel is an unbuildable lot, owned by the neighborhood association. It provides a point of access for the neighbors to the river. While there is ample room for the addition to be constructed, without encroaching further on the lot line, the Board does agree that the unusual angled position of the existing structure makes it impractical, at least, to do so. Further, since the adjoining property is an unbuildable common lot, the need to maintain the full set backs is less significant. In any event, the Board finds that the proposed construction would not be substantially more detrimental to the neighborhood. Therefore, a motion was made by Mr. St. George, seconded by Mrs. Moudouris, to grant the Special Permit for the addition as proposed. Mr. St. George, Mrs. Moudouris, Mr. Reid, and Mr. Richards voted in favor. Mr. Samosky voted against the motion. The Special Permit is therefore Granted. 4- No permit shall issue until 20 days from the filing of this decision with the Town Clerk. Appeals from this decision shall be made pursuant to MGL c40A section 17 and must be filed within 20 days after filing of this notice/decision with the Town Clerk. Unless otherwise provided herein, the Special Permit shall lapse if a substantial use thereof has not begun within 24 months. (See bylaw §103.2.5, MGL c40A §9) Unless otherwise provided herein, a Variance shall lapse if the rights authorized herein are not excised within 12 months. (See MGL c40A §10) David S. Reid, Clerk -2- � w r •� y OWNER MARK S UPPENDAHL ADDRESS 100200 BLUE ROCK RD BUILDING DEPT BY INSPECTION RECORD FIELD COPY Date Note Progress - Corrections and Remarks inspector v"� CONSTRUCTION EXPRESS BUILDING PERMIT APPLICATION TOWN OF YARMOUTH Yarmouth Bui4ding Department 1146 Route.28 South Yarmouth, MA 02664 (508) 398-2231 ExL 261 )DRESS:_ -POO 1640 foc/ Ice/ ASSESSOR'S INFORMATION: Map: r/0 Parcel: I� OWNER: AlrrK 116-e,.l ,71:/ do A/zo *60-1-( 14 Ig%M:,IM1.s.T:4xzy CONTRACTOR: •y/6�}�' S / A 7ol NAME MAILING ADDRESS TEWI iSResideniial O Commercial ESt Cost of Construction g boo Home Improvement Contractor ur— # Construction Supervisor Lic. # Workman Compensation Iasu<anca (check one) XI am the homeowner O I am the sole proprietor O I have Worker's Compensation lasurance Insurance Company Name: Worker's Comp. Policy# WORK TO 13E PERFORMED ❑Tent (FueRetardautCati&ateattachcd) Duratwn 0Siding: #ofSqua= /�� ❑ Replacement windows: # �11 0 Replacement doors: # 0 Re -roof # of Squares a d XStripping old Zk gles+ . () going over layers of ocisting roof 'The debris will be disposed of at z)I/ MG? ejklv- I declare under penalties of perjury that the statements hence contained arc true and correct to the best of my knowledge and beliet I understand that any false answer(s) will be just cause for denial or revocation of my license and for prosecution under MG.I.. Ch. 269, Section 1. Applicant's Signal Owners Signature Approved By: Due Building Mial (or designee) Zoning District: " 6 & f, Historical District: kYes i,No Flood Plain Zone: O Yes ❑ No Water Resource Protection District: Within 100 R. of Wetlands: `Yes ❑ No Yes ❑ No FILe" Ccpy � z `� ,r.2003 D 9� B • �'rG 0 � BPNK t� �Z TOP COAEXIST STS - . ROCK -•-- -- - - r D K— �a1' � -,o o z� %WALL r MST 2 STORY GARAGE EXIST. DWELLING LOT 23 PARCEL 164 0.69 ACRES+ BZ& �004- 40 8 JOB # 94-310 FOUNDATION PL 0 T PLAN FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT ONLY LOCATION 200 BLUE ROCK ROAD SOUTH YARMOUTH, MA SCALE : 1" = 50' DATE : JUNE 23, 2003 PREPARED FOR: REFERENCE : LOT 23 LCP 28477E MARK UPPENDAHL ASSESSOR'S MAP 101 PARCEL 164 I HEREBY CERTIFY THAT THE STRUCTURE - - �tw SHOWN ON THIS PLAN IS LOCATED ON THE ��SN ISZ GROUND AS SHOWN HEREON. TI v"OTHY H. I fmr SO6 562-9EB0 1 CiOUK al E� clown cape engmeeriag, inc. CIVIL ENGMEER4 �- -- ---_ I.ANn SURVExoxs DATE REG: t+ a• D�—C6*R OR 939 main sL yormo&, ma 02675 v • TJ ^' HILBROOK ENGINEERING & /. CONSTRUCTION 107 BEACH STREET DENNIS, MA 02638 1-508-385.8682 ERING DESIGN • CONSTRUCTION INSPECTIONS • BUILDING, ALTERATIONS 8 RENOVATIONS 17 April 2003 To: Town of Yarmouth Attn: Mr. James Brandolini Building Commissioner South Yarmouth, Massachusetts 02664 Reference: Slab Footing Inspection —Reference Letter Dated 7 April 2003 UPPENDAHL Residential Covered Entry 200 Blue Rock Road, South Yarmouth, MA Dear Sir: Previous site conditions remain unchanged. The proposed entryway will be constructed as a porte-de- chere (flat roof with ornamental 1 V-24" ballistrade). This structure remains a non -habitable covered entryway. At the owner's discretion 2 or 4 or more columns can be installed however the original design requirements remain; a minimum of 2 are to be load bearing and 2 (at the comers if square or at the 113(+/-) points if an arc) are to be connected for uplift restraint. Loading remains essentially unchanged as previously snow on a pitched roof less than 7/12 was taken to govern; 25 lb/sq ft. Dead loads will be slightly reduced as the roof is the ceiling in the new structure vs. a roof and ceiling in the gable assembly. Respectfully submitted, f63-08 I" OF T. �. ... �� PH LBAO� T. VARNUM PHILBROOK, P.E. MECHANICA y No. 30G90 L ) l `X °°° PHILBROOK �� ENGINEERING & 107 BEACH STREET \ 1 CONSTRUCTION DEN 5108 385.8682 q� ENGINEERING DESIGN • CONSTRUCTION INSPECTIONS BUILDING, ALTERATIONS 8 RENOVATIONS 7 April 2003 To: Town of Yarmouth Attn: Mr. James Brandolini Building Commissioner South Yarmouth, Massachusetts 02664 Reference: Slab Footing Inspection UPPENDAHL Residential Covered Entry 200 Blue Rock Road, South Yarmouth, MA Dear Sir: U L5 11 U C APR 5 Li 2003 1 By- I conducted an investigation of the in -situ soils and site conditions at the above address on 28 MAR 2002. The purpose of this letter is to present conditions per Para. 115.1 of the State Building Code (6th ed). In accordance with Para. 1804.1 of the State Building Code this letter shall serve as documentation for the suitability of the soils and reduced depth foundation at this site to support the proposed new covered entryway. Presently there is a large semi -circular brick veneer front step. The step is about 30 years old, sound and in reasonably good condition. In order to determine the condition and depth of the concrete base an excavation was dug on one side and two holes were drilled with a rotary hammer -drill. Observations: • The base slab edge is continuous concrete and extends below grade about 16" • The two holes drilled through solid masonry then concrete for a depth in excess of 16" • The following soils determination was made: USCS Type Classified - SP Medium -Coarse Sand (Non -frost susceptible) State Building Code Material Class — 8 Soil Bearing (allow) - 3,000 lb/sq ft Commentary: The spread slab footing will support a non -habitable covered entryway; 2 faux -marble round columns and a gable peaked roof. The structure will cover less than 100 sq ft and the surrounding grades are favorably pitched away from the front step. As such this base will safely support the proposed construction and provide a bearing factor of safety in excess of 2.4. Uplift attachment is more of a concern. Some form of positive attachment anchored to the step with a capacity in excess of 600 lbs is required at both column bases. 3/8" dia. SS aircraft cable threaded thru embedded eye -bolts and made captive to the framed roof plates would suffice. Respectfully submitted, �ySH OF 414 q �C>72ni� pro T. VARNUM U o PHILBROOK MECHANICAL T. VARNUM PHILBROOK, P.E. o ^No. 30690^ -Wosoyg 3 7 �- S - z PERMIT 375 LOT "164 ( X23 ) /Cid m Uppendahl, Mark 200 Blue Rock Road South Yarmouth, MA 02664 Screened porch, deck, 2 baths SHEET 101 (90) 6/1/99 6/1/9� 7- 2 -PP 7 4 --7f (P $10,000.00 00j a dw " TOWN OF YARMOUTH Application for a Permit to Builo��v0. 3'!, Q� 90 x .23 UPON FINAL APPROVAL � \\ � `� MAP 1 ° I LOT I & `'f FEE MUST ACCOMPANY THIS APPLICATION. DATE 19 The undersigned hereby applies for a permit to build according to the following specifications 6/;le,?112 1. Name of property owner Address -NkqA"t+l- Tel. !!Cq 17(,j .D _ .1-f A _ A._•,1_ 2. Name of Architect (if any) Tel. 3.Nameofbuilder MAVIK- Address i2`f �1-,QiA-ry 6ry 4n 4. License No. Tel. **7q 0227 W. �S 5. Name of Mason Address 6. License No. 7. Construction address Tel. 8. Date of subdivision Approval pIC 9. Private dwelling Er Estimated Cost p 10. Multifamily ❑ /o 11. Commercial ❑ 12.Other ❑ 13. No. of stories 14. Foundation — Full ❑ Half ❑ Crawl ❑ Slab ❑ 15. Materials — Wood ❑ Cement ❑ Other ❑ 16. Type of heat — Oil ❑ Gas ❑ Electric ❑ Other ❑ 17. Garage —1 ❑ 2 ❑ 18. Swimming pool - Size 19. Storage shed — Size 20. Stove — Wood ❑ Coal ❑ 21. Size of lot: No. of feet front 22. Size of building. No. of feet front 23. Distance from nearest building: Front 24. Distance back from line or street 25. H.I.C.R. No. l aa3q& LOT RELEASED BY - : ►tiliyacT*em. M-U7 Date C zne ct n zone .o1/ b DO NOT WRITE IN THIS SPACE Fn a /p.oa Type of room No. ,,�� ll'p rC4 S6� PpcK -3 ) ° `aaW�l 7 5— j vOJ Kitchen Dining Rm. Living Rm. Bed Rm. Bath Deck Closed porch Family Rm. Sun room Garage Shed Alterations No. of feet rear Signature Addre No. of feet deep _ No. of feet side No. of feet rear _ _ Ft. side Ft. side Rear From rear lot line Side line BUILDING PERMIT APPLICATION SIGN OFF APPLICANT: h Apk O 4&BUILDING PERMIT #: ADDRESS: ]ZLZMD[Ahj Pbfjll TELE. NO.: 59y-6227 DATE FILED: BLDG. SITE LOCATION: &p &d'", MAP#: Jbi LOT#: I&LI 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, IN THE RESPECTIVE ORDER, PRIOR TO BUILDING INSPECTOR ISSUING THE REQUIRED BUILDING PERMIT: REVIEWED BY: I. WATER DEPARTMENT DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT DATE: la _ 3 1-qq N/A: INDUSTRIAL AND/ 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. A SIGNED RECEIPT FROM THE DISPOSAL SITE MUST BE SUBMITTED TO THE BUILDING DEPARTMENT PRIOR TO ISSUANCE OF THE BUILDING PERMIT. COMMENTS: BLM 89 LOT NO.: ADDRESS : 2C(-) ,pl -1 , D OWNERS NAME: • SEtJAGE PERPiIT N0.: `y b9_NEW: REPAIR: DATE ISSUED: DATE INSTALLED: INSTALLERS NAME: QcNne,(k i INSTALLATION OF: Recta v, S ►s�f-ern , WATER TABLE: FINAL INSPECTION BY: f i DRAWING OF INSTALLATION ON REVERSE SIDE: � vPeA.-O BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: JOB LOCATION: NUMBER STREET VILLAGE OWNER OF PROPERTY: I�PPe�VOA 1- CONSTRUCTION SUPERVISOR: LICENS ADDRESS:— • I" NA-4 V4 . oe-Y N l S • MA- 1 r4- ) 2 lwl U LICENSED DESIGNEE: (IF OTHER•THAN SUPERVISOR) NAME LICENSE NO. 2.15 RESPONSIBILITY OF EACH LICENSE HOLDER: D VLZ I 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, MIOVAL OR DEMOLITION INVOLVING THE STRUCTURAL ELEMENTS OF BUILDING AND STRUCTURES ONLY PURSUANT TO THE STATE BUILDING CODE AND ALL OTHER APPLICABLE LA;S OF THE COMMONWEALTH,. EVEN THOUGH HE, THE LICENSE HOLDER, IS NOT THE PERMIT HOLDER BUT ONLY A SUB- CONTRACTOR'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 REGLI ATIONS AND ANY PROCEDURES, AS AMENDED, SHALL 3E SUBJECT TO REVOCATION OR SUSPENSION OF LICENSE BY THE BOARD. 2.16. ALL BUILDING PEK%IT APPLICATIONS SHALL CONTAIN THE NAME, SIGNATURE AND LICENSE ,LUMBER OF THE CONSTRUCTION SUPERVISOR.WHO IS TO SUPERVISE THOSE PERSONS ENGAGED IN CONSTRUCTION, RECON- STRUCTION, 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 DEPART`SENNT. I HAVE READ AND UNDERSTAND MY RESPONSIBILITIES UNDER THE RULES AND.REGULATIONS FOR LICENSING CON- STRUCTION SUPERVISORS IN ACCORDANCE WITH SECTION 109.1.1 OF THE STATE BUILDING CODE. I UNDERSTAN: THE CONSTRUCTION INSPECTION PROCEDURES AND THE SPECIFIC INSPECTION AS CALLED FOR BY THE BUILDING OFFICIAL. INSURANCE CO ERAGE: I have a eurrebility insurance policy or its substantial equivalent which meets the requirements of MGLiCh.152• Yes No ❑ It you have checked v=s, pleas indicate the type c average by checking the ap:rcpriate box. A liability Insurance policy Daher type of ademnity ❑ Bond ❑ OWNER'S INSURANC-c IVER: I am aware that the ucensee does not have the insurance coverage. require :y Chapter 1 2 of a Mass: eneral Laws, and that my signature on this permit co; ticaticn wanes this requirertier. Check one: Owner❑ Agent p� Signature of net or Omer s Agent SIGNATURE: IBUILDING OFFICIAL APPROVAL: PLOT PLAN AbutborIs Name + Lot # r fjuJ157 If this is a corner lot, ;2 1' write in name of street. 5 FOR LOT # 2= Indicate location of garage or accessory building Additions with dashed lines -------------------- Sewerage disposal (cesspool) Well 0 SIDEYARD 0_ 14 /7_FT. (lot.M.tf :'Y........ ft. rear) I REAR YARD .....i7:. ....ft. I 4> HOUSE Q SET -BACK SIDE YARD 0__2v ET� (lot ..... �3�.......... ft. frontage) (NAME OF STREET) Information ,A/� �� Supplied by 1�►� l Abuttor I s Name Lot # If this is corner lo- write in name of a other rostreet. MARK NORTH POINT Suggested Affidavit for Home Improvement Contractor Permit Application For omce Use only NAME OF CITY/TOWN Permll No. Dale aim—F9XIIV Home Improvement Contractor law Supplement to Permit Application MGLc. 14ZA requires that the "reconstruction, alteration, renovation, repair, modernization, conversion, inprovement, removal, demolition, orconstruction of an addition to any preccisting owner -occupied building containing at 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 aceptioms, along with other requirements, Type of Cost IO i cm Address of Work ?,0D 72Cqt55 Gklea AniAJ4 07, b Owner Name: r1—^M1 -To AV del---W 04ztb= Date of Permit Application:4 If51.1l I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law _Job under S1,000 _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: '4 b.?, Lin , — '� A►u- A. L�.ykV�-�1 12237 Da a I Contractor Name I Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owncr Name The Commonwealth ojMassachusetts Department of Industrial Accidents Of aollaresUyttliis 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit citv VV. 0,'7Yl/16 (IlFi 07,VID phone# 646S �51Y1)= 1 am a homeowner performing all work myself. I am a sole proprietor and ha%e no one working in any capacity gr'l`am an employer pro%iding workers' compensation for my employees working on this job. city: phone 0: insurance co It policy # 1 am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below %%ho ha%e the folio%%in_ %%orkers' compensation polices: company names addr «• city phone #- insurance co policy 0 Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of crisis" penalties of m time op to S1.S00.00 and/or one years' Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I maderstand that a copy of this statement may be forwarded to the Once of investigations or the DIA for coverage verificadoa. I do hereby certify und.fr,#hepait4 and Print name that the information provided above is true and correct Date N III I�C; ;Mcial use only do not write in this area to be completed by city or town official city or town: YARMOUT11 _ permit/license 0 [311uilding Department ❑Wcensing Board ❑ check If immediate response is required 261 ❑Sclectmen's Ounce contact person: ❑health Department phone#:_ (508) 398-2231 eat. r,Other leaned 3AS P1A1 Information and Instructions Massachusetts General Laws chapter I52 section 25 requires all employers to provide workers' compensation for their eniplo%ees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An etnph{ver is defined as an individual. partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the o"ner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the d« elling house of another who employs persons to do maintenance , construction or repair work on such dwelling house. or .in the urounds or building appurtenant thereto shall not because of such employment be deemed to be an emplo%er. \1G1_ chapter 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 of this chapter ha%e been presented to the contracting authority. Applicants Please till in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying= company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial .accidents. Should you have any questions regarding the "law" or if you are required to'obtain a %%oikers' 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 ftflt0 of Imstilluens 600 Washington Street Boston Ma. 02111 fax #: (617) 727-7749 phone #: (617) 7274900 ext. 406, 409 or 375 v • ' - - ` ' Massachusetts Department of Environmental Protection Town of Yarmouth Wetland By -Law Bureau of Resource Protection - Wedands Chapter 143 WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131e §40 General information From: Yarmouth Conservations 6ozmr bocoonzww Commission 1. Applicant: Mark & Joan Unoendahl None aPb=M,"V It*" 200 Blue Rock Rd. unV,amass South Yarmouth C /TMM MA 02664 Saar ro code 2. Property owner. Afeme0IftWyoWW(,I r&WeoJn"aV rwa;�,wareu CAry/rown s" rIp code U Determination Pursuant to the authority of LUL c.131, §40. the 3. Title and final Revision Date of Plans and Other Documents: Yarmouth Conservation Commission Coaurnu'on Commission has considered your Request for a Determination. of Applicability, with Its supporting documentation, and has made the following Determination regarding: 200 Blue Rock Rd. SoeeMAdarss South Yarmouth, MA 02664 eY/rown rb code new:101 164 Assessas Wpfln/ PmDIa/ Rev.10/98 Page 1 of 4 M Massachusetts Department o/Environmental protection Town of Yarmouth Wetland By -Law Bureau of Resource Protection — Wetlands Chapter 143 WPA Form 2 n Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §49 Determination (cont.) The following Deterninabon(s) Ware applicable to the proposed site and/or project relative to the Wetlands Protection Act and Regulations: Positive Determination Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of Conditions (issued following submittal of a Notice of Intent or Abbreviated Notice of Intent) has been received from the Issuing authority (i.e., conservation commission or the Department of Environmental Protection). 1. The area described on the plan(s) referenced above, which includes all or part of the area described in the Request, is an area subject to protection under the Act Therefore, any removing, filling, dredging, or altering of that area requires the filing of a Notice of Intent 0 2. The delineations of the boundaries of the resource areas listed directly below, described on the plans) referenced above, which includes all or part of the area described in the Request, are confirmed as accurate: Therefore, the resource area boundaries confirmed in this Determination are binding as to all decisions rendered pursuant to the Wetlands Protection Act and Its regulations regarding such boundaries for as long as this Determina- tion is valid. However, the boundaries of resource areas not listed directly above are n2 confirmed by this Determina- tion, regardless of whether such boundaries are contained on the plans attached to this Determination or to the Request for Determination. 3. The work described on plan(s) and document(s) referenced above, which Includes all or part of the work described in the Request, is within an area subject to protection under the Act and will remove, fill, dredge, or after that area. Therefore, said work requires the filing o1 a Notice of Intent C 4. The work described on plan(s) and document(s) referenced above, which Includes all or part of the work described In the Request, is within the Buffer Zone and will atter an Area subject to protection under the Act Therefore, said work requires the filing of a Notice of Intent 5. The area and/or work described on plan(s) and document(s) referenced above, which includes all or part of the work described in the Request, is subject to review and approval by Nun 0fMuiirl0* pursuant to the following wetlands law, bylaw, or ordinance (name and citation of law). D 6. The following area and/or work, R any, is subject to municipal bylaw but mi subject to the Massachusetts Wetlands Protection Act: C 7. It a Notice of Intent is filed for the work in the Riverfront Area described on plans and documents referenced above, which Includes all or part of the work described in the Request, the applicant must consider the following alternatives (Refer to the Wetlands Regulations at 10.58(4)c. for more Information about the scope o1 alternative requirements) : O Aftematives limited to the lot on which the project is located. 0 Alternatives limited to the lot on which the project is located, the subdivided lots, and any adjacent lots formerly or presently owned by the same owner. C Alternatives limited to the original parcel on which the project is located, the subdivided parcels, any adjacent parcels, and any other land which can reasonably be obtained within the municipality. Alternatives extend to any sites which can reasonably be obtained within the appropriate region of the state. Rev.10/96 Page 2 014 Massachusetts Department of Environmental Protection Town of Yarmouth Wetland By -Law Bureau of Resource Protection — Wetlands Chapter 143 WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 t Determination (conL) Negative Determination Note: No further action under the Wetlands Protection Act Is required by the applicanL However, if the Department of Environmental Protection Is requested to Issue a Supersed- ing Determination of Applicability, work may not proceed on this project unless the Department fails to act on such request within 35 days of the date the request is post- marked for certified mail or hand delivered to the Depart- ment. Work may then proceed at the owner's risk only upon notice to the Department and to the conservation commission. Requirements for requests for Superseding Determinations are listed at the end of this document. 1. The area described in the Request is not an area subject to protection under the Act or the Buffer Zone. = 2. The work described in the 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. y 3. The work described in the 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. The work described in the Request is not within an Area subject to protection under the Act (including the Buffer Zone). Therefore, said work does not require the filing of a Notice of Intent, unless and until said work alters an Area subject to protection under the Act Authorization This Determination is Issued to the applicant and delivered as follows: .3 by hand delivery on Date 3 by certified mail, return receipt requested on ... This Determination is valid for three years from the date of Issuance (except Determinations for Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. 5. The area described in the Request is subject to protection under the Act. Since the work described therein meets the requirements for the following exemption, as specified in the Act and regulations, no Notice of Intent is required: r.WWAcOvio, M 6. The area and/or work described in the Request is not subject to review and approval by Ahme01"M VJ11y pursuant to a municipal wetlands law, ordinance, or bylaw, (name and citation of bylaw). * SEE CONDITIONS ON SEPERATE SHEET. Thrs Deternunauon must be signed by a majority of the conservation commission. A copy must be sent to the appropriate Department of Environmental Protection regional office (see appendix A) and the property owner (if different from the applicant). / tf Rev. 1 GI98 April 1. 1999 Aire Page 3 of 4 DETERMINATION OF APPLICABILITY SPECIAL CONDITIONS MARK UPPENDAHL 1. Roof run off shall be handled by downspouts and drywells. 2. The Conservation Administrator shall review proposed walls with contractor prior to construction. DEP Massachusetts Department of Environmental Protection Town of Yarmouth Wetland By -Law Bureau of Resource Protection — Wetlands Chapter 143 WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 12 Appeals The applicant, owner, any person aggrieved by this Determina- tion, any owner of land abutting the land upon which the Proposed work is to be done, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate Department of Environmental Protection Regional Office to issue a Superseding Determina- tion of Applicability. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and Fee Transmittal form (see Appendix E: Request for Departmental Action Fee Transmittal Form) as provided in 310 CMR 10.03(7) within ten business days from the date of issuance of this Determination. A copy of the request shalt at the same time be sent by certified mail or hand delivery to the conservation commission and to the applicant 0 he/she is not the appellant. The request shall state clearly and concisely the objections to the Determination which Is being appealed. To the extent that the Determination is based on a municipal bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has no appellate jurisdiction. Rev.10/98 Page 4 014 94zp r-uxFp wgT• przoft FIGI- � i'Rop� m of J No.26S1e ,lZlh paw ° "�' c� oW R•I 1'LaNs b.(.coMPo•1�1Yit-kx P�'fl'fia�l of Llv 1. 41$q _ -rC> Cl>"j rjz.0 LT t44r? F W r-JTb IN a WOOJ> PILE TMBeIZ rIF17- c Gjz 7"FIr-. I.LId'('G1L5 r�F t�`� 1zIV� 1z•, cSouYl�� Y�rr�ol,�t-�. Ma- F(ZaPotis:b �I.oafi�U DoGK (3) C,' -,CEO FL4-ps 01?- 12) &P' x IC" ncA-r5 CC,,aa��E �JUitJ�tzi�l�, Ct�1Cil aaju SURvEYYv�I� •.I b'lA� 5`rizr%�T "AoLF, &7 4i-fd'IA1 r-rttiru,} 33. I q q S Appeal #: 31 a TOWN OF YARMOUTH YARMOUTH BOARD OF, APPEALS TOWN CLERK APPLICATION FOR HEARING 2001 DEC 20 PH' 3: 51 RECEIVED Hearing Date: 11 IV 02. Fee$ 6 7� (Address) (zip) (Telephone Number) and is the (check one) K Owner ❑ Tenant ❑ Prospective Buyer ❑ Other Interested Party Prore�rty: This a plication relates to the property located at: aQD z/� Ac /D raj. Yllrm0 which is also shown on the new Assessor's Map: as Parcel: (old Map & Lot #) 10X a� Zoning District: Project: The applicant seeks permission to undertake the following construction/use/activity :(give a brief description of the project. i.e.: "add a 10' by 15' deck to the front of our house" or "change the use of the existing building on the property"): ''b e_)Cg RELIEF REQUESTED: The applicant seeks the following relief from the Board of Appeals: 1) REVERSE THE DECISION OF THE BUILDING INSPECTOR OR THE ZONING ADMINISTRATOR dated (attach a copy of the decision appealed from). State the reason for reversal and the ruling which you request the Board to make. 2)_SPECIAL PERMIT under § 3. o'Z �� of the Yarmouth Zoning By-law and/or for a use authorized upon Special Permit in the "Use Regulation Schedule" §202.5 3) VARIANCE from the Yarmouth Zoning By-law. Specify all sections of the by-law from which relief is requested, and, as to each section, specify the relief sought: Section: Relief sought: Section: Relief sought: Section: Relief sought: ADDITIONAL INFORMATION: Please use the space below to provide any additional information which you feel should be included in your application: FACT SHEET Owner of Property (if other than applicant) �JIL m (Full Name) ( Address) (Telephone Number) How long has the owner had title to the above (Give title reference if available) Use Classification: Existing: 51 2 &t _ §262:5 # v Proposed: , ,;,, 0g.— §202.5 # Is the property vacant: � 0 How long has it been vacant: Lot Information (if available) Area: i 6q -QereS Subdivision/Plan Reference: / Is this property within the Aquifer Protection Overlay District: Yes No Other Department(s) Reviewing Project: Indicate the other Town Departments which are/ have/ or will review this project, and indicate the status of their review process: Repetitive Petition: Is this a're-application! � If yes, do you have'Planning Board Approval:..' Prior Relief: If the property in question has been the subject of prior application to the Board of Appeals or Zoning Administrator, indicate the Appeal number(s) and other available information: Building Commissioner Comments: Applicant's Sign e/Attomey Signature Address. idigngOC—ormrinissioner Signature Owner's Signature Site Plan Review Required Completed ❑ Yes ❑ No ❑ Yes ❑ No Application.wpd Property Location: 200 BLUE ROCK RD Mon ID: 13654 ALIPID: l0U 164111 Other M. 90/ X023/ / / Bldg #: 1 Card 1 of Print Date.,12/20/2001 15:40 MAMi JPPENMUHi JOAN M 00 BLUE ROCK RD 02664 Description Loae ppraue a ue sense Value YARAf 815 11JTlf, MAYARINIOUM,SU IDNTL 1013 196,60 196,60 t ccoun Subdivision 241 Photo Ward Precinct IS ID: VISION Ion qu vc r. Code AiseisedValue r Coda Assesied Value Ir. I Code Ajsej—jedValue 2001 1013 196,600 2000 1013 142,100 0 0 0 -- —. t !s sign ure ow a ges a vtst y a a o e or or ssessor Year yp serlpnon Codee .tcripnon Aumber Amount Comm. Inr APPRAISED VALUESUATAMY Appraised Bldg. Value (Card) Appraised XF (B) Value (Bldg) Appraised OB (L) Value (Bldg) Appraised Land Value (Bldg) Special Land Value Total Appraised Card Value Total Appraised Parcel Value Valuation Method: 194,000 2,600 0 211,900 408,500 408,500 CosUlltarket Valuation o , 10 RMS INCL 1 IN FBS1 0241 et TotalAppraised arce a ue 4U8,5UU -Description Permit issue Date type Amount In-s-p-.-Dalle• omp. to omp. omments Date urpos su t C51 en a , i 7/26195 ♦ RD 10 casU Isl teasu/LtrSnt Letter Se , _ Use Code Vescription zone rootage Depth units unit Price I kactor Y.J. actor AbtuL A at. Notes- AdjlYpeczai Pricing Adj. Unit Price a-ue LndArea.U56 . Uu otat Card Land uniq JU,UZ6.u� Skj Pared I ofaif stiotal Land Valu Property Location: 200 BLUE ROCK RD AMPID: 101/ 164/ / / Vision ID:13654 Other ID: 90/ X023/ / / Bldg #: 1 Card 1 of 1 Print Date: 12/20/2001 15 SKLI CH emenf Icn. Description Commercial Data Lientents ype o omal - ttement Cd CIL Description odel 1 lesidential FUS BAS a irade 5 kverage+20 rameType UBOA tones Stories aths/Pluumbing FSP 28 SP cupancy 0 eiling/Wall 1 3 ooms/Pttns 12 :xterior Wall 1 14 Vood Shingle /a Common Wall 2 9 rick Veneer Wall Height FOP fStructure 3 able/Hip 3 oofCover 3 ph/FGIs/Cmp 6 14 nterior Wall2 5 rywalVSheet emen scrrptron actor WDK nterior Floor 1 2 lardwood 3 FUS 8 omp ex 2 1 oor Adj BAS 8 2 nit Location FBM eating Fuel 3 as 4 eating Type 5 lot Water umber of Units C Type 1 qone umber of Levels 12 1 14 /o Ownership edrooms 3 1 Bedrooms 4 athrooms 1.5 1R Bathrms otal Rooms 10 0 Rooms Jnadj. Base Rate 60.00 ize Adj. Factor 090201 ath Type 02 Modern 3radc (ly Index 1.27 FGR "tchen Style 02 Modern 4 2 dj. Base Rate 68.73 ldg. Value New 269,490 JIALD ear Built 1962 24 ff. Year Built 1972 mil Physcl Dep 28 uncnlObslne con Obslnc 3pccl. Cond. Code peel Cond % 0 0 U.3b Codescn non JLUU erall % Cond. 72 prec. Bldg Value 194,000 Code Description LiB Unas I Unit Price Yr. Do Xt I Y.Cnd I Apr. Vahue FPO rXTRA FPL OPEN B 1 800.00 1972 1 100 600 ' -' 6UILU[IVU JUlf AKC✓rJUbIA]AKY JCGI/VtY -_ Code scrrptronLiving Area ross rea kjj. Area Unit Cost eprec. Palue irst Hour FBJi 3asement, Finished 0 364 164 3097 11,272 FGR 3artge 0 576 230 27A4 15,808 FOP lorch, Open, Finished 0 96 19 13.60 1,306 FSP lorch, Screen, Finished 0 228 57 17.18 3,918 FUS ipper Story, Finished 1,568 1,568 1,568 68.73 107,769 UBM lasement,Unfinished 0 1,204 241 13.76 16,564 WDK eck.Wood 0 744 74 6.84 5.11861 g Val: 1 ice. MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) �^ O TOWN OF YARMOUTH, MA 02664 Date O Z Z 19- V- Permit# 33 6 Building Location 200 P;Iv e Ikoc 4 kA, Owner's Name &,C-k i cifse-jcl 1 Type of Occupancy k>es r A e, c. e? New ❑ Renovation Cld' Replacement ❑ Plans Submitted: Yes M-O No ❑ FIXTURES ��uuuoo x �unu�n �o oono� ��unuo� ■ � unu�u ��ono��ou�oon�au� Installing Company Name Sherman Plumbing Services Corp. Address 24-3 Commonwealtn AVe. Business Telephone Name of Licensed Plumber Check one: Certificate ❑ Corporation ❑ Partnership Cl Firm/Co. INSURANCE COVERAGE: I have a current liability. Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ❑ No ❑ If you have checked Wig, 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. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ 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 3e and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all �tvisions of the Massachusetts State Plumbj' Code and Chapter 1 f /�°eneral Laws. rr�-r4i---�� l/� L, Type of License: Master ®. Journeyman ❑ City/Town APPROVED (OFFICE USE ONLY) License Number /% � - - BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES ! . FEE-6 • i; l3 r APPLICATIONFORPERMIT TO DO PLUMBING NAME-& TYPE OF BUILDING Pc.rk Uppev Ac j^1 LOCATION OF BUILDING ZOO PLUMBER S`-•ems,,.,, �.,.,.. P1 �,,.,.,1,,; ,._.� S�'ryir. .5 C.ocL�. PERMIT GRANTED DATE 19 81999 PLUMBING INSPECTOR A G PROGRESS INSPECTIONS � 1 NOTES: 1. ELEVATION FROM RM 9 (NGVD) 2. FLOODZONE A5 EL 6 & C (HOUSE IS IN C) (FIRM 250015-0002 D, REV. 7/2/92) 3. ASSESSORS MAP 101 PARCEL 164 4. ZONING: R-40 (FRONT: 30', SIDE, 20') 5. ROOF RUN-OFF TO BE DIRECTED TO DRYWELLS KEY: C GUY WIRE M> U11L POLE {L� TREE PARCEL 163 V* LIGHT POST BLUE ROCK HEIGHTS + 11.2 SPOT ELEV. ASSOC. 1 i LOT 23 I Toff. 5W-362-4541 fax 508-362-9880 down cape engineering, Inc. CIVIL ENGINEERS LAND SURVEYORS 939 main St. yarmouth, ma 02675 94-310 DRIVE/PARKING WOODCHIPS �3\ C7 13 R pck r i AS Rpq� BENCHMARK CATCH BASIN ELEV 10.8' TRANSECT *78. EQ L4- ' +3,?; n �F! �� titll Celts ',1 ►11.0 i 'EXIST. SEPTIC ias LEACHING AREA (APPROX. AREA) +Iu EXIST. DWELL. ` TRANSECT zs ii NETLPNO Nss __._ �20 p0 X K M TOP DECK I EXIST t t GARAGE .+ +��� L�►Ixs +1 EXIST. ST 12" TREE (�)j 2 STORY EXIST. DWELLING PARCEL 164 ( , 0 69 AC BULKHEAD DETAIL 1"=15' 1st STORY SCREENED PORCH W/DECK OVER O EXIST. ROCK QwAu EXIST BRICK ate, ao - O. PROP. 6.3'x 5.3' BULKHEAD (SEE DETAIL ABOVE) oo PROP. SUNROOM i J .9 I i k 3.9 ' PARCEL 165 PATRICIA J. CEDERIC GRENIER TR LOCATION MAP NTS - FLOOOZONE EL Ala " °(TOP COASTAL BANK) 8 R L 0 2003 By sIrr pro" OF #200 BLUE ROCK ROAD IN THE TOWN OF: (SOUTH) YARMO UTH PREPARED FOR: MARK UPPENDAHL 30 0 30 60 90 SCALE: _ DATE. DECEMBER 19. 2001 1 �' DATE REV. 1/14/03 (BH) C I NOTES: ;�2_. FLOODZONE �A5"EL �6 GVD)' rt:: ELEVATION_FROM'RM 9 (N,.,(HOUSE •IS- IN C) (FIRM 250015-0002 D. REV. 7/2/92) 3. ASSESSORS MAP 101 PARCEL 164 4. ZONING: R-40 (FRONT. 30', SIDE, 20') 5. ROOF RUN—OFF TO BE DIRECTED TO DRYWELLS KEY- C GUY WIRE cQ-1 U11L POLE TREE PARCEL 163 0� LIGHT POST BLUE ROCK HEIGHTS + 11.2 SPOT ELEV. ASSOC. 1 t I i r +riL f2:i LOT 23 f1L] ` ] TRANSECT 2A fl pf Qc 37 ]14 TRANSECT +V7 z a TZ to n 7.7 DRIVE/PARKING / WOODCHIPS 7)4? off. 506-362-4541 5Cf'Is{a fox 508-362-988o B(lje ��dfFN�ra down cape engineering, inc. Rock T 6 CIVIL ENGINEERS 11?010 LAND SURVEYORS BENCHMARK 939 main St. yarmouth, ma 02675 CATCH BASIN ELEV 10.8' 94-310 t>a ,,a•txr �— t EXIST is I GARAGE etas j EXIST. DWELL. '- - - TRANSECT L� X 9s D bt r COASJS DECK t 2 STORY EXIST. DWELLING BULKHEAD DETAIL 1 " = 15' 1st STORY SCREENED PORCH W/DECK OVER 1. EXIST. ROCK � WALL EXIST QUU BRICK `'�, `'o O. PROP. 6.3•x 5.3• BULKHEAD fib, a. (SEE DETAIL ABOVE) PROP. SUNROOM \ LOCUS ell a - LOCATION MAP NTS FLOODZONE-EL 8�-'� (TOP COASTAL BANK)' Ii 0 2003 Lol PARCEL 164 Qo�,�' pata +t oo x SITE PLAN ' EXIST. ST 'EXIST. SEPTIC 3.y ias LEACHING AREA (APPROX. AREA) PARCEL 165 OF ## 2 0 0 BLUE R 0 CK ROAD 12" T'�REE PATRICIA J. CEDERIC GRENIER TR 1-0 { ">pl > z IN THE TOWN OF: +Ia (SOUTH) YARMO UTH 'AA OF j A�RNE H. O�1 No.. 226�� ARNE H. 'OUALA, PE, PLS W146� DATE PREPARED FOR: MARK UPPENDAHL 30 0 30 60 90 SCALE: 1" a 30• DATE: DECEMBER 19. 2001 REV. 1/14/03 (BH) M 7117/2015 SlipGen - Portal Hone Document Category Map -Block Number Street Number Street Name Town of Yarmouth Template [Building Dept] ■�i Slipshcct Identifier [sg33555] Building Permits 101.164 0200 BLUE ROCK RD Department Building Parcel ID 13654 Backfile Batch Scan No Document? Additional Naming Info Index Operator Date - Time Operator, Yarmscan 2015-07-17- 12:15 httpJAaserfiche12/SlipGen 1/1