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HomeMy WebLinkAboutBuilding Permitsi, ;�. TOWN OF YARMOUTH Building Department BUILDING 71 `� (508) 398-2231 ext.1261 „ - _ _ _ _ _ _ _ • PERMIT NO B.14841__ PERMIT �a ISSUE DATE : 121912013 PROPOSED USE ;_ _ ........... APPLICANT .Cape Cod Insulation - '-" """' """ ' JOB WEATHER CARD PERMRTO Misclinsulafton ; AT (LOCATION) ZONING DISTRICTK2fl Bldg. Type: Residential 10089ACRES AVE SUBDIVISION MAP LOT BLOCK 1024.2 BUILDING IS TO BE: CONST TYPE 5 B USE GROUP R-3 LOT SIZE O Install insulation on erdsting house REMARKS np AREA (SQ FT) EST COST ($ $2,300.00 FgMIT FEE OWNER 1KIRKPATRICK. BARBARA A BUILDING DEPT BY ADDRESS 10089 ACRES AVE West Yarmouth MA 02673 INSPECTION RECORD Date Note Progress - Corrections and Remarks CONTRACTOR LICENSE 100988 Cassidy, Henry 18 Reardon Circle South Yarmouth MA 02664 5087751214 PHONE 15087757205 FIELD COPY d CAPE COD INSULATION 1-800-696-6611 Town of Yarmouth Regulatory Services Building Division Address — 1146 Rte 28 Address — Seuth Yarmouth, MA 02664 Date: 11 ZQ 1 I q Dear Building Inspector IR' L-:CE1tiv JAN 21 2014 Qur—� - N ivr oy Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. The work meets 780 CMR Mass State building codes; or Mass Save, Cape Light Compact specifications. Property Owner Property Address Village fires AVe- Oes l Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) (9) (33) Slopes ( ) ( ) ( ) ( ) ( ) Floors ( ) ( ) ( ) ( ) ( ) Walls ( ) ( ) ( ) ( ) ( ) Permit J O. _ —y ' --,,FeeS i. "Permit expires 6 months from , �..d..•' 2 iissuedate. EXPRESS BUILDING PERMIT APPLICATION TOWN OF YARMOUTH .Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 Ext. 126/1��j CONSTRUCTION ADDRESS: W. ASSESSOR'S INFORMATION: k Map: Parcel: / OWNER: uli�� /�'� , lvY �'�l -5V- s` S 4N& PRErrSENTADDRES TEL # CONTRACTO f a Y, TAVAOI OG -jtp. �' ( MAILING ADDRESS TEL # esideatial ❑ Commercial ❑ Est. Cost of Construction S Home Improvement Contractor Llc. #FF� _ l��Li Construction Supervisor Lie. # Workman's Compensation Insurance: (check one) 0 ❑ I am the homeown ❑ I am the ole proprietor Er have Worker's Compensation Insurance Insurance Company Name: / � �' S�J �� Worker's Comp. Policy# "000-6 6qz-iI ❑ Teat (Fire Retardant Certificate attached) WORK TO BE PERFORMED ❑ Wood Stove Shed ❑Siding: #ofSquaress ❑ Replacement windows:# ❑ Re # Squares ❑ Replacement doors: # / -roof- of ( ) Stripping old shingles' sil- u�>a -on L4 aw �1� Old K�ingHighwayluiirstoric ()going over layers of exi•stin roofDistrict *The �V t p�Af fing/Siding(Like for Like) L 2 debris will be disposed of at: 6� •'� i VI V"►VW I /tJ" G K. 1eeat n of Facility I dxlare under lti penaes of pcpury that the statements herein contained arc true and correct to the best of my knowledge and belief I understand that any false answer(s) will be just cause for denial of revocatio licence and for prosecution under M.G.I. Ch. 268, Section 1. y Mill 'Oki/ Applicant's Signature: Date: Owners Signature (or attachment) Date. Approved By: Date. Building Official (or designec) Zoning District:--- • G Historical District: ❑ Yes K No Flood Plain Zones , Y l Water Resource Protection District: Within 100 ft. of Wetland: ❑ Yes ALNo 'K Yes ❑ • No 3/01 oF.Y, 3a 'y TOWN OF YARMOUTH _ c BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext.1261 Fax 508-398-0836 -BUILDING DEPARn ENT S Pursuant to M.G.L. Chapter 40. Section 54 and 780 CMR, Chapter i, Section 111.5, 1 hereby certify that the debris resulting from the proposed work/demolition to be conducted at � r''/ 0, b t Work Address Is to be disposed of at the following location: tt Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Signature f Application 2a l Date Permit No. V r Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Superviwr License: CS400988 \\ �% 1 IN HENRY E CASSIO 8 SHED ROW ;'14MV10 WEST YARR101" t � Expiration mm Coissioner 1111112015 VOYjI,fitcf/til"(1 (1'lC1, 0/C3�j Offfcc ofConsun7erAffairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Cotitractor Registration Registration: -' Type: Expiration: l.1U'E COD INSULATION, INC IIFNRY CASSIDY i Iti RFARDON CIRCLE So. YARMOUTH, MA 02664 I i 1 ..r•nruu,rrrr r�r/�ii lri/.ura11to'A4 u(h.: J A'unwmer Al lairs 1; IIusiItess Itegulatinu (suhtr IMPKOVEMkNT CONTRACTOR t �uyut7atwn 153567 Type: { jEApIfJ11U11. 12/15/2014 Private Corporalicn r,f10N.'INQ Io�a:u:�41Yt.iK1;11- �u111 MA UlGIi4 • IludrnrrrelurY a • 153567 Private Corpordliun 12/15!?t)14 Trill 23JUJ1 UpdatcAddress and return curd. Mark rcusun furchauge. 17 Address Q Rencwal (_1 I{ntployment I I Losilard Liccmr or registration valid for individul use only before the cspiratiun date. If round return to: Office of Consumer Affairs and Uusiucss Regulation 10 Park Plata - Suite 5170 8oslou, NIA 02116 A vithu t n:d re-_- _ -� 153567 Private Corpordliun 12/15!?t)14 Trill 23JUJ1 UpdatcAddress and return curd. Mark rcusun furchauge. 17 Address Q Rencwal (_1 I{ntployment I I Losilard Liccmr or registration valid for individul use only before the cspiratiun date. If round return to: Office of Consumer Affairs and Uusiucss Regulation 10 Park Plata - Suite 5170 8oslou, NIA 02116 A vithu t n:d re-_- _ -� Tire Commonwealth ofAfassachusetts a Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, b1A 02111 www.ma=gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le lbly flaunts(Busincss/Organization/Individual): �'i }/� �p �Gl f!/ �✓�'//I/r� _ Address:1F City/State/zip: Ae' G ,4 Phone #: .5� � Z Are you an employeri Check the appropriate box: 1. 1 am a employer with• .,�. 4. p y �' I am a general contractor and I Type of project (required): cmployces (full and#/pf part-time).* 2. ❑ 1 am a sole proprietor or partner- have hired the sub -contractors listed on the attached sheet. 6. ❑ New construction 7. ❑ Remodeling ship and have no employees These sub -contractors have g. Demolition working for me in any capacity. [No workers' comp. insurance employees and have workers' comp. insurance.t 9. [] Building addition required:] 5. We are a corporation and its 10.❑ Electrical repairs or additions 3. ❑ 1 am a homeowner doing all work officers have exercised their .1 LE] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs ituurancc required.] t 3a.❑ I am a homeowner acting as a c. 152, § 1(4), and we have no employees. [No workers' general contractor (refer to #4) comp, insurance rt auiredl fADY APPLicant that checks box #1 must also fill out the section below showing their wodtm' compmutic policyiaformation. Homeowners who submit this affidavit indicating they arc doing all work and then hue outside contractors must submit anew affidavit indicating such tConzractors that chock this box mutt attached an additional sheet showing the name of the sub-comrscton sad state whether or not those entities have . cmploycea, if the sub -contractors have employers, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employeex 2relow is the policyand Job sire information. Insurance Company Policy p or Self -ins. Lic. Job Site Expiration Date`W :', �`o�,�,�/,� City/State/Zip: e ,✓Ip W 4fi Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL e. 152 can lead to the imposition of criminal penalties of a tine up to S 1.500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the 14ndpenalties of perjury that the information provi r �ib�ov�e is true and correct. i ZY. �1 J�(/V IN c'l Date: Phone q: z '0ffleial use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License Issuing Authority (circle one): L Board of Health 2. Building Department 3. CityfTown Clerk 4. Electrical Inspector 5. Plumbing Inspector '6.Other Contact Person• Phone #-. ACQh ' CAPECOD-27 MYOUNG ___ CERTIFICATE OF LIABILITY INSURANCE DATEIMED AS A MATADYYYY) 7/812013 THIS CERTIFICATE IS ISSUTER OF INFORMATION ONLYANO CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is all ADDITIONAL INSURED, the policy(ies) must ba endorsed, If SUBROGATION IS WAIVED, subluctto thu tumis and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the curtihcatu holder In lieu of such endorsements . PNunuc- License # PC-514062 Rogers 8. Gray Insurance Agency, Inc. PHUNAUEA T Margaret Youn 434 Rtu 134 18a ti — lEhIll AIC,NoJ_, __. South Dannis,MA02660 ELAIL,,,,,,,,•„_,;,,_ --y e,�wlul Cape Cod Insulation, Inc. 18 Reardon Circle South Yarmouth, NIA 02664 COVERAGES ItIIS IS TO L INDICATED CtH11FICA1 EXCLUSION UEN[HAL A X tDM OEN't A AUTOMOe1 B l ANI ALL AUT X IIIRt X UMe Exct _I [xD WONKEN'3 AND EMPL ANY PHOPR Ur FIR0. I41kdalury k ii�> Ial l t>ES*HIP[i I I ucs cNIPrION OF' Wurkers Cornp Addtional Imur I CERTIFICATE NUMBER: GROUP_[_ REVISION NUMBER: r tx IIr T 1 HAl THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTV41THSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT VAT) I RESPECT TO "MCH THIS E MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, S AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CLAIMS tx3tEGATE AU10 D HEI.LA ]S OYERS'UABIUTV L Qr10FOPERATIONSbektw rnsatlon TYPE OF INSURANCE A= SUBS POLICYNUMBER MM I MMy UNITS LIAUILTY EACH OCCURRENCE f 1,000,00 MERCIALCENERALLIABILITY -MADE u OCCUR CBP8263063 4/1/2013 4/1/2014 Disocal0 EMI Faoca ence f 100,0 MED EXP aw _!nnL S 5,0 T _...-_ PERSONAL a AOV e4JURY f 1,000,00 ----- _ GENERAL AGGREGATE f $000,00 LIMIT APPLIES PER, _Y PRO. LOC PRODUCTS-COMPIOP AUG f 2,000,00 i LE LIABILITY ED X SCHEDULED AS AUTOS. X NON Sy"' AUTOS - 3MMOCKVMK 4/1/2013 - 4/1/2014 COMB*LED SINGLE LIMIT acodar 1,000,00 BODILY INJURY(P.pmsan) _ f !^ BOOILYIUMY(PsracddanU f DAMAGE$ � f� — UAe X OCCUR EACH OCCURRENCE f 1,000.00 LIAa CLAIMS -MADE ONJ453512 4/1/2013 4/1/2014 AGUREGATE `—• f 1,000,00 X RETENTION 10,000 - f - COMPENSATION IETOR/PARTNDED? CumvE YIN EXCLUDED? ❑ NIA CA00525904 613012013 6130/2014 A TAT - EL EACH ACCIDENT _ f 1,000,00 E.L. DISEASE• EA CMPLOYE f 1,000,00 IILIBERI kI NH) w urxbr E.L. DISEASE -POLICY LIMIT f 1,000,no OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD let, Addlnaml Remarks SdW4.146 Y more spw Is nq,dmd) includes Officers or Proprietors. ad status is provided under the General Liability when required by written contract or agreement with the Certificate Holdar. CERTIFICATE Cape Cod Insulation, Inc SHOULD ANY OF THE ABOVE 13ESCRIDED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS_ AUTHORIZED REPRESENTATIVE 9U ) 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD i i f OWNER AUTHORIZATION FORM (Owner's owner of the property located at (Property hereby authorize an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. /C, r Owners Signature 6 FIELD COPY- : 70M OF BUILDING � r _ CI� 107� .PERMIT Sept. u, 2DOO s-02 -�40 DATE PERMIT NO. APPLICANT M. .ADDRESS 28 S- Y- INO.) (STREET) PERMITTO ADDT'1 (—) STORY (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) NUMBER OF DWELLING UNITS (CONTR'5 LICEN5E) ZONING AT (LOCATION) 89 Acres Ave, N• Y• DISTRICT It-25 (NO.) (STREET) BETWEEN - AND ICROSS STREET) ICROSS STREET) LOT SUBDIVISION 2412 LOT 747 BLOCKHp3 1_SZE i BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE 5-B USE GROUP RA BASEMENT WALLS OR FOUNDATION (TYPE) AREA OR VOLUME ESTIMATEDCOST-$ 14.900.00 FEEMIT • ooln (CUBIC/SYyQ;�DARE FEET( OWNER A. �L.Eick BUILDING DEP I, ADDRESS-89 A=es Ave. W. Y. BY I INSPECTION RECORD DATE NOTE PROGRESS CORRECTIONS AND REMARKS INSPECTOR 9�q�L C f_ " ' , 4L ;a ONE & TWO FAMILY ONLY - BUILDING PERMIT APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING Town of Yarmouth Building Department 1146 Route 28 - Yarmouth, XIA 02664-4492 Tel: (508) 398-2231 x261 - Fax: (508) 398-2365 trice Use Only Planning Board Information Assessors Department Information: Permit No. '�� a� Date Plan Type M cdP for Endorsement Date d 2 2— Permit Fee $l✓4z, — _ ._ Ord New Recording Date Deposit Rec'd. $ d5.—Date % 1.4 Property Dimensions: Plan No. _ Net Due $/a 5 Other Lot Area (sf) Frontage (lt) Lot Coverage Section 2 - Property Ownership/Authorized Agent 2.1 Owner of Record: Mailing Address + 2.2 Authorized Agent: A�zEy H NG��2 a�wy�r�s/�Ary� YAK N� Name (print) Mailin Ad !;/ Signa ure Telephone Section 3 - Construction Services UN`1' 5 '2000 J 3.1 Licensed Construction Supervisor. Q/ NotAppli able ❑ a 0 A/4,?7t---{' M771 S. yAl2Kor�f; ifA 02GGf/ Ucense Number Address C. S Q�j7 <-�' 9 �c39%- �70y- �70y QL Expiration Date Sight a Telephone 12/3 012001 3.2 Registered Home Improvement Contractor. Company Name Not Applicable ❑ BEST fiT wiyDow 9c- D002 CO , =fJ C- Address License Number IA'7 6 o 9-8 WH IT55 �AT�9 3 !�-�/�%(%� Expiration Date Signature e Telephone Z 9-15-99 tof2 OVER Section 4 - Workers' Compensation Insurance Affidavit (M.G.L c. 152 S 25C (6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Faild?e.- - to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes ... No .......... Section 5 - Description of Proposed Work (check all applicable) New Construction ❑ No. of Bedrooms NIA No. of Bathrooms N A Existing Bldg. ❑ Repair(s) ❑ Alterations ❑ Addition 0- T!//2EC SFa9smi Etie%a` 96 Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: ,S'" So CLOXCAR c )C t nj G A €Ct c... OF vs S S ZQ5 C E ' X 12' Section 6 - Estimated Construction Costs Item Estimated Cost (Dollars) to be completed by permit applicant 1. Building / y Qj . 00 2. Electrical 3. Plumbing / Gas 4. Mechanical (HVAC) 5. Fire Protection 6.Total=(1 +2+3+4+5) 7. Total Square Ft. (new houses&adchons) /yy Section 7a -Owner Authorization -To Pe Completed When] Own s Ag t or Contracto plies for ildiWg rmit - I, hereby authorize !SEXE my bahalf "N all matters ignature of Owner Section 7b - Owner/Authorized Acihht Declaration Check Below ❑ Conservation -Commission Filing (if applicable) ❑ Old Kings Highway & Historical Commission approval (if applicable) as owner of the subject property by this building permit application. Date act on I, 14645b R, 2e!_Apixr - , 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. A�r>lzF� .K . r'3c c.9N 7OZ - Print name — Signatu of Owner/Agent Date 9-15-99 2 of 2 TOWN OF YARMOUTH Y''11c ..•,;; BUILDING DEPARTMENT BUILDING PERMIT APPLICATION SIGN OFF :applicant: &P-RRRA 1Gtt2V_P TV2-1C V— Building Permit No.: :address: 9 AC2cS AMS W.YAR OV-19 Tel. No.: iiS-72a:5 Date Filed: Bld,T. Site Locati Map No.: 07 Lot No.: A _�-/ 5✓ The follouing 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 urill determine compliance to the following: (A) Zoning Requirements (B ,Historical Districts (C) Flood Zones. The Building Department will be responsible for-assisting-theapplicantthrough the following departments: RESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT: " Determines Compliance of Water Availability. (applicant to obtain) ENGINEERING DEPART:IIENT: Determines Compliance for Parking and Drainage. CONSERVATION COXMISSION: 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 DEPARTIIIENT: 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: RE% VED BY: . WATER DEPARTMENT: DATE: �- - t1t1a N/A: 2. ENGINEERING DEPARTIIIF.NT: DATE: N/A: 3. CONSERVATION: P # DATE: N/A: 4. HEALTH DEPARTMENT: U DATE: 01 N/A. - INDUSTRIAL AND InIz COMMERCIAL PERMITS 5. WIRING INSPECTOR: DATE: N/A: 6. PLUMBING INSPECTOR DATE: N/A: i. FIRE DEPARTMLNT. DATE: N/A: PLEASE NOTE All stumps and/or brush must be disposed of at an approved site. CO.NINIENTS: N/A L<k XIA A< 8/99 :applicant Signature Date . --••• �j ,..wsuurwrw Department of Industrial ;1 ccidents 4 1 � OfAceo!/msUp�iis 600 Washington Street Boston, Mass 02111 v Workers' Compensation Insurance AlMdavit 9, Y1Jo0,,-10v7-11 , /K4 oz" ' O 1 am a homeowner performing all work myself. 0 1 am a sole proprietor and has a no one workine in any capacity (� 1 am an employer pros iding workers' compensation for my employees working on this job. comnans•name* REFS1 E/7' //Vbof✓ 94bt9DJ2 C C . address, 616 klfi IT&s JOAT'H s, insuranceco. GL/A124 2NSj/�Act-e'G20UP nelirvlf 2>E7vyg3aIX [D'I am a sole proprieto . general contracto or homeowner (circle one) and have hired the contractors listed below s%ho has the following ssorkers' compensation polices: eauure to secure coverage as required under Section 25A of MGL 152 an lead to the impoddoa of criminal penalties of a Bag op to 51,500.00 and/or one years' Imprisoomcnt as weU as civil penalties in the form of a STOP {PORK ORDER and a On nfSIMM a day against me. I eadentsad that s Copy of this statement maybe forwarded to the Me of Investigations of the DU for coverage vetiQatioa. • l do hereby certify seder the pains and penalties o�CdUrY that the tafOrmu foe provided above h mm and correct A-is!-ew Print name / -11-p 0b! //, SFZOIAIZR /, pfiOOe j a 9X g;Po y oRcial use onh• do not write In this area to be completed byeityortown oBlCial city or town: YARMODTI; _ permlt/lieease tt n8uilding Department Q cheek if Immediate response Boardpoase is required 261 OSelectmen s OMee p phoseM:_ (508) 398�2231' t>ort_ nQOtherhDepartment contact person: 41"ned 3.941VA1 %lassachusctu General Laws chapter I 5=section 35 requires all employers to provide workers' compensation, for their entpioy 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 emplut•er is defined as an indi%'idual, part nership.'association. corporation or other legal eritity,`or any. two or more c the fore__oing engaged'in a joint enterprise. and including the legal representatives of a deceased employer, or the recei%er or trustee of an indi%idual 1. partnership, association or other legal entity, employing employees. However the o%%ner of a dnellina house ha% in_ not more than three apartments and who resides therein, or the occupant of the duelling house of another who employs persons to do maintenance. construction or repair work on such dwelling house or on the __rounds or buildings appurtenant thereto shall not because of such employment be deemed to be an employer. %1GL chapter I : _section 2 .alga states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a bu$iness or to construct.buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally. neither the commom%ealth nor any of its political subdivisions shall enter into an%'contract for the performance of public %%ork until acceptable evidence of compliance with the insurance requirements of this chapter ha'L been presented to;the coniraeting authority: Applicants Please till in the workers' compensation affidavit completely. by checking the box that applies to your situation and supply ing company names: address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affida% it 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 %%orkers%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 permittlicense number which will be used as a reference number. The afUdavits maybe returned to the Department by mail or FAX unless other arrangements have been made, The Office oflnvestigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address. telephone and fax number. . The Commonwealth Of Massachusetts Department of Industrial Accidents - MCC of Imstlowe s 600 Washington Street -- Boston, Ma. 02111 fax #: (617) 727-7749 phone #: (617) 7274900 ext. 406, 409 or375 06/24/2030 14:45 5088329565 ` NORTHEAST INSIRAMCE PACE 01/01 t :; �GOR�R'IFAT {3F LirBILtTi �I�fSUEAtNE aATsIMwuDam •. L........... ......... ....... .. ... _.c Emo t 06 14/00 PRODUCER. THIS UZATIFICATF IS ISSUED A5 A MATTER OF INFORMATION ONLY AND CONFER3 NO RIGHTS UPON THE CERTIFICATE Northeast Insutauce Agancy,Inc HOLDER. THIS CERTIFICATEDOES NOT AM.ENO,EXTEND OR 367 Southbridge St. ALTER THE COVERAGE AFFORDED BYTHE PCUCIES BELOW. Auburn RA 01501 COMPANIES AFFORDING COVERAGE Scott Bulger (A144) COMPANY rmane Nv. F . he AGuard insurance Group INSURED COMPANY B . Merchants and Business Menlo Alfred Belanger Best Fit Window & Door Cc COMPANY C 28 White"a Path S Tarnouth HA 02664 j I COL;PAM, D Q;•¢1(�IiAQE$ tti:::;i?;•:•r}i}}::%:::; ;::;:;:,>:'r:•:;'>::?ti•S;•,:•::,,,:;;>:••.:.•.A::•�•,;:::•r:;ii 7::CC•: , � iii:iti4;•>.'• ::::a:;•; :.'.•....::.::.... •., :::.:.'.'. v...•::.: . O TO CERTlYTHATTNp POLICIES D' NSLFANCE LISTED BELOW HAVE BEEN fS&UEO TO THE INSIfTF_D NAMEDA30VE FOR THE POLICY PERIOD •• THIS. INDICATED, NOTWITHET•ANDIND ANY REW REMENT. TERM OR CCNUTION DF ANY mNTRACT OR OTHER DCCUUENT WITH RESPECT TO WHICH THIS CVMrICATE MAY BE ISSUED OR MAY FESTAPL THE INSURANCE A►FORDLD BY THE POLICIES Opsc;LSED HEREIN IS S:AJECT TO ALL THE TERNS, G=U81CHlJs AND CONDMONO OF BUCH POLICIES. LW M3 3HOM MAY HAVE SEEN REDUCM BY PAID CLAIM & LT�R TYPE CF INSURANCE roLCyTIUM1ER POLICYEFFECTRL DATE CWMWYT') POLICY EVXATION i DATE IM?1DO.M) MITI! B CENERAL LNBILTTY Z CONImERCALLOENew "'LITY CLAIMS �X 0020346593 06/03/00 06/03/01 c3hvkkA GGREOATE s 1000000 PRCMCM-COMP,00AGG s 100D000 PERS0NAL&ADVN1URY 1 MACE OCCUR CWwxs&00HTRACTOR•s/ROT EACHOCCVRRENCe 5300000 FiRE OALIACEVPyw*Fn) S - - 1mEvOnomeOWNI) 63000 AUTOMOBLE LNEtL1TY ANYA= 1 Cr'MB!N10 S.NOti UMT p A:1 CA$= AUTDS SC• EO AUTOS I tFOOLYK RY 1 • HAEDAUT03 NONOW!IEO A1TO6 � I � BODLY W1URY p`I, Ice�nq f PROF:RTV CAMA3E GWOELIABILITY ANV AUTO AUTOOfLY•EAACCIDEVT f OTHER THAN AUTO ONLY: EACH ACCIOE!4T f A33REGATM_ S DHSS UA8IUTY - UMBRELLA FORM - EACN OCCURRENCE AGORECAT: f OTHER THAN UMBRILIA FORM f WOPJWA COMP--NSA-MN AND EMPLOYERS' LIABILITY +1 LL T TS LL EACH ACCIDENT 1100000 A PAA MCUIVIC11" INCH OPFICEM ARL iJ(CL OTHER BYDTC030611 10/27/99 10/23/00 ELDISME•POLICY LIMIT s500000 EL QISEAS:• EA E+r_OYPE i100D00 DESCRIPTION OF OPERA' 1OF81CCATION3WtA,CLESZP9QAL IT.Uq )v iTtRiCllTB3iOCDER ::•:::>: < :: i:ri::::: t:r:'.:...... �R N'10E ::.,.•.•::::::......:::.:.•.•.,';<,:, • .......... .. .. ............... ...... ....... 4.. ........ .... Kll, T7 .1 ......• . ... .. ....TOWNOPY ....... ..• •..... ........................ ABOVE DOCREEO POLICIES lE CANCELLC39ETOMTHE BullTown in YarmouthEN anilding Dept 1146 Rt 2BS ERECF, THE IWuN3 COMPAIIY WILL EYDLAVOR TO NAIL VAA NOTICE T'O THE CL7'TPrATE HOLDER NAMED TD THE LEFT. pUCH NOTICG SHALL ILroSE NOOCtJGATgN CR LL46LRY Yarnouth IM 02664 HE COMPANY. RS AMNTS OR REPRESENTATIYFS AUTf ulger (A144) •'�IC4aD:>ypl3Poi�,lapl+i: t�:f ,.�•r�M�n_ T��ncc�� 1146ROL7E28 SOL-M YARMOUTH 1 USS.-,CHI:S=026644451 Telephone (5081 398-_2_231. Ext. _'6l — Fax t5081 398-.363 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT u.S PLUMBING SM S I'urmant to I.G.L. Chapter 40. Section 54 and 780 CMR. Chapter 1. Section 111.5. I herebv certifi• that the debris resulting from the proposed trod: 'demolition to be c<tnducted at P9 AC2c dVC W .YAAH0VW_ NA OZQ3 Work Address k it, br disposed of at the following location: bVMP.S7E22 ask wHiTEs 10A1-►•4 S,%IA(4-( JM Said disposal site shall be a licensed solid waste facility as defined by I.G.L. Chapter I l 1. Section I50A. Signature of Applicant Iiate Perinit No.. . of -,k . TOWN OF YARMOUTH •- BUILDING DEPARTMENT .?�,. 1146 Route 1-8. South Yarmouth. MA 02664 508-398-2231 ext. 261) HOMEOWNER LICENSE EXEMPTION PLEASE PRINT: JOB LOCATION: 6,1zva.A k»V-AgrRtcte_ y9 Res AvE All M*11007 NAME STREET ADDRESS SECTION OF TOWN -HOMEOWNER" 77Y-72-0.S NAME HOME PHONE WORK PHONE PRESENT MAILING ADDRESS A,C2ES' AV6 W j iA0I1aUT14, io�1A O2b-7 3 CITY OR TOWN STATE ZIP CODE The current exemption for `Homeowner' was extended to include owner —occupied dwellings of one or two unit: and to allow such homeowners to engage an individual for hire who does not possess a license, provided that sucl- homeowner shall act as supervisor. (State Building Code Section 109.1.1) Definition of Homeowner- Person(s) who owns a parcel of land on which he / she resides or intends to reside, on which there is or is intendeL to be, a one or two family attached or detached structure assessory to such use and / or farm structures. A persor who constructs more than one home in a two-year period shall not be considered a homeowner, such "homeowner' shall submit to the building official. on a form acceptable to the building official that he / she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned `homeowner' assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and regulations. The undersigned `homeowner' certifies that he ! she understands the Town of Yarmouth .Building Department minimum inspection procedures and requ' ments and that he / she will comply with said procedures and requirements. n _ _ % A / A HOMEOWNERS SIGN APPROVAL OF BUILDING OFFICIAL I/ INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL CIL 142. Yes C--� No 71 Ifyou have checked ves, please indicate the type coverage by checking the appropriate box. A liability insurance policy✓ Other type of indemnity 0 Bond 0 oWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws and that my signature on this permit application waives this requirement. Check one: Signature o Owner or Owner's Agent Owner 0 Agent x_--- .1:homco%%nrnccxemp 310 CHR 10.99 DW Pile tea Cro be provided by DIV) Form 1 Ot7/tos YARM e��j Ct kP�4TR t C. Gosssos:.nealtb of Xxxxaobuiretti Request for a Determination of Applicability Massachusetts Wetlands Protection Act, G.L m 131, §a and the Town of Yarmouth Wetland Bylaw. 1. X. the undersigned, hereby request that the TOWN OF YARMOUTH conservation commissions make a determination as to whether the area, described below, or work to be performed on said area, also described below, is subject to the jurisdiction of the wetlands Protection Act, G.L. c. 131, S40. 2. The area is described as follows. (use maps or plans, if necessary; to provide a description and the location off�the area subject to this request.) Locations Street Address Lot Numbers �-1-I.- 3. The work in said area is described below. (use additional paper, if necessary, to describe the proposed work.) 1-1 Effective 11/10/89 s" 4. The owner(s) of the area, if not the person staking this re , has been ..given written notification of this request on (date) ,The name(s) and addresses) of the owner(s): w • S. Z have filed jvccigplete copy of this request with the appropriate regional of c t sachusetts Department of Environmental Protection (date) DEP Northeast Regional office 10 commerce Way Woburn, MA 01801 DEP central Regional office 75 Grove Street Norcester, MA G1605 DEP Southeast Regional office 20 Riverside Drive Route 105 Lakeville, MA 02347 DEP Western Regional office State House West, 4th Flocr 436 Dwight street Springfield, MA 01103 6. I understand that notification of this request will be placed in a local newspaper at sty expense in accordance with section 10.5(3)(b) I of the regulations by the conservation cc=ission and that Z will be billed accordingly. 1-2 i acREs Av�nly� yd wine - rowN WAY 1 � 1 70. 0 T,/ # ��� N Jae Y t1 %L L k \ %B o \ 1yr 7 0� / —ills C / BRRBliIIs7 K/RKP9TR/cK scAe4ir o ' - 0cTbBF2 / 9 9 Q OVIJN L. Newrm- R•L.S. - ts! y6gRn70//JJ/, tV.4. • ' , ;._' • ,Pp/L�D�t>'-• ji�ltmo�'I'f� Ss�s�li� %��—jV®; �3 levy y DVS ~ a � C.46 Of 114? is v , y. so -I Fill O C , _ _ Ilk As •. ur ®L Q yr► W n 41 V�IS in to IL A No s 0 tp 41 0�ell 41 k A 0 . •�'M• 4.0 • • I f O . •• - Ir' r l} car +t i C�tia4�E 4N O .0 LEWIS POND ti 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 ' General Information From: 3. Title and Final Revision Date of Plans and Other Documents: YARMOUTH Sketch of land at 89 Acres axwvem commtuim 1. Applicant _Avenue, West Yarmouth Barbara Kirkpatrick AMme olPasan AW1V Request 89 Acres Avenue West Yarmouth wom MA. 02673 Stare 2. Property Owner. SAME AS ABOVE IWme of PmPaly 0wrr (l dfdedd from a;;l av Maift kdw CITY/Town Le code Statc LP code Determination Pursuant to the authority of M.G.L c.131, §40, the YARMOUTH Coaservadon commission has considered your Request for a Determination of Applicability, with its supporting documentation, and has made the following Determination regarding: 89 Acres Avenue SeeetAddress West Yarmouth 02673 Q11TOV LC code 13 J 42 AssessorsMaNPW PATIaor! Rev.10/98 Massacbusefts Department ofEndronmental Protectien Town of Yarmouth wetland sy-Law. Bureau of Resource Protection — Wetlands Chapter 143 WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Determination (cont.) The following Determination(s) is/are 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 ❑ 2 The delineations of the boundaries of the resource areas listed directly below, described on the plan(s) referenced above, which includes all or part of the area described In the Request, are confirmed as accurate: Therefore, the resource area boundaries confirmed in this Determination are binding as to all decisions rendered pursuant to the Wetlands Protection Act and its regulations regarding such boundaries for as long as this Determina- tion is valid. However, the boundaries of resource areas not listed directly above are = confirmed by this Determina- 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 alter that area. Therefore, said work requires the filing of 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 alter an Area subject to protection under the Act Therefore, said work requires the filing of a Notice of Intent M S. The area and/or work described on plan(s) and document(s) referenced above, which includes all or part of the work described In the Request, Is subject to review and approval by We Cfmtndpatdy pursuant to the following wetlands law, bylaw, or ordinance (name and citation of law). ❑ 6. The following area and/or work, if any, Is subject to municipal bylaw but =subject to the Massachusetts Wetlands Protection Act G 7. If a Notice of Intent is filed for the work in the Riverfront Area described on plans and documents referenced above, which includes all or part of the work described in the Request, the applicant must consider the following alternatives (Refer to the Wetlands Regulations at 10.58(4)c. for more information about the scope of alternative requirements) ❑ Alternatives limited to the lot on which the project is located. C 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. C Alternatives extend to any sites which can reasonably be obtained within the appropriate region of the state. 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. 13i, §40 Determination (cont.) Negative Determination ❑ 5. The area described in the Request is subject to protection Note: No further action under the Wetlands Protection Act under the Act Since the work described therein meets the Is required by the applicant However, if the Department of requirements for the following exemption, as specified in Environmental Protection is requested to issue a Supersed- the Act and regulations, no Notice of Intent Is required: 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- k°"n 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 ❑ 6. The area and/or work described in the Request is not commission. Requirements for requests for Superseding subject to review and approval by 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. C 2. The work described In the Request is within an area subject to protection under the Act, but will not remove, fill, dredge, or after that area. Therefore, said work does not require the filing of a Notice of Intent X3. 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 firing of a Notice of Intent, unless and until said work afters an Area subject to protection under the Act A67eofLb*law pursuant to a municipal wetlands law, ordinance, or bylaw, (name and citation of bylaw). CONDITION: Sono tubes be hand dug. AUtilOrlZatlDn This Determination must be si net' b a ma'ority of the This Determination Is issued to the applicant and delivered as follows: by hand delivery on Au¢ust 7. 2000 Date ❑ by certified mail, return receipt requested on Dare This Determination is valid for three years from the date of Issuance (except Determinations for Vegetation Management Plans which are varid for the duration of the Plan). This Determination does not relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. g y 1 conservation commission. A copy must be sent to the appropriate Department of Environmental Protection regional office (see appendix A) and the property owner (if Aft us t 3. 2000 Date Page 3 of 4 9 Massachusetts Department ofEnviromnental 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 Appeals The applicant, owner, any person aggrieved by this Determina- Issuance of this Determination. A copy of the request shall at tion, any owner of land abutting the land upon which the the same time be sent by certified mail or hand delivery to the proposed work Is to be done, or any ten residents of the city or conservation commission and to the applicant If he/she is not town in which such land Is located, are hereby notified of their the appellant The request shall state clearly and concisely the right to request the appropriate Department of Environmental objections to the Determination which Is being appealed. To the Protection Regional Office to Issue a Superseding Determina- extent that the Determination is based on a municipal bylaw, lion of Applicability. The request must be made by certified and not on the Massachusetts Wetlands Protection Act or mail or hand delivery to the Department with the appropriate regulations, the Department of Environmental Protection has no fling fee and Fee Transmittal Form (see Appendix E: Request appellate jurisdiction. for Departmental Action Fee Transmittal Form) as provided in 310 CMR 10.O3M within ten business days from the date of Rev.10/98 BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR' FORM PLE4SE PRIM. job Location: t 7 A021FS 4 05 Number Otvner of Property: MA24 Construction Supendsor. Name Address: Licensed Designee: (If other than Supervisor) Name Street S10 2.15 Responsibility of each license holder. License No. Village License No. —'?7D 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 drawins as approved by the building official. g 2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration. repair, removal ordemolition involving the structural elements of building and structures onlypursuant to the state building code and all other applicable laws of the commonwealth, even though he, the license holder. is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any violations which are covered by the building permit. 2.15.4 Any licensee who shall willfullyviolate subsections 2.15.1, 2.15.2 or 2.15.3 oranyother 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 sttperti isors 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 yU, please indicate the type coverage by checking the appropriate box. A liability insurance policy Er Other type of indemnity ❑ Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 15 of the Mass. eneral Laws, and that my signature on this permit application waives this requirement. ��•// 11—� Check one: of Owner or Owners Owner ❑ Agent Q— Signature: Building Official Approval: . .. 1 For Office Use Only E 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: 3 J PQ&!fg E.t/c&asu2tF Est. Cost / 00. aD AddressofWork 95 A02i5S A-j6 W-VARHOVEW.0 nA_ oz6?3 Owner Name: 13A28&Z� 9 VIAX—iOA77219l c Date of Permit Application: G ^/5/-00 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under $1,000 Building not owner occupied Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL'c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner. /z '!G AcFdZD M RECA► GEft Date Contractor Name Registration No. • t_ Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name Abutbor's Name Lot # If this is a corner lot, write in name of street. x ;I FOR LOT # a Indicate location of garage or accessory building Additions with dashed lines -------------------- Sewerage disposal (cesspool) ED We-U 0 I I(lot................ft. rear) I 3 2 �,�ccc�s� �x�sT��G �c►�� `�Y wrrN 3 s�sotil i�o2c 1 cN cCoSc2 REAR YARD SIDE YARD �]-- - - FT. 6% .Q SET BACK 60"s... Oft. I SIDE YARD r (lot.... 7Q........... ft. frontage) �9 Ae2�s���WlaaHa� (NAME OF STREET) Information Supplied by nCz2s lzo /an MARK NORTH POINT rC� �REAMSPAC� PATIO ENCLOSURES Y i n u 0 on F O .G T P* .R 8 .N .T P R : ® G. R A V-? - EKCLOSURE NUMBER: 3037- N DEALER. BEST FIT WDW CUSTOMER: KIRKPATRICK N.LS.m " m HOUSEWALL ® Nod M 0O0 m2 a f a RIDGE BEAM 1�1 n V1/2 X 166- " ®� �o n vI 0� FOS1 AS$EMBL7 2 J/4"�EpVl3TEMPER D ILL FCLASS 113 7/8� 89 15/167 SIDE 2-143 3/4' F O O T P R I N T P R O G R A M DREAMSPACP PAT10 EBT MURES •iY• Y.Y. arts tlYY11• .1�r1 R. ROOF LAYOUT HFfUSFWAL L 84 3/4" 04 3/4- PANEL LENGTH PANEL, LENGTH ENCLOSURE NUMBER: 3087 �i OFq,�: BEST FIT r Co CUSTOMER: KIRXPATRICK N.T.S. at HE 62.945 62.949 9.285 9.285 31.887 31.887 58.750 -- � �— M750 — 143.750 SIDE 2 (OLI) r N 10.000 INGING (EIGHT k (ZkPAT(2-lck a, 6NDif. TO 1.6ck I<Ic%k. Sibs - ,3 600 ELMO;- PRTIU DL)olt- J Z P gy.,g 1NG 1Ao%JSL Industries, INC To thalk it Key RE1 io Roof rl for your home." 301 Btushton Avenue Pittsburgh, PA 15221-2168 (412)244-6400 FAX (412) 244-6496 t ad Teat August 13# 2993 Lowing c Went■ were atilised during the load tests$ IEEUP E 301s 4f'/X7=G Ht 2.5•LBS&I t4-•y?4 AL MOJW 336j 366 OR 612 is KUJLNDED POLYSTYRENE 1.5f DEUSITY x RUE >t .019" L .024' THIClto ALLOY 3003 H 14 ! ORIENTED STMUD ZCMW 7/16' THICK x EXTRUSI 1 $091 — T 6 ALLOT TREPIWMY BROKEN a KULLIOK .050' wALL HAVING 3" WEB 6 3' TIANGE WZjGHING c.6a3fIrT. ullions aLre placed on the side of the test ;anal& and are attached to the panel 2" with 3 4" steel screw on the top only- i alysis is based upon the experimental load testing results.as performed by our employed inq our touts. The test procedures conform to the method described by rican Zoe sty for Testing and Materials, Section E-721 `conducting strength Tests of for xuild zq construction•- please rotor to that report for details of the teat nt and me Zod used in our testing. ,sting was progressively conducted in accordance with these procedures to the load noted. ads sustained for one hour and thenjreleased. UltiMAte load was not mod boas. a the panels ware not tasted to failure. w allowable superimposed live load pounds per square foot with a factor of Safety - 2.5. w 10� 67.9 pef 33� 48.9 paf ISO 27.8 Pat -WV1 Qi'T EDWARD J. .1 9RCWN .2 cmlL thyagse ault ing D. 07697 Fclay �FSS/pNAI EN arr `own OF VINYL FRAMED BUILDING PRODUCTS 3.1 F L81NUM6@� EXPOSED 1,300 .400 1.300 .130 .342 .02S 1.245 cap ,01 OP. 1 .030 X to* IL2.34i .630 I.D' SYN 1.245 R (4) .412 .250 .010 OP. 3iD X 9(y .0=0 t 7 ttt7 R (4) .050 3.000 tt) EXPOSED T.6a0 340 1 .220 f•— R.070 .1es .400 c101 tMMXZID I�ADU R.035 AREA OF POCKET.147 ALCoMRSAa UNu599nCM0 Uf43ftaA90WALL THCKUM �' a '� Excel Extrusions Inc. ' wAlaay. p444a'E �1.,,, AknA di NJ rc MiERMAL INDUSMES F .w 5566 ALLOWABLE SMESSES -IAbi S 3100 Fb 2.0E ffRBEAMSMOi TENEION C0111>RESSION nFt rasuutroaaaw F¢ 3100 OE 31�)0- 2.0 2300 3180 Vafx ' 42' depth IFor other depth% adjust valve+ by (12/depth)% For depths leas than 5b". use the value for 5.5•. Cr-LAM S 3100 Fb 2.0E SECTION PROPERTIES MAXIMUM HEAR MOMEt1T�;INERTIA (� I Fl om) ENT MAXIMUM (Lb 1.1K f!-it4 1i11a 1•tY. 2-� 31X 1.1Y+ 2-a% l•1Y+ 1.1M tau1-1% 311ri r l 14% Al RR I RR77 I 12SM 1 2452 1 4905 1 7355 55 111 188 3.63 7.26 10.89 8978 13967 120936 3214 6428 9642 1 125 j 250 1 375 14.76 9.51 J 14.27 9804 19209 28614 3806 7612 11418 207 415 622 5.63 12 j1d, 10637 21276 31912 4017 8035 12053 244 488 732 5.95 ii!# 14517 290.34 43551 4738 9473 14210 400 800 1200 7.01 14.0 15882137384 SMIS 6413 10826 16240 597 1194 1792 8.01 16.02 24 23337146674 70011 6090 121BO 18270 650 1701 2551 9.01 15.02 127.04 1K Patton: k s%e% tined a for bending (Fb), tension (Ft), tromprnsian parallel to Erwin (Fc), sheer). atso maximum Momentand ' m shear values are for normal load duration. These may be increased where allowed by code for shorter bad durations. F oast For nat did bolts lnstalle perpendicular to the aide face of the beam. use National Design Spew%don (1991) Spruce • Pine - fir vahus teral loads. F naUs Installed in the edge or narrow face of the beam parallel to the glue lines, use the code allowable wlthd 'ues for lumWr havins a maximum specific gravity of 0.47. I=:_�. i� ;�iZi>•fi[:1A�i#�I'7♦��ItIFD,��t1'.1•f�.��P.l��fi1'.>w I^'rG' L^_ '..Jl'�1♦�l��L'"1♦�11tE7��•)�If�11!t��f�ill7f�� 1•r•^.. w'-1. �.�fEt��rE�-�fE������il��t�-.4:,,EsF.•^�u�1� Rim r_-- ><*--+.�a>•ftE�>.l■s>�a�s�t�>,mlllE�urffEl�imrt►>rfE�■��►�wfl.r�fE�rsr L'3� �. u.^�t���•=t�FI� 1�F�t�ifT•'.•z��f���l� 1....�: L^ :1�=�l�fiE1•ft�l��l��)•f�51•�11�1.1�-� Vrn =. Wit":>ewL7f7 .•• faW7}'.301��LF�( '• 11111M NSM-'e>)rwvz!-���fib7ltiT F�Fi'1•� r? •:' P" ••'T.�ir�1!'�ItIR�iltll�t��>�Lri•OtBl�f•ti'.��7•�1!�� t.;L '.y.+7tTF�tif'tII�iRFF!�7�T�'�il?iZF���fF� i_ . ESA'' I.:.: 1!,; i;.Tip)•il�il:>�f�f��)�f�1•�L•1•iUi:7•ifl�fL'twl�Yi L"�,.:. �. r^I?t•E1L!.! rti.ZGF�t6 •�• �>•���*•7�i>•�iF7�SFzf7><:f7•TiJ How besrhv e 1. the number of plies required for the Gan -Larn been and calculate the ma dmum reaction. Y. th appropriate table for 1. 2 or-3 plies. 3. a length a maximum reaction that meets or exceeds your calculated value. 4. M lu the support Is eturally adequate to arty the reaction. Aramp . 2 lice 1V+a" Gang- m LVL with s reaction of 9200 lb. Selatfa : t w 3" beaftlength with a maximum reaction of 10710lb& 9. I 6 E ALLOWABLE ROOF LOADS (PLF) 125% NON -SNOW 17% 1 11i291i 1PhtihS3oli 1Ptytya11141Ph1P+211*A1 1PIy1Ks14 �fly1' 0 120 ss2 - 409 ON 722 608 722 a 7 lea 329 513 341 $17 US 2" 836 TI e 114 247 3bS 237 $14 418 278 557 of 3 95 191 217 tee 398 322 214 429 & 2 T6 150 133 tee 311 293 102 337 4; 0 60 120 1 7 123 240 203 135 270 S 3 49 lie 1N 101 203 165 110 220 2' 0 4o eo 125 e3 1e7 130 90 181 2 0 34 67. 104 70 139 113 75 161 1 2 29 68 65 69 117 95 54 127 1 • 60 t00 61 64 106 1 4 43 8S 60 46 03 1 627 74 60 40 60 1 �t1 22 64 52 35 70 `1T 25 58 46 30 61 um msArnttin lmifonn load tables: t the correet tasle for the beur. applicatlan eed. is the require beam span In the left column. t a beam depth from the tables that satisfies H the fire and I oW load PLF on the begin. k the bearing r iquirtInClIft as shown on pale S. I: Roof live lead 450 PLF. L/240 deflection EMIL al load 675 PLF.IJ180 dellection iinilt. pan 161. 04.115% snow lad cTry 2 piles l 4 x 11W. which can early: oad2x2U•19a450PLF ✓OK toad 2 tt 953. 706 a 67S PLF ✓ OK 12 482 05 742 $22 $44 419 742 668 211 817 891 CM 911 817 10e3 967 1093 967 IM31WV 967 128 1-9 11, 3W 28D C27 tie0 494 320 608 740 W TO 1173 NO 873101310 224 182 440 365 395 322 264 114 527 429 648 S27 432 351 677 03 708 732 645 624 798 732 923 846 9 7 160 125 30a 250 285 221 177 147 353 295 434 302 2gg 241 677 483 "S 540 422 WO S77 en 761 725 0 5 105 211 158 124 245 305 203 497 455 303 588 643 4 3 90 77 179 154 158 138 105 90 111 181, 259 222 1 148 $0 220 W Ul 258 221 816 442 S61 472 3 60 133 117 78 150 192 128 258 257 191 392 406 2 55 116 102 58 138 161 111 223 249 186 332 355 2 51 101 m 59 119 14e 97 105 215 145 291 311 1 45 a9 79 82 105 129 U 172 192 128 250 273 1 39 79 89 ae 93 114 70 152 170 113 =7 242 1 190 190 31 63 6 37 74 012t 135 18-01 M92 1 Notes: 1. All beam spans shmm are clear spans and do not include bearings. 2. 11use.tables are for simple spans (with a support at each end) or for continuous (multiple span) beltrlls if spans are equal 3. PLF values arc for a single ply of 1 tk• Gaag•laln WC • Double the values for two plies. • Triple the values (or three plies. *4. For 14.• x le" beam%and deeper, two plies (rltitllmtml) are requued. S. More than three pries may requbv "ciat design. Contact your LP engineered products distributor. ALLOWABLE ROOF LOADS (PLF) 115% SNOW P41%17% JP1y114291i 1Ph1K19% 1Pty1Y41IiY. Iptir itIV1 1P1y114t14 1Ph114s18 1 1'y.218 IIL WI lb• LIN Tao Live tae 1101 lJw Leae 1M11 tang Taal offeWa1 Lai DUfIYa! We leflw9u teal DafMcom Lug 941WN laY swum LW Uwe Dga•mMe IN Hato Lin 41 NIIa VIN LINO UM t11I0 U140 WHO dill LR41 utw WM LR4 Law tees L/7e0 was Wigs Llaaa tub 2 322 1226 554 430 43 W W8 400 743 043 753 724 7108 750 OW 933 953 1023 1023 877 1023 1232 128212a2 1049 16W 1211 1555 311 1568 1311 te6e 1558 808 BM 1008 15W 66S 665 810 010 810 877 977 ion 1060 47 111 320 613 242 387 998 37a 686 718 615 711 760 724 768 947 $47 647 1122 132 1132 1334 334 1334 M 124 247 US 257 490 415 278 517 640 462 640 AM 544 8M 638 US 838 990 998 998 1187 1167 1187 43 05 121 297 198 396 322 214 420 534 35a 57a 615 419 615 751 088 751 889 IWO 689 1038 IOM 103E 11 73 150 2W 15e 311 253 leg 337 420 230 519 494 329 559 $51 691 = W3 803 934 934 034 90 Co 120 187 125 249 203 135 270 SM 224 44a 396 254 499 523 432 623 722 545 732 849 649 849 73 49 lad 02 101 203 ta5 110 220 273 182 388 322 214 420 687 351 573 D73 524 873 778 747 778 60 90 83 le? 138 10 181 225 150 300 254 177 553 434 209 631 W 432 623 71e 815 715 80 .40 34 87 �25 04 70 In In 76 131 tee 12S 250 221 147 905 W2 241 470 540 3W $79 887 513 W7 42 28 60 Is 59 117 95 64 127 159 105 211 180 124 248 305 283 407 455 303 541 In 422 623 • ;70 50 100 81 64 104 133 90 179 158 105 211 250 173 346 357 250 492 651 W7 594 • 64 43 95 59 46 93 115 77 154 136 90 181 222 140 295 332 221 442 472 315 549 - 37 74 60 40 W t00 Oe 133 117 70 138 lag 128 2M 987 191 3a2 400 m 509 • e 32 64 52 35 70 87 se1 116 102 Oa 135 107 111 223 949 130 332 355 237 404 - 1 28 58 48 30 61 78 51 101 69 69 its 148 17 115 111 145 291 311 207 414 • - 87 4S 89 79 32 105 129 06 172 122 128 258 273 182 385 • - 69 39 79 e9 46 93 114 78 152 170 113 227 .242 181 323 • } - 53 35 70 82 41 e2 lot e7 135 151 101 201 213 142 297 • l I I 47 31 63 55 37 74 90 ISO 135 90 18o 102 lie 256 41 A gal4 33 e0 81 84 1 121 61 1 1 172 115 7W 7 i COUNTERFLASH I HANGING 'HEIOHT— XABLE "F." 10 CHANNiL ROOF; MNEL I r� TEK SCREW -------------- II I II , 9.767 — 7.159 — i i ra 6.175 x 2.500 ALUM. TUBE i 1..WAkied ."r46e.r REMOVABLE TOPWALL "F" SECTION 1/2" x 9 1/2" GANG —LAM POST "U" POST "N" L1Ja THERMAL INDUSTRIES, Brushton Ava.. Pitts rudd PA.npftu pepe.ty Of 7we..ut lwmunMe lse.. �t /r*ttoeMen t+.tiibtue GABLE RIDGE BEAM AND COLUMN FOR DS2000 3000 i°"n br-JAMI 0421 96 ' x 0.33 1.ou &woes. VARIES RBEAM.CWG ' 042000 11WO VARIES "�` The Commonwealth of Massachusetts Department of Industrial Accidents ON00011eresl/ISONs 600 Washington Street Boston, Mass 02111 Workers' Compensation Insurance Affidavit Inret inn•A 3 Wl/)rJ7Lvl L � - 0 E1 am a hotfeowner performing all work myself. 1 am a sole proprietor and have no one working in any capacity 0 lam an employer pro%iding workers' compensation for my employees working on this job. F i :......�nee CO. policy 0 I am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below'aho have the follo«in_,.%orkers' compensation polices: company name, address: city phone N- insunnccCo policy# address, phone N• Insurance co eoflty M JAI Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of s fine ap to SIAN.00 and/or oneyears' Imprisonment as well as civil penalties lathe form of a STOP WORK ORDER ands fine of S100.00 a day against me. f understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. t do hereby c ijy der the pa' it penalties ojperjury that the Information provided above Is true and eotreci Signature -Pate /� Print name h4nEhic oneA %--) oRcial use only do not write in this area to be completed by city or town official city or town: YARMOUT11 p check irimmediste response is required contact person: permitAicense N nBuilding Department pllcensing Board 261 ❑Selectmen's OMce phone M; pHealth Department _ i508) 398-2231 eat. bOther tmned 3A5 P1A1 Information and. Instructions Massachusetts General Lays chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied. oral or written. An enrpinrer 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 da 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 152 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. 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 haw 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 . affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are required to obtain a %workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The aff davits 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 Mce of Ilmsdil dens 600 Washington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone #: (617) 7274900 ext. 406, 409 or 375 TOWN OF YARMOUTH BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION PLEASE PRINT DATE -!� �\1�3 JOB LOCATION R of Cam,,, VJ NUMBER STREET "HOMEOWNER" PRESENT MAILING ADDRESS ECTION OF TOWN -7 I S-7A.S PHONE WORK TY OR TOWN II ST THE CURRENT EXEMPTION FOR "HOMEOWNER" WAS EXTENDED TO INCLUDE OWNER - OCCUPIED DWELLINGS OF ONE OR TWO UNITS AND TO ALLOW SUCH HOMEOWNERS TO ENGAGE AN INDIVIDUAL FOR HIRE WHO DOES NOT POSSESS A LICENSE, PROVIDED THAT SUCH HOMEOWNER SHALL ACT AS SUPERVISOR. (STATE BUILDING CODE SEC- 109.1.1) DEFINITION OF HOMEOWNER: PERSON(S) WHO OWNS A PARCEL OF LAND ON WHICH HE/SHE RESIDES OR INTENDS TO RESIDE, ON WHICH THERE IS, OR IS INTENDED TO BE, A ONE OR TWO FAMILY ATTACHED OR DETACHED STRUCTURES ASSESSORY TO SUCH USE AND/OR FARM STRUCTURES. A PERSON WHO CONSTRUCTS MORE THAN ONE HOME IN A TWO-YEAR PERIOD SHALL NOT BE CONSIDERED A HOMEOWNER, SUCH "HOMEOWNER" SHALL SUBMIT TO THE BUILDING OFFICIAL, ON A FORM ACCEPTABLE TO THE BUILDING OFFICIAL, THAT HE/SHE SHALL BE RESPONSIBLE FOR ALL SUCH WORK PERFORMED UNDER THE BUILDING PERMIT. (SECTION 109.1.1) THE UNDERSIGNED "HOMEOWNER" ASSUMES RESPONSIBILITY FOR COMPLIANCE WITH THE STATE BUILDING CODE AND OTHER APPLICABLE CODES, BY-LAWS, RULES AND REGU- LATIONS. THE UNDERSIGNED "HOMEOWNER" CERTIFIES THAT HE/SHE UNDERSTANDS THE TOWN OF YARMOUTH BUILDING DEPARTMENT MINIMUM INSPECTION PROCEDURES AND REQUIRE- MENTS AND THAT HE/SHE W�L CgTPLY WITi�A�D PPOCEDVP.ES AND REQUIREMENTS. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL INSURANCE COVERAGE: I have acurrent Insuran ❑ ce policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. es 0 NoIf you have checked Les, 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 Ma s. Gene ws. and that my signature on this permit application waives this requirement. eck one: Owner Agent ❑ Signature of Q�wner ar ers A nt Suggested Affidavit for Home Improvement Contractor Permit Application For Office Use Only Permit No. Date MGLe.14ZArequires that orconstruction of an addit to structures which are ad i requirements. NAME OF CITY/fOWN AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application be done by registered oontnaors, with certain exceptions, along with other Type of Work: ESL Cost Address Owner Date of rermit t%ppucauon: I hereby certify that:0 Registration is not required for the following rcason(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: Date Contractor Name OR: Registration No. Notwithstanding th a no , I hereby apply fora permit as t a owner of the above property: Date Owner a l94.33 t • n I AGREE AVENUE w 8{✓/DE - TOWN WRY n Z w'sro •. �89 R Y � C W 0. \\ +I IL i i d of 71 32.74 i or 1 \ 200,00 GGIN 60•6 / _Lu Lb. SKETcs/ PLf/-N `� L Bf7/ZBAQq K/RKP�'TR/C/� B9 ACaES s}Vf- /Y. yR2h7ovTn; nJ!{• SC.¢CE/'w=3o'-Oc7b8F2 /99Y J>7NN G. NFcuToN- R.G.S. - !.�! �4R�Ovld/, dlq• By r� u TOWN OF Y)" TH /j,—ad—�o40� � APPLICATION FOR PERMIT TO DO GASFITTING USE ONLY) By. Fee: $ off) - U U PERMIT NO. G -oI Date Building Owner's AT. Location v Name r 6o r� nrhraufli i Type of Occupancy New ❑ Renovation E3111 Replacement ❑ Plans Submitted Yes ❑ No ❑ N Y Z ¢ Uj �/5 �� cc yW o0m¢ I % Z�17� a m 0 X rn w W a o W aD, W 0 W z 4= M M W 0 W O W S= D: a M z a¢ m z o Z w 0 O N rj) w S w> oJc w LL 3 a J 2 a x 0 0 2 D G C7 V¢> c FW- O .11 SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company Name C. pf Zi skri / a .- A% Address f ir-/G Business Telephone I Name of Licensed Plumber or Gasfitter Check One: ClCorp. o y - 28y6/93 ❑ Partnership ❑ Firm/Company INSURANCE COVERAGE: Check One have a current liability Insurance policy or its substantial equivalent. Yes ❑ No ❑ If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check One: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent _ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Signature of Licensed Plumber or Gasfitter 7937 License Number TYPE LICENSE: 0 Plumber 11 Gasfitter Faster ❑ Journeyman ta �ji�1gq. TOWN OF YARMOUTH Application for a Permit to Build No. ` UPON FINALAPPROVAL 6 /-ao f / FEE MUST ACCOMPANY THIS APPLICATION. MAP / 3 LOT - tqZ DATE qT The undersigned hereby applies for a permit to build //;1 0/ 79 YName rding to the following specifications // of property owner ,"f -892 A PAT Q I c-/ <" TeI.�S�?dS Address 99 1A) QaAvrH,,_, i * Name of Architect (if any) Name of builder (z-zZz:�a-t,) Address 4. License No. Tel. 5. Name of Mason Address V cense No. Tel.nstruction address 'Sq �� fit— w 8. Date of subdivision Approval 9. Private dwelling ❑ Estimated Cost 10. Multifamily ❑ .30o a 11. Commercial C���� Q �O�✓/� 12.Other l•� �I 13. No. of stories 0 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. LOT RELEASED BY PLANNING BOARD Date Tel. i uwu RA zone Zone -F— DO NOT WRITE IN THIS SPACE I Type of room I No. 9;0 aC' WD a•--/� '' Kitchen Dining Rm. Living Rm. Bed Rm. Bath Deck Closed porc Family Rm. Sun room Garage Shed io X. No. of feet rear No. of feet deep No. of feet side No. of feet rear Ft. side Ft. side Rear From rear lot line T Side line YARMOUTH CONSERVATION COMMISSION NOTICE Notice is hereby given for the Request of Determination of Applicability I Mrs. William E. Kirkpatrick 89 Acres Avenue West Yarmouth, MA 02673 O C i 2 3 4ci // b7A" To construct a 10 x 15 shed at 89 Acres Avenue, West Yarmouth, MA in accordance with the plans filed with the Yarmouth Conservation Commission. Hearing on the above will be held in the Yarmouth Town Hall, Route 28, South Yarmouth, MA on Thursday, November 5,1998 @ 7:30 p.m. pnn E. MAGNUSON, CHAIRMAN CONSERVATION COMMISSION TOWN OF YARMOUTH 310 CMR 10.99 Form 2 Commonwealth ` of Massachusetts i ;auk i COPY I (ro b. ao.wd br DM City Town )LARMOUTH Applicant BARBARA KIRKPATRICK Determination of Applicability Massachusetts Wetlands Protection Act, G.L. c.131, §40 and the Town of Yarmouth Wetland Bylaw From Town of Yarmouth Conservation Commission Issuing Authority To Barbara Kirkpatrick (Name of person making request) Same (Name of property owner) Address 89 Acres Avenue, Address Same West Yarmouth, MA This determination is issued and delivered as follows: by hand delivery to person making recuest on (date) K: by certified mail, return receipt requested on November 9 , 1998 (date) Pursuant to the authority of G.L c. 131, §40. the Town of Yarmouth Conservation Commission has considered your request for a Determination of Applicability and its supporting documentation. and has made the following determination (check whichever is applicable): Location: Street Address 89 Acres Avenue, West Yarn Lot Number. I J42 1. ❑ The area described below, which includes all/part of the area described in your request, is an Area Subject to Protection Under the Act. Therefore, any removing, filling, dredging or altering of that area requires the filing of a Notice of Intent. 2. C The work described below, which includes alVpart of the work described to your request, is within an Area Subject to Protection Under the Act and will remove, fill. 1. dredge or after that area. There- fore. said work requires the filing of a Notice of Intent. Effective 2.1 ;• 3. ❑ The work described below. -which includes all/part of the work described In your request, is within the Buffer Zone as defined In the regulations. and will alter an Area Subject to Protection Under the Act. Therefore, said work requires the filing of a Notice of Intent. arts Determination is negative: 1. ❑ The area described In your request Is not an Area Subject to Protection Under the Act.' 2. C The work described in your request is within an Area Subject to Protection Under the Act, but will not remove. fill, dredge, or after that area. Therefore, said work does not require the flying of a Notice of Intent. 3. The work described in your request is within the Buffer Zone, as defined In the regulations, but will not after an Area Subject to Protection Under the Act. Therefore. said work does not require the filing of a Notice of Intent. 4. C The area described in your request Is Subject to Protection Under the Act. but since the work described therein meets the requirements for the following exemption,as specified in the Act and the regulations, no Notice of Intent Is required: '0�, ,lit, This Determination must be signed by a majority of the Conservation Commission. On this cS day of personally appeared AA e- e, 19 ?9� before me , to me known to be the person described In, and who executed, the foregoing instrument, and acknowledged that heishe executed the sam his/her tree act an deed. --- - — _ Sv.. e�— Notary Public My commission expires The DeMrmnsoon was not relieve Iris apphca t from Comdymg with as ofner 110e12ea23le I*Oef*L sate or 10C111 $tances, Onmar ces. tiWaws or regu torrs. Tft Defermnom still be vaw for lives yeses form the We of astrrmee. Tree appkntd•ttu owne4 any pwm aggrwved by tics Dstennuurion, anY owner of fares abtddnq tfte lane Upon VV a ft the trro0osed work into be aorw, or any an faidema of Ina my ortown in whkxt suer land is baud. are ne" naarso of Varr rim to furimthe Depan=fd Of Envftm=nW Praaebon to own a Superseding Deemnimeiat of ApOaDildX paviding ten request is muds by eertduo marl a nand delivery 10 the Departmsnf• with the aWapttate flung tee and Fee Tmnwv=W Form as provided In MO CUR t0.03(r) wkhm ten nays trap In ilea of biue ce of lids Deumdnation. A copy of the request WW at tru same urns be aril by Candied mail or nand delawy to trta Connrveiat Condnission and the appham 2.2A IC APPLICATION FOR PERMIT TO DO GASFITTING 1'I Tu (OFFICE USE ONL EC 19 2000 1 Il Bye Fee: $02© ~ t PERMIT NO. C— 0 12- Building AT. Location Al. ze 5 i New ❑ Plans Submitted Renovation Yes ❑ No ❑ Replacement ❑ Date 1 6d 12, 20o0 Owner's Name -&1ZK4/Fnew-L- Type of Occupancy LVELL/jl/C Cn 3 (n Y W rA rA ¢ UO ¢ Fes- N Q a J_ N W !R m ~ _ Cn cc Q 0 W XO Dp W =¢Z O y p i W=F Z W UL W~W ~ WQ Z W -1Q >- rA mO Z O SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company Name r ✓�F 66rLe ry �LG �Tr' Address X)tlr"bw o/.jlfz.c Business Telephone Name of Licensed Plumber or Gasfitter INSURANCE COVERAGE: Check One: [3,"C'orp. ❑ Partnership ❑ Firm/Company Check One have a current liability insurance policy or its substantial equivalent. Yes ❑ No ❑ If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check One: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent 1 hereby certify that all of the details and Information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Signature of Licensed Plumber or Gasfitter 1912 License Number TYPE LICENSE: 0 Plumber ❑ Gasfitter ICaster []journeyman Expand your living space... imagine Your Dreamspace n just days, your seldom used deck, patio or porch area can be transformed into extraordinary living space at a fraction of the cost of conventional construction. lY i'�iQ.Sti'�'lSz41• Mao 4 ,�, i :� " y � 1',�,�+ _�; '�Yy�• 'i.. 1./ter a Transform your backyard into a beautiful and comfortable "dream space" by incor- porating both a Dreamspace Enclosure and Dream®Deck vinyl decking system. Dreamspace Patio Enclosures provide a new area for family entertainment. A Dreamspace Enclosure with a cathedral roof adds height and elegance. ach Dreamspace Patio Enclosure has over 40 years of design and manufacturing experience by Thermal Industries, Inc. Custom designed to comple- ment your lifestyle and your home's architectural features, your Dreamspace will add to both the aesthetic and resale value of your home. Envision your Dreamspace... an affordable addition that lets your living space blossom, and enhances your quality of life. Custom -Designed Enclosures Complete your enclosure package with the Dream®Deck, Rail and Stair systems. Callonanroom ssociation Charter Member A Dreamspace Enclosure with Legance Patio Doors, glass transoms above, and a cathedral roof brings the great outdoors in' Professionally engineered and structurally tested, Dreamspace's extraordinary features include: ■ ENERGY STAR* certified vinyl windows and patio doors — It You'll have maximum protection against winter's cold and ..� i : V� — ..�� �`.-•s. summer's heat. Plus, outside noise is kept to a minimum. �r. MMOM, _ •... er► . _ . • • • • • • _1p wit • • ■ Polyurethane Thermal Breaks —All aluminum structural members in the roof and walls incorporate a thermal barrier, which inhibits the transfer of heat and cold from the outside to the inside. ■ Screen Room Conversion —Sliding window sashes lift out for h _ .dL! quick conversion to a screen room, allowing maximum ventilation, but no annoying insects. • • • • ■ Symmetrical wall and roof design —Proportionate to each • • other, the panels produce an architecturally pleasing enclosure. • , , ■ Thermocore roof and integral gutter —This roof system provides superior insulation, soundproofing and minimum maintenance. ■ Attractive exterior/interior color combinations and decorative wall coverings enable you to personalize your Dreamspace for your individual taste. ■ 3" rooms feature the new Legancel" II sliding patio door and our new easy -glide, sliding window. Ask you contractor to show you the wide variety of decorative options to personalize your DreamspacE. Enclosure with the DreamGlas• Sunshine Border pattern. Turn your backyard into a family recreation area. Comfort X -•�f RF" �►- �� :7 ► I y-Y ` . 43 ��zrrrr:ri its {1 • 1e�%� y elect from a variety of options to add beauty and comfort to your Dreamspace. Options include marquee or cathedral roof designs, DreamGlas® Gallery Collection glass accents, and a variety of interior wallcovering styles and colors that will personalize your Dreamspace while adding to the beauty and value of your home. Enclose an existing porch with a Dreamspace Porch Enclosure. A marquee style roof on this Dreamspace Enclosure complements the existing —,architecture. l Ar Aaaesnt+ . �- � �^'AAA �-rfc�_•..-.. �°�- `i�` .�J✓: i7;�� f� Ll j 1' ' IuS MG .i�� _ i •�"'�Err ]]]]�rrrr]r���l - 1 � � IFri- VI f` Without leaving the backyard! ci ts / The Commonwealth of Massachusetts Deportment of Public Safety BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Otitee Q Only hreic b. occupancy a roe crocked 3/90 (lea.e blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All Work to be performed In accordance With the Massachusetts Electrical Code. 527 CMR 12:00 (PLEASE PRINT IN INR OR TYPE ALL I2iF0R1 MON) Date a 9 39 City or Towa of Yo.r rel D %)+ I1 To, Insp of i es: The undersigned applies for a permit to perform *the electrical work r3be be w. fJ / Location (Street 6 Number) 8 9. /7 e res tAtp 1' Owner or Tenant l� p y-6 a ra. k Y�ts 4►- c �e Owner's Address Z� b 04-P 11 U 1 DIs this permit in conjunction with a building permit: Yes no ❑ (Check Appropriate Box) Purpose of Building S ke dY Utility Authorization NO. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service. Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity n /� Location ta�nd Nature of Proposed Electrical Work l r lvi t r1t %1✓4t ttie 0�1ar hancQ T�.ec�tl� FVo•vk }toJsQ (o rQ�llev tece�}c.l� I 1 u !tlw.PSw,Nk ovi� a/eeir,.ilro'� No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Fc»- 1,K Swimming Above In- 8 Pool grnd. ❑ grad. ❑ Generators KVA No. of Receptacle Outlets P i0 No. of Oil Burners No. of Emergency Lighting BatteryUnits No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones and No. of trot Devionices Initiating Devices No. of Sounding Devices NDetection/Slf oundingeDevices Local ❑ Municipal ❑ other Connection No. of Ranges No. of Air Cond. Total No. of Disposals No. of Heats Toms - ToKtaal No. of Dishwashers Space/Area Heating 0?, 5 KW No. of Dryers Heating Devices KW No. of Water Heaters KWNo, of o. o Ballasts Low VoltageSigns Wring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Li ilit Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES[NO [] I have submitted valid proof of same to this office, YES ❑ NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE BOND ❑ OTHER ❑ (Please Specify) tl3 iu ttxpi,atio a Estimated Value of Electrical Work $ / O O 0- Work to Start o? AY Inspection Date Requested: Signed under the penalties of perjury: FIRM NAME .rn Rough k,L Qo// Final Hl.// e.A LIC. No. /083 3 LIC. NO. E.21-/20 Addres . 2 (rid✓ ..e .Z73Pus. Tel. No.4F.23 0277 Alt. Tel.'No. OWNER'S INS CE WAIVER: I am aware that the Licensee does not have the insurance coverage or is sub- stantial equivalent as required by Massachusetts General wsa—L , and that my signature on this permit application waives this requirement. Owner Agent (Please check one) . Telephone No. PERMIT FEE S Signature of Owner or Agent 1 w e WIRE INSPECTOR'S DEPARTMENT YARMOUTH TOWN HALL SOUTH YARMOUTH, MASS. 02664 Fee V ' w. Name of Jo r � i Name of Electrician Location ate 0�4- ' e4 X�4v 31- F� yam\ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT .TO DO GASFITTING (Print or Type) Mass. Date Permit ell �� A Building Location E Owner's Name r 11/�sT VAType of Occupancy New ❑ Renovation Q Replacement ❑ Plans Submitted: Yes[] No ❑ 4, k i MEN MENIM MENIM tMENINMEM IN SitttMEMMIa■ 0 no MENEM MENEM -MENNEN�llll�llllii�������t�■ .. ARM MENEM���►���i/��ete���rt�■ Installing Company A ,.�.. Business Telephone ' ' Name of Licensed Plumber or.Gas Fitter t e F a rL6_ Check one: L� Corporation E3. Partnership p Ft m/Co. Certificate /&_4 5 INSURANCE COVERAGE: I have a curt liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you haves ecked ees. please Indicate the type coverage by checking the appropriate box A liability Insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:) am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General taws, and that my signature on this permit application waives this requirement Check one: Owner❑ Agent ❑ Signature of Dwner or Owner's Agent hereby certify that all of the details and information 1 have submitted (or entered) i e I n are true and ocurate to the best o1 my knowledge and that all plumbing work and installations performed under the perm ssued plication I b in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Ge / ' gy T of License: (\ %umber natur f censed lumber or Gas Htter Title Maef sterLicense Number City/Town Journeyman k+AaVm lONLY) PERMIT 38 1/20/99 1/20/99 LOT 342 Kirkpatrick, Barbara A. 89 Acres Ave. West Yarmouth, MA 02673 Shed 10' x 141• $3,000.00 r—HEET 13 `3 3v a l C)R AL-t4l, 7mrzots SlipGen. Portal Hare Town of Yarmouth Template [Building Dept] Slipsheet Identifier [sg34759] Document Category Building Permits Map -Block Number 024.2 Street Number 0089 Street Name ACRES AVE Department Building Parcel ID 634 Backfile Batch Scan No Document? Additional Naming Info Index Operator Operator, Yarmscan Date - Time 2015-07-27 - 08:30 ttWfiaserAchel?/SlipGerV Ut