HomeMy WebLinkAboutBLD-19-001765 o 'Y4R TOWN OF YARMOUTH Building Department CERTIFICATE OF
24- � (508) 398-2231 ext.1261 OCCUPANCY
(0A'.4 y PERMIT NO BLD-19-001765:
JAMES BELLEW
ADDRESS:280 ROUTE 28,WEST YAMOUTH, MA 02673 ZONING DISTRICT Bldg.Type:rCommercial
SUBDIVISION MAP BLOCK LOT 038.3 IBBUEILDING IS TO
REMARKS Use&Occupancy—Wholesale/Retail (tile,flooring, building -:plies)—
Occupancy is subject to all final inspections(508-375-51
'
s CERTIFICATE OF INSPECT • / �
DATE: /�'7• �, (1)BUILDING OFFICIAL. / �. � �
JAMES BELLEW BUILDING DEPT BY
280 ROUTE 28
WEST YARMOUTH, MA PHONE
i1S PERMIT CONVEYS NO RIGHT TO OCCUPOY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR
ERMANENTLY.ENCROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE
JRISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF
JBLIC WORKS.
CERTIFICATE OF OCCUPANCY
BUILDING INSPECTIONS APPROVALS
FIRE: OTHER
DATE: / 0 /2//Y DATE:
INSPECTOR: &(' c 1 INSPECTOR:
ELECTRICAL / i BOARD OF HEALTH
DATE: (D/� / ( 6 DATE: 9-2�- / &
INSPECTOR: /// INSPECTOR: `r Gea-20"0-
PLUMBING/GAS FINAL BUILDING
DATE: /0 // //c DATE: a / -
INSPECTOR: INSPECTOR: /! . 1
COMMUNITY DEVELOPMENT: DATE NAM
Cipro, Linda
From: Smith, Scott
Sent Tuesday, October 2, 2018 4:53 PM
To: Cipro, Linda
Subject: RE: 280 Route 28
Yes we are all set it was done Monday.
Thank you,
Scott A.Smith
Lt. Fire Inspector
Yarmouth Fire Department
From:Cipro, Linda
Sent:Tuesday, October 02, 2018 4:49 PM
To: Huck, Kevin<KHuck@yarmouth.ma.us>;Sawyer,Jon<jsawyer@yarmouth.ma.us>;Simonian, Philip
<PSimonian@yarmouth.ma.us>;Smith,Scott<ssmith@yarmouth.ma.us>
Subject:280 Route 28
Good Afternoon All,
Have you done an inspection at 280 Route 28 and if so may I sign off on the CO for you?
Thank you,
Linda
1
. ..of•Y"A BUILDING PERMIT APPLICATION
., . 2f ; ' 4o APPLICATION TO CONSTRUCT, REPAIR,RENOVATE, CHANGE THE USE,OCCUPANCY OF,
• • ' i •- + C OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING.
.. " . 111 _S Town of Mu• nouth Building Department
.`:•^, 1146 Route 28 • Yarmouth, MA 02664-1.192
Tel: 508-398-2231 ext. 1261 Fax 50$e398-0836 _rctC F f V F D
]Office U e Only n/ Planning Board Information Assessors Department Information:
PermitTO- / - OD"ate� Ran Type /1 1.
Endorsement Date 3F, to 21 2018 r ,i''
Permit Fee $ (Q0 ,...
Recording Date New 6UI� I t=
Deposit Recd. $ OD Date Plan No. 1.4 Property Dimensions: H9: —
Net Due „....$ --O — Other Lot Area(sl) Frontage(ft) Lot Coverage
This Section for Office Use Only
Building Permit Number./ p Date Issued:
Signature`/G / as /8 Certificate of Occupancy
ilding Official Date is Is not required
Section 1 - Site Information
1.1 Property Address: 1.2 Zoning Information:
'080 ate- aIs,WEST-YArt.Moa-n-1- MR- 0 73
Zoning District Proposed Use
1.3 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
• Required Provided Required Provided Required Provided
1.4 Water Supply(MALL e.40.S 54) 1.5 Flood Zone Information: Comment=
Public Private Zone: BFE:
Section 2- Property Ownership/Authorized Agent •
2.1 Owner of Record:
ScittlES V. 6EZ-LFI.l 08o erra8,t4Esrr4nnoyrM MR oac,73
Name 'ret) /A Mailing Address:
301(-376-- sit,o V j;mrnyebettea f;le. con-,
ature Telephone Telephone Email Address: /
2.2 Authorized Agent:
Hams(print) Mailing Address:
Signature Telephone Fax Email Address: I
Section 3-Construction Services
3.1 Licensed Construction Supervisor Not Applicable U
License Number
Address
Expiration Date
Signature Telephone Email Address:
1 of OVER
,
•
3.2 Registered Home Improvement Contractor. ,. •
►
Company Name Not Applicable ❑ '
a-
Registration Number ..'
Address
Expiration Date
Signature Telephone
Section 4-Workers'Compensation Insurance Affidavit(M.G.L.c. 152 S 25C(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application..Failure
to provide this affidavit will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes No
Section 5- Professional Design and Construction Services-for Buildings and Structures Subject
to Construction Control Pursuant to 780 CMR 116 Scontaining more than 35,000 c.f. of enclosed space)
Section 5.1 Registered Architect:
Not Applicable ❑
Name (Registrant): Registration Number
Address
Expiration Date
Signature Telephone
Section 5.2 Registered Professional Engineer(s)
Area or Responsibility
Name
Address Registration Number
Signature Telephone Expiration Date
Area of Responsibility
Name .
Address Registration Number
Signature
Telephone Expiration Date
•
Area of Responsibility
Name
Address Registration Number
Signature Telephone Expiration Date
Area of Responsibility
Name
- Address _ - -- - - - i- - - --- Registration Number -_ - - -
Signature Telephone Expiration Date
Section 5.3 General Contractor
Not Applicable ❑
Company Name
Person Responsible for Construction
Address
Signature Telephone
2 of 4
Section 6 - Description of Proposed Work(check all applicable)
New Construction ❑ (for multiple family only) No,of Brooms (for multiple family only) No.of Bathrooms
Existing Bldg. ❑ Repair(s) 0 Alterations Addition ❑
Accessory Bldg. ❑ Type Demolition Other Specify:
Brief Description of Proposed Work:
%O ENGA6E 1,4 TI+EB0Srr4CSS of P(codtv,4(, WHOt.E5ACE AND CZETf91C.
Tit.E, Fcootzl,JG, Butc ,4c PRoDucrs ArJD SuPPMES/v.'TA /S55ocAAlto AUT) _ ✓
Ac[essnay tLSES, Arta At-c- oTHErZ Cccxo-DS &JD SE12VICES ,40 bEarn L.
THEtZE TC) .
Section 7- Use Group and Construction Type
Building Use Group(Check as appticapable) Construction Type
A ASSEMBLY ❑ A-I ❑ A-2 ❑ A-3 ❑ 1.4 ❑
A-4 ❑ A-5 ❑ 18 ❑
B BUSINESS ❑ 2A ❑
E EDUCATIONAL ❑ 29 0
F FACTORY ❑ F-1 ❑ F-2 ❑ 2C ❑
H HIGH HAZARD ❑ 3A ❑
I INSTITUTIONAL ❑ I.1 ❑ 1-2 ❑ 1-3 ❑ 39 (3M MERCHANTILE 4 ❑
R RESIDENTIAL ❑ R-I ❑ R-2 ❑ R-3 13 SA ❑
S STORAGE ❑ S7 ❑ S-2 ❑ 59 le
U UTILITY ❑
SPECIFY: •
M MIXED USE ❑ SPECIFY:
S SPECIAL USE ❑ SPECIFY:
Complete this section if existing building undergoing renovations;additions and/or change Ili use.
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34 Proposed Hazard Index 780 CMR 34
Section 8 Building Height and Area •
Building Area Existing(ii applicable) Proposed
Number of floors or stories
Include basement levels
Floor Area per Floor(sf)
Total Area All Floors (sf)
Total Height(ft)
Section 9-STRUCTURAL PEER REVIEW (780CMR 110 11)
Independent Structural Engineering Structural Peer Review Required Yes No
SECTION 1 Oa OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
i ZAr'1ES V. SELLei , as Owner of the subject property,
hereby authorize to act on
/✓ my behalf, in all ma rs relative to work authorized by this building permit application.
aos(PaciTs
Sign (Owner Date
3 of 4 OVER
SECTION 10b OWNER/AUTHORIZED AGENT DECLARATION
j, JAMES V. 6EL4.-E`4 , as Owner/Authorized Agent -..
hereby declare that the statements and information on the forgoing application are true and acurate,to
the best of my knowledge and belief.
J Signed under the pains and penalties of perjury.
SAMEs 14 66CLL'AI
Print Name
/77./a--- I9SEP dot�
Sign of Owner/Agent Date
action 11 -ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be
• completed by permit applicant
I.Building •
2.Electrical
3.Plumbing/Gas
4.MechaMcal(HVAC)
- S.Fire Protection
6.Total.lt+2+3+4+5)
7.Total Square Ft.(know smca.w I.meael
Check Below
❑ Conservation-Commission Filing
(if applicable)
❑ Old Kings Highway&Historical
Commission approval
(if applicable) •
•
4 oto
• The Commonwealth of Massachusetts
_�_ Department of Industrial Accidents
t
•=>itl.=` Office of Investigations
- —_la— 600 Washington Street
='tit Boston,MA 02111
.www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): aaLCNN) -rt I..if t Ail PQ(3LE
i Address: a $O RTE ail
City/State/Zip: iNte-sr ypamet,-H JHAioa673 Phone#: Sols- 37 S- Si 00
Are you an employer?Check the appropriate box:
I.0 I am a employer with 4. 0 I am a general contractor and I Type of project(required):
employees(full and/or part-time).* have hired the sub-contractors . 6. ❑New construction
2.0 I am a sole proprietor or partner- listed on the attached sheet 7. 0 Remodeling
ship and have no employees These sub-contractors have g. 0 Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp.insu ance.t 9. 0 Building addition
required:] 5.igi We are a corporation and its 10.0 Electrical repairs or additions
3.0 I am a homeowner doing all work officers have exercised their . 11.0 Plumbing repairs or additions
myself [No workers'comp. right of exemption per MGL 12.0 Roof repairs
insurance required.]t c. 152, §1(4), and we have no
3a.0 I am a homeowner acting as a employees.[No workers' 13.r4 Other Remit. (pc-Co
general contractor(refer to#4) _ comp.insurance d].
.Any applicant that checks box#1 must also fill out the section below showing their workers'eompensatiolimlicy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside eonaacton must submit a new affidavit indicating such. . .
tConttactora that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site
information
Insurance Company Name:
Policy#or Self-ins.Lie.#: Expiration Date:
Job Site Address: City/State/Zip: '
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
• I do hereby certrfy under the pains
penalties of perjury that the information provided above is true and correct
/ Sinnatu re / Date: ,a0 SET a0l Ff
✓
Phone aSoIS- 3D Se S/00
•4
Official 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):
1.Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions � �'
Massachusetts General Laws chapter 152 requues.all employers to provide workers'compensation for their enployeed:
is defined as"..-every person in the service of another under any cart of hire,
Pursuant to this statute,an employer , . , .
express or implied,oral or written."
corporation or other legal entity,or any two or more
An spicier is defined:s"an mdividtial,partnership,association, 'P°i'h of deceased employer,ere the
of the foregoing engaged in a joint enterprise,and inohrdfng the legal rep teen ativa
receiver or tastes of an individual,partoasbip,association or other legal entity,employing employees. However the
owner of a dwelling house having not note than este apartment:and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, ¢25C(6)also states that"every state or local Ikendng ageacy shall withhold the Unmet or
renewal of a!kens or permit to operate a burins or to construct',unclasp la the consmoawalth for say
applicant whe has not produced acceptable evidence of compliance with the insurance canine required."
Additionally.MGI.chapter 152,§25C(7)states"Neither the commonwealth nae any of its political subdivisions shall
of public work until acceptable evidence of compliance with the t nxa e
enter into any this chapt ttheve been pre the authority."
requirements of chapter have been presented
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your titration and,if
necessary,supply sub-contractor(s)name(s),address(es)and phoos numba(s)along with thea certificate(s)
fthat the
insurance. limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with m employees
other members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have
-employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
' Accidents for confamadon of insurance coverage. Abe be sore to sip 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 qucatioos regarding the law a if you are required to obtain a workers'
compensation policy,please call the Department at the mamba listed below. Self-insured companies should enter their
self-insurance license umber on the appropriate line.
City or Town Officish
Please be sure that the affidavit is complete and printed legibly. The Department has provided i space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an app&sat
that mist submit multiple perffitllicense epplicadoos in any given year,need only submit one affidavit indicating current
policy info:motion(if necessary)and under lob Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit teat be filled out each
year.Where a home owl err or citizen is obtaining a license or permit not related to any business or commercial venhre
(i.e.a dog license or permit to burn leans enc.)said paean is NOT required to complete this affidavit
The Office of Investigation.would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give to a calls
the Department's address,telephone and fax camber:
The Commonwealth of Massachusetts
Department of Industrial Accidents
OEIIa of Investigations
• 600 Washington Street
Boston, MA 02111
Tel. 11617-7274900 ext 406 or 1-877-MASSAFE
Fax k 617-727-7749
Revised 11-22436 wwv- .gov/dia
'orY" . TOWN OF YARMOUTH
-C" ''* at e C BUILDING DEPARTMENT
�, I $. 1146 Route 28,South Yarmouth,biA 02664
• 6;,�, 508-398-2231 ext. 1261 Fax 508-398-0836
BUILDING DEPARTMENT
DEMO ► ITION DEBRIS DISPOSA AFFIDAVIT
Pursuant to M.G.L. Chapte A 0, Section 54 and 780 CMR, Ch. . r 1, Section 1113,
I hereby certify that the debris re . ting from the proposed • ork/demolition to be
conducted at
Work Address
Is to be disposed of at the following loc.ti. i:
Said disposal site shall be a licens solid waste :cility as defined by M.G.L.
Chapter 111, Section 150A.
Signature of Applicatio I Date
Permit No.
°r Tf''; TOWN OF YARMOUTH
.. ... oz nog* y BUILDING DEPARTMENT
E, t 4 1146 Route 28,South Yarmouth,MA 02664
iv 508-398-2231 ext. 1261 Fax 508-398-0836
BUILDING DEPARTMENT
DEMOLI ON DEBRIS DISPOSAL AFFIDAVIT
Pursuant to M.G.L Chapter 40, ection 54 and 780 CMR. Chapter I, Section 1113,
I hereby certify that the debris resul t g from the proposed work/demolition to be
conducted at
Work Address
Is to be disposed of at the following locati a :
Said disposal site shall be a licensed solid wast- acility as defined by M.G.L.
Chapter 1II, Section 150A.
Signature of Application Date
Permit No.
• •o'- TOWN OF YARMOUTH
s c HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: Q$O 'RTE as , VJE$T YARMOUTH M aG73
Proposed Improvement: OSE AND OCCOPf}'JC y - Permit FLoolzi46 SToRE
Applicant: ;JAMES BEIEvJ - SELLevjti .EtrMAR6LE Tel.No.: 508.375-6-1oo
Address: ol$6 RTE d8 , WEST YARMo0TH MA 0a(273 Date Filed: ,QosEPaoI$
**Jfyou would like e-mail notification of sign off please provide e-mail address:
Owner Name: 5AM ES V. 6 EL L Ev%)
Owner Address: a vJOLF HILL R b EAST Snamed Ic MA Owner Tel. No.: 508-315- S100
oa573
RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements
For Septage Disposal and other Public Health Activities.
Please submit three (3) copies of plans, to include:
(1.) Site Plan showing existing buildings, water line location,
and septic system location;
(2.) Floor plan labeling ALL rooms within building
(all existing and proposed) -
Note:Floor plans not required for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY: 062 E cy aawtasi,D. DATE: ZI-18
PLEASE NOTE
C M ENTS/CONDIpQNS: 1
C�4- 74 (JOYS-. 1--0 k Gnc( be-7 fie!
ore e
4-erects L-1cCnse pride' TG Stc-e even ins;
MGL AND FIRE
1 TOWN OF YARMOUTH
REVIEWED FOR CODE COMPLIANCE.
fit 414
' / ERRORS OR OMMISSIONS DO NOT RELIEVE
��i THE APPLICANT FROM THE RESPONSIBILITY
OF"AS UIt7"COMPLIANCE.DATE: 4.14 ` 0-ld
C-A-rj eC fAi--
INSPECTOR
YARMOUTH FIRE PREVENTION
New Business Transmittal
Project Name: Bellew Tile and Marble Address: 280 Rt. 28
Contact Name: James Bellew Phone: 508-375-5100
Y N NA Subject Regulation
ES 0
X Building Numbers MGL Chapter 148;sec 59
X Fire Lanes 527 CMR 1;22.3 _
X Extinguishers 527 CMR 1; 13.6,Chapter 148;sec 28
X Maintence of any equipment,system relating to 527CMR1 1.1.4
Fire Protection.
X *Hazardous Materials Storage 527 CMR 1;60.1
X Emergency Plan Required 527CMR1 10.9.1
X Commercial cooking,Hood systems _ 527CMR1 50.2.1.1
X Commercial Cooking Hood Systems Cleaning 527CMR1 50.5.4
X *Commercial Cooking Extinguishment System 527CMR1 50.4.3
X *Candles,open flames,and portable cooking 527CMR1 17.3.2,20.1.1.1
X Blocking electrical panel 527CMR1 10.19.5.1
X Blocking exits 527CMR1 14.4.1
Extension cords shall not be used as a 527CMR1 11.1.7.6, 11.1.7.1
X substitute to permanent wiring
X Limit storage heights to 24 inches below 527CMR1
ceiling without sprinklers 18 inches with
X Maintain Aisle width of 36 Inch's(3 Feet) 780CMR 1101.1
X Storage inside/outside Buildings 527 CMR I; 10.19.4,4.4.3.1.1,19.1.2,34.1.1
X The right to inspect MGL Chapter 148 Sec.4
X *Upholstery 527 CMR I;20.6.2.5
X *Trash Containers 527 CMR I; 19.1.1, 1.12
X Any Hazard to the Public Chapter 148;sec 28
X *Curtains,Draperies,Blinds 527 CMR 1; 12.6.2 _
Description of planned project/other requirements:
The YFD support the application, subject to applicable submissions, permits
and inspections.
A Permit from YFD is required any time a fire protection system is shut down.
* YFD permit required-depending on occupancy and submittal
Plan Reviewed By: Captain Kevin Huck Date: 09-20-2018
Copy for Applicant 0 Copy to Building Department II Copy to Fire Prevention
Entered in Firehouse I—I Final Inspection
•
280 RTE 28
West Yarmouth
. SITE PLAN
$qre Or 1 SRrxaooi t a -
‘ _on / .
UNOCCUPIED $*IIS __/
STORAGE HRER FO'll vJAQENousE
, \
_/ odtR FLO ,J
SToRAGE
-/ \
�/
N
SHOWROOM
UNOCCUPIED
SPACE l
rt -
` IT Rooat '4TORAGE SHoN1Roo,H
Okra Room
—_, /
uNOcCuPIED t/ ._ �M lfl�.
SPACE .
RTE a$