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HomeMy WebLinkAboutBld-19-007167 0f•Y.yR BUILDING PERMIT APPLICATION • • 2� 4 APPLICATION TO CONSTRUCT.REPAIR,RENOVATE,CHANGE THE USE,OCCUPANCY OF, 3 G OR DEMOLISH ANY'BUIL PING OTHER THAN A ONE OR TWO FAMILY DWELLING. 'itTown of Yarmouth Building Department FCc 60a' 1146 Route 214 • Yarmouth. NIA 026t34- 492 — Tel: 508-398-231 ext. 1261 Fax 508498-0836 _ 1, � ,i baud irttorination Assessor;Department lnronrutiorc Pe D Endorsetneri ate Date 5 1 / 9� Permit Fee $ �- /� 'Aetro�11te New• Deposit'Rec'd. $ V Date Plan I�. 1.4 property Dimensions:Net Due $ Other Lot Arm{sf) Frontage(ft) Lot Coverage • This*lion for Office Use Onli Building Permit Number; Date �� • Signature: G' ,� -/5 c of O ,clr. Building Official Date is !Pe F C F greraV fl Section 1 - Site Infarrnatiort ,.l Property Address' 1.2 Zoning Inforrnalionw JUN 1 2019 4q Q erg Zoning District By I 4 P y 1.3 Iuildimp Satanic*:(ft) • 4. Front Yard Side Yards • Rear Yard. Required Provided Regired Provided Required Provided 1.4 Water supply pM.O.L.o.40.11 54) 1s Rood]done Information CommodeA. Pt tic Private Zone._.- BFE Section 2- Property Ownership/Authorized Aient a1 Owner of Recor* W,yo,yynokA -. 0 . Al .it i I I"ri 41old i 417_ fl'kiin sS-. ry-rtcv 03.611 NI pr gr i Maling Address: Signs. Telephone 1 Telephone - / Email Address; 2.2 Authorized Agent 'f't 1 tEC — b '-i- B.= Ce PO. box 1 ch rn • y�,� • c2ar 41 `,r-1. 5•• 2- Q ` 1. , ignature Telephone Fax i Email Address: . Section 3-Construction Services ex.'oUr ( eck,r4 oOUr.Ov. 1.1 Uceosed C Superclean Not Applicable .11199cU 1 iZpbt # G, {•.. u.e-C... ?i,9. EQC I5� iw i ck lAir 6ZLh 4c Ucense Number "lo- 4 ser. 41 Ltu'1 rC OtYeDYO X CA:pir abort Date . Email Address: : .: 3.2 13100011rild Home Improvement Cam:I _ . Not App1C&blS 143_` ti *' y 4 Insurance Affidavit(M.C.L c 152 S 25C(6) ilitiscetvireol7IpOisation Insurance affidavit must be completed and submitted with this apprication. ,Fltikirt to.;�; .~it will result in the deripl of the issuance of the budding permit.` Signed Affidavit Attached Yes le No 'Section 5—Profesidonid Design and Construction Services-for Building and Structures; ject fa Construction Control Pursuant to 780 CMR 116(containing more than 35,000 c.f.of eridosed space) Sian 1 - .,-., , ...Architect Q Address Expkadari Dale Telephone i Nash flegistralloaltrember :. Telephone Sitreition Date ' 1Pavia c1 naao ty Ftegarralart tii,111Sorrr T.Nptaxu ' Address tion Elignottne Telephone _ Ara d' - Address 1 Telephone Expkasoe Des S on 5.3 General Contractor r j � t • Not Apialicable Cor on .O<, "• [` . tI.YVwtG�. t A O2t¢44 O Signature i j Telephone i 5w ;*7 .. - ° . = Section 6- Description of Pro Work N Posed (ctlegk appisat�bb) • , New Construction ❑ (tor mul iple ton*amyl No.of Bedrooms (for mutt le family only) No.of Bathrooms Existing Bldg. ❑ Repair(s) CI Alterations ❑ 'Addition Accessory Bldg. ❑ Type Demolition ft . Other Specify; Iitrili Brief Description of Proposed Work _ V r ''' " ‘ Ptfz2Er Of 3iduihScUn9ik U geirAAYN an plan ?XAk o. ,'U Section 7- Use Group and Construction Type - Building Use Group(Chedc as*Pp Construction Cetrut Lion Type • A ASSEMBLY ❑ A-1 ❑ A-2 ❑ A-9 ❑ 1A CI A-4 0 A-5 CI 1B B BUSINESS ❑ 2A ❑ E EDUCATIONAL ❑ as ❑ F FACTORY ❑ F1 Q F-2 02C O H HIGH HAZARD ❑ 3 I INSTITUTIONAL ❑ I-1 p 1-2 cl 1-3 a 3s ❑ M MERCHANTILE ❑ 4. I] R RESIDENTIAL ❑ - R-1 ❑ R-2 ^. R-3 p S STORAGE ❑ 8;1 S-2 p 513 0 U uTn.ttY ❑ M MIXED USE ❑ SPECIFY S SPECIAL USE ❑ I Complete this.section If existing budding undergoing:renovations,adder andku Change in usf-I Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34 Proposed Heard Index 780 CMR 34 Section 8 Building Height and Area , Building Area Existing 1 aPPNcable) ` Proposed Number of floors or stories include basement levels Floor Area per Floor(sf) Total Area An Floors(sf) Total Height(it) Section 9-STRUCTURAL PEER REVIEW(70OCMR 110 11) Independent Structural Engineering Structural Peer Revue sr Required Yes ... No....---- SECTION 1 Qa OWNER AUTHORIZATION-Tb BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT_ I. lilt)(Aid Oil - ,as Owner of the subject property, hereby authorizeV41/1 -L&.& i. ViçjrLto act on my beh ' Ai)_ _ti a to work authorized by this building permit application. Signature of Owner to . C TtON;lOb OWNER/AUTHORMID AGENT DECLARATION .. - - -- '-'----s`41/114, f",,,ii,_ ,, a b a 1 Z.-- t (\ill('tI as cedArrr hereby the staff and.information.ol l�the'forgoing applic ation are trt�el d .10 r the--�` 'my-&t'ortedge and 6e . Vigned under the pains and penalties of perjury. , ..,. .'-':-.:I...,. ',,Ut.i....-.,;.1,;.,..t..01/11y_ _, iotii( s \ -- ..,,,..,-,..,;, .-,...; -.,.,--,..,,-. , , .,. . , rA,,. , . .. . . . . ... , .„. . ... . , . _ . . ,.. . . , . , ‘-- - ii,),G _ ot,.- ii i .,. ... .,,:.:.__ . ..........,,.... . . . sgrimo.i.. Dn. Section 11 ESTIMATED CONSTRUCTION COSTS Item r Emnierid cost(Calais)to be r bY a a Pluilitikig/cas v_ &Fire?rateclbn 0.Tixal.(1+2+3.4.5) 0-1 d C. ,„/)�� 7.To R.Seises iYrwir eM 4 1pep Chest Below Q tt'lliibriCal C«nmaio icl approval . • • • The Commonwealth of Massachusetts r , Department of Industrial Accidents " I= 1 Congress Street, Suite 100 �t;E= Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/IndividuaI): - '-00c CO . +fl Address: TS).* i"0 City/State/Zip: c�phone#: CPOIC5c432--Q3O • Are you an employer?Check the appropriate box: / Type of project(required): ` 1.1 Iyam a employer with \�Omployees(full and/or part-time).* (777"' 7. El New construction 2.1:1 I am a sole proprietor or partnership and have no employees working for me in ca ac 8. Remodeling any p ity.[No workers'comp.insurance required.] 3.E I am a homeowner doing all work myself.[No workers'comp. insurance required.]t 9. demolition 4.0 I am a homeowner and will be hiring contractors to conduct all work on m YPPAY•ro I will10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet These sub-contractors have employees and have workers'comp.insurance? 13.0 Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.0 Other 152,§I(4),and we have no employees.[No work rs'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors 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:Q ac .._cC Policy#or Self-ins.Lic.#: C)pA Oa0 -1-iS` Expiration Date: V\ 1, '7 O) Job Site Address: 42 O--\e City/State/Zip:U- {rn Ma-p uq-7Q3 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment, as well civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of atement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u e the its a penalties of perjury that the information provided above is true and correct. Signature: Date: 011119 p Phone#: ��� ` f Z'oe�Y`� 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#: RECEIVED •0t=YAit TOWN OF YARMOUTH 4c HEALTH DEPARTMENT �lU►� 172019 ,t' HEALTH DEPT. PERMIT APPLICATION SIGN OFF TRANSMITTAL To be completed by Applicant:Building Site Location: vg02 `%sere 28 C{.1/� -1--.✓ A v-� t e �c, -e(— l Proposed Improvement: ',DEMO/ i& u/( u iAY by /c - .gad-6Rr :T Applicant: C-'z Tel. No.:`j ) -�c3�- 30 Address: )7 ' 91�Es 71). M1C&)1c1'/ Me, Date Filed:,JV/1' /q **If you would like e-mail notification of sign off,please provide e-mail address: Owner Name: 7V L.b j, S Owner Address: i7L MVP) ,cc. i. y4 a>134 /144`4_ Owner Tel. No. 3&- Z.8O .0(067 r 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: 9& \12 , DATE: 17 f 7 PLEASE NOTE COMMENTS/CONDITIONS: i itip C e- c 'FG w k -e - , /4-•, K,tt u1 v)o vV ci h X14-7; S I A-ICI - Z(/ 611 \v`k. Fri ( / �l /y /ct e__ To Cvwy� , u_ O j 5 L -(_ • og•X TOWN OF YARMOUTH ° BUILDING DEPARTMENT 0 „ w+�, 7 1146 Route 28,South Yarmouth,MA 02664 508-398-2231 ext.261 BUILDING DEPARTMENT • TOTAL DEMOLITION SIGN-OFF FORM State Building Code(780 CMR)Chapter 33,Section 3303.6-Service Connections "Before a building or structure is demolished or removed, the owner or agent shall notify all utilities having service connections within the structure, such as water, electric, gas sewer and other connections. A permit to demolish or remove a building or structure shall not be issued until a release is obtained from the utilities, stating that their respective service connections and appurtenant equipment, such as meter and regulators, have been removed or sealed and plugged in a safe manner." "All debris shall be disposed of in accordance with 780CMR 111.5." Building or Structure Location: 140Q 2.fZZ Map: Lot: Owner's Name: Address: Phone: Contractor's Name: Address: Phone: Eversource: Date: Ni By: f l mo o° Title: C % National Grid: Date: N / By: Title: Water Dept.: Date: By: Title: Board of Health: Date: 6 / 3 ( 1 � O''`c 1 Tt1ea7 o-f` Ca� t?`( `� aa T- Condition: ` 'I�`� ) �" ~�`�a Fire Dent.: _ Date: & (/1 By: / tied fe ft4 vt'/Or-es- Title: few Historic Commission: Date: h By: N/ Title: Conservation: Date: N\By:. Comeast: Date: 3/15 MP= REILLY ELECTRICAL CONTRACTORS,INC. 110 Old Townhouse Rd.-So. Yarmouth,MA 02664 508-771-2040•888-GO-RELCO•FAX 508-760-1425 July 9,.2018 Mr.Joe Marrama Cape Cod Family Resort 518 Rte.28 West Yarmouth,MA 02673 Re: Cape Travelers Motel Bldgs.Demolition 492 Rte.28 West Yarmouth,MA Dear Joe, All power, telephone and CATV services to the existing four rear housing bldgs., Rms. 5 thru 30 and pool house at the rear of the property have been disconnected in their entirety. From an electrical and communications systems standpoint it is safe for the demolition and removal of the subject structures. Please consider additional utilities such as water, sewer and gas as well as contacting Dig-safe prior to demolition and excavation. Should you have ay questions and/or concerns,please do not hesitate in contacting me at any time. Yours Truly, Scott 14444.44 Scott A.Ventura Director of Operations Ltr.Cape Travelers Demo Electrical Contracting•Design•Service&Maintenance g n i yam' � a TE f `.# -1 'V O I CV , i ,ifig- = i!- �''.- • rGiu '[ '_. d m u o tam% •;',, i4.4 '-'' 'i — /o 6 : T., 2 d , .:. , , to . d ;ro 4 CJ C N }— 1p :I � k s . j_ ' fi t ads t ^! i i s ti " 1 8 QS ,;� s� f ' ` _,rayF� ""''4„;.- ad ,Ya .a • s s ' .{e 'a �h ;„ 0* 9 '- i . '`' -`Y 67) it va T 6 • 0 ' .� TOWN OF YARMOUTH BUILDING DEPARTMENT 0 o "54j q 1 146 Route 28,South Yarmouth,MA 02664 ' 508-398-2231 ext.1261 Fax 508-398-0836 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR,Chapter 1,Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at ;"[ qc:49 71 (� Work Ad ress y Ocd ce,b2-t _ Is to be disposed of at the following location: COnufeek db-iai 4 Said -hoboe--- ' (A2- disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter III, S�5OA. Che 41/14, q Signature , itfl1 licati ler Date Permit No. • � O tto�sa ms • plsmmn«m«#sn mm . ) Board m��ll0andkA&mm , �n ¥� �r i s0 0322 } C54271 ` ^ § y . p GmL o R S\ i \ _2 H�RICH M p2. \ / % } 'y%r - } Cmm.smnr � . . § . �v:mom . . ...og•x TOWN OF YARMOUTH $ BUILDING DEPARTMENT I,#�,�4. 1146 Route 28,South Yarmouth,MA 02664 508-398-2231 ext.261 BUILDING DEPARTMENT TOTAL DEMOLITION SIGN-OFF FORM State Building Code(780 CMR)Chapter 33,Section 3303.6-Service Connections "Before a building or structure is demolished or removed, the owner or agent shall notify all utilities having service connections within the structure, such as water, electric, gas sewer and other connections. A permit to demolish or remove a building or structure shall not be issued until a release is obtained from the utilities, stating that their respective service connections and appurtenant equipment, such as meter and regulators, have been removed or sealed and plugged in a safe manner." "All debris shall be disposed of in accordance with 780CMR 111.5." Building or Structure Location: L f\ 2..vZ< Map: Lot: Owner's Name: Address: Phone: Contractor's Name: Address: Phone: Eversource: Date: NJ � By: / Title: National Grid: Date: N /�� By: Title: Water Dept.: Date: C'Ai IA T 'i By: 6 4,2j bOG A/rde /r p Title: ' 0 �Z U!� Art' C /G'` MT Board of Health: Date: 6 / 13 Ii G? 1 v L I) ` A c d. e fk' "...i.,`i i By: cZ v Cr (1,e& 0.71— Title: Condition: Fire Dept.: . Date: (J� //9 By: //! e frf( fd /144 7 G, Title: c i,L.e 4. Co.Z .-,.. t..4,/i s c__ Historic Commission: Date: N/0 By: Title: Conservation: Date: N//By:. Comcast: Date: I� 3/15 ` YARMOUTH WATER DIVISION 99 BUCK ISLAND ROAD WEST YARMOUTH, MA 02673 PH.: 508.771.7921 FAX: 508-771-7998 BUILDING PERMIT APPLICATION DEPARTMENTALP� SIGN OFF TRANSMITTAL SHEET Bldg. Site Location YZ?✓/F &' >fl7c,s1(1..!,-7f Map #: Lot #: Proposed Improvement: ,)/L�/,W; _/ EM a Applicant:�l ,s6-/LT a.)jc_ 03. C�c19r'd✓ xi) Address / ,- ,cii ivy, Tel. #:_toP Y, ,i.o f6 Date Filed: /r'`Jv,j /f. L. -� Abb + . RESIDENTIAL AND / OR COMMERCIAL BUILDING Water Department: Determines Compliance of Water Availability and or Existing Location Engineering Department: Determines Compliance for Parking and Drainage Conservation Commission: Determines Compliance to Wetlands Acts; i.e. If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Ocean, Bogs, Bays, Marshland, Etc... Health Department: Determines Compliance to State and Town Regulations, i.e., Requirements for Septage Disposal and other Public Health Activities Fire Department: Determines Compliance to State and Town Requirements for Personal, Safety, Property Protection;, i.e. Smoke Detectors, Sprinkler Systems, Etc... Signa ure o app cant Date PLEASE NOTE: COMMENTS: 6�7 �� Revi ed'Gy: Water Divisio Date • o-1-YA - TOWN OF YARMOUTH • ' BUILDING DEPARTMENT i^' ��. 1146 Route 28,South Yarmouth,MA 02664 ` ' O%.,:.3 g 508-398-2231 ext.1261 Fax 508-398-0836 • BUILDING DEPARTMENT • DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Chapter 40,Section 54 and 780 CMR,Chapter 1,Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 4 �� I �L.,IWork A1.7, (-19 ess Y C)C-F de -i f taxwi ch 1Ycu scor 3- &3 . Is to be disposed of at the following location: COfl( XL debiaI- 4-0 _ Ne,-\-- B - of2--- cep.. Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Se�ction.450A. . 4�_ 111, tIP, &,-- 12-/ - - q Signature i���.licati r n Date Permit No. . ,�, TOWN OF YARMOUTH s, J A.c HEALTH DEPARTMENT „ , PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: c �r ���C� Building Site Location: �qa 28 v - � � U Proposed Improvement: -JLu 1c /R /6"--5J/GlAg Applicant e . OUg. 61)_,_7"ALO . Tel. No.:L.5 40 8 -(43op-( 30 Address:? G 'C9rJESt6 ) 6. /444.),tW , Date Filed:E�Un) /q **Ifyou would like e-mail notification of sign off,please provide e-mail address: Owner Name: 1d /- L.A/,,t r'S Owner Address: '7L /')'w/� ,f�. I . y474410,1114 /144- Owner Tel. No. a- Z8O .O(oC7 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. • • REILLY ELECTRICAL CONTRACTORS,INC. 110 Old Townhouse Rd.-So. Yarmouth,MA 02664 508-771-2040•888-GO-RELCO•FAX 508-760-1425 July 9,.2018 Mr.Joe Marrama Cape Cod Family Resort 518 Rte.28 West Yarmouth,MA 02673 Re: Cape Travelers Motel Bldgs.Demolition 492 Rte.28 West Yarmouth,MA Dear Joe, All power, telephone and CATV services to the existing four rear housing bldgs., Rms. 5 thru 30 and pool house at the rear of the property have been disconnected in their entirety. From an electrical and communications systems standpoint it is safe for the demolition and removal of the subject structures. Please consider additional utilities such as water, sewer and gas as well as contacting Dig-safe prior to demolition and excavation. Should you have ay questions and/or concerns,please do not hesitate in contacting me at any time. Yours Truly, Scott A. 64044 Scott A.Ventura Director of Operations Ltr.Cape Travelers Demo Electrical Contracting•Design•Service&Maintenance 1 ‘� ps )�Prtt ;lF ? !A : - .:r n x .tY' '/ .` i' a•' 4 • p 0' r 4.,,,,,,, ,!t....11:,,,,,.r ;:i.,;,,,te4Lif:: .t:,:;!... E '. :, " 3i,J rJ. , _ • x .. .._,rs= tyr : nt /«..ate. a„�. " :E:a .. 3 '- II jl -, yw .... ,,; i� ,�„vl yk { S':L L .Ra +a e `: .t; rt•v.r.-teapot, :.: s � { � f `' r lrl t ,. y' J'. ut �.. ,r; it } F, ir l r if § �I `.�. qyy„ � ,� .aV ,�• f - �( � ' 1��,.. 4� 'o Ills � i �k ,/: ' d ♦ i of v y` s it:cn z I i t s._ ;. E r Con&ni nii„!s ' tea' %rt v{ a e y �' �. a.S W r' N °'I. " '` Y.VY 13".,r _"_`'"` ! : fi. ,�— "ia(•,t• .1c,4 a t. fil`;r,r.,, .a , , Imagery©2018 Google,Map data©2018 Google 50 ft - -...<.. ..-,. ., *tom ' 1 �- ib 0O t