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Home My WebLink AboutBld-20-2545 1 RECEIVED OCT 28 2019 BUILDING DEPARTMENT d/,o 4.>,, it r By: t O� '''ZW,3 Re 4 gta414CatideItia DIGnettt 4 5 — e . 1146 Rosde 28, ca% pc,.,rftwag, ggy 02664 APPLICATION FOR FIRE PROTECTION PERMIT Date /0 P 2 O/3 PERMIT NUMBER l3LT) - old -60 °2SY.- Projected Start Date: c$fp Date of issue In accordance with the provisions of 780 CMR and M.G.L. Chapter 148, as provided in Section This application is hereby made by C'otre Cod A2._a1^ra \ (Full name of person,Arm or Corporation) Address 7 OLCX o A.'Mfc.9j5 . K oe1 4,, (Contact#) ,50g-398-G3/ Email SaLESe Cap e cod ail owrn _ Corn Owner of property F 4&Ale r-s OCe E YL Job Location .7/21 ROUts E. C6 (PEAR 13Vt Ldi r ) (Street&City or Town) For permission to(state clearly purpose for which permit is requested) hnoa,1 Fr Tee e e x i s -i rg co erci a L pi ce c t2.- .-to i1 s(rsceinn ; r) trcHe R,eaR. euA4A n, / Lower ZED con,--- ??/lr iT, Name of competent operator(if applicable) C-7' evl E C'pr7 of/ (3c.4J�E COd (P rrn J Cert. or License No. � 9 -C Estimated Cost of Construction: b).1fLtiA) (Signature of Applicant) Building Official: J Date: /1-I k-J 9 FEE: $50.00 • The Commonwealth of Massachusetts it.:�s i..s:/ Department of Industrial Accidents 'I!I: l- 1 Congress Street,Suite 100 -`t". '_ i Boston,MA 02114-2017 *',,,„;;,.,P. www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Avnlicant Information Please Print Leeibly Name(Business/Organization/Individual):CAPE COD ALARM COMPANY, INC. Address:204 OLD TOWNHOUSE ROAD City/State/Zip:WEST YARMOUTH, MA 02673 Phone#:608-398-6316 Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with 'VA, employees(full and/or part-time).* 7. ❑New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity.(No workers'camp.insurance requited] 3.0I am a homeowner doing all work rnyselt(No workers'comp.insurance required.]t 9. ❑Demolition 10 0 Building addition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.17:1 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. l3.QROOf repairs These sub-contractors have employees and have workers'comp.insurance.* 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.n✓ Other fl1 Oct cy 'B 152,¢1{4),and we have no employees.(No workers'comp.insurance required.] ex j S-r i Yl fQ f w{. alarm sjy'St'j E() • *Any applicant that checks box NI must also fill out the section below showing their workers'compensation policy informatiot 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 employee;they must provide their workers'camp.policy number. I ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Associated Employers Insurance Company Policy#or Self-ins.Lic.#: WCC-500-5006433-2019A Expiration Date:SEPTEMBER 1,2020 . Job Site Address: 7I R kgU T e C i City/State/Zip: Yarn-)r n'1 Ousr?- ei- Attach a copy of the workers'compensation policy declaration page(showing the policy number and expire n 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 as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify unde a pains p of perjury that the information provided above is true and correct. Signature: ,Gss.� L Jyc.s-7 it Date: 10-25—Rtgr9 Phone#:508-158-2624 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#: • • •• 447....COMMONWEALTH OF ,..." SSACHUSETT: Comnionwealth of Massachusetts .• DIVISION OF PROFESSIONAL LICENSURE 1r Osvisson of Prolessional Licensure • • . BOARD'kg'F Security*\seirki61-S L. ens' - • . ELECTRICIANS lc f' ISSUES THE FOLLOWING LICENSE SSCO-000248 / pires: 11/07/2020• REGISTERED SYSTEM , GEN*C - . GENE.A CORNIER Tpyed ., 9 MARPAIg...! P1 , 14) ' CAPE COD AL — SOUTH DENNIS,MA 02660-2667 )rs',;7111.0` . . . 1507 D 01/31/2022. . 683001 Commissioner C/I-- LICENSE NUMBER EXPIRATION DATE SERIAL NUMBER • . .t-OMMCINWEiLT OF MASSAeHUSETT&,':,..„:;''•1 DIVISION OF PROFESSIONAL LICENSURE BAflD OF ELECTRICIANS ISSUES THE FOLLOWING LICENSE REGISTERED SYSTEM CQNTRACTOR- GENE A CORMIER .1- CAPE OpPA4A40-:0d INC • -,. 1,, 3,, u; 204 OLD TOWN HOUSE RD • .,WEST.YARNIOUTH,-Mkt2673-1631• -,.,-:: • 1592 C iiiistmozz - 655106 • LICENSE NUMBER EXPIRATION DATE SERIAL NUMBER 1 R r O'•LO U Csl1L1 lU i3u,I dE S CSID Zone Information for CSID: 231665 7P1 2-f' CA , V Ak MU 711 PORT FIDDLERS GREEN (REAR BUILDING) CL'XJS777JCY a Mr.LF BibCI) . p. a4 r q . if i A r Physical Zone Description (tExi`Si1) Cs a-1 (2.0Noua-Tta/J) 001 UNIT 720B SMOKE DETECTORS & PULL STATIONS tl =snow me aav,C6 • • 002 UNIT 722B SMOKE DETECTORS & PULL STATIONS 003 UNIT 720B/722B HEAT DETECTORS & SMOKE DETECTORS -. . 004 1ST FLOOR HEAT DETECTORS & SMOKE DETECTORS 005 ATTIC HEAT DETECTORS • . _ _ ___ �____—�______________ _. • 4 --------- ----- - - unary ,I ----7- . ---- -- - - __ _--_--tom-E-- -_- _- __---- _--- - _-_--_, 13wrft r r ___-______-_-----_-__----___-____-________-_-____ __-_-___ _ _-____.__ __-Ste_-__------- —are _-ae--- ---___-____-____ . r I -_ ___---1* . L aFR s S r, 'l? 7_1_7_--- • dLu &11L;iv 6(111 a S CSID Zone Information for CSID: 231665 7141 2-fC (A , V RR.mad TH P'OAr FIDDLERS GREEN (REAR BUILDING) ( 3 n r .... -..... gg -i Physical Zone Description (eXc`STJA(- a3-11 2`-NoWATo/4 • 001 UNIT 720B SMOKE DETECTORS & PULL STATIONS • 002 UNIT 722B SMOKE DETECTORS & PULL STATIONS 003 UNIT 720B/722B HEAT DETECTORS & SMOKE DETECTORS ... 004 1ST FLOOR HEAT DETECTORS & SMOKE DETECTORS . 005 ATTIC HEAT DETECTORS • 18A111R00/11. ' -Q .f, ,. 1. S fi rFi`CG 'C) ; - - • ________________ -- _ . 1111111]I D 1 0FACd- ___-�_- - - --- --------------- ►��rt�,,Ay - -- --- s FF►'Ce _ S _- -— — ---— -- _-_ - —- 6 F _________________. n�frz 4 _ � = Commonwealth of Massachusetts I * ° ' Department of Public Safety \ / Uniform Fire Protection Construction Document Transmittal Form Date: 9/23/19 To: Fire Protection YFD - Capt. Huck or Lt. Moriarty From: Building Inspector YBD - Tim Sears Re: 714 Route 6A Map Parcel I am forwarding a set of fire protection documents to you for your review pursuant to 780 CMR the Massachusetts State Building Code, Sections 107.1.2 and/or R106.3.3.4, as applicable. The following documents are enclosed: Plans modify existing fire alarm system Plans Plans Other: Please review these construction documents for compliance with 780 CMR 9.00 and/or 780 CMR 4.00, 780 CMR 34.00, 780 CMR 51.00 Ch. 3 and Appendix J as applicable. For the purpose of your review, it has been determined that the proposed construction type is VB and the proposed use(s) is/are: A Assembly A-1 , A-2 ❑, A-3 ❑, A-4 ❑, A-5 ❑ B Business B i1 M Mercantile M ❑ E Educational E ❑ S Storage S-1 ❑, S-2 ❑ F Factory F-1 ❑, F-2 ❑ U Utility S ❑ H High Hazard H-1❑, H-2 ❑, H-3❑, H-4 , H-5 ❑ I Institutional I-1 ❑, I-2 ❑, I-3 ❑, I-4 R Residential R-1 ❑, R-2 ❑, R-3 ❑, R-4 ❑, land 2 Family Dwelling ❑, Townhouses ❑ Special Use Special Use ❑, Specify: Mixed Use Yes ❑,No ®; Non Separated ❑, Separated ❑, Combination Non Sep./Sep. ❑ Please forward your written comments, or a request for an extension of time,to this office within 10 days. If you believe the fire protection construction documents are noncompliant with the requirements of 780 CMR or the applicable reference standards, provide your written comments citing the relevant sections of noncompliance (refer to M.G.L. c.148 §28A). If your written comments or request for an extension of time is not received within the allowed time frame,the documents, after review, may be deemed to be in compliance with 780 CMR. Please note, one or more extensions of time for review may be granted, provided that cumulative time does not exceed 30 days. Should you have any questions, please contact this office. Please sign, date and return one copy of this document to the building department. Fire Chief or Designee ()risb, Y Print Name Ta.1/20,, fricv.,5),,�y Date IL/ 19 . For Building Department Use: Received By: ✓_ , Date: /1 / a/ 1 I Permit#: ,r . d.Luu &wL;i ill ! Li;I cla s CSID Zone Information for CSID: 231665 7111 2ifc (di , ViggivulaTH POk r FIDDLERS GREEN (REAR BUILDING) `L"X15 J&- a rrice Bib&) �' . i - ;, \''l .-i . Physical Zone Description (exa`sriW5- a-q (2oivauA-"mitt) • 001 UNIT 720B SMOKE DETECTORS & PULL STATIONS tt = exstr•ive" aDVi`E • 002 UNIT 722B SMOKE DETECTORS & PULL STATIONS 003 UNIT 720B/722B HEAT DETECTORS & SMOKE DETECTORS .. 004 1ST FLOOR HEAT DETECTORS & SMOKE DETECTORS • 005 ATTIC HEAT DETECTORS --------------------____-_—_._-,.____—_ -----_-_-__----------_,-- I e) . . Ur►LYTY I r . a, - . . 13Anthafteit4 __, -4 ^_________ _--__-_ ___________ _____----______________-____ Fes__-__.________-_ ----_-_-_- _�____._w_________ - + Qs:, i• at- . __ _______________________._I I _ ______-_—_ -- _/w --137-try--_--_------------____;____—— _______ d &WL;iv 130;1 dks CSID Zone Information for CSID: 231665 • 7lh/ 2-as (A , V/li2ti u rti Poser • FIDDLERS GREEN (REAR BUILDING) (L'x i5n1J6- a Mice B 1/I CI) . Physical Zone Description GEXI`SIMG- a-li , L AfoU*Tra/V) . • 001 • UNIT 720B SMOKE DETECTORS & PULL STATIONS • 002 UNIT 722B SMOKE DETECTORS & PULL STATIONS 003 UNIT 720B/722B HEAT DETECTORS & SMOKE DETECTORS ... 004 1ST FLOOR HEAT DETECTORS & SMOKE DETECTORS . 005 ATTIC HEATDETECTORS • i • cost i I8A-0Rooiir '- bif►cam___ 45 • xaci.Pr,oN _-----------____—__-_-_ 140 wAy ___- -------___-- _-_ S