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HomeMy WebLinkAboutBld-20-003450 ', _ - - _ • n . :. ::_,_:; Y : BUILDING PERMIT APPLICATION - ;;`,::OF=.'::R ,. :..,.,.,,..r;, HATE:.CHANGE:T_H'Er .USE;:Q000PANCY.QF; at,= , APPLLOATION T..O,CONSTRUCT;REPAIR,KENO, (" :` - OR DEMOLISH'-ANY,BBUILDING OTHER THAN A ONE OR TWO`-FAMILYDDWELLING. ;- : : 0: •,_'`,..: , '-,2y. •,.:. - :, `b`a T<;)i'--HofYs_.routh:Building-De prsartrnrl nt INa .Lot , " ., _ . F 'xr::c•r �s`.�:; -:<:.. - -• . hl4i:Rcite28:..:---Viiriti< iirh..4[ Q2bb4= 74.1, Tel' - ;: ,�..- '< . <; , ,> . .w. :,_ :.',., Of:4c:�:-Use,Oi-ir.y_-� ,., � -�� Plamm�g;,Bod nfprmabion•, _ Asseso =Deparrti,nent_Inforr.rrao, . ` ko ,"- RanTe - payp- Endorsement`Date �P'[Riit::Fee.`f .-$ . • .:New . e /_�j , ��. IU� . �.�"��Recording:Date:�•-, •.�_�-" 1.4 Property Dimensions:. . . rDeposit�`�Rec.d: Date.,• ,_..elan NI.. . ..,::...." >..::-:_ ;, ..; :;-:v.; Fier: Area �st ',, Frontage(tt1:_'..,.:-., ', .Lo-- -overage „ . '.Net Due �..— of !_ot ( .) ., F �'Ttis,�"eoEia%for;office:Use°Only. ��rrte �Datevlssuecl i. :_Pe 1 N�u �Id n �„Certificate,of�.O�ccupancy S,1 h3tl r@: ._'' ..., ., - `ae not. requited . Section 1 .:Site information. .`s. '-Ad':::, %�, 1.2.Zoning Information: . " .tw d Use. ro e U _ - � o"nin :District`.�. P- ..- ��Z E r: - Setbacks-- 'Idfri" i�.'�w �.=B 3. 9= Y�i a-Rea "Side Yarcls�•�, - -,�,-, , � : ' v ed •Re wired: . Provided� Required � 'P.ro�mded,: ��Required� � � =:'Prd.,'id _ . q . _ - � .. r.''` 1::5 Fiood;Zone=infc0ratfon - ' : .Comm e ntx_ t`4`,Vlfafie-Supph►=>(M�GL_e 40:;5 54). ' P"ublic_" " Private.': Zone:. BFE< ' . z .. .;_•:,.. .,r. :; n_�,2=;;°P`ro `e.' " Qwnershi %Autthorized=Agent: . - echo p rtYs P St J "'f>R!"c i M�` x}off: o �,` in .L = 'tom _ 6 i'' V. m nnt. - .ts g N'a .e< gt iP, G� . Sigriatuce` ' , Teleptione<; Telephone Et�y3il:�d.,d1'Er45.` -.:2�2'Autt orized_Agent ..•. .. - 7vi, . „ - an g. (ta... .r�F 7 - a ' ' '- ' /-'-,1-i--m ' ( . - ' /145-:tit,„ze3 - 51 ,7,.' -tin', i/el R_ h le s: ,, , e,le: , ,ioti,t2.:.,: ., a t rF� /1I- - Constructi-n'Seeivice4- - - • - - ' : ��ec�oi�3�a-��C ,.o • -.3 ,.Lic nsed ConstructiorkSupervisor• • - NotA , _ License,Number. " Address " idn Daie: - . ".- St .- Tete iore "" riai,I:Addi'e . - -_ ' . . . k .,-,:.•z:- .>. =',.-....-, .,,,; gnaure; -- _ �., .- _ = , .'; r . E r Section 6 Description of Proposed Work(check all applicable) • New Construction. ` 0 (for multiple family only) No off Bedrooms (for multiple family only) No:of Bathrooms _ F Existing Bldg. ❑ Repair(s) 0: Alterations 0 Addition ❑ Accessory Bldg. 0 Type Demolition Other Specify: Brief Description of Proposed Work: i'l oft/ OS rot, P CI1�P ':-ffP1 4/ rbo11g/ lit 165G7E 1�/4/6rR-i' •-is I/-frf Section 7- Use Group and Construction Type Building Use Group`(Check as a heap able) Construction Type A ASSEMBLY.'. Q,�." A.1 ❑ A-2 (3 A_3 Cl IA' ❑ A-4 ❑ A-5 ❑` 18 ❑ B BUSINESS E EDUCATIONAL. 0 28 ❑ F FACTORY ❑ F-1 ❑ F-2 ❑ 2C ❑ H HIGH HAZARD Q-. 3A ❑ I INSTITUTIONAL ❑ I-1 -0 I-a ❑ 1-3 ❑ 3B. ❑ M MERCHANTILE [i: 4" ❑' R RESIDENTIAL- ❑>' R-1 0 R-2 0 R-3 ❑ 5,4` ❑ S STORAGE - , p. s r p s_2 0 sa .❑_ U UTILITY 0 - SPECIFY: M MIXED USE,, ❑' SPECIFY:- S SPECIAL USE `' '❑ SPECIFY: Complete this.section if existing building undergoing.renovations;additions and/or change in use. Existing Use Group: Proposed Use Group: Index 780 CMA 34 Hazard Proposed Existing Hazard Index 780 CMiB;34- Pro P , Section8 Building Height and Area Building Area . Existing(if applicable) Proposed Number of floors`or stories include basement levels Floor Area per Floor(af), Total Area All Floors (sf) Total:Height:(ft) Section 9 -STRUCTURAL"PEER REVIEW (78OCMR 110 11.) I Independent Structural.Engineering Structural Peer Review Required Yes No I SECTI s 10a OWNER AUTHORIZATION -TO BE COMPLETED WHEN ®- FOR BUILDING PERMIT I - OWNE�- AGEN - ONTRACT R APPLIES l ,, i i,1. as Owner of the subject property, hereb authorize / ki ' 1-z) to act on my b alf, in all matters relative to work authorized by this building permit application. -(2,/e2/1,bli Signatu of Owner` Date 7 of A a0,,.,Y, k TOWN OF YARMOUTH { `fi 6"r HEALTH DEPARTMENT `',.: - " IGN OFF TRANSMITTAL SHEET ,, ,, PERMIT APPLICATION S s To he completed by Applicant: Building Site Location:_ \—)--,‘) g A.'t..- 1 g .--CO tA.Alk V(4 Irv\0 NA/4\ Proposed Improvement: U St. O.A () C C4(AA cry .._ 1.6a-Po . vJ 4i") Co. Ca\ lruL o ^ no S\fib, ... of- YhWI'1.c1u\A 0-Na Tel No.: (g33) 1-1b 7-21�1Z Applicant; tJ�l U�J� _ `� Ad dress: LI Ll Co a S CjrsCov L. '-%c rlitr S 4 Odk'ki\ Date Filed: 1),11/ 11 **If you would like e-mail notification of sign off,please provide e-mail address: Owner Name; C`'\ \< V l &o K Owner Address: L U uk Crb C S-bt1Ws ilk R.[ti) Owner Tel. No.: (17 4) '11 oc1 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 S application signed by licensed installer with fee. .............. REVIEWED BY: DATE: I / PLEASE NOTE COMMENTS/CONDITIONS: MGL AND FIRE �. . TOWN OF YARMOUTH ' � REVIEWED FOR CODE COMPLIANCE. ERRORS OR OMMISSIONS DO NOT RELIEVE ` THE APPLICANT FROM THE RESPONSIBILITY ' , OF"At BUILT" OMPLI I:.NCE. DATE: I Q 7 i. INSPECTOR. YARMOUTH FIRE PREVENTION Commercial Construction Building Transmittal Project Name: Tatra Building Co. INC Address: 1268 Rt. 28 Contact Name: Jan Kvietok Phone: 508-619-6073 Y NO NA Subject Regulation Es X Access for Fire Apparatus 527 CMR 1; 18.2.4.1 X Building Numbers MGL Chapter 148;sec 59 X *Flammable gas/liquid storage 527 CMR 1;42.2.2.1 X Fire Lanes 527 CMR 1;22.3 X *Service Stations 527 CMR 1 ;16.2.3,16.2.3.1,30.3.2 X *Hazardous Materials Storage 527 CMR 1;60.1 X *Kitchen Exhaust Systems* 780 CMR,527 1; 50.1 X Extinguishers 527 CMR 1; 13.6,Chapter 148;sec 28 X Fire Alarm Systems/CO detection* 780 CMR,Chapter 148;,527 CMR 1; 13.7 X *LPG Storage Chapter 148;sec 9,10,28&527 CMR 1;69.1 X Use and Occupancy(FH Building Class) 780 CMR;302.1 X Sprinkler Systems* 780 CMR&Chapter 148 sec 26 A-I X Storage inside/outside Buildings 527 CMR 1; 10.19.4,4.4.3.1.1,19.1.2,34.1.1 X *Upholstery 527 CMR 1;20.6.2.5 X *Trash Containers 527 CMR 1; 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 Business Use. Plan Reviewed By: Captain Kevin Huck Date: 10-07-2019 Copy for Applicant Copy to Building Department I I Copy to Fire Prevention Entered in Firehouse n Final Inspection ,a►• /L'77� CERTIFICATE �F LIABILITY INSURANCE 06/11/19 ND CONFERS NO RIGHTS UPON THE CERTIFICATE H OLDER.THIS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY A CERTIFICATE DOES OF INSURANCE DOESTIVELY OR ANOTELYCONSTITUTE EXTENDEND, ONTRACT BETWEEN THE ISSUING G INNSURER(S) AUTHORIZED ED BY THE POLICIES BE REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. i� RED provisions or be endorsed. IMPORTANT: Ifthe certificate holder Is an ADDITIONAL INSURED,the policy( ) haveides may require ADDITIONAL INSnUndorsomsnt. A statement on If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain poi this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). JIM HINDMAN PR Schlegel 1 i�.N+e: A 50ii TT1.0883 le Earl: Schlegel&Schlegel Ins BrokerImam $ohlegeltnsureneeargmaiLec n West Yarmouth,MA 02673 INSURER(S)AFFORDING 34 Main Street NAM* COVERAGE INSURER A: NGM INSURANCE INSURER B: TRAVELERS INSURED • TATRA BUILDING CO INC INSURER C 776 RT 28 SUITE H INSURER D: . WEST DENNIS,MA 02670 INSURER E: INSURER F: REVISION NUMBER: COVERAGES CERTIFICATE NUMBER: ITHISNDICATED. IS TO CERTIFY THAT THE ANYIC REQUIREMENT,TERMM OR CONDITION OF ANY CO HAVE BEEN NTRACT OR OTHER DOCUMED TO THE INSURED ENABOVE BWITH RESPECT TO WHICH THIS CERTIFICATE NOTWITHSTANDINGBISE CERTIFICATE MAY BE ISSUED INS I�TtOID�I40�SUPERTAIN, H RliCiES.LIMITS SHOWN MAAFFORDED HAVE BEEN REDUCED BY pNDBCtJUMS.D EIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AN TYPE OF INSURANCE POLICY NUMBER MTh 1 000,000 L. EACH OCCURRENCE $ X COMMERCIAL GENERAL.LIABI ISY 4 �0 000 CAMS-MADE Q OCCUR $ 10,000 NW EXP are $ A Mtn-MOM 03(19/19 03/19120 PERSONAd ADv INJURY 1,000,000 '�0i AGGREGATE GEM.AGGREGATE LIMIT APPLIES PER: GENERAL AOG PRODUCTS CREGIOPATE AGG 000,000' POLICY LOC $ S L $ OTHER: AUTOMOBILEAU LIABILITY BODILY INJURY(Per person) $ ANY AUTO BODILY INJURY IPer eceldent) S OWNED ��SCHEDULED P APA $ AUTOS D ONLY ABED $ AUTOS ONLY —AUTOS ONLY EACH OCCURRENCE $ UMBRELLA We OCCUR AGGREGATE $ EXCESS UA9 CLAIMS.MADE $ OW R RETENTION KIII WORMERS COMPENSATION El.EACH ACCIDENT $ 10O,OOt AND EMPLOYERS PARTUABILJTY Y N, N A 6HUB1K24420415 03115/19 Q3115120 100,00( ANY PROPRIETORIPARTNERIEXECUiiVE� E.L.DISEASE EA EMPLOYEE $ B �:n uw�y In EXCLUDED? N 500,00( E.L.DISEASE-POLICY Lam $ D IPT under DESCRIPTION OF OPERATIONS blow DESCRIPTION OF OPERATIONS 1 LOCATIONa!VEHICLES AGORD 101,Additional Remarks Schedule,maybe attached K more space Is required} CORPORATE OFFICERS HAVE ELECTED TO BE COVERED UNDER THEIR CURRENT WORKERS COMP POLICY CANCELLATIONCERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THEREOF,THE EXPIRATION DATE NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCYPRO SIONS. HOVSEPIAN REALTY LLC 131 PLEASANT ST AUTHORIZED REPRESENTa . YARMOUTM MA 02664 ©19• Fi 5 ACORD CORPORATION. All rights reserve( ACORD 25(2016J03) The ACORD Warne and toga are registered mark s of A` "D