HomeMy WebLinkAboutBLD-22-003764 COO TOWN OF YARMOUTH Building Department CERTIFICATE OF
(508) 398-2231 ext.1261 OCCUPANCY
PERMIT NO BLD-22-003764
ADDRESS: 130 Ansel Hallett Road, West Yarmouth, Ma 02673 ZONING DISTRICT Bldg. Type: Commercial
SUBDIVISION MAP BLOCK LOT 083.13.1.1
REMARKS Use & Occupancy-Ophthalmic Consultants of Bosto
09/ZSERTIFICATE OF INSPEC ION
DATE: BUILDING OFFICI
Hallet LLC
277 South Sea Ave
West Yarmouth, MA 02673 PHONE
iIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR
RMANENTLY. 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: L., ge -P
DATE: //9-Z Z
OTHER
DATE:
ELECTRICAL BOARD OF HEALTH
DATE: i 'iA/ DATE:
INSPECTOR: INSPECTOR: ILL
V�J jcc S
PLUMBING/GAS FINAL BUILDING
DATE: //P9/z Z DATE:
INSPECTOR: INSPECTOR: l /�
COMMUNITY DEVELOPMENT: DATE NAME
RECEU261IVED
LQ 1'1C
Town of Yarmo #6'Bujl ing Department
JAN 0 3 2022
BUILDING DEPARTMENT
1146 Route 28, South Yarnno>� . --:JM tel. 508-398-22 t c,
Use and d,CCuP j_:r j =Application
In accordance with the provisions of;thh--Massachusetts State Building Code, section 105.1
Application for a certificate of use and occupancy permit
/� /�
Name of Business OPIfri4AL*TIC l Digs ti rs c� l&Sre; phone l" (,>17 -673' 519. -
Type of Business 'isa Q gt0L ew Email \I eRe 'oLLee-y,
*,srf Co rt
Property Address 1 'c /1,✓sr-e. Lan/. r /c/ (i/ i`s; ) r-loin Unit #
*Square Footage to be occupied c/cjq R—' *attach floor plan Fee: $60
V the operation of administrative offices for its off site medical practice,and recoru
storage;provided,however, that it is understood and agreed that the occupancy of the Demised Premises
shall he limited such that no medical doctors or other persons providing medical services will be on site
The applicant is required to obtain approval sign-otts from the tollowing aepartments as
checked off below:
X Health Department— 508-398-2231 ext. 1241 l
X Fire Department— Fire Prevention, 96 Old Main Street, 508-398-2212
Other
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Building owners Signature .50S'- '7 7 ' - 6-1 Applicant Signature " wM
/7.e ,P C/?nenv.a. /vimr L Ir 895 661'L
Please note: this permit is for use and occupancy only. Any work requiring a building permit
will require a licensed contractor to submit an additional application with all the required
information based on the scope of the project. Bc., - ?-003-760Y
**Office use only**
Zoning District `3 Proposed Use Change of Use: Yes No
Allowed Use: Yes X No APD Waiver: Yes No N/A
VI7p--
Building Officials Signature Date
Updated 3/21
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-�RMQU_ MGL AND FIRE
ya ERRORS OR OMMISSIONS 4 �ti TOWN OF YARMOUTH
REVIEWED FOR CODE COMPLIANCE.
fi,l /� NOT RELIEVE:
THE APPLICANT F OM THE RD�SPONSIBIL TY
OF"AS BUIT" COMPLIANCE.
DATE: 1- S 1-
YARMOUTH FIRE PREVENTION INSPECTOR
New Business Transmittal
Project Name: Ophthalmic Consultants of Boston Address: 130 Ansel Hallett
Contact Name: Nancy Carroll Phone: 617-875-5595
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
ceilin 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 1; 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 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
Description of planned project/other requirements: Medical records and billing office.
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.
Fire Extinguishers inspected and tagged. Exit plans for rooms.
* YFD permit required-depending on occupancy and submittal
Plan Reviewed By: Captain Kevin Huck Date: 01/03/2022
Copy for Applicant = Copy to Building Department Copy to Fire Prevention
Entered in Firehouse I I Final Inspection
„t;Y,,� TOWN OF YARMOUTH
z or DEPARTMENT
0 ,y
,x PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: l 3 0 4.v c, c. )44,._ -rr 4, 1 W, yg-.Q.`r A, z- %./
Proposed Improvement: e -i'ec.� — "4 0>r--re,•e S
Applicant: 6,0/1rrla<n,c (ems,1 «e ..r-s oc” 6 o,vfi.,T3 fc.,Tel. No.:
Address: ,S"o 57,./ ,1. €4, Snee.of r/ des c T_o z -bate Filed: I /q04,
**If you would like e-mail notification of sign off,please 'rovide e-mail address:
/TO ,4AIsid- /1,94/.- T/ ' '/..1 a, L C c
Owner Name: d-� �'�,JI . 6
„...94 a 't. f(t vie►z s+g'
Owner Address: -2 77 _Co rim ,..fa'..7 Af, ,t,t,, Owner Tel. No P=77C. -04e p
L.•Kam,-vo✓r-a
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
ith fee.
..................
REVIEWED BY: i DATE:
/43 ata (
PLEASE NOTE
COMMENTS/CONDITIONS:
,o�—'�- TOWN OF YARMOUTH BUILDING DEPARTMENT
�� Y�R.I„ APPLICATION FOR DETERMINATION OF NON-APPLICABILITY
ce .r AQUIFER PROTECTION BYLAW §406.5.1.1
J 60.3
Applicant/Business Name: C/r'�itrtln�.e7ic-r�brs-i-5 Li,:_rowrs Oc Date: I (3 (iZ
Property Owner: /56 A/✓5 1 /1,944e-n- aA n, L 4 C.,
,Ctiri eF_ (�Q v s.= )
Property location: /. G /.9//i.e< /�.Htt...Fri-64 0 Unit#6406. Map&Lot#
Proposed Use:
Po (').-- (ea .9ira 3'cv4'.*o S.Ta.<7Af-�'- /\/ a 7 C�s
1. Has applicant has fully complied with the Submittal Requirements of§406.5.2 ?
(Attach copy of Hazardous Materials List) �+
2. Does the proposed use meet all of the Design and Operation requirements of§406.5.7, '7I ,
3. Are the chemicals, pesticides, fuels and other potentially toxic or hazardous materials used or
stored at the site, or produced by the proposed use, in qualities not greater than those
commonly associated with normal household use, ykl5
4. Does the proposed use meet all of the objectives and water quality criteria of the bylaw: `,-i_`
The above applicant hereby acknowledges that the Building Inspector may require the applicant to submit the
matter to the Health Agent or Board of Health, and may require the applicant to demonstrate that he/she has
received a favorable report from the Health Agent or Board of Health. The Determination, if made,shall apply
only to the individual applicant and proposed use and shall automatically expire upon any change of use or
transfer of ownership of the business. There shall be no appeal from an unfavorable Determination of any such
application, nor from a failure to act, except for fil ng by the applicant for a Special Permit from the Board of
Appeals as otherwise provided herein. ,�
Ov 1-1TaALM1G reyv5 rAxr6 J F'..7e.>S'7"o"V, LTA/
!3t t .
Applicant Date
) '6ACLI atiti(d)' ►(3) zL
Print Nye` a,,ok,
�f Cc
DETERMINATION: The Building Inspector, based upon a review of this application and information
supplied by the Applicant, hereby determines that the proposed e sati ies the requirements of§406.5.1.I and
that the Applicant need not apply for a Special Permit und;g6 if
.......A•iilio d ..
Building Inspector Date 'ealth Agent Date
Form must be filed with the Town Clerk and copies of this form must be sent to the following
departments(as listed in §406.5.4); Water, Engineering, Fire, Health, Planning,Conservation, Board of
Appeals.
Aquifer Protection District Waiver 05,08
TO: Commercial Applicants in the APD
ti
�4 i z FROM: Yarmouth Health Department
SUBJECT: Hazardous Materials
As part of the application process for a Board of Appeals hearing or Determination of Non-Applicability,
please complete this form and return it with your application. For further information concerning hazardous
materials regulations, contact the Health Department Office.
In the conduct of your present and/or proposed business, do you store, use, generate any of the
following types of products? Please check all which apply and list quantities.
An • , Engine & Radiator Flushes Motor Oil
Hy 'c, Brake, Automatic Trans. Fluid Gasoline/Fuels
Grease, L bricants Degreaser/Cleaners
Floor/Driveway Degreaser attery Acid
Rustproofi*Undercoating V 'cle Detergents
Vehicle Waxy, Polishes Asjhalt, Tar, Sealers
Paint, V Stains, Dyes, Thinners Wood Preservatives
Dry Cleaning So vents, Carbon Tetrachloride Floor/Furniture Strippers
Other Cleaning So ents
Rock salt, Road salt
Drain, Toilet, Cesspool Cleaners Refrigerants
Bug& Tar Removers \ Photo cher i als
Printing Inks& Dyes _ Pool Chlo
Pesticides, Insecticides, I-ler icides R Heide, Fungi,ides
Nitrate Fertilizer Jewelry Cleaner
Leather Dyes PCB=s
Electroplating Sludges Others (List)
L Ai rif A1._!`f,t e6AeS(.
'-'s °trans
Applicant Si
gnature: kAs7—e—( Date: _.
l-EALTAPDDETER 10-99
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Fallon,Rosa
From: Carroll, Nancy <NCARROLL@eyeboston.com>
Sent: Tuesday,January 11,2022 2:26 PM
To: Fallon, Rosa
Subject: 130/134 Ansel Hallet Road
Attention! This email originates outside of the organization. Do not open attachments or click links unless you
are sure this email is from a known sender and you know the content is safe. Call the sender to verify if unsure.
Otherwise delete this email.
I'm hoping we can schedule the walk through for Wednesday 1/19/22 @ 9am.
Please let me know if that works.
Thanks!
Nancy Carroll
Regional Manager, Cape & South Shore
OCB
508 534 6004—work
617 875 5592—cell (preferred)
ncarroll@eyeboston.com
i