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HomeMy WebLinkAboutbld-21-002124 of YqR .. TOWN OF YARMOUTH Building Department CERTIFICATE OF
(508) 398-2231 ext.1261 OCCUPANCY
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{0 � -1-i, PERMIT NO BLD-21-002124
•, M TTaCN[Cs /
Carol Weld Royal
ADDRESS 143 Route 6A, YARMOUTHPORT, MA 02675 ZONING DISTRICT R40 Bldg. Type: RESIDENTIAL
SUBDIVISION MAP BLOCK LOT 122.128
REMARKS USE &OCCUPANCY-PETAL PUSHER ART GALLERY
CERTIFICATE OF INSPECTION
DATE: BUILDING OFFICIAL:
CAROL ROYLA
143 Rte 6A BUILDING DEPT BY
Yarmouthport, Ma 02675
PHONE
1IS PERMIT CONVEYS NO RIGHT TO OCCUPY 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: / — 14- e..aP f-4o e C
OTHER
DATE: -/6- z I
DATE:
ELECTRICAL BOARD OF HEALTH
DATE: DATE: (e, /I (�` t
INSPECTOR: INSPECTOR: 7IL
.. )`"
PLUMBING/GAS FINAL BUILDING
DATE: DATE:
INSPECTOR: INSPECTOR:
COMMUNITY DEVELOPMENT: DATE NAME
0 0 cct1 Cy one '
*,01. 00
Town of Yarmouth Building Department
1146 Route 28, South Yarmouth, MA 02664 tel. 508-398-2231 ext.1261
Use and Occupancy Permit Application
In accordance with the provisions of the Massachusetts State Building Code, section 105.1
Application for a certificate of use and occupancy permit
Name of Businesses j,n,�_ S L-� t.\2_7
Property Address 4:7) ��t� l 5 i IZ F_ t Unit#
Type of Business --; .* LE F=r� y==��-1 t= A' A 't
*Square Footage to be occupied *attach floor plan Fee: $60
The applicant is required to obtain approval sign-offs from the following departments+as
checked off below:
II jj X Health Department — 508-398-2231 ext. 1241
\`�t� X Fire Department — Fire Prevention, 96 Old Main Street, 508-398-2212
Other
<"R ( /(;->
Building owners Signature Applicant Signature
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.
**Office use only** 3L —2_1--CD ZI Zy
Zoning District 13 1 Proposed Use
p / 7 Change of Use: Yes NoA
Allowed Use: Yes /4o APD Waiver: Yes No/K. N/A
uilding Officials Signature Date
-\
� The Commonwealth of Massachusetts
'I� ;"11�► Department of lndustrialAccidents
l=�� 1 Congress Street, Suite 100
rr —
►;=�i Boston, MA 02114-2017
■..SV'�,. 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/Individual): 17isyssL FL, S - _47
Address: ( 4[3 MA ti,1 S-c,
City/State/Zip: oz•aV-5
Cit
Y p:YAa.movro. P - N(4 Phone #: , Cr::, . • f9 641it4
Are you an employer?Check the appropriate box:
Type of project(required):
1.❑I am a employer with employees(full and/or part-time).*
2.V I am a sole proprietor or partnership and have no employees working for me in 7. ❑Newm construction
any capacity.[No workers'comp. insurance required.] 8. Remodeling
3.0 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 my property. I will 10 Building addition
ensure that all contractors either have workers'compensation insurance or are sole
11.Q Electrical repairs or additions
proprietors with no employees.
5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 12. Plumbing repairs or additions
These sub-contractors have employees and have workers'comp.insurance.t 13•El Roof repairs
6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other
152,§1(4),and we have no employees. [No workers'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:
Policy#or Self-ins.Lic.#:
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 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$250.00 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 under the pains and penalties of perjury that the information provided above is true and correct.
Signature:
Date: le i 1'5,210
Phone#: $3?d0 --Rct 6 4,4 i
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#:
YARMOUTH FIRE PREVENTION
New Business Transmittal
Project Name: Petal Pushers Address: 143 RT. 6A
Contact Name: Carol Royal Phone: 860-799-6444
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 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:
The YFD support the application, subject to applicable submissions, permits and
inspections.
YFD Lock Box is recommended
Fire alarm system should be inspected annually.
* YFD permit required-depending on occupancy and submittal
Plan Reviewed By: Captain Kevin Huck Date: 01-23-2020
Copy for Applicant L1 Copy to Building Department Copy to Fire Prevention
Entered in Firehouse 1-1 Final Inspection
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.°f Y `c TOWN OF YARMOUTH
F H 46If 1146 ROUTE 28,SOUTH YARMOUTH,MASSACHUSTS 02664-4451
Telephone(508)398-2231 Ext.1292 Fax(508)394-0836
OLD KING'S HIGHWAY HISTORIC DISTRICTCOMMITTEE
WAIVER OF 45-DAY DETERMINATION
The applicant/applicant's agent understands and agrees that due to the current declared National
and State public health emergencies the determination of our Application for a Certificate of
Appropriateness/Demolition/Exemption may not be made within 45 days of the filing of such
application.
The applicant agrees to extend the time frame within which a determination is to be made as
required by the Old King's Highway Regional Historic District Act.
SECTION 9-Meetings,Hearings, Time for Making Determinations
"As soon as convenient after such public hearing; but in any event within forty-frve (45) days
after the filing of application, or within such further time as the applicant shall allow in writing,
the Committee shall make a determination on the application. "
Applicant understands that the review of this application will be scheduled as soon as the
situation allows.
Applicant/Agent Name(please print): G4 ZC'L__ 'mil. c - 1____
Applicant/Agent signature: its, Date: ct..\0 ,2-©
%., -,,,,\L„. to fp_o
R3LL,
Application#:
3/2020
•
From: Old Kings Highway okh@yarmouth.ma.us
Subject: 143 Route 6A
Date: September 9,2020 at 1:15 PM
To:
Cc: Old Kings Highway Kh@yarmouth.ma.us
Hello,
Please visit the OKH Department page on the Yarmouth Town website for information:
www.varmouth.ma.us/375/Old-Kings-Highway-Historic-District
This property, being north of Route 6 (the Mid Cape Highway) is within The Old King's Highway (OKH)
Regional Historic District. This district was established under Massachusetts General Laws, Chapter 470
of the Acts of 1973, as amended. It is the largest historic district in America which encompasses the
area between Route 6 (Mid-Cape Highway) and Cape Cod Bay extending from Sandwich to Orleans.
Each town has their own OKH Historic District Committee whose purpose is to maintain their District's
esthetic and cultural heritage by protecting and preserving its buildings and settings in keeping with the
early days of Cape Cod. The boundaries of Yarmouth's local OKH District are from the Route 6 (Mid-
Cape Highway) north to the bay between the Barnstable and Dennis town lines.
Please note that all exterior changes and/or additions to settings and structures require a design review
and approval by the local Old King's Highway Committee prior to work being started. Such changes
include, but are not limited to,the following:
- New construction - Demolitions -Additions - \Nindows/doors- Siding- Painting (except to white) -
Stone walls/retaining walls- Decks- Fences -Sheds-Signs-Solar panels.
The OKH Committee hearings take place on the 2nd and 4th Monday of each month at 7:15PM in the
Hearing Room downstairs at the Yarmouth Town Hall. Due to the COVID19 crisis, meetings are being
held remotely at this time.
The Yarmouth Old Kings Highway Committee
okhPvarmouth.ma.us
/' . .
/ 6 ' \
TOWN OF YARMOUTH
HEALTH DEPARTMENT
t .5M
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PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location:
A-5 10-01-5 a A. 2k`'rd1/4) For YV114A
Proposed Improvement + : ' 1
�l_ taL.). CA U Tel. No.:8630.i9\ �i. 4
Applicant: AQ
"1- 6 �{A V-T}-��'p�,T urn S� Date Filed. l(7 1 to ' ' __C_
Address: ���
** u would like e-mail notification of sign off please provide e-mail address: C t (,19t�`d 1r0 a�
Ifyo
Owner Name: VZ4:::.\-- ra.6
Owner Address: [4
1ZT esLl Owner Tel. No..8Gb.4-cn c 4A4
RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance oStt Public wnHealRegulations;th i.e., Requirements
For Septage Disposal andother
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
OCT 16 2020 (all existing and proposed) —
Note: Floor plans not required for decks, sheds, windows, roofing;
HEALTH DEPT. (3.) If necessary, Title 5 application signed by licensed installer
with fee.
J���''/ DATE: /0/t1 /76
REVIEWED BY:
PLEASE NOTE
COMMENTS/CONDITIONS:
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