HomeMy WebLinkAboutBLD-23-001395 g >a v
_,. `CEIVED
e5 a - Office41SEP 14 2022
1146 Rozdo 28, Saaig �a��noi, gLY 02664 i
BUILDING DEPARTMENT
APPLICATION FOR FIRE PROTECTION PERMIT CI "Ik0-7602J
Date 3-9-0?QZ? PERMIT NUMBER B W 23- co/39S
Projected Start Date: /si 'P 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 l �n 11
by erEaiE Co Er" rekre Coo ,tom1, r�
q L (Full n of erson,Fi m or Carport;Lon)
Address c 0 0 24 I D Lk -ems � A 1 yf� (
(Contact#)507 39F— 050 Email sit LES (r�t car e cod ALA rm ® Corn
Owner of property
Job Location 9 Poe(l yi ID r j e
(Stre t City or Town)
For permission to (state clearly purpose for which permit is
requested) CA e O9d (ILR r(1) 'To C E 2-A Cr. E ?c i i &.
Fire H UAr rn o E v,ccs t,uc ce 61A►-a- eked a-� moo'
U
A EL00S. ►Ith co702.L E 6 scrEm WALL mE CuCre scrims CiOO�E.
Name of competent operator(if applicable) E tV f C0 r renr\e c
c.)
Cert. or License No. 15 g02 -C Estimated Cost of Construction: 5 300
By Lit). ,
(Signature of Applicant)
Building Official: %.-s Date: r?-A-
FEE: $50.00
, L ) fmniT TO onOL/ O1--d ` IowAm outs F R 1
‘,v EST Yn r ouu-70 , c2e
r
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.nttass.gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): CAPE COD ALARM CO., INC.
3
I
Address: 204 OLD TOWNHOUSE ROAD
t
City/State/Zip:WEST YARMOUTH,MA 02673 Phone#: (508) 398-6316 i
Are you an employer?Check the appropriate box:
Type of project(required):
1.0 I am a employer with 30 4. ❑ I am a general contractor and I
have hired the sub-contractors 6. 0 New construction
employees(full and/or part-time).
2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling
shipand have no employees These sub-contractors have 8. l
❑Demolition
working for me in any capacity. employees and have workers' 9. ❑ Building addition
[No workers'comp. insurance comp. insurance.t
required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions l
3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself.[No workers'comp. right of exemption per MGL 12.0 Roof repairs
insurance required.]t .c. 152,§1(4),and we have no
employees. [No workers' 13.0 Other i
. comp.insurance required.] P
1`
*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. l
$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 1
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site a
information.
Insurance Company Name: Associated Employers Ins., Co.
.
Policy#or Self-ins.Lic.#: WCC-500-5006433-2022A Expiration Date: 9-1-2023 !
11
Job Site Address: 9 five- s%tn 0C' E City/State/Zip: S y p r mot; )- I � r
Attach a copy of the workers'compens • policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that 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 eijuny that the information provided above is true and correct. i
Signature: �/4.0,�f�
` _3 rc ca 1
et'",
i
Phone#: (508) 398-6316 i
•
Official.use only. Do not write in this area,to be completed by city or town official
t
City or Town: Permit/License# 1
Issuing Authority(circle one): i
1.Board of-Health 2.Building Department.3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
•
t
Contact Person: • Phone#: E
i
, 1 _...._. . .....
, •
•i,.,.k':. .
' ',....'.,',.
. .- .
•
• .
. . , .
• .
.4'COMMONvitAili-trOF MIASSACHUSMS.0 ._ ._.. .... . _ . _
....') DIVISION OF OCCUPATIONAL LICENSURE Conanonwealth of Massachusetts ,.. .
4'...*..,,?-!..:.0.'':•' .;„..BOARD'.0, II: Division of Professional Licensure
EtOlitICIANS .. - ...,,..• .. ,..,.rs:
• ''":.''''4'" ISSUES THE FOLLOWINGUGENSE q ,:,.-:,
.....:,.w.:., v 8acurity.Aigemill4I.LICCOLIS9
Rmistgitio SYSTEM TECHNICIAN
_
SSCO-000248 i.,..., ,-,.. ,.,,''l expires 1110712022
GENE A CORMIER ..-• _,,,,....;„..,,,,
..,...,.,...•:.: , . ;:fit.t, GENOCORMIEN-4,•4,:;.;,,,, :
VMARGATE 144 Opod by
,. t...: ':,---4-p.-.-w&-.... , :•-• ,,,:„....,..,::3r.....-:,:. :,::,,:.:.:..:14
‘0. . Ernpig:
SOUTRDENRI.S;liA 0266072697,.,.;.
,::-.,...,,, ,,,••• • \iE
}g . CAPE COD ALART*.Y. ,C.'.;- ,);:3-ril::-' ••-'-- ':' '''''''''
• . 'f••• • - ,,N,. ' ::::::_,.4,' ,2,..--. -',:;- W :
'te):15. 1.:Csitc— •!,1:tit;:nI:--:: ::•-S-I,N
...i .
--•.:•:••••.' 1507 D:.... '.i':: 0113112025 290762 .,,..,,
Commissioner daida Ba,,,a,,,_
LICENSE NUMBER EXPIRATION BATE SERIAL NUMBER
...... .. . 1
. .
. ,_........ ., . ... .„.. .. ,:,.
i:.:likCOMMONWEALTH OF MASSACHUSET ,S••::,'..,,
DIVISION OF OCCUPATIONAL LICENSURE
1191N91--)VF •
ELECTRICIANS
ISSUES THE FOLLOWING tidENSE ' tt:g ilYi
4.....,
REGISTERED SYSTEM CONTRACTOR
GENE A CORMIER ';.,:, ,' '1•
9,2.
4-0118ARGATE I,N.,...:
. . .,„.. ..... .:••••'I''1
' SOUTHI*NrilS,MR 02660.2667.1
'=,•:4i•••••'•• •
ri•i=l't?.:icW" ,•i: , ,•.:
1562 C.,,:f gl 4,003112025 ,:•,. 290760
?...1•:;.::%.,W, ' .... .,,,,,, e!..i,:td,':
LICENSE NUMBER EXRIRATION DATE SERIAL NUMBER
. ,:....---..- ..,::.'"'' . .. •::-.7.-,a • A
. A ' - E:
DIVISION OF PROFESSIONAL LICENSURE
iy......„,.00pIP1 0,
' ELECTRICIANS . ,vi,,,,.W.ir
•-,-,;".i!fi z:I---:'•'." k::', .. , .,,,-.•.,
ISSUES THE FOLLOWING LICENSE ,,:,i.,,, i
REGISTERED ELECTRICAL BUSINESS
CO
i
CAPE COD ALARacaiNC
.,,,.....„..
1204,oLp TOWN HOUSE RD
INESTYAROCkri'il,W!49?C/1.P$431 `',.. 4
•
-.,*,4- I , • ,, N.-- ,
1395 0,0"-A...::.:.:,.. 0713112022., , :tf 936314,,
.'..c.i.,4,...f.,-.
LICENS.E',NIJMBER .EXPIFIAtION'UATE SERIAL;NyMBER
. ,
9 Morning Drive, S. Yarmouth, MA
Existing 1st Floor- 1552 sq feet
•
Family roomo 7
Dining room
Detailed plans for this section
are attached O 0
Garage
•
Key
ai New Smoke Detector
1 New Heat Detector
OExisting Smoke Detector
Proposed 1st Floor -1552 sq feet l Existing Heat Detector
Family room() Dining room
Detailed plans for this section
are attached •O O
Designer: Matt Cormier
Garage Company: Cape Cod Alarm
Phone: 508-398-6316
Email: mcormier@capecodalarm.com
Date:August 18, 2022
Drawings are not to scale
Lev6I 2
•
./� 61 M. o K� i iv L i� g_ 11/E - R 0 C.l< s
'A1hAt60 fie5i dz r htJS
ATh lk D 1VV�_Ut- E y] 5' i 2.q"-+-3'4 -�21 11^-f
Iffy 2'5' + .
1 Fr
?N‘1\...3 °�`loset �`_° v' v.,, 5'9�� f'{(T
` 1 y - "!, ® -4A\(l)IN`I -C1O563 IrlieRlcvi2
:., Front Bedroom �_i�Ittrinei �°
_ 3 C g viA(\5� REtN(�C- ReeiACC
I _. '`..wr 7,�...1r��T1 N2 . �- n-}-J' 11" DKNi t V A t
-
REVIEWED FOR BUILDING AND ZONING CODE COMPLI- �. V
ANCE. ERRORS OR OMISSIONS DO NOT RELIEVE THI
APPLICANT FROM THE RESPONSIBILITY OF"AS BUILT' - '3" 10'5" • o -\loset 3) ° . ‘(��•
A ((S - irJS�nl�TL
COMPLIANCE. 3' , � ' . 10'." --",_I.(1-w"( I
1) R' w;Atl
DATE:)�)3' . ► &ai.s Bathroom
�,t'c�oir�� Icw� 1kV :. - = = o (-(r Lt r/J\`1 RENAL e DAK Roof's;1017
n
r ' 1 -fL ''' 1 o s e t L"`cv is
��� �n
112 _ So t 1 ` 1
Fn
Coo
N
co i" °O Living Room _ I j = 0 \1-1 I t 1V Ca� I ir
1 RP o\Ic - K -P►Pc
A. 3 3" •;, Kitchen R`I v'1 A 1
1;
N
1 13'3" -~ ,t, ,p,, j.,
` 13'9" ' 12'4" I
IT
APPLICANT'S COPY
Level 2
ROCKSTROH EMS 6/8/2022 Page:2
•
t,
•
•
•
•
•
•
-y
' yr
•
•
T "'
! J 3
E4
•
r G 4'
i
,gyp
0
O
M
!tr.'
Z
En
t----- ,THL
_g,4" , n- —A
w
D N v\IN4 gPtktr.;.-...+, 00 ...-. /7-‘ I 1 f
00
corlo _ 7J
4 to
J' I ' a - to
ELI
o 1. 471—I T <„
j jpo" .
u, c, / l \
1 r.
1F N � 5'211--„7...,,---1' ...;N) (2r, .44, ,...... 1..____ ., i
CN 1 y A
11,E t - cm �' 0„ i -
to
ti .-+ v
d\ v
1 .
Q, IV
r.r
�� w
J
4.r 4
k
.x . Hai -.
fit 4 ' '' V v "�s
A y
i �4g ,
e Y _ —•a'''4' `F' "re- d t` -�s� : t whit
i — - i. ' r •`' - .'� r`' g 5s` i
'� a f
�
}
RD ADS K
23'5"
22'9"
1- T
K M
1 I 3M'7"
1 30'3„ t,
-as oo Basement 2
B sement
v �
�l 11
23' 1"
30' 11" rn
Main Level
ROCKSTROH EMSI 6/8/2022 Page: I
a
9 Morning Drive, S. Yarmouth, MA
Existing 1st Floor - 1552 sq feet
Family room S •
O Dining room
Detailed plans for this section
are attached O
Garage
•
Key
ONew Smoke Detector
OH New Heat Detector
OS Existing Smoke Detector
Proposed 1st Floor -1552 sq feet l Existing Heat Detector
1
•
Family roomo Dining room
Detailed plans for this section
are attached _ O O •
• Designer: Matt Cormier
Garage Company: Cape Cod Alarm
Phone: 508-398-6316
Email: mcormier@capecodalarm.com
Date:August 18,2022
•
Drawings are not to scale
Level 2
.,•° ° 61 r_ 0 R.1\1 i N LI (i IklE - ac(4 c-1--
whoritr( Ke5i.de_i\--no
1* ` � , -� ^ j� I,��J W."-
fir �^
V V l C � L� A- _W. G IFs 11 5 ' I ' -i-3�4 --� „�
1
10' 11�� 2,5, y�� �� r- T
QQ rn
°2.toset l l n I N i` 5'9' 1 0 1-I `��\I -CIS
j ,. �� SZ�S - ir�'('iRir�r2
Front Bedroom 3' 1 , 1Sitang Aes 'n
fro 1\_5 REAme Reemt
.7 ^ r ,7.': ti.':'Fl I—2' , - - , „.a----5' iii, - —
D iz.'I vv A i t
REViL'.VE FOR B:i-DIN3 AND ZONING CODE COMPLI- !1./ \
ANCE ERRORS OR OMISSIONS DO NOT RELIEVE TR �, `
APPLICA.:T FROM THE RESPONSIBILITY OF'AS BUILT' - 1431 3" 10'5" s c -'loset r i)d- o
COMPLIANCE. 3 1 1)':" 'c y-c—q., IA/ A (15 - iNisidAie
1) R t(
DATE: -13' �r► S:ai s "' / 11113 athroem
_ °° I b.. .'. = 2'9"� 0 I-�RG(,n )1 RE pkt e 0/3K FIooQ�
1LDING ICIAL Co
10'7" - 'r,
1 ,,7„-4
y'i' „ c -
�� �� 'Voset L� F
i2` Nte1
lo 00 1
t cn
N
�o 'v, So Living Room 1 j _ e <,1-I ,1 lF, �v l L�L I N
1 3 R. a0\1 C - KGPI
, �c
1-. 3' ' 1 Kitchen 'O R`I W ,
3'1 T
r
I '
1 13 3" e 1u ,p" r (V
I 13'9" I 12'4" I u�-
ir
APPLICANT'S COPY
Leve12
ROCKSTROH EMS 1 6/8/2022 Page:2
R , ,
0
m
g
t(I)P.. - il(Avii u.
1. 4•I'Ve Up -0 (t\IVI A.(( R ePAigi
41.1.4
...__
P-4
I
t---------^ I II I
8'4" i If.---.----1
4 711 i ______
10'4"-----‘
•—i- Ni \e. :::,
DV\\4114 FC-14t4.......N
0 00
Y t-.
0 0 1
8 1--3,7,± f
t.) -
7v
1' 1 l' CD
.,„ CD ....-..."
IR.. e-.Z.........
I Iii off g 8 Fr
ON
1
1 I
17) IQ -4
ID
... . 5'2" -.. '''-'
--_:,. ul
C = (g.
-44. •-. ...„ 1--I
bj , nmni4ommmf jill 1
se t = -
t 4 co a : E tQ •-)
1,3
A ^2 Na E0' 0 o
. 1 p1,15,, o, _
1 T _ -
.A.
I 1g/,.
= CD
I` : ..11.......,,,-..........4
- _
r-,
C..........----- e-,
alliii;L •-•
mu
IL
III
F-
---
oo
N
71
--rd
til <I
— 23'5"
22'9" T
� M
1 't 3(1'7" ,
30'3" �+ -
N
cr Basement 2
0
B•seinent rol
N ..
j
30' II"
EI
Main Level
ROCKSTROH BMSI 6/8/2022 Page: 1