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HomeMy WebLinkAboutBLD-23-001125 ' G # ( R• ! 'F , R BUILDING PERMIT APPLICATION -z_._ ,t 'tr' APPLICATION TO CONSTRUCT, REPAIR, RENOVATE , CHANGE THE USE, OCCUPANCY OF, C OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING. AUG 30 ? � '" !�, .i. Town of Yarmouth Building Department 1146 Route 28 • Yarmoth, MA 026644492 BUILDING DEPARTML --' Tel: 508-398-2231 eat. 1261 Fax 508-398-0836 By - — — Office Use Only_ Planning Etoard Information Assessors Department Information: 6U -23. Map Lot Permit o. ' Date Plan Type_ Permit Fee $ tlY Endorsemenl:Date / Recording Date New Deposit Rec'd. $ Date Plan No. 1.4 Property Dimensions: Net Due $ 1(N.0 Other Lot Area(sf) Frontage(tt) Lot Coverage This Section for Office Use Only Building Permit Number. Date Issued: � Mi- 3- . Certificate of Occupancy Signature: - _ ( �/ Building'Official ' Date is is nat i 1-°"' `1 _------ Section 1 - Site Information 4,, ►. 4___ �\ r 1.1 Property Address: 1.2 ZoningInformation: `-1 (` M. a�j West yar OU t BUILDING DEPARTMENT o, ---— Zoning District 'Proposed Use 1.3 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.4 Water Supply(M.G.L e.40.S 54) 1.5 Flood Zone information: Comments (I;ubIic) Private Zone: e" -. BFE Section 2 - Property Ownership/Authorized Agent I 2.1 Owner of Re rd: t 1,i'` a7 J - . t J lJ "Y w.e.S►�r- \I n,�s•-) I\.4_ Oa-L-7 3 N m print) Mailing Address: ig ature Telephone Telephone / mail Address: 2.2 Authorized Agent .Aoh"')l 4biv0 (x±e.....rle-AI . CD rv‘ P 'C.0 Ta_c; Cos PO. aotc 3LN Yar-tvtovIA Pei-, Mrs O 75— Name( in I Mailing Address: 77,1 -3S"3-6BS-a ace) bS 7 C ' a_Kzu,_._ (0,1 1 Signature Telephone Fait ` Email Address ! Section 3 - Construction Services , 3.1 Licensed Construction Supervisor. Not Applicable i] Pali c_I_. a.c_ot0s C. go)( 3li ti ya. toil l,t P v'4 4 6a 7 License Number Address , 7"711' 35" —6oIFSa- afac.vb178 a heo.,�Expirati n D to Signature Telephone Email Add ess: y y d-a7 y . 3.2 Registered Home Improvement Contractor. Company Name Not Applicable ❑ • 19cr--inA,lacoltS P.O. box ?Kc( Yet r-ri ojtt P c+1 141-4 Addre Registration Number s 6 771/- 3 Si?- Expiration Date Signature Telephone Section 4-Workers'Compensation Insurance Affidavit(M.G.L c. 152 S 25C(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes No Section 5- Professional Design and Construction Services-for Buildings and Structures Subject to Construction Control Pursuant to 780 CMR 116(containing more than 35,000 c.f. of enclosed space) Section 5.1 Registered Architect Not Applicable ❑ Name (Registrant): Registration Number Address Expiration Date Signature Telephone Section 5.2 Registered Professional Engineer(s) Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Section``__ 5.3 General Contractor 41 ri2- acobS Not Applicable ❑ Company ?tips P -, jtLolaS Person Responsible for Construction P, 0. avc etryi.t mitt Por+ t41v3 Address 72Y-f$3-o ef—d--- Signature Telephone ' - Section 6 - Description of Proposed Work (check all applicable) • New Construction ❑ (for multiple family only) No.of Bedrooms C (for multiple family only) No.of Bathrooms Existing Bldg./ Repair(s) Alterations IEL Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: f _ Brief Description of Proposed rWorrk: t ( ` aka t.ta�l 4QDWY\ l4,2ceN 3 o` �c1 o_AC` ��;�d• A �12 If)A Toots. Section 7- Use Group and Construction Type Building Use Group (Check as applicapable) Construction Type A ASSEMBLY ❑ A-1 ❑ A-2 ❑ A-3 0 1A ❑ A-4 ❑ A-5 ❑ 1 B ❑ B BUSINESS 2A C] E EDUCATIONAL ❑ ze ❑ F FACTORY I] F-1 ❑ F-2 ❑ 2C i] H HIGH HAZARD ❑ 3A ❑ I INSTITUTIONAL ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M MERCHANTILE ❑ 4 ❑ R RESIDENTIAL ❑ R-1 0 R-2 ❑ R-3 ❑ 5A ❑ S STORAGE ❑ 5-1 0 S-2 ❑ 58 ❑ U UTILITY ❑ SPECIFY M MIXED USE l] 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: Existing Hazard Index 780 CMR 34 Proposed Hazard Index 780 CMR 34 Section 8 Building Height and Area • Building Area Existing(if applicable) Proposed Number of floors or stories include basement levels Floor Area per Floor(st) Total Area All Floors (sf) Total Height (ft) Section 9 - STRUCTURAL PEER REVIEW (780CMR 110 11) _ Independent Structural Engineering Structural Peer Review Required Yes No I SECTION 10a OWNER AUTHORIZATION -70 BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 'kTsi 9A-1,t0&) , as Owner of the subject property, hereby authorize PQ -L- acubS to act on my b alf, in all att relative to work authorized by this building permit application. (no- si tura o Owne Date SECTION 1 0b OWNER/AUTHORIZED AGENT DECLARATION , I, ___J b btw) NZ ` -‘,1,-1, N , as Owner/Authorized Agent hereby declare that the statements and information on the forgoing application are true and acurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. . 0 kk-) \C -C-- --,A_Al,ot.) . Pnri.r- e ‘ 1( i?1 Ai ( aDs9- ;-, •itliature of Owner/Agent Date .ction 11 - ESTIMATED CONSTRUCTION COSTS _ Item Estimated Cost(Dollars)to be completed by permit applicant 1.Building 2.Electrical I( / 3.Plumbing/Gas 4.Mechanical(HVAC) 5.Fire Protection .o 6.Total=(1+2+3+4+5) 4V07 - 7.Total Square Ft(13-nen str1s61tes&aeottiae) Check Below ❑ Conservation-Commission Filing (if applicable) ❑ Old Kings Highway&Historical - Commission approval (if applicable) _ � The Commonwealth of Massachusetts r" _" _ Department of Industrial Accidents ie 1 Congress Street, Suite 100 =i���i� i a "'-:1,_ Boston, MA 02114-2017 MI 5v'. 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): PC -rlZL6S Address: e p, box 314L( City/State/Zip: Ye,-etot Q i mil__ -7.s Phone #: ,7y- 75-T-GSS- Are you an employer? Check the appropriate box: Type of project (required): 1.7 I am a employer with employees(full and/or part-time).* _ 7. _ New construction 'f am a sole proprietor or partnership and have no employees working for me in y capacity. [No workers'comp. insurance required.] 8. Remodeling 3.—I am a homeowner doing all work myself. [No workers'comp. insurance required.]t 9. [ Demolition 4.❑ ProPem'.I am a homeowner and will be hiring contractors to conduct all work on myI will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 1 I. Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet These sub-contractors have employees and have workers'comp. insurance.) 13. Roof repairs 6._We are a corporation and its officers have exercised their right of exemption per MGL c. 14.El 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 certif. nd th ins and penalties of perjury that the information provided above is true and correct. Signature: Date: f/VI-0,3_1 Phone#: 7 71/-3S -G 85- ,._ 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#: §TOWN'.OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-22311 ;ext.4261 508-398-0836 Office of the Building Commissioner z:.:.:.,... . BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Ch. 40, §54 and 780 CMR- Section 105.3.1. #4. I hereby certify that the debris resulting from the proposed work/demolition to be conducted at L ( :e. a 8 Work Address Is to be disposed of oat the following location: e; A Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. Signature f Application Date Permit No. Sears, Tim From: Sears, Tim Sent: Wednesday, September 7, 2022 4:12 PM To: 'patjacobs78@yahoo.com' Subject: 411 Route 28 Pat, I have reviewed your application for renovations and there are some items needed. 1. Floor plan with rooms labeled for use(existing& proposed) New bathroom will be required to meet 521CMR AAB standards. Please provide drawing showing compliance. Fire department sign off Please provide these items for review. This email is considered a written denial of your permit application per Section 105.3.1 of the Massachusetts State Building Code. Section 105.3.2 states in part that "an application for a permit for any proposed work shall be deemed to have been abandoned 180 days after the date of filing, unless such application has been pursued in good faith" You may appeal this denial to the Building Code Appeals Board in accordance with M.G.L. c. 143 §100, within 45 days of this notice. Timothy Sears CB0 Deputy Building Commissioner Town of Yarmouth 508-398-2231 Ext. 1259 mailto:tsears@varmouth.ma.us 1 f yq'? TOWN OF YARMOUTH -- C, HEALTH DEPARTMENT o . - :,y PERMIT APPLICAT yON SIGN OFF TRANSMITTAL SHEET • To be completed by Applicant: 1 a AUG 3 0 2022 Building Site Location: Li 1\ g*. a h (AM—YanmoatA. Proposed Improvement: 6J;\d cl `lz toa irt, - occk- ic.e_. c.c cse , Ptto,,e_._ walk -Fe o uP o-i`ta., a.r-cas . Applicant: POATVA, ' Ct.CCIS' Tel. No.: 77(/ 3S-3-6,SS Address: O. QOx 31-14 Yctrmou t, 9o\41 (Vt 14 0c75 Date Filed: 0i ci`Doak l**If you would like e-mail notification of sign off,please provide'ie-mail address: Owner Name: 1--)A(' -ev A I Lp i /' Owner Address: 11 C V 1.01A1 S el)/ c 1 • Owner Tel. No.:-7?9 --"_6 R-GQ D a at\4S- MIA `i_._.________..___�____...._..� __ __.� _._.._._.._.._...._............_....._...___........_.. 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 with fee. REVIEWED BY: DATE: L PLEASE NOTE COMMENTS/CONDITIONS: 1:47 Done 2 of 2 AUG 30 2022 HEALTH DEPT. ICI occ e ROOM 12'5" x 11'3" • Walt + v� ce. Immo ROOM it 1© 13'2" x 21'10" ROOM wi 12'5" x 14'00 I a N m x O a . 1:46 . e Ifi. Done 1 of 2 I ..-..---"- VAC9fr ° C'\\I .....-,- ..,...-.. I OOM . N. Foyr '..) 1 7'7"x 2'1' II 1 1—.- 0 ROOM 209"x 116" 0 _ \D 3 _ iwi mom ,..1" . 611" 11 D ‘......_ 3 ..,,, ...., 111 ROOM 115"x 133" II I I •N oi nr, of.,r-it.,t.N.,1 rimy roi,,,.,1 Ili ly.,:11,'PIE 111,..ili'll,'11,1 i.d II:,,l,11;:P:11j(".•HI.' ,.1., ._ —.. ......—.— ..——....--- (Ill <ii; 0 rli Division of Occupational Licensure Board of Building Re ulations and Standards • Cons ionrSrisor s CS-081040 :' spires:04/04/2024 PATRICK H JACOBS • 28 WHITTIEWDR1VE DENNIS MA 0V638 *f tf - )(J.v ill, • Commissioner �ia ii'. t�Cvncltta.., THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Individual Registration Expiration 165888 05/14/2024 PATRICK JACOBS D/B/A P.JACOBS CUSTOM CARPENTRY AND REMODELING PATRICK JACOBS 28 WHITTER DR. a4610.4 DENNIS,MA 02638 Undersecretary MGL AND FIRE -- TOWN OF YARMOUTH $,RMOUTII ,, REVIEWED FOR CODE COMPLIANCE. latiPz ERRORS OR OMMISSIONS DO NOT RELIEVE THE APPLICANT FROM THE RESPONSIBILITY "'"}�►� OF"AS BUILT'COMPLIANCE. - 9-iLI- zL aFpt., DATE. L4-/ f_ __—_t. INSPECTOR YARMOUTH FIRE PREVENTION New Business Transmittal Project Name: Laer Address: 411 Route 28 Contact Name: Patrick Jacobs Phone: 774-353-6852 Description of planned project or business: remove wall and add '/2 bath 1 Y N NA Subject Regulation kl X Building Numbers MGL Chapter 148; sec 59 X Fire Lanes 527 CMR 1; 18.2.1 X Extinguishers 527 CMR 1; 13.6,Chapter 148;sec 28 X Maintence of any equipment,system relating to 527CMR1 1.1.4,MGL 148 section 27a Fire Protection. X *Hazardous Materials Storage 527 CMR 1;60.1,20.15.4 X Emergency Plan Required 527CMR1 10.8.1 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 10.10.2,20.1.5.2.4 X Blocking electrical panel 527CMR1 10.19.5.1 P X Blocking exits 527CMR1 14.4.1 i Extension cords shall not be used as a 527CMR1 11.1.5.6, X substitute to permanent wiring X Limit storage heights to 24 inches below 527CMR1 10.18.3 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; 10.18.1,4.4.3.1.1,19.1.2,34.1.1 X The right to inspect MGL Chapter 148 Sec.4 X *Upholstery 527 CMR 1;20.1.2 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 _ *YFD permit required-depending on occupancy and submittal A Permit from YFD is required any time a fire protection system is shut down,altered or removed. All existing fire protection systems to be inspected and upgraded as needed. The YFD support the application,subject to applicable submissions,permits and inspections. Plan Reviewed By: Lieutenant Matthew Bearse Date: September 14, 2022 Copy for Applicant 0 Copy to Building Department Copy to Fire Prevention Entered in Firehouse 71 Final Inspection 521 CMR: ARCHITECTURAL ACCESS BOARD • 30.00: continued ' 30.6.2 Alternate Accessible Stall: Alternate accessible toilet stalls shall be 36 inches(36"=914mm) wide with an outward swinging,self-closing door and parallel grab bars. See Fig.30c. a. The alternate toilet stall shall have a door that swings out or slides and has a 32 inch(32"= 813mm)clear opening. b. The stall door shall have an automatic self-closing hinge device,a pull device on both sides of the door to assist in closing and opening the door,and a lock located approximately 36 inches (36" =914mm) above the floor that does not require tight grasping, pinching, or twisting of the wrist to operate. c. A coat hook shall be provided at a maximum height of 54 inches(54"=1372mm)above the floor. 30.7 WATER CLOSETS That are required to be accessible shall comply with the following: 30.7.1 Clear floor space: Clearfloor space for water closets not in stalls shall comply with Fig:30d. Clearfloor space may be arranged to allow either a left-handed or right-handed approach to the water closet. y 42" y 18" y I 1067 1 457 "1 R‘CI)F11111 ° ; • in �j 1 Clear I a.- k�:'3iFr.:i}i'i'r� Floor • N 02 1 762 x 1219 ,* 2286 Accessible Unisex Toilet Room Figure 30d CHE SUULT" _.10-3—d.)1\ Lam.__..... _.. ..i.. .- 1/27/06 521 CMR- 123 521 CMR: ARCHITECTURAL ACCESS BOARD 6.00: SPACE ALLOWANCE AND REACH RANGES 6.4.1 Size and Approach: The minimum clear floor or ground space required to accommodate a single, stationary wheelchair and occupant is 30 inches by 48 inches (30" x 48" = 762mm x 1219mm) (See Fig. 6e). The minimum clear floor or ground space for wheelchairs may be positioned for forward or parallel approach to an object (See Fig. 6f and 6g). Clear floor or ground space for wheelchairs may be part of the knee space required under objects. k. �! ' !..';.f. M. ti rill .:.:1 ........4 ::::::4 1. 177-77!f:::::: 1. : L : ::::: J I_ 30" I_ 4` 3 ,. X 762 X 762 762 Clear Floor Space Forward Approach Parallel Approach Figure 6e Figure 6f Figure 6g 6.4.2 Relationship of Maneuvering Clearance to Wheelchair Spaces: One full unobstructed side of the clear floor or ground space for a wheelchair shall adjoin or overlap an accessible route or adjoin another wheelchair clear floor space. If a clear floor space is located in an alcove or otherwise confined on all or part of three sides, additional maneuvering clearances shall be provided as shown in Fig. 6h and 6j. !::::..1 T1111:::::::::..1 1 i 1 � p .. `:'. ':. I. 48" 4" { : ::: X 1219 762 Clear Floor Space at Alcoves Figure 6h 1/27/06 521 CMR-28 521 CMR: ARCHITECTURAL ACCESS BOARD 6.00: SPACE ALLOWANCE AND REACH RANGES X mgmaii ��flir Z� iceZ 8„ mi 1219r Z / "48" min 1219 NOTE: X shall be less than or equal to 25" (635 mm). Z shall be greater than X. When X is less than 20" (508 mm), then Y shall be 48" (1219 mm) max. When X is 20" to 25" (506 to 635 mm), then Y shall be 44" (1118 mm) max. Maximum Forward Reach over an Obstruction Figure 61 6.6 SIDE REACH If the clear floor space allows parallel approach by a person in a wheelchair,the maximum high side reach allowed shall be 54 inches (54" = 1372mm)and the low side reach shall be no less than nine inches (9" = 229mm) above the floor (See Fig. 6m). If the side reach is over an obstruction,the reach and clearances shall be as shown in Fig. 6n. 10" 30" 30" 24" max i.25 ' 762 762 610 .:::.:;4i - cl `t f ` Ri co s N 3 EnI I �N ........ • • \ \ High and Low Side Reach Maximum Side Reach over Obstruction Figure 6m Figure 6n 1/27/06 521 CMR- 30 • 1:47 d tre ,:. Done 2 of 2 ICI ROOM 12'5" x 11'3" ova wal( ogt ce. mom ROOM IC) 13'2" x 21'10" � ofPce ROOM I® z 12'5" x 14'01 I -7 x O of i { Cr3 al 39 a Q. 1:46 Done 1 of 2 r_ ROOM 15'7"x 16'4" z _ FO"Eft 77 xz11," J� II R i ` a 20'9"x 11'6" - / TH 'I \ / 5'1" 6'11" iiOFFx ROOM 11'5"x 13'3" a Q.