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HomeMy WebLinkAboutBLD-23-002540 z :'x 8(, ILD` t P R MIT APPLICATION . ' -' APPUCA' ON TO CONSTRUCT,REPAIR, RENOVA E, CHANGE THE� DR DEM LUSH ANY BUILDING OT; ER THAN A ONE OR TWO AMIL` d ' �y. } t^ �...3r..cfrcnt./' Tba;tiil is Yarmouth 1t?ili}1 Building itrt i T}° .�. w v*'.-*.....ty �. 1146Rili€c, 2, Tel: 508.398.2231 ext. 1261 Fax 50 -.3 Q 6 {{{{��!�s only **�}2nrn r Intonation RfiBriCf�e�}�w h ?R }information: ` {,n Y j� �vf e uf� P�,t+4 V E �Vt+i[a r {!'{36I i.so id 1,Bent i 4sZ, "4 UV{I wm 1: Y ,� Li] ; � o. � n e q 1 '_` i Permit Fee , / f Erdorstmcni'?ate. i'� / % i Ftecerdiinv :ate ? ' De sit Reed. $ L.'' Date1 Pier a. Property" I Per Dimensions: ;� x :) Net Due t i a 77) !other „- Lot Area fat) Frontage ftt) tdt ge This Section for Office use Only Data Issued: r Slur ; ' ` C i i c Occupancy �� , Section I - Site Information , I. 1.1 Prvpnrty Address; -------^ a arinssrt Proposed .3 Building 5ettxac3sslt} __ _ , , Front Yard i �. .,,,a_.____ i Yards I Rear Yard E Required i Provided ! R ur,rar r r video ec aired rs �i d 1.4.Wateri supply ttl.a�,t_iw,.4CS.n$ar4) `1.5 Flood Zone i f thatio u,yy pp; // ire t �� c Sectit 2 Property Owners rA!.tt ori.: Acienti ,__ ,,<, ,; 2.1 Owt r o! ord 1 * ' 03....\ \. '‘ , .. °, r ,� \ Ito Name(Prim) - Mailing Adams svr,p v} Signattili le7.1 hone Telephone i rl11 ire ' 2.2 Authorized Agent:- Tim DeLude, District Manager „ I • 61 Commonwealth Ave., Yarmouth, MA 02664 --_ Marne (print Mailing Ac tress: a}255-141. 3Q2 tim@neusetdisposal.com 54 Signature Telephone ir.a rwieit Adore ss. _j ',:l S on 3 Construe tfon Services 3.141cons.d Construction u r iscer: ` ht t icable i Sjil pY\e, I c__: , - 1‘3Qkiko \ , L er e 3um er �, 2 \-\,-—I --z' zi,--: ��,�' rer reta Ada�`�s.¢r. '_ • r• 'mil`"+ r- aH d`4 ,,,31'�'_ 2. • +`` t�. P` {, ,ii .e ,� s; ;` • dk .1 d;ti '.. 1 C ` {ys', of ,,. #� i-„�',,5..y S a� z • . . is • ,�5 vE� a „ ''..C r a �' `fir - . ' . ." i?j h.. ,.. 4 _. ..' 14 ,. µse 5Y. 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"/,+�rr -.*7- A', ,%,q� s F.. - fix. .->" • - - 7 _ ,. . fJ 'K 'N #r,t. - Y. ,. . . 1 3.2 Registered Home Improvement Contractor: — , - Company Mama ic:3 j\ ,::),.......c\ SZ____a_ty-\---pc"-Cd-- 0 Cs\ a -- Not Applicable 0 i . 5 2:1 fY\CL:\ r S-V '; -\2- ar W sk Or ? 4S \ 4 9 3 -1 Address Registratior N bar_ I ' SbS"-110 giOD 1 -- ) a 1 I 2-9 Sizp;7..tton Date t I:signature Telephone Section 4- Workers Compensation Insurance Affidavit (Nit,G.L.c. 152 S 25C(6)-1 . Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure -i to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavrt Attached Yes ...I..... No 'Section 5- Professional Design and Construction Services-far Buildings and Structures Subject to Construction Controt Pursuant to 780 CMR 115(containing more than 35,000 c.f. of enclosed space) Section Si Registered Architect: Applicable CI Herne (Registrant): ! , Registration Number Address Expiration Date Signature Telephone .- • • Section 5.2 Registered Professional Engineer Name ArEa of Responsibty Address Registration Number Signature Telephone 1 Exiotration Date 1 . . Name Ama oi R --portsbility Address Registration Nurnher Signature Telephone ir-2.xpiration Date I ' Area at Respons:bility Name Address Registration Number 1 Signature Telephone Eviration Date 1 . Mania Area of Responsibility 1 Address e _ li Rgistration Ntrtber 1 Excretion Date Telephone Si onature \Section 5.3 General Contractor 1 ec,5,.,...:22,..\\:(1,,:: :.,,,\\t,..\_.„7:ephnone, oci cc_ \ tiotApik,abie 0 . ,...\, Company HaMe Person RestInsibli3 for Construction . c_ ...„ \\cicv,..) (...)is Acidness 56 LE' ,D R1 OD gnature The Commonwealth of Massachusetts Department of Industrial Accidents _ 1 Congress Street, Suite 100 =-1__ Boston, M4 02114-2017 _ www.mass.gov/dia \Y orkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH TIlE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): (),),)\ � v s. OFain Qn OT C,�, M Cod Z Address: �j 1 I(� �-�— 1 2 �c City/State/Zip: OSAK)\(J .+ 1\ 02-LrA Phone #: 31Ig — H SO g I OU Are you an employer? Check the appropriate box: Type of project (required): l.[?I am a employer with 02. employees(full and/or part-time).* 7. New construction 2.L I am a sole proprietor or partnership and have no employees working for me in 8.any capacity, [No workers'comp. insurance required_] 9. "Remodeling 3.n] am a homeowner doing all work myself. t 9. ❑ Demolition y [No workers'comp.insurance required.] 4.0 I am a homeowner and will be hiring contractors to conduct all work on m YProPen3'• I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑ Electrical repairs or additions proprietors with no employees. 12.❑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. l3•❑Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.El Other 152,§l(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. tContractors 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: @rd 1�C U rancp C�� . Policy#or Self-ins. Lic. #: `.1`.)C oa gaq Expiration Date: \ Job Site Address: 0_,prnm()( City/State/Zip:S. 1,ii\AI�VTr ) OZlploy Attach a copy of the workers' compensation policy declaration page(showing the policy numbel" 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: pAr7i Phone#: 7 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#: SECTION 1 Ob OWNER/AUTHORIZED AGENT DECLARATION I' /0 C01 \ �! ue as Owner/Authozed 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. �-' i) ef) Ck\\ • Print Ns 1 _ � ID\\ \ 2-Z tgriature of OwnertAgont Date (Section 11 - ESTIMATED CONSTRUCTION COSTS item Estimated Cost(Dollars)to be compiete5 by permit applicant 7,Eiuirdtt3F a-Electric 3,Plumbing"Gas 4,mechanical(f1VACi S.Fire Protection 5,Total={X+2+3+4,.5} 7 Total Sire Ft ttirivii0ttr.crxmct kaituaesl J Check Below Conservation-Commission Ring (if applicable) Ej Old Kings'Highway&Historical Commission approval (if applicable) sue•«.-- • Y s:' e �. , � Mid ' 8 ,,.� 3 � fir R i� §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1261 Fax 508-398-0836 Office of the Building Commissioner 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 (p I Cjb [MO ) ke Work Address Is to be disposed of oat the following location: --1)v rnpS i" Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. Signature of Application Date Permit No. • Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers''compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in ajoint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter I52, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and,if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage, Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the.applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 02-23-15 www.mass.gov/din • THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washingtc Bret - Suite 710 Boston, Massachusetts 02118 Home Improvement ttractor Registration :.{ 1t Type: Corporation Registration: 184937 DISASTER RESPONSE&RESTORATIONOF THE CAPE&ISLA DS, INC. D/B/A PAUL DAVIS RESTORATION OF CAPE COD&THE tSLAtBt `# Expiration: 03/31/2024 527 MAIN ST UNIT 12 HARWICH,MA 02645 f ' Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Corporation Office of Consumer Affairs and Business Regulation Reg stration ,,n F.itpinition 1000 Washington Street -Suite 710 184937 `4 03/31/2024 Boston,MA 02118 >ISASTER RESPONSE&RESTORATIONOF THE CAPE&ISLANDS, VC. j, )IB/A PAUL DAVIS RESTORATI©N OFFAPE COD&THE ISLANDS ,TEPHEN P.CAHILL ` 27 MAIN ST UNIT 12 ,.I IARWICH,MA 02645 Undersecretary Not valid without signature \t tNr SnCteNi #11 � t � 4t1E Property Location 61 COMMONWEALTH AVE Map ID 98/89/// Bldg Name State Use 3160 Vision ID 13227 Account# 13227 Bldg# 1 Sec# 1 of 1 Card# 1 of 2 Print Date 9/27/2022 5:16:57 PM CURRENT OWNER TOPO UTILITIES STRT/ROAD LOCATION CURRENT ASSESSMENT NAUSET DISPOSAL HOLDINGS INC 1 Level Public Water I Paved 5 Industrial Description Code Appraised Assessed 815 4 Gas COMMERC. 3160 536,100 536,100 6 Septic COM LAND 3160 669,700 669,700 3 WATERWAY SQUARE PL STE 110 SUPPLEMENTAL DATA YARMOUTH, MA Alt Prcl ID 87/Q016/// VOTE N THE WOODLANDS TX 77380 MISC 295 VOTE DATE 01/31/2011 CHANGES ADD:3/3/08 PRIVATE COMMONWEALT PNE PLANVISION V# 625A, 79 ZIP CODE 2664: GIS ID M_307783_827178 Assoc Pid# - Total 1,205,800 1,205,800 RECORD OF OWNERSHIP BK-VOUPAGE SALE DATE CT/U V/I SALE PRICE VC _ PREVIOUS ASSESSMENTS(HISTORY) NAUSET DISPOSAL HOLDINGS INC D146 0 07-19-2022 U I 1,960,000 1V Year Code Assessed Year Code Assessed Year Code Assessed BROWNING-FERRIS IND INC 1915 0018 08-10-1973 U I 0 2023 3160 536,100 2022 3160 492,600 2021 3160 492,600 BROWNING-FERRIS IND.INC. 0 I 0 3160 669,700 3160 549,600 3160 • 549,600 Total 1,205,800 Total 1,042,200 Total 1'042,200 EXEMPTIONS OTHER ASSESSMENTS This signature acknowledges a visit by a Data Collector or Assessor Year ' Code Description Amount Code Description Number Amount Comm Int APPRAISED VALUE SUMMARY I T t Appraised Bldg.Value(Card) 466,800 r_ va!t 0.00 l I I ASSESSING NEIGHBORHOOD', Appraised Xf(B)Value(Bldg) 12,900 Nbhd H Nbhd Name B Tracing Batch Appraised Ob(B)Value(Bldg) 56,400 D NOTES Appraised Land Value(Bldg) 669,700 REPUBLIC WASTE SYSTEMS Special Land Value 0 Total Appraised Parcel Value 1,205,800 2 STORY 1200SF ADDTN Valuation Method C 1985 BLUE Total Appraised Parcel Value 1,205,800 BUILDING PERMIT RECORD VISIT/CHANGE HISTORY Permit Id Issue Date Type Description Amount Insp Date %Comp Date Comp- Comments Date Id Type Is Cd Purpost/Result 05-118 07-26-2004 AL Alterations 76,000 REPLACE STAIRS,DEMO 2B 03-12-2014 DK 00 Measur+Listed 995266 04-25-1994 126,000 07-25-1995 100 01-01-1995 TRUCK WAS 01-01-2014 BH 01 1 CY CYCLICAL 2014 996431 07-14-1989 310,000 100 ADDITION 10-06-2004 GM 00 Measur+Listed 997257 05-02-1989 4,000 100 MOVE PART 07-25-1995 JF 00 Measur+Listed 99835 01-20-1989 40,000 100 ALTERATIO LAND LINE VALUATION SECTION _ B Use Code Description Zone Land Type Land Units Unit Price I.Factor Site Index Cond. Nbhd. Nhbd Adj Notes Location Adjustment Adj Unit Pric Land Value 1 3160 COMM WHSE M 43,560 SF 9.54 1.00000 D 1.00 D 0.870 0 8.3 361,500 1 3160 COMM WHSE M 4.040 AC 87,700.00 1.00000 D 1.00 D 0.870 0 76,299 308,200 Total Card Land Units 5 AC Parcel Total Land Area: 5 Total Land Value 669,700 Property Location 61 COMMONWEALTH AVE Map ID 98/89/// Bldg Name State Use 3160 Vision ID 13227 Account# 13227 Bldg# 1 Sec# 1 of 1 Card# 1 of 2 Print Date 9/27/2022 5:16:58 PM Gt#N; i G7 E ETA1L CONSTRUCTION DETAIL., , NTINUE Element Cd Description Element Cd Description Style: 18 Office Bldg Model 94 Comm/Ind Grade 01 Minimum Stories: 2 FUS Occupancy 1.00 Code 100 MIXLi;USE BAS Exterior Wall 1 27 Pre-finsh Metl Description 0 Percentage Exterior Wall 2 3160 COMM WHSE M94 Roof Structure 03 Gable/Hip 0 Roof Cover 01 Metal/Tin InteriorWalll 05 Drywall/Sheet COST/MARK TVALUA 30 Interior Wall 2 Interior Floor 1 14 Carpet RCN 232,642T BAS. Interior Floor 2 05 Vinyl/Asphalt Heating Fuel 03 Gas Heating Type 04 Forced Air-Duc Year Built 1974 AC Type 03 Central Effective Year Built Bldg Use 3160 COMM WHSE M94 Depreciation Code G 40' Remodel Rating 30 Total Rooms Year Remodeled Total Bedrms 00 Depreciation% 19 Total Baths 0 Functional Obsol Heat/AC 01 HEAT/AC PKGS Ext.Comment 15 Frame Type35 05 LT STEEL Trend Factor 1 Baths/Plumbing 02 AVERAGE Condition Ceiling/Wall 05 SUS-CEIL&WL AVERAG Percent Good ° Rooms/Prtns 02 E Condition /° Wall Height 10.00 66 RCNLD 153,500 Comn Wall 0.00 Dep°Ao Ovr 1st Floor Use: 3160 Dep Ovr Comment Misc Imp Ovr Misc Imp Ovr Comment - � '". A Cost to Cure Ovr Cost to Cure Ovr Comment 08.OUTAUILDING YARI ITEMS(L)?XF•BUILDING EXTRA FEATURES(B) �� - Code Description L/B Units Unit Price Yr Bit Cond.Cd /°Good Grade Grade Adj Appr.Value rr FN3 FENCE 6'CHAI L 860 9.00 1987 50 0.00 3,900 �`:� TNK2 3000-10000 GA L 12,000 2.00 1987 50 0.00 12,000 ; � � , PAV1 PAVING-ASPH L 60,000 1.35 1987 50 0.00 40,500 � EEC x A.r .. r� x BUILDING SUB-AREASUMMARY M Ai l�SEC N Code Description Living Area Floor Area Eff Value ':-- ��� BAS First Floor 2,250 2,250 2Area,250 Unit Cost 67.43 Undeprec 151,723 � �' n FUS Upper Story,Finished 1,200 1,200 1,200 67.43 80 919 l ; Sri i 232,642 Ttl Gross Liv/Lease Area 3,450 3,450 3,450 Property Location 61 COMMONWEALTH AVE Map ID 98/89/// Bldg Name State Use 3160 Vision ID 13227 Account# 13227 Bldg# 2 Sec# 1 of 1 Card# 2 of 2 Print Date 9/27/2022 5.16:58 PM CURRENT OWNER TOPO UT(Lff`IES- SIR T/ROAD LOCATION CURRENT ASSESSMENT eve '21ublic Water 1 Paved 5 Industrial DescriptionCodeAppraised pssesse NAUSET DISPOSAL HOLDINGS INC IL 1pp Assessed 815 Il 4 Gas COMMERC. 3160 536,100 536,100 6 Septic COM LAND 3160 669,700 669,700 3 WATERWAY SQUARE PL STE 110 SUPPLEMENTAL DATA YARMOUTH,MA THE WOODLANDS TX 77380 Alt Prcl ID 87/Q016/// VOTE N _ MISC 295 VOTE DATE 01/31/2011 CHANGES ADD: 3/3/08 PRIVATE COMMONWEALT PNE VISION- ZIP # 625A,79 ZIP CODE 2664: GIS ID M_307783_827178 Assoc Pid# Total 1,205,800 1,205,800 RECORD OF OWNERSHIP BK-VOLfPAGE SALE DATE 0/U V/I ' SALE PRICE VC PREVIOUS ASSESSMENTS(HISTORY) NAUSET DISPOSAL HOLDINGS INC D146 0 07-19-2022 U I 1,960,000 1V Year Code Assessed Year Code Assessed Year Code Assessed BROWNING-FERRIS IND INC 1915 0018 08-10-1973 U I 0 2023 3160 536,100 2022 3160 492,600 2021 3160 492,600 BROWNING-FERRIS IND.INC. 0 I 0 3160 669,700 3160 549,600 3160 549,600 Total 1,205,800 Total 1,042,200 Total 1,042,200 EXEMPTIONS OTHER ASSESSMENTS This signature acknowledges a visit by a Data Collec,or or Assessor Year Code Description Amount Code Description Number Amount Comm Int APPRAISED VALUE SUMMARY I Tcta 0.0�1 I l I I Appraised B!dg Va!uc(Card) 466,800 ASSESSING NEIGHBORHOOD,, Appraised Xf(B)Value(Bldg) 12,900 Nbhd Nbhd Name B Tracing Batch Appraised Ob(B)Value(Bldg) 56,400 L D NOTES Appraised Land Value(Bldg) 669,700 TRUCK WASH Special Land Value 0 REAR 14X80=HT 10 FT Total Appraised Parcel Value 1,205,800 I BLUE Valuation Method C AOF=BREAK&REST ROOMS REAR 44X50=BP 95 Total Appraised Parcel Value 1,205,800 BUILDING PERMIT RECORD VISIT/CHANGE HISTORY Permit Id Issue Date Type _ Description Amount Insp Date % Date Comp Comments Date Id Type Is Cd Purpost/Result LAND LINE VALUATION SECTION B Use Code Description Zone Land Type Land Units Unit Price I. Factor Site Index Cond. Nbhd. Nhbd Adj Notes Location Adjustment Adj Unit Pric Land Value 2 3161 COMM WHSE M 0 SF 12.00 1.00000 D 1.00 1.000 0 12 0 Total Card Land Units 01 AC Parcel Total Land Area: 5 Total Land Value -669,700 Property Location 61 COMMONWEALTH AVE Map ID 98/89/// Bldg Name State Use 3160 Vision ID 13227 Account# 13227 Bldg# 2 Sec# 1 of 1 Card# 2 of 2 Print Date 9/27/2022 5:16:58 PM Element Cd Description Element Cd - Description 44 Style: 35 PreEngrdGarage Model 96 Ind/Comm Grade 04 Average+10 Stories: 1 Occupancy 1.00 ',WOO USE 75 8 50 Exterior Wall 1 27 Pre-finsh Met' Code Description Percentage 75 Exterior Wall 2 3161 COMM WHSE M96 100 Roof Structure 02 Shed 0 Roof Cover 01 Metal/Tin 0 Interior Wall 1 01 Minim/Masonry COST/MARKET VALUATION Interior Wall 2 " 16 Interior Floor 1 03 Concr-Finished RCN 591,223 Interior Floor 2 Heating Fuel 03 Gas BAS Year Built 1972 Heating Type 03 Hot Air-no Duc 82 Effective Year Built AC Type 01 None Depreciation Code A Bldg Use 3161 COMM WHSE M96 Remodel Rating Total Rooms Year Remodeled Total Bedrms 00 Depreciation% 27 20 80 Total Baths 0 Functional Obsol Heat/AC 00 NONE Ext.Comment 20 Af�F Frame Type 05 LT STEEL 20 Trend Factor 1 Baths/Plumbing 02 AVERAGE Condition 16 Ceiling/Wall 02 CEILING ONLY Condition% 40 40 Rooms/Prtns 02 AVERAGE Percent Good 53 Wall Height 23.00 RCNLD 313,300 Comn Wall 0.00 Dep%Ovr 1st Floor Use: 322Z Dep Ovr Comment 20 40 Misc Imp Ovr Misc Imp Ovr Comment Cost to Cure Ovr Cost to Cure Ovr Comment _ OB-OUTBUILDING&YARD ITEMS(L)/XF»BUILDING EXTRA FEATURES(B) Code Description L/B Units Unit Price Yr BR Cond.Cd %Good Grade Grade Adj Appr.Value MEZ3 W/PARTITIONS B 400 24.00 1990 53 0.00 5,100 MEZ1 MEZZANINE-U B 800 12.00 1990 53 0.00 5,100 SPR1 SPRINKLERS- B 6,320 0.80 1990 53 0.00 2,700 BUILDING'SUB-AREA SUMMARY SECTION °�� � iLi* f" , ,-/' Code Description Living Area Floor Area Eff Area Unit Cost Undeprec Value �-AOF Office,(Average) 800 800 1,000 51.80 41,437 = BAS First Floor 13,268 13,268 13,268 41.44 549,786 1. , , : Ttl Gross Liv/Lease Area 14,068 14,068 14,268 591,223 ,s. 10/18/22, 12:15 PM Vision Government Solutions 61 COMMONWEALTH AVE Location 61 COMMONWEALTH AVE Mblu 98/89/// Acct# 13227 Owner NAUSET DISPOSAL HOLDINGS INC Assessment $1,205,800 PID 13227 Building Count 2 Current Value Assessment Valuation Year Improvements Land Total 2023 $536,100 $669,700 $1,205,800 Owner of Record Owner NAUSET DISPOSAL HOLDINGS INC Sale Price $1,960,000 Care Of Certificate Address 3 WATERWAY SQUARE PL STE 110 Book&Page D1463619/0 THE WOODLANDS,TX 77380 Sale Date 07/19/2022 Instrument 1V Qualified U Ownership History Ownership History Owner Sale Price Certificate Book&Page Instrument Sale Date NAUSET DISPOSAL HOLDINGS INC $1,960,000 D1463619/0 1V 07/19/2022 BROWNING-FERRIS IND INC $0 1915/0018 08/10/1973 , BROWNING-FERRIS IND.INC. $0 /0 Future Owners Ownership History Owner Sale Price Certificate Book&Page Instrument Sale Date NAUSET DISPOSAL HOLDINGS INC $1,960,000 i D1463619/0 1V 07/19/2022 Building Information https://gis.vgsi.com/yarmouthma/Parcel.aspx?Pid=13227 1/4 10/18/22, 12:15 PM Vision Government Solutions Building 1 : Section 1 Year Built: 1974 Building Photo Living Area: 3,450 Replacement Cost: $232,642 ' Building Percent Good: 66 ,� � Replacement Cost Less Depreciation: $153,500 �' ` Building Attributes _. ° Field Description Style: Office Bldg 4 " Model Comm/Ind .. Grade Minimum Stories: 2 Occupancy 1.00 (https://images.vgsi.com/photos2/YamiouthMAPhotos/A00\01\26\18.jpg) Exterior Wall 1 Pre-finsh Met! __.__._.........._ Building Layout Exterior Wall 2 Roof Structure Gable/Hip Fus SAE. Roof Cover Metal/Tin Interior Wall 1 Drywall/Sheet oe SAS Interior Wall 2 Interior Floor 1 Carpet u 4° Interior Floor 2 Vinyl/Asphalt Heating Fuel Gas Heating Type Forced Air-Duc ACT e Central (ParcelSketch.ashx?pid=13227&bid=13780) Struct Class Building Sub-Areas(sq ft) Legend Bldg Use COMM WHSE M94 Gross Living Code Description Area Area Total Rooms BAS First Floor 2,250 2,250 Total Bedmis 00 FUS Upper Story,Finished 1,200 1,2001 Total Baths 0 . ........ .............. 1st Floor Use: 3160 3,450 3,4501 Heat/AC HEAT/AC PKGS Frame Type LT STEEL Baths/Plumbing AVERAGE Ceiling/Wall SUS-CEIL&WL Rooms/Prtns AVERAGE Wall Height 10.00 Comn Wall 0.00 Building 2 : Section 1 2/4 https://gis.vgsi.com/yarmouthma/Parcel.aspx?Pid=13227 10/18/22, 12:15 PM Vision Government Solutions Year Built: 1972 Building Photo Living Area: 14,068 Replacement Cost: $591,223 Building Percent Good: 53 Replacement Cost Less Depreciation: $313,300 Building Attributes : Bldg 2 of 2 Field Description V` �� ��� Style: PreEngrdGarage t��� - M t1 1!e +e NNW . Model I nd/Comm i• Grade Average+10 Stories: 1 Occupancy 1.00 - --- -- -- (https://images.vgsi.com/photos2/YarmouthMAPhotos/A00\01\83\29.jpg) Exterior Wall 1 Pre-finsh Met! Building Layout Exterior Wall 2 44 Roof Structure Shed Roof Cover Metal/n irks 5 .1 28 i 22 Interior Wall 1 Minim/Masonry 75 80 7$ Interior Wall 2 Interior Floor 1 Concr-Finished 18, .. Interior Floor 2 BAS Heating Fuel Gas 82 Heating Type Hot Air-no Duc 20 AC Type None 80 _ __ Ate Struct Class 20 75 40 Bldg Use COMM WHSE M96 Total Rooms 20 40 Total Bedrms 00 (ParcelSketch.ashx?pid=13227&bid=13781) Total Baths 0 _......_...__..._.. __._........__._ Building Sub-Areas(sq ft) L2g2ad 1 1st Floor Use: 322Z Gross Living Heat/AC NONE Code Description11 Area Area t Frame Type LT STEEL BAS First Floor 13,268 13,268 I Baths/Plumbing AVERAGE AOF F Office,(Average) 800 800 j Ceiling/Wall CEILING ONLY 14,068 14,068 Rooms/Prtns AVERAGE Wall Height 23.00 %Comn Wall 0.00 Extra Features .__ _._ Extra Features LQgv I Code Description Size Value Bldg# https://gis.vgsi.com/yarmouthma/Parcel.aspx?Pid=13227 3/4 10/18/22,12:15 PM Vision Government Solutions 4 MEZ3 W/PARTITIONS 400.00 S.F. $5,100 MEZ1 MEZZANINE-UNF 800.00 S.F. $5,100 2 SPR1 SPRINKLERS-WET 6320.00 S.F. $2,700 2 Land Land Use Land Line Valuation Use Code 3160 Size(Acres) 5.04 Description COMM WHSE M94 Frontage 0 Zone Depth 0 Neighborhood D Assessed Value $669,700 Alt Land Appr No Category Outbuildings Outbuildings Legend Code Description Sub Code Sub Description Size Value Bldg# FN3 FENCE-6'CHAIN I 860.00 L.F. $3,900 1 t TNK2 3000-10000 GAL 12000.00 GALS $12,000 1 1 PAV1 PAVING-ASPHALT 60000.00 S.F. $40,500 1 Valuation History Assessment Valuation Year Improvements Land Total 2023 $536,100 $669,700 $1,205,800 2022 $492,600 $549,600 $1,042,200 2021 $492,600 $549,600 $1,042,200 (c)2022 Vision Government Solutions, Inc.All rights reserved. httpsJ/gis.vgsi.com/yarmouthma/Parcel.aspx?Pid=13227 4/4 ,ACUREI CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 10/18/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY•OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Caitlin Regan NAME: Dowling&O'Neil Insurance Agency PHONE (800)640-1620 FAX (A/C,No,Ext): (A/C,No): _ 973 Iyannough Road E-MAIL cregan@doins.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC U Hyannis MA 02601 INSURER A: Colony Insurance Company 39993 INSURED INSURER B: NGM Insurance Company 14788 Disaster Response&Restoration of the Cape&Islands,Inc,DBA:Paul INSURER C: PDR of Cape Cod&the Islands INSURER D 527 Main Street-Unit 12 INSURER E: Harwich MA 02645 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD, POLICY NUMBER (MM/DD/YYYY) (MM!DDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE CLAIMS-MADE X OCCUR PREMISES Ea occur ence) $ 100,000 1 MED EXP(Any one person) $ 5,000 A EV2021104801 11/30/2021 11/30/2022 PERSONAL&ADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 J POLICY I X,PRO 2,000,000 , JECT LOC PRODUCTS-COMP/OP AGG $ X OTHER: DEDUCTIBLE:$5,000 BAILEES CUSTOMERS $ 250,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 ^ (Ea accident) _ ANY AUTO BODILY INJURY(Per person) $ B X OWNED SCHEDULED M1T6117U 11/30/2021 11/30/2022 BODILYINJURY(Peraccident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X, AUTOS ONLY (Per accident) $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 A EXCESS LIAB EX2021104901 11/30/2021 11/30/2022 4 CLAIMS-MADE AGGREGATE $ , , DED X RETENTION$ 0 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER • ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ ' OFFICER/MEMBER EXCLUDED? (Mandatory In NH) I E.L.DISEASE-EA EMPLOYEE $ _ If yes,describe under — DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ PROFESSIONAL LIAB $1 M/$2M MISC LIABILITY A EV2021104801 11/30/2021 11/30/2022 POLLUTION LIAB $1M/$2M DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Job:Nauset Disposal Inc.;61 Commonwealth Ave.,S.Yarmouth, MA 02664 Insurance coverage is limited to the terms,conditions,exclusions,other limitations,and endorsements.Nothing contained in the Certificate of Insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Yarmouth ACCORDANCE WITH THE POUCY PROVISIONS. 1146 Route 28 I AUTHORIZED REPRESENTATIVE South Yarmouth MA 02664 "w.." . O 1988-2015ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Aco CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) `..../ 10/19/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Linda Sullivan DOWLING & O'NEIL INSURANCE AGENCY (A/CC,No,Ext): (508)775-1620 7 FAX (A/C,No): ADDRESS: Isullivan@doins.com 973 IYANNOUGH RD INSURER(S)AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURERA: AMGUARD INSURANCE CO 42390 INSURED INSURER B: DISASTER RESPONSE&RESTORATION OF THE CAPE&ISLANDS INC INSURER C: DBA PAUL DAVIS RESTORATION OF CAPE COD&THE ISLANDS INSURER 527 MAIN STREET UNIT 12 INSURER E: HARWICH MA 02645 INSURERF: COVERAGES CERTIFICATE NUMBER: 826050 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRICY EFF POLICY EXP TYPE OF INSURANCE NSD ADDL SWVD POLICY NUMBER (MMUBR LDDIIYYYY) (MM/DDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE TO RENTED $ CLAIMS-MADE OCCUR PREMISES(ga occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO j JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS N/A BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION �/ PER AND EMPLOYERS'LIABILITY -X STATUTE ERH ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBEREXCLUDED? N/A N/A N/A R2WC280928 11/30/2021 11/30/2022 (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 1,000,000 N/A l � I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B, no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/Iwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN Town of Yarmouth ACCORDANCE WITH THE POLICY PROVISIONS. 1146 Route 28 AUTHORIZED REPRESENTATIVE South Yarmouth MA 02664 Daniel M.Crotvy,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD .0t:YA. 4r TOWN OF YARMOUTH 44.1,1",or HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant: Building Site Location: (DI Efir O iw? f `f €- r1 Proposed Improvement: '� HMO c t NC 0 OCP CI by �c or_. rCJ . n CA* hamn r C O \c Applicant: 7�L.\12._ (`x r \\ �c \ \V �c ( Tel. No.: SD V30 ►C7D Address: 5 Q-1 \CkA n CA r V-W I°V1 i LZLLI Date Filed: I I'`c` 22_ **If you would like e-mail notification of sign off please provide e-mail address: Owner Name: t)Q j Okicx-v ) J alp: - W 0(14�G(s � � `f� 1130 Owner Address: (.(5\ l�U(`(\(NA OnV.?-e C ` 1 Owner Tel. No.: 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: `VA.a AD, PLEASE NOTE COMMENTS/CONDITIONS: NOV 7 8 2022 I!CALIF DEN�, MGL AND FIRE TOWN OF YARMOUTH gti REVIEWED FOR CODE COMPLIANCE. -& �1 ERRORS OR OMISSIONS DO NOT RELIEVE THE APPLICANT FROM THE RESPONSIBILITY 4:11; ►►+ OF"AS BUILT"COMPLIANCE DATE. 1/- 2• LI-- INSPECTOR YARMOUTH FIRE PREVENTION New Business Transmittal Project Name: Nauset Disposal Address: 61 Commonwealth Ave Contact Name: Steve Cahill Phone: 774-836-8762 Description of planned project or business: New use and occ I Y N NA Subj t Regulation 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 X Blocking exits 527CMR1 14.4.1 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: November 22, 2022 Copy for Applicant E1 Copy to Building Department II Copy to Fire Prevention Entered in Firehouse ri Final Inspection TOWN Off' YA: OUTH 1146 Route 28, out i. arm®uth, MA 02664 508-398-2231.zex . 26,1 Fax:508-398-0836 Office of the Buildinomnmissioner �rr Massachusetts Existing Building Code Checklist Based on 2015 IEBC w/Massachusetts Amendments To be submitted with Building Permit Application Address: 6/ ebt 1/�l u i z.„4/ThG 4,,,..„--- £JJ-' -ijeifif a '7 , MA (Street number,name) (City/Town) Unit Suite(location within building) Risk Category: (Check one), ❑ Risk Category I,A Risk Category II, ❑ RC III, ❑ RC IV. Work roposed: K"-:ed-Ae4/ Up 0/%/Gc> i!dt AMA/ 04/4 JYO)r/' / /4/C/ir�r- O uf,s- /r/y atf�C .aze,G 6��.1 Fo,uS. / Construction Control,building at 35,000 c.f. or greater ❑ Yes No If Yes then "Investigation & Evaluation Report" is required ( 0 CMR 34, 104.2.2.1.) Compliance Method: [Only one method to be used] (Check all boxes that apply) Prescriptive Work area Performance (Chapter 4) (Chapters 5- 13) (Chapter 14) ❑ Repairs ❑ Repairs: Chapter 5 ❑ Repairs ❑ Alteration ❑ Alteration: (check only one box) ❑ Alteration ❑ Addition ❑ Level 1: Chapter 7 ❑ Addition ❑ Change of Occupancy ❑ Level 2: Chapter 7 & 8 ❑ Change of Occupancy ❑ Level 3: Chapter 7, 8 & 9 ❑ Change of Occupancy: Chapter 10 ❑ Additions: Chapter 11 ❑ Historic Buildings: Chapter 12 ❑ Relocated or Moved Buildings: Chapter 13 Note: Chapter 15 applies to all compliance methods. /�, Applicant's Name: (print) �A(//A4v s/9e./ f ge et/ !f%% vgi`ve-t— Signature: - Date: /i / / i'" PT;opnsed 4st Floor 7.,1--,,,-•,--7 e--- -,--7- -,-_- —--.—,. .....rm fIF`,":n‘....7D FOR r, ':_riiN0 AND Z.::,: C;CODE COMPLI- A:,'...Et. L27,.; .-S C), 0,IMISSIONS DO NOT f17,!EVE THE A1 i"LICAc..:1 i-ROM THE RESPONSIBILITY C: 'AidimpT" 1—d.A"--47044"Vil OI, 3'6" 29'4" I •g ..411,1114": I 4 1'4" ''. - - . 1 BUILDING OFFICIA4Mon- ....-/-- ,,, Open Customer Service Office - •,-- ,.:. 4 1 ti cadet 1 ..c' 4 _ ,J. , _ .-- FA ''4'8""--"-4'8"-f.' 4- - Customer Service Hallway Closet (1:Closet ( ClOga ( . 5' 1---..i.04" I 5 I 118'4" • I - .. F. .= L't " C set:94 - 9'8" 5' ' 17'4" 1- DI er Entry i 15' --,, Break Roorrt t,„, •-, Operations Office Open Dispatch Area :-- '-- Office Manager S. nall Customer Service Offtt .."' Jf...._ fset 1; .._ -.- _ I T b 13 2 9'10"—41'Ill 12' -.. 3' 40'4" 1 ,1= _I ex Restrefink Server Room .- 11 Rest 0 4411 1 ' ?”--/' 'r 11'6" Front Entry 1 _ I JI I 1 7.ef--.=-•..=-1-,71::::D I Cr, Marketing Office i g T '• m— ._ 5'8,, 7 [ upply Clo I - 4 • . - ', 1 Ar ompliant -. 00m tX.1\1 1 8 ZUZZ HEALTH DEPT. 111 _: .; I l - .. I,• 8'6" . VI . 34' Proposed 1st Floor 10/14/2022 Page: 37 NAUSET_SO_YARMOUTH Proposed 2nd Floor 1-6' 2" 1 9' I 15' " 1 � L 1. 6 8' 8" " 14' 2" v M i_-5'-JI T o -o d. 4 "" Undesignated Office Controller Office - r. '-4' 4" I T 13' - 00Hallway 8"�I lechanical ' o 71- o 1 11' 2" j1 "° _ / T � 12' 2" _ = 11' .I. 4 8' FT _ M 14' 2" tit , z �,, Half Bath l a N C'. (n til , 3' 6" _ — ' 11' 10" District Manager Office ,o �' Too N l��'��', _ [� -1 N Conference Room N N co Sales Office `O o cc .._ r_d_ „ , R9 1 13' 1 14' 6" I 12' 2" Proposed 2nd Floor NAUSET_SO_YARMOUTH 10/14/2022 Page: 38