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HomeMy WebLinkAboutBLD-23-001104 .R.EfEI. VED ( - ,-.1. -_, BUILDING PERMIT APPLICATION • 1 ..I DEC .` :y APPLICATION TO CONSTRUCT,REPAIR, RENOVATE, CHANGE THE USE, OCCUPANCY OF, � / • ``t OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING. 1 f�._ - a p'—1 BUILDING ►' r crtcit Dl larr1unith Building Department I. - I I-Ili Ruutr 2 • tiar rmiith. M.\ (!grin•-t-t�l" Tel: 508-398-2231 ext. 1261 Fax 508-398-0836 1 13` /2 Office Use Only Planning Board Information Assessors Department Information: 1 Permit o. "73`f 1 Date Plan Type kfaD Lot i( . Permit Fee S V�Cr lEndorsement Date / Recording Dare New �' I Deposit Fec'd. • a 'Ian No. 1.4 Property Dimensions: 1�\9:1 Net Due $ \co Other I i Lot Area sf) Frontage{t;) Lot Coverage Thin Section for Office Use Only ;Building Permit Number. 1 Date Issued: Signature: ,/ "did--°� Certificate of Occupancy I 3 rng Official Date is is not required ISection 1 - Site Information 1 i1.1 Property Address: ' 1.2 Zoning Information: r ' 4, -i/" heJy 4 4 ©.- 75 Zoning District Proposed Use 1.3 Building Setbacks(ft) Front Yard Side Yards Rear Yard I Required ( Provided Required i Provided i Required Provided I I I 1.4 Water Supply(11-(1.1.-c.40.S 54) 1.5 Flood Zone Information: Comments Public X Private Zone: BFE: Section 2- Property Ownership/Authorized Agent I 2.1 Owner of Record: C//i7 2imo i a (' grryrfirm Scab Name(print) Mailing Address: RECEIVED Signature Telephone Telephone — email d��res ,': 2.2 Authorized Agent:1 DEC 2 7 20i2 BUILDING DEPARTMENT BY l� Name prJ __ ,l Ce_,____ Malting Address: /'1/1 f 1' ,/ LJ ,�°S 7 7G ZG 1 Signature Telephone p Fax [mail Address: Section 3 - Construction Services I 3.1 Licensed Construction Supervisor. Not Applicable t] CT's e i 4 ?4G„z Y ()(bpi p,s / i<�ttJ � 0 leii V)r S r C l/y U License Number / Address / r� So 3e-S 6/SS U lt�vi is`l ey/Y4a/ i Ezpttation Dafe gn ,re Telephone Ernail Addre55:[;dam. //2 / a-y f 4 9 oaa.67) '3.2 Registered Home Improvement Contractor.I rCompany Name �ti ,Not Apohcaale 0 o s�� Gr �4mot f? i Address I Registratar.Number `� 0 u 4PS V1 W.-bowl-4 owl;4 49 vX 3 t '1_f7 96�- •5i tatu 'Eli motion'J�tr i Telephone Sam 3� s �'Ss ��/���3 • is Section 4- Workers'Compensation Insurance Affidavit(M,G.L c. 152 S 25C(6) j 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 OC 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 Ap rile :J Name (Registrant k ` Registration number Address Expiration Data Signature Telephone Section 5.2 Registered Professional Engineers)I Nam. Area o!C-imparmbdrty Address I Registration Number • Signature Telephone Expiratian Dato Hama Area of Resax;dxiity 'Address Regn nation NUT.per Signature Telephone =_xpiratnn Date • I I Hama Area of Rc,o,isibitity i Address Registration Number lSignature :etephone i Erpiratien Dale I Ham. Ares ct Responsibility Address 1 Registration Number Telephone lExpiration Cate l Signature P Section 5.3 General Contractor 1 P z• Not Applicable I] , z---0 , ea, tt_ )4_n_b Company clam• Person Re d sible Icr Cons) ion ' f • DL' te v6� 6Qktir,-r, M Qd� 3e I •dress 56�- gf5- �15S l( l \ iiir ---._ Telephone 1i. tie • • • • . q3? kou - &I° Section 6 - Description of Proposed Work (check all applicable) ' New Construction ❑ (for multiple family only) No.of Bedrooms (for multiple family only) No.of Bathrooms Existing Bldg. ❑ I Repair(s) 0 Alterations 0 Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: f Brie escn tion of Proposed Work: ` e/IS7r42(7 a9h i/ '/Iiiif. ze �t/4//,f %� C%7-'/X/e 11i'l r f'i r r CIO 6lrP w1, 6 `r�® �,i s-/6 e r¢/�iiI' � / { /A re ife'A-/c//K'j e4//74 ii f.feld re fecr7;1 Can/i? e Section 7- Use Group and Construction Type I Building Use Group (Check as applicapable) Construction Type r A ASSEMBLY ❑ A-1 ❑ A-2 ❑ A-3 ❑ IA ❑ A-4 ❑ A-5 ❑ 18 ❑ B BUSINESS ❑ 2A I] E EDUCATIONAL ❑ 2B ❑ F FACTORY ❑ F-1 ❑ F-2 ❑ 2C ❑ H HIGH HAZARD I] 3A 0 I INSTITUTIONAL ❑ I-1 0 1-2 ❑ 1-3 D 38 CI M MERCHANTILE II 4 I] - R RESIDENTIAL I] R-1 0 R-2 El R-3 ❑ SA ZI S STORAGE ❑ s-1 ❑ B-2 I] S8 U UTILITY CI SPECIFY. M MIXED USE 0 SPECIFY: S SPECIAL USE CISPECIFY: I 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) Proppe d i p C F 1 Number of floors or stories include basement levels 1 Floor Area per Floor(sf) r I DEG 2 0 2022 Total Area All Floors (sf) _..__ Total Height (ft) eUlLUIrv� xr i�+tTrl NT Section 9 - STRUCTURAL PEER REVIEW (7BOCMR 110 11) Independent Structural Engineering Structural Peer Review Required Yes No I SECTION 10a OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, j 1- i f, 61 I-16 N , as Owner of the subject property, hereby authorize 7©,f pie Lf P/Jl//k"G to act on my behalf, in all afters relativejo work authorized by this building permit application. Date Signature of Owner • SECTION 1 Ob OWNER/AUTHORIZED AGENT DECLARATION , 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, 6sALL: 0.\1/ • Print Name -� Signature of Owner/Agent Date Section 11 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be completed by permit applicant 1.Building 300© - a Electrical /600 3.Plumbing/Gas Y O O 0 4.Mechanical(14VAC) 5.Fire Protection 6.Total=(1+2+3+4+5) • ✓// 7.Total Square FL(ler now smstnas a ad6ibo'a) Check Below ❑ Conservation-Commission Filing (if applicable) ❑ Old Kings Highway&Historical Commission approval (if applicable) The Common wealth of Massachusetts rl Department of Industrial Accidents 1 Congress Street, Suite 100 il. 'Boston, MA 02114-2017 t1 f~ � �r www.mass.gov/due Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leoihly Name (Business/Organization/_ndivit?ual): Q S �/`,e 4 P/4 /t v Address: ( p S V 1 toe.o l� C� _ CIiylState/Zlp.1ehy is f (44 () d' Pl}one ` : SDe- - 6 /S S Are you an employer?Check the alrpropria:e box: Type of project(required): Lu 1 am a employee with employees(full and/or pert-time).* � 7. �]New construction 2.0 I am a sole proprietor or parnershtp a::d have no employees working for me in S Remcdeiintr any capacity.[No workers'coma. insurance required.] 3.fl 1 am a homeowner doing all work myself. 'No workers'comp.insurance required.]t 9. 0---7� Demolition 4.D I am a homeowner and will be!trine contractors to conduct all work on my property. :will 10 •.`1 13ti1)ditigaddaiori ensure that all contractors either have workers'compensation insurance or are sole 1 1.H E:ect-tcal repairs or additions proprietors with no employees. t 2.D Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed or.the attached sheet. These sub-contractors have employees and have workers'coo. insurarce.t 13.E Kopf repairs I 5.❑We a.e corporation and'.ts officers have exercised their richt ofexeat:tion per MCA-c. 14. Other 152,f,:(4),and we have no employees.[No workers'coma. insurance required.] Any applicant that checks box i?I must also fill out the sect:on be:ov.•showing their workers'compensation policy information. Homeowners who x ibniit this affidavit indicating they are doing ail work and then hire ouside contractors must submit a new affidavit indicating such `-Ccntr:c:ors 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 e:neloyees,they must provide their workers'comp.policy number. I as: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.r?: _ 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 vio'atior..punishable by a fine up. to S1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine.of up to S250.00 a day against the violator. .A copy of this statement may be forwarded tc the Office of investigations of the DR for insurance coverage verification. 1 do hereby certify wider the pains and penalties of perjury that the information provided above is true and correct. lature: Date: /ai //oZ/..?R Phone#: S b - C /SS Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# j Issuing Authority(circle one): I. Board of Health 2. Building Department 3. City/Town Cleric 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone m: ®r Commonwealth of Massachusetts f r Division of Occupational Licensure Board of Building R ulations and Standards Cons IonfSvisor CS-011059 � spires:03/12/2024 JOSEPH R PALINO 9 DUNES VIEW RD DENNIS MA 0V638 i e • Commissioner c'n 0d� fi. Cvnt ia L. l/ice 6v,,..yrwaren/� /444:74 is,0//-,' Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Individual Registration Expiration 179968 09/11/2023 JOSEPH R.PALINO JOSEPH R.PALM) `i • 9 DUNES VIEW RD Lam" DENNIS,MA 02638 Undersecretary Commonwealth of Massachusetts 117 Division of Occupational Licensure Board of Building Regulations and Standards CS-011059 cpires:03/12/2024 JOSEPH R PALINO v 8 DUNES VIVA/RD DENNIS MA 03638 <- Commissioner dia,�u f. UCr%,rl'to ./a- Kivin.riaiiir//'V.//,:i:•„i.�:,;.:.✓/.,; Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR n'PE:Individual Rerais.ratia t Exp 2119n 17A963 09/11/2023 JOSEPH R.PALINO JOSEPH R.PALINO 2 9 DUNES VIEW RD DENNIS,MA 02638 Undersecretary §TOWN OF YARMOUTH 11.46 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 Work Address Is to be disposed of oat the following location: S c; C XCo QNh i f A44 Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. /JD to � nat e of Application Permit No. o�. Yak TOWN OF YARMOUTH HEALTH DEPARTMENT E L 1V E PERMIT APPLICATION SIGN OFF TRANSMITT• L I 212022 To he completed by Applicant: BU1Lp�� �°EpARTMNT Building Site Location: 3? ��/P Proposed Improvement: ///'/(/ 6r /r N f.i C ' S//4 c , Applicant: e Li j /i7,) Tel. No.: 5o ' 3 S Address: /// . ir,/4,I , Uf (%)G ' Date Filed: O/' o/ ta- **Ifyou would like e-mail notification of sign off please provide e-mail address:/3/3')!Q11r/ 1 L. /4/ /la • 6' 4" Owner Name: i 'vr4 is )/INK dr . /3/Z? t�'n"111 L L Owner Address: fr4 / t;Y t f- f/ ,SO✓/ Owner Tel. No.: .5 ' 7n G /3 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 w .,.. (all existing and proposed) - DEC 2 0 2022 Note: Floor plans not required for decks, sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer HEAL': with fee. REVIEWED BY: DATE: /04- I 4516/ PLEASE NOTE COMMENTS/CONDITIONS: 1. ____, .......„,„„„._,,,,,,,,.,„_.;,„=_,,,.,,„T..._ __ _____ _________ . 1 k i .(erts/in, w,i9�er 0 ?-ox 3-0 tiLG " 1 4—s-b" )4 .4-------4---1—____/4:p " a.C"."--... 4)( t-4, s lorb5 e F. 1 I ,� 2.6 xs•5 J`� 3'.o x 1 . I. V4owir T Q x 0. rtik 1 3�o X.2-7 S1�T char ,' 44 " e -< y`-G --7- ; /-----\ : i . sLpI, I 9o !d " i -.4.--------- _ i e *I i i. i { 11/f /1P/1-4F'�tui`j 't14//s. /'/r/,or vey /c „D.c, 14„74 b/CC164fr i //// /tisd/w?/ah c/o-ce vice// _ P, 2, 14,01.1 - f Or- Ri A;c,/ 1,6pi/i' / /`'+c � 1 1 �'h'7e/1d t` .f-,,,is Al To 6 S4e(Tir c I: DEC 20 2022 / i i i r-„, - • I est Moon 198 EAST STREEET MORRIS,CT o6763 RICHARDSON STRUCTURAL ENGINEERS 1080 MAIN STREET SOUTH WOODBURY.CT 08188 203 283 4282 DESIGNED&REVIEWED FOR STRUCTURE ONLY is ROBIN"o PROJECT mo o- n 011ie'a Barn 367'9 938 Route 6a .`•.j,; ±��P.: Yarmouthport,Ma 02675 r'a „' NOTES THIS DR NNG OR THE 12-O" 2A-O UNDERLYING DESIGN CANNOT t BE COPIED OR USED TO BUILD p PP414PP3 LQ it F4a1PPl tJ AN IDENTICAL OR I SUBSTANTIALLY II / SIMILAR STRUCTURE, REGARDLESS OF CONSTRUCTION METHOD, IIITHOUT HARVEST MOON T !' TIMBER FRAME'S WRITTEN 6X10 JOISTS 4.O.C. 4- PERMISSION. WI 1 1/2'T&G DECKING COPYRIGHT 2018 u U Li - REVISIONS: GSE/G3 3/3/21 3/9/21 • r 3/12/21 iP m 3/1/21 Q 3/31/21 R1 DRAWN BY PUP I _-I [Ti SCALE LATERAL BENTS 2&3 or as note or as noted ) l in plans (2) C ISSUE 2/26/21 FRAME SECTIONS 11 4 harvest M0011 198 EAST STREEET MORRIS,CT o6763 RICHARDSON STRUCTURAL ENGINEERS 1080 MAIN STREET SOUTH WOODBURY,CT 05198 203 263 4262 DESIGNED&REVIEWED FOR STRUCTURE ONLY Tire ,.FL MJ0CH1 w. i. PROJECT HIO•Ki'.SONJI. s*m.c uHx a 011ie's Barn -�.37709 938 Route 6a �+ Yarmouthport,Ma •, 02673 NOTES. 12'O" 28.-0" THIS DRAWING OR THE UNDERLYING DESIGN CANNOT ,a�nn BE COPIED OR USED TO BUILD PPvI/lTP3 _ PRZIPP1 _. _. -. AN IDENTICAL OR SUBSTANTIALLY / SIMILAR STRUt/C7URE. } REGARDLESS �y 7 1 OF CONSTRUCTION METHOD !O . P6 TIMBER WITHOUT HARVEST MOON FRAMES WRITTEN 6X10 JOISTS 4.0.C. PERMISSION. W/1 1/2"T&G DECKING .-_. COPYRIGHT 2018 U U ii -- N REVISIONS: 412/G3 3/3/21 3/9/21 3/12/21 3/15/21 3/31/21 o 1 DRAWN BY PGP SCALE LATERAL BENTS 2& 3 1/4"_1.-0" or as noted in plans O (DI ISSUE 2/26/21 FRAME SECTIONS 11 I . " I I irvesl Moon t98 EAST STREEET 3068 MORRIS,Cr 06763 3040 3040 3040 -,r or I,y /� -- "---'-"' - _ —_--- RICHARDSONSTRUCTURAL 1 7 ► - .. -- ram.. L 1)4 y ROBERJ (NEERS MAIN STREET SOUTH \J L.r o a aK:natmsaN�R ._. __ ___.. � - SiRUCRNK WOOOBURV,CT 06798 I N)36109 203 263 4262 I ' w ,� DESIGNED 8 REVIEWED UP I k. .+ - FOR STRUCTURE ONLY 3068 .._ PR JECT P$ • $� 011e a Barn 1 g38 Route 6a Yarmouthp art,Ma i o2675 -MI C NOTES THIS DRAWING OR THE -- UNDERLYING DESIGN CANNOT BE COPIED OR USED TO BUILD �\ AN IDENTICAL OR SUBSTANTIALLY SIMILAR STRUCTURE. S - -- REGARDLESS !ii OF CONSTRUCTION METHOD, I VNTHOUT HARVEST MOON I TIMBER 0 P8 ____ P� 1 �2 - PERMISSION. �-+ FRAME'S WRITTEN COPYRIGHT 2018 REVISIONS: 3/3/21 DEC 2 0 2022 3/9/21 3/12/21 3/15/21 • 1 ' . 3/31/21 ® P3 n npa P3 PS DRAWN BY b O o (:) PGP SCALE 1/4'=1'-O" or as noted in plans FIRST FLOOR PLAN ISSUE 2/26/21 1st FLOOR PLAN 4 O O Q Q Da - i I. Li lilt _ N NT 3 I I , I 'I I � o - N Z 0 rm - r Q O. O0 _ b o D 111 Z _____ I a _ t3 o z O t C O I�., CT 11 8,-„ 1.4'-d, A .. i 30._0" Ill g .,-w ...1�-ti ik,t,. rrr 9R I:I gSe -._ -- --3a �\__ _ _ f IT T � � _ O m A i�O m1CZ0Z N 0m N. W ?z 2� y ` ij77 ; N� m N .0i 'AlOO o � TAQ i 0wmNR` N = ; 4427h pn ., i W IZ o� 1 el'isl1:19 w,',c ,,61 I - , aR = ?-o x 3-a .,.._, , - Pl�ii/ ,r ._, ,4...,...._,_,:.,...170 i e. rI 2c_-., . S%orw e 4' .: f 2.b XS-5 ,�j� ._ _ :_ .4_5:. .....1 ::13n 3 0x 5-,oX2-7 S 47 c/ -L-.-, ,\ 4=6 " .< „...4. ,._...,.. .....___‘ i . i . <--s 4c„ . ,i 1/o %-o # 1 i ,....1 ;,1/41____._.,___________. ____ I •�. J 57 iii 1// /1 G/1-4 P4t%if 4)4/js•. 1 /4%efyor vyy /4 "p.C' 14,i74 b/ceic- f /+l// /HS'o/47/bh c/o-te'(✓CE// -C,P.r Q y se A<y f or RtA ;cJ 1.4, /? % i4e -Z-117ei iot f.'.frit4'4 To 6t+ SheC-ripoC 1° /st,i(--/ dee yet`N,2; I?0(/ fi ie ch i-e . ...-----, z • O I I:111 i t N10011 40 0 . 1 t98 R,AST 811tEEET 12.-0" 16'-0" 12-o" MORRIS,CT o6763 ------- _— -- ----- --._ -_.- —I `3Eµ H'y s,ry, IfIIC.HARosoN Ti IRAI. T' a0017t w. 1 ENGINEERS -- ---- --- !PoCSTRUH,t1;00 FL 1080 MAIN STREET TH —_T C'JRR WOODBURY.CT 0878E RD 36708 203 283 4282 r 1`/1 7 y u',.`_. DESIGNED&REVIEWED .44'- , FOR STRUCTURE ONLY O i, 1 PROJECT 011ie's Ram 938 Route 6a • -. j- Ei Yarmouthport,Ma 1- 1 02675 NOTES -------- _ THIS DRAWING OR THE UNDERLYING DESIGN CANNOT .. ___ LOFT BE COPPED OR USED TO BUILD —T— p AN IDENTICAL OR -� SUBSTANTIALLY SIMILAN STRUCTURE. REGARDLESS .-- OF CONSTRUCTION METHOD WITHOUT HARVEST MOON TIMBER I FRAME'S WRITTEN )11/"..N.\ ON PERMISSION. I 7 ,i y, COPYRIGHT 2018 7 REVISION S: 3/3/21 3/9/21 3/12/21 Q ., , r'{ 3/15/21 cO .,._,....,' 3/31/21 DRAWN BY PCP C. (��J g SCALE �J v 1/4---1-L7 d or as noted x, in mans t 2ND FLOOR PLAN ISSUE 2/26/21 2nd FLOOR PLAN ) 1 I. ...... ......„. E _,,,, _,_ _ _ ,_ ___ . ,fr �,,... W,t1C06t ' 0 2-ox 3•a 1 P-4 " - o s/o!'b f € ! _ II fh3/Jo► • 3-,cx1ti 3 Q x t-8 Y 5-fo .2-7 STi T G b orr ,. ?�4r44 y=6 " THE JILT • • ! • . _ 7:-- 1 ---'. .---_-7—--/-- .z_1_______ ,,, i r .� _� _ __ _. ._ �___ 3� .o _.___ ____ •i ..ti m ,,iiiy' , - -- ..': -.7. enpy T 'qf /1G/l-6e4r%,,p 4) )/6. in(e lia r sky /4 aO,c, 14.i7Z b/cr 6 p lid /di' so/474N c/oJe'c✓ce// _C,PJ y x-eD Ash r -Z'J?ertof ..friis4 To 6:7. 1 S 'C-Td`Dr� � ° iv ►t/(ej knievood, okiel pine SaLrora; 1 FERGAL BRENNOCK P.E CONSTRUCTION & ENGINEERING SERVICES RECEIVED December 15, 2022 -•-._.�.__�..! D-EC 15 2011 BUILDING DEPAR1MENT Mr. Mark Grylls, By Building Commissioner Town of Yarmouth Yarmouth Town Hall 1146 Route 28 South Yarmouth, MA 02664 RE: Structural Capacity Statement of Suspended Ceiling Assembly at 48 Route 28,Yarmouth,MA Dear Mr. Grylls, I, Fergal Brennock PE, on December 15, 2022 inspected the above subject and analyzed the components weights and capacities and conclude the following in accordance with CMR 780 9th Edition MA Building Code and IBC2015. The existing Armstrong 4x2 pattern suspended ceiling assembly with wire supports hangers from the structural roof/ceiling above is sufficient to take the imposed weight of R49 Batt insulation with a continuous 6mil polyethylene barrier. The approximate weight of the insulation and poly assembly is approximately 0.75psf where the rated capacity of the suspended ceiling frame and wire as observed is approximately 4psf. Therefore, yielded a 5.3 Factor of Safety which confirms the capacity of the existing system to take up to at least R49 Batt Insulation. I, Fergal Brennock, attest that the above statement is true under the pains and penalty of perjury. Yours sincerely, TMaM FERGAL D. BRENNOCK No.46244 Fergal Brennock PE '►�a', # 46244 71 LOVELL ROAD WATERTOWN MA 02472 FERGALBRENNOCK@HOTMAIL.COM 617 828 0376 0,,, 9R BUILDING PERMIT APPLICATION ,i.< APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE, OCCUPANCY OF, t,.;- r �'s OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING. fir' - I� � Town oflitrnnrth BuildingDepartment �..F"--•rT .,•.•"MC .� 6 E 1 V E D 1 146 Route _rli . Yarmouth, MA ()2(iEi-f—(-(�)`� E.Tel: 508-398-2231 ext. 1261 Fax 508-398-0836 L4TEt2J Use Qny PAseors Department Information: Peit No. Date Plan Te_ Map 143 Lot 1tAR MENT • Permit Fee $ )\yLa Endorsement Date / ,__„ > -- IL Recording Cate New �' Deposit Rec'd. I .• `'ate plan No. 1.4 Property Dimensions: aNet Due C-0 Other \ SI 7 f Lot Area(st) Frontage(it) Lot Coverage This Section for Office Use Only Building Permit Number. Date Issued: Signature: j ) , . Certificate of Occupancy Building Official Date- is Is not required Section 1 - Site Information I 1.1 Property Address: 1.2 Zoning Information: q,2 3 koL,L IJL if A Jt211 f1Iku(/`)22/ / p// �-� 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(14.O.L c.40.S 54) 1.5 Rood Zone Information: Comments Public Private Zone: . BFE: 4 Section 2 - Property Ownership/Authorized Agent 2.1 Owner of Record: Chapter Two LLC _ Box 206 Yarmouth Port MA 02675 Na (pnt) Mailing Address: Sigkr}",, _ 508 423-9311 Jbasler@comcast.net Telephone Telephone Email Address: / 2.2 Authorized Agent James Basler Box 366 Yarmouth Port MA 02675 ame(print) 508 423-9311 Mailing Address: _ jbasler@comcast.net S g r Telephone Fax Email Address: ! Section 3 - Construction Sery ces I 3.1 Licensed Construction Supervisor. Not Applicable 'J James N Basler Box 366 Yarmouth Port MA 02675 License Number ress CS 012929 508 423-9311 jbasler@comcast.net Expiration Date sin Telephone Email Address: 3/8/2024 3.2 Registered Home Improvement Contractor.} ; company'/"fit?tams � � I`� (� A � � Not Applicable � � •' C Q Address Registration Number lg ,� � � 11 Expiration Date Signatut 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 `4 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(sj 1 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 1 Not Applicable ❑ Company Name Person Responsible for Construction Address Signature Telephone ' , Section 6 - Description of Proposed Work(check all applicable) New Construction 0 1 (for multiple family only) No.of Bedrooms (for multiple family only) No.of Bathrooms Existing Bldg. 16 I Repair(s) ❑ I Alterations ' Addition ❑ I Accessory Bldg. ❑ Type (Demolition Other Specify: P fY: f Brief Description of Proposed Work: Remove non bearing walls as shown on attached plan in order to use units R & S as a single space • [Section 7- Use Group and Construction Type' Building Use Group(Check as.applicapable) Construction Type A ASSEMBLY ❑ A-I 0 A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1 B ❑ B BUSINESS ❑ ❑ 2A E EDUCATIONAL ❑ za ❑ F FACTORY ❑ F-1 ❑ F-2 ❑ 2C CI H HIGH HAZARD ❑ 3A ❑ I INSTITUTIONAL ❑ I-1 ❑ 1-2 0 1-3 0 38 ❑ M MERCHANTILE 0 0 , 4 R RESIDENTIAL ❑ R-1 0 R-2 ❑ R-3 0 SA 0 S STORAGE ❑ s 1 0 s 2 0 58 ❑ U UTILITY ❑ _ SPECIFY- AA MIXED USE ❑ SPECIFY: S SPECIAL USE ❑ SPECIFY_ Complete thissection 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 I Building Area Existing;(if applicable) Proposed Number of floors oratories include basement levels Floor Area per Floor(sf) Total Area All Floors (sf) Total Height(ft) ISection 9 - STRUCTURAL PEER REVIEW (730CMR 110 11) Independent Structural Engineering Structural Peer Review Required Yes No SECTION 10a OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT_ I. James N Basler general manager Chapter Two LLC , as Owner of the subject property, hereby authorize Jameds N Basler to act on my b all, in all matters relative to work authorized by this building permit application. 8/24/2022 Signature\AilOw /\---- ---- Date SECTION 10b OWNER/AUTHORIZED AGENT DECLARATION • I, James N Basler , 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. • James N Basler Print ame ll v k • 8/24/2022 Signa of Owner/Agent "` Date Section 11 - ESTIMATED CONSTRUCTION COSTS Item • Estimated Cost(Dollars)to be completed by permit applicant 1.Building $3500 a Electrical 3.Plumbing/Gas 4.Mechanical(HVAC) 5.Fire Protection 6.Total=(1+2+3+4+5) 7.Total Square Ft.(erne.,mstuAa&adm,e) Check Below (� Conservation-Commission Filing (if applicable) U Old Kings Highway&Historical Commission approval (if applicable) • The Commonwealth of Massachusetts ff1, Department of Industrial Accidents 1 Congress Street,Suite 100 a}� �' Boston, MA 02114--2017 www.rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/ElectriciansfPIumbers. TO BE FILED WITH THE FERMI I'I LNG AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): James N Basler Address: Box 366 City/State/Zip: Yarmouth Port MA 02675 Phone 4; 508 423-9311 Are you an employer? Check the appropriate box: Type of project (required): 1. I am a employer with employees(full and/or part-time).* 7. New construction I am a sole proprietor or partnership and have no employees working for me in 8. Fl Remodeling any capacity.[No workers'comp. insurance required.] 3.D I am a homeowner doing all work myself. [No workers'comp.insurance required.]t 9. CI Demolition 10 [l Building addition 4. I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.[i Plumbing repairs or additions 5.E I am a general contractor and I have hired the sub-coed actors listed on the attached sheet 13.Ei Roof repairs These sub-contractors have employees and have workers'cornp.insurance.: 6.:We are a corporation and its officers have exercised their right of exemption per MGL c. 14.0 Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] 'Any applicant that checks box#I 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 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. 1 do herebJ\certify ui r the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: � 2—O Phone 4: j- L{23 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 Phone#: Contact Person: §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-22311 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 7130 CMR- Section 105.3.1. #4. I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 923 Rt 6A Work Address Is to be disposed of oat the following location: Childs Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. J8/24/2022 Signature of Application Date Permit No. COMMERCIAL ONLY— BULDING PERMIT APPLICATION REGULATORY APPROVALS NOTICE Address of Proposed Work: 923 Rt 6A Sunflower Market Place Bldg 4 unit R& S Scope of Proposed Work: Remove non bearing walls asshown on attached plan in order to use units R& S as a single space Date: August 24, 2022 Based on the scope of work described above, the applicant is required to obtain approval sign- offs from the following departments as checked-of below: Health Dept. —508-398-2231 ext. 1241 Conservation—508-398-2231 ext. 1288 Water Dept. —99 Buck Island Road, 508-771-7921 Old Kings HWY. Hist. Comm. —508-398-22631 ext. 1292 Engineering Dept.—508-398-2231 ext, 1250 Fire Dept.—Kevin Huck/Scott Smith, 96 Old Main Street, SY Note: Please call Fire Department for an appointment. 508-398-2212 Other Appropriate plans and/or application shall be provided to each departments checked-off above. Each of these regulatory authorities has their own requirements outside the jurisdiction of the Building Department. All applicable approvals shall be obtained prior to submitting a building permit application to the Building Dept. Thank you for your cooperation. Receip ckn ledgement: Applicant's Signature Date Rev.Jan. 2019 Commonwealth of Massachusetts Division of Occupational Licensure Iff Board of Building Re ulations and Standards Const }iartTSrisor CS-012929 ' rz spires:03/08/2024 JAMES N BALER *-a '!;, °+ PO BOX 366z " t YARMOUTH tiRT MA,02676 j Commissioner dia.,QQ �' bjEmiQiA MGL AND FIRE y'010 y TOWN OF YARMOUTH REVIEWED FOR CODE COMPLIANCE. ERRORS OR OMMISSIONS DO NOT RELIEVE 'i�t►►�r THE APPLICANT FROM THE RESPONSIBILITY a- OF"AS BUILT"COMPLIANCE. di:t DATE: Jr' 2s•2 4- INSPECTOR YARMOUTH FIRE PREVENTION Commercial Construction Building Transmittal Project Name: Natty's Nails Address: 923 Route 6A Unit R/S Contact Name: James Basler Phone: 508-423-9311 Description of planned project: Y N NA Subject Regulation X Access for Fire Apparatus 527 CMR 1; 18.2.4.1 X Building Numbers MGL C 148;sec 59 X *Flammable gas/liquid storage 527 CMR 1;42.2.2.1 X Fire Lanes 527 CMR 1;22.3 X *Service Stations 527 CMR 1 ;16.2.3,16.2.3.1,30.3.2 X *Hazardous Materials Storage 527 CMR 1;60.1 X *Kitchen Exhaust Systems* 780 CMR,527 1;50.1 X Extinguishers 527 CMR 1; 13.6,MGL C 148;sec 28 X Fire Alarm Systems/CO detection* 780 CMR,MGL C 148;,527 CMR 1; 13.7 X *LPG Storage Chapter 148;sec 9,10,28&527 CMR 1;69.1 X Use and Occupancy(FH Building Class) 780 CMR;302.1 X Sprinkler Systems* 780 CMR&Chapter 148 sec 26 A-I X Storage inside/outside Buildings 527 CMR 1; 10.19.4,4.4.3.1.1,19.1.2,34.1.1 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 MGL Chapter 148;sec 28 X *Curtains,Draperies,Blinds 527 CMR 1; 12.6.2 X Safeguarding Construction NFPA 241,527 CMR 1 Ch 16, 16.3.1,2; 16.3.4.1 X Hot Works Permit,where required 527 CMR 41.1.5.3 * YFD permit required-depending on occupancy and submittal Compliance with the following: 527 CMR 1 Chapter 16"Safeguarding Construction, Alteration, and Demolition Operations." 780 CMR Chapter 33 *Permit is required for temporary shutdown, alterations or proposed removal of fire protection systems. Yarmouth Fire Department supports the application, subject to applicable submissions, permits and inspections. Plan Reviewed By: Lieutenant Matthew Bearse Date: August 25,2022 Copy for Applicant = Copy to Building Department Copy to Fire Prevention Entered in Firehouse I—I Final Inspection 01YgR TOWN OF YARMOUTH °' HEALTH DEPARTMENT '0. �t \ PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Proposed Improvement Natty's Nail Salon addin unit S to existing space to create more room. No change of use e we 7 vi ry watt Applicant: No.: Jorge Bonilla office space 508 648-9201 Sunflower Market Place 923 Route 6A Yarmouth Port MA 02675 August 25,2022 **If you would like e-mail notification of sign off,please provide e-mail address: jbasler@comcast.net Owner Name: Chapter Two LLC James N Basler Manager Owner Address: Box 206 Yarmouth Port MA 02675 Owner Tel.No.: 508 423-9311 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: 6/)\ c• IGEASE NOTE COMMENTS/CONDITIONS: fanned I • playground / Building 3 / unit H unit J Building 4 Building unite units Sunflower Market Mace Il unit \ unit 32,056 Square feet unit F I I ,/ ^ ' unit M I unit N J New location Melissa Alves a 2ndFloor Unit N i unit 2nd Floor ,. ,., ,-, unit 0 I i 1 ffi unit$ , °"tE He �- Natty's Nail Salon (4, Unit R & 5 unit R i / I ; uni ° ///////// ' ,, i L es iii ,, unit C i Site Flan ■ unit AA i HC I 2ndFovr SUNFLOWER MARKET PLACE unit 5 MOW i unst it o� s 923 RT. 6A i YARMOUTH PORT, MA 02675 ( . 1. 1T1'. unit Y ;, i unit A 'unit DO Map 143 unit W&X unit Z ' unit U 2nd Floor ' Lot 111 Building 1 unit v i Building 5 , building 7 unit T Building 6 ; Scale:1"=50' drawn *jnb • GI ; 8/27/92 revised 12/4/18 Sunflower Market Place 32,086 square feet ROUTE 6 A Combining unit R. & 5 to make more space in existing Nail Salon / 42'-0" / I ,3..... I 1 1 e__. __Eye Waeh 1 1 1 Stetter, IIED Existing Bath 1 I V, ;. 1 , E l' ' _ LULL) _ 1 I ttl 0 \ Existing bath ,SvCit?h=c Li ......_-‘ 1 c v _ V= Shelves Shelves . 47: :ticiu: tped re 3 ation Staff area F".73 1.1I vent Intakes 1 • .;,:: u manicure station I . - T I Display case 0 3 vent intake in surface pedicure station built in vent intakes ..J manicure station vent intake in surface , I Remove non bearing ,;',, . pedicure station existing walls «Ardict , built in vent intakes .j "5.:°,,,,,,' 1111 C Reception& \ manicure station ! vent intake in surface Checkout 1 r ., i pedicure station built in vent Intakes 111 , r 1 L. .v Existing Nail Salon Unit"S" Unit"R" _ _21 C --A1- E- - -.1_ 1._ \ Natty's Nail Salon, Inc. 923 Route SA unit tZ&5- - -- Yarmouth Port MA 02675 riL:. 1042 Square feet total „LT* DATE. .. - --_- BUILD 3 OFFICIAL