Loading...
HomeMy WebLinkAboutBLD-23-001692 �" r ,a,l\Ui1h ` RECEIVED • oF•'Yq, BUILDIN PERMIT CATION 4 'r APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHA GEE . ' OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR THit Er,1Q� NCY DF, y Town of Yarmouth Building Department '.....0 . ' 1146 Route 28 • Yarmouth, MA 02(564-1 9 BUILDING DEPARTMENT -- Tel: 508-398-2231 ext. 1261 Fax 508-3 ElY08.36 Office Use Only Planning Board Information Assessors Department Information: 4----2)-041k0cfLPNo. Date Plan Type Map Lot Permit Fee $ I 'Lf� Endorsement Date / Ci� L ,7 Recording Date • New • Deposit Reed.. $ t Plan No. 1.4 Property Dimensions: Net Due $ I S OD Other Lot Area(sf) Frontage(ft) Lot Coverage This Section for Office Use Onty . Building Permit Number: Date issued: Signature: 11-• 3 0-).. • Certificate of Occupancy Building Official Dater is is not required Section 1 - Site Information 1.1 Property Address: 1.2 Zoning Information: 19L / t 04" 403 (wean . 553 ?V -` e•e Cod°c reno(1 ` NA•-o 2,673 • Zoning District Proposed Use 1.3 Eiwriidfny s.rtr;ecks (ft) ' • Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.4 Wete r Supply (M.f1.L e.40.S 54) 1.5 Flood Zone Information: Comments: • Public Private Zone: BFE: Section 2 - Property Ownership/Authorized Agent 1 Ow+rrwwrr of Rwcord: /� I ( v Li vie rca C _r*1 l e.C�i /t c era rr;fey-. lei... 4 OP.li ie bcpt,4/-&:i.7< Na (Pry Mailing Address: � /7 /9-zo 7'. .2,1 1 N°-8' rq r�it%PArsWitAtidekt .16 u Signature Telephone TelephoneE mail Address: 2.2 Authorized Agent: RECEIVED Hume (print) Mailing Address: LcT Signature Telephone Fax • =J • I Section 3 - Construction Services ts utl 3.1 Licensed Construction Supervisor. Not Applicable I] Jirl rl 411 it I or) • License Number q g 1t 0 r9 e rip V. ►1 I.0 r7 e /11 da- 0.2 0.. 1 . �+c Address 0 `J (' d ' Expiration Date Signature J% Telephone Email Address: cr/3 /•.02 . • , Section 6 - Description of Proposed Work(check all applicable) •• ' New Construction 0 (for multiple family only) Na.of Bedrooms (for multiple family only) No.of Bathrooms Existing Bldg. ❑ Repair(s) ❑ Alterations ❑ Addition ❑ Acces6ory Bldg, ;❑ Type Demolition Other Specify: Brief Description of Proposed Work: 14 % 6/, S cc? . P/Pause see tf-ao Li lA ng Section 7- Use Group and Construction Type Building Use Group (Check as applicapable) Construction Type • A ASSEMBLY 0 A-1 ❑ A-2 ❑ A-3 E] to ❑ A-4 ❑ A-5 0 1B ❑ B BUSINESS ❑ 2A ❑ E EDUCATIONAL ® 25 0 F FACTORY ❑ F-1 D . F-2 ❑ 2C ❑ H HIGH HAZARD ❑ 3A ❑ I INSTITUTIONAL CI 1-1 ❑ 1-2 ❑ 1.3 ❑ 3B ca. M MERCHANTILE 0 4 ❑ R RESIDENTIAL ❑ R-1 ❑ R-2 ❑ R-3 ❑ SA Cl S STORAGE ❑ 5-1 ❑ 5-2 ❑ 55 Cl U UTILITY CI SPECIFY: • M MIXED USE ® SPECIFY: S SPECIAL USE Cl SPECIFY: Complete this•section if existing building undergoing.renovations;additions and/or change iri use. Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34 Proposed Hazard Index 780 CMR 34 Section 8 Building Heinht and Area • Building Area Existing(ii applicable) . Proposed Number of floors or stories include basement levels Floor Area per Floor(al) Total Area All Floors (sf) Total Height(ft) . • Section 9 - STRUCTURAL PEER REVIEW (780CMR 110 11) l Independent Structural Engineering Structural Peer,Review Required Yes No l SECTION 10a OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, <-----'°ter11-f r�` ,� , as Owner of the subject property, hereby authorize c VI " '(r �s,4 an . to act on my beha f, 'n all matters relative to work authorized by this building permit application. Signature of Owner.' Date '.\ The Commonwealth of Massachusetts ` -.... 1....../, Department of Industrial Accidents ?�►l= 1 Congress Street, Suite 100 � (?`= Boston, MA 02114-2017 't,4.---r www.mass,aov/dia b Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individua!) s te,nq 7'r1,e)vctWe>,) Rerv;C > fit/C . Address: / Ye) /,cv r City/State/Zip: us,, it-tA- v /q®6 . Phone #: 7 0/ -SS/ - 64 5' '° - Are you an employer? Check the appropriate box: Type of project(required): l.E]I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. Ri Remodeling any capacity.[No workers'comp. insurance required.] 3. I am a homeowner doingall wort,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 mYproperty. I will 10 0 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 5.0 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 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. lithe 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:, e. e G rat ?,,i1; ,,,..4... 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 $250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer.f nder the pains and penalties of perjury that the information provided above is true and correct. Si nature: � ' Date: q /'Ei-2 2 . Phone#: _/, / ... m`91< -. 6-4 6-s- , Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: . . . % .%. §TOWN OF YAR1VIOUTH 1146 Route 24:1,$outh:Yarluouth, MA 02664 508-398-22*.e#4261 .ftic 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 053 CL:10 u/e a; 6,:)44'.-w°IL"' 4-14"62673 . . Work Address Is to be disposed of oat the following location: A-1‘..-4-fiem eiye eele., 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. *spLNotifrer;ck< Concrde : avoss..i cc,va f - -2/0 r--3- 4 (i,,t o titti , m A- c,5 5- S e• ---7e-esou rc-e e 'ecoveircy i"---n-Nc,;6 eri 5fr w.f./c,P7 t ...-io , -,Jr delorN.c' PP-t.-) C; cf-, ,c_tc , "444 - 02644 oonn�oz } | ^"� THIS CERTIFICATE IS ISSULD AS A i IiATTIE.R OF INFORMATION ONLY AND(;O;.FER,6 NIO MCHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFIZIRM xlfiVEELY OR N EGATIVELY AMEND, EXTEN 0 01", i1l'ri-1 E COVERIAGE AFFORDED BY THE POLICI ES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONT1,';--,CT 6E*rV'A-.F-N THE i�vZUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT, If the cartificato holuer is an ADDITIONAL INSURED,the pollcy(ivs)ITILISt have ADDITIONAL INSURED provisions or be endorsed. 1 If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,curtaki pullcius may require all endorsement, A statement oil this col,tificate cioes not confor rigliv;to thu certificate holder in lieLl of-such undursenjunt(s). PRODUCER PAX une �;J�m* v»v/z°°''' � ~~.~~~~.`~—~~~ P»�aax;,-om --- AFFORDING COVERAGE----- ----T��� �xnmuu --� yo�:msuaoo"a"Co.mac max�om | /NSmnso � Custom nevov3um`aa*meumc _�����C; � I Foliage Drive JNSURaRLD' ---' ___ -- -- wwunzpe. _ __ | -------' IvIxomnsJhTL-* NUMBER: CL2231889978 RE-VISION NUMBER: HE POLICY PERIOD CF LISTED GELOWHAVF BEEN THE INSURE D NeNNIIED ABOVE FOR T OR COiNDITIONOF ANY-,-`';T 0%rHi�R 0CM.�EJ11T If.1TH RESPECT TO WHICH THIS I'M OF INSURANCE RCIAL GENE ER OF OPERATIONS I-C)CATIONS I VEHICLES (ACORD 101,Additional Remarks Schocitilu,imjy I-zimiciwLi if mt.ry evac-j i6 rvcwirud) ION CERTIFICihTE HOLDER I H;1'EXPIRATION[)p:I'E TI.JEJ�LOF,NOTICE WILL BE DELIVERED IN xoOnoum(u0o/nx) Thu AooRonomouvu|ocio�w .^��^�mu "w^�,v/^owmo Mi M, Milo M k im CAR il.Pl I Ri W, �r V 3luildings of any c contairt less than cubic feet (991 01 enclosed space. ':'fate is Camse Of f-'I[KAiOn abili ('N 727-3200 oir vi:g- Ow 41111­j'I _-ttak�-- , L_ -- - I '�C' 1, � I',-- i j lljq�ll IRA ��Sjjjt "I-- �I` It Olt ................. J —71 lilt— I,AO a I.— JIM "I'' A l�jjl� —'�Nq 10 w�Qll , . , ••••• • -••.....- •-__-_---,„.--- -,,,,,,-,„,,,,,,--- -5,— Ao.zoip111,411,41c,riiii,,,i,,,..:,..."-W:Lai --,-,':•-"'",'..:":'!:'",,:"•••",,,••,,,'„IS'•:•,•!•-•-•-f-.--i-_-,__.-- -'',":4,;',74•41414:pf,,,p,,,,„:1t::!•:'•'___---,-„,-_-:„.t.fpt",_p'.1• 1P1P11:..:„„.,,....'",'",i,•!„,,...:---,_A :',..'-', ...4,,p_Ittill„.p.,-.,,,'"•,,, ,--,p--.4p1,401iii'„.„t..„.-,.;;-4,.,-A,'„-- -..',..'•.:.!„,:„.".:•:: 11::'1111110hill114.,"r"::•,••,,„--'p '''.'":tY,..11144,,,,,..„-----„PPP-APt,471:',41-,rtt.,,,,PPPP„,..PP'Pr .---— — - -P:','..•4-----4 [kr-,-,:';7T,M7,,ifn, [11110111111:1r."-If:'-'- '------,1---";141,,..."'"i".-.•'".„!:''''''"•.,„ '_-.--.---,_ 1,•,:1110•1.1-g-0.0111,oh-*-71:7.1!!•'01-A'1"4""igit-'11k.*---::',.;_--.--;;-_--..._-..:.0:,,00::.00.',:,,l'!:•;:_•:,,g,.!,._'000;!,:1!0,0•:::000!::':!:•0::,•--____,-ggg.g',-,_-.i„g_..........'•-7-;,g7g4:-..-AtP,Witeillfillri . '10.t0i., 1 _g__---gg-Lgg"!1 :"1,1",•,-. .„...„,,,,,41,41,,pi,i14i11111141010110111111 ,, , ,.111::.:,:t.,.." 4 '. : :.:::!!:,,:,4,.-- . -- ; .. .„,t.:1111t,,„-p,,.y.!.•:!1!!:',,':'''',..-„p.:,:,,,!,:i.p_- -p11 ___-,,p4, ,_-_-....._,;,--.._' .-,,, , „ -p___--_-_,-,-...:.,... $,,,,',,:,•$P-PAP:11;'!1,0411,iiii,:',1.1,iiiiig!,.,•'-'.,P._ ' ,- --'----.,•.!'.',!:;,. •.--''.. - --.- -..4....,,:••,,I,,;•.z.',,Pr-,111111!1,11111,11'11,111p,PIVH,,,Oot,,-,p-P-_kP-P''‘P'---11- :'P • '•'- P-44"-...::!',"-,•••'.."Ii••.'P P--','..'''-,-„,'.'.-----..--a1:--'-'13,,,-R,It`o.li""'P„,,PIP,111.k7..",!,',_- -- -''.-_P'_ =Pp-P •P,7-'•.:•,•,•:,:,•,'r•'- .,Iilhi,,,,'1,§:,p-,-"s_p_,...____,,,r::.,:1:1k14!,',:ire-.--,-...,'''.ds--„,._L,.---_ -i,.,••,,.-. ., ' - '' ' -..'":1.:;i,,',:1,,rp-Pploqii.:p,,,,1,••:•1!il.r..!•1„:••:,,,,•;.„,,...,-. 7ppp-pz,p,-..-_ --:, ,-•:,,,,,Irl,i11.2.,",•,•,A, ..,,,,•,_'"",.•..p.,Ip_:„........,,,,I,:11,11,.,„,....4-,,,,:-„,.-;0,:.:.,,b1r,:pollIvIllp !' "' -,,!::',': _ pilT,,,!,,,..:1,,,riiii..-:T-.11p,!,10iiili,.!..,p,:l. '- .,IP''.4%.4.-.1.-""--;':i"--pP,--_--_''''',...' - --. ','---P-. .' .••''- .•!.:• __• •-''''''...-P.,:;::•."':1,,,P.:01,.:,0••'!::IP.ir...:1,,•.-1',!•P,,,••7-;. -.1------.,''•-,:PPP-_- . "'. .!.,H.:'•'.',..,...,,,:"...':..'", -•P.,..t.'..:•',!:1!,:liiir'ri,,Iiigol.,•,:;----P-11,-••":1';-:',-,,,`",.-T--P..1,111. .-,,,,._ ..,-.1,7".PP-, - ,_,:_-_,_;--p--,'.pm----c-,','„:..,....,,,,p-_-,p 41111114o opapoll ,,, • T.T-pp...„,,,,i[i„..w.,.:4001,1:1„.„,,,:,,p„,.., _',.',1111,i!i•4',.•I ...1,:!,!!:.,:,•!.. -,-, . Consumer Aft :zj4b ,-.-:,!., i-,a,..1,,:,„4.''r,:,, i,,,,i; ,,,,..., , ,,,,,,,..:: —4 -• illit,,'.. .11,fr,1„7;4,6,47.1,.!11111)1ID t71,:,,,,,i,,,;,14111,!!!!;,!11,,.„,:••,!.,,.':%''.';''''''' ',_.''( -•:k f 1;:':l':1;::: 11!'111:i ('-',-;'i‘..el,,'„,,,: ".':':!Ill!ill'!,,''''''''.•:,:.!'. ,.-p •' . . . . -__ .6.-. •• .., :. • ,„ . • . ,_ • , ., , ,i• . -- -- . . - ' • . .: . .• ----, i„. Ji..--. l• ..... 4 •,,,, ...... . ., ' ' ... • •'"'• : '-„'.4. '.• •• .. „ /„..e.-''''..,i,-YZ ;,"1,• ' • '"''''' '''''' ...„, . „ .....,4.„.4" . . ......,.-,„ • ....,:::•>„::::,..... : ... • •, : .. .. .. ' " ..• :,,4:,,..„.„,„. • . .. ...., . . , . ... „, . :i4,',•:',-.4--,7N"-_.,- A7.*7-5,—W,:!-Ii011 11'11,,11,:S10,'141'4i'.14:•'!tit4t,,'„•'i : ---- ._ ___ _ .. :4,.„...,. , 4,.." ."„,:t4,t,'H'''_'-t.--1:-"!-,-'_=';_-T_ .0111110 IV:11111111111111N54.4.""''''"'''•%''.:!'"'tfil••••':'„'''''• -- ' .,.. ..„„4,...44...-5-...7.4„, .: :,-,_:„.,' .4 i.,_-'1,_7:14,•,.''.,",:: 4-r -- -----.:,. .-- -.-.. '..'-.-_..'.....:.,. ''..-1:•,..g.'6'.>'i'''-.'-L''''7W"'7711100110111111[0q.'1,LJ:.,,_:, -.-:TW,:.,......,... . . • . •.•••••..!,-. . •' .„,:!!..!•':.' :,:..!:::H4.!.--'7,--,4,,.',,.---„- .''..±:,•A'..r(-'1'.'!•":'-'4!:'•i:,•;.••. -.. ---- '.:,--",------.!.--....-,."„.::..:,'::••- . .'..'''•':..,..-.-M--..„:-....----?...,„,yixt, ,,ilkitrilif•A,,IP:1,,,,i".4_1= -- ,4,:„A„,:"e-t,:': "....•:.:.... - ., '•:::.;.,„ JI:.•,H.:;.:',,c.-,....,--..L:!--. ..!:',L;:H!'''.'f'y."-,:,,j'H • - , ----;:'.---'-:;--;;,;:-.-..- • -'.: - ".; ',.:,!::•':.,•A.-''.-t-_-_''' --;::-1.i_l)151,..;AAvolligt!':.y,iii ,7-7,--- --..;.:,:iVT,;:'Y'--.--''-:.. ' , . . ',16::.:,••AA',.. - ,........,..:.., .....,,', , .••,••.'..:.,At-:,..`.1.,•',.. -. .. i-4----rt:,.;:i'Y-4,.:,:'.':i3.:'. : 'A';'...1; :.,.,..,.:'%.......' ! ... Ocilf 0,1 0 i 0111 c mg i-,...e.c4L1.3,-.,1J.J."'':r.', H..-,-..: --1 '"'',_ . ."--',!:-:..--::'-'. ''I 11 f il'- 1111110011,!,!•'•• „.„ „1,•41••,!,!!:',,,.. .„.-- ,,,..,...„. „„... . q -- ....•,,,,., ., .. , . „..,__. ...., .. .. „.„,„. _ . ,..,.. • , . . -- -, .....o. ,.•.. '-, -,. •' . . _.. • - . .. .. .. ..... • . .. „... • . . . .. ... . . . . - .. . . . , , ... .... ... .. „ . .. . . . • . , .... . .. • •• . . .. . ,,...„ . . .. . „. .„. ...... 4-. '!!!,..',1111i,.!...111'•!:.••:i",,. ..,„„,. J(,:it''''',',..)„.„,i'i''''Ql ''''.")''" D'fi 4" ''''..-..1i'`Ilv ,,,.„• - . ,,......,....,...„ • ...„ „, .. . ... . .... .__ . . . .. ....„ .„„„_,,:-..„,„;r:1,••••,,,,„:•4:,,•!::§?s,_4.„, s. , ,,,-,11„,.1(.).,,,,gq„..iz„— L:),.„i„..),,,,,,IvE • ...,-,-.•;,:...-.: '------,-.T,--4. CANTON MA 09021 ,.., •,„,:. g_g_... . ....„.,'!..kg.2,"...,--,._-__ g--,-.•,, _,___ .• . ,• .---ggr.!._ . • .. ,.,,.., • . .. . ..___ ...„ .: ql::,.• _ ... .. . . _ ;-- „. . ,:•• ••• • ...„ .. . . .. . . *,•------- „......,...„:.:._ ".••g." :. . - : •,- ::::::,..::: •g_g--gig--_-:„,g,..'1.e..,,:,',:i:.,--,K-1",--.:-.1,--_,...1'111:„;t-..7A,H-.--!,,,,,,.1,:,..-..V.:4—.L:1:.--;..;-. 1;:iel'L.-,;j---'—'"'-''''ItZ--j_4k::;ii'-?;:=4.:"._,,,:.-:,:i,.:11111.,:,:,..,.:!!!::-.:". .„'„'.."••,_-,,-.,-;..-.,.,-.....i,.:ii --_---..,...li!.!.,---i---it.--,,--.-..-A---,,,,5,7 _-,-- -,-...„--.1!,,,,.....-,:ti,...„„,,,.1,1!!„:11111[0ii.,....._,.":..,!...:1.1!!4!!'!1'.: . -- .- '..' - : -,----'-', _.--= :-.Z',!:-4'..4,...'-.----4--N..,!-'k.::....t=1:--,.:,.:4:- .111-!:1.-*;img.fi-i,?,,-;1..1.,r .--_---,ir ,.•_. - 1,,,..,.;.,,.,,',„..:,..:.......,_Ag:1,....-..:,-..,_*,:1,.:„.......•„:!..:. --,..7,,,_,..,,!„1::1,. _,.,,,., :..-.,:,....-i,•,..,toolio,,:.'El'1,:=7_. _..1*,,.,- .4,..,01i3N,Ltr,...,,-,47-:-.„-. .-,;-,.,....,10.01,!.!,.,..,... ....:: : , - .-: - -.-,..-::,.--:-_-1,.%'...- .:ii-- .,,,,;..;,;j:.".;!,1:;,,.4,_-."- ..-s.....::.•..!,:,$-..,.„.....,,_!,_,,,,vo,prw.,.-,$,di,„,,:„..;."1. .,,,,-. -,,-T7,..--,-',.-„-3:--__-L,:.-.--,-_,,-:!,:!.1.11,.,___,_......,.„...,..I.i. i",. - -T-,_,-,.-.:!!.,:•o:'.:.--,- -,!",:10il!'..9:.--.41,ifoodir." .7,-;,;17,,hoody:..'.- --.;_ivtia,--4.1.1i1P.----.._---., .-. '. • .-..=,-._,,n ,..,-,..,!:,,,•.;...._ ,---.---,..„..-..:...1,::.:1 :-,__I___:.,-.4,1.,-.-4,,,."..,0-.----m,,11,111i.,,-...„,.,.,-,t .,,,,, '111;:r,.,.:;-_-,_-7--------,,i'",..,....,.-- _,-;"....11i,:;11,,.'1!!--__-_--.n:7•:,,i7„..!'i---- '-:":"'",-V-.t .•-...":".1•140:4'..,-45,,,---',..,„'7,1v:10;:t.,•..:4M" --77:-.',7.4,1,:;-,- -•-----.:g.---".:••- - . _ :_ ..... -.-:=-:,.-"-_,...':":.:,.": '. --- :41:1:.:•'•.. •--,.-.--.,-.T.,:.,::,1111LI--.;,',...1.::',"..;-.1.,A11,11-1%#:.:ti:1111,,-:;i.;1='-': ::111,1t,:r...'-..-.-.0...p:-,--_..;i....1.:.".."...'::-.,-1..:-.:-...' "-,"_ -:,.:..,:,.....--...:,.'.'..-7.!7•....1.:1::!::''::':••-': ,_,,.,,401:;,11116,,e--.-i1114;12:_.'"1,4iptc-44.,-13r/gige:Ith• -71-Ti3, 1111i1!:-7.-.-------. ••• :-• .". -..,,..":---",-_ ",.__ ", .•-..."., ..•.':-_,_ "..,.----_--.)._•:4•",,..?--..i,-,:b'Illilei %$.1101-11....,i4iiliiii111.0,..-.17'"....,;.;:lilo:::.'„,!::::::::','.'-'-,---,..........:,..?.,',1!..1':.Ayl..,..,:.:,:!:''''..--,.........:-.,-RF4 '•"•.,..1110:111 .-Eiitr 'S`---''.';:q''..': .;1,01j01,00111,!!!4:;410011t;..1.....-•".....,...,:4::'.:1•:•!!'!•• -- : " --:-. '':Iii''"----..---'......:-:;,:il'::'1';':•"_-•',ZIP--', f;j:ii:;:::::::''''. ' '•-•-•'---------i,;'---'7.- :-....-.:-:-'•'..:"!-•"' "'-"I'-'-' '•'..' ,:•:::"F-....:.-'-1."-':':--'..-:::.-Nlg'•1'1''Z':-..,.];!:i,:e''',1.••:,,E.),:jd::::0.....:.:„...,,„::,:......:.:::::::.''. „...,:......._..:'::::-: ' ' . . --';''i'::'!':'''. '''' ---'''' )'41111°;:'''''''••''r:-..::'1145!'-' ••-•••:''.:• " -''- 1' •-''- - :-;';•---"- -'---•-•-•:•:':"'""-''.7-'""..!":_•'' '-'IfTt-_,::"L:.: F----:,,'-',..,-'.....i.:!,„:;:::i.:::: _,._:.:::"I: ,_.,, ,... . _ , . - . • • , SECTION 1 Ob OWNER/AUTHORIZED AGENT DECLARATION 1 •, . _.....,.. • . . C- -----;-:7 4 .. 12 Qv 4 NI C:174 reg. , 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. (,--------7 • P 4 VII (.. .r .7.1 , . . , Print Name - CVZ!. Signature of Owner/Agent Date Section 11 - ESTIMATED CONSTRUCTION COSTS Item • Estimated Cost(Dollars)to be completed by permit applicant I.Building Z.Electrical . 3.Plumbing/Gas 4.Mechanical(14VAC) S.Fire Protection S.Tota12.(1+2-4.3+44.5) 060,000 , 7.Total Square Ft.oretteff SMCIUTS5&/16:960.10 --" Check Below 0 Conservation-Commission Filing (if applicable) Old Kings Highway&Historical Commission approval (if applicable) , , c .71- l'i....3r:7 v• /...; ceo.se._ d A q Rpp/ICJ°* le' <-1-6 ntS e. e r : 000 co:ii be sub;nilif-vi (on 'AR- u ' yul. e•-• A/Ike tri. 64piel,.4;ne 0 li 1 , al 0 e 045 e,nc..2••• •c) n 44,R, e------ ye u;reAkciftii&. ./ • . . . . . r� 3.2 Registered Home Improvement Contractor. n r.T..S^ft.›,,,- e'� s1) '�R��'.06�7. .... V6 . Not Applicable 0 C�+msnip�wt� r�+tanert�!e r Registration Number /,/6-$7 Telephone 4C)4.7 (, , P 9 o Sic�nat� ...�., 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 Na • Section 5- Professional Design and Construction Services-for Buildings and Structures Subject to Construction Control Pursuant to 780 CMR 118(containing more than 35,000 c.f. of enclosed space) Section 5.1 Registered Architect: �1 --� — 'l ;II-0", Ac.04e�" S Not A,pplimble Marne(Registrant): • Box fa, • Registration Number Address 4 n Expiration Date Alec) /spa`to 4..aq-/ 0 �)/7/ Signature C • Telephone Section 5.2 Registered Professional Enginers) • Area nl Respnnslhnity Marne Registration Number Address . Signature Telephone Expiration Date Area of Responsibility time • • • Reglstratlan Number Address Telephone EvIratlan Date Signature ' • Area of Responsibility Mamie Registration Number Address Telephone Expiration Date Signature Area of Responsibility Name Registration Number Address ' , Signature Telephone Expiratton Date Section 5.3 General Contractor /t)C, Not Applicable ❑ Con pant Name Person Responsible for Construction 49/ �� . / # O(.4a :e ' cdtl OS , 14a'"' Addres, 767•-„2 - 1 " • Telephone Signet { r Arc f r. • • •,• ! Land P'hinnini,: riC.OriCil" ViS!rotitiZtitis;it 1,1k t ' - Building rode Review ommirgell, Alterations to st Ito,Liefro-r6 Hunter Green Motel - West Yarmouth, Massachusetts Date: September 15t". , 2022 by Brittany Blinn Project# 2246 Jurisdiction: Town of West Yarmouth, Massachusetts Applicable Codeipl including but not Urnitdtctfoilowhicj 780 CMR Massachusetts State Building Code, 9th Edition International Existing Building Code 2015 (IEBC) (w/ MA amendments) Intern::.tionul Building Code 2015 (IBC) (wl MA amendments) 52'i CIVIR Arc!litectural Access Board International Energy Conservation Code 201S Protect Description: Alterations to all Existing buildings (Motel —Transient Lodging single units) and Office/Pool Building. See floor plans dated 8-30-22 for renovation details. Tyve of Cont,:tL'ucion: 5B per IBC 602.5 Cross Motel Building A — '18,615 SF Motel Building B 9,744 SF Office/Pool Bldg — 2,840 SF Alterations - Level 1 per IEBC 2018 Charu Cilcipt.'sr - Existing Building, Section 503 — General - Level 1 alterations include the roil-loyal and replacement or the covering of existing aleiric-;: , equipment, or fixtures using new materials, elements, equipment or fixtures that serve the same purpose (Complies) % Orvicilecic Is necessary — ay.; no upurades to the building envelope is requiioeti. Demo Work Area: Motel Building A — 14,560 SF Motel Building B — 6720 SF Office/Pool Bldg Phase II — 500 SF Residentftn per IBC 3'10.4 (t)(i.)11 .3-aw.:,, 1%0, i0.i NeW 0:2.1kri I 'I (60:)'',47.6—'1‘g,13 Arciiiircturo iAntl Ink.rior 1);%3i.gn , • VisualizatieN _ • , 521 CIVIR Cna ;:er 3 Existing Buildino: 3.3.1 If the work being performed amounts to ;eso than 30% of the full and fair cash value and If the work costs more than $100,000 than the work being performed is required to comply with 521 CMR. In addition, an accessible public entrance and an accessible toilet room, telephone, drinking fountain (if all provided) shall also be in compliance with 521 CMR. (Complies) --- Owner to provide additional information as required by the town. Currently: Office/Pool Building renovations do not currently have an accessible public entrance or bathrooms. An accessible public entrance, as we understand it, shall not be required as the new work in the existing lobby being performed complies with 521 CMR requirements and does not exceed 30% threshold of the full and fair cash value. Action: if required by Building Department: Per 521 CMR 4,1 a Variance shall be provided by the owner or owner's representative to address the impracticable full compliance of an accessible entrance and public bathroom with 521 CMR. 521 CIVIR Chawer 8 Transient 1„.5211211,41111cifities: Applicanny: Per 521 CMR 3.3.1 Group 2B Dwelling Units shall not have to be updated based on the intecior finish work being performed, and doesn't exceeds 30% of the full and fair cash value of the building. —Current urths = 74 including 2 ADA units 3% SUGGESTED ADDITIONS: 62'i CMR Chapter 24 Parking Spaces: All though not required based on existing building requirements and CMR 3.3.'1, we do suggest to add 1 van accessible spaces. Accessible space to include vertical clearance of eight feet two inches at one parking space along at least one eight foot wide vehicle r:Iccess route to such spaces from site entrance(s) and exit(s). Suggested to provide coch accessible space with a designated sign "Van Accessible" as shown on 521 CMR 23.6 Fallon, Rosa From: Purvish Patel <Purvish@harshimhotels.com> Sent:. Friday, September 16, 2022 2:09 PM To: Fallon, Rosa Cc: JOHN DILLON; Sandra Gubitose; Parth Patel Subject: Hunters Green Building permit pending items Attachments: JDSIGN.pdf; IMG_6852 jpg; IMG_6851 jpg Attention!:This email originates outside of the organization. Do not open attachments or click links unless you are sure this email is from a known sender and you know the content is safe. Call the sender to verify if unsure. Otherwise delete this email. To Whom it may concern, Please see attached items missing from the Hunters Green Application Packet. 1. Signed copy of application 2. Copy of license for John Dillon (General Contractor) 3. Contact Information is below for the John Dillion's company and his direct line. Custom Renovation Services John Dillon: 617-877-0898 Email:J51D@msn.com Sandra Gubitose Office Manager:781-258-9737 Email:Sgubitose@customrenovationservices.com They are both copied on this email should we need any further information. Thank you Purvish Patel 217-819-8036 1 • COMMERCIAL ONLY- BULDING PERMIT APPLICATION REGULATORY APPROVALS NOTICE Address.of Proposed Work!/044e►'S 6rreei 53 T7 -Re et.9.garmodt /-1'4- 73 Scope of Proposed Work:?r.,vc)e,,-a a g:4A+i n p J c)4:9 A 1i�- vest -7a75 irk ` !�(�ilo�'i LI o 'is>- 6// ei)0eir + Date: ®9 /2g-/-Zo2.2 . 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/Matt Bearse, 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. • Receipt Acknowl Applicant's Signature Date Rev. March 2022 Sears, Tim From: Sears, Tim Sent: Tuesday, September 27, 2022 11:58 AM To: J51D@msn.com Subject: 553 Route 28 John, I have reviewed you application for renovations and there are some items needed. 1. Larger plans 2. Separate application for each building Please submit 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 CBO Deputy Building Commissioner Town of Yarmouth 508-398-2231 Ext. 1259 mailto:tsears@yarmouth.ma.us 1 Architecture Land Planning j Fy Interior Dosign 31)Vistiniiztttion Building Code Review )timrpor Alterations to Hunter Green Motel - West Yarmouth, Massachusetts Date: September 15t". , 2022 by Brittany Blinn Project# 2246 Jurisdiction: Town of West Yarmouth, Massachusetts Applicable Code(s) including but not limited to the following: 780 CMR Massachusetts State Building Code, et" Edition 4 International Existing Building Code 2015 (IEBC) (w/ MA amendments) International Building Code 2015 (IBC) (w/ MA amendments) 521 CMR Architectural Access Board International Energy Conservation Code 2018 Proiect Description: Alterations to all Existing buildings (Motel — Transient Lodging single units) and Office/Pool Building. See floor plans dated 8-30-22 for renovation details. Type of Construction: 58 per IBC 602.5 Gross Areas IViotel Building A — 18,615 SF Motel Building B — 9,744 SF Office/Pool Bldg — 2,840 SF Alterations - LeveiI per IEBC 2018 Chapter 0 Chapter 5 - Existing Building, Section 503 — Aherations General - Level 1 alterations include the removal and replacement or the covering of existing materials, elements, equipment, or fixtures using new materials, elements, equipment or fixtures that serve the same purpose (Complies) - No COI is necessary — as no upgrades to the building envelope is required. Demo Work Area: Motel Building A — 14,560 SF Motel Building tr3 -- 6720 SF Oftice/Pcol Bldg -- Phase II — 500 SF Occupancy_Clas,sification: R-2 — Residential per IBC 3'10.4 f;13', Turnpike P.O. Box 10.1 New Ipswich,'N I 1 0307 T(603)878-4823 17(603)$7$-4834 vv,W.Li RI Architecture Emil l'ilii 1 1 1 1 , intevior 1)P.,ign Vistaalizition gr r•L J*040i'rq • j'l.kirg'.1qt4)P1' 521 CMR Chapter 3 Existing Buildings: 3.3.1 If the work being performed amounts to less than 30% of the full and fair cash value and If the work costs more than $100,000 than the work being performed is required to comply with 521 CMR. In addition, an accessible public entrance and an accessible toilet room, telephone, drinking fountain (if all provided) shall also be in compliance with 521 CMR. (Complies) --- Owner to provide additional information as required by the town. Currently: Office/Pool Building renovations do not currently have an accessible public entrance or bathrooms. An accessible public entrance, as we understand it, shall not be required as the new work in the existing lobby being performed complies with 521 CMR requirements and does not exceed 30% threshold of the full and fair cash value. Action: if required by Building Department: Per 521 CMR 4.1 a Variance shall be provided by the owner or owner's representative to address the impracticable full compliance of an accessible entrance and public bathroom with 521 CMR. 521 CMR Chanter 8 Transient Lodging lest : Applicability: Per 521 CMR 3.3.1 Group 2B Dwelling Units shall not have to be updated based on the interior finish work being performed, and doesn't exceeds 30% of the full and fair cash value of the building. ---Current units = 74 including 2 ADA units = 3% SUGGESTED ADDITIONS: 521 CMR Chapter 24 Parking Spaces: All though not required based on existing building requirements and CMR 3.3.1, we do suggest to add 1 van accessible spaces. Accessible space to include vertical clearance of eight feet two inches at one parking space along at least one eight foot wide vehicle access route to such spaces from site entrance(s) and exit(s). Suggested to provide each accessible space with a designated sign "Van Accessible" as shown on 521 CMR 23.6