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HomeMy WebLinkAboutBLDC-23-31 . .. ..01:•-r.61,,i, BUILDING PERMIT APPLICATION . ......4 ., S,,,' APPLICATION TO CONSTRUCT REPAIR, RENOVATE , CHANGE THE USE, OCCUPANCY OF, . „. ' . .e,..; ,i, * ‘-jc,1 OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING. 0 —.-., E-• - ,Z.. Town of`I'irmotith Building Department I 146 Route 28 - Yarmouth, MA 09664-1-492 Tel: 508-398-2231 ext. 1261 Fax 508-398-0836 Office Use Only ,.- .2 — i Permit No. Date Permit Fee $ Gc), CD Endorsement Date , Recording Date Deposit Rec'd. $ 670.0 Date-11)Z plan ND, Net Due $ 0 .... _ _ Planning Board Information /Assessors Department Intormitik Other fdf ap 1.4 Property Dimensions: Lot Area(si) / JAN 11 2023 New __ _ _ _ ' I BUILDING-DEPART-MEW- Frontage(ft) .......--,-,...7._ Lot Coverage Building Permit Number: Date Signature: • .." , _,---- - 4 Certificate _-- ....c-r--- * , This Section for Office Use Only 7-/ - Date Date Issued: . of Occupancy is is not required Section 1 - Site Information 1 _1.1 Property Address; 1.2 Zoning Information: igil AkUlid Jreeer Zoning District Proposed Use 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard \ Required Provided Required 1 Provided Required Provided 1.4 Water Supply MALL.c.40.S 54) 1.5 Flood Zone Information: Commentx Public Private Zone: BFE: Section 2 - Property Ownership/Authorized Agent! 2.1 Owner of Record: .. ..7. Vic A Ad. Sox MD 140,L7A4 er Name (pri Ail worm pc Mailing Address: .-Alla3111fkx ,,, N,. 1 oir , 1 417- ‘45-4f/ jaggries- - -47111,r-p ,ina Telephone Email Address: / rr:Prriz-... - sent JO ., J. il ,./4l4 c1 . / 6 t<oler liil Sr Name(pr_, 1 ippr - Mailin Address: Sig ilipp 411, Teleph• -Mr Fax Erna S-4411. . - Construction Services 3.1 LIcanfad.ConsVustlw Supery . Not Applicablell 4cidress: / 0 A '' /411614, iblAitri Ad4 4O,400 License Number , AA I CS 0 laf515 8' Addres-Vir agiL- .....N. 4.•' 41 i‘i f-f174/510 Expiration Date Sig ature el - illp-phone Email Address- /6."04 - dstOIL ef d•Ma Old le•4,0'411 im 6 pbotil.coati 3.2 Registered Home improvement Contractor: Company Ham® Not Applicable D a/ Address A Registration Number Expiration Date Signature Telephone Section 4- Workers'Compensation Insurance Affidavit(M,G.L c.1s2 S 25C(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure • to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes No Section 5- Professional Design and Construction Services-for Buildings and Structures Subject to Construction Control Pursuant to 780 CMR 116(containing more than 35,000 c.f. of enclosed space) Section 5.1 Registered Architect: Not Applicable Name (Registrant): ISVA Registration Number Address Expiration Date Signature Telephone Section 5.2 Registered Professional Engineer(s) ye A rreeY ei v iI A-A9,44e.es Name , Area of Responsibility / 0115 at. CA•ci144_Xj2_lank_51_ Addres 43iat 2'igf-5: 5;040 Registration Number ignature Telephone Expiration Date Name 11/4 Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Ad dress Registration Number Signature Telephone Expiration Dale Name VA Area of Responsibility Address Registration Number Signature Telephone Expiration Date Section 5.3 General Contractor O LS en Crnjrievemin SEAL/IC.6A Not Applicable Company Same jag-N J. bltse.mgri A Person ": le for Cons ction At //MO A44 #1A0 4/3 Address Tiimpipprx ,r -177415V/ _ - Sigel 410" Telephone ‘. • , Section 6 - Description of Proposed Work(check all applicable) New Construction p (tor multiple family only) No.of Bedrooms (for multiple family only) No.of Bathrooms Existing Bldg. p 1 Repair(s) 13 Alterations 0 Addition (13 Accessory Bldg. (13 Type Demolition Oker "7 Specify: Jr rep Brief Description of Proposed Work: C 444/2. 44140 de—iiifil*C, ace&/3774 VIII ZerAMeN• f v6 tleke,r- cS-2 -71 eir/Als7 prhose mc op Nifiz. _Seado Zmergezel6E,qp Ve4s4le Snap," 14 r17- S ge kilfiCifeD fihasse Ai'II be by 6etleitare-40.44:r) Section 7- Use Group and Construction Type Building Use Group(Check as applicapable) Construction Type A ASSEMBLY 13 A-1 13 A-2 A-3 D to 0 A-4 0 A-5 TB 0 B BUSINESS 2A D E EDUCATIONAL CI 213 1:1 F FACTORY F-1 F-2 3 2C D H HIGH HAZARD 3A D I INST[TUTIONAL 1-2 3 -3 3B ID M MERCHANTILE D 4 D R RESIDENTIAL {3 R-1 R-3 0 SA 0 S STORAGE 13 -1 0 S-2 p 53 D U UTILITY SPECIFY: A doy&on Stlileafife 1.01 MIXED USE c3 SPECIFY. S SPECIAL USE IA. SPECIFY: edargyffidey II hi iy de.siaesse 61101,43 Complete this section if existing building undergoing renovations;additions and/or change iri use. Existing Use Group: Proposed Use Group: Existing Hazard Index 750 CMR 34 Proposed Hazard Index 7B0 CMR 34 Section 8 Building Height and Area • Building Area Existing(if applicable) Proposed Number of floors or stories include basement levels Floor Area per Floor(sf) Total Area All Floors (sf) Total Height(ft) Section 9 - STRUCTURAL PEER REVIEW (780CMR 110 11) Independent Structural Engineering Structural Peer Review Required Yes No SECTION 10a OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT J4 m J. Hditifric _sbz.-A5evr , as Owner of the subject property, hereby authorize ok5g74) '• SIX/14017) 861644e66 to act on my beha all*: er el ative to IN authorized by this building permit application. /MIL_ Sig =ture of • or WOW' Date SECTION 1 OP OWNER/AUTHORIZED AGENT DECLARATION I, JONM' J ' `O�p4 v�- , as Owner/Authorized Agent hereby declare that the statements and in ormation on the forgoing application are true and acurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. JdNIJ • l6t/,4a 4 : Print Name , , - ipv/s Signa'. a of Owne eent — Date S= tion 11 - E'v1 MATED ONSTRUCTION COSTS Ile • Estimated Cost(Dollars)to be completed by permit applicant 1,Building a Electrical 3.Plumbing/Gas 4,Mechanical(HVAC) 5.Fire Protection 6,Total=(1+2+3+4+5) /3S jGDG�C6 7.Total Square Ft.Itornew smcc,zes&additions) Check Below ❑ Conservation-Commission Filing (if applicable) ❑ Old Kings Highway&Historical Commission approval (if applicable) SHIVEHATTERY ARCHiFF' CTURE + ENGINEER , NG Tree Clearing Narrative for Eversource Energy ERP Vehicle Staging Lot This project is located at 484 Willow Street, Yarmouth, MA 02673. It involves constructing a vehicle staging lot that will only be used during energy emergencies after large storms. Workers and vehicles are brought in from other locations to help fix the energy grid when there are large outages. The ERP lot provides a location to stage and organize the additional resources. During normal times the lot will remain empty. In addition to the asphalt parking lot, infiltration basins and storm sewer will be constructed to manage stormwater runoff. Site lighting, landscaping, fencing, and a fire hydrant will also be installed. North of the project limits is the existing Eversource Energy facilities. To the east is a wooded area. To the south is an existing development and a wooded area. West of the project area is the Cape Cod Gateway Airport. The site and adjacent properties are zoned B3 Business and R.O.A.D. Overlay district. The first phase of this project is to remove the existing trees within the project area. Approximately 3.89 acres of trees will be removed. Removing the trees during the winter months follows environmental regulations. Additionally, it promotes a streamlined construction schedule in the springtime. Only the tree clearing activities will be completed during the winter months; the rest of the project scope (as described above)will be completed in the spring and summer months of 2023. After the entire project is complete, native landscaping will be planted along the frontage and neighboring property lines to provide adequate screening. Additionally, the landscape screening will also maintain the existing aesthetic as currently viewed from Willow Street. The infiltration basin and other open areas within the project footprint will be planted with native seeding. Project 3172201210 shive-hattery.com r. Commercial Renovation I Mission Critical Projects I New Construction �r` 21 Deming Road, Berlin, Connecticut 06037Iwww.olsencs.com CONSTRUCTION SERVICES Telephone: (860) 610-1093 I Fax (860)610-0397 I info@olsencs.com January 10, 2023 Town of Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 RE: 484 Willow Street Yarmouth, MA 02673 To whom it may concern, This letter shall serve as acknowledgement that Eversource Energy and Olsen Construction Services (OCS) have entered into a contract for improvements (the "Project") on the Owner's premises referenced above (the "Property"). OCS is performing construction and construction management activities for the Project on behalf of Eversource Energy. The project involves constructing a vehicle staging lot that will only be used during energy emergencies after large storms. Workers and vehicles are brought in from other locations to help fix the energy grid when there are large outages. The ERP lot provides a location to stage and organize the additional resources. During normal times the lot will remain empty. The first phase of this project is to remove the existing trees within the project area. Approximately 3.89 acres of trees will be removed. Removing the trees during the winter months follows environmental regulations. Additionally, it promotes a streamlined construction schedule in the springtime. Only the tree clearing activities will be completed during the winter months; the rest of the project scope will be completed in the spring and summer months of 2023. Estimated cost for this phase of the work is $135,000. Please contact our office for any questions. Thank you. Sincerely, Nick Olsen Vice President Olsen Construction Services Olsen Construction Services is an Affirmative Action/Equal Opportunity Employer YL-V.J ICC,:VO/1.1 STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION This is your Major Contractor registration certificate for your records. Such registration shall be shown to any properly interested person on request. Do not attempt to make any changes or alter this certificate in any way. This registration is not transferable. Questions regarding this registration can be emailed to the Occupational & Professional Licensing Division at dcp.occupationalprofessional@ct.gov. In an effort to be more efficient and Go Green, the department asks that you keep your email information with our office current to receive correspondence. You can update your email address or print a duplicate certificate by logging into your account with your User ID and Password at www.elicense.ct.gov. Mailing address: Email on file to be used for receiving all notices from this office: OLSEN CONSTRUCTION SERVICES LLC jtaglialavore@olsencs.com 21 DEMING RD BERLIN, CT 06037-7278 r t'.. "'y. t�k ! .ems ,.,r �Y �',w^ ��'4 N M S rat-d Ago, I�q7p! e h i c i �Tai�r.I+ yr%. :w 50 d�A'`tilH U' ` r s�. �,�t�y. �;�7 � •r �.s'{`J• f��';k I���, Y,, i -- >•h r ^�'�,} `+{. � ,� r y r 'F,� (9 $r' ,'� � '�. ..:�'iik `'� ° r ' e a %j _-- — fir :i tR ;;§ 7t;.` + — — ', ; STATE OF CONNECTICUT + DEPARTMENT OF CONSUMER PROTECTION �r. 1 ! Be it known that r r ,I OLSEN CONSTRUCTION SERVICES LLC P-41:1 ! „ 21 DEMING RD 1 , . as :5: 1 `' BERLIN, CT 06037-1512 . • p y y N y���, I y1 f'r I T At !y` . t i has satisfied the qualifications required bylaw and is hereby registered as a ! . MAJOR CONTRACTOR Registration #: MCO.0902042 iyA �' , Effective Date: 07/01/20214,1 1 f A. ��, ; Expiration Date: 06/30/2022 i " ) . Mic6ede Saeull,Commiasiouer ' verify online at www.elicense.ct.gov '� r 41y 4 4 44 4 ? 'R_ _I ‘1,,,.,-.i.„.4 ? 4 44 44 44 .I4 44 ;r ♦.,fr u i t , A•i* 1...4 r 4-, y 5 r ^i k Y.. ry y�Y 1•,�, ,i ! •.'` 4 : .:f, �.F. .!� . l. 'S; ✓ . ,v, -it': Y �SBY'rf`ST..t T' --P.A.,4 Q`t' x glfK, .^�,..�, yy#,� PS`� 9 4 ...:.� 4 y�, 4t�:-J $1: y t'd„ �.j•.. :4tir•: �,. f �'f. ,•y;.lE`• `�v'.w"�CY4 �✓ 5�'�� l }; 'caK '�` wY "�{.. �'.:�r. k - �.r., ".r>. ?, • The Commonwealth of Massachusetts } k Department of Industrial Accidents 1 Congress Street, Suite 100 j, Boston, MA 02114-2017 www.mass.gov/dia \Yorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information � W/�,,,.j Please Print Legibly Name (Business/Organization/Individual): en,SG ) /71 &oo//do& • Address: 621 „D�/,1 9`acC City/State/Zip: LFelearb it), 0%060 51 Phone#: 0�id' 43e-331-/ Are you an employer? Check the appropriate box: Type Of project(required); 1. lama 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. ❑Remodeling any capacity. [No workers'comp. insurance required.] 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑ Demolition 10 [] Building addition 4.0 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.[ Electrical repairs or additions proprietors with no employees, 12.0 Plumbing repairs or additions 5.11 I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.Q Roof repairs These sub-contractors have employees and have workers'comp. insurance.: 6.D We are a corporation and its officers have exercised their right of exemption per MGL 14. ther%,.9I4* C 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. l am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Narrie: e / 1#1 R,nek d4k ,46" 72/(Sei1. J 16 Policy#or Self-ins.Lic.#: a 8'qJ Sb 91►bO'11. ztow'b Expiration Date: //3//13 Job Site Address:_ 10 49 A)//fold 67T,tr City/State/Zip: � J�A r /14 Attach a copy of the workers' compensation policy declaration page(showing the policy rber 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 penal-fix in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the viola -. A copy of this statement may b orwarded to the Office of Investigations of the DIA for insurance coverage verificatio . 1 do hereby certify der the ins a• penaltie p' jury at the information provided above is true and correct. Siena a: • Date: / 123 Phon #: 817' V.sW 1- Off use oni Do rite 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#: Commonwealth of Massachusetts �t�� Division of Occupational Licensure Board of Building Re ulations and Standards ConskatiOnirstvipeirvisor CS-078588 v . TM- spires:10/09/2024 JOHN J MORJARTY JR i 140 FORT HIIiL ST t 1 HINGHAM Mlf�02043 .:. i 4.0/LVd.i-1 VA,8888888 JJIVItG1 yyau �.......1 OLSECON-CL AGAGNON A��o CERTIFICATE OF LIABILITY INSURANCE DA6/16/2022 TE Y) 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). CONTACT Amanda Gagnon PRODUCER IjAME: Smith Brothers Insurance, LLC. 68 National Drive 1AHic00,,"ri,Eel):(860)430-3371 1 (A/C,A No): Glastonbury,CT 06033 'Wass:agagnon@smithbrothersusa.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Travelers Indemnity Co of Amer 25666 INSURED INSURER B:Travelers Property Casualty Co of Amer 25674 Olsen Construction Services LLC INSURER C:Charter Oak Fire Insurance Co 25615 21 Deming Road INSURER D:Travelers Casualty And Surety Co America 31194 Berlin,CT 06037 INSURER E: 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 CONTRACTOR 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. 1NSR __..ADOL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYYI (MMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR DT-CO-9045L008-TIA-22 1/31/2022 1/31/2023 pREMIS TORENTEO 300,000 ___ X PREMISES IEa occurrence) $ MED EXP(Any one person) S 15,000 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECTPRO- 'X I LOC PRODUCTS-COMP/OPAGG S 2,000,000 OTHER: S B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 (Ea accide,Rl),_„_ X ANY AUTO 810-3L220234-22-26-G 1/31/2022 1I31/2023 BODILY INJURY(Per person) $ OWNED SCHEDULED __ AUTOS ONLY AUTOS _BODILY INJURY(Per accident) S HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY „-(Per accdent) S S B X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10,000,000 EXCESSLIAB CLAIMS-MADE CUP-0J325884-22-26 1/31/2022 1/31/2023 AGGREGATE $ 10,000,000 DED X RETENTIONS 10,000 S C WORKERS COMPENSATION X I STATUTE 1 I ER OTTH- AND EMPLOYERS'LIABILITY Y i N UB-9J509260-22-26-G 1/31/2022 1/31/2023 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT _-S ,,,__......,, OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S._ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S D Crime-Employee Theft 105883482 1/31/2022 1/31/2025 Limit 500,000 D Crime-Employee Theft 105883482 1/31/2022 1/31/2025 Ded. 15,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) RE:Main Floor Renovations,81 Charles F.Colton Road,Taunton,MA Eversouce Energy is included as Additional Insured as respects General Liability as per policy forms. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Eversource Energy ACCORDANCE WITH THE POLICY PROVISIONS. 107 Selden Street Berlin,CT 06037 AUTHORIZED REPRESENTATIVE I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1261 Fax 508-398-0836 Office of the :yuiMd.ing 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 41 Atha) &lamer Work Address Is to be -A -tier disposed of oat the following location: r — (J�2 C yC��C P � Said disposal site shall be a licensed solid waste facility as defined by M.G.L. C 111, 0 OA. .i/g, t5 Signa Tre of A pp '*�1�` Date Permit No. RE IYED COMMERCIAL ONLY— BULDING PERMIT JAN 132023 APPLICATION REGULATORY APPROVALS NOTICE BUILDING DEPARTMENT Address of Proposed Work: 4151. ENV l L LO'I) steam- eVVQSOchtC( 'rm.(' Scope of Proposed Work: C 4AAAG V4�, nM far Seri/ 5/1-01,/m,9 7• v-a t t` c t re a'Agilares+ty? 14/6Eg 5E/be4 Pex,N,7 Date: / /212.3 16.4- ' v-e.. 9 e- /6,7\ 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 ,9Id 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. Receipt Acknowledgemen •• Applicant's Sig ure Da e Rev.Jan. 2019