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Home My WebLink AboutBLDC-24-7 x�� Town of Yarn olxA B�41 i Department 1146 Route 281 South Yarr{ri.o ry Motel. 508-398-2231 ext.1261 Use and 46cu�l _ ', , linje4pphcation In accordance with the provisions ofih lassac 1us t'ts State Building Code, section 105.1 Application for a certificatease and occupancy permit Name of Business kEl4l //f es'& LAtivbs '' ' '6 Phone # - J02 79-- 2-6 a3 Type of Business L , ebS e9 P /J C-, Emailig-naZ' &6'"mL e47/r i'� Property Address �'� " Unit # �- -- Square Footage to be occupied-CY attach floor plan Fee: $60 Are sue. FEE .� The applicant is required to obtain approval sign-offs from the following departments as checked off below: D X Health Department— 508-398-2231 ext. 1241 JAN 22 2024 X Fire Department— Fire Prevention, 96 Old Main Street, 508-398-2212 I _ BL; uF 'TMENT • Other C.CO Buil ' owners Si ature ftture Please no tfiis is per • se and occupancy only. Any work requiring a building permit will require a licensed contractor to submit an additional application with all the required information based on the scope of the project. **Office use only** Zoning District 8 3 Proposed Use%\ Change of Use: Yes No_ Al lowed Use: Ye No APD Waiver: Yes ' No N/A Building Officials Signature Date ` S / 010, a,,r� Lid-z..4lam. � Updated 3/21 ,7 w > . o� ti4 TOWN OF YARMOUTH BUILDING DEPARTMENT • &D APPLICATION FOR DETERMINATION OF NON-APPLICABILITY °�':c1 �c �.,J AQUIFER PROTECTION BYLAW §406.5.1.1 Applicant/Business Name: 2441r0,scePO4.6 Date: �� O251 Property Owner: �p i)c7I L � -?Ieocoe n S Property location: 24 2�''► � / 14) 1/4/ Unit# Proposed Use: Cl !L€ W Pr?-' ��sl� '74P/7 'L.. fie,"/ .59-�,eR-�s: Sty,q-LL T 'LS .�� 44-NaS ewe, 1. Has applicant has fully complied with the Submittal Requirements of§406.5.2 ? (Attach copy of Hazardous Materials List) 2. Does the proposed use meet all of the Design and Operation requirements of§406.5.7, 3. Are the chemicals, pesticides, fuels and other potentially toxic or hazardous materials used or stored at the site, or produced by the proposed use, in qualities not greater than those commonly associated with normal household use, 4. Does the proposed use meet all of the objectives and water quality criteria of the bylaw: The above applicant hereby acknowledges that the Building Inspector may require the applicant to submit the matter to the Health Agent or Board of Health, and may require the applicant to demonstrate that he/she has received a favorable report from the Health Agent or Board of Health. The Determination,if made,shall apply only to the individual applicant and proposed use and shall automatically expire upon any change of use or transfer of ownership of the business. There shall be no appeal from an unfavorable Determination of any such application,nor from a failure to act, except for filing by the applicant for a Special Permit from the Board of Appeals as otherwise provided herein. ///97b25i A plic�r(t Date Print ame DETERMINATION: The Building Inspector, based upon a review of this application and information supplied by the Applicant, hereby determines that the proposed use satisfies the requirements of§406.5.1.1 and that the Applicant need not apply for a Special Permit under§406.5 4°a/A-i-rn i--z?-2-f Building Inspector Date Health Agent Date Form must be filed with the Town Clerk and copies of this form must be sent to the following departments(as listed in§406.5.4); Water,Engineering, Fire, Health, Planning,Conservation, Board of Appeals. Aquifer Protection District Waiver 05/08 er- "prior- PPr6v t zC9c3v.. i relief 1, ef 6hic r i 0 r� llm S TO: Commercial Applicants in the APD ti= FROM: Yarmouth Health Department SUBJECT: Hazardous Materials As part of the application process for a Board of Appeals hearing or Determination of Non-Applicability, please complete this form and return it with your application. For fiuther information concerning hazardous materials regulations, contact the Health Department Office. In the conduct of your present and/or proposed business, do you store, use, generate any of the following types of products? Please check all which apply and list quantities. Antifreeze, Engine& Radiator Flushes Motor Oil Hydraulic, Brake, Automatic Trans. Fluid Gasoline/Fuels Grease, Lubricants Degreaser/Cleaners Floor/Driveway Degreaser Battery Acid Rustproofing/Undercoating Vehicle Detergents Vehicle Waxes, Polishes Asphalt, Tar, Sealers Paint, Varnishes, Stains, Dyes, Thinners Wood Preservatives Dry Cleaning Solvents, Carbon Tetrachloride Floor/Furniture Strippers Other Cleaning Solvents Rock salt, Road salt % ' Drain, Toilet, Cesspool Cleaners Refrigerants Bug& Tar Removers Photo chemicals Printing Inks& Dyes Pool Chlorine Pesticides, Insecticides, Herbicides Rodenticide, Fungicides Nitrate Fertilizer Jewelry Cleaner Leather Dyes PCB=s Electroplating Sludges Others (List) Applicant Signature: Date: / 10/c2 I-IEALTAPDDETER 10-99 M 1 C r i a - 1 -o s t1 ,:-.:... , NI 2 tL r7: 1 at I C`~' Z �� E j 1 F s C.: A 4 i '6 \."mac f