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Home My WebLink AboutBLD-22-004451 CO TOWN OF YARMOUTH Building Department CERTIFICATE OF (508) 398-2231 ext.1261 OCCUPANCY PERMIT NO BLD-22-004451 ADDRESS: 182 Baxter Ave South Yarmouth, MA ZONING DISTRICT Bldg. Type: Commercial SUBDIVISION MAP BLOCK 021.3 Use& Occupancy-Green Harbor Resort CERTIFICATE OF INSPE ION DATE: 1f/2//2'2— BUILDING OFFICIA-• I " Green Harbor Resort 182 Baxter Ave S. Yarmouth, MA 02664 PHONE 1IS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR ERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE APPROVED BY THE JRISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF JBLIC WORKS. CERTIFICATE OF OCCUPANCY BUILDING INSPECTIONS APPROVALS FIRE: /L(1-'' CAP►. IAJCk DATE:-: q-ZZ OTHER DATE: ELECTRICAL - BOARD OF HEALTH j p U.-,r(z;, DATE: �� 2'Z DATE: /aJ/ S� 1,�.� INSPECTOR: INSPECTORS PLUMBING/GAS FINAL BUILDING DATE: 67/z1/ 7 G DATE: INSPECTOR: INSPECTOR: `'� C COMMUNITY DEVELOPMENT: DATE NAME Town of Yarmouth Building Department 1146 Route 28, South Yarmouth,,MA 02664 tel. 508-398-2231 ext.1261 Use and Occupancy Permit Application In accordance with the provisions of the Massachusetts State Building Code, section 105.1 Application for a certificate of use and occupancy permit Name of Business RJ RESORTS GREEN HARBOR VILLAGE RESORT OWNER LLC DBA GREEN HARBOR RESOI-i I Property Address 182 BAXTER AVE WEST YARMOUTH 02673 Unit# Type of Business MOTEL *Square Footage to be occupied see attached *attach floor plan Fee: $60 The applicant is required to obtain approval sign-offs from the following departments as checked off below: RECEIVED X Health Department— 508-398-2231 ext. 1241 FEB 10 2022 tk X Fire Department— Fire Prevention, 96 Old Main Street, 508-398-2212 _ BUILDING DEPARTMENT Other BY: -- 1C C C/ Building owners Signature Applicant Signature Please note: this permit is for use 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. a C.� _ 22.-( / **Office use only** Zoning District R Proposed Use Change of Use: Yes Nc' Allowed Use: Yes)( No APD Waiver: Yes No)/N/A BLrl1ding fficials Signature Date ryia,rc,h — The Commonwealth of Massachusetts • Department of Industrial Accidents Di ywY= 1 Congress Street, Suite 100 Tapia: Boston, MA 02114-2017 = www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/ElectricianslPlumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): GREEN HARBOR RESORT Address: 182 BAXTER AVE City/State/Zip: WEST YARMOUTH,MA 02673 Phone#: r Are you an employer?Cheek the appropriate box: Type of project(required): 1.2i 1 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 S. Remodeling any capacity.[No workers'comp.insurance required.] 3.E I am a homeowner doing all work myself.[No workers'comp. insurance required.]t 9. ❑ Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 [] Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.0 Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.0 Other 152,§((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. 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: see attached certificate 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 certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: 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 YARMOUTH ' Ar HEALTH DEPARTMENT Ft 1 f 2022 i2 HEALTH DEPT. PERMIT APPLICATION SIGN OFF TRANSMITTAL ' - _ _"" To he completed by Applicant: �y n Building Site Location: 1$7, a c QC AJ e rV yao u 1 h 1\f\ o.-67 '3 Proposed Improvement: Na—.) O n/ e C V SC ` O ccu ft a!1 e_4.1 SO v�I fS ; Applicant: Nrr.v Tel.No.: 5 o$ 37 91/41 1 Address: C$a, .I�ax1 e.c kg e �✓ Iccejot IAA Date Filed: ./c J 9 l '"If you would like e-mailil notification of signoff please provide e-mail address: `o leu±t'e £ e¢& t -Arkooc i soe`•Go Owner Name:, Rtsoc�S lateen 11uloet V�\13�"Re acc LLC_ Owner Address: In, axl'er A+a W )ar r c' h Owner Tel.No.:SOS' 71 l 117, 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: //Q /PLEASE NOTE COMMENTS/CONDITIONS: jj p3 Pec S 7.,rr fi -E v t7 n t ek S "17L 51— .its pc 4- /y/r//4 �`'�� r,t�f, MGL. AND FIRE y 140//4 • # TOWN OF YARMOUTH REVIEWED FOR CODE COMPLIANCE. `, 4_ � ,;Ri;�+� ERRORS OR OMMISSIONS DO NOT RELIEVE THE APPLICANT FROM THE RESPONSIBILITY DEPI- OF "AS BUILT" COMPLIANCE. DATE: 2-9-2 a A -7-- gu C A- - ‘---1- INSPECTOR YARMOUTH FIRE PREVENTION New Business Transmittal Project Name: RJ Resorts Green Harbor Address: 182 Baxter Ave. Contact Name: Ryan O'Loughlin Phone: 508-237-9411 Y N NA Subject Regulation ES 0 X Building Numbers MGL Chapter 148; sec 59 X Fire Lanes 527 CMR 1; 22.3 X Extinguishers 527 CMR 1; 13.6, Chapter 148; sec 28 X Maintence of any equipment, system relating to 527CMR1 1 .1.4 Fire Protection. X *Hazardous Materials Storage 527 CMR 1; 60.1 X Emergency Plan Required 527CMR1 10.9.1 X Commercial cooking, Hood systems 527CMR1 50.2.1.1 X Commercial Cooking Hood Systems Cleaning 527CMR1 50.5.4 X *Commercial Cooking Extinguishment System 527CMR1 50.4.3 X *Candles, open flames, and portable cooking 527CMR1 17.3.2,20.1.1.1 X Blocking electrical panel 527CMR1 10.19.5.1 X Blocking exits 527CMR1 14.4.1 Extension cords shall not be used as a 527CMR1 11.1.7.6, 11.1 .7.1 X substitute to permanent wiring X Limit storage heights to 24 inches below 527CMR1 ceiling without sprinklers 18 inches with X Maintain Aisle width of 36 Inch's (3 Feet) 780CMR 1101.1 X Storage inside/outside Buildings 527 CMR 1 ; 10.19.4, 4.4.3.1.1,19.1.2,34.1.1 X The right to inspect MGL Chapter 148 Sec. 4 X *Upholstery 527 CMR 1 ; 20.6.2.5 X *Trash Containers 527 CMR 1 ; 19.1.1, 1.12 X Any Hazard to the Public Chapter 148; sec 28 X *Curtains, Draperies, Blinds 527 CMR 1 ; 12.6.2 Description of planned project/other requirements: Change of ownership of existing hotel. The YFD support the application, subject to applicable submissions, permits and inspections. A Permit from YFD is required any time a fire protection system is shut down. Fire Extinguishers inspected and tagged. Exit plans for rooms. * YFD permit required-depending on occupancy and submittal Plan Reviewed By: Captain Kevin Huck Date: 02-09-2022 Copy for Applicant II Copy to Building Department Copy to Fire Prevention Entered in Firehouse II Final Inspection ID Green Harbor Resort 182 Baxter Avenue FEB U 9 2022 West Yarmouth,MA 02673 508-771-1126 HEALTH DEPT. .r 4ti p� 0°#a A°O� MINI GOLF �t�� COURSE 0° eP (3C4 01 5a r:5 '52 5,. ' 1: A► Ili' CPI at vir 00 % if,. 45 4 ICE OFFICE O 3 140" SODA 4j ®� TO la HOUSE BAXTE y� 1155 BAXTER AVE. HARBOR HOUSE 18 HARBOR RD.I \ )- GREAT HARBOR HOUSE 24 HARBOR RD. G GARAGE GRAND HARBOR HOUSE 13 r" ..- 42 HARBOR RD. 4 • • • • • • ' J