HomeMy WebLinkAboutBLD-22-004449 CO TOWN OF YARMOUTH Building Department CERTIFICATE OF
(508) 398-2231 ext.1261 OCCUPANCY
PERMIT NO BLD-22-004449
ADDRESS: 39 Todd Road South Yarmouth, MA ZONING DISTRICT Bldg. Type: Commercial
SUBDIVISION MAP BLOCK 100.89
Use& Occupancy-Blue Rock Resort
CERTIFICATE OF INSPECTIO
DATE: 3/2 2/2 Z BUILDING OFFICIAL: _ a
Blue Rock Resort
39 Todd Road
S. Yarmouth, MA 02664 PHONE
-IIS 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: 4 , CATT . NU i--.
DATE: 5 L I-Z Z_ OTHER
DATE:
ELECTRICAL BOARD OF HEALTH
DATE: f1 '2J'1' DATE: 3 — l 7� a-,?- y � �3 , ;
`i<3 S
INSPECTOR: / g---" INSPECTOR: 0i / me,, L-//iT`
1 ,C3 errr--
PLUMBING/GAS FINAL BUILDING
DATE: 3A 7 2 - DATE: 76 ✓ 2
INSPECTOR: (, INSPECTOR: 7#.7 ,---/7/ ..5 -
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 Blue Rock Resort Owner LLC dba Blue Rock Resort
Property Address 39 Todd Rd. S. Yarmouth 02664 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
Fire Department — Fire Prevention, 96 Old Main Street, 508-398-2212
BUILDING DEPARTMENT
Other By. —
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. 13 C f
**Office use only**
Zoning District (R--4/6 _ Proposed Use Change of Use: Yes Not.
Allowed Use: Yes XNo APD Waiver: Yes No2(N/A
B di Officials Signature Date
4, "\ The Commonwealth of Massachusetts
t�, �t, Department of Industrial Accidents
:==
1 Congress Street, Suite IQO
j Boston, MA 02114--2017
www.mass.gov/dia
me
Workers' Compensation Insurance Affidavit; Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Blue Rock Resort
Address: 39 Todd Rd
CitylState/Zip: South YARMOUTH, MA 026664 phone :
Are you an employer?Check the appropriate box: Type of project(required):
l.g I am a employer with employees(full and/or part-time).* 7. 0 New construction
2.❑I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling
any capacity.(No workers'comp. insurance required.]
9. [ Demolition
3.0 I am a homeowner doing all work myself.(No workers'comp. insurance required.]t
10 0 Building addition
4..2I 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
5.0 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 1 Other
t52,§l(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 art 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 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$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
Ido hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: Date:
Phone#:
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License# •
Issuing Authority(circle one):
1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: phone#:
ot. Yak TOWN OF YARMOUTH
1. r. HEALTH DEPARTMENT
o •:; i'"' HEALTH DEPT.
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHE
To he completed by Applicant,
Building Site Location: I oC\ Vk J /ac+'4oe M A U IG(a
Proposed Improvement: N `N 0 . E s O c c ro l
l7` Ie r-ao,'
Applicant: e-R,tAan Q Lvv . n Tel. No.: 5O13 37 141
Address:lickt.Sc a s Vv4.1 oA �s�c l dvntc LL Date Filed: 9 1
**If you would like e-mail notification of sign off please provide e-mail address: t 0 1 o e 1 n of ecc\ 1�'b0`r f esoc\-•w
Owner Name: „ .J Ic ocT s vQ�ock �ts�c� Nw,n e c LI-C ,�
Owner Address: dal 1U 5 Yarrhoo hriirk Owner Tel. No.: SO$ 3946 (.1 ( ()—
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: off/ /�� 7 _
PLEASE NOTE
COMMENTS/CONDITIONS:
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• MGL AND FIRE
• 66- ` TOWN OF YARMOUTH
_ .-- REVIEWED FOR CODE COMPLIANCE.
r v / ERRORS OR OMMISSIONS DO NOT RELIEVE
; THE APPLICANT FROM THE RESPONSIBILITY
;:` OF"AS BUILT" COMPLIANCE.
f
DATE: 2 -4-2 Z
INSPECTOR
YARMOUTH FIRE PREVENTION
New Business Transmittal
Project Name: RJ Resorts Blue Rock Address: 39 Todd Rd.
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 = Copy to Building Department II Copy to Fire Prevention
Entered in Firehouse Ti Final Inspection