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pTt' •YA�q'i �MATT I tMun• �:/ f I t . ' Pe>mit # Agg IFceS�6fi-om r Permit ; IaSUe date. EXPRESS BUILDING PERMIT APPLICATION TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 Ext. �)1261 CONSTRUCTION ADDRESS: , ;? ASSESSOR'S INFORMATION: Map: Parcel: OWNER Wr'� /lyt�✓�•+nf� �j /l�r/ /yw+r J / �i- 3�`'i- 12�,� NAME PRESENTADDRESS TEL # CONTILkCTOR _�� o�,a•ri . /��� %,J• .� /✓.��1 /I (yi✓ fi �f �ff - Zzf� c , "NAME MAILINOADDRESS TEL # ❑ Residential B•COmmercial ❑ Est Cost of Construction $ ,?,, dO O Home Improvement Contractor Lie: # Construction Supervisor Lie. # 46 /02 e v Workman' Compensation Insurance: (check one) I am the homeowner ❑ I am the sole proprietor ❑ I have Worker's Compensation Insurance Insurance Company Name: G '���6i �N �vel� Worker's Comp. Policy# (�d �� �3 9 y� WORK TO BE PERFORMED ❑ Tent (Fire Retardant CertWcate attached) ❑ Wood Stove Shad ❑ Siding: # of Squazn // / ❑ Replacement windows: # GYAeplacement doors: # ❑ Re -roof # of Squares ❑ huuLuioa () Stripping old shiaglrs' () going over layers of existing roof ❑ Old Kings Highway/Historic District Q (� Ole, ,{� Roofing/Siding (Luce for Like)) Th' "e debris will be disposed of at: / Z /y ✓e �� — / ' 2 U�'j �/$/�i w Location of Facility I declare under penalties of peljurylthat the herein true and correct to the bat of my knowledge and belie£ I understand that any Use answgs) will be just cause for denial or ocatio li and f oa under M.O.L Ch. 268, Section 1. Applicant'sSignanue• Date: Z Owners Signature (or aura Date: Approved By: Date. R E CDE� V �D Zoning Distriet: — S V� FEB 0 4 2014 Historical District: ❑ Yes 4o Flood Plain Zone: ❑ Yes 1�No BUILDING RTMENT Water ltesourcePronDistricC Within l0 Rof ds: oy:_ ❑ Yes W No Yes No 3/01 The Commonwealth of Massachusetts Department of Industrial Accidents Of tee of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Af$davit: Builders/Contractors/Electricians/Plumbers Name Address:_ 3 .77 �fo r� . �`ww D4-� City/StatdEp: ,C>- L4ze&c/4 /11,4 02E45`0 Phone #: l�d- - Are you an employer? Check the appropriate box: / 1. ❑ I am a employer with ' 4. I am a general contractor and I employees (full and/or part-time)' • 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required:] 3. ❑ I am a homeowner doing all work myself [No workers' comp. insurance t 3a. ❑ I am a homeowner acting as a general connector (refer to #4) have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' mrnrance,t 5. Erwe are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comix insurance relnrredl Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions 11.0 Plumbing repairs or additions 12.0 Roof repairs 13.lz:Flither �)J OA.- ;Any applicant that ehedes box #1 must also fill out the section below showing their worms' eompensatioetolicy information t Homeowners who submit this affidavit indicating they are doing all wade and then hire outside conttaeton most submit a new affidavit indicating such. tCoanatran that chit this box must attached an additional shed showing the tune of the sub-caotraetoa and slue whether oc not those wide have employees. if the sub -contractors have employers, they must provide they wotk=' comp. policy number. Ian are employer that is providing workers' compensation insurance for my employees. Below Is the policy and fob site information: r Insurance Company v�L`i Cl�vYfi'N4. ✓� Policy # or Self -ins. Lie. #: 07'-,� 7d Z 3 9 Y, Expiration Date: /Z -7/ �/ Job Site Address: fEew ,% City/State2rp: 'r- //V Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to S 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. of pedury that the information provided above Is trust and correct. Pbone#li_ 6Ofi' fye-'LLd—d Official use only. Do not write in thh area, to be completed by city or town oBkial City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. Cityrl'own Clerk 4. Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone #: _ A Information and Instructions Massachusetts General Laws chapter 152 requires all employks to pcvride wmtm' WMPLno fo[ tbeic ea�layeet Pursuant to this statute, an asplew is defined as "_every person in the senrica of another undo any contract of hire, GAPILSf or implied, Oral or written." associating. corpoatiaa or other legal esdity, or any two a more An ssrplayar is defined a as iodiridiral„ partaaship, err the of the facegoicig engaged in a joi t atia der. and ir�g the legal � of a deceased emplom receivc at ttu:tet of n Eadfvidos% putmr * anociatba or other legal eafityl emplaying emPbyeeL How "M the owcic of a dwelling hoaas having not a - d m tbtet q tmeab sad who resides thesei•, ore the o=upant cf the dwelling boast of another who employs pawns to do mainteaaace, contMzdm at repair work oa such dweiting honer of on the gtvaade or building apptakw t tha to shall net because of such employment be deemed to be in employer" MGL chapter iS2. J25C(6) also states that "every► stab K begs Ueenda; sg:aey slag wiflLhow the hSanee sr renewal of a Ikeaere permit to operate a ballot or to construct buddtap to the asaoaswtalth for u7 sptinewd wise has net produced seeeptahle rvkkeee Of etnpllsum with the Imaraaa avtrap req.treV Addidooaltr. MGL chapter 152,125C('}7 states "Neither the commonwealth nor my of its political Subdivisions shall enter into say eon1 a fott the pafacrosao- of Public work nnW acceptable evidence of compliance with the laursact regrri:zmeab of this chapter have been presented to the contracting autImitp•" Applicants , Pleset ®1 oat the worba , compeneation lnsdavit completely, by checking the boxes that apply to your sitastloa cud. if nommy, soppty nab-=�*) oame(a), addtaa(es) acid phone number(s) along with thew catilkIte(sotherkheathe imla�aact I.inded Liabitlry Companies (LLQ a I imited LWnIlty Parmaahipe (L.LP) with on emploYurs member or pactoas, an not required to easy woriaera' eoagemstioa ft=Z L If as LLC or W does have emPbyem a policy is required. Be advised that this affidsvit may be subo iftd to the Department of Ding Aeeidastf fbe coo&=sd= of faaascict eavc tgt Alec be gar t to sip nerd date the affidavit The af5dava should be retteaed to the city at town that the appiiewoa for the permit ac lice . Is being tegoeated. not the Department of finial Accidents. Shona yea hart any questions rrgardicig the law ar if you art requited to obt io a wacbW compenudoa policy, plesse call the Department at the tsamber listed below. Self-ineo ed compaciia should eater their self-iaaotsee license somber an the sypeooaialt Tree. City or Ttwa OtlfdaY Plesse be sure dat the affidavit is complete and Printed legibly. The Department has provided i space at the bottocis of the affidavit foe yea to Wool in the event the Offkt of Iavestifadcus has to contact you regarding dw aPPHCUL Plesse be surf to f M is the pe mWUccnn number which wig be used as a mferean amber. In addition, m:Qptieas>1 that moat submit Multiple past apptieadoa in nay given year, need only submit am affidavit indicating COU policy Wzmation (ffnecessary) and under "Job Site triune" the applicant should write "all locatfnos is (city or town" A copy of the affidavit that has been officially stamped at ma1<sd by the city Or town May be Provided 10 the applicant te proof that i valid affidavit fs oa file foc itttaat petumsita err lieemei A naw affidavit neat be filled oat ach year. What a bona owner at citizen is obtaining a lfcease a permit not related to any btuinies or commercial venture (Le. a dog Hennas or parent to bum leaves etm) said perwa is NOT tecloired to complefit this aflld"it. The Office of lnvtstiptioaa would luikito thank you is advance fa your cooperation aid dM" YOU have any gciestior>a. pleats do not hesitate to give us a call. the Degrtment's address, telephone and tie atm�ba: Tile Commonwealth of MtsawIamtts Department of Industrial Accidents Office of kludptiorta 600 Washington Street Boston, MA 02111 Tel. li 617-727r4900 ext 406 or 1-977-MASSAFE Fax 11617-727-7749 Revised l l-22 il6 www.mass.gov/did t�� Massachusetts - Department of Puhlic Safe!;/ d� Board ct Building Regulations and Standards Construction Supemisor License: CS-012060 DEWITT P DAVEN>01RT' - --' '- 20 N. Main Street, South Yarmouth MA 026" 11124l2015 commissioner C� t/?.P �fl J?2�97�0�92GG�:CZ�Gl2 t���Q�;GJ?�L(/,1�✓�� Office of Consumer Affairs and Business Regulation 10 Part: Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration = Repistration: 106024 VP Trust Expiration: 7/21/2014 Tray 226654 DAVENPORT BUILDING COMPANY`TR.UST:;:' Dewitt Davenport `_-,•_ :.: r.;: 2D North Main Street South Yarmouth, MA 02664 "Up dateAddress and return card. Mark reason for change. Address Renewal DEmployment Lost Card scA I Cs 20ne-o5111 mO"ffilrs ' Business 'lation 0"d License or registration valid for Individul use only Office of ConsumerAffalrs&BusinessRe�ulation e Y SOME IMPROVEMENT CONTPACTOR before the expiration date. If found return to: registration: ,aD6p24 Type: OfficeofConsumer Affairs and Business Regulation piration: ,-7/z]12D14._ Trust 10 Park Plaza -Suite 5170 -_ Boston, MA 02116 q; <_„ DAVENPORT BUILDINCZ'DMPANY_; (RUST Dewitt Davenport F,e_ 20 North Main Street South Yarmouth, MA 02684 = Undersecretary Not Val; wi out signature ~, Y CERTIFICATE OF LIABILITY INSURANCE �/17/2013 ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIgN 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 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). PRODUCER Eastern Insurance Group LLC 77 Accord Park Drive CONTACT Anita NAMEChesson : PHONE (7B1)596-B913 Arc o:(508)647-3261 noDRcSS:achesson@easterninsurance.com Unit BI CUSTOMERIO PRODUCER 00029279 INSURERS AFFORDING COVERAGE NAIC0 Norwell MA 02061 INSURED INSURER AAssociated Industries Ins CO INSURER B : Davenport Building Co. INSURERC: 20 No Main Street INSURERD: INSURER E : South Yarmouth 1✓M 02664 INSURERF: COVERAGES CERTIFICATE NUMBERAavenport Bldg Co 13-14 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 CONTRACT OR 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. INSR LTR TYPE OF INSURANCE ADDLISUBRi fNSR WVQ POLICY NUMBER POLICY EFF MM/DDrYY1'Y) POLICY EXP (MM/DDryym LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a$ OCCUR kES1026631 /1/2013 /1/2014 EACH OCCURRENCE S 1,000,000 DAMAGE TU PR-MIScS fcaRENTED S 100,000 MED EXP (Any one person) S Excluded PERSONAL 6 ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE 7 POLICY LIMIT APPLIES PER PRO LOC PRODUCTS-COMPIOP AGG 5 2,000,000 S AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Es accident) f BODILY INJURY (Par peracn) S BODILY INJURY (Par accitleN) i PROPERTY DAMAGE (Peraccldent) S 6 S UMBRELLA LIAR EXCESS LIAS OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE S DEDUCTIBLE RETENTION S S S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yyea describe under DESCRIPTION OF OPERATIONS below NIA VJC STATU- OTH- E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEd S E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedula, If more apace Is required) I1=0GP14J3i4 Evidence of Insurance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Ronald Cleaves/ACI / �� �- ACORD 25 (2009/09) 019BB-2009 ACORD CORPORATION. All rights reserved ^ e OP ID: KD K� Kam' CERTIFICATE OF LIABILITY INSURANCE O04/01/2013Y) 04101/2013 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 INSUREP.(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must 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). PRODUCER Phone: 610-279.8550 The Addis Group, Inc. Fax: 610.279-8543 2500 Renaissance Blvd. Ste 100 King of Prussia, PA 19406.2772 Jeffrey A. Grebe CONTACT PHONE FAX - A/C No EMAIL AooR=_Ss, PRODUCERCUSTOMZR Do, DAVEN-1 INSUReRfSI AFFORDING COVERAGE NAIL a WSURED Davenport Building Co. CIO Davenport Realty Trust Stephen Aschettino 20 North Main St. South Yarmouth„ MA 02664 INSURER A: American Zurich Insurance Co. 140142 INSURERB:Zurich American Insurance Co. 16535 INSURER C: INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER- REVISION allIaacrc. 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 CONTRACT OR 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. LT R TYPE OF INSURANCE U POLICY NUMBER POLICY EFF MMIOD/1'1'YY PDLICY EXP MMlDO LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CWMS-MADE FRDOCCUR EACH OCCURRENCE 1 S DAMAGETURaNizu PREMISES a occurrence)f MED EXP (Any oneperson)S PERSONAL It ADV INJURY S GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC PRODUCTS-COMP/OP AGG S S B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS ' SCHEDULED AUTOS HIREDAUTOS NON-OWNEDAUTOS 250 Comp BAP8196256 - 03/01/2013 03I01/2014 COMBINED SINGLE LIMIT (Ea accident) S 1.000,000 X BODILY INJURY (Par person) f BODILY INJURY (Per accident) S X PROPERTY DAMAGE (Per awtlent) S X f X f UMBRELLA LIAR EXCESSUL OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE S DEDUCTIBLE RETENTION S f S A WORKERS COMPENSATION AND EMPLOYERS' LIABILTY ANY PROPRIETOR/PARTNER/EXECUTNE YIN OFFICEWMEMBER EXCLUDED? (Mandatory In NH) If Yes, describe under DESCRIPTION OF OPERATIONS below N / A CBISS035 03/0112013 03/01/2014 X WC STATU- OTH• E.L. EACH ACCIDENT s 1,000,000 E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEAS E- POLICY LIMIT I S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addldonal Remarks Schedule, If more spare Is required) TOWNOFY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Yarmouth THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1146 Route 28 South Yarmouth, MA 02664 AUTHORIZED REPRESENTATIVE TZ7�� IFJ 198E-2UU9 AGGRO CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD (fomnwnwsaldt of ///aeaacLatie Official Use Only } cc�Parinwni oE.tcc7/irr Services Permit No. L� 3 - ( Z8 q 1Jr Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/071 ,cave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 3 City or Town of: YJAPZMOdT q To the Mspebor of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 3,;1 e� p SOuTt+ SAOMIF, b(LI ✓ Q, Owner or Tenant 1 11 / R as rm-G I-( IR fi So fL ( Telephone No. Owner's Address permit to conjunction with a building permit? Yes ❑ No (Check Appropriate Box) in lurl ise of Building CD/YI m F;mi c 4-C— Utility Authorization No. LU N �is ng Service Amps I Volts Overhead ❑ Undgrd ❑ No. of Meters v ervice Amps ! Volts Overhead ❑ Undgrd ❑ No. of Meters W N ''a ter of Feeders and Ampacity i� �� c ion and Nature of Proposed Electrical Work: FL asrs1*6 At TS U 8 S� 691 to 2 Fi V oO — t.s a /.ciF� 1A) e— r reL3,4SqIXvl I ' Completion of the followingtable may be waived by the Inspector of Wires. f Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans o. Of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool ove ❑ - ❑ o. o ergency Lighting rnd, rnd. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o etection an Initiatin Devices No. of Ranges No. of Air Cond, Tons No. of Alerting Devices No. of Waste Disposers leaf Pump um er ons o. oSelf-Contained Totals: �` Detection/Alerting 'Devices ANo. of Dishwashers Space/Area Ileating KW Local ❑ MunicipalEl Other Connection No. of Dryers Heating Appliances KW Security Systems: - No. of Devices or Equivalent o. of Water KW o. o o. o Data Wiring: Si Ballasts No. of Devices Or-Rcluivalent - - l4o. Hydromassage Bathtubs No. of Motors Total lip c ecommunications Wirmp,. No. of Devices or Equivalent OTHER: Attach additional detail if desirer4 or as required by the ligpector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such cove a is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [BOND ❑ MITER ❑ (Specify:) I certify, under the aims and penalties of perjury, that the information on this application is true and co/nplete. M FIRM NAE: b F1 fL- yGTPL t G LTC. NO.: /// y Licensee: 4,AWe,3- (P "/7NliaN a K Signature LIC. NO.: i� (If applicable, enter "exempt" In the license number line.) Tel. No.-, 0 Address: /i5G A- M(n Tfic 14 bB 1u a u ac yAlL n10 T!-i Alt. Tel. No.: 'Per IvLG1. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement.Q am the check one [ owner k owners a e t.OwRcr/Agenh Signature Telephone No. PF•RilffT FEEc $ U C 4n_ MTT nLc�a A s5� 4y��,• � 2 "J,ay n EXPRESS BUILDING PERAUT APPLI TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 Ext. 1261 /3 * 6 FPermit Sce Permit expires 6 issue date. 2QIGDE 12 1 PT CONSTRUCTION ADDRESS: 3Z7 50t3 . 6�b �bk►ye- A'll. MAC ASSESSOR'S INFORMATION: OWNER CONTRACTOR:1),gW,lr Nuo- pgg - Zo 1,6& WHa n2aff- S`/,tl�it�3fti ;:!a 3 B -Z2/ NAME ' MAILING ADDRESS TEL # ❑ Residential Commercial $ EsL Cost of Construction S esco Home Improvement Contractor Lia #_ I40(06t-/ Construction Supervisor Lia #_ Workman's Compensation Insurance: (check one) ❑ I am the homeowner -- ❑ I am the sole proprietor X I have Worker's Compensation Insurance Insurance Company NamH+e: m efrfj Z u2r. g T4,5 RA.Kr Io Worker's Comp. Policy# LC— $iaLo Zt% WORK TO BE PERFORATED ❑ Tent (Fire Retardant Certificate attached) ❑ Wood Stove Shed I!�Siding: # of Squarza 3 ❑ Replacement windows: # G Replacement doors: # ❑ Re -roof # of Squares ❑ Insulation () Stripping old shingles* () going over layers of existing roof ❑ Old Kings Highway/Ifistoric District Roofing/Siding (L1Ye for Lace) "The debris will be disposed of at: \1"4-11�6014 TWA �b[ $ p 5 s.,\ 43 I declare under penalties of perjury that the statements contained are true and correct to the best of my knowledge and belief.I undestand that any false answer(s) will be just cause for deaial or revoc on of mY li/crence for prosxution under KG.L Ch. 268, Section 1. Applicant's Signature �/ Date \\ 1 Zi (IZ Owners Signature (or a h t) Date: I\ Z7 / I Z Approved By: Date: Zoning District 1-4, R Historical District: ❑ Yes ' \ No Flood Plain Zone: *es ❑ No Water Resource Prot on District: Within 1,00 R of Werlands: ElYes Laxo 0)❑ • No 3/01 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organizationandividuai): • UMM LOVEWPi �:.. Phone M J�DIt Are you an employer? Check the appropriate box: I. MI am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required:] 3. 111 am a homeowner doing all work - - myself, (No workers' comp. insurance re t 3a. ❑ I am a homeowner acting as a general contractor (refer to #4) listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance t 5. ❑ We are a corporation and its zz9 3 Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions ----officers have exercised their --11:❑ Plumbingrepairs or additions right of exemption per MGL -. _ __ - - -- - c.152, § 1(4), and we have no 12.❑ Roof repairs employees. [No workers' 13•❑ Other comp. insurance required-1 ;Any applicant that checks box #1 must also till out the section below showing their workes' wmpmudodi�oucy information. iHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Coattactors that check this box must attached an additional sheet showing the name of the sub -contractors and stare whether or not those entities have employees. If the sub -contractors have employees. they must provide their wodcm' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and Job site informadom Insurance Company Policy # or Self -ins. Lic. #: o2,41 Expiration Date: Job Site Address: 327 -:" t179%4- _�), City/State0p:.:50 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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 S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby eer J& under thegairts and penalties of pedury that the information provided above is true and correct .e4. O icial use only. Do not write in this area, to be completed by city or town official 0/Z711Z City or Town: Permit/License # Issuing Authority (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone #-. Information and Instructions . Massachusetts General Laws chapter 152 requires all employeha to provide wockaa' c:ompenuticn foe their emPWYM& Pursuant to Ibis statuae, an emplgee is defned as "...every person in the service of another under any contract of hire, express at implied, oral or written" An eacpiyw is defined ss "era individual, partnership, association, corpontioa a other legal entity, or any two a more of the fa pin copgedis a jaiat eataerpcise, and iachidiag the lq* rep =Mtltiva of a deceased empbM or the receiver or trustee of n individual, partnership, aaaociatiod or otbw legal entity, employing cmQbyea. Flaweva the owner of a dwelling home having not more than three aft and who reskw therein, or the occupant of the dwelling bouse of another who employs persona to do maintenance, conswJctiod or repair work on such dwelling house or an the grounds or building appurtenant therein shall not because of such employment be deemed to be an employer:" MGL chapter 1529 §25g6) also stater that "every stab or I" Uexadag agesicy shag withhold the issue= err renewal of a amn w permit to operate a btulsiess or to coastraet butldtags to the esraraoatscealth for nay applicant whe here sot prodoe" aaoptabH erldeses of complisna with the ltwaaa c6TMp nRdrw Additionally, MGL chapter 152, ¢25g7) states "Neither the commonwealth our any of its political subdivisions shall enter inns nay contract foss the paftmaace of public worst until acceptable evidence of compWace with the inataanco requirements of this chapter have bees presented to the contracting au dwcity." Applleaate Please fM out the washes' compeaaadod affidavit completely, by checking the boxes that apply to your situadw sad, if t>ecomyo.mpply h(s) minds), addtess(es)-and phow mrmber(s)-along with tbeir cestitieate(s) of--- - _ -- inn,.�,r" I,i� Liability Companies (LL-C) oc F hx m Liability Pannenhips (`.`•` )with no emPbyea Other than the memI ers or partners, are not nquhsd to carry wodkera' compensatiad lnsiaance. if an LLC cc LLP does have cmployeet, a policy is required. Be advised that this al$darit may be submitted to the Department of Inch atrid Aeddenb for confirmation of insurance coverage. Aire be sots to sip and date the allldaviL The affidavit should be redacted to the city or tows that the %*cadoa far the pamit cc license is being requested, net the Depaslment of Industrial Accxk3ft Should you have nay grestiooe regarding the law at if you are required to obtain a wociors' compensation policy, plesse call the Department at the munber listed below. Sdf-insuoed exiair es should enter their self-insa:anee licanae mambas on the spQcapriate line. City or Taws O(Ildsie Plesse be sun that the affidavit is complete sad printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out is the event the Of a of lnvestigadoaa has to contact you regarding the applicant Please be ruse to fill is the persmNHeense number which will be used as a reference ®ber. In addition, an applicant that taut submit multiple permittliceme applications in nay given year, need only submit ono affidavit indicating current polity inibrundon (if necessary) and under "lob Site Address" the applicant should write "all locatbaa in (city or town)." A copy of the affidavit that has been officially stamped err marled by the city at town may be provided to the applicant it proof that a valid affidavit is on file tar fate a permits or licenses. A new affidavit taut be filled out each yrsr. Where a home owner or citizen is obtaining a license at paffit not related to nay business or commercial venture (La. a don liceaae or permit to burn lea seer cr.) said pawn is NOT required to compIcts this atllldavit The Onus of Investigations would Bice to thank you in advsnca for your cooperation and should you have any gnesdom, please do we hesitate to give us a call The Department's addresstelephone and fax number: 'lire Commonwealth of Massachusetts Dcpar=mt of Industrial Accidents oala of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext406 or 1-877-NIASSAFE Fax tf 617-727-7749 Revised 11-22.06 wwv,mass,gov/cilia OP ID: KD CERTIFICATE OF LIABILITY INSURANCE DAT05/15112 osnsnz 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 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 endorsements . PRODUCER 610-279.8550 The Addis Group, Inc. 610-279-8543 2500 Renaissance Blvd. Ste 100 King of Prussia, PA 19406.2772 Jeffrey A Grebe CONTACT , PHONE AX A/C N A/C No MAIL PRODUCER CUSTOMER to 11. DAVEN-1 INSURERS AFFORDING COVERAGE NAIC e INSURED Davenport Building Co. INSURERA:American Zurich Insurance Co. 40142 c/o Davenport Realty Trust INSURER B:Zurich American Insurance Co. 16535 Stephen Aschettino 20 North Main St. INSURER C: South Yarmouth„ MA 02664 INSURER D: INSURER E: INSURER F: ' COVERAGES CFRTIFICATF NIIMRFR- RFVI.CIrTN NI IMRFR• 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I LTRR TYPE OF INSURANCE POLICY NUMBER MM/DD MM'DD LIMITS GENERALLIABILITY COMMERCIAL GENERAL LIABILITY CLAUMS-MADE O OCCUR EACH OCCURRENCE s TO RENTED DAMAGEPREMISES (Ea o--urrence) f MED EXP one person f PERSONAL S ADV INJURY s GENERAL AGGREGATE s GEWL AGGREGATE LIMIT APPLIES PER POLICYFR0. LOC PRODUCTS - COMP/OP AGO S S B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED ALTOS NON -OWNED AUTOS 250 Comp SAP8196256 03/01/12 03/01/13 (CO,BIINdEDSINGLE LIMB It 1,000,000 BODILY INJURY (Per pareal) s X BODILY INJURY (Per accident) S PROPERTY DAMAGE (Par attldard) f X X s X s UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE S DEDUCTIBLE RETENTION f S f A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICBEANY RROPRI TORIEXCL.NEREUDEDUTNE Y (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA C8196024 03101/12 03/01113 X I WC SIN CRYTATU- OTH- E.L.EACH ACCIDENT s 1,000,000 EL DISEASE. rA EMPLOYE f 1,000,00 E.L.DISEASE-POLICYLIMIT f 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) ' a, BUILDID Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD � C/ Q� �C��LiiGf2ZG�P�/S Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Repistration: 106024 Type: Trust Expiration: 7121/2014 Tr# 226884 DAVENPORT BUILDING COMPANY'TRUST:-,,.:_.. Dewitt Davenport 20 North Main Street South Yarmouth, MA 02664 1'.:; :.'Update Address and return card. Mark reason for change. -- Address Renewal Employment ❑ Lost Card SCA 1 G 20M-05111 C924 1pomm a'uvwla o`VYN.aQdar�udeiQ Office of Consumer Affairs & Business Regulation _ nMEIMPROVEMENTCONTRACTOR gistration: ,,166024 Type: piration: �„712_j%2614_ Trust DAVENPORT BUIL0160-COMPAN,Y;7RUST Dewitt Davenport 20 North Main Street South Yarmouth, MA 0Undersecretary % License or registration valid for Individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation to Park Plaza - Suite 5170 Boston, MA 02116 Not vali wi out signature \lassachusctts - Dcparuncnt of Public Safct� liml Board of Buildim_ Rc,ulations and Standard.% Construction Supervisor License License: CS 12060 DEWITT P DAVENPORT 20 N MAIN ST S YARMOUTH, MA 02664 eZ7L —di Expiration: 11124/2013 ( mwni,4wrr Tr#: 7314 m e FILE COPY 4 �- Y . . I This. form must be returned-, with application. Town of Yarmouth 2008 Motel Census Directions: Please complete the forth below noting the number of guest units and bedrooms associated with #was guest units in each of the categories noted. Each unit should be counted in ONLY one (1) cateony. This Information will be user" Health In their consideration of your applicallm for a Moth Into License and for tracking purposes. This matioti coley r : ; by the Building Commissioner where non4rarslant rentals are Identified. The rebvant deflnitios are provided bolo pe l-'k. complete the form using Information that best describes your general business practices. . NOV 2 0 2007 ramol"Ill Unit StsndaM bins TWW of Pental s Unfte 0 Bedrooms s Units i Bedrooms i Units s Bedrooms Sh ort4ean (Trarafen9 119 119 6 6 Log -Earth (Public - NOT OWN EMPLOYEES Owner's Employees - Permanent Owners Employees - al Total I hereby aclanowAedge that the FleaBh time of wbmftta Slgnaturer. will be``basedd an the Mff=Wn provided by the owns at tee V�� Date: P ;A NOTES: Type of Motel Unft: Standard motel units provide o=qads with a place to sleep and batim Kitchen fadYtles other than a microwave are not provided. Eflidency Units provide occupants with a piece to sleep and baths. as wall as MWW bdld@L Kitchen facUes may be alther a cooktop Ora Pot stove. F18dsrwy unb are generay contained wiWn sir iam cmww y mcoWdwd as mode. La cwnprlsed of a or more conenguoue units. Efficiency un is may contain one or mars bedromm CAGag*& Cabins are detached stnxdurss that provide occupents with a piece to sleep and bathe as wall as kitten facilities. Cabln WcoCagea may contain one or more bedrooms: Type of Rental: Start-Eemr (rrarsfeng rentals are chose mob considered temporary and shomenn as defined by the Yarrouth Zoning Bylaw (see below). Lorg4arm Public vandals are thaw rentals meta to the general pulft for periods of the that cumulatively, or in and of 8ernsehm, are outside of the definition of transient Parmanent Employee rentals are those rental& made for the purpose of providing housing to the owners employees on a brg4arn basis. Seasonal Employee rentals are thaw rentals made for the purpose of providing housing to the owners employees for the summer season UuneSepternberl. . Definitions: Guest Unit A room or sub of morns In i hotel, motel, motor kin or guesthouse, suitable for separate rental Transient: For the purposes of the IMltatlors of motel or hotel.use, Transient ocapsncy stall be fsnited to the tewoxwy and start tern occuparny. Ordinarily and w$Wffm y associated vM motel and hotel uw. Transient ocwpants must haw. and be ebb to demostrate that VW maintain, a principal place of residence elsewhere. Transient occupancy shall generally refer to continuous occupancy of not more than thirty (30) days, and an aggregate of no( more than ninety (90) days wilt any six (6) month period. Use of a guest unit as a residence, or dwelling unik shop not be considered transient For Office Use Only: Zoning Determination Needed No Yes License issued No Yes License cola PiU<V_iC4_ ►•.2u�'�- 4301 TO:,^I OF Y: ?I OJTII P,W- /P-0 1_z-60 PIA,,` i� i►�1� BOA:2D OF AP LALS Uc� lg3� D_ CISIOAi This is an Appeal frora decision of Selectmen � refusing T:errait to: a. /-&K or The Petitioner requested pewit tof e e' .. 4 0 . • ... Jets °t %ss .t�,,,,� PS•° s - ;ufi which was refused because..................................0.............. "else . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . contrary to tho zoning by-laws, in that. ?:�►:•. Y;. s"'�''�� I Y<yAtt✓ cp grat H.l.) •so �1ss�. Pr s .. .. ...............'� . is ta'�r ...... ....... L.embers of Board of Appeals pre.<ent: 'Present Absent °° �,b3 s a /� C t1� ��,y 5111y Iq6rr,'5 /�,,r�d CZ �t.5ftiwf �I`1�tik1.� It tiopearing that notice of said -hearing has been given by sendi:i, notice thereof to the Petitioner and all those owners of property d-c;i.-. by the Board to be affected thereby, and that iublic notice of such hearing having beea given by publication in'the Cape Cod Standerd T..ues on ..................................... the hearing was opened Lind held on the date first above written. f The following app-ared in favor of the Petition: � r.��rvr�. iTkh.r�Rl.hd°►� a �}r. re�rasRw�ed l G/4h de,� The foll6wing ?-iieared in ol_iosition to the Patition: A:>;)ea7. ti. I 17sf.G :- page -: - for Decision: ,22eason /1 Opp. // ap,-ra aa 1 by-- 1 it h i/Mq t..embeersof Board Votin3. Therefore, the r etition for a-),)roval is 6'ran-M d,ea:lw� n � d MA-Qd , ancwe authorize a variance to...*..,* .... 000 ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........................................................... on the following conditions, viz: ........................................................... ........................................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........................................................... No permit issued until. 15 days froU date of docision. le rk eae a l9 ►'.GdRY.G , .n14 1�4. L J �. C_7 _i h� O j� , /�.e /// I' / .' o M �+Y.t % f ��Js N.P ¢ ►j( ram! SC h ,! �i 4'k re ,.� ��'j'hy i h�. ��a,d •�Y •1"� .ipp tCu3., of fh-c Sq�- .�i vi S% 07L . f 2a " T;.>i i3z `"t�''` �.�or� �` ✓ �N� TOWN OF YARMOUTH Ia� /f� /qs BOARD OF APPEALS G� /11 1�+. DECISION 4 This is an appeal from decision of Selectmen refusing permit to: or Petition for approval of: The Petitioner requested permit to.4:&.. Ar J. .............' ' :� ,C.. • ,✓��" �/1 A' toe ..:>..r'�.... �yv ch was refused because f � ? � �L •` ~ . `C:a::....... �t�%'.I /fir r� .F . f....... ......::{ :::.................................... .. i....MI.I..%. •+ •...............• ./ contrary to the zoning bylaws, in that.................................................................................0...................... .......................................................................................................................................................... .. Members of Board of Appeals present: y' Present Absent X/ r�L a It appearing that notice of said hearing has been given by sending notice thereof to the Petitioner and all those owners of property deemed by the Board to be affected thereby, and that public notice of such hearing having been given by publication in the Cape Cod Standard Times on ........c .%.1.-2:14:a ::.L.... l.Q .... i ................................................................ the hearing was opened and held on the date fast above written. The following appeared in favor of the Petition: . Appeal: r r,- The following appeared in opposition to the Petition: Appeal /: Reason for Decision: Q�( /.I""'">`4�'v`►�~"�—"-/"--" ♦'�L A / ,` /% —•G—►7 .a/1.e+� .-oT/71ye/.r✓� /tFY lxv-"ir/.°1^`I^i�,/.L�G,+ �WJ Members of Board Votin ; Therefore, the Petition for Approval is i J , granted, and we authorize �avariance to ........ ........-`-�'!7.�--r:fh?f.tj -�-air.�.�r,�......���1q�,,�..��.�r..-:l�-r.4.��:�'�r.,��:►%e...rw... l...��'�'.,I. !-�!�►`.ri L� t.,^! � ..�? t�-.. }.. �n..rt�crc�-r.. on the following conditions, viz: '♦ .�......... 4�`f " .....P...... ......'... d : "y.ttt. ...?....• ..r:a-t� r!ka.. Y'................ �....... No permit issued until 15 days from date of decision. i G, ....�..... ....................... Clerk Y c:.LS May 5, 1960 5a1) 0.1 1 J , .. . , l . . l Steve and Mae in�ar a petition for approval of: (/] 50 5 �� •_J XXXXX i( XXXXAXXXXXXXXXXXXXXXXXXX J l X xxxxjx%SXxxxXXxxxx / xxx� 1 xxxxxxxxxxi kxxxxxXXXXXX a.l.iow,,construction. of a. forty,;(40), unit.,.. motel on..Lots, 1.39.thr.ough,.140, on,Land Court..p•lan, no,.14114D.,,;located,,, on. South. side- of ,South, ShoSe,Dr.ive.,,,Hass ,River,, .Nantucket Sound., which Boa requires. the .approval : of, _the, .. , XXXor;Cx�RRAR�XXRR�RKXx �RXRKRx ix.ARR.1 of the zoning by laws. . t•: �.: J�.Vi 1J��'.'i �.! ...��. LL. _.. .. J.:L.: ,l ..)f _.. i)..Li L•i 'i3 `. �. �!•'J :.la _.: .. u .:_ •l.l.0 1_ .�._.� t'. .� :�...� Z :j :1.,:.,._.: .. •✓_. i.l _.. ..: •Ji:� .. )n4 15.-, ar}d 4 _22-60 _ . Elliott K. Slade, Jr., Main St., W. Dennis, Attorney for Petitioner Steve and Mae Wishar n 1' �a were not opposed but requested that the Board place ih: °o11GAng x u Jxxicx'zx'.-cxxzxx.ik'ocxxxx�4xxk2cyc txxxx �� G,•!� on the motel requiring them to make R;2xx2x adequate provisions for sanitation.,xx`xxjyxxx/ ;:�� �• rr icxxxxMx _ Ig,i. wr/lrI; x,xxxxxxx f.I;i. jir•7 Rea *n for U,:;-43iG.1i a restrictio The Petitioners presented plans which were examined by the members of the Board. The -Board found the plans in keeping with good architectural desi9.. and felt that the building when erected would be an asset to the area. Th area involved is one which has several motel facilities and the Board felt that the plans submitted are in keeping with the surrounding property. However, the Board does feel there was sufficient evidence presented at the hearing to indicate that there may be a serious problem concerning sanita- tion and therefore the Board approves the plan submitted by the Petitioners contingent upon their securing the necessary approval of their sanitation systems by both the Commonwealth of Massachusetts and the local Board of Health. There shall be no building commenced until both the State and Town officials have approved a sanitation system and in that event the permit may be issued based upon the prior approval of the proper state and local authorities. in favor <:��' -•e� TJ ci „J.a, rlt� for iscontingent upon the approval of SG X3eX xXXXXx the sanitation system by the State and Town. xxxx-x-xxxxxJcxx,xxxXXXiCiCXXXXi{ *aa,,,,a,.I,".aaIIQJa.lvaa.0 a0.•J.)*a,,*,I,OU42r a0V ).JOo.rCaa l..0.lr0 0.00:)0 a 0r a Co•J0)•)a.2.40J)0a,..0000.00J0 Jo0OVaJ000J 0 a a O 3003)0)4GOC JP CVO Maio ) a •J V i 0 C V a. 0 :: ! D a a a) 1 0 )) ) J o a a a) .. 0 a) ! O a e a 0. 0 0 0 a 0 o v 0 0 0 J.• o.! 0 .. u J r a. r ..•a ) 0! o a a 0. J v! .. . xxxxxxgx cxxi xxx:xxi*xkxxx;<x;kxxx r J. a l •) !. a: a l o J J) 7 J) n> a J )) 0 0 0) J) 0 1 C) C J J •) 0 J] O! J .! a J J J ,) J u J V 7 C• J 0 O o J J =,,) O !) a i! i. O J! J J J o V .) a a. 4 7 ,sic 24a. ) J 'J ') J i]) J J) Q O .) ) a) III) C Q O J 0 0 •) ) Q) J O J) ):, a O J J! 2.7 'J J O a J 0110 ) C a a 0 ) J! 1 0 0 0 so ") 0 � a J O J .) a s a) V J a a 10 O 0 C J)) J)) O G V J 10 O J 0) a 04 00 J J 00 a J 0 O 0 1 0 0 7.1 0 1 a o J) C 14 •: n n. J n v J) C 0 1 1 J r a V. 0 0 a, 0) .) 0 07 0) a 0 10 !) 0 ,a V a J a a+ J) Q .a J! a 0 J a) J J) a 0 J+ J o J a J a J a) O J 0 i a 1•2 a a c, Q J) Q t a) 01 0 0211 J+ a J J a 0 J •) J J J]) a 14 J a 0: a a J :a 0 110 �. .�S.L :., .�.._ r. .d�a.u. `. .. •J :J %a C..1 -'. of O.•) J!lJac Jaa I a ;'�.)a,J•JooaJ (:1' 1'A1u;(iJ`1'11 =111D OF API'E S May 5, 1960 5-01 DcCI.1IUI1 Route 28 Realty Trust a petition for approval of ;'iris is xaxsl6'xxIc.tr axicxalx'=x9Xk: xx�= x " kZA M g x;xxMi: k A= x x=x 1xtaickxxi=xRulaxucxuixxkx ao? r l I'f:t-a. , *,sted permit We a I.Lv'd. MC. CPRS hotelan.Chq, tpwi}. qf.Ya.T'.F1QUShAS�.���4I'�..�PSA..��:�.-.1,5Q...�°.�Ilq.lG.ts►.1Sr�..��rPd39h<,�S�..P,lan 1.I{1.11 D South Shore Drive which requires ebt„clq tx*:t=zkxx:&xkzxxt xxxoxxg)d xixxx- of Appeals under the zoning by law. 0"'b-a-a of Board of tippoala present: Present: xtbL tve66e/� Abs!x:t: `tewv T /Yydrx Albr.e-t luebL c�d�P,r1f�� N�rre�rld NQy�s Nccti'�Gn�� spt�.�n ;a+•ir i t,11at notice oi' nnid Hearin;; I>Ls been given by scndini:crtl.!:) t:i:c�:»C t 1 c:.iticner and all those a;zicr3 of propold:y dcerzd by tho ilcard W ba n'fecl%ti '.t:ct 1r3fJ.ic notice of such hearing having boon, givan by publ!co--lon i.a the Gan- Co Tl.Tleu Uno TDe ..1'W.> .:70.6.0...' the h aring := Or(;IIVAI 'Z71 11:f1d ork t'-,;13 ':1- i11;UVe 1J1.1ttGn. .10.11.owin,r appcarud Li faa)r of the Petition: Apl:ca7.: I(;I' 11A Palmer Davenport •r 3 iha Al follotring appearod in opposition to the Petition: caN�►�ek The following requested that the Appeal: Board consider the sanitation gaxatiox J�1r7, SbNr.dF(op' kkxk problem. REASON FOR DECISION: The Board finds that the area is suitable for the proposed motel. The Board considered the existing facilities in the im- mediate_area`'and.'finds;that the area•.that,is involved:in this petition is adjacent to uroperty�that is.currently being used for motel or house- keeping purposes: The.Board.examined the.plan submitted -by -the petitioner and'finds that the plans are in accordance -.with good architectural•.princi p16s and are suitable:,f,or a motel.ln the. area.reques,ted. Therefore -the, Board approves the:request:contingent-upon the peti.t.ionerls having an..'. approval of.the State and Town concerning'the:sanitation facilities,which rill be utilized inconjunction.with the motel.,tThe'Board,is of -the opinion that as a question. exists. concerninglthe .disposal.-of.waste. that. both the State -and Town;.should approve „the sanitation system prior to the Issuance— of a•bulldinq permit. ��4Gc� (VepArR'' - Members of Board Voting: I'll iavut• 12yo(� 5few 4R-t - in favor e47 oveb4 in favor 1l,jKa1'd {,�,Yes c1WRa1411 - in favor hocYAnk sp"W - in favor Thor©fore, tho Petition for Appitval.is ;panted contingent upon the approval of the XI AWAAx State and Town of the sanitation system. uctxx, nmbdxxia;oxr= ibm a>tc,S•o•eeeao•goo•.eeo..•asoo•••••o•o•oso.a..••o. aooe•v0..,.or ••oo•••o•a•..•••••••.••ooeeeeeo•oeoo•eooeeoo•.••o•e•.coo•ov0000�o•e00000000000Yoeeeo•aoo ••oeee0•oe•e••••••eee•e•e O�oeeoe•ee••ee•.o.•••o••.0000e.••. •+•+•••+. ••+•.e •. or••o.e ••.00 a411X9itix 7i�i%�M!$;ix7G7iOri7i jC3CD�]CZ ++e••o••oe oeov0000s•••e000so oYoo 0000000eoe000•0000000•ovv0000 oYOJo.ess••oe eo •000 )e. o•e. eo •••e ee0007000000e 0•.OD000••OOOOVO00 Oe00 p0000000000 e00000000000 e.000.0 e•oeo0004•esYJ eOraVO 00000000•e0 e000000000 e00 J•0000000000000•pOJ 000000 OOOu0e ee00.000 f00. OO•oOu+J S000e0 ue 1J00.O +eY OOO eY0000 YOOOOYO.Oa•00000000000 YYOOOOOee•+0000000•oeae•OOOOJOpO e00000Y000000Y•0000 )OLO 110 pazrAt i narad Mtil 15 d-vs fioia data of decision. 0aUortra, Y •O JO 000000000 67 DO O..O.Y 0000 Werk I /A* � r ?4ed with Town Clerk: AUG 7 TOWT or YARoiouTH BOARD Or APPEALS 1963 PetitUoner: R;.vLejt a` Motel Inc. DECISION Hearing Date: Petition #635 June 20, 1963 July 11, 1963 f Zhe p©titioner roquosged permit to allow the continued food service in connection with existing motel; on South Shore Drive, Bass River, South Yarmou i Members of Board of Appeals present: Harold L. Hayes Jr. - Chairman Albert Wobb H. Stuart Ryder. Alexander Catto Kenneth H. Studley. It appearing that notice of said hearing has been given by sending notice thore- of to tha petitioner and all those oumers of property deemed by the Board to be affected thor0y,'and that public notice of such hearingg having boon given by publication in the Cape Cod Standard Times on 5/30 &16/6/63,'the hearing was:,opened and held on the date first above written. The following Atty. John John Kelly Mrs. J. C. Mr. & Mrs. The following None appeared in favor of the petition: I Hart Mrs. J. Sullivan Mrs, Robt. 'Johnson Queen J. Walsh appeared in opposition:* 1 Reason for Decision:. This hearing was opened on June 20, 1963, and it is noted that there was no one present who oxpressed an intorost in this hearing. The hearing was to be continued until July 11 and all the abutters were noti- fied of this continuance. The -continuance was made upon the request of the petitioner through ,its attorney, John -Hart, -The hearing was r©-opened on July 11 and it appeared that the original plans of the motel which were previously Approved by this Board had an area Mich was designated as a dining room. It further appeared that this area was not pointed out to this Board and that through inadvertonco the petition was for a motel and did not include a request -for a.rostaurant. It further appeared that upon theopening of the motel for business that a ccmon vietuallorts liconse.was securod.from the Yarmouth Selectmen and that the area called, "coffee shop" which is the subject of this hearing has.been open since the irotol opened for business. It appeared that.the coffee shop was designed primarily for use of the patrons of the Riviera Motel. It further appeared from several photographs that the facilities were in keeping with -the motel.itself and wore in -good taste and design. The only indication of the fact that food is being served in connection with the motel is .a small sign; "coffee=shop," which appears attached to the building itsolfa I,� y / J The Board was of the opinion that a hardship existed to the petitioner wor© so-called "coffee shop" he not allowed to continuo the operation of the The Board further finds that the.public good will Board adversely urther affected by the granting of a variance to the petitioner. nds that the intent of the zoning by-law will hot be substantially derogated from by the granting of a variance. The Board specifically finds the amount of space utilized for the so-called coffee shop is very small in relation to the overall size of the Riviera Motel tand that he promises are designed of efacilities priimarily toaservecguests of theat it is guite RivieraeMotolan �.t Therefore the Board grants a variance the allowRiviethe continued use of food service in the existing food Members of Board voting: Harold L. Hayes Jr. inn favor avor Albert Webb in favor Ale or Catto in favor H. Stuarb Ryder in favor Kenneth H. Studley Therefore, the petition for approval is granted. Kenneth H. Studley Clerk fi TOVB OF YUMOUTH t ^ 5,) slyze- 4h-c (, • BO UD OF z,'L'' 1LS tj A j Filed with Town Cl: rk: Mulcok 1.511,10 Hearing Oato: Fobruarf 1, 1963 Potition^r: Riviera Ro•tlty Trust Petition .Voo DF3C. SIOII The petitioacr requoatod permit to: oract an addition to existing; motel atructuro; said addition to.consict of 30 units with enelos3d coffee shop with kitchen and storage area; offi marking areas and signs appurtenant thereto. Assessors p Noo 22 T125. MEMbors of Board of Appeals prosQat: Harold Hayes, filbert Yobb, Robart Sherman, Emmanuel DiTiborioa K. R. Studley. It appeariag that notice of said hcari3ag has boon given by sending notice thereof to the potitioncr and all those owners of property deemed by the Board to be affected thereby, and that public notice of such hoariag haviag boon given by publication in the Cape Cod Standard Times on 1/18/68� 1/25/68 the hoaring waa opened,and hold on the date first above written. The following appeared in favor of the petitiow Attorney Charles Ardito, represented Riviora•Realty Trust Mr. Peter Brown o. Architect T'te following appeared in opposition: None Rtason for Decision: It appoared that tho petitionors are tho,owners of the Riviera motel located on South Shore Drive in South Yarmouth. The petitioner presented plane designatad "Addition to Riviera Motel" including a site plan, a first floor plan, and a second story plan. The petitioner also presented an aerial photograph recently taken indictin; the proposed change. A subdivision sketch, being plan 14114D. was submitted iadicatinm the lead. which was involged. Recent photographs showing the immediate area to the oast and west wero pro• seated for coacidorntion of the Board. The Board deliberated and considered all the plans bubmitted by the petitioner. The Board approved petitioncr.'s roquoct, subject to the plans being redrawn to indicate certain parkin; changes recommended by tho Board. The Board made reconAiQt:dationo which were satisfactory to tho petitionev and they were instritctad to.submit amended pinns. Plans were submitted to the'Bodrd in.accordanco with the :p&commbnBatLbnd ram forth and in accordance with the desires of the Board. lficreforo f thlc requoot is c=pproved in gccordaaco;,t.-i:L"n; vino p1saw oulmIttod and as amended by .the petitioner. It is understood and agreed -thdt there will be a 30' setback from the right of wad at the westerly most building; sideline. Following a complete deliberation, it was aeboed that potitioner'c request coaformad with the requirements of the Town of Yarmouth aad the Board approved the potitionar's requost. Therefore the petition for approval is granted, in accordance with this opinion. Membara of the Board voted unanimously in favor, therefore the petition for approval is granted and we autiorizo a variance to allow potitionor's roquoct In aceordanco with this decision. No permit ieauod until 20 daya from data of filing decision with the Town Olo& Kenneth Ho ftudley, Clerk TOI.*I OF VWIOUTH BOARD OF APPEAIS led with Town Clod,: APR 7 1971 Hearing Date: Harch l.B, 1971 rtitionor: Octal Realty,Inc. Petition #1024 q 15 `SG / DECISION e petitioner requested permit to: Provide for the use of the existing coffee shop for the rpose of a restaurant serving food and alcoholic beverages to guests and all other patrons the Riviera Beach lktol.. Assessors nap /r`fi22, Parcel T)arj 2L tubers of Board of Appeals present: Joseph Grool.ish, Jolco Sears.. E =nucl DiTiberio, Eldredge aw, Gcorge Saito. appearing that notice of said hearing has been given by sending notice thereof to the titionor and alrl those otmere of property deemed by the Bead to be affected thereby, and that blic notice of such hearing having boon given by publication in tho Cape Cod Standard Times March 4 and March n, 1971, the hearing was opened and hold on the date first above written. s following appeared in favor of the petition: Charles Ardito, Attornoy for petitioner. s l.ollctring appaarcd in opposition: Z--ne. anon for decision: a Board considered the petitioner's request and ndns that there will be no change in the build- 3 and the petitioner does not ask for a lairger area than presently used. Jest ppeared to the Board that, conoidoving the size of the petitioner's facilities, that his was reaconablc and in keeping t:ith the uses expacted of a facility of this typo. 3 Board finds the },ubl.ic good will not be adversely affected and that the use is in looping .h motels which s;ny be permitted by tho Beard of Appcals and the zoning by —lax. 3refcro, the Board, after considering all the facts oubmitt4 grants the petitioner's request. cbers of Board voting: Joseph G.rocli.sh, Joyce Saars, Eu:-,mnuel DiTiberio, Eldredge Shaw, )rge Waite. All voted in favor. 3rofore, the Petition for Approval it+ ,rantod. 1 we authorize petitioner's request. permit issued until 20 days frcm date of filing decision with the Town Clerk. Joseph Grealish. Jr. Acting Clerk TOWN OF YARMOUTH BOARD OF APPEALS Hearing Date: Petitioner: Riviera Beach Petition #1443 Motor Inn The petitioner requested permit to: October 13, 1977 Allow construction of an indoor swimming pool to be located at the Riviera Beach Motor Inn, South Shore Drive, Yarmouth, which is a resi- dential area. Members of the Board of Appeals present: Robert W. Sherman, David Oman, Morris Johnson, Thomas N. George, John Neylon It appearing that notice of said hearing has been given I by sending notice thereof to the petitioner and all those owners of property deemed by the Board to be affected there- by, and that public notice of such hearing having been given by publication in the Cape Cod Times on September 26, 1977 and October 3,1977, the hearing was opened and held on the date first above written. The following appeared in favor of the petition: Palmer Davenport The following appeared in opposition: None Reason for decision: Petitioner indicated:a need for pool to satisfy requests of guests in early spring and late fall. There would be no•additional rooms added and there- fore, the Board felt no greater burden to area as regards traffic or environmental effects. This is a well established business property and addition of pool would.not effect the neighborhood or derogate from protective by-law. Members of the Board voting: Robert W. Sherman, David Oman, Morris Johnson, Thomas N. George, John Neylon Therefore, the petition is granted And we authorize a variance as petitioned. No permit issued until 20 days from date of filing decision with the Town Clerk. :i Filed with Town Clerk: OCT 2 19M Petitioner: Riviera Beach Motor Inn a-1 South Shore Dr. ,WSJ So. Yarmouth, Mass. TOWN OF YARMOUTH BOARD OF APPEALS DECISION Hearing Date: 9/11/80 Petition No.: 1696 The petitioner requested a variance and/or special permit from the Board of Appeals to allow the continuation of employee parking on Lot U-1, Assessors map #22. Also allow the continuation of rental use of (2) two buildings on one lot shown as Lot T138 of Assessors map #22. Property located on South Shore Dr., So. Yarmouth, Mass. Members of Board of Appeals present: Robert Sherman, Thomas George, Donald Henderson, David Oman, Herbert Renkainen. It appearing that notice of said hearing has been given by sending no Of - to the petitioner and all those owners of propert oard to be affected thereb and that public notice aving been given by publication in the Yarmouth Sun Ean 3/80, the hearing was opened and held on the date first above written. The following appeared in favor of the petition: Attorney Mycock for Smugglers Beach Motel, Joan Davidson, letter, Cliff Hagberg, Douglas Frisbee, Yarmouth Seaside Village, Joseph Carapeza, Robert Bolduc. Paul McBride, Mr. Campbell, John Gilligan. The following appeared in opposition: By letter, Mrs. James Wilson, Stuart Wells, Neil & Shirley Moodey, Richard Sherman. Howard Wensley, Mr. Rothman, Manny Wensley, Mr. & Mrs. Mitschke, Mary Cushing, Anthony Vellante, Robert Block, Elizabeth Martin, Mrs. Howard Wensley. Reasons for decision: The request for use as three living units on Parcel T138 is a special permit situation . does not require the proof of hardship. The use has existed since 1962. There is ample footage in the lot to accomodate the use. This community is already established as a rental area and the continued use would not create any additional hazard or congestions. The apartments are rented to older tenants and no nuisance has ever been reported and none is anticipated. The request for parking on lot U-1 is granted with.the restriction that it be for employees of petitioner. There was some evidence that parking has been existant on this lot from 1956 and maybe even before. There would be no hazard created as the parcel has good exposure for oncoming traffic, and there is no record of accidents occuring there and the grade is level with the road so the passage is smooth and at eye level. The congestion that exists in this high traffic area will not be increased by the use of this lot as its present use is part of the congestion already existing. This lot services 20 to 22 automobiles and should not be enlarged. Members of Board voting: Thomas George, Robert Sherman, Donald Henderson, David Oman, Herbert Renkainen. All voted in favor. TOWN OF YARMOUTH BOARD OF APPEALS Filed with Town Clerk: SEP 2 4 1982 Petitioner: Riviera Beach Motor Inn South Shore Dr. S. Yarmouth, Mass. DECISION Hearing Date: 6/24!82 Petition No.: - 1849 The petitioner requested a variance and/or approval and/or special permit from the Board of Appeals to allow the construction of 46 motel units, a retaining wall, parking area, whirlpool, wens and ladies bathrooms, dressing room, service & storage rooms normal and customary for motels to be located at the Riviera Beach Motor Inn, _South Shore Dr., S.Yarmouth, Mass., property shown on Assessors map #22-T125, T133 & T138,.being in a residential area. Members of Board of Appeals present: Herbert Renkainen, Myer Singer, David Oman, Donald Henderson, Judy Sullivan. It appearing that notice of said hearing has been iven ere of to the petitioner an property deemed by the Board to be e ereby and that public notice of such hearing having been given by publi- cation in the Yarmouth Sun on 6/9/82 and 6/16/82, the hearing was opened and held on the date first above written. The following appeared in favor of the petition: Palmer Davenport, DeWitt Davenport, John Gilligan, Paul McBride, Thomas Joy. The following appeared in opposition: Mr. Rothman, Mr. Wensley, Mr. Lippman, Neil Moody. Reasons for decision: This is an appeal to allow the addition of 46 motel units to an existing motel together with a retaining wall, parking area, whirlpool, wens and ladies bathrooms, dressing room, service and storage rooms, normal and customary for motels. The property is known as the Riviera Beach Moror Inn, is located on South Shore Dr., in S.Yarmouth, and is shown on Assessors map #22 as parcels T133. T125 & T138. The property is in a residential area and under the zoning by-law, motels are allowed in a resi- dential area on a special permit from this board. Petitioner submitted a plan to the Board dated 6/l/82,by Thomas W. Joy, Registered Professional Engineer. Mr. DeWitt Davenport, Mr. -Palmer Davenport and Mr. Joy presented the petitioners case. In addition, reports were submitted by the Conservation Commission, Board of Health and Planning Board. A lengthly hearing was held and numerous people from the surrounding residential area spoke in opposition. Under Section 175-2300, B7, a motel is permitted in this area on approval from the Board of Appeals. Petitioner demonstrated to the Boards satis- faction that the additional motel units and other facilities requested would not create undue nuisance, hazard and congestion, and that there would be no harm to the established or future character of the neighborhood or town. With respect to the retaining wall, Section 175-4441 - allows superficial clearing of areas of private beach and this is obviously necessary in order to construct the wall as shown on the plan. All of the criteria and information required under Section 4442 were provided, and the Board finds that the criteria set forth in sections 4460 to 4463, were satisfied and therefore grants the special permit for construction of the retaining wall. 1 Petition No. 1849 Page 2 With respect to the way or street, which runs along the westerly sideline of the locus, the Board expresses no opinion with respect to its status. The•Board is unsure as to whether or not petitioner needs a special permit or a variance to allow the parking area to be constructed as shown on the plan. It has already been stated that the Board believes all criteria necessary for the granting of a special permit have been demonstrated by the petitioner. To the extent that a variance may be needed to locate the parking area as shown on the plan, it is granted. Members of Board.voting: Donald Henderson, Myer'Singer, David Oman, Judy Sullivan, Herbert Renkainen. All voted unanimously in favor of request. . Therefore, the petition is granted for the above.stated reasons. No permit issued until 20 days from the date of filing the decision with the Town Clerk. JUDITH M. SULLIVAN Town of Yarmouth Board of•Appeals Filed with Town Clerk: Hearing Date: October 10, 1991 Petition No: 2853 '= Petitioner: Davenport Realty Trust and David O. Mugar•, South Yarmouth, Massachusetts. r1J% DECISION �r. Relief Request: Petitioner request a special permit under•Sectio 104.3.2 of the Yarmouth Zoning Bylaw to r ocean front rooms, enclose the o s and add four decks to the se rooms, and to waive strict compliance with the rules and regulations and provide other relief the Board deems neces- sary. , Property is located at 327 South Shore Drive, South Yarmouth, Massachusetts and shown on Assessor's Map 22 as Parcel T-125. Locus: Locus is comprised of one parcel having frontage in South Shore Drive. The Riveria Beach Motor Inn, a 125 unit motel facility with outdoor and indoor pools, whirlpool, coffee shop, lounge and administrative offices, was built in two stages. The section of the building where the desired relief is requested was construct- ed in the mid 19501s. Plans/Documents: The Petitioner has submitted plans as follows: Site Plan for locus by Coastal Engineering 6/1/82. . Proposed plan for construction with detail site plan by Coastal Engineering 9/18/91. Site Plan review comments dated 10/1/91. 0 Hearing: The petition was duly filed. Notice was given as re- quired by law, including twice publication in the Yarmouth Sun, a weekly publication having circulation in Yarmouth.• Pursuant to notice a public hearing was held by the Board of Appeals on the evening of October 10, 1991. In the course of the hearing, several questions were posed to the petitioner's representatives by members of the Board of Appeals. Members of the Board of Appeals Present P. Magnuson F. Lindquist D. Henderson D. Reid L. Campbell a Reasons for the Decisions: Prior Relief: The subject property has the benefit of prior relief of this Board of Appeals. The most recent relief allowed for the construction of the most western section of the motel with parking adjacent thereto. Criteria: The criteria for the granting of a special permit are as follows: • "Zoning Bylaw Section 103.2.2: Special permits shall not be granted unless the applicant demon- strates that no undue nuisance, hazard or congestion will be created and that there will be no substan- tial harm to the established or future character of the neighborhood or town". • M.C.L. Chapter 40A, Section 9 (in part) "Special permits may be issued only for uses which are in harmony with the general purpose and intent of the ordinance or bylaw, and shall be subject to general or specific provisions set forth therein;" t Facts and Criteria Satisfied: The Petitioner's plans is to rebuild a portion of the existing motel (use A-7) in the R725 residen- tial zone. No new units (rooms) will be added. No change in use. The proposed increase in square footage of occu- pance space is less than one percent of the exist- ing facility. The new construction will be better suited to with- stand strong wind loads than the current design, which the Petitioner has the right to rebuild. The architecture of the building will.essential be the same. additional traffic will be created. The.parking__ar_eas_a.r�d.driveways will not be af- fected by this the proposed work. Conclusion and Desired -Relief: The Petitioner has demonstated that the relief re- quested comes about due to damage done to a portion of this facility during the recent hurricane (Bob). In the course of preparing for the repairs, the Petitioner's engineers recom- mended that additional steps be taken to better anchor the new roof to a more permanent and weatherproof foundation. Due to the nature of the existing foundation, this would best be done by extending the roof line approximately six feet (61) and con- structing a foundation/footing according to current construc- tion practices. Such an extension necessarily involves some increases in the area of the building, which is a nonconforming use, therefore, requiring a special permit. The Board is satisfied that the minimal expansion of this portion of the building will not create any new nonconform- ity, and will not substantially increase the existing nonconform- ity or increase any adverse inpact upon the neighborhood. The increase itself is minimal and will not increase the number of units nor allowable occupancy. - 3 - r �` • . r A motion was therefore made by Mr. Reid, seconded by Mr. Henderson to grant the special permit as requested. The Hoard members voted unanimously•in favor of the motion. The special permit is therefore granted. No permit shall be issued until the expiration of 20 days from the filing of this decision with the Town Clerk. avid S.Re d - er - 4 - TOWN OF YARMOUTH I 1 16 RMA E 2S Sot "I'l i NAR\IM1 Ill \I.\.SSAC111 SETT S 02661-1-151 l Ck-plimic 1508) :19-S _'_' ;1. Fm. _N.l — I ;l\ 1508) r4O F� 7�7 4 TOWN OF YARMOUTH BOARD OF APPEALS DECISION FILED WITH TOWN CLERK: FEB 7 1997 PETITION NO: HEARING DATE: PETITIONER: PROPERTY: #3364 January 23, 1997 Palmer Davenport & David G. Mugar DB/A The Riveria Beach Motor Inn 327 South Parcel: T125 1UWH �LL�fttf(.i�lhEgc&%f ': MEMBERS OF THE BOARD PRESENT AND VOTING: David Reid, Chairman, James Robertson, Jerry Sullivan, Andrew Ryan, Mike O'Loughlin. It appearing that notice of said hearing has been given by sending notice thereof to the petitioner and all those owners of property deemed to be affected thereby, and to the public by posting notice of the hearing and published in The Register, the hearing was opened and held on the date stated above. The petitioner, represented at the hearing by Mr. DeWitt Davenport, operating this existing (non- conforming) motel use in a residential (R-25) zone. They purpose at this time to expand the structure by adding a drive -through canopy at the front entrance, expand the rooms above the lobby_ and new canopy, and to enclose the adjacent building connector area. Each of the alterations would itself comply with current dimensional requirements of the by-laws. No additional guest rooms or occupancy will be created. The petitioner demonstrated that there previously existed a canopy at the same location as the proposed new construction. That had been removed some time ago. The new canopy will be constructed as shown in the elevation plans filed with the Board. It will include decorative features which, with the above room expansion, will tie in architecturally with the building. In addition to providing coverage for guest vehicles arriving at the front entrance, this renovation will facilitate the construction and enclosure of a handicapped access ramp into the lobby area. The second floor rooms will be expanded by the addition of a 12' x 12' area. No additional bedrooms or units are to be added. -a > N Page 2 Decision #3364 Davenport & Mugar d.b.a. Riveria The board finds that this expansion may be made without being substantially more detrimental to the neighborhood, and without creating any undue nuisance, hazard or congestion. After review of the plans and proposals, a motion was made by Mr. Sullivan , seconded by Mr. Robertson , to Grant the needed Special Permit , per §104.3.2, but to deny the Variance request without prejudice, as it does not appear to the Board to be needed. The members voted unanimously in favor of the motion. The Special Permit was therefore Granted. David S. Reid, Clerk Property Location:327 SOUTH SHORE DR NIAP ID:26/ 18/// Bldg Name: State Use:3010 Vision ID:3335 Account #0327000 Bldg #: 2 of 4 Sec #: 1 of 1 Card 3 of 5 Print Date: 04118/200812:35 815 YARMOUTH, MA VIERABEACH LTD PARTNERSHIII 20 N MAIN ST SOUTH YARMOUTH, MA 02664-3150 Additional Owners: XAvel blic Water I I rfront escription Code Appraised Value Assessed Value as aved OMMERC. OM LAND ODtMERC. ODll11ERC 3010 3010 3222 32Z 551,700 5,355,000 207,200 16800 551,706 5,355,000 107,300 1,268200 ptie SUPPLEMEN TAL DAT Other ID: 22/T125/// Subdivision 170 RANGES U NENT LAN LANNUDIIIE194B PCODE IS ID: 3335 ASSOC P! VISION Total 7=,2WI 7,282,200 RECORD OF OWNERSHIP BK-VOLIPAGE SALE DATE E/A v/i SALE PRICE V.G PREVIOUS ASSESSMENTS HISTOR VIERA BEACH LTD PARTNERSHIP DAVENPORT PALMER TRS D651174 I IAH11995 I I 0 Yr. Code I Assessed Value Yr. Code Assessed Value Yr. Code Assessed Value OS OS 08 OS 3010 3010 3010 3222 551,700 5,355,000 107,300 1 268,200 007 7 007 007 3010 3010 3010 3222 530,600 5,2511,000 107,3W 1 219,500 006 0063010 0063010 006 3010 3222 431 300 5,250,000 100,700 1,154 500 Total• 7 82 00 Total: 7 107 400 Total: 6 36 00 EXEMPTIONS O HER ASSESSMENTS This signature acknowledges a visit by a Data Collector or Assessor Year Tvpe eseri tion Amount Code Desert tion Number I Amount I Comm. Ina. APPRAISED VALUE SUMMARY Appraised Bldg. Value (Card) Appraised XF (B) Value (Bldg) Appraised OB (L) Value (Bldg) Land Value (Bldg) Special Land Value Total Appraised Parcel Value Valuation Method: Adjustment: 536,400 200 0 0 0 7,282,200 C 0 . ASSESSING NEIGHBORHOOD NBHD/ SUB NBHD NAME I STREET INDEX NAME TR CING BATCH 0000/A IAppraised NOTES 40 UNITS & REST/LOUNGE(MEETING ROOM) G 40 SEATS LNGE-55 STS LL UNITS I RM THROUGHOUT COMPLEX et Total Appraised Parcel Value 7,282,200 BUILDING PERMIT RECORD VISIT/ CHANGE HISTORY Permit ID Issue Date nwe Description Amount Insp. Date % Comp. Date Camp, Comments Date Type Is ID Cd PurposeMesult 7/19/2004 4/20/2000 6/19/1998 7/27/1995 5/20/1992 GM 00 BD 00 BD 00 JF 00 DB 00 leasur+Listed leasur+Listed leasur+Listed leasur+Listed leasur+Listed LM LINE VALUATION SECTION B # UA Code Use Description Zone D Frontage Depth Units Unit Price L F ictor S.A. Acre Disc C. Factor ST. Idx Ad'. Notes- Ad' Svecial Pricint Adj. Unit Price Land Value T 3222 COMM BLDG M94 0.00 BL 0.00 1.00 0 1.0000 1.00 0.00 0.00 0 Total Card Land Units: - SF Parcel Total Land rea: SF Total Land Value: 0 Property Location:327 SOUTH SHORE DR MAP ID:26/ 1 8/ / / Bldg Name: Vision ID:3335 Account #0327000 I Bldg #: 2 of 4 Sec #: 1 of 1 Card 3 of 5 State Use:3010 Print Date: 04/18/200812:35 rade 5 verage +20 tones 3ccupancy AffX Code 10esrription or Wall 1 4 Wood Shingle 3122 0111M BLDG M xterior Wall 2 1 Clapboard oof Structure 3 Gabldffip oof Cover 3 AsphIF Gls/Cmp teriorWall I 5 wall/Sheet COST/MARK tenor Wall 2 kdj. Base Rate: terior Floor 1 14 tenor Floor 2 'on. RCN: eating Fuel 3 as et Other Adj: eating Type 3 lot Air -no Due eplace Cost YB C Type 2 ieat Pump YB p Code ldg Use 222 OhlAl BLDG N194 lemodel Rating otal Rooms fear Remodeled otal Bedrms P % otal Baths unctional Obsbrc temal Obslnc ost Trend Factor eat/AC 1 JEAT1AC PKGS Complete rame Type 2 WOOD FRAME vemU Cond aths/Plumbing 2 AVERAGE kpprais Val iling/Wall IL & WALLS p % Ovr ooms/Prtns 2 AVERAGE p Ovr Comment Wall Height disc Imp Ovr Comn Wall disc Imp Ovr Comment ost to Cure Ovr ost to Cure Ovr Comment orch, Endosed, Finished 0 384 orch, Open, Finished 0 4,176 1 pper Story, Finished 8,028 8,028 8 85. 11 I PTO I 2 Property Location:327 SOUTH SHORE DR NI P ID:2 118/// Bldg Name: State Use:3010 Vision ID:3335 Account # 0327000 Bldg #: 3 of 4 Sec #: 1 of 1 Card 4 of 5 Pont Date: 04/18/200812:35 815 YARMOUTH, MA RIVIERA BEACH LTD PARTNERSHIII 20 N MAIN ST SOUTH YARMOUTH, MA 02664.3150 Additional Owners: vel Public Water I I aterfront 5escription Code Appraised Value Assessed Value as ved OhtMERG OM LAND OMAIERC. OhT11fERG 3010 3010 3222 3222 551,700 5,355,000 107,300 1,268,200 551,700 5,355,000 107,300 1,268200 ptic SUPPLEMENTAL DA Other ID: 22/T125/// Subdivision 170 HANGFS LBE1 94B ANK UM h1BE1 LAN N IP CODE IS ID.3335 ASSOCPI VISION Totall 7,282,200 7,282,200 RECORD OF OWNERSHIP BK-VOLIPAGE SALE DATE v/i ISALK PRICE V.C. PREVIOUS ASSESSMENTS HISTOR VIERA BEACH LTD PARTNERSHIP DAVENPORT PALMER TRS D651174 I IMU1995 I I 0 Yr. Code I Assessed Value Yr. Code Assessed Value Ye Code Assessed Value 8 zM ZM 2008 3010 3010 3010 3222 551,700 007 S,355,000 007 107,300 007 1268,200 007 3010 3010 3010 3222 530,600 54250,000 107,300 1,219,500 006 3010 3010 3010 3222 431.M 5,250,000 100,700 1,154,500 Total: 7 82 Total 7107 400 Towl: 69 00 EXEMPTIONS OITHERASSESSMENTS This signature acknowledges a visit by a Data Collector or Assessor Year T e escri tion Amount Cade Description Number Amount I Comm. Int. APPRAISED VALUESUMMARY Appraised Bldg. Value (Card) Appraised XF (B) Value (Bldg) Appraised OB (L) Value (Bldg) Appraised Land Value (Bldg) Special Land Value Total Appraised Parcel Value Valuation Method: Adjustment: 297,200 0 0 0 0 7,282,200 C 0 ASSESSING NEIGHBORHOOD NBHD/ SUB NBHD NAME I STREET INDEX NAME I TR kCING BATCH 0000/A NOTES 0 UNITS G NC=UBM et Total Appraised Parcel Value 7,282,200 BUILDING PERMIT RECORD VISIT/ CHANGE HISTORY Permit ID Issue Date Ape Oescription Amount Ins.Date I % Comp. Date Comp. Comments Date Tire IS ID Cd Purpose/Result 7/19/2004 4/20/2000 6/19/1998 7/27/1995 5/20/1992 GM 00 BD 00 BD 00 ]F 00 DB 00 leasur+Listed leasur+Listed leasur+Listed easur+Listed feasur+Listed LANO LINE VALUATION SECTION B # Usb Code Use Description Zone D Fronta a Depth Units Unit Price L ctor S.A. Acre Disc C. Factor ST. Idz Ad'. Notes- Ad' Special Pricing di. Unit Price land Value 3 3222 COMM BLDG M94 0.00 BL 0.00 1.00 0 1.0000 1.00 0.00 0.00 0 Total Card Land Units: 61SF Parcel Total Land rea, SF Total Land Value 0 i Property l ocatioa327 SOUTH SHORE DR MAP ID: 261118/ / / Bldg Name: State Use:3010 Vision ID:3335 Account I10327000 I Bldg N: 3 of 4 Sec #: 1 of 1 Card 4 of 5 Print Date: 04/18/200812:35 e 5 verage +20 es Pmcy for Wall 1 Wood on Sheath for Wall 2 4 ood Shingle Structure 3 ablcffp Cover 3 sph/F Gls/Cmp or Wall 1 5 rywall/Sheet or Wall 2 or Floor 1 14 t or Floor 2 ng Fuel 3 as ng TYpe lotAir-no Due ype 2 feat Pump Use 222 OMM BLDG A194 Rooms Bednns Baths ,C 1 MEAT/AC PKGS Type 2 WOOD FRAME Plumbing 2 VERAGE ;/Wall Ell,& WALLS firms 2 VERAGE Al Height Comn Wall Lpplk Floor h, Open, Finished er Story, Finished ment, Unfinished Wood V-7"i ection. RCN: et Other Adj: eplace Cost YB YB ep Code emodel Rating ear Remodeled ep % unctional Obslnc xtemal Obslnc ost Trend Factor tatus i Complete verall % Cond Oprais Val ep % Ovr ep Ovr Comment list Imp Ovr lise Imp Ovr Comment ost to Cure Ovr ost to Cure Ovr Comment I 100 :ost nde rec. Value 89.26 371686 2235 29,367 89.26 371,686 _ 17.86 74,35$ 1151 2,053 849147 I Property Location.327 SOUTH SHORE DR MAP ID:26/ 118/// Bldg Name: State Use: 3010 Vision ID: 3335 Account # 0327000 I Bldg #: 4 of 4 Sec #: I of I Card 5 of 5 Print Date: 04118/200812:35 815 YARMOUTH, ALA VIERA BEACH LTD PARTNERSHIII ZO N MAIN ST SOUTH YARMOUTH, NIA 02664-3150 Additional Owners: vel blic Water aterfront escription Code Appraised Value Assessed Value as vedl OMMERC. OM LAND 014NIERC. OMMERC. 3010 3010 3010 3222 551,700 5,355,000 107,300 1,268aM 551,700 5,355,000 107,3W 1,2.68,200 ptic I SUPPLEAFENTAL'DATA Other ID: 2L T125/// Subdivision 170 RANGES ETTERNIENT LAN NUNIBE194B IP CODE IS ID: 3335 ASSOG PIDt VISION Tonal 7.282,Ml 777f52 200 RECORD OF OWNERSHIP BR-VOL/PAGE SALE DATE /u vR SALE PRICE V.C. PREVIOUS ASSESSMENTS HIST1t7R VIERA BEACH LTD PARTNERSHIP AVENPORTPALNIERTRS D651174 11/01/19 5 1 I 0 Yr. Code Assessed Value Yr. Code Assessed Value Yr. Code Assessed Value 2DO8 20 OS ZD08 2008 3010 3010 3010 3222 551,700 5,355,000 107,3W 1,268,200 007 007 007 007 3010 3010 3010 3222 530,600 5 250,000 107,300 1,219,500 0063010 0063010 006 006 3010 3222 431,3W 5 250,000 100,700 1,154,500 Total:7282,200 Total: 7107 400 Total: 6 936 00 EXEMPTIONS I OTHER ASSESSMENTS This signature acknowledges a visit by a Data CoUector or Assessor Year Are 10escription Amount Code Oescriptionj Number Amount Comm Int. I APPRAISED VALUE SUMMARY Appraised Bldg. Value (Card) Appraised XF (B) Value (Bldg) Appraised OB (L) Value (Bldg) Appraised Land Value (Bldg) Special Land Value Total Appraised Parcel Value Valuation Method: Adjustment: 434,400 0 0 0 0 7,282,200 C 0 ASSESSING NEIGHBORHOOD I NBHD/ SUB NBHD NAME STREET INDEX NAME 'TRACING BATCH 0000/A NOTES 6 UNITS I/G PIER FOUNDATION et Total Appraised Parcel Value 7,282,200 BUILDING PERMIT RECORD VISIT/ CHANGE HISTORY Permit ID Issue Date esrri tion Amount Insp. Dare L `b Com . Date Comp, Comments Date Tire IS ID Cd. Pu selResult 7/19/2004 4/2012000 6/19/1998 7/27/1995 5/20/1992 GNt 00 BD 00 BD 00 JF 00 DB 00 easur+Listed teasur+Listed teasur+Listed easur+Listed teasur+Listed LAND LINE VALUATION SECTION B # Use CTde Use Description Zone D Frontage Depth Units Unit Price L actor S.A. Acre Disc C. Factor ST. Idz Ad'. Notes- Ad' SDecial Pricine Adl.UnitPrice Land Value 4 3222 a ONINt BLDG A194 0.W BL 0.00 1.00 0 1.0000 1.00 0.00 0.00 0 Total Card Land Units:1 0 SF Parcel Total Land"Aren:0 SF Total Land Value: 0 I Property Location:327 SOUTH SHORE DR NIAP ID:26/ 118/// Bldg Name: State Use:3010 Vision ID:3335 Accotmt #0327000 I Bldg #: 4 of 4 See #: I of 1 Card 5 of 5 Print Date: 04118/200812:35 rior Wall I rior Wall 2 if Structure if Covet rior Wall 1 rior Wall 2 rior Floor 1 rior Floor 2 ting Fuel ring Type Type g Use d Rooms d Bedrms d Baths I Type all Height Comn Wall ge +20 ib Wood Shingle Hip ? Gls/Cmp dr-no Due Pump At BLDG h194 EAT/AC PKGS /OOD FRAME VERAGE Ell, & WALLS VERAGE [First Floor orrh, Open, Finished pper Story, Finished 4, 4, Son. RCN: Other Adj: lace Cost 3 3 Code iodel Rating r Remodeled % :tional Obslnc anal Obslnc t Trend Factor as bmplete rall % Cond rais Val % Ovr Ovr Comment c Imp Ovr c Imp Ovr Comment t to Cure Ovr t to Cure Ovr Comment J .osr nae rec. value 87.86 419,611 1( 21.96 105,166 S. 87.86 419,610 { 944 87 . I Property Location:327 SOUTH SHORE DR MAP ID:26/ 118/// Bldg Nana: State Use:3010 Vision ID:3335 Account # 0327000 I Bldg #: 1 of 4 Sec #: 1 of 1 Card 1 of 5 Print Date: 04118/200812:35 VIERA BEACH LTD PARTNERSHII 1 vel blic Water aterfront escription Code Appraised Value Assessed Value N MAIN ST SOUTH YARMOUTH, MA 02664-3150 Additional Owners 815 YARMOUTH, AIA ved I OMMERC M. LAND OM MERC. OM1fERC. 3010 3010 3010 3222 551,700 5,355,000 107,300 1,268,200 551,700 5,355,000 107,300 1,268 200 ptic I SUPPLEMENTAL DATA Other ID: 22/ T125/// Subdivision 170 HANGFS 1BETTERNIENT VISION LAN NUMBE194B ' CODE IS ID: 3335 ASSOC PI 50 Totall 7,282,200 7,282,200 RECORD OF OWNERSHIP BR-VOL/PAGE SALE DATE /u v/! SALE PRICE KC. PREVIOUS ASSESSMENTS HISTOR VIERA BEACH LTD PARTNERSHIP D651174 11/01/1995 I Yr. Code Assessed Value Ye Code Assessed Value Yr. Code Assessed Value DAVENPORT PALMER TRS I 0 008 3010 551,700 007 3010 530,600 006 3010 431,3W 3010 5,355,000 7 3010 5,2SO,000 D06 3010 S,250,000 OS 3010 107,300 007 3010 107,3W 006 3010 100,700 ZM 3222 1 268,200 007 3222 1,219,5W 006 3222 1,154$00 Total: 7 82 00 TowL 7107 400 Total 6,936 EXEMPTIONS OTHER ASSESSMENTS This signature acknowledges a visit by a Data Collector or Assessor Year I Type 12escriprion Amount I Number Amount I Comm. Int. :Tnprion APPRAISED VALUE SUMMARY Appraised Bldg. Value (Card) Appraised XF (B) Value (Bldg) Appraised OB (L) Value (Bldg) Appraised land Value (Bldg) Special Land Value 550,600 1,100 107,300 S,355,000 0 ASSESSING NEIGHBORHOOD NBHD/ SUB NBHD NAME I STREET INDEX NAME TRACING I BATCH 0000/A NOTES VIERA BEACH MOTOR INN 125 TOTAL UNITS Total Appraised Parcel Value 7,282,200 UNC=UBM INDOOR POOL Valuation Method: C 9 UNITS & OFF-6 EFFICIEN Adjustment: 0 et Total Appraised Parcel Value 7,282,200 gLDG BUILDING PERMIT RECORD VISIT/ CHANGE HISTORY Permit ID Issue Date 7Nve loescrintion Amount Insp. Dare % Comz7. Date Comp, 7omments Date T • e IS ID Cd Purpose/Result 06.1318 05-658 03.777 05/09/2006 11/10/2004 03121/2003 RP RP RF lepair tepair leroof 11,500 2,000 81000 0 0 100 01101/2004 iTRIPREROOFPAPE1 ZEROOF 7/19/2004 4/20/2000 6/19/1998 GM 00 BD 00 BD 00 leasur+Listed leasur+Listed leasur+Listed 427 0611611999 CM mmercial 60,000 100 01/01/2000 ZEROOF 7/271199S JF 00 easur+Listed 151 03116/1999 CM mmercial 60,000 04/20/2000 100 01/01/2000 1EPLACE POOL 5/2011992 DR 00 easur+Listed 21 01112/19" CM mmercial 1,200 04/20/2000 100 01/01/2000 EMOLIMI POOL 106 O-VO611997 Cbf mmercial 30,000 06/19/1998 100 01/01/1998 ANOPY,AL LAND LINE VALUATION SECTION B Ute Use Unit I Acre # Cpde Description Zone D Fronta a Deoth Units Price L Factor S.A. Disc C. Factor ST. Idx Ad'. Notes- Ad' Special Priciniz Adj. Unit Price Land Value 1 3510 fOTELSM94 125.00 BL 14,000.00 1.00 0 1.0000 3,00 0000 1.02 SITES.00AC/LOC 42,840.00 5.355,000 Total Card Land Units: 01 SF Parcel Total Land Area SF Total Land Value: 1 5,355,000 Property Location:327 SOUTH SHORE DR MAP ID:26/ 118/// Bldg Name: Vision ID:3335 Account #0327000 I Bldg #: 1 of 4 Sec #: 1 of 1 Card 1 of 5 State Use:3010 Print Date: 04/18/200812:3.1 Element Style or Wall 1 zterior Wall 2 oof Structure oof Cover interior Wall 1 interior Wall 2 Interior Floor 1 Interior Floor 2 Heating Fuel Heating Type AC Type Bldg Use Total Rooms Total Sedans Total Baths Heat/AC Frame Type Baths/Plumbing Ceiling/Wall RDoms/Prtns Wall Height %Comn Wall PATI �ATIO-AVG PATI ATIO-AVG PAV1 AVING-ASPI ge +20 Shingle card 'Hip F GIs/Cmp 1 arpet dj. Base Rate: .15 1 P 3ection. RCN: .720,750 lectric et Other Adj: .00 FUS BAS place Cost ,720,750 'otAir-rwDuc %YB 961 P ;eat Pump iYll 989 AS p Code Is 2 IOTELS D194 lemodel Rating p ear Remodeled OP P p % 8 FUS unctional Obslnc 2 temal Obslnc 5 E2 B 40 ost Trend Factor 4 68 EAT/AC PKGS tams ?% Complete LCAMJ JOODFRAME ll % Cond 2 .... Val 50.600 ~� EIL EIL & W &WALLS ep p% Ovr VERAGE p Ovr Comment Aisc Imp Ovr ! isc Imp Ovr Comment 1 ost to Cure Ovr ost to Cure Ovr Comment —�_ Y, -� s, _. •� NG &YARD ITEMS(L) / XF-BUILDING EXTRA FEATURES(B) Sub Descri t kinits Kinit Price 1Yr e Rt nd nd r Value ry 18 00 961 0,500gak)"� �glq:i -oo M 0 S00 BUILD Code BAS Floor CAN py FEP r Lescriprian , Enclosed, Finished FOP Open, Finished FUS rStory, Finished WDKWood 700 • rer. Value 15,317 2OA35- 134,874 667,558 3,491 _ 1.720750 Property Location:327 SOUTH SHORE DR NIA P ID:261118/ / / Bldg Name: State Use:3010 Vision ID:3335 Bldg li: 1 of 4 See it: 1 of 1 Card 2 or 5 Print Date: 04118/200812:35 815 YARM0UTH, MA VIERA BEACH LTD PARTNERSHI ZO N MAIN ST SOUTH YARMOUTH, MA 02664-3150 Additional Owners oescription Code Appraised Value Assessed Value SUPPLEMENTAL DATA Other tD: 22/ T125/// IS ID: 3335 SSt7C PIDA VISION Totall 7,282,200 7,282500 RECORD OF OWNERSHIP BR-VOL/PAGE SALE DATE /u 0 SALE PRICE V.C. PREVIOUS ASSESSMENTS HISTOR Code Assessed Value Yr. Code Assessed Value Yr. Code Assessed Value D Total Totaki Total: EXEMPTIONS OTHER ASSESSMENTS This signature acknowledges a visit by a Data Collector or Assessor Year Awe Pewription Amount Code Oescription Number Amount I Comm Int. APPRAISED VALUE SUMMARY Appraised Bldg. Value (Card) Appraised XF (B) Value (Bldg) Appraised OB (L) Value (Bldg) Appraised Land Value (Bldg) Special Land Value Total Appraised Parcel Value Valuation Method: Adjustment 550,600 1,100 107,300 5,355,000 0 7,282,200 C 0 ASSESSING NEIGHBORHOOD I NBHD/ SUB NBHD NAME STREET INDEX NAME I TRACING BATCH 0000/A NOTES et Total Appraised Parcel Value 7,282,200 BUILDING PERMIT RECORD 1 VISIT/ CHANGE HISTORY Permit ID Issue Date escri lion Amount Insp. Date %Co Date Co Comments Date • e 1S ID Cd. Pu se/Result LAND LINE VALUATION SECTION B # t3se Qode Use Description Zone D Frontage Depth Units Unit Price L Factor S.A. C. Factor ST. Idz Ad'. Notes- Ad' S ial Pricing d'. Unit Price Land Value r Total Card Land Units: 0LSFTojtalLand Area:p SF Total Land Value: 0 Property Location:327 SOUTH SHORE DR I DIAP ID: 26/ 118/ / / Bldg Name: State Use:3010 Vision ID:3335 I Bldg N: 1 of 4 Sec #l: 1 of 1 Card 2 of 5 Print Date: 04/18/200812:35 CONSTRUCTIONDETAIL CONSTRUCTION DETAIL CONTINUED Element Cd. CIL Description Element Cd Clt pescription - -J] MIXED USE Code Desrription Percentage 3010 NtOTELSN194 I 100 COST/MARKET VALUATION ost Trend Factor No Photo On Record OB-OUTBUILDING & YARD ITEMS(L) / XF-BUILDING EXTRA FEATURES(B) Code Oescription Sub ISub Descri t JB Units Onit Price Yr 3de Rt Cnd nd 4prValue HD1 HDl L SHED FRANIE SHED FRANIE WIURLPOOL 1 144 30 1 3,500.00 00 1980 1980 1989 D D 1 60 70 too 700 00 1,100 BUILDING SUB -AREA SUMMARY SECTION Code Description Uvin Area Gross Area E . Area Unit Cost Undeprec. Value I T 01 01 01 1 720 75 TOWN OF YARMOUTH BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1261 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG NAME: RIVIERA BEACH RESORT ADDRESS: 327 SO. SHORE DR. S. Y. This log is to be signed by the appropriate inspectors upon a satisfactory inspection of your building/premises. When all signatures are obtained, this log shall be presented to the License & Permits office and/or the Health Department in order to obtain your license. Licenses will be withheld until all inspectors have signed. Date Comments Approved for Liccpsq Issuance Yes No Fire Department Rep. Date Comments Approved for / Licenseissuance No Board of Health Rep. Date Comments Approved for S�Gh•.6'• License Issuance SL�='10 es No Plumbin as Inspec Electrical Inspector Date �I-dM( Date Comments Approved for Lice= Issuance Ye No Comments Approved for License Issuance Yes No Taxes Paid Yes No Rev.SepL 2003 ofR TOWN OF YARMOUTH_ BUILDING DEPARTMENT N' ATT� C 9 T 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 261 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG NAME RIVIERA BEACH RESORT .ADDRESS 327 SO. SHORE DR. S. Y. This log is to be signed by the appropriate inspectors upon a satisfactory inspection of your building/premises. When all signatures are obtained, this log shall be presented to the License & Permits office and/or the Health Department in order to obtain your license. Licenses will be withheld until all inspectors have signed. Date 5.17.1d Comments Approved for License I uance es No Fire Department ep. Date Comments Approved for s'/lLicense Issuance �� (/o 0�1 No Board of Health Rep. Date Comments Approved for NlPot iu Lic ssuance d oc oz- - Yes No Plumbing/Gas Inspector Date Comments Approved for License Issuance Yes No Electrical Inspector Date Comments Approved for License Issuance Yes No Taxes Paid Yes No RevSepL 2003 o� .YgR TOWN OF YARMOUTH �} BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, NIA 02664 508-398-2231 ext. 261 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG NAME RIVERA BEACH MOTEL ADDRESS 327 SO. SHORE DR. S. Y. This log is to be signed by the appropriate inspectors upon a satisfactory inspection of your building/premises. When all signatures are obtained, this log shall be presented to theLicense & Permits office and/or the Health Department in order to obtain your license. Licenses will be withheld until all inspectors have signed. Buildi ,77s 'ione Date Comments Approved for Licease�suance U Fire Department Rep. I Date Comments Approved for cense Issuance VW��/z'l� �JYes ❑ No Board of Health Rep. Date Comments Approved for License Issuance ❑ Yes ❑ No Plumbing/Gas Inspector Date Comments Approved for Lie Issuance �n Pr�l'es ❑ No Electrical Inspector Date Comments Approved for License Issuance Yes ❑ No Taxes Paid ❑ Yes ❑ No Rev.sepL 2003 0 c T TOWN OF YARMOUTH BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, NIA 0266.1 508-398-2231 ext. 261 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG NAME RW&RA BEACH RESORT ADDRESS 327 SO. SHORE DR. S. Y. This log is to be signed by the appropriate inspectors upon a satisfactory inspection of your building/premises. When all signatures are obtained, this log shall be presented to the License & Permits office and/or the Health Department in order to obtain your license. Licenses will be withheld until all inspectors have signed. Building Commissioner Rep. Date Comments Approved for License Issuance XYes ❑ No Fire Department Rep. D4ex ate Board of Health Rep. Date r113/006 Plumbing/Gas Inspector Date 0 � oq Electrical Inspector Date Comments Approved for L' Issuance Yes ❑ No Comments 0, ,•� Approvai for Li,se Issuance e�S'es ❑ No Comments Approved for Li Is cc es ❑ No Comments Approved for License Issuance ❑ Yes ❑ No Taxes Paid ❑ Yes ❑ No RN.scpc.2003 PERMIT 106 LOT T125 Davenport, Palmer/Mugar, 327 South Shore Drive South Yarmouth, MA 02664 J 3/6/97 3/6/97 David (Riviera Beach Motel) Construct drive -through canopy, lobby modifi- cations, change door/windows, expand 2 units above canopy, hand-i-cap ramp $30,00.00 S HEET 22 C!' TOWN OF YARMOUTH APPLICATION FOR PERMIT TO DO GASFITTING Fee: PERMIT (OFFICE USE ONLY) OZ Date_ /(07SIC1�_ Building 3a-7 So�� S � Owner's p 10 I W &ACV C� AT: Location ' Name Newt' Renovation ❑ Plans Submitted Yes ❑ NOA Replacement ❑ Type of Occupancy a' N N N L) W Z W CAP cc ' W S ¢ 0 2 CW7 y O 0 m = y ¢ M 0 W a W¢cc _ Q~ A (n CAICl) a W a 2 Zcol N p > W % a Z W F- Z W m W W a 0> LL W V -J N CC W �+ y 71 � �" ,Jj M X 00 0 X u. M 3 c a g L) M o °a W o 0 SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) 6 Check One: Installing Company Name Nkw ' rc2 'X Corp. Address ��J��0.N�Jo��� ❑ Partnersh ��g 3Z %Rq BUILDINGD 2� Business Telephone to LBY Name of Licensed Plumber or Gasfitte-rV¢�bOc�✓Lt� INSURANCE COVERAGE: Cheek One have a current liability insurance policy or its substantial equivalent. Yes fit( No ❑ If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General laws, and that my signature on this permit application waives this requirement. Check One: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and Information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under Permit Issued for this application will be In compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. cl,_219`r� Signature of Licensed Plumber or Gasfitter Q 6� License Amber � TYPE LICENSE: ElPlumber L _Gasfitter 0 Master ❑ Journeyman �F, r�yg TOWN OF YARMOUTH BUILDING DEPARTMENT ' 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 261 Fax 508-398-0836 Inspection and License Report BUnDING -ELECTRICAL PLUMBING GAS TONING SIGN CODE Address 7 J 1l' — /%/ . Business Name (/ (.. Date of Inspection ' ' Contact 17, '/ �'� ' �% Phone / /J^ During the annual Inspection of your premises, performed in accordance with the provisions of Section 106 of 780 CNIR (1liassachuselts State Building Code), the Board of Selectmen and/or the Board of Health rules, the following violation (s) were observed: Eeress ❑ Emergency egress signage Location ❑ Emergency egress fighting Location ❑ Egress door hardware ❑l Maintenance of exits L4-_ Guards/Ilandmils Mechanical ❑ Combustion Air ❑ vents ❑ Storage in boiler rooms ❑ Automatic door closures on boiler room doors Smoke Detectors Other Location Location Location Location Location Location Location Location Location ( / Y .✓ c A t - _ /.�., ✓,-, — /�.: / i, Peck/Stairway Certification r 780 ChIR Section 103 MAINTENANCE provides that the owner, as defined in 780 Chin Chapter 2, shall be responsible for proper maintenance. In order to abate the above violation(s) you most: ❑ Make corrections immediately and contact thiis� office for a follow-up inspection. lY Make corrections within c/ days and contact this office a follow-up inspection. i Local Official / Inspector ✓� ' / `l - v Received By: Title Rev. 3/04 Original -Premises Yellow -Building Department Pink -Licensing Authority - - TOWN OF YARMOUTH MAY 1A 2006 APPLICATION FOR PERMIT TO DO PLUMBING (OFFICE USE ONLY) By Fee: $ PERMIT NO. ' ff—j Date 5 � -Vo 20 Building Owner's 21 v +ertflh AT: Location 'So SAorie Qfl Name New Plans Submitted Renovation ❑ Yes❑ No❑ Type of Occupancy [jctCl_ /male( Replacement ❑ ' z z_ H N y O V a M W W (n Y J M z Z V' y a 7 JO N W N N= Cn F- V � V) Z N CL LL a a�a OJ D O W O W Q U) Q W C J z 0 6. O LL I QQQJ xa =a z zW Y W►- ►W-a cYi ° x D ' a a°° .O aZ � cc ita°¢ o x N O a xM N LL C9 7 G a 1X MIS SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Check One: Installing Company Name PALi i5 PfN ❑ Corp. Address N ?..)A% ( 5--M ❑ Partnership ��O oe0elI5, WA 6Z&Gn ❑ Firm/Company Business Telephone �X 3 $S 23(� Name of Licensed Plumber TAY"e S yIA-ZAIC15 INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes ❑ No ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. A liability insurance policy 8� Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Signature or Owner or Owner's Agent 1 hereby certify that all of the details and information I have subVfted (or entered) In above application are true and accurate to the besLer my knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all, pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Check on Ow5ar-p Agent ❑ S�i aetLre of ' en Plumber QL-160 30'-►o License Number Type: MasterZ] Journeyman ❑ or (d �Z .,I MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) Sii-o 0-7 OZ Mass. Dale �a Permit # r ;)'� Bu �_— ilding Location �o? �/011744 '5'41zle h2 Owner's Name ZIVICk.eg Sn 11111-7 i Type of Occupancy Oe m m r � e* 1,f � New ❑ Renovation O• Replacement O Plans Submitted: Yes❑ 'No p C W f N z ¢ vi N V) U O ¢ ] N -t-. x T O ¢ "". O W ~ Q CC... O D W W O a C W W V) W = d r. = C W cc W ~ W r' = . ¢ c Q �� Q W> ¢ 9 C 0 O W Y O a .S O < 3 ¢ O Q tl_j Q O O O C> W o O ►.J F- a h O —85MT. BASEMENT ISTFLOOR 2ND FLOOR 3RO FLOOR 4TH.FLOOR � STH FLOOR /I 6TH FLOOR 11`✓✓ 7THFLOOR STH FLOOR Installing Compan N m Check one: Ce ificate addressPC,Corporation On O Partnekship Business Telephone 3 - O Firm/Co. Name of Licensed Plumber or Gas Fitter - INSURANCE COVERAGE: I have a current liability insurance policy. or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes V No O If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy B Other type of indemnity ❑ Bond p OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. -= Check one: Slgnalwe of Owner or Owner's Accent OwnerO. Agent O I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions, of the Massachusetts State Gas Code and Chapter 142 of the Ge eral laws. /� /� 4y_ Type of License: M1�� a & %ter y Plumber Sign re of LicensedPlumber or Gas titter Tine_ L9 Gaslitter aster license Number �( City/Town Town: _ Journeyman APPROVED (OFFICE USE ONLY TOWN OF YARMOUTH ° BUILDING DEPARTMENT, O y _ � .A a 1146 Route 28, South Yarmouth, NIA 02664 m' 508-398-2231 ext. 261 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG WM NAME: Riviera Beach Resort Address: 327 So. Shore Dr. S. Y. This log is to be signed by the appropriate inspectors upon a satisfactory inspection of your building/premises. When all signatures are obtained, this log shall be presented to the License & Permits office in order to obtain your license. Licenses will be withheld until all inspectors have signed. Building Commissioner Rep. Date Comments Approved for Lice ssuance Yes ❑ No Fire Department Rep. Date Comments Approved for Lice a Issuance es ❑ No Board of Health Rep. Date Comments Approved for License Issuance Yes ❑ No Date � 2! 07 (Elleectrical Inspector Date f". .L(1'zz(nj('::� Comments Approved for License Issuance 'V Yes ❑ No Comments Approved for License Issuance /Yes 0 No Taxes Paid ❑ Yes ❑ No Rev.sepL 2003 TOWN OF YARMOUTH BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, NIA 508-398-2231 ext.261 Fax 508-398-Ob LICENSE INSPECTION APPROVAL LOG NAME RMERA BEACH MOTEL ADDRESS 327 SO. SHORE DR. S. Y. This log is to be signed by the appropriate inspectors upon a satisfactory inspection of your building/premises. When all signatures are obtained, this log shall be presented to the License & Permits office and/or the Health Department in order to obtain your license. Licenses will be withheld until all inspectors have signed. Building Co 'ssioner Rep. - Date Comments Approved for / Licence�ss Issuance n- Ycs ❑ No Fire Department Rep. Date Comments Approved for , if Anse Issuance 1 Yes ❑ No Board of Health Rep. Date Comments Approved for Licsgse Issuance it Yes ❑ No Wei 16;e Date Comments Approved for License Issuance ,A --Yes ❑ No Electrical Ins", Date Comments Approved for \l �iccense Issuance _ O '"Yes ❑ No Taxes Paid ❑ Yes ❑ No Rev.sepL 2M OF k; TOWN OF YARMOUTH F I BLUDING DEPARTMENT `0 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 261 Fax 508-398-0836 Inspection and License Report - BUILDING ELECTRICAL PLUMBING GAS BONING SIGN CODE Address 3 Z �I . -e Business Name Date of Inspection / D Contact Phone SOc - 3%1 2 During the annual inspection of your premises, performed in accordance with the provisions of Section 106 of 780 CD1R (Massachusetts State Building Code), the Board of Selectmen and/or the Board of Health rules, the following violation (s) were observed: Egress ❑ Emergency egress signage Location ❑ Emergency egress lighting Location ❑ Egress door hardware Location ❑ Maintenance of exits Location ❑ Guardsalandrails Location ^-- Mechanical ❑ Combustion Air Location ❑ Vents Location ❑ Storage in boiler rooms Location ❑ Automatic door closures Location ` on boiler room doors ✓, Smoke Detectors Location Other Location Deck/Stairwav Certification 780 CI11R Section 103 MAINTENANCE provides that the owner, as defined in 780 CDIR Chapter 2, shall be responsible for proper maintenance. In order to abate the above violation(s) you must: ❑ Make corrections immediately and contact this office for a follow-up inspection. ❑ Make corrections within l �ldays and contact this office for a follow-up inspection. Local Official / Inspector Ue',7�L 1& ' VAX ��%�►- Received By:_ Rev. 3/03 Original -Premises Yellow -Building Department Pink -Licensing Authority APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Allwork to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 (OFFICE USE ONLY) TOWN OF YARMOUTH ey Fee: $_j 00 r L Z�3J^0 PERMIT NO. ( 6-64?0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: To the Inspector of Wires: By this application the undersigned gives notice of his or her int work described below. ^^�� c Location (Street & Number) -32 % $-D U ?'N Owner or U Owner's Address ,..,/ Is this permit in conjunction with a building permit? L� Ye? [IN. Purpose of to perform the electrical !: FFR 0 7 2005 J ne No. T (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts OverheadQ New Service Amps / Volts Overhead[] Number of Feeders and Undgrd ❑ No. of Meters Undgrd ❑ No. of Meters Location and Nature of Proposed electrical Work: Rri'moDri l- 99 R60I0-S Comneetion of the followine table may be waived by the Insneetornf tires No. of Recessed r o a l Fans No. of Total Transformers KVA No. of Li htin2 Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above n- SwimmingPool md. Q Q. [] o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Bumers FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of7l3etection an Initiating Devices No. of Ranges No. of Air Cond. T Tons No. of Alerting Devices No. of Waste Disposers Heat p Totals: um er ons — — — — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Q Local Q Connection Other No. of Dryers rY Hearin Appliances KW g PP Secutiry Systems: No. of Devices or Equipvalcnt No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or uivalent Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Q BOND[] OTHER[] (Specify:) (Expiration Date) Estimated Value of lectrical Work: (When required by municipal policy.) Work to Start: o Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete�1 FIRM NAME E ' e. m i e. 0. LIC. NO. 4 Ll1 Y 9 Licensee: t1ee- Mae nern,v Signature LIC. NO. (If applicable, enter "exem t' in the license umber line.) Bus. ,S'v Tel. No.:Fi ?SS-00a D Address: /&� i D %CC4 Die I� f . �L� �/1l r7 c/ Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Llcen%4 does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) owner owner's agent. 13 Owner/Agent Signature Telephone [Rev. 041001 TOWN OF YARMOUTH -- -- _�° BUILDING DEPARTMENT ,A" T 1146 Route 28, South Yarmouth, AIA 02664 508-398-2231 ext. 261 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG 000 3 27 NAME: RIVIERA BEACH MOTEL ADDRESS: 315-S0. SHORE DR. S. Y. This log is to be signed by the appropriate inspectors upon a satisfactory inspection of your building/premises. When all signatures are obtained, this log shall be presented to the License & Permits office in order to obtain your license. Licenses will be withheld until all inspectors have signed. Building Com issioner Rep. ate Comments Approved for e Ys�suance Fire Department Rep. Date V Comments Approved for License Issuance ❑ Yes ❑ No Board of Health Rep. Date Comments Approved for q License Issuance B�Yes ❑ No Plumbing/Gas Inspector Date Comments Approved for License Issuance 11 No Electrical Inspector Date Comments Approved for 1 rL SO—r K, nse Issuance 6Yes ❑ No Taxes Paid ❑ Yes ❑ No xev.Sepe 2003 TOWN OF YARMOUTH BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 261 Fax 508-398-0836 Inspection and License Report Address L 7 -� ` 1� / Business Nae �, m BUILDING ELEC IUCAL ----- _ _. PLUMBING GAS ZONING SIGN CODE '2 Date of Inspection S 7-7 •/7 `' Contact �� 6s , Phone _ r G G1VQG During the annual Inspection of your premises, performed in accordance with the provisions of Section 106 of 780 CNIR (Massachusetts State Building Code), the Board of Selectmen and/or the Board of health rules, the following violation (s) were observed: E2ress ❑ _ Emergency egress signage Location D� Emergency egress lighting Location �l - J . r / 3 ' O ❑ Egress door hardware ❑ Maintenance of exits C//Guards/ilandrails .•' Mechanical ❑ Combustion Air n'- Vents ❑ Storage in boiler rooms ❑ Automatic door closures on boiler room doors Smoke Detectors Other Peck/Stairway Certiticatiorr, I Location Location / A Location i��% /^+� /L �.//'r �C_ Location Location ^✓.cix�_.1:. .= � (.✓y/ 14JrW-e Location c Location 1 Location Location 780 Cb1R Section 103 MAINTENANCE provides that the owner, as defined in 780 CDIR Chapter 2, shall be responsible for proper maintenance. In order to abate the above violation(s) you must: zMake ections immediately and contact this office for afollow-up inspection. .... ections within ay; and c tact ttys� offic fo ollow- ou. Local Official / Inspector / ,F Received By: Title �► r Rev. 3/64 Original -Premises Yellow -Building Department Pink -Licensing Authority TOWN OF YARMOUTH Building Department BUILDING -- (508) 398-2231 ext.261 '- PERMIT NO FB-06-1318 ; [�'....... PERMIT ISSUE DATE :_ _@/9/2006_ _ ; PRO SEo USE ........ APPLICANT MikeMongeau : JOB WEATHER CARD .............................. PERMIT TO Repair AT (LOCATION) 100327SOUTH SHORE DR ZONING DISTRIC R-25 Bldg. Type: Resldentlal SUBDIVISION MAP LOT BLOCK 1026.118 BUILDING IS TO BE: CONST TYPE USE GROUP = LOT SIZE strip and rerooi, 53 squares, paper and vent to code REMARKS AREA (SO FT) EST COST ($ $11,500.00 PERMIT FEE ($) $60.00 OWNER RIVIERA BEACH LTD PARTNERSHIP BUILDING DEPT BY ADDRESS 120 North Main Street South Yartram I MA 102W4 INSPECTION RECORD Date „ Note Progress - Corrections and Remark CONTRACTOR LICENSE 06670 Mongeau, Mike 77 Traders Lane West Yarmouth MA 026M 5087789797 PHONE 15=989694 FIELD COPY EXPRESS ASSESSOR'S INFORMATION: Permit Fat Pernik expires 6 rodaths from i issue date. APPLICATION - - -- -. TOWN OF YARMOUTH - __ Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 C3 -2� •7 ❑ Residential PcAmaurciiaal((11 Est Cost of Construction S Home Improvement Contractor Lia # I 7 r Construction Supervisor Lia # _ n 6 /V _ Workman's Compensation Insurance: (check one) ❑ I am the homeowner ❑ I am the sole proprictori/[ have Worker's Compensation Inwrance Insurance Company Name: Worker's Comp. Policy# SIF0 K zce0(ti, ❑ Tara (Fire Retardant Certillcate attached) Duration Wood Stove Shed ❑ Siding # of Squares ❑ Replacement windows: # ❑ Replacement doors: # kf: # ofSquarcs ,, \\ tnpping old shingles* ( ova root *The debris will be disposed of at x Ucati'on of Facility I declare under penalties of perjury a shtemen is coNained am true and correct to the best of my knowledge and belief I understand that any fdse answers) will be just canoe for deaial or of i for prosecvtien under MO.L Ch. 268. Section 1. Applicant's Siouan:, Date: Owners Signature (or ) Date: Approved By'. Date: BuildingOfficud (or designee) Zoning Distrlct�- 1/ Historical District: ❑ Yes Sct: o WaterResource Proton Dis ❑ Yes Y-_No Flood Plain Zone: Yes es I WithinRctlannes ❑ No No 3N1 Department oflndustrial Accidents Office oflnvestigadons 600 Washington Stred Boston, MI 02111 NkEw www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information - _- _ -- _ _ - Please Print Leeibly City/StateMp:( jt) - tAPhone M i `? 8-% ?q !% Ap 'you an employer? Check the. appropriate box: fI am a employer with _. ,� 4• employees (fa and/orpakt•time).• 2. ❑ I am a sole proprietor or pnlz=- ship and have no employees working for me in any capacity. [No workers' amrp. insurance 5• required.] 3. ❑ I am a homeowner doing all work myself [No workers' comp. uuurance required.] t ❑ I am a general contractor and I have hired the sub -contractors listed on the attached sheet = Thcse sub -contractors have workers' comp. insaranco. ❑ We are a corporation and its officers have exercised their right of exemption per MGL a 152, J 1(41 and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling S. ❑ Demolition 9. ❑ Bufldmg addition 10.0 Electrical repairs or additions 11.❑ Phrmbing repairs or additions 12.❑ Roof repairs 13.❑ Other -may apprraod that caecta box xi alas atso U out Me section below sbowmg ffieir warden' wmpeoa&tion Policy information t Homeowaen who R&rrd ffiis affidavit mina they an doing all wort sad then tan outside eosbnch n nand submit a new affidavit indicating such tContacbn the cheek We box rout allschW am addideoel abed showing the name of the subcoutnctors and then worteo' cooV6 policy iafornatiom MIMMEMEMME MINE I an an employer that It provldtng workers' eontpemadon buUMMO jor ANY empio/ye/es Below is de policy and job sits e: Insurance Company Nami �� a („ I,2 � � l/1_ Policy # or Self -ins. Lic. li, Job Site Addreu: 7 2 CitystateMip. ' ' Attach a copy of the worker' compensation policy declaration page (showing the policy number and expiration date). Failure to secure wvcrage as required under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year mVrisonment, as well as civr7 penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage vcrificatiom I do hereby certify penakin of perjury that the information provided above, Is &W and correct Offlelal use only. Do not wrtye In this area, to be completed by city or town o,Q7ckL City or Tots: PermWUcense 0 Issuing Authority (circle one): 1. Board of Health 2. Building Deport, at 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: lniormauun anu illatl u��=�u►� '. ter 152 require all employers to provide workers' compensation for their employed.. Massachusetts General Laws is defined as "...every person in the rewire of another under any contract of hire, pursuant to this statute, an employ - - ` express or implied, oral or written." An employer is defined as "an individual, partnership, association' Corporation or other legal entity, or any two or more the of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employ or the receiver or trustee of an individual, partnership, Association or other legal entity, employing employccL owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling horse of another who employs persons to do maintenance, construction or repair work on such dwelling house or building appurtenant thereto shall not because of such employment be deemed to be an employs." or the grounds MGL chapter 152, §25C(6) Also states that "every state or local Ileensing agency shall withhold the issuance or renewal of a license or permit tooP erste a business or to construct buildings in the commonwealth for any_ evidence of compliance with the Insurance coverage required." applicant who has not produced Acceptable Additionally, MGL chapter 15Z §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall ; e performance of public work until acceptable evidence of compliance with the insurance, cater into any► contract for th requirements of this chapter have been presented to the contractingauthority." ---_ Applieanb ation affidavi ary necess. supply sub-ContractorKsS) name(� t completely, by checking the boxes that apply to your Situation and, if please y out the workers' ctOns a addresses) and pbone number(s) along with their certificates) of ones (L.LC) or Limited Liability Partnerships (L.I.P) with no employees other than the insurance Limited Liability Come m workers' compensation insmancx. if an LLC or LLP does have members or p nc' are �t 2e�� tent be submitted to the Department of Industrial employees, a policy is required. Be advised that this affidavit may Accidents for confirmation of insurance coverage. Also be sure to sign and date the atfldarlavl � �Dep��t>M Of be returned to the city or town t o �ed�g or license is being requested. to obtain a workers' Industrial Accidents. Should you the law or if you are ralua� Compensationpo cy,P • li lease call the Department at the number listed below. Self -insured companies should enter their self-insurance If nambtr on the te line. 1011111 City or Town 0MCIala ti Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bot of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding �applicant. Please be sure to fill in the permidlicense member which will be used as a reference number.. In addition, an applicant that roust submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and Hader "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a horse owner or cid= is obtaining a license or permit not related to any business or commercial ventur e (ie. a dog license or permit to burn leaves etc) said person is NOT required tocomplete this affidavit 7be Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not besitate m give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents OMce of Investigations 600 Washington Street Boston, MA 02111 TeL # 617-727-4900 east 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 5-26-05 www•mass.gov/dia HIKE MONGEAU 77 Traders Lane W, Yarmouth, MA 02673 Proposal Name: Street: City: State: (508) 778-9797 . Cell (508) 367-2646 Lic. No. 006670 matted To: Mailing Address Zip Code: PROPOSAL Date: Work to be performed at: Street: \Vigl City: c - State: Zip Code: Home Phone: Work: NOTES/Suggestions:C'� AF> •- . //�, L '? LY5rej We Hereby propose to and perform the labor necessary for the completion of: 1. �kp,JR oS &- (b) Removing old roof, Install new roof with a J . a shingle estimate (�3 __) sq, This price will include a year warranty on workmanship, new aluml- num drip edge, 15# felt underlayment, roof vent collars, install ice and water barrier around chimney, valleys, nail loose boards, clean gutters, and total clean up and removal of all debris. Color of roof is to be 13u 1�) 2. Venting - can be critical on certain homes (a) Install[? ft. of Cobra continuous ridge vent $ (b) •InStdi_ — —ft-of-Hieks vented-dr47-edg-uzn-soffit. $ (c) Do not want to upgrade venting. / n (d) Other 'S yg" cvr �"��� r< �L� 17 i, .UL� 5k'.!C,��:x%�-5, try. All material in guaranteed to be as specified, and the above work to be performed in accordance with the specifications submitted for above work and completed in a professional workmanlike manner for the sum of $ GO , with payments to be ma 0 follows: Deposit of $ Balance due upon comple i Respectfully ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined obovV Date: �� • Signature: _ __ G � We rorerve the right tcd re ace any rotted or broken roof or trim boards. This will be an e a cost above the quote roof price. The charge for this will be, if needed, $50(hr. plus materials. All agreements contingent upon accidents or delays beyond our control. Outstand- ing balance over 30 days will Incur 1.5% finance charge per month. Owner to remove oil valuables from walls. Liability insurance on all above to be token out by: Mike Mongeou PERMIT 151 t ° P LOT T125 / c%c`v• ell s ✓ 3/16/99 3/16.4/99 .�/gy/f14 0/4<� U-L&'7 Riviera Beach Res /Davenport Assoc. 327 South Shore Drive South Yarmouth, MA 02664 Replacing existing in -ground pool $60,000.00 SHEET 22 TOWN OF YARMOUTH Applicati n for a Permit to Build UPON FINAL APPROVAL 2), MAP 2-FEE MUST ACCOMPANY TH��IqLICATIO2 N. DATE The undersigned hereby applies for a permit to build according to the following specifications 1. Name of property owner 'V i Address 2. Name of Architect (if any) 3. Name of builder �OUV .SXa(P �Un,le -6 4. License No. 0 !2 � 20 Tel. 5. Name of Mason 6. License No. 7. Construction address Tel, 8. Date of subdivision Approval jplair 9. Private dwelling ❑ Estimated Cost 10. Multifamily ❑ E 62 0a 6'00 11. Commercial 12.Other ❑ 13. No. of stories �- 14. Foundation — Full ❑ Half ❑ Crawl ❑ Slab ❑ 15. Materials — Wood ❑ Cement ❑ Other ❑ 16. Type of heat — Oil ❑ Gas ❑ Electric ❑ ' Other ❑ 17. Garage —1 ❑ 2 ❑ 18. Swimming pool - Size 7y, �P�� ����' S G/, es�- Poll ' 19. Storage shed — Size 20. Stove — Wood ❑ Coal ❑ 21. Size of lot: No. of feet front 22. Size of building. No. of feet front aim 51 t�-L No. LOT i / 2-'S— A Tel. S0Lf -- 79� 3 i uistnct zone i Zone ��`�1'— DO NOT WRITE IN THIS SPACE �DOO 6 r-1tt,, Type of room I No. 1� l ""_""M 1 Cs� ` Kitchen Dining Rm. Living Rm. Bed Rm. Bath Deck Closed porc Family Rm. Sun room No. of feet rear No. of feet side Shed Alterations No. of feet deep _ _ No. of feet rear 23. Distance from nearest building: Front Ft. side Ft. side Rear 24. Distance back from line or street Q,00+ From rear lot line b� Side line of Ot 25. H.I.C.R. No. )Ly-gS LOT RELEASED BY PLANNING BOARD Date Signature Addre t._ The Commonwealth of Massachusetts Department of Industrial Accidents Bolen oflaMOSOJONS 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit �,i U��/iF1r/YllSllth phone O 1 am a homeowner performing all work myself. O 1 am a sole proprietor _ad haN a no one working in any capacity Cg 1 am an employer pro%iding workers' compensation for my employees working on this job. chy.8 /V 4T. Law � f'YlA phone#: ( VO �....���. 0. A f A noliev 0 U/CC l Y V 7eV /9 X 1 am a sole proprietor. general contractor, or homeowner (circle one) and have hired the contractors listed below who have the follow in_ workerscompensation polices: Failure to secure coverage as required under Section 2SA of MGL 1S2 can lad to the imposition of criminal penalties of a One up to 51,5"A0 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against ma 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify unlfyr the pains and penalties of perjury that the information provided above is true and correct 109 : r S00 �G'y9- P-a S-0 Print name I fficial use only do not %rite in this area to be completed by city or town official city or [own: YAR140UM p check if immediate response is required permitnicense 0 mBuilding Department pl.ietnsing Board 261 ❑Selectmen's Ogee (508) pHcaltb Drpartmeat 398 2231 t phone 0; _ ea riOther• contact person: 0ned s,vs Put Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their etttpluyees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An entphr ver is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the _rounds or buildings appurtenant thereto shall not because of such employment be deemed to be an employer. %IGI_ chapter 152 section also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionaliy, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha%e been presented to the contracting authority. Applicants Please till in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the `law" or if you are required to obtain a workers' compensation policy. please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The aMdavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents MCI of INVIS910122 600 Washington Street Boston, Ma. 02111 fax ll: (617) 727.7749 phone #: (617) 7274900 ext. 406, 409 or 375 BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: JOB LOCATION: STREET OWNER OF PROPERTY CONSTRUCTION SUPERVISOR: ADDRESS: LICENSED DESIGNEE: (IF OTHER.THAN SUPERVISOR) NAME LICENSE NO. 2.15 RESPONSIBILITY OF EACH LICENSE HOLDER: 2.15.1 THE LICENSE HOLDER SHALL •BE FULLY AND COMPLETELY RESPONSIBLE FOR ALL WORK FOR WHICH HE IS SUPERVISING. HE. SHALL BE RESPONSIBLE FOR SEEING THAT ALL WORK IS DONE PURSUANT TO THE STATE BUILDING CODE AND THE DRAWINGS AS APPROVED BY THE BUILDING OFFICIAL 2.15.2 THE LICENSE HOLDER SHALL BE RESPONSIBLE TO SUPERVISE THE CONSTRUCTION, RECONSTRUCTION, ALTERATION, REPAIR, RDIOVAL OR DEMOLITION INVOLVING THE STRUCTURAL ELEMENTS OF BUILDING AND STRUCTURES ONLY PURSUANT TO THE STATE BUILDING CODE AND ALL OTHER APPLICABLE LAWS OF THE COMMONWEALTH, EVEN THOUGH HE, THE LICENSE HOLDER, IS NOT THE PERMIT HOLDER BUT ONLY A SUB— CONTRACTOR'OR CONTRACTOR TO THE PERMIT HOLDER. 2.15.3 THE LICENSE HOLDER SHALL IMMEDIATELY NOTIFY THE BUILDING OFFICIAL IN WRITING OF THE DISCOVERY OF ANY VIOLATIONS WHICH ARE COVERED BY THE BUILDING PERMIT. 2.15.4 ANY LICENSEE WHO SHALL WILLFULLY VIOLATE SUBSECTIONS 2.15.1, 2.15.2 OR 2.15.3 OR ANY OTHER SECTION OF THESE RULES AND REGULATIONS AND ANY PROCEDURES, AS AMENDED, SHALL BE SUBJECT TO REVOCATION OR SUSPENSION OF LICENSE BY THE BOARD. 2.16. ALL BUILDING PER.`IIT APPLICATIONS SHALL CONTAIN THE NAME, SIGNATURE AND LICENSE NUMBER OF THE CONSTRUCTION SUPERVISOR.WHO IS TO SUPERVISE THOSE PERSONS ENGAGED IN CONSTRUCTION, RECON- STRUCTION, ALTERATION, REPAIR, REMOVAL OF DEMOLITION AS REGULATED BY SECTION 109.1.1 OF THE CODE AND THESE RULES AND REGLUTIONS. IN THE EVENT THAT SUCH LICENSEE IS NO LONGER SUPERVISING SAID PERSONS, THE WORK SHALL IMMEDIATELY CEASE UNTIL A SUCCESSOR LICENSE HOLDER IS SUBSTITUTED 0.1 THE RECORDS OF THE BUILDING DEPARTMENT. I HAVE READ AND UNDERSTAND MY RESPONSIBILITIES UNDER THE RULES AND.REGULATIONS FOR LICENSING CON- STRUCTION SUPERVISORS IN ACCORDANCE WITH SECTION 109.1.1 OF THE STATE BUILDING CODE. I UNDERST4Ld, THE CONSTRUCTION INSPECTION PROCEDURES AND THE SPECIFIC INSPECTION AS CALLED FOR BY THE BUILDING OFFICIAL. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGLiCh.152 Yes K No ❑ If you have checked ves. please indicate the type coverage by checking the ap;,rcpriate bex. A liability Insurance pc:icy9 Daher type of :ndemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the ucensee doei not have the insurance coverzge• required :y Chapter 52 of t Mass.' General Laws. ana that my signature on th:s permit cc;lication waives this requiternea- �/hpy��,� Check one: �1^�_ OwnerJ Agent SIGNATURE: BUILDING OFFICIAL APPROVAL: PLOT PLAN AbuttorIs Name Lot # If this is a corner lot, write in name of street. FOR LOT # / D / Indicate location of garage or accessory building Additions with dashed lines -------------------- Sewerage disposal (cesspool) Well p� I I I(lot................ft. rear) SIDE YARD REAR YARD SIDE YARD d _ _/1�t2.f FT SET BACK .. AL I (lot..................ft. frontage) SoU9 r„� ate & ✓e \ / (NAME OF STREET) / \ Information / \ \ Supplied by MARK NORTH POINT Abuttor I s Name Lot # If this is corner 1z write in name of a other 8 street. b 4 BUILDING PERMIT APPLICATION SIGN OFF APPLICANT: v BUILDING PERMIT #: ADDRESS: A TELE. NO.: pW-6 y p j'0to DATE FILED: 3 ! BLDG. SITE LOCATION: 397JQL*/ core Orole MAP#: LOT#: X THE FOLLOWING INFORMATION OUTLINES THE PROCEDURAL STEPS REQUIRED TO OBTAIN A PERMIT TO BUILD, ALTER, OR ADD TO A STRUCTURE WITHIN THE TOWN OF YARMOUTH. THE BUILDING DEPARTMENT WILL DETER- MINE COMPLIANCE TO THE FOLLOWING (A) ZONING REQUIREMENTS (B) HISTORICAL DISTRICTS (C) FLOOD PLAINS ZONING. THE BUILDING DEPARTMENT WILL BE RESPONSIBLE FOR ASSISTING THE APPLICANT THOUGH THE FOLLOWING DEPARTMENTS: WATER DEPARTMENT: ENGINEERING DEPARTMENT: CONSERVATION COMMISSION: HEALTH DEPARTMENT: FIRE DEPARTMENT: RESIDENTIAL AND/OR COMMERCIAL BUILDING DETERZIINES COMPLIANCE OF WATER AVAILABILITY. DETERMINES COMPLIANCE FOR PARKING AND DRAINAGE. DETERMINES COMPLIANCE TO WETLANDS ACTS, I.E.: IF LOTS) BORDER ANY TYPE OF WETLANDS, STREAMS, PONDS, RIVERS, OCEANS, BOGS, BAYS, MARSH LAND, ETC. DETERMINES COMPLIANCE TO STATE AND TOWN REGULATIONS, I.E.: REQUIRE- MENTS FOR SEPTAGE DISPOSAL AND OTHER PUBLIC HEALTH ACTIVITIES. DETERMINES COMPLIANCE TO STATE AND TOWN REQUIREMENTS FOR PERSONAL SAFETY, PROPERTY PROTECTION, I.E., SMOKE DETECTORS, SPRINKLER SYSTEMS, ETC. THE FOLLOWING DEPARTMENTS MUST SIGN OFF, IN THE RESPECTIVE ORDER, PRIOR TO BUILDING INSPECTOR ISSUING THE REQUIRED BUILDING PERMIT: REVIBY: 1. W WATER DEPARTMENT DATE / N/A: 2. ENGINEERING DEPAR DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMEN ATE: N/A: INDUSTRIAL AND/OR COMMERCIAL PERMITS 5. WIRING INSPECTOR: DATE: N/A: 6. PLUMBING INSPECTOR: DATE: N/A: 7. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE ALL STUMPS AND/OR BRUSH MUST BE DISPOSED OF AT AN APPROVED SITE. A SIGNED RECEIPT FROM THE DISPOSAL SITE MUST BE SUBMITTED TO THE BUILDING DEPARTMENT PRIOR TO ISSUANCE OF THE BUILDING PERMIT. BLM 89 TOWN OF YARMOUTH BUILDING DEPARTMI 1146 Route 28, Sonth Yarniouth, NIA 508-398-2231 ext. 261 Fax 508-398-08 NAME: RIVIERA BEACH RESORT ADDRESS: 327 SOUTH SHORE DR S. Y. This log is to be signed by the appropriate inspectors upon a satisfactory inspection of your building/premises. When all signatures are obtained, this log shall be presented to the License & Permits office in order to obtain your license. Lictnses will be withheld until all inspectors have signed. Building i er Re ate Comments App avad for Lice= Lwum= ❑ Yes ❑ No Fire Department Rep. Date Comments Approved for Licenseme Lif s �j -�� tq- Yes Wua❑ No Boar# of Health Rep. Date Comments Approved for Iicease Lsaw= bQYcs ❑ No Electrical Ins pector I Date Comments Approved for License L�suanco 1�Yes ❑ No Date L( i Va A Comments Approved for qp&= wuw= Yes ❑ No Taxes Paid ❑ Yes ❑ No Rev.Scpt 2003 I & TOWN OF YARMOUTH APPLICATION FOR PERMIT TO DO PLUMBING (OFFICE USE ONLY) By—ZA)LI-t . Fee: $ 411 7�&4,0 PERMIT NO. P- ()n- Iy ja Date !' -I I 2005— Buildi g Owner's fQe`p 71kC% --74rL4j4en4 hack AT. Location 32-50 . ,S6np c>(L - Name PA-Vc RL- QvtSS X%vto'- Type of Occupancy Cbwr _ New ❑ Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No ❑ `1z Z Y z N J N U FQ- > in Y z y H u] w Q M_ Q 2 � O z O z N z W o CC OJ N W N t!1 W = 0 F- U M N Q N LL i1 Q � U W Co O CC W Q z o Q J Z 0 a cc O LL J W = O F Q W 3 Q 0 0 z= 3 W J Y V7 a 0: O H Q Y a Q W G LL U. Y M W L d Q ZQ OJ OJ Q S W P Q O 0 = 3 Y J m 0 O O O = F- ur LL 0 M M 0 e Q 9 0 X Q m H 0 SUB-BSMT. BASEMENT 2 I 1ST FLOOR ►� 13 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) 7 n Installing Company Name Check One: ❑ Corp. Address ICI LTG . ❑ Partnership — to etn n-% 5 VhA 02(oGo [9,11rm/Company Business Telephone SOcG -3Bs-'Z317_ Name of Licensed Plumber INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes 0 No ❑ If you have checked YES, please indicate the type of coverage by c cking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check on Owner Signature of OwnerorOwner'sAgent I hereby certify that all of the details and Information I have submed ' ure of Lic (or entered) in above application are true and accurate to the be t of Plumber my knowledge and that all plumbing work and Installations performe under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and License Number Chapter 142 of the General Laws. Type: �/ Master❑ Journeyman L7 G T -,Or JpT UTH MAY 1i2�05 D By �'� 3Z APPLICATION FOR PERMIT TO DO GASFITTING (OFFICE USE ONLY) By dW . Fee: $ PERMIT NO.�—OrJ— R7B Date ullding— Owner's AT. Location 317 5O, 61 o vn e Dr-, Name 'kef> SAc12c ^iAAecy Gbn 7 _ New ❑ Renovation ❑ Plans Submitted Yes ❑ No ❑ Replacement ❑ Type of Occupancy IDIM - w Y N ¢ p Z 2 uj M WF C7 J O FEW- Q} Z Z �O I=�-- W m W r a w = w z 0 �- 0 N a¢ O W > a w °C rn w z a = ¢ ¢ W O aat w F- y z FW, a z w '.I F- a Z cc t W I- W > ur O> Z u' O Iw- V w J r In W cccc S O = M 3 0 a g V ¢> 0 H o ta.7 U. raj a. SUB-BSMT. BASEMENT 1 1ST FLOOR 2ND FLOOR 1 3RD FLOOR (PRINT OR TYPE) p Installing Company Name Address 1 L-1 6 n L-+ v 'RD SO. oeyin% f Vh4 , c5z(,06o Business Telephone —I � � S 2� 12 Check One: ❑ Corp. ❑ Partnership — CB'Pirm/Company Name of Licensed Plumber or Gasfitter Arwt eA ")41 S 3n t INSURANCE COVERAGE: Check One I have a current liability insurance policy or its substantial equivalent. Yes M' No ❑ If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy E?' Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent I hereby certify that all of the details and Information I have (or entered) in above application are true and accurate to tl my knowledge and that all plumbing work and Installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. License Number TYPE LICENSE: LT Plumber ❑ Gasfitter ❑ Master Journeyman 9tv TOWN OF YARMOUTH BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 261 Fax 508-398-0836 Inspection and License Report BUBOING tLECMCA. PLUMBING GAS TONING ,r SIGN CODE Address j U • . `� <. iJ / • / Business Name �I /�-t%— f?G'� .mil 1 i w7 Date of Inspection "rl I • yr Contact Phone 7 L � - z 7 During the annual inspection of your premises, performed In accordance with the provisions of Section 106 of 780 CI11R (Massachusetts State Building Code), the Board of Selectmen and/or the Board of Ilealth rules, the following violation (s) were observed: Egress 7 ❑ Emergency egress signage Location ❑ Emergency egress lighting Location ❑ Egress door hardware Location ❑ of exits Location �Maintenance Q/ Guards/Ilandrails Location Mechanical ❑ Combustion Air Location ❑ Vents Location ❑ Storage in boiler rooms Location ❑ Automatic door closures Location on boiler room doors Smoke Detectors Location Other Location( Deck/Stairway Certification ri..i /., n 7 v/.c ✓l lrJ //-.ice /,.c A Z/r ,*,... .f (.A . ✓ c' .'/�- fir.... .�_ . � J /%1• CA 790 C111R Section 103 MAINTENANCE provides that the owner, as defined in 790 CAtR Chapter 2, shall be responsible for proper maintenance. In order to abate the above violation(s) You must: ❑ Make corrections immediately and contact this office for a follow-up inspection. � r Make corrections within /C" ays x dd contact this Local Official / Inspector L- Received By: - 3 Title Rev. 3/04 Original -Premises Yellow -Building Department for a f019w_up inspection. Pink -Licensing Authority r 3 L} / rsc' ? of k TOWN,OFrI(ARMOUTH Building DepartmentAd BUILDING (508) 398-2231 ext.261 ........ PERMIT NO. �FB-05-915- PERMIT wAlpk, ISSUE DATE' t, :• PROPOSED USE 1/28/2005 _ ....•--•- f3 JOB WEATHER CARD Sauro APPLICANT .David ' PERMIT TO Repair AT (LOCATION) 100ii7SOUTH SHORE DR ZONING DISTRICTEfl Bldg. Type: Commercial SUBDIVISION MAP LOT BLOCK 1026.118 BUILDING IS TO BE: CONST TYPE= USE GROUP= LOT SIZE residing 15 squares, 27 replacement sliders REMARKS AREA (SO FT) ,J( irw < • diti, EST C.RST ($ $30,000.00 PERMIT FEE OWNER IRIVIERNBEACKLTD 7ARTNERSHIP BUILDING DEPT BY ADDRESS 100327SOUTH SHOR DR • . - ✓;!' F'�1tiurt,nd INSPECTION RECORD tr CONTRACTOR LICENSE 072866 Sauro, David 20 North Main Street South Yarmouth MA 026U 5083982293 FIELD COPY Date INote Pro ress - Corrections and Remarks Inspector f !i / J. ....,.. .tat.;�t�..r ..�,, /�i-and � 1• .; EXPRESS BUILDING PERMIT APPLICATION r`'J' TOWN OF YARMOUTH Yarmouth Building Department 1rs 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 Ext. 261 CONSIRUMONADDRlS5:7 ASSESSOR'S INFORMATIOR Map: Parcel: nwwr���/%riirPH .C.LC� c�CJ �/OP.�� /��-•C:S� _ � 0 u«:6»tlom s3 qP-aa23 0 Residcatial t❑�Carrtmadal PsL Cost of Con*uc ion S 3d / 00 0 Home Improvement conhactorik. a/ �G�b� 4/ construction sw isorl k Workmen's Compeasatim losw== (check one) ❑ 1 am the homcownncr 0 �C7 ey 1 am the sole propcidal l Lave Wakces Compeaaafm Iurance lama= Compmy NamrZg--- r4�'c%'�Ps cam- wakds Comp. Poagj C!J c $� 9�i oc� i�o �O WORK TO BE PERFORMED a Test (FoeRdwdntcatificsk Doratioo wood Stan shed . lo�� u of squares �� o Roplaccwc t windows: iaeeaoat aoo<a r o2 7 ❑ Re -EWE N of sgm= ()VjiP0ngddAi0fw ( )going cvczIsym of -.;sling roor *rho debri3 wf be disposed of Facilely M I declare miler peaabies of perjury 1hN the 1;satatea�ee,t�a .I is codaiaed are toe and coaedto the bat of my bnwledge and belicE I uDdashnd that soy false amwa(s) Will he just com for dcniA ormo•atiou ofasy —'fT snda Ma.L (h 26S, Section 1. Approved By. Data Building Official (or "go") Zoning District;---�K"�- `— IfigodcalDistdcL 0 Yes ❑ No Flood Plain Zone; ❑ Yes ❑ No Water Resource Proration District Within 1001L of Wetlands: ❑ Yes ❑ No ❑ Yes ❑ No 3/01 TOWN OF YARMOUTH Building Department BUILDING (508) 398-2231 ext.261 9VOI PERMIT NO FB.05-658- ISSUEDATE ; _ 11/10/2004. ; PROPOSED USE PERMIT APPLICANT :David cox :::::: -- �---- - - - - -' JOB WEATHER CARD PERMITTO 'Repair -- AT (LOCATION) ZONING DISTRICTE2fl Bldg. Type: Commercial 100327SOUTH SHORE DR SUBDIVISION MAP LOT BLOCK 1026.118 BUILDING IS TO BE: CONST TYPE USE GROUP= LOT SIZE strip and reroof, 10 squares, paper and vent to code REMARKS AREA (SO FT) EST COST ($ [$2,000.00 PERMIT FEE ($) 1$35.00 OWNER IRIVIERA BEACH LTD PARTNERSHIP BUILDING DEPT BY ADDRESS JPOB401 South Yarmouth MA 02664 INSPECTION RECORD CONTRACTOR LICENSE 063537 Cox David 77-71 19 Lavender Lane West Yarmouth MA 02673 6087753469 FIELD COPY Date I Note -Progress - Corrections and Remarks Inspector e NOV 1 0 004 EXPRESS BUILDING PERNUT APPLICATION TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 Ext. 261 • : u' Ii �/ _' 0L{ /I rot, l[E—p Oaks UM Oetd , ; v 1'amit ��5, Fps ftmk *Vim 6 aeonths lion ❑ Residential vCatnmeseial Fsi Cost of Canstroctiea: Z , /i///% J. Home hweoraneat Canhactor Uc. ay T Jj Coostrnctian SaparisarLic / /; S ��� �. WaktnWs Campc=a im h=anea (ebmk aoe) 111 am the homeowner 111 am the sole pa WWJXI have we=k eS Ca WCMbOn hueaoce Insurance CampauyName ,� �/Y 7O���wcdoces Camp. Pdicyi (mac 7-�'��� WORK TO BE PERFORMED O Temt (Fire RawdsotCati5oleattached) Doatioa wood slave Shea O SidizV (i of Squrea O Reptaoemeat wiwd - d O Repiaameo/ doom t YReaooP Bofsewem () old thislocso () 6oio6 ovclbyes ofeaisliagrod *rho debris win be dispwed ofat:> d eL�l1lJT2V lmcaliar of Faeliy l delve soda pmaltirs orpaj y the Wa sWeaara4 herein eoatained ere and coed la the bat of my knowledge and bdiei 1 tmda*md the ray fabe answer(s) will be just cause for denial at of my liceeme mddffar M.O.L Ch 26S, Secsioa 1. Applicant's Signateaex!-/��/ owaas Suture (o aarbmm / .l \./ _ 4�CrCcl �J ib1C desi8AeC) Histmical District ❑ Yes 4 No Water Resource Protection District: 0 Yes '14 No W Flood Plain 7.00ew V Yes ❑ No Within of We:Uand.� Yes ❑ No 3101 oF. TOWN OF YARMOUTH 0.3 BUILDING DEPARTMENT A. s _ 1146 Route 28, South Yarmouth, A1A 02664 508-398-2231 ext. 267 a DIRECTIONAL SIGN APPLICATION Date: 12/1/2002 Permit No. 28 Application Is hereby made for a permit to maintain and advertising sign, so taped' Public Information Sign', In accordance with Sec.8,Chapt.85 of the General Laws. RENEWAL FEE: $10.00 Payable upon receipt PERMIT EXPIRES: 1-02-2004 Permit is issued pursuant to Yarmouh Sign Code, Art 303;sec.3.2.1 shall require a permit to be issued by the Building/license Dept. In accordance with Chapt.85 of General Laws. These will be limited to a, ma)amum size of Five and one half by forty inches and will include only identification of business. The lettering will be black with background. These signs must be placed on racks in locations approved by the Yarmouth Department of Public Works. An annual fee, determined by The Board of Selectmen may revoke any permit at any time, for any infraction of the regulation. BUSINESS: Riviera Beach Motor Inn LOCATION: South Shore Drive & Sea View Ave WORDING: Riviera Beach Motor Inn OWNER/ AGER: Davenport Realty Trust ADDRESS:3a7 South Shore Drive, South Yarmouth, Ma 02664 Phone: 508.398-2293 MAIL ADDRESS: 20 North Main St, South Yarmouth, Ma i vP-er"ta Signature of Pers autho ' agent, to Title Whom permit is to granted. Date Please Note: 1) Application form must be submitted for each permanent sign 2) The Building/license official shall be notified within ten (10) days of any change in the above information oF. TOWN OF YARMOUTH a$ �G BUILDING DEPARTMENT �...� �t. 1146 Route 28, South Yarmouth, NIA 02664 508-398-2231 ext. 267 DIRECTIONAL SIGN APPLICATION Date: 12/1/2002 Permit No. 29 Application Is hereby made for a permit to maintain and advertising sign, so caged' Public Information Sign', in accordance with Sec.8,Chapt.85 of the General Laws. RENEWAL FEE: $10.00 PERMIT EXPIRES: 1-02-2004 Payable upon receipt Permit is issued pursuant to Yarmouh Sign Code, Art 303;sec.3.2.1 shall require a permit to be issued by the Building/license Dept In accordance with Chapt85 of General Laws. These will be limited to a, ma)dmum size of Five and one half by forty inches and will include only identification of business. The lettering will be black with background. These signs must be placed on racks in locations approved by the Yarmouth Department of Public Works. An annual fee, determined by The Board of Selectmen may revoke any permit at any time, for any infraction of the regulation. BUSINESS: Riviera Beach Motor Inn LOCATION: South Street & Old Main WORDING: Riviera Beach Motor Inn OWNER/MANAGER: Davenport Realty Trust ADDRESS: South Shore Drive, South Yarmouth, Ma 02664 MAIL ADDRESS: Signature of Pb Whom permit is North Main St, South Yarmouth, Ma or authorized agent, to e granted. Phone: 508.398-2293 16 ✓P— elo Title Date M Please Note: 1) Application form must be submitted for each permanent sign. 2) The Building/license official shall be notified within ten (10) days of any change in the above information. �4•YAR TOWN OF YARMOUTH BUILDING DEPARTMENT ., 1146 Route 28, South Yarmouth, I11A 02664 yam S d 508-398-2231 ext. 261 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG NAME: Riviera Beach Resort ADDRESS: 327 So. Shore Dr. So. Yarmouth, Ma This log is to be signed by the appropriate inspectors upon a satisfactory inspection of your building/premiscs. When all signatures are obtained, this log shall be presented to the License & Permits office in order to obtain your license. Licenses will be withheld until all inspectors have signed. Building Commissioner Rep. Date Comments Approved for License Issuance ❑ Yes ❑ No Fire Department Rep. Date Comments Approved for License Issuance U Yes ❑ No Board of Health Rep. Date Comments Approved for License Issuance Ij Yes ❑ No Plumbing/Gas Inspector Date Comments Approved for License Issuance ❑ Yes ❑ No Electrical Inspector Date Comments Approved for License Issuance ❑ Yes ❑ No Taxes Paid ❑ Yes ❑ No Rev.Sept 2003 TOWN OF YARMOUTH Bulidin artment BUILDING (508CUSE a .261 PERMIT NO --6-03....: .....---- PERMIT --=------- ISSUE DATE :3[21JQ3_ _: PROPOAPPLICANT -RIVIERA BEACH LTD PARTNERJOB WEATHER CARD ADDRESS :00327 SOUTH SHORE DR PERMIT TO Repair AT (LOCATION) 100327SOUTH SHORE DR ZONING DISTRICT R-25 SUBDIVISION MAP LOT BLOCK 1026.118 BUILDING IS TO BE USE GROUP R-4 LOT SIZE CONST TYPE 5-B CONTR'S 072866 strip and reroof, paper and vent to code. REMARKS AREA (SO FT) EST COST ($ $8,000.00 PERMIT FEE ($) $60.00 OWNER RIVIERA BEACH LTD PARTNERSHIP ADDRESS 00327 SOUTH SHORE DR BUILDING DEPT BY INSPECTION RECORD LICENSE CONTR'S NAME Sauro, David FIELD COPY Date I Note Progress - Corrections and Remarks I Inspector a P,IAR 21nZ003 i9l ,.OffictiJu'Onlj �3rt�6� ?eunnta�'I�3� 'issuedate. - EXPRESS °BUI LD]NG PERMIT APPLICATION TOWN OF YARMOUTH Yarmouth Building Department 114b Ro • ute.28 . South Yarmouth, MA 02664. z (508) 3998/-2231 ExL 261 commucnoNADDRMSS. ✓ ? !Qom; ✓�torLc YR-. ASSESSOR'S WORMATION: Map: 216 Parcel: ! / OWNER: �I V f erzA �er��la .3z7 Sou-yjy Shone fir(. 45��) 3<�8 - Z2-73 NAME PRESENT ADDRESS TEL, i ,P,y viD Srlv,24 CONTRAC�rOR:_ I7��e-pm,;p .&(cf 1 Zo Nbi2y(a iZj/a� v sG yA2,� %r)3I P-ZZi3 NAM£ MAULINGADDRESS TEL.ts ❑ Residential , // vet Q cial Est. Cost ofConstruction $ _ O, O D . — Ilome Improvement CMtr=arlia.# 1060 f cu%straction &Vervisar Lin # C.5 D 7 2 k 6 6 w«kman's ComPc:lsatioa Imrance (check ooe) ❑ I am the homeowner O I am the sole proprietor tg'I have workees Compensation Lsstaane hatrrance Company Name: ZyP4 c. fq W& /w c o Worker's Comp. policy# WORK TO BE PERFORMED 0Teat (FueRetudantCaUfiaiea=dwd) 0 Siding: # of Squares Il Replacement windows: M Q Repia=mc%t doors I 2L roof # Of Squares % V 6440*goldshi�- ()SAS Iayasofexistiagtoof `The debris wdl be disposed of st -1 . Location of Facility I dmlve under penalties ofprapny thatihe-"cmcou harem coat umdare true and correct tothe beg of my knowkdge and bdbd I u dustasd thuany bLse auswv(s will beinst cause for dcoW or 'evocation of my Gccuse and for prosecution under KG.L. M 264 Section 1. Apphant's Signature / Date Owners si@naturo (err attachment 3" z I— 0 3 err Approved By: Datc Building Official (err designee) Zoning Dist is Fiistaical District-• ❑ Yes Y,,No water Rrsaace Protqfim District: ❑ Yes No f '" VC Flood plain Zone: kk Yes' ❑' No Witbin 100 8. of Wetlands: Yes ❑ No z PERMIT 427 0 LOT T125 rE� Blue Water Motel 327 South Shore Drive South Yarmouth, MA 02664 6/16/99 6/16/99 �K tL4 Re -roof, rubber roof, strip $60,000.00 SHEET 22 TOWN OF YARMOUTH Application for a Permit to Build No. UPON FINAL APPROVAL �_I`-q l ( , MAP as LOT 7-l�-5' FEE MUST ACCOMPANY THIS APPLICATION. DATE / 19 99 The undersigned hereby applies for a permit to build •eE Ij0 �UBBPit'��d / according to the following specifications 1. Name of property owner Address 2. Name of Architect (if any) rC� - 31aE7- Tel. 36?-9 2 cSo.Y-1e;"41bv"- 3. Name of builder Address 4. License No. Tel 5. Name of Mason Address 6. License No. Construction address 3 2 -,;' 8. Date of subdivision Approval Tel. 9. Private dwelling ❑ Estimated Cost 10. Multifamily ❑ 621000 11. Commercial 0 p,`,PPP-V&J'TTo Cw^E 12.Other ❑ 13. No. of stories 0 14. Foundation — Full ❑ Half ❑ Crawl ❑ Slab ❑ 15. Materials — Wood ❑ Cement ❑ Other ❑ 16. Type of heat— Oil ❑ Gas ❑ Electric ❑ Other ❑ 17. Garage —1 ❑ 2 ❑ 18. Swimming pool - Size 19. Storage shed — Size 20. Stove — Wood ❑ Coal ❑ 21. Size of lot: No. of feet front 22. Size of building. No. of feet front 23. Distance from nearest building: Front 24. Distance back from line or street 25. H.I.C.R. No. LOT RELEASED BY PLANNING BOARD Date Tel. I n uistrict zone Tt Zone DO NOT WRITE IN THIS SPACE I Type of room I No. t; ;-vciar rccnh. IJ No. of feet rear _ No. of feet side _ Ft. side From rear lot line Signature _s Kitchen IW Dining Rm. Living Rm. Bed Rm. Bath Deck Closed porc -Family Rm. Sun room Shed Alterations No. of feet deep No. of feet rear _ Ft. side Rear Side line Address 0 32? S0C.Z-6 Shaetp 46eite In accordance with the provisions.of MGL c 40, S 54, a condition of Beilding Pe. —.lit Number is that the debris resulting from this work shall be disposed of in a properly -licensed solid waste disposal facilir. as defined by MGL c 111, S 150A - The debris will be disposed of in: (Location of Facility) Sicnature of Pc.r:tt Apph=nt Date • M ' BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: JOB LOCATION: �GUE lij9TE/(' /»UTEL saor� Sjiae� NUMBER OWNER OF PROPERTY: �9yEN.00 reT CONSTRUCTION SUPERVISOR:3�s,14-u f O Q 9'6; 6, .3 NAME LICENSE NO. PHONE NO. ADDRESS: l 3 7��P�L G�PiyE _ .vTe 2 ci�L �o /1'%/9• G �—�3� LICENSED DESIGNEE: (IF OTHER.THAN SUPERVISOR) NAME LICENSE NO. 2.15 RESPONSIBILITY OF EACH LICENSE HOLDER: 2.15.1 THE LICENSE HOLDER SHALL. BE FULLY AND COMPLETELY RESPONSIBLE FOR ALL WORK FOR WHICH HE IS SUPERVISING. HE•SHALL BE RESPONSIBLE FOR SEEING THAT ALL WORK IS DONE PURSUANT TO THE STATE BUILDING CODE AND THE DRAWINGS AS APPROVED BY THE BUILDING OFFICIAL 2.15.2 THE LICENSE HOLDER SHALL BE RESPONSIBLE TO SUPERVISE THE CONSTRUCTION, RECONSTRUCTION, ALTERATION, REPAIR, REMOVAL OR DEMOLITION INVOLVING THE STRUCTURAL ELEMENTS OF BUILDING AND STRUCTURES ONLY PURSUANT TO THE STATE BUILDING CODE AND ALL OTHER APPLICABLE LAWS OF THE COMMONWEALTH,. EVEN THOUGH HE, THE LICENSE HOLDER, IS NOT THE PERMIT HOLDER BUT ONLY A SUB— CONTRACTOR OR CONTRACTOR TO THE PERMIT HOLDER. 2.15.3 THE LICENSE HOLDER SHALL IMMEDIATELY NOTIFY THE BUILDING OFFICIAL IN WRITING OF THE DISCOVERY OF ANY VIOLATIONS WHICH ARE COVERED BY THE BUILDING PERMIT. 2.15.4 ANY LICENSEE WHO SHALL WILLFULLY VIOLATE SUBSECTIONS 2.15.1, 2.15.2 OR 2.15.3 OR ANY OTHER SECTION OF THESE RULES AND REGULATIONS AND ANY PROCEDURES, AS AMENDED, SHALL BE'SUBJECT TO REVOCATION OR SUSPENSION OF LICENSE BY THE BOARD. 2.16. ALL BUILDING PERMIT APPLICATION'S SHALL CONTAIN THE NAME, SIGNATURE AND LICENSE NUMBER OF THE CONSTRUCTION SUPERVISOR.WHO IS TO SUPERVISE THOSE PERSONS ENGAGED IN CONSTRUCTION, RECON- STRUCTION, ALTERATION, REPAIR, REMOVAL OF DEMOLITION AS REGULATED BY SECTION 109.1.1 OF THE CODE AND THESE RULES AND REGULATIONS. IN THE EVENT THAT SUCH LICENSEE IS NO LONGER SUPERVISING SAID PERSONS, THE WORK SHALL L`MEDIATELY CEASE UNTIL A SUCCESSOR LICENSE HOLDER IS SUBSTITUTED . ON THE RECORDS OF THE BUILDING DEPARTMENT. I HAVE READ AND UNDERSTAND MY RESPONSIBILITIES UNDER THE RULES AND REGULATIONS FOR LICENSING CON- STRUCTION SUPERVISORS IN ACCORDANCE WITH SECTION 109.1.1 OF THE STATE BUILDING CODE. I UNDERSTI'L:: THE CONSTRUCTION INSPECTION PROCEDURES AND THE SPECIFIC INSPECTION AS CALLED FOR BY THE BUILDING OFFICIAL. INSURANCE COVERAGE: I have a currenViability insurance policy or its substantial equivalent which meets the requirements of MGI.Ch.152 Yes. No Cl If you have checked jes. please indicate the type c average by checking the ap:rcpriate box. A liability insurance pciicyo'*� Daher type of '.idemnity ❑ Sond O OWNER'S INSURANCE WAIVER: I am aware that the acensee does not have the Insurance coverge. required ty Chapter 152 of the Mass: General Laws. ano that my signature on t .:s permit ccplication wanes this requirerrer.*- Check one: OWnerO Agent O Signatur r G1.ner or Owner s A9ent SIGNATURg:/�uui� BUILDING OFFICIAL APPROVAL: The Commonwealth of Massachusetts Department of Industrial Accidents omeeollnesvoidess 600 Washington Street .Boston, Mass. 02111 sue' Workers' Compensation Insurance Affidavit Applicant. information: P/essePR[NTTedGtsia l�E•t, location: �C+20 X/'D-oe --S740 - cif, eJn _ Yfi HMO C/ >4-h t G 7 phone M �3Q,9 931 1 am a homeowner performing all work myself. 0 1 am a sole proprietor and ha%e no one working in any capacity p lam an employer pro%iding workers' compensation for my employees working on this job. company name: address: city: phone N• ina�r�nre co. _ poliey 0 1M--Tam a sole proprietor-eneral contrac or homeowner (circle one) and have hired the contractors listed below who ha%e the following workers compensation polices: aaY name / �i/Ew rsmnc4E1d e� 9.Pao.�c••�•g �` �5'/1��r/�1e� 1"�y c� . address: /tC1! /Ole 0-,V/ bE/��i�'Oi.! city: z6l K/ phone a: SOS • rt'4o2 • S�'F G. Failure to secure coverage as required under Section 23A of MGL 152 can lead to the imposition of erimlaal penalties of a fiat up to SIAN-00 and/or one years' Imprisonment as well as civil penalties is the form of a STOP WORK ORDER and a One of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby ify under the pains and penalties of perjury that the Information provided above is true and eorred �+ Signature Print name �� 'S �ea - Phone it official use only do not write in this area to be completed by city or Iowa aMcial city or town: YARMODT11 _ permitAieense 0 [3Buildiog Department pUeenslsg Board p check if immediate response is required 261 OSelectmen's Office pHcalth Department contact person: pbone Mt _ (508) 398-2231 ext. nOther Imned 1.9s P1A1 Yi t` 15-99 INIJU 13:27 NEW BEDFORD ROOFING 508 990 8994 N.IJU1 U13 1 PRODUCBR (508)584-2300 FAX (508)584-2187 Tn15 GCKIIrhAre Hs siavrA. n�� d Mcks b GBrardi ONLY AND CONFERS NO RIGHTS re 0 HOLDLR THIS CERTIFICATE DOES Insurance Agency, Inc. ALTER THE COVERAGEAFFORDEI 1313 Belmont Street COMPANIEGAFrQ1 Brockton, MA 02301 QWAP "i... "kFMFIER INSuKANC { COLIPA/IY Attn: Eat: I A ........(...... ..._.... ___ ..... ..................... 1N&UAt° New Bedford Roofing b Sheet Metal, Inc. j cOAiPwrx DATB(MMIOONY) ••c: 06/15/1999 ;t OF INFORMATION CERTIFICATE TEND, EXTEND OR S POLICIES BELOW. DVERAOE 169 Mt. Vernon Street I......«.........._..»..« __«_«........................................ . New Bedford, MA ' COMPANY ' e •COMPAN/ , I D T W!{ IB TO CERTIPY THAT TILE POLICIES OP tvsuRANCB LISTED BELOW HAVE BEEN ISSUED TO 7NE INSURED NAMED ABOVE FOR THE POLICY PEA100 SNO"TED. N01 WITHSTANDING ANY MCKAREMGNT, TERM OR CONDITION OP ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TF92 CERTIFICATF MAYBE ISWUED OR MAY PERTAIN. THE INSURANCE AFFORDED DY THE POLICIEO DESCRIBED HEREIN IS tU8JEC1 TO ALL TFIC TCRM9. EXCL USION9 AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. • •• •. , „ ,,, , ,,,, , ,,,, , , ...... ............. ..... __.. .._ _.......�. .... .... «....._... «...�...... _« .... ............ _._ «.. ..«_ ___ . _.... CO POUOY EIfEOTPA I POLICY EXPIRATION • UMITG LTA TY►B OI iISURANr$ POLR)Y NUMBGR { nATE (MWWNY) I DATE MMICUM — ! OEHEIIAI luaLRlr • OGNGRALAOCREGATB a 2000000 X'CMAWMGLALocNCRALLIAWLiTy rRODUOrs coiialoPAlAO•t 100n000 ..............__.._............«_.««««_..«_...,............ A w, L's3; •; CLAWSMADE : X : OCCUR' SAA043162-00 I OS/22/1999 OS/22/2000 ; PERS?NAL ARV iaARTY i 1000000 OWNPJTB a CONTRACTOR'S PROT BAC14 OCCURRENCE i 1000000 ..« .. ....... I .............. . rIRC CAMAOG (Any frd . t...... 30000 ' r MCOOTFpnvenAeANenl t 5000 AUTOMOMLE LIABILITY i • LOMaINGD pNOLi LIMIT • ..... ANY AUTO ! ... 1,000 D00 ALL OWNGO ALITOS ! &OOILYWJURY A X MREO w1EwLEDi AUTOS X3P083223-00 ! OS/22/1999 05/22/2000 � PW I pv ... • �'•• "•• •-....•' • •AUTO ' « X NONOWNGO AUTO& 1 ? .. • • • • i PROPERTY OAMAOG • a WRAOG LIABILITY - i • « AUTO ONLY. to A=OCNT S NY AUTO shy .�y�a?t.;:'•L .. _.'A i nMFR THAN AUTO ONLY; ,.�i:.l-ir.;::^Yf • I + i EAGN ACCJOGNr t ��, • AGBREOATP A I EXCISS LIABLITY ; I GACN OccuRRENCII t 1 000,000 A ; Xy wBRCLLAFORM §SX005S47-00 : 05/22/1999 ! 0S/22/2000 ' AO"ECATE s 1,000)000 _i OTHLR THAN UMDRGLI.A DORM { A ¢✓ _—WORKEII&CON►GIItaTION AND i I ~-- X' TA i I .q,i'�•a:T': ! LM►LDYERS LIABILITY A • , , ,' 1L PACN AC J)kNT .9 ,100 , 000 TWO PR0PR16TOR1 05/22/2000 SIECTIVS NVCLPARrNert•( aoIGGAu-Pl,ucr LIMIT t 500T000 OrPICERS ARE' ! 1 'XCL { ........, . «_ ....... ................. EL DL4EASC•GA GMPIOYPP 6 300.000 OTHER I r ' I Davenport Builders 20 North Main Street So. Yarmouth, MA 02G64 61IQlLO ANY OF THE ABOVP, DESCNDED POUCJL& BB DANCGLLID BiPORE THE EXPIRATION DATE TNLRCW. THE ISSUING COMPANY WILL RNOLA VOR To MAIL —3.Q_ DAYS WRITTEN moms TO THE CLRTInctrB HOLDER NAM10 TO THE LEER. BY r FALURg TO MAIL suem NOTICE &HALL IMPOSE NO ORI.HIATPH OR LUIILITY ot) TfITI]I O I a' I t PERMIT 21 LOT 118 Riveria Beach Ltd. Partnership 327 So. Shore Drive South Yarmouth, MA 02664 Demolish existing swimming pool SHEET 26 1/12/99 1/12/99. $1,200.00 44-4e-- /99i6 a0 o TOWN OF Y RMOUTH Applica 'on for a Permit to Build No. 11 � P � �6 UPON FINAL APPROVAL (' / M�nAP LOT FEE MUST ACCOMPANY THIS APPLICATION. DATE 8� uOAWW-Y 19 The undersigned hereby applies for a permit to build g 7acpording to the following cations Name of property owner vi FQs+ .9efF ,C� i /.�-�..s�. Tel ���cZZ3 Address C�g-,/ Name ofArchitect(ifany) Tel. ame of builder�� 6 Ca • ddress �a /f.•- /i1��v �.er�e—' License No. 5. Name of Mason Address 6. License No, 7. Construction address 8. Date of subdivision Approval 9. Private dwelling ❑ 10. Multifamily ❑ 11. Commercial ❑ 12.Other ❑� 13. No. of stories stimated Cost / 14. Foundation — Full ❑ Half ❑ Crawl ❑ Slab ❑ 15. Materials — Wood ❑ Cement ❑ Other ❑ 16. Type of heat — Oil ❑ Gas ❑ Electric ❑ Other ❑ 17. Garage —1 ❑ 2 ❑ 18. Swimming pool - Size 19. Storage shed — Size 20. Stove — Wood ❑ Coal ❑ 21. Size of lot: No. of feet front 22. Size of building. No. of feet front 23. Distance from nearest building: Front 24. Distance back from line or street _ 25. H.I.C.R. No. LOT RELEASED BY Sig PLANNING BOARD Date ri U Zone , ` o DO NOT WRITE IN THIS SPACE I Type of room I No. jyrd- "r'�`" �1.•� Kitchen WO Dining Rm. Living Rm. Bed Rm. Bath Deck Closed por( Family Rm. Sun room Garage Shed Alterations No. of feet rear No. of feet side R. side No. of feet deep No. of feet rear _ Ft. side Rear line Rl ING PERMIT APPLICATION SIGN OFF APPLICANT: F— BUILDING PERMIT #: ADDRESS: yTe7 ;r c�iN�/,�a�r�(� Ott. TELE. NO.: DATE FILED: 8 �' BLDG. SITE LOCATION: MAP#: LOT#: THE FOLLOWING INFORMATION OUTLINES THE PROCEDURAL STEPS REQUIRED TO OBTAIN A PERMIT TO BUILD, ALTER, OR ADD TO A STRUCTURE WITHIN THE TOWN OF YARMOUTH. THE BUILDING DEPARTMENT WILL DETER- MINE COMPLIANCE TO THE FOLLOWING (A) ZONING REQUIREMENTS (B) HISTORICAL DISTRICTS (C) FLOOD PLAINS ZONING. THE BUILDING DEPARTMENT WILL BE RESPONSIBLE FOR ASSISTING THE APPLICANT THOUGH THE FOLLOWING DEPARTMENTS: WATER DEPARTMENT: ENGINEERING DEPARTMENT: CONSERVATION COMMISSION: HEALTH DEPARTMENT: FIRE DEPARTMENT: RESIDENTIAL AND/OR COMMERCIAL BUILDING DETERMINES COMPLIANCE OF WATER AVAILABILITY. DETERMNES COMPLIANCE FOR PARKING AND DRAINAGE. DETERMINES COMPLIANCE TO WETLANDS ACTS, I.E.: IF LOT(S) BORDER ANY TYPE OF WETLANDS, STREAMS, PONDS, RIVERS, OCEANS, BOGS, BAYS, MARSH LAND, ETC. DETERMINES COMPLIANCE TO STATE AND TOWN REGULATIONS, I.E.: REQUIRE- MENTS FOR SEPTAGE DISPOSAL AND OTHER PUBLIC HEALTH ACTIVITIES. DETERMINES COMPLIANCE TO STATE AND TOWN REQUIREMENTS FOR PERSONAL SAFETY, PROPERTY PROTECTION, I.E., SMOKE DETECTORS, SPRINKLER SYSTEMS, ETC. THE FOLLOWING DEPARTMENTS MUST SIGN OFF, IN THE RESPECTIVE ORDER,, PRIOR TO BUILDING INSPECTOR ISSUING THE REQUIRED BUILDING PERMIT: REVIEWED BY: . WATER DEPARTMENT DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT DATE: N/A: INDUSTRIAL AND/OR%COMMERCIAL PERMITS . WIRING 4INSPECTOR:, dtt j DATE: ! ^ N/A: PLUMBING INSPECTO :.i DATE: / - C�S% N/A: FIRE DEPARTMENT: DATE: /- //^ �j' /A: PLEASE NOTE ALL STUMPS AND/OR BRUSH MUST BE DISPOSED OF AT AN APPROVED SITE. A SIGNED RECEIPT FROM THE DISPOSAL SITE MUST BE SUBMITTED TO THE BUILDING DEPARTMENT PRIOR TO ISSUANCE OF THE BUILDING PERMIT. COMMENTS: BLM 89 BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: JOB LOCATION: OWNER OF PROPERTY: CONSTRUCTION SUPERVISOR: ADDRESS: 4 9/ a /oV—,oy o-j"am I NAME ^` ) 1 .0770 V M.-lo C 1 o1.0a6/ :.ICENSE NO. J rOL Z LICENSED DESIGNEE: (IF OTHER.THAN SUPERVISOR) NAME LICENSE NO. 2.15 RESPONSIBILITY OF EACH LICENSE HOLDER: NO. 2.15.1 THE LICENSE HOLDER SHALL. BE FULLY AND COMPLETELY RESPONSIBLE FOR ALL WORK FOR WHICH HE IS SUPERVISING. HE.SHALL BE RESPONSIBLE FOR SEEING THAT ALL WORK IS DONE PURSUANT TO THE STATE BUILDING CODE AND THE DRAWINGS AS APPROVED BY THE BUILDING OFFICIAL 2.15.2 THE LICENSE HOLDER SHALL BE RESPONSIBLE TO SUPERVISE THE CONSTRUCTION, RECONSTRUCTION, ALTERATION, REPAIR, REMOVAL OR DEMOLITION INVOLVING THE STRUCTURAL ELEMENTS OF BUILDING AND STRUCTURES ONLY PURSUANT TO THE STATE BUILDING CODE AND ALL OTHER APPLICABLE LAWS OF THE COMMONWEALTH,. EVEN THOUGH HE, THE LICENSE HOLDER, IS NOT THE PERMIT HOLDER BUT ONLY A SUB- CONTRACTOR OR CONTRACTOR TO THE PERMIT HOLDER. 2.15.3 THE LICENSE HOLDER SHALL IMMEDIATELY NOTIFY THE BUILDING OFFICIAL IN WRITING OF THE DISCOVERY OF ANY VIOLATIONS WHICH ARE COVERED BY THE BUILDING PERMIT. 2.15.4 ANY LICENSEE WHO SHALL WILLFULLY VIOLATE SUBSECTIONS 2.15.10 2.15.2 OR 2.15.3 OR ANY OTHER SECTION OF THESE RULES AND REGULATIONS AND ANY PROCEDURES, AS AMENDED, SHALL BE SUBJECT TO REVOCATION OR SUSPENSION OF LICENSE BY THE BOARD. 2.16. ALL BUILDING PERMIT APPLICATIONS SHALL CONTAIN THE NAME, SIGNATURE AND LICENSE NUMBER OF THE CONSTRUCTION SUPERVISOR.WHO IS TO SUPERVISE THOSE PERSONS ENGAGED IN CONSTRUCTION, RECON- STRUCTION, ALTERATION, REPAIR, REMOVAL OF DEMOLITION AS REGULATED BY SECTION 109.1.1 OF THE CODE AND THESE RULES AND REGULATIONS. IN THE EVENT THAT SUCH LICENSEE IS NO LONGER SUPERVISING SAID PERSONS, THE WORK SHALL I:LKEDIATELY CEASE UNTIL A SUCCESSOR 'LICENSE HOLDER IS SUBSTITUTED ON THE RECORDS OF THE BUILDING DEPARTMENT. I HAVE READ AND UNDERSTAND MY RESPONSIBILITIES UNDER THE RULES AND.REGULATIONS FOR LICENSING CON- STRUCTION SUPERVISORS IN ACCORDANCE WITH SECTION 109.1.1 OF THE STATE BUILDING CODE. I UNDERSTti::; THE CONSTRUCTION INSPECTION PROCEDURES AND THE SPECIFIC INSPECTION AS CALLED FOR BY THE BUILDING OFFICIAL. INSURANCE COVERAGE: I have a current liability insurance pclicy or is substantial equivalent which meets the requirements of MGLCh.152' Yes ❑ No ❑ If you have checked ves. please indicate the type coverage by checking the ap;,rcpriate bex. A liability insurance pc!icy O O:her type of :�demnity ❑ Bond O OWNER'S INSURANCE WAIVER: 1 am aware that the ucensee does not have the insurance coverage. required by Chapter 152 of the Mass: General Laws. ano that my signature on tn:s permit ccplicatien waives this requirernem- Check one: %) OwnerO Agent O Signature of 0*ner cr Owner s Agent / SIGNATURE: /; 5 OFFICIAL APPROVAL: The Commonwealth of Massachusetts Department of Industrial Accidents omce111nenfli loss 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit cltL phone 0 - 1 am a homeowner performing all Work myself. C] I am a sole proprietor and hase no one working in any capacity 0 1 am an employer pros iding workers' compensation for my employees working on this job. insurance co policy # 1 am a sole proprietor. general contractor, or homeowner (circle one) and have hired the contractors listed below who ha%c the folloss ing workerscompensation polices: company name: address: cih• phone #- insurance to policy q Failure to secure coverage as required under Section 25A of MGL IS2 can lad to the impoaidoo of criminal peanjues of aline up to 31 wuAu aaaor one years' Imprisonment as Weil as civil pcnaldes in the form of a STOP WORK ORDER and a fiat of S100.00 a day against me. I understand that a copy of this statemeat may be forwarded to the Office of Investigations of the DU for coverage verifiadoa. t do hereby cenify under the pains and penalties of perjury that the information provided above is true and correct Signature Date Print name Phone 0 official use only do not %rite In this area to be completed by city or town official city or town: YART•1011'PIi _ permlNlcense # mBuilding Dtpartmeot [3Uceasing Board check if immediate response is required 261 OSelectmen's Office contact person: pHcalth Dtpartmcnt phone#:_ (508) 398--2231 eat. mother l,t ,,ed 195 PIA) Information and Instructions Massachusetts General Laws chapter I52 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An emph{r•er is defined as an individual, partnership, association. corporation or other legal entity, or any two or more of the foregoing enga(_ed in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual . partnership, association or other legal entity, employing employees. However the o%%tier of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. %lG1_ chapter I S_ section also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally. neither the commomvealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha%e been presented to the contracting authority. Applicants Please till in the workers' compensation affidavit completely, by checking the box that applies to your situation and supply in,_ company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The aff ida% it should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. . The Office of Investigations would like to thank you in advance,for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address, telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents rffco of Imstlildels 600 Washington Street Boston, Ma. 02111 fax H: (617) 727-7749 phone th (617) 7274900 ext. 406, 409 or 375 i 'If 0 " BUILDING � o TOWN O F �Y A`R M O U T H ELEGTRICAL y 1146 ROUTE 28 SOUTH YARMOUTH DIASSACHUSETTS 0266.1-4451,. , I-" P UDIBING Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 tr v -� SIGNS ter� BUILDING DEPARTMENT NOTICE OF VIOLATION Inspection Date: ► ��'`� f 0 % /� ,Inspection Type: le) Property) .Name: ! Owner 1❑�Tenant ❑ / 13 / / (/-ire-� rC f*-.-� (Cv� -n ,•' D A: Telephone: 3. Mailing Address: City / Town: State: Zip Code: o An inspection of the above captioned property was conducted by the undersigned, duriulr which the followine VIOLATIONS were observed:.. ., r I / r d t�i You are hereby ordered to abate +or correct said violations within days. Failure to do so may result in criminal/civil complaints being filed against you, which may be subject to fines as prescribed by pertinent laws and regulations, or may delay the issuance f your license. / Signed: ► — f'°' nspector Title Copy Received By: Original - Owner/Tenant Yellow Copy - Licensing Authority Pink Copy - Bldg. Dept. TOWN OF YARMOUTH i1VO\1:1)`". ) FEE-? p `1:04 TOWN OF YARMOUTH BOARD OF APPEALS DECISION FILED WITH TOWN CLERK: FEB 1 1997 PETITION NO: #3364 HEARING DATE: January 23, 1997 PETITIONER: Palmer Davenport & David G. Mugar DB/A The Riveria Beach Motor Inn PROPERTY: 327 South Shore Drive, South Yarmouth, MA Map: 22 Parcel: T125 i\IENIBERS OF THE BOARD PRESENT AND VOTING: David Reid. Chairman. James Robertson, Jerry Sullivan, Andrew Ryan, Mike O'Loughlin. It appearing that notice of said hearing has been given by sending notice thereof to the petitioner and all those owners of property deemed to be affected thereby, and to the public by posting notice of the hearing and published in The Register, the hearing was opened and held on the date stated above. The petitioner, represented at the hearing by Mr. DeWitt Davenport, operating this existing (non- conforming) motel use in a residential (R-25) zone. They purpose at this time to expand the structure by adding a drive -through canopy at the front entrance, expand the rooms above the lobby and new canopy, and to enclose the adjacent building connector area. Each of the alterations would itself comply with current dimensional requirements of the by-laws. No additional guest rooms or occupancy will be created. The petitioner demonstrated that there previously existed a canopy at the same location as the proposed new construction. That had been removed some time ago. The new canopy will be constructed as shown in the elevation plans filed with the Board. It will include decorative features which, with the above room expansion, will tie in architecturally with the building. In addition to providing coverage for guest vehicles arriving at the front entrance, this renovation will facilitate the construction and enclosure of a handicapped access ramp into the lobby area. The second floor rooms will be expanded by the addition of a 12' x 12' area. No additional bedrooms or units are to be added. Page 2 Decision 43364 Davenport &. Mugar d.b.a. Riveria The board finds that this expansion may be made without being substantially more detrimental to the neighborhood, and without creating any undue nuisance, hazard or congestion. After review of the plans and proposals, a motion was made by Mr. Sullivan , seconded by Mr. Robertson , to Grant the needed Special Permit , per §104.3.2, but to deny the Variance request without prejudice, as it does not appear to the Board to be needed. The members voted unanimously in favor of the motion. The Special Permit was therefore Granted. David S. Reid, Clerk a I � MOTOR INN RESTAURANT & LOUNGE - Qtth:L, 1 7 , lu-n- W 1V OF YARMOUTH BUILDING ELE.CrRICAL ' 1TE 28 SOUTH YARMOUTH AfASSACUUSETCS 02664 MAP 90— LOT �I�-S Tcicphunc (508) 398-2231 BUILDING DEPARTMENT APPLICATION TO ERECT AND MAINTAIN SIGN GAS PI.U&1t�lIVG i;ils DATE * � & L I 19 TO THE SIGN INSPECTOR: UNDER SECTION 303 OF THE YARMOUTH BY-LAWS, THE UNDERSIGNED HEREBY APPLIES FOR A SIGN PERMIT ACCORDING TO THE FOLLOWING INFORMATION:' BUSINESS NAME TEL: 378 -- Z-273 LOCATION/ADDRESS 3Z% :5oQ -W\ 5\y\o`zg Z>Nz L,,-Q Sd.�IW�\.nty yv�X C+2Cc<,cf ZONING DISTRICT L.B. C.B. IND. RES. HIST. DIST. BUSINESS OWNERS NAME/ADDRESS J% 'QQ �p1 'Trv, �. TEL: 3g c�-ZZrr'3 OWNER OF RECORD OF BUILDING �AV1 pOZA. VA16Vwl ADDRESS ZO ►yC9"" N WVAYv.j SIGN BUILDER 4yVyl0d%V\ �NCQ ADDRESS &0400N S0",g4tL TYPE OF CONSTRUCTION MATERIALS) Y�V L'C LIGHTING ✓ TYPE�_Vs-hA,vC FREE STANDING__ATTACHED TEMPORARYpERMAT�T DIAGRAM OF LOT AND SICN WITH DIMENSIONS AND SET -BACKS FROM PROPERTY LINE. SHOWN LETTERING AND ADVERTISING ON SIGN. FOR ATTACHED SIGNS SHOW LOCATION ON FACE OF BUILDING AND RUNNING FOOTAGE OF PORTION OF FRONTAGE OCCUPIED BY BUSINESS. _:.: MOTOR `INN_ _ - 5!S RESTAURANT & LOUNGE ZTst."i-rvW123 • 5i�v . lv ` Vj -AC,1C act .,h l o -k- L. I kr.&> I HEREBY AGREE TO CONFORM TO THE ZONING BY-LAWS, SECTION 303 OF THE TOWN OF YARMOUTH REGARDING THE ABOVE SIGN CONSTRUCTION: I FURTHER AGREE THAT THIS SIGN WILL NOT BE ALTERED, ADDED T02 OR CHANGED IN ANY WAY UNTIL A NEW PERMIT HAS BEEN GRANTED. THE NUMBER'OF THIS PERMIT WILL BE AFFIXED TO THE SIGN IN NO LESS THAN 3/4" NUMBERS. ALL PERMITS SUBJECT TO APPROVAL OF THE SIGN INSPECTOR. ;moor NAME APPROVAL BY �'L DATE �i /Gyl% FEE ,�'�iUMsiD; I A BUSINESS: f�?' IVIC'RA NMI? INN 3 �2-'7 .,�'ov7-11 sh'o/t D OWNERS NAME: FREE STANDING: SIZE: ATTACHED: SIZE: ✓ l y-d ` �• l L0 n RUNN114G FOOTAGE: OTHER: SIGN PEP MITNO.: DATE: 8-6 — �D SIGN ERECTED: SHEET NO.: VARIANCE: 1;4 O, LOT NO.: r ( 7-5- Y..... • RESTAURANT -?•LOUNG E MAP - Co' (Y�y Al a Gant PL I A NC S.wVr 14 Cps �o T/0 jA — /0 CICrE &p 4 LK Slav %* 9—�7`— / /V r,E ini�v(2 ¢�(o7G� COL ORS / el of For (Hove &RovMD NO pc)sts t. S-17-E i� l • 1 ww Ilk A EnlsnvFss: (� I VI E R 3 a7 �ourif sftor� �2 owNET:s NJ{fd� FREE Sf/LE: ATrAC"Eo::.� RtJhT1i,'1G FUMAG - OTHER: S'GN PEPAI pM C�ti'� R - 6 - �O SIGN ERECTEn: saE>`rhog Lr VARwVcE MAP -LOT yc5 Na eCMPLIANC& wIT 14 co C /0 F'r 6 0BOVP &P%Ovt%I D COL ORS 6k 5/a/v %& fiT- NO pairs t. SIZE .ky 4 so �F 'DOWN OF YARMOUTH 1146 ROUTE 28 SOUTH YARMOUTH NJAS.SACHUSETTS 02664-4451 Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 3• �� BUILDING DEPARTMENT �o �s NOTICE OF VIOLATION Inspection Date: S- ��' 00 A , Inspection Type: C T Property Address: -S—� V Name: Owner Tenant ❑ D / B / A: Telephone: Mailing Address: City / Town: State: Zip Code: BUILDING ELECTRICAL GAS PLUMBING SIGNS An inspection of the above captioned property was conducted by the undersigned, y� u in�/T�Iw'hiich the following VIOLATIONS were observed: yI /�� 'Lf -s /1 i i _ _ - i Ybt1/aVe • he r erd e�a �ati' to or cloct sat vio oln' s wttFiin f� , days. Failure to do so.may result in criminal/civil complaints being filed against you, which may be subject to fines as prescribed by pertinent laws and regulations, or;may delay the issuance oyour license. Signe Copy Original - Owner/Tenant Yellow Copy - Licensing Authority Pink Copy - Bldg. Dept. TOWN OF YARMOUTH BOARD OF APPEALS Hearing Date: Petitioner: Riviera Beach Petition #1443 Motor Inn The petitioner requested permit to: October 13, 1977 Allow construction of an indoor swimming pool to be located at the Riviera Beach Motor Inn, South Shore Drive, Yarmouth, which is a resi- dential area. 2 �7 Members of the Board of Appeals present: lJ Robert W. Sherman, David Oman, Morris Johnson, Thomas N. George, John Neylon It appearing that notice of said hearing has been given by sending notice thereof to the petitioner and all those owners of property deemed by the Board to be affected there- by, and that public notice of such hearing having been given by publication in the Cape Cod Times on September 26, 1977 and October 3, 1977, the hearing was opened and held on the date first above written. The following appeared in favor of the petition: Palmer Davenport The following appeared in opposition: None Reason for decision: Petitioner indicated a need for pool to satisfy requests of guests in early spring and late fall. There would be no additional rooms added and there- fore, the Board felt no greater burden to area as regards traffic or environmental effects. This is a well established business property and addition of pool would not effect the neighborhood or derogate from protective by-law. Members of the Board voting: Robert W. Sherman, David Oman, Morris Johnson, Thomas N. George, John Neylon Therefore, the petition is granted And we authorize a variance as petitioned. No permit issued until 20 days from date of filing decision with the Town Clerk. APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00. TOWN OF YARMOUTH (OFFICE USE ONLY) By II Fee: PERMIT NO. (PLEASE PRINT IN INK OR TYPE ALL INFORAfATION)1 Date: D To the Inspector of Wires: By this application. the undersigned gives notice of his or her intention' to perform the electrical work described below. Location (Street & Number) SO UT I+ S 11 o Ii: f2 7)/L l u Fa Owner or Tenant R 1 Of Fi 12 fF /3 Fi #4 G ►i MOT'O n. 2 ,v N Telephone No. } Owner's Address cee Is this permit in conjunction with a building 'permit? ❑ Yes 10 (Check Appropriate Box) 1'70 Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead Undgrd Cl No of Afeters t New Service Amps / Volts Overhead ❑ Undgrd No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed electrical Work: ,RRyourz t— FoufL R6e)AI S Ankh Tina M#1R4VA-LE Rooms 13 9, 11/0, ;L3 9 Aqd. Co letion ofdbe following table maybe waited by the Inspector of Isms No. of Recessed Fixtures I No. of Total Transformers KVA ' o. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above In- Swimming Pool grnd. ❑ rnd. No. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches �ff i ^ ) No. u-Qas gurners No. o Detection an Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Nam r — Tons KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating K-W Municipal Local [] Connection ❑ Other No. of Dryers Heating Appliances KW cuttry ystems: No. of Devices or Equipvalent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. H dromassa a Bathtubs y g No. of Alotors Total HP Telecommunications Wiring: No. of Devices or E uivalent Attach additional detail ijdesired, or as required by the Inspector of w1res... INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND[] OTHER[] (Specify:) 0 Al FIL Fe (Expiration Date) Estimated Value of Electrical Work: (When required by municipal polity.) Work to Start: Inspections to be requested in accordance with AfEC Rule 10, and upon completion. �. I certify, under the _pains and penalties of perjury, that the information on this application is true and complete. FIRDS NAME: t.)" Fr (L ko<-Tai c 00,L LIC. NO. All/ ti R Licensee: Signature LIC. NO. (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: Address: Alt. Tel. No.: OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I and the (check one) owner ❑ owner's agent. Owner/Agent Signature �' Telephone No. [Rev. 04/007 TOWN OF YARMOUTH & —/ U e;,� o-60 I1�01 Building AT. Location R1tV/ r-r9 1,-% jL-- New C9� Plans Submitted Renovation ❑ Yes ❑ No ❑ TION FOR PERMIT TO DO GASFITTING (OFFICE USE ONLY) Fee: $—� Xx PERMIT NO. -DO 4�y Replacement ❑ Date S— 2 Owner's NameA94M- n,Wgt Type of Occupancy .&a 41 1 tii q �L-S N ►p Z N YUl V Z S y MAYU30 N W (nW oUmtM=¢ ¢ 0: a w ¢ o M °o �% ��/ LU W Q y N Ir V7 (7 U W 2 rA W Q 0 O a > � W Z W J Q Q t F } 0 Z LL O W J W W CC 0 3 Qma Lu a H 2 0 2 LL : a (7 J U X > O O SUB-BSMT. BASEMENT 1ST FLOOR 0 2ND FLOOR 3RD FLOOR 1—t (PRINT OR TYPE) Installing Company Name E3 Address Check One: C Morp. ❑ Partnership — ❑ Firm/Company Business Telephone � - 7 ff- y4 / Name of Licensed Plumber or Gasfitter �R<<► Gvtn/6R � b -PV. INSURANCE COVERAGE: Check One I have a current liability insurance policy or its substantial equivalent. Yes Il No ❑ If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ®--, Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General laws, and that my signature on this permit application waives this requirement. Check One: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent q -4 I hereby certify that all of the details and information I hae ebgItted (or entered) In above application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under Permit Issued for this application will be In compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Signature of Lice sed Plumber or Gasfitter 748�111E, License Number TYPE LICENSE: umber ❑Gasfitter ❑masleir []journeyman s Li A TOWN OF YARMOUTH .,APPLICATION FOR PERMIT.TO DO:PLUMBING (OFFICE USE ONLY) By Fee: $ `C TT PERMIT NO. Date iS�e y .,� . 1 Building �` Owner's ej!yi1Fr4 &� 4 AT. Location 7 a 7 F1S1vfF it ` Name — Type of Occupancy My le-1 New ❑ Renovation E '_ Replacement ❑ Plans Submitted Yes ❑ No ❑ z yW to O V z Z W W y N Z O a cc Z q y LL Z Z Zp ; ¢ w O w a w a w Q¢ _j z c a s W= = 3 O o = 3 Y (z—o jr F- Q Y W .Oa Y w a t Q Q z N y Z a O O. 0 00 Q LL 3 Y m W a a g 3= Q F- m LL a¢¢¢ 0 D a a a 3¢ 0 Q m I- o SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR .77 3RD FLOOR _ .. (PRINT OR TYPE) Check One: 4l i Installing Company Name low; �c f/,, �,, r . Corp. 5119 7 Address /pm Mvy ❑ Partnership P E `'! 1 ❑ Firm/Compan. Business Telephone 9 F- `2 SYh Name of Licensed Plumber R����, w'r3 LCAI 'rtr:� IV, INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes ®' No ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance voerage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. / Check on Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and Information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under Permit Issued for this application will be In compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. SIgnatur6 ofificensed Plumber License Number Type: Master Mo"' Journeyman ❑ Z% 41:11rt r,r uw� The Commonwealth of Massachusetts t� m. ! rl (v'11J1 Departent of Public SoJcty 1 1_ UrYt+wry a Art tsaraai- 1 BOARD OF FIRE PNLYENTION REGULJ1f10N5 S27 CMR 1Z:W 3/1M lips.. W.w.l APPLICATION FOR PERMIT TO PERFORM ELECTRICAL-WDE AN work to be pttlorined In accordance with the Mauachusclu EJecirical Code, S27 C1 :00 /n� 0 (FLWE P=Ir III illl; OR TUB era, I1IF0132=1010 Date I LL City'or Yuen of /4lzfY10UT f4 To Lila Lispector f Wl�iiR 2 2 1999 Ills undersigned applies for a permit to perform the electrical work described tJ� Location (Str et lumber) S6uT-1 / Owner or e 9 el U I Fill F, BRAC-P N07-02 1 n/ AJ Owner's Address v Is this permit in conjunction with a building permitt Yes ❑ Ito ❑ (Check Appropriate Box) w Cl" r Purpose of Building 1'190TGL L Utility Authorization 110. Existing Serviee •Amps / Volts Overhead ❑ UndErd ❑ Ila. of lietcrs— New Serrice Amps / Volts Overhead ❑ Undgrd ❑ Ila. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work rh,001VD1A1t- 4/✓4 (,l l elX)6— T d /V iq lt/ O UT D oo n, j>0 (3 L No. of Lighting Outlets No. oFlbt Tubs Ila. of Transformers Total Y.VA No. of Lighting Fixtures SwIxoln Fool Above gin rnd. ❑ grad. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners Ila. nat of Emergency Lightingnatter Units No. of Switch Outlets No. of Gas Burners FIRE AIAPHS Ito. of Zones IlIno. of Detection ofslid Devices No. of Sounding Devices Ila Detectlon/SoundingaDevices Local ❑ Iluniclpnl ❑ Other Connection No. of Ranges No. of Air Cond. Ttons No. of Disposals No. of Vests Total ToTons talump No. of Dishwashers Space/Area Ileating KW No. of Dryers nestingDevices KW No. of Water nesters' KW No, of o. o Signs Ballasts 1111rinr Low Voltage No. llydro Massage Tubs No. of Motors Total UP OTHER: t• INSURANCE COVERAGE: Pursuant to the requirements of Maasachusetta General Laws I I have a current Llabllit Insurance Policy including Completed operations Coverage or its substantial '\ equivalent. YES[ NO [J I have submitted valid proof of same to this office. YES E] I40 �•If you have checked YES, please indicate the type of coverage by checking Lila appropriate box. Cr) INSURANCE ® BOND ❑ an1ER ❑ (Please Specify) U. S F- '�� 9 xpiration ate ' Estimated Value of Electrical Work S Work to.Start Inspection Date Requested: Signed under the penalties of perjury: 1 F1RM NAME FUMM EIECPRIC COMPANY — 'i Licensee LANCE A. MACENERNEY ' Signature Rough Gl//c G C� LC_ Final LIC. No, Al 1149 n A11149 Address 126A MID TECH DRIVE We YARMOEMIF MA 02673 Bus. Tel. No- B081775-0030 Alt. Tel. Ila. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the Lnsurance coverage or its sub- stantial equivalent as required by Massachusetts General ws, and that my signature on this permit application waives this requlrgme tt Ownar Agent (Please check one) !/ lions No. PERMIT FEE S Signature of Own r pr Agent)e 254 WIRE INSPECTOR'S DEPARTMENT YARMOUTH TOWN HALL SOUTH YARMOUTH, MASS. 02664 Fee 9-2 Date —a g ' Name of Job A '6t v Name of Electrician�z-p- Location (Print or Type) • ••� • •�� "'u. . v vv vMar1 r r IIVk� 14 ff.., Y' ' _ "Z4 Mass. Date . Permft #�_17cC oBuilding LotaU Owner's Name .,I Em Type of Occupancy /`9n h—/ New ❑ Renovation ❑ Replacement [r Plans Submitted Yes❑ No Eg, Y ENNUMENNUMmom E 0 t ONE . .. ■ENN NNESERN���nnr.; r�MORH .. ■I�Err NINWERAKE�����1=�1!s:�NNW WEENJIMMUNN■ 1u; ONE ®r�L'I�IIOr�t�l�NS MR! MIN MR MINN Installing Company Name 3 Aril Pltimh.ina h flvn#in8, inr• ,Chrporation Rq? � eck one: Certificate Address 188 Ala in St.. 'Rte. 28 ®/ Co —_ ''Ueruuiepo�.t, MA 02639 � ❑ Par Business Telephone 508= Partnership 398-3846 i ❑ n/Cs. Name of Ucensed Plumber or Gas Fitter--Ratph J. G.iana)tPnnhin_ Th _ INSURANCE CO RAGE: I have a current pity n u0 policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes It you have checked.M. please Indicate the type coverage by checking the appropriate box. A liability Insurance policy [B' Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the IlcenseeAoes not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that any signature on this permit application waives•this requirement. Check one: gna a R Owner or Owners ent Owner❑ Agent ❑ hereby certify that all of the details and Information I have submitted (or entered) in above application are true and aowrate to the best of my krwMedge and that an plumbing work and installations onned under the peter Issued for this appUoation w1p be in compliance with an pertinent P0"ons of the Massachusetts State Gas Code and Chapter 142 of the oral Laws. T of Ucense: liva filt�ar gna e o tense r as r er al Rowe •' Master UcenseNumber itninti T_ %�r�•., 0�[t0 It. .burrreyman----�W9 r ,,a MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) ✓ Mass. Date ? Permit #o_/ ot3 Budding Locatlo. r ce7�i f�on� %,ii'u: 'Owner's Namolliii. Type of Occupancy, 1 7 n —/ New ❑ ; Renovation ❑ Replacement pK Plans Submitted: Yes[] No M— ■�■�a■■■■■■■■■■■ ■ ■■■■ ■o■I . ... ■■■N■■■.■N■.■■.nM►aE!���� �I�■■�@I■ilia■`ii■-I111■■�■■■■■■■■/■�■ .. ...I��1r�f�Gfll.11n..........■ ■.■ CM ... _�..�e..��i�.....��■�......■ Installing Company Name 3 nrA PYumh.Ina £ Hea ina, Tne. ,Check one: Certificate Address 188 Main St., 'Rte. 28 ®/Corporation R97 r Denni.apont. M 02639 ❑ Partnership Business Telephone 508:398-3846 • i ❑ Flun/Co, Name of Licensed Plumber or Gas Fitter Rafnh J. G.ianaAegoA. o. J4. INSURANCE COVERAGE: 1 have a current bpfty Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes IR No ❑ It you have checked ye . please Indicate the type coverage by checking the appropriate box A liability Insurance policy Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. Genera) Laws. and that my signature on this permit application watves'this requirement. Check one: Signature o Owner or Owner's Agent Owner❑ Agent ❑ I hereby certify that all of the details and Information I have submitted (or e knowledge and that all plumbing work and Installations performed under th peril a rovislon$ of the Massachusetts State Gas Code and Chapter 142 T of Ucense: True.% /P � mbar _ _ter srilter Master Cil /Town J umeyman ntered) in above application are true and accurate to the best of my e permit Issued for this application will be in compliance with all of the eral laws. 6 gna e�mnbwtr uas Ruer Uoense Number Ralph T - rzinagugo4io, Jn. BELOW FOR OFFICE USE ONLY A41 SPE4=tjON SKETCHES FEE 22' APPLICATION FOR PERMITTO DO OASFITTING I i NAME d TYPE OF BUILDING LOCCAT.IOON� OF BUILDING PLUMBER OR OASFrrTER RatPh J. G•iangnegoti A. 3 G' a Ptum6Lng 8 Heating, Inc. LIa NO. 8722 -. " PERMIT GRANTED DATE 19� GASINSPECTOR PROGRE9 INSF L l MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) �/ ,y�42d ✓/ ' r Mass. Date . jg Permit # " �p �,01 Building Location^Qo97 T,A cr/nm— AVr.,'u- ' Owner's Name_&j-!YM� days, 91'r/:�z Type of Occupancy, tlo7W New ❑ . Renovation ❑ Replacement g—Y Plans Submitted: Yes❑ No [g- lam■���������������� ■������� mom cz Installing Company Name 3 rrA Vinmhin8 B Noe roil. 1nr_ ,Check one: Certificate Address 188 A(a.En St., 'Rte. 28 ®/Corporation R97 r Denni..epat, MA 02639 ❑ Partnership Business Telephone 508:398-3846 * ' ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter _ Ra.Lph J. Glangneawt.io, Jn. INSURANCE CO ERAGE: I have aYe rtent bAtty n u a ee policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. 111 It you have ciieckedyes,, please x. see Indicate the type coverage by checking the appropriate bo A liability insurance policy ❑ Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws. and that my signature on this permit appllcation waives this requirement. Check one: Signature of Owner or Owners ent Owner❑ Agent ❑ 1 hereby cerGy that all of the details and Information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the pemolt Issued for this application will be in compliance withal pertinent prWsions of the Massachusetts State Gas Code and Chapter 142 of the Ge eral Laws. ey T of Ucense: tir ?,= �.�,�:v" Tiff . mbar Signs re o tense um er or Gas Fitter' Cil /T e fitter Master Ucense Number Ralph 1 _ rin�hv n90,t.i0, Jn. own " Journeyman puJ'� u c "I-.. ' BELOW FOR OFFICE USE OHLY s • i �- -:� � � �. PROGRE�L INSP • � �� XAk INSPEMON SKETCHES FEE APPLICATION FOR PERMITTO DO GASFITTING NAMM�E.A TYPE OFF BUILDING . /1 �(/i�-Y7�-!)ram-�7' /1 �—T!•/T . LOCATION OF BUILDING A Tr /P:'l��e c PLUMBER OR OASFiTTER Ra•£ph J. GianQhecoti 3 G's Ptumbina 8 Heating, Inc. - LIC. NO. 8722 .. _ PERMIT GRANTED DATE 19 ` - OASINSPECTOR of r TOWN OF YARMOUTH Building Department BUILDING (508) 398-2231 ext.261 PERMIT NO e:Qs-»,5 ......-- PERMIT ISSUE DATE 5{13/2QQ9 _ ; PROPOSE ItIS APPLICANT VeWttDavenport .. JOB WEATHER CARD .............................. PERMITTO -Repair ; AT (LOCATION) 10327SOUTH SHORE DR NING DISTRICT R-25 Bldg. Type: Canmercial SUBDIVISION MAP LOT BLOCK 1026.118 r BUIiLDIN$ IS TO BE: CONST TYPE F-1 USE GROUP= LOT SIZE CONTRACTOR strip and reroof, 50 squares, paper and vent to code REMARKS LICENSE 012060 Davenport, Dewitt no 20 North Main Street AREA (SO FT) EST COST ($) $10,000.00 PERMIT FEE ($ $75.00 South50839822932293 th MA 02664 OWNER IRIVIERA BEACH LTD PARTNERSHIP BUILDING DEPT BY ADDRESS 20 North Main Street SouthYamiouth I MA 102664 1 PHONE 15083982293 INSPECTION RECORD FIELD COPY Date Note Progress - Corrections and Remark Inspector M. AeI' 94 Official Use OOnnll t//Z camnwnwaa[ih o� ///W9ac�a6Q�! �c o "' r� I Ulu cc�� cc77 Permit No. � 1 11aParlmant o�.}ira �Yrvicad Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] Icaveblank v APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code ( IEC), 52 CMR 12.00 ! EASE PRINT IN INK OR TYPF ALL INFORMATION) Date: J gf/1) City or Town of: � � -in�l0 J Ti-;~ To the Ltspeclor of Wires: this application the undersigned gives notice of his or her intention to perform the electrical work described w. cation (Street & Number) 3 SUu TN S 4o 2 Q, b 7L i v FL vner or Tenant �[ (/1 �t 2a 6 6A-G(4- tMo T(i L Telephone N Address this permit in conjunction with a building permit? Yes ❑ No 9-10' (Check Appropriate Box) of Building Utility Authorization No. Service New Service Amps / Volts Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ 14.07 L No. of Aleters No. of Aleters G n rrrl 4, Completion of the following table may be waived by the IIJSpector ofWires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans r o ota Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool rnd. Above ❑ In- ❑ d. o. o Units cy tg rng Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o eteng D an Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat aTotal P umber ors Detection/Alerting No. of Self-Contained No. of Dishwashers Space/Area Heating KW icippi Local ❑ un Connection ElOther No. of Dryers n Heating Appliances KW ecurity Systems:* No. of Devices or Equivalent o. o Water KW Heaters o. o o. o Signs Ballasts Data Wiring: No. of Devices or E uivalent No. H dromassa a Bathtubs y g No. of Motors Total HP a ecommu mcatrons V 1'y"a No. of Devices or E uivalent OTHER: Attach additional detail ijdesired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: t,(/(GL GQ-t_ G Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The lersigned certifies that such cove ge is in force, and has exhibited proof of same to the permit issuing office. W CHECK ONE: INSURANCE [BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRAfNAME: FULLFzrl. TZL1tcT4i a LIC.NO.: /llSf Licensee: L- Ayvc.& t E/yFi4.WA4 Signature LIC. NO.: p (Ijapplicable, enter "exempt" in the license nun er line. Bus. Tel. No.: o -% S '� O Address: �o'Z(o !7- /ltl0 —th e Ff )&(✓ r Alt. Tel. No.: ty *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. rJ OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally "Trequired by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. owner/Agent PERMIT FEE: $ 0 9 Signature Telephone No. _g red Jket John Verity General Manager Blue Water & Riviera Beach Resort 327 South Shore Drive • South Yarmouth, MA 02664 508-398-2273 • 508-398-2288 • Fax:508-398-1202 www.rediacketresorts.com • Email: jverityn bluewater-resort.com FILE CO 0 Jim Brandolini, Building Commissioner Town of Yarmouth 1146 Route 28 S. Yarmouth, MA 02664 July 29, 2009 Dear Jim, In July of this year the Town of Yarmouth received an anonymous complaint regarding some issues at the Riviera Beach Resort. Ken Smith, our Director of Operations, and myself performed an inspection with six others from the town and agreed to address the issues of concern. I am attaching a list of the items and the actions taken to correct them, as well as who performed the work. 1. OUTSIDE GRILL WATER LINES, GAS LINES, ELECTRICAL OUTLETS: Fuller Electric replaced three outlets and installed GFI rated boxes with exterior weather- proof covers. Exterior gas and water lines were inspected by Hall Plumbing and found to be correctly installed and up to code. Two electrical panel boxes had unused breaker slots that needed blanks installed. This work was performed by Fuller Electric. 2. OPEN WATER PIT, SINKS DRAINING: Sinks draining were connected to correct drain and traps were cleared. Hall Plumbing and Riviera Beach maintenance will clear traps bi-monthly moving forward. 3. ROTTING DECKS: Rotting deck supports were all replaced by Finnemore Constrcution and floor was replaced in room 107 of the Courtside Building. Work was performed by Joe Finnemore and the Riviera Beach maintenance staff. 4. UNREPORTED FIRE: Fire Marshall and Building Inspector reviewed exterior area of Grande Building B, where small fire occurred. All exterior lights replaced with energy saver bulbs and new fixtures installed. Damaged pressure treated boards were replaced. Work was performed by Joe Finnemore and Fuller Electric. John Sawyer of the Yarmouth Fire Department reviewed and signed off on completed work. See attached. 5. DIRECT FILL LINES: Direct fill lines were corrected by Hall Plumbing and new back flow preventer valves were installed on indoor pool and spa. Outdoor pool had no concerning issues. 6. BLACK MOLD: Black mold investigated with no documented mold located by the maintenance staff and General Manager of the Riviera Beach. 7. KITCHEN: Overflow of sink water under building was located and connected to proper drain by Hall Plumbing. 8. DECK -CARRYING BEAM: Deck -carrying beam under room 131 in Poolside Building found to be safe. Even so, we will reinforce after the 2009 season. This was,okayed by Andy Arnault. 9. UNPROTECTED GAS METER AND GAS VALVE: Lally poles were installed in front of gas meters and valves. Work performed by Frank Pina, Riviera Beach maintenance staff. Fire extinguishers were installed at outdoor grill by Ralph J. Pcrry, Inc. on July 13, 2009. These items have all been addressed and any and all substandard items have been brought up to code as of July 27, 2009. I appreciate the cooperation of the Town of Yarmouth officials who responded and feel confident that the Riviera Beach Resort is now in compliance with the town's building codes. jSinceerity, General Manager iera Beach Resort lqi�- �' i, S"o c? • G i `/ • 6 SaA Please come in to the office ASAP between 8:30 AM - 213M. 1r 1 The office will be closed on Friday for the holiday. Andrew Arnault - �y Local Building Inspector From: mike [mailto:buyhubley@gmail.com] Sent: Wednesday, July 03, 2009 8:36 PM To: Arnault, Andrew � rJ Subject: reporting violations , Y `- 3Z1 Soma Hi I would very much like to report a company in south yarmouth for code violations. I do not know how to go about it as different violations are covered by different departments. should I make each report separate? 1. construction without permit (water line ra iinne run, electrical sub panel with numerous electrical outle uried LP gash e. ) No permits pulled work done on down low. 2.Open Grey water pit servicing sinks smell covered up using chemicals. drain d by 2 make shift sump pumps. located Directly under hotel rooms. — c.l 0J e}" 3. rotting decks main supports collapsing rotten floor in bathroom of at least one rented room. vwA`^— F --130 4. UN reported fire on May 15th burned wall light fixture and burned through deck. Fes-- ZSL 7J 3 5. Direct fill lines to�swimming pool without any form of air break or back flow prevention. 6. Extreme Black mold in nearly every room in same hotel. — c •v�Tsi %� `--� please let rYie know if these should be reported. Will stop in office if i know who to speak with and which issues maybe of interest. thank you mike 0 I Hi I would very much like to report a company in south yarmouth for code violations. I do not know how to go about it as different violations are covered by different departments. should I make each report separate? MIA, 1: construction without permit (water lines & drain line run , electrical sub panel with numerous lebcirical outlets Bu ieo�1 LP gas line.) No pgrmits pulle wo done n down low. 9 ( tft° ?'/ LjeCtr; C- _(,.,"CVr Nzfl r;,+•,-; t„ fN r %mot . 2.Open Grey water pit servicing sinks smell covered up using ch micals. drained by 2 makPg� shift sump pumps. located Directly and r hotel roo s. -/AW,0; �-i /4.7ZL-r/ VL�� V/ S/.%' krM y,e----ro--P; SI/�' r-, ,' �'c / �v+•' pficn^� -Cmw 3. rotting decks ;rain supports collap ing rotten (floor in/bat room Q at lea t one rented room.` `- (- i 3 a —/.,� j crt� Fi f ��`�l - �,.I'I S4. UN reported fire on May 15th burned wall light fixture and burned through deck. 4 S. Direct fill lines to swim i pools vgithout any form of air break or back flow prevention. "-c-d =0-:a r• %C-- 6. Extreme Black mold in nearly every room in same hotel. please let me know if these should be reported. Will stop in office if i know who to speak with and which issues maybe of Interest. o(�a rtC� 511./4' —'�/hfPeu� l�t'^" u . DC-4 J � uK �!o � '`1s v�Vt — �kclC-�(-e5i41� co PA Hi - I would very much like to report a company in south yarmouth for code violations. I do not know how to go about it as different violations are covered by different departments. should I make each report separate? 1. construction without permit (water lines & drain line run, electrical sub panel with numerous electrical outlets Buried LP gas line. ) No permits pulled work done on down low. 2.Open Grey water pit servicing sinks smell covered up using chemicals. drained by 2 make shift sump pumps. located Directly under hotel rooms. 3. rotting decks main supports collapsing rotten floor in bathroom of at least one rented room. 4. UN reported fire on May 15th burned wall light fixture and burned through deck. 5. Direct fill lines to swimming pools without any form of air break or back flow prevention. 6. Extreme Black mold in nearly every room in same hotel. please let me know if these should be reported. Will stop in office if i know who to speak with and which issues maybe of interest. vc4 bVCl�ou �✓���ri..e-�-(ti 13S- 4-15wi1�' fie, 4- I'S v.JV {- Xm )S<i II ,- x N c � L�N , Ilc" 416- J1 19 /p q • �o redjacket resorts Andrew L. Amault Town of Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 July 14, 2009 3Z� So.f�-.ram D�• Dear Mr. Amault, 1358 Route 28 South Yarmouth, MA 02664-3143 Direct: 508-398-7900 Toll free: 800-277-7900 Fax: 508-760-9250 www.redjacketresorts.com Pursuant to our conversation at Riviera Beach on Tuesday July 7, 2009 I am requesting an extension to the date of September 1, 2009 for testing and certification of all exterior bridges, steel or wooden stairways, fire escapes and egress balconies. I have started the process with Michele Cudilo, P.E. and expect to complete all of our inspection sometime in the next couple of weeks. Based on our findings we are in relatively good shape and would need a week to complete the minor repairs needed. The issue with a September 1, 2009 deadline is the repairs needed would have to take place in the height of the season and require a second inspection from Michele. I am requesting an extension to October 1, 2009 this would allow me time to complete the repairs and finish the inspection without any disruptions to our guest during the busiest period of the year. If this date is acceptable to you could you please advise me at your earliest convenience at 508.760.92127 I'm also forwarding a completion letter for Blue Rock Golf Resort. I appreciate your understanding and look forward to hearing from you. Z erely Kenneth A. South Director of Operations Red Jacket Resorts 20 North Main St. South Yarmouth, MA 02664 508.760.9212 7• i1•o1 7� �-- °K Red Jacket Beach Resort & Spa, Blue Water Resort, Riviera Beach Resort, Green Harbor Resort, Blue Rock Resort & Golf Course - Cape Cod, Massachusetts Red Jacket Mountain View Resort & Spa, Kahuna Laguna Indoor Water Park, Fox Ridge Resort North Conway, New Hampshire -\ Commonwea[Ut of /r/aefac4uJalfa. V. et Official Use Only cc77 Permit No. CaLJ tCJ 2,parlmanl of ira Sarvicae Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (NEC), 7 CMR 12.00 PLEASEPRINTININKORTYPEALLINFORAIATION) Date:/�/� 9 City or Town of: YA&mo u -r p To the Inspectorof Wires: �is application the undersigned gives notice of his or her Lion to perform the electrical work described below. Location (Street & Number) �j Z-7 lrr}i S 2 E ,--� ;Owe erorTenant T?.1 Ut FI t2►4 13Ft►¢GI1- `rtOTFi !� Telephone No. i f �w er's Address Is t(lis permit in conjunction with a building permit? Yes ❑ No (Check Appro ate Box) Pur;Ilpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑l etc s New Service Amps / Volts Overhead ❑ Undgrd ❑ No. o ters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: REPPILS 7-0 CU D IF, / SSufi.S SN,4C1G Aow 0FF1C,2 BylLOlNfry f no L P t' j Completion of the followine table may be waived by the InsDector of iVires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators. KVA No. of Luminaires Above n- Swimming Pool rnd. ❑ rnd. ❑ o. o mergcncy rg rng Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o erection and Initiating Devices No. of Ranges al No. of Air Cond. Tons No. of Alerting Devices o. of Waste Dis posers p eat ump Totals: um er ons o. oSelf-Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ '"unicip?l ❑ Other Connection No. of Dryers ry Heating Appliances KW Security Systems:* No. of Devices or Equivalent o. of Water KW Heaters o. o o. o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. H dromassa a Bathtubs y g No. of Motors Total HP a ecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail ifdesired, or as required by the Inspector of Wires. %A Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless e licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. `CHECK ONE: INSURANCE 0, BOND ❑ OTHER ❑ (Specify:) ertify�, under the pains and penalties o perjury, that the information on this application is true and complete. 11 ' qIRAI NAME: LIC. NO.: N `'l 4 icensee: -e Signature LIC. NO.: (If applicable, rater "exem t"irlthelicense�yn Bus. Tel. No.: `�iDR� 30 Address: FJtd�'�1J✓vr Alt. Tel. No.: Per M.G.L. c. 147, s. 57-61, security work requires epartmcdt of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally nrequired by law. By my signature below, I hereby waive this requirement. I am the (check one) El owner ❑ owner's agent C) Owner/Agent PERMIT FEE: $ Signature Telephone No. y BUILDING PERNIIT APPLICA TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 Ext. 261 ASSESSOR'S IIEORMATION: Map: 1 Paroel: Its I M TEL. ;off Za V304. ww S1 (668) 3(8-2245 ❑ Residential P&MMVW Fst Cast of Comnttction $ 1C�, o op Ilome hnprovement eutttraotar tic. r cammawoo Supervisor Liao (? L>tvo Worl:mm's eompauatiau hwtr m= (chock one) ❑ I am the hotmmou ❑ I am the sole psopricw?d I hm wwws Campmsaim iommoe hmmnce Compmy Name Worker's Comp. "icy# WORK TO BE PERFORMED ❑ Toot (Fn*Rctir"CerHBatesttwhvQ wood Stove shod ❑ Sidior r of Syusra o ReOmmoeot wiodowc 0 ❑ Rcoacccoca doom r IiRsroot:IofSCP. �S.o — Xlg ofddA iben ()toteso.v �ofexkftroot •Iuo debris wM be disposed of at � j e�C L 0 ofFuZO I deolere ardor pashties of perjury Hot the ststemmts loci cootshW are true sod Davao to Iho bat ofsopr koowle fto and bdid 1 soderstsod that day Wso aoswor(s) will bo jud can for deald or rcv ca*a of my bean and for psooaLtion aader 1dAL OL 261L Secdoo 1. •.5 - J• - l� 51 I3lo, Owners ftostoro (or Approved By. I I 1 Dam zmiogDiwkc f 1 a � U / ITistarical District: ❑ Yes P"No Flood Plain Zoos /�] Ales 0 No waterRcKuvc Diwkc Withine & of Wcdm l& O Yrs //j\ Ycs ❑ No VD I • - • ,per The Commonwealth of Massachusetts Department of Industrial Accidents office of Investigations if 600 Washington Street Boston, MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizatiowlndividual): 'D0WU+-PoZ4 t>ot W 110cw �m• Address Zo V IkN- SC' City/State/Zip:'� Are you an employer? Check the appropriate bo Waant 1 Type of project (required): 1. ❑ I am a employer with 4. a general contractor and have hired the sub -contractors 6. ❑ New construction employees (full and/or part-time).' 2. ❑ I am a sole proprietor or partner- listed on fire attached met' 7• ❑ Remodeling ship and have no employees 'These sub -contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' insurance.t 9. ❑ Building addition [No workers' comp. insurance comp. 5. ❑ We are a corporation and its 10. Electrical r ddi airs or ations ❑ required.] 3. ❑ I am a homeowner doing all work officers have exercised their right of exemption per MGL 11.❑� /Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 17, of repairs insurance required.] t employees. [No workers' 13.❑ Other. comp. insurance required] •Any applicant that check, box M mat also fill out the action below showing *" wmkcm' cortyat bOn poky inkrzod n• t Honwowncra who submit dais &Mdavit indicating they we doing all work and that hue ouuuk cmitrwtas mot wbmit anew affidavit indicating such tC,onttactois eat check this box mat awrhed an additional shoes showing the acme of the sub•conirwtms and state whether or not those entities have employees. If the subtontracww have cnVk*vu, d+ey must provide dwir woikas' comp. policy nwnbcr. I am an employer that is providing workers' compensatioe inanranee for my employees Below is the pokey and Job site Information. Insurance Company 2 r t,—,V . Policy # or Self -ins. Lic. #: W G 5 t 1 looz- Expiration Date: Job Site Attach a copy of the workers' compensation policy City/Statemp: S. '/Ag-&A page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal Penalties of a Cute up to S 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 th; violator. Be advised that a copy of this statement may be forwarded to the Office of 1 do hereby certify under the pains' and pexa/ties of peerjury that the information provided above is true and correct. 1-Date:9��[y Imo% Phone # �3 rut only. Do not write in thh area, to he comp y city or town ofJiclal. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of HealUt 2. Building Department 3. Cityfl'own Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person, Phone #: Ot -;✓4W �i'. - -1 Q;5o fl r] COP $YARMOMA44 DOW !�v 90004 ...,boo R G FIV I L T 44 y-.p ai ry�j u a DC I . . . . . . _ - ✓ AdmofKWil mg Regulat`ons and Mar s One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvemei Vbutractor Registration Registration: 106024 � Type: Trust i I F19 Expiration: 72l/2010 DAVENPORT BUILDING COM Dewitt Davenport 20 North Main Street South Yarmouth, MA 02664 OPS-CA1 A 5oA407107-PCe490 ' �is Poom�noauaealG4 o�✓iiaaoaa/uaeQ3 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registratlont, 106024 T xplraflon'=0=010 Tri 271689 DAVENPORT BOLD Dewilt Davenport 20 North Main Street; South Yarmouth, MA TRUST Administrator- Trtl 27168$ late Address and return card Mark reason for change. U Address ❑ Renewal E] Employment O Lost Card License or registration valid for individul use only before the ezptration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston, Ala. 02108 Not vali with t signature _ Commonwealth of Massachusetts o 1;dal use unl C Department of Fire Services PcrmitNo. l O" 75 D ARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked MAY C'D r Rev. 1/07] leave blank APPLIC TION FOR PERMIT TO PERFORM ELECTRICAL WORK IY work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASEPREVTININK ORTYPE ALLINFORAMTIOA9 Date: 5-14-10 Cityor Town of: yarmouth To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 327 SOUTH SHORE DRIVE Owner or Tenant RIVIER,$ BEACH MOTOR INN Telephone No.508-398-2275700 Owner's Address SAME Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building COMMERCAL Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: INSTALLATION OF 2-NEW HORN STROBE LIGHTS AND INSTALL A 411UD DIALER Comp etion o f o awing table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil.-Sus p (Paddle) addle) Fans r o ota Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above n- Swimming Pool rnd. ❑ rnd. ❑ No. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners n and et g Devices o. o Initiating Devvices No. of Ranges No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers �T Pump umber ons No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local Elunicipa Cyyonnection El Other No. of Dryers Heating Appliances KW SecN of Det ices or Equivalent o. o ater KW Heaters o. of INO. 01 Signs Ballasts Data Wiring: No of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications No. of Devices unication E u ing: vat OTHER: =d Attach additional detail iJ desired, or as required by the lnspec! of C t V- Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee providcs proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) 1 certify, under the paints and penalties of perjury, that the Information on this application Is true and complete. O FIRM NAME: Intercity Alarms LIC. NO.: 11975-A i Licensee: William Allison Signature LIC. NO.: 11975-A (/:applicable, enter "exempt' in the license number line.) Bus. Tel. No.: 508-394-9900 -4z.�Addrss: 22 White's Path, South Yarmouth, MA 02664 Alt. Tel. No.: 900 R72 9923 .4 *Per M.G.L. c. 147, s 57-61, security work requires Department of Public Safety "S" License: LIC. NO.: SSCO 001348 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's aeent. 2 Owner/Agent PERMIT FEE: $ Signature Telephone No. Cormnonwaalth of ) amacL*11d Official Use gnly 2Ccyycc--�� Permit No. �l. �'� ` epartmarrt of ire Sarvicas Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMTION) Date: City or Town of: Y%42Moo r P To the Inspecto �{ ,i By this application the undersigned gives notice of his or her intention to perform the electr[ca w r • escribed below. Location (Street & Number) 3o'2 S 0Tf4 S lkoa FL ,Dk d i 2011 Owner or Tenant (� I V 1 2A 8 64,c -F /Z eS o R� T le �No—I Owner's Address l Is this permit in conjunction with a building permit? Yes ❑ No E3— (Che a vrugre ox) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Dieters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ( A-r- 41r, rI a n fi Completion of the following table may be waivedbv the Inspector of {Vires. No. of Recessed Luminaires No. of Ceil.-Sus Paddle Fans p (Paddle) o. o Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires SwimmingPool g Above ❑ r ❑ rnd. rnd. o. o Units ncy ig i mg Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o election an Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers p eat ump Totals: umber ons o. o e - onta►ne Detection/Alerting Devices No. of Dishwashers Space/Area IIcatIng KW Local ❑ Connect on ❑ Other No. of Dryers Heating Appliances KW Security r Vevciccs or Equivalent o. of Water KW Heaters o. o o. o Signs Ballasts Data Wiring: No. of Devices or Erin valent No. H dromassa a Bathtubs y g No. of Motors Total HP a ecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such cover a is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTIIER ❑ (Specify:) I certify, under the pains and penalties ofperjury, that the information on this application is true and complete. FIRDI NAME: Fy"ta tL rLrF.[T24 L' D t LIC. NO.:j4:-Lljq F Licensee: 1.I4NGFL U A'Chtvff/ZNrrW Signature (Ifopplicable, enter •'exempt" in the lie se number n e.) Address: IOla�i Ytivr4 1"j l�• av _ LIC. NO. Bus. Tel. Nu. 77 5 m3� Alt. Tel. No.: 'Per M.G.L. c. 147, s. 57-61, security work requl'res Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE: $ 0 Signature Telephone No. �^ .. (nommanw•a[lh o/ ///maachw•tt! Official Use Only � cc cc77 Permit No. ( ( " I 2aparim•ni al5ir• Seruic•s Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code ( IEC), 27 CMR 12.00 PLEASE PRINT IN INK OR TYPE ALL INFORb1AT10N) Date: S131111 14 City or Town of: `//=}-awO UT 1+ To the Insr— ector of {fires: Byjthis application the undersigned gives notice of his or her intentio to perfo i the electrical work described below. Nti cation (Street & Number) 3 `� �• jer(1t_, o vner or Tenem ant 1 L t (/t rt ao- A tz A-C 4 (2-aso o L Telephone No. ftrgr, Ito Wrier Address this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) rposc of Building Utility Authorization No. s= xisting Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: jhl pO0 ti p00 L L!G tj_7- S 67f/b OVr.1 rD /2i 0vrt•A-t- a aPr)-tn,S Completion of the following table may be waived by the Insnector of Wires. No. of Recessed Luminaires No. of Ceii: Susp. (Paddle) Fans No. of Tal Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires SwimmingPool Above ❑ nr ❑ rnd. rnd. o. o Units ncyLighting Battcry Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o erection an Initiating Devices No. of Ranges No. of Air Cond. Tons . No. of Alerting Devices No. of Waste Disposers p eat ump Totals: Number Tons o. oSelf-Contained Detection/Alerting Devices _ No. of Dishwashers S ace/Area Heating KW p g Local ❑ fort cipr ❑ Other Connection No. of Dryers Heating Appliances Key SecuriNo. f fie' i es or Equivalent o. of Water KW Heaters o. o o. o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. H ydromassa a Bathtubs S g No. of Motors Total HP Telecommunications irm No. of Devices or E uivalent OTHER: Attach additional detail iJ desired, or as required by the Inspector of Wres. stimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. �CIIECK ONE: INSURANCE [I BOND [IOTHER ❑ (Specify:) I certify, under tire and penalties ofperjury, that the information ors this application is true and complete. FIRSINAME: Ilusii'I. iZLrrcmtG CU :rz LIC.NO.: // 9 `� Licensee: L14NU7. ejfVjcirl,p/ry y Signature c& (Ifopplicable, enter "exempt" in the licensenumberline) Address: LIC. NO.: Bus. Tel. No.: Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage nomrally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's aeent. Own PERMIT FEE: S 0 °i Signaturetune Telephone No. .J Inspection Date: TOWN OF YARMOUTH 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-0836 BUI LDING DEPARTMENT NOTICE OF VIOLATION S /20 / r • :.� ;, ,.:�,t� `� via ELECTRICAL GAS PLUMBING SIGNS Inspection Type: ZL � Property Address: —W S �Soyrf/ )404 o - Name: h ` v I E, (27(l '7 Cp u ( r A Owner ❑ D/B/A: Mailing Address: Telephone: Tenant ❑ City/Town:(102 t✓10y744 State:_Zip Code: An inspection of the aflove captioned property was conducted by the undersigned, during which the following VIOLATIONS were observed: �tnc(�rN C��tKs \t You are hereby ordered to abate or correct said violations within _days. Failure to do so may result in criminal/civil complaints being filed against you, which may be subject to fines as prescribed by pertinent laws and regulations, or may delay the issuance of your license. You are also required to contact the Building Department for a re -inspection by the time noted above. Signed: 1I61'jl\ wc:= Title Copy Received By: Original - Owner/Tenant Yellow Copy - Licensing Authority Pink Copy - Bldg. Dept. n IWI = I'm / N () C. 19 W Z V z W -' j n W cccommmonwratlk o`cc/77//aaachwo(L! 2eparlmonl o�Jiro Servicoe BOARD OF FIRE PREVENTION REGULATIONS Official Use Only � r r Permit No. ( l rr Occupancy and Fee Checked Rev. 1/07j leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 PRINT IN INK OR TYPE ALL INFORMATION) Date: 6/912011 City or Town of: Yarmouth To the Inspector of Wires: this application the undersigned gives notice of his or her intention to perform the electrical work described below. on (Street & Number) 327 S. Shore Drive o' Tenant Riviera Beach Resorts Telephone No. 508-760-9212 's Address Same permit In conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box) _ of Building Commercial Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters \ New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace lighting with energy efficlent fixtures 34726 Completion of the following table may be waived by the Inspector of if'ires. No. of Recessed Luminaires • No. of Cell: Susp. (Paddle) Fans o. n ota Transformer KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ n- ❑ cod. rnd. o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FiRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection and- Initiatingand- Initiating Devices No. of Ranges No. of Air Cond. Tons tal No. of Alerting Devices o. of Waste Disposers eat Pump Totals: erors " o. aSelf-Contained Detection/Alerting Devices Ito. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection Na of Dryers rY Heating Appliances KW Security ystems: No. of Devices or Equivalent o.oWater KW Heaters o. o o. o Signs Ballasts Data Wiring: No. of Devices or E uivalent No. Itydromassage Bathtubs No. of Motors Total HP a Nomm Devices o r Equivalent No. of Devices or E uiva ent OTIIEII: \ Attach additional detail tf desired, or as required by the Inspector of tVires. Estimated Value of Electrical Work: $1,400.00 (When required by municipal policy.) Work to &24: 6/2011 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANa COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: 'INSURANCE ® BOND ❑ OTHER ❑ (Specify:) P ston Assurance Alliance 4/12 I certl&, under the pains and penalties ojperjury, that Nre lnjormatlon pllcatlon is true and completes FIRM NAME: Thielsch Engineering O.: Licensee: Ralph Carroccio Signatu LiC. NO.: 657A flfappllcable, enter "exempt" in the license number line) Bus. Tel. No.,• 401-784-3700 Address: 1341 tlmwooa Ave., Uranston, KI U291U Alt. Tel. No.: 800-422-5365 *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE: $ 80.00 Signature Telephone No. Hall, Lee From: John Verity Overity@bluewater-resort.com] Sent: Wednesday, May 08, 2013 8:47 AM To: Amault, Andrew; Hall, Lee; KELLIOT@YARMOUTH.MA.US; Armstrong, James; prenaud@yarmouth.ma.com Subject: Riviera Beach Resorts request for inspections for 2013 season Attachments: Picture (Metafile); Picture (Metafile); Picture (Metafile); Picture (Metafile) Good morning Gents, I will be attempting to open our Resort in a few weeks. I request iPM order to do so. Could we please inspect the property loacted at 327 South Shore Drive South Yarmouth o Frida between 1000am and 230pm. Please call or email me so iam prepared and on premise for these inspections. is 774-208-1305. Thank you John Verity c, John P. Verity General Manager Blue Water Resort & Riviera Beach Resort Hotel:508.398.2273 Direct 508.398.9694 ].vve�erity nvieraresort.com f loffl + 1-04 T dllpov- 64s s/y 0 9 4sYsT�� —til" s/,5e -� oo -r5GAS 41A)-e Nff b�S T� � � �' T1 (AJ Ts D ( N/If //v TWI/ G4 TOWN OF YARMOUTH r. BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1261 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG NAME: RIVIERA BEACH RESORT ADDRESS: 327 South Shore Dr, S. Yarmouth This log is to be signed by the appropriate inspectors upon a satisfactory inspection of your building/premises. When all signatures are obtained, this log shall be presented to the License & Permits office and/or the Health Department in order to obtain your license. Licenses will be withheld until all inspectors have signed, Building Commissioner Rep. Date Comments Approved for License Issuance Yes No Fire Department Rep. Date Comments Approved for License Issuance Yes No Board of Health Rep. Date Comments Approved for License Issuance Yes No Plumbing/Gas Inspector Date Comments Approved for 11cense ssuance Yes No Electrical Inspector Date Comments Approved for License Issuance Yes No Taxes Paid Yes No Rev.Sept 2003 Hall, Lee From: John Verity <jverity@rivieraresort.com> Sent: Wednesday, May 07, 2014 8:59 AM To: Amault, Andrew; Elliott, Ken; Hall, Lee Cc: Hill, Linda Subject: Riviera Beach Resort opening inspections Attachments: image001.gif Hi Andy, Ken , Lee and Linda, I would like to schedule our opening inspection's for Tuesday May 20t' at 327 South Shore Drive. Our opening date is May 23`d at 12 noon. Please email me back to confirm that this day will work well for each of you. Andy can you contact The Fire Department as well to join in? Thank you John Verity my cell number is 774-208-1305.1 also will contact Phil from The Health Department this morningl John Verity General Manager Blue Water -Riviera Beach Resort 327 South Shore Drive South Yarmouth, Ma 02664 508-398-2998 phone 508-398-1202 fax iverity(a),blu ewater-resort. com iverity(a)rivierare sort. com www.rediacketresorts.com I 1/21/2015 SlipGen- Portal Home Town of Yarmouth Template [Building Dept] Slipsheet Identifier [sg17245] Document Category Building Permits Map -Block Number 026.118 Street Number 0327 Street Name SOUTH SHORE DR Department Building Parcel ID 3335 Backfile Batch Scan No Document? Additional Naming Info Index Operator Operator, Yarmscan Date - Time 2015-01-21 - 12:17 httpJAaser6che1MipGerV 1/1