HomeMy WebLinkAboutBuilding Permits' of.vgR`
3(c TOWN OF YARMOUTH BUILDING DEPARTMENT
y` $ 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ezt.1261
SIGN PERMIT APPLIC ION �2
Date /1 2,10 /3 Application Accepted :C Permit No.1101
Applicant Instructions
1) Applicant shall complete both sides of application.
2) One application form is required for each sign. Each sign will be assigned its own permit number.
3) Applicant shall attach separate 8'/3"x I I" sheets including the following diagrams:
A) Design, dimensions and colors of the proposed sign
B) Freestanding Signs: provide certified plan by a professional land surveyor that describes how the proposed
sign meets the zoning requirements included in Zoning Bylaw 3035.6 or 3035.4.2 (as applicable). A
stamped and sealed "as -built" will be required before the permit will be issued.
C) Attached Signs: show length of portion of building frontage that is occupied by applicant.
D) Temporary Signs: show location for sign
4) Sign permits are $40.00 each, payable at the time of application.
Address of proposed sign e1 1-yA.0 uo ucN Ro . Historic Distrito
Name of Business for proposed sign ,SN%FL Dr /92I
Name of Business owner S/{i,Ftpr L'OAla/Wfi S79.6OF7_ LP
Mailing Address of Business owner Zoo ebAlowrsss S'T QUi.vey, MA CJ/6 j
Business Owner Phone: Business L/7- 37G — 7//00 Home
Name ofBuilding Owner R,'ALa of C'APa top LLC Phone
fast'
Sign Builder SiCAJ D.F.0 CAI Se- Sign Materials 13�y" CSDA P ��1o0-00
Da561
Sign Builder Address /70 ,Ciaeitri' sT 6acr1erow Y4 Phone SdP- 6'kd-007y
Singly Occupied Building ✓ Business Center Internal Light ExtemalLight
FreestandIne SiLyn Size: IMFPL,I CB F1r%ST/ ✓G i7efc tWLY F' f /r 7/VP !✓ipa K I
05in/6 FYJCr.✓C POLEC)
Attached Sion Size:
Temporary Sien
Dates: /j/ffJo/3
Please complete other side of Sign Permit Application
9
4
All Permits are subiect to the approval of the Sian Inspector
I hereby agree to conform to the provisions of Town of Yarmouth Zoning By-law Section 303 governing sign
construction and installation. I further agree that this sign will not be altered, added to or changed in anyway unless
a new permit has been issued. Sign Permits are not valid until the Building Commissioner issues Use and
Occupancy Permits (where applicable). Freestanding sign permits are not valid until the "as -built" from a
professional land surveyor has been received
Signature of Applicant: 6a,,r�. Date AJ2,013
Property Owner Authorization: I hereby authorize the applicant to act on my behalf in all matters related to this
sign applicatiot
Approved by:
With the following conditions:
I have read and understood the conditions of this Sign Permit listed above:
Date /�/.3
Date
>16vH)vb h¢75Y
CShields MRI
CAPE coo
2 IYANNOUGH ROAD
I CT & MRI IMAGING I
5" x 71" -13/4" thick carved cedar
to match existing sign - double sided
S/GNdesfa inc
46j-
1-800-500—SIGN
Tel. 50"0-0093 Fax 508-580-0096
1100 W Chestnut St, Brockton, MA 02301
www.ss0ndesdyJnc.eom
Date
Additional Sign Panel For Existing Sign ""` SPECS.
coum
9/17/01 M
BACKOPOAD
McCarthy & Company
DESVER Eft
Steve McCarthy
January 7, 2013
Yarmouth Building Dept.
Town Hall,1146 Rt. 28
So. Yarmouth MA 02664
To Whom It May Concern:
I authorize Sign Design, Inc. to act as our agent for the enclosed sign permit application.
Business Name: Shields
Property Location: 2 Iyannough Rd. Yarmouth MA
Building Owner: EOPL11F CA fC C6pL , L C S41ci-O
Building Owner Address: Teo fn.fit"r Sr (; b1J 6Q
Phone: 617 37010
Sincerely,
uQcal1 r
Title
EM
Date
Cedar Panel
SIGNDES191L
:
Quantity: 1 double -sided :.-� ;:�
°0""'•'"""°'
Size: 71.625V x 36.125'H -- - \
170 Uberty Gnat
Matelot: 1 3/4' Cedar Panel - -----"--z,' I i>;
Brockton. MA 02301
Graphke: V-Bevel Carved Graphics • PaW Fried: PMS 288C, 355C T ' -
Boa-S"114
Installation; Installed Only Exisang Posts
m
c.n coo
Client
Shelds Congress
Street LP
Description:
,yt1g(,
New So Panel
MM
2 lyarmugh Road
_I
Date: 12.12-12
CAPE COD
Project Number.
69220
Project Developer.
C. Jones
2 IYANNOUGH ROAD
Designer.
BM
Design Scale:
100%
71 S'B'
w Y4.n� wrwuYw
YT..Mww�
r.«au«a..Yryo.ww
w r.r,w.r.Y«wY.�.►
The Commonwealth of Massachusetts
Department oflndustrid Accidents
Office oftnvestigations
600 Washington Street
Boston, MA 01111
www masxgov/dia
Workers' Compensation InsaranceAffidavit: Builders/ContractorsMeetrlcians/Plumbers
Applicant information 'Please Print Lealbiv
Name awsiamorganbadannad'ividuai): Si Qf1 T�QSigr-, In tt,
Ci /Statc/Zi :
0
OA301 Phone#:
—580- 4
Are you an employer? Check the appropriate box:
Type of project
1. M I am a employer with 14 0
4. Q I am a general contractor and I
New
ti. [1 Nconstruction
employ= (full and/or part-time).•
2. ❑ I am a sole proprietor or partner-
have hired the sub -contractors
listed on the attached sheet.
7. ❑ Remodeling
ship and have no employees
These subconttactorshave
8. ❑ Demolition
working for me In any capacity.
employees and workers'
�P
9. ❑ Building addition
[No workers' comp. fmmnanee
rmhv&l
S. ❑ We are a corporation and its
I0.❑ U=Wcal repairs or additions
3. ❑ 1 am a bomeowner doing all work
officers have exercised their
11.❑ Plumbing repairs or additions
myself INo workers' comp,
right of exemption per MGL
12.❑ Roof repairs
inarnnce required,) t
empl�oyees4[[No�wo workers, no
MIX Other_ .S i ati5'
comp. insurance remdred.l
•Amy ■pplicaot that checks box #t oust also fill our me section below showing mdrwrorkm' oaopmotloo policy inibrmaion.
► llona»wnen who submit 0ir affidavit indicating nay are doing dt wodr sod rhea him outside tonbacko must sohma ♦ new allldevit itdicatiag itch.
tConbactors that dw* this box most saarhed an additional sheet showing the mane of thecobeoatracsora and stain whedwormt those entities have
employees If the sub-conowa ns have empbyas, fty moot povide didr woxkas• camppolicy ovmbe.
I air an employer drat B providing workers' compensation Imuwnee for my employees Below 4 thepltcy and fob she
informadlon.
Insurance Company
Policy # or Self -ins. I.ic. #. Ip t D 8 Q Q 3 ? 11e.'4 — Fapiration Date:_
Job Site Address Ctty/Swelzip:
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 2SA of MGL c..152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one-yearimptisonment, as well as civil penalties In the form are 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 tie DIA for insurance coverage verification.
Ida hereby cerdfy an der the pains and penoldes of perjury that the Information podded above Is true and correct
Official use only. Do not write In Alt area, to be completed by e4 or town ejfkiat
City or Town:
Permitfucense #
Issuing Authority (circle one):
1. Board or Health 2. Building Department 3. City/fowu Clerk 4. Electrical Inspector I Plumbing Inspector
6.Other
Contact Person: Phone #:
CERTIFICATE OF LIABILITY INSURANCE
life"�2�o z
THIS CERTIFICATE R 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: N the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. H SUBROGATION IS WANED, subject to
the terms and condttlora of the policy, certain polities may require an endorsement A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsements
PRODUM!R
Bearce Insurance Agency, Inc _
670 Pleasant Street
P. O. Box 1709
Brockton xA 02301
Tasmyy Bryant
HONE 0
P(508)586-3400 F'� .rsosl srf-7T9
A[AX .t:bryantsbearce.OosL
INSURERS AFFORDING COVERAGE
NAIC8
NSURERA:TLe Treiber Group LLC
INSURED
Sign Design, Inc., DBAt 170 Liberty St., LLC
170 Liberty St.
Brockton HA 02301
INSURER a :
INSURERC:
NSURER0:
eM11RER E
1NSURER77
COVERAGES CERTIFICATE NUMBER-CLI211600439 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.
TYPE OINSURANCE
FF
E%P
Wns
OENEMLLMIIRT
CO&W RCIAL GENERAL LMBI TY
CWMSLMDE ❑OCCUR
EACH OCCURRENCE
f
f
MED E%P "
f
PERSONAL I ADV RMURY
s
GENERAL AGGREGATE
f
GENL AGGREGATE
POLICY
LIMIT AMES PER
PRO-JECT LOC
PRODUCTS• COMPOOP AGG
f
f
AUTOYWI I LIABILITY
ANYAUTO
ALL OWNED SCHEDULED
HIREDAUTOS AUTOS
AUTOS NON-OWNEDPROPERTY
AUTOS
t—E.mee.e
BODIY INNRY 0'> P,oFml
f
BODIY NARIY IP�.rNeNI
s
DAMAGE
f
f
L IMlRELLA UAI
EXCESS U"
OCGTIIt
CIAMS,MDE
EACH OCCURRENCE
f
AGGREGATE
f
DED I I RETENTION
f
A
WORKERS COMPENSATION
AND EY►LOYERS ILIMInY
ANY PROPRIE'TOriFARMERAtECU1NE❑
(M.1 wyIn MI E%CI.WEDt
(Yy�aydYA, NMI
DESCRI OF OOPERATIONS Who
NIA
009-97 -71f7
1/1/2017
1/1/201]
WC TATU.I ITr
EL EACH ACCIDENT
f 1,000,000
EL DREASE•EA EMPLOYE
f 1,000.000
EL. DISEASE -POLICY LIMIT
f 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VENN:LEI (Ae«A %CORD rot. AlBeMIJ ftm w sch".b. ff.
Proof of Coverage
SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED N
ACCORDANCE WITH THE POLICY PROVISIONS.
Bearce, III/JOSN dC-.wAr'ft.
INS025 amoos}Ot The ACORD name and logo am registered marks of ACORD
ISSUED by TOIL SI OCK INSLIn ANCE COMPANY MIIIEIN CALLED THE COMPANY
COMMERCE AND INDUSTRY INSURANCE COMPANY
15172
SIGN DESIGNRTY. INC.
BROCKTON,KA 02301-0000
SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE - W090010
II%
MA IRS-
4fiLNf NINAMH POLICY NUMMLH
11 1. 11 WC119
CHARTISiro-
A Chortle compary
EXECUTIVE OFFICES:
173 Water Street
New York. NY 10030
013-82-1112-20
RISK PLACEMENT SERVICES INC
WORKERS COMPENSATION AND EMPLOYERS
AR OAK SMET. SUITE 400
LIABILITY POLICY INFORMATION PAGE
GARDEN CITY. NY 115 0-0000
INSURED
R
RENEWAL 00 16
OTHER
WORKPLACES NOT SHOWN ABOVE SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE - WC990610
rtEr t
roLrcr nuoo tar All. n..e.1e tlf.. el a. alefllls'.
..41"a••.•• MIN 11/01/12 to 11/01/13
MIN t
A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed
hers:
MA
IL Employers Liability Insurance: Part Two of the policy applies to the work In each state listed In Hem S.A.
The Omits of our liability under Part Two are: Bodily Injury by Accident S 1.000.000 each accident
Bodily Injury by Disease $ 1,000,000 policy limit
Bodily Injury by Dlssow S 1 .000.000 each employee
C. Other States Insurance: Part Three of the policy applies to the States, H any, listed hers:
AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MD ME MI MN NO MS MT NC NE NH
NJ NM NV NY OK OR PA RI SC SO TN TX UT VA VT WI W1/
D. This policy Includes these endorsements and schedules:
SEE EXTENSION OF ITEM 3D. OF THE INFORMATION PAGE - WC990612
ne11 a
The premium for this policy will be determined by our Manuals of Rules, Classifications. Rates and Rating Nana
All Information required below Is subject to verification Saint change by sudlt.
O.sfiation@
Owe IANMw
A on Bea.
Total Im
bb M1r
Ft»orb.
Fsh"dw
ITemlu
AI.I.I SYaw
O
N..ntlM
Ar.%yl 11 3Yad,
SEE EXTENSION OF ITEM 4. OF THE INFORMATION PAGE - W C7754
TAXES/ASSESSMENTS/SURCHARGES
$662
EXPENSE CON"(E=CEPT WHM APPLICYLI NY UAM MA
momm MPMWK $500 MA 10TALEMATECIAIINUALPfIEMlUM 116,882
E Yldalad War. 1,96" ERuelmants of premhNn Shell be moue
❑ sa i-Amway ❑ Qwlany ❑ siknoy DEPOWTIPMEYmM
08/29/12 PARSIPPANY 82
Nov. me. Yeeh.p dint. A.Iherl.d Hepre".Inlw WC 0000 CIA
3NU QWd 0410E)
I
}pt Massachusetts - Department of Public Safety
Board of Building Regulations and Stand
Coartrsrtiun Sopenlwr '
License: CS-MI12 t
70 HIA R FERB1911 w
70HP�►TBERiIII1.
BRMGLrwATEIEMA
PI It Expiration
06f2112ti16
commissioner -
BUILDING PERMIT APPLICATION
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE, OCCUPANCY OF,
OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO MILYDWELLM.
Town of Yarmouth Building Department 1)
1146 Route 28 • Yarmouth, NIA 02664-4492 NOV 0 2005 I Tel: (508) 398.2231 x261 • Fax: (508) 398-083 ' I
n `I
Ice Use Only
mit
PerNo. - t ateil
Permit Fee a�S`�
Deposit Rec'd. $ a�j 1b Date
Net DUB ��3J—//lypj
Pla g Board Information
Type
Endo ementDate_
R ording Date
o
er
Assessors Department InI rmation:
New
1.4 Property Dimensions:
Lot Area (s1) Frontage(ft) Lot Coverage
This Section for Offics Lisa Only
Building Permit Number.
Date Issued:
Signatures
Certificate of O=ma
Is -- ienot required -
- BW ollidef _ Date
Section 1- Site Information
1.1 Property Address:
I �a�rn C TrAD
1.3 Su11dhM Setbacks Ift)
12 Zoning Information:
Zoning District
Proposed Use
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
30' w.3 'zo 2,Z9
1A water supply (RLGJ.. c. 40.8 54) 1.5 Flood Zone Information: Comments:
Public Private Zone: BFE:
Section 2 • Property Ownership/Authorized Agent
2.1 r of �IeeoN: /1� /l� /t rY
`�1�,1 ! ��.lP,i�rV D�-il��i 1.e7 /C'l7 li� �tt. L� QZL6
Name (prim) Mailing Address:
Gt7 376-74�0
Signature Telephone Telephone
70b eft'Gr,
Nam rl ) Mailing Address:
Gm 7 in % 6r q32,
Signature Telephone Fax
Section 3 - Construction Services
3.1 Lleensed Construction Supervisor
'ET1
nrT 1 9u
License Number
07dC4 / rz ra r-: r�
Expiration Date
7•8•zaoG'11 OCT 1 2005 D
1 of OVER
Home
Company Name
Not Applkable
Registration Number
Expiration Date
Signabae Telephone
Section 4 - Workers' Compensation insurance Atridavit AL C. 152 S 25C (8)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure
to provide this affidavit will result in the denial of the issuance of the building permit
Signed Affidavit Attached Yes .......... No ..........
Ito n 5 - Professional Design and Constriction Services -for Buildings and Strictures Subject
Construction Control Pursuant to 780 CMR 116 (containing more than 35,000 c.f. of enclosed space)
5.T
Na Applcaae ❑
Registration Number
EVIrseon Date
Signahxe — - Telephone I I
ce..n.... c 7 PantetaraA Prnfae innal Fnninnarki
Name -
Area of Resporrsbft
Address
SI9nish"
Telephone
Registration Number
Emlration Date -
Namo
Area of Responsibility
Address
Signature
Telephone
Registration Number
Expiration Date
Name
Area of Responadgty
Address
Sigma
Telephone
Registration Number
EViration Date
Name
Area of Respnxabmty
Address
Signature
Telephone
Registration Number
Expiation Date
Contractor
Not Applicable ❑
Address
Signature Telephone
2 of
Section 6 - Description of Proposed Work (chedc an appncable)
New Canstructlon ❑ (far muPople family on'-
) No. of Bedrooms
(for mui8ple family ony) No. of Bathrooms
Existing Bldg. ❑
Repair(s) ❑
I Alterations
Addition ❑
Accessory Bldg. ❑ Type
Demolition
Other Specify.
Brief Description of Proposed Work:
Di n1Lr�
Section 7 - Use Grow and Construction Tvoe
Building Use Group (Check as applicapable)
Construction Type
A
ASSEMBLY
❑ -
A-1
AJ
❑
❑
A-2
A-5
❑
❑
A3 ❑
1A
113
❑
❑
B
BUSINESS
2A
2B
2C
❑
❑
❑
E EDUCATIONAL
❑
F FACTORY
❑ F-1 ❑ F-2 ❑
H
HGH HAZARD
❑
3A
3B
❑
❑
1 INSTITUTIONAL
❑ 1.1 ❑ 1.2 ❑ F3 ❑
M
ME 104MMLE
❑
❑
R
RESIDENTIAL
❑
R-1
❑
R-2
❑
R3 ❑
eA
eB
❑
IY
S STORAGE
❑ S-1 ❑ S-2 ❑
U
UTIIrTY
❑
SPECIFY:
SPECIFY:
SPECIFY
M MIXED USE
❑
S SPECIAL USE
❑
Complete this section if existing buildling undergoing renovations, additions and/or chanje in use.
Exlsfing Use Group: CIC� Proposed Use Group:
E dssng Hazard Index 780 CMR 34 1 Proposed Hazard Index 780 CMR 34
euBdngArea
Nurtber of soma orslorim
hickAs bauffiert busk
FloorAres per Floor (af)
Total Area An Floors (s
Total Helcht (It)
Section 9 =STRUCTURAL PEER REVIEW 80CMR 11011
Irxfeperderd Sauchaal Engtleering Structural Peer Review Required Yea No ..........
SECTION 10a OWNER AUTHORIZATION - TO BE COMPLETED WHEN
I, —
hereby
my bet
, as Owner of the subject property,
to WA authorized by this building permit application.
/O •/0.05
0
to act on
3of•
OVER
I, dL/A A u-t/Mz
hereby declare that the
, as Owner/Authorized Agent
and information on the forgoing application are true and acurate, to
the best of my knowledge and belief.
Signed under the pains and penalties of perjury.
Section 11 • ESTIMATED CONSTRUCTION COSTS
Rom
EWmaroe Cost Mdlam) b be
Competed by pem* appkml
1. &#q
'' ^^
2. EkcWcW
rs �
1 PYm Vf an
4. W darkM (MVO)
s
s FIM RdecOon
e.ToW-(1+2+3*4a5)
7.T0WSQLe RV&a Mwmealfay
I Check Below I
❑ Conservation -Commission Filing
(it apple)
❑ Old Kings Highway & Historical
Commission approval
(If applicable)
0
1
4 d 4
I
e
The Commonwealth of Massachuseta
Department of Indlestrial Accidents
IfflessfAIRIONOM
600 Washington Street
Boston. Mart 02111
Workers' Compensation Insarsnee AfBdarit
ZF-V, V5-
am a homeowner performing all work myselt
am a sole proprietor a.-d have no one workine in any capacity
I am an employer pro% iding workers' compensation for my employees working on this job.
%�- nheaaF J-a38-69�s
1 atn a sole proprietor. general contractor. or homeowner (chute one) and have hired the contractors listed below who ha%
the following workers' compensation polices:
tkrr Mann F
Failure to ware coverage as required Bader Section ZSA of MCL eel can had in the l=paddm of eslaalrl peadtln of ■ one upon SI.VLN andhr
one fear$' hnprbnmtM In wen IN dwU penWd a In tk form of a STOr WORK ORDER mad a ter of f1ILdB a day opirt nil. 1 rdaseaait to at a
copy art►la statement may he forwarded to tht Omer of I read. don of dw DIA t►r reenp serfAcedow
t do Aenby eerriif"nder the
Print name
the lnjonmadm Prodded abort h rare and correm
official use only do not write in We ern is be comphted by dq or tows affkW
city or taws. YARHDU I; . _ permllAkase d nBoUdiag Department
0 tbeck If Inmtdiate response In required Board required 261 OSelectmen s Omen
SOf� 011ealt► Department
contact person: p►enrd;_ (�� 398-2231 ext. mother
Information and Instructions
Massachusetts General Laws chapter 152 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. repress or implied. oral or written.
An eniplot'er is defined as an individual. partnership, association. corporation or other legal entity, or any two or more
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 anployees -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 Mother who employs persons to do maintenance. construction or repair work on such dwelling hou:
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chapter 1=2 section 23 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 building is the commoawtalth for any
applicant who has not produced acceptable evidence of compliance with the Insurance coverage required.
Additionally. 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
been presented to the contracting authority.
Please fill in the workers' compensation affidavit completely. by checking the box that applies to your situation and
suppling 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
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 Plea
be sure to fill in the permitilicense number which will be used as a refacrice number. The affidavits may be returned t
the Department by mail or FAX unless other arrangematts have beam made.
The Office ofinvestigations would like to thank you in advance for you cooperation and should you have any question_
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
Ma tll Infistllslllim
600 Washington Street
Boston, Ma. 02111
fa: N: (617) 727-7749
phone M: (617) 7274900 eat. 406, 409 or 375
PLEASE PRINT:
Job Location: _
TOWN OF YARMOUTH
BUILDING DEPARTMENT
CONSTRUCTION SUPERVISOR FORM
RaA1)
Numbirr���Street ViUage
owner of Property. M16LJ)C �I It l ' JLt4(�NG of CAYE CDD
Construction Supervisor.
07;-+7
No.
Address: 3 kEma, Lmc H r (rm fbi3CTr , k A 02-7 5 9
Licensed Designee:
(If other than Supervisor)
Name
2.15 Responsibility of each license holder.
License No.
36 -&q on
Phone 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 subcontractor 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 Anylicensee who shall willfullyviolate subsections 2.15.1, 2.15.2 or2.15.3 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, reconstruction,
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, thework shall immediately
cease until a successor license holder is substituted on the records of the building department
2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may
be deemed a violation of the permit conditions.
I have read and understand my responsibilities under the rules and regulations for licensing construction
supervisors in accordance with section 109.1.1 of the state building code. I understand 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 MGL Ch.152
Yes Rr No ❑
If you have checked yg;i, please Indicate the type coverage by checking the appropriate box
A liability insurance policy Id Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 152 of the Mass. General Laws, and that my signature on this permit application waives this requirement
Check one:
Signature of Owner or Owners Agent Owner ❑ Agent ❑
Sivnatnre: Building Official Approval:
TOWN OF YARMOUTH
1146ROUTE28 SOUTHYARMOUTH MASSACRUSEPTS02664d451
Telephone (508) 398.2231, ExL 261 — Fax (508) 398.2365
BUILDING DEPARTMENT
DEMOLITION DEBRIS DISPOSAL AFFIDAVIT
BUILDING
ELECTRICAI,
GAS
PLUMBING
SIGNS
Pursuant to M.G.L Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5,
I hereby certify that the debris resulting from the proposed work/demolition to be
conducted
�--
is to be disposed of at the following location: � � 'I°63 A23Lro Lckr'o's
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, Section 150A.
Signature
Permit No.
/b •1O-06
Date
TOWN OF YARMOUTH
d Building Department
Town Hall
Yarmouth. MA 02664
(508) 398.2231 eA261
BBUILDING PERMIT
TRANSMITTAL
Temp Permit No.: T-06-172
Applicant Name:
Applicant Phone:
Building Location:
Stephen McCarthy
5082386985
00002 IYANOUGH RD
Owner's Name: Shields MRI & Imaging of Cape Cod
Owner's Addres 700 Congress Street
Quincy
Owner's Telephone: (617) 376-7400
MA 02169
(OFFICE USE ONLY
Recorded By:
Ic
Permit Fee:
$0.00
Deposit Rec:
$25.00
Payment Type:
Check ChkNo.: 949
Net Owed:
($25.00)
Application Date: 10/17/2005
Issue Date:
Expiration Date
Comments: Map/Lot: 036.99
remove e� g MRI Machine
sy--_-
REVIEWED BY:
1. WATER DEPARTMENT:
DATE:
PIA: NI
2. ENGINEERING DEPARTMENT:
DATE:
WA: E.
Ly-
3. CONSERVATION:
DATE:
WA
4. HEALTH DEPARTMENT:
DATE:
WA:
5. BUILDING DEPARTMENT:
DATE:
WA:
6. FIRE DEPARTMENT:
DATE:
N/A:
PLEASE NOTE
COMMENTS:
RECEIPT OF COPY:
U E it
V 0 4 2005
DEPT.
SIGNATURE OF APPLICANT: ,C Y j t DATE: /1' Y' oS
I
Date Printed: 10/17/2005
TERE
MAY 16 2006
I
TOWN OF YARMOUTH
BUILDING DEPARTMENT
46 Route 28, South Yarmouth, MA 02664
APPLICATION FOR SIGN PERMIT
Location / Address for proposed signs) 2 I YAW N o V kW K.D
v
MAY 1 6
la
Permit No. S— L 003 7
Assessor's Map Lot Zoning District: Bl B2 B3 Res Hist.Dist
Name of Business for proposed sign(s)
Name(s)of Business
C>
Mailing Address of Business owner(s) 5 5 Q'Wk j5TtiS P IZ 1 V IE-� 5 P4 0j( ,n N a 2.3v 1
Business Owner(s) Phone: Business 7 431 Home
Name of Building Owner(s) S A'M b
Sign Builder 61 ESN D r,5l EnJ Address: 1 TV l ttfil g y Si". 13 P- 0C,/LTDIJ
Type of Construction C&b fib Ta B t I :)1i 1-2,1> O N E k (S.j-IN 6-POUT
Internal Light External Light a l sr -Irv% 6fUUNP
1A&TM jN(r—
Applicant Instructions:
Applicant must attach a separate 8'/:"x I I" sheet including two diagrams:
A) Design, dimension and colors of the proposed sign(s)
B) Location of the proposed sign(s) with setbacks from property. lines that are at least 6 feet per code.
Application for attached sign must show running footage of portion of building frontage occupied by
business.
Freestandioa Shm(s)
Size of proposed Standing Sign(s) is: :?V S I b r-J it Gf
Attached Sitn(s)
Size ofproposed Attached Sign(s) is:
Temporary Sirn(r)
Size of proposed Temporary Signs) is:
Date ofproposed Temporary Sign(s) is:
All Permits are subiect to the avoraval of the Sian Inspector
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 to or changed in any way until a new
permit bas been granted. The number of this permit will be affixed to the sign in no less than'/." numbers. Sign
Permits are not valid until the Building Commissioner issues Use and Occupancy Permits.
Signature of.
Signature of Building
Tbis Permit R
With the following conditions:
Shields Realty: Cape Cod Signage
Panel Replacement (for existing poles)
Quantity: 1 double -sided
Panel: 36' x 71' x 2' thick sandblasted cedar panel
Graphics: V-bevel carved and paint filled to match (PMS 288 Blue / PMS 355 Green / White / Black)
Posts: decorative posts painted white
' §u*el& MM &CT
w
CAPE COD
2 IYANNOUGH ROAD
t
WE
t
i�
I
Ei
J
Sbi id"sMRI
CAPE COD
��� e•r--., i-�) d�ln ; 1.�,4q+'�. .ddh d: "vi) )A s"Yd�1' n.+. i.Y. � t ,. .M it W. J�.
,air � F`i � ) Y• 1 t � ,
CT NOW. -'AVAILABLE `' " 4
y, )
L
COMMONWEALTH OF MASSACHUSMS
DEPARTMENT OF INDUSTRIAL ACCIDENTS
600 WASHINGTON STREET
BOSTON, MASSACHUSETTS 02111
iomu mpeencorrinmar WORKERS' COMPENSATION INSURANCE AFFIDAVIT
I, S1 &fJ brs I . INe--
0iccnsce/prnnittm)
with a principal place of business/residence at:
1 ✓ Mh-
' (cityisiaiuziv)
do hereby certify under the pains and penalties of perjury, that:
[t.I, am an employer providing the following workers' compensation coverage for my employees working on this job,
Am&9Jc4krJ wiu=VAiiPPft-J' r kvc
Number
[ ] I am a sole proprietor and have no one working for me.
[ I I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below
who have the following workers' compcnsation insurance politics:
Name of Contractor
Name of Contractor
Insurance Company/Policy Number
Insurance Company/Policy Number
Name of Contractor Insurance Company/Policy Number
[ ] I am a homeowner performing all the work myself.
NOTE: Please be aware that while homeowners who employ persons to do maintenance, construction or repair work on a
dwelling of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto are not gcncr-
ally considered to be employers under the Workers' Compensation Act (GL C.152, sec.1(5)), application by a homeowner for a
license or permit may evidence the legal status of an employer under the Workers' Compcnvtion Act.
I understand that a copy of this statement will be forwarded to the Department of Industrial Accidents' Office of Insurance for cov-
erage verification and that failure to secure coverage as required under Section 25A of MGL 152 can lad to the imposition of crim-
inal penalties consisting of a fine of up to $ 1500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop
Work Order and a fine of $100.00 a day against me.
lay of 20
Licensor/Permittor
K� '
SIGNDESI9N,
sign and graphic solutions
Christine D!Mestico
508.580.0094
800.500.SIGN
r 508,580.0096
. Chris dimeslico@signdmgninc.com
w signdeslgninc corn
mi cie" Sr amain, su ozaor
'.-eldslViRI
JiOck Shlelda,Feq,
corporate Office
Crown Colony Park
700 Congress $tree' .
Quincy. MA 02169
617-376-7400
Fax: 617-d+76-7419 .. ..
Email. Jack®shields.com
BOARD OF BUILDING REGULATIONS
qn Yam' Llesnss: CONSTRUCTION SUPERVISOR
...`' Numbar•,.CS 068112
Bhlhdots:0821/1964 !
Eapirim. 08212006 Tr. no: 1179.0
Restricted: �00
RALPH R FERRIGNO JR -
70 HEATHER HILL A -
� t BRIDGEWATER. LM'02324
J
-U .� K7f+ � .a; 'w4 Tr• j4� E s�y.My^,y�.
l r+,•�c•�e+"Y4•f,. yfN�'¢�l i .. i � .•iI�-'ei^;' �' � A..` .: Jie� f �`c Y
5.:..:�t�IJ S�'•rii•^��.�J..nit'1. �-': ].i i��.w• -.+tr ` r+.- • -. �.,�.�;. _M^y ..
Tom' � +� r •i ('� '� _•L '1- l - !• �i �t •. f!
40.06/12/05
a r
0TOWN OF YARMOUTH Building Department BUILDING
(508) 398-2231 ext261
PERMR NO B G6.639 .
ISSUE DATE 11/4/2005 PERMIT
ii '"
APPucANr sepnerJOB WEATHER CAR D
PERMITTO Atteratiorts '
AT (LOCATION) 1000021YANOUGH RD ZONIN 1 82 Bldg. Type: Cammerclal
SUBDIVISION MAP LOT BLOCK
LOT SIZE
BUILDING IS TO BE: CONSTTYPEI 5-B I USE GROUP
remove eAsting MRI Machine as per plans dated 1024N5.
REMARKS
AREA (SO FT) EST COST ($ 553,000.00 PERMIT FEE (S) 5150.00
OWNER IShields MRI & imaging of Cape Cad BUILDING DEPT BY
ADDRESS Congress Street
OU" I MA 102169
PHONE 161737674M
INSPECTION RECORD
CONTRACTOR
LICENSE 072471
Cassidy. Stephen
3 Kestrel Lane
Mattapoisett MA 02739
5082386985
FIELD COPY
Date I Note Progress - Corrections and Remarks I Inspector
TOWN OFYARMOUTH
Building Department
BUILDING
_ '9 •
(W8) 398-2231 ext.261PERMIT
(F
SUN
NO Mg-06829
ISSUEDATE :.j2/15n_ 5.: PROPOSEDUSE
-PERMIT
APPLICANT .Ericonmerslal sterts,'Inc...........
------------------------------
. .:
JOB WEATHER CARD
PERMITTO MlschnecharJcal ;
AT (LOCATION)
ZONING DISTRICT®
Bldg. Type: Commercial
10=IYANOUGH RD
SUBDMSION MAP LOT BLOCK 1036.99 BUILDING IS TO BE CONST TYPEQ USE GROUP O
LOT SIZE
mechsMcal system - Install one split system air con 0tiorw and ratrpgeretlon piping
REMARKS
AREA (SO Fr) EST COST ($ 1$44,000.00 PERMIT FEE ($)
OWNER IREALTY OF CAPE COD, LLC BUILDING DEFT BY
ADDRESS 17DO Congress Street
OU" I MA 102169
INSPECTION RECORD
CONTRACTOR
LICENSE 0
Beldasaro, James
6 Howard Ird" DrNe
Aelebcro MA 02703
5082266006
PHONE 16173767400
FIELD COPY
MECHANICAL PERMIT
{ DATE 11122105
RC-105129 PERMIT NUMBERMR -
CONTRACTORS LICENSE NO. SLOG. PERMIT N0.
LOCATION' Y- I annou h Rd (jut Yahnouth MA
Job 8171 1313
OWNER Shields MRI, 700 Conq)Laz St, Quincy 11A
KIND OF BUILDING wood zt uc tme USED AS medical
TO BE COMPLETED ABOUT 2/1/06 ESTIMATED COST $ 44,000.00
NEW ERATION'- REPAIR - ADDITION (Circle One)
OIL ❑ GAS ❑ `LPG ❑ ELECT.
Air
Forced Air SYateme—R.T.U.
MEa.
. Orsritt Systems—R.T.U.
M Ea. '
Floor Furnaces—R.T.U.
M
Wall Heaters—R.T.U.
M -
Unit Haters—R.T.U. -
M
- Comeralon Surner.-
Clothes Ortere
1, Ventilation Fen
Range Hod --
--
Air Handling 1200
- C.F.M.
Incinerator
Gas piping • "'t
Rome COM. Dom
One dplit zusteE
YLcAiU4eAatxon
zuppfied e4u.LM
1-
O
a
W
IM
O
F
O
o bl owneA
I. -
TOTAL FEE
- _ .I 't
100.00 I
ONTRACTOR'! NAME AND ADDRESS
EnvikonmenW Systems, Inc., 6 Howaiuf Iceland Delve
m "ATE
Attleboto 91A '
_ L
ZIP CODE
02703-4612
,1 READY FOR INSPECTION ON 1123106 OR WILL CONTACT PERMIT CLERK LATER -
P .
APPLICANT CERTIFIES THAT,ALL INFORMATION GIVEN tS CORRECT AND THAT ALL PERTINENT_:-
�: MECHANICAL ORDINANCES WILL RE COMPLIED WITH IN PERFORMING THE WORK FOR WHICH THIS
-T PEERMMIT 1! ISSUED.`
g.rn.+ of C Mters�ggtoo�r or Ale Authorized Slgnatu S of Permit Clerk
J tkv Dk[LLAQ� IWlo lon
FILE COPY
.. - _ 0 CepPpS 2003 R/IER HATI )NIIL CODE COI/LI . - �. • - - r
BUILDING PERMIT APPLICATION MECHANICAL
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE, OCCUPANCY OF,
OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING.
Town of Yarmouth Building Department
1146 Route 28 • Yarmouth, MA 02664-4492
Tel: (508) 398-2231 x261 • Fax: (508) 398A836
Office Use Only 1
Permit No. to ►`�i
Planning Board Information
hio
Assessors Department Information:
A' Lot
Permit Fee $
Endo ement Date
lording Date
New
Deposit ReC'd. $ Date
1.4 Property Dimensions:
r0tUN
No
Net Due $
other
tot Area (s1) Frontage (it) Lot coverage
Section for Office Use On r `' r y
Vi
Building Pef
M Y +•: 1 `{h.. -I - �; i .yam .. S
,Certificate of OCCU an Y. �d ] C
Si nature z .- r_
9.-
t ..1 .
i ,r yP. �Y ,,yp.?,
A 1
-� �BuildingOffidal a�] Date +',
> • _ . ,
is`' w,
` is -. � required < �,
Section 1 ="Site Information
1.1 Property Address:
12 Zoning inform Non:
2 Itlannough Road
g a--� 8
Zoning District Proposed Use
1.3 Building Setbacks (ft)
Front Yard
Side Yards
Rear Yard
Required
Provided
Required
Provided
Required
Provided
30'
30.3'
25'
20.8'
20'
229'
1A Water Soppy (IIA.O.L. C. 40. S 54)
15 Flood Zone Infortnallon. , K Comments_
Public Private
1 `
>= •',`BFE. � ''
Zone: ..� r2. , { �,"
Section 2 �: Property.OwnershtrVAUthoriied Agent
2.1 Owner of Record:
Sh,ieEde MRI 5 Imaq.i.ng og Cape Cod
700 Cor hede St, Quincy MA 02169
Name(print)_ 1V03G�TA WC l3 �� Mailing Address:
,'-+�/ T 617-376-7400
Signature Telephone
Telephone _
2.2Authorized Agent
Mechan.icat Con.Utactoh
Envitonrienta.t Syd•temb, Inc
6 Howard Iaetand Dn., A•tttebono MA 0 7
N e (print) JamM aaa)LO RC 105129
Mailing Address:
508-226-6006
508-222-1344
ignature Telephone Y.T
Fax
Section 3 --:'Construction Services'
3.1 Licensed Construction Supervisor
pplicabie [✓�
DEC 0 8 200 Number
Address
n Date
Signature Telephone
03-461
1 of 4
OVER
8a Regfstefed Home IrriroVement tContractor-
Company Name
Not Applicable
Address
Registration Number '
Fxpirstbn Date
Signature Telephone
(M.ML' c:,152 S 25C (6)
Section 4=Workere'_Co ` risation'lnsurance Affidavit
Workers Compensation Insurance affidavit must be completed and submitted with this applicptioiV Failure
to provide this affidavit will result In the denial of the issuance of the building permit.
Signed Affidavft Attached Yes .......... No ..........
Secbort 5 Professional Udtign and Construdtfori Service`s fort LH1dingsand.Structures Sub)ect
to Constructlo`n_Confrol Fruesuant to 7@0 CM _11ning7rjore tFlan 35,000 r f of 6ncl6sed,spatef,_ .,
Section 5''1,Registered Architect
Not Applicable ❑ -
Name (Reglatimnt):
Fle0slration Number
Address
Signature Telephone
Expiraton oate
Section 5.2 Registered Professional EA 166dr s
Name
Area of Responsibility
Address
Signature Telephone -
Registration Number
Expiration Date
Name -
Area a?espons illy
Address
Signature Telephone
Registration Number
Expiration Dare -
Name
Area of Responsiblllty -
Address
Signature Telephone -
Regfsindlon Number
Expiration Date
Name
Area of Responsdiay
Address .
Signature Telephone
Registration Number
Expiration Date
Section 5013 neral Contractor
Not Applicable ❑
Company Name
Person Responsible for Construction '
Address
Signature Telephone
2of4
Section 7 - Use Group and Construction Type
Building Use Group (Check as applicapabie)
ConstruMon Type
A ASSEMBLY
❑
A-1 ❑
A-4 ❑
A-2 ❑
A-S ❑
A3 ❑
1A ❑
10 ❑
B BUSINESS
Ed
2A ❑
2B ❑ .
2C ❑
E EDUCATIONAL
❑
F FACTORY
❑ F-1 ❑ F-2 ❑
_
H HIGH HAZARD
❑
3A ❑
3B ❑
1 INSTITUTIONAL
❑ 1-1 ❑ 1.2 ❑
1-3 ❑
M MERCHANTRE
❑
4 ❑
R RESIDENTIAL
❑
R-1 ❑
R-2 ❑
R3 ❑
SA ❑
SB I�
S STORAGE
❑ S-1 ❑ S-2 ❑
U UTILITY
❑
SPECIFY:
M MIXED USE
❑
I
SPECIFY..
S SPECIAL USE
I ❑
SPECIFY.
Complete this section If existing
building undergoing
renovations. additions and/or change in use.
EAsBng Use Group:
Existing Hazard Index 780 CMR 34
Proposed Use Group:
Proposed Hazard Index 780 CMR 34
Section 8 Building Heiaht and Area
Building Area Existing Of applicable) Proposed
Number of floors or stones
trcWe basemerx laves
2
Floor Area per Floor(s0
1,&t 5786 2nd 490
Total Area All Floors (so
6266 occupied
Total Height (it)
30 r + -
9 - STRUCTURAL PEER REVIEW (780CMR 1101
mt St uchnal Enaineerino Sbuct ral Peer Review Required
Yes ---. No --
I, , as Owner of the subject property,
hereby authorize to act on
my behalf, in all matters rel veto work authorized by this building permit application.
Date
3of4
OVER
IM710ITPi2I=1 I
I Jame6 S, Baldaaano ,as4)wner/Authorized Agent
heredeclare that the statements and Information on the forgoing '
by rgo g application are true and accrete, to
the best of my knowledge and belief.
Signed under the pains and penalties of perjury.
JameasS. Batdabano
Print Name
12/5/05
Date
Section 11 -ESTIMATED CONSTRUCTION COSTS
ma' Edknama Cast P mn) b be
CM)Wed by Porn* app&am
1. Buamnp
Baas-:a-ai
a Pa,maac r o.a
�• rded,sriam pN�cl1 44, 000.00
s. Poe rraeaan
IiThta "+2+3+4+5
7. Total SausreRmnw.auy..emiurm dd AAA An
I Check Below I
❑ Conservation -Commission Filing
(mf applicable)
❑ Old kings Highway & Historical
Commission approval
(0 applicable)
Woxkelw Compenbati.on Inaunance A56aday.rt is afAeady .thee with ema.tt. We
mechartimt pvun.it appti.cati.on and Check 00055498 boa 100.00.
4or4
BUILDING
TOWN OF Y A R M O U T H ELECTRICA2
GAS
1146ROUTE28 SOUTHYARMOUTH MASSACHUSEITS02661-4451 PLUMBING
Telephone (508) 398.2231, EsL 261 — Fa: (508) 398.2365
• SIGNS
BUILDING DEPARTMENT
DEMOLITION DEBRIS DISPOSAL AFFIDAVIT
Pursuant to M.G.L Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5,
I hereby certify that the debris resulting from the proposed work/demolition to be
conducted at —shield', 2 Iyannouah Road
Work Addnm
is to be disposed of at the following location:
,acAap metal wilt be brought back to ouA ecxap mgtat dumpste2 at ouA shop,
Envi onmentaL System, Inc., 6 howand IAetand D&, Attfebono MA 02703
which .ta emptied pvtiodica.ffy by Anestoa Meta.T6 611-666-3405
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, Section 150A
Signature of Applicant
James S. Batda6aAo, VP
EnvaAonmentat Sybtemb, Inc. (blech ContAactot)
6 HowwLd Ine2and DA, A.ttteboto MA 02703-4612
Permit No.
12/5/05
Date
DEC-05-203E-MON 01:15 PM
1.002
TOWN OF YARMOUTH
Building DepadmDRt
BUILDING.
(508) 398-2231 ext261
�•
PERMIT NO ;, ,¢DkkTQ ..
..
PEF�MIT
- - • . PROPOSED
ISSUE DATE :_J1(�QD$,s
USE '_...__._.
i
-•-•-- .....
APPLICJWy Stephan.....Y..
JOB WEATHER CARD
`__...._.•
^' ........:......'
,
PERMRTO NteraUonc
AT OCAmt n WlYANOUGHRD
ZONING DISTRICT®
BIdg.Type: angel
13UECMSIONMAPLOTBLOCK o58.89 EUILDINGISTOEE: CONST
LOT SIZE o
remove mdadng MRI Mechho as per plans dated 1=405.
REMARKS
AREA (50 F7) EST COST ($ 000D0 PEwrr FEE (6)
OWNER Stdetdc MRI a Imagdng of Cape Cad BUILDING DEFT BY.
ADDRESS Congreaa SR6eT
PHONE 16170757400 I
THS PERMIT CONVEYS NO RIGHTTO OCCUPY ANY SIRE ET,AU.EY CA SIDEWALK MANY
klm
CONTRACTOR
LICENSE
Cassidy. Smprbn
S K"tal time
Maftpolsovt MA CZM
$08=065
MINIMUM INSPI:CRONS REQUIRED FOR ALL
APPROVED PLANS MUST BE RETAINED ON
JOB AND THIS CATS KEPT POSTED UNTIL
gWHERE TEP� ARE
CONSTRUCTION WORK 1)FOUNDATIONS OR
F1HAREA E
ICJF
pEQLARFDIiELECTTSGLL
PLl1MBPxY['AS AND
FOOTINGS. 2) PRIOR TO COVERING STRUCTURAL
RTFI;rmCAAS OF O
WHEREACERTFIGLTe QP OCGVPANCYIS
MECHANCAI. NS7Al1ATKNS.
MEMBERS (READY FOR LATH ORFINISH
REOIARED•SUCHBULDWOSHALL NOT 05
COVERING) 3) FINAL INSPECTION BEFORE
EmD UNTIL �MPECDON HAS
OCCUPANCY 4) REFER TO DETAILED INSPECTION
WORK SHALL. NOT PROCEED PEWIT WILL BECOME NULL AND VOID IF INSPECTIONS INDICATED ONTFgS CARD'
U NTA.THE INSPECTOR HAS CONSTRUCTION WORKIS NOT STARTED WITHIN SW CAN Be ARRANDID FOR IYTELEPHONE
APPROVEDYHE VARIOUS MONTHS OF DATE THE PERMIT IS ISSUED AS NOYED • OR WRITTEN NQDPICATIOIL
STAGES OF CON•3TRUCf1CN ABOVE.
I
IIB..TAICI AOYLi — - . • - oET BUORE D&Oa
001216 TOWN OF YAMOUTH
c11oR DATE
RERER E
Gg98 AM w
OF➢ULRoi1
META w
_11/21/05
8171 008171
100.00
'vS
1 , r
- , (
y`'�S_ t �x''
tY• ssxw*
qt•c,
ro-'
V.
�
3�i
� � li, .! I'R:1 SL �
t{A! yk€d
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•S.f •.i �
�5�'4 9 y'1 i ��L
:' C i
� ..5�4 1 { T •jv._ "' Ij
iIN
ns i.r.
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t!t .ti t
h �. r7./:�. 3+"
f/' i' Yi (�
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sent, rriday, November 04, 2005 2102 AM
Set Jaeme Saldaaarol Bassett, Bradt Biilian Stadelrm/ Nlark.200laol.oa
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The Commonwealth ojMassachusetts
Department oflnduttrial Accidentr
• o�eeiularaapsa�s
600 Washington Sind, 7m Floor
, Boston, Mass 02111
Shield MRI Job 8171 88
2 Iyannough Road
city Dleat Yarmouth star MA zio: ahow d
--dsite l-- •tnedlnmt Game ab above
❑ 1 am a lnmcowoerperforming sl wok myself_ Project Type ❑ New Construction ❑Remodel
I am a sole proprietor and have no we wtnkmg in any capacity �❑ Bolding Addition �m� ""'• ern waklxcfir ���+1�'"a�'�'.'^S
U 1 am m employer providing wodter' eomplmsation for my employees worl®g on this job.
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6 114 a =laeCand Vic vi
imtar.ece e, AU
❑ 1 am a sole proprietor,
the following worker' cos
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iciated EmpLoyenb .Ina Co naoea ',: WCC 5000 691 ;01
corral coatractor, or homeowner (circle one) and have hired the contractors listed
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fanan w tern ronrap ao,ogdrad muter Seca" 25A of MCL 152 cooked a the Impeakim of edealmal Passion eta fW y h St lOOJO Am"r
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I do hereby eerrlfy coder the pales and pencIA a of perlmry amt As tnjowmadon yrspided abort Is true eadnrrret
Sitnanae �la�n-�:�o.�y ny— 11/22/05
Print name Linda Souza, Admin. Aab.t ph,,,N 508-226-6006
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►,, TOWN OF YARMOUTH
Building Department
= Town Hall
Yamauth, MA 02664
(508) 398-2231 exU61
BBUILDING PERMIT
TRANSMITTAL
Temp Permit No.:
T-06-243
Applicant Name:
Environmental Systems, Inc.
Applicant Phone:
5082266006
Building Location:
00002 IYANOUGH RD
Owners Name:
REALTY OF CAPE COD, LLC
Owner's Addres
700 Congress Street
Quincy MA 02169
Owner's Telephone: (617) 376.7400
REVIEWED BY:
(OFFICE USE ONLY
Recorded By.
k:
Permit Fee:
$100.00
Deposit Rec:
$100.00
Payment Type:
Check ChkNo.: 55498
Net Owed:
$0.00
Application Date: 12/8/2005
Issue Date:
Expiration Date
Comments:
mechanical system - Install one split system air
conditioner and refregeration piping
1. WATER DEPARTMENT:
DATE:
WA:
2. ENGINEERING DEPARTMENT:
DATE:
N/A:
3. CONSERVATION:
DATE:
WA:
4. HEALTH DEPARTMENT:
DATE:
WA:
5. BUILDING DEPARTMENT:
DATE:
WA:
6. FIRE DEPARTMENT:
DATE:
N/A:
COMMENTS:
RECEIPT OF COPY:
PLEASE NOTE
SIGNATURE OF APPLICANT:
DATE:
Date Printed: 12/8/2005
WPS - Permit _
pro 0
SQAM TAR
WPS - Permit
"IPA
Utiliity AuthMO #: 01444632 Date: 04/192005 Company BEA LORD
Rep:
Report By: YAR 2 IYANOUGH RD SHIELDS MRI & IMG CT R CC 582
Status: ACTIVE Service: INCRS Type: COM
Nature of Work:
Service Information:
There is no Service Information.
Page ) of )
Permit #: E05-0000 Meters: 1 Reseal (YIN): Y Date: 02/02r2
Inspector. W10060 Description:
Search Detail Contacts
NSTAR Home WPS L000n VVP$ Help Cornmerft M Ft*gm Wws PS Ne
® � �� 40
knagesCoprtest or other content at this web sRs mist granted by NSTAR. Bosbston Streek Boston INA USA. AN rights s NA. USA. UmA orlud teproductIon In whole or In part of itfoation of �M«,
stored at this site msy mLdt in criminsi prosecution. any Informatlon
http://www.nswon)ine.com/apps/wps/wpspermit.cfm7Page=Pemvt&Unique={ts_'2006-02-... 2/2/2006
OFFICE MEETING NOTES
ADDRESS: .2, 100aa DATE:
Names of Attendees:
Zoning District: 2
Flood Zone:
Meeting Topic: 91 ,
%lields ;�
HEALTHCARE GROUP
September 20, 2004
Mr. James Brandolini
Town of Yarmouth
Building Commissioner
1146 Route 28
South Yarmouth, MA 02664
Dear Mr. Brandolini:
This is a summary of events since we met on Wednesday, September 1, 2004 and
discussed our request to provide mobile MRI service at our Shields MRI location at 2
Iyannough Road. The basis of our request is to provide mobile MRI service when the
appointments at the Center are backlogged to the point where patients will have to wait
too long for an appointment in which they may need immediate MRI results to be
treated. Presently, we anticipate the use of the trailer at 2-3 days per week. The trailer
Will not be a permanent fixture, as it will be moved to alternate locations when not being
used in Yarmouth. We have also indicated that the use of the trailer will more than
likely be a "seasonal use" based on the current data.
We have distributed copies of the site plan with the trailer location to the, Building .
Department, Fire Department, Board of Health and have completed the Aquifer
paperwork with signatures. At this time we anticipate having our paving completed by
September 24, 2004 and have the trailer in for a test run the first week of October.
Also, our landscape contractor recommended planting the 5 trees on the property mid -
October, which we will do.
We appreciate the assistance you have provided in this matter.
Stephen McCarthy
Director of Real Estate & Paalibres
I II I SEP; 2 2 2004
SEP-20-2004-MON 10:19 AM P.002
%b*elds
FAUN GIWE GROUP _
September 20, 2004
Mr. James Brandolini
Town of Yarmouth
Building Commissioner
1146 Route 28
South Yarmouth, MA 02664
Dear Mr. Brandolini:
This Is a summary of eventsslnce we met on Wednesday, September 1, 2004 and
discussed our request to provide mobile MRI service at our Shields MRI location at 2
Iyannough.Road. The basis of our request Is to provide mobile MRI service when the
appointments at the Center are backlogged to the point where patients will have to wart
too long for an appointment in which they may need Immediate MRI results to be
treated. Presently, we anticipate the use of the trailer at 2-3 days per week. The trailer
will not be a permanent fixture, as it will be moved to alternate locations when not being
used in Yarmouth. We have also indicated that the use of the trailer will more than'
likely be a "seasonal use" based on the current data.
We have distributed copies of the site plan with the trailer location to the, Building
Department, Fire Department, Board of Health and have completed the Aquifer
paperwork with signatures. At this time we anticipate having our paving completed by
September 24, 2004 and have the trailer in for a test run the first week of October.
Also, our landscape contractor recommended planting the 5 trees on the property mid -
October, which we will do.
We appreciate the assistance you have. provided in this matter.
Since ,
Stephen McCarthy
Director of Real Estate & Eacl t/es
SEP-20-2004-MON 10:19 AM
P. 001
Real Estate & Faci ities
Shields Health Care Group
Crown Colony Park
700 Congress Street
Quincy, KA 02169
Phone: 617-376-7431
Fax, 617-376-7439
Fax
To: Mr.3ames Brandolinl
elds
HEALTH CARE GROUP
From: Marde L Stolte
Fax: MO-T - -2365 'Date: 9.20.04
Phone. Pages,
Re, CC:
'O Urgent ' ❑ For Review ' O Please Comment O Please Reply
Comments:
❑ Please Recycle
ti OF•YAR
TOWN OF YARMOUTH BUHDING DEPARTMENT
APPLICATION FOR DETERMINATION OF NON.APPIICA]
14F I Date
Property location:� 1&i awUl YA!) Map# 3G
Proposed
fftttiit
#tiiitttt#it#titfi#fiiii#i#ttifiifi#tittittit!
1. The applicant has hilly complied with the Submittal Requirements of §406.52
(Attach copy of Hazardous Materials List)
L i
a rrSrEP 0 209
D g O�
rn C F�
f�1 T?
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2. The proposed use meets all of the Design and Operation requirements of §406.5.7,
3. The chemicals, pesticides, fuels and other potentially toxic or hazardous materials used or
stored at the site, or produced by the proposed use, will be in qualities not greater than those
commonly associated with normal household use, and
4. The proposed use will meet all of the objectives and water quality criteria of the bylaw..
The above applicant herby acknowledges that the Building Inspector may require the applicant to submit the
matter to the Health Agent or Board of Health, and may require the applicant to demonstrate that he/she has
received a favorable report from the Health Agent or Board of Health The Determination, if made, shall apply
only to the individual applicant and proposed use and shall automatically expire upon any change of use or
tnusfer ofownership of the business. There shall be no appeal from an unfavorable Determination of any such
application, nor from a failure to act, except for filing by the applicant for a Special Permit from the Board of
Appr als as otherwise provided herein.
Appli ate
DETERMINATION: The Building Inspector, based upon a review of this application and information supplied
by the Applicant, hereby determines that the proposed use satisfies the requirements of §406.5.1.1 and that the
t need not apply for a Special Permit under §40
Q-1-UY o �
iding Inspector Date ealtAAgentA- Date
Copies of this form mast be seat to the following departments (as listed In §4065.4); Water, Engineering,
Ere, Health, Planning, Conservation, Board of Appeals.
M
APDdetemonapp 10-99.wpd
TO: Commercial Applicants in the APD
FROM: Yarmouth Health Department
SUBJECT: Hazardous Materials
As part of the application process for a Board of Appeals hearing or Detamination of Non -Applicability, please
complete this form and return it with your appiicatiom For further information concerning hazardous materials
regulations, contact the Health Department Office.
In the conduct of your present and/or proposed business, do you store, use, generate any of the
following types ofproducts7 (Check all which apply):
Antifreeze, Engine & Radiator Flushes Motor Oil
Hydraulic, Brake, Automatic Trans. Fluid Gasoline/Fuels
Grease, Lubricants Degreaser/Cleaners
Floor/Driveway Degreaser Battery Acid
Rustproo5og/Undercoating Vehicle Detergents
Vehicle Waxes, Polishes Asphalt, Tar, Sealers
Paint, Varnishes, Stains, Dyes, Thinners Wood Preservatives
Dry Cleaning Solvents, Carbon Tetrachloride Floor/Fumiture Strippers _
Other Cleaning Solvents Rock salt, Road salt
Drain, Toilet, Cesspool Cleaners Refrigerants
Bug & Tar Removers Photo chemicals
Printing Inks & Dyes Pool Chlorine
Pesticides, Insecticides, Herbicides Rodenticide, Fungicides
Nitrate Fertilizer Jewelry Cleaner
Leather Dyes PCB's
Electroplating Sludges Others (List)
Applicant Signature: �i ^ Date:
CAMy Files\DocumentsWpplication\HEALTAPDdeterl0-99.WPD
Confirmation Report— Memory Send
Date 8 Time: Sep-02-2004 09:08
Tel line :
Ilachine ID :
Job number
375
Date & Time
Sep-02 09:05
To
8016409071
Number of pages
. 001
Start time
. Sep-02 09:05
End time
: Sep-02 09:08
Pages sent
. 000
Status
: NG BO
Job number : 375
*** SEND FA I LED ***
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Confirmation Report— Memory Send
Date [ Time: Sep-02-2004 12:41
Tel line :
Machine ID :
Job number
Date [ Time
To
Number of pates
Start time
End time
Pates sent
Status
Job number : 380
TO:
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FROM:
380
Sep-02 12:40
16173767439
002
Sep-02 12:40
Sep-02 12:41
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*** SEND SUCCESSFUL sss
TOWN OT' YAI2MOUTS
BiJIZ.DII�TG DEPARTMENT
1346 Route 26. South Yarn�ou[h. MA 0266I
Phones 508-398-2231 a:L 261
Fax: 508-398-0836
Tafam Pass. feaslad(ae sir pates
cos`n►>zcnrls:
ebb%414
TOWN OF YARMOUTH
BUILDING DEPARTMENT
1146 Route 28, South Yarmouth, MA 02664
Phone: 508-398-2231 ezt.261
Fax: 508-398-0836
TO:
FAX#
DATE:
FROM:
Total pages, including cover page.
COMMENTS:
6t7
'ell
�P,4ad r M9
V
i
K�
Z
3( °e
o H
r�� r
February 28, 2001
TOWN OF YARMOUTH
BUILDING DEPARTMENT
1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 260
Mr.Stephen McCarthy
99 Derby Street
Suite 200
Hingham, MA 02043
Re: 2 Iyanough Rd. (Rt. 28)
Dear Mr. McCarthy:
We are in receipt of your building permit application dated February 9, 2001 on which you propose
to perform the following work:
"Mobile MRI Trainer"
After having reviewed said application I have determined that this proposed work would violate the
following Town by-laws: The proposed temporary placement ofa mobile MRI unit requires a Spacial
Permit from the Zoning Board of Appeals pursuant to table 202.5 use 01 APD (Aqua Protection
District).
Therefore, in order to proceed you are required to file all necessary applications for a public hearing
and appeal with the Yarmouth Zoning Board of Appeals pursuant to MGL Chapter 40-A.
Any questions regarding this matter may be directed to this department and / or the Board of Appeals
secretary.
Very may.
James D. BrandolK CPC
Budding Commissioner
Copy to: Board of Appeals
3=of YgR�c TOWN OF YARMOUTH
° BUILDING DEPARTMENT
F ? . 1146 Route 28, South Yarmouth, NIA 02664 508-398-2231 ext. 260
February 28, 2001
Mr.Stephen McCarthy
99 Derby Street
Suite 200
Hingham, MA 02043
Re: 2 Iyanough Rd. (Rt. 28)
Dear Mr. McCarthy:
We are in receipt of your building permit application dated February 9, 2001 on which you propose
to perform the following work:
"Mobile MRI Trainer"
After having reviewed said application I have determined that this proposed work would violate the
following Town by-laws: The proposed temporary placement of a mobile MRI unit requires a Special
Permit from the Zoning Board of Appeals pursuant to table 202.5 use 01 APD (Aqua Protection
District).
Therefore, in order to proceed you are required to file all necessary applications for a public hearing
and appeal with the Yarmouth Zoning Board of Appeals pursuant to MGL Chapter 40-A.
Arty questions regarding this matter may be directed to this department and / or the Board of Appeals
secretary.
. Very truly.
• Au��
James D. Brandolini, CPC
Building Commissioner
Copy to: Board of Appeals
TOWN OF YARMOUTH BUILDING DEPARTMENT
PL %N REVIEW & BUILDING PERMIT APPLICATION REVIEW NOTE
Address: et
?�
Map/Lot: • .
Date of Initial Review o -;C Other Approval Date
Inspector. R
Notes:
ooloce
Zoning Denial (if applicable):
:
:Section 104.32, pats. Change, Extension or Akemdon (pre-adsft
nonconforming)
The propose rAtim= , �i ti. ,_r•� a tsgttires a Special Permit from
the Zoning Board of App .., �• x
Building Code Denial (if applicable)
BUILDING PERMIT APPLICATION
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE, OCCUPANCY OF,
OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING.
Town of Yarmouth Building Department
1146 Route 28 • Yarmouth, b1A 02664-4492
Tel: (508) 398-2231 x261 • Fax: (508) 398-2365
- - Office Use Only - - Planning Board Information Assessors Departrnent Information:
Permit No. Date Plan Type UV Lot "W cor
Permit fee a - Endorsement , . Old - _ Now
Recording Date
Deposit Rec'd. 3 Date 1.4 Prop" Dimensions.
Plan No. -
Net Due a Other LotArea(so Fontage(n) Lot Coverage
This Section for Office Use Only
Building Permit Number. Date Issued:
Signature: Certificate of Occupancy
Building Official - - Date IS is not -required
Section 1 - Site Information
1.1 Property Address:
P— I Roar (Rr. zel
12 Zoning Information:
8 8
Zoning District Proposed Use
1.3 Building Setbacks (tt)
-
Front Yard
Side Yards
Rear Yard
Required
Provided
Required
Provided
Required
Provided
50,
3b.3
z5
/o.6
;.o
2z9'
1 A Water Supply (M.G.L. c. 40. S 54)
Public Private
1.5 Flood Zone Information: Comments: - --
Zone: , BFE.
Section 2 - Property Ownership/Authorized Agent
2.1Owner of Record: /�
J*CLJ)3 NK I � I4G A.uCs DF CAPE CC7
N m
9
ture Telephone
Name
Section 3 - Construction Services 1
3.1 Licensed Construction Supervisor.
Telephone
Mailing Address:
Gr7- FIG -
Telephone
Mailing Address'.
'161-55G-1056 CM 7bl-,L54-4
Telephone
Not Applicable
License Number
Expiration Date
9- 15-99 1 of 4 OVER
3.2 Registered Home Improvement Contractor.
Company Name
Not Applicable
Address
Registration Number
Ettpiration Date
Signature Telephone
Section 4 - Workers' Compensation Insurance Affidavit (M.G.L c.152 S 25C (6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure
to provide this affidavit will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes .......... No ..........
Section 5 = Professional Deslgn and Construction Services - for Buildings_ and Structures Subject'
to Construction Control Pursuant to 780 CMR 116 (containing more than 35,000 c.f. of enclosed space) .
Section 5.1 Registered Architect:
Not Applicable ❑
Name (Registrant):
Registration Number
Address
Signature Telephone
EViretbn Data
Section 5.2 Registered Professional En ineer s)
Name
Area of Responsibiliy
Address
Signature Telephone
Registration Number
Expiration Date
Name
Area of Responsibility
Address
Signature Telephone
Registration Number
Expiration Date
Name
Area of Responsibility
Address _
Signature Telephone
Registration Number I .
Expiration Date
Name
Area of Responsbility
Address
Signature Telephone
Registration Number
Expiretion Data
Section 5.3 General Contractor
Not Applicable
Company Name
Person Responsible for construction
Address
Signature Telephone. , r.
9-15.99 2 of 4
Section 6 Description of Proposed Work (check all applicable)
New Construction
❑
I (for multiple family only) No. of Bedrooms
(for multiple family only) No. of Bathrooms
Existing Bldg. ❑
Repair(s) ❑
I Alterations ❑
1 Addition ❑
Accessory Bldg.
❑ Type
Demolition
OthN..'� Specify: TEAlLcr
Brief Description of Proposed Work:
As q RKEFALarivAtile, I - flic" M4 K)ra I J)
TROVIC;Ner 140Xe
u 1 vl
ro Nr"r- A
- d "ur &-nif
M&
-fLECr, 11 Af Iu,
T ICC
- IRAI F-?) ;14 -rJ) RWIQF7 1&4ApAAfj1/ N aA1JAI AN
ha 0-
Cur Am q HMjL?-k(2r .
Section 7 = Use Grouo and Construction Tvoe
Building Use Group (Check as applicapable)
Construction Type
A
ASSEMBLY
❑
A-1
Ad
❑
❑
A-2
A-5
❑
❑
A-3
❑
to
18
❑
❑
B
BUSINESS
❑
2A
213
2C
❑
❑
❑
E EDUCATIONAL
❑
F FACTORY
❑ F-1 ❑ F-2 ❑
H
HIGH HAZARD
❑
3A
38
❑
❑
I INSTITUTIONAL
❑ 1-1 ❑ 1-2 ❑ 1-3 ❑
M
MERCHANTILE
❑
4
❑
R
RESIDENTIAL
❑
R-1
❑
R-2
❑
R-3
❑
5A
5B
❑
El
S STORAGE
❑ S-1 ❑ S-2 ❑
U
UTILITY
SPECIFY:
M
MIXED USE
❑
SPECIFY:
S
SPECIAL USE
❑
SPECIFY:
Complete this section if existing building undergoing renovations, additions and/or change in use.
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34 1 Proposed Hazard Index 780 CMR 34
0
Area
Number of floors or stories
Include basement levels
Floor Area per Floor (sr)
Total Area All Floors (so
Total Height (ft)
Section 9 = STRUCTURAL PEER REVIEW (780CMR 110 11)
Independent Structural Engineering Structural Peer Review Required Yes .......... No ..........
SECTION 10a OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING_ PERMIT
it, TkL 941", as Owner of the subject property,
hereby authorize
my behalf, in all I
v VVa.
of Owner
M6^3 M�CA)trl.},[ to act on
relative to w k authorized by this building permit application.
d/7101
Date
9.15-99 3 of 4 OVER
AGENT
I, jArf MinnS�SrE>°��l�✓ r , as Owner/Authorized Agent
hereby declare that the statements and information on the forgoing application are true and acurate, to
the best of my knowledge and belief.
Signed under the pains and penalties of perjury.
#7(ol
Date
Section 11 -ESTIMATED CONSTRUCTION COSTS --
Item
Estimated Cost (Dollars) to be
completed by permit applicant
1. Sulldirg
2- Electrical
3. Plumbing / Gas
4. Mechanical (HVAC)
5. Flre Protection
6. Total .(1+2+3+4+5)
7. Total Square Ft. Rurne+mcbn 6 wunrl
Check Below
❑ Conservation -Commission Filing
(if applicable)
❑ Old Kings Highway & Historical
Commission approval
(if applicable)
9-15-99 4 of 4
OWN OF YARMOUTH
ry" BUILDING DEPARTMENT
Applicant:
BUILDING PERMIT APPLICATION SIGN OFF
Building Permit No.:
Address: Tel. No.:
Bldg. Site Location:
Map No.:
Date Filed:
Lot No
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 determine compliance to the
following: (A) Zoning Requirements (B) Historical Districts (C) Flood Zones. The Building Department
will be responsible for assisting the applicant through the following departments:
RESIDENTIAL AND/OR COMMERCIAL BUILDING
WATER DEPARTMENT: Determines Compliance of Water Availability. (applicant to obtain)
ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage.
CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts; ie., If Lot(s) Border any Type
of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc.
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements
for Septage Disposal and other Public Health Activities.
FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal
Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc.
----------------------------------------
The jbUou4ngDepartments must sign off, in the respective order, prior to building inspector issuing the required
building permit:
REVIEWED BY:
1. WATER DEPARTMENT: DATE: N/A:
Y. ENGINEERING DEPARTMENT: DATE: N/A:
3. CONSERVATION: DATE: N/A:
4. HEALTH DEPARTMENT: DATE: N/A. -
INDUSTRIAL AND/OR COMMERCIAL PERMITS
5. WIRING INSPECTOR: _
6. PLUMBING INSPECTOR
7. FIRE DEPARTMENT: _
PLEASE NOTE
AU stumps and/or brash must be disposed of at an approved site.
COMMENTS:
DATE
N/A:
DATE
N/A:
DATE
N/A:
8/99 Applicant Signature Date
^R TOWN OF YARMOUTH
03r � .
�=.5,�� BUILDING DEPARTMENT
CONSTRUCTION SUPERVISOR FORM
PLEASE PRIM.
job Location:
Number Street Village
Owner of Property:
Construction Supervisor.
Address:
Licensed Designee:
(If other than Supervisor)
Name
Name
2.15 Responsibility of each license holder.
License No.
License 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 subcontractor 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 Anylicenseewho shall willfullyviolate 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 applications shall contain the name, signature and license number of the
construction supervisor who is to supervise those persons engaged in construction, reconstruction,
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 immediately
cease until a successor license holder is substituted on the records of the building department.
2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may
be deemed a violation of the permit conditions.
I have read and understand my responsibilities under the rules and regulations for licensing construction
supervisors in accordance with section 109.1.1 of the state building code. I understand 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 MGL Ch.152
Yes ❑ No ❑
If you have checked yu, 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 152 of the Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
signature of Owner or Owner's Agent Owner ❑ Agent
Signature: Building Official Approval:
M
The Commonwealth of Massachusetts
Department of industrial Accidents
0lllef fllnM11, SONS
600 Washington Street
Boston. Mass. 01111 .
Workers' Compensation Insurance Affidavit
Applicant Information- PfeaieTHIIPPiFdsm
1 am a homeowner performing all work myself. I
0 1 am a sole proprietor znJ ha%e no one working in any capacity
1 am an employer pro%iding workers' compensation for my employees working on this job.
insurance eo. noliey 0
[am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below who have
the followin_ workers' compensation polices:
city, phone a:
Foilure to secure coverage as required under Section 25A of MGL 153 can lead to the imposition of criminal penalties of a floe up to 51,500.00 and/or
one years' Imprisonment as well as civil penalties In the form of a STOP WORK ORDER and a time of f100.00 a day against me. 1 understand that ■
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
t do hereby certify under the pains and penaldes of peolury that the information provided above is terse and eor►ect
Signatu -c Date
Print name
official use only do not %rite in this area to be completed by city or Iowa official
city or lawn: YARMOOT$
❑ cheek if Immediue response is required
contact person:
_ permittlicense 0 nBuilding Department
Ol.iensing Board
261 OSelectmen's Office
011caltb Department
phone#:_ (508) 398—=31 ext. Mother
Penh 195 r1A1
Information and Instructions
Massachusetts General Lags chapter 152 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 anv
contract of hire, express or implied, oral or written.
An enip/grer 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 trusteeof 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
dtelling house of another who employs persons to do maintenance. construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.
NIGL chapter 152 section 2 also states that every state or local licensing agency shall withhold the issuance or
rencnnl 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 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 has e
been presented to the contracting authoriq. I
Applicants
Please fill 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 may be 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.1
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 Town
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 permittlicense number which will be used as a reference number. The affidavits may be returned to
the Department by mail or FAX unless otber arrangements have been tirade.
The Office of Investigations would like to thank you in advance for you cooperation and should you have any
please do not hesitate to give us a call.
and
The Commonwealth Of Massachusetts
Department of Industrial Accidents
MCI If Imstlnt tin
600 Washington Street
Boston, Ma. 02111
fas N: (617) 727-7749
phone #: (617) 7274900 ext. 406, 409 or 375
TOWN OF YARMOUTH
1146ROUTE28 SOUTHYARBIOUTH MASSACHUSEM026644451
Telephone (508) 598-2231, Ext 261 — Fax (508) 898-2365
ABUILDING DEPARTMENT
Iv
DEMOLITIO( DEBRIS DISPOSAL AFFIDAVIT
BUILDING
ELECTRICAL.
GAS
PLUMBING
SIGNS
Pursuant to M.G.L. Chapter 40, Section 54 and'780 CMR, Chapter 1, Section 111.5,
I hereby certify that the debris resulting from the proposed work/demolition to be
conducted at
Work Address
is to be disposed of at the following location:
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, Section 150A.
Signature of Applicant
Permit No.
Date
a
CURBSIDE ELEVATION
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OFFICE MEETING NOTES
ADDRESS: DATE:
Names of Attendees: _ f. �� ��./L. /t /( 4'
Zoning District: .Z
Flood Zone: C
Meeting Topic:
pf� 'O�e7
/ U //`` AL
LOT AREA: 2.58 AC.t �•.`
ARE
TO E O M
�• PPOS WORK LIMIT LIN ! ANDSTABILI ED
POOR TO REMO
P(AYBACES AND SILT FE PROP. BASIN / OF SILT FENce. TO E
/ 14 / SEE DETAIL SHEET FkG 12.01
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,� TIE NEW DRA NAGE INTO / /, , , . , �'• PROP
✓p ray EXISTING SYSTEM WITH .. •, O• ''// APPRt
6" SCH40PVC AT 0% '•' '•' .ti . gDNC;; RETAIN SLIM*
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SAWCUT AND REPLACE • ' .Q�/'\'•'.'. •.'. •'.••'. I
•�• EXISTING ASPHALT AS / �Sntr•`% ' ' '•�'"'•'.• ~
J ; REQUIRED. NEW ,; C �.'•••'•'.''••
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EXISTING/ / , / // \ / NPP
�''•-8�0ERf 2 �'• ✓,✓i' '' PAVED PARKING/
AREA TO REMAIN
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J
594 SF
EXISTING
c, /= , J Sa4Cfs / LEACHING FIELD
EX Z VENT
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University Conference Services
University of Massachusetts
FAJAmherst, MA 01003
413-545-2591
i
J1
FROM McCarthy 8 Company,Inc. FAX NO. : 7815561052 May. 30 2001 033:03PM P2
MCCARTHY & COMPANY1 INC.
HEALTHCARE REAL ESTATE SERVICES
99 Dieer sTamm, Surrc 200 • Him"AY, MA 0"43 • T«: 781.556-1050 • FAY: 7a�-aawiva� • c-■+��. ++.�^-�•-•^-^__.__._
May 29, 2001
Mr. Don Tullie, Assistant Building Inspector
Town of Yarmouth
1146 Route 28
South Yarmouth, MA 02664
Dear Don:
Based on our meeting of May 23, 2001 regarding the planting questions at Shields MRl that were
brought to your office by the Route 28 Committee, we arc proposing to supply and install two (2)
corpus kousa dogwood.; in the southern corner of the property (front right). The area is somewhat
confined with the existing flowerbed, building and fence, so we feel that this it an attractive
option. I have provided your office with a sketch of the area in question along with the planting
information, and it is my hope that this letter will satisfy all that are involved
Please contact my office with any questions that you might have.
Very truly yours,
I� nI I e.
^Stephen• W. McCarthy
cc: Bill Demianiuk
b'
FormaLx InfonmaL_ Review
SITE PLAN REVIEW COMMENT SHEET
Deputy Sherman
Beth Schultz
Ron Peters
Jim Brandollni
Karen Greene
Michael Stusse
Bred Hall
N WALA
Brian Heasl
This is a formal site plan review.
Protect Sunman
Applicant proposes to expand parking to the rear of the existing lot. Seven existing parking spots will be relocated
to the new area and seven additional parking spaces will be provided (for a net Increase of seven parking
spaces). No changes to the building are proposed.
Comments
Building: (1) The proposed site change will require a special permit pursuant to Section 411.3A R.OJLD's
district. (2) A special permit or waiver is required for the proposed parking expansion as per 406 APD. (3)
Additional trees are required In the following locations: at the sw comer, as comer and easterly sideline (exceeds
20 foot Gmh).
Conservation: Project will require Noon of Intert�n Comm. H ZBA approvals are requlmd, ZBA filings
must occur prior to Con Comm submission /
Design Review: (`
Economic Development: Applcant's proposal Will meet greater than expected demand. Applicant is an
Important local business and has benefited through the Towrm 'a Economic Development incentive Progra
/through a Tax Increment Finance Agreement.
Engineering: The Applicant claims that the existing dndnage functions properly. The leaching structures sm
located entirely within the high groundwater elevation. We suggest revising (regrading) the proposed parking
lot to create a low point in the center with a catch basin. Also, a cape cod born should be added around this new
parking area to contain any runoff, not slowing it to enter the wetlands. C�
Fire: Do" Chief Shemurc Proposed parking change actually Improves access for emergency vehicles to rear
loading area. No other comments. Him
Health: No Commerts.W
Planning: This project was originally approved under the R.OJLD. provisions of the Zoning Bylaw, which are
outlined in section 411. In accordance with section 411.3.4, which deals with modification of an approved
R.OJLD. project, a new special permit Will be needed from the Board of Appeals for the proposed parking lot
change. Approval by the Planning Board will also be required prior to application to the Board of Appeals.
Water. Not Present
Read i Received by Applic;rt(s)
7
Formal„X Informal Review
SITE PLAN REVIEW COMMENT SHEET
Deputy Sherman
Beth Schultz
Ron Peters
Jim Brandolini
Karen Greene
Michael Stusse
Brad Hall
El
NWALA
Brian Hesslip
This Is a format site plan review.
Project summafY
Applicant proposes to expand parting to the rear or the existing laL Seven existing parking spots will be relocated
to the new area and seven additional parking spaces win be provided (for a net increase of seven parting
spaces). No changes to the building are proposed.
Comments
Building: (1) The proposed site change will require a special permit pursuant to Section 411.3A R.O.A.D's
district (2) A special permit or waiver is required for the proposed parking expansion as per 406 APD. (3)
Additional trees are required In the following locations: at the sw comer. se comer and easterly sideline (exceeds
20 foot llmlt .
Conservation: Project will require Notice of Intent Comm. B Z13A approvals are required, ZBA filings
must occur prior to Con Comm submission.
Design Review: / ✓ f G
W
conomic Developrternt; Applicanes proposal will meet greater than expected demand. Applicant is an
mportant local business and has benefited through the Town's Sconomic Development Incentive Programrough a Tax Increment Finance Agreement
Engineering: The Applicant claims that the existing drainage functions property. The leaching structures are
located entirely within the high groundwater elevation. We suggest revising (ro-grading) ate proposed parking
lot to create a low poinnt in tie center with a catch basin. Also, a ape cod berm should be added around this new
parking area to contain any runoff, not allowing It to entertle wetlands. C�
Fire: Deputy Chief Sherman: Proposed parking change actually improves access for emergency vehicles to rear
loading area. No other comments. t-4Z5�
Health: No Commerds.W
Planning: This project was originally approved under the R.OJLD. provisions of the Zoning Bylaw, which are
outlined in section 411. In accordance with section 411.3A, which deals with modification of an approved
R.OJLD. project, a new special permit will be needed from the Board of Appeals for the proposed parking lot
change. Approval by the Planning BoaM will also be required prior to application to the Board of Appeals.
Water. Not Present
Read & Received by Applicant(*)
TOWN OF YARMOUTH
BOARD OF APPEALS
DECISION
N
FILED WITH TOWN CLERK: May 10, 2000
PETITION NO: #3602
HEARING DATE: April27, 2000
PETITIONER: Shields Health Care Group
TO "^; 10
PROPERTY: 2 Iyanough Road, West Yarmouth
Map: 36, Parcel: 99 (30/D2) Zoning District: B1
MEMBERS PRESENT AND VOTING: David Reid, Chairman, James Robertson, Joseph
Sarnosky, John Richards, Douglas Campbell, and Alternate, Robert Reed.
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 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 Applicant proposes to acquire the property located at 2 Iyanough Road, West Yarmouth for
the purpose of installing a Magnetic Resonance Imaging facility. To that end, the Applicant has
entered into an agreement to purchase the property from the current owner, Goose Hummock
Shop Nominee Trust.
The site is also located within a APD District and falls within the jurisdiction of the Yarmouth
Conservation Commission. The Board finds that prior to applying with this Board, the Applicant
has received approval from the Conservation Commission, the Building Commissioner relative to
APD compliance, and received a plan approval from the Yarmouth Planning Board.
The Petitioner was represented at the hearing by its attorney, Nfichael B. Stusse.
Required Relief
In order to construct the MRI facility, the applicant will require a special permit to allow the
building to encroach within the 25 foot sideline setback limitation as set forth in Section 203.5
(Table of Dimensional Requirements).
The application before the Board is for a special permit and not a variance as the Planning Board
and Board of Appeals are allowed to adjust lot dimensional requirements pursuant to Section
411.1.2, where the objectives and mandatory criteria of the Revitalization and Overlay
Architectural District are met.
The Board finds that the objectives and criteria of the ROAD District have been met.
4-
Obiectives and Mandatory Criteria Satisfi
Shields Health Care has voluntarily submitted its proposal to the ROAD zoning District and is not
seeking any waiver limitation as enumerated by Section 411.3.3 of the By-law. The application
has been approved within the APD District and has completed the Site Plan Review process.
The applicant has submitted all information required by Site Plan Review, as well as a landscape
plan, and abutters list. Accordingly, all procedural requirements for approval have been met.
With respect to the General Criteria for approval as set forth in Section 4111.5, the Board fads
that the applicant is in compliance therewith as follows:
Site Plan Review: The site plan review objectives of Section 103.3.1 have been met. The
applicant has met with Site Plan Review on three occasions and has developed a satisfactory site
Plan.
The Board finds that the objectives of Section 1033.1 have been met, to wit:
(1) The design provides for adequate parking.
(2) Parking areas have been removed from the front of the building and placed in the
rear of the building. ,
(3) Access. A new, conforming and adequate curb -cut will be created.
(4) Utilities. Utilities will be provided underground.
(5) The plan minimizes environmental impacts by avoiding impacts on wetlands,
providing a new Title V septic system, reducing the need for fill as the site
maintains most of the site in open space and provides for increased planting and
landscaping in buffer and front yard areas.
Effects on Abutters: The plan enhances abutting properties by improving a derelict site,
avoiding impacts on wetlands and achieving greater conformity with the by-law than at present.
The Objections of Section 411 are met The purpose of the ROAD District is to induce
rehabr3itation of existing buildings by, in some cases, relaxing dimensional requirements in return
for site and architectural review that promotes attractive structures and grounds and minimmi es
environmental impacts. The design criteria and goals of the by-law are met by the current
application.
Economic Benefits. The economic benefits of the project are: (1) a derelict, empty building will
be put to beneficial use; (2) the commercial tax base of the Town will be improved; (3) up to six
persons will be employed in well -paying positions and; (4) a diagnostic facility will be made
available for Cape residents.
-2-
1-:
Project Recommendations The proposal has received the endorsement of the Site Plan Review,
the Route 28 Task Force and the E.R.C.
Supplemental Standards:
1) Architectural Stvle: The plans submitted depict a Cape Cod style building. The colors,
materials, and design will improve on the existing building an d create a positive visual effect at
the entrance to Yarmouth from Hyannis.
2) The natural environment is enhanced by the design in that any impacts on wetlands are
avoided and greater compliance with the by-law is achieved.
3) The benefits to be derived by the project outweigh any ill effects of a deviation in the
sideline setback requirement for the underlying zoning district
Special Permit Criteria of Section 103.2.1: The site will be utilized by appointment only. As
such, there is adequate parking and access and there will be no undue nuisance, hazard or
congestion created by the facility. The re -use of the vacant building with its aesthetic
improvements to the site, will enhance the character of the neighborhood and the Town. While
this stretch of Route 28 is very congested at peak traffic intervals, the proposed use is expected to
generate traffic at a slow and steady rate, without real peak volumes of incoming or outgoing
traffic. The traffic impact is expected to be less than most other uses to which this commercial
site could be put.
The Purposes of the ROAD District Are Accomplished: The ROAD District seeks to utilize
flexible zoning standards to induce rehabilitation and re -use of existing buildings. The proposal
will re -use a vacant building and enhance the visual presence of the property.
The Purooses of the Underlying Zoning Are Accomplished: By allowing the project the
Board of Appeals will meet the objectives of the Byd.aw as the site will be in conformity with the
underlying zoning, both as to use and dimensional requirements, with the exception of the easterly
side yard setback. No pavement or traffic will be permitted along the easterly boundary, so that
the entire reduced side yard well serve as a buffer for the building.
The Project Benefits the Neighborhood: By improving and beautifying what has become a
derelict property, the development will enhance the neighborhood and there will be no adverse
impacts from the requested variation.
Planning Board Approval: The Planning Board has endorsed the project and approved the
architectural and site designs. The Planning Board's Form R-1 is dated March 29, 2000 and
received by the Board of Appeals on April 3, 2000.
No abutters appeared in opposition to the proposal. The commercial neighbor (across Route 28)
wrote a letter in support of the petition.
Therefore, a Motion was made by Mr. Robertson, seconded by, Mr. Richards, to grant the
-3-
V
Special Permit as requested and as represented, in order to allow the Petitioner permission to
install a Magnetic Resonance Imaging facility, as set forth in the petitioner's Site Plan (dated
3/6/00, revised 4/19/00) and architectural plans (received by the Board on March 24, 2000) and
incorporating by reference the Planning Board's Form R-1 dated March 29, 2000.
The members voted unanimously in favor of this motion. Therefore, the Special Permit as
requested is granted.
No permit shall issue until 20 days from the filing of this decision with the Town Clerk. Appeals
from this decision shall be made pursuant to MGL c40A §17 and must be filed within 20 days
after the filing of this notice/decision with the Town Clerk.
Z4�
David S. Reid, Clerk
KI
SITE PLAN REVIEW
X FORMAL INFORMAL
August 19, 2003
TO:
__ASSESSOR (w/o plans)
-CONSERVATION
__PLANNING DEPT (3)
Planning
Design Review
Econ. Development
__HEALTH DEPT
_ENGINEERING DEPT
_FIRE DEPT
RATER DEPT
Town Clerk's Office (2)
wlo'lUns-tor posting
✓ BUILDING DEPT
FROM: James D. Brandolini Building Department
SUBJECT: SITE PLAN REVIEW AGENDA
TIME: 2:30 PM
NAME OF PROJECT: Shields MRI
ADDRESS: 2 lyannough Rd.
FLAP: 36 LOT: 99
IIAME OF APPLICANT: Shields Health Care Group
CHAIR: Water Dept
TABLE 2
SITE PLAN REVIEW REQUEST AND PR07ECr DESCRIPTION FORM
SUBMISSION DATE: 8-11-03 REVIEW DATE: 8-! 9 03 TIME: ? Oil
Do
ASSESSORS MAP NO. 36 LOT 99 (Old Map 30 Lot D2 )
LOCATION OF PROJECT: #2 Iyannough Rd (Rt. 28), West Yarmouth MA
NAME OF BUSINESS/PROJECT: SHIELDS MRI
APPLICANT NAME: Shields Health Care Group attn: Stephen W. McCarthy
APPLICANT ADDRESS: 700 Congress Stint, Quincy, MA 02165
APPLICANT PHONE NUMBER: 1-781-556-1051
ENGINEER/SURVEYOR Down Cape Engineering, Inc., Daniel A. Ojala
TIRE REFERENCE: 8430/167 etc. REGISTRY SURVEY: see plan
DESCRIPTION OF PROJECT: (attach additional pages if necessary)
This is a formal SPR filing for a small (7 cars net) parking lot expansion to the rear
of the ei gtm parking lot at the West Yarmouth location of Shields AM. The
project consists of relocating two lightpoles and adding a third, crating a new
parking lot island, and the installation of approx. 4154 sf of paved parking with
associated drainage off the rear of the existing parking lot. Additional buffer and
parldng tram are planned. The expansion is completely within the cleared area
behind the existing parking lot.
No changes to the building or it's use are planned.
ZONING DISTRICT. B2 FLOOD ZONE: C
BUILDING SIZE: 5802 sf footprint (square feet) Attach floor plan(s)
BASEMENT: 0 FIRST FLOOR: 5802 SECOND FLOOR: 1000 est.
MAXIMUM NUMBER OF EMPLOYEES: no change
TO YOU HANDLEISTORE OILS OR HAZARDOUS MATERIALS7 unk.(no changem i
IF SO, ATTACH LIST OF THEM BY NAME, QUANTITIES, AND
PROPOSED METHODS OF STORAGE/HANDLING/DISPOSAL/ETC.
BOARD OF APPEALS ACTION EXPECTED: NO
IS THE PROPOSED CONSTRUCTION WITHIN 100 FEET OF A
WETLAND? YES
SIGNED:
SUM 8 mples of this mnpleted ram and the site pan to the &ddng Departnent h order to
get ymr protect on the Site Plan ReAew agenda. A 90 mpy is regtAred If WO d. 100 ft of a
weUard.
Filed with .Town Clerk:
Petitioner--
TOWN OF YARMOUTH
BOARD OF APPEALS _
Hearing Date: 10/25/73
Petition No.: 1240
DANTI M. and•ROBERTA X. BRATTI
23 Dres's Way
Hyannis, Massachusetts
". DECISION
:The-petitiondr requests -a -.variance and/or approval and/or
specialpermit. from the..Boazd.af.Appeals to -al -low .the: petitioner. to
„., fill- Im.land. at_-the_r-eat-of_ hi__gxeper_ty..for- an .addition- to. an. ex-
. -••--.iating..bui.lding.: -Said laud being -in-the dVetlands-Conser-vahcy.-District.
Property located at No..2 and 14 Iyanough Road, West Yarmouth, Massa-
--.;chusetts,.;and.shown on the As3essor's Map., No.. 30 as parcels D1 and D2.
Members :of :Board:.of .Appeals present::
+ _-WTL.LIAMzF.:BUTLER..III _ HAROLD-L..HAYES-,r•.JR.
- DAVID DMAN:.-- - DONALD F. HENDERSON
AUGUSTINE L. MURPHY
It appearing that -notice -of said hearing has been given by
sending.-mntice thereaf..to _the _petitioner. and all 'those owners of pro-
perty- deemed-1y -the rBoaid to be -affected .thereby.; and that -public
notice of.such_hearing.having-been_givvn.hy�publioation 'in the Cape
Cod Standard Times on October 8,-1973 and -October 15, 1973, the hear-
- - -dug. was opened.and-.held. on the date.. first above written.
The-.following.appeared in favor of the petition:
Petitioner
Planning Board (by letter)
Board of Health -(by letter)
The following appeared in opposition:
None
r
a
REASON FOR DECISION:
Petition No. 1240
Petitioners request a special. permit to allow the filling
of land at the_rear.of their.property.for an addition to the. -exist-
ing building under .S18.05A.4.of. the zoning by-law. A detailed plan
has been submitted to the_Board.and the application has been re-..
ferred to the Planning.Board,.the Board_o£ Health and the Conserva=
.tion Commission. Reports have been received by all three of those
boards.
The Board finds.that the proposed filling will eliminate
a. mosquito problem -.that presently-. exists -in .this area without having
any detrimental.effect•on-the Town.;_ We are -satisfied that such fil-
ling, subject-to.the conditions. hereinafter.imposed�.will not pro-
duce unsuitable development in areas..subJect to-flooding•or other
areas of wetland; --.will facilitate the adequate protection and pro-
vision of water.supply; and will -not affect the -purity of waters in
the area for the propagation and protection of aquatic life.
Members of Board voting:
WILLIAtf F.. BUTLER III Voted in Favor
HAROLD L. HAYES, JR. - Voted in.Favor
DAVID.OMAN,. - Voted in Favor
•- ; - DONALII F. HENDERSON . , ....- ..... •.Voted. in Favor
AUGUSTINE L. MURPHY -
Voted in Favor
Therefore-, the petition is granted.
And we authorize a special permit to allow filling of petitioner
land in -accordance with the plan filed with the Board and subjec-
to the following conditions:
I. Any building erected on the lot will have town
water.
i
2. All sewerage facilities shall be installed four
(4) feet above the water table.
3. Any paving shall be limited to the front portion
of the property.
4. No material shall enter the ditch at the northeast
i
corner of the lot or the creek at the rear of the lot.
S. Any material used as fill shall be clean and free
i
from organic matter.
f
i No permit issued until 22 days from the date of filing decision
i with the Town Clerk. z
I per DONALD F. HENDERSON
ACTIN CLERK
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TOWN OF YARMOUTH
BOARD OF APPEALS
A 15 P 3 :15
Filed with Town Clerk: 7-15-88 Hearing Date: July 14, 1988•
Petitioner: Luke P. Lally Petition Ni�iiN1?S59kE� a ..
2 Iyanough Road
West Yarmouth, MA
Owner: . Luke P. Lally and Jeanne F. Lally
Title Reference: Barnstable County Registry of Deeds
Book 3881, Page 136.
DECISION
The Petitioner requested variances from the Board of
Appeals to allow construction of a parking area and drive on
his property within fifty (50') feet of a wetland and with a
curb cut on Route 28 greater than twenty-four (241) feet in
width. The property is located at 2 Iyanough Road, West
Yarmouth, Massachusetts and is shown on Town of Yarmouth
Assessors' Map 30 as Parcel D2. Locus is comprised of a
single parcel of land of approximately 2.6 acres improved with
a two-story wood -frame structure, being more particularly
described in a deed recorded with the Barnstable County
Registry of Deeds in Book 3881, Page 136.
Members of the Board of Appeals present: Donald Henderson,
David Reid, Fritz Lindquist, Joyce Sears and Leslie Campbell
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 Yarmouth Sun on June 29,1988 and
July 6, 1988, the hearing was opened and held on the
Hearing Date set forth hereinabove.
The following* appeared in favor of the petition.-"
Philip Michael Boudreau, Esq. and Luke P. Lally
The following appeared in opposition: None
This is a request for two variances to allow a parking
lot and drive to be constructed within the fifty (501) foot
setback of a wetland and to allow the curb cut servicing said
parking lot from Route 28 to be constructed to a width greater
than twenty-four (241) feet. Article IV, Section 405.1 of the
Yarmouth Zoning By-law requires that all paved parking areas
and drives be set back from wetlands a distance of fifty (501)
feet. The Petitioner's plans show parking areas and drives
set back from the wetlands to varying degrees --as close as
twenty-five (251) feet at one point. The Petitioner has
received an Order of Conditions from the Yarmouth Conservation
Commission approving the proposed work. Article III, Section
301 et seq. of the By-law allows a maximum driveway width of
twenty-four (241) feet accessing parking lots. The curb cut
delineated the plan filed with the Board shows a width of
fifty-two (521) feet. The Commonwealth of Massachusetts
Department of Public Works designed this curb cut and has
issued a permit to the Petitioner to construct the same.
Upon the evidence presented at the hearing, the Board
found as follows: If the requested relief were not granted,
the Petitioner would suffer a severe financial hardship as he
would be unable to obtain an occupancy permit for locus. The
Petitioner's hardship is directly owing to circumstances
relating to the odd shape of locus and its peculiar topography
and soil conditions, all of which combine to limit greatly the
siting and design of improvements to -locus. These special
circumstances affecting locus do not affect generally the
zoning district in which locus lies (General Business). The
desired relief may be granted without substantial detriment to
the public good and without nullifying or substantially
derogating from the intent or_purpose of the By-law.
The Board voted unanimously to grant the requested
variances subject to the following conditions: All construc-
tion is to be in accordance with the plan and landscaping
sketch dated June 2, 1988 submitted by the Petitioner.
Variances are hereby issued to allow access to the premises
from Route 28 to be widened from.the requirements of .Section
300 et seq. of the By-law..and.to allow the parking lot and
drives to be constructed within the set back areas defined in
Section 405.1 of the By-law, all in accordance with said plan.
Members of the Board voting: Donald Henderson, David Reid,
Fritz Lindquist, Joyce Sears and Leslie Campbell
The decision to approve the petition was unanimous.
No permit shall be issued until twenty (20) days have elapsed,
from the filing of this decision with the Town Clerk.
Fritz Lindquist e
Clerk
I/llbasp
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1� _;92
Fornal„x IrrfornaL— Review
SITE PLAN REVIEW COMMENT SHEET
Deputy Sherman
Beth Schultz
Ron Peters
Jim Brandolini
Karen Greene
Michael Stusse
Brad Halt
N
Brian Heasll
This Is a formal site plan review.
Prolect summary
Applicant proposes to expand parking to the rear of the existing lot. Seven existing parking spots will be relocated
to the new area and seven additional parking spaces will be provided (for a net increase of seven parking
spaces). No changes to the building are proposed.
Comments
Building: (1) The proposed site change will require a special permit pursuant to Section 411.3A ROAD's
district (2) A special permit or waiver Is required for the proposed parking expansion as per 406 APD. (3)
Additional trees are required in the following locations: at the aw comer, ad comer and easterly sideline (exceeds
20 foot limit).
Conservation: Project will require Notice of Intentt)h on Comm. IfZ13A approvals are required, Z13A filings
,
must occur prior to Con Comm submission. g /ll
Design Review:
0,Economic Development: Applicant's proposal will most greater than expected demand. Applicant is an
mportaid local business and has benefded through the Town'a Economic Development Incentive Program
through a Tax Increment Finance Agreement
Engineering: The Applicant claims that the existing drainage functions property. The leaching struchrres are
located entirely within the high groundwater elevation. We suggest revising (re -grading) the proposed parking
lot to create a low point in the center with a catch basin. Also, a cape cod berm should be added around this now
parking area to con In any runoff, not allowing it to enter the wetlands. C fs
Fire: Deputy Chief Sherman: Proposed parking change actually improves access for emergency vehicles to rear
loading area. No other comments. t,.ezy�
Health: No Commerrts.w
Planning: This project was originally approved under the ROAD. provisions of the Zoning Bylaw. which are
outlined in section 411. in accordance with section 411.3A, which deals with modification of an approved
ROAD. project, a new special permit will be needed from the Board of Appeals for tiro proposed parking lot
change. Approval by the Planning Board will also be required prior to application to the Board of Appeals.
Water. Not Present
Read & Received by Appliwrnt(s)
4 d 1�7 475;
ARITO, SWEENEY, STUSSE, ROBERTSON & UPUY, P.C.
ATTORNEYS AT LAW
25 MID TECH DRIVE, SUITE C
WEST YARMOUTH, MASSACHUSETTS 02673
(508)775-3433
(508) 790-4778
December 3, 2003
Edward J. Sweeney, Jr.
Michael B. Stusse
Donna M. Robertson
Matthew J. Dupuy
Charles M. Sabatt
Please Refer to
File No.G4569Z
Ms. Rhonda LaFrance
Yarmouth Zoning Board of Appeals
Yarmouth Town Offices
1146 Route 28
South Yarmouth, Massachusetts 02664
RE: Shields Health Care Group
Petition No. 3867
` 2 lyanough Road, West Yarmouth
Dear Rhonda:
Richard P. Morse, Jr.
Betsy Newell
Thomas P. Carpenter
Kelly S. Jason
Herbert F. Lach, Jr.
Girard C. Brisbois
Charles J. Ardito, P.C.
With reference to the above, I enclose herewith a recorded copy of the recorded special
permit for your records. .
Thank you.
Very trut yours,
-10nK
Michael B. Stusse
MBS:Ics
Enclosure
cc: Building Department
DEC 0 5 0
iO3
y I
Bk 17996 P928 0137618
12-03-2003 a 03=30P
Of YAk
i
�C
TOWN OF YARMOUTH
BOARD OF APPEALS
DECISION
2T' !'-7 -S Pt4 12: 0
FILED WITH TOWN CLERK: November 6, 2003
PETITION NO. 43867
HEARING DATE: October 23, 2003
PETITIONER: Shields Health Care Group
PROPERTY: 2 Iyanough Road, West Yarmouth
Assessors Map: 36, Lot: 99 (30/D2) Zoning District: Bl
COPY
MEMBERS PRESENT AND VOTING: David Reid, Chairman, John Richards, Joseph
Sarnosky, Diane Moudouris, James Robertson and Forrest White, Alternate.
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 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 requests a Special Permit or modification of an existing ROAD Special Permit, in
order to alter and extend the sites existing parking lot. The site is located within the Bl zone.
The lot contains approximately three (3) acres of gross area. The site is improved with a medical
use building, having been authorized by a §411 Special Permit (#3602-2000) which is
incorporated by reference for purposes of background of the site).
The current proposal seeks to remove 7 existing parking spaces to the rear of the site, and extend
the parking lot further toward the rear of the lot. The new area would contain 14 parking spaces
resulting in a net increase of 7 spaces. The new area would be fully in compliance with the
bylaw.
No one appeared in opposition to the proposal. The Board finds that the proposal is an
appropriate use of the site, which would not be inconsistent with the relief previously granted.
The Board incorporates by reference its previous findings as to the satisfaction of the bylaw's
criteria for this Special Permit and finds that those findings continue to be warranted.
Therefore, a motion was made by Mr. Robertson, seconded by Mr. Richards, to grant the Special
Permit, as requested, for the site modifications shown on the petitioner's plan by Down Cape
Engineering, dated 8/11/03 with revisions through 8/29/03 (2 sheets), on the condition that the
petitioner completes the plantings shown on the plan (including plantings required by the
original permit but not presently on the site). The members voted unanimously in favor of the
motion.
Y
>' v permit shall issue until 20 days from the filing of this decision with the Town Clerk. Appeals
gom this decision shall be made pursuant to MGL cAOA section 17 and must be filed within 20
days after filing of this noticeldecision with the Town Clerk. Unless otherwise provided herein,
the Special Permit shall lapse if a substantial use thereof has not begun within 24 months. (See
bylaw §1032.5, MGL c40A §9) Unless otherwise provided herein, a Variance shall lapse if the
f rights authorized herein are not excised within 12 months. (See MGL c40A § 10)
lz .YL�
David S. Reid, Clerk
2
Appeal#3867
COMMONWEALTH OF MASSACHUSETTS
TOWN OF YARMOUTH
BOARD OF APPEALS
Date: November 28, 2003
Certificate of Grantine of a Special Permit
(General Laws Chapter 40A, section 11)
To: Sheilds Health Care Group
Address: 2 Iyanougli Road
Town: West Yarmouth, MA 02673
Affecting the rights of the owner with respect to land or buildings at: 2 Iyanough Road, West
Yarmouth. Assessor's Map: 36, Lot: 99 (30/D2) Zoning District: Bl and the said Board of
Appeals further certifies that the decision attached hereto is a true and correct copy of its
decision granting said Special Permit, and that copies of said decision, and of all plans referred to
in the decision, have been filed.
The Board of Appeals also calls to the attention of the owner or applicant that General
Laws, Chapter 40A, Section 11 (last paragraph) and Section 13, provides that no Special Permit,
or any extension, modification or renewal thereof, shall take effect until a copy of the decision
bearing the certification of the Town Clerk that twenty (20) days have elapsed after the decision
has been filed in the office of the Town Clerk and no appeal has been filed or that, if such appeal
has been filed, that it has been dismissed or denied, is recorded in the registry of deeds for the
county and district in which the land is located and indexed in the grantor index tinder the name
of the owner of record or is recorded and noted on the owners certificate of title. The fee for
such recording or registering shall be paid by the owner or applicant.
David S. Reid, Chairman
TOWN OF YARMOUTH
TOWN CLERK
0
CERTIFICATION OF TOWN CLERK
I, George F. Barabe, Town Clerk, Town of Yarmouth, do hereby certify that 20 days
have elapsed since the filing with me of the above Board of Appeals decision #3867 and
that no notice of appeal of said decision has been filed with me, or, if such appeal has
been filed it has been dismissed or denied.
George F. liarabe
Town Clerk
i
TOWN OF YARMOUTH
Page 1 of 2
Brandolini, Jim
From: LaFrance, Rhonda
Sent Thursday, November 06. 200312:03 PM
To: Joe Samosky (Joe Samosky); Sylvia, Terry; BamstablePlannirg; Brandotini, Jim; Carries. Peter,
Cipro, Linda; Currier, Mark; DeFreitas, Peter, deMello, Ride Greene, Karen; Hessilp, Brian; Lawton,
Robert; Raiskio, Peter, Schultz, Beth; Smith, Sarah; Spalrina, Jane
Subject Sheilds
TOWN OF Y OL TH
BOARD OF APPEALS
DECISION
F XD WITH TOWN CLERK: November 6, 2003
PETITION NO. #3867
HEARING DATE: October 23, 2003
PETITIONER: Shields Health Care Group
PROPERTY: ; 2 Iyanough Road, West Yarmouth
Assessors Map: 36, Lot: 99 (30/D2) Zoning District BI
MEMBERS PRESENT AND VOTING: David Reid, Chairman, John Richards, Joseph Samosky,
Diane Moudouris, James Robertson and Forrest White, Alternate
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 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 requests a Special Permit or modification of an existing ROAD Special Permit, in order to
alter and extend the sites existing parking lot The site is located within the B 1 zone. The lot contains
approximately three (3) acres of gross area The site is improved with a medical use building, having
been authorized by a §411 Special Permit (#3602-2000) which is incorporated by reference for purposes
of background of the site).
The current proposal seeks to remove 7 existing parking spaces to the rear of the site, and extend the
parking lot further toward the rear of the lot The new area would contain 14 parking spaces resulting in
a net increase of 7 spaces. The new area would be fully in compliance with the bylaw.
No one appeared in opposition to the proposal. The Board finds that the proposal is an appropriate use
of the site, which would not be inconsistent with the relief previously granted The Board incorporates
by reference its previous findings as to the satisfaction of the bylaw's criteria for this Special Permit and
finds that those findings continue to be warranted.
11/6/2003
TOWN OF YARMOUTH Page 2 of 2
Therefore, a motion was made by Mr. Robertson, seconded by Mr. Richards, to grant the Special Permit,
as requested, for the site modifications shown on the petitioner's plan by Down Cape Engineering, dated
8111/03 with revisions through 8/29/03 (2 sheets), on the condition that the petitioner completes the
plantings shown on the plan (including plantings required by the original permit but not presently on the
site). The members voted unanimously in favor of the motion.
No permit shall issue until 20 days from the filing of this decision with the Town Clerk. Appeals from
this decision shall be made pursuant to MGL c40A section 17 and must be filed within 20 days after
filing of this notice/decision with the Town Clerk. Unless otherwise provided herein, the Special Permit
shall lapse if a substantial use thereof bas not begun within 24 months. (See bylaw §1032.5, MGL e40A
§9) Unless otherwise provided herein, a Variance shall lapse if the rights authorized herein are not
excised within 12 months. (See MGL o40A §10)
David S. Reid, Clerk
11/6/2003
TOWN OF YARMOUTH
BOARD OF APPEALS
DECISION
Y/' iw10i 1TH
T0� IN, C'!-ERK
103 MY -6 Pil 12: 0
FILED WITH TOWN CLERK: November 6, 2003
PETITION NO. #3867 i
HEARING DATE: October 23, 2003
PETITIONER: Shields Health Care Group
PROPERTY: 2 Iyanough Road, West Yarmouth
Assessors Map: 36, Lot: 99 (30/D2) Zoning District: B1
MEMBERS PRESENT AND VOTING: David Reid, Chairman, John Richards, Joseph
Sarnosky, Diane Moudouris, James Robertson and Forrest White, Alternate.
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 atected 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 requests a Special Permit or modification of an existing ROAD Special Permit, in
order to after and extend the sites existing parking lot. The site is located within the Bl zone.
The lot contains approximately three (3) acres of gross area. The site is improved with a medical
use building, having been authorized by a §411 Special Permit (#3602-2000) which is
incorporated by reference for purposes of background of the site).
The current proposal seeks to remove 7 existing parking spaces to the rear of the site, and extend
the parking lot further toward the rear of the lot. The new area would contain 14 parking spaces
resulting in a net increase of 7 spaces. The new area would be fully in compliance with the
bylaw.
No one appeared in opposition to the proposal. The Board finds that the proposal is an
appropriate use of the site, which would not be inconsistent with the relief previously granted.
The Board incorporates by reference its previous findings as to the satisfaction of the bylaw's
criteria for this Special Permit and finds that those findings continue to be wan -anted.
Therefore, a motion was made by Mr. Robertson, seconded by Mr. Richards, to grant the Special
Permit, as requested, for the site modifications shown on the petitioner's plan by Down Cape
Engineering, dated 8/11/03 with revisions through 8/29/03 (2 sheets), on the condition that the
petitioner completes the plantings shown on the plan (including plantings required by the
original permit but not presently on the site). The members voted unanimously in favor of the
motion.
r No permit shall issue until 20 days from the filing of this decision with the Town Clerk. Appeals
from this decision shall be made pursuant to MGL c4OA section 17 and must be filed within 20
days after filing of this noticeldecision with the Town Clerk. Unless otherwise provided herein,
the Special Permit shall lapse if a substantial use thereof has not begun within 24 months. (See
bylaw §103.2.5, MGL c40A §9) Unless otherwise provided herein, a Variance shall lapse if the
rights authorized herein are not excised within 12 months. (See MGL c4OA § 10)
,� )aj --
David S. Reid, Clerk
It
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Occupancy mod Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS Rev. 'M les"W rk
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed be recatdsom sit► do Musechmab flre=w Code (ME" SZ7 01R 1100
(PLEASE PRLVI'IN INK OR TTP ALL LVFOJUMFOA7 Date.. o2 " off / — /02.
City or Tows oft l/nU To the Impemr of Mra:
By this application the uodersi cd gives notice of b or ha intimfion tat
eo electric work desei blow.
Location (Street S Number)/yp
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BUILMIN6 COVERA,61E 125%
/i 1 wcIN
PARKING:
0 GRO55 FEET PER OCCUPANT= 24
REQUIRED PARKINS SPACES = 12
let SPACES PLUS ONE AMBULANCE PROVIDED
ONE HC 5PACE AT 15'.x WIDE BY 20'LON6.
10
0�1 0�1 11
// I n4- vX%
10
12
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JD cb,
a &
W AND SEW
LOAM AND SEED
02"P0,44f,"'.
0 ,•0 sodc�,
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02
LOAM AND SEED
- - - - - - - - - - - — — — — — —
-\NOUr.7H ROAE7
6
EX1511H6 EX5TINO 6A5
ELECTRICAL POLE gyjzj to
AIS TALt, 1:Dotj�" 7)S iq 50-LM. 01-i
pile,
Tk
42 MASS -
L
SITE
IMARKS.....
WN CAPE ENGINEERING
AASHT0=H2O UNLESS NOTED. .
S NOT TO
PROVIDE VEGETATED SWALES IN
'F IS RETAINED.
PAVED.
))QUAIL
:EALED WITHOUT
31ON OBTAINED.
>RIATE VENDORS.
OTORISTS. PEDESTRIANS,
CULVERT d
�%
CALIPER THAT EXIST IN BUFFER ZONES SHALL BE
NOT EXIST, 3' CALIPER TREES SHALL BE PLANTED AT / w
)1.4.4)
,
/
n
r
3b I
r I
' OPEN PAVED`. 4//
AREA OVERGROWN I
W/ TREES/SHRUBS
& GRASS '
BARNSTABLE PCL 16
DO 3919 PG 050
FAY AND HARRY MAH
183 LUKE SHOP DR. ,
WAYLAND, MA /
j
/
/
i
110
,
1 j5 0
�i
AC.t •
PROPOS WORK LIMIT UN •• AREA TO BE LO M AND SEEDED
/ J{A AND SILT PROP. BASIN AND STABILIZED OR TO REMOVAL
' j .! SEE DETAIL SHEET F&G 12.Ot 1 SILT FENCE
I 4 r
r r
, i r
i 12 0� �w
• <hh' i' .� .. , .� , . - L PROPOSED BUFFER TREES
I i :: •'.: ' • • . ;. 20' ON CENTER. 3' CALM
NURSERY STOCK.
j3a(�, ,moo `°Ao?::.,..F{,
rq
va
' �•••• •% •�:'':: �:' lu' ,l/' PROPOSED PARKING LOT EXPA
TIE NEW DRANAGE INTO /':;•:,,•,,•. Sf, APPROX. 4154 SF OF NEW AS
Vr EXISTING SYSTEM WRH �t9 :'':•:'.' �•. /� ..+/ ^ " 1 ELIMINATE 7 SPACES. CREATE
/ p i 6' SCH40PVC AT OX •: • : ..:ONC: ;RETAI Pad
r ' SAWCUT AND REPLACE , ' v • fl ,\ •.r,•. • . to w r'
I EXISTING ASPHALT AS NEW STORMWATER INFILTRATIO
OUIRED. / En; '. , :.. '.k f I I T (7) 4'XB' H-20 FLOW DIFFUS
r r / F,pj Of+:•:'.•::••'r 'I I ALL AROUND. OVERALL DIMEN:
13 IN
I ' /% / isifs S� /, / ' I:' / / / 5' UNSUITABLE SOIL REMOVA
J� /I TO 13 FEET BELOW GRADE I
' COARSE SAND. OVERALL DIMI
I? JS /EXISTING / / �> APPROX. 72' X 20' X 13' C
/ / !; PAVED PARKING/ INSPECT. NOTE HIGH GROUNI
`•-B�ERIN �' .��� ' � '. I � ' („ I �
EXI$'f. AREA TO REMAIN \
•-J ice• �, 9A51N RE -STRIPE AS SIHOWN • ,
FdjG 12.Ot� / I i EXISTING
Ts594 SF
LEACHING FIELD
gCFs
[^-L XIST. I VENT
S/T S RESERVE AREA NOTE
?pA, ` 11 IN EVENT OF LEACHING FIELD FAI UR
f t1 I SHALL BE REMOVED, THE CONTAMINA
/' �' •0• i C S 3t �• THE FIELD REMOVED AND REPLACED
CONC. WALK. �• �., /G• Is LEACHING FIELD RECONSTRUCTED WIT
\ORIGINAL POSITION.
- EXISTING ry�� / j ; / �l'� a ( is^•�
'� •RAVEQ PARKING / o
AREA TO -REMAIN.!
7mrzoIs
SlipGen - Portal Hone
Town of Yarmouth
Template [Building Dept]
tva
Slipsheet Identifier [sg34871]
Document Category Building Permits
Map -Block Number 036.99
Street Number
0002
Street Name
IYANOUGH RD
Department
Building
Parcel ID
5166
Backfile Batch Scan
No
Document?
Additional Naming Info
Index Operator
Operator, Yarmscan
Date - Time
2015-07-27 - 12:38
trp:1nased&e1?1511pGe V 1/1