HomeMy WebLinkAboutBuilding Permits (4)PRIOR ENGINEERING, INC.
PEI200173
Deputy Chief William Green
Fire Prevention Department
96 Old Main Street
So. Yarmouth, MA 02664
Re: Fire Alarm Narrative
Shields MRI
#2 Iyannough Rd. (Rte. 28)
West Yarmouth, MA
Dear Deputy Chief Green:
531 Second Sweet, Everett, NIA 02149
617-381-0294 • Fax 617-381-0272
April 11, 2000
Project No. 20106
Summarized below is a description of the fire alarm system for the referenced building. The building consists
of a first floor level with approximately 5700 sq. ft. to be used as a magnetic resonance imaging office and a
second level attic space for RVAC mechanical equipment only.
In addition, ADA compliant audio/visual alarm devices, pull stations, strobes, smoke and duct detectors with
remote LED test switches will be provided throughout the building as indicated on the drawings. Storage
rooms and mechanical/ electrical spaces will be provided with smoke detectors having remote LEDs.
Activation of the fire alarm system by any manual or automatic device within the space shall cause the
following action:
Transmit the alarm signal to an authorized central station service through dedicated leased telephone
lines from the fire alarm control panel.
2. Simultaneously, the following will occur:
Indicate the stricken zone at the fire alarm control panel and remote annunciator.
Sound a Code 3 temporal pattern evacuation horn signal as well as synchronized pattern of
flashing signals with the strobe lights.
Deputy Chief William Green PEI 200173
Fire Prevention Department
April 11, 2000
Page 2
• Shutdown all air handling equipment for the stricken floor. The equipment may only be
reactivated after the fire alarm system is reset.
The fire alarm system will be tested in accordance with NFPA 72. All devices will be tested to ensure proper
operation. The installing contractor will provide copies of test certificates as required by NFPA 72.
If there are any questions, please contact me at your convenience.
Very truly yours,
APP:ak
Enc.
zc: M. Hartford - MHA
PRIOR ENGINEERING, INC
. +
Formal_ Informal_ Review
SITE PLAN REVIEW COMMENT SHEET
Terry a
Bill Greene
Jim Brandolini
Peter B anton
Bruce Murphy
Dan O ala
Vem Santos
Michael Stusse
Jack Shields
Comments:
Planning: The applicant proposes a Magnetic Resonance Imaging (MRI) facility at this site in the B2 business zone and
the Aquifer Protection Overlay District (APD). The use, code 01 (SIC 8071) is an allowed use in the B2 zone, but requires
a Special Permit in the APD, per Zoning Bylaw section 202.5. The applicant has applied for and recellved a
Detemdnation of Non -Applicability, per section 408.5.1.1 Instead of a Special Pemdt for the use In the APD. A complete
upgrade of the site is required per section 3012. Parking appears to be adequate with 18 spaces shown on the plan.
Underground utilities are required, per section 301.4.10. Parking lot lighting must be under 35 it. in height. As outlined in
secton 301 AA, the Site Plan Review Team has unanimously voted to allow the existing fences to remain in the property
buffers.
Any future sign must meet the design and display criteria of section 303. Meet with the Sign Inspector to review sign
designs. A street number must be mounted on the building per Town Code and Massachusetts General Law.
Building: 1. Constrution shall be placed under Consirction Control, pursuant to Chapter 1 of 780CMR
2. Compliance with site lighting and underground utilities shad be shown on the proposed site plan.
Conservation Commission: A Request for Determination application will be required.
Fire Dept.: Recernnends fire alarm and sprinkler system, stretcher access to rooms, emergency shut down plan to be
submitted to the Fire Dept., and extinguishers, as required by code.
Board of Hearth: Review detail notes: factory rubber boots for septic tank and pump chamber Inverts. Both tanks to be
water proofed at factory, elec pernent needed, cap end on each leach One, 2'pressure pipe. septic design based on one
floor, upstairs for storage or uOOtes onl"o office use, for reserve septic- note primary area to be reused, add eng
Inspection sch, to include overdig soil removal prior to badddgng. Insp of tanks rubber boots, pump chamber float levels,
entire system; add 8 mil liner to Inside of retaining wag; revise plan date
Water Dept.: Water service Is now new plastic and would have to be sleeved though the new area. Sleeve must be 4
Inch schedule 40 P.V.C. from stop to building. Fxdsting crab stop may be used. Water Dept would do work at owners
expense. New area meaning paved area or planted area.
Engineering: Please provided and engineer's stamped letter staling that existing drainage system Is adequate in size and
condition to aecomodated the proposed stormwater flow. Also state in the letter that proposed flow will be contained within
the pavement area and wig not flow Into the adjacent wetland.
Economic Development: The proposed project would add 8 fug time positions to the local economy. it would also be a
substantial Improvement to the general area.
Building Dept. 1. Construction shag be placed under Construction Control, pursuant to 780CMR, Chapter 1. 2.
Compliance with site lighting and underground utilities shall be shown on the proposed site plan. 3. Final construction
plans shall reflect all applicable MR] related systems.
l
l /,Y A _/ Reviewers:
S7.33 • '
BUILDING PERMIT APPLICATION SIGN OFF
APPLICANT: LV.//. $ouc/f/Z2r 1-iL BUILDING PERMIT #:
ADDRESS: :V- �� �y/y a Fey JPT.Lierh!iTELE. NO.:L/7-A9y-V5-0/ DATE FILED:
BLDG. SITE LOCATION: MAP#: P/9G L30� LOT#: 94' CDX-�
THE FOLLOWING INFORMATION OUTLINES THE PROCEDURAL STEPS REQUIRED TO OBTAIN A PERMIT TO BUILD,
ALTER, OR ADD TO A STRUCTURE WITHIN THE TOWN OF YARMOUTH. THE BUILDING DEPARTMENT WILL DETER-
MINE COMPLIANCE TO THE FOLLOWING (A) ZONING REQUIREMENTS (B) HISTORICAL DISTRICTS (C) FLOOD
PLAINS ZONING. THE BUILDING DEPARTMENT WILL BE RESPONSIBLE FOR ASSISTING THE APPLICANT THOUGH
THE FOLLOWING DEPARTMENTS:
RESIDENTIAL AND/OR COMMERCIAL BUILDING
WATER DEPARTMENT: DETERMINES COMPLIANCE OF WATER AVAILABILITY. _
ENGINEERING DEPARTMENT: DETERMINES COMPLIANCE FOR PARKING AND DRAINAGE.
CONSERVATION COMMISSION: DETERMINES COMPLIANCE TO WETLANDS ACTS, I.E.: IF LOT(S) BORDER ANY
TYPE OF WETLANDS, STREAMS, PONDS, RIVERS, OCEANS, BOGS, BAYS, MARSH
LAND, ETC.
HEALTH DEPARTMENT: DETERMINES COMPLIANCE TO STATE AND TOWN REGULATIONS, I.E.: REQUIRE-
MENTS FOR SEPTAGE DISPOSAL AND OTHER PUBLIC HEALTH ACTIVITIES.
FIRE DEPARTMENT: DETERMINES COMPLIANCE TO STATE AND TOWN REQUIRMMS FOR PERSONAL
SAFETY, PROPERTY PROTECTION, I.E., SNOKE DETECTORS, SPRINKLER SYSTEMS,
ETC.
THE FOLLOWING DEPARMUMTS MUST SIGN OFF, IN THE RESPECTIVE ORDER, PRIOR TO BUILDING INSPECTOR
ISSUING THE REQUIRED BUILDING PERMIT:
BY:
. WATER DEPARTMENT DATE: S /I) /G5c N/A:
2. GINEERING DEP DATE: N/A:
�T SERVATION: DATE: - Q p N/A:
co
DEP 1 DATE: N/A:
��WIRING
(� INCG
. FIRE DEB
ALL STUMPS AND/OR BRUSH MUST BE
DISPOSAL SITE MUST BE SUBMITTED
PERMIT.
I
I
I
I
I
II
I
I
BLM 89 .
DATE:
b N/A:
PLEASE NOTE
DISPOSED OF AT AN APPROVED SITE. A SIGNED RECEIPT FROM THE
TO THE BUILDING DEPARTMENT PRIOR TO ISSUANCE OF THE BUILDING
n
FILED WITH TOWN CLERK:
TOWN OF YARMOUTH
BOARD OF APPEALS
DECISION
May 10, 2000
PETITION NO: #3602
HEARING DATE: April 27, 2000 'L
PETITIONER: Shields Health Care Group
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 bearing 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 bearing by its attorney, Michael 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-
blectives and Mandatory Criteria Satisfi
Shields Heahh 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 Genial Criteria for approval as set forth in Section 4111.5, the Board finds
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 103.3.1 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 budding.
(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 Obiections of Section 411 are met. The purpose of the ROAD District is to induce
rehabilitation of existing buildings by, in some cases, relaxing dimensional requirements in return
for site and architectural review that promotes attractive structures and grounds and minimizes
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-
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 reuse 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 reuse a vacant building and enhance the visual presence of the property.
The Purposes of the Underlying Zoning Are Accomplished: By allowing the project the
Board of Appeals will meet the objectives of the By -Law 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 will serve as a buffer for the building.
The Protect Benefits the Neighborhood: By
derelict property, the development will enhance
impacts from the requested variation.
improving and beautifying what has become a
the neighborhood and there will be no adverse
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-
Special Permit as requested and as represented, in order to allow the Petitioner permission to
install a Magnetic Resonance Imaging Ewil ty, as set forth in the petitioner's Site Plan (dated
3/6/00, revised 411 V00) 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 is13rawed.
No permit shall issue until 20 days from the Sling of this decision with the Town Clerk. Appeals
from this decision shall be made pursuant to MGL c40A §17 and must be Sled within 20 days
after the fling of this notice/decision with the Town Ckrk.
David S. Reid, Clerk
WE
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OS-30_-2000 ._. C•' . 12 = SS
THE COMMONWEALTH OF MASSACHUSETTS
si ` T OF si
BOARD OF APPEALS a drN
U
N N
Appeal #3602 Date: May 30, 2000
Certificate of Granting of a Special Permit
(General Laws Chapter 40A, Section 11)
6 • •.1 1 1 11� I I 1 • I I Inn, 1 II I+1 - • Yti III�w 1. ,
•M 111 I.I 1- I'1 .41-•
To: Shields Health Care Group
Address: 265 Westgate Drive
City or Town: Brockton. MA 02402
affecting the rights of the owner with respect to land or buildings at: 2 Iyanoagh Road, West
Yarmouth, MA. Assessor's Map: 36 Parcel: 9921 (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 fled with the Planning Board and the Town Clerk
The Board ofAppeals also calls to the attention ofthe 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 under the name of the owner of record or
is recorded and noted on the owner's certificate of title. The fee for such recording or registering
shall be paid by the owner or applicant.
David Reid, Chairman
CERTIFICATE-S.P.#3602WPD.wpd
TOWN OF YARMOUTH
BOARD OF APPEALS
DECISION
FILED WITH TOWN CLERK: May 10, 2000 t
..'l' 1J
PETITION NO: #3602
HEARING DATE: April27, 2000
PETITIONER: Shields Health Care Group
PROPERTY: 2 Iyanough Road, West Yarmouth
Map: 36, Parcel: 99 (30/D2) Zoning District: Ill.
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, Michael B. Stusse.
Required Relief
In order to construct the MIRI 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.
-1-
biectives 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 411.33 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 finds
that the applicant is in compliance therewith as follows:
Site Plan Review: The site plan review objectives of Section 1033.1 have been met. The
applicant has met with Site Plan Review on three occasions and has developed a satisfactory site
plan.
TheBoard 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
rehabilitation of existing buildings by, in some cases, relaxing dimensional requirements in return
for site and architectural review that promotes attractive structures and grounds and minimizes
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-
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 Stvk: 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 distric L
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 vaunt 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 Pumoses 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 reuse a vacant budding and enhance the visual presence of the property.
The Purposes of the Underlvine Zoning Are Accomplished: By allowing the project the
Board of Appeals will meet the objectives of the By -Law 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 will 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 Foci 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
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H
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 Cleric. Appeals
from this decision shall be made pursuant to MGL c40A § 17 and must be fled within 20 days
after the fling of this motice/decision with the Town Clerk.
-4-
,. TOWN OF YARMOUTH
BOARD OF APPEALS
••*:,: APPLICATION FOR HEARING = =
Appeal #: 3 (o O J. Hearing Date: 41 a1( 00 Fees(o% oo _
Applicant: Shields Health Care Group —
265 Westgate Drive, BroT(EFullNAM-ACIBJJ%�b/a)
g txton, c/o Atty. 508-775-3433
(Address) (zip) (Telephone Number)
and is the (check one) ❑ Owner ❑ Tenant ,M Prospective Buyer ❑ Other Interested Patty
Property: This appplication relates to the property located at: 2 Iyanough Road, West
Yarmouth, MA 02673 which is also shown on the new Assessor's Map: 3
as Parcel: 99(old Map & Lot 9) .391Z 30/pa Zoning District: B-1
Project: The applicant seeks permission to undertake the following construction/use/activity :(give a brief
description of the project. i.e.: "add a 10' by 15' deck to the front of our house" or "clipga the use of the existing
building on the property"):The applicant proposes to remodel the existing building to
allow its use as a magnetic resonance imaging facility (MRI) w ereas a bui dj
will exceed the side yard setback areas and the driveway is no ee rom
adjoining or oppose a ariveways.
RELIEF REQUESTED: The applicant seeks the following relief from the Board of Appeals:
1)_REVERSE THE DECISION OF THE BUILDING INSPECTOR OR THE ZONING
ADMINISTRATOR dated (attach a copy of the decision appealed from). State the reason for
reversal and the ruling which you request the Board to make.
4 It A,—q (o Y-":5. 2 %�
2) x SPECIAL PERMIT under § 4 11.""r of the Yarmouth Zoning By-law and/or for a use
authorized upon Special Permit in the "Use Regulation Schedule" §202.5
')_VARIANCE from the Yarmouth Zoning By-law. Specify all sections of the by-law from which relief is
requested, and, as to each section. specify the relief sought:
Section:
Relief sought:
Section:
Relief sought:
Section:
Relief sought:
Additional comments: The applicant's plans have been approved for the use in the APD
district and have received approval from the Yarmouth Conservation Commission.
FACT SHEET
This sheet must be completed and filed at the time of application.
Owner of Property (if other than applicant) William Ho �Boucher & B & B Company
a Pennsylvania Pattnership, P. O. BoxWdndenhall, PA, c/o Atty Robert Pen-
( Address) (Telephone Number) 0
How long has the owner had title to the above premises: 7 years, Book 84301 Page 167
(Give title reference if available)
Use Classification: Existing: Retail §202 5 # H-11
Proposed: §202.5 # —
Is the property vacant: yes
How long has it been vacant: 3 years, approximately
Lot Information (if available) Area: 3 acres
Subdivision/Plan Reference:n/a /
Is this property within the Aquifer Protection Overlay District: Yes x No
Other Department(s) Reviewing Project: Indicate the other Town Departments which are/ have/ or will review
this project, and indicate the status of their review process:Conservation Commission, Site Plan
Review Committee, Planning Board, Route 28 Tasz
Repetitive Petition: Is this a re -application If yes, do you have Planning Board Approval:
Prior Relief. If the property in question has been the subject of prior application to the Board of Appeals or Zoning
Administrator, indicate the Appeal number(s) and other available information:
ADDITIONAL INFORMATION: Please use the space below to provide any additional information which you
feel should be included in your application:
Michael sB rgStu setorneyAddress
25 Mid -Tech Drive
West Yarmouth, MA 02673
ding Inspector's Si®-
Signature
. Site Plan Review
Required Completed
� Yes 13 No ❑ Yes ❑ No
Atty.
SITE PLAN REVIEW COMMENT SHEET
James Brandolini
Terry Sylvia
Bob Savage
Vern Santos
Corev Kittila
Brad Hail
Dennis Broom
Michael Stusse
Jack Shields
Comments:
Planning: The applicant proposes a Magnetic Resonance Imaging (MRU facility at this site in the B2 business zone and
the Aquifer Protection Overlay District (APD). The use, code 01 (SIC 8071) is an allowed use in the B2 zone, but requires
a Special Permit in the APD. The applicant may apply for a Determination of Non -Applicability, per section 406.5.1.1
Instead of a Special Permit for the use in the APD. A Variance will be required under section 203.5 for less than the
required side setback;10 ft. is shown on the plan where 25 ft Is required. A complete upgrade of the site is required per
section 3012. A note regarding buffer trees (301.4.4) should be noted on the plan. Parking space #1 is in front of the
building and should be reiocated/elminated or relief sought from section 301.4.1. Relief must also be sought from 301.4.7
for less than the required 250 ft. separation of driveways. Parking appears to be adequate (with space #1 removed), as
shown for the proposed facility. Underground utilities are required, per section 301.4.10. Parking lot lighting must be uner
35 ft. in height
Any future sign must meet the design and display criteria of section 303. Meet with the Sign Inspector to review sign
designs. A street number must be mounted on the building per Town Code and Massachusetts General Law.
The applicant plans a ROAD application to the Planning Board, per Bylaw section 411.
Building: 1. Constrution shall be placed under Constrction Control, pursuant to Chapter 1 of 780CMR
2. Compliance with site lighting and underground utilities shall be shown on the proposed site plan
Conservation Commission will require a Request for Determination application.
Fire Dept. 1. Recommend supervised alarm system for the unheated attic 2. Recommend supression sytem suitable to
use. 3. Portable fire extinuishers required.
Board of Health: New septic syetem will be installed in accordance with title 5 regulations. Septic plans must be
submitted to health agent for review. No hazardous chemicals are proposed on site. Future use of chemicals will require
approval from Health Department.
Design Review: proposed architecture is a substantial improvement at this gateway location. Underground utility
proposal is a definite plus. Route 28 Task Force wiftupport this ROAD proposal
Water Dept 1. New water serice shall be shown on plan detailing sleeve through slab and parking lot
2. Old service shall cut and capped by Water Dept at owner's expense.
n
,-rrrm
Building Div.
Conservation Div.
Health Div.
Planning Div.
EngineerinO Div.
Water Div.
Fire Dept.Desi
n Review
Police Dept.
Economic Development
L3
TOWN OF YARMOUTH BUHMING DEPARTMENT
APPLICATION FOR DETERMINATION OF NON -APPLICABILITY
AQUIFEW 406.5.1.1
MAN 2 0 Y000
TOWN OF YARMOUTH
Applicant: Shields Health Care Date Filed: 01"VPOFeoeS
Property location: 2 Iyanough Road,West YaamuthMap# 30 Parcel# 2
Proposed Use: MI Facility (Magnetic Resonance Imacim)
iifrtiitttittrt••itit•tttrtrtkktktttrtrttt#trttttrtitttrtktttrtrtkttrtittirtitttittrtiirtiftt
1. The applicant has fiilly complied with the Submittal Requirements of §406.5.2 N/A
(Attach copy of Hazardous Materials List)
2. The proposed use meets all of the Design and Operation requirements of §406.5.7, N/A
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 hereby acknowledges that the Building Inspector may require the applicant to submit the
matter to the Health Agent or Board of Health, and may require the applicant to demonstrate that he/she has
received a favorable report from the Health Agent or Board of Health. The Determination, if made, shall apply
only to the individual applicant and proposed use and shall automatically expire upon any change of use or
transfer of ownership of the business. There shall be no appeal from an unfavorable De&pination of any such
application nor from a failure to act except for filing by the applicant for a Special Perm from the Board of "
Appeals as otherwise provided herein. Shields Health Careb3
Appliea'nt / Date
Michael B. Stusse, Esquire
DETERMINATION: The Building Inspector, based upon a review of this application and information supplied
by the Applicant, hereby determines that the proposed use satisfies the requirements of §406.5.1.1 and that the
Applicant need not apply for a Special Permit under §406.5
Ci r , / 3 0 -j ► j 00
iding Inspector Date ricalth Agent Efate
IYU
Copies of this form must be sent to the following departments (as listed in §4065.4); Water, Engineering,
Fire, Health, Planning, Conservation, Board of Appeals.
AP Ddetemonapp 10-99.wpd
TOWN OF Y A R M O U T H PLµA�NNI{Nq�G
1146 ROUTE 28 SOUTH YARhfOUTlt AfASSACHL'SETTS 07 E C "Z iVSkLY .
Tctcphone 398-2231
APR 3 2000
TOWN OF p APPEATH
LS
FORM R-I BOARD O
PLANNING BOARD
TOWN OF YARMOUTH, MASSACHUSETTS
CERTIFICATE OF APPROVAL OF A R.O.A.D. PLAN
March 29, 2000
Town Clerk
Town of Yarmouth, Massachusetts
RE: Planning Board R.O.A.D. Reference No. 200011, Shields Health Care.
It is hereby certified by the Planning Board of the Town of Yarmouth, Massachusetts,
that at a duly called and properly posted and advertised Public Meeting of said
Planning Board, held on March 29, 2000, it was voted, by the requisite majority, to
approve a R.O.A.D. application and plans submitted by Shields Health Care Group,
of 265 Westgate Drive, Brockton, MA The plans are entitled: A-1, Front Elevation;
A-2, Proposed Floor Plan; A-3, Side Elevation; A-4, Side Elevation; A-5, Side
Elevation; C-1, Existing Site Plan; D-1, First Floor Demolition Plan, and; Site,
Proposed Site Plan The plans and the application were originally filed with your
office on February 17, 2000.
The applicant seeks relief from the Yarmouth Zoning Bylaw for.
1. A reduction in the side setback requirement of Zoning Bylaw 203.5. The
proposed building addition is to be 10 feet from the Eastern side setback where
25 feet is required by the Bylaw.
The Planning Board granted its approval upon the conditions that:
1. The building is to be clad entirely in red cedar clapboard siding, with the rough
side exposed, and painted or stained white or gray or with color shades that are
pre -approved by the Yarmouth Old King's Highway Regional Historic District
Commission;
2. The roof is to be Gad entirely in white cedar shingles and remain natural in color,
3. Window shutters are to be installed on all windows and that the shutters be
painted green;
4. Building trim is to be painted white;
Form R-1, Ref. 2000/1, Page 2
5. Outdoor lighting is to be limited to a maximum of 20 feet in height. Outdoor
illumination is to be minimized so as to be restricted to the site;
6. The roof pitch be constructed with an 8 inch rise in a 12 inch run, as shown on
the plans;
7. Windows to have sashes with a divided light (individual pane) configuration of 8 .
panes over 8 panes, and;
8. Outdoor signage to be of wood construction with wooden support post(s), with
carved lettering, and painted in colors complementary with those of the structure.
The applicant must present a plan of any sign for final Planning Board approval.
NOTE TO THE APPLICANT: Approval by the Planning Board does not grant zoning
relief. Application must be made to the Board of Appeals.
NOTE TO PLANNING BOARD: Conditions must be written on the plan and
endorsed, per Zoning Bylaw section 411.6.
NOTE TO THE BOARD OF APPEALS: Planning Board approval is a
recommendation to the Board of Appeals that the above referenced zoning relief be
granted in the form of a Special Permit, as outlined in Zoning Bylaw section 411.3.2.
Mandatory criteria of Board of Appeals approval are outlined in Bylaw section 411.5,
paragraph 2.
Yarmouth Planning Board
Duplicate copy sent to applicant
Duplicate entered into project file
Duplicate sent to Board of Appeals
March 29, 2000
Yarmouth Zoning Board of Appeals
Yarmouth Town Offices
1146 Route 28
South Yarmouth, Ma. 02664
Rc: Appeal Number. 3602
Good People:
CHRISTY'S OF CAPE COD, LLC
105 PLEASANT STREET
HYANNIS, MA. 02601
Telephone: 508-771-0900
APR 2 z 2000 r j
TOINN OF YARMOUTH
BOARD OF APPEALS
As the operator of the business known as Christy's Market. located at the intersection of I}anough Road and East
Main Street in West Yarmouth. I would like to be recorded in favor of the application of Shields Health Care for a
Special Permit.
The property, which is the site of the proposed MRI facility, has been vacant for several years. The proposed use is
one that is needed by the people of Cape Cod and the Islands and is properly situated nearby to other medical
facilities.
The site plan and building elevation indicates that the property will be made attractive and pleasing in all respects.
By granting a Special Permit the Board of Appeals will demonstrate its willingness to work with business and
property owners to enhance the appearance of Route 28.
Further, I have personally known the Shields family for over two decades. Their commitment to the people and the
communities they serve is of great admiration to me. As a Town resident. I know their presence here will enhance
the future of Yarmouth.
With the hope that you act favorably upon this request. I am.
Respectful) yo
Christy P. M'
President
CPM/jam
Formal_ Informal_ Review
SITE PLAN REVIEW COMMENT SHEET
Terry
Bill Greene
Jim Bmndolini
Peter Bryanton
Bruce Murphy
Dan O ala
Vem Santos
Michael Stusse
Jack Shields
Comments:
Planning: The applicant proposes a Magnetic Resonance Imaging (MRI) facility at this site in the B2 business zone and
the Aquifer Protection Overlay District (APD). The use, code 01 (SIC 8071) Is an allowed use In the B2 zone, but requires
a Special Pert in the APD, per Zoning Bylaw section 202.5. The applicant has applied for and rece0ved a
Determination of Non -Applicability, per section 406.5.1.1 Instead of a Special Permit for the use in the APD. A complete
upgrade of the site is required per section 3012. Parking appears to be adequate with 18 spaces shown on the plan.
Underground utilities are required, per section 301.4.10. Parking lot lighting must be under 35 ft. in height. As outlined in
secton 301.4.4, the Site Plan Review Team has unanimously voted to allow the existing fences to remain in the property
buffers.
Any future sign must meet the design and display criteria of section 303. Meet with the Sign Inspector to review sign
designs. A street number must be mounted on the building per Town Code and Massachusetts General Law.
Building: 1. Consbution shall be placed under Constrclion Control, pursuant to Chapter 1 of 780CMR
2. Compliance with site fighting and underground utilities shall be shown on the proposed site plan.
Conservation Commission: A Request for DeterNnation application will be required.
Fire Dept.: Recommends fire alarm and sprinkler system, stretcher access to rooms, emergency shut down plan to be
submitted to the Fire Dept, and extinguishers, as required by code.
Board of Heath: Review detail notes: factory rubber boots for septic tank and pump chamber inverts. Both tanks to be
water proofed at factory, elec pemxent needed, cap end on each leach One, 20pressure pipe. septic design based on one
floor, upstairs for storage or uUHtes only -no office use, for reserve septio• note primary area to be reused, add eng
Inspection sch, to include overdig soft removal prior to backlIHI g, Insp of tanks rubber boots, pump chamber float levels,
entire system; add 8 ml Brier to Inside of retaining wail; revise plan date
Water Dept: Water service is now new plastic and would have to be sleeved though the new area. Sleeve must be 4
Inch schedule 40 P.V.C. from stop to building. Existing tab stop may be used. Water Dept would do work at owners
expense. New area meaning paved area or planted area.
Engineering: Please provided and engineeft stamped letter stating that existing drainage system is adequate In size and
condition to accomodated the proposed stormwater flow. Also state In the letter that proposed flow will be contained within
the pavement area arid wit not flow Into the adjacent wetland.
Economic Development The proposed project would add 8 fur time positions to the local economy. It would also be a
substantial Irnprovement to the general area.
Building Dept 1. Construction shall be placed under Construction Control, pursuant to 780CW Chapter 1ja-
Compliance with site fighting and underground utdi ies shall be shown on the proposed site plan. 3. Final construction
plans shall reflect at applicable MRI related systems.
DJ_/,Reviewers:
/��SW�'� it/�
.. .:�[71��•7T..:
: I rL,. /���1��!
Se, _ �-
MF.,
MEMO
U
SITE PLAN REVIEW COMMENT SHEET
James Brandolini
Terry Svtvia
Bob Savage
Vern Santos
Corey Kittila
Brad Hall
Dennis Broom
Michael Stusse
Jack Shields
Comments:
Planning: The applicant proposes a Magnetic Resonance Imaging (MR0 facility at this site In the B2 business zone and
the Aquifer Protection Overlay District (APD). The use, code 01 (SIC 8071) is an allowed use in the B2 zone, but requires
a Special Permit in the APD. The applicant may apply for a Determination of Non -Applicability, per section 406.5.1.1
Instead of a Special Permit for the use in the APD. A Variance will be required under section 203.5 for less than the
required side setback;10 ft. is shown on the plan where 25 ft. Is required. A complete upgrade of the site is required per
section 3012. A note regarding buffer trees (301.4.4) should be noted on the plan. Parking space #1 Is in front of the
building and should be relocatedlefiminated or relief sought from section 301.4.1. Relief must also be sought from 301.4.7
for less than the required 250 ft separation of driveways. Parking appears to be adequate (with space #1 removed), as
shown for the proposed facility. Underground utilities are required, per section 301.4.10. Parking lot righting must be uner
35 R in height.
Any future sign must meet the design and display criteria of section 303—Meet with the Sign Inspector to review sign
designs. A street number must be mounted on the building per Town Code and Massachusetts General Law.
The appliicant plans a R.OA.D application to the Planning Board, per Bylaw section 411.
Building: 1. Constrution shall be placed under Consirction Control, pursuant to Chapter 1 of 780CMR
2. Compriance with site lighting and underground utilities shall be shown on the proposed site plan
Conservation Commission will require a Request for Determination application.
Fire Dept. 1. Recommend supervised alarm system for the unheated attic 2. Recommend supression sytem suitable to
use. 3. Portable fire extinuishers required.
Board of Health: New septic syetem will be installed in accordance with tide 5 regulations. Septic plans must be
submitted to health agent for review. No hazardous chemicals are proposed on site. Future use of chemicals will require
approval from Health Department.
Design Review: proposed architecture Is a substantial improvement at this gateway location. Underground utility
proposal is a definite plus. Route 28 Task Force wiInsupport this ROAD proposal
Water Dept. 1. New water serice shall be shown on plan detailing sleeve through slab and parting lot
2. Old service shall cut and capped by Water Dept at owner's expense.
n
Reviewers:
Building Div.
Conservation Div.
Health Div.
Planning Div.
-Engineerir4 Div.
Water Div.
Fire Dept.
Design Review .,
Police Dept.
Economic Development if
ft
SITE PLAN REVIEW COMMENT SHEET
Formal ✓ Informal_ Review
Terry a '
Peter Ralskio
Jim Brandolini
Peter Bryanton
Bruce Mu v
Shawn Macinnes
Vern Santos
Michael Stusse7jkl
Dan Ojai
Comm€nts:
Planning: The applicant proposes a Magnetic Resonance Imaging (MRI) facility at this site In the 82 business zone and
the Aquifer Protection Overlay District (APO). The use, code 01(SIC 8071) is an allowed use in the B2 zone, but requires
a Special Permit In the APD, per Zoning Bylaw section 202-5. The applicant has applied for and receiived a
Determination of Non -Applicability, per section 406.5.1.1 Instead of a Special Permit for the use in the APD. A Variance
will be required under section 203.5 for less than the required side setback; 10 ft. is shown on the plan where 25 ft. is
required. A complete upgrade of the site is required per section 301.2. A variance under 301.4.4 and 301.4.9 for
pavement, a concrete retaining wall, and fencing within the buffers. A note regarding buffer Ines (301.4.4) should be
shown on the plan. Parklmnpp appears to be adequate with 18 spaces shown on the plan. Underground uBtlties are
required, per section 301.4.1.0. Parking lot lighting must be uner 35 R In height
Any future sign must meet the design and display rrfieria of section 303. Meet with the Sign Inspector to review sign
designs. A street number must be mounted on the building per Town Code and Massachusetts General Law.
The applicant plans a R.OA D application to the Planning Board, per Bylaw section 411.
Building: 1. ConstnNon shall be placed under ConstrWon Control, pursuant to Chapter 1 of 780CMR
2 Compliance with site lighting and underground utilities shall be shown on the proposed site plan.
Conservation Commission: A Request for Determination application will be required.
Fire Dept.: Recommends fire alarm and sprinkler system, stretcher access to rooms, emergency shut down plan to be
submitted to the Fire DepL, and extinguishers, as required by code.
Board of Heakk add detail notes: factory rubber boots for septic tank and pump chamber Inverts. Both tanks to be water
proofed at factory, elec perfnent needed, cap end on each leach line, rpressure pipe, septic design based on one floor,
upstairs for storage or Willies only -no office use, for reserve septic• note primary area to be reused, add eng Inspection
sch, to Include overdig sob removal prior to baddtiling, Insp of tanks rubber toots, pump chamber float levels, entire
system; add 8 mil Iner to inside of retaining wall; revise plan date
Water Dept.: Water service is now new plastic and would have to be sleeved though the new area. Sleeve must be 4
Inch schedule 40 P.V.C. from stop to building. Existing curb stop may be used. Water Dept would do work at owners
expense. New area meaning paved area or planted aerea.
Engineering: Please provided and engineers stamped letter stating that t dsting drainage system Is adequate in size and
condition to accomodated the proposed stormwater flow. Also state in the letter that proposed low will be contained within
the pavement area and will not flow Into the adjacent wetland.
Economic Development: The proposed project would add 8 full time positions to the local economy. it would also be a
substantial Improvement to the general area.
Building Dept. 1. Corudnrdion shall be placed under Construction Control, pursuant to 780CMK Chapter 1. 2.
Compliance with site lighting and underground utilities shall be shown on the proposed site plan. 3. Final construction
plans shag Felled all applicable MR] related systems.
Reviewers:
IJ�
TABLE 2
APPLICATION FOR SITE PLAN REVIEW
SUBMISSION DATE: 312?1cn REVIEW DATE: d%y TIME: ;t: 3a
ASSESSOR'S MAP REF. NO. -5&Aci LOT NO. oLD M1W 30/D L
LOCATION OF PROJECT: tt- 2. 1YANNoucyrt:6 rxrl-, R328 we. yRM^au7H,nW
NAME OF PROJECT: 51-4\ aL�S /ATz\
APPLICANT NAME: SHtr_t_a5 lic-.sic-T•) L^n a 6TLo%,p
APPLICANT ADDRESS/PHONE NO: 2-c5 wC -rv^rrLvlt.. 3z.oc.r70N0n?A
OWNER NAME (If not applicant): ;3 cvv+CTL'•rL. FoosE HVWA*tV.sriep Trz.
OWNER ADDRESSIPHONE NO.: 'pc ZOA 5T oms.Ls.4,JS, �1
ENGINEER/SURVEYOR: bew N c.4 6aa�a�Rwc,
TITLE REFERENCE: $ Li'tn/le-7 REGISTRY SURVEY: hr3 .Lw'5
CHECK IF A R.OAD. PROJECT
DESCRIPTION OF PROJECT (Attach additional pages, if necessary):
jL6N0Vh-T'E- . m� C cLST>N G- '3L71t_'7lr�Cr I o¢- .1-
oFFt c.E , 'ill tS T�L_ 4nm t S jy-1jr`-V\Stor.1 '70
OtuG WAL- A?PLuhTDp
VJ'P• \-AfJLC /'ij Crc..\At_ -PE72.nTT5 .
A T-ty. M\V-C' STVC,5E i
ZONING DISTRICT: '$ ( APD? &N) FLOOD ZONE: 3
BUILDING SIZE (Square feet): 21WW ' -7W)
BASEMENT. 0 FIRST FLOOR: 10 4-7-n SECOND FLOOR: 9rIin3 07rFLF--
MAXIMUM NUMBER OF EMPLOYEES: i„ro F-a" Amy ST.Ksc
TOTAL NUMBER OF RESTAURANT SEATS: 9
IS THE PROJECT WITHIN 100 FEET OF A WETLAND?	N)
DO YOU USE, HANDLE, STORE, OR PRODUCE HAZARDOUS MATERIALS OR
OILS? (YIN) If yes, attach list, by name and quantity. Attach MSDS sheets.
Provide a description of proposed method of storage, handling, and disposal. Include
a description of emergency spill & containment procedures. -<-, j tad, . -1Arx,y,,)ccT.
SIGNED: -:�> -A �� "�l�N1EL_ .�. oytLA
�Owr� th'�E rtNGaN EEdL�Nrr
Submit 8 copies of this completed form, any hazardous material information mentioned
above, Boor plans, and a site plan, containing all of the information outlined in Zoning
Bylaw section 103.3.3, to the Building Division in order to get your project on the Site
Plan Review agenda. Building elevations and architectural drawings are required for
new or substantially reconstructed buildings in B 1 and B2 commercial districts south of
Route 6. A 9"' copy of the site plan will be required if the project is within 100 feet of a
wetland.
racy le,19M
TABLE 2
APPLICATION FOR SITE PLAN REVIEW
SUBMISSION DATE: 3-6-M REVIEW DATE: :7A(1 � TIME:
ASSESSOR'S MAP REF. NO. 99 LOT NO. oL.UMAT /D-z
LOCATION OF PROJECT: %YANNOZ*I+ iz3
NAME OF PROJECT: 51+1*l aS . M'¢•\ ye H • MARTrors'V%A0DC
APPLICANT NAME: Heh4--N &Ar- Z brco.rp t•�t�•�t•'�5o�
APPLICANT ADDRESS/PHONENO.: �.LS L�G.lTc��. >oc7wt,JLM oz,-w
OWNER NAME (If not applicant): WLl.L%APA i3OUC.H EfL -rP-- 6001be 1+WA^ nocK S+Lor-p .
OWNER ADDRESSIPHONE NO.: po 8ox 5't
ENGINEER/SURVEYOR: �owr+ c,^-r& 6N4LrLEEruv36-
TITLE REFERENCE: -P3843o/167 REGISTRY SURVEY: A4 P- &cr's
® CHECK IF A R.OAD. PROJECT
DESCRIPTION OF PROJECT (Attach additional pages, if necessary):
TLGNO V A-7r- i 5A % 5T N ` I V IL.D tN fr t-o ti- MR\ OR LG-
jL6F- eLAO S op Pit-6 'by NAfrrFo%D 8 h65mX- fi �ti�l YS.
'ft}LS PLAT► 6Maw5 SErTr�L sYSTFr� 9:'7X. FoR- PIL.EVtousW
$ V3M cTreZ> -DErS16N .
Alf AMY-4S Sl1265F R-�Pr�ESC�N7W6 G�LENT.
ZONING DISTRICT: 7.7\ APD? t9N) FLOOD ZONE:
BUILDING SIZE (Square feet): noo+/—
BASEMENT: O FIRST FLOOR: 5-7oo SECOND FLOOR: D NAZivo L-C-
MAXIMUM NUMBER OF EMPLOYEES: A*r +n4v• ALLZ ohly,
TOTAL NUMBER OF RESTAURANT SEATS: p
IS THE PROJECT WITHIN 100 FEET OF A WETLAND?AN)
DO YOU USE, HANDLE, STORE, OR PRODUCE HAZARDOUS MATERIALS OR
OILS? (YIN) 1f yes, attach fst; by name and quantity. Attach MSDS sheets.
Provide a description of proposed method of storage, handling, and disposal. Include
a description of emergency spi71 & containment procedures. e� q�,, 4 Ae ,,; k,-T not
6 vre .
SIGNED: �''� ` Z-• TL-5
-AO W N CJ4P:c 6Nf.�N�L�Hbr
Submit 8 copies of this completed form, any hazardous material intbrmation men6:)ned
above, floor plans, and a site plan, containing all of the Information outlined in Zoning
Bylaw section 103.3.Z to the Bui7ding Division in order to get your project on the Site
Plan Review agenda. Buflding elevations and architectural drawings are required for
new orsubstially reconstructed but7dings in Bf and B2 commercial districts south of
Route 6. A' 9")copy of Me site plan will be required if the project is within 100 feet of a
wetland. ", /
"Le, IM9
SITE PLAN REVIEW AGENDA
�. 1:30
TUESDAY,: ••3/14)2000 STARTING AT IdnP.M., FOR THE FOLLOWING:
1. SHIELDS MRI LOT 99 MAP 36
SHIELDS HEALTHCARE GROUP OLD D-2 30
21 IYANNOUGH ROAD..
WEST YARMOUTH, MASS..02673
RENOVATE AHD EXPAND EXISTIMBUILDING
2. 0. LOT MAP
A
3. LOT MAP
w
4• LOT MAP
ASSESSOR •. PLANNING DEPARTMENT t
BUILDING DEPAR WATER DEPARTMENT
CONSERVATION ECONOMIC DEVELOPMENT
DESIGN REVIEW
ENGINEERING DEPARTMENT BOARD OF APPEALS
FIRE DEPARTMENT ,
HEALTH DEPARTMENT
HISTORIC COMMISSION ,
SITE PLAN REVIEW AGENDA
1:30
TUESDAY`.-'-3/14)2000 7 STARTING AT IMP.M., FOR THE FOLLOWING:
1. SHIELDS WU LOT 99 MAP 36
SHIELDS HEALTH CARE CROUP OLD D-2 30
,$ t'1 nAHHODGH ROAD.- •
WEST YARM UTH. MASS..02673
REBOvATE ARD EZPAim EasTnrzu LDIRG � y �� •
2. LOT MAP
r.
3. LOT MAP
.N
4• LOT MAP
ASSESSOR...
BUILDING DEPARTMENT
CONSERVATION
DESIGN REVIEW
ENGINEERING DEPARTMENT
FIRE DEPARTMENT
HEALTH DEPARTMENT
HISTORIC COMMISSION
PLANNING DEPARTMENT i
WATER DEPARTMENT
ECONOMIC DEVELOPMENT
BOARD OF APPEALS
C.
TOWN OF YARMOUTH
BOARD OF APPEALS I�'7
'8& ,AFL 15 P 3 :15
Filed with Town Clerk: 7-15-88 Hearing Date: July 14, 1988•
Petitioner: Luke P. Lally Petition N�iiN55§RtM
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 (501) 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 (50') 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 fo'b 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
deroghting 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
o � •7
N:.
- � t
r� W
EDWARDI SWEENEY. JR.
MCNAEL 9. STUSSE
DONNA M. ROBERTSON
MATTHEW I DUPUY
CNARLES X SABATT
ARDITO, SWEENEY, STUSSE, ROBERTSON & DUPUY, P.C.
ATTORNEYS AT LAW
MATTACHEESSE PROFESSIONAL BUILDING
25 MID -TECH DRIVE, SUITE C
WEST YARMOUTH. MASSACHUSETTS 02673
TELEPHONE (508) 77534aa
FAX (508) 790.4778
G 4569 Z
February 10, 2000
Yarmouth Town Hall
Building Inspector
1146 Route 28
South Yarmouth, MA 02664-4451
Re: Aquifer Protection Bylaw §4065.1.1
Shields Health Care Group
or���anr�D
IIII FEB 16 2000
Dear Building Inspector:
Enclosed with regard to the above -captioned matter please find the following:
1. Aquifer Protection Bylaw §4065.1.1
Should you have any questions or concerns, do not hesitate to contact me directly.
Very truly u
I
'L B. SE
nv
Enclosure
cc:
MCNARD P. MORSE, JR
oBu o NEWELL
CMARIES I ARDITO, P.C.
'Mw WNIW M MNNE
TOWN OF YARMOUTH BUILDING DEPARTMENT
APPLICATION FOR DETERMINATION OF NON -APPLICABILITY
F41111i I W DI 40,41 a toil M_ ill0 LINS 0-311AWMAXI BMW
Applicant: Shields Health Care Date Filed: 02/09/00
Property location: 2 Iyanough Road,west .Yarn outhMap# 30 Parcel# 2
Proposed Use: MRI Facility (Magnetic Resonance Imaging)
iiitiiiiiiiititiiitititiitiiiiiiiiiiiiiiiiiitiiiifi►tiiiiiiiitiiiiiiiiiitiiFii
1. The applicant has fully complied with the Submittal Requirements of §406.5.2 N/A
(Attach copy of Hazardous Materials List)
2. The proposed use meets all of the Design and Operation requirements of §406.5.7, N/A
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 hereby acknowledges that the Building inspector may require the applicant to submit the
matter to the Health Agent or Board of Health, and may require the applicant to demonstrate that he/she has
received a favorable report from the Health Agent or Board of Health. The Determination, if made, shall apply
only to the individual applicant and proposed use and shall automatically expire upon any change of use or
transfer of ownership of the business. There shall be no appeal from an unfavorable Det'etmination of any such
application, nor from a failure to act. except for filing by the applicant for a Special Perm from the Board of
Appeals as otherwise provided herein. Shields Health Care bY„
Applic.fnt / Date
Michael B. Stusse, Esquire
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
A licant need not apply for a Special Permit under §406.5
C� 3 -/3-�� 3 /3 DO
uilding Inspector Date ealth Agent l5atc
Copies of this form must be sent to the following departments (as listed in §406.5.4); Water, Engineering,
Fire, Health, Planning, Conservation, Board of Appeals.
APDdetemompp 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 Determination of Non -Applicability, please
complete this form and return it with your application 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 of products? (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
Rustproofing/Undercoating Vehicle Detergents
Vehicle Waxes, Polishes Asphalt, Tar, Sealers
Paint, Varnishes, Stains, Dyes, Thinners Wood Preservatives _
Dry Cleaning Solvents, Carbon Tetrachloride Floor/Furniture Strippers
Other Cleaning Solvents Rock salt, Road salt _
Drain, Toilet, Cesspool Cleaners Refrigerants _
Bug & Tar Removers Photo chemicals _
Printing Inks & Dyes Pool Chlorine _
Pesticides, Insecticides, Herbicides Rodenticide, Fungicides
Nitrate Fertilizer Jewelry Cleaner _
Leather Dyes PCB's _
Electroplating Sludges zo Others (List) I -
Applicant
Shield Health Care by
B. Stusse, Esquire
Ei
C:\My Files\Documents\Application\HEALTAPDdeterl0-99.WPD
TOWN OF YARMOUTH BUILDING DEPARTMENT
APPLICATION FOR DETERMINATION OF NON -APPLICABILITY
Applicant: Shields Health Care Date Filed: 02/09/00
Property location: 2 Iyanough Road,West :YarmouthMap# 30 Parcel# 2
Proposed Use: MRI Facility (Magnetic Resonance Imaging)
**sssssssssssss*ssasssssssssssssssssssss**sssss*ss***ss*sssss**srs*****ss*****
1. The applicant has fully complied with the Submittal Requirements of §406.5.2 N/A
(Attach copy of Hazardous Materials List)
2. The proposed use meets all of the Design and Operation requirements of §406.5.7, N/A
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 hereby acknowledges that the Building Inspector may require the applicant to submit the
matter to the Health Agent or Board of Health, and may require the applicant to demonstrate that he/she has
received a favorable report from the Health Agent or Board of Health. The Determination, if trade, shall apply
only to the individual applicant and proposed use and shall automatically expire upon any change of use or
transfer of ownership of the business. There shall be no appeal from an unfavorable Deikmination of any such
application, nor from a failure to act. except for filing by the applicant for a Special Perm from the Board of
Appeals as otherwise provided herein. Shields health Care by..
Applicd'nt 0 Date
Michael B. Stusse, Esquire
DETERMINATION: The Building Inspector, based upon a review of this application and information supplied
by the Applicant, hereby determines that the proposed use satisfies the requirements of §406.5.1.1 and that the
Applicant need not apply for a Special Permit under §406.5
iding Inspector Date
ealth Agent tj D to
Copies of this form must be sent to the following departments (as listed in §4065.4); Water, Engineering,
Fire, Health, Planning, Conservation, Board of Appeals.
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 Determination of Non -Applicability, please
complete this form and return it with your application. 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 of products? (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
Rustproofing/Undercoating Vehicle Detergents
Vehicle Waxes, Polishes Asphalt, Tar, Sealers
Paint, Varnishes, Stains, Dyes, Thinners Wood Preservatives
Dry Cleaning Solvents, Carbon Tetrachloride Floor/Furniture Strippers
Other Cleaning Solvents Rock salt, Road salt
Drain, Toilet, Cesspool Cleaners Refrigerants
Bug & Tar Removers Photo chemicals
Printing Inks & Dyes Pool Chlorine _
Pesticides, Insecticides, Herbicides Rodenticide, Fungicides
Nitrate Fertilizer Jewelry Cleaner
Leather Dyes PCB's
Electroplating Sludges �Others (List)
Applicant
Shield Health Care by
B. Stusse, Esquire
C-.\My FRes\Documents\Application\HEALTAPDdeterl0-99.WPD
SITE PLAN REVIEW COMMENT SHEET
James Brandolini
Terry Svlvia
Bob Savage
Vern Santos
Corey Kittila
Brad Hall
Dennis Brown
Michael Stusse
Jack Shields
Comments:
Planning: The applicant proposes a Magnetic Resonance Imaging (MR) facility at this site in the B2 business zone and
the Aquifer Protection Overlay District (APD). The use, code 01 (SIC 8071) Is an allowed use in the B2 zone, but requires
a Special Permit in the APD. The applicant may apply for a Determination of Non -Applicability, per section 408.5.1.1
Instead of a Special Permit for the use in the APD. A Variance will be required under section 203.5 for less than the
required side setback; 10 ft. Is shown on the plan where 25 ft. Is required. A complete upgrade of the site is required per
section 301.2. A note regarding buffer trees (301 AA) should be noted on the plan. Parking space *1 Is In front of the
building and should be relocatedleliminated or relief sought from section 301.4.1. Relief must also be sought from 301.4.7
for less than the required 250 ft separation of driveways. Parking appears to be adequate (with space #1 removed), as
shown for the proposed faaTity. Underground utilities are required, per section 301.4.10. Parking lot fighting must be uner
35 f . In height.
Any future sign must meet the design and display criteria of section 303. Meet with the Sign Inspector to review sign
designs. A street number must be mounted on the twflding per Town Code and Massachusetts General Law.
The applicant plans a R.OA.D application to the Planning Board, per Bylaw section 411.
Building: 1. Constrution shall be placed under Constrction Control, pursuant to Chapter 1 of 780CMR
2. Compliance with site fighting and underground utilities shall be shown on the proposed site plan
Conservation Commission will require a Request for Determination application.
Fire Dept. 1. Recommend supervised alarm system for the unheated attic 2. Recommend supression sytem suitable to
use. 3. Portable fire extinuishers required.
Board of Health: New septic system will be installed in accordance with tide 5 regulations. Septic plans must be
submitted to health agent for review. No hazardous chemicals are proposed on site. Future use of chemicals will require
approval from Health Department
Design Review: proposed architecture Is a substantial Improvement at this gateway location. Underground utility
proposal is a definite plus. Route 28 Task Force wilRaupport this ROAD proposal
Water Dept 1. New water serice shall be shown on plan detailing sleeve through slab and parking lot
2. Old service shall cut and capped by Water Dept. at owner's expense.
n
Reviewers:
Building Div. .� -�
Conservation Div.
Health Div.
Planning Div.
Engineerin§ Div.
Water Div.
Fire Dept.
Design Review
Police Dept.
Economic Development
SiTE PLAN REVIEW COMMENT SHIN
James Brandolini
Terry SvMa
Bob Savage
Vera Santos
Corey Kittila
Brad Hall
Dennis Brown
Michael Stusse
Jack Shields
Comments:
Planning: The applicant proposes a Magnetic Resonance Imaging (MRI) faaTity at this site in the B2 business zone and
the Aquifer Protection Overlay District (APD). The use, code 01 (SIC 8071) is an allowed use in the B2 zone, but requires
a Special Permit in the APD. The applicant may apply for a Determination of Non-App6cebility, per section 406.5.1.1
Instead of a Special Permit for the use in the APD. A Variance will be required under section 203.5 for less than the
required side setback;10 ft. is shown on the plan where 25 ft is required. A complete upgrade of the site is required per
section 301.2. A note regarding buffer trees (301.4.4) should be noted on the plan. Parking space #1 is in front of the
building and should be relocatedlefiminated or relief sought from section 301.4.1. Relief must also be sought from 301.4.7
for less than the required 250 ft separation of driveways. Parking appears to be adequate (with space #1 removed), as
shown for the proposed faaTity. Underground utilities are required, per section 301.4.10. Parking lot lighting must be uner
35 ft. in height
Any future sign must meet the design and display criteria of section 303. Meet with the Sign Inspector to review sign
designs. A street number must be mounted on the building per Town Code and Massachusetts General Law.
The applicant plans a ROAD application to the Planning Board, per Bylaw section 411.
Building: 1. Constrution shalt be placed under Consirction Control, pursuant to Chapter 1 of 780CMR
2. Compliance with site lighting and underground utilities shall be shown on the proposed site plan
Conservation Commission will require a Request for Determination application.
Fire Dept. 1. Recommend supervised alarm system for the unheated attic 2. Recommend supression sytem suitable to
use. 3. Portable fire extinuishers required.
Board of Health: New septic syetem will be installed in accordance with tfile 5 regulations. Septic plans must be
submitted to health agent for review. No hazardous chemicals are proposed on site. Future use of chemicals will require
approval from Health Department.
Design Review: proposed architecture is a substantial improvement at this gateway location. Underground utility
proposal Is a definite plus. Route 28 Task Force will\urpport this ROAD proposal
Water Dept. 1. New water serice shall be shown on plan detailing sleave through slab and parking lot
2. Old service shall cut and capped by Water Dept at owner's expense.
F7
Reviewers:
..
TABLE 2
SITE PLAN REVIEW REQUEST AND PROJECT DESCRIPTION FORM
SUBMISSION DATE: 01/27/00 REVIEW DATE: TIME:
ASSESSOR'S MAP NO.-
.jr 3O LOT: _Dl_LMap 36/Parcel 99 )
LOCATION OF PROJECT: Iyanough road. West Yarmouth. MA 02673
NAME OF BUSINESS/PROJECT: Hyannis MRI Facility
APPLICANT NAME: Shields Health Care
APPLICANT ADDRESS: 265 Westgate Drive, Brockton, MA
APPLICANT PHONE NO.: (508) 559-7616
ENGINEER/SURVEYOR: _Down Cape Engineering
TITLE REFERENCE:` Book 8430/PaQe 167 REGISTRY SURVEY:
DESCRIPTION OF PROJECT: (attach additional pages if necessary)
ZONING DISTRICT: B1 FLOOD ZONE:
BUILDING SIZE: (square feet) 5, 21 sq. ft. ATTACH FLOOR PLANS: Yes
BASEMENT: N/A FIRST FLOOR: 5,621 sq. ft. SECOND FLOOR: _N/A
MAXIMUM NUMBER OF EMPLOYEES: _ Three to Four Employees
DO YOU USEMANDLE/STORE OILS OR HAZARDOUS MATERIALS?
No Radiation/No .hemi al%
1F SO, ATTACH A LIST OF THEM BY NAME, QUANTITIES, AND PROPOSED
METHODS OF STORAGE/HANDLING/DISPOSAL ETC. N/A
BOARD OF APPEALS ACTION EXPECTED: Yes
IS THE PROPOSED CONSTRUCTION WITHIN 100 FEET OF A WETLAND? _Yes
RESPECTFULLY SUBMITTED,
L B. STU
ARDITO, SWEENEY, STUSSE,
—ROBERTSON & DUPUY
25 MID -TECH DRIVE, SUITE C,
WEST YARMOUTH, MA 02673
(508) 775-3433
DATED: / 3-- OL) BBO # _ 483960
Submit 8 copies of this completed form and the site plan to the Building Department in order to get
your project on the Site Plan Review Agenda. A 9th copy is required if within 100 feet of a wetland.
TOWN OF YARMOUTH
Application for a Permit to Build No.
,J
UPON FINAL APPROVAL f140/ I jag MAP 7-� LOT
FEE MUST ACCOMPANY THIS APPLICATION. DATE
The undersigned hereby applies for a permit to build
according to the following specifications
1. Name of property owner
Address
t ew o -z.- 6�71f STel.
2. Name of Architect (if any) Tel.
$. Name of builder dress iV,<
4. License No. Tel. '77 VI—T w' Yf¢/L s99�9
5. Name of Mason Address
6. License No.
7. Construction address
8. Date of subdivision Approval
Tel.
9. Private dwellingX Estimated Cost
10. Multifamily ❑ 1 3-ro
11. Commercial ❑ 'S , pe jt�
12.Other ❑ �/�lyT'1�GoO P
13. No. of stories 0
14. Foundation — Full ❑ Half ❑ Crawl ❑ Slab ❑
15. Materials — Wood ❑ Cement ❑ Other ❑
16. Type of heat — Oil ❑ Gas ❑ Electric ❑ Other ❑
17. Garage —1 ❑ 2 ❑
18. Swimming pool - Size
19. Storage shed — Size
20. Stove — Wood ❑ Coal ❑
i ^District 3 ��
zone — Zone
DO NOT WRITE IN THIS SPACE
I Type of room I No.
21. Size of lot: No. of feet front No. of feet rear _
22. Size of building. No. of feet front No. of feet side
23. Distance from nearest building: Front
24. Distance back from line or street
25. H.I.C.R. No.
LOT RELEASED BY Signature
PLANNING BOARD
Ft. side
From rear lot line
Dining Rm.
Living Rm.
Bed Rm.
Bath
Deck
Closed porch
Family Rm.
Sun room
_ No. of feet deep _
No. of feet rear _
Ft. side Rear
16�lfA.6�z°Do� �/j
Side li
Date
Y
Suggested Affidavit for Home Improvement Contractor Permit Application
rer cruet uaa ony NAME OF CITY(TO WN
Penn Ns
DNa
MGLc.
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
contractom wits certain eaeptioos, along with other
Type of work: Re Ovf 00 R m 12 57RI PE 4r��'. Cost
Address of Work
Owner Name: A?ASS a 4e/<eosv
Date of Permit Application:
I hereby certify that:
Registration is not required for the following reason(s):
_Work excluded by law
Job under S1,000
_Building not owner -occupied
_Owner pulling own permit
_Other (specify)
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOTHAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL
c. 142A.
Signed under penalties of perjury:
I hereby apply for a permit as the agent of the caner.
OKL,91
Date' I, Contractor Name Registration No.
OR:
Notwithstanding the above notice. I hereby apply for a permit as the owner of the above property:
Datc Owncr Namc
Z
In ac:d:.ac with the. provisia= of MCL a 40, S 54', a c:.ditioa of :�in, ?e—•:
Num..be: is this the debris re:uitiw; from this wwk st»:: be
disposed of in a prep=:; lic---c :solid waste di-aai::a Licht as dcEac : b r MC7 c :. S
Ltd
The debris wM be disroscd of itt: ,
y/s���lo'y7`!1`
Sicture of ... �tr..�...
' Date
The Commonwealth of Massachusetts
Department of Industrial Accidents
8=88IIOf1'MSI S90IS
600 Washington Street
Boston, Mass. 02111
y Workers' Compensation Insurance Affidavit
-Applicant information: PleaseVRJB:Ufdlbia
locmion- AZ
cin Z/(^ ;hone 0 'i 7
O 1 am a homeowner performing all work myself.
CC3�'l am a sole proprietor and hase no one working in any capacity
I am an employer pro%iding workers' compensation for my employees working on this job.
insurance co.
eoliev M
I am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below who ha%c
the follow in_ Worker' compensation polices:
Failure to secure coverage as required under Secoou 25A of MGL 152 can lead to the imposition of crindad penalties of a line up to a1.S0a.00 and/or
one years' imprisonment as well as civil penalties In the form of s STOP WORK ORDER and a fluent 11100.00 a day against me. 1 uadentaad that a
copy of this statement maybe forwarded to the Office of Investigations of the DtA for coverage veri0utfoe.
t do hereby certify under the pains and p1tgltles of perjury that the information provided above is true and correct
Print
G�5�9�F
�15e6 //G �i _____Phone ?? 7 of/�
omeial use only do oat write in this area to be completed by city or Iowa official
city or town: YARHODTQ
p cheek if immediate response is required
contact person:
permit/license a nBuilding Department
DlJeensing Board
261 OSeleclmea's Omce
C3Healtb Department
phone#;_ (508) 398-2231 ext. nOther
0�. 3.95 IOAI
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, express or implied, oral or written.
An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of
the foregoing engaged in a joint enterprise. and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual. partnership. association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on•such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chapter I: _ section _: also states that even state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required.
Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the
performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha% e
been presented to the contracting authority.
Applicants
Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and
supply ing 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. Please
be sure to fill in the permit/license number which will be used as a reference number. The afUdavitt may be returned to
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions.
please do not hesitate to give us a call.
The Department's address, telephone and fax number.
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Irtlee of tmstlntloa
600 Washington street
Boston. Ma. 02111
fa: N: (617) 727-7749
phone 0: (617) 7274900 ext. 406, 409 or375
76:.
TOWN OF YARMOUTH
BOARD OF APPEALS �7
'8b JLL 15 P 3 :15 �,
Filed with Town Clerk: 7-15-88 Hearing Date: July 14, 1988
Petitioner: Luke P. Lally Petition
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 (501) 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 *wo 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 servicingd
arking lot from Route 28 o e constructed to a width eater
than twent - ice IVI 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. a etitioner'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
o
f_.
1
r:
c
�
�
- �c
J- TOWN OF YARMOUTH
BOARD OF APPEALS
W JUL 15 P 3 :15
Filed with Town Clerk: 7-15-88 Hearing Date: July 14, 1988 <
Petitioner: Luke P. Lally Petition NJ1Mit.ENt55#RLA: L:,
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 (SONY 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 (50')
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
deroghting 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.
Wo permit shall be issued until twenty (20) days have elapsed
from the filing of this decision with the Town Clerk.
Fritz Lindquist c
Clerk
I/llbasp
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CAPE COD
2 IYANNOUGH ROAD
TOWN
1146 ROUTE 28
BUILDING
OF YARMOUTH ELECTRICAL
GAS
MASSACHUSETTS 02664
PLUMBING
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BUILDING DEPARTMENT
Op
APPLICATION TO ERECT AND MAINTAIN SIGN (� __—A
3
w��� Q Q DATE (S 5 � 0
TO THE SIGN INSPECTOR: UNDER SECTION 303 OF THE YARMOUTH BY-LAWS, THE UNDERSIGNED
HEREBY APPLIES FOR A SIGN PERMIT ACCORDING TO THE FOLLOWING INFORMATION:
SOUTH YARMOUTH
Tcicphonc (508) 398-2231
ZONING DISTRICT L.B. G.B.Yj=a no. RES. HIST. DIST.
BUSINESS OWNERS
OWNER OF RECORD OF
SIGN BUILDER
TYPE OF CONSTRUCTIbFI kkfff�) () reMM C��CI1 FnaM ALM;neyn LIGHTING TYPE
FREE STANDING 1� ATTACHED TEMPO PERMANENT L/
DIAGRAM OF LOT AND SIGN WITH DIMENSIONS AND SET -BACKS FROM PROPERTY LINE. SHOWN
LETTERING AND ADVERTISING ON SIGN. FOR ATTACHED SIGNS SHOW LOCATION ON FACE OF
BUILDING AND RUNNING FOOTAGE OF PORTION OF FRONTAGE OCCUPIED BY BUSINESS.
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Sh IP�dS ��" I 3r
02 Y114,0/614
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 HAS BEEN GRANTED. THE
NUMBER OF THIS PERMIT WILL BE AFF1%ED TO THE SIGN IN NO LESS THAN 3/4" NUMBERS.
ALL PERMITS SUBJECT TO APPROVAL OF THE SIGN INSPECTOR.
Rs�,PR.go�3(4� NANE..61�✓I(�.ea _•/,�
9 ae
APPROVAL BYJ DATE /rJ-3O-dd FEE NUMBER_
I
3' x 6' 2" Thick Cedar Panel with carved out text &
graphic with painted 5" x 5" cedar post with flutes
%hieldsMRI
CAPE COD
2 IYANNOUGH ROAD
S/GNderian inc
1-800-500-SIGN
r.L 50"80-0094 Fax 50"90-096
two W Ceaatnut St, Broaktor% MA 03301
www.sWdoalpgnc.com
sipudra Data
New Routed Post & Panel Sign
10/23/00
McCarthy & Company
Steve McCarthy
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR I
Number. CS 068112
Birthdate: 0821/1964 I
Expires: 0821/2002 Tr. no: 1214
Restricted To: 00 i
RALPH R FERRIGNO JR /
70 HEATHER HILL DR
BRIDGEWATER, MA 02024 Administrator
00.35.000 a enrbsed apace
(MGL C.112 S.60L)
IA - Massey o*
I -1 d 2 Family Homes
Failure b possess a ounent edWM or gm
MassaUuae4s State BuYdep Code
is cause for reroaton of MW Manse.
DIG SAFE CALL CENTER: (888) 744-723]
OF
TOWN OF YARMOUTH
o'er, •j-/f� �T�DOr� ��
11
APPLICATION FOR PERMIT TO DO PLUMBING
m� u
Fee: $--26
PERMIT NO.
Date `7 — / a -t9.dp
Building Owner's f^ qxA SST
AT: Location Q. J--.1/cLn A O e. ICJ G.. Name -
Type of Occupancy ss'�! eetC 9-
New ❑ Renovation Replacement ❑
Plans Submitted Yes ❑ No 0_�_
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SUB-BSMT.
BASEMENT
1ST FLOOR
2ND FLOOR
3RD FLOOR
(PRINT OR TYPE) Check One:
Installing Company Name ' ❑ Corp
Address ❑ Partnership
P. G IE# rm/C impany
Business Telephone Name of Licensed Plumber- I? . �� ce=
INSURANCE COVERAGE: 1 have a current liability Insurance policy or its substantial equivalent. Check One: Yes Ei—No ❑
If you have checked YES, please Indicate the type of coverage by checking the appropriate box.
A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑.
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance voerage required by Chapter 142 of
the Mass. General Laws, and that my signature on this permit application waives this requirement.
Signature otOwnerorOwner's Agent Check on Owner ❑ Agent ❑
I hereby certify that all of the details and Information 1 have submitted
(or entered) in above application are true and accurate to the best of
my knowledge and that all plumbing work and installations performed
under Permit Issued for this application will be In compliance with all
pertinent provisions of the Massachusetts State Plumbing Code and
Chapter 142 of the General Laws.
, 1
A.
�7 Signatu censed
Plumber
License Number
Type: Master 0--youmeyman❑
Office Use On'
idle TLIMM6nw 810 of if assttrllusefts Permit No. E-61-mil
Utpartment of Ilubl(c £taftfg Occupancy A Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Wo (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Oo
y City or Town of Qr iikoJ-t�A To the Inspectoil of Wires:
The udersigned applies for a permit to perform the electrical work described below.
Location (Street A Number) I,' a —1 i A-n O`q�" 1� of
Owner or Tenant
Owner's Address
Is this permit In conjunction with a building permit: Yes 0' No ❑
Purpose of Building
Utility Authorization
Existing Service Amps _/ Volts Overhead ❑ Undgrnd El�1 ''ww�\
New Service 1Amps--L49__at%)Volts Overhead 0-- Undgmd ❑
JUL U 6 2000
Dropriate Box)
No. of Meters
No. of Meters
Number of Feeders and Ampacity A-`-( A-t
Location and Nature of Proposed Electrical Work fDn...r��Q i1�y �S o r J tL Qs' C
No. of Lighting Outlets
No. of Hot lobs
No. of Transformers Total
KVA
No. of Lighting Fixtures
Swimming Pool Above In-
❑ ❑
gmd. gmd.
Generators KVA
No. of Receptacle Outlets
No. of Oil Burners
No. of Emergency Lighting
Battery Units
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS No. of Zones
N . of Dg
No. of Ranges
No, of Air Cond. Total
was
Devion and
No. of Disposals
No of Heat Total Total
Pumps Toro KW
No. of Sounding Devices
No. of Self Contained
Detection/Sounding Devices
No. of Dishwashers
Space/Area Heating KW
No. of Dryers
Heating Devices KW
Local ❑ CCononneectiicipal on [:]Other
cti
No. of No. of
Low Voltage
No. of Water Heaters
Signs Ballasts
Wiring
No. Hydro Massage Tubs
No. of Motors Total HP
OTHER:
rNaUr rvct ULNERAGE: Pursuant to the requirements of Massachusetts general Laws
1 have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES Z) NO ❑ 1
have submitted valid proof of same to the Office. YES Y] NO ❑ If you have checked YES, please indicate the type of coverage by
checking the appropriate box.
INSURANCE M BOND ❑ OTHER ❑ (Please Specify) .Tannary 1 - 2001
Estimated Value o EI dceI Work a 350. d�
Work to Start Inspection Date Requested:
Signed under the Penalties of perjury:
(Expiration Date)
Rough — Final (.
FIRM NAME
LiC. NO. A74497
Licensee al ynn V l prt ri r r Tni-Signature L IC. NO. Al 449
Address 17_..rpm fral Ctrppt F—at Arid pt.— r'A AILTel.NO. 1509) 97A—nA74
CJ tf'Y Aft. TeL No. SAR 47A nnaw
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have thrQZ&&3e coverage or Its substantlal equivalent as re-
quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent
(Please check one) /
T,J
(Signature of Owner or Agent) Telephone No. PERMIT FEES
x-6565
' APPLICATION FOR PERMIT TO INSTALL AND REQUEST
FOR ELECTRICAL SERVICE
Inspector of Wires Wiring Permit rf E—PLOO COM/Electric
Town of :y "#to rr'4 Massachusetts Building Permit a Date
Customer. J k SLn.�� An+ on(Streeto) TYIrNOugs 1RoAd
Lot • in the village y� utility pole number a underground number
Customer's billing address l9 iCrosQ Awe r s. � ��t KO V-H. M14
Temporary ^ New installation Ctuuge of §grvice Starting Date 71710 Q—
Job descripI Q wpoLk` f .� r ica r n w rct
Service enhance voha e—
Wire size (cu.
Number of meters —
Estimated bad: Electric heat
Ready for first Inspection _
Electrical nbactor-61Z
Address
Additional Remarks:
per phase
Water heater Off peak Yes — No —
kw, lights kw, Range dryer Motors. H.P. 3 PhasCAL0e
Ready for na1 rrs
11 ��4° =10 �
Do Not Write Below This Line
ELECTRICAL WIRING INSPECTION CERTIFICATE
INSPECTIONS �^ 4 INSPECTOR OF WIRES
[��
Temporary Service +�w�r `� J "' • ~:" [�"'7""
Roughing in
Service and Meter
Off Peak Meter
Final Approval.
Disapproved'
'For the following
CERTIFICATE OF INSPECTION
To the COMMONWEALTH ELECTRIC COMPANY. The installation described above has
approval granted for connection to your service.
FEE CHARGE
WIRING INSPECTOR TO BE NOTIFIED WHEN WORK IS READY FOR INSPECTION
Permit Good For One Year From Date Of Issue
been Ins ed and
is
CA 4s r
White —COWEtecsb Green —bspecror Canary —Town Receipt Pink— Inspector's Copy Goldenmd— Ekcbxw Contractor
to COM/Electric
Office Use Only
(I01Iimanwallt Of Musar4aEffs Permit No. E-ei-ootl
11martilunt Of public eafav Occupancy a Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 sled Peeve blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All -work to be performed In accordance with the Massachusetts Electrical Code, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL I�Nt�F1ORMATION) Date 60
City or Town of 'YAr`MO rz v� To the Inspecto of Wires:
The udersigned applies for a permit to perform the electrical work described below.
c )a -� Ya„ o ,�� �d 111 /�1 NISI-�In
Location Street 8 Number
Owner or Tenant
Owner's Address
is this permit in conjunction witt) a building permit:
Purpose of Building r
Existing Service Amps _,/ Volts
New Service Amps _!�9_'&_�Volts
Yes 'B" No ❑
Utility Authorization
No. of Meters
No. of Meters
Number of Feeders and Ampaclty fir'( Act
Location and Nature of Proposed Electrical Work T n� S a w tc'i it C �S eKZ tp�
Overhead ❑ Undgmd ❑
Overhead 0� Undgmd ❑
No. of Lighting outlets -
No. at Hot lobe
No. of llansformom KVA
No. of Lighting Fboum
Swimming Pool Above In-
Wrd. ❑ gmd. ❑
Generators KVA
No. of Receptacle Outlets
No. of Oil Burners r
No. of Emergency lighting
Battery Units
No. of Switch Outlets
No. of Clan Sumem
FIRE ALARMS No. of Zones
rIn Initiating Devicesud -
No. of Sounding Devices
No. of Self Contained
DetectlonfSounding Devices
Local ❑ Municipal
[ -]Other -
No. of Ranges
No. of Alr Cord. tonne
No. of Disposals
NO•m Heat TOW TOW
Pumps Tbns KW
No. of DishwashersSPace/Area
Heating KW
No. of Dryers
Heating Devices KW
.
No. of Water Heaters - KW
No. of No. of
Signs Ballasts
Low Wltage
Wiring
No. Hydro Message Tubs
No. of Motors Total HP
LryGly-P
INSURANCE COVERAGE: Pursuant to.the raqulremente of Massachusetts general Laws
1 hav► a Current U& UIty Insurance Polley Including Completed Operations Coverage or Its substantial equivalent YES = NO ❑ 1
have submitted valid proof of same to the Office. YES Y] NO ❑ If you he" checked YES, please Indicate the type of coverage by
checking the appropriate box.
INSURANCE Ja BOND ❑ OTHER ❑ MesseSpectW ' aannary 2001
J
Estimated Val EI rkal Work S — IS 1. O
Work to Stan .0'O Inspection Date Requested:
Signed under the Penalties of perjury:
FIRM NAME
(Expirauon Dnate)
Rough - Final au co
UC. NO..A14497
Ucensss- Glynn FIPr*rlrr Tnr Signature 1IC.NO. A14497
Address 17 Bus Tel No (50R 1 37B_f]474
L`y�,tr j;roa* Fast Arldmawn s_MAj> a Ti u 8 7757 04174
OWNER'S INSURANCE WANER: I am aware that me Licenses does not have m!a?e3r8nie Coverage or Its substantial equivalent as re-
quired by Massachusetts General laws, and that my signature on this permit application walls this
(Please Cheek one) requirement Owner Agent
Telephone No. PERMIT FEES
(Signature of Owner or Agenq
X45e5
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusem Electrical Code, (MEC), 527 CMR 12.00
TOWN OF YARMOUTH
(OFFICE USE ONLY)
By /
Fee: $ 6 C
PERMIT NO. E-M -3,
(PLEASE PRINT IN INK OR TYPE ALL INFORAIATION) Date:
To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work
described below. t
Location (Street &
Owner or Tenant /7e 10(. IK- r 1114ei— Telephone No.
Owner's Address0%-16C'144—'VA rn V5
Is this permit in conjunction with a building permit? I~I Yes ❑ No (Check Appropriate Box)
Purpose of
Utility Authorization No.
Existing Service Amps f Volts Overhead ❑ Undgrd ❑ No of Meters
New Service Amps / Volts Overhead ❑ Undgrd
Number of Feeders and Ampacicy
t
Location and Nature of Proposed electrical Work: 7 I'
i l.6• Db I
Complawn of the fol ,t table Gray he uwitrd by The Insp tar of Wirtt
No. of Recessed Fixtures
No- of s
No. o _
Transformers KVA
No. of Lightiniz Outlets
No. of Hot Tubs
Generators KVA
No. of Li htin Fixtures
A ve In-
SwimmingPool rnd. ❑ md. ❑
No. of Emergency lighting
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Bumers
No. c Detection m-
Initiating Devi¢
No. of Ranges
Total
No, of Air Cond. Tons
No. of Alerting Devices
No. of Waste Disposers
Heat Pump
Totils:
Num r
Tons
KW_
No. of Self -Contained
Dcteaion/Aletting Devices
No. of Dishwashers
Space/Area Heating KW
Municipal
Local ❑ Connection ❑ Other
No. of Dryers
Heating Appliances KW
uuty ystems:
No. of Devices or Equipvalenr
No. of Water
Hearers KW
No. of No. of
Signs Ballasts
Data Wiring:
No. of Drim or Equivalent
No. H dromassa a Bathtubs
Y g
No. of Motors Total HP
Telecommunications Wiring: Z
No. of or Equivalent
a Attach et&itional detail if desired, or as regaired by the Inspector of Viret.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licenser provides proof of liability
\insurance including *completed operation' coverage or its substantial equivalent. The undersigned tenses that such coverage is in force, and has exhibited proof
C of same to the permit issuing office.
CHECK ONE: INSURANCE ❑� BOND ❑ OTHER❑ (Specify:)
� ,c__ (Expiration Date)
Estimated Value of Electrical Work: a C56 (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with DfEC Rule 10, and upon completion.
I certify, under thep ains a penalties of peter (ry, that the information on this application is true and complete.
FIRM NAME: /7 A a � J NG; .S nco----o LIC. NO.
(If applicable, eppter'exem the license number ineA ^'
Address: __/� 9A'GArWA-; J C�/1�
OWNER'S INSURANCE WAIVER: I am aware that the licenser does not have
below, I hereby waive this requirement. 1 and the (check one) owner
Owner/Agent
Z""' LIG NO.
Bus. Tel. No.:
Alt. Tel. No.:
is liability insurance coverage normally required by law. By my signature
owner's agent. ❑
Signature
[Rev. 04rbo)
Telephone No.
&;4o,00
^+ Office Use Only
of CruMt1Wn M1t4 of IfflttssuC41Metts Permit No.
ErVartmutt of Ilublic Safifg Occupancy Free Checked
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 Peeve blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed In accordance with the Massachusetts Electrical Code, 527 CMp 12.p
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date - -Lc1JI-3t I OO
City or Town of i(K'M.J{:.� To the Inspector of Wires:
The udersigned applies for a permit to perform the electrical work described, below. /n1 Ff ..�
Location (Street & Number) Q.( u c\ - ip�
Owner or Tenant a`ex,okks vltr-AL.1
Owner's Address SA. e _ d'
Is this permit in conjunction wit a building rY ❑ it./oSJ I
P 1 h g permit: Yes IJ No �hsg�-q{ate.g�
Purpose of Building M %T. t rMJ-1142a — CUtility Authorization No.
Existing Service 'Amps —J Volts Overhead ❑ Undgmd ❑ No. of Meters
New Service 4 OO Amps —416-O a2 Volts Overhead ❑ U1ndgmdNo. of Meters
Number of Feeders and Ampacity _ 1 _ (600 rICMk 00 eAr iv in -Az
Location and Nature of Proposed Electrical Work (-�� , e _Q.i.\r� • its 1- %4 0.+-.'i
No. of Lighting Outlets
.
No. of Hot Tube
No. of Tansformers
Q1 O
No. of Lighting Fbdursa
('
Swimming Pool t7nr+d• ❑ g. ❑
Imd
Gw rotors KVA
No. of Race ptacie Outlets
-
`a,l
I O. t
- -
No. of Oil Burners •
No. w Emergency Lighting
Battery Units .. -
No. of Switch Outlets - - ""-
S 7
No. of Gas Burners - -
-FIRE ALARMS ---No. of Zones - a"
No. of Detection and -
Initiating Devices
No, of Sounding Devices
No. of Self Contained
DeteWoNSounding Devices
Local ❑ Municipal
Connection
No. of Ranges
-
Noof Air Cond. Q Tom
.
0 tone rb
No. of Disposals
-
No.of Heat Total Total
Pumps Tons KW
Na. of Dlahwsahers
Space/Area Nesting KW
No. of Dryers
Heating Devices KW
No. of Water Heaters 1
KW
No. of No. of
Signs Ballasts 6
Low Voltage
Wiring nV
No. Hydro Massage Tuba
//
No. of Motors '4- Total HP b
OTHER: Sjps S.ffi-tew.c - a, ti r Cr�t�'cSol h�en,e,-c
m�urw uv ULNERAGE: Pursuant to the requirements of Massachusetts general Laws
1 have a current Liability Insurance Policy Including Completed Operations Coverage w he substantial equivalent. YES x) NO ❑ 1
have submitted valid proof of same to the OMce. YES Y) NO ❑ If you have chocked YES, please indicate the type of coverage by
Checking the appropriate box.
INSURANCE M BOND ❑ OTHER ❑ (Pleas@Specify) 2 ,Tannery 00'
Estimated Value El"cal Work S -) a1S�pD-00O n� final W(Expiratbn Date)
Work to Start 1 w �w 0 00 Inspection Date Requested: Rough `
r(l
Signed under the Penalties of per)ury: -
FIRM NAME -GJYn EJ eCt r4 r T Uc. NO, A144Q7
Licensee 1111Tnn F1or1-rirr Tnr+ signature C.NO. A1449
Bus. Tel. No. (5n8) a7R_n474
Address 17-�i'.-f =+ Q+-use.♦ x'aaf• PH ripper-�� 1�'A ao Tr u ie 9 77�n4-rw
OWNER'S INSURANCE WAIVER: I am swam that the Licensee does not hove thJ0253r3niscoverage or tts substantial equivalent as re-
quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent
(Please check one)
y 01.
Telephone Na. PERMIT FEES $ a Q
(Signature of Owner or Agent)
)14563
APPLICATION FOR PERMIT TO INSTALL AND REOUEST
FOR ELECTRICAL SERVICE
inspector CRor�Wires Wiring Permit r COk4Electric r
Town of rF-"Jt� Massachusetts Building Permit If nee S/1
Customer. `]�S •t`aS PRAC--I L CARe— on (Street r)
Lot If In the tillage of
Customer's bring address
Temporary
Job descrtl
New
utifdy pole member or urderground number
Date
Sim -
Service erdra voItage O a- Amperage - c/cc� Phase
Wire size oor al.) rmeo Conductor per phase - -
Number of meters Water heater Off peak Yes — No J�
Estimated bad: � eeat�—kw. lights kw. Range dryer Motors. H.P. 6 Phase tips
Ready for first inspectionC not Ready for final Inspection U3• 11 Cn40
Electrical Contractor LTfYN 1=ttcT2,; Llc.r A IMy9a. Telephonerr122-�7a-OK7y
Address 1 I cenr6iii, ST
Additional Remarks: a- f%Wz -1'1►n saSC aJOS S�Tortit
Do Not Write Below This Line
ELECTRICAL WIRING INSPECTION CERTIFICATE
INSPECTIONS INSPECTOR OF WIRES DATE FEE CHARGE
Temporary Service
Roughing in 4 l� O I tam
Service and Mere. L-A- 0 -
t.
Off Peak Meter
Final Approval t
Disapproved'
*For the following reasons
CERTIFICATE OF INSPECTION /
To the COMMONWEALTH ELECTRIC COMPANY. The Installation described above has be been this day Inspected and
approval granted for connection to your service. �A _v►.4Gj(e^I ,
WIRING INSPECTOR TO BE NOTIFIED WHEN WORK IS READY FOR INSPECTION
Permit Good For One Year From Date Of Issue rw 46-1
White — COM/Electr c Green — Inspector Canary — Town Receipt Pink— Inspector's Copy Goldenrod — Electrical Contractor
to COM/Electric
a
APPLICATION FOR PERMIT TO INSTALL AND REQUEST
J.
'FOR ELECTRICAL SERVICE
S _
•
rr s ctorofWires
Wiring Permit t COMIElectr)c11y--^—'-
1 Town of " `yfi3,.c-�
�`- Massachusetts "-- - " Building Permit Date
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In the village of .. ..' ulflitj!Dole inmlber or, underground �umbei -
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,.: _:r ti� a �.. JCA�_+Ai.-�+t Ai'Al •• _ .:.4fri1 r.. ti'dw:. .Ms".-,
t TemperalY •., " New lnstaearlon mange or perwce -., S-tarep
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CN;A X4 1 +' [
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Service entrance voltage "`'I Lt o ai 7 " ' Amperage _Phase. . z.
Wire size (cur al.)Conductor per phase
' Number of meters �— Water heater I Off peak: Yes _ No -W. ` ^ s . � s •�
' Estimated bad: EleMkeeat tlh kw, Ugh kw, Range �yei ° ors, N P. 3�Phase "�.
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Ready for first Inspection t Ready for IiQ)nspectlon ' ' .. • a • 11 to ( ',.. • �"""` .,
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+IYM,y �twr eft'. e• `.1—_. Telephonet`
ElecMcalContractor Lk.t ��-L_�S. `L1 7
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_ Address 17-. _ _ _ V a., •.-„•;--,...��_ _....•...t-
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ELECTRICAL: WIRING INSPECTION CERTIFICATE
-
INSPECTOR OF WIRES''
- INSPECTIONS _ DATE 49 .. FEE CHARGE
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- Temporary Service
-
•
" Roughlrgin
. i • Service and Meter R"�s"'� �' 4e.>
. 1 Off Peak Meter
C4raf Approval
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raaPProVR1ed*
c - ...1Focthe lfeasons
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}✓ To dtd COMMONWEALTH ELECTRIC COMPANY The Mstalla8on descntied above has been�n this days been inspeoed this days ee Inspeoed and
tr approval Granted for connection to your service . jl�r _ji'J' —••�' ''�
Inspector of Wires - - -
WIRING INSPECTOR TO BE NOTIFIED WHEN WORK IS READY FOR INSPECTION
z _ Permit Good For One Year From Date Of Issue a 46-1
White — COMIElect is Green = Inspector Town R _ - . " Canary— eoeipt Pink Copy ". " � Goldenrod - Ekrr.Yrkal Contractor
- " .. lo COM/Electric .
Commonwealth of Massachusetts Official UsCee Only
Department of Fire Services Permit No. L— Ol-21�
t3 - BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
} [Rev, 11/991 1cawblanl
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (NEC), 527 CMR 12.00
(PLEASEPRINTININKORTYPEALLINFORMATION) Date: o8-28'—ao
City or Town of: atimr WA15!er7otJ77Y To the Inspector of Wires:
By this application the undersigned gives not] his or elf cr�intenuon to perform flu electrical stork described below.
Location (Street & Number) 1-Z-Y/JA/O UG Al /�Oe9D
Owner or Tenant S6iEt9) Afe/ 110.470.ZLIA49ZM(S CaawrneTelephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
New Service Amps / Volts Overhead ❑ Und-erd ❑ No. of Mcters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: �?e te644.e ,4.44e�w s- C&Ty.SYJY;FM
Cone letian o the ollowin table mar be Yres.
No. of Recessed Fixtures
No. of Ccit.-Susp. (Paddle) Fans
o. o p of
Transfo s V
n.
No. of Lighting Outlets
No.,6r Ilot Tubs
Generator
&VA
No. of Lighting Fixtures
Swimming Pool os•e ❑ n- ❑
cad. cad.
n rgc hb
oil'
Batten U its i
No. of Receptacle Outlets
No. of Oil Burners
FIRE AI:�i1IS
No. of Zones
No. orSwitehes '
No. of Gas Burners
No. of I lerectinn an -
Initiatin2 Devices
No. or RanTotaT
_
No. or AirCond. Tans
No. or Alerting Devices
No, of Waste Disposers
cat Pump
Tntnit-
I PLumber
JTon3
o. of Scir-Containcl—
Detection/Alerting Devices
No. of Dishwashers
Spdcc/Arca Heating KW
Local ❑ blumcipa ❑ Other
Connection
No. of Dryers
Heating Appliances l(V
ecurity ystems:
No. of Devices or Equivalent
o. o eatter KW
Heaters
o. o o. o
SiZns Ballasts
Data Wiring:
No. of Devices or E uivalent
No. Ifydromassagc Bathtubs
No. of Motors Total HP
c ecommumcalhons long:
No. of Devices or E uivalent
OTHER:
Arrach additional detail lJ'derired or as reghdred by the Inspector ofWirca.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:)
( phrauon te)
Estimated Value of Electrical Work: S 9667 ego (When required by municipal polity.)
Work to Start:_ E Ito _oc` Inspections to be requested in accordance with MEC Rule 10, and upon completion.
f terrify, under thepains and penalties ofperjuiy, that the information on this application is true and complete
FIRM NAME: .ADT Security Services Ill Morse Street, Norn•ood, MA 02062 LIC. NO.: 1533C
John S. Bassett
'e, enter "exennpt" ht
required by law.
Owner/Agent
Signature _
JKAIN UL WAl VLK: t am aware Illat UIIC Licensee tloeS
By my signature below, I (hereby waive this requirement
Telephone
�. 1b)444.rG LIC. NO.: 1533C
Bus. Tel. No.: 781-278-1131
AIL TcL No., 791-779-1725
not hm a the liability insurance coverage normally
I am the (check one) ❑ owner ❑ owner's agent.
PERMIT F,EE: $ys00
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�11 pU6 � 9 2000
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APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00
TOWN OF YARMOUTH
(OFFICE USE ONLY)
SO
�=
PERMIT NO.
Fee: $ E,0I"t3 /p
ff
(PLEASE PRINT IN INK OR TYPE ALL INFORAIATION) Date:
To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work
described below. 7 .
Location (Street & Number) :�ft Z � Zg
Owner or Tenant .S H 16 L D S M Y�TL Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? 0 Yes ❑No (Check Appropriate Box)
Purpose of Building C L I N 1 C" Utility Authorization No.
Existing Service
New Service
Amps / Volts
Amps ! Volts
Overhead ❑ Undgrd ❑ No of Meters
Overhead ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed electrical Work: _1-0LJ V11LTAb tr- 11 F-R m 6% TA'R F'O T2- a A C. U m Z:T5
�f} GAS PEA-=ms AN'D ( F_YH(ju5', GAIN _
Com le
ion . the llowre table be waned the let or v Warr
No. of Recessed Fixtures
No. of Ccil.-SusI211'addle) Fans
No.of Total
Transformers KVA
No. of Lighting: Outlets
No. of Hot Tubs
Generators KVA
No. of Lighting Fixtures
A ve In
SwimmingPool rnd. ❑ md. ❑
No. of Emergency lighting
Battery Units
No. of Receptacle Outlets
No. of Oil Bumers
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
No. o Detection an
InitiatingDevices
No. of Ranges
Total
No. of Air Cond. Tons
No. of Alerting Devices
No. of Waste Disposers
Hu[ Pump
Totals:
Num r
Tons
—
KW —
No. of Self -Contained
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating
Local ❑ Municipal
No. of Dryers
Heating Applianct.
KW
utrty yscem
No. of Devic
a
al
No. of Water
Heaters KW
No. of of
Signs last
AI O U 1 D 2000 I
ata Wiring:
No. of Devi,
E
No. H dromassa a Bathtubs
Y g
1B
No. of Motors i) l HP �
Telecommunicat
Na. of Devic
t
o Equivalent
Attach additional detail tjdesrre , a n lurr y r nspM it o Wires.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability
insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has mhbited proof
of same to the permit issuing office.
CHECK ONE: INSURANCE BOND❑ OTHER❑ (Specify:)
(Expiration Dam)
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: I spections to be requested in accordance with MEC Rule 10, and upon completion.
I certify, under the pains and penalties of perjury, that the information on this application is true and complete.
FIRAI NAME: LIC. NO. 36 1 Sa t
"-"` ` ' " `�� .SAM�Signature LIC. NO. �7 S3 e
Licensee: -ram--c-ca-ro�
(If applicable, enter 'exempt" in the license number line.) Bus. Tel. No.:_L 1-1- 7 1-L— L i7
Address: 5 3 PEAR1_ S l AAt! LQesr JOA _ 61 'I 'I (p Alt. Tel. No.:
'-n( OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signuure
U below, I hereby waive this requirement. I and the (check one) owner owners agent.
Owner/Agent
Signature Telephone No.
[Res: 04/001
n
The Commonwealth of Massachusetts ORlea use Oa
hnlr Jb.
Department of Public Safety
Ocwr.ecr a rw awk.a 16D •m)
BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 1200 3/90 tt,,w Mani:
oo�A PPLICATIIONeFOR PERbe perforated IneMITance�TOe PERFORM IELEnCTRICAL WORK
An work1 (PLWE PRINT IN nM OR TIPE ALL'INFORHATIOI) Date i 0/fof
p h
City or Tovof 49V ..r,,.'� A To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street i Number) OZ. ' 1 do Cr,, Q /,, /gOR r✓
e
Owner or
Owner's Address C .r L'i ...r f q 1. / r iiv" L c —
Is this permit In conjunction vith a building permit: Yes ❑ No ❑/ (Check Alppropriate Box)
Purpose of Building Al R r ,(La /4hC,,.-, utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
New Service Amps / volts Overhead ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work Z1 4r /.. //
No. of Lighting Outlets
No. of Not Tubs
No. of Transformers TotAa
KV
No. of LightinjoFSxtures
SwimmingPool Above El grnIn-
rnd. d. ❑
Generators KVA
No. of Receptacle outlets
No. of Oil Burners
No. of Emergency Lighting
Battery Units
No. of Switch Outlets
No. of Can Burners
FIRE ALARMS No. of Zones
No. of Detection and
Initiating Devices
of Sounding Devices
No. of Self Contained
Detection/Sounding Devices
local❑ Municipal Connection []Other
No. of Ranges
g
Total
No. of Air Cond, tons
No. of Disposals
No. of Heats Tons Total Total
pumpsNo,
No. of Dishwashers
Space/Area Heating KW
No. of Dryers
Heating Devices KW
No. of Water Heaters 1,W
No. of o. o
signs Ballasts-
Low Vol
Wirin
No. Hydro Massage Tubs
No. of Motors Total HP
Ll
OTHER W FEB 0 2 2001
I
io
INSURANCE COVERACEs Pursuant to the reoulrements of Massachusetts Cenera
I have a current LlaDi St Insurance Policy including Completed Operations Coverage or i substantial
equivalent. YES 10 a I have submitted valid proof of same to this office. YES�O
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE �ND ❑ OTHER El, (Please Specify)
xp ration ace
" Estimated Value of Electrical Work S G o ed'' �- - -•
+' / At IP"I, Coe&./cticn
•Work to Start - /i G/ Inspection Date -Required: Rough Final
Signed under the penalties.of perjury;; _.
LIC. NO- Ali e y y
Licensee Signature 0Ll V 1-. LIC. NO.
Address A .i/oY AV.& Bus. Tel. No.
Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or Its sub-
stantial equivalent as required by Massachusetts Ceneral La vs, and that my signature on this permit
application waives this requirement. Owner Agent (Please check one)
Telephone No. PERMIT FEE S /06. OU '
Sfernn.re of r`.mrr or Agent
P
""ASSACHUSEa IS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or Type)
TOWN OF YARMOUTH, MA 02664 Date 911 $ dt�e Pe Imtit
Buliding.Loeation Z Aso. v.c,_,t,.1 t.... Q d. Owner's Name S U e o 1 je P/ 9 T
�,t % C/' S + Y, (- w �. ,�T L Type of Occupancy
New pr Renovation ❑ Replacement ❑ Plans Su ttte rY �]S9.fio
FDCfURES SEX 112000
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Installing Company Name Sherman Plumbing Services Corp Check one: Certificate
Address 24-3 Commonwealth Ave. PoSorporation 8 - C-
SuuM u,
❑ Partnership
Business Telephone ? 98- 2 9 ❑ Firm/Co.
Name of Ucensed Plumber
INSURANCE CO GE:
I have a current fifty insurance policy or Its substantial
Yes No ❑
equivalent which meets the requirements of MGL Ch. 142.
If you have checked ye;, please Indicate the type coverage by checking the appropriate box
A liability insurance policy ❑ Other type of Indemnity ❑ Bond ❑
OWNER'SANSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by
Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement
Check one:
Owner ❑ Agent ❑
1 hereby certify that all of the details and Information I have submitted (or entered) in above application are true and accurate to the best of my
knowledge and that all plumbing work and Installations performed under the permit issued for this application will be in compliance with all
pertinent provisions of the Massachusetts State Poumbing�CJpda and Chapter 14 tt��Pneral Laws.
Title Signature of LicensedPlumber
CiA/Town Type of License: Master [ .loumeyman ❑
I NL License Number 9T%5-�
Commonwealth of Massachusetts
Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
Official UseeOnly //�%
Permit No. 4-- D f —2 / Y
Occupancy and Fee Checked
[Rcv- 11/991 leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MECI 527 CMR 12.00
(PLE(SEPRINTININKORTYPEALLINIORMATION) Date:_ 08-28'-00
City or Town of: ttJEST y.4e/r/O!/TH To the Inspector of Wres:
By this application the undersign�rves noui uTi or tf ei'uuention to perform the electrical work described below.
Location (Street & Number)_ 1 --2 y.9d/e LJr L/ /�C OAD
Owner or -Tenant SYsrE&o voe/ ,*up _Vq.9i9i.-vG Cs N76POF[e4,eDTcicphonc Na
Owner's Address
Is this permit In conjunction with a building permit! Yes ❑ No ® (Check Appropriate BOX)
Purpose of Building Utility Authorization Na
Existing Service Amps / Volts Overhead ❑ Undgrd ❑ Na of Meters
New Service Amps / Volts Overhead ❑ Undgrd ❑ Na of Meters
Number of Feeders and Ampacity '
Location and Nature of Proposed Electrical Work: �?ae6A4.e i4:9e,wy- eeny .3Yd7$,vl
^--. '-1--- -1., _
Na of Recessed Fixtures .
nm
Na of Ccil.-Susp. (Paddle) Fans
a+oar rune ae lres.
No. o
Transfo { s V
Na of Lighting Outlets
Nabf Hot Tubs
Gencrato
A
. 1111
No. of Lighting Fixtures
Swimming Pool ovc ❑ n- ❑
cod. rnd.
o. o n rgc r
Battery its r IT
Na of Receptacle Outlets
Na of Oil Burners
FIRE AI:W1S Na of Zones
o. InD r ectitin2 Dc Devices
Na of Switches '
Na of Gas Burners
No. of Ranges
Na of Air Cond. Tons
No. of Alerting Daises
No. or Waste Disposers
cat ump
Totals:
um er
ons
o. o c - ontarnc
Detection/Alerting Devices
Na of Dishwashers
SpdcdArea Heating KW
A*"ccUNriiYe'r'YD5=
Local ❑ unicrpa ❑ Other
Connection
No. of Dryers
No. of ater
Heaters KW
Heating Appliances KW
ao as
SiEns Ballasts
or E uivalcnt
DarsNo. of Devices or E uivalcnt
No. Itydromassage Bathtubs
Na of Motors Total HP
c ccommunicalrons rung:
Na of Devices or E uivalcnt
OTHER
nuacn aaauronar aerarr y oeslrea. oras required by the Inspector of Mmrc
INSURANCE COVERAGE: Unless waived by the owner, no permit for Ue perfonmmce orelectrical work may issue unless
the licensee provides proof of liability Insurance including "completed operation" coverage or its substantial equivalent. The
undersigned certifies that such coverage is in fora, and has e.•dtibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:)
• ( pwuon te)
Estimated Value of Electrical Work: S 96ee7 00 (When required by municipal policy.)
Work to Start: 9 .2o—oo Inspections to be requested in accordance with NIEC Rule 10, and upon completion.
I certify, under the pains and penalties ofperjury, that the Information on this application is true and complete.
FIRM NAME: ADT Security Services 111 Morse Street, oryyood, MA 0 062 LIC. NO.: 1533C
Licensee: John S. Bassett Signature LIC. NO.: 1533C
(lfapplicabkenter tsenlpt-Inthe ficensenumber fineJ Bus. Tel. No.; 781-278-1131
Address: AIL TeL Nas 781-778-1725
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does nor have the liability insurance coverage normally
required by law. By my signature below, I hereby waive this requiremenL I am the (check one) ❑ owner ❑ owner's a ent.
OwnedAgent
Signature Telephone No. PERMIT FEE: $o0
P
-0/io.00
"1ASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
fPrint or Tvrnel
TOWN OF YARMOUTH, MA 02664
Date--? $ W ft Permit
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Installing Company Name_ Sherman Plumbing Services Corp. Check one: Certificate
Address 24.3 Commonwealth Ave. 26orporationSOOM e-
u,
MA UZ1554 ❑ Partnership
Business Telephone_ ? 96— 2 219 ❑ FlmVCo
Name of Licensed Plumber
INSURANCE CO GE.
I have acutyes eM ulty Insurance
c ra ce policy or Its substantial equivalent which meets the requirements of MGL Ch. 142.
If you have checked ye;. please indicate the type coverage by checking the appropriate box
A liability Insurance policy ❑ Other type of Indemnity ❑ Bond ❑
OWNER'SjNSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement
Check one:
Owner ❑ Agent ❑
I hereby certify that all of the details and Information I have submitted (or entered) In above apprication are true and accurate to the best of my
knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plumbina.Code and Chanter 1a9dthA rm.... h r .,.,.
Type of Ucense: Master Journeyman ❑
Ucense Number 9S%5�
c71 !!t (117mmunwM10 of Al"llar4imf o
1epartmfixt of Ilubi(c $afclg
SOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
t
Office Use Orly Permit No. I-- nI-c2L(�-
Occupancy A Fee Checked
wo (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed In accordance with the Massachusetts Electrical Code, 527 CMP 12: 0
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 3t 00
City or Town of ABMbJKti To the Inspector of Wires:
The udersigned applies for a permit to perform the electrical work described y,�1low.
Location (Street & Number) Ar, c%&14�.
Owner or Tenant '0\Ate1As iLPaLT6. P'.�
Owner's Address
.Sty-/O,Op
Is this permit in conjunction with a building permit: Yes No ❑ ' q ��O
`te+t A�praryrie(e 8etr1
Purpose of Building - M_%%i +- ris i e C4+c Utility Authorization No.
Existing Service 'Amps _/ Volts Overhead ❑ Undgmd ❑ No. of Meters
New Service 4 OO Amps-4-1 VJ ai7 yogy Overhead ❑ Un1dgmd [�' No. of Meters I_
Number of Feeders and Ampacity —L (000 KGt/w no par 4y Q
Location and Nature of Proposed Electrical Work t .l4 H� \a. let .y, Id" d,.+-. -
No- of Lighting Outlets
No. of Hot Tube
No. of ltensformsrs Tbial
KVA Q
No. Of Lighting Fixtures
Swimming Pod Above
gmd.
In•
❑ gmd. ❑
Generators KVA
No. of Receptacle outlets
I a.�
No. of Oil Burners r
No. of Emergency Lighting
Battery Units
No. of Switch Outlets
S 7
No. of Gas Burners -
-
FIRE ALARMS No. of Zones . �
No. of Rarges
No. of Air Cond. OW
No. of Detection and
to"I Z�
Initiating D"ces
No. of Disposals
No.of Heat lbtal Taw
Pumps Tbna
KW
No. of Sounding Devices
No. of Dishwashers
SPaca/Ms Heating
KW
No. of Sere Contained
DateetioNSounding Devices
No. of Dryers
Hosting Devices
KW
Local Municipal E5
❑ Connection CJOtMr
No. of Water Heaters 1
KW /
J
No. of No. of
Signs I Ballasts
Low Vonage
Wiring rJ%j Q44n...
No. Hydro Massage Tubs
ff
No. of Motors Total HP {p
nTHER.
�—
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or Its substantial equivalent YES )0 NO ❑ 1
have submitted valid proof of acme to the Oftles. checking the +Prropriau box. YES M NO O ifyou have checked YES, please Indicate the. type of coverage by
INSURANCE JU BOND O OTHER ❑ (Please Spttdty) Jannary 1, ?001
Estimated Valve EI00 Work i _ SDOJ.D O (Expirationn Dnata)
Work to Stan 0 Inspection Date Requested: Rough \\ �� Final \..lr(I C.o-+�Y
Signed under the Penalties of pgqury: .
FIRMNAME-/1J'yZD � nn}rinr 7 UC. NO. A1d4Q9
Ucensse r•1 inn F7pr}ri rr Tnr Igrutun "O C. NO. -All 4492
Address 17'11 f•ra1 S}rn } s . Bus.Tel No On RI 378_0474
g Aft. Tel No. PA 77C nw�rw
OWNER'S INSURANCE WAVER: I am aware that the Uceases doea not hew thdiirs covenge or its substantial equivalem as re -
(PIOUS by MassCheek one)
General Laws, and that rtry signature on this permit application walvss this requiremem. Owner Agent
(Pieties check one)
(Signature of Owner or Agent) Telephone No. PERMIT FEE S $ ayo 0-
11d565
P
Plans Submitted
TOWN OF YARMOUTH
APPLICATION FOR PERMIT TO DO PLUMBING
(OFFICE USE O LY)
BYAI tL�,-��J5
r c
Fee:
PERMIT NO.
Date
Building Owner's 1L4d`"". _ rZ3 1 S le+
AT: Location Name
Type of Occupancy Ri sr�t'17C 9-
New ❑ Renovation ❑� Replacement ❑
Yes ❑ No 2--�
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SUB-BSMT.
BASEMENT
1ST FLOOR
2ND FLOOR
3RD FLOOR
(PRINT OR TYPE)
Check One:
❑ Corp.
❑ Partnership
`' C3'FGm/C mpany
Business Telephone Name of Licensed PlumberT�L21 e�
INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent. Check One: Yes E?—No ❑
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance voerage required by Chapter 142 of
the Mass. General Laws, and that my signature on this permit application waives this requirement.
Check on Owner ❑ Agent ❑
Signature of Owner orOwners Agent
1 hereby certify that all of the details and Information 1 have submitted
(or entered)In above application are true and accurate to the best of
my knowledge and that all plumbing work and installations performed
under Permit Issued for this application will be In compliance with all
pertinent provisions of the Massachusetts State Plumbing Code and
Chapter 142 of the General Laws.
t
Signatu fticensed
Plumber
License Number
Type: Master 0---Joumeyman 0
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00
(OFFICE USE ONLY)
TOWN OF YARMOUTH By
Fee: $ c/
PERMRNO.___
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:
To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work
described below.
Location (Street & Number) b S 1 n nil DU Sit /Gl%1
Owner or Tenant A l EGOS},, 11ZhL 7B �/�a %y% 2� Telephone No.
Owner's Address G�5 L& �' rn 0
Is this permit in conjunction with a building permit? Ili Yes ❑ No (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No of Meters
New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampaciry
Location and Nature of Proposed electrical Work:
(�b• bb
Comolrtion o Nxfdlorulffg table br rvahisd by the Inspintor of Wirtt
No. of Recessed Fixtures
-NQ-.QECriI.-SuscJPaddIe) Fans
No. o Tot
Transformers KVA
7—
No. of Lighting Outlets - r
No. of Hot Tubs
Generators KVA
I .
No. of Lighting Fixtures
Arnd. ve In-
SwimmingPool ❑ rnd. ❑
No. of Emergency Ug Ling .
Battery Units
No. of Receptacle Outlets -
No. of Oil Burners -
FIRE ALARAIS
No. of Zones
No. of Switches
No. of Gas Burners
No. ot Detection an
Initiating Devices
No. of Ranges
Total
No. of Air Cond. Tons
No. of Alerting Devices
of Waste Disposers
Heat Pump
Torals:
Num r
Tons
—
KW
No. o Self-ContainedNo.
Detection/Alerting Devices
No, of Dishwashers -
Space/Area Heating KW
Municipal
Local ❑ Connection ❑ Other
of Dryers
ry
Heating Appliances KW
8 PP
uory yuems:
bCCNo. No. of Devices or Equipvalent
No. of Water
Heaters KW
No. of No. of
Signs Ballasts
Dara Wining:
No. of Devices or Equivalent
No. H dromzssa a Bathtubs
Y 8
No. of Motors Total HP
Te"Ni—.funicatiom Wiring: Z
No. of Devirn or E uivalent
Attach additional detail if desired, or ar required by the Inspector of Wine
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability
insurance including 'completed operation' coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof
of same to the permir issuing office.
CHECK ONE: INSURANCE ❑ ,a BOND❑ OTHERQ (Specify:)
g' I� �c� (Expiration Date)
Estimated Value of Electrical Work: tJ( rJa G� (When required by municipal policy.)
Work to Stan: Inspections to be requested in accordance with Iii Rule 10, and upon completion
I certify, under the Eains andipenal_ies of pet�ury, that the information on this application is true and complete.
FIRM
(If applicable,
OWNER'S INSURANCE WAIVER: I tan aware that the licensee does not
below, I hereby waive this requirement. I and the (check one) owner
Owner/Agent
NO.
LIC. NO.
Bus. Tel. No.:
Alt. Tel. Nci
A liability insurance Coverage normally required by law. By my signature
ownei s agent. ❑
Signature
(Rev. 041001
Telephone No.
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachuseas Electrical Code, (MEC), 527 ChIR 12.00
TOWN OF YARMOUTH
(OFFICE USE ONLY)
MA
Fee: $ Irr) •�D
PERMIT NO. C--0
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:
To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work
described below.
Location (Street & Number) L C ,YA ANiik)00 &k ii i-1—D
Owner or Tenant SN lephone No.
Owner's
Is this permit in conjunction with a building permit? ❑ Yes 0 No (Check Appropriate Box)
Purpose of BuildiinJg�� M`ZS— I 11 (- Utilit uthorization No. _
Existing Service Amps �/ Volts Overhead Undgrd ❑
No of Meters
New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity ? C /
1V Location and Nature of Proposed electrical Work: 0j V�K-fG �j. nT E S %6'.
Completion of The follminir table way k waned by the lsomrw of Irlims
No. of Recessed Fixtures
No- of Ccil.-SusplPaddle)
Fans
No. of Total
Transformers KVA
-
No. V Li htin L Outlets
No, of Hot Tubs
Generators KVA
No. okiRhring Fixtures
Above
swimming Pool gmd.
In-
❑ rnd. ❑
Na. of Emergen Lig ring
Ba trery Units r
No. of AFeptacle Outlers
No. of Oil Bum"Bum"t.,
FIRE ALARMS
o. of Zones
No. of Swi hes
No. of Gas Burner
No.no Detec
Iirlatin
an
n viers
NqA of 4ange
No. of Air Cond
Ton
Tons
No. of Aler
'ng evices
N . rice Du sers
cat Pump m
Toals:
Tons
KW
No. of Se -Contain
Detection/Alerting Devices
No. of Dishwashe
Space/Ana Heating
Local ❑ Conne cNion
❑ Other
. No. of Dryers
ry
Heating Appliances , KWScL
g PP
Systems:
No. of Devices or Equipvxlent
No. of Water
Heaters
No. of No. of
Signs Ballasts
Data Wiring:
No, of Devices or Equivalent
No. H dromassa a Bathtubs
Y 8
No. of Motors Total HP
Telecommunications W r rag:
N of ices s E n lent
ls
Attach additional detlhil ifdairrd, or at rrgnired by the InVertor of 1ltrzr.
INSURANCE COVERAGE: Unless waiv by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability
insurance including 'compltted oprnt 'coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof
of same to the permit issuing once.
CHECK ONE: INSURANCE �j BOND❑ OTHER.❑ (Specify:)
Estimated Value of Electrical Work: Oy � (Expiration Date)
(When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion.
I certify, trader the pains and penalties of perjury� that the information on th' a pli i ' eve and complete.
FIRDINADIE: SMNRtGU<�L CCYLtMUNtCIff1u ��Q, LIC.NO. GKCA^q r
Licensee: Signature LIC. NO.
(If applicable, enter "exempt in he life rise no leer ne. Bus. Tel. No.:
Address: 12212 �f { f /UtJI �1F(A. /t Alt. Tel. No.:
OWNER'S INSURANCE WAIVER I am aware that the licensee does not hale the liability insurance coverage normally required by law. By my signature
below, I hereby waive this requirement. I and the (check one) owner owner's agent.
Owner/Agent
Signature Telephone No.
IRrv. 04/001
r
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00
TOWN OF YARMOUTH
(OFFICE USE ONLY) .
By
Qb
Fee: $
PERMIT NO.
(PLEASE PRINT IN INK OR TYPE ALL INFORAIATION) Date:
To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work
described below. -7.
Location (Street & Number) Z 'F:`07- Z%
Owner or Tenant .4 h t e L- V S M 'F')T Telephone No.
Owner's
Is this permit in conjunction with a building permit?
Purpose of Building C
Existing Service
New Service
Number of Feeders and,
Ox
Yes ❑ No (Check Appropriate Box)
Utility Authorization No.
Amps / Volts Overhead ❑ Undgrd Cl No of Dieters
Amps I Volts Overhead ❑ Undgrd ❑ No. of Dieters
Location and Nature of Proposed electrical Work: (_Q W YLL,-r)Ab t _ -r ii e- I~M F o -A Ti F C a Lk A G u h) --r-
L� Gbit, PEXTE GS ANn I F_Y11405 GANJ.
CovrDktiaa af!!x foltatuinr table rear he uwised br t!x IaftMY01 of Wirti
No. of Recessed Fixtures
h1s2.12f Ccil.-Su5p,(Raddle) Fans
No. of Total
Transformers KVA
o. of Li6ting Outlets
No. of Hot Tubs
Generators KVA
No. of LightingFixtures
Above In-
Swimming Pool gird. ❑ d. m❑
No. of Emergency Ug ting
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALAIMS
No. of Zones
No. of Switches
No. of Gas Burners
No. ot Detection an
Initiating Devices
No. of Ranges
Total
No. of Air Cond. Tons
No. of Alerting Devices
No. of Waste Disposers
Heat Pump
Totals:
um r
Tons
—
KW
No. o Self -Contained
Detection/Aletting Devices
No. of Dishwashers
Space/Area Heating KW
Municipal
Local ❑ Connection ❑ Other
No. of Dryers
Heating Appliances KW
or Equipvilent y
No. of Devices
No. of Water
Heaters KW
No. of No. of
Signs Ballasts
UIr. Wiring: -
No. of Devices or Equivalent
No. H drommsa a Bathtubs
Y 8
No. of Motors Total HP
Telecommunications Wiring:
No. of Devices or E uivalent
- Attwb additional detail tfdafrrd, or at required by the Inspector of Wires.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability
insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof
of same to the permit issuing office.
CHECK ONE: INSURANCE BOND ❑ OTHER❑ (Specify)
(Espuation Due)
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: . I spections to be requested in accordance with MEC Rule 10, and upon completion.
I certify, under the pains and penalties of perjury, that the information on this application is true and complete.
FIRAI NAME: AA LIC. NO. ? S S3G
Licensee: �-? RED+c SAMI= Signature LiA LG LIC.NO. '3S-rS"SC-
(If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 4 1'1- 7 12 - 74 4 b
Address: t- 1i IALLRtSC�iAA 61 I'1( Alt. Tel. No.:
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the liability insurance coverage normally required by law. By my signature
below, I hereby waive this requirement. 1 and the (check one) owner owner's agent.
Owner/Agent
Signature Telephone No.
Iaer. o4ro03
4r Cgommonf=A4 of c4ffiussar4usetts #1079
TOWN OF YARMOUTH
In accordance with the Massachusetts State Building Cbde, Section 120.0, this
CERTIFICATE OF USE AND OCCUPANCY
Is issued to LOUIS KISH
c� (Qerfifq,thatlhaveinspectedthe PREMISES known as GOOSE HUMMOCK SHOP INC.
located at 2 IYANOUGH ROAD to the TOWN Of WEST YARMOUTH
Cbunry of BARNSTABLE Cbmmonwealth of Massachusetts. 7Ae building is hereby certified to be in compliance
with the Basic Code and for the purpose stated below.
USEGROUP M LIVE LOAD 150 LBS.
FIREGRADING 5B OCCUPANCYLOAD 4210 PERSONS
MARCH 1, 1993 y.�, G ?�
Dare Certgiaate lamed Building 011cial
The building official shall be notified of any changes in the above informariom
COMMONWEALTH OF MASSACHUSETTS
TOWN OF YARMOUTH
APPLICATION FOR USE AND OCCUPANCY
DATE: �� y
FEE $25.00
IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE,
SECTION 119.0. I HEREBY APPLY FOR A CERTIFICATE OF USE AND OCCUPANCY FOR THE
BELOW NAMED PREMISES, -LOCATED AT THE FOLLOWING ADDRESS:
NAME OF YOUR BUSI
STREET
PURPOSE FOR WHICH PREMISES IS USED
CERTIFICATE ISSUED TO, O '"S S
HOME ADDRESS:
SOUARE FOOTAGE TO BE OCCUPIED:
OWNER OF RECORD OF BUILDING:
NAME OF PRESENT HOLDER OF CERTIFICATE:
-% ,nl_ . _i_ 7 / .r .
u" (V TELE:
FT%
SISNATURE OF PERSON TO WHOM CERTIFILYSTE TITLE
IS ISSUED OR HIS AUTHORIZED AGENT 1 y 17 L
. wo&-t- DATE
050)e7OL Wr-jr�/�i�.seo« i /Jilf.[92.C, 77i-7/45'
PLEASE NOTE:
/?. APPLICATION FORM MUST BE.SUEMITTED FOR EACH BUILDING OR STRL'-TORE OR
PART THEREOF TO BE CERTIFIED.
2?. AFFLICATION AND FEE MUST BE=ECEIVED BEFORE THE CERTIFICATE DILL BE
ISSUED.
�). THE BUILDING OFFICAL SHALL SE NOTIFIED WITHIN TEN (10) DAYS Z:F ANY
CHANGE IN THE ABOVE INFORMATION.
CERTIFICATE NUMBER
r
U G M
FG
i
��cs�"sf �rr�-�.•--a aJ
cZhe hlommoufuealth of Mttsonhusetto #737
TOWN OF YARMOUTH
In accordance with the Massachusetts State Budding Cbde, Section 120.0. this
CERTIFICATE OF USE AND OCCUPANCY *1
Is issued to DUNHAM SHOE COMPANY
,3 (geiflfgt,thatlhaveinspectedthe PREMISES knownasDUNHAM SHOE COMPANY
locatedat- 2 Tyanough Road in the Town of West Yarmouth
CWnty of Barnstable Commonwealth of Massachusetts. ?he budding is hereby certified to be in compliance
with the Basic Code and for the purpose stated below.
USE GROUP M LIVE LOAD - - 100 lbs .
FIRE GRADING --. 4 -B OCCUPANCY LOAD 420 Vapple
August 11, 1988
Date Certilunte issued eutiilrt; Olftcid
The budding official shall be notified of any changes in the above information.
c
U
CITY/TOWN OF YARMOUTi
owjpl(wikl(*MEO• .ti a ••• w
DO
( ) FEE REQUIRED $Ow
IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE, SECTICN
108.15, I HEREBY APPLY FOR A CERTIFICATE OF USE AND OCCUPANCY FOR THE BELOW NAMED
PREhIISES, LOCATED AT THE FOLLOWING ADDRESS:
NAME OF PREMISES paAo1!/6r49 .57/!z-7e GO"Fd h/Y
STREET AND 1114M 2 ` /%d NOu6:/i /�D . J�%� �,f,�J• Y/yRt7oo#
I Ma. �9 •: 7altalY aa•. 10t40.1 30,: 4 lips'Jha�l `I a. :f HY.lal; !•�/alCwla
E: �. r: N i!•1V: C N f
LICENSE OR PERMLT
N
//I/+•�crV ...� 1Ll.H //1/ /
p0 Sy.177
r• I • •'1aCla • Yal• • Mal• • Y• �
OF AGENT, IF
C r. •r • • al'.: • / • I • •gal •/
1'}1 • • 11. .1. •••• AP- ljryl raCold
PLEASE NOTE:
1.) APPLICATICN'FURM MUST BE SUBMITTED FOR EACH BUILDING OR STRUCTURE OR PART
THEREOF TO BE CERTIFIED.
2.) APPLICATION AND FEE MUST BE RECEIVED BEFORE THE CERTIFICATE WILL BE ISSUED.
3.) THE BUILDING OF'FICAL SHALL BE NOTIFIED WITHIN TEN (10) DAYS OF ANY CHANGE IN
THE ABOVE INFORMATION.
«a•• • v 0 0
�11 fag
UG M
FG ►� 6. D .L: 1 l o
GI dle Tomm ilwealt of ttssttrllu5efftt
Etpartmwt of ilublir Eafell
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
r
Office Use only
Permit No. "
Occupancy d Fee Checked '
L
(leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 1 00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 1
City or Town of -----)!A To the Inspector of Wires:
The udersigned applies for a permit to perform the electrical work described below.
Location (Street & Number)
Owner or Tenant a"\.okA"'of
Owner's Address s (e p
Is this permit in conjunction with a building permit. Yes ❑ No L_I (Check Appropriate Box)
Purpose of Building AQ;LP I: , Dd—MQ1T Utility Authorization No.
Existing Service LITS' 'Amps ovf �77yolts Overhead ❑ Undgmd Q�No. of Meters
New Service Amps _J volts Overhead ❑ Undgmd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
Na. of Lighting Outlets
No. of Hot Nibs `
No. of 4snefonnars Total
KVA
No. of Lighting Flxtursa
Swimming Pool Above
❑ ❑
gmd.
Generators KVA
No. of Receptacle outlets
No. of Oil Sumers *
No. of Emergency Lighting
Battery Units
No. of Switch Outlets
No. of Gas Bunters fit!
FIRE ALARMS No. of Zones
No. of Ranges
No. of Alr Cond. Total
No. of Detection and
tone
Initialing Devices
No. of Disposals
No.of Heat Total
Pumps lone
No. of Sounding Devices
No. of Olehweshers
Space/Arsa Heating
MKW
No. of Solt Contained
Dstection/Sounding DMus
No. of DryersHeatlng
DMces
Local Municipal
❑ConnectionNo.
of Water Heaton KW
of No. ofLow
Signs BallastsWiring14
Voltallo.
Da
No. Hydro Massage 11rbs
No. of Motors Total HP
t
OTHER:
l Iro
/ INSURANCE COVERAGE Pursuant to the requirements of Massachusetts general Laws r�7
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equNalent YES 10 NO ❑ 1
have submitted valid proof of same to the Otto, YES i] NO ❑ It you have checked YES, Pismo Indicate the type of coverage by
O Checking the appropriate box.
`INSURANCE X] BOND ❑ OTHER ❑ (Please Specify) January 1 2002
Estimated Value of cal Work S �tlil (� (1f'1 1/ (Expiration Date)
M Work to Stan Inspection Date Requested: Rough _LA 1.L_ Final W'T
Signed under the Penalties of perjury: 1
FIRM NAME
UC.NO. A144o7
Licensee_ r71 Ynn F1 F+r•t ri r r Tn r Signaturs C. NO. A 1 449
ress t 7 rant q Bus. Tel No
Add
gt r,ri11g AltTi u tcn8 M R4
OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have thfuzzaae coverage or its substantial
g g equivalent as re-
quired by Massachusetts General Laws, and that
(Please Cheek one) my signature on this permit application wahroa this requirement. Owner Agent
(Signature of Owner or Agent)Telephone No. I PERMIT FEE S a1 a0ock
x4se5
Ville TommunwralO of fifusnr4usetfs
Erpartment of llubffr $afftg
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
otnca use ony
Permit No. "
Occupanry &Fee Checked
L
(leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 1 00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date aIn I
City or Town of iARAtr To the Inspector of Wires:
The udersigned applies for a permit to perform the electrical work described below.
Location (Street & Number) — , 1 y Ar` .,,,,tSi.% ';�Ol
Owner or Tenant
Owner's Address
Is this permit In conjunction wit a building LI (Check Appropriate Box)
M g permit: Yes ❑ Na
Purpose of Building—alklae : eUtility Authorization No.
Existing Service tAo'o 'Amps _& ��17 volts Overhead ❑ Undgmd Q� No. of Meters �_
New Service Amps _J Volts Overhead ❑ Undgmd ElNo. of Meters
Number of Feeders and Ampaciry
Location and Nature of Proposed Electrical Work
No. of Lighting Outlets
No. of Hot Tube
Na. d 7tanefor Total
KVA
No. of Ughting Fixtures
Swimming Pod Above In•
❑ ❑
grind. grind.
Generators KVA
No. of Reosplecle Outlets
No. of Off Burners r
No. of Emergency Lighting
Bahery Unite
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS No. of Zones
Na. of Ranges
No. of Air Cond. Tom
Na. of Detection and
tons
Initiating Devkbs
No. of Disposals
No.d Heat Total Total
Pumps lbna KW
No. of Sounding Devices
No. of Dishwashers
Space/Area HeatingNo.
KW
of Salt Contained
0etecdoNSounding Devices
No, of Dryers
Heating Devices KW
Local Municipal
❑ Connection her
No. of Water Heaters KW
No. of No. at
Signs
Lay Volta
Ballasrs
Wiring
No. Hydro Massage lUbs
No. of Motors Total HP
OTHER --
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws
I have a Current Liability Insurance Polity Including Completed Operations Coverage or its substantial equivalent YES 10 NO ❑ 1
have submitted valid proof of same to the Office. YES Y1 NO ❑ If you have checked YES, please Indicate the type of coverage by
checldng the appropriate box.
INSURANCE b BOND ❑ OTHER ❑❑ (pleas@Specify) January 1 2002
Estimated Valued cal Work S S `"Z(') On fkpirstwn Date)
Work to Start Inspection Data Requested: Rough —L_ Final�_
Signed under the Penalties of per)ury:
FIRM NAME
UC. NO. A144Q7
Licensesr•l �nn Floc+ri r Tn Signature C. NO. .A1 4497
Address Bus. Tel. No. i RnA) 77A—n474
AIL Tel. No. I 5nR 1 97R nd7d
OWNER'S INSURANCE WANER: I am aware that the Licenses does not have th&QZ133e coverage or its substantial equivalent as re-
quired by Massachusetts. General Laws, and that my signature on this parmit application waives this requirement. Owner Agent
(Please check one)
Telephone No. PERMIT FEE: �°
� �0w
(Signature ofOwner or Agent)
x-6665
W=2015 SlipGen- Portal Home
Town of Yarmouth
Template [Building Dept]
Slipsheet Identifier [sg348721
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
t JAaserlkhe1M1pGed 1/1