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0381 CAMP STREET
�l j� �%i7��� 'r� }+ - I jj/6i r � A a• � ' �, i1 y •x � 3.. i��- �' fir. UAI Lui l, 711 5 9 _ J Town of Barnstable Building Department Brian Florence, CB Building Commissioner 200 Main Street,Hyannis,MA 02601 .www.town bamsfable.ma-os Pre-application for Business Certificate Date Map Parcel Applicant Information Applicants Adriress. C'C,T/Js ��i Email Address /• - TelephoneNmnber Listed UasEed ❑ Business Information New Business? -----------------=--- -------------- Yes No Business is aregistered corporation? ------------------------- No If yes Name of Corporation Does business operate under the registered corporate name? � . .No Is the business a sole proprietorship or home occupation? _--___-_- Yes No if yes then a Home Occupation Registration is required-See Building Division Staff AZName ofBusiness � Business Address or Type of Business aZ�= �� 3 . Bu ildmg Commissioner Office Use Only Conditions Building Commissioner Date. Clerk Office Use Only Town of Barnstable Building Department Brian Florence, CB 0 Building Commissioner 200 Main Street,Hyannis,MA 02601 .www.town.bamstable.ma.as '. . Pre-application for Business Certificate, Date Map Parcel Applicant Information liceats Name ( l �/ �19 6�fi 1�C �bGz (,'�CS �� �/� !4PP. _...__. . ..... _. ApplkantsAddress, V ie �/✓ �J � Email Address . 15,2&21�CC'G TelephoneNunbea Listed 0� Unlisted ❑ Business Information New Business? -------------------------------------- __ Yes No Business is a registered corporation? --------------------- Yes No If yes Name of Corporation l Ya y d7 CIO —Z 29e_, Does business operate under the registered corporate name? No Is the business a sole proprietorship or home occupation? _________ Yes No If yes then a Home Occupation Registration is reqatred(—See Building Division Staff Name ofBusiness ��2U y12 .L��T� ��' , L/��CL liQ/ Business Address , 3 Type of Business Building Commissioner Office Use Only Conditions Building Commissioner Date Clerk Office Use Only I Anderson, Robin From: Anderson, Robin Sent: Friday, June 15, 2018 9:02 AM To: Florence, Brian Subject: RE: 381 Camp St. Brian, In regards to your request for background information concerning the site at 381 Camp St: There were 2 joint site plan review projects involving Yarmouth,the Camp St gas station and CCH. I'm sure Ellen's SPR records reflect this but my recollection is that Tom deferred the Camp St renovation to Yarmouth but withheld the jurisdiction over signage as a that time there was an effort to re-configure Yarmouth Rd for airport and traffic improvements. People were complaining about the unsightly signage on the main access off the highway into Hyannis. Jim Brandolini and Tom Perry agreed to divide the review and responsibilities as I stated above because the building is bisected by the town line. With regards to the signage: A sign permit was issued on 11/25/17 for a re-face of a 40 sq.freestanding sign, 15.8 on the canopy and misc.existing signage—not to exceed 78 sq.for the entire site.Permit# 17-1634.FYI:The freestanding sign was reduced from the original sq.ft. Our file also includes: Permit 20070105 issued 11/16/2007 to replace existing freestanding w/49 sq.sq.ft.changeable/reducing height and earlier permit from 2004(issued by Dave Mateos,local inspector)for three signs totaling 79 sq.ft. Included in the file is Permit#12339(4/24, 1969)for the construction of a block building and outlining an agreement between the property owner and Barnstable concerning a conveyance of land for roadway purposes. It speaks of tanks locations in Yarmouth,restricts the 2nd hand sales of automobiles,and addresses design(Colonial)and location of the free standing sign.This document is signed by three Barnstable selectmen. At the end of the day,there is no agreement to.my knowledge to defer jurisdiction to any other authority in perpetuity for this location or any other. The agreement was per project and this-is why there were joint SPR meetings concerning the Camp St and the CCH project. I hope this information satisfies your request but if not I will need a little more time to research it. Please advise. Robin From: Florence, Brian Sent: Thursday, June 14, 2018 11:55 AM To: 'Grylls, Mark' - Cc: Jay Talerman (jay@mtclawyers.com); Brandolini, Jim; Anderson, Robin Subject: RE: 381 Cam St. P Hi Mark, Thanks for the email,that helps: Looking into it today... back to you today or tomorrow. -Brian . Brian Florence, Building Commissioner Building Department I Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4038 Brian.forence@town.barnstable.ma.us From: Grylls, Mark [mailto:mgrylis@yarmouth.ma.us] Sent: Wednesday, June 13, 2018 4:14 PM 1 I nce, Brian To:�Iore Cc: Jay Talerman (jay@mtclawyers.com); Brandolini, Jim Subject: 381 Camp St. Hi Brian, We spoke last night regarding permitting at the gas station on Willow/Camp St. The initial reason for my call is,that over the years,Tom Perry has deferred all permitting to the Town of Yarmouth as the portion of the building that is located in Yarmouth is in a residential zoning district which is more restrictive. He used this approach in his decision making process. While speaking with Jay Talerman,Town Counsel it was suggested that I search for any prior relief. I am not sure why I had not thought of that. The history of the gas station started in 1965 when Munroe Construction Co.filed for a Variance with the Town of Yarmouth ZBA with Petition#761.Variance denied. In 1967, the petitioner filed in Barnstable Superior Court, Docket#29000 wherein James L.Vallely,Justice,.Superior Court, remanded the matter back to the Yarmouth ZBA. With petition#818,the variance was granted to construct the gas station in question. There have also been four other petitions filed with the Yarmouth ZBA at different times for other matters. Based on these facts, my opinion, although I am not an attorney is that all permits for this particular property should be filed with the Town of Yarmouth Building Department as the'gas station would not have existed at all if not for the variance granted by the Town of Yarmouth ZBA. I believe that if any sign permits for LED pump toppers and additional signage have been issued by the Barnstable Building Dept.that they have been issued in error. I am not certain how to proceed if the aforementioned permits have been issued b the Barnstable Building Dept. Y g pt I am trying to identify the applicant as I think it is the same person who has filed for the required relief to install similar signage in question at the Mobil on Station Ave.Yarmouth. She had applied for the same relief and signage at another property in Yarmouth and was denied. I welcome your input regarding moving forward and look forward to your response. Talk soon, Mark e MARK GRYLLS DIRECTOR OF INSPECTIONAL SERVICES/ BUILDING COMMISSIONER TOWN OF YARMOUTH (508) 398-2231 x 1260 ' . Town of Barnstable ,,-,," ,, .; Building�..Ai,., *rnaw., .- ..• •,n ` „v.v :`. a�.:, ..^^.a Si;..s. a� ,, �. Rostr'fhis.Card So T,hat.�t is Visfb�e Fro,Knrthe,5tree �ApPrgyilm ans Must,be Retained on Job analti Card._Must be'Kept s r '"" Posted Until'Finalµlnsection'H s Been`Made. �`' 3?` �} .}ry t $t ,. '"` • . , .,, gas':• ,�� u .,�,,- 4 Y.4n gv7u:,� �s ert�fieate ofuOccupancy is R qulred,such:'Bwildin shall Not:be Occu ied„until a,;Final-Inspectionhasbeen made ru. Permit i p Permit No. 13-174634 Applicant Name A IMAD ENTERPRISES LLC Approvals Date Issued:. 65/25/2017 Current Use: Structure Permit.Type: 'Building-Sign Expiration Date:' 11/25/2017 Foundation: Location: 381 CAMP STREET(YARMOUTH), HYANNIS Map/Lot 345 009 Zoning District: B Sheathing: Owner on Record: JJ IMAD ENTERPRISES LLC sR �5� xContracto Name: Framing: 1 Address: eta g '' ' . ' Contractor License 2 381 CAMP STREET WEST YARMOUTH, MA 02673 � , . Est Project Cost: $0.00 Chimney: =Pe: Description: 78 sq ft signage 5 ermit�Fe $200.00 Insulation: r Fee Paid:` $200.00 40 sq freestand reface F �. or Final: 15.8 sq new on canopy &mist exisitng. Total site not exceed 78 sq Date 5/25/2017 Freestand proposal is reduction in sq ft 7.. 0A f Plumbing/Gas' Project Review Req: 78 sq ft signageR Rough Plumbing , f �� g Zoning Enforcement Officer Final Plumbing: 40 sq freestand reface # a g: 15.8 sq new on canopy &mist exisitng Total site not exceed Rou h Gas: 78 sq. r g � - _ Freestand ro osal is reduction ins ft I Final Gas: P P q t. This permit shall be deemed abandoned and invalid unless the work authorised by this permit is commenced within siz:months'aftessuance. All work authorized by this permit shall conform to the approved application and theapproved construction documents for which this permit has been granted. Electrical All construction,alterations and changes of use of any building and stuctures shall be in comprancewrth the local zoning by lavrs'and codes. Service: This permit shall be displayed in a location clearly visible from access street road and shall b maintame [open for�publ oric.inspection for the entire duration of the work until the completion of the same. Rough: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Final: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Low Voltage Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Final' 4.Wiring&Plumbing Inspections to be completed prior to.Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Health 6.Insulation 7.Final Inspection before Occupancy Final: F' a Where a:pplitable'sepa_rate permits are required for Electrical,Plumbing,and Mechanical Installations. it _.Department . Workshall not proceed until the Inspector has approved the various stages of construction Final: Persons-contracting with unregistered contractors do not have access to the guaranty fund" (as set forth'in MGL c.142A). y j i =1 s { dF�rqk, Town of Barnstable Regulatory Services . 1 BARNSTABIS, MASS. *' Richard V. Scali,Interim Director 1 'D o A`0$ Building Division.. / Tom Perry, Building Commissioner ( -200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit# Building Official approving J Application for Sign Permit Applicant:— -------_�-----__ _--Assessors No,_3ys DO 9 Doing Business As: �___—___--___--�---_--�-Telephone No. ____-- _ Sign Location Street/Road: -_ �Lf��-M�_-5T-------- Zoning District: Old Kings HighwayP : Yes/No Hyannis Historic District? Ye Property Owner \Tame: _T A D P /SrS_Telephone:___�_�_ Address:--_—�_I —0a6r7 3 Sign Contractoru d7� 8D bty� c Name: �L;SLGNS----�---------=---Telephone: y37_aoo .. Marlin Address: // Goc o t�u�c= .)3��" � v6 /✓ jVl/ o �__ g Y1Y�--------------D-e-sc-r—ipt-io-n--. ------------- Please follow the cover directions.You must have an accurate rendition of sigh with,dimensions and O location. Is the sign to be electrified? I'e To : (!\rote:Ifyes,a pvmngpenrutisrequired) Width of building face; S 7 fk x 10 5 74 x.10- S Z q Check one Reface existing sign New Total Sq.Ft of proposed sign(S) lCt;PIACIA/Co f;!?o . s/��►/ _ cegN0Py -origL ok St�tvs. Ifyou ha ve addivonal signs please'attach a sheethsting each one u th dimensions, If refacing an existing sign please provide a picture of the existing sign with dimensions. ' I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information.is correct and that the use and construction shall conform to the provisions of §240-59 through 040-89.of the Town of Barnstable Zoning_Ordinance: w Signature of Owner/Authorized Agent:_^ 1x' Gl 1. Date 1�7TA-0/57) IYAR17147i441 ,-,-, ' SIGNS/SIGNREQU - revisedl'10413 x r To whom it may concem: This letter authorizes Indaba Holdings, dba NH Signs of 66 Gold Ledge Ave.,Auburn NH to act as an authorized zed agent for Property owner of � Q�f/� With respect to the submission of applications.for sign permits, Sign waiver requests, variances or other permit related documents to the Town/City of As an authorized agent of the owner, NH Signs is allowed to sign and submit all forms necessary for the aforementioned application. Date: o? / " Regards, Signature The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 �•J� www.mass.gov/dia lVorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERtitITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual): r^N�� �� �QLPIA/ 5 b gd IN S,16{IT Address: to GDC 0 4. �4t. A t,Pc' City/State/Zip: ,) vByl?TF N 11 03'93 Phone#: Are you an employer?Check the appropriate box: Type of project(required): I am a employer with employees(full and/or part-time).* 7. New construction . 2❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 3❑1 am a homeowner doing all work myself.[No workers'comp.insurance required.)t - 9. El Demolition 4.a I am a homeowner and will be hiring contractors to conduct all work on m roe I will 10�.Building addition Y P P rty• ensure that all contractors either have workers'compensation insurance or are sole I I n L Electrical repairs or additions proprietors with no employees. 5C] 12.�Plumbing repairs:or additions[am a general contractor and I have hired the sub-contractors listed on the attached sheet.. These sub-contractors have employees and have workers'comp..insurance.:. 130 Roof repairs 6.]We are a corporation and its officers have exercised their right of exemption per MGL c. + 14%P. Other S/6 AA-V 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and slate whether or not those_ entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that Is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self--ins.Lic. /off�I 71 3 9 —A Expiration Date: Job Site Address: C�rYI,In T City/State/Ztp /a?NS/ Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereb nder the ins and penalties of perjury that the information provided above is true and correct Si nature- I N� M�G�r�/' s- /L 7 Date: Phone#: Official use only. Do not write in this area,'to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk. 4.Electrical Inspector 5.Plumbing Inspector: 6.Other Contact Person: Phone#: t ® • Issue Date:Ian 03,2017 Sigma-One This certificate is issued as a matter of information only A Workers'Coro pensation Trust and confers no rights upon the certificate holder.. T'he Granite.State\Yorker;'Conipensation Nlanuhcturcrs Trust PO Box 1387 This certificate does not amend,extend or alter Concord,NH 03301-1357 the coverage afforded by the policies below. Certificate Holder Certificate of Insurance Companies Affording Coverage Peter March Indaba Holdings,Inc dba NH Signs Company Granite State Workers'Comp Mfr.Trust Letter A 66 Gold Ledge Avenue Auburn,NH 03032 Company Safety National Letter B This policy is effective at 12:00 am on 1/1/2017. ,and will.expire at 1201 am on 1/1/2018 This policy will automatically be renewed unless notified by either.party by October 1st of any fund year. Coverages This is to certify that the Workers'Compensation and Employer's Liability Insurance has been issued to the insured named above for the policy period indicated,not withstanding any requirement,term or condition of any contract or other document with respect to which this certificate may be issued or may pertain,the insurance afforded by the policies described herein is subject to all the terms,exclusions and conditions of such policies. Type of Insurance/Carrier Policy Number Effective Date Expiration Date LIMITS A:Workers'Compensation &Employer's Liability EL Each Accident $1,000,000 Granite State Workers'Comp Mfr.Tr WC0120171000392 1/1/2017 1/1/2018 E.L.Disease-Pol Limit $1,000,000 EL.Disease-Each Emp $1,000,000. B:Excess Insurance Workers'Compensation Statutory Employer's Liability $1,000,000 Safety National SP4055878 1/1/2017 1/1/2018 Description of Operations ✓® officers Excluded March,Peter C March,Noeleen A Member - Cancellation Peter March.' Should an of the above desa ibed policies be Indaba Holdings,Inc dba NH Signs cancelled before the expiration.date thereof,the 66 Gold Ledge Avenue issuing company will endeavor to mail 30 days Auburn,NH 03032 written notice to the certificate holder named to the:left,but failure to mail such notice shall impose no obligation or liability of any kind upon i, the company,its agents or representatives. Administered by: - WE Com -SIGMA Ltd. an 03 2017 VIAWDp I , Authorized Representative Date o � ' e� ° -in MEE JUP .- 1114 ... ... s 51,' X. 8'Monument with. Base ... f.,.' .. •.__.....�...,-..,�:..___.__..�T---.- ..,.._..^-._._._.,.v.,...._ _ __._,......._:..._.. ..�.�.�........._........_���.. -_—REVISION NOTES BY I ®rtw,ac v[e ivvunv DESIGN s MANUFACTURE-INSTALL•SERVICE CLIENT.Energy North - cmwy«va.rm^�• 1 - nhsignseomn 603.437.1200 i LocenoN:weltyarmDDih ENERGY Igns 66 Gold ledge Avenue,Auburn,NH 03032 DATE:05 10 17 xo rn a 3 `L +uc[n+[ FAN60143ZI222 �OESC�NlA Bo�,routitnm - - _ ACC[av: 6Y Dw ! /is .. .. SWYlYa7fmmk e�asa.r-mv yaeaaa.� oumu wtm+¢ ammm, mr�rtautemt�a: 4T'3RD O Ms a ft.rt,au eras " acro� mArvad. a a3 a 'w-+.�.�--mmr..n. .. .. .. Ors [avr�®rmauvrwssB�ussoseraaa - y f F �1 `I °._ M �'b I. 01 r-804.7S°--i SAY ON - NEW SIGN LOCATION-ILLUSTRATED TO APPROXIMATE SCALE TO PHOTO 5' X 8' Monument with Base 1.5 EXISTING CONDITIONS i �„erw„�„�.,o<.,nerd REVISION NOTES DY -OMONISM Amnas tUVIUa VA.DUALAUD DESIGN.-MANUFACTURE°INSTALL-SERVICE CLIENT: ENERGY NORTH lsnon7 3R "f°01Afa ^'""°`°»..3: ® nhsigns,com- 603.437.1200 LOCATION WEST YARMOUTH ENERGY 2_ C3'RAS,CAMXsoA; �.;, ' ns ,..,y aC]mui DDAvwc 66 Gold Ledge Avenue, Auburn,NH 03032 DATE 042117 3 . ruaS moeurnaq s1An+Sw FAX 603.437.1222 DESIGNER CFC ® BlOE9rdlAPiRDVFD uy,ranawmiganmD�aioouwaaru _ ACCT.REI CAN MCNIRS. BY-DATE 1 117 ldauu r105ClffbDlG1„°imRiNUU3 1 s 1 - Canopy D &A Canopy D &A j r. h i e 3*!- ..Canopy C Canopy C Existing Conditions New Canopy Graphics with Mobil:Logo 1� • � • R � � a; . y I y. n B' 1 ~� - REVISION NOTES BY 4 ®ua3Ea1Po37ArtaN DESIGN-MANUFACTURE"INSTALL-SERVICE 1 CLIENT..Energy North IosTon 1R aowuo lnntlaafnfticutle LOW 2 1 stlfmxEEatarol tb"9,, , '��� nhsigns,cotn= 603.437.7200 I i o�1, .... .� 66 Gold Ledge Avenue, Auburn,NH 03032 DATE:011717 B t .�"mn—•�. ®rtYflnfoOU[Tax 1 DESIGNEWA ODESI6NAPPRM oamnwrrouwaf. FA%603.437.1I22 1 SItlIf/7!3 �•.� w19011arilalXlaYlaGRatl,lLLpgrtWa6K13t .ACCT.REP .. Ay-am ! !1a .. .... � ,••,,,• .•,•�'�,„,",mmxwnm- .1 ,dsrw r mmwirt .-•. . NHSIG-2 : . OP ID: NB CERTIFICATE OF LIABILITY INSURANCE DATE,MM!°°IYYYY, 01/17/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CN°alwE qT Michael Kimball Planright Insurance-Salem PHO� 603-890-6439FAX 224 Main Street Suite 2A c o ran: Arc No):603-890-6521 Salem,NH 03079 E-MAIL Michael Kimball ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC 0 INSURER A:Concord Group 20672 INSURED NH Signs INSURERB: . Indaba Holdings Inc. INSURERC: 66 Gold Ledge Ave Auburn, NH 03032 INSURERD: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AUUL LTR TYPE OF INSURANCEINSD POLICY NUMBER MMIDDNYF MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,006,000 DAMAGE TO RENTED CLAIMS-MADE ❑X OCCUR 20029184 10/05/2016 10/05/2017 PREMISES Ea occurrence $ 100,000 20031851 10/05/2016 10/05/2017 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY a PRO- JECT LOC PRODUCTS•COMPIOPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 A ANY AUTO 20628729 10/05/2016 10/05/2017 BODILY INJURY(Per person) $ ALL AUTOS OWNED X SA�OSULED BODILY INJURY(Per accident) $ X HIRED AUTOS X NON•OWNED PROPERTY DAMAGE AUTOS Per accident $ $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS Line XCLAIMS-MADE 20031850 10/05/2016 10/05/2017 AGGREGATE $ 2,000,000 DIED I X I RETENTION$ ` 10000 $ WORKERS COMPENSATION' PE O H• AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIErORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Property 20029184 10105/2016 10/05/2017 building 400,000 BPP 93,000 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached it more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN i For Information Only ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014l01) The ACORD name and logo are registered marks of ACORD ' ,�� �,/� � / �J . : . � � - _ z - !- � ` - � �:% x .�-� � � �� �. ._ ,. ,, � . . , . ,. + ;r�_e.. w�, .. .. ...�� *�y _T __ _. ,., �: � _ .ice. � .��.."_�.��+d _ ... 4 r:,# ,. bC{a• _.. _ � �' � �����f' I 3� �� u �, � Nam, X � � � � � � ,� il} _�. .`Zi 4 � .. ... y,1Gr� �_. e�,.� .r, ,,, �.�}� .t,�,�^ � ..-1�� �r . ... .. ��� ���_ .r VA I MG. y f .. 3A•hmh tm�et MDlu SoortWD4g!.t, �•� � � � system to meet A4oDD;petlfRdtian Window YI�11 .. I...' :. r•".'. - � .... •� _ �:. �+ron�YVrfl��«mh e'•AJI�11� �w'¢tl IG@ aii a+J 4(il 1./17ai+ti.D](i•mbl • � ,:L,n• "°td:\ / \- � certr.o inyr ae.ert ymw;.i� m i-J�H�t>[.l:Hi n'ii.u,ie.r•�7a•ev , _ � / -'^�.. •YM/. tmJ n.yp.# a1J ni nlq �.bpa•lYrik•esfY� mule 23.43"X 52" 1,921 SQ.IN. 1144=13.35 SO.Ft syscom Derails 3D lUgminated Fasela System -uti IUMMINATED tANOPr LERERS UUMINATED-CANOPif SMPES �n -- 6� loll T ®�-OilAtollbm, I LL CAt�bR,Y�' + u i i I I ►� ,, ��` I��a� �:f «, fit �Y'"�rx �� 7,1 z3 i r.:.ZJ' ;F JjJ Mil ..-- "o-« I — t> - _ ..An II� ? 6Cr; t a Sav-On Gas sign Inventory Current: Name H . W Sq Ft Main ID 85 84 50 - Lube and oiL 9 96 6 Brakes and Service 9 96 6 State Insp. Gemini 9 96 6 ...Enjoy Drive 36 57 14 Mechanic on Duty 18 34 4 Inspection- lawn 32 36 8 Wall various 14 _24 12 Canopy 36 36 18 current 124 http://ecode360.com/6557833 Barnstable Code Allowed 79 sq ft Recommended H W Sg Ft Main ID 60 96 40 Canopy-2 sets 15.8 Dispensers, Waves etc- not incl 0 0 0 Inspection- not counted 32 36 0 Lube and oil 9 - 96 6 Brakes and Service 9 96 6 State Insp.Gemini 9 96 6 Mechanic on Duty 18 34 4 Inspection- lawn 32 36 0 proposed 78 . oFt► , Town of Barnstable Regulatory Services I ' BARMSTAB[E, ' Richard V.Scali,Interim Director Building Division. Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.towmbarnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit# Building Official approving------------ J pt y Nj Fl b Application for Sign Permit Applicant:—SO __ _`—_Assessors No:_ 'y��o0 9 Doing Business As: Jh l_VAI_G A 5 --- -Telephone 1'0._3--$"-7 Sign Location Y --- - -- -- - - - Street/Road: Zoning District: Old Kings Highway? Yes/No Hyannis Historic District? . Ye o Property Owner li —TJ'-rfI A D j rtT�CR15 b NTame:_ ------ --- - -- Telephone:__--------- Address:_--_—__ a f7 Sign Contractor \Tame:--- G1�S &03,QA /� (03' / N N__SI_— —_ __-Telephone: 37" o�t?O Mailing Address:_6& G©(0_Lc3 D&C F_13 JL� )1 c,-3C-WT1✓ jV// O�_2� Description Please follow the cover directions.You must have an accurate rendition of sign with dimensions and location. Is the sign to be electrified? Ye To (Note.-II•yes,a Fvir gperrmtis required)- Width of building face fb x 10- J`J4 x.10 Check one Reface existing sign New. Total Sq.Ft of proposed sign'(s) /p '' ��pt,r}et,�/� �Rv�vn. S/��✓ _ cgN0PY S*t6�xl" 'rOr)Y OF SIGNS Ifyou ha ve additional signs please attach a sheeths6ig each one uaitli dimensions X' If refacing an existing sign please provide a picture of the existing sign with dimensions. I hereby certify that I ani tlne owner or that I have the authority of the o«7icr to make this application, that the information.is correct and that the use and construction shall conform to the provisions of §240-59 through§240-89 of the Toi%rn of Barnstable Zoning Ordinance. Sipatilre of Owner/Authorized Agent:' Date EiF P TA e0150 yr HORI714i14411 SIGNS/SIGNRE U Q . revised1.10413 To whom it may concern: This letter authorizes Indaba Holdings, dba NH Signs of 66 Gold Ledge Ave.,Auburn NH,to act as an authorized agent for Property owner of I FaO C7 With respect to the submission of applications for sign permits, Sign waiver requests, variances or other permit related documents to the Town/City of As an authorized agent of the owner,.NH Signs is allowed to sign and submit all forms necessary for the aforementioned application. Date: o� Regards, Signature Page 1 of 1 Anderson, Robin From: Don Booth [photosbydonald@yahoo.com] Sent: Tuesday, May 16, 2017 9:37 AM To: Anderson, Robin Subject: Sign Permit Sav On Gas Camp St Robin, attached are the application and supporting documents for the signs to be replaced at Sav On Gas Station 381 Camp St. You indicated that you would allow up to 79 sf of signage based'on previous permits from 2006 folder. In addition to the required state and federal require signs. An inventory of existing signs has been included. Also you indicated the permit fee would be $200.00. After your review of the documents, - would you please advise what else may be required to complete this application. Thank You Don Booth permit acquisition NH Signs 66 Gold Ledge Ave Auburn NH 03032 603-682-1602 (cell) , 5h 6%2017 Issue Date:Jan 03,2017 Sigma—one This certificate is issued as a matter of information only ® A Workers'Com pensadon Trust and confers no rights upon the certificate holder. The Granite.State\Yorkers'Conipensation Manuf-.tcturcrs Trust PO Box 1387 This certificate does not amend,extend or alter Concord,NH 03301-1387 the coverage afforded by the policies below. Certificate Holder - Certificate ®f insurance Companies Affording Coverage Peter March lndaba Holdings,Inc dba NH Signs Company Granite State Workers;Comp Mfr.Trust Letter A 66 Gold Ledge Avenue Auburn,NH 03032, company Safety National Letter B This policy is effective at 12:00 am on 1/1/2017 and will expire at 12:01 am on 1/1/2018 This policy will automatically be renewed unless notified by either party by October 1st of any fund year: Coverages This is to certify that the Workers'Compensation and Employer's Liability Insurance has been issued to the insured named above for the policy period indicated,not withstanding any requirement,term or condition of any contract or other document with respect to which this certificate may issued or may pertain,the insurance afforded by the policies described herein is subject to all the terms,exclusions and conditions of such policies. Type of Insurance/Carrier Policy Number Effective Date Expiration Date LIMITS A:Workers'Compensation &Employer's Liability EL.Each Accident $1,000,000 Granite State Workers'Comp Mfr.Tr WC0120171060392 1/1/2017 1/1/2018 E.L.Disease-Pol Limit $1,000,000 EL.Disease-Each Emp $1,000,o00 B:Excess Insurance Workers'Compensation Statutory Employer's Liability.$1,000,000 Safety National SP4055878 1/1/2017 1/1/2018 Description of Operations ✓® officers Excluded March,Peter C March,Noeleen A Member - Cancellation Peter March. Should any of the above described policies be Indaba Holdings,Inc dba NH Signs cancelled before the expiration date thereof,the 66 Gold Ledge Avenue issuing company will endeavor to mail 30 days Auburn,NH 03032 written notice to the certificate holder named to the left,but failure to mail such notice shall impose no obligation or liability of any kind upon the company,its agents or representatives. � t Administered by: Comp SIGMA Ltd. SU4kM Jan 03,2017. Workr*''COmpcnaOriun Aitonatircz Authorized Representative Date The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Aimlicant Information Please Print Leeibly Name (Business/Organizatiort/lndividual): �!IN B, 14OLDIA165 b W IN H SWIT Address: - to 6 60(-O C��)6 t:: A mac' City/State/Zip: l) u L3h/?�' N li 0-03 Phone#: 6t�9 35/ 3 7/d U> Are you an employer?Check the appropriate box: Type of project(required): I am a employer with employees(full and/or part-time).* 7. ❑New construction 2 proprietor or partnership h p and no employees working for me in ❑I am a sole proriet 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 3❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 4.❑[am a homeowner and will be hiring contractors to conduct all work on my property. I will 1 O❑ Building addition ensure that all contractors either have workers'compensation insurance or are sole 1.10 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions SO[am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.* l3[]Roof repairs 60 We are a corporation and its officers have exercised their right of exemption per MGL c. 14040ther -514;A44 152,§1(4),and we have no.employees.[No workers'comp.insurance required.] Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ?Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. `C Insurance Company Name: /G/�ie `�! d� Policy#or Self-ins.Lic.#: &c— L9/a 0 f'�/0.'x,--� 3 9 A Expiration Date:_ Job Site Address: �O CAMP ST City/State/Zip: T"*1?*SrQ8,6r �"JN Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Fai.lure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereb nder the ins and penalties of perjury that the information provided above is true and correct Si nature: E v m/wt v Date: l 1 L -7 Phone#: Official use only. Do not write in this area,to be completed by city or town Official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Sav-On Gas sign Inventory Current:Name. H V1l Main ID 85 84 50 Lube and oiL 9 96 6 Brakes and Service 9 96 6 State Insp. Gemini 9 96 6 Enjoy Drive 36 57 14 Mechanic on Duty 18. 34 4 Inspection- lawn 32 36 8 Wall various 14. 24 12 Canopy 36 36 . , 18 r. current 124a s http://ecode360.com/6557833 Barnstable Code Allowed 79 sq ft .-Recommended H .W Sq Ft,, Main ID 60 96 40 Canopy-2 sets . ' . 15.8 Dispensers, Waves etc- not incl 0 0 0 Inspection-not counted 32 36 0 e Lube and oiL 9 96 6 Brakes and Service 9 96 6 - State Insp. Gemini 9 96 6 _. Mechanic on Duty 18 34 4'',:, Inspection- lawn 32 36 :. 0 _. proposed 78 ; t .. , c < { w `3.� OIE 'i f2. 1�;��yT '7.��� ¢ •ybi� R• i3�x....� } �x t' t i i i �. 28•Noh laternate/Iliamir4te0 Cabinet. •� ! iq system to meet MoOQ Gtail sGdonLL )0 Dartslttcartl T7 r ` 1 Arlylle Windom 4„ / � � � i ... �"`�. ":�,•«". W1G/JF' f1!:A!'k i.rih'NI'w'`-riG+'m' H.�IC� 1P«1 w1).A.V.IP,T^+�.:y:'<'iGr.. J 11 �`1.. ._.�•�.� ..F.,., »r sa.l.n..orl.,,wer 1J,e ia..,��. 1 �wao Wefbrnn.r-sa•�zo ww en .r„>w•. "9.G:1 .on �. C�r.V+re lil rr.•�:sv�^^.«-„.,��na.:a..:.�:�w,:••r::E.�/+6a�wtiuzla.:na�+�erv+ IrtgOAMPMel 23.43"X 82"=1,921 50.IN. /144=15.35 50.FT 3y&tom Dotnll� r 3Dlifuminatetl.Fascia System ILLUMINATED CANOPIFLEMRS -`_ ILLUMINATED CANOPY STRIPES 1, ® 21,002 c Opy, l M. ,.w yr � - k �.... • }•-k� ,�. n � 1 (r' ' � 47�R��y��. S S to •. � �t II � � a ex r x• l y j Rv l i e y . .. ,sty t• .. rA i 84.75'— r• SAV ON ' �• ?aw+A9,S:�•.,,:� S �? ❑ �* �+�-� s, ;`:�,� 'Y ., ,�„,, �rt�€n:r,,.,,. .¢ �"..a �E.�Y^'.K—.. NEW SIGN LOCATION-ILLUSTRATED TO APPROXIMATE SCALE TO PHOTO 5' X 8' Monument. with Base J4r,6,J1 i5 ' EXISTING CONDITIONS DESIGN-MANUiACiUAEoINSTAIIoSERVICE CLIENT: ENERGY NORTH REVISION NOTES DY OHatmraE[unON ern:..Y• .• uauaro ®_Il AIIND Nts tp GIA DD ENERrY 1 SDAV[Y NEEDED MR. � M, 5/10/17 1R nhsf ns•com- 603.437.1200 LOCATION WEST YAAMOUTH ,, z o �- n Aqlmv66 Gold Avenue, Auburn,NH 03032 DATE 04 21 17 3 mrNwO.NOWNDL"^K{„'"""' SaNt:ivvS FAX 60J.43Z7222 .,0 DESIGNER CPC 00MAPPROVED ❑W,rwtpODINISOnu[xax.uaucvmwYAq ACCL REP DAN NUTCHINS' BY DATE./: 117 . .. .. � - ©rxc•. - nntionr�o'�rruu`oaw'rwri•am'wuum 0 ' - o 0 96 in WE v 51' X. 8' Monument with Base CLIENT Energy NOfIh.�F REVISION NOTES BY DESIGN+MANUFACTURE-INSTALL®SERVICE g9 `O"�101D41p1OO13°� 1 ®Sfv1tl6°`°`°01°° LOCATION:West Yarmouth nhsignscom° 6o3.a3�uoo ENERGY 3 66 Gold ledge Avenue.Auburn,NH 03032 DATE OS 1017 sro.in a�, s�°tt sass � FAY 6014311222 DESWak E3 ®R�A1�0'A0 \..._ Y..' A=RED: - BI OUT 1 115 L.. - 0Awa tas SV3YLY97E8fi1E02 xac0idamau bcwra ®umtt� l5i L'j'M 0MY°9a8 c®IdsdminlYMw°ddd�al AH 866GT6M Of1°°ALLfMBSLLO®6;' App� ®44�YdYnsdlbYMd$e:1 +swsr��aa - ❑IEe'S OSI].4:mi +Mela+aMlmYf°Fm !NSl�EY030°SD'°IWB4lHW4GIN1H81®lS NHSIG-2 OP ID: NB A� �n CERTIFICATE OF LIABILITY INSURANCE- DATE 1 11 7120 1 YY) 01 h 7l2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Planright Insurance-Salem PNAM Michael Kimball - F 224 Main Street Suite 2A Arc o E#:603-890-6439 (AMC.No):603-890-6521 Salem,NH 03079 E-MAIL ss: Michael Kimball INSURERS)AFFORDING COVERAGE NAIC 9 INSURER A:Co nco rd G rou p 20672 INSURED NH Signs INSURERB: Indaba Holdings Inc. INSURERC: 66 Gold Ledge Ave Auburn, NH 03032 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:. REVISION NUMBER: THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT.TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT"TO ALL THE.TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE AUUL POLICY NUMBER MMIDDNYY MMIDDYYYY LIMITS A X COMMERCIAL GENERAL VIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FRI OCCUR 20029184 10/05/2016 10/05/2017 PREMISES Ea occurrence1 $ 100,000 20031851 10/05/2016 10/05/2017 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 JRCT LOC POLICY a PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 A ANY AUTO: 20028729 10/05/2016 10/05/2017 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIREDAUTOS X NOWOWNED. PROPERTY DAMAGE AUTOS Per accident $ X UMBRELLALIAB X OCCUR EACHOCCURRENCE $ 2,000,000 A EXCESS LIAR CLAIMS-MADE 20031850 10/05/2016 10/05/2017 AGGREGATE ' $: 2,000,000 DEO I X I RETENTION$ 10000 $ WORKERS COMPENSATION' P O AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPAR EXCLUDED? NI A E.L.EACH ACCIDENTOFFICER/NEMBERTNERIEXECUTIVE $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $ A Property 20029184 10/05/2016 10/05/2017 building 400,000 BP P 93,000 DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) I CERTIFICATE HOLDER CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN For Information Only " ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE - - - O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD y Canopy D.&A Canopy D &A f Canopy C _ Canopy-C Existing Conditions New Canopy Graphics with Mobil Log® 1 _ g a (" REVISION NOTES 6Y ®uonmFanu�nou ..,.�, DESIGN=MANUFACTUAE-IHSTAIIo SERVICE CLIENT:Energy North tCSt017 1R Iff "�®fltr l9c tl[N IYGUPP .. SO¢PEVNEEMOFOk .. [ '��� nhsigns,tom-603,437,7200 LO'ATIODATE: iWest Yarmouth z ? o� 66 Gold Ledge Avenue, Auburn,NH 03032 ;. DATE:011117 f ®r[un nmourn[u "0d"ibe"i°r""tt SINCE 1902 FAX 603.437.1222 OES7cRER-JR © QDEDfiVAPPAOVFD �� .°ra ,[uy ` AEET.REP: EY DAiE / /7E [ °`O1 aivat�mnonowirtwor~zw�o'm ' TOWN OF BARNSTABLE SIGN PERMIT PARCEL ID 345 009 GEOBASE ID 25078 ADDRESS 381 CAMP STREET (YARMOUT PHONE HYANNIS ZIP - LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT TYPE BSIG3 TfTLEIPTION 79 � izTa for 3 signs SAV-ON GAS STATIO CONTRACTORS: ARCHITECTS: Department of Regulatory Services TOTAL FEES: $150.00 2' BOND $.00 CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE 1 PRIVATE * BAMSTABLE, Mass. i639. ♦� RFD MP'�a BUILDI D SION BY DATE ISSUED 09/22/2004 EXPIRATION DATE Town of Barnstable F'("E T° Regulatory Services do Thomas F.Geiler,Director '`' MASS. � Building Division 9 ass. � g s63q. �0 AtEo �a Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Tax Collector Treasurer 11" Application for Sign Permit Applicant: J y - a Assessors No. 3 S — G sow 3 C 2 Doing Business As- 514 V -m"' G'S �'C Telephone No. 72 C �z U i Sign Location Street/Road: Zoning District: Old Kings Highway? Ye& Hyannis Historic District? Ye& Property Owner Name: ��7� -7/y 4 y Telephone: ��� - 7 2 C a'f Address: W It,-4c("xi 13ti 't OR, Village: �z2 -4 /f " Sign Contractor ` Name: v r o Si 9ti S' G '� Ca ,r� c Ca cb Telephone: ri' OS -3c-7 4*1,-7`f Address: 3 S i 1v Village: 7 Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions,location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Yes/No (Note:If yes,a wiring permit is required) I hereby certify that I am the owner or that I have the authority of the owner to make this application,that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinance. Signature of Owner/Authorized Agent: Date: Size: 7 �e CL FT. -rMe- F 3 516-1 S Permit Fee: Sign Permit was approved: r k-S 'Disapproved: Signature of Building Official: �/ "� Date: �'� Signl.doc rev.122801 /S -IV �.3 1 o � -1 � I 0?7 / IJ O-KI - REGULAR — q a 1. ,o PLUS 1.8 9 9 PREMIUM 139 0 9 118910 O • y �j2y i f4C�CS OF rE l (�X q`v/c.tFiT4 v-IA, yL L 4-7-74 //Z C2,/I- C C l Fx,57ir1-� sT��l poS r5 G'= /j19X f/lc 4 sF� 64 1 t�bj Ta V i i 31 � to Z OR 2. T��Tot ljt144. �Y► r DECKER & COMPANY, INC. COMMERCIAL REAL ESTATE CONSULTANTS 33 PARK PLAZA,BOX 258 1 LEE,MASSACHUSETTS 01238 413-243-4083 413-243-4088(FAX) GASOLINE STATION&CONVENIENCE STORE DESIGN&DEVELOPMENT REAL ESTATE ACQUISITION CONRAD R.DECKER,President r t , COMMO 600 es Camp0el: N1 9SACHOSE! 0-,11l �omrnasioner CORK£pLS' M,f':'i1•,N_TIO'N INSUAKNIC L aI I'1 D,'�tir11 l _ Eugene H. Benoit (�iccnitc/punimce) with principzl place of busittGSS/residc>>::c BCS Designers & Constructors i Inc., 333 a-sh i ngtton Hi hwa -Smi thf i el d,� 02917 do hereby certify, under chc pains and penalties of per;ury, Otat; (�) I am an employer providing the following workers' Ompinsariar tovcrag.. {or: ►ny employct:s working on this job. i- Providence Washington Insurance Company WC008192001 _ lnsur2nce Company Pc;l cy N-u!JJbc: �. ( ) 1 am sole proprietor and have no ont: wo.4ing for rnc. ( ) I am a sole proprietor, general contractor or hornCowner (circle onc) and .,Lave hiiYd rltc contractors lis—d below who have the following workers' comperinnon insur:bx Policies: Name of Contrwor Nurr.ber Burnt.- of Conrmctor fin sanf.ct Cotrtosnvil'olicv Number Name of Contracior a 4,;ynsltrantt: Company/Poiicy l�urnbcr Q 1 am a homeowner performing all the work myself NOTE.A1cL:c b�c #wue thit-wbilr horucoyeoer:kilo froolovpersan�tq do tn�iptcoui t,`ccpstructioo pr rVP, worst on dwtllip of roorc thin three units in wbith the bort;cowncr'iiso raids,ar or;tllc ginurad� gyp. )itua:tsF tbcrct rc of tocrsl) considertd to be eroploycrt uo(rr the Wotikcn' t;c,rnpcerAd.6ia C. ls! stet ](5)), ttppliestjQs p gwafr for I IiCCDae or permit may eYidcace the I' jai status of am employer ucdq thc. prkcr}'Co►pptost►tion Ace ,5 1 underhand that a copy of ii is ststement will br for+vuged t4�'�,f DePkgmm, tit pf leis ui4'1*4 Arc d'�na 011—i Isi`sur}na for corersp vcri�ie}tion end tnat iailurr to ieeute`eovers�e a rr quires�nticf ac:Doq 25h X 5 1152 fut l�aIq ehs s osition of mmind penslcics consitdng of I fine of up co SI 500,00 andlor 3tnprisonment�f p to up '� {u{t3 ciY1J�p�rn f�r3�r5 aat g $to 'O�ork{Jrdcr uld finf•of$100.00 a day against me. "V ....... ...j j t wrW s, Y 1 y. �4 t y'F.7 •tr 4 Signed this Fourth -. .Jy a.J��Y+��w —S l:t� rl _ 4 to o1f1.•t .t Y F1 w L1c;,^,:..rhe;� :.... Assessor's office(1st Floor): Assessor's map and lot number nor,IN tt>oi Conservation(4th Floor): Board of Health(3rd floor): = sesisr►ntc Sewage Permit number � - � ru• Engineering Department(3rd floor):. ; 3� oo� Malt �a39 House number y. Definitive Plan Approved by Planning Board 19 y APPLICATIONS PROCESSED 8:30;9:30 A.M:and 1:00-2:00 P.M.only �l TOWN OF BARNSTABLE 0 BUILDING INSPECTOR APPLICATION FOR PERMIT TO � '3( Gk�`a\ i�(_)fl� <�(,L � TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location— Proposed Use Zoning District S' Fire District 414 Q Z*.Z,i� SU d Name of Owner \ Address Wt_ SAC `lE`t 333 cs�PLst-sv--Vt� evy" Name of Builder 60r%�kS TLCI�1Z� Address 11 `�C—:C� Z OZ i P-C3.C Z Name of Architect '�`� Address Number of Rooms NC Foundation '�� Exterior Roofing Floors PbC�C2k� C�1.�C� F •`�� Interior r!� Heating �� Plumbing Fireplace �' ( � Approximate Cost Diagram of Lot and Building with Dimensions Fe � 5 S OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable r ga he above construction. Name co Fati S is v G Construction Si ipervisor's License _ ©143 87 SHELL OIL COMPANY -.»•. s No -3-6-'6- --' Permit For REMODEL PUMP ISLANDS P � BUILD CANOPY J d -, Location 381 Camp S't r e e t - Hyannis Owner Shell Oil Company a Type of Construction Steel Plot Lot , 19 October . 26 93 Permit Granted � . i � � . • -� „� v _ + 4 Date of Inspection: _ - - • �. Frame 19 ,� •- t, �. Insulation -19 — Fireplace - 19 Date Completed 19NI �^ � f { 6' The Town of Barnstable i '".,,M ' Inspection Department ik&I 1 367 Main Street, Hyannis, MA 02601 508-790-6227 Joseph D. DaLuz Building Commissioner July 13, 1993 Mr. Conrad Decker Decker & Company, Inc. P. O. Box 258 Lee, MA 01238 Re: Amended Plan, Site Plan Review Number 08-93 Decker_&.Comp_any, Inc. on behalf of Shell Oil Company 381 Camp Street, Hyannis, M- Dear Mr. Decker: The above referenced amended site plan is deemed conditionally approvable based on the following requirements and recommendations: Health Department 1. All floor drains shall be sealed, closed or connected into a holding tank. 2. It is recommended that the underground fuel storage tanks, which are greater than twenty years of age and are in violation of Barnstable Board Of Health regulations, be replaced this year, even though the tanks are located in Yarmouth. Hyannis Fire Department 1. Requirements as set forth by the Yarmouth 'Fire Department. Building Department 1. All signage must meet the requirements of the zoning Ordinance. Attached, please find an amended Certificate Of Review and a copy of the conditionally approved plan. S930713A Mr. Conrad Decker July 13, 1992 Page 2 The letter of certification required by Section 4-7.8(7) of the Town of Barnstable zoning ordinances must be submitted to the Building Commissioners office upon completion of all work. should you have any questions, please feel free to call. Peaces, oseph D. D ' uz- Building Commissioner JDD/km cc All Site Plan Review Staff enclosures (2) L r - ARROW of C.Ve Cod 3 Silver Street West Harwich, MA 02671 Phone 508-394-7446 John A.Hesse 508-432-1446 President Toll Free;800-704-7719 arrowsigns@comcast.net SAV-bW REGULAR UNLEADED t 109 x _ y IF YOUR STICKER IS STOP HERE Haw 4, Y YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 15t FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) and 200 Main Street Offices at the Licensing counter. PRIMMERDATE: !O O A � � �i` Fill in please: I� LLC. � APPLICANT'S YOUR NAME: �1� �t�a- v BUSINESS YOUR HOME ADDRESS: l O Ol'f (505 175-5`77D 2 5 TELEPHONE # Home Telephone Number: SN SS Q $NAME OF NEW BES?2 TYPE OF BUSINESS , OISTHISA HOME OCCUPAIONS E Have you been given approval fro the buildm divisio 7 YES NO ;2{00 . ,ADDRESS OF BUS INESS 8I $ MAP/PARCEL NUMBERS _ When starting'a new business there are several thin s you ust do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM NER'S OFFICE / This individual Alsen.in ed'of any permit requirements that pertain to this type of business. Authorize i ature' �. C MMENTS: —,° 01 Al �. 2. BOARD OF HEALT This individual as eJq�e 'informed f th r it requirements that pertain to this type of business. _it thorize Signature" ' COMMENTS: o ✓ � [ 4�cd �� 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual h /�een i rmed of t ceyMing requirements that pertain to this type of business. Authorized Signature** ��y 'COMMENTS: Cr_ e L'7" C-D Barrows, Debi From: Schlegel, Frank Sent: Thursday, January 17, 2008 3:01 PM To: Barrows, Debi Subject: RE: 381 Camp St. (345-009) Hi Debi, Oh boy! I used to have this property addressed as Yarmouth Road, Hyannis. When this was being permitted for reconstruction a few years back, I got the request from the owner to change the address to# 381 Camp Street, Yarmouth. The problem here, I think, is the confusion between the 2 local Camp Streets. one in Hyannis and the other in Yarmouth. I have a request into Info Systems to see if they can modify my database under the village code to show parcels in Barnstable but addressed for the abutting town. I have this particular Camp Street indexed as Yarmouth. It's when I attach the road name that I need to index the parcel for Hyannis which is where it is. So, the road names says "Camp Street (Yarmouth)with the village description on the property as"Hyannis", which is where the property actually is. In order to change an address like this on a property, I would need a written request from the owner to change it back so that they are aware of the issue before I can change this again! I was under the impression that when I fixed this the last time, it worked for permitting. The problem I have with this is the 911 issue. The land & building straddles the town line. The owner is currently aware that when they make a 911 call, it goes to Yarmouth. There will come a time (COMM. Fire already has this)when the call will come in and the computers will search the town maps to find the property. Right now, it's indexed correctly with the address on Camp Street in Yarmouth with part of this parcel in Hyannis. What's the real problem here? Maybe I can help Robin sort it out. Thanx, Frank -----Original Message----- From: Barrows, Debi Sent: Monday,January 14, 2008 12:37 PM To: Schlegel, Frank Subject: 381 Camp St.(345-009) Hi Frank, Robin wanted to know if we could have a Yarmouth Rd. address instead of 381 Camp Street? Thanks Debi 1 �n��� ��� illy/oS V Gl I IAvartment or missioner 02601 .us Fax: 508-790-6230 tEOUIRING CONSTRUCTION lication. required prior to toric District: he Mid Cape Highway) ict(See map for boundaries) fullv dimensionalized required for new n, framing schedule, insulation detail & ith a Red `S'.) 5 copies of floor plan d. Plans must show room sizes and engineering data. an be obtained at 200 Main St.: 0 PM) —9:30 AM &3:30—4:30 PM) ARROW ofCaw 3 Silver Street IGN West Harwich, MA 02671 Phone 508-394-7446 John A.Hesse 508-432-1446 _ -- President Toll Free 800-704-7719 arrowsigns@comcast.net u ,g 8A �aa 't 7 DEC 13 AM {q; 58 Revised post dimensions for sign at Camp St. SAV-ON Ref. #200707343 Photo .showing new hight and location 36" further back from roadway to follow. distance from roadway after move = 13' r 8Y " �{ rl GiEurUdaR UNLEADED � er ° 1 0 60 , Y SINE Sign TOWN OF BARNSTABLE Permit BARNSTABLE, 9 MASS. i639. 'OTF 3•�a Permit Number: Application Ref 200707343 20070105 Issue Date: 11/16/07 Applicant: HATEM ENT CAMP STREET, LLC Proposed Use: GASOLINE SERVICE STATIONS' Permit Type: SIGN PERMIT Permit Fee $ 50.00 Location 381 CAMP ST (YARMOUTH). Map Parcel 345009 Town HYANNIS i Zoning District SPLT Contractor PROPERTY OWNER Remarks REPLACE EXIST FREE STAND SAV-ON SIGNW/49 SQ REDUCE HEIGHT SAV-ON CHANGEABLE .Owner: HATEM ENT CAMP STREET, LLC: .Address: C/O SAV-ON GAS, INC 476 ROUTE 6A YARMOUTHPORT, MA 02675 Issued By: PC�. POST THIS CARD SO THAT IS VISIBLE FROM TFIE STREET `_ E Town of Barnstable , Regulatory Services.,,,-' :. Thomas F.Geiler,Director 43Building Division , t39. ► Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 bb� www.town.barnstable.ma.us Office: 508-862-4038 - Fax: 508-790-6230 Permit# Application for Sign Permit r Applicant: - Assessors No. r`1 1;_ ()0 Doing Business As:� �W�y f` -� � Telephone No. i E'2 2 C Sign Location Street/Road: Zoning District: Old Kings Highway? Yes&Hyannis Historic District? -Yes • w Property Owner 6 'y 2 Name: A 4 Telephone: 7 — Z 7 O Address: �� m q C o.A-o� iC -�. Village: Y� °✓ ��ois�'� .Sign Contractor ,A / �. _ 3 g y_ c f c f 6 ' a/ Ca "a6 Telephone: Name:- crow qhS �P •s ` .Mailing Address: 3 -S% �� e !7` ►- wf c , 3 Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions,location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? &No, (Note:If yes,a wiring permit is required) - •� Q — O a + = 5-O f Width of building face S ft.x 10— z.10. I hereby certify that I am the owner or that I have the authority of the owner to make this application,that the information is correct and that the use and construction shall conform to the provisions of§240-59 through§240-89. of the Town of Barnstable Zoning Ordinance. Signature of Owner/Authorized Agent: Date: n A - Size: y g S'q Permit Fee: . Sign Permit was approved: Disapproved: Signature of Building Official: Date:, Q:I wFffX0SIGNSISIGNAPP.DOC 6 4 P vA � �� -------------------------------------- v o 4L µ- E:l j REGULAR UNLEADED' IL210 o jj � gj g J I � 0 REBULAR UZLEAD,ED .L (cn ron g y ILI, boo ",[D) LJL jia.r° �3ys- 9at "0oq tid 7 -TO t x4c ? 0 C-, 0- �- TG4 a mcaaw `� � SAV•ON C � i �-- VV Al 1 1 � T 1 NO "+3 • �n Owl- Providence:(401)331-0442 PAUL F. CONNOLLY One New Street District Engineer FALL RIVER, MASSACHUSETTS SHELL OIL COMPANY Phone: (617)676-1916 ♦ -k.n. .i 4 -,:_4 . »_ Y f tf.S_s .`S:siE4'w.� nib 9' d '�5�4 r 01a dk �', r t• ; ' '.,. fir.: �'• x+. Ibr. ChaAes 116 YaCrath 4; htto a tol 26 Barastable Road , • Dear. mra ,. ,srutht I sw1wim 4 aertifted oopy.of the remad of the W' aetion tit by the Boer of Selsetma vpon the mat of yow eUentes Mmuft Cmstruoticm Ameeiation, Inc* ,,andJaacpAm Rs J. Rcvws for a Uc moo to o two and 11 petwoUimm prodvata Om by they at tte IgtooWtion of Yammth Rwd and Oup StMb In the tMW of Be tabs and Fur th. ''ohm ponditioto Nb# I anC o. 2' re,vat "the Board of i selmtmm,wiu vier ca to the T CIe , the � of • the �,. . -; -- If-there the �.t teriv _-pU to.:aaU as I v.ch to. get.this star ht d cut as Board q GLC/j February 14, 1969 At a meeting of the Board of Selectmen, held this date, with all three members presents it was unanimously voted to approve the application of Monroe Con- struction Assoc-ation, Inc. of North Attlebor; Massachusetts and JoaW im J. Rosary of 614 Yarmouth 0, 1 Hyannis Massachusetts for a license to have pumps for the ine in the�Towan of Barnstable, and specifying that the tanks dispensing of :aso1 dis �, S ., � e in p _ � gallons of gasoline for storage shall be ir. the Town of Yarmouth except 75 g � g automobiles that wri.11 be temporarily parked in the service station awaiting service, and 500 gallons of fuel oil for the heating of the bus-lding on the premises with the followring conditions: 1. that the owner of the property shall.convey to the Towm of Barnstable for roadway purposes, that portion shown on a plan of the Shell Oil Company of the Providence District, Plot Plan "Yarmouth Road and Camp Street, Hyannis, Massachusetts, dated January 22, 1969, Scale 1"=10"t. 2. that portion which is shown in the Towm of Yarmouth shall be conveyed to them for roadway purposes. 36 there shall be no sale of second hand vehicles &rental of trailers. 4. 'the sign as shown on the plan at the intersection of Camp Street and Yarmouth Road shall be stationary. 5 the station shall be built in a colonial design, in keeping with a photograph that is filed with the Towm Engineer. a �� electmen of Barn table RerNrded by Clerk of Se ec men February 14, 1969 At a meeting of the Board of Selectmen, held this date, with all three members present, it was unanimously voted to approve the application of J-. Craig Medeiros of 78 Linden St., Hyannis for a license to store (not for resale) 5,000 gals. gasoline, 5,000 gals, diesel fuel oil in underground tanks; 1,000 gals gasoline in vehicles and equip, 1,500 gals. grease & oil, 150 gals anti-freeze above-ground -for a garage on property owned by J. Craig Medeiros and Barbara J. Medeiros on Lot 21, Corporation Rd., Hyannis.` (After apublic hearing held on this date at 9 a.m.) I? d d ZZ Recorded by Clerk of Selectmen electmen ;of Barns ble THEt��y TOWN N OF BARNSTABLE BABB AG STABLE, i "6 BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..... ..:SQT;va.CQ..Sration............................................. TYPE OF CONSTRUCTION ............Concre. .te. .......Block .... . . .. ................................................................................................ .......................1969.... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..Corner of Yarmouth Road and Camp Street, Hyannis, Massachusetts ....................................................................................................................................................................... Proposed Use .Gasoline Service Station .................................................................................................. ............................................................ Zoning District ........................................................................Fire District ......x3'annzs................................... Shell Oii Com an One New Street Fall River Massachusetts 1 Nameof Owner ...............................p....Y.............................:Address ..................................t.........................�...................... Nameof Builder .....4.v..........t.o..........9.4........................................Address ......6.4..............4.`...................................................t......... Name of Architect ...it t4 44 44 .........50..................................................f'........ ...............................................................Address ........... Number of Rooms 6 Foundation 89...and..12°. . ...Con..c.rete. ...Block. . ................... .... ...... .. . . ...... ...... . ...... . .. Wood Veneer Exterior Concrete.,Block,Brick Veneer Roofing 1�2�� Plyscore w�silyer cedar shingles oured concrete .Interior Concrete Block Floors .....p..........:............................................................... .............................:.................................... Per local regualtions Heating SWpe.Tided..Ho:t..Air..............................................Plumbing Z.rest„roomss..T�...A C. ............... Fireplace .................................Approximate Cost Aq1 000.00 ................................................. ............................................ Difinitive Plan Approved by Planning Board ________________________________19________. Building: 2150 square feet Diagram of Lot and Building with Dimensions /01 �G?J p !r See attached plot plan #D_69271 D i /ee4w,*tl� a � I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ............ .................... ... ..... - Paul F. Connolly, Distri ngineer - �-~ x9Y ' / ' r Shell Oil ~~~p~ y � w ' ^� � | 12339 �aaoIloe � v^���_���J- | , No -----.. Permit for ------------ ^ '~Service station ` ............................................................... Location .......................................u^ �^ . � Hyannis (Yarmouth line ----.---------. ' Shell Oil x Co.------_______ ________. y ' Type of Construction --..maaoory______ -----^--------------------.. , Plot ............................ Lot ................................ � � y | ' T ! Permit Granted -- 24 lV �� ----------- ' � J Date of Inspection &/�..��.��-----'l-u��' � Dote Completed �r�^ �� l� ��i . -----.�~ -----' ~ ~~ v ' ~� | 7 PERMIT REFUSED � -----_----..---------.. lA --------------------------.. '----------------^--------'' —.-----.------------.--.----- ------.-------.—...~...~----., ` - Approved ................................................ lQ ^ � ----------------..--------.. ------------------------....' / ^ ' � � r ,.,y.,� _ r,^ ,,,,,.,&.�.i,y.,�.,--.,,,�:�,, .F: ::, ,.,. ,......, ,_-1.. , ,y"..., ..:r:- u'n'`yk�i,r 1,...w v t, p�:`aS..t,�^A *,w: - .f'r w.r Ls". r . 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