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Home My WebLink About0018 CENTER STREET Cam: Inn r, i 1 � � � . � I�;ne �,.��,��rma..T I �ee-r,w�cjo�s Ca�e S 6jo,,y� � �Y� . y� y G,nn,V t C ear - " J. SMEAD No. 10339 smead.com Made in USA �cVCIFp� - gay � �r t v ENGLAND HOME SOLUTIONS LLC. RICARDODEOUVEIRA r Loan?bloaa�ication Exert DiRWFOR OFFICE:508-815-3462 . FAx:508-418-7399 MOBILE:508-221-4848 • .� TOLL FREE:800-585-NEHS(6347) e r 1 j f s.` {F Things.<you •2 most;recent tax returns(all;pges) k Ifryou are W2 '`Copy of most recent paystubs 1 Mont $� }Last 4 months of Bank StaMnents-(all:pages) Most recent Mortgage State nt of each loan •Home Owner's Ins u an e`�D"eclaratn Page" y •Most recent Real Estate Tax Statement •Recent Utility B�118,(Proof ofoccupancy) 4 C�111 us for a Free • r 14- ' =4 24 a v NA01 o g . } f t permit. s will be to ~ s of roof) #of doors (maximum .44)#of windows h other town department regulations,i.e. Historic,Conservation,etc., ter Letter of Permission. tractors License & Construction Supervisors License is mot . sign aAYMON4srAs . * TOWN OF BARNSTABLE Permit MASS. 9$p 1639. rFG 3�A Permit Number: Application Ref: 201005485 20070521 Issue Date: 10/14/10 Applicant: GRIFFIN, DANIEL M JR& TOBIN, GLENN E TR Proposed Use:- RETAIL & SERVICE STORE SMALL Permit Type: SIGNTERMIT Permit Fee $ 75.00 Location 18 CENTER STREET Map Parcel 327155 Town HYANNIS Zoning District H V B Contractor PROPERTY OWNER 4 Remarks NEW 31 SQ WALL SIGN HYANNIS FOOD MART Owner:. GRIFFIN, DANIEL M ]R 8T TOBIN; GLENN E TR x Address: 1436 IYANNOUGH RD HYANNIS, MA 02601 r r Issued By: PC POST THIS CARD SO THAT IS VISIBLE>FROM THE STREET Y � a'""y .o �� i;:� , a�4 Cr7 4m"e �'`c i f AI'f J` - e,� 1 !r,' �"'� �"`` ..w i;,'�'es .. .. `1 F • ' �ti..i�� . a of1HET Town of Barnstable �n P ti Regulatory Services top , �B'MA�8 $ Thomas F. Geiler, Director Foh,;ra,� Building Division Tom Perry, Building Commis ioner 200 Main Street, Hyannis, MA 0 01 www.town.barnstable.ma.us Office: 508-862-4038 Fax:_508-790-6230 Permit# Ob Building Official approving Application for Sign Permit Applicant:_ 1.�1�1 l� VV t'��. -_Assessors No Doing Business As:------------------------------------Telephone No.____-_—_______ Sign Location ' / n n Street/RoacL --� ----- — — ---� _ -_ YA (�_f__—l� ---� 'I Zoning District: Old Kings HighwayP Yes/No Hyannis Historic District? Ye CIN?) Property O er 1 Name:-------- — — -- — -----=-------Telephone: ------------------ Address:------------ — -----Village:-------=-------- — — Sign Contractor ( r Name:— ---S1tQN —PD �Akil"C7C _Telephone:5 Vq_ ( q(J_ _/1h Mailing Aciclress:_�O�_—�P- — —_ J __—"_ Description ' Please follow the cover directions.You must have au.accurate reOltioii of•sign with dimensions and 1 location. Is • electrified?, s e s•i gn to be Yes/No (Note:I1 ycs, a wiring permitls rcquired), Width of building face _ —__ft. x 10 —__—__—_— x .10 —_—____--- ll� Check one Reface existing sign—__- or New Total Sq. Ft. of proposed sign(s) � Ifyouh,ive addi4'ojlzls1�rJsPle,1se,lttich a sheetlisti», e,ich o)c m*Llj dimcrJsions If refacing an existing sign please provide a picture of the existing sign with dimensions. I hereby cerdly that I am the owner or,�tliat I have die authority of the owner to make this application; that the information.is correct Lid tliaf the use and construction shall conform to the provisions of' §240-59 through §24.0-89 of the Town of lnistable Zoning Ordinance. � . Signature of Owner/Authorised Agent: Date_______-__ t SIGNS/SIGNREQU *revised 103009 �•. r} F �� .f Y � � t }"� .. . ..t a�p� J `^DX •�, ; r + � .. -. � F ` - t �� _ ' � }r. � - � - .. t � .. .. k is .. � � r 1 k fir., �'k e W ZI p 0 r' ❑ [j i or r ; ssww fj e - ''ITT ° -, . � '�.�. � 4•� "fie.. ��.p ,ra � � C-�Y. `s � •tom - �' � ,�;-r: ='.x .;� �� ;. �,: .f r c ,( - - r= 3K s LIP 94 Ak 7�3 n - 14 IT iZi Aj r � e Rl ; v 4 . { — : 45 ';a IT a `rt s ,�- d�. "€� [ �wt4 f-e- ,3 { 4 p' a _ 't . r fi f - 'sal j WOW 41 1 *M"M = r _ wr , ._ t � y i r} 41 cy 152 gr 41 NP of � � � ' fir,�• s�� r� �r � nU ,� ,� � y r k y„. ..7 _ y. R , Qo-• _ Ja 9 _ P^ n f la ti �"ae t a ^ 3 i� S i S ' 'S � Y an p �tix a •kx a. 3 4 5A 3 � �W h Y$ks w x �z YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$40.00 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.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: 4/11/2017 Fill in please: APPLICANT'S YOUR NAMES: HarryBhoorasingh BUSINESS YOUR HOME ADDRESS: 690 Utica Avenue,Brooklyn,NY 11203. (866)735-6002 is ` "+k'" - ""�'w=;� TELEPHONE # Home Tele hone Number h 9utidQJ9iec�lur1:! 4c nUV.;.vit,;cmo,-. ? . E-MAIL: hbhoorasin h nousa.com . NAME OF CORPORATION: JN Money Services(USA) NAME OF NEW BUSINESS JN Money Services(USA)Inc, TYPE OF BUSINESS money Transmission IS THIS A HOME OCCUPATION? 'YES NO X ADDRESS OF BUSINESS. MAP/PARCEL NUMBER ? /S S (Assessing) l 1i OZ( Oy When starting a new business there are several things you must do in order to bb 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 ISSIO ER'S OFFICE This individu I he e info—rrqQof n per it requiremerts that pertain to this type of business. ut rized Sign * ` , COMMENTS: 1 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business.- Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) .This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: f i State License/Registration List Page 1 of 1 ,r State License/Registration List JN MONEY SERVICES(USA),INC.(71415) Current Renewed Original License Adverse Renewal Through License Number License Name Status Status Date License Date Items Status Status Year MT-71415 Connecticut Approved 12/20/2016 12/8/2004 0 No Renewal 2017 Money Approved Transmission License MTR71415 District of Approved 11/18/2014 721/2004 0 No Renewal 2017 Columbia Approved Money Transmitter License 19639 Georgia Approved 1/20/2005 1/20/2005 1 No Renewal 2017 Money Approved Transmitter License - 71415 Maryland Approved 3/19/2013 11/18/2004 0 No Renewal 2017 Money Approved Transmitter License FT71415 Massachusetts Approved 3f7/2017 5/12/2014 0 No Renewal 2017 Foreign Approved Transmittal Agency B500335 New York Terminated- 3/12011 9/29/1992 0 No Mortgage Surrendered/Cancelled Banker License https://www.statemortgageregistry.com/View/Company/Licenselnfo.aspx?Companyld=71... 4/14/2017 TOWN OF BARNSTABLE . BAR_W 3223 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager Address of Offender MV/MB Reg.# Village/State/Zip Business Name 4e(n 1 n i ( ;`u l t')6-e a r) A Y"- /a/pm; on -, 1 20 1!tom. Business Address �AAryl Signature .of �,orcing Officer Village/State/Zip. 4Wnti t PA— Od,(--1 1 Location of Offense: (. Enforcin6 Dept/Division Offens�1a q() " �-� f �� 1 P/1 U�I Facts �-( Gl +,This will serve only as a warning. At this time no legal action has been taken. jilt is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. ' Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. r: '�+� �� a � ��w ,�� ppKy=r '.+.;^+•.rs ' .. .y k,•-' 'e '�. i< d.Z' y �x S 5k t '.,, r f � f '{ TfOWNOF ,BARNS BLE 4-r r w th r"i TA tx} W f �" . , 1 4 .Ordinance orf Regulation r L f s -._il ,r a 7 r v d�a° ca., f 5 �'i •� �' �kf f'td-s$=*�Y�u¢ 7rR4 t r ,,WARNING NOTICE w+ � u ; .y L, �.. -40 rl K �E a.ri"��r 4 v :'x �. ,✓,'�s d rSs'€Y� "e,�� :> .,,k :Address of Offender h' y 3 E ,k MV/MB Regl # ] +=a r �>. w:Vllldge/state/Zl 'Nx f� +f k�k, x ,.1� �z 1 . y t• `y , �, .4 J P, 1,.. ' k °BusinessNaine , t � �� s 1 pni, on' 20 � tr, i S iature of rEnforci ig ng t0ff ice r i.h i YVillag e/Sgtate./Zip<,14, �Cr`1` €I( r,' ,.�'1:; ".. > `� ..f `_,.t ;�. F ,,, ry..,'• ` .rp° �# �ays,Z, = 6 .- 1 t a. i r '>L ,a .t a Zocationoft x0ffense .�-1 � sA�a"` �tfh; ;i s « a 'rt 'F� �'. , i > `° Enforcin`A�Dept/Division { #,} .t.z `t,. f E` ' P /tY 1 :'� l •r �. 1, \.J �x r '-, 10217 fi,� ,, Al'! Offense M - jj rF,aCtS f �. k y �FYA � � �.,j � a � Ee> k �� iat J 'd to �l+ ♦ r'a3 g j � ,}'f ,r d ;Ai - f t y g At this t1:me no legal actlon� has N een taken.Thiswil1 serve onl a`s� a warnin 5 , - y„"- x * x f y"+ µ, 7 t '.1 k "x. :.' K ! t yr. t `P! r as - K z It { s the' goal of Town ,agencies,to achieve voluntary; compliancef 1 of :'Town j.''_Ordinances, Rules( and }Regulations M . Education Aeffforts,=and t warning. notices are /.attemptsrEyto ;gain ,,voluntary compliance Subsequent violations wild jres`ult in :appropriate legal 'action by the;_ Town` E r =1WHITE OFFENDER CANARY ORD/REG.FROG PINK ENFORCING OFFICER 'GOOD ENFORCING DEPT E f i x P aN` wr 71 ` t h } ro r, i F >t: v � '- may. ✓�„� �o. r x x � - r .. _ as. .. d"w Y ,�# +• to . x , i sp �4ol �f i - . d it fi ' YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00.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.) You'musf first obtain the necessary signatures on this format MO Main St„ Hyannis. Take the completed`form•to.the Town Clerk's Office 1 st FI'., 367 Main-St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate'that is required by law. tip + r i,tia a DATE: 2 Z 201 O Fill in plepse: , a I APPLICANT'S YOUR NAME/S: / BUS ES S YOUR HOME ADDRESS: l / I*.✓ S?��r "ir-46��arrRsulr , o aoo wE — u7 Z63" TELEPHONE .#- Home Telephone Number ,� �S NAME OF CORPORATION :� %N!. . C f 9�A(V 'dn NAME OF NEW BUSINESS -TYPE OF.BUSINESS 15 THIS,A HOME OCCUPATIONS YES', ND / - _ _ ADDRESS:OF B.USINE$5 57 NIl own . MAP/FARCEL;NUMBER (Assessing];` When starting a new,business there are several things you must 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. 3 1. BUILDING COMM SIO ER'S OFF CE This individua4 h s e icon• e fjabe it e uire nts that ertain to this type of business, t,,u orized�Sii n t COMMENTS. 2. BOARD OF HEALTH This individual has been informed'of the perrimit requirements that pertain to this type of business.':, Authorized SignaCur•e*'* t COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) , This individual has been informed of the licensing requirements.that pertain to this type of business. Authorized Signature* COMMENTS: w fix. � _ an R+ •• Ks.a — � � i �^ �. V r ia _ „ e` r AM �I Ai' F? air T"k k it £ rY fi a. Sign BARN7 A' STABLE. TOWN OF BARNSTABLE Permit MASS. 6 i 9�A1� 39. A Permit Number: Application Ref: 201102850 20070602 Issue Date: 05/31/11 Applicant: GRIFFIN, DANIEL M JR& TOBIN, GLENN E TR Proposed Use: RETAIL & SERVICE STORE SMALL Permit Type: SIGN PERMIT Permit Fee $ 50.00 Location 18 CENTER STREET Map Parcel 327155 Town HYANNIS Zoning District HVB Contractor PROPERTY OWNER Remarks OPEN SIGN NOT TO EXCEED 22 X 14 TO BE IN WINDOW FACING CENTER ST Owner: GRIFFIN, DANIEL M JR 8i TOBIN, GLENN E TR Address: 1436 IYANNOUGH RD HYANNIS, MA 02601 Issued By: p POST THIS CARD; SO THAT IS VISIBLE FROM THE STREET � �; -• -.� ep!; .�s�' r �,� «f�4,mot �� .�'� ' }y��y'�. � � �. ,,.,�, �'S'( `I A., �'. f� �� a ppZHE Tp� Town of Barnstable` Regulatory Services n Thomas F. Geiler, Director.: 16.39.,tA�� Building Division Tom Perry,.Building Commissioner', -HO Main Street, Hyannis,`MA 02601 d . www.town barnstable ma.us ' 6 ti Office: 508-8624038 s z• Fax: 508-790-6230;T» Permit# s` .Building Official appi ovmg 'Application for`.Sign PerrTut, - k ---- -- Applicant- -�1�..� ---- _ _ _ _Assessors No_ '��'_ 00 Uoirig Business As:_ _ - -=Teleplioiie N. r` . Sign Location Street/Road I`NI �:° S ----- Zoning District: "?_') Old Kings HighwayP`> Yes/No, Hyannis°Historic DistrictP,.-Yes/No- Property Owner E , r � :elephoiie Address:_----=--- . _ Villa c Sign Contractor, x Name:------= -- --r"-----=------ -=`-¢ ------ Peleli ._ l� —=- one - - - - Mailing Address: v s . - escnphon eetis"You must' ave°ai accurate, vcPlease followt�e cover cir � imeiisio is vio ` location. A °Is'the sign to be electrified? Yes/No (Note I%yes, a winngpperm�t'�s"require ') , ° h ofuidig face . £. 16x Width f x 10 4 Check one Reface existing sign_ _ or New __,Total Sq. Ft. of proposed sign (s) _ r - - 11•you have additional Signs Plerzse Rawli a ek11bijc witL dimensibnsf If refacing:an existing sign.please provide a picture of the existing`sign LLwith dimensions. I herehy certify t Mul aria the owner or.-that I l ave the`°authority of 11ac ow�ier to'iiiak. lhis'apl)licauoii, that the inforination is correct aiid tlia(the use_aiul consu-uctioii shiill conform`to.tire prciv isi6ns'of '240 59 d�irough§21.0-$9 of the Torvii of Barnstable Zoning Ordi�iance �W,� :� 1. .FAI Signature of Owner/Authoriz _ Date 6 .,. ed Agent: 1 7, ry awt,'p 41 SIGN revised12110 a • . ,♦ ,< '� a �. ' a. r' .. #„ , a ._ a ,•. � e'� yY+. 1 ' y �1 A i Sign � . : TOWN OF BARNSTABLE Permit BLAM MASS. 6� s'OIF A Permit Number: Application Ref: 201404153. 20071001 Issue Date: 06/24/14 Applicant: GRIFFIN, DANIEL M JR& TOBIN, GLENN E TR Proposed Use: RETAIL & SERVICE STORE SMALL Permit Type: SIGN PERMIT Permit Fee $ 50.00 Location 18 CENTER STREET Map Parcel 327155 Town HYANNIS Zoning District HVB Contractor PROPERTY OWNER Remarks NEW 20 SQ ROOF SIGN GEMINI CARIBBEAN MART 4 " Owner: . GRIFFIN, DANIEL M )R 8e TOBIN, GLENN E TR 3 Address: 1436 IYANNOUGH RD HYANNIS, MA 02601 Issued By: pl-,� POST THIS CARD SO>TI3AT IS VISIBLE FROM THE ST ET E r° Town of Barnstable Regulatory Services �g"R'' `K� Richard V. Scali,Director Ep 39. 01 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# ,(` Buildingi 1 Official approving ,�b\l� � Application for Sign Permit d• 1 I .� Applicant- -. � t.,�P � �'G Assessors No. a� -� �__,�,• _. _. Doing Business As: _ Telephone No. � O 0 Sign Location Street/Road:_� R rJ+e(- Zoning Districj+.VA .- Old Kings Highway? Yes/No Hyannis Historic District? Yes/No Property Owner l Name: dtil ee 1+ )�� !� ( N Telephone: © � -3 eO Z Address: e_ I.3 Z Village:-_q ,j i S' Sign Contractor C6 Name: L M I e "^cr�S' D C lephone: S�t Mailing Address: S 0 2- a- t'j , 7 G r M 0''474L� "tL Description 71 ' n Please follow the cover directions.You must have an accurate rendition of sign with dimension_ location. E c Is the sign to be electrified? Yes o (Note:Ifyes, a wiringpermitisrequrred) Width of building face fL x 10 e 30 0 x.10 3 0 Check one Reface existing sign or New V Total Sq. Ft. of proposed sign (s) 2- 0 Ifyou have additional signs please attach a sheet listing each one with 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 cons shall conform to the provisions of §240-59 through§240-89 of the Town of Barnstable Z ance. g aturesof.Owner%Authorized Agent: �' v Date �CJ- SIGNS/SIGNREQU revisedl10413 / r Town of Barnstable Regulatory Services * BARNSTABLE, MASS. Richard V. Scali,Director i639• �0 Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 SIGN PERMIT REQUIREMENTS 1. ,A.photograph showing the existing`facade, on which has-been indicated the proposed tk sign4ocation. The photograph is to include a portion of adjoining stores or building. For:a proposed building or new facade, an architect's elevation may be submitted in lieu.of a photograph. - 2. t-A scale drawing of the proposed sign. A scale drawing indicating: 1) The type of proposed sign(wall,hanging, free standing) 2) Dimensions of the proposed sign and'any designs, logos, or lettering 3) A cross-section with dimensions showing edge detail. Minimum scale 1"= 1'. Minimum sheet size, 8.5 x 11". 3. A scale drawing of the bracket..A colored scale graphic indicating dimensions, showing colors, materials and method of affixing it to the sign and to the building. Minimum scale 1"= 1'. Minimum sheet size, 8.5 x 11". i 4. A completed Town of Barnstable Sign Application, including scaled diagram showing location of sign on building or location of free-standing sign. Show dimensions. X 5. The width of the building face or the leased area. NOTE: the map/parcel number is required on the application. SIGNS/SIGNREQU revised110413 e i DC SignComp- i U reassembled 8" Single Face Kits 1i_Part 8" s/F Body and 2Part 8" s/F Body with 2Part Retainer Part#1922 Part#1927 Part#1944 W' 1-3 4" 6.1 4" ;F Top,Bottom&1 Side 1 Side ' S x ��B ,� 8 au�.�;�G^ Y x -4• ��a'��.'�.'�'��/ L�V:J� � �j w�-./u b��+"."�'...r�+r'!�++�(/s o.. '4<'N�5% ' WO ,_ w�g9r� - ♦ .. N 120"X 24►'X 8►►Sign Comp Box 3 Brackets total 1;5 X 1.5-angle Steel with multi punch holes Extruded Aluminum Galvanized and Painted Black Lexan Face W/Print Applied Secured to roof W/318 X 3"Galvanized Lag Bolts& Washers _- 4 In each Bracket r x k ��J A , M,E woo r # F fi a € 4 '< �. r� ,-sioj Aq xv -'tiif 0 rim 10 $ �{ �1 .: h i 4i N �� .�� k: W, pp 0 A. 9 If T pk ng � 1 3 At rm R1 } :, l Aft fit," m m €._ } �3 kf; - � f ,�•< �E� � T �� I R i �_ foyy.n..rsl e t i as < We - - # 46 IRIML i u � a 3 =" _ ., � * ; Yam. .F` �•�.. .a 6 J Town of Barnstable Building ��,-", '�. -:.,� �m'k., �',_: }u,•�7 ,u e d .-_ .a y.� .,>��n. rr.. ��t.3 �.�;�'�.v � a�, tea'^ f-� � .:�'� � � Post This CardSoTHa#it°is;V�s�bleFrom=the Street, A rouedFlans;,.Must be Retained on Job and this Card�Mustbe Ke,t ;>: Permit s ` Posted Until Fnallnspection Has Been Mader kj- �', ,: ° �Wh'ere-aCertificate of Occu anc is Re wired uch Buildm -shall Not:be Oc ied?un#ii a Final Ins`"ection�-hasleen.made �.. - .._ Permit NO. B-19-2956 Applicant Name` CAPE COD ALARM CAPE COD ALARM Approvals Date issued: 09/24/2019 Current Use: Structure Permit Type: Building-Smoke Detector-fire Alarm Dection Expiration Date: 03/24/2020 Foundation: 'System Map/Lot: 327-155 Zoning District: HV13 - Sheathing: Location: 18 CENTER STREET,HYANNIS ; Contractor Name: GENE A CORMIER Framing: 1 Owner on Record: GRIFFIN,DANIEL M JR&TOBIN,GLENN E TR Contractor•License;i,1592 2 Address: 10 WIANNO AVE SUITE 2 E Est Project Cost: $5,950.00 Chimney: OSTERVILLE, MA 02655 $160.00 Permit Fee: Description: CAPE COD ALARM O INSTALL FIRE ALARM DE-VICES IN THE NEWLY Insulation: T Fee Paid.: $160.00 RENOVATED PART OF THE BUILDING AND CONNECT TO THE EXISTING FIRE ALARM CONTROL PANEL Dater 9/24/2019 Final: Project Review Req: Plumbing/Gas x Rough Plumbing: 3 Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzedby this permit is commenced within six months after-issuance. All work authorized by this permit shall conform to the approved applicklon,and�the`approved construction documentsfor which,this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zonirig by-laws.`and codes. This permit shall be displayed in a location clearly visible from access street or r-oad and shall be maintained open for public nspection for the entire duration of the Final Gas work until the completion of the same. x t _ Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the%BQilding and Fire Officials are provided on this-permit. Minimum of Five Call Inspections Required for All Construction Work:"' 9 � �� Service: 1.Foundation or Footing y 2.Sheathing Inspection i Rough:. 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Person ting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: cl Fire Department � Building plans are to be available on site �� All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Town of Barnstable �. " �,; .,, ,'�.. x sf �, � ��.., xqc ��:s" ��,a,, ` � ,.� a+�� } � sue^• .,,�, z&"`r'� �4 Building t Postk ayThis Card So That�t�s 1/isible Fromtfie Street A, ',rouetl Plans M:ust.be Retained on Job and this_Card Mus!be Kept � + tAN2sSlA[iSB d MAC Posted Until final Inspection Has Been Made � � �. s s perm Wh03 ere a Certificate of Occupancy'�syRequ�red,such Bu�ldmg shall Not be Occupied until a Final Inspection has been made it .�!• Permit No. B-19-1399 x Applicant Name: David Sergi . Approvals Date Issued: 05/15/2019 Current Use: Structure Permit Type: Building-Sheet Metal-Commercial Expiration Date: 11/15/2019 Foundation: Location: 18 CENTER STREET,HYANNIS T Map/Lot: 327-155 Zoning District:` HVB Sheathing: Owner on Record: GRIFFIN DANIEL M JR&TOBIN GLENN E TR Contractor me,Na -,DAVID SERGI Framing:. 1 Address: 10 WIANNO AVE SUITE 2 Contracto License: 5350 - 2 .` OSTERVILLE, MA 02655 Est Project Cost: $70000.00 Chimney: .Description: Install Exhaust Hood System to NFPA 96,State`.and Local Codes as Perrn�Fee: $ 160.00 well as Upgrade the Fire Suppression System for new,cooking Insulation: Fee Paid; $160.00 equipment layout to meet NFPA 17A,State and Loc8ECodes. Final: :. Date 'J 5/15/2019IJ Project Review Req: iM,, i�� '�i Plumbing/Gas ., Rough Plumbing: Building Official Final Plumbing:' This permit shall be deemed abandoned and invalid unless the work authonzed by this permit is commenced within s z months after issuance. All work authorized by this permit shall conform to the approved appl cation'and the,approved construction documents for whic t s permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structuresshall be in compliance with the local zoning=by laws and codes. This permit shall be displayed in a location clearly visible from access street or road•and shall be maintained open for public Ihnspe on for the entire duration of the Final Gas: work until the completion of the same. )% ri: Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and.Fire Officials vid a 6 roed o01` s permit. Minimum of Five Call Inspections Required for All Construction Work:#- �;- ,` Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final`. "Per§nsco cting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A).Building plans are to be available on siteFire Department � All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: U.S. Postal Service Tax SRTIF1EQjMAEILTM RECEIPTomestir Mail,On/y;IVo lnsur- Coverage,Provided) (Fo�,dPl'v:information vvisit ourweb`site aat www.usps.com® _ 1 w PS Form 3800,August 2006 See_Reverse tor,Instructions i Certified Mail Provides: R a A mailing receipt o A unique identifier for your mailpiece a A record of delivery kept by the Postal Service for two years Important Reminders: a Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. is Certified Mail is not available for any class of international mail. a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. a For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a LISPS®postmark on your Certified Mail receipt is required.__ a For 'an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement'Restricted-Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the.Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02.000-9047 ! TOWN OF BARNSTABLE BAR_W 49 Ordinance or Regulation WARNING NOTICE Name of Off ender/Manager"R„j ( � b� I t.` Address of Offender t t CJ�*r fed MV/MB Reg.# Village/State/Zip q o( -,� o\,q d ,C oI Business Name ��'� n, ,1 ,°' i �� /prn, oq ',a +". 2 ' Business Address %Sikr'Y"NC C, - t , M .,,, S' gnature oEnforcing Officer Village/State/Zip ! en l Location of Offense f a..f.. '�'+[ 4ft �` Enforcing Dept/Division .. Offens �t. ) k q o " � ., lt , 1�y1 `�• �` ((,()(At-t �'.t'�t"'(c 14 - Facts i`SOWU t CYJe 5a+ , - 'C i o rp&�i _� `'—nt:`�6n 1 rm-l' '1 This will serve onl>y as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the 'Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. * I �.` '�.' ^a.,,.".'e..T.+T"""'.y+'^n�'+'r^`.`^.",�Av.Ti..n•+'R..".rrn.w'^'/'1'�*-r+."'^+'.`^r - V) >�-n°� TOWN OF BARNSTABLE BAR_W 469 t WIMryliA/ r a Ordinance or Regulation �. WARNING. NOTICES Name of off ender/Manager"ilr Nt r �� Address of Offender ! r — ( MV/MB Reg.# Village/State/Zip �t r'�� ' 4`2�0 Business Name ..> ,� 1 / ,,�., /lam` . �' " am/pm, ,on h' 2011 . Business Address ,r x Signature .&€ Enforc°ing Officer Village/State/Zip Location of Offense ` atIAlt 1 1��/r trr16rcing Upt/Division Offense t _ l 2W) --] I �� i�l�_S tVt1 VA �t �a� � r ry-(,1(rr6 Facts 1)0 ,^ti . 6^ C. . t :. T"lr1c.� t ,t71f' t P/rat i This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town ' agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education -efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. UNITED STATES `"� • Sender: Please print your name, address, and ZIP+4 in this box • I I ILDINa DIVISION SIT AMU$* I XU I . SENDER: COMPLETE THIS SECTION ComPLETE THIS SEC. TION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sign re Item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X ❑Addressee so-that we can return the card to you. B. Received by(Printed Name) C. Date f Deli ery ■ Attach this card to the back of the mailpiece, e or on the front if space permits. [4 D. Is delivery address different from Item 1? ❑Yes CAP 1. Article Addressed to: If YES,enter delivery address below: Flo V Servi86 Type XCertitied Mall ❑Express Mall ❑Registered W4tetum Receipt for Merchandise ❑Insured Mail ❑C.O.D. I 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number :7 0�0 8 r3 2 3 0 t 0 0 0 21.51"7 8 2,"114 j t t (rransfer from service label) t +• � r t r t PS Form 3811,February 2004 Domestic Return Receipt 102595-02-tot-1540 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION SMap �/S Parcel Application# a 00 C 3/ 31 Health Division Conservation Division _ E P114 I.. '36 Permit# Tax Collector Date Issued Treasurer r _'t,�:uF9 Application Fee - Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis 6 —" Project Street Address IS Cewmm el T Village RVAPA 9;S Owner Mt. p3�wJ§nj nCL?S j Address o260 9 �"XeA_ t21�. O STe12v 1 i 1 P Telephone S0 9 - -77& -a S'dS' Permit Request S"TR 1 S? gA-vk rRe, Rod F RoT RwA i 2 L w%i r' 6 4 iNT ��C�STIIJ G 1 u, b N Y- Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type irp Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. �y Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals.Authorization__❑ .Appeal-#- __ - Recorded 0 - - -- -= Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use jDf}vQ M+ZZ o L q. BUILDER INFORMATION Name G.C.]- yii _2g T-oc Telephone Number 50f) Address &4 4 Riv cti License# CS Home Improvement Contractor# I S a o253 Worker's Compensation# W C.000 A.174 ALL CONSTRUCT 0 1 EBRIS RESULT ROM THIS PROJECT WILL BETAKEN TO bvM D 1j7 _Dy!'jCA Vd SIGNATURE DATE '9 11 lob FOR OFFICIAL USE ONLY PERMIT NO. l DATE ISSUED MAP/PARCEL NO. " l ADDRESS -VILLAGE OWNER " DATE OF INSPECTION: FOUNDATION FRAME r 7 - INSULATION Y FIREPLACE ELECTRICAL: ROUGH FINAL t PLUMBING: ROUGH FINAL , GAS: ROUGH FINAL _... f FINAL BUILDING =_ DATE CLOSED OUT ASSOCIATION PLAN NO. r . i ` The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information �+ Please Print Legibly Name (Business/Organization/Individual): G.0 , i. ti 1(,QeQS =a L Address: PO - so )c City/State/Zip:Mg2sTou 6 GIs MA.. 0 A G I O Phone M S08 - 1a 8 • 1814 , S,0&-77(,-14JJ Are you an employer?Check the appropriate box: Type of project(required): 1.Y I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I I.❑ P mbing repairs or additions myself [No workers' comp. c. 152, §1(4),and we have no 12. loof repairs insurance required.] t employees. [No workers' 13.0 Other 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. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: WOA MAWCA XUS-aRur- - C.Q. Policy#or Self-ins.Lic.#: w CM0 el 37 of Expiration Date: S /0-7 Job Site Address: Ilb C ea-le-A. ST City/State/Zip:_N)/ztmwlt /1'!�. Oo�(o0 1 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DI nsurance co erage verification. I do hereby cer 'y under the pain nd penalties of perjury,that the information provided above is true and correct. Si nature: Date: Phone#: SO - & S-6 9 a- --CtO 3 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#: tKE A 'Yos Town of Barnstable Y f dARNSCA13M MASS Regulatory Services Thomas F.Geiler,Director Building Division Tom Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, P 'o a a ( M� K-t4", r4as Owner of the subject property hereby authorize C•T rS f rJ L to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) ` Signature of Owner ��(L�a l}�jr-�S�' Date Print Name Q:Forms:expmtrg Revise071405 r ACORDM CERTIFICATE OF LIABILITY INSURANCE 09/11/20 6 PRODUCER (508)775-3131 FAX (508)790-1677 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Fair Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 430 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 619 Main St. Centerville, MA 02632 INSURERS AFFORDING COVERAGE NAIC#: INSURED GCI BUILDERS INC INSURER A: National Grange - - PO BOX 509 INSURERB: Savers Marstons Mills, MA.02648 INSURERC:' INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY MP143707 05/28/2006 05/28/2007 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY _ DAMAGE TO RENTED $ 501 OOO CLAIMS MADE a OCCUR MED EXP(Any one person) $ 51000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMP/OP AGG $ 2,000,000 POLICY PRO JECT LOC AUTOMOBILE LIABILITY . COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG- $ - EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE . $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC0002374 05/28/2006 05/28/2007 1 WCSTATU OTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 100,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under SPECIAL PROVISIONS below E:L.DISEASE-POLICY LIMIT $. 500,000 OTHER 05/28/2006 05/28/2001 TEREX LIFT TELEHANDLER A EQUIPMENT FLOATER SERIAL#09664 VALUE 47745 1,000 DEDUCTIBLE DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, MC Realty Trust BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 18 Center Street OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Hyannis, MA 02601 [AUTHORIZED REPRESENTATIVE ath Silvia/FAI]ST ACORD 25(2001/08) ©ACORD CORPORATION 1988 fFx ahnli '3�3'�5 39n °,.°('� t'>♦r7Ton., t:::.»•. ..,/� c5$ / . Y1yPr43�tilO��f)LO�2U rC ��/L t7> ✓�G!l6.1C1rlQ ¢ >�, I Boartl of Bu9 jigegte Chas s iid Stantin9'[.5 � �y CJh f� �` k i!��t��R�{�1 y[7'V��'LJ'�� }1.1 � �9��1•Jj� I 1 . .; HOME IMpRpVEMEt4T CONTRACTOFZ4y C — PG6696 rCQ1VSTRUCTIOIr SUPER1f( R'�,: ' Re istratloyh 'i5'M3 9 Ep �+#� IVutfilbar ''` 057934 t Exy�srat6oq 8tlA/2008 1 4i i e a Pva Corporation g IF �� ;Y I it ?}15: X �� 4Qb��g� � 7a1�i Tfi I10: A04 .. .. - .mil - 1 � A•` 1 jyl kl� ��k)• .- a 4{I'.iGC BUILDERS IN N, ' �f :'F�r iI t St�Srts � f�,�+4;'• t NvJ tFM. Atlr�I t'toZ p61O'Q,'ot�:_hf j}l r��1Y,ir i}4�tUy£j'f}.1 z�} <V1tS PAUL MAZZOLA PAU - " i ,]F V'1644 RIVER RO k ' k MAMARSTONS MIkI 6' I 1�l1'ii , S'1�'isi cq �a . - _ fig, ,��"�" [l ,� i'l�'E x 3' dt i t � �c,# �• gig 5�i� t � - R� >P t'�`' �F�P } kp�� t�r s fi�P�'Y{,�� ,�a1 . -. i,lKit ",t t }�.:lY `,, �l Ef.} it i art 4 ki�� ♦ i - �.,..,. ,....� . __. _., �. -, _... +rr--*r+.>..'.,_r--.-,,,.-,,,....r^-._..-r,r.TMn.,.'� .J'...tP'"f"Yidl.•a+^"t+.v.:,,,7•-+-o-�^"r.'.-*+i...-'��','c-ryvr"Tr..r1-1'��a''.++r"�'r1`�w-..r^-,. TOWN OF BARNSTABLE BAR-w 460 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager- n( l� ,: 6 cyllh,/ F Address of Offender _ r MV/MB Reg.# Village/State/Zip 444innl1 , Aol,66 1 '4Business Name `� 4 f w r f It ' Y!am/pm, on �" th 20/6 Business Address � �'► r# Signature,;.of Enforcing Officer Village/State/Zip ! 1nkE :. Location of Offense t Enforcingf%Dept/Division Offense ? til Facts` 1'.+i�{� L�. J'°� it r >+ 0 {� This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. : h WHITE-OFFENDER CANAR't-ORD`/REG:-PROG,. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. ii ' ♦ d IV iOR } TOWN OF BARNSTABLE BUILDING PERMIT LICATION Map Parcel S Application # Health"Division AO Date Issued Conservation"Division ` .Application Fee Planning,Dept. ` 'Permit Fee Date Definitive Plan Approved by Planning Board p f�---- Historic - OKH J `7 t Preservation/Hyannis Project Street A dress Village /U) Owner Address r Telephone 36 / Vky Permit Request C`'1,4 s L !tti /,40 a X_-t Lee " to Ft4^19r �„ L" XlZ i Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation / , Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: q existing ❑ new, size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ ` Commercial .WYes ❑ No If yes, site plan review# .g Current Use 4-4 CZP4, Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number _r0 k. Address & o 40��. License # C Home Improvement Contractor# Worker's Compensation # r ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL.BE TAKEN TO SIGNATURE DATE- 2 lr� r FOR OFFICIAL USE ONLY ` APPLICATION# 1 r DATE ISSUED MAP/PARCEL NO. f ADDRESS Y_ VILLAGE OWNER r DATE OF INSPECTION: FOUNDATION FRAME " INSULATION FIREPLACE ELECTRICAL:. ROUGH FINAL.-.-- PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING [ DATE CLOSED OUT ASSOCIATION PLAN NO. G . f The Commonwealth of Massachusetts Department of Industrial Accidents office of Investigations t500 Washington Street L - • ----�� Boston, MA 02111 rvrvw.mass.gov/dia , Workers, Compensation Insurance Affidavit: Build ers/Contractors/Electriciins/Plumbe Applicant Information Please Print Le it Name (Business/organization/Individual): Address: City/State/Zip: e, 9- 6�?6 Phone#: �� ~Z7 S Are you an employer?Check the appropriate box: Type of project(required): 1.❑. I am a employer with .4• ❑ I am a general contractor and I •6 ❑ New construction have hired the sub-contractors employees (full and/or part-time).* listedlisted on the attached sheet. 7, Remodeling 2.❑ 1 am a sole proprietor or partner- These sub-contractors have ship and have no employees employees and have 8. [] Demolition working for me in any capacity. workers' 9. ❑ Building addition No workers' com insurance c p.insurance.t [ P• . 10.0 Electrical repairs or ad( required.] 5• tiVe are a corporation and its 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or ad( right of exemption per MGL 12•❑ Roof repairs m u [No workers c. 152, §1(4),and we have no insyself.rance required.] tcomp. •employees. [No workers' 13.❑ Other comp:insurance required.]. *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information.. t Homeowners who submit this affidavit indicating[hey are doing all work and then hire outside contractors must submit a new affidavit indicating suc tContractors 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 s; information. Insurance Company Name: Policy# or Self=ins. Lic.#; Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration d,- Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties 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 of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify tinder th pains and penalties ofperjury that the information provided above is true and correct. Si ature: Date: td Phone#: �r7$ �64PY Official use only. }Do not write in'lhis 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 information and. Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, 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 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or construct buildings in the commonwealth for any operate a business or to o g renewal of a license or permit to op coveragere required." applicant has not produced acceptable evidence of compliance with the insuranceQ aPPh Additionally,MGL chapter 152, §25C(7)states"Neither the conurionwealth nor any of its political subdivisions shall y compliance with the insuran f enter into any contract for the performance of public work until acceptable evidence o requirements of this chapter have been.presented to the contracting authority.' Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and,if � numbers along with their certificate(s) of� -contractor names ; address(es)and phoneg necessary,supply sub (s) ( ) insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. if an LLC or LLP does have employees,a policy is required. Be advised that this affidavit 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 Should-you have an questions regarding the law or if you are required to obtain a workers' Ind ustrial Accidents. S y Y Q . policy, lease call the Department at the number listed below. Self-insured companies should enter their ati on P compens p y,P, theappropriate line. e license number on h t self-insurance 1 City or Town Officials 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. In addition, an applicant "t indicating current given ear,need only submit one affidavit g ermrUlrcense applications in any gr y Y , � must su bmit multiple pp that mr. P P � (city or policy information(if necessary)and under"Job Site Address" the applicant should write"all locations m town)."-A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as roof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each e PP P Commercial vertu to an business or c ommer year. Where a home owner or citizen is obtaining a license or permit not relatedy (i.e, a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your 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 Office of Investigations 600 Washington Street. Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia • Ntassachusetts- Department of Public -S tkti- . Board of Building Rel-uhttions and SM"t irds Construction Supervisor License License: CS 764M j Restricted to: 00 'J TIMOTHY SHERRY s PO BOX 169 = E DENNIS, MA 02841 r (, Expiration: 10/142010 ('ouunis4inecr Tr—,: 5075' t Buildi Board of _ ng R egalations and ndaMs HOME IMPROVEMENT CO CTOR Registration:-.163296 Exp1�dort°4112011 TrB 284720 - =.=TYPW 1?"rate Corporation TIM SHERRY HOMES,INC: TIM SHERRY 2 SIGNAL HILL DR. t DENNIS,MA 02638 Administrator r � Town of Barnstable Regulatory Services uxxsr.3t ,�• $ Thomas F.Geiler,Director Building.Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.b arnstab l e.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner.Must Complete and Sign This Section If Using A Builder as Owner of the subject.property. hereb authorize — 1�� to act on my behalf, y ® . in all matters relative to work_authorized by this building permit application for.. (Address of job) S' of Owner JC. Da Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. n•GnRMG•nWNFR➢FRMT.CC1f1N - .. . _ hW Towns of Barnstable Regulatory Services • stxxsntat.E. v Muss. �, Thomas F. Geiler,Director �qfo �� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 i www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and. Sign.This Section If Using ABuilder as Owner of the subject property hereby authorize T— � xr to act on my behalf, -in all matters relative to work authorized by this building permit application for (Address of Job) Signature f Owner Date Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION Town of Barnstable o Regulatory Services Thomas F. Geiler,Director ntws.� 1639. �� Building Division PrED 1 u'y Tom Perry,Building Commissioner 200 Main-Street, Hyannis,MA 02601 www.tovs'n.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess.a4license,provided that the owner acts as supervisor. DEFINMON OF HOMEOWNER Persons)who owns a parcel of land on which he/sbe 'resides or Ltends to reside, on which there is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one borne in a two-year period shall not be considered a homeowner: Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building?permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,roles and regulations. The undersigned"homeowner"certifies that,he/she understands the Town of Barnstable Building Department rnn=um inspection procedures and requirements and.that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Constriction Control HOMEOWNER'S EXEMPTION The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section.(Scction 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work, that such Homeowner shall act as supervisor." Many homeowners who use this cxcmption are unaware that they are assuring the responsibilities of a supervisor(see Appendix Q. Rulcs&Regulations for Licensing Construction Supervisors,Section 2.15)'This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner.acting as Supervisor is ultimatelyresponsiblc. To ensure that the homeowner is fully aware of his/hrr responsibilities;many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a.form currently used by several towns. You may care t amend and adopt such a foms/certification for use in your community,. Q:fcrms:homccxcmpt #5. i Exhaust Fan -10' ---i M.0 A.Fan Single ingle Roof �r HIE Zero Clearance r I Fire V*ep Over ( Duct Work [ Drop Ceiling— Grease r(vatl is 1 5)8"layer of sheet .1,, F— FifEers roct:: 1 layer of metal.studding- ' than another layer of 519' Preferated" sheet rock Supply Plenum (P-s-p) Stainless Steel wail panel » Gemini Carribean Mart Prime Fire & Ventilation, Inc 18 Center Street 79 Brook Street Hyannis,MA 02.601 New Bedford, MA 02746 l 508-999-2277 Exhaust Fan MUA Fan I All duct wrapped with j I zero clearance fire wrap rig I Exhaust Duct I }C L G I I M 4 MUA Duct 1 ! � t I I 2w IN-A Ansul - --- R-102 1F 1F 1F 230 245 Puit p Station gas valve 6 Burner Ranae Frver 4 Burner 1g r� Y 01 � T, _ ,97 s r Fw asp s 't's1 "'• • -, `� a. -a.`__._ fie: Pgrc)SCa1" !-sue-i vee r _ .a, � jY:at a�i{- t•'Troe•~' v�1-te ' g e _ sv "Ir wn ifsrefelg' uvt EnclosureEms?At .. =ttiw ,f st Ilan Guide e Pra.t�;�..�LatY � In a .on �t�.d i. PrYHuEpi-De5cripvan ' '-'h lid P9 G lti l F4(..;'=Et''' r,t Fit�U 2L Is it Y `•.•'v-'r_��"c='��: '4p 2'S E �r �-'._ i rrBlrrr�l F• r4 (� r E`iJ�. Y i and li i:�&rit it w{�.{+�,•_,a r[4utSri�!G 13 r.,.:�i,3 t t i5A5j- s+-� s �r ..NO— PSr ,T t.iinnest ;1 p the ASTM, E 2336 test standard required by the 20,16 INIC and NFPA 96 for reduced clearance enclosure materials used to provide 1 or 2 hour fire rating for kitchen exhaust ducts. Duct Wrap XL Is also UL Classified and Labeled per ISO 8944' as an alternative to a 1 or 2 hour rated enclosure for air venti- lation ducts. The Duct Wrap XL core blanket is manufactured using Thermal Ceramics patented SuperwooM fiber,a 2000•F rated, non-combustible, alkaline-earth silicate wool with low biopersistence. Duet Wrap XL Is the product of extensive WXy, research and development resulting in break-through improve• ments in fiberization technology with signlficant enhancements in thermal properties beneficial to fire protection applications. , Duct Wrap XL when used in combination.with an approved firestop sealant provides an effective through penetration 4• Performance Specifications F firestop in rated floor and wall assemblies. Duct Wrap XL is UL Reference Standard Standard No. Performance Classified and is part of UL's Listing and Follow-Up Service Grease Duct EnGosure System ASTM F2336 Peas " Program to ensure the consistent quality essential to the criti- cal nature of this life-safety application. Sedion 16.1-Non- ASTM E136 Pass Combustibility Product Features Section 16.2-Fire Resistance ASTM E119 Pass •Zero clearance to combustibles at any location (wall) Section 16.3-Durability Test ASTM C518 Pass •Thin and Lightweight at 1.112 inch thick,6 pcf density •Contours easily to complex duct designs Section 16.4-In' 1 Fire Test ASTM E2336 Pass •Butt Joints on inside laver-save labor.space.and material �10n 1 ' 're '�ul n'®"t ACTAA calerc„o o�� - Fully foil encapsulated for fast and clean installation (duct) 3urreee Burning Characteristics •Completely Inorganic and non-combustible Flame Spread(foNblanket) ASTM E84 5/0 •Contains 2000 F rated fibers for added safety margin Contains no low temperature mineral or glass fibers Sriwka Developed(foil/blanket) ASTM E84 50 nna •Wide variety of through penetration systems esistance -va ue ASTM C518 . 7.3 Per layer , • Resistant to mold growth Mold Growth(75%-9576 •Extensive Listings and detailed installation instructions humidity) ASTM D8329 Resistant Offered in 50 and 100 square foot rolls Air Ventilation Duct Enclosure ISO 6944 Pass •Available Ir(48 Inch widths for less joints and installation Grease Duct Enclosure System UL 1978• Pass: labor •t�eYtrry iiwyM5,p8 pu ntl,dMrn Jtngry 7,700E Nrdly ate"+t6 Es rpm l toAYTM E2398. 2.Applications •Applied in 2 layers to provide 1 or 2 hour fire protection to grease duds exhausting Type 1 hoods per 2006 IMC, NFPA g,Listings/Building Code Reports 96 and 2006 IAPM0 UMC •Applied in 1 layer as an altemative to a 1 or 2 hour rated Listed Uses Agency Listing enclosure for air ventilation ducts Graeae Duct Enclosure system(Zero 3. Physical Characteristics Clearance)-AC101(ASTM E2336) ULG18 Greene Dud ErOosure System(Zero ICC•EW ESR 28.'t2 Product Unit Size Units/WtJ Clearance)-ASTM E2336 . Ctn. Ctn. trough penetration Fireftp System-ASTM UL Sae Figure Duct Wrap XL Roll 1-112'x 24•x 25' 1 37.6lbs. E814/1,11.1479 2 Duct Wrap XL Roll 1-1/2'x 48"x 25' 1 75 be. Duct Wrap XL Cotter Roll 1-112'x 6"x 25' 37.5 lbs. Ventilation Duct lcndosure System-ISO 6944 UL V19. Color While blanket with silver lot encapsulation bwr� r�� •ervc�osny seMee �t Sign TOWN OF BARNSTABLE Permit * sARNSTABLE, MASS. s6 9�At�p 39. A Permit Number: Application Ref: 200703801 20070061 Issue Date: 06/20/07 Applicant: GRIFFIN, DANIEL M JR ET AL TRS Proposed Use: RETAIL & SERVICE STORE SMALL Permit Type: SIGN PERMIT Permit Fee $ 50.00 Location 18 CENTER STREET Map Parcel 327155 Town HYANNIS Zoning District HVB Contractor PROPERTY OWNER Remarks REFACE EXISTING SIGN HYANNIS FOOD MART/GEMINI CARIBBEAN MART Owner: GRIFFIN, DANIEL M ]R ET AL TRS Address: 1436 IYANNOUGH RD HYANNIS, MA 02601 Issued By: pj-y�� POSTS CARD SO 4HAT IS VISIBLE FROM THE STREET •'6G�'i P4=oalh ISign ce Co.)1956 { COMPLETE INTERIOR & EXTERIOR SIGNAGE i DAVID J. NOONAN (508)398.2721 63 OLD MAIN ST. (508)760.3130 Fax P.O.BOX 134 plysigncom@capecod.net S.YARMOUTH MA.02664 www.plymouthsign.com Town of Barnstable Regulatory Services Thomas F.Geiler,Director MASS.A$ Building Division . ��► Tom Perry,Building Commissioner . 200 Main Street,Hyannis,MA 02601 2007 JUN 19 AM 8: 35 www.town.barnstable.ma.us Office: 508-862-4038 F a)c--& z M.9_-6 Z30 Permit# ! 763k p lication for Sign Permit Applicant: Dpnro Map&Parcel#- Doing Business As: Telephone No. Sn 1 f Sign Location NAee,. �Street/Road: M /V3 Zoning District: Old Kings Highway? Yes/No Hyannis Historic District? Yes/No m Property Owner Name: Telepho e: Address: `Q Village: Sign Contractor 11 ,n Name: �� " t ��7VV Telephone: —s - w4 Mailing Address: r` 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) Width of building face ft.x 10=` x.10= + Sq.Ft.of proposed s n I hereby certify that I am the owner or that I have the authori of the owner to make this application, the information is correct and that the use and c nform to the provisions of§240-59 through89 of the Town of Barnstable Zoning 0 ' ance. i 1 Signature of Owner/Authorized Agent: Date: Permit Fee: Sign Permit was approved: Disapproved: Signature of Building Official: Date: In order to process application without delays all sections must be completed. Q:IWPFILEMIGNSISIGNAPP.DOC Rev.9112106 1 : CENTER STREET 1 1 1 FRUITS o VEGETABLES o JUICE BAR 0 MEATS • 63 OLD MAIN ST S. YARMOUTH, MA_ 02664 Inc. Since 195C� wwwPlymouthSign_com �+ • �� .,.,. a Ul mow/ : • Y.Ni: .. 'h w�.,'..._. .,. � aw k.,.-J... ! " ..2, ".,.. u:'•_wK,.� w '!`h.� 'Y,.• .b«v' S 9� ;K r E•'��•.i t y $,y,,P,t � 0. � i 4 i• ..e 'lf { Y 4+ IT'X ° + - t 4" r . l 4 4 i t Z k I i e4 c TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION . Map Parcel Application# Health Division Conservation Division ` 2006 OCT 10 AM $; 43 Permit# Tax Collector Date Issued b Treasurer --,. Application Fee 10 ,100 Planning Dept. Permit Fee r g� Date Definitive Plan Approved by Planning Board ® - Historic-OKH Preservation/Hyannis Project Street Address I Q� CePTe� �'�'. n Village -vaaNyl S Owner V 5 Address 01(10 16 ?moo RD • t�r�* Telephone —a Permit Request 02 f&194eC Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio 8GNU w Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes,attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: - Zoning Board of Appeals Authorization._❑.-Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# _ Current Use Proposed Use uL jM�zZv BUILDER INFORMATION Name 6-C.1 Fv,1cQee5 ANC Telephone Number �C> R Address ��yCf? (� . License# 0 S 34 NeMi� /M/ S 4"1 k Home Improvement Contractor# /_t9 O.1!1� Worker's Compensation# IJC 000 *:Z 71 ALL CONSTRUCTION DEB ULTIN OM THIS PROJECT WILL BE TAKEN TO DjDc fto SIGNATURE DATE 0 O .4 FOR OFFICIAL USE ONLY I PERMIT NO. x DATE ISSUED � • . MAP/PARCEL NO. r ADDRESS VILLAGE , OWNER ' r ' i DATE OF INSPECTION: ; FOUNDATION i FRAME [ INSULATION FIREPLACE 4 I ELECTRICAL: ROUGH FINAL i PLUMBING: ROUGH FINAL I i ?� GAS: ROUGH FINAL ' FINAL BUILDING DATE CLOSED OUT _ ASSOCIATION PLAN NO. The Commonwealth of-Massachusetts Department of Industrial Accidents Office.of Investigations: 600 Washington Street - y Boston,MA 02111' . °�N 5yJ www massgov/dia Workers' Compensation.Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly, Name (Business/Organization/h&vidual): Address: City/S Phone#• — '4477S P,re u an employer? Check the-appropriate box:. Type of roject equired):- I am a employer with 4. ❑ I am a general contractor and I 6. ❑ ew construction employees (fall"and/or part time).* t have hired the sub-contractors .0 I am a sole proprietor or partner- listed on the attached sheet 1 7 Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity- j workers' comp.insur•anCe. • i 9.1 ❑ Building addition ' { [No workers' comp. insurance 5. ❑ We,are a corporation and its officers have exercised their 10-❑ Electrical repairs or.additions . required.] . . I.❑ I am a homeowner doing all work right of exemption per MGL 1"1.❑ bing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12. Roof repairs insurance requited,] t employees. [No workers` 13.❑ Other _ comp.insurance required.] Sny applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: *e Homeowners who submit this affidavit indicating they are doing all-work and then hire outside contractors must submit a new affidavit indicating such ;ontractor.that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. am an employer that is providing workers'compensation insurance for my employees'Below is the policy and job site rformation. isurance Company Name: olicy#or Self-ins.Lic.#: ,0W. 1•3 2 Expiration Date:" ab Site Address: (�l��d � City/State/Zip: Itach a copy of the workers compensation policy declaration page(showing the policy num er andexpiration date). ailure to.secure coverage as required under Section 25A of MGL C. 152 can lead to the imposition of criminal penalties of a ine 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 f up to$250.00 a day a ' lator. Be advised that a copy of this statement maybe forwarded to the Office of avestigations of the D for insur a coverage verificatiom do hereby ce under th ains and penalties of perjury that the information provided above/is t e and correct d atare:. Date: 'hone#: . 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.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions r Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, 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.*e 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 woik-ou 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 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence-of compliance with the insurance.coverage required." Additionally,MGL chapter 152;§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable.'evidence.of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es) and phone number(s)along with their certificates) of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners; are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit 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.. Self-insured companies should eater their. self-insurance license number on the appropriate line. City or Town Officials . 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. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current r policy information(if necessary)and under Job Site Address the applicant should write all locations in (city o town)."A copy of the.. he affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that-a valid affidavit is-on file for.future permits.or licenses..A new affidavit must be filled out.each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (it a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a can. The Department's address,telephone and.fax number: The Commonwealth of Massachusetts . . Department of Indnstrial.Accidents ..Office of Investigations . ,. .600 Washington.Street4 . . Boston,MA 02111.. r `Tel. #617-727-4900 ext 406 or-1-877-MASSAFE Fax#617-727,7749 tevised 5.26-05 wwwmws.gov/din { i r * r h ct Imo}; ,�: A+ rdB iU4ngR gi6 ��s ita�V�Stnci` ade4 �t � Yrr+`. ✓fae c�n �arctf�xt f'�'o '� re�Ctct3 + — }1011ltiE 1MPR0VEt T rONTR�AGTQR Registratlg4 ej52253 w ,m 4hss CO TRU �C(QiV UP �( V0 " " J € ldu�h¢SQr� G�' b57934 Ixg1 fat lo.rp 8f192008 { s G ' fi � + ypQ Corporation 1 i � fGl pr + 01 9d"�007 , Tr I GCI BUILDERS INC PAUL MAZZOLA h U ti44 RIVER ROAD ` ..... 1 � + Jr iV�A ZOLA M� RSA ONS MILS,MA b�M48 l�cp fy r�dsne llst! log t�rA TON d�pI�LS MA 02648 I + via i ni5 a at + rCB 716510no, , +' - n l A�Yf i k ri f I sY""N' i,. y BR' }%+.�A I f� L bf �' P,,P - �ar+�rm^.yr^rx rer7^ <�''�a '"I� r i � L ro b ,�r►+e t� 0 ' Town of Barnstable +� QARN9?ABI�, D ,.�' Regulatory Services y Thomas F.Geiler,Director Building Division Tom Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, 6k Mz— r4as Owner of the subject property hereby authorize C.1 to act on my behalf, in all matters relative to work authorized by this building permit application for: Fn n I S Htl d2 O 1 ( of job) ob) T Signature of Owner Me g:R Date Print Name Q:Forms:expmtrg Revise071405 f SINE A Town of Barnstable 200 Main Street,Hyannis,Massachusetts 02601 • BARNSrABLE. - 9�6„�039. � Growth Management Department Thomas A. Broadrick, AICP 367 Main Street,Hyannis,Massachusetts 02601 Director of Regulatory Review Phone(508)862-4785 Fax(508)862-4725 www.town.bamstable.ma.us October 24, 2006 Gemini Caribbean Mart, LLC c/o Jeffery Johnson 1550 Falmouth Road Center Place Suite 4C Centerville, MA 02632 Reference: Site Plan Review(056-06)=Genini Caribbean. 18 Center Street, Hyannis Map 327, Parcel 155 l Proposal: Grocery business selling Caribbean foods: fruits, vegetables, meats, canned, L� dried,baked products, health and herbal products. Health food juice bar without seating. Dear Mr. Foster: Please be advised that site plan review application, plans and information submitted on Octoberl6, 2006 has been reviewed by the Building Commissioner, Tom Perry, was administratively approved subject to the following: s • Board of Health compliance and approvals will need to be obtained regarding food preparation and grease trap. • Applicant must obtain all other applicable permits, licenses and approvals required including,but not limited to signage permits. If you have any questions or require further assistance, my direct telephone number is 508-862- 4679. Sincerely, Ellen M. Swiniarski Site Plan Review Coordinator CC: SPR File7. . Health D.ivisio Tom Perry,Building Commissioner YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town(which you must do by M.G.L-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, V FL,367. Main Street,Hyannis,MA 02601 (Town Hall) DATE: Fill in please: \ D � APPLICANT'S YOUR NAME: G 0 01^ ^' ` eA^r BUSIN S YOUR HOME A DRE569. SS: 3 TELEPHONE # Home Telephone Number NAME'OF NEW BUSINES YY11P11 n bbean 14 CLe L C: TYPI GE BUSINE$S. O S IS THIS A HOME OCOUPATION1.0" YES Nb Have you been given approval fir m buildin .di 1 i n? -YES NO ADDRESS BUSINI=3S MAP/PARCEL NUMOER ! `� I SJ� S When starting a new business.there are several things you must 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. -.[comer 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 COMMIS ONER'S OFFICE N. This individuaV"a en i e any permit requirenmnts that pertain to this type of business. Authorized ' ature* COMMENTS: Ise A,6cJ cSD n e-lr) 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature". COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: �t T Town of Barnstable T l VN4 OF B ARN S TA ;LE 200 Main Street, Hyannis,Massachusetts 02601 BARNSrABM • 2006OCT.27 AM 6:'43 MASS9�6 9. Growth Management Department " Thomas k: Broadrick, AICP 367 Main Street,Hyannis, Massachusetts 02601 Director of Regulatory Review Phone(508)862-4785 Fax(508)862-4725 www.town.barnstablaAma us- DIMICN October 24, 2006 Daniel Griffin, Trustee 1436 Iyannough Road Hyannis, MA 02601 RE: 18 Center Street, Hyannis Redevelopment,- Dear Mr. Griffin: ` I am writing to inform you that you will need to file a site plan if you are proposing to redo your parking lot area. If you have any questions or require further assistance, my direct telephone number is 508-862- 4679. Thank you. Sincerely, Ellen-M. Swiniarski Site Plan Review Coordinator CC: SPR File {Tom Perry,Building Commissioner e t � � � � .. I � � �! � � I � ��' ;�i � � ' �a r � � � I � � '' ! 'I ,� V � n � I\ v, �""� � ' � i � � � � i� �� ' � i � i , � 'cam I � i � � � i � jQo L � � � j� �§ � I i 1 � i '. � � j h � � I 1 TOWN OF BARNSTABLE j SIGN PERMIT PARCEL ID 327 155 GEOBASE ID 24257 j ADDRESS 18 CENTER STREET PHONE HYANNIS ZIP LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 49953 DESCRIPTION "HYANNIS FOOD MART" - 24 SQ. PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $25.00 BOND $,00 Ox THE CONSTRUCTION COSTS $.00 753 MISC. NOT- CODED ELSEWHERE 1 PRIVATE P * BARNSTABM MAW 1639. ED MICI BU1 DIN DIVISy0N A. DATE ISSUED 11/14/2000 EXPIRATION DATE I �' I .� . •..� , . , _ � ..3 r -�,' _ a. �: i", '��.. �I$ �r'� .� a ��. t i Town of Barnstable oFt Taff Regulatory.Services o� Thomas F.Geiler,Director i BARNSzABLL ' Building Division 9�Ar fD ►`0� Ralph Crossen,Building Commissioner 367 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Tax Collector Treasurer Application for Sign Permit Applicant: Assessors No. Telephone No. Doing Business As: Zy_-, � / Sign Location �— Street/Road: Yes/No Hyannis Historic District? Yes/No Zoning District: Old Kings Highway? Property Owner Telephone:, L J `7 p % y Name: S�� y /� Address: Village: Sign Contractor S Telephone: J-0 4Zk' q 9lo Name: Address: Po 136 2.1 Village: 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? �e 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:117 �U�J CL ,t Permit Fee: Size: Permit was approved: Disapproved: Sign P , Signature of Building Official: Date: signl.dbc rev.8/31/98 r t s rta 0 o a a a O l O � a o o . � • | . \ y, ) . . . � ' . •/\ | ! Z 7 -7 �O . ' � . �. r==' z ;;. r'4 ! �� ` "� ��`� � � s� � T 1 , -�r, nuns I F tHE The Town of Barnstable ■nnxsTABLE + . MASM Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner August 25, 2000 Mr. Mian M Saeed 2751 Falmouth Road Osterville, Ma. 02655 Re: SPR 115-2000, Hyannis Food Mart, Inc. ` Proposal Establish mini-mart at 18 Center St.,Hyannis, (R327-155) Dear Mr. Saeed; Please be advised that your application was approved at the Site Plan Review hearing on August 24th with the following conditions: • Curbing shall be installed along the property line (Center Street). • The applicant shall landscape the southern most point of the site to the satisfaction of the Planning Department. • The applicant shall maintain low level lighting. • In the event of any expansion or amendment.to the approved use, the applicant shall re-apply for approval. • A grease trap shall be installed to the satisfaction of the board of Health should circumstances warrant the provision. • The applicant shall provide hash marks in the deficient area adjacent to the last parking stall in order to discourage parking. Sincerely, a p Crossen Building Commissioner To: Kathy Malonay From: Lt. Donald Chase Thu 26 Oct 2000 14:46:54 pace: 1 HYANNIS FIRE DEPARTMENT 95 HIGH SCHOOL ROAD EXTENSION HYANNIS, MASS. 02601 HAROLD S.BRUNELL.E.CHEF FIRE PREVENTION BUREAU LT. DONALD H. CHASE, JR. LT. ERIC HUBLER Inspector Inspector To: Building Commissioner Fr: Lt. Chase Dt: October 26, 2000 Sj: Occupancies We have completed inspections and do not object to occupancy for the following property: • Cape Mart -new kitchen installation -Cnr. Barnstable Rd & Center St. Thank You, Lt. Don Chase, CFI Business 508-775-1300 Emergency 9-1-1 Fax 508-778-6448 Facsimile Cover Sheet Recipient Kathy Malouey Organization Barn. 13u ldinn Dept.. Fax Number -508-790-62:30 From: Sender Lt. Donald Chase Organization Hyannis Fire Department Phone Number 508-775-1301 Date Thu 26 Oct. 2000 14:46:54 Pages 1, excluding cover sheet. Note They added a netiv kitchen set up to the property. All set. This facsimile was transmitted trom an Apple LaserWriter 161600 PS printer ` utilizing the Adobe PostScript interpreter and Adobe PostScript FAX capability. POSTSCRIPT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 32; Parcel / Permit# r' A-�462 ICANT MIST OBTAIN A SEWER CONNECTION PERMIT FROM THE Health Division - � OGINEERINa DIVISION PRIOR'"`t Date Issued f/ - e7JM=ION Conservation Division Fee �� Tax Collect ' " " ' Treasurer C Planning Dept. Date Definitive Plan Approved by Planning Board lYrl Historic-OKH Preservation/Hyannis Project Street Address Village �Ai Nta \S Owner VIAL E CLcUT- ER EA Address EQ. LK 12W Telephone E_�O - 4 26 7100 Permit Request 1 q �atS — ' t FAA Square feet: 1 st floor: existing.3400 proposed 5 2nd floor: existing proposed Total new Valuation to! ®.cam® Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ . Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes - Cl No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new w * Total Room Count(not including baths): existing new First Floor Room Count A Heat Type and Fuel: Cl Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial YI Yes ❑No If yes, site plan review# Current Use Proposed Use <Z4&1e*31WCr— ^-� BUILDER INFORMATION Name P2\� I/. l,1t1 Telephone Number 701-5W5 9477+ Address F?A►•C(S AXE • . License# CS C74a 349 1(niNC ROD . 997-51(ol- Home Improvement Contractor#. Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE •r ; FOR OFFICIAL USE ONLY •, -` . y PERMIT NO. Ei DATE ISSUED r MAP/PARCEL NO. . 1�2max."` `• ADDRESS• - , rvILL,AGE ' . OWNER .fit .'�u ... �` -` w4 ' F 4� .- •}ram •' - ` . �, - DATE OF INSP'EC7lI6k x- -+- - FOUNDATIONS121 !,!T Ear,. 5' f~• '; t,fy'! { ' ' FRAME INSULATION, ,` _.cam; . FIREPLACE'.- t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH - FINAL GAS: ROUGH FINAL FINAL BUILDING. DATE CLOSED OUT ASSOCIATION PLAN NO. 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IX 4. .::...... ..v ., ..vti:.:r........ .. i}x 7 vw}.{-0�: :a....r{,r^M�pt+�,{::vY.v�.n rx:.}}y:::G..:r::•{.:v. .....,:4v:{:.n:,:.:..:::iC'�•. •:is ijii:•: •rr.. .... r�{Yi4r{co-, ".,x;:,{%d... ...9F .kr..,,.......:......rx................::....:::,. ..............:::::::::: �nv.Y:Y:.v;-:•4:-.v:nv.:•:::::.•Y.• ...:v:r. •x.: fY{!:{:.+3't�.} �•: �►.#nv?:^;.::........ ...................... .........v:;.;::r::rxx..iv::nr4'r•$M.Y^^r: 7N Y44^w^hh' ,,}•M1.��, vv?. ....................:............ ,....,:{:.:i vvrrn�.h.'{{4:{{w:}}},v,Y,.K}':yy}ii :k^"•' ::::.:::.•..,•...... •::.��. in�nran ce cos»;; ::;; ';:;: of eeindnai pe�itles of a tine up to Sl,soo•oo and/or civaceder geetlm2SA of MQ.1•Qfine of 310QOO a day against tne• I d that a Fafinre to secure coverage as in the form of a STOP WOGS OFand one years'imprisonment as ell�watded tLeto pmajdOflloe o[7n�tlPdi�!oi�a DMA for t�nnaaLe��0m' copy of this statesneat may be f information provided above is true tmd eorred I do hereby certify rur p Date - Sipat= ph=# _e6_ 54-74 print name —O��u ` official use only do not write in this arcs to be eompkted ortownoIDcisl by city Q Department Bunding town• P e DLicensmg Board city or ❑Selectmen's OMce response is required ❑Health Department checkif immediate rapo -' QOther Phone 1!; contact person: I lilt ', uev ad 9/95 PJ�U Information and Instructions 152 section 25 requires employers to provide workers' compensation for their Massachusetts General Laws chapter to defined as Amy person,in the service of another under any contraCt employees. As quoted firm the"law",an employee . of hire, express or implied, oral or written. ' p association, Corpration or other legal entity, or any two or more of An employer is defined as an mdiHdual,p of a deceased era lover, or the recei�•er or ed in a joint rise, and including the legal represeatanv� P the foregoing engag J �rP - io ees. However the owner of a trustee of an individual,partnership,association or other legal entity, employing ant of the dwelling house of dwelling house having not more than three apartim�and who resides oc cup dwelling house or on the grounds or to persons to do maintenance, canstruct�an or nP�'work°n such another who employs p be deemed to be an employer. building appurtenant thereto shall not because of such emp oyment state or local licensing agency shall withhold the issuance or renewal MGL chapter 152 section 25 also states that every onwealth for any a licant who has of a license or permit to operate a business or to with construct coverage required. AdditionallYpnertthe not produced acceptable evidence of comp s heater into performance o fpublic work until commonwealth nor any of rts political sub have been p resented to the conWa a ng with the insuramcx requirements of this chapter acceptable evidence of compi�aace . authority. Applicants . ' checkiagthe boo;that applies to your situation and `ensad=affdI&cbmpl�y,by please.-Min.,the workers' comp��with a caff=ft��ce as all affidavits maybe -supplving company names,address phA , far c of ins . Also be sure to sign and submitted to the.Dep-ar��of Industrial: T � � . _ - application for the permit or license is lie returnedto the&y a�townthatthe, `9a�'or if you The afi idavrt s Muld the date the affidavit- Indns�Accsd� have�,questionsregarding �b.-Mg ii nested--not-the-Department-of the ep�=at the number listed below. are required to obtain a worker' compeasatsonPolu'y,P� D City or Towns imz and �,ly, The Department has provided a space at the bottom of the .please=be sure that the off davit is P� the licaat. Please to fill out is the eveirtthe Office of vm to contact You regarding aPP. affidavit for you number. The affidavits may be retained t^ be sure to fill in the pie member which wsllbe ush e a =inn ca b marl ar FAX unless other have hem made. th.,Department y The Office of kvestigatians world like to thank you is advance for'you cooperation and should you have any questions. please do not hesitate to give us a call. Ing ]IMIL 1111 The Department's address,teleph01ne mad fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Oince of Imtestioations • 600 Washington street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 eat. 4069 409 or 375 /nclus/onar Affordable Housin Fes Residential Commercial" a . Property Owner's Name Project Location Ia P Project Value !�0� PermitNumb **Existing Sq. Ft. 460 "Proposed New Sq.Ft Fee 5 LAHFORN4 113i00 g BOARD OF BUILDING REGULATIONS y� License: CONSTRUCTION SUPERVISOR 076349 Number-tS y — Tr.no: 76349 Expires 12f=p03 Restricted To: EDWARD D TRIMBLE 15 SAIN T FRANCIS AVE_ :� KINGSTON, MA 02364 Administrator Engineering Dept:(3rd:*froor) Map 2- Paicel Permit# House# Date Issu d .7 . oZi Board of Health(3r oor)(8:15-9:30/1:00-4:30) ` Fee. .�J�O d� 9.30/1:00-2:00) , franni Bldg.) .» r �THE ing Board 19 BARNSTABLE, TOWN OF;BARNSTABLE COHRg� 0111 A�,ER Building P rmit Application , ps Projec treet ddress_ �( c��" MMMU MONAMftsp&8lo Village Owner yA C—d s ,` CL&v T i Address \ C fA ?/l S T Telephone Permit Request e ®p . First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ t® G Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family. ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing ' New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) LAttached(size) ❑Barn(size) ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use Builder Information Name CA2yA,, i T C c� Telephone Number Ca $ 5112 '� ► d 0 Address n4 Q f2 p 7 S2 License# $ 0 3 4 -7 o f l E<,°r.. er /7-1 04 Home Improvement Contractor# 1.2 (6 G fj C� ( :1-67 Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION D EBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BU DING PERMIT D ED�F�ORE FOLLOWING REASON(S) S; 4ui FOR OFFICIAL USE ONLY ii PERMIT NO. DATE ISSUEd' MAP/PARCEL NO. • r _ . � i t _ . _ i , = � .jam•# ADDRESS c a. VILLAGE` OWNER DATE OF INSPECTION: R FOUNDATION FRAME } � r � _~• � ' # -' .. _ � . • - 1 INSULATION FIREPLACE } f r 1 1 1 I ELECTRICAL: ROUGH FINAL t i t I PLUMBING: ROUGH ' ' FINAL GAS:..•-,%p ROUGH FINAL FINAL BUILDING t C Q�/ •� i1 a + , f ' i - , i Y + i • DATE CLOSED OUT awl 1 1 ASSOCIATION PLAN NO. s+�* ! ; • 1 / � r i f t t t x The Town of Barnstable $ Department of Health Safety and Environmental Services �►`° P Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Cr0ssrn Fax: 508-790-6230 Building Commissions For office use only ' Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL a 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. ✓Type of Work: L (,-,,L— 4 c)0 4 ,1 g Est. Cost Address of Work: 1 ��`1�� S I .,-,-'Owner's Name L'2 YYl Q s a�'� \ c, `' 7 c-V ,,_-�ate of Permit Application: S 2 t,7'1• 1 7 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 Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE 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 owner: Date Contractor Name Registration No. OR • The Conmrunivealth ojafassuchusettt --- xii /�Dc� artnunt ojlndustrial.4ccitlents office8"'Westigal/offs • 600 If'ashiirrtun Street Bovon. Alas. 02111 workers' Compensation Insurance Affidavit .. ._- .-�.._� ..---:--,- -•--• Please PRINT � al 1�?l �Pltc•tnt tnformattnn. , 1 am a homeown performing all work myself. I am a sole proprietor and have no one working in any capacity Cj lam an emplover providing workers* compensation for my employees working on this job. cmmnanv name: address, city; nhnne#• insurance cn. [� I am a sole proprietor. general contractor, or homeowner(circle otte) and have hired the contractors listed below who have the following workers compensation polices: comn:tm• name, atirlresr. cit. 11hone#- insicrancc rn. # �- ' '`�.. ...�•�''- - •�:Y•-•,:•-••-.--- -- �--.:.-�-.�;T•-r--......s. .��.:._- ...-••.,. .�._ice..- - com n nn%• name• adclress� rite Rhone#• insurance co nolict•if Attach additional sheet if neces'sary - c -"��- ='i' -_ � �'r•"� ° ""'w' "•" —"- --� Failure to secure coverage as required under Section.5A of NIGL 152 can lead to the imposition of criminal penalties of a tine up to S1.500.00 andlur unc years' imprisonment a.%well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement mat be forwarded to the Orrcc of Invcstigations of the DIA for coverage verification. 1 do herebt•certlft rr rr!' t/rc p17 s a petthltles of perjun•that the information provided above is true wrd correct. Sianature Date 02 .- )9 g Print name L Phone# official mcial use univ du not write in this area to be completed by city or town otTiciari cin or t .n: permit/license# I•'1Building Department Licensing Board [. r I] check if immediate response is required OScleetmen's Office t C311calth Department E phone#• rJ01her 4, contact person: � Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all emplovers to provide workers' C011fpcnsation for employees. As quoted from the "laW_- an c�mPlnree is defined as every person in the service of :nu ilicr under any contract of hire, express or implied. oral or written. An rmplurrr is defined as an individual. partnership, association. corporation or other legal entity, or any two or m; the foregoing en�ua�=cd in a joint enterprise, and including the legal representatives of a deceased el plover. or the receiver or trustee of an individual , partnership. association or other legal entity, employing employees. However owner of a dwelling_ house having not more than three apartments and who resides therein, or the occupant of the d\vcllin house of another who employs persons to do maintenance, construction or repair work on such dwelling_ to shall not because of such employment be deemed to be an empio\ or oft the _rounds or building appurtenant there MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant Nvlto 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 been presented to the contracting authori y. ,applicants Please fill in the workers* compensation affidavit completely, by checking the box that applies to;your situation anc as all affidavits may be submitted to the Department of supplying company names. address and phone numbers 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 reauir: 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 the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. P be sure to fill in the permit/license number which,will be used as a reference number. The affidavits may be returner tite Department by mail or FAX unless other'arragements have been made. t' The Office of]m estiUatiotts would like to thank you in advance for you cooperation and should you have any questi e please do not hesitate to give usa_ The Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Ae _.. Office of Investigations 600 Washington Street Boston,Ma. 02111 fax irlr: (617) 727-7,749 ' ;�; -. .. .. � _ _,� -- GTE ld� �� • . DBPARMIT OP POBLK SUCY C61STRUCTIOH SOPBRVISOR LICBBSB L,, 9wbeia==-=- BYpires: ' a` _flestrifi�ted Ta: AA dAIU;S L �C1� ULT z _ 193 CLWHEIL COVE - COTOIT, .!U' 12635 r ,�RY— �i� - �.fe�ra�wowa�alGE o�.�lamac�e�ellsf .yam•• ae1�� .. - -' •. HOME IMPROVEMENT CONTRACTOR ` Registration. 120689. Type = DBA i .: j Expiration 07/21/98 ` la CAZEAULT CO ,,J,_MES L. CANAULT ;. o `I031 MAIN ST "NISTRATM •. - '. <. OSTERVILLE MA 02655- -"'-�`�•�_-��+c-e�..�cv�:-.�•. 'R.-yew--�.ra¢�s i I� � Y JANIAK-All Foot) 18 Center St., Hyannis 4/19/.2010 31 Yl a �� ¢� ''',��i�'�•t"'#� ,.$ate.,, :x �� ' a r , fi�r++ ,. =-w •�. ' i -99 _ ! 's 71 18 Center St., Hyannis 4/10/2010 ko- ,zg.aurtaiorruE,a�y: t'tj, , w C 18 Center St., Hyannis 4/19/2010 a .t vwrrw�s.w 1 18 Center St., Hyannis 4/19/2010 � - TOWN OF BARNSTABLE ' CERTIFICATE OF OCCUPANCY PARCEL ID 327 155 GEOBASE ID 24257 ADDRESS 18 CENTER STREET PHONE HYANNIS ZIP - ti rLOT BLOCK LOT SIZE _ DBA DEVELOPMENT DISTRICT HY PERMIT 26262 DESCRIPTION COMMERCIAL REMOD. PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services BTOTAL FEES: BOND $.00 ox iCONSTRUCTTON COSTS $.00 756 CERTIFICATE OF OCCUPANCY * BARMABLE, ; MASS. s6;q. A� I Ep�l I BUILDIN-Go •I ON I BY ~ DATE ISSUED 10/10/1997 EXPIRATION DATE I � �' ' •, �_„�. w� << , ti If ��...►: eY.�.- ��v� � f J C'� "'M+�aa�^+ I k/� a ..� �-� � '} � � �` � , �� ``�;�_a tom-.,_. Ali '�•f'��"�f�- `x.�r�..,� '�:�.: ;ems. - �..�_ �J. ... ......r..;.J _ IrpwN ,OF' .BARNSTABLE . 3fJILT)'OF PERMIT _ `*PIXEL ID 327 155 - GEOBASE -ID 24257 ADDRESS "°18. CENTER STREET. SHONE HYANNIS _ ,. ZIP - LOT HLOCI, LOr�LLySIzk DBA t DEVELOPMENT DISTRICT' HX PERMIT 25733 DESCRY P '10N 1NTF; OI 1EM0p_LAi7NDERlKAT PERMIT `Tx PE . DREMODC TITLE , COMMERCIAL AiI,T/CONY .. ,,CONTRACTORS: :QEKAYO,-THOMAS I Deparfinent of;Health, Safety ARCHITECTS: kand-Environmental Services TOTAL FEES; $183�00 , BOND $-OttdrTHE . CONSTRUCTION COSTS 80 y`00(7,(3c? � . "�•� I 437 NONRES_/NONHSKP ADD/CONV 1`- PRIVATE P '?El« * BARN3TA13M * I MASS, �► I 3 • OWNER dOCJTTER, • EMERS'ON ADDRESS fp 33. EVERGREEN DR MARSTONS MILLS MPS -•BUILD ; D I IO1�T I BY '• I DAT .�'SSaUED...-09/18/1997 EXPIRA`.ION DATE ,. THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,.ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU 2. PRIOR TO COVERING STRUCTURAL MEMBERS ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. ' 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4..FINAL INSPECTION BEFORE OCCUPANCY: ` I BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS i Ldoe C tp-U`T 'Gcti 2 2 2 I 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2C211 ,•:4 BOARVOAFT H I OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL'BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- J ON NOTED ABOVE. TION. B 1 MIT ING x t Ft I (. VC --p — ._>> Am �tF � ,� t. - : ,.,,.:;, r _ ,. �t{fix •r ;ti - a`` G t� �L,� {/fir . . � . .. ., amll ',.".x(:vn1': - ' r ►� Fly; r 44! w 4 Cr1SNiCK A[ Et1 �r � •i � x ^PI •� F�"v,,. Gdr,-;{1� >� OL pp L jr Ti • , / f- -r { am! '� \ _ `r a~ " _ w ° a , a, s ,r °t _ ! t , f `f — r n v .:. e. .. r `1` yy _ ' t 1 y 3 F ..ems _.J �. �. a .; ...., �nA v ,T d r ' �• .� a{„ � tea:—'.. = r : i � � � ,. �' �� _:-� _ ter, � .� • , a , , y 4 u z. x, m w E ) ?_. ► kj- • a ♦ . �: .+� a s: ,.- .� _ - 111 :. , : ♦ ,t _ _aa�• I �. a p:, S s , r i i « ' x h e 6 ( • I 1 �. it • u A a a /eI i' �t S✓�r: z I : _ Fly Pigpjfe /,/\A 0260E oorz, wAry I � AS LOT 154 4 DEED REF• 3027173 ° tz 14945 � \ TRAIL SPLI IV8146 p6 E N86 57 26 E 76.26' • 41 2 All D 0 UNITS DUMPSTER / LC'��,. \' N. 00 34.1 LOCUS MAP m cfl 4. //rrr/rr/r./r EMSTINO::�:::::::::�:::�:::::;tom\ ////////////ir///////BUILDING.r///rrr./rr//././rrrr./../ NOTE' BUILDING SERVICED BY TOWN WATER & SEWERAGE. b ZONING. �)B„ T;;;;;;;; �� / PLAN REF.- 77/107 » �, p FLOOD ZONE C f �,//,,, z� / 1191137 ASSESSORS MAP 327 —p�� .145155 _ / OVERLAY DISTRICT• . "AP" 314/36 26 C NCRE ,w 33155 , 347129 o�� LC 7736A AS LOT 155 LC 9132A 2 DEED REF CTF# 141364 / y0 20 0 AREA= 28,073f sq/ft / T t ® /� ,�ITE PLA1\1 Dh LA.1 D LOCATED LEGEND. os�� ® / N/F PENN CENTRAL ----- , 1 S CENTER ST. 40 l RAILROAD UTILITY POLE' RA.R.NSTABLE (HYAN.NIS) MONITORING WELL PREPARED FOR: ® CATCH BASIN wv MIA A T SA�ED WATER VA VE VN A UG UST 24, 2000 719 9E � �, )"A WEE SUR BEY CONSUL TANTS vDscAPED �� PARKING PRO VIDEO P. O. BOX 265 UNIT 5, 403 INDUSTRY ROAD 2 HANDICAP MARSTONS MILLS, MA. 02648 \ .p0 9.12 23 PARKING SPACES PH.(508)428—0055 — FAX(508)420-5553 G, EE�\ ' o� ��1� . �82161 NOTE. PARKING LOT GRADE IS EQUIVALENT TO CONCRETE PAD 1� ON SOUTH SIDE OF BUILDING THEREBY AlLOA7NG FOR HANDICAP ACCE'SSABILITY. GRAPHIC SCALE 20 0 10 20 40 a 007 00 per\ ( IN FEET ) RELawl M 9 A 1 inch = 20 ft. PR PENDING SEWER DEPARTMENT SPECS A. FOR PROPOSED GREASE TRAP. I CERTIFY THAT THIS SURVEY AND PLAN WERE MADE IN ACCORDANCE WITH THE PROCEDURAL AND TECHNICAL sr� STANDARDS FOR THE PRACTICE OF LAND SURVEYING IN TnMMONWEALTH � OF MASSAAIA 0. CHUSET , PA UL A. MERIT W, P.L S. ATE 52453 , 1I , i - 1 L1 w I 1 - , UG�SS l � I I - i - 0 0 VI Kew L`.� Z" WA It ye i .. f�JEw metal( MPS)7a Aj VN Uj II , : �H f a i 7 r i I , r I rr�r' r : i� , ,,.. M a : „ If rat. 54 -c� A x , -P 14;Pu ..5