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.�9 � ,� v ,. ��� -- M1 �� ,� N a '� �- �i i I� r �i I � i �' �'1 e � 'i ` I :M ,I _ T ..:�= ---__ ..1 t _as ._ .-. .. Martin Vazquez 66A Willow Ave Hyannis Ma 02601 (508) 776-9849 Re:Residential occupancy permit At 66A willow Ave Hyannis.. I have. rented 66A Willow ave (formally 20 Willow Ave Unit 9 since March 1 1996. ( Y , ) It (66A) has been used as a Music instruction and'production facility for 22 years' in that ` time there has never been a complaint about how I am using the facility; until now. In 2017, while in litigation;I was contacted and inspected by the Health Dept. The Health Dept. stated that'an "anonymous complaint" about drug sales.and illegal , activities.at 66A were reported. and it was determined that the "break room" at 66A was not a violation. Since 1996 I have use'd'66A to instruct thousands of students and produced shows that have toured America; Canada, and Australia. During production sessions with. musicians (some local and some as far away as the`west coast) I have used 66A till 4,or 5am. And then slept at 66A; It is with this'continued use in mind that I am requesting that the Town of Barnstable review and grant 66A willow ave Hyannis a.residential occupancy permit. Martin Vazquez •r P CC. Dave Dumont , 1 t 378b1SN��� J0 ,a1 Town of Barnstable IMAIM"S`$ Building Department- 200 Main Street Hyannis, MA 02601 / Tel. (508) 862-4038 Certificate Of Occupancy Permit Number: 13-17-104 CO Issue Date: 5/18/2017 Parcel ID: 327-066 Zoning Classification: HVB' Location: 59 CENTER STREET, HYANNIS Proposed Use: ONE BEDROOM APARTMENT Gen Contractor: JAMES K SMITH Permit Type: Commercial - Mixed Use Comments: UNIT ADDRESS 73 - 05/18/17 Building Official Date: t tHE T Town of Barnstable , r" '"""`s'"B`g - Building Department- 200 Main Street . H MA 02601 rEOTAA�a�m yannis, Tel. (508) 862-4038' '✓ Certificate Of Occupancy Permit Number: B-17-107 CO Issue Date: 5/18/2017 Parcel ID- 327-066 �' Zoning Classification: HVB Location: 59 CENTER STREET, HYANNIS Proposed Use: ONE BEDROOM APARTMENT Gen Contractor: JAMES K SMITH Permit Type: Commercial - Mixed.Use Comments: UNIT ADDRESS 50A 05/18/19 Building Official Date:. i CF 1 E T o� Town of Barnstable sAxrtsrea[.E 200 Main Street Tel.(508)862-4038 rED.MA'� INSPECTION REPORT Date: 5/18/2017 3:11 PM Inspector: mckechnr Permit Number: -B-17-107 I Name: DUMONT, DAVID S TR Address: 59 CENTER STREET, HYANNIS Inspection Type Inspection Item Status Comment Building Final A- Inspection.Results Pass Inspection Overall Comment: Overall Inspection Status: PASS Re-Inspection Date: Inspector Initials: Person in Charge Initials: Total Score: 100 I Town of Barnstable Building Department-200 Main Street D i639' �0 Hyannis, MA 02601 Tel. (508) 8.62-4038 Certificate Of Occupancy Permit Number: 13-17-105 CO Issue Date: 5/18/2017 - Parcel ID- 327-066 Zoning Classification: HVB Location: 59 CENTER STREET, HYANNIS Proposed Use: TWO BEDROOM APARTMENT Gen Contractor: JAMES K SMITH Permit Type: Commercial - Mixed Use _ Comments: .UNIT ADDRESS 50B .05/18/17 Building Official Date: I Town of Barnstable 200 Main Street Tel.(508)862-4038 TfoMAY.A INSPECTION REPORT Date: 5/18/2017 3:22 PM Inspector: mckechnr Permit Number: B-17-106 Name: DUMONT, DAVID S TR Address: 59 CENTER STREET, HYANNIS Inspection Type Inspection Item Status Comment Building Final A- Inspection Results Pass Inspection Overall Comment: Overall Inspection Status: PASS Re-Inspection Date: Inspector Initials: Person,in Charge Initials: Total Score: 100 D Final Construction Control Document u To be submitted at completion of construction by a y d Registered Design Professional V h for work per the 8`h edition of the Massachusetts State Building Code, 780 CMR, Section 107 o i Project Title: L014' Date: Permit No. Property Address: Project: Check one or both as applicable: ❑ New construction ❑ Existing Construction Project description: 1[v, Li IAL f` }; , I .� MA Registration Number: Expiration date: ,am a registered design ofessional, and I have prepared or directly supervised the preparation of all design plans, computations and specific 'ons concerning: [ ] Architectural Structural [ ] Mechanical [ ] Fire Protection [ ] Electrical [ ] Other: for the above named project. 1,or my designee,have performed the necessary professional services and was present at the construction site on a regular and periodic basis.To the best of my knowledge,information,aridbelief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved s part of%e buihfiing cm permit and that I or my designee: W �1. Have reviewed,for conformance to this code and the design concept,shop drawings, sam, les and o-ther Aenittals by the contractor in accordance with the requirements of the construction documents. 7-5 \ 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable. m v 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the _ progress-and-quality-of the work and.to determine if the work was.performed in.a manner consistent with the _ construction documents and this code. Nothing in this document relieves the contractor of it sibil ng the provisions of 780 CMR 107. CI mo, K K SKI Enter in the space to the right a"wet"or electronic signature and seal: Phone number: ' Email: j ' G Building Official Use Only Building Official Name: Permit No.: Date: Version 06 11 2013 r ` , � � � Y .. i dam;;�� _ ?�,� �.. a r. #' i`t� ,;. r. �' a SHE t o� Town of Barnstable RARMSr"SM _ -Building Department- 200 Main Street . MAS4. A , - rEOMo'm Hyannis, MA 02604 ; Tel. (508) 862-403.8 Certificate Of Occupancy Permit Number: 13-17-104 CO.Issue Date: 5/18/2017 Parcel ID: 327-066 Zoning Classification: HVB location: 59 CENTER STREET, HYANNIS Proposed User' ONE BEDROOM.APARTMENT _ . Gen Contractor: JAMES K SMITH Permit Type: Commercial - Mixed.Use Comments: UNIT ADDRESS 73 - 05/18/17 w;, Building Official Date: , o Town of Barnstable Building Department- 200 Main Street t . Hyannis, MA 02601 Tel.. (508) 862- 4038 Certificate Of Occupancy Permit Number: B-17-105 CO Issue Date: 5/18/2017 ,Parcel ID:. 327-066 Zoning Classification: HVB . Location: :59 CENTER STREET, HYANNIS Proposed Use: TWO BEDROOM APARTMENT Gen Contractor.: JAMES K SMITH Permit Type: Commercial - Mixed Use Comments: UNIT ADDRESS 50B _ 05/18/17 Building Official Date: I, o Town of Barnstable '"RYM"B`B ` Building Department- 200 Main Street : . TEo °.. Hyannis, MA 02601 �> Tel. (508) 862-4038. Certificate Of Occupancy Permit Number: B-17-107 CO Issue Date: 5/18/2017 Parcel ID: 327-066 Zoning Classification: . HVB Location: 59 CENTER STREET, HYANNIS Proposed Use: ONE BEDROOM APARTMENT Gen Contractor.:. JAMES K SMITH Permit Type: Commercial - Mixed.Use ; Comments: UNIT ADDRESS 50A D 05/18/19 Building Official Date:. Project Name:_ �`�I�YLC�1 Address:__ bv)hf �— Permit#: 1-7__I b�I ' ��_I�� _I�-IN Permit Date:_ LARGE ROLLED PLANS ARE IN: BOX: SLOT:_�1��� Date entered inMAPS program '5 on: I .i10 By r Phase Construction Control Document s To be submitted at completion of required site reviews of phase construction for work per the $t" edition of the tl G Massachusetts State Building Code, 780 CM.R, Section 107.6.2.2 To 4 Project Title: Date: i Permit No. Property Address: 1, MA Registration Number: Expiration date: C , any a registered design pt-gfessional and 1 hereby certify, to the b t€if nt in fcartrtattptlW l a o vied c;Mitt t eli .-that 1 or my designee have gbs rvetl HiW 4ed-the following work,and 4— that the work has been performed in a manner consistent with the approved plans and specificatidns for the:following phase of construction as indicated: Required.SiteReview and Documentation for Phase Construction" (to be perforated b'the a .i•o riate:registercd design professional or hisihcr deli ncebt M:G.L.c 112§81 R`contractor) Site Review and Documentation R Site Review and Documentation R Soil condition and analysis Engrg,,,effcienc• Footing and Foundation,including Reinforcement and Fire Alarm fistallation'' Foundation attachment Concrete door and Gndcr Moor Fire Suppression Installation' l .Lowest Floor Flood Elevation Field Reports' Structural Franc—wall floor roof J Carbon Monoxide Detection System' Lath and i'lastcr/Gypsum Seismic reinforcement Fire Resistant 1> tll/Partitions framing Smoke Control Systems Fire Resistant Wall Tartitions finish attachments Smoke anti Neat Vents Above Ceiling,inspection Accessibility(521 CMR) fire(31locking,%Stopping,System I Other. Emergency Lt,hting!Exil Signage Means of Egress Com oncnets Special Inspections(Section 1704): Roorina,co)ing/Sy$tcni Venting Systems(kitchen;chemical,fume) Mechanical Systems I. indicate with in�x'the work you reviewed for compliance with the approved plans and specifications and describe in detail below. 2. Include NFPA 72 test and acceptance documentation 3. include applicable NFPA 13, 13R, 13D,14,157 17,20,241.etc.-test and acceptance documentation 4. Include NFPA 720 Record of Completion and inspection and Test Form �. include field reports and related documentation 6.Nothina contained within construction control shall have the effect of waivim or limiting the building official's.authority to enforce this code with respect to examination of the contract documents,including plans,computations and specifications,and field inspections. Work Description': a.t)scribe in suatusni detail the,vork(ic.1'uundatien steel reinforcing kitchen rent system,etc)and tits`4xa Q i}p e i'st it;tpptie IC.Lhe subntiai tixumems th,i pertain ut tN_work which was inspected. U� FY3' �. Enter-in the space to the right a"wet"or ; electronic signature and seal: ' �.� '��� •�� ,..y r� u-a?,,� i� tom,�,s �ct �' '`,r `��F������ Phone number: Email- ; Ott Building,,Official Use Only Building Official Name: Date: Trial Version 10092012 UUMUN l bUILU1Nb 71 CENTER ST. HYANNIS, MA. CANTILEVERED DECKS FRAMING 2 X 8 SOUTHERN PT PINE. .#2 NON-DENSE Fb = 950psi E = 450000 min value Joisfs. p snow dri f L 8' lap 50 psF p dead 12 psF double 4.08' ends 4.0 8' cantilever deck Joist, 16" o.c. 2 x 8 pL sect ion properties 1112 x 7114 A = 1088 in-2 Ix = 476 in-4 Sx = 13.14in3 bending moment max = w.l 2 1.2 = 8235 in-# !where w = L33 x 62 psF) Mb allowable = FLU x Sx = 12483 in-# < 8.235 in-# olk max at end w.l-4 / 8 . E1= 021 " edwinkeminskl®uahoo.com �� � � ��� �� � � �-�5 :.� ��� ' Initial Construction Control Document z To be submitted with the building permit application by a a , d Registered Design Professional - for work per the 8a'edition of the SVo�� Massachusetts State Building Code, 780 CMR, Section 107. Project Title: 60w+0 � u� �v, Date:l C> CZ b Property Address: �_ :a Project: Check one or both as applicable: "ANew construction '%'-4 Existing Construction Project description: N4J ' ; CP V—JL"r Zod 1, , 1 I MA Registration Number: ry Expiration date: $ ,am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: , [ ] Architectural �"" j Structural [ ] Mechanical [ ] Fire Protection [ ] Electrical [ ] Other for the above named project and that to the best of my knowledge,information, and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary _ professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings,samples and other submittals by the contractor in accordance with the requirements of the construction documents.—,'" 2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work-is being performed in a manner consistent with the approved construction documents and this code. " Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. r Upon completion of the work, I shall submit to i g official a`Final Clo,n.,st_ruction Control Document'. Enter in the space to the right a"wet"or electronic signature and seal: Ft-),WM '' �. Q :�C• �{;AR&lRdS1�► st. 316 I lei Phone number: 0 S b' Email: .1L 1r•7 H Q W)►Vn S • COIn g Official Use Only Building Official Name: Permit No.: Date: Version 06 11 2013 wr w e . a a. ♦ Y r p a . 1 4 R . BUILDING DEPT, ` DEC 0 9 2016 • , STABLE TOWN OF�BAFiN S I Town of Barnstable Building Post`7h�s Card So That rt�s Ursible°<From the Street-AppravedPlansxlNust be Retained o w ob and tfiis Card Mus be.Kept , Posted Until'Fitia`I Ins ection Has Been Made __ p m W.ece a.:Certi#icate of Occu anc. �i�Re aired"such E#uildin sli'alh<Not be,®ccu red u°ntil a E�nal�lns ectronfiasbeen made 1 erjjll� Permit No. B-17-400 Applicant Name: Sidney K Horton Approvals Date Issued: 03/09/2017 Current Use: Structure Permit Type: Building-Sheet Metal-Commercial . Expiration Date:' 09/09/2017 Foundation: Location: 59 CENTER STREET, HYANNIS Map/Lot 327 066 Zoning District: HVB Sheathing: Owner on Record: DUMONT,DAVID S TR )P Contractor Name Sidney K Horton Framing: 1 Address: 298 MAIN ST SUITE 7, K n�tractor Ucense 5121 2 HYANNIS, MA 02601 4 Est Project Cost: $0.00 Chimney: Descri tion: install 3 small hvac s em into three se aratea artme is P Yt P P Permit Fee: $ 160.00 Insulation: Project Review Req: install 3 small hvac sytem into three separ�a aprt�ments Fee�,Paid $ 160.00 Final: Dates � 3/9/2017 , " Lcm Plumbing/Gas Rough Plumbing: • � � �� � __ :�_� ;� �� � ��=_=.Buildin Official g Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afferissuance. �', Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents:for whic*KAhis permit has been granted. All construction,alterations and changes of use of any building and str ctures shall be in with the local zon.A% laws a codes. Final Gas: This permit shall be displayed in a location clearly visible from access streetor,oad and shall be maintained open for 0 ,04IJc1Ihs&cfi6n for the entire duration of the work until the completion of the same. q fi Y Electrical The Certificate of Occupancy will not be issued until all applicable signatures bey the B ildmg andFire Officials are,prov�dedlon this"permit. 74 _ - Service: Minimum of Five Call Inspections Required for All Construction Work �� �� 1.Foundation or Footing ° Rough' 2.Sheathing Inspection ...21 . 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 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: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT d,p 3-9-1 -Commo.nwealth of Massachusetts NO 0 %11 Sheet Fetal Permit Map Parcel ® ' a Date: 1 a Permit# - f � FES 14Y Estimated Job Cost: $ ���K r0WA1�y / ?®�, Permit Fee: 11,15 / Plans Submitted: YES:, NO ��148 Reviewed;: YES NO Business License# !'jj -- Applicant License o Business Information: _ Property Owner/lob Location,Information: Name: 0 _ A4.lad eLAIa4 L4 l Name,: Street: -eQ in Street:59 &ev&,0VS f-ZA[A 7.7 6re,,kvf:r)- City/Town: City/Town: Ouct !.&q Telephone: 5 ob 3 W?S yi - - -_ Telephone: ,�O - qa)— U Photo I.D. required/Copy of Photo-1D: attached: S Staff Initial J-1 /M-1-unrestricted license J-2/M-2-restricted to dwellings 3-storie8 or less.and,commercial up,to 10,000 sq. ft. /2-stories or less Residential: 1-2 family Multi-family t/ -Condo/"Townhouses Other Commercial: Office Retail Industrial:. Educational Fire Dept17 a stitutional Other, Square Footage: under 10,000 sq. ft. ilk over X0,000,sq, ft, Number of Stories.: g , Sheet metal work to b completed: New Work. ✓ Renovation: HVAC metal'Watershed Roofing Kitchen Exhaust System Metal Chimney:./Vents;_ Air Balanciang Provide detailed description of work to be'done-, I. INSURANCE COVERAGE: I have current insurance policy or its equivalent which meets they requirements of M.G.L.Ch.'112 ° Yes �No ' I If you have checked Legt Indicate the type of coverage,by checking the apprvpriate.box below: A liability insurance policy Other type of indernnity' E] 130nd. ❑ OWNER'S INSURANCE WAIVER: I'am aware that the licensee does not have the insurance coverage required by Chapter 11'2 of the ' Massachusetts General Laws,and that my signature on this permit application wWyo this require, m6nt., • Check,,,One Only uvnee`❑: _ Agent Cl Signature of Owner or Owneles Agent By checking this box ,I hereby certify that all of the details and Information I have submitted(or entered)regarding this application are tree and accurate to the best of:my.knowledge and thatail sheet metalwork and installations perfotir�ied uncer the permit Issued for this application yvill be: in compliance with all pertinent provisign,of the.Massachusetts Building Code.and'Chapter.1.12 of the.General Laws. Duct inspection required prior to insulation installation: YES. NO Date Eo=ents t �+ at n9d Ql ecfi� Date Comments:: - D , Type.&License` i 3Y aster. Fite Q Masfer=Restricted`., Wi own _ . ❑Jourrieyperson. Signature of Licensee 1:14ourneyperson-Restricted License.Number: -- =ee$ Check atdft nspector:Signature of PeT*nit Approval - ' • ,M - :1 ���rt,� i we �� s f '"" r�t'tri v„'• �� ; r 11- I SPQ77i,Gi tt'7VR a \ r ..k r _ n Town w of'Barnstable Regulatoryervices 4NAM Thomas F.Geiler,Director. Building Division -Tom.Perry,Building Commissioner 200 Main Street,Hymiis,MA 0260 i • vato�mm.bara�stabiea�aa:us Office: 508-862-4038 'Fax: 508-790-6230 Property er must Complete•and Sigri This Section if Us n 'A. Buffder I, G V 4 t�wlq-�► ,as {owner of the property subject l hereby authorize d e_ WCQ to.act on my behalf, in:all matters relative to work;authorized,by this building.permit (Address of Job) **Pool fences and alarms are the respoI nslbility of the applicant. Pools are:not to be filled before fence is installed and,pools are not to be utilized until all final inspections are performed and. accepted. Signature of Owner Signature 6f Applicant Print Name Print.Name aA)h)_ Date Q:FORMS OWNERPE,RMiSSIONPO0LS The Commonweaalikof Maasssachuseas DepaFhnent of lndustrW A ccidenis Office 0f1-�estagaat o s 600 Washinkton Street. Boston,MA 02111 wwwenaass.golv/diaa Women' Compensation insurance Affidavit: BuRders/Co>ntracfors/Eleetricgas/Plumbers Applicant Information Please Print Legibly Name(Business/Organization%lndividuat) CIA ("V Address: ae,0%ro' \sea c City/State/Zip: c�L ' i0(rW JW t4n G hone:#- 7SP Are 1. y10 aom aemployer?Check the appropriate bog: -Type of project(required);; e to gen er wiil eralconraoatid:I 6. ❑New construction: . employees(full and/or pazt:time).* have`hired the sub=contractors 2.0 I am a•sole proprietor or.partner- wed on the•attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. [[•]Demolition working for me in•-any capacity, employees and have workers' [No workers comp:msTrance., mPco •insura ce.t 9. []Building addition , retluired J 5. ❑ We are it corporation and its 10.❑-Electrical repairs or additions 3.❑ 1 am a homeowner doing.ail work officers have exercised their 11.0 Phimbing repairs or additions myself. 'co . right of exemption per MGL [No workers >nP• 12.[]Roof repairs . insurance required.)t c. 152,§1(4),and we have no employees. [N� workers' 11[1 Other comp:insurance regared.] "Any applicant @tat checks box#1 must also fill ou2the 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. 1Contractors that check this box must attached an additional sheet showing the name of the sub-cont wtors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp:policy number., I a8rn an employer that is providing workers'compensation insurance for-my employees. Below is the,policy and job site information Insurance Company Name: \2.,*-vu7 vc�ufc �W S Policy#or Self-ins.Lic.P. Expiration Date: Z >_l j Job Site Address: 5 city/State/Zip:' Attach a copy of the wormers'-compenasation.policy declaration.page'(showimg the policy number and expiration date). Failure;to secure coverage as required under Section 25A of MGL c. 151 can lead to the imposition of crimni tal.penalties of a fine up to$1,500.00 and/or one-year imprisonment,as:7e11'as civil penalties in the form o£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 forwarded to the Office of Investigations of the DIA for insurance.coverage verification. I ilo hereby certify under tDie paiDas and penalties'of perjury,that the information.provided above is true and correct Si store: Date: . Offuial use only. Da not write in tBis area,to be cotrrpleted by city arlown-official C or Town:' ' PermitfLicense'# .Issuing Authority(circle one): A.Board of Health 2.Build,i IDe artr�aent,,3.Ci /']'own Clerk 4.Electrical Inspector 5:Plumbing;Ins Inspector � P . t3' . � �p : 6.Other Contact.Person: Phone#: I ,aco CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDDIYYYY) 1 12/21/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - NAMEACT Michael Edwards Lawrence Carlin Insurance Agency PHONEP E_t): (508)540-7100 FAX Not (508)540-8426 230 Jones Road E-MAIL Michael@lawrencecarlin.com ADDRESS: INSURER`S)AFFORDING COVERAGE _ NAIC A Falmouth MA 02590 INSURER A.Norfolk & Dedham Mutual Ins Co INSURED - INSURERB:Technology Insurance Cc Cape Cod Mechanical Systems Inc. ---wsuRERc: ---._------ ._.- 8 Fruean Avenue - • INSURER D: - INSURER E: - South Yarmouth MA 02664 INSURER F COVERAGES CERTIFICATE NUMBER:CL1591700897 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - ADOL S BR - — - _ LTR� TYPE OF INSURANCEINSD WVDPOLICY NUMBER MMLDDIYYYY MMIDDIYYYY LIMITS I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE OCCUR - PREMISESS Ea DAMAGE ( _Ea oc S cururence $ - ,-- MED EXP(Any one person) $ I-- - - PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE $ POLICY I l PRO- D JECT _J LOC - PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT r $ 1,000,000 - Ea accident) _ANY AUTO _ - - BODILY INJURY(Per person) $ AI ._.._..._.._.. .. ALL OS R SCHEDULED 91275445A 12/22/2015 12/22/2016 BODILY INJURY Per accident) $ -_- AUTOS AUTOS ( X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS 12/21/16 12/22/17 $ per accident) Uninsured motorist combined $ 50,000 _ UMBRELLA LIAB OCCUR - EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE - AGGREGATE $ Y DED I RETENTIONS $ WORKERS COMPENSATION PER OTH AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? n N/A - B (Mandatory in NH) - WWC3156200 9/21/2016 9/21/2017 E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) - - CERTIFICATE HOLDER CANCELLATION (508)790-6230 . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Dept., ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis, MA - 02601 AUTHORIZED REPRESENTATIVE David Lawrence/MEDWAR ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 r91`114011 Town of Barnstable Post;Th�s"Card SoThat it is Visible F.rom.the Street-A roved Plans,Must beReta�ned on Job and this Card 10 Must be,Ke t � • - v M Pos �Unt�l Final Inspection Has.Been Made „ y R Wh tedere a Certificate of Occupancy istiRequired,such Bu ldmg shall Not be Occupied until a;F<nal Inspeet has been made �� l� Permit No. B-17-107 Applicant Name: DAMES K SMITH Approvals Date Issued: 02/13/2017 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 08/13/2017 Foundation: Commercial , Ma Lot: 327-066 Zoning District: HVB Sheathing: Location: 59 CENTER STREET, HYANNIS y "' ' f K. Contractor Name. DAMES K SMITH Framing: 1 Owner on Record: DUMONT,DAVID S TR Contractor License.; CS-005150 2, Address: 298 MAIN STSUITE 7 Est Protect Cost: $65,000.00 Chimney: HYANNIS, MA 02601 % ,3 , Permit Fee: $716.50 Description: FIT OUT SINGLE BEDROOM APARTMENT 50A Insulation: Fee Paid S 716.50 Project Review Req: FIT OUT SINGLE BEDROOM APARTMENT 50A Date�`N 2/13/2017 Final:At Plumbing/Gas �e a Rough Plumbing: BuildingOfficial Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized 6y this permit is commenced within six rnonYhs after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents; or whidh4his permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public$mspection for the entire duration of the work until the completion of the same. Electrical ... . The Certificate of Occupancy will not be issued until all applicable signatures,by the Bu,ildmg and'Fire Qfficials�are provided on thisipermit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing ,:i Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: er.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7;,;inal 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. s Final: "Persons contracting with.unregistered contractors:do not have access to the guaranty fund'' (as set forth.in MGL c.142A). - Fire Department - Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT ISSUED RECIPIENT Town of BarnstableBuildin r This Card=So That rtrs Visible From:the Street <A rovedEPlans Must-be Posh Epp Retained=on;J , e b a ModrsCrd a 9 �► � Posted••Until�Flnal�Insp�ect�on�Has�Been�Made s � ` � � � ; � ; �' Permit here's Certificate of Occu anc, �s Re ,used such8uildin ShaIlNot be Occu red,untal?a Final Inspectron',has been , Permit No. B-17-105 Applicant Name: JAMES K SMITH Approvals Date Issued: 02/13/2017 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 08/13/2017 Foundation: Commercial. Map/Lot 327-06,6 Zoning District: HVB Sheathing: Location: 59 CENTER STREET, HYANNIS t f �Contractor Narne: JAMESK SMITH Framing: 1 Owner on Record: DUMONT, DAVID S TR n Contractor License CS-005190 2 Address: 298 MAIN ST SUITE 7 ,_. , Est Project Cost: $65,000.00 Chimney: HYANNIS, MA 02601 Permit Fee: $716.50 MI Insulation: Description: FIT OUT 2 BEDROOM APARTMENT 506 Fee Paid $716.50 •', s f Final: Project Review Req: FIT OUT 2 BEDROOM APARTMENT 50Bgg-•� Date , 2/13/2017 Plumbing/Gas Nt y Rough Plumbing: ' "•;Building Official Final Plumbing: .. . This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within sikp' nths after issuance. p '" Rough Gas: All work authorized by this permit shall conform to the approved application:and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures all be in compliance with the local zoning by la sand codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public mspect6 for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Buildirig�and Fire Of vials are provided on Lhispermit. Service: Minimum of Five Call Inspections Required for All Construction Work:' f 1.Foundation or Footing r ,< k Rough: 2.Sheathing Inspection -... .,.: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4-Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation - 7jinal 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: 'Persons contracting with unregi"stered contractors do not have:access to.the guaranty fund (as set forth-in MGL c.142A). Fire Department Building plans are to be available on site Final' All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT I Town of BarnstableBuilding s,..f `PostThis.Card So.ThatUis�ble,From theStr,.eet A , roved Plans'M',ust be.Retamed onJob and`th�s Card;Must be Kept , Posted Until•`F,mal 1pspection Has Been:Made � � �: � 3 9 � "' � � � ' � �.�� � Permit �W,he shall°Notbe;Occu iedrant�l3a"""Final Inspection;-.has been made Permit NO. B-17-104 Applicant Name: JAMES K SMITH Approvals Date Issued: 02/13/2017 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 08/13/2017 - Foundation: Commercial Map/Lep ot: 327-066 Zoning District: HV13 Sheathing: Location: 59 CENTER STREET, HYANNIS Contracto NSme: JAMES K SMITH Framing: 1 Owner on Record: DUMONT DAVID S TR r ir Contractor License:" CS-005190 2 Address: 298 MAIN ST SUITE 7 Es't ,Project Cost: $65,000.00 Chimney: HYANNIS, MA 02601 rmit Fe` $716.50 Pee: Description: " fit out single bedroom apartment THIS IS 73 CENTER STREET Insulation: Fee Paid: $716.50 Project Review Req: fit out single bedroom apartment THIS;IS'73-CENTER STREET Date 2/13/2017 Final: 4 Plumbing/Gas Rough Plumbing: Building a � "tiff All 4111, � g Official Final Plumbing: ' This permit shall be deemed abandoned and invalid unless the work authonzed bythis permit is commenced within six months afterrtissuance. Rough Gas: All work authorized by this permit shall conform to the approved application andxthe°approved construction documents for whichithis permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zo6i,g by laws a'nd codes. Final Gas: This permit shall be displayed in a location clearly visible from access sYreei or goad and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. y Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing Y..• Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4,.-Wiring&Plumbing Inspections to be completed prior to Frame Inspection 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: "Persons contracting.with unregistered contractors do.not have access.to,the.guaranty fund".(as set forth in MGL c.142A). Fire'Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3a-e 1 Parcel 0Application # ' �`V_)_ Health Division . Date Issued 2,!) VI-7 Conservation Division Application Fee r� Planning Dept. ,� G �v Permit Fee ,0 Date Definitive Plan Approved by Planning Board 9 1`b Historic - OKH — Preservation/ Hyannis%: n Project Street Address 50 /S� w Village /Aitgls ; FSfi.RN ST kA Al rt V Owner bAv f 0 Cl rn ©I-l-F Address o)-9�;; 11*0 N S 1 4 is lgr4 Telephone C-c h .66's 4010--q' 00 C)4,FlLc- .S-' -V'5-ff-200 Permit Request r^:I— Oc-s S/'/A d-1 Square feet: 1 st floor: existing 916 proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay, Project Val uatio o 5 0_ Construction Type rmm r Lot Size Ac"S Grandfathered: ❑Yes B o If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) 3 Age of Existing Structure Historic House: ❑Yes 9 o On Old King's Highway: ❑Yes U'ICIo Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other S LA6 Basement Finished Area(sq.ft.) -0 1- Basement Unfinished Area(sq.ft) Number of Baths: Full: existing O new I Half: existing O new Number of Bedrooms: 0 existing I new Total Room Count (not including baths): existing U new First Floor Room Count Heat Type and Fuel: �as ❑ Oil ❑ Electric ❑ Other Central Air: s'Yes ❑ No Fireplaces: Existing © New O Existing wood/coal stove: ❑Yes Detached garage: ❑ existing ❑ ne ize ool: ❑ existing ❑ new size — Barn: ❑ existing ❑ new. size_ Attached garage: ❑existing ❑ n i Shed: ❑ existing ❑ new size Other: 9 9 9 — g Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial U'Yes ❑ No If yes, site plan review # Current Use VACS Ilf-I Proposed Use !ZI t4 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name d ri i? S i i It Telephone Number 5Gg 101C142 Address Jia9 License# CS `'©���50 y A rR A S i A J,�)U�:- Home Improvement Contractor# 10010 q c° Email Sh S14 i 7"14-4,1 0 69'ill I"ri Cvh-- Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO A- Fk ci A% F 2-C 0 HAyLE-A- SIGNATURE DATE 0 l 06 P7 f FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application Health Division Date Issued 2113h7 Conservation Division � �, Application Fe Planning Dept. �� �T� 0 Nl : Permit Fee e Date Definitive Plan Approved by Planning Board -,�v `V Historic OKH _ Preservation/Hyannis 4 Project Street Address L 3 C Qi4_i-�lZ.. S� Village 14 ti 8W II.i K �f)�IN57A-PMC. Owner V_i V) u1AoN'T . Address �!,919 /'1441 Si !�yA , /l/�4- Telephone SOS 4C;0 glt'1® C,1( 0_F9-C,4 Permit Request r;i 00i- ;S f M6-fL r'�c�/� �r�2i iN►:�� i r Square feet: 1 st floor: existing 2IL-proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 65(0 ?'0 Construction Type earn M Lot Size f M V:hCAaS Grandfathered: ❑Yes ®o If yes, attach supporting documentation. Dwelling Type: Single Family Or'*' Two Family ❑ Multi-Family(# units) Age of Existing Structure 65 lizs Historic House: ❑Yes Q<o On Old King's Highway: ❑Yes Z1 Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other :SLO1J3 Basement Finished Area (sq.ft.) — 0— Basement Unfinished Area (sq.ft) Number of Baths: Full: existing 0 new Half: existing U new Number of Bedrooms: ► 0 existingX new Total Room Count (not including baths): existing 0 new First Floor Room Count � �— Heat Type and Fuel: U15as ❑ Oil ❑ Electric ❑ Other Central Air: R<es ❑ No Fireplaces: Existing 0 New 0 Existing wood/coal stove: ❑Yes Q<o Detached garage: ❑existing ❑ new Ize/ Po�. ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ ne Shed: ❑ existin ❑ n w iz h r: g g gg e size e Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial Lk1es ❑ No If yes, site plan review# Current Use VIN ctPf t-+**r Proposed Use _ A j?Ap_ w_Q.H7T- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address I(A5' M\-1ANN•15 License # CS 00,51 ci Home Improvement Contractor# i oo 6qq Email S FA i r� 1A R fth,i I CO M" Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO A LA-aA i z;�j J�AiJL•�� SIGNATURE �Q/rr�L" DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER " DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL F-INAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. " TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2 Y1 Parcel G 130V Application r pp // Health Division ,�N r -Date Issued Conservation Division p� Application Fee Planning Dept. Permit Fee ca v 1 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis MAM, S£ ' Project Street AddressC� �u /T V - Village P i/A 1V j S �vA S I ►��� Owner IDJD y I to 1)iJNk1 N I Address ac!ZI MAIM- Telephone ' I Cx)—Ita vo CVP C4 50% 177.5 r- s7o cj, Permit Request �cj' 0ti► 2L (')V)A xT W-J4T' Square feet: 1 st floor: existing 139 1_proposed b 2nd floor: existing proposed ® Total new U Zoning District Flood Plain Groundwater Overlay Project Valuation 4c5 o G U Construction Type AAt4 r Lot Size a 4 Cl R<it Grandfathered: ❑Yes ❑11110 If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) 3 Age of Existing Structure fo Historic House: ❑Yes U-N On Old King's Highway: ❑Yes a1q'o Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other13 Basement Finished Area(sq.ft.) 0 Basement Unfinished Area(sq.ft) 0 Number of Baths: Full: existing Lf new b Half: existing U new Number of Bedrooms: existing?•new ' Total Room Count (not including baths): existing 0 Ft-- new 3 First Floor Room Count 3 Heat Type and Fuel: L2<Gas ❑ Oil ❑ Electric ❑ Other Central Air: es ❑ No Fireplaces: Existing New- Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing 0 new Ne Pool: e ' ti'ng ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ newS d: ❑'ex(stin ❑ new size Other: g 99 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial Pores ❑ No If yes, site plan review# Current Use Proposed Use �P����`fi !`} APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �f�1�1'r�S S14 i T 14- Telephone Number Sy F (ny9-- J JOY Address 160,57 P N I�1 S Act License# C Qa9 -A S 1 6. Home Improvement Contractor# CCJ 6 cy Email :f-K S Ml T t+ L'clh'\ Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO J�ci�rUl�-i�-P� l��S✓�r'r� SIGNATURE DATE of 01) /P7 FOR OFFICIAL USE ONLY APPLICATION # } DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL «� FINAL BUILDING a DATE CLOSED OUT ASSOCIATION PLAN NO. r Shea, Sally From: Deputy Dean Melanson <dmelanson@hyannisfire.org> Sent: Thursday,January 19, 2017 8:13 AM To: Shea, Sally; Lauzon,Jeffrey;:Roma;Paul; Franey, Patrick;Barrows, Debi; Lt.John Cosmo; William Rex; Kelly Foley _ Cc: Dave Dumont Subject: Fwd:73 Center& 50 A& B Willow Ave Hi Sally, Back on 12-JAN-17 I sent the e-mail below with HyFD'a approval for the buildout of these three units. . Amanda ha approved the dresses. James Smith for Dave Dumont came in recently stating you had told him you had not received our approval for fit out. There may have been some confusion on Mr. Smith's part as it appears he may have stated"70 Center Street" instead of the correct address of 73. . : b If you have any questions let me know: - Acting Chief Chief Dean L. Melanson Office 508-775-1300 1 fax 508-778-6448 dmelanson@hyannisfire org Begin forwarded message: 1. From: Dean Melanson <dmelanson(c)-hyannisfire.org> Subject: 73 Center & 50 A & B Willow Ave h Date: January 12, 2017 at 8:27:06,AM EST -To: Sally Shea <Sally.Shea town.barnstable.ma.us>, jeff.luzon <ieffrey:lauzon(aDtown.barnstable.ma:us>, Paul Roma <Paul:Roma(aD-town.barnstable.ma.us>, Patrick Franey <Patrick.franey(cD_town:barnstable.ma.us>, Debi Barrows <Debi.Barrows(a)-town.barnstable.ma.us>, John Cosmo <<cosmo(@_hyannisfire org>, William Rex <wrex hyannisfire.org>, Kelly Foley <kfoley hyannisfire.org>, Amanda Ruggiero <Amanda.Ruggiero town.barnstable:ma.us> CC: Dave Dumont <david-dumontenterprises(a)-comcast.net> Hyannis Fire is Ok with the issuance of build out permits for these three units e. x Acting'Chief Chief Dean L. Melanson „ 4 Office 5087-775-1300 1 , Fax 508-778-6448- dmelanson@hyannisfire.org - 2: `t �" Town of Barnstable Regulatory Services ` Richard V.Scali,Director 1639. Building Division. Paul Roma,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 UsinLy A Builder I p v i b '5v 0ut4 T' ,as Owner of the subject property, hereby authorize T��"� r S Q4 +74 to act on my behalf, in all matters relative to work authorized by this building permit application for. U4� Q (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all'final inspections are performed and accepted. 96:6 tore of Owner GgLture of Applicant .Print Name Print Name Date QTORMS:OWNERPERMISSIONPOOLS 27m Coinwomvealth ofM ssadrusa Deparh est cif rndurt ud Acadents Offilce ofinves6ga.fiom 600 WaSIdUgfort&set { Boston,lam!02H1. nimmasmgm1dia Wcwkers' Compensaf=Insurance Afffdavit:Bmldex-lCantraactQrrslElectdcmn&Thmbers Applicamt Infann3tian Please Print . s- Address: 1 1� f�N i�( i �l f j�A 21�5; i� �/l✓+ Cityfsta-& Phono Are you an employer?Check the appropriate bow 'Type of❑ project r I_❑ I am a employer v.ith. 4. ❑I am a general contractor and I 6. New construction � (full an&or park timed* Have lmedthe sub-confta. 2. am a sole proprietor orpartaer- listed aathe a#6ched sheet, 7. ❑Remo&Hng These sub-cau4ractors have sbFp and have no employees g- ❑Demolition wading forme ia,any capacity_ employees aadbave Wolkers, 9. ❑Building addition rNQ i adon.w camp.i m=nce Comp.msaranc e 1 . required-] 5. 0 We are a corporation.and its 1�1 0 Electrical repairs ar adds 3.❑ I am.a homeowner doing all work officers have exercised ffiek 11_0 Plumbiagrepairs or adrfitions ' mps&f_[No workers'gip- of em=ptibn per MW, 17-0 Roofrepairs insurance requited-]i c.152,§1(4),andwe hwe no ,. employees.[No WGAoe& 13.0 Qther cam-insurance e&] .*Any W5cznt&stcbed-3bos ffl must also flloutth�sectEoahcIows dog ifie¢�o3ces'compersafi+�+pa&cginfo xdML #liameeataers who sabot d=dB&ndr in&cztffig they Em dGmg alf waA and then hie ou de contactors— sa'Sma anew affid=t indicztiog such fCanbmctMthzt cbWX W5 hoot ffiust attached=adeliti-al sheet s8owiaagthenameof the Sub-ccntrxcftsand state whether ar nut those entnaeshave empimes.if the hweempleyeasiEfieynnurymv'i&their xvrkers'c p.policyaumism lam ar!s!lipInJ�r tlerrt fsprmJidinrg ivrrrkers'a o!lrpertsrdiar!$tsriraffce far alzS*e>rrploy�eex $eloav is t7lepvlicy arid jab site fr1farraaffan Insurance Company Nam.-- 'Policy ` Policy-4 or Self--ins.Lic- FKpirationDate: Job Site Address: CifylStaW2�p: Aft2ch a copy a:f the workers'compensation policy declaration page(shavving the policy!number and expiration date). Failure to secure coverage as req*edunder Section 25A of MGL tx 157 can lead to the imposition of criminal pamalfiies of a fine up to$LSOD OD muVor one-year imprison as well as civil penalties is the fang of a STOP WORK;ORDER and a fie'" of up to$250-00 a day against the violator. Be ad dsed drat a copy of this statement snag,be fnnvvarded to tli a Office of Investigations of the DJA.for insurance coverage yrecificatton I Ao ifereby cettfy' alder the pails and pea aWes afperju y t7lat fit informadws ptmided abate i4 trace and Correct �t**rF'' �C�✓Y V -Date: U i !Gs7' 1 17 Ph e;k u�, 6Li d - 1 oU - Of d d use wily. Da not wrote in this area, be cmrlpl'eted by city artown vjq cfat City or Iowa: PerrtbT,kense 9 Issuing Anthur€ty(circle one): L Board of Hmdth 1 Builst"mg Department,3.CRylrovm Clerk 4_Electrical Inspector 5.Plumbing Inspector 6.Other Cantact Person: Phone 9- 6 ` Information and Instructions Mucear}mcetf 5 GehPaal LBWS❑hapy=M requires an employees to pmvi&Wozke&compensafon fbr theg employees. purmlant{n this statute,an eMr!PIvyee is defined as.`�.ev=y person.in&0 SMTice of another under ffixy cDntcazt of ham, . egpr=or implied,oral or Wtif of An zmpkyer is defined as-an incfiyidual,per[nrasbT,associafia a,corporation or other legal eatiiy,or any two or mole of the foregoing=gaged is a Joint use,and inchiding the legal repressfives of a,deceased employer,or$ie rmdver or trustee of an in ividnal,parftimship,association or other legal entity,employing employees- However the owner of a.dwelling hone having not mare than tip=apartments and who resides therein,or the occupant Dfthc- dweMag house of another who enapIoys pmxsa as to do mace,construction or repair work.on soch dwelling house or on the grounds or bming appmt antthereto sbzHnotbecause of such emplaymentbe deemedto be an employer." MGL chapter 152,§25CC6)also slates that"every state or local Trenrm-g agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct bmwdings is the commonwealth for any applicantwho has notprodnced acceptable evidence of cdmpH=ce With the i1sm-2nce covexage regnke&" t r M,§25C(7)sus-N6iffi=the nor any ofifs poIiiical subdivisions shall Additionally.MCrZ chap - enfer into any contract for the performance ofpublio Wonc unE acceptable evidence of compliancewith the msm-mce.. reT•�,C,;enfs of this chapter have been presented to the contracting aufhodty:' A-pplicaais Please Sl Dirt &0 v,*orkeas'compensation affidavit completely,by c3heclanc the boxes that aPply to your srtuation.an if necessary,supply sub-confi=tor(s)nam(--(s), addressCes)and phome nnmbez(s) along with their certftcate(s)of insurance. U:m t Liabfl y Compardes(LLC)or Limited LiabRity`Pa taershrps.(LLP)withno employees other than the members or parhim-s�=not xbqaaed to cagy waikers' compensafon inSQtmm Nan LLC or LLP does have Clnpioyees,a.policy is required. Be advised that this afd&,Tk may be submitted to the Deparhnent of Iudastial Accidentsfor confnmation of ice coverage- Also he sure to si&m and date tthe affidavit The affidavit should be retnmad to the city or town that the application for the permit or license is being requested,not the Department of dal A m rats Tumldyou have any questions regarding the law or ifyou are req=ed to obtain a workers' compeusationpoliC;L Please call the,Dep a tneart at the n=ber listed below. SeIf-hontd camp=es should enter their self-i�`suce license nz®.ber on the line. . City or Town Officials Please be sure that the affidavit is complebe and pried leghbly. 'the Depa rt mcnt has pmvided a space at.the bottom of the affidavit for you to f M out m the event the Office of Invesdg cm has in contact you regarding the applicant Pleas a be sure to fill in the pen�it/Iicense mmhber which wM be used as a rt:Bm.mce number. In addition,an applicant that must submit multiple penni'dliceos0 aPPlieaiions is any giv=year,need only submit one affidavit iadicafmg ctmmnt " or oT.ldwite "all IDcalions n C the ' lir.�t.h _ policy information(if necessary)and tinder fob the Address aPP iDwn)_'A copyof the•affidavit that has been officially stomped or marked by the city or town maybe provided to the a 'd affidavit is on file fur�e ermi�or licenses A new affidavrtmust be filled.out each applicant as proofthat valid _ P enitue year.Whew a home owner or citizen is obtammg a license or permit not related to any business or commercial v y - a dog license or permit to b�leaves etc.)said pecan is NOT regtmed�complete th�s affidavit The Office of Invest-Juvestiga.ten would Elm to thank you i a advance for your cooperation and should you have any ques cans, please do not hesitate to give us a call tel one and fax mm�ber.' c The I3e�arimer�s address eph . ' . • Departramt c6f lam ACOZenta E �of Iiz tio= �4 Stan Sfr�t B MA Oil11 Tf,-1.4 617' -4 e,%t 406 car 1-977 MA SRAM Fax 9 617 727 7749 R.eviscd 4-24--07 -gp1Tl p ���e�n!/z•91204u11eC/(C/L n�.C>��J9ac�u9nr/d Office of Consumer Affairs&Business Regulation License or registration valid for Individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: s Registration:, 1,00699 Type: ; Office of Consumer Affairs and Business Regulation Expiration _6/23/2018 DBA 10 Park Plaza-Suite 5170 ! s Boston MA 02116 ONCAPE CONSTRIJT1f�N James Smlth 1695 HYANNIS RD i BARNSTABLE,MA 0263 Undersecretary Not valid without signature Massachusetts Department of Public Safety 9 Board of Building Regulations and Standards License: CS-005190 Construction Supervisor `=' JAMES K SMITH PO BOX 124 BARNSTABLE MA 02630 4, I Expiration: Commissioner 03/21/2018 �"E Town of Barnstable Regulatory Services , MAM ' Richard V.Scali,Director 4 6 ►1� Building Division. +. r Paul Roma,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 4 If Usin—a A Builder I, 0 Q u moo 1 ,as Owner of the subject property hereby authorize -� t�r �� 1-TI-1" to act on my behalf, in all matters relative to work authorized by this building permit application for. C-0�14[-P-1L (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final- inspections are performed and accepted..A� 4 Signature of Owner tune of Applicant AU f Du)l e914 I Print Name Print Name - Date OLS Q,F ORMS:OWNERPERMISSIONPO tt ti T7zle Cormmomveah*ofmrrssadrmetts Dea'tament of rndr h iat A ccidads ' J t e-Q0MVWVa1�•LtM. ' 600 Waslturgton,S`reet Baston,MA 02111 wwoumasmgavIdia Wkw1mrs' CampensatenInsurance Affidavit Bmlder-./Cuntracturs/Electricmn&fPh=bers Applicant infMMSt nu Please Print Ee��ily_ Address: c�/s t� � �- CJa,431�Plhmcno - l�c1� sire you an emploper?Gliecl�the appropriate bow Type of project(required): I.❑ I am a employes with 4. ❑I am a generaconfiactor and I 6 El New eonsfrucEiora l full andfor part-time).* liave limd'9te sub-cozafracfaas . 2 am a style proprietaff arpartner- Tilted oathe attached sheet. 7. ❑Remodeling ship and have no employees Them sub-confractam have 8. Demolition tvoddng far me in'any capaci4g employees andbave wodws' [No wodm 'camp-invnance comp.imsuran=..1 g. El�II11�lIIg SdY�1fI07P ' required-] 5. ❑ We are a coaporafi an.and its 10-❑Elechical repairs er adds officers have esescised their 3_❑ I am a homeoumer doing all mark 1 L❑Flumbiagrepairs or additions myself o vxxkets'D0 - T g of ez=Fdon per MGL 12_❑Roof repairs imnzan ce requited-]1 c.152,§l{ and We have no * °[NO wi - employees_ nes=' 13_❑Dther comp_msuranw require&] ` #Any W, d—mt cbedcsbos ff1 mast also fllooEthe seciioabeIaa shatsiag Hieira�adces'compeasatinapa&cyinfa�afiaa Iiameovraemwho submit r1as affid=i g they Rmdam.-allwa l WA&Mhim natadecaatiactossmnst svhmit anew afdae5t indicadatl sacs_ fCaa>ractos$mtchartthb b=must attached asadditionst sheet showfngtbeaameof the mb-cmdmcbmand statewhadm ornat'f me eatitiesha— employees.lftbe mb-c i� hwe employees,theeyzm1srpmvide&&w"keW C-p.J3GrMJ numbet F I am art euipla�r ilerrtis prauitiurg�vrrrkers'catr�,pertsri[iart irrsztrarrca fnr rsrJT empfa}�ee� $etoav is ihsgvfi arad1ata sire 4' irtformafiorz Insurance CompanyName: s Po�ricy,4 or Self--ins.Lic.; F-vim ion Date: Job Site Address: ' City/Stafelzip: Attach a copy of the workers'compensation policy declaration page(shov&g the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c-152 can lead,to tine imlposidoa of criminal penalties of a fine up to$L50aOD andr'or one-yearimprisonmen,as w8ll as civil peaatties.in fhe farm of a STOP WORK ORDERand a time" of up to$250.00 a day abgaimst the violator_ Be advised that a copy-of this statemerd maybe forwarded to the Office of izrves§gations aMe DIA for insurance coverage��fic�iam T afu frer ry ceriaJjy un&r the pains acid psnahYes afpedW7 Scat die irtfor madvn prm &d abm e is tnra mid correct Date: Phase igr tljocioi am rutfy. Do riot write in dill area,to be cawpietod by cifp artown afjrdaL City or Ta m Perruat Ucense Issu7ngAufharity(circle One); L Board of Health 2.BTdmg Department;3.CStyfTawn Clerk 4 Electrical 1wpector 5.Plumbing Inspector 6.Other Contact Person: - Mona#: -j 6_ hnformation and Tastruction,s ' Massac m Cbs 61�Laws dup;ter M ryes an employers to provide:worker'compensanon for f3DIr empIoyees. PM-Sr this Statute,an errrpinpee is defied as. every person in i ie service of anatbzer under any contract oflifie, espr=or iinpliec�oral or wiiii=." An employer is defied as"an indrvidnal,partnes93ip,association,corporation or other legal entity,or any two or more of The foregoing magaged is aioiat cntmpim,and incbndmg the legal rel'a atives of a deceased emplayer,or Sic receiver or tust=of su mdivi&A partnership,association or other legal enStY,�PloY �P�Y - However the owner of a.dwellaig horse having not more than three apartments and who resides$herein,or the occupant of the- dwIJlIiug house of another who employs persons to do make,construction or repair wu&on such dwelling bouse or on the grounds or bm7dmg aPP�T�thereto sballnotbecause of soh employment be deemedto be an employer." MOL chapter 152.§25C(6)also siuf'es that"every state or local liicevs ag agency shall withhobd fie issuance or renewal of a license or permit to operate a buskess or to construct buildings ui the commonwealth for any applicant Who has not produced acceptable evidence of compliance Wn the hmur n re coverage requ=tress" AdditionaIIy,M(ff.chapter 152,§25C(7)sus-Ne thm the commgnrwealth nor lay ofits political subdivisions shall emirs tutu any contract for the pmfoffianee ofpubho wmk tmtiL acceptable evidence of compliance with file insurance.. regairem�ents of this chaptEr have been.pre$eoted to file conft�anihoriiy." APplicaais Please fill out the worms'compensation affidavit completl'ly,by chm'Emg thy e boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), address(es)and phone-r— et(s)along with inert ceai Ecate(s)of ;r,crr,-arce. L=ited Lmblfity Companies(LLC)or LimitedF iebl7ityParta=sbips.9 U)witlino employees other than.IhO memb=s or p are not Mquirtd to cagy wGzk='compensation insurance- If an LLC or LLP does have employees,a policy isreq ircd. Be advised that this affidayk may be mbmithdto the Department of Indvsftial Accidents for conf mnaiion ofinsurance coverage Also be sure to sign and datethe affidavit The affidavit should be retuned to the city or fawn that the application for the permit or license is being requested,not the Department of Tip a �s czi dents. Sbouldyou have any questions regarding the lair or ifyou are required to obfam a workers' compensationpofiey,please call the Department at the number listed below Self insured companies should cut Z their sebf-msmaace license R=ber on the apprapriain line. City or Town Officials T - Please be sure that the affidavit is complete,and prhtd d.legibly. The Department has provided a space at.the bottom of the affidavit for you to fill out in the event the Office oflnvestigation has to rOn actyonregardmgthe applicant Please be sure to U in the p�llicense nvnber which will be used as a reference nnmber. In addition,an applicant that must submit vliiple pe�licause applitaiions in any given.year,need-only mbmrt one affidavit mdicaimg cusent m policy information.Cif necessary)and under"Job Site Address"the applicant rhoLld wute"aU locations'a (may or- town):'A copy of-the-affidavit that has been officially stamped or masked by the city or town may be,provided to the ' applicant as proof that a valid affidavit is on fle for f atn permits or lic=es. Anew afFadavitmust be filled oirt cash year.Where a home owner or citizen is obfaming a license or permit not relattd t,any business or commel-ial vaat= (ie. a dog license or peunit to bum leaves etc.)said person is NOT rued to complete this affidavit The Ofce of Investigations would like tothankyou:ia advance for your cooperation and shouldyou have any won-; please do not hesitate to 1'ivo us a caIL tel eandfaxnnmber: The Depffitmenf's address, ephon - - Thl-CaMMMwedth Of nsdb; ' Depalfmmt of IudustdA Accidents face Of XMe9d9atio= la MA 0�111 Ted. G17- -4 t:Qt4-06 Qr 1-977 MA SAFE Fax 0 617 72'-'749 Revised 4-24-07 mg (mil/fie�pa�T6��r04etUca!f[��o��n��r.JdCXr.�c�1e%/i Office of Consumer Affairs&Busifess Regulation License or registration valid for Individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: = Registration: ,°100699 Type: Office of Consumer Affairs and Business Regulation Expiration 6/2S%2018 DBA 10 Park Plaza-Suite 5170 s tt ` Boston,MA 02116 I ONCAPE CONSTRlt tldN r 4' James Smith 0 i 1695 HYANNIS RD BARNSTABLE,MA 0263 `i-': Undersecretary ¢ Not valid without signature Massachusetts Department of Public Safety 9,I Board of Building Regulations and Standards License: CS-005190 Construction Supervisor JAMES K SMITH PO BOX 124 BARNSTABLE MA 02630 Expiration: Commissioner 03/21/2018 �IWEE Town of Barnstable Regulatory Services Richard V.Scali,Director 639. Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 . www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section. If Using A Builder I. P,y i c C)L�) f qCJ!W-r ,as Owner of the subject property hereby authorize 27"y LIE S :S1, L14 to act on my behalf, in all matters relative to work authorized by this building permit application for. P (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner S ture of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS I i ?lie CoMrnomrealth ofMassgadiusd s Office 00MVE69adom �Ppas�r�re�t a,f�'It�s�`riat�lccid ' 600 Washhlgtort J eet }VFV�4�'il1AS�g'aP�[�Ifl Workers' Cu mpensationInsuranceAffdavit B•ceders(Crntractars/Electricians/Phimbers App coat Infax-mafil}on Please Print Acidness: 1,fo 5 �ti �hl j S Rc eit,/Sfatef 2fi� As31�,_ �+ Phow 1c-0"Y Are you an employer?Check the appropriate bow Type of project(required): I_❑ I am a empl vWfth 4. ❑I am a general confractor and • (fall arEdfor par�time}_ * lrage]sired lha sub-con a 6. ❑New ooristrac i 2.P1 am a sole proprietor orpartuee- Tinted OIL the attached sheet I ❑Rerrtodeliag ship and have no employees These sub-contradom have g_ ❑Demolition wading :Forme ui•any capacity employees andhave workers' [No wod=s'camp_insurance comp iosuranml �_ El Building addition, rewired 1 Electrical r ' S_ ❑ We are a t;ouparati�ou and its ❑ epairs or additions . officers have exercised their 3_❑ I am a homeowner doing all vrork 1L❑Plumbing repairs or additions. Myself[No worlaets'comp- right of ememption per MGL L_❑Roof repairs. ;ns ance requirea]i c.152,§1(4)6 andWe have no employees_[NO wormers' 1.3-❑other comp-insurance required_] 4,Amyapp£ur fiatdbedabosfflmast also filloufthesectiortbeIowslz u theawo:keWcampeusafwnpoRUiaftmauao- t Hameownem who submit r$is dfidarn indicatmg they are doing RU wal szA then hire outside coa>ractarsmmst submit anew amdaeit iadicniin sad fCaa cio6iffid shed c this box trust attached rig additional shed showing the nazaeof lbe sab-camas sad state whether orriotlbase entities have employees.If the sabtontacturshaceemplayw%theynnutpmtd&their nmrlters'-mmp.paRgnumber. I am ara emplW"Ma is prutadutg n�rrlr ens'caturpertsatiatt vtsziratrca f or�zy enrpb��eex Setoov is rihepvEcy ar d jab site trc,jormatian Insurance C-ampanyNan e: Poficy 4 or Self-ins-Iic- Expimtka Date: Job Site Address: citg/State Zip: Attach a cop} of the workers'conipensationpolicy declaration page(showing the policy number and expiration date). ' Failure to secure coverage as required under Section 25A of MGL c..157 can lead to$ie imposition of criminal penalties of a fine rip to$1,54a OQ andl'or one-year imps isonment,as well as civil penalties,in fine form of a STOP WORK ORDERand a fine of up to$250-00 a day against the violator. Be advised that a copy*of this statement may,be forwarded to the Office of lmvesdgaafiions of the DIA for insurance covenge verification- Ida hereby c=dfy under dtapains and psrualfies r#pet jut ry fliatthe irz;f bnnafiWt prm dud abm a is bus and correct Date- v I / //7 Phomik 0jowd use wily. Do rat Wry in dds area,to be compietesd by city aribwvn gfiL-fat City or Town: Perniftffikense f h=s trrity(thcle one): L Soard of Hcd& -Building Department 3.Cay1rmrn Clerk 4 Electrical Fnspector S.Plambing Inspector 6.Other Contact Person: Phom p: Sarmatian and lastructions ` Massa msetts 6eb;Mal Laws chVfEr M regu=all employers to provide waj=:'compensation flir fbew employees. ss easonm$ie service oflea'ffidea any coact ofbIIe, purr-alto fins sf�,as�layr�is deed eveayP express or i mpliec�oral or wrifitezi." Au.ernployer is de fined as"an in ividn9 pa:r nr�,associai�om,c oapor�xon or other Legal city,of any two or mole Of the foregoing engaged in a Joint eotcrprise,and i mhaling the legal FepresentafiVCs of a deceased employer,or the receiver or trustee of an indmdnal,pant=Mhip.association or other Iegal entity,employing eMPloyeM Howesver the owner of a.dwelling house having not more three apar(menis and who resides therein,or the occupant of t31e - dwelling house of amo9ier who employs pecBom to do mai deaance,construction or repaa woik an such dwelling house, or on the gmtnds or building agptnteaanttiier;b sbaIl not becanse of sash employment be deemed be an cmployer." MGL chaptnr 152,§25C(6)also stags that every sib or local licensing agencY shall wMhold fhe issaance or renewal of a Hcense or permit to operate a business or to construct buildings in the commcnwealta for any applicant:who has notprodnced acceptable evidence of cdmpIraneewith the insarance coveragermgaire&" Additionally,MCIL chapter 152,§25CC7)sbdns-Neither the,commonwcalth nor;Ly of its political subdivisions shall enter inn any contract fortlieperfortnarim ofpoblic work urr tl acceptable evidence of compliance with the insWaII=-. recjtinrnlerds of this chapt cr have been p==t nd to the confr�allffiD ty_" Applicants ' Please Sl Dirt the world= ,compensation affidavit completely,by the c&iag-&o boxes that apply to your situation and,if necessary,supply sub-conixactOr(s)name(s),addresses)and phone-- er(s) along with their=tda-cate(s)of kozmce. LimitrdLiability Companies(LLC)orLmaitcdLiabMtyPmtaershigs.(LU)withno employees other thanth_e members or partners,are not requited to cagy workers' ecrmpensaiion.Tr=mm If an LLC or T T V does have employees,apolicy is required. Be advised that this affidayk may be rnbmittrd to the Department of Indnstial Accidents for confm nnaEon of fi sura ce coverage Also be sure to sign and date the affidavit The affidavit should be ret amed to!he city or town that the application for the permit or license is being requested,not the Department of rrb1striat Accidmfr_ Shouldyou have any guest ens regarding the law or ifyou are regvsed to obtain a wormers' cornpensationpoliey,please call f e,Department atthenutmberlistDdbelow Self-insured companies shoulden`nrt3�eir s e1f-insarnce license noniber on the appropriate line. City or Town Officrials Please be sore that the affidavit is complete m dpri:rfecl legmly. The Department has provided a space at.the bottom Df the affidavit for you to fM O"t in the event the Office offnvesdgafianshas to contact you regarding the applicant Pleas a be sure m fill in the per�aitllicense MMber which wM be used as a rsfercace namber. In addition,an applicant that must submit multiple pennitlicense applications in any given year,need.only submit one affidavit indicating cmreat p olicy infbunation(if necessary)and under`rJob Site Address"the applicant should writ--"all locations in (�'or. town)- A copy of the affidavit that has been officially stamped or ma3md by the city Dr town may be provided to the " applicant as proof that a valid affidavit is on file for fot= peunits or licenses_ Anew affidavit mast be fiIled out each year.Where a home owner or citizen is obtaining a license or permit not related to airy busmess or commercial vmotru tie_ a dog license or permit to bum leaves etc_)said person is NOT requhed to comple#e this affidavit The Office of Invesfigations would Itke to thank you is advance for your cooperation and should you have any que sfions, please do not hesitate to give us a call telephone and fax mnnb : The Departments address, eph - . Ilia f jazamonwala Of l s�`ac11v , IDepaxfment cif Accidents �4�asbin�n Stream o MA 0�11k Tf,-I<0 CZ'- -4900 cmt 4-06 Qr 14M MA S A Revised 4-24-07. gam �72,e (pp/ie-77a0lttaec�l a���� JJac��i9n//J Office of Consumer Affairs&Busibeas Regulation License or registration valid for individual use only HOME IMPROVEMENT CONTRACTOR i before the expiration date. If found return to: s Registration: :>'1.00699 Type: Office of Consumer Affairs and Business Regulation 1 Expiratlon;-.,.`6%2312018 DBA 10 Park Plaza-Suite 5170 z r X Boston MA 02116 ONCA E CONSTRU1hy N' = ' Irr;Ems. F � i James Smith `;-?: t-_;. ' t' t L 1 1895 HYANNIS RD BARNSTABLEBLE,MA 0263 6' Undersecretary Not valid without signature Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-005190 L. Construction Supervisor JAMES K SMITH '. PO BOX 124 BARNSTABLE MA 02630 CA, Expiration: Commissioner 03/21/2018 J Parcel Lookup Page 1 of 1 0 THE Y U 41 - � "An MASS k- Logged In As: `Parcel Lookup. Thursday,January 26 2017 Road•Lookup Condo Lookup Multiple Address Lookup Reports. Search Options , Search By Street Street# 59 Street - Name cent < Village All Villages v L. Search <Prev Next> Page 1 of 1 Rows/Page: 80 . Parcel Location Owner Village Index Map 59 CENTER STREET-Multiple Address - 327- _ DUMONT,:DAVID S (50 WILLOW AVENUE Unit A-AP-ARTMENT-(NORTH-LEFT HY 0271 327066 006 TR SIDE)) — a. 59 CENTER STREET-Multiple Address 327-"-`� � � DUMONT, DAVID S- •- G'S6�-- (50 WILLOW AVENUE Unit B;APARTMENT,(SOUTH-RIGHT TR `. . HY 0271 327066 SIDE)) :. 327- 59 CENTER STREET-Multiple Address' DUMONT, DAVID S . . HY 0271 327066 066 (60 WILLOW AVENUE-RESIDENCE) TR 327 59 CENTER STREET-Multiple Address DUMONT,DAVID S 066 (66 WILLOW AVENUE Unit A-MV DRUMS) TR HY 0271 327066 327- 59 CENTER STREET-Multiple Address. DUMONT; DAVID S..: HY 0271 327066 066 (66 WILLOW AVENUE Unit B-FUEL ASSISTANCE) TR - 327- 59 CENTER STREET-Multiple Address DUMONT, DAVID S HY 0271 327066 066 (66 WILLOW AVENUE Unit C-TELEMARKETING) TR 327- 59 CENTER STREET-Multiple Address DUMONT; DAVID S :' HY 0271 327066 066 (67 CENTER STREET-DESIGN HOUSE) TR 327- 59 CENTER STREET,Multiple Address DUMONT;DAVID S 066, --` (73'CENTER STREET-APARTMENT) TR I HY. 0271. 327066 http://issgl2/intranet/Prop.data/lookup.aspx - c 1/26/2017. ` ' T`UWN OF BARNSTABLE BUILDING PERMIT APPLICATION CJ Pf- f P_ Amiu v3,'� t l Map Parcel (� C�MYW Application 4- �. Health Division `x> Y'tt��b Date Issued , Conservation Di ' ion Application Fe i - Planning Dep tG Permit Fee Date Definitive Plan Approved by Planning Board A - = Historic - OKH a Preservation/ Hyannis Project Street Address Si- 71 CENTEA ST1AI11Nf5, /v1la Village HVPV NH,I S ISlaP-NS7A5LE Owner D Av a 1J bw On t -T- r Address XL 9 MAINPIA t Telephone 50(� q00 _1 21izoC7 ..fC(?/r� (of-Fic-e) uo,2 0 t76--6' O 0 Permit Request( Cam'o N fit,,d\T 11s7 F I QoX To A _1 NAM Apd21 , Cwq�7Auc'r UJ.;3fj� placilvs Square feet: 1 st floor: existing g 16 proposed SA11r_2nd floor: existing 0 proposed Total new $a D Zoning District Flood Plain Groundwater Overlay 40 c9c?b Project Valuation` u v Gfonstruction Type r-AA 14 Lot Size 1�C1 At12e Grandfathered: ❑Yes Vlo If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure 6 Historic House: ❑Yes Flo On Old King's Highway: ❑Yes it No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other�5L�6 Basement Finished Area (sq.ft.) 0— Basement Unfinished Area (sq.ft) - 0' Number of Baths: Full: existing ® new 3 Half: existing 0 new 0 Number of Bedrooms: 0 .existing t4 new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: P"Gas ❑Oil ❑ Electric ❑ Other Central Air: des ❑ No Fireplaces: Existing New Existing w.8 P[Yes W110 Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: wov,s 11�i0ew IC ze Attached garage: 0 existing ❑ new size _Shed: ❑ existing ❑ new size Other: 0 Pk �RA W/4 H 1 A TOWN OF BARNSTABLE Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial des ❑ No If yes, site plan review # Current Use C As, R0,- 7 AL- Proposed Use If' )Pit S APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number So 9, (OL1T "100 Address L 6q5 H1 A►NIA 1S R D , WSi Ricense # C S '51 qD Home Improvement Contractor# _ 1 Ott b q q Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Av`f'Ijop�,a e p C4 Au L F R S SIGNATURE 4DATE IV l 5 fly I �'t (�• ' G mA r 1 a co UV� FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED +, MAP/PARCEL NO. ADDRESS VILLAGE OWNER t i, t DATE OF INSPECTION: , FOUNDATION j FRAME�- INSULATION LND#3 -7 JO- �..�. FIREPLACE ELECTRICAL: ROUGH FINAL t PLUMBING: ROUGH FINAL V y Y GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. w r { Spcullicdttullb 111Cet tile applicaule p1UvlL.lulls Ul the tVldSbaL:11U9CL0 Oldie DUIIUIIIg I.UUe,t10V%-lvlMh dnu accepteu engineering practices for the proposed project. i understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: I. Review,for conformance to this code and the design concept,shop drawings,samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,i shall submit Field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work;I shall submit to, e_ _ ng official a'Final Construction Control Document'. Enter in the space to the right a"wet"or. —� v;� t�"' �N electronic signature and seal- t 1 O 25 Q / / 1 /') Phone nwmber: �o3 U 5 b r Email: .1�41+�t w �1`�1P1 t•Y1S C�la A.CA n1 e otiicial Use Only 13uilding Oliicial Namc: Permit No.: Date: Version 06 11 2013 Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 8th edition of the Massachusetts State building Code;780 CMR,Section 107 Project Title: j,Jyw�®�n T y r +1 r+ Date:�.� '2 r. Property Address: �.. Project: Check one or both as applicable: 1.►New construction "`vU-Existing Construction Project description: k..t w Y jos r 1 rig!A t�,Vj , JO t Y1G�� M.A Registration Number::J� 15 Expiration date: ;am a registered design prglessional,and I have prepared or directly supervised the preparation of all design plans; computations and specifications concerning: [ ] Architectural ] Structural [ ] Mechanical [ ] Fire Protection ( J Electrical J Other for the above named project and that to the best of my knowledge,information,and belief such plans,computations and 1_ 4J 12> f ' V `� The commonwealth of Massachusetts Department of lndustrW Act cidents 7 Office of Investigations,• '600 Washington Street Boston,MA 02111 www.mass gov/dia ' Workers Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pltimbers Applicant Information ) Please Print Le 'b Name(Bnsmess�Org±izationaEvid?aD:_ TAM —'s X �I171 T ` ` -Address: S R8 &AN57Pi3LL City/StatcwMp: © 20 Phone.#: Are you an employer?Check the appropriate bog: Typ a of ro uu e •4. I am a general contractor and I p j ectre( q �:: 1.0 I am a employer with 0 � . employees(foil and/or part dine).*• have hired the sub-contractors b. []New construction 2.JZ I am a'sole pioprietor or partner- listed on the-attached sheet. 7. Q Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me irr any capacity, employees and have workers' [No workms' comp.insurance comp..insurance.t. 9• Big addition required-] 5• We are a corporation and its. 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing ill-work officers have exercised their 11.0 Plumbing repairs or afiditions myself: [No wor]ers' camp, ri&df exemption per MOIL 12.0 Roof repays insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other Pomp.insurance req>ired] *Any applicant that checks box#1 Hurst also fill oat the section below showing theswurkers'compensation policy fifMM anon. t Homeowners who submit this affidavit m catmg they are domg all work and then hire outside contractors must submit:a new affidavit indicaiiag such $Cont<actors that check this box must attached as additional sheet showing the mane of the sub-contract and state whetter ornot those entities have employees. If tine sub-cor Macias have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for-my employees Belaw is the policy and job site . information. Insurance Company Name: Policy#or Self ins.Lic.A Expiration Date: lob Site Address: City/State/Zip: Attach a copy of the workers'^compensation policy declarafion page-(showing the policy number and expiration date). Failure.to.secure coverage as regmredunder Section25A ofMGL c. 152 can lead to the imposition of criminal Pena lties'of a fine tip 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 ctat=mit may forwarded to the Office of Investigations of the DIA for insurance coverage Verification, I do hereby certify under the pains-and penalties of perjury that the information provided above is true and correct, Si Date: Phone D�`zciaZ use only. Do not write in this areg to be completed by.city or town afftcial City or Town: PermitlLicense# 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#: � �e rpo.r�x•�yrom,it�er��•tr�n��'��J9Rc�ttJeC/d Office of Consumer Affairs&Business Regulation License or registration valid for individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: s Registration: -,"AD 699 Type: ; Office of Consumer Affairs and Business Regulation 1 Expiration,:.-_.`.t31.1.2312,018 DBA ` 10 Park Plaza-Suite 5170 i Q Boston,MA 02116 ! ONCAPE CONSTR {=11QN James- Smith 1695 HYANNIS RD BARNSTABLE,MA 0263if"t: UndersecretaryLJ Not valid without signature l Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-005190 Construction Supervisor JAMES K SMITH ' PO BOX 124 BARNSTABLE MA 02630 CA, Expiration: Commissioner 03121/2018 Town . B . . of arnstable t~ Re ato Se •e. ry rvi es mesas Thomas F.Geiler,Director BIIi1dIIIg DIv AO Tom'Perry,Building Commissioner 200 Main Street;Hyannis,MA-02601 . wwwaown.barnstable.ma.ns Office: 508-862-4038 Fax: 508-7K76230 Property Owner Must Complete and Sign This Section If Using A.Builder as Owner of the subject property• hereby,autb.orize J tYl e �ln i to act on my beh it in all•m a tttrs relative to work authorized by this building permit (Address of Job) - Pool fences and alarms are the responsibili f the a ty o pplicant. Pools are not to be filled before fence is installed and pools are not to be utilized until aIl final inspections are performed and accepted. <7—�""� Signature of Owner tare of Applicant + Print Name Print Name ►� a�-16 Date QFORMS:OWNERPMU MSIONPOOLS . THE Town of Barnstable Regulatory Services . snsr�e, F Thomas F.Geller,Director , .59 . .�� Bnildin Division ' g Tom Perry,Building Commissioner. 200 Main Street,.Hyannis,MA 02601 vrww.town.barnstable.ma.us Office: 509-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE F.XEWTION Please Print DATE: JOB LOCATION: . number street village "HOMBOWNER": name home phone# work phone# CURRENT MAZJNG ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwe tius of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as Supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends 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 constricts more than one home 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,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she.will comply with said procedures and I 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 Construction 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(Section 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 exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious articularl problems,P Y 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 ultimately responsible. To ensure that the homeowner is fully aware of his/her 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 can:t amend and adopt such a fnrm/certification for use in your community. i Q:forms:homeexempt 1NE Town of Barnstable ' MAW M"� BARNSTABLE '" �' Regulatory Services 16g9. ♦� uxxsrzouvnzvrs.cwn•nrunrs. AtS'4Y5 M W•SSTE4YtJE RES B:.R45fA&F F0""Ar A Richard V. Scali;Director �639_zo14 573 Building Division Paul Roma Building Commissioner 200 Main Street, Hyannis,MA 02601' www.town.barnstable.ma.us November 18, 2016 Mr. David S. Dumont Dumont Enterprises 298 Main Street, Suite 7 Hyannis, MA 02601 RE: Site Plan Review#038-16. Driftwood'Sterling Trust 59-71 Center Street, Hyannis Map 327,Parcel 066' Proposal: Renovate lower floor unit, currently being used as a car rental office (71 Center), into a 1-bedroom apartment. Construct 1 st and 29d floors consisting of 1 one-bedroom apartment and 1 two bedroom apartment.. Dear Mr. Dumont: Please be advised that the above proposal was approved at the November 17, 2016 formal site plan review meeting subject to the following: • Approval is based upon marked-up plans entitled"Plot Plan of Land in Hyannis,:MA" prepared for Driftwood Sterling Realty Trust, dated March 16, 1995 depicting proposed location of dumpster, addition of 4 new.parking spaces, and the designation of parking spaces per uses of the 3 buildings on the site. • Proposed location of the dumpster within 10 ft of the property line will require a variance from the Board of Health. • All storm water must be retained on site. Roof leaders for storm water'are required to discharge to dry wells. Contact Assistant Town Engineer, Amanda Ruggiero, 508-790-6400 ext. 4933 if you have any questions. • A wastewater modification application will be required to be submitted and approved by Water Pollution Control. • New addresses will need to be assigned to the site/units through DPW. • All apartments will require annual registration and inspection through the Health Department • Applicant must obtain all other applicable permits, licenses and approvals required. Upon completion of all work, a registered engineer or land surveyor shall submit a letter of certification,made upon knowledge and belief in accordance with professional standards that all work has been done in substantial compliance with the approved site plan(Zoning Section 240-105 (G). This document shall be submitted prior to the issuance of the final certificate of occupancy. A copy of the approved plan will be retained on file. Sincerely, Ellen M. Swiniarski Site Plan Review Coordinator CC: Paul Roma,Building Commissioner Health Department DPW Attached as requestedi., r 1,have rece ve the tr`i �r f i f t t ofr� r i r� the dirawinigs Accordingly. I will let you know he-n they are complete. o-p all i e.11. Jeffrey M. ` t Ife,i.•R .. a C� i ° •r_ s tj ', - -... _. '. ":,.ram r6i'. �.• '�_' i= m `+��d :-":. r _ TP he Subwftt d vvit gybe,bLiaf fng.}.-rnnItapoi�mion tw,t 5 for Ww"k pte th-I"alition vr*g„ gar. "tale. uald C's tc; 7 t It Sc�l n 107 l�rdt Gt rr1P dr Y ;a� _ q a ,Y w AL k4[ Neer*` Abirr-. Na r Cbjxttrr cir.b�sdtns,a i lu. r w airrtn��Ei ` a I'uda}�€itidt sIU•ac`aiFrt�;�?�: �-4_ :_ ��.. � ` MIA FttfcO av�, wr�saF10, 6SOMliian dw-t c r F tCd'afifia tea u r a,nW l h4 ur pared dirt a 1w cri esD ire ja }�c iii n=ii d(I cliesi rt}t uts SPia� at+�t&3 Arthit irwl 1 taca trail- :++t � t�i at r A` I:Farcotxinn ,EIrT;triral. w , ' Faar slo tih� n J 1 "?! I, d 1Ftnf-i tiif kre a�sF'r y-krtr�uf i n9rmnatY�nn,and 7xe et' h fa n ccrt �taS esnx fr l . t , " L..; .4.- ...v�.e•+•.�- �m ,.. 'sm«.� .w.e'c.A.. wr.es. t—v. m. ...K- - .« •m.- , �� 4 4 L6 x' .. ryya�.�rJasui, ;su ar�e�.eiar`� ,; �iaAw�:iynnra�r ir�:�sMra:�s�vcrus�urx,sr�s�.�,;w,�rrtar�a•4tirGit�.j'gwr,,�a,=n��uw.r rs. r , �i. ' � kf7 lii pr,mrigeo frw t rrv-,-x7wi 7m,rt]er ('utklee.i n,5,a 11ra1 6 tu3.tmy'i1t�3i �3l tip t[ t�i l'ft irf :a5ui;}' t i iax� as uid bo pment cs•i 0owroruaiian We tin m rtiW. &x ,orWd pedoffic tsar 3 r_ 9. Review f•,*r this cok aaaerwr t Wign:cjmctpl.shv md,mph W"R als by ate tm mucL,]r in N4orft:, +cilia the regr PrTe-nm of Rim txrerssngalorl dTSGlEL1mIlL, 2. B ic:iuram dii!.dLdim-f,r Gai a t1:�� ra�f raisin .lUt ,C�l a eptr !?4 n ''n ca�i71 . r , �. �6�'��enC�i iratal �a; �ci�le+aaa�ra��faE,.ryi� t�ifs4r7i�tt�t��tLa� x i� f`aarai�ar w3�1�'fiis�� r��iu3d1 '�,-.; riia`Txl"ate uai �Al _a3gYir ij tl Sri i Eairt rrTarr<sf 9te9 m� err,It•i� f watts tll�'3rtxw ' r ctni.�tAarcba>�drzR;�rectt� rid Sri€; ,.;: �. .: f*'vi�iiar�,yr�r3ii��is��Jr�erus����:���;t�aecr�rirrr•xf i�.�+;� s��l"�"�cra'tra��h��u-m� '7fC�•9R,lifs'- = Vltwn Cmv lred hy the Wild in etf fiat! AMP rral li .a1, taHAr';irefm its("z it m 3.)ffr �erx=irhjuri nE r3prxn oumpleboll.of the wyfk.'14611 sd+mt>i t n��e��licial�T" al cmwwn avn't i,�r�r� +le rtsr �t�natvreti Jaunt r om 5'`e sion wj t,' kk; ir , IV n a - a S £ s 3 v x , A � y • - - .Mn. ,,w- Y .,._� v -' Y .M-� �«V.. y�..�nn4�n....--'a.�•+,-.1r TAN') Da y `�� � G� F �C�8J3b4 Town of Barnstable Geographic Information Sysi'em N �� r 1.1 e; � 319015 ,A #28 3191 ~� Town of Barnstable BAMSTABLE IARNSI'ABLE. r., . �. Regulatory Services s639. ��0 oaanstrmc•on�.:E.oun•nra,�s WWStp!i511'.•i•lSIER\R:IF•msra;&xy,raaz[ ArFDN1°�A Richard V. Scali,Director 1634_2014 Building Division Paul Roma . Building Commissioner 200 Main Street, Hyannis,MA 02601 W".town.barnstable.ma.us s November 18, 2016 Mr. David S. Dumont Dumont Enterprises 298 Main Street, Suite 7 Hyannis, MA 02601 RE: ' Site Plan Review#038-16 Driftwood Sterling Trust J9-7� 1'Center Street;HyanrusY -,,.Map 327, Parcel 066 Proposal: Renovate lower floor unit, current being used as a�car_rental-office (71 Center),into a 1-bedroom apartment. Construct lst and 2° floors consisting of l one-bedroom apartment and 1 two bedroom apartment. Dear Mr. Dumont: Please be advised that the above proposal was approved at the November 17, 2016 formal site`plan review meeting subject to the following: . , • Approval is based upon marked-up plans entitled"Plot Plan-of Land in Hyannis, MA" prepared for'Driftwood Sterling Realty Trust,dated March 16, 1995 depicting proposed location of dumpster, addition of 4 new parking spaces,and the designation of parking spaces per uses of the 3 buildings,on the site. • Proposed location of the dumpster within 10 ft of the property line will require,.a variance from the Board of Health. • All storm water must be retained on site. Roof leaders for storm water are required to discharge to dry wells.-.Contact Assistant Town Engineer;'Amanda Ruggiero;508-790-6400 ext. 4933 if you have any questions. 41 • A wastewater modification application will be required to'be submitted and approved by Water Pollution Control. • New addresses will need to be assigned to the site/units through DPW. • All apartments will require annual registration and inspection through the Health Department f ` • • Applicant must•obtain all other applicable,permits, licenses and approvals required. y Upon completion of all work, a registered engineer or land surveyor shall submit a letter of certification,made upon knowledge and belief,in accordance with professional standards that all work has been done in substantial compliance with the approved site'plan(Zoning Section 240-105 (G). This document shall be submittedprior to the issuance of the final certificate of occupancy. r A copy of the approved plan will be retained on file. 3 Sincerely, ell Ellen M. Swiniarski Site Plan Review Coordinator v CC: -PaulkRoma, Building Co miss orier 5 _ Health Department - e DPW tME Tpw Town of Barnstable Regulatory Service Director ®(r Richard Scali '' do Regulatory Services * * Consumer Affairs Supervisor BARNSTASLE, * Licensing Division Elizabeth G. Hartsgrove yQ MASS. $ 200 Main Street, Hyannis, MA 02601 Vp i639' 1� Consumer Affairs Administrative tFp �A www.town.barnstable.ma.us Officer Assistant Telephone: 508-862-4778 Fax: 508-778-2412 Stephen 0.Estey Margaret Flynn November 16, 2015 R&Y Enterprises, Inc. Attn: Tanida Sariyawong, Mgr. 59 Center Street Hyannis, MA 02601 SUBJECT: SHOW CAUSE HEARING-NOVEMBER 16, 2016 Dear Ms. Sariyawong: The Licensing Authority held an advertised show cause hearing, on November_ '16, 2015 for R&Y Enterprises, Inc, d/b/a ;Yings'Sushi Bar &-Lounge;-Tanida `Sariyawong, Manager, 59 r -'Center Street-, Hyannis for the following violation of the Town of Barnstable, MA Code: LL • 501-7 Section I. Alcoholic beverages sales and laws: for the sale or delivery of an alcoholic beverage to a person under 21 years of age. • 501-7 Section B. Alcoholic beverages sales and laws: failure to maintain a schedule of the prices charged for all drinks be served and drunk on the licensed premise or any room or, part therof. Such prices shall be effective for not less than one calendar week. Charged $14.50 for a bud light and price not posted. After testimony from Consumer Affairs Officer Steven Estey, the following motions were voted 3-0 by the Licensing Authority: • FINDINGS:'To move that the Licensing Authority determine violation of Section §. 501-71 and § 501-713 of the Barnstable Licensing Authority Rules and Regulations was found; VERDICT: To move that the Licensing Authority find Ying's Sushi Bar & Lounge at 59 Center Street Hyannis guilty in violating Section § 501-71 and § 501-713 of the Barnstable Licensing Authority Rules and Regulations; • ACTION: To move that the Licensing Authority suspend the Annual All Alcohol Common Victualler License, the Common Victualler and Entertainment Licenses for fourteen consecutive days which you will serve the suspension February 1"through the 14th, 2016. The licensee has the right to appeal this decision of the Licensing Authority to the Commonwealth of Massachusetts Alcoholic Beverages Control Commission within five (5) days of receipt of this decision as to the Alcohol License and the Barnstable Superior Court within 60 days of receipt of this decision related to the Common Victualler and Entertainment licenses. Should you have any questions please contact this office. Respectful) , l Iza eth G. Hartsgrove Consumer Affairs Supervisor Cc: Barnstable Licensing Authority, Regulatory Services Director Richard Scali,Barnstable Police Department,ABCC I\ :N— _ Commercial i �t yAd vis o Luanne M. Persson Associate 222 West Main Street, Hyannis, MA 02601 Office 508.862.9000 Ext.128 Fax 508.862.9200 Direct 774.470.6062 1persson@comrealty.net www.comrealty.net r y C3 fill p rz. Ar, :Ic Eri III"NO ,N k7n,"N' 'Y, COX ,gg p"i 24 MIR 0, TREK CAR q- -A M-Innll i � ; i ANN qu 100 E ;�O,-1 Vi M' IN i0it RIM -44,-4i a MAW T'UW OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 Z—1 Parcel Application # q pp , Health Division Date Issued -13 Conservation Division Application Fee V Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis ffy(o Project Street Address J-9 Confer .3frrip t Village 14wa.n h 4s Owner nsir -� Address�� Telephone_ Permit Request ��:� 11,,t l,�,_. ra �..�,�s - cow o ( . 11-61 5�� Ewe LJ `�devi,n LheX sP Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation • t,-70 D 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ew1, Telephone Number 5b$=7714- 51q 2 G Address Menke, S*r-ee-j- License # CS-lD 5'3® (ylxs6pex�. MA 6ZIP42 Home Improvement Contractor# 170 173 Email Jove`; Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 7- (0 .. i FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER 7 • 'S DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. .rr a cw.r �,t3a�rassf€�r�o��stFf�iu�� f1(Y , • tGftftA.Ft�IISLg1���¢ • Ii�x�I�m�r�a • Plgase•��EF ' { yl F= M�sly FYtili e21.0cf Y P7= c5718 ��(o SZ{z� Axeytan=plgTar7Crxc& mAa�bream rypeafF4°icct . E.Q Iam a e3gl0y=Viffi. • d: Q I�a� I co�ef�r I New c �Cirrc`i �ea slayees�WATDrpMt{- )* I�acelmm��stun El?5a 1 am a sole pmpzFdr orpadmr Esfe3 an tb�sumTmd Enact 7- Q�ndc&ng ship and hate no empkrfees- Th=rnb-cow Have g Q 71r, oaEiD. WMEng f=MM.ia.37Y mpariiIr =3pl7l=a dhUeWo.J=I' [Nu Camg a cow- �;r�-f,-,ir�t aradrl¢inns 5-❑ We am a axparaf a mdifs 10 0 mpaim IEl I mn a.hoamwwnnr Sauk alfHc=lzXVM e==tdffi= .ItoPlmmbmgn - � S my-cm[No wali 'comp- ligbi ofr agparEof- 1�-❑ =� [lea wDd=& Camp-kmuzarf o. j &sFdI51Ct�TiG�¢LID�tt3�"n:ir.n Tsii�tchbcciast�mm�[¢15L• 7m���' GELig$iCSL �SKS, Ift svb � Apra �g s�pw7l&ffiEr Ddme nmF-POET $nm aza B�faptF�isgra �rcr7rers'eon�urrrr�+r��ar tag rlrgrlayEsc �P3ut�it Ss�,gcrii�aedja5� TLC,,,fnm Gompanyyia a- a Foficg 44,or Selwirzs_Z.ic- �fir,rr T?a+P_ To1�Sitc Aff&c s cTx a w2y of flit•wartime tximpm—fian p aI-icy&,cM ssfian gags(sl�aarsng tic pnlieg fin er grad exps�fioa d �. Fazhueis see¢r��±�asn e3uuc3rs S=6mm25AcfM3Lr-M caalradfaiffimimpasih m orcc msaalp=xlffm cifa fmc up fo l t)[}Qa aadlor - - as l as cirsZ gesalfi�m ffie fo=mof$SMF WGRIK ORI Manff afins r�Bp.ig�50 O+D adaga�mctf�cviolaSre I#c arlaised$sa�acapgrtfffriss�snm+��bc3adiu$tic Qf�Ce t}f . . T�,P.��,Q o€$�DI�fnr*^�^�ca•�g� o� Ida F�sr aPr�fp ztirdrr-€�spa=aurF saa� rss u g urp f stffa�it nix wagravzd�d+2lz axe a G se tam ccuFrar t`•+vrsxfrrw I}afe_ 'I �O �r`» ' F} nid urs£y: l?a nattrr�tsiu ffii� �* &s cQa Fip dfF aF funm afeinE My or Town: P r tlf*rcasc# r mrity(=do L So=d of I[r+Tffi ?BwTffia;Ile t� 3�CjL.qFaga a=k 4IIer ical l�sga�#oF �spct�or 6.Cla= 6 • l �ZHEr Town of Barnstable do Regulatory Services 9HARNSVMM MAS& g Richard V.Scali,Director 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 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize ��r r .Jl���,,-{E'z to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools - are not to be filled or utilized before fence is installed and all final pections are performed and accepted. Signature of Owner Signature of Applic ant Print Name Print Name Date Q.FORMS:OWNERPERMISSIONPOOI S t _ Q` J U ter`' L rn zk 40 �J •n ;. 71 ttJ e • b 0 © V L c Town of Barnstable Geographic Information System July 7,2015 3f7054 327056 #100 � ► 327154 p A �Z x �No�t - i~ N - 327065 #79 #73 aTj� 327057 � #92ik 327154001 CN D ry4 68 ;r Y.. #59 327058 #84 � 327059 ffonts 10 #76 e to �„� ilt'i6A w 327064 327068 'r. #67 #49 327060 327067 �s #70 �e�.,.. �' ` #58 i 327155 �/E #18 Oro P 327063 #30 x 327061 ��r ,� 327069 327073 0 31 8 #17110 Ei DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:327 Parcel:066 - boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:DUMONT,DAVID S TR Total Assessed Value:$869400 Selected Parcel 1"=100'may not meet established map accuracy standards. The parcel lines on this map are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner:DRIFTWOOD STERLING RE Acreage:0.51 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:59 CENTER STREET such as building locations. - Buffer r j ' �'ME laf• Town of Barnstable ri Regulatory Services RARNSTABiE,�« Richard V.Scali,Director '0r 63F9. ► 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 Property Owner Must Complete and Sign This.Section If Using A Builder t as Owner of the subjec property - J P P riY hereby authorize 4 6(D Wo ABCI- to act on my behalf, in all matters relative to work authorized bythis building permit application for. (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are e ormed and accepted. Signature of Owner Signature of Applicant \ Print Name Print Name ' Date Q:FORMS:O WNERPEPW SSIONPOOIS r , t Town of-Barnstable Regulatory Services zite rOiy,� Richard V.ScaIi,Director Building Division VLALMS'Aar. " Tom Perry,Building Commissioner txas.S. i639. ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.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: cityltown i 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 a Iicense,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends 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 home 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,rules and regulations. _ The undersigned"homeowner"certifies that he/she understadds the Town of Barnstable Building Department minimum 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 Construction 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(Section 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 exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.1S) 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 Iicensed Supervisor_ The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her 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 form/certification for use in your community. Q:IWPFIL TORMSIbuilding permit furmslEXPRESS.doc Revised 061313 _ j I Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-105530 DAVID M SMITH 2 MAPLE STREET MASHPEE MA LV264 - Expiration Commissioner 04/05/2016 *� ro t{�arr�ar.��acaea cpf�t! lcudella Office of Consumer Affairs&Business Regulation . License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date..If found return to: egistration 170173 Type: Office of Consumer Affairs and.Business Regulation e xpiration :9/23/2015 DBA 10 Park Plaza-Suite M70 c � Boston,MA 02116 DOVETAIL WOODWORKS +� r s 3 � ff DAVID SMITH 2 MAPLE ST MASHPEE,MA 02649 Undersecretary Not valid without signature 4, Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991m3) of enclosed space. Failure to possess a current edition of the Massachusetts state Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS �e rGanr�r�torrrueca�a�G�/�/�ibatr.��tael,Ta-; _ Office of Consumer Affairs&Business Regulation a License or registration valid for individul use only `OME IMPROVEMENT CONTRACTOR before the expiration date..If found return to: — — egistration: 170173 Type: Office of Consumer Affairs and.Business Regulation Expiration: 9/23/2015 DBA 10 Park Plaza-Suite 5170 ` Boston,MA 02116 DOVETAIL WOODWORKS_ DAVID SMITH x ' 2 MAPLE ST MASHPEE,MA 02649 Undersecretary. Not valid without signature Town of Barnstable Regulatory Services Q Thomas F.Geiler,Director g. Building Division ' fTom Perry, Building Commissioner j 200 Main Street, Hyannis,MA 02601 Y www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Pe # Building Official appro ng Application for Sign Permit _ Grant Gao _ Applicant----------- ---- sessors No. r - Doing Business As:Ying's Restaurant p _ _-_ Tele hone No.(5fl8 ------- Sign Sign LRca d: 59 Center St------------------\- ------------------- -----�- Street/Road:_ j Zoning District: _Old Kings Highway? s/No Hyannis Historic District? Yes/No Prope Owners Name avid Dumont _-_ _ _Telephone:(508)280-4725 ---- Address:280 Main St, Suite 7, Hyannis, M 02601 __—_— Village:Hyannis---------------- 1" Sign Contractor Name:Excel Signs Telephone:( �617 479-8552j ^� ---------- -------- --- -------- �f ' Mailing Address:info@excelsign_com -_- �. Description Please follow the cover direc • us.You must have an accurate rendition of sign with dimensions and , location. C / Is the sign to be electrifi d? Yes/No (Note:Ifyes,a wiringpermitis requued) Width of building f e 92_--ft.x 10=920 x.10= 92 Check one Refac existing sign or New-/Total Sq.Ft.of proposed sign(s) 17.3 ffyou have a lional signs please attach a sheetlishng each one with dimensions C , If refacing existing sign please provide a picture of the existing sign with dimensions. I hereby ertify that I am the owner or that I have the authority of the owner to make this application, S that th ormation is correct and that the use and construction shall conform to the provisions of ��' §240 9 through§240-89 of the Town of Barnstable Zoning Ordinance. tore of Owne%uthorized Age .N,,.r Date 7/10/2014 SIGNS/SIGNREQU revised12110 f THIS LICENSE SHALL BE DISPLAYED ON THE PREMISES IN A CONSPICUOUS POSITION WHERE IT CAN BE READ 1 LICENSE No. 7000228 LICE A 1 L --ALCOHOLIC BEVERAGES THE LICENSING AUTHORITY OF The TOWN OF BARNSTABLE, MASSACHUSETTS HEREBY GRANTS A COMMON VICTUALER License t® Expose, Keep for Sale, and to Sell All Kinds ®f Alcoholic Beverages To Be Drunk On the Premises To: R &Y Enterprises, Inc., d/b/a Ying's Sushi Bar&Lounge _ ....................................................... •-•--••-•--•-•--•-•-----•----•.............-- Tanida:Suriyawong, Manager .................. ........--•-- , on the following described premises 59 Center Street;Hyannis, MA . .................................... 59 Center Street,Hyannis with.2 entrances/exits to parking lot and 1 entrance/exit at rear from kitchen. Four restrooms. Inside seating 73 with 12 Stabdees in bar area. 85 total patrons inside,25 total seats at both areas outside. r' This license is granted and accepted upon the express condition that the licensee shall, in all respects,conform to all the provisions of the Liquor Control Act;Chapter 138 of the General Laws,as amended,and any rules or regulations made thereunder by the licen sing authorities. This license expires December 3l,2,014 unless earlier suspended,cancelled or revoked. IN TESTIMONY WHEREOF,the undersigned have hereunto affixed their official signatures this...................1. day of ..... ........January, 2014.. The Hours during which Alcoholic RESTRICTIONS -See Below ': 6veL 1: $ Beverages may be sold are:, f f . , WEEKDAYS: 8 A.M. TO 1 A.M. . . ........................................... SUNDAYS: 12 MIDNIGHT TO 1 A.M. ....................................................... 12 NOON TO 12 MIDNIGHT --- ............................................................... f- NOT VALID unless issued in conjunction ....:....................... ._ .... with a Food Service Permit. LICENSING AUT TY PAID: $3,050.00 RESTRICTIONS I . A00-L-SIGNS EX w 259 uiNcir AveNue TEL 617. 479.8552 a QuiN 02169 FAX 617.479 4852 - ._ '4 ,.' - i• z ,' EL SIGNS AL 3RESERVEO- WWW.EXCELSIGNS.COM w< - OEXC v a t ri, to » - t �'• z ) +i NOTES L:. f f . c�JNSiIi Bar - w�• i _ - + R i, iO a s .. xr a r , • # „ < j-v a s , a+' Customer. ry Company Ying's` Phone: 508-280-4725 v ' - _ a4' a • r Address: 59 Center St City: Hyannis a 601 �.� St to/Zip MA 02 File Name: Awning-B.fs • . r t - Job No. 4230824P- 1 , � - ` � F Original: 05/10/2014 oa e. Revision 7/19/2014' p � � F. Estimate ($0 Means No Price): $0 00 ,a APPROVAL n� aaslu Bar - The'uridersigned,in his or her individual and official . ,,, �, � � : � ,: •k _ �,; _.,_ , " capacity,hereby certifies that the quoted prices,designs,, specifications, . terms,and conditions are accepted'Excel Signs is authorized to perform the work as specified" ` .. �.- s �y'>�"'>rxlw,q• -.. " ,c..s a;.. .f� �' � aA. a�Y.L � �- � - - , n � { Y xF 041 3,.4"".... „eW' � ,�'� - - ,a -i w Date: a fill 1 Prinf Name C , . ^k. 360 (4) 2"dia. columns = • •KAHBAR THAI - JAPANESE - KOREAN TO GO . DELIVERY 508.790.2815mow. r ti • SPECIFICATIONS: moo Fabric: Sunbrella Black Structure: 1 sq. galvanized tubing Lettering: Polyester insignia. v 4.8 Clear vinyl windows Black BTF-19 roll-up blinds Customer: Address: 54 Center St The undersigned,in his or her individual and official capacity,hereby certifies thatFEX G S the quoted prices,designs,specifications,terms,and conditions are accepted.ExcelCE S Si ns is authorized to erform the work ass ecified: JCompany: Ying's City: �Hyannis . - 9 P P Phone: 508-280-4725 State/Zip: MA. 02601 t 259 QUINCY AVENUE TEL 617.479.8552 Original: 05/10/2014 Revision: 7/21/2014 File Name: Awning-Us x Date QUINCy, MA 02169 FAX 617.479.4852 - Estimate($0 Means No Price): $0.00 Job No.: 1404230824P Print Name ®EXCEL SIGNS ALL RIGHTS RESERVED WWW.EXCELSIGNS.COM EXCEL SIGNS . K 259 QUINcir AveNue TEL 617.479.8552 . QUINCY, hu 02169: FAX 617.479.4852 • f - — ®EXCEL SIGNS ALL RIGHTS RESERVED WWW.EXCELSIGNS,COM - 1 NOTES 4.s N Al " Sushi Bar 0 ' PROJECT INFO Customer: -• x x Company: Ying s r.- rr' a'�y �e.: •rw'M�,.+..' `�-" r�°�'�{'� *i,.. �r 1,4C5� ':� .. �.`�®++•c+�.sMd;.� .� . F < Rn�r' �' � i�,��sr•.` 4 .. • , .. 4725 v t ' �` a fir. f d n;. . . - ,, .<.:. "`> , Ate, - . `��� . � hdress: 59 Center St E< �0. .}� - �,. ,`y; Ad < - City:, .Hyannis w State/Zip:,MA 02601 I ;File Name: Awning-B.fs- n r a s _ Job No.:- 1404230824P' g _ Original: 05/10/2014 , SEC Revision: 7/19/2014 Estimate(SO Means No Price): $0.06* ` ' APPROVAL jushi Bur • �i , The undersigned,•in his or her individual and official � capacity,hereby certifies that the quoted prices designs, specifications,terms,and conditions are accepted.Excel razed t perform o . Signs is authorized o pe m the work as s y w . lie _DIY •:. t 4.,�:: ,+, '�#�;,.a ^v" •' .�.� ,.a�•n+ '..+ ".'' `° �' .,"'"' _ �. _a:,:,..G,a'� w �.• p Date '•'1'1 1 1 1 1 ' " o , Print Name I 360 (4) 26 dia.columns _ SPECIFICATIONS: Fabric: Sunbrella Black . . Structure:.1" sq. galvanized tubing _ Lettering: Polyester insignia • Clear vinyl,windows Black.BTF-19 roll-up blinds. Customer: Address: 59 Center St The undersigned,in his or her individual and official capacity,hereby certifies that 1 the quoted prices,designs,specifications,terms,and conditions are accepted.Excel __K _� Company: Ying's City: Hyannis Signs is authorized to perform the work as specified. _ _ _ - SIGNS Phone: 508-280-4725 State/Zip: MA 02601 259 QUINCY AVENUE TEL 617.479.8552 Original: 05/10/2014 Revision: 7/21/2014 file Name: Awning-Us X Date QUINCY, MA 02169 FAX 617.479.4852 Estimate O Means N Job No.: 1404230824P Print Name ®EXCEL SIGNS ALL RIGHTS RESERVED VWVW.EkELS1GNS.00M ($ o Price): $0.00 -- 4 .. __. s •.r. Qom. F ' t t f� ,F �.,N �k -,� n c t't � •. III .. � sl a •. � •' '4! a 4 5.9 Center St, Hyannis 8/6/14 x L h y R , c f Cn ♦? 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' , I 1 !-ssd 8t _ L� �.,t tr � �e +�7• _y�,��i .+: r ��vr•. •pia � v`�'� � ~�``�•` .� (lst��-�-.ffny�ii�"—`} t r. i 1�' �,e� r r� ,. �.#$rI'�� ft ` •. � + 'i (n4 lit � rf� c }' ti ip r" 14, -r 's�j;.•.-� 9; '.�7 [� 7 ,,. 1 .v- x" ' •„� �f}. ;,:•_ 11 `', ,�, ` � � t�� . : � �„�e.rtra� , ,,. .,y, _ �T -iyF•l '... A{1 /` } .ea ,�'iw. •1'��r� r'Wia r ,.•i-� - ��sr�L*'1..Y !.�" r ','` j'^"�tys=_r__�.•TI'3-� ��•,,,,•.s,�'"t i "��.um d3S WWI- r�r 1 "w:y c4y i•t,ta v�W 11" _ \•r n E ' ., w dJS do. 401, t o � l � ram~ p y e Awl owia Rol vp \ l sm NOW L c. OS l h"d 3S Fjol do 1 r EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES 3/12/13 A. Correspondence —Asim Jamal proposing different kinds of Middle Eastern Herbal Teas and Middle Eastern Hydro Herbal Hookah. Asim Jamal was present and read his letter to the Board stating that he is interested in bringing some Middle Eastern culture to the town and suggests a tobacco free hookah lounge with Middle Eastern music and hydro-herbal hookah and belly dancing. Hookah is the name of a large water pipe that originated in India but gained popularity in the Middle Eastern countries. Smoking the hookah is a social event. Hydro-herbal infuses herbal senses. It is 100% tobacco free. David Wood, owner of Puff the Magic was present: Puff the Magic is the only smoking bar in town as it was established before the non-smoking regulation came out. David spoke of how he worked with the Board at the time the original tobacco regulation went in. He stated that Article 371.15 defines smoking as "having in your possession, or lighting, a pipe, cigar or cigarette". So it doesn't matter what is in the pipe, it all falls under "smoking". Mr. Wood said they had introduced a hookah pipe to his establishment, then, decided against it. He was not comfortable with the sharing of the pipe and the possible sharing of illness. He said they are very hard to keep clean as they have long hoses, etc. They have discontinued the use of it. Mr. Wood said he has two concerns: 1) if someone is permitted to have a hookah pipe, how could the Town enforce it if that establishment started using tobacco in the hookah pipe? Secondly, he is concerned anything which may tarnish his good reputation. Dr. Miller said he researched the internet, etc, and believes our local regulation governs anything smoked through a pipe under it. He will have the Legal Department review it as well. Dr. Miller said that the State's definition of smoking is any inhaling of a combustible material. Dr. Canniff and Mr. McKean agreed with Dr. Miller's interpretation of the smoking regulations. They agree it does not matter whether there is tobacco or herbal. Anything inhaled through a pipe falls under the tobacco regulations. Mr. McKean said that the only place where it would be allowed would be on a designated patio/area outside. He is aware that there is a person who is currently considering proposing hookah be smoked on a patio area. Dr. Miller said the Board will have to review any health issues which may exist using a hookah pipe. Dr. Miller said that he will have someone from Legal get back in touch will Asim Jamal upon their review. Q:\MfNUTES\EXCERPT OF WNUTESTnerpt BOH Mar2013 HOOKAH Lounge.doe �tW h Sign ti Permit BARNSTABTOWN OF BARNSTABLE MASS. .i639 '0tF0 39 A Permit Number: Application Ref: 201105156 20070656 Issue Date: 09/23/11 Applicant: DUMONT, DAVID S TR Proposed Use: RETAIL & SERVICE STORE SMALL Pen-nit Type: SIGN PERMIT Permit Fee $ 50.00 Location 59 CENTER STREET Map Parcel 32 7066 Town HYANNIS Zoning District HVB Contractor PROPERTY OWNER Remarks PLATINUM KITCHENS &BATH DESIGN 15.52 SQ FT TOTAL TWO SIGNS 1@11.52 SQ FT WALL AND 1@ 4 SQ FT ON LADDER Owner: DUMONT, DAVID S TR Address: 298 MAIN ST, SUITE 7 HYANNIS, MA 02601 Issued By: SS /i— POST THIS CARD SO THAT IS vISYBLE FROM THE S REST -O-DD C-7DD m I �C] S1\307-4 M �t DDT 233 m I F-ID -<OCO m �o i S� DOh-irt :;u Mmm z = i mm z mz mml-� M3>-4 H I ..•. zTmO H ZZD M-o m � I C�f)HZT t •" '. m0 EA I —CD - ZL7 _0 i r mmo m� _0 i ..-- �Cnon -< Tt-iz om M. I —N : =z o n i `IrJ M:I>U) z C33 CT) m f f CD Po CZ) zm C7 � H =CD=O m — CDm— ci CDC7 cn cn O CD I NT�O 00 I LP I 000 O I C31 000 O I I I 1 I i I I t Ir ` , I { , OIL °FZHE, Town of Barnstable Regulatory Services"' *9BA NSTABLE, Thomas F. Geiler, Director- .. E16.39A. Buildin Division Tom Perry, Building Commissioner�!�` ic)�4 260 Main Street, Hyannis, MA 02601 www.town.barnsta,ble.ma.us Office: 508-862-4038 ((Fax: 508-790-6230 Permit# tuilding Official approving---=-------- Application for Sign Permit Applican � � � —'— -----Assessors No. � +h - t Q Doing Business As::: NIL_ �i _-----r•---Telephone No.,�6 Sign Location I ���✓`t�r-T� ��Ilt Street/Road: --- Pal Zoning District: Old Kings HighwayP Yes o yannis Historic DistrictP Ye, _ t' Property wner Name:_ 1 -------------------Tel e hhhe:_ 1 oi �Q� Address:--------------------------------- Sign CoWractor Name: _ Telephone: Mailing Address:1Q_ _ _ - - � 11 --==------- De Grip Please follow the cover directions. You must hake an accurate rendition of sign with dimensions and . location. Is the sigih to be electrified? Ye (Note.I%yes, a mr1118.permit 1s required) Width of building face_ -1___ft. x 10 ---------x .10 --------- Check one Reface existin sign g gn---- or New__V_"Total Sq. Ft. of proposed sign (s) J U you h;1Ve ad(h6011al Sl,71S pease atGlch a spice/I1Stlllx'each One Wltll d1r11ells]011S 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 die authority of tine owner to make this appliCation, that the information is correct and that die uu a d consU-uctio1i shall conform to die provisions of' §240-59 through §240-89 o1'die"1'owii of Un able Zoning r lii TiCe. ` Signature of Owner/Authorized Ag ------ - -= -- ate---------- SIGNS/SIGNREQU revised 12110 v .4 1 68 Center Of. �r Unit #18 Hyannis, MA 02801 W.Glgnifgl na.00rn Estimate #6695 8/19/2011 Prepared for: Prepared by: Platinum Kitchen & Bath Designs Sign Itl Arianna Salesperson: Billy Hutchinson 59 Center St. 68 Center St. Unit#18 Hyannis, MA 02601 Hyannis; MA 02601 Phone:774-994-2035 Fax: Phone:508-775-2501" Fax:508-775--2502 Description: Quantity Description Each Amount Tax 1 Sign w/Laminate-Style B 1.50 Feet x 7.50 Feet ; J Yes 1 Set Up-BASIC Sign w/Laminate-Style B-1.00 Feet x 4.00 Feet `. r Yes TOTALS Subtotal: Sales Tax: Total: Terms: The estimate good for 2 Weeks. 50% deposit due up front. Balance Due When Job Is Complete. Thank you. By my signature below,I authorize work to begin and agree to pay above amount in full according to the terms on this agreement SIGNED: � ,:; ,, --DATE :. " _ AMT.PAID TODAY: �u< , Platinurn itchen PARKforING j� � K •1 � >1 MondOYR86 & 713ath De iu eday 10.5 signs ._ram Wednesday 10.0 - ' manger 10.7 1 I Vloleroia 7owe0at atNNryA a Oomeon Plat i n u Kitchen own Expense sander rawepwrxexreair ath713 Desl n� g t 1 _ f t� • i' 1 F, 1 MINE MEMO MEMO MOMMI MEMMOMISMOSEMS ON MEN MISMINMEMEMEMOMMEMM MEMO OEM 0 ME MENNEN ME ME mommom MONIES �N■ �p� MEMO mom MEMMEMOMMEMISISMI MENEM LIESOMME ME MENEM �� NONE �Ilom MEN MEMEMEN ■ MIESSEEM MONSOONMMEMEM OEM INS it■omEMMONS Nis M ME MENNEN MINE 0 NONE s MIESSE MMMMM- OMEN MEN NOME rm.. MENNEN on m ME MEMO MEN No ME MEMEMEM ME NEI so NONSENSE EMMONS MEMO 1! ME mimm ME ME MENEM ME MOMMISM ISEEMEM MEN ■ Ems y k 1 I p - I� 4 t i L I � I F I I i L 1 i - I f i ,� '� A� 3 i a.� o ,� �� 1 I �' ��- !t \�. 1 �� `rF `� �f L 0 a a a O ® r 9 a Ja V� r a • •r � � o , r r o a � a' S ya• 1 a �; o -� .A M Ircim- N 46 a d � O LW a I n u o. " y 3 VtMWAM CD i J J J ® o 0 J` J` J• f 9 JJ J♦ J r�1 •}i7 'r? \ J• J• J` J, f f J 1f . t f � 9♦ i 1.r,'♦+ ., � �)y ',: r I a 1 •}i I lye�1 (J} f JJ J J 1 5 t THAI KOREAN 11 APANESE • SUSIHen7l; 71A M .V. DRUMLESSONS �-� ... E M Plati'onum Ki* tchen r i - signs ,, Bath De f=i J` J� 9' � aY aD 9 � V f1 � ei O 0 O f o sv o stir .i`' Jv JD i J � W o 0 kq a�1 r ti �) {gip• 1 '• 67 it Ing V. r J•I, ' a' is' s + •: ' is ���f•'' � �.(� r�� " "� i+p. ' �yf It jz 41 ( ,• ( y y I tiIA. r >}� f?• 'J+7 lit r p 9 �iP Q 7 r � � ♦ r r u ® y Nan shot four times outside Hyannis eatery CapeCodOnline.com S �" � Page 1 of 1 Man shot four times outside Hyannis eatery By Karen Jeffrey kieffrey@capecodonline.com January 06,2011 7:15 AM HYANNIS-A 23-year-old man is being treated in a Boston hospital after being shot four times outside a Hyannis restaurant early this morning. The man was hit twice in the arm and twice in the torso, according to Barnstable Sgt. Sean Sweeney. Sweeney did not know the man's condition, but said the man is expected to survive. He told police that he lives in Mashpee sometimes and in Falmouth othertimes Police were called to the shooting scene by an employee of Ying's.Restaurant on Center Street around 12:40 a.m. reporting a shooting in the parking lot outside, Sweeney said. When police arrived there was a black sedan with a flat tire and shattered driver's side window parked outside the ,restaurant but no people around,Sweeney said. Police discovered the shooting victim was at Cape Cod Hospital seeking treatment. Sweeney said investigators were told the man and a female friend were inside the'restaurant shortly before the shooting. The woman left but while driving away realized she had a flat tire. She returned to the restaurant where - the manoffered to change the tire for her. The man later told police that his female friend got into the passenger side of the car as he went to the trunk to get equipment to change the tire.As he.headed towards the front of the car,the driver's side window shattered and then"he said that he felt stings and realized he was being shot,"Sweeney said. The man told police that he began running, heading up Dynoflow Avenue then looping around to Elm Street intending to return to the restaurant. Before getting there, however, he spotted a cab, hopped in and was driven.'. back to the restaurant where the female friend and her dog hopped in the cab and accompanied him to the hospital, Sweeney said. The man was transferred from Cape Cod Hospital to a Boston hospital, Sweeney said. Sweeney said the man told police he did not recognize the man who shot him, but described the shooter as a white man wearing a hoodie. Police recovered two shell casings from the scene.They are not releasing the caliber of the gun-, but said s handgun was being used in the shooting. Sweeney said investigators had not determined a motive for the shooting.The victim has two pending.criminal cases, but the exact nature of the charges against him were not available. Copyright©Cape Cod Media Group,a division,of Ottaway Newspapers,Inc.All Rights Reserved: http://www.capecodonline.com/apps/pbcs.dll/article?AID=/20110106/NEWS11/1101.09833... - 1/6/2011 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map � � Parcel Application Health'Division Date Issued Conservation Division ,Y, `- Application Fee Planning Dept. y Permit Fee Date Definitive Plan Approved by Planning Board 0` Historic , OKH _ Preservation/Hyannis 06D, 0 169k.Project Street Address S C' it c S� ft Village Owner � Sy � Address Telephone ] 4zo "" �Ae Permit Request Q'm 1E�c Square feet: 1 st floor: existing]` 8 Wroposed —` 2nd floor: existing proposed —Total new�"-- Zoning District Flood Plain Groundwater Overlay Project Valuation 15 e s e O 6 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 0No On Old King's Highway: ❑Yes Xlo Basement Type: ❑ Full ❑ Crawl ❑Walkout 350ther Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing_ new `---r 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 kNo 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# ' UJ _"i Current Use _ e _. Proposed Use _ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name w �� )&CZ t+-a G 1& Q e�� Telephone Number T t .- 11 — 4 �a AV+c Address �c ®, i a c 26 h License#_ CS q 6 e� 4 &KAU S n a)J Home Improvement Contractor# Worker's Compensation # + ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Lc C EN Ig SIGNATURE DATE—fe i QOL 4 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED t MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ` ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL t„ FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The CornmonrvealthiofMassachusetts �-� Department of Industrial Accidents Office.ofl"nvestigations w ` 600 Washington Street r. 2•.• �---��;-, .Boston, MAD 111 \ yI }vmv.mass.gov/dia Workers' Compensation Insurance Affidavit: Build ers/Contractors/Electricians/Pluml Applicant Information Please Print Ise Name (Business/Organization/Tndividual): VI&W Ls )6t Address: © 9 l City/State/Zip.: ph Ci tY p• 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 employees (full and/or part-time).* have hired the sub-contractors. listed on.the attached sheet. ; 7, [X Remodeling 2. I am a sole proprietor or partner- These sub-contractors have 8. ❑.Demolition . ship and have no employees working for me in any capacity. employees and have workers' 9.` ❑'B011,ding addition comp.insurance,$ [No workers' comp.insuuance 10.❑"Electrical repairs or required.] .. 5• ❑ We are a corporation and its 3.El I am a homeowner doing all work officers have exercised-their 1`l.❑ Plumbing repairs or myself. [No workers'.comp. right of exemption per MGL 12.❑ Roof repairs Y insurance required.] t C. 152,,§1(4), and we have no employees. [No workers' 13.❑Other t comp.insurance required] *Any applicant that checks box fll 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 tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities ha employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I rem an employer that is providing workers' compensation insurance foamy employees. Below is the policy and job information. Insurance Company Name Policy# or Self-ins.L.ic.#: Expiration Date;' Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(shotiving the policypumber a.nd expiration Failure to secure coverage.as re K. quired under Section 25A of MGL.c, 152 can-lead to.the imposition of criminal`penalti fine up to$1;SOO.00pandlor one-year imprisonment, as well as civil penalties in the farm of a STOP WORORDER a; of up to $250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to•.the Office of Investigations of the DIA for insurance coverage verification. I r/o hereby certify tinder thepains andpenalties ofperjuq that the in formationprovidedobove is true and c 11 orrect. SignatureDale:: Phone#/ 0 l ;kg 3 Tq �-- 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): , pl„mhino TnSDeCfC information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant !o 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." more An employer is defined as "an individual,partnership, association, corporation or other legal entity, or any two or ing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the of the forego 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,constriction 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 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 of public 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), addresses)and phone number(s)along with their certificate(s) 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' t at the number listed below. Self-insured companies should enter t compensation policy,please call the Departmen heir 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 permiAcense number which will be used as a.reference number. In addition, an applicant that must submit multiple permiUlicense applications in any given year, need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (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 I Fax # 617-727-7749 TKr Town of Barnstable Regulatory Services f pp t Thomas F. Geiler,Director 1659- 1�6 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstab l e.ma.0 s Office: 508-862-4038 _ Fax: 508-790-6230 y Property Owner Must . Complete and Sign This Section If Using ABuild6r I 1 �,yl g��leCep as Owner of the subject ro e .P P rty hereby authorize wp` p VA tAi&V to act on my behalf, in all matters°relative to work authorized by this building permit application for 4 C �F. (Address of Job) 6 65 S a D(40. Signature of Owner Date` Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. , Town of Barnstable �pFYttr ray 0 Regulatory Services Thomas F. Geiler,Director uxrrsrws[.E. MASS_ Osp ,- Building Division x PrED. ya Tom Perry, Building Commissioner 200 Main Street,_Hyannis, MA.02601,www.town.barnstable.ma.us arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOV NER 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 a license,provided that the owner acts as supervisor. DEFIArMONr OF HOMEOWNER Person(s)who owns a parcel of land on'which he/she resides or intends 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 home 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.L 1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that,hdshe understands the Town of Barnstable Building Department rrrinimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. t . 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 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that: "Any homeowner perfonrring work for which a building permit is required shall be exempt from the provisions of this section.(Section l D9.1.1 -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 rxemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&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 procccd against the unlicensed person as it ti•ould with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsrble. To ensure that the homeowner is fully aware of his/her rtsponsibilitics,many communities require,as part of the permit application., that the homeowner certify that hclshe understands the rcsponsrbilitics of a Supervisor. On the last page of this issue is a.form currmtlyused by several towns. You may care t amend and adopt such a form1ecrtification for use in your corrununity. Q:forms:homccxcmpt .. �I (ti ,(clni set ts bclrii tment.(if Pulilit SjCtA Board of Buil(linh Re!"uli(tibn and Stand u(ls Construction Supervisor License i License: CS 4656 .a Restricted to: 00., -. . EDWIN K HOUGHTON P.0..BOX 214 HYANNIS PORT MA 02647 • �, Expiration: 3/19/2012 Tr#: 24671 r A y ,. ....-,..,,.r^.-,,..:• r.. ...-.. .,. ..-..__--• •T-._ �...,.,� ,..._ _....,.......•...�....-<L-.,+•..-r....-......� :_'^`��, .^v-.!"`n..^ ",... r•Y�»Y'*-s-•.r*^•..r�'+�. .3✓"'*y ^r 1t*^ .-.+....,.- yi.- . . - TOWN OF BARNSTABLE BAR-W (�t Ordinance or Regulation WARNING NOTICE Name of Offender/Manager k rN 4 4' k.- ().ri ( 1 a r ich » ," Address of Offender MV/MB Reg.# !Village/State/Zip Business Name o.i n al-I ajm/ m�, on Business Address � �t � �,�'� '� � r _ _ dtur-,, . ..... Signae .of Entorcing`Officer Village/State/Zip Location of Offense A-n .-ip " - Enforcing Dept/'Division Offense Facts.( Sfrp` 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. ZI WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. t7l' VT 77, = TOWN OF 3 BP,RNSTABLE Z C BAR W �V � ' �t _N, Ordinance or Regulation t } - h WARNING NOTICE Name' of Offende=/Mana:ger = r& �" _ �f , t 'i .:iVX.; .' f »44 Address of Offender Reg °# tVillage/Stage/Zips „ }, Business v.Name t � = 41 , , ` ' K r ;. � y am/Pm�; On { .� 20 ` v r ,'#' _� �.; 1'"' � r �� cz f,r(�' � 1 u-.. t (.,. � _ �� r �- 'd� 4�-f Y• 7 t u Y _ .y Y��,,,��{, f Tr_,. Business Address "�s.. o'Cjl 77 r ;' Signature of� forcing fficer - 1 r Village/State./ZiJA g'' P Y y._•.�Y4 F G f v t _ + �- ,Hr is as `} * f f a ' ;zj'Locatlon ' .-Offense, r r ►, H r W Enforcing pe t/Division: - s - `Offense. lt .- ,. -L.: I�=F"�xrs,t�:; ' .. ', f. Mt.Fact:s z3 - K.feel -f3.�i`c f=t/,lh�• } .f h k .�?t 6 riR f h :�;' x t .F r* „+r- 7 .i This'will-t'serve ;only� as< a warning At this t me no�legal action has been,taken .'. It `is the. goah� off Town agencies- tom achieve - voluntary ?compliance of Town ordinances, Rules; and• Re ulations Educate-on efforts andzwarning, xno 'ices`'are g attemptsu"to gainKvvoluntary compliance Subsequent violationsxwll "result in ` propriate 1,egal aEction by tie Town p> - $ 'w r h ;+ �' 4VHITE OFFENDER, CANARY ORD;/REG PROG PINK ENFORCING OFFICER`; GOLD;ENFORCING DEPT. r: ` TOWN OF BARNSTABLE BUILDING PERMIT.APPLICATION Map_ . Parcef 0 6` Application # 07, S Health,Division Date Issued Conservation Division Application Fee ';" Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic- OKH Preservation/Hyannis Project Street Addre I Village krA oh,1 Owner �(�y� T —Address-M ma`Vn Telephone j Permit Request �0 o Res eA (Ov- .� u ry o Square feet: 1st floor: existing proposed 2nd floor: existing 301,0 proposed �Ic Tcl'neu Zoning District Flood Plain Groundwater Overlay Project Valuation' D Construction Type w r: Lot Size 0 .151 G re14 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family- ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure 1 q 50 Historic House: ❑Yes ❑ No On Old :Kin 's Highway: ❑Yes ❑ No 9 9 Y Basement Type: ❑ Full ❑Crawl D Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing Z 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: R'Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes D No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑existing D 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 APPLICANT INFORMATION._ _ -_ _ (BUILDER OR HOMEOWNER) Name Telephone Number Address 3R ate O K`C C License# C�)rl �( � f v Home Improvement Contractor# Worker's Compensation # 3GY 6,Z60 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE l ✓ ' DATE 3 t l FOR OFFICIAL US_E ONLY " APPLICATION# DATE ISSUED ' MAP/PARCEL NO. ADDRESS VILLAGE OWNER 44 DATE OF INSPECTION: FOUNDATION -FRAME ` INSULATION I FIREPLACE ELECTRICAL: ROUGH-'FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING _ DATE CLOSED OUT ASSOCIATION PLAN NO. ,r fF r The Commonwealth of 11lassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, ,AfA 02111 www.rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers AppUcant Information Please Print Le ibl Name (Business/Organization/Individual): C A?e, � CRJ CFi 1-N(G ` � t Address: j 1 Ek-& l City/State/Zip: W64 YagmogA,� MA UM"Phone.#: 508 3Z6 -' 1950 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. ❑ I am a general contractor and I 6. rJ[O'New construction employees (full and/or part-timc).* have hired the sub-contractors 2.[�j7am a sole proprietor or partner- listed on the attached sheet 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity, employees and have workers' Y . P ty. $ 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required] 5. ❑ We are a corporation and its. 10:0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp.insurance required] *Any applicant that checks box#1 must also till 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 subrrdl a new affidavit indicating such. Tc.tmactors that check this box must attached an additional shcct showing the name of the sub-contractors and state whether or not those entities have employees'if the sub-contractors have employees,they must pro-)ride their workers'conmp.policy number. X aril an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: �] � .Y_ Policy#or Self-Ws. Lic. #:�`4 6 b Expiration Dater 17 CJ l �f Ci /State/Zi fGvV3�� 2' Job Site Address: tY p: � r V �0.1 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 izaprisonment, as well as civil penalties in the fora:of a STOP WORM.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 MA for insurance,coverage verification. f do hereby ce ' u t e pains an nalties of perjury that the information provided above is true and correct. Signafore: G�� Date: t2 3� � g Phone#: (-7 2!5 (Q `�S�i — Offeeial.use only. Do not write in this area, to be completed by city or town gficial City or Town: Perznit/License# Issuing Authority (circle,one). 1.Board of Health 2.Building.Department 3. City/Town Clerk 4.EIectrical Inspector 5..Plumbing Inspector 6. Other r Contact Person: Phone#: 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 hiie, express or implied, oral or written. A.D.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 trustccof 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 renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any t who has not produced acceptable evidence of compliance with the insurance coverage required," applican . Additionally,MGL chapter,1.52, §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until acceptable evideace of cornpliznce 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; i.f necessary, supply sub-contractors)name(s), addresses) and phone nuiober(s) along with their certificates) of insurance. Limited Liability Companies'(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or pa tncrs, 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' 5 compensation policy,please call the Department at the number listed below. Self insured companies should enter 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 ofInvestigations 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 policy information(if necessary) and under"lob Site Address" (he applicant should write "all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for fixture 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 (i.e. a dog license or permit to bu'M 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 nxunber: The Commonwealth of Massachusetts Departm(-,nt of In.dust6ai Accidents Office of InvestigatiGns 600 Washington Street Boston, MA Q2111 617-.727-4900 ext 406 o:r 1-877-MASSAFB Fax# 617-727-7749 evised 11-22-06 www-.mass..gov/dia . Town of Barnstable x x * BAMSfABLE, k Regulatory Serviees pTf°►*��A Thomas F. Geiler,Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barustable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete.and Sign This Section if Using _A.Builder as Goa .of the subject property hereby authorize � � l) to act on MY behalf, ,n all matters relative to work authorized bythis building pemait application.for. P ` �'� ,� l y �P� 1 (Address of Job) signature of Owner Date 'rin ame \WPFILES\FORMS\building permit forms\EXPRESS.doc evise020108 ' s. Town of Barnstable 00 KE r *_ Regulatory Services Thomas F. Geiler,Director BARNSTABLE, v� i639• ,��' Building Division °reds a Tom Perry,Building.Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 1OMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: — street village number "HOMEOWNER": work phone name home phone# P 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 homeow hers to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to sucb use and/or farm structures. A person who constructs more than one home 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 pernut._(Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws, rules and regulations. The undersigned"homeowner"certifies that he/she rurderstands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and . requirements. Signature of Homeowner k Approval of Building Official Note: Three-farxnly dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOi14EOWNER'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(Section 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 exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&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 Supenmisor is ultimately responsible. To ensure that the homeowner is fully aware of liis/her responsibilities,many communities require,as pari 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 form/certification.for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC 3 IS-0 _ 6- -Z IYA F6" PREVENTION iNN-tviS FIRE DEPARTMEN] BUgEAU • �� � rt r �� Z1'5 HBGKg Y N MA 02601 r/o o r �l� IA Wfady)®®i4 St `� -- - - - - - _ 18bdfie300tH Na arm SNa"J M3N 1 frf ,I put�o;Z/ rr; ,r�� _____ ✓`ze-�o�nvnwvuaea�•-t�7 ✓�.daac�zueeC7� ? dBoard'of Building'Regulations and Standards I.y Construction`Supervisor'License,- ° License CS 77711 - Expiration 11/3/2009 Tr# 22355 . ORVILLE C MUNROE T wal 38 FAIRMONT ST CAMBRIDGE,MA 02139 Commissioner r.:. S t • Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality Please Enter Decal# BWP AQ 06 M Notification Prior to Construction or Demolition ------------ A. Applicability Important: When filling out A Construction or Demolition operation of an industrial, commercial, or institutional building, or forms on the residential building with 20 or more units is regulated by the Department of Environmental Protection computer,use (DEP), Bureau of Waste Prevention=Air Quality Division, under Regulations 310 CMR 1.09. only the tab key Y 9 to move your Notification of Construction or Demolition operations is required under 310 CMR 7.09 (2)ten (10) cursor-do not days prior to any work being performed. The following information is required pursuant to 310 CMR use the return 7.09. key. rab B. General Project Description 1. Facility Information: b4 �W O 3es.r 9,tV0A15 Name � L BV'%C Address Instructions c)2 b O i City/Town 6 S State Zip Code 1.All sections of l_t y yA tJ this form must be Telephone Number E-mail Address(optional) completed in order to comply with the Size: Department Environmental Protection notification Square Feet Number of Floors requirements of Was the facility to 1980? 310 CMR 7.09 Y built prior rlor M YeS ❑ NO 2.Submit Original Describ .the curr nt or prior use of the facility: Form To: Commonwealth.of. cam` r Massachusetts Asbestos Program P.O.Box 120087 Is the facility a residential.facility? ❑ Yes 9--Ko Boston,MA 02112-0087 If yes, how many units? 2. Facility Owner: Nat G O (VyCV1.') "�' �tx�� ' 1 i Add r ss _0'w"h 1L5 Cityrrown State Zip Code (Telephone Number(include area code,n WiV'�E-mail Address(optional) On-site Manager COMf111ONV'J uF MASS DEPIROSTOPd' ag06app•6I04 2ND FLOOR RECEPTION BWP AQ 06•Page 1 of 3 , II Massachusetts Department of Environmental Protection � �� Bureau of Waste Prevention • Air Quality Please Enter Decal# BWP AQ 06 Notification.Prior to Construction or Demolition B. General Project Description (cont.) 3. General Co tractor: go E Name ' == � Address m City/Town State Zip Code 510 — 551 r7 t4 rn Telephone Number(include area code and extension) E-mail Address(optional) �r On-site Manager C. General Construction or Demolition Description General Statement: If 1. Construction or demolition contractor: asbestos is found l during a lv t Li V-1,n'� Construction or Name Demolition � it ° .r mo C�. • operation,all "•^'� `-'V responsible Address parties must comply with 310 Telephone Number(include area code and extension) E-mail Address(optional) CMR 7.00,7.09, 7.15,and Chapter 21 E of the On-site Manager General Laws of the 2. On-Site Super visor: Commonwealth. ( q This would � va Cl vV`Lt ti U include,but would Name not be limited to, filing an asbestos 3. Is the entire facility to be demolished? ❑ Yes ©� removal notification with the Department 4. Describe the area(s)to be demo shed: and/or notice Q pr o - WCtA �7 (ASS Q t�� d release/threat threat off 1 t `mil release of a hazardous substance to the Department,if applicable. 5. If this is a construction project, describe the building(s)or addition(s)to be constructed: em ry , ag06app•6/04 BWP AQ 06•Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality Please Enter Decal# BWP AQ 06 Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.), 6. If this is a demolition project, were the structure(s)surveyed for the presence of asbestos containing material (ACM)? ❑ Yes ❑ No If yes, who conducted the survey? Name Division of Occupational Safety Certification Number 7. Construction or Demolition 13 I - ,�o ��$ Qq t t Date End Date . 8. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding ❑ gaving ❑ wetting shrouding If other, please specify: ❑ covering ❑ other 9. For Emergency Demolition Operations,who is the DEP official who evaluated the emergency? cp Name of DEP official rn M T Title Fri ,Date ofAuthorization ' o DEP Waiver# D. Certification 1 n n I certify that I have examined the 0�Y t `� 'V i(AN O above and that to the best of my Print Na knowledge it is true and complete. . The signature below subjects the Authorized$i nature signer to the general statutes C0"9 regarding a false and misleading Positionrritle statement(s). Representing Date P.E.# agO6app•6/04 . BWP AQ 06•Page 3 of 3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 4 Map ' Parcel. 6'uy Application # ©bU7 Health Division 0 3 =Date Issued 1 U Conservation Division Application Fee �� Planning;Dept: 'Permit Fee Date Definitive Plan Approved by Planning Board -- Historic _ OKH Preservation/Hyannis e , Project Street Address j C QWJer S�_ Village h"`;a n p;S: T Owner j�trI Liq R 1112,0 a Ittl cin4 - Address 0) 1 me, S+ Telephone .4Z-02- ` 00 ^ L 'L O 0 ' Permit Request ID.e MC Fx1,4,wa �.!'�� .•�ps;r �°w s s er ry4Q At bQ-r�n 3. F r�e %11Xr% -Ida I ' V Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District: Flood Plain Groundwater Overlay Project Valuation CC 0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ..❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.). Basement Unfinished Area (sq.ft) Number of Baths: Full: existing.• new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas W"CiI ❑ Electric ❑ Other Central Air: iKes ❑ No Fireplaces: Existing New Existing wood/coal stove:]Yes Ll No C) Detached garage: ❑ existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑ exis ing ❑ Fi w size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Z;1 M 0% 6: J> Z ' Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ o 01 Commercial I4es ❑ No If yes, site plan review# N) Current Use Proposed Use rn t APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name "C � S^Vf&S Telephone Number Address L$ 3 0 P-T 8' License # ®6.S7 31 IYYIA C)/a, 6 '3S Home Improvement Contractor.# Worker's Compensation # 1���f �1H, 37� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE i� FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED a - MAP%PARCEL N0. 'L ADDRESS VILLAGE OWNER } DATE OF INSPECTION: t FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL :r PLUMBING: ROUGH FINAL . F GAS: ROUGH FINAL' s FINAL BUILDING DATE CLOSED OUT , ASSOCIATION PLAN NO. - The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, ,AM 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLyibly Name (Business/Organization/Individual):^/ ew /It 'C..— Address: t 0 A 4- City/state/Zip: rt.�V t Phone.#: S�d'� �/�c�r`�/ '� U C' Are you an employer? Check e appropriate box: Type of project(required): 1.P1 am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a'sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. demolition workingfor me in an capacity. employees and have workers' y p �`• t 9. ❑ Building addition [No workers' comp,insurance comp. insurance. 10.❑Electrical re airs or additions required.] 5. ❑ We are a corporation and its P 3.❑ I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing thcir workers'compmsation 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. XContractors 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 ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Z! tT Policy#or Self-ins. Lic. #: 5? 6 Expiration Date: ���. ® g lob Site Address: G 4-- City/State/Zip: iqyv&f 3 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 MA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature /�T Date: Phone#: C-� �OC� Official use only. Do not write in this area, to be completed by city or town gficiaL ` City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Insttn.coons Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for theirwemployees:n 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 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 of public work until acceptable evidence of compliance,%vith 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 enter 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 policy information(if necessary) and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn 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. # 617-727-490.0 ext 406 or 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22.06 www.mass.go v/dia l _ SHE rpm Town of Barnstable. MRNSfABLE, MASS16.3 9. Regulatory Services pTf°►�`� Thomas F.Geiler,Director Building Division Thomas 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, jr ,as Owner of the subject property hereby authorize -� to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) a , Signature o er Date Pent Name QORFILESTORMS\building permit forms\EXPRESS.doc Revise020108 Town of Barnstable Ft r Regulatory Services , N • Thomas F.Geiler,Director an$rasxMai.a, mass. Building Division ArEn �a Tom Perry,Building.Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.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: cit�/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or,less and to allow homeo�xners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends 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 home 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) F The undersigned"homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws, rules and regulations. The undersigned"homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/slie 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 Construction 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(Section 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 exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&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 ultimately responsible. To ensure that the homeowner is fully aware of his/her 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 fonn/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC —Ucf. 0. JOUd— 1: 16VM Insurance Agency of Cape Cod No. 3115 P.- 1 j4P=. CERTIFICATE OF LIABILITY INSURANCE OATE(MM/DDWYYY) PRODUCER (500888-2766 FAX (508)833-0909 10/15/2008 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Insurance Agency of Cape Cod Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 490 Rte 6A HOLDER.THI8 CERTIFICATE DOES NOT AMEND,EXTEND OR P 0 Box 960 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. E Sandwich, MA 02S37 INSURERS AFFORDING COVERAGE NAIC#INSURED APCON Inc. INSURER A- Scottsdale Ins. Company 4830 Rte 28 INSURERS: AIG American International Co COtult, MA 0263S INSURERC: INSURER D: INSURER E: VERAGES EEE�] 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 C POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ONDITIONS OF SUCH 118. DD' TYPEOFINSURANCE POLIC%ECTIVE POLICY EXPIRATIOQATVN' POLICY NUMBER GENERAL LIABILITYCPS09ZZ402 06/12/200$ 06/12/2009 ,FACH OCCURRENCE LIMITS COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 11000,010 O CLAIMS MADE ❑OCCUR $ 100,OO A MED ExP(pry one pa son) S 10,000 PERSONAL 6 ADV INJURY 11 11000 000 GENERAL AGGREGATE S 2 GOO,OO GEN L AGGREGATE LIMIT APPLIES PER: POLICY j�Y LOC PRODUCTS•COMP/GP AGO S 2,000,000 AUTOMOBILE LBIBILITY ANYAUTO COMBINED SINGLE LIMIT (Es accident) S ALL OWNED AUTOS SCHEDULED AUYOS BODILY INJURY HIRED AUTOS (Per person) S NON•OWNED AUTOS BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident) S #EXCEOGNMORELLA DILITY TO AUTO ONLY-EA ACCIDENT b OTHER THAN EA ACC S AUTO ONLY: AGO S LIABILITYFACH OCCURRENCE S �CLAIMS MADE AGGREGATE 6 IDE DUCTIBLE S RETENTIONWORKER $ S EMPLOYSCOLABlUrTIONAND WC 6986376 03/26/ZOOS 03/26/2009 WCSTATU 6 EMPLOYERS'LIABILITY OTN• - B ANrCEPJMEETOR/PARTNDCO? UnV0 E.L.EACH ACCIDENT S 1,000,000 OFFICER/MEMBEREXClUD60? Iryoi,deeuiee under E.l.DISEASE•FJ EMPLOYEE �ii,SPECIAL PROVISIONS below0OTHER E.L.DrSEASE•POLICY LIMIT 0 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENOORBEM ENT/SPECIAL PROVISIONS I CERTIFICAIE-HOILDERANC Ti 1 .- SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPI ON DATE THEREOF,THE 166UING INSURER WILL ENDEAVOR TO MAIL AYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Town of Barnstable LIT F LURE T TICE SHALL IMPOSE NO OBLIGATION DR LIABILITY 200 Main St. FAN KING Hyannis, MA 02601 ER ITjAGE?(W0RREPRESENTATIVE6. AU R D ESENTATIVE ACORD 26(2001108) OACORD CORPORATION 1988 { '� + ,�� ✓fie-�Uamvnznaauiea`t/' ./�aaoac�uraelY � . a +'$oardnft'Buddi"ngR�``gulat�o sanitStan°ilar"l's 1„ �� _., ti,.a. :e 'Co ristr.'uction°.S,upervisorLkense �. Lic@t;e�; C"S 6'53118. F Q t Ef to; 1 8/201'0 Tr#+ 1.2025 ! t estrl;ton 0 4 t S M9@HAEL A &ANT S T` r rr COTUIT,M`02635' Commis one"r [ l�iP �arnaao7uaea a�/�/laaaaecael Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration:,: 143064 Expiration; 615/2010 Tr# 276305 Type; Private Corporation APCON, INC. MICHAEL SANTOS 4830 RT 28 COTUIT,MA 02635 � Administrator TO ALL NE USINESS OWNERS DATE: i ISO' Fill in please: .: ; � APPLICANT'S YOUR NAME: — tdCc Suy i Y6t6CAp j� BUSINESS YOUR HOME ADDRESS: 'Z �ti (1�1 LSE II e, TELEPHONE ' "" �� Telephone Number Home NAMEF NEVII ., T1lPE OF BIJSIIyESS �L :G% - ' IS THIS A HCYNI OCCUPATIONS YES NO ,;:_. 7 Have ;;ou been w.en..a: r'�Vat fr he..b di:: dv s� ...'YE N j y . g FI* I a S QjJ ADDRESS O r IVIAP. IAkEEL NUMBER ` `.... ..... When starting a new business there are several things you must do in ord 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. Once you have obtained the required signatures, listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor- Town Hall) or if you get the business certificate first you MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St.— (corner of Yarmouth Rd. & Main Street)and you will find the following offices: 1. BUILDIN CO ISSIO ER'S OFFICE This individual s erFinf ed f ny ermit requirements that pertain to this type of business. A ized Signa_ a** COMMENTS: 2. BOARD OF HEALTH This individual b en in ed of the permit requirements that pertain to this type of business. Authorized ignature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual �fty en inf th ce a uirements that pertain to this type of business. AAuthoriz Signature** /' COMMENTS: �1 N5a-tZ ,� o,,, 01 JL Business certificates (cost $30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. - it does not give.you permission to operate -you must get that through completion of the processes from the various departments involved. **SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY. TO ALL NEVV BUSINESS OWNERS DATE: Is 7 Fill in please: ' �St-16 , , APPLICANTS YOUR NAME: �ISeS, /fic BUSINESS ;.. � YOUR HOME ADDRESS: y- 555' T LEPHONE Telephone Number (Home) . NAME OF'NEW BUSINESS 1 TYPE OF BUSINESS IS THIS A HdCIAE OCCUFATIQ YES NQ Have .:ou beet i+�e a�: rove f Q e bu Id1n dt astott YES hIO Y g . . . P r ADDRESS.OF BU`Sli'� SS "" MAP/1rARCL NUMEt� ... : .:...:,.:;: When starting a new business there are several things you must do in o der 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. Once you have obtained the required signatures, listed below,you may apply for a business certificate at the Town Clerk's Office (Ist floor- Town Hall) or if you get the business certificate first you MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St. - corner of Yarmouth Rd. & Main Street) and you will find the following offices: 1. BUILDI COMISSIONER'S OFFICE _ This individualias' en-info d %ty permit requirements-that pertain to this type of business. Autftwized Si at a* COMMENTS: 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 AF AIRS (LICENSING AUTHORI This individual ha n infor of e liing e ui ments that pertain to this type of business. uthorized Signature" COMMENTS: ro( Oct Iv/#L bc-aw'sV Business certificates (cost $30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. - it does not give you permission to operate -you must get that through completion of the processes from the various departments involved. "SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE.ONLY. TOWN OF BARNSTABLE SIGN P .MIT I PARCEL ID 327 066 , GEOBASE ID 24177 ADDRESS 59 CENTER STREET PHONE HYANNIS - ZIP I LOT 11 12 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 39735 DESCRIPTION DESIGN HOUSE 8 SF OF SIGNAGE PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety .ARCHITECTS:ARCHITE _ __ and-Environmental Services TOTAL FEES: $25.00 BOND $.00 Ox1NE CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE- 1 PRIVATE P �E ' BYLDIN DIV0 �2- 1 DATE ISSUED 07/14/1999 EXPIRATION DATE ;/ . t ' A _ 1 (/ i h• - The Town of Barnstable Departm : ent of Health; Safdty and Environmental Services . BuiIding Division ! 1 367 Main Street,Hyannis MA 02601 Fo Mwt Office: 508-790-6227 Ralph Crossen Fax: 508-790.6230 Building Commissioner Application for Sign Permit Applicant: v` Assessors No. �c�1- �do Doing Business As: C�_� r �� Telephone No. Sign Location Street/Road: Zoning District: O,?Z6'1 Old Dings High«ay? Yes .To Property Owner 7�_�� .i ame: �I V Telephone: r Address: Wlunw auk Village: U-44aif Sign Contractor 7s-4SI Z- Name• 4bQ 6!� Telephone: Address: Village: Description Please draw a diagram of lot showing location of buildings and e.,asting signs with dimensions, location and size of the new sign. ?his should be drawn on the reverse side of this application. Is the sign to be electrified? I es/'•OIQJ (Note:If jr-s, a cv=gpermit is requir a9 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 Zo ' ance. Signature of Owner/Authorized Age Date: Sue: Permit Fee: W k . o`er Disapproved: Sign Permit was approved: v Signature of Building 0 ��. Dare: � -/ � ��� �,.. �:� 7 - + �r 1 4 C a +. � ... � t' � .. t ,� y � � � � ,� s: `, ;�;� 2� ' � 1 q � Engineering Dept.(3rd floor) Map Parcel Permit#' 1 7 Ji House#• Date Issued - '7 1 Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee d Conservation Office(4th floor)(8:30- 9:30/1:00-°2:00) ; Planning Dept. (1st floor/School Admin. Bldg.) f11E Definitive Plan Approved by Planning Board 19 RNSI RLE,�` 4 - - MASS P TOWN OF BARNSTABLE Building Permit Application F ` Project Street Address t!G ( nkTM'f- ; Village I Owner Address Telephone Permit Request i f First Floor square feet Second Floor f square feet Construction Type Qwliesl9 Estimated Project Cost $ ��n.O6 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 a<o 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-&4)E 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) ❑Attached(size) ❑Barn(size) one ❑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 G Name[ j� Telephone Number 7� �6 t Z, Address 30 ifs&0,C(0,AA A*1" License# 0501-1 -A �AnM� S Home Improvement Contractor# Worker's Compensation# WC- -6 5! &S NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE BUILDING PERMIT DENIED FOR THE LLOWING REASON(S)77 t FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED • M �j _ Y MAP%PARCEL NO. ADDRESS VILLAGE OWNER j _ s DATE OF INSPECTION: FOUNDATION FRAME r INSULATION FIREPLACE - ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ' ! DATE CLOSED OUT + ASSOCIATION PLAN NO. r " ----- .._....... r Z-Brackets I 11 gauge zinc plated steel 3, . ��•' =#�;�< ;:#:-pit.' .,.ry;. Header Bar Detail { i i Head Bar-� (rindr square) I . Installation „Z„ Clip Anchor Bolt (not supplied) 20 y. __._..---------- -- +k R ) tl r -i 'L Cam. � I u_ Y �f �i f� +V1'. t� t�. {I{ + I i I t. . s _ oj I i i I Imo. - TOWN OF BARNSTABLE SIGN PERMIT PARCEL ID 327 068 QEOBASE ID 24177 ADDRESS 59 CENTER STREET PHONE HYANIS ZIP - a LOT 11 12 BLOCK LOT SIZE _ DBA DEVELOPMENT DISTRICT HY PERMIT 37030 DESCRIPTION YING'S (13 & 4 SQ.FT. ) i.PERMIT TYPE ' BSIGN TITLE SIGN PERMIT � CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL 'FPES $35.00 1HE Ox CONSTRUCTION COSTS $.00 , 753 MISC. NOT CODED ELSEWHERE * BARNSTABM • I MAST& 039. A10� Fp N11►1 BU DING DIVI� DATE ISSUED 03/11/1999 EXPIRATION DATE a '`` . t t , • NO Ao 1 •� 1' �y 46 tt '✓ rt 's M•KAM Vepartment of Health, Safety and Environmental Services Building Division :4 Fo 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Tax Collector rr Treasurer Application for Si Permit 3 J 1 1 9 P � Applicant: 9(Z(SeS �: C Assessors No.__d��- O� -I Doing Business As: c-�`� G S Telephone No. 2 "cZ X3 2- Sign Location Street/Road:- Zoning District: Old Kings Highway? Yes/No Hyannis Historic District? Yes/No Property Owner Name: � /2 ;�--V Wz�W Telephone: Address: 7 9ef Village: Sign Contrac r Name: .� Telephone: Address: Village; z teA 0,; Description Please draw a diagrun of lot showing location of buildings and existing signs with dimensions, location and size of die new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Ye&-,—Wote.Ifyes, 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 Barnstabl g O ' ance. Signature of Owner/Authorized Agent: Date: 3�O � 9 Size: f ,/d,O=Permit Fee: a^ Sign Permit was approved: Disapproved: Signature of Building 0 1 ial: Dare; Signl.doc rev.8/31/98 i � h t xM R ..t 4 .a SAS S + 3 Ir `I ,. _. .� P. ��. �. ,. 'I �` t�" ;s' �, �' �. .�; a ' y } YIN- Env Y S }{ 1 AMR. {�' 1 F #1•�'• � . r5 hf y a {y, `z#.}k �` fit' ' ,y •& MWK fly, AA A Ld , ti Z' • - >F k� 'rid`i b �! �.,. � `� �- �• •. e n� x r _... .... .. may. f TOWN OF BARNSTABLE r SIGN PERMIT PARCEL ID 32-T"066 GEOBASE ID 24177 1ADDRESS �ACENTER STREET ZIP N14 d. LOT 11 12 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 29834 DESCRIPTION M.V.DRUMS (a. Q_FT,.,) ,�,. PERMIT TYPE BSIGN TITLE SIGN PERMIT ax >m > , r _Depart�c dent of Health, Safety CONTRACTORS; ARCHITECTS: and Env ronmental:Services, TOTAL...FEES- - T . BOND $.00 " --- CONSTRUCTION COSTS $.00 1 753 k sC. NOT CODED ELSEWHERE * BARNSTABLE; +' MASS. 163 FD MA'I B ILDING DIv!rSIO 7V DATE ISSUED 04/02/1998 EXPIRATION DATE ,._,ti �� ��• _� + r: ;� ,y f -i�,i � �,p1 . S .m . , 9y`�;�� � ti'{- -- •. r,. � .. f t� fy}t. ...... .� .�� .. ...�._ � `u.� _ .k. 6 The Town of Barnstable -- Department De of Health, Safe and Environmental Services • snuvernsi.�. • P t3' MAM Building Division 059. r6p Mp`l 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Co ssioner Application for Sign Permit �— 9 Applicant: / 4er//c.., Assessors No. Doing Business As: � ' y �' Telephone No. ago—We Sign Location Street/Road: 1<1 Zoning District: 7/V �� ' Old Kings Highway? Yes/No Property Owner Name: &4V/D bumy"—F Telephone: 77/'a3rd Address: ?C Ab ?ECG{ booyf Village: 6 Sign Contractor - P Name: Telephone: 77s'2Su/ Address: 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? Yes o (Note:Ifyes, a wirinffpermitis 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 Or din ce. Signature of Owner/Authorized Agent. M' ate:✓ Size: Permit Fee: Sign Permit was approved: /4 Disapproved: Signature of Building Offi 'al: � ��. Date: s TOWN OF BARNST.ABLE BUILDING PERMIT PARCEL -ID 327 066 GEOBASE ID 24177 .ADDRESS 59 CENTER STREET PHONE HYANNIS � ZIP -- LOT 11 12 BLOCK LOT SIZE DBA, DEVELOPMENT DISTRICT HY IPTIdN THE ULTrMA j� NAIL (x1.4 4_FT. V_ PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services J TOTAL FEES: $25.00 TIME BOND $.00 CONSTRUCTION COSTS $_00 i 753 MISC. NOT CODED ELSEWHERE ; * BARNSTABLE + MASS. s639. A� Ep Mpl UILD NG DIVtISI N B DATE ISSUED 10/06/1998 EXPIRATION DATE e r_- ..� F ..' a-„ �� �" '� e. Mtn 4 w I �(y' �'t ��� ' ice..:..^.t� �:^T 1A 4 � Department of Health, Safety and Environmental Services �- Building Division _ 367 Main Street,Hyannis MA 02601 Office: 508 790-6227 Ralph Crossen Fax: 508 790-6230 (/ Building Commissioner Tax Collector Treascarer Application for Sign Permit Applicant Assessors No. Doing Business As: Telephone No. Sign Location Street/Road: Zoning District Old Kings Highway? Yes4tpNyannis Historic District? Ye�o Property Own Name: Telephone: Address. ' ' Village: Sign Contractor _ Name: ���� -� Telephone: 77S Address: �iE' S 7° Village: Description Please draw a diagram of lot showing location of buildings and elmsting signs with dimensions, location and size of the new sign. This should be drawn on the reverse side of this application. Lithe sign to be electrified? Yes(q (Note.Ifyes, a.wirmffpe=t is requ.L=7 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 43 of the Town of Barnstable Zoning Ordinance. Signature of Owner/Authorized Agent: /1� Dom: Size; Permit Fee: Permit was roved: _ Disapproved: Si p&a approved. Signature of Building O Date' Signi.doc NnIL- (508)775-2501 FAX #:(508)775-2502 Address: Price: Ot Phone: Fax: Date: lQ / G / 1 8 F i 0 e : .fS 1/2 DOWN UP FRONT ry BALANCE DUE AT PICK DP l 84'@ `. 'he a Ict tMate Nat# C The Ultimate Fall 39 © Copyright & Property of sign It! Signs Size Colors Surface # Signs Sides: 1 2, Please Sign, Check Spelling & Return with Approval Payment Method Cash Check (#/Name): Credit'Card # - Exp. Date -�` TOWN OF BARNSTABLE SIGN PERMIT PARCEL ID 327 066 GEOBASE ID 241.77 ( ADDRESS 59 CENTER STREET . PHONE HYANNIS ZIP - LOT 11 12 BLOCK LOT SIZE --- DBA DEVELOPMENT DISTRICT HY PERMIT 31356 DESCRIPTION P_DEL THAILAND CUISINE (23 SQ.FT & 4 SQ.FT_ ) PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL. FEES: $35.00 BOND $.00 THE CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE + BAMSTABM + .� MASS. Ep�Cl UILDI G DIVIST DATE ISSUED 06/03/1998 EXPIRATION DATE �" ,r;,.a •� r , ' ; `, ' a'�of��-" ~•r � �.5*` � ` ` • ,- i �'11�5 Plr �,�� �'�� �j ,-: ,� _ ,w,� � �.4r _t. it .\ „' �1 � •� A K j'1, �'i i'.�f `�� 'S f i .�a.r�. � .r ...... --s t. .� -�. ...4r...r� •� � � • . .. 1 � ter° . The Town of Barnstable Department of Health, Safety and Environmental Services K- Building Division Fp"� 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Application for Sign Permit Applicant: � � [1)lr�se n Assessors No. 7 6 6 Doing Business As: �� ��� i �)����'�� �/js� � Telephone No. �10� Sign Location Street/Road: I<A— S 1 A 4 n t7%s o,-, Zoning District: Old Kings Highway? YesE Property Own •Name: P � �� ®'r} L Telephone: Address: V, Village: JflfM� t Sign Contractor ; Name: ����� /� —Telephone: Address: 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? Ye o (Note.Ifyes, a w=gpermitis 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: v 1) U Size. • ." of ? I Permit Fee:��� �'� Sign Pennit was approved: Disapproved: r Signature of Building Off vial: - T Date: 'z 77 F - � �, The Town of Barnstable k RAMUM,E, . Department of Health Safety and Environmental Services MASS. egg' Building Division v t A 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M. Crossen Fax: 508-790-6230 Building Commissioner April 2, 1998 Martin Vazouez 77 Glen Eagle Drive Centerville, MA 02632 Re: INFORMAL MV Drums, 59 Center Street Unit 9, Hyannis (327/066) Proposal: Martin Vazouez is proposing a new 1,500 sq.ft. music instruction and retail sales. Previous use was ticket agency. Dear Mr. Vazouez, The above referenced proposal was reviewed at the Site Plan Review Meeting of April 2, 1998 and approved under Section 4-7.4 (2) of the Barnstable Zoning Ordinance Please be informed that a building permit is necessary prior to any construction. Upon completion of all work, the letter of certification required by Section 4-7.8 (7) of the Town of Barnstable Zoning Ordinances must be submitted. Also, all signage must be discussed with Gloria Urenas of this Division. Should you have any questions, please feel free to call. Respectfully, Ralph Crossen Building Commissioner TOWN OF BARNSTABLE SIGN PERMIT PARCEL ID 327 066 GEOBASE ID 24177 ADDRESS 59 CENTER STREET PHONE HYANNIS ZIP - LOT 11 12 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 26551 DESCRIPTION "SIGN IT" PERMIT "TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $50.00 BONDS .00 CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE i * BARNS ABLF, + MASS. 039. A� Eo� B LDIKG.DI�SIO� DATE ISSUED 10/24/1997 EXPIRATION DATE r' eat� �w' t._'rtr4 _ // j h ���.+«mot_ •�. �.ii�,i�sr yFd���� F L y r of Barnstable � �60 Tha Town : Department of Health, Safety and Environmental Service—/6 KUL � Building Division Ep� 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crosser Fax: 508-790-6230 `f Building Commissioner (A Application for Sign Permit Applicant: ^ ,ZA, Assessors No. 1 P Doing:Business As:J 7,A) -L�, Telephone Rio. Sign Location Street/Road: Zoning District: - ' _ Old Dings High«ay? Yes o Property Owner f _� 0 ���" �4 ame: Dila f cl c en—> Teleph n1 Address ,�� Village: ;r 7� Sign Contractor Name: A1It2 e? Telephone: j� Address: Village: � Description Please draw a diagram of Iot showing location of buildings and e.�asting signs uith dimensions, location and size of the new sign. This should be drawn on the reverse side of this application. s the sign to be electrified? IesYo (Note.Yjrs, a rviringpermit 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 constructIgn shall conform to the provisions of Section 4-3 of the Town of B e - Signature of Owner/Authorized Agent: Date: o,, Sue: —(��` f- o � Permit Fee: -k e - Sign Permit was approved �-� Disapproved: Signature of Building Off ci i Date: �� �:-.�•.. F' `� � �. �1(� 1 � 1 � ` -/ .. �� e r f, � , ,. . .�:� . . .� �, . _ � . 4 . �: � - �; .s x� n v' �x V AL f cb x' ...................... .. . A - .. _Engineering Dept.(3rd floor) Map 3c�? Parcel-C� Perm it# s(o T)PL7 House# '� ? �� Date Issued -/6`-9."7 (3rd floor)(8:15 -9:30/1:00-4:30) i t%JS . Fee. • o-� C:n. Conservation Office(4th floor)(8:30-9:30/1:00-2:00) Planning Dept. (1st floor/School Admin. Bldg.) �tNE rp W JPro*etreetAA:ldress Approved by Planning Board 19 BARNSTABLE, MASS TOWN OF BARNSTABLE' Building Permit Application CCAJfie�C5, -- Village �N Owner 1"7Roil Address _ cicly-kr ! ` -cc�xr� Telephone 'Permit Request -11 7v AU4,)f—% First Floor square feet Second Floor square feet Construction Type N&i —j-A 10 Estimated Project Cost $ Tom. 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 23No On Old King's Highway ❑Yes •�460 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) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) _ ,Other(size) �2(--"o x o2 4P-0 el Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use Builder Information Name AWN j,,)!Q �, - Telephone Number 77�5-6 G Q Address r Cc License# / 4'S Home Improvement Contractor# - Worker's Compensation# , NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. 1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE.TAKEN TO t)&VE ir SIGNATUR DATE UILDING PER_ IT DERNIEDT)FOR ggTHE FOLLOWING REASON(S) Y r ' t' E f . FOR OFFICIAL USE ONLY W.. PERMIT NO. DATE ISSUED MAP/PARCEL NO. " 1 ADDRESS ^ '.' • �! -- 'X _ VILLAGE OWNER DATE OF INSPECTION:. t f FOUNDATION j f FRAME •, t —' i INSULATION b. , FIREPLACE _ ELECTRICAL: , ROUGH FINAL PLUMBING: ROUGH FINAL f ° GAS: ROUGH ROUGH FINAL t ' ,FINAL BUILDING e DATE CLOSED OUT a ,; ASSOCIATION PLAN NO. u +*` The Connizonwealth of:lftissachusetty rtIl 1:_. �� 4 ---. Dc partmutl ojlndustrial Accidutts '�. 011i 9VROv A9,711017S 600 11•aWthi;tun Street Boston.A1uay. 02111 Workers' Compensation Insurance Affidavit _ aliniic.ini inttirmatitin: Please PRINT le &j77 "'�'��• ' —� --'� name: iiC;l19 1 location cen city yylfy,t S nhnnc# `775--.461 I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity . —•v- -•---•-+'...—.�:�.ur.»i.++��rXa�_•+.w.r+lfr¢++`�rw��.w_ .+w,.+w!�ww�.r`"'�7+•.+.+•w..�yw... ++•yw...••--«....+.••_--•----••_:. am an empIover providing workers' compensation for my empiovees working on this job. coat t. nv names r T t nddrest: 130 & city, T -n, Ithonc#• insurance co. Potic+•# EeVG 71 1 am a sole proprietor ^eneral contractor or_ tomeo++ner(circle one) and have hired the contractors listed below who have the following workers compensation polices: comnanv name: atitiress• cirv. 11hone#: incurancc ro. none+•# . •i.. �.. Y..^._. _ �..t..._ =_ __ _lr��::�-'1�iT•'f!�ww•St�� -�:lr.L.__ ...w•�.....i�..._..._..r_ cmmnanv nhnnc* atldrescr nhnnc#- insurance co. nolic+•# _ _ Attach additional sheet if necessary; ::`: >y � i Ji""`n' i'•.i..'. '""�'�^`'u'"• y�v_ " �' _`':' . �Z ----� :are. ••4AI,W1.•U F::iiurc to secure coveracc as required under Section 35A of NIGL 152 can lead to the imposition of criminal penalties of a line up to S1.500.00 andiur unc%cars'imprisonment as well::s civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. 1 understand that a cop} of this statement ma% be forwarded to the Office of investigations of the DIA for coverage verification. ! r Or certt •under to pain t enalt s of erjuty that the information protided above is true and correct L . Si_natur Date s ,1-`" Print name �� Phone* r�ofriicini use only do not write in this area to be completed by tiny or town official -� ciq•or town: permittlicense# r-tlluilding Department IC3Licensing Board 0 check if immediate response is required (:ISclectmen's Uffee 1 C31lc21th Department phone#• MOthcr. contact person: '- Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all emplovers to provide workers' compensation for the employees. As quoted irom the "law an enrplitree is defined as every person in the service of another wider an%• contract of hire, express or implied. oral or written. An emplorer is defined as an individual. partnership, association, corporation or other legal entity, or any two or nor the forcC, - cnza�scd in a joint enterprise, and including the legal representatives of a deceased employer• or the recei%•er or trustee of an individual , partnership. association or other legal entity, employing employees. However 11, ' �. of more than thre e apartments and who resides therein. or the occupant of tite owner of a dwelling house having n P P dwelling house of another who employs persons to do maintenance , construction or repair work on such d'%vellin�, lic or oti the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an empioye MGL chapter 152 section 25 also states that ever- state or local licensing agency shall withhold the issuance of rene��al of a license or permit to operate a business or to construct buiidinrs in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally. neither the,commonwealth nor any of its political subdivisions shall enter into any contract for the perforniance of public work until acceptable evidence of compliance with the insurance requirements of this chapter been presented to the contracting authority. 77 Applicants Please fill in the workers* compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law' or if you are require,: to obtain a workers• compensation policy. please call the Department at the number listed below. City or towns •r Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom c the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant, Pie be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned the Department by mail of FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any auestio: please do not hesitate to give us a ca11. �-..y.v..r+...... ....-..7ti:....- .•••+....r•+-••r.��r.-..v+-z��.....-w Twrtw.w'.+_•...-.w.vv. . . .. ... The Departments address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax N: (6I7) 727-774/9L r.i,nnn ii• (rl—n '777-19fl() p t_ 406. 409 or 375_ l TOWN OF BARNSTABLE SIGN PERMIT PARCEL ID 327 066 GEOBASE ID 24177 A ADDRESS 59 CENTER STREET PHONE Hyanni.B ZIP 02601- i LOT 11 12 BLOCK LOT SIZE _ DBA DEVELOPMENT DISTRICT HY ,PERMIT 19028 DESCRIPTION CENTER STREET NEWS CAFE (23 SQ'& 4SQ'STAND PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services � TOTAL FEES: $35.00 BOND $.00 Oki CONSTRUCTION COSTS $.00 753 MISC. NOT CODED .ELSEWHERE . * BARNSTABLE, ; MASS. OWNER- DRIFTWOOD STERLING REALTY TRUST, ADDRESS 79C MIA -TECK DRIVE ,E'D M0�► WEST YARMOUTH, MA B - LI DI G DJVI%S ON B �,r 'y DATE ISSUED 11/04/1996 EXPIRATION DATE 1 r.` The Town of Barnstable Department of Health Safety and Environmental Services g012 MAM �� Building Division 1"9- 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Application for Sign Permit Applicant: OleNtEr grW#_I&V� S -�QVC• Assessors No. Doing Business As: d0 A A16W% 69 Telephone No. 7 797 Sign Location Street/Road: 1rh • 6246 Zoning District: _ Old Kings Highway? Yes/No Property Owner Name: I � r ��� I`T7 �1�UST Telephone: Address:_e_M y0 T5:!' ®f VJ'y'W. MA°=33Village• Sign Contractor Name: �� -Telephone:— Address: —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? Yes/ (Note.ffyes, a wirirfffpermit�&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 Barnst#le ^Zoning Ordinance. Signature of Owner/Authorized Agent: / Date: Size: ee:,.o Permit Fee: Sign Permit was approved: Disapproved: V. Signature of Building Offi al: Date: /^ 1 2Z/ Pal" r7- DRIFTWOOD STERLING REAL ESTATE TRUST West Yarmouth, Mass. (508) 771.0310 FAX (508) 771.0399 August 27, 1996 To Whom It May Concern: Mr. Giovanni Costa, President and Treasurer of La Siciliana, Inc. , is no longer doing business on the premises known as La Sicilians, located at 67 Center Street, Hyannis, Ma. He has closed the resturant and sold its contents to David S. Dumont, Trustee for the Driftwood Sterling Resl Estate Trust, owner of Center Plaza. Should you have any additional questions please do not hesitate to contact us. Sincerely, David S. Dumont Trustee TOWN OF BARNSTABLE S;GN PERMIT PARCEL ID 327 066 GEOBASE ID 24177 ' ADDRESS 59 CENTER STREET PHONE Hyannis ZIP LOT 11 12 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 12073 DESCRIPTION ALCHEMY & LACE BRIDAL CONSIGNMENT PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services I'I TOTAL FEES: $25.00 Tt1E BOND $.00 4 , CONSTRUCTION COSTS $.00 ` 753 MISC. NOT �ODED ELSEWHERE * BARN3TABLE. MAS& I OWNER DUMONT„ DAVID Ep 39. ADDRESS 79C MID TECK DRIVE YARMOUTH, MA BLTILD� ING DIVIS-1ON DATE ISSUED 12/05/1995 EXPIRATION DATE` /� ~' The Town of Barnstable # ��o. _ Department of Health, Safety and Environmental Services MAM 1 Building Division date S 9 1659. `� 367 Main Street,Hyannis MA 02601 fee Application for Sign Permit Applicant: -e--, Assessor's no.✓ �i Z - 0 �k Doing Business As: jq LP N-grY, r►rm l lNt-,L �e� I Afe1epnone ,7/- t t io 1�z Sign Location streettroad: C o✓t-c� S T Zoning District Old King's Highway District? yes no / Property Owner Name:_ v,0o�7� Telephone Address: Village Vd&d e v75f - Sign Contractor Name: Telephone Address: Village Description Diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign to be drawn on the reverse side of this application. Is the sign to be electrified? yes no__4Z_ (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 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 Ordinances. Date Signature of Owner/Authorized Agent Size (sq. ft.) Permit Fee �✓�" a� Sign Permit was approved: disapproved: 17 (;L Date Signature of Official R TOWN OF BARNSTABLE SIGN PERMIT PARCEL ID 327 066 GEOBASE ID 24177 ADDRESS 59 CENTER STREET PHONE Hyannis ZIP LOT 11, 12 BLOCK }° LOT SIZE -DBA _ ' DEVELOPMENT' DISTRICT HY PERMIT 12076 DESCRIPTION VELIA BY DESIGN PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $25.00 tNE BOND $,00 � CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE *+ * ■ARNSTABM MASS. OWNER DUMONT, DAV I D ib39. ADDRESS 79C MID TECK DRIVE FD r d BUILDING DIVISION / YARMOUTH•, MA BY 2t • DATE ISSUED 12/Q5/1995 EXPIRATION DATE �` a The Town of Barnstable t o71 Department of Health, Safety and Environmental ServicesNAM 1 Building Division date S 9S 367 Main ShrM Hyannis MA 02601 , fee Application for Sign Permit cry Assessor's no. 3 Z o Applicant: Lk(L � (�V1 ��� � (o Doing Business As: z Q Telephone Sign Location / streettroad: C am-- ST Zoning District / 3 Old King's Highway District? yes no Property Owner Name: (1 (�M r�Al Telephone Address: Village qm m o yt}- Sign Contractor Name: Telephone Address: Village Description Diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign to be drawn on the reverse side of this application. Is the sign to be electrified? yes no (Note: if yes, a wiring permit is required) I hereby certify that I am the owner or that I have the authority of the owner to make application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinances. - Date Signature of Owner/Authorized Agent Size (sq. ft.) Permit Fee �S- Sign Permit was approved: i,-� disapproved: r Date Signature of B din cial �ru adrd,Dace 59 Center Street Hyannis, AIM 02601 (508) 771-1166 F-4 R c (' tVN r ' 6 I .. C TLC. ALA- 2-4 1 4L c en, c' ,a Lace- 7 V�, deg ' Assessor's office(1st Floor): .2 h �� � i Assessor's ma and�lotnumber Twc+ JoC \/1 _ _ � Conservation _ e Board of Health(3rd floor): d =aa�� ��0� A!'YLlcar 0A8�WE$ w 1 Sewage Permit number ,./� :/(� CO�j t�QBTO +o Engineering Department(3rd floor): o s639. House number � �� �o Definitive Plan Approved by Planning Board 19 APPLICATI PR ESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN ' OF BARNSTABLE BUILDING INSPECTOR PPLICATION FOR PERMIT TO add doorway TYPE OF CONSTRUCTION _ is o o d frame/glass . f July 7 , 1995 19 TO THE INSPECTOR OF BUILDINGS:. The undersigned hereby applies for a permit according to the following information: Location S9 ('"onto Rtreet Hyannis Proposed Use store/business Zoning District Fire District NameofOwner navid n„mnnt Address 79C Mid TPek Drive Yarmouth American Home & NameofBuilder D. Williams dha /Enyirnnmanta1kdd1@m 35 Winter Street , Hyannis Name of Architect none Address b/a Number of Rooms no Foundation n/a Exterior g a l a s s Roofing n/a Floors i n/a Interior n/a 1 Heating n/a Plumbing n/n Fireplace n/a Approximate Cost $12 0 0 . 0 0 Area Nb 0.M�rx Diagram of Lot and Building with Dimensions Fee /G7),ati 7 i , )eJ 10c) ctixl=D rJet3 114S s qb--Z m✓du - - ZL OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License 016 9 81 t No 8813 Permit For * " Remodling Location 59 Center Street ,-Hyannis,' MA 02601 Owner. David Dumont Type of Construction Plot %f- Lot i Permit Granted 19 Date of Inspection 19 Date Completed 19 r 11/02'94 17:02 $`817 7 27 7 122 DEPT IA'D ACCID Q0 Conun0nitleahli. of Vja6jac1zu6ettj ' ..LJa�arl`inetf o��ndu�Erial�cctd�w ^ 600 Vl/asftiton..�t,�t James J.Campbell &ton, aasagwisib 02111 Commissioner Workers' Compensation Insurance Affidavit with a principal place of business at: do hereby certify under the pains and penalties of perjury, that: �am an employer ovid'mlg workers' compensation coverage for my employees working on this job. tN A- o 5� y �r�( 0 2 0 Insurance Company Policy Mmnber () I am a sole proprietor and have no one working for me in any capacity. t I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Humber Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number O I am a homeowner performing all the work myself. I underscard&..it n copy of this slte:nent will be form-arded to time Office of investisations of cite DIA for coverage verification and that failure to recur c0.t1a9e s rtc i,ed under Section Z5A of MGL 152 can lead to the Imposition of criminal penalties consisting of a fine of up to S 1,500.00 and/or c yea:s' impruonnnem as well as civil penalties in the form of a STOP WORK ORDER and a fine of S 100.00 a day against me. Signed this k f ,��---�--- day of , 19 Q� Licensee/Permittee Building Department Licensing Board Selectmen Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 �a eta y S c -� (h- s � I�y - � , , �'" ,i e � .. �• ti � � � � c t ... � . �....5 j : � i �, The Town of Barnstable 'e Department of Health, Safety and Environmental Services Building Division 367 Main Street,Hvannis MA 02601 Office: 508-790-6227 Ralph Crosser Far: 508-790-6230 Building Commissioner SITE PLAN REVIEW rw� CERTIFICATE OF REVIEW I certify that David Dumont, for Nardone Carpet, ham submitted a site plan SP-00-34 pursuant to Barnstable Zoning Ordinance, Section 4-7, and that such Site plan has been reviewed and deemed approved. Building Cbfmnissioner June 29, 1995 date of action t i ' 2a3^�`+tCiGI r 4 5010191RC a F3/15/1994 21:06 5087710399 DOE INC PAGE 01 s The Town of 'Barnstable AM Department of Health, Safety and Environmental Services Building Division 367 Main Str+cce,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Far: 508-790-6230 Building Commissioner June 30, 1995 David Dumont 79 C Mid Tech Drive W. Yarmouth, MA 02673 Re: site Plan Review dumber 00-34 Nardone Carpet 59 Center Street, Hyannis Dear Mr. Dumont: The above referenced site plan is approved. Please be informed that you must comply with any conditions listed on the Certificate of Review and that a building permit is necessary prior to any construction. Upon completion of all work the letter of certification required by Section 4-7 .8 (7 ) of the Town of Barnstable Zoning Ordinances must be submitted. Should you have any questions, please feel free to tali. Respectfully, R�1 h Croaeen Bui ding Commissioner RMC/car enc. a01.091c TOWN OF BARNSTABLE �. SIGN PERMIT PARCEL ID 327 088 GEOBASE ID 24177 ADDRESS r 59 CENTER STREET PHONE Hyannis ZIP. LOT 11 12 BLOCK LOT SIZE DBE DEVELOPMENT DISTRICT HY PERMIT 9715 DESCRIPTION NARDONE CARPET COMPANY PERMIT TYPE. BSIGN' TITLE -i SIGN PERMIT Department of Health, Safety CONTRACTORS- � �* �r and Environmental Services ARCHITECTS: - i TOTAL FEES: $50.00 i; pxTNE BOND $.00 I CONSTRUCTION COSTS $.00 , QA # 1ARN3TABM OWNER DUMON i6gq. A�� T, DAr�ID �ED ADDRESS 79C MID TECK DRIVE YARMOUTH, ,MA r ' BUILDING DIVISION j DATE ISSUED 08/15/1995 EXPIRATION DATE BY--- �� �• l�td� I E DIVISION APPROVALS FOR CERTIFICATE OF-OCCUPANCY ' TO BE SIGNED BY EACH DIVISION HEAD UPON COMPLETION t BUILDING: `* ' DATE: COMMENTS: PLUMBING: - DATE: COMMENTS: Y ELECTRICAL: DATE: COMMENTS: GAS: DATE: COMMENTS: CONSERVATION: DATE: COMMENTS: ' OKH: DATE: COMMENTS: HISTORIC: DATE: COMMENTS: FIRE DEPT.: DATE: COMMENTS: D OTHER: DATE: COMMENTS: s_ TURN THIS IN TO THE BUILDING COMMISSIONER AFTER ALL SIGN-OFFS AR1E COMPLETED.A CERTIFICATE OF OCCUPANCY WILL BE ISSUED AT THAT TIME. TOWN 4F BARN'STABLE SIGN PERMIT PARCEL: ID"32?7 066 GEOBASE !D 24117 .ADDRESS r 59 CENTER`.St EET PHONE Hyannis ZIP LOT lI 12 BLOCK LOT SIZE I BA DEVELOPMENT DI STRS CT HY PERMIT 9715 DESCRIPTION NARDON:E CARPET COMPANY PERMIT TYPE . BSIGN TITLE SIGN PERMIT Department of Health, Safety CONTRACTORS ! and Environmental Services ARCHITECTS: TOTAL FEES: - $50..00 BOND $.OCR CONSTRUCTION COSTS $.001639. �► OWNRR' D 3MON`.[`e DAV I D ADDRESS "79C KID 'TECK.,�3RIt .` YARMOU'TB Y ILDI G DIVISION J DATE ISSUED b8/15/t995 PSXPIRATI.ON i� TE 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 APPROVED PLANS MUST BE RETAINED ON JOB AND FOR ALL CONSTRUCTION WORK: WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READYTO 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. VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 I 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT I 2 BOARD OF HEALTH SITE PLAN REVIEW APPROVAL OTHER: S , WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS I, THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX. CARD CAN BE ARRANGED FOR BY I VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. 508-790-6227 . I i Y I I f I I I I C I f I I f f I V I I I I I I I I I ! I I I I N N I N N I N I I I The Town of Barnstable permit no 7i Department of Health, Safety and Environmental Services Building Division date 367 Main Street,Hyannis MA 02601 Application for Sign Permit . Applicant:_ Assessor's no. = — F Doing Business As: o Telephone Sign Location _ street/road: Zoning District Old King's Highway District? yes no ✓ Property Owner D n Name: Telephone�`j�__��i�,�, Address: Village Sign Contractor Name: ,���� Telephone Address: Village k ` Description Diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign to 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) ..,H N . I hereby certify that I am the owner or that I have the authority of the owner to make 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 Ordinances. Da a Signatur of Owner/Authorized Agent Size (sq. ft.) Permit Fee Sign Permit was approved:_ disapproved: Date Signature o uilding,0fficial • - MQ- /0"�ti - 7 �. THE T TOWN OF BARNSTABLE B�gTI IL : OfficeM of the Building Inspector ras �Op 1639 Date May 24, 1995 Fee $75.00 Permit No. 99 PERMIT TO ERECT SIGN IS HEREBY GRANTED TO Giovanni Costa La Siciliana Inc. DIBIA LOCATION Center Street Hyannis ANY VIOLATION OF THE SIGN LAW WILL CAUSE-IMMEDIATE REVOCATION OF THIS PERMIT `' Building Inspector The Town of BArnsta lile Y =pe 9 Department of Health f rmit no. De >�T P , Sa ety and Environmental Services' ,e$ Building Division date S" qr- 367 Main Strect, Hyannis MA 02601 fee I' r Application for Sign Permit n f Applicani: ,,�,,,• �� �f � S�� � Assessors no. Doing Business As: J r .d� •Lc o �• c, l- Tel hone _ eP Sign Location streedroad: YY, C:"Y, S ee ! ` Zoning District �/--c� Old King's Ifighwa District? es y y H no. Property Owner x Name: � � v`= ���e�-e Q n , Telephone Address: `��' e API Id Village Sign Contractor . Name:_ Telephone Y Address: Village Description ? Diagram of lot showing location of buildings and existin g signs with dimensions, location and size of the new sign to be drawn on the reverse side of this application. �"•�� c.. �. � +--V�.y,'`- • .� _ �, Is the sign to be electrified? yes no y (Note: if yes, a wiring permit is.required) r� I hereby certify that I am the owner or that I have the authority of the owner to make 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 Ordinances. 931 Date Signature of Owner/Authorized Agent Size (sq..it.) _ �G Perri; Tee f. Sign Permit was approved: 4/ pproved: .Dat Signature of Buil ' g Official YOU WISH TO OPEN A BUSINESS For Your Information: Business certificates Qcost$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.) Business Certificates are available at the Town Clerk's Office, 'I" FL., 367 Main Street, Hyannis, MA 02601 TTown Hall) DATE: Fi4 in pleas - sis + , APPLICANT'S YOUR NAM d ►�� U HOME ADDRESS:BUSINESS �50 . IA/v/`.',S TELEPHONE # Home Telephone Num er -446-36SO 1 FM t-. 1.,;.[ 1]II r lv- a. u,�19�(��'✓ '\� `V4� 1-� V1� NAME OF CORPORATION: NAME OF NEW BUSINESS TYPE OF BUSINESS K] ,-- E'N _A » IIS THIS A HOME OCCUPATION? YES O L-----c7 ADDRESS OF BUSINESS C� e�+L S NNi !� O O MAP/PARCEL i0➢UMBER �( f� a �- w (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. 1. BUILDING COMMISSIONER' FIAay This individual has b ] rmeermit re uirements that pertain to this type of business. q u orized Signature** -� COMMENTS: � S L - ��."CkN 2. BOARD OF HEALTH This individual has beer;tijforme cJ,of the permit requirements that pertain to this type of business. A thorized Signature* COMMENTS: I. r 3. CONSUMER AFFAIRS (LICENSI ��h TI 9®RITY) This individual has be �' info icensing requirements that pertain to this type,of business. k1 A thoriz Sgna re** ,7 ��C� ^v C 4 r' CABINET _ 40.25 4 � 4o.2g f KITrHEN LA � 1000 - �3.55'' BAR SUSHI BAR �qo„ 129' 46 ' O O CD 0 CD O O } 3t•5� R�STROOM a 0 0 0 0 - o o Q oLl � aCD WATER FALL ay g3s41 - 0 0 0 � O 0 IT 0 ' 0 O o 3� -a H 96 Al -t EXIT . 1 : 50 3 y 99 . 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MA t plymouth,massachusetts 02360 . II e _ _ • 09 D IL O 131 2d0••CHEE WALL zi m ♦ 70 p ........... .... . ..-...._:,......,.. .. ........ .. _ u O m .. .... .... .._ x ... � .. ♦� \ ....-...-. .. .__(3)'2dd^CHEEK WALL..-�- __._�_.__. -_....__....... m N _ om o u n o -- ------ D Z y 9 m o -------------- m , x ♦ - 70 \ `` - A 131 2d •CHEEK WALL 70 Sf LVL•STAIR OPEN'G - , �. s -p __-----_-131_2d0'•CHE WALL - 3 N, r s D z D' - n °off Om 2 x 6• O. R TE m D - D ap � 2 x B CL J 9T5 pD Z pm b m O O 'DOS R nG _ ° " O•Y - 2 x OP 2x P S o o rc m ° o mm . D s _ 21 e• 6'1, RJPTE SW -2 xB CG.J I D � O W °S nc 0 '12)12-LVL•GABLE WALL I c y Z u - y I I I I ----------------- '.. �. ♦ u I I I I D Ozlx-n-n _ D p u I I I I I I I I 3 . I DyoE u m m D ------ ---------- -------------- y ' ♦ DFm I I I ___________ ___________ N S O _____ O (P I !1 ____ _ _ ___ _______ p_____ n 0 D ____________________________ u H - HM- rn ADO I 1 D m m D O I ' i 2 'IQ DGE i OD �f1 wOp O ______ _________ ^I r ___ ___ _____ ___ _____ , a o o °sD -Dim mp n - `s 3 -- --- - ------ - - - - ---- n Q ro , _ _ -- -- -- - �E' m u oE. m ' m °---- --- m T �rl u - O ________ _______ _ _____ p - /U �xm . I I I r c m A I _ 1 im< I - O _ ___ __ ________ ____________._______ T W p ___________-__ ___-______-__ Cc I I I I pro n lo S 1 I I �1 I 1 NpI I I I I D - I. I I I Zl_ W I I W, LVL BM.AT BRG.WALL ABOVE \ A +. rO. O ' cED-z I EO, _ D _ DX' D%_ __ O_______ m 4 m°r - Z E .. • t Ayr n• y my n_ D________9 a_ __ ________ p - n . 3 m , p • O ---------------- LVL AT RG. L "AB VE L L M.A ERG. LL OV - S) OD - a 15T I Dy m- r is i Dumont Building Date. Jeffrey m. metcalfe, r.a. O 28-Septembert-2016 N 11 Center Street O 44 Jan made drive Hyannis, MA plymouth, massachusetta 02340 x j Bathroom Bathroom Notes: I . Remove all existing interior finishes ie floors, walls ��% ceilings. , 2. Remove all interior non-bearing wails except mechanical rooms and bathrooms. L, o 3. Make safe/remove all abandoned electrical as required M o 4. Ensure existing smoke detectors, E13U 5 and exit 51gn5Cli to remain entact or be reinstalled and functioning. ! Mechanical I. CD II I m ! i i Jw ! ! o ! Mechanical NR Li 4j A i \�T 1 I 4-4 iJ CO ! V1S111NS i I DATE ! l ! A- 1 DATE 10/05/0,5 E0o � Q 11J N O� OOO �'V � 00 Q 4A E Glass/boa a le shelves GI +s /boa I Ic Shelves E i 41 J-' ^ J`O+ ZeGkor Pump 0 cj o �'4.1 %3) �o QO o o KITGHBN � o V L _____________________ __ _____________________ Bar Seating for 13 0000000000000 H , b a, :1,' U Ur- :z �J o - ----------- --- --- ------ -- - � Q D 0 ° a v Lounge seating fort ° 2 Seats 2 Seats -e;2LX-;1N1t�t:)AP- ---------------------------------------- Waiting Bar seating for 6 2 5eats —1 F2 5eats r-1 E2 5eats y� v 000000 u 2 5eat5 2 Seats:1 Ez d V 0 fj EXIT 4 Seats 4 Seats 4 Seats � v EXIT � h - .._ 0 M r7 - ' F] ri 7 M X 4 Seats 5 5eats 5 Seats ` OOOIti�r L�OCOOO�IO� 2 Seats v _ ' -� �— r �o� V =E-,. O ' 0 � C7[ _ 4 5eat5 4 5eat5 4 5eat5 2 OUTI�00� PAT10 SEATING 2 5 lea f s foav R r- - - ool �o� _ _r� �o� ---E E- �0�� - OOP - A- ----d . `S m v o E W o (V PLAN 4-- S 0- QL) � o V E - t o t Gal c:: f / 4 ►� ! ►_��� c- s v1 E a ,� �. o- FL � a , _ I ___ v s `` G 925 5f. Ft. @ 1 55f. =6 1 Occupants E UI E LA Y.' PM NT P N Q o ' ' x � # FIX'rU[✓E 26 1 5f. Ft. @ I5f. =3-7 Occupants �, ,a� 2 4 " GoGk.•haiV IGe sink � I ry 2 4" IGe sink only Ingress Path 42" clear E i °�' q 8 Total Occupants ( 15t.Floor ) p 8' P-eaGn-in beer Gaoler d m m L m � >; 2 Nead f7ra'f4h beer head w/ drain4.1 -7 80 GMR: m 0 p x m V w w Table 1 005.1.2 P 2 4" G1(ass washer s i �; p N N N Maximum Floor Area Alowance5 per Occupant o -- - Assembly without fixed Seats: G t O" x 18" Nand sink �, a o 3 0 \ Standing Space 3 5.f. net Y i o c Goncentrated ( chairs only- not fixed ) 7 5.f. net �Q� � �� o s c q � Unconcentrated ( tables and chair5 ) 15 5.f. net N f�everac�e Gun �' v _� N -T T � ,4�PNLT Fl-lo o tft obi obi o v fl W d DRA W I NG TYPE: 4:-;7ea4-ino) and C juiF men-h flan SHEET NUMBER: i 1 1 I � ' o 1 , /1 � !i n l � '1 c� �l ��eti �1 < �y�l e 11 d � ��\ rn Ho it 1 'F�rc i '3 1S _,r O 39 Po NO BUILDING ENCROACHMENT ZC7 {r Y -ip I' P. [r• I - p 4n L� O 1 �120LQ� LOCUS MAP 1" 2000' 6� 2$k D. 01< ul EXISTING COMMERC. ve, REFERENCE PLANS: w BOOK-77 PAGE-107 BOOK-119 PAGE-137 LAND COURT 9132—A2 LAND COURT 11106-8 4 REFERENCE DEEDS: , CERTICATE #105284 DID BOOK 4918, PAGE 334 ^3 RLB FND. EXISTING COMMERCIAL/ BUILDING ? , w E � - \ \ \p `c, DENOTES UTILITY POLE \i�. OH DENOTES OVERHEAD UTILITY LINES t� ° �w < AND 18 EXISTING COMMERCIAL.. �. OTS 11,12,1 ,14,17 BUILDINGS SHOWN LA D COURT PLAN Z —A2 HEET-1 oy I HEREBY CERTIFY TO CHICAGO TITLE INSURANCE rn 21,411 s .ft. COMPANY THAT THE STRUCTURES ARE SHOWN ON 9 acr s THE PLAN AS THEY EXIST ON THE GROUND AND N CONFORM TO THE TOWN OF BARNSTABLE ZONING z App BYLAWS AT THE TIME OF CONSTRUCTION. \I.F�. FND. t r �6.33p0r i ;-----F•P• TO -- --S..4.3�01'S6__F--- DATE PROFESSIONAL AND SURVEYOR --_-_ N R'R' SPI�E FOUND R.R. SPIKE o 135 83 FOUND NOTE: LOCUS DOES NOT LIE IN A FLOOD HAZARD ZONE. Q CKpDE FENCE 13� 29 1� Sao Cp. '�> A� PLOT PLAN OF LAND W P�KVI P - S�PIRW IN H'i ANNIS, MASS. 15.TERfp ��y GRAPHIC SCALE STEPHENJ. �N PREPARED FOR 20 0 10 20 40 so LL// /7 tf? WYLE DRIFTW001) STERLING REALTY TRUST C„�•°q ii���� �V/ � No, 37559 S, P Q� - IN FEET ) ,�c�5�c AJa'To lq�0SU���y DATE: MARCH 16, 1995 SCALE: 1" 20' 1 inch - " �X'Sr�nS 1 J L STEPHEN J. DOYLE AND ASSOCIATES 0 it. 1�P5 , 9 1V CLfod S par TELEPHONE: 5 8/540-2534 \��Si 42 CANTERBURY VILLE, MA. 025 5 - tieLx) S Pac'(05 _ oec.o �um�sfiP� ��xa t�r�►� tNEr°��,� TOWN OF BARNSTABLE ii . i BARNS ABLE. "6 9 BUILDING INSPECTOR € �'c war°'• i 4 F APPLICATION FOR PERMIT TO .................... .......................................................................................... .kll--124 TYPEOF CONSTRUCTION ..................................................................................................................................... j.j. ...... ........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..............04 .. ..:.......!.. 0rt�!(At.S �AA-I.S..................... ProposedUse .......... .i .I ���4....G r�l. '........................ ................................................................................................. J / ZoningDistrict ..........:.............................................................Fire District .............................................................................. Name of Owner ? :..4`� t. .. .E '........Address ...... !lf� ! ............................................... Name of Builder ..... .4�I�.��..� R� !?� ..............Address ............... ...nls....................................................... Nameof Architect ..........`�(�. A..............................................Address .................................................................................... Number of Rooms .............55 qa.............................................Foundation ........... +ra ............................................. .�.Exterior .............�f .. . ........,...................................................Roofing .............. .........................:.............................. Floors5�4� ...............................................Interior ......... ............................................................. Heating .................`.. /. ....................................:............Plumbing ............... ? T)IE...................................................... Fireplace '.................................................Approximate Cost ................ "5 ..................... Definitive Plan Approved by Planning Board -----------_------_-----------19________. Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH s �? Efi � ® z 0 (D w 0 CD cr) Z M O >: = n- N O /� Hqq w ^ w W L.U) ZD Ld.. JrI \.w W Lu Q Q O Q V) (1) a.. z � zz o � 00 X � wz wF- a � h Z � W cn 4 �, w \\, Q a- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name °� {��' $1Qr` �t�flr�� ............... haughnessy, Kenneth 9. No ..1527 .... Permit for ,,, remodel commercial w �. .... i building .......... ..... ................. Location 4�... Center Street .......................... Hyannis a Kenneth..C.... aughnessy...... Ir e .41 Owner .................................... ......................... _ Type of Construction frame Yp ............. 1 N11� ....................................................... ............. Plot ............................ Lot ................................ , Permit Granted &1Y �9 2 Date of Inspection ......: ... ........ .............19 p .. Date Completed .. PERMIT REFUSED ................................................................ 19 .......................... t � ............................................................................... bt Approved ................................................ 19 11 ................ ........................................................... .................... ........................................ ............. �pF THE Tp� TOWN OF BARNSTABLE i i HAHHSTAHLi, i "6 9 ,•� .j O BUILDING , INSPECTOR a � MPYa' ,< �'� o APPLICATION FOR PERMIT TO A� A. . ........ ................................ ......... ......................... TYPE OF CONSTRUCTIO � v� ot-�d "Qcl t4 ° ........... . ............................... .. N ? it ................................................19 TO. THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accordingTto the following information: Location ..........................................................�i$ Proposed Use � ` 4 ........... . ...................................... ...?:!` .�� ... i..... Zoning District � � �'� ...Fire District ... ...... ................... .............................................. s. .......................................................... Name of Owner Ct, �C85J� 91h �.5`� «• ahno .............................................. ................. %Address ... .. ........ .......................................I............ .... Name of Builder .... „�� :.�r.... � � Add ress ................... . ..................................................... Nameof Architect �Iq N e...........................................Address .......................................... ......................................... . Numberof Rooms .............................................Foundation ........... ................................................................ Exterior :......................... C c , S I E-C is ...5 T E L f✓ Roofing ....................... .................................................. Floors .................... ....a"�.. ................................................� Interior C Heating .r ...n../..... V� U rl!i�. Plumbing ...............4�. .l. l�. . Fireplace ...............................f�I e............................................Approximate Cost ...........�`..........p .. ........ ... .... ' Definitive Plan Approved by Planning Board -------------------____________19 Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH LLQJ a. w a Qa 41 all � p n00 �.. . { I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. (� Names:- hc �-- `........................ Shaughnessy, Kenneth No i5643 add to commercial u Permit for ............... building Location 5�..... CenteT';StYGeT..................................................... , 41 Hyannis.' ............ .... ............ .. .. Owner Kenneth Shaughnessy . .. .. steel. i Type of Construction ........................................ !# ..... .................. . ... ... .... .;>', 4 x Plot ............................. Lot ................................ 3 Permit Granted"".......November 1................................:19 72 Date of Inspection ............ :....... ................19 Date Com leted l ..`.. ... Z p �. .............19 - PERMIT REFUSED ! a .... ....................... .......:. 19 ................ ... \n.. ................................................... ................. ..`..... . ..:............... .................... R ' .... ........:. . . ........... ........ F ,k •, ......... .................. ..........................: Approved ......................................... 19 ➢ ., .... ............. _ .... ............. .... ...........................................................