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0055 FALMOUTH ROAD/RTE 28
,_: -�.�-- r - �� C���� �� �,� �p �, fb i ,.d+ 4 t I� � � � r q ' / /' _� yy 1(�_ ��� ��� ,. �z ����CC � �� s ��.. - .� ____._._�,_____..__ __ _�---- :� ti r j Date: Nov. 7, 2018 To: Building File RE: Work without a Permit Address: 55 Falmouth Rd, Hyannis Originator: Paul Ruforufoconstruction@gmai,l.com Complaint: Work without a pemit Enforcement Process Steps ® 1. Initiate local investigation: YES ® 2. Document/enter into system Yes ® 3. Contact ® 4. Property Owner JLTS VII LLC, 59 Center Street, Brocton, MA 02303 5. Seek access to subject property 6. Seek administrative warrant(if necessary) NA 7. Notify state authorities of findings NA ® 8. Document conclusion OPEN ® 9. Referred Bob McK Property—311-070 Property is developed with a 1 commercial warehouse (1959) on 0.58 acre located in the HB zone. 11/02/2018 A RFS submitted by Paul Rufo concerning work without a permit involving window replacement, residing and masonry at the subject address. Assigned to Hyannis Local Inspector Bob McKechnie. s TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION rl _ Map ParcelL/U�6Application Health Division Date Issued ` 0&*Z1 Conservation Division Application Fe �)] Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village Owner e-15" 60/)5,,9L JIL- ` Address .J S��A/j iiJOf l 812 Telephone V1,03 �/ay u �r Permit Request w w-jold S f�all"l e- /0E-1V7 9 61, 0,3o Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ,006.60 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 BUILDING DEPT. Total Room Count (not including baths): existing new First NnrUTNDunt Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other TOWN OF BARR1STAt3LE 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 O Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) NameT,,94/lF_G T. �zR1, /'R b Telephone Number Llg,63 '�/5�/U y� Address �7, ���6/217 gD. License # C S//9 O e',0 Aq 5— Sli./Z>G✓1C41 f?W D 5'�� Home Improvement Contractor# / 76//3 Email -bBEi42D1 TR,60,PG0 41?GI957r,ML7— Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 9,9 RA)STPBF �SIGNATU DATE l FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER r .j DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE F ELECTRICAL: ROUGH FINAL i F PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Y. � .�xt'C`o�rrxana��rlt�off•�asscre.Ttus�s Deparftnmt affadusft-hd Accidents - - O.&eofImes gations 600 Wsykingtom&reef wnm inass�gaWdia- Workers' Compensat ou InsuranceAffidavit:Builders/Contractors/ElectricianMumbers Ap Ak-aut Please Print L+egibN �atne(l �rorgani�ionrina�th>ai7: /�s9J1�>�-G �i' �.hR f�'�i Address: RD. City/Staty-:-/Zip: Phone 9- Are you an employer:'Check the approppriate box: T of ect ;r 4. I atxr s ctmtractor and I Type 1?Toi ����� 1.❑ I am a employer witbL 6- ❑New construc�tioit loyees{full and/or part-time}* have hired the sub-contractors_ 2 I am a sole proprietor or partner- listed on the attached sheet 7- ; —modeling ship and have:no employees 'Ilse sub-contractors have $_ MC Demolition v cddng for me in any capacitjr. employees and have workers' SI_ Building addition [No:workers' comp.in uranre comp-insuranrt=l 5-.❑ We are a corporation and its 10.[]Electrical repairs or additions 3.❑ I am a homeowner doing all Work officers haves exercised their 1I-.Q Plumbing repairs or additions myself [No workers'comp- right-of en=pfion per MGL 12-0 hoof e_152, 1(4),and we have no �s in�rranrre required.]� � �� 13_0 Other employees_[No wodoers' comp_inset-ance required.] *Arty wpticant that checks Box W 1 tans#also fa oit the section below dmwing polity in hrsnatiens. T Homeowners vrho submit dos sf5dsvif iadicaiaeg they are doing all zrear anal then hire oUtd&contractors= stehniit a aeax RMan-t k dirSSt Mr-b- lConinctors fast rfie'c this box mast aMchpd an additional sheet showing the name of the sit-oonftm�and state vrhethec ornot those entities have eropk lees if the sob-contmctcm have employees,they mast provide thew workers'comp polity aumhes lam an empl'vyer that is pm iditrg workers'compensation irmirmce for my emp7aye am Helatr is the policy and}ob site in fotmalion- Insurance Company Name: Policy 9 or Self-ins-Uf-4- Expiration Date: Job Site Address: City/State/2 tp: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as regtureduuder Section 25A of MGL c 152 can lead to the imposition of criminal penalties of a fine up to$1,50D_OD and/or one-year imprivonment,as well as civil penalties in the faros of a STOP WORK ORDER and a fine of np to$250_00 a.day against the violator_ Be advised tbat a copy of this statement may be forwarded its tale Office-of Im--eWgations of the DIA for insurance coverage verification- I do hereby semi reader the pains andpenalties ofpetJury thatthe dnfonrrtdion pravi&gd abave is hue and correct Sitma6 n1/� Date: o2�J lv Phone 9- ©fficiat use only. Do not write in this area,to be completatI by d3'or town o fi'ciaL City or Town- PermitUceuse ff Issuing Authority(circle one): 1.Board of Health 2.Building Department I CitytFown Cleric 4.Electrical Inspector S.Plumbing fuspector .6.Other Can_tact P erson: Phone#_ 6 Information and. Instructions Massachusetts General Laws chapter 152 rrquires all employers to provide workers'compensation for their employees. Pursuantto 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 common-??ealth 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 compli.snce,,,ri'lui the insTuznce 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 ceriincatc-(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)wit' no employees other than the members or partners,are not required to cant'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 Deparment of Industrial Accidents for confirmation ofinc,rance coverage. Also be sure to sign and date the ac$davit 'llie afr?davit 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 ob:Ein a vrorkers' compensation policy,please call the Department at the number listed below. Seli insured companies should enter their self-insunince 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 retarding the applicant- Please be sure to fill in the pens itllicense number which will be used as a reference number. In addi don,an applicant that must submit multiple perm-itllicense 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 Ilse 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 CoDa Ilonwealth of Massachu.setts DepaAment of ladustaal AQGI{ e41 Office Of kvest ntiaxxs 600 WasEngton Sheet Roston,MA 02111 Te1.4 617-727-4900 w 406 or 1-9 MASSAFE Revised 4-2447 Fax#f 617-727-7-149 www.inass-gov/dia MASS. Town of Barnstable pTED►IMF p Regulatory Services Richard V.Scali,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 as Owner of the subject property _ r hereby authorize Jz-b to act on my behalf, in all matters relative to work authorized by this building permit application for: RD nl�)N(W� (Address of Job) Sign e erowe1r, Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPHLESTORMS\building permit fo ms\EXPRESS.doc Revised 061313 A .M. Mutual A.LM Mutual Insurance Company Massachusetts Employers Insurance Company INSURANCE COMPANIES New Hampshire Employers Insurance Company Associated Employers Insurance Company BILLING STATEMENT This statement represents additional charges and/or credits to your account. Daniel Berardi Page: 1 of 1Policy Number: WCG-500-5012204-2015A(1) 5 Oxford Road Policy Term: 6/30/2015-6/30/2016 East Sandwich, MA 02537 Statement Date: 6/5/2015 Statement Number. 873748 Due Date: 6/30/2015 Amount Due: $668.00 IN 1-2 51 I Sk 6/1/2015 Down Payment-Premium $637.00 ---.. --- - DOW!1 Payment-DIA.Assessment , s ... _."�`-tea' • -r '� `g. _.._`� ,Y 44+ 4 ,k-' - €"r �' {^gCurrent Bal nGe " a .S�^ 668'00: Broker: 844- 1 Malcolm&Parsons Insurance Agency Inc Phone: (781)344-3200 If a prior balance appears on your statement,a portion of the Current Balance may be due earlier than the Due Date shown. Premium amounts shown may also be subject to audit. For billing inquiries,please call(800)8764765 54 Third Avenue • P.O. Box 4070 • Burlington, MA 01803-0970 o Tel: 781.221.1600/ 800.876.2765 • Fax: 781.272.5847 _. 3RIDGEyvA TER• BURUNGTON •CONCORD, NH • HOLYOKE* MARLBOROUGH sponsored by Associated Industries of Massachusetts 0 Please be sure to return this remittance stub with your payment: Insured: Daniel Berardi Policy Number: WCC-500-5012204-2015A(1) Instructions: Policy Term: 6/30/2015-6/30/2016 1. Make checks payable to Associated Employers Insurance Company. Statement Date' 6/5/2015 2. Include your Policy Number on the check. Statement Number: 873748 3. Remove stub at perforations and return with payment in enclosed envelope. Due Date' 6/30/2015 ' Amount Due: $668.00 Associated Employers Insurance Company Pol Premium Policy Id Pol Unit Insured No P.Q. Box 4131 $21,549 1572394 1 5012204 Wopum, MA 01888-4131 Product: Guaranteed Cost AEIC 02 0008737;48 OQ1572394 001 00000066800 8 500 i �� fpavrir��oruueall�d��?/��,;;��cc�rc�eCl IS 0frice of Consumer Affairs&Business Regulation f OME IMPROVEMENT CONTRACTOR ` egistration 176113 Type: icpiration:<7118/2U17 Individual DANIEL BERARDI == Massachusetts.-Department of Pub DANIEL BERARDI _ Board of i3Uiidi Public Safety. 5 OXFORD RD rlrlstr ng Regulations and Standards .' UlltI/11 JU�ICI�l�l'/I' E.SANDWICH,MA 02537 License: 1 I�an CSFqo6p Undersecretary . � , D ERgi East Sande F Jack P.Raeke Commerciai Sales. INSURA N Cornrnissioner Expiration RA `CE 03�2312017.:, 4e AY25�LA Family&Business o�C-'1 INSURANCE SOLUTIONS 770 Washington Street,FO.Box 527,Stoughton,MA 02072 Tel(781)344-3200 ext:22•Fax(781)844-1425 j"malcolmandparsons.com•www.malcOlmandparsons.com RE-ROOFING/RESIDING/WINDOWS (COMMERCIAL) �f ❑ If located in OKH or Hyannis Historic District- Certificate of Appropriateness required unless same color/same materials specified on application ❑ Map/parcel number Approval Sign-offs from: ❑ Tax Collector ❑ Treasurer y-- ❑ # of squares of shingles or square footage of roof or sidewall to be shingled/sided ❑ Specify stripping old shingles or going over old roof. ' If going over ❑how many roof layers existing now X ❑what size are rafters? What is span? X Owner's name & address Project valuation must be entered [t] Builders Information [� Signature [� Workman's Compensation Insurance Affidavit State form must be completed and.a copy of Insurance Compliance Certificate must be submitted. A copy of the Construction Supervisor license is required. Effective March 1, 2009 ❑ Check expiration date,no restrictions ❑ Permit fee$160.00 [✓]� Property Owner must sign Property Owner Letter of Permission. Projects requiring the use of a crane must complete the forms issued by the Aeronautics Commission I q-forms/bldgpermits/permitcheckl ists rev.070610 THE ' FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I A m /� 7L I DATA �y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION zG` i�,�' ��Q� op °v �e.��<�';yS S�Si�`�F-� Map 5 �� Parcel ©�(� Application#2l/`'" R�•0' Health Division Conservation Division Permit# Tax Collector Date Issued Treasurer Application Fee — Planning Dept. Permit Fee • Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis / Project Street Address S>> _�d ; It,�,,{FIB ,j.L =.:_ � ,.�,_Rn�_� 0) a 6 I f ✓�/b Village Owner `S L 15 �ew���r Address �J CE„iyu tLk & ,c J-\ A 13 Telephone �D�` SRe 3�I Syl Permit Request ;11 0(&,,c 6f. Gr j "quare feet:1st floor:existing_ proposed lab 2nd floor:existing proposed Total new I oning District Flood Plain Groundwater Overlay e ttyCE c ' . ., leg a s, �oject Valuation I Si M Construction Type `(-e r t Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. �1 K yelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) !of Existing Structure Historic House: ❑Yes O No On Old King's Highway: El Yes ❑No ement:Type:.._O-Full__0 Crawl_ ❑Walkout:-: O Other ement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) car- ~ Iber of Baths: Full:existing new Half:existing new Cc 7��.-39 I Richard J. Kelleher be of Bedrooms: existing new Sales Manager Ext. 1277 FAX(888)771-5752 d Room Count(not including baths):existing new First Floor Room Count E-Mail:rick.kelleher@wbmason.com Aimee Cugini Ext. 1291 .._-,.-_—Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Customer Service Specialist _- W.B. Mason Co., Inc. Central Air: O Yes ❑No Fireplaces:Existing New Existing wood/coal stove: ❑Yes O No Office Supplies,Printing&Furniture 55 Falmouth Road Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:O existing ❑new size Hyannis,Massachusetts 02601 1-888-WB-MASON(1-888-926-2766) Attached garage:❑existing ❑new size Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use 0�_L_c.e 'WeYu L 4e Proposed Use S.f M C BUILDER INFORMATION Name &t,!LLS L�C.. Telephone Number ��v2?° $Z 3• (.3u3 �• p Address �yw' �Q �p License# C' S 6-1,2-()�-S Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE. DATE HYANNIS FIRE DEPARTMENT "95.HIGH.SCHOOL RD. EXT. HYANNIS, MA.02601 �llfi . ?.. HAROLD S. BRUNELLE, CHIEF E'-T.EFI:.AETt� - - ETYOEYT AWAREEEiE Of FIRE EOYCATION VIRE PREVENTION BUREAU BUSINESS PHONE:(50$)775-1300 FACSIMILE PHONE:(508)778-6448 LT.D()NA LD.H. CHASE;JR.,-CFI _ LT.ERIC F.IIRJBLER,CFI FIDE REV)ENTION OFFICER FHtE PREVENTION OFFICER BUILDING=. G.4I :E COMPLIANCE FORM THIS FIREPHEVENTION BUREAtJ.HAS REVIEWED THE PLANS DATED 1(3 [()'C FOR THE PRO!?ERTY-LOCATED AT. . - AL'$O KNQV`JW AS = -a THE .CHART BELOW INDICATES: THE STATUS OF OUR REVIEW; t . TYPOFCONSTRlJC14N13ZCUMEtVT, N/A RECEIVED REVIEWED COMPLIES t=AfAR (AT ��FE iEPCIRT =;n - ` AFIREICFfT `J �kECI?E. t✓C:E-S:5 ; :::Y.` 3 HYDH,4NT.�E3sATIE)N/WA,t;EFi StJ 'PLIf.` <��'' 4,5PFiINKLER S1fSTEt�S x ' �' - -- t S SPRINKLER CZ3NTRQL V-10. MENT ''` ;��STAN[?M�IpE S1f,STEt1h`S - • 7 ST NIP - 1PE VAI VE L4GATIbI�1 , 8 FIRE pEPpRTNtENI":�OIVNEGTIOIV � ;, _ .� .��. C5�3 S F v J: r: gARE,Por Ntnr 10=F P 3 S &ANNUNCIATOR LOOAT�Of - — - 11-SMOKE COhl j Ri4,/EXHAUST 4 t' 12.SMOKE CONTROLEQ(JIP LOCATION 13=�1FE SAFETY SIFSTENI.F�PcTURES :� - .. > 14=FIRE EXTIiVGl11SHING SSEMS ;i5-F E S CONTROL EQUIP LOCATION 16 IRE PROS EGTIC?N ROOM 1 T-FIRE Ff#OTECTIOI EQUIP1GNAGE :ALARM TAANSMISS{pN — ` 15 SEQUENCE of OPERAT`I0 k I EP.ORT - iIACCEPTANCE TESTING RiTER]A WE SE CEVE THE QOCUM T. T . E MPLETE AND.COMPLIANT FOR THE ISSUAMCE OF A BUILDING RI=flM1T' WE HAVE COMPITETED THE A CEPTANC ESTING FOR THE OCCUPANCY PERMIT AND BELIEVE THAT WITHIN THE SCOPE'OF THE BUILDING P-ERMIT'THE ABOVE IS5l1E8 ARE IN COMPLIANCE. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ry Q� qJC? Map U Parcel TO Application#�C/�' Health Division Conservation Division 7 Permit# Tax Collector Date Issued Treasurer Application Fee — Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address ; qu Q. �'� Ad i S 2 6 Village IS Owner 2 L I S e=eA_ 1 'ki Address �`� CGn yu S�-2�e`1- �Q Telephone S$L°3(I S L Permit Request 4(R dz.4 L-ocr 91h4 t O Ca v Square feet: 1 st floor:existing '� proposed 2nd floor:existing proposed _ Total_new Zoning District Flood Plain Groundwater Overlay ` ='�r Project Valuation S� Construction Type (.A A o0c ~' Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting d 1cumentation. �r 'Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Ag6 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 fi�`�-f t.e. Proposed Use S A/K e BUILDER INFORMATION tciC tN13 0$'74-39V Name I uNtj L L Telephone Numbers ® i Address �I o License# L' 6+2:'() 57 Lti"1 Lr� �� -��- Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �' 2 2. OL ' FOR OFFICIAL USE ONLY PERMIT NO. ` DATE ISSUED' Ie MAP/PARCEL NO. ADDRESS - VILLAGE OWNER t h w ). DATE OF INSPECTION: < FOUNDATION -� FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL c R GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT • ASSOCIATION PLAN NO. t r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION � "l J Application#���(" Q ` �" Map S ' Parcel Health Division Conservation Division Permit# Tax Collector Date Issued Treasurer Application Fee :Mo ' Dept. Permit Fee Planning p Date Definitive Plan Approved y Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village Owner 3 L Address CEn S�-2ce Telephone 1 r The C:ommonweaun of iwassacnuserrs Department of Industrial Accidents A Office of Investigations P 600 Washington Street Boston, M4 02111 www.massgov/dia Workers',CompensationInsurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibiy Name (Business/Organization/Individual): •`/ �(.U/i.L Address: City/State/Zip: Phone#: Are you an employer? Check the-appropriate box: Type of project(required): LX I am a employer with 4. ❑ I am a general contractor and I 6 employees(full and/or part-time).* have hired the sub-contractors � New construction 2.El am a sole proprietor or partner- listed on the attached sheet $ Remodeling ship and have no employees These sub-contractors have St. Demolition working for me in any capacity. workers' comp.insurance. 9. ❑ Building addition [No workers' romp.insurance i 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions required.] officers have exercised their 3.ElI am a homeowner doing all work right of exemption per MGL I LEI Phimbing repairs o additions myself:(No workers' comp. c. 152, §1(4),and we have no 12.7 Roof repairs insurance required.] t . employees. [No workers' 1.3.7 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information t Homeowners who submit this affidavit indicating they are:doing all work and then hire outside contractors must submit a new affidavit indicating such tContractors that check this box must attacbed an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic. #: IV l- Expiration Date: �T o� Job Site Address: Facc �Is�l ay„ , �City/State/Zip: r Attach a copy of the workers' compensation policy declaration page(showing the policy Haan er 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$1,504.00 and/or one-year imprisomnent, 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 maybe forwarded to the Office of . Investigations of the DIA for insurance coverage verification. I do hereby certify u the pain naldes ofperjury that the information provided above is true and correct Signature: Date: �' Phone#: 50 u- $ 2-3 . 63 cj 3. Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority (circle one): 1.Boar of Health 2.Building Departmeaat 3.City/Town Clerk 4.Electrical inspector 5.Plurr:oincr Inspector 6. Other Contact Person: Phone#: Information and Instructions • r Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as "an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the . receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However 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 employmentbe deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their 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' lion policy, lease call the Department at the number listed below. Self-insured companies should enter their compensation p Y�P ep mP 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. Anew 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 aiddavit. The Office of Investigations would line 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. +1 617-727-4900 ext 406 or 1-o77-MASSAFE Fax�r 61.7-727-7749 Revised 5-26-05 WWW.ffiaSS.gOv/Cla Town of Barnstable °* Regulatory Services L � = Thomas F.Geiler,Director XAM �'°�Ec►+►. Building Division. Torn Perry, Building Commissioner 200 Main Street, Fjymnis,MA`02601 www.town.b arnstable;ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Scction. -If Using A Builder as,owner of the subject property ,12 hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Sig na o er ate Pnnt ame Q:FORMS:oWNERPERMISSION 06-22-'06 08:58 FROM- T-394 P002/003 F-422 ACORQ CERTIFICATE OF LIABILITY INSURANCE 06/iiz 0 PRODUCCA (800)333-7234 FAX (508)65S-8853 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION WTERN INSURANCE CROUP LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 233 WEST CENTRAL STREET HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NATICK. MA 01760 INSURERS AFFORDING COVERAGE NAIC# INSURED Turner Brothers LLC INsvPZ�A: Acadia Insurance Company 34 Bellows Road INSURERB: American Nome Assurance Raynham, MA 02767 INSU REM Q INsuROR 0: INSURER M COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSuREO NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDIN ANY REOVIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 6E LBSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES C)MCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR TYPE OF INSURANCE POLJCV NUMBER P041CY RF POUCY E7[W124TION UMITS GENERAL L1AS( TfY CPA012800810 09/25/2005 09/15/2006 EACH oCCURRENcE $ 1,000,0001 MXCOMMERCLAL CE14ERAL LIABIUTY ETO ANTED s 10D,0001 VfZr-mL9FR(Ea CLAIMS 4700E CD OCCUR NED EXP(Arty me pefson) $ 5,0001 A PERSONAL K ADV INJURY S 1,0001000 X Contractual Li ab GENERAL AGGREGATE $ Z i 000,00 GEN'LAGGREGATEQMITAPPLIESPER_ PROOUCTS-COMNIOPAGG S 2,000.00 POUCY X PFI& X LOC AUTOMOBILE LIADWrV MAA012807510 09/15/200S 09/25/2006 COMBINED SINGLE UMft ANY AUTO (es evddrnt) S 1,000,000 ALL OWNED AUTOS BODILY INJURY 8 X SCHEDVLEDAVTOS IPgrper5m) A X HIRED AUTOS BODILY INJURY X NON-0WNEDAUTOS (Poraocdent) PROPERTY DAMAGE (Peracz eenq GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHERTHAN EA ACC 5 AUTO ONLY: AGG S EXCESS/UMSRELLAUASILITY CUA012800910 09/1S/200S 09/15/2006 EA0HOCCURRENCE S 2,000,00 X OCCUR ID CLAWS MADE AQWMQATE S 2 000,00 A S DEDUCT15LE s RETENTION g 10,000 $ WORKERS COMPENSATION AND WC9305793 09/23/200S 09/23/2006 X wcsTATu- OFR TN• Et+PLOYERS'LIA61lrrY B ANY PROPRItTOR/PARTNMR/pJIECVTIVE E.L•6oCK ACCIDENT S 7L,000,000 OFFICERIMEMBER Exrt.UDED? F—L OLSEASE•EA EMPLOYEES 1,000,000 If yes dceibe dnaef SPEi?IAL PROVISIONStoow E.L.D'SWE-POLICY LIMfr $ 1,000,000 L aFR Rented CPA012800810 09/15/2005 09/15/2006 $250,000 A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/F=LLLVONS ADDED BY ENDORSEMENT/SPOCIAL PROVISIONS W. B. MASON, SS FALMOUTH RD., HYANNIS, MA 02601 CERTIFICATE HOLD LATIO SHOULD A14Y OF THE ABOVE DESCR15E0 POLICIES BE CANCELL90 BEFORE THE EXGIRATION DATE THEREOF.THE=UIN6I%SURER WILLENOEAVORTO MAIL 30 DAYS WRATEN NoTIcE TO THE CI=RTIFICATE HOLDER NAMED TO THE LEFT. TOWN OF BARNSTABLE pNT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO osuGATION OR UABILI Y ZOO MAIN STREET OF ANY FOND UPON THE INSURER ITS AGENTS OR REPRESENTATWE& HYANNIS, MA 02601 AVr"ORPF0REPRE5ENTATIVE Rosemary Fulham PMA ACORD 25(2001108) FAX: (508)823-2045 (PACORD CORPORATION 1988 �an �omIN` FtEGV� R BaPRD OF Bvv�T1ON SUPER�ISO t '',�Icense' C�NgZR . 072075 umpei,. 25 A2 i N 0a N' —� FtOeERT NI ppQ `�..` Comm155jOnef AS gFt1ARN N EAS•TO Assessors'Office(1st floor) Map 3 ) L Lot 10 Permit# &7M3 Conservation Office(4th floor) hj- Date Issued Board of Health(3rd floor)(8:30-9:30/1:00- 2:00) / Fee Engineering Dept. (3rd floor) House#1 CAOP�dC�`1' JNASM COJ\�I�JN MYT�BLE. Def n fLy .l �tged-b�"Pl Inn 19 039• �f Fob` TOWN OFSBARNSTABLE Building Permit Applicat' n Project Street Address .�� ��� 7 �/�/�i�/si a Village OwnerzkwpU_S�l`f�Ne.E'�,�� �(7� fj�s J S9 Address /U,FO-1 e,44M 1.49—Adf, t6eAfAW&4r/ Telephone Permit Request . /PEC7' /-4/P 9E/4 � I O Total 1 Story Area(include 1 story garages&decks) �� square feet Total 2 Story Area(total of 1st&2nd stories) square feet \dEstimated Project Cost $ ,? CJU,&0 Zoning District Flood Plain Water Protection Lot Size Grandfathered? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type 04ve5w7 6A vc Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds A✓`cci 05, 36 '�?s Other Builder Information 2 KJN�me Telephone Number Address Pc� `7 ! �'�v License# ('� (y -� ca:0-4 Sup �5+svg-0,0A--d bP, Home Improvement Contractor# (� ma oe. G Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS7,1"-expe �;T ILL BE TAKEN TO IGNATURE - DA�/ BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. #378'33 DATE ISSUED June 6, 1995 MAP/PARCEL NO. 311.070 _ . r ADDRESS 55 Route`-28 r VILLAGE Hyannis, MA 02601 ' OWNER Hyannis M Hinckley Road R.EITrust- DATE OF INSPECTION: j% i FOUNDATION FRAME INSULATION ` FIREPLACES ' y - ELECTRICAL: ROUGH `FINAL ' PLUMBING: ROUGH FINAL 1 1 GAS: @GH -FINAL r FINAL BUILDI I r r Nt DATE CLOSED IQ ASSOCIATION NO. rig i' Y / I • r r r �UuPa�tme�tl a��J'ndu�trial�cc 600 Was y,on SIPS, James J.Campbell &&n, "/aaaadwdA 02111 Commissioner Workers'-Coi ipensation Insurance davit with a principal place of business at: ^� (carisrs�z#a) do hereby certify under the pains and penalties of perjury, that (�[ am an employer providing workers' compensation coverage for my employees wori this job. Insurance Compan Policy Number I am a sole proprietor and have no one working for me in any capacity. () I am a sole proprietor, general contractor or homeowner (circle one) and have hired contractors listed below who have the following workers' compensation policies: Contractor Insurance Comparry/Policy Nu Contractor Insurance Company/Policy HTr Contractor Insurance Company/Policy Nu O I am a homeovti•ner performing ail the work myself. -.Z cc;-;of C S_:f.T.Eni K'ii be for.:-rced is tt:e Of ice cf fn•.e:bF.—tons of d;e OTA for coverage veriffa,i= and that f:!Hu: ee:e-age rec::Ed uncer Sec en 2.A of MGL 152 an ieaa to eic fnpcsition of criminal penalties eonsisiintt of a fine of Lp to S 1,500.0: Yeas' imrracn.mEnt;,s weii uS crivii ;.entities in the form cf a STOP WORK ORDER and a tine of S100.00 a day;p-rLtt mc. Signed thi day of '�A V—, Uc see e/PerrO ee Building Department Licensing Board Selectmens Office Health Department INFORMA.7CT: 61 7-727-4?00 X402, 404 405 G07' A iS;M ur Kv� ��`;.t {;,i Fei z5 jiY ''e a4 x t r y_ \ '/ d t 1 of �:i• i �Y�. .,Myt�3{x1.�.m �/ ! �).••.W \ - ' t� t��;' r: ta Tye. r� 7 y' ,t w i 3 '' .,i•+7F4ndwe+ i {,.34..5;' ,r r ` , q a �� rr t• d`y ,y}}`; 7 77. t. T .;a� -f..- .L.t+. d N.',/.•.L_..vw-,.....s :.'.:..wsfi :a 'lt:' L � t i.. ' v3 a1 3 W. vs . gy { x ` �J ,) rr►i�` } •�0 LA r 3CV.:t� T a�,b 1• (l idA �,9L tj fi ' !�6•�Y-i`.t.� } l2�f°�� r. ;',,,` S ..ti.��'r�i-'•�S9f...tii+y�� r�?�,i": t_+ � Y � 1 _ t,. ,i } r s } y a -- "_.c-,-a"."'.�'. ,�. � ���r"� ..$�,��i t•,� 7 J � 11 �¢s� Tl> �,P i�' i, )�' {�.�'"ra t�'• �`p�,t� �� �.t� q, �.,i. �'�� 7 •�� J '�•+.:� � t�p��A t 5� „t � rt t OS �_.1.. { t-_ - f����� ��. `'. R. � t �:.avie4e..r.� l�r� �t }�J 3r a' "A �•T t y �t d >a y t2 ? a ' 9 1 . ...,,. ' ta'�� �d'-Uf i�iF`'� y�.r�,f�.f�� 4} �} �� r� l 'i' •� r �.y� h'3 �." t j.: r•: i 4. e . r ss ,��/ �. •9�1 -` � ° a .�:� ..L -,-..-r_ J} �•!n +...w.S S..r^•=l._.y a.F_� i. + .._ t '• - 1 i 2C �.l;.k f .#a °'._' „` �" :9 < !' +� .F, �'• ° t .. I.Ye '�� .-i L..., 'x>� •°�i fi its {r ty. � �'�� yt ,e° ii..,l i ,7 fr �. a � € , } r l� ` � � `y(e ", A �•.., .1 ._-z- a .i. . t .�._ 'i'`� 1 �.' y t�^.aljy ti J .._-_._.. •.� yi- i� �' t,..�x fi �>*',� !tq- {'•, � �r .:Fx � �'i.� t ti i,r'� � ta.•T J � - ;. J,t, _.._. .�.--.-__'-.�._,1- -= ...e.--- .fir..,-•--" 7,.; � , i »� S' � . Fk - .... ..-.. Wi.:'.bw. iAY-11-y5 ; THU ti:5 .t3�i artWN C �� $ri,,e,fr I,� .�313tE � _ ge6Q p 0� •�^ PROPO B � t C;j `'NTI N �• �t.'i;� t '.q 3 14 r y 'sue _ `� um�� {' FUR ti S.UPPLIE, 17, � ,,�. . r .•8r , '" � I Ir F �` d ..i'P � 1 L t � ht T �'F y,'b,i ,J3 a• "(�� i (�q� r Y: fNL .3 . i Y 1 yr at5 £ate°� 4` UJ J P \t { qbr F Ff � . k y :A DENSELY VEGETAjE Tl TREES AND r v 's ra � �"�""'''1 • -'--' '�.. —''yam °� r,�r�• d t `. L�y`♦4 a i l �p r q � l I �i„jb 1. C � 2� 4lx9 .r: � J,(� �,�� �✓u�raaua�usoe� _e , f , OEPAR TBEN1 OF PUBIIf SAFETY �<"- 6l1N)aVtIPlTfj►J SIIDtpUTS Di.T iucc �bf ExPires: k ''-R st acted Q 00 OEIORME i4`STAR80ARO EN POBX 868 MASHPEE, MA 02649 , o TOWN OF BARNSTABLE •' CERTIFICATE OF OCCUPANCY PARCEL ID 311 070 GEOBASE ID 23062 ADDRESS 55 FALMOUTH ROAD (ROUTE PHONE Hyannis ZIP LOT 235&236 BLOCK LOT SIZE DBA DEVELOPMENT .- DISTRICT HY PERMIT 15532 DESCRIPTION COMMERCIAL INTER_RENOVA_HINCKLEY PERMIT TYPE BCOO TITLE CERTIFICATE 01" OCCUPANCY I CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: Im BOND $.00 CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY * HAxNSTABi.E, MASS. OWNER COHEN, BERNICE TRUSTEE E1639. ' ADDRESS HYANNIS & HINKLEY RD R E TR 10803 PALM LAKE AVE BUILD`°NG DIVISION ' BOYNTON BEACH FL BY DATE ISSUED 05/31/1996 EXPIRATION DATE f ;€'.t'F:.it'si�'7','v rS`Ir�•Y�f\`i nti�Ai , ro;.r. .z>r. y,�,.iati •.JtW .nr i.I v � � t , /.• } Ni. S Yl t J k .1 a v x 1 -:.}`a w .i• Jc �$ - xt ey \- we.s r in -c `'i$(., y, ( � �:-fit':r�Fp..; 9v, �-}�•� � ,..r- k a ct d y r� ty .'' '�� t " t,. ��� 'Y e•s � }�ro�S' �u �� / � r Y ll+t f� f Id i . h TOt/\Li ..4.\!:f• .�,!•,AYLE: yp 'R )'. 5 Yg i` rh i L y�f ? aT \ J ) �\ 1 I. 7� T�• TA/�' `Q��y(Try7 3:rf S '� a r" 3 �X L ' , �� r' +t �1 �',`i,J.s t - DU111LJJ.1`iVT�P�.7a�►411. �xs. -} e 4 z S r e', ,5�.{'�{('. }a,tis:r\r �' dt•:gr��i �> i€'e v s3' �i$ w Y �i'` 's '"z r s y�F �� � < s i� �t���rt j IyD �I. .Q70 GEOBAS9-'i- '4' 0`2 >a 4 x . , 'FALMUUTH ROAD (ROUZE rt�R PHONF. nnis ✓t,sr s=J, ,1�1..,'`-t .sk- } 'r , Er ;' .✓"5 9 l,, .rsv i r <, �• ' 235&236 BLOCK 'a - a . , } LOT SIZE • :E DEVBI�OINT A '"� ��' _ 4f,DISTRICT -HY.gr t�ERMIT 11448 DESCRIPTION 61 '/INTER:'RgNOVATIL3�tS PrR[ -IT TYPE BREMODC TITLE s,4 CO DIAL ALT/COH�partment of Health, Safet3 otaTuacTa s: CAPE COD H(?ME :MPRPVM ,.Tr sg�C ALI STS . an_ d Environmental Services ARCHITECTS:. . ' TOTAL FEES: BOND CONSTRUCTION COSTS $29 •853.00 437 NOIdNES./NOt � SKP AllD/CONV 3'g PRIVATE P Age - OWNER COHEPts BERNIt;E TRUSTEE x r ADDRESS HYANNIS .& HINKLEY RD R E 10803 PALM LAKE: AVE BOYNTON BEACH FL BUILD G D I4. N DA'TE .LSSUED 1S/06/1995 EXPIRATION 7.DA E B tmmm 'THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,r ALLEY OR SIDEWALK OR-ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- ;; OROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE:BUILDING.CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR c ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE 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 *s.� =r"4 �.' "•" - : fir;; r FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST.BE RETAINED ON JOB AND t ,: A WHERE APPLICABLE,:`SEPARATE THIS CARD KEPT POSTED UNTIL. INSPECTION ` 1:FOUNDATIONS OR FOOTINGS J '`-^N �� PERMITS_ARE. REQUIRED FOR 2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE ACERTIFICATE OF:OCCU- ELECTRICAL,PLUMBING AND MECH- (READYTO LATH) K PANCY IS REQUIRED SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS Ar 3.INSULATION..: :, - OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE 4.FINAL INSPECTION BEFORE OCCUPANCY. c4' POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS `' ELECTRICAL INSPECTION APPROVALS 1 1 saww z 74; 2 2 ' ..:� ,r, : 3, 2 3 _' 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT ._ 2 ,1J 31_.d.� BOARD OF HEALTH, OTHER: r. SITE PLAN REVIEW APPROVAL. �., w. 5 � = h .. WORK SHALL NOT PROCEED UNTIL PERMIT WILL.BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVEDTHE STRUCTION WORK.IS.NOT STARTED WITHIN SIX: `CARD:CAN-BE.ARRANGED FOR BY- VARIOUS STA' MONTHS OF DATE THE"PERMIT.IS:ISSUED AS TELEPHONE ORWRITTEN.NOTIFICA TION. "OTED ABOVE. TION 508-790-6227 1�3 _ Restricted To: 00 00 - None lA - Masonry only 16 - 1 5 2 Fatily Hooes PIN bN 133dHSVN;. 898 X80d NI ONVOOSVIS 3N801W.1 8 ISULI, -- :s9aTdz3' y =;jagenN 3SN33I1 BOSIANNOS'NOUNS1SNO3 s.. 4133VS 3I180d 30 1N3911W30 PAR ] Real Estate System - General Property Inquiry] Help [ ] Parcel Id: 311 070- - Account No: 230627 Parent : Location: 55 FALMOUTH RD/RTE 28 Neighborhood: HY04 Fire Dist : HY Devel Lot : 235&236&2 Lot Size: . 58 Acres Current Own: COHEN, BERNICE TR State Class : 316 HYANNIS & HINKLEY RD R E TR No. Bldgs : 1 Area: 9600 12209 CALLAWAY GARDEN RD Year Added: BOYNTON BEACH FL 33437 Deed Date : 030193 Reference : C129484 January 1st : COHEN, BERNICE TR Deed MMDD: 0393 Deed Ref : C129484 Comments : Values : Land: 173500 Buildings : 60800 Extra Features : Road System: 55 Index: 522 (FALMOUTH ROAD (ROUTE 28) ) Frntg: 111 Index: 1922 (HINCKLEY ROAD ) Frntg: 217 Control Info: Last Auto Upd: 050397 Status : C Last TACS Update : 050197 Land Reviewed By: Date: 0000 Bldgs Reviewed By: Date : 0000 Tax Title : Account : Taken: Account Status : Hold Status : Cancel [ ] Press XMT for more data Next screen [PAR ] Action [ ] Owners Name [ ] Road Index [ ] Road Name [ ] Parcel Number [311] [071] [ ] [ ] [ l r � 1 15PARKI • 00 . . 8 • � � • �� IVERFLIGHTS., 1 A ASSESSORS MAPS 1989 PROPERTY NOTE: TH Engineering Dept. (3rd floor) Map ��= Parcel jo- Permit# / House# Date Issued ll "v2 S� Board of Health(3rd or)(8:15 -9:30/1:00-AW) Fee 15 i O-;� Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) (-MPMCANTMU9r0 SEA Planning Dept. (1st oor/School Admin.Bldg.) - ENGINEERING PE EN TIiB ' T Definitive p oved by Planning Board 19 CONS;nUCTJON • BARNSTABLE. • _ { TOWN OF`BARNSTABLE; ' Building Permit Application ' Project Stree Address Village r. Owner ddress09, Telephone Permit Request First Floor square feet Second Floor square feet Construction Type ' i Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling e: Single Family ❑, Two Family ❑ Multi-Family(#units) Age of Existing St re Historic House ❑Yes ❑No On Old King's way ❑Yes ❑No. Basement Type: ❑Full raWl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Un ' s ed Area(sq.ft) Number of Baths: Full: Existing ew Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existin w First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil lectric ❑Other Central Air ❑Yes ❑No eplaces: Existing New xisting wood/coal stove ❑Yes ❑No Garage: ❑Detached(siz Other Detached Structures: ❑ of(size) ❑Attac (size) ❑Barn ' e) one ❑Shed(size) ❑Other(size) Zoning Board Zes als Authorization ❑ Appeal# Recorded❑ Commercial ❑No If yes, site plan review# rent Use Proposed Use Builder Information L� f Name G, I (� r,•,�Q_ Telephone Number Address � P 0, 7-Ef- License# C�; l h�Lt 1M A-SS 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. ALL CONSTRUCTION D-BRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO _ SIGNATURE DATE zG BUILDING PERMI ENIED FOR THE OLLOWI G REASON(S) - Zr � VAO�? �Q ! FOR OFFICIAL USE ONLY PERMIT NO. ,• - F _ - DATE ISSUED_ MAP/PARCEL NO. .. 1 it ^. '! ` 8 '" _ � �. •t !.' ADDRESS a �., VILLAGE OWNER { t DATE OF=INSPECTION: FOUNDATION t FRAME 10z- - `•INSULATION ' - i , FIREPLACE ELECTRICAL:t ROUGH ' `FINAL• ` - ( _ •; a PLUMBING: ;�R?ROUGH FINAL" GAS: f' iyy� ROUGH ; r FINAL .` FINAL BUILDING,.`:: s DATE CLOSED qUT ASSOCIATION PLAN'NO, t 4 1 Assessor's office(1st Floor): Assessor's map and lot number c/ L/ ( / `l�� > pi THE to Conservation(4th Floor): Board of Health(3rd floor): s ' • >; Dd817TADLt Sewage Permit number Engineering Department(3rd floor):_- $'., �o�ieto a,���° House numbers i Y�r Definitive Plan Approved by Planning Board 19 f E APPLICATIONS PROCESSED 8:30-9:30 A.M.',and 1:00-2:00 P.M.only ; TOWN OF BARN;STABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO 61E ,TYPE OF CONSTRUCTION _ 2E: TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location !�T— 'r- j ��YT.�1�t.�✓/S Proposed Use r Zoning District Fire DistrictLfji�I!/<S Name of Owner lWUjo /V Address jti Name of Builder A a i 0A!,A*9 e1 17_ Address a2riZ /�/�i��,� F�icc 1114 Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing ¢y Fireplace Approximate Cost 06w Area .yo 4reir G4wi- Diagram of Lot and Building with Dimensions Fee V 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 Siipervisor's License3 S— z Cohen, Dcivid a No . S—M- Permit For Paul J_ Cazeault & Sons Location 0222ute 28 , Hyannis n ' Owner David Cohen Type of Construction _ Plot Lot r t - Permit Granted May 3 1994 Date of Inspection: `. r f Frame 19M1 Insulation 19 Fireplace 19'. Date Completed 19 J R �• p t f ?• f i L y �t A/:Q�I:11�' CERTIFICATE OF INSURANCE - • ? ` ISSUE DATE(MM/DD/YY) -/2219.1 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Dl) . AKI::: SWAN & CI?OCI;F I? I NIS . A(3(,Y COMPANIES AFFORDING COVERAGE PO BOX 4 129 0 R L.I:'A N S) M A 02653 COMPANY A LETTER 1:1 C.1 v,(:1 _ _... COMPANY __ INSURED � LETTER B PAUL.. J CA/_I. AUI... T I: I A... I.)1:3A COMPANY F)AUL.. J CAlF-AUL.. I 8, SONS 13001 1 NG LETTER C P O BOX 2 /8 1 ; COMPANY D OF?L_L-ANS MA 02653 LETTER AMI:::F? I (,AN POI... I CYI'iOL 11\IS CO COMPANY E LETTER COVERAGES �. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDV 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, f EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. T TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD/YY) DATE(MMIDDIYY) A GENERAL LIABILITY 1 M 11)i 0 O+')'l 2 15 1 O 01 CI 13 9 3 9 -1 Z 04 GENERAL AGGREGATE $ 1 U U o � Q Q G k COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG.. $ 1000 a O(.I O CLAIMS MADE OCCUR. PERSONAL&ADV.INJURY $ 1')I I I,I ; ()I,l I OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ +,0 U 000 FIRE DAMAGE(Any one fire) $ +5 0 ("Of J MED.EXPENSE(Any one person) $ 5. ()0(I AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT F [ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ j HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM I;,' ;I,.)0 '1 (I'9 I i U 9 9� ,' STATUTORY LIMITS WORKER'S COMPENSATION EACH ACCIDENT $ 10(I � ()0(,I AND DISEASE-POLICY LIMIT $ 5 0 11 rl 1.()0 EMPLOYERS'LIABILITY - -- - DISEASE-EACH EMPLOYEE $ 10 0 . (1(I(1 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL I:?O 0 I: I 1\1(:I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO I04�1h1 Oi l'AI?h'IOL.1I1I 10 ( MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE t 13l.1I 1 1.) 1 N(:i I)1::.1'Ah I`+fFI\ 1 I LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR .1 ..14E MA I N S I . I?OU I-1.:: 28 YA F?h�iOU l I Ii A (1:'I (i/I LIABILITY OF ANY KIND ON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENT V t I)I? cA ) ACORD 25-S(7/90) CQ ACORD CORPORATION 1990 ��� .•;r-� y Nouraroaos�urocaovo u+u�d ewuu l►ow•+��+w 'c •N3 N3NM U3010" 3M1 d03t 16 i0NO8kOdiM1NOQ3� 3NnJU LLYNM 3A08r TWIJ M 3YYrN N918 38 am 1N3v*vw swu E66t 61 u3409WWA00 3Ni 403bftVNM-u0-GURVIE 1H013H CLIi�[Jy'( ATMrWUO OW 33W6XI A8 03NM 1UNn tWWA LON o o•o o. .�3 IAirp m0 nNusvm�ol�a r '01OHd3oniON119nW SMG dp 3111AV31SO � SU01Vrl3d0 ON11SV19 Is "Ivy OP S t 1lninvu InVd '3SN3011 NO X08 31V1h1dOdddVNIJN1dd SLS920 £6aL/OE/9Q 3�i0PI 8WRH11HJIa Ind 133H1 'ON-on 31VO 3AU033.33 SNOL10IH1 LSNWV N000310W 803 566 t I0 Z/�]L NoLinvo 49SIAa3dnS omisNoi 31YONOLLVUIdX3 vaw+rwrp�lo ectro vw'srotaoa sjLwnN*v88vw # M/as+�s�INaO 33"NOINOOmev wo : �ftJls i•Sasso�O�max/Rd HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of Building Regulations, and Standard-- One Ashburton Place - Roorn Bosto-n , Massachusetts 02108 HOME IMPROVEMENT CONTRACTOR Registration 103714 Expiration 07/09/94 Type — PARTNERSHIP NONE IMPROVENENT CONTRACTOR Registration 103714 Paul J . Cazeault t4 Sons Roofing Type - PARTNERSHIP Paul J . Cazeault Expiration 07/09/14 22 Giddialt Rd . P .O . Box 2781 Orleans MA 02653 Paul J. Cazeault i Sons Roof Paul J. Cazeault 22 Giddialt Rd. P.O. Box 27 ADMWOMOM Orleans NA 02653 TOWN OF BARNSTABLE � SIGN p8RMIT PARCEL ID 311 070 GEOBASE ID . 23062 ADDRESS 55 FALMOUTH ROAD (ROUTE PHONE Hyannis ZIP LOT 235&236 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT �,509 DESCRIPTION W.B.MASON, INC. ( J.,?7 HINCKL19'L' R,0A.D) PERMIT TYPIA t�IGN TITLE SIGN PERMIT Department of Health, Safety CONTRACTORS: ~ and Environmental Services ARCHITECTS: TOTAL FEES: $126.00 pxIm ( BOND $.00 CONSTRUCTION COSTS $125.00 0 753 MISC. NOT CODED ELSEWHERE '• •ARNSrABL& s iMA$$. OW14ER COHEN BERNICE TRUSTEE 0 MI`►� ADDRESS HYANNIS & HINKLEY RD R E TR 10803 PALM LAKE AVE BOYNTON BEACH FL B ILDINGG DIVISION DATE ISSUED 11/07/1.995 . FAPIRATION DATE BYE f ill ��'�'���" ' t � DIVISION APPROVALS FOR r CERTIFICATE OF OCCUPANCY TO BE SIGNED BY EACH DIVISION HEAD UPON COMPLETION BUILDING: DATE: COMMENTS: PLUMBING DATE: COMMENTS: 1 - ' ELECTRICAL: DATE: COMMENTS: GAS: DATE: COMMENTS: CONSERVATION: DATE: COMMENTS: OKH: DATE: COMMENTS: HISTORIC: DATE: COMMENTS: FIRE DEPT.: DATE: COMMENTS: OTHER: DATE: COMMENTS: TURN THIS IN TO THE BUILDING COMMISSIONER AFTER ALL SIGN-OFFS ARE COMPLETED.A CERTIFICATE OF OCCUPANCY WILL BE ISSUED AT THAT TIME. PERMIT NO. : M S r+• r DATE: _ // `, r 9 6® TOWN OF BARNSTABLE BUILDING DEPARTMENT 367 MAIN STREET HYANNIS, MA 02601 APPLICATION FOR SIGN PERMIT APPLICANT: ASSESSOR'S DOING. BUSINESS AS4-0 ��L�' '^/'� 1 ac'`• t. TELEPHONE %r SIGN LOCATION Street/Road: ZONING DISTRICT: OLD RINGS HIGHWAY DISTRICT? yes no PROPERTY O ER Name: Addre s s: \,o S 0 P i-N VV\ city: `(Q/1�.Au State: t , t Tel. No.: Zip: � SIGN CONTRACTOR Name: v�Vv ' • ► \ GO , �1�►` J Address: City: Sto \kV-NQ' State: Zip: 2 Tel. No.: DIAGRAM OF DESCRIPTION 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? yesy— 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. l ( t � Dat Signatur�of wner/Aut i Agent For, O,f.fice Use - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Size f S � 9 Ft. ) / "� Permit Fee Approved Disapproved 9,15- "OfBuilding-o Date signfficial NISC4 } j '"..•NOTES � - .. Site Plan Review December 01, 1994 Present: Thomas Geiler, Director of Health, Safety and Environmental Services; Ralph Crossen, Building Commissioner; Thomas McKean, Director of Health; David Palmer, Assistant Planner; Lt. Eric Hubler and Lt. Chase, Hyannis Fire Department; Robert Burgmann, Town.Engineer; Thomas Marcello, Engineering Department; and Carol Ann Ritchie, Record Keeper. Also in attendance: Attorney Curry; Stanley Alger, Engineer, Tim Brady, Michael Macheras, Attorney Michael Princi, Attorney Patrick Butler. Attorney Christopher Friset, David Rosenfield SP-46-94 Atlantic Amusements,Inc.,d/b/a Courtyard Marketplace, 308/130 541 Main Street Hyannis Atty. Friset represented the applicant.., - Burgnann expressed concern;.with_the drainage on this project. R. Crossen read from the notes of the November -17 meeting stating that attendance at this meeting was not necessary,as:long as the revised plans met the specifications of the engineering department. The revised plans were submitted as noted. Consensus: Approved SP-48-94 JOHN F. & BONNIE M. COOPER-ACADEMY OF EARLY LEARNING,292/091, 465 Falmouth Road, Hyannis S. Alger was in attendance representing the petitioners. R. Burgmann verified receipt of drainage plans. After a brief discussion between Lt. Hubler& T. Geiler, re. fire lanes S. Alger noted that the applicants agree to asphalt the fire lane& have it striped according to regulations. Consensus: Approved. SP-50-94 WEST MARINE 311/70 55 Falmouth Road, Route 28, Hyannis Tim Brady of East Cape Engineering gave a brief overview of the project which proposed using this property for a marine hardware retail store. Concerns voiced by the staff were: This property is a big building`on a small lot; with limited parking facilities; unmarked parking; lanes location of the loading dock. Some suggestions made by the staff, relocation of the loading dock; designated employee parking in the rear of the building; curb cut redesign to aid the traffic flow. R. Burgman addressed handicap access. T. Brady assured the panel that HP access would be included in the remodeling. T. Brady also reminded the panel that this operation is a low volume high turnover type of business, which should require minimum long term parking. R. Crossen addressed signage. T. Brady indicated that the sign presently was near the roadway, it would be removed and a new sign would be affixed to the building along with a new free standing sign in a new area of the property. The current proposal would not be a change of use for this particular building. T. Geiler noted that approval for this business at this location cannot be approved without providing more parking. R. Crossen addressed pooling in the area that occurs after precipitation because of the broken pavement. T. Brady stated that the parking lot should be regraded. R. Crossen asked that the redesign plans show landscaping& sign location. R. Burgmann addressed grading to prevent run off. D. Palmer noted that this particular property is zoned SP (HB) use and that this proposal would need to go before the before ZBA, which would also address parking. T. Geiler questioned why the need to go to ZBA if BB Id ' district grandfather and no change in use. There will be no boat repair on premise strictly retail. This facility is located on town sewer, and is in groundwater protection district request made for a list of hazardous materials article 39 hazardous materials. T. Geller noted that this location was lacking 40 parking spaces for approval, and putting the loading dock out back might free up space for additional parking. T. McKean wanted to know where the dumpster would be located. T. Brady will show dumpster location, drainage etc. on revised plans. T. Brady will,try to return for the December 15 meeting. SP-51-94 MICHAEL MACHERAS(EMILIO'S) 309/224 182 North Street, Hyannis. Michael Macheras made the presentation for Emilio's. M. Macheras explained that he took over the business last year and because the HP ramp faced the front of the building there was no room to put in a fence. He claimed that did not know he had to come before board to install the fence and a grade to stop autos from coming too close to building. R Crossen asked if there would be outside dinning? T. McKean, addressed the requirements for outside dinning. This property is zoned DP. M. Macheras explained that the concrete slab is not part of the structure. T. McKean noted that outside public dinning must be set back 10'. M. Macheras claims he is only 9' back from sidewalk and that his building is 26' from edge of sidewalk. R. Crossen questioned how many tables are currently '-:: the premises M. Macheras replied three or four. T. McKean, asked about the grease trap. D. Palmer inquired about the former use of the building. It was noted that three indoor tables required ten parking spaces to be up to code, Emilio's currently has only seven. R. Crossen noted that if more tables are added more parking spaces would be required. M. Macheras will install a correct HP ramp. Along the right side of the building. M. Macheras noted that most of his business is pick up with lots of walk-in trade. M. Macheras feels he does not need more parking at the present time. M. NSacheras wants to put tables on the biucwain. �� was noted that a permit was needed for HP Ramp. but not for slab. Consensus: Approved for slab & fence NOTHING ELSE NO OUTSIDE D_ SP-52-94 TREND LINES 311/33 411 Barnstable Road, Hyannis Attorney Princi made the presentation for converting the present property consisting of one business into two. A reconfiguration of the traffic flow is proposed. Putting in a traffic island, designating "In/Out" reducing the number of parking spaces in the front of the building. T. Marcello inquired as to why not let cars park in front of building?. M. Princi replied that traffic flow lines and a drive through design will deter such parking. R. Burgamnn asked why there are only eighteen parking places of correct size. M. Princi replied that two properly sized HP spots were created. The building use proposed agrees with past use. R. Burgman noted that the parking spaces don't comply size wise. M. Princi mentioned that the SPR had previously agreed to look favorably on the number of parking spots. D. Palmer noted that intensification of use on site, be consistent if the parking is inadequate the proposal must go before ZBA for variance. R. Burgmann, DPW, noted that the parking is already deficient. It was also noted that the plans did not have an engineering stamp R. Burgmann referred to his notes on this project. T. Gieler noted that at one time A. F. German contained two businesses, one owner two businesses, this changed about a year ago. T. Geller suggested that the applicant needs to explore with the former owner how the businesses were formerly delineated. R. Crossen asked if two businesses were S,�N HOVO � 'rc(ZA4jS3.M;ASoV 1J ec.0 l oC �l�ti SINC 1= 1898 w r� ' PRO��o URNOTURE I i i - i kc) J 1 PL MOUTH SIGN CO. P.O. BOX 134. 2 S ARMOUTH, MA;0 .66,-4, i - � e 3 i E �- _. c`4 1 — � N ,. �• Law I ^fir A 0 CORNWEJL i 1 =i�"�. The Commonwealth of Massachusetts _ = --:Z- Department of Industridl Accidents - office , Office oflnlrestfffatioes _ 600 Washington Street Boston,Mass.. 02111 Workers' Compensation Insurance Affidavit t/e: e L c9 �ocation: �' X Z Z&55 'hone# '7✓:i5/ I am a homeowner performing all work myself a . I am sole o proprietor and have no ne working in amr capacity %/% //////0//%/////////%///////%%%%//%//////////%///O/O//� ///,%i. ❑ I am an employer providing workers compensation for my employees working on this job. com anv name: address: dtv- phone* insurance M policV# ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: ........ com anv name- address: ci hone#: insurance ca com anv name: address: dtv hone#: .... . .:... 1i Insurance co. 0 cv# Fsflure to seeose coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a tine up to s1�soe o0 and/or one years,imprisonment as well as civil penalties in the form of a STOP NORK ORDER and a tine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the oMce of Investigations of the DIA for coverage veriIIeation. I do hereby cad der the p • and penalties of perju �that e information provided above is true and correct p Signature Date Print name: Phone# Ccheckff y do not write in this area to be completed by city or town official city permitilicense# ❑Building Department ❑Licensing Board ❑Selectmen's Onfee mediate response is required ❑Health Den• phone#• ❑Other (w#um 9/95 P1A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all emplovers to provide workers' compensation for their ernplovees. As quoted from the"law", an employee is defined as every person in the service of another under anv contrsc 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 raore of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver . trustee of an individual, partnership, association or other legal entity, emploving 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 o. who--mire nP.cnne`do maintenance , construction or repair work on such dwelling house or on the grounds another ....V .,..r.v�..r......+._ building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuancey or renew of a license or permit to operate a business or to construct buildings in the commonwealth for an applicant who ha not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation nd be supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may 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. / / //�/%%//////%%�%/�/m 1�/ , City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permiWicense number which will be used as a reference number. The affidavits may be returned t^ the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions• please do not hesitate to give us a call. / // The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of InvesdUadons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 TOWN OF BARNSTABLE SIGN PERMIT PARCEL ID 311 070 GEOBASE ID 23062 ADDRESS 55 FALMOUTH ROAD (ROUTE PHONE Hyannis ZIP LOT. 235&236 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY A PERMIT 13257 DESCRIPTION W.B.MASON OFFICE SUPPLY (45 SQ.FT- ) PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services { TOTAL FEES: $25.00 INE BOND $.00 CONSTRUCTION COSTS $.00 C 753 MISC. NOT CODED ELSEWHERE * BARNSTA M MASS. OWNER COHEN, BERNICE TRUSTEE Ep 39. A� ADDRESS HYANNIS & HINKLEY RD R E TRH, 10803 PALM LAKE AVE BUI L7 ;7/I G DIVISION BOYNTON BEACH FL B e r r a• /. /J�. DATE ISSUED 02/12/1996 EXPIRATION DATE `C�` w - ✓ I The Town of Barnstable . Department of Health, Safety and Environmental Services Building Division date i6 367 Main Street,Hyannis MA 02601 fee Application for Sign Permit Applicant: V ` �,v' ��O Assessor's no.�L 07 U L�. � � 1� `" Doing Business As: ��l' ( L 5 `(��� Telephone Sign Location street/road: Zoning District Old King's I-Eghway District? yes no� Property Owner Name: C., l� L Z_v_`aJU,, c-Q, Telephone Address: 0 g `J PA-LVV1 �--A-C-f Village �-�kxco-, C�t> Sign Contractor n _ Name: 2\-k,vv .,u V `' 1 C c, Telephone Address: �q vkjv V�I �A3 - Village Description Diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new si€ 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. �Z l Dad Signs of Owner/Authorized Ag Size (sq. ) 'V S ( 1 Permit Fee 17'5 . Sign Permit was approved: ✓ disapproved: Date Signature of Building Official <i:''�: :..;: ;:::: :::: ..: : :::::::`� � ...:::: ::: ..t:"B. I....L .: :: . •. -.. .; :.;::.; .;:;.;:.>:.::.:»:.>::.:.;:.;:.::.;;:::;:;.A,�ORD T1T :: .: . 1 .:: .::::::::::::.::::::::.:::::::::::::.....;:.:. ..,..:.:.::::.::.:::::: :::: ::: :::::::::::...:.:. :::::.::. :,. 01 8 1 PgoDucER (508)540-2400 FAX (508)540-6671 7ALTER ND CONFERS NO RIGHTS UPON THE CERTIFICATE u r r a y & MacDonald Insurance Services .THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 406 ]ones Road THE COVERAGE AFFORDED BY THE POLICIES BELOW. Falmouth, MA 02540 COMPANIES AFFORDING COVERAGE ............._........................................................................................................_........._...... ..... COMPANY Maryland Insurance Group Attn: Ext: A INSURED................................................................................................................................... ......................................................................................................I.................. I........Carl DeLorme COMPANY B ..................................................................................................................................................... COMPANY C ................................................................... ........................................................................... COMPANY D • ---��- � • - - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCELISTEDBEL0VHAVEBEENISSUEDTO T.EINSURED NAMED FOR THE POLICY 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE ::POLICY EXPIRATION: LIMITS LTR DATE(MM/DD/YY) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000 X. COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OPAGG $ 2,000,000 CLAIMS MADE X :OCCUR: $ 11000,000 PERSONAL 8 ADV INJURY A <:»: g....... ....... BINDER 01/18/1997 01/18/1998 ................................. ........ .. ............................... OWNER'S 8 CONTRACTOR'S PROT: EACH OCCURRENCE $ 11000,000 ........................................ ............................. FIRE DAMAGE(Any one fire) $ 0 .. ........................................... MED EXP(Any one person) $ 5,000 AUTOMOBILE LIABILITY __. ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS _...$..... BODILY INJURY NON-OWNED AUTOS (Per accident) ....... ..................................................... : PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ...............................................:::.:::::::::::::::::::::..:::::::::: ANY AUTO OTHER THAN AUTO ONLY: _...._.......................... .......::.........:...:.:.:.:..............:.... EACH ACCIDENT $ ............................................................................. AGGREGATE: $ EXCESS LIABILITY EACH OCCURRENCE $ .................................... .................................................. UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND TORY LIMITS: ER EMPLOYERS'LIABILITY ................................... ..::. ...................................:: EL EACH ACCIDENT $ ................................................ THE PROPRIETOR/ ..................... INCL EL DISEASE-POLICY LIMIT $ PARTNERS/EXECUTIVE _.............. .......... _...:.......... ...... _..._.._.. .. OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ .OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS C. .ERTJFtGATE:i O LDER>:>:>:>::;:<:.: `:: :>z::?`:>`:<:<::>:>::::>:>':::z' :> :::::>::>:>:>:>:»:><:< ::;. .>:G TJ(3Is1 >:;:>::> :>:::>:::<:>>::::r;::':>>::::>::»>:«::: ::::s«:::>::>: :::>:::::::::::> ::::....::.........:::::::>::>:: X. A £. ..........:::::::::•:::::::::::.::::::.:::::::.::................................................_::..............:....... :...:.:..:::::::........................:.:::.:::.::::::::::::::::::::::::.::::::::::::::.:::.::::.:::::::::::::•...._:::.::::::....:.::::: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Kitchen Tech BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Route 130 OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. Sandwich, MA 02563 AUTHORIZED REPRESENTATIVE Cabral A. ,. . .`; Robert ] . CO L95....:.................... ..::::::::.::............ .............................:...:.:::::::::::::::::::::::::::::::::::::..................................................::.::..::.......................:.:::.::::.::::..::::::.::::::::::::::::::::.::.C$AC :CO PORA71C3I!t::198 y \ . } SUPID OOFF�CE Ho#? ;D p o � i 1 '� NT� NG wi 3I N CE 1696 `/ FURN �TURE PLYMOUTH SIGN CO. P.O. BOX 134 SOUTif YARMOUTH, W 62664 �r C 8KA Ard .r.hm Arob1tootur•�+I�Interiors r m M2 C Bary a+ C r C u tsl = 506.583.5603 z fax = 508 .584.2914 3 e-mail = bka•bkaarchs.com 'v C v d '7 �0 O Y N .L X N XISTING ADJ. BLDG 0 PARCEL a. SPIRIT AUTO SALES 0 m PROPERTY EXISTING LINE DECK c Id r � II EXISTING ; GARAGE DOORLi I U 'M �L .0 CL O W �O !O �0 3 O cli BUILDING i i I M CJ. ON ENtRANCE W s 0 ff II I EXISTING I 5U I L ID I I G PARKINASPHALT PARKING LOT 0 @��\ R� R, kph TFC� � o No. 396 z+ BROCKTON, EXISTING MASS. OVER-GROWTH INOTE: EXISTING PLATFORM TO EXISTING A2.1 BE REPLACED IN ITS ENTIRETY PRIVATE F�iry0 W/NEW PLATFORM OF SAME GRAVEL DRIVEWAY SHAPE a DIMENSIONS EXCEPT u 0 V-0" WIDER AS SHOWN, AND cP m THE ADDITION OF NEW STAIRS m TO THE SIDE AS SHOWN E ° b' / EXISTING: �h 8'-0" X 8'-0" EXISTING I CL o SAY BAY (NOT USED) 1 ° 22'-1" 10'-3" I I PROPOSED NEW Z { GALVANIZED METAL U STAIRS W/HANDR4ILS 0 BOTH SIDES M EXISTING LOADING DOCK PLATFORM To BE REBUILT, G.G. TO EXISTING DOCK B MPERS, COORDINATE I PROPOSED EXISTING GRAVEL e PARKING AREA HEIGHT ABO GRADE WITH OWNER PLATFORM EXISTING: EXTENSION " ROCK WALL E t n LOADING 0 O AREAo EXISTING 121'-0" q O GRAVEL PARKING AREA ASSUMED PROPERTY LINE v O . d f� 0 � EDGE OF EXISTING PAVING o s H INCKLEY ROAD EXISTING o CURB N C O O w �U . O N 0 N 3 EXTENT of ROAD OPPOSITE SIDE EX 15T I NSI/PROP09=7 SITE PLAN 4 L OAP I N& PLATFORM X SCALE: 1/6" = I'-O" t e v Q $Cella: VgN s p.0. Dates 6/13/06 Drawn 8y: ,c j< 59: KP m Job Nwbw: 206OW a o Drawing: 1 a U g lr s'C O U 1 REE TREAD 1 1/2" DIA. STEEL PIPE, HOT DIP GALVANIZED 10'-3" 3'-0" * 11" EA. (TYPICAL). CORE INTO CONCRETE SLAB d , PROVIDE METAL SLEEVE 8KA ArChld 5" V% .IF. EXISTING: OPENING 1'-1011 04 1 M13ARS (12" LONG) * 24" O/C Arehlt•etar• + Interior• 1 1/2" DIA. GALV. STEEL HANDRAIL BOTH SIDES 00 LELLED INTO EXISTING t FIELD VERIFY SIZE V.I.F. FOL NDAtION WALL AND CONCRETE ap MC12X10.6 STRINGER, BOTH SIDES SL B < EPDXIED SOLID m � 02 O — . •'y :\°r A .A is P' ° U a+ 0 A~ !-1- aSTEEL DIAMOND PLATE TREADS Oil 1-1!i ` 8" tel 508.583.5803\ IE a" "- s I° C2RISERS (GALW, TYPICAL. PROVIDE c ! 9 i I--I I i i—! a _ m _ � ":> TY'. �C ' o-. " I I { t_I-{_I L_!_I_ ,�, - � fax 5 O 8.3 8 4.2>i 1 4 CLIP ANGLES At BOTH SIDES. t� P � �� ` �I�! 11 I ! I i l l' ° , ; s-mail = bka• I s�i I I I�1 i!' °i'i�i • . ' A2.1 ' bkaarchs.com !—i ..b ° «.o- a.A.' I 1 •Ir-ICI 1�i'�'t� `i�ili� rn t A2.1 a a m ,• »' \ CL 2 `\ FORCED' CO1C T I 1 " 1'-II" ,�` 'a\\ , I,,dcB 101� 9" COMp' C rm.. ' TYPICAL = � � •� � ` -� .."� �1' 1 , . � 0. tzUC7r��4"L.'FIL�L • �' � 0 �9 . D PLATE STEEL DIAMOND ` . '" ' .I TREADS t RISERS, REST ^ w CIL ON LONG. PAD BELOW �/ \ u 1/4" WELDED W 4nX4" STEEL ANGLE \y w \`.. \ j a = i' LINE OF FOUNDAAION t- f CLOSURE PLATE, = EDGING WITH EMBEDED `�`. y\\ `° b a . 1 , E WALL BELOW GRIDS SMOOTH ANCHORS 24" O/C LINE OF FOOTING BELOW ` a c � a ° ;° �!'.\ ,\ °. `'` °'° /\ ''. `f"``, /�;^''',.,°`' �/ r�. • 'flQ' c m. Y \ F o. b n,,a. s' �.rzl I' d `� /'^ ,```'\\f'' /`\ / ;�".� f,.. Ff 1 /` �, !- '• /r f'' a •.�Jr, , n * P I t b CL cX it `°w',''°, °\\�\, . °'` ww+.''``, �'\ ''"`*,s",°` .�.a '' �\\ `,,./!rl`� \,° ,r 1 w ` '`',, f,^ > a ^• n N � a' « p: ; &X18" REINFORCED CONCRETE PAD WITH 3 r/ ! TWO '04 REBARS ° d q ° �\ CLIP ANGLE WITH 1 11 �'o ' , r /r f �/ EXPANSION BOLTS 6 -1' /- 3 -0 p ° \ TO ANCHOR STAIR 9'-1" a r' E�l1 AFUSED PAN DETAIL c \ \ L I J.. ° ; * 5/8" = 1'—O"5G?d.E: ° I Q NOTE: SEE 2/A2.1 FOR TYPICAL 04 REINFORCING * 12" O/C 0 FOUNDATION WALL 4 SLAB (BOTH WAYS) — o CONSTRUCTION t REINFORCEMENT +'4 REBAR, 12" LONG p p W/ 12" BEND T T f G I A5T�A11 4X4" STEEL EDGING ANGLE WITH o = EMBEDED ANCHORS * 2'-011 SCALE: 3/4 I O O O c ,dkTOF OF SLAB _ _ _ _ _ _ _ \s-MgED All? TO MATCH EXISTING ' .��.' e> ti� R, k �lF ° rA e � O� No. 396 ti lil 1 ✓ C✓�47 #C� f�?( �� o + BROCKSON. ~ LL RUBBER DOCK BUMPER BEYOD. Q ?(' ? r Mass. Z COORDINATE HEIGHT < LOCATION ) .c., .<a� ,. t �Fa N WITH OWNER t OWNER'S TRUCKS "p '° ,'' ''�OKC; T " SL,4, NTH of pi BITUMINOUS ASPHALT PAVING \~~ �`'�``�.\�� .\r'�,\' \�`\ ° (SEE CIVIL DRAWINGS) A ,� 5"rC.01"iPACJI` ,D `' `''' ,'/ti;T1 TURA FILL H:,17J,4 S OBE w THE w'.,°\,w .r°�,,\''\f f '`,,,\`',l,,/�3� •w^, \ '`,. ` ,•r�'`,\� ��� I WXe�L � j\ f \ J. f :1 �C,�,11J� �6 R o /61T•Y-1 2,4"` LEGS Z 10" REINFORCED'`,. IN!- z FOUDNATION WALL, CTINI\O77 ,�# REBARS, 12" LONG WTIH 10" BEND o �e. / r 10"X20" (7) REINFORCED ;r`' ` "` 4 « r';r ' A CONCRETE FOOTING, CONTINUOUS �` ° '" ' r • TWO, w4 REBARS, ' f; ONTINUOUS r 1 !` ° E m lu C UNDISTURBED BEARING 0 A MATERIAL, TYPICAL t V N w � O TYf�G I t�r—OU�ID��'�ON�D�T,�11. 2 E �- c v� ° L O 9 7- FACE M OF EXISTING BUILDING _ •v V" PREMOULDED JOINT °' N FILLER, CONTINUOUS )- W n •• r ° AS Namp 04 REBARS * 24" O/C [�Oux ,�\`\,' \ = Date 6A3/06 q EXISTING FOUND,4T1' CONCRETE SLAB < „ Drawn �y: RtK \ < Che'redced By: KP Job Number: 29*OW NOTE: SEE 2/A2.1 FOR TYPICAL SLAB . CONSTRUCTION t REINFORCEMENT N OraW O 3 D�T,�I L ® E�11 �Tl �0 ,: O�l5T1'ZUGT�10NI ■ . , : ,r , 5 _ 'i t � x DR COf V�ffE�E , C3 3 C� 1 �— S� � F k 1 jft A . r , - „ a ` C3 t WPM@ <. MEMO ` -MI Pill 4 VAIMI . x s