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1120 IYANNOUGH ROAD/RTE132
YOU WISH To.OPEN A BUSINESS?: For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) ' DATE: ( Fill Yease, < " Q► a'S O SIF, as BUSINESS ` YOUR HOME ADDRESS: ds C _ ,� �1 'l 7.J-0'1�� i? Ae. V�✓� _�I C TELEPHONE # Home Telephone Number 2r. - NAME OF CORPORATION: T114 NAME OF NEW BUSINESS oUL 's TYPE OF BUSINESS s aw^aN IS THIS A HOME OCCUPATION? YES NO - oa �9 MAP/PARCEL NUMBER o2�� (Assessing) ADDRESS OF BUSINESS Id0- hro �l —� When starting anew 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 COM ISSIO IER'S OFFICE This individual{ha ee ifrftac e of ny per it re uirements'that.pertain to this.type of business. ut orized Signature ' COMMENTS: Y. 2. BOARD OF HEALTH This individual has been informed of the.permit requirements that pertain-to this type of business. Authorized Signature** ` COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. ` Authorized Signature COMMENTS- A TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION' Map _ 2 fl— Parcel— Application # f3 — � `1 Health Division Date Issued 3—�� 1(e r� Conservation Division Application Fee le' Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address I� ® �' Gv� �c �(�(f .*A- rQ6 o L Village Y QlA i, 1 Owner O ckljqAddress Za i � Telephoned 1 Permit Yequest Wl (�A4 (E::UU/ yc Fu v4 A Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 2,000b Construction Type 19 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 0_newZsize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: ems:1 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 Cyh l Telephone Number` b 0 - 1 Address License # ©q�J e -` Home Improvement Contractor# I 3,5�6 Email ��A\r 57ck el )JLfVr6A1 'Worker's Compensation # AWC g wi o��_T ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO r o SIGNATURE DATE i 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.. The Comraomveakh of sadiusef Deparfmivit r due-hid Acddads offi-- -- — e 600 Wash`hWo x Skrset _ Boston,MA 02HI + t���mas� ilia . Workers' Compensafin Insurance Affidavil-BuddetsICantractGrsMectnxmnsfPlmnbers Applicant Infig=atiQn Please Print Leeffily Address: Citgf4atef 1�L Phone� C � Are you an employer?Check the appropriate bar; Type of project(retpared)c I.❑ I am a employer with. 4. ❑I am a general contractor and I p3ployees(firll artdfor part-time).* have hired tize sub-contractors d- ❑New eonsiradi� n 2.JZ1 am a sale proprietor orpartuer- listed onthe attached sheet. I- ❑Remodeling ship and have no employees . These sub-coact=have 8. ❑Demolition. wo dng forme is any capacity employees andhave wo&en' 9. ❑Building adxiifi INC W06MM'COMP.irianrH=M coop-inura ce oa rewired-] 5. We are a corporatiflnand its . 1-ix❑Electrical repairs or adclitnoas officers have wrcised their I❑ I ama homeovener doing all work 11-❑Plntabingrepairs or addiiians myself[No wrorkm'oomp- right of eseuagtim per MM 12.❑Roof repairs insurancerequired_1 E c.I52,§IM andwehaveno employem[No modcess' . 13-❑Other co=qx insnra,im requh 'Anyapp&czmt&2tcbedsboar1xmui also fiIlautihesectioabelawslxmv &eirwa&execa®p=Mfi uporscyiafrmSrdmL I Rameowners who salsnt dns sffdast mdrtmg&--y axe doing all teak sad.tim hba a=,,de cnntmctorz=1st sub= sadi fCa as4dditim shag shau!agthenaaaeofthesab-c and styewhetmargottheseeatitiesln employees.Ifthesvlrt asI>�e empIoSers,tfiey�tstpxoyide the vodw&tamp.paHq a m -Tam am BdmV is file p acy antd job site irzformalion. � ' Insurance CompaapName: TorR714 eor pelf-irna UC-4. Job Site Address` CifyfStateMp_ Attach a copy of the workers`compensationpolicy declaration page(showing the poficy amber and expiration date). Failure to secure coverage as required under Section 25A of MGL c-15'7 can lead to the imposition of criminal penalti s of a tine up to$1,500:Oo andfor sae-yearimpdsonamrt,as well as cif peaalEies.in the fa=of a STOP WORK DRDERand a foe of up to$250-00 a day against the vio]ainn Be adiased that a copy of this statement maybe faswarded to the Office of . ItevesEgatiom of the D-TA for iasmmaca coverage yedfic ation- I do hemby csrfify under Ste d1wzWm-*f, er ur}a diatfire ufforrrniWm proni&Zabmw is true wt atrn a Date_ - — o t - Phalle i� Ojo al use amyl Da not write in dds area,€a be campteted by city artown df)aeral City or T°awa Pernsifficense 5 Lssuitrg Audority(circle one): L Board of Health y ceding Deparbueat 3.drawn Clerk 4.Electrical Inspector 5.Plumbirg Inspector 6.other contact Person: - Phonff#: ' ri. Information and T-ustructiorrs, MWsaLC}rt s5ft CTe1eal Laws chVIrr M rml= s all employees ID gravid--workras'=mpensattan far their=q)Iayees. . Pia this sfatmim,era: is detmed as.`�.may personm tha service of aaoi3=under any contract ofbhe, express or implied,oral or w itirn" • assocation,cotporafion or other legal m d3ty,or any two or mare �4n e�Tvy�is defined as an mc$vidnal,partnetsh�, of the E.-egoiag=gagcdm a joint else,and mclnding tbm Iegal rap=natives of a deceased employer,or the ec reiver or trustee of aQ individ M-LL paitoeesbip,association or ofherlegal entity,employing employees. However the owner of a.dwelling house having not more than tb=aparIn=±s and who resides therein,or the occupant of the dwelling house of and who m3ploys Perms tD do mace,constraction.or repay work.an such dweIImg house or on the g: =& or bMI&Mg appratenaatthMrAD shaIlnotbecanse of such employmeutbe dcemedto be an employer." MCU.cbspter I52,§25C 6)also stems that aevery state or local 1icensmg agency shall withhold ffie issuance or renewal of a Ur-en m or permit to operate a business or fn construct buHdh:gs is the commanwrdfh for any applicant who bus not produced acceptable evidence of compliance Tun the bjwxan ce.coverage regained-" AdditionaIIy,MGL chapter 152,§25C(7)status-Teftber the connnqnwrzhh nor igy ofits poIitical subdivisions shall Mfrs i3tD any contract for the pmfm manse ofpnbho woik mnfI acceptable evidence of compliancewith the ins�ce.. regLm-emertE.s of this chapter have been preseszted to the conirazg ar>j3io }:" Applicants Please fill oitr fl3D WorI=,compensation affidavit compImtely,by checking the boxes that apply to your situation and,if necessary, pPly� r(s)�e(s)' (es)and phone numbers)along wiffi their ce tficate(s)of insurance. Lfin t Liability Compa> - (LLC)or LkatedLiabiTityP�hips.(LLP)Wno employees Other thmthe meitbers or pmta=s,are not rbqumed to caury voilcersr compensafon i imian - If as LLC or 112 does have employees,a policy is rapis4 Be advised that this aifidayitmaybe mbmitted to the Department of Industrial A=clwfs for confmaati ofm=ance coverage Also Be sure to sign and date the affidavit The affidavit should be rnfrnned to the city or town that the agpficatiour for the,permit or license is being rmgaest�A not the Depailinentof . LT2ust:ml 14 rr; e�i ShotzTdyon have any ga m regmding the law or ifyo .are regnfred to obtain a workers' =npsationpoficy,P�ec&UthoDepatmentatfhen=berlis� below: Self-iusm:edcampaniesshonld enter t3�eir eu self-haso=ce>license mmnbm an fhe appropriate Line. City or Town Officials - Please be sate that the affidavit is complete and prated Iegtbly. The Department has provided a space at,the bottom of the affidavit for you to f M out in the event the Office ofInvestigations has to cone ct yam regmg the appIiamzt Please:be sun c to f M in the pmLit iccmm mtnbes which WM be used as a mf==cz number. In addition,an applicant that must sabmit mmuYTIO pennitllice use applications in any given year,need only suzbmit one affidavit indicafnag current policy information(ff necessary)and umdP.L`Job S@Z Adam&*faze appli=vt should vj=--"all locations in (c-iiLY ar- town)_'A copy of the affidavit that has been officially stamped or maticed by the city ar town may be provided to the ' • applicant as proofthat a valid affidavit is on file for fatate.pezmitr or licenses. A new affidavitmust be fmcd out each year.Wheae a home ownea or citizen is obfaiaing a.l D==or permit not related to any business or commercial venfuu'e C 0. a dog license or permit to bwn leaves eta.)said pmson is NOT rmgtuned to Clete this affidavit IiIm to tank you io;advance for your cooperatian and should yam have any quesft=, 'Ili--Office of Investig&ons would please do not hesitater to give us a call- The Department's telephone and fax=Mbet: Departnmt f}f�I3� IIr A GC1��tS Bost .,MA 02111 Tel.#617- -49=d4-06 or 1477 ILA ES,SAFE Fax 617'27 '749 Revised¢24-07 Ind- g IKE 1659;- Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO r' Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must t Complete and Sign This Section. If Using A Builder I. o en s, I Tiffi'c_ b as Owner of the subject property J Yl C EVri� Y�Ut (A�� o a't o�m b hereby authorize E'C, � f' Z m� y in all matters relative to work authorized by this building permit application for. c�WOO I (Address o ob) , COO c� Signature of Owner ' Date . Print Name If Property Owner is-applying for permit,please complete the Homeowners License Exemption Form on the P rty reverse side. QAWPI ILEST�ORMS\buildmg permit formsUTRESS.doC Revised 040215 Mass. Corporations;,external master page ; Page 1 of 1 r i � Corporations Division Business Entity results Number of records: 13G Print results Entity Name ID Number Old ID Address Number COOK ESTATE CONDOMINIUM 001067811 84 STATE ST., STE 300 ASSOCIATION, INC. BOSTON, MA 02109 USA COOKE SERVICES, INC. 042436372_ 41 NORTH ROAD BEDFORD, MA 01730 USA COOKE SPORTS INC. 042694173 57 EASTERN AVE. DEDHAM, MA 02026 USA COOKE STONE, LLC 001062846 12 VILLAGE GREEN LANE #11 NATICK, MA 01760 USA COOKE STREET 042959828 106 COOKE ST. C/O COOKE PARTNERSHIP, LLP STREET PARTNERSHIP, LLP EDGARTOWN, MA 02539-2540 USA COOKE STREET REALTY LLC 001015884 130 COOKE ST. EDGARTOWN, MA 02539 USA COOKE'S FAMILY FOOD 042745636 000177114 79 SUMMER ST. MART, INC. E. FOXBORO, MA 02035 USA COOKE'S RESTAURANT- 042644826 P.O. BOX 301 HYANNIS, INC. W. HARWICH, MA 00000'USA COOKE'S RESTAURANTS, INC. 132835083 52 CAILLOUET LANE P.O. BOX 630 OSTERVILLE, MA 02655 USA COOKE'S SEAFOOD HYANNIS, 202014174 1120 ROUTE 132 INC. HYANNIS, MA 02601 USA - COOKE'S SKATE SUPPLIES, 043518030 000000000 446 MAIN ST. INC. WILMINGTON, MA 01887 USA COOKE'S SKATE SUPPLY, INC. 043518030 000000000 446 MAIN ST. WILMINGTON, MA 01887 USA COOKES-MASHPEE, INC. 043342427 000554462 52 CAILLOUET LN. OSTERVILLE, MA 02649 USA fj New Search http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSearchResults.aspx 3/3/2016 y - toMassachusetts -Department of Public Safety Board of Building Regulations and Standards r.___._ _ _ MV L.1/111L1 Lt1L11111 JUIlC1 Y11111 JlIG L1All_V License: CSSL-099382 HECTOR R SANCE 286 STRAWBERRY • CENTERVIILLE Expiration Commissioner ' 09/14/2017 Restricted To: CSSL-WS-Windows and Siding CSSL-RF-Roofing S A.° 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 ' r rf