HomeMy WebLinkAbout1140 IYANNOUGH ROAD/RTE132 e� � �-l� s ����
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�` tio Town of Barnstable �.7y
Building Department - 200 Main Street
&U MSTABLE, * Hyannis, MA 02601
MASS
9q,A t639- . (508) 862-4038
tFD MA'i A
Certificate of Occupancy
Application Number: 20061826 CO Number: 20060159
Parcel ID: 273079 CO Issue Date: 12104106
Location: 1140 IYANNOUGH ROADIROUTE132 Zoning Classification: HIGHWAY BUSINESS DISTRICT
Proposed Use: SERVICE STATION
Village: HYANNIS
Gen Contractor: BOCK, JOSEPH J. Permit Type: CC00
CERTIFICATE OF OCCUPANCY COMM
Comments:
`+—°
Building Department Signature Date Signed
�TN1E'Taf• ' TOWN OF, BARNSTABLEBuilding
Application Ref: 20061826 •
t - Permit
" sAxlvsTASI.E, Issue Date: 08/03/06
MASS
9� i639• ��+� Applicant: BOCK, JOSEPH J.
QED MAC s - _ Permit Number: B 20060820
Proposed Use:
Expiration Date: 01/31/07
Location 1140 IYANNOUGH ROAD/ROUTng District HB Permit Type: COMMERCIAL ADDITION ALTERATION
Map Parcel 273079 Permit Fee$ 502.20 Contractor BOCK, JOSEPH J.
Village HYANNIS App Fee$ 100.00 License Num 06438
` Est Construction Cost$ 62,000
Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND
TENET FIT OUT-A.J. MARKS THIS CARD MUST BE KEPT POSTED UNTIL FINAL
INSPECTION HAS BEEN MADE. WHERE A
CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH
Owner on Record: PRIME 132, LLC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL
Address: 297 NORTH ST INSPECTION HAS BEEN MADE.
HYANNIS, MA 02601 z•
r
Application Entered by: DB
Building Permit Issued By
:
THIS PER.\11T CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY.
ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.
STREET OR ALLY 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.
MINMMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK:
1.FOUNDATION OR FOOTINGS.
2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED.
3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION..
4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH).
5.INSULATION. F
6.FINAL INSPECTION BEFORE OCCUPANCY. R
WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL°INSTALLATIONS.-
WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION.
PERIY11T WILL BECOME NULL`AND VOID IF-CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF
DATE THE PERMIT IS ISSUED AS NOTED ABOVE.
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.I42A).
WARM
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
2 2 . ��� '`'`.v 2
3 ��d`( DkC 1; Hating Inspection Approvals Engineering Dept
Fire Dept 2 Board of Health
HOLLY MANAGEMENT & SUPPLY CORPORATION
297 North Street
Hyannis,Massachusetts 02601
(508)775-9316
FAX(508)775-6526
December 1, 2006
Town of Barnstable
Building Department
Paul Roma, Building Inspector
200 Main Street
Hyannis, MA 02601
Re: 1140 Iyannough Road, Hyannis, Massachusetts
Town Fair Tire and A. J. Marks Jewelry
Dear Mr. Roma;
Enclosed please find the final as-built certification from Baxter&Nye Engineering dated
November 29, 2006. Also, please find an email from Rich Westergren of Poyant Sign
Company(who was contracted by Town Fair Tire) indicating that the neon rings on the
pylon sign have been rendered inoperative.
To my knowledge, all outstanding items required by the Building Department in order to
issue a permanent certificate of occupancy have been completed.
I would be more than happy to meet you on site if need be.
Kindly, S , occ . PC` 17J
Aaron Bornstein
INOV-29-2006 09:32A FROM:BAXTER NYE ENGINEERI 1-500-771-7622 TO:85087756526 P.2
BAXTER NYE ENGINEERING & SURVEYING
Registered Professional Engineers and Land Surveyors
78 North Street,3rd Floor,Hyannis,MA 02601 Tel:(508)771-7502 Fax:(508)771-7622
November 29,2006
Mr.Thomas Perry,Building Commissioner '
Bamstable Building Dept
200 Main Street,
Hyannis,MA 02601 _
CW%SITE PLAN MN-91 RUCTION AS-RUILT CERTIFICATION
PROJECT: ZBA Appeal$12005-046
Town Fair Tire&Tenant Retail
LOCATION: 1140 lyannough Rd.(Rte.132),Hyannis,MA
RE: Civil Engineer—Site Plan Construction As-built Certification
I, Matthew Eddy, being a registered Professional Civil Engineer with the firm of BAXTER NYE ENGINEERING &
SURVEYING, Registered Professional Engineers and Land rSurveyors, hereby certify that I have supervised the
preparation of the Civil Engineering Site Plans and specifications for the above named project and that,to the best of my
knowledge, information and belietj such Civil Engineering Site plans and specifications meet the applicable provisions
of the Massachusetts Building Code, Sbah Edition and.generally accepted standards of Civil Engineering practice in
effect at the time of performance.
I further certify that I have reviewed the completed construction,as of the date of this Certification,for the above project
and it has been substantially performed,with the notes below,in general accordance with the Site Plan as Approved by
the Town of Barnstable. This certification is for the purpose of checking for conformance with the design concept and
general compliance with the information given in the Approved Civil Engineering Site Plans,revised through 3/25/05,
and additional ZBA conditions.,It is not to be considered a field control as-built of all vertical and horizontal
information shown on the Approved Site Plans nor is'it to imply daily inspections of site plan related work.
The following items regarding the Approved Site Plan are noted:
1. There is no curbing installed along the rear aisle(north end of site)behind the building. This condition appears
to be acceptable as all runoff is maintained on site due to the natural berm along the rear property line.
2. The site lighting pole mounted fixtures are not required per the Barnstable Building Commissioner.
!��{
X. UF-!va'��
►ss� Name Matthew Eddy,P.B.
Registration No.--7-
� ry�1 w 9Oy !.�S 1 _9 1
W.
\
7 A 043
1
Seal � Signature
`.:, ..
Cc: Mr.Aaron Bornstein,Holly Management
File
0:\2005U005-0111ADNfDUE7TERS12005-011 L7 Final ConstrAs built Certification.doa
Page 1
Land Surveys • Subdivisions • Septic Design • Wetland Filings •. Site Design
'omcast Webmail - Re: hyannis location("Rick" <Rwestpoyantnhga aol.com>) Page 1 of
From: 'Rick"<Rwestpoyantnh@aol.com> t
To: hollymgmt@comcast.net, "NH Office Rick Westergren"<rwestpoyantnh@aol.com>-
CC: "Donna Travers"<dtravers@poyantsigns.com>
Subject: Re: hyannis location
Date: Thu, 30 Nov 2006 23:20:23+0000
......... _ ......... ..... ......... ...........
Yes......This in fact confirms our earlier telcon:...The open tube neon rings
located on the pole cover have been rendered inoperative....This alteration was
completed on November 20, 2006. 1 trust this is the information you need.
Poyant Signs, Inc.
Richard Westergren
Regional Vice President t
BlackBerry service provided by Nextel
-----Original Message-----
From: hollymgmt comcast.net
Date: Thu, 30 Nov 2006 22:42:24
To:rwestpoyantnh ,aol.com
Subject: hyannis location
Dear Mr. Westergren,
Re: Town Fair Tire
1140 Route 132 f
Hyannis, MA 02601
Per our conversation, please send me an email confirming that the neon bands
underthe
Town Fair/AJ Marks, Pylon Sign has been rendered inoperable.
Thanks
Aaron Bornstein
hollymgmt -verizon.net: <mai Ito:hollymgmt(d-)verizon.net>
.........._ .__......._ ............ . .................. .._...... .. ........... ......._.......................y..,.,............ ............
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ittp://mailcenter2.comcast.net/wmc/v/wm/457039EB0008EODD0000037422070245539B03090397040401... 12/l/200t
T_
'Hizid'tlat Construction Company TOWN OF BARNSTABLE
DATE INVOICE NO DESCRIPTION INVOICE AMOUNT
11-30-06 TFT-OC. PE OCCUPANCY PERMIT -`TFT 75.00
DATE
CHECK 11=30-06 NU BER IECK 982 TOTAL> 75.00
PLEASE DETACH AND RETAIN FOR YOUR RECORDS �: }
NOV-29-2006 09:30P FRON:EAXTER NYE ENGINEERI 1-509-771-7622 TO:e5oe7906 30 ® -
BAXTER NYE ENGINEERING & SURNTYM.
Registered Professional Engineers and Land Surveyors Lr
78 North Street,3`s Floor,Hyannis,MA 02601 Tel:(508)771-7502 Fax:(508) 71.7622 ca
r
November 29,2006
Mr.Thomas Petry,Building Commissioner
Barnstable Building Dept
200 Main Street,
Hyannis,MA 02601
CIV[LLSITE PLAN CONSTRUCTION AS-BUILT CERTIFICATION
PROJECT: ZBA Appeal#2005-046 t i
Town]fair Tire&Tenant Retail
t
r
LOCATION: 1140 Iyannough Rd.(Rte.112),Hyannis,MA
RE: Civil Engineer—Site Plan Construction As-built Certification
1, Matthew Eddy, being a registered Professional Civil Engineer with the firm of BAXTER NYE ENGINEERING &
SURVEYING, Registered Professional Engineers and. Land Surveyors, hereby certify that I have supervised the
preparation of the Civil Engineering Site Plans and specifications for the above named project and that,to the best of my
knowledge, information and belief, such Civil Engineering Site plans and specifications meet the applicable provisions .
of the Massachusetts Building Code, Sixth Edition and generally accepted standards of Civil Engineering practice in
effect at the time of performance. 1
I further certify that I have reviewed the completed construction,as of the date of this Certification,for the above project
and it has been substantially performed,with the notes below,in general accordance with the Site Plan as Approved by
the Town of Barnstable. This certification is for the purpose of checking for conformance with the design concept and
general compliance with the information given in the Approved Civil Engineering Site Plans,revised through 3/25/05,
and additional ZBA conditions. It is not to be considered a field control as-built of all vertical and horizontal
information shown on the Approved Site Plans nor is it to imply daily inspections of site plan related €work.
The following items regarding the Approved Site Plan are noted:
1. There is no curbing installed along the rear aisle(north end of site)behind the building. This condition appears
to be acceptable as all runoff is maintained on site due to the natural berm along the rear property Iine.
2. The site lighting pole mounted fixtures are not required per the Barnstable Building Commissioner,
uF Name Matthew Eddy,P.E.
Registration No.043
. S
li yt
.h 9/
Seal '^ ��`Z'lSYE�� a Signature
IYV%*Wy
G'
Cc: Mr.Aaron Bornstein,Holly Management ;
File s.
0.1200512005.0111ADMIMLE77ER312005-011 L7 Final Conscr As built Certification.doc , r,) CU
� —'
E�
N t'rl
Page 1
Land Surveys • Subdivisions • Septic Design • "Wetland Filings. • Site De ign
f
NOU-29-2006 09:30A FROM:BAXTER NYE ENGINEERI 1-508-771-7622 TO:85087906230 P.1
FAX TRANSNUTTAL
BAXT'ER NYE ENGINEERING & SURVEYING
Registered Professional Engineers and Land Surveyors
78 North Street,3rd Floor,Hyannis,MA 02601 Tel:(509)771-7502 Fax:(508)771-7622
Date: I November 29 2006 To: Mr.Tom.Perry
No.Pages: 2 Barnstable Building Department
BN Job No.: 2005-011:4 200 Main Street
Hyannis,MA 02601
Subject: 1140Iyannough Road Fax:508-790-6230
Hyannis,MA
Cc: Aaron Bornstein
We are sending you ❑Attached ®Via Fax(No.of pages including Transmittal Sheet)__2
Hard copy to follow via US Mail
The following documents:
❑Prints ❑Specifications ❑Estimates[]Shop Drawings❑Samples
❑Reports/Calculations ®Other Fetter Civil Site Plan Construction As-Built Certification
DATE COtPIES N D.PAGES DESCRIPTION
i l/29,'06 1 1 TLetter -Civil Site Plan Construction As-Built Certification
These items are transmitted as checked below:
® For your use ❑As requested ❑Returned with corrections
❑ For review and estimate ❑For approval ❑For distribution
Remarks:
If you have any questions or comments please do not hesitate to call.
Matthew W.Eddy,P.E.
Managing Partner
MWE\lah
\:.file
Note:
This transmittal contains privileged information.Please contact the sender immediately if this transmittal is illegible,
incomplete or not intended for your use.-Thank you. . I:\document templates/transmittal template
i .
ONE FINANCIAL PLACE
2 9 7 N O R T H S T R E E T
H Y A N N I S M A 0 2 6 0 1
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BAXTER NYE ENGINEERING&SURVEYING
Registered Professional Engineers and Land Surveyors .
..
78 North Street,3nd Floor,Hyan ns,MA 02601 Tel:(508)771-7502 Fax:(508)771-7622
1 ;
August 31,2006
'
Mr.Thomas Perry,Building Commissioner
Barnstable Building Dept
200 Main Stream
Hyannis,MA 02601 L. - ,
CrAL SITE PLAN CONSTRUCTION C<. �` lll
Is
1 PROJECT:<. ZBA Appeal#200S-W (F k,P- C
Town Fair Tile&Tenant Retail
LOCATION: 114017 annoogh Rd.(Rte in),Hyannis,MA
RE: r r Civil Engineer-Site Plan Coustraction As-buff
1,Matthew Eddy,being a registered Professional Civil Engineer wi ��
SURVEYING,Registered Professional Fngmce+s and
preparation of the Civil Engineering Site Plans and specifications for,
knowledge,ufformation and belief such Civil Engineering Site plat
of the Massachusetts Building Cade,Sixth Edition and generally accepted end"of Civil Engineering practice in
,. effect at the titne of performance.
r' I further certify that I have reviewed the completed construction,as of the date of tbis Certification,for the above project
• and it has been substantially performed,with the exceptions noted below,in general accordance with the Site Plan as .
Approved by the'reviewing authority'.This certification is for the purpose of cherJ®g for conformance with the design .
concept and general compliance wilh the information given in the Approved Civil Engineering Site Plans,revised
through 3/25/05,and additional ZBA conditions It is not to be considered a field control as-built of all vertical and
horizontal information shown on the Approved Site Plans nor is it to imply daily inspections of site plan related work.
The f XFg==hone t >-5 App d-,WSit-e an=are :Wft-
_l. tare inn aubmginstailed along 9le'tearai>lr(nerth .oEsile�behind 1Lebm7dm8 This cendmon appears
as all r®off is maintained on site due to the natural berm along
the rear property lice.
1 4 rl� = ce is not installed at the dumpster and used tire storage area.
3_5The ,�61es-ire not installed.
4—The fight tam arrow,"(W label,and stop bar pavement mazkings are missing from the westerly exit from the
r site.
f ytSAA AaWATnew
.,
W.
Name MatPoew Eddv PE
Registration No.
SriSeal
..
Cc: h1r.Aaron Bornstein,Holly Management
File
01200A2005-011�5-011 LS Ca�H6�lt Carifivrion TJ06-08dl.doc .
Page 1
Land Surveys • Subdivisions 9 Septic Design • Wetland Filings • Site Design
Co
b<-- SAS l�
-sue
I
BAXTER NYE ENGINEERING & SURVEYING
Registered Professional Engineers and Land Surveyors .
78 North Street,P Floor,Hyannis,MA 02601 Tel:(508)771-7502 Fax:(508)771-7622
August 31,2006
Mr.Thomas Perry,Building Commissioner
Barnstable Building Dept
200 Main Street,
Hyannis,MA 02601
CIVIL SITE PLAN CONSTRUCTION AS-BUILT CERTIFICATION
PROJECT: ZBA Appeal#2005-046
Town Fair Tire&Tenant Retail
LOCATION: 1140IyannongbRd (Rte132�Hyannis,MA
RE: Civil Engineer—Site Plan Construction As-built Certification
I, Matthew Eddy,being a registered Professional Civil Engineer with the firm of BAXTER NYE ENGINEERING&
SURVEYING, Registered Professional Engineers and Land Surveyors, hereby certify that I have supervised the
preparation of the Civil Engineering Site Plans and specifications for the above named project and that,to the best of my
knowledge, information and belief,such Civil Engineering Site plans and specifications meet the applicable provisions
of the Massachusetts.Building Code, Sixth Edition and generally accepted standards of Civil Engineering practice in
effect at the time of performance.
I further certify that I have reviewed the completed construction,as of the date of this Certification,for the above project
and it has been substantially performed,with the exceptions noted below,in general accordance with the Site Plan as
Approved by the`reviewing authority'. This certification is for the purpose of checlung for conformance with the design
concept and general compliance with the information given in the Approved Civil Engineering Site Plans,revised
through 3/25/05,.and additional ZBA conditions. It is not to be considered a field control as-built of all vertical and
horizontal information shown on the Approved Site Plans nor is it to imply daily inspections of site plan related work.
The'fo`llowing exceptions to the 'Site Plan are noted:
I.There'is-noycading-installe&along the rear aide-(north-end-of site)behind file bur3dmg This condition appears
to acceptable-as all runoff is maintained on site due to the natural berm`Rong the rear property line.
—2 `Fbeg-fence is not installed at the dumpster and used tire storage area.
3. The=si -pore _are not installed
� 4—The r*ht turn arrow,"Only'label,and stop bar pavement markings are missing from the vwesterly exit from the
site. ��f:� �9 A A.
�. .._ ;�
MATTHEW 9�
Q W. cf�, Name Matthew Eddy P.E.
_ EDDY '�`'`. Registration No. 413/R
Cift
Seal ; Signature
Ap
1+v,sr°•
Cc: Mr.Aaron Bornstein,Holly Management
File
0:\2065V005-011\ADMINEE1TERS\2005-011 L5 Constr As built CeNScation 2006-08-31.doc
Page 1
Land Surveys • Subdivisions • Septic Design • Wetland Filings • Site Design
NE
tti Town of Barnstable
Building Department - 200 Main Street
* S'MIZ• * Hyannis, MA 02601
9 MASS. (508)
i6gq. 862-4038
� -
'°rFD
Certificate of Occupancy
Temporary
Application 20061826 CO Number: 20060126
Parcel ID: 273079 CO Issue Date: 10/16/06
Location: 1140 IYANNOUGH ROADIROUTE132 Zoning Classification: HIGHWAY BUSINESS DISTRICT
Owner: PRIME 132, LLC Proposed Use: SERVICE STATION
297 NORTH ST
HYANNIS, MA 02601 Village: HYANNIS
Gen Contractor: BOCK, JOSEPH J. Permit Type: CTCO
COMM TEMPORARY CO
Comments: 45 DAY TEMP CO - LANDSCAPING MUST BE DONE EXPIRES 11/20/06
O
Building Department Signature Date Signed Expiration Date
TOWNC", ".ARNSTABLEBuilding
Application fief: 20061826 BARNSfABLE, ; Issue Date: 08/03/06 Permit
9 M"ss
1 MAC� Applicant: BOCK,JOSEPH J. Permit Number: B 20060820
Proposed U.se: Expiration Date: 01/31/07
Location 11401YANNOUGH ROAD/ROUT District. HB Pernvt Type: COMMERCIAL ADDITION ALTERATION
Map Parcel 273079 Permit Fee$ -502.20: Contractor BOCK,JOSEPH J.
Village HYANNIS App Fee$ 100,00 License Num 06438
Est Construction Cost$ 62,000
Remarks APPROVED PLAINS MUST BE RETAINED ON JOB AND
TENET FIT OUT-_A.J.MARKS THIS CARD MUST:BEKEPT POSTED UNTIL FINAL
INSPECTION HAS BEEN MADE. AMERE A
CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH
Owner on Record: PRIME 132,LLC BUILDING SHALL NOT.BE OCCUPIED UNTIL A FINAL a
Address: 297 NORTH ST INSPECTION HAS BEEN MADE.
HYANNIS, MA 02601
Application Enured by: DB Building Permit IssuedBy:. Pr
THIS PERMMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER T Eiv1PORARILY OR PERMANENTLY.
ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION
STREET OR ALLY 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.
MIN,PAUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: .
I.FOL'1vDATION OR FOOTINGS.
2.ALL FIREPLACES MUST BE INSPECTED AT Tat THROAT LEVEL BEFORE-FIRST FLUE LINING IS INSTALLED.
3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION.
4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH).
5.INSULATION.
6.FINAL INSPECTION BEFORE OCCUPANCY. '
WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,.PLUMBING AND MECHANICAL INSTALLATIONS.
WORK SHALL NOT PROCEED UNTIL.THE INSPECTOR HAS APPROVED THE VARIOUS STAGES,OF CONSTRUCTION.
PERMIT WILL BECOME.NULL'AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF
DATE THE PERMIT IS ISSUED AS FOOTED ABOVE.
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A).
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
2 2 � ot., 2
3 1 Heating Inspection Approvals Engineering Dept
aAs
Fire Dept60
2 Board of Health
92����
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'Ma.-W11 _4�
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
i
Map—a, Parcel Application# &)691�a
Health Division
Conservation Division r Permit#
Tax Collector Date Issued
Treasurer Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved.by Planning Board orb ®�
5PR -.ems.
Historic-OKH Preservation/Hyannis
77 Project Street Address D
Village
Owner Address
Telephone
eri Request
Square feet: 1 st floor:existing 22 proposed 2nd floor:existing proposed ry Total new
Zoning District Flood Plain Groundwater Overlay
XJProject Valuation.��,,4D0 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 Cr--- O Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other S r A fa>
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of�Baths.D Fuldexisting new Half:existing 2_ new
Number of'Bedrooms: existing new
Total Room'Count:(not including baths):existing new r First Floor Room Count
Heat Type and Fuel: YGa&� ❑Oil ❑Electric ❑Other
Central Air'-'N4 ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes M'No
Detached garage``O 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#-- _-,-_ - r — -- --�_ --- ----
Current Use Proposed Use
BUILDER INFORMATION
(Name �/osE�/ �/ OG Telephone Number
Address e License# d63 7 ��
Home Improvement Contractor#
Worker's Compensation# .7v%j ������/��
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO• �L� � `�/l�j,
SIGNATURE i DATE'S "3d 496
FOR OFFICIAL USE ONLY
y
PERMIT NO.
DATE ISSUED `
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
E
DATE OF INSPECTION:
FOUNDATION
FRAME �` ` 'o P��
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH -FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.-
K
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"i00I
��A,R,45 Qn�III `/CC�aavaclzu°e�
l,ic' IRIM" R'��ila1L�AT�QNiS .
Anse: GINS R+UGTIQ'I`I SUPERVV-3b t
r N AN, 06438
Tr.nod 4238:0 ,
J;pSEPH J _
BOCK , t�
>NAUSHON R!m
SAGA'MQ.R+E BEACH G
Com'mission�r;;' t� '
�� 1!LG l�Vlltn•Vnrrcw•ar• vJ auwvu»..............
Department oflndustrialAccidents
" Office of Investigations
600 Washington Street
f Boston, MA 02111
y " www.massgov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pluxnbers
Applicant Information ]Please Print Legibly
Name (Business/Organization/Individual): �/��E�/� ✓• ®� C !'//�� ����,
Address:
City/State/Zip: Phone#:
Are you an employer? Check the-appropriate bqx: Type of project(required):
1,❑ I am a employer with 4. Erl am a general contractor and I 6. ❑ New construction
employees(full and/or part-time). have hired the sub-contractors
2.❑ I am a sole proprietor or patoer- listed on the attached sheet $ ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
workingfor me in any capaci workers' comp.insurance. 9.ty. ❑-Bufiding addition
o workers' Comp.insurance 5. We are a corporation and its
required.] El officers have exercised their 1 O.�lectrical g additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs oT additions
myself.[No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs
insurance required.] t employees.[No workers' 13.0 Other
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information'
t Homeowners who submit this affidavit indicating they are doing all work andthen hire outside contractors must submit a new afFrdevit indicating such.
=Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy inforn7sttion.
I am an employer that is providing workers'compensation insurance for.my employees. Below is the policy andjob site
information.
Insurance Company Name:
Policy#or Self-ins.Lic. #: Expiration Date:
Job Site Address: City/state/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration 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 civfi 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 DIA for insurance coverage verification.
I do hereby ce under the pains and penalties of perjury that the information provided above is true and correct
Si ature: Date:
Phone#• gwe--.7-
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority (circle one):
.1.Board of;wealth 2.Building Depaa-t wr ment 3.City/TCn Clerk 4.Electrical lnsp.ector, 5.Piun bima Inspector �
e
6. Other
Contact Ferson: Phone#:
Information and Instructions ;
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as "an individual,partnership, association, corporation or other legal entity, or any two or more
of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the .
receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment-be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of alicense 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 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. He 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 stan3ped 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 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 Deparonent's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA.02111
Tel. -17, 617-727-4900 ent 406'or 1-877-NtASSA.FE
Fax#617-727-7749
Revised 5-26-05 www.mass.gov/dia
mayvmU-a A.&I i/J.V:7
f PxOr sc THIS CERTIFICATE IS ISSUED AS A MATTER OF MFORMATIONt
MC SWeesiey & RieCi Ins Aa Inc ONLY AND CONFERS NO RIGHTS UPON T14E CERTIFICATE
420 Washington Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
P.C. Box OS0904 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Braintree NA 02185 ;
Phone&781-848-8600 Pax:781-843-8807 WSURE"AFFORDING COVERAGB NAIG#�
;NSLWWD 943URER A: National Grange btatual
wsURtRs: The Hartford _
E R M builders INSLYtER G:
Edward and tlanay Matane8 Dba
5 Carlos Estates Drive INSURERD:
Berkley Kh 02179
�UasuRER E:
-COVERAGES
TK POLICIES OF INSURANCE LISTED BzR W HAVE BEE.W ISSUM TO T14E INSURED KAMEO ASOYE FORTrM POLICY PER=WMATEO.NO1Wi!HSTANDING
ANY RWOIR DENT,TERM OR CONOJT N CF ANY OOWSRACT OR OTHER DOOMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY K WAX-0 OR
KhY PEA t,%J t.TIL MWI►AILE APPO1tIM BY THE POLICIES OFSGRtWO HEITEIN 18 SUBJECT TO AU.THE TERMS..EXCLUSiONSANO COND IONS Of Sty-H
POLICIES.AGGREG_ ATE LUAITS SS WI(MAY HAVE SEEN R&mDUGED BY PAID CLAWS.
R- TYPE OF JNSURANCP POLICY NUIINIER tp1 LStTS
"KERAL LASILITY I i EACH OCCUIRRENGE �5 500 000
A X COQWR EN CIALGERALLUffiLOY WJ14869 09/08/05 09/00/06 PREMMStEacca6laro $500,000
CLAIMS MAW t A;OCCUR �.' I !MEDEI(Prpnycneplksan) $10,000
! PERSSO @NAL AaliwUKY 1500,000
I 4ENER4A00FISUTE $1 000 000
4"1AGOREOATE LIMIT APPLIES Pm. i PRODWTS•COAIPvpWS $1 000• 000 _
POLICY JE.PFOT I LOG I
AU101,E0811LE LIABILITY
COIA8INED SJT�GLE Uiki
1 :(Ea accklenl) 8
ANYAuro Ds3s14969 I 08/15/0' � 08/15/o.. • i
ALL OVJWO AUTOS { ! I
@O51LYINJURY - S 50,000
X SCHEDULED AUTOS I (Perpeftm)
X WREDAU70S ! BWLVUVJUP.V
X WM-OIAIHEDAUTOS I (�.cadw) I S100,000
µ
i PROPEfiTY DAMAGE
$100,000
-� � (PeYtimOW)
f GARAGE LIABILITY - i I AUTO ONLY-FA AC UXNT 6
ANY AUTO 1 i OT'NERTHAN EAACG $.
AUTO ONLY. ACT; 3
E S IUMO ELLJ1 LIAb%M i ERCH OCCU�tEAICE 8
cc-CUR CLAIMS MVE
AGGREGATE b
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RiEIENTION S I 18
� WORHERSCOMPE_VSATION AND To"LUEITS Fat
U PT.OYEA.Y 1U19TUTY
Ji IANY PROPRIETOMPARTHERNXECUTIVE ( 68600028061 10/31/05 � 12/31/06 ! -11 EACHAWDENr !$100,000
aFFICEWlAEMBERBXCtUOf� I E.LD� 18EA3g_EAEWWYe S 100,000
demnbend
kL PROVISIONSbet4a a 1 E.L DPJEA3E.POLICY VXT is 500,000
IOTHER
I
DESCQIP'Tl4UI4F OPERAt10N9!LOCATIONS!IfH9CLE3!EIICLUS�Nff AADFA BY END;iR$T;UIENT/SPESIAL PRCYISiONS
CARP3=RY-RZ5IVZNTIAL
" I
CERTIFICATE HOLDER CANCELLATION
COR>Rs SHOW-0 ANYOF 111E A801JE OMMEOPCIUM3 8E CA.Y EUM ICE THE E7tPIRA7ION
DATE THEREOF.THE!SUING I WREP WILL EWEAVOR VO WL 10 DAYS W'RRTFN
Cornerstone guilders rud. w NOTICETOTHECERTIMCATEhOU)ERNAMEDTO THE LOT.INTFAWRETOoO30SNALL
Joe 11MM 140 OSLIGAWN OR LIABILITY Or ANY KIND UPON THE IOURER,IT8 AGENT'S OR
8 ATaushon Road . - "
Sagmore Beach VA 02562 REPRE$CNTATVES
AUTHOWPSEPRIUMmm
ACbRG 25(2001I0S) @400RD CORPORATION 9688
.. f
i
°f,we Town of Barnstable
Regulatory Services
Thomas F.Geiler,Director
MBS. $ ,
Building Division.
Tom Perry, Building Commissioner
200 Main Street, Flymmis,MA b2601
www.town.barnstable.ma.us
office: 508-862-403 8 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Scction.
If Using A Builder
I, I"�Aek C h;Gk ,as Owner of the subject property
hereby authorize bo c k to act on my behalf,
in all matters relative to work authorized by this building permit application for.
• n J
ff`to Ty4,' �0 �k e �•.� -ylrii5 nor,4
(Address of Job)
L/� (O 24 06
Signature of Owner Date
Ckk-
Print Name
Q:FORMS:OwNERP.MESSION
4
r4 ` HYANNIS FIRE DEPARTMENT
Harold S. Brunelle, Chief
FIRE PREVENTION OFFICE
School Rd. Ext., Hyannis, MA 02601
(508) 775-1300
p 56
BUILDING CODE COMPLIANCE FORM
Plans dated or the property located at 0 A6 V`(W�'JOO O 943
also known as �.`c`�i'r��=� q"f-�qjJG .H have been reviewed by
of the Hyannis Fire Department.
THE CHART BELOW INDICATES THE STATUS OF THE REVIEW:
TYPE OF CONSTRUCTION DOCUMENT N/A RECEIVED REVIEWED ' COMPLIES
1. Narrative Report
2. Firefighting & Rescue Access
3. Hydrant Location &Water Supply
4. Sprinkler Systems c
5. Sprinkler Control Equipment ✓
6. Standpipe Systems
7. Standpipe Valve Locations z/
8. Fire Department Connection
9. Fire Protective Signaling System
10. F.P.S.S. &Annunciator Location
11. Smoke Control/Exhaust
12. Smoke Control Equipment Location L✓
13. Life Safety System Features
14. Fire Extinguishing Systems
15. F.E.S. Control Equipment Location a/
16. Fire Protection Rooms
17. Fire Protection.Equipment Signage
18. Alarm Transmission Method
19. Sequence of Operation Report
20. Acceptance Testing Criteria
t4__We believe this document to be complete and compliant for the issuance of a building permit.
❑ We have completed the acceptance testing for the occupancy permit and believe that within the
scope of the bull r , the ove issues are in compliance.
Signature of- i O icial Date
From-(508)644-2447 To,Mr.Aaron Somsleln Dale-8/3/2008 T1me-12-05,30 PM Page 2 of 2
piping systems inc:
32 Mill Street(Rt, 79)
P.O.Box 409
Assonet,MA 02702
TEL:508/644-2221 P FAx:508/644-2447
FMAM psi®piping-systems-inc.com
wFesnr www.piping-systems-inc.com
August 3, 2006
Mr. Aaron Bornstein l
1 � o l(zo 13 2
Holly Management&Supply Corp. 17)297 North Street `
f HYANNIS, MA 02601 �
Dear Mr. Bornstein:
Thank you for selecting Piping Systems, Inc to handle your fire protection needs. The following
agreement lays out the terms and conditions for this order. Please keep a copy for your records
and return a signed copy to me via fax.
Your order consists of Employing Fire Protection Services as the Registered Professional Fire
Protection Engineer to design the retail tenant space at 1140 Ivanough Road, Hyannis to be
known as A.J. Marks Jewelry Store. The scope of work consists of additional pendant coverage
of approximately 2500 sq.ft. of retail tenant space as required to accommodate drop ceiling,
wall configuration and soffit layout.
Architectural drawings submitted by Cornerstone Builders have been forwarded to the engineer,
and design is currently being worked on. Upon completion of the fire protection system design
a copy of the stamped drawing(s)will be forwarded to yourself and the local AHJ, Lt. Hubler,
CFI of the Hyannis Fire Department for official submission and request for permit.
Sincerely,
Mr. Tom Boissoneau
Project Manager
Piping Systems, Inc
ACCEPTED AND AGREED
by: date:
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