Loading...
HomeMy WebLinkAbout0425 IYANNOUGH ROAD/RTE 28 (12) y�s�y��,�o ��ti �� �, Town of Barnstable Building Department - 200 Main Street JIM MSTABLE, * Hyannis, MA 02601 9 MASS. (508) i6 862-4038 39' RFD MA't s Certificate of Occupancy Application Number:, 200905919 CO Number: . 20092367 . Parcel ID: 328070 CO Issue Date: 12103/09 Location: 425 IYANNOUGH ROADIRTE 28 Zoning Classification: HYANNIS GATEWAY DISTRICT Proposed Use: SHOPPING CENTER - MALL Village: HYANNIS Gen Contractor: PROPERTY OWNER Permit Type: PCCO PRECODE CERT OF OCCUPANCY Comments: Building Department Signature Date Signed TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel` ' :Application Health Division Date Issued Conservation Division F Application F Planning Dept. ; Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address '4 Z S `^ R� Villaget -^-`^� 5 Owner P �'i 4- -v�t -'r v� �' Address 2 a' �44e,.r- - S4. 6 4zy 7_ayt MA Telephone ] �S 7- �03 �LDCG! D� ��' Te-ek Gi/liS- 28n-VYrr Permit Request �fJM) 7� -- -jig Square feet: 1 st floor: existing 107 proposed 1071,42L floor: existing proposed Total new Zoning District G Flood Plain Groundwater Overlay Gt Project Valuation Construction Type Lot Size _ 13 is cy-e s 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 ��# PVm 7 Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other - a C> z� Basement Finished Area (sq.ft.) Basement Unfinished Area-(sq.ft) Number of Baths: Full: existing c2- new Half: existing "= .,,,new Number of Bedrooms: existing _new cn -a Total Room Count (not including baths): existing new First Floor Room Count V i-n Heat Type and Fuel: QdGas ❑ Oil ❑ Electric ❑ Other Central Air: d 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 A Yes ❑ No If yes, site plan review # Current Use�a< "• J�� fz_� t Proposed Use t - s lOe S cce sso yres APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1�� � Telephone Number do Z� Or 9 9,3 Address 9210 9+-b t License# yarmsx4LP2!�tHome Improvement Contractor#. Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE C6) �� / + FOR OFFICIAL USE ONLY i APRLICATION# ATE ISSUED � MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: i FOUNDATION FRAME s INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ` k r,i PLUMBING: ROUGH FINAL GAS: ROUGH FINAL. FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. t The Commonwealth of Massachusetts �1 / Department of Industrial Accidents � w Office of Investigations• 600 Washington Street Bos(on, MA 02111 ,;•�`. www.tnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl Na usiness/Org izti n/Individual): — 1 Address: " ran ►-\ � City/State/Zip: {i'�/r+�n�` S Phone.#: S�� 6 O ^Q�� Are you an employer? heck the appropriate bog: Type of project(required): 4. I am a general contractor and I 1.❑ I am a employer with � 6. ❑ New construction employees (full and/or part-tim.e).* have hired the sub-contractors 2. 1 am a•sole proprietor or partder-' listed on the attached sheet. T. O Remodeling ship and have no employees These sub-contractors have g, Q Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers'•comp. insurance comp. insurance.$ required.] S. We are a corporation and its '10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.(]Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.�]Roof repairs insurance required_] t G. 152, §1(4),.and we have no employees. [No workers' 13.❑ Other comp. insurance required-] *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy infomiation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. XContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is pro viding workers"Comp ensation insurancefor my employees. Below is the policy andjob site inforncation. 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 crimifi4l penalties of a fine tip to $1,500,00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the for insurance coverage verification. I do here rt' ender e pains and petr.altie ofperju that die inforrnation provided above is true d correct. Si tur . Dater Pk�4. Official use only. Do not write in this area, to be completed by city or town official 'City or Town: Pern-it/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.EIectrical Inspector S. Plumbing Inspector 6. Other 0nnfhrf_Pnrcnn- Phone #: __ r I formation and Instructions R Massachusetts General Laws chapter IS2 requires all employers to provide workers' compensatiou.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 tiustee 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 of on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that"every state or local Licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable.evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §2SC(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 Rrith 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-contractor(s)name(s), address(es)and phone number(s) along with their certificates) of insurance. Limited Liability Companies.(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have empjoyees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Offzcials 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 Sile 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 fo any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to-thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone-and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Iuvestigatious 600 Washington Street Boston, MA 02111 Tat. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mas.-.gov/dia 12/01/2009 13:26 FAX 6173507791 JPA Corp U 001 HMEr Towiv of Rar>jsfable ` Regulatory Services. vWASS.� �; Thavitas F. G6iler,Director 'Teor�t" Building Division Tom Perry,Buiidingr Commissioner 20D Main Street,Hyannis,MA 02601 rs�wt.toe�n.b arnstab le.rna.us Office: 5 08-862-403 8 Fax: 50 8•-790-62 Propel tyOv nie-rMUSt Complete and Sign 'This Section. If Using A.B-uildei �I, p����2� aU/ a S VS (" , as Owner of the subject.pmpeay hereby authorize: �LAO-Ja 9trdDO A e _to act on my behalf, is all rmuers relative to work attthotized bytb.is building permit appkadonfor. ��5- �#10' P s (Address of Job Dee 2,,007 ���,Q�CKm e1 �(�►ec� P Date CIT W 7-4 2 p�L C�3 $`� Print Name If Property Owner is applying fox pema#please complete.the Homeowners License Exemption Form on the reven,e side.