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0366 MAIN STREET (HYANNIS) - SEASIDE GALLERY
`S�rgs:d� �o`l��-7-i c�n�s 9 Town of Barnstable Building rnsst�ra Poste t This Card So That it is Visible from the Street-Approved Plans Must be,Retained on Job"and this Card Must be Kept °1 Ass Posted Until Final Inspection Has Been Made. .= Permit s65q- � 'Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspectionhas been made Permit No. B-19-1091 Applicant Name: Approvals Date Issued: 04/03/2019 Current Use: Structure Permit Type: Building-Sign Expiration Date: 10/03/2019 Foundation: Location: 366 MAIN STREET(HYANNIS), HYANNIS Map/Lot 327-002 Zoning District: HVB Sheathing: Owner on Record: GEORGE,THOS N,ALICE M, CHRISTOPHER N Contractor Name:`,, Framing: 1 Address: P O BOX 30 _Contractor"License: 2 YARMOUTH PORT, MA 02675 - Est: Proj"e,ct Cost: $0.00 Chimney: Description: 1 New sign over two storefronts Permit Fee: $ 75.00 =Fee Paid:.'` $ 75.00 Insulation: 1) 30'Sq sign ! 4/3/2019 Final: Seaside Selections g Date: Project Review Req: ; � . Plumbing/Gas Rough Plumbing: Zoning Enforcement Officer . ., ... Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months"after,issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are"provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work:; Service: 1.Foundation or Footing ' 2.Sheathing Inspection r` Rough: 3.All Fireplaces must be inspected at the throat level before firest flue'lining is installed ` 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: 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. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Town of.Barnstable Building; Department Brian Flot•ence,CBO } Building Commissioner BARNTABLE v M^� 200 Main 3 !Street Hyannis MA 02601 ^° 11 "°� °��°' '.1534-201 plEu MA�a wwNvaoNvn.birnsNb)e.ma.us Office: 508=862-4038 Faa 50.8-790-6230 Sign Permit Application Zoning District Permit'# Historic District . Location by .310 AIRIN sT HVAAtA4l.T MA aU0/ Street address and village- Applicant 1eatAeria e MdMr4Aeclr7d<t<itt Ma & ParceK�'-- Telephone Number Yd Email ,07744 n 1�41 '-f zOD — , SGS•280 Z/Zz Sign #1. Sign #2 `.' C" Wall Wall CP Freestanding C� Freestanding 0 Electrified* Electrified CO Dimensions Sign #1 319 5 Dimensions Sign #2 Square feet. . Square feet Reface Existing Sign 0 New/Replace Sign Width of Building Face ! - ft.. X 10 _ X .10= 3% *Lighting Type ��ai - �,1 A wiring permit is required if sign is.electrified.. W A0 Signature f Ow er/A orized Agent Mailing address oFTHE raf, Town of Barnstable Building Department lAMSTAaLE, Brian Florence,CBO 9 MASS. 1639. .0 Building Commissioner ArF p rviot a g 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 5.08-790-6230 . SIGN PERMIT REQUIREMENTS 1. A photograph showing the existing facade,on which has been indicated the proposed sign location. The photograph is to include a portion of adjoining stores or building. For a proposed building or,new facade, an architect's elevation maybe submitted in lieu of a photograph. ,M .`s S 2. A scale drawing of the proposed sign. A scale draw in dicating: ndicating: 1:6 , 1). The type of proposed sign(wall, hanging, free standing) 2). Dimensions of the proposed sign and any desks, logs, or lettering 3 A cross-section with dimensions showin edge e 1. Minimum scale 1"= 1'.Minimum sheet size, 8.5 x P. ',A,sale draw&I of the bracket.A cbfore'&S"Cale=grapfuc indicating dimensions, showing colors, materials and metWd'of affik- g ifi- the sign and to the building. Minimum scale 1"= 1' Minimum sheet size, 8.5 x 1.1". 4. A completed Town of Barnstable Sign Application, including scaled diagram showing location of sign on building or location of free-standing sign. Show dimensions. 5. The width of the building face or the leased area. NOTE: the.map/parcel number is required on the application. signs/signrequ&app revised: 9/22/17 "r e • , Y a +1 s e y C q M IRS. „'" weed&:,:• btu,. BUILDING FACE = 31 ' SIGN 18 X 20' (30 SQ. FT. 6�0'e(�yu,/ /j DATE: Wednesday, February 27, 2019 CLIENT CONTACT: PHONE: FILENAME: APPROVED BY 103 ENTERPRISE RD., HYANNIS, MA 02601 - 508-815-3431 o •• . - .- e „ „ r 4� Vd fi g c t a R . m x 1 �+ ,M +, .".. ,. ,:-,x ��..a C - 43 ,..�^ � ,. �i W ,� R A.® a x - ¢3 c `��m •� .� �,;.�- .r a< �z ^ c .R '� f A ,¢�, � _• A`w '� � {# �'3- e, .'d)�, a z. ,8,.�' i_k _�. ,."`a �.. .. :. a •._ � �� ,y+ �9� �. ,+'�, � �a'��� �° - ..A !r�� � 4 Ulm jr) lzr g.T�l x A t' , x 14, a ff f.4 777 ., - ro� 77 h g �bAte ,.. - .. •L - Y', .p .A •• iN - �. ,a .' en A6 y --. -"n�,..""� ,. Wd',.r. � �,a3•$[' �:ts ,W. _ 4+ a b in R ry r. M,b�aA' ��� � ...� :. - � ,::`• ,.- -a.» � �` .r,m v m .m - �... � R 8y v .N, ..<, T^.v..� ",i "c m a„ m n. W eeei^11"' —max a� -:"t4�'+ �,"° � `y Wy M: :` ,` °' v��k�.a to ���rd a�+' � �� '��rr?✓ r..`a"` �. _. �.+„y'" ..r i . d �, ai .,� �s" 11e� .a,y 'fit ,"e"+fir t �'� •,�' + .� �1 af�T y � a'^' ��-� at i � '+qb J tick• ' . W +.. u m •. �R`�.A�. a -' ' o� Hyannis Main Street Waterfront Historic District Commission 200 Main Street �. BABNSTABLE• : Hyannis,Massachusetts 02601 e�"• ��? MAC Phone: 508-862-4665 / Fax: 508-862-4784 •.,• O,� i63q. �Fo a www.town.bamstable.ma.us/hyannismainstreet Cheryl Powell Karen Herrand,Principal Assistant ACKNOWLEDGMENT OF TWENTY DAY APPEAL PERIOD Required by Section 112-33 of the Hyannis Main Street Waterfront Historic District Ordinance 15 600#1A MACH AS ("Applicant"), acknowledge that the Certificate granted by the Hyannis Main Street Waterfront Historic District Commission is subject to a twenty (20) day appeal period, pursuant to Section 112-33 of the Code of the Town of Barnstable. Within 20 calendar days after the date of issuance of a Certificate, any person(s) aggrieved by the determination of the Commission may appeal the decision to the Historic District Appeals Committee. The Appeals Committee, after an evaluation of all pertinent evidence, may uphold, overturn, or remand a determination of the Hyannis Main Street Waterfront Historic District Commission. Decisions of the Historic District Appeals Committee may be further appealed to Superior Court. Any subsequent permitting or licensure conducted in reliance of the Certificate granted by the Commission is contingent on the validity of said Certificate at the conclusion of any appeal. The Applicant shall be required to fully comply with any decision of the Historic District Appeals Committee or, upon remand, revised decision of the Hyannis Main Street Waterfront Historic District Commission. - Sin re: A5plicant Date Print Name 370 Amlw S7. HyI"NN/J MA LiZdai Address of Proposed Work q R eVt. 9ARMAZU6 Town of Barnstable Hyannis Main Street Waterfront Historic District Commission Application Certificate of Appropriateness for Signage Application is hereby made for the issuance of a Certificate of Appropriateness under MGL,Chapter 40C,The Historic Districts Act,for proposed signage as described below and on drawings or photographs accompanying this application. CHECK ALL THAT APPLY: 1. Business Sign ✓ 2. Open/Closed Sign 3. Trade Flag 4. Trade Figure or Symbol 5. Location Hardship Sign Assessor's Map No. Parcel No. Address of Proposed Work 3V MA/N ST, NVANN/S Applicant _ _IYEAr&AF4 1??,g QfMAS Tel# 509,290•Z/Z? Applicant Mailing Address _370 1VIj1/V S'T. hyqwN/S Town/State/Zip H y'WIV IS MA 02J0/ Applicant E-Mail Address sMachera s jmgid •CO 'T Property Owner :770M &,Edg&C Tel# �Qft 362•690G o. 502•310•;01/ Owner Mailing Address P.O. BOX -go Town/State/Zip 7yA,rlm�lirti PO,�rr M.t1 026 9`5 Agent or Contractor 9&&PE,&1S[.4/V,D Sl6-/►/S Tel# Mailing Address /d3 Agyr, W se RD. Town/State/Zip #VAS w/V/AM 0260/ Agent E-Mail Address ._/ ?d acuDesiAr�s.cor» Signature of Applicant Date 3l/hay APPROVED ❑ For Location Hardship Signs&freestanding Trade Figures or Symbols to be located on private property, Check box if property owner has granted permission to locate Sign or Figure on their property abutting the building front. TOWN OF DARNSTASLE HYANNIS MAIM ST WATER=RONT YlS.ORIC D;STFSCT CC" e f } Business Sign 1: Size of Sign /�•, x 20 , Material(s)of Sign 61a#e. back Dlbohd a/tiry,/n tir» Material of Lettering(if different) _2Z k go/d l�a►f eylr vinv/ i Will the sign be illuminated? (a No If yes,what type of light fixture h&ak ame Location of Fixtureol- �hr ry h ne.e-* /i9ht Business Sign 2 : Size of Sign x Material(s)of Sign Material of Lettering(if different) Will the sign be illuminated? Yes/No If yes,what type of light fixture Location of Fixture Open/Closed Size of Open/Closed Sign x Sign: Material of Open/Closed Sign: If Neon,indicate color(circle one option): Red/Red&Blue Color of Open/Closed Sign: Trade Flag: Size of Trade Flag: x Material of Trade Flag: I Trade Figure Dimension of Trade Figure or Symbol: x x Or Symbol: Material of Trade Figure or Symbol: Location Size of Hardship Sign: x Hardship Sign: Material of Hardship Sign: APP ' Lettering Color and Material: TOWN OF BA?INST, HYANNIS N114::v Sl n/F"r -73ONT HISTORIC Page 2 of 2 • s _ Home m # 777� ............. .......... 0 z 8 Fn r c mi m m_. �ai �0m BUILDING FACE = 31 ' SIGN 18" X 20' (30 SQ. FT.) DATE: Wednesday, February 27, 2019 CLIENT CONTACT: PHONE: FILENAME: APPROVED BY: 103 ENTERPRISE RD., HYANNIS, MA 02601 :• ••o• e1-50 SIR 1;11wiplq • •- 508-815-3431 •• • . • o• •• • o 4 iOVED TOWN OF BARNS TABLE HYANNIS MAIN ST WATEnFRONT HiSTOR C DIS*rFuCT COMMISS;v'i TOWN OF BARNSTABLE SIGN PERMIT j PARCEL ID 327, 002 GEOBASE ID 24117 ADDRESS 368 MAIN STREET (HYANNIS PHONE HYANNIS ZIP - LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 39143 DESCRIPTION SEASIDE COLLECTIONS 9' X 16" PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $25.00 BOND $.04 CONSTRUCTION COSTS $.00 E 753 MISC. NOT CODED ELSEWHERE 1 PRIVATE P:'C*1 BLF. MASS. 039. A� FD MI`►1 B ILDI G DIV ' IO Bl�G ��' - DATE ISSUED 08/i57/1999._ - .- -EXPIRATION-DATE - -v - - - - r UPDATE PERMIT RECORDS : ADD CHANGE DELETE PRINT FEES HELP END ADD RECORDS TO PERMIT TABLE 0 PENTAMATION----------------------------------------------------------- 06/02/99 PERMIT NO. 38811 PARCEL ID 344 009 436 YARMOUTH ROAD PERMIT TYPE BSIGN SIGN PERMIT DESCRIPTION BIFF' S AUTO REPAIRS (18 SQ FT) STATUS Q APPROVED APPLICATION DATE 06/02/1999 DATE ISSUED 06/02/1999 EXPIRATION DATE DATE COMPLETED MASTER PERMIT VARIANCE VALUATION 0 . 00 BOND 0 . 00 CONSTRUCTION TYPE 753 GROUP TYPE CONTRACTORS ARCHITECTS/ ENGINEERS/OTHERS ENTER Y IF ALL ARE CORRECT OR N TO REENTER Building Division 367 Main Street,Hyannis MA 02601 l Office: 508-862-4038 Fax: 508-790-6230 Ralph Crossen ` Building Commissioner Tax Collecto Treas (40 5 Application for Sign Permit Applicant_��,�I7s�/.�it2 )LI(Pq _Assessors Doing Business As: Telephone NoZZZ__ /4 3 9' Sign Location Street/Road: � ,VAY4A/W S Zoning District Old Kings Highway? Ye .o Hyannis Historic District? Yes/No Property Owner ) � � Name:_-- r Telephone: 7;z 2 / 9 Address:e�'0 C" iOc&. g P® g 7- _ Village: 11,&AW.i s 8...�--51 Sign Contractor Name:___ Lfo s4 l�r' 4 Telephone:So 0/- �q Address:A2�? lli�9/A/C��•✓�r.� �2, l7/ Village:&69 I SO le C7'_ Description .Please draw a diagnim,of lot showing location of buildings and existing signs with dimensions, location and size of die new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Ye�No j (Note:If'yes, a wiring permit iu required) I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinance. Signatuue of Owner/Authorized Ageo L D 9� to Y Size: l X ermit Fee: o?�—,oU Sign Permit was approved: Disapproved: Signature of Building Official Date: /,a Slgni.dw reVA61198 r Hyannis Main Street Waterfront Historic District Commission. rrrra k)- z�a sow stet trunkmUmcw2ft 0ml TEL: 50&M-4 0 / FAX S08-7 "2118 air to � H"Mis Main Sired waft&O t ffi toric District Coz issio hi the Town of BwnstWM fora r d y CERTIFICATE OF APPROPRIATENESS Applimticn Is.hereby made, In boftft for the ieauance of a Cerfflkab of Approprkdeness under M.G. L. Chapter 40C. The Moto&Dbblds Ad for p q=W work=dmsnW below and an plans, d mwinp or OwWgmphe In9 thin applksadon for PLEASE CHECK ALL CATEGORIES THAT APPLY: 1. Exterior BuRding Caostrwdon: p New Brn'iding © Additiaa p Albxatian Ir ate qp of WHOW CJ H00w O Gww ® Commoew p Odw 2. Eiftriar Paine :� � Naw� � sip � 'a p wp mp � S. Pa idag Lot p New Bnfl ft p Adder p Abmdon (Please see die O&H=for a glanadon and sequiremeY&O, ) TYPE OR PRINT LEGIBLY DATE r �Th/ ADDRESS OF PROPOSED WO J✓ ; ASSESSORS MAP NO. 7 OWNEIt: Ar. .i+1�/�itl�A_�' ASSESSORS LOT NO. HOME ADDRESS/ �'.�e C&xg Ae f�O__ 11 TEL.NO. FULL NAMES AND ADDRESSES'OF ABUT MNG OWNERS.Include==of a t property (Attach additional sheet if naoessaay). owam acw"any PQ�9islveet arway. . •. 4 a 5 AGENT OR CONTRACTOR TEL.NO. ADDRESS A ' •' 'fit l DETARM DESCR>p'1TON OF PROPOSED WORK: ' Give an pff cnlars of wort to"be done, including delaiied data on such architectural tbaum as: Mon,chWmy,siding,roaEng,roof pit*sash and doors,window and door Sraetses,wh%guttors- hadeta,rooting ad paint ooW,including momnala to be used,if specie do not accompany plan& b dta ease of give bons of aausting signs and proposed boatim of new signs. (Attach aei clonal dwK if necossary� 06 &OA 6 M4—e0 6.- (iA1 'IVa4-v y 6z-1�� G -ns R s' Owner v contra-Agent R17 ED Sam>er ►tie cannerJis4ien use. MAR 2 9 "'qq9 Recaeiwed by HMSMMDC Y p a c HISTORIC PRESERVATION DN Dace Time By Tito cwdncw is hereby: A��� j > l moved a DW ' r y . IIMRTANT:>f Certificate is approved,approval is subject to tl►e 20 day appeal period provided in the Ordinance. SPECIFICATION SHEET FOR SIGNAGE BE SURE THAT YOU HAVE INCLUDED WITH YOUR APPLICATION: a a full-scale drawing of the .proposed signw • color chips for all colors on your sign • a full-scale drawing (or photo) of the building which shows where the sign will hang g PIease fill out all information requested below. If you are applying for a Certificate of Appropriateness for more than one sign, please fill out ONE SPECIFICATION SHEET FOR EACH SIGN. Size of Sign X !� Shape of Sign x t Material of Sign Material of Lettering PI Type of Sign (carved wood,painted wood, vinyl, etc.)__ L✓r9ob Additional Detail (molding around the edge,cut-outs, etc.) 4Si�zL P-0 VA", LCAl4 Location In Which the Sign Will Hang Will the Sign Be Lit?-- p If So, How?-- - - {+'v � I v � � I� � � i M4H0 C7 air y $a7sE -Apt CARv4-0 ACC 7-7,6,Q 5c tLo �i /Crn/ W/,C/ /3 /A Ch(ti`� m w/T- s cat-ws A?ivp 3nI.r d-0 oAoO' ti ox 2- 1 mappars-for-labels tj z ----- ----..----- - --- -- -------- -- citystate zip ma ar ownerl owner2 addr 326021 BARNSTABLE,TOWN OF(MU 367 MAIN STREET HYANNIS MA 02601 _ 327001 i GAROUFES, KALLIOPE G TR / JOAKIM,N J,&DOYLE,DTR 67 LONG POND CIRCLE CENTERVILLE MA 02632 32700211, GEORGE,THOMAS N&ALIC TR 17 THACHER SHORE RD YARMOUTHPORT MA_02675 327003 FIELD,JANET B PO BOX 81 OSTERVILLE MA-02655 ------ -----AAjaR '` t$ BARREIRO REALTY TRUST P O BOX 2417 HYANNIS _MA 02601 — 1. ----- ----- --- --- P O BOX 2126 HYANNIS MA— 02601 - --� � ---- POST OFFICE ---- HYANNIS — -- MA _02601 -- - -- - - ERIC.A� - _ --- ---- 3 _ M — - NNIS 02148 118 MAIN ST MALDEN MA 327115� DINANNO,JOSEPH A -- -- -- -------- MA 02601 327271 i BARNSTABLE,TOWN OF(MUN) / 367 MAIN STREET HYANNIS ,w I 6 y } t i� 4� f • �t ' S T \ y4 f j' Page 1 -,; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ZParcel (/� Permit# Health Division -V=3 7.a T Q�Cj 7, T014191 OF BARNSTABLE Date Issued Z s 0-7 Consery ivision [ 0111 FEB —3 AM 1(; 15 Application Fee Tax Collector 1 Permit Feesb Treasurer �_� ,I iSfOi'd— G /5 c?3 Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 366 Y miet` ,, SA7 Village _f�af-wk S5 Owner CYN 1-A-fLK Cd r-655 Address l 0 Cz� 02 _ A1c+4r 4(T f. yf iWO Telephone 6/z Z. Permit Request _ ���(! `1"-1/o(ye- � �i e.7�S� f in Square feet: 1 st floor: existing/ ' O proposed 2nd floor: existing proposed Total new ~ T Zoning District Flood Plain Groundwater Overlay Project Valuation L, 0 60 Construction Type Q�l% Cthh� 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 Wlo On Old King's Highway: ❑Yes ❑ No Basement Type: g411111 ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 2-00 Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing_ new l� Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: was ❑Oil ❑ Electric ❑Other Central Air: L11e-s" ❑ 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 � iSlaf Proposed Use < J BUILDER INFORMATION Name < �y Telephone Number 62 - `7 Address Gf` 5 l- License# 0- 055 Home Improvement Contractor# b1 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOo�«� SIGNATURE DATE 2, FOR OFFICIAL USE ONLY o. PERMIT NO. DATE ISSUED - MAP/PARCEL NO. - - G k - ADDRESS VILLAGE OWNER DATE OF INSPECTION: , FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 4 PLUMBING: ROUGH FINAL _ f GAS: ROUGH FINAL FINAL BUILDING X DATE CLOSED OUT ASSOCIATION PLAN NO. i �i•%�f=��%��i{�s�W lvurlv/�o0///O//%//!/����������/�G7//�/.2.//!%/% ;%%3: .%'�i��f'%i��������������������� %//� ��� i 1 f / rt (= __ri�� vim!/>11���1�1I���i+�al•r— � ��.-�� ���� L!WA 1„• �r�rirri �r . 11 1•I11_.• .-••111.111 ._ •••1•. 11 //////////////////////////////////////////ii//////////////////////////////////ii/i////////////%//////iiii/zz%/'/ii�oi/rri!/i ■ n 1 ..nu • •1 • •ul ••. ..•-. ...... �:n •n 1n n ..uu - n1.•11 n •. El bi /////-----//////////------ J :111 •1 •11•.+1.1 • JI 11111 IIU •1 . 1 I _1 1 111 1 .U111.: •Iw - • 1 1 . ;m. • a 1. y�jr> " ;^ y�£, A.wct>,a �A`t�,w��. `' x(y`.wM.r✓ � ,•� 9ao+oxi �� x ',( J `f2 raN`f J<a.f x` "Vr x � �S Jaw•D3-^��•"I.,eo>?{I .v' d yV S.`^`fe•S�"Pf.^'+j.. sY .:J .:4 £<• ,,,apJ�<+YtM IC Y,W. �'l�d1Q�'J'Y. .,. v �? �<<ao<YnF.Ca:,L<C•nLi.Y •a d�LY 4 / �fq l 1!l�..�'a'.-s - ",� f£a r <`x<k r• :tea .a ?ra .. . <c`'� .y�a> .�5%r, -a a•^�. „"„f o.e,�'..:.ar�aa2'cra ���,'.. .^'^a' . 1 C. r H ♦ - - I I I I 1•I �MA V "NO 1• - city or toww C3chcckffimntedL&te response is required r� Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for tLz employees. As quoted from the"law", an employee is defined as every person in the service of another under nay cam- of hire, e:cpress or implied, oral or written. An employer is defined as an individual.partnership, association, corporation or other legal eatit�', or any two or more of the'foregoing engaged is a joint enterprise. and including the Iegal representatives of a deceased employer, or the rec.:ti e: or trustee of as individual, partnership, association or other legal e=tq, employing employees. However the owner of a dwelling house having not more than three aparancatc and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, fiction.or repair work on such dwelling house or on the mounds c. • 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 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. AdditionaUY,ncuherthe commonwealth nor any of its political subdivisions shall enter is o any contract forthe performance of public work until acceptable evidence of compliance with'the f*=mn=reg ofthis chapter have beer presented to the=rua" a authority. - Applicants Please fill in: the workers' compensation affidavit completely,by cbeclangthe.baxthat applies to your dM#m and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits maybe submitted to the Department of Industrial Accidents for wMIM alien ofiasm==coverage. Also be sere to sign and !: date the affidavit The affidavit should be returned to the city ortowathattba application for the permit or ii=e Ss being requested,not the Departmea#of Industrial Accidents. SbeuId yaa have any questions regarding the"law"or if you are required to obtain a workers' cc®peasatiaa policy,please call the 1]eparmoe atthe amber listed below• City or Towns Please be sure tbat the affidavit is complete and printed legibly. 'Ihe Departm. has provided a space at the bottom of th-' affidavit for you to fill out in the event the Office of Invcstigad nrrhas to camtact you regarding the applicant- Please be sure to�0 in the Pciii Iicaase number which wM be used as a refers nj:i num The e affidavits may be retarnec to the Department by mail or FAX unless other arrangemc=have bees made. The Office of Investigations would Iike to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. MIMI The Deparaaent's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents amce of lavesduadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 °p'THE,°� Town of Barnstable NP Regulatory Services saaxsUBLE. ` Thomas F.Geiler,Director 1639.9 MA.4.S. g �pleD MA'S Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-403 8 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. LwAnd. T e of Work: —il Estimated Cost q Aw Address of Work: HPOwner's Name: Date of Application: f � I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 []Building not owner-occupied 'Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR ¢ > s Date Owner's Name 8. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �� TOWN OF 0,��,tPer�mit# Health Division 7 -1 � "^ ��e�r� Date Issued A be Conservation Division 20103 FEB -3 AAp�lic IA Fee Tax Collector Permit Fee Treasurer _CIVISSOR Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Stree Address � 39 f 4 w s r Village i� Owner AtI/4 Address A/4% S. Telephone Permit Request } Square feet: 1 st floor: existing D proposed_S c?-2nd floor: existi_ ased- Total ew Zoning District U Flood Plain Groundwater Overlay Project Valuation �d _Construction Type Cs 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: null ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 2X ,0 e Number of Baths: Full: existing new Half: existing 3 new Number of Bedrooms: existin new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Oil ❑Electric ❑Other Central Air: es ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:El existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial e�'Y s ❑No If yes,site plan review# Current Use 6697W,14MIT Proposed Use ✓ i C a �J GO BUILDER INFORMATION Name Number Tele hone a _� r �z C Address 0 C�� 7 License# 07C)o `er. L� MET Home Improvement Contractor# 75_0 Worker's Compensation# / ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 6a1,96Ud_' C �t/QlGC., SIGNATUR F - FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. I f s ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL , GAS: ROUGH FINAL FINAL BUILDING I - DATE CLOSED OUT ASSOCIATION PLAN NO. r r ` � a ' J r