Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0420 MAIN STREET (HYANNIS) (7)
die L Sa t 61 aid! ♦ wf arm a mot•' � P° s r K; 1 t .1 - o _ .s 't1 r — r ��� .,T# '�'S- .—..fie�'wc 4 ••�.r y,7.. '�<'^"�C e�sa � `r" -��� ' :r# �ca�..�'.�.,;• �'`'.ate® �.. �..y'.. a _�� .C► ", w "��r�" of ,m +� �.'�� , aar a� `., ,��. G �.o ebb r �� g �^~'� Q-•rt T d�" '' '� + •, � e r ° tea- �;a ' �a�® .� `®•' r ,f. F At ¢ a di r r. J V NOISIA1O 60 :IRd 4 �Q�1SU�V� �0 Nf�pl TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Appligation #� � S Health Division Daterlsed -711 Conservation Division Pp A licat oAY Planning Dept. Permit Fee - Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village Owner - l� C' Z k6Address � 't Telephone / Permit Request 41`0%N Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay D Project Valuation U�� 'f Construction Type Qe 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 R t� Total Room Count (not including baths): existing new First Floor Room-Count ' Heat Type and Fuel: as ❑ Oil ❑ Electric ❑ Other Central Air. Yes ❑ No Fireplaces: Existing New Existing wood/coal stoNe: ❑ `es ❑ 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 es ❑ No If yes, site plan review# / , / pCurrent Use 5�1/1� n L0401 �h Proposed Use <��� G APPLICANT INFORMATION - _- 6716�4tr� (BUILDER OR HOMEOWNER) Name G' 1 Y� �� S Telephone Number Address 90ev sGvdlo Low a-C.,L License # 422V//3 �ml q 1 5 Vh0 �� ��(1 Home Improvement Contractor# A Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Zajw;( �_ �eflizp SIGNATURE DATE � 7 v,O S FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED ..MAP/PARCEL NO. „ ADDRESS VILLAGE ` OWNER w I DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ` PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. i SAMPLE EQUIPMENT LIST ITEM NO QUANT. LIST OF EQUIPMENT DESCRIPTION & MODEL NO 1 wee �C (J�UP dm 0,,Ied 1 g7 54lu 0�Lj IM, - -27- y a � a i ! t z , �y tit' s.$t 2.�.��-`s R.,a t✓' 1> � { # t t' t r Ole u'v y 4o pp 3 A. f IV 1 1 A.0 f . •'a • iJ Massachusetts Department of Environmental Protection Bureau of/�Waste Prevention •Air Quality. BWP AQ 06 Asbestos Project Number Notification Prior to Construction or Demolition A. Applicability Important: When filling out forms on A Construction or Demolition operation of an industrial,commercial,or institutional building, or residential the computer, building with 20 or more units is regulated by the Department of Environmental Protection(MassDEP), Bureau use only the of Waste Prevention-Air Quality Division, under Regulations 310 CMR 7.09. Notification of Construction or tab key to Demolition operations is required under 310 CMR 7.09 2 ten 10 days prior to an work being move your p 4 ( ) ( ) Y p y g performed.The cursor-do not following information is required pursuant.to 310 CMR 7.09. use the return key. Is this a fee-exempt notification(city,town,district,municipal housing authority,state facility,owner-occupied residential property of four units or less)? ❑ Yes ® No Type of Notification: ream ® Project Revision ❑ Project Cancellation Instructions: 1.All sections of B. General Project Description this form must be completed in order to comply 1. Facility Information: with the Department of little sandwich shop 428 main street Environmental Protection Name of Facility Street Address notification hyannis ma 02601 1-617-800-6409 requirements of Cityfrown State Zip Code Telephone 310 CMR 7.09 dean walton owner/operator 2.Submit Facility Contact Person Contact Person Title Original Form To: 1-617-800-6409 Commonwealth Facility Contact Person Telephone Facility Contact Person Email of Massachusetts P.O.Box4062 Facility Size: Boston,MA 02211 1800 1 Square Feet Number of Floors Was the facility built prior to 1980? ® Yes ❑ No Describe the current or prior use of the facility: Catholic novelty/card retail store r Is the,facility a residential facility? ❑ Yes 0 No If yes, how many units? 1 Number 2. Facility Owner: david dumont 428 main st Facility.Owner Name Address ;hyannis ma 02601 1-508-400-4200 Cityffown State ZIP Code Telephone dean walton 428 main st On-Site Manager/Owner Representative Address hyannis ma 02601 1-617-800-6409 City/Town State ZIP Code Telephone 07114 BWP AQ 06•Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Waste Prevention •Air Quality BWP AQ 06 Notification Prior to Construction or Demolition B. General Project Description (continued) 3. General Contractor: richard j peckham/integrity home solutions 204 Scudder ave Name Address hyannis ma 02601 1-774-836-6654 City/Town State ZIP Code Telephone richard peckham 774-836-6654 General Contractor On-Site Manager/Foreman Telephone General C. General Construction or Demolition Description Statement: If asbestos is found during a 1. Construction or demolition contractor: Construction or Demolition richard peckham/integrity home solutions 204 Scudder ave operation,all Contractor Name Address responsible parties must hyannis MA 02601 774-836-6654 comply with 310 CMR 7.00,7.09, City/Town State ZIP Code Telephone 7:15,and RICHARD PECKHAM 774-836-6654 Chapter 21 of the Generrall Construction&Demolition On-Site Manager Telephone Laws of the 2 Licensed Contractor Supervisor: Commonwealth. P This would include,but RICHARD J j PECKHAM R CS-094193 would not be Supervisor Name License Number limited to,filing an asbestos 3. Is the entire facility to be demolished? ❑ Yes ® No removal notification with 4. Describe the area(s)to be demolished: the Department and/or a notice NONE of release/threat of release of a hazardous substance to the Department,if applicable. 5. If this is a construction project, describe the building(s)or addition(s)to be constructed: it's a open floor plan unit.has two bath rooms.we are building a few non load bearing walls to frame out a kitchen 6. If this is a demolition or renovation project, were the structure(s) ❑ Yes ❑ No surveyed for the presence of Asbestos-Containing Material (ACM)? 7. Was asbestos containing material (ACM) found? ❑ Yes ❑ No If yes, who conducted the survey? Name Department of Labor Standards Certification Number 07/14 BWP AQ 06•Page 2 of 3 Massachusetts Department of Environmental Protection ILI Bur0au of Waste Prevention .Air Quality BWP AQ 06 Notification Prior to Construction or Demolition C. General Construction or Demolition Description (continued) The Asbestos Abatement Notification Number for this address is: This project is: ❑ Construction ❑ Demolition Project Start Date(MM/DD/YYYY) Project End Date(MM/DD/YYYY) 8. For demolition and construction projects, indicate dust suppression techniques to be used ❑ Seeding ❑ Wetting ❑ Covering ❑ Paving ❑ Shrouding ❑ Other—Specify: 9. For Emergency Demolition Operations, who is the MassDEP official who evaluated the emergency? Name of MassDEP Official Title of MassDEP Official Date of Authorization(MM/DD/YYYY) MassDEP Waiver Number D. Certification "1 certify that I have personally examined the foregoing richard j peckham jr and am familiar with the information contained in this Print Name document and all attachments and that,based on my inquiry of those individuals immediately responsible for Authorized Signature obtaining the information, I believe that the information is true, accurate,and complete. I am aware that there owner/operator are significant penalties for submitting false PositionrTitie information, including possible fines and imprisonment. dean walton/dave dumont The undersigned hereby states, under the penalties of Representing perjury,that I am aware that this permit application or 08/11/2015 notification shall not be deemed valid unless payment Date(MM/DD/YYYY) of the applicable fee is made." 774-836-6654 P.E.# 07/14 BWP AQ 06•Page 3 of 3 J - ' r oFIIiE rti •sAsxsrasA '� ,�� Town of Barnstable �kb Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.towu.barnstable_ma.ns Office: 508-8 62-403 8 Fax: 508-790-623 0 Property Owner Must Complete and Sign This Section If Using A Builder 2z Owner af.the ssbject pzoperty hereby authorize 7`��C C,a'� ) k-�0v-c ,- f to act on my beh2X in all matters relative to work authorized by this building permit application for. (Address of Job) 7 Signature of Owner Date rL �C Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reYerse side. Q.MPFEES\FORMS\buiiIdingpccmitform M PRESS.doc " Revised 061313 ?Tie Commornveakh o,t -4 assaclti setts Depart newt of rndustrial Accidews - - Offire of1mvstigations. r" 600 Washington Street Boston 41A#2II1 wrvtu niass gvv/dia W rlmrs' Campensaf an Insurance Affidavit:BuilderSICantractarsJEI.ecfricianslPl hers APP Brant Inf6rmatian Please.print Le l Name(Busi�aniza4it} a nan i 50 u t Address: 0 �GuG�G�6r SUP f city{Stetef ,tft t� !� Phone Are you an employer. Chech.the appropriate box: Type of project(required): 1.❑ I am a employer With. 4 ❑I am a general contractor and T 6- ❑New construction. employee (full an&or part-time)-* lucre hired:the sub-contractors 2. I am a sole proprietor orpartner listed on.the attached sheet. 7., modeg These sob-contractors have ship and have no employees. . $_ ❑Demolition wad-ing for one in any capacity employees autihave 10fk1' [No arke ' comp.insur ce comp-insurance-1 9. Building addition �v- rs required—] 5_ ❑ We are a corporation and its 10❑Electoral repairs or additions 3.❑ I am a homeoumer doing all work of have emercised their 11 ❑Flumbingrepain or additions € o vworke�:s' �t of exemption per MGL' . �'� � - 13_❑Itoofrepairs i mgtx=e require d.j s c.152; §1(4)�and we have no employees.[No workers' 13-0 Other comp-insure m required.) *mayWHcsartdhatchecksboxRZ also fill out the sectionbelowshmaimgrheaweir'campevsaAcapoEcyin5maeiam. t Mmeawnemwha submit dais af5dnii iu&catimg they are daiag RU wak and themhhM au=decontmctoesnmzt submit anew affidavit indxxdm_-sucIh_ Z0onhactm thst ebeck ibis box must attached an addiliouat sheet slowing the narue of the sub-contructocs and state whether or not those eadtieshme employees.If the sdb-co axon shave employees;they=ntpmv-ide their warkew comp.policy number_ I ant art emp4wr that ifi pratzdirrg�varkers''canrperesativrt i�fsurarrca,�vr�r}*enzplay�ees Iteloov is die policy rued jalp sites informadort ' IusuranceQontpaMyN3me:, Po1lcy,or Self--ins.Luc.;k F wiration Date: Job&te A(klregs: CitplStateJ.tp: ', F A[#ach a copy of the workers-compensationpolicy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Secfibn 25A of MGL c 152 can lead to the imposition of criminal penalties of a fine up to$U-06 00 anitor one-year impfisomnent,as w811 as civil penalties in the form of a STOP WORK ORDER and a 1-Me of up to$250.00 a day against the-violator. Be advised&at a copy of this statement maybe forwarded to the Office Of invesE gations of$ie DIA for insurance coverage verificatiom I a&ergby c td •t d penal s of penury thattlte infonrzatavmrprin-t ,ed abmv is bug acid correct Signature: s Date: • Phone Ir t3�ial rarrty �Do nut svrete its fibs area,ter be c,7trspleted by t:itp r�rfpnm o,�jrcfat _ �",' :'< .. � �. . City or Town.: PernuitlI,icense# Issuing Auflrarity(ca der one): L Board of Health RuffTing Department 3.CR3Yrown Clerk 4.Electrical Inspector rr.Plumbing inspector 6.Other Contact Person: Phone#: lbnformation and Last`nctions MassachusetFs General Laws cbapt!a'152 rmpires all employers to provide worl�eas'ca�ensatian for-their employces. �this ,an�Iayee is defined as."_.every Person in the se$vice of another under any Contract ofhae, p express or implied,oral ar written.-" .An Moyer is defined as"an md"xvidaal,partnership,association,corporaion or other legal entity,at awry two ar more of the foregoing engaged m a joint entexprise,and including the legal representatives of a deceased employer,or the receiver or tnstee of a a individual,partnership,association or other legal entity,employing employees- However the owner of a.dweelling house having not more than three apartments and who resides therein,or the occupant of the - dweIling house of another who employs persons to do mamtcuace,contraction or repair work on such dwTeIlmg house or on the grounds or building agpurten zat thereto shall not becanse of sash employment be dcemed 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 iu 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 airy of its political subdivisions shall eutnr min any contract for the performance ofpublic work until acceptable evidence of compliance with the in soraace. reT=eMents of this chapter have been preseniad to the contracting author" Applicants Please full out tTse wo&ers'compensation affidavit completely,by rlmerTm,oa he boxes that apply to your sitnad n and,if necessary,supply sub-contractor(s)name(s), address(es)and phone numbers) along with they certficate(s)of incrnance_ Limited Liabilky Cam panics(LLC)or Limited Liabi-ityPerfnerships.(LLP)with no employees other than the members or partners,are not rbqufi-ed to carry woikers' compensation insarmce. If an LLC or LLP does have employees,a policy is regnhcd. Be advised that this affidayitmaybe submitfnd to the Department of Industrial Accidents for conffimation of ins arance coverage. Also be sure to sign and date+he affidavit The affidavit should be returned to ffie city or town that the application for the permit or license is being reques A not the Depmtnenf of Tn USftWj Accidents. Shouldyou have any questions regarding the law or ifyou are required to obtain a workers' compensation policy,Please call the Department at the number listnd below. Self-i mu,--d companies should enter thew self-m crrran ce license number an tie appropriafm at. City or Town Officials t - Please be sore that the affidavit is complete and printed.legibly. The Department has provided a space at.the bottom of the affidavit for you to fM out in the event the office of Investigations has to contact you.reg�the applicant Please be sure to fill in the penDitllicense ninnber which will be used as a reference number. In addition,an applicant that must submit mu bl ple pennitJIicense applications in any given year,need only submit one affidavit indicating cmurreat policy information Cif necessary)and under"lob Site Address"tie applicant should w "all locations in (cry or. town)-"A copy of the-affidavit that has been officially stamped or ma>$ed by the city or town may be,provided to the applicant as prooft3mat a valid affidavit is on fife for Errand permits or licenses. A new affidavit must be filled oirt each year.Where a home owner or citizen is obtaining a license or permit not ielated to any business or commercial venture (Le_ a dog license or permit to bum leaves etc.)said person is NOT req�ed to complete this affidavit The Office of Investigations would lake to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call tn1 hone and fax number. The Ilepam-lnment's address, ep - T e C�Dmm:�MWatth of Mamachusf S Departmmt of Iuditstial Ac cZents Bostmn,MA 02111 Tf,-L 4 617' 7-4900'ext 406 or 1-M-M GAFF Fax 9 f 17-`27-7M Revised 424-07 snas ga�fca Details Page 1 of 1 The Official Website of the Executive Office of Public Safety and Security(EOPSS) Mass:Gov Home State Agencies ensee Details empairwhmc r ull Name: CJ PECKHAM, JR ender: viner Name: dress: Address 2: City: Hyannis State: MA ipcode: 02601 o nt : U ited tates License apon Icense o: Inform-- 9 License Type: Construction Supervisor rofession: Building Licenses Date of Last Renewal: 8/7/2015 Issue Date: Expiration Date: 7/29/2017 Icense Status: Active Today's Date: 8/11/2015 Secondary License: Doing Business As: atus Change: License Renew I Prerequisite InTormation o Prerequisite Information No Discipline Information ocumen um _ ry Close Window ©2011 Commonwealth of Massachusetts Site Policies Contact Us http://elicense.chs*.state.ma.us/Verification/Details.aspx?agency_id=1&license_id=283134& 8/11/2015 ��^T ie oyn�iwiiciieccl�l o- ��aauaea .. �P 1;. License or:registration valid for individul use only before the expiration date. If found return to: s Office of Consumer Affairs&Business Regulation ( i 'WOME IMPROVEMENT CONTRACTOR Type I. office of Consumer Affairs and Business Regulation egistration: ;66334 10 Park Plaza-Suite 5170 E Expiratio �5/1_3�120.16.j DBA Boston,MA 02116 INTEGRITY HOME S'O�LU NS RICHARD PECKHAM;JR. G F P.O.BOX 1269 signature CENTERVILLE, MA 02632. Undersecretary Not li g sa{om ri 'o{Pub{�c�aatds . met aid sta ..O? Vc e �{a"t\ins t a55a6b"—\d\t g S'a. LZ/ � VC oa,dCi�,tt"Se'GS-09A-\s 1)i,�,��r' Cam' VEgAb EXP��a�`015 �4 his Commonwealth of Massachusetts mit Mal) � Parcel Date: SEP 22 2015 Permit to C22 ( V W T ftN OF BARIVS.TA94$ ) ( 76 Estimated Job Cost: $ a`K" Permit�Fee: Plans Submitted: YES NO Plans Reviewed: YES NO Business License## 5 Applicant License## Tz 6b Business Information: Property Owner,/Job Location Information: Name: E A$T CDAISrF f Name. Lt M9 5M-Vw lG� op Street: a t ,4JTtV_S d►l �942 00 Street: IN &.Q City/Town: b 1 City/Town: �t'NIV l S Telephone: 109—221 "44_�O Telephone: . Photo I.D.required/Copy of Photo I.D..attached YES NO,; Staff Initial 1 1/M- - estricted license J-2/M-2-restricted to.dwellings 37stories or less and.commercial up.ao 10,000 sq. ft./2-stories or less Residential: 1-2 family Multi-family Condo/Townhouses . Other Commercial: Office 'Retail` Industrial Educational Fire Dept. Approval pk'W'W Institutional_ Other Square Footage: under 10,000 sq. ft. over 10,000 sq.ft. Number of Stories; �— Sheet metal work to be completed- New Work: Renovation: V HVAC Metal Watershed Roofing Kitchen Exhaust System :Metal Chimney/Vents Air Balancing f Provide detailed description of work to be done: I sye..'ewt LovvOs -aea lv 1116'v+ QG t!74- h � E { INSURANCE COVERAGE: i I have a current liability insurance policy or its equivalent which meets the requirements{of M.G:L.Ch:112 YdSKNo'❑ If you have checked Yj&indicate the type of coverage by checking the appropriate box below: i A liability insurance policy ] Other type of indemnity ❑ ; Bond 0 OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachuseft General Laws,and that my signature on this permit application waives tfiis requirement. Check One Only Owner � Agent- Signature of Owner or Owner's A ent y By checking this box[],I hereby certify that all of the details and information I have submitted(or entered)regarding this application;are true and t accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be se Buildin Code and chapter ter 192 of the General Laws. in compliance with all pertinent provision of the Massachu tts g p. Duct inspection required prior to.insulation installation:YES NO 4— Progress-Inspectiojg Date Comments 1 Final Ins'eo etion ' Date Comments Type of Licenser 3y Master ;v0,4 title ❑Master-Restricted AA a4rrown ❑Joumeyperson Signature of icensee c— ❑Joumeyperson-Restricted License Number' ✓� zee$ ❑ Check at www.mass.u2XWpl 1 ' nspector Signature of Permit Approval i i WITH- gREASV- I�- �D ► Box + AlNGir a Cure I R�F v �RoP Ce►L►�.1�,- E HevvsT v � � CptJc�ETE W A-WI �F��►J�r5S STEE to W R-I.L- PA NE L— C�eK�►� slTe k►►G4EA GOAUST � A S 6, �o0 D SyST-EM a'(J SUPPRESSION FIRE COASTEAST RESSION SYSTEM System Type: 9 When a fire occurs in a protected area, it Tanks: t is quickly sensed by detectors located in [Fire Alarm and electrical by / the duckwork or exhaust hood. thers: Flow Points Used: F 36O / l �{ EXHAUST HOOD AL WEr CHEWCAL V Q r Yzeata -�:E87:,�131_NEA �*a'1IC+;t � � _ �1 ✓vu�-' �'�tJ�.V �,�(r,,,1 0RAPPR0-VEC dill �vY LIVED,E XISBI:+ [The detectors tigger theleasing mechanismhich actuates the stem...pressurizing the agent storage tank. Chemical applied directly on the fire in Liquid suppressant flows through the specific spray patterns... suppressing the distribution piping to discharge nozzles. fire in seconds. Job Name: ll_LE �CNVI�AC 6 u 'n I� 1 Date: U` Address: l a� A-i. S) � Summitted To: ,1�rN11/1 S - 5 HOOD MAX. EXHAUST PLENUM TOTAL HOOD CONFIG. NO. TAG MODEL LENGTH COOKING TOTAL RISERS) SUPPLY HOOD TEMP. EXH. CFM WIDTH LENG.1 D1A. CFM S.P. CFM CONSTRUCTION E END O ROW 1 5424 8' 1.00' 10' 19' 2000 -0.450' 430 SS ND-2-PSP-F 600 Deg. 2000 1650 Where Exposed ALONE ALONE . HOOD FILTER(S) LIGHT(S) UTILITY CABINET(S) NO TAG TYPE QTY.HEIGHT LENGTH EFFICIENCY @ 9 QTY WIRE FIRE SYSTEM ELECTRICAL SWITCHES FIRE HOOD MICRONS • TYPE GUARD LOCATION TYPE SIZE MODEL p QUANTITY PIPING WGHT 1 SS Baffle with Handles 6 16' 16' 30% 3 L55 Series E26 NO NO 435 HO D OPTIONS LBs HOOD NO. TAG OPTION 1 BACKSPLASH 80.00' High X 97.00' Long 430 SS Vertical PERFORA ED SU P Y P ENUM H RISE OOD TAG POS. LENGTH WIDTH HEIGHT TYPE RS) NO. WIDTH LENG. DIA. I CFM S.P. 1 Front 97' 20, 6' MUA 12' 28' 1 825 10.25211 MUA 12' 28' 825 0.252' 3' -� Field Cut 10' X 19' Exhaust Riser 54' U.L. Listed L55 Series E26 Canopy Light Fixture - High Temp Assembly 28' 28' o 20' 12 ® OF,leld Cu� -- -- 10. L24114' —�--- 48 1/2' —I 8' 1.00'Nom,/8' 1.00'OD PLAN VIEW — Hood #1 8' 1 .00'LONG 5424ND-2—PSP—F � 5JOB LITTLE SANDWICH aC9TlON West Wareha1, MA, TL' 8/21/2015 JOB 2399005 1e0BfekC 1 DRAIYN BYPWB-26 P SC4LL' 3/8' = 1-0' ,++ „ ,-.•�� �„ ,�� �r,nvrr„„ --r WWII WA1.7 IDVOLD14770 � a+►erlsrAns t Town of Barnstable Regulatory Services Richard Sca1i,Director Building Division Thomas Perry,CBO Buildiug Commissioner 200 Main street, Hymnis,MA 02601 www.towo.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder IQ Uk—w to 1 , as Owner of the subject property hereby authorize, Fn.e t CGl'?s:t �►"eY-- to act on my behalf, in all matters relative to work authorized by this building permit application for: ,��t 4 hit�'v- ;� ,�7/a a-•.�,s (Address of Job) -Signature of Owner Date Pant Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPFnM\FORMS\building permit fo mslsmokeeerbondctccton.doe Revised 040714 : CC-001568 Fire Equipment Certificate of Competency David R Sergi 47 MeadowStreet Carver M"2330 Expiration Date 03/2412017 . State Fire Marshal y M Via !T �iiOT6�"d it7-0 ae751i7S fSE � gOARi1O " SHEET FIl TL CORKERS " ISSUES Tt'�E FOLI_UWiG I i`G�NSE AS f?l°ASTER:�1NRESTR f CTED r (7 - pAU14 SERGI N �ARUFR � rtA o`2330 ;3.�9 C)MMONWEALTH. .�OFriMA�S�ACHUSETT • • - • • � . ea • a< ahBOARD' s �� SHEET rM1� ALWC'.RKEt "rFO,LLOW51i'IJ LJ.CENSE ' i I'SSU! �FsT ES° FkEa� , , lz pE WNW IS �T 'r- zT, " � r DQ1 la�` Nt t c,cm t. qwt 14, >�1;1T�1F►t���°��. r °��'� � y�� ��� � 2�0�8�6�414�� � `�, S .R ` Sx�d# ji .�k (y�` .y W� 1• ..:ey,}w����,�" � .qS `9.s^'� 1Gr"('SG q. . .. s :. y. �� �*zir �,y�9'` ,ter __ =• � _.: ,�, � � >.,� .� ..x. r e Mass. Corporations, external master page Page 1 of 2 Corporations Division Business Entity Summary ID Number: 200442572 Request certificate New search Summary for: EAST COAST FIRE &VENTILATION, INC. The exact name of the Domestic Profit Corporation: EAST COAST FIRE & VENTILATION, INC. Entity type: Domestic Profit Corporation Identification Number: 200442572 Old ID Number: 000855560 Date of Organization in Massachusetts: 12-08-2003 Last date certain: Current Fiscal Month/Day: 12/31 Previous Fiscal Month/Day: 12/31 The location of the Principal Office: Address: 21 PATTERSON BROOK RD., SUITE G City or town, State, Zip code, WEST WAREHAM, MA 02576 USA Country: The name and address of the Re istered Agent: 9 Name: DONALD A. DENNIS Address: 21 PATTERSON BROOK ROAD, SUITE G City or town, State, Zip code, WEST WAREHAM, MA 02576 USA Country: The Officers and Directors of the Corporation: Title Individual Name Address PRESIDENT DONALD A. DENNIS 361 COTUIT BAY DR. COTUIT, MA 02635 USA TREASURER DONALD A. DENNIS 361 COTUIT BAY DR. COTUIT, MA 02635 USA SECRETARY DONALD A. DENNIS 361 COTUIT BAY DR. COTUIT, MA 02635 USA DIRECTOR DONALD A. DENNIS 361 COTUIT BAY DR. COTUIT, MA 02635 USA 9 Business entity stock is publicly traded: ❑ http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=200442572&... 9/22/2015 Mass. Corporations, external master page Page 2 of 2 IThe total number of shares and the par value, if any, of each class of stock which this business entity is authorized to issue: Total Authorized Total issued and e Class of Stock Par value per share outstanding No. of shares Total par No.of shares value CNP $ 0.00 200,000 $ 0.00 0 ❑ ❑Confidential ❑Merger ❑ Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Administrative Dissolution , Annual Report Application For Revival Articles of Amendment v View filings, Comments or notes associated with this business entity: _............ . ... New search . 3 http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=200442572&... 9/22/2015 The Commonwealth,of Massachusetts Department of Industrial riceidents Office of Investigations 600 Washington Street " Bosfgi,MA 02111 www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information am• Please Print Legibly Name(Business/ocgdmiration/Individnal)• E/ -S7 60/d-ST Adorers: � .11� � O-K �4601L, City/State/Zip: -�irt Phone:#: Are you an employer?Check the appropriate box: ,hype of project(required):: 1.12 I am a employer with � •4• ❑ I am a general contractor and I employees(full and/orpart4ime).* have hired the a'ub�-contractais 6. ❑New construction . 2.❑ I am a'sole proprietor or.partner- listed on the-attached sheet. 7. ❑Remodeli rig ship and have no employees Tie sub-contractors have 8. ❑Demolition wo .for me in an ac employees and have workers' YP nY 9. ❑Building addition [No workers'comp.insurance. Comp.IItSRI8IICe.# e�i 5. ❑ We are a corporation and its '10:❑Electrical repairs or additions requir3.❑ I am a homeowner doing all work officers have exercised their .. l l.❑Plumbing repairs or additions. myselL[No workers'comp. ri&of exemption per MGL 12.❑Roof repairs insurance )t c. 152,§h(4),and we have no . employees:[No workers' I3.❑Other: comp.insurance regiiired:] *Any applicant that checks box#1 must also fll out the section below showing the workers'compensation policy information. t Homeowners who submit_this affidavit indicating they ate doing all work and then hire outside contcactois must submit a new-affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the Heine of the sub-contractors mad state whether or not those entities have employees. if the sub couttactois have a loyees,thcy nwst providt then x!oilaars'camp.,policy namber . lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: A/V l J674 `f Mf T M Policy#or Self-ins.Lic.# Expiration Date: Job Site Address• F "fAI ti S'f City/State/Zip: S Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure.to sectae 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 civil penalties is the form of a STOP WORK ORDER and a Erne 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 certify under the pains d p allies of perjury that the information provided aabove is true and correct. Si hire:, Date: 9 70 !� Phone# 'OJ)icial 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): J.Bbard of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5..Plumbing Inspector 6.Other • t -Contact Person: Phone#: . i L55 SERIES E26 CANOPY LIGHT FIXTURE - HIGH TEMP ASSEMBLY, INCLUDES CLEAR THERMAL 54' AND SHOCK RESISTANT GLOBE (L55 FIXTURE) FLDRISERATTACHING FIELD CUT SUPPLY RISER ANGLE PLATES WITH VOLUME DAMPER 23.5% ❑PEN STAINLESS WITH 2 3/4' STEEL PERFORATED PANEL HOOK 6' ANDOFF 20' -T 24' NOM. 18' IT IS THE RESPONSIBILITY OF THE ARCHITECT/OWNER TO ENSURE THAT THE HOOD CLEARANCE FROM LIMITED-COMBUSTIBLE AND COMBUSTIBLE MATERIALS IS IN COMPLIANCE WITH LOCAL CODE REQUIREMENTS, GREASE DRAIN 48.0' MAX WITH REMOVABLE CUP BACKSPLASH 80.00' HIGH X 97.00' LONG 80' AFF REFERENCE EQUIPMENT BY OTHERS SECTION VIEW - MODEL 5424ND-2-PSP-F HOOD CAP77V& VWJ0BLITT SANDWICH '0% (( VL0C4rjoff Wet Wareham, MA, ouv DATE 8/21/2015 JOB 2399005 Intanak O DWC 2 DR9{YN BY P W - B 26 REV O FAN UNIT TAG FAN UNIT MODEL R CFM ESP. RPM H.P. B.H.P. 0 VOLT FLA WEIGHT (LBS.)SONES NO. 1 DU85HFA 2000 1 0.550 1 1229 1 0.750 0,3680 1 1 230 1 4.9 1 75 13.1 MUA FAN INFORMATION — Job 2399005 FAN UNIT TAG FAN UNIT MODEL R BLOWER HOUSING CFM ESP. RPM H.P. B.N.P 0 VO. LT FLA TIEIGHT (LBS.)SONES NO. 2 AI-G10 GIOD Al 1650 0.500 877 1.000 0.5360 1 230 6.1 194 18.5 FAN OPTIONS FAN UNIT TAG OPTION (Oty. - Descr.) NO. 1 1 - Grease Box 2 1 - ECM Wiring Package for Exhaust Fans or Untenpered Supply Fans - Manual Speed Control. CURB ASSEMBLIES NO I 0 N WEIGHT ITEM SIZE 1 N 1 36 LBS Curb 23A00'W x 23.000'L x 20.000'H Vented Hinged 2 R 2 29 L. Curb 21.000'W x 21.000'L x 20.000'H �\ 23' 23' FAN #1 DU85HFA - EXHAUST FAN r VENTED FEATURES: CURB -ROOF MOUNTED FANS 317/e -RESTAURANT MODEL 20' UL705 AND UL762 VARIABLE SPEED CONTROL INTERNAL WIRING 20 GAUGE WEATHERPROOF DISCONNECT STEEL CONSTRUCTION -THERMAL OVERLOAD PROTECTION(SINGLE PHASE) HIGH HEAT OPERATION 300'F(149'0 -GREASE CLASSIFICATION TESTING ` 3' FLANGE RMA M RAT: T T � 30 1/2 EXNOHAUSTLT FANP MUSTR OPERATE CONTINUOUSLY 23 WHILE EXHAUSTING AIR AT 300-F(149'0 ` / ROOF OPENING UNTIL ALL FAN PARTS HAVE REACHED THERMAL EQUILIBRIUM,AND WITHOUT ANY 21 DIMENSIONS DETERIORATING EFFECTS TO THE FAN WHICH 21 WOULD CAUSE UNSAFE OPERATION. GREASE DRAIN ABNORMA FAR-P TEST EXHAUST FAN MUST OPERATE CONTINUOUSLY 2 WHILE EXHAUSTING BURNING GREASE VAPORS L 4 7/B I AT 600'F 1316'G FOR A PERIOD OF 15 MINUTES WITHOUT THE FAN BECOMING DAMAGED TO ANY EXTENT THAT COULD CAUSE AN UNSAFE CONDITION. 21 I OPTIONS 24:i/4 GREASE BOX DUCTWORK BETWEEN EXHAUST RISER ON HOOD AND FAN (BY OTHERS) JOB LITTLE SANDWICH y a LOCATION West Wareham, MA, *a 00 O 0,4FE 8/21/2015 JOB 41 2399 005 1i°2'�1c DWC# 3 DRANAr BYPWB-26 RFV SCALL' 3/8' = 1'-0' FAN #2 AI-G10 - SUPPLY FAN 1, DIRECT DRIVE DIRECT DRIVE UNTEMPERED SUPPLY UNIT WITH 10' BLOWER IN SIZE 41 HOUSING WITH SPEED CONTROL, DISCONNECT SWITCH. 2, INTAKE HOOD WITH EZ FILTERS-LOW CFM 3. DOWN DISCHARGE - AIR FLOW RIGHT -> LEFT 4. ECM WIRING PACKAGE AND MANUAL CONTROL FOR ECM MOTORS ON PRVS. BLOWER DISCHARGE CURB 1 3/4' oe 13 1/4' it L_ � 3 7/8' FLEX FOR FIELD CONDUIT WIRING 27 3/8' 58' 32 1/8' LIFTING LUG ° AIRFLOW ;-SERVICE_ AIRFLOW DISCONNECT � 29 3/4' SWITCH BLOWER/MOTOR ACCESS DOOR oo 24' SERVICE 'C ARANCE R O. ' 3 3T/4' I 16 1/4' 20' EQUIPMENT CURB 2 C � 21' ROOF ❑PENING 2' SMALLER THAN CURB DIMENSION, • JOB LITTLE SANDWICH n a LOCATION West Wareham,1, MA, Illy ✓ O DATE 8/21/2015 ✓OB 2399005 1rOorWk DiYC 4 D)Z4 BYPWB-26 RER SCALE 3/8' = 1'-0' ELF PA G - Job#239900-15 ND. TAG PACKAGE # LOCATION SWITCHES OPTION FANS CONTROLLED LOCATION t__�LN—TITY TYPE0H.P. VLT F AASC-21111002 Wnll Mount In SS Box SS Wnll Mount BOX ht EXhnust 1 0,750 23D4.9Fnn Smart Controls Basic Supply 1 1.000 230 6.1 SPECIFICATIONS: ELECTRICAL PACKAGE (SEE TABLE FOR DETAILS) A PRE-WIRED ELECTRICAL CONTROL PACKAGE SHALL BE PROVIDED TO OPERATE THE HOOD LIGHTS AND FANS. THE WIRING OPTION, LOCATED IN A HINGED COVERED ELECTRICAL BOX, SHALL INCLUDE A STAINLESS STEEL SWITCH PANEL CONSISTING OF AND LCD SCREEN INTERFACE TO PROVIDE FAN(S) & LIGHT CONTROL, A STARTER/OVERLOAD ASSEMBLY FOR EACH 3 PHASE FAN (OPTIONAL), NUMBERED INPUT/OUTPUT TERMINAL STRIPS, AND A TERMINAL STRIP FOR DOUBLE-DUAL FIRE SYSTEM MICROSWITCH CONNECTION. ONE MICROSWITCH IS WIRED TO A RELAY FOR SUPPLY FAN SHUTDOWN AND A REALY FOR ADDITIONAL FIRE SYSTEM ACTIVATED DRY CONTACTS, AND THE OTHER MICROSWITCH REMAINS OPEN FOR CONNECTION OF BUILDING FIRE ALARM SYSTEM (DRY CONTACTS). A WIRING DIAGRAM SHOWING THE CONNECTIONS OF THESE PARTS IS LOCATED ON THE DOOR. ELECTRICAL CONDUIT R D OPS FROM THE FAN(S) SHALL BE CONNECTED TO THE NUMBERED TERMINAL STRIP. CONDUIT BETWEEN THE PRE-WIRE PACKAGE AND THE FAN(S) SHALL BE SUPPLIED BY THE ELECTRICAL CONTRACTOR. DET4fZ OF REBfOTE S/S BOX DET4fZ OF LCD TOUCH PAD 1- 1a O O LIGHT AND ®. FAN AND LIGHT _ O O FAN SWITCHES SMART CONTROLS WITH LCD SCREEN ALARM INDICATING LCD SCREEN. EM LiGHTS FANS O BUTTON(UNCTIONS VARY HY MODEL TYPE. I• ALARM INDICATING LCD SCREEN. BUTTON FUNCTIONS VARY BY MODEL TYPE, O O JOB LITTLE SANDWICH c n CAPIN&W LOC.�TION West Wareham, MA, ��Vi� D4TE 8/21/2015 ✓OB 2399005 �'1iDa^e°` DfYC 7 DRA{YN BYPWB-26 RE7! SCALE 3/8° = 1'-0° JOB NO MODEL NUMBER SC-21111002 DRAWN DY 5CIEMATIt 719E DESCRIPTI❑N ❑F ❑PERATI❑NI 2399005 INSTALL 220V 1 Phose N/1 Exhoust ion,1 Supply Fon,Exhoust on In Fire,Lights out In Flre. JOB NAME LITTLE SANDWICH DATE DING No B/21/2015 ECP pl-1 1 2 BREAKER PANEL TO CONTROL PANEL CONTROL PANEL TO ACCESSORY ITEMS Responslbllltyl Electrician Responslbllltyl Electrician 3 BREAKER SIZE SHOWN IS THE MAXIMUM ALLOWED CONTROL PANEL COMPONENT BREAKER PANEL CONTROL PANEL 4 MICROSWITCH 1 BREAKER IPH '®Hot CONTROL PANEL 4�NO RF Neutrol — 120 V ---------------Graune —� TO -------------- IC 'NC, 5 15 A CONTROL POWER. DO NOT WIRE FIRE SYSTEM _ ----- ----J MICROSWITCH WIRE CI TO COMMON(1). TO SHUNT TRIP BREAKER. WIRE AR7 TO NORMALLY CLOSED(2). 5 IS7 HOOD LIGHT BREAKER SHARED W/ Cl TO ARI SHOULD HAVE MS-1 CONTINUITY WHEN ARMED.———— INC � CONTROL POWER. SWITCH #1 1 _____________ LEG 1 MORE THAN ONE —� T BREAKER IPH _____________LEG 2 — FIRE FIRE SYSTEM, WIRE I MS-2 4�NO F 23D V G�ouna —yq-ETlpq� IN SERIES AS SHOWN L.— go� C MCAT 6.1 A --------------- B MCA, IS A EXH-1 ---- ------ ----- ——————————————— LEG L—�T�iy CONTROL PANEL ALL SWITCHES FACTORY WIRED —————————————9 BREAKER IPH 2 — TO 4 CAT-5 CONNECTION — 230 V ---------------Ground —� SWITCHES MCA: 7.6 A SUP-2 ID MOCP- 15 A HOOD LIGHTS I CONTROL PANEL ——————————— BLACK n TO )j C ——————————— WHIT HOOD LIGHTS ——————————— GREEN ----J 1400 W MAX WIRE TO J-BOX ON TOP OF HOOD 12 CONTROL PANEL TO FANS Responslbllltyl Electrician THE FOLLOWING CONNECTIONS MAY OR MAY NOT BE B CONTROL PANEL FANS REQUIRED BASED ON JOBSITE SPECIFICATIONS Load Wiring —yEG I i NOT----- FANS-01 — EXH-1 —-do W,0.9 HOT TO SHUNT COIL SHUNL COIL , R C_I 4EG g_i N�ranL--------- __moo w�0.750 CONTROL PANEL ————— --GRaaD------_-- �T'2My SIGNAL FOR ___NE_UL FROM SHUNT COIL ____ —J WIRE DIRECT — ——TO STARTER WIRE TO EXTERNAL ST TERMINAL IS ENERGIZED 5 DISCONNECT SHUNT TRIP IN FIRE CONDITION, FAN, 02 CONTROL PANEL COMMON B Load Wiring —yE�li 1$T---- ACR SUP-2 FL&W — ------ -- SPARE FIRE __ NORMALLY OPEN C-2 IEGj J6UTRNL---- VNITE o aT�jo v SPARE CONTACTS USED WHEN FIRE SYSTEM DRY SYSTEM DISCHARGES TO DISABLE GREEN i, CONTACT EQUIPMENT OR PROVIDE SIGNALS. 71 WIRE DIRECT WIRE TO FACTORY (NOT FOR BUILDING FIRE ALARM WHICH MUST BE WIRED DIRECTLY TO STARTER PROVIDED CONDUIT DROP TO THE ANSUL ALARM INITIATING SWITCH LOCATED IN ANSUL AUTOMAN l8 BMS SWITCH CONTROL PANEL —————————————— —co-`C Cl 13 TO —————————————— ----� EXTERNAL SIGNAL SWITCH THROUGH BMS SWITCH WILL ACTIVATE ZONEI FANS AND LIGHTS 20 21 22 23 24 CERTIFICATE OF LIABILITY INSURANCE °A�'M''"1D°"m'r' FICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUIRER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsem s. PRODUCER CONTACT NAME: MASON&MASON INS AGOY PHONE FAX 458 SOUTH AVE (arc,No,Ext): (ANC,No): E-MAIL WHITMAN,MA 02382 ADDRESS: 237XM INSURER(S)AFFORDING COVERAGE NAIC S INSURED INSURER A: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA EAST COAST FIRE&VENTILATION INC INSURER B: INSURER C: 21 G PATTERSON BROOK ROAD INSURER D:INSURER E: WAREHAM,MA 02571 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 15 TO CERTIFY THAT THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE BURRO NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMBfr,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO NMICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTABL THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICEb.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MR ADD SUB POLICY EFF DATE POLICY EV DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MMIDDIYYYY) (MM%=yYYY) LIMITS GENERAL LIABILITY CH OCCURRENCE $ COMMERCIAL D EXP ERSO GENERAL LIABILITY CLAIMS MADE OCCUR. AMAGE TO RENTED $ REMISES(Ea o=urence) (Any one person) $ GEM AGGREGATE LIMB APPLIES PER: NAL&ADV INJURY $ ENERALAGGREGATE RODU $ POLICY PROJECT❑LOC CTS-COMPIOP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Es acddent) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per amld�t) PROPERTY DAMAGE $ Per aodder0) UMBRELLA LIAR OCCUR rGCGREGATE H OCCURRENCE $ EXCESS LIAR CLAIMS-MADE $ DEDUCTIBLE $ RETENTION $A WORKERS COMPENSATION AND WC STATUTORY OTHER EMPLOYERS LIABILITY YIN UB58774704-15 01/08/2015 011=018 LIMITS ANY PROPER BERIEXCLUDEDXECUTNE E3 NIA E.L EACH ACCIDENT $ 1,000,000 OFFICERIhAErABER EXCLUDED? (MarAMM In NH) E.L DISEASE-EA EMPLOYEE $ 1,000,000 I yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONSILOCATIONRIMICLESIRESTRICTIONSISPECUAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE H01DER AFFECTING WORKERS COMP COVERAGE, CERTIFICATE HOLDER CANCELLATION EAST COAST FIRE&VENTILATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 21 G PATTERSON BROOK ROAD BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. WEST WAREHAM,MA 02571 AUTHORIZED REPRESENT ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reserved. CERTIFICATE OF LIABILITYINSURANCE EASTCOA-03 G'JOSBURGH DATE(NWDDNYYY) RM THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS 5/2014 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE:POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is in ADDITIONAL INSURED,the policy(ies)must be endorsed. It SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER Mason&Mason Insurance Agency,Inc. c NT NAME: ACT 458 South Ave. PHONE Whitman,MA 02382 �� Ext:(781)447-5531 Na:(7g1) 147-7230 ADDRESS: INSURERS AFFORDING COVERAGE NAIC 0 INSURED INSURERA:ASsociated Industries Insurartt: INSURER a:Charter Oak Fire Insurance Co 25615 East Coast Fire&Ventilation,Inc. INSURER c:Associated International Ins. 16 Kendrick Rd. Wareham,MA 02571 INSURER D: INSURER E: COVERAGES INSURER F: CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NREVAMED NUMBABO�EER: THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED DOCUMENT HEREIN SUBJECT TO ALL THE SPECTTOWHIC THIS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE P IC A X COMMERCIAL GENERAL LIABILITY POLICY NUMBER DIRM22MM LIMITS CLAIMS MADE OCCUR ES102717901 EACH OCCURRENCE $ 1,000,000 07/15/2014 07/15/2015 PREMISES Ea occurrenceL $ 50,000 MED EXP(Any one person) $ GEN'L AGGREGATE LIMB APPLIES PER: PERSONAL&ADV INJURY $ 1,000,000 POLICY GENERAL AGGREGATE $ Z,000,000 JECT LOC OTHER: PRODUCTS.COMP/OP AGG $ 2,000,000 AUT0410BILE LIABILITY $ B I OME1 EC SINGLE UMI ANY AUTO BABS38945114AUF � ALL �(OWNED SCHEDULED 07/01/2014 07/01/2015 BODILY INJURY Per person) $AUTOS _ 20,000 NOWO NED BODILY INJURY(Per accident) $ 40,000 L OS X AUTOS Per ac i G $ I UAB X $ OCCUR EACH OCCURRENCE $ 1,000,000 C ; B CLAIMS.MADE UBW4613113 07/15/2014 07/15/2015RETENTION$ 10,000 AGGREGATE $ 1,000,00ERS COMPENSATION + $ AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/PI STATUTE ER OFFICER/MEMBER EXCLUDED? a N/A(Mandatory in NH) E.L EACH ACCIDENT $ It es•descnbe+mder E.L.DISEASE-EA EMPLOYE $ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ I I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Satiedule,may be attached If more space is required) t *OFFICE COPY**"' CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE East Coast Fire&Ventilation,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 16 Kendrick Rd ACCORDANCE WITH THE POLICY PROVISIONS. Wareham,MA 02571 AUTHORIZED REPRESENTATIVE ACORD 25 2014/01 ©1988-2014 ACORD CORPORATION. All rights reserved. ( ) The ACORD name and logo are registered marks of ACORD �t yaww_ Sign _. -Y `ram .;� TOWN OF BARNSTABLE Permit, * sARNSTASLE, MASS. Permit Number. Application Ref: 201506041 20071140 Issue Date: 09/16/15 Applicant: Proposed Use: RETAIL& SERVICE STORE SMALL Permit Type: SIGN PERMIT Permit Fee $ 75.00 Location 428 MAIN STREET, HYANNIS Map Parcel 309218 Town HYANNIS Zoning District HVB Contractor PROPERTY OWNER Remarks 2 SIGNS HANGING 11 SQ & 17 WALL SIGNS LITTLE SANDWICH SHOP Owner: DUMONT, DAVID S TR Address: 298 MAIN ST, SUITE 7 HYANNIS, MA 02601 Issued By: p�. POST TIS CARD SO THAT IS VISIBLE:FROM THE S ;REST PERMIT PAYMENT RECEIPT TOWN'OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET ,HYANNIS, MA 02601 DATE: 09/16/15 TIME: 09:31 ----- -- ._.------TOTALS------------------ PERMIT $ PAID 75.00 AMT TENDERED: 75.00 AMT APPLIED: 75.00 CHANGE: .00 APPLICATION NUMBER: PAYMENT METH: CHECK PAYMENT REF: 1514 _: _.... .......... Town of Barnstable Regulatory Services saaxsz" E 9 MAS& $ Richard V. Scali,Director ;,. :f CD -, �iO1EDMA��`� Building Division : Tom Perry, Building Commissioner 70 200 Main Street, Hyannis,MA 02601 1, - www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit# Building Official approving Application for Sign Permit A lic nL W P __. pp . Assessors No Doing Business As: ) t 3,4JOIA Telephone No Sign Location Street/Road:--� c �---/1x ----- Zoning District: Old Kings Highway? Yes/No Hyannis Historic District? Yes/No Property Owner �t ���� �0?— wa Name: � JUG Telephon .\l Address: > Village: Sign Contractor Name: Telephone: Mailing Address: -. Description Please follow the cover directions.You must have an accurate rendition of sign with dimensions and location. ) Is the sign to be electrified? Yes/No (Note:Ifyes, a wiring permit is require Width of building face_L _ft.x 10= x.10= I i Check one Reface existing sign or New Total Sq. Ft. of proposed sign (s) Ifyou have additional signs please attach a sheet listing each one with dimensions If refacing an existing sign please provide a picture of the existing sign with dimensions. 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 ao constructions all nform to the provisions of §240-59 through§240-89 of the Town of Barr le Zoning r ' Signature of Owner/Authorized Agent:: � Date SIGNS/SIGNREQU revised11041 1 r p THE Tp� . Town of Barnstable Regulatory Services * BARNSTABLE, « 9 MASS. Richard V. Scali,Director . i639� 'AFC 39 6. Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 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 may be submitted in lieu of a photograph. 2. A scale drawing of the proposed sign. A scale drawing indicating: 1) The type of proposed sign(wall,hanging, free standing) 2) Dimensions of the proposed sign and any designs, logos, or lettering 3) A cross-section with dimensions showing edge detail. Minimum scale 1"= 1'. Minimum sheet size, 8.5 x 11". 3. A scale drawing of the bracket. A colored scale graphic indicating dimensions, showing colors, materials and method of affixing it to the sign and to the building. Minimum scale 1"= 1'. Minimum sheet size, 8.5 x 11". 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 revisedl 10413 BARMABILA Town of Barnstable Growth Management Department • Hyannis Main Street Waterfront Historic District Commission} _ www.town.barnstable.ma.us/hyannismainstreet _ Decision —Certificate of Appropriateness Dean Walton d/b/a The Little Sandwich Shop 428 Main Street The Hyannis Main Street Waterfront Historic District Commission,pursuant to.the Code of the Town of Barnstable Chapter 112,Historic Properties,Article III,Hyannis Main Street Waterfront Historic District,hereby approves a Certificate of Appropriateness for the following property: Property Address: 428 Main Street Assessor's Map/Parcel: 309/218 At the August 5, 2015 hearing, after consideration of the testimony given and materials submitted by the applicant and members of the public, the Commission found the proposed design 'for specific signage as outlined will appropriately contribute to the historic character of the Hyannis Main Street Waterfront Historic District. The Commission considered the material,design,color, size,location, and context of the proposed signage and found it to be appropriate for the protection and preservation of the district. Based on these findings, the Commission voted to grant the certificate of appropriateness subject to the following conditions: 1. On the Main Street fagade, a double-sided business sign not..to exceed 72" x 24" as submitted to the HHDC file dated June 25,2015 2. On the rear of the building, a business sign consisting of.12" letters, in addition to sign fascia painted blue with white check pattern at the bottom 3. Sign permits from the Building Division are required prior to'installation of the signs. x Present and voting in the affirmative to grant the 'certificate of appropriateness were: Paul Arnold, Bill Cronin, Marina Atsalis,and John Alden. Opposed:None y George A.Jessop,jr AIA Date Hyannis Main Street Waterfront Historic District Commission cc: Dean Walton d/b/a The"Little Sandwich Shop-Applicant Tom Perry,Building Commissioner File I,Ann Quirk,Clerk of the Town of Barnstable,Barnstable County,Massachusetts,hereby certify that twenty(20) days have elapsed since the Hyannis Main Street Waterfront Historic District;Commission filed this decision and that no appeal of the decision has been filed in the office of the Town Clerk. ,p Signed and sealed this 0 "" day of under the pains and penalties of perjury. Ann Quirk Tow Clerk 7 1-- �'' 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 3 0 r Parcel No. a U F . airrovs Address of Proposed Work Z� �� 5 � �--- Applicant I,�,P��+� �J�C � Tel# Applicant Mailing Address \ C1LX ( Gi "-� Town/State/ZipNlC��(S�l(1S Applicant E-Mail Address \M e\3s� Property Owner Owner Mailing Address I�C1L-VY1 ll Town/State/Zip Agent or Contractor Tel# Mailing Address Town/State/Zip Agent E-Mail Address A Signature of Applicant � Date v �� g PPVEDPOP ElFor Location Hardship Signs&freestanding Trade Figures or Symbols to be located on p vp Check box if property owner has granted permission to locate Sign or Figure on their property abuttinggdhe t ilda %front. TOWN OF BARN[[STABLE HYANNIS MAIN ST WATERFRONT HISTORIC DISTRICT COMMISSION r-k IMF Town of Barnstable Hyannis Main Street Waterfront Historic District Commission Application Certificate of Appropriateness for g Si na, g._e . 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 v 2. Open/Closed Sign v 3. Trade Flag 4. Trade Figure or Symbol 5. Location Hardship Sign Assessor's Map No. Parcel No. Address of Proposed Work ��?�� �10�-�►� S�TQQ_A-j �' ►�1 �l�S . !v r C�-�d Applicant I,)�P�a� ���JC UY ' Tel# �' ton —2 X — (p L�Dcl Applicant Mailing Address 1 ���A� OdCJI �C-�1 Town/State/Z'ip)Acy",�om IU161 6� Applicant E-Mail Address Property Owner t k Owner Mailing Address �� I C �'��— Town/State/Zip 60)n 1 S UQ-4o01 Agent or Contractor Tel# Mailing Address Town/State/Zip Agent E-Mail Address Signature of Applicant ZLIt Date v �� ❑ 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. i I _ Business Sign 1: Size of Sign, ( O x& — Material(s)of Sign - ��. Material of Lettering('If different) y'✓ )� Lf//Z-/(- - Will the sign be illuminated? es bye),whams peg of light fixture Location of Fixture �X Is�� S' Business Sign 2 Size of Sign Ci ! x, Materials)of Sign/ Material of Lettering(if different)' Will the sign be illuminated? gYe /No If yes,what type of light fixture. , Location of rFixture OpenfClosed Size of OpenlClosed Sign. x Sign: y Material of OpeNClosed 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: 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: ArrNUVED Lettering Color and Material. : AUG - 5 2015 r TOWN OF BARNSTABLE HYANNIS MAIN ST WATERFRONT Page 2 of 2 HISTORIC DISTRiCT COMMISSION S i . :�� i"� Y"'4... e�r 'r•.� 'mow;- �""s1171OY ^ w .n q 4 t t Y .. _ '.;• � ••r' t ,yam �•'"� .' _ -p. M . . r - a w' say9twil-11h shop it -14 a .yWAIN Alotill-Ji ' little Sandwich Shoff 7N II �IWk f'Y F vkif ClgR & � • .,.� . c yn 1 _ , _ f t r _ r 1. i I � r _ , : ICA— DG .._ _ ..1._._'.".�y�• .�_.e,>_� .._. t"___5.. �'��i*"Q_'�_�'� I ^.�"__-. -' 1 ^' I i 'r I I S _ I ! ! I _,�_._-7_____._,____t.-....__a •' ..t. 1 1 E . I f ., _ , 5f� . F !ll ; TVN IN f,. - T_'.uk�4l"sue.• .-- � t - - 4- T x r I ,p 1 � Y-- _r.. ` I r 1 I , I _ _ F � i " t _ t , '.1 Boa P ; . - t � y i ti- V��• V T f 5144 , { j 4 L. =_ r- --ter-•-`�,.•,. 1 1 t � � _ ,� r f R _ _ _ _. ,r_,_ _�--_`I--. _-� - r 1 i t I • •!` cove -4«--_ t F 1',� t _ i ,-__ _-- •Y„ i -i_. _-. "-Z---'--.y »_ 1 T-_•T S 4 a77 - _ 1 ` I ! { ; f , 1 , .m r r. i— t i I y r — 1 r_ - r { . t + I Y I ' f 1 � , I + i 4 ; r _ r � 64 AIR I - , af. ���-_r'�. � - .-i __ �_.• t _ �,. ,.._....I, -. .. .r,r-- un�.._ 1.-.-. �-_ _. '� ^'�._ Y _Y - '� l � I f_-._ � _ ... i t + A'1} r._ 4 : I '. I t ,�+:V♦ �� f � 1 1 •_, I _ -"`._.. { _i - _.. .._— - , t �. I_", k I ' I I J_4 Y P• L _ ' F f - - _ ' t i, n ~Emma - �' . _- .r --F• �. r - r I m!M VIA "t I �wy�/� ti, r 1 , I t . I _.. . n N x hey R!