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0573 MAIN STREET (HYANNIS) (2)
�7� AOL,, ba Town of Barnstable Building Department ' Brian Florence, CBO Building Commissioner ray._s__,�__;tt,,•� 200 Main Street, Hyannis, MA 02601 BUILDING DEP www.town.barnstable.ma.us 1.9 202� -- JAN 1 Pre-application for Business Certificate TOWN OF BARNSTABLE D ` Map_ Parcel L_~ .6 6 Date Applicant Information Applicants Name Email Address Applicants Address �y j �y(� Telephone Number Cis V"I� �`� ''�- Listed ❑ Unlisted ❑ Business Information Yes New Business? -------------------- No O V� Business is a registered corporation? -----------------------_. Yes No C If yes Name of Corporation Does business operate under the registered corporate name? Yes No Is the business a sole proprietorship or home occupation? _________ Yes 1 5 If es then a Home Occupation Registration is required-See Building Division staff y i . Name of Business V Yy) - Business Address Type of Business uilding Commissioner Office Use Only Conditions r S n Building Com missi J,2//1.(1�3'� Date, �C'_ Clerk Office Use Only r Town of Barnstable Building • wuvsn�ei.e. Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept Posted M $ Until Final Inspection Has Been Made. Permit .ego �e Ea►uN` Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-16-2352 Applicant Name: Eric Barsness Approvals Date Issued: 11/04/2016 Current Use: Structure Permit Type: Building-Accessory Structure-Commercial Expiration Date: 05/04/2017 Foundation: Location: 573 UNIT B MAIN STREET(HYANNIS),HYANNIS Map/Lot: 308-111-OOB Zoning District: HVB Sheathing: Owner on Record: SHORE,CARYLYN A TR Contractor Name: ERIC A BARSNESS Framing: 1 Address: 1418 COMMONWEALTH AVE Contractor License: CS-079883 2 WEST NEWTON, MA 02165 , Est. Project Cost: $15,000.00 Chimney: Description: TENANT FIT-OUT FOR HOMEMADE SAUSAGE. CARRYOUT RESTAURANT Permit Fee: $286.50 Insulation: ` NEW EQUIPMENT AND FINISHES Fee Paid: $286.50 Project Review Req: TENANT FIT-OUT FOR HOMEMADE SAUSAGE. CARRYOUT, Date: 11/4/2016 Final:_ D [�2? ,7 RESTAURANT NEW EQUIPMENT AND FINISHES p ` Y , Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: S �� 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 ` i the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: ,z [ "Persons contracting with unregistered.contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: dal/Y�/(� �'�✓ All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ON `pf.�HEipk� Town of Barnstable WUWWABLE` Building Department-200 Main Street ^rfoMA+6 Hyannis, MA 02601 z, Tel. (508) 862-4038 r _ Certificate Of Occupancy Permit Number: B-16-2352 CO Issue Date: 2/1/2017 Parcel ID: 308-111-00B Zoning Classification: HVB -- - Location: 573 UNIT B.MAIN STREET Proposed Use: (HYANNIS), HYANNIS Gen Contractor: ERICA BARSNESS . f Permit Type: Commercial_ Business Comments: HOMEMADE SAUSAGE' I1 2! l � Building Official Date: Commoawealth of Massachusetts Sheet Metal Permit Map Parcel - Bate: erzat# V9 Estimated Job�osf:.$. �lJd(a ermit 1~ee: MAY 032016 Plans Submitted: YES No Plans Reviewed.: YES NO Business License# /j_ TMN OF BNTAI&E e# 6,N,93 Business Information: Property Owner/Job Location Information: Name: ��/CC1�i0 -_ Name-X,u;v1i e&c, Street: �� r/� Street: JZ ^//'L„cl .57" City/Town: lgD,✓,4 City/To--Am: ; Gt- Telephone: `�dF 5t� 99s�U Telephone: Photo I.D.required I Copy of Photo I.D. attached: YES � INTO -- — — Staff dnitw f eT 1 /M-1-unrestricted license = '= J-2 J,M-2-restricted to dwellings 3-stories or less and commercial up'to 10,000 sq. ft./2-stories or less- � i Residential: 1-2 family Multi-family _T Condo/Townhouses Other Commercial; Offices � Retail Industrial Educational Fire Dept.Approval Institutional m Other i✓ i Square Footage: under 10,000 sq.ft._ over,10,000 sq.ft. Number of Stories. , Sheet metal work to be completed.: New Work: Renovation: _ I HVAC Metal,Watershed Roofing Kitchen Exhaust System . I Metal.Chl i2nney/Vents Air Balancing Provide detailed description of work to be done: ./442 ZrC Un �� ati-41,50- 01,51 ��l/ j INSURANCE COVERAGE: t have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch,112 Yes(] No if you have checked XM indicate the type of coverage by checking the appropriate box below: A liability insurance policy El Other type of indemnity Bond OWNER'S INSURANCE WAIVER.lam aware that the licensee does nett have the insurance coverage required by Chapter 112 of itie ; liAassach efts General Laws that to signature on this permit application y ape waives this requirement, I ' Check One Only - Owner ® Agent El Signature of Owner or Owner's Agent 4 By checking this boxo:.I hereby certify that all of the details and information i have submitted(or entered)regarding.this application are true and 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 in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 11.2 of the General Laws, Duct inspection required prior to insulation Installation:YES NO lProUess Iatsreections 1 Date Comments irital I asgectiort Date Comments ; 'hype of license: 3Y __- master U n aIA-g-14A Ma;iter=Restricted 4 - - i :itylrown ElJoumeyperson Signature of licensee �ennit ----- E],loumeyperson-Restricted License i\lumber. =ee3 El Check at www.mass.aov/dol i i aspector Signature of Permit Approval F i t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information [[�� Please Print Legibly Name (Business/Organization/Individual): AleaC/0-s Address: Cry City/State/Zip: gall-)— Phone#: �`�/� Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp.insurance comp.insurance.$ required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. 1 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 c. 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 information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: /&4W Policy#or Self-ins.Lic.M Expiration Date: r L1/ _ ( _ Job Site Address: ��� �/�^/.J �% 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 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 PIA for insurance erage verification. I do hereby cerf un the pains nd penalti f perjury that the information provided above is true and correct. Signature _ Date: Phone#: Y K y 9�� 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 Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: f ACORD® DATE(MM/DD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE 4/l/2016 THIS CERTIFICATE 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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. 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 an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Monica DaSilva NAME: Sylvia & Company Insurance Agency, Inc. PHONE xt: (508)995-4553 FAX No:csoat99s-452s 500 Faunce Corner Road E-MAIL rou ADDRES y g p'mdasilva@s lvia com ry S: Building 100 Suite 120 INSURER(S)AFFORDING COVERAGE NAIC# Dartmouth MA 02747 INSURER A:Hartford Insurance Company of the INSURED INSURERB:Safety Property & Casualty 12808 Horacio's Welding & Sheet Metal, Inc. INSURERCAmGuard 42390 64 John Vertente Blvd. INSURERD: INSURER E: New Bedford MA 02745 INSURER F: COVERAGES CERTIFICATE NUMBER:15-16 GL BAP UMB WC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMOIIDDDY� MIOWUDDIYYX Y LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TRNTED A CLAIMS-MADE ❑X OCCUR PRE"SESOEaEoccuence $ 300,000 08SBAVX2433 5/1/2015 5/1/2016 MED EXP(Any one person) $ 10,000 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JECT PRO- ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Employee Benerns $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B ALLOWNED SCHEDULED AUTOS X AUTOS 6209916 5/1/2015 5/1/2016 BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED I X I RETENTION$ 1(),000 08SBAVX2433 5/1/2015 5/1/2016 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE N/A E.L.EACH ACCIDENT $ 1,000,0 OFFICER/MEMBER EXCLUDED? C (Mandatory in NH) HOWC641555 6/14/2015 6/14/2016 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Job Ref: Linguiceria Do Guacho 573 Main St Hyannis, MA 02601 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main St . ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Maureen Armstrong/LP V ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 r9ounit [ aUmm�,���,n.vr k�■«a�nva��w«` , . � e � ., „ ■ , �� . pf9¥OF .« TAL WORK Rs» .}:< iJ HE FOLLOW G S CEN \ . :\ \ MA f g STRIC Eo ^^^¢ ,� 4 CHAEL B (AV RES ƒ . . . : . , . 3 P|NECONE LN REED WN: )A 02717}i/ 2}� \ *ff , � ��J��� Fotd,Then Detach Along A➢f Perforations 7.>::COMMONWEALTH OF MASSACHUSETT:S. NON ® Mo m Q ...._. a BOAF�lD''G1 F SHEET'.n AL WOR:KE:RS }SSUES. THE FOLLOWIN:G''L9GENSE. 'AS A BUS LNESS a z 1:IGHAEL B TAVARES HORAC}0 WE:L'D.-I W6 AND SHEET METAL N 64 JOHN: VERTENTE BLVD j�}s 11 6=LF17R0 `,A C 4,z 45 1:2/071.}6 1. 358208 ' .I.:tsL7�9 SIZE EXHAUST SUPPLY MATERIALS FILTERS LIGHTS DUCT SIZE CFM SP DUCT SIZE jCFM SP INT E� T TOP QTY. SIZE TYPE. QTY. TYPE WATT 0 x ALUM. UL-VAPOR 51' 24' 16" 16" 3600 .75 12" 12„ 2880 .50 HS/S S S S S 5 p 1 100 EA. NSF -4r GENERAL NOTE: ALL WORK SHALL BE INSTALLED IN CONFORMANCE WITH ALL THE GOVERNING CODES, REGULATIONS AND ORDINANCES. NOTE: 1. CONSTRUCTED FROM 18 GAGE, DOUBLE WALLED, INCLUDING, BUT NOT LIMITED TO, NFPA 96, NFPA 17A AND UL 300 TYPE 304 STAINLESS STEEL, NO. 4 FINISH 2. ALL SEAMS WELDED IN COMPLIANCE WITH N.F.P.A BULLETIN #96 3. 3" AIR SPACE WILL BE PROVIDED BETWEEN RIGHT-HAND SIDE SHOWN THE WALL AND THE HOOD 3" AIR SPACE 51" u oL EXHAUST DUCT SUPPLY DUCT WITH COLLAR FIRE DAMPER 24„ 3" AIR SPACE 3" AIR SPACE 3"AIR SPACE GREASE TRAY 108' AIR SUPPLY BAFFLE TYPE DIFFUSER GREASE EXTRACTOR AIR SUPPLY VAPOR PROOF LIGHT H ora C i o'S HOOD WITH INTAKE AIR SYSTEM DIFFUSER Welding & TOWN OF BARNSTABLE, 200 MAINS T Sheet Metal Inc. HYANNIS, MA IRA"' sr:MIKE TAVARES uc• N/A T— MECHANICAL ENGINEER DATE. 04/1/2016 1 SHEET DWG #1 !J GENERAL NOTE: ALL WORK SHALL BE INSTALLED IN CONFORMANCE WITH ALL THE GOVERNING CODES, REGULATIONS AND ORDINANCES. INCLUDING, BUT NOT LIMITED TO, NFPA 96, NFPA 17A AND UL 300 EXHAUST AIR INTAKE ROOF Uo FIRE L INSULATED BUILDING INSULATED ATTIC 2' 9NSF NOTE: 1. CONSTRUCTED FROM 18 GAGE, DOUBLE WALLED, TYPE 304 STAINLESS STEEL, NO. 4 FINISH 2. ALL SEAMS WELDED IN COMPLIANCE WITH N.F.P.A BULLETIN #96 3. 3" AIR SPACE WILL BE PROVIDED BETWEEN 1ST FLOOR THE WALL AND THE HOOD H ora c i o's STD MUA EXHAUST HOOD—EXTERIOR VIEW Welding & TOWN OF BARNSTABLE, 200 MAIN ST Sheet Metal Inc. HYANNIS, MA DESIGNED B ENGINEER Y.-MIKE TAVARES GALE: N/A DATE: 4/1/2016 DWG #2 { GENERAL NOTE: ALL WORK SHALL BE INSTALLED IN CONFORMANCE WITH ALL THE GOVERNING CODES, REGULATIONS AND ORDINANCES. INCLUDING, BUT NOT LIMITED TO, NFPA 96, NFPA 17A AND UL 300 EXHAUST AIR INTAKE ROOF FIRE ® L INSULATED BUILDING INSULATED - ATTIC 2' 9' NSF NOTE: 1. CONSTRUCTED FROM 18 GAGE, DOUBLE WALLED, TYPE;304 STAINLESS STEEL, NO. 4 FINISH 2. ALL SEAMS WELDED IN COMPLIANCE WITH N.F.P.A;;BULLETIN #96 3. 3" AIR SPACE WILL BE PROVIDED BETWEEN 1ST FLOOR THE WALL AND THE HOOD " H'OrCIC`i") 'S "S MUA EXHAUST HOOD—EXTERIOR"VIEW Welding & TOWN OF BARNSTABLE, 200 MAIN ST Sheet Metal InC. HYANNIS, MA DESIGNED BV:MIKE:TAVARES ALE: N/A DATE: 4/1/2016 DWG #2 �� �� a a i MEMORY TRANSMISSION REPORT TIME :04-18-'16 11:44 FAX NO.1 :508-985-9965 NAME :Horacio's FILE NO. .420 DATE 04.18 11:43 TO 9 15087786448 DOCUMENT PAGES 8 START TIME 04.18 11:43 END TIME 04.18 11:44 PAGES SENT 8 STATUS OK • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION.,:- Map Parcel �' T0'�M OF A NSTABLE t /w Application Health Division 73 jUI ( ! "P1 '•, Date Issued IZ? 17 Conservation Division Application Fee Planning Dept. � Permit Fee Date Definitive Plari Approved by Planning Board Historic - OKH _ Preservation/ Hyannis �M�L S NNT Project Street Address Village 110 vim � rt^e4� Owner L . Z L Address lee Telephone L5—® - Permit Request PiLla Q Y Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 800,66 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 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ 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 Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name &rce-sk )Telephone Number S09 (� Address �W/T 0,�y+er License # 7 M-3 0-�--40 Home Improvement Contractor# Email kOU.IkU I5�QAre 2�w"l eq Worker's Compensation # E-A w L ALL CONSTRUCTI N DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1eC�yrra� SIGNATURE—� y �z� � 'd��d/ DATE f ' FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION ' FIREPLACE e ELECTRICAL: ROUGH I FINAL PLUMBING: ROUGH i FINAL GAS: ROUGH FINAL FINAL BUILDING i I i is DATE CLOSED OUT ASSOCIATION PLAN NO. ri 6j- A p, v40 1� 10 F - boo ------------ ------------- .. n . e Client#: 761906 2BARSNESSER ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 10/14/2016 THIS CERTIFICATE 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 INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. 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 an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: &O'Neil Dowling&O'Neil Insurance Ag' PHONE FAx A/C,No,Ext:508 775-1620 A/c,No): 5087781218 973 lyannough Rd, PO BOX 1990 E-MAIL COI DOINS.COM ADDRESS: Hyannis, MA 02601 INSURER(S)AFFORDING COVERAGE NAIC# 508 775-1620 INsuRERA:Essex Insurance Company INSURED INSURERB:Guard Insurance Group E.A. Barsness&Company, Inc. INSURER C: PO Box 1582 INSURER D: Hyannis, MA 02601 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR 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 HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MMIDD/YYYY MMIDDIYYYY A GENERAL LIABILITY 3EE3328 04/16/2016 04/16/2017 EACH OCCURRENCE $1 OOO OOO X COMMERCIAL GENERAL LIABILITY PREMISES ERENTED r nce s50,000 CLAIMS-MADE 4 OCCUR MED EXP(Any one person) $5,000 X BI/PD Ded:500 PERSONAL SADVINJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO LOC $ JECT AUTOMOBILE LIABILITY •• COMBINED SINGLE LIMIT Ea accident $ ANY AUTO _ BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED - PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $, EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B AND EMPLOYERS' YERS'LIABILITY IONILIT EAWC755915 09/21/2016 09/21/201 X w RVTAM T ER" AND EMPLOYERS'LIABILITY } ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? - N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE s500,000 If yes,describe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT s500.000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Insurance coverage is limited to the terms,conditions, exclusions, other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. w CERTIFICATE HOLDER CANCELLATION Town of Barnstable-Building SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE '7 G ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) '.1 of 1 The ACORD name and logo are registered marks of ACORD AC4744R�/tiA4744R4 rpn L Town of Barnstable Regulatory Services MAM ' Richard V.Scali,Director. Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.maus Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder F I, S�S !/' r��.✓� , as Owner of the subject property } hereby authorize to act on my beh4 in all matters relative to work authorized by this building permit application for. r f''�Jr'Zlfir'l. (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools , are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. ZZ S• tore of Owner Signature of Applicant • rs Print N e Print Name a, Date Q:FORMS:OWNERPERMISSIONPOOLS Town of Barnstable Regulatory Services pF Richard V.Scali,Director Building Division MAM •' Paul Roma,Building Commissioner i639• �� 200 Main Street, Hyannis,MA 02601 Epp www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two=year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official that he/she shall be re onsible for all such work performed under the building ermit. Section P g sP P �P ( 109.1.1) The undersigned homeowner' assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. 5-75- L L C of Tsi Approval of Building Official , Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. III To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page this,issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit fomu\EXPRESS.doc 06/20/16 7'he Coznpizarr?vecdth otf Vassacliusetts Deparwtent of�'rdu-[.- 1 Accide ds ofl6ce of lrcflertigaiaons { 600 Mashiilb aFr,Street Briton,CIA 07HI, • tvrvx�:rrzcr�gtrv�c�in Workers' Campensafion Insurance Affidavit: BuildersXantra.ctursJUectrkians(Phunbers Applicant Infarmatian Please.Print Legibly Nam,-(Susinessl)DrgM1ir-,lGnlLnrl arrl)- A rs"C'.5 C . _I't& j 3&tsS City I S.tatelZip- �/1/rG v. Pltane Are you an employer? Checkthe appropriate bow: ' Type of project(required�c 1 am a general contractor and I I.(� I our a employer urith �__�_ ❑ � employees(full and/or part-time)_* have Iured.the sub--coata&o*s 6. Nevi canstructiog 2-.❑ I am a sole promietor orpartn fisted on the attached sheet. 7- ❑Remodeling s = and have no em 1 .,ees. These sub-conlrac-tors haze P o5 $_ I?emolitioa workag for 7T P in any capacity_ employees andhave wodcers' [No w.or- ' comp_insurance. c'�p-n=ant� g- ' Building addifiott required] 5. ❑ We.are a corporation and its la_❑Electrical repairs or additions 3_❑ f am.a homeovmer doing all work of lcei-s.Lave exercised tlieir 11_[]Plumbingrepairs or additions myself [No worker 'comp u�tt of e$emgtio>z per I1rfGI 13_❑Roafrepairs msuranre required:]i c. 152, §1(4),and-,*e have no empYam- to o workers' 13.❑Other comp.insurance rcqu ed_] 'e��y gPPtic�st that checks baz�l mrLsi also fill out the section b-low shm�g d1eir woecers'compemsatinn policy irdonozaaa_ 1 Homeawitemwho subunit this xf uizvii zbff mg th-Y are daiag all team and mm hize aut ade cantnctocs nmst submit a new atad vit iadicatinZ suds Icantractpa fait rhxtr ibis box must xttached in additional sh eal showmg tha'nmne of the sub•-cautac as and state-whether or not-base Eadties have eam4oyeES. Iftliesabtaatactmshive emplayees,they=u.;rpra ide their nvrken'rump.polite nimbu. I ant arr eutpl rrr tlattt i�prox�dir tt orkets'Corr rtsrtYiart itrszrrtzacs jor rrc}s encplv��ees. $elow is tltgpoucy and job site irtformadort Insurance Compariy Kanm: ' f p� LI Policy or Self ins.Lie_ �� .W L. �j � t� T=�piratcon Date: L Job Site Addle J-7J / ILI}l'l City/Stafe 2�p: Ct i Q D I k Attach a copy of the workers'coanpensatiompolicy decl-2rafion page(sh•ott g the policy num er and expiration date). Failure to secure coverage as required.under Section 25A of MGL c_ 152 can lead to the impasition of criminal penalties of a fine up to,S 1,50Q00'and.'or one-year imprisonmv>f as-well as civil peaallies.in the farm of a STOP WORK ORDER and;a.time: of up to$250-09 a day against the violator- Be advised that a copy of this statement maybe forwarded to tlxe Office of lmvegEgati s of$re DL4 for insurances ca�era e vet cation I rfa hereby car6f}i ran der the prritis artd psrraI res qfpeJiu.y that the irzf orma6mj prm*L- ahmv is b us ar:rl carrect Sit�rature_ Irate- / ks& Phone Offal use only. Do)tot wrtfe in th s mreQ,to be campletesd by rdy artomn oiciaL City or Tong: PernutJ-icense# Lssuiag knihority(circle one): L Board.of Health I Rnfl inn Deparhrarent 3.CityIrown Clerk 4.Electrical f- spector S.Pluanbing Imspector 6.Other Contact Person: Phone#: L • Massachuserts,Departrrent of Pubilc Safety Board of Burid1. g,Reguia#ions and Standards Cisristructi'94 Supervisor License•'CS.-0791%3 Restrctedto:, nstruction Sa Rer•r='set ¢"; Unrestncted-Buildings of anyuse group rvtiich con2arri lessthan.3s t)t10 cubic:feet 091 cubic►netersj of enclosed ERIC A BARSNESSy ?, space: - 54 ANGUS WAY CENTERVILLE MA 4 Commissioner J27t2017: Fail u€e to possess a current ed tivri of the tvlassarhusetts.: State... uildingsCode is.cause for revocation'of-this licerise, DPS Licensing nformatson.visit Y1tWV1l1�rt ASS.GOViDPS: f(/ ♦/ i,��y/-/'�/ j/ } j j J /`jJj ( �y J y/ ,/ �f J'' / 1�E _, n ! lf,Y'3' l`r!C.:t.J+f P X .�/Y� /C;' f P �.C.i lr S_.: I,[.:+f..T'Lr �F,✓'f f r a" . - t tf c °of Con sumei 1 fa>ra°and 13> siness 1 egU 4:1 r 10"Park.plaza - `Suite. 511,0 }3ostc;n, ?Vlas acl usc�tts 0'1;1"6 Home�Izx�prOmeme t"Ct�lltracr Red fteg strat�on 14907' : Pr�vGteCorpora.t�an Ezptratian, 1201$ E.A BARSNESS.&.CO.; INC:.' `" ,. ERIC BARENESS : 54 ANG:.US`1NAY' C'ENTE;RVILL"E; %Mtn 02632 L'HatG Address tnd return earl: rk reason forz, Inae:, ldclress 1Renes al Cmpioyment ;.I o tCd Officeaf.COnsll 5lEr:�.f lY? �U$inCS CelllfltiQn'.. t IGCnSe or iE f5 tr9tlon+'alld fo r'17YdBV1dlI�A52 onJ}�. c x HwAt ItJlPROVEMEN7 CONTRACTOR; UefUre the expat"1. date If found return to " Regisiratfon: 1q � ,0 Type;: Office•iSfCoisunatl'A ffa rr4andBnsrness;IZeeutatori Expiration. d6 2Ca1rt Rrlvate Corporation< !Q Park Ptvza -SUitl 5�170 - Bosfoii _Y1A 0.2�L1G� - EA 6r PS. NrsS rs.CO.r ihG RIC BAR$.NESS 84 Clt1US wnY .* { �E-NTER`iLLE,h3&02$-2 l�ndcrse�rctryr}�; tiot-vand»itliout srgnature �j Sign TOWN OF BARNSTABLE Permit 163 A Permit Number: Application Ref: 201405129 20071013 Issue Date: 08/06/14 Applicant: Proposed Use: RETAIL CONDO Permit Type: SIGN PERMIT Permit Fee $ 50.00 ' Location 573 MAIN STREET (HYANNIS) Map Parcel 30811100B Town HYANNIS Zoning District HVB Contractor PROPERTY OWNER Remarks NEW WALL SIGN 4 SQ IMPOPNITO Owner: SHORE, CARYLYN A TR Address:- 1418 COMMONWEALTH AVE WEST NEWTON, MA 02165 Issued By: p!r � POSE' THIS CARD SO THAT YS VY5TBLE FROM THE ST ET - ' PERMIT:'F:AYM[N TOWN`OF BARNSTABLE ' .BUILDING DEPARTMENT, = 200 MAIN STREET HYANNIS, MA 0''60 1 DATE' 08/06/1=1 . TIME: 14:21 --- - .---- --.__TOTALS -_---- �-- PERMIT ; r'AI:D' 50.00 - AMT TENDERED: 150.00 � AM T APP LIED: 50.00 CHANGE: .00 APPLICAIT011 NUMBC:i'. PAY ENT METH:: VCK PAYMEN l RL1=: < , . ..... . . ..... . �+E T Town of.Barnstable Regulatory Services TOWN 0r A NSTAB'U"" ' '', & Richard V. Scali,Director 'QED.39. � Building Division 2014 JUL 10 Pik 3' 31 Tom Perry, Building Commissioner r�b 200 Main Street, Hyannis,MA 02601 (��\ www.town.barnstable.ma.us ®I ' Frj Office: 508-862-4038 Fax: 508-790-6230 Permit# Building Official approving Application for Sign Permit Applicant: F.b Assessors No. U l3 Doing Business As: Telephone No. Sign Location Street/Road: Zoning District- _ Old Kings Highway? Yes/No -Hyannis Historic District? ces2yo Property Owner Name: Telephoner Address: � ►\W a v " . l�o v Village: /v e L/ �OkA Sign Contractor Name: ( � �b—r�e� T lee phone: �`�C3- r 3�97e(';(°�•J Mailing Address: f -2-' 7k Description Please follow the cover directions.You must have an accurate rendition of sign with dimensions location. Is the sign to be electrified? Yes6g/ (Note:Ifyes, a wrnngperrrutts required) � 1 Width of building face (�5 ft x 10- x.10- one Reface existing s' or New Total S . Ft. of proposed Check � � � q P P (s) �— Ifyou ha ve 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 ensions. 5 I hereby certify that I am the owner or that I have the authority of the owner to in this applicatio , that the information is correct and that th and construction shall conform to the pro s of §240-59 through§240-89 of the Town B sta Ordinanc 7 Signature of Owner/Authorized Agent Date SIGNS/SIGNREQU j& ' revisedl 10413 F Toy, Town of Barnstable Regulatory Services • BAMSTABLE. MAss. . $ Richard V. Scali,Director i6S9' .0 CFO MAS" Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.maxs 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 br the leased area. NOTE: the map/parcel number is required on the application. SIGNS/SIGNREQU revisedl 10413 `i 14 MAY 2,3 Fr1:3 t6 MIN Town of Barnstable Growth Management Department Hyannis Main Street Waterfront Historic District CommissionBANSTABLE To,`,rj CLERK www.town.barnstable.ma.us/h yannismainstreet Decision —Certificate of Appropriateness InPOPnito - 575 Main Street, Hyannis 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: 575 Main Street Assessor's Map/Parcel: 308/111/OOB At the May 21, 2014 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 two Business Signs will appropriately contribute to the historic character of the Hyannis Main Street Waterfront Historic'District. The Commission considered the materials, 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. The design the business signs shall match the rendering submitted to the HHDC file dated April 28,2014,with modifications as follows: (a) The website shall be omitted from the freestanding sign. (b) The freestanding sign shall include a 1/2"wide border,set in 1/Z" from the edge of the sign. The border shall be purple to match proposed.sign color. (c) The wall sign is encouraged to have a border meeting the specifications in(b)above. 2. The signs shall not exceed 12" x 48" (wall sign) and 24" x 48" (freestanding sign) and shall be made of PVC with printed graphics. 3. The freestanding sign shall be mounted to the existing sign.pole. 4. The signage shall utilize existing lighting. 5. Sign permits from the Building Division are required. Present and voting in the affirmative to grant the certificate of appropriateness were: George Jessop, Paul Arnold, Brenda Mazzeo and Marina Atsalis Opposed:None g bo George A. Jessop,jr AIA Date Hyannis Main Street Waterfront c District Commiss on . cc: Jim McDermott,Sign-A-Rama Tom Perry,Building Commissioner File 1,Ann Quirk, Clerk of the Town of Barnstable,Barnstable County,Massachusetts,hereby certify that twen*ey(20) days have elapsed since the Hyannis Main Street Waterfront Historic District Commissionfiled this decision and that no appeal of the decision has been filed in the office of the Town Clerk. - '= '�J l' Signed and sealed this 1 U ` day of under the pains and penal s of,. erJury: � Ann Quirk,Town Clerk nAnnmr,aw Town of,.B a rn saa b'f era' Hyannis-Main Street Waterfront Historic�District Coiln i� son Application ,= Certifica a idnage of Ap.propr`iateness ;for S x ! ...., . • j Application is hereby made for the issuance of a Certificate`of Appropriateness.under MGL,Chapter 40C,The Historic Dastncts Act,for proposed signage as described below and on drawirigs or photographs accompanying this application I CHECK ALL THAT APPLY: 1. Bmsiness Sign �� t R 2. OpenlClosed Sign,.: 3. Trade Flag 4. Trade:Figure 0r Symbol .' _ Town`ofi BarFl hway pid Kinds ttee 5: Location Hardship.Sign_ ', Comm Assessor's Map No. 3 6 Parcel ..'.: g 4 $ 1 Address of Proposed Work" q77 Applicant Applicant Mailing Address tt S � S �,> Town/State/Zip Applicant.E-Mail.Address 6:(7 Property Owner`—d'�l �H r� �a X Tel# Owner Mailing:AddressW4- TowNState2ip x Agent or Contractor °s�• `� w�•g� Tel Mailing Address. Town/State/�p 7�r t„�•o�crt'�. s •t Agent E-Mail Address C # i r Si9 nature of'Appll Date. v u _ Q L7, For'Cocaton Hardship Signs&freestanding Trade Figures or Symbols to be located:jon pnuate property Check box if property.owner has granted permission to ocate'Sign or Figure on ahei, property abutting the building front ` XMibit Date: S� �L/ HHDC t Business Sign 1: Size of Sign « x �f g M'atmal(s)of sign, v Ii GCS Or \e �Y4r��1c c Material of Leftering(if different). Will the sign be illuminated?' Yes.i If yes,what i pe:of ight,fodure. Location of.Fixture Business Sign 2. Size of Sign ` x Matenal(s)of Sign 1`�uG: wr`}�. r�K �rt�+cs. Material of'Lefteririg(if different) Will the sign tie'illuminated?'- ke .l`.No If;yes,vhat type of light fixturec:• 5 Location of Fixture:g Qa�e .. OpenlClosedSize of Open/Closed Sign x Sign: :Materiaf to 0p en1C1 osed sign: .n.. If.Neon,indicate color:(circle.one optlonj;' Red!Red&Blue. Colorof 0penlClosed Sign: Tradefla Size ofTrade,Fi ' ' x _ g �; Matenal,of;Trade,Flag:. Trade Figure Dimension'of Trade Figure or S'ymboi: x x Or'Syrrbol Material of e'ads Figure or Symbol:. Location Size of Hardship Sign x Hardship.Sign:: Matenal of Hardship Sign: Lettering Color,and Material: Paget of 2 COMPANY:.. PHONE: . 4/28/2014 VERSION: 1 2 3 4 5 CONTACT PER80N: FAX: �1 eat "(1 f''I OO. STREET: 1 51:46 PM F-�l�i9 d 8i ed P,-�JI(CO CITY: BTATk ZIP: EMAIL: ,■ pu Name:inpdpnito—bulidlno_hanping_alpne.fa "� • • �. " Folddr Name\18aolwpblFLEXI�ILEBUUnpopnito Popoofi r t , X MAY 2 1 2014 Town of Barnstable'. " OId King's Highway ; u Committee G; f)PYtIvMTCS ,SICN•k'+F� Mi ,'fi , THIS RENDERING IS INTENDED AS A SAMPLE ONLY.COLOR,TEXTURE;°MEASUREMENTS,AND ACTUAL APPEARANCE=MAY VARY SLIOHTLYFROM COMPLETED WORK AND Ia CON8IDERED NORMAL 8 USUAL:, Mimi ahaolr tayoui tertwoA Wi t@ i� ou mre)and fat tarot*01VWW .fhnd�iatlm� �nnat ilmo k tii wtitam rapptovW 10 neaNad.I�IdRlunal aharpaj will be appAad fur em ohanpae O d O O (CONTENT OF WORK TO B PERFORMED�0 the aro medal ow approved is rmihocL IEGN+A*'RAWIA W mt rapomial�for qry orrorF In .s.. AND APPROVE TtilB PROJECT TO BEGIN., NS 8 HEREBY FULLY UNDERSTAND THE ap ding,Inyotrt.dr dimattdorta that how bean epov by Ste:ouommen This ptpdf la for.", Ct!$TOMEp;APpROVALSlGNED BY Rents dMri Atty ohatpaa of daladomW tho uuatdme�riet ahawh or oharpad;fwraln will bo Wild 2 Whitaa Meth SYIU O,t;outh Ydn►quth,AAA 0,�004 F aeparaWly 5o5s Ot voetr:I aT n of OAtiER;Ifu6 emouitE it uttdar 0100E I)Anoe dud Phene:titJB 9a8 040d Fair 60f1�9a t7a0. ` DATE upat dma Of�mtallagon.l MAYE ttFl10 atdo AC itEE Td ALL TERNta tI tlTt/FJ EniaA:CClBr®VadfOf4nat PRINT` www.Hgndr■rn■ayamtouth,owtt ,T{980kSUMiAt DESiGlI APD K401f0391A?BOtI_CON"fAtfi&D�ffRE1N iS11�PROrR7Y OF SIOiY.#'R##IA An i'[S USE d1#NY WAY O7KER THAN Aa WTMORBL'D ISE11fN51.YFORIDDDEII.TtN'S PROPERTY IitAY kO�dE REPR00110ED 0R OUPtICAT�D'A7ItIOUP W(ai7E_PI PEAYIA9101V_Qf$t6M'A'RANA OR iHROlX3M FtIRCifASE: _ _. ._,.........,;...:..�:.,....�.,,...;�:...,. ..�....._ ..;..'��,».._:,.r.: .,...::_,.._.:............................::.-.�..s....:w.-...;........�...�w...,c..�..,..:.�,:....,k '>w........w,..Y.....�....w .:.F�,.�.,a...r*e.�. ,.�- a,x.., ,n,,..�r. ... ..,., P. t a :x b NI O APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name brl� 'I� � � �V � ��ill �.L Telephone Numberes ct Address A4 cf, License # v o Home Improvement Contractor# Email Worker's Compensation # I ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO f SIGNATURE" '� DATE '<\ �p TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �2D 1 4�_6 Z43 Map Parcel X0� Application Health Division Date Issued y-Z7 it r Conservation Division � Application F Planning Dept. Permit Fee UJ� 'o b Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis �� I OL=� Project Street Address c�n_e Village � t Owner Address r�UA A241AJu�� Telephoner�5eq-�� Ce _ Permit Request pC /, Square feet: 1 st floor: existincN A proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 15�1;' 0c9 Construction Type Lot Size Grandfathered: ❑Yes El"No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes &IVo On Old Ki g's Highway: ❑Ye-s Z No �:.-.4 4 � Basement Type: ❑ Full f Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count 6 Heat Type and:5uel: 6-6-as ❑ Oil �ctric ❑ Other Central Air: ❑3Yes 8--N o Fireplaces: Existing New Existing wood/coal stove: ❑Yes 3' z 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_ �O If yes, site plan review# -� Current Use oa,; Proposed Use __ �_ ~ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Nameo. rc> Telephone Numb L-� (Q Address d L "S License # Home Improvement Contractor# ® Worker's Compensation # ®' o ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE • n . { FOR OFFICIAL USE ONLY : APPLICATION# dATEISSUED MAP/.PARCEL NO. I ADDRESS ► VILLAGE ` OWNER I i DATE OF INSPECTION: w < L-FOUNDATION0AT!Dl'ldi� FRAME { A=INSULATION, a j FIREPLACE t _ r ELECTRICAL: ROUGH FINAL r f PLUMBING: ROUGH FINAL GAS:. _ ROUGH FINAL r' FINAL BUILDING 4 t DATE CLOSED OUT ASSOCIATION PLAN NO. 1 ATM Accidei7& .ate HA a2 J . . ,:tvfc�ttf Fgo�rFut CampensahmnIasm-anm. dam Buff& sf cf ��ctr�cL �fPfu ers I��rm rr Pease l"I� Na= / d iD: ' �0 -,Ajci LityfstKb--I..zp_ S _ { Areyon aitemployer? ;eckfmZ-p- rat�ba-= T �7,�of, pert rr- r �ii`- �j ( - I❑ I am a v? 4- ❑ I ssaa gemml ccnfmct=ash I eaupla�{fu11 - am a sole grapt}t arpartner- listed on the attached s �- ? sbtgaudhaveurlemgloyeesThesesab-ooALac�toss-ba1oeY g- ❑.Dema tioa i ea3plIIyeeS 8adbaFts Was '�.ag forIDP..m try[apaLaiy: Q_ ❑B.usld-mg addifiian [No-WUIjC=T-' COaIp_iM�E C=DP-mc,.r� D l dI 5. ❑ We area coigorEHaamd ifs 10-0 Mnnc repair c r additions- �_❑ I am a homez w=dbiag Z wash officers have==icimd their 110 Fiambmg repairs or additions zu_yseL£[No mark s'txyuig. of es tiorl get ZrfQ, 12-0 gnaf repairs d I- c-152,$1(4),aadwe bnm aD ��❑other isicrtrs,n_rg F . �ayeez-1Na ' cam-iasaranm regiti. gay�gF fl:dcbar+sbar firm stx)- ffi out the sechonb9ow-shasm.5frswo&en'm=eum =p*RLTnERmnxfftna- gm:h- tCmArRmaIffist rhork thh bar, atiached m:aft,nr.,At ch dbndm6-than�of Hie M&-conftXtaa nistatp vllmt lec ocnarlhase xs5.-ve emp�: Ifthe soh co�aazsh-re rsmlars,rheg Mae tizI taara�'tamp.plc}m�br� hni sr�,gnvinper ihcttis pmPiiag tvor.Lers'cottz inrt insrtrrrgce far trc�errtplmy�ss. Belau zs fFte gaF��ccrid job rftcrmrnrn�'Ami78ff�1�8>IIC_ - FoFmy+9 or Seif-im-Iic xgiratioz<I?ate. Attach a copy of the vmrke-rs'compeusatinn paricg d lzrsfiou pzge(showbag the poULT er ar d erp-aLion dste): - } Failnm to sew coverage as repirednader Sedim SA ofMM c- 152 can lead to the imposition of criminal pmaffies of a f n e up to ST,5010D andlor one-yearimpdso as Evan as czia7 peaalfies in the fay of a STOP WORK ORDIIZ and a fine of up-to S250.00 a day agaifist the violator- Be advised tiff a r-zW ofthis std=Eut may be:E�d tv the Qftice of IfttesEtgahaas of�e DIA for**,�nr�cov�ge v��diorL. , ¢ " T cta Fa n t€cs}�tdus �l€isS u` ' urF fhat�i�zprzricc#ian praxzcfc��dj uFzavc is (us emd eve tact Phone 9 curl uss r�tt , Div trot wnr*is f ds area,�u tic CaREPieted by�or faun a�icinl Gay,or Tow= �*t�T Tcease� LBt12x-dof$eat 2.BmIdingIlep"Cat afwTawna=k 4:ElectricalInspectur 5.P Em3p�ctor • ? assachos i s ompcns�ion for General Lames chapter 152 rrquacs Ed=[ploy=to pzavide v�Mh='c e�enip ogees Pm suantto this stafrdL-,an mnp£oyee is defined as�__n ery person in fire service of mothe-mulm any contract ofhire, ezkpress or implied, oral or van.." . An avp ryez•is defined as``an>ndivic3nal,pa t2mY ship,associafian, corporation or C$ier legal entif ,or any two or more ofthe fDregoing engaged in-a joiid mtc p es and i acladmgthr Iegal repre mtdives of a deceased employer;or file receiver or trustee of an mfrvidxzal,partaeashig,association or other legal entdy,employing employee,. However the owner of a dwelling]rouse havmg not more than three apartmerds and who insides fherem;or file occupant of the - dwelling IiDuse of another Who eroploys pmmns to do mabitea m,construction or repair work on such dwcffiag house or on the grounds or bolding appurtmant thereto shall not because of such employment be deemed to be-an employer." MGL chapter 152, 925C(6)also states thmat'every,st a_e or local limnsmg agency shall withhold the issaance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any apphcant who has not produced acceptable evidence of compliance with the am s>zr-anm.coverage required." Additionally,MCH, chapter 152, §25C(7)slates`either the commonwealthnor any of its.politcal subdivisions shall enter into any contract for the performance ofpubEc work natal acceptable evidence of compliance with the;n cRrauce requu-ement:s of this chapter have been presented to fig contracting authority.' -A Pplicants ' e da co letel b chec the boxes that 1 to ycur sit�tron and,if ease fill o� the workers compensation affi vet y> y apply PI mp mP nex ess sub-contracto s)name{s),addresses)aad.phone numbers)along with their=L�ncaie(s) of . �Y; PIY r{ iasu n=. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)withno employees other than the members or partners,are not requulm to cagy workers' compensation ic�ce. If an LLC or LLP does have employees;a policy is required. De advised that this affidavit maybe submitted tc,'the Department of Industrial Accidents for confrrmaiion ofmnce Coverage. Also be sure to sign and date the affidavit The affida)at should be returned to the city or town that the application for the permit or license is being requested,not the Departm cat of Industrial Accidents. Should you have any questions regards the law or if you are'required to obtain a v*orkers' compensation policy,please call the Department at the ntmmber li5bd below. Self ios d companies should enter their self-ir.crrrance ficeme number on the appropriate line. City or Town Officials Please be stare fh za-ffie affidavit is co fete and Ie The Department has rovided a a.ce at the boi "zn. mp prnrim=d llY P P Space of the affidavit foW. r you in fill out in the event the Office of lnvesti Lions has to contact you regarding me applicant Please be sure,to fill in.the pennitllicense nmmber which will be used as a reference number. In add tion an�plicaut that must submit multiple,pcmik/license applications in any given year,need only suhmif one affidavit indicating current b ddmss"the ' licaat should write;'all locations in (city or policy infnrmafion ifne�cess )and under 7o Srte A app P c3' ( az5' town)."A copy of the affidavit that has been officially stamped or madred by the city or town maybe provided tD the applicant as proof that a valid affidavit is on felt far future permits or Ketoses. Anew affidavit must be f07led out each year.Where a home owner or citizen is obtaining a license or permit notrelated to-any business or commercial ventiae (i_e,a dog license or permit to bum leaves etc.)said person is NOT rr_c�to complete this affidavit The Office of lnvestigafions would at to thank you in advance foryour cooperation and shouldyou have any questions, please dD nothesitate to givens a call. The Departments address;telephone and faxnvmberr aF Et)MMUaw(lea of MassachumtLs D.epaz�mcmt ref Ind al Aoaid.ets of iUV= o-nq washingtan. Rastn=MA G21 I l F=A 617-727- 4-4 Revised 4-24-07goddia ' Date: ' Z, ��' Ad Ref: Call Taken By.: > orr 20"� Send Literature Fax Quote Order Phone Quote V Steel Spiral The leading Manufacturer of Spiral stair Kits• Showroom Quote: Aluminum Spiral Pennsylvania; Mail Quote Floating Straight P.O. Box 547,400<Reed Road .• Location Quote .Broomall, PA 19008, Stair Tel:(610) 544-7100 ,XEmail Quote Fax:(610)544-7297 Toll Free:1-800-523-7421 Customer Name r GC 12 5�6.fjlE —, Ship to: Business Name .5g0?&k5}nE at fi�•,�10RS c/o Address ' Address City, State,Zip City, State,`Zip y W Home Phone(Ebb - B63-jjf6j Notify;Phone( )_ Work Phone ( ) Alternate#{ ) Fax Personal or Business Check`., VISA # (Order will be held for up to 10 days:for check to clear.) MasterCard' asterCacd Cazdholder � � • Bank Check AMEX Address Money Order DISCOVER Exp.Date / Auth.# ( )Risers GO XYes.Made customer aware o m code uuements. Kit cost fbwlduog � . ACCESSORIES QTY Price XYes.Made customer aware of minimum finished well opening. Oak Treads/Landing Q+Z t x� 11 Adual. x Flake Board Treads/Landing sL1Li- 0 Paper Template I Diameter Vt) CZ17rr= No. of Risers 1 Diamond Plate Treads/Landing Floor to Floor Riser Height ---Fa` 1t, Aluminum I Y4"Diameter Handrail Hand Up Brass IA"Diameter Handrail AZL Solid Oak Handrail Rises Bars . .. ` n Ietween spindles U n B LEN Balcony Rail N �� Well Rail/:Post 't/- Special Shaped Landing `j t 1 . Galvanized pf 3 Rush Expedite � 'iLRiVis AccessoryTohel 2o - WILl. F11..�J�' A so%deposit is iequired Kit Price Total to hold a stair or to order Sub Total arty custom work. All S to orders must be paid is g and Han full prior to pickup or Freight LISU ai=; ,` N. shipping. Mce`quotes Sub Total' are valid for 30.days. _ a° Tax 'thank you, GRAND TOTAL ` \ *` The Iron ShopDEPOSTf BALANCE DUECFT(C)PAL 4.150, 00% - xa+tn.um Shop � .,� 4 , Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-090845 ]KEVIN DOWNIN� 70 PINE G11�7VE 2► HYANNIS MA 0601 - Expiration Commissioner 07/19/2016 . t s Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor AMIN&Lc License; CS-090845 KEVIN DOWNINq` 70 PWE GROVES y HYANMS MA 0 601 Expiration Commissioner 0711912016 Mass. Corporations, external master page Page 1 of 2 i s. Corporations Division Business Entity Summary . ID Number: 481267610 �equest certificate+ New search, Summary for: 575 MAIN LLC The exact name of the Domestic Limited Liability Company (LLC): 575 MAIN LLC Entity type: Domestic Limited Liability Company (LLC) Identification Number: 481267610 Old ID Number: 000821929 Date of Organization in Massachusetts: 07-17-2002 R Last date certain: The location or address where the records are maintained (A PO box is not a valid location or address): Address: 1418 COMMONWEALTH AVE. City or town, State, Zip code, WEST NEWTON, MA 02465 USA Country: The name and address of the Resident Agent: Name: CARYLYN A. SHORE Address: 1418 COMMONWEALTH AVE. City or town, State, Zip code, WEST NEWTON, MA 02465 USA Country: The name and business address of each Manager: Title Individual name Address' MANAGER CARYLYN A. SHORE '1418 COMMONWEALTH AVE. WEST NEWTON, MA 02465 USA In addition to the manager(s), the name and business address of the person(s) authorized to execute documents to be filed with the Corporations Division: Title Individual name Address The name and business address of the person(s) authorized to execute, acknowledge, deliver, and record any recordable instrument purporting to affect an interest in real property: Title Individual name Address , http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=481267610&... 4/17/2015 Mass. Corporations, external master page Page 2 of 2 REAL PROPERTY CARYLYN A. SHORE 1418 COMMONWEALTH AVE. WEST NEWTON, MA 02465 USA 0- r Confidential Q Merger 5 Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Annual Report Annual Report - Professional Articles of Entity Conversion *` Certificate of Amendment (View filings Comments or notes associated with this business entity: 3 .4 1Si'S� I New search http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=48126761 O&... 4/17/2015 t S � 4 ___._ i ' 4 1 * � ��y, _ MAM ( PUBLIC — VARIABLE WIDTH ) STREET N 66°04 •?"£ 167. • \Qai;3• ml^ 9j� 5� Y�1 � � a N �.Oi Oi O N SV N� 23.79 UN I A Z STORY 7 ti UNIT B : 2 STORY ° e a, WOOD ' _. 22 771 ' f i 24,56 I 4 S"f i 3 OF CA 3- WOOD 22,49,4 4 . / z BUILDING • 0 U N I TS 0I-D12 , a 7 I STORY BLOC K M �^ 37 !7 89.05 - �? w' DAMES A, SHEA O C. a K: �ni a; BG''tir1S3?s?r tiU5 wF I', DRADFQRO SAIVETZ, P,EGSSTERED L.7tNA 5UnV$YOP., HAVE VEPIFIF.D AND HEREBY CERTIFY THAT THIS PLAN SHOTIS THS UNIT DESIGNATION OF UNIT NO, B : i HYANNIS OAKS CONDOMINIUM, BARNSTASLE (HYANNIS), MASSACHUSETTS, BEING CnNvEYED BY. UNIT DEED RECORDED HEREWITH AND OF THE IMMEDIATELY ADJOINING UNIT$, AND THAT THE PLAN FULLY AND ACCURATELY DEPICTS THE LAYOUT OF THE $ UNIT, ITS LOCATION, DIMENSIONS, APPROXIN.ATS AREA, MA ENTRANCE Y. r 1"04EDIATE COMMON AREA TO "MICH IT HAS ACCESS, AS BU T. `�N OF A44\ •: February 16, 1988 OR . DATE B DFORD AI 5%,ZTG. Ex1 -'a ",p �' Cty�CISTi��pQ ,j rr ti SUR V. ' V N a - SECOND FLOOR PLAN p I NCRCRV MRTn rNAT tSR$PLAN WAS !�� { ,•RCpAA(p IN A"4 OO AX VXTW TNt PVkts . AND REDVIAT10145 CC THE MA57V-CNV51TTr, •�'; RtPS'7:IE5 a DEEDS.,w o oEv To 1679, doN'S, Of tMIQ SNK'R O.�S QAK. 99� T I WtAt9T CtATD'f TWAT TWIS DVA TIALY . i ANO ACwAATELr DEPICTS NC LAYOUT, - L,OCATIQN,UNIT WVMRER AND DA,Divoks 9 0<TlIC VNIT kVMBERETI B, AT MrANNYy OAKS CONOOuINN4, AS 9MY,ANO TvAT TWt DU4QINQ WAS •.�` /1 NO MAUL TE G�- d'a a.lS DABAl 1NIS NimbiN0 Mom CM cCAN p-nijo • AU 7 DN Qr IAMD.8AAMSTA6LQMTAHNI$) MASS.,SCA,t 1`-Da,JAY D,,I1197, •`j'.. C�% - A BRADFORD SPINETS tt ASSOCIATE&W_ . MGNttA.-0 AROCTEDTS.BRNNTRM MASS' . :T4 , HYANNIS OAKS CONDOMINIUM T. j BARNSTABLE(HYANNIS), MASS. �. ytp: •�;., -�" SCAI£: t/a'—t'-p- DATE: DULY JT,1967 <; " BRADFORD SAIVETZ+ ASS00ATES,ING •. ENCANCEAS AND ARCHITECTS `o-f. {y�'• BRAINTAEE,MASSACHu5E7t5 s5f FIRST FLOOR PLAN ' :��. AT•�,' QRAPNIO seAtt a.TEtt - - . MAR 4 88 :: kA'e' SNtCr�CDL 4 I imT T ' I 1 I / ` ETati Town of Barnstable Regulatory Services puss �, Thomas F.Geiler,Director '°rFor„a�A. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,M�02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder'. I, �'� ���N 'C"L �� a of the ro subject e l P P riY hereby authorize qk —' ( to act on my behalf, in all matters relative to work authorized by this building permit. S7-- >9.yN iS (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Si e of Amer )signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS 6/2012 BIKE Town of Barnstable Regulatory Services UM ' Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\ContentOudook\QRE6ZUBN\EXPRFSS.doc Revised 053012 P • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel — l/: Application K4, Health Division ` � �1 Date Issued Conservation Division Application Fee l Vp Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board 0,00000000000 Historic - OKH _ Preservation / Hyannis #4r, Project Street.Addres s 576 �i ft I o S 7h.EIL T Villages e-'—L'N ft*)iJ\ S Owe0 4 Ste. Address CTeleph� o e� `� �� rc Permit`Request� $ F'i J CnXI .. � � � V b-1l I V. 16rSquare feet: 1 st floor: existing proposed " 2nd floor: existing proposed Total new. 'Zoning District Flood Plain Groundwater Overlay Project,Valuation 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 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other ., a Basement Finished Area (sq.ft.) Basement Unfinished Area (s ft) Number of Baths: Full: existing new Half: existing '° ' new ry �a Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ 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 Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ?hw�'� V�Ibv-lbft U-10— <Name�= T - �� ��� er(a !� r----TeIephone-Numb 17 � � - c Address—MOS 2,J s s f-L 1 z �1,,u S X�s License# D �'1 Home Improvement Contractor# Worker's Compensation # ALL-CONSTRUCTION-DEBRIS'RESULTING-FROM-THIS-PROJECT WILL B""TAKEN-TO--�,__ SIB GNA 77J. .- DATE i FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED MAP/PARCEL NO. �. ADDRESS VILLAGE OWNER DATE OF INSPECTION: i 4 i FOUNDATION ;s r )t,� im,loft t:r, FRAME '> tINSULATIONj, FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL i rf ' GAS: _ _ROUGH FINAL r FINAL BUILDING, " DATE CLOSED OUT ASSOCIATION PLAN NO. 1 `The Commonwealth of Massachusetts Department of IndustriatAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia r Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers fApplicant Information Please Print Legibly Name(Business/Organization/Individual): r Address: City/State/Zip: 0 Af4 Ve-0 U ( .Phone#: t 7 P ,7 � 1S ? Are you an employer?Check the appropriate bo : YType of project(required): 1.❑ I am a employer with 4. (] I am a"general contractor and I " 0'.-6. . -New construction. ` employees(full and/or part-time).* have hired the sub-contractors 2.El I am a sole proprietor or partner- listed on the attached-sheet. _7. [],Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y P tY # 9. ❑Building addition [No workers'comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs.or additions officers have exercised their I I. Plumbing repairs or additions 3. I am a homeowner doing all work ❑ g P myself. [No workers' comp. right of exemption per MGL. 12.❑Roof repairs insurance required.] t C. 152, §1(4),and we have no employees. [No workers' 13.7 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 and then hire outside contractors must submit a new affidavit indicating such. $Contractors 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job 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 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 DIA for insurance coverage verification. "h:ere ti nder the pains and penalties of perjury that the information provided ove is true and correct Date: Z' Phone#: f�- p 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 Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Op THE Tp� k f 9� , : ,.� Town of Barnstable prfD MP'I A Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main.Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize_moo fi to act on my behalf,Xtj r in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\QRE6ZUBN\EXPRESS.doc Revised 053012 I , COMMERCIAL LEASE r This Lease Agreement made this 18th day of June, 2013;.by and between Carolyn Shore, of 1418 Commonwealth Avenue, west Newton, MA 02465 (the Landlord); and Harold Miller,'.Individually and of LLC, of Dartmouth, MA, (the Tenant). W,ITNESSETW In consideration of the mutual covenants.and agreements,hereinafter set forth, the parties hereto do hereby covenant and agree as follows: PREMISES AND IMPROVEMENTS > A. Landlord hereby leases exclusively to;Tenant, and Tenant hereby takes from Landlord, 575 South Street First Floor Unit 2 (Right Side). B. So long as Tenant is not in default hereunder, Tenant shall have peaceful and quiet use and possession of the premises without hindrance on the part of Landlord. C. This Lease shall at the election of Landlord ' be subject a 1.nd „ subordinate to all mortgages which may now or hereafter affect the real estate of which the premises form ..a part, and to all renewals, modifications, consolidations, replacements and extension thereof. In confirmation, of such subordination, Tenant agrees at the request of Landlord from time" to time to enter into a subordination agreement with any holder of any such mortgc ige. which shall bind and benefit the respective parties and their successors. D. Tenant is given the "right, of non-exclusive use, in .common'4 with others entitled thereto, of,the sidewalks, parking area- and loading area at the building. These common facilities shall at all times be subject to_ the exclusive' control and management of . the Landlord, which shall have the right to establish, modify and enforce reasonable rules and regulations with respect to the same. Tenant shall'be responsible for removal of snow and ice from the sidewalks used to access the leased premises. ^` ' § Page 1 of 11 TERM The term of this Lease shall be two .(2) years, commencing at 12:00 AM on June, 17, 2013, and ending on June 30, 2015. . BASE RENT AND RENTS PAYABLE Tenant covenants and agrees to pay to Landlord as . rental for the premises, the sum of $10W for Years One and Two, payable in equal and consecutive monthly installments of $911111110.00, which includes the tenant's portion of property taxes. Each payment will be due on the first day of each month commencing July 1, 2013. Landlord acknowledges that Tenant has paid $11M.00 for first and last month's rent and as a security deposit for Tenant's full and faithful performance of this Lease. Lease Commencement: June 17, 2013 Rent Commencement: July 1, 2013 OPTION TERM The Tenant shall have the right, upon written notice to Landlord at least ninety (90) days prior to the expiration of the original term or the.First Option Term to extend the term of this Lease for four (4) individual periods of Two (2) years upon the same terms, covenants and conditions except that the rent for the Option Term. Option rental increases shall be based on the US Consumer Price Index each year and shall not decrease from the previous year. USE OF THE.PREMISES Tenant shall use the premises as retail, wholesale food service business. Tenants use shall be lawful. FIXTURES Tenant shall not remove, paint, or deface existing bar if unwanted. If Tenant does not want bar, Lessor will`remove. All trade fixtures and trade apparatus (as distinguished from leasehold improvements) owned by Tenant and installed in the premises shall immediately become the property of Landlord and may be removed during the term only with Landlord's written assent, provided Tenant shall not then be in default of any terms or covenants of this Lease, and provided further that Tenant repairs any damage caused by such removal. Initials. Page 2 of 11 OPERATION BY TENANT A. In regard to use and., occupancy of the premises ,and common facilities, Tenant will at its expense: a) Keep the inside of all glass in the doors and windows of the premises clean; b) Replace promptly any cracked or broken glass of the premises with glass of like kind and quality and, to the extent required by Landlord, maintain plate glass insurance coverage; c) Maintain the premises in a clean, orderly and sanitary condition and free of insects, rodents, vermin and other pests; d) Keep any garbage, trash, rubbish or'refuse in rat=proof containers within the interior of the premises until removed; e) Have such internal building garbage, trash, rubbish and refuse removed on a daily basis; f) Keep all mechanical apparatus free of vibrations and noise which may be transmitted beyond the premises; g) Comply with all laws, ordinances-, rules and regulations of governmental authorities and allrecommendations of the Fire Underwriters Rating Bureau now or hereafter in effect; h) Keep all sidewalks, steps and landing (front and rear) free of snow and ice; and i) Have the premises treated annually regularly by a licensed professional to exterminate rodents, vermin and all other pests. j) Tenant shall have the option to treat the property for pests if it deems appropriate. B. In regard to use and occupancy of the premises and use of the common facilities, Tenant will not without the. prior written consent of the Landlord: a) place or maintain any merchandise, trash, refuse or other articles in any vestibule or entry of the premises, on the sidewalks or steps adjacent thereto, or elsewhere on the exterior of the premises; b) use or permit, the use 'of, any advertising medium, such as, without limitations, loudspeakers, phonographs, public address systems, sound amplifiers, reception or radio or television broadcasts, which in any manner is audible or visible outside the premises; c) Permit accumulations of garbage, trash, rubbish or other refuse within or without the premises; e) Solicit business in the common facilities; Page 3 of 11 f) Permit the parking of trucks or delivery or,other'.vehicles so' as to interfere with the use of any d(veway, footwalk or other common facility; g) Use the sidewalks or,any parking area adjacent to the premises for the sale or display of any merchandise or for any other business, occupation or undertaking; h) Use or permit the use of any portion of the premises for any,unlawful purpose; i) Suffer or commit waste; or, j) Permit any mechanics liens or other lien to remain of record longer than five days after notice thereof to Tenant.. STRUCTURAL REPAIRS Landlord will make all structural repairs to the premises and will keep the roof, foundation and exterior of the premises, except any doors, door frames, windows and glass, in repair, provided Tenant shall give Landlord written notice of the necessity for such repairs, and provided that the damage thereto shall not have been caused by negligence ,of or willful acts by Tenant, -its patrons, visitors, invitees, employees, licensees or contractors, in which event Tenant shall be responsible therefore. Landlord shall be under no liability for repair, maintenance, replacement, alterations'or any other action with respect to the premises or any part thereof, or . any plumbing, HVAC, electrical, or other mechanical installations therein, or any of Tenant's improvements .or fixtures except as may be expressly set out in this Leaser Tenant shall be responsible for annual maintenance for all Heating systems which costs shall not exceed $500 annually. The Landlord / Less.or is responsible for. replacement of systems if deemed necessary by all parties. INTERIOR REPAIRS A. Tenant will keep all non'-structural elements and the interior of the premises, together with all electrical, HVAC, plumbing and other mechanical systems and installations therein, in good order and repair, and will make all replacements from time to time required thereto at its expense;. and will surrender,the premises at such time as ,it may vacate, the premises in as good condition as when. received, excepting depreciation caused by ordinary wear and tear, damage by,fire,.unavoidable accident or Act of God. Tenant will not overload the electrical wiring servicing the premises or within the premises,.and will install at its expense any additional electrical wiring which, may , be required in connection with Tenant's apparatus: Page 4 of 11. I B. Any damage sustained by any person caused by mechanical,. electrical, HVAC, plumbing or any other equipment or installations whose maintenance and repair is the responsibility of Tenant shall.be paid by Tenant, and Tenant shall indemnify and hold Landlord harmless from and against all claims, actions, damages and liability in connection therewith, including, but not limited to, attorneys' and other professional fees, and any other cost which the Landlord might reasonably incur. DAMAGE TO THE PREMISES Tenant will repair, at its expense, any damage to the premises caused by Tenant or its customers, employees, invitees or guests, and upon demand shall reimburse Landlord for the cost of repair of any damage to the premises or the building caused by such persons or by bringing into the premises any property for Tenant's use, or by the installation or removal of such property, regardless of fault or by whom such damage shall be caused, unless caused by Landlord, its agents, employees, or contractors. In.default of such repairs by Tenant, at the expiration of three (3) days after delivery of written .notice to Tenant, Landlord' may make the same and Tenant agrees to pay the cost thereof. ALTERATIONS BY TENANT A. Tenant will not alter the exterior of the premises (including but not limited to signs) and will not make any structural alterations or improvements to the premises or any part thereof. without first obtaining Landlord's written approval. Tenant agrees that in the absence of-. written agreement to the contrary, any leasehold improvements made by it shall immediately become the property of Landlord and shall remain upon the:premises. Tenant further will not cut or drill into or secure any fixture, apparatus or equipment of any kind to any part of the premises without first obtaining Landlord's written : consent. Which shall not be unreasonably withheld. B. Any alterations, renovations, improvements, and other installations to be made in or on the 'premises, including, but not limited to, 'electrical,. plumbing and mechanical installations, shall not be performed until plans and specifications therefore have been submitted to Landlord and Landlord has approved the same in writing. ' Page 5 of 11 SIGNS AND ADVERTISING Tenant will not place or suffer to be placed or maintained any signs, advertising matter or any other thing of any kind, and will not place or maintain any decorating, lettering or advertising matter on the glass of any window or door of the premises without first obtaining Landlord's 'written approval; and Tenant will maintain such signs, decorations, lettering, advertising matter or other thing as may be approved in good condition and repair at all times. An addendum should be drawn up to be signed with this contract approving all items that can be placed on the windows and doors; such as, but not limited too; name of business, hours of operation, promotions, specials, etc. No chasing needed this way. All signs shall be permitted by the Town of Barnstable and shall be to code. No lettering on windows or doors. All interior signs must be portable. Tenant shall have right to 66% of the pylon sign on Main Street. UTILITIES AND SERVICES Tenant shall maintain in its name and pay for all utilities and services such as gas, oil, telephone, television, electricity, air conditioning, water, and the like, serving the premises. Tenant will also pay, or reimburse Landlord-for, any such expenses or utilities provided to the leased premises that are not separately metered, hereby indemnifying Landlord against all such expenses and costs. INSURANCE A. Tenant will keep in force,at its expense as long as -this Lease remains in effect and during such other time as Tenant occupies the premises. or any part thereof: i) general public liability insurance in companies and in form acceptable to Landlord with minimum limits of One Million ($1,000,000.00) Dollars on account of bodily injuries to or death of one person, and One Million($1,000,000.00) Dollars on account. of bodily injuries to or death of more than one person as the result of any one accident or disaster; ii) Property damage with minimum limits of Five Hundred Thousand ($500,000.00) Dollars; and iii) Fire and extended, coverage insurance on . Tenant's personal property including inventory, floor coverings, furniture and other property removable by Tenant. Page 6 of 11 I B. Tenant will give a copy of the policy of insurance deposit the policy or policies of such insurance or certificates thereof with Landlord, which policies shall have Landlord and its designee as additional named insureds, and shall also contain a provision stating that such policy or policies shall not be canceled except after ten (10) days written notice to Landlord. If Tenant shall not comply with its covenants made in' this section, Landlord may cause insurance as aforesaid to be issued, and in such event Tenant agrees to pay, as additional rent, the premium for such insurance upon Landlord's demand.' INDEMNITY A. Tenant indemnifies Landlord and saves it harmless from and against any and all claims, actions, damages, liability and expense, including attorney's and other professional fees, in connection with loss of life, personal injury and/or damage to property arising from or out of the occupancy or use by Tenant of the premises or the building occasioned wholly or in part by any act or omission of Tenant, its agents, licensees, invitees, customers, guests, contractors or employees. B. Landlord agrees to indemnify and save harmless Tenant from and against all claims of whatever nature arising from any act, omission or negligence of the Landlord, or Landlord's contractors, licensees, agents, servants or employees, or arising from any accident, injury or damage whatsoever caused to any person or to the property of any person occurring during the term hereof within the 'demised premises where such accident, damage or injury results from an act or omission on the part of Landlord or Landlord's agents or employees. FIRE AND.OTHER CASUALTY A. If the premises or the building. shall be damaged by fire, the elements, accident or other. casualty; but the premises are ' not thereby rendered untenantable in whole or in part, Landlord shall promptly at its. expense cause such damage to be repaired, without abatement of rent. If, as the result of casualty, the premises are rendered untenantable in part, subject to unavoidable delays due to labor disputes, Acts of God or the public enemy, governmental. regulations or controls, or other conditions or causes beyond its reasonable control, Landlord shall at its expense cause such damage to be repaired within six (6) months of the date the damage occurred, and the rental and other charges. shall be abated; proportionately as to the portion of the 4 Page 7 of 11 -premises rendered untenantable from the date of such casualty,'A until the premises or portions thereof are rendered tenantable. If, as the result of casualty, the premises are rendered r, wholly untenantable, subject to the provisions listed below, Landlord shall at its expense cause such damage to be repaired and the rental and other charges shall be abated from the date of such casualty until the premises, or any portion thereof, have' been rendered tenantable, in which case the proportionate abatement in the rental.and .other charges shall be made as determined above for partial damage. B. In no event shall Landlord be liable-'for interruptiom to Tenant's business or for damage to .or replacement or repair of. Tenant's personal property, including inventory, trade 'fixtures, floor coverings, furniture and other property removable by Tenant under the provisions of this Lease or to Tenant's leasehold improvements. C. If the premises are (a) rendered wholly untenantable, or (b) damaged as' a , result 'of any cause `which is not covered by Landlord's insurance, or if the building is damaged to the extent of fifty (50%) percent or more of, the useable floor area, whether or not the premises are damaged, then in any such event, Landlord may terminate this Lease by giving to Tenant notice.within 30 days after the occurrence of.such event.. Rental and other charges shall be adjusted as of the date of such�cancellation. INSPECTION BY LANDLORD n Tenant will ,permit .Landlord,, its .agents,. employees a d ,contractors to enter all parts of the premises during Tenant's business hours to,inspect the.same and to enforce or carry'out any provisions of this lease. . In addition, Landlord,- and its agents may enter'and show the premises to prospective purchasers and tenants during the last 90 days. of 'the term .hereof,, if not renewing. Further,- Landlord may enter and take appropriate protective action at anytime during an emergency. :. NO ASSIGNMENT OR SUBLETTING A. Tenant-will not assign'this Lease, ;in whole or in part, nor sublet all or, any part of the premises without first obtaining in each -instance 4he' written. consent of Landlord. B. No assignment, subletting or licensing shall affect or reduce the liability of Tenant for the performance of the terms and provisions hereof during the term. Page 8 of 11 . BANKRUPTCY If any sale of Tenant's interest in the premises created by.this Lease shall be made under execution or similar legal process, or if a voluntary or involuntary petition or answer proposing the adjudication of Tenant as a bankrupt or the reorganization of Tenant pursuant to the Federal Bankruptcy Act or any similar Federal or State proceeding is filed against Tenant and such petition or answer is not discharged or denied within thirty (30) days of the date of the filing thereof, or if Tenant shall be adjudicated a bankrupt or insolvent and such adjudication is not vacated within ten (10) days, or if a receiver or trustee shall be appointed for its business or property and such appointment shall not be vacated within ten (10) days, or if a corporate reorganization of Tenant or any arrangement with its creditors shall be approved by a court under the Federal Bankruptcy Act or any state bankruptcy law, or if Tenant shall make an assignment for the benefit of creditors, or if in any other manner Tenant's interest under this Lease shall pass to another by operation of law, Tenant shall be deemed to have breached a material covenant of this Lease and Landlord may re-enter the premises and/or declare this Lease and the tenancy hereby created terminated. Notwithstanding such. termination, Tenant shall remain liable for all rent and damages which may be due at the time of such termination and shall be liable for the damages set forth herein. DEFAULT: REMEDIES A. If the Tenant shall fail to, pay any rental or other charges required to be paid by Tenant hereunder or shall fail to perform or comply with any of the other terms, covenants, agreements or conditions of this Lease, or if Tenant vacates or abandons the premises, such act or omission shall constitute a default under this Lease. In the event of a default by Tenant, Landlord may give written notice to Tenant, and if Tenant thereafter fails to cure any such''default involving the payment of money within five (5) days after the date on which such notice was given, or if the default involves some act or omission other than the payment of money which cannot be cured within five (5) days after the date on which such notice was given and the cure thereof is not undertaken promptly within such period and thereafter expeditiously`completed, then in any, such event, upon Landlord at its option serving a written notice of cancellation upon Tenant, specifying the nature of said default and the date of such cancellation, this Lease and term shall terminate and come to an end on the date specified in such notice of cancellation, and Tenant 'shall quit and surrender the premises to Landlord as if the term hereunder. ended by the expiration of the time fixed herein, but Tenant shall remain liable as hereinafter. provided. Page 9 of 1 L r B. Upon any such expiration or termination of this Lease, Tenant shall quit and peacefully surrender the premises to Landlord, and Landlord, upon or at any such expiration or termination, may without further notice enter upon and re-enter the premises and possess and repossess itself thereof by summary, proceedings, ejectment or otherwise, and may dispossess Tenant and remove Tenant and all other persons and property from the premises (and such property may be removed and stored in a public warehouse or elsewhere at the cost of and for the account of Tenant without resort to legal-process and without being deemed guilty of trespass or becoming liable for any loss or damage which may be occasioned thereby) and may have, hold and enjoy the premises and the right to receive all rental income of and from the some. C. Tenant, for and on. behalf of itself and all persons claiming through or under Tenant, also waives any and all right of redemption or re-entry or repossession in case Tenant shall be dispossessed by a judgment or by warrant of any court or judge or in case.of re-entry or repossession or dispossession by Landlord or in case of any expiration or termination of this. Lease. The terms "enter', "re-enter", "entry", "re-entry", "repossession", "dispossession' "possess", and "repossess", as used in this Lease are not restricted to their technical legal meanings. D. No failure by Landlord to insist upon the strict performance of any agreement, term, covenant or condition hereof or to exercise any right or remedy consequent upon a breach thereof, and no acceptance of full or partial rent during the continuance of any such breach, shall constitute a waiver of any such breach or of any such agreement, term, covenant or condition. No agreement, term, covenant or condition hereof to be performed or complied. with by Tenant, and no breach thereof, shall be waived, altered or modified except by a.written instrument executed by Landlord. No waiver of any breach shall affect or alter this Lease, but each and.every agreement, term, covenant and condition hereof shall continue in full force and effect with respect to any other then existing or subsequent breach thereof. E. `Should Tenant at any time fail to make any payment to.Landlord or any other person under this Lease, Landlord may withdraw such amount from the security deposit. F. Lessee will be responsible for any and all attorney's fees in event of Lessor's need to seek legal assistance to collect rents and or eviction of Lessee / Tenant. Page 10 of 11 RECORDING Each party agrees on request of the other to execute a Notice of Lease in ' recordable form satisfactory to Landlord's attorney. In no event shall such Notice set forth the rental or other charges payable by Tenant hereunder. BROKERAGE AND MANAGEMENT The Lessor shall be responsible for any and all management and leasing fees due to GJSW, INC. DBA Premier Commercial. Premier shall be paid one month's rent as a lease fee. SUCCESSORS AND ASSIGNS This Lease and the covenants and conditions herein contained shall inure to the benefit of and be binding upon Landlord, its successors and assigns, and shall be binding upon Tenant, its successors and assigns, and shall inure to the benefit of Tenant and only such assigns of Tenant to whom the assignment of Tenant has been consented to in writing by Landlord, as herein provided. :PARKING Tenant shall have the right to one parking space behind the building. 575 Main Street only has three spaces behind the building, one for each tenant. - In witness whereof, the said -parties hereunto. seta their hands. and seals this day of June, 2013. Harol Miller Individually Carolyn Shore, L dlord Harold Mil er, M be DulyAuthorized l Duly Authorized boa LAC Page 11.of 11 Town of Barnstable Geographic Information System New Search Home Help Parcel Viewer Custom Map.—IF Abutters I Map Size ❑ ❑ Zoom Out0 0 0®D O O®D In A R hey ® ®- Map: 308 Parcel: 111 - OOB Full • '-• IPG Property 30807.4CND Location: 573 MAIN STREET(HYANNIS) Info 308278 -* 308271 4 N540 308096 t✓572 Owner: 308270 R:588 "`. 308D72 30 p3800t $S 308103 346299 LOCatI®n I,nformation v: 30827i +i i 1p245 - �` ia547 Ma & Parcel 308111006 ' ! q 574 P • 308073d02 3D$06e002 Location 573 MAIN STREET (HYANNIS) ;q,259 308104 578 J'! 555 308130 Acreage 0.00 acres 308d68 N 541 #586 t.. Current Owner 308097 3o8D73D�0t Mailing Address SHORE, CARYLYN A TR p:30 >u 59 2 , 575 MAIN TRU ST' - . 3081 D 1418 COMM ONWEALTH AVE 3 I 308067 - 3081t1 -ND M657 WEST NEWTON, MA 0216.5 - IU BD O 0 569. 368275 a 33 Appraised Value (FY 2.0.1.3.) 308066 Extra Features $0 iV606 3D8113 9 �5s55577 Out Buildings $0 30812g.:: Land $0 308.12$ � 3$D Buildings $499,800 ip 394 3081.16) Total Appraised $499,800 q 59 J6 a 308114 • QN583 308285. ASS2SSed Value (F•Y 2�,1�:,3-) - 308119 # 2f Extra.Features'. $0 _ t ip005 308117. ,�tt77 � Out Buildings $0 l 1 g 308128 :F "d $0. 308118 308125 tk'414 3D8 0CND 308280 308124. qq d 30$220 1 821 39 11 Buildings $499,800 #' MW p434 +'a42$F �g395� Total Assessed $499,800 �> Set Scale 1" 29= 1 Ae.r_iaLPJ s1Sp �. ';•a MAP DISCLAIMER [Construction Detail ` Copyright 2005-2010 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS - BarnstableMA v1.2.4748 [Production] COMMERCIAL ADDITION/ALTERATION L er of Approval from Site Plan Review(if necessary) located in OKH or Hyannis Historic District - Certificate of Appropriateness required Plot Plan ap & Parcel number F Description of project(U-value of replacement windows if applicable) If sprinkler.or fire alarm system is required, do not accept application package without pr or approval from Fire'Department-in writing"—' ❑ DEP le r attesting notification, hazardous materials results , if necessary Sign Offs fro 30 Health Tax Collector tt ❑ Treasurer If ZBA relief(Special Permit or Variance is required for project: ❑ Copy of Decision 10 Documentation proving that the decision was recorded at the Registry of Deeds w/in one ear of ZBA decision date. reet address of project Co 'ect square footage ffContractor's ' aced Cost r's name & address name, address &telephone number ctor's signature F sized plans, stamped plans (1 full size and 1 reduced) Workman's Comp. form. Copy of Insurance.Complianc Certificate must be on.file. Construction Super's License OR Controlled Construction Documents Check expiration date on license 00 next to restrictions Application Fee Vproperty ermit Fee Owner must sign Property Owner Letter of Permission. ❑, Projects requiring the use of.a crane must complete the forms issued by the Aeronautics Commission q-forms/bldgpermits/perm itchecki ists rev.080410 s. AWE Town of Barnstable Building Department - 200 Main Street S& * Hyannis, MA 02601 f16:59. (508) 862-4038 Certificate of Occupancy Application Number: 201304622 CO Number: 20130081 Parcel ID: 30811100B CO Issue Date: 07/23113 Location: 573 MAIN STREET (HYANNIS) Zoning Classification: HYANNIS VILLAGE BUSINESS DIST Proposed Use: RETAIL CONDO Villager HYANNIS Gen Contractor: BRUTE AND HECTOR LLC Permit Type: CC00 CERTIFICATE OF OCCUPANCY COMM Comments: TENANT FIT-OUT FOR INPOPNITO 7 Building Department Signature Date Signed f; �tHE TOWN'OF BARNSTABLE Building 201304622 BARNSTABLE, * Issue Date: 07/18/13 Permit , 9 MASS. Applicant: SHORE,CARYLYN A TR Permit Number: B 20131720 Proposed Use: RETAIL CONDO Expiration Date: 01/15/14 Location 573 MAIN STREET (HYANNIS) Zoning District HVB Permit Type: COMMERCIAL ADDITION ALTERATION Map Parcel 30811100B Permit Fee$ 60.00 Contractor BRUTE AND HECTOR LLC Village HYANNIS App Fee$ 100.00 License Num Est Construction Cost$ 2,500 Remarks APPROVED PLANS MUST,BE RETAINED ON JOB AND TENANT FIT OUT: PAINTING AND PLUMBIGN FOR SINKS THIS CARD MUST BE KEPT POSTED UNTIL FINAL INPOPNITO(BRUTE&HECTOR,LLC) *NO CONSTRUCTION* INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: SHORE,CARYLYN A TR BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 1418 COMMONWEALTH AVE INSPECTION HAS EN MADE. WEST NEWTON,MA 02165 Application Entered by: SS Building Permit Issued By: �%r THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY(R RMANENTLY,ENCROACHMENT PUBLIC PROPERTY,NO r , SPECIFICALLY PERMITTED UNDER THE BUI DING CODE,MUST BE APPROVED BY THE JURISDICTION.`STREET ORALLEX`GRADES AS WELL AS DEPTH AND LOCATION' F PUBLIC SEWERS:MAYBE OBTAINED FROM THE DEPARTMENT_OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOTRELEASE THE APPLICANT FROM THE CONDITIONS Of ANY APPLICABLE SUBDIVISION . RESTRICTIONS: MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 51 PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. s 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 NOTED 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 1Zkcer' 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept r,� 2 Board of Health