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0592 MAIN STREET (HYANNIS) (2)
G'es+ �� �i e 1\jessage Page 1 of 2 Anderson, Robin From: Anderson, Robin Sent: Thursday, December 17, 2015 8:47 AM To: Hartsgrove, Elizabeth; Scali, Richard; McKean, Thomas . Cc: Perry, Tom; Lemieux, Laurent Subject: FW: C'est la Vie, 592 Main St, Hyannis With regards to the applicant's current intention to add outdoor seating, see my email below sent directly to the applicant in Oct. 2015. 1 confirmed with Larry this morning that the proposed seating in excess of 19 seats will trigger the requirement for additional bathrooms. In the alternative, a variance from the state may be secured but without relief the number of restrooms must be increased accordingly. You should also be aware that Historic approval must be obtained for the outdoor seating including the tables/chairs, placement, signage and lighting. Because of the confusion with the original application I am compelled to reiterate the requirements -just to be very clear. Even if the applicant satisfied the LOCAL health requirement governing the number of restrooms - as of this date she has NOT satisfied the state requirement (at least to our knowledge). The applicant must inform all of us with regards to her intention to proceed and which option she will pursue. We will need a new layout/plan for inside and out. Plumbing , electrical and building permits are likely required to be determined upon submittal of a final plan and the nature and scope of the proposed work (if any). 0�96& Robin C.Anderson Zoning Enforcement Officer 200 Main Street Hyannis, MA 026oi 5o8-862-4027 -----Original Message----- From: Anderson, Robin Sent: Thursday, October 01, 2015 10:01 AM To: 'Cestlavie Patisserie' Cc: Hartsgrove, Elizabeth; Scali, Richard; Miorandi, Donna; Deputy Chief Dean Melanson (dmelanson@hyannisfire.org) Subject: C'est la Vie, 592 Main St, Hyannis Hi Natalie, As of this moment, the contractor is still active in our system and has not removed himself from the job. If you do not have the official permit you will have to obtain a duplicate (here at 200-Main St) for a nominal fee. Also, in order to avoid the requirement of a state variance for the number of bathrooms, your seating must be LESS than 20. This distinction 12/17/201'5 Message -Page 2 of 2 was not clear to me yesterday but was clarified to me this morning by the plumbing inspector while checking on the status of the required sign-offs. Therefore, you must amend your plan to show only 19 seats.- For the purposes of the building permit/CO & COI - staff can assist you with making that simple correction. However, since you have advised me that you are permanently reducing your seating, you are required to amend your license as well - even if you ultimately decide that this is only temporary. All amendments,, proposals, common victualer licenses, floor plans, capacity inspections and descriptions must match exactly in each and every document and in each and every department. The sequence of events and inspections must take place as follows: Present the original or duplicate building permit for signatures. Fire inspection - sign off Electrical inspection - final sign off Health - sign off After the above sign offs are secured: Building permit - final sign off (construction). Business owner or contractor may make this request. Building Certificate of Occupancy Building Certificate of Inspection - Capacity Inspection You must also consult with Licensing regarding proposed changes to the original floor plan approved vs. the proposed amended floor plan as described above. It is my understanding that until these matters are resolved you have been ordered to remain closed by the Licensing Authority. �,gbin Robin C.Anderson Zoning Enforcement Officer 200 Main Street Hyannis,MA 026oi 508-862-4027 12/17/2015 i Page 1 of 2 Anderson, Robin .From: , .Flynn, MargaretIt S Sent: Thursday, December 17, 2015 10:43 AM 4 19E To: Hartsgrove, Elizabeth Cc: Scali, Richard; Anderson, Robin; McKean, Thomas Subject: FW: outdoor seating From: Cestlavie Patisserie [mailto:cestlaviepatisserie@gmail.com] ° Sent: Thursday, December 17, 2015 10:12 AMA To: Flynn, Margaret Subject: Re: outdoor seating ° Thank you. Very Clear! i will recontact you early next year. Happy.Holidays :) R On Thu, Dec 17, 2015 at 10:06 AM, Flynn, Margaret<Mar ark et.Flynngtown.barnstable.ma.us>wrote: Nathalie, In order to accurately advise you of the next steps in adding exterior seats We will need,to see existing and proposed floor plans with a complete description of your request. According to Zoning any additional seats to the existing 19 will require a State variance, not just the local Health Board variance in reference to the number of required bathrooms. As a result, we want to be sure to advise you of ALL the necessary requirements to add exterior seats at one. time.To accomplish this, we will meet as a group and review your submitted plans and provide you an update. Maggie From: Cestlavie Patisserie'jmailto:cestlaviepatisserie@gmail.com] Sent: Tuesday, December 15, 2015 8:49 PM To: Flynn, Margaret Subject: RE: outdoor seating I got the agreement from Mr McKean and ijust received in the mail the variance with the two bathrooms. m', Could you double, triple check with him and tell me.so i can then come see you to do the amendment and everything else?Thank you;- On Dec 15, 20.15 12;12 PM,"Flynn, Margaret"'<Mar arg het.Flynn(a�town.barnstable:ma.us>wrote: Hi Nathalie, . The firstthing you need to do is talk with the Health Department about adding the outdoor seats. Once the Health Department approves your request you will need to come to the Licensing Authority for an amendment ` . to your Common Victualler license which will require a hearing. Additionally, we will need to ensure that all requirements have been et with the'use of Town property. We.can work on this after the Health department approves your request. , Christmas.Merry Chris 12/17/2015: t e Page 2 of 2 Maggie From: Cestlavie Patisserie [mailto:cestlaviepatisserie(�bamail.com] Sent: Sunday, December 13, 2015 12:32 PM To: Flynn, Margaret Subject: outdoor seating Good morning Maggie, I would like to start the application for outdoor seating.Before I make anymore mistake and everyone mad...could you please tell me exactly how I should proceed? Thanks so much for your help. -- I Nathalie Tournier "a PH.PH.603-831-0430 www.cestlavieus.com Nathalie Tournier C12aV12 I t PH.603-831-0430 www.cestlavieus.com i 12/17/2015 Page 1 of 1 Anderson, Robin a� , an CE- 94 From: Cestlavie Patisserie [cestlaviepatisserie@g mail;com] Sent: Wednesday, February 03, 2016 9:59 AM , To: Anderson, Robin Cc: Hartsgrove, Elizabeth Subject: Re: Plumbing Variance Thank you so much Robin. I will look into all this with my plumber. have a great day. On Wed, Feb 3, 2016 at 9:53 AM, Anderson, Robin<Robi.n.AndersonL&.toNyn.barn stab l.e.m.a.us>wrote: Natalie, The state plumbing variance applications are found on the commonwealth's website but I am attaching one with this email for your convenience.The owner/applicant or agent may only apply for a variance under a pre-installation application to the state plumbing board. This board meets the first and last Weds,of each month. It is advisable that the applicant appear on his or her own behalf but it is not necessary. Pains should be taken to ensure that the application is completed and accurate otherwise it may be rejected before it's heard. It is also necessary to submit a letter from the Health Division indicating that they are aware of this variance request along with the corresponding fee of$86.00. 1 am providing this information with the caveat that this is not my area of expertise so you may want to consult with your plumber about the requirements identified on the application and any clarification necessary. Remember also that proposed or approved and altered floor plans/seating plans(including outside dining)will now be necessary for review by Health, Building&Licensing. I hope you find this information to be helpful. o�96k Robin C.Anderson Zoning Enforcement Officer 200 Main Street Hyannis,MA 026oi .go8-862-402� Nathalie Toumier C PH.603-83.1-0430 www.ccstlavieus.com i 2/3/2016 r Message Page 1 of 2 Anderson, e son Robin .. From: Anderson, Robin Sent: Thursday, October01, 2015 10:01 AM To: 'Cestlavie Patisserie' Cc: Hartsgrove, Elizabeth; Scali, Richard; Miorandi, Donna; Deputy Chief Dean Melanson (dmelanson@hyannisfire.org) _ Subject: C'est la Vie, 592 Main St, Hyannis Hi Natalie, As of this moment, the contractor is still active in our system and has not removed himself from the job. If you do not have the official permit you will have to obtain a duplicate (here at 200 Main St) for a nominal fee. Also, in order to avoid the requirement of a state variance for the number of bathrooms, your seating must be LESS than 20. This distinction was not clear to me yesterday but was clarified to me this morning by the plumbing inspector while checking on the status of the required sign-offs. Therefore, you must amend your plan to show only 19 seats. For the purposes.of the building permit/CO & COI -staff can assist you with making that simple correction. However, since you have advised me that you are permanently reducing your seating, you are required to amend your license as well - even if you ultimately decide that this is only temporary. All amendments, proposals, common victualer licenses, floor plans, capacity inspections and descriptions must match exactly in each and every, document and in each and every department. The sequence of events and inspections must take place as follows: , Present the original or duplicate building permit for signatures. Fire inspection - sign off Electrical inspection-„final sign'off Health - sign off After the above sign offs are secured: Y Building permit`- final sign off (construction). Business owner or contractor may make this request. Building Certificate of Occupancy. Building Certificate of Inspection:= Capacity Inspection You must also consult with Licensing regarding proposed changes to the'original floor plan approved vs. the proposed amended floor plan as described above. It is my understanding that until these matters are resolved you have beemordered to remain closed by the Licensing Authority. 12/17/2015 aiaaaao�aaavat�iaJt7bL1MULCU1 rconomic expansion is is set torelease its first es _9- HYANNIS C`HA.-L. GES _1% S r_ff_%T) 171 _"r-" _"N Mh MAIIN ,^r}�e �G r h d, -.� aV�'^'� �, ( ,.u �� r dAI i��pI"di(a�I���r'�r*i rca�aa�v r t&4GG',y n'd• �' t 1 S 1 ��' �i 'tt'•`1y �5a to ar. • ��' " ���� >�, ,r� Via' at�IS��° + �+ �i � afi .A � 5 r ixj a�aNµtc AA� r� dog a s�A�r ,a (I,��i�{�,�6'Sd''C}��tr� 7 'u + Mao ac iSrfz��a aazt u 4, dy krya 3 w 4A G i't � f. t - I tz Chloe Tournier,right,and baker Kim Manning work to set up the kitchen in C'est la Vie,a French cafe slated to open today in Hyannis.The new restaurant is owned by Tournier and her mother,Nathalie.MERRILY CASSIDY/CAPE COD TIMES Two newcomers join downtown dining.scene; Island Merchant departs By Lorelei Stevens 10-year run on Sunday. Istevens@capecodonline.com Even with the closing of the east-end local music hot spot, a HYANNIS — The Main the street is currently home to +� Street restaurant scene is 54 restaurants,according to changing with the seasons.. Elizabeth Wurfbain,executive C'est la Vie, a French director of the Hyannis Main ' ' bakery and cafe,is scheduled Street Improvement District. a"ti d2v to open today at S92 Main "There's a lot of variety and St. and, by mid-October, vitality,"she said,referring to d;4 The Little Sandwich Shop her organization's designation ; will have relocated across of Main Street as the Fabulous 3 the street from the Sturgis Owner-Operated Dining, Charter Public School East or F.O.O.D., District. "The ...? Campus. whole street is family-run." The high concentration of restaurants has prompted the Hyannis Main At the same time, The Street Business Improvement District to deem the area the"Fabulous Island Merchant ended its SEE RESTAURANTS, A10 Owner-Operated Dining District."JIM PRESTON/CAPE COD TIMES FILE - 1 RESTAURANTS_ , From Page A9 �r Nathalie Tournier and her �r daughter, Chloe Tournier, - hope C'est la Vie will become a , {r retreat where customers visit, read and work while enjoying classic French pastries,crepes, quality sandwiches and a range �l of espresso drinks, teas and 9t smoothies. ` r Sandwiches are available both on-demand from the patisserie's menu or as grab- and-goes made fresh each ' morning.Boris Vilatte of the f boulangerie.Maison Vilatte in Falmouth is supplying baguettes-traditional,Gran- berry,cheese and olive-baked fresh daily. If C'est la Vie sounds famil- iar,it may be because Nathalie , Tournier, who grew.up in ` Provence and moved to the United States from Paris a E dozen years ago,opened a gen- M eral store of the same name in New Seabury over the summer. >` - I She intends run that store, r from Memorial Day to Labor x , Day,but to concentrate on her year-round Main Street loCa- ' ! tion centered on her love of `• 4: z , i traditional French baking and i cooking. M "This is what I want to do," she said Friday afternoon as she and her staff rushed to , assemble furniture and stock , shelves in anticipation of , today's opening. , LLI:co . �. s C]C: 1 I • f ' hope C'est la Vie will become a retreat where customers visit, read and work while enjoying classic French pastries,crepes, quality sandwiches and a range of espresso drinks, teas and smoothies. Sandwiches are available both on-demand from the patisserie's menu or as grab- and-goes made fresh each' J morning. Boris Vilatte of the boulangerie Maison Vilatte in Falmouth is supplying baguettes -traditional,Gran- berry,cheese and olive-baked fresh daily. If C'est la Vie sounds famil- iar,it may be because Nathalie ' Tournier, who grew.up in I1 Provence and moved to the United States from Paris a doz?n years ago,opened a gen- eral store of the same name in New Seabury over the summer. She intends run that store from Memorial Day to Labor j Day,but to concentrate on her i year-round Main Street loca- tion centered on her love of I 1 traditional French baking and cooking. "This is what I want to do," she said Friday afternoon as she and her staff rushed to assemble furniture and stock s shelves in anticipation of today's opening. People think French food is + expensive and nd pretentious.It s just fresh.That's all,"she said. "I want people to be able to sit, Lis and enjoy good food that Lis affordable." Calm and assured in the pre- opening clamor,Tournier said, i "We will open the door and have croissant and coffee and sandwiches and then ramp up through Sunday.It will be fun." Meanwhile, Dean Walton, ; chef-owner of The Little Sand- wich Shop, said he's looking forward to his move to Main Street after seven years at the Village Market Place on Ste- i vens Street. He and his crew have completely gutted the 1J former Sullivan's gift shop and installed a commercial kitchen. "We'll have a baker's dozen of breakfast sandwiches - 13 — and we cook all of our own turkey and roast beef and make all of our soups,"he said. "We grind.our beef for burgers daily and make our own pesto sauce. It's been on the menu since day one." 4 One restaurant,though,has shut its doors. Joe Dunn,chef-owner of the r Island Merchant said a combi-` nation of things convinced him to close his 302 Main St.loca- tion,including other business { opportunities and concerns about what he described as the declining state of the neighborhood. "Ten years was a really good ! run,"he said. Moving forward, Dunn said he and his wife,Beverly, would be focusing on their Osterville seasonal restaurant, The Islander, their catering business and a new partner- ship with The Sausage Guy,a Boston-based sausage maker, wholesaler,caterer and opera- for of the famous cart outside Fenway Park. Follow Lorelei Stevenson Twitter:@CCTLorelei. i 10/5/2015 The Barnstable Patriot-A little piece of Paris a +„ Home News Sports Opinion Business Arts/Events Villages Sections Advertising Search Pcpular THIS WEEK (; "if your builder Ln't ustne Shepley...please ask whyl- ; IN PHOTOS i -aai House shuttered until eatery addresses health violations —own manager search committee sees discord i Events 1G-2-15 Rich in friends and supporters Slideshow: Bamstable High School Class of 1950 j reunion i I's all about Main Street p i Pirates imrade Cotuit Center for the Arts ( f"" i Slideshow: Soccer Clinic in Hyannis Honoring years of good Counsell I Hyannis group ordered to stop giving out syringes „w ShepleyWood cam i .............. Sharete'1 a Friend®NO M. A little piece of Paris LAildf Latest Additions 2�0,.5 ��amail 4, Rich in friends and Written by Rachael Devaney supporters Honoring years of good I Counsell - Town manager search committee sees discord a BI teacher S teac e recognized It's all about Main Street The County Beat: 1 Commissioners prepare budget message -- _ Group sues Eversource County Notes 10-2-15 4 5 Things to Do 10-2-15 Early Files...10-2-15 S I i ttl I r s � r ' �. `•eta E I { Kim[Manning, a former teacher-tumed-baker, shows off some the edibles at C'est la Vie, at 592 Main St., Hyarn is,which'is due to open soon. Photos by Noah Hoffenberg M � I I C'es:is vie for Cape Cod locals as many area businesses pack up after the summer season. Luckily, Nathalie TOUmIEr has filled some of that vacancy with the fragrant aromas and flavorful cuisine of the south of France. Toumier,who was borrm and raised in Provence, France, is soon opening her French patisserie, C'est la Vie, at 592 Merin St.;Hyannis, and will not only bring a collection of classic French pastries to her new shop, but also sups, sEndwiches and a selection of tarts, cakes and mousse.Toumier,who co-owns the business with her daughter:Woe Tournier,said they have also formed a partnership with Boris Vilatte of the boulangerie Maison Vilatte.n,Falmouth,which will enable them to offer cranberry, buckwheat or classic sourdough baguettes to 1 http://Wm.bams_abl epatri ot.comlhon)e2rii ndexphp?option=com_content&task=\Aew&id=39902<emid=111 1/2 10/5/2015 The Barnstable Patriot-A little piece of Paris customers for what she calls"affordable prices." "We are very much a traditional French cafe, and we want people to know that they deserve authentic,fresh food made from natural ingredients without spending crazy amounts of money,"Tournier said."People should ' come in and sample a Provencal ratatouille with some eggs and cheese or even some bagels and lox without worrying about their wallet." i Tournier,who also owns the seasonal C'est la Vie New Seabury Country Store in Mashpee, decided to d i renovate the new Hyannis location with a"living room feel,"and refers to the cafe as a"retreat"where customers can not only eat but also rest,work and meet new people. "Customers can come in and feel right at home.We decorated with some of our own furniture, and have included items that have been passed down from my mother and through my family,"Tournier said."It's simple but beautiful." The mother of four,who formerly owned a cafe called Baby Cakes in California in 2008, and currently co-owns a C'est la Vie location in Peterborough, New Hampshire, as well as La Gribouille, a restaurant located in Paris, said over the years she has learned to"keep things simple"in the restaurant business. "I moved to the United States 12 years ago and throughout all my ventures I have found that most people like things to be straightforward,to the point and simple,"Tournier said."People love the little French coffee shop in New Hampshire because the food is fresh, affordable, and there's a comfortable atmosphere as well as Wi-Fi. We've tried to bring the same to Hyannis, and I think we've accomplished that and we're off to a great start." While Tournier feels it was challenging to meet new suppliers and form town relationships,the community has been"nothing but welcoming." "It's not always easy to open a business, but I've been working really hard to bring a great place to Hyannis that everyone can embrace,"Toumier said.And with the holidays right around the corner,Tournier said her customers have"a lot to look forward to." i "This isn't the type of place that will have the same food every day.We will continue to watch what's happening in France and in Europe in the food industry and apply it here,"she said. "I think we really have something special." j ..__._._ Subscribe to Email Updates iClick HERE to subscribe to e-mail updates from barnstablepatriot.com. i _:.. I 1 f I CONTACT LIS I The Barnstable Patriot 14 Ocean Street 1 P.O.Box 1208 1 Hyannis,MA 02601 1 508-771-1427 1 Copyright©2015 Local Media Group,All Rights Reserved. http://wu t.barnstablepatriot.com/home2lindexphp?option=com_content&taskkew&id=39902<emid=111 2/2 T Sign . TOWN OF Permit * sAMSTABLE, # MASS. � s6 ArF p.19..�a Permit Number: Application Ref: 201506496 20071147 Issue Date: 10/01/15 Applicant: Proposed Use: RETAIL & SERVICE STORE SMALL Permit Type: , SIGN PERMIT Permit Fee $ 50.00 Location 592 MAIN STREET (HYANNIS) Map Parcel ,4 308073001 t Town HYANNIS Zoning District HVB Contractor PROPERTY OWNER Remarks 1 WALL SGIN C'EST LA VIE 4X 2 Owner: 592 MAIN STREET LLC Address: 22 COMEAU STREET WELLESLEY, MA 02481 Issued By: p d POST TINS CAIZD SO'THAT IS VISIBLE FROM THE ST ET r ;+ PERMIT PAYMENT RECEIPT i .'TOWN OF BARNSTABLE iBUILDING DEPARTMENT 6200 MAIN STREEV ,HYANNIS, MA OMO1 DATE: 10/01/15 `TIME: 11 :03 -----------------TOTALS------------------ PERMIT $ PAID 50.00 AMT TENDERED: 50.00 CHANGEPLIED: 50.00 APPLICATION NUMBER: PROPERTY OWNER PAYMENT METH: CHECK PAYMENT REF: 159 Town of Barnstable Regulatory Services (��Q EARNSTAE sue. Richard V.Scali,Director l \ �E16 0. 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 Permit# Building Official approving Application for Sign Permit Applicant C,e Assessors No. Doing Business As: e Alothc1cTelephone No. Sign Location Street/Road: '5 ,2 !4 Zoning District Old Kings Highway? Yes/No Hyannis Historic Districts' (RN 0 Property Owner g l Telephone: Address: L 2 Village: Sign Contractor Name: Telephone: Mailing Address: Description Please follow the cover directions.You must have an accurate rendition of sign with dimensions an location. f W' Is the sign to be electrified? YesX9 (Note.Ifyes, a K5ir gpermitisrequired)- - Width of building face Jeb l " ft. x Io a _x.10 s- ,y Y Check one Reface existing sign or'New Total Sq. Ft of proposed sign(s) S Ifyou have additional signs please attach a sheetlisting each one T4ath dimensions. If refacing an existing sign please provide a picture of the existing sign with dimensions. I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of - §240-59 through§240-89 of the Town of B s le Zoninng Ordinance. Signature of Owner/Authorized Agent Date Lk' SIGNS/SIGNREQU revisedl 10413 r r NEW`&USED GDS&DVDS ^' A 4, , e �' � x... �� i.,€ � _....,,,,,r e�z '• � � .,± ti a� 636� '617 239 36 Ii 3 g 1 1 - - • h {1 _. « { 2; e i .. r. W f_!g 181237.9522' r Y t x M - �Vti Town of Barnstable Building Department - 200 Main Street iARNSTABLE. * Hyannis, MA 02601 . MASS 1639.- 1508) 862-4038 Certificate of Occupancy Application Number: 201501114 CO Number: 20150202 s Parcel ID: 308073001 CO Issue Date: 10/01/15 Location: 592 MAIN STREET (HYANNIS) Zoning Classification: HYANNIS VILLAGE BUSINESS DIST Proposed Use: RETAIL & SERVICE STORE SMALL Village: HYANNIS Gen Contractor: PROPERTY OWNER 4 Permit Type: CC00 CERTIFICATE OF OCCUPANCY COMM Comments: C'EST LA VIE Building Department Signature Date Signed S�iZ YV1� � n :JTVo. l 5as s� wDv NU Ke 1�a�ze � hr� Page 2 of 2 asked for updates about periodic promotions,special events.new store. Rights berty Avenue,Union,NJ 01083 e, — 4 ti I - - 1 TOWN OF BARNSTABLE Build tHEr 20150111-4 * BARnIs'rAg>lE,•* Issue Date: 06/15/15 Permni 9 MASS. �p i639•rFD _k Applicant: 592 MAIN STREET LLC Permit Number: B 20151518 I MA't A , Proposed Use: RETAIL&SERVICE STORE SMALL Expiration Date: 12/13/15 Location 592 MAIN STREET (HYANNIS) Zoning District HVB Permit Type: MISCELLANEOUS Map Parcel 308073001 Permit Fee$ 60.00" Contractor LAWRENCE M.NADZEIKA Village HYANNIS `°t<App Fee$ License Num 040948 w Est Construction Cost$ 0 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND TENANT FIT OUT FOR C'EST LE VIE THIS CARD MUST BE KEPT POSTED UNTIL FINAL ADDITION OF 1 HANDICAP UNISEX BATHROOMS INSPECTION HAS BEEN MADE. WHERE A r CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: 592 MAIN STREET LLC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 22 COMEAU STREET INSPECTION HA EN MADE. WELLESLEY,MA 02481 ¢� Application Entered by: PF Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PARYTHEREOF,;EITHER TEMPORARILY OR PERMANENTLY ENCROACRMENTS'ON LIC PROPERTY,NO. SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLEY.GRADES AS WELL'AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED.FROM THE DEPARTMENT.OF PUBLIC WORKS.'THE ISSUANCE OF THIS PAMIT DOES NOT RELEASE 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. 5.PRIOR TO COVERING STRUCTURAL MEMBERS'(FRAME INSPECTION). 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY, WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). DY a e s 1 Est ' e �. ✓' BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS 'ELECTRICAL INSPECTION APPROVALS 1 1 P/P O/M 2 2 2(i ` 3 J� 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 B a lth Tiftl I f .�:. kwl� Y �. S.• i� i�yY 3 Jm `, • 1�.1�_Y' r. �A 3"sr�+i "�^-�' r r•:�'r 1,j'!' ft:: I' / a. ar 6 ��k.+ <, �� 'w4 c3�.'`, ' t�r,. •''Y'�} ri by`. k�6 ���'� 11 t 74 ?� �* ..�+y,•? tYr aS�,4tV. � •,1 a ,• 'A i Of i 4VA " an r I: i (I :In I�lt M' �• �y�.fic 7 / Fresh 1 �� • . 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C � ,�,��s' �. �' wrr <I'1��f/,R�i?J� yr r y(-pia `i� d�1•ry `-Ci l• � c •c� �t 4M��1 ..ri a ' i 47 �a:, A, s y i 7 i r 4 Sl�li I / 1,71 OISM jo ��4d Iln�1 _J 1 Km`e l Message 'p Page 1 of 1 Anderson, Robin From: Miorandi, Donna Sent: Monday, September 28, 2015 9:18 AM To: McKean, Thomas Cc: Wadlington, Ellen; Building Dept Subject: FW: requirements -----Original Message----- From: Cestlavie Patisserie [mailto:cestlaviepatisserie@gmail.com] }' Sent: Sunday, September 27, 2015 9:15 PM To: Miorandi, Donna Subject: requirements Donna,just want to make you aware that the second bathroom was finished as promised so we can operate with seating now. We are closed tomorrow to bake but you can stop by whenever you want after 1. I will stop by your office to pay and fill variance during the day. Thanks. Nathalie Toumier PH.603-831-0430 wa�1�.cestlavieus.com * 9/28/2015 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name YA DZ Pl 1k) Telephone Number Address � � 2�3�7 License # r�' /9!�Ko 45�� Home Improvement Contractor# Email Ab4-D 2.e4 0&eHaz LC Worker's Compensation # ALL CONSTRUCTION DEB IS RESULTING FROM THI PROJECT WI L BE TAKEN TO Al SIGNATU DATE TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION MapV Parcel Application # Health Division Date Issued' Conservation Division 3 SVp` Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation Hyannis o / Project Street Address C �ca. i P t'G�"1\ ' r j S� o► _ ��' Village � WNKZl M A 02.6 Owner LL C. Address 2,2 �ner�cu S" � k, Telephone v Permit Request I\Atr Ok 0301� CiL-.0 r)caovj�m I k t Square feet: 1 st floor: existing proposed 2nd floor: existing proposed . Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio r� 1` 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.) Qka§ement Unfinished Area(sq°ft) Number of Baths: Full: existing new Half: existing j new Number of Bedrooms: existing _new ~' f , 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: -,.❑Yeses No 0-_-1 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 J . 1 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1 fi 1 Telephone Number — Address I License # Ho e Improvement Cc actor# Email Q," C�Vi f�1�C'� Worke ' Compensati n # ALL CONSTRUCTION DEBRIS E LTING FRO THIS PROJECT L BE AKEN TO_��' I ' SIGNATURE UkA DATE 6 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED ' MAP/PARCELNO. a ADDRESS VILLAGE ; ' OWNER i i i DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO. i • i °��'�"'°°"Y""' ACOO® ' CERTIFICATE OF LIABILITY INSURANCE 1111.� 5/18/15 THIS CORTIFICAYE 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: JOE DEOLIVEIRA Deoliveira Insurance Services PHONE FAX 800 Falmouth Rd. E-MAILIAIC.N. • (508) 477-3023 / No: (508) 638-6463 UNIT101-A ADDRESS: joe@dinsinc.com Mashpee, MA 02649 INSURE S AFFORDING COVERAGE NAIC# INSURER A:AMGUARD INSURED INSURER B Lawrence M Nadzeika INSURERC: P.O. BOX 2337 INSURERD: Mashpee, MA 02649 INSURERE: 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 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. LTR DD ------ AL TUBR — — POLICY EFF POLICY EXP --- - - --- -- - -- LTR TYPE OF INSURANCE INSR I WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREM ES Ea occurrence $ CLAIMS-MADE OCCUR ME EXP(Anyone person) $ PERSONAL&ADVINJURY $ GENERAL AGGREGATE $ GEN'LAGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ POLICY JE LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea.ccident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION 001015244 10/22/14 10/22/15 X WC STATU- OTH- ANDEMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACHACGDENi $ 100,000 OFFICE R/MEMBER EXCLUDED? N/A (Mandatory in es,describe under If nder E.L.DISEASE-EA EMPLOYEE $ 500,000 ` yy DESCRIPTIONOF OPERATIONS below E.L.DISEASE-POLICYLIMIT 1 $ 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is regui red) CARPENTRY LAWERENCE NADZEIKA IS NOT A COVERED OWNER UNDER THIS WORKERS COMPENSATION POLICY LOCATION:592 MAIN ST HAYNNIS, MA 02601 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABO E DESCRI ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE HE OF NOTICE WILL BE DELIVERED IN TOWN OF BARNSTABLE ACCORDANCE WITH THE P CY P VISIONS. BUILDING DIVISION , 367 MAIN ST AUTHORIZED REPRESENTA E HYANNIS, MA 02601 JOE DEOLIVEI / ©1998-20tT_AddRD UORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: (508) 790-6230 E-Mail: Town,of Barnstable s Re,, R'�Qi " dervi es ltieiyard'V_lgeuhi IN'ror for Turn Perry. Canwdssfauer tiVi O�.�`�43I 54��vV:CCIr�'»:It:ra:rluf.l�, ;��s° Fax. 508-790-6-7-so Property :herMust If U. ing"A 'Builde- Ox act o)a L=tteas rcl vork 3ut,hon4 c i by this,bA �,�:-t-r t,p. K-Atl jl fvr ""Pbo fc-races 1,nd 4r ar :t r-csp© si }r s I:rho a ji c it".Nob �� , are nay,a-v �VI'Me ,or utl� befo rc kr-.nte.,is ins—tih C� alilina1. =11cctorls are ped6mled. atcepteai; ; `�ix �3tsrr tx. ,.. sib 0i_ }iIicni Mass. Corporations, external master page Page 1 of 2 William Francis Galvinlow— yp h Secretary of the Commonwealth of Massachusetts Corporations Division Business Entity Summary ID Number: 000980930 {Request certificate I' New search J Summary for: 592 MAIN STREET, LLC The exact name of the Domestic Limited Liability Company (LLC): 592 MAIN STREET, . LLC Entity type: Domestic Limited Liability Company (LLC) Identification Number: 000980930 Date of Organization in Massachusetts: 06-26-2008 Last date certain: The location or address where the records are maintained (A PO box is not a valid location or address): Address: 22 COMEAU STREET City or town, State, Zip code, WELLESLEY, MA 02481 USA Country: The name and address of the Resident Agent: Name: SCOTT C. RAVELSON Address: 22 COMEAU STREET City or town, State, Zip code, WELLESLEY; MA 02481 USA Country: The name and business address of each Manager: Title Individual name Address MANAGER SCOTT C: RAVELSON 22 COMEAU STREET WELLESLEY, MA 02481 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 SOC SIGNATORY SCOTT C RAVELSON 22 COMEAU ST WELLESLEY,' MA 02481 USA 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.a... 6/3/2015 Mass. Corporations, external master page Page 2 of 2 REAL`PROPERTY SCOTT C. RAVELSON 22 COMEAU STREET WELLESLEY, MA 02481 USA • r r Confidential r Merger r Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Annual Report I Annual Report - Professionala Articles of Entity Conversion Certificate of Amendment View filings Comments or notes associated with this business entity: I y New search s http://corpssec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.a... 6/3/2015 - Oftee of Cousumer Affairs&Ba iiness itegulat:lon License o;r registration valid for irudividrul use only 3 BIOME,IMPR.OVEMIENT CONTRACTOR before the expiration date. of found retu.ruao: ytegisitration; 111841 Type, Oaof Consumer Affairs nd Br sines Regulation xpirtition: 2/4/2017 individual 10 Park Plaza Suite 5170 LAWREN M. NADZE IKA Boston, C;E MIA 02116 LAWRENCE NAOZEIKA 14 WILANN RD MAR;SHPEE, MA„0264$. 1lnderseeret rr �Not without slgitatuiry i. 1 Massachusetts -Department of Public S:a E•ty Board of Building Regulations and Standards Construc[iun Sup�rai+ur License: WiL040948 LAYNUNCE At NOZEEKA. PO BOX 2337 Marihpee 11RA 02t 9 , °✓�.�w+ .e�'�,,6C�c., '+ "r` Expiration Commissioner 07/C15/2015 t A. Tlie Commomvealth ref Massac husetts F Lkepcart tint o,f&d=&ia!Acciderds Office of Imestigadons 600 Washington Street Boston,AL4 02III rtmumamgvv1dia a orkers'rCa mspensafion Insurance Affidavit:Bnilders/C,ontractarsMectricianslPlumbers Applicant 15nfarmatign Please Print Legit Name _- CitylSta&zig: An Phone 5 Are you an employer?Check thi appropriate box: Type of project(required): I am a contractor and I" 6. ❑New constructim T.�] I am a employee with(2) 4. ❑ employees(full andfor part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or parer- listed on the attached sheet. 7. ❑Remodeling, ship and have no employees These sub-contractors have, g_ ❑Demolition wonting for the in any capacity. employees and have woslaers' [No wodoers'comp.insmance comp_msurance.1 9. ❑Building addition reg3ired] .5."❑.We are a-cc porafion and its 10-❑Elechicai r+epa=or additions officers have exercised their 3.❑ I am a homeou�er tiaisg all work . 11_❑Plumbing repairs or additions. mysel€ [No workers' _ right of exemption per MGL 12.❑Roof repairs a 152, 1 4 and have r�o insurance re�rired_j F § ( � - _. . employees.[No vrorkers' 13.2 Other Un I i `5e. camp-insurance required_j 'Awry applicmm chat chedl 3 boys#1 nmst also fill out the section bdow showing their wadere compensation policy informatioaL - 1 Homemvners who subamt this aMdmit m iicsdng they are daiing all wal sad then}sire outside contractors mast submit a new affidsm mdicatiq;smdi ZContractors test chmk this box roust attached sn additional sheet shovemg the name of die sub-caaawtcxs and state whether or not those en it have employees.Ifthe snb-cantntctnrs have employees,theymvstpmvide their workers'-romp.policy number. I am an emplo;I.w that ispnwiding workers'compensatian insurance for my enrp1vjwes. Below is the policy and job site informalrors �. �-Iuslurance Company Name: zn� SS ' Policy#or Self-rues.L ac.#. Wi(% Expiratt Date:---/t ?.Z_LS . f rib ate Aadr : r��Lr2, M ca ..` •' � >u>,Ii,6 c rSta�erzim �, . a 2 bd I U. Attach a copy of the workers'compensation policy de ration page(shoving the policy number and expiration elate}. 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 andfor one-year imprisonment,as well as t h it peuakies.in the form of a STOP WORX 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 ofthe DIA for insurance coverage verification: I do hereby certify render thapains and nalties of eefury atthe infortnationr provided abmw is hue and correct Sitmattrre: ` t r'f,- -Date: Phone 0: Official use only. Do not write in this area,to be completed by city ortown officiat City or Town: Pera dtUcense# Issuing Authority(curie one): 1.Board of Realth 2.Building Department 3.Citp/rown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone'#: 1 Information and lastruction s . ., .. ; Massachusetts G&acral Laws chapter 152 requires all employers to provide workers'compensation for their.employees. Pursuant-to this sf Autp,an anplvyee is defined as."-.every person in the service of another under any contract of hire, express or implied,oral or va tlnn." , An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more Of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of a a individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work on such dweDing house or on tine grounds or building appuatenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(G)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings commonwealth for any T applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commgawealth nor i iy of its political subdivisions shall enter into any contract for the performance ofpublic wouc until acceptable evidence of compliance with the finm-an ce.. requirements of this chapter have been presented to the contracting auihouty." : Applicants Please fill out the wodcers'compensation affidavit completely,by cheer the boxes that apply to your situation and,if necess I sub-contracto s)name(s), addresses)and phone number(s) along with their certfficate(s) of �Y�DPP Y � ins n nce. Limited Liability Companies(LLC)or Limited Liabr7ity Partnerships(LLP)with no employees other than the members or partners,are not required to cast'workers'compensation insman=. If an LLC or LLP does have empIoyees, a policy is regnued. Be advised that this affidayit may be snh�d to the,Department of Industrial Accidents for confirmation of incrzrance coverage. Also be sure to sign and date the affidavit The affidavit should be retnmed to the city or town that the application for the pemmit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at tine nnmber listed below. Self-insured companies should enter their self-insurance license number on the appropriate lime. City or Town Officials t Please be sure that the affidavit is complete and printed.legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of lnvesfigations has to contact you regarding the applicant- Please be sure to f M in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applir ations in any given year,need only submit one affidavit indicating current policy information Cif necessary)and under"Job Site Address"the applicant should write"ail locations in (city or town)_"A copy of the-affidavit that has been officially stamped or minced by Ahe city or town maybe provided to the applicant as 'proof that a valid affidavit is on file for furinre permits or licenses_ A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i-e. a dog license or permit to bu i n leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call- The Department's address,telephone and fax number. Tie CammmWedtbE of Massachnsett, , Department of Ldusbial,Amidenta. Of ace of)nvegunlio.� 604 WashiVGIi Stztret B aston,MA G2i 11 Tf,-L 4 617'27-4}QO ci t 4€6 or 1-977-MSSAFE Fax#617-727-7749 Revised 424-07 .masg-gov/dia ............................................. ,, M lip �g '£� rr /� ; r ,A / �I y y/r3 3 a�' `"��� £v � s� �/9/i1� •,� 3 ':4 :.3;< ��� � � ��' pI�2 /T ......, W. o r � � Rif UalE I7�YI�RI3CU ResC€�i gd�3rr y i i 33 Ci dd t pp Pf„LlItI@ �� .i �S„h Psi^,^. ..:.,• fl ,k ri fi.!. 99 fi, 4 .,.. 0 » £PLUM ROl'1`1 ��1 � y DSHE 08/21/2015 �r PASS ��- n� 811571 F4MIGLIETTE GARY: £ F ! i qq T q 13 -- n' a 1a 3 e r r�s s Wn ILL I €y / T"f4" � w.xresrv9 aai`. 1 �38, 3 ll> 3 • ar 1 ..,..3 r -k n6� ✓ ,;.�,,..",. ,,,,,,,... ,;r;.,r„ n,w.;,.. ... ........ J £'_T4..i:: .;fr�il}.'�E < - � 'AT j 11.f -v L""�, . y tnf�'7f, �?✓��,,,��r - " ., .o,.,..n.+.�.ye,a. .r......,. Fit r1'.�� ,;,�:x �tv,,a. 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You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law: DATE: Fill in please: i_ APPLICANT'S` YOUR NAME/S: k3 `nc `E rO ,. BUSINESS YOUR HOME ADDRESS: o TELEPHONE # Home Telephone Number g c)p —rn L NAME OF CORPORATION: NAME OF NEW BUSINESS �_E-SIe TYPE OF BUSINESS - IS THIS A HOME OCCUPATION? YES NO 7C ADDRESS OF BUSINESS 2 v- S H, D2 60 MAP/PARCEL NUMBER �Q (Assessing] When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the,information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFIC This individual he can informs f any permit requirements that pertain to this type of business. . r! Authorized Sign COMMENTS: q , 2. BOARD OF HEALTH This individual has.been informed of the permit requirements that pertain to this type of business, Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This Individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: • f Commonwealth of Massachusetts She Metal Permit - V yr0 (a(, ( t s' X-PRESSPERjA Date:f� —ZG -t f g # Z 01 5l/IL5 0 1 Estimated Job Cost: $ I a Off OCT 2 8 2015Permit Fee: $ Coo OWN OF ' � RT d: YES NO Plans Submitted: YES NO la J Business License# 31 Applicant License# ���_I Business Information: Property Owner/Job Location Information: Name: PVA& MCCI.f A-N I C dkL ' '-J kf UC. Name: , S?w(-E- SoEAJ Street: PO 6--ic `Z y 1 Street: -C(A VAK I IV SA- o- City/Town: 1/i7 f C S\,d'J'e- A"PA City/Town: Telephone: '�b� 811fs 17 Ys- Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES NO Staff Initial J-1 /M-1-unrestricted license J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less Residential: 1-2 family Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq. ft. X over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work: Renovation: X HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing . Provide detailed description of work to be done: l�c 2 Rv A-L v co.A-,5 Town of Barnstable - Regulatory Services Eve rays Richard V.Scali,Director ; Building Division 1AENSMBL Tom Perry;Building Commissioner MASS.9� 1659. ,�� 200 Main Street, Hyannis,MA 02601 QED MAt�` www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 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. DEF '4rnON 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 ie'ponsibility for' oc mp'lia'iice""wit)i`the State Building-Cade 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 • r , 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. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doC Revised 040215 i oFtt+e t� t • snxxsz�sca, * - 16 Town of Barnstable Regulatory Services Richard V.Scali,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 I, 5C-4+ �civ e-�S o ,as Owner of the subject property hereby authorize l�M� jY1 eCC���„,e r�� s�:a- ,� LL C. to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) 2G 1 S-- Signature of Owner Date srd Q C-0-4ir2l jrn. Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPHLESTORMS\building permit formsTYPRESS.doc Revised 040215 -`` 27W CoMinomvea1-1h,.gf- a---YaC1JUsetts D—p ut ymit c�,f rndashza1Acciderafs Offixe offmWS69a1ions. 600 Washington,S'treet y Boston,41A 02111 ' Workers' Compensatian Insurance Affidavit:$•mldei-s/CuntraciarslEIectriciaurJPlumhers APPEcant InfGi-nation Please Print 1&.c bIy Name IBusfiwssPOrganizationfludi�Mi Address: �� o`� "J�•7 City/StatetZiF-_ Plrono-4k S-Dig- Are}ou an employer?Checkthe appropriate box _ Type of project(required): 1_�'I am a emp loyer with 4 ❑I am a general contractor and I employees(full andfor part-time).* have hired the sub-contractors 6_ New construction 2.❑ I am a sole proprietor orpastner- listed on the attached sheet, 7- ❑Remodeling s. . and have no employees. These sub-cantractors have � S_'❑�Demalition wa zing RMme in any capacity- employees and ha,,e workers' [o tw orktrs'comp.insurance, comp_insurance-1 �_ El Building additioze regained-] 6_ ❑ We are a corporation and its 16❑Electrical repairs or additions 3111 am a homeoumer doing all work officers have-exercised their 11_❑Plumbingrepairs or additions myself-[No workers'comp- tight of exemption per MGL 12-❑Roofrepairs insurance required]i c.152, §lM andwe have no employees_[No workers' 1 _[2 Other comp_insurance required-] OAnyagpPic=tQbatcbecls box Rmmstalsa fill out the secliaab9 wshavdngtheywuaers'comp—mti npoI'icginfamrauaa_ Hameownerswho submit tftis sffidaeii indfativ-g tb--y are dG' -all wa l an$gun hire autdae contractarsIImtt submit a newaffida4it huacafiag such_ r0antrnctmrs1h t clPcicihis brat mast 2ttached an addWnad sheet shoceing thennae of the sutrca a zad state whether.arnatthase entitieshave • earployees.Ifthesub-caatmctnis�eemgIoyres;theym�stpmv-ideiheir nnrkecs'tomp.palicFa>mrher_ I am aft eriipJaper tFecrtis pratzdr'rcg workers'catuperrsrriratr insuuanca farm}*enrploy�ees $etoav is tjrLr patiry cued jr?b zit�r information. Insurance Company Name: Pflficy or elf--ins_Lit. U r& I 7 A 2fig' ExpiiatioaDate: 1 �6 Job Site Address: 2— CM et!.v Sk- CitylStatdZ�p: l J14 N Al t S Af k Attach a copy afthe warlters'compensationpolicy declaration page(shoving the policy number andexpiration date). Failure to serum coverage as required under Section 25A of MGL c�152 can lead to-the imposition of criminal penattaes of a fine up to$1,5p0:O0 indlor one-�!esrimprisDnmmt,as well as civil penalties•in the form of a STOP WORK ORDER and a Erne of up to$250-00 a day against the vioLdar. Be adsdsed that a copy of this statement nsaybe fmviuded to the Office of InvesEsgations of the DIA for insurance-coverage verifrca#icn- F do herz6y c&tVfy io th pains andpanalYz- s a:fFedWy thattJrs in or atiarrpm-ided ahmv s&ug mid correct Sitnrature_ Date: p L£& —l5 Phone A: 7 L(S O,I�tCial arse QrrTy. �Do nut a�rrte>•rt tltrs area,i�►be cauiplete,+d hp tdip ar fa�mn o,�`rctat City or Town- - Perm tff icense# ' Issuing Anfharfty[cu cIe one]: L Board of$eg& RuffTiing Department 3.Cylrosvn Clerk 4 Electrical hapecfor S.Plumbing Inspector' b.Other Contact Person: Phone#: Tuformation and last-nc-lons Massachusetts Geze-9 Laws chapter 152 regofim all employers to provide Wotkeas'compeasaflCm for fhe r erciployees- TMt to this stye,as employee is defined as-"_.evesp peasan inIs the service of another Under aay contact of hire, express or implied,oral or wrhn_" An employer is defined as-an individual,partnership,association,corporation or other Iegal entity,or any two or more of the foregoing engaged is a joint enterprise,and including the Legal representatives of a deceased empIoyer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees- However the owner of a.dwelling house having not more than.tbree aparhnents and who resides therein,or the occupant of the - dwelling house of another who employs persons to do ma�ance,construction or repair work on such dweling house or on.the grounds or bmlding appurtena�$ereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also sides that"every state or local licensmg agency shall withhold the isstrance or renewal of a Tic— e or permit to operate a business or to construct buddmgs in the commonwealth for any applicanfwho has notproduced acceptable evidence of compliaricewith the incaraace coveZagerequited" Additionally,MGL chapter 152, §2SCM stains¢Neither the commonweala nor any ofits political subdivisions shall , entering any contract for the pPrma„ceofpublicworlcun�Iaccepfableevidenceofcompiiancev�itiifi�e;,,s, ,ce. req=menfs of this chapter have been presented to the ContracliDg avfhodit Applicants Please fH oil the woik='compensation affidavit completely,by checliag the bones that apply to your sitnation and,if necessary,supply sub-contractor(s)name(s), addresses)and phonennunber(s) along with their certfficate(s)of „nua ce. Limited Liability Companies(LLC)or Limit-d.Liabi-ify PartnersEps(LLP)with no employees other than the members or parfners,are not required to carry workers' compensation file rrance. If an.LLC or LLP does have employees, apolicy is regnired. Be advisedthatthis afdayltmaybe subm�dto the Depu went of Industial Accidents for conf=ation of insirran ce coverage. Also be sure to sign and date the at�dayit. The affidavit should be retnmed to the city or,tbwn that the application for the permit or license is being requested,not the Dep artmeat of Tr rt rt�-trial Accidents. Should you have airy questions regarding the Iaw or ifyou am e regnaed to obtain a.Fvorkers' compensation policy,please call the,Department at the,number listed.below. Self-insrned companies should enter th5ir self-i ora ce license number on the appruprrafe line. City or Town OfEiciaLs Please be,sure that the affidavit is complete andprmjrd Ieg�bly. The Deparimenthas provided a space of the botfom of tha affidavit for you to fill out in.the event the Office oflnvestigat ins has to coufact youregarding the applicant Please-;be sure to fill in the pen .it/licease nnanber which will be used as a reference number In addition,an applicant that must submit iaukTIe penDit/license applications is any given year,need only submit one affidavit indicate cuzcent policy kf6 atidu.(if necessary)and under`clob Site Address"the applicant should write"all locations' prod (may or town)"A copy of the-affidavit that has been officially stomped or marked by the city orFtaym m may b e provided to the applicant as proofthat a valid affidavit is oa file for future permits or licenses A new affidavitmust be filled.nit each year.There a home owner or citizen is obtaining a license or permit not related to any brisiness'or commercial venture (Le. a dog license or pemnit to bum leaves etc_)said person is NOT required to complete tins affidavit The Office of Investigations would hke to thank you in advance for your cooperation and should you have any questions, please do not hesrtafe to give us a call The Depa finenfs address,telephone and fax number_ y Tht canmlanweala of Mks aches;tttts . ' DegM�M t af liidutdA AOCZenta �R�man Str�eT; - r o-n=MA Oil 11 Tf,-1.4 617' -4900=t 4-06 or 14771MA SSAF Fag 9 617 727-7749 Rtvised¢24-07 gfdra i ACORO® DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 3/20/2015 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 Siedi Bergeron NAME: 4 Eastern Insurance Group LLC PHONE ($OO)572-4538 FAX 781-586-8244 233 West Central St A DAIL RE :selectwork@easterninsurance.com INSURERS AFFORDING COVERAGE NAIC# Natick MA 01760 INSURERA:Travelers Indemnity Co 25658 INSURED INSURERB:Trav Ind of,. CT 25682 Pmg Mechanical Systems LLC - INSURERC: J P.O. BOX 797 INSURER D: INSURER E: Forestdale MA 02644 INSURERF: COVERAGES CERTIFICATE NUMBERCL1531954877 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. IUD? TYPE OF INSURANCE POLICY NUMBER ADDLSUBR MM/DDY EFF MM/DDY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE X COMMERCIAL GENERAL LIABILITY PREMISES Ea O R TED PREMISES occurrence) $ 300,000 A CLAIMS-MADE a OCCUR 6801575BB16 /15/2015 /15/2016 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ .2,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY CEOs BIKED SINGLE LIMIT 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED 1595B298 /15/2015 /15/2016 AUTOS X AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident Underinsured motorist BI split $ 500,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ A :4 EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION t7P8587W106 /15/2015 /15/2016 $ B WORKERS COMPENSATION X WC STATU- OTi+ AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $- 500,000 OFFICER/MEMBER EXCLUDED? ❑ N I A ,s (Mandatory in NH) 1987B208 t /15/2015 /15/2016 E.L.DISEASE-EA EMPLOYE $ 5()0,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. -200 Main Street Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE John Roegel/MET ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS1125 i7mnnsi m Tha at non noma onr1 Innn ora raninfararl m2rka of annan INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes 9 No❑ If you have checked Yes,indicate the type of coverage by checking the appropriate box below: A liability insurance policy 16 Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 am aware that the licensee does not have the Insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box❑,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and 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 112 of the General Laws. Duct inspection required prior to insulation installation:YES NO Progress Inspections Date Comments Final Inspection Date Comments Type of License: By ❑ Master , Title ❑Master-Restricted City/Town ❑Journeyperson Signature of Licensee Permit# / G ❑Journeyperson-Restricted License Number: Fee$ ❑ Check at www.mass.nov/dal Inspector Signature of Permit Approval I� Commonwealth of Massachusetts a '� a Department of Public Safety .3 Sr1F x p2• .b.t. �ri5.( .._ 7 .y 4£SSS-s=r.'�`'"-£` ' PiPe/itter Journevroan License: PJ-030149 a PAULGENSP.O.BOX 797 F n z n ;i FORESTDALE MA i � r x M. t � ' Commissioner xpirrationi FURS q FdA 02644 09/06/2015 s qa ram �i .o�,tss �. 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