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HomeMy WebLinkAbout0620 MAIN STREET (HYANNIS) - dragonlite -i 7zE- J i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map U Parcel 0 C .� `� IN STx �_� Application Health Division y, r 0. Date Issued — i VT�� P Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 2 hl A r3 i Village Y A Pi x,is Owner Q iv Q Address JJ A CIA tZA �,� . ;r�►,-, �, Telephone 5 i Y Permit Request � ,c � :�,� ,s .. L'+ Square feet: 1 st floor: existing /"' proposed 2nd floor: existing proposed Total new Zoning District V. Flood Plain Groundwater Overlay Project Valuation Construction Type u_iod.A, Lot Size © , 3 L Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure 19 9 o Historic House: ❑Yes ` l\lo On Old King's Highway: ❑Yes 3-No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) / Basement Unfinished Area (sq.ft) 7207 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: 0 Gas ❑ Oil ❑ Electric ❑ Other Central Air: 2-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 �d Yes ❑ No If yes, site plan review # Current Use Qr,As,, i;. Proposed Use sn APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ZO. CC71 Telephone� n N �© , ► II,� T C • e umber �� ems" Address (0 �Qekc _ (Rae i �ua- License # C 3 0 S 1 mAr<M11 �r _ Home Improvement Contractor# 13 7 7 Y Email Q I\,�t s ) ( CC w � } N Worker's Compensation # to e 0 S P -3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO f SIGNATURE DATE Ina ap ,�5 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. o Hw Ctrrr!omit slth of'Massachusetts Department of Indusftial Accidents 01TWe Of IMes ations . 600 Muskingtom&meet Boston,` AM 02111, wnw rnasmgrri,�Idia ' orket-s' Compensatign Tnsnrance Affidavit:Builders/Contractors/ElectriciansMumbers Applkant Information t Please Print:Le?ibTy Ive- Andress_ 10 �,P A e.r 2 u-%-4_ �. cl'rf City/Stat�IZip_ M n ra:s�o-•• Yn%k1 S N� Phone �a 3 2.c4 0 Are you an employer?Check t appropriate box: Type of project(required}: I.❑ I am a employer with 4.'�&I ama genaral contractor and 1 6- ❑New caeg -z6on employees(full andlorpast-fiime)-* have hired the sub-ctmtract m ?._❑ I am a sole propuetor or partner- listed on the attached sheet; 7- [ odeling ship and have no employees These sub-contractors have g. ❑Demolifioax w for�e m an capacity employees and have wos$ers' o��g y - 9_ ❑Build-mg addition [NOT workcrs' conlp: i insurance comp- ncnranr : required-] 5_.❑ We are a corporation and its 10_❑Electrical repairs or additions 3_❑ I am a homed-Amer doing all w:*ofL offieetss b""exercised their I I_❑Plumbing repwis or additions myself. [No workers'comp- right.of ex-emption per MGL 12.❑hoofrepairs. insu ante required.]F c.15Z §1(4} and we IiaS`e no employees_[No wmitess' 1 _❑Other comp-insurance regwred-I *Ary appUcmt that checks bowl=nst slw fill out the section below showhmg their woakea'rna¢gensatiaaE Pow finiht oS i Homeowners vrho submit this affidxm ln&cxt g they are doing all uc&ed then hire outside contractors must submit a tEew ai6d3vA mX rev mrh =6ont[Rctors ihst r hE!C-k this boa mast sttarhhed an additional sheet shot--mg the one of the sob-am m:wn and state whether ornut those a bites hxvq� employees Ifthe sob-contractors here empIcyees,they mmst pmrvide their warkeW comp.po3icS number. Taman smpFrryer thrct isprenddirag tt�orkers'coat �tsnhvn an.�crrutce far tti}*e-nrpli�yeer� Helots•is the pvoHry arid job site ixformahatt Insurance Company Dame: �'�-q y� t t9 S c e) Policy:9 or Self ins_Tic_4_ Q j ' c) .S f �/q Expiration Date: J 3 J 0 Job Site Add ess:K c;-0 W A i,-) .5 Cify�"StabelZig: 11 =1i w a► r �� d� t�/ Attach a copy of the workers'compensation policy-dedaration page(showing thre policy number and expiration date). Failure to secure coverage as regturedunder Section 25A of MGL c. 152 can lead to the imposition ofcriminal penalties of a fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the fom of a STOP WORK ORDER and a fine of up to S250.0.0 a day against the violator_ Be advised that:a copy of this statement may be forwarded to the Office of Im estigations of- ie DIA for Tnsrrsmce coverage verification_ Ida hereby tkepmns andpenaltees of perjury that the inrformatian pravi&d above iss true and correct Simatune: "yX v Bate.: 3 i/J Phone 9: G' ©ffEdal use anly. Da not write in this area,to be completed by cit3:or town nffi'ciaL City or Town: PermitUcense# Issuing Authority(circle one): 1.Board,of Health j.Budding I3eparbneut I CitylI awn Cleric 4_Electrical Inspector S.Plumbing Irtslrector 6.tither Contact Person: Phone#_ 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written_" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or tnrstee of an individual,partriershilp,association or other legal entity,employing employees. however the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or IocaI licensing agency shaII withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any :;ontract for the performance of public work until acceptable evidence of compli.snce,,,rich the insurance requirements of this chapter have been presented to the contracting authority_" Applicants — Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificates)of insurance. Limited.Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance_ If an LLC or LLP does have employees, a policy is required_ Be advised that this affidavit may be submitted to the Department of industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit_ 'I1ze affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please caE the Department at the number listed below. Sell insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permitllicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"ail locations iz (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is TTOT required to complete this a.ffidav�t. The Office of Investigations would Ile 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 adaress,telephone and fax number_ The�omrman 'ealth of Massachusetts Depai went cif 7ndustdal Accidents €?ffzce Qz I.�.vesfgatFaus 600 Washingtau Strut Bast(?u,MA 02111 Tel,A 617'27-4900 W 406 or 1-P-7-I AS.SAFE Revised 4-24-07 Fax#617-727-7749 Fww.ma,-s_govjdia o� * aaxxsT�srs. s �$ MALS& Town of Barnstable ArFQ MA'S p 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, >J ,as Owner of the subject property hereby authorize 01 hl Lc,-1 (;5 J, to t.j It's, i xi-e- to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) SigLature of Owner ate C40NC-7 v PiA Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:\WPHLESTORMS\building permit fomis\EXPRESS.doc Revised 061313 Massachusetts -Department of Public'Safety Board of Building Regulations and Standards �Onstf uction Supervisor License: CS-051497 i i Ts O JOHN F GH11S 10 LEDA-ROSE tit A+MnONS MMaS UK 619 9 Expiration Commissioner 11/13/2016 4- . /L �� ` -% �j� r License,or registration valid,for rndividul nse�enly F� ae arr���ea�uae�c l�a C-�/f�c;,ucc ucaeC�, � _1 j Office of Eousamer Affairs&Business Regulation q «3 �'OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egg-fttion• 37746 Type { Office 61 Consurrier Affairs and Business Regulation Expiration:='112Z20l7 Individual19- 20 Park Plaza-Suite 5170 Boston,NU 02116 JOHN F.GIWS Pp rs. 0 „mot i JOHN GIWS + s 10 LEDA ROSE LN. `�.%'�' MARSTONSMILLS,MA 02Ii48 Undersecretary Not Valid witliout signature s - 1� A II A a )Yv 1f I l II I` �! it i! i i ii i u i� Rightfax N3-1 4/16/2015 6:23:42 AM PAGE 2/002 Fax Server CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) T14340TIFICATE 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. N Q-THE CERTIFICATE OL R. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the pollcypes)must be endorsed. If SUBROGATION IS WAIVED,subject to the erms and conditions of the policy,certain policies may require and endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER CONTACT NAME: SULLIVAN GARRITY&DONNE PHONE FAX 1046 MAIN ST (A/C,No,Ext): (WC, OSTERVILLE,MA 02655 E-MAIL ADDRESS: 78G2N INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: TRAVELERS INDEMNITY COMPANY OF AMERICA SILVA PROPERTY IMPROVEMENT INC INSURER B: INSURER C: 1046 MAIN 5T STE 13 INSURER D: OSTERVILLE MA 02655 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 INDr_ATED.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 POLIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS. INSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (LBIDWYYYY) (MM1DD%YYYY) LIMITS GENERAL UABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR. 3AMAGETO RENTED $ REMISES(Ea occurrence) ED EXP(Anyone person) $ GEM AGGREGATE LIMIT APPLIES PER: ERSONAL&ADV INJURY $ ENERAL AGGREGATE $ POLICY PROJECT a LOC RODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE $ LIMIT(Ea accdent) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS. BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND WC STATUTORY OTHER EMPLOYER'S LIABILITY Y/N UB-2EB17112-15 03/28/2015 0312BI2016 LIMITS ANY PROPERITORMARTNER/D(ECUTIVE MN OFFICERrMEMBER EXCLUDED? N/A E.L EACH ACCIDENT $ 100,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 n yea desaft under DESCRIPTION OF OPERATONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESIRESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFEL71NG WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION J.GIL.LIS INC. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 10 L EDA ROSE LANE BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED W ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENT VE MARSTONS MILLS,MA 02655 ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reserved. d = 8J 'i �. r HOPPE --- Dom 01 a f 'tx s ACQ SILVA-2 OP ID:MC �--�' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 04/15/2015 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(f—)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 certificate holder in lieu of such endorsements. PRODUCERthe SGBD Agencies-Osterville coNrncr Fredericks Insurance PHO NAME: 1046 Main Street AICNN0 ii.508-428-8999 AX Osterville,MA 02655 EMAIL ac No ADDRESS: INSURElli AFFORDING COVERAGE INSURED INSURER A:Western World Insurance CO NAIC# Silva Property Improvement Inc 1046 Main Street Suite 6 INSURERS: Osterville,MA 02655 INSURERC: INSURER D: INSURER E COVERAGES CERTIFICATE NUMBER: INsuRER F THIS IS l CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE 11 BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD REVISION NUMBER: INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY O 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 CI PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADD SU A X COMMERCIAL GENERAL LIABILITY POLICY NUMBER POLICY EFF POLICY EXP MM/DD/YYYy MM/DD/YYYY LIMITS CLAIMS-MADE a OCCUR X NPP1374475 EACH OCCURRENCE $ 300,00 11/20/2014 11/20/2015 PREMISES Ea ocanr0ence $ 100,00 MED EXP(Any one person) $ 5�� GEN L AGGREGATE LIMIT APPLIES PER PERSONAL 8 ADV INJURY $ 300,00 POLICY P CT LOC GENERAL AGGREGATE $ 600,00 OTHER: PRODUCTS-COMP/OPAGG $ 300,00 AUTOMOBILE LIABILITY $ ANY AUTO EOBI COMBINED SINGLE LIMIT $ ALL OWNED SCHEDULED BODILY INJURY(Per person) g AUTOS AUTOS HIRED AUTOS NON-OWNED BODILY INJURY(Per accident) $ AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB $ OCCUR EXCESS UAB CLAIMS4VIADE EACH OCCURRENCE g OED RETENTION$ AGGREGATE $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY $ ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N PER OTH- OFFICER/MEMBEREXCLUDED7 ❑ N/A STATUTE ER (Mandatory in NH) El.EACH ACCIDENT $ If Eyes,describe under E.L.DISEASE-EA EMPLO $ DSCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Rama rks Schedule,may be attached ff more space is required) CERTIFICATE HOLDER CANCELLATION JGILLIS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE J.GILLIS INC. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10 LEDA ROSE LANE ACCORDANCE WITH THE POLICY PROVISIONS. MARSTONS MILLS,MA 02648 AUTHORIZED REPRESENTATIVE A0, ACORD 25 2014/01 ©1988-2 ACORD CORPORATION. All rights reserved. ( 1 The ACORD name and logo are registered marks o ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �[�� Application Health Division ( 929 22 Date Issued d Conservation Divisions Application Fee 4, . Planning Dept. Permit Fee O Date Definitive Plan Approved by Planning Board 62"t,41n) Historic - OKH _ Preservation / Hyannis Project Street Address d90 S Village kwA Owner",d /1�vv1 , f/ Address l� ��r D��, � Telephone Permit Request A/25_7Z�/�`� ee- F � Square feet: 1 st floor: existing posed 2nd floor: existing il proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation s- ,OVConstruction 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 f14a� Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) - Number of Baths: Full: existing new Half: existing 6 new- Number of Bedrooms: existing dnew Ulf Total Room Count (not including baths): existing _ new &12 First Floor Room Count"" e' Heat Type and Fuel: �as ❑ Oil ❑ Electric ❑ Other Central Air: KYes ❑ No Fireplaces: Existing_QNew �2 Existing wood/coal stove: ❑Yes(ZOO 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) ��� �6� /70''Name � ���� � �4��e E-44se�, �Ss��Telephone Number ',Address � �`���4vle License # ?42!1 &4 ,�s ,253;� Home Improvement Contractor# ��6 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE o2 L FOR OFFICIAL USE ONLY k , s APPLICATION# DATE ISSUED i MAP/PARCEL NO. 1 ADDRESS ' VILLAGE o OWNER - DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' t 's PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 3y` FINAL BUILDING it !1 !t DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street �11 Boston, MA 02111 www.mass.gov/dia t Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lefibly Name (Business/Organization/individual): Address: City/State/Zip Phone #: Are you an employer. Check the appropriate box: Type of projecf(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 , mployees(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, 0 Demolition workingfor me in an capacity. employees and have workers'; Y9. 0 Building addition [No workers' comp. insurance comp. insurance!T . required.] , 5. We are a corporation and its 10.0 Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised'their l L0 Plumbing repairs or-additions myself. No workers comp.,�' right of exemption per MGL Y [ P• 12.F] Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers'. 13.90the comp. insurance required.],, j I h weigw *Any applicant that checks box#I 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 Dater 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. 1 do hereby"certify under the pains and penalties of perjury that-the information provided above is trite and correct. Signature: �. � �/r ��. Date: Phone#: 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): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: , Information and n Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance., If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation.of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the'permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the.number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly: The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current .policy information(if tibcessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."a copy of the affidavit that has been officially stamped or marked by the.city or town may be provided to the is on file for future pe rmits or licenses. A new affidavit must be filled out each applicant as proof that a valid affidavit p PP r related to an business or commercial venture r home owner.or citizen is obtaining a license or permit note y year. Whe e a g (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. advance for our cooperation and should you have an questions, The Office of Investigations would like to thank you m ad y p y Y please do n.ot hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel-,9,617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 4-24-07 www.mass.gov/dia Town of Barnstable 'OTFn nnt•+" 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 Ir I, -t V7 LL y , as Owner of the subject property hereby authorize 69df _Ej_ � T to act on my behalf, in all_matters relative to work authorized by this building permit application for: (Address of Job) f Signature of Owner ate a 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.Out]ook\DDV87AAZ\EXPRESS.doc Revised 072110 Y Town. of Barnstable Regulatory.Services anRN5TA8LE Thomas F.Geiler,Director q4, ' ��� Building Division �°rEOA 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 witlr•said procedures and requirements. Signature of Homeowner Approval of Building Official l 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 t ,1 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 ]09.1.1-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 ofa 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:forms:homeexempt itil�ssachusctt�- Bo trd of , Re,,-trncnt bf P Buildinti Rc�j ublic Satoh Construction SUP..ulations and Standard License: cs ervisor License Restricted to: 00 42423 4 MICHAEL T PARECEG � � 338 OLD PLYMOUTH RD SAGAMORE BEACH, MA 02562 (uir�nrissiuncr Expiration: 9/16/2011 - - rr#: 6973 P c� e S 4 zo lA �,., o� ' m y Q ;g e ` ' v�-.. � L a` 1 •� .. _�r.I a � at i 4 � � '� _. _,.� .......r. -.. .:.:�.e•. '� � µme' s _ ... . ����ra . t �" I�°' � r a � 4� (�k e h PAR �P�R APR P�PtR ARC �R� . :- --. ., .... ..-..-Y,..--....,.� ,,;�.�...-�.-•,,,,,,.,�-,.-�-,+.+.,rti..rT-,:.-�tr"-..,.•-,..^+f+�s--vNrv�. rT-•-w^•.F.•re a}�:--.n•..--�,,.,.,.s..,'t.,.+.,...>.�t,..,..f,--.....-...»..ti.-.-.�.Y,_.,..,.w... :. t _ TOWN OF BARNSTABLE BAR-W 5452 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager Address of Offenders t I/ MV/MB Reg.# Village/State/Zip Ql nt_) L. 17,1�3- Business Name •� �, .` am/pm,�on l�Ei,�`� "� 20 k�;.` A �.r' S Tit $usiness Address\ � �(� � f,�,4.;�A `�' � ���` � '�� IV I ( Si'gnatur`e�o nforcing Officer_e Vr��llage/State/Zip .;4 + t� • Y x Location of Offense` f v q Enforci6g Dept/Division Offense ( t Facts `" �� r ��/� '�` \ I �1\+fl ti Cam% '(�1 <\ t 6 This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance A-of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. ` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �7:20 90 &A Parcel Application# c&7® 1613 Health Division Conservation Division Permit# - Tax Collector Date Issued Treasurer Application Fee Planning Dept. Permit Fee n Date Definitive Plan Approved by Planning Board D I� Historic-OKH Preservation/Hyannis Project Street Address !n„20 M&M 577- �2 i4C�-o/J c-r7' e�2E5T�9y/L�4�T" Village Owner Address ?W1W S l, i�.U�UIS c>z 6o I Telephone Permit Request _5'�1)e A N b 9 E - k QC) 30 SQ S T t-7Ae-,^ b 1177 _ `rye c���-i2 . s�-lANC9-car S y 5 Q Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio�&S"O e:z 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 e �� Historic House: er 'Y s ® On Old King's Highway: ❑Yes O-Pdo Basement Type: ©-Fu11 ❑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 Bam:❑existing iLl new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑- Appeal#- - Recorded❑ � Commercial L r es ❑No If yes, site plan review# Current Use iR ZE57`AUiZANIT Proposed Use f BUILDER INFORMATION =' Name 02�>AAI w281�J6 (/� Telephone Number y I o a Address/5S/ tA--2z4/TE ►/ZCW LA-.)A Y License# 1�D 3o X 6, y l Home Improvement Contractor# JC.��oZSra WC'5,7- I19 J2 '7/9&Z,,!5- C)y Worker's Compensation# -✓�- an t- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO �(l 0C- UDUi S%, SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT-NO. DATE ISSUED .(r ten• ' }I ` { . MAP/PARCEL NO. f ADDRESS VILLAGE -T s-- let OWNER DATE OF INSPECTION: r' FOUNDATION FRAME i f Y_ INSULATION - . FIREPLACE f s I'y ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING `()} DATE CLOSED OUT '.-j ASSOCIATION PLAN NO. fT V i 0' � �fie �jom�rea�uae¢�i o���aaaaclauae�a �. j. Board of Building Regulations and'Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: K"N Board of Building Regulations and Standards Registrafon;__1:05252 One Ashburton Place Rm 1301 z Expiration-7/;16/2008 Tr#; 125541 Boston,Ma.02108 JOHN.W.-RODRIGl1ES&'"`MY e John Rodrigues r 151 White Birch Way" Not valid without signat W.Barnstable,MA 02668 Administrator r ��e U�amzmaauifea�l�i o�✓�,czaocicfivael7a- BOARD OF BUILDING REGU,LATk NS License: CONSTRU.OTION SUPERVISOR r Numbed CSC 005829 6 Exptres6/21720'08 Tr.no 27364 RestrEctEe i JOHN W RODRIGU j PO BOX 641 - G- W BARNSTABLE, MA�t}2668 € . Commissioner S P The Commonwealth of Massachusetts Department of Industrial Accidents = Office of Investigations a' d 600 Washington Street Boston,MA 02111 ,• '� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name(Business/orgmizationandividual): LA-2 /�Q Dal]6l..yL Address: City/State/Zip: 'waS'TT Phone.#: Are you an employer?Check the appropriate bog: -Type of project(required):. l I. am a genera contract and Ior 1.❑ I am a employer with 4 � 6. []New construction . e loyees (full and/or part;time).* have hired the sub-contractors 2. 1�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 .t. 9. ❑Building addition [No workers'comp.insurance comp.insurance. required.] 5. [] We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their M❑Plumbing repairs or additions ' myself. [No workers'comp. right of exemption per MGL 12, oof 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. tContractors 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 bave employees,they must provide their workers'comp.policy number. lam an employer that is providing workers'compensation insurance far my employees. Below is.the policy and job site information. Insurance company Name: Policy#or Self-ins.Lic.#: t —©f9 7 3 L 1 �� —O Expiration Date: / 0 O Job Site Address: &.,.Z 0 /`9411Y S`l-- City/State/Zip:, S 0-Z o/p Attach a copy of the workers'compensation policy declaration page(showing the pokey 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 I do hereby certify under the pains-and penalties of perjury that the information provided above is true and correct. Signature: Date: 3 _ O h P one 2- 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the eceivP. nr t a t_ee-of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling-house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." mGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to*operate a business or to construct buildings in the commonwealth for any applicant who has not produced,acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until-acceptable evidence of compliance with the insurance requirements of this chapter have been presented*to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contiactor(s)name(s), address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit: The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents.Should you have any questions regarding the law or,if you are required to obtain a workers! compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate'line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom Of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all-locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e.a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions._,- please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Commww(� alth of Massachusetts Department of lnustal A.ceclents Office of Investigations 604 Washington Street Boston,MA 0.2111 Te,1.##617-727-490.0 ext 406 or 1-977-MASSAF`B Fax 4 617-727-7749 Revised 11-22.06 www.mass.gQv#dla I Anchor Building Services 2 BUILDER INSPECTIONS RENOVATIONS CONSULTATIONS Note: This proposal may be withdrawn by us if not accepted within 30 days. Acceptance of Proposal: The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work specified. Payment will be made as outlined above. Date of acceptance 3 -a Signature P.O. Box 641 WEST BARNSTABLE, MA 026E28 (508) 428-1 500 1-888-428-1 500 860-277-0111 Z/1/Z007 1:41 :05 FM PAGE 0U3/0U3 Fax server - 4 f •�• ••se Q.r. :'ITS-'{. r'f'Y-ivA:isT:+^.Siiv.'.n.w, �?lr±:K• aJ:�,:.vi�irCiri a::w+Yip. ✓ . _•,ww;� �eruy:•oLGn�,rr:.w.wch roF -;�.M�Q.c..•:c.:�:.,' :: .......r..r,..,x..n: fit..'-.5.. ........_ ..�i:a«:,%ra;r;.-t_..;.w;;a,'m:>..._....:6.w%_>r;�c {✓_Qy>"__._.. - -�;q,:rw-tt,.v;...:• :.,www•l+irx.-Y jyS;etrty _. .. ..:vr:.w^a-vx.......w..v... •...a�+=.r...:.:.�.v..'+i':'-' :n5%ti...-..wm_i.._-.. PRODUCER IS CERTIFICATE AS A MATTER OINII�A 10 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE WILLIAM PALUMBO INS AGCY HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR 125 ROUTE 6A ALTER THE COVERAGE AFFORDED 13YTHE POLICIES BELOW. SANDWICH MA 025630374 COMPANY COMPANIES AFFORDING COVERAGE A IIAR== UNDERWRITERS INSURANCE CoMpAr INSURED COMPANY RODRIGUES, JOHN W DBA B ANCHOR BUILDING SERVICES COMPANY P 0 BOX 641 C W BANSIABLE MA 02668 COMPANY D V.•�wF..Av"t�:..e aS�.a':T?v. wiwiw dV vC�C:.dO'Wvv.Jw�a -- :nBFw,xv+n`r3v.'tvvM C:x:�e,.,,iv?_4-c4:.Yv..iwaz}rnL -. _ .. - w.itiv.,+�.w.triw:J';'-rwi:invhAv,,•i ��Ya%n^!w-r✓�ivwv�: ...w i..LyL.'fr.. � n:��^-:G::��a :M4 .,mom Hips::a:.. .,�JL`nv '"`rv.G•Yrf.JV....';.':Yri{ - �T'a _ - _ n•>_.vlv:i-:... '"F:r .�,. Jk::.:e3:=c4 .`�✓ ..Nl.•.I.i,S�.:::4... ;,fi.T;:a:aa.C,'i3.�t:.&%7C{.;Gam.: - - �:f�� :w --.r..cw-:...ren.,rea.,r..".r••a,;.wv.,:7.^.s:.w:.ra-�:..:.e.Lc....=^':•as;.w.w..-rrwwzv w`?ti:,,;,i =-.aFw �'..:a'. :-: ���::•- rv..�:a L..,.�.�s;��•:�."an:�n'.:.�- w•Up v.v:- ,vr_ : nn .. ..q nn .. 4wv{+^."n a^+t^^.^Axtra: w,..--.u_+4t.._...n:n4w�:.CiJm'.-r,--v.".i.:1.nvJ�4wM::`.cr.:rpw .. r. v+.`. THIS S TO CERTIFY THAT THE POLICIES OF IN�JRANCE L15TED BELOW HAKE BEEN ISSUED TD THE IN.SUAED NAMED ABOVE FOR THE POLY PERIOD INDICATED, NOTWITHSTANDING ANY REOUIiEMENT,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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY E%PIRATI UMTTS LT DATE(MftDDIYY) DATE(MPAODLYY) GENERAL LIABILITY GENERAL AGGREGATE i COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGO. I CLAWS MADE OCCUR. PERSONAL&ADY.INJURY I OWNER'S 8 CONTRACTORS PROT. EACH OCCURRENCE ; RRE DAMAGE(Any one Are) I MED.EXPENSE(Any one person) I AUTOMOBILE LIABILITY COMBINED SINGLE _ ANY AUTO LIMIT ALL OWNED AUTOS BODLY INJURY SCHEDULED AUTOS (Per Person) I HIRED AUTOS BODILY INJURY I NOW-OWNED AUTOS (Per AaddenQ PROPERTY DAMAGE I GARAGE LIABILITY AUTO ONLY.EA ACCIDENT I ANYAUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ - AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE I UMBRELLA FORM AGGREGATE I 07M THAN UMBRELLA FORM WORKER'S COMPENSATION AND STATUTORY(NITS A EMPLOYERS UABUM (UB-0073L16-8-06) 11-10-06 11-10-07 EACH ACCIDENT I THE PROPRIETOIV pA� MM OISEASE—POLICY LNIT I OFFICERS ARE: on DISEASE—EACH EMPLOYEE I OTHER OMPnON OF OVERAMSILOCAMONVJEMCLLVRESTfUCTIONSSPECIAL ITEMS THIS REP CES ANY PRIOR CERTXFIZU ISSUED IO IS C RIIFICATE HOLDER AFFECIING WORKERS COMP COVERAGE. �;•-i�Ca"��'.��.M;:�u.��r=.o.:�=..=�xcr,�.i,T- a-<�2°s ....:�:s•w z -�.c::::;:::3.:";cu:sF.�,:��s�r-.>>' �sn...Ps•;r.;;• :s,=�=:�a-r. -' :.a,::r.4. '••wd't:w•.lso.,,....;`.c:.w:a-twtae`..,.sa.:�r:^ai,'ww.�+^rR`n_-.. .w:e:...;.:le4xr,..rxc,4,�..•�T.,c:'•.:rn..,c...�,rww.•:•.rn=rsnaw.w..wF:+::•rr�v. _nt ., ...n- _. n.,�.. ... _....rr.. _. - '+++.wc'�;.ri tvH.�.,.....,.yc o"- ..,,.rai':•:.i.=:� :ia: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOREr THE F EM4RAT10N DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL TOWN OF HANOVER 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE BLD DEPT LEFT, BUT FAILURE TO MAL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 550 HANOVER ST STE 8 LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTAflVES. HANOVER MA 02563 AUTHORIZED REPRESENTATIVE y� -'Q�;:;F;:ii:ca�'sxn vrgas�i: i:.+�+r`ii'�"<�,i,'.',`woa'+a"S�';�i- i5tiS2;,'�'�'i:.c::ac5 rati-akn.;,» ':.::i:"�' '"iCti,:?::i• - -- "+ ..,...<b' Q�,..rac;::;i_r',...v3:.a....m4w..r4acnf^.'>.•.S. ..fiSr. ra'«`:$w.;r r •+....:::va:..nn....vv....i........va,vra.,..:_..a..;.aw.,..--:.,:`-.fir.:.;:e: _ •1:" � E CEO VE ABUTTER'S LIST 5 2006 620 Main Street,Hyannis,MA(Map 308/Parcel 062) HISTORIC PRESERVATTION Prop ID:30806100A BACON TERRACE,LLC C/O COMMUNITY SUPPORT ASSO P O BOX 1987 HYANNIS,MA 02601 Prop ID:308054 COLELLA,ALESSANDRO TR VAGABOND REALTY TRUST 640 MAIN ST HYANNIS,MA 02601 Prop ID:308053 COLELLA,ALESSANDRO TRS VAGABOND REALTY TRUST 65 HOLLIDGE HILL LANE MARSTONS MILLS,MA 02648 Prop ID:308063 FONG,MOY O 63 LAWTON ST BROOKLINE,MA 02446 Prop ID:308120 HYNES,JOHN J TR %POPOVICH,ANDREW D IV& MCPHEE,WENDY E 27 HOLWAY DR E DENNIS,MA 02641 Prop ID:308119 JEFFERIES,WILLIAM E JR TR COMMON WEST NOMINEE TRUST 605 MAIN ST HYANNIS,MA 02601 Prop ID:308062 LIU,MEN CHUNG TR THE 620 MAIN ST REALTY TRUST 15 ACADIA RD W YARMOUTH,MA 02673 Prop ID:308131 ` COUTOS REALTY INVESTMENT CO.,LLC C/o COUTOS MANAGEMENT GROUP 169 MAIN STREET STONEHAM,MA 02180 I. �. a F �, 4 ., :- jma4 71 t tw bv i:. t r k ti ki �k C y_ 1 HYANNIS MAIN STREET WATERFRONT HISTORIC DISTRICT COMMISSION, . i *** SPECIFICATION SHEET ADDRESS OF PROPOSED WORK 620 Main Street, Hyannis, MA FOUNDATION Existing Concrete Hillcrest Tan & SIDING TYPE Repaint Existing Stucco COLOR Classic Beige Maibec White Cedar Shingles CHIMNEY TYPE N/A COLOR ROOF MATERIAL GAF Timberline Ultra COLOR Black PITCH Existing WINDOW Existing COLOR Paint Frame to Match Trim TRIM COLOR Navaio White Semi Gloss Exterior DOORS Existing COLOR Existing SHUTTERS N/A GUTTERS White Aluminum—Match Existing DECK N/A GARAGE DOORS N/A COLOR N/A NOTES: Fill our completely, including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application, along with three copies each of the plot plan, landscape plan and elevation plans,when applicable. The Plot plan need not be "Certified", but should show all structures on the lot to scale. D E0WE 9 5 2006 TOWN OF BARNSTABLE HISTO�RtC PRESERVATION D� L r. DETAILED DESCRIPTION OF PROPOSED WORK: 20L I Give all particulars of work to be done, including detailed data on such architectu l atuf+0h91ARNSTAAE foundation,chimney, siding,roofing, roof pitch, sash and doors window and door fra .17RIS6lbQIl(� leaders,roofing and paint color, including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). Remove existing false gable facing Main Street as well as existing roof shingles on entire building. Rebuild gable at true size including smaller gable for cover at entry door. Repaint stucco fagade. Install new painted PVC trim,signage and fagade lighting as shown on drawings. Signed Owner-Contractor-A ent AurtE. r K(Brown Lindquist Fenuccio&Raber Architects,Inc.) SPACE BELOW LINE FOR COMMISSION USE. Received by HMSWHDC Date Time This Certificate is hereby By Date Si i IMPORTANT: If this Certificate is approved, approval is subject to the 20 day app todprovided in the Ordinance. CONDITIONS OF APPROVAL: Hyannis Main Street Waterfront Historic District Commission WJ E 230 South Street Hyannis,Massachusetts 02601 �� i t.3 5 2006 TEL: 508-862-4665/FAX: 508-862-4725 )F BARNSTABLE Application to ^^�cFRVATION Hyannis Main Street Waterfront Historic District Commission in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under M.G.L. Chapter 40C, The Historic Districts Act for proposed work as described below and on plans, drawings or photographs accompanying this application for: PLEASE CHECK ALL CATEGORIES THAT APPLY: C3J --�Co ; o TD 1. Exterior Building Construction: ❑ New Building ❑ Addition ❑X Alteration Indicate type of building: ❑ House ❑ Garage ❑X Commercial ❑ OtherCn 2. Exterior Painting: ❑X M-]W 3. Signs or Billboards: ❑X New Sign ❑ Existing Sign ❑ Repainting existing sign ::D ' rn 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other 5. Parking Lot: ❑ New Building ❑ Addition ❑ Alteration (Please see guidelines for explanation and requirements) TYPE OR PRINT LEGIBLY DATE 2/5/07 ASSESSOR'S MAP NO. 308 ASSESSOR'S LOT NO. 062 APPLICANT Brown Lindquist Fenuccio&Raber Architects TEL.NO. 508-362-8382 APPLICANT MAILING ADDRESS 203 Willow Street, Suite A,Yarmouthport,MA 02675 ADDRESS OF PROPOSED WORK 620 Main Street,Hyannis,MA 02601 PROPERTY OWNER Men Chung Liu,Tr.The 620 Main St.Realty Trust TEL NO. 508-775-9494 OWNER MAILING ADDRESS 15 Acadia Rd.W.Yarmouth,MA 02673 FULL NAMES AND MAILING ADDRESSES OF ABUTTING OWNERS. Include name.of adjacent property owners across any public street or way. This information is best obtained at the Town Assessor's Office. (Attached additional sheet if necessary) SEE ATTACHED LIST AGENT OR CONTRACTOR BLFR Architects,Inc. TEL NO. 508-362-8382 ADDRESS 203 Willow Street,Suite A,Yarmouthport,MA 02675 1EC i I _`'-� WE Ed �.:�-"ram ?�- 3 Mmlo S-a g{7 AN j Ml r< �M- 5 ON t ,Y E' F � I jEl Al OR !!F { 4 r "' 1. J reflX C 1�4 1 NZ, Y;1 r " r �' .{ ai.r-s,.'C•+�e s`�,c.r ' _�z.7 y, 'd,' y y j IT�i imsr k i I� FFR 5 coos R 31/2" ` TOWN OF RNSTABLE e° 331l2° ESERV / 45° R 14 1/2" 39-14 N.P.T. 1/2-14 N.P.T. 47 1/4" 14 3/4" B_2 H —C 13 1!4" R71/2" N R710 1 Icr) 12 3/4" 3/4.14 N.P.T. � ) . I6" 45° T 35" 1 3/4-14 N.P.T. r J 1° 30° r� B-3 HL-D i \ R 7"! � N '171/4" ! R 121/2" co 3/4-14 N.P.T. _1J� 3/4-14 N.P.T. { r 347 24„ HL—A H / i R 141/2" / 14 N.P.T. \ _r 2". 7 1/2" T R 41/2" 401/4" 8 45` a 3/4-14 N.P.T.J 22 3/4" 221/4" s MODEL WTH HT PROT BULBS WATT [WAREHOUSE 15008 8" 7" 1 MED 100W 15010 10" 8" 1 MED 10OW 15106 6" 8" 8" 1 MED 100W 15108 8" 12" 10" 1 MED 100W 15109 8" 12" 10" 1 MED 100W 15110 10" 13" 13" 1 MED 100W 15112 12" 8" 1 MED 200W 15114 14" 9" 1 MED 200W 15116 16" 10 1/2" 1 MED 200W 15117 17" 10 1/2" 1 MED 200W 15118 18" 12" 1 MED 200W 15120 20" 15" 1 MED 200W 15124 24" 15 1/2" 1 MED 200W ' 15127 27" 16" 1 MED 200W RADIAL SHADE 19008 8" 7" 1 MED 100W 19108 8" 10" 11" 1 MED 100W 19010 10" 7" 1 MED 100W 19110 ' 10" 12" 10" 1 MED 10OW 19116 16" 8" 1 MED 200W 19118 18" 8" 1 MED 200W 19120 20" 8" 1 MED 200W 19124 24" 8" 1 MED 200W ANGLE SHADE 18107 7" 8". 1 MED. 20OW 8 0 0" 10 1/2" 1 MED 20OW 1 112 12" 1 " 1 MED 20OW 18114 14" 141/2" D 2 OW DEEP BOWL 16110 10" 11" 1 MED 20OW 16112 12" 13" 1 MED 20OW 16116 16" 16 1/2" 1 MED 20OW LARGE BAY REFLECTOR 17118 18" 18" 1 MED D �® V E r EB 5 2006 EMBLEM SHADE TOWN OF BARN TABLE HEM-12 12" 14" 1 MED HIS 2 RIO PRESERVATION 53 - �it� . �pp ! , � F L0:`ES1.AU6MFA.�♦�� .F CIS �R.s pop Ru I Ail U /TAYI► I _ a It mF r it � .I p EC .E0 U E A A. ti • .:r, �-;';�'�ti:�:: �!�' 'tip ;� �• ( 'ti::1 •:;r";;lr«; ! t3 'r CNART MOI►sa•vu.wt ry JA �:r. ;e�� . . .(�[• „ O e7 ' c rHILL i r Ir ll 1 A �A .row .. S.i.t. mk% 3 ti ,r• .• ` .a w ati�• p v9 . Mr IAi ,•fe v�.•�r1 b, F .A .gyp •`�• •V mow. 'r� � •�'� VA All to 415 t b • r Nip Nef�A I9►6. w sr }�ew.b •» � `��•• '" ^� \�6� oil ®b all r Pill Op, \\ sib• ,i 138 ^ io ,erc p� `s;, fear JNl !j lea '� ,sac cage 165 oeaC-s tv'� rows •� 11 r 10�146 A I54 151 .W U AC130 1 a 20AC ,•7DAC 04RMrrwyl„f `O/MVIfW ' U is at 18fa.erw/rf1 ITS 'IA tt t 2 If6 a.T fewetuaT wrhTe s«rAs«we��� C S`aeb B e 169- 1�t0 eta . IAB q tat• : 'i�o`:�, " :r'•. ,.� I a� Jac 199 ` ... JJAC Site Location Figure 2 620-628 MAIN STREET Bewlck Associates i Locatio.n Mari HYANNIS, MA 617-9�24-7455 � ........__ _.... ._._.__ fl� TOWN OF BARN TABLE 'STORK PRESERVATION .. le tl 2s M.s 11 �PProari�a�i .Scw�e: t'�s�p � WA 3o G timer- �oNFr V • � ' I h It ' e a ti figure 3 620-628 MIN STREET Bewlcl( Associateal Site .Puri HYANNIS, MA 617.924-7451 j s',y •3 .. "; r +^;.: Sri Xs tsa, .,r_ -y.at' & . r�i' ui rr,�r>h ..3 s,A� <' - ^3=yr,3�5 1' z#3 'kr Y -r.. 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T 'C- c�:i¢ 1 K r�. �s rx Town of Barnstable Building Department Brian Florence, CBO Building Commissioner 200 Main'Street,Hyannis, MA 02601 www.to wn.b arnstab l e.ma.us Pre-application for Business Certificate Date — ( � Map 3��5 Parcel 0 61 Applicant Information Applicants Name S'HU , Jar C__- Applicants Address VYI�IAI cSr,j L A/L S; Vn,& Email Address I l t,Q mA-Ate. ® Gm I, m l l�ty Telephone Number �U�- 97,5-', q 4 q q Listed El Unlisted El �� D�� R��, WL Business Information New Business? ----------------------------------------- Yes No Business is aregistered corporation? ------------------------ Yes No If yes Name of Corporation S k U.► :TNe..-, Does business operate under the registered corporate name? Yes No Is the business a sole proprietorship or home occupation? --------- Yes No If yes then a Home Occupation Registration is required-See Building Division Staff Name of Business W"i L;1c1- EE M 7 Business Address Type of Business RE S fi!�AJ&qM'r— Building Commissioner Office Use Only Conditionsl 4-h C CS, ( UJ Building Commissi ate ( � Clerk Office Use Only c q- a2 k� TOWN OF BARNSTABLE BAR-Wil Ordinance or Regulation WARNING NOTICE < y 1 ` Name of Offender/Manager 1 Address of Offender 4 ')'(D ry IL n MV/MB Reg.# I ,~ Village/State/Zi P 3'�/} hn �'� I Business Name . i1am/pm, on ,-- 20 f - �- Business Address ( i � )� ` 9Tgnatur6y 1­� forcing, Officer Village/State/Zip (/�A (le'1 ► � , �' ii`-t (� -,�c� I Location of Offense ' ,._ Eriforcirig ept/Division Offense Facts �� ,I.:t �'1►�ltr' 'c_l d \ � �oreC � -U`✓ This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING.DEPT. The Town of Barnstable i IA�LfTIfLL •�•� Inspection Department t670 367 Main Street, Hyannis, MA 02601 508-790-6227 Joseph D. DaLuz Building Commissioner February 12, 1993 Ms Julie Nolan C.O.R.D. P. O. Box 954 Hyannis, MA 02601 Re: Dragon Lite Restaurant Dear Ms Nolan: In response to your inquiry of February 11, 1993, I made an on-site inspection of the Dragon Lite Restaurant on this date. My observations were as follows: New ceiling tiles installed. New wall coverings (plastic laminate) A "wind-break wall" by the front register. New half walls to separate booth arrangement. I noticed nothing of a structural nature requiring the issuance of a building permit. If you have any further questions, please feel free to call. very truly yours, Richard R. Bearse Building Inspector RR9/km L930216A C ion rC N' Nt. LO 1/ b-GOO C� r�LLS �.raTe �ao�i �tr-r•��j e evjT P d�v .c 5 ct c> �s o.v e TOWN OF BARNSTABLE { BUILDING DEPARTMENT COMPLAINT/INQUIRY REPORT I. ea f ssesso �s c3b6' p�Z Last Name ORjGINATOR /a First Name tre Set c C�rC� Villa a All s E: State it7ooq- Tele uho1 e. Zi Q lill"Me esc i ti Wo 775 ®� t� COMPLAINT . /Tr -_INQUIRY � ' Reque$tovs �< signature Crowe.. �•��3 -- . COMPLAINT Etreet LOCATION Address INSPECTOR °Fg2cE vsE oNLy �S ate ACTION/ �/��/�,3 COMMENTS Ins ector< `Vs00 F ' Z,eol �s ��c 01- luvad r5'!�►JG%ND,v7- FOLZow-Up ACTION ADDITIONAL INFa . ATTACUED i copyl 2gTRI8UTIONs _PINK TO'. DEPARTMENT FILE - N:sc1 — INSPECTOR (RETURN YELLOW — INSPECTOR r _ OFFICE MG.R. •. • The Town of Barnstable i IAISITAUS Inspection Department " ��a�►+'� 367 Main Street, Hyannis, MA 02601 508-790-6227 Joseph D. DaLuz Building Commissioner March 15' 1993 U� William W. Thomas, Esquire Thomas & Bailey, P.C. P. O. Box 978 Hyannis, MA 02601 Re: Shu, Inc. d/b/a Dragonlite Restaurant Your letter dated, February 8, 1993 4 Dear Bill: ; . The signs at the Dragonlite Restaurant are non-conforming as they were installed in 1965. Accordingly, they may remain without any changes. ` However, please be advised that any changes to these signs may be ,1.4'. tJ - subject to the current ordinance. Thank you for your cooperation. Peace, a n seph D. DaLuz Building Commissioner =E JDD/km V. L930315A UP _. SC �P� THOMAS & BAILEY, P.C. ATTORNEYS AT LAW POST OFFICE BOX 978 160 BASSETT LANE TELEPHONE HYANNIS, MASSACHUSETTS 02601 FAX (508)771.4644 February 8, 1993 (508)790-1334 Mr. Joseph DaLuz, Building Commissioner Barnstable Town Hall Main Street Barnstable, MA 02630 RE: Shu, Inc. d/b/a Dragonlite Restaurant Dear Joe: Just a follow-up on the above-entitled matter. No action was taken on the complaint against the restaurant back on December 17, 1992, when the matter came up for hearing at the district court. This is due to the fact that we did get an affidavit from .Chuck Fong showing that the signs were all installed at the time that he originally took over the restaurant in 1965. I would appreciate receiving a note on the Building Commissioner' s stationary which confirms the fact that this matter has been reviewed, that the signs were installed in 1965 and that they, therefore, constitute a pre-existing non- conforming condition for my file with a copy to Shu, Inc. so that we would not have this repeated five or six years from now when people don't remember what we did. If you could provide this letter, I would be most appreciative. Thank you for your help in this matter. Yours ve truly, William W. Thomas WWT: jos cc: Men Chung Liu Dragon Lite restaurant 620 Main Street Hyannis, MA 02601 DRAGON SITE ��Restaurant-and°Cocktail-Lounge r- 620-MAIN-STREET•--HYANNIS;-MA 026(Dl-- ,_— 775-9494 October 17, 1992 District Court Department First Barnstable Division Court Compound Main Street Barnstable, MA 02630 Attention: 21 D Noncriminal Hearing In accordance with option 2 in our"Notice of Violation of Town Ordinance", we are requesting a hearing on the matter of our sign violation. Please notify us of the date of hearing. Very truly yours; 6. �44 Men Chung Liu Tome-Geiler Town of Barnstable vGloria Urenas Town of Barnstable THOMAS & BAILEY, P.C. ATTORNEYS AT LAW POST OFFICE BOX 978 160 BASSETT LANE Y HYANNIS,MASSACHUSETTS 02601 TELEPHONE FAX (5O8) 771-4644 (508)790-1334 December 14, 1992 Joseph DaLuz, Building Commissioner Town of Barnstable Town Hall Main Street Hyannis, MA 02601 RE: Shu, Inc., d/b/a Dragonlite Restaurant Dear Mr. DaL uz: Pursuant to our conversation two weeks ago regarding the status of the signs at Dragonlite, I had the pleasure of meeting Chuck Fong last Friday with his wife and son. We went over the signage situation at the Dragonlite. He advises me that back in 1965 he went into partnership with Johnny Yee. The corporation was known as the Golden Eagle, Inc., d/b/a Dragonlite. They leased the property from Mr. Segerman which at the time was known as the New Yorker Restaurant. In 1965 Mr. Fong and Mr. Yee re-habed the unit changing the exterior and interior. The signs were ordered from Jim Did It Sign Company in Brighton. Mr. Fong has advised me that that company is still in business and probably has records of the transaction. Jim Did It also installed the signs on the building, according to Mr. Fong. Mr. Fong took a look at the signs before coming here and advises me that they are the same as they were in 1965, with the exception that now two of the signs referred to Mandarine and Szechuan quisine. To Mr. Fong's knowledge, all work was done with the Town's permission. L I had Mr. Fong execute an affidavit. His wife supported all of the statements. I did not bother to obtain an affidavit from her. Pursuant to our meeting, it is my understanding that as long as the signs were in existence in 1965, they pre-existed the sign code and as such have the benefit of grandfathering. A hearing is presently scheduled in Barnstable District Court for 2:00 p.m. on the 17th of December. Can we agree that this matter g will now be dismissed so that we will not have to appear? Please let me hear from you. Yours ve y uly, ///j�J" A WWT:ss William W. Thomas THOMAS & BAILEY, P.C. • ATTORNEYS AT LAW POST OFFICE BOX 978 160 BASSETT LANE HYANNIS•MASSACHUSETTS 02601 TELEPHONE FAX (508) 771-4644 ' (508) 790-7 334 December 1, 1992 Omer Chartrand, Clerk First District Court Barnstable, MA 02630 RE: Town of Barnstable VS: Men Chung Liu (Dragon Lite Restaurant) Sign Code Violation Case No.: 39988 Dear Mr. Chartrand: Please be advised that this office represents Men Chung Liu, Manager of the Dragon Lite Restaurant, which actually trades under the corporate name of Shu, Inc.. A hearing for an alleged sign code violation, being case number 39988, is scheduled for Thursday, December 3, 1992 at 2:00 p.m.. I have discussed the matter with Gloria Urenas and Joseph DaLuz of the Building Inspector's Office for the Town of Barnstable. We have agreed to continue the hearing on this matter for two weeks, so that I can provide them with additional information as to the status of the signs. Would you please, therefore, continue the hearing on this complaint from December 3, 1992 to December 17, 1992 at 2:00 p.m.. I certify that I have sent copies of this notice to the Office of the Building Inspector for the Town of Barnstable,Attn.: Gloria Urenas; Town of Barnstable Consumer Affairs, attn: Thomas Geiler and L. A. Hochschwender. -� You vet,truly, a W. Thomas WWT:ss cc: Gloria Urenas Thomas Geiler L. A. Hochschwender Joseph DaLuz N THOMAS & BAILEY, P.C. • ATTORNEYS AT LAW ' POST OFFICE BOX 978 160 BASSETT LANE HYANNIS, MASSACHUSETTS 02601 TELEPHONE FAX (508) 771-4644 (508) 790-1334 December 1, 1992 Omer Chartrand, Clerk First District Court Barnstable, MA 02630 RE: Town of Barnstable VS: Men Chung Liu (Dragon Lite Restaurant) Sign Code Violation Case No.: 39988 Dear Mr. Chartrand: Please be advised that this office represents Men Chung Liu, Manager of the Dragon Lite Restaurant, which actually trades under the corporate name of Shu, Inc.. A hearing for an alleged sign code violation, being case number 39988, is scheduled for Thursday, December 3, 1992 at 2:00 p.m.. I have discussed the matter with Gloria Urenas and Joseph DaLuz of the Building Inspector's Office for the Town of Barnstable. We have agreed to continue the hearing on this matter for two weeks, so that I can provide them with additional information as to the status of the signs. Would you please, therefore, continue the hearing on this complaint from December 3, 1992 to December 17, 1992 at 2:00 p.m.. I certify that I have sent copies of this notice to the Office of the Building Inspector for the Town of Barnstable, Attn.: Gloria Urenas; Town of Barnstable Consumer Affairs, attn: Thomas Geiler and L. A. Hochschwender. --—�� You 9'vet,truly, ------------ a W. Thomas WWT:ss cc: Gloria Urenas Thomas Geiler L. A. Hochschwender Joseph DaLuz t •a INC The Town of Barnstable '"" S. ' Inspection Department ^ 000 1670. �6 hill►• 367 Main Street, Hyannis, MA 02601 508-790-6227 Joseph D. DaLuz Building Commissioner TO: L.A. Hochschwender Department of Consumer Affairs FROM: Joseph D. DaLuz, Building Commissioner RE: Ordinance Citation #39988 DATE: December 15, 1992 This office is in receipt of an affidavit from Chuck Fong the original owner of the Dragonlite Restaurant re the , status of the signs. It is my opinion that the signs enjoy a "non conforming" status and are legal. You may dismiss citation #39988. THOMAS & BAILEY, P.C. ATTORNEYS AT LAW POST OFFICE BOX 978 160 BASSETT LANE HYANNIS.MASSACHUSETTS 02601 'TELEPHONE FAX (508)771_4644 (508)790=1334 December 14, 1992 L. A. Hochschwender Department of Consumer Affairs Town of Barnstable P. O. Box 2430 Hyannis, MA 02601 QED 15 1992 RE Barnstable Ordinance Citation#39988 TOWN OF aARNSFABLE WEiCiKM AND MEMUAE8`:' Dear Mr. Hochschwender: LICENSING/PARKING Pursuant to our conversation of two weeks ago, I am enclosing an affidavit that I obtained from Chuck Fong the original developer of the Dragonlite Restaurant. Mr. Fong confirms that the existing signs were all installed by the Jim Did It Sign. Company in 1965, when he and Johnny Yee took over that location. It is my understanding from previous conversations with the office of the Building Inspector that this proof would be sufficient to protect the grandfathering of those signs. I have sent a copy to the Building Commissioner to confirm this. The matter is scheduled for a hearing on Thursday, December 17, 1992. 1 hope that we can now cancel that matter. Please let me hear from you. Yours very truly, William W. Thomas WWT:ss enclosure cc: Shu, Inc. J- AFFIDAVIT I, .Chuck Fong, under oath and under the pains and • penalties of perjury, do hereby make the following affidavit. � I I state that Johnnie Yee and I, as partners, took over er the New Yorker Restaurant on Main Street in Hyannis, Massachusetts in 1965. We converted the New Yorker Restaurant into a chinese-style restaurant that we called "The Dragon Lite Restaurant" . We operated under the corporate entity of Golden Eagle, Inc. I state that we remodelled the building in 1965, fixing up the inside and outside. We contracted with a Boston sign company known as "Jim Did It" on Cambridge Street, Boston, MA to repair the electrified signs and to. have them installed at the restaurant. I state that to my knowledge, the Jim Did It Sign Company installed those signs in 1965. They were in place in their present locations and in their present size at that time . I .did not change the signage on the restaurant from that point forward. I state that in 1982, I sold what was then my business alone to Shu, Inc. , a corporation which is now owned by Mr. Liu. They continue to operate The Dragon Lite at that location with the signs that were originally installed in 1965. I state that to my knowledge, the signs as they appear today are of the same size and in the same location that they were when they were originally installed by the Jim Did It Sign Company in 1965. To all of the above, I swear is a true statement under oath and under the pains and penalties of perjury on this llth day of December, 1992 . Chuc ' Fong COMMONWEALTH OF MASSACHUSETTS Barnstable, ss December 11, 1992 Then personally appeared the above-named Chuck Fong and swore that the above instrument is a true and accurate statement under oath and under the pains and penalties of perjury, before me, Notary Pu lic My Commission Expires: /a.— Sign TOWNOF BARNSTABLE Permit * sAxrrsTABLE, MASS 6� i'01F 3.�A Permit Number: Application Ref: 200703165 •Issue Date: 05/23/07 20070042 Applicant: LIU, MEN CHUNG TR Proposed Use: RETAIL & SERVICE STORE SMALL Permit Type: SIGN PERMIT Permit Fee $ 50.00 Location 620 MAIN STREET (HYANNIS) Map Parcel 308062 Town HYANNIS Zoning District HVB Contractor PROPERTY OWNER Remarks New hanging sign 20 sq & 24 sq wall sign DRAGON LITE RESTAURANT CHINESE CUISINE TAKEOUT COCKTAILS Owner: LIU, MEN CHUNG TR Address: 15 ACADIA RD W YARMOUTH, MA 02673 Issued By: P� (;o POST THIS CARD SO'THAT YS VISIBLE FROM TIDE STYZEET I ' Town of Barnstable Regulatory Services Thomas F.Geiler,Director • . =�.E� Building Divisionf , Y"NSTABLE 16 9 p µit► Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 2007 MAY.-3 PM ,4: 23 www.town.barnsta ble.ma.us Office: 508-862-403 8 88-790-6230 Permit# Application for Sign Permit p 66763 I Applicant: -S"VU /VC Map&Parcel# 0 6 2. Doing Business As: Imo. C'�v GrTc— 57y L►qr-j-r Telephone No. "7-7,sr Sign Location Street/Road: 2 G /'V4/N S T' �!�/�/yC,✓is' 19� c�L�;!a 1 Zoning DistrictOld Kings Highway? Yes/No Hyannis Historic District? Yes/No ` Property Owner --�^ � Name: � LC'9 ► 41t1 57- k�Li h I P-U.i i Telephone: Address: -PU Village: N!v41y1ta//.- M4 op-&ol Sign Contractor Name: i I i 6 � Telephone. 3,Fd' Z7 2 � Mailing Address: I ra'iC� j 1J (,,!/ Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? es/No (Note.Ifyes, a wirin8Permit is required) L X T�—rZ _ V,.1A N �F pWidth of building face ft.x 10= / 40 g 10— ° Sq.Ft.of proposed sign 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 Ba rnstable Zoning Ordinance. Signature of Owner/Authorized Agent: joys/ Date: ' a Permit Fee: Sign Permit was approved: Disapproved: Signature of Building Official: Date: ~ In-order to process application without delays all sections in be completed. Q.V WPFILES1S1GNSfSIGNAPP.DOC Rev.9112106 i2F 1 Town of Barnstable Regulatory.Services Thomas F.Geiler,Director • �- Building Division 16 • '0i� ►' Tom Perry,Building.Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit# Application for Sign Permit Applicant: SOU //SIC : Map&Parcel# 0 6 2.- JY>sp ' Doing Business As: DV,46.0 v G/Tc:- 7v4-L)12j}t.t—r- Telephone No. ..7 S_ Sign Location Street/Road: Zoning District: Old Kings Highway? Yes/No Hyannis Historic District? Yes/No Property Owner -z,�r• Name: M4It./ 5 7- RC-4 �`i TP_0.i Telephone: `?:75= Address: TU Village: N i9lwil/-S /b1 na&cif Sign Contractor Name: 6t) Telephone: _--" ,d'— Z'7 2 Mailing Address:J�, Cox i �; jiac--j 14 1' I A o 2 e, 5/ Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? YeslNo (Note:Ifyes, a wiring permit is required) L X rFrt�4A%__ Width of building faceft.x 10= �7CG�cd x,Ip= Sq.Ft.of proposed sign q � 1_F4C C ®'fo^13 U#L YO.0"C_ SleA/ 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 Barnstable Zoning Ordinance. Signature of Owner/Authorized Agent: �� t g f ��� Date: � � � 120 c)7 Permit Fee: Sign Permit was approved: Disapproved: Signature of Building Official: Date: In order to process application without delays all sections must be completed. QAWPFILES131GNSISIGNAPP.D0C Rev.9111106 r by F TAKEOUT • COCKTAILS • 63 OLD MAIN ST S. YARMOUTH, rA 02664 � (SOti) 39f3 2721 <508) 7E(-:)'- 3CJ Fax � � ► ���ii �Oi' c-mail; ply�t �ac4ui��<?J�+lycc.od._�icl Zn.a. 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I .. r ±r',�..eM'•ww.a..`t+YNwi�.rwvwwnrw,+tynwmRo-,.�,.v..m..+wrw:rnx.vaw ,.... w, . +wn.f �Q�KTAILS � � SUSHI r �y • 63 OLD MAIN ST S_ YARMOUTH, MA_ 02664 ��� �Oi C508> 398-2727 C508� 760-3"130 Fax r � e-�mai.l� ply�igr,cvrr.ls2ca:�?ecoci_Y�E..t Iac_ Sir�cr� "t958 www�ji.lyz.�to�tl�.s=j�i-�._c.csr=-�. •' .✓ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map t 3 0O Parcel 0 957 Permit# Health Division Date Issued Conservation Division / s /0 b �a Application Fee Tax Collector /0 Permit Fee �� \ Treasurer 6;_I /0 Planning Dept. / Az Date Definitive Plan Approved b _Plannin .Board ,O` O PP g a- Historic-OKH � reservation/Hyannis� Project Street Address �20 ��� Sr. cStil Village .s Owner—_ Address l f 2*4 //J- Telephone — ~7 7 76 Permit Request 4- S Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District_ Flood Plain Groundwater Overlay Project ValuatiM6 � 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: Cl 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 BUILDER INFORMATION Name Telephone Number - 7� Address License# (:::'5 ��1S15- Home Improvement Contractor# .5� &A -o_Z__ Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE u • FOR OFFICIAL USE ONLY - !PERMIT NO. 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I�dersfand that a' copy of this Statementaiay be forwarded to the Oftice of Investig e h ^ d p en alties-o r ury hat- tthe-inforI atian-pr-avaided-above-islcu ats�eairect I da hereby certi fP.e1 :.; Date Signature ... ,. . �',,,..• , .....'r Phone# Pliat name afflclal us a a�Y do not write in this area to b e completed by city or tawn of Ecial p ermit/liicense# QBuflding Dep+�t� B dty or town QSelects:ens OfSca • yno..e a; � , contact person: r Information and Instructions for ir Massachusetts General Laws chapter�152 section 2e requires employers all e ersOn, , the serviceeof another underrany contract zmplovees.._As quoted_fromt4e `law , an employe is-definedrYP .. of hire,'express or implied or or An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of engaged in a joint enterprise,"and including the Iega1 representatives of a deceased employer, or the receiver or the foregoing gag trustee of an individual,partaers}np, as or other legal entity, employing employees. However the owner.of a ..•. dwelling house having not more thanthree apartments and who resides therein; or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or onthe grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer: r MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or perinit.to operate a business or to construct buildings e quired�AdditionallyPth for any neithbrthe plicant o has not produced acceptable evidence of compliance with the insurance coverage commonwealth'nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. ,; .' .. .. .. o j Applicants your situati;�7iiicf Please fill in the workers' compensation affidavit completely,by checking the box that cate of insurance as lies all affidavits may be supplying company names, address and phone numbers along with a certsfi _. submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and r" date the affidavit. The.affidavit should'be retumed to the city or town that the application for the permit or lice se is being requested,not the Deparment of Industrial Accidents. Should you have any questions regarding the`law"•o �ifyQu btaan a workers' cAmpensatiois policy,please calf the Departuieut afthe number listed below:: are required,to o City or.Towns be sure that the affidavit is complete and printed legibly. The DeparEment has provided a space at the boetbom othe Please Investigations has to contact you regarding a applicant. r YOU to fill out lathe event the Office of Invests Y g dsng� cant. ,. be surerttoofill inthe.permitTlicezise iiii sbei wliichwillbe used as a reference numlier.�TFse;affidavits maybe r "' _' artme>zt by mail of FAX unless other arrangements have be6n.made the Dep ^,,�,,.• • . ations would like to thank you in advance for you cooperation and should you have•anyquestions, . The Office of Investsg ,. _, _,. .., please do not hesitate to`give us'a call. FEN The Department': address,telephone and fax number. Y The Commonwealth Of Massachusetts Department of Industrial Accidents once of lnVeS119 lotta 600Washington Street Boston,Ma. 02111 , fax ff: (617) 727-7749 :;�;.,'„p • «171727-4900 ezt. 406, 409 or 375 Assessor's map and lot number ...... Sewage Permit number *1111E T 0 W N OF BARNSTABLE • MA"STABLIS. I mum '"a.1639. BUILDING INSPECTOR 101 M If. APPLICATION FOR PERMIT TO .......R�YYN,�2 .......... C.......VZe'J.................................... TYPE OF CONSTRUCTION 9!n...... ........ ........... ... ......... .. ........................................ .......................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: . .aN.N........ ......... . ........... ...... ........ Location .......... ....... ........... ............ Proposed Use ............. .......... .. ....... .. Zoning District *-,-,,-C- .4--..........................................Fire District .... .... . .......................................................... Nameof Owner ...... .......F ......................Address ..................................................................................... Name of Builder ..........................Address .......... ....... ......64e.ivy( Nameof Architect ............... ............................Address ...... ............................................................. Numberof Rooms ............ ...............................Foundation .............................................................................. ExieriorC,,rvvs� ......s -, C: �!v�t Roofing ......................................:............................................. Floors ......... ....................Interior ... .........Gsmd..Lmo��......................................... Heating ......................Plumbing .................................................................................. Fireplace .... ..............................................Approximate Cost ... ...................................... Definitive Plan Approved by. Planning Board --------------------------------19--------- Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... . ........ ............................... ........... Foxagv Chuck D. ( ^ No ... Permit for r e—'--- -- ' ' ( of __~_�_~__~ ���������� � --------------'' ---' | / D�c�� 1 x ^~^..~. -------~----.�'-�.-----.. ~~ —.-----..� �.-------------.. ` Owner D. I�,�� --------^~.—~--------- ~ ` Type of Construction ........... .������g��� 7 ^ � ��� ------------------.------- + ^ . � ^ ~ | Plot Lot ---------. ----------.. � March2I �� Permit Granted -------------.]V ' ' Date of | -----' ' ----lg Y ' Dote Comp|e�o6 . ----lA/Y`' �� ~~~' �0 ' ~ � � ` PERMIT REFUSED | � ^ . .----.---.--.--.-------.. lg .--.-------.---------------- '—_-----.----.—~----------- °+ | —^---~—'—'-------''------''--^''' ^ —'------^—^''^----'^^—~------^'' | � � Approved _------------_—.. lQ ' ) — -------.----------,.-------- , . ----------,.-----.----..--..,. ` � | � | py" n Assessor's office(1st Floor): Assessor's map and lot number X-0 I'( (PYMIt>o�` Conservation(4th Floor): ' a• Board of Health(3rd floor): ' Sewage Permit number yDLUyOLZ ' Engineering Department(3rd floor): o°''�'639 House number I Io��r Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED.8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING ' INSPECTOR , APPLICATION FOR PERMIT TO f fq;` L W 14V 10� � �I ( A-L� Q0 4vet, p TYPE OF CONSTRUCTION (3 1 rws IF a a — M R,C— L 19 _ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Proposed Use V !,j Zoning District "° Fire District ! 7� Name of Owneru " U /�3C DM C1v1//'C'6.Saddress Name of Builder/Q f G i S . Address ( J� Name of Architect Address Number of Rooms— Foundation Exterior 1'� Roofing G Floors V N�- Interior tj 7 �, �9 I Heating f 4 G� i Plumbing I Fireplace N � Approximate Cost Area Diagram of Lot and Building with Dimensions Fee /I®. i i I ' 3 � I Y 1 L DV 6 s OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nameo V V Construction Supervisor's License �� r SHU INC. d/b/a DRAGONLITE RESTAURANT t« Ai 5. 4 No 36522 Permit For ADD WINDOWS - - RESTAURANT/Store Front Location 620_ Main Street - Hyannis . Owner SHU INC. /d/b/a DRAGONLITE REST.,( r Type of Construction Frame Plot Lot f Permit Granted March 8 , 19 Date of Inspection: r r t Frame 19 t Insulation 19 � • �f '` - Fireplace 19 Date Completed 19 i i t 1 A. cb i 1 r_ rq OF 1010 COMMONWEALTH RAVE. MASSACMJSE rg I DOSTON MA.• 022 t!i EXPIRA-nOv DATE E r.. f't;�ivf 1r�F1 CAUTION RFSTFqJCTl01YS ' C:FFrT'Vt DATE t tG NC, , ' FOR PROTECnoON AGAINST s THEFT,PUT HIGF'T T)4ums PPJNT IN APRROPRIATE t BOX Orr L ICENSE. A Z _ •�_�. 3 SLAST(NG OPERATORS t i. FEE. MUST INCLUM'PHOTO t � .. _ � � /`txC. Y.NEO B"IMJTh3YE NY7 tJtilCu�.r , N,01 K( f" 'i ls�Jti�r P�• Y4 ^'s Cl,'W ww•rr' . ;�� . +.a. 1..•irruEurw ir,�*sFSYiw p1 � : IP ' 1 i' T,* r✓x.OtA w+rfN ra (V uLft15EE Y S1K71r Wie.tt k nlcA�NOrE saGwr" � �( �!' 4�Cif:Oh MtSCrJCiP�T"Kr. �ht 7j ti _..._..____.. ---- ___�__..,__.___—_____. __ - ._._�_...._.._.__.__._.�. __-_..-- .�_._.,__.-. ___.,...._ _._._.._ ___.._.._ _____..__..... ------ STAMP: i ONO co m UJI � c' u� M M W co co C) O � � 2 X {.) Q" W LL 1— U U Z o v; z �- uj Q10 LLJ Z o OU W � mLIJ Q C/) 0 j ■B o 5 OB =' 0 �B o N } MAIBEC "BAR HARBOR" NEW SIGNAGE SERIES SHINGLES PLYNOUTH SIGN COLOR: CLASSIC BEIGE CO. / \ (DOUBLE DIPPED) NEW GAF TIMBERLINE NEW RIDGE VENT NEW PVC CORNER BD. RAKE NEW HARVEY CLASSIC X SHINGLES W/ MANUFACTURER $ WINDOW TRIM SURROUND DBL. HUNG REPLACEMENT NEW EXTERIOR FACADE COLOR: BLACK SUPPLIED RIDGE CAP WINDOW COLOR: WHITE LIGHTING SHINGLES TYP 3 IX2 PAINTED PVC BED MOULD ON IX8 PVC IX4 PAINTED I 1 ,11VI I PVC FRIEZE _w__..�._.w___.�..�..__�.___.,__.�.__.._ _..M—__._.._.._...__._.�.....,___� _�.____�__ .____. ON IX SPACER oe, NEW 51GNAGE W 1—_ PLYMOUTH SIGN CO. F— _ —__ ,_.___ ---- L j -_._..__ _,___.__._. MOUNT ON PVC BACKER J Z W ___. _ _.___._.�..-.._.,._.__ ._. w.._-..__ ___.�.�_____ ___..�.. -._._.�.. PANEL �y witAolow _______ _ __— __—__ __ _ _ L--------------- --------J LINE OF FALSE Z _. _ _ - - — PEDIMENT TO BE -- _-. — REMOVED z IX PAINTED PVC FACIA Cf) � z ry ATW MOULD #3072 0 3 i ATW MOULD #3068 FM t. It. NEW PAINTED PVC TRIM SITE BUILT PVC EXISTING STUCCO 2 4 2 MENU BOARD SURROUND 2 PAINTED EXISTING FACADE TO REMAIN NEW FACADE WORK TO MATCH SHINGLES TITLE: w PROPOSED MAIN STREET ELEVATION MAIBEC DOUBLE DIPPED - tia"��►�—o" CLASSIC BEIGE 02 BENJAMIN MOORE EXTERIOR PROPOSED RECESSED EXTERIOR NAVAJO WHITE FLOURESCENT FIXTURE n p' BENJA 11N MOORE EXTERIOR i FROI VT HILLCREST TAN i ® BENJAMIN MOORE EXTERIOR s ELEVATION FAIRWAY OAKS ---- �' .. --.- --- --- ---- ---------- - - ----- - L- --�' Et X§ EXISTING WINDOWS TO REMAIN €( ( LINE OF ROOF ABOVE LINE OF ROOF ABOVE DATE ISSUED: 02/01/07 - - . :. . t REVISIONS: a i 4 • 3 4 k 3 PARTIAL MAIN FACADE PLAN DRAWN BY: gp/CLS PROJECT #: PROJECT NO. DRAWING NO.: 0 a : a C3 nfl A� l rn c Z U p f^ F 3 L