HomeMy WebLinkAbout16-18 NORTH STREET ���/� _`
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Hyannis
IC-17-367 12/12/2017 12/9/2018 Wimpy's �u
IC-17-368 12/11/2017 12/1/2018 Scudder.Family Cafe
IC-17-185 12/11/2017 8/13/2018 Seacoast Inn
IC-17-333 12/8/2017 10/4/2018 Hostelling International--hyannis
IC-17-366 12/8/2017 12/31/2018 B2 Burrito Bistro 7
IC-17-166 12/5/2017 9/3/2018 West Parish Family School 2049
IC-17-359 12/4/2017 11/6/2018 Dragonlite Restaurant
IC-17-369 12/4/2017 12/30/2018 Captain David Kelley House 5
IC-17-235 11/29/2017 9/29/2018 Captain Gosnold Village 2
IC-17-191 11/29/2017 8/27/2018 Larry Doughty House 7
IC-17-351 11/29/2017 11/12/2018 Cape Cod Church Of Christ 49
IC-17-242 11/29/2017 9/15/2018 Alberto's Ristorante 360
IC-17-341 11/27/2017 7/22/2018 Barbyann's 1
IC-17-346 11/20/2017 10/5/2018 Wianno Yacht Club 101 Brid
IC-17-337 11/13/2017 10/12/2018 Oyster Harbors Club 170
IC-17-232 11/13/2017 9/23/2018 Osterville Community Building 93
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TOWN OF BARNSTABLE Permit
* BARNSTABLE.
y MASS
1639.
�ArFO MA'S a` ., Permit Number:
-Application Ref: 200803969
20070195
Issue Date: 07/25/08 4
Applicant ". ` MONAGHAN, LIAM P TR.
- ProposedUse: MOTELS ;
Permit T ,
. • 4 Ype SIGN PERMIT -
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Permit Fee
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Location 16 NORTH STREET }
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Map Parcel 327010
Town HYANNIS; . r
Zoning District .H V g a `
Contractor PROPERTY OWNER,
Remarks
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34.5 SQ:BL'OCK.L'ETTERS HYA TRAVEL-INNNNIS
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Owner: MONAGHAN LIAM P TR `
Address:, baHYANNIS TRAVEL' INN
100 WEST'MAIN ST SUITE-6--1
„'HYANNIS; MA 02601 ;a
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Issued By:' -PC ginj
POST THIS CARD SO THAT IS VISIBLE FROM THE STREET
irsRNt TABLE
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Town of Barnstable
oF�"E'O�ti Regulatory Services ZO O J 15 F1 3: 57
Thomas F. Geiler,Director
�nA RNsrABLE•� Building DivisiontO
i639 ♦0
ArfD�,ta 'Tom Perry,Building Commissioner v
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us �
Office: 508-862-403 8 Fax: 508-790-6230
Permit#
Application for Sign Permit
Applicant: jg�iO�-N l S T,h A�lTL ��r'�' Z" Map & Parcel#
Doing Business As: S T(a AV(51- ZN'ry Telephone No.
Sign Location l'b I d1_TN 5
Street/Road:
Zoning District: Old Kings Highway? Yes/fo Hyannis Historic District? YesQ
Property Owner `pt� A,lsyrt-
Name: //Q r-• {? 6 H�81J�JY� f S l..%r,r� Telephone: ,S �i y—
Address:-.;y wls nA► Q `t�r G Village:
Sign Contractor �Y �/��
Name: C ,/t� lJ Cy S�6 Telephone:
Mailing Address:
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? Yes/No (Note:If yes, a wiring permit is required)
Width of building face V -1 � ft.x to= (Yb 0 x.10= I t` 6 Sq.Ft. of proposed sign f,
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 §240789
of the Town of Barnstable Zoning Ordinance.
Signature of Owner/Authorized Agent: , Date: �
/
Permit Fee: .
Sign Permit was approved: Disapproved:
Signature of Building Official: Date:
In order to process application without delays all sections must be completed.
n•I WP FILEA31 GNSI SPGNAPP.D 0C
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42,WAREHOUSE RD HYANNIS, MA. 02601
TEL ' 508-771-4465'
Proposal
CAPE COD 42 WAREHOUSE ROAD
HYANNIS, MA. 02601
IL SIGN TEL 508-771-4465
JULY 1,2008
Proposal Submitted To Job Name and Location
HYANNIS TRAVEL INN SAME
NORTH STREET
HYANNIS, MA
We hereby submit specifications and estimates for:
FABRICATION AND INSTALLATION OF 18" FORMED PLASTIC LETTER
COPY = "HYANNIS TRAVEL INN" COLOR = BLUE
We he propose to furnish materials and labor,complete in accordance with above specifications.*for the sum of.
ONE THOUSAND FOUR HUNDRED FIFTY DOLLARS PLUS TAX ($1522.50)
Payment to be made as follows:
50% DEPOSIT BALANCE PAID UPON RECEIPT
All material is guaranteed to be as specified.All work to be completed in a workmardike manner according to standard practices.
All agreements are contingent upon strikes,accidents or delays beyond our control.
AUTHORIZED SIGNATURE/DATE
VOW ITis proposal may be wit yawn if not accepted within 30 days
ACCEPTANCE OF PROPOSAL-The above prices,specifications and conditions are satisfactory and Leref&gg0jC d.You are
authorized to do the work as specified.Payment will be made as outlined.
AUTHORIZED SIGNATURE/DATE
- :.... t :..,,. rw _«.,•�...wr.1•>•�x. .w .. rr. � '� - •.. � - , _...er.w++.�.•as�.a..•e_ .ar .. .... +.. . , .a ..
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PROJE
NAME CT
ADDRESS:
�A.r/S �� �� ,6 WX5
PERMIT# �� OD 16
PERMIT DATE:
M/P:
LARGE ROLLED PLANS ARE IN:
BOX
SLOT 3 C
Data entered in MAPS program on: jcj5g , _,24�
BY:
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Co
Map Parcel ,""7`� e -Application#r �
Health'Division - Date Issued 6
.a f
Conservation Division Application Fee
Tax Collector Permit Fee
Treasurer '
ol
Planning Dept. i ++Ak-IRE PREV _ M�BgE:-d
h
Date Definitive Plan Approved by Planning Board
\91fli ll& hen
Historic-OKH . Preservation/Hyannis � 41�MLC4/
�
ecr
Project Street Address lV fj C)rz-
Village ly y 9,N N 1 S l'1 ►� 6X"6 U
P&Vs LPr'.'t I'�Ati,gb�rhls�7G i� 5V t�
Owner t-rqt% P- 0 0-A UNN (MatiAa �tiG Pfir� Address t � 0 Wts5T l I Q 1� ST
Telephone S o O A
Permit Request -PAC.A D C IMP o Jt-�l�is (Z 6 PLACCf FLAT je o"r
y 4vs S K2 Q O 1A`0 i T-iy KA C S PACC D 4 l012 -S itiNI tvt,
65
Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
� i
Project Valuation 3.w' 3� Construction Type
\
Lot Size ' V Grandfathered: ❑Yes ❑No If yes, attach supporting documentation.
j
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units)
s`
/Age of Existing Structure `/ f-S Historic House: ❑Yes Alo On Old King's Highway: ❑Yes o
Basement (�se ent Type. ❑ Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full:existing new Half:existing new
Number of Bedrooms: existing new
Total Room Count(not including baths):existing _new First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil Electric ❑Other
Central Air: ❑Yes V No Fireplaces: Existing New Existing wood/coal st�ve: ❑ ❑No
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑e4ting ❑now size
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: i�] w
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review# r- '
o �-
Current Use Proposed Use
BUILDER INFORMATION
Name L /�J Telephone Number
�--�(E�1�t� s
Address 100 l-tf 5 T M ft i N S T S" l Tt 6 License# C 0 Z 6 3 to (L(F5►k tc Tl�a S
��(��1�w�•-; 5 ; (�A U O 1 Home Improvement Contractor#
Worker's Compensation# (A!M 7— 3 6 6
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE ! I d_J
FOR OFFICIAL USE ONLY
APPLICATION#
,DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
v OWNER
DATE OF NSPECTIO,N:
'FOUNDATION `
FRAME
INSULATION
t
FIREPLACE "
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
IN
DATE CLOSED OUT
ASSOCIATION PLAN NO.
�i.
Y�Y
Y
Towne of Barnstable
Regulatory Services
. � swaNsr,►sL1e. :.
Thomas F. Geiler,Director
i67g, �e
Building Division
Thomas Perry, CBO,Building Commissioner
200 Main Street, Hyannis, MA 02601
www.town.barnstable.ma.us
'Office: 508-862-4038 F : .508-790-6230
]PLAN`REVIEW
Owner: Z-1 A-( ® t ��,-/{t�,�q Map/Parcel:
Project Address nuilder: �� u-1 L
The following items were noted on reviewing:
z,� yi 6— //�--t tL
Reviewed by: i
Date:
Q:Forms:Plnrvw
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations -
a 600 Washington Street
Boston, MA 02111 -
wM s� www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information 'Please Print Legibly A
Name(Business/Organization/Individual): TV4-AV K f p N
Address:
City/State/Zip: l' lr ' C) �^1Phone#:
Are you an employer?Check the appropriate box: Type of project(required):,.
1-0I ant a employer with _ 4. ❑ I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. URemodeling
ship and have no employees These sub-contractors have g, ❑Demolition
workingfor me in an capacity. employees and have workers'
Y p tY 9. ❑Building addition
[No workers' comp.insurance comp. insurance.$
required:] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their. 11.❑Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs
insurance required.]t c. 152, §1(4),and we have no
employees. [No-workers' 13.❑ Other
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then,hire outside contractors must submit a new affidavit indicating such..
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 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: l t�G l j"90�R�l��' C' ,� 7� t `31f�^ 4J i (,( A 6 .
Policy"#.or Self-ins. Lic. #:&y M'7,?j O 036 4 � 6 1� 0 O'l e Expiration Date:
Job Site Address: NOpLTA 51_ ,- City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to'secure jcoverage 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 nd penalties of perjury that the information provided above is true and correct.
Si nature: _ Date:
Phone#: i �_Z" u
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 J.'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
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 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 to any business or commercial venture j
(i.e. a dog license or permit to burn 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 Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. ## 617-727-4900 ext 406 or 1-877-MASSAFE
Fax## 617-727-7749
Revised 11-22-06
www.mass.gov/dia
oFIMEr Town of Barnstable
Regulatory Services
9B" MASS. ` Thomas F.Geiler,Director
16.19. Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-8624038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
It e'y:vT 0-4;
as finer of the subject property
hereby authorize r 10 A to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
Signature of Owiie . jPtt.c�S �;.pt l Date
Print Name
If Property Owner is applying for permit please complete the
Homeowners License Exemption Form on the reverse side.
Q:FORMS:OWNERPERMISSION r ...,
THE Town of Barnstable
pF Tp� ,
Regulatory Services
BARNSTABU, Thomas F.Geiler,Director
MASS.
�A 039• A.0 Building Division
lFD � Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
wwN.Aown.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/to 111ate zip code
The current exemption for"homeowners"was a ended to include owner-occupied dwellings of six units of less and
to allow homeowners to engage an individual for hi who does not p�sssess a license,provided that the owner acts as
supervisor.
DEFINITION O OMEOTNER
Person(s)who owns a parcel of land on which he/she resides ntends to reside, on which there is, or is intended to
be, a one or two-family dwelling, attached or detached structures essory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shal of be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a form acceptable °°�the Building.Official,that he/she shall be
responsible for all such work performed under the building pernut. (Section h 9.1.1)
d
The undersigned"homeowner"
assumes responsibility for co, plane with the Statea uilding Code and other
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner certifies that he/she understands the Town of Barnstable Building Department
minimum inspection procedures and requirements and that.he/she will comply with said procedures and
requirements.
Signature of Homeowner
f�
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:fonns:homeexempt
JAN. 29. 2008 2:04PM HART INSURANCE N0. 959 P. I
ACORD, TE
� CERTIFICATE OF LIABILITY INSURANCE 01/24/20 8
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HART INSURANCE AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
243 MAIN STREET - HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PO BOX 700
BUZZARDS BAY, AAA 02532-0700 INSURERS AFFORDING COVERAGE NAIC#
INSURPD Hyannis Travel Inn INsURSRA; AIM INSURANCE COMPANY 18929
16-18 North Street INSURER II:
Hyannis,MA 02601 WSuRER C.-
INSURER 0:
INSURER E:
COVERAGES
THE POUCIES 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
POUCIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR Q POUCYNUMBLR POLICYIEFFECTIVE POLICYEXPMAT10N LIMITS
OENWALUABR.RY EACH OCCURRENCE E
DAMrjFTORENT
MERCIAL GENERAL UABIUTY PREM E as nc S
PCOM
- CLAIMS MADE OCCUR NED SW__ ..GM f -
PERSONAL 6 AOV INJURY $
GENERAL AGGREGATE S
GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO S
POLICY F7 PR LOC
AUTOMOBAR LIABILITY
COMBINED SINGLE UNIT S
ANY AUTO (Ea aimidWq
ALLOWNEDAVTOS -, BODILY INJURY S
SCHEDULED AUTOS (Par onion)
MIREO AUTOS BODILY INJURY S
NON-OWNED AUTOS (P4V ft6don0
PROPERTY OAMAGE 8
(Pe►accdeny
6ARA6ELLABRJTY AUTO ONLY-EAACCIDENT S
ANYAVTO EAACC f
OTHER THAN - '
AUTO ONLY: AGG S
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S
OCCUR CLAIMS MADE AGGREGATE $
S
DEDUCTIBLE f
RETENTION S f
WC
A VVMZ8003666012007 04/01/07 04/01)08 maxwmcm
u. OTH-
WORNPRS CAMPEfr$ATNiN AND
EMPL.OYERS UABILnY
ANY PROPRIETORIPARTNERIMOVmE E.L.EACH ACCIDENT f
OFFICER/MEMBER EXCLUDED? E.L DISEASE-EA EMPLOYEE f 500000
If Yea.GB cmm undet- s
SPECIAL PROVISIONS bdo - E.L.DISEASE-POLICY LIMIT S 500.000
OTHER
DESCWTION OF OPERATIONS I L.00ATIONSI VEHICLES/EXCLUSIONS ADDEO DY.ENOOMEMENT I SPECIAL PROVISIONS
Town of Barnstable additional insured as respects Pool
Faxed to Health Dept 508-790-6304
Fax to Lian 508-775-8200
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Town Of Bamsatble HE
DATE TREOF,THE AIL ITTE ISSUING INSURER WILL ENDEAVOR TO M 3O DAYS WRN
367 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 80 SMALL
Hyannis,MA 02601 IMPOSE NO OBUGATION OR UABILITY OF ANY IONO UPON THE INSURER,ITS Ar.@KTS OR
REPRESENTATNES. .
AUTHORED REPRESENTATIVE
,ACORO 25(2001J00) ORPORATION 1 B8B
r
67,
Board of Building Regulations and Standards
14 '. Construction Supervisor License
License CS 70763
N` Exp�ratlon 611612009 Tr# 15077
•Restncfion 00.
LIAM P MONAGHAN
100 W MAIN ST#6 ,
HYANNIS,MA 02601 Commissioner
,
l "
CONSTRUCTION CONTROL AFFIDAVIT
PROJECT NUMBER: 07334 ,
PROJECT TITLE: Hyannis Travel Inn
PROJECT LOCATION: 18 North Street
Hyannis,MA
NAME OF BUILDING: Hyannis Travel Inn
SCOPE OF PROJECT: Addition of Roof Trusses
In accordance with Section 116.0 of the Massachusetts State Building Code,`1,Richard J.Dempsey,P.E.,
Massachusetts Registration Number 29173,being a registered professional engineer hereby certify that I have
prepared or directly supervised the preparation of all design plans,computations and specifications
concerning:
( ) ENTIRE PROJECT ( ) ARCHITECTURAL ( X ) STRUCTURAL O MECHANICAL
r
FIRE PROTECTION'( ) ELECTRICAL ( ) OTHER(specify):
for the above named project and that,to the best of my knowledge,such plans,computations and
specifications meet the applicable provisions of the Massachusetts State Building Code,all acceptable
engineering practices and all applicable laws for the proposed project:
I further certify that I shall perform the necessary professional services and shall be responsible for the
following as specified in Section 116.2.2:
.1. Review,for conformance to the design concept,shop drawings,samples and other
submittals,which are submitted by the contractor-in accordance with the requirements of
the construction documents.
2. Review and approval of the quality control procedures for all code-required controlled
materials.
3. Be present at intervals appropriate to the stage of.construction to become,generally familiar
with the progress and quality of the work and to determine,in general,if the work is being
performed in a manner consistent with the construction documents.
I shall periodically submit progress reports;following site inspections together with pertinent comments as a
record for the Hyannis Building Department. Upon completion of the work,I shall_submit a final report as to
the satisfactory completion and readiness of the project for occupancy:
ti of rays
S9
� ey
RICHARD J. G"p,
a
ORIG r TURE ANl) STRUCTURAL C
Subscribed and sworn to before me this day of OY&' 4� 20 O �O .1p 2917? ���•
_ � GISTEp' �
zoosASS/O N A L ENG\
NOTARt PUBLIC _ '' r=y My Commission Expires On
.0
Assessor's map and lot. number l,,..... .....
i
A, ST/frc. /9 a el z c=�
T U'1 �kJ ......
t fHETp� TOWN: - OF 'BARNSTABLE
"ABIL i63q BUILDING ' INSPECTOR
Apo, . `�0
'EO MPY
1 � ..................... .............................
-4 APPLICATION FOR. PERMIT TO ......... ,.... ............ .. ........ ........ �
TYPEOF CONSTRUCTION ......,. ... . ..... ..............................................................................
47
........./.t.`..!...........................19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following infor tion:
Location ............. .. .. ..... ...........1.}1..`L....7 .....�-z... ,a7....... .. �.. `...........................
ProposedUse ..................................:...........................................................................................................................................
ZoningDistrict ........................'..............................................Fire District ...............................c.......:. .........,..........................
Nameof Owner ...... .................. ........ ddress ..... ....... ......... ......... ....... ......./.........
Name of Builder y� �...... /V� ................Address ..� / (: •� • .. .... ........ ..............................................
Name of Architect .........Address
Numberof Rooms .............,r-................................................Foundation• .............................................................:.................
Exierior ..................................................................................Roofing ....................................................................................
Floors .. .............................................Interior ......................................................................:.............
Heating .........................Plumbing
Fireplace ......................... ....................................................Approximate Cost .......i•��Z @ -, ....
p 6-0
............................................................
Definitive Plan Approved by Planning Board ________________________________19--------. Area .....1.. :....:.....
Diagram, of Lot and Building with Dimensions Fee ........ 0�..................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
r r 0 •`�
aJ0
r
I hereby agree-to conform to all the Rules and Regulations of the Town of Barnstable regarding t e above
construction.
N/ . /...... .............. ...............................
Monaghan,' Francis G.
No ...1918.3.... Permit for ....swimming pool
.... . .......... . .... .. . ....
.................................................................................
A
Location North Street
0
...................Hyannis.....................................
Owner .........Francis. . . ...G ...Mona a.ghan...............
.. ........ . . .. . ...... . ........ .
Type of Construction
...........................................
....................... .........................................................
Plot ............................ Lot ............ ................... .
Permit Granted..........K.xy.. 5................ .....19 77
Dbte of Inspection ........19
... ,
Date Completed' ........ .......197
pg
PERMIT REFUSED
........................ ...................*...............
..... 19
............................. ............ ....................... .............
...........................................................
............................................................................
...................................................
Approved ................................................. 19
................................................................................
...............................................................................
mm -:
p •••t.•t::� - l� � � g PTIC SYSTEM -MUST K
Assessor's mci and lot number
32'7 v 2? ��/ INSTALLED IN COMPLIANCE ,
r. 1 WITH ARTICLE 1.1 STATE
/ ... ..
Sewage Permit number .... Cd... jp• ANITAR CODE AND TOWN
TIONS.
Er
TOWN- TOWN OF ' BARNSTABLE
l; 2 STME, i �~
"�a • DUILDI�NG � INSPECTOR
1 ......�~.. 1
_7
' APPLICATION FOR PERMIT TO ..... ..................... . .
TYPE OF CONSTRUCTION .................. .....Z.1"Z:P� .....��!'` ............ .........1. ..1.... ....0........
................. ...... 19 .
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information: /�
Location ........ ..�✓ k '..........^J��' .......�...... .v'... ....................�.`... ...... . .......... . .................
..
ProposedUse ....................:.......... . . ..•�, .............. ...... .........................
Vl.�!W.... .....Fire District ...........................................
Zoning District ...... .. ...... ......................./...`..........�/�
Name of OwnersJ.. � . '� all, . ....... .... .. ...4:../U..L.-C
.. ........Address ...................r��G ••
Name of Builder . ...�:�.:�.... . ...�1.`Z�!. .. .�� .......................................
Nameof Architect ................. ......................................Address ....................................................................................
Number, of Rooms ............../-�-..jPaqw,.n...k-... .Foundation A,,.,ei ...... L.�lC. ......
^r ....... .Roofin .................... ''�d : . .. Xi .. .
Exterior �/.�.��. .....�I ..�".............Iak4� . 42. 9 � .........................:..
1
ee t
FloorsG Interior {
�,I.. ... ... . .............. G'.. --,i...........................................
Heating ! .... ....................................Plumbing ..! ..........................................................
/ a .....................v�b
Fireplace ..................41! ,................................�................Approximate Cost ........V� n) ..
(lam.�./
Definitive Plan Approved by Planning Board ---------------____-----------1'9________- Are. )10.1.�^.W.......L.:.... .....
Diagram of Lot and Building with Dimensions Fee ......................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
�7
L ( -�- -
s ,
1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ... ..... . ........ ...................
Monaghan, Francis
18757 move dwellings
No ..................Permit-for ....................................
.......................... ................................................ ,
Location:.......:North Street
....................................... \ _
Hyannis ,
Owner Francis Monaghan
Type of Construction ....frame
r
.... .................................
_Plot ........................... Lot ................................
Permit Granted ........Oc.taher...22..........19 76 ,
"Date of Inspection ......................... .....19 4 r:
Date Completed` ........: ...... ....... '19'�
'PERMIT REFUSED
................................................................ J19
................................... .....................................
.................. ..........................................................
.............................................................................. • K' - ,
Approved ............................................ 19
...................................................................:...........
Assessor's offioe (1st floor): ✓� r p
Assessor's map and lot number .. /� 1� ° Q o iTNE o�
Board of Health (3rd floor):
Sewage Permit number ...
.......� ...... Z MAUSTLDLE,MAM
Engineering Department (3rd floor): '°o 39• �e0�
Housenumber .............................: ..�............................. " o .40'
APPLICATIONS PROCESSED 8:30-9:30 A.M. sand 1:00-2:00 P.M. only
TOWN. OF BARNSTABLE
BUILDING [NS�PECT.0110,ok/
APPLICATION FOR PERMIT TO ..... ....:tulN.........l'fl L............... ...... .. .......... ... ... .....................................................
TYPE OF CONSTRUCTION .. .� ���./...'................................................................................................
................................................19........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ..............� ................ .....................................al�pL(,C.[��1.
Proposed Use. ...............
:....................................................................
.........................Fire District .......`.�G /V�.�
Zoning District ...... ..G�i�:7!l.:Ltl..Y..J......... ...........................................
Name of Owner .. ...! .... ...... 1......Address^ U.� �� ��t./ 1. ... ............a&�a,lz.
Name of Builder 1 �'v ............................Address ..
........ ... r.... .V �a...................:.......... !..... ..........................................
Name of Architect".!.CT.(Z. .U.......d V !�V......Address ° . .v!.''y.�!�'�!.. !.....00..... ......
Number of Rooms................. .................................:Foundation
Exterior .............Roofiin
Floors ....................................................................}.................Interior ....................................................................................
Heating Plumbing lQK.3.
............_. ..... ... ...........................................................
Fireplace ..............Y.10............................................................Approximate Cost ...069.1b
Definitive Plan Approved by Planning Board ________________________________19________ . Area ...... ` ...........................
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of B nstable r garding the above
construction.
Name ...... .............. .... .. ^...":
Construction Supervisor's License ... J(�.. ....
S
<
. . .
-No — Permit for —A[/D.� POOL
' '
----/����N���ial../_By onio_TraveI Inn
-
'
Loco/inn .......l6.....Nort�.....S.t���et______. ^
' - . '
. .-
.................... �.........................................
- - -
Owner .....Fz�n.ci.s...G�_88o����ba.n____
Type of Construction ----Fra���-----�
.
- ^
--------------------------� ` ^
-
P|ct ---------. Lot -----`'�----
' .
/July 15 87
Perm���n±n|ed ------'�---�--]P
,°.- .
Date, of Inspection -----------....ly
'
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Assessor's map and lot number ....` .../.... ...... :. /�;, O" Csti.
'SEPTIC'SYSTEM MUST B�
Sewage Permit number ... ...( �.+ INSTALLED INCOMPLIANCE
WITH; ARTIICCjLE- II STATE
yof;tNero�y TOWN l� ®� �� 1'� Aliii7E`VD TOWN
R,
�OO 1639• \e0� ri, ' e
,BoA,BHs�TLE a '� �® � INSPECTORID?Val {
n.�-�. .. r .... ..... .......................
_ u APPLICATION' FOR PERMIT TO ........................................
,
i, TYPE OF CONSTRUCTION ................� ::•'•••••/••••�•G�?T1. ....... ................................
t' ............... �.... . ...
19A.
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
. L .....:� ............. Y � .................Location ...W/hw� �..... . ' C/4 ........../W �
ProposedUse .............................................................................................................................................................................
Zoning District ....4r5-: ...' ! ..............Fire District .............:................................................................
' Name of Owner ... . .......... Add re ..ao t1q,
Nameof Builder ................. . ..... .......................................Address .................... ..
Nameof.Architect ..................rvn. . .'....................................Address ......................:...........................................................
Number of Rooms ..............................Foundation
r .
Exierior ....................................................`:...............:...............Roofing .........................................:..........................................
Floors .........................:............................................................Interior ......................................................:.............................
Heating ...................................................I..............................Plumbing ................:..:..............................................................
- t �aa
Fireplace ............:.......'.............................................................Approximate Cos ...........!. ................................
Definitive Plan Approved by Planning Board ---_____-______________________1,9--------. Area ..�... ...........................
Diagram of Lot and Building with Dimensions Fee '
SUBJECT TO APPROVAL OF BOARD OF HEALTH
e <ell
I hereby agree to conform to all the' Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name . . ..... ........................V. ..........
Monaghan, Francis G,.-
18842 enclose stairway
No .............. Permit for ....................................
d corridors
....... ........................................................: ` r
North Street
Location• ... ...................................... .............. `
Hyannis
.. .. .............................
Francis G. 44-
i n
onaghan
Owner
e of Con frame
T
YP Construction ..........................................
.......................................................... �.. .
Lot
Plot
? �-
ze
�Permit Granted .......November' 29... .i:.19 76
''Date of Inspection ....................................19 f
Date Completed' .... :....+""19`77 ! t. �f�•
/ C }
"PERMIT REFUSED
......... ......................................... ... 19
.... . .................... . ........................ ..................... ,f /' •'
................................................... ........................... �• `T _ - . '. r 'l.. ,T' t'� .v /'�'
.. ✓; fr-.' .+stir - � ✓ � „..+� � `
....................................................., : .. .... .. /y� �..•� �: ..r _a•,..-�. '" .. ` '1
................................................... .r.. ....... �., .i•F.^t `• 9'f :R �' _._
Approved ......................................:..... 19
r ti
...............................................................................
................ ...........................................................
i
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Department of Health, Safety and Environmental Services
PY6s9. �• Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 ? `Ralph Crossen
Fax: 508-790-6230 - • Building Commissioner
Tax Collector. V
�7 Treasurer 6 ,
Application for Sign Permit
Applicant: f� �q 1� >> V Assessors No.
Doing Business As: �� �'14� S 7-9 RV(:`(. Telephone No. .q
Sign Location
Street/Road: 4)A te,>v s T Yi V Zs R Ye 0
Zoning District: Old Kings Highway? YesA& Hyannis Historic District? YesMgg)
Property Owner b�N Y�CS
Name: L j A a'J /"��.�n h i�yB a✓ P 1�m ` Telephone: S
Address:— 18 iv o m-m Village: 1� N
Sign Contractor
Name: ?�Q YC �, 6 Telephone:
Address: ('7,ne-v-iZ prr,I S tf Gi 0 Village:
Description
Please draw a ding un 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 die sign to be electrified? CYe t o (Note.Ifyes, a wiriwpem tisrequired)
I hereby certify that I am the owner or that I have the authority of the owner to make this
application,drat the information is correct and that the use and construction shall conform to die
provisions of Section 4-3 of the Town of Barnstable.Zoning Ordinance.
Signature of Owner/Authorized Agent: Date:
Size: I.0 6IV X � 11416/d __Permit Fee:
Sign Permit was approved: Disapproved:
f
Signature of Building Official: Date:
Signl.doc
rev.8/3//98
4
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HYANNIS
j TRAVEL
s INN
INDOOR & POOLS +
OUTDOOR
WHIRLPOOL-SAUNA tL,
I
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. ,
TOWN OF BARNSTABLE
x
SIGN PERMIT
PARCEL ID 327 010 G$OBASE ID 24124
ADDRESS 16 NORTH STREET PHONE
H'MNNIS ZIP --
jLOT VARIOUS BLOCK LOT SIZE
IDEA DEVELOPMENT DISTRICT IIY
PERMIT 32357 DESCRIPTION HYANNIS TRAVEL INN (.32 SQ..F'T. & 8 SQ_FT_ )
PERMIT TYPE BSIGN TITLE SIGN PERMIT
CONTRACTORS: Department of Health, Safety
ARCHITECTS: and Environmental Services
TOTAL FEES.: $75.00
1NE
POND $.00 �
CONSTRUCTION COSTS $.00
753 MISC.-NOT CODED ELSEWHERE
* BARNSTABM.
MASS.
039. A,
� BUILDI DIVIS Nf/ �
i BYE% Li
DATE ISSUED 07/27/1993 EXPIRATION DATE
The Town of Barnstable
✓ en f Health, Safety an Environmental 1 '1 Department o H a ty d Environmenta Services
Building Division
367 Main Street,Hyannis MA 02601 ri
jll:t:;;!li:;',J.IY.i:�:;,ti.
Office: 508-790.6227 �� s�% Ralph Crossen
Fax: 508-790-6230 a Building Commissioner
'. y ,
i ti 41 p aiyr r
A li on S- Permit
pp = x
Applicants KAVEL'I + ivN 'Assessors No 3 273}=of d
Doing Business As: NYAms T zrivee- T.-w Telephone No:' 76- SZoo
Sign I ocatloII
Street/Road: I Nc> r" %7REE1- . HYANN/S /►'� �aG�✓ r
Zoning District: Q Old Kings Highway? Ye�
Property Owner
Name: HYAMNIS 71?Ay&- N/V Telephone: 775:®Zoo
Address: : Village:
Sign Contractor
Name: JbRGAN 51 c N Cowt PtWY Telephone: 771-'l0 Z O
Address: 103, eH MC PRtsE F-4A P Village: NYANIV I S ao ;z G o f
KELE?jER EXISTlac F <65 - NO cAANGE ;�V hWd NT S
O2 SMAI /2E
y$ x 32L 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?, Ye o (Note.If yes, a wiIiDffP Emit is requircO '
Ql U71N
I hereby certify that I am the owner of that I have the authority of the owner to make this
application,that the information is correct and that the use and constriction shall conform to the
provisions of Section 4-3 of the Town of Bars le r ' ance.
Signature of Owner/Authorized Agent: Date: ?Iel Td�r 98
Size: 3 Z CI So Permit Fee: `` ,'oV ?,5 75'
Sign Permit was approved Disapproved:
Signature of Budding Offi 'al: Dated
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20 v, 40
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TRAY I
&JTHE MONAGHAN COMPANY
' Engineering Dept.-(3rd floor) Map 3 Parcel 6.1 G l.� Permit# �3 8
House# Date Issued s
Board of Health(3rd floor)-(8:15 -9:30/1:00-4:30) Fee 1600 • d-Z)
Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) Aft�q�,
co -?,OQ 8 Q 8
Planning Dept.(1st`floor/School Admin. Bldg.) BNtiINEg F
tb
Definit!* pproved by Planning Board 19,
BARNSTABU.
TOWN OF BARNSTAELE
Building Permit Application
pA'rojiectStreetdress46
7
�?
r�
./Village r__
su
Awner 14,E Address -
Telephone
Permit Request .�
l
First Floor square feet Second Floor square feet
Cons on Type
Estimated Proje ost $ 07h�
Zoning,District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family ❑ T amily ❑ Multi-Family(#units)
Age of Existing Structure Hist House ❑Yes ❑No On Old King's Highway ❑Yes ❑No
Basement Type: ❑Full ❑Crawl ❑Walkout ❑ er
Basement Finished Area(sq.ft.) Ba ent Unfinished Area(sq.ft)
Number of Baths: Full: Existing New If: Existing New
No. of Bedrooms: Existing New
Total Room Count(not including baths): Existing New First Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other
Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal sto ❑Yes ❑No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board ZYe
eals Authorization ❑ Appeal# Recorded❑
Commercial ❑No If yes, site plan review# -
Current Use Proposed Use
Builder Information
Name hQ �!J /Uf�� �/ Telephone Number . 9
Address f 3�,�, VA-C",p License# g'—
�,.
Home Improvement Contractor# 1,4[O
Worker's Compensation#
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS
OPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
�r
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) ��
fa
FOR OFFICIAL USE ONLY
•
PERMIT NO.
DATE ISSUED'
MAP/PARCEL NO. _ t
ADDRESS r VILLAGE
OWNER _.
t
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICALi ROUGH FINAL `
glo
PLUMBING: UGH : FINAL r;
?S o� , �•
GAS: UGH FINAL ; - *
FINAL BUILDI � �✓� t�, „� f% .�s
-cgs r
DATE CLOSED
ASSOCIATION PLAN NO.
� 1
{�{ � ��
I
a L- 3
.1Z
� � � �
�,-�,.
.��.
-� �.�
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• Tile Cuntnru1r11-ca/1/t of Atassuchuseff-
;rti 'i.�: •' Depar`tirutrt of Industrial Accidents
z ', ;" . ;i� p�cPa!lmresugatlntts
6011 ti<it:�lriu�;tuir Street
;'
N Boston,,Huss. 03111
J `� �•' , cnsation lnsurance Affidavit
1 orkcrs Comp ._...^-�------
-- Pi P
i�Ii 3 inf•rat itin•
•
(Ic, o v
s
httn.8
UIq
`•
r 1 am a homeowner performing all work myself.
l am a sole proprietor and have no one working in any capacity ,_�__....
I am an empiover providing workers compensation for my employees working on this fob.
mn tam• name!
r '
1dtlrccc•
hnnc l!•
t,•-
inolicv 0 _ f
[� I am ne) and have hired the contractors listede:o�� u
a sole proprietor. ecneral contractor, or homeowner(circle o
the foilowing workers' compensation polices:
cnm any name•
ltltirrtc! •
• -•� 11nt1C e!•
city
con+ nn%, nnmc-
9:
;tddresc-
hnnc ii•
city-
- oil •�
insurance cn =�_.__•"'—'--.:
Attach additional sheet if neca_ia_rv� • ''-"��K-• '•
Failure to secure cove race if as required under Seetton 3SA of��1GL 15_can lead to the Imposition of ertmmai penalties of a fine up to SISOU.UL
+ unc cars imprisonment a•••'cil as cirii penalties in the form of a STOP WORK ORDER and a fine of St00.00 a dad against me. I uadetstanc
COPY of this a(ateme:It ma.' be fornarded to the alrcc of InTcstit;ations of the D1A for cotent a yerificatian.
!rlo beech!creel[•urr cr rl •pains and nailles of perjuq tkat rile information prorided above is true and correct.
13 _
S i_nature
Phone ±
Print name
' official se nni� do not write is this area to be compicted by city or town otTicial
ltertnit/liecnse it rltluildinz Department
1' city or town: QL•ceasin�13oard
Qscieetmen's Uff►cc
-•- -_.. .. ...Y rruuired r,ttraith I)cnartmt•-•
lassachusetts General Laws chapter 152 section 25 requires all empiovers to provide workers* cc III]pensation for tttei
nPloyees. As quoted from the "l���", an einph ree is dcfincd as even, person in the service of another under ally
)ntract of hire. express or implied. oral or'%rritten.
n empinrer is dcfincd as an individual. partnership. association. corporation or other legal entity. or anv two or morc
c forcuoina ena-aged in a-joint enterprise. and including: the legal representatives of a dec=cd emplover, or the
cciver or trustee of an individual , partnership. association or other legal cntity. employing employees. However the
vner of a dwelling house having not more than three apartments and who resides therein. or the occupant of the
..cliitt�_ house of another who employs persons to do maintenance , construction or repair work on such dwelling_ iiou
on Ill. :7cunds or building appurtenant thereto shall not because of such employment be deemed to be an employer.
3L chapter I52 section 25 also states that even-state or local licensing agency shall withhold the issuance or
tei�al of a license or permit to operate a business or to construct buildings in the commonivealth for any
;ilicant who lzas not produced acceptable evidence of compliance with the insurance covernbc required '
ditionall•.. neither the commonwealth nor am• of its political subdivisions shall enter into any contract for the
formoncc of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha
n presented to the contracting authority.
-
Aiicants
'.Sc fill in the \vorkers' compensation affidavit completely, by checking the box that applies to your sitmt:on and
)Ivin ► company names. address and phone numbers as all affidavits may be submitted to the Department of
:strial Accidents for confirmation of insurance coverage. AIso be sure to si-n and date the affidavit. The
.:Wit should be returned to the city or town that the application for the permit or license is being requested.
.he Department of Industrial Accidents. Should you have any questions regarding the "law- or if you are required
-:ain a workers' conipcnsatiot: policy. please call the Department at the number listed below.
or Towns
` be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of
Ttdavit for you to J-111 out in the event the Office of Investigations has to contact you regarding the applicant. Pleas
re to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to
'zpartment by mail or FAX unless other arrangements have been made.
>ffice of Investigations would like to thank you in advance far you cooperation and should you have any questions.
do not hesitate to 1_11ve us a cell.
..__._�._. .._...._..�.., ...,_.�......_..._ --.r r.—.,.._._
,cparttnent's address. telephone and fax number.
The Commonwealth Of Massachusetts
w: Department of Industrial Accidents r i
Office cf investigations
600 NA'ashindton Street
Boston,Ma. 02111
fax #: (617) 727-7749
phone #: (6I7) 7274900 ext. 406, 409 or 375
HONE INPROVENENT CONTRACTOR '
j` registration �101087
{YPe Ml I 9VATE CORPORATION
M., Expiratioa ; Ob/25/98 F p
t
CLAUDE R CORRIVEAU BUILDER,
-
"�co�n
ADMINISTRnroR ._ox: 284/ 84 Plne`St
' %�M=rariouthport NATo2675
✓lie Vi aryvrnoouuea o�✓��aasac/zuaet3 A':
DEPARTHBRT OF PUBLIC SAFETY
CONSTRUCTION SUPERVISOR LICENSE .
Nu�ber Expires:
Restricted To:. '00
VF
x CLAUDE R CORRIVBAU
PO BOX 284 N
YARHOUTHPORT, NA 02675
• i
a-
1 . '
7 71)
4
53
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HART INSURANCE AGENCY INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
240 MAIN STREET HOLDER, THIS CERTIFICATE-DOES NOT AMEND, EXTEND OR
I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
J COVERAGE BUZZA WIS BAY, MA 02532 -COMPANIES AFFORDING _
I COMPANY NEW urNLN COUNrn a ALA
INSURED --
COMPANY GRANITE STATE INSURANCE CO.
B
HYANNIS 'TRAVEL INN --.... .....
16-18 NORTH STREET COMPANY
HYANNIA, MA 02601 ___ C
COMPANY
� c ens D
�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 RECUCED BY PAID CLAIMS.
PO
LTA I TYPE OF INSURANCE T
POLICY NUMBER LICY EFFECTIVE. !POLICY EXPIRATION LIMITS
DATE(MWDD/YY) DATE,MM/DDIYY)
GENERAL LIABILITY GENERAL AGGREGATE S7 11AQ I1�.
71` X,COMMERCIAL GENERAL LIABILITY I--�+-
_{— PRODUCTS-COMP/OP AGO S 1 ov
I -1 CLAIMS MADE t X l OCCUR 5SM30621 ; 10/25/96 1 1 0/25/9% PERSONAL&ADV INJURY F$1,ma.00O
OwNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $
_....
FIRE DAMAGE(Any one fire)I $
VIED EXP(Anyone person) I$
AUTOMOSILE LIABILITY
GONBINED
SINGLE LIMIT $
ANY AUTO
ALL OWNED AUTOS j BODILY INJURY $
{ I SCHEDULED AUTOS + i (Per person)
II HIREDAUTOS I r— --- —
t� -BODILY INJURY I S
I NON-OWNED AUTOS (Per accident)
it
PROPERTY DAMAGE S
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S
j ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
j AGGREGATE I$
EXCESS LIABILITY EACH OCCURRENCE $
—�UMBRELLA FORM
AGGREGATE $
OTHER THAN UMBRELLA FORM $
WORKERS COMPENSATION AND TORY LIMITS ER i
EMPLOYERS'LIABILITY I EL EACH ACCIDENT - I$ 1 flfl�00
B' THE PROPRIETOR/ l INCL WC3510964 i 5/3/97 5/3/.98 EL DISEASE_POLICY LIMIT $ 5flfl 000
PARTNERS/EXECUTIVE
OFFICERS ARE' EXCL EL DISEASE-EA EMPLOYEE S 100,000
OTHER
• I
_ i I
DESCRIPTION OF OPERATIONWLOCATIONS/VEHICLES/SPECIAL ITEMS
{+��I•t't!!FI'�A'�E I�(?E.�R �At����.L#T1C�N
SHOULD ANY Of THE ASOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
TOWN OF BARNSTABLE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
BUILDING INSPECTOR 30.,. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
508-790-6230 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTAT)YE
ACCt> I ; iRA'f'tt N 1-408-
TO'd 99CL-59L 80S 60CE AOV 33NvbnSNI 12ibrH `dLS =Oi L6-LZ- vew
Assessor's offioe (1st floor):
Assessor's map and lot number 7 � THE
c c
� � F t
Board of Health (3rd floor):
Sewage Permit number ........ ......,.:.,........ !
"' ' Z BAB.39TODLE i
Engineering Department(3rd floor): /� +o YA°a
p t6}q•
House number
mo
APPLICATIONS PROCESSED 8:30-9:30 A.M, and 1:00-2:00 P.M. only
TOWN OF BARNSTABLE
BUILDING I. INSPECTOR O&t/
APPLICATION FOR PERMIT TO .....'..!..'...p......'..:'.... G�� / �I V S Q )E L
....................................................................��..........lrvh 0
TYPEOF CONSTRUCTION .. .:.`. .... ................................................................................................
..............................................19........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location
ProposedUse .................:S ..I. .f j!. !?. ......... ....... IL...... ........................................ ............................
Zoning District ...... �.%Q Y11,/iY7...................................Fire District .......14 ' ...5.......
.. ......
...........
Name of Owner ... hf1'MILS... .............. '1PhL.....Address�
Name of Builder (�
� `rbQy V ...............................Address ....................................................................................
Name of Architect/'.'1 .��.IC°.�....... 1.( ✓ .( ...Address .. _.
�......................... .. ......
Number of Rooms ....... .................................Foundation � .. ... ....
�'ICI..1 rFCTf...��fJ
Exier for l.-1 N
//.(E:.../. ��G�.............Roofing .."I�l/.,�
........ .;1.�..............................
Floors ......................................................................................Interior ....................................................................................
Heating Plumbing'
f � •1
Fireplace ...............V.`f. ...........................................................Approximate Cost ... ��! :......................r.....................
Definitive Plan Approved by Planning Board --------------------------- __19________ , Area .....!.......,::....................
Diagram of Lot and Building with Dimensions Fee
..........t... .......................
SUBJECT TO APPROVAL OF BOARD OF,HEALTH
1;0
1
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.
Name ... ! ........t. .................r. ,.!':?..........
Construction Supervisor's License /
MONAGHAN, 'FIRANCIS G. A=327-10
No ..3.0.9.8.7.. Permit for .,Add...To...Mot.e.1.../Pool
.... .. .. .. ....... .. .
Commercial/ Hvannis Travel Inn
........................................................................
Location ....U...N.Q r.t I.I.-St r.P—e.t....................
......................UyaXlylia.......................................
Owner ......:Fran
...q i.5...Q.p...UQTAa.g11dx1..........
Type of Construction ......Frame.......................
...............................................................................
Plot ............................ Lot ................................
Permit Granted ........j3A�y... ............19 87
Date of Inspection ....................................19
Date Completed .........
Assessor's map and lot•number ..........................................
r♦' e`t,� '� r[ .. �' �'C ? ? - _ -✓1 I�` .'� r.. . TU T/rG t3 f T ♦t .� �c:'�/ -,: .
Sewage Permit number :.............................. ..
y�F7NET��y «y TOWN OF •BARNSTABLE
Z BAHBSTODLE, i `?
"6 9s_e�� BUILDING INSPECTOR
oo� •
APPLICATION FOR PERMIT TO .........:..! ...�.. -L,•.............................................� ,!�.............................
TYPEOF CONSTRUCTION ........... .;�.•. .�................ . .......................................................
e ........:.../..................................19.
TO THE INSPECTOR OF, BUILDINGS:
The undersigned hereby applies for a permit according to the following information: _
/ . 6 ,7� J� / 16
Location �^ .... ...,
ProposedUse ........................................................................................................................:....................................................
ZoningDistrict ..�..,.�......................................... ........................Fire District .................................................... .........................
-'
Name of Owner"c . .. ..r }:: -�g� a Address 'h •• t••••
.....
Name of Builder (°�.....il ' ..' .. ............Address .(94W _..... �
Nameof Architect ........:..'""�...................................................Address .....................................................................................
Number of Rooms .................................Foundation .��
Exterior ........................... :^....................................................Roofing ....... 7=....................................................................
Floors ....................................:: ..............................................Interior ....................................................................................
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 `
f�
- M
1?9 70
I hereby agree-to conform to all the Rules and Regulations of the Town of Barnstable regarding the.above
construction. k
Name ............... .................... ...............................
Monaghan, Francis G i^
�
7
No ..l9l03—. Permit,for ....................................poml
.........................k—.------------..---..
North Street -
Location -------_—______------
-----'-- o-------------.
�
Francis � ^ '
Owner -----------�..,�,ox�znu�---..
Typo of Construction .......:Ex----------.
,
'
...........................................................
'
Plot ............................ Lot .......... ......
.
^~~y 5
uo,e or / '
�
uo,= ~
. �
` -
`
� -
'
`
-
'' --'
1'../D
`
........................0
�—. ------ � � �
` ^ �
.----.---..--. . —.—.-----.. �
' \ � .
\
.......................................... .............................
�
\ �
Approved ................................................ 19 .
� ' ^
----------------..
..—.—.—..--.— `
`
----------------------.--.— . .
_ �
�
'"�,,...- .�. ..---•.» -^i J-.. ...._. .. .......-.-s'.-:.,.--� _..-.--. .. r a._...:�.-•,e°n'<-.+:,0...4j..F�e.' �i+:r`.'b.1��y�41/� -.E+.Y:s<.:yr'-�..;:.x.A ....-.-�.ai...r4,..++::cZ.e....L."•^.r.
Assessors map and lot' number d ,;4 /d
Sewage Permit number ..:,...,... �? �.,,.-....._......... ..., .....! .......,.....�-L
F7NET0�o TOWN' OF BARNSTABLE
1i BARNSTABLE,
MABIL BU11ILDING INSPECTOR
APPLICATION FOR PERMIT TO �... a d �� .'`
a ........................................................
r -
� r��
TYPEOF CONSTRUCTION .....................................................................................................................................
` ` /� �% ............19 ..
'TO THE INSPECTOR OF BUILDINGS:
d
The undersigned hereby applies for a permit according to the following information:
?Or
x 1' Zvi'^ t,/..`1.-��..vAll-! '
ProposedUse .....................................:........................................................................................................................................
�,,u��u/ I/ /�� / '?...............Fire District
Zoning District ..r..............`..........r..•....................
Name of Owner .................... 44Ue..Add re'sVMN2 64� A.. .......
r
Name of Builder ................Address ./ i ,.:4?.:,....,..._, ..................
Nameof Architect ........................:.-"....................................Address .......................---:....................................................:.
Numberof Rooms ..................................................................Foundation ..............................................................................
Exierior ....................................................................................Roofing ....................................................................................
Floors ..........................................................Interior
Heating ....................... ........Plumbing
................................................... .................. ......................... .....................................
`�% ��a
Fireplace ..................................................................................Approximate Cost........:................:. j.. ....................
Definitive Plan Approved by Planning Board ________________________________19________ , Area
Diagram of Lot and Building with Dimensions Fee
................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
r 05,0
tv_�
(zl�- ,
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ... 1(! ! ........................V ..........
Monaghan, Francis G. A=327-1fl T r
No ...18842... Permit for enc.l...ose. ...s.tair. way
.. . . .. . .
and corridors c
............................................................................... .
Location North Street --
......................Hyannis......................................... --�—
G� 7
Owner Francis G. Monaghan
Type of Construction ........frame
................................
................................................................................
Plot ............................ Lot ................................
IPermit Granted .....Novem er 29 76
t
Date of Inspection ......... . ...... ... .el.O....19
Date Completed ... ... .. .. V. ..........19
RMI REFUSED-
........................ .. ... � !.................. 19 r
�. .. .... .. ......................................
��. ►..................................................
R .'. ........................................................ #f �
i
Approved ................................................ 19
...............................................................................
.............................................................................
j
� � �(:�s• .....-...f-...,..,.y,.�.m..s.�,.�-o.ti...e».w..,. _, ts.=... _ -.. �r.. P r......x•. a
,�✓ *�
Assessor's map and lot nu�}mber .... ..... . �. r. .. .. "
41- 11
Sewage Permit umber .................... r
r �OFTMET�� OF BARN TA LE
TOWN S
1i BAHHSTAIILE, • e
oaya.•�� BUILDING INSPECTOR,
APPLICATION FOR PERMIT TO ...... ................... l .�......?
TYPE OF CONSTRUCTION .................... ... .'. .... :`:h ...........'.�..?...... .`'� ....�+...... .�.....
IG ............ .......�...........J...........19T L
TO THE INSPECTOR OF BUILDINGS: '
The undersigned hereby capplies}-f-o—r a permit according to the following information:
Location........ ..: :.t"�, ...�?.. ...... t :�jt,f�. v VZ7.........�` " `.`"� ^j... '� r�!L�'Lt V �............
Proposed Use ................................ fL�}!#r ...tl n/1.�... '�`....................................( 1h S' 't 'k... ..........................
( t � � ..
Zoning District .... :.. ...... .............?.. .. �.:'t.!t'7 �,?'��.....Fire District ..................`............................................................
Name of Owner ,�,-l-,F,+ , !/�. .,`,.1.11.. � .�f!� ..Address
f
/dU ... � . <' ` �.. .........................................
Name of Builder ........ ...Address ......... ........
Name of Architect .................:,�:--A
�..........................:............Address .........../................................./........................................
°'7-' 71�'Yw� r" �h`ua� �/.�r� (�an/� (�a r o t�v Number of Rooms ...............:..... ..........:...........Foundation ,:....,. .................,...
Exterior ........,... ,..........:. .... ....................Roofing .................... ,........ .....................................
v r
(� ` 1 i 1. .................Interior i.:' f,�t z � --/
Floors ........ :��+..-./................ .....................................................................................
,r f
}fat Plumbing .. .:.. .............................
Heating ......................... q
Fireplace .................. ..................... ...........................Approximate Cost ....... !/t�,Z� ...�... 'C'....;�� 1-�....
. ...
�
Definitive Plan Approved by Planning Board_ --------------------------------19-------- . Area '��� ....
p~ Diagram of Lot and Building with Dimensions Fee ..
SUBJECT TO APPROVAL OF BOARD OF HEALTH /
S � �.L
�-
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding•the above
construction. f
f Name ...................... ....
J Monaghan, Francis A=327-10
18757 move dwellings
No ................. Permit for ....................................
...............................................................................
North Street _
Location ................................................................
Hyannis .
...............................................................................
Owner Francis Monaghan
.. ..................................................................
Type of Construction frame
................................................................................
Plot ............................ Lot ........:.......:...........
October 22 76
Permit Granted ....19
Date of Inspection ..........: ..............:.......19
Date Completed ............. .......19
PERMIT/ REFUSED
................................. . .......................... 19
.................. ......... .J............................................
..................... ..... ................................................
.......................... ................................................
Approved .....:....................................:..... 19
.............................................. . ... .� . .5 .
.................... ........ �. � ........
existing buildingLn
Ir-'
existing building Z,[/
Q 3K X
NEW ADDITION CLZc c
ME
c� cn
_. . co� .. .
WASHINGTON AVENUE
0 0
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C= ac ac
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—SCALE 1" 20'0"PLAN � 0SITE oo
w
C= z o
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--.,-.existing foundotion existg. 0
_ IL
foundation Oku w
z
+p /` m
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exlatg, foundation - <� f,,, / �� � . � � i�t � Z
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4" CONC. SLAB W 16X6 iO/i0 WIRE M 8'0" DIAMETERESH
I OVER . ,'J�_� I JACUZZI FOUND.
cc
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"Fu O Z
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EDGE OF FOUNDATION_..
"
I
7'0'
v
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F O v I V D A T I O 4" CONC. SLAB ,
N PLAN
DATE. ,JgN• 22, 198
Brt MJl3
6" GRAVEL - �;�,`� FIN.GRADE
REV:
SCALE I/4" = I'0" " " ,Y •
EARTH
is WON iDRAWING BER
_. fasom : 10 CONIC. WALL
D G NUM
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REG!S i ERED ENGINEER & LAND SURVEYORS
I' MID-CAPE OFFICE BUILDING—1265 ROUTE 28
POST OFFICE BOX 70
SOUTH YARMOUTH, MASS. 02664
TELEPHONE: (617) 394-2230
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