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0001 SOUTH STREET
S�ot- �- . . f , f �r. k t l i 1, Global Zoning 8205 NW 691,Street Oklahoma City, OK 73132 405-613-0742 LaKisha@globalzoning.com Global Zoning www.globalzoning.com 10/29/2021 RE: Zoning Verification Letter-1 South Street,Hyannis,MA(Ref#15622) Block&Lot 326 119 Greetings: Please find this to be a request for Zoning letter on the above stated property.We are researching these matters for a zoning compliance report. Please incorporate the answers to the following questions in a letter on . letterhead. ..V • What is the current zone of the property?Are there any overlay districts? r • Did the property receive any variances,PD's,conditional or special permits issued or require site plan approval? • Is the property permitted in the Use Designation? • Are there any conformance issues with the property? • Are there any active outstanding Zoning or building Code Violations? If you require any additional information, please feel free to contact me at 405-613-0742.Thank you for your assistance with this matter.iPlease email the letter and documents to LaKisha@slobalzoning.com if possible. if you cannot E-mail or fax to 844-866-8503, please return the letter to: Global Zoning 8205 NW 69th Street Oklahoma City,OK 73132 Warm regards, LaKisha Ellis BUILDING DEPT. NOV 0.j 2021 OF BARNSTABLE C- SCANNED //l! / Z' BUILDING DEPI Town of Barnstable NOV 0 3 2021 Certificate of Zoning Compliance TOWN OF BARNSTABLE Certificate No. 2021-50 Map 326 Owner Name as of 1/1121: Parcel 119 Address 1 South Street HYANNIS BLDG & DEV ASSOC Village Hyannis 1 SOUTH ST HYANNIS, MA. 02601 Zone HD Harbor District Zone AP Water Protection Year Constructed 1955 & 1984 Lot Size 1.29 Acres Property Use: Commercial/Motel Setbacks: Front Yard 20' Cert of Occupancy Issued: YES Side Yard 10' Rear 10' Date 09/24/1984 10/7/2002 Permit 25893 & 64311 Open Permits: Yes. List attached. Code Violations: Yes. List of incomplete/failed Building permits attached. Recently failed electrical for pool 11/1/2021. The Certificate of Inspection expires on 11/30/2021. Outstanding Health/Permitti ng issues. 508-862-4044. The Building Division does not receive or maintain information regarding municipal liens. Municipal Liens - Tax Office 508-862-4054 Refer to the Planning Dept.for information pertaining to the Zoning Board of Appeals filings and decisions. Property Description: Situated on the corner of South Street and Lewis Bay Road in Hyannis, this property was originally developed in 1955 with a commercial motel. A swimming pool was constructed in 1975 and subsequently a 2 story annex was added in 1984. Reviewed by Title Date: Robin C. Anderson Code Compliance Manager 11/04/2021 r i i I i Town of Barnstable, MA Inspection Report i Inspection:'ElectricalInspection - Inspector: Inspection Date: Nov 1,2021 Record: Electrical Permit#ELEC-21-1870�` i Location: 1 SOUTH STREET, Hyannis, MA 02601 Applicant: John Duquette Electric-4. Rough t Overall Result: Fail S t Overall Remarks: I have been to the site twice. No electrician on site. Don't know what you want inspected.Some new service equipment is locked. I i s Commonwealth of Massachusetts OF THE 1p� y� Town of Barnstable • Y BAANSTIAST4 ; I S m° 200 Main Street(508)862-4038 ATED MA't A�@ PERMIT REPORT BY ADDRESS Address: 1 SOUTH STREET,HYANNIS PIN Status ,-; Permit For Parcel°ID ,,;Apllicant Work Des�crtption Inspection, Irspectedoon Inspectlon Inspectton = _ Status 'comment r e B-17-156 Closed Building Alteration k Only- 326-119 CHRISTOPHER M remo et, svanities, Building Final 2/7/2018 Pass INTERIOR Wo RTY in two Commercial B-2006-3950 Closed Inspection Certificate 326-119 COI CONTRACTOR ANCHOR-IN B-2007-07559 Closed Inspection Certificate 326-119 COI CONTRACTOR ANCHOR IN B-2008-06039 Closed Inspection Certificate 326-119 COI CONTRACTOR ANCHOR IN B-2009-05767 Closed Inspection Certificate 326-11`9 COI CONTRACTOR ANCHOR IN B-2010-05939 Closed Inspection Certificate 326-119 COI CONTRACTOR ANCHOR IN B-2010-06177 Closed Addition/Alteration- 326-119 STRUCTURES RE-INSULATE Building Final 3/22/2011 Pass PROM: Commercial BUILDING INC. SOUNDBOARD DRYWALL,UNITS 101- 108 SLIDER AND STATIONARY PANELS B-2010-06177 Closed Addition/Alteration- 326-119 STRUCTURES RE-INSULATE Building 12/7/2010 Pass PROM:FTGS IN Commercial BUILDING INC. SOUNDBOARD Foundation BASEMENT/1ST DRYWALL,UNITS 101- FL UNITS FOR 108 SLIDER UPPER LEVEL AND STATIONARY PANELS 1-of 11 Commonwealth of Massachusetts DF THE'Tp�: Town of Barnstable sARNSTABLE. 9 ro 200 Main Street(508)862-4038 $ArfO MAC°`0 a PERMIT REPORT BY ADDRESS P1N Status - Permit For; Parcel ID; a Apllicant h Work Description Inspection Inspe ted on„ :Inspection. ; Inspection' Status Comment �- B-2010-06177 Closed Addition/Alteration- 326-119 STRUCTURES RE-INSULATE Building Frame 12/22/2010 Pass PROM: Commercial BUILDING INC. SOUNDBOARD DRYWALL,UNITS 101- 108 SLIDER AND STATIONARY PANELS B-2010-06177 Closed Addition/Alteration- 326-119 STRUCTURES RE-INSULATE Building Insulation 1/3/2011 Pass PROM: Commercial BUILDING INC. SOUNDBOARD DRYWALL,UNITS 101- 108 SLIDER AND STATIONARY PANELS B-2010-06632 Closed Addition/Alteration- 326-119 STRUCTURES EXISTING HEADERS Building Final 3/221/2011 Pass PROM: Commercial BUILDING INC. ABOVE WINDOWS IN BASEMENT NEED TO BE REPLACED TO CARRY 1ST FLOOR AND ROOF LOAD B-2010-06632 Closed Addition/Alteration- 326-119 STRUCTURES EXISTING HEADERS Building Frame 12/22/2010 Pass PROM: Commercial BUILDING INC. ABOVE WINDOWS IN BASEMENT NEED TO BE REPLACED TO CARRY 1ST FLOOR AND ROOF LOAD B-2010-06632 Closed' Addition/Alteration- 326-119 STRUCTURES EXISTING HEADERS Building Insulation 1/3/2011 Pass PROM: Commercial BUILDING INC. ABOVE WINDOWS IN BASEMENT NEED TO BE REPLACED TO i CARRY 1ST FLOOR AND ROOF LOAD B-2011-05907 Closed Inspection Certificate 326-119 PROPERTY OWNER PROPERTY OWNER/ANCHOR INN HOTEL B-2012-06692 Closed' Inspection Certificate 326-119 PROPERTY OWNER PROPERTY OWNER 2of11 Commonwealth of Massachusetts OF THE:r, Town of Barnstable R Fg. 9 roa 200 Main Street(508)862-4038 �ArEO MAY a`0` . PERMIT REPORT BY ADDRESS PIN status , Permit For Parcel ID:, Apllicant, Work Description Inspection Inspected on Inspection Inspection C, men It B-2013-07431 Closed Inspection Certificate 326-119 PROPERTY OWNER PROPERTY OWNER/ ANCHOR-IN MOTEL B-2014-07593 Closed Inspection Certificate 326-119 PROPERTY OWNER ANCHOR INN B-2015-00443 Closed Addition/Alteration- 326-119 STRUCTURES UPGRADE EXISTING Building Final 2/7/2018 Pass Commercial BUILDING INC. BATHROOM.REMOVE FIXTURES REPLACE WITH NEW,NEW TILE SHOWER AND FLOOR-INTERIOR ONLY RM#110 B-2015-07986 Closed Inspection Certificate 326-119 PROPERTY OWNER ANCHOR INN B-22087 Closed Sign 326-119 Nardini,Richard ANCHOR-IN MOTEL (20 SQ.FT.) B-24202 Closed Inspection Certificate 326-119 COI CONTRACTOR ANCHOR IN MOTEL B-42501 Issued Addition/Alteration- 326-119 CAPIZZI,TOM,JR. REMODEL MOTEL Building Frame 1/7/2000 Pass RJON: Commercial OFFICE AREANVINDOWS/DOO RS B-42501 Issued Addition/Alteration- 326-119 CAPIZZI',TOM,JR. REMODEL MOTEL Building Insulation 1/7/2000 Pass RJON: Commercial OFFICE AREANVINDOWS/DOO RS B-51545 Closed Addition/Alteration- 326-119 PETER M POMETTI REMODEL&ENLARGE Building Final 5/24/2001 Pass TPER: Commercial EXISTING DECK 3of11 Commonwealth of Massachusetts " Barnstable Town of B a a 200 Main Street 508 862-4038 MA't PERMIT REPORT BY ADDRESS ` PIN Status , Permit For Parcel ID Apllicant Work Description Inspection Inspected on- 'Inspection Inspection Status Comment B-51545 Closed Addition/Alteration 26-119 PETER M POMETTI REMOD OD � �• EL&ENLARGE Building 2/20/2001 Pass TPER: Commercial EXISTING DECK Foundation B-52243 Closed Siding/Windows/Roof/Door 326-119 CAZEAULT COMPANY STRIP&REROOF s EXISTING BLDG B-56522 Closed Siding/Windows/Roof/Door 326-119 CAZEAULT COMPANY STRIP&REROOF s EXISTING BUILDING B-59554 Closed Addition/Alteration- 326-119 MARC N CASOLI ELIMINATE ONE Building Final 10/7/2002 Pass TPER: Commercial SUITE/CREATE SUITE : IN BASEMENT E-17-317 Closed Electrical-Add/Alter 326-119 Raymond E Lafleur Wiring offices and Electric Final 10/26/2017 Pass Bathrom removel E-17-317 Closed Electrical-Add/Alter 326-119 Raymond E Lafleur Wiring offices and Electric Rough 2/23/2017 PASS Rough electrical Bathrom removel passed E-19-821 Issued Electrical Smoke Detector 326-119 CAPE COD ALARM CAPE COD ALARM TO and Alarms CAPE COD ALARM INSTALL CAMERA SYSTEM E-2006-5047 Closed Electrical-Add/Alter 326-119 COLEMAN,DAVID WIRING FOR WEST Electric Final 2/12/2007 Pass WAMA: WING REMODEL- HALL LIGHTS,ADDED OUTLETS, BATH FANS SECOND FLOOR FINISH E-2010-01840 Closed Electrical Service 326-119 COLEMAN,DAVID REPLACE SERVICE, Electric Service' 4/30/2010 Pass WAMA: CONDUCTORIN EXISTING PIPES. 1 SET LIGHTING AND 1 SET HEAT 4of11 i Commonwealth of Massachusetts OF THE i Town of Barnstable 200 Main Street(508)862-4038 SATE°M PERMIT REPO AC' RT BY ADDRESS Y PIN,, Status Permit For ParceLlD .xApll cant Work Description a�Inspection Inspected on Inspection Inspection F StatusComment E-2010-06177 Closed Electrical-Add/Alter 326-119 STRUCTURES RE-INSULATE Electric Final 2/24/2011 Pass WAMA: BUILDING INC. SOUNDBOARD DRYWALL,UNITS 101- 108 SLIDER AND STATIONARY PANELS E-2010-06177 Closed Electrical-Add/Alter 326-119 STRUCTURES RE-INSULATE Electric Rough 12/22/2010 Pass WAMA: BUILDING INC. SOUNDBOARD DRYWALL,UNITS 101= 108 SLIDER AND STATIONARY PANELS E-2010-07010 Closed, Electrical-Add/Alter 326-119 CAPE COD ALARM ROUGH WIRE&TRIM Electric Final 3/10/2011 Pass WAMA: OUT MODIFY EXISTING SYSTEM E-2010-07010 Closed Electrical-Add/Alter 326-119 CAPE COD ALARM ROUGH WIRE&TRIM Electric Rough 12/29/2011 Pass APUL:PER OUT MODIFY GENE EXISTING SYSTEM CORMIER WIRED AS CLASS B. E-2011-02156 Closed Electrical Service 326-119 COLEMAN,DAVID REMOVE NEMA 3 Electric Final 5/3/2011 Pass WAMA: CUTTER DUE TO RUST IN BACK CABLE COMPROMIZED BY SMALL FIRE IN GUTTER E-2012-06559 Closed Electrical Service 326-119 COLEMAN,DAVID NEW 400 AMP 1 0 Electric Service 11/7/2012 Pass WAMA: SERVICE FOR FUTURE DOCK EXPANATION AUTH#01903934 E-2012-06559 Closed Electrical Service 326-119 COLEMAN,DAVID NEW 400 AMP 1 0 Electric Trench 10/26/2012 Pass WAMA: SERVICE FOR FUTURE DOCK EXPANATION AUTH#01903934 5of11 Commonwealth of Massachusetts pp THE'T Town of Barnstable �00q 200 Main Street(508)862-4038 ATf°Mpia PERMIT REPORT BY ADDRESS PIN StatUsV. Permit_For Parcel ID Api'licant Work Description Inspection Inspected on inspection _ Inspection 1 Status Comment E-2012-07440 Closed Electical-Minor 326-119 CHRISTOPHER SMITH LOW VOLTAGE Electric Rough 12/4/2012 Pass WAMA: MASONRY LLC LANDSCAPE LIGHTING WITH IN STONEWORK E-2012-07988 Closed Electical-Minor 326-119 COLEMAN, DAVID SEP CIRCUIT FOR Electric Final 2/27/2013 Pass WAMA: (LOW VOLTAGE LIGHTING BY OTHER) TRANSFER&PHOTO CELL PLUS FINE P.T. POWER E-2015-00443 Issued Electrical-Add/Alter 326-119 STRUCTURES UPGRADE EXISTING Electric Final 3/31/2015 Pass WAMA: BUILDING INC. BATHROOM.REMOVE FIXTURES REPLACE WITH NEW,NEW TILE SHOWER AND FLOOR-INTERIOR ONLY RM#110 E-2015-00443 Issued Electrical-Add/Alter 326-119 STRUCTURES UPGRADE EXISTING Electric Rough 2/9/2015 Pass WAMA: BUILDING INC. BATHROOM.REMOVE FIXTURES REPLACE WITH NEW,NEW TILE SHOWER AND FLOOR-INTERIOR ONLY RM#110 E-43382 Closed Electrical Service 326-119 COLEMAN ELECTRIC GENERAL Electric Final 4/3/2000 Pass RWES: REMODELING INTERIOR AREAS E-43382 Closed Electrical Service 326-119 COLEMAN ELECTRIC GENERAL Electric Rough 1/5/2000 Conditionally RWES: REMODELING Approved INTERIOR AREAS Custom Status: Conditionally Approved E-52702 Closed Electrical Service 326-119 COLEMAN ELECTRIC FEED ELC'ECTRICAL Electric Final 4/19/2001 Pass, RWES: POOL HEATER AND PUMP 6of11 Commonwealth of Massachusetts OF THE Tp� Town of Barnstable MASS. 3 S. a 200 Main Street(508)862-4038 ""A�a ` PERMIT REPORT BY ADDRESS PIN Status Permit For Parcel IDS Apllicant Work Descri tion Inspection , Inspected on Inspection Inspection! Status Comment E-62020 Closed Electrical-Add/Alter 326-119 R&S LAFLEUR DBA BASEMENT BEDROOM Electric Final 9/23/2002 Pass RWES: LAFLEUR ELECTRIC LR KIT UNDER 500SF CK 2005 E-62020 Closed Electrical-Add/Alter 326-119 R&S LAFLEUR DBA BASEMENT BEDROOM Electric Rough 6/26/2002 Pass RWES: LAFLEUR ELECTRIC LR KIT UNDER 500SF CK 2005 E-81229 Closed Electrical-Add/Alter 326-119 COLEMAN,DAVID MISC E-81539 Closed Electrical-Add/Alter 326-119 COLEMAN,DAVID 1ST&2ND FLOOR Electric Final 3/7/2005 Pass WAMA: OUTLETS/MISC G-16-254 Issued Gas 326-119 FRANK W RODERICK 1 Fixture Gas Final 8/28/2018 Dryer G-16-254 Issued Gas 326-119 FRANK W RODERICK 1 Fixture Gas Final 8/28/12018 FAIL G-16-254 Issued Gas 326-119 FRANK W RODERICK 1 Fixture Gas Final 8/28/2018 FAIL Vent on ground G-16-254 Issued Gas 326-119 FRANK W RODERICK 1 Fixture Gas Final 8/28/2018 PASS G-18-1379 Closed Gas 326-119 FRANK W RODERICK (1)Fixture Gas Final 8/28/2018 PASS G-18-1379 Closed Gas 326-119 FRANK W RODERICK (1)Fixture Gas Final 8/28/2018 PASS Fire approval G-2012-07204 Closed Gas 326-119 MUNRO,ROBERT TEST AND GAS LINE Gas Final 11/21/2012 Pass RBUR: G-2012-07204 Closed Gas 326-119 MUNRO,ROBERT TEST AND GAS LINE Gas Rough 11/21/2012 Pass RBUR: G-86364 Closed Gas 326-119 RUSTY'S, INC. WTR HTR Gas Final 10/25/2005 Pass RBUR: GHL-17-38 Renewed. Health-Motel Application @ParcellD Anchor-in Motel Seasonal Human Habitation 11/28/2017 PASS GHL-17-38 Renewed Health-Motel Application @ParcellD Anchor-in Motel Seasonal Human Habitation 11/28/2017 PASS Ok continental breakfast 7of11 Commonwealth of Massachusetts OF THE TA,_ Town of Barnstable 1 1' BARNSTABLE. !. 9� 1639 �00p . 200 Main Street(508)862-4038 ATf°""A�' PERMIT REPORT BY ADDRESS P'IN riStatu's Permit For Parcel ID` `;Apllicant .Work�Description Inspection Inspected3on Inspection Inspection" Status Comment u GHL-17-38 Renewed Health.-Motel Application @ParcellD Anchor-in Motel Seasonal Human Habitation 11/28/2017 PASS Town sewer GHL-17-38 Renewed Health-Motel Application @ParcellD Anchor-in Motel Seasonal Human Habitation 11/28/2017 PASS Town water GHL-18-41 Renewed Health Motel Application @ParcellD Anchor-in Motel 2019 Human Habitation 10/23/2018 PASS GHL-18-41 Renewed Health-Motel Application @ParcellD Anchor-in Motel 2019 Human Habitation 10/23/2018 PASS See separate food inspection paperform GHL-18-41 Renewed Health Motel Application @ParcellD Anchor-in Motel 2019 Human Habitation 10/23/2018 PASS Town sewer GHL-18-41 Renewed Health-Motel Application @ParcellD Anchor-in Motel 2019 Human Habitation 10/23/2018 PASS Town water GHL-18-41 Renewed Health Motel Application @ParcellD Anchor-in Motel 2019 Human Habitation 10/23/2018 PASS GHL-19-67 Closed Health-Motel Application @ParcellD Anchor-in Motel 2020 Motel Permit Human Habitation 12/16/2019 PASS IC-16-287 Renewed Building-Certificate of @ParcellD Anchor-in Motel - Certificate of 12/9/2016 Pass Inspection Inspection IC-17-358 Renewed Building-Certificate of @ParcellD Anchor-in Motel Certificate of 10/25/2017 Fail EMERGENCY Inspection Inspection LIGHTING/SEC ONDARY EXIT ILLUMINATION NOT OPERATIONAL IN'LIBRARY' AREA(780 CMR 1006,1011), BASEMENT AREA CHANGE OF USE TO'B USE'WITH NO SEPERATION (IEBC 912.1.1.1) IC-17-358 Renewed Building-Certificate of @ParcellD Anchor-in Motel Certificate of 2/7/2018 PASS Inspection Inspection IC-18-264 Renewed Building-Certificate of @ParcellD Anchor-in Motel Certificate of 11/26/2018 PASS Inspection Inspection IC-19-305 Renewed Building-Certificate of @ParcellD Anchor-in Motel Certificate of 12/16/2019 PASS Inspection Inspection IC-20-312 Issued_ Building-Certificate of @ParcellD Anchor-in Motel Certificate of 12/1/2020 PASS Walkthrough ok Inspection Inspection P-17-604 Closed' Plumbing 326-119 Robert E Penney kitchen sink,service mop Plumbing Final 4/10/2018' PASS sink,urinal P-18-1029 Issued Plumbing 326-119 FRANK W RODERICK (1)fixture 8of11 Commonwealth of Massachusetts Town of Barnstable • auwsrnate. 0 200 Main Street(508)862-4038 ` PERMIT REPORT BY ADDRESS PIN Status Permit For -Parcel ID Apllicant Work Description Inspection..,' Inspected on Inspection Inspection -� ti Status Comment P-18-1052 Issued Plumbing 326-119 FRANK W RODERICK (1)Fixture Plumbing Final 8/28/2018 FAIL P-18-1052 Issued Plumbing 326-119 FRANK W RODERICK (1)Fixture Plumbing Final 8/28/2018 FAIL To hot P-2010-06613 Closed Plumbing 326-119 BOB PENNEY TUBS(8),LAVS(8), Plumbing Final 2/28/2011 Pass RBUR: PLUMBING&HEATING SHOWER STALL, WATER CLOSETS(8), BAR SINK /2 10 Pass EJE N: _ Plumbing Roug h 12/7 0 LAYS 8 P-2010-06613 Closed Plumbing 326 119 BOB PENNEY TUBS(8), ( ), 9 9 PLUMBING&HEATING SHOWER STALL, WATER CLOSETS(8), BAR SINK P-2010-06987 Closed Plumbing 326-119 BOB PENNEY REPLACE BATHTUB, Plumbing Final 2/28/2011 Pass RBUR: PLUMBING&HEATING WATER PIPIN, BAR SINK P-2010-06987 Closed Plumbing 326-119 BOB PENNEY REPLACE BATHTUB, Plumbing Rough 12/22/2010 Pass EJEN: PLUMBING&HEATING WATER PIPIN, BAR SINK P-2014-02409 Closed Plumbing 326-119 BISHOP,CRAIG P CROSS CONNECTION Plumbing Final 4/29/2014 Pass DSHE: DEVICE AND WATER PIPING P-2015-00443 Issued Plumbing 326-119 STRUCTURES UPGRADE EXISTING Plumbing Rough 2/11/2015 Pass LLEM: BUILDING INC. BATHROOM.REMOVE FIXTURES REPLACE WITH NEW,NEW TILE SHOWER AND FLOOR-INTERIOR ONLY RM#110 P-61.978 Closed Plumbing 3267119 RUSTY'S,INC. 8 FIXS CH#005271 Plumbing Final 10/7/2002 Pass EJEN: P-61978 Closed Plumbing 326-119 RUSTY'S,INC. 8 FIXS CH#005271 Plumbing Rough 6/21/2002 Pass EJEN: 9of11 Commonwealth of Massachusetts of I I WI 'L Town of Barnstable s�rrsrni3►.e, � " . 9 MAS& 200 Main Street(508)862-4038 $ATEO MA'S a�0 PERMIT REPORT BY ADDRESS PIN StatusPermif'ForParceh ID Apllicant Work Description` Inspection Inspected"on Inspection Inspection A a Status Comment 4 P-61978 Closed Plumbing 326-119 RUSTY'S,INC. 8 FIXS CH#005271 Plumbing Rough 10/3/2002 Pass RBUR: P-86365 Closed Plumbing 326-119 RUSTY'S, INC. HOT WTR TANK Plumbing Final 10/25/2005 Pass RBUR: PO-17-1 Closed Health-Pool @ParcellD Anchor-in Motel Outdoor Pool Pool-Swimming 5/3/2018 PASS and Wading PO-17-1 Closed Health-Pool @ParcellD Anchor-in Motel Outdoor Pool Pool-Swimming 5/3/2018 PASS 51 GPM and Wading minimum PO-19-13 Closed Health-Pool @ParcellD Anchor-in Motel 2019 Outdoor Pool. Pool-Swimming 5/21/2019 PASS and Wading PO-19-13 Closed Health-Pool @ParcellD Anchor-in Motel 2019 Outdoor Pool. Pool-Swimming 5/21/2019 PASS 3.8 and Wading PO-19-13 Closed Health-Pool @ParcellD Anchor-in Motel 2019 Outdoor Pool. Pool-Swimming 5/21/2019 PASS 7.6 and Wading PO-19-13 Closed Health-Pool @ParcellD Anchor-in Motel 2019 Outdoor Pool. Pool-Swimming 5/21/2019 PASS Shall paint line in and Wading pool PO-19-13 Closed Health-Pool @ParcellD Anchor-in Motel 2019 Outdoor Pool. Pool Swimming 5/21/2019 PASS Shall put name and Wading and address on phone PO-19-13 Closed Health-Pool @ParcellD Anchor-in Motel 2019 Outdoor Pool. Pool-Swimming 5/21/2019 PASS Shall replace and Wading VGB next year. PO-20-19 Closed Health-Pool @ParcellD Anchor-in Motel 2020 Outdoor Pool Pool-Swimming 6/2/2020 Pass and Wading PO-20-19 Closed Health-Pool @ParcellD Anchor-in Motel 2020 Outdoor Pool Pool-Swimming 6/2/2020 Pass 5.0 and Wading PO-20-19 Closed Health-Pool @ParcellD Anchor-in Motel 2020 Outdoor Pool Pool-Swimming 6/2/2020 Pass 7.8 and Wading PO-20-19 Closed Health-Pool @ParcellD Anchor-in Motel 2020 Outdoor Pool Pool-Swimming 6/2/2020 Pass 90 and Wading 10 of 11 Commonwealth of Massachusetts CF THE l� BAiMS TABLE . Town of Barnstable `�m°i = 200 Main Street(508)862-4038 M D. ` PERMIT REPORT BY ADDRESS PIN Status Permit':For Parcel ID Apllicant Work Description Inspection Inspected on Inspection Inspection z . = sStatus,. _ Comment PO-20-19 Closed Health-Pool @ParcellD Anchor-in Motel 2020 Outdoor Pool Pool-Swimming 6/2/2020 Pass Generally allowed and Wading up to 19 for bather load. However,due to Covid-19 regulations and Mass.gov/reopeni ng guidelines it must be limited to 40%occupancy. Therefore,this allows 8 bathers in pool at a time. Under workplace safety standards the owner must self-certify and enforce. This isfrom the period of Phase 2 beginning June 8, 2020 until such time it is amended by the Governor of Mass. PO-20-19 Closed Health-Pool @ParcellD Anchor-in Motel 2020 Outdoor Pool Pool-Swimming 6/2/2020 Pass Pool must and Wading painted.New black swimmer line and depth markings TG-2015-00443 Inactive Gas 326-119 STRUCTURES UPGRADE EXISTING BUILDING INC. BATHROOM.REMOVE FIXTURES REPLACE WITH NEW,NEW TILE SHOWER AND FLOOR-INTERIOR ONLY RM#110 804000 17036 Total Permits: 105 11 of 11 i i Final Construction Control Document To be submitted at completion of.construction by a Registered Design Professional for work per-the 8*edition of the Massachusetts State Building Code,780 CMR,Section 107.6.4 Project Title: Anchor-In Change of Use Date: 02/12/18 Permit No. Property Address: 1 SautbL Street BLupts,MA 02601 Project: Check(x)one or both as applicable: [ ]New construction [ x ]Existing Construction Project description: Proodde the rmdew and design for the fire stparation between a business•and dwelling unit I Brent T_Hein?er MA Registration Number: 20581 Expiration date: 8/31/18 ,am a registered design professional,and hereby certify that I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': [ ] Entire Project [x ] Architectural [ J Structural [ ] Mechanical [ ] Fire Protection [ J Electrical [ ] Other: for the above named project. I certify that.I,or my designee,have performed the necessary professional services and was present at the construction site on a regular and periodic basis to determine that the work proceeded in accordance with the requirements of 780 CMR and the design documents prepared by me and approved as part of the building permit and that I or my designee: 1. Have reviewed,for conformance to this code and the design concept,shop drawings,samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. A 0,A4 T. Enter in the space to the.right a"wet'.or. o NO.2os61 electronic signature and seal: Wc-8TliaisTFp Ana, 0 Phone number: 9178.400,7732 Email: Building(M ial Use Only Building Official Name:' . Pennit No.: Date: Note 1.Indicate with an Y project design plans,computations and specifications that you prepared or directly supervised.If'other'is chosen, provide a description. Trial Version 10 092012 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel BUILDING 0Fr"_ Application # ,F `7 - / S (� Health Division JAN 25 2017 Date Issued 2 2 C' Conservation Division TOiI�'i Q� Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Boardi►1lL ST Historic - OKH _ Preservation/ Hyannis Project Street Address Village C, f lCX Owner AMA 1�� 664 OScin—Address Sd4N.A C44 Telephone f�p�_s — 0 (,Q:a Permit Request - -C te UP- Square feet: 1 st floor: existing `Dproposed �� Lnd floor: existing {�roposed4,�_ Total new _ Zoning District Camxrc, Flood Plain Groundwater Overlay Project Valuation WIWO Construction Type Lot Size A Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes �On Old King's Highway: ❑Yes A-NT— Basement Type: 2,Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) 8C)Q 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): e:Zlectric g new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ 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 a es ❑ No If yes, site plan review# Current Use 1��:�Jy� Proposed Use �.�a�� APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name I( Telephone Number 0E5LJ Address QIC) b5v I ct 6 q License # CD d S(O 5C .n &,A)d,G-, oA4 0�)-t b3 Home Improvement Contractor# n ` - nn cU�'� Email C,\nr;S °V �czc ,SAS J✓�1rX�w� f . Worker's Compensation # 670c)— SG 12 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TOPS, SIGNATURE DATE ��/) 1 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. - . 371e Commompealth af-Marsadrrse is r .. . . _ ,.� 3�ep,��re��t o,�'�a�drestrial�cc�derrts • . . oil af�n7ions. 600 on street ' - Bastin,MA 02111 tt�vx�ntass:•gr�vfda "gTarkers' Cam pensafionInsurance Affidavit:B-ade�s/ContractursinectdciansTh�mbers InfarmatFl}II "it5e PrnLf Name _ 'A k*kA Vic city/sta& Are you employer?Check the appropriate bey I. am a 1 oath 4. ❑1 amagetrerral ecmt�actesr sac€I Type of gralect(rt�lniretl)c„ .. employeesfall.and br ;r ime * have]sired the sub-conductors 6. ❑New oonst�ucfii 2.❑ I am a sale prqpFietor orpartner- Fisted authe attacked sheet 7. ❑R,emodedigg s * and have no employees These sub-cofractam have �P �P� $_ ❑Demolition wading forme in,any amity employees aadhave.wodbers' [No WodMW comp.imsun nce comp-masuran t $ 9. ❑SBuilt4 athhfiaa re:gnired-] 5_ ❑ We are a coaporation and its 16-❑Electrical repairs or adds. -fracas 3.❑ 1 am.a homeoumer doing all work of w-e n have ex=-sed flu eir 1L❑Plumbingrepaim or ad&tiom myset€[No workers'comp- t of eaempfion per MQ. L_❑Rnafrepairs imm ancerequired.jt c.152, §1(4)6andwehavens' eusployees.[To workers' 13_❑#?tfier comp-msarance required_] •A¢yap ECZLt6stcbed3bos9ltffist also Moutthesectiaa below shadnthervm&es' �P P &cgiafoxmsua� H'amemunemwho submit&s.affdMfin ntheyaxe�mn�aIfwao3Gandthenhiieoutsidecantaicmrsnmstsubmitanewaffidaeatmdicxyaesack ZCautractoxs ffzt rI wI &baac nsust attethe� additianaZ street shoxiag thenuae of[he r¢b c a anti state whether arnat these effiitiesha� employees.If the sob-r��har:a emplgee%dfiey=sr pmmvide their Wo&Me comp.poHU avmvIser- I am all eTrrip r tleat ig pretuidirtg liWrkers'eaMperestdtart ursrira>Eca f br MY entpLg1--e x Setosv is tjce paticy sad jeib site s information. Insuamce Companyifam�I 9A��, Pa&cy,41'or Self-ins-Iic:4: 14-1116 -r-A 2 EspiratioaDate_ Job Site Addresw Attach a copy of the workers'compumationp.olicy declaration page(showing the policy mrmb�.dexpir�,.afidm.Ldate). Faiinre to secure coverage as repaired under Section 25A of MGL cs. 157-can lead to the imposition of criminal penalties of a flue up to$L,0D OD andl'or one-yearimprisonmecd,as weill as tip penalfies.in the fans of a STOP WORK€?RDERalid a fine of up to$250.00;;�17A t the violator_.Be advised first a copy of this statement may be forwarded to the Office of l avestigataans of M- Susanca coverage Irerific a ioxt I onto Fit>rslty Harder s aawes afICIU4 thatthe inforwa€wtprmi d abm a is bars road c arrest Si gnature- Date- Phone ak&d use anly. Der not write in 616 are;,&be-c mnpieeteJ by c*y ar tows n o ieial City or Tana: _ Permitff&ense Issuinb orety(rode one): L Board of$ -Buff2ing Deparf amt 3.Qtylrown Clerk 4:Electrical Lupector 5.Plumbmg Inspecter CL Other Contact Person: Phone#: - formation and Instructions ' Massacl=c is Cre=rg Laws M rues all ploy=to PmMde Worms'courpmsaiion far then,employees. Fvrsuant-to this statnfe,an�layw is defined as"_.evea ypersonm ffie sertice of aaoiier under any comer ofhire, express or iinplied,oral or vzlit� An ernpkYer is de fined as-an fix&iffiA paxtn=ffi�p,associafian,torpor-ion or other legal=t'fy,or nay tvvo or mare of the foregoing engaged in.aloint •and mchzdmg the legal=preseutafives of a deceased employer,or the receiver or trastee of imdiYid P� iP�association or voter Iegal MtItY,=Ploys�plDyees. HoWeves the house not mcu-e than tbree apadme�is Who resides thPaein,or the. such d el the- owner of a.dWeIIing having House of another Who emploYs pe M=to do mabbma ce,c n*uct;on or repair wOlk On, snch dwelling house or o31 tie grounds or buiVmg agpurh anttheretn shall notbecause of sash m3ployment be d=nedto be an employer." MGL chapter 152,§25C(6)also states that'everystate or local Faceusimg agency shall hold Ste issuance or renewa.f of a Tcense or permit to operate a business or to construct buitdings in the commonwealth for:any nce of compapplic=twho has notprodnced acceptable evidefiaace witTz the incnr�ce coveX-age regIIired Additionally.MM cbapt�r 152,§25C(7)states-Nei&&fie commzmWea�nor�y of its poIiiitcal subdivisions shall enter h3jD any contract for the performance ofppbL,o walkuaff acceptable evidence of compliance Wish the inset=ce.. rCgUnTMents of this chapter have been preset to the c antra_ a an o " A.Ppli 4 Please fill o:rt tine wofl='compensaiian affidavit completely,by chm a th e boxes that apply to your sitoafron and,if necessaiY,supply addresses)and phone uunbes(s) along With their cer ifaczlte(s)of insurance. Limited Liability Camp ames(LLC)or LimitedLiabRityPmtozlships.(LLP)vino ezopIoyees other than the members or partners,are not rtqdird to cagy wolkeas'compeasafim j sumo - If an LLC or LLP does hate employees,apolicy is rupired. Be advised that this affidayrtmaybe submitted to the Department of Industrial Accident for confirmation of insa U11CC coverage A-TSQ be sure to sign and date he affidavit The affidavit should be,r et>mmed to 1he city or town that the application'ar the.peunit or license is being requestecl,not the Department of Industrial A_ccid=:L-, Should you have any questions rega-ding the law or if you are rcq=ed to obtam a wolf= compensation policy,please call thz Departmect at the nnmbea lisi�d be Ion pelf-insured co�anies should eo`er ti�eir s elf-msnr-ance HC nSe n=ber on the appropriate line. City or Town.Officials t Please be sore that the affidavit is complete and primed legibly. The Department has provided a space at.the bottom of the affidavit for you to frIl out in the event the Office ofIavesll�has to confact you regarding thD applicant Please be sure to fill is the peu iWlicense m= Which w71 be used as a=f since number- Iu addition,an applicant that must sabmit multiple penni t/Hcrose applications is any given year,need only submit one affidavit mdicatmg current " ovations m �y ar « '� ' „ aII I ( _ osdwrite: _ policy mform.ation(if necessary)and under Job'Site Address tie applicant h , town)_,,Aoyofhe-advt that has be officially stamped or makd by the city pr town may be provided to the p y ' applicant as pr-ooftbat a valid affidavit is on file for 5 m e pez�or licenses•Anew affidavit must be filled out each a.license or e nnit not related to any business or commercial 4�ae year.Whez�a home ownea,or citizen is obtamin.g p . (ie_ a dog license or p®it tn,bUm leaves etc.)sail person is NOT rcTiired to complete t3iis affidavit The:Oiice ofinvestigafrnns would hb--to tbankyou in.advance for your cooperafionand sbovldyouhave any questions please do not liesi ate to give M a ca]L The Dgp art ni mfs address,telephone and fax n maber: • . TThe StbE of I1�1as�h - _ ` t of Ind�ial Accidents -k 1 anIca of 111vegQN%tZOLM • _ �t 4-06 car 14M MA T�1. �' Fax 9 617 727='749 Revise 4-24-07. gp �WE Town of Barnstable Regulatory Services MAS& ' Richard V.Scali,Director 639. ��� Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601' www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder . I ,as Owner of the subject property hereby authorize to act on ray behalf, . in altmatters relative to work authorized by this building permit application for: Sc OL jel "(Address of Job) **Pool fences and alarms are the responsibility of the applicant,Pools are.not to be filled'or utilized before fenc stalled and all final inspections are performed and accepte . Signature of Owner ignatur t Print NatneM Print Name 1 l � Date . QTORMS:OWNERPERMISSIONPOOLS__ .5 6 � 4 { { i d� 4 jj� gg a ' NX cn G) t N t f oj --i I { i ; ` f --t r-n--�-� e i _ _ E p j CD H w Cf 2 vLL ? co f O l i iT ii it �t , e �� ..__.v.r....x.e.�. ...--n+—re..s.�nw.�m.+:•n••-fwYcxaa.w_-�.... �y �(:� t r xt n f r y e r%1re lrcoaarurauxrrldr o��xffi�urr/u+e13 flan of Consumer Affairs&Business Regulation License or registration valid for individul use only E IMPROVEMENT CONTRACTOR before the expiration date. If found return to: M iatrati R 176887ENT Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Expiration: 101/12017 Corporation Boston, A 0 -16 M STRUCTURES BUILDING INC. CHRIS DOUGHERTY 168 MAIN ST -- R.. SANDWICH,MA 02563 Undersecretary of vali t s' iraaawnuacaw vcYouncua v, r Za &y Board of Building Regulations and Standards License: CS-083689 ' Construction supervisor CHRISTOPHER M DOUGHERTYf, PO BOX 1969 a SANDWICH MA 02563 , " Expiration: 'Commissioher 12/20/2018 Mass. Corporations, external master page , Page 1 of 2 {: r n ti Corporations Division Business Entity Summary ID Number: 042238763 i Request certificate New search Summary for: HYANNIS BUILDING AND DEVELOPING ASSOCIATES, INC. The exact name of the Domestic Profit Corporation:, HYANNIS BUILDING AND DEVELOPING ASSOCIATES, INC. Entity type: Domestic Profit Corporation Identification Number: 042238763 Date of Organization in Massachusetts: 09-06-1955 Last date certain: Current Fiscal Month/Day: 03/31 Previous Fiscal Month/Day: 03/31 The location of the Principal Office: Address: 1 SOUTH ST City or town, State, Zip code, HYANNIS, MA 02601 USA Country: The name and address of the Registered Agent: . Name: GEORGE F. SIMPSON Address: 1 SOUTH ST. - City or town, State, Zip code, HYANNIS, MA 02601 USA Country: The Officers and Directors of the Corporation: Title Individual Name. . Address PRESIDENT LISA A. SIMPSON 75 NORTHWINDS LN. W. BARNSTABLE, MA 02668 USA ` TREASURER GEORGE F. SIMPSON 75 NORTHWINDS LN. W. BARNSTABLE, MA 02668 USA SECRETARY LISA A. SIMPSON 75 NORTHWINDS LN.'W. BARNSTABLE, MA 02668 USA DIRECTOR GEORGE F. SIMPSON, 75 NORTHWINDS LANE W. BARNSTABLE, MA 02668 USA DIRECTOR LISA A. SIMPSON 75 NORTHWINDS LANE.W. BARNSTABLE, MA 02668 USA http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=04223 8763&... 1/20/2017 t r�1 STRUBU1 OP ID: LT DATE(MMIDDIYYYY) �acorzn- CERTIFICATE OF LIABILITY INSURANCE 01/2012017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. CONTACT PRODUCER NAME: _ Paul Peters Insurance Agency PHONE FAx -� 680 Falmouth Rd. (A/C.No.Ext): �All C,No): Mashpee,MA 02649- ADDRESS: John J.Lynch,IV INSURERS AFFORDING COVERAGE NAIC a INSURER A:Capitol Specialty Ins CO { INSURED Structures Building Inc INSURER B:AEIC Chris Dougherty INSURER C PO Box 398 Cummaquid,MA 02637 INSURER D: INSURER E: INSURER F: ' COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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., INSR TYPE OF INSURANCE ADD L SUB POLICY NUMBER MPOA DDNYYY MM%D/YYYY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE s 1,000,000 A X COMMERCIAL GENERAL LIABILITY CS16002122401 11/19/2016 11/19/2017 PREMISES RENTEDGE TO occur enc) $ 100,00 CLAIMS-MADEFK OCCUR MED EXP(Any one person) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 POLICY 7 PRO ECj 7 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acc dent $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per aocident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS _F AUTOS PER ACCIDENT $ UMBRELLA ccUR EACH LLA {EXCESS AS B CLAIMS-MADE GGREEGA E�ENCE $ f DED RETENTION S $ WORKERS COMPENSATION TWO STATU- OTH- AND EMPLOYERS'ABILITY TO Y LIMIT E B ANY PROPRIETOR/PARTNERJEXECUTNE Ya. E.L.EACH ACCIDENT - $. 500,00 OFFICER/MEMBER EXCLUDED? N NIA WCC-500-5012688-2016A 11/05/2016 11/05/2017 E.L.DISEASE-EA EMPLOYEE $ 500,000 (Mandatory in NH) If yes,describe under DESCRIPTION OF OPERATIONS belowE.L.DISEASE-POLICY LIMIT S 500,00 DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) I , , 1 CERTIFICATE HOLDER CANCELLATION t BARN005 + SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF BARNSTABIE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 367 MAIN ST. . HYANNIS, MA 02601 AUTHORIZPD REEPCRES NTATIyE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD iMassachusetts Department of Environmental Protection { 'BWP AQ 06 100258257 fi Notification Prior to Construction or Demolition Asbestos Project# Project Revision ri Project Cancellation A.Applicability A Construction or Demolition operation of an industrial, commercial, or institutional building,or residential building with 20 or more units is regulated by the Department of Environmental Protection (MassDEP), Bureau of Waste Prevention,Air Quality Division, under Regulations 310 CMR 7.09. Notification of Construction or Demolition operations is required under 310 CMR 7.09 (2)ten (10)working days prior to any work being performed.The following information is required pursuant to 310 CMR 7.09. 1.Is this a fee exempt notification(city,town,district,municipal housing authority,state facility,owner-occupied residential property of four units or less)? 1 a Yes — b.No 2.Blanket Permit Project Approval,if applicable: Approval ID# 3.Non-Traditional Asbestos Abatement Work Practice Approval,if applicable: Approval ID# Instructions: B. Facility Description 1.All sections of this form must be 1.Facility Information: completed in order to ANCHOR IN 1 SOUTH STREET comply with the a.Name of facility b.Street Address Department of Environmental HYANNIS MA 026010000 5087750357 Protection c.City/Town d.State e.Zip Code f.Telephone notification requirements of 310 SI4P&USA SIMPSON OVV qER CMR 7.09. g.Facility Contact Person h.Facility Contact Person Title 2.Submit Original 6086857067 SI4PSIMPSON@COMCASTNET Form To: i.Facility Contact Person Telephone j.Facility Contact Person Email Commonwealth of Massachusetts k.Facility Size: P.O.Box 4062 Boston,MA 02211 10,000 2 1.Square Feet 2.Number of Floors MassDEP Use Only 1.Was the facility built prior to 1980? 7 1.Yes 2.No m.Describe the current or prior use of the facility: Date Received HOTEL n.Is the facility a residential facility? F71.Yes P7 2.No o.If yes,how many units? 2.Facility Owner: '. Same address as Facility SI4P&USA SIMPSON 1 SOUTH STREET a.Facility Owner Name b.Address HYANNIS MA 026010000 6086857067 c.Citylrown d.State e.Zip Code f.Telephone 3.Facility On-Site Manager/Owner Representative: $7. Same contact person as facility W Same address as facility F`. Same address as owner SIdP&USA SIMPSON 1 SOUTH STREET a.On-Site Manager/Owner Representative b.Address HYANNIS MA 02601 6086857067 c.City/rown d.State e.Zip Code f.Telephone Revised: 03/17/2014 Page 1 of 3 `T7 Massachusetts Department of Environmental Protection 100258257 -- `, BWP AQ 06 Asbestos Project# Notification Prior to Construction or Demolition Project Revision Project Cancellation C. General Project Description 1.This project is: rv;: New Construction Demolition f7 Renovation 2.Project Dates: 1/30/2017 3/30/2017 a.Project Start Date(MM/DD/YYY`Y) b.Project End Date(MM/DD/YYY`) 3. General Contractor: STRUCTURES BUILDING INC. PO BOX 1969 a.Name b.Address SANDIMCH MA 025630000 5082749261 c.City/rown d.State e.Zip Code f.Telephone CHRISTOPHER DOUGHERTY 5082749261 g.General Contractor's On-site Manager/Foreman h.Telephone 4. Construction or demolition contractor: r Same as General Contractor STRUCTURES BUILDING INC. PO BOX 1969 a.Contractor Name b.Address SANDVUCH MA 025630000 5082749261 c.City/Town d.State e.Zip Code f.Telephone CHRISTOPHER DOUGHERTY 5082749261 g.Construction and Demolition On-site Manager h.Telephone 5.Licensed Construction Supervisor: CHRISTOPHER DOUGHERTY CS-083689 a.Supervisor Name b.Construction Supervisor License(CSL)Number 6. Is the entire facility to be demolished? a.Yes b.No 7.Describe the area(s)to be demolished: 8.Describe the building(s)or addition(s)to be constructed: REPLACING EXISIIING PLUMBING AND ELECTRICAL FIXTUR 9 a.Were the structure(s)surveyed for the presence of Asbestos-Containing r 1.Yes 2.No Material(ACM)? b. Who conducted the survey? 1.Name of Asbestos Inspector 2.DLS Certification# f Massachusetts Department of Environmental Protection I- i 100258257 BWP AQ 06 Asbestos Project# Notification Prior to Construction or Demolition171 Project Revision Project Cancellation C. General Project Description (continued) 10 a.Was asbestos containing material(ACM)found? 17`1.Yes r_7 2.No General b. If ACM was found during the survey,please provide the Asbestos Statement:If Notification Form(ANF)Project Number. asbestos is found during a Construction 11.For demolition and construction projects,indicate dust suppression techniques to be used: or Demolition r7 a. Seeding 17 b.Wetting r., c. Covering(" d.Paving ri e. Shrouding operation,all responsible parties must comply with 310 1--- f Other-Specify: REPLACING PLUMBING AND ELECTRICAL FIXTURES NO NEED CMR 7.00,7.09,7.15, and Chapter 21 E of the General Laws of 12. Is this an Emergency Demolition Operation? rJ a.Yes Wi b.No the Commonwealth. This would include, but would not lu c.Name of MassDEP Official who evaluated the emergency limited to,filing an asbestos removal d.Title notification with the Department and/or a notice of e.Date of Authorization(MM/DD/YYYY) f.MassDEP Waiver Number release/threat of release of a A Certification hazardous substance to the Department,if "I certify that I have personally CHRISTOPHERM DOUGHERTY applicable. examined the foregoing and am 1.Print Name familiar with the information CHRISTOPHER M DOUGHERTY contained in this document and 2.Authorized Signature all attachments and that, based PRESIDENT on my inquiry of those individuals immediately 3.PositionlTitle responsible for obtaining the STRUCTURES BUILDING INC. information, I believe that the 4.Representing information is true,accurate,and 1/19/2017 complete. I am aware that there 5.Date(MM/DD/YYYY) are significant penalties for submitting false information, including possible fines and 6.P.E.# imprisonment.The undersigned hereby states, under the penalties of perjury,that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is made." Revised:03/17/2014 Page 3 of 3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 3 MapParcel _ ; ati rr#ce `�f'pica o pP Health Division ^4 r—l", Date Issued 2— Conservation Division Z - ll Application Fee Planning Dept. Permit Fee Zo tK Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village ft�_A YA is Owner C--: ep� e Address 1 Telephone Permit Request ) D P b�c,�4D ?_,dn C9r,-C__ lam( Y�\�C'� lJ�L L J f V N c� L/10.1 9�C1 64 It 0 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Cep-z Lot Size . Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family 0 Multi-Family (#units) �4d jp C.�. ❑ A Age of Existing Structure 1 Historic House: Yes o On Old King's Highway: ❑Yes UNe-- Basement Type: ull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing (D new © ; Half: existing 1 new jo Number of Bedrooms: /0 existing Qnew Total Room Count (not including baths): existing �newer_First Floor Room Count Heat Type and Fuel: MGas ❑ Oil ❑ Electric ❑ Other Central Air: U1es ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn:,U existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other_.. 1 ` Zz Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ v "� Commercial ❑Yes ❑ No If yes, site plan review# -a vn Current Use Proposed Use -C; .ray 'APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address IC ,b 60 �G(� � License # 0 P�?2 �a' 46Q btl Aq Home Improvement Contractor# Email y ,Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ��Z FOR OFFICIAL USE ONLY APPLICATION# DKE ISSUED f MAP/PARCEL NO. i ADDRESS VILLAGE OWNER ti DATE OF INSPECTION: FOUNDATION FRAME : INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ! : PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ;f FINAL BUILDING DATE CLOSED OUT a ASSOCIATION PLAN NO. 4 The Corntt annwalth of-Massachusetts Deparhnent of bdustrial Accidents - ce o nveff&rfions -- 600 Was-hinlgton&reeit Boston,MA 02L11 Wlt'11 maSmgo Min Workers' Compensat an InsuranceAffiidavit:Builders/,Contractors/ElecEricianslPlumhers Applicant Information Please Print Legibly Name(usinesftanizatmllndivid=l}_ r� , Address. City/StatrJZip: Phone.9-- D Are�YG�uenmployer?Check the appropriate bozo 4, Tanta contractor and I Type # iect rIT 'd}�: 1.. am a employes with ❑ 6_ New construction, employees{full andlorpa;4=e).* hired sub eonbactors. listed on the attached sheet. 7- ❑Remodeling 2_❑ I am a sore proprietor or partner- . ship and have no employees These sub-contractors have g. ❑Demolition w for me many ci �. employees and have workers' or�ng Y� � _ 4_ El Building additioncrzranr [No Workers, comp:ine camp-insurance-1 reT3ired_] 5..❑ We are a corporation and its 10-Fl Electrical repairs oraddifions ❑Plutmbini officers have exercised their 11_. airs or additions• 3.❑ I am a h�sme�vs�ner doing all work g� , myself [No workers'comp- right of exemption per MGL 12..❑Roof repairs c-152, i no,in�trnnre required.]t �and we hnm n 131❑Other employees_[Na 7orkers' comp-msurance reLiL ulred.1, Any apgHrsat that checks boa*1 nmst also fill out the section below showing Their waajrers''coa¢pe�ati oa palitg infntmation_ gomeowners wrho submit this affidavit infcatkg they are doing all Zroar and then hire outside contractors nmst submit anew affidavit indirstm such C, tractors that check this box mast attached an additional sheet showing the name of the mb-eontzactors and state whether ornot these entities have employees. If the sub-contractors hate employees,they must provide their works'comp.policy number. I am an empftryer that isprmidittg workers'compemwfion imsurarice f br my employees Hetaw is the patio and job site irt_formation Insurance Company Name: VC4-A Policy#or Self-ins_Ile-#: SO 1 2(a - 61 ExpirationDate: Job site Address: 1 ��"" t/ '`• Citylstawzip: 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$1,500.0t1 and/or one-year-imprisonment,as well as civil penalties in ffie form of a STOP WORK ORDER and a fine of up to S250.00 a.day against the violator- Be advised that a copy of this statement may be forwarded to the Office of lm estrgHtlons of ffie DIA far Insurance cot ge-vrerilication_ I do hereby ce ceder e s art pen es of acry that the informafionprovidedabmre rs Inca and correct Sitmature: Date: ZV 1 Phone#: s (Jffrdol use only. Lb not writs in fhis area,to be completed by city or town off ciaL City or Town: Permit/License# Issuing Anthar'rty(circle one): 1.Board of$ealth .Budding Department 3.City[rown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person. Phone#: 6 ' 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 Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the common•rYealth for arty 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 per5ormance of public work until acceptable eviderce 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), addresses)and phone number(s)along with their cer ificate(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 affidaVZt "Ilie 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 perm-it/license number which wily.be used as a reference number. In add don,an applicant that must submit multiple permit/lice_nse 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 (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. 'fie Commonwealth of Massachusetts Depax�nent Gf Industrial Accidents Office of kvestiptims 600 Washhigton Strut B Gston?MA 02111 Tel.4 617,727-45M at 406 or I-9 MAS E Revised 4-24-07 Fax# 6I7-727-7-749 www.mas��n��dia l -- 1AN/22/2015/THU 10:30 PaulPetersAgency FAX No. 15084776498 P. 001 STRUBUI OP ID:JL �.... CERTIFICATE OF LIABILITY INSURANCE D0112 12016Yl 01/22t2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: N the certificate holder is an ADDITIONAL INSURED,the Poilcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of d*policy,certain Policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONT Paul Peters Insurance Agency NANI , 680 Falmouth Rd. PAX MashPee,MA 02849- IN : N0: John J.Lynch,IV INSUR S AFFORDING COVERAGE NAIL$ ua V A:WestOMWorld 1Nsu o Structures Building Inc wouRERa:AEIC Chris Dougherty PO Box 398 INSURER 0: Ctrmmaquid,MA 02637 IN8URER0: MUMS! INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIMO BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS R TYPE OP INSURAI POLICYNUMM P F Mo LArtT8 GEMMAL UAMLtFY EACH OCCURRENCE _ s 1,000.00 A X COMMERCIAL.GENERALLIAB1UTY 3DW7966 11119/2014 11/19/2015 RMEMISES g ✓6 50,00 CLAIMS�,44DE OCCUR MEDEXP Anyone a 1, PERSONAL B ADV INJURY 3 11000.00 GENERAL AGGREGATE $ 2,000,00 GERL AGGREGATE LIM17 APPLIES PER PRODUCTS-COMPIOP AGG $ 1,000.0 PoucY P ° f LOC a AUTMOg"LJABILnY BINED SINGLE LIMIT Ea ANY AUTO SOOILY INJURY(Per person) $ OrWED SCHEDULED AUTOS BODILY INJURY(Per 8CMent) $ HIRED AUTOS p N(ON1_0vVNED PR PERTY a S VAIBRELLA LIAR OCCUR EACH OCCURRENCE $ ZDFO SS UAH CLAIMS41ADE AGGREGATE a RETENTIONS $ R8 COLLPE A ILR STA C OTM AND EMPLOYERS'1J LI ABILITY /H Y I Tu- B ANY PROPRIETORIPARTNER/MCUTIVE — OFRCERAdEMBER EXCLUDED? N IA E.L EACH ACCIDENT $ 500.000 (AMandatory In NH) C"00.6012689.2014A 111OSt2014 11/O6/2015 E.L.DISEASE-FA EMPLOYEE a 600 00 If yea,deeMbe urder DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LwT a 500,00 OESCRIP7fON OF 0"-M' =I LOCATIONS I VEHICLES Offaah AdoRD'101,AdMOM Rema tre Behedule.If a cre spore W,r"UM) CERTIFICATE HOLDER CANCELLATION BARN005 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF BARNSTABLE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 367 MAIN ST. ACCORDANCE WITH THE POLICY PROVISIONS. NYANNIS,MA 02601- AUIHORMEQRBPREUNTAnVE John J.Lynch,IV @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 2S(201010) The ACORD name and logo are reg-Lstamd marks of AGORD a th of Massachusetts William Francis Galvin-Public Browse and Search Page 1 of 2 The Commonwealth of Massachusetts William Francis Galvin Secretary of the Commonwealth, Corporations Division One Ashburton Place, 17th floor Boston,MA 02108-1512 } 4F';i* Telephone:(617)727-9640 HYANNIS BUILDING AND DEVELOPING ASSOCIATES, INC. Summary Q Screen c - Help with this form .,� � Reguest,a Certlficate,� ,y�4 The exact name of the Domestic Profit Corporation: HYANNIS BUILDING AND DEVELOPING ASSOCIATES,INC. Entity Type: Domestic Profit Corporation Identification Number: 042238763 Date of Organization in Massachusetts: 09/06/1955 Current Fiscal Month/Day: 03/31 Previous Fiscal Month/Day: 03/31 The location of its principal office: - No. and Street: 1 SOUTH ST City or Town: HYANNIS State:MA Zip: 02601 Country:USA If the business entity is organized wholly to do business outside Massachusetts,the location of that office: No. and Street: City or Town: State: Zip: Country: Name and address of the Registered Agent:- Name: GEORGE F. SIMPSON No. and Street: 1 SOUTH ST. City or Town: HYANNIS State:MA Zip: 02601 Country:USA The officers and all of the directors of the corporation: Title Individual Name Address(no PO Box) Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term. PRESIDENT LISA A.SIMPSON 75 NORTHWINDS LN. NONE W.BARNSTABLE,MA 02668 USA TREASURER GEORGE F.SIMPSON 75 NORTHWINDS LN. NONE W.BARNSTABLE,MA 02668 USA SECRETARY LISA A.SIMPSON 75 NORTHWINDS LN. NONE s W.BARNSTABLE,MA 02668 USA t ' DIRECTOR r LISA A.SIMPSON 75 NORTHWINDS LANE W.BARNSTABLE,MA 02668 USA DIRECTOR GEORGE F.SIMPSON 75 NORTHWINDS LANE W.BARNSTABLE,MA 02668 USA http://corpssec.state.ma.us/corp/corpsearch/corpSearchSummary.asp?ReadFromDB=True&UpdateAllowed=&F... 1/9/2013 Massachusetts Department of Environmental Protection eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: CHRISD Transaction ID: 716877 Document: AQ 06 -Construction/Demolition Notification Size of File: 218.84K Status of Transaction: in Process Date and Time Created: 1/2212015:10:50:02 PM F Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. Massachusetts Department of Environmental Protection � - Bureau of Waste Prevention•Air Quality , ; . BWP AQ 06 Notification Prior to'Construction or Demolition G This is a revision to an existing form. Project ID for existing form to be revised:• 1 i This job is being conducted under a Blanket Permit MassDEP assigned Blanket Authorization ID: r This job is being conducted under a Non Traditional Abatement Work Practice Permit. MassDEP assigned Non Traditional Work Practice Authorization ID: r None of the above conditions apply,generate anew form. Revised: 11/13/2013 Page 1 of 1 Massachusetts Department of Environmental Protection Bureau of Waste Prevention•Air Quality BWP AQ 06 1UO2,4463 Project Number# Notification Prior to Construction or Demolition Asbestos Pro j A.Applicability A Construction or Demolition operation of an industrial,commercial,or institutional building,or residential building with 20 or more units is regulated by the Department of Environmental Protection(MassDEP), Bureau of Waste Prevention,Air Quality Division,under Regulations 310 CMR 7.09.Notification of Construction or Demolition operations is required under 310 CMR 7.09(2)ten(10)working days prior to any work being performed.The following information is required pursuant to 310 CMR 7.09.Is this a fee exempt notification(city, town,district,municipal housing authority,state facility,owneroccupied residential property of four units or less)? Is this a fee exempt notification(city,town,district,municipal housing authority,state facility,owner-occupied residential property of four units or less)? 1__J Yes FFi No Type of Notification: r; Revision of an Existing Form rJ Cancellation of Project Instructions: 1.Blanket Permit Project Approval,if applicable: Approval ID# 1.All sections of this 2.Non-Traditional Asbestos Abatement Work Practice Approval,if applicable: form must be completed in order to Approval ID# comply with the Department of B. General Project Description Environmental 1..Facility Information: Protection notification THE ANCHOR IN 1SOUTHSTREET requirements of 310 CMR 7.09. Name of facility Street Address HYANNIS MA 026010000 5087750357 2.Submit Original City/Town State Zip Code Telephone Form To: Commonwealth of GEORGESIMPSON OWNER Massachusetts Facility Contact Person Contact Person Title Asbestos Program 5087750357 MPSIMPSON@COMCASTNET P.O.Box 120087 Boston,MA Facility Contact Person Telephone Facility Contact Person Email' 02112-0087 Facility Size: 3072 2 Square Feet Number of Floors Was the facility built prior to 1980? F Yes UI No Describe the current or prior use of the facility: HOTEL Is the facility a residential facility? r Yes r No If yes,how many units? 2.Facilitv Owner: GEORGE SIMPSON 75 NORTH WINDS LANE Facility Owner Name Address BARNSTABLE MA 026680000 5086857067 City/Town State Zip Code Telephone GEORGE SIMPSON 75 NORTH WINDS LANE On-Site Manager/Owner Representative Address Barnstable MA 02668 5086857067 Cityrrown State Zip Code Telephone Revised:03/17/2014 Page I of 3 Massachusetts Department of Environmental Protection Bureau of Waste Prevention• Air Quality BWP AQ 06 100214463 Notification Prior to Construction or Demolition Asbestos Project Number# B.General Project Description(continued) 3.General Contractor: CHRISTOPHER DOUGHERTY PO BOX 1969 Name Address SANDMCH MA ' 025630000 5082749261 City/Town State Zip Code Telephone, SELF 5082749261 General Contractor's On-site Manager/Foreman Telephone C. General Construction or Demolition Description General 1. Construction or demolition contractor: Statement:if asbestos is found CHRISTOPHER DOUGHERTY PO BOX 1969 during a Construction Contractor Name Address or Demolition operation,all SANDWCH MA 025630000 5082749261 responsible parties City/Town State Zip Code Telephone must comply with 310 SELF 5082749261 CMR 7.00,7.09,7.15, and Chapter 21E of Construction and Demolition On-site Manager Telephone the General Laws of the Commonwealth. 2.Licensed Contractor Supervisor: This would include, but would not bw CHRISTOPHER DOUGHERTY 083689 limited to,filing an asbestos removal Supervisor Name License Number notification with the Department and/or a 3. Is the entire facility to be demolished? f_J Yes r No notice of releasefthreat of 4.Describe the area(s)to be demolished: release of a hazardous substance to the --„) Department,if bo applicable. 5.If this a construction project,describe the building(s)or addition(s)to be constructed: MassDEP Use Only ONE BATHROOM REPLACED;INCLUDING FIXTURES AND TILE �='�j Date Received 6.If this is a demolition or renovation project,were the structures)surveyed for the presence of Asbestos-Containing Material(ACM)? r Yes rNo 7.Was asbestos containing material(ACM)found? �!Yes r No If a survey was conducted,who conducted the survey? Name Department of Labor Standards Certification Number Revised:03/17/2014 Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Waste Prevention- Air Quality BWP AQ 06 1100214463 Notification Prior to Construction or Demolition Asbestos Project Number# C.General Construction or Demolition Description(continued) The Asbestos Abatement Notification Number for this address is: This project Construction Demolition is: 2/1/2015 4/1/2015 Project Start Date(MM/DD/YYYY) Project End Date(MM/DD/YYYY) 8.For demolition and construction projects,indicate dust suppression techniques to be used j Seeding (j Wetting Covering r-1, Paving Shrouding Other-Specify: 9.For Emergency Demolition Operations,who is the MassDEP official who evaluated the emergency? Name of MassDEP Official Title Date of Authorization(MM/DD/YYYY) MassDEP Waiver Number D. Certification "I certify that I have personally CHRISTOPHER DOUGHERTY examined the foregoing and am Print Name familiar with the information CHRISTOPHERDOUGHERTY contained in this document and Authorized Signature all attachments and that,based PRESIDENT OF STRUCTURES BUILDING INC. on my inquiry of those individuals immediately ANCHOR IN RIN responsible for obtaining the information,I believe that the Representing information is true,accurate,and 122/2015 complete.I am aware that there Date(MM/DD/YYYY) are significant penalties for submitting false information, including possible fines and P.E# imprisonment.The undersigned hereby states,under the penalties of perjury,that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is made." Revised:03/17/2014 Page 3 of 3 ZO �. c f rN - ot is t �i i } i 10 i CIO r e # + cl , 4 sf e. y , f f Massachusetts -Department of Public Safety Board of Building Regulations and Standards v. CviistTiGtt1'oit SiiPCiS'Imid' - License: CS483689 cHIi:LSTOPi3SR ° PO BOX 1969 Sandwich MA 025§3 Expiration } Cornmissioner 12/20/2016 u flice of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. It found return to: istration: 176'887 Typo; Office of Consumer Af fairs and Business Regulation xpiration: ; l0/7l2015 Corporation 10 Park Plaza-Suite 5170 BOStold MA t1Z116 STRUCTURES BUILDING#NC CHRIS DOUGHERTY 168 MAIN ST SANDWICH,MA 02563 Undersecretary wk" patu TMe To,,, Town of Barnstable Regulatory Services * sniuvsr.11U, * 9 Mass. �, Thomas F.Geiler,Director, i639• tia' '°rF 19ra Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Ovmer Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, Y in all matters relative to work authorized by this building permit (Address of Job) - I **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final Ware pe rmed and°accepted. ner Somtare of Applicant S �A Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS 6/2012 PROJECT NAMIE: ADDRESS: H -V\ tS PERMIT# PERMIT DATE: cl� D M/P• 4: LARGE=ROLLED PLANS ARE IN: BOX SLOT . ,. . . . . ! k Z�- Data entered in MAPS program on:. BY: q/wpfiles/forms/archive r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application #_2,>00 Health±Division Date Issued t -1 Conservation Division Application Fee Planning Dept. Permit Fee /6 3 I —I? - 13 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis R I3 Project Street Address 1 �9 � - - Village Owner Q-YX -r NP_ C- tv % 12 ScA! \ l,�n _&.a4A(rr 1ddress Telephone o CoDS-r- i Zo I Permit Request O `Z �,nn S � dGl �JC LT,< �. TCcAnn 6-J_)n �n_ !4MLdL1-4 .(&CtA Ljgl S,. IPI,"LC- CNA t.L.A Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation I&®aQ 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 / q d istoric House: ❑Yes Wqo On Old King's Highway: ❑Yes ®-Pdo Basement Type: ®'Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) ,�/� Basement Unfinished Area (diq ) Number of Baths: Full: existing new 0 Half: existing n W Number of Bedrooms: existing D new a Total Room Count (not includ' aths): existing new 7 First Floor Ro Counter_ Heat Type and Fuel: as ❑ Oil lectric ❑ Other t t u» Central Air: es ❑ No Fireplaces: Existing '0 New Existing wood/coal stove: ❑Yes 8Jo— 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;2es ppeals Authorization ❑ Appeal # Recorded ❑ Commercial rp ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION - _ -- -- (BUIL-DER OR HOMEOWNER) - _ Name Telephone Number E Address License # CS- 09) S &Vjq (-,Uyy\ ��GtI A-CA Home Improvement Contractor# ��y v10 d Worker's Compensation # /A PS�a j 1-2— ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ,, e SIGNATURE DATE���� t FOR OFFICIAL USE ONLY APPLICATION# i DATE ISSUED MAP/PARCEL NO. ' ADDRESS VILLAGE OWNER DATE OF INSPECTION: I I..-(FOUNDATION=t s `` FRAME INSULATION i FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL y GAS: ROUGH FINAL FINAL BUILDING r 1. DATE CLOSED OUT ASSOCIATION PLAN NO. i Department of Industrid Accidents Office of Investigations 00 W'askington Street Bosfon,;11MA:02111 ; t A . ww:mass.govvdi ry n Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 6at `►t- •Address: `p ® - SCI 10A City/State/Zip:. Phone.#: Are yo employer? Check the appropriate box: Type of project(required) 1. I am a employer with 4. 0 I am a general contractor and I employees (full and/or part-time). * , - have hired the stib-contractors 6. U�,w construction 2:❑ I am a'sole proprietor or partner listed on the•attached sheet: 7. modeling , ship and have no employees , These sub-contractors have g- 0 Demolition working for me in an ca. aci employees and have workers' Y p t3'• $: 9. ,0 Building addition . [No workers' comp, insurance comp.insurance. ; required.] 5. Q We are a corporation and its 10.❑Electrical repairs or additions: 3.0 L am a homeowner doing all work' officers have exercised their 11.E Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 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'compensatim 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 bave employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for.my employees. Below is thepolicy and job site . information. Insurance Company an Name: ,_„ram,..; Policy#or Self-ins.Lic.#: U - H� g Q .M1` — 1/L Expiration Date: Job Site Address: J City/State/Zip: �' � T_ Attach a copy of the workers'compensation policy declaration page fshowing the policy number and expiration date). Failure.to secure coverage as required under Section 25Aof MGL c. 152 can lead to the imposition of criminal penalties of a fine tip 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 c un er_the pains-a enalties of perjury that the information provided above is true and correct- Signature: bate: Phone#: � Official use only. .Do not write in this area,to be completed by.city or to.wh official City or Town:::, Permit/License# Issuing Authority(circle one):. .L Board of Health 2,Building Department 3.City/TovPn Clerk 4.Electrical Inspector, S.Plumbing Inspector 6. Other Contact Person Phone#: . • 4 •• I format on and �In" rU one Massachusetts General'Laws cha ter 152 r es all e 'to ers to' 'rovide workers compensa P � mP Y P ton.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_" •� 0 or more e ti or an tw o Lion or other 1 al en m e is defined as an indivi artnershi associaho co ra , An e ploy r dual,P p, n, rp g of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or.tlie ......_ receiver or trustee-of an individual,partnership, association or other legal entity,employing employees. However ffie 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 ground s 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 cork:sntil-acceptable evidence of compliance w ith the in rs ce 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. 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 P lease be.sure that the affidavit is complete printed legibly. The De artment has provided space.at the bottom � mP PP . P e event OfficeInvestigations as to contact ou re ardin the a licaat ' of the affidavit for you to fill out in the v nt the Offi of h YY g g PP 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 pemritllicense 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 t year.Where a home.owner or citizen is obtaining a license or permit not relatedfo 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 lake 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: } 6 Commoiiw lth of Massarhusotts Dgputmemt cif Fndusarial A.ceibnts Office of In ti-ons 600 Washingtmi.StMot l'ostGn, MA 0-2111 Tel. # 617-727-49-00 ext 406 Qr 1-M-MASSAFE Fax# 617-727-7749. Revised 11-22-06 WWW-Mass.gQV/dia a TME to, ToWn of Barnstable Re ulatoJ Services: . Thomas F Ge4r,Director 'OrFn . Building Division Tom Perry,Building Commissioner , 200 Main Street,Hyannis,MA 02601 wwwaown.barnstable.ma.us Office: 508-862-4038 Fax:_508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder. as Owner of the subject property hereby authoriz ✓ / C�(/ to act on my behalf, in all matters relative to work authorized by this building permit s (Address of Job) . Pool fences and alarms:are.the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final ; ins ti s are erformed and accepted.! i e of Owner o pplicant ' F, •:, Print Name Print Name Date- r' Q:FORMS:OWNERPERMISSIONPOOLS 62012_' e •s • Town of Barnstable 4 . . . i Regulatory Services * eivsxnstE, : Thomas F.Geiler,Director , o. mass 94� 1639• ,�� Building Division.:: ArFD MA'1 A 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 s DATE: JOB LOCATION: number street. village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state '4zipcode l� The current exe7—N, mption for"homeowners"was extended to includeaowner"occu"id dwellta s f six units�br lessrand P to allow homeowners to engage an individual for hire who does not possess a li nse,proyidedthat the owner acts as a supervisor. % «� V 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 Offigial on a form acceptable to the-,Bi ldmg fficial,that) e/she shall be responsible for all such work performed unde?VtWbu ldhiing De ection;109 The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other. applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and.that he/she will comply with said procedures and requirements. Signature of Homeowner y Approval of Building Official q .' 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,theprouisions �.' of this section(Section 109.1.1 -Licensing of construction,Supervisors);provided that if the homeowner engages a person(s)tf8thire to-do uA�`*, Work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they,?.re assuming the responsibilities of a supervisor(see Appendix Q, 'Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness ofteri.results in serious,problems,pamcularly4 when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a,licensed a, '�� Su ervisor. The homeowner actin as { 1 p g Supervisor is ultimately responsible. _ To ensure.that the homeowner' p S'�'� '' i`is fully aware cif his/her many communities require,as part of the,Permit application; y that the homeowner certifythat he/she understands the responsibilities of a Supervisor; n he p p O t last page of this issue is a form currentlyused b Y several towns. You o may care t amend and adopt such a forr✓certification for use in your community.. Q:forms:homeexempt TOO 9 F f Q. Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-083689 V TS CHRISTOPHERV'60-U'-.. a Rrfi� PO BOX 398 . Cummaquid MA1637 f o-� F10 Expiration Commissioner 12/20/2014 Unrestricted - Buildings of any use group which contain less than 35,000 cubic feet (99 1 M) of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 1 of 2 The Commonwealth of Massachusetts William Francis Galvin Wit ' 11 Secretary of the Commonwealth, Corporations Division One Ashburton Place, 17th floor Boston,MA 02108-1512 -�- Telephone: (617)727-9640 STRUCTURES BUILDING INC. Summary Screen Help with this form j ,Request a'Gertlficate % The exact.name of the Domestic Profit Corporation: STRUCTURES BUILDING INC.` The name was changed from: . CMD REMODELING CO.,INC. on 7/26/2012 The name was changed from: CMD REMODELING CO.,INC. on 3/11/2009 Entity Type: Domestic Profit Corporation Identification Number: 000995025 Date of Organization in Massachusetts: 02/02/2009 Current Fiscal Month/Day: 12/31 The location of its principal office: No. and Street: 142 ALTHEA DR. City or Town: CUMMAQUID State: MA Zip: 02637 Country: USA If the business entity is organized wholly to do business outside Massachusetts,the location of that office: No. and Street: , City or Town: State: Zip: Country: Name and address of the Registered Agent: Name: CHRISTOPHER M. DOUGHERTY No. and Street: 142 ALTHEA DR. City or Town: CUMMAQUID State: MA Zip: 02637 Country: USA The officers and all of the directors of the corporation: Title Individual Name Address(no PO Box) Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term PRESIDENT CHRISTOPHER M DOUGHERTY 2 PALMER ROAD EAST SANDWICH,MA 02537 USA TREASURER 'CHRISTOPHER M.DOUGHERTY 2 PALMER ROAD EAST SANDWICH,MA 02537 USA SECRETARY CHRISTOPHER M DOUGHERTY . 2PALMER ROAD EAST SANDWICH,MA.02537 USA. DIRECTOR CHRISTOPHER M DOUGHERTY 2 PALMER ROAD EAST SANDWICH,MA 02537 USA http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB.=True&... 1/9/2013 The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 2 of 2 business entity stock is publicly traded: The total number of shares and par value, if any,of each class of stock which the business entity is authorized to issue: Par Value Per Share Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding Num of Shares Total Par Value Num of Shares CNP $0.00000 275,000 $0.00 500 Consent Manufacturer Confidential Data Does Not Require Annual Report Partnership Resident Agent For Profit _ Merger Allowed Select a type of filing from below to view this business entity filings: ALL FILINGS 17`` Administrative Dissolution Annual Report Application For Revival ] Articles of Amendment . View FilmgsM � i ' , ; t New Search E 77 Comments O N01-2013 Commonwealth of Massachusetts All Rights Reserved Halo . 5 http://corp.sec.state.ma.us/corp/corpsearch/CorpSearch$ummary.asp?ReadFromDB=True&... 1/9/2013 RX Date/Time 10122/2012 05:12 31 P.002 d,I—g-fritfax C3-1 10/22/2012 5:09:58 AM PAGE ' 2/002 Fax Server w/ CERTIFICATE OF LIABILITY INSURANCE DATE tMMrnommrl IFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to he terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to he certificate holder in lieu of such endorsemen s). PRODUCER CONTACT NAME: PAUL PETERS AGENCY INC PHONE FAX 680 FALMOUTH ROAD (A/C,No,Ext): (A/C,No): E-MAIL MASHPEE,MA 02649 ADDRESS; 28LBR INSURERS)AFFORDING COVERAGE NAIC# INSURED INSURER A: ACE AMERICAN INSURANCE COMPANY STRUCTURES BUILDIFG INC �� _ `` INSURER B: Ci/�ttiSjClt^tS� � '1�6tt INSURERC: •] 1 INSURER D: P O BOX 398 INSURER E: CUMMAQUID,MA 02637 INSURER F: COVERAGES CERTIFICATE NUMBER. REVISION NUMBER: HIS IS TO CERTIFY THAT THE POUCESOF INSURANCEILISTED 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 OOCUM ENT 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 POLICES.LM9TS 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 (MM MYYYY) (MIM ODAYYYY) LWT$ GENERAL LIABILITY :ACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY AMAGETORENTED $ CLAIMS MADE OCCUR. MISES(Ea occurrence) ED EXP(Any one person) $ 3ERSONAL&ADV INJURY $ rGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE $ LICY PROJECT LOC ODUCTS-COMPIOP AGG $ AUTOMOBILE LIABILITY OMBINED SINGLE $ ANY AUTO IMIT(Ea accident) ALL OWNED AUTOS ODILY INJURY $ SCHEDULE AUTOS Per person) HIRED AUTOS ODILY INJURY $ NON-OWNED AUTOS Per accident) ROPERTY DAMAGE $ Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE' $ RETENTION $ $ A WORKER'S COMPENSATION AND X WC STATUTORY OTHER EMPLOYE'SLIABIL17Y YIN US-471BP881-12 08/07/2012 08/07/2013 LIMITS ANY PROPERITOR/PARTNERIEXECLT[VE OFFICERIMEMSER EXCLUDED? Q N/A E.L EACH ACCIDENT $ 100,000 (Manddoryln NH) EL DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPfIONOFOPERATIONSbelow. E.L.DISEASE-POLICYUMIT $ 500,000 DESCRIPTION OF OPERATIONSILOCAT]ONSIVEHICLESIRESTRICTIONS(SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 367 MAIN ST BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILLQ DELIVERED IN ACCORDANCE WITH THE POLICY PROV AUTHORIZED REPRESENTATIVE HYANNIS,MA 026DI ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1FZB-2010 ACORD CORPO gh er eed. r The Commonwealth of Massachusetts William Francis Galvin-Public Browse and Search Page 1 of 2 r� The Commonwealth of Massachusetts William Francis Galvin 0. ei Secretary of the Commonwealth,Corporations Division One Ashburton Place 17th floor rtl Boston,MA 02108-1512 Telephone: (617)727-9640 HYANNIS BUILDING AND DEVELOPING ASSOCIATES, INC. Summary fi Screen Help with this form ^> Request a Certificate The exact name of the Domestic Profit Corporation: HYANNIS BUILDING AND DEVELOPING ASSOCIATES, INC. Entity Type: Domestic Profit Corporation Identification Number: 042238763 Date.of Organization in Massachusetts: 09/06/1955 Current Fiscal Month/Day:03/31 Previous Fiscal Month/Day:03/31 The location of its principal office: No. and Street: 1 SOUTH ST City or Town: HYANNIS State:MA Zip: 02601 Country: USA If the business entity is organized wholly to do business outside Massachusetts,the location of that office: No. and Street: City or Town: State: Zip: Country: Name and address of the Registered Agent: Name: GEORGE F. SIMPSON No.and Street: 1 SOUTH ST. City or Town: HYANNIS State:MA Zip: 02601 Country:USA The officers and all of the directors of the corporation: Title Individual Name Address(no PO Box) Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term PRESIDENT LISA A.SIMPSON 75 NORTHWINDS LN. NONE W.BARNSTABLE,MA 02668 USA TREASURER :GEORGE F.SIMPSON 75 NORTHWINDS LN. NONE W.BARNSTABLE,MA 02668 USA SECRETARY LISA A.SIMPSON 75 NORTHWINDS LN. NONE W.BARNSTABLE,MA 02668 USA DIRECTOR LISA A.SIMPSON 75 NORTHWINDS LANE . W.BARNSTABLE,MA 02668 USA DIRECTOR GEORGE F.SIMPSON 75 NORTHWINDS LANE W.BARNSTABLE,MA 02668 USA http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True&UpdateAllowed=&F... 1/9/2013 The Commonwealth of Massachusetts William Francis Galvin-Public Browse and Search Page 2 of 2 y business entity stock is publicly traded: _ The total number of shares and par value,if any,of each class of stock which the business entity is authorized to issue: Par Value Per Share Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding Num of Shares Total Par Value Num of Shares CNP $0.00000 2.000 $0.00 77 Consent _ Manufacturer _ Confidential Data _ Does Not Require Annual Report Partnership X Resident Agent _ For Profit _ Merger Allowed Note:There is additional information located in the cardfile that is not available on the system. Select a type of filing from below to view this business entity filings: ALL FILINGS Administrative Dissolution (=3; Annual Report Application For Revival Articles of Amendment Articles of Charter Surrender View Filing New Search1� Comments O 2001-2013 Commonwealth of Massachusetts 7' All Rights Reserved Helo http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True&UpdateAllowed=&F... 1/9/2013 OU 72 PO BOX 70 E SANDWICH,MA 02 _ a. cam_ Expiratio t?112 f +nuns.' r Tr#: OMMOfCoMA Baste - HME MPROVEMEN CON RACTOR -�_ WOO15w;,, S En 5/2013 IrKlMdual --� t PALIW LANE jF0�2E5FDE,MA'tf — :; . -- Licease or registration valid,for indiv►dul°.use only before the expiration date. If found return o' Office.of Consumer Affairs and Business Regulation 10.Park Plaza-Suite 5170 Boston.,tip 16 t valid without signature Massachusetts Department of Environmental Protection Bureau of Waste Prevention - Air Quality i0b/Ll -mil BWP AQ 06 Decal Number Notification Prior to Construction or Demolition Important: A. Applicability When filling out PP ty forms on the computer,use only the tab key A Construction or Demolition operation of an industrial, commercial, or institutional building, or. to move your residential building with 20 or-more units is regulated by the Department of Environmental Protection cursor-do not use the return (DEP), Bureau of Waste Prevention-Air Quality Control Regulations 310 CMR 7.09. Notification of ' key. .,Construction or Demolition operations is required under 310 CMR 7.09(2)ten (10)days prior to any work being performed. The following information is required pursuant to 310 CMR 7.09. rea B. General Project Description 1. a. Is this facility fee exempt-city, town;district, municipal housing authority, owner-occupied Instructions residence of four units or less?❑Yes No 1.All sections of b. Provide blanket decal number if.applicable: this form must be Blanket Decal Number ? completed in order to comply with the 2. Facility Information: Department of Anchor In Environmental Protection a.Name notification 11 South Street requirements of b.Address 310 CMR 7.09 H annis - MA 02601 c.Ci /Town d.State e.ZiD Code (508)775-0357 f.Tele hone Number area code and extension .E-mail Address(optional) 7,200 2 h.Size of Facility in Square Feet i.Number of Floors j. Was the facility built prior to 1980? ❑ Yes ❑✓ No k. Describe the'current or prior use of the facility: Hotel I. Is the facility a residential facility? ❑ -Yes ❑✓ No _o m. If yes, how many units? Number of units �c) 3. Facility.Owner: , =N Hyannis Building and Developing Associates Inc. �o a.Name 0 11 South Street b.Address H annis MA 1 02601 ED c.CitvrTown d.State e.ZipCode �o (508)775-0357 f.Tele hone Number area code and extension .E-mail Address(optional) George Simpson �Q h.Onsite Manager Name ® ag06.doc-10/02 BWP AQ 06•Page 1 of 3 I � s LF1, Massachusetts Department of Environmental Protection Bureau of Waste Prevention •Air Quality l /14-0 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition General statement-If B. General Project Description cont. asbestos is found during a 4_ General Contractor: Construction or Demolition JChristopher Dougherty operation,all responsible parties a.Name must comply with P.O box 398 310 CMR 7.00, b.Address and Chapter Cumma uid MA 02637 Chapterer 21 E of the General Laws of c.C /Town d.State e.Zip Code the Commonwealth. (508)274-9261 This would include, f.Tele hone Number area code and extension .E-mail Address(optional) but would not be limited to,filing an Christopher Dougherty asbestos removal h.On-site Manager Name notification with the Department and/or a notice of release/threat of C. General Construction or Demolition Description release of a hazardous substance to the 1. Construction or demolition contractor: Department,if applicable. same a.Name b.Address a CitvrFown d.State e.Zip Code f.Telephone Number(area code and extension) g.E-mail Address optional h.On-site Manager Name 2. On-Site Supervisor: On-Site Supervisor Name 3. Is the entire facility to be demolished? ❑ Yes 0 No N =0 4. Describe the area(s)to be demolished: _0 2 bathrooms will be remodeled. �N �O -0 5. If this is a construction project, describe the building(s)or addition(s)to be constructed: �o �o �a �Q aq 10/02 BWP AQ 06•Page 2 of 3 I Massachusetts Department of Environmental Protection ■ Bureau of Waste Prevention •Air Quality lOO/ --d BWP AQ 06 Decal Number Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.) 6. a. If this is a demolition project,were the structure(s) surveyed for the presence of asbestos containing material (ACM)? ❑ Yes ❑✓ No If yes, who conducted the survey? b.Survevor Name c.Division of Occupational Safety Certification Number 01/20/2013 02/14/2013 7. Construction or Demolition. a.Start Date(mm/ddtyyyy) b.End Date(mm/dd/yyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding El paving b. If other, please specify: ❑ wetting ❑ shrouding ❑✓ covering ❑ other 9. For Emergency Demolition Operations,who is the DEP official who evaluated the emergency? a.Name of DEP Official b.Title c.Date mm/dd/ of Authorization d.DEP Waiver Number D. Certification I certify that I have examined the Christopher Dougheigy =o above and that to the best of my a.PrAftiaw �o knowledge it is true and complete. The signature below subjects the b.&utho' igna ure -N signer to the general statutes 9 9 president/structuresbuildinginc. �o regarding a false and misleading c. os io e �o statement(s). Structures building inc. d.Re resenti co e.Date(m 1 d yyyy) �o �d �Q ® aq 10/02 BWP AQ 06•Page 3 of 3 pp THE rpm --- --- -.rye--�• •--- p " ..... .Town of Barnstable 4F* MRYSTABLE, "ems t6501 Regulatory Services • y�pp 9. ��� TED Mfi�A )Public Health Division 200 Main_Street, Hyannis;..MA 026.01. Offce:. 508-862-4644 Fax`. 508-790-6304 MAIL TO: TOWN OF'BARNSTABLE PUBLIC HEALTH DIVISION 200 MAIN STREET HYANNIS,MA 02601 PLEASE INCLUDE SIGNATURES OF INSPECTORS.FROM THE BUILDING,FIRE AND HEALTH DEPARTMENTS AND THE REQUIRED$S0.00 FEE MADE PAYABLE TO:TOWN OF BARNSTABLE APPLICATION FOR A'MOTEL LICENSE / DATE ( /2— NAME OF MOTEL '/') /`� ADDRESS'OF MOTEL VILLAGE OF MOTEL IT'S NO. OF UNITS SWIMMING POOLS: . INSIDE POOL' - CAPACITY OUTSIDE"POOL CAPACITY SOLE OWNER PARTNERSHIP s 1✓ CORPORATION,' STATE OF CORPORATION FEDERAL-IDENTIFICATION NO. IF PAR RS Nc AND HOME DRESS OFTARTNERS ' - Tel.No. 75 6 3J Tel.No. IF CORPORATION; NAME AND HOME ADDRESS OF CORPORATE OFFICERS President Tel.No. Treasurer Tel.No. Clerk.. Tel.No.: IF SOLE OWNER:NAME AND HOME ADDRESS Tel.N INSPECTED'' IONATU APPLICANT BUILDING DIVISION DATE Id�lf Q IRE EPARTMENT DATE- 1AIII : ALTH DIVISION DATE Q:1App1ication Fo L.DOG ; ConSery GROUP, INCORPORATED January 25,2011 Mr. Paul Roma,Building Inspector Town of Barnstable 200 Main Street , Hyannis,MA 02601 Re: Building Permit Issued for ,-Renovations to Anchor Inn One South Str`eet,_Hyannis'7 r Dear Paul: I stopped by to see you back in November with regard to a Building Permit Application pending at the above referenced address. You happened to be on vacation at the time. When I viewed the pending permit file, I noticed that architectural schematic drawings prepared by ConSery were included as part of the application. Since you were on vacation, I left a request with your staff to have you call me prior to issuing a permit on the project. Shortly thereafter I received a message from Jennifer in your office that a permit had been issued by Tom on the project. The reason for this letter is to clear up my reason for wanting to speak with you at the time. We have a very cordial relationship with the owners at Anchor In. We do not know the builder that they hired to complete the work that is currently underway. We had prepared schematic design drawings for the project but did not receive the authorization to proceed with construction. We understood that they hired instead a contractor with whom they had a previously positive experience. Since their builder put our plans in witli the building permit application,we just wanted you to know that the drawings you have,were prepared as schematic drawings only,.for discussion purposes with the Owner,not as construction documents.No code analysis, structural analysis, nor construction details were completed. If this work had been done,David Vachon, our architect would have stamped the drawings. We are also not providing any construction oversight of the construction work. We trust that everything will go along just fine on the project and that the builder and/or his architect/engineer will provide these services as needed. It would be appreciated if this letter could remain in your records with the project file. Thank you for your attention in this matter. ery t ly ours, and n� President ConSery Group, Inc. 2277 State Road, Plymouth, MA 02360 — Mail to: PO Box 278, 5agamore Beach, MA 02562 P (508) 888-6555 P (508) 888-6566 www.con5erveroup.com Page I of I i PROJECT NAME: TP_np,yoJiDn ADDRESS: a, '{'1 n I S d PERMIT# PERMIT DATE: NI/P: LARGE ROLLED PLANS ARE IN: BOX V 1 SLOT 4 Data entered in MAPS program on:. BY: - q/wpfile`s/forms/archive w s . ° TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel,' Application #.7-,o l 0(-P(V 3 Health Division Date Issued Conservation Division `,:,Application Fee Planning Dept. _"Permit Fee . Date Definitive Plan Approved by Planning Board (� Historic - OKH Preservation/ Hyannis Project Street Address , . Village Owner Address. IMU-4LA( U)4AL Telephone s (a D(0 a Permit Request C C' Square feet: 1st floor: existing/3(proposed A)U- 2nd floor: existing p roposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type (-e. Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family. ❑ Two Family ❑ Multi-Family(# units) s Age of Existing Structure _ Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: UT'ull ❑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 '.- L,,"s ' 3 Heat Type and Fuel: W9 as ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes 00 Fireplaces: Existing New Existing wood/coal stove:�n❑Ye"-- 0116 Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ew s ze_ c• Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of AAP eals Authorization ❑ Appeal # Recorded ❑ Commercial O�Yes ❑ No If yes, site plan review # Current Use 0 �--� ( Proposed Use APPLICANT INFORMATION __(BUILDER OR HOMEOWNER) Njme Telephone Number( S�� -7 2 L 4 Address P�d � License# Home Improvement Contractor# I—r D I-IL Worker's Compensation # tit d ef- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO CCr SIGNATURE DATE _ Z- Z7 Zo i FOR OFFICIAL USE ONLY APPLICATiION# C DATE ISSUED 7 t MAP/PARCEL NO.,_ 4 i c ADDRESS VILLAGE OWNER i DATE OF INSPECTION: ..'FOUNDATION - FRAME INSULATION. FIREPLACE ELECTRICAL: ROUGH FINAL ,t PLUMBING: ROUGH FINAL a ai i.•.. may"+:•.r w_ GAS:- ROUGHfu _'.a FINAL ` FINAL BUILDING e `- IM06fi P DATE_ CLOSED OUT. 1 ASSOCIATION PLAN NO. 4 r The Commonwealth of Massachusetts Department of Industrial Accidents l Office of Investigations 600 Washington Street, Boston MA 02111 - www.tnass.gov/dia Workers' Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers Applicant Information PIease Print Legibly Name (Business/Organization/Individual) Z f Address: City/State/Zip: [3.0 ou an employer? Check the appropriate (f Type of project(required): [ a employer with 4, am a eral contractor and I e ployees(full and/or part-time). * have hired the sub-contractors 6. ❑ New construction am a sole proprietor or partner- listed on the attached sheet. : 7. ❑ Remodeling These sub-contractors have . Demolition hip and have no employees S. ❑ working for mein capacity. employees and have workers' g Y � 9. ❑ Building addition No workers' comp. insurance comp. insurance. quired.] 5. [� AWe area corporation and its 10.❑Electricairepairs or additions officers have exercised their 1 1. Plumbing repairs or additions ama homeowner doing all work ❑ g Pyself. (No workers'comp. right of exemption per MGL 12.❑Roof repairs surance required.] t C. 152, §](4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must.also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below Is thepolicy andjob.site information. Insurance Company Name: CA�, Ur .? Expiration Date: Policy:#or Self-ins. Lie..#.^ '`�'�� �p I� Ex p 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 Ias 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 certi u der th pains a d penalties o erjury that the information provided above is true and correct Si nature: 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)•.3 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 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 maybe 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 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 4-24-07 www.mass:gov/dia I Town of Barn-stable Regulatory Services - v Mtas Thomas F. Geiler,Director . 16 m °rEv► ` Building Division Tom Perry,Building Commissioner 200 Main-Street, Hyannis, MA,02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign. This Section If Using A Builder >, � A) as Owner of the subject property hereby authorize, S to act on my behalf, in all matters`relative to work authorized by this building pe t application for: (Ad Aess,of Job) Sig e of er Da P t Name If Property`Owier is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION �C't ray Town of Barnstable o Regulatory Services t .-rAE Thomas F. Geiler, Director EARNLF- cuss. � 1639. .,"b Building Division PrED MAt a Tom Perry, Building Commissioner 200 Maiu.Street, Hyannis,MA.02601 vt wmto wn.b arnsta bl e.ma.us Office: 508-862- 038 Fax: 509-790-6230 HOI\4 OWNER 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 owMBt-OCcuplCd dwellings of six units or less and to allow homeowners to engage an individual for hire who does not.p6ssess a license,provided that the,owner acts as supervisor_ t DEFINITION OF HOMEOWNER-' � Persons)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 rninirrrum inspection procedures and requirements and that he/sbe will comply with said procedures and. requirements. I Signature of Homeowner 1 ' 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 pcmvt is required shall be exempt from the provisions Of this SCetiOn_(Sectiorn 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a p=on(s)for hire to do such wofk,that such Homcowner shall act as supervisor." Many homeowners who use this exemption arc unaware that they arc assuring the responsibilities of a supervisor(see Appendix Q, Rules&Rcgirlations 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 responsrbilidrs,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the]an page of this issue is a.form currently used by several tDwns. You may care t amend and adopt such a form/certification for use in your community. Q:forrrs:homccxcmpt i IOUGHERTY--ANCHOR INN MA Botello Lumber Company 2010.4 Allowable stress Design Mal: 0.76 MOTE: LOAD TABLE 2 PLIES 1.760 X 8.000 LPLVL296OFb-2.OE DESIGN CRITERIA. VSI: 0.54 I.THIS COMPONENT IS DESIGNED TO SUPPORT ONLY DESIGN CONSISTS OF 2 — PLIES FASTENED RSI: 0.89 THE VERTICAL LOADS SHOWN VERIFICATION OF NOTE: LOADS SHOWN ARE FOR INPUT LOAD CASE(1). OTHER LOAD CASES TOGETHER (REFER TO NOTES). FOR PATTERN LIVE LOADING ARE CHECKED AS REQUIRED.LOADING,DEFLECTION LIMITATIONS,FRAMING (DIMENSIONS MEASURED FROM LEFT END OF SPAN OR CANTILEVER.) FLOOR LIVE LOAD 40 PSF METHODS,WIND AND SEISMIC BRACING,AND OTHER FLOOR DEAD LOAD 10 PSF LATERAL BRACING THAT IS ALWAYS REQUIRED IS DISTRIBUTION SOURCE TYPE TOP/SIDE LOAD FROM TO LDAO LDF FLOOR TOTAL LOAD = 50 PSF THE RESPONSIBILITY OF THE PROJECT ENGINEER FT—IN—SX FT—IN—SX OR ARCHITECT. UNIFORM ROOF LIVE TOP 450 PLF 00-00-00 08-06-00 1.15 ROOF LIVE LOAD 30 PSF 2.PROVIDE RESTRAINT AT SUPPORTS TO ENSURE UNIFORM ROOF DEAD TOP 225 PLF 00-00-00 08-06-00 0.90 ROOF DEAD LOAD 15 PSF LATERAL STABILITY. UNIFORM FLOOR LIVE TOP 150 PLF 00-00-00 08-06-00 1.00 ROOF TOTAL LOAD 45 PSF 3.DO NOT CUT,NOTCH OR DRILL LP LVL. UNIFORM FLOOR LIVE TOP 120 PLF 00-00-00 08-06-00 1.00 4.SHIM ALL BEARINGS FOR FULL CONTACT. UNIFORM WALL DEAD TOP 85 PLF 00-00-00 08-06-00 0.90 FLR LEFT SPAN CARR. 0.00 FT 5.VERIFY DIMENSIONS BEFORE CUTTING LP LVL UNIFORM FLOOR DEAD TOP 75 PLF 00-00-00 08-06-00 0.90 FLR RIGHT SPAN CARR. 6.00 FT TO SIZE. UNIFORM FLOOR DEAD TOP 30 PLF 00-00-00 08-06-00 0.90 ROOF LEFT SPAN CARR. 0.00 FT 3.THIS LP LVL IS TO BE USED AS A UNIFORM BEAM WEIGHT 8 PLF 00-00-00 08-06-00 0.90 ROOF RIGHT SPAN MUM. 30.00 FT COMBINATION ROOF AND FLOOR BEAM ONLY. 7.COMPRESSION EDGE BRACING REQUIRED AT WARNING NOTES: DEFLECTION CRITERIA EACH END OF COMPONENT, LIVE LOAD DEFL: L / 360 THIS COMPONENT DESIGN IS SPECIFICALLY FOR L-P ENGINEERED WOOD PRODUCTS. TOTAL LOAD DEFL: L / 240 DESIGN ASSUMES COMPONENTS CARRIED ARE USE OF THIS DESIGN FOR ANYTHING OTHER THAN LP LVL OR LP LSL OR LP HOISTS IS APPLIED TO TOP EDGE OF LP LVL,SUCH THAT STRICTLY PROHIBITED.ANY MODIFICATION OF THIS DOCUMENT REQUIRES REVIEW CODE COMPLIANCES LOAD IS DISTRIBUTED EQUALLY TO EACH PLY. BY A DESIGN PROFESSIONAL. REPORT # ATTACH THE TWO PLIES WITH 2 ROWS OF led ICC—ES ESR-2403 (3.12")NAILS AT 12"OC.STAGGER ROWS. MINIMUM BEARING SIZES ARE SUFFICIENT TO PREVENT CRUSHING OF THE LP LVL LOADS RR-25783 NAILS CAN BE DRIVEN FROM ONE FACE OR HALF BEAM AS DESIGNED.IT IS THE RESPONSIBILITY OF THE PROJECT ENGINEER, HUD MR-1214 FROM EACH FACE. NAILS MAY BE COMMON OR ARCHITECT OR DESIGNER TO VERIFY THAT THE SUPPORT STRUCTURE FOR THIS CCMC 11518—R BOX NAILS WITH A MINIMUM SHANK DIAMETER BEAM IS CAPABLE OF SUPPORTING THE REACTIONS. OF 0.131". led SINKERS(3-1/4")MAYBE USED,BUT HALF MUST BE DRIVEN FROM ANCHOR LP LVL ROOF/FLOOR BEAM SECURELY TO BEARINGS OR HANGERS. EACH FACE THIS FLOOR FRAMING COMPONENT HAS BEEN DESIGNED WITH AN INPUT TOTAL LOAD DEFLECTION LIMIT OF L240.(PROVIDED BY THE LP CUSTOMER), THIS COMPONENT CANNOT BE USED TO SUPPORT CERAMIC TILE FLOORS. THIS NON-STANDARD LVL DEPTH IS NOT AVAILABLE FROM I.P. T IT MUST BE RIPPED ACCURATELY FROM A LARGER DEPTH, ALLOW ADDITIONAL MATERIAL AND LABOR. "a aeo 22e 225 SUPPORT REACTION9 (LBS): e.000 1lAXIMUM B E AR I NG NUMBER 1 2 1,750 DOWN 4093 4093 3.500 UPLIFT --- --- . CROSS SECTION MIN BEARING SIZES (IN—SX) ' 1-12 1-12 MAXIMUM DEFLECTIONS t CALCULATED ALLOWABLE LIVE LOAD 0.20" 0.28" - -DEAD LOAD 0.23" e— 6— 0 TOTAL LOAD 0.3511 0.4211 """THIS DRAWING IS NOT TO SCALE landling&Erection Miscellaneous Information LP LVL,LP LSL and CTR,LP IJoist Specifications Software Provided By: 12/02/10 IBC 2006 emporery and permanent bracing for holding component The use of this component shall be specified by the designer of the 'Supports and connections for LP LVL,LP LSL,CTR and UPI to be specific applications. LP Engineered Wood Products lumb and for resisting lateral forces shall be designed and complete structure.Obtain all the necessary code compliance approval and'Common nails driven parallel to glue lines shall be spaced a minimum of 4"for 10d 414 Union Sheet,Suite 2000 retalled by others.No loads are to be applied to the Instructions from the designers of the complete structure before using this and 3"for ad. 414 Union St 37,Su omponent until after all the framing and fastening are component.If the design criteria listed above does not meet local building 'Do not cut,notch,drill or alter LP LVL,LP LSL and CTR,LP IJolata except as shown 19 ompleted.At no time shall loads greater then design loads code requirements,do not use this design.When this drawing Is signed in published material from LP any use of LP LVL,LSL and CTR,LP IJolsto contrary Phone 800.515.7570 e applied to the component. and sealed,the structural design Is approved as shown In this drewing to the limits set forth hereon,negates any express warranty of the product and LP Fax 866.753.4369 , )asi n Criteria based on data provided by the customer.LP LVL,LP LSL and CTR,LP disclaims all Implied warranties Including the Implied warranties of merchantability 9 lgoiste are made without camber and will deflect under load.Wood in direct and fitness for a particular use. he design and material specified are In substantial contact with concrete must be protected as required by code.Continuous -DWG # onformity,with the latest revisions of NDS.'Dead load lateral support is assumed(wall,floor beam,etc,).LP does not provide enaction includes adjustment factor for creep.Total load on-alto inspection.This drawing must have an Architect's or Englneark seal'A COPY OF THIS DRAWING IS TO BE GIVEN TO THE INSTALLING CONTRACTOR SHEET # affection Is Instantaneous. afixed to be considered an Engineering document. lP is a registered trademark of Louisiana-Pacific Corporation. ile:\\fsl\usersWgreenlavALP\Beam Celrs\WOODE.SPX Page 1 of 1 Shea; Sally r From: Lt.. Don Chase [dchase@hyannisfire.org] Sent: Tuesday, November 23;.2010 8:42 AM ' > To: Shea,.Sally Subject: Anchor InnHil All set with plans to renovate 4 rooms at Anchor In{n. ( #101 1"04+ 111) Thanks Don Lt. Don,Chase Jr. FPO k Fire Prevention Officer Hyannis Fire Department 95 High School Rd Ext. Hyannis, MA 02601 568-775-1300 x106 s_. ° T 11/24/2010 mom b mom TOWN OF BARNSTABLE MASSACHUSETTS BUSINESS CERTIFICATE ATE ISSUED: 09/09/2003 DATE RENEWED: 10/22/2007 COOK:189 RENEWAL BOOK: 197 RENEWAL PAGE: 11-080 AGE: 03-253 DATE DISCONTINUED; CERTIFICATE EXPIRES: 10/22/2017 DISCONTINUED 13UOK: DISCONTINUED PAGE: In conformity with the provisions of Chapter One Hundred and Ten(110). Section Five(5)of the General Laws,as amended,the undersigned hereby declarc(s)that a business is conducted under the title below,located as shown, by the following named person,person's or corporation: M0. 1aa X. ANCHOR IN iiAILING ADDRESS: I SOUTH ST HYANNIS,MA 02601 DISTINCTIVE WATERFRONT HOSPITALITY , GEORGE SI P N,T ASURER 75 NORTHWINDS LN W. BARNSTABLE,MA 02669 Signatu THE ABOVE NAMED PERSON(S)PERSONALLY APPEARED P0RE,ME AND MADE OATH THAT THE f OREGUING � STATEMENT IS TRUE. ' TJTLE Identification Presented: or Other: 27-5460277 DATE: March 11,2011 CONDITIONS: 0311112011-CHANGED THE CORPORATE NAME FROM HYANNIS BUILDING&DEVELOPING ASSOC INC.OLD BK 193 PG 07-666, OLD EIN 04-2238763 In accordance with the provisions of Chapter 337 of the Acts of 1985.and Chapter 110, Section 5 of the Mass General Laws,Business ' Certiftoatcs shall be in effect for four years from the date of issue ar d.sha►l be renewed each four years thereafter. A statement under oath must be filed with the city clerk upon discontinuing, retiring or withdrawing from such business or partnership: Copies of such certificates shall be available at the address at which such business is conducted and shall be furnished on request during regular business hours to any person who has purchased goods or services from such business. Violations are subject to a fine of not more than three hundred dollars($300)for each month during which such violation continues. CERTIF N Cl, Si I under i penalties ofpctjury that I.,to the best of my knowledge and belief, have filed all state tax returns and paid all state taxes requir der law Sign ture of 1 dividua or Corporate Name(Mandatory) By: Corporate Officer(Mandatory if applicable) - "• or Federal ID Number " This license will not be issued unless this certification clause is signed by the applicant. ; Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have mct tax filing or tax payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or revocation. This request is made under the authority of Mass. G.L. Cha 62C S.49A. . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ti Map 3'a Parcel Application # Health Division Date Issued Conservation Division Application Fee V Planning Dept. Permit Fee 7"� 66 Date Definitive Plan Approved by Planning Board Historic - OKF-1 Preservation / Hyannis �J Project Street Address �-- Village Owner �er�r-�-c � c-�c^c_ tea, Address t 3 ;3aaS WE TelephoneC� TC Permit Request �. y►,��I cv,".s 1' d G fe)g LN)I ,.� �t�c,' 4-CS016� &VyA-e.r S Square feet: 1 st floor: existing L<Aproposed 2nd floor: existing 1S, :M9 proposed Total new �.• vv�� Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes,attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) ` l av,-LS / Age of Existing Structure ; t4e""� Historic House: ❑Yes ❑ No On Old King's Highway: ❑YesO Basement Type: U'Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) ('fib Number of Baths: Full: existing new / Half: existing new- Number of Bedrooms: existing Onew Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: Vnc/Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes UNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes 0-No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: O,,existing 0 new size_ Attached garage: ❑ existing 0 new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial 2 Yes ❑ No If yes, site plan review# ' Current Use Lcr_t::c� Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name nlnr\� ac.t l Telephone Number Sb�� � "[ Address \�.1� ��a Ck License # � tJG Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO ;�i��>v 6,4 C C S SIGNATURE DATE J`u 12.1i� - 1 h . S FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED ' MAP/PARCEL NO__ s. r� ADDRESS ,1 VILLAGE OWNER i `= DATE OF INSPECTION: t FOUNDATION._ FRAME INSULATION t,y FIREPLACE ` ELECTRICAL: ROUGH FINAL �k _ s , �i PLUMBING: ROUGH FINAL OAS: < ROUGH } FINAL -- — ;FINAL BUILDING4"a £ "t+G'.--: DATE CLOSED OUT ` --- ASSOCIATION PLAN NO. ' The Commonwealth of Massachusetts Department of Industrial Accidents r Office of Investigations 600 Washington Street. t Boston, MA•02111 Y y' wn.w.tnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): m-c Address: Cv . City/State/Zip: Phone #: 0 — t Are you an employer? Check the appropriate box: Type of project(required): 1. 1 am a employer with 4. am a general contractor and I 6. ❑ New construction ptoyees(full and/or part-time).* have hired the sub-contractors , �. ( am a sole proprietor or partner-; listed on the attached sheet. . 7. emodeling These sub-contractors have ship and have no employees - 8. ❑,Demo ition workingfor me in an capacity. employees and have workers' Y Buil ' a i i n 9: ❑ g ddto (No workers' comp. insurance - comp. msurance.t w required.] 5.,❑ We are-a corporation and its 10. �umbing' a1 repairs.or additions officers have exercised their 1 1. re airs or additions 3.❑ 1 am a homeowner doing alLwork., - P myself. [No workers' comp. right ofexemption 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 sliowing 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 thepolicy and job site information. \ Insurance Company Name: ` ` Policy#or Selfins'.,,Lic..#: Expiration Date: Job Site Address: 1 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'. I do hereby ce under th pa�andpenalli f-perjury that the information provided above is true and correct. r ' Signature: Date: Phone#: — FEuseon only. Do not.write in this area, to be completed by,city or town official n: Permit/License# hority(circle one): ` Health, 2. Building Department 3: City/Town`Clerk' 4.. Electrical Inspector S. Plumbing Inspector on: 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." ` 4 MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal ofla license or permit to operate a business or to construct buildings in the commonwealth for any applicant i0o 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-contractors) 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 (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 4-24-07 www.mass.gov/dia C� '��j �enin✓� �Soal Tl�(07 �1.�,� cue QttDR�i'�r2 f pp THE r, ti F F • BAANSTABLE, � ' 9� MASS. Town'. of Barnstable a67q• �� plFD MAC� Regulatory Services Thomas F. Geiler, Director Building Di'visio'n . Thomas Perry, CBO Building Commissioner 200 Main.Street, Hyannis, MA i02601 WTYW.to) n.barnstable.me:ris . Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section ff Using A Builder Y • , ; as Owner of the subject property hereby authorize C�r` to act on my behalf, in all matters relative to work authorized .by this building permit application for: S 0el (Address of Job) Ca Signature o caner Date Print Name If-property Owner is applying for permit, please complete the Homeotvners License Exemption Form`on the reverse side. Q:\VIPFJLESIFORMSIbuilding permit formslEXPRESS.doe t . Revised 07211.0 0 Town of Barnstable ` r�ti ' Regulatory Services " [{STABLE,lass. AThomas F. Geiler� Director .� _ lbi.41*1 Building .Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www,town.ba rnsta ble.mn.its Office: 548-862-4038 Fax: 508-790-6230 --------------- HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: _ number street village ..HOMEOWNER" nn me home phone N work phone N CURRENT MAIL NG ADDRESS: city/town state zip code The current exemption for"homeowners" was extended to include owner-occupied dwellings ofsix 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 IOMEOWNER 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-yearperiod shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. e IlOtv1E0WNER'S EXERfPT10N The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt frorn'the provisions of this section(Section 109.1.1 -Licensing ofconstruction 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 Ilit 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 ofa Supervisor. On the last page of this issue is a form.currenrly used by several towns. You may care 1 amend and adopt such a form/certiFication for use in your community. 0:1WPFILESIFORMSIbuilding permit forms1EXPRESS.doc f_evised 0 72 110 l Massachusetts Department of Environmental Protection ■ Bureau of Waste Prevention •Air Quality 100116670 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition ImpoWhen�filli g out A. Applicability forms on the computer,use only the tab key A Construction or Demolition operation of an industrial, commercial, or institutional building, or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection cursor-do not use the return (DEP), Bureau of Waste Prevention-Air Quality Control Regulations 310 CMR 7.09. Notification of key. Construction or Demolition operations is required under 310 CMR 7.09(2)ten (10)days prior to any work being performed. The following information is required pursuant to 310 CMR 7.09. am B. General Project Description 1. a. is this facility fee exempt-city,town, district, municipal housing authority, owner-occupied Instructions residence of four units or less? Yes ✓ No- 1.All sections of b. Provide blanket decal number if applicable:this form must be Blanket Decal Number completed in order to comply with the 2. Facility Information: Department of ANCHOR IN. Environmental Protection a.Name notification 1 SOUTH ST. requirements of b.Address 310 CMR 7.09 Hyannis MA. 02601 c.Citvrrown d.State e.Zio Code 5087750357 chris@cmdconstructioncompany.com f.Telephone Number(area code and extension) g.E-mail Address(optional) 3072 2 h.Size of Facility in Square Feet i.Number of Floors j.Was the facility built prior to 1980? ✓ Yes No k. Describe the current or prior use of the facility: :HOTEL I I. Is the facility a residential facility? Yes ✓ No �0 m. If yes, how many units? Number of Units -0 3. Facility Owner: �N GEORGE SIMPSON �0 a.Name �0 75 NORTHWINDS b.Address BARNSTABLE MA 02637 0 c.Citv/Town d.State e.ZiD Code =0 5086857067 skipsimpson@comcast.net _ f.Telephone Number(area code and extension) o.E-mail Address(optional) _d CHRIS DOUGHERTY h.Onsite Manager Name ■ ag16.doc•11102 BWP AQ 06•Page 1 of 3■ Massachusetts Department of Environmental Protection Bureau of Waste Prevention -Air Quality 100116670 - - - BWP AQ 06 Decal Number Notification Prior to Construction or Demolition General statement-If B. General Project Description cont. asbestos is found during a Construction or 4. General Contractor: Demolition CHRIS DOUGHERTY operation,all - ._ ._ -- --- _ -- ---- ----- - - -- responsible parties a Name must comply with IRO BOX 70 310 CMR 7.00, b.Address erg and Chapter �02537 Chapter 21 E of the SANDWICH FmA General Laws of c.Citvlrown d.State a Zip Code the Commonwealth. [5082749261 I Ichris@cmdconstructioncompany.com This would include, but would not be f.Telephone,Number(area code and extension) q E-mail Address(optional) limited to,filing an CHRIS DOUGHERTY asbestos removal h.On-site Manager Name notification with the Department and/or a notice of release/threat of release ofa C. General Construction or Demolition Description hazardous substance to the 1. Construction or demolition contractor: Department,if applicable. i CHRIS DOUGHERTY a.Name �----(P.O Box 70 b.Address SANDWICH MA 02537 c.City/Town R d.State e.Zip Code 15. 082749261 chris@cmdconstructioncompany.com f.Telephone Number(area code and extension) g.E-mail Address(optional) rCHRIS DOUGHERTY h.On-site Manager Name 2. On-Site Supervisor: CHRIS DOUGHERTY On-Site Supervisor Name 3. Is the entire facility to be demolished? _ Yes ✓f No N =0 4. Describe the area(s)to be demolished: �o ROOMS 101-108 �N �0 _0 5_ If this is a construction project, describe the building(s)or addition(s)to be constructed: - NO ADDITIONS UPDATING ALL FIXTURES AND FLOORING o �o I. -a _Q ag06.doc-10/02 BWP AQ 06-Page 2 of 3 Massachusetts Department of Environmental Protection ■ Bureau of Waste Prevention •Air Quality 1oo116670 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.) 6. a. If this is a demolition project, were the structure(s)surveyed for the presence of asbestos containing material (ACM)? ❑ Yes Q No If yes, who conducted the survey? b.Survevor Name c.Division of Occupational Safety Certification Number 11/29/2010 2/14/2011 7. Construction or Demolition. a.start Date mmld( d/yyyy) b.End Date(mmlddlyyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding [3 paving ❑ wetting shrouding b. If other, please specify: covering ❑ other 9. For Emergency Demolition Operations,who is the DEP official who evaluated the emergency? a.Name of DEP Official I I b.Title c.Date(mm/dd/yyyy)of Authorization d.DEP Waiver Number D. Certification I certify that I have examined the ICHRIS DOUGHERTY �O above and that to the best of my a.Print Name -o knowledge it is true and complete. The signature below subjects the b Au`tGrfz signature IN signer to the general statutes CONTRACTOR �o regarding a false and misleading c.PoM6-5iTtie _o statement(s). CMD BUILDING AND REMODELING INC. [d.Representing 1--� �-�_ �(D e.Date(mm/dd/yyyy) �o _Q ■ ag06.doc•10/02 BWP AQ 06•Page 3 of 3 ■ - � ✓�ie�onnmzooiu�ea�l�q�.iL�� Office of Consumer Affairs&Business Regulation. HOME IMPROVEMENT CONTRACTOR Registration. 140441 .. . Expiratto ITTi 12011 Tr# 293577 Typee fndssnta ' CHRIS DOUGHERW.> CHRISTOPHER 00kiGHI=RAY :. 4 PAULS LANE = s FORE$TDALE MA 0364 Undersecretary r .=: Alass..clttt'ctte-fl9el3aa;,raattt Q f lattb9is `afell . �c,;trtl i►f-13utf �� • Rc.e�I zt ,< F4 Stataal�rai�. Ask •. _ 4s s r License: CS 83669 Restricted to: 00- .: } : CHRISTOpHER M DOUGHERT j PO BOX 70 x E SANDWICH,MA 02537 znte: 171201L010 11663 ;gs 44 q\�o SUR I OO N g215 b m s` —',ILI -- — g P m® t O I ® I or „A p III III : � I L III II 9 _ I P •® s :® 0n{ g y I n= I F $ i -D - 8k iG 4�� � faisiaip € € 4 �0 9s ECA (n 2 R= Im R $o�� �0 gg s Rgc" $O= s F g 17 "Fn l g 3g8 NPmifi �; e: .. A. g X p a° H mogo F �m � m= g Vm o s R ° e n o n D m = o o m o PROPOSED RENOVATION e.q M for �onSery ke r v o' p w ANCHOR IN HOTEL Group Incorporated N ~ C >C z ONE SOUTH STREET 2277 State Road Suite H r- 0 ..o..�...° .�. Pl--th MA 093R0 i 3'-6- omi / n >r k u. c n o 2._6. 0 om m �am� (n 4n z ^qo3 �aPn i a Fad" z gg10 _ p p �g > > = r o o a PROPOSED RENOVATION ConSery m for r m .4 = Q ANCHOR IN HOTEL Grdup Incorporated m R[ ° N 2277 State Road Suite H r c ° ONE SOUTH STREET Plymouth,MA 02360 O > W HYANNIS,MA W Z Tel:508.888 6555 run nv�rvmcvv TYOICOlv[YV Ga0UI6vM[IOMT[O I �� a�zr.' •:�.. . �� � � �� � I (� S � J 1 �. � � r ram® E OM :NORFIELD ASSOCIATES FAX NO. :4014311571 Oct. 09 2008 01:21PM P1 NORFIELD ASSOCIATES, INC., INSURANCE INVESTIGATORS'and ADJUSTERS .1240 PAWTUCKET AVENUE, 2n4 FLOOR EAST PROVIDENCE, RHODE ISLAND 02916-1427 TELEPHONE: 401-431-15 52/FACSIMILE: 401-431-15 71- FACSIMILE TRANSMISSION f":001 . Company: Barnstable Building Dept. .Attn: Robin 16'X440M-- Name: Scott Handren Date: 10/9/2008 RE: Insured George Simpson, Hyannis Building & Development Assoc. Claimant: John Beattie D/L: 7/13/08 Your File: Our File: 7-663-219-1 Number of 1 (includes cover) pages: Good afternoon Robin, I am a claims adjuster from Norfield Associates, an independent insurance adjustment firm hired by Mr. Simpson's insurer,the Essex Insurance Company. I am investigating an alleged fall at the Anchor Inn. on 1.South St, Hyannis, MA, I am.requesting any citations.or violations for the property, as well as a building permit for the rear exterior slate path and stairs that were constructed by Rob Donaldson. If there are any inspection" reports for these stairs after they were completed, please include them as well. Please.feel fine to contact me at(401) 431-1552 if you have any questions.'I appreciate your assistance in this matter. Sincerely;. Scott Handren " THIS FACSIMILE CONTAINS CONFIDENTIAL INFORMATION WHICH M.A.Q.' ALSO BE LEGALLY PRIVELEGED AND wHICH IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY NAMED ABOVE. IF YOU ARE NOT THE INTENDED RECIPIENT OF TI RS FACSIMILE, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING IT TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION, OR COPYING OF THIS FACSBULE IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS FACSIMILE IN ERROR PLEASE NOTIFY US IMMEDIATELY BY TELEPHONE AND RETURN THE ORIGINAL TO US BY MAIL AT THE ABOVE ADDRESS. THANK YOU. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION, Parcel �l . Permit# _ s-1 �-y h& ',h Division lf/ Date Issued © (. Co servation Division A/" = rI Di' Fee 6 � Tax Collector Treasurer Ct�� rc r. L ® i!NCOMPLIANCE V711 H TITLES Planning Dept. EN-VIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TWNIN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Ad �Gl /drress 1-506t �7L Village / A yl/1� S c Owners /�� f � Address 1a:;Z, Coco��y C/�� Kam, v �vi Telephone ,�d-, _ Permit Request 61 �4`J'10�� � �v�j ��/S�i�� / ciccZ��y S LND � e Ski-i'�!7 cl Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District _Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathored: ❑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: Cl Yes ❑ No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) s 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: O Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:Cl existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded Cl Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use � BUILDER INFORMATION Name 104y 7©rnt,171, ,a .�.,g, Telephone Number 64A Address D Zbx a'Z o T& License# dSQ /57 7 re, Home Improvement Contractor# 'lD9�O D to Worker's Compensation# lit/C S -0/a,2.. 7 7 P ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO F' ee_ cS�Ul�L SIGNATURE DATE TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION " Map Parcel � � pplication# Health Division Date Issued 00 Conservation Division Application Fee 00 Tax Collector Permit Fee Treasurer r Planning Dept. � yi ' Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis l Project Street Address dV"•e11 �— Village Owner Qe.cAC cA Mein Address 0^^ L Telephone •mac. Permit Request I .< ` t i.tlri �° . n Square:feet: 1st floor:existing`- �_6�) proposed 2nd floor:existing proposed'—Total new Zoning District Flood Plain Groundwater Overlay Project Valuation I , Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) 11 �•S Age of Existing Structure Historic House: ❑Yes UkNVo On Old King's Highway: ❑Yes to Basement Type: ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 2C,3r; Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new .�� ~ Half:existing j =new .{ Number of Bedrooms: existing new Total Room Count(not including baths):existing ( new First Floor Roorn Count`''. Heat Type and Fuel: U Gas ❑Oil ❑ Electric ❑Other i r Central Air: es ❑No Fireplaces: Existing —� New Existing wood/coal stove,-❑Yes W-N -d hed garage:❑existing ❑new sizeA/ Pool existin ❑new size Barn:❑existing ❑new size Detac g g g �_ 9 Attached garage:❑existing ❑ new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial es ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION 1 Name Telephone Number T> 2 �`��" C12�f Address o License# /J Home Improvement Contractor# AZI rj -z"f 2 Worker's Compensation# 1121 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO inL(��— �t SIGNATURE DATE �2 /�'� r n TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map __2->R 4, Parcel // i Permit# A� - Health Divisions/ v"e a Y { Date Issued _ �r 7 Conserva4ion Division /C+11C. 12-ool Fee Tax Collector ti, ,� �;( (��I �(� � '� > pMCANT TiAU 1 OB'1�IAt c ; Treasurer. ", i' ��y / Coi�iniRCTIO e FEW aR^ii �3CIyi s, :c1�IC DTVISIui4 F"Ri6A Planning Dept. Date Definitive Plan Approved by Planning Board - Historic-OKH Preservation/Hyannis, Project Street Address J C'`' 1 S' Village . �,'c s ��r3 Owner _ P �a �,� �- s � �) -, s� Wt Address Telephone Permit Requests z� j Square feet- Ist floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District, Flood Plain Groundwater Overlay Construction Type Lot Size Grandfatliered: ❑Yes ❑ No Ifyes, attach supporting documentation, Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other . Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing . ' new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑new size Pool: ❑existing ❑new size Barn:O 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 —5, Z Cl -2ify Telephone Number Address 5 7 s 2- License# C S t 3 G ?c/ CIL ►� �- �`� Home Improvement Contractor# ) a 0 Worker's Compensation# ALL CONSTRUCTION.DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE i TOWN OF 13ARNSTABLE BUILDING PERMIT APPLICATION Map Parcel- �. Permit# Z1 j Iea44-9iisfen Date Issued �a�se+�a#te►�8+visic3n- n / Fee Tax Collector Treasurere' -/—:_4— - <-... Date Definitive Plan Approved by Planning Board fi Hester 8}�# P49&& 4onA4yamis Project Street Address ff r c- S0t,t.i .Village `i"` A 1 � zn� y 1Owner p Address ` PI Telephone Permit Request fF�Cw)a I .r��;�( ��i^ > C �1 � IDS Cne�t� �a�a� D 77;ooC ,y l Al C17 bul i &I D04 Square feet: 1 st floor: existing proposed 2nd floor: existing r proposed Total new Estimated,Project Cost 0-D Zoning District Flood Plain /`- Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes W,<o If yes, attach supporting documentation. l� Dwelling Type: Single Family ❑ Two Family ❑ Nfu ti-Family(#units) Age of Existing Structure Historic House: ❑Yes G3< On Old King's Highway: ❑Yes Basement Type: ❑ Full ❑Crawl 0 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 0 No Detached garage:❑existing ❑new. size Pool:❑'existing ❑new size Barn:0 existing ❑new size Attached garage:O existing 0 new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded Cl Commercial C�'Yes ❑No If yes, site plan review# Current Use Proposed Use -scu ilf- ' n BUILDER INFORMATION Name ( ; Q ,�. �� �, ,rp; ���� r!i��� Telephone Number 5 Address�� �S /VC �cI��d/�jAf K�m License# ( �r7,;?�j (. J l�7T f J r, -2- �,, S' Home Improvement Contractor# f/ C � Worker's Compensation# ' S ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO � � SIGNATURE �., / %. DATE TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ✓ Parcel Permit# l � Health Division CC) Date Issued Conservation Divisi /�' S, �T- Fee Tax Collector Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board � 10 -Historic-OKH Preservation/Hyannis - 7 ,jam 0 3-�_7 Project Street Address0tJe So(? i 4 5 r Village t� lq tJ a 5 Owner 4AJ&H 0'(- ' (J AR4 AtJ11J Address Telephone T? � 5 t Permit Request �0 Ili j T P'-111)CI {10 Iv`,t- f?""OM M Sty i,, 2 N", S l IVL J Ci - = � Square feet: 1 st floor: existing proposed 2nd floor: existin` proposed To al new Valuation 3'3,oi Zoning District . L Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age o' Existing Structure �S Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: }-Full ❑Crawl t alkout ClOther Basement Finished Area(sq.ft.) )6�Okt5 CQ Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing 0 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: Cl Yes )(kNo Detached garage: ❑ existing ❑new size Pool:❑existing ❑new size Barn: ❑existing ❑ new size Attached garage: ❑ existing 0 new size Shed:❑existing ❑ new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial 4Yes ❑ No If yes, site plan review# 45 Current Use �i� rrE Proposed Use ✓ BUILDER INFORMATION t Name M d � C ���` Telephone Number �d Z o' �'1 3 Z Address �s Lo r`- Pc1 t\ln License# 0 7`2 S-3 + 1/sA I Ls ( Home Improvement Contractor# I Z 7 Z 1 --( Worker's Compensation #`-XC/ 3 5 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO cc, 2i 61(z ' DATE SIGNATURE .U � � ' Assessor's map,and lot number .....,rL " ., r J _ *THE Tob Sewage Permit number BARSSTADLE, i House number .....:............. 9�C ub 9 e�0 �0 MAI a\ T®WN OF,,, BARNSTABLE `'pry UUIL® I 0 IS �. APPLICATION FOR PERMIT TO .............. ......... ......... .............................................................. TYPE OF CONSTRUCTION ...............11.e14.1 `.. .............. ................................................................ ................ ................ ..:..... 19...%':.: 's TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......................'a .... ..tit .............. �. ._. �.. . '. .. 3....r a .... . ...;{..i. S i s °.� ;r I ProposedUse ...........................Ar4t. '.....{::.::................................................................. Zoning District Fire Distract . . Name f ......... ................... ....... ..... .. . ..... A..... .. ............. .:'. .... ..... ..... ......r.�.r ......! .`.. .........o Owner �' %; ' .Address �3 ° 'e; Name of Builder .....................................Sz. � .....a...............:...:Address ....at,° ....... ."...:�'..?:.. ......: rr f:}..:..... ........... .. Name of Architect ..................................... �� 1,'�' r` /k.3 / rr ` U'! .................. ...................Address ............................... ......... .. Foundation ............... Number of Rooms ' .:. :....:f :.... .:.:.......................................... Exterior ........... .E.;:?.'r .........` 1 ::"� �...........................Roofing ................Z. t......:.................................:.... Floors ....................... r..:: .'a. .c` .......... .. ..........Interior .................:....:.!w� : ......j 2.11�..... .............................. gHeatin 6 ,t F r Plumbing 3 ........................... ...... .. ...:::....:........: ......::..... .. Fireplace ......................f�. a.•�w.......... .........................Approximate Cost ............ •• f.'.�9,.. ......... ........... Definitive Plan Approved by Planning Board ---------------___-----------19________. Area .......: ..................i............. Diagram of Lot and Building with Dimensions Fee �.15'1.' ' SUBJECT TO APPROVAL OF BOARD OF HEALTH s 4 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: Jr> f. .i ...ar - F�a t Construction V � , Super isor's L tense e ' e --Areessor's office(1st Floor): _ Assessor's map and lot number ,f{7 � ' 7 TWE P TD`y Board of Health(3rd.floor): Sewage Permit number `O Engineering Department(3rd floor): Z DAS39TGDLL i House number 'mo rb 9- 7 _ Definitive Plan Approved by Planning Board 19 �o*At b. APPLICATIONS PROCESSED 8:30-9.30 A.M.and 1:00-2:00 P.M.only TOWN OE BARNSTABLE BUILDING I -SP CTO APPLICATION FOR PERMIT TO f TYPE OF CONSTRUCTION -- 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location J�_-f/ Proposed Use 7 Zoning District_ Fire District Name of Owner vf�, -��,�/L Address Name of Builder � ,1������f Z4,'41 Address�4 1i ,1i / 7 Name of Architect ,L5_ Address w' =,r-"e Number of Rooms ,L 2 L)L-z,/5 Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost Area Diagram of Lot and Building with Dimensions Fee ,AV 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 Construction Supervisor's License 1521 4z f s office(1st Floor): 326 lot 119 ,dr's map and lot number p moo`1ue TOE .rd of Health(3rd floor): eWQ^� ♦� jewage Permit number i BAHd9TSBLL Engineering Department(3rd floor): MMa House number °o 1639. i" Definitive Plan Approved by Planning Board 19 0 rnr a• APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-.2:00 P.M.only A A P P R o v. TOWN N ® F - BARNSTABLE j;rnsb;1e Conservation Co rnis' 0011.01 'rMG INSPECTOR tCATION FOR PERMI>Da'M Rebuild existing buldkhead, dredge 200 cy TYPE OF CONSTRUCTION Wood frame with piling and timbers CCA treated January 30 19 90 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 1 South Street, Hyannis, M A Proposed Use` Zoning District Fire Disfr ct Name of Owner Rexford Arnett Address 1 South Street, Hyannis, MA Name of Builder Gillmore Marine Contracting, Inc. Address 381 Old Falmouth Rd, Marstons Mills, MA Name of Architect NA Address Number of Rooms NA Foundation NA Exterior NA Roofing NA Floors NA Interior NA Heating NA Plumbing NA Fireplace NA Approximate Cost $65,000 Area Diagram of Lot and Building with Dimensions Fee 30 Replace existing approx. 140' of bulkhead, dredge approx. 200 cubic yards OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS a hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding'the above cods ru tion. Name ` Co strr ction perviseeUcens / s; o� ..�•Utyy u v rr Asa .4r"x "a L",LjAu *Permit �^ Expires_6 months from issue date` EAMSrABM MASS Regulatory Services, Fee �b 1639 ,�� Thomas F. Geiler,Director Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601w Office: 508-862-4038X-PRESSRERMIT Fax: 508-790-6230. EXPRESS PERMIT.APPLICATION MAR 1 6 2001 Not Valid without Red X-Press Imprint TOWN W O BA R TAB L Map/parcel Number Property.Address` Residential OR Commercial Value of Work o �y Owner's Name&Address J r L { �fS 4 .?7cc, J; 7- Contactor's Name C 2 rz A " /T Telephone Number Home Improvement Contractor License.#(if applicable) Construction Supervisor's License#(if applicable) 0 3 (� Workman's Compensation Insurance Check one`: ❑ I am a sole proprietor 1 am the Homeowner 9-1'have Worker's Compensation Insurance Insurance Company Name 1 -; \Vorkman's Comp. Policy# / Pei:nit Request(check box) Re-roof(stripping PP '; old shingles) " I.S Re-roof(nor stripping. Going over existing layers of roof) Re-side ❑ Replacement Windows. U-Value (maximum.44) ; Other(specify) 'Wnerc required; Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation.e(c. Si2narure expmtrg Assessor's office(1st Floor): d, ) Assessor's map and lot number —&A 1/1 / "J �Of THE>0` €€Board of Health 3rd floor): E; ai=� Sewage Permit number f/— �-�O `� ss ��' `ZJ�►9 Engineering Department(3rd floor): , U = DAH39TULL House number � l �C/ j 'oo rb �� a oj+ Definitive Plan Approved by Planning and tg �p any d` APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M.only TOWN OF BAR.NSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Proposed Use Cv/`I Zoning District Fire _ District ..%,� ,Name of Owner- fa L72C � ,� .--� . A - Address Name of Builder Address r: r Name of Architect t ' - 1.1 Address Number of Rooms Foundation %/�`✓ 7 �i;...d�� Exterior I ,r.f,e1_ r��✓,,%�- � Roofing Floors . .,- -- --- - — Intarinr f.a Heating_L I, -fir�y✓J s� i/j-/ 7 Plumbing _^l J ✓� � 4� Fireplace Approximate Cost 1 7S� r Area Diagram of Lot and Building with Dimensions Fee 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 + Construction Supervisor's License P, 1 ' Communication Result Report ( Oct, 9., 2008 2:38PM ) 2) Date/Time : Oct, 9. 2008 2: 31PM File Page No, Mode Destination Pg (s) Result Net Sent -----------------------------------------------------------------------------------------=---------- 9860 Memory TX 914014311571 P. 11 OK ----------------------------------------------------------------------------------------------------- Reason for error E. 1) Hang uD or line fail E. 2) Busy " E. 3) No answer E. 4) No facsimile connection E. 5) Exceeded max. E—ma id s i ze 140WIELD RSSOCI:PTES, FAX NO. :a014311s71 Oct. 09 zoOB 01:21PM Pi - NORFIELD ASSOCIATES,INC., w. INSURANCE INVESTIGATORSand ADJUSTERS - - 1240 PAWTUCKET AVENUE,211 FLOOR EAST PROVIDENCE,RHODE ISLAND 02916.1427 - TELEPHONE. 401-431-1552/FACSIMILE: 401.431-1571 - FACSIMILE TRANSMISSM Company: Barnstable Building Dept. 'Attn: Robin b4 Names Scott Hwdren Date: IO/9/2008 RE: Insured George Simpson,Hyannis Building&Development Assoc. Claimant: John Beattie D/L: 7/13/08 Your)File: .. Our File: 7-663-219-1 Number of 1(includes cover) pages Good attemoon Robin I am a claims adjuster from Norfwld Associates,an indepcndcat insurance adjustment firm hired by Mr. Simpson s insurer,the Essex Insurance Company.I am investigating an alleged fall at the Anchor Inn on 1 South St,llymmis,MA lam requesting any citations Or violations far fix property,as well as a building permit for the rear exterior elate path and stairs that were conshuetai by Rob Doaaldsom If there are any inspection reports for tbese stairs after they were cmnpletad,please include them as well- Please feel fret to contact me at(401)431-1552 if you have any gmestions•'I appreciate your assistance in this matter. Sincerely, Scott Ilandren TUM FACS11ME OONTAINS CONFIDENTIAL INFORDIATM W=H MAY ALSO BE LEGALLY PRIM WED AND VAWH 18 IITIEN➢ED ONLY FOR THE USE OF THE INI11V MAL OR ENTITY NAhM ABOVE.IF'YOU ARB NOT THE . 114TENDE D REC PIENT OF TIDE PACSWLE,OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING Tr TO TH&INTENDED RBLSYTL NT,YOU ARE 1EERMY NOTIFIED THAT ANY➢LSSEMINATION,.DtSTRMMION,OR COPYINO OF THIS PACER=IS'STRICTLY PROMIrEO, IF YOU HAVE 9ECEIVED THIS F'ACa aLE,IN ERROR PLEASE NOTEFY US Da4aOIATELY BY TELEPHONE AND R6ITIRN THE ORIGINAL TO US BY MAIL AT TIM ABOVE ADIIRM.THANPLYOU. - P; t' OM :NORFIELD ASSOCIATES FAX NO. :4014311571 Sep. 30 2008 11:32RM P1 NORFIE LD ASSOC , IATES INC. INSURANCE INVESTIGATORS and ADJUSTERS 1240 PAWTUCKET AVENUE, 2nd FLOOR EAST PROVIDENCE, RHODE ISLAND 029.16-1427 - TELEPHONE: 401-431-1552/FACSIMILE: 401-431-1571 FACSIMILE TRANSMISSION -� 0 • Barnstable Building Department TO. Company. g P Attn: Robin w c.� FROM: Name: Scott Handren Date: 9/30/2008 RE: Insured George Simpson, Hyannis Building & Development Assoc. Claimant: John Beattie D/L: 7/13/2008 Your FHe: Our File: 7-663-2.19-1 Number of 1 (includes.cover) pages: Good afternoon Robin, I am a claims adjuster from Norfield Associates, an independent insurance adjustment firm hired by Mr. Simpson's insurer, the Essex Insurance Company. I am investigating an alleged fall at the Anchor Inn on 1. South St, Hyannis, MA. I am inquiring about any citations or violations for the property, as well as a building permit for the rear exterior slate path and stairs that were constructed by Rob Donaldson. If there are any inspection reports for these stairs after they were completed,please include them as well. Please feel free to contact me at(401)431-1552 if you have any.questions with regard to this request. I appreciate your help in this matter. Thank you, Scott Handren THIS FACSIMILE CONTAINS CONFIDENTIAL .INFORMATION WHICH MAY ALSO BE LEGALLY PRIVELEGED AND WHICH IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY NAMED ABOVE. IF YOU ARE NOT THE INTENDED RECIPIENT OF THIS FACSIMILE, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING IT TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION, OR COPYING OF THIS FACSIIbff LF, Is STRICTLY PROHIBITED, IF YOU HAVE RECEIVED THIS FACSIMILE IN ERROR PLEASE NOTIFY US IMMEDIATELY BY TELEPHONE AND RETURN THE ORIGINAL TO US BY MAC AT THE ABOVE ADDRESS. THANK YOU. � 1 710 l 2�� 12/20/2001 1E:40 5087751313 ANCHOR IN CAPE COD PAGE 01 :c ch® fi I Distinctive Waterfront Lodging on Cape Cod One South Street • Hyannis,,MA,02601 December 20, 2001 Robin C. Giangregorio Town of Barnstable Site Plan Review C:oordi.n..atw Subject: Managers apartment: Project summary: The project consists of converting a portion of an existing full, walkout basement space. The space will consist of a living zoom,bedroom,baduoom and kitchen. The space will be used as a Managers Apartment. Parking: The project will not have any effect on our parking requirements. The project will not generate the need for additional parking requirements. We operate during the Summer at or near fail capacity on a daily basis with open parking spaces. Exterior Changes: I have enclosed a drawing of the South Elevation. The exterior changes will include: 1. The addition of a sliding glass door which will provide natural light and serve as a third exit/entrance point. 2. The extension of the existing deck to cover the area in front of the new sliding glass door. Additional information: 1. We axe not in.the Historic District, 2. The project is not located within 100 feet of the water. I have enclosed a floor plan and a copy of the South Elevation. It would be my pleasure to walk you tbrougb.a site visit and answer any Questions you may have. Tcorge y "Skip"Simpson Tel: (508) 775-0357 • Fax: (509) 775-1313 • ;Email.info0anchorin.com •web:www.anchorin.c(.)m 12/20/2001 16:40 5087751313 ANCHOR IN CAPE COD PAGE 02 LAM 74AOI� ................. 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'\`. y. ,.•vh,k� -'+'�`:. 5'Srr: "�',�' .a.; :J+,,,f.. �5,:.. :i,'>•,!.-:4;u" ''<' ir::,:,.',., �.f. ., �(' �', �, 'r`..�r-,'g.;...:,• ...•,.;..•,'x' '',"'' •3,1'�/' "�' f";r:,,. „'xe;•�jt!u ( :,r y'�fF�MK` ��,,"v'" 1 FL.:,Ado+,r.. ,r�i:.F' chi• 5..� .;�i'; :1ti;,,.;tz'�:. .e 1 ",., � � ,.:-• +.f:.5..• -..,r ,,:._. rv� ,� �,., '.f�' .r.pk�'r-.'d; �' � J ,"!Y> r.a•::•'.J �.,' tl•✓ . ry • - ^ 'I: ,'�. .:, .�Aa:�.'!."e.:..•.r:�i!�+.�M-TV.•.�.:;��1::::.,ti u;"4'.�'iY�'Le �-rN�V-;':� .n .:�.�/ - : ����1��::` `54��, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION (P Parcel //� Permit# 5 �/ h Division lU �� Date Issued a o ervation Division J11,31, DI Fee 57(o ax Collector SEPTIC TIC SYSTEM FAUST BE Treasurer_ %- � �—e-y ���,Gl�) l INSTALLED IN COMPLIANCE WITH TITLE 5 Planning Dept. ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS r Historic-OKH Preservation/Hyannis 6 Project Street Address ��G�—�l'I �7l Village n/11 S /� /�Gt V, �Gc✓1�,. C/c� ��, �i�i Owner �� f Address y Telephone Permit Request �G1 Oy Z17 let,16<'k� �i�R AUAI ll' AND ;?e U s c �A o de AND feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size 9 CG�'e 5 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 Y 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 0 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 - � Telephone Number Name� v �ofi 'g• e one umer #�_ �foZL�j Address O• ZinX aZ o JZ0 License# 6?5'0,�457 7 Home Improvement Contractor# Worker's Compensation# j yt/ '0/a�?- 77 6- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. } I f DATE ISSUED `" f MAP/PARCEL NO: ADDRESS VILLAGE ? i OWNER T f; DATE OF INSPECTION: FOUNDATIONS o f FRAME F INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL i r: PLUMBING: ROUGH- • FINAL GAS: ROUGH FINAL ' FINAL BUILDING , DATE CLOSED OUT w" ` 3 ASSOCIATION PLAN NO. t i ' �i yy • T ( 1 1 f The Town of Barnstable BARNSIABLL 1659. Regulatory Services _ rEOMat16 Thomas F. Geiler, Director c Building Division Ralph Crossen, Building Commissioner h 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax:' 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion. improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. 1 Type of Work: re m 76 Estimated Cost o2�� 00 Address of Work: Owner's Name: Date of Application: I hereby certify that: ` Registration is not required for the following reason(s): ❑Work excluded by law OJob Under$1,000 ]Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav LIVING SPACE - (high end construction) square feet X$115/sq. foot= (above average construction) square feet X$96/sq. foot= (average construction) square feet,X S57/sq. foot= GARAGE (UNFINISHED) square feet X$25/sq. foot= PORCH square feet X$20/sq. foot= DECK square feet X$15/sq. foot= , ' g?`�•�� OTFIER square feet X$7?/sq. foot= Total Estimated Project Cost For Office Use Only /nCAlsionary Affordable-Housing Fee Residential Commercial** Property Owner's Name Project Location Project Value . P 't er "Existing Sq. Ft. ** posed New .Ft Fee$ IAHFORNI 113100 The Commonwealth of Massachusetts s - = Department of Industrial Accidents Office oflosestigatieos 600 Washington Street -= T Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit i ci (� Of^� hone# < ❑ I am a homeowner performing all work myself. ❑ I am a sole prolprietor and have,no one worldn in any capacity I am an employer providing workers' compensation for my employees working_on this job. omnany acme• t ,- .:... ...:::.::..:.::.:.:.:.:..::. ..:.::.:::..... address . - ...............:..:::. ... .. ........ ..... �......._.............._.., .:. ..................... ... h ::,::: insurance co _ :.; olicu# ;"jmdi ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who . have the following workers' compensation polices: :cam an name: . ................................. h ::.............................................:..:..........................:::.:.:::::::;•;:...........................:..... ................................. ::.. :..:::::::::::.:.. ........:::.... l.. }. .......:.:...:.:......:......:.:....... .......... .....:•:::::::::::................................................... .SJi:.....:U.v4iiiiXi+.ii:::•i:::iii:<•:iiii::::;•iY.i•':::�ii:0:•.......:}r';. ^'S•: ii';.�::.�::iii::v:::-i'-ii:hi:i:•:; .................................. nv::.�n.......:.:...... ' ::/►::::i':: :::!;isi;i:;::i::::.::::: ::::::::::::::i::i:::::1 `i::::jS::::::::':::::: isl:.::.:.ii:<.::: ^':::i:::::i:::: •:.�:.....:.....::..':':i'ii •:::::.iii:i•i}i:• +::S+•: i::•ii::.i::isisSi+..:.;}is�::iiiii•::.iiiii.;:::{;{?Y.<} � ::i<.vi:v.:.+:-X;ii:i:;:;:+i':%+:i>.�?' Ol�� :. :address: ' ;: ,> ti be :<..><: : Yy;:>.::•:i:::;}}j::tiff:iFi::i;:j;:;:; ............. w::::::•:::.�:•:::::.:::::::::.:.::::::............:::::.�.�:: .......:.. :.i'•iiiiii::•w:::::::::: :::: -:v:•:::::.:......... ?:iJ`iiii:S ii:v:v:i iii:':r i: .i:i>.i:^:;::'iiii:.; 7= ...j{ :::.:::::!:i^:i•iiiJ.^Y::is^::.; :..;..,...:i:i;;:i::::'i`?::i-?i si;:;;:;::":%ii:iiii<`?isi; •:;iii::'i x, o ..#• < emrancc ca.:.:: ...... Falb we to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a Sae up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify he paws p es of perjury that the information provided above is tnw and correct Signature Date Print name Phone# 17W - offlcial we only do not write in this area to be completed by city or town official city,or town: permitilicense# ❑Budlding Deparbnent LjLicensing Board ❑checkif Immediate response is required ❑Selectmen's Office OHealth Department contact person: phone#; ❑Other Uniud 9/95 PUq Information and Instructions ' Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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, an individual,partnership, association or other legal yentity,employling employees. However the owner of a dwelling house having not more than three apartments and who resides therein;of 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. V MGL chapter 152 section 25 also states that everystate or local`licensing agency. allwithhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the coinmonwealth'for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,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: ,�`'• _ ° u'R s �,* .�� . A^ Applicants " Please fill in the workers compensation affidavit completely,by checking the box that applies to your situation and `x an names,address and phone numbers along with a certificate of insurance as all affidavits maybe :ry, ;;�, �,• submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign an date the affidavit.. The affidavit should be returned to the city or town that the application for the permit or cease is supplyingt ., of Industrial Accidents. Should you have any questions regarding the"law"or if you being requested, not the Department ' are required to obtain a workers compensation.policy,please call the Department at the number listed below. FIII� 7a����;1 City or Towns Please be sure that the affidavit is complete and printed legibly. The Departuicait 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 permitllicense number which will be used as a reference number. The affidavits may be retuuned t'n the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The D artirient's-address,telephone and fax number: �- ep The Commonwealth Of Massachusetts Department of Industrial Accidents ortice of Imtesduallons 600 Washington Street Boston, Ma. 02111 fax* (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 f JUL-10-e-UUU 1Ut 1U.[4 tlfl KUI&V.NZ&1 6 =J1tl'MUn rHA Mi. OW M1 04ot r. Ue Pu • iz..y+::.Y=.> ..C.a•;e•., c:: .•._. o+ r<.,y07/.18/2000 (508)FSTENDA6 xFAX (308)991-s462 ON,YANDDCONFERSNoR1GNTSE1Pp1+ITHECERTIF[CATE UtKOhISKI b K6STEN8AUM ALTERB?HTE =pCFRPia COUNTY S aEtT P BOx soil H GEODOTAHMEENODL.IECXIEPSE BELOW. RW. COMPANIES AFFORDING CO1 e"GE NFIt BEDFOkfi, NA 02792-S911 COMPAN11 Maryland Insurance Company 'k0nt Fatima Rei6-Costa Ext; A A T Enterprises Inc COMPAW Legion Insurance Company B No Box 2056 . . .. ... . . .. .. 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OFSfxt6Ep POLtC1E$ilE t:ANCktLEO BEFORET}tE • k7iPJAA110gCl1TET11ElZBOF.TIN:IS�KGCOl6PAttYViM.LENDEAVOATOAWtt _3 0„DAYS WHT M NOTICE TO THE CS%TW LATE HOLO£R NAMED T OTHE LaT Off FAR.UK TO Aft St"MMSHALL If1POW NO OOLtGATWN OR UAWAY OFAW14*M)NTHECONpANy,ITSA6EP(t5ORREPRGSBYTAiNE5, Torn of Barnstable A o , 64NTItT1YE� < '� to<✓-''.•'::-fit ..� •;'? s 'ION 1-:.. ..3 %'�r•e`; "" e,.:x.s>,t. �s`:� .t.`- i. azers•n�_: i2A r . T30ARD OP•BUJtDi1iG REGULATIONS CONSTRUGnONI SUPEWSOR MUM= CS 050457 ......... , . E�hss:04/191 OQ Tr.no: 21346 RsatrkEed TO: 00 PETEit M POMETTI PO,SDX 2056 Gam.•- � GQTYtFT, MA a26TS ✓,fie'P�umonuaeall�a�.ram i Soi d of S-j&ft Regmed ow i mi Saadw& RO1S IAVROVCJP NT CONTRACYOR Regbttww.' logm Lgpratiwr ogaiRQ02 �/px PRIVATE OORPORATON A!EPiTERPRIM SIG PEM POMETT i4ORIVER RD ♦ _�._ __ i J � ,; 'I /1) } t � j k � 4I� L , . , / yy Z lv'°, l�' � ..__ N^�... 6F��iNy...�(.\,4N.Gy_.�./rr"L—i�RMJL...�•n'��. .. j. � 1 � Z� 11 -- i 1 i•.o.. .. ri 1 �erok, ,r.o o w— —41 r� . 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W.Ts 6D i q,e-a AR..' e4,Deo N t d p♦ I '7' k =j 7 _ � • Nb.PIE.+o N'.MMtFs TmN r�~,•s7 ;n�v�•s I i i W WD ffft PAZY11I4.. r ®' ,ar .�•' ' M P34J,PED - Sy r CSO WITS) 1.G Z wUNf .� • U � PPyJ�ns� - U sIAt.Gs { i. \ / K oTY yP v� FLJATiws :.bNN xe CMSti aJ vU.�0.(.yfl WA ✓y (\ [� �•t- 1 z.Th rW to M.ea orl DIfuUMr�w F.H ro1Fl4-z ItANh J3 • GA+YI w A.J. , - AW KO AT PEfl�r Irs CWIM`I,A+xJol w THE S Z 1 I GAW yr LVI60k.4 ® y Q R ,� 9. `ttaE mr..K-%A.s4..7w--lb Is,.i:.ww,. /dawr-IywNs sn.I s a z tur_u[x ' qr M. PA"` o y � 1.fiTJRE wcf IN T11G .IMVlMNT ACPA Niw Crf6ND N•i'e� 1�MT1�- G u`- ' YfMAfiW AUN4 ✓BAvWu_- I � _ rj,(9� )jv11AD,.l r. DSTAy.}I INTaF.o0. N1D r,(rQIOz N XrT I y Di•�15nNs,ANO 6M W,Nb O.ESv A�� ND U2)'y�,_ AKS .WI/. i G�n� AacMlrb.T D A-I,A-2,A-S rersrl... � Q � nNO A-4,1 A-4,% A-4I313 , r > tl I N!. � Itrr w� •1`w1Or Chi ACT.NAty. 1 " TAAMYD !RD•6s Atip 7- l , - LNNJ WC FEtXE '.fie ' T•e4c'JLIT PAIII. FtNtb Ing tm WAIM GATSMr r"FtrIE 1'wJ JAR 2 1b Ib.en v J+Ti-A nu.ir ARN NM40.E CsVt2. I C-1-Ce NIT AL 1 AT I I O LVrN PA" No. MTO xu ION ; 1 I I +�-mrw wuce.E B.ua lb— RAN o P �kJo • // .Te 1 AT1111a - . I / � ypT ra<Mnw A`IJ!7K :n Ho TEL 1 GCA+srP ARGA O /r euwNt,4 ex T .?Av4 9w.E ice•20 b6 No. 1392 '�, i �' dYANNlS 'NaRao� ICI / t. -wm'- ,.EJ�. lyCa�•fi WAGN6G�.bocY'iEs / ._..____'.__ _. _.. ee4 A9sT rq-..: ��T �,as:•i•E.y14 Gz,:!v2 COMMERCIAL ADDITION/ALTERATION l �`��...Sv Letter of Approval from Site Plan Review(if necessary) If located in OKH or Hyannis Historic District - Certificate of Appropriateness required ❑ Plot Plan Map &Parcel number r Full Description of project(U-value of replacement windows if applicable) If sprinkler or fire alarm system is required, do not accept application pack without prior approval from Fire Department(phone call or in writing). Sign-Offs from: p Health C [D/ Tax Collector j C Conservations I [� T surer ❑ If ZB relief(Special Permit or Variance is required for project: ( py of Decision ocumentation proving that the decision was recorded at the Regi of Deeds w/in one year of ZBA decision date. (�p Street address of project ©� Correct square footage C,J R c o Q- kA1- 01— Estimated Cost g,(Q ao©f Owner's name & address y A-)IDVContractor's name, address & telephone number l C Z Contractor's signature 0_,_�Full sized plans, stamped plans (1 full size and 1 reduced) Workman's Comp. form hl�f. ,_,_ /Construction Super's License OR Controlled Construction Documents ✓�� [� Check expiration date on license ��� 00 next to restrictions Permit Fee 17101 g4orms:permitsl rev.08/30/00 ���-- �i 1�'j�•` _ fI'Gs -?..y .':.. '..; '.' _ r '— _ e i -..� .' fe h,..yr- Y. r ,„Y� 'if T„yAi, -\"'. • � el��,a�y>�^' ^h r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. Map Parcel lication# Health Division Date Issued., h. Conservation Division .Application Fee Tax Collector ~Permit Fee Treasurer Planning Dept. ko Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis PAS ,f Project Street Address Village Owner Owner Q e cg-c�A ���v►�G ivy Address Ova- Telephone �' Permit Request I G t aim c �C M V,i VC L-X-eA Vl-c�► ) c i✓1 (=e- I e f'12 L4 �r�`d✓t ,tit) 165 C ) Square feet: 1 st floor:existing°?� proposed 2nd floor:existing proposed Total new 4/ /T Zoning District Flood Plain Groundwater Overlay' Project Valuation I 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 2<o On Old King's Highway: ❑Yes O'�lo Basement Type: ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new .�✓ Half:existing �ew Number of Bedrooms: existing new r Total Room Count(not including baths):existing l new First Floor Room Count'' _! t Heat Type and Fuel: IVGas ❑Oil ❑Electric ❑Other Central Air: es ❑No Fireplaces: Existing �_N w Existing wood/c al stoves❑Y ®-Pd'o Detached garage:❑existing ❑new size& Pool: ex isting ❑new size Barn:❑ `xistin ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial es ❑No If yes, site plan review# oe -��Current Use-___ . Proposed Use BUILDER INFORNIATION—_ -•-- —_ _ = - -' Name Telephone Number Address License# _E �- �C.v �l����/1 Home Improvement Contractor# ✓1/l.A Worker's Compensation# r` ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE A DATE T 1`7 f Zo 2) S 'Vjr, F FOR OFFICIAL USE ONLY 'a APPLICATION# DATE ISSUED ' MAP/PARCEL NO. ADDRESS VILLAGE OWNER I DATE OF INSPECTION: FOUNDATION �p FRAME o (e--- �� V 14 INSULATION FIREPLACE + Y ELECTRICAL ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING r: DATE CLOSED OUT ASSOCIATION PLAN NO. Town' of Barnstable Regulatory Services ' �. Thomas F. Geiler,Director b e $uiluing Division rED M}. Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax- 508-790-6230 PLAN REVIEW Owner: s / �r Map/Parcel: Project Address l S° 77.4 S i Builder: Q y The following items were noted on reviewing: S.S 70 Co b b Reviewed by: Date:— © f 0 1 Q:Forms:Plnrvw 10/31/2007 20:21 FAX 19766402970 COUNTER.CONNECTION Z 003 .1<.Afl 0:arps 1 :p 8ouaaic I I ddl— .uu{�oy�--7— ..---------------� •p—ld aapio qo{Jo prod aaaq •91MOT3wuoo qof ill 04[uiu"toulow 1 IIDO10 711 at0 9 l ddv sta ll11 dm 10 i9Ba ai CY i7[t O 00 aoyn al Yfa IlY LOO:JII.AO[ Y t+d s�q°W 14�.[ i Fpl p I p q ( BF�^ ki l + oo ma at as' naiEuo tm ti r� 7'Tf.' aN_aowdt V-t00!—O LOCYJ8[/o l:pacsH}s�Q aq l [s P oP. .y.L �Ot'w__ ���Rr o�v my t I I , 1 x lZ I � I .40► ^-- .aY ^f--- .19t I. -.HOL Ott I i I �4 JL y i ` fi w u ill v/ r 01/28/2008 15:21 5087751313 ANCHOR IN CAPE COD PAGE 01 Asp i II 00 ! lam; 01/28/2008 15:21 5087751313 ANCHOR IN CAPE COD , . PAGE 02 (5ye ,� h _ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a d .600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): . Address: o City/State/Zip: SC-4 1 wtrl j Phone.#: Are you an employer?Check the appropriate box: Type of project(required):. 1.VIam a employer with 4. ❑ I am a general contractor and I oyees(full and/or part-time).* have hired the sub-contractors6. ❑New construction 2. a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. employees and have workers' Y P h'• 9. ❑ Building addition [No workers' comp. insurance comp;insurance.$ 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: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investi ations of the-VIA.for insurance coverage hrification. I do hereby certi u er the ains and p alties erjury that the information provided above is true and correct. Signature: Date: Phone M 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 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 i (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 j 600 Washington Street I 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 B a� and Staedards t~. Construction Supervisor License License: CS 83669 Expiration: 12/20/2008 Tr# 3291 Restriction: 00 CHRISTOPHER M DOUGHERTY PO BOX 70 E SANDWICH,MA 02537 Commissioner ,, �� ,°�� c! �✓lZa�.�% �pper�\ Board of Building Regulations and Standards — _ HOME IMPROVEMENT CONTRACTOR Registration: 140441 Expiration: 10/15/2009 Tr# 261230 Type: Individual CHRIS DOUGHERLY CHRISTOPHER DOUGHERLY 4 PAULS LANE ,u,��,` FORESTDALE,MA 02644 'i' hministrator CN(D �r Distinctive Waterfront Lodging on Cape Cod One South Street • Hyannis,MA 02601 To: Town of Barnstable Building Department Re: Remodeling January 18, 2008 Chris Dougherty of CMD Construction is authorized to perform a remodeling project for An r I . George Skip" Simpson Tel: (508) 775-0357 • Fax: (508) 775-1313 • Emaik info@anchorin.com • Web:www.anchorin.com 2� / � , IZ � � � � � � � 6 2c) O`o t � - p�, Town O OFIME r Regulat Thomas F BARNSrABLE ' Buildi' v MASS. $ �p a6g9. A�� Tom Perry, B TFC � 200 Main Stree WWW.toW Office: 508-862-4038. PROCEDURES FOR 1. The following departments, located at 200 Ma' ❑ Conservation Commission: available' ❑ Health Department: available from 8: ❑ Tax Collector ❑ Treasurer Historic Preservation Commission 2. Historic District Commission, 200 Main Street, a properties located in a Historic District: ❑Old Kings Highway Historic District(north o ❑Hyannis Main Street Waterfront Historic Di 2 F7Q -,--R' nn ni-rmit Ate-re demolition debris i ` �� i � � �i � � � .i �� �� Massachusetts Department of Environmental Protection Bureau of Waste Prevention . Air Quality 11600 b'? D ` Decal Number 1` BWP ACC 06 Notification Prior to Construction or Demolition Important: A. Applicability When filling out pp y forms on the computer,use only the tab key A Construction or Demolition operation of an industrial, commercial, or institutional building, or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection cursor-do not (DEP), Bureau of Waste P use the return revention-Air Quality Control Regulations 310 CMR 7.09. Notification of key. Construction or Demolition operations is required under 310 CMR 7.09 (2)ten (10)days prior to any work being performed. The following information`is required pursuant to 310 CMR 7.09. B. General Project Description 1. a. Is this facility fee exempt-city, town, distri , municipal housing authority, owner-occupied Instructions residence of four units or less? [3 Yes [ to 1.All sections of b. Provide blanket decal number if applicable: Blanket Decal Number this form must be completed in order to comply with the 2. Facility Information: Department of Environmental Protection a.Name notification a requirements of b.Address 310 CMR.7.09 MA Q `�r•c.Ci /T n d.State e.Zip Code �- I r,ro r. f.Telephone Number area code and extension E-mail Address(optional) h.Mzel5f Facility in Square Feet i.Number of Floors , j.Was the facility built prior to 1980? 10/yes ❑ No k. Describe the current or prior use of the facility: I. Is the facility a residential facility? ❑ Yes No' - �o m. If yes;how many units? Number of units s0 3. :Facility Owner. S �N y �o a.Name - b.Address F (-M;/� OZcp a �o a Cit o n d-State e.Zip Code O { =� f: ele hone Number area code and extension). q.E-mail Address optional �Q h.Onsite Manager Name e ag06.doc•10/02 BWP QQ 06•Page 1 of 3 • �._ Massachusetts Department of Environmental Protection Bureau of Waste Prevention a Air Quality 1r90a C970q BWP AQ 06 Decal Number Notification Prior to Construction or Demolition General con B. General Project Description t. Statement:If � 19 (cont.) asbestos is found during a Construction or 4. General Contractor: Demolition �5 operation,all a.Name responsible parties must comply with 310 CMR 7.00, b.Address 7.09,7.15,and 2 Chapter 21 E of the General Laws of c.Ci /Town d.State e:Zi Code the Commonwealth. This would include, 17 but would not be f. le hone Number(area code and extension) q.E-mail Address(optional) limited to,filing an ir,�s asbestos removal h.On-site Manager Name notification with the Department and/or a notice of release/threat of release of a C. General Construction or Demolition Description hazardous substance to the 1. Construction or demolition contractor: Department,if applicable. c Du s_J a.Name b.Address c.CI/To CIty[To%V ff d.State e. ip Code l.0 f.Telephone N mber(area code and extension) g.E-mail Address(optional) h.On-site Manager Name 2. On-Site Supervisor: 'S v On-Site Supervisor Name 3. Is the entire facility to be demolished? ❑ Yes No �N -0 4. Describe the area(s)to be demolished: i �N VVlC;.a.S l �0 10 . 5. If this is a construction project;describe the building(s)or addition(s)to be constructed: CD r s0 JV aC3 - ag06.doc•10/02 BWP AQ 06•Page 2 of 3■ • Massachusetts Department of Environmental Protection ■ L7TBureau of Waste Prevention • Air Quality Dam BWP AQ 06 'Decal Number. Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.) 6. a. If this is a demolition project, were the structure(s)surveyed for the presence of asbestos containing material (ACM)? ❑ Yes No If yes, who conducted the survey? µ b.Survevor Name c.Division of Occupational Safety Certification Number 7. Construction or Demolition: r f 17770�5 CA S a.Start Date(mm/dd/yyyy) b.End Date(mm/dd/yyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding ❑ paving ❑ wetting ❑ shrouding b. If other, please specify: covering ❑ other . 9. For Emergency Demolition Operations, who is the DEP official who evaluated the emergency? a.Name of DEP Official b.Title c.Date mm/dd/ of Authorization d.DEP Waiver Number s D. Certification Cl' I certify that I have examined the �O above and that to the best of my a.Prin ame -o knowledge it is true and complete. �— The signature below subjects the b.a orized Sig ature N signer to the general statutes d C.v �� C�h/\ r✓ o regarding a false and misleading c.Positionflitle �o statement(s): Q an d.Representing 6 (D e.Date(mm/dd/yyyy) O o • Q ■ ag06.doc•10/02 y BWP AQ 06 Page 3 of 3 ■ �4• . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map a Parcel // Permit# 2 Health Division) / .0"w �i Date Issued Conservation Division /0 Zoo/ P& Fee Tax Collector - ApMCANT Mt7ST OB"A SE Treasurer ��r ZL- j i'tY_ CONNECTION PERMIT FROM TxIE ENGINEERING DIVISION PBIOB TO Planning Dept. CONSTRUCTION. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village 40 `A- 1 s � 09 Owner t4 U F� .�, s AS n tl Address 'T _K i Telephone Permit Request ge,E' j Square feel st floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage: ❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# - Current Use -Proposed Use BUILDER INFORMATION Name `� Z_ Telephone Number Address 7 S2 License# C S es 3 6 ?�/ �-T- Home Improvement Contractor# Worker's Compensation# f ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 7 SIGNATURE DATE FOR OFFICIAL USE ONLY PE)MIT NO. DATE ISSUED y t MAP/PARCEL NO. ` ADDRESS VILLAGE OWNER--- DATE OF INSPECTION: ti Y FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL f FINAL BUILDING � r DATE CLOSED OUT ASSOCIATION PLAN NO. � r The Commonwealth of Massachusetts Department of Industrial Accidents f � '__- , �_ _ Ofllceoflonestla8doos , 600 Washington Street Boston,Mass. 02111 = 'workers' Com ensationInsuranceAffidavitw/ � name location: city /-r/11 A i S phone ❑ I am a homeowner Performing all work myself. I am a sole etor and have no one worldn is any dm workersOwso ensation for my employees working on this job.:: ::: ::::::::.:. ::::. lover �mP : :..........::::::.............:::::::.::.,..::::::::::.;:.:::.;::.::.;:.?:.;:.;;:.....::::::::>::>::»::<:>::> amanemp P ......8...........::..:::..::::.:::::::::.:::.::..:::.:,...:::.:::::,.;!.:::.::::.::::::::...::,::::::::.::::::.:.::.::n.::::.::::::::::::::::.:,:;.::::.:::r......:..:.::::..:::.:::::.:::::::::::::::.:::. mpanv dame : 4'¢l:z,.:::•�:...:... ... address :.:.::.....:...............:..:..n,................ '±:":}±:::ii�;>?}:;:jv?:i': ;:;:•>.::�?'�' atw Y ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contactors listed below who have workers' co ensatioa oIices: the following .............. .... .......:.:............... ..............::::..............:::. ............................ :::::::::}:.?.::...?:?:±.};.::::;.;; ....... 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Faitme to'secure coverage as eegui ed miler Section ZSA of MGL 152 can lesid to the imposidion o[ertrmnai Qmaltin o[a 6ae to Si imoO sadlor one yam,imprisomumt as weH as edva pemdtLw Ls the form ota SPOP WORK ORDER and a tlne o[5100.00 a day ageitut m� I understand a copy of this statement may be forwarded to the O[IIce o[Inveatom otthe DIA for coverue veriffeatloa the of Perjury that the informs ion provided above is tru'and correct e I do hereby eenify P P Hate 6 1 outs f C 2 1 signature Print name {�► 7�1 LS �J�2 �'' Ph=# ot8dai use only do not write in this area to be completed by city or town ofadal pesndocense# ❑Building Depart city or town: — ❑Licming Board (3sdeetrnen's Office ❑checkif immedLite response is required Ogphh Department ❑Other contact person: phone q; (tewao 9195 PIA) d . Information and Instructions 401. ti Massachusetts General Laws chapter" section 25 requires all employeoprovi the se orkeiceof another nndon for employees. As quoted from thepersonheir 'law , an employee is defined as every of hire, express or implied, oral or written. An emplover is defined as an individual.Partnership, association, corporation or other a deceased ems ploor ver, or the re y two or ore or the foregoing engaged in alomt enterprise, and including the legal representatives of 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 ersons to do maintenance, construction or repair work on such dwelling house or on the grounds c another who employs p be deemed to be an employer. building appurtenant thereto shall not because of such employment ter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renev MGL chap applicant who h: of a license or permit to operate a business or to construct buildings is the commonwealth for any ppthe not produced acceptable evidence of compliance with the insurance coveragecre�iperfoAdditionally,C bliic work until commonwealth nor any of its political subdivisions shall enter y have been presented to the coffiactinQ tract acceptable evidence of compliance with the insurance requirements of this.chapter authority. / Applicants ' compensation affidavit completely,by checking the box that applies to your sib and Please fill in .he workers comp with a certificate of insurance as all affidavits may be supplying company names,address and phone ruuabers alongof �Vie. Also be sure to sign and submitted to the Department of Industrial Accidents for confirmation for the permit or license is date the affidavit. The affidavit should be returned to the cuts'or town that the application `Jawn or if yc not the Department of Industrial Accidents• Should you have any questions regarding the being requester ensatioa policy,Please call the Departtneat at the number listed below. are required to obtain a workers comp City or Towns bl The Department has provided a space at the bottom oft. Please be sure that the affidavit is complete and printed legibly. the applicant. Please affidavit for you to fill out in the event the Office of Investigations has to contact you regarding be rest to e=mitilicense number which will be used as a reference number. The affidavits may be sure to fill in the p . the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have nay questions. • please do not hesitate to give us a call. O The Department's address,telephone and fax number The Commonwealth Of Massachusetts Department of Industrial Accidents Ofifce of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat- 406, 409 or 375 y+§�1< e ` BOARD OF BUILDING REGULATIONS a +• `? ' NSTRUCTION SUPERVISOR ! ti License: C,0 Number ES— 036701 BirtHdate 405120/1949 Tr.no: 24705 ' �rpires:O5ZO/2�2 r Restricted To`�:` '; ?�✓ JAMES L CAZEAULT 4193 CLAMSHELL COVE COTUIT, MA 02635 Administrator TO ALL NEW BUSINESS OWNERS DATE:8 ~ Fill in please: APPLICANT'S # YOUR NAME:�"l 10A •-a t o A�6\0%.'j &L-I uN� JJ''LL^^\\\ BUSINESS YOUR HOME ADDRESS: Su J •r: '7`3a-k5"�Ti t4ti.�y�►; s � a o1 Soc. 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'..I...' !:�i �'... r,.. n.r. r., !.,......:._.._. �,,,.., ..I...... ..h...,........,,..,.!r...J..!L I �,.r..., ,.., ............. ,.,..r.rr, ::..... .,!....... .:....r..,�!.. ..,: .. , ...,,. ....,.....1!I...r.....,.. „� s ..,,.�... ......... ..!..,.. r...!:,..r ...r...rr... .. .i..i.,. .m...I... ,r .!..._,...d.:r..!....31_,. ........J.,..n Ia.L6 .... ..... .a...,.r.....1...1 .........: ....v..I.. r.._I.., LiP .... ......... ..:�._.. .. ..... ...�.._.. {.. .,v.....n.....rr!........v...nar .r..,.._...:.. _r.......... .I. .... .L,J..v.n............. 4... ..I... ... .I....... ...... ....... ........... .. : , ,nn.... !.vr.. .....i. .. .. u.v.....s......_ir�:.......,..._!J........v.n v_..-.-::r..._......._,......., �.r!...�:v,:... , :UI:�.�:�F.��_._: r. ..... �............... ...........s.r.._......,...........r.._........._.,.._...._....._. ._. .....,�...._�.._... �:!JL,....,..,. ..,,:.......n..._ r.::•.:::... ....:. n..._......r. ..,.. .._ When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall) or if you get the business certificate first you MUST go to the following office to make sure you have all the required•permits and licenses.. GO TO 200 Main St. —(corner of Yarmouth Rd. & Main Street) and you will find the following offices: 1. BUILDING COMMISSIONER'S OFFICE This individual h s inform of any permit requirements that pertain to this type of business. Au horized Signature** COMMENTS: 2. BOARD OF HE This individual ha b n i ed of he p rmit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual been "i formed o .e en Ang requirements that pertain to this type of business. C�il Jra�I Authorized Signature** COMMENTS: 30•00 E in the town you must YOUR NAM (which y I business certifi cate ONLY REGISTERS Business certificates (cost$��for 4 years). A n do by M.G.L. - it does not give you permission to operate -you must get that through completion of the processes from the various departments involved. **SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY. �' 6' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION , 'Map XP Parcel - Permit# 4Z- 50 F -9ia�isien Date Issued — 9 Fee 00 Tax Collector . 9 Treasurer '� — (/A ,9"S RW*ff9-Dept Date Definitive Plan Approved by Planning Board Histeras--9Kk�- � P-�esewatien/�ya�ie - Project Street Address . II r-- sou � `1 Village �i 15 IT, [Aw 'Ownel P /Q Lchi 4-2e&ix Address me Telephone Permit Request L /P'nbeL `o F . _ r e 1p Square feet: 1 st floor: existing ; proposed CX 2nd floor:existing proposed Total new Estimated Project Cost 0'0 Zoning District Flood Plain /y Groundwater Overlay, Construction Type W) r� ;•Lot Size Grandfathered: ❑Yes U11(o If yes, attach supporting documentation. �. C 0 Tae 0e C0 P/-i t�/ti-F ' Dwelling Type: Single Family ❑ Two Family ❑ Mu amily(#units) Age of Existing Structure Historic House: ❑Yes U o On Old King's Highway: ❑Yes , ©-Po -.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: 0 Gas ❑Oil ❑ Electric 'O Other ` Central Air:. ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove:,O Yes ❑No, " Detached garage:❑existing ❑new size Pool:❑existing ❑new' size' Barn:❑existing ❑new size 4 Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑: Commercial U ''Yes ❑No If yes,site plan review# Current Use Proposed Use SCLyy�; BUILDER INFORMATION Name 011M'Z°7__j }t-t%r, �✓h PtZ.VtJCft1(,A,tj'Telephone Number 40s" 1 Address /.gat & . License# (�S �r7 0677 LI7;i' / J'611�(2 S Home Improvement Contractor l oo 740 Worker's Compensation# �o ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO UL A4_ i SIGNATURE 40- DATE del L� �, ; FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL-'NO. ADDRESS. - VILLAGE OWNER % �� _ "o �, ` � I' + - -. ` � _ r • *- I , - `• - Af DATE OF INSPECTt FOUNDATION FRAME INSULATIONjj FIREPLACE _ ELECTRICAL: ROUGH' FINNAL', PLUMBING: ROUGH FINAL:., ' GAS: ROUGH Y' FINAL: FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 0 r 0 i w L i � N X 2. 0 u I ; 3vrorodud w ' 0 5 - b '� 'W 5 W e 0 h7 �y—--- --- yPj � I a f7 9 OZ r 3 o v� ;w vh 3 - 020Q OO i ED ED a -4? k S s o; III oe W � _ 11 0 0 .. J -1 F a m O W = I LL ~ m 'a S ,8 I ?ivNBxe-p » 01,8-9 _ Z - 2 u ..OS avn.-od�3 T � l 0 5 j w y n 10 W i Q goe e ('fit C I ^ v J2u iz LU rL 0 H J W 3 � Q o< � �y ..A;O O l C 2 k, ztk. .,1 16 n S o � oy Jg Qj 3 n_ dy nc N7N37 r+�n 1100 - Window & Door Prime Products Page-of rr�►RVF v ■► Ar Order Form Harvey Industries, Inc. • 725 Huse Road Manchester, NH 03103-2339 Ship Via Delivery Request Date Ordered Dealer Na > - sit Account N U Warehouse Truck O Standard Address • O Factory Direct O Special Cust.P.O. U Factory Pickup • O Pick up at Ordered by Job Name n th (Delivery Area) 12l« Window Specifications: Interior Exterior Glazing: Screen: Bay/Bow Type: Slz Color: Col Q Clear U H• U DH Angle: Flankers: Wall Depth: Veneer O V�JpyY1 KpenIng O While hale L E ull U CSMT U 10° O VY U 4 9/16'(STD) Interior. tD'011ood O Buck O Almond O Almond ow-E Argon O None O Center DH U 300 U 1'9' U Other O Oak O Aluminum O TTT O Bronze O Med.Bronze O Obscure O Center PW 0450 U 2'0' O Birch ❑Stock 105ine O Dark Bronze U Special Temp. Grids: O Multi-point lock Q 2'4f See�chlanical pe: O Catalog Size O Oak Frame: O Other �O�olonial In-Glass (�of tiles) ' O Oaklone U Replacement dTColonial Snap-In O Welded *Aail Fin U Diamond In-Glass COMMENTS: o. Z 6CVDHI .. /o 'r 3 h r.9 S :� Ito i Vinyl Patio Doors Te s Colonial Quantity Size style Grids Glazing Color L-Lt • � O Standard U Low-E O Argon O Bevelled -- - _- - - --- -. --- -- -- - - - - - - Wall - << - Hardware Prep ---- - - It Depth yyOd O Brass O AAuIU poirtl Locking O Stainless system{Intrudes custom .: Deadboll Seel Wheels polished Wass handle r A� . The Commonwealth of Massachusetts T ON -? + -- -" Department of IndIastrial Accidents s.:w. r .•':�� � . F •- 019�ceaJla�sUAsUoQs ... ... __. _._�.. .� . - -� 600 Washington Street Boston,Mass 02111 Workers' Compensation Insurance Affidavit can � •ocvt:ttmsir;./. „�///%/!�/'�G>�////////�////%/// . � y ,�, /////� / ,.::r: name: ovation ❑ I am a hom tivner performdig all work myself. ❑ I am a sole prcmrietor and have no one worldn . anv ca acity WE � i%� r��nrr•s NV G N.• I am an employer providing workers'compensation for rmy txnplovees working on this job. companv name: address: 160 S. Alet1723%ll Al t:lty: o M i r Dafe 3-T phone#: V 0,r " Y88., Insurance co. 20licy# ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the folloning workers' compensation polices: eompanv name• address: :.._.:,.:. city phone#• _.... insorance cn. poliev# :..,..<:.<.. . Z NNE �; /; eomnanv name: address: dh: phone#: o If cv# ruorance co. :.... :.:..,..:.... ��.,-,.:....:.:: %///t///%%%/ / / / Failure to secure coverage as required under Section 25A of MGL 152 an lead to the Imposition of criminal penalties of a Bne up to 31.500.00 and/or one years'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Me of SIOU.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage veriecation. I do hereby certify wider the pane and dppen alties perjury that the information provided above is urn•and correct Signanur�" _ !/ — Date _- // /0 �,5 Print nata< �R Ed t*.J� V. (!�As c H_IIt ; Ariz Phme 0 C,ntact ly do not write in this area to be completed by city or town olBcial perndtmceme o - ❑Building Department __--- QLlceadngBoard mediate re a is coredPon req OtIIu❑Health Department n: phone#: ❑Other (rewea 995 P1A1 ' ✓1ae �O�I7Upz6r2ll/e2U.i1. o`�✓�ZczdOuc�uae�ZJ ! Nljmber: cc ��ie i0ammonurea�e o�✓uai!ac�iueeLG 'estrl''?d T0: �!7 a HOME IMPROVEMENT CONTRACTOR ►x THOMAS CAPT'i. Registration 10.0Z40 - ' 164S NEWTOWN ','sC Type PRIVATE CORPORATION :I� UIT, 01a A_j;.;; • Expiration 06�23/0� ' _ _ _.. _,. � ___�-. ___.__._._� - tCAPIZZ� I HOME IMPROVEMENT, INC as Capizzi, Sr. -_ 1645 Newton-Rd. #, r ADMINISTRATOR ,Cotuit HA 02635 z }: Tfze TDorrr Wfv. 'veaal %..147W,aoxajeg I W. a DEPARTMENT OF PUBLIC SAFETY i CONSTRUCTION SUPERVISOR LICENSE �r= Number - Expires: Restr-ioted _To: 66 THONAS X. CAPIZZI JR — v�-`280 PERCIVAL OR W BARNSTABLE, NA 62668 „ram,.=,......_. , �& r.:' ✓/re Corrz.rrrarzueall o� jadlaNeG7't QEPaRTNENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number: xpires: Restricted To: 86 _ FRELEuc LV RASC.� iI< BOURNE RD PLYNOUT9. NA 6'_368 TOWN OF BARNSTABLE SIGN PERMIT PARCEL,/ID 326 119 GEOBASE ID 24091 ADDRESS 1 SOUTH STREET PHONE "Hyannis ZIP LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 22087 DESCRIPTION ANCHOR-IN MOTEL (20 SQ.FT. ) PERMIT TYPE BSIGN TITLE SIGN PERMIT i i CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $25.00 ,BOND $.00 Okay CONSTRUCTION COSTS- - $.00 I 753 MISC. NOT .CODED ELSEWHERE * HAItN3TABI.E. ; r MASS. � OWNER HYANNIS, BLDG & DEV ASS D ADDRESS 1 SOUTH ST /`'\ Mlr►� HYANNIS MA BUI DING DIVISIO N y Bf , DATE ISSUED 03/28/1997 EXPIRATION DATE S I IKE The Town of Barnstable 3 -ZL-9� snxtrsTnsi.E. : Department of Health, Safety and Environmental Services Building Division rFo MAC A 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner ��// Application for Sign Permit f Applicant: , i X 'f � / 1'r11r��.— Assessors No.����1 Doing Business As: VCJR--TAf M67V Telephone NZ) "" Sign Location � �, m/ Street/Road:-- �J��( _—` /V� G 'lam Zoning District: — — Old Kings Highway? Yes/6 Property Owner, ---__Telephone:—_ Address: —_ --_Village:_— Sign Contr t ���� �a 3 Name: . Telephone:----- -- Address:__— ----_—_--Village:—.....____-- 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:Ifyes, a whingpermitisrequired) 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 Section 4-3 of the Town o4Ble Ordinance.Signature of Owner/Authorized Agen Date:___—______ Size:_ p --- -- --------Perrmt Fee:Sign Permit Permit was approved: v —__ _ Disapproved:_—__ — Signature of Building Official Ll i, Date:__ �Z 4 .It .y I rn Z N 1 Z V , Eui f Assessor's office(1st Floor): Map 326 lot 119 Tuc Assessor's map and lot number o� >o`o Board of Health(3rd floor): Sewage Permit number Z DADl9TADLL i Engineering Department(3rd floor): r,us House number °0�t639.6`�� Definitive Plan Approved by Planning Board 19 c OR APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only A P P R O V ETOWN OF BARNSTABLE 111,11rnstAble Conservation Co is °�11 L D I H G INSPECTOR L4161CATION FOR PERMII)= Rebuild existing buldkhead, dredge 200 cy TYPE OF CONSTRUCTION Wood frame with piling and timbers CCA treated January 30 19 90 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 1 South Street, Hyannis, M A c Proposed Use' } Zoning District Fire Dis ct Name of Owner Rexford Arnett Address 1 South Street, Hyannis, MA Name of BuilderGillmore Marine Contracting, Inc. Address 381 Old Falmouth Rd, Marstons Mills, MA Name of Architect NA Address Number of Rooms NA Foundation NA Exterior NA Roofing NA Floors NA Interior NA Heating NA Plumbing NA Fireplace NA Approximate Cost $65,000 Area Diagram of Lot and Building with Dimensions Fee Replace existing approx. 140' of bulkhead, dredge approx. 200 cubic yards 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 cons ru tion. Na;St Ak Corctiolnpervis License i ARNETT, . REXFORD I 6 " r No 33553- Permit For Rebuild Exist. Bulkhead t Location 1 South Street Hyannisu l I! Owner. Rexford—Arnetit Type of Construction -'Frajk.e �. Plot Lot Permit Granted March 12 , 1990 it Date of Inspection 19 Date Completed - 19�� r t J S .. r 1 P • y•� r I � ,amrrranwmnil,mugrr•tm.�m wwn►rrmowu: w...r.mr.w.---•••-+•r.« :wrrr�rr .w+•.wrr�w.iw...Mrn.rr„N.r.m.r...nrrr..r � �c C. , c,Ei c • 3 0'`% *, ter � M to Yam:"•'ll 0 f LOT 119 LOT 120 L 1(f S'•IG'C�r.fG l �.J Kr-`e N►AP 5r.4L5 1.25,000 off Ri 1.1.S.Cz.S. H"GN�415 Gi+.io.D, . �. C ` - e_. I�.�V 'taw �!_PLAc.E �?C I STt r.16 �:-•'LLI-1=.=.� , IV7 hr �L ! ?OC c.y. 5EAl (aC,.,S`+_ 1LWO.p o DLL-D� — TO -q.0 M LW p.g gYrST• vr.+-+ ,17 •e• 37VNE HI�s AM LOT 118 ��.__`•' PLAN ACCOMPANYING PETITION OF REXFORD ARNETT xZN OF M,q y. � ° TO DREDGE AND DISPOSI: HY.4NN/S INNER IIARWR ROBERT A. HYANNIS , BARNSTABLE , BRA MAP! ;C BARNSTABLE CO. ,MA. j PLAN \ NO. 10905 At %° ; OCTOBER 2 , 1989 SHEET 1 OF 2 j FCISTERE� •� b.��/If� �' BRAMAN ENGINEERING COMPANY , LTD. SCALE : I 30' 'rSJOir'At { ��r G' CIVIL ENGINEERS AND SURVEYORS 258 MAIN ST. , BUZZARDS SAY , MA. DREDGE PERmrr NO. 9�--,--- AppmvW by Dq~d Enimmubl Protection of �ssatchusd L � VIS If ION DIRECTOR V. SECTION CHIEF -- January i24 192P DATE i i I tiPPaoX Ex i 3 ti eE l*v E ,�.�,,,� 4 Q>A D -4 M L V--/ i VAtZ.ICS I • DREDGE SECTION Pl_a T W1AMEE4zl4f.&jQ NOT TO SCALE PE R M I"J` ��. ' �F�GF{ SS 9 (z° ToP F_Ey I sT. toil GoNc. S t t-TAT!ohJ =s At. - , f To EL B.3 I. � � aPPRox �uST� M/�.'r�.lZl.B•.I... Zcx� G,►�,�- NOTES W EL.�.�'�� 4w�EP f'•�t�E t�?�.��//�.ct0/.1S SH��ri E!:Atz� of M h1 LoW wA h'lI&JL.IS THrc � L,i.t�l�.. VAT(UN'S Z)-ax1ST. PlE2 1 � S rz ,o DISPOSAL DETAIL 3)TIMB�Iz SLlLI`H�:t� IZ�PL�.==M SCALE : I 10' g_�FER To o2c;�Erz or- col.tot- TIONS t=EC a FI LE #S E 3-1911. Cr 'l�QcEO MA T arz 1;&. T c> 6E I�L?.GEt� ABUTTERS cfF= Towr-4 o��� B�Ns'ri�agLE �� .41J I NLAN� C�►�3F�J��n.:_ 3"0 7 MA-If-4 S =Z E. ' Ht�rvt5 , N�,e.. ozcool S;Fp� WZG2E,ATION^L U6E O2 z gNc�-oo►`i s. c��r�o n ��c3��� OF F-XIsT- 6AQ6 wA I, HY s Tr was oz�o I y�� 1=L0A T5 $ut_K.H S4 D BRANtAN ti A. �FGP- To DEl LlG N a Ko. 1o9os 1903 A'Por 9EG/STER�o F` 1G1;'AL ENE'\ VI!. REXFORD ARNETT OCT05ER 2 taaa ���T S� ALL T 2 OF 2 s TOWN OF BARNSTABLE LOWER_ UNIT ,CERTIFICATE OF OCCUPANCY Y _ PARCEL ID 326 119 GEOBASE ID 24091 ADDRESS 1 SOUTH STREET PHONE HYANNIS ZIP — LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 64311 DESCRIPTION CERTIFICATE OT, OCCUPANCY--LOWER UNIT/BP 595!1 PERMIT TYPE BC00 TITLE CERTIFICATE OFF OCCUPANCY CONTRACTORS: Department Of ARCHITECTS: p Regulatory. Services TOTAL FEES: BOND ' CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE- : * fAR MBLE, MASS. , 039, , �FD MA'S A BU [,� IVISIO1 t BY � DATE ISSUED 10/07/2002 EXPIRATION DATE 3UILD FGj PERMITT.. PARCEL SD 36 .19 ` . CEOI#AS yD 24091 f ADDRESS 1 SOU U STREET PHONE I-IYANN I i Z I P LOT BLOCK LOT SIZE ' DBA DEVELOPMENT DISTRICT HY iPERMIT 59554 .DESCRIPTION ELIMINATE ONE-SUITE/CREATE SUITE IN ISEMENT� PERMIT TYPE BREMODC TT.TLE COMMERCIAL ALT/CONV CONTRACTORS: MARC N CASOLI Department of Health, Safety ARCHITECTS: and Environmental Services r., TOTAL FEES: $233.00 BOND $.00 INE CONSTRUCTION COSTS $:30,000.00 437 NONRES./NONHSKP ADD/CONY 1. PRIVATE P * 1ARNSTABM • MA83. i639• A�O� ED MI� . E _ BUILDING DIVISI BY DATE ISSUED 03/11/2002 EXPIRATION DATE TOWN OF BARNSTABLE BUILDING .PERMIT" PARCEL ID 326 119 GROBASE ID 24091 1 ADDRESS 1 SOUTH STREET, PHONE HYANNIS ZIP LOT BLOCK. . LOB' SIZE ' DBA DEVELOPMENT DISTRICT HY PERMIT 59554 DESCRIPTION ELIMINATE ONE .SMITE/CREATE SUITE IN &SERENT'' PEt�MIT TYPE BREMODC TITLE COMMERCIAL ALA`/CONY � CONTRA6TORS r MARC N CASOLI Department of Health, Safety CITFc�S and Environmental Services I,TOTAL FEES: 233.00 i I BOND .00 i;CONSTRUCTION COSTS 3p,.00q 00 437 'hj NONR.ES./NOkTHSKP ADD/.CON ` PR, ,V F ,P°.*�' ; y° * BARN3TABM s 03 BUILDING DIVISIBY ON DATE ISSUED 03/:11/2002 EXPIRATION DATE r �- THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,"ALLEY OR SIDEWALK OR ANY'PART THEREOF, EITHER TEMPPRARILY OR PERMANENTLY. EN CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC.SEWERS MAY OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS_CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR ;2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- 6 (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. '.3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. f4.FINAL INSPECTION BEFORE OCCUPANCY. ® o BUILDING INSPECTION APPROVALS PLUMBING INSPECTI N APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2 3 1 HEATING INSPE RPPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW AP'°ROVAL r0 C N WOR SHALL NO OCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HA APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAWBE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE'OR WRITTEN NOTIFICA- TION. NOTED ABOVE. _ TION. �;. � ,` � � �, I R f I F w I �', �§ r� II '� -t } f i i I I 4} 1t = 1 -.,. .. a.. w .. e F- ... _. �uF.. ..:..n .. _ TOWN OF BARNSTABLE I LOWER UNIT CERTIFICATE OF OCCUPANCY > . 4, PARCEL ID 326 119 GEOBASE ID 24091 ADDRESS 1 SOUTH STREET PHONE HYANNIS ZIP - LOT BLOCK LOT SIZE i DBA DEVELOPMENT DISTRICT HY PERMIT 64311 DESCRIPTION CERTIFICATE OF OCCUPANCY--LOWER UNIT/BP 5951 PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: ARCHITECTS: Department of Regulatory Services TOTAL FEES: BOND $_00 CONSTRUCTION COSTS $.00 , 756 CERTIFICATE -OF OCCUPANCY 1 PRIVATE +► BARMABLE, +► MASS. 039. FD Mpl A BU IVISI DA ,E,,,ISSUED 10/07/2002 EXPIRATION DATE Y i I nOwN OF BHtiVST��t:sz.a a } BUILDIFG PERMI'J' GEOBASE LD 24094 F�ARCEL ID 326 3.19 PHONE."; , ADDRESS 1 SOUTH STREET -ZIP HYANN I ` LOT SIZE LOT BLOCK DISTRICT Hy ll SA DEVELOPMENT UITE CREATE SUITE I1�i ASEMENI 59554 DESCRIPTION ELIMINATE �JNE S / PERMIT �n COMMERCIAL ALT,�CONV PERMI`'' '?'Yl?E BREMODC .:-ITL£ CONTRACTORS: M,a�Rc ?.� cAsc�T,I Depar-Meng of Health; Safety - ARCHITFGTS; and Emir>on-Mtnt�al,Services $233.00 'TOTAL FEES: �; 0t; BOND C0NvTZUiCTION COSTS $30,000. 00 f _ Qi► NONRES./NONHSKP ADD/CONY PRIVATE :P ' Mix. f I 437 * MB . scY BUILDING DIMS`` BY DATE ISSUED 03/11/2002 EXPIRATION DATE SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENT THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR LY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT'RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE FOR ALL CONSTRUCTION WORK: THIS CARD KEPT POSTED UNTIL FINAL INSPECTION 1.FOUNDATIONS OR FOOTINGS PERMITS ARE REQUIRED FOR :2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH; PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. (READY TO LATH). OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 3.INSULATION. :4.FINAL INSPECTION BEFORE OCCUPANCY. i BUILDING INSPECTION APPROVALS PLUMBING INSPECTI N APPROVALS ELECTRICAL INSPECTION APPROVALS 3 1 HEATING INSPF- TPROVALS -•-ENGINEERING DEPARTMENT l Q v BOARD OF HEALTH 2 OTHER: SITE PLAN REVIEW AP.SROVAL WOR SHALL NO OCEED NTIL PERMIT.WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HA APPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELETIONPHON5. R WRITTEN NOTIFICA TION. NOTED ABOVE. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel )� Permit# Health Division Date Issue_ Z Conservation Divisi Fee Tax Collector Treasurer °j,%C-qp1 ,4TLS1'fiFfi!i1A' i,g .. Planning Dept. " r`: h Date Definitive Plan Approved by Planning Board -Historic-OKH Preservation/Hyannis -7 7 Project Street Address QIyt 600 iW 67— , Village I S Owner 4N&Hyj _T A-r,rNi$ DiI A Address Telephone �7S'— 03 Permit Request C OO ST"Cji UfJt 6""OM S07k 6 5tMCWT— /vo CGj .N e o o® / a61AAJQ J1,7-e— N rT rC Square feet: 1st floor: existing proposed 2nd floor: existin propose I Aa I new Valuation '30,OW Zoning District L— Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. in Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age 0-Existing Structure r 0 WLS Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑ No Basement Type: O�Full ❑Crawl oft alkout ❑Other Basement Finished Area(sq.ft.) f���5 Basement Unfinished Area(sq.ft) i S Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing © new Total Room Count(not including baths): existing O new First Floor Room Count Heat Type and Fuel: !A Gas ❑Oil ❑ Electric ❑Other Central Air: iYes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes )6,No Detached garage:❑existing ❑new size Pool: ❑existing Cl 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 7 BUILDER INFORMATION ,d Name AA C S 61 ) Telephone Number 509 r J Z 6— '1 3 Z Z Address J S L N/; [u t\/O License# 0-7 2 653 L576 cs S VA I k LS r Home Improvement Contractor# /Z 7 Z l I Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO c —v SIGNATURE w DATE POR OFFICIAL USE ONLY t - PERMIT,NO. DATE ISSUED MAP/PARCEL NO. • t ADDRESS VILLAGE OWNER e DATE OF INSPECTION: - FOUNDATION FRAME r • INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL t GAS: ROUGH FINAL ' t FINAL BUILDING 0/-7/ DATE CLOSED OUT ASSOCIATION PLAN NO. t �lk!ilf 71t/1•s i•iltfitt<I•. LFAWS7 ■ 11 1•111- 1 J •wan/ul I_ "11/. 11 ' III Ril ON ---------------- -1•II• • w • • • •111 ••. L1� r•1111✓�+. „1• •11 1.1 11 wl•1• • _^ ••n1..11 11 ul .. 1 . ■ w1.1 ' JI 11111 '.•1 •1 1 1 _1 1 111 - 1 r•111•I:w •11. :111 •1 ••1/ 1 ' .. .;..,,, ^..;.:., ..,......�>K: .:»>?;"d.'dv .:•>3.,<:!.; r3:r'u::>?S!:`<'s2. 2J'..2..<a6::.:> :. R ;\ •> ara..asN•� .eeec:.. ....w:>. �o.,:: ww '•f:` '<• \n r a .ur> `':y`::ky>:*;:<: 2. > `fi..-w,. ay �,�..v ,-v+�0'�'..N tifp Y b � as ,a r„�.,✓'<"°`spa, ,R,' o•�`^^a#2Airoc?r .a f >'?: v'•lu a a cY"r,.. .. ' S 6 �at>,``��.;,,i,�,,°a"{'�a�y��M �ny�3-.'{t� vwr< `o'2°�'� >.,;.... �•'^`�.. .I ,...: i:`:?dy^^C:::::ai:;:::::ir:?l:�'i??2 1 fo+r XMM : ago' ul IH 1. ■ .•I. I cityortowm ■Ltczmdug Board [3&&&ift edistermpomisrequired ■ 1 ■ • .� Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to Provide tivorkers' compensation for their employees. As quoted from the"law",an employee is defined as every person in the service of another under any cant---::: of hire, e:cpress 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 recewe. 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 them,or the occupant of the dwelling house of another who employs persons to do maintenance, suction or repair work an such dwelling house or on the P=Lds c: building appurtenant thereto shall not because of sw A employment be deemed to be an employer. MGL chapter 152 section 25 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,nerthcrthe commoacwealth nor any of its political subdivisions shall eater into any contact for the performance of public wort:um:d acceptable evidence of compliance with the insax-mee requirammts bf this chapter have been presented to the ca==da•; authority. - . . %' „i,,. /%// // Applicants and Please fill in the wotiCers' cx�mpensation affidavit campietdy,by checlaag the bmc that applies to your supplying company names,address and phone numbers along with a certificate of iasaraace as all affidavits maybe submitted to the Department of Industrial Accidents for=flanation ofiasmance coverage. Also be stets to sign and U date the affidavit The affidavit should be returned to the city or totavn that the application for the p ermit or lic�se is being requested,not the Department of Industrial Accidents. Should you have nay questions regarding the"law"or if you are required to obtain a workers'compeasadda policy,please c:&the Department atthe member listed bdow. MOURNERS, City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of tl,� affidavit for you to fill out in the event the Office of -has to contact you regarding the applicant. Please be sure to fill in the pemutllicease number which well be used a reference a a ntimlier. The affidavits may be ruarciR to the Department by mail or FAX unless ad=an=gemmtr have beenmade. The Office of Investigations would Ike to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. 77 MEN The Deparuamt's address,telephone and faxmember.The Commonwealth Of Massachusetts Department of Industrial Accidents amce of Imresduatlons 600 Washington street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 7274900 ext. 406, 409 or 375 fi If J t .�ic6 l0 n i !!a BOARD OF •• BUILDING i License .CONST REGU �' RUCTION SUP LATIQNS' i Nurnberg C� ERVISOR 072653 . I a 2 'p�3 ! j f Tr..no: 11281 f 5MA O N CASOLI �. MARSTONPOND R S MILLS;:MA{1026gg Administrator . '� � � rg•�lati a,.rn�S��td t.. s , Bnatd or HGtra"hrF.C` 1 NtcftT Cl V. 121i��2 `13., i 'x ="'(y7n� ItvDIV'�L1HL I 0.3/03/2002 16:36 5087754646 VIRTUALBOOK:S P.AGE 01 SPECIAL REPORT Unit Condition Check-list Here's a haitdy Cl{LCklist for voLL to use vlhen tenanl3 move in or out, Remember, thou ni gh. that yot r state pr vnicipalitc' may Fave additiotlal req�ircments sure Your cheC#clist complieswith ali state and local la.vs. Address lln;, v.;mher � General Condition of R.00ms ' Condition upon ` Condition upon i Comments Estimated Cost to arrival I leafing ; I rC,IIiY I (circle; good fair bad) fcircle: zood f F air badl 1 II i 1_ivinc- Room I I I Fiucrs F;C'7r i,r�vrr!n2c ! V F S I C, F B Cry' es 1ViridCvr CcIvefin s Wails F B _ B _ I Cr 1~ Doors f� G F B f G I F,r,nt Door L I_l:tCks c r c ( � . a i Kitchen t_ F F,' I I Ffc,Crs tit Flcur Coverings I G F 8 i t, F i _ I � B � e i `Yz;ali.5 G v r�� C�utnv_5 I B i f C; i ' Y:ht Fi:i:urec G F B F I i (-Ouster, r- F J I I G F B F B I I l Re rigcrator _ i G F B { j I?i3ktwashcr !�r' B F I , + ` t;, F B I I Sink Piumbins i G F B `� F B I Puhfisher: E. r`aichoel Quinlan, Es: ,, "Ii.anaging Editor; Stephanie Federico ,Editor in Chief; Michael R. Jung, Esq. Editors: Jcrmifcr Kavanaugh, I— 1-?untcr 30vle, Mary N1o!:lan Legal Editors: Carol Johnson Perkins, Esq., A anne t... Belasco: Esq., AJf:!d Gordon, Esq. 'Ay 0Ga'mC:.^ranS7 Onra raY•geIo.O'�ra wI(s1•ra 7•u!;elrufp�f„.1 ee nO'Tlr'ao rleS9�n•Otlfi1 OCO"Rpraa•pl'61nT R a4pO'$a8 faysena l. OG a y ner•,q7 Oar C7_1n0M/:Cu".nO 4OeO,r7. rh•u inloOr•n.avnCed Or !Af if"} SOr 2fe1aaam :•tltra ar M a.ly:•]Hn�afol u}d n•i,� ^i qrE•ea2O u•'nOi;airaa•nr`wo1 0ea n•C n1aQ11r r1•O.r9aRL Hv n olaRrr•OVurnl•,rp iOCreCl}aafOnil Odvie•.ajPd.f a!0 0L•m,anf ern JN erub if M7 J4eNbn7•if t"—;d.IR•eQetia Of a t1,a CVMI:a:))r•).a_)a Ort n"Pro(!Im ham 1.'r."afy.f'r b/c,01—InfOr^Jnu'YI. — —,, — ?6t)bh'ht d by L NULGRD TENANT J-AW BULLETIN 1 Co ri ht V 1993 (ISSN 0�71-5?2Fi) ONIAN Pt'BLISH NNG; Co. 23 Drydack Ave. Soston, ,NG% 02210-2337 (517) 542-0g43 a-mail: inforquir,tirn.com phlfaaa 03/03/2002 16:36 5087754646 VIRTUALBDDKS PAGE 02 --•----------------.,.� -Lst .. Speci,lf :Report ' other ihlrl� F{n[>nt "�� ---.—.•—. J P B Li 2 hc fi�rctre� --� G F C, I,e—�SwrL_ _ors` I C �� F B F $ I e . 3;r— Floo;'Cvvetinus + l.j�,!,I•:.�IXIIJfe ��_—....._,�+...�—„—.. � I (1 ^F Fvj 1� ., r .—,� ,»��,�.,_ _ 0t11_`-- —F_B ( F -.— I r r r� --- vn —T-----,_ .S^1C1ke i;' r O(Cler, and ';'.:4t filC testis-tg F• S r. W�5 CY'I fined ecCJrS �'�r iLYrZ(j L'f Iheir I)r 52,r, d U bC lr1 w C? et.;J i t iDU 1CJ I ttr rc'' ro Illerl. T�nil,tls �+Y.,� cr•lil.r,rJ�rt ?+I) pfu�!ctn.s to l,,nd?us+.li�!an'In 7 to tcS a!I det .ctctrs �, !c;tst one , �y�r Ir! a•2rc tU rer,'� I,<Inc!Ir r.�i•"-,c, , , - r:•I�e smoke s�etr,:tur !1;�tltnCg 25 !12J:?S:SJrY. t r.t �hcClaist ::,t plhrecJ on rr,t•vin$ in ,n 199--_,_attd oF,prCwt J by — -- — _ Tcnan[ St completed On mo�;l?ti nu r,n 9I I I a cr 19 and approv,-d by : PlacesToStay.com -Anchor In Motel Page 1 of 2 es STi4 Co U . -place 4,4® � I illr„ea i « 9 iii a I npi i1141�TlJ�Vy�17 �, fi n—d a pl a @ � � � �� ,`�4 �� � �M! !''��I�7�9_- � �4�1IM i Viz` mop search Back to results Anchor In Motel Distinctive A "` `° ,. Waterfront Lodging ' � T on Hyannis Harbor - Hyannis, Massachusetts 02601 United States - Price Range: 59.00-306.00 (US Dollar) Property Type: Motel17- a va.itabftit+ att r tt r Rates-Guestrooms-Services &Amenities Activities The Anchor In is located at the waters edge on one of the most picturesque and charming harbors on the Cape. A sit back, relax and enjoy the.beauty that is right at your very doorstep. If you wish to take a trip to the enchanting is Nantucket or Martha's Vineyard, the ferry is but two hundred yards from the Anchor In. Great restaurants are just E your location and the choices are fantastic. For the shoppers, Main Street is also a short walk with many shops, gii sidewalk cafes, J. F. K. Museum, miniature golf and the.Cape Cod train station. Beaches are close by, some are w distance while others are but a short drive away. Property Summary 43 rooms. 2 stories. Distinctive Waterfront lodging on Hyannis Harbor. Walk to island ferries, harbor and sunset cri Credit Cards Accepted Visa, MasterCard, American_Express, Discover Check In/Check Out 3PM / 11AM Children Children age 10 and older are charged at the same rateas'adults: Smoking Policy This property has non-smoking rooms. r" http://pts.placestostay.com/script/gen_prop.asp?LA=1&NN=1&PR=1&CP=I&CO=225&C... 3/9/2002 PlacesToStay.com -Anchor In Motel Page 2 of 2 Deposit and Cancellation Policy Deposit Policy: When making a reservation we require a deposit equal to one nights stay. This will be applied to yc Cancellation Policy: A one week cancellation policy is in effect here at the Anchor In. If you cancel at seven days o arrival date, your deposit is non refundable. If you notify us that you are canceling your reservation eight days or m arrival date, your deposit will be refunded, less a$10.00 per room reservation fee. You will be refunded by a credit credit card.Your balance is due on arrival. Thanks for planning your stay with us,we look forward to your visit. Rating ` AAA 3 Diamonds Rates -Guestrooms - Services &Amenities -Activities International versions of PlacesToStay.com: Dutch i French i German Ita..lian i Portuguese I Spanish I UK Find a Place i My Travel Info i Discounts i Packages I Customer Service About Us I Help I Modify/Cancel Reservation I Free Membership i Home Online Hofaf Reservations I'Vorldi0de ©Copyright 1997-2002 WorldRes,Inc.All Rights Reserved. http://pts.placestostay.com/script/gen_prop.asp?LA=1&NN=1&PR=1&CP=1&CO=225&C... 3/9/2002 �'"� �' (J (�' � � �� i �l U ` -Assessor's map and lot number ............................................. xi67 THE Sewage Permit number,,., ..' .!1 ',.,.i% '!1 air _ • Z BJHHSTSDLE, House number ..................................:..........i� .............. ``` 'oo M639 a' ',,r 1 � •o�,E YPY a' �•. i TOWN OF ; BARNSTABLE ' _� xF 6UILDIRG ',"I NSPECTO R V. % 1 APPLICATION FOR PERMIT TO v �.� iV f"W AA.QT-E L t'U .......... .................................................................. rk TYPE OF CONSTRUCTION ..............�tqe.;p..............:......................................................::....................... "" /.�l%�.. .. .........19...r .� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following'sinformation: Location .......... .......:?.ICU ?.............................1 !f}:�tfJU l ..........M. .............. 22. 0.2......................................... Proposed Use ........................... .............................................................�.................. I� ... ......................................... Zoning District ...................��.�?.........................................Fire District ..............:W.y,4..c✓N/1$.................................................... Name of Owner ............cJ M. ........,1,',CN�!?.�LAddress ........r...SQU..7 H.....`j...T..........d,y VitJI S........ I �X 12�c�G 7-r /Z2 CooNTR.y Club /20 S', S,_+1JD+u1C/� Nameof Builder ....................................................................Address .................................................................................... Name of Architect . .Address Number of Rooms ....................�.F�..................................Foundation C :�/24'Z4 ................ . ............................................. ....11/ S'1 D�iV G ) , Sri/SAG T Exterior ......... ...�;..:�.........�............................................Roofing .................... ......................................................... CAS?�Ep` .Interior ,S" FT /20G k Floors ..................................................................................... ......................... .:. .................................................. Heating .............#IF,.4....7......?Q? !.P...............:.........!:......Plumbing .............. .TA:V 42 Fireplace ....`.................:N ..!U ...........................................Approximate Cost .................°Z��..` ........... y .41I a� 4 Definitive Plan Approved by Planning Board -----------____§_-----------19______. � Area .......................................... Diagram of Lot and Building with Dimensions Fee ...... .......J� l?.................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I r i �1 1�r444 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. Name ......... .. .............. Construction Supervisor's License g.....�....... PENDERGAST, JAMES A=326-119 r _ N- :25893' permit for ADDITION . ......... ......................... MOTEL /ADDITION ............................................................................... 1 South Street Location ................................................................. ....Hyannis................................ Owner ...James Pendercjast ..................... Type of Construction F.>ame............................. ................................................................................ Plot ............................. Lot Permit Granted ..December 19, 19 83 ..........I........................ Date of'Inspection ......................19 ` Date Completed - .�.. -,-_ 25893 ' TOWN OF BARNSTABLE Permit No. __---------- -______________-- Building Inspector suur�a, i Cash ------------___--__ .670. 'OCCUPANCY PERMIT Bond _.__-------------- Issued to Jamess Pendergast Address 1 South Street, Hvannis (Anchor Inn - 18 units) - Wiring Inspector 4f ! �, Inspection date Plumbing Inspector, Inspection date Gras Inspector k .y7 �*a _ Inspection date7 S, Engineering Department id f A Inspection date Board!of_Health ..�! �A �� Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ........................ 19. .._.'._ r✓'/ ................._................................................. ...... __... Bu idin Ins eetor I 'I 1 } .^ 617-775-1 120 TOWN 'OF BARNSTABLE i saaaSrAu ! ZONING BOARD OF APPEALS i9Aa0. ��O l639• `� 367 MAIN STREET HYANNIS, MASSACHUSETTS 02601 June 5, 1984 Mr. Joseph Daluz, Building Inspector Town of Barnstable 367 Main Street Hyannis, MA 02601 Dear Joe: Under Appeal No. 1983-01 , Anchor Inn (.James Pendergast) of One South Street, Hyannis was granted a Special Permit/Variance to add on to his existing motel at the corner of South St. , and Lewis Bay Road, namely, a 16 foot addition, three stories high which would contain three additional units, as well as a second story to his existing building which would contain four additional units, for a total of seven additional units. At the present time, it appears he is building a complete new building facing on Lewis Bay Road. As this is located in a BLB zone, a Special Permit is required for building a motel under Seca K A 0) of our Zoning By-Laws. According to our records, this Special Permit was never applied for or issued for this location. Would you please verify this and advise us of your findings. _. Thank you for your assistance Gail Nightingale w 1 e q � ti { ,.,. . . . i t � . : ��S- 2/, 3Z /�� Assessor's map and lot number / THE }.^SewFSge Pefet' number Ji' . .... . . ... Z RARBSTADLB. House number .................................. .......0...................... : NAM fps,039. 'F0 MAI TOWN OF BARNSTABLE BUILDING • [NSPECTOR APPLICATION FOR PERMIT TO v!!. .........N..) ...... �T L.........W ............................. TYPEOF CONSTRUCTION ............... /. . ........................................................................................................ t' ...................1 ........7.........19... � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to`the following information: Location ..........I.......5Q. 7 .1 ........S.T..............f7!,Yi'4r $...........MA............O.R.6.Q.1.......................................... ProposedUse ........................... .............................................................................................................................. MV4 Zoning District ...................5.. ...................... ..............Fire District ................ .lii�/✓/°.5.................................. Name of Owner ............c�./9.� 5........p gg914S.FAddress ........ ...4aq.ui.....J�...r........ �y ........ Name of Builder ......... ..........:.......Address ...I 2....Cd01 T1 Zy.. v ..�0....5.-.S�DWICH Name of Architect ......... L��E� ....! ..4 v ...........Address .44171?!1 �5. .[7Y Number of Rooms ....................! ......................................Foundation ............ Q.IV. i2 ! ................................ Exterior ..............VINYL......... .1.�.��!.G.............................Roofing ................A.s. 01.4..7`....................................... Floors C �� .........................................Interior ................. / ..........1�4G.............................. .......................... .... Heating .............#&.4.'T. ......&P.................................Plumbing ......... ...... Fireplace ....................../.(�Q.Cv O............................................Approximate Cost ...... !R!ct, �Q.......... Definitive Plan Approved by Planning Board -----------___-_____--------19________. Area ............................. ............ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH /��(/r 'yYt� 11o70-1 ` P d. tV kP V 4 s, OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town Barnstable re rding the above construction. 1 Name ........... �`... .. . ... ......................... . 377 �,j Construction Supervisor's License ...... ................... ......... PENDERGAST, JAMES No Permit for .ADDITION................................... ---�4bTEL/ ADDITION ............................................................................... Locaticfn 1 South Street ................................................................ Hyannis ............................................................................... Owner ......James....Pendergast .... .. .... .. .... ........................ Type of Construction ...Frame........................... -\j ................................................................................. Plot ........................... Lot ................................ December 19 83 Permit Granted ........................................19 Date of Inspection, ....................................19 Date CoTZ ......I 47 % Assessor's office(1st Floor): / Assessor's map and lot number // `7 Tr c ro Board of Health(3rd floor): i�aiC�� CONNEC T 10 d C'JM 0"VER Sewage Permit number Engineering Department(3rd floor): DA8391►DLL House number Definitive Plan Approved by Planning and 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE s �� BUILDING INSPECTOR APPLICATION FOR PERMIT TO i e J TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .�v��i/ <'7;1 2,� Proposed Use n J 'V �a &s!4S Zoning District Fire District -4e Name of Owner .�- Name of Builder (A �a�f' 1 ��51 Address � rr�i/� / 4 Name of Architect Address ",VV S Number of Rooms �/ , - � �' Foundation fr�r-mac/— Exterior ►' y�j d�f � Roofing .1 %44, Floors .. a� ,. -�> --..._._..,_---.._.._. Intprinr Heating 64-,4�,—��tiL %/�;�f� Plumbingd/ y Fireplace �T Approximate Cost n\ Area 76 Diagram of Lot and Building with Dimensions Fee 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 Construction Supervisor's License Q� ` HYANNIS BUILDING & DEVELOPMENT ASSOC. , INC. No 34110 Permit For ADD TO MOTEL a 1 South Street Location I Hyannis Owner Hyannis Building & Develop, Assoc. Inc. Type of Construction Frame _ I` { Plot Lot Permit Granted December 19 , 19 90 Date of Inspection 19 E Date Completed ` 19T/ r $ i a } i 3-. (- ii Ass�ssor's map and lot number :. .................................. ... 73 - Sewage Permit number .......t� D.. ...... ................... .......... v . ��Pyo`THEro�y� TOWN OF BAR.NSTA.BLE BAWSTODLE, i r._ m 9 UI 6 G INSPECTOR �E91 BPI a. !I APPLICATION FOR PERMIT TO .... ....... 4.. .. .......................................................... y...... .... t7 n p TYPE OF CONSTRUCTION ...............�..... ......... ...... . ... .�.�.......... ..N......P4.�.4.�/E,S ....................... ... ..v...192 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: LL Location ........................ ....SIP ?..Q...V.. ............`5.. .. ...........NJ�/¢I�,N I...S... ./..... ...................................... ProposedUse ...........................`.5.AJAE.....................................................................................................,......................... Zoning District ........................................................................Fire District ......... ,� I�l.l!!y �.l..`...:.....:.. 1 .o.ur*...S.�...... �i ® � p M'YNNN�S Name of Owner ......HY...BLIDS�.--DE 1a•A 1210m..I.t:V�,.....494M f+►A Name of Builder 5A 1/.FL....3.17!l\.IiI.thkN W........... ........ .N..0.191.M....!!)jv. ,�.."..N..y.4/VY/f.-��� Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ...................................:..............................Foundation ........................................................................:..... Exierior .............................................:.......................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... a Heating ..................................................................................Plumbing .......................... . ..................................................... Fireplace ..................................................................................Approximate Cost ....................i "'......... Definitive Plan Approved by Planning Board -------------------_-----------19________. Area �O Diagram of Lot and Building with Dimensions Fee ...........fir........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH s I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ........... ...... ............Name ::-�'�':::�..:,./��� .. .. Hyannis Building & Developing Assoc. , Incg No ..16713... Permit for .... remodel.............. Location ..........1:Southe ................Str.......et....................... f ..................:.....: Y.a???us........... Owner ... ..annis..Building & Developing Assoc. , Inc. ......... , Type of Construction frame ................................................................................ * Plot ............................ Lot ................................ November 8 ?3 ' Permit Granted ........................................19 Date of Inspection'?���,! ............ � Date Completed ......................................19 . y PERMIT REFUSED ' ................................................................ 19 ........................................ ................................... ................................................................................ . f .......................... ................................................. Approved ................................................ 19 ............................................................................... ............................................................................... FEE - TOWN OF BARNSTABLE, MASS. d -• "�'-� 19 a.d c oTHIS IS TO CERTIFY THAT A PERMIT IS HEREBY GRANTED TO �R ..............................................................................................................._....................._..._.___.................... ..........._.............................._......_..___.._...._.................. ___._ DO 7 (PROPERTY OWNER) - (ADDRESS) (BUILD) � � ) A( LTER) ,/'� rJ � (REPAIR) o C C P (T P OF BUILDING) •F' � )APPROXIMATE SIZE) DCCCo000A LOCATION ............._._............_w...._...._...._`� __.............: ..._._ _ ..._.._.......:lll...._......._....:.........................._.......__ �N d ++ (STREET AND UMBER) ` (VILLAGE) NAME OF BUILDER OR CONTRACTOR M ..... _.._ .� .__ .._ ............_... ____ _.._.__�_.__._ E APPROXIMATE*COST op I HEREBY AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF THE TOWN' c 0 OF BARNSTABLE REGARDING THE ABOVE CONSTRUCTION. MM )y , .Q darJ� (OWNER) (CONTRACTOR) Cvy: CS O ............................ 13UILDING INSPECTOR Subject to Approval of Board of Health. C Py6FTHE TO�a TOWN OFiBARNSTASLE fps ° �•w I BARasTABLX = ASSESSORS' OFFICE MAB& >�oo,i639 367 MAIN STREET, HYANNIS, MASS. 02601 775-1 120 BOARD OF ASSESSORS DIRECTOR OF ASSESSING MARY K.MONTAGNA ROBERT D.WHITTY ALFRED B.BUCKLER GLORIA W.RUDMAN �,,,, � r _ �-�, I '� � �----� `�. Assissor's map and lot number':':... .....Ao2Z_ ; Sewag Permit number ' - TOWN OF BARNSTABLE TI E T� BARNSTADLE, i ti BUILDING = INSPECTOR i639. 0� ^ 'EO YPY a' ti; APPLICATION FOR PERMIT TO ................. . ................................................. ' TYPEOF CONSTRUCTION .......... ............ ............:........................................................................... .............. ..� .... (� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: l ..... ...:............... .. ................... ......................................................,.. Location ................................... ProposedUse ...........Q. ............. ....................................................... . .......................... ............................ Zoning District ........................................................................Fire District ................ ..... 'r!�!!- t�..a.................................. Nameof Owner ... !!-,�..... ......... .........................Address .........�.... .. ..................... Name of Builder ....................Address .......... ......................... Name of Architect .......... .......... .....................................Address Number of Rooms - ..................,................................................Foundation ...........:.................................................................. Exierior ....................................................................................Roofing ......................................................................:............. Floors ................................................Interior ....................... Heating ..................................................................................Plumbing .................................................................................. - Fireplace ...........................................................:......................Approximate Cost ........ .......... -Definitive Plan Approved by Planning Board --------------------------------19-------- . Area" ........ .D. . ... .. 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 ......... •.........`.... . ••••••••..... Pendergast, J. F. :18725..... deck......... n o Permit for . .......................................... Location 1 South Street Hyannis ................................... ...................................... ' Owner ............J. - . Pendergast..................................................... f rame:. Type of Construction ........................................... ............................. ....................................�...... - ' E. Plot ............................ Lot ................................. .. October 12 ,Permit Granted ...............................:......:19 76 Date of Inspection ........... ` ............ ..... .19 { Date .Completed,.1P.// ...........19 , �.PERMIT REFUSED .....................*_ .......... 19 .................. .........................................................• ., i♦ . - ... ............................... ....•... ............. ................. ... ................. ••.......... ................... ...... 'N. ...................... ................................................ Approved ' ...................................................................:...... ................. ......................................................... 3. Assessor's map and lot number • �I O Sewage/Permit number .......................................................... T"Er°�°�.� TOWN OF 'BARNSTABLE Z BAHBSTLU i p, 1639.M a' NAM BUILDING INSPECTOR �RFD PY e r • n L APPLICATIONFOR PERMIT TO .................................................... ..................................................... TYPEOF CONSTRUCTION ..........1 .'` , - .................'................................................................................... .. ....!.. '...19,�jC, TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................... ................................... '! ° 9......................... Jrt;v.e................................................................... ProposedUse ........... :°ter,! ... .....CS?'........................................................................................................... Fire District Zoning District f!-t-c.:...:................................... t ......................... Name of Owner ., .. .........................Address ........./.... ..�-..:. Name of Builder ....` !fA ..-... i(!Y�t^ Address ......... ''?ti ..................... ''......................... Nameof Architect ............................::....................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. t Exierior ....................................................................................Roofing .................. ...-.-............................................................. Floors ..............................................Interior ............... ........................................ ..................................................................... Heatin .........................Plumbing Fireplace ..................................................................................Approximate Cost ............ .Q..a.:`. Definitive Plan Approved by Planning Board _________it'f_________________19________ . Area ........Z.. .. ... - Diagram of Lot and Building with Dimensions* ,,!~ �'• Fee ............... ....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH � t f I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...................................................... ...... , ............ Pendergast, J. F. A=326-119 1 South Street Hyannis Owner J. F. Pendergait PERMIPREFUISE ....... .......... .... ............. ................................. ............... .................. . ...........1.'/...................... .---.—~—.-----..—..---..—.----- , � .—.--~-----------..~..,—..---..— . . . � . App,oved --------- lQ ...................................... —~--.---. . � --- ............................ � � v Assessor's ;map and lot number /.!/.........,... ..........�. ✓...... �• Sewage Permit number �• :4, (flc TOWN OF; BARNSTABL-E a r. "ASa B'UIDING ' INSPECTOR 4p 039. \00 APPLICATION;` FOR PERMIT TO ............ .................... ......................:.......................................................... TYPE OF CONSTRUCTION ............i cL- w�.o........ t ..... .............1 ...7.... m ..y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........:r:. ... ...` ........ ...lr............(.l..r . .'�..�t�....... .`4.s.s......................... . ................................... ProposedUse ..................... ...�........`.............................................................................................................................. Zoning District .....................................Fire District .............. .:. ... ..................................... ..................................................... Name of Owner ........ vvi. .. T. �'ilcl�� '`ifs Address ..... ......5 p ....... / ^ o v 7 - y iPnn +S Name of Builder .... . . v Ark i,��,er� //1 evh 0 / s l 11y, n.. .. /at:!9.....................................................Address ................................................................... Nameof Architect ..................................................................Address ..................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. 7 Exierior ....................................................................................Roofing ............,....................................................................... Floors .................................................................:....................Interior .................................................... Heating ..................................................................................Plumbing .........................................:........................................ n Fireplace ...................................................................................Approximate Cost Definitive Plan Approved by Planning Board ---------------____-----------19________. Area �lJ a S� ......... d Diagram of Lot and Building with Dimensions Fee. .............. .............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH VA X 3 �/ fr, N�� +�- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...... .e.. ... Pendergast, James F. Z�W 17922 add Deck to Motel ' No"Q............. .Permit.for .................................... .............. .............................................................. 1 South Street Location ...............:............................ ;A Hyannis ..... ............................................ ....... ........... James F. Pendergast Owner ................................................................... frame Ty' p,e of Construction ........................................... . ................................................................................. ..................... Lot ................................ Permit -Granted ..........September 3......19 75 ,Date of,"inspection ............................ .......19 Date Compleied ....................................n19 PERMIT'REFUSED ......... .................................................... 19 ............................................................................... .......................................... ....................................... . .......................... ................................................... ............................................................................... Approved ............................................. 19 ....................................................................... ....... ................................................................... ........... Assessor's map and lot number ..........................'lf =' Sewage 'Permit number Gam. /6 ?"ET°�° TOWN - - OF BARNSTABLE 33A"STODLE; i �' /r °° "6 D,UILDING INSPECTOR ' �o war a' APPLICATION FOR PERMIT TO ............................................................................................................................ TYPE OF CONSTRUCTION ................................................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... ` ........v....'...... ...........5....:.................................... .. . �......5:................................................................ ProposedUse .............................................................................................................�................................................................ ZoningDistrict ........................................................................Fire District ..............`.... :�..................................................... i / f Name of Owner .......::.�.................................fD t° ruf er f.at/ Address .....f.:. � ` �...�. `? .:.5............. . ....... ......y. .... ............................ .��y Name of Builder �i1.tt. �� 5.at �.aNe<i ......� :/•? ................... ......:...........................................................Address ........... ............................... s Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exierior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ...................:..............................................................Plumbing .................................................... ... ............................ O � u Fireplace ..................................................................................Approximate Cost ..................../.. .......................................... Definitive Plan Approved by Planning Board ---------------____-----------19________. Area •w Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH C 1:1 J 1 t I I G x Jv f✓ I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............ . . .... ....................... t jRruz.• a'; -�`6- Pendergast, James F. A=326-119 No .... Permit for add deck to P r .................................... Motel ............................................................................... Location ............1...S.ou.th..St. ---et...................... . . .... .... .... .... . .......................... .. ........... ..................... Owner .............James.... ....Pendergast ........... .. . ...... .. . ...... ...... a Sou th S '***e an/....n-i-s.. ........ .me F end f ral Type of Construction ...........fKAme .......................... .................................... ............................................. Plot ....................... .... Lot ......... ......................... Permit Granted ......... September .3.....19 75 ................... .. Date of Inspec on ....................................19 Date Comple d ......................................19 PERMIT REFUSED .................... ............................................ 19 ........... ................/- .......L................... .............Li.9..... ...... ..11.................................... ................. ......I. ..................................I............ ............................................................................... Approved ................................................ 1-9 ........................................................... ............................................................................... Assessor's map and lot number .:. .......... _. Olt '• /� Sewage Permit number ..........C.L.xu!<c,6-4r,&-d1..:..:..TG......���� 'If"ET°�° t: TOWN OF BARNSTABLE Z BA"ST"LL i 16 .e� BUILDING INSPECTOR cm o APPLICATION FOR PERMIT TO ............... .0...!..5..(........................ ............................. TYPE OF CONSTRUCTION 0-o n c r 91................................................................................... . il.. .1.....................19J• r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................ ..................... r�.... N!As.s:.......:................:............................. o Proposed Use S w ,^^ �` "' e 0 Zoning District I`..Y.' :!'.^..l.s................Fire District Name of Owner .......... e..... n,d er;A rT Address ....I- Sri v 'i'j. S ?� ......... .... Name of Builder ................................ .......Address Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ........:.........................................................Foundation .............................................................................. Exierior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .......................... ....................................................... ��D 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 SoLj4-Q _o V n C- _i, YX ryX re. l L3 S -T boo n In b/ I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regar ing the above construction. Name .��:,'..... .. .............. Pendergast, James F. F No• 17628 Permit for ,, swimming pool ,i. .............. .................................. ............................................................................... Location ...............1....South.............S............treet.................... H annis ..............................x......................................... -� Owner James F. Pendergast ,J .................................................................. Type of Construction ....motel fool j' ` ................................................................... .. Plot ............................ Lot ............:................... Permit Granted ....... April 3 19 75 ......... r: Date of Inspection ......... .........19 l7 Date Completed ........ f ll !... ......................19 PERMIT REFUSED F ..............................................................:. 19 t' E t .. ... ............................... ...................................... T ............................................................................... - - Ij Approved ................................................ 19 f � W i,,.s.t/.i�y, -� v f r si F i+•ry�`� M ems" �).....VA'«'�,^4.y'��Ati µ h:. �+ i 1 Assessor's map and lot number ...., ..^..f'...`... ......... Sewage Permit number TOWN OF BARNSTABLE Z EAWST"LE, i "6 9. BUILDING INSPECTOR APPLICATION FOR PERMIT TO 7 ..�" S ....o TYPE OF CONSTRUCTION .. >, c �7`M................................................................................... .................................................. .....................19. � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .. , . ._r,,f4 .,•. s +a� ..s........................................................ ........................�........:....�!.............` ................................ ........... Proposed Use .. , ... ..,`I............................................................................I......I. .................................................. ...... .... ........................ 7 Zoning District 1W Y .4 'I" Fire District �-� v a r n.r ...................................................... .............................................................................. Name of Owner ....... .....' ..:?' �. ! .?.r.�..............Address .....!.:.... .......5. ............:�s:!......::..5.....'...'sr..... Nameof Builder ....................................................................Address ...'................................................................................. Name of Architect ...................................................Address ............... .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exlerior ....................................................................................Roofing .................................................................................... .............................................Interior ............................................................................... Floors ........................................ ..... Heating ..................................................................................Plumbing ................................................... ............................ d Fireplace ..................................................................................Approximate. Cost ..........'� .�.:-::.............................................. Definitive Plan Approved by Planning Board ----------------------/19--------. Area .......... q.,i*'.................. Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH -r i '1C R h n,A 4 7u I`�0 J a - I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. rr ' Name ... ......................... '..........0 ............. Pendergast, James F. ............................................................. ................. Location ...........I...S.o.uth...S.tre.e.t/............... Jam es F.**'P/n.d.erga-s-t otel pool Date Comple/d .................................19 PERMIT REFUSED V........................................ App,ovad ---------------' lg ' -------------'----^-~------' ' --------------------''-^---^' ( -assessor's office(1st Floor): Iq v, Assessors map and lot number Board of Health(3rd floor):Sewage Permit number . Z �ASl9TLDLL i Engineering Department(3rd floor): ryas House number °o 039. Definitive Plan Approved by Planning Board 19 ��r�r A, APPLICATIONS PROCESSED 8:30-930 A.M.,and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING IN-SPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION 19 — TO THE INSPECTOR OF BUILDINGS: The undersigned/JJ hereby applies for a permit according to the following information: f Location Ga�l �n'� �� Proposed Use 414 Zoning Districts- Fire Districtsr°rxw.t i Name of Owner) y vs/��� IAILP�e, A— Address i Name of Builder � 6�������.�oE �l %��s� Address�'� / 4 Name of Architect 6LA-1 Address Number of Rooms r 6:Mf� Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost Area Diagram of Lot and Building with Dimensions Fee C> r 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 Construction Supervisor's License j�>/ HYANNIS BUILDING ASSOC. ,. INC. 0 3.4064 permit For Demolish Blilg. Frame Building Location 1 South Street Hyannis _ Hyannis Building Assoc -Inc I .r ;ry X Owner Y g t Type of Construction, Frame xI Plot Lot Permit Granted, November 16 , 19 s 90 Date of Inspection 19 I z. Date Completed•- �` ��91 `5•19 1�_ 2 hF , " .1 a r., .-. r f. r .+• .. :+f-- - ,....'a....7°t+�.*,fir. .N?fY-+t9'r' d r ��' �r" ��•�h �' _{ ra �� Assessor's office 1 st-Floor: Assessor's map and lot number 3 b"' J ' Hof THE Board of Health(3rd floor): Sewage Permit number Engineering Department(3rd floor): 'Dss19rant is House number a7p.�\��' Definitive Plan Approved by Planning Board 3x ' 19 c��� 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 TYPE OF CONSTRUCTION e 19 �. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby '�applies for a permit according to the following information: Location Proposed Use� '�►�,/a.. °I� A;,7; �)f.�� ,4 Zoning District ���• ' Fire District 4-L1A-1,V t C oName of Owner jk,,Vw>is J)u"44— Address ,j!jj,.4am6,of Builder �, ��/� y,a-Al: /A/4f .Address Name of Architect .4,s tI Address h/yIll-w'y 5 N#mber of Rooms Foundation I Exterior Roofing i t Interior Heating Plumbing Fireplace Approximate Cost y Area Diagram of Lot and Building with Dimensions Fee r S. 3 C OCCUPANCY PERMITS REOUIRED FOR.NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of.Barnstable regarding the above construction. r Name � '...,r < Construction Supervisor's License D�4 HYANNIS BUILDING ASSOC. , INC. A=326-119 w ., No_34064 Permit For Demolish Blda. Frame / Building i Location 1 South Street Hyannis Owner Hyannis Building Assoc. , Inc. Type of Construction Frame �. is i Plot Lot ` Permit Granted November 16 , 19 90 Date of Inspection 19 Date Completed 19 I fak 7 4,ej4 �- PE COMPLETED /00>. A/72 FtrtF ra U n IIS Lc1U1C *Permit#s2 2 f4-.-, Expires 6 months from issue date • Regulatory Services Fee BARNSrABLL MASS. 9 1659. Thomas F.Geiler,Director Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601w Office: 508-862-4038 X-PRESS PERMIT Fax: 508-790-6230 MAR 1 6 2001 EXPRESS PEF.AHT APPLICATION c,Not Valid without Red X-Press Imprint TOWN OF BARNSTABLE Map/parcel Number `2" Property Address % s O`' _(l Residential OR Commercial Value of Work y O c ( wner's Name&Address r— r`t'J IN3a� e lq1S c� u 7cc> Contractor's Name L Cq 2 rZ,4 1; Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) © 3 U/ d / Workman's Compensation Insurance - Check one: I am a sole proprietor I am the Homeowner have Worker's Compensation Insurance Insurance Company Name Z Pic A L Workman's Comp. Policy# / / Permit Request(check box) Re-roof(stripping old shingles) "l 0 Re-roof(not stripping. Going over existing layers of roof) Re-side Replacement Windows. U-Value (maximum.44) [] Other(specify) •Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation.etc. Signature expmrrg I ' I s 4 .. ._ 95''a r,C r" .A - tip�., �a #• `=fz, �L`. is r I�r *L., �Md. " ,'.R' N "" r R 4'„ fir' - t r , }A t - 3 _ - F<{', w y..�"�,,{r, .+ ip,t, i '#t Y. w:YP`. »'l ""�, ;k';'p" 'SFir :` *. r,�,3 �:'t ,r•- ai u;�- ,� C ,. ra.,a . I ["rt. . a.... .r, �% I,7 r .. �� ,)`.y[, :t. 5�,5• �r�,r L 4C'':� w A :11,. �„ } "s 1 �, ,fX� � •�"•�" I�: try M a .. .a.;r :••A' } ,.y' -'. t : 3i5,yJ.,L cA4- 4� P3 e�is[f p a' ,..,. g'y',t w t.P y a i' it. r,q, •I,.t.., �. `rM"f: y• ';'', eF h • �S r wt,. ¢r.. IN fi-rr ._4 a .,+ w ;. `rs"' 6 Af � WWW �(�-.' l � ' `F. •l '3 .. r an ", a •rt l:.. -ill,� - d "-, " u' i !"r" G ti 'ii' .+ 9i A J�'& Y,. iaC„ rS - •� r: r. - s.aM.. 4r. MyG r.' :11H� rY w1 P6, , � } q.. 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'" ' ,r,..,r 'a' , .,,_. .tip.. .. .,Y`„� r „S" aW t r:. trn u,4.:i ".. •:, Irh '.. 7 .. t", ,. ;� '$r .,.�'. 't's .,, ti r(4'. .••f `?•, re,s s Liy�: z Sr +� s�* r 4 d w °1. r,9 i "4 :¢4 AS m J y, y,r +, .rrk r ,t ;^rrr: { "y,''' t. _ q",, s r. ,R �i ,. ' - '.. p,� `3 :"'' x."- .'°'. s. =�;,11. h, " ":: ;'a,a'W."'F� ' :"�o a'"+: _ .,v'..:#+.�tys. r, a.�r," .x,. 4'F,;',a •+1?``', *+w z'r t a r .c: :(._t1 1 .,..". r �+ S!. >r ,r` a,. �",f y :..�,#Mf �,,,. 'b_ � r _ F ';.�+r$i:. rCaWF Her, Yj 1.a'a, 7t., .i' A �a� a'F d`t+ �et ' d< ti rxxP.,4 �. Y fir• z.. a .. � :.r r� ,1. 44 p r,;"Mt .4 ran r f A- 7r,,. .'ry '**i aa?'4: }pi d " +yf:'t,p :4`f :-,,! .F' + rrr^f � -," -h' ?# ;�Vy 1, Ira { + :,A. _fc r _ t. r" .�"..! ,Y,"- •„r,= K M :"' o- t'7 w''';:w<t• ''i.s'S'" } Y. Y" ,; i «4.. „� 'i.: - ;�S"; •.t+G' y '..ys w • ^�k a.' w r 4 5r'd,� t4 r k w.E4.. y a` 't . ' 't t r "DF.iz :.+ .. i1 +- r .hw'A�,6dkkacBair` M:u, 'Nik ,.✓w .aa+n c: .' a.w•ne..rlarx'.c w, ..-aL A'r.".Z'`rktt,x^,. u..t �ri'. .rr^.z.n. ei ''IrW.,�:,t+'eL.,.-', r •a,raCtex Yr.'aaw.`..A. ,-: d.e,.Yk+..w-••,i7 ++r•w. ...� -...- ti?-" a° SUMP A i i PUMP i bECTok a IA CMEA i �itr i UNIT BATH ----- a7 f 1 O ----- --------------- thy§ - , s ~ S♦♦ t. 2.5" x „! cli --- _ 216x6/8 4/Ox6/8 4/0x6/8 -� (t1 NOTES. 911 interior doors to be louvered doors 0015 KITCHEN h 10"I X137 14' 14' * R19 insulation in ceiling z AREAy BEDROOM S s T� to B15 2/6X6/8151 Eked panels _ Q•`Q Y � m `{laminate earns 4 •: 1 p cv I -- mu�atcd6earts-- 2;5„ cri Wo Auk 5 }, 'ir f , FLOOR PLAN GENERAL NOTES: 3/Ox6/8 y 1 1 Smoke detectors Stems shall be i :_ z NEW 2' 603:1 „ Type III in conformance with(3 .6.3). PLUMBING 1310"x 11,81, _ . 13A5EM T, LIVING ROOM s to 3" fa, 9/0x6/8 slider existing - doorfim•,t' ."t La Y j I All wood used In construction � of decks and steps shall be treated. Fasteners for treated wood(nails,bolts, 5.8 hardware,ect.)shall be galvanized Sul i , c i 5/4 x 6 treated decking ------- EXISTING DECK ABOVE ----------Q-------------- 10"son,tube rad 4'0"below 6'4-1/2" —6'4-1/2" 1�4"—` 5'10"—� g � NOTE: Measurements are to be verified by.contractor on Site prior to construction693 ` scale: 1/4"-1.0.. Anchor-insuite s c/rawn*112zr01 one south St q w alan maki hyannis ma fir LO FLOOR 12LAN GENERAL Smoke detector systems shall be 3/0x6/8 Type III in conformance with (30 03.1.0.3). 2' I = 18,ro 13'0"x 11'8" � 13 TASEME =�a LIVING ROOM s y N �- y' Dom1} I x t� 9/0x6/S slid exiotiner 9 - � door I I ' I I�� I I kk 10,S" o i 5,6. 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D315 KITCHEN 101 X13 7 . �, .,_ 1 4 4 1 1' (� . 1 ".,.::. x ... ,. ,... ..,n,.a, .. . .. .:.. ': ,v<3\. A EA ..... :. _w 1 ion �n ce Ilan Z _ l��9 in5u at ., 9 .�_ B 1200M II d,, B30 i. J . -!� .• • .. ?,c:. , ,. �.. E ....3:, . ` .J . c ...,. , f. , , � � K. C c� _ • B15 ,, . - 2 X6 81 Ilse ;ry.A /6 / 5 :. CO : . :. <2 C c fixed 'anelo . C , O • ,: " . . „ O . 3, �, . , . O .. - .. 0 zs Q r -- ------ --'laminated beams . , ..,,. rn .. t L • . : .s •: - _ nt _ ,,.. ., sz x , . 3 • Z _ p Q y . ,,. w . j _.. - . •• -- : ------- ------ .,, aminatec6eamo N . k-r�; : : 2 . :1 5 -.: ,; 'I` -'� . • 0 -.v'. I1.1 .: : .: ,.,,.,,- ,: f t, I_.,, 6 11 cn -, 5 5,R,, , Q O s .J .,, „ .._. A � . FL0012 CLAN GENERAL NOTES. �' >` z . . „=.t .,, , 0, 1 mo t t otem5 5h I1 be: , :. _ 5 ke de ec or 5 a 3/Ox6/8 .. . .: y . ,:. - .. � , J :': :.: :.: _ ,. f :F, 2 iL , .1.T Ill i conformance with 3603 6.3 f e n y p 0 c,,;, I : -- .• . PL UMB NG +� , • 4 3 f r �, 18 6 F Ox11 8 _ . r , 13 13A5EME T -1 I i L1V1NG ROOM s . ''''rl_ . ..`. , 11 ,..1,-., ll 11 , ,, _ 3 1 /2 , 11 9 . q, • _ , „' E 3 x . . N • i . 10 ,3 3 =.. i • . . , . ,. 1, . :, , i ': . : x 8 slider 9/0 6/ ewytln _. g t „.;,. .., door 1` I I All wood used in con tructlon I I 11 10 r II e rated. 5 r '' of decks and Ste 5 aha b t e I p o r Fasteners for treated wood Wally,bolts, 5 8 5 8 I hardware,ect. shall be alvanized 9 , Q 1 x I 4 x 6 treated N 5/ _I • I deckln 1� 9 ----- EX15TIN DECK ABOVE ---- --- --------------� • 11 .. . ' WE 10 yona tube 40 below` rad t g - 6 4-1 2 -- 4 y 6 4 1/2 1 13 5 10 . w b f f -.. :�. - ' ' ,w NOTE. Meaouremento are to be verified b contractor on site rior'to construction . y p . �i_ �� a • / , - 6 93 scale. 1 f4 = 1 0 Anchor rn ,': - t I drawn:1/22102 one -south st ° st , , q f � , �° by. alanj makr hyannrs ma �0 ®®