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HomeMy WebLinkAbout0596 WEST MAIN STREET 54L 61/c,r/�lau sr. Town of Barnstable Building , eaiznsrwB�e JPosf This,Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept !!° a Posted Until Final Inspection Has Been Made. � �� Fo naa�" ,Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. i IL e s Permit No. B-19-3706 Applicant Name: MARK modestino Approvals Date Issued: 11/14/2019 Current Use: Structure Permit Type: Building-Addition/Alteration-Commercial Expiration Date: 05/14/2020 Foundation: Location: 549 WEST MAIN STREET, HYANNIS Map/Lot: 269-002 Zoning District: SPLIT Sheathing: Owner on Record: BARNSTABLE,TOWN OF(SCH) Contractor Name: MARK A MODESTINO Framing: 1 Address: P.O. BOX 955 Contractor License: 3428 2 HYANNIS, MA 02601 Est. Project Cost: $.101,000.00 Chimney: Description: Installation of freezer/cooler Permit Fee: $ 1,019.10 Insulation: Project Review Req: Fee Paid: $ 1,019.10 ,Date: 11/14/2019 Final: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within'six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street.or•road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. .,A Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this:permit. Minimum of Five Call Inspections Required for All Construction Work: ' _ Service: 1.Foundation or Footings, r 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final Co1struction Control Document To be submitted at completion of construction by a R a Registered Design Professional for work per the ninth edition of the See Massachusetts State Building Code, 780 CMR, Section 107 Cent. 'LVe kt3i T_ Project Title: Date:Cbf g f Permit No. "Am Property Address: S,q Vl T N ST .1 � Vl sl Project: Check (x) one or both as applicable: New construction )C Existing Construction A Project descri,ption: r2o,am a registered design professional,and I have I MA Registration Number: Expiration date:04 prepared or directly supervised the preparation of all design plans,computations and specifications concerning: Architectural Structural Mechanical Fire Protection Electrical Other: Describe for the above named project.' I, or my designee, have performed the necessary professional services and was present at the construction site on a regular and periodic basis. To the best of my knowledge, information, and belief the work proceeded in accordance with the requirements of 780 CMR and the design documents 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 s: submittals by the contractor in accordance with the requirements of the construction docu�kiento fY; 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17, as-appligable 3. Have been present at intervals appropriate to the stage of construction to become generallyifamiltar 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. j Nothing in this document relieves the contractor of its responsibility regarclin.g the nro��iciona of;30 C' R 10, Enter in the space to the right a"wet" or �EN�TH oFg, electronic signature and seal: ' gss9 U F4 STRti 0 C C c v o CTURq rn p0 9R 34��4 /� —7 TERE� 6l Phone number: W Email: cNAL ENG�e�`�Q ' d�'I Building Official Use Only Building Official Name: Permit No.: Date: Version 01 01 2018 Construction Control Progress Checklist H To be submitted at completion of required site reviews for construction progress per the ninth edition of the � Y F Massachusetts State Building Code, 780 CMR, Section 107 sY°v Project Title: Date:l 2/J Permit No. Property Address ��r� �� r`kI N S'-,'I WI.411 MA I, R' �. �v bl L� 4-1 CHN A�2egistration I-�mber: Expiration date: -lzo am a registered design professional and I or my designee have observed the following work, and to the best of my knowledge, information, and belief the , construction work indicated below has been performed in a manner consistent with the approved plans and specifications; Requrred Site Review axid ,aciuxcentationtfox Poxhons ar Phases tsf Construcfiion z� 6,b >. .. s-r .r tr r7 s;� s,, .r t6,l .rformed b theta, m Hate r_ erecljdes' rofess onal'or lus/,het desr _ee or M G L e 112,3$1R,contractor s site,Review and Documentation +X„ Site Review andDocuaieritation X Soil condition and analysis Energy fficiency Requirements Footing and Foundation,including Reinforcement and Fire Alarm Installationz Foundation attachment. Concrete Floor and Under Floor Fire Suppression Installation3 Lowest Floor Flood Elevation ', Field Re ortso Structural Frame-wall/floor/roof L$ Carbon Monoxide Detection S stem4 Lath and Plaster/Gypsum W Seismic reinforcement x ,prSmoke Control Sy Fire Resistant Wall/Partitions framing {Special Inspection per Sections 909.3 ; <; and 909.18.8 Fire Resistant-Wall/Partitions finish attachments x> Smoke and Heat Vents ` Above Ceiling inspection Accessibility 521 CMR) Fire Blopking/Stopping System Other: _ Emergency Lighting/Exit Signage Means of Egress Com onenets -= Special Inspections(Section 1704): Roofing,coping/System Venting-Sys ms kitchen and cleanouts,cherr ical,fume Mechanical S stems 1.Indicate with an'x'the work you reviewed for compliance with the approved plans and specifications and describe in detail below.' 2.Include NFPA 72 test and acceptance docurneitation 3.Include applicable NFPA 13>13R,13D,14,15,17,20,241,etc. -test-and acceptance documentation 4.Include NFPA 720 Record of Completion and Inspection and Test Form 5.Include field reports and related documentation 6.Nothing contained within construction control shall have the effect of waiving or limiting the.building official's authority to enforce this code with respect to examination of the contract documents,including plans,computations and specifications,and field inspections. Description of Construction Work Observeda: a. Describe in sufficient detail the work (i.e. foundation steel reinforcing, kitchen vent system, etc.) and the location on the project site,and list if applicable,the submittal documents that Q pertain to the work which was inspected,Ut U t— Pam= �N itc ( -tPt �Uro-r �gL1 t��2`lZx S`/z— `(5l Z« IM2 w Enter in:the space to the right a"wet"or 1. 3 ¢ t , electronic signature and seal: 1 �N of Phone nu:piber:50�73Zai1: C� �. 1 goy MICHELEninim ycrn . o STRUCTURA y Building Official Use Only No 34774 Building Official Name: Date: 0 9 Q 9p FcisTEP� � ' ONAL Version 01 012018 Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the ninth edition of the c;� e 5� Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Date: Property Address: � VVVS-r jl"tt/l' N Project: Check(x) one or both as applicable: New constructionx Existing Construction x Project description: r91 9�5 TD Cam) C`H, u, "e_L_0SUg.V_%; 1 A Registration N�,mber: xpiration date:D�O/?10 ,ar:�a registered design prc�assianad, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': Architectural Structural X Mechanical Fire Protection Electrical Other:. for the above-named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), arfd accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, 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. Perform the duties for registered.design professionals in 780 CMR Chapter 17, as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a 'Final Construction Control Document'. .�µ OF Mqs _ Enter in the space to the right a"wet" or ���� °ti ` G� ELF electronic signature and seal: I° C�pI a� � 0. o STRUCTURAL m G ClC 9 No 34774 l Phone number: Og—�??�SoZI EmailQO s�',sTE�G���' Building Official Use Only Building Official Name: Permit No.- Date: Note 1.Indicate with an'x' project design plans,computations and specifications that you prepared or directly supervised. If'other' is chosen,provide a description. Version 01 01 2018 Town of Barnstable Building Department Brian Florence, CBO Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.bamstable.ma.us Pre-application for Business Certificate Date /� 2�'i� Mapo'14 Parcel �� 1 Applicant Information Applicants Name &r19Z)Z zi tv,S / Applicants Address �s/4.1i Email Address h� 1070�11, °wl1 C22�f'Lr��. 171f9 026 V Telephone Number /, ? -2-,�i„ "7 Listed ❑ Unlisted ❑ Business Information New Business? ----------------------------------------- Yes Business is aregistered corporation? ------------------------• es No If yes Name of Corporation C 6d ea l L ,C^ Does business operate under the registered corporate name? Yes Is the business a sole proprietorship or home occupation? --------- Yes If yes then a Home Occupation Re tigistra/tion is required—See Building Division Staff Name of Business WhoP &9#4 / h1W11 wr Business Address r! Sj 7i /j 10 026'�l Type of Business juilding Commissioner Office Use Only Conditio W ' - Building Commissi Date 2 Clerk Office Use Only YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall)and get the Business Certificate that is required by law. DATE: 7/16/2 014 Fill in please: : . � APPLICANT'S YOUR NAME/S: Karryn Lewis & Brian Lewis "' �� ' x � BUSINESS YOUR HOME ADDRESS: 12 7 Gordon Ave Hyde Park, MA 02136 j TELEPHONE # Home Telephone Number617-594-2127 NAME OF CORPORi4TION CAPE COD PHARMACY & HEALTH Ltd NAME OF NEW BUSINESS WHOLE HEALTH: PHARMACY TYPE OF BUSINESS LLC IS THIS A HOME bc ,I nbN9f4YES`'z NO XX' Q ADDRESS,OFBUSINESS.) 6 WEST MAIN .ST :HYANNIS MA, 026O,1e:MAP ,PARCELNUMBER G(O;I ZS.� Assessor / When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S F E This individual has bee o d of an p mit requirements that pertain to this type of business. AN orized Signature* COMMENTS: 2. BOARD OF HEALTH This individual ha ee i fo d f the per s that pertain to this type of business. Authorize ignature* n �(� COMMENTS: I�S v� �� s-C4 4-A)s O / ✓vetikl2pt-- 4-A-yy,�+ 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: tHE h,. Sign TOWN OF B ARNSTABLE Permit BARN MASS. '0?Fp A Permit Number. Application Ref: 201408237 20071049 Issue Date: 11/24/14 Applicant: STUBORN LP Proposed Use: RETAIL & SERVICE STORE SMALL Permit Type: SIGN PERMIT Permit Fee $ 75.00 Location 596 WEST MAIN STREET \� Map Parcel 269251 t Town HYANNIS Zoning District SPLT Contractor PROPERTY OWNER Remarks REFACE EXISTING SIGN 50 SQ WHOLE HEALTH PHARMACY Owner: STUBORN LP Address: 297 NORTH STREET HYANNIS, MA 02601 i Issued By: PC PUSfi THIS CARD SO THAT IS VISYBLE FROM T1E S <RET PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: ',11/24/14 TIME: ,�11 :23 ----='-----------TOTALS-=--------------- PERMIT $ PAID 75.00 AMT TENDERED: 75.00 AMT APPLIED: 75.00 CHANGE: .00 APPLICATION NUMBER: � PAYMENT METH: CHECK PAYMENT REF: 1019 Town of Barnstable Regulatory Services , r 3' gHAie1, S. Richard V. Scali,Interim Director Eo;p. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit# Building Official approving_-_----_-_-- L Application for Sign Permit. A _ �� /►Cat il/a A N Assessors o.-4 Applicant: --- -�-----77- -/��J ---C . Doing Business As:-_ �C_ L14- -1Agr l4CY"_-_--Telephone No._78� Sign Location ---- Street/Road:--__ 9� �5 /q_ih__- �F/Ct/1ni5 _t�A d,26 / -n 11 *- -- --- -�- ---------0------�I----- , tip Zoning District:RJ3 ji 13 01d Kings Highway? YeseHyannis Historic District? Ye ME c,n Property Owner Name: - - ------ 93/6 � ------ - 11 eepone: ---------------- -T --= c-- , Address: S _ ! Village:__ Sign Contractor N.une:------P�lt7ou -----, h oin k� 6' W 212 --� �-d ---�-�- ------------Telephone:-'-S�-----�-----/- Mailing Address:_ �' L,3__D�� Qin J1 Y4// -Aa4 /y7A____Q2 GG y Description Please follow the cover directions.You must have an accurate rendition of sign with dimensions and location. Is the sign to be electrified? YONo (Note:Ifycs,a mi ingpcnnitisi-cquircd) Width of building face��.* ft.x 10 D x.10= Check one Reface existing sign or New Total Sq.Ft of proposed sign(s) ® If'vou have additional signs please attach a sheet listing each one Frith dimensions If refacing an existing sign please provide a picture of the existing sign with dimensions. T` I hereby certify that I am die owner or that I have the authority of die owner to make this application, that the information is correct and tha"uand truction shall conform to the provisions of '240-59 through§240-89 of the"TownOrd nance. Signature of Owner/Authorized Agen _ Date1 �y SIGNS/SIGNREQU revisedl 10413 Emailing: wholehealthpharm_sketch-karrynlewis@gmail.com - Gmail Page 1 of 1 v:holeheallhpharm_sketch;pdf Open with karrynlewis@gmail.com - ......__.....__. ..__..... Gmail _ compost Why this ad? Inbox(57) Starred Important Fill' va Sent Mail Drafts(50) [Gmail]Trash y ioo.com [Imap]/Drafts F11 A RNq ACI Y [hnap]/Sent y [Imap]/Trash • Apothecare Deleted Mess: .E Hm > .RNIN Search people Ryan Pow, f Automalec VIA 02664 Brian Lewi Jane Haml Ads Matthew L i50" Brian Lewi Chisholm, �, s Devon Bur Forsythe,I CUS"'Pt7t,A.ER s=ERMrT No. Romanick, & �"F: t+��t ltn€srr:ttEl om tom.warrer AVtSiC)NS: x ridual cr:c !4z5 E"xu'S, 53]-f E+s .-A n11G- rx ,4rziC6 k.; C G Mk tw T' S ca3pt n .C F,F r "y Y 1 .ri.c- a•tam. - - -.. dx's-Y�s'.rP.rzsh,..ry d,n oe u�-�sx r2.X:✓+f i•.Mne� «hmk. kP f f'�,y J#'ri layyny,•x:,c.s,xz+!np f'�s"xaL.h(•�T��+'. - In 7(� X F of 2 fsrris https://mail.google.com/mail/u/0/ 11/13/2014 HEALTHWHOLE HEALTH PHARMACY WHOLE ' • ' ;"PW 508-775-2100 508-775 -2100 S ■ , tuL MAIN r CUSTOMER PERMIT No. DRAWN BY DATE: MATERIALS APPROVED BY LOCATION: P.OJ REVISIONS: SCALE This is an o val unpublished drawing, created by Plymouth Sign Company, Ina it is submitted for yornr personal use in connection with the project being planned for by Plymouth Sign Company, Inc ti is not to be shown to anyone outside you organ. ton, nor is it to be used, reproduced,copied or exhibited in any fashion whatsoever.All or arty parts of this dies (exce timkregistered trademarks)remain property of Plymouth Sign Company, Ina Charge for design without permission of Plymouth Sign Comparry,Ina Is t 500 ,r TOWN OF Bj STABLE _Permit No. _ 24�36 ' Building..Inspector i ^:...: Cash -- ------- e�a X , ...� OCCUPANCY PERMIT Bond -__ --_ _- y� Issued to Merchants Bank Address Lot 101,j 596 West Main' -Street, Hyannis Wiring Inspector (��f� - `` Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date X Engineering Department -� �.Y �.� Inspection date Board of Health . y ,. .�Cl/i Inspection date THIS'PERMIT WILL NOT BE VALID, AN 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. ��%..7/3t� 15 19 �. tt�� h .......................... .......... Auilding Inspector x r s� map and lot n, ul- Oe:... ....................... yOF THE T� Sewage Permit number �/ BARNSTABLE, i House, number ..................... .....................:.................... 9�O�i63q. ♦� w. TOWN OF BARN,STABLE BUILDING INSPECTOR .. ♦ 4 ee , .. ,• APPLICATION FOR PERMIT TO .....:.... ................................... ..�v.`........... ............................ ` TYPE OF CONSTRUCTION ...................,...... J'l. r j ......1 A TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............ ,1 ......:...... .... . .. ........:.... .......... ... .. ��..................:�:.�:T ...:� ................... ProposedUse .............. ................. ............................................................................................. Zoning District ....................;a.............................................Fire District N... . '....::..................................... Name of Owner ........5ti h............Address .. . ................................. ' Name of Builder .....Address......................................... ................................................................ ................ Name of Architect .., P. /.L..//.c.... /.!/ �11 .....Address .... .. 0................. ........................ 41 r. 1'y�QS S. Number of Rooms ...........Foundation ' .......................................... Exierior ...Roofing ................. .. . .......................................... ....... Floors .... ...................................................Interior ............. 3 ' eati ...'..... l ................/..l!t� . ..........Plumbing ...... . �.... ........ . :�... H ng . .......................... • 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 .. -OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules 'and Regulations of the Town of Barnstable,regarding the above construction. - Name ..................................... t ' Construction Supervisor's License, ..;�..�� �� . ERCHANTS BANK ' 2473.6 BUILD BVK o ' . Permit for .. .......... ............. _ :.....:.......Commercial :............. + ' Locd''ion Lot #101 596. . ...Nest. . ...Main St.i........ .. . ..... .. .. ..... Hyannis............................................ Owner PMerchants Bank ; ! e ... Y .................... ................................ Type of Construction Frame............................ ......................... - Plot ...........................: Lot .................. �.f January 19[, 83 , Permit Granted ........................................19 Date of Inspection '`' k. Date Completed .................... ....................19 -. L Assessor's map and lot number .... �......�.....�...i.. Sewage" Permit number ................ ...........................:........... BJBHSTODLE, i House number q rasa l..�... / ........................................... '�po,i63q. 6� TOWN OF BARNSTABLE I BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..........".. :j!i ......y...'. 4%.. J.`.. . TYPEOF CONSTRUCTION ........................... !. ...................................................................:............... ...... I.,, ??.!`"ti-..../7......19 . TO THE INSPECTOR OF BUILDINGS: 4y.t The undersigned hereby applies for a permit according to the following information: Location ............��! ................(.rRl. ....!!.! 7....................... ...... .........07- � .... .. ProposedUse ............0 j/�w................................................................................:............::..........�. ..... ...............................................Q'stirto{ . ..... Zoning District ................................................Fire District .......... Name of Owner ss}' !1 .............................. Nameof Builder ...................f..............................................Address ....................... .. ......... ................................. Name of Architect /lerZ......Address ........ ... Number of Rooms ..................................................................Foundation ............ ..... .... ................................. Exterior .....................'Y>ne-k..........................................Roofing ......................... .�( ............................................. FloorsInterior .............. ............... .... s.......n..................................................I... .�............... ..................... . ......... Heating �� Plumbing . .............. ............................... .... .......... .. Fireplace ..................................................................................Approximate Cost ......../.-'/... . .................................... Definitive Plan Approved by Planning Board ---------------_---------------19________. Area ....J..` l. ........................ Diagram of Lot and Building with Dimensions Fee ' SUBJECT TO APPROVAL OF BOARD OF HEALTH a y . I 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. Namer? �- ................................. Construction Supervisor's License ... .3..7..L�... ....... t :1 '�el��HANTS BANK A=269-251 24736 BUILD BANK No ................. Permit for .................................... s Commercial .........:..................................................................... Lot #101, 596 West Main 8t. Location .................:.............................................. ;,> Hyannis ................................ .;� n .............................. Owner M „ channk .............................. Type of onstructionme .............................. .................................... ..... ....................... fPlot ........................... ............................. i January 19, 83 Permit Gra led 19 Date of Insp, ....................................19 Date Completed .......................... ...........19 A l vl ~ 09 4z � 5 , �I Town of Barnstable Building Department - 200 Main Street Hyannis, MA 02601 9 MASS Fo a. (508) 862-4038 Certificate of Occupancy Application Number: 201406784 CO Number: 20140132 Parcel ID: 269251 CO Issue Date: 10/07/14 Location: 596 WEST MAIN STREET Zoning Classification: SPLIT ZONING Proposed Use: RETAIL & SERVICE STORE SMALL Village: HYANNIS Gen Contractor: PROPERTY OWNER Permit Type: CC00 CERTIFICATE OF OCCUPANCY COMM Comments: WHOLE HEALTH PHARMACY 9 b Building Department Signature ate Signed PERMIT PAYMENT RECEIPT ITOWN OF BAR�NSTABLE BUILDING DEPARTMENT 2001MAIN STREET HYANNIS, MA 02601 DAT 10/07/14 " IME: 09:06 -------------TOTALS----------------- 'PERMIT $ PAID 75.00 AMT TENDERED: 75.00 AMT APPLIED: 75.00 CHANGE: .00 APPLICATION NUMBER: 201406784 ' PAYMENT METH: CHECK PAYMENT REF: 1004 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma "' Parcel Application C#I d lf� p pp Health Division 1iYANNI'R NMSS F RE.RES DEp�pg pe Issued l0_�_(vt P r 93 HIGH SCHOO R Conservation Division Application Fee Planning Dept. > 1 #ermit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Jca�� Ps MoAh Village ��AYV(115 Owner fie 11 UC Address ,.-TelephoneL - - I B �Pb mitRequest - T"Qi O"- , YNO (o 14rV C_4i C>Y) f [ Real* Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay P oje-ct Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other 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 a, "#g Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other . .--� C> Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing woogpal stover ❑YE),, ❑ No er Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing qew Sze. Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER.OR-HOMEOWNER) Name Cwt Telephone Number 74 7,/3/Co Address 110 �-�� J q� � License # Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE rDATE /°% /& FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED :j MAP/PARCEL NO. �! is ADDRESS VILLAGE OWNER " DATE OF INSPECTION: ' " FOUNDATION: FRAME INSULATION�"!� ' FIREPLACES x ELECTRICAL=1,ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE-CLOSED OUT AS;$OCIATION PLAN NO. p 1 ' �'4OWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 4arcel- Application # i Health Division «,�, Date Issued AI 1 N Conservation Division YANPoi �Ap lication Fee Planning Dept. r`/`` ermit Fee r Date Definitive Plan Approved by Planning Board Historic-.OKH _ Preservation/ Hyannis Project Street Address Jam'% V P4 lna%n -, Village AY1�15 Owner 7 YttkA LtC_ - Address Telephone_ Permit Request Tv\ct4 .�-, QKA - Y10 (011 SI(VC-�On ( eo l r", F Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay , Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No 3+ - Basement 7Xpe: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Feished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new f Total Room Count (not including baths): existing new First Floor Room Count— -, Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other s 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: y u Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION _(BLDER-OR-HOMEOWNER) � - Name 6Y 1 , n*s a in l wi( Telephone Number 74 7,131(a Hylf Address U) Ao J un -10 6 License # Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �� DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED -Y 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. 27w Constrto7auea M QfHassaehusefts flew Pfrndksftid Accidei& office I OfInvesfigafiens 600 Wm'hhgpjt,beet $ostm,MA 02M tM .Mas&gov1dia Wurkeers' CampensaflanIusurance.4Lffidavit:BtiildersfCan&actorslElectricianslPlumbers ia-sn#information Ftease Prmf Fegihly Na=(fit 6wm/Oxgmiz;rfinn(Fnri-rvicina : hdlP eo AU �Qrm AC� mess: e9�P NA e5i mm- S� Cityfsta&zip: aV\ j o Pho=47 joo _ 21 l 3)b Are you an employer?t<heckthe appropriate box: T , of ect r Iarst$ czmfracEorairdl 3'Pe �� (�1��� - L❑ lam a employer with ❑ 1 6_ El New won employees(€all.audlorpart-time}* have hired the vet rmrrrart.+rz listed on the attached sheet 7_ ❑Remodeling El I am a sole proprietor orpartner- - sbip and have no employees These sub-oontractors have g- ❑Demolition wodiug for me is any capacity employees and have workers' 9. ❑Building addition [No workers'comp.insura=e Comp_mcnra= I required_] 5_ ❑ We are a coiporationand its 10-0 Electrical repairs or additions 3.❑ I am a home-awner doing all work offi=s have eitrcised their 11-0 Plumbiag repairs or additicus myself[No worbars'comp right of exemption per MGL 12 0 Roof repairs m 152,§1(4),and we haw no incrtranre required.].F 13_❑Qt#iei employ-[No ' comp_insurance mqui eZj *Any P that checks boa-1 mmst also fill out the sectionbelowshmaing theirwolkess,compensstiouporkTSnffirmafk r[ameowners wha submit this s ild. ic^tiagY a_�e doing eII r. —* thn h outside contxactars mast submit anew afdscit such- :Cbnb:Rcwrs thst check this box mr=sashed sa additional sheet&bolero-the name of the Mb_cont3dDnand state wMther urnot Ihnse entities have employa!s. if the svlr-contnactars hsre employees,they r mst pmvide their waders'comp.policy amnber I am arz employer fhati:spmtltdixg worke-rs'c0agmasatian inmiraace for my emptayaes. Belau is thepa& an.d job site i7ifDr�t t,Qfili tL lus=ance cotmpmyldame: Pobcy#or Self-ms_Uc.& Expiration Date: Job Side Addiess: cityf5tattaig_ Attach a copy of the workers'compensation policy declaration page(showing the policy number and e3zpiration date). Failure to secure coverage as requiredunder Sectioir 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.Od andfor one-pear impris as well as cii R penalties in the fowl of a SWOP STORK ORDER_and a fine of up to$250.00 a day against the violator_ Be advised that a copy of this statemes t may be forwarded to the Office of Isrves#ptions of the DIfr for insurmce coverage vexffirxtion_ I do hereby certify under thepanis andponahFies r f'pe uq that the informcd&npriwirkd abbmw is fins and"correct Sienature: ��-------� Date- Phone#: 11,fcial use anly. Do nat wriia in fkis area,ita be cawp&ad by ci47 ur town of�iciaL City or Town: PermitlUcense ff Issuing Ai thority(circle one): 1.Board of Health 2.BuRding Department I CiVrown Orxk 4.Electrical Inspector 5.Plumbkg Inspector 6.Other Contact Persan: Phone#- 6 Information and Instructions Massachusdts 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 receives 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 mairrtenance,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 IDCal 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 in cRnance 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 numbers)along with their certincate(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 maybe submitted to the Department of Industrial Accidents for confirmation of inctnance coverage. Also be sure to sign and date the affidavit The affidavit should be retumed to the city or town that the application for the peanit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or 11 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 lime. 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 permittlimnse 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 aff davit 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 If-ayes 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 Depaztmt.-ut Qf Industrial Accidents Q-ffZce of kvc sgdgatjo-m 600 Washingtau Strut Bnstw.,MA 02111 Tel.A 617'727-4900 W 4-06 or 1-9 hEA�SS.AFE . Revised 4-24-07 Fax# 617-727-7749 wwwxa _gnv/dia 1. 1 LEASE 596 Vest Main Street Hyannis,Massachusetts THIS INDENTURE OF LEASE made this 2 9 day of July, 2014, by and between Preefall, LLC, a Massachusetts limited liability company, having a mailing address of 297 North Street, Hyannis, MA 02601, hereinafter referred to as "Landlord", and Cape Cod Pharmacy & Health, LLC , a Massachusetts Limited Liability Company, having a mailing address of 127 Gordon Ave, Hyde Park, MA 02136 hereinafter referred to as "Tenant". HEREBY WITNESSETH: ARTICLE I Premises 1.01 DEMISED PREMISES: Landlord hereby leases to Tenant, and Tenant hereby leases from Landlord, upon and subject to the terms and provisions of this Lease, the land and building located at 596 West Main Street, Hyannis, Massachusetts 02601 (hereinafter referred to as the "Demised Premises"). The Demised Premises includes all the Leasehold Improvements, lighting and other fixtures now or hereafter installed therein. The Demised Premises are located on a tract of land in the Town of Barnstable (Village of Hyannis), Barnstable County, Massachusetts, owned by Landlord. ARTICLE II Term of Lease 2.01 LEASE TERM: To have and to hold the Demised Premises unto Tenant, for a term of five (5)years, (1)month commencing September 16, 2014 (the"Commencement Date"), and ending on September 15,2019 (the "Expiration Date"). 2.02 RENEWAL OPTION: Tenant shall have the option to renew for one additional five (5) year term, upon the same terms and conditions as set forth herein,.with rent for said Renewal Term to be agreed upon by the parties at least ninety (90) days prior to the Expiration Date, provided Tenant has given written notice to Landlord at least 120 days prior to the Expiration Date,of its intent to renew. ARTICLE III Rent 3.01 DENTAL PAYMENTS: Landlord acknowledges that the Rental Payment Period commences September 16, 2014 and ends on the Expiration Date of September 15, 2019. Tenant shall pay, or cause to be paid, to Landlord without any setoff or deduction whatsoever and without any prior demand therefor,the rental amounts set forth below(hereinafter referred to as the"Minimum Rent"): YEAR MONTHLY ! ANNUALLY (commencing September 16, 2014) -I j 1 $ 4,000.00 $ 48,000.00 I i � I 2 $ 4,000.00 j $ 48,000.00 3 $ 4,000.00 $ 48,000.00 4 $ 4,000-.00 $ 48,000.00 , I 5 $ 4,000.00 $ 48,000.00 Make rent checks payable to: Freefall,LLC Mail rent payments to: Dept.3048,Lock Boa 4110,Woburn,MA 01888-4110 Such rents are to be paid in advance, on the first day of each and every calendar month during the term hereof. If the Lease shall commence on a day other than the first day of a calendar month, or shall end on a day other than the last day of a calendar month, the applicable rental installment for such first or last fractional month shall be such proportion of the monthly installment as the number of days such fractional month bears to the total number of days in such calendar month. 3.02 FIRST AND LAST MONTH'S RENT: Landlord acknowledges that it has received from the Tenant the sum of FOUR THOUSAND and 00/100 DOLLARS ($4,000.00) to be applied to the first month's rent due on the September 16, 2014, plus last month's rent in the amount of FOUR THOUSAND and 00/100 DOLLARS ($4,000.00) to be applied to the last month's rent due 30 days prior to the Expiration Date. 3.03 SECURITY DEPOSIT: Landlord further acknowledges receipt of FOUR THOUSAND and 00/100 DOLLARS ($4,000.00), as security deposit, to be held until the expiration or earlier termination of this .lease. In the event of any default or defaults in any payment, performance or observance required to be performed by Tenant pursuant to the terms of this lease, Landlord may apply said sum or any part thereof towards the curing of any such default or defaults and/or towards compensating Landlord for any loss or damage arising.from any such default or defaults. Upon the yielding up of the Demised Premises at the expiration or earlier termination of this Lease, if Lessee shall not then be in default or otherwise liable to Landlord, said sum or the then unapplied balance thereof shall be returned to Tenant. In the event Landlord's interest in the Demised Premises shall be transferred or assigned during the term of this lease, the Landlord shall credit or turn over to such transferee or assignee the se curity deposit or the unpaid balance thereof. In such event, the Tenant agrees to look only to the transferee or assignee, as the case may be, of the Landlord with respect to the security deposit or the unpaid balance thereof, its application and return. Landlord further covenants that it will not assign or attempt to assign or encumber the amount deposited herein. The parties agree that the Tenant shall also tender an additional Security Deposit in the amount of TWENY THOUSAND and 00/100 DOLLARS ($20,000.00) pursuant to the Security Agreement attached hereto as Exhibit"A" 3.04 LATE FEE: There will be a one (1%) charge per month on accounts thirty (30) days overdue, which is an annual rate of twelve percent (12%). This clause will apply to all overdue amounts of rent or any other sums payable under this Lease. ARTICLE IV Taxes 4.01 REAL ESTATE TAXES: Tenant is responsible for the payment of real estate taxes on the Demised Premise. Landlord shall forward the real estate tax bill to Tenant immediately upon receipt, and Tenant shall pay directly to the taxing authority on or before the date on which the same are due. Any default in making the tax payments on a timely basis shall be considered a breach of this agreement, and a default in the payment of rent hereunder. 4.02 PERSONAL PROPERTY TAXES: Tenant shall pay directly to the taxing authority all taxes which may be charged, assessed, or imposed upon all signs, fixtures, equipment, and other personal property.of every type owned by Tenant and Tenant or anyone claimed by, through, or under Tenant; and Tenant shall pay all license fees which may be lawfully imposed upon the business of Tenant conducted upon the Leased Premises. Tenant shall also pay directly to the taxing authority all personal property taxes, if any, applicable to its personal property located at the Demised Premises. ARTICLE Utilities 5.01 UTILITIES: Tenant shall pay for all of its requirements for utility usage directly to the applicable utility company, including but not limited to oil, gas, electricity and water and sewer. Tenant shall pay the water& sewer bill directly to the Hyannis Water Department. 5.02 ELECTRICAL COMPONENTS: Tenant is responsible, at its sole cost and expense, for the replacement of all light bulbs and ballasts within the Demised Premises and any electrical work or parts. 5.03 FIRE INSPECTIONS: Tenant, at its sole cost and expense, shall be responsible for yearly inspections of fire extinguishers on the Demised Premises (and carbon monoxide detectors if required by law). Tenant shall supply and maintain appropriate fire extinguishers (and carbon monoxide detectors, if applicable) in sufficient number and of a type appropriate to the Demised Premises, all as may be proscribed by local Fire Department regulations. 5.04 HVAC: It is understood and agreed that the Demised Premises is being leased with the HVAC systems in"as is condition" and Tenant is solely responsible, at its sole cost and expense, for any necessary.HVAC repair and/or replacement; provided however, that the Tenant shall only be responsible to pay no more than FIVE THOUSAND and 00/100 DOLLARS ($5,000.00) for HVAC replacement if necessary. Maintenance and repair is a tenant responsibility. Landlord agrees to provide tenant with a certified inspection report of HVAC prior to lease execution. 5.05 TRASH REMOVAL: Tenant is responsible, at its sole cost and expense, for the removal of all trash on a regular basis from the Demised Premises. 5.06 WATER HEATER: Tenant is entitled to the use of the water heaters.located in the Demised Premises, if any, and Tenant shall be responsible, at its sole cost and expense, for the repair,maintenance and/or replacement of said water heaters. ARTICLE XI Covenants between Landlord and Tenant 6.01 USE: Tenant covenants and agrees that the Demised Premises, during the term hereof, shall be used and occupied by Tenant as a pharmacy, and any such ancillary office use. Tenant agrees to operate said business in a professional and proper manner, and in compliance with all state and local law and ordinances. The parties further agree that Tenant's obligations under this Lease are contingent upon the.Tenant obtaining all necessary permits to operate a pharmacy from the Commonwealth of Massachusetts, Executive Office of Health and Human Services, .Board of Registration in Pharmacy, and/or any other state, federal or local board/agency having jurisdiction over the Tenant. In the event that such permitting is not obtained by Tenant prior to the Commencement Date, this Lease shall be voidable by Tenant upon which all deposits made to Lessor shall be immediately returned to Tenant. 6.02 TENANT AND LANDLORD MAINTENANCE: Tenant covenants and agrees that it shall, at its sole cost and expense, keep, or cause to be kept, the Demised Premises neat and clean and maintained in good order, condition and repair, and to remove, or have removed, all trash and debris from the Demised Premises at least on a weekly basis.. . Except as specified herein, Tenant agrees that from and after the date that possession of the Demised Premises is delivered to Tenant and until the end of the term hereof, Tenant will keep the Demised Premises neat, clean and in substantially the same order as it delivered, excepting reasonable wear and tear. Tenant will be responsible to repair damage caused due to Tenant's sole negligence in and about the Demised Premises, including any damage to the storefront, the exterior and interior of all doors, windows, doors, plate glass, plumbing and sewage, fixtures, interior walls, floors, ceilings, signs, wiring and electrical systems. Tenant is further responsible, at its sole cost and expense, for any and all maintenance of parking lots, including snow and ice removal, as well as any lawn mowing and/or landscaping. 6.03 LANDLORD'S COVENANTS: Landlord covenants and warrants that Landlord has full right and lawful authority to enter into this Lease for the full term hereof, and that Landlord has good marketable and record title to the Demised Premises, free and clear of encumbrances, easements and restrictions which may prevent the use of the Demised Premises by Tenant as contemplated herein. 6.04 AS-IS CONDITION: Tenant is leasing the Demised Premises in "as is" condition. Tenant has inspected the Demised.Premises, and has agreed to lease the same in the current condition, and any and all improvements made by Tenant to the Demised Premises shall become the property of Landlord at the Termination of the Lease Term. At the expiration or earlier termination of this Lease, Tenant shall bring the Demised Premises back to the condition in which it is as of the date of this Lease, reasonable wear excepted, and whenever necessary, the replacement of plate glass and other glass therein, acknowledging that the Demised Premises are now in good order and the glass whole. Any personal property of Tenant remaining on the Demised Premises at the expiration or termination of this Lease shall remain property of the Landlord. If Tenant removes any fixtures from the Demised Premises, any such items must be returned at the end of the lease term, so the property is in substantially the same condition as it was when the Tenant took possession, excepting reasonable wear and tear. 6.05 NO BANKRUPTCY SALE: Tenant covenants and agrees that no auction, fire or bankruptcy sales may be conducted within the Demised Premises without the previous written consent of the Landlord,which consent shall not be unreasonably withheld. 6.06 COMPLIANCE WITH LAWS: Tenant further agrees that the Demised Premises shall be kept in a clean, sanitary and safe condition in accordance with the laws of the Commonwealth of Massachusetts and ordinances of the Town of Barnstable and in accordance with all governmental agencies having jurisdiction over such premises. Tenant shall not permit or commit any waste other than commercial dumpsters for operational waste materials. 6.07 MECHANIC'S LIENS: Tenant agrees immediately to discharge (either by payment or filing of the necessary bond, or otherwise) any mechanic's, materialman's or other lien against the Demised Premises and/or the Landlord's interest therein, which liens may arise out of any payment due, for any labor, services, materials, supplies or equipment alleged to have been furnished to or for Tenant, in, upon or about the Demised Premises (but excluding any liens arising out of labor, etc., provided.by the Landlord pursuant to this Lease) and in no event shall permit the existence of such lien for a period in excess of thirty (30) days_beyond the time said lien takes effect. 6.08 NO BROKERAGE: Tenant warrants and represents that it has dealt with no broker in connection with the consummation of this Lease and in the event of any brokerage claim against Landlord predicated upon prior dealings with Tenant named herein, Tenant agrees to defend the same and indemnify Landlord against any such claim. 6.09 WHEN LEASE BECOMES BINDING: Employees or agents of Landlord have no authority to make or agree to make a Lease or any other agreement or undertaking in connection herewith. Submission or this document for examination and negotiation does not constitute an offer to lease, or a reservation or option for, the premises, and this document shall become effective and binding only upon the execution and delivery hereof by Landlord and Tenant. All negotiations, consideration representations and understandings between Landlord and Tenant are incorporated herein and may be modified or altered only by agreement in writing between Landlord and Tenant, and no act or omission or any employee or agent of Landlord shall alter, change or modify any of the provisions hereof. 6.10 RECORDING: Tenant agrees not to record the within Lease, but each parry hereto agrees on request of the other, to execute a Notice of Lease in recordable form and complying with all applicable Massachusetts Laws and reasonably satisfactory to Landlord's attorneys. In no event shall such document set forth the rental or other charges payable by Tenant under this Lease; and any such document shall expressly state that it is executed pursuant to the provisions contained in this Lease, and is not intended to vary the terms and conditions of this Lease. 6.11 TENANT'S WORD: In the event Tenant desires to perform any work with respect to an alteration, addition or improvement to the Demised Premises,that exceeds a total cost of TWO THOUSAND and 00/100 DOLLARS ($2,000.00)Tenant shall provide Landlord with written notice, describing the proposed work to be performed in detail, including copies of any and all plans, at least 10 days prior to the date on which such work is scheduled to begin. Landlord must provide written consent of such work in order for the work to commence, which consent shall not be unreasonably withheld or delayed. The parties expressly agree that, should the.Commonwealth of Massachusetts, Executive Office of Health and Human Services, Board of Registration in Pharmacy, or other state, federal or local board/agency having jurisdiction over Tenant, require any certain alteration, addition or improvement to the Demised Premises for the purpose of permitting the Tenant's proposed pharmacy operation,the Landlord shall consent to said work provided it is completed at Tenant's expense. 6.12 WORKER'S COMPENSATION INSURANCE: In the performance of any work. worked to be performed by Tenant in accordance with the foregoing Paragraph 6.11 hereof, Tenant agrees to maintain or cause its contractors and sub-contractors to maintain insurance, including Workman's Compensation and liability insurance. Tenant or its contractor and/or sub-contractors shall provide a Certificate of Insurance to Landlord evidencing said coverage, and naming Hyannis Office Park Center L.P. as additional insured. 6.13 SURRENDER OF PREMISES: Upon the expiration or earlier termination of this Lease,the Tenant shall surrender all keys to the Demised Premises and yield up the Demised Premises and all additions thereto (except Tenant's fixtures), in good and tenantable repair, reasonable use and wear excepted. Tenant shall remove all of its machinery and personal property in the Demised Premises as well.as all of Tenant's signs wherever located, and repair all damage caused by such removal. Tenant shall leave the Demised Premises in broom-clean condition and in the same order and repair in which Tenant is obliged to keep and maintain the Demised Premises by the provisions of this Lease. In the event Tenant fails to yield up,then hold-over rent shall be charged atthe rate of 150% of the rent set forth for such period as set forth in ARTICLE III hereof. 6.14 NOTICES: Any notice from the Landlord to the Tenant relating to the Demised Premises or the occupancy thereof or the termination of this Lease shall be deemed duly served if sent by certified or registered mail, return receipt requested, to the addresses set forth in the introductory paragraph of this Lease, or to such other addresses as the parties may hereinafter designate in writing. The parties further agree that, with the exception of a notice claiming a default, other notices may be given by any form of email transmission sent by one party to the other for which an electronic receipt of reading is available. ARTICLE VII Assignment/Subletting 7.01 Notwithstanding any provisions of this Lease, Tenant covenants and agrees that it will not assign this Lease or sublet (which term without limitation, shall include the granting of concessions, licenses, and the like) the whole or any part of the Demised Premises without in each instance having first received the express written consent of Landlord, which consent shall not unreasonably be withheld or delayed. In any case where the Landlord shall consent to such assignment or subletting, the Tenant named herein shall remain fully liable for the obligations of Tenant hereunder, including, without limitation, the obligation to pay the rents and other amounts provided under this Lease. The restrictions of this Article VII shall not, however, be applicable to an assignment of this Lease by Tenant to a subsidiary or controlling corporation, or corporation with or into which Tenant shall merge or consolidate, provided (and it shall be condition of.the validity of any such assignment) that such subsidiary or controlling corporation or corporation into which Tenant shall be merged or consolidated, agrees directly with Landlord to be bound by all the obligations of Tenant hereunder, including without limitation the obligation to pay the rent and other amounts provided for under this Lease, and the covenant against further assignment; but such assignment shall not relieve the Tenant named herein of any of its obligations hereunder and Ten ant shall remain fully liable therefore. ARTICLE VIII ®cc ��c� Indemnity and Insurance 8.01 Tenant shall, at Tenant's cost and expense, maintain fir/and casualty insurance on the Demised Premises for full replacement value, as well as a polio of commercial general liability for the Demised Premises with minimum limits of One /Million Dollars ($1,000,000) per occurrence/Three Million Dollars ($3,000,000.00) aggregate. Tenant shall provide Landlord with a Certificate of Insurance evidencing such cover es and naming Freefall, LLC as additional insured, within ten (10) days , and the certificate shall provide,to the extent obtainable, for at least ten(10) days' notice to the additional insured before cancellation. 8.02 Tenant and Landlord agree to indemnify and save harmless each other from and against all claims of whatever nature arising from any act, omission or negligence of each other, and each other's contractors, licensees, agents, servants or employees, or arising from any accident, injury or damage whatsoever caused to any person or to the property of any person occurring from any accident, injury or damage occurring on the Demised Premises where such accident, damage or injury results from an act or omission on the part of the Tenant or Landlord or Tenant's or Landlord's agents or employees. This indemnity and hold harmless agreement shall include indemnity against all costs, expenses and liabilities incurred in or in connection with any such claim or proceeding brought thereon, and also the defense thereof. Pursuant to the above, Tenant shall obtain and maintain in full force during the term hereof a comprehensive liability and property damage insurance and general liability policy covering the Demised Premises under which Landlord (and such other persons as are in privity of estate with Landlord as may be set out in notice from time to time) and Tenant are named insureds and under which the insurer agrees to indemnify and hold Landlord and those in privity of estate with Landlord harmless from and against all costs, expenses and/or liability arising out of or based upon any and all claims, accidents, injuries and damages mentioned herein. 8.03 All of the personal property of every kind, nature and description of Tenant and of all persons claiming by, through and under Tenant which, during the term of any occupancy of the Demised Premises by Tenant or anyone claiming under Tenant, may be on the Demised Premises, shall be at the sole risk and hazard of Tenant and if the whole or any part thereof shall be destroyed or damaged by fire or other casualty, or by the leakage or bursting of pipes, by theft or from any other cause,whether or not covered by Tenant's insurance, no part of said loss or damage is to be charged to or is to be borne by Landlord. The Landlord shall not.be responsible for any loss of income to Tenant, for any reason, including the previously mentioned causes, whether said loss of income is actual or projected. ARTICLE IX Landlord's Access to Premises 9.01 Landlord shall have the right to enter upon the Demised Premises after due notification at all reasonable hours for the purpose of inspecting or of making repairs to the same, or the building of which they are a part. If repairs are required to be made by Tenant Pursuant to the term hereof, Landlord may demand that Tenant make the same, forthwith, and if Tenant refuses or neglects to commence such repairs and complete the same with reasonable dispatch, after such written demand, Landlord may (but shall not be required to do so) make or cause such repairs to be made. All such repairs shall be made in such a manner as not to unreasonably interfere with the business of Tenant. 9.02 For a period commencing ninety (90) days prior to the termination of this Lease, Landlord may have reasonable access to the Demised Premises for the purpose of exhibiting the same to prospective tenants. ARTICLE X Default 10.01 It is covenanted and agreed that if the Tenant shall neglect or fail to perform or observe any of the covenants, terms,provisions or conditions contained in this Lease and on its part to be performed or observed, within thirty (30) days after receipt of written notice of default, or such additional time as is reasonably required to correct any such default (except for payment of rent, in which case said period of notice shall be ten (10) days after receipt of written notice of default), or, if the estate hereby created shall be taken on execution or by other process of law, or if Tenant shall be judicially declared bankrupt or insolvent according to law, or if any assignment shall be made of the property of Tenant for the benefit of Tenant's creditors, or if a receiver, , or trustee in involuntary bankruptcy or other similar officer shall be appointed to take charge of all or any substantial part of Tenant's property by a court of competent jurisdiction, or if a petition shall be filed for the reorganization of Tenant under any provisions of the bankruptcy laws now or hereafter enacted, and such proceeding is not dismissed within sixty (60) days after it has begun, or if Tenant shall file a petition of such reorganization, or for arrangements under any provision of the Bankruptcy Act now or hereafter enacted and providing a plan for the debtor to settle, satisfy or extend the time for the payment of debts, then, and in any of the said cases, (but only in such of the foregoing as may occur are not cured within sixty (60) days after receipt of a written notice from Landlord) notwithstanding any license of any former breach of covenant or waiver of the benefit thereof or consent in a former instance, Landlord lawfully may, immediately, or at any time thereafter, Landlord lawfully may, immediately, or at any time thereafter, and without demand or notice, enter into or upon the said premises or any part thereof in the name of the whole and repossess the same as of his former estate, and expel Tenant and those claiming through or under it and remove its or their effects without being deemed guilty of any manner of trespass, and without prejudice to any remedies which might otherwise be used for arrears of rent or preceding breach of covenant, and upon entry, as aforesaid, this Lease shall terminate; and Tenant covenants and agrees, notwithstanding any entry or reentry by the Landlord whether by summary proceeding, termination or otherwise, to pay and be liable for, on the days originally fixed herein for the payment thereof, amounts equal to the several installments of rent and other charges reserved as they would, under the terms of this lease, become due if this Lease had not been terminated or if Landlord had not entered or reentered, as aforesaid; provided that Tenant shall be entitled to a credit in the net amount of rent received by Landlord in reletting after deduction of all expenses incurred in reletting the Demised Premises (including, without limitation,remodeling costs, connection therewith). Notwithstanding any contrary provision of the foregoing, Tenant shall not be deemed in default hereunder if Tenant is engaged in proceedings under Chapter X or M of the Federal Bankruptcy Act or the reasonable equivalent or any comparable private restructuring of the debt of Tenant provided that Tenant is not otherwise in default hereunder. ` 10.02 Landlord shall in no event be in default in the performance of any of its obligations hereunder unless and until the Landlord has failed to perform such obligations within five (5) days or such additional time as is reasonably required to correct any such default, after notice by Tenant to Landlord properly specifying wherein the Landlord has failed to perform any such obligations. 10.03 No payment by Tenant, or acceptance by Landlord, of a lesser amount than shall be due from Tenant to Landlord shall be treated otherwise than as a payment on account. The acceptance by Landlord of a check for a lesser amount with an endorsement or statement thereon, or upon any letter accompanying such check, that such lesser amount is payment in full, shall be given no effect, and Landlord may accept such check without prejudice to any other rights or remedies which Landlord may against Tenant. Tenant may make any payment "under protest" reserving any rights Tenant may have to contest the requirement or propriety of Tenant making the same. ARTICLE XI Fire, Casualty, Eminent Domain 11.01 Should a substantial portion of the Demised Premises, or of the property of which they are apart,be substantially damaged by fire or other casualty, or be by eminent domain,the Landlord may elect to terminate this Lease. When such fire, casualty, or taking renders the Demised Premises substantially unsuitable for its intended use, a just and proportionate abatement of rent shall be made, and the Tenant may elect to terminate this Lease if: a. (a) The Landlord fails to give written notice within thirty (30) days of intention to restore the Demised Premises,or b.(b) The Landlord fails to restore the Demised Premises to a condition substantially suitable for their intended use within ninety (90)days of said fire, casualty, or taking. (c) The Landlord reserves, and the Tenant grants to the Landlord, all rights which the Tenant may have for damages or injury to the Demised Premises for any taking by eminent domain, except for damage to the Tenant's fixtures,property or equipment. ARTIC/XHO-7/2-41iYRight of Fi 12.01 Tenant shall have the right of first refusauilding during the term of the lease (five years), and subsequent renewals, for tom Landlord's written notice that the building is available for sale with an offer legitimate offer pending. In the event either (i) Tenant does not respond within said 10-day period, or(ii)Landlord and Tenant cannot reach mutually acceptable terms for procurement of the building,then in either event,the provisions of this paragraph shall be deemed null.and void, and the Landlord shall have the right to sell the building to another party. ARTICLE XIII Miscellaneous 13.1 Effectiveness. This Lease shall become effective on and only on its execution and delivery by the parties hereto. 13.2 Complete Understanding. This Lease represents the complete understanding among representations, guaranties, warranties, promises, statements, or agreements, either written or oral, among the parties hereto as to the same. 13.3 Amendment. This Lease may be amended by and only by an instrument executed and delivered by the parties hereto. 13.4 Waiver. No party hereto shall be deemed to have waived the exercise of any right, which it holds hereunder unless such waiver is made expressly and in writing (and, without limiting the generality of the foregoing, no delay or omission by any parry hereto in exercising any such right shall be deemed a waiver of its future exercise). No such waiver made in any instance involving the exercise of any such right shall be deemed a waiver as to any other such instance or right. 13.5 Applicable Law. This Lease shall be given effect and construed by application of the law of Massachusetts, and any action or proceeding arising hereunder shall be brought in the courts of Barnstable County, Massachusetts. 13.6 Time of Essence. Time shall be of the essence of this Lease. 13.7 Headings. The headings of the Sections, subsections, paragraphs, and subparagraphs hereof are provided herein for and only for convenience of reference, and shall not be considered in construing their contents. 13.8 Construction. As used herein, all references made (a) in the neuter, masculine, or feminine gender shall be deemed to have been made in all such genders, (b) in the singular or plural number shall be deemed to have been made, respectively, in the plural or singular number as well, and (c) to any Section, subsection, paragraph, or subparagraph shall, unless therein expressly indicated to the contrary, be deemed to have been made to such Section, subsection, paragraph,or subparagraph of this Lease. 13.10 Assignment. This Lease shall be binding on and shall inure to the benefit of the parties hereto and their respective heirs,personal representatives, successors, and assigns hereunder. 13.11 Severability. No determination by any court, governmental body, or otherwise that any provision of this Lease or any amendment hereof is invalid or unenforceable in any instance shall affect the validity or enforceability of(a) any other provision thereof, or (b) such provision in any circumstance not controlled by such determination. Each such provision shall be valid and enforceable to the fullest extent allowed by, and shall be construed wherever possible as being consistent with, applicable law. 13.12 Disclaimer of Partnership. Status. Nothing in the provisions of this Lease shall be deemed in any way to create among the parties hereto any relationship of partnership, joint venture, or association, and the parties hereto hereby disclaim the existence of any such relationship. 13.13 Hazardous Materials. Except for ordinary cleaning and office supplies, Tenant 13.13 Hazardous Materials. Except for ordinary, cleaning and office supplies, Tenant represents and warrants that it shall not use, or permit to be brought into the Demised Premises, any hazardous materials, and Tenant agrees to indemnify and hold Landlord harmless against any and all claims related to any hazardous materials which were caused to be brought into the Demised,Premises by Tenant during the term of this Lease. The parties expressly agree that this paragraph does not apply to any materials that may be considered "hazardous" but are sold or otherwise stored at the Demised Premises by the Tenant under a valid permit associated with Tenant's operation as. a pharmacy. 13.14 No Smoldng Policy. Tenant understands and acknowledges that there is no smoking allowed in, on, or about the Remised Premises, and hereby agrees to abide by, and have its employees and invitees abide by,this No Smoking Policy. 13.15 Tenant's Access. The parties agree that Tenant shall have reasonable access to the Leases Premises prior to the Commencement Date, upon twenty-four (24) hour notice to Landlord (or Landlord's agents or employees), for the purpose of showing the premises to architects, contractors, subcontractors or other trades; and, for making repairs or improvements required for the proposed use as a pharmacy. WITNESS the execution hereof,under seal, on this�4 day of July 2014, in any number of counterpart copies, each of which counterpart copies shall be deemed an original for all purposes. TENANT: LANDLORD: FREEFALL, LLC By: Holly Management and Supply Corp., Its Manager s Brian T. Lewis, Manager By: Stuart A. Bornstein Cape Cod Pharmacy &Health,LLC Its: President Exhibit "A" - Supplemental Security Deposit In addition to the Security Deposit tendered under `Article III, section 3.03 of the Lease Agreement, Tenant shall also tender on or before the Commencement Date a Supplemental Security Deposit in the amount of Twenty Thousand and 00/100 Dollars ($20,000.00). The Supplemental Security Deposit shall be paid in consideration for an express agreement by Landlord not to require from any individual a Personal Guaranty upon Tenant's performance under the Lease Agreement. To the contrary,the Supplemental Security Deposit shall be in lieu of any personal guaranty, and Landlord acknowledges that under no circumstances whatsoever shall any member, manager, employee or other agent of Tenant, including but not limited to Brian T. Lewis, be liable to Landlord for any claimed breach by Tenant. To the contrary, Landlord hereby releases, releases and holds all individuals harmless from any claimed breach of the Lease Agreement. The Supplemental Security Deposit shall be held by Landlord in a separate interest bearing account for which Landlord shall identify to Tenant the name and address of the banking institution and account number; and, Landlord agrees not to commingle the Supplemental Security Deposit with Landlord' s other funds. The Supplemental Security Deposit shall be held as security for the performance by Tenant of Tenant's covenants and obligations under this Lease, it being expressly understood that the Supplemental Security Deposit shall not be considered an advance payment of rental or a measure of Landlord's damages in case of default b Tenant. Landlord may, from time to time, g Y Y without prejudice to any other remedy, use the Supplemental Security Deposit to the extent necessary to make good any arrearages of rent_or to satisfy any other covenant or obligation of Tenant hereunder, but only after complying with the "notice of default" provisions contained in Article X of the Lease Agreement and affording Tenant the prescribed opportunity to cure. Unless otherwise agreed upon in writing by Landlord and Tenant, if Tenant is not in default at the termination of the Lease Agreement, the remaining balance of the Supplemental Security Deposit shall be returned by Landlord to Tenant within thirty (30) days from lease termination date. 7 Landlord Tenant Message Page 1 of 1 Anderson, Robin From: Anderson, Robin Sent: Tuesday, October 15, 2013 8:44 AM To: 'Honey Dew Hyannis' Subject: RE: Honey Dew Donuts Zoning Question Hi Mr. Gionfriddo, ' In response to your information request I checked the zoning of the site you identified to confirm that the structure is indeed in the HB zone. The HB zone includes a special permit provision allowing a drive thru. As this site has been designed and constructed with the drive thru (and I assume it has not been compromised in any fashion)you need only to seek approval to re-establish the drive thru use with a special permit. You may also need to obtain a special permit for the retail sales of prepared food. With regards to the sign question, I see a permit for a 35 sq pylon sign only. You would be able to reface this as a matter of right with a permit. I do not have the actual frontage of this space available in order to determine if you are entitled to additional square footage or not. I suspect that the free standing sign is non-conforming and likely consumes your entire sq ft allotment. Having said that, you are entitled to pursue a variance for additional signage including a drive thru menu. Please let me know if you have additional questions. P,96in Robin C. Anderson Zoning Enforcement Officer ,own of BarnstabCe 200 Main Street Hyannis, MA 026oi 5o8-862-4027 -----Original Message----- From: Honey Dew Hyannis [mailto:hyannisdonuts@comcast.net] Sent: Saturday, October 12, 2013 4:33 PM To: Anderson, Robin Subject: Honey Dew Donuts Zoning Question Hi Robin, I stopped in to see you on Friday but I think you were at training. Anyhow I am looking at another location for a Honey Dew as I dropped out of the Centerville Mobil spot. Can you let me know if there are restrictions to this location. It is 596 West Main Street and in the HB Zoning District. It was a former bank and Medicine Shoppe. I was interested because of the existing drive-thru window. Is it allowed in this district? Could it be if we seek a variance? Would it possible to add a drive-thru menu board too if the drive up window is allowed? I would like to know as much as possible up front before I spend too much money pushing further. Any insight would be appreciated. Thanks, Tony Gionfriddo Honey Dew Hyannis/Dennisport 617-817-0697 (cell) 10/15/2013 _ _ 1 TOWN OF'BARNSTABLE BUILDING PERMIT r PARCEL Ib 269 251 GEOBASE ID 17636 ADDRESS 596 WEST MAIN STREET PHONE HYANNIS ZIP — i LOT 101 LC1 BLOCK LOT SIZE DBA, DEVELOPMENT DISTRICT NY 1 ppgggg,�� 77pppp3344 g pp�� PERM TYPE BSIGN ff� EJIPTION gIGNXP RMIT CHANGE FROM SHOPPE TO STORE CONTRACTORS: PROPERTY OWNER Departmentof ARCHITECTS: II i Regulatory Services I TOTAL FEES: $50.00 BOND $.00 CONSTRUCTION COSTS $1,000.00 t 753 MISC. NOT CODED ELSEWHERE 1 PRIVATE0P► I wnvsTABLE, Mass QED MP'�A BUILDINrM) SIGN BY /0l O DATE ISSUED 07/10/2003 EXPIRATION DATE /V TW�, 10 "' - 7 508-771-4020 r.Fax (508) 771-6658 II • ' � A MMUMM 103 Enterprise Rd. Hyannis, MA 02601 PETE JORDAW Sign Technician Town' of Barnstable .,*'THE do Regulatory Services Thomas F.Geiler,Director MAMAMSrA Building Division t6;q. �0 ATED 1' Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 j f, � Fax: 508-790-6230 '7110/a 3 ;q� zda3A/ Tax Collector Treasurer Application for Sign Permit s/ Applicant: �'� ��,, V ssessors No. Doing Business As: Telephone No. Sign Location Street/Road: Zoning District: Old Kings Highway? Yes/No Hyannis Historic District? Yes/No Property Own Name: Telephone: Address: Village: Sign Contractor ' Name: _ Telephone: 7 /" VG ZQ A Address: Vill Vie: V r"r -en— Description V "1 Please draw a diagram of lot showing location of buildings and existing signs with dimensions,location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Yes/No (Note:If yes, a wiring permit is required) 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 of Barnstable Zoning Ordinance. Signature of Owner/Authorized Agent: &44 Date: 6 Size: I l / �'I Permit Fee: Sign Permit was approved: Disapproved: Signature of Building Official: Date: Signl.doc rev.122.801 i �,. P12,OPO,56D ,,UCH FRCE v� J\-JL : D) vo 0 R-Jl Z% ,D Z% Cr SCALE 3/411 = I ft . AMrr7F C14 r) FtZOM MC-D161A)e SHOPPE 7-0 MEDICIlUE 6T'ORE, 11L)C. TWA /�'I�j�/e/,�t✓�' �'h�O.Di�� MA Wy'9n /)/,5 02,601 779- 5?28 JORDA ,J SIGN COMPANY lo/L)EPL- Or 103 ENTERPRISE ROAD �7rU �����1� HYANNIS, MA 02601-2212: LOCAL 508-771-4020 FAX 508-771-6658 L O Q C� � � p �1LQG3G� LQ � � SCALE 3/4 I ft . JORDAN SIGN COMPANY 103 ENTERPRISE ROAD HYANNIS, MA 02601-2212 LOCAL 508-771-4020 Fax 508-771-6658 TOWN OF BARNSTABLE,.BUILDING PERMIT APPLICATION 77 Map _ Parcels Application # 1; J Health Division Date Issued Conservation Division l .Application Fee Planning.Dept. .,'Permit Fee Date Definitive Plan Approved by Planning Board Historic ' OKH Preservation Hyannis Project Street Address i/ Village a ex- Owner Aele Address Telephone Permit Request jX,—0'-X 7- kQ Square feet: 1 st floor: existing proposed —.2nd floor: existing proposed ---Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: U Yes J No If yes, attach s p portini6bocumentation. l Dwelling Type: Single Family 0 Two Family Ll Multi-Family (# units) Age of Existing Structure Historic House: LJ Yes LJ No On Old King High,. v&: Ll.'Yes J No Basement Type: LJ Full Q Crawl LJ Walkout El Other Basement Finished Area(sq.ft.). Basement Unfinished Area co Number of Baths: Full: existing new Half: existing t ew Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: LJ Gas LJ Oil U Electric Ll Other Central Air: Ll Yes 13 No Fireplaces: Existing New Existing wood/coal stove: LJ Yes LJ No Detached garage: 0 existing Ll new size—Pool: LJ existing LJ new size Barn: L3 existing LJ new size Attached garage: Ll existing Q:new size —Shed: Q existing LJ new size Other: Zoning Board of Appeals Authorization L3 Appeal # Recorded LJ Commercial - Yes Ll No If yes,-site-plan review # Current Use -&-e-A2 eL �J 12ef Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name //-Z lei,el C/ Y Telephone Number 7 ;>6_-, 7314 Address C9 Akle License # le Home Improvement Contractor# U Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE c9 S--0�z 4 13 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. �;K I ADDRESS VILLAGE t OWNER i rL ;r DATE OF INSPECTION: FOUNDATION x FRAME INSULATION 'a FIREPLACE u, ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r _ Town of Barnstable ' Reg lAtory Services Thomas 1 ,eoer,Director , iSS. Building Division 9� Seq. A�0 . jDrfOM�`'� Ton Terry, Building Comnrissiouer , 200 Main.Street, ZY=3is,MA 02601 www.iown.barustable-pa.us Fax: 508 790-6230 O¢Fice; 508-862�}038 Property pWnerMust Complete and Sign Tbis Section If Using ABuilder ,as Qwmer of the subject prope 17 by Stuart Bornstein T Micrrael J. Roberts. to•actonnvbehalf, '• ' ithOYl7,e� . hereby a ermit a kation for. in au mse� relative to work authorized bytes binding p Pp -- -- (Ad 6 atJob) 6/16/2009 Date glgna of Stuborn LLC , By Holly Management & Supply Corp. , Ids Manager Its President By Stuart Bornstein ��,tT*Tame s- .,•: ""� - - Depa?Tment of Industr al Accr`!lenfs of 1=95#930fis BY `�- �i,�IN. �=-�;� 300 Washington Street ;� rrr»».777 Boston, Mass. 02111 . _-• ,� . �.� Workers' Compensation,Insurance Affidavit M0111710111 IF ow name: S I PPEWISSETT CONSTRl1C location: 297 North St: citv Hyannis MA 02601 phone# f 508 ) 775- A�_1 ❑ I am a homeowner performing all work mysei>i. • ❑ I am a sole proprietor and have no one working in anv�acity ® I am an employer providing workers compensation for my employees working on this job. com nnv name: siopewiaaell address: aet .. ,..n. Hyannis, MA 02601 phone 508 ) 775-9316 cih,: olicv#WCC 500054901200 8 insurance cn. o I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the coattactors listed below whc have the folloning workers'compensation polices. comvanv name: address: • .. hone* city: . . oliiv tl:. . ME :� .:' :• n :W. insurance cm ' '�"' '! 'lu" S�sp////.(///'//.lw.�<�i�i/,c%iuiaG✓/.(//.% _ .._ eomnanv name- . " �a. •mom,-v atddreS7: ti .... .. . ,.....,. ................... ti.,....�e�%xK_•�.s •� ar vX::rw .eTLtsro-�a.r insQrsn cc c0. erseedon 2sA orMGI:Is2 can lead-to the Imposition of erjminal penaltlta of a Sm np to S2.500.00 and/or Failure to secure eorence as r 40"d eaalda in the toms of s STOP MORK ORDER and a ane.of S300.00 a day aLainst tne_ I vnderatartd that s one years'imprisonment as wml as dvil p to the Olnu otlnrtsti�sdous o[the DU for cortratie reverification.copy of this statement may be forwarded I do her ee ify tin the d ertalt' f perlu the information provided above is trap and correct Date 6/16/2009 .Signature Mucha J . Roberts Phone# (508) 775-9316 Print name omdf d we only do not write in this area to be completed by city or town otIIcisl permitlilcense 0 ®auildine Department city or town: (:]Uctnsing Board owe is required []Selectmen's oftlee ❑ check if immediate reap 4 OHealth Department contact per9on• phone f!; (°]Other (!':rl�•t+7 995 P)it . Client#: 16170 2SIPPEWISSETTC0 ACORD. CERTIFICATE OF LIABILITY INSURANCE 01108/os° '"' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Agency ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 973 lyannough Rd., PO Box 1990 Hyannis,MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Associated Employers Insurance Compa Hard Hat Construction;BayPoint,LLC& INSURER B: Sippewissett Construction Corp. INSURER C: 297 North Street INSURER D: Hyannis,MA 02601 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN SR&DD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRE TYPE OF INSURANCE POLICY NUMBER DATE IMMIDDIYYI DATE MM DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DPR,AFM MAISES(Ea occurrence)GE TO RENTED $ CLAIMS MADE 0 OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY JET LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-0WNED AUTOS i PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ ]DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION AND WCC5000549012008 12/07/08 12/07/09 X WC LIM OTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT 1$500,0OO ANY PROPRIETOR/PARTNER/EXECUTIVE. OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000 If yes,desaibe under E.L.DISEASE-POLICY LIMIT $500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION SufFeld.Mgmt Corp.etal DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN 297 North Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #55003 LS1 © ACORD CORPORATION 1988 j yea a� ar/ueaPt� tj Bo'aYd�pt$ dl mg egulahbns an �nc�ards I' til ConstNctwn 5upeii�isor=Licensg Expi ation 21 /2010 TF#`16013 �1X C i i�1}OFiAEL,�3ftQBERTS 8T5 Af MIO�7H R s a y CENTERWLE,MA,02� Cothmissioner I, loo• oo 19 Cu 4 .t III x IL 1 t I� tv o P o" CERTIFIED PLOT PLAN I - WEST MAiL3 ST./5EA F�A2D L, b'E) ST I N n • SCALE- I 20' DATE al• �d . ®3 i 6L A2. 4T-( OF�A s9 r,►Dr4i`tcsf l: Dr4EDGE ,E/dGlly��./?!dVls C®.1/V ��� �� yG 1 CERTIFY THAT THE , CLIENT . �o SHOWN ON THIS PLAN IS LOCATED ECISTERED REGISTERED g -�, q H ON THE GROUND AS INDICATED AND CIVIL I LAND JOB NO. ,...�....._... � ` 2W4 ® CONFORMS TO THE ZONING LAWS ENGINEER SUFdYEY06t DR. ® a�`v� OF DARNSTA E A33. 712 MAIN S a T R E ET Chi.By, g; No suRd�y ol•14 B3 `� H YA N R I S, MASS.. SHEET„I,OF I DATE FtEO. LAND SURVEYOR