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HomeMy WebLinkAbout1600 FALMOUTH ROAD/RTE 28 (28) ATM z cel,4, Gin. in, r\ r �X,:� .�:;�. �F � 7370, ? '.Y• TWA +l it ��i „• �, ' �o .�;�;; s it sell ''.se� , .1 s .9 ;ax r.• + .fax ANN r � 1s tiw � t t S � � ` , 1 , t } +/ Y i •.1j"5WWQW0- ass .y a ,aSAKS ANK =�t t A osmosis, ANSWAKIT 1 � F ti MAM -w Toy {5 ,ice M f MOO two MOM 1" GAT COUP,, Alva QT his hill- WK Moto Y ;K k 1 l I e- k l f {. � k `f� f' 4 Alum, viol;500­3 MAN 11 r i 1 l �[ 4• a t �2 J t dr x m J l i w 4 1, 3' AWWAS"Ay�'A Monr a is By x, 7 i � i >.ti. _r a �i +i u, i i� f 1 � is ti %r r t WAVE- - L 1 I t } 7 Y 3.1 t t F t f h 3 r y big Vol S^ i Q� t f. V WNvowy- 1 [ L i f +xfi f . i 0who > 7KYARPOp i 11 I i o s r ,.. ,ulf oil +r,1.. ' F;i ` , f t r. d 4 i t b t tSPAS } 'r1 tits y t t r Y f Town of Barnstable Building Department Brian Florence, CBO - Building Commissioner 200 Main Street, Hyannis, MA 02601 www.t6wn.bamstable.ma.us Pre-application for Business Certificate Date Map Parcel J/ Applicant Information i . Applicants Name Applicants Address�l�/J�,QJ�1//DF,�!S �G�/f,� �y�^2 Email Address ^.-69-5 C" / ��/ �� Telephone Number� �`%�/ �IQDg Listed ❑ Unlisted ❑ . Business information New Business? nnf /j 5 -`vW ---t//J W -�`-- ---(1-��--- Yes No Business is a registered corporation? ------------------------• Yes N If yes Name of Corporation Does business operate under the registered corporate name? Yes N Is the business a sole proprietorship or home occupation? --------- Yes No If yes then a Home Occupation Registration is required—See Building Division Staff Name of Business A'A ( )//r0 S r,�f.� Business Address 4Q0 AIMt)C" Type of Business Building Commissioner Office Use Only Conditions Building Commissio r EK Date Clerk Office Use Only 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 Map Parcel Applicant Information Applicants-Name Applicants Address 1p��fQfJV/D f�(f�/�G�l� �T Email AddressC6r? Telephone Number'�� %(/ Listed ❑ Unlisted ❑ Business Information New Business? ----------�_----a--)-<_�_A_--_. Yes No Business is a registered corporation? ________________________. Yes N If yes Name of Corporation Does business operate under the registered corporate name? Yes Is the business a sole proprietorship or home occupation? _--_-__-- Yes No If yes then a Home Occupation Registration is required-See_ Building Division Staff Name of Business Business Address upo Type of Business Building Commissioner Office Use Only Conditions Building Commissio r Date rN Clerk Office Use Only l 6pll .en se u n� New England Authentic Eats LLC Fed ID: 61-1905885 - DBA: Papa Gino's - DBA: D'Angelo Officers: Neer Mayenkar—Secretary 6250 North River Road Rosemont, IL 60018 William Van Epps—CEO 616 Old Coach Road Nicholasville, KY 40356 Thomas Victor Sterrett—COO 105 Inverness Court Hendersonville,TN 37075 617-651-1360 Corey Wendland—CFO 3 Aimhi Woods Road Windham, ME 04062 Karen Bray=VP Finance/Controller 171 Buck Knoll Road Raynham, MA 02767 '\ The Commonwealth of Massachusetts Department of IndustrialAccidents a I Congress Street,Suite 100 Boston,MA 02114-2017 www.massgov/dia Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Business/Organization Name: New England Authentic Eats LLC d be PRga G l ho l S Address:_ ( b o Fto m o© k '.h � eA Td V e-f PA 60 1 City/State/Zip: C 211�U V r ft I MA O 1 G 3 2 Phone#: S 0$ - '� I g '� S S n Are you an employer?Check the appropriate box: Business Type(required): 1.Q✓ I am a employer with —20 _employees(full and/ 5. ❑Retail or part-time).* 6. E Restaurant/Bar/Eating Establishment 2.❑ 1 am a sole proprietor or partnership and have no 7. Office and/or Sales(incl.real estate,auto,etc.) employees working for me in any capacity. [No workers'comp, insurance required] 8. ❑Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c, 152,§1(4),and we have 10.0 Manufacturing no employees. [No workers'comp.insurance required]* 4.❑ We are a non-profit organization,staffed by volunteers, 11.❑Health Care with no employees. [No workers'comp.insurance req.] 12,0 Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#I. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information. Insurance Company Name: United States Fire Insurance Company Insurer's Address: 305 Madison Ave City/State/Zip: Morristown, NJ 07960 Policy#or Self-ins.Lic:# 408-850450-2 Expiration Date: 02/11/2020. 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 cepope, under the pains and penalties of perjury that the information provid d abo is true and correct Ah Sign tare: (� ?G �` .�,/� Date: W Phone#: 781-467-1608 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.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: www.mass.gov/dia ACCP o® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDA-rM OW03/2019 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(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER NCONTACT AME: Certincates The PLEXUS Groups LLC PHON u Eat (847)307.8100 FAXNo: (Mn 3D7 8199 21805 W Field Parkway,Ste 300 aODRESS: cerBHcates@plexusgroupe.com MSURER(S)AFFORDING COVERAGE MAIO I Deer Park IL 80010 INSURER A: United States Fire Insurance Company 21113 INSUREDINSURER B: XL Insurance America,Inc. 24554 New Erptand Authentic Eets LLC INSURER c: Crum&Forster Indemnity Company 31348 DBR:Papa Gino'sID'Angelo ►NSURER D: 600 Providence Highway ►NSURERE: Dedham MA 02626 INsuRERF: COVERAGES CERTIFICATE NUMBER: 10120 GL WC,UMB,EXCS, REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. — LTR TYPE OF INSURANCE INSD WVO POLICYNUMBER —PuDlyar- -policy-up J MM/D MMID LIMITS. X COMMFJtC1ALGENERAL LUA8ILTIY - EACH OCCURRENCE i 1,000,000 CLAIMS-MADE DAMAGE TO RENTED PREMISES Es occurrence 3 1,000,000 MED EXP one person s Excluded A GL543-850449-3 02JI1/2019 02/11/2020 PERSONAL&ADV INJURY 11,00D,000 OENL AGGREGATE LIMIT APPLIES PER: - GENERAL AGGREGATE 10,000,000 x POLICY El JECT LOC PRODUCTS.COMP/0PAGO s 2,�0,000 OTHER; s AUTOMOBILE LIABILITY COMB N 0 SINGLE IT ANY AUTO Me aoddenl OWNED SCHEDULED BODILY INJURY(Par person) - AUTOS ONLY AUTOS - BODILY INJURY(Poneddanl) s HIRED NON-OWNEDLY ROPERTY DAMAGE s AUTOS ONLY AUTOS ONLY - Psr acddan s x UMBREUA UAB x OCCUR EACH OCCURRENCE s 25,00D,000 B EXCEss use CLAIMS-MADE US00089484LI19A 02/11/2019 02/11/2020 AGGREGATE, s 25.000,000 DED X RETEN IONS 10,000 WORKERS COMPENSATION - S AND EMPLOYERS'LIABILITY Y rN x STATUTE ER o C ANY PROPRIETOR/PARTNERlEXECUTIVE a NIA WC4a6.850450-2 OZ/11/2019 O7J11/2020 E.L.EACH ACCIDENT s 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory in an If yes.describe under E.L.DISEASE-EA EMPLOYEE I s 1,000,000 DESCRIPTION OF OPERATIONS below . E.L.DISEASE-Policy LIMIT Ts 1,000,000 Liquor Liability Per Occurrence •51,000,000 A GL 543 850449 3 02/11/2019 07/11/2020 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached H more apace Is required) SEE LOCATION SCHEDULE PROVIDED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD I GRILLED S A N D W I C H E S February I Ph,2019 RE: License Application Please note that Papa Gino's Inc. and D'Angelo's sold all of their assets to New England Authentic Eats LLC. (DBA Papa Gino's&D'Angelo Grilled Sandwiches)as a result of Chapter 11 Bankruptcy filing. As such,we are submitting a check and application in order to obtain a new license under the new . owner's TIN. Please contact: License @p_papinos.com if you have any questions or if there is additional paperwork that we need to complete in relation to the change in ownership.Also,please note that the General Manager and other staff at the restaurant have not changed. The new TIN is: 61-1905885 Regards, Pam Swain, License Coordinator 600 Providence Highway Dedham, MA 02026 781-467-1608 New England Authentic Eats LLC, 600 Providence Hwy. Dedham,MA 02026 Phone: 781-467-1200 r.• v v se New England Authentic Eats LLC Fed ID: 61-1905885 DBA: Papa Gino's DBA: D'Angelo Officers: Neel Mayenkar—Secretary 6250 North River Road Rosemont, IL 60018 William Van EPPS-CEO 616 Old Coach Road - Nicholasville, KY 40356 Thomas Victor Sterrett—COO 105 Inverness Court Hendersonville,TN 37075 617-651-1360 Corey Wendland—CFO 3 Aimhi Woods Road Windham,ME 04062 Karen Bray—VP Finance/Controller 171 Buck Knoll Road Raynham, MA 02767 �\ The Commonwealth of Massachusetts Deparintent of IndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www massgov/dia Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Business/Organization Name: New England Authentic Eats LLC d be\ PcA, G 1 no i S Address: Fa m o u�.h d � cM Td U/cy- C1 _ City%State/Zip: C hi _f V I A O I G 3 2 Phone#: Are you an employer?Check the appropriate box: Business Type(required): 1.Q I am a employer with —20 _employees(full and/ 5. ❑Retail or part-time).* 6. ORestaurant/Bar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no 7. Office and/or Sales(incl.real estate,auto,etc.) employees working for me in any capacity., [No workers' comp. insurance required] g• ❑Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c. 152,§1(4),and we have 10.❑Manufacturing no employees. [No workers'comp.insurance required]* 4.❑ We are a non-profit organization,staffed by volunteers, 11.Q Health Care with no employees. [No workers'comp.insurance req.] 12.0 Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#I. ` I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information. Insurance Company Name: United States Fire Insurance Company Insurer's Address: 305 Madison Ave City/State/Zip: Morristown, NJ 07960 Policy#or Self-ins, Lic.# 408-850450-2 Expiration Date: 02/11/2020 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 certi , under the pains and penalties of perjury that the information provid d abo is true and correct. Sign lure: KU a •' fit: �; �i' Date: lU - Phone M 781467-1608 . 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.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: www.mass.gov/dia I A���® CERTIFICATE OF LIABILITY INSURANCE OATE(0312019 Y) 02l03/2019 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 pollcy(les)must have ADDITIONAL INSURED provisions or 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 endomement(s). PRODUCER NAME: Certificates v The PLEXUS Groupe LLC PAHOON o E:e (847)307-6100 Ne: (8qn 307-6199 21805 W Field Parkway,Ste 300 ADDRESS: certificates@plexusgroupe.00m INSURERS)AFFORDING COVERAGE NAIC Deer Park IL 60010 INSURER : United States Fire Insurance Company 21113 wsuRED INSURER e: XL Insurance America,Inc. 24554 New England Authentic Eats LLC 1Nsom c: Crum&Forster Indemnity Company 31348 DBA:Papa Gino's/D'Angelo INSURER D: 600 Providence Highway WSURERE: Dedham MA 02026 INSURER F: COVERAGES CERTIFICATE NUMBER: 19/20 GL,WC,UMB,EXCS, REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. — LTR TYPE.OF INSURANCE INSD WVD POLICY NUMBER M MIOD1YYYY1 LIMITS X COMMERCIALGENERALLIABIL"Y - - EACH OCCURRENCE S 1,000,000 CLAIMS-MADE OCCUR - PREMISES Ea oocurranee S 1,000,000 MED EXP(Any one person S Exduded A GL 543-850449-3 02/11/2019 02/11/2020 1,000,000 PERSONAL SADVINJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE - - S 10,000,000 X POLICY JECT LOC PRODUCTS.COMP/OPAGO S y+�0,000 OTHER: AUTOMOBILE LIABILITY - COMBINED OMB N D SINGLE IT S ANY AUTO Esseddenl) BODILY INJURY(Par Person) S GAMED SCS/EDULEO AUTOS ONLY AUTOS BODILY INJURY(Per socldaM) S HIRED NON-OWNEDSONLY OPERTY DAMAGE AlJT03 ONLY AUTOS ONLY - Per aoddanl S S X UMBRELLA LU19 OCCUR - - EACH OCCURRENCE S 25,000,000 B EXCEssLL1e CWMS-MADE US00089484LI19A 02/11/2019 02/11/2020 AGGREGATE S 25,000,000 OED I X RETENTION S 10,000 S WORKERS COMPENSATION ER O AND EMPLOYERS'LIABIUTY YIN X STATUTEH. T OFFICEANY PRIETOR/EXCLUDE/EXECUTIVE NIA WC408-850450.2 - 02/11/2019 02/11/2020 E.L.EACH ACCIDENT a 1,000,000 C O Mandatory In Nf R EXCLUDED? (Mandatory d ory br and 1,00Q000 Iryes,deealbeunder -, E.L DISEASE-EAEMPLOYEE S DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY UMR S 1,000,000 Liquor Liability Per Occurrence $1,000,000 A GL 543-650449-3 0211 W019 02M 1/2020 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES(ACORD 101.Addidonal Remarks Schedule,maybe attached B more space Is required) SEE LOCATION SCHEDULE PROVIDED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and Togo are registered marks of ACORD GRILLED SANDWICHES February I Ph, 2019 RE: License Application Please note that Papa Gino's Inc. and D'Angelo's sold all of their assets to New England Authentic Eats LLC. (DBA Papa Gino's&D'Angelo Grilled Sandwiches)as a result of Chapter l l Bankruptcy filing. As such,we are submitting a check and application in order to obtain a new license under the new owner's TIN. Please contact: License.@papaginos.com if you have any questions or if there is additional paperwork that we need to complete in relation to the change in ownership.Also,please note that the General Manager and other staff at the restaurant have not changed. The new TIN is: 61-1905885 Regards, Pam Swain, License Coordinator 600 Providence Highway Dedham, MA 02026 781-467-1608 New England Authentic Eats LLC, 600 Providence Hwy. Dedham,MA 02026 Phone: 781-467-1200 Sign _ TOWN OFBARNSTABLE Permit BARNSTABLE, MASS. s6 �39. A Permit Number. Application Ref: 201504451 20071125 Issue Date: 07/16/15 - Applicant: . BELL TOWER CORPORATION " Proposed Use: SHOPPING CENTER- MALL . Permit Type: SIGN PERMIT Permit Fee $ 50.00 Location 1600 FALMOUTH ROAD/RTE 28 Map Parcel 209014 Town CENTERVILLE Zoning District SPLT - Contractor PROPERTY OWNER Remarks REFACE 7.5 SQ FREESTANDING PAPA GINOS Owner: BELL TOWER CORPORATION Address: P O BOX 1461 - SOUTH DENNIS, MA 02660 ' Issued By: p�C POST TI•1IS CARD SO THAT IS VISIBLE FROM T1E TREET i, t �4� PERMIT PAYMENT RI` .TPT TOWN OF BARNSTABLE ''BUILDING DEPARTMENT 200 MAIN STREET ,; HYANNIS, MA 02601 DATE: 07/16/15 TIME: 14:43 -------------- --TOTALS--------- ------ --- PERMIT $ PAID 50.00 AMT TENDERED: 50.00 AMT APPLIED: 50.00 CHANGE: .00 APPLICATION NUMBER: PAYMENT METH: CHECK PAYMENT REF: 34423 A , s r OF !3APNSTown. of Barnstable Regulatory Services + iARN3TABI E r t= €a Mass. t'7 *Richard V. Scali,Interim Director Building Division Tom Perry, Building-Comm issioner s__200°Main Street, Hyannis,MA 02601 b www.town.barnstable.ma.us� Office: 508-862-4038 Fax: 508-790-6230 Permit# Building Official approving________ _ Application for Sign Pernik, 4(/pl-f� Applicant:�LeLLP _:// �1 �__►1 �12 �_�nVh.�'��1 __Assessors No ohs► ��11'�S,Ir Doing Business As:_Plc�- 1 �x� Qj� _ Telephone No.=? 1' ��_12a� Sign Location Street/Road: �� _ 4�1✓�eU�h - _dlS-m�i� r,r" I��_ '-------- Zoning District:_____Old Kings Highway? Yes co Hyannis Historic District? Yes o/ o Propertye'r - Name: _—CJ�-- -- _Telephone:----------------- Address:�0= 1 _1 �1__J_._�1�►�✓ZS __ �1--=-------Village:---------------- Sign Contractor 1 /� Name:-1[�.Qa1✓�L_ lrr�2±_1 ��, bo = Mailing Address:_��-�����----�11--��3--��?_�ZL2�_—=-------------------- Description Please follow the cover directions. ou must have an accurate rendition of sign with dimensions and location. Indni mCil 'D1q 0j'q jil , 4� Is the sign to be electrified? Yes No (Note:I}yes, a wiringpermitisrequired) Width of building face _ft. x 10=__�_ Check one Reface existing sign or New Total Sq.,Ft. of proposed sign (s) / Ifyou have additional signs please attach a sheetlisduff each one with dimensions If refacing an existing sign please`provide a picture of the existing sign with dimensions. I hereby certify that I"am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of §240-59 through.§240-89 of the Town of Barnstable Zoning Ordinance. Signature of Owner/Authorized nt /� ^� � ------- Date /ACle,�� �17� SIGNS/SIGNREQU ` revised110413 7/14/2015 Official Website of The Town of Barnstable-Property Lookup 5 I Select Language Assessing Division Property Lookup Results - 201 5 367 Main Street,Hyannis,MA.02601 <<BACK TO SEARCH << Print Friendly Owner Information - Map/Block/Lot: 209 / 014/ -Use Code: 3230 Owner Owner Name as of 1/1/15 BELL TOWER CORPORATION Map/Block/Lot G IS MAP_ S PO BOX 1461 209/014/ Property Address SOUTH DENNIS,MA.02660 1600 FALMOUTH ROAD/RTE 28 Co-Owner Name Village:Centerville Town Sewer At Address:No GIS Zoning Value:SPLIT RC;HB --- -- ------.....:----......-------._.....__............._......_..................-----------.._.--_............._... Assessed Values 2015 - Map/Block/Lot: 209 / 014/= Use Code: 3230 2015 Appraised Value 2015 Assessed Value Past Comparisons Building Value: $ 5,300,100 S 5,300,100 Year Total Assessed Value Extra Features: $0 $0 — 2014-S 7,194,300 r 2013 $ 7,194,300 Outbuildings: $220,600 $220,600 • 2012 -$ 7,31 7,100 Land Value: $ 1,673,600 $ 1,673,600 2011 -$ 71279,500 201.0-$7,754,200 2009-$9i276,300 ' 2008-$%264,900 2015 Totals $ 7,194,300 $ 7,194,300 2007-$9,264,900 Tax Information 2015 - Map/Block/Lot: 209 / 014/ - Use Code: 3230 - Taxes C.O.M.M.FD Tax(Commercial)$ Fiscal Year 2015 TAX RATES HERE . 11+151.17 - Community Preservation Act $.1,812.96 Tax Town Tax(Commercial) $ 60,432.12 73,396.25 Sales History Map/Block/Lot: 209 / 014/ - Use Code: 3230 ' History: Owner: Sale Date Book/Page: Sale Price: BELL TOWER CORPORATION 1992-05-15 7998/167' $2500000 SHIELDS,T TR,LEBEL,D W TR 1987-10-15 5958/242 $1 ' SHIELDS,THOMAS M 1985-02-15 4430/200 $850000 WOLFE,LESTER 2087/198 $0 Photos 209 / 014/ - Use Code: 3230 Sketches - Map/Block/Lot: 209 / 014/ - Use Code: 3230 ........... _----- ----- ----------- http:/twww.towriofbarnstable.us/Assessing/propertydisplayscreenl5.asp?ap=0&searchparcel=209014&searchtype=address&mappar=&awnname=&streetno=l... 114 7/14/2015 ; Official Website of The Town of Barnstable-Property Lookup i kt Mw BELL TOWER MALL AsBuilt Card N/A Constructions Details - Map/Block/Lot: 209 / 014/ - Use Code: 3230 Building Details Land Building value $ 5,300,100 Bedrooms 00 USE CODE 3230 Replacement Cost $6,471,122 Bathrooms 0 Full Lot Size(Acres) 9.91 Model Commercial Total Rooms Appraised Value $ 1,673,600 Style Store Heat Fuel Gas Assessed Value $ 1,673,600 Grade Average .Heat Type Hot Air Year Built 1988 AC Type Central 3 Effective depreciation 20 Interior Floors Ceram Clay Til- Stories 2 Interior Walls Drywall Living Area sq/ft 73,621 Exterior Walls Vinyl Siding Gross Area sq/ft 82,621 Roof Structure Gable/Hip -Roof Cover Asph/F GIs/Cmp i Outbuildings & Extra Features - Map/Block/Lot: 209 / 014/ - Use Code: 3230 Code Description Units/SQ ft Appraised Value Assessed Value KSK3 Bank Kiosk ATM 190 $63,300 $63,300 PAVI PAVING-ASPHALT 85000 $ 153,000 $ 153,000 SHED Shed 960 $4,300 $4,300 Sketch Legend Property Sketch Legend B2N Barn-any 2nd story area FPC Open Porch Concrete Floor REF - Reference Only BAS First Floor,Living Area FTS Third Story Living Area(Finished) SOL Solarium BMT Basement Area FUS Second Story Living Area SPE Pool Enclosure (Unfinished) (Finished) BRN Barn GAR Garage TQS Three Quarters Story (Finished) CAN Canopy GAZ Gazebo UAT Attic Area(Unfinished) CLIP Loading Platform GRN Greenhouse UHS Half Story(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UST Utility Area(Unfinished) FCP Carport KEN Kennel UTQ Three Quarters Story http://Www.townofbarnstable.us/Assessing/propertydisplayscreenl5.asp?ap=0&searchparcel=209014&searchtype=address&mappar=&awnname=&streetno=l... 214 ® Massachusetts Department of Pub4c,Safety Board of Building'Regulations and Standards .' (..'i,�tscructiun Suruc r�;isc�r, a License: CS-076718 yllil DAVID J RANDA �uu 8 Cider Hill Lane ilt " I Sherborn MA O1770 h ,) Ex ratiort Commissioner 03/15/2016 ..... .. a ... ..�. v _ .. .r�t'IC'C� t',�► CERTIFICATE OF LIABILITY INSURANCE DI muDOrY'rrr) >/2222f2014 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY ANIEND, 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 ADOITIONAL INSURED, the policy(ies) must be endorsed.=1f SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER COYrA T Elizabeth Bortona NAME: FM Walley Insurance Agency Inc PHONE {781}326-8383 FA Nol:C1311 3 2 5-9 33T 475 High Street E-MAIEL .. ay in ADOR P. 0. BOX 469 INSURER S)AFFORDING COVERAGE. NAIC 0 Dedham MA 02026 = INSURER A:Travelers Indemnit Co of CT 25692 INSURED - - ." -. INSURERe Charter Oak Fire 'Ins Co 25615 Expansion Opportunities Inc INSURERC:Trivelers Prop Cas Co of Amer 5674 DBA VieuPoint Sign & Awning INSURERD:Travelers Casualty & Su ret C0 19038 35 Lyman Street 4 INSURER E Northborough KA- 01532 IINSURERF:' COVERAGES CERTIFICATE NUMBER:2014 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, TERNI 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 TERNIS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOt/VN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN SR I TYPE OF INSURANCE ADOI UBR POLICY EFF POLICY EXP LTR POLICY.NUMBER MMIDOIYYYY MMIDOIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X CDMrAERCIAL GENERAL 1IA31LITY - - PREMISES Ea occurrencel S 100,000 A CLAIMS-ibIADE 7XOCCUR 6305509c939 9/14/2014 9/14/2015 MEO EXP(Any one person) S 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT.APPLIESPER:, PRODUCTS-COMPIOPAGO S 2,000,000 X POLICY 7 PRO- LOr S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Eaac: ,dentl $ 1 000 000 B X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED A0123T720 9/14/2014 9/14/2015 BODILY INJURY(Per accident) S AUTOS AUTOS , X HIRED AUTOS X NON-01ANED - PROPERTY DAMAGE S AUTOS - Per accident }{ UMBRELLA LIA3 x OCCUR EACH OCCURRENCE . S 51000,000 C EXCESSLIAS' CLAIMS-MADE , AGGREGATE S 5,000,000 DED X RETENriof,is 10,00 UP7673C707, 9/14/2014 9/14/2015 b D WORKERS COMPENSATION - - - _ X +NC STATU- - OF H- � AND EMPLOYERS'LIABILITY YIN QRY I IMITIR ANY PROPRIETOR,'PARTNER,EX<6CUTIVE E.L'.EACHACCIDENT S 1 000+000 OFFICERNIEMBER EXCLUDED? - N❑ NIA _. (Man datory In N H) UB-4A693605-14 9/14/2014 /14/2015 E.L.DISEASE EA EMPLO YEE S 1 000 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1 000 000 DESCRIPTION OF OPERATIONS(LOCATIONSI VEHICLES(Attach ACORD 101,Additional Remarks Schedule,irmore space Is required) CERTIFICATE HOLDER CANCELLATION (50 8)393-4244 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE 'WILL BE DELIVERED IN Expansion Opportunities, Inc. ACCORDANCE WITH THE POLICY PROVISIONS. DBA Viewpoint Sign & Awning 35 Lyman Street AUTHORIZED REPRESENTATIVE Northboro, VA 01532 Frank Walley T_II/BETH -- ACORD 25(2010105) ©1983-2010 ACORD CORPORATION. All rights reserved, INS025ontnns,nt Th. onri —n,Lc of At r1GTl The Commonwealth of Massachusetts Department of Indcrstrial Accidents W Office of Investigations . a 1 Congress Street, Suite 100 Boston, AM 02114-2017. www mass.gov/rlia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information - `Please Print Legibly Name (Business/Organization/Individual) Expansion Opportunities dba ViewPoint Sign and Awning Address: 35 Lyman Street Suite 1 ' City/State/Zip:Northborough, MA 01532 phone #: 508.393.8200 Are you an employer? Check the appropriate box:. ,` f- ' Type of project(required): 1.V I am a employer with 49 4. ❑ F am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑..New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7: ❑ Remodeling ship and have no employees- These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' + Y9:°,❑tlBuilding 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. ;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 isproviding workers'compensation insurance for mV employees. Below is the policv and job site information. Insurance Company Name:Travelers Casualty&Surety Co.MIC..# 19038 Policy# or Self-ins. Lie. #: UB-4A698605-14 ,, ' " Expiration Date:09-14-2015R Job Site Address: 'b4, iti ► �� City/State/Zip: „- 4. Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Se'ction'25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under lite pains and penalties of perjury that the information provided above is true and correct. Signature: Date: � ) 5 Phone#: 5083938200 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License # Issuing Authority(circle one): 1.Board of health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: Sign Panel (double-sided" Shoe Mounted 6._0" - �� (72") _ __ _� � ,�,�„•' -ems ' c Existing Posts t 14" f .- a f Sign Panel is 4"Dee F - ) � ' Elevation:#6923.1(0 1)Sin Pone) 9 F + Scale: l"=1; s v Description: I I (Clty 1)Sign Panel,doublmided' y Aluminum tube inner frame with DiBond on faces.(4"Deep) Face graphics are digitally print with ovedaminate.(flooded) Logo: Supplied Papa Gino's(edited/cleaned vector) Colors: Sign Panel- painted to match Green PMS 3435c Returns) Face Graphics- digitally printed"at 720 dpi on 31A 11180c Controhac vinyl with 3M 8518 Clear Glass over4omioate. (Closest printed match to PMS 3435,HAS 484,PMS 1215,and PMS 419) Y Installafion: " Proposed: By Viewpoint. Shoe Mounted -- r Existing: Job: Aimu,thoop: Dote: Wuons: 'RMiM - (astwnu ApRard - Aca.Manage Apiovd' Pvod.Ifi.Appmrd - i I. Y -I InD BY VIENOTSIGtl ARD WO OMURICKSanrs aViewPolnt EgoGino's RmrSt■fe m.m.Is Lo1.508.393.8200 cRrum Rr narrourr ua ono AamaG au Rears RfsrRno.taafion: fge. Ongicer. URADnIORQmDUMURORORRMODUaDR6PRa111Rn1D. SIGN ANo AWNING FAX 1.508.393.4244 16W fdowA Rd-remuvdle,MA IPG_cemmMA_9FF-*Ia.d mi"Hoard _ if Milo- 'P- Rol --7 e _ i� Y L MRI W77 t 1�= W v fit?:.}NZ t� ► � � A '^wxuss, } r ViewP®9n$ July 14th1 2015 SIGN AfYo AWNING Town of Barnstable 35 Lyman Street Regulatory Services, Building Division Northboro, W 01532 200 34ain Street Hyannis, MA 02601 508 393-8200 508 393-4244 Fax Attention: Robin Anderson signs@ViewPointSign.com www.ViewPointSign.com Re: Papa Gino's Pizzeria, 160o Falmouth Rd(Bell 9"bwer MaCo INTERIOR/EXTERIOR SIGNAGE HeCCo Robin, Electric Architectural Dimensional Encibsedplease find an application and associated Wayfinding documents to add a tenant paneCto the existing Channel Letters directory sign at above location. There was another LED/Neon Electronic Message Centers tenant paneCin the proposed area previously. Digital Graphics I have encCosed a check for the fee of$50.0o based on AWNINGS the square feet of the sign. I have provided a self addressed Commercial stamped envelope for the permit once it is issued. Backlit Canvas Retractable thank you very much for your help with this project. I Cook forward to hearing from you. SIGN SERVICE Best Regards, ARCHITECTURAL METAL FABRICATION VEHICLE GRAPHICS Sandy .Cu Permit-'Manager MEMBERS Viewpoint Sign andAwning Massachusetts Sign Association 35 Lyman St Rhode Island Sign Association Northboro, Nia. 01532 Internationaln Assoetption t 508-393-8200 sandy@viewpointsign.com Northeast Statign Asf;iiciation llr— North East as Prd cts Associa}ion _ �F 4 Industrial FabrgilAssociation ti Intern6e.fl�o�nal UL LISTED FABRICATORS `"4A