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1620 FALMOUTH ROAD/RTE 28 (8)
I t��D �"a-I rr►oe��t �� ch+erv, lie, Fi r� sS , u o t .. .. - .. .. .. ..1. - P TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �Ul Application # � Health Division ����� ���� Date Issued /' 3 Conservation Division JAN 25 2017 Application Fee Planning Dept. 7-0 Kikf OF ��'?f�► Permit Fee �75 '6 S.�,BL� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis ur JProject Street Address b �G �M a V I �� o Village=ram ✓! f"�(� 'Owner a4 aAt Address Zb F Cq±4p oaa nr�. �o�f�lk Telephone g ^ 2 a g-0 b m Permit Request Tt�� 0UJ _ u)y C15G6� � 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 Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes., site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) „c Name ��j o,�� �-Telephone.Number Address CID 6Q?( :J License# 4 O,, Home Improvement Contractor# ,Erria l I�VL . 42,6/ Q2I A, rj,rl/Z @aoiaj cN Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO yZ 5/2 SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. CF tNE Tp� * BARNSTABLE, 9. Town of Barnstable AtFp��a Regulatory Services , Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A.Builder I, MarrPl R Pnvant ,as Owner of the subject property hereby authorize Matthew Clark enan ) to act on my behalf, in all matters relative to work authorized by this building permit application for: 1664 Falmnnth Rnarl,Centerville,MA 6632 WaS2 209-Parcel 013) Tannary 25 2n17 -signatu e of Owner Date Marcel R_Po ant Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Intemet HeAContent.Outlook\2PIO IDWEXPRESS.doc Revised 040215 Parcel Detail Page 1 of 7 4 bth58 aIN Logged In As: Parcel Detail - Wednesday,January 25 2017 Parcel Lookup • Parcellnfo _�.__- �.�.._.._ Parcel ID 209-01.3 l Developer Lot �) Location 1620 FALMOUTHMROAD Pri Frontage Sec Road Sec Frontage i Village rCenterville 1 Fire District MM � Town sewer exists at this address NO � «--I Road Index 0522 Asbuilt Septic Scan: 209013_1 ' 209013_2 Interactive Map 209013_3 r .-.. 209013_4 r Info W �.... �...��.. ........... owner�POYANT, MARCH R � � co Owner r. Streetl2 F CAMP OPECHEE R�streetzW CO CENTERVILLE State FM—A - (zip 02632 country . Land Info ....... .... .... ...... ......... . . ......... ......... ... .. Acres 4.60 use SHPCTR-cci MDL-9 ' zoning#SPLIT RC;HB - Nghbd CI24 Topography rLevel r „� Road Paved. Utilities Public Water,Gas,Septic) Location rK District Construction Info Building 1 of 3 Year .. Roof .�� �.:..,,,,,,,-,,�„ EXt ;:�>,:. _. YBuiltear 1976 � Struct Gable/Hip Wall Concr/Cinder Living Area�4364 J cover, AC GIs"' Type Central Style Post Office-Branf wan D,rywall — Rooms00 1 Model Commercial . Flootr Vinyl/Asphalt R oms 0 Full-O Half Grade Average , Type Hot Air . J� Rooms Total u, Heai Ftistories Toured�Conc.a � ., Gross 4524 ' Area .. Building 2 of;3 Year 1976 — Roof.Gable/Hi E'�tiWood Shin le Built Struct p Wall° g Living 20015 �� 'Roof Ash/F GIs/Cm AC Central Area Cover» p p Type style Shop Ctr-Nbad wan Gail_ Rooms 00 Model Commercial Flo t Carpet Roth O�Full-0 Half http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=14832 1/25/2017 Parcel Detail Page 2 of 7 Grade Heat Total rAverage Type HotAir� � Rooms;_ i Stories 1 Heat Fuel Gas .� . Fund-ation Conc. Slab Gross 22809 Area - Building 3 of 3 _9i5,.,d year 1{ 975 Roof Gable/Hi Ext Wood.Shin le. Built I Struct p wall g Area#0 5 cover Asph/F GIS/Cmp Type Central "� �� Style Branch Bank 1 weliDrywall 1,Rooms00 Model iCommercial Int Bath Floor Carpet = � Rooms�OFull-4 Half Grade V13rage Type Hot Air � Rooms x Heat Stories 1 Fuel Gas I F und- ation Poured Conc. Gross 9332 1 Area 1 Permit History Issue Date Purpose Permit# Amount Insp Date Comments the back walls,the bathrooms walls, install ' 4/26/2016 Alt-Int work-Comm 16-807 $48,000 new cabinets paint walls, wallpaper wall, build sm 1/2 wall., new wood trim boards. RE-FIT BATHROOM TO 10/30/2015 Commercial 201507020 $8,000 HANDICAP CODE (#1660) DEMO EXISTING PARTITIONS (EXCEPT- SMALL LAV) PARTITION 6/23/2015 Commercial 201502580 $1,120 HANDICAP LAV, SHEETROCK EXT. 1 INSTALL HOLLOW CORE DOOR REPLACE FRONT 6/30/2015 STOREFRONT WINDOW . 3/4/2015 New Windows 201500838 $2,500 1.2:00:00 NO HEADER CHANGE AM SAME SIZE (NUMBERED 1652 TENANT SPACE) INTERIOR REMOD 6/30/2014 TEDESCHI -COOLER- 2/21/2014 Commercial 201400074 $300,000 12:00:00 OFFICE-WALKIN AM FREEZER-SHELVING-' DISPLAY CASES WINDS-DRWY 6/30/2014 REROOF FRNT& 11/7/2013 Commerciale 201308104 $14,466 12:00:00 SIDES-CC5 BANK BLDG AM 9/15/2011 Commercial 201104887 $18,790 STRIP& REROOF http://issgl2/intranet/propdata/Parc6lDetail.aspx?ID=14832 1/25/2017 Parcel Detail Page 3 of 7 6/30/2012 12:00:00 AM' 6/30/2011 VESTIBULE-HEATED 12/16/2010 Commercial 201006727 $34,000 12:00:00 WALKWAY-CAPE COD AM SCENT SAVINGS BANK 6/30/2010 2/12/2010 Remodel 201000336 $8,486 12:00:00 INT RENO'S ` AM 6/30/2010 NEW ATM KIOSK& 9/18/2009 Other 200904235 $601000 12:00:00 CANOPY AM 12/3/2009 F O 6/23 20X20 FC R OVER LDING /2009 New Roof 200902912'$4,800 12:00:00 20X20 T OVE ` AM 1/1/2006 10/20/2005 Commercial 87737 $48,000 12:00:00 AM 8/11/2005 . 10/20/2004 Wood Deck 80051 $10,000 12:00:00 . AM 8/11/2005 2/26/2004 Remodel 74956 $200 12:00:00 . - AM 8/18/2004 ALTER CONDITIONS IN 8/11/2003 Remodel 70725 $37,966 12:00:00 AM BANK 8/18/2004 . 2/21/2003 Remodel 67097 $100,000 12:00:00 REMODLE INTERIOR AM 1/1/2002 5/15/2001 New Siding 53352 $12,000 12:00:00. AM 1/1/2001 11/8/2000 Remodel 49877 $16,000 12:00:00 INTERIOR WALL AM 1/15/1996 3/1/1995 Remodel B37537 $20,000 12:00:00 CE:REMODE AM 1/15/1995 7/1/1994 Commercial B36872 $2,500 12:00:00 CE DOORS AM i - 12/31/1991 5/1/1991 Remodel B34323 $15,000 12:00:00 CE REMODE AM 12/31/1991 4/1/1991 Commercial B34303 $1,975 12:00:00 CE PLATFM AM 3/1/1985 Addition B27570 $25,000 12:00:00 CE ADD'N AM 11/1/1984 Commercial B27247 $280,000 CE STORE http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=14832 1/25/2017 Parcel Detail Page 4 of 7 6/15/1985 12:00:00 AM 6/15/1985 2/1/1984 Commercial B26102 . $280,000 12:0000 CE'STORE AM 3/15/1986 6/1/1983 New Construction B25192' $3,000 12:00:00 CE KIOS AM 6/15/1983 9/1/1982 Commercial B24277 $4,500 1200:00 CE 5X8 1S AM ,w .Visit History....... .... .... _ .............. ......... ........ _...... Date . Who Purpose 12/9/2015 12:00:00 AM Jeff Rudziak In Office Review 12/1/2014 12:00:00 AM Jeff Rudziak In Office Review 8/24/2010 12:00:00 AM . Tony Podlesney In Office Review 10/15/2008 12:00:00 AM Nancy Finch In Office Review 8/11/2005 12:00:00 AM Jason Streebel Bldg Permit Completed 8/18/2004 12:00:00 AM Paul Talbot Bldg Permit Completed 7/30/2001 12:00:00 AM Gary.Brennan Bldg Permit Completed Sales History.... _... ......... .... ......... Line Sale Date Owner Book/Page Sale Price 1 10/15/1993, POYANT, MARCEL R C131734 $1 2 POYANT, MARCEL R 2072/8 $0 Assessment History Save Year Building XF Value OB Value Land Value , Total Parcel # Value Value 1 2017 $2,285,900 $177,200 $381,100 $1,413,000 $4,257,200 2 2016 $2,475,800 $117,300 $251;100 $1,413,000 $4,257,200 3' 2015 $2,164,100 $50,3010 $248,900 , $1,101,900 $3,565,200 4 2014 $2,203,100 $0 $260,200 $1,101,900 $3,565,200 5 2013 $2,191,800 $0 $271,500 $1,101,900 $3,565,200 6 2012 $2,170,200 $0 $142,400 $1,101,000 $3,414,500 7 2011 $2,158,600 $0 $145,600 $1,149,400 $3,457,600, 8 2010 $2,433,900 $0 $156,600. $1,149,400 $3,739,900 9 2009 $2,337,800 $0 $162,400 $1,420,300 $3,920,500 10 2008 $2,594,700 $0 $364,600 $1,420,300 $4,379,600 12 2007 $2,594,700 $0 $364,600 $1,420,300 $4,379,600 13 2006 $1,672,400 $0 ,$118,400 $1,420,300 $3,211,100 14 2005 $1,593,800 $0 $119,700 $1,420,300 $3,133,800 15 2004 $1,576,900 $0 $120,400 $1,420,300 $3,117,600 16 2003 $1,577,300 $0 $121,700 $1,255,800 $2,954,800 17 2002 $1,577,300 $0 $121,700 $1,255,800 $2,954,800 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=14832 1/25/2017 r Parcel Detail _ Page 5 of 7 18 2001 $1,577,300 $0 $121,700 $1,255,800 $2,954,800 19 2000 $1,468,800 $0 $123,700 $878,300 $2,470,800 20 1999 $1,469,400 $55,100 $68,600 r $878,300 $2,471,400 21 1998 $1,469,400 $55,100 $68,600 $878,300 $2,471,400 22 1997 $1,313,700 $0, $0 $857,400 $2,171,100 23 1996 $1,313,700 $0 $0 $857,400 $2,1.71,100 24 1995 $1,313,700 $0 $0 $857,400 $2,171,100 25 1994 $1,505,300 $0 $0 $887,500 $2,392,800 26 1993 $1,505,300 $0 $0 $887,500 $2,392,800 27 1992 $1,406,700 $0 $0 $986,100 $2,392,800 28 1991 $1,662,500 $0 $0 $1,393,300 $3,055,800 29 1990 $1,662,500 $0 $0 $1,393,300 $3,055,800 30 1989 $1,662,500 $0 $0 $1,393,300 $3,055,800 31 1988 .$1,314,100 $0 , $0 $931,500 $2,294,900 32 1987 $1,017,100 $0 $0 $931,500 `$1,9970900 33 1986 $1,030,400 $0 $0 $931,500 $2,0111200 Photos fY. §C� http://issgl2/intranet/prop4ata/ParcelDetail.aspx?ID=14832 1/25/2017 Parcel Detail Page 6 of 7 Mt �v E � _ x� 3 t 3 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=14832 1/25/2017 Parcel Detail Page 7 of 7 t n ` ���v�':, •< m � .,�•ta c'�� "fig-^'fir.-`r���s a �7u„-'-�- � �1�.H 4 x,a Z http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=14832 1/25/2017 Town of Barnstable Building ePost,This'Card.50-That rtisVisible<.From the..5treet..A roves!Pia Must.beNRetamed on J,ob,andwthis Card Must be Kept /ARNTl A + ,' _<' £,:,� x :�.x �; pp ? eq..:. ' �q.. ��s ,s M Posted UntilKFinal Ins ectionHas Been:Made v, , .. s, ,3 �___� H .��_� :�� � . ._ a � �� _ ;�� R . Permit .. R Where a Cert�ficate�of'. n as;;Re airetl such Buldm3hall Notbe Q.ccu iedunt�l:a Fipai lnspect�on has beenymatle �.. ..z:� ,..wOccupa cy q g k Permit No. B-17-230 Applicant Name: POYANT, MARCEL R Approvals Date Issued: 01/26/2017 Current Use: Structure Permit Type: Building-Sign Expiration Date: 07/26/2017 Foundation: Location: 1620 FALMOUTH ROAD/RTE 28,CENTERVILLE Map/Lot 209-013 . Zoning District: 'SPLIT Sheathing: Owner on Record: POYANT,MARCEL Rs '' g Contractor Name Framing: 1 z Address: 20F CAMP OPECHEE RDh 'ContractoraLicense 2 CENTERVILLE, MA 02632 Est Protect Cost: $0.00 Chimney: Description: REFACE EXISTING SIGNS 2 SIGNS 72 SQ FT TOTAL ' ermit Fee:, $200.00. ONE LADDER SIGN ai 200.00 ONE Fee Pd: - S ONE ROOF SIGN CENTERVILLE FITNESS , . �- 11, M _ Final: IT Date 1/26/ Project Review Req: REFACE EXISTING 2 SIGNS 72 SQ FT TOTAL ' ` 1 A € . Plumbing/Gas ONE LADDER SIGN vtn2 r. Nk ONE ROOF SIGN CENTERVILLE FITNESS xf fix' Rough Plumbing: � s �• 3• � r Zoning Enforcement Officer Final F Plumbing: ------------ This permit shall be deemed abandoned and invalid unless the work authonzediby per mit rmit is commenced within sa months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the-approved construction documents.for¢which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoni g by laws and codes. Final Gas: This permit shall be displayed in a location clearly-visible from access streeuor road`and shall be maintained open for p blic inspection for the entire duration of the work until the completion of the same. Electrical -� The Certificate of Occupancy will not be issued until all applicable signatures by the Building andiFire Officials are provided on this`permit.' Service:. Minimum of Five Call Inspections Required for All Construction Work: s .tom 1.Foundation or Footing Rough: 2.Sheathing Inspection 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 Town of Barnstable Regulatory Services MAW 8AR11g''"B' Richard V.Scali,Interim Director BUILDING Building Division p7 'Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 JAN 2 6 2017 www.town.barnstable.ma.us YO ftf® Office: 508-8624038 Fax: 508-790-6230 Permit#. 6 J Building Official approving _ Application for Sign Permit Apphcant:Centerville Fitness Company,, Inc Assessors No. 209/013__ Doing Business As:Centerville Fitness Comp ngelephoneNo.774-487-7183 Sign Location Street/Road: 1664 Falmouth Road, Centerville — Zoning District: Old Kings highway? Yes/No Hyannis Historic District? .Yes/No Property Owner Name: Marcel R. Poyant Telephone: 508-775-0079 Address:20F Camp Opechee Road Village: Centerville Sign Contractor Name: Plymouth Sign mpany Telephone: (509)398-2721 — Mailing Address: 0-Box 134,Snnth Yarmouth,MA926fi4_ Description' Please follow the cover directions.You must have an accurate rendition of sign with dimensions and `~ location. S'` Is the sign to be electrified? es o (Note:Ifyes,a wiring,permit is required) ��r Width of building face 81 &x 10® 810 x.10 a 81 Check one Reface existing � proposed X or New Total . ro s' (s) 798 .Ft of � Ifyou have additional sj ns please attach a sheetlisting 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 Or ZO Signature'of Owner/Authorized Agent: Date' r I SIGNS/SIGNREQU revisedl 10413 j P�Of IMF tp�� BAR:NSCABLE. .. MAC To�'6'Ii.of Barnstable - - - %639. �0 Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO , Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax 508-7.90-6230 Piroperty Owner Must Complete and Sign This Section If Using A Builder • I, Marcel R Po*nnr as Owner of the subject property hereby authorize Matthew Clark nant) - to acton my behalf, in all matters relative to work authorized by this building permit application for: 1604 Enlmm th Road,Centerville- MA 02612 (MAP 209 Parcel 013), w - T� _annarc 2 �(117 Signatule of Owner Date Mnrcel'R Pc�mnt Print Name If.Property Owner is applying for permit,please complete the.Homeowners License Exemption Form on the reverse side.. C:\Users\pcc Uik\Appt)ata\1,ocal\tvlicrosofi\Windoivs\Temporaiy kieinetFiles\Cdntent.Outlook\2PI01MMIEXPRESS.doc Revised 040215 i Itm gpkllm(n)um MOMS) C ROPO -1 :0S ROOF SIGN -avv PROPOSED LADDER IGN . : : g ' q� APPROVED 1/25/'17 mar el R. Poyant RM�6 lFka"Dum MOM,) Lum=VMZ61k M& mms XISTING IGN ROPOSED SIGN . , �'� ...�, ?y sr +�.ti .�'' ,��..{. ♦ `�'a � '+ =;raA t � r h�,.,,,� ,c'1'r^=r ^�'� y„,*sr,y.. "�' 1r,� s. f. . ' }+•.. t r�{vAt'��'e' s'�==. y� :%nn'rS� .y, .56 s. 4 .�•i:."w. w .. '� a�*':.•� _w; r .s'�, - :.. # r°ry r k V :q +.�•,• .¢+ t Y"' tit ;:nC iY Y,°f '.'4 f't�' A w v'"st .s. F', '-'tkr*r + � ✓, e, ..� �s," g� •y °^° :sW' '$ o, '.y, R ,'r s a �'-+ .t, i .+,°d'e..'7'. ¢ c''-�w .i x'k` ^',.xw4 a:s m'¢�',: y., ,;».. 5; ,r�•a k`s r,,x -",-r ¢9'T,.AW. ycy c' .. .i ..,1L..,L.' 2.' :' w# aY._q�'Y ASY.^ a.P. `i.`. - °,��'3.' .. ..<. c t' �' r:•c:_" 'z °+'r t-:. ✓ � e }:� " nya �.�'.: `.a }a r r,9�. ,- ' .. .. ., ri ,-R ,.r...:.�.. .� •,a .."&:Y'.a�S �+*:� � .: °�" ar. p•u�T.rr'a. .rti. �°,�;_ � °. -. ', a..ar : t�" S - "ThP 'R+r,� `r`�,'x.W ♦ SHOPPING P ��,° �� key,,. .a�+ a"41P 3.. r'. r't". h .F 'r �"" : 'S `° 1, . HOPPING CENTER CENTER �R iw . ,. V .. a A", +y+ y 'fir �,+ s' ,, ,,�. +a...L•a N',r, , a ..d3. � }'�' �7 r _ 8"wtpc a . , `h otT t t n .. yAar ♦A�"/-' v'M'sAu.d mr.ry✓ � v.h^ �\w: A"• • � 4".W �vr 4� 1�. +,y 'f ,,,r " v� w�'':y y �.. *�wrsd,,y,•v`►.-r ,* ��" y ° �4 `'�' �Y �,,�'4,�,�. y� _ 4 k„ +";.,n�. a, .t t ;�, .'.. h' y '�, .,�,ry. ^NGr. ;" `r.°f ~� .�,•r '.N l 1 i- n•�... , t_ ,. 'i ..^�""� iiyyq '�k s�'Ad' �`�fi 'S,,ti,. y'., 't^ 0 6C �i^ .t;a �S►,:y clJ.afi ?ti "�.iM" 'R +�« a*+k „s*"., APPROVED 1/2-5117 M rc R. t , arce Poyan 4 a. TtM VMS ..... ..... XISTING: ROOF IGN �. ,.. .,,;- �'.� 'k r W +;..«,.;.�., «.: {F...:tJ� ° .%�,+..' -:,.' T y,fir. -.� A ,...- •�� � ` .�". '.'�z n',ar.'"°a+° e; .e,s:' e�: .•v'�rr. i q : ... . ....... .... .... ., ;,s ,, u•[' e G kr r r,_ .ems '°" ;. .� ... .4 .,, j, h- k Yi ' i- - - ' . �•v n, ,�. •, a.x..a' "" •''" ",r, °="'q.,�,;�"i'? u'Y„ ,«•r`,z"� -v y� }• ,:W�r ,�, �'wd,�w.*''^�," ,yyr, a� a,;s ��.2��:w •,�,, ��,; .0 $ : MOM - 55 s �+.; - aro, K,r .a. .�-=i "� k '.,r ..,°` 's.t.:•>�,��` °� - a i4t,� �.�. �r a +,rr'"r 4�.�. .*at:.. w • i a. `q{'.�lr 4'im`,t , 5+•+- )'' + `'� ns 9 ,yyY. ° sr '*' V W, i 1 RSED::, P Approved 1/25/17 O OROOF I GN . . . rcel R. ant. r,s ,':•., t'.<Sa ,..n: -,' '+=4x;.":-:. GR'1 ,a. •-:,f+ ";`ta,`� e,r;:., r .:r'.`.r ,.- „,,.• a.t ,.,y,,. �. n° .r ", :..s." r• a. _.. Y.r :r :f" ,�. t' <?� t,. } %� d. �''��.' a ;`rr,,. �• ... ,'�.• .' � .�'+c �,tt ,�^'sc, .;�� :.�:• -`:„; �„�,',e } +.�.�w, ,r8,�.a sit. �^',,a•'. r °•">„ t.«. �� �, `:� r*�� rv*l+,,rrfy„, �" �..,�,� t;� r� r Lr kb �'k�1��•+�+w.�yfjsat i1 '�' • ►.i6N{117►1Y4�3.L7 !rK v. Jr•w: �;f� � y �� •' } � � roxti;Y+KS rtn e..nrt�.� �. �.,a .mph �:-- '^,�.'. .�4,. a> � �._ � _ � -__� . - .-. -.d..,:.y,o_ � ,• � a} 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 Fl , 367 Main St., Hyannis, MA 02601 (Town Hall).and get the Business Certificate that is required by law. DATE: 1(24L2117 Fill in please: APPLICANT'S YOUR NAME/S: Matthew D. Clark BUSINESS YOUR HOME ADDRESS:209 Gleneagle Drive, Centerville,MA 02632 774-487-71 R3 t4M1'�' �@'rw1 ? a1 ttf r t, 1zti��,EvcE�l�t'� TELEPHONE # •Home Telephone Number 774-4$7-7183 'siM #: 81-5 833 E-MA centerville.fitness' NAME OF CORPORATION: NAME OF NEW BUSINESS Centerville Fitness TYPE OF BUSINESS Gym IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESS 1664 Falmouth Road'Centerville MAP/PARCEL NUMBER 209/013 (Assessing] When starting a new business there are several things you must do in order to be In compliance with the rules and regul'ations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST.GO T0.200 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 FICE f This individual has been r ny permit re e s ert 'n to this type of business. Autho ' ed n tur COMMENTS: .z 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. , Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS[LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: Si�a ��T I ,v Cuff �� Duei - BE 218 IF a t LL l m\JT 3 -�3 3 3 4 F � d � a t � III PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, NA 02601 DATE: 07/18/06 TIME: 15:41 -----------------TOTALS----------------- PERMIT $ PAID 75.00 ANT TENDERED: 75.00 ANT APPLIED: 75.00 CHANGE: .00 APPLICATION NUMBER: 87737 PAYMENT METH: CHECK PAYMENT REF: 1169 ' �t"Eti Town of Barnstable Building Department - 200 Main Street t SST"LE. * Hyannis, MA 02601 i639• y MASS. (508) 862-4038 CFO MP'�a Certif icate of Occupancy Application Number: 87737 CO Number: 20060079 Parcel ID: 209013 CO Issue Date: 07/18106 Location: 16 7("-%-9FALMOUTH ROAD (ROUTE 28) Zoning Classification: Owner: POYANT, MARCEL R Proposed Use: POBOXK HYANNIS, MA 02601 y Village: CENTERVILLE Gen Contractor: LAMBORGHINI,LANCE Permit Type: CC00 CERTIFICATE OF OCCUPANCY COMM Comments: G CSS SA(' B Vfldi&ePartment Signature Date Signed Town of Barnstable Regulatory Services { Thomas F.Geiler,Director • BARNSTABM MAC• $ Building Division 1639. ATFONIA'�a Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit#_ 7 3 Application for Sign Permit Applicant: `�1 , �4 = � Assessors No. D � A Doing Business As: lam. � Telephone No.!�N Sign Location ,? Oq)" Street/Road: ��`� � Zoning District: Old Kings Highway? Yes/No Hyannis Historic District? Yes/No Property Owner���� Name: Telephone: Address: IKL Sign Contract _ Name: _ Telephone: Mailing Address: M&S i Description 4 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 o (Note:If yes, a wiring permit is required) =o Width of building face ft.x 10= _x.10= 4 3 1 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 thrI gh§240 9 M of the Town of Barnstable Zoning Ordinance, Signature of Owner/Authorized Agent: Date: ZO Size: Permit Fee: Sign Permit was approved: Disapproved: Signature of Building Official: Date: Q:IWPFILESWGNSWGNAPP.DOC c ---gr-�M2-:C� MY 41 _ LI i cl�H S'�orz�orsr �•vn-�onl-3ii��.=thou Ot✓fl AW -CAt T ,�.,��:< o : ' 1 _� F11�{•� �.�iPtr'IT FUkOt�SCEtJT i t.LU,1. --�":.-I ! ��'i ! ? t` '14:55�(, • � lE� <'ytCx�.t _ yEi — (� 9b00 ej.;n . w•. r u 0 R40 `1. 3t�7�0tj.ih- . 544 .in. - 74.58 � : ''4"=t,Q, .. a. 1, r., l W(IC) VtPYL v,COW 3YIV4 o h .ti @a cam DOWN OF. a 0 � 0 w Oe 0 Q Oo 00 O CUSTIOMER - -FERMI Y�No. _ ,�pFggNjN E3Y DATE: & MATERIALS APPROVED BY LOCATION: SIGN �:p. REVISIONS:_ SCALE i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION i n �A pp licat o I V Map Parcel'- Health+Division Date Issued Conservation Division Application Fee Planning. Dept. Permit Fee` - Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project St et Address I t U _ b 7 Villagel Owner [Y I0A 2 Pel Pi�_ A4 Address. bin e. lvf4m Telephone 0 C' ► ;vfb lk, ZFO —C Permit Request � S • Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning DistrictA, Flood Plain Groundwater Overlay Project Valuatio Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family, ❑ Two Family ❑ Multi-Family (# units) _ s Age of Existing Structure Historic House: ❑Yes ❑ No On Old"Kirig's Highway:C Yes ❑ No ate,£ , )-. Co Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other - - Basement Finished Area (sq.ft.) Basement Unfinished Areayy(sq.ft) h Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new ' CD Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ 'Appeal # Recorded ❑ Commercial es ❑ No If yes, site planreview # Current Use Proposed Use ��- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name W I bids rfev-Ar'Telephone Number Jv b- '12,D I W U Address P10 I 1 License # ( m- 0, tF0 Home Improvement Contractor# � Worker's Compensation # (09 ALL CONSTRUC ION DEBRIS RESULTING F OM THIS PROJECT WILL BE TAK N TO SIGNATURE DATE r FOR OFFICIAL USE ONLY APPLICATION# ' DATE ISSUED5uxtr:` "_MAP/PARCELNO.: _ I' r ADDRESS. _ VILLAGE 1`--. OWNER - r DATE OF INSPECTION: r FRAME f ` ,-INSULATION.' y rT) "I I. FIREPLACE ELECTRICAL: ROUGH FINAL S PLUMBING: ROUGH FINAL } GAS-:RAglui ROUGH w4 wR,-. FINAL t _ r a: IDATE.CLOSED:OUT, ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office Invesli ations' ff of r g 3 ° i 600 Washington`Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information _ Please Print Le ibl Natne (Business/O'rs;anization/Individual) ° ACICIress: • City/State/zipOftilk. YWA02 k _Phone #: Are)3R an employer? Check t e appropriate box: Type of project(required): am a employermith 5' 4. 1 am a general contractor and employees{full and/orpart-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 working for me in any capacity. employees and have workers' : 9.. Building addition• [No workers' comp. insurance '~ comp. insurance.+ required.] 5. We are a corporation and its I O.Qbectrical repairs or additions work officers have exercised their 1 l:Q Plumbing:repairs or additions 3.❑ I am a homeowner doing all' myself. [No workers' comp. ' ., right of exemption per MGL 2. Roof repairs insurance required] t c. 152, §1(4),and we have no employees..[No workers' 13. Other y comp. insurance required.] *Any applicant that checks box#I must also Fill out the section below showing their workers'comrensatibn policy information. .. f Homeowners who submit this atiidavit indicating they are doing all work and then hire outside contractors must submit a new aN'fidavit iridicatirig such. . *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or 1_16t those entities have ` employees. If the sub-contractors have employees,they must provide their workers'camp.policy number: I am an emplQver that is providing workers'compensation insurance for My'emplovees. Below is.the policv and job site information. L01' 16" Insurance Company NameNd' M (Ar*wk Policy #or Sell-ins. Lic. #: ��. � Expiration Dater Job Site Address: tu City/State/Zip: /Ilrl V 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 Investigation of the DIA for insurance.coverage verification. I do hereby rti �nrler Ile p i and penalties of perjury that the information provided above is true and correct. Si mature: 1 Date: Phone#: Z�� s Official use only Do not write in flits area, to?becompleted 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#: Ae6RL> CERTIFICATE OF LIABILITY INSURANCE DATE,06/ 011 �.....� o7/osnoll THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING.INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - CONTACT - - , NAME: - - Gerrnani Insurance Agency - - - ` PHONE,-' - - FAX - 908 Main Street c o zt•(508)428-9194 Alc No: 508 428-3068 -• E-MAIL - - ADDRESS: Osterville,MA 02655' PRODUCER CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED , INSURER A: SAFETY INS CO - Scott Peacock Building&Remodelling, Inc. INSURER 8: P.O.Box 171 Osterville,MA 02655 INSURER c INSURER D: National Union Fire ins.Comp. - - - INSURER E - - INSURER F: - COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,* EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR: POLICY EFF POLICY EXP - LTR TYPE OF INSURANCE POLICY NUMBER MM/DDIYYYYI (MM/DDIYYYY1 LIMITS- - A GENERAL LIABILITY CP00001152 7/5/2011 7/5/2012 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY - DAMA NT - PREMISES Ea occurrence $ - CLAIMS-MADE F—IOCCUR - - MED EXP(Any one person) $ - v - PERSONAL&ADV INJURY $ % o - GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- LOCJE $ AUTOMOBILE LIABILITY - - COMBINED SINGLE LIMIT - $ - - ANY AUTO , (Ea accident) 4 BODILY INJURY(Per person) $ a ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS r PROPERTY DAMAGE HIRED AUTOS (Per accident) NON-OWNED AUTOS - . - - $ $ UMBRELLA LIAB - = - - - - OCCUR _ „ EACH OCCURRENCE ' $ - EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ ` r - RETENTION $ $ D WORKERS COMPENSATION WC 5815464 6/22/2011 6/22/2012 We STATU oTH- AND EMPLOYERS'LIABILITY - - _ ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N « E.L.EACH ACCIDENT $' 100,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE_ $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below . E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) .- CERTIFICATE HOLDER CANCELLATION Scott Peacock Building&Remodeling,Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE d. THE EXPIRATION DATE -THEREOF, NOTICE WILL BE DELIVERED IN- Fax#"508-428-7625 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD t Office of Consumer Affairs&B siness Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 151853 -Type: Office of Consumer Affairs and Business Regulation Expiration: 7%7/2012 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 SC TT PEACOCK BUILDING&R.EMODELING INC l .; JAMES PEACOCK 1046 MAIN STREET SUITE7 OSTERVILLE,MA 02656y Undersecretary Not valid without signature i +=. Massachusetts Department of Public Safety Board of Building Re; dations and Standards -Construction Supervisor License License:,CS 94500 JAMES S PEACOCK PO BOX 171 a T OSTEVILLE, MA 02632 +' " Expiration: 7/22/2012 ('nuwi,.�iuncr . Tr#: 29233 . f Sep 07 11 01 : 36P SCOTT PERC 508 428 7625 io. 3 ' owim off Bairmsftbk KAM v IWEWeB'A6IIS, o %63 oo� Reguh%toiry Servgces Thomas F.Ceiler,Director BUDRdi ng IIDnva$iou Thomms Ferry,CBO Building Commissioner 200 Main Street, Iiyannis.MA 02601 www.town.b2iras2sblc.msa.us Office: 508-862-4038 Fax; 508-790-6230 Property Owner Must Complete and Sign This Section. If Using A BWldeir I, MARCEL R. POYANT , as Owner of the subject property hereby authori745-�M ' . to act on my behalf, in all,rmttexs rclauve to work authorized by this building permit application for. (in mtffi (Addmss of job) u 9/8/11 azure of Owner Date MA L R. POYANT Print Name q\WPFJLLS\F0JkMS\building permit tbnns\EX'RL•SS.d0C Rcvisc0201 09 T NOTES RECEIPT i%t' DATE All A.�3 4 No. 3036 RECEIVED FROM e��� /.e ,c ADDRESS // (� —// 76 t'C 6 - IfAA) / A g FOR ACCOUNT HOW PAID-- �r AMT.OF CASH ACCOUNT AMT. CHECK .PAID BALANCE MONEY. BY2 DUE ORDER` ©2001 REDIFORMo 8L808 s . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION • tk Y Map � Parcel � Permit# HealthaDiuision- ---- fa)-5/6' Date Issued D 2 Conservation Division �m ®� �� Fee 6 c) Tax Collector �� (� Q( - Treasurer Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address I(o(A e 1670 mOvT Village csr'TGia�,J 1 U_E_ Owner �12c�__L, 1,. 'POY el'tNJ—I Address 2 2 IIAPIWS i F't feILDL fit Telephone 5-o s'-Li zo — 0z aB Permit Request 1*-4T 3�oz ?-e—L O 0E__A N Cr OF- rXk1�rI r,,\GC -Cc-cu aleb s-10Zr o1\,N_,S Square feet: 1st floor: existing proposed SArY-'. 2nd floor: existing - proposed Total new cA<Valuation VS,000,0 a A'i , Zoning District Flood Plain Groundwater Overlay Construction Type Cow-\111 2 Lrlr( 4 Lot Size Grandfathered: ❑Yes ❑,No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family 0 . Multi-Family(#units) Age of Existing Structure 5 2A. Historic House: 0 Yes o On Old King's Highway: ❑Yes `�N0 Basement Type: 0 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) /AV Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing 6k new First Floor Room Count s Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric .. ❑Other Central Air: t Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ,.No Detached garage:❑existing ❑new size Pool: 0 existing 0 new size Barn:0 existing ❑new size Attached garage:❑existing ❑new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial Yes ❑ No If yes, site plan review# N Current Use Proposed Use BUILDER INFORMATION Name W3NCX-_- VA s LRr,\%1CP_G- w,,11 Telephone Number Address q . l 8� ,Inn_ V _ 13OY-, 7GS License# c6ao9 S�C-.AY2e (' Y-)_ a5Ro Home Improvement Contractor# 17 yz Worker's Compensation# WCZ3 J 5'317J 8 7 0/S'� ALL CONSTRUCTION DEBRIS RESULTING FROM.THIS PROJECT WILL BETAKEN TOL1iV� SIGNATURE DATE �� R FOR OFFICIAL USE ONLY r PERMIT NO. -' DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: f FOUNDATION t FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT r r.. ASSGCIATION PLAN NO. COMMERCIAL-BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $150.00 Alterations/Renovations $100,00 . Building Permit Amendment $50,00 FEE VALUE WORK SHEET NEW BUILDINGS . square feet x$140.001sq:foot= x.0081= ALTERATIONSMENOVATIONS OF EXISTING SPACE square feet X$96/sq.foot= S 4' STORAGE BUILDINGS ONLY f square feet X$32.00/sq.foot= X.0081 Commprojeost Rev:063004 `fHE Town of Barnstable �pf �aY ~ Regulatory Services r• � 9BAMAMRNSTABM *. Thomas F. Geiler,Director �'OTFppjpla�0 Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder j MARCEL R. POYANT , as Owner of the subject property hereby authorize LANCE LAMBORGHINI DBA LAMBORGHINI CONST. to act on my behalf, in all matters relative to work authorized by this building permit application for: 1664-70 Falmouth Road, Centerville, MA 02632 (Address of Job) Marcel R. Poyant dba .Centerville Shopping Center II Sept 21, 2005 Signature.of Owner Date Print Name M reel R. Poyant Q:F01 MS:OWNERPEPMISSION i BOARDOF BQkLDING REEl1LA+TIONB i LicenseOI6eTRUCTIONSUPER•UISOR ' NumbArf:AS. 062092 r. � :, ' I +Exips 1�05/2005 Tr.no: 14116 F ResVi ed._�00� I a:s/ LANCE W I-'4MBOR'GFilC�ll �i�rir PO BOX 259 SANDWICH, Administrator f c � 1 ne."mmonweacrn of massacnusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www-mas&gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/orgamzation/Individual)._ \j r �Sjs►S(, Address: ie FO �- uG�— City/State/Zip: •�. �� •� v�� , ice. • Phone#: �U 92-5 Are you an employer? Check the,appropriate box:. Type of project(required): 1.P I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet 1 7• ❑ Remodeling ship and have no employees These sub-contractors have S. ❑ Demolition working for mein any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or.additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' comp.insurance required.] 13.❑ Other.*. *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: �F 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees."Below is the policy and job site information. Insurance Company Name: iiC6,cLk-A l til S -►�-.z n/a ? �r 21 S Policy#or Self-ins.Lie.#: u,-\ kI �C Expiration Dater Job Site Address: 1620 FAQ- f'lkc ^ City/State/Zip: C2 V-,z PQ" 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 Section 25A of MGL c. 152 caii 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pa' nd penalties that the information provided above is true and correct: Si ature:. / - Dater Yam. Phone#: 5-zi 6-. 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 6.Other 5.Plumbing Inspector Contact Person: Phone#• Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as.:`_` ? �dna�.:p ,'.,asso0ation,Corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. Howcver.the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair woTkvn such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." o states that"eve state or local licensing agency shall.withhold the issuance or ter 152 25 C(6)also "every , MGL chap , § renewal of a license or permit to operate 'business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states `Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable:evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants 1 and,if. Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your necessary,supply sub-contractors)name(s), addresses)and phone numbers) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners; are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' at the number listed below.. Self-insured companies'should-� r-t� #heir compensation policy,please call the Department self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the app Please be sure to fill in the permit/hcense number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"'the applicant should write"all locations in L (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that.a valid affidavit is onfile for:future permits or licenses..A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and.fax number: The Commonwealth of Massachusetts . Department of Industrial.Accidents Office of Investigations 600 Washington Street . Boston,MA 0211 L. Tel. #617-727-4900 ext 406 or-1-877-MASSAFE fax#617-727-7749 Revised 5-26-05 www.ma'ss.gov/dia RE °fs may° Town of Barnstable A Planning Division Thomas A. Broadrick,AICP 200 Main Street,Hyannis,Massachusetts 02601 Director of Planning,Zoning, Tel: (508) 862-4786 Fax: (508) 862-4725 &Historic Preservation www.town.barnstable.ma.us August 9, 2005 Richard Travassos The Gym Express C/o Attorney John Kenney 12-Center Place 1550 Falmouth Rd Centerville, MA 02632 SPR 050-05 The Gym Express, 1664-1670 Falmouth Rd, Centerville (R209-013) HB Zone Proposal: Change of Use - Convert former CVS (retail use)to fitness center. Dear Mr. Travassos: Please be advised that the aforementioned proposal was approved at the site plan review meeting on August 4, 2005 with the following condition: ❖ Board of Health approval must be secured for the septic system (as required by the intended change of use). This application has been referred to the Board of Appeals for relief under Section 240-25 (C) Conditional Use— Special Permit. Sincerely, Robin C. Giangregorio Zoning& SPR Coordinator e BARIMA-AM Town of Barnstable Zoning Board of Appeals Decision and Notice Appeal 2005-074—Travassos/Gym Express Special Permit- Section 240-25 Conditional Uses in a Highway Business Zoning District. To convert the former Centerville CVS Pharmacy(5,000 sq.ft.)to a fitness/health center. Summary: Granted with Conditions Petitioner: Richard Travassos,The Gym Express,Inc.. Property Address: 1664-1670 Falmouth Road(Route 28)Centerville,MA. Assessor's Map/Parcel: Map 209,Parcel 013 Zoning: Highway Business Zoning District a Relief Requested &Background: , In Appeal 2005-74 the applicant,Richard Travassos,d/b/a The Gym Express,Inc.,is seeking a Conditional Use special permit to allow a fitness/health center to operate within 5,000 sq.ft., of the Centerville Plaza Shopping Mall. The locus is zoned Highway Business and the proposed use can only be allowed by special permit from the Zoning Board of Appeals as per Section 240-25. The space is that of the former CVS Pharmacy. Only interior alterations are being proposedwto'convert that retail store into the fitness center. For standing, a copy of a signed lease between Marcel R.Poyant, owner of the property and Richard Travassos,d/b/a The Gym Express,Inc.,the tenant,has been submitted to the file. Procedural &Hearing Summary: This appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on August 1,2005. A public hearing before the Zoning Board of Appeals was duly advertised and notice sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened August 24,2005, at which time the Board found to grant the special permit with conditions. Board Members deciding this appeal were, Gail Nightingale,Randolph Childs,James R. Hatfield,Jeremy Gilmore, and Acting Chairman Ron S. A Jansson. F Attorney John W.Kenney represented the applicant Richard Travassos who was also present at the hearing. Mr. Kenney stated that the proposal before the Board was to convert the 5,000 sq.ft. former CVS Pharmacy from retail to a health and fitness club.` He noted that an August 18,2005 traffic report of Vanasse Hangen, Brustlin,Inc., submitted shows that the average daily traffic and peak traffic would be reduced by granting the conditional use permit. He also cited that a septic permit has been issued by the Health Division for repairs and improvements to the existing on-site septic system. Mr. Kenney noted that only interior improvements to the building are proposed should the Board issue the permit. Public comment was requested and no one spoke in favor or in opposition to the request._Findings of Fact At the hearing of August 24,2005,1he Board unanimously made the following findings of fact: 1. In Appeal 2005-74, the applicant is Richard Travassos,d/b/a The Gym Express,Inc. The property is addressed 1664-1670 Falmouth Road(Route 28) Centerville,MA and is located as shown on Assessor's Map 209,Parcel 013. It is in a Highway Business Zoning District. 2. The applicant seeks a Conditional Use Special Permit in accordance with Section 240-25 conditional uses in the Highway Business Zoning District. The applicant seeks to.convert the site previously occupied by the CVS Pharmacy(5,000 sq.ft.)to a fitness center. Only interior alterations are being proposed to convert that retail store into the fitness center. 3. The locus is within the Centerville Plaza Shopping Mall. That property is a 4.60-acre parcel developed with 28,072 sq.ft.,commercial shopping mall with 203 on-site parking spaces. Construction of the mall dates to 1975-1976 when the area was zoned Business B. In 1985,the area was rezoned to Highway Business allowing only offices and banks as principal permitted use. Uses in the Business B Zoning District were made conditional uses and require a special permit from the Board. 4. With regard to on-site parking, Staff calculates that for retail use of the entire 28,072 sq.ft. mall, 152 on- site parking spaces would be required under the ordinance. The mall at present has 203 on-site parking spaces and sufficient parking does exist on-site for the conversion. 5. The proposal has been reviewed by the Site Plan Review Committee and found approvable on August 04, 2005 subject to Board of Health approval of the septic system. That Board of Health approval has been granted and an on-site septic repair/improvement permit issued. 6. With regard to traffic generation,according to the ITE Trip Generation Manual, a Health/Fitness Center would generate a peak average flow of 4.05 vehicle trips per 1000 sq.ft. during the hours between 4 and 6 PM. (Land Use Code 492). A pharmacy/drugstore with no drive through would generate a peak average flow of 8.42 vehicle trips per 1000 sq.ft. during the hours between 4 and 6 P.M. (Land Use Code 880).From a traffic standpoint,the use is less intensive. 7. Conditional uses are allowed in the HB District by Special Permit provided such uses "do not substantially adversely affect the public health, safety,welfare,comfort or convenience of the community." 8. This application falls within a category specifically excepted in the ordinance for a grant of a Special Permit and after evaluation of all the evidence presented,the proposal fulfills the spirit and intent of the Zoning Ordinance and would not represent a substantial detriment to the public good or the neighborhood affected. Decision: Based on the findings of fact,a motion was duly made and seconded to grant the Conditional Use Special Permit with the following conditions: 1. This permit is issued to allow an existing 5,000 sq.ft. unit located in the mall to be used for a health/fitness center. The space to be occupied by the fitness center is that area formerly occupied by the CVS Pharmacy as shown on a plan submitted entitled"Site Plan for the Centerville Shopping Center _ 2 1664-70 Falmouth Road,Barnstable(Centerville)Mass."dated June 15,2005 as drawn by Sullivan Engineering,Inc., and initialed by the Chairman. 2. The interior of the unit and proposed interior improvements are shown on a plan presented to the Board entitled"Proposed Health Club and Fitness Center Located at the Centerville Shopping Center Falmouth Road, Centerville,Massachusetts"dated 6/2/2005,revised 8/l/2005,as drawn by AKRO Associates Architects. 3. The on-site septic system must be approved by the Health Division for the change-in-use prior to the issuance of a building permit for the health/fitness center. 4. Development must comply with all applicable Building,Fire and Health regulations for the intended use. 5. Signage shall conform to the requirements of the Zoning Ordinance. 6. No exterior storage of any type,including trailers or containers shall be permitted on site except that which may be permitted by the Building Commissioner as temporary and then only during the redevelopment of the interior area of the space. The vote was as follows: AYE: Gail Nightingale,Randolph Childs,James R. Hatfield,Jeremy Gilmore,Ron S. Jansson NAY: None Ordered: Conditional Use Special Permit 2005-74 is granted with conditions. This decision must be recorded at the Registry of Deeds for it to be in effect.,The relief authorized in this decision must be exercised within one year. Appeals of this decision, if any, shall be made pursuant to MGL Chapter 40A, Section 17,within twenty(20)days after date of the filing of this decision, a copy of which must be filed in the office of the Town Clerk. Ron S. Jansson,Acting Chairman Date Signed I,Linda Hutchenrider,Clerk of the Town of Barnstable,Barnstable County,Massachusetts,hereby certify that twenty(20)days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been filed in the office of the Town Clerk. Signed and sealed this day of under the pains and penalties of perjury. Linda Hutchenrider,Town Clerk 3 $08 ao8- s7gy � ,-e R�rm P�diems Ne c� ��P do 2. Plan of Record recorded at the Registry of DeedIsh boundaries,Site Plan must also be submitted showing the loc parking, etc., Copy of deed. 3. Historic District Commission,200 Main Street,appro construction/demolition for any properties located in a • Old Kings Highway Historic District(north o • Hyannis Main Street Waterfront Historic Dis • Historic Preservation (if applicable). 4. Five sets of house plans measuring 11"x 17" scaled 1 must include a foundation, cross section,framing schedul smoke detectors(locate with q Red `S'.) 5. The following departments must sign the Building Permit • Engineering Department(located at 367 Main St.; • Health Department (8:00—9:30 AM&3:30—4:30 0 Conservation Department M-3.0_4•zn eM , z•zn TOWN OF BARNSTABLE z. • 60 DAY TEMP CR tTIFI A`E 6F OCCUPANCY EXgAES. J5/01/06 -PARCEL ID 209 01 v GEOBASE 'ID 12811 ADDRESS 1620 FALMOUTH ROAD (ROUTE �" PHONE CE!!TERV I LLE -ZIP LOT BLOCK ,, at ell S I��F _ DBA DEVELOPMENT ��+ •DTSTRICT, Cis, 7 'DESCRIPTION i 7 j7 PERMIT 8801(0 �DESCRIl TION 2ND TEMPCO FOR SI, �' 4 PERMIT TYPE ETCOO TITLE TEMP- OCCUPANCY PERM, w CONTRACTORS: I.De art en"T of ARCxITEi�'IS.: Regulatory Services.., TOTAL FEES: $150-0f3 BOND $,00 GO:�I,TRr�t�TION COSTS >.00 -758 MISC. NOT CODED ELSEWHERE Mass: 161 A� ED MA'S . BUILDIN ISION BY DATE ISSUED 1.2/09/2005 _ E'XP IRATION! ,DATE . 05/01/`006 �� h7 - TOWN OF 2A NS TABr.R�a. Al{ CEs I ICA?EOQ(•L UTES-� R /J/Jlls i f.F DDR Gs{`r`' !, `~.(,, I.J.AD 7 RO TE' PTig MT!E _ 1.,oT s Ai'�i Wti ..-,OT zi "P R r!`.` (;� .j Jf'°`{"_'*�,N TEMP 'y r� FOR T i t .,T, D ez.-w. ?..� .c'i1vlJ t L� 1L a!� i� ?.1'LEJ! '' �i .lJ. � 1�1 tV= 1 �t�Ss �. 'PERMHIT ��,`i:PE .ts`.�"COO T I.T!;E . . - TEMP. OCCUPANCY PE''RM�fy,,_ CON RAC'TORS: Department of k A�.Ci�a I T`ECTS:- h.. Regulatory Services ?TOTAL FRE'S 75-00 BONDt 00 CONSTRUCTION COSTS 75 �A =3 AfjTc� ° T to CODED '! 'ri1 "RRE • # BMWgrABLE, • �1639. A1� FD Mlr►� BUIL G DIV ON BY DATE !GSU D 12/09/20,05 RXPIRA.TION LATE C�M9/�C�u �']y }/•i ��Y.sr r� a f• ^ .. (wry{' / !f <,,, {�•�J� .i r `•a •i�'sfn}lJ {_.! 1.K L.�V \ «•1 •. L'si. � ..?J a .I.. .3.�. .. � . PPMJRl al ZQT jflF'1CL�V�. f �� �bt+ ! � •`��� "�' l"'• "+/ .7 eSF s r xy a" 1) r �r t i"r cr'>` a ! i-r3 R S+� '!' t'7� f 1.`1 5"t[• t '1 f'• t. t �— Y .n 11 `, f I lLv, 4 �'.Me,y_icy«J. �J.�'�' ✓JkuJLJ.4:l J./1,J .Y. L.�.tf�. � lJ .� _....a...ii:Jy Y,A•�.1 �� J.'�V1�}� CN �• r Regulatory.Servic'es '`�';�!(� .�.v,•.: c,j .r/.L rt`a.. 1 'i ti),i�'�' `h° .! .',. °'.1. . t� :�u. ?�• _'1", ~. tl :+ •v f. � ,► BARNSTABLE, # e' BYE` . _ :'1, ,.'� �. Jx�1,;�'i� ' ti.'•�K0f1v�.e .ald.: P•'i''1;� - ,,,r''� ti�:..�''`�! ' q' aiAiT: 7A'd�i �i.�c 2t���r�1 ti:•: 7 ,�. ' ". a f rs ' •t t?.. �� k. ' er t c � y ' mill rV YIN XX J I I x 1,4 ;' , } 1 e J uP �> Jxf • { A� L1+{'Y.u CY.S}Y I;. a/t1�yY'.to h. y & P ex v ' ' , of O 8 q _ r �♦ ✓1 � ' f 4�3 -.. , 8 ' THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) m A- F DATA �• t r��. t;r,l v f •1:.� 14 '(;r-'1 fY t(t. � fl'! +'. f^V{ + t rti'1'�+ -r( 1� y r r:jr f e_ "t •fir :1 1 � s f ) '� GZt F.t.4. :R�k V.}.�.13.1. �' rt. 7 � :4 � �� • r,`� `� Yl"�4i�i':S + e � ! t. i�h�-vNJ��I t . '� `'�`7'�.1. ���c.3�• " ` �rD - r a 7 r Alt r,�+ ttr r4 ti t ?F A l y C'.Ai i E rIT fyi ,, 13W'S'J } `r t Al) !�, rf'. t�s i •�n +� s �;t W4 .-s.t�.•.'Zv � � �� ���1 p� � V � p °j'. z fS.�r/ e t°�. 1 1)epartm of o clr t r4 a e Regulatory Services Me N\atT` .�M' RU•�p.T ril t-� ���,��1 s• 3 �5+ {�.?i^�„f �+r�r��� `l r �r'` a.yr, � _ BUILDING DIVISION. �t�, b + l'1L`t�1 +fi5, +•• .r 's'&, lY�± y i,J L..eu.a a. {.7�t t .{-• r �' ?UILDINd PER1111T, PARCEL ID 209 013 GEOBA.SF ID ..12 811 ADDRESS :1.620 FALMOUTH ROAD? (-R.OUT PHONE CENTERVILLE `"`�._ ZIP LOT BLOCK LOT SIZE DBA - DEr1ELOPMENT _-___. DISTRICT CO ffi && MRCC C VT RMS TYPE ADC � a `f CONTRACTORS: LAMBORGHINI ,LANCE Department of. ARCHITECTS:. Regulatory Services TOTAL FEES: $526.98 BOND $.00 pF ` CONSTRUCTION COSTS , 52,714.00 437 NONRES./NONHSKP ADD/CONY 1 PRIVATE s'*snRrisias . IKAS& FD MA'S A BUILDING�DIIVISION BY Y���•�r,.�r� ,� DATE ISSUED 10/20/2005 EXPIRATION DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. EN= CROACHMENTS'ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES�AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS "PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL`CONSTRUCTION WORK: % APPROVED PLANS MUST BE RETAINED ON JOB AND f WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTING$'` THIS CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- P ECTRIC•.ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS/ , ELECTRICAL,PLUMBING AND MECH- 3. PA INSULATION.LATH).READY TO '. ` 'OCCUPIED UNTIL NCY IS FINAL IJNSPECTION HAS BEEN MADE.CH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. '+� BUILDING INSPECTION APPROVALS PLUMBING-INSPECTION APPROVALS ELECTRICAL INSPECTI N APPROVALS �2M o�� 1t- �3'J_l� �G17 3 �rJ'� f . Q p� 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT ?j O v`" P �O 2 e BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL �D r ,;1tor--d'r" ©c LS. -c+9-c WORK SHALL NOT°PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TIQN. NOTED ABOVE. TION. y . r y r i� i • BUll. 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