HomeMy WebLinkAbout0627 SOUTH MAIN STREET �.27 �Soo A1 Y-F-
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Town-of Barnstable
Building Department
Brian Florence,CB
Building Commissioner
200 Main Street, 5yannis, MA 02601
www1own bamstable-ma us
Pre-application for Business Certific
ate
Date <2 Map La-L2 Parcel
Applicant Information
Applicants Name -
Applicants Address.
Email Address '- L C7_C�� r(A
Telephone Number Listed❑ Unlisted ❑
Business Information
New Business? __----__ _-__-__----_- es No
Business is aregistered corporation? ------------------.------ - Yes No
if yes Name of Corporation 2o::2 {�� 1� P��C D
Does business operate under the registered corporate name?6YPS No
is the business a sole proprietorship or home occupation? -------- .Yes No
if yes then a Home Occupation Registration is re *ed—See Building Division Staff
Name of Business
PP ,
Business Address
Type of Business
Building Commissioner Office Vse Only
C ditiotls
Building Commissio Vq LlDate ��
Clerk Office Use Only
Town of BarnstableBuilding '
snxrvsrnaLK Post This Card So That it is Visible From the Street=Approved Plans Must be Retained on Job and this Card Must b_e Kept Y?
Posted Until Final Inspection Has Been Made.
Where a Certificate of Occupancy is Required;socFi Building shall Not be Occupied until a Final Inspection has been made. Permit
Permit NO. B-19-2660 Applicant Name: CLOUGH, DEBORAH Approvals
Date Issued: 08/16/2019. Current Use: Structure
Permit Type: Building-Sign Expiration Date: 02/16/2020 _ Foundation:
Location: 627SOUTH MAIN STREET,CENTERVILLE Map/Lot: 186-062 Zoning District: RD-1 Sheathing:
. � -
Owner on Record: CLOUGH,DEBORAH Contractor Name: Framing: 1
Address: 633 SOUTH MAIN STREET Contractor License: 2
CENTERVILLE, MA 02632 A Est. Project Cost: $0.00 Chimney:
Description: 30"X36" SIGN FOR PROPERTY CAPE COD Permit Fee: $S0.00
Insulation:
Fee Paid: $50.00
Project Review Req: Date: 8/16/2019 Final:
_ i '^xluti Plumbing/Gas
i - Rough Plumbing:
- v Zoning Enforcement Officer
-This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. final Plumbing:
All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas:
All construction,alterations and changes of use of any building and structores shall be in compliance with the local zoning by-laws and codes.
This permit shall be displayed in a location clearly visible from access street or'road and shall be maintained open for public inspection for the entire duration of the Final Gas:
work until the completion of the same. L
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Electrical
Minimum of Five Call Inspections Required for All Construction Work:i Service:
1.Foundation or Footing
2.Sheathing Inspection ZRough:
3.All Fireplaces must be inspected at the throat level before firest flue`lining is installed
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final:
S.Prior to Covering Structural Members(Frame Inspection)
6.Insulation Low Voltage Rough:
7.Final Inspection before Occupancy Low Voltage Final:
Where applicable,separate permits are required for Electrical;Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Health
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (asset forth in MGL c.142A). Final:
Building plans are to be available on site Fire Department
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final:
v\\0\� . ®® 'own of Barnstable
�oFIHME ��16� Buong Department
P �P�N
" NSF Building Commissioner BA�NSTABI,E
BARNSTABLE
1 gym° '�0�' 200.Main Street, Hyannis, MA 02601 "�`''` J`'°°""'""'�;al ,
1 IP]'d.TMln
A�Fp �a www.town.barnstable.ma.us JJ
Office: 508-862-4038 Fax: 508-790-6230
s � ,
p✓� Sign Permit Application
Zoning District Permit # -��r�� ce
Historic District❑
Location b
Street address and village c-c"` ,, r�
ApplicantYr '3 �;� A- �
Map & Parcel
Telephone.Number �`7_� -Email' , e ,
Sign #1 Sign #2
'Wall Wall E�J
Freestanding Freestanding 0
Electrified* 0 Electrified*
Dimensions Sign #1 4 Dimensions Sign #2
Square feet Square feet
Reface Existing Sign 0 New/Replace Sign
Width of Building Face _ ft, X 10 = . X .10= C�C�
T-
*Lighting Type
1-4
A wiring permit is required ' ign Is e ectrified.
Sig ature Ow r/ th ized Agent /
i ing address
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PROPERTY
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627 S . MAIN STREET
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=n�_ s�r,�e ,�s� e-mail; plysigncom@capecod.net
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel 0 Application# C
Health Division
Conservation Division Permit#
/ .7
Tax Collector Da ss �d gib
Treasurer qcation fee OU
Planning Dept. Permit Fee
Date Definitive Plan Approve anning Board �K �f 2.�%`
Historic-OKH � \ eservation/Hyannis
Project Street Addres . 6:2 7 J° 0A.0,1V
Village
Owner —Address 4: 2.7 /%p�•� �•
Telephone 7 7 5 .. S 7
Permit Request Yv-ze'F a o .1—i Xre Ill
Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation i 6U Construction Type
Lot Size C11JGrandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family, ❑ Two Family ❑ Multi-Family(#units)
r ,
Age of Existing Stricture Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes O No
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full:existing new Half:existing new
Number of Bedrooms: existing new
Total Room Count(not including baths):existing new First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other
Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name K4!�oTelephone Number
Addresses ��i+i✓ve�✓yl� �� License#
Home Improvement Contractor#1C19 �%
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE O�
FOR OFFICIAL USE ONLY
F;
7 PERMIT NO. s '"
DATE ISSUED
MAP/PARCEL NO. v
r
i•
ADDRESS t VILLAGE
t OWNER ^
>f
DATE OF INSPECTION:
.5
FOUNDATION ��
FRAME
INSULATION
FIREPLACE
j
ELECTRICAL: ROUGH FINAL
r
r �
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL r
FINAL BUILDING
DATE CLOSED OUT
t ASSOCIATION PLAN NO.
1 }
s
°FIB 1� Town of Barnstable
Regulatory Services
" Bnnx SS MASS. * Thomas F.Geiler,Director
9•�lbA 163 ,��'
tED Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
• r
as Owner of the subject property
hereby authorize �y&;02 alGe—.S to act on my behalf,
in all matters relative to work authorized by this building permit application for:
�o���y S�• CiG��i�dC�l/��
(Address of Job)
Signature of Owner ate •
Prin4Name
Q:FORM&OWNERPERMISSION
I-arnmonweiUrh 01 Massachusetts.
Department oflndustrial Accfdents
Office ofArnvestigations
600 Washington Street ,
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit; Builders/Contractors/lElectricians/Pluimmbers
Applicant haffornnation Please Print'L 'blv
Name (Business/Organization/Individual): S
Address: ?o fir,�i•i.�,we �v�o k ed
City/State/Zip: •S'•Y.oJ-.o2 ovA ,/1jj• Phone#:
Are you an employer? Check the•appropria-te box: Type of project(required):
1,❑ I am a employer with 4. ❑ I am a general contractor and I
aloyees (fall and/or part-time).* have hired the sub-contractors 5' New construction
2.L� I gm a sole proprietor or partner- listed on the attached sheet $ 7. ❑ Remodeling
ship and have no employees These sub-contractors have S: ❑ Demolition
working for me in any capacity, workers' comp.insurance, . g, ❑ Building addition
[No workers' Comp,insurance 5. ❑ We are a corporation and its
required,] officers have exercised their 10•11 Electrical repass or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.01 Plumbing repairs or additions
nrf self,[No workers' comp, C. 152, §1(4), and we have no 12. oof repairs
mswance required.] t , employees. [No workers' 13,0 Other
comp.insurance required.]
*Amy applicant that checks box#1 must also a out the section below showing their workers'compensation policymforrnatiow -
t Aameownm wbo submit this affidavit indicating they are doing all work and then hire outside ewmtractora must submit anew affidavit indfouting such
ZContraetors that check this box must attached an additional sheet shaving the aurae afthe sub-contractors and their workers'comp,poliay.iufor nation.
I am an employer that is providing workers'compensation insurance for my employees. Below is the
policy Andj®b side -
information
Insurance Company Name:
Policy#or Self-ins..Lie. i#: Bxpiration Date:
Job Site Address: Citylstate/Zip:
Attach a copy of the workers' compensation p.vlicy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of Ivi'GL 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 oi'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.
1 do herehy certify under the pains and penalties of perjury that the information provided above is true and correct;
Si afore: Date: 7-
Phone#: s 8' 'ZZ 1 i s S'y
Official use only. Do not*rite in this area,to be completed by city or town o,f ieial
City or To": Permit/License#
Issuing Authority (circle one):
1.Bo2-rd of Flealth 2.Building Department 3.City/•T owu Clerk e.Electrical Inspector 5.Flumbina lasp cto>r
6. Other
Contact Person: -Phone#:
k
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employee's: '
Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,.oial or written." a
An employer is defined as."an individual,partnership, association, corporation dr other legal entity, or any two or more
of the foregoing engaged in a joint enterprise, and including the legal repreSMtatives of a deceased employer, or the .
receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance, construetien or repair work on such dwelling house
or on'the grounds or building appurtenant thereto shall not because of such employment be deemed to bean employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coerage7equired."
AdditionaIly,MGL chapter 152, §25C(7)states"Neither the corrrm ealth 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
req,-±ements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if
necessary,supply sub-contractors)name(s),address(es) and phone numbers)along with their certificate(s)of
insurance. Lanited 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 submitted to the Department of industrial
Accidents for.confumation 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 Depart' nent of .
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies shou3d tester their
self-insurance license number on-the appropriate line.
City or Town Officials.
Please be sue that the.affidavit is complete and printed legibly: The Department has provided a space at the bottom,
of the affidavit for you to M out in the eYent the Office of Investigations has to contact you regarding the applicant
Please be sure to fill in the permit/license number which will be used as a reference number. In addition;an applicant
that nmst submit multiple pmmit/licens a applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job.Site Address"the applicant should write "all locations in • ; (city or
town). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that•a valid affidavit is on file for future permits m licenses. A new affidavit must be filled out each '
year.Where a biome owner or citizen is obtaining a license or permit not related to any business or commercial vesture
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts -
Department of Industrial Accidents
Office of Investigations :
600 Washington Street
Boston, MA 02111
Tel,. 617-727-4900 e;;t 406 or 1-o77-M-ASSAFE.
Revised 5-26-05 Fax# 617-727-7749
Wi&-w.mass.crov/Cia
1
TOWN OF BARNSTABLE
SIGN PERMIT
(PARCEL ID 186 062 GEOBASE ID 10722
ADDRESS. 627 SOUTH MAIN STREET PHONE
CENTERVILLE ZIP -
LOT BLOCK LOT SIZE
DBA DEVELOPMENT DISTRICT CO
WAIT TYPE N Y�EJIPTION Xjg�A E f,AL ESTATE, INC. - 30" X 36"
CONTRACTORS: Department of Health, Safety
ARCHITECTS: and Environmental Services
TOTAL FEES: $10.00
BOND $.00 ,�,
CONSTRUCTION COSTS $.00
753 MISC. NOT CODED ELSEWHERE 1 PRIVATE P]i( ..�3TABLE.
MA83. I
i639. A�O�
B ILDI G DIV. I N
BY
DATE ISSUED 03/15/2000 EXPIRATION DATE �--
The Town of Barnstable
Department of Health Safety and Environmental Services '
,, Building Division
367,Main Street,Hyannis NIX 02601
,y
Otfiice: 508.862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Q. _
' Tax Collector
k 'measurer
Application for.Sippa Permit
Alphege T. Nault and
ApplicantVivian F; ,, .,,, } — -- Assessors No. a-
}b - -
�! Doing Dusuness As: Vivian' s Real Estate, Inc. Telephone No. ' 508-775-01 58
Sign Location
627 South Main .Street, •Centerville, MA 02632
Street/Road
Zoning'District: Old Kings`Highway? Yes/No Hyam. 's-Historic Distric(P Ye51-mo
Property Owner
Nante.Alphege .T. and Vivian F. Nault 5M 775-0.158
I - Telephone: -
i Address:10 Crosby Circle, ViljageCenterville,,' 02632
„k Sign Contractor
Name: , Telephone.
Address: Village.
Description
Please draw a cliagram of lot showin location of btvl ° ling tgn
g dings and exis S.
s wi ensions,
,y ., locative :uld size of the new sign. This should be drawn on the reverse•stde alibis application,
I
Is the sign to be clestriliedr' Yes/No (No(e:Ifms, a i#7)r*perrr it is mquirrd) �J
�,
I hereby certify that I am'tlu owner or that I have the authorityof the owner to make thi
s
application, that.the'inlonnation is correct and that the use and construction shall conform to,the
provisions of'Section 4-3 of the Town of Barnstable Zoning Ordinance.
Signature of Owner/Authorized Agent p ;�: C)
_ Size: ST ?�. Permit Fee•
Sign Permit wns approved - Disapproved•
Signature of Building Oflicr �,� - � � Dat
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