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0010 MAIN STREET (COTUIT)
I Z o I'� 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 format 200 Main St., Hyannis.. Take the completed form to the Town Clerk's Office, 1 st FI.,367 Main St., Hyannis,MA 02601 (Town Hall)and get the Business Certificate that is required by law. DATE: 10 5-21-V Fill in please: P r APPUCANTS YOUR NAME/S: ' 1-.exGs Cz r call a BUSINESS YOUR HOME ADDRESS: O `P�n O!R`3- rg [_: AALP� 6 eCo TELEPHONE # Home Telephone Number 1i o Z- 5�► i r�SS NAME OF CORPORATION �h er e s�:: Fc�\l a n M�tiSSaG�' . NAME OF NEWT BUSINESS lon TYPE OF BUSINESS- M R l�55 CTE IS THIS A HOME OCGUPATION� YES'< ' NO �2ip35 c ADDRESs Go•-�r-'�' M.AP PARCEL NUMBER C. ��J :-� ,- ss.ssin •� ",,, When starting a new business there are several things you'must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St.-(corner of Yarmouth Rd.&Main Street) to sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO ISSIONE 'S OFFIC This individ al hats b orm �anyer� requ' meets that pertain to his type of business. oriz d Sign tur ** f OMMENTS: ! 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: 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 1st FI:, 367 Main St., Hyannis, MA 0.2601 (Town Hall) and get the Business Certificate that is required by law. DATE: 01 Fill in please: ua , ��;�,r, f t� APPLICANT'S YOUR NAME/S: ;' ' ►j', '%)' .+h�.` BUSINESS YOUR HOME ADDRESS: y TELEPHONE It Home Tale hone Numb r v l*t � ki� 1`t EIN #: �� E-MAIL: NAME OF CORPORATION: NAME OF NEW BUSINESS TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESS. MAP/PARCEL NUMBER, /1D�1 DlS [Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town.of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town, 1. BUILDING COMMISSIONER' OFFIC This individual has been ''f f any per r uiremerits that pertain to this type of business, �A !�PA ed Si nature COMMENTS: / 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: I YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town(which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office,1 st FI.,367 Main St.,Hyannis,MA 02601 (Town Hall)and get the Business Certificate that is required by law.. 1 rM DATE: t 1 r in please: APPLICANTS YOUR NAME/S: TLESHONE /, YOUR HOME ADDRESS: # Ho a Telephone N mber NAME OF CORPORATION: NAME OF NEW BUSINESS 4 21 A MA TYPE OF BUSINESS±MW'l - -- 5 IS THIS A HOME OCCUPATION? y ADDRESS OF BUSINESS MAP/PARCEL NUMBER D CMG S Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St.-(corner of Yarmouth Rd.&Main Street)it; Ai tf ure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO MITAuth R' OFFICE This indivi& he i rme ofKry p mit se uir en hat pertain to this typ of business. .izeq Signature* COMMENTS: A ''; 1(� ✓. . ". 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: X ti:t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION t Map Parcel Application # hl (f1 7- Health Division Date Issued Conservation Division Application Fe c) e Planning Dept. Permit Fee Date Definitive Plan Approved.by Planning Board Historic - OKH — Preservation/ Hyannis 271 Project Street/Address b fA0.bV 5�. ti Village WA z Owner &cmI-, ?-omtATi l t61(P .c aAP-5 Address ac� 02635 Telephone Perm it Request Lf (( s z � t-D. aylu; C"O, of "4&1 & ��TWW 66-C);- (Wk 4VQJ %eA(444.,Iq Square feet:4w4. existingWl proposed 2nd floor: existing proposed Total new Zoning District _ffFlood Plain Groundwater Overlay Project Valuation Construction TypeV Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) __60A2� �l Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: X 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 ❑ Others Central Air: XYes ❑ No Fireplaces: Existing New "" Existing wood/coal stove: ❑Yes XNo Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: ' c3 C) Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial XYes ❑ No If yes, site plan review# rK , Current Use Proposed Use I APPLICANT_INFORMATION rn (BUILDER OR HOMEOWNER) Name �W4�15—��L �� Telephone Number ��� 31 S�4 Address �� i � License # Home Improvement Contractor# /0�7_3�r� Email �� ,�� Worker's Compensation AwCft 190331107404- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE , d FOR OFFICIAL USE ONLY e APPLICATION # DATE ISSUED MAP`/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME y I! l4 INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. f i4 ?7is Commorrivealth of-Massachusetts Deparhneat of rndustrial Acdderr#s - f3, ree o,flnivs rgadam. 600 Washington Street Boston,?CIA 02111 tmvtnniamLgovIdia Tar.leers' Campensat nn Insurance Affidavit:BmlderdCantractarsJEIecfricians/Phimhers Applicant Infarmatian Please Print adbi Nia=(BIMMF St Miza 3.rmar7ama Address: <!/ . 4_67 otj Citylstat,J- Gore _SP11ane - sa6 'w `s SLl �, 6 Are u an employer?Checkthe appro riate box: Type of project(required): I Mn employer u7th ❑ 4. I am a general contractor and I G_ ❑New consiiucti . on I • employees(fall andlor part-time)-* Itave isired:the sub-contractors 2.❑ I.am a sole proprietor orpartner listed on.the attached sheet, 7.;N R11=0&Hrtg ship and have no employees. r1he3e sub-contractors have g_ ❑Demolition worl`ing for me in any capacity. employees and have workers'. [No workem'camp.insurance; cOInp.' rant5e 9. El Building addifiion required-] 5. ❑ We are a corporation and its 1�_❑Electrical repairs or axdi ons 3.❑ F am a homeommer doing all work officers have"exercised their 1L❑Plumbingrepairs or additions ' tight of exemption per MGL mil£' �o worms �F- 17_❑Roofregairs. ura insnce required]i c.1.52, §1M andwe have na employees.[go worker' s.,Elother comp.insurance required.) •Any apyKcarrtthat cber1sbox R mad d w fill out the sectiombelowshoring the wo&eW compersatiaupoliicy iaEormation. Rnmeowaerswha submit this affidavu indicating they axe doing 81Iw,oxiG sad theahiie autsidecoatractnrsnmst submit anewaffidavit indiev�nv snrfi ZOon=ctorstfu t rhea t1ds boa must attached m sdditiamA sheet showing the nmm of the sulb-cautwAom and state whether or not those entities have emplayees.If the suir-contxctmshase employees.,they=ntpmtiide their workers'romp.policy number. I ant ari elriplo}�r tltrrt rs prvuidutg workers'canrperlsrrtialr utszirarrce f or�}�empio}�ees $eIo�v is flte paticy rcrzd joFa arts . hi,formation _ Insurance Companyi'slame: •�-,/ / ��(���- •Policy 4t'or Self--ins.Uc. /4 EkpiirzationDate: /® •1 v�'�OC� Job Site Address: citylstate z7 p: Atta6 a COPY trfthe workers'compensationpolicy declaration page(showing the policy number and"expiration date). Failure to serum coverage as requiredunder Section 2 A of MGL c,15'2 can lead to the imposition of criminal nal peaatges of a fine up to$1,50D OD andloi one-yearimprisoumeut,as we11 as civil peualties.in the form of a STOP WORK ORDERand.a fine . of up to$250-00 a day against the violator..Be adirised that a copy of this statement maybe forwarded to the Office of Investigation of the DID for insurance-coverage variffcation. I tfa TierRiiy c/erta r iardt<r t}it<prrirrs aredpanaIt es of perjFWy.thattlre ire;fornzadmt pm.uTed abbmv s true acid correct SaEnature: / -vL— Date: 1 v'`X v It5 Phone t,�,�iat use urrTp. J7o not o-srrte fir fFris urea,[�x be co•�npTeted by riip arton'n a,�crat City or Town.: Permi f lcense* j Issuing Aulh arity(drde one): L Board of Health 2.Budding Department 3.Citylrown Clem 4.Electrical Inspector 5.Ptu¢abrg Inspector b.Other Can-tact Person: Phone#: Town Of Bamstable - i Building Mvi +on ' mas pay'',CSO 2At) 5 e MA 02601 wwvr 4mea.barvR4ikb9e.mr{.,as - Off: $0$-8624039 Fax: 509-790-6230 Provem Owner Must P Complete and Sign This Secdon. 'If Us x�g� Binder Own,=a th[ �CGt p�+er��tp hereby t •tip,:acE on. -be ailelavc wrssk auofa y bdtraPlictian fc (AddsimS of Jobs Sig=t=of z IUM&Y N T,t A'rIpperty Owner is applzog far Ksmi ;p{cse compk z the Hamawnem UtMe lemption Form 611 t REVL.Md`66M • Co4nit. .1�ire/Reseuc Department FIRE DEPARTMENTS OF THE TOWN OF BARNSTABLE Fire Prevention Office - Hinckley Building 200 Main Street, 1yannis, MA 02601. 508) 862-4097 • `d� 7`ra���0 4A�. BUILDING CODE COMPLIANCE FORM Plans dated 3� I�` <�' for the property located at also known as �.o- -(`�"�'�-�t-_. �13��� L,)Cja OUhave been reviewed by C je,,U of the ❑. Barnstable ❑ COMM Cotuit ❑ Hyannis ❑ West Barnstable Fire Department. THE.CHART BELOW.INDICATES THE STATUS OF THE REVIEW: TYPE OF CONSTRUCTION DOCUMENT N/A . RECEIVED REVIEWED. COMPLIES 1. Narrative Report ✓ ,/ �/ 2. Firefighting & Rescue�Access' y v 3. Hydrant Location &Water Supply 4. Sprinkler Systems 5. Sprinkler Control Equipment 6. Standpipe Systems 7. Standpipe Valve Locations 8. Fire Department Connection 9. Fire Protective Signaling System 10. F.PIS.S. & Annunciator Location ✓ r! r! 11. Smoke Control/Exhaust w 12. Smoke Control Equipment Location 13. Life Safety System Features `, X >^ -^� 14. Fire Extinguishing Systems 4 t 15. F.E.S. Control Equipment Location 16. Fire Protection Rooms 17. Fire Protection Equipment Signage 18. Alarm Transmission Method 19. Sequence of Operation Report A -� 20. Acceptance Testing Criteria ,' We believe this document to be com fete and corgi P,li'ant for'the issuance:of,'a'bulldin ermit. . ` v, We have completed the acceptance sting for the occupancy permit and believe that within the scope of the building permit, he a ove iss es are in compliance. vle G�- 3 ^zs � G /A _ . . . . . . �/ ��� . %\s % a� kju y . ¥ � . _ : §\ Ou \ko ° ¢§ « � \ . `~ ^ .y / '> . , wy . \\� . : �« . : sy� . . . .s�� v 2«. » « w 2T\ < ¥pF l % �Ng§ d \ ell, �« \\ 2 a. . <� /�� 6m Office of Consumer Affairs and Business Regulation -- �� 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Co. tr ctor Registration Registration: 183696 ? Type: Corporation Expiration: 11/4/2017 Tr# 272011 TRAVIS CUNDIFF ASSOCIATES, INuC .� ' = TRAVIS CUNDIFF1 P.O. BOX 484 OSTERVILLE, MA 02655 Update Address and return card.Mark reason for change. SCA 1.0 20M-05/11 Address Renewal 0 Employment Lost Card �e�a�wneaiecueccll�o�C�/�irau�c�uaeCld ! � -Office of Consumer Affairs&Business Regulation License or registration valid for individul use only _ OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ' -Registration: Type: Office of Consumer Affairs and Business Regulation Expiration� :11/4/2017 Corporation I 10 Park Plaza-Suite 5170 Boston,MA 02116 TRAVIS CUNDIFF ASSOCIATES fNC. TRAVIS CUNDIFF 17 CROSSWAY PLA E;'N OSTERVILLE,MA 02655 Undersecretary Not valid without signature r AC40 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD"r") 3/25/2016 THIS CERT)FICATE'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 B M aCe NAME: Megan y Eagle Insurance Group, LLC PH�NN (508)659-5250 F No:(666)676-9319 Ten Commerce Way ADDRESS:meganmacbey@eagleinsurancegroup.net Suite 3 INSURER(S)AFFORDING COVERAGE NAIC p Raynham MA 02767 INSURER A.Nautilus Insurance Company INSURED INSURERB:Trayelers Insurance' Company Travis Cundiff Associates, Inc. INSURERC: 17 Cross Way Pl INSURER D: INSURER E: Osterville MA 02655 INSURERF. COVERAGES CERTIFICATE NUMBER:15-16 MASTER LIAR REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL UBR POLICY EFF POLICY EXP LTR D D POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A CLAIMS-MADE 1 OCCUR DAMAGE TO RENTED 50,000 PREMISES(Ea occurrence) $ NN623539 10/26/2015 10/26/2016 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY PRO- LOC JECT PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS 81-5G319814 11/04/2015 11/04/2016 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accidentZ____ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A x EXCESS LIAB CLAIMS-MADE AN023814 11/05/2015 10/26/2016 AGGREGATE $ 5 000 000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate of liability detailing the WC coverage will be sent directly from the carrier. CERTIFICATE HOLDER CANCELLATION sally.shea@town.barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main St Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Michael Cox/MACBEY ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(2m4nn AC�® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/25/2016 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: Megan MacBey PHONE EAGLE INSURANCE GROUP LLC ( C.No.Ext); (508)947-5556 F"" (A/C,No): EMAIL ADDRESS: meganmacbey@eagleinsurancegroup.net 10 COMMERCE WAY SUITE 3 INSURERS AFFORDING COVERAGE NAIC# RAYNHAM MA 02767 INSURERA: AIM MUTUAL INS CO 33758 INSURED INSURER B: _ TRAVIS CUNDIFF ASSOCIATES INC INSURERC: INSURER D: PO BOX 484 INSURER E: OSTERVILLE MA 02655 INSURER F. COVERAGES CERTIFICATE NUMBER: 39889 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MMIDD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $_ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ PRO JECT ❑ LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) $ i UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X STATUTE OERH _ AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBEREXCLUDED? N/A N/A N/A AWC40070334092015A 10/23/2015 10/23/2016 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 11000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Barnstable.- Building Dept. 200 Main St AUTHORIZED REPRESENTATIVE Hyannis MA 02601 'D�Daniel M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD i Massachusetts Department of Environmental Protection Bureau of Waste Prevention•Air Quality 100239746 =` BWP AQ 06 j r { Notification Prior to Construction or Demolition Asbestos Project Number# A.Applicability A Construction or Demolition operation of an industrial, commercial,or institutional building,or residential building with 20 or more units is regulated by the Department of Environmental Protection(MassDEP), Bureau of Waste Prevention,Air Quality Division,under Regulations 310 CMR 7.09. Notification of Construction or Demolition operations is required under 310 CMR 7.09(2)ten(10)working days prior to any work being performed.The following information is required pursuant to 310 CMR 7.09.Is this a fee exempt notification(city, town,district,municipal housing authority,state facility,owneroccupied residential property of four units or less)? Is this a fee exempt notification(city,town,district,municipal housing authority,state facility,owner-occupied residential property of four units or less)? r Yes r No , i Type of Notification: r Revision of an Existing Form Cancellation of Project Instructions: 1.Blanket Permit Project Approval,if applicable: Approval ID# 1.All sections of this 2.Non-Traditional Asbestos Abatement Work Practice Approval,if applicable: form must be completed in order to Approval ID# comply with the B. General Project Description • Department of J p Environmental 1.Facility Information: Protection notification THERAPEUTIC BODYWORK 10 MAIN ST requirements of 310 CMR 7.09. Name of facility Street Address BARNSTABLE MA 026350000 5087769478 2.Submit Original Cityrrown State Zip Code Telephone Form To: Commonwealth of LAN WARNER BUSINESS OWNER Massachusetts Facility Contact Person Contact Person Title P.O.Box 4062 7742381870 ACERDESIGNSTUDIO@GMAIL.COM Boston,MA 02211 Facility Contact Person Telephone Facility Contact Person Email Facility Size: 8431 2, Square Feet Number of Floors Was the facility built prior to 1980? r Yes F No Describe the current or prior use of the facility: DOCTORS OFFICE Is the facility a residential facility? I yes Pi No If yes,how many units? 2.Facility Owner: RONALD J MYCOCK 10 MAIN ST Facility Owner Name Address COTurr MA 026320000 7742381870 City/town State Zip Code Telephone LAN WARNER 10 MAIN ST On-Site Manager/Owner Representative Address Cotuit MA 02635 7742381870 City/rown State Zip Code Telephone Revised:03/17/2014 Page 1 of 3 t Massachusetts Department of Environmental Protection Bureau of Waste Prevention •Air Quality BWP AQ 06 100239746 _ Notification Prior to Construction or Demolition Asbestos Project Number# C.General Construction or Demolition Description(continued) The Asbestos Abatement Notification Number for this address is: This project r Construction r Demolition is: 4/8/2016 8/30/2016 Project Start Date(MM/DDNYYY) Project End Date(MM/DDNYYY)• 8.For demolition and construction projects,indicate dust suppression techniques to be used r Seeding . r Wetting r; Covering r-, Paving Shrouding J Other-Specify: 9.For Emergency Demolition Operations„who is the MassDEP official who evaluated the emergency? Name of MassDEP Official Title Date of Authorization(MM/DD/YYYY) MassDEP Waiver Number D. Certification "I certify that I have personally TRAVIS CUNDIFF examined the foregoing and am Print Name familiar with the information TRAVIS CUNDIFF contained in this document and Authorized Signature all attachments and that,based PRESIDENrOMER on my inquiry of those Posibonfritle individuals immediately RONALDMYCOCK, responsible for obtaining the information, I believe that the Representing information is true,accurate,and 3/25/2016 complete. I am aware that there Date(MM/DD/YYYY) are significant penalties for submitting false information, including possible fines and P.E.# imprisonment.The undersigned hereby states, under the penalties of perjury,that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is made." Revised:03/17/2014 Page 3 of 3 f Massachusetts Department of Environmental Protection N Bureau of Waste Prevention•Air Quality r BWP AQ 06 1100239746 Notification Prior to Construction or Demolition Asbestos Project Number# B.General Project Description(continued) 3.General Contractor: TRAVIS CUNDIFF ASSOCIATES,INC. PO BOX 484 Name Address OSTERVILLE MA 026550000 5087763154 City/Town State Zip Code Telephone TRAVIS CUNDIFF 5087763154 General Contractors On-site Manager/Foreman Telephone General C.General Construction or Demolition Description Statement:if asbestos is found 1.Construction or demolition contractor: during a Construction ' or Demolition TRAVIS CUNDIFF ASSOCIATES,INC PO BOX 484 operation,all Contractor Name Address responsible parties must comply with 310 OSTERVILLE MA 026550000 5087763154 CMR 7.00,7.09,7.15, City/Town State Zip Code Telephone the General Laws of and Chapter E of TRAVIS CUNDIFF 5087763154 • the Commonwealth. Construction and Demolition On-site Manager Telephone This would include, but would not bw 2•Licensed Contractor Supervisor: limited to,filing an asbestos removal TRAVIS CUNDIFF CS-092568 notification with the Department and/or a .Supervisor Name License Number notice of release/threat of 3.Is the entire facility to be demolished? 1-;Yes r No release of a hazardous 4.Describe the area(s)to be demolished: substance to the Department,if TWO CLOSET WALLS AND A RECEPTION DESK ! applicable. =-=') • - T.ti� MassDEP Use Only 5.If this a construction project,describe the building(s)or addition(s)to be constructed: Date Received TWO INTERIOR DOORS ADDED 6.If this is a demolition or renovation project,were the structure(s)surveyed for the presence of Asbestos-Containing Material(ACM)?, r'Yes h.No 7:Was asbestos containing material(ACM)found? r Yes r No If survey was conducted,who conducted the survey? Name Department of Labor Standards Certification Number Revised:03/17/2014 Page 2 of 3 y -, Assessor's office(1st Floor):Assessor's map and lot number 6 c?"In /0000V. SEPTIC SYSTOR MUST B TwE tp Board of Health(3rd floor): �� r INSTALLED IN COMPUA �� Sewage Permit number'/ '�1� L i�/ v, �� � Engineering Department(3rd floor): ^n w, t: Barns �Ffo? p �LL House number ! : d 'a gn °° 'O39' Definitive Plan Approved by Planning Board 19 ommi F o Nxt d'n c salon APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only' Si TOWN ? OF BARN BL Dote -� BUILDING INSPECTOR APPLICATION FOR PERMIT TO (.//� ®dJ>T�eJi-7 T/7/ � ��ww TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: J • Location Proposed Use Zoning District l� Fire District �r�✓�� Name of Owner-l',17 G'pGlG °�ut��ciiYY Address Name of Builder,/. %• � �� —�!'s��"vZ114W Address Name of Architect Address Number of Rooms 4�/�1 ���� `Q"' �`� ' Foundation Exterior �'�`'�' Roofing Floors Interior Heating >r' r ,�1/ Plumbing �Y,,��c/��N Fireplace /7d Approximate Cost d? Area /V 4 Efk CA G lQ� GO Diagram of Lot and Building with Dimensions Fee ' 1 � 6 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the abp,,4 con n. t Name Construct' n Supervisor's License �� f MYCOCK, RONALD ti No 34660 Permit For ALTERATION ' Y Commercial Bldg. r 1. 4 Location 10 Main Street ^, r Cotuit _. 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S '•�4 � -tl � U �i 6 "� . �.' � a t: t,` F- -a'+ ,.. ty_ `� 2�t'� }'�,1.::s s�'ar w ''�ri.-.^`r •t'�K .rr `� 'K 's` . x b PP ,t { � - -O NOTE CHANGES ,._ TOWAMF BARNSTABLE Ins Buildin i g pection Department 6 r� ,y MR 1.. /Acer ueslgn otumo i i I Remove toilet and sink and cap plumbing for future use Office Building Add new door 4' Emergency Alarm and Lights EXIT to Dentist.Offices and shared Bathroom - PROPOSED RENOVATI NS THERAPEUTIC BODYWORK OFFICES , MA Scale: 1/4" = 1'-0" 3.15.16 Acer Design Studio 1'-7" Closet M 7 URI= } Treatment Room 10'-5" o (91 sf) Office N } Break Room TOTA - if50. 7' 11'-7" Closet utility co Treatment Room c (91 sf) I � Fireplace Emergency Exit Sign T-5" Carbon Monobde Detector i, { N 12 Smoke Detector u' .2 CON Hallway _ Waiting Area Emerge and Lig Fire Alarm with Emergency E)d Sign Above u D -Basement to 0 Smoke Detector— at fV7t, p 13'-10" I Desk with G N a I s clos Treatment Room Glass En ure (128 sf) Reception r 1 —Emergency Exit Sign Fire Extinguisher EXITto Main Street Side 3 I i I _ - I ' I 77 it TOTAL SF: —, 50 s Office Building Emergency Alarm and Lights i EXIT to Dentist offices and shared Bathroom = EXISTING CONDITIONS THERAPEUTIC BODYWORK OFFICES Scale: 1/4" 3.15.16 Acer Design Studio PLUMBING NOTES: y All plumbing will be removed by licenced 35' Plumber and will be capped in wall from which it extrudes or in basement,.for Remove closet walls 1 1'-5° and cap plumbing for potential future use. future use Treatment Room(91 sf) t insFa nib 4mgTammate floor over ice existing floor,remove Flourescent install new floating laminate floor over Remove vanities and cap Lighting and replace with(2)recesse existing floor n plumbing in wall for futur can lights. ELECTRICAL NOTES: i use All electrical work to be done by Licenced .� Electrician. Any electrical systems (outlets, Remove existing door T-7, and fill in wall Treatment Room 91 �k switching, etc.) within walls to be removed nsta new oar—; gTa ateflo°r°ver existing floor,remove Flourescent will be relocated to the nearest wall.' oLighting and replacewith(2)recessed F can lights. Flourescent Lights to be removed and I Add(2)new door I replaced with recessed cans in treatment ! ; Fireplace rooms and track lighting in the arbon Monoxide Detector Emergency Exit Sign- Waiting/Reception Area. r° �-Smoke Detector MCiIJ/ ure.nt light to gN be removed and Waiting replaced with(1) recessed can fight EMERGENCY SERVICES: Re waif waail TOTAL SF: alarms li hts, and Fire Alarm with Emergency U p 50 s All existing emergency � 9 elements to remain as is ExllsignAb°ye a ement All existing wood floors �i Smoke Detector refinished Remove existing door and All existing Flourescent fill in wall Waiting Area/Reception removed and replaced track lights Treatment Room Q 28 sf) Instil new floating laminate floor over existing floor,remove Flourescent Lighting and replace with(2)recessed Rece tion can lights. eR move reception desk glass surround.Suppor remain. 1T-10" mergenc EXIT Fire E dinguisher to Main Street Side ,I I i 35' —1V-711'-5 0'-10 Treatment Room(91 sf) costa now now floafm`g laminate floor over Office Break Room existing floor,remove Flourescent coins aif new floating laminate floor over Lighting and replace with(2)recess existing floor f4 can lights. Remove toilet and sink and cap plumbing for future use Treatment Room 91 install new floating(laminate floor over - er existing floor,remove Flourescent • Lighting and replace with(2)recessed can lights. Fireplace _ ' arbon Monoxide Detector —Add new door. fq , moke Detector HaI ay oFl urescent light to be removed and V Waiting t replaced with(1) Area Emergency Alarm recessed can light and Lights J�install TOTAL SF:, D Tf90T— B ement EXIT _ All existing wood floors to be to Dentist Offices and refinished shared Bathroom All existing Flourescent lights in Waiting Area/Reception to be removed and replaced with(2) track lights m(128 sf) o 'ngTamrate floor overremove Flourescent 7 Lighting and replace with.(2)recessed " can lights. Re�ce ��ion eR move reception desk and glass surround.Support post to 3'-10" remain. 17'-9, EXIT mergenay Exit Sign Fire Extinguisher to Main Street Side R/25/2016/FRI 10: 57 AM Cotuit Fire Dept FAX No, 5084280202 P, 001/001 Cotuit Hire/Reseise Department FIRE DEPARTMENTS OF THE TOWN OF BARNSTABLE Fire Prevention Office - Hinckley Building - 200 Main Street, Hyannis, MA 02601 508) 862-4097 BUILDING CODE COMPLIANCE FORM Plans dated 3• i for the property located at \cCs also known as '36 a"t u)cjv14 601e ave been reviewed by of the U. Barnstable ❑ COMM A Cotuit Q Hyannis ❑ West Barnstable Fire Department. - THE CHART BELOW INDICATES THE.STATUS OF THE REVIEW: TYPE OF CONSTRUCTION DOCUMENT N/A RECEIVED REVIEWED ' COMPLIES 1. Narrative Report ✓ `� 2. Firefighting &. Rescue Access y F�a 3. Hydrant Location &Water Supply 4. Sprinkler Systems _ „- 5. Sprinkler Control Equipment ff 6. Standpipe Systems .i 7. Standpipe Valve Locations p 8. Fire Department Connection 9. Fire Protective Signaling System y �' 10, F.P.S.S. &Annunciator Location 11. Smoke Control/Exhaust - 12. Smoke Control Equipment Location -� 13. Life Safety System Features 14. Fire Extinguishing Systems 15. F.E.S. Control Equipment Location 16. Fire Protection Rooms ✓ i 17. Fire Protection Equipment Signage J 18. Alarm Transmission Method 19. Sequence of Operation Report 20. Acceptance Testing Criteria We believe this document to be complete and compliant for the issuance of a building permit. We have completed the acceptance sting for the occupancy permit and believe that within the scope of the building permit, e a ove iss es are in compliance. ST T = THE COMMONWEALTH OF MASSAGHUSETTS �IF ' I - EXECUTIVE OFFICE OF TRANSPORTATION Eas MASSACHUSETTS HIGHWAY DEPARTMENT . DEVAL L. PATRICK - - .JAME.S A. ALOISI JR. GOVERNOR - - SECRETARY TIMOTHY P. MURRAY LUISA PAIEWONSKY LIEUTENANT GOVERNOR COMMISSIONER Certified Mail 7099 3220 0004 3005 3368 k August 26, 2009 Ronald J. Mycock Mycock Properties P.O. Box 437 Cotuit, MA 02635 Dear Sir: ` SUBJECT: Barnstable-Route 28 Falmouth Road=Towii Parcel No. 009005-'State Highway Layout (SHLO)-Encroachment MassHighway,Permits Office has received your response letter on August 17, 2009 regarding the encroachment. This property was surveyed by Tetra Tech Rizzo and enclosed is a copy of the plan. You are imviolation of encroachment and as mentioned in a previous letter to you dated July 10, 2009, a sign, spot�lighis"and'associated wiri iginust be1removed immediately,as a�riew sidewalk will soon be constructed along Route 28 within the State Highway Layout. If you have any questions please contact the Permits Office at(508) 884-4211. Sincer Bernard McCourt District Highway Directgr�, E3 p r GLB: glb rn Enclosure -d cc: BEM �` co ca RPF KJC I' PRH'. -- S. Soares rn Foreman. 4< d a t !� � a{ > r Barnstable Building Inspector 200 Mam Street Hyannis MA 02601.� File" �,; �r •G = r . �., , r� , w, al - .�+. Cp �. �+ S.• S ignEncroachmentParcel009005b.doc Massachusetts Highway Department, 1000 County Street, Taunton, MA 02780 Telephone: (508) 824-6633- Telefax: (508) 880-6102 Mycock Properties JRAUG 1 7 2009 PO Box 437 Cotuit,Ma 02635 - 508-428-3484 phone 508-420-5584 Fax PERMITS OFFICE rjinycock@ mycockagency.com Bernard McCourt District Highway Director Commonwealth of Massachusetts Massachusetts Highway Department 1000 County Street Taunton, MA 02780 Re: Rte,28, Barnstable Town Parcel No 009005 SHLO Encroachment Dear.Mr. McCourt: I am responding to your letter of the above date concerning our property located at 10--) �mainTStreet C uit;.Ma with regard to an alleged sign encroachment violation.The subject sign has been in place for the past 25 years.To.the best of my knowledge the sign post is on our property along with any associated lighting and wiring.The sight line limitation that you mention in your letter hasn't been an issue at any point.over these many years. Could you please confirm with me if an actual survey was done by your in in determining whether.or not the sign actually encroaches'in the SHLO? Sincerely yours, RECEIVED: 2009 Ronald J. M_ycock FORWARDED TO ✓ REPLY BY: P DEV RJ M/r CO NST MAINT - TRAFFIC BRIDGES ADMIN OPERATIONS STATE AID MASSHIGHWAY_ R1 ; 5 t THE COMMONWEALTH OF MASSAGHUSETTS EXECUTIVE OFFICE OF TRANSPORTATION E011 . c MASSACHUSETTS HIGHWAY DEPARTMENT DEVAL L. PATRICK .JAMES A. ALOISI JR. GOVERNOR - - SECRETARY TIMOTHY P. MURRAY ���� ��� � LUISA PAIEWONSKY LIEUTENANT GOVERNOR I COMMISSIONER Certified Mail �� 5 7099 3220 0004 3005 July 10, 2009 L,v L JUL .1 5 2(?09 .. Mr. Ronald J. Mycock MASS. ir` ' 1T R"CT 5 Mr. James McGuire 10 Main Street Cotuit,MA 02635-2518 SUBJECT: Barnstable—Route 28—Falmouth Road—Town Parcel No. 009005 - State Highway Layout (SHLO)—Encroachment . Gentlemen: It has been brought to my attention.that a SHLO encroachment exists at property you own, Located at the corner of Route 28 and Main Street in the Town of Barnstable. The subject encroachment consists of a si.gn(s), spot lights and the associated wiring. These objects also contribute to limiting the sight distance along Route 28. Please immediately remove all of the sign(s), spot lights and associated.wiring within the SHLO and notify this office at(508) 884-4211 when the work is complete. Sic rely, Bernard McCourt GV District L-lighway Director WMC: glb cc: BEM RPF Barnstable Building Inspector,200 Main Street, Hyannis,MA 02601 Foreman File Sign.EncroachmentParcel009005.doc Massachusetts Highway_Department, 1000 County Street, Taunton, MA 02780 Telephone. (508) 824-6633 Telefax: (508) 880-6102 rrrrr, ICI I I ee PROPOSED 5.5'HMA1/ eye 90 WALBK AND VERTICAL GRANITE Al P]I P -!• �6(aS°(+ / 1 uv i,.I01naa. REMOVE FENCE I �> RhR STREET SIGNS p� I�1 j 1 REMOVE 9 RUB r M,,vvfr,m>rn�n...a Ren GUIDE sIDNFLI ' - 1. GG f Wal-z. i SELECTVE CLEARING AND THINNING PROPOSED 5'HMA SIDEWALK ,J,� J - " w I(/ _- PROPOSED VERTCAL GRANITE CURB — -- T g . _ r - --15a.� —� ISD._AO vAl�i ovRH ,u' rroao —�.. —_ __ __�`.i� _ �If• '� I. �a 1 I ro { ew. • y_ ., ,..-__F - Y..T. '�r .. �•\ ast<rsm nrh'mr �1 •,,.I II \ \, ?. � j; �-'_ `f , ',...,i / ,i.,i vl /`� : ' a T r�` 1 I •r>n-G � �''' rfi�:ry _ ' I " All }., u... .�.M,P^,11':.,ueiJ 11 W11-2 �� �1_2 - snn r,t.smv-. it DY WI6-7pL WI6-9p n__a .- ,�' q.- is s ➢( u:Du LJng I e WI6-9p P ,1ilt \9ep%nr `w.az I Ii � PROPOSED 5.5'HMA SIDEWAU( AND VERTICAL GRANITE CURB i Route 28 Barnstable,Massachusetts ®TETRATECH RIZZO JO NOR.SCALE.IN FEET 130 ROUTE 28 PEDESTRIAN IMPROVEMENTS Figure 1 THE COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF TRANSPORTATION os MASSACHUSETTS HIGHWAY DEPARTMENT DEVAL L. PATRICK. .JAMES A. ALOISI JR. GOVERNOR SECRETARY TIMOTHY P. MURRAY LUISA PAIEWONSKY LIEUTENANT GOVERNOR COMMISSIONER Certified Mail 7099 3220 0004 3005 July 10, 2009 Mr. Ronald J. Mycock Mr. James McGuire C1:WMai7n-Street"t Cotui,MA 02635=2518 SUBJECT: Barnstable 'Route 28-Falmouth Road-Town Parcel No. 009005 - State Highway Layout (SHLO)-Encroachment Gentlemen: It has been brought to.my attention that a SHLO encroachment exists at property you own, located at the corner of Route 28 and Main Street in the Town of Barnstable. The subject encroachment consists of a sign(s), spot lights and the associated wiring. These objects also contribute to limiting the sight distance along Route 28. Please immediately remove all of the sign(s), spot lights and associated wiring within the SHLO and notify this office at(508) 884-421.1 when the work is complete. Siiicerel , Bernard 1VMcCourt District Highway Director WMC: glb cc: BEM RPF / Barnstable Building l.n.spector,200 Main.Street, Hyannis, MN 02601 v Foreman ...;. i 't Sit Al"' rsf.::9' ar`� ... r` �✓F t i S ..A.. ..t, 44 .1'. ! 'X1;: .. :1': ..' ,... .... S,2 i�;.-. n ;f'� - Sign.Ei croachmentParcel009005.doc i.i• Tf `i r _+ T7 ts• j fiR '�•,t. t":1 qz::c. .f rV ' 5 p—,L l�J�'�-`rv', c'�. ...f.,:.`�.i._'i li'i �.. }i- �tc. 11...;' �^l`.'•2.��., Cf�,.��r 1_ 43.�:: ..:� all . f Massachusetts Highway Department, 1000 County Street, Taunton, MA 02780 Telephone: (508) 824-6633 - Telefax: (508) 880-6102 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., 36.7 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. Imo DATE: J Fill in°.4A�a'; t'�Y�� .• . � � Please: APPLICANT'S YOUR NAM BUSINESS BUSINESS L—r i r Cr LtJt�'��le�l Ile I YOUR HOME ADDRESS: ' - M 5, TELEPHONE # Home Telephone Number 5O2 :Z 66y�n NAME pF CORPORATION . `NAME OF NEW BUSINESS I►-� TYPE OF BUSINESS C IS 'HIS A:HOME F OCCURA�ION? YES _ O PA ;ADDRESS O BUSINESS MAp RCEL NUMBER [Assessing], When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. . 1. BUILDING COM 'SS' ER'S OF ICE This individ al h s n info d ny ermit requiremen hat pertain to this type of business. Au horiz Sig ure** COMMENT ( R 2. BOARD OF HEALTH ' This individual ha n inform d s er i equire s that pertain to this type of business. COMMENTS: Authorized Si ature* i 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: - rr TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 00 l Parcel 00 — Application # �b��t god Health Division n Date Issued 0),ill� Conservation Division �ll�-' r ' '' Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address /O rl l-a tog 4r�nxto ; Village Oukv, r Owner . An) - my eat_/C Address ��'� f c cw l FX eek,,7`' Telephone Permit Request Av, /d d, 2 9r 3 ' skw A,-L 0X-y ClyYt 1'Gi r yr a �'r,i Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation a 6)0.'- 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/c Qal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing D' ewe ssize_ f Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size — Other: 3 `� < _ Zoning Board of Appeals Authorization ❑ Appeal # Recorded U E51 I Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 6, it e- CC, e ti Telephone Number 50 01> � �O O Address (�4U• G X" G 3� License# 009 0( 3 Hsi < ki Vt t f Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTI FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE / �/� 4 y FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED T -iVIAP/PARCEL NO. c' ADDRESS VILLAGE "'OWNER i DATE OF INSPECTION: ; ' FOUNDATION FRAME ' INSULATION E FIREPLACE ELECTRICAL: ROUGH FINAL } PLUMBING: ROUGH FINAL I GAS: ROUGH FINAL ' T FINAL BUILDING I DATE CLOSED OUT r `' ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organin ion/lndividual): Address• (� �(�- - City/State/Zip: L one.#: Are you an employer? Check the appropriate bog: Type of project(required): . 1.� T�a er with 4. ❑ I am a general contractor and I 4 Y 6. ❑New construction Dye (frill and/or part-time).* have hired the stab-contractors listed on the attached sheet 7. ❑Remodeling 2/ am a'sole proprietor or partner- �. ship and have no employees - These subcontractors have g, ❑Demolition workingfor me in an ca aci loyees and have workers' Y P $ 9. El Building addition [No workers'comp.-insurance rp.insurance. 10.❑Electrical repairs or additions r��] G `5.. area corporation and its P 3.❑ I am a homeowner doing all v6ork officers have exercised their 11.0 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. comp.insurance workers' 13.❑Other urance required.] •Aay applicant that checks box#1 must also fi➢out the section below showing their workers'conTmrsation policy information. t Homeowncrs who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContracton: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 providb their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: G Policy#or Self-ins.Lic.#:L(/7 Expiration Date: Job Site Address: a/to S �n. e 1 7— —City/State/Zip: jyV jft 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 rrimirial penalties of a fine tip to$1,500.00 and/or one-year imprisonment;as well as civil penalties in the form of a STOP WORK ORDER and a fine, of up to$250.00 a day against the violator. Be a that copy-of this statemterit may be forwarded to the Office of Investigations of the DIA for insurance cov a verifica' I do hereby certify`un a pains. penalties er'U. the information provided above is true and correct. Signature: Date: Phone# Official use only. Do not write in this ar a,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 S.Plumbing Inspector 6.Other Contact Person: Phone M 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 hue, express or implied,oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance'with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies•(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to-contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as'a reference number."In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related io any business or commercial venture (i.e. a dog license or permit to bairn 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 TO. #617-727-4900 ext 406 or 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia I Town of Barnstable Regulatory Services • snxxszascE, • Mass. Thomas F. Geiler,Director o u." Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-.790-623 0 Property Owner Must Complete and Sign This Section If.Using A Builder I, -vi jr, L L) M4 C QT _, as Owner of the.subject property hereby authorize e C � ky to act on my behalf, .in all matters relative to work authorized by this building permit application for: �o ,VOA (Address of Job) Signature of Owner Vate Print Name . If Property Owner is•applying for permit please complete the Homeowners License Exemption Form on the reverse side. fl•Fl1RMC•(1W�fRRPFRMi.CC1(1U .. .. - . f Town of Barnstable °p THE Tp� " Regulatory Services BARNSTABLE Thomas F.Geiler,Director 9 MASS. 163;9. a10 Building Division TfD � Tom Perry,Building Commissioner 200 Main Street, Hyannis;MA 02601 www.town.b arnstabl e.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official. Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption ue unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. lb iMAl rJ cJ e-tj �3 v-tt kf s -p(V,e T![r,w, AJ Fv-e-�-g- 'A// - C,Z>)< ply JL Ob 6z Chew 6 /xe Porrurno�zuealC! J� / I. /7 p Qi/UGl!.QQl�C1LlL6P.�6 �.-i vt in ✓ "(O'� ., 4r .r", .� ' p •;/,/ CL(�LCGE BOARD_OF BUILDING REGUCATLONS ?¢ �.- tBCLLLIL Oy /I GCIAO j License CONSTRUCTION SURERVISOR t „Board of:BulIRdO,g Regulations and Stundai ds _. HOME`IMP VEMENT,CONTRACTOR .; Number,,<CSy 0090.13 _ I� Registration1,06395 s - - i ! ptrati /2008 I � Ex �7L2�r�" . ` Expires 05/11/2008 Tr. no: 25325 7 S T a hndtuidual 'R - Yp Restricted 00 1 j l�' ' j GREGORY M:CAUL E`��r GREGORY M CAULEY 33A BAXTER AV �> ,4 "t / ? Gregory Cauley }� �J W YARMOUTH, MA 02673 :: Commissioner j 33 A Baxter Avenue ^ C Yarmouth; MA 601 eputy""'Adm'nistrator • j I .Parcel Lookup Page 1 of 1 THE • £ 4 1415TAT}L€ i 3 � « ti MASS 1 r Logged In As: � Pa t"Ce I Lookup Friday, Octob� .Road Lookup Condo Lookup Multiple Address Lookup Reports Search Options Search By Street.-,-,— Street# 10, Street MAIN Name - Village Cotuit <Prev Next> Page 1 of 1 Rows/Page m Parcel Location Owner Village Index Mr 009-005 10 MAIN STREET(COTUIT) MYCOCK, RONALD J COT 0951 00 http://issql/intranet/propdata/lookup.aspx 10/19/2007 t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Mapes Parcels Application # Health.Division _ Date Issued 2� 8 Conservation Division F'w Application Fee L Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis o Project Street Address .�� L, Village Owner p� 2L, Address Telephone Permit Request ?� � � /�� �12 1 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation a0e2C2 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) V Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: mull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new 1-2 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 , _ _ cs� Central Air: ❑YesLA401 Fireplaces: Existing New Existing woodl.Q al stovN ❑Y, s ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ 'isting anew-., size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: v �. co oning Board of Appeals Authorization ❑ Appeal # Recorded ❑ i Commercial ❑Yes ❑ No If yes, site plan review # __Current-Use ---_- ° -= -- ---:—� -._ . _ , r- Prop osed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name T om_(r�n Telephone Number �O�'- l7 d4 z/ Address 7— a< � License # Cod (p Home Improvement Contractor# Z � Worker's Compensation # 7b I,g j(e D t ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �� SIGNATUR DATE k�� FOR OFFICIAL USE ONLY fi APPLICATION# DATE ISSUED MAP/PARCEL N0: ; ADDRESS VILLAGE Y OWNER DATE OF INSPECTION: s FOUNDATION FRAME ' ` INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING i DATE CLOSED.OUT ' ASSOCIATION PLAN NO. t i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers APPUcant Information Please Print Le 'bl Name(Business/Organization/Individual): Address: J 'Li L l City/State/Zip: U t Phone.#: 56 3!�-7-r LOT M�- . o��i� A.re you an employer? Check the appropriate bog: Type of project(required): . I am a general contractor and I 1.[�I am a employer with� 4 _ � 6. New construction employees(full and/or part time).* have hired the stib-contractors 2.El 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 0 Building addition [No workers' comp.-insurance camp.insurance.$ required..] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself:[No workers' comp_ right of exemption per MGL 12 J]Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that chwla: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 anew affidavit indicating such. t-_=tractots that check this box most attached an additional sheet showing the name of the sub-contractors and state whether of not those entities have employees. If the sub-,onirectots have employees,they must provi&their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the poUry and job site information. Insurance Company Name:_L& - Policy#or Self-ins.Lic.#: 77 O l ( �-` �( Expiration Date: Z t Job Site Address: City/State/Zip: L/�w ff bx'3"T -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 tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be.forwarded to the Office of Investigations of the DIA for insurance co a ve ' I do hereby certify unde enalties of perj the 'formation provided above is true and correct Si afar . Date: �4 _ Phone# CTIn " Z97 _hpt?�& Official use only. Do not write in this area,.to be completed by city or town offu-iat City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health-Z.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions R Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL,chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,i.f necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required Be,advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be. sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit(license number which will be used as a reference number. In addition,-an applicant that must submit multiple permit/license applications in any given year,need only,submit one,affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related io any business or commercial venture (i e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit_ The Office of Investigations would 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 W. #617-727-4900 ext 4-06 ar 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.masE;.gov/dia °F�HEr � Town of Barnstable Regulatory Services vs"xx "$IENAM Thomas F. Geiler,Director Building Division TornXerry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www:town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section g If Using A Builder as Owner of the subject property hereby authorizeT-6& C �1 f.l (/ to act on my behalf, in all matters relative to work authorized by this building permit application for: Wkkt (Address o ob) Signature Own ate Pant Name —� If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable �oF ttte)11 Regulatory Services Thomas F.Geiler,Director sAexsTAate. y MAS& g g, i639. Building Division PJED���a Tom Perry,Building Commissioner . 200 Main Street, Hyannis,MA 02601 wmv.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed.under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations: The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be.required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section ial*.I-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a forn-Acrtification for use in your community. . yJRD,M 'E.'�1�;•II:r' C,AT ,,,OI L�'�K I{;�I ': DATE(MMIDDrm r :: :TY t N S.I IN : RO 7/14/2008 RUCER r THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION GERMANI INSURANCE AGENCY" ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 908 MAIN STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED B THE PE)bICIES__BELOW. OSTERVILLE, MA 02655 COMPANIES AFFORDIN COVER E COMPANY M MUTUAL INSURANCE C MPANYC A AI .... INSURED C_-); �— COMPANY PETER D, FIELD '= B �-• w DBA PETER FIELD BUILDING & RESTORATION PO BOX 16 COMPANY O' COTUIT, MA 02635 C _ v; COMPANY COVERAGES r•� THIS IS TO CERTIFY THAT THIF POLICIES OF INSURANCE LISTED.BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE OR THE POLICY PERIODACT OR OTHER DOCUMENT WITH RESPEC INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED 9 Y 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. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE(MMlDDlYY) DATE(MM/DDlYY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAI I IA81.1-fY - - GENERAL AGCREGATE $ " CLAIMS MADE OCCUR PRODUCTS•CDMP/OP ACC S _ r; a OWNCR'S 8 CONTRACTOR'S PROT - PERSONAL ADV INJURY EACH OCCURRENCE $ FIRE DAMAGE (Any one qre) S I AUTOMOBILE LIABILITY MED EXP (Anyone Person) S i ANY AUTO I COMBINED SINGLE„LIMIT a, ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY a - HIRED AUTOS (Per pprgon) NON-OWNED AUTOS BODILY INJURY $ (Prr❑midgnl) . PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ANY AUTO OTHF,R-THAN AUTO ONLY, EACH ACCIDENT ;6 AGGREGATE EXCESS LIABILITY EACH OCCURRENCE a _ UMBRELLA FORM AOCREGATC OTHER THAN UMBRELLA FORM • S A WORKER'S COMPENSATION AND AWE; 7011996012008 wC STATU- onr EMPLOYERS'LIABILITY 04/07/08 04/07/09 TORY LIMITS ER EL EACH ACCIDENT - $ 1 OO,000 THE PROPRIET0 INCI- - PAR1'NERS�ExecunVE - E.DISEASE-POLICY LIMIT $" 500,000 orr-ICERS ARE EXCI. EL DISEASE-EA EMPLOYEE $ OTHER 100,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CERTIFICCATE,m LLEjER - . . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ATTN.: SALLY EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR YO MAIL TOWN OF BARNSTABLE 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE$HALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVES• FAX#; 508-790=6230 AUTHO R�TATIV�GG�LC� Of2D.'CORPORATION, 988' . I f a TOWN OF BARNSTABLE BUILDING PERMIT,APPLICATION.. Map Parcel ..Application �' �� Health Division Date Issued. Conservation Division Application Fee Tax Collector 'Permit Fee Treasurer �d c -- Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address (CO APB(L( �2T Village Owner Address d 7— Telephone U 3�7 `01 y / Permit Request 4TRR371ZD Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation (O.CX22 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: 0 Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout 0 Other ` n Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)�c' Number of Baths: Full:existing new Half:existing Q, new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Rom Count: cz 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: _ x Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use -T _ BUILDER INFORMATION Name. � 2 -�lr�� Telephone Number — -Cgs/ Address`l T7 kL Nh( �T License# 6t Co 3� &O'v i' ( 14k,&, (ya(g7?g: Home Improvement Contractor# (;)U3&a— Worker's Compensation# 70 ( (C(1:�'( &o( �7 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 11z� 0�7 ..r FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED MAP/PARCEL NO. t ADDRESS VILLAGE OWNER ' �s DATE OF INSPECTION: FOUNDATION .. FRAME INSULATION FIREPLACE n ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ;K The Commonwealth ofMassachusetts Department of lndusiriabAecidents Office of Investigations 600 Washington Street Boston,MA 02111 www.m ass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information _ Please Print Legibly Name (Business/Organization/Individual):• � Address:-7-5-7 City/State/Zip: �n`rV rt �,k� Phone.#: Are you an employer? Check the appropriate box: 1. ] I am a employer with 4. ❑ I am a general contractor and I 'Type of project(required):. . employees (full and/or part-time). have hired the sub-contractors 6. ❑New construction 2.❑ I am a'sole pioprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp.insurance.# 9. []`Building addition 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' . 1311 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 anew affidavit indicating such. lCdntractors that check this box must attached an additional sheet sbowing the name of the sub-contractors and state whether or not those entities have 1 employees: If the sub-contractors have employees,they must providb their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:- 1 t+N Policy#or Self-ins,Lic.M _ 70 UR9 (oD -�),007 Expiration Date: 765ioxt Job Site Address: 1 Q N\414 N City/State/Zip: -(_ k U 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 6. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby certify un a' so erjun,thatfhe information provided above is true and correct: Siena e; Date: J - Phone #: 69-3697• 6 Official use only. Do not write in this area A7 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 CIerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: I JHE�o Town of Barnstable. Regulatory Services BAMSfABLE, y Huss. $ Thomas F. Geiler,Director 16 vA, Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 wvt w.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder T, �a�b��' hit-1LLl� ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to.work authorized by this building permit application for: . laa��r (Address of Job) to�3(07 Signature of Owner Date hlJNPd,(� I �V g(2"6 Pnnt Name Q TO R.M S:O W NEn ERM IS S ION 74 ,r n s ��l r f .r;_+/�!A �"..'� n� n/I�/'n '�'�l' 1•!� f �i nj 1�a ann�r�LU t"tl` Jo One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home lmprovemeai Qgntractor Registration y Registration: 120362 -:- - Type: DBA Expiration: 11/30/2007 PETER FIELD BUILDING & RESTORATION. PETER FIELD P. O. BOX 16 COTUIT, MA 02635 -- Update Address and return card-Mark reason for change. Address i Renewal i Employment Lost Card lPs-CAI SMI.-04104--101216 — — - Eih'ri`�i o mfto :tiYti' �t 60-1-4 License or registration valid for individul use only u,r HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards RegistrAtion: 120362 One Ashburton Place Rm 1301 - Exr — .-1 Boston, a 0211/30/2007 M08 Type: DPA PETER FIELD Bl1ILDING&RESTO (3 `FwLD 857 MAIN ST. --- COTUIT•MA 02635` ,Administrator .of valid without a Bo ra d`ot2uicIfbg'$F"egUlAhons aiia�Y:lhdarr'iisr .. Construction Supervisor License License: CS 65638 Birthdate: 7/15h 965 Expiration' 7115200g T►# 16160 ........ x Restriction- 1G �x PETER D FIELD PO BOX 16 COfUrr,MA02635 Commissioner 10/04/2007 10:46 FAX 5084283068 • GERKANI INSURANCE 0001 L I p1'4 l 7 .1� 1, 1 ((,,1,�1 •J• f' :..AC oRD ''IFed�I��, i1,;J.�R1..,•1 DATE IMNUDOIYYI.. . am,:" WR 10/42007PRODUCER THIS CERTIFICATE ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE GERMANI INSURANCE AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 908 MAIN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. OSTERVILLE,MA 02655 COMPANIES AFFORDING COVERAGE COMPANY A AIM MUTUAL INSURANCE COMPANY A INSURED COMPANY PETER D.FIELD B DBA PETER FIELD BUILDING&RESTORATION COMPANY PO BOX 16 COTUIT,MA 02635 —• COMPANY D I _ �' IT �lu� �,g0nnfl ,,ff uIp�IIINII I; 1 rlM,u Mr:1 R,'r'pa°•Yry?•;n:9 •:' •�—.,. ...19� �hl�u� k ..�?.d�i°FJh'tila.'�:k ..J•�,'e:.� L•�.:.�.ia I e 11. �_:�a::.�! THIS IS TO CERTIFY THAT THE POUCIES 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 8 Y 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. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MWDDIM DATE(MMR)WM GENERAL LIABILITY GENERAL AGGREGATE S COMMERCIAL GENERAL LIABILITY PRODUCTS-COMPIOP AGG S 1CLA 4MADE "OCCUR - - - PERSONAL 6 ADV INJURY 1 OWNER'S B CONTRACTOR'S PROP I EACH OCCURRENCE 1 _ FIRE O_AMAGE(Any one gm) S MEOW (Arty ale Pam) S AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT S ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS (PerpereoR) _ _ HIRED AUTOS BODILY INJURY — NON-OWNED AUTOS (Per soddwe) S PROPERTY DAMAGE I 1 i GARAGE LIABILITY AUTO_ONLY-EAACCIDENT S ANY AUTO OTHER THAN AUTO ONLY: - - _EACH ACCIDENT / AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE S UMBRELLA FORM AGGREGATE 1 OTHER THAN UMBRELLA FORM 1 A w0alcEas COMPENSATION AND 'AWC 701199601 04/07/07 04/07/08 a I ea EMPLOYERB'UAB►LITY EL EACH ACCIDENT 1 100,000 THE PROPRIeTOR/ INCL EL DISEASE-POLICY LIMIT 1 PARYWRIIIE MUTIVE 500,000 OFFICERS ARE: E1EXrL EL DISEASE-EA EMPLOYEE 1 100,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVFMCLES)SPECIAL ITEMS LC'E TIF - ,�tar:'s y.,,:r't4 NS'n......,..awl •. ..,. .. �._.��._ �sM,-• -azr NORM. '"M1 �i . . : •e_un 2u::}u:i!:r"r."�• �l: ::P u,.y!n}=t. ,;} u:_sia;le��•:• I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE PETER FIELD ;RATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE$HALL NRPOSE NO OBLIGATION OR LIABILITY FAX#: 608-428-1393 OF ANY IOND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVES, AUTHOPAP REPR ESEN TATn� �1 Gil Y'i�" '' �• •ye}[p�p�1Ip{��ry9yy., d, ..P p', I��Q� �'a 'W ..•��II`I.`,1•,>v.,:.�'I ,::c_.., .:IIW1eE1!'J!BtR%1! ..... ._ !�t.•I �.•'_v-''•._ 'A��O'�o-Ca .cnw9,8� ,1.;�:b�exe 1,�cti:ltr a ti TOWN OF BARNSTABLE SIGN PERMIT PARCEL ID 009 005 GEOBASE ID 220 ADDRESS 10 MAIN STREET (COTUIT) PHONE COTUIT ZIP - LOT BLOCK LOT SIZE 'DBA DEVELOPMENT DISTRICT CT PERMIT 62509 DESCRIPTION STRESS MANAGEMENT CENTER/6 SQ PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of ARCHITECTS: Regulatory Services TOTAL FEES: $25.00 BOND $.00 ptr CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE * BARNSI'ABLE, MASS.16,39. ♦� UILD , G DIV�N ' + Y }. DATE ISSUED 07/22/2002 EXPIRATION DATE �, :n � 1 ll�i 1 V �'0' 11 Vl .iJ(.il 11►7l.Lilll�i Department of Health, Safety and Environmental Services q so jL63 - 9. ��� Building Division °2 PIED MAy� 367 Main Street, Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Tax Collector Treasurer Application for Sign Permit, Applicant: A yu 1S nI,J Are A A Assessors No. ,G 9 —e�9 Q S5 Doing Business As: e J� -/Jfr Telephone No. Y�-S' 9.-_ Sign Location Street/Road:_ ^4 .. Zoning District: Old Kings Highway? Yes/6). Hyannis Historic District? Yes/zo Property Owner Nainc: Telephone:' SDS- Address:_�i�Sm�I c�f, : elf Village: Sign Contractor Namc: aj rr�. @ �aM�- Telephone: Address:_ U3� `.�.�4r �. Village:i-�•` Description Plcasc draw a diagmun of*lot showing location of buildings and existing signs with dimensions, location and size ol•the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Y o (Note:. If yes, a wiring permit is required) I Hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to die provisions of Section 4-3 of the Town of Barnortable Zoning Ordinance. Signature ol'Owner/Autliorized Agent:.,_,V �y��� Date:_;/O 2 Size: Permit Fee:' Sign Permit was approved: Y Disapproved: Signature of*Building O ricial: j — Date: —7 �-- Sign 1.doc rev.8/31/98 Stress Reduction Training Natural Healing Therapies 6 D. Kovanda, (508) 428-8635 Stress Reduction Training Natural Healing Therapies D. Kovanda, (508) 428-8635 Stress Reduction Training Natural Healing Therapies D. Kovanda, (508) 428-8635 Stress Reduction Training Natural Healing Therapies D. Kovanda, (508) 428-8635 i TOWN OF BARNSTABLE BUILDING PERMIT . PARCEL ID 009 005 GEOBASE ID 220 r ADDRESS 10 MAIN STREET (COTUIT) PHONE COTUIT ZIP - LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CT PERMIT 87250 DESCRIPTION FS LADDER SIGN 17.25 SF TO REPLACE EXISTING PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS:ARCHITECTS: Department Of TOTAL FEES: $25.00 Regulatory Services �- BOND � $.00 ZME CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE 1 PRIVATE * BABi MBU, MASS. i63g�- A, BUI=D1G DIViIS ON -_.._ DATE ISSUED 09/30/2005 EXPIRATION DATE 4 d° Town of Barnstable v�'�FtHE 1pl, o Regulatory Services Thomas F.Geiler,Director * BARN �rnsLE, ; .� MASS. g Building Division i°tFp 39. a Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit# ®72-M Application for Sign Permit Applicant: Assessors No. Doing Business As: l� `���5 Telephone No. Sign Location 1 ` Street/Road: 1 Li Zoning District: Old Kings Highway? Yes/No Hyannis Historic District? Yes/No Property Owner C : �`� Name: TEI Telephone: Address: I V(- S�- Village: Sign Contractor c Name: - l Telephone: SO X 3 9 too Mailing Address: Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions,location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Yes N�o (Note:If yes, a wiring permit is required) Width of building face ft.z 10= Iz.10= I hereby certify that I am the owner or that I have the authority of the owner to make this application,that the information is correct and that the use and construction shall conform to the provisions of§240-59 through§240-89 of the Town of Barnstable Zoning Ordinance. Sfg-natu iwner/Authorized Agent: Date: ���• - Size: / i Permit Fee: Sign Permit walarov . Disapproved: / Signature of Building Official: Date: 3o/f� Q:I WPFILESWGNMSIGNAPP.D OC n i MPLETE 85 WELLNE a aeeaa c�d6d�rsp�caa �. Patricia dater, dri r , Ac+ Pointe Acupuncture A Therapeutic 8adywork P. Y s 5Q$-42�-138$ Isola di Bella Trrrr�rac he -i�p: TOWN. OF BARNSTABLE SIGN PERMIT PARCEL ID 009 005 GEOBASE ID 220 ADDRESS 10 MAIN STREET (COTUIT) PHONE � COTUIT ZIP - i LOT BLOCK LOT SIZE _ DBA DEVELOPMENT DISTRICT CT PERMIT.' 60320 DESCRIPTION ACCUPOINT/6 SF PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS:ARCHITECTS. Department of Health, Safety and Environmental Services TOTAL FEES: $25.00 'BOND $.00 ptr Im CONSTRUCTION COSTS $.00 753 MISC_ NOT CODED ELSEWHERE * BABNSTABM MASS. 0,39. A� ED INI� ! BUILDIN/G DIVISION Bi // DATE ISSUED 04/09/2002 EXPIRATION DATE � /� Town of Barnstable 6�z P VE'O'+ti Regulatory Services Thomas F.Geiler,DirecT #N OF 8ARNSTABLE sntuvsraste. �. g Building Divisi 059. Peter F.DiMatteo, Building Comm isssiioon� PM (2' 50 367 Main Street, Hyannis,MA 02601 2 � Office: 508-862-4038 L-'IVIS10 Fax: 508-790-6230 Tax.Collector �� /���� �` 1 Treasurer Application for Sign Permit Applicant: L O'(kr l C t✓ J. Va Gkw (� Assessors No. 00 9 C) Doing Business As: C C a �n �� Telephone No. 5o�-gq ) -5gII Sign Location Street/Road: Zoning District: /vn Old Kings Highway? Yes(Njo Hyannis Historic District? Yes/No Property Owner JAG Lfa.� y�� Name: G 2 Telephone. Address: D '5CA 0 y Village:CD-&l Sign Contr ,.tor Name: , Telephone: 7.7- — o Address: 6e1r,41( j A6r) n�_S Village: Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign. This should be drawn.on the reverse side of this application. Is the sign to be electrified? YeSQ (Note:If yes, a wiring permit is required) I hereby certify that I am the owner or that I have the authority of the owner to make this application,that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable oni Ordinance. Signature of Owner/Authorized Ag ent: Date: Z �' U / Size: 07 �� Ile, Permit Fee: Sign Permit was approved: �f Disapproved: Signature of Building Offici L`' Date: & 7 Sibnl.dor rev.8/31/98 0 Q l�vv t)e."ll i mecca z j sc u IN �t �"- � _ { I -�- C � -� Assessor's map and lot number THE Sewage Permit number �r AtL /'e .......................... d ,► BAUSTADLE, i House number 9�C M6 9 ♦� 0 a\ TOWN OF BARNSTABLE - - BUILDING INSPECTOR j � APPLICATION FOR PERMIT TO .......... .....'t'��.r ' +' �` ; r TYPE OF CONSTRUCTION .................�f� ri.: ................................................................................................. .... . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for'a�/permiit•'a�c/cording to the following information: Location f ?.... 19/G1 \ ............................................................................................................ f....... ProposedUse ....... d.."..'.� ................................................................................................................................................ Zoning' District ....... J -+l;t...................................................Fire District ........5:. Name of Owner .. t.,�a, ..J.�J;,....k� '��1��3�! ........Address .... .....5/Ie / ...... � ...`.`l. L'� A114 y. ., ...� .... ;.... _... ... �.. Name of Builder' .... ",I1) .... .f �.................Address .................................................................................... Name of Architect ....`!!.! ...1>� ... ��.GC9C.k...................Address .................................................................................... r Number of Rooms ..................................................................Foundation ....... ....t:�..................................................... -od Exterior ..... C? '.V..............................................................Roofing ........�.0 ......................................................... l l` Floorsf�:........................................................................Interior .........f...... ....� ..E...!............................................. Heating !#� 0 re ........Plumbing ....... ��'..�.......................................................................... ................................................................... "7 Fireplace ...............r................................................................Approximate Cost .....:..: ..©................................................. Definitive Plan Approved by Planning Board --------------------------------19--------• Area = z ... �1��, Diagram of Lot and Building with Dimensions Fee .-l.........!� SUBJECT TO APPROVAL OF BOARD OF HEALTH Plaa •-i Wit I� �q0 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. / rf Name ....1.�..'? .................. 't � .................. C p-UL. MYCOCK, RONALD J. tl No ..2 3 9 0 4.. Permit for ....ADD...TO................ /yam /��sa OFFICE ............................ E............................................... Location .10 Main S ...v .......................... cote .................................................. ��, Owner ...Ro„ ald J. Mycock..................... ;1 ( ��,��J•�v ,' �i�lC/S (.,�c. Type of Construction ............ e ......................... ................................................. /lusts i' ''� lAt Plot ........................ Lot ................................ of rzr4, 4DC? z Permit Gra ed „Ma.rch...25,..............19 82 f eoe,/4. r Date of Inspection ......`..19 Date Completed ............................. .......19 - - p 7; r Assessor's map and lot number ..................:......................... . SEPTIC SYSTEM MUST �v uJ r E TO.- - - i�"iST,�LLE� i4� CC�6VI�°Li P �♦ Sewage Permit number ...../,7.C...... 1...........:� Kshc /zrI �' Epp d WITH TITLE 5 ENMONMENTAL COM ITODLE, House number t ls�,. TOWN RECULATIC� 039. TOWN .OF BARNSTABLE UUILDING,4' jINSPECTOR APPLICATION FOR PERMIT TO (.,.1 . ... UA....... ................ . .................... ............................................. TYPE OF CONSTRUCTION .................. j llJ..................... ................... .�� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �(/.... .... .�.[� <��Y............................................................................................................. ProposedUse .......0I..1...CCr.............................. ........................................................ .. .................................................. Zoning District .......... . ............................:...................Fire District ...........V. v�.t........................... ...................... Name of Owner ... Ail 0. A.(60.C .. nn �G�......V..`.... _. .........Address ..../ .....: XPYlz' � .................`` 14 .�....... a Name of Builder' ... d`�.wl1i ..:.!..:'!.` / .............Address.... .................................................................................... Name of Architect ...ZL..3 ....x�y......G ...................Address ..............:.................................................:...........:....... Numberof Rooms ..................................................................Foundation .......V;otwj...................................................... Exterior ..... :.............................................................Roofing ........V.P rri.......................................................... Floors ............................................Interior .......:.4�.�. ..` ` .. .. .(............................................. .......................................... 71 Heating !..... ..el/2........................................................Plumbing .......V. .............................................:.............. Fireplace .........../. :o................................................................Approximate Cost .... ?/.!'!�4�............................................... Definitive Plan Approved by Planning Board -------------------------------19________. Area ... 7. 0 Diagram of Lot and Building .with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH f x OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... ........... ....... .......... .................. MYCOCK, RONALD J. No ..U.9.0.4... Permit for ....ADD„T.0................ ................QF.FICE................................................ Location .......................... Cotuit . ............................................................................... Ronald J. Mycock Owner .................................................................. Frame Type of Construction .......................................... i �� f ................................................................................ i? Plot ............................ Lot'................................ March 25, 82 Permit Granted ........................................19 Date of Inspection ................19 ..................... Date Completed 19 .• Cl nw..w�,{7H .«.- - yhAr-v""'rp''T�ltie.t�-�r•^^'"."..f'"'*Y'drry,rv,.,r..'-.�a..rr*r'-+...rr...rq...+:.w�'.y.;..::vss.��_M.... ._:,...-...j;�"w„'t�.r« .--r Jvn.rern•'i+;Nr�-N.�...•.vrs'-µ.•'bwr�r ...r-n",,,^^."ram.. i Assessor's office(1st Floor):Assessor's map and'lot number D 0-Ip I Q V . 'pi:<wE:To Board of Health(3rd'floo V Sewage:Permit number Engineering Department(3rd floor): _' NAM a: c .' House number �i63p. Definitive Plan Approved by Planning Board 19 bYkY'd� APPLICATIONS PROCESSED 8:30 9:30 A.M.and 1:00 2<00 P.M.only TOWN OF BARNST .BLCE -��- BUILDINGA IN,SP'ECTOR � APPLICATION FOR PERMIT TO �(1//Q 40Oi _ zf91� A�Alva ,W t M TYPE OF CONSTRUCTION•G!/OO,Q C/t,.q� /p��/� /i¢�r►d►,01 100, 19 'I TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: [ Location Proposed UseP®/t�� Zoning District TIF Fire District p Name of Owner/_O/ Address z�// 9�70e- Name of Builder el— /Ve/VM �-�'�'d�/'�jr�� _ Address Name of Architect ��11 Address Number of Rooms/�' /V f � �� � Foundation �dY1Gr`� Exterior�l✓'b Roofing Ala�.� Floors ��h / Interior Heating Plumbing �y,,�/✓J✓ �`� ��5' Fireplace Approximate Cost �!?. Area /Va 14zACA Diagram of Lot and Building with Dimensions Fee 1 rBl�tl 1 AZ7A7 !J/� /�0G�J511�ors mar- ,� ,210V �` 9-x i 61 ' 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS h T wn of.Barnstable regarding the.a o0 co ctlon. I h reb �a ree to conform to all the Rules and Regulations oft he o g g e y g 9 i Name . I r 9 Construcf'on Supervisor's License MYCOCK, RONALD A=009-005 -f' "=- No 34660 Permit For ALTERATIONS Commercial Building , Location 10 Main Street l Cotuit Owner. Ronald Mycock Type of Construction Frame i Plot Lot Permit Granted October 23 , 19 91 Date of Inspection 19 Date Completed 19 F PERMIT COMPLETED Map #1[ Lot #5 �- - �D Airsssso;O map and lot numb 9........................ F,TkE t f ;:�*•Swc S"` To ffy .e Sewage Permit number ..............v�.a..fir:............................ - INSTALLE 0ia•: z. ��,�1 �`'.. : °� ONITF-I TITLE >: BABH$TIlBLE, i 1....House' number ® ash Ur'e�'"........................... ............ ...........,. •' ENVIRONMENTAL CO f TOWN REGUlAT10 G war a� TOWN OF BA=RNSTABLE BUILDING INSPECTOR ,PERMIT TO construct a,°small retail store—Varity APPLICATION FOR TYPE OF CONSTRUCTION Frame y° ............ ... .........:.......f9.& . .,,., ...Y. ' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... Corner.:.of_..Rte.28 and Main ...Street,...Cotuit,,MA., 02635 ..................................... Proposed Use ....Small Retail Varity..Store....................................................................................................... Zoning District BZ—C COtuit h ......................................:.................................Fire District ................................................................ Ronald J. Mycock 139 Shell bane,Cotuit Nameof Owner ......................................................................Address ..................................................................................... Name of Builder GS�y St. Pierre Address .`Jackson Dr. ; CO Cult .................................... ........... ................................... ►� n €� � . ft Nameof Architect ..................................................................Address .................................................................................... Number of Rooms 1 Poured 10tt With a Footing .................................................................Foundation ..................................................................g......... Exterior ....... Shingled.... ........................... . ...... ..Roofing . Au4e' l ......................................................... . . Floors Tvdo D Interorl ... ry Wall a ..... .o- ..............................._ 9. _ Heating ....EleCtrlC�......................................................Plumbing ........ ... .�l.l..:!:3 a QQe Fireplace ..................................................................................Approximate Cost ..............W. Definitive Plan Approved by Planning Board ________________________________19________. Area . .. Diagram of Lot and Building with Dimensions See Attached Fee {I SUBJECT TO APPROVAL OF BOARD OF HEALTH {�Z� -�� 1z 071?47v ' I hereby agree to conform to all the Rules and Regulations of the Town of BarnSable regarding the above _. _construction. Name .. .a ...; ...... .................... MYCOCK, RONALD J. ..2264 ' KO .. Permit for ...Build................t... ...Store..............:............... ... Location .1�0....".'fain...Street....:.............. Cotuit Owner ......Ronald..J.-.2!iycock..... - "-- Type�-,of Construction ........F.........rame......................... ....... ...................... . ......... Plot ............................ Lot ................................ November 5 (3 e Permit Granted ...............................!.....?19 c� Date of Inspection ..... �. .19 Date Complete .. ............... l 7-1 PERMIT REFUSED F C3 V. .. ............................. 19 ................................................... .... . . ................. ................. } .s : ............. = . . ........................ ..................: . -Approved ... ................................... 19 7�` :...........!......................................................... (4 - - ............. ... ..................................... ............ . . "� a n 'c /,Gyp _ .. � - -. Assessor's map and lot number ............................................ THE Sewage Permit number ..... ................................... / BAUSTABLE, i House number `' ....;�.,?.�.'.�.�.?....t`e �: D Mae6 1639. ♦� a, TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......vonatruC......U waval rerail stcre�-varv- ................................................................................................. TYPEOF CONSTRUCTION ........,P`.'.ame.................................................................................................................... .............. f'............................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........co'em�_...or..._Ue,2f:..:Ord..I..ain...Street,�...Cotuit,?TA..02::.1}..... ProposedUse .................................................... ....................................................................................................................... ZoningDistrict .........................�......p.........................................Fire District ................]........(......................................................... lycock Nameof Owner .......................................................................Address .................................................................................... Name of Builder ...�`.�.`+: r.. .`'.`.... � .........................Address .` GriSQY3...D'' *........0,D ill ............................ t} tt t� 1i Nameof Architect ..................................................................Address .................................................................................... 1 1 Poured 101, v th a _,Doti 1•_,. Numberof Rooms .................................................................Foundation ............................................................. ., ,. - 01. Exierior -;hi"_'' ` Roofing xs .ki ................................................................. ..............:..................................................................... Floors Tv.o .........................................Interior rtT Wall .................................. .............................................................................. - - .� 3 7rA ., ' Heating .............Plumbing Fireplace ........` ......................................................................Approximate Cost .......... .....;;�Q'W........................ 01 .. ....... i........ �" 7 P Definitive Plan Approved by Planning Board ________��_++________________ ------19--------. Area -:7? Diagram of Lot and Building with Dimensions Fee ' .� .�.......... SUBJECT TO APPROVAL OF BOARD OF HEALTH r, V. Q (J _TlI I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. - Name .. M !"Y;r2? ....t f...A1f.ff.."{t..%�. ............. I MYCOCK, RONALD T A=9-5 No 2.2.6.4.4.... Permit for .....Build................. Qom.s ...........V-i=-x O.t= ................................. Location ..1.0...Main.....S........tre...e.t......................... .. .. .. .... .. .. Cotuit Owner .................... Type of Construction .....................Frame..................... ......................................... ................................ Plot ..:......................... Lot ................................ Permit Granted .....Nqve.dbg.-r....5...... 19 80 Date of Inspection ...........fi................... Date Completed .................................. ...19 PERMIT REFUSED .................I..... ............:....................... . 19 �... .. ............... ............................................................. .................. :... ... :.. . - ............... ............. I......... .. ....... .. ... .... .................... Ix Approved ......................................... ..... 19 .............................................................. 1........... .............................................. ................................ .o TOWN OF BARNSTABLE Permit No. ----------—--------- 1 »nn Building Inspector Cash ----_ � �YL E79. P �O URI•` OCCUPANCY PERMIT Bond -- "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to R011a!,(1 J- i'tYCOCK Address lay bne.11 uaIie, l:utuit in Street Wiring Inspector =% i' Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department ► Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ............................I........................., 19... . ..........................................._........................................................... Building Inspector O • ---4, �• 11'-7" Closet ih 7' ; Utility co 10'-5" w Treatment Room Office iv CD (91 sf). _ Break Room ' TOTAL SF: a 1150 sf ? 1 7 L"`j ,3 11'-7" Closet Utility Treatment Room °' o (91 sf) w ------------ Fireplace Emergency Exit Sign 7'-5 Carbon Monoxide Detector � 12 Smoke Detector X S co _ Hallway �— w 04 Waiting Area Emergency Alarm and.Lights Fire Alarm with Emergency Exit - -- Sign Above U DISI ment c° EXIT - s to Dentist Offices and Smoke Detector N shared Bathroom . e , 13'-10" N - Desk with Glass Enclosure Treatment Room M (128 sf) Reception 1T- -E-XI-S-T-I-NG--COND-I-T-IONS__ r } = THERAPEUTIC BODYWORK OFFICES —,/ mergency Exit Sign 10 MAIN ST. COTUIT, MA Fire Extinguisher EttoIT Scale: 1/4" = 1'-0' Main Street Side 3.15.16 - Acer Design Studio } PLUMBING NOTES: 35' ° All plumbing will be removed by licenced Plumber and will be capped in wall ` from which it extrudes or in basement,for potential future use. Remove closet walls 11'-7" 11'-5 10'-10" ELECTRICAL NOTES: and cap plumbing for All electrical work to be done by Licenced Electrician.An lectrical systems future use,. y i, t a, , • � � •` ..* .(outlets, switching, etc.)within walls to be removed will bE relocated to the nearest wall. Flourescent Lights to be removed and replaced with recessed o Treatment Room 91 s - cans in treatment rooms and track lighting in the Waiting/ caption Area. ' insta I new floating laminate floor over Office 9 ". Break Room instal existing floor, remove Flourescent l new floating laminate floorover EMERGENCY SERVICES: Remove vanities and cap Lighting and replace with (2)recesse existing floor LAll_ existing emergency alarms, lights, and elements to re n 3in as is plumbing in wall for futur can lights. use I " „ n V-7„ N plumbingtoilet future Suse a d,cap Remove existing door - _ q - and fill in wall, Treatment Room(91 so install new floating floor over ` existing floor, remove Flourescent c Lighting and replace with (2).recessed can lights. 1 . r Add (2)new door - Fireplace , T ' Add.new door. +. t arbon Monoxide Detector. . Emergency Exit Sign__ - . LO m Smoke Detector - .0 - " Hallway .200 05 Flourescent light to Waiting - be removed and Area g Emerge cy Alarm ti Q: replaced with (1) n t9 recessed can light and Lights r Remove door'and patch m I wall f - - - TOTAL SF: Fire Alarm with Emergency U p 5 — IJ Exit Sign Above- Basement ' g EXIT re All existing be t ro I s ng wood floors to o Dentist Offices and Smoke Detecto refinished shared Bathroom Remove existing door and fill in wall All existin Flourescent lights in - Waiting Area/Reception to be r.* removed and replaced with(2) track lights k Treatment Room (128 sf� w install new floating laminate floor over'. K. iv 6 existing floor, remove Flourescent '� Lighting and replace with,(2)recessed a can lights.' Reception _• . Remove reception desk and glass surround. Support post to ` re 13'-10" f main - r: i _PROPOSED REN ATIONS _ r TH:ERAPE.UTIC=BQDYWO _9F_F_TCE_S- -- y 10 MAIN ST. COTUIT, MA ` mergency Exit Sign Scale: 1/4" = V-0" w , Fire Extinguisher Eto XIT ' 3.15.16 - Acer Design Studio Main Street Side e Remove,toilet and sink and cape +ri.• . _ plumbing for future use, ' .PLUMBING NOTES: All plumbing will be removed by licenc d Plumber and will be capped in wall from which it extru �es or in basement, Remove closet walls and two doors and cap_ 11'-7" 10'=5" for potential future use. plumbing.for'•futur ELECTRICAL NOTES. use.Wall off for.new Staff Room 91 sf� All electrical work to be done by Licenc d Electrician.Any office. : :y All Room(114�s costal new floating laminate floor, � �• electrical systems outlets switching, etc.)within walls to 0 over existing floor, remove install new floating laminate be removed will be relocated to then rest wall. •- Flourescent - A ` floor over existing floor, i Lighting and replace with(2) 1' T remove Flourescent, Flourescent Lights to be removed and -eplaced with recessed,can lights. 2. , - Lighting and r e recessed cans in treatment rooms and rack lighting in the g g 9 with(2) recessed cane lights. w a Office � .- � Waiting/Reception Are •. laminate floor over t 4• do .EMERGENCY SERVICES: m is a new floatin Add new or existing floor. All existing emergency alarms, lights, and elements to >. r 1 _ remain as is -, F , —Ad d wall , I o Treatment Room (91 sf� - F • • la , , - `7 installnew�foating fammate floor over " existing floor, remove Flourescent. Treatment Room (99 sf), Lighting and replace with(2)recessed floortver existing new g� �nate _ can lights. ' floor, > �, remove.Flouresc t ' . . c .Fireplace, a U hting and replace with (2J;�recessed can lights. —RemoveWalland cap lumbin for future use arbon,Monoxide Detector _P P 9, Emergency Exit Sign M Smoke Detector'. 10'-5" Hallway + ti o oFl urescent light to 5 ' Waiting u� c� be removed and J , . Area ._ Emergency and rg h cy Alarm replaced with (1) i recessed can light s a Lights Remove door and patch TOTAL SF: , r ��' r Fire Alarm with Emergency p — . Exit Sign Above B ement. EXIT All existing wood floors to be to'Dentist Offices and Smoke Detector , refinished . r " shared Bathroom Remove existing door and , fill in wall All existing Flourescent lights in ' ; ' Waiting Area/Reception to be - -• - ' removed and replaced with track lights o , ack li h • Treatment Room (.128 sf) . costa new oating laminate floor over . iv existing floor, remove Flourescent Lighting and replace with(2)recessed " can lights. Reception emove reception desk and glass surround, Support post to , remain. 13'-10" Ll i PROPOSED RENO TIONS -- THERAPEUTtC-BODYWORK O FICES r y C 10 MAIN ST. COTUIT, MA mergency Exit Sign Scale: 1/4" = 1'-0" EXIT Fire Extinguishe 3.15.16 - Acer Design Studio r to ' Main Street Side ;4 4.29.16 - Issued to Building Department y. , t .-�j a_' ''r !G. 'Y F .. • Y r . % •• .j ' f. ' .. ! F ' - - ' 7. 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W. i9731 WIVI. 1 ,4,e W/C,<. ,4..s.5oc. le SYSTEM PROFILE NOT TO SCALE 10P OF FOUNDATION FINISH GRADE FINISH GRADE OVER EL FINISH GRADE OVER EL. 74.0 SEPTIC TANK 73.5 DISTRIBUTION BOX PAVEMENT GRADE 11 A'. OVER TRENCHES 73.0 k C.I. FRAME RISERS TO 6" / A&COVER OF FINISH GRADE) PRECAST CONCRETE ,. _� ,.; ,, �, 500 GALLON DRYWELLS RISERS TO 6" �3"MIN. H-20 REINFORCED LOADING '\° MIN.SLOPE 1% OF FINISH GRADEOUTLET PIPES)LEVELFOR 2'( MIN.1% SLOPE TRENCH LENGTH = 33'-6" 3 g' .' MIN.SLOPE 1% ° BEYOND>• MIN. 0 DRYWELL LENGTH = 8'-6" o �o 13"MIN. 14 ,. _��, - �c,, ,o - N/A N/A /. r .. +, °_O: � ° „ °-0. , r. +r Q�O• �,: ,��: .r Q�O.v ��, ':. +r �O MIN. 6"SUMP _ f 69.80 ` �- PVC OR CAST IRON TEES �.. � PROPOSED 69.�0 •; ��°'• '�• ;,�.; , �= EXISTING 1000 GALLON A. DISTRIBUTION BOX wASHE�cRu�sHE� 3/4"- 1-1/2" DOUBLE 4, 4 kl� WASHED CRUSHED PRECAST CONCRETE -4 H-20 REINFORCED sTONE STONE ot BSMT.FLR. SEPTIC TANK ELEV. TRENCH SECTION NOTE: EXCAVATE TO=C= STRATUM IN ORDER TO REMOVE ALL =A= &=B= IMPERVIOUS MATERIAL WITHIN 5' OF THE SAS. REPLACE WITH CLEAN, " MIN. 3" OF 1/8"- 1/2" v��Zap CLAY-FREE SAND 4" DIAM. 36" MAX. DOUBLE WASHED PEASTONE 14. C14 < . °. ,, , °'• •�r' �, . ,r o'o 3/4"- 1-1/2" DOUBLE #1t� PAVED \ 48" 5r_2,. WASHED CRUSHED SPARKING \ J ` STONE ��y \ TRENCH-WIDTH \ PROPOSEA \ \ 13-2 VENT \ ' NUMBER OF TRENCHES 1 REMOVE STING ,� #� z0i , GENERAL NOTES: NUMBER OF DRYWELLS 3 LEACH IT 1. ELEVATIONS SHOWN ARE BASED ON ASSUMED 2. ALL PIPES IN TF;E SYSTEM MUST BE CAST IRON OBSERVATION PIT J 521' OR SCHEDULE 40 PVC. E STING 3 3. HEALTH AGEN-1/CAPE & ISLANDS ENGINEERING HOS ENGINEERING ASSOCIATES DI BOX �� o MUST BE NOTIFIED WHEN CONSTRUCTION IS PERCOLATION RATE: < 2 MIN./IN \\ w COMPLETE PRIOR TO BACKFILLING. 4. ANY CHANGES IN THIS PLAN MUST BE APPROVED DATE: SEPT.9,1980 BY CAPE & ISLANCS ENGINEERING AND THE BOARD \ \ N OF HEALTH. DESIGN DATA \ ( �o 5. MATERIALS AND INSTALLATION SHALL BE IN 0' oG COMPLIANCE WITI-I THE STATE SANITARY CODE EXISTING \ \ o �o 1Q� [TITLE V]AND LOCAL APPLICABLE RULES AND 1000 GALLON ` �Ga N> REGULATIONS. LOAM & 75 GAL5,400 J1 OOO OFFICE SPACE SEPTIC TANK \ \ \ 2 A �J�^ 6. NORTH ARROW L FROM RECORD PLANS AND IS SUBSOIL NOT INTENDED .CGR SOLAR ENERGY PURPOSES. DAILY FLOW 405 GPD. `� 7. WATER SUPPLY: MUNICIPAL WATER SYSTEM. EXISTING SEPTIC TANK 1000 GAL. \ \ Mn 8. FLOOD ZONE C [NON-HAZARD] 30' LEACHING REQUIRED 405 GPD. �� 9. THIS PROJECT DOES NOT INVOLVE ANY PHYSICAL p� \ 35.2� , �✓ r�'t e v� S GROUND DISTURBANCE OR VEGETATION REMOVAL WITHIN N� � \ � � � � ' L� � _ �^" �2 BANKS O OR FLO�DC� OR COASTAL HAZARD ZONE D 3- \ \ I \ MEDIUM SAND SIDEWALL AREA = 186 SF. (COTUIT) 186 SF. X .74 G/SF. = 137 GPD. BOTTOM AREA = 441 SF. \ i\ \ \ � \ \ 441 SF. X 0.74 G/SF. = 326 GPD. LEACHING PROVIDED = 463 GPD. LEGEND 156" NO GROUNDWATER EXISTING\ \ PAVED PARKING �\ S2 PROPOSED CONTOUR SEPTIC SYSTEM UPGRADE 52 EXISTING CONTOUR PROPOSED SEWAGE DISPOSAL SYSTEM -� N0. 10 MAIN ST. �r,� ��FA�� \ Q \ OBSERVATION PIT R,;����"-- �7 \ 'I 23,627 SF. / _ _ — / ��� PREPARED FOR ,.r RONALD MYCOCK \ 1 ❑ DISTRIBUTION BOX I o o SEPTIC TANK `"s NO.10 MAIN STREET COTUIT,MASS. ice / i U SOIL ABSORPTION SYSTEM w PLAN NO. 032301 SCALE: AS NOTED FILE NO. 384BA DATE: MAR.23,2001 59 RESERVE AREA �,�,�}� o� a,� `� 'i a1 RESERVE sf9� PCS FILE: MAINST10 , SEPTIC FILE NO. 69 _ ti �nvl� ti�� 22.26 PIPE INVERT ELEVATION Cf-vV3LFS sn,n��c«I CAPE & ISLANDS ENGINEERING 0 0 0 � , �FG TEn�° PQ 800 FALMOUTH ROAD, SUITE 301C PLOT PLAN 9 w w w w lA�4D`,v`r` MASHPEE,MA 02649 (508)477-7272 MAP SEC PCL LOT HSE > � (O $4Y-ee4" MYCOCK.KILROY,GREEN &MCLAUGHLIN ATTORNEYS AT LAW 171 MAIN STREET EDWIN 5 MYCOCK HYANNIS,MASSAOH USETTS 02S0I BERNARD T.KILROY AREA COOE 617 ADDRESS ALL MAIL ALANA.GREEN 77I-5070 P.O.BOX IAS CHARLES S-Mclaughlin.JR Hyannis.Mass.0S60I MICHAETorORD JUHS 26,198 0 ANITA j.McCarthy Mr.Joseph D,DaLuz,Building Inspector Tovm Hall Hyannis,Massachusetts 026.0.1 Re:Request for building permit Dear Mr.DaLuz; Please be advised that this office represents Mr.Ronald Mycock of Shell Lane,Cotuit,Massachusetts.Mr.Mycock has under agreement for purchase a parcel of property located on the corner of Route 28 and Main Street in Santuit (Cotuit).The property is located within the Limited Business District C Zoning area which zone permits "small retail business common to a residence district." Mr.Mycock would like to construct a small office building to house a small real estate and insurance office on the premises. Kindly advise whether or not you consider Mr.Mycock's pro posed project a permitted use under the Zoning By-law,so that upon submittal of complete plans,Mr. Mycock will be able to obtain a building permit.If you should find it is not a permitted use, please advise as to your reasons for such a decision in writing at your earliest convenience. Thank you for your anticipated assistance and co-operation in this matter. MDF:jmf File No.9471 Very truly your Michael D.Ford