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Home My WebLink About0730 BEARSE'S WAY SeS Lot r - j TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Cfe� 0(� Map Parcel Application AllL Health Division Date Issued Conservation Division IUILDING DEPT. Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board JUL 112016 Historic - OKH _ Preservation aRksIRNSTA( L Project Street Address 22 � �f9-,� e Village Owner Address Telephone Permit Request �� Z �''� '1f04ckt1 SPri✓ 0340C Jrt l OF b�<",J1 AW %,,sk11 Ale-1 60"00 r5/��-�s f}�a o►� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation "'I'5760V Construction Type /A� ow Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of AppealsAuthorization ❑ Appeal # Recorded ❑ Commercial W Yes ❑ No If yes, site plan review# a Current Use , ,�/JIB Proposed Use APPLICANT INFORMATION 57 eUeN -�4P2 (BUILDER OR HOMEOWNER) Name L <� Telephone Number _ �L��" � 07 Address �� /� J �j License # -AU 1* OR �-i Home Improvement Contractor# �J�� Email G r-f "j AA Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO IS SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # ' DATE ISSUED F MAP/ PARCEL NO. r , ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION -" FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 4" PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT it ASSOCIATION PLAN NO. r ` INVENTORY & RECOMMENDATION DETAIL - nx Sign Text r Michelin � d Existing Sign Description - Pylon Sign <� - Height Width Depth � I � ,e Y¢ t:,ab_� „.s� _ `y Letter Height . OAH above grade Face'Material Sign Material ` - { it W Visible Opening Retainer Size § 3` Surface Material Surface Color t" Available Height Available Width . ' Illuminated, Illuminated Type Inventory Comments Double Face Mount Single Pole . Recommended Action Recommended Sign Type Z O Sign Type Description ,To Be DeterLEI mined a Wall Repair Action Z W X Signage Text O V W Recommendation Comments G INVENTORY & RECOMMENDATION DETAIL x r Sign Text I i Existing Sign Description Wall Sign I Height Width Depth �T a Letter Height OAH above grade Face'Material Sign Material W Visible Opening Retainer Size Surface Material Surface Color h,,N IRK wn Available Height Available Width yr- J�, ��-�,.��: w�r„ �-y. '�°12 �„ .�.�. �" s.T+p�'�s'4'�'a• � 'z i-e s� °• h" Y£'�� try� .- T ,•" I Illuminated Illuminated Type Inventory Comments Double Face Mount Flush -Wafl i �.�....� ri ... .,. ..emu,.,,��i`"°•�:=;;�..�,r�:; ,..-�ra.a„`•,,rt Y,,.�.a.i*��4,.tiYr➢`�5r„�-.S,.Maba�t�#>.�ww0e,.�r,,,.,.�asa�P�"�?ac�slGnr Recommended Action Recommended Sign Type ZI O Sign Type Description To Be Determined rod F � a 0 Wall Repair Action W Signage Text O V W Recommendation Comments INVENTORY & RECOMMENDATION DETAIL Sign Text Michelin st«r:� ,��y �, ,^.�Art.��#4 a�^. ��t'f`�' �,': ft,� Existing Sign Description -----�---~�~ - _-- Trt - _ Hanging Box Sign < ., Height Width Depth Letter Height OAH above grade }p HE O • � _ � _ � '. �f" ABM� 1`m �. .� ?_�` �d� - z Face Material Sign Material luminum W Visible Opening Retainer Size , • I � , �� id�}� ° 'LrV. a 1 i Surface Material Surface Color �V �. <r ziq Available Height Available Width Illuminated Illuminated Type Inventory Comments Double Face Mount • . -. 4_,_,.,..'�'�?.-'',aft r:,�+�^?'�rk�';�fdCt;?k�?`fi�!+q¢$+..;;U°ti++�br�..k,rF'TFfaz;i.��s R�.r,s;:z�k>. .r.�•`:9?�t 7.5 £;g., �a��.;. tiz Recommended Action Recommended Sign Type Z 2 0 Sign Type Description To Be Determined a f Wall Repair Action ' W Signage Text O V W Recommendation Comments T7xe Camxuromwealth of Massachusetts Deparhaerrt crf Indushzal Accidents �' - -- Office 0f11"Wft'gatians. 600 Wasihirrgton Street Boston,41A 02111 tt mitsrra--mgovIdia Warkers'.CompensafsonInsuranceAffidavit:BuildersiCanirac GrsJEfedri�Plumbers Applicant Informaf Qn Please Print Le. Name(Bnsiuemnig a ((Z V. Address: U'V'VV_ �W- 026y City/stalteMix C yl 10' Phone TUF Are You an employer?Check the appropriate ba= Type of project(required): I.V I am a employer Uith. 4 ❑I am a general contractor and 1 6. ❑.Netts construction employees(full andlor part-time).* age 13ired the subs contractors 2.❑ I am a sole proprietor arpmtuT listed on the attached sheet 7. ❑Rrmodeling slop and have no employees. 21rt se sub-contractors have g_ ❑Demolitioa wnr a form in any ci 3` employees andhae wo9e ' d 9�. El Euilmg addition jN0 Wor"an-M,comp.irrBLlr=e comp_ msuran required.] 5. ❑ We area corporation anal 1 its ❑Electrical r ep=or additions 3.❑ I am a homeoumer doing all work officers have fi xudsed their 1 L❑Plumbingrepaus or additions es myself [No tivorlcers'gyp_ �t of exemption Per MGL 1?.❑ afrepairs insurance required.]1 c.152,§1(4}L and we have no employees.[No woAoers' 13.I Yf Other , comp.insurance required_] 'Any appticsnf—&at cberl£sbox R toast also fiIloutthe swdoabgmslioviag ibeTxwo&ets'campenm&npotieginformsdaa IS.amemnerswho submit dais dEzvir i g thry axe dole;slfwah aadtheahte out�decoatiaciarsmnst mtmitanewaffidavit indicating f,. sock K•onlr=ctm-bstchec3r ildssourmustattachedasadditinnat skeet slowingthammneof themb-ccnh=to-gandstatewhether.arnottbnse eaddesh ve . eW1o3ees.Ifthesub-coatactoisluveemployees;they=Ustpmvidetheir nnrkers'romp.palicynumber. I am an enip1gvr that is pr4nUing workers'cangwisirdon imnirance-for tiny ewp&yem ffeloiv is ilue poticy and jah s-rtrr irzformafiorz, rr k uranceCompanyName: P4ficy 441 or self-i:ns.Iic_* (oS b00 60G3 yG 7 14S I Expiaatioa Date: L Z 1 {rn Job 9ite Addtes- 7?0 iOrtSt°S l"54 eitylstafe/ , Attach a copy of the workers'compensationpoHicy declaration page(showing the policy number and e3:p1ration date). Failure to sew coverage as required.uuder Section 25A of MGL c.I522 can lead to Se imposition of criminal penalties of a flue up to$1,50D OD ancl•'or one-yearimprisoument,as we11 as civil penalties in the fonn of a STOP WORM ORDERand a fine of up to$250_00 a dap abQainst the violator. Be adiised that a copy of this statement maybe forward to the Office of Investcgatiom ofthe D utance coverage vet¢rca'tiion. Ida hemby certi er tl pain rzd�peizatt&s o,f pelujy gjatflre irzformadmi proiuded a:7;F'7'6 carrect Sisnature: ry1M Date: Phone \ �. f 30 Ofictal use—only. Da aot ivrke in this area,to be cvmpTeted by cite artonvz g€jrciat City or•;€'owe: PerrmtUcense# Issuing Authority(circle one): L Board of Health 1 BuffTlng Department 3.Cifyffown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#_ MAY-03-2016 .16:24 PAUL PETERS INSURANCE P.02 ACC>RJDO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 05/03/2016 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 NA E: Lois Ferreira PAUL PETERS AGENCY INC. PHONE (508)548-2500 AIC ARNESS, lois@paulpetersaqencv.com 6 FALMOUTH HEIGHTS RD. INSURE S AFFORDING COVERAGE NAICtt FALMOUTH MA 02541 INSURER A: HARTFORD UNDERWRITERS INS CO 30104 INSURED INSURERS: CAPE COD RETRACTABLE AWNINGS LLC INSURERC: INSURER D: 9 JONATHAN BOURNE DR 2 INSURERE: POCASSET MA 02559 INSURER F COVERAGES CERTIFICATE NUMBER: 49707 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. ADDL SUBR POLICY EFF POLICY EXP ILTR TYPE OF INSURANCE wV0POLICY NUMBER MM7DDIYYYY IY MWDDYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE OCCUR -,RENTED PREMISES(Ea gccurrencel $ MED EXP(Any one person) $ WA PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑J Re LOC PRODUCTS-COMP/Op AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLELIMIT $ Ea agddart) ANY AUTO BODILY INJURY(Per person)ALL $ AUTOS OWNED SCHEDULED AUTOS N/A N/A BODILY INJURY(Per accident) S WNED HIREDAUTOS AUTOS PROPER AMAGE $ Per accident $ UMBRELLAUAS OCCLIR EACH OCCURRENCE $ EXCESS LIAS CLAIMS-MADE N/A AGGREGATE $ DED I RETENTION$ WORKERS COMPENSATION PER pT"_ $ AND EMPLOYERS'LIABILITY YIN X TATUTE ER A OFFICEWMEMBEREXCLUDED?XECUTIVE WAI NIA NIA 6S60USOG34071815 09/22/2015 09/22/2016 E.L.EACH ACCIDENT $ 100,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 ff yyes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 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.govAwdANorkers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Crape& Island Tire ACCORDANCE WITH THE POLICY PROVISIONS. 730 Bearse's Way AUTHORIZED REPRESENTATIVE Hyannis MA 02601 Daniell RA CS ro v ey,CPCU,Vice President—Residual Market—WCRIBMA 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD TOTAL P.02 Stephen Fowler Phone:(508)539-3307 Cell:(508)221-8052 ��" �" �� _ Fax:(866)250-1738 j c�rn�V1 shadystevel@verizon.net Scuet 1,A'Auttev o Jonathan Bourne Dr. UnitM CAPE COD RETRACTABLE SCREENSNSHUTTERS,LLC 1 c I Pocasset, A02559 www.screensNshuners.com $ Te. sc i e �c cL. -� 7nP rn1- W' gs r!]ANTpW 4�oolrolt I QM/ :-7 3--) -3-7 3-7 3-7 3-7 77-7 1 3-7 3-7 -7 /y - fir— �� 7I o"n cm jecco all Tr-pq x (7i- 1vAv) i 2c= ��- - f ow( ' � CIO - �. ft • • CUSTOMER PERMIT No. DRM BY DATE: MATERIALS APPROVED BY LOCATION: P.Od REVISIONS: SCALE This is an orgmal tnpt>3lished draumg,seated by Plymadh Sign ConnpanK Inc.N is stAxrulted for yaa personal use in connection vxth ffx proiect being planned for by RymoA Skp Company,htc It is riot to be drown to anyone outside you argarr¢ation,nor a d to be used reproduced,copied or eztidted yr any ta�ian whatsoever.lU ar arty pzrfs of tfis destgn(except%gr t tiered bademarhs)rerun property of Plw 5c,P Company,trfc. Charge for design wilhotit pemus ion of Aymouth Sign Cmrpary,Ilnc is S5�t BRACKETSHARDWARE BRACKETS SKU:AWG-UAB-1 Zinc Short Leg Z-Bracket g SKU:AWG-UAB-11 L B_ Zinc Medium Leg Z-Bracket SKU:A1VCs-UA8-11 Lar- Zinc Long Leg Z-Bracket b SKU-.AWG-UAB-SEC Zinc U-Bracket G E SKU:AVVG-UW T{.-11 Zinc Large Weld Tabs A B C Width Length Thidmess F ,SKU:AWCrUWTS-11 AWG-UAB-11 15" 1" .87' 15, — %, Zinc Small Weld Tabs g AWG-43AB-11L 2.46' 1" .71" 15' — }�^ AWG4JAB-11L2 3.25" 1" .71' 15' — }g G SKU:AWG-MI6 A AWG-UAB-SEC - - - 1s" ZaS• W Aluminum Short Leg Z-Bracket AWG-UWTL--11 - - - .75" • AWCrUWTS-11 - - - .75" AWG-M16 1.75" - - .75" 15' Ya' TM o Afumnum Bracket System for Signs&Awnings Bu F. llcl or.. Awning and Sign Frames WlT#-1QUTiNELp1Rt61 - _ - �"E Town of Barnstable Regulatory Services ` M `s ` Richard V.Scali,Director 659. �� Building Division. Paul Roma,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 If Using A Builder I. / dhex) Qo,,J , as Owner of the subject property hereby authorize e' PP C-,,j A M�ac14 Or to act on my behalf, in all matters relative to work authorized by this building permit application for: 30 (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or-utilized before fence is installed and all final inspections are performed and accepted. 'Signature of Owner Signature of Applicant le " 4 Print Name Print Name - 40 Date QTORMS:OWNERPERMISSIONPOOLS - I Town of Barnstable ` Regulatory Services oFtHWE rgyr Richard V.Scali,Director Building Division . t 181ABIX ` Paul Roma,Building Commissioner MAss. 039. 200 Main Street, Hyannis,MA 02601 Fv www.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 4 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 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 a ° w ` } (� \s \ (� �/ � ,. N:i I I GL7 1,4P� �avNc�95�.Ale 7`� °F"ME T° Town of Barnstable Regulatory Services d/f/s V"2/- ' $" MAS& Richard V. Scali Director Building Division $ Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www,town.barnstable.ma.us N of B Office: 5008-862-4038 Fax: 508-790-6230 Permit# Building Official approving RR Application for Sign Permit .Applicant- L- R 13 ,N G — Assessors No. Doing Business As: Cr9pE I5 IAndS 1 ► r2 Telephone No..("-D Sign Location Street/Road: 7.3 0 1' !q rS e 5 LA)A y V 19 dlel, S tl 0 P-6 d f Zoning District-- Old Kings Highway? Yes/No Hyannis Historic District? Yes/No Property Owner i ` 11 / Name: G i l b e-r+ W O D U Telephone: l 6 9 7 3-7' i 9 3 3 Address: '14 y G e19r s e s iJJ�,y Village: Sign Contractor i Name: c _AoP C>d R2��ra�t��l� Telephone:-(so S 39 -3 -7 Mailing Address: q �p,�a��a✓1 1,D y Y r ram. } Z Po G A SAC.r/AA a SS 1 Description Please follow the cover directions.You must have an accurate rendition of sign with dimensions and location. Is the sign to be electrified? Yes (Note:Ifyes, a wiringpermitisrequired) Width of building face _fL x 10= 0a0 x.10=_/09 Check one Reface existing sign or New�_Total Sq. Ft. of proposed sign (s) Ifyou have additional signs please attach a sheet listing each one with dimensions If refacing an existing sign please provide a picture of the existing sign with dimensions. I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of §240-59 through§240-89 of the Town of B stable Zo ' Ordinance. Signature of Owner/Authorized Agent: Date 3 / SIGNS/SIGNREQU revised110413 °FIHE r Town of Barnstable Regulatory Services EARN 9 _ Mnss Richard V. Scali,Director i639n. �0 �Fo�+a Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 50,8-790-6230 SIGN PERMIT REQUIREMENTS 1. Aphotograph showin the exist ing facade on which has been indicated the proposed g g � P p sign location. The photograph is to include a portion of adjoining stores or building. For a proposed building or new facade, an architect's elevation may be submitted in . t lieu of a photograph.: 2. A scale drawing of the proposed sign. A scale drawing indicating: 1).-The type of proposed sign(wall,hanging,+free standing) ` 2) Dimensions of the proposed sign and any designs, logos, or lettering 3) A cross-section with dimensions showing edge detail. Minimum scale 1"= 1'. Minimum sheet size, 8.5 x 11". 3. A scale drawing of the bracket. A colored scale graphic indicating dimensions, showing colors, materials and method of affixing it to the sign and to the building. Minimum scale 1"= 1'. Minimum sheet size, 8.5 x 11". 4. A completed Town of Barnstable Sign Application, including scaled diagram showing location of sign on building or location of free-standing sign. Show dimensions. . 5. The width of the building face or the leased area. NOTE: the map/parcel number is required on the application. SIGNS/SIGNREQU revisedl 10413 a �� ('1 i• L� ?i k .� � j r j 3 al_ ?ra n e pp i€a� �p X� •� r � 10 t � jj °'NO CD co N co CD Q ; c) C7 O w ad'"s h a a e _wn> i aai;aaa 'u l N) O {� —1 CN71 O z V7 N �'�' 00 `C C) 00 C) J a IV3 C3= �p CUSTOMER PERMIT No. DR MN BY DATE: MATERIALS P.R w BY LOCATION: P.D_` REVISIONS: 11VE his is an or at uip .s d drawkA created by Flymoutlt Sam Gargta.ry)nc R,is s lfed fa you pe satJ its in corxrectiar with lie Jxoect berg ptarned to by Pt3Ten�dt n CcvrWY.W-It is W.,to be sh m to ampm oubz•.+e you aganaatwn,nor is it to be G.ed reproduced,cgxed a exhe5;ed n arry faction vfiatsoeuer.At!a arty pads of U'is tPxC�Lvr reg�*aed hademarkst rcma'rt Property of Poym"Siqt Cttino sm,hc. C cuye for de;�g vrithwt petrel m of Plymouth Sign CmWarryry,Tnc s SSOCt. �tME Sign TOWN OF BARNSTABLE Permit MASS. 9�or16 9.�p Permit Number: Application Ref: 20062230 20060030 Issue Date: 08/02/06 Applicant: WOOD, GILBERT C, TRUSTEE Proposed Use: IND/COMM Permit Type: SIGN PERMIT Permit Fee $ 125.00 Location 730 BEARSES WAY Map Parcel 293002 Town HYANNIS Zoning District B Contractor PROPERTY OWNER Remarks Reface 3 exist signs (2) 4' x 18' Michelin (1) 1 X 3 Michelin no change in sq ft Owner: WOOD, GILBERT C, TRUSTEE Address: 730 BEARSE'S WAY HYANNIS, MA 02601 Issued By: PC POST THIS CARD SO;THAT IS VISIBLE FROM THE STREET t b � i ��. \� I �\ I � I �. i �t►+E r ', ,: ::, , £ E Town of Barnstable Regulator 8: i g y Services 1AiNSTABI:E: • , Muss, g Thomas F.Geiler,Director 0 39. Building Division ------Tom Perry, Building Commissioner 206 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit# Application for Sign Permit Applicant:—___1 _ QQZ __—____—___—___--Assessors No.__-2q3 ;')_ Doing Business As:—e StLCO -Telephone No._R5__CQ(6-(, Sign Location 1 t StreeVRoad• ------- - --C2, , F QQ �----------------------_ _ Zoning District:_—v_-_Old Kings Highway? Yes I0�Hyannis Historic District? Yes No o Property Owner Name:-------- �� Sd a3P� r£F p Address:-------- af- S �s a-A �--�__�tl�__ _Village: 'k� --- Sign Contractor Name: ---Telephone:kJym�.. �i _ Gar! (d -- Telephone: _0 -Q 7a l Mailing Address:— W) Y`NUA _c_� , MQAz,(1 MA -- 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/No. (Note: If yes,a wiring permit is required) ?A0V L �a5'X SSuv FZEP AU 1VG Width of building face ft.x 10=_ x.10= /dl� I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of§240-59 through§240-89 of the Town of.Barnstable Zoning Ordinance. Signature of Owner/Authorized Agent: Date: Size: --------------------- --------—------Permit Fee: Sign Permit was approved:__---_-----_--- Disapproved:______ SIGNS/SIGNREQU — — ^ter r t#9 RE; $ -�-S(Lv��S TI 6�E ' r i � y t � 0 yV7A ct 12 - i 1 Survey ID M07120 �' Office ID 1014458 Cape Islands Tire Co Inc 730 Bearses Way Hyannis MA 02601-2258 8-nt �rd g SITE BRANDBOOK no r. im { R f � a u, Y g 3 5 Point,. INVENTORY & RECOMMENDATION DETAIL SurveytD M07920 OffetD� 104458 A4, Pape Islands Tire Co Inc 730 Bearses Way En V 1 " ' Hyannis,MA 02601-2258 Siqn Text Michelin ;—; Existing Sign Description P Ion Sign Y n-- >, s 1 ;.1 4- 18- N/A Letter Height OAH abovegrade N/A N/A S' Material Face Material ign Plex AluminumVisible Opening Retainer Size e N/A N/A N/A N/A ... N/A Yes Internal N/A Double Face mount No Single Pole/ TBD • TBD • To Be Determined To Re N/A mom • TBD N/A C INVENTORY.7777 RECOMMENDATION DETAIL • fl �yrvey ID: M07320 Office ID 101445$ �� R � Cape Islands Tire Co Inc ' 730 Bearses way. Hyannis,MA 02601-2258 Sign Text Existing Si gn Description k i�'Wj� €� t �¢aro�r�t Height • • t 4' 18' N/A n 4 N � s LetterHeight • ' grade •• - � NIA NIA Face Material Sian Material u k Plex Aluminum N/A N/A S�itace Mat-eria I- Surface Color N/A N/A n NIA Illuminated Illuminated Type Inventory Comments Yes Internal N/A Double No Flush-Wall Kecommended Action TBD .ed Sigm TBD • To Be Determined To ft N/A • TBD N/A INVENTORY & RECOMMENDATION `DETAIL 1 .0 Sign Text Michelin Existing Sign Description . ,_. . ". ... .. Hanging :. :._ �a� �* Height Width Depth m ._...._ Letter Height OAH above grade` & ° Face Material Sign Material , � ar LU v.r, Visible,Opening Retainer Size Surface Material Surface Color , Available Height Available Width � � Illuminated Illuminated Type Inventory Comments Double Face Mount` Recommended,Action Recommended;Sign;Type 2 Sign Type Description ' Be Determined 0 Wall Repair Action14 W jx;> c ,Sgnage'Text O � V W I �li Recommendation Comments I Official Website of The Town of Barnstable -Property Lookup Page 1 of 4 �i Select Language j Assessing Division Property Lookup Results - 2015 367 Main Street,Hyannis,MA.02601 <<BACK TO SEARCH < ( Print Friendly Owner Information - Map/Block/Lot: 344 / 003/ - Use Code: 3260 —� Owner Owner Name as of 1/1/15 DUBIN,RICHARD S TR GAS MAPS f Map/Block/Lot !v 730 BEARSES WAY 344/003/ ! Property Address ` NIS,MA.02601 FFi-t \477 YARMOUTH ROAD Co-Owner Name C/O GILBERT C WOOD \, Village:Hyannis run Town Sewer At Address:No GIS Zoni , u�:B Assessed Values 2015 - Map/Block/Lot: 344 / 003/ - Use Code: 3260 2015 Appraised Value 2015 Assessed Value Past Comparisons Building Value: $484,900 $484,900 Year Total Assessed Value j Extra Features: $900 $900 2014-$717,400 2013-$718,500 Outbuildings: $25,400 $25,400 2012-$590,100 Land Value: $205,200 $205,200 2011 -$546.100 2010-$547,200 2009-$552,200 201 5 Totals $716,400 $716,400 2008-$612,200 2007-$612,200 f AI� Tax Information 2015 - Map/Block/Lot: 344 /003/ - Use Code: 3260 Taxes Hyannis FD Tax(Commercial) $2,579.04 Fiscal Year 2015 TAX RATES HERE Community Preservation Act $180.53 /� Tax 6uf— d Town Tax(Commercial) $6,01 7.76 $ 8,777.33 - j Sales History-Map/Block/Lot: 344 / 003/ - Use Code: 3260 History: Owner: Sale Date Book/Page: Sale Price: DUBIN,RICHARD 5 TR 1997-01-22 10577/282 $277000 f TSOLERIDIS,DEBORAH A TR 1996-12-26 10542/276 $200000 l�� MERE,MARIO B TR 1982-10-25 3590/199 $128000 Photos 344 / 003/ - Use Code: 3260 I _j 0-77 f�� I Sketches -Map/Block/Lot: 344 / 003/ -Use Code: 3260 http://www.townofbamstable.us/Assessing/propertydisplayscreen l 5.asp?ap=0&searchparce... 9/8/2015 YOU W ISH TO OPEN A BUSINESS? ForYourhfmm atim: Busiiess cerEcates (cost$40 .00 f=4 years).A business certifcate ONLY REGFTERS YOUR NAM E in town 0hsh�,ou mustdobyM G L.-tdoesnotgieyouperin ssinntDcperate.) You must first obtain the necessary signatures on this format 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA.02601 (Town Hall) and get the Business Certificate that is required by law. DATE: f I i Z FJIU-1 p_aAN se APPLICANT'S YOUR NAM E/S: �DJ 6 I�S J'ci V� G A iA p s BUSINESS YOUR HOM EADDRESS: t FA�✓wr4-y 7) Ti V 2 one 13 TELEPHONE # Hom e_Teaphone Num ber �,� / - G 12 NAM E.OF CORPORATDN : L fk8 �•'1C _ NAM EOFNEW BUSINESS_ �qn_¢ /s_/gna�S_ 7,r_e _ - �- TYPEOFBUSINESS 7 , - IS THIS A HOM E OCCUPATDN? YES NO _✓ a ADDRESS OF BUSINESS e ✓- s UJ ��trvSAj 0. G• ' M AP/PARCELNUM BER Z l 3 -O O V assessing) W hen startiig a new business there are sezeralthiags you m ustdo is ordertD be in com plane w-th the rubs and reguhtins ofthe Town of Bamstaba. This fDrni s intended tD assstyou in obtaining the inform atbn you m ayneed. You M UST GO TO 2 0 0 M an St.- (coinerofYarm outh Rd.& M ail Street) to m ake sure you have the appropriate perm is and 1- enses required to agaIlr'operate y�urbusiness in this town. 1 BUILDING COM ISSD R'S OFFICE Ths indiril s (any enzn requaem is that ertain to tins type ofbusiaess. ry u rid Signature* c COM M EN 2 BOARD OF HEALTH This iadirdualhaslIbe rm•ed ofthe peen trequaem ents thatpertaia W the type ofbushess. MUST'A,OMPLY WITH ALL l_ F'lt r \/I v I :?A7ARDOIJS�AATRRVA1 c Authored Si3nature* COM M EN TS 3 . CONSUM ER AFFAIRS (LICENSING AUTHORITY) This indirdualhas been inform ed ofthe livening requaem ents thatpertah tD the type ofbushess. Authored S#lature* COM M EN TS 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 the Town (WHICH YOU MUST DO according to 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, I" FI., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required by law. Fill in please: DATE r APPLICANT'S YOUR NAME/CORPORATE NAME AN INESS TYPE: , BUSINESS YOUR HOME ADDRESS: I I TELEPHONE # Home Telephone Nurqber NAME OF NEW BUSINESS vlJar CDHave you been given approval f the building divisi n? YES N ADDRESS OF BUSINESS "7 J9�L �,V19-� t MAP/PARCEL NUMBER Z� When starting a new business there are several things you must A 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 ini& mation you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropri a permits and licenses required to legally operate your business in this town. CA,0 Acm � A4e9 2i Al e- 1. BUILDING CO SSIO R'S OFFICE This individ alT. utk n Wsr d?�Jpjemit requirements that pertain to this type of business. rized Sin �l ��(' Z_ MNTS: —- j S i al 44 2. BOARD OF HEALTH This individual has bee ormed of the per equire is that pertain to this type of business. u ized Signature"* MUST ;;OMPLY WITH ALL COMMENTS: HAZARDOUS MATERIALS RFm It r+nn 3. CONSUMER AFFAIRS (LICENS G AUTHORITY) ' This individual has C!"�n.infWktt licensing requirements that pertain to this type of business. Authorized S' ure*'` -A Ll COMMENTS: 5 _0Oe� 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 th'e` ' Town (WHICH YOU MUST DO according to 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, I" FI., 367 Main St., Hyannis, y MA 02601(Town Hall) and get the Business Certificate that is required by law. z... Fill in please: DATEt APPLICANT'S YOUR NAME/CORPORATE NAME INESS TYPE: Aft- BUSINESS YOUR HOME ADDRESS: 1 1 TELEPHONE # Home Telephone Nu Ober NAME OF NEW BUSINESS.' i'a- i6d.- Have you been given approval f the building divisi n? YES N ADDRESS OF BUSINESS '? MAPIPARCEL NUMBER C? • <-\-j When starting a new business there are several things you must dd in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you,in ob taining � y g the in mation you ma need. You MUST _Y Y GO TO 200 Main St. (corner of Yarmouth Rd. & Main Street) to make sure you have the appropri a permits and licenses required to legally operate your business in this town. C,q LJi is 2-- ACM 4 /Lf 4 24 AJ e 1. BUILDING COM SSIO RX OFFICE This individ al h s n r d an pe mit requirements that pertain to this type of business. ��-1 7 ut rized Sin MMENTS: pal _ JUJAJ 2. BOARD OF HEALTH This individual has bee ormed of the per equire is that pertain to this type of business. t u ize Signature'* MUST ,OMPLY WITH ALL COMMENTS: HAZARDOUS MATFRRIALS Ri= -1 11 in,,, 3. CONSUMER AFFAIRS (LICENS G AUTHORITY) This individual hasCqlen inf r e e licensing requirements that pertain to this type of business. - Author'zed S, ure** L COMMENTS: 5 rJ YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 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.) Business Certificates are available at the Town Clerks Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: / Z/ /e Fill in please: APPLICANT'S YOUR NAME/S: M 6ND BU INE S_ YOUR HOME ADDRESS,�?z��'� T—evr+�l�S ik ''` TELEPHONE # Home Telephone Number _/ NAME OF CORPORATION: NAME OF NEW BUSINESS °t? 1 YPE OF BUSINESS IS THIS A HOME OCCUPATION? YES O ADDRESS OF BUSINESS MAP/PARCEL NUMBER a��3 O�� (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. P 1. BUILDING COM ISSIO ER'S OFFICE This individ-al h n infar e any permit requirement s that pertain to this type of business. Jul uthorized Sig ature* COMMENTS: �'" 2. BOARD OF HEALTH _ This individual ha inform e per it requirements that pertain to this type of business. Authorized Whature KWCOMPLYWIVIALL COMMENTS: ONS 3. CONSUMER AFFAIRS (LICENSING AUTHO ) This individual h en inf 'of the i n requirements that pertain to this type of business. � Auth=dSignature** / ( � J -zOl 0 COMMENTS: y 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 the Town (WHICH YOU MUST DO according to M.G.L. - it does not give you permission to operate). You must first obtain the necessary signatures orfthis form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st Fl., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required by law. �` Fill in please: DATE tt APPLICANT'S YOUR NAME/CORPORATE NAMEa�1A�1� INESS TYPE: Z BUSINESS YOUR HOME ADDRESS: 1 TELEPHONE # Home Tele hone Nu er NAME OF NEW BUSINESS �,a' Have you been.given approval f the building� divisi n? YES N ADDRESS OF BUSINESS '7 �� LVV�1 �l MAP/PARCEL NUMBER— When 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 COMISSIO R'S OFFICE This individ alWnWor d an pe mit requirements that pertain to this type of business. zed Sin �91VIMENTS: AIX04 ,q _ At S , r 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 (LICENS G AUTHORITY) This individual has&n.infft2 he licensing requirements that pertain to this type of business. - Authorized S& u e** ` COMMENTS: 5 -�j Ct? GEORGE BUTLER ADJUSTERS, INC. APTUSTERS FOR INSURANCE COMPANIES P.O.Box 710120 .Quincy,Massachusetts,02171 (617)-479-2619 Springfield,MA. Pittslickl,MA. Worcester,MA. Hartford,CT. SO. Eastem,MA. (413) 781-2897 (413) 442-6328 (508) 754-4100 (860) 525-9034 (508) 758-6633 Fax# (617) 479-1740 l E-MAIL buticr.ad0dic-spa.com Building Commissioner Board of Health or Town Hall Board of Selectmen 367 Main Street 200 Main Street Hyannis, MA 02601 Hyannis, MA 02601 Attention: Records Attention: Records COMPANY: Lloyd' s of London POLICY NUMBER: QMP0713267 INSURED: Gilbert C. Wood ETAL LOSS LOCATION: 730 Bearse ' s Way, Hyannis, MA DATE/LOSS: 12/12/07 DESCRIPTION: Property OUR FILE NUMBER: MAT14468 Gentlemen: Claim has been made involving loss, damage, or destruction -of the above captioned property which may either exceed $1 , 000 , or cause . Massachusetts General Law, Chapter 143, Section 6, to be applicable. If any notice under Massachusetts General Law, Chapter 139, Section 3B, is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, company claim number, date• of loss, and claim or file number. .Very truly yours, iamulattagli o Adjuster C-5 c M On this date, I caused copies of this notice to be sentzbo the-324-persons named above at the address indicated above, by first class< nail .- cc v� > ca Secretary ca May 11 , 2009 NUMBER FEE 7 THE COMMON TH OF MASSACHUSETTS $150.00 TOW O F BARNSTABLE AGENT'S OR SELLER'S LICENSE - CLASS II f TO BUY AND SELL SECONDHAND [MOTOR VEHICLES In accordance with the provisions of Chapteel40'o,,the GeneraILaws with amendments thereto ---------------------- e r. Raymond G Blackburn "DBA Blackburn'sAutoSales ................_------------- ------------ -_-_---___- -- --------- ------------- ------ --------- - is hereby licensed to buy and sell second=hand�n'o.tor vehicles --------------- --------- -'730 Bearses Way Hyannis,;, w. ----- ----------- - - - on premises described as follows: Paved parking area, office, two (2) repair bays IS cars for sale; total_of I8 spaces--- ------------- ----___-_• -_ ---_--..---__-. ---------------- -------- --------------- RESTRICTIONS: _--___-_---_--- No_more-thaSnre-g le -c~n' tmtay oneWPldfgrto_Gilbert C_Woo ............ ttered vehics h _ n_ ge --- ---- d/b/a Cape Wide Auto & Zartiie - --- ----•---- -- -- ------------------ ------ --- z -•6 h, ----- -------------- Wow�� Issue Date: October 26, 2009 '•• �,Signed: ..................... . .... . ....... ........ -------- ------------- ....... THIS LICENSE EXPIRES: December 31, 2009 THIS LICENSE MUST BE POSTED IN A CONSPICUOUS PLACE UPON THE PREMISES. s TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. Map Parcel Application#. Health Division Date Issued Conservation Division Application Fee 1 V Tax Collector Permit Fee Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address ''__-- �QiYSe S lXJ Village Eta i Q n h I-S Owner G i I W o o Address 13e--a-�e.S W w t 14-1a n s7i�J Telephone 5c� 1-75 -60(0G Permit Request Q n ct r-e- d n Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation' (0 9000 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 k 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 Sze Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: 9CpA `t1 r ffi. Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ - Commercial -❑Yes - ❑No—_ If yes, site plan review# Current Use Proposed Use /� BUILDER INFORMATION Name I'f I li UFC k, l �"/riS' nt(,f t V2— Telephone Number Address 56 L15A EAPE License# 'bAM5 JA6L A Home Improvement Contractor# Worker's Compensation# LU C a a 4�&tb ff ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO�,39-`A w4-&—/e J16-ln/. i SIGNATURE DATE I I FOR OFFICIAL USE ONLY Y _ APPLICATION# DATE ISSUED MAP/PARCEL NO. I , ADDRESS: VILLAGE t , OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT - ASSOCIATION PLAN NO. , i ,r t � 1 The Commonwealth of Massachusetts ' Department oflndustrialAccidents Office of Investigations IMPORTANT 600 Washington Strut SEPARATE PERMIT IS R_QUIRED FOR THE INSTALLATION ° OF SMOKE DETECTORS - FIRE ALARM INSPECTIONS ARE Boston,MA 02111'PERFORMED BY THE FIRE DEPARTMENT HAVING JURISDICTION. www.mass.gov/dia 'PERMITSAREAVAILABLEAT200 MAIN ST,HYA.NNIS,MA. Workers"Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plumbers Applicant Information I Please Print Le ibl Name(B /In usiness/Organizationdividual): OA kC ,-Co CAL- :5 r� 'Uyn •Address: J U..5 a • Lan-c, �mS -- Phone.#: �O� —1T5—T7(v� • City/State/Zip: . Are you an employer?Check the appropriate box: Type of project(required):. 1. I am a employer with 4. I am a general contractor and I _ 1_ 6. ❑New construction . employees(full and/or part-time).* • have hired the sub-contractors listed on the'attached sheet. 7. ❑Remodeling 2.❑ I am a'sole proprietor or.partner- These sub-contractors have ship and have no employees 8. ❑Demolition employeeg and have workers' 'working for me m any capacity. t, 9, ❑Building addition [No workers' comp.insurance comp,insurance. 5 We are a corporation and its 10.❑Electrical repairs or additions r ,required.] ' 3.❑ I am a homeowner doing all-work . officers have exercised their It.❑Plumbing repairs or additions ' myself,[No workers'comp. right of exemption per MGL 12,0 Roof repairs insurance.required.]t c. 152, §1(4),and we have no ] employees. [No workers' 13.❑ Other comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners.who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating'such. $Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must providt:their workers'comp.policy number. I ant an employer that isproviding workers'compensation insurance far my employees. Below is.thepoCicy and job site information. Insurance Company Name: Yl l � ✓ l�(� Policy#or Self-ins.Lic,#: �A�O �. � Expiration Date: Job Site Address• lbo l�Ct/) City/State/Zip `n'S 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 maybe forwarded to the Office of Inv esti ations of the MIA for insurance coverage verification. I do hereby certify i . e pain nd penalties of perju�that he information provided abov�Utr.ue an'd correct. Si afore: Date: _ Phone#: rOfficialonly. Do not write in this area, tb be completedbycity or town official n:' Permit/License# Issuing Authority(circle one): -1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Phone#: Contact Person: 12/10/2007 14:07 508-790-0249 GOLDMAN & ASSOC. PAGE 01/01 �sICORD CERTIFICATE OF LIABILITY INSURANCE csR A9 DATEIMIMOWYYY) ;iITCH50 1 12 10 07 PRODUCER THIS CERTIFICATE IS IS ED AS :t MATTER OF INFORMATION GOLDMAN 6 ASSOCIATES INSURANCE ONLY AND CONFERS NO RIGHTS JPON THE CERTIFICATE FINANCIAL SERVICES INC. HOLDER.THIS CERTIFICATE DOE.3 NOT AMEND,EXTEND OR 933 FALMomw RD. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. HYANNIS MA 02601 — Phone., 508-775-6010 Fax:508-790-0249 INSURERS AFFORDING COVERAGE _ NAIC0 INSURED INSURER A! I;RJ1ITE STATE :.N!)iJAANCE CO INSURER 0: HITCHCOCK CONSTRUCTION INC INSURERC: WESTIBARN9�TABLE MA 02668 INSURER D: INSURER F,: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR INS POLICY PERIOD INDICATED.N0-;ITHSTANDING ANY RCOVIRF,MENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 1 SUM OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDIT.TN:I OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR R P F•SU C r POLICY NUMBER GATE fAMIDD DATE MMIDjFW _ LIMITS GENERAL UABILlTY EACH ICCURRENCE t COMMERCIAL GENERAL LIABILITY PREM SES(VA o umwg9) a CLAIMS MADE n OCCUR MED I (P IA^Y eno prawn) i _ PERS,'NA'.S ADV INJURY 6 GENE-AL AGGREGATE S _ 43EN'L AGGREGATE LIMIT APPLIES PER! PROD CT'!•COMP/OP AGG S POLICY _ JECT 7 LOC — AUTOMOMLE LIABILITY COMB JEII SINGLE LIMB ANY AUTO (ea ft.d"4) S ALI.OWNEO AUTO 9 BOOIL 'INJURY BCHEOULKDAVTOS (Perol 'eon) 3 HIRED ALTOS BODR IN IURY 8 NON-OWNEOAUTOS (Pere, Jderd) PROP RT'DAMAOE S (Per a ldom) GARAGE LIABILITY AUTO INL Y•EA ACCIDENT S ANY AUTO EA ACC 6 - OTHEI THAN AUTO INLY� AGO I EXCFSSIUMBRELLA LIABILITY EACH ICCURRENCE I OCCUR fl CLAIMS MADE AOGR GAGE S s DEDUCTIBLE - s RETENTION t S WORKERS COMPENSATION AND - rl TI•C 7= ER A EMPLOYERS'LIABILITY ANY PROPRI6TORIPARTNERIEX£CUTNE *#WC2246868 03/28/07 03/28/09 E,L.FJ I'm 4CCIDENT F 100000 -. OFPICER/MEMBEREXOLUDED9 E.L.DI EA3E-EA EMPLOYEE $100000 t1 Yoe do:e ibc under 6�EGIIAL PROVISIONS below E.L.01 EASE•POLICY LIMIT S 500000 OTHER DESCRIPTION OF OPE-RATIONS l LOCATIONS/VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT)SPECIAL PROIVWMS CERTIFICATE HOLDER CANCELLATION _ TOWNOFB SHOULD ANY OF THE ABOVE DESCRIBED PO IC AM BE CANCELLED 99FORB TH6 EXPIRATION DATE THEREOF,THE 1BSUING I98URER WILL ENLEAVOaTHEINgURFA rD DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAME 1 TI I THE FAILURE TO DO 30 SHALL TOWN OF BARNSTABLE IMPOSE NO oeuoA R u 1;Y AN P UP ITS AGENTS OR 200 MAIN STREET REPRESENTAIWES. — HYANNIS MA 02601 AUTNORIxE0REPRESE IANN LOUISE BELANGER _ ACORD 25(2001108) 0 ACORD CORPORATION 1988 i 55 LISA LANE 1211212007 - WEST BARNSTABLE MA 02668 (508)775-7763 f UCHCOCKt.- CONSTRUCTION . CAPE AND ISLANDS TIRE ATTENTION:GEL WOOD TEL:775-6066 730 BEARSES WAY FAX: 508-790-2311 HYANNIS,MA 02601 JOB NAME:CAPE AND ISLANDS TIRE 730 BEARSES WAY,HYANNIS WE HEREBY PROPOSE TO SUPPLY ALL MATERIAL AND LABOR TO DO THE FOLLOWING: • REMOVE AND DISPOSE OF EXISTING TAR AND GRAVEL ROOF. • INSTALL 1" ISO INSULATION. • INSTALL EPDM MEMBRANE ROOFING(TOTALLY ADHERED). • REPLACE ANY ROTTED PLYWOOD AT$1.00 PER SQUARE FOOT. • REPLACE ANY ROTTED FASCIA BOARD AT$5.00 PER LINEAR FOOT. • ALL DUMP FEES INCLUDED IN THIS QUOTE. WE HEREBY PROPOSE TO FURNISH MATERIAL AND LABOR IN ACCORDANCE WITH THE ABOVE SPECIFICATIONS FOR THE SUM OF TWENTY ONE THOUSAND NINE HUNDRED DOLLARS($21,900.00) BASE RATE:.$21,900.00 PAYMENT TERMS: DEOPSIT OF ONE THIRD DUE AT ACCEPTANCE OF PROPOSAL, PAYMENT OF ONE THIRD DUE AT HALF-WAY POINT AND ONE THIRD BALANCE DUE UPON COMPLETION. ACCEPTANCE OF PROPOSAL:THE ABO CES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY HERBY ACCEPTED.PAYMENT WILL BE MADE AS OUTLINED ABOVE. i SIGNATURE OF CONTRACT O DATE: �) SIGNATURE OF CUSTOM DATE ;? i i . . . . . . . . . . . . . . . . . . . . V _ �ti SEPTIC SYSTEM MUST BE Assessors ma and lot number 9 .. ...,� INSTALLED IN COMPLIANCE c• p " "' WITH ARTICLE II STATE SANITARY CODE AND TOWN , Sewage Permit number ....... ...` ................................... _ RE 61�1GU ATI S. - Mll�)-1-7--S C. o`T"Er°� T®WlI OF BAR.NSTABLE i EAHISTADLE, i y 1639. r BUILDING .- INSPECTOR APPLICATION FOR PERMIT TO .............................................. TYPEOF CONSTRUCTION .. .� .................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to'the ,following information: Location .1.U.�. .1�.�......r�... sfS.. ... .... N� ... .a........................... ................................... ProposedUse .....1./.ef.....��Nhx............................................................................................................................... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner ..KU�dQ�..............................Address ............................................ c1Gd. 4I1&16/iAddress,( ( .. Is ...... ...� ...IU fAI � AvName of Builder j�L... ....... ( ,/ :. Name of Architect ............. �r�f.l'�...... v.........................Address ............, f it C Number of Rooms Foundation ............... �� &,4 .................................................................. ........................................ / �QN Roofing � VC.,Exierior ......................................... ....................................... ........................`................... ........................................ Floors ................... . ..... ..........................� .....Interior ................ ................................................................. 47' lte FL c t ........ ..... ..... ........................... P_lumbing .........................Heating .............. mo ... r ................................�/ 4�0 �-- Fireplace ....................... .......................................Approximate Cost ..........................!..................a ................. �g®V 41 Definitive Plan Approved by Planning Board ---------------____-----------19________. Area ..................... .®.... Diagram of Lot and Building with Dimensions Fee .................... SUBJECT TO APPROVAL OF BOAR OF HEALTH Q 7, �k I hereby agree to conform to all the Rules and Regulations of t own Barnstable ar.' ove construction. a ............`.. ` .. . ......? ......... .... ... ................... - � J