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HomeMy WebLinkAbout0276 FALMOUTH ROAD/RTE 28 (8) t I r i S mot . Sign TOWN OF BARNSTABLE Permit ' * BARNSTABLE, MASS. � 16 9. prFG A� Permit Number: Application Ref: 200705411 20070087 Issue Date: 09/06/07 Applicant: BORNSTU LIMITED PARTNERSHIP Proposed Use: SHOPPING CENTER- MALL Permit Type: SIGN PERMIT �-- /� Permit Fee $ .00 00 7 Location 276 FALMOUTH ROAD/RTE 28 Map Parcel 293031 Town HYANNIS Zoning District H B Contractor PROPERTY OWNER Remarks TEMPORARY SIGN 70 SQ FT SPIRIT HALLOWEEN SUPERSTORES Owner: BORNSTU LIMITED PARTNERSHIP Address: 297 NORTH ST HYANNIS, MA 02601 Issued By: SS !POST THIS CARD SO THAT IS vISIELE FROM TIDE STREET l Town of Barnstable FTHETgk�� Regulatory Services ' " ;j 13, ; 1-ALE Thomas F.Geiler,Director ?�o, * I''MASSB ' ` BuildingDivision BUG �'DtFa39.tA Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit# © .Q 670 7 �� Application for Sign Permit 1 Applicant ,® �&///jj &O LY&�zo,/s Zale Map& Parcel# Doing Business As: �Q Telephone No SGV-7 7/ —Z1c) ,c1 O Sign Location s Street/Road: ;;?•76 /n0e17-t/ oeD JI.Y.,41✓I✓/1 , I7-).4 4>2,60 Zoning District: Old Kings Highway? YesA"yannis Historic District? Yes Property Owner Name: ST",o91Z r 6eAn/ r—elxi/ Telephone: vZ-OS 73/4 Address: a 97 ,vorr rN --c Village: Sign Co ntr ctor / Name: p d Telephone: JO S Mailing Address: Q/ 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? Ye(5 (Note:Iftyles, a wiringpermit is required) Width of building face Iq t. x to= r�l U x.lo=V Sq.Ft.of proposed sign 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:,e � Date: Permit Fee: Sign Permit was approved: Disapproved: Signature of Building Official: Date: In order to process application without delays all sections must be completed. Q:I WPHLESISIGNSISIGNAPP.DOC Rev6/5/07 Let's Party Cape.kIslands. 276 Falmouth Rd. ( Rte. 28 Hyannis, MA 02601' 4 20 / w w o - i 1 A !' The Commonwealth of Massachusetts Department oflndustrial 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 (Busiaess/Organizationandivida {u W,6 Address: City/State/Zip: Phone#: Are u an employer? Check the appropriate ox: Type of project(required): 1. I am a employer with �rt 4. I am a general contractor and I 6 El New construction employees(fall and/or part-time).* have hired the stab-contractors 2.❑ I am a sale proprietor or partner- ' listed on the attached sheet t ❑ Remodeling ship and have no employees These sub-contractors have 8: ❑ Demolition working for mein any capacity. workers' comp.insurance. g, ❑ Building addition [No workers' Gomp.insurance 5• ❑ We are a corporation and its required.] . officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all,work' right of exemption per MGL 11.❑ Plumbing repairs or additions myself.[No workers' comp, c. 152,§1(4),and we have no 12.0 Roof repairs bmance required.] t , employees.(No warkers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 mmat also fill out the section below showing Their workers'campensation policyiafaanation: t Homeowners who submit this affidavit indicating they are doing all work andtheu hire outside contractors must submit anew affidavit indicating such xContractors that check this box must attached an additional sheet showing the name ofthe sub-eontmi:tors and their workers'comp.policy ia#•ormstion. I am an employer that Is providing workers'compensation Insurance for my employees. Below is the policy and job site , Information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/5tate/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500,A0 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby eerti nder the pains and enalties of perjury that the Information provided above is true and correct. Sr afore: Date: & Official use on(v. Do not write in this area,to be completed by city or town officilaL City or Town: Permit/License# ? Issuing Authority(circle one): 1.Board of Re&,.h 2.Building Department 3.City/Town Clerk e.Eiectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees, Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,.oral or written." An employer is defined as•"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 persona 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 bean employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shalt 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 ofpublic 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 checVmg the boxes That apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone numbers)along with their certificate(s)of insurance. 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. He advised that this affidavit may be submitted to the Department of industrial Accidents for conformation 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 Depariment 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 shoM cuter their self-insurance license number on the appropriate line. City or Town Offldals . 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 pmm itllicense number which will be used as a reference number. In addition;an applicant that mast 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. Anew affidavit must be filled out each year.Where a&me owner or citizen is obtaining a license or permit notrelated to any business or commercial venture (i.e. a dog license or pem3it to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax mmker: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ent 406 or 1 o77-NIASSAFE Fax#61.7-727-7749 Revised 5-26-05 www.m.ass.uov/dia Client#: 18103 2AMERICANTE ACORD. ;CERTIFICATE OF LIABILITY INSURANCE 04/18/06D"YYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency- HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR g y + ALTER THE COVERAGE AFFORDED'BY_THE POLICIES BELOW._ ---.- 222 West Main St.PO Box 1990«. Hyannis,-MA-02601 "" INSURERS AFFORDING COVERAGE" u_ NAIC INSURED INSURER A: Associated Employers Insurance Compa --- American Tent and Table, Inc. s - ( INSURERS: P.O..-Box 1348 -- � - INSURER C: t � Marstons Mills, MA 02648 t INSURER D: - INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATEYMMIDDIYYE PI MP DIYY IRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COrf IERCIAL GENERAL LIABILITY DA@GE TO ISIS P,ENTED $ CLAIMS MADE DOCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS -BODILY INJURY'. SCHEDULED.AUTOS� _ (Per person) �I HIRED AUTOS BODILY INJURY 1" ^n NON-OWNED AUTOS 'T S (Per accident) -•'' $ 7 'PROPERTY DAMAGE $ ~4: (Per accident) _�n GARAGE LIABILITY 1 AUTO ONLY-EA ACCIDENT $. ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR FI CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION AND WCC5004440012006 04/23/06 04/23/07 X W RY C STATUS OTH- LIMITS I ER Er.IPLOYE S LIAEILITY - ----- -- -- - E.L.EACH ACCIDENT $100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $100 000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT s500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Job:#9418-30x6O'Tent Operations performed by the named insured subject to policy conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION In Home Furnishings DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1f DAYS WRITTEN Attn: Sandy NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 276 Falmouth Road,Route 28 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Hyannis,MA 02601 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #42431 LS1 0 ACORD CORPORATION 1988 TOWN OF BARNSTABLE SIGN PERMIT PARCEL ID 293 031 GEOBASE ID 20537 ADDRESS 276 FALMOUTH R.D/RTE.28 PHONE HYANNIS ZIP - LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY i PERMIT 58098 DESCRIPTION HIDES N' SEATS 78 SQ FT PERMIT TYPE BSIGN TITLE SIGN PERMIT i CONTRACTORS: Department of Health, SafetyARCHITECTS: and Environmental Services TOTAL FEES: $150.00 BOND $.00 THE CONSTRUCTION COSTS $.00 Gg�' 753 MISC. NOT CODED ELSEWHERE `T BARNSTABLE, # MASS. 039. ED MI`►I UILDINQ DIVISION BYiaaaL ��Ih DATE ISSUED 12/28/2001 EXPIRATION DATE - - i Town of Barnstable Regulatory Services o ef Thomas F.Geiler,Director +—J� anaxs•rnat.e, / MASS. g Building Division 039• �iDtFp t��a Peter F.DiMatteo, Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Tax Collector Treasurer. G Application for Sign Permit Applicant: 9TOi�z J-DFpr&'?' Assessors No. l ed' Doing Business As; 1 1 PZ� IV' 5��7-5 Telephone No. 1/7 Sign Location �jf41VV1 Street/Road: 274/- Zo Ynin District: Old Kings Highway? YesAq Hyannis Historic District? es/ To Property Owner Name: L —Telephone: 7 7-5 Address: 2 A'ldjATl� Village: Sign Contractor JORDAN SIGN CO. Z Name: eNTERPRISE Telephone: �7 � - Q '� RUAU Address: HYANNIS,MA 02601-2212 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? Yes (Note:W 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 Zoning Ordinance. Signature of Owner/Authori d Agent: G'l Date:�_ k Size: Permit Fee: Sign Permit was approv d: Disapproved: Signature of Building 0 is Date: Sign 1.dor• rev.8/31198 JORDANSIGN 103 ENTERPRISE RD. HYANNIS, MA 02601-2212 TEL 508-771-4020 FAX 508-771-6658 EMAIL: signs@mediaone.net Website: wwwjordansign.com .,.�..��K...��_ ,w....... ....E- Now a � f I i �q f < • 5t . n xr a �a �..r _ _ z } { �J J I IBM1-✓ ly J R p►NSIGN x. 103 ENTERPRISE RD. f v ANNIS, MA 02601-2212 TEL 508-771-4020 FAX 508-771-6658 EMAIL: signa@mediaone.net Website: wwwjordansign.com ` ._.e� V HUMES M SEATS LEATHMR PURNI'TURE 0 . 0 o O '-7 7 /op o&f Town of Barnstable Regulatory Services BARMSPABM ' Thomas F.Geiler,Director Mara 9`bA Eo 39. 6. Building Division Peter F.DiMatteo. Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 August 31, 2001 Mr. Stuart Bornstein 297 North Street Hyannis,MA 02601 Re: SPR 055-97,Hyannis Crossing, 276 Falmouth Road, Hyannis Dear Mr. Bornstein; Please accept this as a kindly reminder to confer with Bob Burgman, Town Engineer regarding the intended installation of the sewer line in this area of Falmouth Road and its potential effect on the landscaping of Hyannis Crossing. I advised you during our telephone discussion earlier this month that according to Mr. Burgmann,the sewer lines are now scheduled to be installed on the opposite side of Route 28. All reasonable attempts to avoid the disruption of your property shall be made. In fact, Mr. Burgmann indicated that the connection could be designed to meet at the site access with little disturbance. It is my sincere desire that you meet with Mr. Burgmann in order to resolve this matter to the satisfaction of both the town and yourself. I would be happy to assist you in any manner necessary in order to facilitate the required landscaping and close the corresponding Site Plan Review file. Your immediate attention to this matter will be greatly appreciated. Sincerely, Robin C. Giangregorio SPR Coordinator