HomeMy WebLinkAbout0540 MAIN STREET (HYANNIS) (11) - BAKER SUITE 4 v� i
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t"ET�ti Town of Barnstable
Building Department - 200 Main Street
BARNSTABLE, # Hyannis, MA 02601
9� b& ,� (508) 862*4038
ATFO MA'S A
Certificate of Occupancy
Application Number: 200900668 CO Number: 20080314
Parcel ID: 308074 CO Issue Date: 05104109
Location: 540 MAIN STREET (HYANNIS) Zoning Classification: HYANNIS VILLAGE BUSINESS DIST
Proposed Use: DEPARTMENT DISCOUNT STORE
Village: HYANNIS
Gen Contractor: OCEANSIDE CONSTRUCTION & DEV Permit Type: CC00
CERTIFICATE OF OCCUPANCY COMM
Comments: BAKER SUITE
Building Department Signature Date Signed
�tl � TOWN OF BARNSTABLE BdRdIn' 9..
�+ Application Ref: 200900668 •
BARNSTABLE, Issue Date: 02/26/09 Permit .
9 MASS.
Q�Ar�O 339. a�� Applicant: OCEANSIDE CONSTRUCTION&DEV Permit Number: B 10090266
Proposed Use: DEPARTMENT DISCOUNT STORE Expiration Date: . 08/26/09
Location 540 MAIN STREET (HYANNIS) Zoning District HVB Permit Type: COMMERCIAL ADDITION ALTERATION
Map Parcel 308074 Permit Fee$ 682.50 Contractor OCEANSIDE CONSTRUCTION&DEV
Village HYANNIS App Fee$ 100.00 License Num. 48102
Est Construction Cost$ 75,000
Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND
i OFFICE BUILD OUT,NON STRUCTURAL 1699 SQUARE FEET-INTERIOltms CARD MUST BE KEPT POSTED UNTIL FINAL
"BAKER SUITE" INSPECTION HAS BEEN MADE. WIJERE A .
CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH
Owner on Record: AMADAN LLC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL
Address: 250 FIRST AVENUE SUITE 200 INSPECTION HAS BEEN MADE.
NEEDHAM,MA 02494
Application Entered by: PR Building Permit Issued By:
THIS PERMIT.CONVEYS NO RIGHT TO OCCUPY ANY.STREET,ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY.
ENCROACHEMENTS ON:PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION
STREET OR ALLY GRADES AS WELL AS DEPTH AND LOCATION.OF PUBLIC SEWERS MAY BE OBTAINEDTROM THE DEPARTMENT OF PUBLIC.WORKS..
THE ISSUANCE OF:THIS.PERMIT DOES NOT RELEASE THE APPLICANTFROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS
MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK:
1.FOUNDATION OR FOOTINGS.
2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED.
3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION.
4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH).
5.INSULATION.
6.FINAL INSPECTION BEFORE OCCUPANCY.
WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. .
WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION.
PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF
DATE THE PERMIT IS ISSUED AS NOTED ABOVE.
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A).
ROME=,
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
1 1 . v 1 �Ga�('/ i5 c3�
3 p[C. 1 Heating Inspection Approvals Engineering Dept
Fire Dept 2 Board of Health
TOWN OF BARNSTABLE BUILDING PERMIT,APPLICATION.,-
Map- Parcel AApplication # �v
Health Division °Date Issued .
Conservation Division -Application Fee (uU
Planning Dept. i Permit Feena r�
Date Definitive Plan Approved by Planning Board
Historic = OKH Preservation/ Hyannis
Project Street� Address ��0 f'VO���`1 S�2�� ;h�-�T`"^�" 1;y
Village
Owner S4y rn+atn LL6, Address
Telephone
Permit Request d44qce— Q;kJ.UO of &)0%J L f*_
J '
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family :0 Two Family 0 Multi-Family (# units)
Age of Existing Structure qO" Historic House: ❑Yes 6:410 On Old King's Hig way: giYes Cl�Ple
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other W_�t r*
-Ti
Basement Finished Area(sq.ft.) Al Basement Unfinished Area (sq.ft)% cr;%_
Number of Baths: Fui!I: existing new Half: existing at nev
Number of Bedrooms.: existing _new •�9 5'
_ m
Total Room Count (not including baths): existing new First Floor Room,Count Cn
Heat Type and Fuel: was ❑Oil ❑ Electric ❑ Other
Central Air: -Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑ existing ❑ 9e� Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_
Attached garage: 0 existing ❑ n94/* _Shed: ❑ existing ❑ new size _ Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial aYe—s ❑ No If yes, site plan review#
-Current Use _ _ _ Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name Telephone Number -7 y
Address P'o License #
QZbk Home Improvement Contractor#
`` Worker's Compensation #
I ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
CgS�Cra tNasl-e. ,
SIGNA URE DATE 1-0(0 cA
Al FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
MAP PARCEL NO. r
ADDRESS VILLAGE
i OWNER
DATE OF INSPECTION:
i FOUNDATION
h
FRAME
} INSULATION
FIREPLACE
} ELECTRICAL: ROUGH FINAL
r "
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL .
FINAL BUILDING � ' 0�
1 _
DATE CLOSED OUT
ASSOCIATION PLAN NO.
i
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
' 600 Washington Street
Boston,MA 02111
s�• www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): O CtLoAltt 6 tp<
Address:
City/State/Zip: i(`(1A25MV M�Lt5 ma Phone.#: 7-)4 Z3.19 E 11k 1
Are you an employer?Check the appropriate box: Type of project(required):
I�E am a employer with 4. ❑ I am a general contractor and I
employees(full and/or part-time).
* have hired the sub-contractors6. ❑New construction
..2.0 I am a sole proprietor 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' 9. ❑Building addition
[No workers'-comp. insurance comp. insurance.#
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 I LEJ 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' 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 a new affidavit indicating such.
TContractors 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 provide their workers'comp.policy number.
Iam an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.M Expiration Date:
Job Site Address: City/State/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 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
Investigations of the DIA for insurance coverage verification.
I do hereby ce ify u r he pains and penalties of perjury that the information provided above is true and correct
Signa e: Date: 2A-2z 45
Phone M 77 H 23! BY ti
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
oF� rati Town of Barnstable
Regulatory Services
iAa9�Bt"E Thomas F.Geiler,Director
i63g6 �
Building Division
Tom Perry,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, as Owner of the subject property
hereby authorize_-_.,aV to act on my behalf,
in all matters relative to work authorized by this building permit application for:
yv��r i 4.-V2<=49— —
(Address of Job)
2��et Lp'l
'Signklim-77 Owner Date
Print Name
If Property Owner is applying for permit please complete.the
Homeowners License Exemption Form on the reverse side.
Q:FO RM S:O W NERP ERM IS S I ON
Town of Barnstable
„�. Regulatory Services
BARNMEM : { Thomas F.Geiler,Director
MASS.
Building Division
Tom Perry,Building Commissioner
200 Maui.Street,__Hy_annis,MA_02601._
www.town.b arnstable.ma.us
Office: 508-862-403 8 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 HOMEOWNIER
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.be/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 pemvt is required shall be exempt from the provisions
of this section(Section ID9.1.1-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 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.
Q:forrns:homeexempt
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FEB-23-2009 09:14 PAUL PETERS MASHPEE 6084776498 P.001/001
PAUL PETERS AGENCY, INC.
�I depeadenl
• j �n�urarxce Insurance
680 FALMOUTI 1 FOAD IAgBnI�
i MASHPF.E,MASSACHUSE77S OVA9
Est.1927 i TFI•F,PHONF.508-477-(H)21
FAX 508.477-6498
I
February 23,2009
I
Town of Barnstable—Building Dept.
200 Main Street
Hyannis, MA 02601
To Whom It lviay Concern:
Please be advised that a Certificate of Workers Compensation will be forwarded directly
from Atlantic Charter Insurance.
Please accept this as proof of insurance with the following terms:
i
Effective Date—2/3/2009 to 2/3/2010
Company—Atlantic Charter Insurance Company
Limits - S 100,0001500.000% 100,000
Policy#: WCV00617204
Please review and advise if you need any additional information.
Regards,
ary Bruno
5/mi.,AP,Jnjaflihy WA YJ
TOTAT. P nn1
y
( I
. of Public Safct� `
pcpu►-tmcnt Standar(ls
ti�tts- rtm tions and
u NLISS' chin uildin`:Re,. License
Bo,�rd of B ervisor
Construction Sup
License: CS gS102
Restricted to. 00 �
UTC
c
40 RITONS MILLS,MA 02648
MARS 9116120t 0
Expiration:
siune►'
('un►mi:
Jefferson Group Architects, Inc.
Wayne J. Jacques, AIA
ISD AF 8
ARCHITECTURAL FINAL AFFIDAVIT
To the Inspectional Services Commissioner:
I certify that 1,and/or my authorized representative,have inspected the work associated with
Permit No.B 20090266, for the Baker Office Suite tenant space located at 544 Main Street,
Hyannis,MA,on the dates noted below during construction,and that to the best of my
knowledge,information,and belief the work has been done in conformance with the permit and
plans approved by the Inspectional Services Department and with the provisions of the
Massachusetts State Building Code and all other pertinent laws and ordinances.
Wayne J.Jacques,AIA,
Architect—Mass.Reg.No.6935
0'' PiO.06935 Jefferson Group Architects.Inc.
BOSTON 700 School Street,Unit 2
MA G�J Pawtucket,RI 02860
OF 21-2245
Inspection Dates: 03-05-09 and 4-10-09
Then personally appeared the above-named Ac t1e and made
oath that the above statement by him is true.
Before me /?
r
y v_
My Commission expires:
LA 20
700 School Street
Pawtucket,RI 02860
(401)721-2245 Fax (401)721-2238
AFA-2008-05 Baker Office Suite.doc
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/Eleetricians/Plumbers
Applicant Information Please Print Lezibly
Name(Business/Organization/Individual): 0 C tA't? S t01C [^ d—
Address: P-D °oy. Est
City/State/Zip: MA2S!rbl6S M&LL5 Ma Phone.#: 77 4 2--.a C,k
Are you an employer?Check the appropriate box: Type of project(required):
j 'Tam a employer with 4. I am a general contractor and I
employees(full and/or part-tim.e).
* have hired the sub-contractors 6. [].New construction
2.� I am a sole proprietor or partner listed on the attached sheet. 7.. 0 Remodeling
shipand have no employees These sub-contractors have
8."E]Demolition
working for me in any capacity. employees and have workers'
co insurance.# 9. Building addition
[No workers'"comp. insurance comp.
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.El 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' 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 a new affidavit indicating such.
=Contractors 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 provide their workers'comp.policy number.
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.Lic.#: Expiration Date:
Job Site Address: City/State/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 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
Investi ations of the DIA for insurance covers a verification.
I do hereby ce fy u r he pains and penalties of perjury that the information provided above is true and correct.
Si a e: Date:
Phone#: 7)4 2 751 J 16y-1
I
fficial use only. Do not write in this area,to be completed by city or town official
ity or Town: Permit/License#
suing Authority(circle one):
Board of Health '2.BuildingDepartrment 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
Other
ontact Person: Phone#:
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
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): tLYAt1 S iQt e;A -
Address:
City/State/Zip: i('(1A25rb1K6 M kL15 mg- Phone.#: 7-11`t '2.�3 Sk(t
Are you an employer?Check the appropriate box: Type of project(required):
lam a employer with 4. I am a general contractor and 1 6. ❑New construction
employees(full and/or part-tim.e).* have hired the sub-contractors
2.El I am a sole proprietor or partner-' listed on the attached sheet. T. 0 Remodeling
ship and have no employees These sub-contractors have g, 0 Demolition
working for me in any capacity. employees and have workers' 9. 0 Building addition
[No workers' comp. insurance comp. 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 I LE]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.
xContractors 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 provide their workers'comp.policy number.
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.Lic.#: Expiration Date:
Job Site Address: City/State/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$1,500.00 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 ce . u r he pains and penalties of perjury that the information provided above is true and correct.
Si a e: Date:
Phone M 774 Z2i`.> $44
Official use.only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one): 1
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
7
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 i4 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, if
necessary,supply sub-contractors)name(s),-addresses)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 Addre"ss"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 to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call. ,
The Department's address,telephone-and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations,
600 Washington Street
Boston, MA 02111
Tel. #617-727-4900 ext 406 or 1-877-MASSAFE
Fax# 617-727-7749
Revised 11-22-06
www.mass.gov/dia
TOWN OF BARNSTABLERuIlding
r;
�tHEra,� .
Application Ref: 200900668 sARNSTASLE, Issue Date: 02/26/09
Permit
9 MASS
�A i639• Applicant: OCEANSIDE CONSTRUCTION&DEV
rFC Mph A Permit Number: B 20090266
Proposed Use: DEPARTMENT DISCOUNT STORE Expiration Date: . 08/26/09
E
cation 540 MAIN STREET (HYANNIS) Zoning District HVB Permit Type: COMMERCIAL ADDITION ALTERATION
Map Parcel 308074 Permit Fee$ 682.50 Contractor OCEANSIDE CONSTRUCTION&DEV
Village HYANNIS App Fee$ 100.00 License Num 48102
Est Construction Cost$ 75,000
Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND
OFFICE BUILD OUT,NON STRUCTURAL 1699 SQUARE FEET-INTE IOFfHIS CARD MUST BE KEPT POSTED UNTIL FINAL
"BAKER SUITE" I INSPECTION HAS BEEN MADE..WHERE A .
CERTIFICATE OF OCCUPANCY IS REQUIRE),SUCH
Owner on Record: AMADAN LLC BUILDING SHALL NOT BE OCCUPIED UNT16A FINAL
Address: 250 FIRST AVENUE SUITE 200 INSPECTION HAS BEEN MADE.
NEEDHAM, MA 02494 ;
Application Entered by: PR Building Permit Issued By:
THIS PERM,ITCONVEYS.NO RIGHT.TO OCCUPY ANY STREET,ALLY 0.R SIDEWALK OR ANY PART THEREOF`,EITHER TEMPORARILY OR PERMANENTLY.
ENCROACHEMENTS ON.PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED.UNDER THE BUILDING,CODE,MUST BE`APPROVEDBY THE JURISDICTION.
STREET ORALLY GRADES AS WELL AS DEPTH AND,LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.
THE ISSUANCEOF+THIS PERMITyDOES NOTRELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION-RESTRICTIONS.
MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK:
1.FOUNDATION OR FOOTINGS.
2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED.
3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. `
4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). �
5..INSULATION. 3
6.FINAL INSPECTION BEFORE OCCUPANCY. ?°
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WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING ANDMECHANICAL INSTALLATIONS. .
WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION.
PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT'STARTED WITHIN SIX MONTHS OF
DATE THE PERMIT IS ISSUED AS NOTED ABOVE.
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.I42A).
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