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0540 MAIN STREET (HYANNIS) (14) - 200900670
Town of Barnstable Building Department - 200 Main Street RAMST"LE. # Hyannis, MA 02601 9� 1639. ,��' (508) 862-4038 ATFD MA'i A Certificate of Occupancy Application Number: 200900670 CO Number: 20080316 Parcel ID: 308074 CO Issue Date: 05/04/09 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: CODE REALTY LLC Building Department Signature Date Signed { tHE dTOWN OF BARNSTABLE Bu an jn 9 Application Ref: . 200900670 • BARNSTABLE, Issue Date: 02/26/09 Pum'' It 9 MASS �A i639• �� Applicant: OCEANSIDE CONSTRUCTION&DEV rFD MA't A Permit Number: B 20090265 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$ 637.00 Contractor OCEANSIDE CONSTRUCTION&DEV Village HYANNIS App Fee$ 100.00 License Num 48102 Est Construction Cost$ 70,000 Remarks —.—: APPROVED PLANS MUST BE RETAINED ON JOB AND - j 2500.SQUARE FT OFFICE BUILD OUT-NON STRUCTURAL-ALL THIS CARD MUST BE KEPT POSTED UNTIL FINAL j INTERIOR"CODE REALTY LLC" ". _ INSPECTION HAS BEEN MADE, WHERE 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 r Application Entered by: PR , Building Permit Issued By: U( THIS PERMIT CONVEYS NO.RIGHT TO OCCUPY ANY S1 REET ALLY OR SIDEWALK ORgANY PART,THEREOF EITHER.TEMPORARILY OR PERMANENTLY: ENCROACHENIENTS"ON PUBLIC PROPERTY NOT SPECIFICALLY PERMITTED''UNDER THE BUILDING'CO DE-MU ST BE APPROVED BY THE JURISDICTION. STREET OR ALLY;GRADES'AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE.ISSUANC F.THIS PERMIT DOES NOT`RELEASE 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. 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). NMI IPIIII Flj ME Nij BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL.INSPECTION APPROVALS 2 2— •. (7 2 c� 3 1 Heating Inspection Approvals Engineering Dept 0q Fire Dept Dg 2 Board of Health TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel °:Application # MOD Health Division Date Issued Z: 1S Conservation Division Application Fee ail Planning Dept. Permit Fee, Date Definitive Plan Approved by Planning Board 1 Historic -. OKH _Preservation / Hyannis Project Street Address S40 MVA�k 1'7 Village q- fy I Mnr �C�bC R Owner S�W O'Atti 'rl LLB Address Telephone —1l Permit Request 5-00 L(-j 0;4c Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0� Construction Type Lot Size Grandfathered: ❑Yes C3olQof yes, attach supporting documentation. Dwelling Type: Single Family ,❑ amily ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑- oo' On Old King's Highway: ❑Yes Basement Type: ❑ Full ❑ Cra/4196 Valkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing W * new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Roo Count Heat Type and Fuel: I as ❑ Oil ❑ Electric ❑Other Central Air: -a"Ye—s ❑ No Fireplaces: Existing New Existing wood/co l stove]Yev ❑ No Detached garage: ❑ existin�,/�0 size Pool: ❑existing ❑ new size _ Barn: ❑ exr'ng ❑ pewsize_ Attached garage: ❑ existing q y� e _Shed: ❑ existing ❑ new size _ Other: Ln Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial 2`7e—s ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name OC40 b9 6 LW_ (fb�_Sc' Telephone Number -7-7`t 7.3 u 61-J W Address yy 96 9 ov, License # Q'i 8 l O I r Home Improvement Contractor# Worker's Compensation # k ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGN TURE DATE ?�ZD 01 FOR OFFICIAL USE ONLY "APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME* INSULATION FIREPLACE. ti •- s ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL i GAS: ROUGH FINAL © cam (Z- FINAL BUILDING r t . C t DATE CLOSED OUT . ASSOCIATION PLAN NO. ,t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations" ' 600 Washington Street Boston, MA 02111 w., s www.mass.gov/dia Workers' Compensation_ Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): OC��c� \fie CyNS"� Address: 1w 'fa_ t'S"1 City/State/Zip: MA i25rrDtn.,IYti S &1p_ Phone.#: '"n4 23ce_, `J`tk Are you an employer? Check the appropriate box: Type of project(required): 1.LR'T7'a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction .2.❑ 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 workingfor me in an capacity. employees and have workers' Y P t3'• $ 9. ❑Building addition [No workers'-comp. insurance comp. insurance. 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its ❑ P 3.❑ 1 am a homeowner doing all work officers have exercised.their i 1.❑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: �\t 0 (4't N S--Wcszs*V--- City/State/Zip: 02r6y 1 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce nder the pains and penalties of perjury that the information provided above is true and correct Si ature: Date: Phone#: 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.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical 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 persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),-address(es)and.phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is.being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to-thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of lndustri:al 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 � Tati Town of Barnstable ' 20Regulatory Services. v�ce� Thomas F.Geiler,Director En.3g6 6. 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, GL"CLO-- '�`e , as Owner of the subject property hereby authorizes to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) 2` el(at Signature of Owner Date cA6� Dae Print Name If Property Owner is applying for permit please complete.the ` Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERM ISSION . Town of Barnstable �tt�ram, Regulatory Services RARNSr.,SU : Thomas F.Geiler,Director 59. .�� Building Division rf�MA'1 Tom Perry,Building Commissioner 200 Main.Street,-_Hyannis,MA_0-2601_ vrww.town.b arnstabl e.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 sunervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that.he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements, Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 1D9.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall ad 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 responnbilities,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 corrmrunity. Q:forrns:homcexempt FEB-23-2009 09:14 PAUL PETERS MASHPEE 5084776498 P.001i001 PAUL PETERS AGENGY, INC. jn �I depeadenl n.4 aranca /lnsuraace 680 FALMOUT!1 ROAD Agenlm MASHPF.E,Mh.MSACHUSE•I I S 02649 Est.1927 I TFI FPHONF 508-477-0021 FAX 508.477-6498 February 23, 2009 Town of Barns I ble—Building Dept. 200 Main S tree t Hyannis, MA 02601 To Whom It Miy Concern: Please be advis led 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: - EffeI tive Date—2/3/2009 to 2/3/2010 Company—Atlantic Charter Insurance Company Limits - S 100,000/500,000 000,000 Policy#: W CV00617204 Pleas- review and advise if you need any additional information. Regards, ary Bruno Jhanhd/ur J"J arifty WA U4 — TnTAT. P nni Jefferson Group Architects, Inc. Wayne J. Jacques, AIA ISD AF 8 ARCHITECTURAL FINAL AFFIDAVIT To the Inspectional Services Commissioner: I certify that I, and/or my authorized representative,have inspected the work associated with Permit No.B 20090265, for the Code Realty Office 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, �D A`r. Architect—Mass. Reg.No.6935 �,OHN Jefferson Group Architects. Inc. NO.06g35 700 School Street,Unit 2 C sOSTON Pawtucket,RI 02860 • 721-2245 ,qc of aAPs9 Inspection Dates: 03-05-09 and 4-10-09 Then personally appeared the above-named VVci C AC c4 and made oath that the above statement by him is true. Before me, F j, � f I My Commission expires: WO 4, .f 20 700 School Street Pawtucket,R102860 1 (401)721-2245 Fax (401)721-2238 AFA-2008-05 Code Realty.doc SO Jel G ....... �O 80 I CWISIILTAM- y `A '�GTyI FFNtP`'SP }Id50pAwpGL4 APABT m ANINIEGMT®�1'OP y § ' 7Icll' WSW ]I(@. emxmlmm®ro•ce++zvn�amornons•. SUMMARY OP woPR•ANO ANY APPIICA918 COY®l i G011®l Comm /� �� \� i M9MIPACIIIIIPASTFLNMGLSPFLTPIGnONS (jam e�ro,w.mnmonnwwmPoxmralarP 1 OFT F�I� OFFICE OF T F 1 / \ / scoeemwau. OFFICE i I o� £ I ' '� —� /-H.C:ACCESS I`-- / I A9�.v+�Av-a�w.sNmroeescvmAnooa usm OFFICE I — REVISIONS Na DA18 OFYNPaoN coy I SUPPLY �� SEC.1 CLOSET I CORR. SEC.4 SEC.3 SEC.2 _—_—_—_—_—_—_ ----- .L------ _—_— -- ------ - I WAITING/ immvLL OAIIIW OFFICE RECEPTION ..WW.F swim 1 gp. V4 AII I� I - ; MBIIJQM7m I 1 i P80IEmNAt� I I FIVE HUNDRED BLOCK BE VER I HYANMS e -� aosET I I I NORTH STREET BUII.DING ------- FILE STO GE' I (MECHANICAL aA � CONFEFNCE lll'''"""'''''' ����00000000MMMM ROOM 1 - - BATH= . KITCHENETTE I 'R COPY AREA KRCHENETTE -- r ° --- -- , -- - ------ ---- — -- ------ -- — -- ----- vIG RO ' CORRID RA` , LF�i DR. II I 1 I I ARCPiITECTUAAI.DESPGN J.C. 'UP OFFICE I WDMEN Jefferson Group Architects,Inc 1 II I I I 00�151 U(40 �roo>e� Pbove:(101)J213215 F¢(aopnl-zvs I II I I I I PNPET,TaE OFFICE FLOOR PLANS II 1 f MEN LL— II OFFICE ,OFFICE ( l 1 00 ,� I sass 2008 OS:OB&.10 oxAwnBy sx: MEM 1 REALTY OFFICE- FLOOR PLAN 2 OFFICE- FLOOR PLAN V'v lVh °o�NY' SIM A1:9 SCALE:114"-V-W A1.9 SCALE:1/4"=1'-O" ont[rssimo: FEBRUARY 9,2009 Noted 96EINIII�FA -NM2 A1.9