HomeMy WebLinkAbout0540 MAIN STREET (HYANNIS) (19) - COMPUTER CAFE 200900669 i
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 Clerk's Office, 1-FL., 367
Main Street, Hyannis, MA 02601 (Town Hall)
DATE: s ° r M Fill in please:
2 _ APPLICANT'S YOUR NAME/S: �'`
RBUU/SINE1/^S�S YOUR HOME ADDRESS:
YA� V '1
TELEPHONE # Home Telephone Number -77�
Ar si w V y Gg
"1.
.224E 3 ?5 d�` rK•t
NAME OF CORPORATION: �
NAME OF NEW BUSINESS ' n` s TYPE OF BUSINESS n J ' Av",l
IS THIS A HOME OCCUPATION? YES NO ;
ADDRESS OF BUSINESS -_ a k S - MAP/PARCEL NUMBER 3 G o 7 (Assessing)
When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of
Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth
Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town.
1. BUILDING COM ER'S OFFICE
This individu I ha b n ir�for e�.nanpe mit requirements that pertain to this type,of business.
ut rized.Signatur * ;
COMMENTS:
2. BOARD OF HEALTH
This individual has b informecypf t e it requirements that pertain to this type of business.
ZV
Authorized Signature*
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual ha rm oft licensing requirements that pertain to.this type of business.
Authorized Signature*
COMMENTS:
��tTti Town of Barnstable
Building Department - 200 Main Street
SAMSTABLE, # Hyannis, MA 02601
9�A b3 A,��' (508) 862-4038
rFo Mai
Certificate of Occupancy
Application Number: 200900669 CO Number: 20080315
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: COMPUTER CAFE
��oq
Building Department Signature Date Signed
tt
°FINE TOWN OF BARNSTABLE '_ Building
Application Ref: 200900669
* BARNSTABLE, Issue Date: 02/26/09 Permit
9 MASS.
�p 1639• Applicant: OCEANSIDE CONSTRUCTION&DEV
rFC MAC a Permit Number: B 20090262
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$ 709.80 Contractor OCEANSIDE CONSTRUCTION&DEV
Village HYANNIS App Fee$ 100.00 License Num 48102
Est Construction Cost$ 78,000
Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND
3025 SQUARE FEET OFFICE BUILDING-NON S`T^R�CTURAL-INTE OI IFHIS CARD MUST BE KEPT POSTED UNTIL FINAL
ONLY fY�V 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
Application Entered by: PR Building Permit Issued By:
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY;STREET,ALL Y.ORS IDEWALK 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. 1
STREET OR ALLY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS..'
THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE'APPLICANT FROM THE CONDITIONS OF,ANY APPLICABLE SUBDIVISIONRESTRICTIONS,,, ,
MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTTTRUCTION,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 PR10R 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).
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
1 1 1 • ,
2 2 s � an�Z �� 5 ,n 2
/_Art 6 t,✓� i�.-Z�CS G �
�
1
3 �jj /�_ 1 Heating Inspection Approvals Engineering Dept
Fire Dept 2 Board of Health
L
TOWN OF,BARNSTABLE BUILDING PERMIT APPLICATION.
Map Parcel _ ,Application # 0g00 dog
. ,`
Health"Division "�� Date Issued
Conservation Division ;.Application.Fee (_COC7
Planning`Dept. Permit Fee.
Date Definitive Plan Approved by Planning Board
Historic OKH Preservation/Hyannis
Project Street Address
Village_ e
Owner h L l_c_ Address : Y
Telephone
Permit Request Lr— '8.�.kh p-r'— NOW v ctu 0*4,oe
4\10 .G '
uare feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation bar Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Sing- 9--T*e-Fam.i4L_ Multi-Family(# units)
Age of Existing Structure Historic House: ❑Yes ❑ }o— On Old King's Highway: ❑Yes r<o
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' - unt
Heat Type and Fuel: 46r as ❑ Oil ❑ Electric ❑ Other
cn
Central Air: des ❑ No Fireplaces: Existing New Existing wood/coal s ove: ❑Yes ❑'No
Detached garage: ❑ existina 0 new size Pool ❑ existina ❑ new sizV✓VZi�-Barn: ❑existing ❑ new size_
Attached garage: ❑existing 0 new size _Shed: ❑ existing ❑ new size r:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
C�G.�NStcl�� Co�bT"
Name Telephone Number _J-1 g4 L 1
Address 'AeC kLUC - VeZ License # &`{bt 0"7--
�dCS"h�t-S MLk 5 Nw 62.6 4_v Home Improvement Contractor#
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
CAS51A W05
SIGN URE DATE 2 �2_01
1
• FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
}
ADDRESS VILLAGE
i
OWNER
t
r
f
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE-
r�
_ELECTRICAL: ROUGH FINAL '
4 PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL -
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
t
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): OCJLSP('t-►5l r,�� r5�
Address: Q-O l5'1 fYA<5J'b'rrS not (L 5
City/State/Zip: Mom. pZ6A Phone.#:"7-7h 23 2 15�tt-k
Are you an employer?Check the appropriate box:
Type of project(required):
1 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.❑ I am a sole proprietor or partner-' listed on the attached sheet. T. E'%Gmodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
workingfor me in an capacity. employees and have workers'
Y P tY• $ 9. ❑Building addition
[No workers'comp. insurance comp. insurance. 10. Electrical repairs or additions
required.] 5. ❑ We are a corporation and its ❑ P
3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
myself. [No workers'comp. right of exemption per MGL 12.0 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 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.
lam 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.M Expiration Date:
Job Site Address: SL[o MAk r1 S�<,-Gar City/State/Zip: A W4r4n t.S ivw 1fL6 01
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 theDIA for insurance covers a verification.
I reb certify d the pains and penalties of perjury that the information provided above is true and correct
ature: Date: Za CA _
Phone
Official use.only. Do not write in this area,tb 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 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
� Toti Town of Barnstable
' Regulatory Services
RAMSDAM
v HASS. Thomas F.Geiler,Director
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 ABuilder
I, C � �` �� , as Owner of the subject property
hereby authorize t` AAA L t*5 to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
-T
lure of Owner Date
Print Name
If Properly Owner is applying for permit please complete.the
Homeowners License Exemption Form on the reverse side.
Q:FORMS:O WNERPERMISSION
Town of Barnstable
zKE
Regulatory Services
BARNST"L : Thomas F.Geiler,Director
MASS.
Building Division
�PfFD MA`l t+
Tom Perry,Building Commissioner
200 Main.Street, Hyannis.MA 02601._ _. ..
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 buildint?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 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 assuring 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
1
f
of Public Safct�
" D�purtmcnt �nJ Stan(f411.Js
ti�tts- s 1 ttions
Massuchu uilJin`g Rc'u License
BoltrJ of B Supervisor
construction
48102
License: cs
C
Restricted to: 00
�ONN H1ITCHINS
4 NS MILLS,MA 02648
e��
19 RIVER RD
MARSTO 91161201 O
Expiration:
viunc�•
FEB-23-2009 09:14 PAUL PETERS MASHPEE 5084776498 P.001/001
PAUL PETERS AGENCY, INC.
pp �I depeadenl
��`n�urance Insurance
680 FALMOUTI I ROAD IAgent
.
MASHFF.E,MM4;ACH1JSF1')S 01(49
Est,7927 I TFI.F.FHONF 508-477-0021
FAX 508.477-6498
February 23,2009
Town of Barnstable—Building Dept.
200 Main Street
Hyannis, MA 0260)
To Whom 1t May 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:
Effective Date—2/3/2009 to 2/3/2010
Company—Atlantic Charter Insurance Company
Limits - S 100,000/500,000/ 100,000
Policy#: WCV00617204
Please review and advise if you need any additional information.
Regards,
ary Bruno
TMAT. P nOl
i 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 20090262, for the Neuoffice tenant space, 3025 square feet,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,
oWfV�� Architect—Mass. Reg.No.6935
N P
NO.0�35 �' .> Jefferson Group Architects. Inc.
BOSA 700 School Street,Unit 2
MA �Jti Pawtucket,RI 02860
G�"� ags .721-2245
Inspection Dates: 03-05-09
Then personally appeared the above-named q 4c! ve and made
oath that the above statement by him is true.
Before ^�
My Commission expires:
24 LA 4�i A P� 2007
700 School Street
Pawtucket,R102860
(401)721-2245 Fax (401)721-2238
AFA-2008-05 Neuoffice.doc
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