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BURGER KING 184 NOTH STREET HYANNIS - Certificates of Inspection
' BURGER KING 184 NORTH STREET HYANNIS . i LBK; LLC 822 Lexington Street,'2"d Floor Waltham, MA 02452 11HET° The Commonwealth of Massachusetts �L Town of Barnstable ,`6 9.- 2020 TEO MA'S s Certificate of Inspection Issued to Burger King Certificate No. Type: Building -Certificate of Inspection DBA Burger King IC-19-239 Identify property address including street number, name, city or town and country Certificate Expiration Located at Map/Lot 309-260 9/30/2020 in the Town of Barnstable 184 NORTH STREET, HYANNIS Location Use Group Classification(s) Allowable Occupant Load 1st A-2: Banquet halls, night clubs, restaurants, bars 59 A-2: Outside/Patio 11 Restrictions 59 Inside Seating 11 Outdoor Patio Seats This Certificate of inspection is hereby issued by the undersigned to certify that the premise, structure or portion thereof as herein specified has been inspected for general fire and life safety features. This certificate shall be framed behind clear glass and\or laminated and posted in a conspicious place within the space as directed by the undersigned, Failure to post or tampering with the contents of the certificate is strictly prohibited. Name of Municipal Building Official Jeff Lauzon Date of Inspection 10/2/2019 Signature of Municipal Building Official Date of Issuance 10/1/2019 t. _ The State of Massachusetts Town of Barnstable New and Renewal Certificate of Inspection Application Date 8/12/2019 Fee Required 50.00 In accordance with the provisions of the Massachusetts State Building Code,Section 110.7,hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: 184 NORTH STREET,HYANNIS Name of Premises: Burger King DBA: Burger King Purpose for which premises is used: Llcense(s)or Permit(s)required for the premises by other governmental agencies: Certificate to be Issued to: Burger King (Corp,LLC,or name of Business) Address: 284 NORTH STREET,HYANNIS Telephone: (781)893.0990 Owner of Record of Business or LBK LLC Establishment: . Address: 822 Lexington Street 2nd Fl Waltham, MA 02452 Manager or Persons responsible for Brek A.Kohler daily operation: -Mail: aiicia.mosto@mastoran.com rc trJ•: �� j IGNATURE OF RSON TO WHOM CERTIFICATE IS ISSUED OR AUTHORIZED AGENT n�y PLEASE PRINT NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. FQR OFFICE USE ONLY: CERTIFICATE# TIC-19-239 EXPIRATION DATE 9/30/2020 �IHKE Town of Barnstable Building Division ` 200 Main Street k HnRNsrAsLE• ` Hyannis,MA 02601 BARNSTABI,E j MASS. q�pr1e39• ,• (508) 862-4038 M oasaf EF �,�kW FD Mp�i a 1e39-20i4 Inspection Report ❑ Notice of Violation Business: &A K_G, k ►-,1)6 Date of Inspection: /d Contact: Info: Address: 1711 M mg ST Info: Phone: Info: Email: Info: During the annual occupancy inspection of your premises,performed in accordance with Section 110.7 of 780 CMR, Massachusetts State Building Code,as amended the following deficiencies and/orf violation(s)were noted: 0 > �GE,vC ' LSG HT ) I�S MI Section(s : Location: Q/(,k L((- Na-r pPr—'1ZXf"10w&Section(s): Location: p�10ltt J�RV�fzwt Section(s): Location: Section(s): Location: 0 Section(s):" Location: aj. 0 Section(s): Location: 0 Section(s): Location: 0 Section(s): Location: 0 Section(s): Location: Action required to abate the above violation(s)you must: 0 None:no violations were observed at the time of inspection Make corrections immediately and contact this office for a follow-up inspection Re-inspection fee of$ is required and a re-inspection to be requested by business within V days. 0 Make corrections prior to your next annual or semi-annual inspection. 0 Property/business owner or owners approved agent contact inspector for consultation " /') /'9 Official/Inspector: Telephone: 508 862-4038 Received By: r',7r.� � ems' y y ) Dater Print Name: `^n C' No ry i rL! � Section 102.6 existing structures-The owner as defined in 780 CMR 2,shall be responsible for compliance with provisions of 780 CMR 102:6 And,if aggrieved by this notice and order;to show cause as to why you should not be required abate the violation in this notice,you may file a_Notice of Appeal(specifying the grounds thereon with the State Building Code Appeals:Board within (45)days of the receipt of this order and in accordance with MGL c. 143§100. ,„Erg The Commonwealth of Massachusetts Town of Barnstable NAM a2019 Certificate of Inspection Burger King Certificate No. Issued to Brek A. Kohler Type: Building -Certificate of Inspection IC-18-234 Identify property address including street number, name, city or town and country Certificate Expiration Located at Map/Lot 309-260 9/30/2019 in the Town of Barnstable 184 NORTH STREET, HYANNIS Location Use Group Classifications) Allowable Occupant Load 1st A-2: Banquet halls, night clubs, restaurants, bars 59 A-2: Outside/Patio 11 Restrictions 59 Inside Seating 11 Outdoor Patio Seats This Certificate of inspection is hereby issued by the undersigned to certify that the premise, structure or portion thereof as herein specified has been inspected for general fire and life safety features. This certificate shall be framed behind clear glass and\or laminated and posted in a conspicious place within the space as directed by the undersigned, Failure to post or tampering with the contents of the certificate is strictly prohibited. Name of Municipal Building Commissioner Brian Florence Date of Inspection 10/11/2018 Signature of Municipal Building Date of Issuance Commissioner 9/13/2018 The State of Massachusetts &AmffrABM ,' MPt Town of Barnstable fO New and Renewal Certificate of Inspection Application Date 11/7/2017 Fee Required 50.00 In accordance with the provisions of the Massachusetts State Building Code,.Section 110.7, hereby app y for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: 184 NORTH STREET, HYANNIS Name of Premises: Burger King Purpose for which premises is used: License(s) or Permit(s) required for the premises by other governmental agencies: Certificate to be Issued to: Address: 822 Lexington Street 2nd FI Waltham MA 02452 C> Telephone: Owner of Record of Building: _. O Address: 822 Lexington Street 2nd FI Waltham MA 02452 _ Name of Present Certificate Holder: LBK LLCM-i a .. m m f Agent if an c 00 X_ - J L SIGNATURE OF PERS TO WHOM CERTIFICATE IS ISSUED OR AUTHORIZED AGENT E I I A^a i I / PLEASE PRINT-NAME INSTRUCTIONS: 1) Make check payable to:TOWN OF BARNSTABLE 2) Return this application with your check to: BUILDING COMMISSIONER, 200 MAIN STREET, HYANNIS, MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten (10) days of any change in the above information. FOR OFFICE USE ONLY: CERTIFICATE# 1 -245 EXPIRATION DATE 9/12/ 8 ,,17 I�/ 1 q 3 tr y�THEt°t,_ _ The Commonwealth of Massachusetts - �Y° Town of Barnstable t639. `0b 2017 Certificate of Inspection Burger King Certificate No. Issued to Brek A. Kohler Type: Building -Certificate of Inspection IC-16-210 Identify property address including street number, name, city or town and country Certificate Expiration Located at Map/Lot 309-260 9/12/2017 in the Town of Barnstable 184 NORTH STREET, HYANNIS Location Use Group Classifications) Allowable Occupant Load 1st A-2: Outside/Patio 11 A-2: Banquet halls, night clubs, restaurants, bars 69 Restrictions 59 Inside Seating 11 Outdoor Patio Seats This Certificate of inspection is hereby issued by the undersigned to certify that the premise, structure.or portion thereof as herein specified has been inspected for general fire and life safety features. This certificate shall be framed behind clear glass and\or laminated and posted in a conspicious place within the space as directed by the undersigned, Failure to post or tampering with the contents of the certificate is strictly prohibited. Name of Municipal Building Commissioner Paul Roma Date of Inspection 10/17/2016 Signature of Municipal Building Date of Issuance Commissioner !' ' 10/17/2016 �� ��- k t ►8 y �la�- - S4. &-'A;1;s Vl) r) COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date /6p (X) Fee Required$ 50.00 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code,Section 110.7,I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: r�`71 �. ' 2A�. Name of Premises: 071 f�. - i Purpose for which premises is used: License(s)or Permit(s)required for the premises by other governmental agencies: Licens o Permit Agency Certificate to be Issued to: ,� �.�., Lp, CY IJ Address: gl— Telephone: ax9lz) s Owner of Record of Building: a J Address: = Vz e� Name of Present Holder of Certificate: 7SIG. of Agent,i any: " PLEASE PROVIDE EMAIL:OF PERSON TO WHOM CERTIFICATE IS ISSUED OR AUTHORIZED AGENT We are now able to email the certificate to you. PLEASE PRINT NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER;200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee.must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. FOR OFFICE USE ONLY: CERTIFICATE#v 'l EXPIRATION DATE: q I G� J020115c i The Commonwealth of Massachusetts TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 110.7, this CERTIFICATE OF INSPECTION is issued to LBK, LLC Certify that I have inspected the premises known as: BURGER KING . located at 184 NORTH STREET in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: 2C Use Group(s): A2 The means of egress are sufficient for the following number of persons: Location Capacity Location Capacity INSIDE SEATING 59 OUTDOOR PATIO SEATS 11 EMPLOYEES 10 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 201505575 9/12/2015 9/12/2016 309 , 260 The building official shall be notified within(10) days of any S changes in the above information. Building Official PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 , DATE: 08/28/15 TIME: 13:53 -----------------TOTALS----------------- ' PERMIT $ PAID 50.00 AMT TENDERED: 50.00 ' AMT APPLIED: 50.00 ! CHANGE: .00 Y 1.APPLICATION NUMBER: 201505575 `,PAYMENT METH:' CHECK }PAYMENT REF: 14827 COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date (X) Fee Required$ 50.00 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code, Section 106.5,I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: LZ- i jL ' f Name of Premises: r Purpose for which premises is used: License(s)or Permit(s)required for the premises by other governmental agencies: r Li e se or.Permit, Agency'_ W. f Certificate to be Issued to: Address: Telephoner & Owner of Record of Building: A— Address: J Name of Present Holder of Certificate: N of Age ,if any: SIrNA &— PvSON TO AVHOM CERTIFICATE IS ISSUED OR AUTHORIZED AGENT PLEASE PRINT NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1),Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official.shall be notified within ten(10)days of any change in the above information. OFFICEFOR USE ONLY: . CERTIFICATE# o?d/$O SS 75 EXPIRATION DATE: a J020115c I Town of Barnstable Regulatory Services i Richard V.Scali,Director :b�q4 !t a Building Division Tom Perry,CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstabl e.ma. Office: 508-862-4038 Fax: 508-790-6230 July 27, 2015 LBK, LLC BURGER KING 184 NORTH STREET HYANNIS MA 02601 Attached you will find an application for a Certificate of Inspection as required by Section 110.7 of the Massachusetts State Building Code, Eighth Edition. Please complete the application and return to the Building Commissioner's Office with the required fee (amount as set on the top right-hand corner). The fee has been established by the State (Table 106), and amended by the Barnstable Town Council effective 08/06/01, and must be paid before the Certificate of Inspection/Capacity Card may be issued. A copy of said Certificate shall be kept posted as specified in Section 120.5 of the State Code. Sincerely, lQyk Tom Perry Building Commissioner Enclosure r The Commonwealth of Massachusetts TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION . is issued to LBK, LLC Certify that 1 have inspected the premises known as: BURGER ICING located at 184 NORTH STREET in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: 2C Use Group(s): A2 The means of egress are suff cient for the following number of persons: Location Capacity Location Capacity INSIDE SEATING 59 OUTDOOR PATIO SEATS I 1 EMPLOYEES 10 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 201405568 9/12/2014 9/12/2015 30 260 The building official shall be notified within(10) days of any changes in the above information. Building Official PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 08/22/14 TIME: 08:45 --------------1--TOTALS----------------- PERMIT $ PAID 50.00 'AMT TENDERED: 50.00 AMT APPLIED: 50.00 CHANGE: .00 APPLICATION NUMBER: 201405568 PAYMENT METH: CHECK PAYMENT REF: 12621 i COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date (X) Fee Required$ 50.00 ( ) No Fee Required In accordance with the provisions.of the Massachusetts State Building Code, Section 106.5,I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: Name of Premises: Purpose for which premises is used: / License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit ,...ems AA Certificate to be Issued to: Address: Telephone: ��/ . 9. e) 9� Owner of Record of Address: Name of Present Holder of Certificate: i= L Z_L Na e f Agent, if any: f SI NATURE OF PERSON TO WHOM CERTIFICATE a IS ISSUED OR AUTHORIZED AGENT " ca PLEASE PRINT AME ? INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued, 3)The building official shall be notified within ten(10)days of any change in the above information. FOR OFFICE USE ONLY: CERTIFICATE# EXPIRATION DATE: J081210 t TO Commcoubiealtb of finazzar juzetto TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to LBK, LLC QCBht[fp that I have inspected the premises known as: BURGER KING located at 184 NORTH STREET in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: 2C Use Group(s): A2 The means of egress are sufficient for the following number of persons: Location Capacity Location Capacity INSIDE SEATING 59 OUTDOOR PATIO SEATS 11 EMPLOYEES 10 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 201306433 9/12/2013 9/12/2014 3 26 The building official shall be notified within(10) days of any changes in the above information. Building Official PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 09/16/13 TIME: 1- -- TOTALS--------- � ----------------- ------- PERMIT $ PAID 50.00 AMT TENDERED: 50.00 AMT APPLIED: 50.00 CHANGE: .00 APPLICATION NUMBER: 201306433 PAYMENT METH: CHECK PAYMENT REF: 10301 COMMONWEALTH OF MASS ACHUSETTS TOWN OF BARNSTABLE 3 APPLICATION FOR CERTIFICATE OF INSPECTION Date = —(—X—)--Fee,-Requir j$ 50.00 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code, Section 106.5, 1 hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: ,dam i C� Name of Premises: (.LT �'-r ✓ Purpose for which premises is used: ar ;f License(s)or Permit(s) required for the premises by other governmental agencies: License or Permit _ Amy _ Certificate to be Issued_to: Address: �5 Telephone: w�9 CS449Q Owner of Record of Building: Address: �/ //Qin1> �. CO Name of Present Holder of Certificate: ,� r�/,2_ co ame f Agent, if any: 03 j` SIGNATURE OF PERSON TO WHOM CERTIFICATE IS ISSUED OR AUTHORIZED AGENT PLEASE PRINT NAME INSTRUCTIONS: 1)Make check pay ble tt . TOWN OF BARNSTABLE 2)Return this appl bn with your check to: BUILDING COMMISSIONER,200 MAIN STREET, NYANNIS, MA 02601 PLEASE NOTE: —'- ------ "' 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and f must be received before the certificate will be issued. 3)The building officia shall be notified within ten (10) days of any change in the above information. FOR OFFICE USE ONLY: CERTIFICATE#,-.40 130( TL/�� EXPIRATION DATE: J081210 I TOWN OF BARNSTABLE INSPECTION WORKSHEET Close CERTIFICATE NO: 201306433 CANCELLED: MAP: 309 DBA: IBURGER KING PARCEL: 260 NAME/MANAGER: JLBK,LLC STREET: 184 NORTH STREET VILLAGE: HYANNIS STATE: MA ZIP: 02601- SEQ NO: 1❑ BUSINESS TYPE: IRESTAURANT CONSTRUCTION TYPE: 12C STORY1: CAPACITY: USE1: A2 Capacity Under 50: O STORY2: CAPACITY: USE2: Outside Seating: ❑ STORY3: CAPACITY: USE3: BY PLACE OF ASSEMBY OR STRUCTURE CAP1: 59 LOC1: INSIDE SEATING CAPS: LOC8: CAP2: 11 LOC2: OUTDOOR PATIO SEATS CAP9: LOC9: CAP3: 10 LOC3: EMPLOYEES CAP10: LOC10: CAP4: LOC4: CAP11: LOC11: CAPS: L005: CAP12: LOC12: CAPE: LOC6: CAP13: LOC13: CAP7: LOCI: CAP14: LOC14: INSPECTION: DATE ISSUED: EXPIRATION: PrintTh s'Sciesn �0 12/ 011 09/12/2013 09/12/2014 Prnt'Certificate of Inspection : COMMENTS: OPINE ' TOWN OF BARNSTABLF Date: ................................ ! �' ❑ N ppI.ication LICENSE.APPLIC4TI0N "Renewal � M g 200 Main Street. i639 .�� ❑ Transfer Eon A Hyannis;MA 02601. (508) 862-4674 ❑ Other llTo `Busss ';NIaY 0pRATE ITFI®u V .;iD. LiCENSE ON TnE .PRENUSES a— Name o appllcan borporatlon/LLC _T_F� f��,�' -�—�� _____ ____ _ __...., Home phone#....:..__ y -- Address u applicant/corporatlonlU.0 ! �.. ..... Business phone#: ....................... D/B/A U - ........ `.._ .................. _ :- . .-. -. ....—.......----- ------ location — ---� - .... =:...'_.. + Cc��+r�....... _' .�4 ............_-.............. ._...............- - - Busmess Business mailing address if different_fram.abave)°. , t' L f i - u `-- ........ f Ucense T e � ti ai j �/ -- - --- -Yp _ _ Gl�: ..................r .... Annuals Seasonal Hours of Operafio !� / Ur✓' crr _./�ztf-� _ ::Federal.ID#: -- Hours of'::Entertainment; Hours.of Alcohol Service: Name of Manager _ email: Ge 12) Manager's permanent mailing address '1....-, c.;�'%ram '7 > 1� fti_ �� f, ,t �� J J ...... - -- i Manager's home phone# _.A ___.__ Business phone.#: �,! _%'%lGlh .....__ _. ...........__... Name of property owner ,, ' .... ... __ ASSESSOR S:MAP/PARCEL# MAP l Uc (�C� PARCEL :....:............_ y List any flammable substance or hazardous was te`used in business(specify): _ Applicants must .,ONLY , contact: the.: Building,Commissioner,S office, (508) 862- 4038, the Board:'-of Health office (508) 862-4644, and . the appropriate Fire Dis rict` office -to schedule inspections .IF YOU ARE NOT OPEN OFFICE BUSINESS :HOURS (8. 30 - 4 s 30 daily),, Signature of applicant ....... ........ r T wn use only REAL.ESTATE TAXES PAID IN FULL ('Al t PAYMENT AGREEMENT IN EFFECT ON IS THIS USE PERMITTED WITHIN THIS!ZONING D STRICT YES '❑ `;NO ❑ CQ'� INSPECTORS APPROVAL Capacity set by Building Division,...__I_�. ... _ - — ----- - ;Buildin Zornn Date oard of Health _.:.._ 9- -- - - - - ------- --_-- Date ............._.._....._.-...-- ---.--..__.._ Flre Dlstnct ::__ _ _— ._� _Date__...-- . _._._ _..:_: Comments;._.._...._........._.._..........._ _. While Lcensmg Aulhdnty Gold•Building Commissioner Pink-Fire Department Canary-Health Division TOWN OF BARNSTABLE INSPECTION WORKSHEET ;4�ose '7 --.—CERTIFICATE NO: 201306433 CANCELLED: MAP: 309 DBA: BURGER KING PARCEL: 260 NAME/MANAGER: JLBK, LLC STREET: 1184 NORTH STREET VILLAGE: JHYANNIS STATE: aA I ZIP: 02601- SEQ NO: 1❑ BUSINESS TYPE: IRESTAURANT CONSTRUCTION TYPE: 12C STORYI: CAPACITY: USE1: A2 Capacity Under 50: ❑ STORY2: CAPACITY: USE2: STORY3: CAPACITY: USE3: Outside Seating: ❑ BY PLACE OF ASSEMBY OR STRUCTURE CAP1: 59 LOC1: INSIDE SEATING CAPS: LOC& CAP2: 11 LOC2: OUTDOOR PATIO SEATS CAP9: LOC9: CAP3: 10 LOC3: EMPLOYEES CAP10: LOC10: CAP4: LOC4: CAP 11: LOC11: CAPS: L005: CAP12: LOC12: CAPE: LOC6: CAP13: LOC13: CAP7: LOCI: CAP14: LOC14: INSPECTION: DATE ISSUED: EXPIRATION: R int l kScre ne' s o 09/17/2013 09/12/2013 09/12/2014 am-a a ' t C,ertifte gf InspeEtl I COMMENTS: The Commoubjealtb of Aa5S,5arbUqdt,5 TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.S, this CERTIFICATE OF INSPECTION is issued to LBK, LLC Q�EYt[fp that I have inspected the premises known as: BURGER KING located at 184 NORTH STREET in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: 2C Use Group(s): A2 The means of egress are suff cient for the following number of persons: Location Capacity Location Capacity MAXIMUM SEATING CAPACITY 100 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 201104891 9/12/2011 9/12/2012 0 The building official shall be notified within(10)days of any S changes in the above information. Building Official ,1 ------------------------ PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 09/12/11 t. TIME: 13:00 t ------------------TOTALS------------� ---- PERMIT $ PAID 50.00 AMT TENDERED: 50.00 AMT APPLIED: 50.00 CHANGE: .00 APPLICATION NUMBER: 201104891 PAYMENT METH: CHECK \PAYMENT REF: 5297 i COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date �� ( X) Fee Require $ 00.00 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code, Section 106.5, I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: Name of Premises: er Purpose for which premises is used: License(s)or Permit(s) required for the"premises by'other governmental agencies: " T License or Permit Agenc �fv/T)i»on Certificate to be Issued to: 4 L� Address: V _ GZ, Telephone: Owner of Record of Building: - Address: ; Name of Present Holder of Certificate: d ame f Agent, if any: w. .^~M SIGNATURE OF PERSON TO WHOM CERTIFICATE IS ISSUED OR AUTHORIZED AGENT PLEASE PRINT NAME INSTRUCTIONS: 1)Make check pay l5le t TOWN OF BARNSTABLE 2)Return this appl n with your check to: BUILDT�I' COMMISSIONER, 200 MAIN STREET, HYANNIS, MA 02601 PLEASE NOTE: —� 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and f must be received before the certificate will be issued. 3)The building officia hall be notified within ten (10) days of any change in the above information. FOR OFFICE USE ONLY: a CERTIFICATE# + EXPIRATION DATE:__ J081210 i I IKE TOWN OF BARNSTABLE date . ..... . ❑ w flpplibation t snxivsrnBM LICENSE APPLICATION' Renewal 9 Mnss $ 200 Main Street 4e39. �� ❑ Transfer Hyannis,MA 02601 (508) 862=4674 '❑ Other o NO BUSINESS MAY OPERATE WITHOUT A VALID LICENSE ON THE .PREAUSES 4 Name of applicant/corporation/LLC: 2- L ..._._ _..._...... _....._................._....._.........................._... Home phone#:.................... _..._...... __... _ Address of applicant/corporation/LLC _3- -- -�- == -__:_ :.�- %: ___ x�:.L.l_�f 1.__ Business phone#: P ' D/B/A _...__._. J � --- - - -- -- --- __ Business location: - F;� - _,l._. .. rr ..` ram' .... � �r E.... -.. - - -_ . Business mailing address..(if..diffei•entfram.aboVe.).- � ?_..__ _..::4!/<_r.r__;.. License Type:. c rt` ./..1 Tr :...�'r ......L' %....?4 r <� �...�................................................ Annual �.: Seasonal Hours of Operation}' :....._'f�.....1r1r ....._ ....... Federal ID#: Hours of Entertainment: Hours of Alcohol Service: Name of Manager: em .; ` atL �� r %', ;�r� C" Manager's permanent mailing address - ._1.r_.r ��.._.__il ......�..... _. W} :_i` _r 1� ...-_ d) i_ f Manager'saiome phone#: _..,.., _ __.__.. _...._ Business phone#: ._....._. — .._.._._ Name of property owner: ps _ ... ... _........,_ _........._....... ..............-- -. ... ASSESSOR'S MAP/PARCEL t AP ..:.:....� `.};. .:. PARCEL rL!...:.,,..... ... . List any flammable substance or hazardous.waste used in business(specify): Applicants must ONLY contact the Building Commissioner's . office, (508) . 86.2 4038, the Board of Health office, (508) 862-4644, and the_ appropriate Fire` District office to schedule inspections IF YOU ARE NOT OPEN OFFICE BUSINESS HOURS (8 :30 - 4 3-� daily) 11I j�`� J Signature of applicant ,, ................. ........ .................................... ...... ... ................................................... .... .. ....................... .... . Foy Town use only REAL ESTATE TAXES PAID IN FULL f . PAYMENT AGREEMENT IN EFFECT ON .IS THIS USE PERMITTED WITHI IS ZONING'DIST CT? YES NO INSPECTORS APPROVAL Capacity set by.Building Division.........._ �l._`�.. ..... . ......._.._......._:....... ... : . _. ... Building/Zoning...._.-. _.....---......._._.. _.........:..._ Date l..0 .. .. __ Z/Board of Health... _:_ .. Date ..:_.........___..._.._........... Fire District _ --= --._...�._..---......._.—..------ _ Date_...-... _ ----- - Comments: ..._..__........._..............__. While-Licensing Authority Gold Building Commissioner Pink-Fire Department Canary-Health Division I TOWN OF BARNSTABLE INSPECTION WORKSHEET Chose„ CERTIFICATE NO: 200905798 CANCELLED: CANCEL MAP: 309 DBA: IBURGER KING PARCEL: 260 NAME/MANAGER: JLBK, LLC STREET: 1184NORTHSTREET VILLAGE: JHYANNIS STATE: EkA ZIP: 02601- SEQ NO: 1� BUSINESS TYPE: IRESTAURANT CONSTRUCTION TYPE: 12C STORYI: CAPACITY: USE1: A2 Capacity Under 50: ❑ STORY2: CAPACITY: USE2: STORY3: CAPACITY: USE3: Outside Seating:. ❑ BY PLACE OF ASSEMBY OR STRUCTURE CAP 1: l � �. .LOCI: MAXIMUM SEATING CAPACITY CAPS: LOC8: CAP2: LOC2: CAP9: LOC9: CAP3: LOC3: CAP10: LOC10: CAP4: LOC4: CAP11: LOCI 1: CAP5: L005: CAP12: LOC12: CAPE: LOC6: CAP13: LOC13: CAP7: LOCI: CAP14: LOC14: INSPECTION: DATE ISSUED: EXPIRATION: „ .•Print Thi§;Screed i 09/12/2011 09/12/2012 _, Pfint Certlficate'of Inspection COMMENTS: TOWN OF BARNSTABLE INSPECTION WORKSHEET o:se CERTIFICATE NO: 201104891 CANCELLED: CANCEL MAP: 309 DBA: BURGER KING PARCEL: 260 NAME/MANAGER: JLBK, LLC STREET: 1184 NORTH STREET VILLAGE: IHYANNIS STATE: FWA ZIP: 02601- SEQ NO: 1❑ BUSINESS TYPE: IRESTAURANT CONSTRUCTION TYPE: 12C STORY1: CAPACITY: USE1: A2 Capacity Under 50: ❑ STORY2: CAPACITY: USE2: STORY3: CAPACITY: USES: Outside Seating: ❑ BY PLACE OF ASSEMBY OR STRUCTURE CAP1: 100 LOCI: MAXIMUM SEATING CAPACITY CAPS: LOC8: CAP2: LOC2: CAP9: LOC9: CAP3: LOC3: CAP10: LOC10: CAP4: LOC4: CAP11: LOCI 1: CAPS: L005: CAP12: LOC12: CAPE: LOC6: CAP13: LOC13: CAP7: FILOCI: CAP14: PLOC14: INSPECTION: DATE ISSUED: EXPIRATION: Fr`int This Scree 0 09/12/2011 09/12/2012 Print Certi#icate.ofklnspection COMMENTS: TO CorrYr onbjealtb of '41a.55arbuatt5 TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 1065, this CERTIFICATE OF INSPECTION is issued to LBK, LLC QCCrt[fp that 1 have inspected the premises known as: BURGER KING located at 184 NORTH STREET in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: 2C Use Group(s): A2 The means of egress are sufficientfor the following,number ofpersons: Location Capacity Location Capacity MAXIMUM SEATING CAPACITY 92 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel . 200905798 2/1/2010 2/1/2011 309 260 The building official shall be notified within (10) days of any changes in the above information. Building Official PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE fY BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 11/24/09 TIME: 15:04 -----------------TOTALS----------------- PERMIT $ PAID 50.00 AMT TENDERED: 50.00 AMT APPLIED: 50.00 CHANGE: .00 i APPLICATION NUMBER: PAYMENT METH: CHECK PAYMENT REF: 61616 Nov, 16. 2009 1 : 21PM No. 6557 P. 4 COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date (X) Fee Required$ 50.00 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code,Section 106.5,I hereby apply for a Certificate of Inspection for the below-named premises locate(d/at the fonllowing address: Street and Number: �� D/' �/J� �/�n s, ,;/ , Name of Premises: Purpose for which premises is used: License(s)or Permit(s)required for the premises by other governmental agencies: License or Permt Agency Certificate to be Issued to: � L�C Address: »64 A,-',_ Y1 ' Telephone: ,fz L;2Q Owner of Record of Building: i,. Address: Name of Present Holder of Certificate: jti Z� Na f Agent,if any: SIGNATURE OF PERSON TO'WHOM CER IFICATE IS ISSUED OR AUTHORIZED AGENT PLEASE PRINT NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. POR OFFICE USE ONLY: CERTIFICATE# EXPIRATION DATE, !C22�/�-�'%,, J081210 AGORA. CERTIFICATE OF LIABILITY INSURANCE OP ID AJ DATE(MM/DD/YYYY) MASTO-1 11 19 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DGP-Miles Insurance Agency,Inc HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 3 School Street P.O. Box 1018 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Taunton MA 02780-0957 Phone: 508-824-8961 Fax:508-880-2734 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Star Insurance Company INSURER B: Mastoran Corporation INSURERC: dba Burger Kin 822 Lexington 245 INSURER . , 2nd Floor INSURER D: Waltham MA 0 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. INS UL LTRINSRE TYPE OF INSURANCE POLICY NUMBER PO E C E POLICY EXPIRATION DATE MM/DDIYY DATE MM/DD LIMITS GENERAL LIABILITY EACHOCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES(Ea occuranca) $ CLAIMS MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY E jEa LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND X TWC LIMITS ER A EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE WC0109051 12/12/08 12/12/09 E.L.EACH ACCIDENT $500000 OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE $5 0 0 0 0 0 If yyes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Evidence of Workers Compensation Insurance effective 11/30/09 for Burger King #664 located at 184 North Street, Hyannis, MA 02601 CERTIFICATE HOLDER CANCELLATION TOWNBA1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Town of Barnstable IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Hyannis MA 02601 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE �1 David G. Pietro:Lat ,(m ACORD 25(2001108) ©AG`ORD CORPORATION 1988 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations wl " 600 Washington Street Boston, MA 02111 4 www.mass.gov/dia Workers'.Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Legibly Business/Organization Name: Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Business Type(required): 1.❑ I am a employer with' employees(full and/ 5. ❑ R tail or part-time).* 6. Restaurant/Bar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no 7. ❑ Office and/or Sales(incl.real estate,auto,etc.) employees working for me in any capacity. [No workers' comp.insurance required] 8. ❑ Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑ Entertainment their right of exemption per c. 152, §1(4),'and we have 10.❑ Manufacturing no employees. [No workers' comp.insurance required]* 4.❑ We are a non-profit organization,staffed by volunteers, 11.❑ Health Care with no employees. [No workers' comp.insurance req.] 12.0 Other *Any applicant that checks box#1 must also fill oit the section below showing their workers'compensation policy information.. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#1. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information. Insurance Company Name: I Insurer's Address: City/State/Zip: Policy#or Self-ins.Lic.# Expiration Date: 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 violater. 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 certify, under thepains andpenalties ofperjury that the information provided above is true and correct Signature: 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.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: ww,v.mass.gov/dia L 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 your insurance company's name, address and phone number along with a certificate 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). 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 640 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax #617-727-7749 www.mass.gov/dia Form Revised 5-26-05 TOWN OF 6A INSTABLE 7M 0 V 2 4 PM 12: OO D November 23, 2009 Town of Barnstable Building Commissioner 200 Main Street Hyannis, MA 02601 RE: Burger King#664 To Whom It May Concern: LBK, LLC will be acquiring the above referenced Burger King on or around December 1, 2009. Please find enclosed the license/permit application and fee included. Please mail the original license,once complete, to LBK, LLC, 822 Lexington Street, Second Floor, Waltham, MA 02452. We will keep a copy for our office files and forward the original to the restaurant. If you prefer to mail the original to the restaurant, please either mail or fax a copy to us. <' If you have any questions or need any additional information, please give us a call at (781) 893-0990. Thank you in advance for your prompt attention to this matter. Sincerely, �IissaGoldberg Accounts Payable Manager. Enclosures LBK, LLC 822 Lexington Street, Second Floor, Waltham,MA 02452 (781)893-0990 Fax (781)899-6977 A Franchisee of Burger King.Corporation y� oFT�tqk, TOWN OF BARNSTABLL Date: .............................................. LICENSE APPLICATION El New Application BARNf'"BM * �enewal MASS� 200 Main Street 059. _ ❑ Transfer iOrFo. �� Hyannis,MA 02601 ❑ Other 508 862-4674 o NO BUSINESS MAY OPERATE WITHOUT A VALID LICENSE ON THE PREMISES 4 Name of applicant/corporation/LLC:. _ Z--C- Home phone#: _— ___.. Address of applicant/corporation/U. - r _` L--LZIZ'�--= f Business phone#: 7av/. /, � C� _ Q1 _ � ------------- Business location: � �1�7`1= Business mailing address.4if_differeadr:or.-aba.e.)--!42-W-0r° _ z0az az zlvG -Doi License Type: C . ` ..... .rr10 •-.........:........ C? .�4:jr.. . ................................................. Annual ©� Seasonal Hours of Operation: �J �► - =/ "~'�- Federal ID#: Hours of Entertainment: Hours of Alcohol Service: Name of Manager: f- `yam h/�% i7�1—wg/k email:Q CyC' i!Q.6X 7 Mra_. Manager's permanent mailing address: Manager's home phone#: _ Business phone#:L-620Z-17--ZG1�9 Name of property owner:. - ASSESSOR'S MAP/PARCEL#: MAP (-?0 PARCEL........................ List any flammable substance or hazardous waste used in business(specify): Applicants must ONLY contact the Building Commissioner's office, (508) 862- 4038, the Board of Health office, (508) 862-4644, and the appropriate Fire District office to schedule inspections IF YOU ARE NOT OPEN OFFICE BUSINESS HOURS (8:30 - 4:30 daily) . Signature of applican f?:���� . ....................................................:::............................... ....... ...n use only....,...................................................... fy�,................................... REAL ESTATE TAXES PAID IN FULL PAYMENT AGREEMENT IN EFFECT ON IS THIS USE PERMITTED WITHIN THIS ZONING DISTRICT? YES ❑ NO ❑ INSPECTORS APPROVAL -- —__ — _—�— Capacity set by Building Division,_ Building oning_ - Date .��--01� f_-_ Board of Health--,._ Datd,.1-1 Fire District --� Date White-Licensing Authority Gold-Building Commissioner Pink-Fire Department Canary•Health Division TOWN OF BARNSTABLE INSPECTION WORKSHEET µYC"ose" CERTIFICATE NO: 201104891 CANCELLED: CANCEL MAP: 309 DBA: IBURGER KING PARCEL: 260 NAME/MANAGER: JLBK, LLC { STREET: 1184NORTHSTREET VILLAGE: JHYANNIS STATE: MA ZIP: 02601- SEQ NO: 1❑ BUSINESS TYPE: IRESTAURANT CONSTRUCTION TYPE: 2C STORYI: CAPACITY: USE1: A2 Capacity Under 50: ❑ STORY,2: CAPACITY: USE2: STORY3: CAPACITY: USE3: Outside Seating: ❑ BY PLACE OF ASSEMBY OR STRUCTURE CAP1: 100 LOC1: MAXIMUM SEATING CAPACITY CAPS: LOC8: CAP2: LOC2: CAP9: LOC9: CAP3: LOC3: CAP10: LOC10: CAP4: LOC4: CAP 11: LOC11: CAPS: L005: CAP12: LOC12: CAPE: LOC& CAP13: LOC13: CAP7: LOCI: CAP14: LOC14: INSPECTION: DATE ISSUED: EXPIRATION: �PI► 1aeni E> e L� 09/12/2011 09/12/2012 r�K;,q-�KE�.;s';��� rite �`j' ✓ Prin Cart fl atetof+t COMMENTS: - t � Date: .... .................+ .. .. o TOWN OF BARNSTABLE E]. New Application LICENSE APPLICATION enewal BMMSTABM MASS 200 Main Street ❑ Transfer n Hyannis,MA 02601Other (508) 862-4674 f; E t ` --♦ NO BUSINESS .MAY OPERATE WITHOUT A VALID LICENSE ON l r�r• PREMISES 4 . — / Home hone# Name of applicant/corporation/LLC:_-� �' L— ' _.._ _. .'.. _-_� _- .'_.-�_�_ 1.__.__ Business phone# i f :' ,�� I%!%U Address of applicanVcorporation/LLCM , D/B//A - // c "i': t _. _.___ ....__.._._. .._...-...._......__._......... ---- Bustness location. ` _----- Business mailing address..(if..difterent..frotn..abave)�'� T' .............. � ` -. ... G=`".�`/ `�`'� ./ L 7' _........F..._1 ..._._...... License Type: r r f : . ; , �.�rt /.... r............................................... Annuaf; � Seasonal . .. ��'�.�•__..-._��_. / ors ...._ Federal ID# �:._. R .'` Hours of Operation: 7.7 .-- -- Hours of Entertainment: Hours of Alcdhol.Service. !Tt ./ ` 7/ Name.of Manager: � 1, e/ Iematl. r_ Cr a -- -- x� r ,. r, %..... G� !�P /j/11.Ct .......�.� �v. ........ Manager's permanent mailing address �.. / .: -.. _tf �� �� - = Name of property owner: -........................_ ...._._ ----- - - ASSESSOR'S MAP/PARCEL#: MAP " "�` ................... PARCEL List any flammable substance or haiardous waste used in business(specify): Applicants must ONLY contact the Building Commissioner's office, : (508) 861 4038, the Board of Health office, (508) 862-4644, and the appropriate Fire. . District office to, schedule"inspections IF YOU. ARE NOT OPEN- OFFICE BUSINESS HOURS (8:3 0 - 4:3 0 ;daily) . Signature of applican .... ....... ...:.............................. ........................................................... ... r orTown use only REAL ESTATE TAXES PAID IN FULL f PAYMENT AGREEMENT IN EFFECT ON IS-THIS USE PERMITTED WITHIN THIS ZONING DISTRICT? YES O NO :�—____..._ Capacity set by Building Division•,___,_,,,•, ....._ INSPECTORS APPROVAL � C ...:.._ IOvin._,... V.- ---.. ....... �,.._...... ..._...._._..._. . Building/Zoning....=_.__.___._..:__.__......._...._-...__.:_..-.....__......_.._... Date ._......_........._.... _........ Board of Health....__._.____..._._..._ .. Date......_ =--- Fire District -----:_.._Date ..._..._.._...__..........-----....-----....Comrnents:...._.__...._.__...-........ _.�__.= ......-............. .._._._............_._:.:..... ..... _.......:_. White9 -Licensing Authority Gold Building Commissioner Pink-Fire Department Canary-Health Division TOWN OF BARNSTABLE INSPECTION WORKSHEET Close CERTIFICATE NO: 201104891 CANCELLED: CANCEL MAP: 309 DBA: IBURGER KING PARCEL: 260 NAME/MANAGER: ILBK, LLC STREET: 1184NORTHSTREET VILLAGE: HYANNIS STATE: FVA7 ZIP: 02601- SEQ NO: a BUSINESS TYPE: IRESTAURANT CONSTRUCTION TYPE: 12C STORYI: CAPACITY: USE1: A2 Capacity Under 50: ❑ STORY2: CAPACITY: USE2: STORY3: CAPACITY: USE3: Outside Seating: ❑ BY PLACE OF ASSEMBY OR STRUCTURE CAP1: 59 LOC1: INSIDE SEATING CAPS: LOC8: CAP2: 11 LOC2: OUTDOOR PATIO SEATS CAP9: LOC9: CAP3: 10 LOC3: EMPLOYEES CAP10: LOC10: CAP4: LOC4: CAP11: LOC11: CAPS: L005: CAP12: LOC12: CAP6: LOC6: CAP13: LOC13: CAP7: LOC7: CAP14: LOC14: INSPECTION: DATE ISSUED: EXPIRATION: jj piiht+This Screen o 12/07/2011 09/12/2011 09/12/2012 '��.,„,P,�int'Certificate bf Inspection ��� COMMENTS: I TOWN OF BARNSTABLE INSPECTION WORKSHEET Coos. CERTIFICATE NO: 200905798 CANCELLED: MAP: 309 DBA: IBURGER KING PARCEL: 260 NAME/MANAGER: ILBK, LLC STREET: 1184 NORTH STREET VILLAGE: JHYANNIS STATE: FMAJ ZIP: 02601- SEQ NO: BUSINESS TYPE: IRESTAURANT CONSTRUCTION TYPE: 12C STORYI: 92 CAPACITY: USE1: A2 Capacity Under 50: r STORY2: CAPACITY: USE2: STORY3: CAPACITY: USE3: Outside Seating: r( BY PLACE OF ASSEMBY OR STRUCTURE CAP1: 92 LOC1: MAXIMUM SEATING CAPACITY CAPS: L005: CAP2: LOC2: CAPE: LOC6: CAP3: LOC3: CAP7: LOC7: CAP4: LOC4: CAPS: LOC8: INSPECTION: DATE ISSUED: EXPIRATION: Pr1nt 7his3c een f 02/01/2010 - PrintCertificate oftlrispec� "tip '`�" c�._a 3. ►o I COMMENTS: The Commonbjeattb of j'Ra.5.5arbU.5ett TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to BOSTON WYMAN, INC. #664 Q�Ertifp that I have inspected the premises known as: BURGER KING located at 184 NORTH STREET in the Village of -HYANNIS r County of Barnstable Commonwealth of.Massachusetts. Construction Type: 2C Use Group(s): A-3 The means of egress are sufficient for the following number of persons: Location Capacity Location Capacity MAXIMUM SEATING.CAPACITY 92 Certificate Number, Date Certificate Issued: Date Certificate Expired: Map Parcel 200806957 1/7/20.09 1/7/2010 309 260 The building official shall be notified within (10) days of any changes in the above information -:✓.." -- -- ---- — - - Building.Official r PERMIT PAYMENT RECEIPT TOWN OF BARNSTABI.E BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 12/16/08 TIME: 11 :49 -----------------TOTALS------------------ PERMIT $ PAID 50.00 AMT TENDERED: 50.00 AMT APPLIED: 50.00 CHANGE: .00 APPLICATION NUMBER: 200806957 PAYMENT METH: CHECK AYMENT REF: 1789 i t COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date e,c- Q-00$ { X) Fee Required$ 50.00 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code, Section 106.5, I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: 1 -6 4 M,2,6 n SA` ed Name of Premises: `.�V.0 G �,�( kl nC, At (o6 4 Purpose`for which premises is used: FcoA IF4 ) License(s) or Permit(s) required for the premises by other governmental agencies: License or Permit A enc Certificate to be Issued to: �Q"y'� — t ��m,(��� i TY}C, Address: 11n—�iC )AA � � ual V Telephone: 5C`jgj— `� — a L4 Owner of Record of Building: "'r Q'4L r K Co Address: L43y � UJoadSGn a sb►�, lerr r`l® �3134 Name of Present Holder of Certificate: (xn , i hlG ,v Na e of Agent, if any: F� Sr E O 4PER4STO WHOM CERTIFICATE SUED OR AUTZED AGENTCo ^ uy PLEASE PRINT NAME r= r � INSTRUCTIONS: 1) Make check payable to: TOWN OF BARNSTABLE 2) Return this application with your check to: BUILDING COMMISSIONER, 200 MAIN STREET, HYANNIS, MA 02601 PLEASE NOTE: 1) Application form with accompanying fee must be submitted for each,building or 'structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3) The building official shall be notified within ten (10) days of any change in the above information. FOR OFFICE USE ONLY: CERTIFICATE# �ZOO�� � EXPIRATION DATE: Q J020115b L Town of Barnstable Regulatory Services * snwvseABM 9 MASS& Thomas F. Geiler,Director �ArE039. Building Division Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 November 16, 2009 Alicia Masto Mastoran Corp. 822 Lexington Street, 2nd Floor Waltham, MA 02452 By fax: 1 781 899 6977 Re: 184 North Street,Hyannis 2145 Iyannough Road, W. Barnstable Dear Ms. Masto: Attached you will find an application for a Certificate of Inspection as required by Section 106.5 of the Massachusetts State Building Code, Seventh Edition. Please complete the application and return to the Building Commissioner's Office with the required fee (amount as set on the top right-hand corner). The fee has been established by the Massachusetts State Building Code (Table 106), and amended by the Barnstable Town Council effective 8/6/01, and must be paid before the Certificate of Inspection/Capacity Card may be issued. A copy of said Certificate shall be kept posted as specified in Section 120.5 of the State Code. Sincerely, Thomas Perry Building Commissioner Enclosure jcoilet TOWN OF BARNSTABLE INSPECTION WORKSHEET cibs CERTIFICATE NO: 200806957 CANCELLED: MAP: 309 DBA: IBURGER KING PARCEL: 260 NAME/MANAGER: BOSTO , INC.#664 STREET: 1184NORTHSTREET VILLAGE: IHYANNIS I STATE: F MA ZIP: 02601- SEQ NO: 1❑ BUSINESS TYPE: IRESTAURANT CONSTRUCTION TYPE: 12C STORY1: 92 CAPACITY: USE1: A2 Capacity Under 50: STORY2: CAPACITY: USE2: STORY3: CAPACITY: USE3: Outside Seating: r1 BY PLACE OF ASSEMBY OR STRUCTURE CAP1: 92 LOC1: MAXIMUM SEATING CAPACITY CAPS: L005: CAP2: LOC2: CAPE: LOC6: CAP3: LOC3: CAP7: LOCI: CAP4: LOC4: CAPS: LOC8: INSPECTION: DATE ISSUED: EXPIRATION: Print TThis Screenl 12/17/2008 01/07/2099 01/07/2010 print,Cert�ficate of I peCtion t` COMMENTS: I TOWN OF BARNSTABLE INSPECTION WORKSHEET Coos CERTIFICATE N0: 200708026 CANCELLED: MAP: 309 DBA: IBURGER KING PARCEL: 260 NAME/MANAGER: IBOSTON WYMAN, INC.#664 STREET: 1184 NORTH STREET VILLAGE: JHYANNIS STATE: F MA ZIP: 02601- SEQ NO: 0 BUSINESS TYPE: IRESTAURANT CONSTRUCTION TYPE: 12C STORY1: 92 CAPACITY: USE1: A 3 Capacity Under 50: STORY2: CAPACITY: USE2: STORY3: CAPACITY: USE3: Outside Seating: L 1, BY PLACE OF ASSEMBY OR STRUCTURE CAP1: 92 LOC1: MAXIMUM CAPACITY CAPS: L005: CAP2: LOC2: CAP6: LOC6: CAP3: LOC3: CAPT. LOC7: CAP4: LOC4: CAPS: LOC8: INSPECTION: DATE ISSUED: EXPIRATION: Print This Screen; 01/16/2008 01/07/2008 1 F-01/07/2009 Punt ertificate of Inspection COMMENTS: Ebe eommconweartb of '-ffia55arbU5ett'q TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to BOSTON WYMAN, INC. #664 I Certifp that 1 have inspected the premises known as: BURGER KING located at 184 NORTH STREET in the [pillage of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: 2C Use Group(s): A-3 The means of egress are sufficient for the following number ofpersons: Location Capacity Location Capacity MAXIMUM CAPACITY 92 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 200708026 1/7/2008 1/7/2009 309 260 The building official shall be notified within (10) days of any changes in the above information. Building Official i t -. _ � - -.�,_ _ it _ 1'`- 1 1 i 1 � r���. w„'�°� i d t4' +y*�.-•:FCC,r4! OF MR& I3 d ARTME I M IN 5 -.T ID S., 2601 " }trio, .. t A T s PAD . ENPEREN 50. 'i; P TED: Rd ilf'' L TION NUMBER- 2 . �E, y 00 t�isu i COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date (X) Fee Required$ 50.00 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code, Section 106.5, I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: /'0,41 Name of Premises: ICJ Purpose for which premises is used: �� License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit A enc i Certificate to be Issued to: Address: //D 3I Cc,-s A a 3 (z/I i 7-fS #Z/0 zj/)i S, Telephone: 50&- '7M-50114 Owner of Record of Building: jt 10 0 Address: c?Oo Name of Present Holder of Certificate: -00 3 y N W I AI ,4 iU � Name of Agent, if ny: N D ill P SIGNATURE OF PERSON TO WHOM IFICATE IS ISSUED OR A `TH/ORIZED AGENT V 1,n A N J e S PLEASE PRINT NAME/ INSTRUCTIONS:-. / 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET,HYANNIS, MA 02601 PLEASE NOTE: 1)Application form with accompanying.fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. FOR OFFICE USE ONLY: CERTIFICATE# Z EXPIRATION DATE: J020115b 1 T. be eommouwea ltb of Iflac.5.0a rbuzettss TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to BOSTON WYMAN, INC. #664 3 Certifp that I have inspected the premises known as: BURGER KING located at 184 NORTH STREET in the Village of 14YANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: 2C Use Group(s): A-3 The means of egress are sufficient for the following number of persons: Location Capacity Location Capacity MAXIMUM CAPACITY 92 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 20065372 1/7/2007 1/7/2008 309 260 The building official shall be notified within (10) days of any changes in the above information. Building Official .0 COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date /yvr'��L (X) Fee Required$ 50.00 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code, Section 106.5,I hereby apply for a Certificate of Inspection for the below-named premis es/located at the following address: Street.and Number: �c) Yye e 4ji ni v. MA ©�/ao� Name of Premises: LL i f757 cs- Purpose for which premises is used: �5 an�— Licenses)or Permit(s)required for the premises by other governmental agencies: License or Permit Agency Certificate to be Issued to: 05 11�� L [ Address + d A fft Owner of Record of Building: /F [//lsn xl ]` / o is c�r A;off Address: CYO �, Cc� �y S�/ee T N S 5 r774, /! in ti /_/Ar Name of Present Holder of Certificate: 7505 0 !rL/ Name of Agent,if any: SIGNATURE OF PERSON TO WHOM CERTIFICATE XISSD OR AUTHORIZED AGENT All— P T NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)j Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. FOR OFFICE USE ONLY: CERTIFICATE# EXPIRATION DATE:—z/;7/®g J020115b TOWN OF BARNSTABLE INSPECTION WORKSHEET Coos CERTIFICATE NO: 1 200708026 CANCELLED: MAP: Fa09 DBA: IBURGER KING PARCEL: 260 NAME/MANAGER: IBOSTON WYMAN, INC.#664 STREET: 184 NORTH STREET VILLAGE: IHYANNIS STATE: MA ZIP: 02601- SEQ NO: 0 BUSINESS TYPE: IRESTAURANT CONSTRUCTION TYPE: 12C STORY1: 92 CAPACITY: USE1: A-3 Capacity Under 50: `_ STORY2: CAPACITY: USE2: STORY3: CAPACITY: USE3: Outside Seating: BY PLACE OF ASSEMBY OR STRUCTURE CAP1: 92 LOCI: MAXIMUM CAPACITY CAPS: L005: CAP2: LOC2: CAPE: LOC6: CAP3: LOC3: CAP7: LOC7: CAP4: LOC4: CAPS: LOC8: Pnt Thi§'Scree INSPECTION: DATE ISSUED: EXPIRATION: �^ ? tz?8Ar3, 01/07/2008 01/07/2009 ;., Print Certificate of Inspection COMMENTS: e CommonWeattb of TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.S, this CERTIFICATE OF INSPECTION is issued to BOSTON WYMAN, INC. #664 3 Certifp that I have inspected the premises known.as: BURGER KING located at 184 NORTH STREET in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: 2C Use Group(s): A-3 The means of egress are sufficient for the following number of persons: Location Capacity Location Capacity MAXIMUM CAPACITY 92 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 20194 1/7/2006 1/7/2007 309 260 The building official shall be notified within(10) days of arty changes in the above information. Building Official L 6� COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date X uired$ 50.00 ( ) Fee Re q ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code, Section 106.5,I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: ��' ne n 13 O2,kw Name of Premises: n Purpose for which premises is used: - 7�P5Y'At�/an7L 'License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit Agency a Certificate to be Issued to: TD 57 '* Address Telephone:': 0��7�9 4 Owner of Record of Building: Address: o�UO 5. AL 1. 317q� fi/i h n , 1V9 J`�4�d-2 Name of Present Holder of Certificate: �os�o n �,()M&Ail/ 106 4� N o Agent, if any: /// • G(/ �I1�!!✓ 21; SI OF PERSON WHOM R IFICATE I S D RXAUT�HORIZED N C1457 PLEASE PRINT NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. FOR OFFICE USE ONLY: CERTIFICATE# 2 ( % 9' EXPIRATION DATE: /71O J020115b f TOWN OF BARNSTABLE INSPECTION WORKSHEETci s CERTIFICATE NO: 20065372 CANCELLED: MAP: FS09 DBA: IBURGER KING PARCEL: 260 NAME/MANAGER: IBOSTON WYMAN, INC.#664 STREET: 1184 NORTH STREET VILLAGE: IHYANNIS STATE: FkA I ZIP: 02601- SEQ NO: BUSINESS TYPE: IRESTAURANT CONSTRUCTION TYPE: 12C STORY1: 92 CAPACITY: USE1: A-3 Capacity Under 50: STORY2: CAPACITY: USE2: STORY3: CAPACITY: USE3: Outside Seating: rl BY PLACE OF ASSEMBY OR STRUCTURE CAP1: 92 LOC1: MAXIMUM CAPACITY CAPS: L005: CAP2: LOC2: CAPE: LOC6: CAP3: LOC3: CAP7: LOC7: CAP4: LOC4: CAPS: LOC8: INSPECTION: DATE ISSUED: EXPIRATION: Print This,Screen 0 01/07/2007 01/07/2008 - Print Certificate of.lnspection ap-1/(% COMMENTS: R eommonbjealtb of Aaq'qarbU'qCttq TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to BOSTON WYMAN, INC. #664 3 Certifp that I have inspected the premises known as: BURGER KING located at 184 NORTH STREET in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: 2C Use Group(s): A-3 The means of egress are sufficient for the following number ofpersons: Location Capacity Location Capacity MAXIMUM CAPACITY 92 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 20194 1/7/2005 1/7/2006 309 260 The building official shall be notified within(10)days of any changes in the above information. Building Official COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date �T/ (X) Fee Required$ 50.00 ( ) No Fee Required In accordance wMffie provisions of the Massachusetts State Building Code,Section 106.5,I hereby apply for a Certificate of Inspection for the below-named premises located at a following address: Street and Number: %�I L�� �` �.7 0 . Name of Premises: J Purpose for which premises is used: Licenses)or Permit(s)required for the premises by other governmental agencies: License or Permit A_genn r Certificate to be Issued to: Address:,,. Telephone: J�Op Owner of Record of Building: 1&- L�1l Address: S Co /f5 3774 !AL�) Name of Present Holder of Certificate: Name of Igent,if any: SIGNA RE OF PERSON TO WHO ERTIFICATE IS IS D OR AUTHORIZED AGEN PLEAV PRINT NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. FOR OFFICE USE ONLY: CERTIFICATE# EXPIRATION DATE: J020115b Commonbjealtb of Aaoarbuatt.5 TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to BOSTON WYMAN, INC. #664 31 Certtfp that I have inspected the premises known as: BURGER KING located at 184 NORTH STREET in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: 2C Use Group(s): A-3 The means of egress are sufficient for the following number of persons: Location Capacity Location Capacity MAXIMUM CAPACITY 92 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 20194 1/7/2004 1/7/2005 309 260 The building official shall be notified within (10)days of any changes in the above information. Building Official r� COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date AC-12 f (X) Fee Required$ 50.00 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code,Section 106.5,I hereby apply for a Certificate of Inspection for the below-named remises to d Mae follo g address: Street and Number: Name of Premises: I Purpose for which premises is used: eS License(s)or Permit(s)required for the premises by other-governmental agencies: License or Permit Agenc „x a. .,, :. _. _.:..... ... .. . ... _. _.....— Certificate to be Issued to: �S Address: O �J e2 �l n Telephone: JD 8_ Z ZE—J OW Owner of Record of Building: Address: ©= 3 D`j ?LD d o;�2w Name of Present Holder of Certific S oA) R jus 7" Name of Agent,if any'— SIGNATURE OF P SON TO WHOM CERTI ".'---E IS ISSUED OR AUTItORIZED AGENT AW PLEASE PRINT NAME INSTRUCTIONS: - 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee.must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. CERTIFICATE# / EXPIRATION DATE: /Z-z 4�r J020115b TOWN OF BARNSTABLE INSPECTION WORKSHEET CERTIFICATE NO: 20194 CANCELLED: MAP: 309 DBA: IBURGER KING PARCEL: 1 260 NAME/MANAGER: BOSTON WYMAN, INC.#664 STREET` 184 NORTH STREET VILLAGE: IHYANNIS STATE: MA ZIP: 02601- SEQ NO: 0 BUSINESS TYPE: RESTAURANT CONSTRUCTION TYPE: 2C STORY1: 92 CAPACITY: USE1: A-3 Capacity Under 50: . STORY2: CAPACITY: USE2: STORY3: CAPACITY: USE3: Outside Seating: 1" BY PLACE OF ASSEMBY OR STRUCTURE CAP1: 92 LOC1: MAXIMUM CAPACITY CAPS: L005: CAP2: LOC2: CAPE: LOC6: CAP3: LOC3: CAP7: LOC7: CAP4: LOC4: CAPS: LOC8: INSPECTION: DATE ISSUED: EXPIRATION: Print This Screen, 01/07/2005 01/07/2006 �� Print-Certificate of Inspection? COMMENTS: TOWN OF BARNSTABLE INSPECTION WORKSHEET Gos CERTIFICATE NO: 1 20194 CANCELLED: MAP: 309 DBA: IBURGER KING PARCEL: 260 NAME/MANAGER: IBOSTON WYMAN, INC.#664 STREET: 1184 NORTH STREET VILLAGE: JHYANNIS STATE: FMA ZIP: 02601 SEQ NO: 1❑ BUSINESS TYPE: IRESTAURANT CONSTRUCTION TYPE: 12C STORYI: 92 CAPACITY: USE1: A 3 :�apacity Under 50: STORY2: CAPACITY: USE2: STORY3: CAPACITY: USE3: Outside Seatlnq: BY PLACE OF ASSEMBY OR STRUCTURE CAPI: 92 LOCI: MAXIMUM CAPACITY CAP& LOC& CAP2: LOC2: CAP& LOC6: CAP3: LOC3: CAP7: LOC7: CAP4: LOCO: CAP8: LOC8: � l?nn#This.Scre� INSPECTION: DATE ISSUED: EXPIRATION: 02 �. 01/07/2003 01/07/2004 prinf C�rtlf�cafe f(nsp coon COMMENTS: TOWN OF BARNSTABLE INSPECTION WORKSHEET Close CERTIFICATE NO: 20194 CANCELLED: MAP: F309 DBA: IBURGER KING PARCEL: 260 NAME/MANAGER: BOSTON WYMAN, INC.#664 STREET: 1184 NORTH STREET VILLAGE: IHYANNIS STATE: MA ZIP: 02601- SEQ NO: 11 BUSINESS TYPE: IRESTAURANT CONSTRUCTION TYPE: STORYI: 92 CAPACITY: USEI: A-3 �'apacity Under 50: STORY2: CAPACITY: USE2: STORY3: CAPACITY: USE3: Outside Seating: BY PLACE OF ASSEMBY OR STRUCTURE CAPI: 92 LOCI: MAXIMUM CAPACITY CAPS: L005: CAP2: LOC2: CAP& LOC6: CAPS: LOC3: CAPI: LOC7: CAP4: LOCO: CAP& LOC8: INSPECTION: DATE ISSUED: EXPIRATION: - PSI, t ThSn II�t< Ol/07/2002 Ol/07/2003 ow ~ Priat.,Certificat®of Inspcfib COMMENTS: The eommouweattb of �a'qrcYju�ett TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to BOSTON WYMAN, INC. #664 I Certifp that I have inspected the premises known as: BURGER KING located at 184 NORTH STREET in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: 2C Use Group(s): A-3 The means of egress are sufficient for the following number of persons: Location Capacity Location Capacity MAXIMUM CAPACITY 92 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 20194 1/7/2003 1/7/2004 309 260. The building official shall be notified within(10)days of any changes in the above information. Building Official t t ':4 COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date 'q 1 ` (X) Fee Required$ 50.00 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code,Section 106.5,I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: Name of Premises: U r V V Cl l� -L4 Purpose for which premises is used: "" 06 License(s)or Permit(s)required for the premises by other governmental agencies: License or Perm L A.�Y A Certificate to be Issued to: Xrn- ilJ� Address: , 1 V Gy-P P� mo- o-W Telephone: �/IJC�"no F-504 Owner of Record of Building: 2)orCc�� a' -�ne-,AfS Address: o �� �4h ' , , N SJ 11 I kA l nn , MN S a z Name of Present Holder of Certificate: Name of Agent,if any: 1 C l Ij a SIGNATURE�OF PERSON TO WHOM CERTIFICATE IS ISS R�UTH RIZED AGENT 4 P z PLEASE PRINT NAME / INSTRUCTIONS: 1)Make check payable-to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. CERTIFICATE# EXPIItATION DATE: Z z TMl111,1. The Corr monbjealtb of Aa5'qarbU'qett.5 TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to BOSTON WYMAN, INC. #664 JJ Certifp that I have inspected the premises known as: BURGER KING located at 184 NORTH STREET in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: Use Group(s): A-3 The means of egress are sufficient for the following number of persons: . Location Capacity Location Capacity MAXIMUM CAPACITY 92 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 20194 1/7/2002 1/7/2003 9 260 The building official shall be notified within(10)days of any changes in the above information. Building Official r� ' Lq(A COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE 1 APPLICATION FOR CERTIFICATE OF INSPECTION Date 1 t (X) Fee Required$5 0 . 0 0 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code, Section 166.5,I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: Name of Premises: .. Purpose for which premises is used: r' License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit Agency Certificate to be Issued to: n —VV T' (QtQ4 Address: y J 14�l I a n n IS rn o\ Telephone: O ' ( OUCA Owner of Record of Building: buf co I �p Q►�J�l���� Address: v1 �d iy-) 7 5546 o Name of Present Holder of Certificate: 6oSA0n -W �MQn ,(nc- -* Name of Agent, if any: I l Jr L OAA OF RS TO WH CERTIFICATE IS SSUED OR AUTHORIZED AGENT INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER, 367 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. CERTIFICATE# +� d 9 L/ EXPIRATION DATE: 117104 Town of Barnstable Regulatory Services KAM Thomas F.Geiler,Director es�ss. � . Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 CERTIFICATE OF INSPECTION CAPACITY INSPECTION DBA '&r r NC LOCATION 1 7 OWNER 1 OSmn klia lnm a,iIc 4k 6,6 y USE CAPACITY&FEE DATE OF INSPECTION fgE TOR COM31ENTS `.� The Commonwealth of M assachusetts TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code,Section 106.S, this CERTIFICATE OF INSPECTION is issued to BOSTON WYMAN, INC. #664 Certify that I have inspected the premises known as: BURGER KING located at 184 NORTH STREET in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. The means of egress are sufficient for the following number ofpersons:. Use Group Construction Type Location Capacity A-3 92 20194 1/7/01 1/7/02 Certificate Number Date Certificate Issued: Date Certificate Expired: The building official shall be notified within (10)days of any changes in the above information Building Offici r COMMONWEALTH OF MASSACHUSETTS �uA TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date 1 � (X) Fee Required$ 4 0. 0 0 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code, Section 106.5,1 hereby apply for a Certificate of Inspection for.the below-named premises located at the following address: Street and Number.( ( QV / Name of Premises: Purpose for which premises is used: License(s)or Permit(s)required for the premises by other governmental agencies: Y License or Permit Agency Certificate to be Issued to: l Address: `l Telephone: Owner of Record of Building: Address: mo l�'- k O ma CON( 55tG Name of Present Holder of Certificate: �A Name of Agent,if any: m\ br *\ NAMTURME TOW OM CERTIFICATE IS ISSUED OR AUTHORIZED AGENT INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return t1ds application with your check to: BUILDING COMMISSIONER, 367 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. CERTIFICATE# 9 © / 9 �� EXPIRATION DATE: / 7zO Z The commonwealthofM ass achusetts TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.S, this CERTIFICATE OF INSPECTION is issued to BOSTON WYMAN, INC..#664 Certify that I have inspected the premises known as: BURGER KING located at 184 NORTH STREET in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. The means of egress are sufficient for the following number ofpersons: Use Group Construction Type Location Capacity A-3 92 20194 1/7/00 1/7/01 Certificate Number Date Certificate Issued: Date Certificate Expired: The building official shall be notified within (10) days of any changes in the above information _._. Building Official COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date / (X) Fee Required$ 4 0. 0 0 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code, Section 106.5,I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: h?�( Ald6ll' n AV— n06o I Name of Premises: Purpose for which premises is used: Licenses)or Permit(s)required for the premises by other governmental agencies: License or Permit Agency Certificate to be Issued to: QS n (a n�Q fir- (p(o(� Address: r) I S f9 0c) Telephone: C502 ) `72,-5_6q�/ Owner of Record of Building: �j u_��n (1 Address: Qo () b - l &N n Name of Present Holder of Certificate: Name of Agent,if any: SIGN E OF PERSON TO M CERTIFICATE IS IS UED OR AUTHORIZED AGENT INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER, 367 MAIN STREET,HYANNIS, MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. CERTIFICATE# a 7 EXPIRATION DATE: 7/O J .�.--., ��4�, .Tbe-:Com monwea ltb Jof Ifla os a rbu, etts; ;TOWN`OF BARNSTABLE' In accordance with the Massachusetts State Building Code,Section 106.S, this + CERTIFICATE OF INSPECTION is issued to BOSTON WYMAN,INC.#664 3 Certifp that 1 have inspected the premises known as -BURGER KING located at 184 NORTH STREET . in the Village of HYANNIS County of Barnstable 'Commonwealth of Massachusetts. The means of egress are sufficient for the following number ofpersons ' Use Group "i Construction Type r` '° ': ; Location Capacity . ' M 1• �, arl ! ; i r t X. f s I� tG: L.tt 'S,F;b .i. „4,q-yr , .J'4 ., - '� :'h t , e 3�, , , ,f.� ;,, ,. � :,,_x ,�, '<. g ;.� i ,<:.,, 92 r :;3 :>•: :tl�+a. A 3 t.r z .,:Y t fi : ..'4,.. 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COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date Ld g (X) Fee Required S 4 0. 0 0 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code,Section 106.5,I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: l ( 1, Name of Premises: &% 4D Purpose for which premises is used: e'n License(s)or Permit(s)required fo.the premises tr other govem.mental agencies: License or Permit Agency Certificate to be Issued to: iGZ Address: lD 4l cn n Telephone: EL 9 e) --?7 S S b L4 Owner of Record of Building: Zu-r ro,rl Address: 40 0 Name of Present Holder of Certificate: n Wu n16"r) �►'l� [��� Name of Agent,if any: M 1(i6lQ it e?m- L�-- ' in SIGN OF ERSO O WHOM CERTIFICATE IS IS UED OR AU THORMED AGENT INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER, 367 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. CERTIFICATE# ;�y/ EXPIRATION DATE: The Commouteaftb of 41a.0sarbuatt.9 TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code,Section 108.S, this CERTIFICATE OF INSPECTION is issued to BOSTON WYMAN, INC. * �ertifp that 1 have inspected the premises known as. BURGER KING N located at 184 NORTH STREET in the tillage of HYANNIS County of Barnstable Commonwealth of Massachuetts The means of egress are sufficient for the following F number of persons: r Use Group Construction Type Location Capacity A-3 92 20194 1n 198 1/7/99 Certificate Number Date Certificate Issued: Date Certificate Expired: The building official shall be notified within(10)days of any changes in the above information Building Official COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date 1 a I n Q '�'l 7 (X) Fee Required$ 4 0. 0 0 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code, Section 106.5,I hereby apply for a Certificate of Inspection for the below-named/prem'isle_s located at the'following address: n Street and Number: I F ! 11/d/-'7 ) + a n �n s H" 9(go Name of Premises: I� Purpose for which premises is used: I License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit Agency Certificate Certificate to be Issued to: (O Address: (\n Telephone: Owner of Record of Building: Address: S4- --N/S 3 Minn LKI L — ((�� Name of Present Holder of Certificate: 9OLS4zD(1 Name of Agent,if any: !v , , Li-2 IG RE OF PERSON TO WHQV CUTIFICATE IS ISS ED OR AUTHORIZED AG N INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER, 367 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. CERTIFICATE# % 9 `� EXPIRATION DATE: //7�> CERTIFICATE OF INSPECTION EXPIRES IN DECEMBER. PLEASE DO COI INSPECTION WITH LICENSING INSPECTION,LET ME KNOW IF THERE ARE ANY CHANGES OR NOT, AND RETURN FORMS TO ME. LOIS Commonwealtb of Alaq2acbm;M5 TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 108.5, this CERTIFICATE OF INSPECTION is issued to BOSTON WYMAN, INC. 3 QCertifp that I have inspected the premises known as. BURGER KING located at 184 NORTH STREET in the irllage of HYANNIS County of Barnstable Commonwealth ofMassachuetts. The means of egress are sufficient for the following number ofpersons. Use Group Construction Type Location Capacity A-3 92 20194 12/30/96 12/30/97 Certificate Number Date Certificate Issued: Date Certificate Expired: The building official shall be notified within(10)days of any changes in the above information Building Official f ii�� THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITYDRIGINAL (S) �A�A i 86-10 ,xY' ❑ New Application _ TOWN O RNSTABLE ❑ Renewal .6,39. .� ❑ Transfer ❑ h LICENSE APPLICATION Other Date.........................Print or type only (Please bear down hard) Name of A licant 1 f l.::a . ` k ...........DB/A ¢r c�Yxv l.. ..�!-.t.. . .� ...................... ............FID#.. dd .0 ..�r._��.� .. Corp.Name if Different...........:........................................................................................ . , .,.�'.�:: Permanent Address of Applicant.. h. Local/Mailing Address..tir.....£ ... . .................. .......................................................Place of Birth................................................................................ ................................. Property Owner . .; ° .. 1 ..r.;' +' ....� �".. ........Business Loeatio .. J . . .. .. 4 rr i� Seasonal..... . `'�/• ^° =fir, Type of License... �.la"'�:.x:'$lT:a .�s/i.::�::f �'t.. ..r �. .��. .....Status:Annual...... .................. ............ Name Of-h-I'a jv "� ..R err sr ag `W {, �s� i�► , .s u , w , , , , Permanent Address.. :. .�.. .. .. .: .. ...z..try ....... .... r. .... ".... .....5., :e... ....�' '. 1.. ....jai................ LocalMailing Address.......................................................................................................................................................................... ..... .Place of Birth................ ........................................................................................................... Telephone#of Applicant: Home(......................)..............:..............................................Bus Telephone#of Manager: Home „ 'f p g ( :...... .) - I•h: �, .. ! ........................Bus( ''� ).... � :.. :d. " Assessor's Map#(s)...N1,z,, . .........Parcel#(s).. ...., :: Zoning District... ................................................ ...:..::+.... t' w Any flammable substance or hazardous waste use in business(specify).. NO BUSINESS MAY OPERATE WITHOUT A VALID LICENSE ON THE PREMISES ,� 44 Applicants must contact the Building Commissioner's Office 4 ., a Board of Health Office, the appropriate Fire District Office to schedule inspections. , '< Signature of Applicant.....r...... ..a,. . �.... ....................:.:"?::`.`...........:`................ .................................... ............................................................. .. .:... ... .. ?.. . . .................................................................................... ..... . For Town use only IS THIS USE PERMITED WITHIN THIS ZONING DISTRICT?...................................................................................................... ..r .. IIV RS ARO PPVAL... ......... p .....................................................` ��'....f.....:.,�� �.:;. B ilding/Z ing. .... -G�-.......Date.......f a.A. .� .....Board of Health.....................................Date. .................. .............................Date.................Plumbing ............................Date.......................Gas.................................Date Fire Dist........................ ......................Date TAX OFFICE USE ONLY TAXES PAID IN FULL PAYMENT AGREEMENT IN EFFECT ON - �e TAX COLLECTOR White-Licensing Authority Green-Tax Office Canary-Health Department Gold-Building Commissioner �'.` Pink-Fire Department =fir The CDmmoftealtb of ji1a5.qarbu,5dr,5 TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 108.5, this CERTIFICATE OF INSPECTION is issued to BOSTON WYMAN, INC. 3 (Certifp that I have inspected the premises known as. BURGER KING located at 184 NORTH STREET in the Village of HYANNIS County of Barnstable Commonwealth ofMassachuetts. The means of egress are sufficient for the following number of persons: Use Group Construction Type Location Capacity A-3 92 20194 12/30/96 12/30/97 Certificate Number Date Certificate Issued: Date Certificate Expired: The building official shall be notified within (10)days of any changes in the above information Building Official e COMMONWEALTH OF MASSACHUSETTS ,�oq CITY/TOWN OF Barnstable q 6 0 AFPLICATION FOR CERTIFICATE OF INSPECTION R Date v ( X ) Fee Required s 40.00 ( ) No Fee Required In accordance with the provisions� of the Massachusetts State Building code. Section 108,15, I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: ► t Street and Number: O a CDC Name of Premises (1 j )�1 mn`n T_& lC '*6p(0� Purpose f or which premises is used: lY License(s) or Permit(s) Required for the Premises by other Governmental Agencies: t License or Permit Agency Certificate to be Issued to. ' Address: . , Owner of Record of Building: ��c�(� / M Address: -�OD��c )< C[ 1 S+ AIS 3 2 2' I + I 1 11n 1 i /��r Name of esent Holder of Certificate: Iye� Name ent, if any: SI OF PERSON TO WHOM CERTIFICATE IS SSUED OR HIS AUTHORIZED AGENT INSTRUCTIONS: 1) Make check payable to: TOWN- OF BARNSTABLE 2) Return this application with your check to: BUILDING COMMISSIONER 367 MAIN STREET, HYANNIS, MA 02601 PLEASE NOTE: 1) Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2) AppllcaLluu and fee roust be received before the certificate will be iruued. 3) The building official shall be notified within ten (10) days of any change in the above information. CERTIFICATE f EXPIRATION DATE: � 1 � � �, 6 3p 9 A6 0 CERTIFICATE OF INSPECTION 7 So BURGER KING, 184 NORTH STREET, HYANNIS 12/10/96 Application and request for $40 fee mailed to: Renee Wyman Burger King 110 Breeds Hill Road, No. 8 Hyannis, MA 02601 Al Martin will inspect to determine capacity. FCC Comrnfm:irN rU uc::r;^s: ---- ., V,w,1 fum. m. .... L�' � ...._. SIDEWALK Outdoor Patio Furniture . 11 SEATS 15 55-00 1 Burger King 184' North St ee'� GARDEN Hyannis,MA j BI dy,T ype: Decor Type:Custo-in 2020 Salesperson:Steve Mlogrdichian ^— i G 1�ALta n i i _�.__._C S= gg e F3 F4 to F&A F3A t...�...� 3SCS _ .. 1 ` 24x27 ,2 s+ ♦ \ j .. 2x7 3 � Mastoran Corp. 13 LL C7► Z..._. tA'. t = � 24x27 --24X27 24x27 Q Q Q D: 0510611 ,19 I , � 2 I W , NF11 • . .. .. .:. ......... ....,, Floor Plan 06 f 17 FCC FCC Commercial Furniture Inc 53'-4 1/2" 8452 Old Highway 99 North Roseburg,OR 97470 13'4 1/2" 9'-1" 30'-11" T.800.322.7328 F.541.673.7441 www.focfum.com Property of FCC Cusnmedal Furniture Inc This presentatlan Is for Olusfretlon pu'poaea and to expese concepts only.The design and conceptual drawings herein sha0 not be adhered or used as consbucdon documents.Do not reproduce or land Wthotd ;'L0 � � 10 � pennlaslan from FCC commercial Furniture inc. 10 10 10 10 F1 F_9 Account: 15755-001 F 1 < aG K 0 o ,o C.4 Burger King#664 \ N N � cli 184 North Street X x A ^ �.. . Hyannis, MA A '-i Bldg.Type: A Y: Decor Type:Custom 2020 E Salesperson: Steve Megrdichian 10 F3 F4 / F5 FB-A F3A g Revisions: 35"CS R - 24x27 Al ALO 1 07.01.11 H ;I �� _JI/I _-- 244.227 t0 y I I —H —T11 E � N m 0 j' 3 A L — 'C 1L JJ// _ - .......... .. p E = H �� 13 i N.4 � C I I $�Pi ��[7 N F13 v __ i kJ' ` C H H _ N 9 8 y 'o Q H 36�1/I� H U -- 30 ---LA — A . --1'Y—44 7 N F12 (� �•� 11 H 30x1700.0. : _ 24x27 44 58 U I t tL 42"H ���JJJ/// n Client r H I� Mastoran Corp. —� A G H S a 13 Lj B \ -- 24x27 trwi . -- A 24x27 -- -- A 24x27 -- — A 24x27 — -- SEATING CAPACITY 69.� �—_ ) �__ _� �__ __� C__ —) UNIT CAP. UNIT QTY. TOT.CAP. %OF TOT. 1 PLACE 12 12 20% Scale: 2 PLACE 9 18 31% 9 3/16"=1'0" 3 PLACE 0 0 0% Drink Station by Others JEI❑R O °o a�4 PLACE 3 12 20% - Date: 5PLACE 1 5 8% L 05/06/11 6 PLACE 2 12 20% / s TOTAL 27 100°i6 i `F11 A ON �(/ I Work Order: / k 4'-5" 16'-7" 28'-0" k I I n H I -30"HIGH BAR STOOLS cY L__J � Prepared By: SPT FREESTANDING CHAIRS L--J -A.D.A.COMPLIANT SEATING Floor Plan 06 of 17 --, - - .. s f. NEW HOPE COMMUNITY L BAPTIST CHURCH ` = � wry � t 259 NORTH ST. \� 6 LM PARTNERSHIP N77'20'17=E m i I 143.89' LOT C s t 30,417t SF. a I m N 3 SLOPED GRANITE CURB(TYPICAL) N I 9 v 20 Q _�. MASONRY =COMMON DRIVE" BUILDING AS SHOWN ON PLAN a PLAN BOOK 274 PAGE 69 R=5 5 y 3 o O PAMELA I APOSTOLIC CHURCH- g = — - - - --- - - - — _..._ o� S 2 LEA WIT GO a i 1.0 3'GATE 9 • I EMU.BOARD 9 v 20' ORDER'GI IIRMATION UNIT REVIEW BOARD• C S c'CLF N77.50'25'E 1.16' R=20' • CONC.BLOCK RETAINING WALL 4! R=10' _ X—X—XX—X—X PROPOSED EDGE OF PAVING A b R=5'• DRIVE STANDARD = EXISTING PAVING LINE pv CLEARANCE O SIGN Q � W C y MASONRY CHAMFERED BUILDING EDGE W 1 20, yYf �7 ELEVEN' a < MASONRY BUILDING ss N m IY < a m D b a _ 37-B' ^ 'DVS PHARMACY ,�p�' BITUMINOUS c )0, PAw+ENT PROPOSED BUILDING W � THE 3 a 15'7 CONCRETE PAD SOCORP.ND P N R- R_5 6 1D 1 PAVEMENT yO II' BITUMINOUS BICYCLE RACK Z DINING — OLP HYANNIS LLC R=5' TERRACE WALK 18' �34 HANDICAP RAMP WALK HANDICAP HFN.,MAP) HANDICAP Z R=20 TYP. RAMP v RAMP �bp R=20 lYP. _j J BITUMINOUS ALK S77'19"'""' Q (1) W To Bassett Ln. co NC. GRAN.CURB CROSSWALK VERTICAL GRANITE CURB(VGC) CROSSWALK GRANITE CURB 1 - ,^ r— CURB (EXISTING) (EXISTING) r •� V l F... � � Z NORTH STREET BITUMINOUS Z D`U J Q PAVEMENT ( To High School Rd. IL? ~ � III GRANITE CURB (E%ISTING) — . CONCRETE SIOEWAIX I' W W� > O D � W Q D J GENERAL NOTES Q J 1) THIS PLAN 1S THE RESULT OF AN ON THE GROUND FIELD 6) SEE ARCHITECTURAL DRAWINGS FOR BUILDING DIMENSIONS, PARKING EVALU4TI AN J m WZZQ SURVEY AND PUBLIC AND PRIVATE PLANS. BUILDING MATERIALS AND DETAILS. SEATS 60 (INCLUDES OUTDOOR TERRACE) > `1 F- - 2) UTILITIES SHOWN ARE BASED UPON FIELD SURVEY AND 7) ACCESS RAMP FROM WALK TO HANDICAP PARKING SPACE EM'LOYEES 10 (A44XI"SHIFT)� O Of RECORD_PLANS AND ARE NOT NECESSARIL Y INDICA 77 VE OF AND RAMPS TO CROSSWALKS ALONG NORTH STREET 00 Z LLJ UNDERGROUND CONDITIONS SHALL BE ADA COMPLIANT. SPACES PROVIDED, 30 (yf J) THE CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING AND DETERMINING THE LOCATION, S12E AND ELEVATION OF ALL ~ EXIS77NG UTILITIES, SHOWN OR NOT SHOWN ON THESE PLANS = m m PRIOR TO ANY CONSTRUCTION. THE ENGINEER SHALL BE NOTIFIED , IN WRITING OF ANY UTILITIES FOUND INTERFERING WITH THE PROPOSED CONSTRUCTION AND APPROPRIATE REMEDIAL ACTION BEFORE PROCEEDING WITH THE WORK. 4) THIS PLAN IS BASED ON THE REFERENCED PLANS, DEEDS AND 7HE RESULTS OF A FIELD SURVEY AS OF THIS DATE. NO CER77FICA77ON 1S INTENDED AS TO PROPERTY TITLE OR AS TO THE EX157ENCE OF UNWRITTEN OR UNRECORDED i �LP EASEMENTS - F 15765 r 5) THE OWNER SHALL CONFIRM COMPLIANCE WITH ALL APPLICABLE I CODES AND REGULATIONS'GOVERNING THE MATERIALS AND/OR METHODS OF INSTALLA77ON OF ANY IMPROVEMENTS DEPICTED - SHEET NO- ON THIS PLAN. r 3 OF 9