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Home My WebLink About1070 IYANNOUGH ROAD/RTE132 - FESTIVAL MALL VERIZON WIRELESS Are, vikizo /V hr! r pool WX My zoo, �C A, poll KK Why", Awn 4� 2v lilts 41 gy v loan 0 Re two AVERAL cost ..... wpm —now Rom 1 001 IBM Not tax; Ono MIT ino glum.=qamps am, Nam&— "nix; mamma a-011 almmmm Off'IRAN NOW 19 M5 NMI wpm it 1 WIN rww MM BMWs 1. out =NNW wpm,, __W Alto "Is"ST Any Ry too,low%U •' '` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Awoxioi Map Parcel I Application..' # Health Division 0, AM 9 `s = i Date Issued Conservation Division Application Fee Planning Dept. Permit Fee ��•tt Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis P_roject°StreetWddress 107d I yANN006-41 ZCL �Vilfage'' ,rv�) Own er�G�� -1-1YC1r2,�f`��l7C'� Ad ress /(�l�?,171�i� lag . Telephones ��. � - ,�'— (Permit-Request w v er)6,r DI f&, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size e ,y� f)6 r, Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT.INFORMATION - - - v (BUILDER OR HOMEOWNER) Narne* -P6,4" IS • Cie11 ale— rTelephone`Number Address ) C en kon c�1 (�c . u:iR-5D License # C57Z 12(o .t . 0_1?e�T-YA Q I q rob Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE e 6 FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE ,a OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 27ze Comurorriveaith of Massachusetts Department afIndushid Accidents Owe of Imwsiigadwm. 600 Washington�Mtreet . J.— , Bast on,CIA 02111 f!lFV1-nma—mgovIdia , Workers' Cumpensatian Insarar<ce Affidavit:Bn dersiContraactGrsJElecfticians(Phmhers licaut Infarmaf ant Mease'F`riut Leg ibT cz— - Na=(Bus ss,'Organ¢abanlFn�i Ziva1 � it�r{ tatef &g D KU Proneik � AieyOuanemployer?`Checkthe appropriate box: ----i ` � ',- ¢ 3 am a Qeslerai Victor and I Type of project(required)'- I.❑ I am a employer with b 6. Ideas'constuctiun employees(full.anNorpart-time).* llavehirerl:the sub-contractors ❑ 2.❑ I am a sale propiietoir orpartuer- listed on the attached sheet: 7. ❑REMO&ling s and have noemployees. These sub-contractors have�P 8_ IZ Demolition wod:ing far RSA in any capacity. employees andfiave woikers' �II11dtIIg adCliflolP [No WorYam 9_ comp.insurance comp. nsurannel ❑ requured] I ❑ 1We are a corpoIafian and its 10❑Electrical repaim or additions of€cen have�exerdsed their I El am a homeavu*ner doing all Work 11_❑Plumbing repairs or additions nryscl€[No workers'comp• right of exemption per MGL 7 - c.152 1 atid h weavena 1 ❑Roafrepairs ,mcrirarire reclni�d]( .§ �� . employees.[No Workers' 13-❑Other comp_insurance required_). Amy WHcxnt&st ched:siwx R Est also JMa=the smfi=below sbmaing their v;orkets'compeasa5aupoTup info�suo� Mmeaavaerswha submit ilii4 afiidaS ii indixaiiag thry azedaiag alI w-0QiG 83d tbealsaE outsidecontc=rsnm 5aI}mlt anemaffids�it indieatiog rnrh rCoat<aetoes ebecY ibis box must attschea au addit9aasl sheet showing the rune of the snb-eoatreefio-rs sad state whether ar not those entities biLve ' empla}nees.Iftbesnh-ccatmctamhave emplUee,theyramsrpmsv-ide their workers-cnmp.paHU number- lam an eihp£o;£Yrr that ispratiding it;arkers'comipandian imuirairceforiny cnrp&pem $efosv is lltepalicy curd job sits itforma on Insurance Company Name: - pricy tt'or Self-ins-Lic.4 Expitatiroa Date: Job Site Address: Cityl5tafe{ p: t Attach a cop} of the workers'compensationpolicy declaration page(showing the policy number and expiration date).-- Failure to secum coverage as requ ired.0 nder Swkbn 25A of MGL m 152 cam lead to the imposition of criminal penalties of 3, fime up to$1,5O1}OQ andfor one-year impnsomn mt,as well as citric penalties•in the fo=of a STOP WORK ORDERand a fine of up to 50-00 a day against the violator. Be adtdsed that a copy of this statement may.be forwarded to tine Office of Investigations of the DL4 for imcurrance courage tedficatiem_ life ItercRby csr ' uacdor tiie proms ndpetjaZ*-s afpergujy t74atthe infor�xafrrJr1. i&d abmw i s&ue acid correct enatvre' Ida phone ik Ofjzsirrl use aril}. Do not writs Mr ffth area,fa be campfeted by cite artoo- offi cat City or Tom n: PeriniffAcense r Issuing g afliarity(circle one): 3 L Board of$•ealth 1-Rp Ting Department 3.fh*ltown Clerk'4.Electrical Inspector S.Phirabmg TnMpMfior b.Other Contact Person: MORE#: aformatzon. and. lnstractions Massachusetts Genf Laws c3aapt=152 raquires an employers to provide workers'compensation far their employees. P -to this ,an TIDY=is defined as."_.every persanM the Service of another under any coMfract ofhire, express or implied,oral orb" • oration or other le enffiy,or any two or more An anp is defined as an individual,partnership,association,corp Of the foregoing engagpd m a1oi at e bmT se,and including the legal representatives of a deceased employer,or the receiver or t ustee of an individual,partnership,associa�or other legal entity,employing employees. However the owner of a.dwelling house having"not more than three aparlmanis and who resides therein,or the oecapant of the- dwP+IIing house of another who employs persons tD do mabt__ -_ ,constructionor rePaa work.on such dwelling house or on the grounds or bu admg app thereto shaRnotbecanse of suich employmeutbe dezmedto be an employer." MGL chapter 152,§25C(6)also sfafes that"every sib or Iocal licensing agency shall withhold$le issuance or reuew2j of a license or permit to operate a buiskess or to construct buildings is the commonwealth for= ho has not prod acceptable evidence of compliance with the insurance•coverage requir. applicantw P Additionally.MGL chapter 152,§25C(7)states Neither the commonwealth nor�y of its pcdilical subdivisions shall enter into any cont Tar for the p erfcrrm ance ofpubIic work u�I acceptable evidence of compliance with tho insurance•. rcquir=cEts of this chapter have been presented to the coutracthig Please fill out the-vworIoeas'compensation affidavit completely,by eherS:�hg$le boxes that apply to your sitnaiion and,if necessary,supply sub-contractors)name(s), addresses)and phone MUM ex(s) along with their certficaf e(s)of Dance. Lii i Liabulity Companies(LLC)or Limited Liability partnenLips,(LU)withno employees other than the members or partners,are not rbTnmd to caury workers'compensation msarance If an LLC or LLP does have empToyaes,apolicyisregaked. 13 e,advised that this affida:vit maybe submitted to the Department of Industrial Accidents for confirmation of ins2sace coverage Also be sure to sign and date t_he affidavit The affidavit should be reiimmed to the city or flown that the application for file permit or license is being requester not the Department of In In�Accidents. Shouldyoui have any questions regarrUmg the law or ifyou are repaired to obtain a workers' coinen psationpoHc;LpleasecalltheDepartnentafthenu�berlistedbelow Self-insuredcomPaniesshouldenterti�eir self-insarmce license number on the appropriate Ime. City or Town Officials f Please be sore that the affidavit is complete and pritcuedlegIbr The Departmenthas Provided a space at,the bottom of th affidavit for you to fill out in the event the Office ofInvestigations has to contact you regarding the applicant e Please be sm-e to fill in the pemih/license mrnber which will be used as a reference umbers. In addition,an applicant that must submit MAtiple Permitllicense applications in any given year,need only submit one affidavit indicating cuireat policy in i:) ation.(if necessary)and under"Job Site Address"the applicant should write"all 10caficns is (may or_ town)_'A copy of the affidavit that has been officially stamped or maimed by the city or town maybe provided to the applicant as proofthat a valid affidavit is on file for fbta, permip or licenses. Anew affidavit must be:filled out each. year.Wh=a home owner or citizen is obtaining a license or permit not related fin any business or commercial vmt= a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Of of Investigations would like to thank you in advance for your cooperation and shouild you have any questions, please do not hesitate to jve us a call. The I}eparimenfs address,telephone and fax nber I�ega�tment c}f 1ud Ac�,Idents office of j,,ve9tk. k io-= Boston,Irk 01 111 Ta .4 617' -49— eXt 4-€6 car 1-977-MA S9AFE Fax#617-727 7M Revised 4-24-07 � �r� r AC R MRGCO-1 OP ID:TD CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDIYYYY) 12/30/2015 -THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY:AND CONFERS NO RIGHTS UPON THE CERTIFICATE- HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE_A CONTRACT BETWEEN THE ISSUING. INSUR,ER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT; if the certificate holder is an ADDITIONAL INSURED, the paiicy(ies) must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an:endorsement: A statement on this certificate does not confer rights It the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT - - - - DeSanctis Insurance Agcy,Inc NAME: Bryan F.Juwa 100 Unicorn Park Drive PHONE Alc No:781-933-5645 Woburn,MA 01801 Mai-_ 781-935.8480 .AODRESSi - iNSUREA(S)AFFORDING.COVERAGE, .NAIC4 INS. RERA:Acadia Insurance Company_ 31325 .INSURED MRG Construction Management;Inc.: &SURER.a_: ' 3 Centennial Drive,Ste 50 INSURERC Peabody,MA 01960 INSURER o: INSURER.E ' INSUREwF; - COVERAGES CERTIFICATE NUMBER: REVISION NUMBER-: THIS IS TO CERTIFY THAT THE,POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THEINSURED NAMED.ABOVE FOR THE,POLICY PERIOD INDICATED_ NOTWITHSTANDING ANY.REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER,D06UME14T WITH RESPECT TO,:WHICH'THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJ.EGT TO.ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES:LIMIT&SHOVIIN:MAY HAVE BEEN REDUCED BY PAID CLAIMS. TN-SR. AD L t _ . LTR TYPE-0F INSURANCE. 1 ) 'POUGYNUMBER. MM)DDtYYYY MMIDDNYYY� LIMITS _ A. X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE I—XIU OCCUR CLA506201614 0.10112016 01101/2017 ISET RE TPy PREMISES.Ea occurrence $: 250,000 X Blkt Contractual MED EXP(Anyone oorson) S, 5,000 X XCU Hazards PERSONAL ADV INJURY $., 1;000,000 GEtd L AGGREGATE LIMIT APPLIES PER; I..GENERAL AGGREGATE �$: 2,000;000 1 POLICY[�1.JERCOT i�LOC l PRODUCTS-,COMPlO '$s 2,000;000. I I 70THER: AUTOMOBILE LIABILITY - COMBINED`SINGLE LIMIT fea accident $' 1,000,00 A• ANY AUTO � MAA511493013 01/011201;6, 01/01/2017 BODILY INJURY(.per person) ALL OWNEO I ^II SCHEDULED AUTOS I „I AUTOS BODILY INJURY(Per accident) �' .X I NON-OWNED HIREDAUTOS AUTOS PROPERTYDANAGE $- {Per'accident) S UMBRELLA.LUIB, X OCCUR 1 X EACH OCCURRENCE A. 5,000,00 q Excess GA9 CLAIMS-MADE CUA51.1401613 01/01/2016 01/01/2017 AGGREGATE $. 5,000,00 DED X RETENT16N$ NONE S WORKERS COMPENSATION -- AND EMPLOYERS'UABIUTY ITH X I STATUTE I I FOR A ANY PROPRIETOR/PARTNERIEXECu.TIYE'YIN WCA511401712- 01/011201,6 '01/01/2017� IDrSdRIPTION OFFICERIMEMBEREXCLUDED? a N!A. E•LEACH ACCIDENT -$ 500,00(MandatorylnNH) ` MA,CT PA,NH,ME E:L-DISEASE-EA EMPLOYEES 500,00 It s describe underI OF OPERATIONS'below E.L.DISEASE•POLICY,LIMIT .$ 500,000 DESCRIPTION OF OPERATIONS.I LOCATIONS)VEHICLES(ACORD 101,Ad_dit_Ional Re_marka Schedule,.may be attached If more space is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER_ CANCELLATION EVIDE-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIEV'BE'CANCELLED BEFORE EVIDENCE OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH.THE POLICY PROVISIONS. AUTHOR O REPRESENTATIVE 0_19b 8-2014 ACORD 1.CORPORATION. All rights reserved. ACORD-25(201.4101) The ACORD naive and logo are registered marks of ACORD Massachusetts -Department of Public Safety Board of Building Regulations and Standards _ a..uuau uCiiui� jii}'ei viSCi License: CS-078126 �T MATTFIEW R GEl�ZALE= 32 SANDRA RD E$ PEABODY MA 6196d �c jw- a Expiration Commissioner 01/03/2017 ti VAIMAZEA 6 ,, Town of Barnstable Regulatory Services Riebard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.mans Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section, If Using A Builder ,h !; as Owner of the subject property hereby authorize tJNr�CTilJtUl+z%7�YT. to act on my behalf in all matters relative to work authorized by this building permit application for. /o o 46±11�v oc/v /CJ , , �s71 Ya (Address of Job) t - Signawxe of Owdtr , Date - �i--: Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:1WPFnYZTORMslbu3ldmg permit£oam McRESS.doe Revised 040215 t Lli Massachusetts Department of Environmental Protection eDEP Transaction Itoopy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: RYEBBA Transaction ID: 837613 Document: AQ 06-Construction/Demolition Notification Size of File: 100.67K Status of Transaction: In Process Date and Time Created: 6/8/2016:9:45:49 AM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. f -- Massachusetts Department of Environmental Protection Bureau of Waste Prevention•Air Quality f� BWP AQ 06 Notification Prior to Construction or Demolition ❑ This is a revision to an existing form. Project ID for existing form to be revised: r This job is being conducted under a Blanket Permit MassDEP assigned Blanket Authorization ID: r This job is being conducted under a Non Traditional Abatement Work Practice Permit. MassDEP assigned Non Traditional Work Practice Authorization ID: r None of the above conditions apply,generate a new form. Revised: l 1/13/2013 Page 1 of 1 _ Massachusetts Department of Environmental Protection Bureau of Waste Prevention •Air Quality - D WT A^ 06 100244573 Notification Prior to Construction or Demolition Asbestos Project Number# A.Applicability A Construction or Demolition operation of an industrial,commercial,or institutional building,or residential building with 20 or more units is regulated by the Department of Environmental Protection(MassDEP), Bureau of Waste Prevention,Air Quality Division,under Regulations 310 CMR 7.09.Notification of Construction or Demolition operations is required under 310 CMR 7.09(2)ten(10)working days prior to any work being performed.The following information is required pursuant to 310 CMR 7.09.Is this a fee exempt notification(city, town,district, municipal housing authority,state facility,owneroccupied residential property of four units or less)? Is this a fee exempt notification(city,town,district,municipal housing authority,state facility,owner-occupied residential property of four units or less)? EJ Yes EJ No Type of Notification: r Revision of an Existing Form r Cancellation of Project Instructions: 1.Blanket Permit Project Approval,if applicable: Approval ID# 1.All sections of this 2_Non-Traditional Asbestos Abatement Work Practice Approval,if applicable: form must be completed in order to Approval ID# comply with the Department of B. General Project Description Environmental 1.Facility Information: Protection notification 1070 IYANNOUGH RD requirements of 310 CMR 7.09. Name of facility Street Address HYANNIS MA 026010000 6174555659 2.Submit Original City/Town State Zip Code Telephone Form To: Commonwealth of JIM CHRISIIE SCOTT BOTHFORD Massachusetts Facility Contact Person Contact Person Title P.O.Box 4062 9785.873099 617-455-5659 Boston,MA 02211 Facility Contact Person Telephone Facility Contact Person Email Facility Size: 5000 1 Square Feet Number of Floors Was the facility built prior to 1980? ❑Yes r No ' Describe the current or prior use of the facility: RETAIL SPACE Is the facility a residential facility? EJYes RJ No If yes,how many units? 2.Facility Owner: SCOTT BOTHFORD 25 HORNSMAN DRIVE Facility Owner Name Address HYANNIS MA 026010000 6174555659 City/Town State Zip Code Telephone JIM CHRISTIE 3 CENNTENNIAL DRIVE On-Site Manager/Owner Representative Address Peabody MA 01960 9785973099 City/Town State Zip Code Telephone Revised:03/17/2014 Pagel of 3 Massachusetts Department of Environmental Protection Bureau of Waste Prevention•Air Quality BWP AQ 06 100244573 Notification Prior to Construction or Demolition Asbestos Project Number# B.General Project Description(continued) 3.General Contractor: MRG CONSTRUCTION 3 CENNTENIAL DRIVE Name Address PEABODY MA 019600000 City/Town State Zip Code Telephone BILL CONGDON 6076844243 General Contractor's On-site Manager/Foreman Telephone General C. General Construction or Demolition Description Statement:if asbestos is found 1.Construction or demolition contractor: during a Construction or Demolition MRG CONSTRUCT10 3 CENTENNIAL DRIVE operation,all Contractor Name Address responsible parties must comply with 310 PEABODY MA 019600000 9785873099 CMR 7.00,7.09,7.15, City/Town State Zip Code Telephone and Chapter 21E of the General Laws of BILL CONGDON 6076844243 the Commonwealth. Construction and Demolition On-site Manager Telephone This would include, but would not bw 2,Licensed Contractor Supervisor: . limited to,filing an asbestos removal MATT GENZAIE CS78126 notification with the Department and/or a Supervisor Name License Number notice of release/threat of 3.Is the entire facility to be demolished? r Yes F No release of a hazardous 4.Describe the area(s)to be demolished: substance to the Department,if INTERIOR CEILING AND FLOORING. all applicable. MassDEP Use Only 5.If this a construction project,describe the building(s)or addition(s)to be constructed: Date Received INTERIOR Err OUT.NEW FITNESS CENTER. I 6. If this is a demolition or renovation project,were the structure(s)surveyed for the presence of Asbestos-Containing Material(ACM)? ❑Yes Rl No 7.Was asbestos containing material(ACM)found? r Yes 0 No If a survey was conducted,who conducted the survey? Name Department of Labor Standards Certification Number Revised:03/17/2014 Page 2 of 3 Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991m)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit; www.Mass.Gov/DPS r Massachusetts Department of Environmental Protection Bureau of Waste Prevention•Air Quality BWP AQ 06 1100244573 Notification Prior to Construction or Demolition Asbestos Project Number# C.General Construction or Demolition Description(continued) The Asbestos Abatement Notification Number for this address is: This project (-Construction ❑ Demolition is: 6/12/2016 6/16/2016 Project Start Date(MM/DD/YYYY) Project End Date(MM/DDNYYY) 8.For demolition and construction projects,indicate dust suppression techniques to be used Seeding r Wetting r- j Covering r Paving Shrouding Other-Specify: 9.For Emergency.Demolition Operations,who is the MassDEP official who evaluated the emergency? Name of MassDEP Official Title Date of Authorization(MM/DD/YYYY) MassDEP Waiver Number A Certification "I certify that I have personally JAMES M.CHRISTIE examined the foregoing and am Print Name familiar with the information contained in this document and Authorized Signature all attachments and that,based PROJECTMANGER on my inquiry of those individuals immediately Position/Title responsible for obtaining the MRG information,I believe that the Representing information is true,accurate,and complete. I am aware that there Date(MM/DD/YYYY) are significant penalties for 06/06/2016 submitting false information, including possible fines and P.E.# imprisonment.The undersigned hereby states,'under the penalties of perjury,that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is made." Revised:03/17/2014 Page 3 of 3 w "Building for Business" Affiliations: Retail Contractors Association Associated Builders and Contractors Institute of Store Planners International Council of Shopping Centers Construction Financial Management Association "Building for Business" " - Affiliations: ' Retail Contractors Association Associated Builders and Contractors Institute of Store Planners International Council of Shopping Centers Construction Financial Management Association TOWN OF BARNSTABLE BUILDING.PERMIT APPLICATION /�✓.-v��i Map `r' ,' Parcel 10A - "to (_ Permit# 7, 7 l Health Division 5A-*710 Al a� Date Issued Conservation Division Application Fee SO,m d Tax Collector Ido Permit Fee Treasurer - s . ffR T Q /z /01� . Planning Dept. "-PPIMCANT MUST OBTAIN ASEIVER - - CONNECTION P-r-mJIT FROM ENGINEERING DIVISION PRIOR TOO Date Definitive Plan Approved by Planning Board CONSTtiUCTION: " Historic-OKH Preservation/Hyannis Project Street Address 1070 /YA f--1W" !Z QANb (F=&_SyAL_A7r1+YAw !.s M�11.-•� Village Owner 17%v4 CoM-f C ( e_bl> Address :Zs: S�Lcr�l 0�y� Telephone ` AI �y - 9 d0 lklg�bAA A NA dZ-'1y`V Permit Reques A/O ON V � E kl/2 .47-7#6 Ar k �G477C7/�/ VIOiZ� -TV R( �O�E3��S ,�y�Di _ La ta770.�1q=�,&A/ 13E7Y i =1vt - Square feet: 1 st floor: existing y8 proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation/7.5 CW-oc� Construction Type � Lot-Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address License# 4Z — 0(6 702 /1UG`10 /44 �/b9' Home Improvement Contractor# Worker's Compensation# klQ '769 41Z=87 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO —C" 4"Ae . SIGNATURE DATE `t FOR OFFICIAL USE ONLY t e • PERMIT NO. { DA'I«ISSUED MAP/PARCEL NO. �• - ; • 1 Y ADDRESS VILLAGE , OWNER OF DATE INSPECTION: . 1 FOUNDATION &/ R O f . � / y } FRAME ��?I3j 4 r r��SO,�' �/9 S? �l>�/ T O f�a ,ANSULATION ~1'' z FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH, f FINAL - r r GAS: ROUGH ' FINAL ' " FINAL BUILDING -� DATE CLOSED OUT ASSOCIATION PLAN NO. 4 nht=l0nyIT xn Occardance Ni.tll the prvvl.s$,r.i;, -off tiGL p 401 54 .canditii.on or UviXdi,(qu Paxmi.t Number is that; the dehrj,:. re:.�tti.ngxdin Chi.. .Iaxc da.st)u5ed of i.n •a property liccilsed zvli.d uast:e gaca.7.i y os dctinad by HCL C 111, S 150A, . The' ciebris uill be d:lipu ied )f in: *ao c t (I ot�*Tacl Jt �agnaturc o • vx Rpp scan Hate _ The Cotrimonwealth of Massachusetts Department of Industrial Accidents _ Offfcg affayestf9atfvus 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insni anteAffidavit / / - nsme' , S'" location: Z1.5 Cho d770• OoIeDS� J il�lG a❑ I am a homeowner pedarming all work myself. ca aci rl I am a sole rietor and have no one worlds in es working on this job. 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Q� i t:f?"F ':'j•''r'::•}GR•!/r•'q,: v,}r<x;�Y:•y-':;}.f{+fF:v{}yY.x,:?i•' .. �{..... r yt';3 fi,:?{;rY,.;SSf:}:•�6 �?R N. ?{.#!!.{r;?1 g:+.?tS:fi•:a,,.}f;:{tb.,,.R...t.! WPM f:}>"Memul:rea .}:x?4::rx, . na <!;::.•::.:5•, ositionoierlsnina�lp�tles OfaftneIIp to s1,50a.Q0 mdfor under Section 2raA of MGL 152 esaies3 to the imp enalties in the form of a STOP WORK ORDER atui a One of 5100.00 fa day against ma Itmdentmd�fft a one years'imprisonm't as weU as dvIl p zoom of tht DIA for coverage verliiCSAon be forxardea to the Office of Investig copy of this statrrneatmay _ ` under the enaldes of perjury that the information provided above if true and correct. I do hereby certi Date �alt"3 /03 - - Signature phone# �•77d� � puitr name /��-' _ � • offidal use only do notwrite in this area to be completed by city or town OMddal C] g Department per7rdtMcense# (]Licensing�� city or town: ❑sdectracn!%Office ��nq�d _ []$ealthDepartment ❑ checkifinuneaatemF° Other contact person: (fsvised 9195 P7� ' Information and Instructions as sachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation n for heir M " an ern ,lo ee is defined as every persontract on in the serve Y quoted from the `law , p .y. employees. a T ' 4 of hues impress or implied., oral or written. : hi association, corporation or`other legal dnt,v or any two or more of f ned'as an individual, partnership, An employer is dedeceased employer, or the receiver or p ed in a joint enterprise, and including the Legal representatives of,a. r , ;, the foregoing engaged 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 app meant•thereto^shall iioi.'iecause,of such employment be deemed to be an employer. MC c er 1y52 section 25 also states that every state or locaklicensing agency shall withh for.{an l applicant u who has , , for,..an of a license or`per vcit to operate wbusiness or to construct buildings it`the comm n�ea1 er the not produced`acceptable evidence of compliance with the insurance'oover�g£orthelrerforman�e'Additionally, f lu,blic workualil commonwealth nor any of its political subdivision,5 5ha11 enter into any contract,% y P $ acceptable evidence of compliance with the insurance regviremests othi . hapterhave been.presentedto the contacting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies o your,situation bed P Y supplying company names,•address and phone numbers along with a certificate-of insurance as submitted to the Department cf 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 . Should you have any questions regarding the"law"or if you being requested, not the Department of industrial Accidents are required to obtain a workers' compansatioa policy,please call the Department at the number listed below. City or Towns 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 numbe mayr. The affidavits may be rebamed to the Department by mail or FAX unless other arrangements have been made. ,. The 0$'ice of jnVestigatpns would'like to thank you in advance for cooperation and should you have any questions• please do:not hesitate to give us a call. iai��%/////////%�///D///////% / k EM The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of invesdgatlans 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 nhone#: (617) 727-4900 ext. 406, 409 or 375 ACORN` ::ERTIFICATE OF LIABILITY NNSURANCE DATE(MWDD" 01/06/2003 PRODUCER (781)356-4S50 FAX (7E1)356-4549 JNFUKMATION Arthur 7.' Gallagher & Co. of Massachusetts, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR So Braintree Hill Office Park ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Braintree, MA 02194 INSURERS AFFORDING COVERAGE INSURED Commonwealth Building Inc. INSURER A. Travelers Property & Casualty 265 Willard Street INSURER8: Commerce is Industry Insurance Quincy, MA 02169 INSURERC: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE-POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IMIK LTR TYPE OF INSURANCE POLICY NUMBER DATE(MMIDO/YY) DATE(M4,13or 1() LIMITS GENERAL LIABILITY DTC0430D7021IND02 X COMMERCIAL GENERAL LIABILITY 12/31/2002 12/31/2003 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE(Any one fire) $ 100,000 CLAIMS MADE �OCCUR MEO E%P(Anyone person) S 5,000 A X General_ Agg per Pr PERSONAL&ADVINIURY $ 1,000,0.00. GEML AGGREGATE LIMIT APPLIES PER IERAL AGGREGATE $ 2,000,000 POLICY EC PRO LOC PRODUCTS-COMPIOP AGG $ 2,000,000 AUTOMOBILE LIABILITY DT&10463D7033TILOZ 12 ANY AUTO 12/31/2002 12/31/2003 COMBINED SINGLE LIMIT ALL OWNED AUTOS $(Ea accident) 1,000,000 A X SCHEDULED AUTOS BODILY INJURY $ (Per Person) X HIRED AUTOS X NON-OWNED AUTOS BODILY INJURY j (Per accident) PROPERTY DAMAGE $ ` (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS.LIAB1L1TY DTSMCUP463D704STTLO2 12/31/2002 12/31/2003 EACH OCCURRENCE j Xi OCCUR MAIMS MADE AGGREGATE 10,000,000 A j 10,000,000 DEDUCTIBLE $ RETENTION j s ' S WORKERSCOMRENSATIONAND C9694287 12/31/2002 12/31/2003 X TORY LIMITS ER EMPLOYERS'LIABILITY B E.L.EACH ACCIDENT S 100..,000. E.L.DISEASE-EA EMPLOYE $ 10 O,QO O OTHER T66022 E.L.DISEASE-POLICY LIMIT $ S00,000 1DZ569TIL03 12/31/2002 12 31 2003 Contractors Equipment / / $25,000 Leased/Rented A Equipment - All Risk DESCRIPTION OF OPERATIONSQOCATIONS/VEF 1;LESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROV SIGNS $S O O Deductible f r CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL _3 Q_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. For Bidding Purposes AUTHORIZED REPRESENTATIVE Barbara Miller/GFGOs �aa^ 4 c i � �" -��, �j�6ie-[�amv»aaiugea`l� a�✓�aaaac�ivaelta= � ` BOARD<OF�BUIWIINGREGtI.ATtOaNS License -�ONSTRUCt{QNSUPERNISO Numbed '0 67093' mate 03110113963 z=3 (_fT 4� xp s �31a%20.04 Tr.no: 17851` 4-1 r A - 'R�s ncd�t0 Xl j PATRICK F D.UFFINf=r f1 25 ALDENtiRQ WEYMOUTH %MA 021'88 Administrator f CONSTRUCTION CONTROL PROJECT NAME: PROJECT OWNER: zon PROJECT LOCATION; tole wf I }�� ARCHITECT/ENGINEER: K A IN ACCORDANCE WITH SECTION 127.0 OF THE MASSACHUSETTS STATE BUILDING CODE, REGISTRATION NO. I0&- BEING A REGISTERED PROFESSIONAL ENGINEERfARCHITECT HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECTIFICATIONS CONCERNING: ENTIRE PROJECT ARCHITECTURAL STRUCTUAL MECHANICAL FIRE PROTECTION ELECTRICAL OTHER (Specify} FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEDGE, SUCH PLANS COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE_ PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE :BORIC IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 127.2.2: I. Review of shop drawings, samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit, and approval for conformance to the design concept. 2. Review and approval of the quality control procedured for all code required controlled materials. 3. Special architectural or engineering professional inspection of critical construction componets requiring controlled materials or construction specified in the accepted engineering practice standard listed in Appendix B. PURSUANT TO SECTION 127.2.3; I SHALL SUBMIT PERIODICALLY A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE PEABODY BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS Q THE SATISFACTORY COMPLETION. AND READINESS OF THE PROJECT FOR OCCUPANC . SIG A E ��, g , n" SUBSCRIBED AND SWORN TO BEFORE ME THIS �o� DAY 0 C/ !�C�LP7� �� 7�o?bo J NOT AR`f Pt3 LIC MY COMMIS6awks OTARY PUBUC OF KW MR L 4',r MY COMMtSM EXPIRE$ NFUILW �1 r yr` i > t � � t+ IYf�dBfs��v��S�L#d YM l_' — —UCI_22-2003 12:06 P.03 FINARD & COMPANY r�•.-uy.,ri;.._—=YVr:.''...a: ._z-IrY7J.—<sV:. s r_ .':4 is�:.. .-�rrJ4.:_ _:1.'f�M1ll:t.=_:<Y'R,xv�•.:�:�hq.•-.... MEMORANDUM - �,R.=.=et.,.:--r", ..---'Se.n- =-.e�.M)1¢:=::meehJ-R c_.: r• <_-:. r •- � -•- - TO: N"I FA III'!!(nN'1CI1 FROM: SUBJECT: C N1 At!NTS ON S111041'1 O 1)R ;N(Il'.0 ION l'I.AN DATE- 10/22/03 CC. Kindly accept this list as IAndlord's comments on the recently submitted renovation package: 1. All construction work must be approved by the local govemmg agcncieK and mun comply %%ith all local codes. including but not limited to building, fire, electrical, plumbing and zoning. 2, Contractor shall mount horn light strobes and rXit signs building code. 3. Contracur shall equip rear egtesc with a crash bar and alarm. 4. Contractor shall suspetid all I IVAC ductwork and sprinkler pipes from top chord of trusses. S. Contractor shall contact the management office at (781) 444.9903 49 hours prior to electrical,sprinkler or fire alarm shutdowns or dugouts. G. Contractor shall keep smoke and hear detectors active at all times during ccrostruction. 7. Contractor shall supply a ftrc watch is Any welding occurs in the space or on the roof. 8. Contractor shall employ Landlord's roofet if any cuts or disturbances are made ten Lhe rubber membrane. 9. Contractor shall furnish appropriate paptrwork from the Building Department to Landlurd for completion,if necessary. 10..Contractor and'I'craani shall furnish certificate of insurances for all trades that will work m the'spact, On the certificates, Finard & Company'is die certificate holder and Finartl & Company, CH Realty II/Hyannis, IJA: and Crow Holdings are also named as additional insureds. Plcasc call this office with any questions and with an appru",nate work cornmencctrient date. Thank you. FINARD&COMPANY,U.0 HILLSIit on icE WILDING ■ 7%SECOND AVENUE ar SUITE 45n ■ NFFDHAM,NiA 024W r PH:(781)444-9903 0 FX;(701)-155.6461 TOTAL P.03 Town of Barnstable �P Dp SHE Tp��O.r N Regulatory Services s LE. Thomas F.Geiler,Director 9 1619� BuUding Division Tom Perry, Building Commissioner 200 Main Strect, Hyannis,MA 0260I office, 508-862-4038 Fax: 508 790-6230 Property Owner Must Complete and Sign This Section If Using A Builder . I ,as Owner of the subject prop etty.- hereby authorize to act on my behalf,. is all rnattets relative to work authorized by this building p wait application for: (Addtess of Job) -------------- Sigaataxe of Owner Date Print Name Q:F0p MS:0WNEUER1ZS SMN COMMERCIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $100.00 Alterations/Renovations $50.00 Building Permit Amendment $50.00 FEE VALUE WORKSHEET NEW BUILDINGS square feet x$140.00/sq.foot= x.0061= ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet X$96/sq.foot= Z ss O d 4, X.0061= 7 STORAGE BUILDINGS ONLY square feet X$32.00/sq.foot= X.0061 Commprojcost i Address: �?,iaon W i ILC � M,4-1i 16 7,f _Aq Permit#: 7 Date: M/P: � LARGE ROLLED PLANS ARE IN B OX FOR ARCHIVING. Date: °F Teti Town of Barnstable Regulatory Services BAMSTABv I'E$ Thomas F.Geiler,Director . i639� ♦0 Ar fD 39 a Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 April 27, 2001 Robert J Klancher 5185 Macarthur Blvd#200 Washington, DC 20016 Re: SPR 032-01, Verizon, Voicestream Wireless, Capetown Plaza, Hyannis Proposal: Establish retail use in former medical facility (HB Zone) R311-092 Dear Mr. Klancher: Please be advised that this application was approved at the Site Plan Review hearing on April 26, 2001 and was subsequently referred to the Zoning Board of Appeals. t You should also be aware alterations to the existing fire protection system are subject to approval by the Hyannis Fire Department. Sincerely, Robin C. Giangregorio SPR Coordinator Q:B ldg\siteplan\2001\voicestream j TOWN OF BARNSTABLE . SIGN PERMIT PARCEL ID 295 019 X01 GEOBASE ID 41309 .ADDRESS 1070 IYANNOUGH ROAD/ROUTE PHONE (617)932-1244 HYANNIS, MA ZIP 02601- LOT 3 4 5 6 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT BA PERMIT 52373 DESCRIPTION .VERIZON WIRELESS PERMIT TYPE BSIGN TITLE SIGN PERMIT i . CONT ARCHITECTS:AR Department.of Health, Safety and Environmental Services TOTAL FEES: $25.00 BOND $.00 _ INE CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE . * •ARNSTABLE, MASS. . ED MIB B ILD C3 DIVIMN 7 / DATE ISSUED 03/26/2001 EXPIRATION DATE r s Town of Barnstable oFt"E'�,ti Regulatory Services o� Thomas F.Geiler,Director , AS&g Building Division .q ib3 �0 iOrE ° Elbert C Ulshoeffer,Jr. Building Commissioner . 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Tax Collector Treasurer /t c� Application for Sign Permit Applicant: ti�� --u �Z� lt✓ Assessors No.J� l!-r Doing Business As: l)LYV 0 W�C � Telephone No. Sign Locations Street/Road: L67 Zoning District: Old Kings Highway? Yes/No Hyannis Historic District? Yes/No Property Owner Name: f 0 Telephone: Address: Sign ContraqK Name: d �\-Qj(2:S____:reIephone: 6 Address: 5o age Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions,location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Yes/No (Note:If yes, a wiring permit is required) I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinance. q Signature of Owner/Authorized Agent: ate: 1149 Size: / J / Permit Fee: C Sign Permit was approved: Disapproved: Signature of Building Offi 1: Date: o� o'le Sign 1.doc rev.8/31/98 4. Pu t I � I I S ! I I_1LO ------ — I x F in 05. etc �m i"n EZ f i 4 i p` sit € a � I I VV o � C 01 � rn cmiti I II 1 eG , I p3120002(64Ox48Ox24bjpeg) J— L� DO „jam Cr� L J TOWN O.F BAANSTABLE SIGN PERMIT PARCEL ID 295 019 X02 GEOBASE ID 41310 ADDRESS 1070 IYANNOUGH ROAD/ROUTE PHONE ZIP - LOT 3 4 5 6 BLOCK LOT SIZE _ ABA DEVELOPMENT DISTRICT HY PERMIT 47943 DESCRIPTION VERIZON WIRELESS 46 SQ. PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $50.00 BOND $.00 Ox THE CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE 1 PRIVATE PH;.E * BARNSTABLE, MAS& 1639. Ep NIM►I . B ILDING DIVISIO C DATE ISSUED 08/08/2000 EXPIRATION DATE / °+ Department ofHealth. ,alesy _ • Ruilding ntvsion f 79 y 3. 9 doss 367 Main Sttzes:Hya MA 02601 Ralph Crossen Office: 508-862-4038 Building Commissione: Fax: 508-790-6230 Tax Collector A4,Treasurer 7 �°6a application for Sign permit c;) 9S o19 Assessors No Applicant: � Doing Business As: �C'l ZO a �i«'Telephone No. Sign Location '0, 7 6 c Street/Road: y Yyannis Historic District? Zo istrict: J Old Kings Hi€,hwa ? YegL✓ �'Ca,�,-pbe►l�r�iRss,� �o 0 property Owner (� Telephon Name• 09 116 • Address: Sign Contractor Telephone: Name: Address: Description with of lot showing location of bmldings and emstz o �� Please draw a diagram � shobrld be drawn on the reverse side of dimensions, location and size of the-new sign. this application. Is the sign to be electrified? Yes/No (Note:If yea, a wiring permit is required) that I have the.authority of the owner to make this that I am the owner or I hereby certify and that the use and construction shall conform application, that the information is correct Zoning Ordinance. a the provisions of Section 4-3 of the Town of Barnstable � Date: Signature of owner/Authorize Agent. permit Fee• Size: Disapproved: Sign Permit was approved: Date•— Signature of Building Offi 'al: sus-n r.�a� 1070 IYANOUGH RD. HYANNIS, MA 60'-0" 21'-10 3/8" 15" 3'-4" c^C^U rm�1 x=w+ � 5-•�^..:TwtRL a.1. �-. I•;,=-'" `.r'$"�i +�.a��ac.� a^�.'u�p� i. ,per � cr ..;to „-4 � >�`.'-��.;'#��'Ze'�,.:.-. ..�i BLA ti Y yy� �ui� mac+ 'St ` �\A ' I — can C ALTOONA,PL AVE166 Vy veri onhjreiess ALTOONA,PA 16601 ✓ L, PK CHANNEL LETTERS (814)949-8287 FAX(814)949-8293 E-MAIL: email 0blairsign.com M# 66811 CONCEPTUAL ARTWORK-C1A YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) and 200 Main Street Offices at the Licensing counter. , � :DATE - 8 b o 1�01 io k Fill in please: eEr Bell Atlantic Mobile of Massachusetts corporation, Ltd 5' APPLICANT'S YOUR NAME: a� h BUSINESS YOUR HOME ADDRESS: one yerizon wav, Basking Ridge NJ 07920 508-790-6944 TELEPHONE # Home Telephone Number: NAME OF NEW.BUSINESS"verizon wireless P wireless communications TY E OF BUSINESS IS THIS A HOME OCCUPATION? Have your been grven,,approval fr"om the��build'ing division? M AD:DRESSOFBUSINESS `, '..o70 lyannough Road xyannis,>MA ozeo? �8?.i AP/PARCEL NUMBER �:, ��, : X �: When starting a new business there are several things you must do' in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. —(corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate.permits and licenses in this town. required to legally operate your business 1. BUILDING CO MISS NER'S OFFI E This indivi ual b e�in rrn' o an permit requirements that pertain to this type of business. Authorized Signat COMMENTS: 2. BOARD OF HEALTH This individual h�s be ' for of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual h been infQrmeq of thelicensing requirements that pertain to this type of business. Authorized SignaturEQt COMMENTS: