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1070 IYANNOUGH ROAD/RTE132 - CC VACCUUM MART
-7C) ecA � ., Town of Barnstable Building s � PostThis Card So..That t is Visible From the Street°Approved Plans Must be Retained on Job and.this Card Must be Kept ;z t . 3p sUtilFinal 6 Insection Has '' ".'. Permit Whe ty abe mdfl until jaiFi s , Permit No. $-16-2337 Applicant Name:.. FESTIVAL OF HYANNIS LLC Map/Lot: 295-019-X02 Date.lssued: 08/24/2016 Current Use: Zoning District: SPLIT Permit Type: Building-Sign Expiration Date: 02/24/2017 Contractor Name: Location: 10701YANNOUGH ROAD/RTE.132, HYANNIS Est..Project Cost: $0.00 Contractor License: Owner on Record: FESTIVAL OF HYANNIS LLC Permit Fee: ' $75.00 Address: BILLBOX'018726 1053 Fee Paid: $75.00 HICKSVILLE, NY 11802-7522 8/24/2016 Description: 49.84 sq ft sign for CAPE COD VACUUM �� -'� �•� Project Review Req : 49.84 sq ft sign.for CAPE COD VACUUM 4 k , c ; •�M — Zoning Enforcement Officer This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within siz months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be'incompliance'with the'local zoning by-Jaws:and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open'for public inspection for the entire duration of the work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signtures by the Building and'Fire Officials are provided on this permit. Minimum of five Call Inspections Required for All Construction Work:, I.Foundation or Footing 2.Sheathing Inspection �- 3.All Fireplaces must be inspected at the throat level before firest flue lining:is installed - 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection' = , S.Prior-Jo Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall.not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT r V �. 'ME Tay Town of Barnstab e eukOIN Regulatory Services DEF--pr ` �; Richard V. Scali,Director 1, 20 E1 3;9. 1'�0 Building Division TOWN of eAR NS Tom Perry, Building Commissioner 200 Main Street,.Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit# — 1 � Building Official approving Application for Sign Permit \ Applicant �DIU �[�/�D-l/ Assessors Noa Doing Business As:[ 4Ae r U►� '��Ll� W� Telephone No.Q .3 9 F 0�.3&Z Sign Location Street/Road: l' fa;, YANMA,41 Zoning District Old Kings Highway? Yes&Hyannis Historic District? Yes/1 Property Owner `, Name: KL M Cc tL(I j Telephone: �? d3 c)9 Address:oZ zuAt q) Cj e e,�akc g j i00 MPw'TV(U OAO Village: Sign Contractor Name: 94' PC—VII it Telephone:(Qg'.3 7Y c1/4-V 1 Mailing Address: Q—� u lru,lI ��r7t^. R YAAMilo* l� Description Please follow the cover directions.You must have an accurate rendition of sign with dimensions and location. Is the sign to be electrified? Yes o (Note:Ifyes, a winngpermkisrequired) Width of building face ft x 10= CS�U x.10= C� Check one Reface existing sign or New Total Sq..Ft. of proposed sign (s) 3� Ifyou have additional signs please attach a sheethsling each one with dimensions If refacing an existing sign please provide a picture of the existing sign with dimensions. 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 constru on shall conform to the provisions of §240-59 through§240-89 of the Town of B9qtable g Ordinance. Signature of Owner/Authorized Agent Date �d SIGNS/SIGNREQU revisedl 10413 8/12/2016 2:27:58 PM D f VERSION: 1 2 3 4 5 F E-Mailed Called NO PROOF REQUIRED 0 0 COMPANY: Cape Cod Vacuum r} 7 RR �ry CONTACT - O O O0 O C) OOO OOO 0 O'000O0O00000 (: 00 "' PERSON: ry 4,i STREET: Festival Plaza f CITY: Hyannis STATE: i x Dyyp ZIP: PHONE: - FAX: EMAIL: ZJ O �?t y e D ., 1 0"a ,) LED Channel Letters Mounted To Brick Fascia -,x kv Y , ,-,. ",.�•. T�-"rr..C..Si'�.T M n r �i4 File Name:Festival_Plaza_Hyannis.fs Folder Name:\\Backup\e\FLEXI_FILES\C\_CAPE COD_\Cape Cod Vacuum O COPYRIGHT 2014,SIGN*A*RANIA,Inc. THIS RENDERING IS INTENDED AS A SAMPLE ONLY.COLOR,TEXTURE,MEASUREMENTS,AND ACTUAL APPEARANCE MAY VARY SLIGHTLY FROM COMPLETED WORK AND IS CONSIDERED NORMAL 8+USUAL. Please check layout(artwork,spelling,dimensions)and fax back with signature.Production I HAVE REVIEWED THE ABOVE SPECIFICATIONS&HEREBY FULLY UNDERSTAND THE cannot begin until written approval is received.Additional charges will be applied for any changes p O O O CONTENT OF WORK TO BE PERFORMED that are needed after approval is received.SIGN*A*RAMA is not responsible for any errors in AND APPROVE THIS PROJECT TO BEGIN spelling,layout,Or dimensions that have been approved by the customer.This proof is for listed CUSTOMER APPROVAL SIGNED BY: items only.Any changes or deletions by the customer not shown or charged herein will be billed 12 Whites Path-Suite 6,South Yarmouth,MA 02664 separately.50%DEPOSIT DUE AT TIME OF ORDER(full amount if under$100),balance due Phone:508-398-9100 Fax:508-398-1760 Email: averizon.nt uPon time of installation.I HAVE READ AND AGREE TO ALL TERMS. INITIAL www s gnaremasyarmouthecom Pf�INT. DATE: THIS ORIGINAL DESIGN AND ALL INFORMATION CONTAINED THEREIN IS THE PROPERTY OF SIGN'A'RAMA AND ITS USE IN ANYWAY OTHER THAN AS AUTHORIZED IS EXPRESSLY FORBIDDEN.THIS PROPERTY MAY NOT BE REPRODUCED OR DUPLICATED WITHOUT WRITTEN PERMISSION OF SIGN'A'RAMA OR THROUGH PURCHASE. PW DATE 7/27/2016 1 10:30:24 AM s E€ PROOF ? x VERSION: 1 2 3 4 5 N Wyk r Cape Cod Vacuum Rz STRF= Festival Plaza CITY: a , f ' Hyannis ST1iT=: R ZIP � ¢ y f � PHONE: ` FAX:' i 3 DESCRIPTION LED Channel Letters Mounted To Bric , File Name:Festival_Plaza_Hyannis.fs a Folder Name:\\Backup\e\FLEXI_FILES\C\_CAPE COD_\Cape od VaeiutTa = ; S 'a .�ci'� THIS RENDERING IS INTENDED AS A SAMPLE ONLY.COLOR,TEXTURE,MEASUREMENTS,AND ACTUAL APPEARANCE MAY VARY SLIGHTLY FROM COMPLETED WORK AND IS CONSIDERED NORMAL&USUAL. Please check layout(artwork,spelling,dimensions)and fax back with signature.Production '''I�I11 I HAVE REVIEWED THE ABOVE SPECIFICATIONS&HEREBY FULLY UNDERSTAND THE cannot begin until written approval is received.Additional charges will be applied for any changes . ® O / CONTENT OF WORK TO BE PERFORMED that are needed after approval is received.SIGN*A*RAMA is not responsible for any errors in AND APPROVE THIS PROJECT TO BEGIN spelling,layout,or dimensions that have been approved by the customer.This proof is for listed CUSTOMER APPROVAL SIGNED Y: items only.Any changes or deletions by the customer not shown or charged herein will be billed 12 Whites Path-Suite 6,South Yarmouth,MA 02664 separately.50%DEPOSIT DUE AT TIME OF ORDER(full amount if under$100),balance due Phone:508-398-9100 Fax:508-398-1760 upon time of installation.I HAVE READ AND AGREE TO ALL TERMS. INITIAL www s gna csar@verizon rmouthet PRINT: DATE: ., THIS ORIGINAL DESIGN AND ALL.INFORMATION CONTAINED THEREIN 15 THE PROPERTY OF SIGN'A'RAMA AND ITS USE IN ANYWAY OTHER THAN AS AUTHORIZED IS EXPRESSLY FORBIDDEN.THIS PROPERTY MAY NOT BE REPRODUCED OR DUPLICATED WITHOUT WRITTEN PERMISSION OF SIGN'A`RAMA OR THROUGH PURCHASE. Inc Town of Barnstable . . ABLF ,.p Building Department-200 Main Street rEOMA+° Hyannis, MA 02601 Tel. (508) 862-4038 Certificate Of Occupancy Permit Number: B-16-3307 CO Issue Date: 12/19/2016 Parcel ID: 295-019-X02 Zoning Classification: SPLIT Location: 1070 IYANNOUGH Proposed Use: ROAD/RTE132, HYANNIS Gen Contractor: PAUL C LEACH Permit Type: Commercial - Business Comments: CAPE COD VACUUM MART Building Official Date: { C A P E C O D v cuum S A L E S AND SERVICE MARCIE LEACH 1-800-649-9755 ACCOUNTS MANAGER 508-255-7011 j P.O.Box 1438,Orleans,MA 02653 f . �tWE Sign Permit &' �SrABLE. * TOWN OF BARNSTABLE MASS. s6 Permit Number: Application-Ref: 201001184 20070429 -Issue Date: 03/19/10 Applicant: FESTIVAL OF HYANNIS LLC Proposed Use: i SHOPPING CENTER- MALL Permit Type: SIGN PERMIT 'Permit Fee $ 50.00 Location . 1070IYANNOUGH.ROAD/RTE132 Map Parcel 295019X01 Town BARNSTABLE { Zoning District SPLT Contractor . PROPERTY OWNER Remarks WALL SIGN-21.5- SQ CC VACUUM Owner: FESTIVAL'OF HYANNIS LLC Address: BLLLBOX 01 8726 1053 PO BOX 7522 .. r HICKSVILLE, NY 11802-7522 Issued By: PC............................. HSTEVISIBLEFRMTPOSTTHIS CARDAS O RET Town of Barnstable Regulatory Services OF Thomas F.Geiler,Director _ TOWN BA STALLE WXNSTABM ' Building Division eo ►`e$ Tom Perry,Building Commissioner � ' + + ' Q 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us DIVISTON Office: 508-862-4038 Fax 508-790-6230 Permit# V I v l a Application for Sign Permit Applicant: I�j Lo c>)4o \ - Map & Parcel#C L)12 � V/) Doing Business As: CaP° CD- � c cutw�" Telephone No. Sign Location Street/Road: I0"7;Z> QL —IZ Zoning District: Old Kings Highway?, Ye Hyannis Historic District? Yesl� ' 4 Property Owner Name: vv\ o \ n ®-� Telephone: 9 1 fo.. $6ck�"�1�L1 F-esT\"cL d t_L C- Address: VP > 2csx Village: AJQW NLQt Sign Contractor Name: sosn— Tla vhca Telephone �U� 3`i�-- 1 00 Mailing Address: rl b y �� � * �- / ck%r�v 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) Width of building face'21 S ft.x 10 x.10 . 'Sq.Ft. of proposed sign 21 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§240-59 through§240-89 of the Town of Barnstable Zoning Ordin Signature of Owner/Authorized Agent: Date: 3__ Permit Fee: Sign Permit was approved:' Disapproved: Signature of Building Official: Date: In order to process application without delays all sections must be completed. Q:I WPHLESI SIGNSI SIGNAPP.DOC Rev.9112106 PROOFDATE " • • CONTACT INFO 3/10/2010 COMPANY: Cape Cod Vacuum PHONE: PROOF 1 2 3 CONTACT PERSON: 4:24:47 PM STREET: Festival Plaza FAX: IVI CITY: Hyannis STATE: ZIP: EMAIL: File Name:Festival_Plaza_Hyannls.fs Folder Name:W3ackup\e\FLEXI_FILES\C\_CAPE COD \Cape Cod Vacuum DESCRIPTION LED Channel Letters Mounted To Brick Fascia S 1 r # u s Vr F Ft11T t,EAyf2 1 V t L SI ^.l,I r� .f y. 'ZO fi F. } TO ASSURE SAFETY AND QUALITY OUR PRODUCT IS®LISTED ©COPYRIGHT 2009,SIGN*A*RAMA,Inc. THIS RENDERING IS INTENDED AS A SAMPLE ONLY.COLOR,TEXTURE,MEASUREMENTS,AND ACTUAL APPEARANCE MAY VERY SLIGHTLY FROM COMPLETED WORK AND IS CONSIDERED NORMAL&USUAL. Please check layout(artwork spelling,dimensions(and fex back with signature.Production I HAVE REVIEWED THE ABOVE SPECIFICATIONS&HEREBY FULLY UNDERSTAND THE cannot begin until written approval is received:Additional charges will be applied for any changes y. TII'' q y4 CONTENT OF WORK TO BE PERFORMED&APPROVE THIS PROJECT TO BEGIN: that are needed after approval is received.SIGN*A*RAMA is not responsible for any errors in 77 I CUSTOMER APPROVAL SIGNED BY: spelling,layout,or dimensions that have been approved by the customer.This proof is for listed PRINT: DATE: items only.Any changes or deletions by the customer not shown or charged herein will be billed 12-6 White's Path,South Yarmouth,MA 02664 separately.50%DEPOSR DUE AT TIME OF ORDER(full amount if under$10%balance due Phone:508-398-9100 Fax 508-398-1760 LANDLORD APPROVAL SIGNED BY: Email:cssr®verizon.net upon time of installation.I HAVE READ AND AGREE TO ALL TERMS INITIAL W W W,signarama.com102884 PRINT: DATE THIS ORIGINAL DESIGN AND ALL INFORMATION CONTAINED THEREIN 15 THE PROPERTY OF SIGN'A'RANA AND ITS USE IN ANY WAY OTHER THAN AS AUTHORIZED IS EXPRESSLY FORBIDDEN,THIS PROPERTY MAY NOT BE REPRODUCED OR DUPLICATED WITHOUT WRITTEN PERMISSION OF SIGN•A•RANA OR THROUGH PURCHASE. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # 369— Health Division Date Issued L J Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board &L Historic - OKH Preservation/ Hyannis Project Street Address (070 (�z� I cvillage � f-OWnen \nn C� Qom\ Address `�>,Dy� "1 52Z1I�o`3- CTelephone, cPermit Request LON L L CAQa- Gcs9 k GLLUVV\ aqua e f et: 1 st floor: existing proposed c �4 2nd floor: existing X proposed Total new ,Z,on.ing Districts 46 S Flood Plain Groundwater Overlay c.Project Valuation WC00 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: 0 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: BUILDING DEPT., Zoning Board of/Appeals Authorization ❑ Appeal # Recorded ❑ NOV 15 2016 commercial O Yes ❑ No If yes, site plan review # TOWN OF BARNSTABL ,Current-Use rP_roposedTUse � �• APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ,jfN Tele Addre sX �� �' a Lieense # `i�' `�n �q ov I-e-a-IDS O Z C,S 3 Home Improvement Contractor# 1No� rkers C p nsafion# �— � ' XTVALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO GNATUREP _ 4DATE1 I ce _� FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL z FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 27ie Commommah*of Massadi=e& Deparftffeat afrarhutrid Acddentg face o,�'Fici adow.. 600 Waslrurgion&-met Bastan,HA 02111 . ww��zmass`�rw�dia .. Workers' Cumpensaifen Insurance Affidavit:B•�dex-s/Cantracturs/Electricians/Phi nbers Am cant Inforinatian f Please Print C'iLgl falx�f s Phiono -)7( ".?90- Are pau an employer?Checkthe appropriate box: Type of project(reguim* 1.❑ I am a employer veith 4. ❑I am a general contractor and I . • employees(ftz11 az�for par time). * Nave hired sub contxactors 6. ❑New consfrnt�iort �. I am a sae proprietor orpartnee 1i. d OIL the 1tt61hed sheet .. 'I- ❑Remodeling ship and have no employees These sub-contractors have $. ❑Demolition mod-zing- forma irrauy capacity- employees aadbave wodcers' [No work='CAmp.insurance comp.%nerrran ze 1 9- ❑E.nilding addifica required.] 5. ❑ We are a cozporati=and its 16-ElElectrical repairs or additions officers have exercised their 3_❑ I am.a homeowner doing all ward€ . 11_❑Plumbingregairs or additions my-self [No workers,comp. right of emempfion per MGI. 17_❑Roofrepairs rncrnancereqmired]f c.152,§1M andwe have na eavloyees:[Nowosoers' 13.❑ other comp_msnraace required.] Any appitcsutdwtchedsbox#1 alsofillonEth setiaabeTaasbosdagEheiiwo�exs'ca®pP,•�fi�„poyepiafoemsao� I F€ameovraers who subnnt do&XMdaca`i g dzY axe doin RU wax and then hie outside coubmcfar;— sd=k a new aMdaui iadiaiing sudL fConI - ff=t cbW2 tb¢s box mast a2mr1T in additional died showing thexsane of the sub-cw=uxr.sad state whew araat those entities ham employees.Ifthesnbtantractaorshmarapioyee-%they n=ymvidetheir workers'comp.palicynariser lam an Insurance srriplayRr tlztrt is prauidirrg tvarezx'cazzrperzsrrft'an uiszirarica for isr enrplvy�ees. Selabv is flieprrticy and job s71e inform�iozz. - Insurance Company Name: 'Policy 4'or Self--ins.Lic. Expiration Date: ` Job Site Address: CO/State/zim Attach a ropy of the workers'cwnpensationpolicy det:Iaratiozs page(showing the policy number and expiration date). Faalrue to secure coverage as requke dunder Section 25A of MGL c 157-can lead to the imposition of criminal ptmaltsesofa fine up to$l,5aa OQ andlor one-year impdsonmenk as well as civil penalties.in the form of a STOP WORK ORDERand a#md of too$250-00 a day a the violator. Be adsdsed brat:'a ofthis baement uP` F b copy maybe foswarded to the Office of Investigations ofthe DIA for insurance-coverage veei$cafion. I rfa hem y csrtzfy u thf pains andperzaNks of jret iiq dud its a informafiozz-pnn-i ed abmv is trzw acid carrect Sitnatare- Date: Phone ojokird am apil. Do not write in thb area,ter be compTetad by dJF ortol n OJOT rat City or Tara: N-rmitUcense 4 Issuing Amfho'lity(carte one): L Board of Health t Bu Ting Departmeeat &Qtp Town Clerk 4 Electrical Impector S.Plu nbmg Iuspmtor 6.Other Contact Person: Phone#: ormation and Instructions M�s2xj- rce�t8 Ge�al Lases chapter 152 regmres all employers Yn prcx&wprb�as'co�eas on for their employees. pm th this St2tnfe,an=V&5Mff is defined as¢.even p person m$�a seavicm of another Mder any coMkact ofhiM, CxP=ss or implied,oral or veiift of An wnpkyer is defined as rani dividaal,partnership,anDciefion,corporation or other legal may,or any two or more of the foregoing=gaged is a joint mtmprisq,and including the legal=preseotatives of a deceased employes,or the receiver or tustee:of an individual,partnm mhip,association or other Iegal entity.employing employees- However the owner of a.dwelling house having not more than three apartments and who resides therein,or the occ pmxt of the- dw'eIling house of another who employs p=s to do maims cm,construction or repair work on such dwelling house or on the grounds or bmld mg agpcarte -ffierefn ffiOnDtbca=e ofsuch employmentbc d=nedto bena employer." MGL chapter 152,§25C(6)also stafns that"everys on or local Iicensivg agency shall withhold$ie issuance or renewal of a license or permit to operate a business or to construct bufldings in the corumonwealt' for ang $-PPlicantwho has not produced acceptable evidence of cdmpfian=with the insurance.coverage requ_irecL" Additionally,ly,MGL chapter 152,§25C(')stair's-Neither the coulllimweabh nor jay ofits political subdivisions shall entr-z in� any contract for the peifibrinauce ofpnblic Walk n1161 acceptable evidence of compliance Vith file msUrance._ requirenients of this chapter have been presented to the rrntra ctirig midlioz~ity." Applicants ' Please fill oin rite worl�as'compensation affidavit completely,by checker ire boxes that apply to your situation and,if necessary,supply sob-con 7actor(s)name(s), addresses)and phone numbers)along wish their ceri>frcate(s)of ins Trance. LunitDdLnbiility CompaIIies(MC)orL=tedLiabRrtyPmtnenhips.(LLP)Wuhan eaployees other f imffiD mertibers or partneTrs,are not regcd ed to carry walkers'compensation insurance. If an LLC or LIP does have employees,apolicy is required. Be advised that this affidaQrtmaybe submitted to the Department of Industrial Accidents for confirmation of ice mverage_ Also Be sure to sign and date the affidavit. The affidavit should be rctumed to the city or town that the application for the pemit or license is being mqueste(L not the Department of rr rci m tom_ M unild you have any questions regarding the late or if you are reguhed to obtain a worms' comppensationpoliey,please call the Department at the number listed below- Self-insured companies should enter their self-ir sura cd ficarise number on the appropriate line. City or Town Officials f - Please be sore that the affidavit is complete and pri5f ed legibly. The Department has provided a space at.the both of the affidavit for you to fill out in-the event the Office of Investi gati has fin cozdact you regarding the applicant Please be sure to fill in the pe�L t cense mnnber which wdl be used as a r B=mce number. Ica.addition,an applicant that must submit multiple p ermitlIicense applications in any gam year,need.only submit one affidavit indicafin.g current policy inforiation(if necessary)and under`Job Site A des"the applicant shouldwrite"all locathns in (citY m- town)_'A copy of the-affidavit that has bey officially stamped or madced by the city or town may be provided to the applicant as proofthat a valid affidavit is on file for falm permits or licames. A new affidavit must be filled.0i±each year—Where a home owner or citizen is obtaining a license or permit not re7at�d to any business or commercial-V=tlm (Le. a dog license or permit to bum leaves eta.)said person is NOT required to complete this affidavit u in advance for our co er-ation and should you have any gaes'lior s, Thin Office ofInveshgaizo�veovldliketatharkyo Y oP please do not hesitate to give us a call— The I}eparimenf's address, mph _ - - Depadmmt of Izid Accidents Office 0x j1t.Ve&ttkfio= 64 wawmatm Stf, t � E�IIk TT.: Cl'-' -4 cxt 4-€6 Qr I-M MA SSA Fax#617 727 7749 Revised 4-24-07. -maga P r• � r - N Massachusetts-Department o.¢Public Safety ��c oon�•rrecitiuealf�c GGIt� Board of Building Regulations and Standards Office of Consumer Affairs&Busrness Regulation Construction,Jti pl'""I 11JLf - r;a HOME IMPROVEMENT CONTRACTOR License: CS-040398 _ Registratiorr:,i-101479 Type: Expiration 6/26/2018 Individual ��.. PAUL C LEACH PAUL C.LEACH PO BOX 1306 . 0RU,4NS MA 02653 Paul Leach 24 CAPTAIN DOANES WAY- Expiration ration _ ORLEANS,MA 02653 ........... p - Undersecretary Commissioner 11/10/2016 J • 19' 0' BACK BATHROOM BATHROOM 81 FULL WALL 8' - 191_61 FULL WALL 8' �- 6 4' 6' 18 INCH SQ. COLUMN ULL WALL 8'2' NT - COUER 31 , 12, — 6' 64'_6" 72' 5'-11 " , b1 1_611 26 31- 11 ^1 1_G11 (INCH SQ. COLUM 21_211 HALF WALL 4' - HALF WALL4' - 25' 25' 81 17' 7,_6,. FRONT 48' CAPE COD VACUUM MART HYANNIS, MA EXHIBIT"13-1" CONTRACTORS INDEMNITY AGREEMENT This INDEMNITY AGREEMENT pertains to work:to b-e performed,at the,Festival at Hyannis Shopping Center, and located in Hyannis, MA_he.rein referred to as-"Shopping Center" (Site: SMAH1114B) By C"e.CooC Vice,+u:n erein referred to as "Contractor"), having an address at: 'o- x t`i3,% 0-Itar)5 MA Oz&53 and is part of the Contract with 5a rn (herein referred to :" "Tenant"), ,having an address at which Contract' is dated f 1 for work'to be done at the :Shopping Center from''approximately through 5c t►'t��q,r ayYk Contractor acknowledges that Tenant-is coritractuailyobligated to obtain this Agreement under a lease for its store at the Shopping Center. Contractor:has entered into thisAgreementin order to induce Tenant,to retain Contractor to perform certain work.at its store. Contractor hereby agrees to INDEMNIFY, SAVE'.& HOLD HARMLESS FESTIVAL OF HYANNIS,Ll.0 and Kimco Realty Corporation,hereinafter collectively referred to as Landlord,its-respective agents and employees,assigns, and architects of and from all"liabilities,claim's, losses;damages,injury,causes of actions and suits of whatever nature for personal injury,including;death,and for,property-damage,arising out of or.alleged-to arise out of,orany conditions of,.the work performed under this Contract;whetherby Contractor or by any sub-contractor, and whether any claim,cause of action,.or suit is asserted against Landlord or,its agents and employees,assigns,and architects,or Contractor,severally,jointly,or jointly and severally. Contractor hereby agrees to INDEMNIFY,SAVE&'HOLD HARMLESS Landlord,its agents and employees;assigns, and architects of and from-any and all costs of any nature, including,without limitation investigation, adjustment, attorneys fees; expert's fees, court costs; administrative costs, and other items of expense:arising;out,of any claim,cause of action or suit of the"kind and nature herein':set forth. Neither Contractor nor any,sub-contractor shall file any mechanic's, materiaimen's, or other liens either against the Leased Premises or the Shopping Center from any work,labor,services or materials supplied or performed by Contractor or by any sub-contractor. Contractor-hereby agrees to INDEMNIFY,SAVE& HOLD HARMLESS Landlord,its agents and employees,assigns;and architects of and from-any and all costs of any nature, including without limitation investigation,.adjustment, attomey's,fees,expert's fees, court costs; administrative costs, and other items of .expense arising, out of any. mechanic's: materialmen's,or other liens.filed against the.either against the Leased Premises or the Shopping Center by Contractor or by any sub-contractor. Contractor hereby agrees that it will obtain Comprehensive General Liability insurance including Blanket Contractual Liability with minimum amount of$3,600,600.00 Combined Single Limit forbodily injury and property damage, Additionally. Contractor must also Obtain Workers`Compensation and Occupational Diseaseinsurance with statutory limits and form as required by the State in which the work is to be performed,-and Employer's.Liability with a limit of not less than$1,000,000.00 for all damage. Certificates for all insurance will be submitted to Landlord before commencement of any:work. The Certificates must indicate that the"HOLD,HARMLESS AGREEMENT"contractual indemnity as set forth in this agreement is insured. Landlord must be named as an additional insured-andthe policy.must provide that no less than 15 days advance written notice will be given to both the party to whom,such Certificates; are issued.and the additional insured in the event of cancellation of the policies or a reduction in the limits of liabilities.set forth above. At Landlord's request,Contractor will immediately furnish Landlord with a true and complete copy of any insurance policy Landlord wants to renew. No invoices for payments will be honored unless such Certificates of Insurance (or the policy, if requested)had been filed timely with Landlord at 3333 New Hyde Park Roadi.Suite 100,New Hyde Park,NY 11042-0020. Contractor acknowledges that:Landlord did'not retain Contractor to perform any work,,at the Shopping Center and agrees that Contractor will not took'to Landlord for any compensation whatsoever for any work. itperforms•atthe.Shopping Center. IN WITNESS HEREOF,tjiisContractor"has executed this Agreement this t_l day of X,20112. CONTRA TOR L C i d By: Name: J Title; tkjitei-,Il npu coc�aevvm zneanwramen,mpewewwum)t+�,<o)i7;27,r:coc. BE_drt+s h:. x , 1 . , Y .. td r t elo rse rhs.rtate me us(+•�fv trn{)Pt ,s.. {•.c��. y:n 1$p^.err 44 P j3 ZtL, c�Ji Suits r � fd 7 -Oetas *� Y� sj s ^s c Siaz yF � r / ��Y� � � � •• rl� _ r � � r rr r = Owt ` r r y � Licensee Details: u r bemoKlap*Information _ fi r z ati ✓ Fu0 Name PAULC LEACH -... rr, Yn � Wv owner Name �x , s ✓ I.Ie erase Address information ✓ 3 City. ORLEAtJ3: �z � ! '� ✓,1z � , State MA - � 2spcode 02653 � y x f Counhy United States .. s License No: ` CS O40396 Llc:.: _ 11 license Information. .... ig _. enSC TypE .... Conslruc n Supervisor IF Licenses Date of Last Renewal 10/28/2016 ,issue Date: _ Expirat{on Date_:: 1711012018 ✓ License Status: Active Totlay'S Date: 11l15I2016 Secondary License Type: tin R✓w Co{ng Business As: Status Change Reason: License Renewal Oil - `'✓5 .Prere9nistte Information L rMN � - � �'. ,.'�. usNoPq iniormhor J ' ....e NAM r .':fit -:.r i Syr z )ri€€ r e x NA � €' �, Y k�, ..pa ,t. }€ _ €€ 94M7 :.�i. 'Y «,.�. k� J .:., €a,.�' ,1,,ire'J...__.,:....,'',z ,,.. /::<.. f .,,,i .� �'Jtl,€. �`� r>.,.K.3 .ww.utCsckzt.Jf1, .,,,.Su •P.,..,.:, .. .. ,.; TOWN OF,BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel `°°Application # r r Health Division 'Date Issued l� Conservation Division °.Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis . (o° TO Project Street Address A-4-4- Village ah S Owner --0 Address Telephone Permit Request re C006_� C:2 Cam. c One( . U KA G Square feet: 1 st floor: existing proposed 2nd floor: existing propose Total new Zoning District Flood Plain Groundwater Ov y Project Valuation Construction Type Lot Size Grandfathered: ❑Yes No,, If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two F/L1Iti-Family (# units) Age of Existing Structure H Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Wr Basement Finished Area (sq.ft.) sement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room/existing ludi baths): existing new First Floor Room Count Heat Type as ❑Oil ❑ Electric ❑ Other Central Air: o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached gng ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached gg ❑ 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 (BUILDER OR HOMEOWNER) Name rwcu,Clc-e. Telephone Number Address l'o, Z24 4?�� License # OVl�Q.k A4 d 2(e 72 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Q �o D .._ic j } FOR OFFICIAL USE ONLY ,r APPLICATION# } DATE ISSUED -MAP/PARCEL NO.. f a ADDRESS VILLAGE t OWNER r DATE OF INSPECTION: FOUNDATION. = _ 4 FRAME 1 INSULATION i - FIREPLACE { ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r GAS ss:t ' ROUGH (47'f� §' FINAL r •1 DATE CLOSED OUT ASSOCIATION PLAN NO. i v Revised 1/28/10 I SHOPPING CENTER LEASE This lease ("Lease"), dated as of December 15.,2009, by and between FESTIVAL OF HYANNIS. LLC ("Landlord") and CAPE COD VACUUM. INC. ("Tenant"); WITNESSETH: WHEREAS, Landlord and Tenant wish to enter into this Lease on the terms and conditions hereinafter set forth; NOW, THEREFORE, in consideration of the foregoing, and the mutual covenants and agreements contained in this Lease, Landlord and Tenant hereby agree as follows: Tenant hereby leases the Leased Premises (as hereinafter defined) from Landlord and Landlord hereby leases the Leased Premises to Tenant upon, and subject to, the terms and conditions hereinafter set forth in this Lease. 1. Basic Lease Provisions and Definitions. In addition to other terms defined in this Lease, the following terms whenever used in this Lease with the first letter of each word capitalized shall have only the meanings set forth in this Article, unless such meanings are expressly modified, limited or expanded elsewhere herein. (A) Shopping Center Location: Depicted on Exhibit"A", located in FESTIVAL AT HYANNIS SHOPPING CENTER HYANNIS MA Site No.: SMAH1114A (B) Leased Premises: The premises identified as 72 shown hatched on Exhibit"A". (C) Floor Area: Approximately 1,600 square feet. (D) Lease Commencement Date: The date that Landlord tenders the Leased Premises to Tenant with Landlord's Work as set forth in Article 34 substantially complete, but in no event shall Landlord tender the Leased Premises later than March t, 201 (see Article 34). eO� U (E) Rent Commencement Date: The earlier of: (i) 60 days after the Lease Commencement Date; or (ii) the date any portion of the Leased Premises initially opens for business. (F) Lease Term: Commencing on the Lease Commencement Date and ending at 12 noon on the Expiration Date. (G) Expiration Date: The last day of the calendar month in which occurs the Fifth (5 h) anniversary of the day immediately preceding the Rent Commencement Date. (G1)Additional Term: One (1)five (5) year option (see Articles 1(H)(i) and 33). ----------------------------------------------------------------- (H) Base Rent Schedule—Original Term: Lease Annual Monthly Year Base Rent Installment $27,200.00 $2,266.67 2 $27,200.00 $2,266.67 3 $27,200.00 $2,266.67 4 $27,200.00 $2,266.67 5 $27,200.00 $2,266.67 (H)_(i) Base Rent-Additional Term (see Article 33): Lease Annual Monthly Year Base Rent Installment 1 $36,800.00 $3,066.66 2 $36,800.00 - $3,066.66 3 $36,800.00 $3,066.66 4 $36,800.00 $3,066.66 5 $36,800.00 $3,066.66 CAsealclienNemplease-Cape Cod(1-CS4YX) 1114A.doc 1 1/28/2010 ams IN WITNESS WHEREOF, the parties hereto have executed this Lease under their respective hands and seals as of the day and year first above written. WITNESSES TO LANDLORD: LANDLORD: FESTIVAL OF HYANNIS, LLC By: Festival of Hyannis Holdco, LLC, its Sole Member By: Kimco Income Fund I, L.P., its Sole Member By: Kimco Income Fund I GP, Inc., its General Partner By: Print Name: Scott Gerber (corporate seal) Title: Vice President Date Signed: _��I0 WITNESSES TO NANT: TENANT: CAPE COD VACUUM, INC. By: (corporate seal) � Print Name`�e�� �� r / > Title: Su Date Signed: 'z y- Zo\o Fed Tax ID#_ --------------------------- FOR TENANT(CORPORATION) : State ofA0)5q(hJ5e-#5) )ss.: County of On the day of (`jean in the year 2010 before me, the undersigned, a Notary Public in and for said State, personally appeared r�rncj rl J?G N(') /e , personally known to me to be, the individual whose name.is subscribed to the within instrument and acknowledged to me that he/she executed the same in his capacity, and that by his/her signature on the instrument, the individual or the person upon behalf of which the individual acted, executed the instrument. Notary Public Eu�A9ETM A. �AA* AM Com *wm IEk May S.2011 CAsea\client\temp\Lease-Cape Cod(I-CS4YX) 1114A.doc 3 1/28/2010 ams '--- . 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 the Town I (WHICH YOU MUST DO BY M.G.L. - it does not give you permission to operate). You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, .151 FI., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required by law. F 1 Ai DATE: o/1 O xa Fill in please: APPLICANT'S YOUR NAME: L0- ��C- o- L/- VK, BUSINESS YOUR HOME ADDRESS: gip• X l'�3 TELEPHONE '# Home Telephone Number. NAME OF NEW BUSINESS_. CocL (a_o_GLw TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES' ✓ NO Have you been given approval from the building division? YES NO f ADDRESS OF BUSINESS toZ Q - -?a MAP/PARCEL NUMBER :-;�615 - 0 16 -/X 0 ) V xt When starting a new. business there are several'.th.ings 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 inforrriation you may'need. You. MUST.GO TO 200 Main St. = (corner of Yarmouth Rd..& Main Street) to make sure you,have the appropriate permits and' licenses required to legally operate your business iwthis•' town. _ 1. 'BUILDING COMI}KSS�I NER'S OFFICE This individu I h nrinfor d f rmit re uirements that pertain to this t ' try P p type of business. �. A horiied Signatu e** COMMENTS. 2. BOARD OF HEALTH .This individual has,be in rmed oft p r ents that pertain to this type of business. Authorized Si ure** COMMENTS:f- 3. CONSUMER.AFFAIRS (LICENSING AUTHORITY) This individual. has be In informed nofnth licensing requirements that pertain to this type of business: ' Authorized Signature** COMMENTS: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map_ /���� Parcel d/ X Application #oX/G Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board p IL Historic - OKH Preservation / Hyannis Project Street Address 1 070 Tyanough Rd uyannis Ma (Festival at Hyannis ) Village uyannis Owner Kimco Realty Corp Address 433 South Main St Suite 322 Telephone 860 561 0245 West uartford,Cm 06110 Permit Request Remove .four partial an,9 one total partition wall. Replace ceiling tiles and remove existing flooring. 7 P, g 4 9' Square feet: 1 st floor: existing'► 4 0 0proposed 2nd floor: existing proposed Total new 0 Zoning District Flood Plain Groundwater Overlay Project Valuation 31 0 0 0. 0 0 Construction Type Masonary steel frame Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure 25 years 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 2 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 n Yes ❑ No If yes, site plan review# Retail store V. : Current Use Proposed Use Retail storek 1 ' Q N p sli , r APPLICANT INFORMATION (BUILDER OR HOMEOWNER) - rn Name- dill Croston Telephone Number 50R 9R9 1 464 Address P.O. Pox 138 License # 1 41 1 2 Q s t e ry i l l e f Ma 02655 Home Improvement Contractor# 1000 2 3 Worker's Compensation # 7013419022009 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Yarmouth transfer station /61 c. SIGNATURE AX4 DATE 7-I ZZl 7&/(, A � FOR OFFICIAL USE ONLY "APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE 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. i The Corntrtonwealth of1k4assachusetts Deparortent of Industrial Accidents Office ofInvestigations'- 600 Washington Street .BOStDft, MA 02111 .�• wwwanass.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information Please Print Legibly_ Name (Business/Organization/Individual): 'Rill croston Ruil,9incf C'ontraetor Address: P.O. pox 138 Ostervi ll e, ma 02655 City/State/Zip: Phone.#: - 50R 7.71 3591 Axe you an employer? Check the appropriate bog: 'Type of project(required): 1. 1 am a employer with ? 4. �.I:am a general contractor and I 6. ❑New construction employees (full and/or part-tim.e).* have hired the strb-contractors. , 2.0 I am a sole proprietor or�partDec listed on the-attached sheet. 7.. 0 Remodeling ship and have no employees These sub-contractors have g, '[� Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers'•comp. insurance comp. insurance.$ S. We are a corporation and its '10. Electrical repairs or additions required.] 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp_ sight of exemption per MGL 12.[Roof repairs insurance re aired t c. 152, §1(4), and we have no q ] employees. [No workers' 13.0.Other comp. insurance required.] '-Any applicant,that cheeks box#1 must also fill out the section below showing their workers'compensation policy infomiation. t Homeowners who submit this affidavit'indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional shcetshowing the name of the sub-contractors and state whether or not those entities have ctnployccs. Cf the subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site info rnt atio n. Insurance Company Name: 7\•T•M• Mutual Insurance Policy#or Self-ins, Lic.M 701341 9 0 2 2 0 0 9 Expiration Date: 9/9/2 01 0 fob Site Address: 1 070 Tyanough 1?d T4yannis Ma City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of crimiri4l penalties of a fine tip to S 1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statemcrit may be forwarded to the Office of Investigations of the MA for insurance coverage verification. I do hereby cent under the i ert.glties ofperjury that the information provided above is true and correct. Si attire: Date: Phone#: Y 1' 3 / Official use only. Do.tot write in this area, fo be completed by city or town offcciaL .City or Town: Permit/Licease # Issuing Authority (circle one): 1.Board of Health`2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector.. 6. Other r Information and 1.nStr",uCt10n9 . Massachusetts General Laws chapter IS2 requires all employers to provide workers' compensation'for thcir 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 representativesof 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 be-cause 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 nrith the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary, supply sub-conti'actor(s)name(s), addresses)and phone numbers) along with their certificates) of insurance. Limited Liability Companies (LLC) or Limited Liability Paziuerships(L'LP)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,;ri11 be used as a reference number. In addition, an applicant that'must submit multiple permit/license applications in any given year,need only submit oite affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write"aln l locations ii. ed to(city or town):".A copy of the affidavit that has been officially'stamped or marked by the city or tow may be provid 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 fo any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office.of Investigations would like to.thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone•and.fax number: Teo Commonwealth of MassaGhUSQttS Department of Industrial AGciclents QfAce of ruvesUg'ad'ons. 600 Washington Street Boston, MA 02111 Te1. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 . Revised 11-22-06 www.mass.gov/dia ISSLEDA"B 09,' Si2U09,`` f . C. RGL L .rTi I THIS CERTIFI 4TF IS ISSUED AS A MATTER OF INFORMATION ONLY AIv'D ,Ih•Sllie N:..cartiit CONFESS NO RIGHTS UPON THE CERTIFICATE HOLD£R THIS CERTIFICATE idba Dowlwe&O'Neil Ins Agcy i IDOLS NOT AIAEND.LATI.ND OR Amu TIIE COVERAGE,AfI'omm DY TIIE PC'I IC IL? BELOW.' 73 lyannc:.gh Road - I Iy'armis,NLA 02601 CONIP;ANIES AFFORMG COVERAGE IVJillian.W CI.-ston I I `dba William VI:Croston Buili:leContiactot j CO�APIY.� I M:lvlu w L1.3aramc.Ca . O Bos.138` I. Lh'ITIIt' „i., Win THIS IS TO CERT'FY THAT.THE POLICIES OF M.URAN'cr ,TED BELOW HAVE BEEN LSSLM TO T iE INSURED NAMED ABOVE FOR THE POLICY PERIOD IhD[GATl 9,NOTRTIH3T II\T)ING aI\'s R&JL 1RF11f�!i;TF&110t;COIvPTIIC2�OF ANY CONTRACT JF OTHER'DOCUMENT RTi H RESPECT TO WHICH THIS C-PATIFICAT3 MAY Fr ISSUED OK MAY Pl:KTAIn 'dE l!NSURANCE AFFORDED BY TILE PoL CIES DESCFJBEU HEREIN IS SUBJECT � TG ALL THE TEKM&EXCLUSIONS ANO CG:v':LTlt NS(;F SUCH PULLC TES.LIMII'S'SHOWN MAY mxt-BEEN REDUCED BY PALE i-LALVtS — ----- T TYPE OF INSUR=YR P: N. �MIBED I PULIr1 fFFEr•71YE POLICY..YPIRAT1Jh r`,„�glTt L1R Y; r.yTE I CFHERAL Li"ILIT V �• I E ER' .Lo;i OAT' i i 1 I IIF..._'C' O.fIYCP ACC i IC-:ORLIEF�CiAI .ENER.:L LiAEiLrT4 A.ADJIN JRi r' I ' iL:1 CLAI :NnDEQCCCUF. I y j OC VRa NCEr'I )-.vii 0 S. .wmA,TCTr9 PRO' s - I:'PE CAIdACE(AuJonc tucl _ 1 --- i AIITOMpRII F I IARILIT - � WE!-SrNULE•' "�� L � �Au OWNLC AUW .i �1. h 1R Y I ali F.lLJLW AUIU • .d µ I r _ l EzceuLlaealxr,;.UM6REL1.1 FORK Ax—.u. \ lw OTHER THAT•UNERE LA FORM - I "d h WORTfFRR(p11QFNRATTON AM 4 STAT LEI TS STATE !IF1ER i:: i YhLYLUYt kB LLAtl1L1'1 b = I X i MA j HE PROPUETOw -- P P;:EwExEcvrIv ELEACh ,, tDErrr s l,l_IUU,000 j ?- Fl:IEPSAAE. �P4Yi. 7013419022009 09G8/2_�09 ail?-:12010 `� Dlsra,c-piTCTUICr = i:�:flfj ujp 1: EL DLSEAS, EAc LL` R 0LOYEE s QOO,C'IU COMMENTS/DESCRIPT ION OF OPERATIONS OR LOCATIONS: i 3 LLIAM W CROSTON IS NOT COVERED 8Y INY%ORKERS'CONIPENS ATION POLICY. `.. � t i _ k PILOM—P ANY GI TTIE P �L 3L: I:I L oLli SS LL CAWCI T r,r,r,iIIORC till L1YIkATIGD DA �01 r3AFf)F,iEIE LS4LI\. ,�T+vT L.. Jrd�10A TO Mi1II 111 WRTTTFN 1(7rIC&TOT�CERra Tip \'AMFT)TO T I F RTr1 '11,F TJ HTAIf.SfIC:R LIYiTCR SRAT T 1NlMRF.NQ ORT.TCiAT A rt ' RI1ANL.ITY-OYANY L DI P.�i 0:.`NA\S'.RSACiFN1SCR?fYRESFNI3rNFS' i.. 1C,1WRIZED REPRPS'.NT,,Tlyr — — —--- -- 1569 G"rN oa.�..naecu�zl0'a ,�!'aoaa��icc - ✓d Board of Building Regulations and Standards j- f Construction Supervisor License License: CS 14112 . ' T 22290 k Ezpirattort l2612010 e Restnct OVI4 . ' AM W CROSTONA � WiLLI 55.SUOMI RD HYANNIS,MA 02601 `- ,. Commissioner ?' CVowv)2042U/P.Q.GL1b O�✓l�GC7.OJC f> € _ ,, „ F yy Board of Bui(dmg Regulatons4aud bt {� * Ltceirseo'r regtstr`atton slid for tndii idol aso�lY . HOME IMI?ROVEiUIENT GONTRAGTaF � lctore th e exptrQEion=date�If found returnv I3n�rd of;Auildtiig Regulations and Statrclard}� x Re9istration 100023 x Onc Asliburton Place Rat:1301 `� Ex naton 6t8%2010 Trlf 26�:r t� p Boston,�2a 0210& i x ,3 .� y CROSTON;$U DING CONTRACTOR ` ` P �I e #> - - Z. �_ � �- ` tidsrums�i=ator - ' ' fi0t�atttl�ti ttli0ut SI i�.•tture � �:a , .� YAhN�S MA•0260t g ,_ r � eDEP- MassDEP's OnlineFiling System Page 1 of 1 MassDEP Home I Contact I Feedback I Tour Privacy Policy MassDEP's Online Filing System Usemame:BILLCROS Nickname:WILLEY My eDEP I Formsc=j My Profiled Help L Receipt Forms Signature Payment Receipt Summary/Receipt print receipt Exit Your submission is complete. Thank you for using DEP's online reporting system. You can select"My eDEP"to see a list of your transactions. DEP Transaction ID: 290412 Date and Time Submitted: 2/19/2010 8:43:35 PM Other Email : Form Name:AQ 06-Construction/Demolition Notification Payment Information DEP code:43664 Date: 2/19/2010 8:42:40 PM Amount($): 85 Payment Detail: CROSTON BILL--AccountType--AccountNumber***'2647 ConfirmationNumber. Contractor Contractor Number Name Address, , Supervisor Project Monitor Lab My eDEP MassDEP Home I Contact Feedback I Tour I Privacy Policy MassDEP's Online-Filing System ver.9.1.7.0©2010 MassDEP https:Hedep.dep.mass.gov/Pages./PrintRecdipt.aspx 2/19/2010 02i18i2010 THU 11. 0E PAX E60 561 0426 AimCo R*01ty CT OOIIOC'_ FROM :BELL CROSTON E:UiLDEPS FAX NO. :097713e9i Fe6. 18 2010 07:47AM P2 Town of Larastable IT Regulatory Services Thow s F.Gs aer,motor s Building M on Toil']ferry, Build.1mg Camndwdo=r OFfiee: 50"62-4039 Pu• 509-790.62.30 'ruperty C wrier must Complete a±xd S gon Mis Section If UsfiV a k Buffdar 'Zo C N e;t of the sub'eCt m Pff IT bfutby wahoAw d t Co act on my behalf, -.�. - .in 211 mitt=relative to wojg sutho ed icy th,�;buidms Ft=t apphcadan fi r_ r d ss ofjol) I pint Nat= APPROVED Y'AA/F �t71t� W6 ED REALTY vfJNP. Q-.�vts:o�t�t 'Feb . 24 2010 6 : 58PM BARNSTABLE fire dept No 4434 P 2 FIRS DLFARTKLNTS 01F THE, TOWN OF BA.�' {'i,•e >revention O ' ice - inc�';Jey Building � BARN TA . . r 200 Main Street 11 ;2Djjis M 0260:1 ;~� �� ft, ;� 24 ' (508) 862-4097 BUILDING CODE COMPLIANCE FORM -10ii Flans dated Rio. for the property located at 10-10 �cq LC Cam Cbc� .also known as .4r� have been reviewed b-y of the . Barnstable- :D COMM D Cotuit FJ Hyannis ❑ West:Barnstable Fire LDepartment. THE CHART BELOW INDICATES THE STATUS OF THE REVIEW: . TYPE OF CONSTRUCTION DOCUMENT NIA RECEIVED REVIEWED COMPLIES 1. Narrative Report 2. Firefighting & Rescue Access 3, Hydrant Location &Water Supply 4. Sprinkler Systems 5. Sprinkler Control Equipment. 6, Standpipe'Systems c/ 7. Standpipe Valve Locations 8,.Fire Department Connection ✓ 9, Fire Protective Signaling System ✓ 10. F.P,S,S. &Annunciator Location ✓ 11, Smoke Control/Exhaust 12. Smoke Control Equipment'Location 13. Life Safety System Features ✓ 14. Fire Extinguishing Systems �✓ 15. F.E.S, Control Equipment Location 16, Fire Protection Rooms ✓. IT Fire Protection Equipment Signage ✓ _ 18. Alarm Transmission Method 19. Sequence of Operation Report ✓ 20, Acceptance Testing Criteria (We believe this document to be complete and compliant for the issuance of a building .permit: We have completed the acceptance testing for the occupancy permit and believe that within the scope of the.building permit, the above issues are in compliance, v aJ. of. TMC <Pr2%r-*UA 1tr L-A .SOS 7D 3E At)MvLb.S,mNmv—t-,ek 'rD J2EvieAJ `@ g 9rr I �r j r