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Home My WebLink About0735 ATTUCKS LANE (12) 739' A�Iud6 G1411F- i J` t I x PROJECT c NAME: dvL ADDRESS: 3 mi-jas F PERMM PERMIT DATE: M/P: - O 1 "7 00.R LARGE ROLLED PLANS ARE IN: BOX �D g SLOT Data entered in MAPS program on: 3 BY: q/wpfiles/forms/archive I - I tf . Fletc-herTilton.c Attorneys at law June 21, 2019 The Pond View Professional Building Trust c/o First Property Management 1046 Main Street, #I1 Osterville,MA 02655 i Nancy Bucken,Trustee Joseph Carroll,Trustee 735 Attucks Lane 735 Attucks Lane Hyannis,MA 02601 Hyannis, MA 02601 Chuck Jones,Trustee Hyannis Court Associates, LTD 735 Attucks Lane 2170 Chestnut Drive Hyannis,MA 02601 Westlake, OH 44145-3119 i RE: Notice of Termination of License Agreement Regarding Parking lot between 695 and 735 Attucks Lane;Hyannis ("Parking.Lot") !! Ladies and Gentlemen: This office represents The Cooperative Bank of Cape Cod("Bank"). As you may be aware, the Bank and Hyannis Court Associates, LTD(the prior owner of the building and land at 735 Attucks Lane)entered into a certain License Agreement relative to the Parking Lot in October 2009{"License Agreement") By prior correspondence, the Bank notified you of concerns with congestion on the Parking Lot including a request that employees and guests to your offices refrain from parking on designated areas of the Parking Lot that are on the Bank's.property. Unfortunately, the issues related to the Parking Lot have not abated. ACCORDINGLY,PLEASE TAKE NOTICE,pursuant to the License Agreement,the Bank shall i have revoked and terminated the License Agreement effective in one hundred twenty(120)days I from the date of this letter. The Bank reserves the right upon termination of the License j Agreement to exercise its rights with respect to its own property including,but not limited to, discontinuation of access to the Bank's portion of the Parking Lot by fencing and other barriers necessary to separate the two properties. i i FletcherTilton.com Client Files/37182/0042/03172900.DOCX WORCESTER I FRAMINGHAM I BOSTON I PROVIDENCE I CAPE COD o FletcherUton.c Attorneys at law Thank you for your anticipated cooperation and understanding. Very truly yours, Alex M.Rodolakis,Esq. Fletcher Tilton PC 1597 Falmouth Rd., Ste. 3 Centerville,MA 02632 Tel. 508-778-1100 arodotakis(@fletchertilton.com AMR/dr i I i i j I i I j i i j Client Files/37182/0042/03172900.DOCX ` I The Cooperative Bank of Cape Cod e The Pond View Professional Building Trust c/o First Property Management 1046 Main Street, tl11 Osterville,MA 02655 Nancy Bucken,Trustee Joseph Carroll, Trustee 735 Attucks Lane 735 Attucks Lane Hyannis, MA 0.2601 Hyannis, MA 02601 Chuck Jones,Trustee 735 Attucks Lane Hyannis,MA 02601 RE: License Agreement Regarding Parking lot between 695 and 735 Attucks Lane,Hyannis ("Parking Lot") Dear Trustees: As you may be aware,the Bank and Hyannis Court Associates, LTD (the prior owner of the building and land at 735 Attucks Lane)entered into a certain License Agreement relative to the Parking Lot in October 2009("License Agreement"). For your convenience,a copy of the License Agreement is enclosed. I am proud to let you know that the Bank's branch at 695 Attucks has grown Increasingly active and vibrant(and the same appears true forlhe use of your building). As a consequence, however, the Parking Lot has become somewhat congested to the detriment of the Bank's customers and employees. The Bank recently had the Parking Lot surveyed in order to look at potential solutions to the congestion. As a result of this survey,the Bank has staked areas of the Parking Lot that are exclusively on the Bank's property. By this letter,the Bank requests that you inform your employees and guests not to park in the staked areas of the Parking Lot. The Bank is also exploring a simple and tasteful fence,consistent with the design of the Bank's building, with appropriate signage indicating parking in the designated area is intended for the exclusive use and convenience of the Bank's employees and customers. The Cooperative Bank of Cape Cod 25 Benjan,iin Franklin Way,HyDnius, 10A.02601 / 5W 68.3200 / 600,641 1,100 / wwvv nry,-apP(—o(jhan,;.torr1 L LICENSE AGREEMENT Reference is hereby made to a Letter Agreement between HYANNIS COURT ASSOCIATES, LTD., a Limited Partnership, organized under the Statutes of Ohio (the "Court") and CAPE COD COOPERATIVE BANK (the "Bank") dated April 10, 2006(the "Letter Agreement'), whereby the Court and the Bank granted to each other parking licenses on the respective properties of the Court and the Bank located at 695 (the "Bank's property")and 735 (the"Court's property")Attucks Lane, Hyannis,MA 02601(coliectively,the"Licensed Premises'), In order lid implement the intent of the Letter Agreement the parties have agreed that: a. The Court snail make certain improvements to the parking areas of the Bank's Property and the Court's property, all in accordance with the zoning by laws, rules and regulations of the Town of Barnstable and In a good and workmanlike manner(the "Work'); b. The Bank shall contribute the sum-of$25,000.00 as its total share of the cost of the Work; c.The Court has hired P.K.M. Contractors, Inc. (`PKM')to complete the work; d. Simultaneously with the execution of this Agreement, the Bank will pay said sum of $25,000.00 to Court and Court shall be responsible for the total payment to PKM for the Work; e. The Court shall ensure that all appropriate insurance coverage Is maintained by PKM and that the Bank and The Court are named as additional named insureds under such coverage; f. The location of the Licensed Premises Is shown on the attached plan which depicts the approximate location of the parking spaces and travel lanes on the Courts property and the parking spaces and a portion of the travel lanes on the Bank's property; and g. Insofar as there maybe a lack of clarity in the Letter Agreement as to the extent of the right.of each party to use the property of the other, the licenses granted to each other are hereby confirmed as the license to use up to_fifteen (15) parking spaces and such portion of the travel lanes within the overall parking areas on the respective properties of each party hereto as are necessary to access..and use said spaces during the normal business hours of each licensee. In addition to the above, the parties wish by the terms of this Agreement to clarify the respective rights and obligations of the parties under the said Letter Agreement, 6. Either party may revoke and terminate the license granted to the other at any time upon at least one hundred twenty days (120) days prior written notice to the other party at its address set forth in the said Letter Agreement. Provided, however, neither party may terminate this license until all work contemplated by this Agreement to be installed on the Bank's premise has been completed In .accordance with the provisions of this Agreement. 7. Each party affirms to the other that no representations or promises with respect to their respective premises, or the condition thereof, or the making or entry into the respective licenses has been made except as In this Agreement expressly set forth, and that no claims or liability shall be asserted by the either party against the.other party for, and neither party shall be liable to the other party by reason of, breach of any representations or promises not expressly stated in this Agreement:. , 8. This Agreement and the said Letter Agreement is personal to the parties hereto and any attempted assignment or recording by either party, without the prior written consent of the other party, which consent will not unreasonably be withheld,or any breach of any obligation by either parry, shall immediately and automatically terminate the license granted to the defaulting party. Both parties acknowledge that, notwithstanding the tenor of the said Letter Agreement, each party may lease or sublet Its respective properties to third parties and that said third parties may also use the licensed premises for parking without further authority from the other party. Upon the sale and transfer of all or a portion of each party's premises to third parties, said third party or parties may have the benefit of this Agreement and the Letter Agreement provided it or they, In writing, assent and agree to be bound to the terms of this Agreement and the Letter Agreement, as the same may have been amended. 9. If any provisions of this Agreement or of the Letter Agreement shall be held or declared to be invalid, illegal or unenforceable under any law applicable thereto, such provision shall be deemed deleted from this Agreement and the Letter Agreement without Impairing or prejudicing the validity, legality,and enforceability of the remaining provisions hereof and thereof, 10. Each party represents and warrants to the other that all necessary action has been taken under the constituent documents of each party to authorize the execution and delivery of this Agreement and the Letter Agreement by the undersigned. (signatures on the following page] 3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel r 6� 13U1LDfNu D^ Application..# �" �- 6 Health Division FPT Date Issued Conservation Division w0i APR 2 6 2016 Application Fee Planning Dept. TOWN OF ggnf,� Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 73 ts- a uc Ls &ue Village & / //U Owner 1�84425042 C.r M(JA )f /f(:��—dress Telephone ` ) 12 n� d. Permit Request er � ��l�� DQQ/;�- 105-rA L641_10 1V -E JA �y Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3 . 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name C&PI-0 / Telephone Number Address _35 L )MMLA10 c q'J License # 4 6 — Home Improvement Contractor# Email � �1() �2 f ) d ��W Worker's Compensation # LCJ�V r � lJ yd ALL CONSTRUCTION DEBRIS RE ULTING FROM THIS PROJECT WILL BETAKEN TO�sI � � L SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. 1ADDRESS VILLAGE x OWNER DATE OF INSPECTION: FOUNDATION t' FRAME INSULATION r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. �i�zt��zaaxf�a,�'�asscye�tars�s • - - Mice cr�" i�ga�'ioru - ' 6010 Wm&q i% -eel Sastat%,Ift 02 rvee�ts�rr�usxgas�drr: - _ 'markers'Ccimpensatka7nsurziice day E dersr� aafra:dars ctricia�aslPliuuben ant Iufaim� Please Print Nam=CBasmesslOrganizafianlfndiviclnai): c /Stabv',Zzp= I-1 (��' Phmm 9--Z Are y au an employer?Che&flrc apprupriaf-:bo= 1we of pr•oiect(re:drep_ Pam a employer v3itft 4- ❑I gtu ai I confiacf6r tad I 6- ❑New co� z employees{full a4dlorgart-#ime _* hatvef�re4i�s�co�iDM listed an t I El I am a sore proprietor of-partner- ship gttarhed sbe� Remodeling T_ ❑Remodelingship and have no employees These vub-wafractors have g- ❑I3emnlifir�u wo for me in any capacity emPrnyees and have WO&Cre c mmraru'�$ � ❑�IIild111�aL�dif10II WO Workers' COMP:ishihrran a omp- regaired I S;❑ We are a corporatiouand ifs 10-0 Electrical regaim cr additions 3-Ell atn a h&nmwncr doing all vaarli of s hati� +Tised their 1 1-0 Plumbing repairs or additions a wadm' right of eiTmpfion per MGM �1f�`I �= 12.0�afrepaas. aM=MAc required-j 1 c-152.§1(4',andwehaven* �l� INEY Warp' 13.0€lfhcr d2 comp_instttance r equked-I *Frayaaplioutt5ztrT3e has-*1hmst-IsofM out the secHnabeIows $hrswo&uni'rnzz>nr pn t ffnmmw ne s vrho submit ffnr AfE&Vd mxTMcetnrg they am damg sff via and&Iai mm Data&ComMaurg�t salxi a € a t T s�uc& txckna&%trhxYthisGar,must stter'h =xMitirmMysihePts bW-MgtisPnsmeCf8iesc# smdste2evchPtheceennt7MmasmaibesI> �s2IQyees_ IftIte suTY�outha�ha�es>pIcrgees,tfieg>ffist piavide ter'tvad�s'comp.paLep ahhmisez_ lam an efrtp&syeF this prrr►ddirig tonr$ets'ca uatia3a frerrarartce far az Y earrglayeax BelmF is the palicy anal jobs irtforrt;Qhi�rt, ins�n�camga�r�ame_ � � ,I 1613 sty (�n�ll�l. S CiiylsfatelT_tg= Affach a tops'of the:tf arkers''compenza6m paNty decTamfiou gage(showing dLe policy nuxaber and exomtiaa dx(e). Failure to secure-coverage as reqdredunder Sedioai SA o€MGL c 152 can lead to the imposifim ofcriminal pemifties of a fine up t6 S L50tk OD amdlor one=gearia as well as civil pemaffies i m the fo=of a STOP WORK ORDER-and a� ofup to$250-0-0 a clay a e violator_ Be advised f and a copy of this statemat maybe fr}rwarded to tbe Of5be of Iuve*gatior s a€f3ie D for a co verffiration_ Fcid{rcrreblr }p psrraTiisr°: IF t#etf#s zrtar�atiarrtpravid�£icbar a hire card correct fiticnafrere� I}ate= Pie#: anal rrsg artF,}. 77rr tLat sprite in tfris arerc,€4 bs caxrpi'et�rI byz dfy ax totFn af�icurl . City or'Fown.: 9 Iwaing uthorrtg(arele:one L Baaxd of Heal i BuTfiug Drpartme-ut 3.C<i d'ym Qerk 4.Electrical Fnsgector S.Plumbmg EmTs ector .6.Ckher Con. fact Perm= phone:9- 6 w �a, Town of Barnstable Regulatory Services Richard V.ScaH,Director Building Division Thomas Perry,CBO Building Commissioner ,200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 50 8-862-403 8 Fax: 508-790-623 0 Property Owner Must Complete'and Sign This Section If Using A Builder L ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. j QAWPHLESTORM%uilding permit forms\WRESS.doc , .Revised 061313 f � CERTIFICATE OF LIABILITY INSURANCE 7(WIDVIYYYY) ACORN 3 30 16 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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(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 thi s certificate does not confer rights to the certificate holder in lieu of such endorsemen s. PRODUCER NW PAUL SCHLEGEL Schlegel & Schlegel Ins Broker PHONE 08 771-8381 raX Not: LSGa> 771-0663 34 Main Street Aonks : schle elinsurance@ ail.com West Yarmouth, MA 02673 INSURE 3 AFFORDING COVERAGE NAIC# INSURER A:NGM INSURANCE COMPANY 14788 INSURED INSURERS:ATLANTIC CHARTER FABIO PRETTI INSURERC: 38 Wendward Way INSURER 6: WEST YARMOUTH, MA 02673 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICES 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I ADDL LTR TYPE OF INSURANCE INAR SUBR WVD POLICY NUMBER PMI DIY% MPMMIIDDIYYW U14TS A GENERALLIABILITY MPS6863R 11_/19/15 11/19/16 EACH OCCURRENCE S 1,000,000 X C07ERCIALGENJERALLIABILITY DAMAGE TO:a occurrenriii)RENTED $ 500,000 CLAIMS-MADE Fx]OCCUR ME EXP(Any oneperson) $ 10,000 PERSO NA L&ADV I NJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE L IMI T APP LIE S PE R PRODUCTS-COMPIOPAGG 3 2,000,000 POLICY I I PRO LOC $ AUTOMOBILELIABIUTY COMBINED NSINGLE LIMT $ ANY AUTO BODILY INJURY(Per person) $ ALLOWNlED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PReOPE�RTY DAMAGE $ HIRED AUTOS —AUTOS $ UMBREUALUM [7OCCUR ' EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MACE AGGREGATE $ DIED RETENTION$ S B WORKERS COMPENSATION gJCVOO935903 il/19/15 11/19/16 WCSTATU- OTH- AND EMPLOYERS LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE Y/N NIA E.L.EACH ACO DENr S 100,000 EX ((MMandatotryInN� ��ED? E.L.DISEASE-EA EMPLOYE S 100,000— If es,descibeunder DESCRIPTION OF OPE RATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Addlaonal Remarks Schedule,If more space Isregulred) FABIO PRETTI HAS ELECTED NOT TO BE COVERED UNDER HIS CURRENT WORKERS COMPENSATION POLICY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN HARBOR HEALTH COMMUNITY HEALTH ACCORDANCE WITH THE POLICY PROVISIONS. CENTER --HYANNIS 735 ATTUCKS LANE A UTHORIZED RE PRESENTATIVE HYANNIS, MA 02601 /�GlldliL9 ©1988-0 10 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: ERIBEIRO@HHSI.US - Office of Consumer Affairs&Business Regulation IMPROVEMENT CONTRACTOR .Registration: 182418 Type: Expiration: 6/19/2017 DBA FABIO HOME IMPROVEMENT. FABIO.PRETTI 38 WENDWARD WAY, YARMOUTH,MA 02673 Undersecretary ...... i;5 .lam u st c .' Cntt;ii'tlCilnll Si101'i'�3klC - CS -108659 PABIO PRETTI Ir 38 WENDWARD WAY West Yarmouth KA 02673 ; i Fabololl , .... Home Improvement , CS 1 OW9 HIC 182418 We get it done! Proposal Date: 03/01/16 To: Harbor Community Health Center— Hyannis Aft: Eduardo Ribeiro— Facility Coordinator 735 Attucks Lane Hyannis MA 02601 Work to be performed at: same address above Work description: • Cog2me vial glass door installation 1. Remove existing window; 2. instal new 6'wide by 7'tall handicap double door,with automatic opener; 3. Install missing floor tiles; 4. match interior wall painting; 5. match exterior trim painting; 6. all debris from demolition will be removed from site by FHI; 7. (owner is aware that we need to place dumpster plus a portable toilet on location during performance of the worts) Total: 26,450.00 • wild concrete walkway from new door 1. build a 6'wide walkway; 2. install new railing,on both sides of walkway; 3. adapt new ramp to existent walkway; 4, all debris resulting from demolition will be removed by FHI; 5. (owner is aware that we need to place dumpster plus a portable toilet on location during performance of the work) Total: 5 ,250.00 Q 6 rNIO v r� Home improvement CS IO 59 HC 182418 We get it done! All material is garanteed to be as specified, and the above work to be performed in accordance with the especifications 6ubmited for the above work and completed in a substantial workmanlike manner for the sum of: ($31,700.00 )with payments to be made as follows: Deposit: $ 18,000 (material) $6,000 at door installation completion $ 7,700 at work completion General Provisions: Any alteration or deviation from the above specifications,including but not limited to,any such alteration or deviation involving additional material and/or labor costs,will be performed only upon a written order for same,signed by Owner and Contractor and,if there is any charge for such alteration or deviation,the additional charge will be added to the Contract Price of this Contract. if payment is not made when due,Contractor may suspend work on the job until such time as all payments due have been made.A failure to make payment for a period in excess of 4(four)days from the due date of payment shall be deemed a material breach of this Contract. Dtanceo coat Name: Title: h Date: Signature: HE " �, Town of Barnstable Building Department - 200 Main Street ASTABLE. * Hyannis, MA 02601 y MASS. 1639. . (508)p 862-4038 Certificate of Occupancy Application Number: 201304385 r CO Number: 20140032 Parcel ID: 29501700B CO Issue Date: 05/09/14 Location: 735 ATTUCKS LANE Zoning Classification: INDUSTRIAL DISTRICT Proposed Use: CHARITABLE SERVICES Village: HYANNIS Gen Contractor: SHAW, KEITH L. Permit Type: CC00 CERTIFICATE OF OCCUPANCY COMM Comments: Building Department Signature Date Signed TOWN OF BARNSTABLE ■ �;<� BuRding 2013.04385 * BARNSTABLE, * Issue Date: 07/29/13 . , Permit. MASS. � 1639• N Applicant: SHAW KEITH L. Permit Number': B 20131787 Proposed Use: CHARITABLE SERVICES Expiration Date: 01/26/14 Location 735 ATTUCKS LANE Zoning District IND Permit Type: COMMERCIAL ADDITION ALTERATION Map Parcel 29501700B Permit Fee$ 18,697.22 Contractor SHAW,KEITH L. Village HYANNIS App Fee$ 100.00 License Num 74039 Est Construction Cost$ 2,054,640 Remarks APPROVVED PLANS MUST BE RETAINED ON JOB AND RENOVATION/FITOUT TO EXISTING SHELLED SPACE FOR MEDICP L THIS CARD MUST BE KEPT POSTED UNTIL FINAL OFFICE SPACE INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: HARBOR HEALTH SERVICES INC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 1135 MORTON STREET INSPECTION HAS BEEN MADE. MATTAPAN,MA 01581 Application Entered by: PF Building Permit Issued By: THIS PERMrr,CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY ENCROACHMENTS ON PUBLIC PROPERTY,N_O SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED:BY THE JURISDICTIOM-STREET OR ALLEY:GRADES AS.WELL AS DEPTH AND.LOCATION©F PUBLIC SEWERS.MAYBE- OBTAINED FROM.THE DEPARTMENT'OF PUBLIC WORKS'THEISSUANCE OF THIS'PERMIT DOESNOT`RELEASE.THE APPLICANT FROM THE CONDITIONS OF.ANY APPLICABLE'SUBDIVISION•.` RESTRICTIONS MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PRIOR TO 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. PERMIT•WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). p.: s W' -R BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS �Irh (evf i6ra z- 1 Ua l . ?7 4 t-VV �r�i r J —� 2 O, 2/ G( ,{� �4? ` oK tyZIiY -� PIS 3 1 Heating Inspection Approvals Engineering Dept Fir t I / 2T`h p L C9'Rs Board of Health ' ) �/�0/Zwy ij_2- I q �/')r//L r �r ._ O . , J ,iJ�i. .. � .. .. ! j:i 1 �. e ., J ,.` Final Construction Control Document To be submitted at completion of construction by a Registered Design Professional for work per the 8`"edition of the Yp Massachusetts State Building Code, 780 CMR, Section 107 Project Title:Harbor Community Health Center-Hyannis Date: May 6,2014 Permit No. B 20131787 Property Address: 735 Attucks Lane,Hyannis MA Project: Check(x)one or both as applicable: New construction X Existing Construction Project description: Renovation/Fitout to existing shelled space. I Dennis Kaiser MA Registration Number: 5053 Expiration date:August 31,2014 am a registered design professional, and I have prepared or directly supervised.the preparation of all design plans, computations and specifications concerning: X Architectural Structural Mechanical _ Fire Protection Electrical Other: Describe for the above named project. I,or my designee,have performed the necessary professional services and was present at the construction site on a regular and periodic basis. To the best of my knowledge, information, and belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit and that I or my designee: 1. Have reviewed,for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. Enter in the space to the right a"wet"or s electronic signature and seal: °No. 5053 i N BO5T0 . MA � �Fqt Ty OF MPSSP�� Phone number: 617-478-0300 Email: Romeo.Moreira@perkinswill.com Building Official Use Only Building Official Name: Permit No.: Date: i Version 06 11 2013 Final Construction Control Document F To be submitted at completion of construction by a off Registered Design Professional for work per the 81h edition of the o �,v 5 Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Harbor Community Health Center-Hyannis Date: May 5, 2014 Permit No.B 20131787 Property Address: 735 Attucks Lane,Hyannis MA Project: Check(x)one or both as applicable: New construction X Existing Construction Project description: Renovation/Fitout to existing shelled space. I, Sean J.Brice,PE MA Registration Number: 40419 Expiration date: June 30,2014 , am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Architectural Structural X Mechanical Fire Protection Electrical Other: Describe for the above named project. 1, or my designee,have performed the necessary professional services and was present at the construction site on a regular and periodic basis.To the best of my knowledge, information,and belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit and that I or my designee: 1. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. Nothing in this document relieves the contractor of its responsibili regarding the provisions of 780 CMR 107. » IiA OF. « Enter in the space to the right a wet or SEAN J. electronic signature and seal: BRICE 19 MECHANICAL 9 0.40418 V GISTS Phone number: 508-748-2620 E t so - onsultants.com Building Official e Only Building Official Name: Permit No.: Date: Version 06 11 2013 f Final Construction Control Document H To be submitted at completion of construction by a Registered Design Professional for work per the 81"edition of the gY Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Harbor Community Health Center-Hyannis Date: May 5, 2014 Permit No. B 20131787 Property Address: 735 Attucks Lane,Hyannis MA Project: Check(x)one or both as applicable: New construction X Existing Construction Project description: Renovation/Fitout to existing shelled space. I,Kieran J. Guinan,PE MA Registration Number: 50091 Expiration date: June 30, 2014, am a registered design Professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: Architectural Structural Mechanical Fire Protection X Electrical Other: Describe for.the above named project. 1, or my designee, have performed the necessary professional services and was present at the construction site on a regular and periodic basis. To the best of my knowledge, information, and belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part-of the building permit and that I or my designee: I. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. ZN OF`MgSsgc Enter in the space to the right a"wet"or electronic signature and seal: KIEEw►N,. o GUINAN Cn ELECTRICAL NO.50001 9oc R Is Rti Phone number: 508-748-2620 Email: kguinan@thompson-consultants.co s ION I- E Building Official Use Only Building Official Name: Permit No.: Date: Version 06 11 2013 Final Construction Control Document To be submitted at completion of construction by a Registered Design Professional for work per the 8t" edition of the 5 Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Harbor Community Health Center-Hyannis Date: May 5, 2014 Permit No.B 20131787 Property Address: 735 Attucks Lane,Hyannis MA Project:,Check(x)one or both as applicable: New construction X Existing Construction Project description: Renovation/Fitout to existing shelled space. I, David J. Ferguson,PE MA Registration Number: 31208 Expiration date: June 30,2014, am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: Architectural Structural Mechanical X Fire Protection Electrical Other: Describe for the above named project. I, or my designee,have performed the necessary professional services and was present at the construction site on a regular and periodic basis. To the best of my knowledge, information,and belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit and that I or my designee: 1. Have reviewed,for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 7 R 107. IN of Enter in the space to the right a"wet"or o DAVID electronic signature and seal: F� T. 0 No.31208 9p 9F6IST Phone number: 508-748-2620 Email: dferguson@thompson-consultants o Building Official Use Only Building Official Name: Permit No.: Date: Version 06 11 2013 FIRE CERTIFICATE OF INSPECTION In accordance with the requirements of General Laws, Chapter 111, Section 51, this Fire Certificate of Inspe,41on issued by the head of the local Fire Department certifying compliance with local ordinances is a prerequisite for an original or renewal license. Harbor Community Health Center - Hyannis NAME OF FACILITY 735 Attucks Lane Hyannis MA 02601 ADDRESS OF FACILITY was inspected on -7• %a.,- Date Name of Inspector I HEREBY CERTIFY THAT THIS INSTITUTION COMPLIES WITH THE LOCAL ORDINANCES. YES NO If answer is"NO", indicate violations and recommendations. Violations: Recommendations: ISSUED B Signature Head of Local Fire Department INSTRUCTIONS: FIRE DEPARTMENT TO RETURN TWO COMPLETED COPIES TO CLINIC CLINIC TO RETURN ONE COPY TO: Division of Health Care Quality 99 Chauncy,2nd Floor Boston,MA 02111 Rev.08-14-2008 DPHCQ117 Town of Barnstable Building Department - 200 Main Street ELAMST"LE, * Hyannis, MA 02601 9 MASS 1639. . (508) 862-4038 Certificate of Occupancy Temporary Application 201304385 CO Number: 20140023 Parcel ID: 29501700B CO Issue Date: 04111114 Location: 735 ATTUCKS LANE Zoning Classification: INDUSTRIAL DISTRICT Owner: HARBOR HEALTH SERVICES INC Proposed Use: CHARITABLE SERVICES 1135 MORTON STREET MATTAPAN, MA 01581 Village: HYANNIS Gen Contractor: SHAW, KEITH L. Permit Type: CTCO COMM TEMPORARY CO Comments: TEMP CO ISSUED 4111/14 TO EXPIRE MAY 30, 2014 FOR MEDICAL OFFICE .. 05/30/14 Building Department Signature Date Signed Expiration Date The Commonwealth o 'Massachusetts ' Department of.,Public Safety Cheater 1,43 General Laws as mended Loc. n 735 Attucks� t3am5tao;e MA: Capacity Pounds Speed ` � F:ea t per minute $tote]D# 21 P-343 � "" F T.# 4027526 41 Issued on . 04/2912014*"�� ,W � � „z Expires: 2015 K A I for Re ins .ection Thomas G Gatzunfs PP Y P.. Ex icatfon:Date ?zn- >Commissioner 60:days Prior to p, P 7 IN;CASE OF ACCIDENT NO.TiF1G(5Q8<)820 144.4 AT ONCE REPORT UNSAFE:COND.ITIONS TQ E3JILDING MANAGER/OWNLR 4. ' F Town of Barnstable Building Department - 200 Main Street MENSTMLE, * Hyannis, MA 02601 '°rFDMA�a,� (508) 862-4038 Certificate of Occupancy Tem� orar a y Application 201304385 CO Number: 20140023 Parcel ID: 29501700B CO Issue Date: 04/11114 Location: 735 ATTUCKS LANE Zoning Classification: INDUSTRIAL DISTRICT Owner:. HARBOR HEALTH SERVICES INC Proposed Use: CHARITABLE SERVICES 1135 MORTON STREET MATTAPAN, MA 01581 Village: HYANNIS y ' Gen Contractor: SHAW, KEITH L. Permit Type: CTCO COMM TEMPORARY CO Comments: TEMP CO ISSUED 4/11114 TO EXPIRE MAY 30, 2014 FOR MEDICAL OFFICE 05/30/14 Building Department Signature Date Signed Expiration Date SINE TOWN OF BARNSTABCE BuRding 2013.04385 BAMSTASLE, Issue Date: 07/29/13 Permit 9 MASS i639• Applicant: SHAW,KEITH L. ArFp��A Permit Number:. B 20131787 Proposed Use: CHARITABLE SERVICES Expiration Date: 01/26/14 Location 735 ATTUCKS LANE Zoning District IND"Permit Type:. COMMERCIAL ADDITION1 ALTERATION Map Parcel 29501700B Permit Fee$ 18,697.22 Contractor SHAW,KEITH L. Village HYANNIS App Fee$ 100.00 License Num 74039 Est Construction Cost$ 2,054,640 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND RENOVATION/FITOUT TO EXISTING SHELLED SPACE FOR MEDICA L THIS CARD MUST BE KEPT POSTED UNTIL FINAL OFFICE SPACE INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: HARBOR HEALTH SERVICES INC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 1135 MORTON STREET INSPECTION HAS BEEN MADE. MATTAPAN,MA 01581 Application Entered by: PF Building Permit Issued By TIES PERWr CONVEYS,NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY;PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY ENCROACHMENTS ON PUBLIC PROPERTY NO : SPECIFICALLY PERMITTED UNDER THE BUILDING CODE;MUST BE APPROVED:BY THE JURISDICTION> STREET:OR ALLEY.GRADES AS WELL AS DEPTH AND:LOCATION OF PUBLIC SEWERS MAY BE ° OBTAINED FROM THE DEPARTMENT:OF PUBLIC WORKS;THE ISSUANCE OF THIS PERMIT DOES NOT•RELEASE;THE APPLICANT FROM THE CONDITIONS OF:ANY APPLICABLE SUBDIVISION C RESTRICTIONS.� MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE,THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION.- 5.PRIOR TO 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. PERMIT WILL BECOME NULL AND VOID IFCONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF. DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.I42A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2VVoL'Or 2 / .�/�l �/rl� p ®I 2 OK 3 1 ' gHeating Inspection Approvals Engineering Dept . 70._�... g'l� Fir t - 2T A p C gas Board of Health / / i [3RESS ?3ftfiieksLciet annisMA � :; DATE 9J6it)93 EMPLOYEES&WORK PERFORMED Paul Watson Chris Correla 0 men 0 hrs not on onsite today Seth Romanski 0 men 0 hrs not on site today SUBCONTRACTORS&WORK PERFORMED Glynn Electric 1 men 8 has rough,in electric DDS 0 men 0 hrs not on site today Gray Plumbing 0 men 0 hrs not on site today R&A 8 men 8 hrs doing layout lower level and installing insulation and sheetrock dental area Pro Fire 0 men 0 hrs not on site today Digit Construction 2 men 13 hrs and 5 men 6 hrs(1 mini 1 bobcat and 1 excavator) Lucido Masonry 0 men 0 hrs Continental Ceiling 3 men 8 hrs install wires in lower level Total Interiors 0 men 0 hrs not on site today PAL Painting 2 men 6 hrs prime paint lower level Cabe Roofing 0 men 0 hrs not on site today EQUIPMENT&DELIVERIES. The roofer never showed up and the roof leaked at the vent pipe again which we will need to replace the sheetrock again Dig It was excavating from north to south at approx. 30'into it a 6'piece of existing topping gave way and fell into the trench which caused the gas line that was 8'to the north to have a break into it @ that point the gas company and fire dept.were notified and the was evacuated as a precaution the fire dept. called the town inspectors in as a precaution which at that point the rest of the exposed conc. Topping gave way and fell into the trench @ that point we came up with a plan to remove the conc. From the trench and backfill at the gas meter area so the gas company could fix the problem which they worked thru the night to put it back together the plumber was notified of the situation and will be here 1 st thing in the morning to test the gas lines for leaks and put the gas on the gas company will only test there pipe going into the meter not out to the building GENERAL NOTES(INCLUDING VISITORS) Condo Association not on site today r. a- 1 i A T 'tP '� .. � .��-" � F <• a; � ;` fir-. T •� ; T _ " y wr. Y x v v a r s rr _ s G es �y AW Y , u A 46. '�-� a� E. ,:: d' , � .. '*°'� ->,✓"-:+tea§, aY„ { '.a> ,Y r 'YF r" r dl y A' E.i Y s ti Q 4EJ -e/ _ W 000 V -•'� �. .. . .. '. +,�. . _ J k �c � � r '�^� .fir� o yi '��-'7A`•�ti"�� f � ii 'a 0 �.wfi.-:r -r'.�„r �. k` � 4"'trd j ��._ �,..� .�� . £��?"' c. s W 9 , 4 "qK • YY ' M ' _ e a. 7+� µ x-ie' r �l r •'4 rr �, ,.�I v S'�`x 5r .. i '� `wa.'�'.:: � E Atr m - .. ♦. �-=tom.. '��'' +nr'�q°'s'"►°t."' �,•+"'Sr �^ ='., t: «�,� r}am,: �.� a « ,��'ai-v.'"«+ ..•rr,- ...- . "5"�.�.�ate.ij�.�� ,��° �` o � . w. ; n .... ,. 7� ry :. �ky,, i. , A � p_ a w y .. \w.� F:idk• t t •'"t .../ -+v. ' 'F*S� k+,�� ..' '�` +, {t fir.i�Y. Y -'�- u^,:.i _ �' .. yW trA[ll ` .. "`• r. Al _ c a, `�e a n 4 AAL KI .- �l ry o ( 9 [\� •«3 :'fit O hs ik 436 Jv CP lk r * y z. � r I,a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2e1 Parcel D l w Apppf ication Health Division Date4 Issued aA Conservation Division �/1,� Application e �� Planning Dept. Permit FeeCO o Date Definitive Plan Approved by Planning Board r 17.: J Historic - OKH _ Preservation/ Hyannis Project Street Address 3 A A L^44A, Village 1AM a.-PN is Owner -ba..,` r;s Lo l . C ECD N S ddress - Telephone CO11 Y-33 Z30O oZ126 Permit Request JZ zs, /^_14 w• I +oud +q e-t SG.`(ta S. POLCe AC7' n . rv�-GoC ca� o TA cf- S raze , 4 WU 144 Ft-oo K Square.feet: 1 st floor: existing ST00 proposed $ew 2nd floor: existing /3 p°�roposed /3AO Total new d Zoning District Flood Plain Groundwater Overlay Project Valuation !sr ��on`s u ton Type Z �� «�" V�t - = -71+4 740 (W/o mt Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure 10"V�tits. Historic House: ❑Yes l'No On Old King's Highway: ❑Yes 9l0 Basement Type: 2110'Full ❑ Crawl Walkout ❑ Other Basement Finished Area (s�ft)�D �� S> B��mentnt Unfinished Area (sq.ft) � Number of Baths: Full: existing new Half: existing new Number of Bedrooms: N/ A existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: r"Gas ❑Oil ❑ Electric ❑ Other // Central Air: Yes ❑ No Fireplaces: Existing C7 New D Existing wood/coal stove: ❑Yes V No fj ed garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ q*ed garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial W"es ❑ No If yes, site plan review# Current Use rd� 13 Proposed Use !; "Vj? 13 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ke_;*t, S IPL' Telephone Number 50 g Address 1-7 + License # CS 4>"740'M as tqA - M A o 2—& Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE /� /� DATE �� 4 FOR OFFICIAL USE ONLY ; '-; APPLICATION# r. DATE ISSUED MAP/PARCEL NO. :f ADDRESS VILLAGE w OWNER DATE OF INSPECTION: FRAME INSULATION r� >• ,�, ' FIREPLACE _ ELECTRICAL:. ROUGH FINAL PLUMBING- ROUGH FINAL r , GAS: ROUGH FINAL 'r FINAL BUILDING DATE CLOSED OUT r ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): :DeAlpin,• (Jokn.S- y%k G44 ��G Address: -7 C�-*(- D r 1),*-4- Z City/State/Zip: A.s - Mlo O?1:44 Phone#: �j 'C 2 VT Are y u an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 10 4. ❑ 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [1emodeling 1 ship and have no employees These sub-contractors have g. ❑Demolition workingfor me in an capacity. employees and have workers' Y P t3'• $ 9. ❑Building addition [No workers' comp.insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other - comp.insurance required.] I *Any applicant that checks box#1 must also fill out the section below showing their workers'.compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information.Insurance Company Name: ..1�_..-S LA ylG e S�Zt.V GLS Policy#or Self-ins.Lic.#: WC 5 Z4 O Expiration Date: -7 Job Site Address: 77 3 5"' Alyt e_5 L..,. �k A-&KIS Mk City/State/Zip: (-61&o—&-; Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a. fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under the pains and penalties o perjury that the information provided above is true and correct Si ature: e �'4.......... Date: '2�• Phone#: VT 8 L � Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not,more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." ' Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the'performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided'a'space at the bottom of the affidavit for you to'fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number:"th addition,an applicant that must submit multiple permit/license applications in,any,given year,need only submit one,affidavit indicating current policy informationi(if necessary)and under"Job Site Address"the applicant should write"all'locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number:The Commonwealth of Massachusetts - Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-NlASSAFB Fax# 617-727-7749 Revised 4-24-07 vvww.mass.gav/dia f Initial Construction Control Document To be submitted with the building permit application by a dRegistered Design Professional for work per the 8 h edition of the Massachusetts State Building Code, 780 CMR, Section 107.6.2 Project Title: Harbor Community Health Center- Hyannis Date: 06/25/2013 Property Address: 735 Attucks Lane, Hyannis MA Project: Check one or both as applicable: [A,New construction CK Existing Construction Project description: Renovation/Fitout to existing shelled space. I Dennis Kaiser MA Registration Number: 5053 Expiration date: 08/31/2013 ,am a registered design professional, and hereby certify that I have prepared or directly supervised the'preparation of all design plans,computations and specifications concerning: [ ] Entire Project pQ Architectural [ ] Structural . [ ] Mechanical [ ] Fire Protection, [ ] Electrical [ ] Other for the above named project and that such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review,for conformance to this code and the design concept,shop drawings,samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered-design professionals in 780 CMR Chapter 17,as applicable._ 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a `Final ontrol Document'. .410 Enter in the space to the right a"wet"or (�No. a electronic signature and seal: 80. T p rH OF Phone number: 617-478-0300 Email: rom ra@perkinswill.com Building Official Use Only J Building Official Name: Permit No.: Date: Trial Version 10 09 201.2 Initial Construction Control Document To be submitted with the buildingpermit application b p pp Y a d Registered Design Professional for work per the 81h edition of the w Massachusetts State Building Code, 780 CMR, Section 107.6.2 Project Title: Harbor Community Health Center-Hyannis Date: June 25,2013, Property Address: 725 Attucks Lane,Hyannis,Massachusetts 02601 Project: Check one or both as applicable: ❑ New construction X Existing Construction Project description: The MEP/FP fit-out of tenant spaces I Sean J.Brice MA Registration Number: 40419 Expiration date: June 30,2014 ,am a registered design professional, and hereby certify that I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: [ ] Entire Project [ ] Architectural [ ] Structural [ ] Mechanical [X] Fire Protection [ ] Electrical [ ] Other for the above named project and that such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review,for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform.the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. �Zp OF4, Enter in the space to the right a"wet"or �o SEAN J. GN electronic signature and seal: BRICE w MECHANICAL �No,404i$ 90 Fol .BPS �c, Phone number: 508-748-2620 ��0 C ail: sbrice@thompson-consultants.com -B ding Official Use Only Building Official Name: Permit No.: Date`. Trial.Version 10 09 2012 Initial Construction Control Document To be submitted with the building permit application by a T Registered Design Professional for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107.6.2 5� Project Title: Harbor Community Health Center-Hyannis Date: June 25,2013 Property Address: 725 Attucks Lane;Hyannis,Massachusetts 02601 Project: Check one or both as applicable: ❑ New construction X Existing Construction Project description: The MEP/FP fit-out of tenant spaces I Sean J.Brice MA Registration Number: 40419 Expiration date: June 30,2014 ,am a registered design professional, and hereby certify that I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: [ ] Entire Project [ ] Architectural [ ] Structural [ ] Mechanical ] Fire Protection [ ] Electrical [X] Other Plumbing for the above named project and that such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a.regular and periodic basis to: 1. Review,for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to t ficial a `Final Construction Control Document'. OF Enter in the space to the right a"wet"or WAND' electronic signature and seal: MECHANICAL Phone number: 508-748-2620 ONAL ,ail: sbrice@thompson-consultants.com Buildi g Official Use Only g Permit No.: Date: Building,Official Name: Trial Version 10 09 2612 Initial Construction Control Document To be submitted with the building permit application by a 9.3 r _ , d Registered Design Professional for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107.6.2 Project Title: Harbor Community Health Center-Hyannis Date: June 25,2013 Property Address: 725 Attucks Lane,Hyannis,Massachusetts 02601 Project: Check one or both as applicable: El New construction X Existing Construction Project description: The MEP/FP fit-out of tenant spaces I Sean J.Brice MA Registration Number: 40419 Expiration date: June 30,2014 am a registered design professional, and hereby certify that I have prepared or directly supervised the preparation of all design plans;computations and specifications concerning: [ ] Entire Project [ ] Architectural [ ] Structural [X] Mechanical [ ] Fire Protection [ ] Electrical [ ] Other for the above named project and that such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review,for conformance to this code and the design concept, shop drawings,samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered.design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code: When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official Upon completion of the work, I shall submit to the buil al a `Final Construction Control Document'. OF Enter in the space to the right a"wet"or MN J. 1 electronic signature and seal: MECHANICAL � Phone number: 508-748-2620 �O�IA H: sbrice@thompson-consultants.com Building tcial Use Only Building Official Name: Permit No.: Date: Trial Version 10 09 2012 Initial Construction Control Document To be submitted with the building permit application by a d Registered Design Professional for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107.6.2 Project Title: Harbor Community Health Center-Hyannis Date: June 25,2013 Property Address: 725 Attucks Lane,Hyannis,Massachusetts 02601 Project: Check one or both as applicable: ❑ New construction X Existing Construction Project description: The MEP/FP fit-out of tenant spaces I Kieran J.Guinan MA Registration Number: 50091 Expiration date: June 30,2014 ,.am a registered design professional, and hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [ ] Entire Project [ ] Architectural [ ] Structural [ ] Mechanical [ ] Fire Protection [)J Electrical [ ] Other for the above named project and that such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on.a regular and periodic basis to: 1. Review,for conformance to this code and the design concept,shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code: When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official Upon completion of the work, I shall submit to the building official a `Final Construct Of Mgssgc cument'. Enter in the space to the right a"wet"or oo AN' N-4 electronic signature and seal: MECTRiCAL -.pt0.8 1 O Is Phone number: 508-748-2620 Email: k uinan om t nts.com Building Official Use Only, Building Official Name: Permit No.: Date: Trial Version 10 09 2012 M= B-PHU CONSTRUCTION INC. July 2,2013 To Whom It May Concern: Keith Shaw has been an employee of Delphi Construction and will be the Senior Construction Manager for the Harbor Health project:_ If you have any questions, please contact me at 781-893-9900, ext. 108... Sincerely, Mark Paronich CFO, Delphi,Construction, Inc.. Ho Overland Road, Waltham, MA 02451-1721 ! PHONE, 781.893.9900 1 FAx:781,893.9898 1 www.delphiconstruction.net Massachusetts Department of Environmental Protection _ Bureau of Waste Prevention . Air Quality 1100180469 Decal Number BWP AQ 06 Notification Prior to Construction or Demolition ImporWhen fillingout A. Applicability forms on the computer,use only the tab key A Construction or Demolition operation of an industrial, commercial, or institutional building, or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection cursor-do not use the return (DEP), Bureau of Waste Prevention -Air Quality Control Regulations 310 CMR 7.09. Notification of key. Construction or Demolition operations is required under 310 CMR 7.09 (2)ten (10)days prior to any work being performed. The following information is required pursuant to 310 CMR 7.09. B. General Project Description 1. a. Is this facility fee exempt city, town, district, municipal housing authority,owner-occupied Instructions residence of four units or less?❑Yes R✓ No 1.All sections of b. Provide blanket decal number if applicable: this form must be Blanket Decal Number completed in order to comply with the 2. Facility Information: Department of HARBOR COMMUNITY HEALTH CENTER Environmental Protection a.Name notification 1735 ATTUCKS LANE requirements of b.Address 310 CMR 7.09 Barnstable MA 02601 c.Ci /Town d.State e.ZiD Code 6172823200. f.Tele hone Number area code and extension .E-mail Address(optional) 22000 2 h.Size of Facility in Square Feet i.Number of Floors j. Was the facility built prior to 1980? ❑ Yes 2 No k. Describe the current or prior use of the facility: OFFICE BUILDING I. Is the facility a residential facility? ❑ Yes (I No _o m. If yes, how many units? Number of Units �c 3. Facility Owner: �N HARBOR HEALTH SERVICES, INC. �o a.Name -0 1135 MORTON STREET b.Address � MATTAPAN IMA 1 102126 �(O c.Cit /Town d.State e.Zip Code =0 6172823200 pquerner@hhsi.us f.Tele hone Number area code and extension .E-mail Address o tional a PAULETTE SHAW QUERNER �Q h.Onsite Manager Name ag06.doc•10/02 BWP AQ 06•Page 1 of 3 i Massachusetts Department of Environmental Protection Bureau of Waste Prevention . Air Quality 100180469 i� BWP AQ 06 Decal Number Notification Prior to Construction or Demolition General Statement:If B. General Project Description cont. asbestos is found during a 4. General Contractor: Construction or Demolition DELPHI CONSTRUCTION, INC. operation,all responsible parties a.Name must comply with 1130 OVERLAND ROAD 310 CMR 7.00, b.Address and Chapter WALTHAM MA 02451 Chapterer 21 E of the General Laws of c.Ci /Town d.State e.Zip Code the Commonwealth. 17818939900 1 Ikshaw@delphiconstruction.net This would include, f.Tele hone Number area code and extension .E-mail Address(optional) but would not be limited to,filing an IKEITH SHAW asbestos removal h.On-site Manager Name notification with the Department and/or a notice of release/threat of release of a C. General Construction or Demolition Description hazardous substance to the 1. Construction or demolition contractor: Department,if applicable. IDELPHI CONSTRUCTION, INC. a.Name 130 OVERLAND ROAD b.Address WALTHAM MA 02451 —� c.Cit /Town d.State e.Zip Code 7818939900 1 kshaw@delphiconstruction.net f.Telephone Number area code and extension .E-mail Address(optional) KEITH SHAW h.On-site Manager Name 2. On-Site Supervisor: KEITH SHAW On-Site Supervisor Name _ 3. Is the entire facility to be demolished? ❑ Yes ✓❑ No �N =0 4. Describe the area(s)to be demolished: �0 INTERIOR PARTITIONS, FINISHES AND MISC. MEP'S -N �O �O 5. If this is a construction project, describe the building(s) or addition(s)to be constructed: —0 INTERIOR RENOVATIONS, OFFICES AND MEDICAL OFFICES �o �d - �Q aq 10/02 BWP AQ 06•Page 2 of 3 n Massachusetts Department of Environmental Protection __ ■ Bureau of Waste Prevention . Air Quality 1100180469 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.) 6. a. If this is a demolition project,were the structure(s) surveyed for the presence of asbestos containing material (ACM)? ❑ Yes ❑✓ No If yes,who conducted the survey? b.Survevor Name c.Division of Occupational Safety Certification Number 7/9/2013 3/11/2014 7. Construction or Demolition: �: a.Start Date(mmldd/yyyy) b.End Date(mm/dd/yyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: seeding ❑ paving ❑ wetting . ❑ shrouding b. If other, please specify: . ❑ covering. ❑Q other SWEEPING COMPOUND 9. For Emergency Demolition Operations, who is the DEP official who evaluated the emergency? NA a.Name of DEP Official b.Title c.Date mm/dd/ of Authorization d.DEP Waiver Number D. Certification I certify that l have examined the JANDREW COLAMETA =o above and that to the best of my a.Print Name -o knowledge it is true and complete. JAndrew Colameta The signature below subjects the b.Authorized Signature -_N signer to the general statutes PROJECT MANAGER �o regarding a false and misleading c.Position/Title _o statement(s). IDELPHI CONSTRUCTION, INC. d.Representing 6/28/2013 e.Date(mm/dd/yyyy) moo. �d �Q ■ ag06.doc•10/02 BWP AQ 06•Page 3 of 3■ Corey Heaslip From: Chris Ruth Sent: Tuesday,July 02, 2013 1:43 PM To: Corey Heaslip Cc: Andrew Colameta; Ken Brooks Subject: FW: eDEP Submittal Confirmation for DEP Transaction ID: 575240 Christopher Ruth ASSISTANT PROJECT MANAGER DELPHI CONSTRUCTION, INC. Corporate Office: 130 Overland Road,Waltham, MA 02451 (p)781.893.9900 (f) 781.893.9898 www.deIbhiconstruction.net -----Original Message----- From: eDEPConfirmation@massmaiLstate.ma.us [mailto:eDEPConfirmation@massmail.state:ma.usl Sent: Friday,June 28, 2013 2:56 PM To: Chris Ruth Subject: eDEP Submittal Confirmation.for DEP Transaction:ID: 575240 Thank you for using eDEP Online Filing from the Massachusetts Department of Environmental Protection.Your transaction is complete and has been submitted to MassDEP. This email is your receipt for the eDEP Online Filing transaction described below. Please review it and keep a copy for your records. Please do NOT reply to this message,this email address will not receive messages. For assistance with eDEP Online Filing, please email.the EEA Help Desk at mailto:helpdesk.eea@massmail.state.ma.us or call 617-626-1111:. MassDEP is interested in how we can serve you better.To help us make improvements to eDEP, please take a minute to complete our eDEP Online Filing Survey at ht_tp://www.mass.gov/eea/agencies/massdep/service/online/edep-contacts- and-feedback.htmi. To contact MassDEP Programs, please see http://mass.gov/dep/about/contacts.htm. DEP Transaction ID: 575240 Date and Time Submitted:06/28/2013 02:55:49 Form Name:AQ 06-.Construction/Demolition Notification Payment Information DEP code: 85826 Date: 6/28/2013 2:55:34 PM Amount($): 85 Payment Detail: RUTH CHRISTOPHER--AccountType-- AccountNumber****9067 Confirmation Number: Contractor 1 Contractor NuMber Name Address Supervisor Project Monitor Lab EMAIL ID OF THE USER cruth@delphiconstruction.net 2 r a1 1 2 200a MAAW yr W& g D 1(AY a• i j i Massachusetts Department of Environmental protection Bureau of Resource Protection -Wetlands DEP He Number: Ll WPA Form 8B — Certificate of Compliance sE3.4542 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP and § 237-1 to§237-14 Town of Barnstable Code A. Project Information Important: When filling out 1. This Certificate of Compliance is issued to: forms on the H annis Court Associates, LTD computer,use �� only the tab key Name to move your c/o David Bisbee cursor-do not Melling Address _ use the return key. Hyannis MA 02601 _ Clty/Town State Zip Code 2. This Certificate of Compliance is Issued for work regulated by a final Order of Conditions Issued to: Roy Catignani, Consery Group, Inc. Name SEP 19,2006 SE3-4542 Dated DEP File Number 3. The project site is located at: 735 Mucks Lane Hyannis Street Address village 295 017 Assessors Map Number Assessors Parcel Number r the final Order of Condition was recorded at the Registry of Deeds for: Hyannis Court Associates, LTD Property Owner(if different) Barnstable County Book Page I 1,044 454 81137 4 33817-8 C Document Certificate Lot# Plan# 4. A site inspection was made on: MAY 26 2011 Date • wpa[nnHb.doc rev.12l23lOB Town of Barnelable revised BH/2010 WPA Form 8B,CartEBcate of CompOance-Page 1 of 3 � i i - f i LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance SE3-4542 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP and § 237-1 to § 237-14 Town of Barnstable.Code D. Recording Confirmation The applicant is responsible for ensuring that this Certificate of Compliance is recorded in j the Registry of Deeds or the Land Court for the district in which the land is located. Detach on dotted line and submit to the Conservation Commission. --- ---•-•-•---------------- To: I j Town of Barnstable Conservation Commission Please be advised that the Certificate of Compliance for the project at: I 735 Attucks Lane, Hyannis,MA 02601 SE3-4542 , Project Location DEP Fife Number Has been recorded at the Registry of Deeds of- � Barnstable County for: Property Owner I i and has been noted in the chain of title of the affected property on: '. Date Book Page . i If recorded land,the instrument number which identifies this transaction is: • tL�eS....�...1'y—,';��01't. art 1 1 =;t�t-�., I - If registered land,the document number which Identifies this transaction Is: i Document Number i t Signature of Applicant • wpatmt8b.doo•rov.12f23/08 Tavm of Bametable revised 811/2010 WPA Fenn 88,CerfHicete of Compllartce•Page 3 of 3 j J I 7 L 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP Flre Number: WPA rm.BB - Certificate of Cam ance Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP and § 237-1 to § 237-14 Town of Barnstable Code B. Certification Check all that apply: i i ® Complete Certification: It is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed. ❑ Partial Certification: It is hereby certified that only the following portions of work regulated by the above-referenced Order of Conditions have been satisfactorily completed.The project areas or work subject to this partial certification that have been completed and are released from this Order are: ! , I I ❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the above-referenced Order of Conditions never commenced.The Order of i Conditions has lapsed and is therefore no longer valid.No future work subject to regulation under the Wetlands Protection Act may commence without filing a new ' Notice of Intent and receiving a new Order of Conditions. • Ongoing Conditions:The following conditions of the Order shall continue: (include any conditions contained in the Final Order,such as maintenance or monitoring,that should continue for a longer period). i Condition Numbers: see attached page 4, C. Authorization I , Issued by: l Town of Barnstable JUN 7,2011 Conservatlon Commission Date of Issuance This Certificate must be signed by a majority of the Conservation Commission and a i copy sent to the applicant and appropriate DEP Regional Office(See hfto://www.rW.gov/dep/aboudregiontfindvour.htm). Signatur .4A Sp wpefrm8b.doo•rev.12l23100 Town of Barnstable ►evlsad 8/1/2010 WPA Form 8B,Cerltllcale oJCompllance-Page 2 ot3 � Town of Barnstable Conservation Commission 200 Main Street DMNSUBLA Hyannis Massachusetts 02601 MAS& Office: 508-8624093 FAX: 508-778-2412 Attachment to WPA Form 8B - Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. 1312 �40 and § 237-1 to § 237-14 Town of Barnstable Code B. Certification Ongoing Conditions (continued from pageI Special condition# 11: There shall be no disturbance of the site, other than required mitigation planting, beyond the work limit. This condition shall continue over time. Special condition# 15: No creosote-treated or CCA-treated materials shall be used. Special condition# 17: Note: Buffer zone mitigation planting shall be maintained as shown on approved sketch plan dated 5110111. Special condition# 18: The approved stormwater infiltration systems shall be maintained.. Special condition#20-1 All proposed lawn areas shall be underlain with a minimum of 6 inches of loam Special condition#2 1: Herbicide, pesticide and fertilizer use is discouraged on lawns within Conservation Commission jurisdiction. If fertilizer must be used, only slow-release, low-nitrogen (with 30-50% water insoluble nitrogen or 'W.I.N.') and low-phosphorus fertilizers shall b'e applied. Over-fertilizing shall be avoided (not-to-exceed limit = 1 pound of nitrogen per 1,000 sq. k of lawn per application). Ensure that no fertilizer is spread on hard surfaces like driveways and sidewalks. Special condition#23: Note: A split rail fence shall be maintained along the work limit line as shown on approved sketch plan dated 5110/11. Note: The proposed 2-story addition with basement was not constructed. Issued To: Hyannis Court Associates DEP File Number: SE3-4542 Page 4 The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 1 of 3 The Commonwealth of Massachusetts ' William Francis Galvin Secretary of the Commonwealth,Corporations Division One Ashburton Place, 17th floor Boston MA 02108-1512 p f Irr Telephone: (617)727-9640 HARBOR HEALTH SERVICES, INC. Summary Screen Help with this form '4Req6est"a Certificate, 'I The exact name of the Nonprofit Corporation: HARBOR HEALTH SERVICES,INC. The name was changed from: NEPONSET HEALTH COMMITTEE INC. on 4/1/1987 Entity Type: Nonprofit Corporation Identification Number: 237100550 Old Federal Employer Identification Number(Old FEIN): 000003900 Date of Organization in Massachusetts: 07/28/1970 Current Fiscal Month/Day: / Previous Fiscal Month 1 Day:00/00 The location of its principal office in Massachusetts: No. and Street: 1135 MORTON STREET City or Town: MATTAPAN State:MA Zip: 02126 Country: USA If the business entity is organized wholly to do business outside Massachusetts,the location of that office: No. and Street: City or Town: State: Zip: Country: The name and address of the Resident Agent: Name: No. and Street: City or Town: State: Zip: Country: The officers and all of the directors of the"corporation: Title Individual Name Address(no Po Box) Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term PRESIDENT DANIEL J.DRISCOLL 41 LILLY LANE No Term Expiration DEDHAM,MA 02026 USA. TREASURER SUSAN BEAGLE 1828 WASHINGTON STREET 2012 BRAINTREE,MA 02184 USA CLERK ROBERT WALLACE 270 QUARRY STREET,SUITE 15 2011 QUINCY,MA 02169 USA ASSISTANT CLERK DANIEL J.DRISCOLL 41 LILLY LANE 2012 DEDHAM,MA 02026 USA http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True&... 7/9/2013 The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 2 of 3 CHAIR JAMES FOWKES 902 EAST FOURTH STREET 2012 SOUTH BOSTON,MA 02127 USA VICE CHAIR MARY MCCARTHY 42 LONGFELLOW DRIVE 2012 CENTERVILLE,MA 02632 USA DIRECTOR NEF BARBEL 16 BARNSTABLE ROAD,APARTMENT 2C 2012 HYANNIS,MA 02601 USA DIRECTOR GERARD COLLINS 3 SUNSET LANE 2011 DORCESTER,MA 02124 USA DIRECTOR LINDA DUMAS 1736 BEACON STREET 2010 BROOKLINE,MA 02445 USA DIRECTOR EVELYN SUTTON 54 MONSIGNOR LYDON WAY 2012 DORCHESTER,MA 02124 USA DIRECTOR CARLYN J.ELLMS 14 OLD FORGE ROAD 2012 NORTH FALMOUTH,MA 02556 USA DIRECTOR LAWRENCE FEENEY 160 MILTON STREET 2010 DORCHESTER,MA 02124 USA DIRECTOR EDWARD J.GLINSKI M.D. 378 ADAMS STREET 2011 MILTON,MA 02186 USA DIRECTOR ELLEN HARRINGTON 2005 HOCKLEY DRIVE 2012 HINGHAM,MA 02043 USA DIRECTOR REGINA HUGHES 30 HILLTOP STREET,UNIT#1 2010 DORCHESTER,MA 02124 USA , DIRECTOR MARGARET LYDON 15 LENOXDALE AVENUE 2012 DORCHESTER,MA 02124 USA DIRECTOR JAN MATTIMOE 2010 250 CORREY STREET WEST ROXBURY,MA 02132 USA DIRECTOR CLAIRE MCCARTHY 28 AVALON STREET 2612 MILTON,MA 62186 USA DIRECTOR TUAN D.NGUYEN 23 T.J.MULLANEY DRIVE 2012 RANDOLPH,MA 02368 USA Consent _ Manufacturer _ Confidential Data _ Does Not Require Annual Report _ Partnership _ Resident Agent _ For Profit _ Merger Allowed http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True&... 7/9/2013 The Commonwealth of Massachusetts William Francis Galvin - Public Browse and Search Page 3 of 3 Note:There is additional information located in the cardfile that is not available on the system. Select a type of filing from below to view this business entity filings: ALL FILINGS � 'I Annual Report Application For Revival Articles of Amendment4�; Articles of Consolidation-Foreign and Domestic -:- 4 c.View,Filings 3I • New Searic Comments O 2001-2013 Commonwealth of Massachusetts Q All Rights Reserved Help http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True&... 7/9/2013 •E • Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO. Building commissioner 206 Main_Stree%'Hyannis,MA 02601 www.town.barnstable.ma.us ` Office: 508-862.4038: Fax; 508-790-6230 r . P7roperty'dwnex Must Complete and Sign This Section If Using A Builder ;as Owner of the subjcctproperty hereby authorize �� Sit o act o' y'beh . to act on my behalf, in all roattets relative to work authorized by this building permit application for. -s s- f .1 4,A 5 GL YI e i (Address of Job) �� • _ icy !3 • . • . I Signature of Own ate Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on,the reverse side. . ACCORIDIF CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) 6/26/2013 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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(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 to the certificate holder in lieu of such endorsemen s. PRODUCER cONT NAME: Giovanna Alliant Insurance Services, Inc. IAIICONN E :617- 35-72 0 a/c No. 17- 5-72 5 131 Oliver Street,4th Floor E-MAIL Boston MA 02110 ADDRESS: h r e alliant. m INSURERS AFFORDING COVERAGE NAIC# INSURER A: r 19445 INSURED INSURER B:2uric American Insurance Company 16535 Delphi Construction, Inc INSURERC: 130 Overland Road INSURERD: Waltham MA 02451 INSURER E: ` _ INSURER F COVERAGES CERTIFICATE NUMBER:382233984 REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I�iSRR TYPE OF INSURANCE AIN R WVD POLICY NUMBER MPON D/EFF MOM/LDOY EXP LIMITS B GENERAL LIABILITY Y LO5524949-01 /1/2013 /1/2014 EACH OCCURRENCE $1,000,000 �( DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $300,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $10,000 PERSONAL BADVINJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY X PRO JE - LOC $ B AUTOMOBILE LIABILITY Y BAP 5524948-01 /1/2013 /1/2014 Ea accident $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident) $ AUTOS AUTOS ( ) NON-OWNED ` PROPERTY DAMAGE •$ " X HIRED AUTOS X AUTOS Per accident $ A UMBRELLA LIAB X OCCUR Y 8766138 /1/2013 /1/2014' EACH OCCURRENCE $10,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED RETENTION$ $ B WORKERS COMPENSATION Y C5524950-01 /1/2013 /1/2014 X WC STATU- OH- AND EMPLOYERS'LIABILITY Y/N LI I ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? N❑ N/A E.L.EACH ACCIDENT $1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Re: Mid Cape Community Health Center,735 Attuck Lane, Barnstable MA. Harbor Health Services, Inc.and SAR+are included as Additional Insureds as required by written contract and executed prior to a loss, but limited to the operations of the Insured under said contract,with respect to the Automobile, General Liability and Umbrella/Excess Liability policies.Automobile, General Liability and Umbrella/Excess Liability evidenced herein are primary and noncontributory to other insurance available to an additional insured, but only to the extent required by written contract with the insured and executed prior to a loss.A Waiver of See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN `Harbor Health Services, Inc. ACCORDANCE WITH THE POLICY PROVISIONS. 1135 Morton St Mattapan MA 02126-2834 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/65) The ACORD name and logo are registered marks of ACORD Department natandards and S " Massachusetts - gulations t of Building Board coon Super�°isor '• cons CS-07 4039 License: KITH L Sf3A 11 CLEMENT ST �*. SANDwICHMp'0256�3 '•,� ,• Expiration Wj0112o14 cJssioner COMM CD fr-= L_ FDH0 CONSTRUCTION INC. July 2, 2013 To Whom It May Concern: Keith Shaw has been an employee of Delphi Construction and will be the Senior Construction Manager for the Harbor Health project. If you have any questions, please contact me at 781-893-9900, ext. 108. Sincerely, X'7� Mark Paronich CFO, Delphi Construction, Inc. 130 Overland Road, Waltham, MA 02451-1721 1 PHONE: 781.893.9900 1 FAX: 781.893.9898 1 www.delphiconstruction.net July 2, 2013 To Whom It May Concern: Keith Shaw has been an employee of Delphi Construction and will be the Senior Construction Manager for the Harbor Health project. If you have any questions, please contact me at 781-893-9900, ext. 108. Sincerely, Mark Paronich CFO, Delphi Construction, Inc. Page 1 of 1 Shea, Sally_ From: Dean Melanson [dmelanson@hyannisfire.org] Sent: Friday, June 28, 2013 8:54 AM To: Shea, Sally; Perry, Tom Subject: 725 Attucks, Harbor Health Good Morning, We have completed our plans review on this property and are OK with a building permit being issued. Deputy Chief Dean L. Melanson Office 508-775-1300 Fax 508-778-6448 dmelanson@hyannisfire.org 7/16/2013 Message Page 1 of 1 Shea, Sally From: Dean Melanson [dmelanson@hyannisfire.org] Sent: Tuesday, July 09, 2013 11:50 AM To: Shea, Sally Cc: Franey, Patrick Subject: Re: 725 Attucks, Harbor Health That is correct, I used the street number they had on the plans, sorry. Deputy Chief Dean L. Melanson Office 508-775-1300 Fax 508-778-6448 dmelanson@hyannisfire.org On Jul 9, 2013, at 11:33 AM, "Shea, Sally" <Sally.Sheagtown.barnstable.ma.us> wrote: Hey Dean there is no 725 Attucks 735 right?? That's what the permit says. Sally -----Original Message----- From: Dean Melanson [mailto:dmelanson@hyannisfire.org] Sent: Friday, June 28, 2013 8:54 AM To: Shea, Sally; Perry,Tom Subject: 725 Attucks, Harbor Health Good Morning, We have completed our plans review on this property and are OK with a building permit being issued. Deputy Chief Dean L. Melanson Office 508-775-1300 Fax 508-778-6448 dmelanson@hyannisfire.org 7/16/2013 AGENCY CUSTOMER ID: LOC# ACORU ADDITIONAL REMARKS SCHEDULE Pagel of 1 AGENCY NAMED INSURED Alliant Insurance Services, Inc. Delphi Construction, Inc 130 Overland Road POLICY NUMBER Waltham MA 02451 , CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE subrogation applies in favor of above mentioned additional insureds with respect to insured operations where required by written contract but limited to the operations of the Insured under said Contract and executed prior to a loss,with respect to the Workers Compensation policy. P w ACORD 101 (2008/01) ©2008 ACORD CORPORATION.P All rights reserved. The ACORD name and logo are registered marks of ACORD t THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR . . QUALITY ORIGINAL (S) I M 7 7L DATA a �d TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Z9 Parcel Application # C� ` Health Division Date Issued Conservation Division Application Fee 00 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board N�h SEE A'rT14�_IfEn, Historic.- OKH Preservation/ Hyannis 3 Project Street Address Village NI Owner Address. 135 ffl",N) :5IW /// f�AJ Telephone 53 3 2 300 Permit Request TO Pf�k'-a 4YI _1- Mgd V, WV Oi fUyr) • I (6 ,&YJ en VL In 4a;Jk6ZZ1t ?F_J2_,, n Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatioi_ onEtruction Type !'03 4 q-I �, Lot Size Grandfathered: Yes ❑ I yes, tt h ppo ng cu ntation. Dwelling Type: Single Family ❑ Two Fa ❑ Iti-Fa ily nits Age of Existing Structure Histor Ho ❑ s. No On Old King's Highway: ❑Yes YNo Basement Type: ❑ Full wl Walkout ❑ per Baseme inished Are (sq.ft.) Basement Unfinished Area(sq.ft) C Number of ths: II: e 'sting ew Half: existing new Number of Be o s. existing _new Total Room Coun t in ding baths): existing new First Floor Room Count.. c 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 U existing new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing (a new size _ Other d Zoning Board of Appeals Authorization ❑ Appeal # Recorded Ll �. Site plan review# _ E5E81 ,, 33d 100d Proposed Use MIJ H13H 1N3WAdd E..� .00'OO 1 :03I]ddV IWb APPLICANT INFORMATION j 00'001. :03a30N31 .1Wb (BUILDER OR HOMEOWNER) 00'001 OIVd $ IIW83d --- -------------S7d101----------------- , c� ie Telephone Number H/W60 :31b0' License# C � Z 109M VW 'SINNbAH 133816 NIVH OOZ Home Improvement Contractor# 1018b00 9NImine 318d1S09 30 NMOl Worker's Compensation # 1dI3338 1N3WAbd 1IW83d .�� FING FROM THIS PROJECT WILL BETAKEN TO DATE ?hhl �r - r! A; gravel 2 HANDICAP SPACES Odginal Plan ENTRY 735 ATTU C KS LANE C9 i 12 SPACES 2 HANDICAP SPACES 14 SPACES _ a ravel 1 WALKWAY / 1.3-3.2 C3 � AIL - oC2 M IN EN RY 4 SPACES ( � t I 6 SPACES 2 HANDICAP SPACES � 11 5— i �- c t r , gravel ,4- Proposed Plan ENTR 735 ATTUCKS LANE C9 I 3.1-1._3.3.' Proposed Add - i :..._ new handicap ' door parking I gravel for handicap ` use only Proposed Walkway C3 oo i ® VC2 Build kSIN EN RY R RY ramp and Walkway I ' w � ' ROOM I i DENTAL i ; DENTAL! + — _ Y DENTAL I CONSULT EXAM I Mtd3 TREATMENT STAF� TREATMENT TREATMENT STA -_ le -.-- 1 EXAM EXAM WORK ri sF l ,a,es ROOM WORK ROOM ROOM EXAM h,157 1 t3os� `Sf ' M 145 , R1 1a6 hl 15a — -- - _ M 156 I t25$f. M,66 (-- --1I Al 144 I '1M 553 '� S.F 239 SF �.` Its SF ' 130 SF L t 20 SF 115 SF 1 1 I, CLEAN �� ---- _-_-_ -' -- STORAGE X-RAY !I C!3 RIDOVhil STAFF �AT4WT �71 _ �_______ I 1 Ci 11 1 CLOSET M. _ '., _ Si4gf�RS2E�----- ----- , PATIE I r--_- ( M�a2 lII I M179 :TOUCHDOWN `TOILET` �--'-'--"' - M t53 --- t I �! / [M,7ts t TOILE) EDS 3t SF I t: SF - M 143 ' m tab - ' 1 1 -,, ``$ . 1 - 5M,sF STAFF I ` 1 32 SF t z35 sF s*sF> 1 DENTAL T' WORK - h+t69 ; M mTREATMEN t t J 1 615E -� �OUCH0o a56ISFi MROOM TREATMENT 1 EXAM 1 -- _ r ^l ROOM - n1 t6t pR - 305 SFr n1 i77M M tat I t' t� _--_ TOILE , i R� I m r-------- --------------------� M158 EXAM MSF ----------------------- - -- o D �L - 11<SF 1 i A1160 I � ^+�+°-�------- 16F 122SSyF 1 — - 11F RRIdOR 1195E M t59 505E [—S." ;. C�EAN fi.a CLEM 5a (�� Izo SF DENTAL iOILED SipR CLO10 -" N AL ;l�' •T. i TREATMENT I 150 I F.!ut ._ M TREATMENT 1 EXAM t CLpG EXAM ROOM I 1 '6s 1 NSF 1 ROOM DIRECTOR I \_ EXAM i nl 16z NURSE OBSERV I EXAM M 172 M 173 It e t� _ 1[ r.,17s AI t d0 ! 1 C I i` 1 R�ib3' !J 5 t 3 M 165 t - S 79 5F i 36 5F172 SF 1 t22 SF - �� 179 S• 115 SF !% ^�'53 SF 120 SF T ; 1�-' t 1♦ F +- ---- - - ® _DENTAL • `L------ --- -- ----- TRAVEL DISTANCE 179.5' 1` �! \I ` TRAVEL DISTA E 6.5ST/ITFt--j STORAGE . t �- r� / t�polo C I I I DENTAL ( `� 1 t 1 37 SF � I WAITING '' ` 1 I -- _�----� - �-- -:I� _ I I - t CLINICAL u JS E ` 1 'Zi1 AI 663 s r.132 w`_ _-__--=-=- ar---- ---------- ------------- --------- -------Uy61I3t'�--- ----=.1/ REFERRAL SOILE 11 i - 1 } 1 fOiFFICEtt HOLD ~I a SF I--l3 t O ; Ca32 SF t 1 18I S 1 ! M 135 a.- --� I _ -r - - - - ---- — A! 1 -------� VES r ---J % 1 6111 -♦____- 1 1 1 1 I I _ ;+� ` t aMEN Y 1 EXAM EXAM. 1' i �' EXAM_ ° I [ , 1 DIR `..- FINANCE., /'OI/PAR �- OLLEG�T.ION i ^+5z% M 12s �- 1 t v I i OPER�, OFFICE t:-hs - 1 - c EXAM t I 1 1 M t31 t TOILET M 11a t �� t59 SF 5.6 sF ET 1 i 12o SF JJ !.a 107 y0( io1 SF l ,.,� 1 ha 109 tzo SF 1 t=� � ' re, ( 1 I ��l I p 1 5z1 SF: 112 Sr - \ ;f� - �v SF i�CORR+ _ 10 SF_ t f 1 1. ._ M 11(A l '! BLOOD J 104 s� �_J'� T EXAM _7 PHARMACY SUPPORT I s ------ 1 �'�_ TOILET �=�COLLECTION EXAM r• _-_-________ -- I�J M tao M 104 COR IDOR 0.9 542 ' 1.1110 ha 117 `4. 1 - t 120sF RrJO� MO R. _ 3-J si: 72�1 a ' (,`„t 139 SF �120 SF 1 /;' ! I CLEAN Y -- _ - -- l STAFF I ATIEN OR�QI�DOR �. - Q �1�- OIL- ---j �' --MEDS TOUCHDOWN TOILE- t t STORAGE �t 5u.` -- !>I 1 M 12s M.Izs ( Rti26 L--__- _\ 46 SF i ; 1 67 SF 299 SF'� 1 ' F 56 SF - \� CLOSET 1 1 , �. ,a sF LARGE S ,Zi = 1 - t r________-__ ____________________.-.--_---- _ CONSULT 1 _ -- — TAF a WORK EXAM E t CHECK_,W/ UT/ �1 ; ELEVATOR t555F �i55 --------�--------J WAITING ; - - 1 'NLOBBY t.tis 155S 14ssF ►-T, I, _- - - �17SF M if•1 h1AIN r-�,- -*+� ra 101 40 SF ' 1 � ry 605 SF i ENTRY 1 -- 354 SF x _- - - Iz � - a F1?� � '( I a3 sY — EZ Proposed new door _ I I I !r MAIN FLOOR —J.1_L J._t1..1_... for Handicap use only ,/s�_ ,'-o• r 1 ��Q �i ��h � �� O� �� J Q Q� . ��, ,�° �� ., t