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0077 HIGH SCHOOL ROAD
� � ;� � ��, �� �. �: i4. �" �. f e r Town of Barnstable THE o Regulatory Services BARNSTABLE ' 4M31fWS 4:W WiFRVNC•4==65iYG1nRE A t.E, * R Richard V.Scali;Director =639.014 snxxsrea "9 1m� Building Division Paul Roma Building Commissioner -- --'----_:-200 Main Streets Hyannis, MA 02601 - ---- _-- vn w towmbarnstable:ma us_-- -- - - - -' _--- -- --- - --- - January 9, 2017 A Hyannis Fire District c/o Mr. Matthew Eddy, C.I. Baxter-Nye Engineering and Surveying 78 North Street Hyannis,MA 20601 RE: Site Plan Review#045-16 Hyannis Fire District 95 & 77.High School Road Extension& 105 Stevens Street, Hyannis Map 309,Parcels 230, 266 &272 Proposal: Project involves thexemoval of two existing building and the removal.of the foundation fora third previously razed building to all the construction of a new two-story fire/rescue building. Full site improvements are proposed including new parking, reconfiguring entrances,improvements to drainage, stormwater management,utilities, landscaping and site lighting. " Dear Mr. Eddy: Please be advised that the above proposal-received approval at the formal site plan review meeting held January 5,2017 subject to the following: • Approval is based upon,and must be substantially constructed in conipliarice with,plans entitled"HyannisFire—Rescue Headquarters—95 High School.Road Extension",which includes Demolition Phasing, Site Layout and Photometric Plans,22 Sheets, dated December 12, 2016 prepared for Hyannis Fire District by Baxter Nye Engineering and 'Surveying, Hyannis and Kaestle BOOS Associates,.Inc. Foxborough, MA. Also Elevations . and Floor Plans,3 Sheets, dated December 8,2016 and Landscape Plan, 1 Sheet,'dated December 6,2016 prepared by Kaestle BOOS Associates;Stormwater Management Report for Hyannis Fire—Rescue Headquarters, dated November 16,`2016 prepared by Baxter Nye Engineering & Surveying,Hyannis. �fl • Consultation with the DPW Department regarding the design and requirements of the i sewer tie in; water main locations and connections; and signaling improvements will be required. Contact: DPW 508-790-6400. • Applicant must obtain all other applicable permits, licenses and approvals required including,but not limited to, a road opening permit from DPW. ---- Upon completion of-all work, a registered engineer or land surveyor,shall submit a letter of certification;made upon-knowledge=and=belief-iri accordance-with-professional=standards=that= -all work has been done in substantial compliance with the approved sife'plan(Zoning Section 240-105 (G). This document_shall be submitted prior to the issuance_of.the final certificate of occupancy. A copy of the approved site plan will be retained on file. 'Sincerely, Ellen M. Swiniarski Site Plan Review Coordinator CC_: Paul Roma,Building Commissioner Hyannis FD Health Department DPW Planning--GMD I n .{ Town of Barnstable Regulatory Services BARNSTABLE Richard V. Scali,DirectorBAMOMURA 39. Building Division Paul Roma Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us September 6, 2016 Independence Place, LLC c/o Mr. Matthew Eddy, P.E. Baxter Nye Engineering& Surveying 78 North Street, 3rd Floor Hyannis, MA 02601 RE: Site Plan Review#007-16 Independence.Place,Inc. 939 Mary Dunn Road, Barnstable Map 332,Parcel 013 Proposal: Project involves the construction of one new free standing three-story building approx.. 47,000 s.f. The building is planned to be 29 two-bedroom units.. Site improvements for the new building will include new parking lots for 44 vehicles, vehicular connection to the existing adjacent roadways providing full circulation around the site; a new right out only egress onto Independence Drive, drainage and 1 / storm water management facilities, underground utilities, site lighting, and landscaping. Dear Mr. Eddy: Please be advised that subsequent to the formal site plan review meeting held on March,3, 2016, revised plans for the above proposal were administratively approved subject to the following: • Approval is based upon and must be substantially constructed in compliance with the plans , entitled"Carriage House Apartments", 8 Sheets; "Truck Turning Template Plan"dated February 11, 2016 prepared by Baxter Nye Engineering&Surveying;Hyannis for Independence Place,LLC dated February 25,2016 with final revisions August 18, 2016; floor plans and elevations, 5 Sheets dated August 16, 2016 and landscape plan entitled "Carriage House Apartments"dated August 18, 2016 both prepared by Brown Lindquist Fenuccio&Raber,Yarmouthport dated August.18, 2016. • Zoning Board of Appeals relief is required for required lot area; reduction of required minimum front yard setback; and reduction of side buffer strip screening. • Letter dated May 10,2016 from Attorney Eliza.Cox,Nutter McClennen&Fish regarding rights to connect to Town sewer system. • Independence Drive shall be retained as a private road. • Each rental unit will require annual inspection and registration with the Health Department. • Subject to Chapter 1,Article 9 Inclusionary Affordable Housing Ordinance Sections 9-1 through.9-11 inclusive. • For purposes of building permit market/affordable development phasing.provided in Section 9-5, units will need to be identified on the plan. • 2 HP apartments must be provided, disbursed evenly, and identified on the plan. • Mary Dunn Road may not be used as access to the site during construction. • Applicant must obtain all other applicable permits, licenses and approvals required. Upon completion of all work, a registered engineer or land surveyor shall submit a letter of . certification, made upon knowledge and belief in accordance with professional standards that all work has been done in substantial compliance with the approved site plan(Zoning Section 240-105 (G). This document shall be submitted prior to the issuance of the final certificate of occupancy. A copy of the approved site plan will be retained on file. Sincerely, Ellen M. Swiniarski Site Plan Review Coordinator CC: Paul Roma,Building Commissioner Attorney Liza Cox ZBA File Barnstable FD Health Department DPW ti PROJECT n �, L� _75 P 4- -i-->T-AI NAME: ADDRESS: C�v1✓1 l5 PERMIT# PERMIT DATE: M/P: 3�� oZLeQP LARGE ROLLED PLANS ARE IN: BOX 1 SLOT Data entered in MAPS program on: cl s - BY: q/wpfiles/forms/archive TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map — Parcel' . ;Application Zo Health Division Date Issued Conservation Division ,t, Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved b Planning Board 'b Pp Y 9 Historic - OKH _ Preservation/ Hyannis i ,174 Project Street Address T Village :v Owner o7 Nye Addresses aN> Telephone Permit Request Q,� � n er Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation r 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: QKGas ❑Oil ❑ Electric ❑ Other Central Air: )7 Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑existing ,.❑ new; size_ J Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size — Other. Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ - Commercial `4Yes ❑ No If yes, site plan review# � Y00 Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ���� � ®�'.° � Telephone Number S-' Address 1z::097 AXeT� S� License# J 3&Z vv ose Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO e�W� 910� SIGNA E DATE FOR OFFICIAL USE ONLY f APPLICATION# s t r4 DATE ISSUED LI-MAP//PARCEL NO. I f i ' ADDRESS VILLAGE 4• ` OWNER F. DATE OF INSPECTION: yyY S FRAME .* .�';71NSULATION ? FIREPLACE ELECTRICAL: ROUGH - FINAL 7 , 4 PLUMBING: ROUGH FINAL I 'q GAS: �-R t` ° ROUGH S ; '+ FINAL r I S #=DATE CLOSED._OUT 4 ASSOCIATION PLAN NO. 4� , i c ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I? 600 Washington Street ' Boston, MA 02111 ass' www.rn ass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):/77"/40A /ill Address: 0_17ff Sf City/State/Zip: A17Lrw/S Phone #: 7)_7 A;FI ou an employer? heck the appropriate box: Type of project(required): 4. am a or an 1. am a employer with p ,� _ ❑ I general contract d I g 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. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' comp. insurance.# 9• ❑ Building addition [No workers' comp. insurance P• li 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 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. . t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tcontractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. , Insurance Company Name:_,0�50['/ ��JN�,�� •vs Policy#or Self-ins. Lic.#: /0&1 ..s 0(y25 3'�41 D/,7D�Dzy Expiration Date: Job Site Address: City/State/Zip: y ufs Attach a copy of the workew 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 er the pa' enalties of perjttry that the information provided above is trite and correct. Signature: Date: -3 0�0/ Phone#: gel-, ' 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#: �7HE Tp�� Town of Barnstable Regulatory Services s HAS& � Thomas F. Geiler,Director ''rFn 39. `' Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.b arnsta ble.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, STUART BORNSTEIN , as Owner of the subject property hereby authorize MICHAEL J. ROBERTS to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Sig�tarure Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERMISSION of � Town of Barnstable "[KE r ' o Regulatory Services aaRxsTaer E Thomas F. Geilei-, Director Mass. �e39. ,m� Building Division AlE p �a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnsta ble.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the�Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1,1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official , Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certifrcation for use in your community. Q:\WPFILES\FO R M S\homeexempt.DOC HOLLY MANAGEMENT & SUPPLY CORPORATION 297 North Street Hyannis, Massachusetts 02601 (508)775-9316 FAX(508)775-6526 Thomas Perry, Director March 7, 2011 Town of Barnstable 200 Main Street Hyannis, MA 02601 Dear Mr. Perry, This letter is to inform you we're disassembling a building at 77 High School Road Extension, Hyannis MA. The water and gas are in the process of being shut off at the street. The electricity will still be on until the building is physically dismantled. Bayside Electric is the electrician. Kindly, arf A. rns em President r y"ti„ r Client#: 16170 2SIPPEWISSETTCO 'ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 05/04/2011 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 endorsement(s). PRODUCER - CONTAC - NAME: Dowling&O'Neil Insurance PHONE 508 775-1620 FAX 5087781218 A/C No Ext: A/C No Agency E-MAIL -- 973 lyannough Rd., PO Box 1990 ADDRESS: Hyannis,MA 02601 INSURER(S)AFFORDING COVERAGE• NAIC# INSURERA:Associated Employers Insurance INSURED INSURER B: Hard Hat Construction INSURER c 297 North Street Hyannis,MA 02601 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. INSR TYPE OF INSURANCE - ADDL SUB POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD MM/DD GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ CLAIMS-MADE FI OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PE OCT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Peraccidenl $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE - AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WCC5000549012010 12/07/2010 12/07/2011 X WC STU-TORY LIMIT OTH AND EMPLOYERS'LIABILITY' ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N E.L.EACH ACCIDENT $1 000 000 OFFICER/MEMBER EXCLUDED? a N/A (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 I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Operations performed by the named insured subject to policy conditions and exclusions. CERTIFICATE HOLDER CANCELLATION 259 North Street,LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 297 North Street ACCORDANCE WITH THE POLICY PROVISIONS, Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S80497/M80496 JRS Massachusetts- Department of Public it'ctN. Board of Buildin- Re-ulations and St and i-ds Construction Supervisor License License: CS 53861 Restricted to: 00 MICHAEL J ROBERTS 1815 FALMOUTH.RD4C6 CENTERVILLE, MA 02632 .. a Expiration: 2/13/2012 Commissioner Tr#: 16586 i FROM :HYANNIS WATER SYSTEM FAX NO. :508 790 1313 Mar. 09 2011 01:54PM P2i2 . I Department of Public Works 47 Old Yarmouth Rd. Water Supply Division P.O.a®"326 Hyannis,MA. &i�%A a E, 02601-0326 1MIA�. TES.508-779.0063 ' Hyannis Water System Operations FAx sasm7oae1313 March 9, 2011 Town ol`Barnstable 4 Attn: Paul Loma,Building Tnspector Town Hall 367 Main Street Hyannis, MA 02601 RE: 77 Nigh School Road Extension Dear Mr.Roma: Please he advised that on March.8,2011 the water service has been shut off and the meter removed at 77 Iligh School Road Extension. The water line has not been cut and capped. The owner has i.nfot med us of possible plans to demolish the building. If you have any questions, please don't hesitate to contact me. Sincerely, , Christina Ferrari Hyannis Water System -'sr. Operated and Maintained by United Water. MAY-04-2011 09:.20 KEYSPAN 718 403 6986 P.01i01 E � i gal , ri . This letter Is to notify you that the gas service located at 77 High School Rd Ext. Hyannis MA. was out off at the gate box on 4/9/11. If you have any questions, please feel free to contact me @ 781-907•2926. z l you, �Yy David Bregoli Manner GAS CUSTOMER FULFILL U ENT nationalgrEd 40 Sylvan Road Pax 9.781-522-1057 t TOTAL P.01 HYANNIS FIRE DEPARTMENT 95 HIGH SCHOOL ROAD EXTENSION HYANNIS, MASS.02601 HAROLD S.BRUNELLE,CHIEF FIRE PREVENTION BUREAU LT.DONALD H.CHASE,JR. LT.JOHN COSMO .Inspector Inspector PERMIT APPLICATION FOR FIRE SPRINKLER WORK , 2011 oC�1 lull n4 S I. L C C ATE NAME OF COMPANY. �-93 A)Ok-IH Sl _ BUSINESS ADDRESS CITY,TOWN, STATE, ZIP CODE MASS. SPRINKLER CONTRACTOR'S LICENSE NUMBER: (JOURNEYMAN'S LICENSE IS NOT ACCEPTABLE TO OBTAIN A PERMIT) ADDRESS OF BUILDING FOR PROPOSED LKI -�+16N BUILDING NAME:—. . STATE CLEARLY THE PURPOSE FOR WHICH THE PERMIT IS TO BE GRANTED: FEE OF $25.00 1 R MASS. STATE BUILDING CODE AND 527 CMR 1.00 ;:by COPY OF IN RANCE CERTIFICATE STATING THAT THE CONTRACTOR IS.INSURED.Tx�CI�NDUCT INSTAL ON, SERVICING AND,REPAIR OF FIRE SPRINKLER SYSTEM ,1 /Z �/� C ,y,, }` 1 / K 'r `� PER ON GRANTING?ERMIT/ TITLE P 17EXPIRES: E M DATE 0 PERMIT& PERMIT NUMBER Rev.6/10 , Tel. 508-775-1300 Fax 508-778-6448 Emergencies 9-1-1 Massachusetts Department of Environmental Protection 100121998 Bureau of Waste Prevention.• Air Quality � BWP AQ 06 Decal Number i Notification Prior to Construction or Demolition Important: A. Applicability When filling out pp 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 more units is regulated b the Department of Environmental Protection ntial building with 20 or o p reside g 9 Y cursor-do not (DEP), Bureau of Waste Prevention-Air Quality Control Regulations 310 CMR 7.09. Notification of use the return 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 ❑✓ No 1.All sections of b.Provide blanket decal number if applicable, Blanket Decal Number this form must be completed in order to comply with the 2. Facility Information: . Department of 77 HIGH SCHOOL ROAD EXTENSION BUILDING Environmental Protection a.Name notification 177 HIGH SCHOOL ROAD EXTENSION requirements of b.Address 310 CMR 7.09 H annis MA —1 62601 c.CitvfTown tateZip d 5087759316 f.Teler)hone Number(area codeand t E-mail Address(optional) 17000 1 h.Size of Facility in Square Feet i.Number of Floors j.Was the facility built prior to 1980? ❑✓ Yes ❑ No k. Describe the current or prior use of the facility: OFFICE SPACE I. Is the facility a residential facility? ❑ Yes ❑✓ No �o m. If yes, how many units? Number of units �° 3. Facility Owner. N 259 NORTH STREET LLC �-0 a.Name �O 297 NORTH STREET b.Address — HYANNIS MA 22601 to c.Cityrrown StateZio Code �0 5087759316 I.TeleDhonecode and extensionlE-mail Address(outional) C MICHAEL ROBERTS �Q h.Onsite Manager Name ag06.doc•10/02 BWP AQ 06•Page 1 of 3 r Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality 10012199s B W P AQ 06 Decal Number Notification Prior to Construction or Demolition General B. General Project P ro'ect Description Cont. Statemen t:If asbestos is found during a 4. General Contractor: Construction or Demolition IMICHAEL ROBERTS operation,all a.Name responsible parties must comply with 11815 FALMOUTH ROAD,APT C-6 310 CMR 7.00, b.Address 7.09,7.15,and CENTERVILLE MA 02632 Chapter 21 E of the General Laws of c.Ci /Town d.State e.Zip Code the Commonwealth. 5089627792 This would include, f.Tele hone Number area code and extension Q.E-mail Address(optional) but would not be MICHAEL ROBERTS limited to,filing an asbestos removal h.On-site Manager Name notification with the Department and/or a notice of release/threat of C. General Construction or Demolition Description release of a hazardous substance to the 1. Construction or demolition contractor: Department,if. applicable. IMICHAEL ROBERTS a.Name 1815 FALMOUTH ROAD,APT C-6 b.Address CENTERVILLE MA 02632 —� c.Citvrrown tate e.Zip Code 5089627792 f.Telephone Number area code and extensionE-mailress(optional) MICHAEL ROBERTS h.on-site manager Name 2. On-Site Supervisor: MICHAEL ROBERTS On-Site Supervisor Name 3. Is the entire facility to be demolished? ✓❑ Yes ❑ No �0 4. Describe the area(s)to be demolished: �0 ENTIRE FACILITY N 5. If this is a construction project,describe the building(s)or addition(s)to be constructed: DEMOLITION ONLY. �.�0 —d �Q ag06.doc•10/02 BWP AQ 06•Page 2 of 3 f Massachusetts Department of Environmental Protection ■ Bureau of Waste Prevention • Air Quality 11100121998 Decal Number BWPAQ06 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 3/21/2011 —� 4/2112611 -� 7, Construction or Demolition: a.start Date(mm/dd/yyyy) b.End Date(mm/dd/yyyy) 8. a.For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding ❑ paving b. If other, please sp eci ' ❑✓ wetting ❑ shrouding ❑ covering ❑ other 9. For Emergency Demolition Operations,.who is the DEP official who evaluated the emergency?, a.Name of DEP Official b.Title c.Date mm/dd of Authorization d.DEP Waiver Number D. Certification I certify that I have examined the IMICHAEL ROBERTS —moo above and that to the best of my a.Print Name .�0 knowledge it is true and complete. IMIchael Roberts The signature below subjects the b.Authorized Signature N signer to the general statutes JPROJECT MANAGER —o regarding a false and misleading c.Positioni I Me o statement(s). 1259 NORTH STREET LLC d.Re resentin 3/7/2011 �o e.Date(mmlddlyyyy) d �Q ■ ag06.doc•10102 BWP AQ 06•Page 3 of 3■ TOWN OF BARNSTABLE BUILDING PERMIT,APPLICATION v Map Parcel . V l � P1��J Application # Health Division `5 Date Issued dg Conservation Division A'plica on e 'I�}t 1/ p C I '� Planning Dept. I ��� - � ' Permit A Nor'' � nl `�. 4 Date Definitive Plan Approved by Planning Board (-CZ.+ INKS R I rL60 Historic - OKH Preservation / Hyannis M 0 2G ArJ -T'0 Project Street Address l (,t Village� 1-, i 65 Owner `S� /�v�C- S c Address J VI;'JC Telephoned 7 S ' Il3 Permit Request U 1 L w� l-0 rJ LA_, A'(S t 0 Fe C- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 'W Project Valuation _ Construction Type Lot Size Grandfathered: ❑Ye s ❑ No If yes, attach supporting documentation. t4_ Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes YNo On Id King's Highway: ❑Yes ZNo Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other /y Yp � Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 0 existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: > Gas ❑Oil ❑ Electric ❑ Other 0. I Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ r rage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zo of Appeals Authorization ❑ Appeal # Recorded ❑ m + Cc I ❑Yes ❑ No If yes, site plan review# ; Cur Use Proposed Use � ? w APPLICANT INFORMATION (BUILDER OR HOMEOWNER) v r n �/ y �O�G�9� >5'oirJ C �j o L�S Name � � _ Telephone Number 94�=�a.�� Address ��o //� �S=�C f/.�// License#Alf-IS e i._ Dd?C,0 Ho e Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE JZ DATE L - FOR OFFICIAL USE ONLY /* 9 APPLICATION# ~ � q +�j��►�44A Yll DATE ISSUED T, MAP/PARCEL N0: ADDRESS VILLAGE OWNER i "..DATE OF INSPECTION: FOUNDATION FRAME k INSULATION FIREPLACE .' 'r ELECTRICAL: ROUGH FINAL ' R s` PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ` FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r F L' 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 v Please Print Legibly "---N arrCe_—(1 ss/0rganization/Individual): 7 e Addr s? J& f O 41 ec.Ae G aR/l C;.� lele s 7 %r-149�i�,g,r/ o 03 G!o .cam '/S:ta�/Zip7TAG'0��� �i.9� AW Phone.#:,56 F= 7 92P- V7�?y Are you an employer?Check the appropriate bog: Type of project(required): 1- 9 I am a employer with 4. ❑ I 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. 4 Remodeling ship and have no employees These sub-contractors have g• ❑ Demolition workingfor me in an capacity. employees and have workers' Y P h'• � 9. ❑ Building addition � [No workers'comp:insurance comp.insurance. 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its ❑ P 3-❑ I am a homeowner doing all work officers have exercised their 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' 1311 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then.hire outside contractors must submit a new affidavit indicating such. xContractors 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 subcontractors have employees,they must provide their workers'comp.policy number. Iam an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: t Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of 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 certify and a pains and penald of perjury that the information provided above is true and correct Signature Date: D �6 Phone#: Official use only. Do not write in this area, to be completed by city or town offclat- 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 Insttuctions ,. 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 Pease 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 ILdustrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit(license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid-affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The C6mmonwealth of Massachusetts Department of Industrial Accidents .Office of Investigations 600 Washington Street Boston MA 02111 o j Tel. # 617-727-4900 ext 406 or 1=877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass..gov/dia i dnn•„13s,;,�!=gr'rr>,,,r'ss-i `?iq;'.�• 'ri:,°,5'.',:r�r:. �r 5rz roasx,�J°'r`xS°°„�:',t'4fA'4,r „i g t 1 r ISSUE DATE 0511912008 iioDucEx THIS CERTIFICATE IS ISSUED AS A MATTER.OF INFORMATION ONLY AND lark T Vokey Ins Agey Inc' CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE P O Box 1247 DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 4.e POLICIES BELOW. Vest Chatham,MA 02669 - COMPANIES AFFORDING COVERAGE --- Paul J Morgan Jr dba.Horne Works COMPANY A A.I.M.Mutual Insurance Co LETTER `P O Box 1603 West Chatham,MA 02669 ; ..It 'rc[<,xsr". ., !"''�« n. i,..R §,. ...5 .! .°:1 rF si,t, tLs Y., /Er ";'=l.,{.y:�3.�N'> 4fi•...f'. b uE. .k. ;I;.v., �.7'ri� 6 3.. 1•.,. la's':, if}.. 5y �:tt ll i, :u s=, Gr ..,�,, � in� 2n �; .rwY`�t. ,n ns r'���,,nl �. t �'� �;.r„ro ++r> ,.a••. Y'. .Via..:,..,a= s.J{.. ..gn.. 't. ::J•.:.T:E=$'s%, l �. "-� Ar<b .v y»s;ti,t.eea..r,y.�S�,�' i�:?r, - ,poi' ,.(.,yl, ,_.'r/y• ..�, r.py. D'5�" r,��. n,�.i,''..,�.9". ,1. .r.....m,.����' ,e�yvs�" '�'x�,�,w,,+,�.m`s4,v1+3 ',,, i 34�ss�+i4,,.,-.o-..4,,.�c.,\a.� ...".ri'�a�-��L�*nN��r.,,�((.!s;asr:ru,4�,�s;°:L•S.xe >.�Y.,:,�,�xrM..:vae, d _e.3.hs,...,�rS+:t•�e;x»? r t F r ,,,,5'�:YS��r:1�s,.A.,s, 'PHIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY `PE.RIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE TvtAY BE ISSUED OR.MAY PERTAIN,THETNSURANCE 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS I.7R DATE(M M/DD/YY) DATE(MMIDD/YY) CEN ERA L LIABILITY GENERAL AGGREGATE $ PRODUCTS-COMPIOPAGG. $ COMMERCIAL GENERAL LIABILITY PERSONAL&ADV.INJURY $ CLAIMS MADE=OCCUR ' EACH OCCURRENCE $ n OWNER'S&CONTRACTOR'S PROT. FIRE DAMAGE(Anyone tire) Y MED.EXPENSE(Anyone person) $ AUTOMOBILE LIABILITY COMBINED SINGLE - LIMIT ANY AUTO t • 'L'r�. � 7 wr f BODILYINJURY •, ALL OWNED AUTOS $ (Per perso). ,rHEDULEDAUTCS HIRED AUTOS BODILY INJURY r�NON-OWNED AUTOS $ - L� (Per accident) GARAGE L1A81 LITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE UMBRELLA FORM AGGREGATE $ OTHERTHAN UMBRELLA FORM WORKERS COMPENSATION AND STATUTORY LIMITS OTHER EMPLOYERS LIABILITY X HE PROPRIETOR/ EL EACH ACCIDENT S 100,000 A PAMERSIEXECUTIVE GFF,GIERSARE: 7018715012008 03/22/2008 - 03/22/2009 EL DISEASE--POLICY LIMIT S 500,000 INCL ®EXCL EL DISEASE--EACH 100'000 EMPLOYEE CONIMENfSr DESCRDeTIO OF OPERATIONS GRLOCATIO;rS: - PAUL.J MORGAN JR IS NOT COVERED 13Y THE WORKERS'COMPENSATION POLICY. ,,��"S',i"" ,{'s{{��°n4'r'✓Jr',rvrv ' ,rr;r :=•s'§i �"i�?i�„w�n£4tnn 'r§4."�":"t;4'.:r<,. a ,,., ..'r'•r{,'i,e'4,,, ..,r, su ,M,i,'i' . 4 1 t:L3,Z„ t..,§.. ..P..t I•; a,;s,,,,;,, +:t.,s .3 $ s 2+' .s 'hJ t V� u c 6 y,,t,3 '!'.:,y.J .',°,s>3,rrr,-r,-:,,,,Yip,#,er •„4„r r„'w,.x. .n.,r ..t, .3J s. <;.ra -�t•'�,. ,i ¢a;$.�r4i,'%,"'t.=s"y,3;=>>r F t: .e,4r*w^�•'ai, cro<k�.o"� F 1 �k �f t e /, ;8 .i�� +�5sk3 t vc ,.� ., � .°I. txi -ll yl.h'tt, sr?s%. ., �'so$.{PY,.GN ,�Lln7.t{. �t�s�w'�t�n�.�3 ti a : sJ r s,�'` t ." �¢� � �,4Y±.3_.�,'1 3 �.':�.'+�.1'�£ _...,,.....,.� .��, �,k„ it'J,ss c. SHOULD ANY OF THE ABOVE DESCRIBE])POLICIES BE CANCELLFD BEFORE THE EXPIRATION DATE f0\\IN OF C.HACHAM BUILDING?DF..I'T HEREOF,THE ISSUING COMPANY WB,L ENDEAVOR TO MAIL 15 WRI'TTENNO TICE TO THE C'ERTIFICA I , OLDER NAMED TO THE LEFT,BUT FAILURE.TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR:REPRESENTATIVES. ;,.,�, -..�::,,.� .���-_r•_,.�,. __...r__...,..� ._. __ _ _ _. ._.err.. __.._ _ ,__. _.___ _ -_ �61. GEORGE RYDER RD _ e)�eL. �. CHATHAM, MA 02633 [AUTHORIZED REPRESENTATIVE I� '' BOARD OF BUILDI G REGULATIONS i License: CONSTRUCTION SUPERVISOR :. 07393.0 Number: GS 3 8 Tr.no: 3248.0 ,. _Expires"'10/141200 . Restncted - PAUL J MORGAN JR r PO BOX 1603 WEST CHATHAM, MA`02669 Commissioner Town of Barnstable x awxx�rnsi.E. ,' � Regulatory Services °rEn �A Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize R, I'J(. h MG t1'J to act on my behalf, in all matters relative to work authorized by this building permit application for. } . •(Address of Job) . '/06 3p 6.$ Signai=- er ' -+ Date Print Name QAWPFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 r Town of Barnstable Regulatory Services « Thomas F.Geiler,Director BMtNSTABLE, MASS. 1639. ,�� Building Division TED MA't A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b am stable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Persons)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to ` be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Constriction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building pen-nit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC Hallway Exit Door w N 12' x y N Office �V Z N 6'2"x 3'6° Glass Panel Exit Door - - Computer Room Outside Parking Lot !1n�,-h VAR � v-r 0 Buy SmartDraw!-purchased copies print this document without a watermark. Visit www.smartdraw.com or call 1-800-768-3729. Massachusetts Department of Environmental Protection ■ Bureau of.Waste Prevention •Air Quality 1100074465 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition 1 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. Construction or Demolition: 07/03/2008 1 07/15/2008 . a.Start Date(mm/ddlyyyy) b.End Date(mmlddlyyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding ❑ paving El wetting ❑ shrouding b. If other, please specify: ❑✓ covering ❑ other 9. For Emergency Demolition Operations,who is the DEP official who evaluated the emergency?. a.Name of DEP Official b.Title c.Date mm/dd/ of Authorization d.DER Waiver Number D. Certification I certify that I have examined the PAUL MORGAN �o above and that to the best of my a.Print Name o knowledge it is true and complete. The signature below subjects the b.Authorized signature �N signer to the general statutes �o regarding a false and misleading c. Position/I Me �o statement(s). HOME WORKS d.Representing e.Date(mm/dd/yyyy) �O �Q I ■ ag06.doc•10/02 l3WP AQ 06•Page 3 of 3■ Massachusetts Department of Environmental Protection __ Bureau of Waste Prevention•Air Quality 000074465 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition General B. General Project Description (cont. Statement:If asbestos is found during a 4. .General Contractor: Construction or Demolition IHOME WORKS operation,all responsible parties a.Name must comply with 16 WOODPECKER VALLEY 310 CMR 7.00, b.Address and Chapter 21 E of the WEST CHATHAM MA 02669 Cha General Laws of c.Ci /Town d.State e.Zip Code the Commonwealth. (508)740-4729 but would not This would o , f.Tele hone Number area code and extension .E-mail Address(optional) t b be e limited to,filing an JPAUL MORGAN r, 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. HOME WORKS a.Name 6 WOODPECKER VALLEY b.Address WEST CHATHAM MA 02669 c.City/Town d.State e.Zip Code (508)740-4729 f.Telephone Number area code and extension .E-mail Address o tional PAUL MORGAN h.On-site Manager Name 2. On-Site Supervisor, PAULMORGAN On-Site Supervisor Name 3. Is the entire facility to be demolished? ® Yes ✓J No _N 4. Describe the area(s)to be demolished: �° N �° -O 5. If this is a construction project, describe the building(s)or addition(s)to be constructed: TWO WALLS TO CREATE A OFFICE _o �o �a ag06.doc•10/02 BWP AQ 06•Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Waste Prevention .Air Quality 1100074465 BWP AQ 06 Decal Number Notification,Prior to Construction or Demolition Important: A. Applicability When filling out pp ty 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 ❑✓ No 1.All sections of b. Provide blanket decal number if applicable: this form must be Blanket Decal Number completed in order 2 Facili Information: to comply with the ty Department of. FOUNTAIN OF LIFE CHURCH CHRISTIAN COMMUNITY M Environmental ( ) Protection a.Name notification 177 HIGH SCHOOL ROAD requirements of b.Address 310 CMR 7.09 H annis MA 02601 c.Ci /T wn d.State e.Zip Code (508)771-4455 i 1prcarlos@comcast.net f.Tele hone Number area code and extension E-mail Address(optional) 2,500 1 h.Size of Facility in Square Feet i.Number of Floors j.Was the facility built prior to 1980? ❑ Yes ❑✓ No k. Describe the current or prior use of the facility: CHURCH SERVICE I. Is the facility a residential facility? ❑ Yes ❑✓ No W�_0 m. If yes, how many units? Number of Units 3. Facility Owner: �N 259 NORTH STREET o a.Name . �0 77 HIGH SCHOOL ROAD b.Address HYANNIS rA 02601 co c.Citvrrown d.State e.Zip Code o (508)775-9316 f.Telephone Number(area code and e nsion .E-mail Addres o tional , ..��a LARRY PUSHOR Q h.Onsite Manager Name ag06.doc•10/02 BWP AQ 06-Pagel of 3 l i Assessor's m?p and lot number .................. a��.6...1�./t, T2,u ,tom w�< Al JL. � GOG4-car° 1��~ y�FTNET�� ?�^'�9e Permit number .......�...G��EP.......�/l�.Y.......U �'�.w Ii BAR33TAME i House number .....�.7,7... rx...............:. ' Maas 1 �p i63q. 9� r; TOWN OF BARNSTABLE ' BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..r.. ... .. .!....... ..... ........................... . ....... ........ TYPE OF CONSTRUCTION ........4 1.1P..................19.4py TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a (permit according to the following information: Location .......7;7.......... r�l..... C(7.f1 /... `�....... ......... ............................................ ProposedUse .......... ............................................................... ......../......................................................... Zoning. District ....................> s .............................................Fire District ..... 1€: ..1............................................ Name of Owner ..... yl. ...... il ?. .!".....................Address .a� .... `f 4!.4........ a�Grv. / ... Name of Builder .... C4.01 lF.�.�?.fd��,'. a..... .3..Address .J�t?4?:=jwf.",.....L?......���L:Y.!!��:�.�................ Name of Architect ., 1.. . ' ..q.,.....CA.!..!l...................Address .:71..�....1,&Q..!..."�l ..../..����i�.�..�............ Number of Rooms ....2-C. ..........Foundation .....f....<.:a.C.X7.i...... vt.kb ............................. Exierior .... 7-IC.V./..........Roofing ....... .7—T-A/............................................................ Floors ?. .x .... ...... Ay.. �Y^G ..........................Interior Heating .... ?. .../ t.. .......0i.-a—SL............................Plumbing .................................................................................. Fireplace ...... . ................ . ..................................................Approximate Cost .r., ::��, . C7e... .............................. Definitive Plan Approved by Planning Board ________________________________19________. Area .......................................... Diagram of Lot and Building with Dimensions Feed� . / ............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. cName .iaZz... .................... Construction Supervisor's License ....... RAYBURN GENE 26829' Remodel Rink to No ............. Permit for .................................... J' Office Space/ Offices .._�• •...•••.... . .• .. ...... 77 High School RoadExt. Location ........ .................................................... i✓' ................... Iyann : ........... '........ ... ...... f: c Owner Gene..Rayburn S� dame e Type of Construction .......................................... Plot ............................ Lot ....................7.• .......... August 9, - _ 84 Permit Granted ' 19 E Date of Inspection ......1.9 l �Z� :.......... �Date Completed .. . .. ..... �.....:19� _72 � . I � r r TOWN OF BARNSTABLE 268'L9 Permit No. ------------------------------- a` 1 Building inspector SAU77� Cash OCCUPANCY PERMIT Bond __—---_-------- Issued to C. Rayburn Address 77 Hieh School Road Ext. , Hyannis Wiring Inspector_,__' Inspection date Plumbing Inspector "`�-�� Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 11, / 19 ............................. ' .` ................:.................................... �� ��Building Inspector TOWN OF BARNSTABLE SIGN PERMIT I PAIRCEL ID 309 266 GEOBASE ID 22567 ADDRESS 77 HIGH SCHOOL ROAD EXT PHONE HYANNIS ZIP i ;' ` LOT 1 & 2B BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT; 64116 DESCRIPTION 30 SQ SIGN IGREJA FONTS DA VIDA PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of ARCHITECTS: P TOTAL FEES: $50.00 Regulatory Services BOND $-00 �tNE CONSTRUCTION COSTS $.00. 753 MISC. NOT CODED ELSEWHERE 1 PRIVATE R * BARNSTABLE, MASS. 16g9. BUI4D�N- BY IVISIO DATE ISSUED 05/13/2005 EXPIRATION DATE --— Town of Barnstable , �IME r, Regulatory Services Thomas F.Geiler,Director * BARNSTABM 9 MASS. g Building Division i0rfp ,t a Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 -Fax: 508=790-6230 Permit# Application for Sign Permit Applicant: �-uWl lld�l7��^ UPS Assessors No. Doing Business As: '. �< U CbM OWN AV Telephone No. E(�9(-R 6a 3 3 Sign Location f Street/Road: Zoning District: Old Kings Highway? Yes/No Hyannis Historic District? Yes/No Property Owner Name: J"-iX)A y—T— -F�,PQ-xlM<� Telephone: 50 _7:�7`j Address: 201r� 1404A ST_ Village: D.fl —0 r� G Sign Contractor Name: 5e-L�P RNOAaS Telephone: Mailing Address: �V �` `-'H1 , O Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions,location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Yesl(NOte:If yes, a wiring permit is required) Width of building face 1)?ft.x 10= I) O x.10= � I hereby certify that I am the owner or that I have the authority of the owner to make this application,that the information is correct and that the use and construction shall conform to the provisions of§240-59 through§240-89 of the Town of Barnstable Zoning Ordinance. } Signature of Own /Authorized AgenA Date: a Size: Permit Fee: Sign Permit was approved: Disapproved: Signature of Building Official:_ - :4 Q:I WPFILESI SIGIJSI SIGNAPP.DOC �T - gq ��t 1 { t. + t - `e TOWN OF BARNSTABi+E CERTIFICATE OF OCCUPANCY PARCEL 1D 309 266 GEOBASE ID 22567 ADDRESS 77 HICK ;SCHOOL ROAD EXT PHONE HYANNIS ZIP - LOT -r't% 1 & 2B BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 31545 DESCRIPTION CAREER CENTER -(RENOVATIONS) PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: ", }. and Environmental Services TOTAL- FEES: BOND V 00 THE CONSTRUCTION COSTS' $.00 756 CERTIFICATE OF OCCUPANCY +s BARNSTABLF, •MAAt 83.-" E A BUILDn' DIVISI DATE ISSUED 06/12/1998 EXPIRATION DATE ARC 94—rC 309 GEC.►BA"E 6 f 7 Alli}RES8 77 if fGH:SCHOOL ROAD EX`i" r." .� ; � PHONE HYANNIS .I►T 1 & 2B BLOCt. �' (; fyC c fE ;9q. fa r ! gVNLOPMENT I7IS'i`RIC'I' F}Y -- r .: '.M UI 24804 Du'3�7 1I 1'3.'I ON CAREER CENTER - STATF. ( RENOVA'I'}.ON:WADD t T 100 4IRMiT TYPE BREMOD(E T3.`.i'LE W�14MRCl'AI,. Ar.,.T/C0NV MIC;?}:AEL ' Department of Health, Safety "M jl:r,`I and Environmental Services IME $.00 { t i. 1'jCT'Arr� U COSTS a�T�"�3�'��ti1"��+s•7"'�/� d i�rLiu e � �Q ir(UNttL+',' PR1V1T':3 E HARNSTABLF, # MAS& 1639. t;It 2'5,9, L U11TE0 PA'R7.4E .9 0TRk,,Fi`J" BUILDING DIVISION tr.`�l•�d}i++ : rig BY �'I' E't THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY;NOT 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 RESTRICTIONS. . MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED`UNTIL FIN FOR AL INSPECTION PERMITS ARE REQUIRED 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND M FOR (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. CH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS , \ `'+may 1�` �..// ry � _ ✓-��f L •'i,' �� � {/ 2 IYL j j'� f r,�I : 2 .-FI VIA 2 y s vie tr �� I 1 HEATING INSPECTION APPROVALS k v fNGINE,ERINEDEPAR 2`. BOARD 42 OTHER: SITE PLAN REVIEW APPROVAL Alf, �F WORK SHALL NOT-PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON= INSPECTIONS INDICATED ON THIS THE INSPECTOR HASAPPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN SIX _CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. d ,. lb i._i6. . •._,r ,. i fr w_ -i i " 1; I . w +yam a , . x'r jh ytIr " I I I i BAMSTABIX MAM F�A'`� The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner June 15, 1998 Stuart Bornstein The Bornstein Companies 297 North Street Hyannis, MA 02601 Re: INFORMAL Parking Lot, 77 High School Road Ext, Hyannis (309/266) Proposal: Parking Lot. Dear Mr. Bornstein, As per our conversation of today, this serves as a follow up to the rear parking lot requirements set forth at the Site Plan Review meeting of October 16, 1997. • The back"overflow" parking lot spaces must be delineated. Lime is adequate as well as concrete curbstops. Two HP spaces, (#35 and#36) must also be delineated with signage. (See foBowingpage forinformadon). Parking space surface can be paved or hard packed smooth surface. Should you have any questions, please feel free to call. Respectfully, Ralph Crossen Building Commissioner ,//Engineeriri' 'Dept. (3rd floor) Map _ Parcel Permit# �2 House# — �] '� Pis Date Issued R 11?A eI ealt P8:1 -9d30 71:OU-4:30) 1�� -Pdl 'Fee Conservation Office.(4th floor)(8:30-9:30/1:00-2:00) , Planning Dept.(1st floor/School Admin. Bldg.) ofn+E Definitive PI roved by Planning Board f "_ 19 ; ;�,a• • BARNSTABLE. a7 TOWN OF BARNSTABLE Building Permit Application Projec treet dress Village lei Owner -,S Address Telephone Permit Request 7-bi-A ri � u First Floor square feet Second Floor square feet ✓ Co -ruction Type stimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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 No.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 - Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) J ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use Builder Information ame 26 ,6e'15 Telephone Number -,<icense# OY3 'F—G f ww e / Mot_ D 30- Home Improvement Contractor# /Cl w -� Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE BUILDING PERM DENIED FOTHE F OWING REASON(S) + . R FOR OFFICIAL USE ONLY 'PERMIT NO. � � 7 DATE ISSUED ' MAP/PARCEL NO. ADDRESS VILLAGE '*OWNER DATE OF INSPECTION: t FOUNDATION FRAME ZZ gZ-- INSULATION " FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING j5-`1 OZ 1^ i T~' u A,cvy DATE CLOSED OUT ASSOCIATION PLAN NO. THE ray,. + BAMSPABIZ o 9�p ' ,.� i The Town of Barnstable rEo �a Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner October 20, 1997 Stuart Bornstein Holly Management 297 North Street Hyannis MA 02601 Re: INFORMAL 00144-97 Parking Lot, 77 High School Road Ext., Hyannis (309/266) Proposal: Parking lot. Dear Mr. Bornstein, The above referenced proposal was reviewed informally at the Site Plan Review meeting of October 16, 1997 and approved under Section 4-7.4 (2) of the Barnstable Zoning Ordinance with the following conditions: • Lot must be illuminated, • 6 trees must be planted (min. 2 inch caliper), • the 35th and 36th parking spaces at the rear of the building must be HP spaces. Please be informed that a building permit is necessary prior to any construction. Upon completion of all work, the letter of certification required by Section 4-7.8 (7) of the Town of Barnstable Zoning Ordinances must be submitted. Also, all signage must be discussed with Gloria Urenas of this Division. Should you have any questions, please feel free to call. Respectfully, Ralph Crossen. Building Commissioner Ig „h HOLLY MANAGEMENT & SUPPLY CORPORATION 297 North Street Hyannis, Massachusetts 02601 (508) 775-9316 FAX (508) 775-6526 ' September 15, 1997 Ralph M. Crossen, Building Commissioner Town of Barnstable Hyannis, MA 02601 Re : 77 High School Road Permit No. 24894 Dear Mr. Crossen: I am requesting an Application to Modify the referenced permit . The modification is to extend the front of the building to 12 ' X 178' for a total square footage of 2, 136 . This modification will not alter the parking as it currently exists . iaSt . s rts, forimited Partnership T� �F � LST E SUI1400 DEPT. MJR: jk p SEP 15 1997 r 4 CONSTRUCTION CONTROL PROJECT NAME: Addition in front of Building PROJECT OWNER: 259 North Street L.P. PROJECT LOCATION: 77 High School Road Extension ARCHITECT: David A. Farmer at King Des•ic n Associates, Inc. , 10 High St. , Medford, MA IN ACCORDANCE WITH SECTION 116.0 OF THE MASSACHUSETTS STATE BUILDING CODE, SIXTH EDITION,I. David A. Farmer REGISTRATION NO. 8333 BEING A REGISTERED PROFESSIONAL ARCHITECT/ENGINEER HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT ARCHITECTURAL XX STRUCTURAL,_MECHANICAL FIRE PROTECTION ELECTRICAL OTHER(Specify) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF KNOWLEDGE,SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2: 1. Review,for conformance to the design concept,shop drawings,samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled material. 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,in general,if,the work is being performed in a manner consistent with the construction documents. PURSUANT TO SECTION 116.4.,1 SHALL SUBMIT PERIODICALLY A P:OGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE Barnstable BUILDING COMMISSIONER. UPON COMPLETION OF THE WORK,I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. TOWN OF BARNSTABLE BUILDING DEPT. ivo. CONCORD, W w 2ECEI �rNOF* �1 SIGNATURE SUBSCRIBED AND SWO TO BEFOREIME THIS 15thDAY OF September 1997 Jeffrey P. King ' P April 1, 1999 NOTARY PUBLIC MY COMMISSION EXPIRES Y ! .. �: t�' ..... ., __✓1tC VO'17UI➢204ZCl/PQGU2 O�✓I�GCIddG�LCIQG'L[6� - -, DEPARTMENT OF PUBLIC SAFETY i CONSTRUCTION SUPERVISOR LICENSE Nu®ber,'-w,:M', :r Expires: Restricted To.., r`00 •+.r x MICHAEL J ROBERTS 16 HARBOR HILL OR I - "BOURNE, MA 02532 . 7 f✓IE6G� aEt[Qeab HOME IMPROVEMENT CONTRACTOR ' rFrRegistrat�ion 101119 � , TYPe �IHDIVIDUAL HST �. #4-yg"Ixpiration 06/25%98 �F}� '«kMICHAEL ROBERTSYgi "� t xY ` £ ,.Michael J y Roberts Habor. iTI Dr ADMINISTRATOR � � Bourne MA 02532 � - t Department of IndustrialAccidents � — 0197Caallo�stlp��s • . 600 Washington Street Boston,Massa o2111 . ` Workers' Compensation Insurance Affidavit ton- 1.�..d.::�if Si....•. name: location: city phone# ❑ I am a homeowner performing all work myself. ❑ I am a soie proprietor and have no one working in any capacity EZ I am an employer providing workers' compensation for my employees working on this job. comoanv name- strFrieln tyArrnC3=rrr.:<.;::.:;: :;�:> :.•::•:::::>.:.: ::.::.. : ........::.;... address: ::. ... . .... city: :.. yALS ` MA"r;`.`' 26(f `':s:.,;::>i:.. ;:;'. r :' hone f#-;. .,.f {}8')'';775-9316 :.. ,..:: . THE LE .. .. . - insurance co: ••eoiter# 6N• �� B34J��5`44 95 .. ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who hav the following workers' compensation polictx: company name: ;::::::•.,::. address: city- n �`ohonc 114;• .. insurance co. - eolicr# company name: _ address: .... city: nhonc#- • • osier#• •SCttac •a 1$ona' i3Tnecrssuv^ _- Failure to secure coverage as required under Section ZSA of MGL 152 can toad to the imposition of eriminsi penalties of a fine up to SI.500.00 and/oi one.•cars'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine ofS100.00 a day against me. I understand chat copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature Datc 10/27/95 Print name STQ A. BORNSTEIN Phone# (508) 775-9316 official use oniv do not write in this area to be completed by city or town official T ciry or town: permit/lleense# f•1t3uildint Department OLicenstnG Board (]check if immediate response is required C3Selectmen's 0Mce C31lc21th Department contact person: phone it: f"iOther -,"t,ea 1'11 PIAi . 08/06/1997 19:58 5087789628 A B CANCO PAGE 01 HYANNIS FIRE DEPARTMENT-FIRE PREVENTION BUREAU APPLICATION FOR PERMIT APPLICATION DATE: PERMIT NUMBER: STREET ADDRESS: -- �� PROJECT: ,v r•� ti �.•�. �"T"L��Wes{ _. r REQUEST FOR PERMISSION TO: ��, ti4<�� ck t, APPLICANT'S BUSINESS: szj ��� BUSINESS ADDRESS: 3 (1k�; ��' �. APPLICANTS > APPLICANT'S FAX: LICENSE TYPE: LICENSE NUMpER: • i LICENSI:EXPIRES: APPLICANT'S NAME: .� SIGNATU GENERALCONTRACTOR (,( JOB PHONE: °f- S`S' JQB FAX: 7��J�. INSTALLER'S NAME: �� i� (� BEEPER DETAIL REQUIRED: FEE PAID: EXPIRES: RESTRICTIONS: i REQUIREMENTS: i PLANS HL� i t Engineering Dept. (3rd floor) Map �.30 9 Parcel 064 Permit 7 House# '7 ate Issued q Board of Health(3rd floor)(8:15 -9:30/1:00-4:36) Fee _ f Conservation Office(4th floor)(8:30-9:30/1:00-2:00) - X10EL57 Planning Dept.(1st floor/School Admin. Bldg.) f Definiti Ian pproved by Planning Board 19 BARNSTABLE. TOWN OF BARNSTABLE, 'F°"��' Building Permit Ap lication rol t Street Address L illage Owner c qs--g n 6 e7 s/t ,-j L Address -_-- 9 7 A✓o e j1. S T ;Telephone 'Permit Request 4d,*-,t dCX r—X 2 y _J First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size a Grandfathered ❑Yes ❑No 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 No. 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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) r ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial e6Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name / /l4� /J�it;�3 Telephone Number 7?"s S3 Address 02ys' Sl 2) License# 0-5-2dp&/ 4 ,V rS. Home Improvement Contractor# //77 <-' Ov2!p / Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PER IT DENIED FOR THE FOLLO ING REASON(S) r t i, FOR OFFICIAL USE ONLY Ld 7 PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE 1' OWNER t - i DATE OF INSPECTION:' f , FOUNDATION r � { f FRAME _ b INSULATION FIREPLACE ELECTRICAL_ :, ROUGH FINAL F PLUMBING: ROUGH FINAL GAS: ROUGH FINAL - F FINAL BUILDING DATE CLOSED OUT - ASSOCIATION PLAN NO. ' L ✓fie �oanrmta�turPa a�./�¢aocacfivaells DEPARIHENI OF PUBLIC SAFETY CONSTRUCTION:SUPERVISOR LICENSE Kuhr Expires Restricted TO 00 HICHAEL J ROBERTS 16 HARBOR HILL OR BOURNE, HA 02532 1 0� R 65.6 Department of Industrird Accidents t 600 Washington Street Boston,Massa 02111 y Workers' Compensation Insurance Affidavit nammc: location: cin' nhonc if ❑ 1 am a homeowner performing all work myself. ❑ I am a.sole proprietor and have no one working in any capacity Ez I am an employer providing workers' compensation for my employees working on this job. comoanv name: SUFFILLD ME` MANAGENT::.:: ;. :..:..... ..... . ....... ....::;:... :.:.: .......... ...... .. address: T. NORTH ST flYANNIS, MA ' i}26G ., city: ::;::. . :.::.::,.:.. .:::....:.. ':•:..- :pltonci# f013')'`775�9316_ .. ::.. ... insuranCC co: TH TRnvEr.>;xS . ;;< :::::':..` neiicy#'' N.:U45.1.. . �3'4J544-95 ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who hav the following workers' compensation polices: company name: :::.:::•.:::. address: ..... taty: "nhonc# ..::, ..:. .....;v::.......... :. insurance ca. •...:,.. . :•• volley company name- _ address- ,: .. .. CRY* phone#: insurance cn_ ... . noii[Y'#... ....>,.. .•.. Attach-ac aifiona -s e�et31'>reeessarv_. - Failure to secure coverage as required under Section Z5A of MGL 152 can lead to the imposition of criminal penalties of a fine up to SI.500.00 and/o, one.cars'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of SI00.00 a day against me. I understand that copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature Date 10/27/95 Print name STU A. 'BORNSTEIN Phone# (508) 775-9316 i= official use only do not write in this area to be compieted by city or town ofnciat T r city or town: permit/lleense 0 Cifluildin¢Department L, C3Ucensmg Board check it immediate response is required C3,cicctmcn's 0Mcc C311ealth Department contact person: phone is; r'I'Uthcr �[ �1 11�'!1!!�.RI1•�ITI'.!!la71��l�f 1'11 PIA i 7/12/02 Unemployment • • a� ,.e pp - __-- - .� —••• Ir1ViM1arnQ Y ul.dli Yi�Il�_ rt '_ �. � rtt}{d xrrn•"�.'„;;>ea"w'.iiimi�.+7+.cn�� '^°'"" ., �1�mrs'w<rr�:rssv w.®s �,,,,,«, - ., .�ii it :� � � 'awrsaraa 3J gi' n ➢pm.nLnm �y��a°�r,+F ly .`. _ _._... ,�nm_ gu.�A'Pt..,,. .FW[vWw. � � y yyal AJw ii11lYM y,+n w+�.:ur.lw�r i^� JT6G lw.w+t w✓Ntaa L� II �I I`I � T fly �a.PCL'�' �..c � a�l" dl�.r.n. +w.. �r'''°,�y,� nai � =r'•.w] 3 r l' � � r'°`ur" IAIIIII�PIIII. w•u,,dc . ��� i vr..s.+�"w ►,x,. .ec..s..a r � t�� � �y Haas - ��„_ ' •yy na5t I.YMYn '?X'X �f.� ' 1 i Y�{ Yf qA.1� k - !dk , "., xulsfixal� s pa"ai � ","""'_._ � �' ' Waxa�+�..4 T� r�;.�n i�3r'�."—'. ,.,, �-�r�ra.a`':»;n r�•'�', z�, ,rA►�, ,. ! AAw - a _ 1 , m 1 i , , + , .f P. Y1 ,. i,. 1.• - •4 •^ S "�"s S �, a Nil _:� Si'7�7,"�,�.,�,"K. t ',F•yq,°4`� �..r,�'J,�,.ye,r'�'�"""Z�' 4�� � ..-` hi�}'` ";'")�a.. , re, 1i S> w � ..az._.$.,r .v .,�x„-.r.:,: Unemployment Building, 77 High School Rd., Hy 7/12/02 r x- I � eYYw t `- 4 � N174 %.V� p'a.«, 4"3 " "yR'� k^r } ON 5t grlL G _yRL _�� . ? �4 . :� � ,.F p �&�,�r��o it R' `•��'y !!x-,�''9 ��.y �:�� � a �,p��'� a• f �r � �f4k 7. q. S_, 7/12/02 f ` f y, r _ k xy►. to�� r:ix,{ g: _- � : Y u • y , r• a ,Y a � m _ r r _ e, Zo ty rtiJ^'--4ix' ' s� o�� xr #'� 9� � ��;f� r� x��"�A � " w -.t,�•-. cf- ems"- 41 ��.y K �y .5 7, _,My f"w'✓` .b'f � s� r3, �'1q� wx � r Q° A�y y yy, } � �yd � -•� d. � rfi._ _-y , "?.7 h,�,�i�s •��.. �> ^ 3 d`�-:' - ti z'��� `tE` � :r The Town of Barnstable Barnstable Office of the Town Manager [ 367 Main Street, Hyannis MA 02601 w,wnenca; BARNSTABM : www.town.barnstable.maxs Office: 508 862-4610 Fax: 508 790 6226 MASS. ,.�� APPLICATION FORM 2007 USE OF PROPERTY,PARADES,MARATHONS,TRIATHLONS,ROAD RACES The approved application must be on file in the Town Manager's Office at least thirty(30)days.prior to event. Parade/Road Race applications must be received nine 90 days prior to scheduled date. Date of application: Fee amount: $43.00 per request*:Total paid: YES(ck# OR cash) NO *Each request means each event such as a parade,followed by an event on the Town Green,for example. This application must be complete/all signatures prior to submitting to the Town Manager for final approval. You may be required to leave application at various Departments'to wait for appropriate signature. 1. CALL TOWN MANAER'S OFFICE TO TENTATIVELY RESERVE DATE OF EVENT-CHECK AVAILABILITY Request for: Hyannis Village Green Aselton Park Parade Benefit Run/Walk Marathon/Triathlon Other(please specify): Certain facilities may require additional fees for services by DPW depending on location,use of staff&size of event The fees will be determined by DPW and paid directly to that department 2. Name of Event: Day/Date of Event: V SZQ ClRain date: 3. Name of Sponsoring Organization: Mailing and physical address: 7:t 4. Contact person: 6 !CU:S Phone: „ 7 5. Person in charge DAY OF EVENT: ,_/��//i/W-Cell phone: r fl-IIL/ 7 J--4 jDJP 6. Set u time: event start and end time:p Clean up time: 7. Estimated number of volunteers/participants: Estimated number of spectators: A 0 >>POLICE DEPT will determine if extra detail necessary. 8. Admission fee/registration charged to participants?--(�O) If yes: Amount: Will there be food or craft vendors at event? Yes —A % »If yes,indicate the number of vendors and type(food/merchandise/etc): >>Will there be merchandise.available for.sale? Yes _,�No N/A Vendors need to complete application for special licenses at the Licensing Division-200 Main Street,Hyannis. 9. Map attached(REQUIRED)for road race/parade event. >>Are street closures required`. Yes .//No >>Detail of route and rest stops attached/indicated on map. 10. Food prepared/served at event? _Yes ./No »If yes,will there be cooking/heating involved? Yes No n 1 TENTS REQUIRE ADDITIONAL PERMIT FROM BLDG DEPT. Structures&Grounds have designated tent friendly zones. Should you require tent elsewhere other than these zones,location needs to first be cleared with Structures&Grounds. >>No open flames in tents or propane storage use without a fire permit. 11. Are you installing or constructing any structures,including buildings,climbing structures,etc? _Yes /XNo 12. Are you installing any tents or canopies? _Yes l No Quantity and size: Own or rent? Rental company: Tel# 13. Do you plan to have any sound amplification? /Yes No_ usic ^Other(please describe) 14. Is electrical power required? Yes No (for sound amplification(PA system),lighting,popcorn machine,etc) >>If yes,circle: will you provide portable generator? OR will you require TOB temporary service? >>List maximum wattage required.and location for hook-up: If more than'usual'hookups,please note there will be overtime costs if Town Electrician setting up and removing "A-frame"or dropping service before/after event outside of business hours. BARRIERS. 15.Do you have need for barricades/cones? Yes ,I No >>If yes,describe for what use: DEPOSITS: $5.00 each cone. $50.00 each/barricades(quantities/deposits arranged through DPW). . 16.Will you require access to the town building? Yes No >>If yes,describe for what use: 17.Do you plan to drive vehicles onto property? If yes,provide details: Specific loading zones to be reviewed with DPW/Structures&Grounds. Organization will be liable for any damages vehicles may cause the ground. 11ORTABLEIT01 LETS AND HAND WASHING SINKS 18. Do you plan to provide portable toilets and/or hand washing sinks at your event? Yes_No >>If yes: #of regular toilets #of handicap accessible toilets #of hand washing sinks Public Comfort Stations located at Town Hall Parking Lot,North Street and Barnstable Village Fire Station are open from 9AM to 9PM,daily. If event absolutely requires early open,it must be reviewed with DPW. GAIZBAGEAND,REC-)'CLINGSERVICES� ::'. , 19. Trash pick up is the responsibility of the organization requesting this permit Please provide your plan for the cleanup and removal of garbage and recyclables during and after your event: Number of recycling containers: Number of garbage receptacles: A one time disposal fee for use of Town containers may be assessed. Any fee will be determined and collected by DPW. The cost is based on size of event 20.Will there be demos,displays,materials that are potentially hazardous/impact public safety?_Yes_No >>If yes,describe: 21.Have you made any provision for on-site security? _Yes_No 22.Have you made any provision for on-site medical services? Yes No 23.Please provide description of your parking plans(where event attendees will park): >>Plans for disabled parking: >>Plan for emergency vehicle access: >>Please describe your plans to notify residents,businesses impacted by this event: 24.Will the event be advertised? If yes,where: >>Do you plan to distribute flyers or ads before or during this event? Yes /No / >>Do you plan to place any signs or banners or other advertisement at the event site? _Yes No >>If yes,please indicate where: >>Provide signibanner detail and dimensions and method of attachment or support: (Signage may require additional permits). 1 I have read, understand and agree to abide by each numbered item on the attached "Rules and Regulations for Use of Village Green and other Town Property" -H "Rules and Regulations for Parades, Walkathons, Road Races" and e�agent for t e s on ring organization, agree to abide by said rules and any others eci loco di inns lett rs ma�} e attached) established for this particular event. Signature sponso ing agent/Dat Printed Na e: P�,+l�✓�C,� APPROVED BY 41 CHIEF OF POLICE(��(7--/ DATE: Z u� (Barnstable Police Department, 0='sLane, nis 508-77 -3805) CHIEF OF FIRE DEPT(S) DATE: Z- _ �(� (Village Fire Department,Addresses v ) RECREATION DATE: (Hyannis Youth&Community Center, 141 Basset Lane,Hyannis 508-790-6345) PUBLIC WORKS DATE: (School Admin Bldg,230 South Street,41 Floor 508-862-4090) REGULATORY SERVICES DATE: (200 Main Street,Hyannis 508-862-4674) -TBOARD OF HEALTH A ' �(� DATE: 2 ?� (N/A for Parade/Race permits uy reo serving . 5 8-86 4644) BUILDING DEPT DATE: /2-7 la 91 (N/A for Parade/Race permits unless erecting tents. - =4038) TOWN MANAGER DATE: (Town Hall,367 Main Street,2,dfloor,Hyannis 508-862-4610) SPECIAL CONDITIONS and ANY FEES(As determined by Department's above) . DETAILED AS FOLLOWS: A) PHILBROOK I I ENGINEERING FIELD REPORTMORKSHEE� Project No:156 MAIN �� �t YARMOUTHTREET Sheet NO Of PORT,MASS.02675 1- L 1-50&962-9577 : MEMO FOR RECORD : 1 October 1991 Subject : Installation of Dbl-Hung Windows ` Locat. .an: 77 Hiah School Road Ext . Hvannis . 1'M Weather : na Project !,To : P91-47 " Contractor : Mr . Peter Kelley DESIGN/rONSTRUCTION REVIEW CRITERIA: 1 . In acccmplishing the proposed structural chages the fol- °�� loTrTincr additional work requirements need to be implemented : a . All block cutting will be by saw. Do not lack_�-,e.r.ner or pound surrounding areas . Once that port.i t t on o_ h-= in- fill tTall is isolated from the structure normal tion can be carried out . b.. Block off the first 2 courses of lintel bearing_ block and ® f solid fill the vilaster cores w/ grout. The iirit�:l must b=ar at least 6" bevond the rouah c1ne - ® Z ing at each end . d. Lintel size : 3"x 3"x 3/16" e . The block lintel will need temporary shorina until non- shrink grout can be tucked into the open end joints . 2 . Upon completion of the exterior work a good concrete sealant should be applied around the opening to close any hairlin cracks . 3 . Th_ _:Dllowing should be monitored during_ the work nrcc� ss . It is assumed that the block wall is an in-fill wall anc+ not load-bearing. This is based upon the -regular layout of the exiStinq Steel frame . Should excessive deflection or cracking occur in the lintel .or the supported maso.nry , work. is to be secured until a further investigation can be done . 4 . Dead leads for the block wall assembly are as folloT"Tc : w o Hollow Core Block - 55 lb/sq ft. 3" anale - 115 lb/lf C (d) _ . 9 for Long-t_rm Dead Load Re:sl net ctfu11v submitted . T. VARNUM PHILBROOK . P .E; . P82 FRW 7 COMMONWEALTH DEPARTMENT OF PUBUC SAFETY f 1010 COMMONWEALTH AVE. OF BOSTON,MASS.02215 '� f MASSACHUSETTS ENCLOSE CHECK OR MONEY ORDER LICENSE EXPIRATION DATE CONSTR. SUPERVISOR FOR REQUIRED FEE, I MADE PAYABLE TO � fl 6/3 fl!1 9 93 EFFECTIVE DATE LIC-NO. RESTRICTIONS "COMMISSIONER OF PUBLIC SAFETY" NONE . 0' 06/30/1 991 015044 PETER E KELLY c �r( oNor�S�ND CASH) 93 PHEASANT WAY � CENTERVIl L BRA 02632 PL EASE NOTE FEE INCREASE -- PHOTO(BLASTING ORR ONLY) FEE: Lf 1941 100. 00 E f FECTIVE FEE. 1 , 1989 r VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: I+ST RED-OP. -SIGNATURE OF THE COMMISSIONER D �NCT DETAtN LICENSE STUB + THIS DOCUMENT MUST UE IGNATURE OF LICENSEE SIGN NAME IN FULL-ABOVE SIGNATURE LINE CARRIED ON THE PERSON OF ( A, 14 :? THE HOLDER WHEN ENGAG `/ f �} ,r2,i14/,yOMMISSIONER OTHERS -RIGHT THUMB PRINT ED IN THIS OCCUPATION 200M.2-87.81429 a a . 0 Assessor's office(1 st.Floor): Assessor's map and-lot number 2/�.i,e.C_:� { of THE To Board of Health (3rd floor): ' l �p j 'MUST CONNECT TO TOWN SEWER Sewa of Permit number / �r� / f i i f t DAD.l9TODLL Engineering Department(3rd floor): �J� r,ua House number + -� ' ` i °o 3639 Definitive Plan Approved by Planning Board r: 19 ' �0 r1,r A, 4 APPLICATIONS PROCESSED 8:30-9:30 A.M.'and 1:00-2:00 P.M.only ' Ad P P;R 0 V TOWN OF ' BARNSTABLE LarnstablulCenservation commission L D I NG INSPECTOR ECTOR S CATION FOR PERMIR46 kcN Q®w-,Z> ` TYPE OF CONSTRUCTION TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information J Location e\f\_NCB` © Proposed Use aJ�l�J(Ne�`p Zoning District Fire District 'R0� Name of Owner &Ric ���h (Zn Address W 'nn 0 , Name of Builder C' GTE R, Y16k Address Name of Architect V °D � n Address Number of Rooms n ) Foundation Exterior i���L Roofing Floors 0b��-� Interior Heating Tea®� Plumbing Fireplace n Approximate Cost Area Diagram of Lot and Building with Dimensions Fee /toa r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of BarnstablKVgarding the above construction. Name Construction Supervisor's License ® I '1 RAYBURN, GENE No 34609 'Permit For' AID WINDOWS Commercial ,1 r. Location 77 Hiah School 1 't, s Hyannis ' r Gerie Ra t Owner ,b.urn�_ r Type of Construction, Frame -.. -t - ;^ ".,, i1. ii r.. t ice•*^. l r �t S_ ' Plot s r Lot r• 9 � G . eti.P (L.i � ` � t �.' `� ' ' '•J r Permit Granted' October 3r; At 91 Date of Inspection) 119 o Date Completed 7' .19 •' '� ram. V -• � ' --S ,/-�• - _ L - f�: ;»N. � � t�i G—�-• ';� �t [ .,y � dam, a fM r. 3 •j '`, � 1, � +�J� � �t L�it '� r: t ^ _ i . `J„�•'"` .e TOWN OF BARNSTABLE 22361 Permit No. _____---_--- -_ t Building Inspector cash _ 5600.00 rua OCCUPANCY PERMIT Bona No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Pro-Skate Limited Address High School Road Extension Hyannis Wiring Inspector _ Inspection date Plumbing Inspe r Inspection date Gas Inspector Inspection date Wrigineering Department /^ ! Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ........................................__.�, 19_.......... ....... .. ..... ..................l.. �B I Insp etor ,�•""'. TOWN OF BARNSTABLB Permit No. ------------------ t ,ten Building Inspector cash _�it)tl=i;� rua - OCCUPANCY PERMIT Bond "No building nor structure shall be,erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." 1 ` Issued to Pro—Skate Lii-aited Address Pi-vh Scybool Poa t Extension_ Pvanni.q Wiring Inspector ,` -� Inspection date, i Plumbing Inspector ' l ,/ Inspection date Gas Inspector Inspection date ,Engineering Department - Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. r � i ........................_.........................._, ................... Building Inspector r . TOWN OF BARNSTABLE Permit No. ________- t Building Inspector LEl]T.YL Y..A Cash - - -- —- OCCUPANCY PERMIT Bond. No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address '� (. _ is � . '�� •--- —; Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering.Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ...................................._................, 19... ..................................... . ......................._.„......._........._ .. ....... Building Inspector TO r TOWN OF BARNSTABL.E BUILDING DEPARTMENT j Ttrtit o Srnstabe .P.k�, 367 MAIN STREET NYANNlS, AAA 02601 t nemin; Section Phone: 775-1120 i SUBJECT: FOLD HERE DATE October 10, MESSAGE i I y An Occupancy Permit has been requested by FRO-SKATE LDaTED located at High School Road Extension, Hyannis. PI-ease make a.final inspection to be sue all Yo'.requirements have been coWied with. When approved�O3ccupancy Permit must be signed by the 'j SIGNED I DATE REPLY ( / f /Yana"ep'o ramp-t /Ipf C'or/Sfr�c c� aJ `^ fdWn . SIGNED w- N87•RMI RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY PRINTED IN U.S.A. FROM TOWN QP BARNSTABLE BUILDING DEPARTMENT Town of tarnstable O.P.W. , 367 MAIN STREET HYANNIS, MA 02601 Engineering Section Phone: 775-1120 SUBJECT: _ FOLD HERE DATE October 10, 1980 MESSAGE An Occupancy Permit has been requested by PRO-SKATE IMMITED located at High School Road Extension, Hyannis. k Please make a.fiscal inspection to be sure all your requirements have been. cm lied with. When approved Occupancy Permit must be signed by the Engineering Department. _y SIGNE, DATE i REPLY i .. ... .. SIGNED N87•RMI RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY PRINTED IN U.S.A. SENDER: SNAP OUT YELLOW COPY'ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. oaks-1 r's rs p and lot number ..... 0.�"�.... ..... 7`. 8.�(. �"' %T ero e H MUSX,Comm Ct Sewa a Permit number TQ.. W .is it C SYSTEM.MUST g SEPTIC _ S LLED IN COMPLIA "•� INSTALLED asasTllDLE, i House number ....... ............................... WITH TITLE 5 9°o 163 M" I;NVIR®IVIblFIiIT/!L CO�,,r. N:? `°waY°r. TOWN OF BARNSTABLE BUILDING INSPECTOR 4-7 APPLICATION FOR PERMIT TO . }ter . ......l. W...r!'j 0..rO .:jv:.................... TYPE OF CONSTRUCTION d/.1. ` :. ....... tak............................... ...........� ....... .........19 TO THE INSPECTOR OF BUILDINGS: 4 The undersigned hereby applies for a permit according to the following information: Location ............-�- L - --.........: -- ....... ......................:...:..........:.................................... Proposed Use .....14 {�.�..... ., - ..�..�? : ......21.W�........................................................................... Zoning District ........ .`. 4�����-�...........................Fire District ......4 .................................. Name of Owner .0\Kd :��� ...1-�`��r1C�'.s! Address ... ........ !Aes*-?......... ..... a Name of Builder' .Vtf.4. !.(,A .... ...:....Address ���.. .I...... ? r......�. ..................... Name of Architect L :` -' ddress ..... �. .�..i!�4y....J.... ....... Number of Rooms .. I .. 0 ........Foundation ... ..................................... Exterior .f./V .,.... .....*. .S ......................Roofing ...cam .......................-...........................: h� Floors ... . . .i ..t ...........................:..................................Interior ..... fz............ ,. "Heating ................. .......................:.......:..........Plumbing ............. Fireplace ..: ........................................................Approximate Cost ...2.��. ,...Fa�- � .................... Definitive Plan Approved by Planning Board ________________________________19____-___. Area . �.. . ......... ................. Diagram of Lot and Building with Dimensions Fee 5V) ................cs�.................. SUBJECT TO APPROVAL OF BOARD OF HEALTH cas -e 11,en POA rack I hereby agree to conform to all the Rules and Regulations of the Tow of Barnstable regarding the above construction. Name . .......ii....................................../fk- ...................A W�l A-3l ^ CAD ° Y a PRO-.SKATE LIMITED 4,4 Roller Rink Nk) 2.2-3.6.1.... Permit for .................................... C g.................... ... ,...pmme.rci.a Buildin .l................................ ....... .. . L6cati10T.Hi.gjj..Sq14q9l Rd. Ext. ........................ . Hyannis . ..................................................:............................ Owner ......Pro....Skate....Limited. . . ................. .... ....... .... .... .. .... ..... Masonary & Steel Typ6 of Construction ......................................... ........................................................................ Plot ....................... Lot ................................ -)} .. Permit Granted ..........July.............22. ....... 19 80 ......... Date7o'f Inspection ............................:.......19 Date Completed ......................................19 �JPERMIIT REFUSED ......... .......v...................................... 19 ................................................... • ........... P .................................................... in , ,; .......... .......................................................... (r . ......... ............................................................. ApproveAl'................................................ 19 Y. . ............................................................................... ............................................................................... A6 If I - [✓.�IST��C� >�t� tI.DIN 0 o • a � NEW ADt� ITIot`.> N N.M.ENTRANU O HP HP HP HP I 2 5 co 1 8 q 0 I _ 1'1 IPA ►q 2c� Zt Zt Z3 L4 Z5 2� 2T 28 �9 30 o a o1 00 4 3 f 1 3 Z- 33 1 34 1 35 1 3Co 3 '� L I 7 a sq 40 41 �1Z 43 44 ` t-- �-�-- -— - � q o J- 9 0 9'� q 0 -O Q� D�� 2/} p�� 4��� �f�p i Qi.p�� 9:O'� gi.p1 9�p' I Cri-p� ► i1 I N �5 4f0 417 46 44 5o 31 52- 53 S4 S5 56 o 57 58 51 (at (0Z. O 00 1=1�15 T NCo GtZA�S (3 U FF IE t�.. �1�f tprr!QG -L-)ITf. FLAKJ FOFZ -1 - H-1 bH. eCCXL 9C,�P E)k7"10 1,%44 STAFF REQUIRED PROVIDED B.F. DTA AREA DIRECTOR 1 140 SF I 140 SF ENTRANCE SPACE PLANNING DTA MANAGER 1 120 SF 1 120 SF DET AREA MANAGER 1 140 SF I 140 SF ©(4 � c 0 0F148 �136 135 (3 BEACON DET MANAGER 1 12 D SF 1 120 SF VEST. 142 �141 JTEG PRESIDENT 1 140 SF I 140 SF 122 ARCHITE CTURAL - - I ASSOCIATES JTEG VICE-PRESIDENT 1 140 SF 1 140 SF I i 196 I LE-M STAFF - I - - JTEG MANAGER 1 120 SF 1 120 SF ' MAIL ROOM I ' MRC AREA DIRECTOR 1 140 SF 1 140 SF -__ _ 1 ' ® 22 1 W I18 B 111 C - ---- MRG BOOKKEEPER I aO SF I aO SF , 19� ; 198 199 ; 2m1 / -- -- F__ -«) --- --- 145 South Street DTA EDP COORDINATOR 1 am SF 1 Sm SF _ ; - ----- ---- _ ----- ----- ----- ----- _--__ Boston, MA 02111 © 2004 DTA SUPERVISER 5 am SF 5 am SF DTA STAFF / COUNSELORS 25 am SF 25 aO SF DET SUPERVISER 1 80 SF I Sm SF ______ 195 1 1 p p COPY 147 I 143 140 13� JTEC STAFF / COUNSELORS 13 80 SF 13 50 SF i �9 I ®0 00 *� ®gyp V0 ®gyp I O � , 134 MRC SUPERVISER 2 100 SF 2 100 SF — — —_— ---- DET STAFF / COUNSELORS 7 a0 SF SO SF i MRC STAFF / G , ' ' MRC FILE ROOM ® �____ 1 ____ 139 138 133 R OUNSELORS g 100 SF 8 100 SF I - , , 1 - 119 ' MRC CLERICAL 2 4a SF 2 42 SF I ' - - - i - - 116 DTA CLERICAL 4 48 SF 4 42 SF ----- i i I 163 I 162 ® 123 W ® 146 145- 144 RESOURCE ROOM 1500 SF 1500 SF ----- JTEG RESOURCE ROOM 1000 SF 965 SF ' — 1-18 ' I-1� 164 I 161 L L PUNCH GROUP ROOM 200 SF 2al SF - i- -----+---- ----' ' I ® PUNCH + LOCK LOCK + PUNCH STAFF ROOM 200 SF 241 SF + VISION PANEL I I I ® REVISIONS: FILE ROOM 500 SF 591 SF , 1313 I _ 1 i _ I I - + BUZZER INTERVIEW ROOMS 3 125 SF 3 125 SF L------- I i ' I __ ' 124 PHOTO ID ROOM 140 SF 135 SF 192 i ; -- ----- i --_-_ --_ ' Q DATE BY DESCRIPTION FORMS/SUPPLY 25+a SF 212 SF ' I ' --- 1 ----- � 0 GROUP TELECOM +a1/21/04 • JCF • PROPOSED MAIL ALCOVE aO SF �5 SF , _ 1 1�9 I-1� , ROOM ROOM TELECOM ROOM 200 SF 210 SF __________ ' 12m 0 114 0 MULTI-PURPOSE QI • • MULTIPURPOSE ROOM 1030 SF 1054 SF ' ' U ' ' ® 0 � � ROOT"i 1 ----- lam 1�5 I _ > 0 WAITING ROOM 400 SF 465 SF __-----_ ' I 1®8 HEARINGS ROOM IaO SF lam SF i 1 ------------- ------------- DMH E� • • RECEPTIONIST AREA 150 SF 125 SF I I , � 125 • • 166 I 159 LOCK FILE BROOM TOILET ROOMS - SF I88 SF - I i _ , ® 115 _ _ _ _ • • I I I I ' I I • • 191 F---------- -----------'1 1 � PUNCH + LOC 0 ------------ 1 I ----- ---- 1 + VISION PANE FILER ( • • ------------ ------------�19m , _--- ----- I PUNCH MULTI-PURPOSE ' ROOM 0 GENERAL NOTES: ® Plans have been prepared for Agency's space i 0� � 1O� planning purposes pmod fSed, or otherwiseused be reproduced, ---- or construction purposes. ��� 1 — ----- 181 i 1�4 16-f ! ® PP permitting ------ PUNCH—•— 0 p p ❑ 0 _ /�� . C11�3) I ----- d r---------- '---------- ------------ STAFF STAFF 1k >r1 I ! I I , i 158 - _.._ _ _. _ _ _ _ _ _ — _ _ _ Plans do not necessarily show existing conditions (1�' i I i i i i i 168 L_—_—_—_ _-- 126 MENS WOMENS that must be removed. Existing conditions shown on �� C;:f�C�l , - I i , I 129 130 drawings have been obtained from plans and data l 1�- -��'/��t� ��` I 1 - I - ' 15� INTERVIEW INTERVIEW INTERVIEW f furnished by the building owner. If actual conditions ii I ' I ® $ DTA differ from those shown, notify the Agency before ;l,�' 189 ' I _ I j FILE ROO 111 1—Io 1<a9 proceeding with construction. I MULTI-PURPOSE d r ----- 188 182 i 1�3 ' _ I 112 ROOM C`kitc� � ' �� 0 I _ I , ® The provision of the Request for Proposals and �� ��J o� Mrn�,� 1 � I 106 Specifications are hereby incorporated in the general S I j , I �� - notes to the some extent as if written out fully. OA(t 1/J 0 \JeA I I-----------+------ ------------ -------------� - 0V1 1 0��14 IS •-Iv pF'f'mpdy 1 1 ®(4 ; � ; 0 ----- ----- � � 121 T T -------- --- 0 �__ � , � , � 1 ( I PUNCH PUNCH PUNCH PUNCH — rth 1 I II HIV ,ry� 18� i 1a3 I F 1-12 FI56 - COMMON try ----------T---------- F------------ I ------------ WOMENS COMMON ' -- -- la4 1�1 17® 155 132 "ENS ' ' 186 , ; 1 128Aa COMMONWEALTH OF MASSACHUSETTS 8 �11 0-S.3 i S S u e s: 1 I P DTA & DMH �;D C�Q O0 0 77 HIGH SCHOOL ROAD EXTENSION RESOURCE JTEG $7 HYANNIS, MASSACHUSETTS ROOM RE SOURCE Q - RECEPTION/ 1(I14 Lli' 5O5 }}, ` UJ WAITING C 00-A `#1, lay 11a3 o-� D AUDIBLE D N TRO 101-14 PANIC Im2 fJ�/A AU �� ❑ El ALARM ❑ Q ❑ " p 617- 30 6-3 lid E152 1 151 I I , MECHANICAL 15m , 14g ROOM _ i "Mm y W 0 0 � H VESTIBULE FAX 1 c - ---I - - ----, I ----,�I LOPY b _ (�� (3) 1ml '7 '7 0 0 COP 1� d \- AREA: KEY TO 54'fo'Y50L5 DATA JACK / ELECTRICAL OUTLET SI=ECG I AL NOTES 3`15 15 (NO DEDICATED CIRCUIT OR ISOLATED GROUND) W NEW DOOR VOICE JACK ONLY - WALL MOUNTED (NO POWER SOURCE FROM FLOOR I. WHERE OUTLETS ARE SHOWN AT COUNTERS, MOUNT ISOLATED GROUND ELECTRICAL ABOVE COUNTERTOP SURFACE. RECEPTACLE REQUIRED) O SHELF AMID POLE (A SECTION OF EACH EXISTING DOOR POLE AND SHELF ASSEMBLY SHALL BE 2. PROVIDE SINGLE KEY DEAD BOLT MORTISE LOCK EXISTING PARTITION DUPLEX ELECTRICAL OUTLET ACCESSIBLE FOR PHOTO ID ROOM DOOR. ® DATA / PRINTER JACK (ISOLATED O COUNTER / CABINETS / SINK 3. ALL TOILET ROOMS SHALL COMPLY WITH CURRENT NEW FULL HEIGHT PARTITION GROUND RECEPTACLE AND CIRCUIT. ADA AND AAB REQUIREMENTS. JOB NUMBER: 96-010A PRINTER DEDICATED ONLY) O BUILT-IN GENERAL PURPOSE COUNTER � NEW FULL HEIGHT PARTITION W/ GLAZING GF SCALE: I/8"= 0 DUPLEX ELECTRICAL OUTLET O BUILT-IN RECEPTION COUNTER , NEW LOW PARTITION GROUND FAULT O SLOPED SHELVING c: --------- MODULAR PARTITION (5Y AGENCY) DUPLEX ELECTRICAL OUTLET %n :r ISOLATED GROUND. DEDICATED_ O ADJUSTABLE SHELVING FTO-11 SPACE IDENTIFICATION NUMBER c7 QUADRAPLEX ELECTRICAL OUTLET 0 FIXED SHELF (12" WIDE) ® VISION PANEL DOORS ISOLATED GROUND. DEDICATED. BACKBOARD z DOORS W/ DIGITAL PAD LOCKS SPECIAL PURPOSE ELECTRICAL OUTLET 'A " FIRST FLOOR RGUIT FOLDING PARTITION Di 0 ELECTRIC DOOR RELEASE DEDICATED GI o © POWER POLE LIFT-UP SASH W/ LOCK, WRITING SHELF PROPOSED PLAN -0 DOOR RELEASE CONTROL AND BLIND pp POWER POLE FOR MODULAR PARTITIONS © PADDLE BAR ALARM LOCK O DIRECT POWER ENTRY FOR V DUAL VOICE / DATA JACK (ISOLATED MODULAR PARTITIONS O MAIL STATION GROUND ELECTRICAL RECEPTACLE AND DEDICATED CIRCUIT REQUIRED) (3) NUMBER OF CIRCUITS O SECURITY STATION VOICE JACK ONLY (NO ISOLATED GROUND POWER BREAK O 24" ADJUSTABLE SHELVING ELECTRICAL RECEPTACLE REQUIRED)