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HomeMy WebLinkAbout0100 INDEPENDENCE DRIVE (16) sE 0 J ,A TOWN OF BARNSTABLE Q. SIGN PERMIT PARCEL ID 000 000 243 GEOBASE ID I ADDRESS 100 INDEPENDENCE DRIVE PHONE HYANNIS ZIP LOT 14, 14A, BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT i PERMIT 70001 DESCRIPTION 50 SQ FT ACKLAND ORTHOPEDIC CENTER PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of ARCHITECTS: Regulatory.Services TOTAL FEES: $50.00 BOND $.00 �v* CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE 1 PRIVATE x j * sAMMBLE, * I MASS. i639. D MP ,- BUILDIN ISIOQ N 7 BY DATE ISSUED 07/09/2003 EXPIRATION DATE �-, "�'• � Town of�Barnstable y�P ti� Regulatory c ervices t Thomas F:,Geiler,.Director * BMWSrABLE, ,►ss• Building Division i6;9. DV iOTEn���°' Peter,F DiMatteo, Building Commissioner 0 .200 Main Street, Hyannis,MA 02601$ Office: 508-862-4038 Fax: 508-790-6230 Tax Collector Treasurer i Application for Sign Permit • - 1 Applicant: AC,� wka 0�-�•h�[�c��C CQv`�R ' Assessors No. O�U !/���7� Doing Business As-7�* Wttlhe ss ceyrim Telephone No.'�8' 7 70 (k 10 S Location Sign g '�ttwQ - s , Street/Road: pure WY�1 Zoning District: Old Kings.Highway? Yes/No Hyannis Historic District? Yes/No Property O n@@r A� A Name: Ac.K`WNAO C7o�0�tc. (.M'ky� Telephone: SO a-1g0— M0 Address: 10b =0,C4 Q tV%LAW\V2 (tV\'kQ. Village: �.{olmks Sign Contractor6V%004h � CO 5y 5-198-AU'l N`e: � Telephone: Al Address: �P3 V t Q AA A W 3 T. Village: ` • ��p►(L M Ot,Y -;Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions_,location and size of the new' .sign. This should be drawn on'the reverse side of this.application. Is the sign to be electrified?' Yes (Note:If yes, a wiring permit is required) - I hereby certify that I am the owner or that I have the authority of the owner to.make this application,that the information is correct.and that the use and`construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinance. i , Signature of Owner/Authorized Agent: Date: Size: Ise S Q F Permit Fee: • O Sign Permit was approved: Disapproved: Signature of Building Official: Signl.doc rev.122801 y b ~ r 79, _- z e - F f K _ 1 T_- HE 9 N' E3 v; 7� N ER 2 Y 4 E DR CIE , i n y ' t 'r> 'M" +ar,: ^„'was:.a' .hC.�C�'"„�.i. ..:x G4 +' -� s � a'v:� *w a z,.§,.s ��.�n*'�,v,.n•N.��._«..c .��.. —,°s:._"i ,� «ny'AA j, O plysignco@capecod.net ��' Telephone (508) 398-2721 # z elgll Cwww.plymouthsign.com Inc. Since lass Fax (508) 760 3130 `Fc�l�c�wi,n > �A SN-WS A- ()\wACQ -Q-�'T CDSLC�tiS ., w�.C\�S C -T re S l'Z-P -P AV) k)u V3etz— 1 ``�Aelite 1. �.Lck,,v% CZ), �YIO 3 � Post Office Box 134, 63 Old Main Street, South Yarmouth, MA 02664 (508) 398-2721 Telephone • Fax (508) 760-3130 plysignco@capecod.net • www.plymouthsign.com . r TOWN OF BARNSTABLE -SIGN PERMIT 4 PARCEL ID 000 0 00 243 GEOBASE ID � ADDRESS 100 INDEPENDENCE DRIVE PHONE HYANNIS ZIP - LOT 14, 14A, BLOCK LOT SIZE r DBA DEVELOPMENT DISTRICT PERMIT 70002 DESCRIPTION 15 SQ FT ACKLAND ORTHOPEDIC CENTER PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of ARCHITECTS: Regulatory Services TOTAL FEES: $25.00 BOND $.00 fHE CONSTRUCTION COSTS $.00 {. 753 MISC. NOT CODED ELSEWHERE 1 PRIVATE pz li snRxsras�, • I �►ss. 1639. ~' BUILDIN . — I I I ki BY DATE ISSUED 07/09/2003 EXPIRATION DATE t ` Ton- VBarnstable �+", 6�ta ,�' r ' ti =Regulator�y�Ser�ices r trS Aa ati2 ro.K ,., � •. • ' ThomasFGeiler�Duector • STABLE, • }i` �tFr�.S,xvm3 Yf c1,a\T ,l y.; '+ �g ulding Division 9�A 39• rfn Nw�" Peter.F D Iatteo,`Building Conunissioner ? :200 Main Street; Hyannis,NIA 02601 - 1 Office: 508-862-403 8 . Fax: 508-790-6230 , Tax Collector Treasurer N '� Application for Sig 'Permit j On.�h� Applicant:_ 0i1V�Q ( �` C C�v` . Assessors No. y Doing Business As. V��1�he ss CeR. Telephone No. 8' Sign Location k > .," Street/Road: ptWcrat4Q .�R.1Ve M'►hhlS . i J1�► • Zoning District: Old Kmgs jEghway? Yes/No Hyannis Historic District? Yes/No Property Op r t Name: C�e\aAAO 04\ ,0 ;� � Telephone. gC�' l0 Address: �t�0 =^C4 G4V--rU1\ CQh�eR. Village: Sign Contractor rY1�,�L C 0 So 5•$'18-A 7 I . Name: `� n`7lgN Telephone. 0�. Address: �-3 So. � Ike Villa e. . g Description' Please draw a diagram of lot showing location of buildings and.existing signs with dimensions,location and size of the neipv sign. This should be drawn on:the reverse side of this.application. Is the sign to be electrified? Yes�c ° (Note;if yes, a wiring permit is required) I hereby certify that L 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.�ection 4-3 of the Town of Barnstable Zoning Ordinance Signature of Owner/Authorized Agent Date: o2 ya a Size: S Permit Fee:—I> 50Ca Sign Permit was approved: isapproved: Signature of Building Official:. Date: Signl.doc rev.122801 4:` t Telephone (508) 398-2721 " plysignco@capecocl'net � 1 � ' �: � se Fax (508) 760-3130 n� �. ".�A6 n y,-L� 'R S `11' ` �,� +*y"ii�' '„ � �' Y �' `e �'.,���4 � snE, THE ER - �} 4 1 V k � t YR r - ,$�s X " N� R�� ER'' +'-',"K,ESS DER RE ii CBI ATI DNP TER ` ?htf Si ky.c ag r S a., 1r e �, T ACKL t D� k RTT� PEDIC CENTER 5 ACKU. N r G FH P IC CENTER 77, j k {` yw. ' b $' Post Office Box 1134, 63 Old Main Street, SoutliYarmouth,MA 02664 (508) 398-2721 Telephone • Fax (508) 760-3130 plysignco@capecod.net • www.plymouthsign.com i c N-ko m C,l CAL � t o f r 1 Assessor's office(1st Floor): '14u �` 1 3 Assessor's map and lot be 11 TT i THE Pao T o�i Conservation Board of Health(3rd floor): • t Sewage Pe rmit ermit number sAaa 3r Ancc rua Engineering Department(3rd floor): / r-,,-4( %670. House ` number / 0 Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO •S ( ���� TYPE OF CONSTRUCTION � �— 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accordin o the following information: Location PORT , ORT (F a•t Proposed Use Zoning District X 1 Fire District Name of Owner Q r Address D — Name of Builder h t C`�� fit^ n PILGI Address Name of Architect Address Number of Rooms Foundation x I S /h 0Yn tUl Exterior w not — Roofing Floors l .f/YL Interior Heating Plumbing __ X)A- ,V �� /TZTIJ 00 Fireplace Approximate Cost Area Diagram of Lot and Building with Dimensions Fee �1 • �2 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re 4ard'ng the above con truction. Name Construction Supervisor's License . NF,RAK. REALTY TRUST , No--- ermit For DEMOLISH/REBUILD Storage Shed Location 70 Airport Road r ' Hyannis , Owner Nerak Realty Trust - Type of Construction Frame Plot Lot , Permit.Granted May 13 , _ 19 93 Date of Inspection 19 Date Completed 19 y ,A n 424:-S ' s ' Z P E TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map � Parcel 101o6c�z_ Application# Health Division 5-�L Conservation Division 5S Permit# Tax Collector Date Issued '— Treasurer �Z Application Fee Planning Dept. Permit Fee Date Definitive. Plan Approved by Planning Board Historic-OKH t Preservation/Hyannis _ •, d Project Street Address0 _F- r AK. Village Owner Z C Address l J ' Telephone Permit Request t� I - tI Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes,attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House. ❑Yes ❑No On Old King s Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas . ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new, size Barn:❑existing ❑new size Attached garage:❑existing 0 new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use �W19 Proposed Use BUILDER INFORMATION q Name i Telephone Number Address License# l� Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO7/� SIGNATURE DATE 2fe/ I FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED ~MAP/PARCEL:NO. - f r ADDRESS,..- VILLAGE r OWNER' , DATE OF INSPECTION: JJ FOUNDATION t FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL, PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ' ASSOCIATION PLAN NO. ,ft, I °FZHE r Town of Barnstable Regulatory Services • STABLE,MAS . t Thomas F.Geller,Director e 1639. &, Building Division. Torn Perry, 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 I, C� U�C ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Ad riss Job) - Signature of Owner Date r Print Name Q:F0RMS:0Vn4MERMISSI0N r �pF1HE�ok, Town of Barnstable Regulatory Services • snaNsTABLE, MASS. g Thomas F. Geiler, Director . �ATe0N1p'1p Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601• www.town.b a rn s to ble.m a.a s_ Office: 508-862-4038 Fax: 508-790-6230 Building Permit Procedure for Commercial Additions/Alterations ❑ Map and Parcel number ❑ Letter of Approval from Site Plan Review(if applicable). ❑ Site Plan must also be submitted_ showing the location and setbacks of existing/proposed structures, septic,parking, etc. ❑ Historic District at 200 Main Street: Certificate of Appropriateness is required.- Old Kings Highway Historic District(north of the Mid Cape Highway) Hyannis Main Street Waterfront Historic District(See map for boundaries)- Historic Preservation(if applicable). I , ❑ Construction plans -one complete set of full sized plans and one complete set reduced to 11"x17"and fully dimensionalized must be submitted with the building permit application. Both sets must have an original architect or engineer's stamp. Note: The applicant must also submit a set of plans to the appropriate Fire Department for review. The application package will not be accepted without prior approval from the Fire Department. ❑ Approval from the following departments, located at 200 Main Street,must be obtained: ❑Health Department Hours (8:00-9:30 AM or 3:30-4:30 PM) ❑Conservation Department Hours (8:30-9:00 AM or 3:30-4:30 PM) ❑Tax Collector ❑Treasurer ❑ Permit must contain full description of the project,correct square footage,owner's name, address and telephone number, contractors information and signature and dated ❑ Workers Compensation Insurance Affidavit State form must be completed and a copy of Insurance Compliance Certificate must be on file. ❑ A copy of the Construction Supervisor license is required. Note: Construction Supervisor's license holders are not entitled to supervise construction of a building or an addition (regardless of size) to a building with a total cubic volume greater than 35,000 cubic feet. In that case, the application must be accompanied by controlled construction documents as indicated in 780 CMR sections 116& 1705. ❑ Check expirations date, no restrictions ❑ Controlled Construction ❑ If sprinkler or fire alarm system is required, do not accept application package without prior approval from Fire Department(phone call or in writing) Application Fee of$100 must be paid at time of submittal,check made payable to the Town of Barnstable. Permits are $8.10 per$1000 of value of work Property owner must sign Property Owner Letter of Permission. Note: No wall is to be covered before wiring, plumbing and frame inspections. Q:bldg/wpfiles/forms/CADDALT Revised 071305 ♦� � � ,. ��' P�G� r� �- ����. � � � � �---- �CQ i o o P �► h�L GOf1-7 UYVJ`�A , c� w 0\-r4�„C ✓-7 -v Pv7 lk s�-r P CA- I r' 71. �anvinaiu real/ o /�aabaclutaelta BOARD OF BUILDING REGULATPONS License: QONSTRUCTION SUPERVISOR Number,es, 070029 _ Eel M�15006 Tr. no: 4020.0 }} RALPH CROSSEKh. 18 WOODRIDGE E SANDIPICH, MA 02567". Commissioner _ -TOWN OF,..BARNSTABLE 30 DAY TEMPORARY OCUPANCY PERMIT PARCEL ID 000 000 243 GEOBASE' ID ' ADDRESS 100 INDEPENDENCE DRIVE PHONE HYANNIS ZIP - LOT 14, 14A, BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT PERMIT 62411 DESCRIPTION 30 DAY TEMP.C/O UNITS#A,B;,C $P457036 PERMIT TYPE BTCOO TITLE TEMP. OCCUPANCY PERMIT CONTRACTORS: Department of Health. Safety ARCHITECTS: and Environmental Services TOTAL FEES: BOND $:00 THE CONSTRUCTION COSTS $.00 ,. 7 6-, CERTIFICATE OF OCCUPANCY 1 PRIVATE 1" * BARMABLE, .• MASS, r BUILDI IVISION� BY � d--� DATE ISSUED 07/16/2002 EXPIRATION DATE 5/`LO02 � ^ y TOWN OF BARNSTABLE UNITS A,B&C CERTIFICATE OF OCCUPANCY PARCEL ID 000 000 243 GEOBASE ID ADDRESS 100 INDEPENDENCE DRIVE PHONE( HYANNIS ZIP - LOT 14, 14A, BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT PERMIT 62411 DESCRIPTION UNITS A B&C/BP#57036/POSSIBLE CCC REVIEW PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS:ARCHITECTS: Department of Regulatory Services TOTAL FEES: BOND $.00 �tNE CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE ■ARNSTABLE, * i MASS. 039. FD MP'� BUIDDIN ISIO BY DATE ISSUED 07/26/2002 EXPIRATION DATE i b= mw TOWN OF BARIIST'ABLF SIGN PERMIT PARCEL ID 294 013 GEOBASE ID 20567 ADDRESS 70 AIRPORT ROAD PHONE HYANNIS ZIP - LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRIQT HY PERMIT 58085 DESCRIPTION MEDICAL ARTS INC. - 24 SQ FT PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $25.00 i. BOND $.00 CONSTRUCTION COSTS $.00 i 753 MISG. NOT CODED ELSEWHERE * • * BARNSTABM s MASS. 1639. ED BUILDING DIVISION BYE / rP�/- mil DATE ISSUED 12/27/2001 EXPIRATION DATE r TOWN OF BARNSTABLE BUILD#qG PERMIT APPLICAT N t3CO& Q &,er Map Parcel Permit# m I- Health Division "w 00M. Date Issued Conservation Division 10 Z,3 /C Fee u� Tax Collector ix l olri/or 74L Treasurer `. i� I 'l' l Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservatio /Hyannis /06 ft)c-v � ly /SSA IS S4 4 Project Street Address her— Village Owner S -,/_�cldress S — Telephone Permit Request �-- 1 Square feet:1st floor: existingY�lMe) proposed 2nd floor: existing GQ proposed _� Total'new OG Valuation • J? G L5_Zoning District ! Flood Plain 0�)O Groundwater Overlay > Construction Type Lot Size Grandfathered: ❑Yes N No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure ? Historic House: ❑Yes )kNo On Old King's Highway: O Yes u No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) _ n Basement Unfinished Area(sq.ft) _ Number of Baths: Full: existing /d new Half: existing� new Number of Bedrooms: existing new Total Room Count (not including baths): existing _new First Floor Room Count o Heat Type and Fuel: XGas ❑Oil ❑ Electric ❑Other Central Air: Yes D No Fireplaces: Existing New Existing wood/coal stove: ❑Yes '-�Yvo Detached garage:❑existing ❑new size e6aa Pool:❑existing ❑new size.40� Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:,&.existing ❑new sized Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial Ayes 8N0 If yes, site plan review# R Current Use o � Proposed Use BUILDER INFORMATION Name � �5��( i . Telephone Number z J ( { o> Address _ �� _ License# 2 A&2 - Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE /0 / c TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map G' Parcel Permit# _ Health Division _�� /Jww 6ay— [ Date Issued Conservation Division iOW&-oi Pvc Fee Tax Collector lo/i�/or lk �© Treasurer Planning Dept. Date Definitive Plan-Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address ��(� Village Owner Vl S O ly—�ddress 2 C / Telephone 90 Permit Request Square feet: t floor: existing 4O proposed 2nd floor: existing proposed Total new LG Valuation • J? G Zoning District 1,41,2 Z.&DFlood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: Cl Yes R No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes XNo On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other �l,/�e� Basement Finished Area(sq.ft.) Q Basement Unfinished Area(sq.ft) l Number of Baths: Full: existing d new Half:existing_� new 4 Number of Bedrooms: existing G new Total Room Count(not including baths): existing ���� new First Floor Room Count Heat Type and Fuel: gGas ❑Oil ❑ Electric ❑Other Central Air: ,J2�es ❑ No Fireplaces: Existing �_ New Existing wood/coal stove: ❑Yes A�o Detached garage:❑existing ❑new size Pool: ❑existing ❑new size,4Ot Barn: ❑existing ❑new size Attached garage:❑existing ❑new size Shed:;&existing ❑new sized Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial Alyes O❑ If yes, site plan review# Current Use _ Proposed Use BUILDER INFORMATION / Name A Telephone Number — Z Address mil'/'��� ) License# IQ Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 0 /f__T_ SIGNATURE DATE /� —���{ FOR OFFICIAL USE ONLY ' r PERMIT NO. " DATE ISSUED MAP/PARCEL NO. - ADDRESS VILLAGE OWNER _ 1 M DATE OF INSPECTION: 1 FOUNDATION FRAME INSULATION ` FIREPLACE { ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL - FINAL BUILDINGr DATE CLOSED OUT, I. 4 ASSOCIATION PLAN NO. ", 6 42 The Commonwealth of Massachusetts —j- Department of Industrial Accidents y� � _11,:, -- . , _- • O�ceotlorast/aavoos - 600 Washington Street - Boston,Mass. 02111 Workers' comilensaUon Insurance Affidavit name: location. city �f nhone# ❑ I am a horneovA=performing all work ell; I am a sole •etor and have no one worlan 1n anv �.. workers' ensation for my em�la9eesy°Mang oa`this job..:. :.;;,:..:>:::>:<::::<:»:<>:<,::;<:>;<:.-..:.....<.... .. :::: I am an employer providing.:... :.: ..::..:::camp...:. ; ; ;::: ::::::'.:..:.'.;::;:}::»: < :.;}:;:::>; I. >:Oplp8llY eeme ............... ::: .... ... .-......... X. i insurance ca" -am a sole ploprieto homeowner(circle one)and have hired the coauactors ' below who ' tmsatio oIices: workers .........,:::::::::;.;;{: ..,....:.......::.:.:,..:,,.::.v.,x.x.,:.:; owl <: ::>::>::<}:<::::: »<><::: the foll ng ..................... .:::::::...::::::.::.�..::::.}:.:.}:.:::.:�:.;:<::>::: ;:.;:.x.}:. com an name• ....... ................:.:w:::: .................. ...,...mv:.vvnv:.v;....:..:.. v.:.:x::.v}......yr:•;:{.v{;............ ....:..- ... ..... ..... ...... v .. .. ....-.r rv.%w•.v.-w�mw:.............:.v:............'.}i}>:;4i}::;;:.. . .:::............:::::.....nr......::^..4.r.........:v•::•......................•.v,.,.;:..:v::::x. ... ,. v{v}.. �.......::Yix{.�bvr{. "y�. .,v::._::.:::::i'.<}":4>:.}:>:•>::::::-.::... -'•..:::..............:.........:.::::....:.�:.•..>::lea;:;•::�::;:•:::::::::::::::::::::::•....L}{..::��v:{•}�::.:.:;�,�°... w.......•::.....r.....:::... .........::.:....................,.:,:. ............ -------------------------- t'•ik� snv.name:�� ... NdlireaS. :.. .:: ::::..... ........... ...................... ene ::......:.... cl - .......:...:..::....:.:... rsac office one YeFaIlur to secure mpri covemimprisonment as required under Section ISA of MGL 152 can lesd to the impts�of erhrA=I penalties of a f ne up to 51.500.00 and/or one ya„,tmplisomneat as well as dvII penalties in the form of a STOP WORK ORDER and a glue of 5100.l�0 a day against lne. I tmdelatsad "a copy of this statement may be forwarded to the oMce of Iavestigations of the DIA for coverage veiiiiton 1 do hereby certify under the and pen eil%"drat the information provided above is true.and correct Date �' l Si�ature Print name r. ASS Phone# of iciai use only do not writs in this area to be completed by city or town omcisl city or town: peendtfficaue# • QLi�ns$O�� ❑Selectmen's Office ❑checkif immediate rdponse is required ❑Health Department contact person: phone p; -' ❑Other (tevueu 9195 PJA) Information and Instructions es all employers to rovide workers' compensation weir Massachusetts General Laws chapter 152 section 25 requires P P employees. As quoted from the"law", an employee is defined as every person in the service of another of hire, express or implied, oral or written. lover is defined as an individual, partnership, association, corporation or other legal entity, any o ro or eceiver the of An emp _ representatives of a deceased employer, the foregoing engaged in a joint enterprise, and including the legal rep lo. .employees. However the owner of a trustee of an individual,partnership, association or other legal entity, employing therein,or the occupant of the dwelling dwelling house having not more than three apartments and who'resides llin house of persons to do maintenance, construction or repair work on such dwelling house or on the grounds o: another who employs building appurtenant thereto shall not because of such employment be deemed to be an employer. renevv MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance t a ct buildings is the commonwealth for any who hr of•a license or permit to operate a business or to-constru ' the not produced acceptable evidence of compliance with the insurance coverageco� requeiPerdfoAdditionally, rmanCe°of nbh�c wo until commonwealth nor any of its political subdivisions shall=enter into Y have been presented to the contracting acceptable evidence of compliance with the insurance requirements of this chapter authority. Applicants ' ensatian affidavit completely,by checking the box that applies to your situation and Please fill in ,he workers comp with a certificate of insurance as all affidavits may be supplying company names,address and phone numbers alonga Also be sure to sign and submitted to the Department of Industrial Accidents for confirma on of insurance coverage. or the permit or license is or town that the application f date the affidavit. The affidavit should be resumed to the city' questions regarding the-"1aw»or if yo being not the D artmcat of Industrial Accidents. Should you have any he are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns legibly. The Department has provided a space at the bottom of tl Please be sure that the affidavit is complete and printed legs y eP the applicairt. please affidavit for you to fill out in the event the Office of Investigations has to contact you regard ermit/licease number which will be used as a reference number. The affidavits may be reanraed i^ be sure to fill in the p the Department by mail or FAX unless other arrangements have been made• ike to thank you in advance for you cooperation and should you have any questions. The Office of Investigations would l please do not hesitate to give us a call. WWI MEN 0: The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents 0mce of Imtestigedons 600 Washington Street 1 Boston,Ma. 02111 faz#: (617) 727-7749 phone#: (617 727-4900 eat. 406, 409 or 375 , t ) Daniel E. Braman, PE 189 Harbor Point Road Cummaquid, MA 021637 (508) 362-6016 10/12/01 Project 19101 Independence Medical Arts Center, Hyannis, MA To: Peter DiMatteo, Building Commissioner Town of Barnstable, 367 Main Street,Hyannis, MA 02601 In accordance with the Massachusetts State Building Code, 6t'edition section 780CMR 1705.0, for controlled construction, and as SER;the following is a program of inspections: General construction-3 inspections;one when demolition is complete,one when the new entrance is constructed and a final inspection when construction is complete. The General Contractor shall notify the SER when the above inspection times occur. Daniel E. Braman, PE Cc: Kenneth Sadler Ralph Crossen v OMIEL E. v o. S UTh CTUNAL N 1i0. lilli P� x ..� ✓�ie�anrmaaiuura�t/ o�./�aaoac�tudelzb BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR x. _ Number: CS 070029 } Birthdate:.11/15✓.1947 Expires: 11115J2002 Tr.no: 4912 ; t Restricted To: .00. . RALPH CROSSEN• _ BOX 43 ru" HYANNISPORT, MA 02647 Administrator .$1. 10-25-200 2: 18PM FROM K-iANNIS FIRE/FESCUE 508 77B E448 P. 2 HYANNIS FIRE DEPARTMENT Kvam s 95 HIGH SCHOOL RD. EXT. HYANNIS,MA.02601 KEN Teat HAROLD S. BRUNELLE, CHIEF R(�tOgQib� FIRE PREVENTION BUREAU IT9C[Nt AWARENELB OFiIP.E EGYCATI4X 1�9 BUSINESS PHONE:(508)775-1300 FACSIMILE PHONE:(508)778-6448 LT. DONALD H. CHASE,•JR.,CFI LT.ERIC F.HUBLER,CFI FIRE PREVENTION OFFICER FIRE PREVENTION OFFICER PLANS REVIEW `,70.1r100 - INDEPENDENCE DRIVE As discussed in Site Plan and agreed upon; a Hydrant off the Barnstable Water Companies' System shall be installed at / or near the Independence Drive Entrance; and if at all possible, the hydrant shall be located in the median strip on Independence Drive so as to be accessible to both sides of the Drive without shutting down traffic to the entire Drive during Fire Fighting Operations. We will also require a Fire Department Connection at the new front of the building. Further, both items shall be shown on the Sprinkler Plans and stamped with a Fire Protection Engineering stamp, and submitted with Hydraulic Calculations for review to this Station when the Licensed Sprinkler Contractor applies for the Permit. This Department has concerns regarding separation of occupancies and exit distances and capacities based upon our review of the Building Plans. We will be bringing these concerns to the Building Commissioner for his review. Also, the Fire Alarm Permit Application shall include the entire building devices, as well as the Narrative Report and Alarm / Fire Protection Acceptance Testing Criteria. Lt. Eric Hubler, FPO Fire Prevention Office HYANNIS FIRE DEPARTMENT 10-25-2001 2: 18PM FROM HYANNIS FIRE/RESCUE 508 77B 6448 P. ? ANMS FIRE DEPARTMENT 95 HIGH SCHOOL RD, EXT.HVANNIS, MA,02601 HAROLD S. BRUNELLE, CHIEF HIM VEN aN *mFAU irvo[HrrWawnaorriuroaeanai BUSINESS PHONE:(5W 775.1300 FACSIMILE PHONE:(508)778-6448 I►T. ff)(DNALD H.CAE,JR.,CH ><T.ERIC F.MBLER,CFI FIRE PREVl.?NTION OFTICER. FIRE PREVENTION OFFICER BUILDING. CODE COMPLIANCE FORM THIS FIRE PREVENTION BUREAU HAS REVIEWED THE PLANS DATED W kL FOR THE PROPERTY LOCATED AT 7C>-dS?�. , `1 ZDPL�kN , ('60-K ALSO KNOWN AS,_ L(AV� THE CHART BELOW. INDICATES THE STATUS OF OUR REVIEW: TYp OF.CONSTRUCTION,OOCUMENT" WA RECEIVED REVIEWED COMPLIES 1-NARRATIVE REPORT: -2 FIFiEc` FIGiTING/RESCUEC U=ACC SS ,3. 4 0.01ANT LOCATION/WATER SUPPLY 4-SPRINKLER SYSTEMS -- S�SPRINKLER CONTROL EQUIPMENT, g.STANUPIPE SYSTEMS 7-STANDPIPE.WAIVE f:p LIONS, 8=FIAE DEFARTIVIENT.CONNECTION S� t-C�'[IL 9-5IRE PROTECTIVE S(GNAUNG SYST. 10 F.P.S.S. &ANNUNCIATOR LOCATION L 11-SMOKE CONTROL f EXHAUST 12-SMOKE CONTROL EQUIP. LOCATION 13 LIEF SAFFCYSYSTEMfF_ATURES --- -- - -- 14-FIRE EXTINGAUISHING SYSTEMS- rIv _ 15 F,E.S. GONTROLEQUIP LOCATION 16=FIRE,PROTECTION ROOMS 17•FIRE= PROTECTION EQUIP SIGNAGE .18-ALARM TRANSMISSION METHOD 19-SEOUENCE OF OPERATION REPORT _ 20•ACCEPTANCE.TESTING CRITERIA - `TCG -- ----,--..,---------_-... . _ WE BELIEVE THE DOCUMENTS TO BE COMPLETE AND COMPLIANT FOR THE ISSUAN .E 0 A BU Pi MIT, .ft"5t, 'S6�. A ��Lb �s�TC� � FPi � f.1�Ci�uRT►,^� tO�Z�aI WE HAVE COMPLETED THE ACCEPTANCE TESTING FOR THE OCCUPANCY PERMIT AND BELIE A - WITHIN THE SCOPE OF THE BUILDING PERMIT,THE ABOVE; ISSUE'S ARE IN COMPLIANCE_ T. .70 (6o lam- CA tcr_Z.—C,GK-tnx 6 6-4OC-) -- (� .v -f r - ` ---- ,, � f .,I C Y r - ---- � r-- - -- � i ' •, � -- - =-.-_Q..�� ...._ -_� - �-- -- -- --- -- - - -- -�_ �_._»,. __T _�� -�- �_ _ - ��.-,------ - -- - - �� t Ackland Sports Medicine, Inc. MICHAEL K.ACKLAND,M.D. ORTHOPAEDIC SURGERY 130 NORTH STREET PAUL R.BENOIT,JR.,M.D. WWW.SPORTISMEDICINE.COM HYANNIS,MASSACHUSETTS 02601 BRIAN D.BIRD,P.A.,C. TELEPHONE(508)790-1110 FAX(508)790-4482 November 1,2001 Building Department Town of Barnstable To Whom It May Concern: The building on 70 Airport Road has an occupancy use of approximately 26,000 square feet of office space and 17,000 square feet of light manufacturing which produces foam products. We are planning on cutting back the light manufacturing to 10,000 square feet and increasing the offices accordingly. Sincerely, Marco Malovic �f% L�-_ Sf1 ,.-�, .. .� _i f �NuS cc 's � 2 ` ------------- � `� f - - ,� ,.�:�. - � F -. _. '� I L .. Tom Perry Building Inspector Town of Barnstable 367 Main St Hyannis,Mass. 11-5-01 Dear Inspector Perry The owners of the proposed medical building on Independence Drive have,as I told you, eliminated the F-1 use all together.Now the use in the building will be B only.Pursuant to the height and area limitations of Table 503 of 780 CMR we now propose the following: 1. Use Group B Construction type 3B 14,400 sf 2. 150%for open all around 21,600 sf 3. 200%for being sprinklered 28,800 sf TOTAL ALLOWABLE FOOTPRINT 64,800 sf As you know our building Footprint is 44,000 sf. This change will eliminate the need for all fire separation assemblies as originally proposed on the plans. Therefore the amendment we are proposing to the plan is as stated above.Thank You Ralph Crossen Box 43 ►��p�S� OF Mgs�9�v Hyannis Port,Mass.02647 a° DANIEL. E. GRAM g� STRUCTURAL y A� Nqr 95 ®►,Ffss'10-NA� 0 / �� dN F The Law Office of DAVID V.LAWLER 336 South Street Hyannis, MA 02601 } Email Address: Telephone:(508)778-0303 Facsimile: Dlawler.atty@verizon.net (508)790-0072 November 5, 2001 Mr. Peter DiMatteo Building Commissioner Town of Barnstable, Building Services Division 367 Main Street Hyannis,MA 02601 Re: Independence Medical Arts, LLC 70 Airport Road, Hyannis,MA 02601 Dear Mr. DiMatteo: Please be advised that I am the attorney representing Independence Medical Arts, LLC. It has come to my attention that the Town has certain concerns regarding the issuance of a building permit due to the present existence of approximately 17,000 square feet of light manufacturing space within the building. This letter is to certify that the light manufacturing presently in operation will have ceased by the time the owner of the property requests its occupancy permit for the proposed renovations. Some time in the future, the owner intends to convert this additional-space into medical office or other appropriate uses. In the interim,this space will be left unused but fully protected by the in-house sprinkler system. As such, it is respectfully requested that the di pe it be issued forthwith. Should you have questions or concerns,please direct them to my ention Ve ruly yours f David V. L r DVL/dlf TOWN OF BARNSTABLE BUILDING PERMIT PARCEL iD_2R4 013 GEOBASE ID 20667 ADDREGS 70 AIRPORT ROAD PHONE HYANNIS 'LIP - LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY ' PERMIT 57036 DESCRIPTION RENOVATE EXISTING TO MEDICAL OFFICES PERMIT TYPE BREMODC TITLE COMMERCIAL ALT/CONV I CONTRACTORS: RALPx CRosSEN Department of Health, Safety ARCHITECTS: i and Environmental Services I TOTAL FEES: $8,030.00 BOND $.00 Tt1E -CONSTRUCTION COSTS $1,300,000.00 1 324 PROF, BANKS, OFFICE BLDG 1 PRIVATE P.14_1 BARNSTABLE, MASS. 039. A�O� ED MEN •► -- BUILDING DIAS16N BY DATE ISSUED 11/08/2001 EXPIRATION DATE } > ' TOWN OF- BARNSTABLE BUILDING PERMIT _ PARCEL I ► .? 413 s GEOBASE ID 2456 ADDRESS-'-' '70,,AIRPOR` RtfAD PHONE 't r HY`ANN�S ZIP LOT BLOCK LOT SIZE DBA rs DEVELOPMENT DISTRICT -HY PERMIT 57036 DESCRIPTION RENOVATE EXISTING TO MEDICAL OFFICES PERMIT TYPE BREMODC,' . .TITLE ' ,, COMMERCIAL AL,T/CONV CONTRACTORS: RALPFI CROCSEN ARCHITECTS: Department of Health, Safety ; +. and Environmental Services TOTAL FEES: $8,030.00 BOND $,00 per INE CC7NSTR[JCTION COSTS $1,300,p00.00 324 PROF, BANKS, OFFICE BLDG I PRIVATE P. * BARNSTABLE, MASS. 1639. ` -. . BUILDING DI IS N BY ✓ DATIE ISSUED 11/08/2001 EXPIRATION DATE 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 OFTHIS 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 FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- (READY TO LATH). PANCY IS REQUIRED, SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. e BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS\ 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE 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. 1'�. >_ .`s '�� .� �� 1 �: �. �' 3y # p p: 1� 1 11 (11 1 it I `I I r'� — ""---- —� TOWN OF BARNSTABLE 60 DAY TEMPORARY CERTIFICATE OF PARCEL ID 000 000 243 GEOBASE ID ADDR!,'SS 100- INDEPENDENCE DRIVE PHONE HYANNIS ZIP {..- LOT 14, 14A, BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT PERMIT 65916 DESCRIPTION 60 DAY TEMPORARY C/O UNIT#G KESSLER. PERMIT TYPE BTCOO TITLE TEMP. OCCUPANCY PERMIT CONTRACTORS: Department of ARCHITECTS: Regulatory Services TOTAL FEES: BOND $.00 �tNE 1 CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE on T. *. BrrsTnsi.E. Mass. z6g9. ♦� BU -DINUDF ISION BY DATE ISSUED 12/13/2002 EXPIRATION DATE V13/2003 I :r- TOWN OF BARNSTABLE SO DAY TEMPORARY CERTIFICATE OF lulANCY PARCEL ID 000 000 243 OEOBASE ID ADDRESS 100 INDEPENDENCE DRIVE PHONE HYANNIS ZIP - LOT 14, 14A, BLOCK LOT SIZE DBA DEVELOPMENT . DISTRICT PERMIT 65916 DESCRIPTION 60 DAY TEMPORARY C/0 UNIT#G KESSLER PERMIT TYPE BTC00 TITLE TEMP.. OCCUPANCY PERMIT CONTRACTORS: De ,artment,Of ARCHITECTS: P rt Regulaaor Services TOTAL FEES: - BOND $ 00 � . CONSTRUCTION COSTS $,00 ^ Y 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE • :3AIM aB •, yy d. i6;q. Af1�, •� BUM IN GBy WISI� i DATE ISSUED 12/13/2002 EXPIRATION DATE , I 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 GRADESAS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS R80UIREO FOR.ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION k 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- PERMITS ARE REQUIRED FOR (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION: OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. - 4.FINAL INSPECTION BEFORE OCCUPANCY. I 11 1 0 . � tP BUILDING INSPECTION APPROVALS PLUMBING INSPELTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2� . 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 �� BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL << t ox WORK SHALL OT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN SIX . CARD CAN BE ARRANGED FOR BY k VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA TION. NOTED ABOVE. TION. ti TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 0 • q S Map_ (? Parcel Q t _ Permit# E P Health Division Date Issued f Conservation Division Fee �� Tax Collector Treasurer - Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village Owner Address Telephone Permit Request C V-eAr4 CCdLI l/12GX,, Gov'v,c oaL.. Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation s Zoning District Flood Plain Groundwater Overlay Construction Type C 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.) 4114 Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 0/ —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:j4as ❑Oil ❑ Electric ❑Other (�� w Central Air: Xes ❑ No Fireplaces: Existing w Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑existing ❑new size gPool: ❑existing ❑new size Barn:❑existing ❑new size IV Attached garage: ❑existing ❑new size Shed:❑existing Cl new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial XYes ❑ No If yes,site plan review# er — Current Use_Q (Ge Proposed Use CX,--f(Ce BUILDER INFORMATION ! Name Telephone Number Address — d License# Home Improvement Contractor# (L<< Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO _ SIGNATURE DATE /,op r i FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED 1 MAP/PARCEL NO. I ; f ADDRESS VILLAGE r-_ OWNER- DATE OF INSPECTION: FOUNDATION FRAME INSULATION r - - FIREPLACE ELECTRICAL: ROUGH FINAL ;. PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r? • FINAL BUILDING ' j DATE CLOSED OUT s d ASSOCI-ATION PLAN NO. -s i _ � 3 ACORDM CERTIFICP.TE OF LIABILITY INSURANCE 11'/08�2D0002 PRCSDUr ER k508)540-2400 FAX (508)760-1988 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MUrray & ,MacDonald Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 406 Jones Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Falmouth, MA 02540 INSURERS AFFORDING COVERAGE INSURED Ralph Crossen INSURER A: Scottsdale Ins, Co DBA The Ralph Crossen Construction Company INSURERB: 18 Woodridge Road INSURERC East Sandwich, MA 02537 INSURER0: MASS WCRIB INSURERE: Zurich COVERAGES I, THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE;FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION - LIMITS LTR DATE MM/DD/YY DATE MM/DD/YY GENERAL LIABILITY BINDER 11/08/2002 11/08/2003 EACH OCCURRENCE S 1,000,000 COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) S CLAIMS MADE a OCCUR MED EXP(Any one person) S 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO. LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S ANY AUTO ' (Ea accident) ALL OWNED AUTOS " >• BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE S t (Per accident) - - GARAGE LIABILITY -... .- - - � -' o AU/UUNLY-'EA ACCIDENT^ $ ... _ . ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG S EXCESS LIABILITY EACH OCCURRENCE $ OCCUR F] CLAIMS MADE AGGREGATE S S DEDUCTIBLE $ RETENTION SOTH- WORKERS COMPENSATION AND , BINDER ' 11/08/2002 11/08/2003 X I TORY LIMITS ER A EMPLOYERS'LIABILITY - E.L.EACH ACCIDENT $ 100,000 E.L.DISEASE-EA EMPLOYEE S 100,000 E.L.DISEASE-POLICY LIMIT $ 500,000 OTH R BINDER 11/08/2002 11/08/2003 $ 267,000 Builders Risk A Insurance f • DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Kessler Outpatient Rehab Project - Hyannis, MA fi y CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL LThe Gale Construction Company, LLC 20 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, John Czarecki BUT FAILURE TO MAIL SUC NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 300 Campus Drive OF ANY KIND UPON THE MPANY,ITS AGFNTS OR REP ESE TATIVES. Florham Park, N3 07932 AUTHORIZED REPRESENT' I ACO RDD 25-S (7/97) ©ACORD CORPORATION 1988 The Commonwealth of Massachusetts = * V` Department of Industrial Accidents force of/osesmoodeos t 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance davit name- location: city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole P, net and have no one woridn Many ca achy ❑ I am an employer providing workers' compensation for my employees working,on this job. :: :: ::::: ::::::::::::::::: ::::: :: coma n m .... dress. :::;.;:.;:.;:.:;.::;;".;:.;:.;:.::;:..:::.::.:::::::::::::.::::::::.::::.:::.:::....: :.::.::.:::...:::.:.::::..:•:::::::::::.,:.;.: ohon tasi `:a ::;> ;.;;ii;:; ;,.;(.;<':i: i: :`::uliev risuranc ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: ........... `a'iddes i4 r i�iii f?i':i!i i?:'i?is{{?:ii:?:+:i?ti!ti�i:iiii: ,hon i� ..................................... ::w: ::•.�::::'::::•::::::::::::::::w..:......................:t.....:....:............................:........................................................:.......: .................................... w.... t ........ ....w::::::::::::::::::::::::::::::::::.�::::::::::.�::::::::.:•:•:iL:�{•:ii:4iiiiii:iii:{.ii:•:ism:iiiiiiiiii:•iiii:{4i:{4:+•iiiiii:{?4i:'::..••.•.. :Ji iiiiiii::::nii'iiii:•::{4:is{:4:v. ........:.............. .::.�::.......v........................:.............................:.... .<....................................................:.....::::......................:.............................. ::•::. �::. ..... ::..................... <...•.•t...,..:J..:�:.Y.•i.•nw:::.� ....... .. ........................... .................... ..:. .......................... .........:..:..:: :::. {_•i:.i:.ii:{;$:;:{;i:}::::::::i:::::�:+`vii:•i:{:.:�v::•::{:.i'.iii:.iiiii:{ryi:::: .:::.:.:::::.:::::.::::::.:::.:::.:,::::.:::::.::::..,............................................. ols :.:.....:.......:.. f//f%�% the ad�Uess• ':> It ' <..... mum' tih on ��anran :<; oli Fafiure to secure coverage as required under Section 25A of MGL 1S2 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a 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 truo and coned Signature Date Print name Phone# official use only do not write in this area to be completed by city or town otScfal city or town: permittlicense# ❑Building Deparhment ❑Licensing Board ❑checkif inmediste response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other_ (t-nd 9195 PJA) Information and Instructions " Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", 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 section 25 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 required. Additionally,produced acceptable evidence of compliance with the insurance coverage q y, neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until ce requirements of this chapter have been resented to the contracting table evidence of compliance with the insurance quit pt P acceptable P ep authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and of insurance as all affidavits may be company names address and hone numbers along with a certificate Y supplying , P P Y 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 be' requested, not the Department of Industrial Accidents. Should you have any questions regarding the'law"or if you mg qu are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and p legibly. Department printed 1 'bl . The D artment has provided a space at the bottom of the e event the Office of Investi ati-ons has to contact you regarding the applicant. Please affidavit for you to fill_out in the g _ Y cease number which will be used as a reference number. The affidavits may be retained to be sure to fill in the ermrt/h P the Department by mail or FAX unless other arrangements have been made _.._..._.--,_..........:._.._...._..� ._ _ .. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Me of Invesduadons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 I � l - BOARD O. B Lleens.e F BUIL®ING REGULATIONS ffit G II �CONSTR•UCTION SUPERVISOR'Numbed 070029 195�/I h Ei� 047 Msv— Tr.no: 5451 Rdwil Q RALPH CROSSE' =� � 1`8 INOODRIDGE E SANDWICH, ' MA 0�'1537 ", Administrator 12-30-02 Applicable Code Sections : P171. Deffinitions: Common Path of Travel:That portion of an exit access which the occupants are required to traverse before two separate and distinct paths of travel to two exits are available. Paths that merge are common paths of travel.A common path of travel is measured the same as travel distance but terminates at that ppoint where two separate and distinct routes become available. Table 1010.2 minimum number of exits for occupant load: 500 or less=2 1011.2 Dead Ends: Exit access passageways and corridors in all stories which serve more than one exit shall provide direct connection to such exits in opposite directions from any point in the passageway or corridor insofar as practicle.The length of a dead end passageway or corridor shall not be more than 20 feet. 1011.2 Common Path of Travel: In occupancies in use group B the length of a common ' path of travel shall not exceed 75 feet. (100 if building is sprinklered). Table 1006.5 length of exit access travel: B use sprinklered building 250 feet Table 1011.4 Corridor fire resistance rating 0 hrs Ralph Crossen TOWN OF BARNSTABLE k " r BUILDING PERMIT PARCEL ID 294 013 GEOB SE Ia 20567 ADDRESS 70 AIRPORT ROAD f ioo 'l'j ice_ PHONE HYANNIS ZIP — LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY _4_"'n I PERMIT 66139 DESCRIPTION ELIMINATE DEAD-END CORRIDOR/CREATE ENTRANCE PERMIT TYPE BREMODC TITLE COMMERCIAL ALT/CONY CONTRACTORS: RALPH CROSSEN _- � � ='--=-_.--�.-� , Department of ARCHITECTS: Regulatory Services TOTAL FEES: $100.00 BOND $.00 prr CONSTRUCTION COSTS $5,00.0.00 - - / V 1 PRIVATE s Ors Q► 437 NONRES_/NONHSKP ADD CaN VAT *: sARN31'ASM MASS. 1639. �D MA'S A BUILD N D ' ISION BY .a�.... .�=" ... DATE ISSUED 12/30/2002 EXPIRATION DATE Tom Perry 1-30-03 Attacohed are the rated information relative to the rated coridor building permit. The owner is looking for a final.sign off from you and the State Inspector. I told him that your sign off is all that is needed. Would you please verify this for me with the owner's rep. Thank You His name is Peter Lamenzo and his phone number is 737-4256 Thank You Ralph Crossen . G - �tw •^7tt�44, .« w t} a*d gab; r r F3 �' �? h° J s "� a IS dAs g a /�In.--�o4Rk��' 4 M.: Ne ors so �'��� 4-.:�—bf,��-4r'�"Y''✓i.+.t�'a 'LL rr y,� 3. �f` . ® 7,. 4. ��p.}q���g Fa #�:,x 7"'c s d ,•i,,.i n tee �:; .'t?: � {^: NiN '-1 fib. .01 h•h v _ s r Via+ ��:z��`•`. .,`d ter. i�°�� ��+.� �� �` °" .f •J� `=y. - =i ` ( t } 1 ` r C � t i } ® ® BP 20 made in United States of America hy:Fe)riosia to Esbedes Unidm per.Febrique=+W—Una per. 1852 Ameho�iq world Md.Inc.,Lancaster,PA 17604 R4177—Type p ASS/F_/w w4vurt�-nnwr uwir��wr pSS/F _^-- TM _._uu��G rire vuard� B �r�ied uiar g1 CoMente Not Over 48 Sq.Ft P ® t' tFor�,e, iseuieNo. BP-6o46 Yd HumiGuard T" lus SURFACE BURNING FIRE RESISTANCE CLASSIFICATION WHITE 24 in x 24 in x 518 in (nominal) CHARACTERISTICS OES1GNNUMBM A202 610 mm x 610 min x 16 mm(nominal) . FLAME SPRW ..25. SEE U.L.FIRE M%NCE DIRECTOW BLANCO SMOKE DEYELMED ..,,_,18 AW U.L I]IREC IORY t3P PROS i CEFMF�M FOR CANADA. 48&q K(4.46 m2) ACOUSTICAL PROPERTIES BLANC P NRC 0.50 " in accordance with ASTM C423-00. CAC min.33 in accordance with ASTM E1414-00. 12 pieces nStl LA295633 IL Mio1 12 piezas 15 mm Approved by the Board of Standards and Appeals 12 pieces Fot use in New York City under Cal No 72759—SM _,. z 12 MAR 02 s 4 - SI tiff F. x�?+'" 7ltal,{, TOWN OF BARNSTA BUILDING PERMIT PARCEL. ID 294 01.3 GROB SE ,I 2058'T ter' ADDRESS '70 AIRPORT ROAD,._/ r�p -r""� ����a�C e. PHONE I, �IYANN JCS ZIP ` LO u. t . B`LOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY ,` . PERMIT' 66139 DESCRIPTION ELIMINATE DEAD—ENDCORRIDOR./CREATE ENTRANCE I _ PERMIT TYPE BREMODC TITLE COMMERCIAL ALT/CONV OONTRACTORS: RALPH CROSSEN { �M " "Department Of ARCHITECTS: Regulatory Services } µ TOTAL FEES; 100 ti BOND $;00. p1U CONSTRUCTION COSTS $5,000.00 _.�� � ...ry I 437 NONRES-/NONHSKP ADD/'CONV PRI�ATk" ; Ox _ t .�,.s .. Epp Mp�l A _..�, • BUILDIN DjvL VISIOrV BY DATE ISSUER 12/30/2002 EXPIRATION DATE } n _.. 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 FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL-,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. . 4.FINAL INSPECTION BEFORE OCCUPANCY. BUILDING,INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL !! 1 WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE 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. i LDI N BUI G PERMIT i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1 q Map € Parcel 0W60 Z_ Permit# `[ Health Division Date Issued ft)it 5K Conservation Division Application Fee ®� Tax Collector Permit Fee ,L�_-� /0 Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address too DAVIO Village Owner Address Telephone r Permit Request 7( 2(.21LD CIZ'- 1�i&�i 71 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new_ Zoning District Flood Plain Groundwater Overlay Project Valuation f% Construction Type S 113 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 &�Io Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(s .ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing4 new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: )<Gas ❑Oil ❑Electric ❑Other Central Air: Kes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes AdNo Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial MYes ❑No If yes, site plaQ review# V Current Use Proposed Use �C BUILDER INFORMATION Name Telephone Number Address - License# ,� Home Improvement Contractor# /1 z/, !'7_ — Worker's Compensation# 0 5 X 20 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO U� SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS 1 VILLAGE OWNER r DATE OF INSPECTION: FOUNDATION FRAME INSULATION !' �► FIREPLACE _ 4 y y r � ELECTRICAL: ROUGH '. 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Failure to secure covers=e a,required ender Section 25A bf MGL 15l can]ead to the imposition of criminal penalties of a 9ne np to 51,500.00"t d- one yearn'imprisonment as weIl as dvII penalties in the form of a STOP WORK ORDER and a 9ne of S100.00 a dap against ma I mtders4smd that a' copy of this stateinentmay be forwarded to the Office of Investigations of the DIA for coverage verification I do)iereby-certifyunderthe'airs and-pe -of-perjury th�the-information-pr-oariderLabove_issrue-= coirert j Date - Signature Phone# Print name - omdai1L9e only do not write in this area to be completed by city or town offidal permit%iicense# CIBullding Department city or town: ❑Licensing Board []Selectmen's OfSce ❑checkif immediate response is required ClgealthAepartnent contact person: , phone#; ❑CJther_�_ ' fl.-A-A 9195 P1A1 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their « e person in the service of another under any contract e ' .defined as ev employee� rY .. • employees. As cpioted from the law , an p y of hire, express or implied, oral or written. , Oyer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of An empl the foregoing engaged in a joint enterprise, and4ncluding the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association 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 section 25 also states that every state or local licensing agency shall withhold.the issuance br renewal of a license or permit.to operate a business or to construct buildings in the commonwealth for any not produced applicant who has with the insurance.coverage a required. Additionally, ither the acceptable evidence of compliance wi 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 P es to our situation and' b checking the box that applies y • Please fill in the workers compensation affidavit completely, y keg P :. supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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.i's being requested, not the Department of Industrial Accidents. Should you have any questions regarding the'law".of if ygu are required,to ob{ain a workers' compensation policy,please call the Depaitaierit at the niunlier listed below:.' FIN City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of<te affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pleas-e•� be sure to fill tlie•Pemutllicense iiiinber whichwilLbe used as a refeieace numE?er. Tfie affidavits maybe'r tc IIl • . `amaiT or FAX unless other arrangements Have been made.; the Departmentbyf : .�. . » � ,.• • f The 0$zce_of Investigations would like to thank you in advance for you cooperation and should you have any questions, . please do not hesitate to give us a'call. The Department's address,telephone and fax number. : The Commonwealth Of Massachusetts Department of Industrial Accidents r ' Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat.406, 409 or 375 - .141c mm COMS RUf3'fnlaC��fY Sl t+ .. Rumbe�, § 6 .; 070: Bi=rt da e¢ 11/ 51f94'7 # is�r �j 1`1J1� /� ©i2 49b1F2 , r m 0I RestrctedxF`t0� FKLPH GROSS B'OX 4-3 tiAli FMYANNI'SWO:RT, IIAA 02647 A mininaoF I 7hestmal WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY QUOTE PROFILE POLICY NUMBER: (GS16UB-805X209-A-02) INSURER : ST.PAUL FIRE AND MARINE INSURANCE COMPANY - 80063-MA INSURED'S NAME : EAGLE EYE INSPECTION SERVICES INC RATE BUREAU ID: 421108 PREMIUM BASIS ESTIMATED RATES ESTIMATED TOTAL ANNUAL PER $100 OF ANNUAL CLASSIFICATION CODE REMUNERATION REMUNERATION PREMIUM LOCATION 001 01 FEIN 043533362 ENTITY CD 001 EAGLE EYE INSPECTION SERVICES INC 6 WHEELER AVENUE SCITUATE , MA 02066 CARPENTRY NOC 5403 IF ANY 16.60 CARPENTRY-DETACHED ONE- OR TWO .FAMILY DWELLINGS 5645 IF ANY 10.62 CARPENTRY-DWELLINGS-THREE STORIES OR LESS 5651 IF ANY 10.62 INSPECTION OF RISKS FOR INSURANCE OR VALUATION PURPOSES NOC 8720 57200 .93 532 ------------------------------------------------------------------------------------ MERIT RATING/EXPERIENCE MOD: NONE MODIFIED PREMIUM $ NONE TOTAL ESTIMATED ANNUAL STANDARD PREMIUM 532 EXPENSE CONSTANT(0900) 244 4.50% MA WC SPECIAL FUND AND TRUST FUND 24 TOTAL ESTIMATED PREMIUM 800 nFRneTT Amnt]NT DUF 800 HYANNIS FIRE DEPARTMENT 95 HIGH SCHOOL ROAD EXTENSION HYANNIS,MASS.02601 HAROLD S. BRUNELLE, CHIEF FIRE PREVENTION BUREAU LT.DONALD H.CHASE,JR. LT.ERIC HUBLER Inspector Inspector TO: Building Commissioner FIR: Fire Prevention r SJ: Building Permit DT: October 7, 2002 Property: 100 Independence Dr Dear Sir, We have reviewed the plans for the above named property, per the building code, and recommend that the building permit be issued. "SPACE F" Thanks, Fire Prevention Officer Hyannis Fire Department ' 0 Page 1 COM MRCIAL ADDITION/ALTERATION tter of Approval from Site Plan Review (if necessary) If located in OKH or Hyannis Historic District- Certificate of Appropriateness required Plot Plan [�Map &Parcel number Full Description of project(U-value of replacement windows if applicable) If sprinkler or fire alarm system is required,do not accept application package without prior approval from Fire Department in writing. . Sign-Offs fro Health Tax Collector Conservation Treasurer ❑ BA relief(Special Permit or Variance is required for project: Copy of Decision Documentation proving that the decision was recorded at the Registry of Deeds Win one year of ZBA decision date. [� Street address of project [+/ Correct square footage Estimated Cost Owner's name &address Contractor's name, address &telephone number Contractor's signature ❑ Full sized plans, stamped plans (1 full size and 1 reduced) [� Workman's Comp. form ' ❑ Construction Super's License OR ❑ Controlled Construction Documents ❑ Check expiration date on license ❑ 00 next to restrictions ❑ Application Fee ❑ Permit Fee . q-forms:permitsl rev.1115101 YOU WISH TO OPEN A-BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1'FL., 367. Main Street, Hyannis, MA 02601 (Town Hall) DATE: 411;,106 Fill in please: APPLICANT'S YOUR NAME: i BUSINESS YOUR HOME ADDRESS: �{`flrpm IS TELEPHONE # Home Telephone Number S IH NAMEOF NEW BUSINES INESS sI4� IS THIS A HOME DCCUhATION� YESin- N, Have you been given approval from the:buildirla divisions YES NO A,p V / /ADDRESS OF;:BUSINESS / � �_ �c99L .cSJtU� ..:.! yNP S p1MAPJPARCEL;NUMBER When starting a new business there are several things you must do in order to be in compliance with.the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure' you'have the appropriate permits and licenses required to legally operate your business in this town. . 1. BUILDING COMF TS35 NER'S OFFI E This individ �al his en irrFo f any parmit requients that pertain to this type of business. Au orized i ture** COMMENTS A—A — L 2. BOARD OF HEALTH h6t jec, C fQvi QcJ i rl. This individual h � ���enin r f th rmi irements that pertain to this type of business. LVn ;n i sk-G�G� thpriz Signat re** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has b e inform oft licensing requirements that pertain to this type of business. ' Authorize, Signature,* . COMMENTS: h I 1` , -14 1 ` �$~ ` 1/41 4DOW- �- 5 � ! I ! •� Il �1•� LwoAwmJ 'L1011ifr � !1F PAT�R70N ,Y, IM �� , Oct., F low 0400 AM SiWC Y qM. 1�A lt�rtr,+N�t, F: `; �� �,, ��r rl� t,. �',u._��.,�'�Y�, �„1„�•,1 � ,���"1�' „'�. 1 EI�i14 MINE IIDIAtIt "�F• v/IMlD r 'd' +"'�1 a .. ,' Y •ic+ ..I.,' •� ... ,� �... '•.t, , �n'' �� (r 7 j� \_;; :,..�. a �'� 4 I`�:t r.,lt c `'!�'_ .� I'"N {il"IA 1 ;/4 j141�'"•{�' ::+�Yt � t - ( �;�.N y •'A �11� 4 yy tl j ,4{ 1 yl ' 1.. � t :ir,'� �.1' a �I�F#+' 1 1 �)t f y� 1� � ! +��7� w�•� F 1.1 5, 1.. �� � 5'�, ;' _