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0973 IYANNOUGH ROAD/RTE132 (9)
�� �'I SINE Sign TOWN OF BARNSTABLE Permit * BARNSTABLE, • c.. MASS. t639. A° Permit Number: Application Ref: 201500894 20071077 Issue Date: 02/27/15 Applicant: NEWMARKET PLACE LP Proposed Use: OFFICE CONDOMINIUM Permit Type: SIGN PERMIT Permit Fee $ 75.00 Location 973 IYANNOUGH ROAD/RTE132 Map Parcel 29402600D Town HYANNIS Zoning District $PLT Contractor PROPERTY OWNER Remarks - REPLACE SIGN WITHNEW FOR MIRACLE EAR 28 SQ FT ON BLDG Owner: NEWMARKET PLACE LP Address: 297 NORTH STREET HYANNIS, MA 02601 Issued By: PC POST THIS CARD SO THAT IS VISIBLE FROM TEE ST: ET Town of Barnstable Regulatory Services " BABNSrABIX ` Richard V. Scali,Interim Director Building Division Tom Perry, Building Commissioner, 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790�-66230 Permit#0 Building Official approving-------____- Application for Sign Permit Applicant:__0 E_ Q� 26—LLB---------------Assessors No.p� Doing Business As:1!1�c-e,-,�g—_�_Af _ ___Telephone No.- - ' Sign Street/Road:n�� (�Y-\vNt3 `� � L - -- - --r---------- ------------- - --- - --------tee Zoning District:- Old Kings.Highway? Yes/& Hyannis Historic District? Yes& Property Owner Name:_--Gam—MPTY,& NVCC - ---------Telephone:--------------- Address:_—'�119 ---!v �" �C �v_�v� _ 1 N c v A S_ -------- ---Village:—''I_+------- ---- -� Sign Contractor Name:-------S� �tRrrM,tP�-------------------Telephone: O _64D-f rQ Mailing Address: Description ------- ------------ ----- �� � Please follow the cover directions.You must have an accurate rendition of sign with dimens ns and `- location. REQ l ZX 1S2n SNC�Y1 Is the sign to be electrified? �/e No (Note:If yes,a wili»gpetmitislequiled) I—E� Width of building face�fr.x 10= H t b x.10= .y G Check one Reface existing sign or New Total Sq.Ft.of proposed sign(s) 28 50 F T If you have additronal signs please attach a sheet listing each one with dimensions If refacing an existing sign please provide a picture of the existing sign with dimensions. I hereby certify that I am the owner or that I•.have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of §240-59 through§240-89 of the Town of Barnstable Zoning Ordinance. s Signature of Owner/Authorized Agent Date SIGNS/SIGNREQU revisedl 10413 Direct mount LED internally illuminated Channel Letters ( i �- + t ❑❑ I. '1 :C 1UP6 S� OL UT,1005 .0 I O r.� r� � � 1 � •�hWM � �:1 �~ wgaW 5.. - C-cm 1' 29 i WALPOLE -Proof colors may vary from monitors&actual sign meterlals. p •ciisid sipnotare oinum all wilhlps a=pealtotlon:for sipaape on eorreet. A pdf proof Is not a correct representation of printer output color. CLIENT .AI veto are your rosponsilillty ones final op►rml Is ntolrsd, �� �� Resolution a color from files provided by customer are the APPROVAL -Mill ml ehorpes opply 11 you risk Is mob ebgos into ar wA has boon plated,hbrttolsd sndAr lao llod. The way to groan your business. customers responsibility. -Hard Proofs can be printed to ensure color satisfaction at a coat 458 High Plain St.Intersection Rts 1 &271 to be determined. Customer:Miracle Ear Hyannis -Additional design charges may apply If customer does not proceed Walpole,MA 02081 with all or part of proles!, Dam, 508-660-1231 slgnaramawalpole.com PROOF FRooFs wmoF+ PrwoFs slgnaramanorwood®comoast.net � E FEE �'0Dm �0'0° Approved By: ` Thl8padkfarcmephlail se-aduWsfzvs1o*m1pmpwf v 71418 ORIGNAL DESIGN AND ALL INFORIAMON CONTAINED HERE IN ARETHE PROPERTY any s1w'-Y• OF SIGN A RAMA,AND SU&JEDT70 RETURN.ANY UNWDICRIZED USE IN FOFMXN N Direct Mount 5" Aluminum Return ~..__ _ = - . L'ED Lead Wire ("Whip") Aluminum Back . 5" Aluminum Return_ A Acrylic Face' _ A 1 Trim-Cap f�A i - Pass Throw Fi Cromrnet }� 9 T gh Pala ' hrau Grommet 'Clinched f a and Caulked Seam Power Supply _ Lid I'lluminatton Y . s , `LED illumination Drain Hole _ w FRONT' W s }: SIDE VIEW FLUSH MOUNT . .. 4 i. WALPOLE Proof colors may vary from monitors&actual sign materials:•_ f ;�_p •Client signature ensures all spelllnps&specificatlons for slgnage are correct' o P A pdf proof is not a correct representation of printer output color. 'CLIENT -All errors are your responsibility coca final approval is received g aResolution&Color fromfiles provided by customer are the g y N= ak g ed,fabricated and/or installed.0 APPROVAL Adtlilional char es apply if ou wlsh'ia make chae is ante artwork has been print customers responsibility i 9 Y Hard Proofs can be printed to ensure color satisfaction at a cost to be determined. Customer: 458 High Plain St. Intersection Rts 1 &27 Additional design charges may apply if customer does not proceed. Walpole, MA 02081 with all or part of project 508-660-1231 Date: signaramawalpole.com PROOFI PROOF2 PROOF3 PROOF4—�— PROOFS'' -- - - signaramanorwood@comcast.net FREE FREE $20.00 $2500 _�$30.00_ Approved B pP :Y y ®� Thl3 pr00(lS(Or COIfCaprU81 USa-actual SIZa9/COIOrS/QrOp07fIO11S - THIS ORIGINAL DESIGN AND ALL INFORMATION CONTAINED HEREIN ARETHE PROPERTY may slightly vary. OF SIGN A RAMA,AND SUBJECT TO RETURN.ANY UNAUTHOR12ED USE IN FORBIDDEN. The Commonwealth of Massachusetts Department of Industrial Accidents Ila Office of Investigations 600 Washington Street 4 Boston, MA 02111 5� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly qnnName (Business/Organization/Individual): 1 I 1 Address: 4 (, City/State/Zip: m Phone 4: �- 11 Are you an employer?Check the appropriate box: Type of project(required): 11A,I am a employer with to 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 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. K workers' comp. insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I LE] Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' comp. insurance required.] 13.�,Other I' *Any applicant that checks box#I1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. +Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. 1 � P Insurance Company Name: ,Iwrll ,, Policy#or Self-ins.Lic.#: I d� .yV (_� 3� 0 Expiration Date: (Out Job Site Address:03 A �� v City/State/Zip: T'I\ an h �� l MM Attach a copy of the workers' compensation poliq 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 eerti under ains enalties of perjury that the information provided above is true and correct. Signature: Date: �V Phone#: 5 ^� I 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#: RAEDAWN-01 CLEDDUKE ACORL�` CERTIFICATE OF LIABILITY INSURANCE DAT 2/10/201510/2 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 CONTACT NAME, Linda Taddia,CISR,CPIW Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 C No Ext: Alc,No): (877)816-2156 South Dennis,MA 02660 E-MAIL Itaddia ro ers ra ADDRESS: s g ycom INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Valley Forge Insurance CO. INSURED INSURER B:HARTFORD INSURANCE COMPANY ' Rae Dawn Corporation DBA Sign-A-Rama INSURER C: 458 High Plain Street INSURER D: Walpole,MA 02081 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS . CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EXP LTR TYPE OF INSURANCE ADD UBR POLICY NUMBER MMIDDPOLICYIYYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 TO CLAIMS-MADE N OCCUR B4029430802 09/01/2014 09/01/2015 DAMAGE PREMISES Ea cc ENT o urrence $ r 300 000 o MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X POLICY❑PE0 LOC - PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER:. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO - BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION SPER OTH- AND EMPLOYERS'LIABILITY TAT YIN UTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE 12WECLZ3866 09/01/2014 09/01/2015 E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? ❑ N I A (Mandatory In NH) E.L.DISEASE-Fes,EMPLOYEE $ 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable/Hyannis THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD S18 `per b3lo� ------------- I"E' Town of Barnstable do Building Department - 200 Main Street * AB BAJW&rIE, # Hyannis, MA 02601 16 9. (508) 862-4038 Ce.' rtif icate of Occupa' ncy- Application Number: 201105620 CO Number: 20120004 Parcel ID: 29402600D CO Issue Date: 01123112 Location: 973 IYANNOUGH ROADIRTE132 Zoning Classification: SPLIT ZONING Proposed Use: OFFICE CONDOMINIUM Village: HYANNIS Gen Contractor: ROBERTS, MICHAEL Permit Type: CC00 CERTIFICATE OF OCCUPANCY C.OMM Comments: _ ;L3 y Building Department Signature Date Signed TOWN TO WN OF BARNSTABLE Building 201105620,- Permit LE. * Issue Date: 11/16/11 MABS Applicant: ROBERTS MICHAEL rFp s Permit Number: B 20112506 Proposed Use: OFFICE CONDOMINIUM Expiration Date:. 05/15/12 Location 973 IYANNOUGH ROAD/RTE132Zoning District SPLTPermit Type: COMMERCIAL ADDITION ALTERATION Map Parcel 29402600D Permit Fee$ 136.50 Contractor ROBERTS,MICHAEL Village HYANNIS App Fee$ 100.00. License Num 053861 Est Construction Cost$ 15,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND TENANT-FIT OUT FOR MIRACLE EAR THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: NEWMARKET PLACE LP BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address:. 297 NORTH ST INSPECTION HAS BEEN MADE. HYANNIS,MA 02601 Application Entered by: PR Building Permit Issued By: _ '. THIS PERMrr.COWEYS NO:RIGHT TO OCCUPY ANY STREET;-.ALLEY OR SII)EWALK'OR ANY PART TIii�REOF EITHER TEMPORARII Y 6k�PERMANENT'L'Y ENCROACHMENTS 01�PUBLIC PROPERTY N< F SPECIF[CALLY;PE UNDER THEBUII.DINGCODE MUST BE APPROVED BY;THE JURISDICTION STREET OR ALLEY GRADES AS WEI;L AS DEPTH AND LOCATION OF.'PUBLIC:SEWERS MAYBE s OBTAINED FROM.THE DEPARTMENT OF:PUBLIC WORKS THE ISSUANCE'OF THIS PERMrr DOES NOT RELEASE THE APPLICA . M FRO THE�CONDITIO' OF ANY-APPLICABLE SUBDIVYSION RESTRICTTONS MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING_INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS.STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL a 142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2�� L ' 3 G �� Q tC 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health KE t � Town of Barnstable Building Department - 200 Main Street BARNSTABLE• * Hyannis, MA 02601 MA59. (508 s6g9• ) 862-4038 9 �ioj.fD MAC a _ tertificate . of Occupancy Application Number: 201105620 CO Number: 20120004 Parcel ID: 29402600D CO Issue Date: 01/23/12 Location: 973 IYANNOUGH ROADIRTE132 Zoning Classification: SPLIT ZONING Proposed Use: OFFICE CONDOMINIUM Village: HYANNIS Gen Contractor: ROBERTS, MICHAEL Permit Type: CC00 CERTIFICATE OF OCCUPANCY COMM Comments: Building Department Signature " Date Signed TOWN OF BARNSTABLE Building 414E 201105620 BAMSTABLE, Issue Date: 11/16/11Permit y MASS. �ArFG 339. a�� Applicant: ROBERTS,MICHAEL Permit Number: B 20112506 �. Proposed Use: OFFICE CONDOMINIUM Expiration Date: 05/15/12 Location 973 IYANNOUGH'ROAD/RTE132Loning District SPLTPermit Type: COMMERCIAL ADDITION ALTERATION Map Parcel 29402600D Permit Fee$ 136.50 Contractor ROBERTS,MICHAEL Village HYANNIS App Fee$ 100.00 License Num 053861 Est Construction Cost$ 15,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND TENANT FIT OUT FOR MIRACLE EAR THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A > CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record; NEWMARKET PLACE LP BUILDING SHALL NOT BE<OCCUPIED UNTIL A FINAL Address: 297 NORTH ST INSPECTION HAS BEEN MADE. HYANNIS,MA 02601 ! (� Application Entered by: PR Building Permit Issued By: v_ THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR.PERMANENTLY..ENCROACHMENTS ON.PUBLIC PROPERTY,;NO SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.;STREET OR ALLEY GkADES AS WELL AS`DEPTII ANDLOCATION OF PUBLIC SEWERS:MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS,THE ISSUANCE OF THIS,PERMIT DOES 40T RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE,SUBDNISION RESTRICTIONS. s MINIMUM Of FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURALMEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). a:x!�$ , Si. • .., 'ni • ';s ,iu :P .A1� � ¢�'S-ex''� BUILDING INSPECTION APPROVALS' PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 f � 2 2 2 3 �/i D 1 Heating Inspection Approvals Engineering Dept v Fire Dept 2 Board of Health TOWN OF BARNSTABLE BUILDING PERMIT APPLICA I N Map �� Parcel „ Application #c�®`� �c�6 Health Division it - Iowa deliver yS Date Issued I Ilil Conservation Division Application Fee Planning:Dept; Permit Fee'- < r Date Definitive Plan Approved by Planning Board Historic OKH _ Preservation/Hyannis Project Stree//t//Address .v Village Owner C&J Address lvoe& Telephone SD C—_ / Permit Request Square feet: 1 st floor: existingAo-� proposed 100� 2nd floor: existing proposed Total new Zoning Districts Flood Plain Groundwater Overlay Project Valuation A. oli a Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ;0 Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway:-)❑Ye& ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing �2 new o2 Half: existing nevo Number of Bedrooms: existing —new b ';j, '' Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel J4-Gas '❑Oil ❑ Electric ❑Other Central Air: XYes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial Yes ❑ No If yes, site plan review# / Current Use .154,944 e ss / rs G�itC N Proposed Use ��e -- -- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) - � Name /C "Z - _2 Telephone Number Address 07y7 ��'?- mil J�� License# ::f,321 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ✓ � - U� % SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION 3 DATE ISSUED MAP/PARCEL NO. ' ADDRESS VILLAGE OWNER t a r = DATE OF INSPECTION: FOUNDATION r FRAME : t t INSULATION ,I FIREPLACE I ELECTRICAL: ROUGH 'FINAL f PLUMBING: ROUGH FINAL GAS: ROUGH FINAL t _ FINAL BUILDING t t DATE CLOSED OUT ASSOCIATION PLAN.NO. ` The Commonwealth of Massachusetts. Department of Industrial Accidents Office of Investigations d 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): �Q Address:c;E�! dILI2 .5�� City/State/Zip: g n. Phone.#:( 7Vd-— A ou an employer? heck the appropriate box: Type of project(required): 1re I am a � with employer j 4. I am a general contractor and I - 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors listed on the attached sheet. 7. ❑ Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. employees and have workers' Y P t}'• $ 9. ❑Building addition [No workers'comp.insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *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. lContractors 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: Policy#or Self-ins. Lic.#: Expiration Date: 7 ` 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 tip 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 under the p enalties of perjury that the information provided above is true and correct Si ature: Date: 2 c=-)0 /< _ Phone#• SD C 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#: i 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 Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 11-22-06 Fax# 617-727-7749 www.mass.gov/dia Client#: 16172 2SUFFIELDMA DATE(MM/DDI A�CORUM CERTIFICATE OF LIABILITY INSURANCE 01/04/2011 ) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Agency ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 973 lyannough Rd., PO Box 1990 Hyannis,MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: CNA Suffield Management Corp. Etal INSURER B: 297 North Street INSURER C: Hyannis, MA 02601 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _IN SR DD POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD DATE MM DD YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ Poccurrence) CLAIMS MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY M PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION AND WC294080721 12/07/10 12/07/11 X WC STATU- OTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $1 000,000 ANY PROPRIETOR/PARTNER/EXECIJTIVE (; OFFICER/MEMBER EXCLUDED? - E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under SPECIAL PROVISIONS below IE.L.DISEASE-POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION S' Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1Q_ DAYS WRITTEN Building Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 367 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Hyannis,MA 02601 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #S76102/M76101 JRS O ACORD CORPORATION 1988 r �7HE Tp� Town of Barnstable .Regulatory Services vUMMSTABLM MAM $,` Thomas F. Geiler,Director �f1639r Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1, 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. (Add ss of Jo �ig;zatnre Owner Date Print Name If Propert�Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMIS S ION of Yt�ram, Town of Barnstable o Regulatory Services saxrrsTwsr E, Thomas F. Geiler, Director MAss. 0.19. ,�� Building Division lFn nna't" Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 10B 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'ihe 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/certification for use in your community. Q:\WPFILES\FORMS\hom6exempt.DOC '' Nius..Ichusetts- Dep.111111c'Iit OI Public �;it Boat-d of Building Kegulations and Standards Co.ottructi,on Supervisor License License: CS 53861 Restricted to: 00 MICHAEL J ROBERTS 1815 FALMOUTH RD#C6 CENTERVILLE, MA 02632 ' � ,. Expiration: 2/13/2012 { onuisvioncc Tr#: 16586 Page 1 of 1 Shea, Sally r From: Lt. Don Chase [dchase@hyannisfire.org] Sent: Tuesday, November 08, 2011 5:42 PM To: Shea, Sally Subject: Miracle Ear Hi, All set on plans for the Miracle Ear store at 973 lyannough Rd. (behind the Cape Mac store) Mike knows that there might be some additional sprinkler work involved. Thanks Don Lt. Don Chase,Jr., FPO Fire Prevention Officer Hyannis Fire Department 95 High School Rd. Ext, Hyannis, MA 02601 508-775-1300 x106 f 11/9/2011 L Io'—Y 34'—Y ♦REST j ROOM q CFWR RAIL °° t_---_-- a RECEPTION ---- A Id`! oa c-o• HALLWAY W9 p~p '02 • W j yZ� Z b� W zi3 rr- 4 x1i SOUND SOUND ROOM ROOM ® TEST TEST O7 ROOM ''ROOM �. LARD/ ,v 4��ESK01\• N. y 9C cr 105 .' 0 4'DE9C 6$�{ N g ti .. 8'DM � 8'DM � 4'DE51( 8'DESK d y=j ??? V 15' S'� 14' yyj y 3er—Y � NOTE: THIS DRAWING IS BASED ON PRELIMINARY DIMENSIONS THAT CAN'T BE VERIFIED FloOR PLAN AT THE PRESENT TIME AND MAY NOT BE USED FOR CONSTRUCTION. ` PRUr TIDE:NEW FREESTANDING STORE OWNER DON GROSS C508) 668-4499 SCALE,3/16' 34'-Y 0 a - 4\c 10 ' 4 Tj EN N . UGHTS �G 6 �+ s5 a g rc a E! o � 4'-0' HARD CdUNG "� o d ' q IXHAUsf A J� � �.1Jyy RQZ �l7 yy I O - FAN RQ W Ir U W Z?3 M IF FAN 'r'': ,'�.r.,; .q ' ,��:,� �'i�• ;Ei as �� '� yWJ1�� HARD CEILING _ =w m' p H_ ®8'-D� �' .. 'Y� .j.�'�,'i tom'. - - W ✓i LJ N 3 ~ > = a "P � 4o m N N N NX�ll v 1 7x K K f.O pQQ d 6 K U REVOM m aa W �1 15 5' 14'- DaOe vi N p �M N ITS NOTE: THIS DRAWING IS BASED ON PRELIMINARY DIMENSIONS THAT CAN'T BE VERIFIED REFLECTED CEILING AT THE PRESENT TIME AND MAY NOT BE USED FOR CONSTRUCTION. �`` PLAN PROJECT TYPE:NEW FREESTANDING STORE OWNER-DON GROSS (508) 668-4499 SCALES 3/16' = 1'-O• A 2 SCHEDULE OF WORK ROOM FINISH SCHEDULE SPECIFICATIONS SUPPLIED INSTALLED ROOM ROOM FLAOR wAlis DOORS ,. GIRPEF.WNW - NUM NAME DESCRIPTION OF WORK C ME � STYE-DU7D-2 " ME. _ COLOR-CUSTOM CDNI'ACT:1HERESA GOODWIN O AMPUFDN USA . - WALL WSULATKIN-UNFACtD INSULATION BATTS WITH R-13 RATING FOR x x - PHONE: (70 288-M 2'x4'WALLS AND R-19 RATING FOR 2'x8'WAITS 2 IV CARPET BASE TO MATCH CARPET CEILNG INSULATION,-UNFACED INSULATION BATTS WRH R-19 RATING. x x I c xa NOTE:SOLID CORE TESTING h CONSULTATION ROOM DOORS 70 RECEIVE x x C3. POLORII:NC-31 N CREAM(MATTE FM)L Y (1)POL.YPRENE WEATHERSIRIP-REESE P979-17(17 FEET) 3 ' iL (1)AUTOMATIC DOOR BOTTOM-REESE IM-38 101 RECEPTION , 2 3 5 4- 5• AI 4. OPANTTj2: BENJIIN A MOORE (1)38'CARPET SEPARATOR THRESHOLD-REESE/565A H-70 LINEN WHITE(SEMI-GLOSS). a CONTACT REESE ENTERPIM INC.1-BOD-328-0953 102 WLLLWAY 1 2 3 5 a 5• 5. STAIN: MNWAOL COLOR-/235 CHET6t1 2 ALL EI LIWA..PHONE AND DATA OULLEIS. X x. _103 HAL ROOM 1 2 3 4' 5� FINISH TO DE A POLYURERYOIE y - q .. PENDANT UM'(3)PENDANTS IC613-NI,(3)PW WT soco $ x x - 104 TEST ROOM , 2 3. a 5- ` DOORS g DOOR TRIM-IF E)(ISRNG DOORS 3 TRIM ARE 3 y LX-9 Iw-801 (3)CNmEs Ili- -BTU. PAINIED.REPAINT WITH 14 ABOVE. IF THEY ARE =z y 1D5 LAB/STORAGE 1 2 3 a 5' STAINED,LEAVE AS-IS NANL�FACTURED BY WAG UGHDNG(BOO)528-2588 - 108 TEST RDDM 1 2 3 4 5• p TO BE CHOSEN BY FRAKK7{�AND/OR LANDLORD. q d ALL PLUMBING ' - h FDLNRES SHONN CT PLAN x x FLOOR CARPET: NOHAWK 107 soLlro Roots 1 z 3 a W X X q� Q CARPET ADHESIVE _ x. X _ ,' REST ROOM '� a 3 a 5• a a b 1: W CARPET g 3 4' BASE - X X 6LJU , z ALL PANTS&FINISHESX X � ¢ IL CHAR PAIL x $a� � W y l�N 1 BUILT-IN CINELS SUPPLIED BY LANDLORD OR FRANCHISEE x x �+ a ALL FURNITURE AND FIXTURES WINN ON PLAN - X X dN n NQN N 4i P N PROJECT SPECIFIC NOTES MOVINDESOUNO INSULATION N WAILS,CEILING,A AROUND VENTS&DUCTS IN ALL TEST Z a - ROOMS. SEE SPECIFICATIONS UNDER SCHEDULE OF WO K PHONE!!DATA REnimaucwic. FIFASE ORDER ALL POSTERS AND POSTER HOLDERS FROM a cy'i INSTALL PHONE LINES FOR 2-UNE PHONE SYSTEM. .. THE COMPANY STORE THE FURNITURE VENDOR WILL of INSTALL ?� PHONE LINE TO RECEPTION AREA FOR F INSTALL THE POSTER HOLDERS FOR 3 AX/NO OEM. YOU AT NO ADDRIONAI. REVISON6 INSTALL PHONE OLIRLTS IN LEST ROOKS,AND RECEPTION FOR 2-UNE PHONE SYSTEM. CHARGE PROVIDED YOU HAVE THEM ONSIE WHEN THE NS ALL R M DATA OUTLETS AS SH DIN& THEY MUST BE WIRED WITH CATEGORY 5 CAME. FURNITURE IS INSTALLED. PJ45 OUTLETS WILL EACH TERMINATE AT THE RI45 OUTLET N THE LAB/SIORAGF- NEML NOTE: THIS DRAINING IS BASED ON PRELIMINARY DIMENSIONS THAT CAN'T BE VERIFIED INFORMATION AT THE PRESENT TIME AND MAY NOT BE USED FOR CONSTRUCTION. SHEET` PROkCT TYPE:NEV FREESTANDING STORE OWNER: DON (RD= (508) "8-4499 SCALE-N/A Gl- PLAN SYMBOLS (ONLY IF SHOWN.ON PLAN) qaECTWJIL P -FLUSH MOUNTED sNM PANEL- RFACE MOUNTED n 37WAY SWRCN � ' 1FIEPFIONE TERMINATION BlLxa( 88 UGIff C ALL-MOUNTED -' MUCIptlU STRI UGHT(SURFACE-YOUM) (MOUNT a B•ABOVE COUNTER UNLESS NOTED) SINGE OUTLET I VN(OWALL o IS-AFF UN.o.UNLESS NOTED) uplT( ESSEII) a o DUPIEx OURET 115V .NEW.E—RIIG UGFIf DED (TNsuLL o 1s•AFF U.N.0 UNLESS NOTED)Duna OUTI.ET . ® (RAOR�)15V Flllf lxiTf FIXTURE SURFACE-MOUNTED �s a . ~ (CEILING MOUNTED) ® LRilf FIXTURE - - � 11 a pNsrALL o 1s•AFT uN.a uNLEss NOTED) FwoREsrA(r ut;flr FoauRE susT�EIIOED �y� ® (T m MOUNTED) 11 ! FU10 If txaLr FIXNRE DPtECRONAL >o! DOUBLE MPLEX OURET 11sv a d (Cam MOUNTED) (WALL-MOUNTED) a (INSTALL o 15•AFF L%0.UNLESS NOTED) oUNDERM ` ^►0 Zp X L�H W Z 3g 3 TEu3'FIa@ OURET=AN 1 ¢ Z S /(T�1W&LLL 0 15•AFF uN.o.waFss N=)TEISPI OUTLET ® yak/ =y (RDO.-MID.) O N N y p LLATA OUREf-RJIS(/REFERS TO THE NUM OF CEILING FM a PORTS ON (NSGLL 015•AFF U.N.O. ® DATA OUTLET-RHs(/REFERS TO THE NUM OF vow PDRTs oN JACK)(FLDDR MOUNTED) W iz. N Q VOICE/d1TA 01lTLEi(RJ11/RJ(5)COMBO JACK A _ > � •. ONsnuL a 15•AFF uN0 uLBEss NOTED)fi a OVI om) (RI11/RJ15)COY80 JACK ® NVAC SIMPLY VENT(FL - ® JUNCTION BOX(CETIMG-0UNiEp) Z WVAC TIEra URN AIR wn JUNOITON Box -MOUNTED FILE SPPoNKLER HEAD (INSTALL o is•AFF uN 0.UNLESS NOTED) 00 (INSULL 0 IS-AFF Uxo.UNLESS NOTED) g g EXIT SIGN-lArMUNTED F .. FIRE ALARM IWIUAL PULL STATION- i0 V R EXIT SIGN-CW4 o ® (ME FACED) (] SMOKE DETECTOR REVISIONS e (DOUBLE FACED) © CARBON MONOXIDE DETECTOR chi FLOOR ORAPI o a i7 �m NOTE: THIS DRAWING IS BASED ON PRELIMINARY DIMENSIONS THAT CAN'T BE VERIFIED INFGENEP ORMATION AT THE PRESENT TIME AND MAY NOT BE USED FOR CONSTRUCTION. SHEET. PROW TYPE.NEV FREESTANDING STORE OWNER DDN GROSS (508) 668-4499 SCALE,N/A G 2 " I �L9