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Home My WebLink About1019 IYANNOUGH ROAD/RTE132 (3) /0/9 —=��1l��ou � �� _�=�/ �O y -� { �. �f Town of Barnstable Post This Card So'That3�t is,Uis�ble'From the,•Street,Approved Plans Must be Retained on JobandQA,this+`ard Must bye Kept Posted•;= Sign Permit �Uritil Final,nsp ction Has BeenMade To G : 5 ' ez► "` ere a Certificateo�f Qccupancy,is Requiretl,such Build ngshal�Not be® upie ccunt!l a Final lnspeet�on has been�made , Permit#: B-20-578 Applicant Name: Plymouth Sign Approvals Date Issued: 02/25/2020 Current Use: Structure Permit Type:' Building-Sign Expiration Date: 08/25/2020 Foundation: Location:. 1019 IYANNOUGH ROAD/RTE132,HYANNIS Map/Lot 294 040 Zoning District: SPLIT Sheathing: Owner on Record: 1019 ROUTE 132 HYANNIS LLC C ntractor�Name: Plymouth Sign Framing: 1 F ` Address: 1046 MAIN STREET SUITE 1141 x` ContractorLicense Exempt 122 2 ' r OSTERVILLE,MA 02655 �'C/q��E® _r Est Protect Cost: $0.00 Chimney: Description: 2 signs for WELLS FARGO' Permit Fee: $0.00 ONE'7.3 AND ONE 9.7 SQ FT Insulation: ' FeerPaidh: $0.00 ` Date 2/25/2020 Final: PERMIT PAID FOR UNDER PERMIT B-19-3212 CHECK NUMBER 4647 rt Project Review Req f k (. �_ Plumbing/Gas ,try L< lu Rough Plumbing: Zoning Enforcement Officer -n �- Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six;inonths after issuance. All work authorized by this permit shall conform to the approved application an`d'the approved construction documents four which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shaIli,be in compliance with the local zoning by laws and codes. r-h Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open four public inspection for the entire duration of the work until the completion of the same. .; Aff g k Electrical The Certificate of Occupancy will not be issued until all applicable sigiiatures�by the Bwfdmg and Wre Officals are provided3on Lhis permit. Service: Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or footing '. '' Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: . 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Ce Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Bowers, Edwin From: Florence, Brian Sent: Tuesday, March 10, 2020 4:50 PM To: Bowers, Edwin Subject: FW:Wells Fargo.Town of Barnstable - Regarding your permit: B-20-578 at 1019 IYANNOUGH ROAD/RTE132, HYANNIS for Building- Sign Attachments: ViewPermit_Document_637182229705202982.PDF Importance:. High Hi Ed, SCANNED --------------- Can you follow-up on this for me? Thanks, -Brian From: Skyy Anderson [ma i Ito:skyya nderson(ab h iltond isplays.com] Sent: Tuesday,March 10, 2020 4:15 PM To: Florence, Brian Subject: FW: Wells Fargo. Town of Barnstable - Regarding your permit: B-20-578 at 1019 IYANNOUGH ROAD/RTE132, HYANNIS for Building - Sign Importance: High Good afternoon Brian, I am reaching out in regards to this install that was done in Hyannis, MA for customer, Wells Fargo. The permit is attached. We need something in writing that states that a final inspection has either been approved or is not necessary. Could you please assist in retrieving this necessary information. Thanks so much, Skyy Anderson Project Manager s 125 f tillside Dr. Greenville, SC 29607 C: (864)520-386OD: (864)233-0401 x261 IF: (864)242-2204 www.hiltond.isplaysy coni 1 From: Skyy Anderson<skvvanderson@hiltondisplays.com> Sent:Tuesday, February 25, 2020 10:48 AM To: Mike<Plymouthsign@comcast.net> Cc: Robin.Anderson@town.barnstable.ma.us Subject: RE: Wells Fargo.Town of Barnstable - Regarding your permit: B-20-578 at 1019 IYANNOUGH ROAD/RTE132, HYANNIS for Building-Sign Thank you. Is a final inspection required? If so, has this been completed and can we have something from the Town of Barnstable stating that the final inspection has been conducted and is approved? Thanks, Skyy Anderson Project Manager 125 Hillside Dr. Greenville, SC;29607 C: (864)520-3860 0: (864)233-0401. x261 !F: (864)242-2204 www..h.ittondisl)tays.com From: Mike<Plvmouthsign@comcast.net> Sent:Tuesday, February 25, 202010:39 AM To: Skyy'Anderson <skvvanderson@hiltondisplays.com> Subject:Wells Fargo.Town of Barnstable- Regarding your permit: B-20-578 at 1019 IYANNOUGH ROAD/RTE132, HYANNIS for Building-Sign Hi Skyy, attached permit for Wells Fargo ,thx,mike Celebrating 62 yrs Family Owned & Operated G.Michael Caggiano,Jr President/Owner P.O.Box 134 63 Old Main Street South Yarmouth, Ma. 02664 Ph: 508-398-2721 Fax: 508-760-3130 www.Plymouthsign.com 2 I From: NoReplyCabviewpointcloud.com [mailto:NoReP ly viewpointcloud.coml Sent: Tuesday, February 25, 2020 10:23 AM To: plymouthsignCcbcomcast.net Subject: Town of Barnstable - Regarding your permit: B-20-578 at 1019 IYANNOUGH ROAD/RTE132, HYANNIS for Building - Sign Dear Plymouth Sign , Y CAUTIO .Ais email originated from outside of the Town of Barnstable. Do'not'click l inks, open', attachments or reply, unless you recognize the sender's email address and know the content is safe! 3 Town of Barnstable Building Post ThisCa"r`d So Thatit iszUisible;From he,Street ,A` roved Plans Must be.Retamed on;Jobthis Card Must be;Ke t j s rswn.xSTABI.6. ' � ,� � M" Posted Unt�l'Final Inspection Has Been Made i �� 163 0� x .;;. "` :: .�' '.ter. t;;` zt. �1i°" �*...,z.,': wrti Y`.ate f ..`: `�- aa'�-�..t d^ r r r Permit Fad Where a Certificate of�Occupancy�s Required,such Buildrng shall Not be Occupied untilga F,mal Inspection has beef made Permit NO. B-20-7 Applicant Name CARLOS H FIGUEIROA Approvals Date Issued: 01/13/2020 Current Use: Structure Permit Type: Building Deck• Expiration.Date: 07/13/2020' Foundation: , Location: 1019 1YANNOUGH ROAD/RTE132, HYANNIS Map/Lot: 294-040 Zoning District: SPLIT. Sheathing: Owner on Record: 1019 ROUTE 132 HYANNIS LLC Contra ctorName:: , CARLOS H FIGUEIROA Framing: 1 Address: 1046 MAIN STREET SUITE 11 Contractor License: CS-104107 2 OSTERVILLE, MA 02655 7Est Project Cost: $ 10,000.00 Chimney: Description: REMOVE DECK INSTALL NEW DECK WITH PRIVACY WALL . • Permit Fee: $ 160.00 Insulation: Fee Paid;' $ 160.00 Project Review Req: u Date 1/13/2020 Final: F Plumbing/Gas r i Rough Plumbing: ,Building Official " Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized&by this permit is commenced within siz•months after issuance. All work authorized by this permit shall conform to the approved application,And.the approved construction documentsfpr�w pc. this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zonin&V,laws and codes. This permit shall be displayed in a location clearly visible from access street or:road and shall be maintained open for public mspection for the entire duration of the Final Gas: work until the completion of the same. y , ; Electrical X The Certificate of Occupancy will not be issued until all applicable signatures by th636dilding and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:' , ' r Service: 1.Foundation or Footing x Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A)., Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT. �tNE Application `� . .. ..................................BAWMABLE, • r � t � / 4e ` Perni t Fee... .....Other Fee,....................... CVn. Ze Total Fee Paid................. .. TOWN,OF BARNSTABLE Permit Approval by....4 ...............on.! .. oV BUILDING PERMIT Map......... ... ............Parcel...... .C ....................... APPLICATION Section 1 — Owner's Information and Project Location - i i Project Address '101q S Village ' a n`.S MA. 00-G01 Owners Name d .4y LL C v . Owners Legal Address (-7 L© vtj Li� Lo, -r-� 1 City mOLI5 T yrv�-, (M r 1( 6 State y y)A- Zip O 2_( y r ' Owners Cell# 15b q f7(p -3 1q 13 E-mail am L(P rr\cA e Cool. Ca rn 1 Section 2 —Use of Structure Use Group- Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Single%-Two FamilytDwelling A. Section 3 =Type of Permit - f . ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/ entire structure )) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ; Deck: Apartment © Sprinkler System ❑ Addition ❑ Retaining wall ❑ ' Solar ❑ Renovation ❑ Pool ❑ Insulation l' Other—Specify Section 4 - Work Description .: i ► Ix I , 11 vi rw o x TactnnAateri- 11/15nmR Application Number.................................................... Section 5—Detail )4, Cost of Proposed Construction DCO-OOSquare Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression r ❑ Heating System ❑ Masonry Chimney* ❑ Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes No i ' Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed x. Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes �No Last updated: 11/15/2018 I n L _r I WID f _ _ . 00 </ t OV �i;4��w�u�•.. ,...wts�..;.r-,.:M.s.�xr-µ�;;yy�.,,;��.....,. ..a�y,,..•:a.�. '�%�e :rv-n.:,i. :fir a"��.'+�; 3 1�.•.......-.. - � raw -. .... ,...-w Y, � ''�..�+tn^_.$:�'�!Sy A R �s tea _- rN) xt#rxi4^ i nnr.aj. �`�'°.�.^.a•.--� ywr'ev �,�y-i 3 K44-:? , w - to a u s Prescriptive Residential Wood Deck Construction Guide Based on the 20151nternational Residential Code guard decking ledger'board blocking existing'house floor.construction o i guard post-` ledger board: attachmentattachment to t o existing house' rim joist joists o beam, ostto-beam connection: (flush,tight bearing} footing joist-to-beam post connection Where applicable, provisions and details contained in this document are based on the International Residential Code(IRC)[bracketed text references applicable sections of the IRC]. Prescriptive construction methods recommended meet or exceed minimum requirements of the IRC. Provisions that are not found in the IRC are recommended as good industry practice.Where differences exist between provisions of this document and the IRC, provisions of the IRC shall apply. This document is not intended to preclude the use of other construction methods or materials. All construction and materials must be approved by the authority having jurisdiction. Every effort has been made to reflect the language and intent of the IRC. However, no assurance can be given that designs and construction made in accordance with this document meet the requirements of any particular jurisdiction. Copyright© 2018 American Wood Council I The Commonwealth of Massachusetts Department of IndustrialAccidents,. A Office of Invest1gationi 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit:Bu7ders/Contractors/Electricians/Plninbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): /\.� Address: 2 a City/State/Zip: - Phone#: O. 3 Are you an employer?Chec4 the appropriate box: a of project(required): . I am ageneral'contractor and I, ]p ( e9 � l.❑ I am a employer with 4 ❑. ❑ employees(full aaid/or`part-time).* have hired the sub-contractors 6: New construction 2. I,am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingY c for mein aa aci employees and have workers' capacity. 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.❑Plumbing repairs or additions right of.exemption per MGL myself[No workers comp. 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. *Contractors that check this box must attached an additional sbeet showing the name of the sub-contractor,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: v lei Policy#or Self-ins.Lic,#: w cC So So v. Expiration Date: 0 Lf 3e, a Job Site Address: �� - City/State/Zip: 4VA_41/yt A Attach a copy of the workers'compensation policy declaration page(showing the poUcy 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, 1 do hereby certify u the pains and penalties of perjury that the information provided above is bue and correct Signature: Date: Phone#: , Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person id 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. 71he 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 pernit(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 burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 0mce of Investigations 600 Washington Street Boston,MA 02111 - Tel.#617-727-4900 ext 446 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 . www:naass.gov/dia - , - OVJIVIII IYIM Vt110 - Not valid without sigRpture_ i Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Corporation Registrration Expiration _ E 53792-== 01/07/2021 C&F REMODELING INr✓ CARLOS H.FIGUEIROA - -r 20 CAPTAIN NOYES;RQ. f S.YARMOUTH,MA 02604 Undersecretary, .l8uoiss1uiwo3 . zn[LtiSIU, r+ Agiol1 w H1ilOW21tJA H1t10S S3J10& NIVIcIV0 OZ 1102113f1J1d H SOl2ivo LZOZ/9Z/80 SaJ.140 - x LOI�OT=S� JOsiAJ40,p uu srr�>tsuo� spjepuelS pue suo!1eln6aa 6u!pl!ne 10 pjeog ainsua3rl leuo!ssalad 10 uo!s!A! suasny3essew 10 ylle8enu0wtuo0 d �f .4�Co�tO® CERTIFICATE OF LIABILITY INSURANCE ATE 0 6/25252019/ Y) 015 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(les)must have ADDITIONAL INSURED provisions or 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 NAME: Deborah Kelly Leonard insurance Agency,Inc PHONE o (508)428-6921 Wk Nd (508)4205406 683 Main Street to U. s: deborahk@leonardagency.com Suite B INSUREMS)AFFORDING COVERAGE NAIC A Osterville MA 02655 INSURERA: Alain Specialty Insurance INSURED INSURER B: The Commerce Ins.Co. 34754 Carlos Figueiroa,DBA:C&F Remodeling Inc. INSURERC: Associated Ind.Of MA-ARWC 28158 INSURER D: 20 Captain Noyes Road INSURER E: South Yarmouth MA 02664 INSURER F: COVERAGES CERTIFICATE NUMBER: Master 2019-2020 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. DISH LTR TYPE OFINSURANCE IVUL POLICY NUMBER POLICY MMIDD LIMBS COMMERCIAL GENERAL LIABILITY FACHOCCURRENCE S 1,000,000 CLAIMS-MADE ®OCCUR PREMISES ur a ocaence S 100,000 MED EXP(Any one person) 5 5,000 A CIP383515 04/182019 04118Q020 PERSONAL&ADV INJURY S 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: '' GENERAL AGGREGATE S 2,000,000 POLICY JET LOC PRODUCTS-COMPIOPAGG 5 2,000,000 OTHER: S AUTOMOBILE LIABILITY COMBEaarxldent INED SINGLE LIMIT S ANYAUTO BODILY INJURY(Pet person) S 250,000 B OWNED SCHEDULED RVM277 01/182019 01/182020 BODILY INJURY(Per accident) S 500,000 AUTOS ONLY x AUTOS HIRED NON-OWNED PROPERTY DAMAGE 5 250,000 AUTOS ONLY AUTOS ONLY Per atadenl - Medical payments S 10 000 UMBRELLA UAB OCCUR EACH OCCURRENCE S EXCESS UAB CLAIMS-MADE AGGREGATE S DIED RETENTION$ S WORKERS COMPENSATION " PER AND EMPLOYERS'LIABILITY STATUTE ER C ANY PROPRIETORIPARTNERIEXECUTIVE Y� NIA WCG-500-5018589-2019A 04/30/2019 D4/30/2020 EL.EACH ACCIDENT S 500,000 OFFICER/MEMBER EXCLUDED? 500,000 (Mandatory In NH) EL DISEASE-EA EMPLOYEE S If yes,describe under 600,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached N more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Mark Newbed ACCORDANCE WITH THE POLICY PROVISIONS. 148 Paddock Circle AUTHORIZED REPRESENTATIVE Mashpee MA D2649 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD Application Number........................................... Section 9- Construction Supervisor Name Telephone Number C� ��j��•Z Address '2.0 P5 petty S, State License Number 10 License Type C S L Expiration Date . aC) I Contractors Email_C�-{ I�lnGy(�-( p ? ,FM+� L�)�Cell # wa I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation req ' ed by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date o � Section 10—Home Improvement Contractor Name S Ft� v`� Telephone Number ISO �1 z 7 j ' Addressesgq&�tj'wj� City '1nn(_ State ' ; - p IL a <66 y Registration Number t.S 371 a- Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date z/' Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date Print Name �o S c AP,&`O� Telephone Number cL9 q S p E-mail permit to: G : ' Cf 2 Last updated: 11/15/2018 Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation For commercial work,please take your plans directly to the fire department for approval Section 13 — Owner's Authorization as Owner of the subject property hereby authorize U^ to act on my behalf, in all , matter relative to work authorized by 's building permit application for: �o�� h �j 1 A. oozro®1 kA U( (Address of jo ) UIVI SignaHure of Owner date Print Name i f i r Last updated: 11/15/2018 P. i En eerin De t: 3rd floor Ma "� �'' Parcel Permit# g g P ( • ) P �__ f House# (� .6 Date Issued / -Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee. 0, Office(4th floor)(8:30- Planning De t oor/ c n. Bldg.) e initive Plan Ned by Planning Board 19 - • BARNBTABLE. 119. ' TOWN OF'BARNSTABLErFDN�°` Building Permit Application Project Stre ess Jall00, F 32. Village ►.t 1 `�' , " Owner 01 L �-k L102 Address t Q 19 ZYAf4 O U g 4 p p 9 Telephone 7 7 8 -1 S 12. -Permit Request r or— ©c9 0 pm V Az E fi� �v �.l.saTl 1�ov� 1►.� 1 �o� .s-rrr.�c-cu2 L`('yoq-�'► ,1S za 14T�i�t ANQ 4Y4G ZPoc-CS First Floor e5> square feet Second Floor square feet Construction Type 1 i 11 L hl d .5-6 CQ Estimated Project Cost $ Z ©© � f1/Ll fi �� V�j`Z� , Zoning District Flood Plain Water Protectionor L Lot Size54., ZZ ,5 , Grandfathered Yes ❑No Ft. tt vi& e, M t Act 62 `,�p�!►.4 �jedG IG.j Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure 16 4M Historic House p Yes ;4No On Old King's Highway ❑Yes VNo Basement Type: ❑Full ❑Crawl ❑Walkout X Other_:!Si_A,mz oa C rzA, _f Basement Finished Area(sq.ft.) IA. Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New, LA. Half: Existing _ New No.of Bedrooms: Existing New & %Total Room Count(not including baths): Existing New Q64 First Floor Room Count Heat Type and Fuel: XGas ❑Oil ❑Electric ❑Other. 1 !�4 !Central Air XYes No Fireplaces:Existing New Existing wood coal stove es ❑ P g g / ❑Y o Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) i ❑Attached(size) ❑Barn(size) i XNone ❑Shed(size) _ ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial XYes ❑No If yes, site plan review# Qj Current Use Op Proposed Use t*©O S Builder Information Name W1>✓L_!1-1�2 Telephone Number�l " 7 r� 1912, Address , ® k� -/ 0c3Q t- 1 OO.Q License# 0 14—(p to Lit-h Q f Home Improvement Contractor# Worker's Compensation# ,4 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO��jJ2G � SIGNATURE re wt&VLAK�_4 DATE --t-�, R 5 7 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) 7y FOR OFFICIAL USE ONLY .; r PERMIT NO. DATE ISSUED '< ' >• _. `. -Y - rz .. 3 �p '.MAP/PARCEL NO _ ADDRESS s j ` VILLAGE-f OWNER . _ f 0 •DATE OF INSPECTION:. FOUNDATION- FRAME' INSULATION - - FIREPLACE ELECTRICAL: , ROUGH = FINAL :: r PLUMBING• ROUGH FINAL _ GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ' ASSOCIATION PLAN NO. r k r f r f I � i J TOWN OF BARNSTABLE SIGN PF%RMIT PARCEL ID 294 040 GEOBASE ID 20644 ADDRESS 1019 IYANNOUGH ROAD/ROUTE PHONE k HYANNIS ZIP I LOT 1 BLOCK LOT SIZE DBA K ^'VELOPMENT DISTRICT HY PERMIT 39183 DESCRIPTION "EDWIN WATTS GOLF SHOP" 43 SQ FT PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: ' Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $50.00 BOND $.00 Ox CONSTRUCTION COSTS $,00 753 MISC. NqT CODED ELSEWHERE 1 PRIVATE P''41 BAItIV3TABLE +' MASS. 039. A� fp Mpl I ILDI�/ DIV +LION z-DATE ISSUED 06/17/1999 EXPIRATION DATE i 1' rcjl.4 - I i ne own or tsarnstaDie ' Department of Health, Safety and Environmental Services °1� ?,3 ``� �`b,,, 16 3�,�•� Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Tax Collector Treasur -' �J Application for Sign Permit �) A lican . I TI L Ire' I� P�� I sessors No. � �� PP 4 woo Doing Business As: � IjV]I�M M,�ephone No. Sign Location t/`y l � Street/Road: C� r Q a Zoning District: Old Kings Highway? Yes/No Hyannis Historic District? Yes/No Property O Name: 161ck CQQ C L- L-+,C--L , P ;� n r r-�k.t(2 Telephone: Address: o V-\ PAIVillage: f �� Sign Q tr ctor Naive: A Q. Telephone: L:S Address: � � K-ta cl fit - Village: _ �1 Description Please draw a diagrams 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 die sign to be electrified? Yes/No {No f yes, a wiring permit is required) I hereby certify that I am the o er or have the authority of the owner to make this application, that the info on ' ect and that the use and construction shall conform to die provisions of Section 4- of a n' ce. Signature of O r. ed Agent _ Date• ////0— Size: 171d Permit Fee: y 6.00 v Sign Permit was approved: Disapproved: Signature of Building Official: -2 40�e- -��-/ Date -/� Signl.doc rev.8/31/98 4S 6 E Tom' ED LJI �A w R--rT L u?� LZ 30 P , ,;L, '16- Q P PP 7 � 59 �LAC� cw YE LWO PRO-LINE & Warehouse Outlet 5 a Q ►1TS pR� G OLF i Warehouse Outlet TENANT TENANT -77 �o �- D v 1-1 TENANT TENANT TENANT A Y a TOWN. OF BARNSTABLE s SIGN PERMIT PARCEL ID 294 040� GEOBASE ID 20€344 ADDRESS 1019 IYANNOUGH ROAD/ROUTE PHONE HYANNIS ZIP — 1 LOT 1 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT .HY I PERMIT 28314 DESCRIPTION THE GOLF MARKET, INC. 02.8 SQ.FT. ) PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $50.00 Tt1E BOND $.00 CONSTRUCTION COSTS $.00 i 753 MISC. . NOT CODED ELSEWHERE + BARNSTABLE, +* j MASS. I i639. A� BUILD G IVISION BYV DATE ISSUED 01/14/1998 EXPIRATION DATE The Town of Barnstable : ent of Health, Safety and Environmental Services Department. Building Division . 9. 367 Main Streei,siyannis MA 02601 ' Ralph Crossen Office: 508-790-6227 Fax: SO8-790�Z30 HuiIding Commissioner #'u3/� Application for Sign Permit f ' /41 9 f( Applicant: 0�• q 29 A-O M�ULIl.�"t' 11�� Assessors No. Man � - Doing Business As: Qom MAM V-0 !; Telephone No-!!!.: 4�53 Sign Location �,� Street/Road: 0 AN O v � Zoning District W ky �e, 1"15 0 Old Kings Highssay? Ye(2) Property Owner 7 ?� a1--L -tee, IM9 Mi UM%-CEO elephone: Address: ® ` dL1.�oU Iti� Village: ��?S.AI►•t 1 S Sign Contractor •�►1 A q b� ame: Telephone: Address: 1i0 Village: Description Please draw a diagram of lot showing location of buildings and e.:dsdng signs with dimensions, lomdon and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? &-1 o emote:B'jw, a rnizrrgpermitis requi=0 I hereby certify that I am the owner or that I have the authority of the owner to male 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. Signature of Owner/Authorized Agent Date: 11— 0 S • �'�• Permit Fee: � Q . o� size: : � Sign Permit was approved: _= _ Disapproved: Daze: Signature of Building Official: / �-e V > lb • EM: A R K E:T:: a►Ull'olm-e : 10 55 = 5;50 s.�. • 'liT 1NC ""C I Cl 2'EL0C^TC-0 Fno/A F*STIVAL PLAZA = 2 .5 8.75' = 21 .87 S.f= �. MAMItf-T" SI6r9 : 1. 25 9 8 .?5 S, f • ASS-_-Taan.+J: Q►L 1.aVreC.7 Q,Liica►� 1 c� SQUAfLC fwapT/arw ALLOWfir.) P.lA11�14 No.8879 YARMOUTH PORT, MASS. cc Q p �sr �`� �/iN• �Z�. t 1 1ao G ' a x ' ��urerrsss3'eZ'� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Zq Parcel ,. ® pp 'A lication # Health Division $" :Date Issuedlot Conservation Division ` P.Appficatioh F Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address •® t L 2 Village ��V a.1'1 / S ' � Owner E W 7 aft U d/ Address 71 Telephone 5b - 7 7 V 3 f 0 0 Permit Request X d 22; rSAA e ig -f' er �' V' ' � wSquare feet: 1st floor: existing—proposed 2nd floor: existing proposed TotaId ra sr Zonin District - Flood Plain Groundwater Overlay Y Project Valuation Construction Type C?- Lot Size___ _�/ X -TU Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) TeName �- -n cow VIA, _ Telephone Number Address 26- gdh)ell Sf�e�� License# Y;_7 y" ALmn , WA I A n3 z_Z Home Improvement Contractor# Worker's Compensation # JA I G o Y 21 3� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO /✓l-. SIGNATURE DATE r FOR OFFICIAL USE ONLY -APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION -FRAME WSULATION FIREPLACE ELECTRICAL: ROUGH FINAL { PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT I ASSOCIATION PLAN NO. Town of Barnstable Regulatory Services MANS9 MMaAS& a g" Thomas F.Geiler,Director i63� �� 'OTF16396 Building Division Tom 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 1� vG as Owner of the subject ro e T S, J P P m' hereby authorize k OUJ i/y N A TTS Cr0 i..1— to act on my behalf, in all matters relative to work authorized by this building permit application for. D i g .L y,4Ny U Gl4 12) IJV WIV i S , 1*q (.,T6/VT (Address of Job) tZ LC) Fl,;71Z 0 1�izgnature of Owner ate , Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FO RM S:O W N ERP ERM IS S ION Town of Barnstable ` Regulatory Services saxrtsTABM ; Thomas F.Geiler,Director MA & � 1639. .,0 Building Division pIEG MA'I 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: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended'to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner r 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\homeexempt.DOC i AUG-29-2009 09:07 BC TENT & AWNING 509 506 7177 P.002 DATE(M)AIDDIYY) A Q-I?- n CERTIFICATE OF LIABILITY INSURANCE 02/OW20o9 MOUCER Serial# 3032 THIS CERTIFICATE IS ISSUED AS A.MATTER OF INFORMATION KIRKILES&ASSOCIATES ONLY AND CONPERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND. EXTEND OR COMMERCIAL INSURANCE BROKERAGE LLC ALTER THE COVERAGF AFFORDED BY THE POLICES BEL OW, 299 RIVER STREET NORWELL,AAA 02061.2209 INSUREIRS AFFORDING COVERAOe NATO# INSURED INSURER A: STAR INSURANCE COMPANY BC TENT&AWNING CO,,'INC. INSUREIR B: 25 BODWELL STREET INSURER C: . AVON,MA 02322 INSURER D: INSURER E: COVE NES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDIRON OF ANY CONTRACT OR OTHER DOCUMENT WITH RE$PEGT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICES DESCRIBSO HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDTTIONB OF SUCH POLICIES,AGGREGATE LIMITS SOWN MAY HAVE BEEN REDUCI£D BY PAID CLAIMS, Y TYPE Of INSURANCR POUCYNUMBER UMITe OLIVE WL LIABILITY EACH OCCURR6NC8 COMMERCIAL(9NERAL UABILTTY O CLAIMS MADQ 11 OCCUR MBO E*mom E PCR80NAL A ADV KIPPY QFN L R GATE 5 OEIYL AOORPCOATS LIMIT APPLIES PER: PROD S-CC A POLICY P LOC AUTOM001.6 UA©ILMY - OOMONED aNOLN WIT . 8 A AUTO (EN ewI111 VQ NY ALL OU,11TO ALn= BODILY IIQURY - _ 4CH5dJLEDAUTpS - (P�0®rsaR) S MPttD AUTOS BODILY INJURY 6 =DAUTOS _ _ (PorxrJmr� PROP(�ATY *AGE IIq Icy AUYOONLY.EAACGDENT S ACC 6 R AM!A AUTO ONLY: EA AGG E eb81U RJTY H OCGURR �� 8 OCCUR CLAIMS NADC AAWREOATE bfDUCY18LE � f .o. -WItETENTION S - - PLC MPBN ATIONAND X A WC0428730 1/1I09 1/1/10 L AMDBNT 6 5000� IFICgEF�UAvAEE BER WQ.`QR/FARTLUCCO, G�� FL DISEASE-PA EMPLOYEE s 500 000 9r lAl PROVISIONS ovow EL DISFrsE- LICY QMrr 500.000 OTHER DESCRIPTION OF OPERAIIONGILOCATIONOWNCE—MLW nM=N8 ADOED BY ENOORSEMENTI WMAL PROVSIONS TOE USUAL TO THE INSURED H S S RED , CERTIFICATE HOLDER CANCELLATION BHOULDANY OF TM&ABOVE DkSCRIRED POLIGEB BE CANCELLED BEFORE THE IDPIRATION DATE THEREOF,THE ISSUING INSURER 1MLL ENDEAVOR TO MAIL 1 Q DAYS WRITTEN TOWN OF HYANNIS NOTICE TO THE cE,Rnwf"Tp-mL0-mA NAMEDTO THE LEFT,BUT FA)LURV To 00 SO SKALL ATTN:BUILDING INSPECTOR 200 MAIN STREET IMPOSE NOOBLIGATION OR UA81UN OF ANY KIND UPON THE INSURER,ITS AoswTsaR HYANNIS, MA'02601 REPRESENTATIves, AurNORIZED II9PRE8ENYA1NE ACORD 26(2001l08) J - 0 ACCIRD CORPORATION 1989 :002. Total P The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Mass. 021111 www mass.Gov/dirk Workers' Compensation Insurance Affidavit: Ceueral.B3 sinesses A licant informations: �. 1 F�Iase Pled#'le ibE Business/Organizarion i�tame: B:C.TENT �1WNiNGO� INC: Address: _. ...._.....__.---..—. 25 BODWELL STREET City/State/Zip: AVON,MA02322 '' Phone# (5045&0960 Are you an employer? Check the appropriate box: Business'Type(Required): I. I am an employer with j(1-3 employees(fully. S. 1 Retail and/or part-time)* 2. 9. J Restaurant/Bar/Eating Establishment 3. ❑ I am a sole proprietor or partnership and have no employees working for me in any capacity. to. u Office and/or Sates(incl.real estate,auto,etc.) (No workers' comp. insurance required) . 11. ❑ Non-profit 4. ❑ We are a corporation and its officers have ` exercised their right of exemption per c. 152,§1(4), 12: ❑ Entertainment', , and we have no employees. [No workers'comp insurance required]** 13. i1 Manufacturing 6. ❑ We are a non-profit organization,staffed by 14. Health Care. volunteers, with no employees. (No workers'comp. insurance required) 15. y 'C3ther F.l_ AILY " 7. :Any applicant that checks box#1 must also till out the section below showing their workers'compensation policy inform:uion. If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an.organization should check box#l.. In?"can employer th at is providing workers'eDnipea9:raafon iaasi.iratac'e ff)r sty empiDyees: Belaw is the policy information. Insurance Cam an nanie: STAR INSURANCE COMPAINV Y Insurer's Address: 2625• AmERICAN DRIVVE f City(State/Zip:_ S UTHFIELD W,A8,034 Policy r Self ins Lie # WC0428730 Expixalion Date: 0t/01110, Attach a copy of the workers' compensation policy declaration page(showing the Policy number and expiration date).. ri Failure to secure coverage as required under Section 25A of MGI.,c. 152 can lead to the imposition of criminal penalties of a tine 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 $250,000 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. T cln here 'artr uvc ire', s frn pe}��, s dJ'perjaa,y tliiat t3se infvY3rrsadaDY tirr�v{idtd al�UYe l3 ir:tts and correcs: .�, ' -tJ� ; Date Print Naane Lebra I . :arr"Uo10 Phone .....,4SU3)Safi 0901?....____. __... ' 15,��ici�Ti use U1Yijb'. �U l9Ua li9?TG i19 ti3IS CYL'Lt 3fCU991pi'1Efi r5 tl1J 0r'$U31 P?UfdCis 1 City of T°ovvn: Issuing Authority(circle one) F i. Board of Health 2. f?uildinlr Department 3.City Town Cizrk 4.1..{ enyi g Roa+d 5.Selectmen's Office ti.Uther.' contact Itel'sf n M1 � � ro ti Town of Barn-stable Regulatory Services t a t BARNSTABM t - - v � , Thomas F. Geiler,Director d JBailding Division m Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town arnstable.ma.us Office: 508-862-403 8 Fax: 509-790-62 Property Owner Must Complete and Sign This Section If Using ..A.E uilder. Sro(IF M4W''b`12_ I �(LEAl ri , as E�� subject property hereby authorize Te T "A) i AJ CZ) , to act on my behalf,. M all matters relative to work authorized by this building permit application for. (Addxess of job) v 26 O P ignature of Owner Date STo2E lY1tHU�G� - �� I/V w4ps 66LF Print Name If PropetU Owner is applying for permit please complete the . Homeowners:License Exemption Form on the reverse side. Town of Barnstable d 4 Regulatory Ser-vices Thomas F. Geiler,Director Building JDivision 4rE° Torn Perry,Building Commissioner 200 Mairi:Street—Hyarmis,MA 02601 www.town.barnst2ble-ma.us Office: 509-862-4038 Fax: 508-790-6230 EfOA'IEOWNER LICENSE EXEMPTfON Please Print DATE: JOB LOCATION: number street village '.HOMEOWNER': name home phone fl work phone# ' I CURRENT MAILING ADDRESS: city/town state zip code The mment 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 BOMEONVNER Persons)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.L 1) The:undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned."homeowner"certifies that.he/she understands the Town of Barnstablp.Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signaarm 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 hov=wner perfomring 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 parson(s)for hire to do such work,that such Homcowna shall act as supervisor.' Many homeowners who use this exemption are unaware that they arc assuring the responsibilities of a supevisor(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 hirrs 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 ofhis/hor msponsrbilitics,many communities require,as part of the permit application, that the homeowner certify thta hdshe understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may can t amend and adopt such a fomnleertification.for use in your community. I - - i i«; '4 •. y "� '' (( YY hi f p k t 4�y • I 1 t > �i<i �g y�� - `�'v -'Jt,> # .,L- 7 • '� Y }v� t & k�= q�, F�,,,�.�`., +Y€ ° e '-�"� ga.E:k- = ,� r 'ry' .,'' - .? •�kti�'�'A `z'� "r?��c.��s,;�f�' ;��°� r `f''.,x � lz-s �. i �l- �•� L� � �"{ -v_�Ss+a�i n:+k:. t s jit s N Y l ,z !', ; �><, 1d � .S,4A 4T� 1' - so gold 7� n�a. n I'm ��, fly ��s} -6�� J l Sit t` t � J' 3' Pt firal P kr •}�•�'. ��. �"�, I•� � 1 1 � 1 ��' �. Imo. � t� - ` • 11 4 � 1 AUG-13-2008 16:53 BC TENT & AWNING 5OB -586 7177 P.006 .a . m Total P.006 `rP€c s 1?s 13c�s 3�r cl r 4"r�i?cJi e1�1;:1906 c3c tJ r r r lr r [ IMPORTANT DOCUMENTs r Ress.. .. ._ Iwo; ISSUED BY taaqee Certifileale - of Fla ;, REGISTRATION Pate of Shi�tment L: APPLICATION � ' � 404:2007" NUMBED Teat Idepf focatlbRi , H EVANSVIL.L.E, INDIANA 47725 � 4111)1' 1 MANUFACTURERS OF THE FINISHED OilI .�.. 'PENT PRODUCTS DESCRIBED HEREIN rk This is to certifv that the materials described'have been flame-retardant treated ('or are inherently noninflammable) and were supplied to: - 190610 : l PARTY SERVICES INC £€ 25 BODWELL ST . AVON MA 02322 ! - t f LI! jj £ �(E ... Certification is hereby crude that; J, The articles described on this Certificate have been treated with a flame-retardant,approved III chemical and that the application'of said chemical was done in conformance.with California B Fare Marshal Code, All fabric has been tested and passes NFPA 701-99, CPAI 4, ULC 109. t 80_4000(2) E . � m i1 ;;l-;s'°sption of items certified; " FIESTA EXPANADABI E..T()P 20WX20 �. `l l SNYDER WHITE:VINYL. � IN Mame Retardant Process Used, Will Not Be Removed By Weshing And Is Effective For The f The Fabric M77�i'.M v�b ly 1. I l 1:A. 1'C' ,� �t'3s«a£1.afPli Fil�i�h� �,NCIC�ft ii� STBlS INS: wr' . r r ¢rwlc i .I ( lr clsI�c 1 ,� r_ � r � rJ �r.J�r PCPrJi trc tc! rtr 1�I1r1 t ar ,r • , iof ISSUED BY Manufachued by- Date treated or # - «� Burlan Corporation Fred's Teats&Cttno ieS manufactured p ' 7 Tent Lane 06/06 Saltwater,NY 12170 " This is to cer*that the materials described below have been flame-retardant treated(or are Inherently iianflammoble) FOR BC Tent&Awning 25 Bodwell Street ' _ "Avtit;MA 02322 1 Certification is hereby made that:(Check"a"or"b") a)The articles described below this Certificate have been treated with a flame-retardant chemical approved and _ registered by the State Fire Marshal and that the application of said chemical was done In conformance with the taws of the State of Cali fornia and the Rules and Regulations of the Slate Fire Marshal. Name of chemical used ' Chem.Reg.No. Method of application x (b)The articles described below are made from a flame-resistant fabric or material registered and approved by the State Fire,Marshal for such use. Trade name of flame-re§istant fabric or material.used. ;:: .14o7, WHITE_.BI,OCKOUT - s Reg.No. Fs 3,501 = The Flame-Retardant Process Used ML NOT Be Removed By Washing ; Fred's Studio Tents&Canopies; Inc. Plant Supervisor - (4) 20W x 20 Expandable tops TBD Product Description Cpustomer Invoice# TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map , A94 Parcel Permit# ' �—� Health Division Date Issued Conservation Division Fee Tax Collector Application Fee Treasurer Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board ,� Approved By Historic-OKH Preservation/Hyannis Project Street Address !�� 9 x'y��'Vd a4, �D Village t�l��hN �J Owner 104�k1114 i 4S �sss• 1`c, JfJWV At Address 1d 19 /eT. 132, MXi4 All-;, A Telephone Permit Request R1 — Add r— G�/77P2� Ran r eo,.;e qni .r�.� ayew k4 . r 2n floor: existing proposed Total new Square fe t: 1 st floor: existing d o0 q g proposed g p p Valuation Bb-a Zoning District Flood Plain Groundwater Overlay 3 S, Construction Type '�S Lot Size A' Grandfathered: ❑Yes El No If yes, attach supporting documentation. Dwelling Type: Single Family O Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: 'Cl Yes alo On Old King's Highway: ❑Yes 340 Basement Type: ❑ Full 0 Crawl ❑Walkout r 6ther JkAn 01 604Y1W Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing n _ Number of Bedrooms: existing new C> � o Total Room Count(not including baths): existing new First Floor Rock fount Heat Type and Fuel: C(Gas ❑Oil ❑ Electric ❑Other �� Central Air: ErYes 0 No Fireplaces: Existing New Existing wood/coa stove: Lffes r;(a] No Detached garage: ❑existing ❑new size Pool: 0 existing ❑new size Barn:❑existing ❑new size Attached garage:0 existing ❑new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial Rles O No If yes, site plan review# �• -Current Use 01%yvi ce' Proposed Use s � BUILDER INFORMATION Name's �✓�' i Me � Telephone Number Address � �• C. Z1,?- License# Cs $757 R,0AAAl0 $ �T�Gia✓.@�/I iP1�s`?2� Ogg—)_ . Home Improvement Contractor# �•A- Q Z Z Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO djt'a2- or.�L 91�P �G✓LG SIGNATURE DATE [A4J FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED I �r .. �- \/? rr'� ` -r if �^ .,- fi. MAP PARCEL NO. ADDRESS VILLAGE 0 WNER -DATE OF INSPECTION: FOUNDATION 17 FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL' PLUMBING: ROUGH FINAL . GAS: ROUGH FINAU,-' FINAL�BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. IT 1 ne.uommonweatrn of juassacnusetts Department of Industrial Accidents Office of Investigations, ' a 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plu abers Applicant Information Please Print Legibly Name (Business/Organizationandividual): VOA,1Swv- Address: City/State/Zip: YAAA Yjp� 1"Cg Phone#: Are y u an employer? Check the-appropriate box:. Type of project(required): 1. I am a employer with '� 4. El am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction . 2.❑ I am a sole proprietor or partner- listed on the attached sheet $ 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for mein any capacity. 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 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ oof repairs insurance required.]t employees. [No workers' 13.[v�Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: �F t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tcontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their worker;'contP:policy infor rsation - I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: T y b't/.0G)rY/A/$�. Cp . Policy#or Self-ins.Lic. #: A/A/Z C`Jt. S86/ 613 Expiration Date: ///.f Job Site Address: !0/9 l V.44/074 f/-040 jQT / Z City/State/Zip: y/8�✓ .� �� 117.�0> Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to.secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500,.00 and/or one-year imprisonment, as well as.civfi 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby, Pdertheai a dpe hies of perjury th he informationprovided above is true and correct:Si ature. Date:.Phone#: Official use only. Do not write in this area,to be completed by city.or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• Information and Instructions r 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 WIV14ua1,.:Pa ephiP,: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 artnership,,association or other legal entity, employing employees. Howev..erl e receiver or trustee of an individual,p 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 lie deemed to bean employer." MGL chapter 152, §25.C(6)also statesthat"every state or local licensing]agency,shall;withhold,the issuance or renewal of a license or permit to operate a business or to construct;huildings,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-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s) of . Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the insurance i � ' LLC or LLP does have t required to c workers compensation insurance. If an e no arty members orparhiers; are q the Department of Industnal • be submitted to erployees,a iiolicy rs�required. Be advised that this affidavit may eP 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 - °� ,- ' 's: :y� � ,:;. ,, , . �•,k_ �;,,�•. Please be sure.that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for ""to°fill out in the event the Office of Investigations°has to contact you'regarding the applicant Please be sure:to fill in the.permitlicense number which will be:used assa 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 L (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,telephorie'and fax The Commonwealth of Massachusetts Department of Industrial.Accidents . . .. .. ,, s Office of Jnvestigations 600.Washingfon Street. . Boston, MA 02111, ` Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-7274749 Revised 5-26-05 www.mass.gov/dia r `Massachusetts- Department of Public Safetc Board of Buildim- Re�-ulations and Standards Construction Supervisor License License: CS 5157 Restricted to: 00 ROLAND B CATIGNANI 60 GEMINI DR W BARNSTABLE, MA 02668 Expiration: 5/23/2012 ( unmi�si mer Try+: 24301 1 ` .✓z r Town of Barnstable Regulatory Services BARNWO Thomas F.Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Otivner Must Complete and Sign This Section If Using A Builder I, }&tom,A/14L1*q S PR*VVPv-r- ,as Owner of the subject property D^q I-/G 1 440•/D/9 *40 4..P. hereby authorize C_dWX4 J11 4jjkA4v4 IAJ?_. to act on my behalf, in all matters relative to work authorized by this building permit application for: s , (Address of Job) Signature pf Owner 'o 14 c. Date r. Print Name 0TORMS:OwNEUERML4SION CERTIFICATE OF LIABILITY INSURANCE DATE 05/25/DD010 410-,p d00)782-0251 FAX 781-261-2099 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION h ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ,?Ahern Insurance Group LLC HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 7 Accord Park Drive, Unit Bl ALTER THE COVERAGE'AFFORDED BY THE POLICIES BELOW. Norwell, MA 02061 INSURERS AFFORDING COVERAGE" NAIC# INSURED COnsery Group Inc. - - INSURERA: Peerless Insurance Company P.o. Box"278 INSURER e: Hanover Insurance Co. 22292 Sagamore Beach, MA 02562 INSURER c: TPA Insurance Agency ` 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 SUBJECTTO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH " POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 4DD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION - - LTR NSR _ DATE MMIDD/Y DATE MM/DDN LIMITS GENERAL LIABILITY BKO1053511978 07/07/2009 07/07/2010 EACH OCCURRENCE $ 100000 PCOM MERCIALGENERALLIABILITY DAMAGE TO RENTED $ 10000 CLAIMSMADE m OCCUR MED EXP(Any one person) $ - 1000 A _ PERSONAL&ADV INJURY $ 100000 GENERAL AGGREGATE $ 200000 GENL AGGREGATE LIMIT APPLIES PER: - PRODUCTS-COMP/OP AGG $ 200000 X POLICY PRO LOC 10 JECT AUTOMOBILE LIABILITY ADN8411SO203 08/27/2009 08/27/2010 COMBINED SINGLELIMIT ANY AUTO - (Ea accident) $ 100000 ALL OWNED AUTOS - BODILY INJURY $ - X SCHEDULED AUTOS - - (Peer person) - B X HIRED AUTOS BODILY INJURY $ - - X NON-OWNED AUTOS (Per accident) IX Comp Ded $500 PROPERTY DAMAGE $ X Coll Ded $500 (Per accident) GARAGE LIABILITY - AUTO ONLY-EA ACCIDENT $ ANY AUTO - - EA ACC $ - - - .OT.HER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY US01053511978 07/07/2009 07/07/2010 EACH OCCURRENCE • $ 2,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 2,000,00 A RDEDUCTIBLE - X RETENTION $ 1000 - - - WORKERS COMPENSATION AND WC003 730404 11/09/2009 11/09/2010 X. ORY L MITS ER EMPLOYERS'LIABILITY _ - C ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 10000 OFFICER/MEMBER EXCLUDED? - - _ E.L.DISEASE-EA EMPLOYEE $ 10000 If yes,describe under - LSPECIPL PROVISIONS below - E.L.DISEASE-POLICY LIMIT 1$ 5000010 OTHER _ BPP $126,000 AProperty BKD1053511978 07/07/2009 .07/07/2010 Leased/Rented Equip. $40,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - -• - - , yannis Toyota, 1056 Iyannough Rd., Hyannis, MA .y • - T� CERTIFICATE HOLDER CANCE' t ^''^"I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Town of Barnstable suj� L00 T AILhl9CHJTV J F r L IMPOSE NO OBLIGATION OR LIABILITY 200 Main St. OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Hyannis, MA 02601 AUTHOFSona1D � Nmol ACORD 25(2001/08) ©ACORD CORPORATION 1988 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �9 Parcel D Application # Health Division r'� Date Issued 3 . Conservation Division ::Application Fee 42( Permit Fee Planning Dept. >a Date Definitive Plan Approved by Plann' Bc Historic - OKH Pres ` tion/ CP_fo—ject_Street_Acldr_esS'_ 1 ILU 132 village--� A-NAI iS C F4X it- 711 - Flt 7Z0 �ne--ram Cr0 L-F0 L 0 6- Address elephon-e > �D� - 77/- y4O _3 �s o r�> Tel ' P7l'D��D (ewph cu_n ' C—_=P_ermit Request20 X ® ' E1V'� �tl� jLTA]C. S'fl - re pT Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay A Project Valuation Construction Type 1 i 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 I] new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current-Use- - Proposed.Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) 1::::Name� 6'o LF0 L4 6- _ _TelephoneNumber_---, , 0?- 77/ ,�—_Address-_-_-,./d/� �YANVNd J�tq 40i411) License # �JyAWMS 1 m4 D z60 1 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO &ZA SIGNATURE — DA_TE�---IX 7C� i t FOR OFFICIAL USE ONLY APPLICATION# 4 , 4 DATE ISSUED 1 MAP/PARCEL N0. ADDRESS _ VILLAGE OWNER f DATE OF INSPECTION: FOUNDATION FRAME $' f J INSULATION =-t FIREPLACE n ELECTRICAL: ROUGH FINAL ` PLUMBING: ROUGH FINAL ' ROUGH FINAL r ! ,FINAL BUILDINGR_.� .;�G J ,•,g DATE CLOSED;OUT j. .f E ASSOCIATION PLAN NO. } i The Commonwealth of Massachusetts ' 46p- . Department oflndustrialAccidents 1 : Office of Investigations 600 Washington Street c� Boston, MA 02111 sy www,mass.gov/dia Workers' Compensation Insurance Affidavit:-Builders/Contractors/Electi-icians/Plumbers Applicant Information Please Print LeEibly NaIIle=(Busin anization/Individual): O 6_Y Ad ss 1D i TY�►'AffJOU,G—f-1— �UA-7 �ei_ty/-S_tat6--/Zip: A Phone Al: .? Are you an employer?Check the appropriatXb :' Type of project(required); 1.El I am a em loyer with m a general contractor and I 6. New construction employeep'(fii11 and/or part-time).* have hired the sub-contractors.. . _ �...- 2_❑ I am a sole proprietor.or partner- listed-on the attached sheet. 7. ❑ Remodeling These sub-contractors have g, Q Demolition ship and have no employees working for mein any capacity. employees and have workers'`. 9 ❑ Building addition [No workers' comp. insurance comp:'insurance.$ required.] 5. 0'We are a,coiporation and its 10.E Electrical repairs or additions 3.0 1 am a homeowner.doing all work officers have exercised their 1 1.❑ Ph s imbing repairs or addition myself. [No workers' comp. right of exemption per MGL 12.[]Roof repairs insurance required.] t c. 152, §1(4), and we have no q ] 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. tContraetors 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: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine .of up to$250.00 a day against.the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification., Ldo hereby certify cinder the pains and penalties ofperjury that the information provided above is trice and correct. Si I gmtui-e: r Date: �Phorie# �00 7/I e 7�� , 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#: Aug 27 2010 8: 34RM Kirkiles L Associates CIB 781 -659-3366 P. 1 - ,; CERTIFICATE OF LIABILITY INSURANCE °s/z o 0 .;ER Sedal# 3856 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION KIRKILES&ASSOCIATES ONLY AND CONFERS NO RIGHTS UPON' THE CERTIFICATE COMMERCIAL INSURANCE BROKERAGE LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 273 RIVER STREET NORWELL,MA 02061-2209 INSURERS AFFORDING COVERAGE NAIC# 3URED - INSURER A: STAR INSURANCE COMPANY BC TENT&AWNING CO., INC. INSURER B:' 25 BODWELL STREET INSURER C: AVON, MA 02322 INSURER D: a INSURER E: )VERAGES 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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. i NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS R NSR DATE MMlDDIYY DATE MM/DDIYV GENERAL LIABILITY - EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occu rence $ CLAIMS MADE OCCUR - MED EXP (Anyone person) $ PERSONAL&ADV INJURY $ ' GENERAL AGGREGATE $ - GEN'L AGGREGATE LIMIT APPLIES PER! PRODUCTS-COMP/OP AGG $ POLICY JECOT- 71 LOC - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS " (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) - RPROPERTY DAMAGE $ - (Per accident) GARAGE LIABILITY " AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER-THAN EA ACC S - - AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ - $ WORKER'S COMPENSATION AND X WG STATU• OTH- TORY LIMITS EMPLOYERS'L IABI LITY ER ANY PROPRIETOR/PARTNER/EXECUTIVE WC042873D 1/1/10 1/1/11 EL EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? - - EL DISEASE-EA EMPLOYEE $ SOO,OOO If yes,describe under SPECIAL PROVISIONS below - EL DISEASE-POLICY LIMIT- $ 500,000 OTHER SCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS LOSE USUAL TO THE INSURED OPERATIONS, DING BUSINESS AT: 1019 IYANOUGH ROAD,HYANNIS, MA °RTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER"WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN TOWN OF BAR NSTAB.LE 367 MAIN STREET NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL HYANNIS, MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR FAX: 508-790-6230, REPRESENTATIVES. AUTHORIZED REPRESENTATIVE " :ORD 25(2001108) C ACORD CORPORATION 1988 ATE ACORD,,,, CERTIFICATE OF LIABILITY INSURANCE T D 01111/2010Y) PRODUCER Serial# 3032 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION KIRKILES&ASSOCIATES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE COMMERCIAL INSURANCE BROKERAGE LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, 273 RIVER STREET NORWELL,MA 02061-2209 INSURERS AFFORDING COVERAGE NAIC* INSURED INSURER A: STAR INSURANCE COMPANY BC TENT&AWNING CO., INC. INSURER B: 25 BODWELL STREET INSURER C: AVON,MA 02322 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POL10Y 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 POLICES 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 oR'L TYPE OF INSURANCE POLICY NUMBER PDATE EF ppTIVE PDATE EXP N LIMITS L lYYl GENERAL LIABILITY D MMI EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurence $ CLAIMS MADE OCCUR MED EXP (Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ FD POLICY PR LOC AUTOMOBILE LIABILITY 'COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS - BODILY INJURY NON-OWNEDAUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTOONLY-EAACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE RETENTION $ $ WORKER'S COMPENSATION AND X TORY LIMITS OER A EMPLOYERS'LIABILITY WC0428730' 1/1/1O 1/1/11 EL EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? If yes,describe under - EL DISEASE-EA EMPLOYEE $ 500,000 SPECIAL PROVISIONS below EL DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS THOSE USUAL TO THE INSURED OPERATIONS. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TOWN OF HYANNIS DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN ATT.N: BUILDING INSPECTOR NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 200 MAIN STREET IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR HYANNIS,MA 02601 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE etr' ct.�.a�c�J ACORD 25(200.1108) I 0 ACORD CORPORATION 1988 I AUG/26/2010/THU 03: 52 PM FAX No, P, 002 The Commonwealth of Massachusetts Cr Department of Industrial Accidents Office of Investigations 600'Washington Street Boston,Mass.02111 wtvw.tt:asszov/dia Workers' Compensation Insurance Affidavit: General Businesses A licant information; IM 0 6,Lk 0Please PRINT le gib Business/Organization Name: B.C.TENT&AWNING CO.,INC. Address: 25 BODWELL STREET City/State/Zip! AVON MA 02322 Phone# 508 586-0900 Are you an employer? Check the appropriate box: Business Type(Required): 1. I am an employer with 1.Q-30 employees(full 8, D Retail nd/or part-time)* 2- 9, Restaurant/Bar/Eating Establishment 3. :1 I atn a sole proprietor or partnership and have no employees working for me in any capacity: 10. Office and/or Sales(incl.real estate,auto,etc.) [No workers'comp.insurance required] 11. ]Non-profit 4. We are a corporation and its officers have exercised their right of exemption per c. 152,§1(4), 12, : Entertainment. and we have no employees, [No workers'comp insurance required] 13. Manufacturing S, - 6, D We are a non-profit organization,staffed by 14. :1.Health Care volunteers,with no employees.[No workers'comp. insurance required] 15. 0J -TEMPORARY TENT W *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. —If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#1. I am an employer that is providing workers'corn ensation insurance or m employees, Below is the olio p g p }� Ypolicy information, Insurance Companr name: STAR INSURANCE COMPANY Insurer's Address: 26255 AMERICAN DRIVE Cit /State/Zi : SOUTHFIELD M148034 policy#or Self-ins. Lie. # WC0428730 Expiration Date' 01/01/11 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 MGI,e. 152 can lead to the imposition of criminal penalties of a fine up to$I,500.00 and/or one-year imprisonment,as well as civil penalties ui the form of a STOP WORK ORDER and a fine of up to $250,000 a day against the violator, Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. r I do hereby c tify un e the Pains andpanaldes ofperjtt y that the information provided above is true tint!correct. Signature Date PrintNa Jinni Vidna Phone# 50$ 5$6-0900 Official use only. Do not write in this area to be completed by city or town official City of Town; Pennit/liccnse# Issuing Authority(circle one): 1.Board of Health 2.Buildino.Department 3,City/Town Clerk 4.Licensing Board 5.Selectmen's Office 6.Other Contactperson: Phone# CERTIFICATE OF LIABILITY INSURANCE OP ID AK DATE(MMIDDIYYYY) BCTEN-1 06/25 10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Berry Insurance Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 9 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Franklin MA 02038 Phone: 800-824-5201 Fax:508-520-6914 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A at Paul Fire 6 Marine Ine. Co. INSURERB: Ohio Casualty Grou BC Tent &Services Inc. , Tnc. INSURERC: SafetyInsurance Company 39454 Party Services p 25 Bodwell Street INSURERD., Avon MA 02322 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMEIDDIYYYY DATE MMIDDfYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $1 0001000 A X COMMERCIAL GENERAL LIABILITY CK00221646 06/30/10 06/30/11 PREMISES Ea-occurance $100,000 CLAIMS MADE X�OCCUR MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2 000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $1,000,000 POLICY PRO•JECT 7 LOC AUTOMOBILE LIABILITY C ANY AUTO 6203752 06/30/10 06/30/11 Eaacci acciED dent) LE LIMIT $1 OOO OO (Ea accident) r r O ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ X HIRED AUTOS BODILY INJURY- $ X NON-OWNED AUTOS (Per accident) PROPERTYDAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILRY EACH OCCURRENCE $2 000,OOO B X OCCUR [_�CLAIMSMADE UUO (10) 53742528 06/30/10 06/30/11 AGGREGATE $2,000,000 HDEDUCTIBLE $ X RETENTION $10,000 $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN _ TORY LIMTIS ER ANY PROPRIETORIPARTNER/EXECUTIV� E,L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E,L.DISEASE-EA EMPLOYE $ If yes,describe under SPECIAL PROVISIONS below — E.L.DISEASE-POLICY LIMIT $ OTHER A Equipment Floater CK00221646 06/30/10 06/30/11 $875,000 Limit $1,000 Deduct. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Operations Usual to Party goods rental CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 14YANNI2 DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Town of Hyannis/Barnstable Attn: Building Inspector REPRESENTATIVES. 200 Main Street annis MA 02601 ACORD 25(2009/01) w`^�^ ghts reserved. The ACORD name and logo are registered marks of ACORD Map 'Page 1 of 1 Town of Barnstable Geographic Information System New search ° Home f Help _ Parcel Viewer Custom Map Abutters Map Size ® Zoom Out fl D fl fl fl fl®fl a1In I,� ®_ ]PG Map: 294 Parcel: '040 Full 77r-N Property 294072 294002 ! Location: 1019 IYANNOUGH ROAD/RTE132 Info 294042 N 1056�N 1040 4 1095 ,�. n 19 PROPERTY S 294003- Owner: 10 R RTY LTD PARTNER P.:-, - N 1020 }� f!� 29400a Location Ynformation NiyoG�y N990 Map& Parcel 294040 Location 1019 IYANNOUGH ROAD/RTE132 p Acreage RT�r 1.24 acres > , _ 'p•2 295015 X02 N6fi _ s ✓' Current Owner Mailing Address 1019,PROPERTY LTD PARTNERSP, j �J' - ,� ■ ,. 1019 ROUTE 132 , 294040 � � HYANNIS, MA 02601 � ,1 294061 CND N 1019 4f. �`C N800 -f r` _ 294039 lu Zu Appraised Value;(FY 2010) tj w Extra Features $0 Out Buildings $32,800 ' 4 p Land $580,000 294026CND Buildin s $2,862,700 294025 9 1 k973 p955f , t � Total Appraised $3,475,500 9 294032 CND 294038 � { �" µ Assessed Value FY 2010 ti N 1029 N 31 294037 ( ) N 367Extra Features $0 et 294036 k�f Out Buildings $32,800 r_ 294022 294053 294056 N ta� N 146 Land $580000 N� N44 Buildings $2,862,700 Total Assessed $3,475,500 .-�- Set Scale 1" = 185 I Aerial Photos I MAP DISCLAIMER Copyright 2005-2010 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS BarnstableMA v1.2.3867 [Production] http://66.203.95.236/arcims/appgeoapp/map.aspx?property1D=294040 8/26/2010 �aF zr+e ray Town of Barnstable o Regulatory Services , swrtxsrAare Thomas F. Geiler,Director MASS. Building Division PrfD}AAI A Tom Perry,Building Commissioner , 200 Main.Stmet, Hyannis,MA.02601 WWWAown.b arnstable.ma.us Office: 509-862-403 8 Fax: 508-790-6230 HW) OWNER LICENSE EXEMPTION , G / Please Print DATE: 0 Z(o I V 1 JOB LOCATION: l 6 I I 1Y�n►'1VLt(J F()�1� V/V I S /// number street. village "HOMEOWNER': Q_6N9l+N vo, 4fzAy SDt -771 •ylS"3 _771, V6473 name I bome`phonr# work phone# CURRENT MAILING ADDRESS: I I}/ ZjR,41yl d L G6W )ed 42 I- YAW/V/S. d 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. DEFINMON OF HOMMON RNER 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 faun structures.,A ' person who constmcts more than one home in a two-year period shall not be considered a homeowner. Such, "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the,State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that.he/she understands the Town'of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and'' requirements. �q ' rgnatirre of Homeowner �. . t Approval of Building Official • t Note: Three-family.dwellings containing 35,000 cubic feet-or`larger will be required to comply with the State Building Code Section 127.0 Constriction Control. HOMEOWNER'S.EXEN mbN Tbr.Code states that "Any homeowner Performing work for which a building pernvt is requirtd 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 procced against the unlicensed person as it would with.a licensed Supervisor. The homeowner acting as Supervisor is.ultimatcly 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 fomalcertification for use in your community. Q:fonns:homcexempt Town of Barnstable ` Regulatory Services w HA RxsrABLF- q MAS& $ Thomas F. Geiler,Director En.19. 166 Building Division Tom Perry,BuUding Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Ownbr Must Complete and Sign This ection If Usin A Builc- r I, /as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to rk a ' d by this building permit application for. (Address ob) Signature of Owner Date Print Name If Property Owner is applying for permit please co lete.the Homeowners License Exemption Form on the reverse s' Q:F0RMS:0 VJNERPERMISS)0N t af 9&WW jq&j b&Uwe I ISSUED av Manufactured by Date treated or Fred's Corporation manufactured red's Tents&Canopies . 1-704.667-3548 7 Tent Lane 06/06 3 Stillwater,NY 12170 This is to certih that the materials described below have been flame-retardant treated(or,are inherently nonflammable) FOR BC Tent&.Awning 25 Bodwell.Street i iAvon,MA 02322 Certification is hereby made that: Check"a"or"b" a)The articles described below.this Certificate have been treated with a flame-retardant chemical approved and registered by the.State Fin:Marshal and that the application of said chemical was done in conformance with the. i laws of the State of California and the Rules and Regulations of the State fire Marshal. :Name of chemical used Chem.Reg.No. t y Method of application X (b)The articles described below are made from a flame-resistant fabric or material registered and approved by the State Fire Marshal for such use. Trade name of flame-resistant fabric or material used 14nz tarn TE BL0CK0UT Reg.No. F53501 The Flame-Retardant Process Used.WILL NOT Be Removed By Washing Fred's Stud' to Tents & Canopies, Inc. Plant Supervisor r i Product Description_(4) 20W x 10 Mids -Customer Involce M TBD i i . a 3 i 1 0��J�chrPrJ�r�rPrJ��PM' P®R T DOCUMENT�rJ�rP�t�r�rJrrrJ�r�rJ�rJ�rJ�rJ�rJ�r�r� C 5 SREGISTRATION ISSUED BY Date of Shipment 5 APPLICATION e 4/9/2007 5 NUMBER $fr lAr INDUSTRIE INC.® 5 ~ Tent Identification 2 EVANSVILLE, INDIANA 47725 G 5 I=140.I r MANUFACTURERS OF THE FINISHED 04444317 5TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated 5 (or are inherently noninflammable) and were supplied to: 190610 C 5 PARTY SERVICES INC i 5 25 BODWELL ST 5 5 AVON MA 02322 5 � I� 5 Certification is hereby made that: c5� The articles described on this Certificate have been treated with a flame-retardant approved 5 chemical and that the application of said chemical was done in conformance with California 5 Fire Marshal Code. All fabric has been tested and passes NFPA 701-99, CPAI 84, ULC 109. t 5 Serial # 8024000(2) C 5C Description of item certified: FIESTA EXPANADABL.E TOP 20WX20 5 SNYDER WHITE VINYL 5 e 5 Flame Retardant Process Used Will Not Be Removed By 5 Washing And Is Effective For The Life Of The Fabric SNYDhR WC NEW 5 A'OH Signed: 5 Name of Applicator of Flame Resistant Finish ANCHOR INDUSTRIES INC. 0 P�Pr fr�J�rJcPr�cPcPcPLPrPLPrJcPrPr Pr Pr PrrJPrJ��PrJ��frJ�r�r.Prlr�r�rJ�cP�f�frJ�rJ�rJLLPtntPr trl3 G YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 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 ( 'own Hall) - } DATE 2=f d Fill in please: APPLICANT'S, YOUR NAME%S: kGwd�n .... a ff BUSINESS YOUR HOME`ADDRE S` {i �x r V i( �r k+ 'J SCiS�?'I I- L S� S le'✓_. v+1e� b 2 y' TELEPHONE # Home Telephone Number Z 81 99t1--Lg � .`' rtnYf"�liP'uair NAME OF CORPORATION: C U_( LLS•n I-C_ NAME OF NEW BUSINESS TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES ADDRESS OF BUSINESS I v `-iKok MAP/PARCEL NUMBER ' Z��. 0 L4 C) (Assessing) 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.'- (cornei-.of Vermouth Rd.&Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMIMISSIONER'S FFICE This individual has bee formed ny permit requirements'that pertain to this type of business uthorized Signatu COMMENTS: 2. BOARD OF HEALTH r This individual has n infor ed the p rmit r ements that pertain to this type of business. Authorized nature* COMMENTS: 3.,CONSUMER AFFAIRS LICENSING AUTHORITY) - This individual h en in ed of the licensing requirements that pertain to this type of business. f f Authorize Signature* COMMENTS: F TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION l Ma J Parcel a q w. p Application Health Division Date Issued �71 Conservation Division - Application Fee Planning Dept. Permit Fee Date Definitive Plan,Approved by Planning Board Historic - OKH Preservation/Hyannis 9 Project Street Address Village Owner `�l 0 dress a p l � Telephon�l Permit Request 1� ? l — oil �-�o-- 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:':0 Ye"LJ No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other j f� 4rnd Y. Basement Finished Area(sq.ft.) t4 OR Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing ( newer �- Number of Bedrooms: W 0 existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: . ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use -- - -Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) % (8a Nam ��4 ! Telephone Number"��—�� " y ,O ` ;Address License# LYl'C' } c Home Improvement Contractor# �y b Rc f GLC �o ,�Y Worker's Compensation #x1�61�11��=,'1�T Ln1(o t ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE r ` FOR OFFICIAL USE ONLY ' APPLICATION# DATEISSUED ► I MAP/PARCEL NO. .ADDRESS ► VILLAGE OWNER DATE OF INSPECTION: 1 FOUNDATION FRAME i INSULATION 'z FIREPLACE ELECTRICAL: ROUGH FINAL ► PLUMBING: ROUGH FINAL GAS: ROUGH I FINAL FINAL BUILDING Ez DATE CLOSED OUT ! ; ASSOCIATION PLAN NO. i , I; r The Commonwealth of Massachusetts t Cr Department of Industrial Accidents Office of Investigations . 600 Washington Street . Boston,Mass. 02111 www.tnass.,Zov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant information: Please PRINT le ibl Business/Organization Name: B.C. TENT&AWNING CO INC Address: 25 BODWELL STREET City/State/Zip: AVON MA 02322 Phone# (508) 586 0900 Are you an employer? Check the appropriate box: Business Type(Required): 1. I am an employer with 10-30 employees(full 8. Retail 'id/or part-time)* 2. 9. Restaurant/Bar/Eating Establishment 3. I am a sole proprietor or partnership and have no employees working for me in any capacity. 10. Office and/or Sales(incl.real estate,auto,etc.) [No workers' comp. insurance required] 11. Non-profit 4. We are a corporation and its officers have exercised their right of exemption per c. 152, §1(4), 12. Entertainment and we have no employees. [No workers'comp insurance required]** 13. Manufacturing 5. 6. We are a non-profit organization,staffed by 14. Health Care volunteers,with no employees. [No workers' comp. insurance required] 15. t Other TEMPORARY TENT(S) 7. *Any applicant that checks box#1 must also fill out the section below showing their workers' compensation policy infornlation. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#1. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy information. Insurance Company name: TRAVELERS INDEMNITY COMPANY OF CT Insurer's Address: ONE TOWER SQUARE City/State/Zip: HARTFORD CT 06183 Policy#or Self-ins. Lic. # XNUB3578T67611 Expiration Date: 01/01/12 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250,000 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereb c ti un er the rr and pe �r ie ofperjrrry that the information provided above is true and correct. Signature Date Print Name Debra L Carriuolo Phone# (508) 586-0900 Official use only. Do not write in this area to be completed by city or town official City of Town: Permit/license# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4. Licensing Board 5. Selectmen's Office 6.Other Contactperson: Phone# t� { f - e(r/�11(�/�-y/ayR Client#:423663 7562 _ 'ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE )06/30/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate balder is an ADDITIONAL INSURED,the policy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME: USI Rental Specialties PHONE 800 854-3298 P.O.Box 53310 AIc No Ext: AIC,No: Irvine,CA 92619 PRD13ULT ----- ---- — 800 854-3298 CUSTOMER ID 0: _ INSURER($)AFFORDING COVERAGE _ NAM 0 INSUREp INSURER A:St Paul Fire&Marine Insurance 24767 _ BC Tent&Awning Co, Inc. ------- -------- ____..._ Party Services Inc.; BC Tent Rental INSURERS:Phoenix Insurance Company 25623_ 25 Bodweli Street INSURER C: - Avon,MA 02322 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: , THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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. TYPE OF'INSURANCE POLICY NUMBER NMIDDrYYYY MM/DDNYYY LIMITS A GENERAL LIABILITY CK00223795 6/30/2011 06/30/2012 EACH OCCURRENCE __$1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $100 000 CLAIMS-MADE 51 OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG_ $1,000,000 X POLICY JECT PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO $ (Ea accident) BODILY INJURY(Per person) $ — ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ ^~ RETENTION B ANDEMPS YERS'LSATIONILIT XNUB3578T67611 1/01/2011 01/01/201 X WCSTATU- OTH- ANDEMPLOYERS'LIASIUTY Y!N - ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.E500 000 OFFICER/MEMBER EXCLUDED? NIA EACH ACCIDENT $ e (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under - -- - DESCRIPTION OF OPERATIONS below I I I E.L.DISEASE,POLICY LIMIT $500 000 A. Equipment Floater i IM00201848 6/30/2011 06130/201 $875,000 Limit ;,Special Form7 $2,500 Deductible DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) This certificate is issued as a matter of proof only. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town Of Hyannis/Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main St. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE 01988-2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009109)A,rr 1 �Of 1 The ACORD name and logo are registered marks of ACORD f AUG-1>3-2011 14:03 FRON:A000UNTING-EWGS (781) 792-0308 TO:915085867177 P.1/2 golf 01® • MSTABLISHMD 7S'# 9345 gy o:BC TENT From: Kevin Cullivan Fax To:508- -Pages: 2 86-7177 Our Phone: 781-871-0000 Date: 8/18/11 Town Of Barnstable, Please be advised that BC Tent has our permission to act on our behalf in order to obtain a permit for a tent sale at our locatio at 019 lyannough Road Hyannis,MA on September 2-5. Thank you. KKeViUnCuLIlivVanI4 Vice President Philips Upham Enterprises, Ltd. dba Edwin Watts Golf/Golfology 200 Webster Street Hanover,MA 02339 781-871-0000 cullivan@golfologyusa.com �c T DOCUMENT o PEND "1 M P O RTA N5 5 5 - f Ala �esi��ai?ce 5��rtl..f lcate O nN 5 ISSUED BY Date of Shipment REGISTRATION ` Q 03/07/05 5 APPLICATION a� s IND�H��..® 5 NUMBER Tent Identification EVANSVILLE, INDIANA 47725 5 5 04027735 5 5 F140.t MANUFACTURERS OF THE FINISHED 5 TENT PRODUCTS DESCRIBED HEREIN 5 S This is to certify that the materials described have been flame-retardant treated 5 5 (or are inherently noninflammable) and were supplied to: 1906 5 5 �0 5 5 5 PARTY SERVICES INC 5 DBA B C TENT 5 5 AVONDMA 02322 INJ 5 SCertification is hereby made that: 5 5 The articles described on this Certificate have been treated with a flame-retardant approved S 5 chemical and that the application of said chemical was done in conformance with California 5 5 Fire Marshal Code. All fabric has been tested and passes NFPA 701-99, CPAI 84, ULC 109. 5 5 5 Serial # 8024000(3) 5 5 5 55 5 Description of item certified: 5 FIESTA EXPANADABLE TOP 20WX20 5 C, SNYDER WHITE VINYL 5 5Eli Flame Retardant Process Used Will Not Be Removed By S 5 Washing And Is Effective For The Life Of The Fabric S 5 5 SNYDER MFG NEW PHILADELPHIA,OH SI ned: �'� '• ' / "G w 5 5 `'SPECIAL EVENTS DIVISION.ANCHOR INDUSTRIES INC. Cj a �rn��r��rs�rn��r�n��r��l-i��n��s�nor_ �L n�n��r��n�n�� /O ! ®®q UM ��®/T� C.�C.�C.�C.�C�C��C.�C.�C.�C�C.�C�r� ❑ `' IMPORTANT S sCertifleate of If la 5 S ISSUED BY ETent Shipment S 5 05 C► REGISTRATION �„� ��®Il® �— APPLICATION a INDUSTRIES INC. 5 NUMBER cation 5 i EVANSVILLE, INDIANA 47725 > 5 �'y �°r .MANUFACTURERS OF THE FINISHED EF140.1 E TENT PRODUCTS DESCRIBED HEREIN S 5 if that the materials described have been flame-retardant treated 5 This is to cert y lied to: S (or are inherently noninflammable) and were supplied S S190610 5 PARTY Li DBA B C TENT ES INC 25 BODWELL ST S SAVON MA 02322 S S - 5 S 5 S 5 t a roved S S Certification is hereby made that: S ed on this Certificate have been treated withca conform with C alifornia 5 The articles des cnb Ul.C 109. 5 chemical and that the application of said chemical was 701-99, CPAI 84, S S Fire Marshal Code. All fabric has been tested and p S S S S 802 4300(6) S S Serial # S ra S Description of item certified: S FIESTA EXPANDABLE MIDDLE 50 20WX10 SNYDER WHITE VINYL S nt Process Used Will Not Be Removed B) � 5 Flame .Retards S S Washing And Is Effective For The Life Of The Fa 5 signed, r r' SNYDER MFG NEW PHILADELPHIA,OH ''SPECIAL EVENTS DIVISION-I�NCHOR INDUSTRIES INC. S SnUri nfr7n�.P[P[�GP[_P[�CP[J[�r�r�[lr�rlrlrPrJ�[�[PrlCPCP[.P[.Pr�r�r�[Pr�cPrJ� 111V1 �� 5 e IMPORTANT DOCENT , ISSUED BY ETent pment 5 "IN � ------- INC . C► S REGISTRATION a ,f ®® S S APPLICATION s TRIES .® Cj NUMBER cation = EVANSVILLE, INDIANA 477255 C� S rf MP�a� MANUFACTURERS OF THE FINISHED 5 S F14a1 M E TENT PRODUCTS DESCRIBED HEREIN ardant treated 5 to certify that the materials described have been flame-retardant S 5 This Is lied to: S 5 (or are inherently noninflammable) and were supplied S190610 ri p PARTY C TENT ES INC S 25 BODWELL ST SAVON MA 02322 S S 5 5 5 5 5 a roved made that: 5 Certification is hereby S 5 described on this Certificate have been treated with flame-retardant with California 5 The articles descrlb •d chemical was done In .0 109. chemical and that the application of said SFire Marshal Code. A II fabric has been tested and passes NFPA 701-99, CPAI 84, U Serial # 8024300(6) S S 5 Description of item certified: FIESTA EXPANDABLE MIDDLE 20WX10 SNYDER WHITE VINYL - S S Flame Retardan t process Used Will Not Be Removed By S And Is Effective For The Life Of The Far ic 5 Washing � � , � ; 5 's ned: SNYDER MFG NEW PHILADELPHIA,OH ''SPECIAL EVENTS DIVISION•hNCHOR INDUSTRIES INC. r�rJ�r�cP�PrPrJ�PrP�Pr�r P�Prf'�P�r'�Pr PrJ��Pr�r�r�r Prlc��rPr��!'r Pr�rf'r�clr��Pr�r nnrnl�fr�rJ�[PCPCPrSGPr�rP�P�Prlr�r�r�r�rl[Pr��Pr�CPrP[P[Prl[Pr��P —� � x •. .- --+-- 7 1 �J 20 T � CA nri'vc tXJ�y 1 P.Qyv�- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION _ -Z6 ZES Map Parcel .-' Application # Health Division ` Date Issued ' 2— Conservation Division Application Fe .Planning Dept. '' Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis r Project.-Street-Address ewn-c44 k �'d („a.-v��S � O 26 Dl Village--�"-a,»w.S - V,_Qwrier-%!rni t�N CL,.f Address 35q VIA-L b 1 1-4 Telephone 7,$('7 71.ct`�U 0 ZoSp PermitrRequest a rr_�� q,v -� S k4 p cc', .' i Wit.. CJ 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 Baseme!ht Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Numbeof Baths: Full: existing new _ Half:'existing a never Number of Bedrooms: existing newCo a 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.-❑Yg ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing mew"%ize__ Attached garage: ❑ existing ❑ new- size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use I APPLICANT INFORMATION (BUILDER OR HOMEOWNER) v......,Telephone=Number�::.��'!'_ -�---Nar-�e - -Addross39 oAZaTo^t - LA License # Home Improvement Contractor# _ Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 'DATE . Z L9 I u. FOR OFFICIAL USE ONLY APPLICATION# ; —DATE ISSUED MAP,/PARCEL NO. 'S f ADDRESS t VILLAGE _ } OWNER + t DATE OF INSPECTION: ' ~: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL r • ;GAS: ,,,• ROUGH t • FINAL E FINAL BUILDING s F _ DATE CLOSED OUT ASSOCIATION PLAN NO. 'J �i IKE Town of Barnstable Building Department artment - 200 Main Street iARNSTABLE, .Hyannis, MA 02601 9 MASS. (508) 862-4038 r Certif icate of Occupancy Application Number: 200704306: CO Number: 20070290 Parcel ID: 294040 CO Issue Date: 12/26107 Location: 1019 IYANNOUGH ROADIROUTE132 Zoning Classification: SPLIT ZONING Village:. HYANNIS Gen Contractor: WILLIAMS ROGER Permit Type: CC00 CERTIFICATE OF OCCUPANCY COMM Comments: Building Department Signature Date Signed v: �IKEr, TOWN OF BARNSTABLE Building Application Ref: 200704306 i BARNSTABLE, Issue Date: 07/24/07 Per t 9 MASS . QpA i639• �� Applicant: WILLIAMS ROGER Permit Number: B 20071755 Proposed Use: GENERAL OFFICE BUILDING Expiration Date: 01/21/08 [Location 1019 IYANNOUGH ROAD/R0UT13g District SPLTPermit Type: COMMERCIAL ADDITION ALTERATION Map Parcel 294040 Permit Fee$ 243.00 Contractor WILLIAMS ROGER Village HYANNIS App Fee$ 100.00 License Nuin 010246 Est Construction Cost$ 30,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND TENEANT FIT-OUT FOR CHILD AND FAMILY SERVICES THIS CARD MUST BE KEPT POSTED UNTIL FINAL L INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: THE 1019 PROPERTY LTD PARTNERSP BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 1019 ROUTE 132 INSPECTION HAS BEEN MADE. HYANNIS, MA 02601 Application Entered by: PR Building Permit Issued.By: THIS PERMIT CONVEYS NO RIGHT.TO OCCUPY ANY STREET;ALLY:OR SIDEWALK OR ANY PART THEREOF;:EITHER TEMPORARILY OR PERMANENTLY; ENCROACHEMENTS ON PUBLIC PROPERTY,;NOT SPECIFICALLY PERMITTED UNDER:THE BUILDING CODE;,.MUST BE APPROVED BY THE JURISDICTION. STREET ORALLY GRADES AS WELL AS DEPTH ANRLOCATION OFrPUBLIC SEWERS MAYBE OBTAINED FRONt,THE DEPARTMENT OF PUBLIC WORKS.,; THE ISSUANCE OF THIS PERMIT.DOES,NOT:RELEASE THE APPLICANT FROMTHE CONDITIONS OF-ANY APPLICABLE SUBDIVISION RESTRICTIONS MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION 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 FRAM_ E 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 c.142A). ate; r BUILDING INSPECTION APPROVALS PLUMBING.INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 04 rC 2 2 2 3 �I rC 1 Heating Inspection Approvals '' Engineering Dept q -° -7 v� _Fire Dept j ` of o 7 2 Board of Health U ' f t +, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel e TO 'Application # ( � top Health Division Date Issued f Conservation Division Application Fee Planning Dept. Permit Fee.. Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address /,019 1,V,4 A/IVd y�fq ;9;�z'T Z39 Village �N/✓f.S Owner AM &&t 7-y 4-ro 40AArWh 5Y P Address 1.4 IYA�/,✓de! Telon�6�C�. WILLI#7NS� >'iCtS«l0�11'-l�80✓tit?,��/�. -��/e�,qc. - .v�T�►2� oatoi p � r , Permit Request ZS-A/G, Te;�,/A/d m lolrF !/ OF Cyne ,ems Sd�?Vl GAS• Square feet: 1 st floor: existing[proposed 2nd floor: existing fDproposed Total new Zoning District He 46 Flood Plain WA Groundwater Overlay �i P Project Valuation0g 00S Construction Type L Lot Size �• 2'E� A Grandfathered: O'Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family : ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes 1kNo On Old King's Highway: ❑Yes �o Basement Type: ❑ Full ❑ Crawl ❑Walkout ad'other 5Lr 6 a- 444-OC 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: MGas ❑Oil ❑ Electric ❑Other Central Air: U4s. ❑ 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 S"Yes ❑ No If yes, site plan review# Current Use 0AW1 G4r Proposed Use w � APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name !4AIYMV195w, lrfL Telephone Number Address Y• D 6K ?I License# es 6gxf fxx- ��_ A 402Z 2-Home Improvement Contractor# Worker's Compensation # n1klG C��38`818`5 ALL CONSTRUCTION DE)3RISPES LTING FROM THIS PROJECT WILL BETAKEN TO SIGNATUR DATE 490- / FOR OFFICIAL USE ONLY I'y % APPLICATION# i DATE ISSUED .L r ^' �.^ .Pik v • + a .'Y• + •, MAP%PARCEL NO.., _ ADDRESS VILLAGE f OWNER' DATE OF INSPECTION: fi r t. FOUNDATION' FRAME _ INSULATION 1 FIREPLACE _ ' ELECTRICAL: ROUGH FINAL - PLUMBING: ROUGH FINAL GAS 3s£ ROUGH FINAL = FINAL BUILDING y ` , DATE CLOSED OUT , pf ASSOCIATION PLAN NO. f A The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street t Boston, MA 02111 WWW.Mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 1.dNixg �i /W�' Address: .5r�C 9 7,r City/State/Zip:�,bQ�? 07 Phone �" a, Arey am a employer with u an employer?Check the appropriate box: G2Sd 2 Type of project(required): � 1.LJ 1 _ 4. [] I am a general contractor and I mp 6. ❑New construction employees-(full and/or part=time).* have h hired the sub-contractors.- .. _. --- - -- 2.El am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g, 0 Demolition working for me in any Capacity. employees and have workers' 9 Building addition No workers' comp. insurance comp:insurance.$ required.] 5. EJ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1.1.0 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. I.Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. . I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: �� Policy#or Self-ins.Lic.#: N life �T��J O O l� S Expiration Date: Job Site Address: l / Y�AIWO dM# deV City/State/Zip: ��T a2 / 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 MOL 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 hereby41der the pains an enal 'es of perjury tha th information provided above is trite and correct. Si ature:Phone# �� Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# . Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town:Clerk 4..Electrical Inspector. 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and. Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership,association.oi•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, §25CI(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-contractor(s)name(s), address(es)and phone numbers)along with their certificates) 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' elow. Self-insured companies.should enter their e t the number listed b compensation policy,please call the Department a self-insurance license number on the appropriate line. City or Town Officials yPlease'be sure that the affidavit is complete and,printed.legibly.—The Department has provided a space at the bottom contact ou re ardin the applicant. has to o g g PP of the affidavit for you to fill out in the event the Office of InvestigationsY e ce number. In addition,an applicant u ed as a refer n P']ease be'sure'to fill in the permit/license number which will be s 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 burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call t" `" •' ' } 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 Fax # 617-727-7749 Revised 4-24-07 www.inass.gov/dia 1 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) TM1 02/15/2011 PRODUCER (800)782-0251 FAX 781-261-2099 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 77 Accord Park Drive, Unit BI ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Norwell, MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Peerless Insurance Company ConSery Group, Inc. INSURERS: Hanover Insurance Co. 22292 P O Box 278 INSURER C: ACE Property and Casualty Ins Sagamore Beach, MA 02562 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. INSR ADDT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSR DATE MM/DD/YYYY DATE MM/DD/YYYY GENERAL LIABILITY BKO1053511978 07/01/2010 07/01/2011 EACH OCCURRENCE $ 1000000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100000 CLAIMS MADE X�OCCUR MED EXP(Any one person) $ 10000 A PERSONAL&ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2000000 X POLICY PRO LOG JECT AUTOMOBILE LIABILITY ADN841150203 08/27/2010 08/27/2011 COMBINED SINGLE LIMIT -- ANY AUTO (Ea accident) $ 1000000 ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ B X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS - (Per accident) X Comp Ded $500 - PROPERTY DAMAGE $ X Coll Ded $500 (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY US01053511978 07/07/2010 07/01/2011 EACH OCCURRENCE $ 2,000,000 X OCCUR F—ICLAIMS MADE AGGREGATE $ 2,000,000 A $ DEDUCTIBLE $ X RETENTION $ 10000 $ WORKERS COMPENSATION NWCC46388185 11/09/2010 07/01/2011 X wcsTATu- oTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE -- E.L.EACH ACCIDENT $ 100000 C OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100000 If yes,describe under SPECIAL PROVISIONS below - E.L.DISEASE-POLICY LIMIT $ 500000 OTHER BPP $126,000 �roperty A BKO1053511978 07/07/2010 07/01/2011 Leased/Rented Equip. $40,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CHILD & FAMILY SERVICES - 1019 IYANNOUGH ROAD - RTE 132 - HYANNIS, MA - TENANT FIT-UP CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL TOWN OF BARNSTABLE IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR BUILDING DEPARTMENT REPRESENTATIVES. 200 MAIN STREET AUTHORIZED REPRESENTATIVE HY IS, MA 02601 Rosemary Fulham/EJM ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Massachusetts Department of Environmental Protection L7�1 Bureau of Waste Prevention . Air Quality 1100120797 BWP A 06 Decal Number Q Notification Prior to Construction or Demolition Whe Important:lng out A. Applicability forms on the computer,use only the tab key A Construction or Demolition operation of an industrial, commercial, or institutional building, or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection cursor-do not use the return (DEP), Bureau of Waste Prevention -Air Quality Control Regulations 310 CMR 7.09. Notification of key. Construction or Demolition operations is required under 310 CMR 7.09 (2)ten (10) days prior to any work being performed. The following information is required pursuant to 310 CMR 7.09. rm B. General Project Description 1. a. Is this facility fee exempt-city, town, district, municipal housing'authority, owner-occupied Instructions residence of four units or less?❑Yes ❑✓ No 1.All sections of b. Provide blanket decal number if applicable: Blanket Decal Number this form must be completed in order to comply with the 2. Facility Information: , Department of 1019 PROPERTY LTD PARTNERSHIP Environmental Protection a.Name - notification 11019 IYANNOUGH RD.,RT. 132 requirements of b.Address 310CMR7.09 - H annis MA 62601 c.Ci /Town d.State e.Zip Code 5087781812 f.Tele hone Number area code and extension E-mail Address(optional) 30400 2 h.Size of Facility in Square Feet i.Number of Floors j. Was the facility built prior to 1980? ❑ Yes✓ ❑✓ No k , k. Describe the current or prior use of the facility: OFFICE BUILDING I. Is the facility a residential facility? ❑ Yes ❑✓ No - -o m. If yes, how many units? Number of units _0 3. Facility Owner: -N 5019 PROPERTY LTD PARTNERSHIP �o a.Name �0 1019 IYANNOUGH RD., RT. 132 b.Address HYANNIS MA 02601 c.City/Town d.Sae e.Zip Code a 5087781812 f.Tele hone Number area code and extension a.E-mail Address(optional) C7 ROGER WILLIAMS �Q h.Onsite Manager Name ag06.doc•10/02 BWP AQ 06•Page 1 of 3 Massachusetts Department of Environmental Protection r Bureau of Waste Prevention . Air Quality 1100120797 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition General Statement: If B. General Project Description //Cont. asbestos is found during a 4. General Contractor: Construction or Demolition ICONSERV GROUP, INC. operation,all responsible parties a.Name must comply with JP.O. BOX 278 310 CMR 7.00, b.Address and Chapter 2 1 E of the SAGAMORE BEACH MA 02562 Cha General Laws of c.Cit /Town d.State e.ZiD Code the Commonwealth. J5088886555 1 ircatignani@conservgroup.com. This would include, f.Tele hone Number area code and extension .E-mail Address(optional) but would not be limited to,filing an IROLAND B. CATIGNANI asbestos removal h.On-site Manager Name notification with the Department and/or a notice of release/threat of release of a C. General Construction or Demolition Description hazardous substance to the 1. Construction or demolition contractor: Department,if applicable. ICONSERV GROUP, INC. a.Name P.O. BOX 278 b.Address SAGAMORE BEACH I MA 02562 c.Ci /Town d.State e.Zip Code 5088886555 1 ircatignani@conservgroup.com f.Telephone Number area code and extension :E-mail Address(optional) ROLAND CATIGNANI h.On-site Manager Name 2. On-Site Supervisor: PETER SICILIANO On-Site Supervisor Name 3. Is the entire facility to be demolished? 0 Yes ✓❑ No OMMOMMMMM N _0 4' Describe the area(s)to be demolished: �o INTERIOR PARTITIONS ONLY IN.UNIT 12. �N y �O 0 5. If this is a construction project, describe the building(s)or addition(s)to be constructed: TENANT OFFICE FIT UP, UNIT 12 �0 , 0 C7 �Q ag06.doc•10/02 BWP AQ 06•Page 2 of 3 rs =r LlMassachusetts Department of Environmental Protection ■ Bureau of Waste Prevention . Air Quality 1100120797 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.) 6. a. If this is a demolition project,were the structure(s) surveyed.for the presence of asbestos containing material (ACM)? ❑ Yes ❑✓ No If yes, who conducted the survey? b.Survevor Name c.Division of Occupational Safety Certification Number 7. Construction or Demolition: 2/28/2011 1 3/28/2011 a.Start Date(mm/dd/yyyy) b.End Date(mm/dd/yyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding ❑ paving wetting shrouding b. If other, please specify: ❑ ❑ ❑✓ covering ❑ other fi 9. For Emergency Demolition Operations,who is the DEP official who evaluated the emergency? a.Name of DEP Official b.Title c.Date mm/dd/ of Authorization d.DEP Waiver Number D. Certification "' I certify that I have examined the ROLAND B. CATIGNANI -o above and that to the best of my a.Print Name _o knowledge it is true and complete. Roland B. Catignam The signature below subjects the b.Authorized Signature -N signer to the general statutes PRESIDENT _o regarding a false and misleading c.Position/ion Me _o statement(s). CONSERV GROUP, INC. d.Representing ' 2/15/2011 �(D e.Date(mm/dd/yyyy) �o �d �Q ■ ag06.doc•10/02 BWP AQ 06•Page 3 of 3'■ 5 , `lassacbusetts- Delrartment of Public Safet' Board of Buildinll, Re/nilations and Standards Construction Supervisor License License: CS 5157 Restricted to: 00 ROLAND B CATIGNANI 60 GEMINI DR W BARNSTABLE, MA 02668 Expiration: 5/23/2012 ( muni�si mcr Trig: 24301 CONSTRUCTION CONTROL AFFIDAVIT AT PROJECT INCEPTION q ' 4 Parcel Number: -ProjectName: 671-I/C40 .0e �rl�G� 'V;e✓IC05 Project Owner: 10/1 &4 Pe-9 r GTr� �.y��.✓t�rLs >� Project Location: /Q/9 !XXA1 V 400 O�/• l32 11411 T/2 Scope of Project: ' In accor ance with paragraph 116.0 of 780 CMR, the Massachusetts State Building Code, I, Oft I"Jm►KS Massachusetts Registration Number esZ� being a Registered Professional Architect hereby certify that all architectural plans, computations, and specifications, and changes thereto, involving the subject project will be prepared by or under the direct supervision of a Massachusetts Registered Professional Architect and bear his or her original signature and seal as defined by Massachusetts General Law (M.G.L.) c 112, $81R. I further certify that I will be present on the construction site at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work to determine, in general, if the architectural work is being performed in a manner consistent with the construction documents. vl,':El1-1,W"IittVS.,VAII-ts - Architect (Orzg Ignatuf deal) Date No.8879 ' Y,ARMOUTH PORT, MASS. w r A Qp4HE Town of Barnstable ; v Regulatory Services saxxsTasc.e, r -- v� MASS. Thomas F.Geller,Director Arfo y� Building Division , 4 Tom Perry, Building Commissioner 200 Main Street, Hyannis,NIA 02601 . _ Office: 508-862-4038 Fax: .508-790-6230 Property Owner Must Complete and Sign This Section. If Using.A Builder I ��fl.�C K//L[.l�er�s� ��si�Z-�', ��s✓�/b� i�. �G�►��6t-- ��1�2-Ti✓�x. � _ , 9 /y-- ��✓ g2+P , as Owner of the subject property hereby authorize_-(�6W'gx1'1 ��0 to act on my behalf, in all matters relative to work authorized by this building pertnit application for: ` 132 (Address of Job) . ` A �l Signature of Owner Date' Print Name r 1M 1 L E [ A" �, Q:FORM&OWNERPERMISSION Message Page 1 of 1 Roma, Paul From: Perry, Tom Sent: Wednesday, February 16, 2011 11:49 AM To: Roma, Paul Subject: FW: 1019 lyannough Rd -office space FYI -----Original Message----- From: Lt. Don Chase [mailto:dchase@hyannisfire.org] Sent: Wednesday, February 16, 2011 11:44 AM To: Shea, Sally; Perry, Tom Subject:'1019 Iyannough Rd - office space We do not recommend proceeding with the permit for this project as the fire sprinkler is now 3 years overdue for inspection. Also, the fire extinguishers are grossly overdue for inspection. Found hallway units last inspected in 1995. Lt. Don Chase, Jr., FPO l� Fire Prevention Officer l Hyannis Fire Department 95 High School Rd. Ext. — Hyannis, MA 02601 508-775-1300 x 106 3/3/2011 I Kenneth .ShaeveKrems Shaevel & Krems LLP Ke neth A. Krems � Daniel S.O'Connor 0v4 • David R.Jackowitz Amy Rosengarten Waksler Stephen J.Allard Ashley F.Walter DJaekowitz@shaevelkrems.com Kathy Nagle,Senior Paralegal Lisa O'Brien,Senior Paralegal Alice Van Zandt,Paralegal Kim Caranfa,Paralegal Wz7 August 2, 2012 Mr. Thomas Perry Building Commissioner Town of Barnstable " 200 Main Street Hyannis, MA 02601 Re: Vinfen Corporation-1019 Iyannough Road, Hyannis Dear Commissioner Perry: Please accept this letter as a follow'up'to my letter to you dated June 4, 201.2.with.regard.to the above referenced property .as-well as your letter.dated.., -: Y June,20, 2012 seekmg further:information. This letter will also address several questions'raised by Town-'Attorney Ruth Weil regarding Vinfen's proposed use of the property. A summary of the questions in your June 20, 2012 follows: l. What is "medication assistance" and what does it entail? 2. Is there a pharmacy on site? 3. Are medications being dispensed on site? 4. How much(what%)in comparison to the other services provided does the medication assistance take up? 5. What exactly is"medication assistance?" Vinfen's Response: No prescriptions are filled on site, nor is medication taken by clients at the office: .All medications are stored in strict accordance with the Department of Mental-Health regulations. A program:psychiatrist'prescribes=medication for persons with.mental illness, developmental disabilities and/or.issues:with substance abuse. A local pharmacy dispenses medication directly to,the nurses that work for the Vinfen program. Vinfen's staff then delivers the medication to q qoA 5V "jc�,e5)M. 141 Tremont Street . Boston, Massachusetts 02I II-I209 . Telephone: 617 /556-0244 . Facsimile: 617/556-0284 . wwwAh evelkremsskrc( 443 E. Central Street . Franklin, Massachusetts 02038-1304 .Telephone: 800/336-0222 . Facsimile: Sob t I r Mr. Thomas Perry Shaevel & Krems LLP August 2, 2012 D Q Page 2 Vinfen's clientele in the community. The staff members sit with the clients in the community in order to implement a teaching intervention about the medication, e.g. type, dose, side effects. The staff teaches its clients how to become self reliant and self medicating in order to allow the clients to manage their medications independently. Of the approximately 420 clients served by Vinfen's program, only 70 clients (16.6%)receive this type of medication assistance. The questions raised by Attorney Weil in our telephone conversation were as follows: 1. Who is on staff", Are they licensed therapists, social workers, etc. The program staff consists of a team leader, a psychiatrist, a lead nurse, two Psychiatric Assertive Community Treatment Team nurses (PACT), Peer Support specialists,treatment planners,three vocational specialists, an addiction specialist, a housing specialist, and a program assistant. 2. Precisely what services are provided to the clients? Vinfen's programs provide a variety of services to its clientele including, employment training services, community integration services, education and support for social life, education and support for interpersonal relationships, support for leisure time activities,peer support, education and care management, education to clients in self management of symptoms, symptom management, substance abuse treatment and education, education and medication management, assistance with adult daily living skills provided in a rehabilitation model that focuses on teaching. The primary use.in its totality is to educate persons with mental illness, developmental disabilities and substance abuse to enhance their ability to be integrated into the mainstream of society regardless of disability. 3. If someone were to walk into the premises, what would they see? They would see a front desk and waiting area. Staff are set up in an open cubicle setting in order to facilitate communication and collaboration of the team in providing services to the clients. There are a few private offices for the psychiatrist, team leader, one to one meetings, groups/family meetings, and the medication and record rooms. For the vast majority of the day,the premises are quite empty because most of the program services (70%) are provided in the community, not on site. Mr. Thomas Perry Shaevel & Krems, LLP August 2, 2012 Page 3 OQ9 4. How are the services rendered? By appointment or drop in? Seventy(70%)percent of the services are provided in the community. The other thirty (30%)percent of the time staff are in daily morning meetings, education and treatment planning meetings with clients, supervision, and working on paperwork/phone calls. Most often if clients are coming to the office it is by appointment but they do sometimes drop in. 5. How often do clients come to the premises? Clients come to the office to attend their treatment plan meeting and update twice a year and to meet with the psychiatrist. Approximately 16 hours of the week there are clients with appointments at the site. The remainder of the work is done in the community. 6. If Town Counsel walked into Vinfen's use at 310 Barnstable Road, would that give them the same idea as the proposed use at 1019 Iyannough? Yes. It is the same use. We believe a reasonable interpretation of the Ordinance would allow you to determine that Vinfen's proposed use is allowed under the Dover Amendment and Section 240-8(A)(3) of the Barnstable Zoning Ordinance. I look forward to engaging in further dialogue with you and your department after you have had a chance to review this material. Should you have any questions,please feel free to call me at your convenience. Best regards, 7avidJackowitz cc: Ruth Weil, Esq. Vinfen Corporation L7.:/, • a A 43 O I • • .I.l I I sz `1 ru HOIPAIR611 t r7 X\4 b p"T✓ :I" Postage $_ $0.64' a Certified Fee $2.$1 01 r 10 Retum Receipt Fee -VI m C3 (Endorsement Required) $2.34 ere p Restricted Delivery Fee` N (Endorsement Required) $0.44 r o Total Postage a Fees $ $5-79: 42l24US S r q Zo T ----- N �' AptNo.or PO Box No. Oil,State,ZI Certified Mail Provides: li o A mailing receipt o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders. f{„ , f,r; ; ,;+, o Certified Mail may=gNW.Pe combined with First=Class Mails or Priority Mails. m Certified Mail is not available for.any class of international mail. © NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt,servtce,please complete and attach a Return Receipt(PS Form 3811)to the article'and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS9 postmark on your Certified Mail receipt is required. 11 o For an additional:fee,,delivery..may be restricted to the addressee of addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". c If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 _ I Town of Barnstable �'THE Tp Regulatory Services ti Thomas F.Geiler,.Director RAMSTAB� * Building Division i639 �� Thomas'Perry,Building Commissioner �Ep s 200 Main Street, Hyannis,MA 02601. Office: 508-862-4038 Fax: 508-790-6230 August 7, 2012 Attorney David R. Jackowitz Shaeval & Krems,-LLP + 141 Tremont Street Boston, MA 02111-1209 Dear Attorney Jackowitz, This letter is in response to your correspondence of August 2, 2012. In my opinion, you do not need a Section 3 finding under 40A. This proposed office at.,' 1019 lyannough Rd, Hyannis is located in an HD zoning district and what is being proposed here falls under the category of an office use and is therefore; an allowed use in this district. As such, this office can go in as of right. If I can be of further assistance, please feel free to contact.me. Thank you:for clarifying this use. Sincere) Thomas Perry, CB0 Building Commissioner'" cc: Ruth Weil, Esq. r Town of Barnstable Regulatory Services g rY * saxtvsr,�ats, • mass. Thomas F. Geiler,Director 039. �� Building Division Thomas Perry, CBO Building Commissioner 200 Main Street,' Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 June 20, 2012 Attorney David R. Jackowitz Shaevel & Krems, LLP Attorneys At Law 142 Tremont Street Boston, MA 02111-1209 Dear Attorney Jackowitz, This.letter is in response to your correspondence regarding the use of 1019 lyannough Road, Hyannis through a lease by Vinfen. One aspect of this proposal needs to elaborated on. Please explain to us the "medication assistance" and what this entails. Is there a pharmacy on site? Are medications being dispensed here? How much in comparison of the other services provided here does the medication assistance take up? What exactly is "mediication assistance? We look forward to your response: Respectfully Thomas Perry, CBO Building Commissioner l I t William H.Shaevel Shaevel & Krems LLP kenyah A. Krems 'J Daniel S.'O'Connor Ewa D a©a v© No a a David R.Jackowitz Amy Rosengarten Waksler Stephen J.Allard Ashley F.Walter DJackowitz@shaevelkrems.com Kathy Nagle,Senior Paralegal Lisa O'Brien,Senior Paralegal Alice Van Zandt,Paralegal Kim Caranfa,Paralegal June 4, 2012 C> Mr. Thome s Perry Building C namissioner Town of Ba-mstable - a 200 Main Street - ' Hyannis, MA 02601 Re: Vinfen Corporation-10 19 I ay nnough Road, Hyannis Dear Commissioner Perry: This office'represents Vinfen Corporation ("Vinfen"),the"proposed lessee of the prof rty located at 1019 Iyannough Road Unit'#k3, Hyanriis,"MA ('Property '): Please'accept this letter as a request for a ruling from1he Barnstable Building fiepartment that Vinfen's proposed use of the-property for a non-profit'' educational use.is permitted_under M.G.L. c. 40A:§;3,(the. "Dover,amendment.") and Section 240-8(A)(3) of the Barnstable Zoning Ordinance. The proposed use will entail,only some interior tenant fit out in the existing structure. No exterior building or site changes are proposed for,Vinfen.'s use.. There'is ample on-site parking for Vinfen's use, particularly because Vinfen's use will serve persons with menvil illness and developmental disabilities who do not drive cars. Vinfen Corporation Vinfen Corporation is the largest social service provider in the Commonwealth. Vinfen is a private, nonprofit human services organization providing services to adults and children with mental illness, developmental disabilities;., and behavioral health disabilities. Vinfen's mission is to transform the lives of its,clients with the goal of alleviating mental and emotional illness. Vir:='tfen filed its original Articles of Organization with the Secretary of the Commonwealth on July 1, 19777.•The articles indicate that the non-profit corporatioli was formed for"charitable -ed uc:afio' na&anid scientific purposes." In addition; the p@oses, among oi'hers include the"education'arrd traming'in.ihe.` ' field of mental health .. . . ." (See Articles of Organization attached as Exhibit 1.) 141 Tremont Street • Boston, Massachusetts 0211 1-1 209 •Telephone: 617 /556-0244 • Facsimile: 617 /556-o284 • www.shaevelkrems.com 443 E. Central Street • Franklin, Massachusetts 02038-1304 •Telephone: 800 /336-o222 • Facsimile: 5o8 /541-4515 i Shaevel & Krems, LLP Proposed Use Vinfen intends to lease the Property for a professional social service use 'offering services to persons with mental illness and developmental disabilities. The use will be primarily educational in nature with education services, administrative office use, rehabilitation services, employment training services, community integration services, and occasional medication assistance. The primary use in its totality is to educate persons with mental illness and/or developmental disabilities to enhance their ability to be integrated into the mainstream of society regardless of disability. Ba-ed upon Vinfen's proposed primarily educational use of the Property it .. _ 7.S:y:'�'`7 i),..l s.. _:. t _� �..s ,:.a: a �Al,istl Gf�' il��l-, ti:.:�..t cci;t.'li�.0•j;:ilU�.l tl . ��.Y`.:r _ Amendment and Section 240-8(A)(3) of the Barnstable Zoning Ordinance. Dover Use � r Vinfen respectfully seeks your ruling that the proposed use falls within the strictures of the Dover amendment and is thus allowed as of right under MGL c. 40A� 3 Section 240-8(A)(3) of the Barnstable Zoning Ordinance. MGL Chapter 40A § 3 states that no ordinance or bylaw shall: Prohibit, regulate or restrict the use of land or structures for . . educational purposes cn land owned or leased by . . . a nonprofit educational corporation; provided, however, that such land or structures may be subject to reasonable regulations concerning the bulk and height of structures and determining yard sizes, lot area, setbacks, open space, parking an&building.coverage requirements. Massachusetts case law'has defined `.`education" in the broadest sense as "the process of developing and training the powers and capabilities of human beings" and preparing persons "for activity and usefulness in life." Commissioner of Code Ins ,ection of Worcester v. Worcester Dynarnx, 11 Mass. App. Ct. 97;.99 (1980). Tli; key inquiry is whether the facility "is operated primarily for an educational purpose."' Whitinsville Retirement Socy. v. Town of Northbridge, 394 Mass; 757, 760 (1985). Several uses very similar to Vinfen's proposed use have already been recognized by Massachusetts courts as qualifying for the exemption under Dover. The Massachusetts Land Court approved a Dover exemption for a residential facility with educational programs for homeless families, single mothers, persons with AIDS, and other physical disabilities, and persons recovering:from addictive habits. Congregation of the Sisters of St. 2 Shaevel & Krems, LLP v Josy of oston v. Town of Framingham, Misc. Case No: 1,942.16 (Land Ct. 1994'). Sirr!ilarly, the Supreme Judicial.Court approved a Dover exemption for a ,presidential facility for elderly, mentally ill individuals with an:educational component',.Campbell v. City C6uncil of Lynn, 32 Masse. 152 (1982). In the most recent case, decided in May of this year the SJC just ruled that a"proposed use of land or structures may have an educational purpose notwithstanding that it serves nontraditional communities of learners in a manner tailored to their individual needs and capabilities. Regis College v. Town of Weston SJ 10919 slip opinion May 22, 2012 citing_ Fitchburg.Hous. Auth v. Board of Zoning Appeals of Fitchburg, 380 Mass. 869, 874-875 _(1980). The SJC has consistently held that the-Dover Amendment,applies to certain facilities.for he �1�8 1`. or;t e in ar.ri,Lnc1.�Jl�h� anding hal Elz ��v.?E�ation a'ffor led by, such institutions differed markedly from that offered by "traditional" academic _ `institutions, See id. at 869-870 (residential facility in which "adults, with histories .of mental �:ifficulties, will live while being trained in skills for independent living, such as sel =care, cooking,job seeking, budgeting, and making use of community resources"` Gardner-Athol Area Mental Health Assn v. Zoning Bd. of Appeals ); of Gardner, 401 Mass., 12, 13-14 (1987) (residential facility where adults with mental disabilities "would be taught daily living, as well as vocational skills," Lasell Village,-Inc. v. Assessors of Newton, 67 Mass. App. Ct. 414, 423 (2006). ("no reason1he cognitive and physical well being of.elderly persons" through academic and.physical instruction could not be an educational purpose under the Dover Armonument). In the instant case, Vinfen's proposed use of the Property to educate persons with mental illness and/or developmental disabilities on daily life skills, employment training.and rehabilitative services falls squarely into the case law's definition of an educational use. As such, the proposed use falls within the dictates of the Dover amendment. As!he official charged with the enforcement of the Zoning Ordinance, your decisions warrant deference ff they are reasonable constra ions thereof. Further, you have the authority totissue building permits, which"decisions also deserve deference. The Appeals Court has stated that where, as here, "the technical kpowledge of an administrative agency comes to bear," courts will not interfere with an agency's interpretation "in the absence of powerful evidence to the contrary•" Fire Chief of Cambridge v. State Building Code Appeals Board, 34 Mass. App. Ct. 381, 385 (1993) and see also She Enterprises, Inc. v. State Building_G de,Appeals Board, 20 Mass. App. Ct. 271, 278 (1985) (holding that a court will-not.disturb "[a]n agency's reasonable interpretation of its own regulation-. . . ."). If you are reasonable in the construction of the Ordinance your decision deserves the deference granted to the officials in the above-cited cases. s A affix ' s3✓°,de4i�etx�..� �7�c +4,7'�`1 itiY•a�e�44 F�,e �1'r�i Shaevel & Krems, LLP a o© We believe a reasonable interpretation of the Ordinance would allow you to determhie that Vinferi's proposed use is allowed under the Dover Amendment and Sectio '2404(A)(3) of the Barnstable Zoning Ordinance. We~thank you,in advance for your consideration of this proposal and look forward to engaging in further dialogue with you and your department. Should you have any,questions, please feel free to call meat your convenience. Best regards, 4 Town of Barnstable _ v - �.; .} -n ob and td Must be w Building. l.3 s IPost This Card So That it is Visible From the Street Approved Plans Must be Retai ed onxJ Kept y •'.wxtsrwsLe, M Posted,'UntilcFinal,Inspection Has,Been Mad 039. } e. , ' b �� ,aa+° Whpece a Certificate of Occpancy,i Required,such„Building shall ANot be Occupiedµunt l Final Inspem�ct on lias been vmade M+ Permit No. B-18-1109 Applicant Name: Approvals Date Issued: 04/19/2018 Current Use: Structure Permit Type: Building-Sign Expiration Date: 10/19/2018 Foundation: Location: 1019 IYANNOUGH ROAD/RTE132,HYANNIS Map/Lot: 294-040 Zoning District: SPLIT Sheathing: Owner on Record: 1019 ROUTE 132 HYANNIS LLC Xontractor Name:`,, Framing: 1 Contractor License: `` Address: 600 LORING AVE _ 2 SALEM, MA 01970 +`- Est. Project Cost: $0.00 Chimney: 4i Description: Temp sign wall 32 sq Permit Fee: $75.00 Insulation: j Fee Paid: $75.00 Available Space d p F Date : 4/19/2018 Final: Retail Professional4 a� 617-262-6620 �. Plumbing/Gas Dartco.com Rough Plumbing: Zoning Enforcement Officer Project Review Req: r Final Plumbing: Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within siz months after=issuance. All work authorized by this permit shall conform to the approved application and the-approved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall 6t in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Electrical work until the completion of the same. g � , = Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officialsaa a provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: - �' " `�^� Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT OK -ee,..r�aM „W. s 72- Y•.,,i;,, uM.� ar :a. We .•.k „ R �:-h ..• ''.;� ; W '?5xxRf s" ry w. er 45+km�,o*w itt�' ."$ <.: s a mmrr1T� +k•_ YNI {1 I•A',.4 Ma WGW wNL �!I;m1Yy�uld ' 0 W mom.�..5'� 4 ."w a" b '. 5:.�a •wv < w-4 w 9U. '" } ii. } ' 'jar'!; T,17r "`� �;u�4@° '��_ '' "°c�'w�;q�`S✓�'�N1�y�c�*t+? v,�"�'��"",,:� a�iF�mal4��.�,�� wi'�u�r �� a ... - ,.", <�.<,+, �mra.,, ='��'�,,e'.�` �. :�. ". 3R,.,.,r•m. >, �Sy a�: d� '�;::` •M�*`-" se .k�i. F ._...m,! ira`urlt 4." .• . n .r .��u. „� u+b.r* �, rmnm •Uji�ii4'�y�i uo;'RVUR{ 7mWnmllul�RllWn�iN n,u,�inJ"tnir.`�i iWniet(y'��Uru��liPfaku7u�'r,�IW!'Y➢r� N}a4 'T i eri•eem, .� - ;Y'-:s c ' .. .y '": �� •- x..<max t S<x �§ { $°l t w �, ��'�' _ �'� 5 i� \:4 �''"•.< � �w ��`� "�r�� '`�' X7t _ �,'•<Y ryq< '"'P�`.=i t3�..�r';��, -�='.Ai.;, N?' "#'21 +w.?e"F.:. y.� �. S ;.. � .. �;.�a `�.<� cz•'+^_... •: & ,. 5 ,.� �.��b..,.�:". a� f,> ,i�.a "' .xrU j�`� r? r'U ,a rra"- tt �.4r dre',i. '��2,r;' ;;.y. «m. s< _.. T`g�c _a.r - ^--- ,: �;'4 3^... �: � '"'�� ?f 'acs< '.`r,.#- `3 ''��U' n r Via•� <... .. A � .;. +� >« 5„'nz � ->'r� ..:. •- ,� � `;i: ^h .k'�..�...a� �"" a7�.:�M '�. :,y�. U. "s'a xc a �r h r, ' Retail.P#af�ss�onal 617-262-6620 . ,, Town of Barnstable Building T . �, ..: `.��,; Y�4; ,....r s; '-„�+`N 'n�"..u'�. S ,'G .,".: :?. -'?'i : ;- t vy # ;4 Posh his Card SiThatuit is Visible:.,From the Street -=Approved Plans MustbeRetamed onFJob and this Card Must be Kept . s � �� t ' � "� f� M Posted UntilFinal Inspection Has BeenNlade� y { - R Where�a Certificate°of Qccu anc s Re uired;such B�ui tlm' shall Not3be®ccu,pied-until a;Final Inspection;has been made Permit , :" C:r„ ..�,.'`:.., .:•�r;?t.`dv. -'"xe�:::i� .�y�'.:.,...�,~:� w.,,. ., ,'.�..„ ..gam... ,< �$..�<.�..,�.�a„ -„a^�.� .,;�-,w.,<.c.,m,..c._�i=.r:*�>§ 'i�:v„', ."�...v ;:. 'z .t. '/r ..".y�. Permit No. B-18-2287 .Applicant Name: Joseph Teixeira Approvals e Date Issued: 09/18/2018 Current Use: Structure, Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 03/18/2619 Foundation: Commercial Ma Lot 294 040 ZoningDistrict: SPLIT Sheathing: 7 p/ P g. Location: 1019 IYANNOUGH ROAD/RTE132, HYANNIS 5, ContractorkNarne °',JOSEPH M TEIXEIRA Framing: 1 t A Owner on Record: 1019 ROUTE 132 HYANNIS LLC aY Contractor License- CS,7078674 2 Address: 600 LORING AVE Protect Cost: $ 100,000.00 Chimney: SALEM, MA 01970 ; Perrnit Fee: $ 1,010.00 ,ti g Insulation: - Description: Interior partitions walls,no structural walls, install newcubicles, �F e Paid $.1,010.00 a install new carpeting and painting,miner demo work_ nonrbearing Final: walls,electrical,voice&data work77 Date�` 9/18/2018 Project.Review Req: � � Plumbing/Gas Rough Plumbing: ' Building a ,. ,. � g Official Final Plumbing: Rough Gas: Final Gas: This permit shall be deemed abandoned and invalid unless the work authonzed by this permit is commenced within six months after=issuance. All work authorized by this permit shall conform to the approved apphcattion nd the approved construction document f whM�h this permit has been granted. Electrical All construction,alterations and changes of use of any building and structures shall bed n compliance with the Focal zornng by laws and codes. This permit shall be displayed in a location clearly visible from access street or roadand shall be mamta med open for public inspection for the entire duration of the Service: work until the completion of the same. ` i' Rough: .,. The Certificate of Occupancy will not be issued until all applicable signatures by the'Building and F re Officials are p o ided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Final' 1.Foundation or Footing 2.Sheathing Inspection Low Voltage Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Health 7.Final Inspection before Occupancy Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Fire Department Work shall not proceed until the Inspector has approved the various stages of construction. Final`. "Persons contracting with unregi , ntractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Anderson, Robin From: Mckechnie, Robert Sent: Thursday, September 27, 2018 4:34 PM To: Anderson, Robin Subject: 1019 lyannough Road/Route 132, Hyannis Robin, n Y ;The feather flags were removed today while I was at the subject site.The inspection is in View Permit. Spoke to Manager"David". Bob Robert McKechnie Local Inspector Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 a , 508-862-4033 j �� M t � � �� ` { �, P +. Sign TOWN OF BARNSTABLE Permit * BARWNSTABLE, y MASS 1639- Permit Number: Application Ref: 200900106 20070249 Issue Date: 01/12/09 Applicant: THE 1019 PROPERTY LTD PARTNERSP Proposed Use: GENERAL OFFICE-BUILDING Permit Type: SIGN PERMIT Permit Fee $ 75.00 Location 1019 IYANNOUGH ROAD/ROUTE132 Map Parcel 294040 Town HYANNIS Zoning District SPLT Contractor PROPERTY OWNER Remarks REPLACE EXISTING LADDER SIGN WITH 42 SQ LADDER 10' HIGH Owner: THE 1019 PROPERTY LTD PARTNERSP Address: 1019 ROUTE 132 HYANNIS, MA 02601 Issued By: K VYIJ POST THIS CARD SO THAT IS VISIBLE FROM THE STREET i o� Tay Town 0 Barnstable Regulatory Services MONSTABLLNAM Thomas F.Geiler,Director M 16 9. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit# d4 6 66 16 l7 Application for Sign Permit Applicant: Assessors No. =1 off' O Doing Business As: I ` �' \` _ Telephone No.- Sign Location f Street/Road:—�. a_ ° l• VS�fyy1/ S, ' Zoning District: Old Kings Highway? Yes/(@Hyannis Historic District? YesAeo Property Ow _ TeleZ � � � pName:�_ � � -�G� Ar C Vhon Address: �.�1� --_Village:_ V�'-V\yy 5 Sign Contracto Name:— 1 0�'�` .Sl. C 6_ _Telephone:_ Mailing Address:'-PC) k " _2;Mc�C✓s�l i- '4 . O�'�CO 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) Width of building face ft.x 10= x.10= c� I hereby-certify that I am the owner or that I have the authority of the owner to make thi application,that the information is correct and that the use and construction shall conform to the provisions of§240.59 through§240-89 of the Town of Barnstable Zoning Ordinance. Signature of Owner/Authorized�Agent: Date: 1 7 a� i Size: U� �k� tt y - --Permit Fee: Sign Permit was approved: _ Disapproved: 1� SIGNS/SIGNREQU 6 ll" Q � Cj b r - - OLFl�� Warehouse Outlet 019 BUILDIN w.1.c. I...C.B. FAMILY PLANNING: HEALTH CARE.S.F_MA Child&tomily service of Cope cod CORD -- _ - (,� � � ,ti,� ,'� -]� �t�� 1 �� , _ � �- � � � - � ,� �. i� - 4 tt �, RN t ,� c�'� <��yz.}� i. - ~-.pr.i;V '�a}r�Y 2�1`i L ��r.* ti , `j r -� f�' - J .1 � 2.: `�' t t t � aw _�, "t �r22' S� �� F�}` f 1' �-'„�VS�;� '�',S ti� x t v� � ✓ ,l r�_' � ice{ .r�' - - i� S �� r_:.,s71c�,� :�'�'-Ski �T '`r41, - V_,�-) - Y - _ �� f l �» 1 r r i:� - _ - � X�"i�� - +��"-.ram-ram`� '� " r� - .. � -, _ � ti> �. - � ud.� 1.� � -w .,._�l tI�.�M• t _ r I 1019 7.6' NUMBERS I EDWIN WATTS GOLF i CHILD & FAMILY SERVICES 10" x WWI PLAQUES Cape Cod W1C HYANNIS Health care of FAMILY PLANNING Southeastem Mass M uH aos(w sarr awroN MAn W X 327 PLAQUES 42 80. FT. TOTAL mg X 7299. OVERALL HT. j 1(y I i P*n.t�,,Sign CO. (508) 398-2721 (508) 760-3130 Fax Since, 1956 � I I I �a--c-e�cwo�L L•�k��s T� �-e c�e�e�2�v�p �' i WE- DESIGNED BY: aZWER JIM APPROVED BY: FlLE"F- P.O. NUMBER: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION M Cap Parcel Permit# 0?00 Health Division Date Issued ZZ Conservation Division Fee- Tax Collector Treasurer Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address 1019 Eva 0(A "ON01 �' 13� Village N�X ms /�,, A Owner Q W10 /�1�,tk� Golf Address Telephone Permit Request .A(I nn a 8 o8 ftm 6Lg a� 0 P4�4 00AAOV C,v ' U T / t 0O)e 116 Square feet: 1 st floor: existing proposed 2nd floor: existing - proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay 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 0 No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other t Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing ` net J =, Number of Bedrooms: existing new •c r" v> Total Room Count(not including baths): existing new first Floor Roomy unt ` Heat Type and Fuel ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal s ove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:0 existing ❑new size Barn:❑existing ❑new size Attached garage: 0 existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization Cl Appeal# Recorded 0 Commercial ❑Yes ❑ No If es site Ian review# Y p Current Use Proposed Use CJ BUILDER INFORMATION � Name - Telephone Number S /t OS S ` Address as ��L�� License# U M K-P 0c-.&3-2>\,<� Home Improvement Contractor# + Worker's Compensation# 1(d WW -NS8� c ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO KIP SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ' FRAME ` INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Mass. 02111 ► ww.msass.eov1dia Workers' Compensation Insurance Affidavit: General Businesses A licaut information: Please PRINT le;ibl i , Business/Organization Name: B.C. TENT&AWNING CO` INC Address: 25 BODWELL STREET ' City/State/Zit): AVON, MA 02322 Phone# (508)586-0900 Are you an employer? Check the appropriate box: Business Type(Required): IV 1. I am an employer with LQ-30 employees(full 8. iLl Retail and/or part-time)* 2• 9. L-1 Restaurant/Bar/Eating Establishment 3. ❑ I am a sole proprietor or partnership and have no employees working for me in any capacity. 10. Office and/or Sales(incl.real estate,auto,etc.) [No workers' comp. insurance required] 1.1. L7 Non-profit 4. El We are a corporation and its officers have exercised their right of exemption per c. 152, §1(4), 12. El Entertainment ' and we have no employees. [No workers' comp insurance required]** t3. ❑ Manufacturing 5. 6. ❑ We are a non-profit organization,staffed by 14. Health Care volunteers,with no employees. [No workers' comp. insurance required] 15. ! Other TEMPORARY TENT(Sl 7. *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers' compensation policy is required and such an organization should check box#1. Il am an employer that is providing workers'compensation insurance for my employees. Below is the policy information. Insurance Company name: The Hartford Accident& Indemnity Co. Insurer's Address: 308 Farmington Avenue City/State/Zip: Farmington CT 06032 Policy# or Self-ins. Lic. # 76-WEG-NS8635 Expiration Date: 12/31/08 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250,000 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=dundthep ns andpenalti ' ofperjaary that the inforrnationprovided aboveis true and correct. Signature - Date Print Naine Debra L.Carriuolo Phone# (508) 586-0900 Official use only. Do not write in this area to be completed by city or town official City of Town: Pennit/license# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Licensing Board 5.Selectmen's Office 6.Other Contactperson: Phone# AUG-21-2008 10:09 BC TENT & AWNING 508 586 7177 P.002 ACORD,„ CERTIFICATE OF LIABILITY INSURANCE .SA 0s-2o 2o0e PR'ODtWR THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION HARTFORD FIRE INS CO/PAYROLL ASSOC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE EXTEND OR 250760 P (877)287-1316 F: (877) 287-1315 AL`ERR THE COVERAGE A FORDEDBYTHIS CERTIFICATE DOESY THE POAMENLI ; CIESBELOW. -108 FARMINGTON AVE INSURERS AFFORDING COVERAGE FARMINGTON CT 06032 IN AWARD INSURERA:Twin City Fire Ins Co INSURER B: BC TENT AND AWNING CO INC INSURERC: 25 BODWELL SIT INSURER D: ,AVON MA 0 322 INBU COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREO 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 ON 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. Rm TrffQF B4FAACB ROHCVAkb 99 arFrrc DA7Efi fa L6N/T8 GrAIBAALGANUrY _ EACHOCCUMGNCE s COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one 1110) e CLAIMS MADE OCCUR MED EXP(Anyone per Ben) e PERSONAL&AOV INJURY a GENERAL AGGREGATE o GEN•L AGGREGATE LIMIT APPLIES PERT PRODUCTS•COMPIDPA(IG B POLICY PRO- JET LOC AUr4Wfi UAAAnY COMBINED SINGLE LIMIT s ANY AUTO IEa aoaidarrt) ALL OWNED AUTOS BODILY INJURY e SCHEDULED AUTOS (Per person) HIRED AUTOS ` ' BODILY INJURY NON-OWNED AUTOS ` IPer eccloenG e PROPERTY DAMAGE s (PB wddmrrey ` GARAGE L/A&MMY AUTO ONLY-EA ACCIDENT B ANY AUTO EA ACC e OTHER THAN AUTD ONLY: AGG a EXCESSLLMARj" - EACH OCCURRENCE__ c OCCUR CLAIMS MADE AGGREGATE e 8 DEDUCTIBLE - s RETENTION s a WORX!!RS COAfP6VSAT/ON AA® x WC STATU- OTH- A EMilo►:FRauaeanv 76 WEIS PS9656 01/01/08 01/01/09 E.L,EACH ACCIDENT 0100, 000 E.L.DISEASE-EA EMPLOYEE a 10 O 000 E.L.DISEASE-POUCYUMIT e500 000 OVER DE@GfUiJADAIOFOifRATADN8�L0°AT!°NWVEl9GLL�JEXCLlI8AON8ADDED9rENO0W8FA�iJI/Bi�CdALNiOVIffiW116 ' Those usual to the Insured's .operations. r CERTIFICATE HOLDER X ArmvnooaAL�nrslmso;iAWMAIMIn: _ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL Town of Hyannis 30 DAYS WRITTEN NOTICE 110 DAYS FOR NON-PAYMENT)TO THE CERTIFICATE Attn: -Building Inspector HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 200 MAIN ST REPRESENTATIVES. HYANNIS,MA, 02601 AY/71°1�FO RFYREBFMATAIF ACORD 25•S(71971 a ACORD CORPORATION 1988 Total P.002 f r P��J��JJ� � J�� pdd r3P�Jrrs Jr ��J � 1Mp RTA ®OviE i4T N J Certif feat a of Flame Resistapec .. CD a o- REGISTRATION ISSUED BY Date of Manufacture a'j APPLICATION Q i CHORS o3r�oroa NUMBER ) INDUSTRIES INC. EVANSVILLE, INDIANA 47725 Order Number.382159 - F140.1 ''► MANUFACTURERS OF THE FINISHED C0 TENT PRODUCTS DESCRIBED HEREIN LO m� m This is to certify that the materials described have been flame-retardant treated CD L a (or are inherently noninflammable) and were supplied to: 4 ry 190610 PARTY SERVICES INC S DBA B C TENT . 25 BODWELL ST + S _ AVON MA 02322 5 Certification is hereby made that: z 5 The articles described on this Certificate have been treated with a flame-retardant approved 5 chemical and that the application of said chemical was done in conformance with California ob Fire Marshal Code. All fabric has been tested and passes NFPA 701-99, CPAI 84, ULC 909. wThe method of the FR chemical application is: p 5 E Serial # U5 _ m S 8024000(2) Uj Description of item certified: SFIESTA EXPANADABLE TOP 20WX20 5 Flame Retardant Process Used Will Not Be Removed By 0 5 Washing And Is Effective For The Life Of The Fabric S Signed: m cw n r (ti-1+JG�1N AFllbk�llAnu C) ,, T N ENT DEPARTMENT-ANCHOR INDUSTRIES INC. S r�Li�oPrP�PtP�PrJ�rPr��PcPrPrJrJ�r�rJ�r�r�LE�Pcl�rJ��frl�Pr�r�r P�Pr�cPcPr��Prl�cncP�rJ��Pr� �PrPr��!sr�r_PrPrJ�r�rJ�rJ�rJ�c fcPr�tPr�cP�P�P�P�PrPs PrJ��.TtP s I Q) T ®��1��T�LnL�r�C�C�tl�r�i.�CPCninC�� 1 M P t�F�T�►N +► S r.1�rPrl3r sir arlcPcicnr Pc Pr�r��rGr arS'rs► ��71� �;�.► ra y �� 1ecl of F Iame 5c 3 `�m.+o:+�t EDate �4ctureISSUED BY REGISTRATION sAPPLICATION y iND)S�ESINC nber NUMBER JEVANSVILLE, INDIANA 47725 a � t MANUFACTURERS OF THE FINISHED 5 . 5 F140_I £ S TENT PRODUCTS DESCRIBED HEREIN t treated Q [ Ian IL is to certify that the materials described have been flame«retard^ , This tied to: ra S {or are inherently noninflammable} and were supp S 190610 5 S PARTY SERVICES INCENT 5 DBABCT 5 BO WELL ST AVON MA 02322 S 5 S r 10 S Certification is hereby made that: S z Certificate have been treated with aflame-retardant approved 5 z The articles described on this Cert was done in conformance with California S I3 S d application of said chemical chemical and that the app asses NFPA 7U1-99+ CPAI 84, ULC iUJ• S z 5 Fire Marshal Code. All fabric has been tested and p � w 5 application is: 5 V S The method of the FR chemical app 00 Serial # S S8024300(4) S Description of item certified: 5 5 FIESTA EXPANDABLE MIDDLE « M 1Nill Not Be Removed By 5 M S Flame Retardant Process Used 5 S bin And 1s Effective F®r The Life of The Fabric o Washing 5_ m S Si nod: TENT DEPARTMENT-ANCHOR INDUSTRIES INC, 5 S S r�cnrsr��.r-�s�.r�.r �n�r�crrscn rn��.ras��.n�r-rs�� r_,nnr]rr1T7P[�[.PL ER:fP[.�C I�CPC�LPC1� '� ,. o �J"c.ft�PrJ'c�J'� �cn�r�r��n��n�n��.nr��n�nC.n��c..��n��n��cr�rn�n��rn�r��nc.r�� o � c� __ _.;-�Aa' rnstab1e Geographic Information System Map---] Abutters hlap Size ® Zoom Out l,I V I I®®®1 In Pa rcel Viewer Custom )digR Yy + ®+ JPG Map: 294 Pa 4D42 294072 Location: 1019 IYANNC _ f 'Owner: THE 1019 PR yp r �� i } �lllr'y, 2M4. Location Information Map &Parcel 294C n. Location Acreage 1.24 i Current Owner ' y Mailing Address THE 94D4D HYAI >il0 cal k.4 ,, N2939 .. Appraised Value (FY 21 gel n � z; _ � � �M��' ��r k , • Extra Features $U x Out Buildings $67, Land $59,. or ;r'294D2®CND ;294025 Buildings $2,3 qND � Total Appraised 3 0 PP $ j 2Q 32CND N N31 2SAt7 '` �( n Assessed Value (FY 20 r 7 r Extra Features $0 Out Buildings $67, N14 Nob 29��89 � Land $59E 3 944 Buildings $2,3 Total Assessed $3,0 Set Scale V = 185 April 2001 Hi Res �. . Copyright 2005 Town of Barnstable,VA All rights reserved.Send questions or comments to GIS BarnstableMA v0.2.91 [Production) , i of WKEr Town of Barnstable Y Y # BAMMBLE, # MASS.tG59. Regulatory Services .e ��' rF0 a Thomas F. Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize I V l`�V to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date J� Print Name Q:\WPFILEST0RMS\bui1ding permit forms\EXPRESS.doC Revise020108 Town of Barnstable Regulatory Services BARNSTABLE, Thomas F.Geiler,Director 9 MA&& 1639. Building Division rED MA'1 A 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: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling,attached or detached structures accessory'to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be J responsible for all such work performed under the building permit.'(Section 109.T'l)' The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he'/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that'if the.homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community, Q:\WPFILES\FORMS\homeexempt.DOC Willoch Realty Trust,(A=294-40)51019 Iyanough Rd.,Rt 13 2,Hy,permanent,B ox #5,survey date 12-9-98 r ! TOWN OF BARNSTABLE,BUILDING PERMIT APPLICATION. Map Parcel; ry Application # � Health'Division " Date Issued d ' Conservation:Division s Application Fee Planning Dept. Permit Fee l ® ` Date Definitive Plan Approved by Planning Board - Historic:- OKH Preservation/Hyannis Project Street Address 1019 Iyanough Road, Bldg. #1 Units B,C & D -Off Route 132 Hyannis Village Iyanough Village Condo, Hyannis Owner Huntingest Group Management Address 40 Industry Road, Marstons Mills, MA Telephone 508-428-1112 02648 Permit Request Repair fire damage in Bldg. #1 Units B,C & D Unit C - Replace 8-10 Trusses and ceiling, Unit B '& D =Strip & replace sheetrock and insulation, repl . 6 alp vYt�� S �eG? o, Square feet: 1st floor: existing7 50s f proposed 2nd floor: existing 750sfproposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation $120,650.00 Construction Type Fire Damage reconstruction Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) 4 Age of Existing Structure. 1982 Historic House: ❑Yes ® No On Old King's Highway: ❑Yes 3 No Basement Type: ❑ Full ❑Crawl ❑Walkout ki Other Gi ah Basement Finished Area(sq.ft.) n/a Basement Unfinished Area(sq.ft) n/a Number of Baths: Full: existing 4 new Half: existing new Number of Bedrooms: 2 per unit existing —new Total Room.Count (not including baths): existing 16 new First Floor Room Count 8 Heat Type and Fuel: ® Gas ❑ Oil ❑ Electric \ ❑ Other f Central Air: ❑Yes ] No Fireplaces: Existing _New Existing woodkoal stove: ❑.Yes 6 No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: 0 existing ❑ new size Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: i -� Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ r\> _c Commercial ❑Yes E] No If yes, site plan review# Current Use Residential Proposed Use Residential APPLICANT INFORMATION (BUILDER-OR-HOMEOWNER) Name Kerrigan & Axon, Inc. Telephone Number 508-540-4426 u Address 565 Carriage Shop. Road License# CS14638 , CS068287 East Falmouth, MA 02536 Home Improvement Contractor# 100138 Worker's Compensation # WC6887676 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SeaMa.ss SIGNATURE DATE �- �� I R_ FOR OFFICIAL USE ONLY LICATION# ^uHTE ISSUED .MAP/PARCEL NO. T 5 ADDRESS VILLAGE 1 ' OWNER DATE OF INSPECTION: FOUNDATION s FRAME p INSULATION f FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT. ASSOCIATION PLAN NO. 2 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Kerrigan o.'Axon, Inc. Address: 565 Carriage Shop Road City/State/Zip: East Falmouth, MA 02536 phone.#: 508-540-4426 Are yyoou an employer?Check the appropriate box: Type of project(required): L'✓1 1. I am a employer with 11— 4• ❑ I am a general contractor and I 6. ❑New construction . employees(full and/or part-time).* have hired the stab-contractors 7. Remodeling 2.❑ ham a sole proprietor or partner- listed on the attached sheet ❑ g ship and have no employees These sub-contractors have g, ❑Demolition . working for me in any capacity. employees and have workers' 9 ❑Building addition insurance t [No workers ins urance comp. ` 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 l l.❑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.®Othergel nn G r r r i nx� comp.insurance required] after fire damage *Any applicant that checlo;box#1 must also fill out the section below sbowing their workers'corrmpensation policy information. t Homeowners who submit this affidavit*indicating they art doing all work and,then hire outside contractors must submit anew affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contraetars and state whether or not those entities have errmplo-yem If the sub-conbactors have employees,they must providt their worlmrs'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. z Insurance Company Name- Insurance -Company of Pennsylvania Policy#or Self-ins.Lic.#: WC6887676 Expiration Date: 9r13.42nns Job Site Address: 1019 Iyanoutgh Road Off Ror,tP 1 '10 City/StaWZip: Hyannis, MA 02601 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 5ne up to$1,500.00 and/or one 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 pa' s-and penalties of perjury that the information provided above is true and correct Si shire• Date: 5 2 2 _ Phone#- 508-540-4496 Official use only. Do not write in this area,tb 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 w Contact Person: - Phone#: I ; MAY-01-2008 ^' 1554 PAUL PETERS INS. FAL 5085409641 P.002 cATe(moo amY ) .A CORD O ID JT4R �Aw m ! �f p® �V 1lr ( 0.5}02 08 P>�oueen R I THIS CERTIFICATE IS 1884JED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Paul Peters Agency, Tnc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR g 0 Box 669 ALTER THE OMRAGE AFFORDED BY THE POLICIES BELOW. Falmouth Mh 02S41-0669 Phone 1500-548-2S00 INSURERS AFFORDING COVEF.AoF NNC# iNBURED INSURER A ONE BEACOYZ AbERICA N6URER S; INBUBANCE CO OF&P.UA8SLYAN:.A .-.... •,- Kerrigan, & Axon, Inc. I INSURCR0: 565 C=;eim a Rd E �'al�OnthFA 02336 InSURER0: _ iNsvRER E; COVERAGES THE POUCrS OF WSVMNCB L18TE0 99LOW HAVE BEEN 198uE0 TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATCD.NOTWITHSTANDING ANY RECUIREMSNT,TGRM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W ITN RESPR-'T TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAYPERTAIN.THE 94SURAMCF AFFORDEO BY TH£POLICIES DESCRIBcU HEREJN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POI,IOIFR,AGGREGATE LIMITS SHOWN MAY HAVE 9CCN REDUCED BY PAID CLAIMS. LTK TYPg OF IMSUAAdNCE POLICY MUNRIER .,�. I� p�OM' UATG MIMiGIN LIMITS —yam,.,• lGMERA.LIAIMe.Y 0:30vRFkEnOE 61,000,000 A I X 7[X 00MIERCIALQEIJERALLIABILITf 753-01-19-08-0002 06/09/07 . 06/09/08 PREMi3£3 Laoscuronay s500,000��„_ CLAIJ48(BADE ),j OCCUR _MED EKT•(Any One person) S 10 000 I _PERSONAL_&ADV INJURY S 1 000 000 I GENEFAL AGGREGATE S2,000 000 i 'IGEJ'LAGISREG.ATE LIMIT AP(PLILIFSPrR' I PftODUCYS•GORApWpA3�a S2,000,900 I I OGLIC'✓ JCCT � , I AUTOA ONX LSA&L1TY COMBINED 9lNOLE LIMIT $ ANY ALITO I (EB SCCIdeiM) ALL OANM AUTOS BODILY INJURY & I SCIEDULfOAUT05 I i j(PQOOI 1lULEPA�O3 i 6DDILYURY �, n0N-0WN56AWT09 I I(Poe AmIdto y PROPERTY DAMAGE (Par.eG;idertty 3 "IAG€L80.BiLITV� r I AUTO S THAN ANY 1. Itt 7— IZ'. - 4 OTHI-R AN CA.ACC S NYA :AUTd ONLY: AGG S I D(CI255N1�®RlLLALIA9lLJTV I --T If !�NOvCURREnfC6 I$ OCCUR CLAIMSMADG I` j AGGREGATE S DEDUCTIBLE i RETENTION 3 VIORK CO MPBNsAmUN ANO i �TORY LIMITS ER ERS EMPLOYORW UA9161-N ANYPROPRIE.TORIPARTN6R/�(SCUTIVE WC6$$7676 09/13/07 .. :09/13/08 EL.EACH ACCIDENT 3°300�000 OFFICMMEMBER EXCLUNDt E.L.DISEASE-EA EMPLOYCE $SOO 000 If yes,aeeulwunder !SOD 000 SPECIAL PROVISIONS w IS . El OEAS£-POLICY LIMIT 5 O"MEW.. I ! I 0004RirT10H 6>f BFEIeA'A6►�1 IAOATWHO i VCLUELe6'l CXet.uObeaO a$DE6 6Y eUDeRSfiltlaNT!SPECIAt[sRf3ULSIA103 Sri3L��A Giy j8us�avntsOYa�O�piu.� CM 71FvATE NGLD� 0aM0E�P►T11�Nt To=rs $MOULD ANY OF THU°AFCOVE DP,.S6RISED POLICIES BE OJWOEILPLI OSPOR15 THE E%PNLA*N DATE THBRIOP,TNH ISSUING MUR4R WILL ANDRAVOR TO MAfl _ DAYS WRrMN Town Of Barnstable NOTICE TO THE GYRTIFIGATE HOLOER NAMED TO THs Le",OUT FAILURE TOOO BO SHALL Building DepastT w.t IN PO^.8 ND OBLIGATION OR UAOIUTY OP ANY KIND UPON THE IN.,WREk ITS AaGIN TS OR 200 Main St FT1YaiiT11$ NA026Q1 REPREBeNTATiVES AU HORIfBD W ATNE I frt —7 9 ' �h>riSitZi3eS �. A,CORD 25(2001/08) 0 ACORD CORPORATION 1998 TOTAL P.002 Q5/01/2008 10:12 FAX CJ001 MW!-01-200e 09 t01, AM KERRICAN Z AXON S09 $40 69Z4 Town of Bar' nstable Regulatory Services Thames P.Geller,Director .�° Building Division Tom Perry, 84ilding Com nisSioncr 200 Main Street, Hy'arnis, MA 02601' WWW-fowni barnstabla,MA,oj C�ftioa: sos=s�s�.�o}8 Fax. 508-790-6230 ;Property Owncr Must Complete and Sign This Section If Using A IBUilder t 5 ,as Qwwr of the subject,property hereby Ruthc»ite +<E 1 6 to act ozx my behdf, w in all rnattem rek ve to WWk authorized by this building permit apphct tioa for: c {Addlresa of job u� t=e of( eR _ •�•�. D21'E Prnr Name Qp••499 -t L 7- If Property Owmet its appWg for Fein it please complete the Homeowners License Exemption Form on bite revue aisle. I "Section 3: BUILDING, SIGN, WIRING, PLUMBING AND GAS PERMIT FEES BUILDING PERMIT FEES Residential A-3, R-4 Use Groups New Buildings/structures, (includes detached garages) Application fee $100.00 Permit fee $5.10 per$1000 of construction value $25.00 minimum Additions/Alterations/Renovations (includes fences over 6') Application fee $50.00 Permit fee $5.10 per$1000'of construction value $25.00 minimum Commercial &All Other Use Groups r New Buildings Application fee _ $150.00 , Permit fee $9.10 per$1000 of construction value $50.00 minimum Additions/Alterations/Renovations Application fee $100.00 Permit fee $9.10 per$1000 of construction value $50.00 minimum. All other Structures (not specified) Permit fee ---------------,$9.10 per$1000 of actual value $100.00 minimum PLUMBING PERMITS Residential - per unit $40.00/first fixture plus $12 each additional fixture Commercial- per unit $60.00/first fixture plus $15 each additional fixture n GAS PERMITS Residential - per unit $40.00/first fixture plus$12 each additional fixture Commercial- per unit $60.00/first fixture plus$15 each additional fixture ELECTRICAL PERMITS Residential New construction per unit $150.00 Additions/renovations < 500 sf 25.00 > 500- 1500 sf 50.00 > 1500 sf 100.00 Minor alterations/appliances 25.00 Change of Service/meter 30.00 Accessory structures(garage, barn, pool,etc, excl separate meter) 30.00 Temporary service 30.00 Meters per unit 30.00 Smoke detectors/alarms 30.00 t Commercial New construction per unit $200'+ $25.per 1000 sf>4000 sf Additions/renovations < 1000 sf 75.00 > 1000-2500 sf LL 100.00 >'2500 sf $150.00 + $25.00 per 1000 sf>4000 sf Minor alterations/appliances, etc. 25.00 p Change of service/meter 40.00 t Temporary service 30.00- Signs 25.00 Carnivals/fairs 1 - 10 concessions/rides 50.00 > 10 concessions/rides. , 100.00 q:fees/2008newfees SIGNS " Under 25 sf $50.00 Over 25 - 50 sf $75.00 © , Over 50 - 75 sf $150.00 Over 75 sf $200.00 MISCELLANEOUS BUILDING PERMITS& FEES REQUIRED Accessory Building: All Use Groups > 120 sf-500 sf $35.00 > 500 sf-750 sf $50.00 > 750 sf- 1000 sf $75.00 > 1000 sf- 1500 sf $100.00 >1500 sf Same as New Building permit based on actual cost Change of permit holder $25.00 Pre-building code structure, Cert. of Occupancy $75.00 Change of Use permit(no construction) $25.00 Foundation permit(separate from building permit for cause only $25.00 Zoning Compliance Certificate (lots/existing uses/structures) $50. minimum+ research time Reinspections (for work not ready for inspection, incomplete work or failure of inspectors to gain access to premises) $100.00 Removal of Stop Work order $50.00 Replacement of lost permit inspection cards $50.00 Chimney/fireplace (new& reconstruction) $25.00 Certificates of Inspection (CMR 780 Table 106) $50.00 min Permit Renewals 15t renewal $50.00 2"d renewal (for cause only) $75.00 Inground swimming pools $125.00 Above ground swimming pools $75.00 Decks, open porch $60.00 Relocation/moving (includes new foundation) $250.00 Demolition Residential principle buildings $125.00 Accessory buildings .50.00 Commercial buildings $9.10 per$1000 of construction value Home occupation (no construction) $25.00 Pre-permit plan review (one and two family) $75.00 Temporary residential Certificate of Occupancy(for cause only) $75.00 Residential certificate of occupancy $25.00 Temporary commercial Certificate of Occupancy (for cause only) $75.00 Commercial Certificate of Occupancy $75.00 Pre-permit plan fees $100.00 Site Plan (Fees) Project Construction Cost under$5,000 $100.00 $5,000-$14,999 $200.00 $15,000-$49,000 $250.00 $50,000-$249,000 $350.00 $250,000 or more $500.00 . Permit related to work begun prior to time allowed for acquiring permits under Building, Electrical, Plumbing and Gas code 2 times permit cost Express Permits (minimum $25.00) Residing/Reroofing (residential) ($5.10 per$1,000 of construction value) Wood/coal stoves 25.00 Replacement Windows 25.00 Sheds under 120 sf '25.00 Others (as determined by inspector) 25.00 Tents (2-5.1) Residential 25.00 Fund Raiser/Special Event/Non-Profit Agency 25.00 Commercial (Temporary Accessory Structure) 100.00 Qrganized &supervised recreational camp(Special Permit required) 50.00 1:fees/2008newfees i Page 1 of 1 MEREDITH AXON From: <eDEPConfirmation@massmail.state.ma.us> To: <Kerriganaxon@verizon.net> Sent: Friday, May 02,2008 9:38 AM Subject: eDEP Submittal Confirmation Thank you for using eDEP Online Filing from the Massachusetts Department of Environmental Protection. Your transaction is complete and has been submitted to MassDEP. This email is your receipt for the eDEP Online Filing transaction described below. Please review it and keep a copy for your records.. Please do NOT reply to this message,this email address will not receive messages.For assistance with eDEP Online Filing,please email the DEP Help Desk at DEP.HELPcc"�,state.ma.us or call 617-556-1100. MassDEP is interested in how we can serve you better. To help us make improvements to eDEP; please take'a minute to complete our eDEP Online Filing Survey at http://www.mass. og v/dep/service/compliance/edepsurv.htm.. To contact MassDEP Programs, please see http:Hmass.gov/dep/abo6t/c6ntacis.htm: DEP Transaction ID: 178716 c ` Date and Time Submitted: 5/2/2008 9:12:29 AM Form Name: BWP-.Demolition Form for AQ-06 Payment Information DEP code Date Amount($) Payment Detail Contractor Contractor Number Name Address - Supervisor Project Monitor Lab 4 EMAIL ID OF THE USER: Kerriganaxon@a,verizon.net 5/2/2008 i Or Massachusetts Department of Environmental Protection Bureau of Waste Prevention . Air Quality 1100071472 Decal Number BWP AQ 06 Notification Prior to Construction or Demolition Important: When filling out A. Applicability forms on,the computer,use only the tab key A Construction or Demolition operation of an industrial; commercial, or institutional building, or to move your residential building with 20 or more units is regulated by the Department of Environmental Protec use the return tion cursor- not (DEP), Bureau of Waste Prevention -Air Quality Control Regulations 310 CMR 7.09. Notification of key. Construction or Demolition operations is required under 310 CMR 7.09 (2)ten (10) days prior to any_ work being performed. The following information is required pursuant to 310 CMR 7.09. m B. General Project Description 1. a. Is this facility fee exempt-city, town, district, municipal housing authority, owner-occupied Instructions residence of four units or less?❑✓ Yes ❑ No 1.All sections of b. Provide blanket decal number if applicable:this form must be Blanket Decal Number completed in order to comply with the 2. Facility Information: Department of Iyanough Village Condo Environmental Protection a.Name notification 1019 Iyanough Road, Building#1, Units B, C 8r D requirements of b.Address 310 CMR 7.09 —� BARNSTABLE I MA—: 102601 c.Citvfrown d.State e.Zip Code (508)540-4426 f.Tele hone Number area code and extension E-mail Address(optional) 1,500 2 h.Size of Facility in Square Feet, i.Number of Floors j. Was the facility built prior to 1980? 0 Yes ❑✓ No k. Describe the current or prior use of the facility: Residential I. Is the facility a residential facility? ✓ Yes ❑ No 4 _o M. If yes, how many units? Number of units ° 3. Facility Owner. - �N Huntingest Group Management �o a.Name �0 40 Industry Road b.Address Marstons Mills MA 02601 0 c.C'tvrFown d.State e.Zio Code �o (508)428-1112 f.Telephone Number(area code and extension)' a.E-mail Address(ootional) C) James Curtis �Q h.Onsite Manager Name ag06.doc•10/02 BWP AQ 06•Page 1,of 3 Massachusetts Department of Environmental Protection Ll Bureau of Waste Prevention • Air Qualit 100071472 Decal Number BWP AQ 06 Notification Prior to Construction or Demolition General Statement: If B. General Project Description Cont. asbestos is found during a 4. General Contractor: Construction or Demolition Kerrigan &Axon, Inc. operation,all responsible parties a.Name must comply with 565 Carriage Shop Road 310 CMR 7.00, b.Address Chap er21and East Falmouth MA 02536 Chapter 21 E of the General Laws of c.CitvfTown d.State e.Zin Code the Commonwealth. (508) 540-4426 1 Kerriganaxon@verizon.net This would include, f.Telephone Number(area code and extension) q.E-mail Address(optional) but would not be limited to,filing an James Kerrigan asbestos removal h.On-site Manager Name notification with the Department and/or a notice of release/threat of C. General Construction or Demolition Description release of a hazardous substance to the 1. Construction or demolition contractor: Department,if applicable. Kerrigan &Axon, Inc. a.Name 565 Carriage Shop Road' b.Address East Falmouth MA 02536 c.CitVrTown d.State e.Zip Code (508) 540-4426 Kerriganaxon@verizon.net f.Telephone Number(area code and extension) g.E-mail Address(optional) James Kerrigan h.On-site Manager Name 2. On-Site Supervisor: James Kerrigan On-Site Supervisor Name 3. Is the entire facility to be demolished? E' Yes FV_J No N �0 4. Describe the area(s)to be demolished: _o Bldg.#1 �N Units B,C&D 7 moo . 0 5. If this is a construction project, describe the building(s)or addition(s)to be constructed: �o Remove & Replace sheetrock& Insulation B&D 0 C7 �Q ag06.doc•10/02 BWP AQ 06•Page 2 of 3 I Massachusetts Department of Environmental Protection ■ Bureau of Waste Prevention • Air Quality BWP AQ 06 Decal Number Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.) 6. a. If this is a demolition project, were the structure(s)surveyed for the presence of asbestos containing material (ACM)? ❑ Yes ❑✓ No . If yes, who conducted the survey? b.Survevor Name c.Division of Occupational Safety Certification Number 7. Construction or Demolition: 05/15/2008 08/15/2008 a.Start Date(mm/dd/yyyy) b.End Date(mm/dd/yyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding ❑ paving❑✓ wetting ❑ shrouding b. If other, please specify: ❑,covering ❑ other 9. For Emergency Demolition Operations, who is the DEP official who evaluated the emergency? a.Name of DEP Official b.Title c.Date mm/dd/ of Authorization d.DEP Waiver Number D. Certification I certify that I have examined the Brian Axon _o above and that to the best of my a.Print Name -o knowledge it is true and complete. The signature below subjects the b.Authorized Signature -N signer to the general statutes Partner =o regarding a false and misleading c.Position/I itle _o statement(s). JlKerrigan&Axon, Inc. d.Representing �o e:Date(mm/dd/yyyy) 0 �O �Q ■ ag06.doc•10/02 BWP AQ 06•Page 3 of 3■ eDEP: Print Receipt Page 1 of 1 Submittal Summary & Receipt -Your submission is complete. Thank you for using DEP's online reporting system. You can select"My Homepage"to review your status. DEP Transaction ID: 178716 Date and Time Submitted: 5/2/2008 9:12:29 AM Other Email Form Name: BWP - Demolition Form for AQ-06 Payment Information _ DEP code Date Amount($) Payment Detail Contractor Contractor Number Name Address, , Supervisor Project Monitor Lab p e % https://edep.dep.mass.gov/Restricted/we,bpages/printreceipt.aspx 5/2/2008 9 , w_ BOARD OF BUILDINGTREGUL'ATIONS ;- a (License: CONSTRUCTION SURERYISOR' . I-d Number CS 068287 . I Expires 05/10%200& Tr no: 23862 ' � Restnctedr�00�;/ BRIAN T AXON 1 36 OUERY DR: a j' N FALMO,UTH, MA 02556 f + Commissioner 4 s max.,y -M k. f i i - I I I I 1 I • j ' t i t I i I E t i i ! 1 , : I i 7 r NG 4T4e i I i : ' I 'co ! ! 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SEtT10165 t�l71LPINC% a►%pLLW- c, bWI-PiNc Na PrKST rwm MAN v o Q •. 11 /S 1lrN ?21 W1771 TOWN OF BARNSTABLE BUILDING,PERMIT.APPLICATION pp Map 1 Parcel ® A lication#., - Health Division " Date Issued.` 49 _2>�7 (0 , Conservation Division y Application Fee y, Tax Collector Permit Fee Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address C1 lot N lMOU611 0_�o 61 e 13 2- WIA/ " ) G d Villageyr?'1Al Owner E'��/IJ�I �S (� L�� Address SBn�r Telephone '�' ( �-� )p `:t( Lt-Z,`') t t 12. -- TOA 11 V,AMAkN Permit Request yC LI 0 P C tiT '�v s i ok, ri E_rm 1 A-1- T .Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total.new Zoning District Flood Plain _Groundwater Overlay Project Valuation �� ^I Construction Type Gn W a c iv Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) co Age of Existing Structure Historic House: ❑Yes ❑No On Old King's High ay: ❑Yes 0,No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new ` Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use �y BUILDER INFORMATION f Name ��— 1 Telephone Number J_e_F6W—_&'f-66 Address License# G"I V 0 �✓, U 23 a Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO h� SIGNATUR DATE 2 '07 r ' FOR OFFICIAL USE ONLY r, L. APPLICATION# DATE ISSUED ' MAP/PARCEL N0. ADDRESS VILLAGE 'x OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION M a . FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING DATE CLOSED OUT 1 r ASSOCIATION PLAN NO. r. Y of Town of Barnstable.. ,tea yo .� Regulatory Services ar�ss: Thomas F.Geiler,Director _ Building DiAsiOnIJ Tom Perry, Building Commissioner 200 Main'Street Hyannis,MA 02601 wwfr-town.barnstable'ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign. This Section ` If Using A Builder as Owner of the subject.property i hereby authorize &C p �� to act on rnY behalf, in all matters relative to work authorized bythis bi Mrig permit application for: , (Address of Job) S' afar of Owner Date Y Print Name Q:FORMS:O-INFRPBRMISSION Town of 6arnstable Geographic. Information System Parcel Viewer Fcustom Map Abutters Map Size 0 ❑ ❑ Zoom Out Doan no a a DIn ;,R y f + - ® 7PG Map: 294 Pa N - 294072 204002 t� }R � _ � Location: 1019IYANNC � Owner: THE 1019 PR 294003 Location Information Map&Parcel 294( Location 101S .4 v «¢. !► 1',�,� /'` r r Acreage 1.24 �} �295015XD2 f y ` Current Owner Mailing Address THE h 101 S • 4 9404D _, a,«,, `�, . HYAI 294061 CND p 1019 Y r r 294039 Appraised Value (FY 21 } � ,4 i +� . r Extra Features $0 Out Buildings $67, . ,. �' 1 t - Land $59_ JY_ �+ �+ j Q '� 294026CN�D 294025 Buildings $2,3 Total Appraised $3,0 29 32 CND 20403$ 294037 Assessed Value (FY 20 q 35 F r Extra Features $0 j f 294036 Out Buildings $67, �';�. 294022 '� 204056 q 145 Land 59`_ 3� Buildings $2,3 Total Assessed $3,0 Set Scale 1" =L85TApril 2001 Hi Res 0� Copyright 2005 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS BarnstableMA vO.2.91 [Production] PROPOSAL #• 16935-1 25 Bodwell Street EVENT DAY FRIDAY DATE:08-31-2007 I Avon,MA 02322 EVENT TIME '�FE ? : SALES AG,PERSON:: R ; PURCHASE ORDER#: : ' _N T Tel; (508)586-0900 , PROPOSAL DATE: 08-09-20U7 ��V N I N G i j(80Q)66U-TE]vT(8368) TEL: (78 L}871-O000 x16 FAX:(781)878-7209 —••-_ Fax. (508) 586-7177 s ' ORDERED BY TQRY UPHAM TEL IC 11.E INC_ E-Mail: info@bctent.com ! 1 ; RU,-LTOi i ! JOB SITE: BRENDON 508-29275 64 l 5771-4653 E;D VJIN WATTS GOLF 1019 IYANOUGH RD.' 200`V✓EBSTER STREET ; I 14YANNIS ! ' 4 MA j HANOVER 1 MA! 02339 WE-ARE PLEASED TO QUOTE'THE RENTAL OF,THE FOLLOWING. 1 20'X 40'FRAME TENT-WRITE 605.00 ' 605.00 120 T CAFE WALL 30.00 4 8'BANQUET TABLE i °i ` s 8.85 " 3 35.40 i li ASPHALT CHARGE(WAIVED) 4 1 TAKE SAND.&PATCH FOR.TAKE DOWN 1 CUSTOMER WILL OBTAIN OWN PERMIT ?? 7 SUBTOTAL: 1 i 670.40 IT31!I�s r:FRI/SAT/SUNDAY/MONDAY :rORY CELi 781-424-4112` SALES TAX: j 33.52 9 EL:!;�FIRE CERT&WORKERS COMP FAX',TO 508;790-6230 1 LABOR: i ,0.00 , DEL/PU FEE- 150.00. _. I Valid For: 5 DAYS TOTAL: $ 853.92 I , Pavoient to be as follows: 50%DOWN BALANCE NET 10 f I • ' t I i, 4 e 't i I I j ` ' cept8nce of�roays`al- The above prices,specifications and conditions are satisfactory and are hereby accepted. �Yout are authorized to:do the work as specified. Payment will be made as outlined above. Deposits are not refundable ' or ti�tnsferable unlessotherwise specified. Snb-rental of equipment to others;without authorization is prohibited. Please sign and returtz one copy of this proposal I A,ul.horized 4Date ofCustomer ! 1 Signature: 1 i , £Acceptance: Signature: I RAC Z00'd LLTL 989 809 ; t, 6E LOOZ-60-Jn� 9NIHPIY '8 ZHSZ 08 ( Li ,AUG-15-2007 {12:09 BC TENT &jAWN ING; i t509 586 7177 P.002 1 �.� ! .... :..., ». . .. a Department of Industrial Accidents ( ? Office of-I vestigations j 600 Wa',shington Street 1 I I Bostori,Mass:02111 ! + ' www`mass.eov/dia l ! ' Workers'-Compensation Insurance Affidavit:'General Businesses ( pp 1 Please PRINT legibly A � licant"information: � � � ', i � ; � i` BiAine'ss/Organization Name: B.C.TENT&'AWNING CO- INC. Address: ? j 25 BODWEL L STREET ;City/State/Z if ip: ` ? AVON,MA 02322f i Phone'#' (508)586-0900 , lAre you an employer? Check the appropriate boz: i ;Busiiaess Type(Required): ' i i3 1. ` 71 am an employer with bQ�Q employees(full ;i � � 18. D Retail and/or part-time)*' i s 2• ; i ; # ( i 9. D RestaurantBar/Eating Establishment 3. I am a sole proprietor or partnership and`have,no employees workin for me in an ca aci s { j, j 10. 11 Office and/or Sales(incl.real estate,auto,etc.) i . g Y P tY ; ; ! $ [No workers'comp. insurance required] = i ! l l. Nori-profit l i 4. We are a corporation and its officers have ! ? ; exercised their right of exemption per c. 152,§1(4),''. !; 12. Entertainment ? and we have no employees. [Now 'rkers';comp 1 t; insurance required]** _ j ` t ; 13. Manufacturing !! ; s i 5. j ' j 1 ` + 14. Health Care. 6. � We are a non-profit organization,staffed by , ! volunteers,with no employees. [No'workers' comp.; _s insurance required] ! i " 15. _ O er' T E MPORARY TENT(S) 7. !*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. *If the corporate officers have exempted themselves,but the corporation has other,employees,a workers'compensation policy is required and such ' an organization should check box#1. gg ,I am an employer that is providing workers'compensation insuranee for my employees; Below�is the policy information. Insurance Company name: 'The Hartford Accident&.Indemnity Co. Insurer's Address: 308 Farm' Avenue ! i City/State/Zip: p Farmington CT 06032 Policy#or Self-ins. Lic. # 76-WEG-NS8635 Expiration late:! 12,/31/07 Attach:a copyiof the workers' compensation policy declarationpage(showing the'policy riumber and expiration date). i 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 $250,000 a day against the violator. Be advised that'.a copy of thisistatement may be forwarded to'the Office of Investigations of the ° i DIA for insurance coverage verification: j. . .. . �..._ ;1 do hereaby — un er th ains nalties of perjury that the information provided above:sltrue and correcx r , : , Signature Date t jPrint Nam is `� ! I Phone# (508)586-0900 i t!i Official use only.. Do not write In this area to be completed by city or town official City of Town i : i Permitlliccnse# 1 •l` i ' Issuing`Authority(circle one): 1.Board of Health 2.Building Department 3.City/{T{own;Clerk 4.Licensing Board 5.Selectmen's Office 6 Other Contact n. ± Phone# 0 7l V `l 7 �n��_1_M_P..O_R_TA_N T_D O_C_U.M.E.N_T_7n�.l��u� ��.r��n I:r� ��n�n � o - - _ - -- ----___�__._.._-____w_ _ .- r 5 _ �Itl�� _._ S_F J, �ertififatf -of lam. .� REGISTERED--:_,..a___ ul� Date of Manufacture- APPLICATION ' s C1�Bm- 01/26/01 N NUMBER L ?0INDUSTRIES INC. S EVANSVILLE, INDIANA 47711 Order Number o ,,_N._: �F 121'_4 _- . ..• . ... _W. ,' 332724 5 MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN 5 This is to certify that the materials described have been flame-retardant treated 5 S (or are inherently noninflammable) and were supplied to: - :- S :..:PARTY SERVICES, INC 7 1 _ 5 _ P.O BOX 209 . - -- .._.. _. .__ ------ 7- 5 Certification is hereby made that: 5 ,The articles-described--on-this-Certificate--have-been---treated-with-a--#lame-retardant--approved-------- --- 5 -- - chemical-and--that-the-application-of.said-chemicat was-done-in conformance-.with_California_.--Fire--_-._ .5 5 Marshal Code, equal to exceeds NFPA 701, CPAI 84, ULC 109. The method of th®-FR-chemical applicationµis. S Senal#: ._...-------8023000(4). - - - __ - „__ _.- - - .- .__.. -Description-of item-certified Li ---^----- ..�5 - 5 Flame Retardant-Process Used Will Not-Be-Removed E _ ►aching-And-ls-Effective Fr_T ah mLi __... BO LE STATESVILLE NC Signed: N Name of APPlicator of Flame Resistant Finish TENT DEPARTMENT—ANCHOR INDUSTRIES INC. - - - I�LrMCnLI�C I�LI�C I�Lnr.�C.�C�LI�C�CnCnC nCnC IBC IBC IBC I�CPC��C�C�T�C�C�[ aPLI7CI�LIPEr, I7Cnr�C�C�C 1091 1C�C.�L�LILI�C IBC IBC I�LI�C�CnC IBC I�C�C�LI�C�C I�C�C�C�LI�C�C�C�C�C IC�LI�LI�LI�C IBC�C.� 'Tl O O W r�J�rJ�t�t� rJ�tP oom r.P zP rP o o tn��n��esal-�I-��r��n�.n�r��ntn�n��l-u�RlELP111_i. M_P_p_R T.A_N.-T--D_0_C U_WEN T------- ..rr t tratt-ot tan, ISUED-S BY_.._,.__. 0 of S Manuia Date.___ _ - ture c APPLICATION ® .__-. 01/26/01 " 5 NUMBER' " rINDUSTRIES114C. N EVANSVILLE, INDIANA 47711 Order Number o -332724 b 5 5 MANUFACTURERS OF THE FINISHED 5 5 TENT PRODUCTS DESCRIBED HEREIN SThis is to certify that the materials described have been - flame-retardant treated 5 are or( inherently:noninflammable) and were supplied W. S Q 5 190610 PARTY SERVICES, INC. _ PO BOX 209. .._ 5 ------- AVON-MA:_02322__._ -- — -- -- -- -- S - Certification is hereby made that. 5 "5 "The articles�'describedTon-this vCertificate--have- been treated-with-a P flam®-retardant -ap roved - - ----- 5 —_ = chemical and-that-the-application-of-said d-chemical was done in conformance with._California=-.Fire�—____..�= 5 Marshal Code, equal to exceeds NFPA 701, CPAI 84, UL.0 109. S - The method-of the-FR dhemcal application s• -- -_ 5 - -- __ _ __.__ __,_. ._— __.____ -- 5 Description of item:certified: _` 5 F1EXPMIDtowXtov ww_ 4 5 e ame_Retardant Process Used _Will Not Be Removed RY. Washing-And-is-Effective--For The-Life-Qf-The_.Fabr-iC_-____--_ -- -:`-5_m--- Li ------ --_.�_ _____ �. _. _ Signed:._ m 5 Li Name of Applicator of Flame Resistant Finish TENT DEPARTMENT—ANCHOR INDUSTRIES INC. 5 cP�.Pr�cPcPr�cPcPrJ�rJ�rPcP�PrJPr Pr Pr Pr Pr�cl7cPrJ�rJrPr f�[r�rJ�cPtPc Pr�rJ�rJ�rlr�cJ�r�rJ�cPr�cPt Pr�rJ�r TrJ�rJ�rJ�cP�Pc!rJ�rJ�rJ�rJ�r�rl�rJ�cPrJr..!cPrJ��PJ�rJ�rJ��frJ�rJ�rJ�r� ro 0 0 TOO'd IP401 NOTICE NOTICE TO TO EMPLOYEES EMPLOYEES The Commonwealth of Massachusetts Cn DEPARTMENT OF INDUSTRIAL ACCIDENTS Ln N CD 600 Washington Street, Boston, Massachusetts 02111 617-727-4900— http://www.state.ma.us/dia As required by Massachusetts General Law, Chapter 152, Sections 21, 22, & 30, this will give you notice that 1 (we) have provided for payment to our injured employees under the above Ln O mentioned chapter by insuring with: w HARTFORfl ArrTT]= AND TNnFMWTY COMPA N NAME OF INSURANCE COMPANY 0 308 FARNINGTON AVE FAR�dINGTON rr 06037 ADDRESS OF INSURANCE COMPANY WEG 01 01 07 POLICY NUMBER EFFECTIVE DATES NAME OF INSURANCE AGENT ADDRESS PHONE BC TENT AND AWNING CO INC =Z5 RO T. ST MA n2111 EMPLOYER ADDRESS Rhona Dias 12/22/06 "-EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE -_ MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the,injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the-treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the Good Samaritan Medical Center No Pearl St Brockton, MA 02301 NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER Form WC 86 20 01 C Printed in U.S.A. T Ar% iT f%n- T 1 I T 1 nnel. nnel.. MkYT\TMV ■1 T\TMT ^M AT •!^!\ 1l1A17 i9 MAU 1HE Tpw m di .�, o� Town of Barnstable Building Department - 200 Main Street BARNSTABLE• • Hyannis, MA 02601 9� 6 .�' (508) 862-4038 Certificate of Occupancy . . Application Number: 201100779 CO Number: 20110070 Parcel ID: `294040 CO Issue bate: 05127111 Location: 1019 IYANNOUGH ROADIRTE132 Zoning Classification: SPLIT ZONING Proposed Use: GENERAL OFFICE BUILDING Village: _ HYANNIS Gen Contractor: ROLAND B CATIGNANI Permit Type: CC00' CERTIFICATE OF OCCUPANCY COMM Comments: C.O. FOR UNIT 12 CHILD AND FAMILY SERVICES Building Department Signature Date Signed 1HE> , TOWN OF BARNSTABLE RM,ding Application Ref: 201100779 m it &UMSTABLE, * Issue Date: 03/04/11 Perl , , 9 MASS. Qp i639• Applicant: ROLAND B CATIGNANI Permit Number: B 20110367 ArFO MA'I A Proposed Use: GENERAL OFFICE BUILDING Expiration Date: 09/01/11 Location 1019 IYANNOUGH ROAD/RTE132oning District SPLTPermit Type: COMMERCIAL ADDITION ALTERATION Map Parcel 294040 Permit Fee$ 227.50 Contractor ROLAND B CATIGNANI Village HYANNIS App Fee$ 100.00 License Num 005157 Est Construction Cost$ 25,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND TENANT FIT-UP FOR UNIT 12. EXPANSION OF EXISTING TENANC� 1NTHISCARD MUST BE KEPT POSTED UNTIL FINAL UNITS 9,10,10A& 11 OF CHILD AND FAMILY SERVICES. INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record:, 1019 PROPERTY LTD PARTNERSP BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 1019 ROUTE 132 INSPECTION HAS BEEN MADE. HYANNIS, MA 02601 Application Entered by: PR Building Permit Issued By: THIS PERM- IT'CONVEYS NO RIGHTTO'OCCUPY.ANY;STREET,ALLY'OWSSIDEWALK OR ANY PART THEREOF 1.EITHER TEMPORARILY OR�PERMANENTLY. ENCROACHEMEI,ITS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDERTHEBUIL'DING::CODE;MUST BE APPROVED-BY THE JURISDICTION. ,STREET'ORALLY GRADES AS WELL AS DEPTH AND.LOCATION OF,PUBLIC SEWERS MAYBE 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 CONTSTRUCTION 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). l 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). s. s ,.� ® � � ..D moo- Q�,,.,46�'. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 3 �.I ©�► 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION u SO�o mar Parcel O`� Application# • Health Division Y" Conservation Division Permit# Tax Collector Date Issued ay ZS Treasurer Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis // Gl' d d Project Street Address IN9 I rA4do A14 3,2 Village 14)YA) )Jk Owner -rAE to19 P46f"IT-YL-i>MI�►-Pada2r &' Address 1,917 de?-. 320 MAA43, D2—/ i ``4, 904 IV Telephone ;oW'- 1773'- 1,a) 9, Permit Request _@ ( ,() Square feet: 1 st floor:existing proposed ' 2nd floor:existing fS'4' 4) proposed 5W,0' Total new Zoning District 146 Flood Plain Groundwater Overlay Project Valuation 430, ®®D Construction Type 56 Lot Size e a.`f Grandfathered: Ul-�es ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#unfits) Age of Existing.Structure 157 Historic House: ❑Yes a- o On Old King's Highway: ❑Yes 5'-N'o Basement Type: ❑Full ❑Crawl ❑Walkout father dry Basement Finished Area(sq.ft.) A- Basement Unfinished Area(sq.ft) 4-{- 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: Mas ❑Oil ❑Electric ❑Other Central Air: des ❑No . Fireplaces: Existing a��• New Existing wood/coal stove: ❑Yes )lo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existinj ❑new,,size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ rn w Commercial Ves ❑No If yes, site plan review# _ cam, Current Use �� '� � O�C6 Proposed Use 941S1^4%' 4�I6 E5 c..n BUILDER INFORMATION Name a�U U0 , C� Telephone Number IE��125^ -7 7 S— 2� Address Irt�V?i License# GS 0t02.4(O C 'Z- I Home Improvement Contractor# 'KI �r �tw M t D&4 f Worker's Compensation# fJ ��- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO /�1 SIC a�� f� (1;WY17A�� SIGNATURE 1 L DATE -1 FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED' MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: w i ar � FOUNDATION - '1 ' FRAME �r-- 0` - r ' INSULATION , i' FIREPLACE ELECTRICAL: ROUGH FINAL y �' PLUMBING: ROUGH " FINAL GAS: ROUGH "t FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ..» tiff. I he Uommonwealth of Massachusetts , Department of Industrial Accidents r Office of Investigations . i ' e 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/]Eldetricians/Plumbers Applicant Information Please Print LeEihly Name (Business/Organization/Individual): . -ram lot -�y �.� A TGO MCTNeMs(41n Address: Z e City/State/Zip: 0 Phone:#:��fl� 77 l4IZ Are you an employer? Check the'appropriate box: Type of project(required);. . I.❑ I am a employer with 4. ❑ I am a general contractor-and% employees (full and/or part time). * have hired the sub-contractors 2. 6• ❑New construction . 2.[] I am a•sole proprietor or partner listed on the-attached sheet. 7. VT Remodeling ship andhave no employees These sub-contractors hav; g. Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp.insurance comp.insurance. required.] S 'We are a_corporation and its 10.❑Electrical repairs or additions .3.❑ I am a homeowner doing.a officers have exercised their II work 11.❑Plumbing repairs or additions • myself. [No workers' comp. right of exemption per MGL I2.❑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 inforrmtion. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. lContractors that check this box must attached an additional sheet sbowing 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.polidynumber. Aram 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: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the polity number and expiration date). Faihze.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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the 0fF,ce of Investigations of the bIA for insurance coverage verification. I'do hereb certify under theains and penalties of perjury that the information provided above is true and.correct, Signature. �3� T . lL_1-.� /S-F-�I j p Date: 7 7 _ Phone#: a 779 �� 12 � Official use only,. Do not write in this area, ib be completed by city or town offrciaL City or Town: Permit/License# Issuing Authority(circle one): :1..Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5-Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructi®ns Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. . ice of another under an contract of hire . pursuant to this statute,an employee is defined as ...every person in the serve y express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of.the foregoing engaged in ja point enterprise,and including the legal representativeg of a-deceased employer,or the nr`t4Q of an'indi�idual' artaets association og'othei le al`ehtzty'eni loving employees. However the revel owner"of a ciweilu�g house having fiot more than'thrae apartme&and who'resides therein,or the occupant of the , dwelling house of anod et who einploys`persons to do maitAnaiice,construction or repair worlc'o$sucfl dwelling house or on the grounds,or building appurtenant thereto.shall not because of;.such employment be deemed to be an employer." Ir 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,p§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 ins�wce requirements of this chapter have been presented'to the contracting authority." Applicants .y" Please fill out the workers'compensation affidavit completely,'by checking the boxes that apply to your situation and, if necessary,supply sub-contiactor(s)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 A . be returned to the city or town that the application for the permit.or.licens'e is being requested,not the Department of Industrial Accidents; Should you have any questions regarding the law.oi.if you are requirea 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 ToWA 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 policyinformation(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. Anew 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 dbg license or permit to bum leaves-etc,)said person is NOT requited 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 hesitato in Zis a calls, The Department's address,telephone-and fax number: - Commouweelth of Massachusetts Depaxtmezt of bid ustrial Aocidints Office of Investigations 600 Washings ad Streit Boston,MA 0.2111 Tel. #617-727-490.0 ext 406 or 1-M- ASSAFT Fax* 617-727-774R Revised 11-22-06 wwwmass.gov/dis GJ/ze U G REGULATIONS BOAROF License. CONSTRUCTION SUPERVISOR N urn ber'<Cs.o, 010246 L i Tr.no,. 7592.0 i { EXp►res, 12007 Restrictedj00 fi ROGER P WILLIA�MSt a r -/ 51 HOMESTE oner AD LN MA;;r2675 �'`°" YARMOUTHPORT, Commissi J 1 CONSTRUCTION CONTROL AFFIDAVIT AT PROJECT INCEPTION Parcel Number: �g.�L/,0V0 Project Name: vOO Project Owner: -*6 to 19 PRoesgry tt A4 1 T&O P.r �✓e�.sd�p, oy , vJ4--�v�✓ rL .vax. Project Location: loll l}lq�/�/tYY,t# 4�,dbo �2T:/32� N,�/,Q►„/,�/jS� ,�,�,q Scope of Project: 7"' lice v�ruc� �Xvsrr� /sr�Goatt��la,wT -{� ,2k� �Gc�e�, In acco nce ith paragraph 116.0 of 780 CMR, the Massachusetts State Building Code, I, �Vt t Massachusetts Registration Number 8 being a Registered Professional Architect hereby certify that all architectural plans, computations, and specifications, and changes thereto, involving the subject project will be prepared by or under the direct supervision of a Massachusetts Registered Professional Architect and bear his or her original signature and seal as defined by Massachusetts General Law (M.G.L.) c 112, $81R. I further certify that I will be present on the construction site at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work to determine,in general, if the architectural work is being performed in a manner consistent with the construction documents. `��11111 �t`, 0\C-' i g .. Y RMOUTH JV j loot Architect &\',_na'l signat Seal) Date TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map, Parcel Permit# / Health C!wision , Date Issued Conservation Division Fee Tax Collector Application Fee Treasurer Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address o r Opt Village IT AW1( Owner d — -Address* e� Telephone y. f d3 CI UClc7 Permit Request 'Z01s_�r�( m Co Square feet: st floc existinj proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain I Groundwater Overlay j Construction Type -T Lot Size 20 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 0 Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: 0 Yes ❑No Detached garage:0 existing ❑new size Pool:0 existing 0 new size Barn:0 existing ❑new size Attached garage:0 existing 0 new size Shed:0 existing ❑new size Other, Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial e❑Yes Cl No Ifyes,site plan review#, Current Use Proposed Use BUILDER INFORMATION ' Name �'� �/V �� Telephone Number )- ( cf Address "?�OC7 c./i;D sl �ni License# A 6- 0 23�J Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO: DATE ISSUED `I MAP/PARCEL NO. , e 1 i ADDRESS VILLAGE _ OWNER 4 DATE OF INSPECTION: _ FOUNDATION } FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL h GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT n ASSOCIATION PLAN NO. oFJHE, Town of Barnstable Regulatory Services �xxsrest E. Thomas F.Geiler,Director '6 9 .+� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Fax: 508-790-6230 office: 508-862-4038 property Owner Must Complete and Sign This Section If Using A Builder I, �/tq , )��,�NA DgA r�, r�/ A# (,riLl;as Owner of the subject property �L to act on my behalf hereby authorize , in all matters relative to work authorized by this building permit application for: o I [ YAi/voJOt-( -0�9 �3L (Address of Job) Date SignsW e of Owner Print Name Q:FORMS;OWNERPERMISSION 08/30 2005 08: 4:3 7818787209 EDWIN WATTS GOLF PAGE 04 AUG-29-2005 14:SS SC TENT & AWNING 500 586 7177 P.04 IMPORTANT DOCUMENT i VI't tI Imtt of jr1aflit Res-40tante ISSUED BY ! REGISTERED date of Manuwurs APPLICATION is tN 12WOf NUMBER EVANSVILLE.tN(XA .47711 Omer Number j F12i.� 332724 I MANUFACTURERS OF TH:_FINISNEG? � 'VENT PRODUCTS DESCRiIKO 14EREN This is to certify that the materials dal mariind have been flame-retardant treoaaa . (or are lnhereWly noninflammable) and were supplied io: 190610 PARTY SEWCtS.INC P J BOX 209 25 BODWELL 81 AVON MA 02322 Certification is hereby mode that; 'hhi� aartleies-di4irrihed on this Certificate ha i4 been trea*d with a flail iketarvdimht a Apra%. chemical and that the sMicaotion of said chemical was done In confa mance with Callforr►is F Marshal Bode, equal to exceeds NF PA 701, CPAI 84, U LO 109. The method of the FR chemical application is: Des0pdon of Item Ca rofied; n FXP rap 2aw:2o V L W w Flame Retardant Process Used IViII Not Be Removed EV Washing And Is Effective For The Life Of The Fabric Sigred L.. �^ Name of AppkM,of Flamm PdW81 r4 Finl®h ?1ENT DEPARTMENT•--,ANCHOR INDUSTRIES INC< i 1 a a a t 08/.30/2005 08:43 7818787209 EDWIN WATTS GOLF PAGE 03 AUG-29-•2005 14:18 8C TENT AWNING 508 SOS 7177 P.03 IMPORTANT DOCUMENT tfiratt of ftflamt Reot"Otante FEFDIA PlwdiED Il"iSWED QY A1PP"UCAMON Owe of PAOnulrActuran NUMBER 2*wor 41t28n� r,a 21.4 EVMSVILLE,INDIANA 47711 Order Number 33272� MANUFACTUREPIS OF THE FR IISHED TENT PRODUCTS DESCRIBED HEREIN This Is to certify that the materials deecrlbOei have been .flame-rotardant treated or UM inherently n*nInftn>Mable) and Were SUppiled toS �1�9Q PARTY SERVICES,INC P O BOX 209 25 SODWIo1-1~ST AVON MIA 02322 ;erfifloation is hereby made that: ;Ply--articles deecrehed on thW Comte have b imasated..,teith...e fiaMet-MUMMt,appraved 3WMIcal and that the applle ation of sold chemical was done In conformance with California FW Warehsl Code, equal to encoads NFPA 701i CPAI 84, ULC 109. Me method of the 1R 0hemleawl appikation Is: 13�Ocraption ai�e�rry cer�lio�: r j MrsXPMID20WXI0VLWW Flame Retardant Process Used W11I Not Be Removed By . Washing And Is Effective For'The Life Of The Fabric - - -Name 0!AJE!CMor of Fteme Relimt Finish 'TENT DEPARTMENT—ANCHOR INDUSTRIES INC. s�Porty+e;®•®s��x��e�eaeare��®ram szoe ., . ._ ..,....,.-....� i - i I I - 08/30/2005 08:43 7818767209 EDWIN WATTS GOLF PAGE 05 AII0-29-2005 14:19 BC TENT & AWNING 509 586 7177 P.05 COMMONWEALTH O _. F M ASSACHUS "TS DEPAR.TMEI*OF Ili DUSTA tAL ACCIDENTS _ 600 WASHINGTON STREET BOS'TON,MASSACHUSUiTy"S 02111 JamecJ.Cempta WORKERS'COMPENSATION INIURANCEAFFIDAVIT Camrtd5sianer 1:ffAl T qt Ak)Ili/del ali�9 �P�R (iieeneerJpermlute) with a principal place of business/residence at. do hereby certify,under the pains and yer►aitit:s of perjury,that: ( am an employer providing the f4Rowing workers'tompensatic-at coverage for my emp3ayees working on this job. Wggin6t&Aeyaer o aoafm / 16 Gael Insurance Cottopany Policy ritxmbcr �"' i J I am a sole proprietor and have no one working for me. I am a soft proprietor,ge<ncral contractor or homeowner (circle once)and have hired the contractors listed below who have the following workers'compensation insu=ce policies: Name of COMPACtor 1'titsut3.1CC Company/Policy Number Name of Contractor Insurance Company/Policy Number I Name of Contractor I11SuM tee Cotrzpany/PoUcy Number [ 1 l am a homeowner performing all the work myself. NOTE:Please be a%varc that while homeowners who employ persons.;to do maintenance,construction or repair work on a dwelling of not more than three units in which the homeowncr also residua or an the irOunds appurtenant tiscieto are not gciecr- ally considered to be employers under the OWorkers'Compensation Act (GJ.C.152,aeC.1(5)),application by a hamcowner for a liatnse Or permit may evidence the lc9,V status of an employer under the W>rkers'Compensation Act. I understand that k copy of this statement will be forwarded to the fiDcpartml!nt of Industrial Accidents'Office of Insurance for coy. craBc vcrifccation and that failure to Secure covcrage as rcqu red under Secti<in 25A of MGL 152 can lead to the imposition of crim- inal penalties consisting of a fine of up to$1 SOO,00 and/or imprisonment of 1p to one year and civil penalties in the form of a Stop Work Order and a fine of$a4U.t)0.a day against roc. R G� Signed this - _( 20 dt esf y --•-�...e _._ I,icCtlSce/f'crtnittCC ; Liecnsa,/Permittor � I t } TOTAL P.05 K ti t 4 1 . t� . 08!30J2005 08:43 7818787209 EDWIN WATTS GOLF PAGE 02 AUG-29-2005 14:tB SC TENT & AWNING 508 586 7177 P.02 HARTrioin REQUEST FOR CERTIFICATE OF L!ABUTY INSURANCE To request a Cartifloste of Liability Insurance,pi ease FAX this completed form to CUStOmef CWO, 1-877-M-4364Q Da :` Requested• �� r y.cf- Phone#: 9,X) I` Fax • Named Insured• •� ,�er�.o1I. G. Policy Number: Name of the certificate holder: ( e —r 1,A.)a,j+!S Certificate holder address; o JC yvg �- City,state&;Ap code: r l 2 J ,5,- Certificate holder fax number: ' ,t� Send certificate to the attention of if applicable); l; -iirw Job site/location address (city &state):J()tCkn Description of the work ycu will be doing(please be s�eGific); Please detail any speoial language required on,the certificate: You will receive an original of the certificate in the mail within 7 to 10 business days, Please indicate if you would also like to have a copy f.-med to you: No vr'Ye:. l • Your request.will be processed within 24 business hours after a8 required informatlon Is received, If you have any qu ostbons,please call us at s 1-877.207-1316. Please,retaln a copy of this form for to w;a for future requests. l` { �� = �� r 1 ,�p� , ' Vr� _JJ�C/`� �� . The Commonwealth of Massachusetts 4 W ARCHITECTURAL ACCESS BOARD One Ashburton Place - Room 1310 o�M Sve�� Boston, Massachusetts 02108 (617) 727-0660 1-800-828-7222 JANE SWIFT Voice and TDD GOVERNOR Fax: (617) 727-0665 www.state.ma.us/aab DEBORAH A. RYAN EXECUTIVE DIRECTOR TO: Local Building Inspector Local Disability Commission Independent Living Center Complainant FROM: Arrchitectur 1 Access Board SUBJECT: 1411. DATE: !6/1 IPA Enclosed please find the following material regarding the above premises: Application for Variance Decision of the Board Notice of Hearing V Correspondence Letter of Meeting The purpose of this memo is to advise your office of action taken or to be taken by this Board. If you have any information which would assist this Board in making a decision on this case, you may call this office at (617) 727-0660 or 1-800-828-7222 (Voice or TDD), or you may submit comments in writing to the above address. Thank you for your interest in this matter. s' s _e r, 1 ' CIO THE 1019 PROPERTY LIMITED PARTNERSHIP OCT 1 REBOUND INC. . :: .. .. ... GENERAL PARTNER 1019 IYANOUGH ROAD • ROUTE 132 TEL: 508-778-1812 HYANNIS, MA 02601 FAX: 508-771-6702 K. Ott n rZN•o r��s Oct. Zoo i 11, M y Aiz ct-4 4-T a-G-ru tz AL. A c c C-s s f�twzq Vxao�rL I ° I -ry 1611 14 /4",415, MA . oZcooi Ars �- �;L-L--Vvv � r -�n y o w o s �-. -zfs, Zoo i , p c��sG r �'�- �►t S C.Lc4 Cho O " Mea:"T w Tr4&s-4 (7..) 1-�-•.G . 'T w o Ste'-i-S o 5 65 "ow L t ug u� w 1-ri-1,-- r:�sx)5'f�� c.�rt�rS e.v'�'S -Y/ern -�-ttu Cy 4 ` LSK. '�• IV,L L.t A.W f I I \At�v F - J _...��_:::�---- - ._ -•- -may. .� � ... � - -- _--..�._w,..�, �, � . L .. mot• The Commonwealth of Massachusetts ARCHITECTURAL ACCESS BOARD One Ashburton Place - Room 1310 Boston, Massachusetts 02108 yv JANE SWIFT (617) 727-0660 GOVERNOR 1-800-828-7222 DEBORAH A. RYAN Voice and TDD EXECUTIVE DIRECTOR Fax: (617) 727-0665 www.state.ma.us/aab TO: Local Building Inspector Local Disability Commission e Independent Living Center u FROM: Architectural Access Board SUBJECT: ` ot C a. ' Vr DATE: gbw 161 Enclosed please find the following material regarding the above premises: Application for Variance . Decision of the Board Notice of Hearing /correspondence Letter of Meeting The purpose of this memo is to advise your office of action taken or to be taken by this Board. If you have any information which would assist this Board in making a decision on this case, you may call this office at (617) 727-0660 or 1-800-828-7222 (Voice or TDD), or you may submit comments in writing to the above address. Thank you for your interest in this matter. I The Commonwealth of Massachusetts ARCHITECTURAL ACCESS BOARD ' One Ashburton Place - Room 1310 Boston, Massachusetts 02108 JANE SWIFT (617) 727-0660 GOVERNOR 1-800-828-7222 DEBORAH A. RYAN Voice and TDD EXECUTIVE DIRECTOR Fax: (617) 727-0665 Docket No. C01 07lww state.ma.us/aab STIPULATED ORDER RE: 1019 Property , 1019 Iyannough Road , Hyannis A compiaint was fiied with the Architectural Access Board regarding alleged violations of its Rules and Regulations with respect to the above premises. By letter of August 20, 2001 , Roger P. Williams General Partner stated: " Regarding your letter of July 26.2001 and my letter of response dated July 24, 2001, and our subsequent telephone conversation of July 30, 2001, we will plan to re-stripe the handicapped parking at the front entrance to the building so that the handicapped access aisles line up with the existing sidewalk curb cuts. The re-striping should be done by September, 30, 2001." The Board adopts this plan as Its own order, with compliance to be achieved by: September 30, 2001 You are required to notify this office, in writing, within five (5) days of the completion date, indicating whether or not the above work has been completed. You are required to include photographs showing that the work has been completed. Any person aggrieved by the above decision may request an adjudicatory hearing before the Board within 30 days of receipt of this decision by filing the attached request for adjudicatory hearing form. If after 30 days, a request for an adjudicatory hearing is not received, the above decision becomes a final order and the appeal process is through Superior Court. Date: August 21, 2001 ARCHITECTURAL ACCESS BOARD cc: Complainant 'f 1 z 4l Local Building Inspector Chairper ' n Disability Commission Independent Living Center 40 lid/'Lb/'Lbbl 12:lb nlJdI lib IbL ltll'd LID FIN 5h1F' I Alit bl THE 1019 PROPERTY LIMITED PARTNERSHIP RaSOUND INC. GENERAL PARTNER 1019 IYANOUGH ROAD • ROUTE 132 TEL: 508-778-1812 HYANNIS, MA 02601 FAX: 508-771-6702 FAX COVER SHEET DATE: Aw Toni ► .Q a [ TO: � - � COMPANY: 1lfC.[�Nr' A L=�i AAA S S. FAX NUMBER: cp 17 " 7 Z 7 p 6 6 5 FROM: tVt�� a TOTAL NUMBER OF PAGES INCLUDING __ t COVER SHEET: c v NOTES/MESSAGE: Intent 0-m CAZrL. �...' , ey eJV w va , zCAP L ..� �hurc .emu�d v�"�" � I�r, Cn�1y+�So►�,4� Lo o &Q01w40 SV!A c0- A L' t-:;uwctkwca -tit "To, Sa fi sT�up>ta� s1,� t >ou by 501:07. efQ, roa t ly ---E loy " LZ 30„ 7' BLACK `��EQS PR0-LINE � Warehouse Outlet is X EL,eLkIN c�c�u� 98" �— g � � > �►�, � GOLFIL Warehouse Outlet TENANT maw TENANT -77 �i.JH )LE Sl6t.S, TENANT C— TENANT TENANT 4 + 5 6 7 8 � 9 10 11 '•' � 25'-0. 30'_0" µ 30'-0" 25'-0' 25-O"- 30'-0" 30'-0" _Tq UTILITY O OFFICE UTILITY UTILITY '/�//�-�y OFFICE WORK AREA UTILITY OFFICE OFFICE OFFICE ED] S j OFFICE OFFICE ( r (NEW CARPET. . u ,'l>__\/!/. ) (NEW CARPET) (NEW CARPET) LEAD BREAK ROOM vAx :coaiea y` - PR VIDE N -L RING, s El !{ EXISTING PARTITION TO REMAIN OFFICE AS IRE TED IV AN LS 0 — PROVIDE NEW FLOORING. ( 00 - SYSTEM FURNITURE by _ = PARTITION TO BE REMOVED H'C VANITIES AND PAINT WALLS OWNER 0 + AS DIRECTED by TENANT 0 0 >� NEW WALL PARTITION; SEE 1 ,WALL TYPES BELOW I �EXISTING DOOR TO BE RELOCATED OFFICE PLAY RM { 0 OPEN OFFICE AREA REPLACE T NE ACOUSTIC . OBSERVE CONFERENCE RM STORAGE (NEW CARPET) o CEILING TI AS NEEDED STORAGE OFFICE .. — — - .-Y (E VCT) INFILL OPENING CONFERENCE ROOM WALL TYPES: 4444 (NEW CARPET) I�IOTO MATCH EXISTING CONSTRUCTION �NEWiW' T DER NEW 2 4 WOOD STUD WALL WAITING ROOM 10 REMOVE WALL& [E] STD"' ACO 7 CEIL © 16'O.C.x WTH 1/2'GYPSUM WALL cm], _ DOORS AS SHO BOARD EACH SIDE; EXTEND STUDS t-1 AND WALLBOARD TO UNDERSIDE OF L 1 D 0 D 0 ACOUSTIC CEILING TRIM AS NEEDED. OFFICE CONFERENCE RM IT/STORAGE a � 0elev OFFICE RECORD FILES � - _K� BUZZER by , • OFFICE El (1 .. . WAITIN � TENAN7 EW CARPE NEW SLIOW RING AND GLASS do NEW . TRAN TOP CONFERENCE ROOM EXISTING SPACE CHILD & FAMILY SERVICES 1;: = EXPANSION SPACE CHILD & FAMILY.SERVICES " COMPLETED IN 2007 `- FLOOR PLAN #9. r I UNIT N0. 12 UNITS 10 10A and 11 3300 S.F. - - GDNWAL Ho1ESe LEGEND- 1. PATCH AND PAINT ALL EXISTING WALLS ONE COAT i - HEAD UTILITY LATEX PAINT g ■ ■ ■ ■ ■ ® EXISTINGTO NSS,M PIRAMFR 2. PAINT ALL NEW WALLS; PRIMER AND TWO COATS 4 - - C06�By YAI , r .. LATEX FINISH RELOCATED SPRINKLER HEAD 3. REMOVE FINISH FLOORING WHERE NEW FLOORING IS � ■ � CALLED OUT. PREP FLOORS AS NEEDED FOR NEW (,. .,. FINISH � .' �N NEW SPRINKLER HEAD _, O EXISTING LIGHT FIXTURE 4. REPLACE ACOUSTIC CEILING TILES AS NEEDED. t ■ - ® : ALTERNATE SCHEME O O O O ■ , FOR HANDICAP TOILET - S. ADJUST EXISTING HVAC DUCTWORK AND DIFFUSERS _ RELOCATED LIGHT FIXTURE IF REQUIRED TO ACCOMMODATE NEW LAYOUT ■ CEP - 6. AJUST LIGHT FIXTURES AND ADD SWITCHES TO Frj • ACCOMMODATE NEW LAYOUT NEW LIGHT FIXTURE TO ❑ REMOVE SHOWER AND _^- ®N MATC H O O PROVIDE.NEW H'C 7. ADJUST EXISTING SPRINKLER HEADS AS NEEDED ■ O ■ ■ ■ - - NOTES: - LAVATORY o �" _ LRELOCATE DIFFUSERS TO ACCOMMODATE - - -. 8. �N � �W SILLS TAND TRIM.TYPICAL: ■ ,. NEW LAYOUT;. ADD E DIFFUSERS TO NEW REMOVE VANITY _ WIM O O ROOMS AS REQUIRED.H 2.RELOCATE SPRINKLER HEADS AS SHOWN 1. COMPUTER AND PHONE WIRING TO ACCOMMODATE NEW LAYOUT •3.RELOCATE LIGHT FIXTURES AS SHOWN TO O 2. UPGADED LIGHT FIXTURES TO MATCH ADJACENT i ADJUST CEILING GRID ■ O ■ ■ ■ ACCOMMODATE NEW LAYOUT. PROVIDE •" SPACE DESIRED. AND,TILES AS.NEEDED ■ SNATCHING AS SHOWN ON E 1p AS DETERMINED IN THE Flq i w `,�� ` ��5�P P.W�� < r X RM TOILET ROOM OPTION CEILING PLAN �. r - PROJECT: t DATE: 4-6-07 PROJECT NO. ` ROGER P. WILLIAMS 5 �-14—tt ISSUED FOR PERMITCHILD & FAM I LY SERVICES 4w REGISTERED ARCHITECT SCALE: 1/8"=1'-O" 4 1-3-11 EXPANSION of UNIT NO. 12 3 7-12-07 ISSUED FOR PERMIT DRAWING NO. 1019 IYANOUGH ROAD ROUTE 132 HYANNIS, MA ' 02601 2 6-12-07 ADDITIONAL NOTES DRAWN: CADD NANTUCKET FAX HYANNIS 1 5-1 1-07 GENERAL REVISION /�/—,_ 1 t TITLE: FLOOR PLANS AND CEILING PLAN 508-257-4407 t 508-771-6702 508-778-1812 APPROVED: NO. DATE REVISION � -1 - 7 . ; .. - - -- - -- -' - - - - -- ----r { 1 i I _.__._. _ - - --- -- --- -- — - —, . . I . , -t r i L E - - - - ---- - - -'- - --- - -- I _� i I i . I i -{ -1 d j + } - - - __r_._ __.._ -....... _ --i-. __ _�. ;. _ _ _— - _ - -t - - r- - --i---� -- --- ----I a.. i I t I i I i f , I _ __ —_ �_- Aq ..... .. .. .. .._ .. : ... _ __... _ __ _ _ _ __.- _____- ___ _ i 1. .. _ .. ...- -- . "i' I—f F. J._.: ._. ... _..: ..__ _ _ _ - _ __ _ __. .__ ___ __._ _. ____ _- ----_._ . .._. -. .. .1.. L .. i _.... .-. i - I I t ;. 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LAS 1 = �7 �'t.::� pax r-- _ •'� .. "e29 Y I �� GENERAL NOTES: 1. VERIFY ALL DIMENSIONS IN THE FIELD PRIOR TO START OF CONSTRUCTION: 2. OWNER AND CONTRACTOR SHALL ASSUME ALL RESPONSIBILITY FOR CONSTRUCTION CONFORMANCE WITH ALL STATE&LOCAL RULES AND REGULATIONS. EXISTING P.C. EXISTING DOOR ABOVE y FOUNDATION WALL ; i ------- ---- SEE I ECK,A rTACH MENT )ETA IL - _ I i O v. 1 112" EXTENT OF DECK 3.4" N F y — — -- F- . '? IIL — EXISTING P.T.4x6 ---------____---- c�S SUPPORT POST TO REMAIN z EXISTING P.T.RAMP P� I 3- NEW P.T.4x6 POST IN BP.T.DROP I (PITCHED DOWN TO LEFT) W OD BEkM GALV:ANCHOR BASE ON 10"0 CONC.FILLED SONOTUBE-MIN.48" BELOW.GRADE(TYPICAL) o - - - 12'6" REAR OF MULTISTORY STRUCTURE FOUNDATION PLAN & FRAME EXISTING WOOD FRAMED STRUCTURE WSHINGLE EXT.FINISH HANDRAIL&BALLUSTERS TO. MATCH EXISTING RAMP it HANDRAIL ---- --------- -------- - 04 P.T.HANDRAIL POST POLY.BARRIER BETWEEN ATTACHED w/1/2"CARRIAGE CONCRETE&WOOD BOLT&WASHER THROUGH j. 2x'10 LEDGER BLOCK w/}"x4 J"EXPANSION , RIM JOIST BOLTS @ 24"SPACING&GALV.JOIST HANGERS Ul �^ P.T.2x8 JOISTS @ 16"O.C. Z NEW P.T.4x6 POST IN GALV. ANCHOR BASE ON 10'9 Q Z CONC.FILLED SONOTUBE 0FINISH GRADE Q 'v .g EXISTING P.C.FOUNDATION WALL DECK SECTION t REPLACEMENT REAR ACCESS DECK G R EYWI N G DESIGN DATE: 9 JAN 2020 PROJECT: 1019 IYANNOUGH RD., HYANNIS, MA SCALE: 1/4"=1'-0" 131 QUAKER MEETINGHOUSE ROAD, EAST SANDWICH, MA 02537 www.greywing.com (508)888-0886 © 2020 Greywing Design A� OF an rem remea.N.mV.-yb�-°eby�Y' .oft �°'"""�' w PROJECT NO: G200108 SHEET 4 5 6 7 8 9 10 11 25'-0" c� 30'-0" 30'-0" O 25'-0" 25-0" 30'-0" 30'-0" Z 0 ►Z--Q PP I I I I 4 1/2" w< w w< o 0 0 LEGEND iv UTILITY EXISTING PARTITION TO REMAIN It OFFICE UTILITY UTILITY D A3 205 1 230 223 211 BREAK AREA OFFICE OFFICE OFFICE I o unurr = = PARTITION TO BE REMOVED 00 210 209 208 207 iv a I 1 N NEW FULL HEIGHT WALL SEE A A3 04 03 1 WALL TYPES BELOW `} 2 pg TOIL 0 El B YD TOIL 222 204 NEW HALF WALL SEE WALL 2 3 TYPE BELOW � OFFICE H C — 2'— 1/2" 00 229 2 TOIL OPEN OFFICE AREA TOIL 212 TOIL IT 224 221 6'-0" 2 0 203 0 J EXISTING DOOR TO BE RELOCATED a ►� �..� OFFICE - OPEN ICE AREA 228 ��-- OFFICE 'OS 206 - Q2 iv 08 218 W1 0 SEA VE CONFERENCE ROOM 2 \ A3 F A3 213 WALL TYPES: 2 07 C N STORAGE OFFICE — — N 12'-8 1/2" 202 EXISTING UNIT #12 O INFILL OPENING TO MATCH EXISTING FORMER MASS DEPT OF CONSTRUCTION � 227 04 � REVENUE, CHILD SUPPORT 2 NEW 2 x 4 WOOD STUD WALL Cad ALIGN CORRIDOR ALIGN 01 E 4'-4" 6'-4 1/2" O 16" O.C. WITH 1/2" GYPSUM WALL 7C 2 2 04 219 I O A3 BOARD EACH SIDE, EXTEND STUDS O06 ALIGN = 1'-5" AND WALLBOARD TO 6" ABOVE 05 —W " FINISH CEILING O 1 4 —11 2 SIMILAR TO TYPE 2 ONLY WALL IS 0226E CONFERENCE RM IT/STORAGE LOBBY = '-7 1/ O 36" HIGH WITH OAK CAP 220 216 OFFICE ILE S ORACE 201 2 02215E 215 214 2 Lo NOTE: ALL NEW OFFICE AND CONFERENCE 1 '-1" i ROOM WALLS TO BE INSULATED FOR 00 1 SOUND UNITS #9, 10, 10A and 11 FORMER MASS. DEPT OF REVENUE 6370 SQ FT FLOOR PLAN 4 5 6 7 8 9 10 11 Tm (18) 6 x 6 FT CUBICLES by TENANT a UTILITY OFFICE UTILITY UTILITY I OFFICE OFFICE OFFICE WORK AREA Fl FAX COPIER O D BREAK ROOM � � O 0 OFFICE — (4) 8 x 8 FT CUBICLES G El 13 H'C by TENANT 13 oc oc 0 OFFICE 0 OFFICE CONFERENCE RM OFFICE STORAGE El OFFICEFN\ — — — WAITING ROOM Ell OFFICE ci 10 CONF'7RENCE RM IT/STORAGE Fl elev OFFICE RECORD FILES OFFICE El El El do do FURNITURE PLAN — FOR INFORMATION ONLY PROJECT: -- DATE: 4-6-07 PROJECT NO. ROGER P. WILLIAMS § ©aRcy, ►,,� :Y �5 p W► CHILD & FAMILY SERVICES REGISTERED ARCHITECT SCALE: 1 /8"=1 '-0" 3 7-12-07 ISSUED FOR PERMIT l ' NO. = DRAWING N0. 1019 IYANOUGH ROAD ROUTE 132 HYANNIS, MA 02601 2 6--12-07 ADDITIONAL NOTES YARMOUTHPoar. M'DRAWN: CADD 1 51 1 -07 GENERAL REVISIONS � '��`" — OFMS ;.�` NANTUCKET FAX HYANNIS �. A - TITLE: FLOOR PLAN and FURNITURE PLAN 508-257-4407 508-771 -6702 508-778-1812 ''��o�,r�•°`` APPROVED: N0. DATE REVISION T T • I I I I I I unuTY 181 LEGEND EXISTING 18E 181 18! SPRINKLER REFER TO EXISTING SPRINKLER DRAWINGS BY YANKEE SPRINKLER CO, INC* N RELOCATED SPRINKLER HEAD �( N 1$1 N NEW SPRINKLER HEAD ON N ® EXISTING LIGHT FIXTURE 40 IF RELOCATED LIGHT FIXTURE � 18E 111E 18E 18) 18! 18I �! ® N NEW LIGHT FIXTURE TO MATCH 18! NOTES: 1. RELOCATE DIFFUSERS TO ACCOMMODATE 81 NEW LAYOUT; ADD DIFFUSERS TO NEW N ROOMS AS REQUIRED. 000, E N 2. RELOCATE SPRINKLER HEADS AS SHOWN TO ACCOMMODATE NEW LAYOUT ho 3. RELOCATE LIGHT FIXTURES AS SHOWN TO ACCOMMODATE NEW LAYOUT. PROVIDE SWITCHING AS SHOWN ON ELECTRICAL OR AS DETERMINED IN THE FIELD WITH OWNER FLOOR PLAN 4 5 T 7 � 9 10 11 lH 0 7- T TILITY UTILITY UTILITY 205 OFFICE 223 211 OFFICE OFFICE OFFICE I unurY 230 209 208 207 I COPIER ♦ BREAK AREA GFI 210 LFSA 77 TOIL ==Jl IL D222 REF OFFICE TOIL W LEGEND 229 TOIL 212 NEW DUPLEX OUTLET LOCATIOIS TO qp VVQ221 0 t3 (DC BE DETERMINED IN THE FIELD oo—�D NEW SWITCH LOCATIONS TO OPEN OFFICE AREA BE DETERMINED IN THE FIELD 10 OFFICE OPEN 0 FICE AREA ® ® ® ( 206 D oil. 228 24 D DATA/TELEPHONE BOX TO BE OFFICE OTC CONFERENCE ROOM SUPPLIED, LOCATED & INSTALED 11 218 217 213 x by TENANT i\ ® ® STORAGE/ 202 WHIP LOCATION FOR SYSTEM OFFICE ( W FUNITURE ELECTRICAL/DATA 227 ♦ TELEPOLE LOCATION SUPPLIED RRID BY TENANT 219 NOTES: 1. MODIFY SWITCHING IF NECESSARY 7C CONFERENCE RM I LOBBY _ ACCOMODATE NEW LAYOUT, COORDINNTE IT/STORAGE 220 201 OPEN OFFICE AREA SWITCHING WITH BUILD►NG OWNER rx\ 216 OFFICE 2. PROVIDE NEW DATA /TELEPHONE LINES AS 215 ® SHOWN; PROVIDE NEW DATA WIRING TO EXIST'G OFFICE ; OFFICE _ FILE STORAGE TERMINALS; REUSE IF POSSIBLE. ALL WORK 226 225 214 by TENANT 3. MODIFY EXIT SIGNAGE AND EMERGENCY LIGHTING TO ACCOMMODATE NEW LAYOUT IN CONFORMANCE WITH MASS STATE BUILDING CODE ELECTRICAL PLAN PROJECT: DATE: 4-6-07 ��nua RAP PROJECT NO. ROGER P. WILLIAMS o```��ti�`�°p��y%��• 5 P.wlk��F�yi . CHILD & FAMILY SERVICES REGISTERED ARCHITECT SCALE: 1/8"=1 '-0" + 1 7-12-07 ISSUED FOR PERMIT N0.8879VARMOUVPORT, DRAWING NO. 1019 IYANOUGH ROAD ROUTE 132 HYANNIS, MA 02601 1 6-12-07 ADDITIONAL NOTES MASS. DRAWN: CADD NANTUCKET FAX HYANNIS 1 5-11 -07 GENERAL REVISION Of TITLE: CEILING PLAN and ELECTRICAL PLAN 508-257-4407 508-771 -6702 508-778-1812Mi"' APPROVED: N0. DATE REVISION A - 2 01 2'-0" 2'-0" 2'-0" 01 2'-0" 3" PLASTIC LAMINATE tV I I N CABINETS & TOP N NEW OR RELOCATED Q SINK; CONNECT TO EXIST PLUMBING PLASTIC LAMINATE CABINETS & TOPREF I I / \ by TENANT � � � � � � , „ 3> 2'—0 2'-0" 01 2 —0., 11 2?—Olt 2,-0„ 2'_0" [311 EQ 2'-3" op 2'-3" 2'-3" 2'-3" EQ 01 2'_6" 2'_6" 2'-6" 2'_6" EQ ELEVATION "A„ NOTE: ALL CABINETS AND MILLWORK ELEVATION »B» NOTE: ALL CABINETS AND MILLWORK ELEVATION „C„ NOTE: ALL CABINETS AND MILLWORK ELEVATION „D„ NOTE: ALL CABINETS AND MILLWORK 1/2"=1'-0'• SHOWN IS FOR INFORMATION ONLY. 1/2"=1'-0" SHOWN IS FOR INFORMATION ONLY. 1/2"=1'-0" SHOWN IS FOR INFORMATION ONLY. 1/2"=1'—O" SHOWN IS FOR INFORMATION ONLY. ALL TO BE DETERMINED AND SUPPLIED ALL TO BE DETERMINED AND SUPPLIED ALL TO BE DETERMINED AND SUPPLIED ALL TO BE DETERMINED AND SUPPLIED BY TENANT BY TENANT BY TENANT BY TENANT 1 1/2" OAK HALF ROUND DOOR SCHEDULE DOOR FRAME HARDWARE REMARKS 2 SIZE 1 4" TEMP No. TYPE MAT L TYPE MAT L TOP & BOTTOM TRACK FOR N GLASS W H TH SLIDING GLASS PANEL 01 RELOC TED DOOR, FRAME AND H RDWARE PASSAGE — WOOD CAP/TRANSACTION w/ i 02 RELOC TED DO R, FRAME AND HARDWARE LOCKSET 1 1/2- HALF ROUND EDGE 1/4" TEMP GLASS \ 03 RELOC TED DO R, FRAME AND HARDWARE LOCKSET o \ 04 36 78 1 3/4 A SC WOOD 1 WOOD ' PASSAGE I 2'-0" ,-0" M 05 36 78 1 3/4 A SC WOOD 1 WOOD PASSAGE o 0 N-1 06 RELOC kTED DO R, FRAME AND H RDWARE PASSAGE 1 Ll 1 /2" OAK HALF 07 RELOC NTED DO MR, FRAME AND HARDWARE PASSAGE _ ROUND 08 36 78 1 3/4 A SC WOOD 1 WOOD PASSAGE / 09 36 78 1 3/4 A SC WOOD 1 WOOD PASSAGE ' 4" 1 1 4" M / 10 36 78 1 3/4 A SC WOOD 1 WOOD ' PASSAGE 3 —1" 2 —10„ 1 -11 3/ / PARTIAL PLAN NOTE: SEE ELEVATION "E" AND 1/2"=1'-0" DETAILS 1 & 2 FOR RECEPTION AREA GLASS WALL ELEVATION "E" ii NOTES: / 1. HARDWARE TO MATCH EXISTING; NEW SHALL ' SOLID CORE WOOD FRAME BE BARRIER FREE 2. DOORS, FRAMES AND CASING MATERIAL AND WOOD DOOR SPLIT JAMB � TO MATCH w/ CLAM SHELL FINISH TO MATCH EXISTING J 3. CHANGE DOOR FUNCTIONS TO THAT SHOWN EXISTING MOULDING TO ON SCHEDULE WHERE DOORS ARE BEING REUSED MATCH EXIST'G 1/4" TEMP GLASS SLIDING 1/4" TEMP GLASS STATIONARY DOOR FRAME BOTTOM TRACK FLUSH WITH WOOD TOP ACOUSTIC CEILING WITH OAK VENEER LAYERS 3/4- TOP OOD ONE WAY MIRROR t° GLASS VIEWED 1 1/2" OAK HALF ROUNG EDGE EDGING OAK HALF ROUND "' W1 FROM OBSERVATIO SIDE 3/4" OAK VENEER PLYWOOD 2 x 4 WOOD STUD WALL NOTE: ALL CABINETS AND MILLWORK SHOWN IS FOR INFORMATION ONLY. SLIDING GLASS WINDOW WITH ALL TO BE DETERMINED AND SUPPLIED TOP TRACK ASSEMBLY BY TENANT. 0 3'-0" I M 1/4" TEMP GLASS STATIONARY DOUBLE 2 x 4 PLATE DETAIL 2 1/2" GWB FINISH ELEVATION "F" 3"=1'-0" DETAIL 1 PROJECT: DATE: 4-6-07 PROJECT NO. ROGER P. WILLIAMS oil `"AR CHILD FAMILY SERVICES REGISTERED ARCHITECT SCALE: AS NOTED 3 7-12-07 ISSUED FOR PERMIT to.8879 � DRAWING NO. 1019 IYANOUGH ROAD ROUTE 132 HYANNIS, MA 02601 2 6-12-07 ADDITIONAL NOTES YAAM MASS HT, ` DRAWN: CADD ' '�` "` NANTUCKET FAX HYANNIS 1 5-11 -07 GENERAL REVISIONS ' ,�� ,OF N�,, A - 3 TITLE: ELEVATIONS and DOOR SCHEDULE 508-257-4407 508-771 -6702 508-778-1812 APPROVED: NO. DATE REVISION last '' 4 5 6 T 8 9 10 11 25'-O" 30'-0" 30'-0" 25-0" 25'-0" 30'-0" 30'-0" IH ------------ x T OFFICE UTILITY OFFICE F UTILITY UTILITY WORK AREA UTILITY OFFICE OFFICE OFFICE OFFICE OFFICE (NEW CARPET) (NEW CARPET) (NEW CARPET) PR VIDE N RING BREAK ROOM F X COPIER LEGEND \T_lVA AND PAI LS OC El O 0 EXISTING PARTITION TO REMAIN OFFICE AS DIRE TED TE ANT O PROVIDE NEW FLOORING, 0 SYSTEM FURNITURE by — VANITIES AND PAINT WALLS — = PARTITION TO BE REMOVED 0 H'C AS DIRECTED by TENANT O O OWNER NEW WALL PARTITION; SEE oc oc. o © 1 WALL TYPES BELOW �o�_T \Tl EXISTING DOOR TO BE RELOCATED OFFICE 17 - 21'-5" 30 PLAY RM CONFERENCE RM O OPEN OFFICE AREA REPLACE TINE ACOUSTIC OBSERVE STORAGE (NEW CARPET) o CEILING Tl ES AS NEEDED STORAGE CONFERENCE ROOM WALL TYPES: (NEW CARPET) Lo OFFICE — — (EXIST VCT) m 1 INFILL OPENING TO MATCH EXISTING rlmrl O CONSTRUCTION NE LLS T DER � NEW 2 x 4 WOOD STUD WALL WAITING ROOM REMOVE WALL & SID 0 ACO CEIL O 16" O.C. WITH 1/2" GYPSUM WALL DOORS AS SHOW � A BOARD EACH SIDE; EXTEND STUDS / AND WALLBOARD TO UNDERSIDE OF OFFICE �� L 1 00 � F � ACOUSTIC CEILING TRIM AS NEEDED. U CONFERENCE RM IT/STORAGE D 0 elev OFFICE i RECORD FILES i ----KEYPAD LOCK & OFFICE ELEC BUZZER by Fl �EWACARPE ITIN TENANT NEW SLIDING GLASS do do OW AND NEW TRAN TOP CONFERENCE ROOM EXISTING SPACE CHILD & FAMILY SERVICES mom .00 EXPANSION SPACE CHILD & FAMILY SERVICES COMPLETED IN 2007 FLOOR PLAN) UNITS #9, 10, 10A and 11 UNIT NO. 12 3300 S.F. GENERAL NOTES: � LEGEND 1. PATCH AND PAINT ALL EXISTING WALLS ONE COAT UTILITY LATEX PAINT SPRINKLER REFER TO EXISTING SPRINKLER -7 2. PAINT ALL NEW WALLS; PRIMER AND TWO COATS DRAWINGS BY YANKEE SPRINKLER LATEX FINISH CO. INC. 3. REMOVE FINISH FLOORING WHERE NEW FLOORING IS I@ RELOCATED SPRINKLER HEAD CALLED OUT. PREP FLOORS AS NEEDED FOR NEW FINISH 19 N NEW SPRINKLER HEAD 4. REPLACE ACOUSTIC CEILING TILES AS NEEDED. ® EXISTING LIGHT FIXTURE 01 0 ALTERNATE SCHEME t FOR HANDICAP TOILET 5. ADJUST EXISTING HVAC DUCTWORK AND DIFFUSERS IF REQUIRED TO ACCOMMODATE NEW LAYOUT ® RELOCATED LIGHT FIXTURE 6. AJUST LIGHT FIXTURES AND ADD SWITCHES TO REMOVE SHOWER AND ACCOMMODATE NEW LAYOUT N NEW LIGHT FIXTURE TO MATCH ❑ O PROVIDE NEW H'C 7. ADJUST EXISTING SPRINKLER HEADS AS NEEDED pQ NOTES: LAVATORY .1 RELOCATE DIFFUSERS TO ACCOMMODATE $. REFINISH ALL WINDOW SILLS AND TRIM TYPICAL NEW LAYOUT; ADD DIFFUSERS TO NEW REMOVE VANITY ROOMS AS REQUIRED. O SEPARATE WORK BY TENANT 2. RELOCATE SPRINKLER HEADS AS SHOWN TO ACCOMMODATE NEW LAYOUT 1. COMPUTER AND PHONE WIRING -- 3. RELOCATE LIGHT FIXTURES AS SHOWN TO 2. UPGADED LIGHT FIXTURES TO MATCH ADJACENT ADJUST CEILING GRID ACCOMMODATE NEW LAYOUT. PROVIDE 0 SPACE IF DESIRED. AND TILES AS NEEDED—," ID SWITCHING AS SHOWN ON ELECTRICAL OR AS DETERMINED IN THE FIELD WITH OWNER 0 .rA TOILET ROOM OPTION CEILING PLAN 65/ �i PROJECT: DATE: 4-6-07 �� PROJECT NO. ,, ROGER P. WILLIAMS 5 1-14-11 ISSUED FOR PERMIT �� CHILD & FAMILY SERVICES REGISTERED ARCHITECT SCALE: 1/8"=1 '-0 4 1-3-11 EXPANSION of UNIT NO. 12 3 7-12-07 ISSUED FOR PERMIT • '' w .� M.IT.4T. DRAWING NO. 1019 IYANOUGH ROAD ROUTE 132 HYANNIS, MA -02601 DRAWN: CADD 2 6-12-07 ADDITIONAL NOTES NANTUCKET FAX HYANNIS 1 5-1 1 -07 GENERAL REVISION OF .,, 508-257-4407 . 508-771 -6702 50778— -1 1 A I TITLE. FLOOR PLANS AND CEILING PLAN $ 8 2 APPROVED: N0. DATE REVISION ' — CIOS 9 30-0 ,- 30_0 --._ Z a C-) r I /-3 4x F' T 1 'I v { !4x o T2A%PQI I : N /X Fc T2gPb�t H4�8-1 /4x3 0 �22r 1. /4 /�- /z Z / �?� e /� / 3 a 1 1. 14 ! /_ / 1Z - -... 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