The URL can be used to link to this page

Home My WebLink About1165 IYANNOUGH ROAD/RTE132 (3) Gt,no uoQcC Ill c+e I e m®eCd __---_ N e u.) Cam 6ev-I a- I I I I I .: , raossn -ten ' n PM 0. � � THE►p',. � /s� 7 0,�3 § p��C�`'�.7� Y�"'� �R� � r " w �'., i m' ,-� � ` '2 � g y��1�65 IY,r4NN;OUG� ROi4�D%fRT��1�2 �1-I WA1�I�N1S ' � �.54 rE0 MPS n ✓ �� w� Case# C 19 36 � b'�Y«.w. Aiµ s. ,Y3,? ,.,.,G..a<,_, .�.-.,. ,w.,.c3._.., .w8 k&.... ,.<.Y"c.......w .....: ,.,,.. ✓,,,..,.0 .0 ,,,,,m v ,,.. ..,...... Lf,,.>,..,.,,, ... ,, Case#: C-19-636 Address: 1165 IYANNOUGH Date: 7/3112019 ROAD/RTE132, HYANNIS Owner Info: Property Info CUMBERLAND FARMS INC MBL: 165 FLANDERS ROAD 273-082 WESTBOROUGH MA 01581 ' Owner Notified?: Complaint Details: Type of Complaint Classification of Complaint Method of Complaint Zoning, Building Code, Medium Priority Phone Complaint Summary: Report of dedicated areas created for new smoke shop regulations. No permits pulled to create areas inside that require separate entrances. Reported that all Cumberland Farms in Barnstable have created this. Action History: Action Taken Date Description Fee Inspector Close Case 8/1/2019 $0.00 mckechnr Inspector Assigned to Complaint: mckechnr Filed by. sheas Comments: - Comment Date Commenter Comment 8/1/2019 mckechnr Area is made by moving display racks to enclose flavored tabacco product area. See pictures. No building permit required. Iq r2 . o° S �i'ivl CumWdand ' F A R M S June 26,2019 VIA ELECTRONIC MAIL AND CERTIFIED MAIL NO. 7013 2250'0002 0835 8668 Thomas McKean Director'of Public Health Town of Barnstable 367 Main Street Hyannis MA 02601 Re: Adult-Only Retail Tobacco Stores Mr. McKean, As you know, Cumberland Farms, Inc. (CFI)has recently inquired as to the newly-enacted Board of Health tobacco regulations, and is actively exploring all available avenues to continue serving our adult tobacco customers in Barnstable. I appreciate your time in discussing one of those potential paths forward: obtaining and operating under an"adult-only retail tobacco store"permit at our current retail establishments. From the text of the regulation,my meeting with you and your colleagues on June 13,our subsequent emails, and your phone call on June 19, CFI's current understanding of the situation is as follows: • In the event that demand for adult-only permits exceeds supply,CFI will now be .considered first in line and will have the right of first refusal when such permits become available under the new regulations. • However,the requisites and overall process for obtaining adult-only is not well defined among the various Town stakeholders involved here—including,to my surprise,the Board of Health itself,which adopted these new regulations to begin with. • CFI has provided three different draft plans for purposes of discussing an acceptable adult-only store�model.There is still no consensus on how these proposals will be handled by the Town internally,or whether they will be approved. CUMBERLAND FARMS,INC. 165 FLANDERS ROAD,WESTBOROUGH,MA 01581 W W W.CUMBERLANDFARMS.COM a • You have contacted representatives of the Massachusetts Association of Health Boards (MAHB)and the Cape Cod Regional Tobacco Control Program(CCRTCP)seeking their review of CFI's plans. You have received direction from Ms. Sbarra of MAHB,which you have not shared with CFI but which you have shared with town counsel. You have not yet received a response from town counsel,or from Mr. Collett of CCRTCP. This matter remains a very important issue for CFI, and time is of the essence in light of-the new regulation's imminent effective date. Please keep me informed of any new developments as soon as possible. Finally,as•1 am sure you are aware,private entities like MAHB and county programs.like CCRTCP have no regulatory authority over CFI in matters of retail permitting and local rulemaking. Accordingly,please be advised that CFI reserves all rights and remedies to challenge any adverse action in this matter, including without limitation any condition or denial attributable to the involvement of such third-party organizations. Best Regards, CUMBERLAND FARMS,.INC. omas Cacciola Vice President of Real Estate and Construction Email: tcacciola@cumberlandfanns.com Phone: 1 (508)270-4414 Cc: Brian Florence Building Commissioner Town of Barnstable Robert McKechnie Building Inspector Town of Barnstable Robin Anderson Zoning Enforcement Officer Town of Barnstable Ruth J. Weil,Esq. Town Counsel Town of Barnstable ,.fit►S� � ,�`� � .a �� I ,_ ^,,, l 'p - ^:•K M1 i � r � _�, f _ _ _ � � � R 'tr��ts�r ��}i � i" "�'�""' , ".1� - r Y _.. _ / � , ,�, _. �� ' 1 .ice" �� `a�•. � i' t^ C/ , �` 4 _ 1 j �., .r' -� �,e .- r rJ• 7 � ' �� O�, .p „n\ 'F A � .r /1 r Y• I � f Y 0 off" t , ya U Domenic W. DeAnge{o P.E. l lo� 5 Michael Road East Bridgewater, MA 02333 (508) 378-9602 (P) (508) 378-2922 (F) Inspection Report Date: 'C''��0,-v Present: --Domoltu wbbbb Location: `Remarks: O P tMl -P,-V,-SSW WA5 (41AFOCK hp Woop NA-tUy.. Col t�o�! -To -TifumyIL" -%kvL WAS low lai UJ�f�' '1 iStb�l Ml� ia�M Op �bglkul4v o *Z, cn iJG iolJ,) �L iV l( DiL Gkk l om- ih E& A� C`�t(�I�EGG{�OP1S 'r1n� i l TA6 wTA�JL UPPEA. o�.�,�iJS D 7Gk� Q �1� 'If>ivS�tS GAS POW W A�k►3�t.1co NiTA- T71,f1"S n A A A . vvv,% OF , �k" q�,y 4 f DOMENIC W. o e AL -o No. t Cie Ll,f Jf7 .r�SIAb • ® �� ,, � � �� /��9 � / � { _ :. _ �� f Page l of 1 t Shea, Sally From: Lt. Don Chase [dchase@hyannisfire.org] Sent: Thursday, December 15, 2011 6:08 PM To: bdemelo@dfpray.com Cc: Shea, Sally; Perry, Tom Subject: Cumberland Farms- Hyannis Hi Plans all set for permitting at Building Dept. for Cumberland'Farms renovation at Bearses Way and Rt 132/ lyannough Rd. Fire alarm contractor needs a permit from us for installation, $25 to Hyannis Fire Department. All fire protection systems for dispensers will remain in'service during construction. Final inspections for occupancy will require testing and certification documents from both alarm and suppression companies per building code and NFPA. Be advised that despite Cumberland's desire,to.remain open during construction, hazards to the public could unavoidably cease retail operations until renovation are completed. Good luck. Regards Lt. Don Chase,Jr., FPO Fire Prevention Officer Hyannis Fire Department 95 High School Rd. Ext. Hyannis,MA 02601 508-775-1300 x106 12/16/2011 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma o Parcel Application # �a 1 I� 0 � NN Health Division Date Issued I' Conservation Division Application Fee Planning Dept. Permit Fee �� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address IIG.S IYAUNouGN 'oAt!D Village NyEwN► Barg CRoSSwGs 8tvp Owner J�UMSEXLAN'> _rIMMs . INS Address )MAMIP46HAM, MA 0#70Z Telephone 5 a- a 7¢r - I ti 00 Permit Request 'Exobec. or Exts-nNG Cam%ER[.AN•D FARMS 57VRC, IAJTE*idk 'ro INCe.&PC AJE#J Flto6RS, CEIun►GS, 1JALLS, 6QuopMF'ivr, ErC. Q E IoR rb M)ct4De NEN GRAPPWCs ,A)JM SHALL WVPMRS To oarsm,E or Butt.Dwe.. 1wrgbk Square feet: 1 st floor: existing 3,617proposed 3 2nd floor: existing Ai IA proposed N A Total new Zoning District Q5f CODS 330 Flood Plain Groundwater Overlay Project Valuation AM 060.=S_ Construction Type 56 Lot Size 1•4(, ACRES Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure 10 vas Historic House: ❑Yes V No On Old King's Highway: ❑Yes ;d No Basement Type: ❑ Full ❑ Crawl ❑Walkout Other NoN e— 54 S 0— 6 RanE Basement Finished Area (sq.ft.) NlA Basement Unfinished Area (sq.ft) Number of Baths: Full: existing 0 new Its Half: existing a new 07 Number of Bedrooms: 0 existing 0 new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: gGas ❑ Oil ❑ Electric ❑ Other Central Air: XYes ❑ No Fireplaces: Existing 0 New Existing wood coal stove: ❑Yes )d No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: garage: 9 x s Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ ' Commercial X Yes ❑ No If yes, site plan review # r.a Current Use Mjni, -MARr / 6As Proposed Use HiNf-t lART 16,45 APPLICANT INFORMATION l ' (BUILDER OR HOMEOWNER) _ Name 10V TRAY GF^' �� ea-TTAd"RS Telephone Number .508- 328- a73o Addr 25Auruouy SrRE6r• 5WX6A4., 114 00'77t License# 737a2 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ry DATE FOR OFFICIAL USE ONLY APPLICATION# [qr DATE ISSUED i[ MAP/PARCEL NO. ADDRESS - VILLAGE. OWNER, DATE OF INSPECTION: FOUNDATION FRAME , INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL. i PLUMBING: ROUGH FINAL GAS: ROUGH - FINAL _ f FINAL BUILDING r DATE CLOSED OUT r ASSOCIATION PLAN NO. c ' s 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): ! �9P/EY �dN�7P/fC 'L dN�R14CTt�.�q T r Address: a?.r ��unfo>VY rxt -r City/State/Zip: Ko v,7�7/ `Phone#: ,508 ,336•VC94 Are you an employer?Check the appropriate box: '' Type of project(required): 1.❑ I am a employer with 4.0I am a general contractorand 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 g; Demolition workingfor me in an capacity. employees and have workers' Y P ' t 9. :❑Building addition [No workers' comp.insurance comp. insurance. 10:�Electrical repairs or additions required.] 5: Q We are a corporation andrits ' 3.❑ I am a homeowner doing all work officers have exercised their , 11:❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL ; 12:0 Roof repair s insurance required:]t c. 152, §'1(4),and we have no employees:[No workers': 13.0'Oiher 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., $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state'whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number: I am an employer that is providing workers'compensation insurance for my-employees. Below is the policy and job site information. Insurance Company Name:± ilIs of %U(': - r Policy#or Self-ins.Lic.#: DrAeR1it$ 977K825.7// ExpiratiomDate: 47- O/ • oW/�2" . Job Site Address: U(n$ /YWA)iW GN J�oAD' City/State/Zip: /yyR PJAJi J, 14 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).P' ' Failure to secure coverage as required under Section 25A of MGL c..I52 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 r 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 pains and penalties of pedury.that the information provided above is true and correct _ Signature Date: Phone#: 331016 f Official use only. Do not write in this area,.to be completed by city or town official .1 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 ki£{ Contact Person: Phone,#. " �•� ® DATE(MMIDD/YYYy) '�� ® CERTIFICATE OF LIABILITY INSURANCE page 1 Of 1 06/13/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies-may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT :_NAME— „-_. ----- - -- --- --..-. __..__. .. _.. Willis of Massachusetts, Inc. - PHONE TFAk 26 Century Blvd. .�A/L_N.OEXT): 877.-99945-7378- 888 467_-2378 P. 0. sox 305191 : E-MAIL certificates@wil1is.com_._.__,.____.._.:. - .. ... ;_ADDRESS:----- — — _ .. Nashville, TN 37230-5191 INSURER(S)AFFORDING COVERAGE .i_NAIC# I INSURERA: The Charter Oak Fire Insurance Company , 25615-001 INSURED r jINSURER B: National Union Fire InsuranceCompany of _19445-001 ID.F. Pray, Inc. 25 Anthony St ', INSURER C:Travelers Casualty.and Surety Company : 19038-004 Seekonk, MA 02771 - - 1 INSURER D. INSURER E: I INSURER F: COVERAGES CERTIFICATE NUMBER:16069610 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' SUB POLICY EFF POLICY EXP I LIMITS TYPE OF INSURANCE POLICY NUMBER I ITR A GENERAL LIABILITY IDTC0977K6257COF11 7/1/2011 7/1/2012 i EACH OCCURRENCE_._-1$ 1,000,_000_-_ i , I I I DAMAGE TO RENTED j X COMMERCIAL GENERAL LIABILITY I PREMISES(Ea occurence)__��____300,_000-.__ CLAIMS-MADE;OCCUR i1 MEDEXP(Anyone person)__,$ 5,_Q,00 ! ! j PERSONAL&ADVINJURY 1$ _1,000,000 GENERAL AGGREGATE is- 2,-0 00,000__ GE_N'L AGGREGATE LIMIT APPLIES PER: j I PRODUCTS-COM?/OPAGG 1$ J 000,000 __ POLICY i X I PROIF,- - LOC i is - A COMBINED SINGLE LIMIT AUTOMOBILE 2012 LIABILITY DT810977K8257COF11 7/1/2011 7/1/ (Ea accident) $ 1,000,000 X ANY AUTO ! BODILY INJURY(Perperson) $ ALLOWNED 'SCHEDULED - BODILY INJURY(Per accident) $ AUTOS j .._..-AUTOS -- '--E____-I--------- - ---- HIREDAUTOS I INON-OWNED ! rac 1$ PR RTY DAMAGE AUTOS I (Per accident) —_-------- -.._....-----._ is --- - X OCCUR (BE 3X UMBRELLA I7/1/2011 7/1/2012 EACH OCCURRENCE $ i EXCESS LIAB I CLAIMS-MADE I 1 AGGREGATE is 10,000,_0010_- DED ! X 'RETENTION$ 10,0001 i I $C WORKERS COMPENSATION I JIDTACRUB977KB257111 7/1/2011 7/1/2012 X T4aY_uMLTsl 'O TH--E� AND EMPLOYERS'LIABILITY - ANY PROPRIETORIPARTNER/EXECUTIVEf�';IN/A1 ! iELEACHACCIDEtJT -$- 1 000 000 _ OFFICER/MEMBEREXCLUDED? r�-- - --- — Mandalory,inNH) � 1 E.L DISEASE-EA EMPLO_Y_E__E_I$ 1,000 000 ff yes,des cribe under DESCRIPTION OF OPERATIONS below 1 E.L.DISEASE-POLICY LIMIT 1$ 1,000,000 i I 1 I I I I I I I � DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach Acord 101,Additonal Remarks Schedule,If more space is required) Re: Evidence of coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE'ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE D. F. Pray, Inc. . 25 Anthony Street Seekonk, MA 02771 Coll:3387592 Tp1:1280515 Cert:16069610 ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Cumberland Farms �. r 1165 I annou h Road .' a v Hyannis,MA 0261 Subcontractor Trade Insurer Policy Number r x Advances Building Systems Demolition Commerce & Industry Ins. WC001612749 }, s Commercial Waterproofing Roofing CNA Insurance Companies . WC413196633 3 Kamco Supply Corp Doors& Frames Zurich American Ins. Co. WC8196344-04 Stro'ny Glass Glass & Glazing Continental Indemnit Co. 46-840260-01-01 NE Pro Services Painting Beacon Mutual Insurance 63900 KBF Contracting Flooring Liberty Mutual Group WC 1-31 S-372020-011 Commercial Drywall Drywall ABC MA WC.Self-Insured ABCMA00104611-MA `%•`r M&D Services Signage & Graphics American-Fire & Casualty XWA52995646 Malba, Inc Plumbing Hartford Fire Ins. Co. DEWECLC2049 »� A w • . Ken's Beverage Beverage Equipment American Zurich Ins. Co. . WC654186000 r l w tA_ SS Services Refrigeration&HVAC Arbella Protection ins. Co. 0053650910 , Paul Foley Electric Electrical Federated Mutual Ins. CO. 9252524 Building 25 ANTHONY STREET SEEKONK, MA 02771 TEL 508-336-3366 FAX 508-336-3384 Excellence WWW.DFPRAY.COM Since 1959 S E E K 0 N K 8OSTON SAN FRANCISCO R A L E I G H N A S H V I L L E CERTIFICATE Off" �.iABILITY II SURA14C E DA,07101111 71I01 N 101111 YY) 07 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR-NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. ' PRODUCER 918-688-4667 CONTACT TO Insurance,Inc.(MA) NAME:978-662-9037 PHONE ---- --�- ----'FAX ----- — One Griffin Brook Or Ste 100 AIf,..NS E&OL,--_-- (A/c,Me): Methuen,MA 01844.1865 E-MAIL ADDRESS* TD Insurance,Inc. CUSTOMER ADVA-34 — --_ CUSTOMER ID N: __ INSURERUAFFORDINGCOVERAGE I NAIC• _ I INSURER A:Chartls Specialty Ins.Co. 126883__ NsuRtD ?Advanced Building Systems;lnc ✓ p y PO Box 9 INSURER 8_Commerce&Industry Insurance 19410 Salem,NH 03079-0009 INSURER C IN 1J RD RERE: INSURER F: COVERAGES CERTIFICATE UM13ER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF!NSURANCF 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 HF.RF.IN IS SUBJECT TO All. THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - 'AbDL'S09R- - — TP OI ICY EFF-' POLICY EXP LTR TYPEOFINSURANCEINSR POLICY NUMBER II MMIDD _ MWDWYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE 3 1,000,00 A X COMMERCIAL GENERAL LIABILITY X PROP15439295 02/01/11. I 02101112 natAcF to kFattn --' NHL;l.I$L${f:a I Gx,•ren e; S 300,00 _ C1 AIM$-MARL• X OCCUR '.FD F.XP(Any c•ra porson) S 26,00 X LIMITED POLLUTION ,$2,500 DED I / .. ......._ ..--•-•---- ' - PLkSONAL&ADV INJURY S ..Z 000,00 1,000,000 X PROFESSIONAL LIAB :$20,000(LIMITED COV 1 •••/// r .. .. S � I I GFKFHAI AGGREGATE GEN'L AGGREGATE.LIMIT APPI IFS PF:R. � f PRJOUCTS•CCIdC1UC AGG ',$ 2,000,00 POLICY; X _ I LGc I - - r ! Emp Ben.-. S 1mil11mi AUTOMOBILE LIABILITY X x ( It;OMUINLUSINGLELIWI S . (Fa acc,dent! 1,000,00 B X ANY AUTO *CA1932424 I 07/01111 02/01/12 ,.�,._)_,.,•-.+ f-�;J„ (001)1l.Y INJURY(Per perear) 5 _ ALL OWNED AUTOS / I BODILY INJURY(Pe'acGdenl) 5 SCHEDULED AUTOS I / PROPERTY nAMAGE HIRED AUTOS -, ,3��IF tt •) -'•��•'' l(!'M afryyl^r) 5 NON-OWNED AUTOS X UMBRELLA LIAR X- OCCUR I - - •�FACH OCCURRENCE S 5,000,00 EXCESS LIAe CI AIMS-MADE A X IPROtII5440507 I 02101/11 .' 02/01/12 !AGGREGATE __-_-•.5_—.._ _ 5,000,00 DEDUCTIBLE I S X RETENTION S 10,000 I I e po WORKERS AND MPENRS' ABILSIIY YIN - `u�------i'X WCSTt1 U. ORY OTK. - v ANYPRCPRIETCRIPARTNERIEXE(:U'N_ i' IW0 0 01 61 2749'1l 02105/11 1 02I!P2 EL r•.AChlnfpDENT S' 1,000,00 CFF•ICERP..-EMBER ; N NIAl—. ✓/ I _ (IAandalory In NH) _ I F I DISFASF-FA FMPI OYES 5 1,000,00 u yyS acscnoo u^do' E L D SEAS_ POLICY LIWT S 1,000,00 .DESCRIPTIONOF OPERATIONS De!cw DM EASE DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Adlniooal Remarks Schedule•it more space Is requirod)D.F.Pray Inc,New England Retail Construction Corp&any applicable project owner,including the owners affiliates Wor lenders are Additional Insureds on a primary basis per written contract,subject to policy terms& conditions CERTIFICATE HOLDER CANCELLATION NEWEN23 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE C ELLEO BEFORE New England Retail THE EXPIRATION DATE THEREOF, NOTICE WILL E DEUVERED IN Construction Corp AC MCE WITH THE POLL Y PRO SIONS. 33 James Reynolds Rd.,Unit F Swansea,MA 02777 ruE REPRESENTATIV Sur nce,Inc. U 1988.2009 ACO D C N. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD I ' r , OP ID:DD .�acoRv° ��ft�'�,ICATE OF LIABILITY INSURANCE 11118 DATDlVYYY, �"'�HIS IMAGE HAS B 11/18/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER 781-935-8480 - NAM , - - DeSanctis Insurance Agcy,Inc. 781-933-5645 PHONE FAX No: 36 Cummings Park MA,L Woburn,MA01801 PRODUCER COMME-3 INSURERS AFFORDING COVERAGE NAIC 0 INSURED Commercial Waterproofing,InC'y INSURERA:CNA Insurance Companies 418 Pine Hill Road B"LANKET INSURER B:The commerce Insurance Com an Westport,MA02790 'INSURER C. INSURANCE INSURER D • CERTIFICATE x INSURERE: COVERAGES 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.LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OFINSURANCE - ADOL SR -—MLISY POLICY EFF POLICY E P LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILrrY C4013149344 11119111 11/19/12 EM PREMISES HENT n nce S 100,00 CLAIMS-MACE ITI OCCUR ICED EXP(An o.•ne person) $ 5,00 PERSONAL S ADV INJURY s 1,000,00 � _ GENERA!AGGREGATE $ ., 2,000,0 GENL AGGREGATE LIMIT APPLIES PER REVIEWED,�APP-ROVED, PRODUCTS•COMPIOP ACC S ' - 2,000,00 POLICY x JFCTPRO. LOCENTERED IN AP.TL AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ •1,000,00 (Ea accdent) ANY AU-0 BODILY INJURY(Per person) S ALL OWNED AUTOS 80J,Y INJURY(Per ardent) $ B X SCHEOLLEDAUTOS PROPERTYOAMACE X HIRED AUTOS 11MMBCTTOC 11119111 - 11/19/12 (Pereccndenl) S X NON•OWHEDAUTOS S X UMBRELLA LIAS X OCCUR EACH OCCURRENCE S 1,000,0 EXCESSLIAB CLAIMS•MAOE AGGREGATE S 1,000,00 A C4013149358 11l19111 `11N9/12 DEOJcnsLE - S X RETENMN 10,000 s WORKERS COMPENSATION - X I SIATU�. OTH• AND EMPLOYERS'LIABILITY TWC Y _IT A AEMBER NY PROP1M ETORMARRTNER/,ECUiIVE Ya N r a C413196633, 11/19/11 11/19/12 E L EACH ACCIDENT S 100,00 EXCLUD (ManoatoryInNMI (MA,RI,CT,ME,NH;VT) EL DISEASE•EA EMPLOYEd$ 100,00 II disc,be under - -- CRIPTION2E OPERATIONS tlo. IEL DISEASE•POLICY LIMIT S 500,0 DESCRIPTION OF OPERATIONS)LOCATIONS/VEHICLES(Attach ACORD 101,Addltionaf Remarks Schedule.If moc;pace Is required) D.F. Pray, Inc.and any applicable project owner,Including the owner's afQlates and/or lenders,where required by written contract or agreement, re additional Insureds on General and Umbrella on a primary and noncontributory basis. RE: Various Projects. CERTIFICATE HOLDER CANCELLATION DFPRA-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN D.F.Pray,Inc.25 Anthony Street AC NCE WITH THE POLICY PR VI 10 S: ' Seekonk,;MA 02271 AU R12ED EPRESEII�ATTVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD.name and logo are registered marks of ACORD I BLANKET 1N'SURANCE C,ERT•. .r, t. OP ID:EE Ae F+W&- HAS BEEN ALTERED" DATE(MWDOIV—1 �� CERTIFICATE OF LIABILITY INSURANCE 03111111 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 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 endorsements. PRODUCER 610-279-8660 CONTACT M The Addis Group,Inc. PHONE FAX 2500 Renaissance Blvd.Ste 100 610-279-8643 (AIC,No..Ext); _ (Arc,No): King of Prussia.PA 19406-2T72 n'BMDARIL Eric Hobe - PRODUCER_" cu&IP!rERtoe:KAMCOBO --- INSLIRERLS)AFFORDNG COVERAGE NAIC_a INSURED KAMCO Supply Corp.of Boston INSURER A:Zurich American Insurance Co. '16535 MA,ME,NH,VT INSURER a:Federal Insurance Co(Chubb) 20281 181 New Boston Street INSURERC:Navigators insurance Company. 42301 Woburn,MA 01801 -- 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. INSR' TYPE OFINSURANCE 'Abbiml ..'— POLICY NUMBER Il )AMID EYY MOLT YEXP —' •' LINITS LTR GENERAL LIABILITY EACMOCCLTtRENCE S 1,000,00 A X COvM.ERCIAL GENERAL I IABILI;Y 'GLO8196343-04 03101111 03/01112 DAUAGE TO REVTE21 500,0 PREMSES(Ea ccar•roace; S CLAUS•MADE X OCCUR I MED EXP(Any are pc(s0a) i S 10,00 X Contractual PERSONAL aADVINJURY !s 1.000.00 Liability GENERALAGGREGATE i s 2.000,00 GENT AGGREGATE LIMIT APPLES PER i PRODUCTS,COMPIOP AGG .S 2,000,00_ IFrr i POLICY X PRO' I I LOC AUTOMOBILE LIABILITY COVJ3IKEC SINGLE UV.I f 1,000,00 A X ANYAUTO I SAP8196342-04 03101111 03101112 (Eaaroeere) . r - BODILY INJURY(Fe•Cersee) S ALL O'WNFDAL;TOS _ BOCILY INJURY(Fer ame rq.S , ' X SCNEOULEOAUTOS PROPERTY DAM AGE. S X HIREDALJTOS REVIEWED 'APPROVED (Pera:.alerp —• s s _- r-..- NON•OVNJEOAUTOS - ENTERED IN'..AP TL Comp Oed ,I s., - _ -: 25 X' ,, Colt Ded $ 50 UMBREWILIAB X OCCUR EACH OCCURRENCE jS 20,000,0 EXCESS LIAS CLAWS-MADE! AGGREGATE S 20,000,00 B - PH11UMR6763101V 03101111 03101112 oe�UcnBLE :s X RETENTION S 1(),000 1 1 WORKERS COMPENSATION i {. X..TOF3YIAIU 0TR I AND EMPLOYERS'LIABILITY .YIN , L A ANY PROPRIETORIPARTNERIEXECUTIVE �1NC8196344-04 .. o3/01n1 ..I 03/01112 EL EACHACCCENT s 1,000,00 OFFICERALEWER EXCLUCEO9 N I A (MandalorylnNH) ELDLSEASE•EAEMPLOYEE.S 11 Yas.CcsOkD9 OF CI E V OPERATIONS below I I E L D5EASE•POL:CY UM:T S 1,000,00 A Property 12772 01l01/11 01101/12 elk Limit 46,477,53 A .Physical Damage AC DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD101.Additional Remarks Schedule.,I mom%pacetorequired) D.F.Pray,Inc.and any applikable project owner,Including the owner's I •. affiliates and/or lenders,when required by written contract or agreement, are additional Insureds on all general,umbrella and auto liability policies on a primary,non contributory basis. CERTIFICATE HOLDER CANCELLATION DFPRAY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE D.F.Pray THE EXPIRATION DATE THEREOF,-NOTICE WILL BE DELIVERED IN 25 Anthony Street ACCORDANCE WITH THE POLICY PROVISIONS. Seekonk,MA02771 AUTHORIZED REPRESENTATIVE - ©1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORO name and logo are registered marks of ACORD DATE(MWDO/YYVY) ACORDJIM CERTIFICATE OF LIABILITY INSURANCE DA06/13/2011 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Farrell Backlund Ineurance Agency Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 128 Dean St HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Taunton, NA 02780-2762 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (508)829-8666 INSURERS AFFORDING COVERAGE NAIC 0 INSURED - INSURERA Continental Indemnity Co. ;2325e .Strojny`G18ss Co':,1Inc. INSURERS: _ - 92 Weir St INSJREkC: Taunton, MA 02780-3935 INSURER CTL 1273 566617- INSURERS:' 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.. POLICPEWFiFCT1VF(FOIICVt7t0Y10(MN LT. N D TYPE Of INSURANCE POLICYNUMBER GATE MO LIMITS I GENERAL LIABIUTY - - - EACH OCCUHANCE !S !_ •• COMMERCVIL GENERAL LIABILITY PaEVISE$(EAax.rsew) _ CLAMS MADE !OCCUR ►RED EXP(any aa.pe s-L. S - . . PERSONAL&AD_V IN_1)RY_ - �GENERA.AGGRECaTE IrG_E_NL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOPACC•S. I POLICY —..IPfRO• r_...CT 1LOC - AUTOM06OLE LIA6IUTY CC.V.B NED SINGLE LIVIT S ANY AUTO IEa acodenq .._ .—. III ALLONNEDAUTOS - BODILYINJ•RY i I SCHEDULED AUTOS Iry PersOM 1 �•• ,"RED AVTOS _ 6001LYINJURY - n i•_ NCN-0'NA4DAUT05 _ -(PM scooenll S PROPERTYDMIAGE— (Per acooentl - QAIIAGE UABILfTY i AUTO CNLY-EA ACCIDENT S I _ ._...__.._ANY�_O OTHER THAN EAACC b AUTO ONLY AGO S I EXCESSRIMBRELLA LIABILITY EACHOCCURENCE S OCCUR --_CLANS MACE +_ !.AGGREGATE S S .. .....__ .__ I DEDUCTIBLE f. S RETENTION S .. ,, S .. ..-_._.. WORKERS COMPENSATION AND - I EMPLOYERS'LIABILITY F!--j TORY.LIJWTS._._ER AANY PROPRIETORIPARTNERIEXC•CURVE 9 6-840260-01�01 06/01/11 06/01/12 '4EL.EACNACCIDENY $500,000_ :OFFICERMEMSEREXCLLOED1 —_ E L.CISEASE-EA EMPLOYEE S SO I.O.. Ityyccs destr� 'noe, - - SPECIALPROVLSIONSOeIbr - _ iel DISEASE-POLICY LIMIT $500,000 OTHER ! I DESCRIPTION OF OPERATIONS I LOCATIONS I VENICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION D F Pray Inc DATE THEREOF,THE ISSUING INSURER WILL ENDE 25 Anthony St AVOR TO IWL JO DAYS WRITTEN NOTICE Seekonk, MA 02771 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 REPRESENTATIVES AUTHORIZED REPRESENTATr, ' 1783110 ACORD 25(2001108) 0 ACORD CORPORATION 1988 THIS IMAGE HAS BEEN ALTERED'* ACORN, CERTIFICATE OF LIABILITY INSURANCE 04/05/2011 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,£(TEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING"OURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER IMPORTANT: ff the certificate holder is an ADDfCiONAL INSURED,the policy(les)Trust be endorsed. H SUBROGATION IS WANED,subject to the bans and condrdons of the policy,cartaln policies may require an endomemenL A statenwat on this car ificate does not confer rights to the certlNcate hoiden in liw of such endorawnen s. PROoueoT CONTACT MANE: Elisabeth Deschene Troy. Pi res & Allen, LLC AX.L. 401 431.9200 ' Ft N„401.431.9201 Shove Insurance BLANKET= -- _ 376 Newport Avenue INSU'RANCE �!°� _ East_ Providence, RI 02916 _ *W"Re AFFORDTNOCOVlJtAOE NAIL• """R ° CERTIFICATzE INSURERA: Main Street America Assurance_ 29939 NEW EN(0_AfD PRO CLEANERS LL- INSURER Beacon Mutual Insurance Co 24017 203 HARRISON ST TNEUREIRC: PROVIDENCE, RI 02907-2496 - NSURER D: NSIIRlRp: -• �.. .. �• COVERAGES CERTi11CATE NUMBER: 2010-11 w/updated WC REVISFON NUMBER: THIS IS TO CERTIFY THAT THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LMOR TYPE Of NftMANCE NSR wVD FOUCY NUMaER NMIO UNITS —. oaNlRAL WBIIfTY MPT6192 11117l2010 1111712011 EACHOCCURRENCE S _ 1,000,ONI T - . ( COMMERCIAL GENERAL LIABILITY 7u� $ 500 . CLAIMS-MADE OCCUR MED EXP(Any One,person) S 10,0 A _ REVIEWED, APPROVEiD, PERSONAL dAOVINJURY f 1.000._00 s GENERAL AGGREGATE f 2.000 00 GE NL AGGREGATE LIMppLT APPLIES PER: !{{ ENTERED,1K 4TL ; PRooUCTS•COMP/OP AGO- f 2,OOo, POLICY PELT LOC ._. AUTOM06ILE LIABLRY - COMBINED SINGLE LJWT = _ ANY AUTO (EaeOddeM) .. ALL ONMEOAUTOS BODILY NJURY(Per person) SCHEDUUEDAUTOS BODILYINJURY(Psroodderlt) S PROPERTY DAMAGE HIRED AVTOs ATTACHED : (Per eccKs"t) _ NOIFOKNEOAUTOS I - - - •- •- UMBRELLA Ws OCCUR - EACHOCCURRENOE f Excess LL CWMS-MADE AGGREGATE •.. ._ . DEDUCTIBLE -~-- _ i- RETENTION f VIORKRS _ A FpLQYPtS UA�aaITY �390 T)ON1 �t11 WWN12 TORY LIMI ER YIN I S00 ANYPROPREweRIExcLu R/EJCECIRNE E.L.EACH ACCIDENT f B OfFICER/MEMBEREXCLUDE09 � NIA (myes �Fn*") EL.DISEASE-EA EMPLOYE S SOO.00( DESCRIPTION OF OPERATIONS below - E.L.DISEASE•POLICY LIMIT S 500,00 DESCRIPTION Or OPERATIONS I LOCATIONS I VEHICLES(ARee11 ACORO I M.AddbaW Remerlrs SolyduY,M more specs b repW,ed) - - .F. PRAY. INC. AND ANY APPLICABLE PROJECT OWNER. INCLUDING THE OWNER'S AFFILIATES AND/OR LENDERS, WHEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENT, ARE ADDITIONAL INSUREDS THE GENERAL LIABILITY POLICY ON A PRIMARY. NON CONTRIBUTORY BASIS. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. D.F. PRAY. INC. AUTHOw»DRARESENTAmr4 � 2S ANTHONY STREET SE KONK, MA 02771 Elisabeth Oeschene ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD R , .. /2B1<2011 7:19:13 AM PST (GMT-6) FROM: insurancevis ions.com-7'0: 16606523236 Page: 2 of 2 ACORD� CERTIFICATE OF LIABILITY INSURANCE DATEOMMi mv) THIS CER71FICATE 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 BOLDER, IMPORTANT: If the certificate holder In an ADDITIONAL INSURED,the policy(iss)must be endorsed. If SUBROGATION IS WAIVED,sub)ect to the temw and conditions of the policy,certain policies may require an sndorseawnt. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. SMITH BROTHERS INSURANCE 68 NATIONAL DR SUITE 2 � GLASTONBURY,CT 060334314 AAM g , MURERM AITORDINO COVERA06 IIAIC e wwkER A welxkEo -'KBF CONTRACTING INC r19URERe: '41 BROOKS DRIVE SUITE 1005 nwRERC BRAINTREE MA 02184 wuRElto: wuRER e: MURERF COVERAGES CERTIFICATE NUMBER: 1 f 223746 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 PAIO CLAIMS. gw AD LTIt T1'pEOFNSLNIANCE pOtlCYlaTreER TEf DE2LERAL LIABILITY La11TS EACH OCCUMNCE S COMMERCIAL OENERAL 1"VI Y S CLAw"ADE moo" PERSOFiLL a ADV NAIAY S OBERALAOOREpATE f OMAOGPECATEL WIT APPLIESPER. pRODUCTS•COMAgPA00 f POI ICY PRO. LOC - S AVYWAOSILELIABLITY - se f ANY ALTO BOOZY 1KJURY(Prpraoa) f ALL CMREO SClEDIA� AUTOS AUTOS BOOILY If AM(Pr*=k*-t)f HREpAU1OS AUTOS aoda✓� f f UMBRELLA LL48 f OccuA EACH OCCURRENCE f FJtCEbellAa CLAlA9�AA0E AOGREOATE - S DeD At!TFMION f f , f f A wOwJ"COMPENSAtmN YIN WC1-31S-372020-011 3/6/2011 3/6/2012 WC SrA AM GNMATCV&UAdUTY - OOFTI BE EXMaLUII)EO�tECU1•IvfQ NIA E.L.EACHAONDENT f (IM&Ad@Wryi*W) E.L.DISEASE•EAeLPLOVE f II rra.desoM uNar DESdtPT OFOPERATKMbelo. E.L.DISEASE-POLICY LAOr Is 100000 OESCRPT"OF O►ERAIIM I LDCATKM f VENICLEb(Attach ACORD tot,Ad041e"RmasAe ach.d.ls,IN mom apace it t@gWrad) Walkers Compensation Insuranos:Pan One of the pdicy applies Only to the Workers'Compensation Laws of the State of MA. E HOLDER ANC ION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE DF PRAY INC THE EXPIRATION DATE 11HERECF, NOTICE WILL BE DELIVERED IN 25 ANTHONY STREET ACCORDANCE WITH THE POLICY PROVISIONS. SEEKONK MA 02771 ' AkfI110Rn3RO RE9REbt;NTATryE ' Jeff F,dl; e t WASP ®1988-2410 ACORD CORPORATION. All rights reserved. ACORD 25(2010J05) The ACORD name and logo are registered marks of ACORD CEIM 110.: 11213146 CLtg1T OOK: 1372020 Dob 0e990e8gqt 9129/2p11 1:L6:03 AN ►age I of I Tbas G99tk1kC4te cancels and SWrssdoe ^LL p:avwvsty L9SUod Ces0/tlC0%g6 r ' �1 OP ID:75 14� GE HAS ift� LATE OF LIABILITY INSURANCE °�'10118111 10M8/11 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 be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an ondorsemenL A statoment on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER 207-239-3500 CONTACT - TD Insurance,Inc.(ME) NAME: PO Box 406 207-776-0339 i Portland,ME 04112.0406 EJAII TD Insurance,Inc. ADDRESS: BLANKET; cusTOMER ID.:coMMEDr INSURER(S)AFFORDING COVERAGE NAIC e NSUItEo Commercial Drywall$j INSURANCE INSURER A: Undefwflters Ins Co 126042 Construction Co.ent Inc' CERTIFICATE INSURERB:Employers Ins.Co.of.Wausau :21458 135 John Vertente Boulevard tNsuaERc:Liberty Mutual Fire Ins.Co. 23035 New Bedford,MA 02745 _. INSURER D IABC MA WC SELF-INSURED GROUP IN R SURE E: INSURER F• - — .. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE.INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.INSR - TYPE Of INSURANCE S -- - _ POLICY EFF - P - - 1 POUCYNUMBER MMIDOIYYYY MMfDO/YYYY LIMITS. GENERAL LIABILITY I EACH OCCURRENCE is 1,000,00 A X COMMERCIAL GENERAL LIABILITY X YVJZ91449784030 07101/11 01/01/12 PREMISESIullt fEa:rlltvnce) s 300,00 —i CLAIMS-MADE I-X-1 OCCUR N ED EXP(Any one person) �S 10,00 - _PERSONAL&AOV INJURY .•-S •._ 1,000,0 ' - -GENERAL AGGREGATE _ S 2,000,0.. REL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG S 2,000,00 POLICY X LOC PRO- ! �' — 9 AUTOMOBILE LIABILITY X C OMBINED SINGLE LIMIT acudenryS 1,000,00A X ANY AUTO SJZ91449784020 07101/11 01101112 DILY INJURY(Pm person) S ALL OWNED AUTOS2LY INJURY(Per aoadent) S SCHEDIVLEDAUTOS 'REVIEWED, APPROVED aEntOAMAGE mREDAUTCS ` NON-OM.EDAUTos ENTERED IN' AP TL �- X UMBRELLA LIAB X OCCUR EACH OCCURRENCE _ __ ,- s 5,000,00 B EXCESSLIAB L CLAIMS-MADE X THCZ91449784040 07J01111 D1101112 AGGREGATE $ 6,000,00 DEDUCTIBLE $ 'X i RETENTION S 10,000 I - S AND EMPLOYERS EMPENSATIONRS•WBILITY YIN- I X i"fYT�Ts_. ETRH. C ANY PROPRIETOFWARTNERFXECUTNE a N r A WC2Z91449784010 07101/11 01101/12 F.I,.EACH ACCIDEYT S SOO,OO OFFICER/slEMBER EXCLUDED? yes.desrnDe LL•ICef glory le NH)I" STATE:CT&RI i E L DISEASE-EA EMPLOYEE;S 50Q0O M qel, ^• — DESCRIPTION OF OPERATIONS below j E L DISEASE•POLICY LIMIT $ 500,0 p Porkers'Comp rBCMAD0104611-MA) 01/01/11 01f01N2 Accident 1,000,00 A Self Ins Group 'Employee 1,000,00 07CRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additlonal Remarks Sahedute,If more space Is rawked) - DPray,Inc.and any applicable project owner,including owners affiliates and/or lenders,when required by written contract or agreement,are additional insureds on all general,umbrella and auto liability policies on a primary,non-contributory basis. CERTIFICATE HOLDER CANCELLATION DFPRA01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 0.F.Pray THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 25 Anthony Street ACCORDANCE WITH THE POLICY PROVISIONS. Seekonk,MA 02771 AUT"ORQED REPIIESENTATIVE TD Insurance,Inc. ' 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD From: 413-663-9453 Page: 2!2 Date:9/2812011 12 46:45 PM **THIS IMAGE HAS BEEN ALTERED** A�a CERTIFICATE OF LIABILITY INSURANCE 9ATEI.AMIDDf(YYY) /28/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. It SUBROGATION IS WAIVED• subject to the terms and corxlitions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certHicate holder In lieu of such endorsemern(s). PRODUCER c(*n: Diane Wojcik NAME Coakley Pierpan Dolan & Collins Insurance P'1O t1 (4:3}442-9241 °;X Not,1413)66e-6SOi 26 Union Street EMAIL dwojcikecpdcinsurance.com BLANKET INSURER(SI AFFCRDINO COVERAGE NAIL• North Adams Ma 01247 INSURANCE ,:4SURERA Ohio Casualty Group 4082 INSURED sURERs Travelers Indemnity Co of CT 25682. VIED Services Iu6, CERTIFICATE'';suRERc American Fire And Casualty. Co. 24066 PO Box 702 USURER D' URER E: Lanesboro MA 01237 URERF COVERAGES CERTIFICA .,.,it : . Z,7VT as Rep; REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSI)RANCF LISTED RFICWJ HA`;E BEEN ISSIIFn TO THE iN311RFD NAMED ABOVF FOR THE POLICY PFRIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERIA OR CONDITION OF ANY CONTRACT OR 01H.ER 0OGt)U9JT WUH.RESPECT TO V�WCH THIS CERTIFICATE LIAY 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 SHUAN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR T'PEOFINSURANCE L FF POLICY X LTR POLICY NUMBER 14M.IDD/YYYY k1w)DDA'YM LIMB$ GENERAL LIAeIITY ! - _A•14 J;;,,URFEVX S 1,000,000 X COnut_RCWl GLr,L•k:y 1:.@I_t'Y i.'v ,-;.I v : 100,000 - A LIA.n.::Abl 7;,�.�r. K052995646 '/19/2011 /19/2012 I:I:>-x-•,An�p:rpe':•.I:. IS 5,000 1,000,000 REVIEWED:, APPROVED,^,;:,, L::Lt/e.A;,KEG•\TE s 2,000.000 f'Ev'I.ACCRcGA-E 1 1,11-AD:'I IFS-FR -Rcn::Ts.COL P;JF A.Gc S 2,000,000 ENTERED IN AP TL P7L1=Y �l)1. Its. , AUTOMMLE LIABILITY ' : ,r.. I F777 W 1,000,000 B A'y A.,'A - EiC L:II N,,R I';Parrr•;r'1 5 A1934C512 1/1/2011 /1/2012 Ali,f•S X ALITC.`. - ECC I Y rl., t-J'N,;'ANLU rr.'JPEn T 1 I'A AA„r X MFttJAJ"'.5 X AUKS P,r ac':en•: - ♦S 1.'Wl CJ 2Yre:Y; S X UMBRELLA LIAR X OLC_; GCCI.RRE'<C^' S 1,000,000 A EXCESSUAB VyA. %GRD�'AlL _ T 1,000,000 Cr'• I X I RL1 •I'Ia+S 10.00 �SO52995646 /29/2021 /19/2012 t C AORHERS COMPENSATION X Y.::j'A-L• ,, N AND EMPLOYERS'LIABILITY I - Tc:.Y.rens: '^ Y,1. 500 000 Aw Luc<dt'0^.-•a•^-\Carr.:•:..Ir:- _L c:✓ C10C++- S (?-n CE:. ME£F E.<f,•..tif1' - N,A -- r:, (MendatWry n NH* f WA529S5646 - /19/2011 /19/2012 it 500,000 IY`::2PI:Ct.Or r. S 500,000 O'L-;.,:' :,av, l O 5:1•.SF �'i. "Lrd1T DESCRIPT10tI OF OPERATIONS I LOCATICNS f VEKCLES iAtMrn ACORD 101.Addmenal Remarks Scheduit.It more apace a required. - The- cerrif_c,teho d_r and any-crPli?�able prajc_t wn r,- _:dueling the o-ter`r af'_:i:sLa_ a-d cr lend-, is listed as an additional insured with respects to General Liability when required by written contract or agreement on a primary, non-contributory bads CERTIFICATE HOLDER CANCELLATION (508)336-3384 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN D. F. Pray, Inc ACCORDANCE WITH THE POLICY PROVISIONS. 25 Anthony Street Seekonk, MA' 02771 AUTHORIZEDREPRESEMATIYE �- Diane 1•fojcik/T)ONBIS '• � O ��l, i ACORD 25(2010/05) 1988-2010 ACORD CORPORATION. All rights reserved. INS0251ao:Cn;: The ACORD name and logo are registered marks of ACORD T�:-s.................._.,.,r M.../'!(-I rA V..,..b,,.t..,,a r,....,,, n1n•m o,'.. ,dWil hMn•/Iun,n,u nfl r•nm _• _ JAAN. 24. 2011 3: 19PM DELANDAISSONJ81-237-1805 NO. 962 P. 2/2 ACORN' CERTIFICATE OF -LIABILITY INSURANCE 01fz4ml THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTM9CATE HOLDER.THIS CERTIFICATE DOES NOT AFFI MIATfVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE.AFFORDED BY THE POLICIES BELOW. THIS CERTEXATE OF OISURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE MLW 40 WSURER(Sj, AUTHORIZED REPRESENTATIVE OR PRODUCEk AND THE CERTIFICATE HOLDER. MIMORTANT:M the eertNcats!colder Is M AMMONAL MIMIUIM:O,I*poMcypsl wag be ertdorsat M OUBROOATION 10 WAIVW,sobject to ON terns and I I 110 a oT dte Padcy,0 9 Mi t p I'd may rtgtft ea mdorsommilL A solkwmd an Mils caVrotft does not cQnW rlyha to Ire cerwtata holder In Neu or taco atdwseolw"l PPQDV EiI Phase. (7611237.1515 - cpNrAGr Ann BraiO wn DELAND.OIBSON INSURANCE ASSOCIATES,INC. ,�/�� '"iOMF j 237.1515 A" P 0 BOX$1269 �, ��• E -•- ro atratuwrt@dNarM pttlson cam WELLt:SLEY HILLS MIA 02481 _ CVSTQ 12096 wrsU ERlq AMOROINa COVIMAM NUC0 MALBA,MNC.� , Hartford Accident 3 ttdamrlMy Ins Co i� P.O.BOX 1125 ►cu e : Hartford Fir*Ins Co Vx MANWLD MA 0204"125 � raw�c HWfardCasuaky" e �451IgH7F .. COVERAGES CERTIFICATE NUMBER: 57564 REVISION NUMBER: THS IS TO CERTIFY THAT THE POLICIQS OF NUA ANCE LISTED BELOW NAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERI00 MVWCATED.NOTINInWANDWIS ANY REOL4REMfENr, TERM OR CONDITION OF ANY CCWTRACT OR OTHER DOCLMENT VATH RESPECT TO tAH)CH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAMy THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. _ T IM Of R URAN:E ADOL sueR POLICY NUNIBM POUCT ut rouoT err u rm gm B Gomm umw" 06813AV23317 0la M1 01r25M2 EACH OCCURRENCE X C0114A tCINL 3MRAL LVBIUTY owuoe TO Am to i Mow CUVMSANDE X OOCIR m .DO I"oft psm-) i 5,000 / PERSOKAL d ADV INAIRY i 2,00%wa . GENERAL A,',GrtE,^aATE i 4,000,000 GEM AGGREGATE LSAT APPLIES PER. PRODUCTS.COkOJOP AGO i 4,000,000 POLICY PRO OC t I C Aurama"A umam OBYCCIMBB61 (Mf M1 01I25M2 CCIwelED SINGLE LUT i 1,000,000 AW NXO (Ea mold"I ALL ONtFD ALTOS BODILY WJRY(Pa van-) s . BODILY NJIRY(Pa eoadat) i X SCHEDULED AUTOS PRopemy DAMAGIF . X HVEDA1005 (Proadaf) e X KON- ED AUTOS a urrsletLaJL rues 00" EACH otcLRADVLE i now um CW)ASANDE AGGREGATE s OEDUCTIBLE _ s RETE?rnCH s i B � 00VYEC_LC2019) 010M2 r 0n,AMEY i Tin 92 "IT R eTORReRIIIaItlaaStlrlllla E L EACH ACCIDENT = S00,000 aFFIC MNIMI III ncuoeof MIA lwwwllTuIrq EL.OISE.SE-EA94PLOYEE i WOOD yyaaaa r ��oe,oe.uw. Or�RPT 0_DP:itAT0W bhvw E L.r'—ASE•POLICY LatR i 500,000 OEaCRIPiIOM ai OrERATpNb f IOCATn1M r YEMCLEa(AKarll ACORD 1a1,Aratfenrl RMarks stlsdWo,M wen spec b repdnn - AddNlmW kw reds:D.F.Pray,Inc and any appMCallo pngod amwr,Include V Ow awrws afRllatas alnd.or Is Wws whm rawked by millet conha t or apraarrtant an addionaf hand an Al gum af,umbn*s and auto bWlly poik*s on a primary,non conMDtdwy bask. � , CERTIFICATE HOLDER CANCELLATION r SHOULD ANY Of TM ABOVE DESCRIBED POLIM Of CANCELLED OEIIOgR D.F.PRAY WC THE EXPIRATION DATE THMREOF,NOTICE WM.L BE DELIVERED IN - 25 ANTHONY STREET ACCOFAMWZ WITH THE POLICY PROVS11M. t Suskottk MA 02M __..._ K0HOrL13D NlPReMNTAiNE Altention: - - Ann&enliorl ACORD 25 ) O 1 0%9 ACORD C TION AM rights reswved 'no ACORD nano and keno an uesiatsrsd mark:of ACOR 06/09/2011 09:20 FAX 630 285 3922 AR'I'HUR J GALLAGHF.R Z 001/001 BLANKET INSURANCE CERT THIS IRA GE HAS BEEN'ALTERED Aco d° CERTIFICATE OF LIABILITY INSURANCE °06/09/2 11 06/09/2011 THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES N7T AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES 8ELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED REPRESENTATIVE OR VRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of Itw,polity,certain policies may require an endorsement. A statement on this certificate does not confer Mghts to the Certificate holder In Ileu of such endorsement(*). PRODUCER 1-630-773-3000 CONTAcr Bath Soto Arthur J. Gallagher fink rimagaasat Services, Inc. PHONE _ Me.�+*Ie -694-5058 630-285-3922 2V0 Pierce Piece - uAIL DRE bathti30 sotoiajq-con `- Iteaca , IL $0103-3141 WSURERe AFFORDING COVERAGE NAICB Beth SOLO _ _ INaURERA: AlfYRZCAN GUAR i LZAB INS 26247 um"D INSURERB: ANSRICAN ZURICH INS CO 20470 . EW's Beverage, Inc J aMRERC: AWRICAN ZURICH INS CO 40142� P.O. Boa 110 INSURER : ' Noutgomery , IL 6053( (FISUNERE: - INSURERP: COVERAGES CERTIFICATE NUMBER: 21663154 REVISION NUMBER: THIS IS TO CERTIFY THA••THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHST,WDING 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:'ONDII tONS 0=SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TR TYPE OF INSURUICE` POLJCy NUMBER I PO-ICY EFF OUCY EXP WAS A GENERALUARILIT`' ICP0654185900 04/01/1 04/01/12 EACHOCCURRENCE S 1,000,000 TOO-AERCNL aENERILL'ABILI-Y _ � n 3 1,000,000 '— CWUS►•ADE OCCJIA I. MEDEXP ane non $5.000 - PERSONAL 4 ADV INJURY $1,000,000 —._ • GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT M'PLIES P:;R. • I _ PRODUCTS•COMP/OP AGO 12,000,000 X POLICY j -LOC _ B AUTOMOaa.E UAWLIrY PO 5418 9 M L 1,000,000 X ANY AUTO i I 'BODILY INJURY(Pr oww) ;S ALL OWNED SCHEOL.ED BODILY INJURY(Per awderd)AUTOS I X HIREOAUTOS X N..:,'VEO I � PROPERTY-0 E s AUTCS X 8100 Dad. X $2,001) Ded. i 0 -.— - f A X UMBRELLA LIAO I: O^CUR 0F�6541e6100 04/01/1 04/O1/121 i EACH OCCURRENCE 14,000,000 EIfClbalJAB _._�I,N;,(,IADE _ - AGGREGATE !:4.000,000 DEO I X I RETENro 4 S 10,(00 - - WORI ERS COWENSATN)N WC STA c wc6541e6000 AND EMPLOYFJLS'LIABILnI YIN. -., --�- � 04/01/11 04/01/32 I( • ANY PROPRETO"kRTNER EXECUTI lE I E.L.EACH ACCIDENT $1,000,000 OFFICeRNEMOER FXCLUOE 7) NIA X (Mr' .y In NH) - E.L.DISFWSE•EA EMPLOYE S 1.000 000 If Y".007orWe urmw _ - -. ESCRI OF C*ERATI({,IS ae•Iv+. E.L.DISEASE•POLICY LIMIT 4 1,000,000 REVIEWED DESCRIPrION OF OPERATIOMB I L XATION 111 VEHUXES(Aftwh ACORD i01,Addh6wat Ran0rk0 fthedw.II,�....Pee�. „ ,,,�, P P ROV E D D. 1. Pray, Inc. and sny applicable project owner, including the owner?@ affiliates ENTERED IN AP TL and/or lenders, when required by written contract Or agreement, are additional insursde off all asneril, urbrella Dad auto liability policies ow a primary, Doff ?°' contributory basis. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE DP Pray THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 25 Anthony etres: : AUTHOPAL=REPRESENTAINS I Seekonk, NFL 0277L, A USA ®1985-2410 ACORD CORPORATION. AA rights reserved. ACORD 2S(2010105) The ACORD name and logo are registered marks of ACORD betsoto 22663154 x OP ID:OG ,4 E HAS BE IEAl KTI ICATE OF LIABILITY INSURANCE °"1210911 12/09/11 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 HOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed: If SUBROGATION IS WAIVED.subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such andorsemen s). PRODUCER 608-824-687b "TACT Allan M.Walker&Co.,Inc. 120 High Street 508-880.6066 �i�E_E■tL fA1G.ko1: P.O.Bo:.1057 EMAIL Taunton. MA 02780.0960 Terrence C.Quinn PRODUCER p�•SSSER 1 _ _ __ _ INSURERS. ( IAPPORDI11600VER_AGE __NAICP '"'r"uD SS Service Corp. INSURERA:Arbella Protection Ins.Co. .41360 30 Robert W Boyden Unit A100 INSURER s:Safety indemnity Compaq V33618 Taunton,MA 02780 INSUR£RC: — _ INSURERD: i... INSURER E: IN R RF: 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 umns 6ekEJlAIUAStUTM EACHOCCURRENCE S 1,000,00 A ROMO X COMmERCVLGENERALLIABILITY X 8600034342 07120/11 07/20/12 -PREMISES Ea u $ 300,00 CIAWSIdADE Q OCCUR MEDEXv one $ 5,00 PERSONAL49 iWURY S 1,000,00 f GENERAL AGGREGATE S. 2,000,00 GERI AGGREGATE LIMIT APPUES PER PRODUCTS•COMP/OP AGG 5 2.000,00 POLICY PR4 LOC - S AUTOMOBILE LIABILITY X - - COMBINED SINGLE LIMIT S 1,000,0 B ANY AUTO ;2398694 05108/11 05/08/12 (Es awd_4 t10DILYIPIJURY(Prperson) S ALLOWNEOAUTQS I 60DtLY INJURY(per <)ocodw S X SCNFOULEpAUT05 ` PROPa:RTYDAMAGE S X HIREOAUTOS (Pracdeent) x NDNCWNEDAUT06 REVIEWED, APPROVED, S ENTERED]IN AP TL 5 uMaRILLA UAe OCCUR EACHOCCURRENCE- S E1tCE35LIA8 CWMSMAOE ..I AGGREGATE $ OEDUGUOLE z.r S RETFN f f S WORKERSCONIPENSATION WCSTA OTH AND EMPLOYERS'UASIIJTY '_ A ANY PROPRIETORIPARTNERRXECtmVE YIN 00636b0910 09/06/11 09106l12. f L EACk ACCIDENT s 1,000,0 OtiICERIMEMBER EXCLUOEW M I A (F4ndatorybNk) E.L.DISEASE-EA EMPLOYEE S 1,000,00 r rs MON OFF E L OISEA5E•POLICY UMrT S 1,000100 DESCRIPTION OF RATIONS DESCRPTION OP OPERATIONSILOCATIOf1S1 VEMCLBS IAluehACORD tee.Ad&tloniU R*marks SehaduN.Ir mare space is taqulrsdl Heat/Air Conditioning. D.F.Pray,Inc.and any applicable project owner, including the owner's affiliates andfor lenders,whon required by written contract or agreement,are additional Insureds on the general liability policy on a nmary, non-contributory basis and are aditional insured's 161111 CERTIFICAT OLDER CANCELLATI N OFPRAYI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN OF Pray ACCORDANCE WITH THE POLICY PROVISIONS. 26 Anthony.St AUTROAIZEDREPRESENTATIVE Seekonk,MA 02771 Terrence C.Quinn �;_ l 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 2512009109) The ACORD name and logo are registered marks of ACORD A� 1 '�E&ATI`� ATE OF LIABILITY INSURANCE . '"" 10:C6;1 t THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO R°GHTS UPON THE CERTIFICATE FEDERATED MUTUAL INSURANCE COMPANY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Home Office: P.O. Box 328 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. I OwaPhone:l:c'i, 8- 55060 494 COMPANIES AFFORDING COVERAGE I Phone: t-888-333-44t9 ,. I C(::.!••At.- FEDERATED WTUAl INSURANCE C0P41A\Y CH A t'I_UERATED SERVICF INSI IRANC=CO11PANY PAUL FOLEY r CO ELL 1 r�i U PO BOX MIUDLF90R{ 0I'.1A 02s:i8 C --...D _ - __............. ..,....._...... -!:Is i:; ;,. :i.i.ETI Y Ir!. •11 1 !!r,- .� ...... • ..� '7 rS':� L1 L.'..\?,... .L^,TF:i7 i;EE.!)1'JriJ,I'��!•E�: I;SIJc1) .:) :h;t'. q ' 'VCiCA ,hQi'•:!T!I.•'ihtl)itG •.r.}'ki:::IfIK"\.I! :c:�• ,, J.C:: 7:.t,! L •.", !:S•t r':iU{, !'L�+;C!:) -rFf{ir1f:AT, L1 ' `)!t NiP:iJV C)F l.fiY 1�prtT il;,C! 'i4.•i)IHE:R Dot 1MP,i b• rS 1 I. 1 , �?(C:1!"!' r A! :', I':$U'�Ai ,,, til i•l)I?JLO L'Y 7H�� ?UUL:Ca JE.:=t:RIEJ!i; HFH::n' „ �!'i�=C' i v'ti' !-h:.,,:'J i AND :I).`2,;1T"M.:i L)i ,;l)':Y:i'::L :II:S �?:7 i'.' :` ';i.)1):Y VIA' _l CG:)CC:2.Y i'AI'L-: :.Jf: CCN R , i :O TY!'i U!:NSL:F,ANCL POI ICY$WCOM •PotICY FXPIP.ATION l.A P"C::v tit;M11L'3 DATF!IAM.M'YY7 OIITF tN!M,C:)!YY; 'fdtlS , i :LNLitA.IIt.91:ITY •—— - --- 2.000.000 A .:.:r: ... X g252521 2,000.000 03.J15?11 03/15i 12 1.000.000 I I 1 50.000 ! ACTOMOIS:I!::AO:::'Y - '-• _._... .. , `, .. .. 1 X . . d 1:,. 1.000.GC0 A 0115:it 03115 12 REVIEWED, APPROSVED "' ENTERED', IN AP TL £: ---------------• --- ,•!.,\.. .. Y 1 iLKCLSS OAOILI:Y . 'OCR%IM C0M PtNSA!:(Jr:AND _ •LYI-wYLH5•I IAIT1117Y /� A y2 252- 03 1$,11 i 03:1 [I . 1 SCO.OGO 5!;2 00.00 0 500.000 I - I CAI SI::GP::UN Of:ia71.t;:CNS!10L'.::1C.`:S•:'t!t;C�,S.'SPi CI;•1 ITf'61 - � � ••_..--.._ SEE t ATTACHED:DESCRIPTIONS i SEF Al TACHl7)1' GC i 1 CERTIFICATE HOLDER CANCELLATION DF PRAY !NV . I � SHOULL) ANY 01 111L A90VL.t'.SINOw 11 I.011C11s .,I' � NCf I:'!T SFF7nT TII° t 25 ANTHONY ST' I eXFINATION ::ATE ;HFr..FOt, te, •5S0:l:O L•UN.PArjy Y.aL tCnt:v<J r_ %-Af. SEEKONK MA 027-11 I 30 WA'T-.FN:NCTICF TO 7ni CF'0IF•CA1F NAr1Fr) !(I ;lit . ,.. , 80T F:a:LIRE TO MAIL WCII :JO:!CL SI'.1t. ;,PZSJ tie 09lIGATI0\ f,F !:AN!11+Y - A%Y VW) UPON THc ::r.!P.:NY +(?. Ac;!NTS 1`A FFPP.F!C!!i ACORD 25S —� 0 ACORD CORPORATION 1988' r Message Page 1 of 1 Roma, Paul From: Shea, Sally Sent: Friday, December 16, 2011 8:17 AM To: Roma, Paul Subject: FW: Cumberland Farms- Hyannis -----Original Message----- From: Lt. Don Chase [mailto:dchase@hyannisfire.org] Sent: Thursday, December 15, 2011 6:08 PM To: bdemelo@dfpray.com Cc: Shea, Sally; Perry, Tom Subject: Cumberland Farms - Hyannis Hi, Plans all set for permitting at Building Dept. for Cumberland Farms renovation at Bearses Way and Rt 132/ lyannough Rd. Fire alarm contractor needs a permit from us for installation, $25 to Hyannis Fire Department. All fire protection systems for dispensers will remain in service during construction. Final inspections for occupancy will require testing and certification documents from both alarm and suppression companies per building code and NFPA. Be advised that'despite Cumberland's desire to remain open during construction, hazards to the public could unavoidably cease retail operations until renovation are completed. Good luck. Regards Lt. Don Chase, Jr., FPO Fire Prevention Officer Hyannis Fire Department 95 High School Rd. Ext. Hyannis, MA 02601 508-775-1300 x 106 5 12/27/2011 D 0 UE30 0 GENERAL . • December 23, 2011 x t Mr.Thomas Perry x . Building Commissioner 200 Main Street 4 z' Hyannis, MA 02601 a { Y To Mr. Pe . va_ I would like to clarify that Wayne J.Silvia currently is employed by D.F. Pray General - Contractors. He is covered under our current Workers Compensation and Employers Liability coverage and has authorization to apply for and pull permits necessary for the Cumberland Farms project located at 1165 lyannough Road Hyannis, MA02O61. q ' If you have any questions, please feel free to call intovour mainfoffice at 508=336-3366 a Respectfully submitted, „ r cott W. Pray President { Y: i Building Excellence Since 1959 25 ANTHONY STREET ( SEEKONK, MA 02771 TEL 508-33673366 �, FAX 508-33673384 WWW.DFPRAY.COM SEEK-ONK BOSTON SAN. F RAN CI'SCO _' RALEIGH NASHVILLE Nlassschusett-s- Department Of PuhliC Safety Board of Buildin, Re,ulatiuns and.Standatds Construction Supervisor License License: CS 73722 - Restricted to: 00 WAYNE J SILVIA.. 71 TWINBROOK LANE TAUNTON, MA Oz780 Expiration: 3/8/2012 E� P ('inunissiuitcr Tr#: 19376 � I Restricted to: 00 00- Unrestricted 1G-1 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Refer to: WWW.Mass.Gov/DPS i The Commonwealth of Massachusetts State Building Code Construction Control Affidavit PROJECT NO. 11126 PROJECT LOCATION: 1165 lyanough Road PROJECT NAME:Cumberland Farms Store#2348 remodel. NATURE OF PROJECT:Cumberland Farms convenience store remodel ARCHITECT AND/OR ENGINEER: JOHN A.AHARONIAN,RA ADDRESS:310 George Washington Highway,Suite 100,Smithfield,Rl 02917 TELEPHONE NO:.401.232-5010 In accordance with Section 107.6 of the Massachusetts State Building Code 8th Edition, I,JOHN A.AHARONIAN,RA Registration No.8551 being a registered professional engineer/architect,hereby certify that I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: ❑ENTIRE PROJECT V ARCHITECTURAL ❑ STRUCTURAL ❑ MECHANICAL ❑ FIRE PROTECTION ❑ ELECTRICAL ❑ OTHER For the above named project and that,to the best of my knowledge, such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all accepted engineering practices and applicable laws and ordinances for the proposed use and occupancy. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 107.6.2.2 1. Review of shop drawings,samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit,and approval for conformance to the design concept. 2. Perform the duties for registered design professionals in Chapter 17. 3. Be present at intervals appropriate to the stage of construction to become,generally familiar with the progress and quality of the work and to determine,in general, if the work is being performed in a manner consistent with the construction documents. . The permit application shall not be deemed completed until all of the construction documents required by this code have been submitted. Documentation indicating that work complies with the plans and specifications shall be provided at the completion of each phase when required by the building official. S Signatur c' W. owl Subsc bed and sworn to before me this 4rh day of November, 2011. My Commission Expires:March 16,2014 Notary Public �� 7)/ of, The.Commonwealth of Massachusetts State Building Code Construction Control Affidavit JOB NO. 11126 PROJECT LOCATION: 1165 lyanough Road PROJECT NAME:Cumberland Farms Store#2348 Remodel NATURE OF PROJECT:Convenience Store Remodel ARCHITECT-AND/OR ENGINEER: Robert Kyle Baker,PE LEED AP ADDRESS:316 Pocasset Street,Providence,RI TELEPHONE NO.:401-946.9016 In accordance with Section 107.6 of the Massachusetts State Building Code 8th Edition, 1,Robert Kyle Baker, PE LEED AP Registration No.34551 being a registered professional engineer/architect,hereby certify that I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning:. ❑ENTIRE PROJECT ❑ ARCHITECTURAL ❑ STRUCTURAL V MECHANICAL ❑ FIRE PROTECTION ❑ ELECTRICAL ❑ OTHER For the above named project and that,to the best of my knowledge,,such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code,all accepted engineering practices and applicable laws and ordinances for the proposed use and occupancy. I further certify that I shall,perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 107.6.2.2 1. Review of shop drawings,samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit,and approval for conformance to the design concept. 2. Perform the duties for registered design professionals in Chapter 17. 3. Be present at intervals appropriate to the stage of construction to become,generally familiar with the progress and quality of the work and to determine,in general, if the work is being performed in a manner consistent with the construction documents. . The permit all not be deemed completed until all of the construction documents required by this code have been submit �tDO t indicating that work complies with the plans and specifications shall be provided at the completion of each phas ensrequire uilding official. P vA ER HVA� Via.. Signature O��a Subscribed and sworn to before me this 4th day of November, 2011. My Commission Expires: March 16,2014_ Notary Public f 9r VINCEN,T.. A . . DiIOR.IO , INC . CONSL,LTING ENGINEERS 89 Access Road_Suite 1.8 Norwood 'M ass achuselts'; 02062 ELECTRICAL-DESIGN AFFIDAVIT November 4, 2011 Town of Barnstable Building Division' 200 Main Street Hyannis, MA 02601 Reference: Cumberland Farms 1165'Iyanough Road(RT 132) Hyannis, MA To whom it may concern:- I certify to the best of my knowledge and belief that the plans and specifications concerning the above mentioned project located at 1165 Iyanough`Road(RT.132) in Hyannis,MA wily be in accordance with the requirements of the Massachusetts State Building Code, the Massachusetts State Electrical Code, all applicable provisions of NFPA,--Town of Hyannis Planning Board and other pertinent laws and ordinances. FADI A.BARK 34698. ttA of M,*. ENGINEER—MA REG. NO. FADIAZLZ GN VINCENTA. DiIORIO. INC. .r •� BARK COMPANY ELECTRICAL y ,. No.3098 , o�sTEa�o 89 ACCESS ROAD NORWOOD, MA 02062 ma`s` ADDRESS A' (781) 255-9754 TELEPHONE Then the above named Fadi A. Bark made oath that.the above statements by him is true. Before me, My co ion expire % 6 0 — G ..........1� • DANA J.HENNEB.URY'' :oy 'NotaryPublip i; Ulf ' �r'' Afi Co�miss+Qn�zpites •: yP. $eplerraVar 17,2Of5 RY tel: (781) 255-9754. fax: (781) 255-9725 email: vadjr@vadeng.com MassDEP Home I Contact I Feedback I Tour I Privacy Policy MassDEP's Online Filing System Username:DFPGC Nickname:DFP i My eDEP l Forms cO My., Profile CO Help Transaction OvervieW Trans#440315 ID#100140289 AQ 06-Construction/Demolition Notification Forms Signature` Receipt Summary&Receipt Print Receipt: Ezif Your submission is complete.Thank you for using eDEP's online reporting system.Select My eDEP to see a.list of your transactions.Click Print Receipt to save a copy of this receipt for your records.. DEP Transaction ID:440315 Date and Time Submitted: 12/23/2011 11:19:48 AM Other Email Form Name:AQ 06-Construction/Demolition Notification j .. Payment Information DEP code:61721 Date: 12/23/2011 11:17:47 AM Amount($):85 Payment Detail:REDDEN ANDREW—AccountType AccountNumber****6777 ConfirmationNumber. Contractor µ , Contractor Number Name Address, , Supervisor Project Monitor ty . Lab MassDEP Home I Contact I Feedback I Tour I Privacy Policy MassDEP's Online Filing System.ver.11:2.6.1'@ 201,1 MassDEP - Massachusetts Department of Environmental Protection, L� ureau of Waste Prevention •Air Quality 100140289 � BWP AQ 06 Decal Number Notification Prior to Construction or Demolition Important` A. Applicability When filling out PP tY forms on the computer,use only the tab key A Construction or Demolition operation of an industrial,commercial,or institutional building,or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection cursor-do not use the return (DEP), Bureau of Waste Prevention-Air Quality Control Regulations 310 CMR 7.09. Notification of key. Construction or Demolition operations is required under 310 CMR 7.09(2)ten(10)days prior to any work being performed.The following information is required pursuant to 310 CMR 7.09. 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 0 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 CUMBERLAND FARMS Environmental Protection a.Name notification 1165 IYANNOUGH ROAD requirements of b.Address 310 CMR 7.09 H annis MA 02061 c.Ci /Town d S ate e.Zip-Code 5087907118 f.Tele hone Number area code and extension .E-mail Address(optional) 3187 1 h.Size of Facility in Square Feet i.Number of Floors j.Was the facility built prior to 1980? ❑ Yes ❑✓ No k. Describe the current or prior use of the facility: , CONVENIENT STORE FGAS STATION. I. Is the facility a residential facility? ❑ Yes ❑✓ No =o m. If yes, how many units? Number of units 3. Facility Owner. �N CUMBERLAND FARMS,INC. �o a.Name �p 100 CROSSING BOULEVARD b.Address FRAMINGHAM IMA I 01702 -co c.Citvrrown e,ZiaCode O 5082704488 f.Tele hone Number area code and extension E-mail Address o ti nal CHRIS OGONOWSKI �Q h.Onsite Manager Name ag06.doc•10/02 BWP AQ 06•Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Waste Prevention •Air Quality 1100140289 f BWP AQ 06 Decal Number Notification Prior to Construction or Demolition General Statement.lf j p B. General Project Description Cont. � asbestos is found during a 4. .General Contractor: Construction or Demolition D.F. PRAY GENERAL CONTRACTORS operation,all responsible parties a.Name must comply with 25 ANTHONY STREET 310 CMR 7.00, b.Address erg and Chapter 21 E of the SEEKONK MA 02771 General Laws of c.Citvrrown d.State e.Zig Code the Commonwealth. 15083363366 1 lahedden@dfpray.com This would include, f.Telephone Number area code and extension .E-mail Address o tional but would not be limited to,filing an JANDREW HEDDEN 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. JADVANCED BUILDING SYSTEMS,INC. a.Name 97 SHANNON ROAD b.Address SALEM 103079 c.Citvrrown d.State e.Zip Code 6038930380 f.Telephone Number area code and extension g.E-mail Address(optional) WILLIAM SHEA h.On-site Manager Name 2. On-Site Supervisor: WILLIAM SHEA On-Site Supervisor Name 3. Is the entire facility to be demolished? ® Yes ✓J No �N �0 4. Describe the area(s)to be demolished: �o SELECTIVE INTERIOR DEMOLITION OF STORE. �N Oo _0 5. If this is a construction project,describe the building(s)or addition(s)to be constructed: INTERIOR REMODEL OF EXISTING&OPERATIONAL STORE. c0 �o �Q ag06.doc•10/0.2 BWP AQ 06•Page 2 of 3 I Massachusetts Department of Environmental Protection ■ Bureau of Waste Prevention •Air Quality 1100140289 �} 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? ARCADIS U.S., INC. / JOEL LYMNEOS b.Survevor Name A1000236 c.Division of Occupational Safety Certification Number 7. Construction or Demolition- 1/30/2012 1 2/26/2012 a.Start Date(mmlddlyyyy) b.End Date(mm/ddlyyyy) 8. a. For demolition and construction projects,indicate dust suppression techniques to be used: . ❑ seeding ❑ paving b. other, peases specify: ,❑ wetting ❑ shrouding If l p fy: ❑ covering ❑✓ other HEPA FILTER AS REQUIRED 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 1 certify that I have examined the ANDREW HEDDEN -oa above and that to the best of my a.Print Name _oknowledge it is true and complete. Andrew Hedden The signature below subjects the b.Authorized signature _N signer to the general statutes . JASSISTAND PROJECT MANAGER =o regarding a false and misleading c.Posnionrritle �o statement(s): D.F. PRAY GENERAL CONTRACTORS d.Representing 12/23/2011 -(D e.Date(mm/dd/yyyy) �d ■ ag06.doc•10/02 BWP AQ 06•Page 3 of 3 To of B astable Regubtory Serum F Biding DivWon Tom Perry,Building Commissioner 200 Man Stu!t,Hymfls,MA 02601 Www.town.barm t$bl&mmus Cffice: 548-862-403 8 F= 50&79(?-Q330 Property der Must Complete and Sign This Section if Usffig A Builder John Daly, Assistant Treasurer of Cumberland Farms, Inc. as Oet of the subjea P .p=tY hzrebyauthoaze D.F. Pray, Inc. to att on say behA is as inatbets reia#zve to Work azrthatized by this bw1ding pe=iL 1165 Iyanough Road, Route 132 (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled before fence is installed and pools are not.to be utilized until all final inspections are performed as Ld accepted. CUMBERLAND FARMS, INC. By. % n -- e E i of Owner o PP Print Name Pant Name December 19, 2011 Date Q:FORNtS. ' The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 1 of 2 The Commonwealth of Massachusetts William Francis Galvin , �i Secretary of the Commonwealth, Corporations Division X I' One Ashburton Place, 17th floor. Boston,MA 02108-1512 J`r �ti;i Telephone: (617)727-9640 CUMBERLAND FARMS, INC. Summary Screen Help with this form . Request a Certrficate;r_ The exact name of the Foreign Corporation: CUMBERLAND FARMS, INC. Merged with FIRELINE PETROLEUM, INC. on 5/30/1986 Entity Type: Foreign Corporation Identification Number: 042843586 Old Federal Employer Identification Number(Old FEIN): 000111712 Date of Registration in Massachusetts: 09/19/1984 Theis organized under the laws of: State: DE Country: USA on: 09/14/1984 Current Fiscal Month/Day: 09/30 a Previous Fiscal Month/Day:00/00 The location of its principal office: No. and Street: 100 CROSSING BOULEVARD City or Town: FRAMINGHAM State: MA Zip: 01702 Country:USA The location of its Massachusetts office, if any: No. and Street: City or Town: fi State: Zip: Country: Name and address of the Registered Agent Name: C T CORPORATION SYSTEM No. and Street: 155 FEDERAL STREET STE 700 City or Town: BOSTON State:MA Zip: 02110 Country: USA The officers and all of the directors of the corporation: Title Individual Name Address(no PO Box) Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term PRESIDENT JOSEPH H.PETROWSKI 66 ARNOLD ROAD WELLESLEY,MA 02481 USA TREASURER HOWARD S.ROSENSTEIN 67 FLAGG ROAD SOUTHBOROUGH,MA 01772 USA SECRETARY MARK G.HOWARD 15 GREYLOCK ROAD WELLESLEY,MA 02481 USA s http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... 12/19/2011 The Commonwealth of Massachusetts William Francis Galvin- Public Browse and;Search Page 2 of 2 CEO JOSEPH H.PETROWSKI 66 ARNOLD ROAD WELLESLEY,MA 02481 USA CFO HOWARD S.ROSENSTEIN 67 FLAGG ROAD SOUTHBOROUGH,MA 01772 USA DIRECTOR AND CHAIRMAN OF THE LILY H.,BENTAS 3 BATTERY WHARF BOARD BOSTON,MA 02109 USA ASSISTANT TREASURER JOHN DALY 22 THOMAS ROAD BERKELEY,MA 02779 USA business entity stock is publicly traded: The total number of shares and par value, if any,of.each class of stock which the business entity is authorized to issue: Par Value Per Share Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding Num of Shares Total Par Value Num of Shares CWP $1.00000 200,000 $200,000.00 121,014 CWP $1.00000 8 $8.00 8 Consent _ Manufacturer _ Confidential Data Does Not Require Annual Report Partnership Resident Agent _ For Profit Merger Allowed Note:There is additional information located in the cardfile that is not available on the system. Select a type of filing from below to view this business entity filings: ALL FILINGS ' Amended Foreign Corporations Certificate I Annual Report Annual Report-Professional - Application for Reinstatement , - * View Fllmg NewRSearch - Comments O 2001-2011 Commonwealth of Massachusetts All Rights Reserved Help http J/cotp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... 12/19/2011 PROJECT NAME d dam. rs+� C, � PERMIT# 4D O 1 l O-)1 3 PERMIT DATE: l z,'Q-7 ].I ( . M/P: � 3 LARGE ROLLED PLANS ARE IT: SLOT Data entered in MAPS program on: t 136 - BY: a- �HE Signv 4k TOWN OF BARNSTABLE Permit BARNSTABLE. # Permit Number: Application Ref: 201105758 20070665 Issue Date: 10/14/11 Applicant: Proposed Use: FUEL SERVICE AREAS Permit Type: SIGN PERMIT Permit Fee.$ 50.00 Location 1165 IYANNOUGH ROAD/RTE132 Map Parcel . 273082 Town HYANNIS R Zoning District SPLT Contractor PROPERTY OWNER Remarks 39 SQ SIGN REFACE CUMBERLAND FARMS Owner: CUMBERLAND FARMS, INC. Address: 100 CROSSING BLVD FRAMINGHAM, MA 01702 Issued By: 1?O TS �Al2D SCE TEAT YS �TTBY. '11;+D1VI` ` E 'ST I w I T a —J I m I o I m ao o I I O X U1 0 I x o w m I 4 B Sign 1 X rt TOW_ OF BARNSTABLE Permit m N sa7a - Partli lVam6ar. w w I I —- h o APPBcatlon ReE 201105758 - . 20070665 Issue Date: .10/l4l11 I v, li—t: - . Proposed Use: 'FUEL SERVICE AREAS Permit Type: SIGN PERMIT - I I . - Permit Fee S 50.00 Location 1165IYANNOUGHROAD/RTE132 I 1 n 1 0 Map Parcel 273082 I I Town HYANMS Zoning District SPLT mm I I Contractor PROPERTY OWNER Remarks 39 SQ SIGN REFACE CUMEERi 4ND FARMS z m I I Owner: CLIMB ERLAND FARMS,INC. I I o Address: 100 CROSSING BLVD FRAMINGHAM,MA 01702 • Wuee HY n I I -1� o gIItI 1 �a's�fr 'f(�r` �' m I 7c I m . 0 L. I I - 1 . PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET s'. HYANNIS, MA 02601 I DATE: 10/14/11 TIME: 14:54 ------TOTALS $ PAID 50.00 • r AMT TENDERED: 50.00 AMT APPLIED: 50.00 CHANGE: .00 r APPLICATION NUMBER: M PAYMENT METH: CHECK PAYMENT REF: 1738 * .�n Sign1 ° Permit * �SrABIX. ; TOWN OF BARNSTABLE MASS 6 s 9. A� Permit Number: Application Ref: 201105758 20070665 Issue Date: 10/14/11 Applicant: Proposed Use: FUEL SERVICE AREAS Permit Type: SIGN PERMIT Permit Fee $ 50.00 Location 1165 IYANNOUGH ROAD/RTE132 Map Parcel 273082 Town HYANNIS —' Zoning District SPLT Contractor PROPERTY OWNER Remarks 39 SQ SIGN REFACE CUMBERLAND FARMS Owner: CUMBERLAND FARMS,.INC. Address: 100 CROSSING BLVD FRAMINGHAM, MA 01702 Issued By: . POST THIS CARD SO`THAT IS VISIBLE FROM THE S , REST - Curt) 6S �CAROLYN A::PARKER CONSULTING o5 oa �73$ �3 LORION AVENUE 53 7102/2113 .WORCESTER MA 01606 f / eRnNcr+2 r DATE ' tTOTHE- ORD ROF �. � . ; DOLLARS ti . fir Savm s Bank' 1: 21 L37YL0,231:0.7~60736333u■ ----- � 7?3 J Town of Barnstable Regulatory.Services ` 'WR"�AEM ' Thomas F.Geiler,Director 1639. 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 e Permit# Building Official approving Application for Sign Permit ry Applicant C-19ieOZY/V Assessors No. Doing Business As: adlVe,46"D /�� ?J�elephone No. Sign cation i /(O�5-/W y re /V Zoning District: Old Kings Highway? Yes/No Hyannis Historic District? Yese Property Owner Name:_WdVBAF e L49/1D Telephone: 0 Address: _ Sign Contractor " aw4 / Name: �y •Z) s5o0e lICZ6 Telephone: 134. J 0 `Sze C) Mailing Address: Y91®• (� ��_ ti�'T/� i� ✓ c Description r Please follow the cover directions.You must have an accurate rendition of sign with dime sions anal' location. l ,. Is the sign to be electrified? &NO (Note.Ifyes,a witiugpernutisregwred) Width of building face &x 10= x.10= Check one Reface existing sign or New Total Sq.Ft of proposed sign(s) y Ifyou have additional signs please attach a sheet listing each one with dimerisiorls If refacing an existing sign please provide a picture of the existing sign with dimensions. I hereby certify-that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of , §240-59 through§240-89 of the Town iarnsta a Zoning O inan e. n. Signature of Owner/Authorized Agen Date SIGNS/SIGNREQU . .. revised12110 ® � co yr7� d 4 cn � I Q � f"5 - W Q Q w V' z z Q J U-i CD (D w '—' - CC C m C/) O r J CD 0 CIDLS) CC C) Q O7 C-) LLJLLJ �, z Cn Cl) f-- Qo O C/� W� J z a- C) Q � z � ,CO O 0- CD Q O X J ' = U-) CC W �— (D J O CC W CD CC W 0- C-) Y W X C:) CV C 3 1= CC CC m W C3QJ W w C) J -I , Q Q W J Z CWC CD a U� Z coyw � z LJJ U-i � O Cl- W _ O 7 _ Q Q > J X =D d Lc CE z —1 >> CL ' X. CC m. W O CV UD _0- — m > O W CD -- - -- ------------------ ----------- - J o o -, Qc o Op . a C� �I 110-,Z 110-10[ "SIGN SPECIFICATION&CUT-SHEET" a M1 24�� cn 61-011 211 1 611 2„ W M TRANSLUCENT BACKGROUND NON-ILLUMINATED ( Z Pole) ,.. BLUE:3M#3630-97 WHITE COPY TRANSLUCENT WHITE COPY 211 — - ca EXHAUST VENTS - o 2�� DO NOT BLOCK 5" - - - �� --- - -- U 911 w O Z c ' III Q+ o � — ci 0 u 2 1/2"CONDUIT 4-0 NIPPLE,CABLE 8 2 3211 PASS THROUGH . 34" 2903 DELTA DRIVE COLo_D0 SPRINGS, CO 90910-1012 - - 392392.9048 ❑ 9,, eoo-�sa-soar 5„ REMOVABLE U FACE RETAINERS m o W> Wlr• 0 0'g 32"CHANGEABLE NUMERALS _ J W N 0 CABINET PAINTED TRANSLUCENT WHITE COPY }o - 13 w "MAP WHITE" OPAQUE BLUE(363D-97)BKGND a Z U U F - YQ FALL¢ w = In 0 M T 0�LL A% PROPOSAL DRAWING SPECIFICATIONS 2 gg li DRAWING NUMBER:CUMB2203-040711-01 REV. A gs REVISION DATE: 04/08/201.1 8 =' Flourescent Interior Illumination: - Q 1 9 T-12-800 H.O.-F42T12/CW/HO,qty 6 a CATALOG NUMBER: PCS-32SPDFITG a o r 06 Magnetic Ballast: snusTso N m 348 DR,qty 2 ELECrRic `i� `8� >a Input Voltage:120 VAC SIGNS APPROVED: DATE: E o 9 >;€ TOTAL=3 Amps . m SIGN TOLERANCES: +1/8 -1/2 CONFoRMsrouLSTD48 awes �;� --:�!�-%� - . I , �. I I I ,. " --. ,. , , .1 - - - . - 1�11 '� - . 1. I . ,, . : '*� -z.;,,,�� - I� �- I..,- .. I ..., � . � , . , � I . " �,�, �I,�'.1. .. I ��f�J�-. ' 4 e ---.I--,-��-'I-.-. -.---.,I-�I.I.,----."I,--�.-I�--.-��I I..�-,II-1II 1I.I..I1.,I:-��I.. . -..I I 1-.I�.�.1�.�.....I�'.II,..�I��'...1,I.:.:I II..I.,,I I..I,...I I I.-...I1:I�,��,�I�I .I I-��I-I II-I�,I�I�I�..1.I 1 ..��II I.-I,..�:.�.I.1.,�I:: I...I.-�-�I I::�'�.I1I..-�,,..:...,.-.%*,..�-I,,��.��:I,..��1 1-..1.I,.�..�I,-..:.I',0-�-.�'',:,,,�-�K--,-''-I"--''�-..'.;�.��,-,I�:I�.�.�-..;�.-...':-;."..-,.;i.�..,e��I.,-,':",,�;.�-,!.�4,,'..-,-'.1-�";�:-''!...1-,.I.-�1-"��.,1.-".-�,"!.'I-��:�,�F.—,.��.'(';-,,--,�-'.��...:,"--,-..,'.,�.:-�;�'�",�;�,,..�.:...�,,.."�,.��'�S',�...-';',,-,�.�.i.�,:�--,�,,,:'.-.'..�..�.�:..,:..,.�--�,... n I. .�I Skyline Products°Electronic Price Displays °.-Installation Guide': �I I�.I I- I;:�I.�'�--�:II...-,.--.':�I..�.I��..��,I.:I''.,��-::. .�.7-.,.��.�.':�.��-I II Prepare the Sign for Operation G Price Modules Verify that the film'in each`.module is still positioned in the film guides. Ensure that.f lin hasn't, been bumped or pushed out of the`track,durm" shipping`and installation For propel .operation, ,.the,film must be in;the film guide,tracks located at the.top and bottom of each module. Price a- II modules are easily removed from the sign frame by pushing up grid theri:pullmg outward -. . I. �- i k ` »g .. 1 - I-' Upper Fdm Guide N , Y Price ModuiII/e'< I Onside view)' E I Y $ ,l Lower FiIm:Gwde f= ., . _,. . ,,: . . :. -4. ;: ¢ t Shipping Blocks` f t Signs built with. 66" and _91" digits arer assembled with a shipping: I blocks) located at the bottom of th"module chassis Shipping`blocks , 1 �r rialiec 4 rrr - w .ric_�F rF ,.. help prevent module movement or damage ta: the film and roller1 ' 7 j L r _n: assemblies while in transit r f Shipping Block f: Ensure;to remove all shipping blocks m 66"or 91"rnodutes. Shipping blocks on the modules ale tagged with warning labels.;Additional,warningsFare als6,prommently posted.on the exterior'of the sign cabinet y t ,.: Important SHIPPING BLOCKS MUST BE REMOVED.BEFORE OPERATING THE SIGN Serious-damage can occur to the modules i blocks are not removed before ' s operatron;and the sign warranty will be voided , ~� Y t �_ ' 4 ,:d 4 k - E- '1 ,, s ?. This docu Went and the drawings contained herein contain propnetary information ezdusn a to Skyline Products I rc and shall not be used,reproduced coped ` {� a- , drsdosed or exhilbted m whole or in part for manufacture,procurement,or for any'other.purpose except as specificalry authonzed;by Slrylme Products Inc'- y u t Copyright©2009 Skyline ProtluctS Inc = Page .ti j f _ h t xYF a C 3 sk, .. i .. .. .,. - -. f i4 © CERTIFICATE OF LIABILITY INSURANCE 5DATE(MWDDNYYY) /6/20 11 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, O(TEND 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 poliicy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the berms 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 NSACT Audrey Hartley . Coakley Pierpan. Dolan S Collins Insurance PNONED. (413)669-9366 FAx Ne.(413)664-6W4 26 Union Street = .ahartley@cpd=nsurance.com PRO CUSnucEie IDVDO003271 North Adams MA 01247 INSURER(S)AFFORMNGCOVERAGE NAICS INSURED INSURERADhio Casualtv Grow 24082 INSUIMRs:Travelers Indemnity Co of CT 256132 M&D Services Inc iNsuReFtc;American Fire And Casualty Co. 24066 PO Box 702 TNSUF"0: -INSURER E Lanesboro MA 01237 INSURERF ---_ COVERAGES CERIIFICATENUM13EP-11-12 BOP,ADTO,WC,UM 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. IL SR TYPE OF INSURANCE A POLICY NUMBER POLICY EIT POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X C0 MA6ERCIAL GENERAL LIABILITY PR MfSEg1Ee._a E 100,000 A CLAIMS4AADE 5x_1 OCCUR BKO52096646 /19/2011 /19/2012 MED EXP(My one persm) $ 5,000 PERSONAL&AOV INJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 GENt AGGREGATE WIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 PO X1 POLICY F JrC 1-1 LOC $ AU DMOBUE LIABILITY .. . COMBINED SINGLE LIMIT (Ee aft) S 1,000,000 ANY AUTO ` B ALL OWNED AUTOS aA1934dA2 /1/2011 /1/2012 BODILY INJURY(Perpwmm) $ X SCHEDULED AUTOS BODILY INJURY(Per aw del) $ . . .PROPERTY DAMAGE $ HIRED AUTOS {Pefaoctdel X NON-OWNEDAUTOS Medcalpaymem5 $ 5,000 uruns ea matmw B soft big $ 100,000 X UMMIELLA LIAR OCCUR EACH OCCURRENCE $ 1,000,000 EXCESSLUIB HCLAIM"ADE " AGGREGATE. S 1,000,000 DEDUCTIBLE- $ A X RETENTION S 10,000 US052995646 /19/2011 /19/2012 $ WORKERS COMPENSATION N TALI.TU OTH C X AND EMPLOYERS'LIABILITY Y I N 1TS . ANY PROPRIErORIPARTNERIFXECUTIVE a NIA E.I.,EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? 995fi46 /19/2011 /10/2012 (Mandatory ct NH) E.L DISEASE-EA EMPLOYE4 S 500 000 !f yyEess.desmbe under MDESCRIPTION OF OPERATIONS below f E.L.DISEASE-POLICY LIMIT I$ 506,00 l ' DESCRIPTION OFOPERATIONS!LOCATIONS/VEHICLES(Attach ACORD 101,AddWanalRemarksShcetlWp-irmore space isrequired) The certlficateholder it listed as an additional insured with respects to General Liability when required by-written contract or agreement, waiver of subrogation included CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE- DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE .. . Audrey Hartley/ADDHAR ACOM 25(2009/09) 019W2009 ACORD CORPORATION. AU rights reserved. INS02S(2oom) The ACORD name and logo are registered:marks of ACORD Cuer[and G a 1f. a= A R gut s July 15, 2010 To Whom It May Concern: Cumberland Farms, Inc., with a usual place of business in Framingham, Massachusetts, does hereby authorize CAROLYN A. PARKER CONSULTING to apply for and represent Cumberland Farms, Inc. in filing of any applications for required permits andlor approvals for the LED PRICE PANELS at our store/self-service gas station including, but not limited to, appearing before any governmental agency at general meetings or public hearing addressing such construction/improvement of Cumberland Farms retail facilities. Cumberland Farms Gulf Group of Companies, Manny Paiva Planning Department Manager COMMONWEALTH OF MASSACHUSETTS MIDDLESEX COUNTY Subscribed and sworn to before me this V5 h day of July 2010 by Manny Paiva who is personally known to me. MAURE DICKSON kt� WMry Pu4Nc t. , ►k OF wssAc►auAEr,s Notary Pub li�0V "'' rch 2 EApuee My Commission Expires: .2013 Cumberland Gulf Group of Companies 100 Crossing Boulevard,Fran Ingham,MA 01702 50R-270-1400 r • CAROLYN Qo PARKER September 19,2011 Town of Barnstable 200 Main Street Hyannis,MA 02601 Attn: Mr.Thomas Perry Cumberland Farms Building Commissioner V 1284 1171 Route 132 Hyannis,MA 02601 Delivery: Regular mail Dear Mr.Perry, Enclosed please find(1)one Application for a Sign Permit,(1)one photo of the existing pylon sign with scope,(1)one drawing of the existing sign with dimensions and(1)one detail of the Scroller price panel by Skyline Products for the proposed pylon modifications for the sign located at 140 Main Street, Great Barrington,MA . Cumberland Farms,the owner of the property wishes to remove the 4'x 6' price sign,relocate the 2'-6"x 6'-0"Cumberland Farms panel to the top position, install a new 4' x 6' "Scroller"style price changer. The footings, location and square footage of the pylon sign will remain the same as will.the internal illumination. The contractor for the project is M&D Services,Inc., 5 B West View Road,Pittsfield,MA a copy of their Worker's Compensation Insurance is enclosed.Also enclosed please find an Agent for Owner Authorization letter allowing me to obtain the permits on behalf of Cumberland Farms,the owner.An electrical permit will be obtained by a licensed electrician prior to the"Scroller"price panel installation. Lastly,I have enclosed check# 1738 in the amount of$50.00 for the permit fee.Please review the enclosed permit package and if you find everything is in order please return the permits to me in the enclosed self-addressed stamped envelope.If you have any questions or require additional information please call me at(774)239-2781.Thank you in advance for your time in helping to expedite this matter. ? CJ Sincerely, Carolyn A.Parker Cc: Cumberland Farms File N W M SPECIALIZING IN THE PETROLEUM INDUSTRY Project Management,Permit Expediting,Drafting&Fire Suppression Plans 3 Lotion Avenue,Worcester, MA 01606 • Tel: 508-853-1167 • Fax: 568-853-1176 • Cell: 774-239-2781 • capconsulting@verizon.net TOWN OF BARNSTABLE SIGN PERMIT PARCEL ID 273 082 GEOBASE ID 18389 ADDRESS 1157 IYANNOUGH ROAD/ROUTE PHONE HYANNIS ZIP - LOT LT 1 26 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY ';A 124 DESCRIPI ' 'T" ARMS 9 X 7 RECEIPT #6088 TITLE ". ICONTRACTORS: ` Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $50.00 BOND $_00 �Tl1E CONSTRUCTION COSTS $.00 753 MISC. NOT. CODED ELSEWHERE * HARNSTABLE, + MASS. 4639. Ep Mr►l � ' BUI DIN DIVIShON i BY �E�t-t rc /// • /jam Z/✓moo k DATE ISSUED 02/15/2002 EXPIRATION DATE - j SIGN PERMIT PARCEL ID 273 082 GEOBASE ID 18389 ADDRESS 1157 IYANNOUGH ROAD/ROUTE PHONE HYANNIS ZIP - LOT LT 1 26 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY �n `Tm , i ''5 DESCRIPTIOP r " 25 SQ FT RECEIPT #6088 ';N TITLE CONTRACTORS: Department of Health, Safety A . HITECTS: and Environmental Services fd-TAL FEES: $25.00 BOND $.00 pXI CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE + * BARNSTABLE, # MA88. 1639. Eo� r BUILDING DIVISION / BY DATE ISSUED 02/15/2002 EXPIRATION DATE TOWN OF BARNSTABLE r SIGN PERMIT I -q ' PARCEL ID 273 082 GEOBASE ID 18389 ( ADDRESS 1157 IYANNOUGH ROAD/ROUTE PHONE y HYANNIS ZIP - LOT LT 1 26 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 59126 DESCRIPTION CUMBERLAND FARMS16.52 SQ FT RECEIPT #6088 PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $25.00 BOND tME .00 CONSTRUCTION COSTS $.00 �T Qi► 753 MISC. NOT CODED ELSEWHERE * BARNSTABLE, MASS. �► 039. A1� ED M1r►I i BUILDI Iff DIVISION DATE ISSUED 02/15/2002 EXPIRATION DATE i F46� nd G Ulf. Fauns,:, David Audette Construction Supervisor Cumberland Farms,Inca 348 Aliens Avenue,Providence, RI 02905 Phone:401-781-1730 or 800-524-1701 Ext.4331 Fax: 401-941-2822 ' Mobile Phone:. 401-486-0402 .� .i_ � � ' _I 4 v - % � zS- `y . A\ Town of Barnstable r TME F T • � ! �� Regulatory Services nP �� • � Thomas F.Geiler,Director aniuvsrnece. MASS. g, Building Division �1Dtp1 39. Peter F.DiMatteo, Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-110-6230 Tax Collector O Treasurer Application for Sign Permit , Applicant: C't1 y�/�c�G�� '►S Assessors No. Doing Business As: C1ym( [4�� 12rrms Telephone No. ?')D 2-Z5-'7702 Sign Location i �132-) Street/Road: �� No Gd /La �zGoI r, Zonin District: �� Old Kings Highway? Yes; o Hyannis Historic District? Ye Propert Own y_ —9'70`Z N . �S �=��'`��am t, ��A1 rnS Telephone: S"0 Address: 7�"J �l �� S� Village: ( j,�i0� /I/PT C)aG2� Sign Contractor ►'n6 Name: Od E cJ 7�) jr�,Y2 O-S Telephone: W I .5-2%`/lo Address:3V6 lui LDS i9 Village: AW 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/No (Note:If yes, a wiring permit is required) I hereby certify that I am the owner or that I have the authority of the owner to make this application,that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinance. Signature of Owner/Authorized gent:zl�izt �_4� - Date: /� Dt c '21 fi Size: t1OM12'ILL 9 i" rg/ZInS 1 r7 4S Permit Fee: ►�G Sign Permit was approved: Disapproved: Signature of Building Offi ial: c � Date: Sign 1.dbc rev.8/31/98 SEP-27-2001 16:36 FROM MURPHY & MURPHY TO 1781B215723 ;;P. 10 Town of Barnstable Regulatory Services / 5 5�Thomas F. t;eiler,Director m" S. ' Building Division 591 Peter F.DiMatteo, Building Commissioner 367 Main Street. Hyannis.MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Tax. CollecEor V ' Treasurer Application for Sign Permit Applicant: Sm��-\cam Assessors No. Doing Business As-.0fk=es-\rWA �c,c-,r am ,�r� Telephone No.1$\ -Aqm Sign Location Street/Road: G; Z District: i� C� Old Kings Highway? Yeses Hyannis Historic District? Yes)to) propert�-=Lan Name: c\ ��.rm� �rc Telephone:�1 Address: 'Lr1�l ��'A1�A�^ -_ Village: CC Sign Contractor Name: � c �rr1rn� ��e�*M. ��rC;. Telephone:-l5�\-R -� Address:rlrlil nP� `� Village:0 C `(�l'�0 Q i Q'.:. 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? q o (Note:If yes, a toiring permit is required) \a•c� S� CEO I hereby certify that I am the ownerroornthat I havethe authority of the owner to make this application,that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinance. Signature of Owner/Authorized Agent: /C� Date: Out\611-9 %\Co 5•(95 Ste. Size:,,; ____Permit Fee: Sign Permit was approved: Disapproved: Signature of Building Offic' ate: Sign 1.dnr rev.W 1198 TOTAL P. 10 SEP 27 2001 17:40 5087753720 PAGE. 10 Town of Barnstable of IHE o Regulatory Services. / (T � e Thomas F. Geiler,Director an i.E MASS. Building Division 9 Mass. $' . i639. �m Peter F. DiMatteo, Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Tax Collector `--b' Treasurer Application for Sign Permit Applicant: �t� �P��c�r�1 �cac'�(�nS �YtiC. Assessors No. Doing Business As:CLZMbC A(-- n l�r c"M��C•Telephone No.1 FS 1-23 o 1171 Sign Location Street/Road: `3- c_.lQ Mn x:) \ Sara Zonin District: ,_Old Kings Highway? Yes®o Hyannis Historic District? Yes, o� Propert,y Owner Name: l� n�ne�c cri �co�rnS �c�C Telephone:'-n c Address: !3(1it OeAVY�,nc, t. Village: Lr`•�v1 Sign Contractor jName: C-unLes-AodyA Telephone: SA2--q—q00 5 � rAiress:.'ITI '�� j Village: 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/No (Note:If yes, a wiring permit is required) I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinance. Signature of Owner/Authorized Agent:Z� Xbv Date: I �� Size: We-Ac&Yle- S\C1`S- 1 Q0 S Permit Fee: 5 � Sign Permit was approved: Disapproved: Date: — z Signature of Building Offic'al: � —� �S_a Signl.dor rev.8/31/98 � t -`7—C'u ,t 0-(_ &PJJ7&V ek TOWN OF BARNSTA4hy BUILDING PERMIT IPLICATION Map Parcel -: TOWN OF BARHSTAIBL� Permit# Q_ i' Health Division �4a LF r c� Date Issued Conservation Division' Z /SLZIWZ- Fee �� Tax Collector DIVISION Treasurer r `.,�n,'t��y''-t0N P RMIT FROM F � tcRti� q(?JSIOA'?IZIJ!z*. Planning Dept. Date Definitive Plan Approved by Planning Board �''`� �� us v.sTA►� �� 1k°� Historic-OKH Preservation/Hyannis Opeo 9om-1 P Project Street Address /l 1Ll par- Village /` lemAlwt-V Owner Lv/ 6 e rz lg` a 14�r<m 2�)C'. Address Telephone L � Permit Request 3 im6 olel /i0g�/Yfdlo Square feet: 1 st floor: existing proposed 2nd floor: existing a proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. ti Dwelling Type: Single Family ❑ ' Two Family ❑ Multi-Family(#units) e! Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes YNo Basement Type: Likrull 2(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: YGa C/Oil 0 Electric ❑Other Central Air: ❑Yes 7 No Fireplaces: Existing g/ New Existing wood/coal stove: ❑Yes ClNo 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 [5Yes Cl No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name 4115- 16 _. dvskla' �6,-Vlces -Z3c Telephone Number Addres�s/�� License# e'S Home Improvement Contractor# Worker's Compensation# 7PJ U i3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE/TAKEN TO ledctelr eR "R OC PS ?�1� LlJ1�C2G.Te �tJ fCr� �/��d �C, G r f U/rJ SIGNATURE DATE /s�� f• FOR OFFICIAL USE ONLY i PERMIT NO:, DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER ' DATE.OF INSPECTION: r, FOUNDATION FRAME INSULATION FIREPLACE } ELECTRICAL: ROUGH FINAL , PLUMBING: ROUGH FINAL ` GAS: ROUGH FINAL r FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. F t rs .... The Commonwealth of Massachusetts Department of Industrial Accidents 600 Washington Street Boston,Mass. .02111 Workers' Com ensation Insurance davit location: TN q �� Z� phone# ❑ I am a homeowner performing all work myself. ❑ I a sole netor and have no one worl� m' capacity % A A///%%%%%%%%%%%%%/%%%%%%///%/%/%��/%%%//////��%%%/%%%%%/%�%%%%�%�%%%%�%%%%%/G%/%%%/�%�% I am an employer providing workers'compensation for my employees working.on this job.: : »mQ e CO gddr ^. ' Cra 1 : . :.:.:.: :.: ::::..; v :: ' _L.E,.. �nsuraaceea;>.> ; r�,3:.: «;; ❑ I am a sole proprietor,general contractor,or homeowner(circle on and have hired the contractors listed below who have e followingn polices: workers co ensatto .... .. - .:..::..:.: :; ......::..:.. atldse ........: .... J{ ............ :::1/Y:�?::}� ?i{?}``;:}:y:;;>??'...... i.... i i:;:;i$ "`hop��n ...... ........... ........t.....................................................................:::.�::::::•:::::,..�::::::::::::•.�:::::::::. ><>> < kri�niaa c ::::::::::::.:::::....::::....::.:::::......::::.:.:...:.... ::::......::::::::....::::::.,..:•..,:•.:. adiiress• ::;:.: 'AII h ......................... .........::::::.}:.;::::: ................... ::...:::::.:.:......:.:::::::..::... >:>>» iuQraiit:e ' 0 Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a Ste up to S1,500.00 and/or one years'imprison mt as wen as civil penalties in the form of a STOP WORK ORDER and a Sne of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify, th paws penalties of pedury the the information provided above is tn.and coned Signature _ D� Print name Phone# AV f ofncial use only do not write in this area to be completed by city or town official city or town: permit/license# CIBullding Depar�ncut ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office _ C3Heasth Department contact person: phone#; ❑Other_�— ({e+ved 9/95 PJA) A Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to.do,maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,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 in the workers' compensation affidavit completely,by checking the box that applies:to your situation and supplying company names, address and phone numbers along with a.certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license 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. City or Towns 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. The affidavits may be rednmed in the Department by mail or FAX unless other arrangements have been made u._._ ._..- The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Ioves"gallons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 FEB-21-2002 THU 09:58 AM KEYSPAN ENERGY DELIVERY FAX NO, 5087607611 P. 01 I KeySpan Energy be livery 7,j 0;' J4ry 201 Rivermoor Streei West Roxbury,MassarhusellS 02132 Tel 617 723�5512 February 21,2002 Mr. David Audette Cumberland Farms Re: 1157 lyanough Rd, Hyannis(Roadway Motor Inn) To whom it may concern: This letter is to confirm that all the natural gas service, to the above referenced property, has been cut off and capped. T 2002 pA hi s work was performed an February 14, If you have any questions, please call 508-760-7503. Since ly, Steve son Field Supervisor 02/21/2002 THU 14:52 FAX 5087909370 Linda Roderick Z 001 IRNSTJOAR One NS Electric&Gas CarpoMass One NS'CAR Way,Westwood,Massachusetts 02090-9230 EL EC7,91C CA S February 21, 2002 Dave Audette .The electric services at Rte 132, Hyannis meter #`s 1037377 8043709, 5017569,. and 8043730 served from pole 3361P45a , were removed on February 19, 2002. Sincerely, Barbara Trocchi Office Administrator f r ' FEB-21-2002 16:05 BARNSTABLE WATER COMPANY 508 790 1313 P.02i02 Barnstable 47 +p_Bcvc 326 Uth Rpm N Y Hyannis,Massachusetts 022601-4326 50W75.0063 FEBRUARY 21,2002 TOWN OF BARNSTABLE BIQILDING INSPECTOR- TOWN HALL HYANNIS,MA 02+601 RE: 11S7 IYANNOUGH ROAD(ROADWAY MOTOR INN) TO WHOM IT MAY CONCERN, THIS IS TO CONFIRM THAT THE WATER SERVICE LOCATED AT 1157 IYANNOUGH ROAD HAS BEEN SHUT OFF AT THE MAIN AND THE METER REMOVED FROM THE PREMISES AT THE REQUEST OF THE OWNER WHO INTENDS TO DEMOLISH THE BUILDING'THEREON. SINCERELY, SUSAN A. SKARBEK BARNSTABLE WATER COMPANY TOTAL P.02 I� Property Location: 11571YANNOUGHROAD/ROUTE132 MAP ID: 273/082/// I Vision ID: 20953 Other ID: Bldg#: 2 Card 2 of 2 Print Date:02/15/2002 09:30 MIC UMUA1V'LZ,U "TWIR A. LIVENUN I UINE,KUBEKI 1)&%-A]KqJL IS Description Code Appraised value Assessea value CUTVf LAND 3UrO--------358—,M 358,71 P 0 BOX 256 COMMERC. 3010 171,600 171,600 801 S DENNIS,MA 02660 COMMERC. 3010 14,000 14,000 Barnstable 2002,MA ccounan Rel. 4J49-A Tax Dist. 400 Land Ct# Per.Prop. #SR Life Estate #DL I LT 1264 Notes: VISION #DL 2 99-A&2 GISID: 20953 out 54 544,300 WA,W '13 A F — �VoV " . T�Ll V IN Ub I VIN h,HVISEK I V&4-AKUL 15 U131z"8 01/1w1994 Q 1 330,000 Yr. Code Assessed Value r. o e ssesse alue MANN'S MOTEL,INC C130647 07/15/1993 U 1 267,000 L -2Uff 3010 358, 2W 3010 —M 19 9 .3ulu 287,01 MERLESENA ENTERPRISES,INC C95943 04/15/1984 Q 1 324,000 2001 3010 171,6002000 3010 90,9001999 3010 90,900 MANNS MOTEL INC C34273 Q 0 2001 3010 14,000 2000 3010 4,0001999 3010 4,000 544,300—Total: 3 8 19 9 0 U—'Fo—taFr 381'9UU W" I his signature ack now le—idges a—visit by aData Cofiector or Assessor Yw ear 1�vpe Code Description IVUMDer Amount Gomm.Int. rem sw A I W Appraised Bldg.Value(Card) 78,900 Appraised XF(B)Value(Bldg) 0 Appraised OB(L)Value(Bldg) 14,000 Appraised Land Value(Bldg) 0 §EF ...... Special Land Value Total Appraised Card Value 92,900 Total Appraised Parcel Value 544,300 Valuation Method: Cost/Market Valuation ��o�appraised arcerV-aru—e 544,300 UC A-UPIWISTU"K 21,111 M. .. ....... US]I "H ly A"El Permit ssue Date Jype Description Amount Insp.Date %Comp. Date Comp. Commeni— ate urposelMesult lklhl-W F H# Use Code Description one D ITrontagel Depth I units unit Price Pactor S.I. U f,actor Nbhd. Adj. Notes-AdjlNpecial Pricing Adj. Unit Price an lue L JUIU—MUIELS 4 U.Ui SF O.OU -T.W --FW-HYW SPUEM)N-oFe—s. U.UU total Land Valu Total Card Lan 0.0Uj AUI Parcel Lataltand Area: Property Location: 11571YANNOUGHROAD/ROUTE132 MAP ID: 273/082/ Vision ID:20953 Other ID: Bldg#: 2 Card 2 of 2 Print Date: 02/15/2002 09 9w, Element Cd. Ch. Description CommerciatDara Elements 39 Motel Element Cd. Ch. DescriptioF- Model 94 Commercial Heat&AU TYPICAL 3rade C- Average Grade Frame Type )2 WOOD FRAME Stories 1 1 Story Baths/Plumbing )2 AVERAGE Decupancy 00 Ceiling/Wall )8 TYPICAL Rooms/Prtns 2 AVERAGE BAblUBM1235U] xterior Wall 1 14 ood Shingle %Common Wall 2 all Height Roof Structure 03 Gable/Hip Roof Cover 03 Asph/F GIs/Cmp Interior Wall 1 08 Typical 2 Element Code Description lactor Interior Floor 1 20 Typical C o---p-Fe x— GANV50] 2 Floor Adj Unit Location Heating Fuel )6 Typical Heating Type )9 Typical Number of Units AC Type M Unit/AC Number of Levels %Ownership Bedrooms )1 1 Bedroom B -'K" L, UAII athrooms Zero Bathrms 0 Full 'W1 MR GO S' ;M11MV 'M " Total Rooms 1 I Room nadj.Base Rate 80.00 ize Adj.Factor 1.10404 Bath Type Grade(Q)Index 0.97 Kitchen Style Adj.Base Rate 85.67 Bldg.Value New 254,440 Year Built 1960 ff.Year Built 1965 NrmI Physcl Dep 35 Funcril Obslnc 0 Econ Obs Inc 34 Go de Percentage Specl.Cond.Code _3UW_MM d�crzptton 100 Specl Cond% Overall%Cond. 31 Deprec.Bldg Value 78,900 Code Description L/V Units Unit Price Yr. Do Rt xouna Apr. value SPE3 Pool Gum IT'M U Code Description Living Area UrossArea Ejj.Area Unit Cost undeprec. value --B?L-'T--MHUFFoor 2,3511-----2;350------1,-3bT---95.67 20TTB CAN Canopy 0 750 150 17.13 12,851 UBM Basement,Unfinished 0 2,350 470 17.13 40,265 1 1 1 M GrossLiyll ease Area , g vat: 254,440 Property Location: 11571YANNOUGHROAD/ROUTE132 MAP ID: 273/082/// Vision ID: 20953 Other ID: Bldg#.- 1 Card 1 of 2 Print Date:02/15/2002 09:30 WTU V POWo Imo, ioka LIVENUS I VINE,KVJLS1!,K1 IP&I-AKUL IS Descript code Appraised value Assessed value UUM LAND 3010 J5870U 358,7UU P 0 BOX 256 COMMERC. 3010 171,,600 171,600 801 S DENNIS,MA 02660 COMMERC. 3010 14,000 14,000 Barnstable 2002,MA 4n A ACcountp 15.55YJ 4J4Y-A Tax Dist. 400 Land Ct# Per.Prop. #SR Life Estate #DL I LT 1264 Notes: VISION #DL 2 99-A&2 GISID: 20953 7.1all 544,3001 -----544,30 YwAsyu V�jw 53ATE 7 e ,q1 If 1W q qYEg 1W Ll V 11N Ub I LPfN L,KVISILK 1 0&4-AJKUL 0 olliih Q 1 330,000 Yr. Code ASSMW value Yr. Code Assessed value Yr. Code Assessed Value MANN'S MOTEL,INC C130647 07/15/1993 U 1 267,000 L zoul 3uju 35 , -3UW 287,OOU T999-3UIY 287,00 MERLESENA ENTERPRISES,INC C95943 04/15/1984 Q 1 324,000 2001 3010 171,6002000 3010 90,9001999 3010 90,900 MANNS MOTEL INC C34273 Q 0 2001 3010 1490002000 3010 4,0001999 3010 4,000 7 -ro—taF- otar-, 544,3001 Tot.T. 381, I his signature acknowledges It A a visit by Data Co ector or ssessor Year ypelDescription AM lint Code Description NUM Der Amount Comm.Int. AR. Appraised Bldg.Value(Card) 92,700 Appraised XF(B)Value(Bldg) 0 Appraised OB(L)ota Spe Value(Bldg) 0 Tl. Appraised Land Value(Bldg) 358,700 A "I fAf *BLD(;A-DJUNT.YUK cial Land V alu e ECONOMICS Roadway Motor Inn Total Appraised Card Value 451,400 Total Appraised Parcel Value 544,300 1 eff,14 singles,8,doub Valuation Method: Cost/Market Valuation EFF=MGR UNIT Net I otal Appraised Parcel VaFu—e 544,30U F "A-W -3-Is -Nwy� Permit 7D Issue Date I)vpe Descriplion Amount Insp.Date %Comp. Date Comp. Comments Date ID Gd. Purpose/Result lill use Code Description one D Prontage epth Units Unit Price Pactor S.I. C.Eactor Nbhd. ruing ni rice an a ue 1 3010 MOTELS HIS 0.96 AC 102,00.00-1. otes:3U 3NITI ---373,W" 358, Total Card an Units arceTatattandAreal Tatal an Valu�i Property Location: 1157 IYANNOUGH ROAD/ROUTE132 MAP ID: 273/082/ Vision ID:20953 Other ID: Bldg#: 1 Card 1 of 2 Print Date: 02/15/2002 09 1.4El 1 g7,z ,"V D !I 4&12 sU1 ement escription ommerciauataEements iv, id v 'tyle/r lype 39 Motel Element Gd. Ch. Description Model 94 Commercial Heat&AU )3 1 YJr1UA-L Grade C- Average Grade Frame Type )2 WOOD FRAME Stories 1 1 Story Baths/Plumbing )2 AVERAGE Occupancy 0 Ceiling/Wall D8 ICAL Rooms/Prtns 2 AVERAGE 13ASIBMTL3074] xterior Wall 1 14 ood Shingle %Common Wall 2 all Height Roof Structure 03 Gable/Hip Roof Cover 03 Asph/F GIs/Cmp, Interior Wall 1 08 'Typical r 2 Element Code Vescription Vactor Interior Floor 1 20 Typical Co—m—pTe—x CAN[5U4] 2 Floor Adj Unit Location eating Fuel )6 Typical Heating Type )9 Typical Number of Units AC Type X UniVAC Number of Levels %Ownership Bedrooms )1 1 Bedroom Bathrooms Zero Bathrms . .... )VALR 0 Full Total Rooms I Room Unadj.Base Rate 80.00 ize Adj.Factor 1.01662 ath Type Grade(Q)Index 0.97 Kitchen Style Adj.Base Rate 78.89 Bldg.Value New 298,993 Year Built 1965 ff.Year Built 1965 NrmI Physcl Dep 35 Funcnl Obslnc 0 con ObsInc 34 Code Description Pe�rcentage Specl.Cond.Code mqj I LLN JIUU Specl Cond% Overall%Cond. 31 Deprec.Bldg Value 92,700 UB 3, All, 11 Code ascription Llff units Unit Price Yr. Dp Rt %(;nd Apr. Value WIT91 AAM Code Description LivingAre—a (iross Area Aff Area 3 nit Cost undeprec. value BAN First F oor 3,074 J,U74 -31M----18-.99 242,508 BMT Basement Area 0 3,074 615 15.78 48,517 CAN Canopy 0 504 101 15.81 7,968 WX Gro! iv ease Area --J,U-141 0,0�zl 3,7901 Blag Val: 298,993 i p BOARQ OF BUtLDING REGULATIONS k License CONSTRUCTION SUPERVISOR Num.belr . .`.e 066428 Bari•,` a�/�}�964 1 Eees n ,803 Tr.no: 9399 Restricted.Ta;r�A�` DAVI'DIE AUDETT� 401 K NG RD TIVERTON, RI 02878 _ Administ ator e t I , a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map P7 3 Parcel Permit# Health Division Date Issued Conservation Division 3140 JW Fee �'So•au Tax Collector Treasurer �-? � �Zc>JU �tt� �GANN8C�104 " ��1A dEWER Planning Dept. 41NEERI(yG D RMIT FROM THE O ��N 3IONpR10R?r, Date Definitive Plan Approved by Planning Board ;. Historic-OKH Preservation/Hyannis al � Project Street Address 9`�� -3 Z. Village Owner C�4. 6 �Jtt�,110s�aX)e— Address Telephone Permit Request 14-c�oc,4Te. age- J 16lett) .574-i r"S Square feet: 1 st floor: existing proposed 2nd floor: existing proposed. Total new Estimated Project Cost 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 ❑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 Hea*Type and Fuel: ❑Gas ❑Oil 0 Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: 0 existing ❑new size Barn:0 existing ❑new size Attached garage:0 existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals orization ❑ Appeal# Recorded❑ Commercial &Yres ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name k,4, ve �Pl_mx e Telephone Number �1_17Z oca Address License# T025-- Home Improvement Contractor# lh� Worker's Compensation# ��° 'G/�lo 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE — 3 . C - FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS f VILLAGE s OWNER , �i . r -} • :' • f , r f DATE OF INSPECTIO rA FOUNDATION t FRAME INSULATION i FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGI FINAL g GAS: ROUGH Q— FINAL ' c�_ pa Wes' FINAL BUILDING ��'`�-� ('� ) • - , DATE,CLOSED OUT i 4 ASSOCIATION PLAN NO. ' , The Commonwealth.of Massachusetts - - Department of Industrial Accidents ,� �°---.� : � , Oflfce of/orestfg8tfoos 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance davit name: location city G/ `��/l/�/� vhone# 2, J -3,�Z 7' ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working is any capacitv am an em layer providing workers' compensation for my employees wo g on this job..::;..........: ;:;::;:>:;:;;::;; ;; :. :.:::......... :::. ........ . ....... 10. tiom dray ztame:. fires s d ....:.::;::.:.. : . :.:::........::::..:. ;;;;:::.>........... . .............::::::: atv ...:...phone N... . .. . �...... . .. ... insurance co: ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have thee following workers' compensation polices: g .............................:::..:...::.::.:.:::: .......... ....:..::.. : .................:.:.::::..::..........:....... :._. :::.::::::::::.:.:.:::::.;:.;:.;;: twm anvname: ;:. s. `. addres �..< :e <::> >:'»:>:::'>:>:::«:>::<`;:: :>» <> : «<> >::>:«> >`.` hors >.. iesIIrance co..::.....::.:.:;.;;;:.;.::.;:;.>:::.;,:.;•:.;;;;:;;:..:.:.:...:::.....:::..:.:::<.. .. oPicv :.. .. . ;;. . ..... ...::::::... address:. ,:. # ':>«` <'<<' h ::•:: wJ� - OII ._ :::::::::..........................................................................:::::::::::::::::::::::: :::::::::::;;:::.:.:•::::: :... .............................. .....:....... % . ... .. .................................................. N....:::w:•::: :v.:. up Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fineto S1,S00.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 3100.00 a day against me. I understand that a copy of this statement may be forwarded to the Once of Investigations of the DIA for coverage verification. I do hereby co"t* under the,.,, penalties of perjury that the information provided above is trw•mid corral sig Date Print Print name Ul/'�yfJ e �'' ��$/!�O( Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license t! (]Building Department ❑Licensing Board "check if Immediate response b requited ❑Selectmen's Office (]Health Department contact person: phone#; — ❑�u'.� lienud 9l95 PIA) MA Lic. #CS065025 Densmore Building&Remodeling Home Imp. Lic. 3116494 Estimate P.O.BOX 659 � # I S. Yarmouth, MA 02664 DATE El STIMATE I i 1-$08-394-7249 I 0 126 fax 1-508-394-2226 NAME/ADDRESS Roadway Motor Inn Bob& Carol Livingstone I PHONE. I PROJECT I TERMS j +Rt l32 I u ,nnislyra n��nt 77$-3324 I Stairs &Doorway Contract I — DESCRIPTION j Replace deck-new p.t. wood, 2xl0 joists 16" o.c., 2x10 decking,4x6 post, sons tube footing 4'deep x 12",2x12 stair stringer, 2x10 stair tread,2x8 stair riser,railing 2x6 cap 36" to top, 2x2 railing on 2x4's with space under. Deck to be bolted to building with. 1/2" lags&I air space,all post to be bolted to deck frame with 1./2" bolts& ,post to be anchored to footing, deck'to be nailed with 3 1/4" gals. spriral nail. remove existing door,patch door way opening with 2x4's&t1-I I on outside. Reframe for new 3066 steel door 2 lite style, reuse knob&drill hole for dead bolt,new exterior trim, interior finish by other. i j NOT INCLUDED IN PROPOSAL- septic upgrades - survey& engineering problems that may,arise due to I existing plumbing& electrical -plumbing work-cabinets-flooring-fixtures-hidden rot-painting or staining. I All work out of scope or damage/rotten wood, will be fixed at the rate_ of$50.00 per I man hour,$80.00 per hr for 2 men plus the cost of added material. project total cost of ject$3 200.00 I p � i Deposit to hire Densmore Building&Remodeling,for plans to be drawn&permits $200.00 Payment at start of job due on or before start date. $1,500:00: FINAL PAYMENT -UPON COMPLETION&PUNCH LIST, 1 LIST ONLY.-OWNER SHALL NOT HAVE OCCUPANCY TILL THIS PAYMENT IS MADE. $1,500.00 I This proposal is acceptable and I hereby authorize Wayne R. Densmore to act as builder/agent and to proceed I with the terms of this contact Wayne R. Densmore u e- O � 1 I f TOTAL $3?00.00 Ito C-o Wayne R.Densmore MA Lic.#C5065025 Home Imp.Lic.#116494 DENSMORE EMMEM; •� P.O.Box 659 (508) 394-7249 So.Yarmouth,MA 02664 fax(508) 394-2226 All 16O-1111111111lla[/L 0 Ilnu«cl"wella j. � % :��e.�rxrno"na eitl�e o�✓�fa.WrCitule/% . . BOARD OF BUILD114G REGULATIONS HONE IMPROVEMENT CONTRACTOR License: CONSTRUCTION SUPERVISOR (7; Registration 116494 Number: CS 065025 Type - INOIVIOU- Birthdate: 08/06/1960 ;J Explration 06/21/00 Expires:08/06/2001 Tr.no: 1718 R_ Restricted To: 00 DENSMORE REMOLDING WAYNE R. DENSMORE WAYNE R DENSMORE -7�- ,{}"OX 659/ LILY POND DR, PO BOX 659 '. ADMINISTRATOR SO, YARMOUTM MA 02664 S YARMOUTH, MA 02664 Administrator Valuation: PLAN REVIEW RECORD Plan Review# Fee: Date: v;209), ONE AND TWO FAMILY �J DWELLING CODE JURISDICTION ity, County, Township,eta If BUILDING LOCATION �% Street a ress BUILDING DESCRIPTION 0 ' c. REVIEWED BY CORRECTION LIST Code No. DESCRIPTION Section f/d7 09/.3 } aA A ` — _. .. ,._ _� , ter,•+� . .... .- --- —�.�....�-. ��. _ ., - �-. � �' 1 BUILDING DEPARTMENT —— TOWN OF BARNSTABLE -- 6/93 4 �7 \ \\� 7-7 �- r r- .j";----�-`""T i- remove door, __-- _ _reframe wall & remove window, siding t1-11 resize opening for 2 -- lite steel door Ij /Lam_ � T remove stairs, move & rebuild------' stairs I Existing window, door & stair placement, to be removed & alter Project: Roadway Motor Inn, Rt. 132 Hyannis Mass. Densmore Building & Remodeling P.O. Box 659 S. Yarmouth Ma. 394-7249 2nd floor 12" soni tube oN - footing ! Proposed footprint & footing placement Project: Roadway-Motor Inn, Rt.132 Hyannis Mass. Densmore Building & Remodeling P.O. Box 659 S. Yarmouth Ma. 394-724 . -r-,,'-�,�-r`-�-•-`-f�.�-+��....�"_ r.. `��.�;�-'_Y' h L�;` �-�-- �-r'�- \ ��Yam-':'�'Z�y� . �' U C] new 2 lite steel .� door 7 new ,\ 2x12 p.t. stair stringer 2x1jR p t. stair tread placement' 13a I!aS�C/5 l re.�� // ' /� 5e 7 ' of deck Proposed door, deck, & stair placement Project: -Roadway Motor Inn, Rt 132 Hyannis Mass. „ Densmore Building & Remodeling P.O. 659 S. Yarmouth Ma. 394-7249- 2x8 header 3068 steel door 2 lite 2nd floor 2x6 p.t.cap 4k from deck 4x6 p.t.post 1"air space,1/2"lagged to ,r 'building 2`o.c. 2x2 pickets 4 W'space 2x10 p.t,decking 2x10 p.t.joist 16"o.c. joist hangers 46 p.t.post-- . existing tally post 1st floor existing concrete pad` Ii - metal bracket post to footing 12"x 4'concrete filled soni tube Cross Section Project: Roadway Motor Inn, Rt. 132 Hyannis Mass. Densmore Building & .Remodeling P.O. Box 659 S. Yarmouth Ma. 394-7249 I h \ 4�0 4r !~.} NOTE- PRE—LA7S!iX('° ;%�;v—c 47,90",2V RES`. ?.O!0 'HR" This 14OFiTOAC-£ INISPEC.Tioi1 REGISTRY OWNER- OA�OLV _.dL C:AR0L_ &T_'1;1 DEED REF: E�7' -:BUYE-R- F DATE: .1e„LU/ P— _ PLAN RAF: c 2_1 "- ` A -5RCALL-V= 6AU FT I HEREBY CERTIFY TO ---THAT THE -BUILDING YANKEE � SHOWN ON THIS PLAN ]S LOCATED -0N TI{£ GROUND �i� AIJL -CONS_ I. SHOWN AND THAT ITS POSITION DOES --_- CONFORM � 4 0 B (Si, :' TO THE ZONING LAW}'$ ►'BACK 'REQIIIREMENTS' Off' THE � � `" MIUSTRY TOWN OF Q�f� $ __�_��_------AND THAT �-, .•� :, MARSTOPS MILL- IT DOES_ 1VOT _ I:IE -W#THIN -THE SPECIAL FLOOD -HAZARD AREA AS SHOWN QN THE H:U.U. MAP DRTED =M TEL 42 . O l . ..'' 'A 4W-� 4.... +l. ._THUS -PU-N-No-' -RAM F RDM..AN.. 1ST UMENT- 22199 .JF 'a a_�{� `� -........__ -URVE-Y NOT TO -BE USED f'OR £S -E TC, .� TOWN OF BARNSTABLE . SIGN PERMIT PARCEL ID 27{3 082 GEOBASE ID 18389 ADDRESS 1157 IYANNOUGH ROAD/ROUTE PHONE HYANNIS ZIP i LOT LT 1 26 BLOCK LOT SIZE I DBA AE . DEVELOPMENT DISTRICT HY PERMIT 30688 DESCRIPTION ROADWAY MOTOR INN (20 SQ_FT. ) PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Departmeneof Health, Safety i ARCHITECTS: � and Environmental Services i TOTAL FEES: $25.00 i BOND $.00 Oki CONSTRUCTION COSTS $.00 . 753. MSC. NOT CODED ELSEWHERE ; * ■ARNSTABLE. • i MASS. 1 16,19. - BVLDING'DIVISfON DATE ISSUED 05/05/1998 EXPIRATION DATE ,� F The Town of Barnstable Department of Health, Safety and Environmental Services ABIX NAM Building Division Street,Hyannis MA 02601 �$ Ralph Crossen Office: 508-790-6227 36b p P Fax: 508-790-6230 Building Commissioner Application for Sign Permit PMZ C EZ Applicant: 0-cx_f`© ( R. L V L-)q g�yr Assessors No. 2 7 3 ^ 0$a Doing Business As: ` \g Telephone No. Sign Location e Street/Road: l 1 -S 7 v yfie Zoning District: Old Kings Highway? Yet,) Property , er 3'� a - 31/d? Narric 104L ft- Telephone: 775- 330�� Address:_ Z-32 Village: _.&dL/yi5 ' Sign Contracto 1-4 Name: I'VIOy S c` G�� Telephone: 3� a Address: �3 0 r� _Village• —S- Yiq f&Vc--)ot k Description Please draw a diagram of lot showing location of buildings and eaasting 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 o (Note:Ifyes, a mumgpermit is required) I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinance. Signature of Owner/Authorized Agent: e _ Date: Size- Permit Fee: Sign Permit was approved: Disapproved: Signature of Building Official: Date: / Olt �k OLD 51G)J TO fze1w6v q> F6oL 100 L— f a. tv -.LO �d U1L 1}J�- x a # r-' r ..:.0 A CON TRACTORS WELCOME 1 POOL CABLE AC PHONES NED VACANCY • .� �r��- ST�w�f i�G- D( 56 -fit t�ofia� ��v �.1 D . to I�e ,�/4 ic'�17 �NFlmeL T/N/'Slit o rJ/KefAL- � � � I PI C✓ I q(I'CO'W)Jt� f � F POOL CABLE AC PHONES NO VACANCY' ' Yx (o . . ;�,.H St: F-oc)T oo o 6 I-e FcQ-c--A ti - Ur�KEA �lufjlYlEL Dtv /')'7ETft� Yn c(YU.)o 4 fy�1 , ` �'I�Jl �-!J ��'� �-S��D�r-c�'►� A- �'7'(1.�.1C'Tl/�C;- (A2 14A,r'—, N 146 Structure: Any production or piece of work, artificially built up or composed of parts and joined together in some definite manner, not including poles, fences and. such minor incidental improvements .. Tent: A temporary shelter with a frame supporting a cloth or similar flexible covering, without a fixed location, foundation or permanent anchors. (Added by Town Council vote on 2122196 as item #95-194 - by a 9 Yes 2 No roll call vote. ) Upland: All lands not defined herein as wetlands . Very Small Quantity Generators: Those operations that generate less than 26 gallons or 220 lbs of dry weight of hazardous waste per month and no acutely hazardous waste as defined in 310 CMR 30 . 00 . (Added 8/19/93 Item #93-105 - T.Council vote) Wetlands: The land under the ocean or under any bay, lake, pond, river, stream, creek or estuary; any wet meadows, marshes, swamps, bogs, areas where high groundwater, flowing or standing surface water or ice provide a significant part of the supporting substrata for a plant community for at least five (5) months of the year, lowland subject to any tidal action or annual storm flooding or flowage, or any flat, beach, dune or other shifting sand formation. APPENDICES J I^d M:N01� `IN GL U P WY, dl S ISL� GI 77 Q • ' I The Town of Barnstable • 1 KAMM Department of Health, Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner Sign Permit Requirements 1. A photograph showing the existing facade, on which has been indicated the proposed sign location. The photograph is to include a portion of adjoining stores or buildings. For a proposed building or a new facade, an architect's elevation may be submitted in lieu of a photograph. 2. A scale drawing of the proposed sign. A scale drawing indicating: 1) The type of proposed sign (wall, hanging, free standing) 2) Dimensions of the proposed sign and any designs, logos, or lettering 3) Colors, the drawing may be black and white, but color chips must be attached for colors other than black, pure white, or gold leaf. 4) Materials, what the proposed sign and letters are to be constructed of. 5) A cross-section with dimensions showing edge detail. Minimum scale 1"=i' Minimum sheet size, 8.5 x 11". Two Sets. 3. A scale drawing of the bracket. A scale drawing indicating dimensions, color, materials and method of affixing it to the sign and to the building. Minimum scale 1"=1'. Minimum sheet size, 8.5 x 11". Two sets. 4. A completed Town of Barnstable Sign Application, including scaled diagram showing location of sign on building or location of free-standing sign. Show dimensions. J - . '. 99 0 :53 5087750693 _._.._� . _... HA4`'IS & HAYES PAGE 1 1� IP 1 / k OG j\ 'iiir> A. j� NOTE' PRE-EXIS77NG NON--CONx'ORblING FDEWED ONE- 'NB" This MORTGAGE AGE INSPECTION Plan 19 For FLOOD ZONE'• "C" - - REGISTRY OWNER: ! $ ? ..V IL Gc'OLBVIREF: _CEB?'' 4342 —BUYER: _REELYAN — — _ .� — _J1 U1/�7 PLAN REF: -LC24 9 A— SCALE: =60BY CERTIFY TO 1 �Q_QP� ,4 _ AN qos os YANKEE SURVEY _ ___THAT THE BUILDING aN THIS PLAN 15�L.00ATED ON TIIE GROUND AS IhAU�. CONSULTaNTS AND THAT ITS POSITION DOES CONFORM AN�RITMErV � 40B (SUITE l) TO THE ZONING LAW SETBACK REQUIREMENTS OF THE No.E H INDUSTRY ROAD TOWN OF $68N�M&Z__.�___.�_____-AND THAT � "�. IT DOES_ 1VOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD ��' MARSTONS MILLS, MA. Ou6aA 428+ -0055 AREA AS SHOWN ON THE .U.D. DATED�/_19Zd5 _ TEL 00 �;' - 5 aA.�w • _ THIS PLAN NOT MADE FROM AN INSTRUMENT �2189 JF ' A A`V;.' 7�r15 _ SURVEY NOT TO BE USED F04 F N ES ETC. t GEOGRAPHIC INFORMATION SYSTEM n 0 n thi s Ian I n P �V Property lines show are for assessing purposes actual IY and do not rep relationships to physical objects 79,C)• /6a. 6.6 1 �. i\ >/66.5 68:3'' f 67.1 6.7.0 ', ,., \ `X64. ! \i }� 5.3 x--�I'� X 6 7. \ 64. }`67.'1 X 6 ARKING 8 I :`6 .5 66. �� i r X E5.7 /\ /\66 f }\6 j X65.8 \ 80 \ 6 r^ t 1 1126 •1 \ X 67.0 --- / / ;:67.3 t z NwAY we- - PLAN OF LAND IN BARNSTABLE (11Y•) Bearse do Kellogg, Civit Engineers April 7, 1953 .. � r x •,�• u. Md�p cis \ of o% fr G�/fin• Q�' . rat s,. I b � . J9 e.n 3 - 0 0 z •P • o. e � 0 0 0 9 - s'4i`av A �,,/�' Copy of pan;of plan LAND RmsTRATION OFFICE ✓uNE 2, 'toss - Sca/e of this plan loo feet to an incb C.M.Anderaon�114"r frvr Court✓ci N TA BI-E, MASSACHUSETTS \ IAAP3 '�n.ro\ M�7~•�°3 O l,' a � 124 1 , ,r 62 1 `• �:+� �Awgr oC LOT q�` /�^ •'°•Z - , 8p - - 1 `\ J�/� OArN SPgG t-• ./.-. •.' lyJ 1 _OG f.. .may t �� E C f+ / n�.10 Zak 'J 62 3S AC AC 4s' \.r Jr07' o _ i,. j�i 1 I• '2?Ac 31AC o 63 12" P4 Ac -r.• ,� Y o3 Gq I 34 u zr�^ A C y $ Y 17AC 4 Q - u } 433 2-4 5 J I I t - Ziff, J j G) $) Zf4c >A 60 `�.f PLAN OF LAND IN BARNS TABLE Al�LH'S r 26499". N Bearse & Kellogg, Civil Engineers i October 30, 1953 i W E C.S. W ' o 0 e s Q° Soo Henry L. Murphy of ol. C.e M.H.J. � coo w l n= , r Ip v/ } Pen,Iln h CO C 1• �/A♦ ° / Co. V fT' A b A ° O: L N (p L .b s ti; M H '.0 D�y. o� oW !' C flaymond' $. h Hi Its ' w. .8. C.h h oA L C. No -349A RA Cert 2 1 o 2 4 / C.e COPY Of Part of plan 24349At /1kd in LAND REGISTRATION OFF/CE OrcWmbar 9,/SM3 Stale of this P✓an 40 fed fb an indy C.M.Andersar,fnsimer for Cart✓c t _."NEW ADDRESS: , 1165 IYANNOUGH RD' MAP AND PARCEL 000-000.244