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0640 IYANNOUGH ROAD/RTE132
I� 6L Page l of l Shea, Sally 1 v'`-L From: Lt. Don Chase[dchase@hyannisfire.org] Sent: Tuesday, May 15, 2012 9:55 AM To: roy@permitadvisors.com Cc: Shea, Sally; Perry,Tom Subject: Harbor Freight Ok for permitting the tenant fit out for Harbor Freight at the old Circuit City building. Enclosed are my notes from the plan review. Thanks. Don- Lt. Don Chase,Jr., FPO . Fire Prevention Officer Hyannis Fire Department 95 High School Rd. Ext. Hyannis,MA 02601 508-775-1300 x106 5/15/2012 (�4�0 1 � j � '� � � � ✓ � is �a" � � ��; HYANNIS FIRE DEPARTMENT 95 HIGH SCHOOL ROAD EXTENSION O " l HYANNIS, MASS. 02601 HAROLD S.BRUNELLE,CHIEF FIRE PREVENTION BUREAU LT. DONALD H.CHASE,JR. LT. JOHN COSMO Inspector Inspector May 15, 2012 Review notes for Harbor Freight A 0.0 Fire and Life Safety Code is 527CMR in its entirety-`CMR 21 is for flammability of decorations and window treatments. D 1.0 Demolition note#5 —permit required for dumpsters,> 6 yards per 527CMR 3.4.00 D 1.1 Shutting down of existing sprinkler or,.ire.alarm equipment is by permit and notice to the FD. MGL Chap 148: 27A A 0.2 Note#74—FPE stamped plans for sprinkler system forwarded to the FD ,, FPE stamped plans for the fire alarm system forwarded to.the FD. A 2.0 RTU# 1-7 are to be labeled on each unit on the roof for alarm purposes. FP 1.0 (see A 0.2 above) E 1.3 Remote annunciator shall have the capability to reset the FACP following an incident. E 2.1 Locate the remote test switches for the RTU's in the FACP room. Test switches shall be marked to coordinate with unit numbers on�the roof. ti a E 2.3 Note 1 -Provide schematic and installation drawings for fire alarm system stamped by an FPE. Provide test paperwork and certification of both the fire alarm system and sprinkler system per NFPA prior to or during the final inspection for occupancy. Lt Donald Chase, Jr, FPO Fire Prevention Officer Hyannis Fire Department Tel. 508-775-1300 Fax 508-778-6448 Emergencies 9-1-1 'THE�� Town of Barnstable j 0 Regulatory Services sn MASS. Thomas F. Geiler Director 9 Mass.. � Eo 39. Building Division .Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 October 29, 2008 Mr. William Johnson Berkshire Hyannis LLC 41 Taylor Street `Springfield, MA 01103 RE: CIRCUIT CITY 640 IYANNOUGH ROAD HYANNIS, MA Mr. Johnson, The building constructed at#640.Iyannough Road by cm&b Inc has satisfied the required inspections of the Town of Barnstable Building Department. Circuit City or any other future tenant is required to apply for a tenant fit-up permit in order to finish and complete the interior of this building. - Prior to a final.Certificate of Occupancy being issued for whatever tenant may occupy this building the conditions as set forth in the Development of Regional Impact Decision for Circuit City must be satisfied.However as far as these conditions there is nothing to prevent the Barnstable Building Department from completing and signing off on the Building.Permit. Respectiivel , Thomas Perry Building Commissioner Town of Barnstable A TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. Map 1 Parcel 01 Z -` Application # Health Division S 3 Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic'- OKH _Preservation/ Hyannis Project Street Address 6 Litiinin�-Ll. "p Village Owner_'Gis 0 g,+}) R a toe Address i-i/ r94 y, c o R ��S'i �'�Rl�a����JaL-0 Telephone - 2 Qb Permit Request r we a �I�ll D, - (�(�° k 150, - �+tt o Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total n� Zoning District --- ,Flood Plain Groundwater Overlay Project Valuation, Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family .❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing 0 new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION > 0 0 d L/6 (BUILDER OR HOMEOWNER) - - Name c AZdg J:-: X C A PIA Telephone Number zy b Address ci 6 �IQ M G} 1�'i=q l3 0 7)4 License# Home Improvement Contractor# Worker's Compensation # Z7? G 1-,1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO I��1 P V 1 f=l� i & s do PZ SIGNATURE `�� DATE ��/d , r , FOR OFFICIAL USE ONLY a APPLICATION# DATE ISSUED i MAP/PARCEL NO. + ADDRESS VILLAGE OWNER ' + DATE OF INSPECTION: FOUNDATION FRAME r INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ,t PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING + DATE CLOSED OUT ASSOCIATION PLAN;NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information g Please Print Legibly Name(Business/Organizationadividuan: Pd t1 Address: (S-d 1---)?IZ 14 C, -p y 7 OfE 0 6 y-r H �1 /��'S'•_ City/State/Zip: C)z Phone.#: b 14 L' (0 5 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 4_ I am a general contractor and 1 6. ❑New construction . employees(full and/or part time).* have hired the stab-contractors 2.❑ 1 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 tY• t 9. ❑Building addition ance[No workers' comp.-insurance comp-insurance' required.] 5. 0 We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 LE]Plumbing repairs or additions myself[No workers' comp. right 6f exemption per MGL 12 0 Roof repairs , ins;„ance required,]t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp,insurance required.] •Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Hormowne s who submit this affidavit indicating lhey 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 subtontractrna have employers,they must pravidb their workers'comp.policy mmnber. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: pa�f 1 •S' �' A L-L j h j `,4.C— — Policy#or Self-ins.Lie.#: Expiration Date:_T�ft Job Site Address: G Lto lie N oy 60 City/Statelzip: 'lQ 4 1 :2 Attach a copy of the workers'compensation policy declaration page(showing the policy number.and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of crirnirial penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil pmaltirn in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains•andpenalties of perjury that the information provided above is true and correct SignatLe• Date: Phone#- Off cial use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# - Issuing Authority(circle one): aw, 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Insttuctions ,a Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees: Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing.engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"eva state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced•acceptable,evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states 'Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until acceptable evidence of compliance with the inzur-mce requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(ems)and phone number(s).along with their certificate(s)of insu nee. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Bp advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requestcd,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permMicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid'affidavit is on file for future permits or licenses. A new affidavit must be filled out each x year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture { (Le.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Offim of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,tclephone•and fax number. The C6mmonwW11i of M=adhuscM F DVartrnent of Industrial Accidents Office of Investigations 600 Wwhinatan Street Boston,MA 02111 TO. #617-727-4900 ext 4-06 or 1477-MASSAFE Fax#617-727-7749 -06 Revised 11-22 t' www.mass.gov/dia 06/10/2008 21:23 5083364920 BAY STATE SALES DEP PAGE 02 POND VIEW EXCAVATION CORP. 50 FRENCH ST. REHOBOTH, M,A, 02769 508-336-4665 FAX 508-336-4467 June 11, 2008 Town of Hyannis Building Dept. To Whom it May Concern, This letter is to inform you that Roger Furtado is an employee for Pond View Excavation Corp. He is the Foreman for the Job we are doing at 624 & 640 Iyannough Rd. If you have any questions please call me at the above number. Thank You, _ Kenneth J. ey, Pres Pond View Excavation Corp. 5039574508 NSTARYARMOUTH 09:28:24a.m. 06.10-2008 212 ONSTAR One NSTAR Way. ELECTRIC Westwood,Massectiusetts 02090 GAS June 10, 2006 Robert Cunningham 41 Taylor St. Springfield NIA 01103 RE: 640 Route 132 Hyannis Service Removal —WO#01655476 To Whom It May.Concern: This letter serves as confirmation that, as of 06l05/08, the electric service to 640 Route 132/ Iyanough Rd, has been removad. Based on this information, there is no electric power at this address and you may proceed with the demolition. If you have any questions, please contact me at(781) 441-3334. Sincerely, Justin ReIN New Customer Connects Town of Barnstable Department of Public Works nSrAez.s _ 230 South Street, Hyannis MA 02601 MASS � www.engineering@town.barnstable.ma.us Office: 508-862-4090 Mark S. Ells Fax: 508-862-4711 Director May 14 , 2008 Subject : 624 lyannough Road/Rte 132 & 640 lyannough Road/Rte 132 Hyannis village - Disconnect from Municipal Sewer Dear Sirs; This is to notify you that the properties at 624 lyannough Road / Route 132 ( Map & Parcel 311 - 0132 ) and 640 lyannough Road / Route 132 ( Map & Parcel 311 — 012 ) , in Hyannis, Mass was disconnected from municipal sewer on May 8th , 2008. The disconnection was inspected and accepted by the Construction Projects Inspector from the Town of Barnstable DPW—Admin & Tech Support. A field sketch of the disconnection was completed at the time of the work. A sewer compliance record and a record drawing will be completed and filed in the Admin &Tech Support office. If you have any questions, or need additional information, please call Dave I Anderson at 508 —790 - 6244. Sincerely; David J Anderson Town of Barnstable DPW Admin &Tech Support MAY-19-2008 08:a3 HYANNIS WATER SYSTEM 5108 790 1313 P.05;'05 o� Department of Public Works 47 old Yamiouth Rd. P.OWater Supply Division ya Box 320 � inrers,MA. HAMRTTA" 02601.0326 MPA& TEU 508-775-0063 Hyannis Water System Operations FAX:SOW MI NIA May 19,2008 Town of Barnstable Building Inspector Town 1HAU Hyannis, NIA 02601 RE: 640 Iyannough Road Hyannis,MA Dear Sir: Please be advised that the above water service was shut off and the meter removed on. The owner has informed us of plans to demolish the building, Sincerely, udy Bent Hyannis Water System wniaa9n"M-PwuBcbaauets re.�a.,.w aA�moan+ s�ad as„W1hIto- tstar Inn arA wannichuck Water Services Coro, TOTAL P.05 MAY-15-2008 10:19 FROM:FLLL CIRCLE 6179234155 T0:15083364467 P.2 Commonwealth of Massachusetts 100071394 . Asbestos Notification Form ANF-001 DOWumber A. Asbestos Abatement Description (cunt.) 13. Total amount of each type of Asbestos Contairting Materials(ACM)to be removed,enclosed,or e sula_ted: 5700 a.. 0 7 p pas or duels Qlnear T'I alaioiner su ces square 11) surebrea�atingsng,duct tank d.Insulating cement n9 L rt,ft. a.Corrugated or layered paper 5200 Dips Insulation Lin.ft. f.TrowellSprayer coatings ;L' ft. g.Spray-on fireproofing h.Transite board,wall boardq it I.Cloths,woven febrics 1s 500 n j,Other,please specify: in P.Thermal,solid core pipe 1/ATICAULK InsulationLin.iE: Specify 14. Describe the decontamination systems)to be used. FULL CONTAINMENT THREE DECON CHAMBER FOR TEXTURED CEILINGS,PARTIAL FOR V 15. Describe the containerization/disposal methods to comply with 310 CI1IR 7.15 and 453 CMR 0.14(2)O: FIBERBOARD BARRELS OR DOUBLE SIX MIL POLY BAGS DOT AND EPA LABELED 16. For Emergency Asbestos Operations,the DEP and DOS officials who evaluated the emergency: a. ams TDEP Official c.Datem ddf thor ration 0.DEP Waiver s. arrte Official_ c a N g.Date ngn yyyy of` u or"bn`-" -Jh.OOS Walyer 0 17, Do prevailing wage rates as per M.G.L.c. 149,§26,27 or 27A--F apply to this project?®Yes a No B. Facility Description N REALTOR OFFICES 0 1. Current or prior use of facility: ®a 2. Is the facility owner-occupied residential with 4 units or less? ❑Yes R1 No r 3 BERKSFIIRE DEVELOPMENT LLC 1 41 TAYL®R ST r a.F ' Owner Name b.Address ° sPRING' FIELD 01103 13.781.2800 c.ClCown d.zip Code a.Tele one Number(area code and extension) 4 DAN LEVINE I JSAME a.Norm of Factilly Owner's On-Site Menager b.On-Site Manager Address Z SPRINGFIELD 01103 13=781.2800 a CitylTown d.Zip Code e.T eOiion�ber(area a an extension) ® anf001ap.doc-10102 Asbestos Notification Form•Page 2 of 3 nic cAspi bri . and Qonrete Rubble [Fact Sheet) by Massachusetts DEP � � age 6 of ` crushed rubble may be used as a substitute for conventional.materials.For example, the crushed rubb c could be used for the base of.a driveway or for fill. 'while the crushed rubble is not a solid waste,its use,is subject to restrictions imposed by other regulations such as the wetlands regulations. NOTIFICATION FORM FOR ON-SITE RUBBLE CRUSHING Submitted in.Compliance with 310 CMR 16.05(3)(e)5. INSTRUCTIONS This form can be used to satisfy the notification requirements for on site ADC rubb,le crushing. Fill in the information and mail the form at least 30 days prior to crushing the ABC rubult, Send one copy to the DEP regional office that includes the municipality where the crushing will take place and send one copy to the board of health in the;municipality where the crushing will tsr_e place. Notifier Name Address i RLFEB Ecity;State,Zip 1 2008 d_i — � Telephone D.E.P. SOUTHEAST REGION Location where rubble is to be generated and crushe(i(if different from above): Street �1'A 14 N ) S A A S � a� City/Town As required by 310 C>dIR 16,05(3)'(e)5,,I am providing 30 days prior notice that asphalt. back or concrete rubble will be crushed in accordance with tY�e re uirements`of 310 CMR I6:05(3)(e), Cru h:nQ will commence,at the location shown above.on 09 continue for approximately 30 a A 1,'' days. -(approximate date)and I am delivering or sending copies of this notification to the DEP Office and and to the Lk (DEP region where crushing will be done)Re,,' of Health (.•nunieipality where crushing will be done)Board httP:Ilwww.state.ma.us/dep/bwp/dsw'rnifile.-,/abc.htm , 10'2 5/2001 o H Ie� 50 -? f 41' -(�-Um u d. tck Massachusetts Department of Environmental Protection h e EP Transaction Copy ................ .............. Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: PONDVIEWEXC Transaction ID: 165600 Document: BWP- Demolition Form for AQ-06 Size of File: 138.038 K Status of Transaction: SUBMITTED Date and Time Created: 2/1/2008::1:42:52 PM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality100067551 B P AQ 06 Decal Number Notification Prior to Construction or Demolition Important: A When filling out . Applicability forms on the computer,use only the tab key A Construction or Demolition operation of an industrial, commercial, or institutional building, or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection cursor-do not use the return (DEP), Bureau of Waste Prevention -Air Quality Control Regulations 310 CMR 7.09. Notification of key. Construction or Demolition operations is required under 310 CMR 7.09 (2)ten (10) days prior to any t work being performed. The following information is required pursuant to 310 CMR 7.09. B. General Project Description 1. a. Is this facility fee exempt-cit , town, district, municipal housing authority, owner-occupied Instructions residence of four units or less?y❑Yes ❑✓ No 1.All sections of b. Provide blanket decal number if applicable: this form must be Blanket Decal Number completed in order to comply with the 2. Facility Information: Department of N/A Environmental Protection a.Name notification 1640 IYANNOUGH RD. requirements of b.Address 310 CMR 7.09 02601 BARNSTABLE MA c. it T wn d.State g.Zip d f.Tel hone Number area code and extension .E-mail Address(optional) 12000 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: COMMERCIAL BUSINESS I. Is the facility a residential facility? ❑ Yes No �O m. If yes, how many units? Number of Units .c) 3. Facility Owner: �N STAR NOMINEE TRUST �O a.Name �0 1222 BALD PATE RD. b.Address NEWTON MA 02459 c.City/Town P.Zii2 Code �O �O f.Telephone Number(areaode xt n i n .E-mail Address o i naI _Q h.Onsite Manager Name ag06.doc •10/02 BWP AQ 06 -Page 1 of 3 f Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality 100067551 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition General Statement:If Description B. General ProjectP tion Cont. asbestos is found during a 4. General Contractor: Construction or Demolition BOWDOIN CONSTRUCTION operation,all responsible parties a.Name must comply with 1220 RESERVOIR AVE. 310 CMR 7.00, b.Address and Chapter NEEDHAM HEIGHTS MA � 02194 Chapterer 21 E of the General Laws of c.Cit /Town d.State e.ZiD Code the Commonwealth. 17814446302 This would include, f.Tele hone Number area code and extension Q.E-mail Address(optional) but would not be limited to,filing an N/A 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. 1POND VIEW EXCAVATION CORPORATION a.Name 50 FRENCH ST. b.Address REHOBOTHMA 02769 c.City/Town d.State e.Zip Code 4014383000 pondview@conversent.net f.Telephone Number(area code and extension) g.E-mail Address(optional) ROGERFURTADO h.On-site Manager Name 2. On-Site Supervisor: ROGERFURTADO On-Site Supervisor Name 3. Is the entire facility to be demolished? ✓1 Yes ® No �N =0 4. Describe the area(s)to be demolished: -0 12,000 SQUARE FOOT BUILDING �N �0 -0 5. If this is a construction project, describe the building(s) or addition(s)to be constructed: � NOT A CONSTRUCTION PROJECT 0 �Q ag06.doc •10/02 BWP AQ 06 -Page 2 of 3 f Massachusetts Department of Environmental Protection __ ■ Bureau of Waste Prevention • Air Quality 100067551 B w P 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? EAGLE ENVIRONMENTAL b.Survevor Name A1073767 c.Division of Occupational Safety Certification Number 7. Construction or Demolition: 3/1/2008 3/31/2008 a.Start Date(mm/dd/yyyy) b.End Date(mm/dd/yyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding ❑ paving ❑✓ wetting ❑ shrouding b. If other, please specify: ❑ covering ❑ other 9. For Emergency Demolition Operations, who is the DEP official who evaluated the emergency? N/A a.Name of DEP Official N/A b.Title 2/1/2008 c.Date mm/dd/ of Authorization 000 d.DEP Waiver Number _ D. Certification I certify that I have examined the KENNETH J. FOLEY =0 above and that to the best of my a.Print Name �o knowledge it is true and complete. IKENNETH J. FOLEY The signature below subjects the b.Authorized Signature �N signer to the general statutes 1PRESIDENT 9_0 regarding a false and misleading c. osibon ite =o statement(s). IPOND VIEW EXCAVATION CORP. d.Representing 02/01/2008 e.Date(mm/dd/yyyy) �O �Q ■ ag06.doc •10/02 BWP AQ 06 -Page 3 of 3■ r Jun U5 2UU8 b: 2'/HM HV LHShKJEI f-HX p•� x JUIJ-.Q8-26©6 09:225 PM E MORGAN �� r 62 74090696 P.81 ASE►Emg CONSULTANTS,LLC 61 Unity Avenue 0 1 Belmont,loin 0247 B 617-7754658 June Z2 Mr.Sambath Ytm 9M Contractor,Im. 133 Winthrop Avenue Lowell,MA 01554' Refslreree: Air Smaple Anslysh Report Iyannough Road *anzd�MA Dear Mr.Yin: Th"you for providbq Asbestos Consultants,LLC the opportunity to senv your asbestos consulting needs. Asbestos contahua&ceiling u d flomft materials(AC hP was resnoved[Tom the basemen,first ad second floors at the above referenced location.The work was completed an)one 1,20M. The clearance air samples collected within each con%inment Mdieates airborne fiber concentrations are less than 0.010 Fibers/Cubic Centialetelr as required by the Eavira mumtal Protecdon Agency and by the Commonwealth of Massachusetts in 453 CMR 6.93,Appendix 3. The air samples were collected and analyzed using Phase Contrast Microscopy in accordance with NIOSH Method 74 W. A Massachusetts lla rased asbestos project monitor performed the visual inspection. TaWlated air resulo are attached for your records. [Tease cad me directly with any questions at$17-775-4688. Very truly Yours, ASBEStOS CONSULTANTS gey Edwin C.A4aWn Asbestos Services Manager 8nclosure 4 • C z ASBESTOS C.ONSULTANtS aoa�ae. r tABORATORY SAMPLE RESULTS IYAHN000H ROAD.HYAHMS.MA � w r N ' m I 0 Smmffmml lum loC.A7fOIM 1YlLs !AB fiA1E. m 4M{i*� RJIIrIG�IOU !' ■i. rrrsas A!� N tort own CAKFA� !�■ eW Weir --- p IIDftM�i � gum 3 - rmorW MID irIMCIA ■ 3 1i7i1 SNEM AM iN ! a r a M a m 1� 1®e1bM�l� N ? p6Fi0it 0u�TOM Iq:IIYI■tOONIIIIrOf oOrr CLMUWFOr� 7f®ilJCr1a1�0lOmllt J `ei. • 4 - C ' 2 ASBESTOS I�NSULTAKtS .•e�ae. r WOMTOW SAMPLE RESULTS- ROm MY#",S.WA IBM- pgm i N m I m trA1�{Df W�NfCOKYM�J[r •� �e9is• �� [fAli10f1� P� t8� �f®O /A� � i Fm N iow M�Fli�l�i 1�J11d[ � LE tn7•RLYA • 3 illi4� O r 1'CR DNS FARE AI® JO pl{Aa�71106 �' i D r. Z i�. r a M a m 10 a . m IUNDAftrONM N ? i0BH O��ZO•Yi1Rt+MI�Y�/ !q:IM�QON171R�PAr(!�•00►Y <taotusTOsnlr�� 1��III�OMlRSttCll J rtnn-t 4-c uuo r n t uu-4 1 mi t AC 1 Jrmi mmnu t r nn nv. uuo .304 au t 0 F. uu uc 127 Whim.,i PaIII South Yulnrsttrh, MA 02664 March 14, 2008 l'ond Vif;w Excavation FAX: 401-434-3.311 6,10 Iyanough Rd., Hyannis This is to Confirm there; arc no natural gas services to the above addresses, This Was, confirmed by a representative of Keyspan Energy. If You have, Ony questions, please call me at 508-760-7481. Sumn MCM1111in Field Coordinator lKoyspim Delivery Company 5089574508 NSTAR YARMOUTH 09:28:00 a.m. 06-10-2008 112 A NSTA" GA S Fax Corrwapondenoe Tuesday,June 10,2008 To: Roger Furtado Fax t1: 508.336.4467 From: Justin Reihi 1 NSTAR Way, SUM SW330 Westwood, MA 02090 Phone/Fax:781-441-3334 Pages to follow(including this cover):2 pages Service.removal confirmation letter to follow. Thanks, Justin Reihl NCC—Customer Service Engineer } i -e EP -'Payment Confirmation Page 1 of 1 r �U Cam n_o va V� Rd . [7 host. t i t s: a 1 3 rs a s S� n a it x Payment Confirmation DEP Transaction ID : 165600 Payment Date : 2/1/2008 1:52:04 PM $85.00 has been charged to Credit Card ************2335 Transaction Information DEP Payment Code#29172 Payment Confirmation#25285 Please note that payments received after 3:30 pm will not be posted until the next business day. MassDEP Home Contacts Feedback Tour o Privacy Version: 6.9.0.1 https://edep.dep.mass.gov/Restricted/we.bpages/PaymentConfirmation.aspx 2/1/2008 eDEP: Print Receipt Page 1 of 1 Submittal Summary & Receipt Your submission is complete. Thank you for using DEP's online reporting system. You can select"My Homepage"to review your status. DEP Transaction ID: 165600 Date and Time Submitted: 2/1/2008 1:37:26 PM Other Email : Form Name: BWP- Demolition Form for AQ-06 Payment Information DEP code: 29172 Date: 2/1/2008 1:36:30 PM Amount($): 85 . Payment Detail: POND VIEW EXC. FOLEY--Card --2335 Contractor Contractor Number Name Address, , Supervisor Project Monitor Lab WUJuu .. . https:Hedep.dep.mass.gov/Restricted/webpages/printreceipt.aspx 2/1/2008 Alawchusaffs Department of E1vironmMIAll Prolectlen Bureau of Waste Prevention—Air Oualrty t BWP AQ 06 Notification Prior to Construction or Demolition General Construction or Demolition Description 1, construction or demolition contractor d yes,who conducted the survey? PAW QrLOWW dMftWes Gnikalm lVvrr w(/) AddrW Goan — 7. Construction demolition- ......._............ ............ _..„-. „.._.. ..�-.. reset „.._ __._ _ fne ... ' So►1 Deft 2. On-Site Supervisor B. For demolition and construction projects,indimte dust T. suppresslon techniques to be used: „ .........�.. ... ..................... _ _....„ Nre ❑ aeedin ❑ parino we in ` ❑ shrouding 3, is the entice facility to be demosished? p cmnng ❑ other Yes ❑ No 9, for Emergency DemolillOn Operations,who is the 4. Describe the area(s)to be demolished: State or mcai official who evaluated the emergency: .............„........................ -�.._ __.....� ..:'. ... .!4�..... ..(, . ..............................-•-.--... ..............._........ .__ .. 5. 0 this is a construction project,describe the building(s)or _...........„„r _ .............. addition to be constructed: AWh W �L..o .. „....... _ D�4Y�►�sr� 6. 0 this is a demolition project,were the structute(s) surveyed for the presence of asbestos containing material (ACM)? Yes ❑ No ! (General Statement if asbestos is found duNng a Construction or to.ding an asbestos removal notification with the Department Demolition operation,all responsible parties Must comply with mdlor a notice of a releasehhreat of release of a hazardous 810 CMR 7,00,7.09;7.15 and chapter 21 E of the General laws of substance to the Department,it apDlicable,) the Commonwealth.This would include,but would not be Gmiled t Certification t I certify that I have examined the above and that to the bast of put my knowledge It Is true and complete.The signature below .....e .. ���..:_.. subjects the signer.to the general stalutes.regarding a false Aup, aastpnure, - and misleading statement(s). . ..'�..... ...................... ........... ov E BrSHIRE D EVE LOP MENT, LLC May 15, 2007 Pond View Excavation ATTN: Roger Furtado 1 Dexter Road East Providence, RI 02914 y RE: 624 & 640 Iyannough Road, Hyannis,MA Demolition Dear Roger, We are pleased to inform you that it is out intent to enter into an AIA contract with Pond View Excavating as the demolition contractor for 624 and 640 Iyannough Road located in Hyannis, MA based on the following agreed upon terms: • Agreed upon lump sum in the amount of$82,000.00 for the demolition and various demolition disciplines as outlined in following documents: o Hyannis, MA Scope of Work; o HTE Pre-Demolition Hazardous Building Materials Inspection report dated September 6, 2005. • Agreed upon lump sum price of$82,000.00 for the demolition will be held for a period of 90 days from the date of this letter of intent. Please feel free to call me at(413) 781-2800 ext. 284 should you have any questions. Thank you and we look forward to working with you and your company. Berkshire—Hyannis, LLC By: Berkshire Development, LLC, Its Manager 41- X� William Johnson Director of Construction WRJ/runp BERKSHIRE DEVELOPMENT,LLC cc: Timothy J. Traynor 41 Taylor Street• Springfield,Massachusetts 01103 Telephone: (413)781-2800 • Facsimile: (413)781-8888 www.BerkshireUSA.com Berksf llre - Hyannis, LLC 41 Taylor Street Springfield,MA 01103 Ph:413-781-2800 Letter of Transmittal To: Pond View Excavation Corp Transmittal#: 13 1 Dexter Road Date: 5/15/2007 East Providence, RI 02914 Job: 05-5220-01 Hyannis, MA-Sitework Ph:401-438-30000 Fax:401-434-3311 Subject: Hyannis, MA Demo LOI WE ARE SENDING YOU r Attached 177 Under separate cover via None the following items: P 9 I 1 Shop drawings r- Prints r Plans 17 Samples 1 Copy of letter 17 Change order r` Specifications r. Other Document Type Copies Date No. Description LOI 1 5/15/07 Letter of Intent THESE ARE TRANSMITTED as checked below: r For approval r" Approved as submitted l- Resubmit_copies for approval R For your use 17 Approved as noted r Submit_copies for distribution r, As requested C" Returned for corrections r Return_corrected prints 17 For review and comment C Other r FOR BIDS DUE 1" PRINTS RETURNED AFTER LOAN TO US Remarks: Copy To: Bill Johnson (Berkshire Development, LLC) From: Nina Paul Signature. 44, 4 ,1,10 Ad If enclosures are not as noted,kindly notify us at once. Page 1 of 1 FeBEx I Ship Manager I Label 7907 3976 5139 Page 1 of 1 From: Origin ID:FXMA (413)781-2800 Ship Date:15MAY07 Nina Paul FeCE& ActWgt:1 LB BERKSHIRE DEVELOPMENT,LLC Ewess System#:583947011NET2600 41 Taylor Street Account#:S•**RR•... 4th Floor Delivery Address Bar Code Springfield,MA 011031205 1111111111111 I I II I III II II 1111111111 I I 11111 SHIPTO: (401)438-3000 BILL SENDER Ref# 05-5220-02 Roger Furtado Invoice# Pond View Excavation De # Dept# One Dexter Road East Providence, RI 02914 STANDARD OVERNIGHT WED 1 Deliver FORM 116MAY07 y TRK# 7907 3976 5139 020, PVD Al 02 914 -RI-US � ,� � , � EN WSTA ............. Shipping Label:Your shipment is complete 1. Use the'Print'feature from your browser to send this page to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. 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Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide,available on fedex.com.FedEx will not be responsible for any claim in excess of$100 per package,whether the result of loss,damage,delay,non-delivery,misdelivery,or misinformation, unless you declare a higher value,pay an additional charge,document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply.Your right to recover from FedEx for any loss,including intrinsic value of the package,loss of sales,income interest,profit, attorney's fees,costs,and other forms of damage whether direct,incidental,consequential,or special is limited to the greater of$100 or the authorized declared value.Recovery cannot exceed actual documented loss.Maximum for items of extraordinary value is$500,e.g.jewelry, precious metals,negotiable instruments and other items listed in our Service Guide.Written claims must be filed within strict time limits,see current FedEx Service Guide. https://www.fedex.com/cgi-bin/ship_it/unity/3BjQv5BjVw9HiQr7EbQw6Ej Su3BhTv2JgS... 5/15/2007 A-0R�i. . CERTIFICATE OF LIABILITY INSURANCE 03/052 8 PRODUCER (401)431-9200 FAX (401)431-9201 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Troy, Pi res & Al leh, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 376 Newport Avenue HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 4830 East Providence, RI 02916 INSURERS AFFORDING COVERAGE NAIC# INSURED POND VIEW EXCAVATION INSURERA Selective Ins Co of Southeast 39926 1 DEXTER RD INSURERS: Charter Oak Insurance Co 25615 BUILDING #3 INSURERc: Beacon Mutual Insurance Co 24017 EAST PROVIDENCE, RI 02914-2045 INSURERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY S 1685717 01/30/2008 01/30/2009 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,00( CLAIMS WADE T OCCUR WED FXP(Arty one person) $ 10,00( A X No residential eXc PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 3,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,00( POLICY JPER0. LOC AUTOMOBILE LIABILITY BA3376070 01/30/2008 01/30/2009 COMBINED SINGLE LIMIT ANY ALTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY $ B X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE } (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS(UMBRELLAUASILITY S 1685717 01/30/2008 01/30/2009 EACH OCCURRENCE $ 1,000,00 X OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 A $ DEDUCTIBLE g X RETENTION $ $ WORKERS COMPENSATION AND 27764 01/20/2008 01/20/2009 X wcsiniu oTH- EMPLOYERS'LIABILITY EQEY I Ii C" ANY PROPRIETOWARTNER/EXECUTWE E.L.EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? E L.DISEASE-EA EMPLOYEE $ 1.000,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,00 OTHER DESCRIPTION OF OPERATION I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ERSHIRE-HYANNIS LLC and BERKSHIRE DEVELOPMENT LLC are additional insureds for ongoing and completed operations on a primary, non-contributory basis with respect to general liability, auto and umbrella policies. ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE-THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL BERSHIRE-HYANNIS LLC 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BERKSHI RE DEVELOPMENT LLC BUT FAILURE TO MAL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 41 TAYLOR STREET OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. SPRINGFIELD, MA 01103-1205 AUTHORIZED REPRESENTATIVE yy�`� lAmy Kin AMY �1, ACORD 25(2001108) OACORD CORPORATION 1988 THE TOWN OF BAR NSTABLE 33AUST LE. 4 11"IL .1 0 039. nn BUI �DING INSPE Tly,�, e,e APPLICATION FOR PERMIT TO Rogers & Gray Insurance Agency, Inc.............................................................................................................................. TYPE OF CONSTRUCTION ..........Frame......... ................. ................................................................... ...........Februar 5...............19.7.3.. TO THE INSPECTOR OF BUILDINGS: The undersicri'did-hereby appIfes"for a permit according to the following information: Location ....Lot..10 of:Land Cqurt.Plan filed with L.C. Certificate 48846. On the north side ....................... Iyanough Road, Route Proposed Use ....Of.fic e..b.uil.d .. .ing..... .. .. .............. .... .................................................................................... ......................... . .. . ........ .. ...... . .... Zoning District ..Bulneisp..Pirp.tri.q.t...:.....:......................Fire District ......4ypmis......................................................... Name of Owner ..RQ9 8.Wes.t.. Main„..t.......gn!jn..is ....... Name of Builder PhMip.. ......................::...........Address S- .................. Name of Architect .....Harry..Pr.eble....... ...".Address .. . 28, Centerville. .. Number of Rooms .....8................................ ........ .. .............Founclafior� 10"..p.q.ure.4..concrete.................................... Exterior .9lapbqar.d..&...wood...shiN;le.............. ...........Roofing ..�sphal.t.�..or...cedar ............................. .... .. .. ........ ...... .... ........... . .... . ........ ........ ...... Floors ...§!4�f�qor.s..fo.r...c�t��A,�g.................... ...........Interior 1.1.ywood...pan.e.11ing........................ .... .. .... . .. . .......... ...... . ........... ...... Heating .4eqtric Heat jk.:4i Conditio Copp ... ............................' Pump ....................Y?�Plumbing .......... ............................................................. Fireplace Aq Approximate Cost ......$57,000 .................................... . N *. Definitive Plan Approved by Planning Board ----- ----19--------- Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OFF 'BOARD OF HEALTH SEPTIC SYSTEM Musr-BE ' INSTALLED IN COMPLIANCE WITH ARTICLE [II STATE SANITA.Ry CODE AND f0W REOULATONS" Nl� ( 1 4 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............ ..... ... .. ..... ...... ............ Rogers & Gray Insurance -Agency, Inc. No 5951 Permit for ........1..1.../2..stOX7 .. .... ............... officeZ building ...................................................................... L R Location .............. .I..2Av 0.nPAC-0 ......................Hyaruds ..................................................... .... 2 ,0 Rogers.& G?'ay Insurance...Agency; Inc. Owner Type of Construction .........................frame.........ral.m..e........ ............................................................................... Plot ............................ Lot ................................ f I Permit Granted ....................................March 5 73..19 4-0 Date of Inspection 13..........119 Date Completed-6............19 TO PERMIT REFUSED ........................................... 19 ............................................................................... ............................................ ............ ....................... ............................................................................... ........................................................................... C> le < .19 Approved ................................................. ............................................................................... ............................................................................... , �. A � f�_ TOWNIOF BARNSTABLE, MASSACHUSETTS BUILDING PERMIT h 1 A-311-012 DATE December 2, 19 94 PERMIT NO. NQ �37 $1'2 APPLICANT Jack Klim ADDRESS 52 Fodder Hill Road, Barnstable #t017310 (NO.) (STREET) (CONTR'S LICENSE) Stri & Reshin le Roof Commercial Bld • NUMBER of PERMIT TO p � I—) STORY � DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 640 Rte 132, Hyannis ZON LNG AT (LOCATION) DISTRICT — IN0.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: AREA OR No Area Change PERMIT Q. VOLUME ESTIMATED COST $ 500•00 FEE .D 100.80 (CUBIC/SQUARE FEET) OWNER Rogers & Gray Ins. Route 132, Hyannis = BUILD ADDRESS y BY !) OWiJ OF BARNSTABLE, MASS�r%,;%�`� :��,..�,,.�.. ;,�•,�.,,,:�,. ti .,..�„a"�� �,.. : . _.,,., . ACHUSETTS BUILDING PER IT A-3.11 Ail �' 6 DATE Deeembe`r 2, ,9 94 � �2iQi . y PERMIT NO. APPLICANT JSC�c .>im _ ADDRESS 52 Potder Hill Road, Barnstable - 9,1.7310 _ (N0.) (STREET) (CONTR'S LICENSE) } PERMIT TO Strip �' eshingle Roof Commercial Bld . NUMBER OF (_) STORY g DWELLING UNITS (TYPE OF° IMPROVEMENT.)i5 NO. (PROPOSED USE) 640 Rte 132, 'H annie ZONING AT (LOCATION) _ y DISTRICT (NO.) (STREET) BETWEEN AND 1 (CROSS STREET) (CR 11 O55 STREET) f LOT SUBDIVISION LOT BLOCK SIZE . r BUILDING IS TO BE FT. WIDE BY-'� 4 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: sr AREA OR VOLUME No Area Change �, ESTIMATED COST 500.00 PERMIT $ 100.80 FEE (CUBIC/SQUARE FEET) OWNER Rogers` & Gray Ins. . p BUILD)` � DD�� i ADDRESS l:f_ut2 32, Hyannis :"' _, F 8Y t C � THIS PERMIT-.CONVEYS NORIGHT TO �OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERM AN.EN�, ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THdE BUILDING CODE, MUST BE AP- PROVED',, BY' Ty]-1E JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KE PTPOSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY'(S RE- MECHANI CAL,INSTALLAT IONS. 2. PRIOR.TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL ' MINAL IN (RE INSPECTION TO BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT 'W!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. I PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. BUILDING PERMIT .h-� •� ., _, - '� j � l �� 1S• / J, ' ��l Gam`.../Z .� 4 ���z' p%(�'y '"r. .• _ i - .. ,. .. . Assessor's map and lot number .? .............../...... THE Sewage Permit -number ,./ham.......... .......................... ! 339Hd9T/1DLE. i i House number 9 MAs6 ...... :.... '................. ..:x ............... ape,i63q• 9� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO AM � 1."(..:..94 ................... TYPE OF CONSTRUCTION .................. .�� .......................................................................... ..........//...... ...............:19.. ' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 0 U...... �/ /J' ,7. -1 // Q ...........................�• /Y� n ii�i.S. ...................... ProposedUse ...... ................................................................................ ......... ................ . Zoning District ../.....................................................................Fire District :..... ...�......................................................:......... Nameof Owner .....Address ......,5!1. ''!` ..:............................................................ Name of Builder ��� -�F�� c� .'— -T '��NOjr� %/9�i�I�s !�11. mr2? .. ...... ......�.....................Address ... ..,. ..........,...........�.......................f.................. Nameof Architect �—�..................................................................Address .................................................................................... Number of Rooms ..................................................................Foundation .�Q �r Tv/l Exterior Roofing ° .[ L Gcf floors AfyC! ...................................... .....:................Interior .....T�...�..:...`....:....................: .................................. Heating ........C�... f.t.k...........................................:........Plumbing ...... ' ...:.......................................................... Fireplace ................ ...... .......................................................Approximate Cost 9 a17� ................................... Definitive Plan Approved by Planning Board --------------------------------19________. Area ...... ..f(9.......................... Diagram of Lot and Building with Dimensions Fee � � 7� ..... .......... ............................... SUBJECT TO APPROVAL OF BOARD OF HEALTH a,aq0 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... /...:.. " .::.... ........................... Construction Supervisor's License oobSS..... ROGERS & GRAY INSURANC CO. A=311--12 27323 ADDITION No ................. Per it it f .....� .......................... cr. Commercial dg Office Space ............... .......................................................... 17 Location ...640--4?,90t2E:d&........U. ............ Hyannis ................................................ Owner Roger & Gray Insurance Co. ................................................................. Type of Construction ...Fraim.. ................... .......... ......... ................................................................................ Plot ............................ Lot .................. ............. Permit Granted .._Decenioer 13. ........19 84 ............................ Date of Inspection ....................................19 Date Completed ......................................19 '6 5 • • AA • 1 � • i • ? z- f -�"', ^���, w ,� `:���t.- fink,. fi Igj�• W—w, So 44 �S. fF ''�'S�,fz,,."�7�`, s � hr • � �� f $ . +�, r. ��1'4 ti. o � Kjk,. ..,' i..' 'fit ai 'a,✓ `r Tq t va I UMBER SUfF. STREET NAME " rt `E.'MAP PARCEL CARD N0. TOWN CLASS ROUTING N PRO - 010 109 101 113 Loc. "o ----'—=—'� tG� —_ ___ 3/I' =—' .• ---------- QLOFj0 / �o2A r: O/to I_ IYANOIJGH::.ROAD OQ031 1 0 12.000. „ :,. 20 RECORD OF OWNERSHIP AND MAILING ADDRESS* .' LOT NO... DEEDBKJCTF DEED PG. DATE PURCHASE PRICE,: Sol GRAY MILTON. M- R - . 902 903 CRYSTAL .LAKE. .DR 904 ORLEANS MA° �:02c 53 _ MEMORANDUM r ' ACRES ST.CLASS CD. LIVING UNITS FIRE DIST. ZONING MULTI NC NEIGHBORHOOD 102 103 108 r +. 104 105 1 130 3Sa a ' -----e 111 299 DELETE 300.330 LAND DATA&COMPUTATIONS SALES DATA 700 0 NONE ACTUAL EFFECTIVE EFFECTIVE ACTUAL UNIT PRICE DEPTH EFFECTIVE INFLUENCE FACTOR LAND VALUE MO YR TYPE AMOUNT SOURCE VALID N FRONTAGE FRONTAGE DEPTH FACTOR UNIT PRICE 301 LOT L - -•-- --- - - --I - - - r �.--a 200 1 REGULAR LOT L -•- _ - ._ -�- - --I-- 2 MINUSLOT - - .- If• ;-- 201 .3 APARTMENT SITE L -a- --- --t= -- -- L -- 202 _�---�- 4 WATERFRONT -- --- l °o -- - - - - -- - - 304 - L -•- --- --- --I- -- -- L -- TYPE CODES VALIDITY CODES --�('1 -- -- r -- b_O/�/, 1 Land 0 Valid SaN 310 Sa'T PRIMARY SITE l ^�I�- SO.FT. �1�.11C•c+- INFLUENCE FACTORS 2 Land&Building t InwhadAdd�lParcels 2 SECONDARY SITE 2� Q l 3 Building 2 Not Open Market 3 UNDEVELOPED 1-,:-B S I SO.FT. - .._I-•O-" 1 UNIMPROVED -- -- �"`�`� SOURCE CODES 3 Changed After Sale 0 RESIDUAL _ +' - j, r n 4 Related Individuals or Corl). 312 5 WATERFRONT ..S _ _ -i_^_= SO.FT. ___•� � 2 EXCESSIVE FRONT a,l t Buyer 5 Liauidation/Foreclosure - • 3 TOPOGRAPHY -- -- 2 Seller 6 Financing/Land contract 315 ACREAGE + - f 1 0l ' 3 Agent 7 Included E appive Para Prom A _- •_ L`_JICRES — --I--- 4 SHAPE OR SIZE -- -- 4 Other or Other-Sea Man o 1 PRIMARY SITE .�: - 2 SECONDARY SITE q ._' •-� --ACRES — -_i--- 5 ECONOMIC 1� - INFO COD a uNoevELoveD MISIMPROVEMENT - -- ENTRANCE CODES MARSHLAND A ---• -ACRES — --I--- 6 RESTRICTIONS- -- - -- 5.wATERFRONT NONCONFORMING TRANCE 8$IGNATURE.GAINEO 5 CURRENT UNOCCUPIED 1 OWNEF A _ --•---ACRES --I--- - _- 1 ENTRANCE GAINED 6 EST.FOR MISC.REASONS 7CORNER/ALLEYI+I - r 2 NOTAPPLiCABLE,UNIMPPAHCEI (SEE MEMO) TENA% 9 DESIGNATED -- -•---ACRES — FORESTIAND/ A -- -- --I--- BVIEWItI -- L �-- .ENTRANCE&INFO,REFUSED 7 OCCUPANT NOT AT HOME 320 OPEN SPACE -•_ 4,ENTRANCE REFUSED,INf.O AT DOOR r 3 OTHER 72.5 0 TOTAL vl —ncREs _ SUMMARY OF VALUES SIGNATURE BY OWNER OR AGENT BELOW INDICATES DATA ON THIS FORM WAS. DROSS. TOTAL VALUE LAND _ �/: COLLECTED IN YOUR:PRESENCE,IT DOES NOT MEAN THAT YOU HAVE VERIFIED 1 IRREGULAR LOT . G I--^I--- . J 2 SITE VALUE THE INFORMATION HEREON 3 RESIDUAL TOTAL VALUE BUILDINGS ��� 4 HOMESITE .. .. 9 MINUSR.O.W: TOTAL VALUE LAND&BLDGS. �U 41Q ._ PROPERTY FACTORS 405 LOCATION.—. 4i0. PARKING AVAILABILITY ' TOPOGRAPHY UTILITIES STREET OR:ROAD CENTRAL BUS DIST I...-., TYPE QUANTITY Z PROXIMITY INSPECTION WITNESSED BY: LEVEL 1 ALL PUBLIC. t . . PAVED 1 PERM CEN BUS DIST 2 0 NONE 0 NONE . 0 FAR. I OFF STREET 1 MINIMUM 1 NEAR PROCESSING DATA ABOVE STREET 2 PUBLIC WATER 2 SEMI-IMPROVED 2 BUSINESS CLUSTER 3 .2 ON STREET 2 ADEOUATE 2 ADJACENT 3 ON 8 OFF STREET 3 ABUNDANT 3 ON SITE DEL A00, CHG F/D MO DAY YII'' BELOW STREET 3 PUBLIC SEWER ClA D 3 MAJOR STRIP 4 4 PARKING DECK ROLLING 4 GAS ED 4 SECONDARY STRIP 5 BUILDING PERMIT RECORD 1 2' 3, 4 - 1 2 3 4 STEEP 5 WELL GUTTER 5 NEIGH or SPOT 6 DATE NUMBER PRICE PURPOSE 1 2 3 _- 4 - LOW, 6 SEPTIC ALK 6 COMM/IND PARK p 1 2 3 4 SWAMPY 7 NONE 7 INDUSTRIALSITE 8 1 2 3 4MARSHY A q - - .... ,,., ... ,..._j _3. .. V - HEATING&COOLING - • VACANT ti rNIU BLDG.DESC. 818 SYSTEM Bt9 HEATING TYPE 820 COOLING MAIN BLDG.COMPUTATIONS / - . l BSMT J C �� - - :� F FLR FIN SCH FIRST .3 ....w.»+...� _ n sr7MF I HOTEL - t./ I ->.-� ...........,.. HGT TYPE NO RATE•/; .- MOTEL _ UPPER AVG.UNIT SIZE - , I 826 B l0 01 O I f' b :304 1 NONE r - -� -- ' 2 UNIT HTRS 1 NONE 1 NONE - _ 627 t, 2 FHA 2 PKG UNITSZ OP AGE YCENTRAL HTG 3 GHA ^ -- -- D1 3L.�i 0 '- 4 CENT HTG&AC 4 FlR/WL FUR 3 EVAP 828 - _ CfE j EXTENDED REMODELED S ` _/5 ELEC BB/C LG 4 REFRIG - - /l/ _ -- -- - 5 HEAT PUMP fj --- t- 6 STEAM/MOT WTR - r :-. .: .. -. t _ - 829 O -- F.Oo 807 190 /ODD 7 HEAT PUMP - 1 FOUNDATION i PHYSICAL CONDITION "t "--'"""- •- - 8,0 . t- - - --_--- FUNCTIONAL UTILITY ——-- 1 MATERIAL i 3 4 �...1.: ( 621 GOOD AVG POOR UNSOUND 822 i 2 3 4 f 2 9 ;.. ..... 831 1 G 7 J 4 5 G DAVGPOOR ABANDONED _ - LISTED '- /`-S`� - .. ._ .. ,.. 8� OZ Z2 S TOTAL _L.-L•j� n < r - -��•... CB BRK STN. FR' REVIEWED _ 1- BASEMENT 823 BY DATE ✓� I 3 LF c�.77 ""- v K 1/ 24 BY DATE @ A/U .; . Q -11? -- 8 5 SD FT X % �'/y�1 i.ac4c. ' -- IIyJ�7� 4Q9,9 ....-rl i r?o.J,L 1'a v2 J/4 r�ADDITION$ _ .... _ wrL�`*� 836 ADJ BASE RATE _��•.SL a'BtOI EkTE RIOH WA �•AN P7,- - NO TYPE SIZE X RATE - -- - �'�1••^•*-_ 837 INTERIOR FIN -� +�r /!11 AMOUNT '" _ ... (J t,tl �R•1.1^� 11'9 REINFORCED CONE' 85R 1 ..� ... t J HII�fi 10 METAL -. —— • - .... .. - .. I � _ t, --- -- f 838 LIGHTING `" 11 ENAMELED STEEL 859 2 a.fj(- ! _ J t i�� I 839 AIR COND GLASS - -" i- i.. i � ' 840 P� F • y� n Ia STONE 'a STUCCO/FRAME 861 4 .� �6 T;;.E :5 STUCCO/MS s -- Je PRECAST 'Ohf- 16 OPEN 'r-'". 4 43 TOTAL MF&OF 844 SUB TOTAL RATE FRAMING 863 6 f -- - - t_ _ BASE AREA 7 i fj 2 J 1 1 8 7 1 4 I ., .: .-. - —— - - 845 X if ER FIRE RES E?.CONC. S7L/RE IN.CONC TOTAL ADDITIONS -t -"r- - — — - . # ",-� 646 SUB TOTAL 113E o�/o_.Ste i ROOF &E FORM LEFT RET REF EST 847 ADDITIONS IN r-1----.-I-_- ADDITION TYPE CODES MF&OF TYPE CODES 1�vE - -1--- ! i s"rr?uc. COVER MAT. MECHANICAL FEATURES&OTHER FEATURES 848 SUBTOTAL 01 CANOPY 01 PLBG FIXTURE - j OWD FR 02 DOCK IMPR S i 1 U COMP 02 STORE FRONT O OF - -TVBIOIST (2iCOMP SH• 03 CPY/DOCK TYPE IMPq QUANTITY/SIZE �D P" STEEL TRUSS 77T 03 SPRINKLER RATE 849 GRADE C a rnP a SLATE o4 OFF! 867 REPI COST -, �.�.- X I QA I 5 ARCH w'J TRUSS 4 METAL 05 OMP _ 04 MEZZANINE Q 1 U /n T _ - 5 CONC. - OS PARTITIONS -- —ICI-__--.5� y /�) 850 REPLACEMENT COST" j 5 SA v T. I 5 TILE 06 FR ADDTN-FIN gpp _ _ _ YI y L% �q fy 11 rUVITnn 6 COPPER 06 FLOORING 07 FR ADDTN- -_t - - 851 PHYSICAL DEPR- M AN$ARf7 7 WOOD' OF .. 07.DOORS _-- -- ----I � � 'v _■yl 3 nrtn R.EL I - 08 MAS AD IN OB ENC-FIN 869 I 09 MAS ADDTN-UNF 09 ENC-UNFIN —I 1` 853 OBSOLESCENCE -- ��� FLOORING 10 WOOD DECK _ 870 -- • - _ % T - .. 11`PENTHOUSE 10 CRANE 7. - �813IS7HUCTURE8t4.: II PASS ELEVATOR -- '--- �I�� _ 85q "1 )•' 3 4 '_ COVERING MATERIAL 12-SHED - 871 ' -- • -1_ :::NONE FUNC ECO -F&E - 12 FREIGHT ELEVATOR - p$rnT 13 GARAGE 1.3 ESCALATOR- _ +FIRST 99 MISCELLANEOUS 99:MISCELLANEOUS OF 872 • _ 855 NET BLDG VALUE- JC t_ IT _ UPPER I i _ 856 NO:SIMILAR"BLOGS- X. -- osa r cooe8 . OTHER BUILDINGS&YARD . �� T 873 TOTAL - E"`I " 6 .CARPET _ _ -" -MF&OF - - 857 TOT:NET BCD(LVALUECOh CRLTE 7 TERRAZZO "NC TYPE'. CONST SIZE- Ol GARAGE 14AREA GRADE "RATE YEAR COND ;DEPRECIATIONti7L'sTWOOD 8,CERAMIC TILE. COCONC PAVING 82 WD FENCE '1 - REPL VALUE 02 CARPORT 15 SHOP 1 712 `J F M O PHYS L I.:NCJSTI JSTI a ASPRnLT 9 MARBLE - 83.LIGHTING _ �"" � � 7,IJ -" ` "�" � L .03 PATIO 16 OFP ' - - _ _ - 1 i- VY w 1 l'CNCPE TE - 84 CANOPY • �- )11 718 `I♦' - 'a 04HED. 17 OMP FMO S 2' 722 - 85 R.R SIDING INTERIOR FINISH 05.POOL 1S 11FRAME - •' 721 7� -- OB.MOBILE HM 19 1FMAS 86 DOCK: 3 732 fMO - ^'-'17 - 815 WALLS 816 87 TANK - -- - *T_I 733 - -- -- CEILING- 07 BATHHOUSE 381MPSHED " " _ _ -•. "731 7 - _ 88 TANK ELEV �' �712 FMO BSMT - 7 08 SHELTER 70 CABIN " - 743 -- -y+ 89 TANK-UNG• --1-I- - _ _ 744 746 -- -- FIRST '09 STABLE 7) RES G'HSE 90 TANK-PROP .- 5 752 UPPER -3 10 SUMMER KIT 72 COMM GMSE - "FMO' - - -� 91 SCALE -�I�I�-_ 753 �:• 754 7 it CELLAR 75 TENNIS COURT 92 RET"WAIL B 782 F MO � _ 01 UNFIN 05 WOOD PANEL d9 TILE 12'WELL HOUSE 80 BT/C PAVING 9370WER _ 764 13 B.T.PAVING 81 WAY FENCE '7 772 - • 766 02 PAINT O6 METAL IOACCGUS.TILE 95 _ - FMD ` - 03 DRYWALL 07 MARBLE 11 00 MISCBLDGS - --- l -- 71 _ - ---- -776 K SUSP•ACCOUS. � _._. -.._ -i MO. -�- .. .-. __ .. -.. -. � �. -- 08 FIBRE BOARD 72 GLASS 800 TRUE VALUE ALL-IMPROVEMENTS It - ;S•5� ` 14 AK, f i R I " Y - l`♦ 3 l YO b o 2 i 0 00 qjql, 3 r Assessor's map and lot number .:/�-.,�. ..... . F.TH E .. r _ " C'� _ -� ��PvC Tod♦� Sewage Permit number .�.� ✓ .............. 9 Z EAMTADLE, i House number ............ .... ... .:. .........:.. .................... MAB6 SEPTIC SYSTEM MUST BE o te39. 0� �'0 MPY TOWN OF .B�� E F . BUILDING INSPECTOR APPLICATION FOR PERMIT TO •'CORD. �h.....4�...... .... ...., .. F .................... .............. ............ . . ... ... ... TYPE OF CONSTRUCTION ..................Iff ............:........................................................ 4 ...........................a�................19..f!.1.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... yU...... ..�vY.a�.;..... 'li�Q. .... '....: �1 !:��.C�.............................................................. ProposedUse ...... �����. . E�.(�?r 4=.. ..... .......................................................................................................... Zoning District (J ! /4r'N�S ................................. ' ........................................................................Fire District ...... . .yl. .. .....`..........:........ Name of Owner-A, C.l �o ....-T�o .i <: :.....Address ......., .:............................................. .:..... ... Name of Builder �7 ' / l Kf/� ..`�k G ...Address ...d437 f..................... D.JdG ... ................. Nameof Architect ..................................................................Address. .................................................................................... . .Number of Rooms ............:a.. ...............................Foundation .fO........rv.11.. ............ .................................................. Exterior ....u1:r.C.:. f'l.(. rj�G:S................................. .Roofing Floors ...... _ � ...... ;In�rior ...... ... ................................... Heating �'r,.!<lr Yll ;t .` Plumbing ..... Fireplace ... ...... . ......................................... Approximate. Cost ......a �f ei2l? ......... ... Definitive Plan Approved by Planning 'Board _ ___ _._______ , „_19________. Area ............................ ............... Diagram of Lot and Building with Dimensions Fee . . SUBJECT TO APPROVAL OF BOARD.OF HEALTH �aqD ` . Go y610 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...../�...,... .... .. /VY.................................. Construction Supervisor's License ........ .........�....... ` ROGER & GRAY INSURANCE CO;, k 27323 ADDITION .' 'NO ' 'Na Permit for ommercial Bldg....Office..�Sf�Qe r _ Location 640... ram . .... .... ...............Y.annis.........................................." f , O Roger & Gra Ins wner ...........................Y......lla. WsMoa..Co...... _ Type of Construction Fri............................... ; Plot Lot ' December 13 84 ' Permit-'Granted ...... ...................�...........19 _ Date of Inspecti ..... . 1,9 Date ':Com leted .-A9 e f RUG-2.5-199.5 15:40 ROGERS&GRRYFHYRNNIS 1 509 790�4212 P.01 'v,�, �,:9 r• 7;7: :�R7:§?F,^,+t;"9�i:;tKRf :nx7:7sFK:9'kn:t R?:vKk�?2 xas;Ga. :xaxaxn: ��Fx:s:2<xx<:'.�s:n>;xxK:Fk'4x�f��KKk'i:F£;�s:7:ff:.•�r�f x'Y4t` r�ts^; .r•� ........ ,�'`' � n X>: <iv.' ''''k: x% a� �ri�er ,,,i � x �� ;.4�xx6x >€:K•s N:,', F. x<t ®.>e. gin! •> x ;<.. •r,!i <.,..:,<. .% �:, ;r: i„ ,t�f, ,r. ., 'irx. ,w� sr'a:„S .i:' K>, isk•�. ;�: q:n: y.,. i'!i:a; e.�x„�.y„:<':e:�.� ,!t.y. <>:'>;a:<:<'s:on-<.},;.g'i: �'': ' C M jp,r��yy ii fire �:r+�i'•;i. ..Gs"�n�„ �:,x„ ,�x�x:ksj: '*:� 'rr r�r.s,„,��,k :k:'1I:, x'; s!iR rl�l 5 F �:r�; ,n.xrons•x.r'?xs•n ... �xbs.< �.,kss":�x�.x:<tF;t.s.�.<r�riir�ks;<.sc ,< ><r:a. /Z /1 gr5, <8t S.rl`as's � .. :,.:,.,.:::..,.. ...S..................... PRODUM THIS CERTIFICATE 15 ISSUED A9 A MATTER OF INFORMATION ONLY AND Rogers & Gray - Hyannis CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE y y aSnn DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 640 Iyanough Road/Route 132 } POLICIES BELOW. Y ..:..................................................::.:....:.................................. H annis DtA OZ601-1999 COMPANIES AFFORDING COVERAGE ....(508) 775-0011 FAX 775-0866 ..................................................................................... i�Y A CNA ..................................................... INURED ............................................................................ LETTER C 8 Lumbermens Mutual Casualty Co .:...LET7FA................................................................ .................................... American Property and COMPANY C ConstructionServices, Inc ......................................................................................................................................................... 64 Enterprise Road COMPANY D Hyannis, MA 02601 ` ' COMPANY E �!r g k ><k. `r.%:Si«t'i:e:;t. o'`:r4: :•''<:s ;;x.o'c.>x.x xox r,:x>,><rq:.','e5ny,:•><'>nn?><ar:cr;�:� �;r;�<r n 'n'h�s�<,i K� >.�I � ilii. :ri,{%:x„s„sS iy;�i '�•r �Sss;'q ,.x, .fs'� �,�+' ,tis':•'!i7.,. :;�." xq:<.x.rx �i• h.x •> yyttr+ •�E<>s:r'x.x .xxs'xS��td'e�•�fi�s: .. ..�ri#`iFg?xlt��t:F�x ttK:,e,�r3�.,ain,:�t:x;�N,:i�:tk'i„"'sc;r;�,.uq:� THIS IS TO CERTIFY THAT THE PCUCIES OF INSURANCE U97ED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF.SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .......:.........................._...__....._.................._......................_..-....._.................................... .........,....._................;........................................................................................................................ . LT' TYPE OF INSURANCE POLICY NUMBER POUCT OffLRYE VOUCY EXP(RATION USUTS L7Tt DATE(MM/Do f" i DATE(MM/DD/YY) ................................................. ...... A j GENERAL uABumJ GENERAL AGGREGATE .......2 r 000 0® R COMMIMCIAL GENERAL L(ABILm 181t307tt28B6 PROD1lCTbCCMPA7P A00,.... ,?.5.. .........I.. .:. .:....... CLAIMS MADE ? X :OCCUR: 03/07/95 03/07/961 PERSCNAL.s ADV.'Amy. . s OWNERS&CONTRACTORS PROT: EACH OCCURRENCE s 1 000 00 i........: ....................................................... i ` '... IR£OWAGE Om are I4e) _s ............. 0 oa ....................................................................../ ...... . .:.....................:.......................................:....................:................................:.......................................................................... ::............................... MED.EXPENSE(Any one person):; 5 QQ .::. : COMBINED SINGLE ; .....i ANY AUTO LIMIT S :........;ALL OWNED AUTOS _ ,..,...... ........................ BODILY IN,I(IRY 'SCHEDULED AUTOS :(Pet peWDll) :s ........................................ .................................. i MIRED AUTOS BODILY IKMRY ....a NOWOWNED AUTOS (Per agWeno ..... „.,,,,..: ....::,:,..: :GARAGE LIABILITY ..r PROPERTY DAMAGE 7 �,�:...: ..:.........................:...........:..................................................................<.........-..-.................. .. ...................... ..........-....................................................................... .,. ... ...... .. .. MESS UABILIN EACH OCCURRENCE [S ...... ................ ... i umeWLLA FORM AGGREGATE. .. .. $ OTHER THAN UMBRELLA FORM I ` ......... .................................... :,.... ....,....,,. ....... .. .... ... ........ . ......... WORKwl COWiE18ATION ! .. .. STATUTORY LWIITS ........, 8 AND 3BY00't2ilRIi17 03/11/95 03111/96,EA"H.=IDExT .. 100r 9 .......................................... IFMFWYRW LIUMM . DISEASE-POLICY LIMIT S 500r 0. 0 ........ .. ...,.......,...........,. !..................:..............'..DISEASE•EACH FNPLOYFE1. ...........,.... .0 600 10, OMER ; .....:................................................... ......................................................................... �.............................................................................-......... .................................... newmPriON OF OiEliAT10N9110CAnONBNQItCLISJSPa9CIAE ITEMS - - Carppentry NOC. Worcrasl comp is for Masts. only: `rsk, �:k $ :£Rd:��•�:� u:xYr'e ., a . i x �+ exs;u� l�.. .. .x.:..........1ktt rrs•;w!.>. ,.......0:8"iK�..:. .......,�.�?Yf%1r..<x�xtsos:6x..�i��' ::�':r'r?:r8•i°x; SHOULD ANY OF THE ABOVE DESCRIBED POUCIE8 BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL,ENDEAVOR TO "t,re MAIL (0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE Town of Sarastable } LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO 09UQATION OR Building Department-ATTN: RALPA ?r LIABILITY OF ANY KIND UPON THE COMPANY.ITS AGENTS OR REPRESENTATIVES. 367 Main Street .4IRHORIZ®REaP+e�' a RAY INSUR CE AGENC. , Hyannis MA 02501x `�iU n - f ^,y+�t •t� '„67,^.iC!�tjk e r.3: tf>:,pt o>\o"�° i`. h0; xv .,x <'�• .S'�r R rY:rs;x;;F'sx +.x e.`<nX..�}.�:,yf tr•£,+,;•,a„S.+ a :$• 0'«��.,.xx •t sx.>..X.t... s .. :£' ',�G Nip+ gg ;( � � • F.k!A!i:•t..rx:s;%: >t*t�! TISTRL P.01 j Assessor's-Office 1 st floor Ma 5 1 0/ 2— Permit Conservation Office 4th floor Date Issued Board of Health Ord floor) Engineering Dent. (3rd floor) House# Planning Dept. (1st f1wdSchool Admin.Bldg.): Definitive Plan Approved by Planning Board 19n ��'� (Applications processed 8:30-9:30 a.m.& 1:00-2:00 p.m.) ; TOWN OF BARNSTABLE Building Permit Application Proiect Street Address `�3Z Village 1 Fire District 2 \ Owner O�SQ. � � ► : IA Address `' "a� Nw'' -� � Telephone a 0 1 1 Permit Request: t 4o Zoning District Flood Plain Water Protection Lot Size Grandfathered Zoning Board of Appeals Authorization Recorded Current Use Q `1c le Proposed Use Construction Type Eaistine Information Dwelling Type: Single Family Two family Multi-family Age of structure Basement type Historic House Finished Old Kiny's'Highwgy Unfinished Number of Baths No. of Bedrooms Total Room Count not including baths First Floor Heat Tyne and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name tw^� Telephone number oleo fZ " C`• Address License# n Home Improvement Contractor# d (10 - Worker's Compensation # sek r� D lOAA.d NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO. Project Cost 154 Fee 0" 0 D SIGNATURE DATE h. BUILDING PEF DENIED FOR THE FOLLOWING REASON(S) BPERM T A=311-012 rya FOR OFFICE USE ONLY PERMIT # 12-02-94 ADDRESS 640 TOUTE 132 VILLAGE HYANNIS ROGERS & GRAY INSURANCE OWNER i DATE OF INSPECTION: _ FOUNDATION FRAME _ INSULATION FIREPLACE ELECTRICAL: 'ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING: DATE CLOSED OUT: ASSOCIATE PLAN NO.. • �TFIE T� TiThe Tow of I3,-1T T1. tf,1b1c .: 11, I�:� l i !!l,•l�� 1 l i, ..:-:: � .�•.,,, .. I !,\ i r �rinl� rlt:ll �� 1-, ii� : ~�►'��- l:illi�iill•,! 1)!\ 1�1Ui1 367 A4ain Sued_,Hyannis MA 02601 Office: 508 79"227 RalphCz ea Fax 508:??5 3344 ]Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENI'CONTRACPORI.AW � SUPPLEMENTTO PERMTTAPPLICAIION MGL c.142A requires that the"reoorstruetwit,alterations,ream2tion,vepek modernization,conversion, improvement, remosal, demolition, or construction of an addition to airy preexisting owner ooarpied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,azth certain exceptions,along with other requirements. Tjpe of Worm: Qal-� Est.Cost Address of Work- f2.� ��Z V Omer Name: � �vtQ v Date of Permit Application:1 I hereby certify that: Registration is not required for the following vmson(s): Wort;excluded by law Job under S1,000 Building not<m-ncr-occupied Owner pulling Own peanut Notice is hereby given that: O'%VNTERS PULLING"THEIR OWN PE-R.-,,IT OR DEALPNG V:7TN UNREGISTERED CON-RACTORS FOR APPLICABLE HOME II✓PRO�L'•�l` �:'OF.}; DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAI-t OR GUA .A-I 'M.ND LT,",DER MGL c. 1<2A SIGNED UNDER PENALTIES OF P£RYURY I hcrcb\'2pp1\-for a pcnnit d-,L9 A Dat f Contrector name Registration No. OR Date Owncr's name 11:02'94 17:02 'a6177277122 `;. DEPT IND ACCID 16001 k� —J L o;;zaiui;z.ct ea(tli. o i"l'�a��czcicu�e � a1J�artmenl o��ndu�trial�cc� 600 W.6hi ton James J.Campbell Dolton 02111 a�ac�uastta Commissioner Workers' Compensation Insurance Affidavit l% �J ��-'� �l inn eaoensee�permacee� with a principal place of business at: �S Po.J LA' �� I MA 0_ZG3() (QW1Ststelzlp) do hereby certify under the pains and penalties of perjury, that: () I am an employer provid'mg workers' compensation coverage for my employees working on this Job. r Insurance Company Po icy Number O I am a sole proprietor and have no one working for me in any capacity- 1 am a sole proprietor, e I contractor r homeowner (circle one) and have lured the contractors listed below who have the oilowing workers' compensation policies: Contractor Insurance Company/Polity Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number O [ am a homeowner performing all the work myself. 1 t Ct!sUnc t-,_t a copy of dais s:.:te0tent will be f0.-v:zrded to d;e Office of Investigzdons of the DIA for eomage verification and that failure to secure CC`erage<<ree,:ired under Section 25A of MGL 152 can lead to 0.c Imposition of criminal penaitles consisting of a fine of up to s 1,500.00 and/or cre years' impri<cnmrnt as well as Civil penalties in the form of a STOP WORK ORDER and a fine of S 100.00 a day against me. Signed this day of 19 Licensee/Permittee Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 TOWN OF BARNSTABLE -BUILDING PERMIT # , /-I-I � Foundation Certification at #624 & #649 lyannough Road (Route #132), Hyannis, MA. Prepared For: Construction Management & Builders, Inc. N Circuit City Baxter Nye Engineering & Surveying Assessor's Map: 311 Parcels: 12 & 13 Registered Professional Community Panel Number 250001 0005 C N Flood Zone C Engineers and Land Surveyors Plan References: Lot 10 ® Land Court Plan 25266 D N Parcel 2 -Land 78 North Street, 3rd Floor.. Belonging to Kenneth E. Wilson,- dated: 04-24-6Q — L. C. Pet. PI. 29953 Hyannis, MA 02601 Job Number: 2008-023 Phone — (508) 771-7502 Fax - (508)-771-7622 Scale 1° = 40' Date : 06-30-2008CB/DH MD r S aW33'58" E _ S 8519'45- E HUD 143.99' 151.26' LOT 6 LCP 25266 C n , PARCEL AREA /� 1 •r. N .. 110,280`SQ' FT: f" w w 2.53 ACRES o O CY m } J a 10 49, �o SV ,2 0, 20•6 5_I �Y O W W '? 12—INCH FOUNDATION WALL o 10.2� y' e N m ��48'3a CURRENTLY UNDER CONSTRUCTION ,3ro N ,00 N LOCATION DATES: .. w 1p', 06-18-2008 W o 06-27-2008 �a?• 4� A � 1Q 47, 0 CO- co qc4��`r 40 3Q IVp� c'r 10 N Z 0 0 o Q oil e� 0 5 8 �O eloop, CL �0 61,,. Z 1?0 O z " , w I CERTIFY THAT TO THE BEST OF MY KNOWLEDGE THE EXISTING FOUNDATION SHOWN HEREON p; / IS:LOCATED IN RELATION TO THE MONUMENTS SHOWN AND IS NOT,LOCATED WITHIN.A SPECIAL FLOOD HAZARD AREA. mat+ JOHPd o THIS PLAN IS NOT TO BE RECORDED. NOR IS IT TO BE USED.TO ESTABLISH PROPERTY LINES. o REGISTERED PROFS AL LAND SU N BAXTER NYE ENGINEERING & SURVEYING DATE 0 N O Foundation Certification at #624 & #649 Iyannough Road (Route #132), Hyannis, MA. Prepared For: Construction Management & Builders, Inc. N Circuit City Baxter- Nye Engineering & Surveying Assessors Map: 311 Parcels: 12 & 13 Registered Professional Community Panel Number 250001 0005 C ,N Flood Zone C Engineers and Land Surveyors Plan References: Lot 10 ® Land Court Plan 25266 D N Parcel 2 "Land 78 North Street, 3rd Floor Belonging to Kenneth E. Wilson," dated: 04-24-60, L. C. Pet. Pl. 29953 Hyannis, MA 02601 Job Number: 2008-023 Phone — (506) 771-7502 Fax — (506)-7714622 Scale . 1" = 40' Date . 06-30-2008 S 84-3315a" E wHELD 143.99' 181.26' e LOT 6 LCP 25266 C PARCEL AREA SF cV . 110,280 SQ. FT. t 2.53 ACRES t 2 .� Cb to N. , t .� coo CV Q<Cr R LOCA 12- ^^ Us 4Z0• i� 2�w'ul 8 N ek g . r s0 t. 9, aD- 65, y 12-INCH FOUNDATION WALL3�ro CURRENTLY UNDER CONSTRUCTION LOCATION DATES: o o o w - ip t• 06-18-2008 w 06, 27-2008 10.2 N 10 47, o r; ,hog r h O �`?,�� ,3� N Lug CJj T a,w CL Dy3�Ul y �`?�'�• fie, U 'Q to.ej' z CD i 8000.Li a� w I CERTIFY THAT-TO THE BEST OF MY KNOWLEDGE THE EXISTING FOUNDATION SHOWN HEREON IS LOCATED IN RELATION .TO THE MONUMENTS SHOWN AND IS NOT LOCATED VVITHIN A SPECIAL FLOOD HAZARD AREA. off' -JON 6� THIS PLAN IS NOT,TO BE RECORDED NOR IS IT TO BE USED TO ESTABLISH PROPERTY I LINES. g N 74 / �frt 40 o REGISTERED PROFESSION LAND SU N BAXTER NYE ENGINEERING & SURVEYING DATE ' g N O Foundation Certification at: #624 & #649 Iyannough Road, (Route #132)1 Hyannis, MA., Pre ared For: Construction Mena emen.t & Builders, Inc: N Circuit City Baxter .Nye Engineering & Surveying , Assessor's Map: 311 Parcels: 12 & t3 Registered Professional Community Panel+Number 25.0007 :0005 C N Flood Zone. C Engineers and Land Surveyors Plan References: : -Lot 10 ®.Land Court Plan 25266 D N Parcel 2 "Land ' Belonging to Kenneth E._Alson," dated:;04=24 60, — Pet. PI. 29953 s 78 North Street, 3rd Floor ` —023 Hyannis, MA.: 02601. ya Job Number: 2008 Phone — (508) 771-7502 Fax� (508)-771-7s22 Date. 06-30-2008' Scale 1" -_40' - - S 84.33'S8" E S.85�9' " E 'HELD 143CB/014 FM 136• LOT 6. •99' _ 15 LCP 25266',C PARCEL AREA (. Cq 1 1 0,280 -SQ• FT. 2.53-ACRES t CV GIN w tocn of tr w g° 3 - RAC QF iZ.' a7 r �:oe,?� ;► 10, N� 1 r t�� 0 N N , 5' z0,6 �L tot. 400,N y 12—INCH LFOUNDATIONa WALL to?3 N m 10 48'3 a, CURRENTLY UNDER CONSTRUCTION N $ LOCATION''DATES: ° 1. w tot. . 06-18-2008 ',n,a g °° 1 o x 4 06-27'2008` . to Z. 4 r . 07 08 2008 . ... 4 S' J0,811 to2• 1p.4� s LO J see, s?s, j U ��� �y3, � U. h� o y'Qp . < h Z 00 o" JCL �� •Q �"� w �o o w � . w g ; 4 , I-CERTIFY .THAT TO THE'BEST OF MY KNOWLEDGE THE EXISTING,:FOUNDATION`SHOWN HEREON.x �N III IS LOCATED IN RELATION TO'THE MONUMENTS SHOWN AND IS :NOT LOCATEDJON N WITHIN A SPECIAL FLOOD HAZARD AREA. . y "o THIS PLAN I T TO yBE-RECORDED NOR IS IT TO BE USED TO ESTABLISH PROPERTY LINES. 3 `" 00 29814 O c f N o1 o g o $ TtR� o REGISTERED P �LAND RVM N BAXTER NYE ENGINEERING do SURVEYING DATE 7-a-S N =1. 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