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HomeMy WebLinkAbout0049 NORTH STREET Ir n J HE t �o Town of Barnstable Building Department - 200 Main Street BARNSTABLE, * H ya nn is, MA 02601 MAM6 �' 508 862-4038 CFO MA't s Certif icate of Occupancy Application Number: 200906202 CO Number: 20100014 Parcel ID: 309195 CO Issue Date: 02/02110 Location: 46 NORTH STREET Zoning Classification: OFFICE/MULTI-FAMILY RESIDENTIA Proposed Use: GENERAL OFFICE BUILDING Village: HYANNIS Gen Contractor: OCEANSIDE CONSTRUCTION & DEV Permit Type: CC00 CERTIFICATE OF OCCUPANCY COMM - Comments: UNIT 2 P Building Department Signature Date Signed �IHE, TOWN OF BARNSTABLE Building Application Ref: 200906202 • • Permit BARNSTABLE, * Issue Date: 01/14/10 9 MASS. �pr16 �a�� Applicant: OCEANSIDE CONSTRUCTION&DEV Permit Number: B 20100052 Proposed Use: GENERAL OFFICE BrUILDING Expiration Date: 07/14/10 Location 46 NORTH STREET ON VA2 Zoning District OM Permit Type: COMMERCIAL ADDITION ALTERATION Map Parcel 309195 Permit Fee$ 318.50 Contractor OCEANSIDE CONSTRUCTION&DEV Village HYANNIS App Fee$ 100.00 License Num 48102 Est Construction Cost$ 35,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND INTERIOR BUILD OUT AS PER PLANS-3086 SQ FT THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: SCHULMAN, RUBY 8i SHPINER, EDNA BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 540 MAIN STREET UNIT 17 INSPECTION HAS BEEN MADE. HYANNIS, MA 02901 Application Entered by: PR Building Permit Issued By: THIS.PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY`OR`PERMANENTLY. ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET ORALLY;GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.' THE ISSUANCE OF THIS PERMIT,DOES NOT-RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS: . MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). k r err^`Y.h,sn a t pg 94-1 z . @vim, 1e ,sue e My qt Aaa BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 i 1 e1/ .ld X�a S 5� 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 ✓' Board of Health FIRE CERTIFICATE OF INSPECTION In accordance with the requirements of General Laws,Chapter 111,Section 51,this Fire Certificate of Inspection issued by the head of the local Fire Department certifying compliance with local ordinances is a prerequisite for an original or renewal license. NAME OF CLINIC ADDRESS OF CLINIC was inspected on t07• tqt.'CT Date T Name of Inspector I HEREBY CERTIFY THAT THIS INSTITUTION COMPLIES WITH THE LOCAL ORDINANCES. YES NO If answer is"NO",indicate violations and recommendations. Violations: Ytwm Recommendations: ISSUED BY. f)RL" Signature Head of Local Fire Department INSTRUCTIONS: FIRE DEPARTMENT TO RETURN TWO COMPLETED COPIES TO CLINIC CLINIC TO RETURN ONE COPY TO: Division of Health Care Quality 99 Chauncy,2nd Floor Boston,MA 02111 Rev. 12-13-2005 DPHCQ117 Jefferson Group Architects, Inc. Wayne J. Jacques, AIA ISD AF 8 ARCHITECTURAL FINAL AFFIDAVIT To the Inspectional Services Commissioner: I certify that I,and/or my authorized representative,have inspected the work associated with Permit No.B 20100052 dated 1/14/10 , for Condo'Unit No. 2 to be occupied by Gentiva Home Health Care located at 46 North Street,Hyannis,MA, on the dates noted below during construction,and that to the best of my knowledge,information,and belief the work has been done in conformance with the permit and plans approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and all other pertinent laws inances. 0 y cyfi 41CA Wayne J. Jacques,AIA, P F Architect-Mass.Reg.No.6935 OWTON Jefferson Group Architects. Inc. MA Jy� 700 School Street,Unit 2 aSSPG� Pawtucket,RI 02860 o h _ 401-721-2245 Inspection Dates: 2-2-2010 Then personally appeared the above-named I Vi qot and made oath that the above statement by him is true. Before me, My Commission expires: - - 20_� 700 School Street Pawtucket,RI 02860 (401)721-2245 Fax (401)721-2238 AFA-200925 -Condo 2 Gentiva.doc TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # � Health'Division , '��� Date Issued Conservation Division Application Fee Planning Dept. Permit Fee C � Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address 'A 6 0)62� ST1'3L-__adf- U N tT t�672. Village JA\4 Ann�S Owner 4 b n rj�TAA S{' L LL Address Sli 0 `MP�tN V' 49' l-. Telephone `7-7A 238 84l Permit Request 1"�k�XluZ 14 S PV--2 A_Ot� - Square feet: 1 sr floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes .®' o 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 der ,5LA Basement Finished Area (sq.ft.) VA Pt Basement Unfinished Area(sq.ft) Number of Baths: Full: existing w Half: existing new xisting _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: Ad-&'as ❑ Oil ❑ Electric ❑ Other �/r%s Central Air: es ❑ No Fireplaces: Existing New Existing wood/coal stove:" ❑ No Detached garage: ❑ existing ❑ new size �b1: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ N Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zotning Board of Appeals Authorization ❑ Appeal # Recorded ❑ C) Commercial ❑Yes ❑ No If yes, site plan review# , Current Use Proposed Use C ~? APPLICANT INFORMATION (BUILDER OR HOMEOWNER) - oC ept-IDS i 0-r-_- CON S _4c ok=i�,,0. Name Telephone Number-Y) �y Address VS9 "1)R8k )S 1\A6k MA- License# WA 20Z, 6Z6, Home Improvement Contractor# Worker's Compensation # O w CV boo 61120L, ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO (45A r. 4 DLY�SY__ i SIGNAT DATE 2-I L 'BI b C-i { r FOR OFFICIAL USE ONLY •. ' APPLICATION# DATE ISSUED r MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE , ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING r y s DATE CLOSED OUT I ASSOCIATION PLAN NO. l [p t` L { f R The Corninonwealth of Massachusetts Department of Industrial Accidents Office of Investigations' 600 Washington Street Boston, MA 02111 �4 • wwwanass.gov/dia davit: Builders/Contractors/Elet tricians/Plumbers Workers' Compensation Insurance Affi Applicant Information Please Print Legibly Naive (Business/Organization/individual): �� — Address: 9"b City/State/Zip: 0 26 td Phone.#: Are n employer? Check the appropriate bog: Type of project(required): am a employer with 4. ❑ 1 am a general contractor and 1 6. ❑New construction employees (full and/or part-time).* have hired the shb-contractors 2.❑ I am a sole proprietor or parbAcr-• listed on the'attached sheet. 7.. ❑ Remodeling ship and have no employees These sub-contractors have g• '❑ Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers'.comp.-insurance comp. insurance.$ required.] S. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 a n a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.[]Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required] *Any applicant.that checks box#1 must also fill out the section below showing their workers'cornpcnsa6on 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. tf the sub-contractors have ernployees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance far my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: (100 fo\, Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of crimiri4l penalties of a fine tip to $1,500,00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification X do hereb cerf r nder the pains?nd penalties of perjvey that the information provided above is true and correct i ature: Date: Phone Official use.only. Do not write in this area, to be completed by city or town offrciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6. Other (�nnfarb Pr�rcnn• Phone It: t . Information a*nd Instructions Massachusetts General Laws chapter I52 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 a deceased em to er or the a e resentatives of y of the foregoing engaged in a joint enterprise, and including the leg 1 r p P receiver'or istee of an individual,partnership, association or other legal enti ty, em employing ingemployees. 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 of on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal 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 Frith the insurance requirements of this chapter have been presented to the contracting authority.' Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-cont�actor(s)name(s), addresses)and phone numbers) along with their certificate(s) of insurance. Limited Liability Companies'(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be retumed to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant . Please be sure to fill in the permit(license number which Mll be used as a reference number. In addition, an applicant that must submit multiple permit(license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" Lhe applicant should write all locations in (city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e. a dog license or permit to bum leaves etc.).said person is NOT required to complete this affidavit. The Office of Investigations would like to.thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephouc and fax number. The Commonwealth of Massachusetts Department of Industrial Accidenfis Office of favestiga.0.0ns. 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia 1 f rf .. � r Town of Barn-stable a a Regulatory Services "gam Thomas F. Geiler,Director °�Eoa Building Division Tom Perry,.Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-62 Property 0wher Must Complete and Sign This Section If-Using A Builder cAh v�t NS , as Owner of the subject property hereby authorize COA3 sue - to act on my behalf, m all matters relative to work authotized by this building permit application for: UAJ (.Address of job) lgnare tu of Owner Date o Cl �nL�tj Print Name If Propegty Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. j t Town of Barnstable of VE rpm o y � Regulatory Services Thomas F. Geiier,Director RAM Building :Division PrFD � Tom Perry, Building Commissioner 200 Mairi.Street,"Hyannis, MA.02601 www.town.barngt2ble.ma.us Office: SOS-862-4038 Fax: S08-790-6230 EOMEOWNER LICENSE EXEMPTION please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. ' DEFINMON ON HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs mare than one home in a two-year period shall not be considered a homeowner, Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,nines and regulations. The undersigned"homeowner"certifies that.he/sh.e understands the Town of.Barnstable Building Deparhnent minimum inspection procedures and requirements and that he/she will comply with said procedures and requixements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that "Any bomeowner performing work for which a building pcmrit is required shall be cxcmpt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner errgagcs a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this cxerrrption are unaware that they arc assuming the responsibilities of a supervisor(see Appendix Q. Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot procccd against the unlircnscd person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible, To cnsurc that the homeowner is fully aware of his/her responsibilitirs,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a.farm currently used by several towns. You may care t amend and adopt such a form/ccrtification for use in your community. Q:forms:homccxcmpt A } V VIV—JV—GVV7 lO:JV rnvLl rr'IGRJ IIIAonr'L,G uvo'ii iv`r.lu . .uv• vvi ACC 5I1912009 �AODL,cEP THIS CERTIFICATE 1$ISBUW AS A MATTER Of INFORMATION . ONLY AND CONFER3 NO RIGHTS UPON THE CERTIFICATE Pru]Pctcri Age>sDy,inc, MOLDBR. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 680 Falmouth Road; ALYER THE COVERAGE AFFORDED BY THE POLICIES BELOW Mashpoe,MA 02649 COMPANIES uLc co VOWE (AMPANY A Atlantic Charter lmurauce Co22any VDAC �A COMPANY vet/(7 etwide Construction,Inc. Cof*ANY 419 RiveT Road C Mmtons M]I6,MA 02648 COMPANY D TI/I9 IS TO CINTIFY THAT T)Q POLICIES Of INSURANCE L13M BELOW HAVC QEEN I&SUED TO THE INSURED MAMBO AEOVE FOR TM?►OLLCY PERIOD INDICATED. NOTVATHSTANDM ANY RequIREMeNT,T"OR CONDITION OF ANY CONTRACT OR OTMDR DOCUMENT WITH REOrCCT TO WHICH THIS CERYWICATE MAY BE ISEVCD OR MAY PERTAIN,IN?!WjuRANCe A►roRDED®T TMR►OLICIES PrACRIeeo wEnEJN IS SUYJECT TO ALL THE TeAma, ExcLuSION3 AND CONDITIONS OF SUCH POUCICS. UMITe 94OWH MAY MAYS BEEN REDVCED SY PAID CLAIMF, CO TYPE OF T"VAANM roUC7 MUML'JI POLICY EFTECT1VE POLICYEWWATION LJWTe LTR DATA 0"VDt" DATE IsoIVDp" Un Tr4owoal a0!/IAAI.uAennv BODILY INJURY OCC I DIY•FOMA BODILY INJURY 40 s .ao,,+eaa,o►�.AnadS OApD�RTY DAAMOE OOC S PROPERTY PAW"AAO E ➢XrLC410 t1 A COUAM4 IiaZf�RD Si&PO OMMINN QO7 s �RODUC.'TS�CAMPL CTED W L'A HI I.PD Cogo*IM0 AOU 4 - WNM4 CTLL44. ►wgW0WIL,WLCCV A.6C f wrRKMMKr OOW KAcTOFffi ewAC I OWA PAOPwn DAwze PCRSON+I INNM1Y Alr0wQmLE LADAU TY "Lv IwURY AAN PALM (Fu P—) $ ALL 0"�Ne9Ar,JTDy(M+wm lau) 0OaLY INJURY• ALLOWNEDAVT09 lParaK,d�m) b ' (Other than P,{.ple �0 ttM AVT06 PROPERTY DAWOE 3 ",Ilk t ALIT03' 0004YIWUPYt - vPDPCIrTY wAIAcE 6AR/sGE LW hITY coNe+NeO s D(CGPS LIABILITY &ACm OCou 7 LM/�7O.IA 00A1I A�ReOATE S 0TK"TMBN U URE"A roAN s YTATVTORY uMITS vmwomm CD�Aroomw WCV00617204 25/2009 2/3/201(1 1000,000 A ewL®Yeua L Amm ..c' osrnse KXCYLJMrr A 1,000,000 D skr-•EACHDAPQYEE t i,00U,UW DTHW MA0} FrK)N OF 0F8AAT10N WACAlVKEARKPCLZ3/ MAL ITVW _ SmOVLU ANY OF Tup AmWE DeSCRISED POLICIES BE CANCELLED 86FOR6 Tmc EXPIRATION DATE THEREOF.THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 12 DAYS WRITnN NOTICE TO THE CLRTIrICATE HOLDER NAW TO THE LEFT. BUT FAJLVRC TO MAIL SUCH NOTICE SH IMPOSE NO OBLIGATION OR UADILITY OF ANY KIND UPON THe COMfSW fTS ENT$ R REPRESENTATNtS. i I AUTIJORM PASS TATME f , 7AA/I AA MI 9NIlIa Aij30Nf1 L0998BVLL9 XYj WIL 600Z/61/90 TOTAL P.001 i iVlassachusetts- Depai-tment of Public Safeh Board of Build'in-, Relfulations and Standards # Construction Supervisor License License: CS 48102 Restricted to: 00 JOHN J HUTCHIN$ 419 RIVER RD MARSTONS MILLS, MA 02648 + Expiration: 9/16/2010 Conunissioner Tr#: 4320 r Do•_-- 1 s 126.,036 10-19-2009 1 =S9 AL eARNSTABLE' LAND COURT REGISTRY 46 North Street,LLC 46 North Street,Hyannis s This regulatory agreement("Agreement")is entered by and between the applicant,46 North Street, LLC, ("Applicant"and"Developer") and the Town of Barnstable("Town"),a municipal corporation,on this ir'day of October,2009 pursuant to,Section 240-24.1 of the Barnstable Zoning Ordinance and Section 168 of the Barnstable Code; WITNESS: WHEREAS, the Applicant under this Agreement will contribute public capital facilities to serve the proposed development and the municipality or both; WHEREAS, this Agreement shall establish permitted uses, densities, traffic, parking and stormwater management and building and site design within. the Development, duration of,the agreement, and any.other terms or conditions mutually agreed upon between the'Applicant and the Town. WHEREAS, this Agreement shall vest land use development rights in the property for the duration of the Agreement, and such rights shall not be-subject to subsequent changes in local development ordinances, with the exception of changes necessary to protect-the public health, safety or welfare. WHEREAS, the Town is authorized to enter into this Agreement pursuant to Chapters 168 and 240 of the Barnstable Code; nWHEREAS,the Applicant is the legal owner of the property("Property")at 46 North Street, Hyannis,consisting of approximately 101,733 +/-SF, shown on Barnstable Assessor's Map 309 as Parcel 195, title to which is recorded in Barnstable County Registry of Deeds Certificate tL 19Q49,Book 1493, Page 614,Lot 12 as shown on Plan: LC 14306-B,Book 72/143 and a parcel tj of unregistered land bound and described as follows: NORTH 4°26'EAST by land formerly of Mrs.J. Harold Burlingame, for a distance of Fifty-Eight and 501100(58.50)feet; SOUTH 87 °12'09"EAST by land now or formerly of Irving Howland,Nathan Finkelstein and Reuben Anderson,for a distance of One Hundred Eleven and 25/100(111.25)feet; SOUTH 5028' WEST.- by land now or formerly of Reuben Anderson and. Louis V. Arenovski,for a distance of Seventy-Seven And 70/100 feet; and NORTH 77° 16'10"WEST by land now or formerly of Minnie M. Wimmer, for a distance of One Hundred Ten and 96/100(110.96) feet to the point of beginning. and desires to develop the Property pursuant to a Regulatory Agreement; WHEREAS,the Applicant is willing to commit to development of the project in substantial accordance with this Agreement and desires to have a reasonable amount of flexibility to carry out the Development and therefore considers this Agreement to be in its best interests; and WHEREAS, the Town and Applicant desire to set forth in this Agreement their respective understandings and agreements with regard to development of the Property; WHEREAS,the Development will not require regulatory review under the Massachusetts Environmental Policy Act(MEPA)or the Cape Cod Commission Act; WHEREAS,the Applicant has made application to the Town pursuant to Section 168 of the Barnstable Code; WHEREAS,the Development is located in the Hyannis Growth Incentive Zone ("Hyannis GIZ") as approved by the Cape Cod Commission by decision dated April 6, 2006,as authorized by Barnstable County Ordinance 2005=13,Chapter G,Growth Incentive Zone Regulations of the Cape Cod Commission Regulations of General Application; WHEREAS,the Development is not subject to review by the Cape Cod Commission as a Development of Regional Impact due to its location in the GIZ and due to the adoption of Barnstable County Ordinance 2006-06 establishing a cumulative development threshold within . the GIZ, under which this development may proceed and the Applicant has submitted a Jurisdictional Determination to the Town of Barnstable Building Department to confirm the same; WHEREAS,the Applicant has undergone informal site plan review on June 9,2008; WHEREAS,the Development is serviced by municipal sewer and does not impact resources protected by the Barnstable Conservation Commission; WHEREAS,the Development is,serviced by the Hyannis Water Department and does not adversely affect water delivery infrastructure; WHEREAS,the Development has sufficient fire flows to service the intended use without adversely affecting the Hyannis Fire District ISO rating; WHEREAS,the Development has access to sewage capacity to service the intended use without adversely affecting the Water Pollution Control Facility and associated infrastructure; WHEREAS, Hyannis Fire Department records indicate that an underground oil tank was filled in near the Washington Street access to the east of the property. These records also indicate that an important 8 trunk fiber optic conduit is supported by this filled structure, WHEREAS,the existing building is only partially sprinkled; ' 2 ` WHEREAS,existing parking"re uirementsyard setbacks lot area and lot coverage a are lawfully established by/through this agreement and the Zoning Ordinance that existing number of parking spaces satisfy requirements for the proposed development; WHEREAS, the Development currently has sufficient parking and access to accommodate proposed uses and structures; WHEREAS,existing conditions-utilities, vegetation and a pole—may obstruct driveway access from North Street; WHEREAS, streetscape conditions on North Street abutting this property are in need of landscaping and lighting improvements; WHEREAS,the dumpster location as shown on the plan-will serve the proposed development and will not impact abutting residential properties; WHEREAS, a vegetative buffer and fence is shown on the plans lying northerly of the"Proposed Building"separating the property owned by 46 North Street,LLC and the properties shown on Louis Street; WHEREAS, the Applicant will require zoning relief from the use regulation schedule in the OM zoning district,more specifically referred to in Paragraph 24,below; WHEREAS, the Applicant has undergone at least two public hearings on the Agreement application and received a majority vote from the Planning Board recommending that the- application be forwarded to Town Council for their action on July 27,2009; WHEREAS,the Applicant has undergone a public meeting on the Agreement application before the Town Council and received a 2/3rds vote approving the application on October 1,20.09; NOW,THEREFORE, in consideration of the agreements and covenants hereinafter set forth, and other good and valuable consideration,the receipt and sufficiency of which each of the parties hereto hereby acknowledge to the other, the Applicant and the Town do enter into this Agreement,and hereby agree and covenant as follows; 1. The Developer agrees to construct and maintain the Project in accordance with the plans and specifications submitted to and approved by the Town,listed as follows and made part of this Agreement by reference: 2. Plans entitled a) "Commercial Redevelopment,46 North Street in Barnstable,MA, Site Plan Sheet 1 of 1 dated June 19,2009 as revised through August 8,2009"; b) "Commercial Redevelopment,46 North Street in Barnstable,MA,Landscape Plan Sheet 1 of 1 dated June 19, 2009"; c) "Commercial Redevelopment,46 North Street in Barnstable, MA,Lighting Plan" Elevation drawings entitled 1146 North Street,North Street Elevation and Parking 3 Lot Elevation"and "46 North Street New Building Front Elevation and Back Elevation"both dated June 18,2009 by Jefferson Group Architects and Judd Brown Designs. and attached to this agreement and such other plans and plan revisions as may be required by the terms and conditions of this Agreement. 3. The Developer agrees to renovate the existing+/- 26,000 SF building and add a second+/- 5600 SF structure and develop the Property as medical and dental offices or other use as allowed in the OM district with the exception of packaging and delivery services and, in the newly constructed building to the rear of the property,residential uses; 4. The Developer agrees to fully sprinkle the existing building. 5. The Developer agrees to renovate existing parking area in accordance with the Design and Infrastructure Plan as shown on the plan entitled "Commercial Redevelopment,46 North Street in Barnstable,MA, Site Plan Sheet 1 of 1 dated June 19, 2009 as revised through August 8,2009" 6. The Developer agrees to provide a status report to the Building Commissioner,prior to the commencement of any site work,of the aforementioned conduit and take any actions deemed .appropriate or necessary by the Building Commissioner. 7. The Developer agrees to construct driveway access on Washington Street and install signage to prevent left turning movements into and out of the site as shown on the plan entitled "Commercial Redevelopment,46 North Street in Barnstable, MA, Site Plan Sheet 1 of 1 dated June 19,2009 as revised through August 8, 2009 8. The Developer shall construct a Passive Stormwater Maintenance and Infiltration System to service the Development stormwater. M 9. The Developer will provide a bicycle rack at the Property. 10. The Developer shall construct architectural improvements as shown on the elevation drawings entitled"46 North Street;North Street Elevation and Parking Lot Elevation"and "46 North Street New Building Front Elevation and Back Elevation"both dated June 18, 2009 by Jefferson Group Architects and.Judd Brown Designs. 11.The Developer shall install lighting and landscaping improvements along the Property frontage and on North Street as shown on the plan entitled" "Commercial Redevelopment, 46 North Street in Barnstable, MA, Landscape Plan Sheet 1 of 1 dated June 19, 2009 Any and all lighting for the development including site and structure lighting shall not cast glare off site, shall be down cast,shall use fully cut off fixtures and shall not contribute to light pollution of the area. 12. The Developer shall-install street lighting on North Street. Spacing, photometric,location and construction details to be finally approved by the Growth Management Department during 4 the shop drawing submittal phase but.shall generally be as follows; a minimum of one(1) free standing 30 foot tall Pulse Start Metal Halide Renaissance Style Lighting Assemblies along the front of the property on North Street. 13.The Developer shall install and maintain the aforementioned vegetative buffer and fence separating the property owned by 46 North Street and the Louis Street properties as shown on the plan. 14. Developer and its successor(s)shall maintain all landscaping and drainage facilities for the period for.which the development rights granted hereunder continue to be exercised. 15.Upon completion of all work, a registered engineer or land surveyor shall submit a letter of certification,made upon knowledge and belief in accordance with professional standards that all work has been done in substantial compliance with the approved site plan (Barnstable Code Section 240-104(G). This document shall be submitted before the issuance of the final certificate-of occupancy. 16. Developer shall permit or cause its approved operator to permit the inspection of the premises by town staff, including but not limited to health,building and fire safety personnel. 17. All landscaping within the Development shall be low water use and shall minimize the use of fertilizers and pesticides in keeping with the Design and Infrastructure Plan. 18. All plumbing fixtures shall be low water use fixtures and other water conservation measures are encouraged in the design and development of the project. 19.The utility pole at the North Street entrance shall be removed and those utilities shall be placed-underground. 20. Construction and demolition debris from the Development shall be removed and reused or recycled to the maximum extent possible. 2.1,Developer is responsible for obtaining all applicable permits and licenses, including but not limited to the following: foundation permit,building permit,street excavation permit (necessary for work in all public spaces) sewer permits and water permits. 22.Exterior construction impacts shall be minimized and construction shall be limited to the hours of 7:00 a.m. to 6:00 p.m.weekdays, and 8:30 a.m. to 2:00 p.m.Saturdays: No exterior construction shall occur on Sundays. The Building Commissioner shall establish protocols to minimize the location of staging,noise, dust, and vibration. 23.To the extent that the referenced plans do not depict all of the findings and conditions as set forth in this Agreement,revised plans and/or notations shall be provided. In addition to permits,plans and approvals listed above,any and all permits and licenses required shall be obtained. r Y.1JXAt7 YAM 3 lJv+f7 WJATXV. -_ -w.-rpradr"`yR•ge';,inio,...�.�,s,,.vc,,,y,.,, wA ` 24.Town hereby grants a waiver from the following zoning restrictions:.allowing the principal use medical and dental offices in addition to the allowed by-right and conditional uses in the OM with the exception of packaging and delivery services and residential uses in the newly constructed building to the rear of the property,Section 240-24.1.6 of the Barnstable Code 25. The Developer shall submit revised plans which address the comments submitted by the June 9,2009 staff Site Plan Review,to the extent applicable, which plans shall be reviewed and .approved administratively by the Building Commissioner. 26.The development rights granted hereunder shall be exercised and development permits may be obtained hereunder for a period of two(2)years from the effective date of the Agreement, provided, however,that prior to the expiration of said one year period the Applicant may request one six month extension to obtain development permits.Upon receipt of necessary development permits,construction shall proceed continuously and expeditiously,but in no case shall construction exceed 2 years from receipt of necessary development permits. The Renovations have commenced on the existing building. Applicant estimates that construction of the new building to the rear of the property will be completed on or about September 30,2011. IN WITNESS WHEREOF,the parties have hereunto caused this Agreement to be executed,on the day and year first ove written. I � Dated this f -day of October, 2009. Town o arnstable eloper By: John C_Klimm 46 North Street, LC Town Manger By its Manager Charles F.Doe,Jr. hjl ,k 6iA4 Dcr, COMMONWEALTH OF MASSACHUSETTS Barnstable County,s . On this day of October,2009,before me,the undersigned,notary public,personally appeared,John C. Klimm,the Town Manger, proved to me through satisfactory evidence of identification,which was my personal knowledge,to be the person whose name is signed on the preceding instrument and acknowledged to me that he signe 't voluntarily for its stated purpose as Town of Barnstable Town Manager. Notary Public My commission expires: WILEE MAY OAKLEY Notary tpwk commplita"OF MwcAt '2015 6 COMMONWEALTH OF MASSACHUSETTS Barnstable County,ss. On this day of October,2009,before me,the undersigned notary public,personally appeared Chad Doe, the Manager of 46 North Street, LLC proved to me through satisfactory evidence of identification,which was [ ent U.S. ] [my w o be the person whose name is signed on the preceding instrument and acknowledged to me that he/she signed it voluntarily for its rpo a Manager of 46 North Street LLC Notar PW My co sion expW V. tAWLEB Notary Public COMMONWEALTH O/MASSACHl1961i$. ,•- y; My Commission Ezplrss Ootober 22.2016 ' �: - . 7 971& 6'o�►ninoluaecr�t/ / eyrvacht&vettsJ/j Jc`tetag� J f � �o�nrj2on�vi�alf J _ ;�,,, •may.: �l�rfe Aocrse, 60o.r(orr, .�l�rr�r�rcAr%re/%r C� /Y<Y William Francis Galvin Secretary of the Commonwealth October 14,2009 TO WHOM IT MAY CONCERN: I hereby certify that a certificate of organization of a Limited Liability Company was filed in this office by 46 NORTH STREET LLC in accordance with the provisions of Massachusetts General Laws Chapter 156C on June 2, 2069. I further certify that said Limited Liability Company has filed all annual reports due and .paid all fees with respect to such reports;that said Limited Liability Company has not filed a certificate of cancellation or withdrawal; and that said Limited Liability Company is in good standing with this office. I also certify that the names of all managers listed in the most recent filing are: CHARLES F.DOE,JR. I further certify, the names of all persons authorized to execute documents filed with this office and listed in the most recent filing are: CHARLES F.DOE,JR. The names of all persons authorized to act with respect to real property listed in the most . recent filing are: CHARLES F.DOE,JR. C. S jC In testimony of which, _ I have hereunto affixed the Great Seal of the Commonwealth on the date first above written. Secretary of the Commonwealth Processed By:jbm NOUN Wig"OF DES Jefferson Group Architects, Inc. Wayne J. Jacques, AIA CONSTRUCTION CONTROL AFFIDAVIT Project: 46 North Street—Hyannis,MA In accordance with Section 116.2.1 of the Massachusetts State Building Code, 780 CMR, 7th Edition, I, Wayne J. Jacques, Massachusetts Registered Architect/Engineer #6935 of Jefferson Group Architects, Inc.;. hereby certify that I have prepared or directly supervised the preparation of all design plans,computations and specification concerning: Entire Project _ Architectural X_ Structural Mechanical _ Fire Protection _ Electrical _ Other(please specify) For the above named project and to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts Building Code 7th Ed., all acceptable engineering practices and all 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 of the building permit and shall be responsible for the following as specified in Section 116.2.2: 1. Review, for conformance to the design concept, shop drawings, samples and other submittals,which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials 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. Pursuant to Section 116.4, 1 shall submit periodically, a progress report together with pertinent comments to the town of Hyannis Building commissions. Upon satisfactory completion of the work, I shall submit a f ort as the satisfactory completion ad readiness of the project for occupancy. D'�c JOHN,4 9.0 NO.GOM � BOSTON O BRA J� ORIGIN SIGN DATE 700 School Street Pawtucket,RI 02860 (401)721-2245 Fax (401)21-2238 Construction Control Affidavit-MA.doc Y�_ s y�;. 'Town of Barnstable ,P� �o _ •i aae*sxnLe! i Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept was ° ' Posted Until final Inspection Has Been Made. ' 3V✓t@�/ Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a final Inspection.has been made. Perm. Permit No. B-17-3169 Applicant Name: MOSES M CORDEIRO Approvals Date Issued: . 10/24/2017 Current Use Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 04/24/2018 Foundation: Commercial Map/Lot: 309-195-00B Zoning District: OM Sheathing: Location: 46 UNIT 2 NORTH STREET, HYANNIS Contractor Name: MOSES M CORDEIRO Framing: 1 Owner on Record: CAPE COD HOSPITAL Contractor License: CS-074674 2 Address: 27 PARK STREET Est. Project Cost: $ 255,054.95 Chimney: HYANNIS, MA 02601 Permit Fee: $ 2,496.00 Description: interior renovation for pain center unit 2 creating 3 exam rooms & Insulation: Fee Paid: $ 2,496:00 3 offices and new reception area Date: 10/24/2017 Final: Project Review Req: F Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service` Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. WWk shall not proceed until the Inspector has approved the various stages of construction. Final "Persons contracting with unregistered contractors do not have access to tl�e guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site. Final: . All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee CX y�[o Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address i� il/d/L�' ��' xx "1S k& 477 r Village A Owner C � —c�,_�.�� z`yej,-d�z Address 5 Telephone 6 gt— Sri z_ —0 c> Permit Request i 0 r! _e- � t 1 Gar®70'7 aa,/ G[o%� / � �C�?a AZenm S Z3 4 i L Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain .Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑existing ❑ new size _ Other: a cra Cq Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ C� � F Commercial ❑Yes ❑ No If yes, site plan review# > . ' Current Use Proposed Use ® C) - APPLICANT INFORMATION rn (BUILDER OR HOMEOWNER) Name i Telephone Number 6-06F- Address License# F,4- IM-0 14 �� Home Improvement Contractor# Email ll e.-O �^� IL (��1a 116/O o k S Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO r 6 r/' SIGNATURE DATE ' S� FOR OFFICIAL USE ONLY ` APPLICATION # DATE ISSUED MAP/PARCEL NO. ' ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION t i. FRAME C L�o2 �7 INSULATION l zll-ihZ FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING �zll q! ? Arn- �r DATE CLOSED OUT ASSOCIATION PLAN NO. a ' 5 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ' , SE — Map Parcel Application # _ al Health Division ,i� Date Issued f - Conservation Division Application Fee Planning Dept. Permit Fee a I/yt Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address /YZ) /7 `7— '/y` J'T ly� N-,y i S �� a VillageZ4 S Owner C fl-y!�?e_ e- aD 624 LT/fC/9 /t-e Address e'-_.-7 yZ A-- Telephone f5l ©�' �t 2- S~0 C,C� Permit Request �—.�/'t 4 =1 1 f,n/�VA2/®PVS' Z,/, y t- C_ tv Ito �S Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project valuation 5 Construction Type Lot Size Grandfathered: ❑Yes ❑ No . If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑,new-rsize_ Attached garage: ❑existing ❑ new size —Shed: Elexisting ❑ new size _ Other: B Aa DING SE? 14 �011 Zoning Board of Appeals Authorization ❑" Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION _ (BUILDER OR HOMEOWNER) Name o i Telephone Number Address�� 2�/, /l 6� License# 6 7 l am"/--'t 4 1.1 % Home Improvement Contrac or# n Email J e Afro6 f3 r� e � JkS Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE i r FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. I i ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING -DATE CLOSED OUT ASSOCIATION PLAN NO. t 1-7 C 0 SS 3 Existing Building Code Review a J /� HITECTU RAL GROUP Date: October 23, 2017 To: Barnstable Building Department From: MEDCOM Architectural Group, LLC Project: Cape Cod Healthcare Pain Center 46 North Street Hyannis, MA 02601 Preface: The proposed work within the space includes renovations and reconfiguration of less than 50% of the building aggregate area. We have reviewed the existing structure and have determined that the work qualifies for Level 2 Alteration requirements of the International Existing Building Code. Relevant Codes: 2009 International Bu,ilding Code 2009.(1 C-2009) 2009 International Existing Building Code (IE C-2009) Chapter 7 Alterations Level 2 2012 International International EnerAyConservation Code MEDCOM Architectural Group, LLC ,, i Cape Cod Healthcare Pain Center Existing wilding Code Review Page 2 Applicable Code Sections: Chapter 7-Alterations —Level 2 701 General 701.2 Alteration Level One compliance, in addition to chapter 7, all work, shall comply with the requirements of chapter 6, Level 1 Alterations. See below items 602.1 through 605. 701.3 All new construction elements, components, systems and spaces shall comply with the code for new construction. Chapter 6-Alterations —Level 1 601 General 602.1. Interior Finishes shall comply with Chapter 8 of the International Building Code with Massachusetts amendments. 602.2 Interior Floor Finish, including carpeting shall comply with section 804 of the International Building Code and Massachusetts amendments. 602.3 Interior Trim shall comply with 806 of the International Building Code and Massachusetts amendments. 603 Fire Protection. 603.1 Alterations shall be done in_a manner that maintains the level of fire Protection provided. 604 Means of Egress ,A,:,604.1 Repairs shall bedone in a manner that maintains the level of protection provided for the means of egress. 605 Accessibility The existing building is accessible. All new work will comply with 521 CMR 'Arch itectural.Access Board. . MEQCOM Architectural Group, LLG Cape Cod Healthcare Pain Center Existing Building Code Review Page 3 606 Structural 606.1 Where alteration work includes replacement of equipment that is Supported by the building or where a reroofing permit is required, the provisions of this section apply. Equipment weights have been reviewed for structural supports adequacy. 607 Energy Conservation 607.1 Level 1 alterations to existing buildings or structures are permitted without requiring the entire building or structure to comply with the energy requirements of the International Energy Code. Chapter 7-Alterations —Level 2 Continued 703 Building Elements and Materials 703.4 Interior Finish The interior finish materials will comply with the code for new construction. 704 Fire Protedtion i Building is fully sprinkled in accordance.with NFPA 13. Building is fully alarmed with an addressable system. . Refer to the Fire Protection Narrative. 705 Means of Egress The building means of egress has been based upon the code for New construction with regards to occupant load, number of exist, _cravel distanee, stair and door widths, railings and guards. 706 Accessibility_ The,existing building is accessible. All new work will comply with 521 CMR Architectural Access Board. M D E COM Architectural Group, LLC t Cape Cod Healthcare Pain Center Existing Building Code Review Page 3 707 Structural . 707.2 All new structural loads and elements, including connections and anchorage shall comply with the 2009 International Building Code. 707.5 Existing Structural elements resisting lateral loads. There are no additional lateral loads being applied to the structure. Equipment weights have been reviewed for structural supports adequacy. 708 Electrical 708.1-All newly installed electrical equipment and wiring relating to the Work done in any work area shall comply with the materials and Methods requirements in chapter 5. 507.1.Material Existing electrical wiring and equipment undergoing repair shall be allowed to be repaired or replaced with like material. 507.1.1 Receptacles.` Replacement of electrical receptacles shall comply with the applicable requirements of section 40 .q 6 3 (D) of NFPA 70. 709 Mechanical. 709.1 All reconfigured spaces intended for occupancy and all spaces converted to habitable or occupiable space in any work area shall be provided with natural or mechanical ventilation in accordance with the International Mechanical Code. MEDCOM Architectural Group, LLC r Cape Cod Healthcare Pain Center Existing Building Code Review Page 4 709.2 In Mechanically ventilated spaces, existing mechanical ventilation systems that are altered, reconfigured, or extended shall provide not less than 5 cubic feet per minute (CFM) (.0024 m3/s) per person of outside air and not less than 15 cfm (.0071 m3/s of ventilation air per person, or not less than the amount of ventilation air determined by the indoor air quality procedure of ASHRAE 62. 710 Plumbing 710.1 Minimum Fixtures Where the occupant load of the story is increased by more than 20 percent, plumbing fixtures for the story shall be provided in quantities specified in 248 CMR. Increased occupant load. Design has been based upon CMR 248. 711 Energy Conservation 711.1 Minimum requirements. Level 2 alterations to existing buildings or structures are permitted without requiring the entire building or structure to comply with the energy requirements of the International Energy Conservation Code. The alterations shall conform to the requirements.of the International.Energy ff}}/ Conservation Code. l d r f Gregor 'B. iroonian Date MEDCOM Architectural Group, LLC I � • ) IJ 7-11 1eap mae 1 - - - YOU ARE R -; FC p - - El KA J, A---r-1 1=7 f EGRESS / LIFE SAFETY PLAN (BMEDCOM ARCHITECTURAL GROUP Cape Cod Healthcare MEDICAL&COMMERCIAL ARCHITECTURE Suite Unit 2-3, 1st Floor 118 Waterhouse Road Bourne,MA 02532 - WWW.MEDCOMARCH.COM/t:(508)759-9828 46 North St. _ Hyannis, MA (Eplpcom I...RT ®' JI / BUILDING CODE ANALYSIS 8th Edition s 2A I NTERIuaT LAL BU LD rv1 CODE 1111 DA M TSSACHUSEriS Star[BOLD NG CODE)NG CMR EBaS C/COMMCRC,aL ECTH ED,i NAMMLnDMEnTS rp iHC 10091NTER HALL OrvnL BUILOINL CODC. F ' usE caouP CLASSIFICATION BUSINESS GROUP e ' - _ A 'S! �1t FIRE OF GONSTRUCTON.TYPE 28. �R'••� INQaJ y g - ^,� 780 CMR TABLE 903.1 OCCUPANCY AUTOMATIC SPRINKLER REOU ftEMENiS.B PROVIDE AUTOMATC FINErtl I SPRNKLER SYSTEM THROUGHOUT BULONG F> 12000 Sf OR MORE THAN 3 110RES AUTOMATIC FIRE SPRINKLER SYSTEM SHALL BE PROVIDED THROUGHOUT ALL AREAS V 2009 IBC:TABLE 503 ALLOWABLE HEIGHT AND BUILDING AREAS - _ - ALLOWED,3 STORY 60'&23000 5F PER FLOOR ACTUAL BOLDING HEIGHT: I STORY - r� ALTUaL BUILDING AREA. YJ LW .. • • • • v H .. TOTAL FLOOR AREA 26.355 SF I' 2009 BC-TABLE 601 PRE RESSOANCE RATINGS REOUIREMENTS FOR BUILDING ELEMENTS(3B): ^•-^' lul�'I PRIMARY STRUCTURAL FRAME 0 HOUR SEARING WALLS EXTERIOR-0 HOUR BEARING WALLS.LINTER OR 0 HOUR NO BEARING WALLS&PARTITIONS EXTERIOR TABLE 602 130--D HOUR - NON BEARING WALLS&PARTINTONS INTERIOR-0 HOUR FIRE ENCLOSURE OF EXITS,EXIT CORRIDORS,STAIRWAYS- I HOUR HVAC SHAFTS AND ELEVATOR HOISTWAY-2 HOUR - 2009 IBC:TABLE 803.9 INTERIOR WALL&CEILING FINISH REOUIREMENTS BY OCCUPANCY, . -. USE GROUP B EPRINKLERED - EXIT ENCLOSURES&EXIT PASSAGEWAYS-CLASS C ORRIDORS-CLASS C /�• ROOMS&ENCLOSED SPACES-CLASS C 11FIRST FLOOR EGRESS PLAN MEANS OF EGRESS: p - 00 sP+lr-a ,-o 2009 SC:OCCUPANT LOAD TABLE 10041,1 MAXIMUM FLOOR AREA ALLOWANCES PER OCCUPANT. ISSUED FOR ASSEMBLY WITHOUT FIXED SEATS UNCONCENTRATED TABLES&CHAIRS 15 SF NET PERMIT/CONSTRUCTION SET FIRST FLOOR UNIT 2&3 AREA-6.915 EF/100=)G OCCUPANTS August30.2017 6i TOTAL BOOR AREA-26.355 SF TOTAL BUILDING OCCUPANT LOAD=261 OCCUPANTS [CRESS CAPACITY COMPONENTS CODE ANALYSIS SHEET S EGRESS WIDTH PER OCCUPANT WITH APPROVED AUTOMATIC SPRINKLER SYSTEM 2409 IBC t005 EGRESS wOTH- • FIRST FLOOR EGRESS DOORS 0.2"X 70= W.ACTUAL 112" _ 2009 IBC:1015ZA Two EXITS OR EXIT ACCESS DOORWAYS WHERE TWO EXITS ARE REQUIRES AND BUILDING IS EQUIPPED WITH AUTOMATIC SPRINKLER SYSTEM THE EXITS SHALL BE PLACED APART EQUAL TO NOT LESS THAN ONE-THIRD OF THE LENGTH OF THE MAXIMUM OVERALL DIAGONAL DIMENSION OF THE BUILDING. _ CRODNAL DIMENSION 16D-2"/3=53'-5"ALLOWED.ACr1IAi )6'-(L 2009 BE 1609.1.2 PROTECTION OF OPENINGS IN WIND-BORNE DEBRIS REGIONS.GLAZING IN BUILDINGS SHALL BE IMPACT RESISTANT OR PROTECTED _. w/AN IMPACT-REST—AIT COVERING MEETING THE REOUIREMENTS OF AN APPROVED IMPACT-RESISTANT STANDARD OR: ASTM E 1996 AND ASTM E 1886 REFERENCED HEREIN AS FOLLOWS: GLAZED OPENINGS LOCATED WITHIN 30 FEET(9144 MM)OF GRADE SHALL MEET THE REOUIREMENTS OF LARGE MISSILE THE TEST OF ASTM E 1996, LEGEND 2009 IBC:TABLE 1016.1 EX1O ACCESS TRAVEL QISTANCE - '< ••PATH OF EGRESS WITH SPRINKLER SYSTEM 250'-0 ACT NTH 6'-0"MAX M IM. • 2009 IBC 1022.1 INTERIOR EXII STAIRWAYS SHALL HAVE A FIRE-RES15TANCE RATING OF NOT LESS TN _ 2 HDURS CONNECTING FOUR STORIES OR MORE,NOT LESS THAN 1HOUR CONNECTING LESS TITAN4 AN Em FIRE EXTINGUISHER STORIES. .v 16-011 780 CMR:ALL PUBLIC BUILDINGS SHALL BE DESIGNED TO BE ACCESSIBLE TO.AND FUNCTION AND SAFE FIRE ALARM FOR ONE USE BY,PHYSICALLY DISABLED PERSONS.AND CONFORM TO THE REOUIREMENTS 521 CMR 9/30/16 t�_1 PULL STATION MA95ACHUSETTS ARCHITECTURAL ACCESS BOARD'S RULES AND REGULATIONS P GBS 780 CMR:ENERGY EFFICIENCY ® CLG.ILLUMINATED BUILDINGS SHALL BE DESIGNED AND CONSTRUCTED IN ACCORDANCE WITH THE INTERNATIONAL ENERGY Tuml EXIT SIGN COrvS—CON CODE 2009(IECC 2009)w MASSACHUSETTS STATE BUILDING CODE 78D CMR BASIC/COMMERCIAL EIGHTH EDITION AMENDMENTS, YOU ARE HERE A BUILDING EXIT _, /..�00//,''TO OUTSIDE , ` T . _ AREA OF WORK } l • _ .......... ,a.. _ , ... _..... .. .. _.._ I �� K r r.. N. .. ... Yl T r _ w � L e 771 -1� .............. .......... 1 x s L—---—--------———----—---- Ott.---------—-------—---—------- - _ .......... — --- — _...... _....._.—. _ _ ___...... ._. W i OF WORK G SET .......... ........... ISSUED AV 08,2017 �. PART 221 PRRICINM AREA M REVIEW 1 T NEW GROUND �Va�w`m: '., - ........_ FLOOR PLAN FIRE PROTECTION T iV 1 ' k I I r 1 x 1 0 1 MTG... ..... :I 5 ..w v: -- x x -- l �Ro El o� FP101 ........ (E)MEDCOM D.:gCrDRn GFOUP '' e ue uovnvn,ewe,.un - OEMtuE uIN(� _e'' � � ... � IK wort[Xa[s.xn 05[an,[,reeu n¢B:rtRW M{RST ncE•VRv 59[u un CMn[c��o MC ".....• ..". F ?O CaPCrcOD vEaCSNC4RE 7. h ;� .. .. _ ....:. '; a 0. .. K 1 ' t ... ..... ... o� - .... ...... s .. nISSUED FOR DPH REVIEW 'a. } G SET g � � k £ h , Cu [>, - . ADD ALTERNATE#1M .. Q <,.. g M tv ._. _... ................ ._...... ........ 4 .H Y t (n5 .._...... ............ ............... ..... y ............ N .......vwux x� ...8 _............... ...:'. :........24Jnce s .. .. .....,.. _...,,... ........ ............ ....... .. _.._ ..... ry , 16 O11 ...5/08 ... �17 rD RCB `.. \ FA201 �NCW CRODNO C R PUN - - / r ACo CERTIFICATE OF LIABILITY INSURANCE FDATE(MM1DOfYYYY) 8/31/2017 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 CONTACT E; Maria McNutt Alliant Insurance Services, Inc„ PHo 617-535-7200 FAx );_617-535.7205 131 Oliver Street,4th Floor WC Boston MA 02110 -ADDRESS•Maria.McNulty@alliant.com INSURE S AFFORDING COVERAGE NAIC# INSURER n:Allied World National Assurance Com 10690 INSURED INSURER a:The Travelers Indemnity Co 25658 Dellbrook JK Scanlan INSURER C.-Travelers Indemnity Company of CT 25682 One Adams Place 859 Willard Street INSURER D:Starr Indemnity&Liability Corn2any 38318 Quincy MA 02169 INSURER E-Navigators Insurance Company42307 INSURER F: COVERAGES CERTIFICATE NUMBER:461463040 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 1LTR TYPE OF INSURANCE I IN D�WVD i POLICY NUMBER MMILI0DMYYY I MM7uDp1YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y 03084515 711I2017 7/1/2018 EACH OCCURRENCE $1,000.000 CLAIMS-MADE X OCCUR PR I S a urran $300.000 X 'XCu_____ . MED EXP(Any one rson) $10 000 _ X CerMiactUa PERSONAL 8 ARV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE s2,000,000 POLICY a JEC LOC PRODUCTS-COMP OTHERIOP AGG $2 000,000 I B AUTOMOBILE LIABILITY Y 810 3H608117 7I112017 7/1/2018 COMBINLE) N $ Ea acradent 1,00O.000 X ANY AUTO BODILY INJURY IPer person) $ �� ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY IPer accident) $ HIRED AUTOS NON-OWNED _i AUTOS r Per accidenC $ $ D , UMBRELLA UAB X OCCUR Y 1000564533171 7/112017 7/1/2018 EACH OCCURRENCE $10,000,000 FI EXCESS LIAS _ CLAIMS-MADE AGGREGATE 510,000,000 I I OED 1 1 RETENTION s $ !may C WORKERS COMPENSATION UB 3H613658 71,121117 71112018 X PER T ORH AND EMPLOYERS'LIABILITY YIN ------------ ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACHACClDENT S1,000;OdO OFFtCERIMEMBER EXCLUDED7 a NIA _ (Mandatory In NH) E L.DISEASE-EA EMPLOYE $1.000 000 If yes,desuibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT s 1.000,000 E Excess Liability ISI7EXC7114561V 7/112017 7/1/2018 Each Occurrence 15,000,000 Aggregate 15,000,000 DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) RE:Cape Cod Healthcare Pain Center Renovations,46 North Street,Hyannis, MA 02601. Cape Cod Healthcare, Inc.is included as Additional Insured as required by written contract and executed prior to a loss,but limited to the operations of the Insured under said contract,with respect to the Automobile, General Liability and Umbrella/Excess Liability policies., CERTIFICATE HOLDER CANCELLATION. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Healthcare,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 27 Park Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis MA 02601 AUTHORIZED REPRESENTAT�IVEEE 9� I , &,f� ./ V 01988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Town :of Barnstable Regulatory Services Richard V.Scall,Director. Building Division: _ Paul Rama,BuDding Commissioner 200 Mafia Shvet,Hymmis,MA 02601 www bamstable.ma:us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete, and Sign This Section If Us nLy A Builder ' M c I e l h4r-- (s e //V : _,as Owner of the subject property hereby,authorize C. r to act on ray beh4 in aIl matters relative to work authorized by this bw1ding peunit application for (Address of Job) Pool fences aad alarms are the responsibility,of the applicant Pools are not to be filled or utilized before fence is installed and all final ins pe ns:are"performed and accepted. Signs e o Owa Signs a licaat - Piiat Name Print Larne Q:F0R1 iS:0WNEU&V ='N?TP00IS ,fir ms - I' jr , Cor nweatth of:Massachusetts Gvision of Professional Laaosore . . Board of Barildfrqg to ulattotas and 5 ics rids CS-07467 IXP 4$' `i sL' AMISMET Aw f - `.�csr►m�sasra��t .•� - :y 3 is - a��r t *. r Initial 'tial Construction Control Document 4 To be submitted with the building permit application by a Registered Design Professional . for work per the 81h edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Cape Cod Healthcare Pain Center Medical Office Suite Renovations Date:09-05-2017 Property Address: 46 North Street - Project: Check(x)one or both as applicable: New construction X Existing Construction Project description:New Exam Rooms and Office area renovations I Robert C. Bravo MA.Registration Number: 44567 Expiration date: 6/30/2018,am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: Architectural Structural Mechanical Fire Protection X Electrical Other: for the above named project and that to the best of my knowledge, information,and belief such plans,computations and specifications Peet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept,shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 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 if the work is being performed in a manner consistent.with the approved ' construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 101. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a"wet"orSH OF electronic signature and seal: RgBERT C. ®R 4 0 Ell " Phone number; 508.295.0050'6 Email: rbravo@griffithandvary.com Building Official Use Only Building Official Name: Permit No.: Dater Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other' is chosen, . provide a description. Version 06_11_2013 Init ial. Construction Control Document 4 To be submitted with the building permit application by a Registered Design Professional for work per the 81h edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Cape Cod Healthcare Pain Center Medical Office Suite Renovations Date:00-05-2017 Property Address: 46 North Street Project: Check(x)one or both as applicable: New construction X Existing Construction Project description: New Exam Rooms and Office area renovations I Wayne E. Mattson MA Registration Number: 41546 Expiration date: 6/30/2018,am a registered design professional, and l haveprepared or directly supervised the preparation of all design plans,computations and specifications concerning Architectural Structural Mechanical X Fire Protection Electrical Other: for the above'named project and that to the best of my knowledge, information,and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 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 if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. . When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a`Final Construction Control Document'. P OF Enter in the space to the right a"wet"or electronic signature and seal: ` ;o`' WMYNE E. MATTSON m' MECHANICAL y 1NO.41546 Phone number: 508.295.0050 Email: wmattson@griffithandvary.com Building Official Use Only Building Official Name; Permit No.: Date: Note 1.Indicate with an'x' project design plans,computations and specifications that you prepared or directly supervised.If`other' is chosen, provide a description. Version 06 11_2013 ' Initial al Construction Control Document 1 To be submitted with the building permit application by a Registered Design Professional for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Cape Cod Healthcare Pain Center Medical Office Suite Renovations Date:09-05-2017 Property Address: 46 North Street i • Project: Check(x)one or both as applicable: New construction X Existing Construction Project description:New Exam Rooms and Office area renovations I Wayne E.Mattson MA Registration Number: 41546 Expiration date: 6/30/2018, am a registered design professional, and I have?repared or directly supervised the preparation of all design plans,computations and specifications concerning Architectural Structural X Mechanical' Fire Protection Electrical Other: for the above named project and that to the best of my knowledge, information,and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review,for conformance to this code and the design concept,shop drawings, samples and other submittals by the. contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 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 if the work is being performed in a manner consistent with the approved construction documents and this code. ; Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official Upon completion of the work,-I shall submit to the building official a`Final Construction Control Document' ' ,H of Enter in the space to the right'a"wet"or electronic signature and seal: UYAYRIE Ir ti� MATTSOR! MECHANICAL NO.41546 Phone number: 508.295.0050 Email: wmattson@griffithandvary.com �F .T�`�� Building Official Use Only Building Official Name:• Permit No.: Date: Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen, . provide a description. Version 06_11_2613 Initial Construction Control ]Document r To be submitted with the building permit application by a Registered Design Professional for work per the 81h edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Cape Cod Healthcare Pain Center Medical Office Suite'Renovations Date:09-05-2017 Property Address: 46 North Street Project: Check(x)one or both as applicable: New construction X Existing Construction Project description:New Exam Rooms and Office area renovations I Gregory B. Siroonian MA Registration Number: 9748 Expiration date: 8/31/2017 , am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': x Architectural Structural Mechanical Fire Protection Electrical Other: for the above named project and that to the best of my knowledge, information,and belief such plans, computations and specif cationsmeet the applicable provisions of the Massachusetts State Building Code,(780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept,shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. - 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 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 if the work is being performed in a manner consistent with the approved construction documents and this code. . Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall_submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion;of the work,I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a"wet'or electronic signature and seal: ' • }��J.a-eyM� Phone number;508 7599828 'Email: gbs@MEDCOMarch.com Building Official Use Only Building Official Name: Permit No.:, Date: Note.1.Indicate with an`s'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen, provide a description. Version 06_11_2013 I Town ,of Barnstable Regulatory Services f = KAM i QtR'NQ11pTQ f . Richard V.Scali,Director ► ' Building Division. Paul Roma,Building Commissioner 200 Mom Street,Hyannis,MA 02601 www1own.barnstable.ma.us Office: 508-862-4038 Faxc 508-790-6230 Property Owner Must Complete, and Sign This Section If Using;A Builder �e ly • ,as Owner of the subject property hereby authorize ' tI rri- efsu to set on my behaK in all rmtters relative to work authorized by this wIdin pertnit application for- (Address of Job) l'(�V /dY�ZG **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utitized before-fence is installed and all final inspe ns:are`performed and accepted. bigrta e o Own 'Signs a licznt _. Print Name Print Diane Q:F0RW:0WNERPERMrsa0 QWLs f Initial Construction Control Document W = To be submitted with the building permit application by a Registered Design Professional a for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Cape Cod Healthcare Pain Center Medical Office Suite Renovations Date:09-05-2017 Property Address: 46 North Street Project: Check(x)one or both as applicable: New construction X Existing Construction Project description:New Exam Rooms and Office area renovations I Gregory B. Siroonian MA Registration Number: 9748 Expiration date: 8/31/2017 , am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning': x Architectural Structural Mechanical Fire Protection Electrical Other: for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 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 if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a"wet"or �4 electronic signature and seal: I 1 E ra 41 �a.r Phone number: 508 759 9828 Email: gbs@MEDCOMarch.com q A Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an `x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen, provide a description. Version 06 11 2013 Initial Construction Control Document N To be submitted with the building permit application by a Registered Design Professional for work per the 81"edition of the Massachusetts State Building Code, 780 CMR, Section 107 . Project Title: Cape Cod Healthcare Pain Center Medical Office Suite Renovations Date:09-05-2017 Property Address: 46 North Street Project: Check(x)one or both as applicable: New construction X Existing Construction Project description:New Exam Rooms and Office area renovations I Wayne E.Mattson MA Registration Number: 41546 Expiration date: 6/30/2018, am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': Architectural Structural X Mechanical Fire Protection Electrical Other: for the above named project and that to the best of my knowledge, information, and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 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 if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a`Final Construction Control Document'. . gri OF Ib(� Enter in the space to the right a"wet"or o electronic signature and seal: o WAYNE B. yGo, MATTSON m M{ECHANICAI NO.41546 Phone number: 508.295.0050 Email: wmattson@griffithandvary.com Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other' is chosen, provide a description. Version 06 11 2013 Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional a for work per the 81"edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Cape Cod Healthcare Pain Center Medical Office Suite Renovations Date:09-05-2017 Property Address: 46 North Street Project: Check(x)one or both as applicable: New construction X Existing Construction Project description: New Exam Rooms and Office area renovations I Wayne E.Mattson MA Registration Number: 41546 Expiration date: 6/30/2018,am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': Architectural Structural Mechanical X Fire Protection Electrical Other: for the above named project and that to the best of my knowledge, information,and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review,for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CNIR Chapter 17,as applicable. 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 if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a `Final Construction Control Document'. •tto OF Enter in the space to the right a"wet"'or electronic signature and seal: _ o� WAYNE tUTATTSON M ECH ICAI NO.41546 Phone number: 508.295.0050 Email: wmattson rif�thandva com @g �'• OWA►- , Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other' is chosen, provide a description. Version 06 11 2013 Initial Construction Control D� ocument u To be submitted with the building permit application by a R d Registered Design Professional for work per the 81h edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Cape Cod Healthcare Pain Center Medical Office Suite Renovations Date:09-05-2017 Property Address: 46 North Street Project: Check(x)one or both as applicable: New construction X Existing Construction Project description:New Exam Rooms and Office area renovations I Robert C. Bravo MA Registration Number: 44567 Expiration date: 6/30/2018,am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': Architectural Structural .Mechanical Fire Protection X Electrical Other: for the above named project and that to the best of my knowledge, information,and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 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 if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official Upon completion of the work,I shall submit to the building official a `Final Construction Control Document'. "of Enter in the space to the right a"wet"or �► � electronic signature and seal: A08ERT C• BRAVO Phone number: 508.295.0050 Email: rbravo@griffithandvary.com Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other' is chosen, provide a description. Version 06 11 2013 0,17 1 glee # + Diivi sion of.PmAess i LiceOSWt Board o(Suilding9figotations wWStOrRWds -Constr AM T IAN 45 PEACH SLOSSOI #� ACUSHNET M;�, ;a � Commissioner, 7,AF .g i FODELLBROOKIJKS September 5, 2017 Building Department Town of Hyannis 200 Main Street Hyannis, MA 02601 Re: Cape Cod Healthcare To Whom It May Concern: I am writing to inform you that Moses Cordeiro is an employee of Dellbrook JK Scanlan and has authority to request a building permit on behalf of Dellbrook JK Scanlan. If you have any questions, please do not hesitate to contact me at 508-540-6226. Sincerely, Dellbrook canlan Seth Adams,Sr.Vice President QuiNCYOmce 859 Willard Street,One Adams Place,Quincy,MA o2169 t:781.380.1675 f:781.380.1676 FALMOUTH OFFICE:, t5 Research Road,East Falmouth,MA OZ536 I t:508.540.6226 f 508.540.9ZZ2 The Commonwealth of Massachusetts i Department of IndustrialAccidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 ,M SVBv'� www mass.gov/dia «'orkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Dellbrook JK Scanlan Address: 15 Research Road City/State/Zip: East Falmouth, MA 02536 Phone #:508-540-6226 Are you an employer?Check the appropriate box: Type of project(required): 1.0 1 am a employer with employees(full and/or part-time).* 7. New construction 2.F1 1 am a sole proprietor or partnership and have no employees working for me in $. Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.[:]1 am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 0 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 1 l.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.a I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ p 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[]Other 152,§1(4),and we have no employees. [No workers'comp. insurance required.] *Any applicant that checks box#I 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. I f 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:Travelers Indemnity Company of CT Policy#or Self-ins.Lic. #: UB 31­1613658 Expiration Date:7/1/18 Job Site Address:46 North Street City/State/Zip: Hyannis, MA 02601 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against thgation. iolator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage veri I do hereby ce t =ert and penalties of perjury that the information provided above is true and correct. Si nature: Date: Phone#:508 0-6226 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r AG V CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1 8/31/2017 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 CONTACT Maria McNulty Al 1 Insurance Services, Inc., NAME:PHONE .617-535-7200 FAx 617-535-7205 131 Oliver Street,4th Floor A/c "° Boston MA 02110 Eoo IL .Maria.McNulty@alliant.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Allied World National Assurance Corn 10690 INSURED INSURER B:The Travelers Indemnity Co 25658 Dellbrook JK Scanlan INSURER C:Travelers Indemnity Company of CT 25682 One Adams Place INSURER D:Starr Indemnity& Liability Company 38318 859 Willard Street Quincy MA 02169 INSURER E:Navigators Insurance Company 42307 INSURER F: COVERAGES CERTIFICATE NUMBER:461463040 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 POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y 0308-4515 7/1/2017 7/1/2018 EACH OCCURRENCE $1,000,000 CLAIMS-MADE DAMAGE TO xI OCCUR PREMISES Ea occurrence $300,000 X XCU MED EXP(Any one person) $10,000 X Contractual PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY a JEC LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y 810 3H608111 7/1/2017 7/1/2018 COMBINED SINGLE LIMIT $ Ea accident 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS j Per accident $ D UMBRELLA LIAB X OCCUR Y 1000584533171 7/1/2017 7/1/2018 EACH OCCURRENCE $10,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED RETENTION$ $ C WORKERS COMPENSATION UB3H613658 7/1/2017 7/1/2018 PER OTH- AND EMPLOYERS'LIABILITY Y/N X STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1.000,000 E Excess Liability IS17EXC7114561V 7/1/2017 7/1/2018 Each Occurrence 15,000,000 Aggregate 15,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACCORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Cape Cod Healthcare Pain Center Renovations,46 North Street, Hyannis, MA 02601. Cape Cod Healthcare, Inc. is included as Additional Insured as required by written contract and executed prior to a loss, but limited to the operations of the Insured under said contract,with respect to the Automobile, General Liability and Umbrella/Excess Liability policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Healthcare, Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 27 Park Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Massachusetts Department of Environmental Protection f eDEP 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: DELLBROOKJKS17 Transaction ID: 953290 Document: AQ 06-Construction/Demolition Notification Size of File: 227.97K Status of Transaction: Submitted Date and Time Created: 9I5/2017:3:12:52 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 BWP AQ 06 Pre-Form .j Notification Prior to Construction or Demolition LIa r This is a revision to an existing form. Project ID for existing form to be revised: m t r- This job is being conducted under a Blanket Permit. MassDEP assigned Blanket Authorization ID: This job is being conducted under a Non Traditional Abatement Work Practice Permit. MassDEP assigned Non Traditional Work Practice Authorization ID: r7 None of the above conditions apply,generate a new form. Revised: l l/1.3/2013 Page 1 of l Massachusetts Department of Environmental Protection 100z71962 t ��---- BWP AQ 06 (� -[ T Asbestos Project# Notification Prior to Construction or Demolition r Project Revision i- Project Cancellation A. Applicability A Construction or Demolition operation of an industrial,commercial,or institutional building,or residential building with 20 or more units is regulated by the Department of Environmental Protection(MassDEP),Bureau of Waste Prevention,Air Quality Division,under Regulations 310 CMR 7.09.Notification of Construction or Demolition operations is required under 310 CMR 7.09(2)ten(10)working days prior to any work being performed.The following information is required pursuant to 310 CMR 7.09. 1.is this a fee exempt notification(city,town,district,municipal housing authority,state facility,owner-occupied residential property of four units or less)? r a.Yes W b.No 2.Blanket Permit Project Approval,if applicable: Approval ID# 3.Non-Traditional Asbestos Abatement Work Practice Approval,if applicable: Approval ID# Instructions: B. Facility Description 1.All sections of this form must be 1.Facility Information: completed in order to CAPE COD HOSPITAL 46 NORTH STREET comply with the a.Name of facility b.Street Address Department of Environmental BARNSTABLE MA 026010000 5085406226 Protection c.City/Town d.State e.Zip Code f.Telephone notification requirements of 310 BILL HAFFERTY FACILITIES MANAGER CMR 7.09. g.Facility Contact Person h.Facility Contact Person Title 2.Submit Original 5087711800 BHAFFERTY@CAPECODHEALTH.ORG Form To: i.Facility Contact Person Telephone j.Facility Contact Person Email Commonwealth of Massachusetts k.Facility Size: P.O.Box 4062 Boston,MA 02211 5198 1 1.Square Feet 2.Number of Floors 1.Was the facility P'facili built nor to 1980? r 1.Yes W 2.No MassDEP Use Only - m.Describe the current or prior use of the facility: Date Received MEDICAL OFFICE n.Is the facility a residential facility? r 1.yes 17.2 No o.If yes,how many units? 2.Facility Owner: W Same address as Facility CAP COD HOSPITAL 27 PARK STREET a.Facility Owner Name - b.Address HYANNIS MA 026010000 5087711800 c.Citylrown d.State e.Zip Code f.Telephone 3.Facility On-Site Manager/Owner Representative: 170 Same contact person as facility r— Same address as facility W Same address as owner BILL HAFFERTY 27 PARK STREET a.On-Site Manager/Owner Representative b.Address HYANNIS MA 02601 5087711800 c.City/Town d.State e.Zip Code f.Telephone Revised:03/17/2014 Page 1 of 3 f LMassachusetts Department of Environmental Protection 100271962 BWP AQ 06 Asbestos Project# Notification Prior to Construction or Demolition �" Project Revision r, Project Cancellation C. General Project Description 1.This project is: r,— New Construction Demolition Renovation 2.Project Dates: 9/20/2017 1/19/2018 a.Project Start Date(MM/DDNYYY) b.Project End Date(MM/DQNYYY) 3.General Contractor: DELLBROOK/JKS 15 RESEARCH ROAD a.Name b.Address FALMOUTH MA 025360000 5085406226 c.Cityrrown d.State e.Zip Code f Telephone SCOTT MITCHELL 5088587095 g.General Contractor's On-site Manager/Foreman h.Telephone 4.Construction or demolition contractor: i✓ Same as General Contractor DELLBROOK/JKS 15 RESEARCH ROAD a.Contractor Name b.Address FALMOUTH MA 025360000 5085406226 c.City/rown d.State e.Zip Code f.Telephone SCOTT MITCHELL 5088587095 g.Construction and Demolition On-site Manager h.Telephone 5.Licensed Construction Supervisor: SCOTT MITCHELL CS-089397 a.Supervisor Name b.Construction Supervisor License(CSL)Number 6.Is the entire facility to be demolished? a Yes b.No 7.Describe the area(s)to be demolished: 8.Describe the building(s)or addition(s)to be constructed: RENOVATE UNITS 2/3 9 a.Were the structure(s)surveyed for the presence of Asbestos-Containing 5F 1.Yes l-2.No Material(ACM)? b. Who conducted the survey? VERTEX A1062105 1.Name of Asbestos Inspector 2.DLS Certification# Revised:03/17/2014 Page 2 of 3 Massachusetts Department of Environmental Protection 100271962 BwP AQ 06 7 Asbestos Project# L Notification Prior to Construction or Demolition I— Project Revision r' Project Cancellation C. General Project Description (continued) 10 a.Was asbestos containing material(ACM)found? I.Yes W 2.No General b.If ACM was found during the survey,please provide the Asbestos Statement:If Notification Form(ANF)Project Number. asbestos is found during a Construction 11.For demolition and construction projects,indicate dust suppression techniques to be used: or Demolition a.Seeding b.Wetting c.Covering d.Paving e.Shrouding all responsible parties rw f. must comply with 310 Other-Specify: CONTAINMENTIDUSTOONTROL CMR 7.00,7.09,7.15, and Chapter 21 E of the General Laws of 12.Is this an Emergency Demolition Operation? l `a.Yes W b.No the Commonwealth. This would include, but would not be c.Name of MassDEP Official who evaluated the emergency limited to,filing an asbestos removal d.Title notification with the Department and/or a notice of e.Date of Authorization(MM/DD/YYYY) f.MassDEP Waiver Number release/threat of release of a D. Certification hazardous substance to the Department,if "I certify that I have personally LISA MANN applicable. examined the foregoing and am 1.Print Name familiar with the information LISAMANN contained in this document and 2,Authorized Signature all attachments and that,based on my inquiry of those individuals immediately 3.Position/Title responsible for obtaining the APM information, I believe that the 4.Representing information is true,accurate,and 9/1/2017 complete.1 am aware that there 5.Date(MM/DD/YYYY) are significant penalties for 09012017 submitting false information, including possible fines and 6.P.E.# imprisonment.The undersigned hereby states,under the penalties of perjury,that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is a made." . d Revised:03/17/2014 Page 3 of 3 Commonwealth of Massachusetts Sheet Metal Permit 11 I2? h r Map ✓v�Parcel Date: r ( 3jig Permit Estimated Job Cost: $ Si 0 � [ , Permit Fee: $ (Q - od Plans Submitted: YES NO NOV 13 2017 Plans Reviewed: YES NO Business License# TOWN O� bAHNpS U-icense# Business Information: Property Owner/Job Location Information: Name: A/L'_ ✓ CN6(-W)0 T�z14 AW Name:Cyr-( Street: /6 66 r 120 Street:cm J City/Town: J_�A gL J36(Z(>v6 t ,I ML City/Town: Zc ,6 n" S Telephone:c�O`) `7_1 ?? Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES NO sta it;ei J42ADnrestricted license J-2/.M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less Residential: 1-2 family Multi-family Condo/Townhouses Other Commercial: Office 'V Retail Industrial Educational d IsA -t7 -- Fire Dept. Approval Institutional_' Other Square Footage: under 10,000 sq. ft.' V over 10,000 sq. ft. Number of Stories: -� Sheet metal work to be completed: New Work: Y Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents ` Air Balancing Provide detailed description of work to be done: D-e ein a E- I Sal r? WV I-7G-04 - ,-e— ,-p yk e-- 6 151-1C �vL� ��� ti `G,� S lice ���✓ �U���� cJf � oOld-F �4; vn 4 100 X1 sls � INSURANCE COVERAGE: 1.fiave a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes❑ No ❑ If you have checked X=, indicate a type of coverage by checking the appropriate box below: A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box❑,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Progress Inspections Date Comments f Final Inspection Date Comments Typ of License: By ®Master Title ❑Master-Restricted Cityrrown ❑Journeyperson Signature of Licensee Permit# ❑Journeyperson-Restricted License Number: a6LV7 Fee$ ❑ Check at www.mass.gov�/d_ol Email: (el Qr1 Vet re e-,�G+Ir-c'yr, Inspector Signature of Permit Approval , f The Commomveah*ofMam&meft Deparaffent ofludushid Acdderrts OJFwe ofboesfigadens 600 Washfizoon St met Boston,M4 02111 tt m=Lgrw/d= Workers' Compensation Insurance Affidavit Bm'ldeimlC�mtracte hers Applicant Infarrim of n Please Dint v aws Acre u an emplayer?Check the appropriate bom ' Type of project(retlub ed}- 1.; I am a employer vH 4_ ❑I am a general contractor and I 6. env oonsix�ioa mgl eayees(frail andlof part-ime}* have hiredgm snbLcom ctoes 2.El' I am a sole propr�or partner- listed on the attached sheets 'i- ��deling sip and have no employees These sub-contracta=s hate g •Q Demolition w for°�'� f in �wodoere 9. ❑B,uiltiiag addition JNa vup� is� S'comp. sun ce comp-reFire -) 5. ❑ We are a corporation and its 10.❑Elecisical repairs or additions 3-❑ I ama homeowner doing all wash offf=s have exercised da it iL❑Ph=bingrepairs or additions myself[No 'gip- ught d eer M L L.❑Rnofrepaim +s+ettranrEa required-] a Y 152,§ ( 13-❑Other employees-[NO wpa=e com7p-kmxz=e require&] H�atdbedsbas#l=ntalsofaIoutthe:sw&nbelawsbma>agftfirwadces'-new ationpanuittl> aas ? sub=tthisafHdax*i theyateMain-allwaksAthenhEmaatsiecaEtzactmx—stsubmitanewamdaeltmai-ninosacIi aatmctrns*at dl>eclr th&baz must dbi h madam sheet sbaamg therameof 1be sib-coo and me whegm atmtffmse eafitkshalm eugAwjees Iftbesub-caatmct=Iwa a zq&ya2%dLey=srpnmde their wadmm'•mmp,paltry m lam an euepIaysr;Teat is prathdirrg tvarkers'caapemagon L-imraarefbr uzp atrrpinjwm fOTVW is t1fte p7J&7 a r d jab sits itr�ar-rrralian. , hisstarance CompanyName: Policy#or Self-in.€. ic- FxpiiationDate- Job Site Address: Citylstawzix Attach a copy of the workers'coanpensationpoRcyde faration page(showing the policy member and expiration date). FaRnre to secure coverage as regt:iredunder Section 25A o€MQ.m 157 can lead to the imposition of criminal penalties of a fine up to$L50D 0D andfpr one-gearimprisonmeat,as Well as civil peualfiies•in the forra of a STOP WORK ORDERand a fme of up to$250-00 a day against the violator- Be advised that a copy of this statement maybe forwarded,to the Office of five tcgafto s o€the DIA for inswmw coverage vedfica3ian- I d'a hereby catffly tbs prrirls pia aray fhattiie ir}brmafi n pro; abm�a h;bare and carrect Date- / j.3 Phone;k 0LJ a�tci'rd�arz'�tp. Da arat e�rrte arl t1a€�orrery err be rxnnpfetc�by testy arta�eavi afjrcraat City or Taw n: PermitUcense# IssuingAu ority(circle one): L Board of Health Z.IurTdmg Deparl3nat 3.City1rown Cle k 4 Electrical Inspector S.Plumbing Inspector 6.Other Coact Person: Phone& 6 Information and Instructions Ge eaal Laws chapter M ragm=all employers fn provide wow'compensation fw Vm r employees. paisaa�to fhis sfttohe,an ersPlayse is cI ed as" every person m.f-M sea W=of an other M34M any roMft-dd Of ii rr, expj=or implied,meal or vrMenf associatiox>,ccnporaffm or other legal entity,or any two or more Auz ev�IQyer is dew as"an per, - of the:foregoing=gaged in a)oint cmtmydsq,and incb>dingthe legal rspresenhdives Of EL deceased emplmyer,Cr the receivers or ttvstee of an inrftvidaal,pMt=EShiP,awDmaf=or other Iegal entity,employing employers. However the owner of a dwelling horse having mt:more than three apmAmeads and who resides therein,or fie occapant offbe - dwelling house of ano6=who employs persons to do mami=an cc,construction,or repair W03$on such dwelling howz or cn the grounds orbn7dmg appuat==Huth mZb shall not becanse ofsnch employmeutbe deemed to be an employes" MGL rbapte r I52,§25g6)also states that"every sfafe or local liicens mg agency shall wMhold the issuance or renewal of a license or permit to opera le a basiuess or to construct buildings in the commonwealth for any applicantw•ho has notproduc ed acceptable evidence of compliance with the isnrance.covex2ge requu ed." Additionally,M(ff chapter I52,§25C(7)surfer fiTeithmfile commaawealthnor jay of its political subdivisions shall ewer hi!D any contract for the pace ofpublic work umful acceptable evidence of compliance with the i1smmnc6.. reqoi=eEts of this clVter have Been piseinted to the rn lra��aoffioaty." Applicants ' please fill out the workeas'compensation atEidavit comple#ely,by checking tha boxes that apply to your sifnation.and,if nmmsaryy,apply sub-��s)name(s), addmss(es)and phone mmmber(s)along with.their=-Wacate(s)of insurance. Lm=ted Liability Companies(LLC)or LmmifPdLiabz7ity Pazinersbips(I.LP)with no employees other titan the members or pmt ens,are not required to tiny workere campensafron msmance If an LLC or LLP does have empIoyees,apolicyisrequired. Beadvisedthat this a$daY$maybe submbtcdtotheDepartmentofBAnsbrial Accidents.for conE=afim ofamnm a coverage Alsa be smre to siLm and chinthe aidav!L The aEdavitshould boTvftmzed to the city or town that the applicatimn for the permit or license is being requested,not the Department of had mSt rIg A=d=tL Shouldyou have any questions regarding the law or ifyou are rued in obtain a workers' conzpenaEbo policy,please call the Dep artment at the number listed below self-in�companies sbonld enter their s elf-insorance license nnmbe r on the apprm Ifim City or Town OMcials please be sin a fiat the affidavit is complete and priofed-legibly. The Department has provided a space at the bottom off z affichry±for youto fill out m.the eves the Office oflnvestiga6cins has to contactyonregardingthe applicant Please:be sure to fill in the pen�iUlicenm number which will be used as a reference number. Iu addition,an applicant that must submit multipIe permitllicense applYtaticm in any given year,need only submit are affidavit indicating caormt . policy infotmafion(if necessary)and umri `job site!a_ddress"the applicant shou'.d write"all lo6ations in (may or town)_'A copy of tho aff davit that has been officially stamped or manned by t ie city or to may be provided to the applicant as proof that a valid affidavit is on file for H I e'pmmi s or Hcenses Anew affidae uni st be filled ovt ea T3. year.Where a home owner or citizen is obtaunag a license or pezm t not rebrt A to any business or commercial vie (ie. a dog license or permit to bum leaves eta_)sod person is NOT regahEd to complete this affidavit The Office:of Invesdgatimns wouldlulme m thank you in advance for you-coop erafion and should you have any questions, please do not bes t to give us a call The Deparfineufs address,inlephome and fax number _ - - Thm COMMWVMI&Of IR.Sachnsz f ' DepadMent oft t kA=idants fc��.fxuv�g�fi�aa� B0stou,MA 0�111 T(,-1.#617' -4 c�xt 406 or 14M IL S.4FE Fax#617 727 774 Revised 4-24-07 W Town of Barnstable Building Department services Brian Florence,CBO s659. ► Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.ns Office: 508-862-4038 IYZ- Fax: 508-790-6230 Property Owner Must Complete and Sign This Section - If Using A Builder c S � .4 I � "" l--f � ,aser of the subject property hereby authorize aa�14/UD %LGW/QI r to act on my behalf in all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. t Signature of Owner Signature of Applicant ' Print Name Print Name i .3 i Date Q:FORM&OWNERPERMISSIONPOOLS Rev:08/16/17 Town of Barnstable Building Department Services • Brian Florence,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 BARNSTASM KAM www.town.barnstable.ma.us a639 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village k "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the buildingpermit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed.against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure,that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q.:\wPFHM\FORMS%uilding permit forms\EXPRESS.doc 08/16/17 I ACORO® DATE(MMIDDIYYYY) AC� CERTIFICATE OF LIABILITY INSURANCE F12/8/2016 I 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 Karen Sta le NAME: P }' THE ROWLEY AGENCY INC. PHONE : (603)224-2562 (A/C No:(603)224-ao12 139 Loudon Road AIL ADDRESS:kstapleyftowleyagency.com P.O. BOX 511 INSURERS AFFORDING COVERAGE NAIC# Concord NH 03302-0511 INSURERA:The Netherlands Ins. Co. 24171 INSURED INSURERB'.The Ohio Casualty Ins. Co. N.E. Tech Air Inc. INSURER C Maine Employers Mutual Ins Cc 16 Manson Libby Rd. INSURERD West American Ins. Co. INSURER E: Scarborough ME 04074 INSURERF: 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 LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM/DDY� MMIDDY� LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTED D CLAIMS-MADE X OCCUR PREMISES Ea occurrence a $ £ 100,000 BKW57697271 11/30/2016 11/30/2017 MEDEXP'A "J u x Blanket AZ w/ ("ny one person) $ 5,000 completed operations PERSONAL&ADVINJURYT:� $ --k;�1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERM GREGATE ­:_ $ '_ 2,000,000 POLICY PRO. FLOC PRODUC.T.StCOMP/OPAGG, $ 2,000,000 OTHER: Employee Benefits $ 5G 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT r Ea..ident l $ ,�1,000,000 A X ANY AUTO BODILY INJLfRY(Per person)= $ ;J ALL OWNED SCHEDULED BA8880926 11/30/2016 11/30/2017 BODILY INJURY(Peraccident) $ � AUTOS AUTOS n �. HIRED AUTOS NON-OWNED PROPERTY ^AMAGE gY AUTOS BA8881226 Peraccident re$ $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10,000,000 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED I X I RETENTION$ 10,000 US057697271 11/30/2016 11/30/2017 $ WORKERS COMPENSATION 3A:CT,MA,ME,NH,NJ,NY,RI, X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE SC,VT,VA 5101800453 E.L.EACH ACCIDENT $ 11000,000 OFFICER/MEMBER EXCLUDED? y❑ N/A `, (Mandatory in NH) 68537 (RI through 11/30/2016 11/30/2017 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,descrbe under Beacon Mutual Ins. Co.) DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 B Leased/Rented Equipment IM 8883221 Limit:$100,000 Ded: $1000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Fora Records Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE.POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE t� Karen Stapley/KS ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025/51n14n1I OiM'M'„ NEALTII,O'F IVI' I�US 'fT *"..' t SHEE1�M 14°A�LWORk�i�RS + n •��� ��� �i a 4 x ' sISSES7M#s FOLLO INGLICEN$`E ASS , so-U.- ur "�* r� �MASTERLINREST'RICTE ray' 'e�, .c31, A 3 , �5 1��F ai F?1i N!4R,p E EN`,; ISM T� �NEMENGLANI7 T,ECF! S;igRROROUGF°I,ME 04074"9820 r r` h s� y+4 7 r ,' +�� f 11212$42Ql7d r� 2647f�a12138 §y1 � 1�J�212( 6 R f r hNo oQ;MA g� ssns t �j.-I 1-156E%M 16HGT6 0 �b 1g/� 1)T OF IKE TOWN OF BARNSTABLE BMWVrAB BUILDING DEPARTMENT 9`6AlMASS f 39. APPLICATION FOR CERTIFICATE OF OCCUPANCY ' Date Building permit application number f� - IT"3/6 1 map/par �3° 9- I e"5--p013 Address of structure qb tom'-f4\ S+- Area of structure C.O.will be issued to q 6 /Vo✓tk Si- Upj 2 Name of Tenant �A cG`-r. Edition of Building Code Use and Occupancy Classification Type of Construction Design Occupant Load Is the facility licensed by a State agency Yes No El If yes If yes, name of agency Relevant Code of MA Regulations (CMR) that apply Automatic Sprinkler System Sprinklers provided? Yes No Sp p rinklers required? Yes No Building Department Use only Special Conditions: �oFZHEro Town of Barnstable Building Department-200 Main Street 1e39, m Hyannis, MA 02601 Tel. (508) 862-4038 Certificate Of Occupancy Permit Number`. B-17-3169 CO Issue Date: 12/20/2017 Parcel ID: 309-195-OOB Zoning Classification: OM Location: 46 UNIT 2 NORTH STREET, HYANNIS Proposed Use: ' PAIN'CENTER Name of Tenant: CAPE COD HOSPITAL Sprinklers Provided: YES Gen Contractor: MOSES M CORDEIRO Permit Type: Commercial - Non-Profit Type of Construction: Design Occupant Load: 0 Comments: UNIT 2 12/20/17: Building Official Date; A Certificate of Occupancy is Required Prior to Occupying Space Building Code: 780 CMR 8th Edition