Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0130 NORTH STREET
f 130 NORTH STREET ; ra. MEDICAL FACILITY j J ' I 6� J ,I r r l 4 en' o Ca re -ea ai" buildinc a' nJ are ob h If 7-7LI'h'77 7S.,7=771111 e 7; -tervvise coi-i L4 Li Line at -c k comphance v�rith �e proovisic.ln I n'L 0 I L I I s an these regulations. El § 240-67 Signs in CVD,,"0M. HG. TD VB-A, WBVBD and MMV Districts. [Amended 6-1-2006 by Order No- 2006-136, 7-1.6-2009 by Order No. 2009-1371 6-17-2010 by Order No 2010-1221 9-8-2011 by Order No. 2011-138] The provisions of§ 240-65 herein shall apply except that: A- The maximum allowable height of all signs is eight feet, except that the Buildin Commissioner may allow up to 12 feet if he 0 9 finds that such height is necessary for the site and is compatible with the appearance,scale and character of the area- B. The maximum square footage of all signs shall be ro square feet or lob of the building face, whichever is less. C. The maximum size of any freestanding sign shall be to square feet, except that the Building Commissioner may grant Up to 24 square feet if he finds that the size is necessary for the site and that the larger size is in scale with. the building and does not detract from the visual quality or character of the area. ......... ice C5 W )JafYQ_4- 0 � & 40 -4c> Y-nu -k C'Msanne_ 61 Final Construction Control Document y To be submitted at completion of construction by a oil r Registered Design Professional F for work per the 9 b edition of the ' M gJ0 Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Cape Cod Healthcare Medical Suite Date:2-9-2021 Property Address: 130 North Street, Suite C Hyannis MA L� 2t+. v Project: Check(x)one or both as applicable: New construction X Existing Construction Project description: Minor interior renovations and build out of a new Toilet Room. I Gregory B. Siroonian MA Registration Number: 9748 Expiration date: 8/31/2021 ,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 x Mechanical x Fire Protection x Electrical Other: for the above named project. I,or my designee,have performed the necessary professional services and was present at the construction site on a regular and periodic basis. To the best of my knowledge,information, and belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit and that I or my designee: 1. Have reviewed, 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. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Have been 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 was performed in a manner consistent with the construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. Enter in the space to the right a"wet"or electronic signature and seal: V Phone number: 508 759 9828 Email: gbs@MEDCOMarch.com Building Official Use Only Building Official Name: Permit No.: Date: Version 06 11 2013 'Town<.of Barnstablen.. u�� - . ..w uuu.w4...w.e• e•.tt « _ .. +.::4 ..«:• g LnRlNb"TABM ; Post.This,Card So That it is Visible From.,the.Street-:Approved Plans,Must,be,Retained on Job and this Card Must be Kept - 74:A g Posted Until Final Inspection Has Been Made. Wh'ere,a Certificate'of Occupancy_is'Required,such Building shall Not'be Occupied until a Final Inspection has been made. Permit NO. B-19-3859 Applicant Name: ROLAND B CATIGNANI Approvals Date Issued: 11/25/2019 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 05/25/2020 Foundation: Commercial Map/Lot: 309-212. Zoning District: OM Sheathing: Location: 130 NORTH STREET, HYANNIS Contractor Name; ROLAND B CATIGNANI .Framing: 1 Owner on Record: BARE BONES LLC Contractor License: CS-005157 2 Address: 130 NORTH STREET a_ Est. Project Cost:. $50,000.00 Chimney: HYANNIS, MA 02601 Permit Fee: $555.00 Description: Reconfigure Basement P/T space to include removing(1)interior Insulation: Fee Paid: $555.00 wall,adding(1)interior wall, relocating(2)interior.doors,new paint Final: and flooring in renovated area. Relocate elect.-Mech and.fire Date; 11/25/2019 t`K y protection as required Plumbing/Gas Project Review Req: 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. All work authorized by this permit shall conform to the approved application and'the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. M� > -r_--� -. _ Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:` Service: 1.Foundation or Footing 2.Sheathing Inspection - , . Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Pe o 7cFarjing with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Initial Construction Control Document u W To be submitted with the building permit application by a W Registered Design Professional ° for work per the ninth edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title:Cape Cod Orthopedics/ Lower Level Renovations Date: November 7,2019 Property Address: 130 North Street, Hyannis,MA Project: Check(x) one or both as applicable: New construction XX Existing Construction Project description: Interior renovations to lower level including minor walls,mechanicals,Fire protection l P g finishes I, David Vachon, MA Registration Number: #7471 Expiration date: 8/31/2020,-am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning': XX 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 build' onstruction Control Document'. P Enter in the space to the right a"wet" or electronic signature and seal: t F NIA �J V Phone number: (508) 888-6555 x 110 Ema y P rvgroup.com Building Official Use On y Building Official Name: Permit No.: Date: Version 01 01 2018 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): ConSery Group, Inc. Address: 110 State Road City/State/Zip: Sagamore Beach, MA 02562 Phone #: (508) 888-6555 Are you an employer? Check the appropriate box: Type of project(required): 1. ✓ I am a employer with 15 4. 1 am a general contractor and I 6. New construction employees (full and/or part-time).* have hired the sub-contractors 2. 1 am a sole proprietor or partner- listed on the attached sheet. 7. '�/ Remodeling ship and have no employees These sub-contractors have 8_ Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. 1 am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. Roof repairs insurance required.] t c. 152, §1(4),and we have no 13. Other employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Cross Insurance Company/Contenental Casualty Policy#or Self-ins.Lic.#:6014222869 Expiration Date: 7/1/2020 Job Site Address: 130 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 Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby�rttjyderthep and pe alties of perju the information provided above is true and correct. Si at ire: Date: g� Phone#: (508) 888-6555 G •� /'�"t Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes'that apply to your situation and, if necessary, supply sub-contractor(s)name(s), address(es)and,phone number(s)along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships (LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. - City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture ' NOT required t complete this affidavit. (i.e. a dog license or permit to burn leaves etc.) said personis O equ ed o co ple e s a d 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,'tefephone and fax number:, The Commonwealth of.Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 4-24-07 www.mass.gov/dia Commonweatlh of•RAasar�hruseQgs t J Division of ProfessionAl t-iiceimswe Board of Building Regufa6ans aasdf Standards Constructi'bn Supervisor CS-005157 � LKp s:0523v202O ROLAND B CATIGNANI ' 190 CONNERS-ROA0P ` t CENTERVILLE NIA.02SW �(;i��ti:y yea•'-' a Commissioner . s Construction Supervisor Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(617)727-3200 or visit www.mass.gov/dpl 1 I i Town of Barnstable Building Department Services RnRNs?ARM Brian.Florence,CBO Mast �bol i0?9. R�� Building Commissioner EO WU� 200 Main Street,Hyannis,MA.0260.1 www.town.barnstAle.ma.us Office: 508-862-4038 Fax: .508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, a ha X 144 Ais ,as Owner of the subject property herebv authorize C.L w G�:r 7; 1 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. Signa e Owner Signature of Applican. . 1 Print Name Print Name lr' ti e, Date QFORMS:OWNERPERM ISSIONPOOLS Rev:08/16/17 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map . Parcel l �I to Application Health Division .J U �) . Date Issued Conservation Division O _ D Application Fee Planning Dept. Permit Fee 55. 0 6 Date Definitive Plan Approved by Planning Board Historic OKH _ Preservation/ Hyannis Project Street Address tw VL'? m Gf�r, fqpjf QAlt S Village VVIS Address 110 Owner -Eh7ZS L -G '2"t U1� Telephone C7�n�m - 9282 "Cl 1 6--1 Permit Request �-�' Pff SCAC2 �o 11►xl��.. na&twin 11 ul 26Q to Aw Square feet: 1 st floor: existing o osed 2nd floor: existin N ro posed l9' Total Tteer q g_' f p gp p Zoning District 0" Flood Plain Groundwater Overlay Project Valuation U '� Construction Type xa. Lot:Size , L Z A - Grandfathered: ❑Yes ❑ No If yes, attach su orting doum ation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) .mac o -,n Age of Existing Structure Historic House: ❑Yes ❑ No On Old King'ss ighway:0111 YeW❑ No Basement Type: JrFull ❑ Cr wl ❑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: N� Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial Yes ❑ No If yes, site plan review# Current Use Mattyrt., Proposed Use MQ %txaG- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) 57,¢� Cep► Tic Name ,� ( L' ,� Telephone Number 223D 3=-iV Address l 10 G49"`? 205HO W 1�z,��" License# CS -666 1� T ` Aa009t tL9_ NI O 7 Home Improvement Contractor# k10 110 Email M14h0thANI 6QPQ Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE f , FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL " GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' Town of Barnstable . •' PP"oo'-ss�tt,eH'Trd h tL tnCt.,a.>g I'r<:`dF"�i�na l I::nsxp etc t,i:o; kn 3H a`bs,""Been;"�M,sa::de :�<:.t- �p.., of '� ;-,_ st b•:e R�et-t a£in ' t# ;T Building "ro% " MustbQ Kep Sohats, m4676123Ap�r sMu y yBAENSUBSB. M"6& - a63q Permit Where a-.Certificateof Occu,an`c �ssRe ured;such Buildm shall Not be Occupiedunti <a Finai Inspection has been made i ei illy Permit No. B-19-1965 Applicant Name: Approvals Date Issued: 06/12/2019 Current Use: Structure Permit Type: Building-Sign Expiration Date: 12/12/2019 Foundation: Location: 130 NORTH STREET, HYANNIS Map/Lot: 309-212 Zoning District: OM Sheathing: . Owner on Record: BARE BONES LLC � ' Contractor Nam,,' Framing: 1 Address: 130 NORTH STREET Contractor License: 2 Project Cost: $0.00 HYANNIS,MA 02601 Chimney: Description: 4 SQ FT SIGN ON FREESTANDING SIGN FOR CAPE�COD HEALTHCARE P P ermit fee: $50.00 Fee Paid $50.00 Insulation: Project Review Req: i, Final: Date 6/12/2019 Plumbing/Gas 60, b � k Zonin Rough Plumbing: 6 �; g Enforcement Officer Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorizedby this permit is commenced withm ths six mon after issuance. All work authorized by this permit shall conform to the approved application and the.approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall bye in compliance with the local zoning>,by laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. . _ Z � Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the BuildingIand Fire Officials are`:provided on this�permit. Minimum of Five Call Inspections Required for All Construction Work: , .' ; Service: 1.Foundation or Footing r 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed "` & 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: _ 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: r i { Town-of.Barnstable Building Department b Bria'a PMrc'.nc%00 o Binding Commissioner • ,, j $ 200 Maw Street, y#u?nis,MA 02601 '°ram Mpca wwsv tpwn.barhsMb1P nmW D Z Office:508462-4038 i~ar.:508-790-6Z.Q D m W r Sign 1'eft' t APp.[1tation m Zoning District hermit'# HIstoria District M Location by l3 b N a9-T 1A'1 AN►AV-1 Streetaddress grid vl(fage APP licant M'E25 o M AR.Cq�f c�y9�►� . IU�ap &.Paircel 3 Dq �' �' . Telephone Number 508 75�1 �b28 Email 606 C! M1%)COtA—". COM Sign M. Sign-#2 Wall Wall Freestanding 0 Freestanding' 0 Electrified* C3 Electrfed* p Dimenslons Sign #1 oiimdnoiont-S1gn.#2* Square ket Square feet Reface Existing Sign Zr Now4k-eplace Sign 0 Width of Building Face ,ft. X 10. _ X .10= *Lighting Type A wiring ermif is required ' ign.is electriflect f�7 b4o S!#Rtire of er./Authorized Ageht Mailing address 1t EtL NpV�E. _6ay9.14E, Mil PROOF CUSTOMER INFO CONTACT INFO 4/23/2019 VERSION: 1 2 3 4 5 COMPANY: PHONE: CONTACT PERSON: 9.30:37 AM E-Malted Cared NO PROOF STREET: FAX. REQUIRED CITY: STATE: ZIP: EMAIL: ' . ■ • , File Name:130 North_St_Hyannis_roadside_directory.fs Folder Name:\\Hp-backup\BACKUP\FLEXI_FILES\M\MedCom\130 North St-HYANNIS' 13® qq1} " t ' r 84" gyp. .. _ . THIS RENDERING IS INTENDED AS A SAMPLE ONLY.COLOR,TEXTURE,MEASUREMENTS,AND ACTUAL APPEARANCE MAY VARY SLIGHTLY FROM COMPLETED WORK AND IS CONSIDERED NORMAL&USUAL. � �, Irk. ^"f••w Please check layout(artwork,spelling,dimensions)and fax back with signature.Production �` � '� ,��� ,�>�,:, b..+:?"��� I HAVE REVIEWED THE ABOVE SPECIFICATIONS&HEREBY FULLY UNDERSTAND THE cannot begin until written approval is received.Additional charges will be applied for any changes , x p ® 0 p . CONTENT OF WORK TO BE PERFORMED that are needed after approval is received.SIGN'A•RAMA is not responsible for any errors in ° AND APPROVE THIS PROJECT TO BEGIN spelling,layout,or dimensions that have been approved by the customer.This proof is for listed items only.Any changes or deletions by the customer not shown or charged herein will be billed 12 Whites Path Suite 6,South Yarmouth,MA 02664 CUSTOMER APPROVAL SIGNED BY: separately.50%DEPOSIT DUE AT TIME OF ORDER(full amount if under$100),balance due Phone:508-398-9100 Fax:508-398-1760 upon time of installation.I HAVE READ AND AGREE TO ALL TERMS. INITIAL Email: Tama-syarmouth.cn.net PRINT: DATE: www.sig narama-syarmouth.com THIS ORIGINAL DESIGN AND ALL INFORMATION CONTAINED THEREIN IS THE PROPERTY OF SIGN'A•RAMA AND ITS USE IN ANYWAY OTHER THAN AS AUTHORIZED IS EXPRESSLY FORBIDDEN.THIS PROPERTY MAY NOT BE REPRODUCED OR DUPUCATED WITHOUT WRITTEN PERMISSION OF SIGN•A•RAMA OR THROUGH PURCHASE. �. ��'`sSi `" war?. " ✓;\<"� w. � �Y' ✓��'� A? i'll WIT �g ` RT CAPE COD OD 'NOPAEDICS PNYSICAI.ATHERAPY - , ,tf12 .z CAPE& ISLANDS OCCUPATIONALiVEDIDINE ; EVtEItALD :PIS YSICIANS A - --=�- Catalyst Wellness + performance `$ 610 ya3�� wil vr+M,:y�y,�: n,,,:.r wd-t .� 'a'}, „�,�'` ♦\ r,�it d - Town of Barnstable Building Department Brian Florence, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Pre-application for Business Certificate Date Mam-50 Parcel c2 I Applicant Information Michael G.Jones Applicants Name Applicants Address 65 Shady Lane,East Falmouth,MA 02536 Email Address MGJones@CapeCodHealth.org Telephone Number 508-862-5070 Listed ® Unlisted ❑ Business Information New Business? Yes No Business is a registered corporation? ________________________ Yes No If yes Name of Corporation Medical Affiliates of Cape Cod,Inc. Does business operate under the registered corporate name? Yes No *note:this is a non-profi corporation Is the business a sole proprietorship or home occupation? _________ Yes No If yes then a Home Occupation Registration is required—See Building Division Staff Name of Business Medical Affiliates of Cape Cod,Inc.,DBA Cape Cod Healthcare Physicians Business Address 130 North Street,Hyannis MA,02601 Type of Business Physician Practice Building Commissioner Offi a Use Only Conditions t But ing Commisst ner ate, Clerk Office Use Only Any individual, partnership or corporation doing business under a name, other than their own name or incorporated name, must file a Business Certificate. Any individual, partnership or corporation doing business under a name, other than their own name or incorporated name, must file a Business Certificate. The certificate fee is $40.00 and is valid for 4 vears. The Business Certificate form is must be submitted to the Building Division for review and signoff by the Building Commissioner. The form is then submitted to the Town Clerk's Office for processing. Town Clerk Building Commissioner Barnstable Town Hall Town Offices 367 Main St, Hyannis 200 Main St, Hyannis 508.862.4044 508.862.4038 Under the provisions of Chapter 337 of the Acts of 1985 and Chapter 1 10, Section.5 of the Mass. General Laws, business certificates shal I be in effect for foie•years from the date of issue and shall be renewed each four years thereafter. A statement under oath must be filed with the Town Clerk upon discontinuance or withdrawing from such business or partnership. Copies of such certificates shall be available at the address such business is conducted and shall be finrnished upon request during regular business hours to any person who has purchased goods or services from such business. Violations are subject to a fine of not more than three hundred dollars, ($300.00) for each month during which such violation occurs. The issuance of a Business Certificate does not imply that all relevant licenses required to legally operate this business have been obtained or are current. This certificate only records that a business is being conducted. j I Application nu er l.q`,1..1.. . 3 Qa Fee ............... I. . .,.......... KAMBuilding Inspectors Initials............. .ems M +k� 20 i9 /��, APR ®8 Date Issued...................... . 1.:.1......................... TMAIN 0 RARNSfARLE f Map/farce ... (r..J.�4�....................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: /-30.Aldo 14 -54- /y/W Ss'a, C>a_©C f NUMBER STREET VILLAGE Owner's Name: -�&h x, W1 `�� Phone Number( °If Email Address: Cell Phone Number Project cost$ 6,69-40 Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK 13 Siding 0 Windows (no header change)# ❑ Insulation/Weatherization ED -Doors(no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles ���/ Construction Debris will be going too G CONTRACTOR'S INFORMATION Contractor's name I J .rv- Home Improvement Contractors Registration(if applicable)# 13 2/� (attach copy) Construction Supervisor's License# �� �S (attach copy) Email of Contractor d�l-'Ic e- L6)r4 2e.V/>` L'� `� Phone number Jn®� 7 ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY.IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................. + *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have`sides?Yes No " (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one:Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or>Yes No if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections,and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date All permit ap lications are subject to a building official's approval prior to issuance. The Commonwealth of Massachusetts Department of IndustrialAccidents i Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 4-/ v „/, ( 2e Address: IAI S'Z/t ee,7 City/State/Zip: ®S''��y/`� ��J'. e1Wf f' Phone#J ,!5-`(F 7 7 Are you an employer?Check the appropriate box: Type of project(required): 1.S I am a employer with ZL5' 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' # 9. ❑Building addition [No workers' comp.insurance comp.insurance. 10.❑Electrical repairs or additions required.] 5. ❑ We are a corporation and its 3.❑ I am a homeowner doing all work officers have exercised their I L❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees..[No workers' 13.E Other �,vv �pj comp.insurance required.] ter" '�� '� Yq I` *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 1 `S t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. I / Insurance Company Name:f—i f e LY 4y tf/!I/ Policy#or Self-ins.Lic.#: WC S1,f3 ,Fa7eyXY Expiration Date: 1:Y Job Site Address: �,3 /yd� �— _ City/State/Zip:-z6,*&,/'t S O Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of ' Investigations of the DIA for insurance coverage verification. I do here nder the pains and penalties ofperjury that the information provided above is true and correct Signature: C-t * Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street > Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.gov/dia The Commonwealth of Massachusetts Department_of Industrial Accidents 1 Congress Street,Suite 100 Boston,X4 02114-2017 bV,r www.massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. l TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information y 1 Please Print Legibly Name (Business/Organization/Individual): Pam.( C( C Gl 2-f el Cl-- /1 1 S pNS: I in e- Address: City/State/Zip: C�'S 4,e-t/ 0 0 42-1 M/Ir Phone#: �- Are you an employer?Check the appropriate box: Type of project(required)' a employer with employees(full and/orpan-tune).° 7. ❑New construction 2.❑I am sole proprietor or partnership and have no employee_s working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.)t 4.❑ m[a a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑Building addition ensure that all contractors either have workers'compensation insurance or are sole I L[j Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.n I am a general contractor and I have hired the sub-contractors listed on the attached sheet These subcontractors have employees and have workers'comp.insurance.; 13.❑Roof repairs 6,n We are a corporation and its officers have exercised their right of exemption per MGL c. 14 of b� 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees, If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 1 2TY GM V TV A j_.. Policy#or Self-ins.Lic.#:. � G S S— O 6 6 4 Oo2g Expiration Date: g /O 1 Job Site Address: City/State/Zip: /ll/pl s- 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 the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: ;�"S sell CGt Z E' Date: T Phone#' 50c? 7 3 Ofcidl 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): 1:13oard of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person:. Phone#: i F Property Owner Must Complete & Sign This Form P If Using a Roofer 1 Builder: hwintj ci o h i 9� W t 1- 's Mrd , as Owner / Agent of the subject property hereby authorizes Paul J. Cazeault & Sons Roofing Inc. to act on my behalf, in all matters relative to work authorized by this building permit application for: Address of Job 130 Nd✓A n 4 r' • ,4 a i/ Signature of Owner Mailing Address of Owner - -Ih Y-c e 4 7tf /fg ad�Gl I Telephone # 7 -7 f Date Please return this form to.Paul J. Cazeault Roofing along with your signed contract It is needed for us to obtain the building permit required by your town to complete your roofing project fax#508-420-4555 office@cazeault.com a ._.............................._.___...._......_.._.__..._..._.._....._._._._..-- - ----- 1031 Main Stj'Ltei 0 � !' 1lll-� !i? ; ���-;I:,�, _a�. �;1 12(' 'rli.. t.�i!"t�, I I ri�;:;:, 3 a le, l .� :i�i: it... .. ,. t9si1:s`..._� ,; sirs_ Est.i. i, O�;u ut fiOiL:�, 111, ,.:_. F tl { a { Itat � (1 - � � s y� � MON _ {t, �6 9 d 0 �i 441 P _`�d'G'��• �"/C.o'�,✓�t-:��A���ea2�€.'��t-�i'li�����• t�•�•��e,!���.��y.' tat',`r'�, 'i_ll:�. Office of C.,+(1..;,iuUdlCa:1"Mcl° and B d,,ySlt"le:a:7 Fe.egWa:l ("i '1000 Utlas'hJrigzon Street- Suite ?'JC? Bosio.r i, i1f asaachuset s 0211 Home Improvemeil :Can'iyactor Regist abor) Type: Corporation t Registration: 103714 PAUL J. CAZEAUL l &SONS, INC. Expiration: 07/0012020 1031 MAIN STREET OSTERVILLE,MA 02655 Upda4a Addvess and Return Carr. Office of Consumer Affairs&Business Regulation S I'JME immovEivir ENT CON T RI AC T OP RegisPmUon valid for hidividual use only t TYPE;-Corooration toerore the expiration date. If sound return?o: P.egiSi{fl 'h Expiration JS�ice os GorsuM11 _i_airs al�d Business Reguiatioii 1Q3:714s- s._, 07l08/2020 1000 Washington Stree'i-Suite 710 PAUL J_CAZEAIICT Ab Ki I C- Seston,MA 02 08 RUSSELL CAZEAUL7s°_'_; 103 i MAIN STREET, OSTEP.VILLE,MA 02S5ri - - �rJ �'�Ca' lr1s9�tiVE' 9t SE�Yi��S'ire Undersecretary ieaJ"frea in€ A;(800)698-5559 0stervii1e:(508)428-1177 Orleans:(508)255-5569 F-Aroudi:(508)45N 141 Fax:(503)420-4555 MID DD1Y... f --------------- S C E IR- I- CA T E I S I S S L I E-11 A S A, Ivi A T-- F-, cir- ONI!L'i., iu",D C 0 tit FE R'S N!0 R�G ITFS I POt-,! 7 11 :-F fE* t 0 L F E R- 1-�iS T- CERTIFICATE DOES i,!OT AFFjR'!6/-"1.lIVEL`.1 OF, NE`ATWEf Y P h1i E N D, EX-:E 1\1 D OR P',LTER 'THE COVERAGE 6,FF,0RDEE? THE F'OL CIES BELOVul. THIS CERTIFICATE OF iNSUPANCE DOES NOT CONSTITUTE A CONTRACT EIETVVEEN THE iSSUINIG INSURER(S), AUT REPRESENITATWE OR PRODUCER,AND THE CERTIFICATE HOLDER. i---1NTjP0RTA,N1T: if tile certificate holder is all ADDITIONAL INSURED, the policv(ies) must be endorsed.-If SUBROGATIONI IS ViIAIVED, subject to the terms and conditions of the policy,certain policies nlay require all endors'ennert. A statement oil'this certificate does not-confer rights to tile cei'cificat-e holder in lieu of such endorserrent(s). PRODUCER CONTACT NAME: Linda Sullivan DOWLING & O'NJEIL INSURANCE AGENCY (508)775-1620 U FAX AIC-No: E-NIAIL ADDRESS: Isullivan@doins.com 973 IYANNOUGH FDD INSURER(S)AFFORDING COVERAGE I HAIC 4 H YA 1\1 1\1 I S MA 02G01 INSURER A: LM INS CORP___ INSURED INSURER 6: PAUL J C;-,.Z;EAULT& SONS INC PS URER C NOSURIER D 1031 MAIN ST INSURER E RVILLE INSURER F: OS I E1, 11,!iA 02655 -------------- ............... COVERA,GE-S CER FICATE NfUltin-SIER: 334821 REVISION NIUN1713ER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMiED ABOVE FOR T 1-1 E POLICY PERIOD INDICATED- NOT'00THSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUK4ENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSUPANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, N EXCLUSIO AND CONDITIONS OF SUCH POLICIES.1-II,'11ITS SHOWN HAVE BEEN REDUCED BY PAID CI-AIIv!S. INSR ADDLISUB POLICY EFF I P0 -LTR TYPE OF INSURA14CE 1.114sp 1_V'V[l Y N.POLICY ER I(h1,hQDD1YY' 0 I'M11"Licyly,I�-xyPyi LINUTS CCI,fjf,!,ERCIAL GENERAL LIABILITY I EACH OCCURRENCE I S DAMAGE TO RENTED CLAIfdS-KlADE 1-1 OCCUR PREMISES(Ea occurrence rence) Is MED EXP(Any one person) Is N/A PERSONAL&ADV INJURY 1$ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE I$ POLICYF-]JPE'C'T- F—]LOC PRODUCTS-COMP/OP AGG IS OTHER: AU Of4OPILE LIABILITY Ni CON, ED SINGLE LIMIT (Ea accident) I S ANY AUTO BODILY INJURY(Per person) $ ALL OV,IHED F--]SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident.) S HIRED AUTOS l"q0N-OWNED FIFROPERTY DA1%4AGE AUTOS Per accident IS UMBRELLA LIAR I IOCCUR EACH'OCCURRENCE S —1 CLAIMS-MADE N/A Is H EXCESS LIAB I , . �IGGREGATE Fs- I DED I I RETENTION$ 1 1 %A1ORKERS COMPENSATION PER TH- AND EMPLOYERS'LIABILITY YIN STATUTE E OR ANYPP,OPRiETCR/PARTI,IEP,,IEXECUTIVE E� N/A NIA WC531S386670028 08/10/2018 E.L.EACH AC IDENT S 1,000,000 A OFFICER/lAENISER EXCLUDED? (Mandatory in NH) F:I IFOSP A qF P A FfAPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.I.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) kNorkers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This ceitificate of insurance shovvs the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/1wd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE RE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 114 Great Quality General Contracting Inc ACCORDANCE WITH THE POLICY PROVISIONS. 1099 Main Street AUTHORIZED REPRESENTATIVE Marshfield MA 02050 Daniel M.Cro�%1(ey,CPCU,Vice President-Residual Market-VVCRIBMA I 1988-2014 ACORD CORPORATION.I. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1 Map 061 Parcel Application #E— Health Division Date Issued Conservation Division Application Fee Planning Dept.. Permit Fee Date Definitive Plan Approved by Planning Board � � Historic - OKH _ Preservation/ Hyannis Project Street Address /3O NvV77 S"5�_ Scl_r r - r ,Village El Owner � / rW� �s Address 7�r.�/j / a✓d�/ d5 d `'y. �a i►r0 Telephone 3 — B 0 Permit Request ��(n am U W (�VI YU C'�10 vts q tA2 +'e �dr, iLa kz Square feet: 1 st floor: existing p'proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type SZo 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 EWE Ififtisting"Cp new Number of Bedrooms: existing _new AUG Jo au Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) -- Name !Se—an Tele hone-Number`- -7 (Address, le -7 Fo//ot_,L� PC/' rL'icense-M t Home Improvement Contractor# �Emailti ��t-hd ��1Qn �l. royn Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO etsh T_URE ��� ...DATE��II FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: } FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 27w Coanrrtarnveakit of-Massachusetts .� Departwent cr,f rndus-&ia1Acciderrts f}f rce a,f 1mw% gati&=. 600 Washington Street N. , Boston,CIA 02111 ' �4��vX�r naas,�govfitin , Workers' Compensafran Insurance Affidavit:BmldersiCantractursJElecfrkians/Plumbers. Applicant Informatian n Please Print Le Dame lsraatiarral Cr^ a l..S� C�J�ll�►a s s �� t-o rev.even ce LL C CifglStateJip o Pliane',�- 2,D 3— 7 — 1 Are you an employer. Cheekthe appropriate box: Type of project(required).: ❑4. I am a general contractor and I 6. ❑Ides cansiiuctaon I.El I am a employes ufith. ��loyem(full andfor part-time).* have lured the sub-coattacfors 2.LE I am a sole propxietor orpartizer- Listed on the attached Sheet. 7. O'�Zemode�ng ship and have no employees These sub-contractors have g_ ❑Demolition wad;ing far me in,any .capacity employees andhamre workers' [No tv06mrs'camp.fimn•ance comp.Two ranee l 9. ❑Building addition rewired.] 5. ❑ We are a corporation and its 10-❑Electrical repairs or additions 3.❑ I am homeovener doing all work officm lrave exercised their 1L❑Plumbing repairs or additions myself[No workErs'cms. t of exemption per MGL M❑Foofrepaim tanz-ante retFEred p Y c.152,§1(4)6 and we havens employees.[No worimm' 13.❑other comp insurance required-] •gnygTliczntthatcbedcsboxAlnm 21soimoutthesadsaab9awshnhiugtheawodtes'co®peMMrwi1pelieginformao:0n #htameawaeu who submit rtris afddavif=fficatimg they are data.-sal woaic and tben hie outside cantnactorsam s uclL fCantxactors*xrchea this bastmmtzttmliedassdditiaaalshWd-wingthenameofIlesub-cautw ham and state whetherarnatfhaseentitieshave emplcr3ws.If the mffi-<-trzctnrs have mnplayL-as-,ghey must rmid&their warkEMS'tomp.policy numbM I ant an emplq.Yer that is prwiding warkers"compau than irwirancafor ury*entpL y ees 64ow is flee po cy read job s le irtforzaaliarz. Insurance CompanyiEame: Policy#or Self-ins.Lic.#: E�piratibnBate: Job Site.tladress: 1 s a A ©ram Cf t-e=ej 'City/state/zip: /11 Z s -(o Atfach a copy of the workers'compensationpolicy declaration page(showing the policy nu ber and a Thution date). Failure to secure coverage as required under Section 25A of MGL c- 152 can lead to the imposition of criminal penalties of a fim up to$1,50D Oa and for one-yearimplisonment,as well as civil penalties in the form of a STOP WORK ORDER and a i w of up to$25O.00 a day against the violator: Be advised fiat a copy of this statement maybe forwarded to the Office of Imrestigadms of the DJA far insurance coverage v-edfication_ I rfa hereby cgs f},ander tlur pahm wed perza)Yrs Qfperjwy&atti'ze hzforwAfiwiL prin rT,r4ddiahmw is true arsd correct Sitnature_ Date: ZS 1 Phoneik OBEiat use anfy.'Dv itot wrke in this area,to be t: inpLetad by cite ortautn a}orciaL t City or Town: Permit/rAcense# f Issuing_AAffi-orrty(castle one): L Board of 11e9th 2.Ruilffimg Department 3.CS.tpirovm Clerk 4.Electrical fimpeetor 5.Plumbing Inspector 5.Other C'oatact Person: Phone 9: ' laformation and Tastructions I52' all I err fit de woriceas'compensation for belt eoployv s. M�ccar],rrcetfs Ge�e�alLaws chapim' r>;gtures emp oy PSI Puntto this state,an err�Iayee is defined as."_.eveaypersonm the service of anotherumdez any coaixart ofbire, express or»apliut oral or v" , Au errrplay�is defined as"an mdividnaI,parinersTup,assocrafion,c rporatton.or other legal entiy,or any two or Moir,. of the foregoing engaged inaloint ,and inclnding the Iegal represenfatives of a deceased employer,or the receiver or t nstee of an individual,partnership,association or other Iegal entity,employing employees. However fhe owner of a.dwelling house.havingnot more than three apartments aMdwho resides ther"',or the occapant oftie- dwelling house of another who employs persons to do ma>atenan-ce,construction or repair woik on such dwelling house or on the grounds or buRdmg app fh=fo shall not because of such employment be deemedto be an employer." MGL chaptrr 152 §25C(6)also stems tbzt"every sib or local licence agency shall wi$ihold f7ie issuance or renewal of a license or permit to operate a buzshLess or to construct buildings in the commenwealfh for any mcaran ce Coves ere " applic�ntwho has notprodnced acceptable evidences of cumpIrance'�vi:tlx the- g ��- Additionally,MGL chapter 152,§25C(7)staters'Ieifhrs the con:ononwmIth nor iay ofifs political subdivisions shall - - ce. e the insm" meter inib any contract for the perfo�.an ce ofpnbIio work umnl arceplable evidence of comphanc wrth . require7aerts of this chapi--r have been presented to the contracting authority:' Applicants Please fiII oit the Workers'compensation affidavit completely,by chf,-c+ ffie boxes that apply to your situation and,if s nam s address es and one nummber(s) along with their cm tificatr'(s)of necessary,supply sub -for() .e{), ( ) Ph Limited Liability Companies(LLC)or LimitedLiabi-1hyPartaembips.(LLP)V�Iffino elnpIoyf=other than the, members or parfners,are not requited to ca3ry worirers, compensation insurance. If an LLC or L p does have ioyecs,a policy is required. B e advised that this aflffdayif maybe snbmi�d to the Department of In dvsirial emp - . # e of davit The affidavit should Accidents for confrrmaiion of insnrmce coverage_ Also be sure to sign.and dais Jr be,retrrmed to iho city or town.that the application far the pezmit or license is being regnest not the Doparfinent of T T Accidents- Shouldyou have any questions r6gardiag the law or ifyou axe req¢i red to obfam a workers' compe sationpoliey,pInsecallthe,DepadmenEatthennmberlisfadbelow Self instzredeompaniesshouldentnrtheir s elf-;,,snan ce license n=.ber a a the appropriate line- City or Town Officials f - Ple,asebesm-ethat the affidavit is completeandprin:b--dlegrhly. T t-,Deparlmenthasprovidedaspa.ceaf,thebottom of the affidavit for you to fill out in the event tie Office of Investigation has to contact You regarding the applicant Please be,sure to f LI in the pennitllicense number which will be,used as a reference number. In addition,an applicant that must submt Multiple permitucense applications m any given year,need.only submit one affidavit indicates ca=t 0 olicy i ufb=o.ation(if necessary)and under"Job Site Address"tie applicant should v rife-all Iocatiuns in (�Y or e or town ma be rovided to tie ,� ed orma�e�d th Y P awn)_ A copy ofthe�affidavitthathas Bern officiaIIy stamp bY_ �Y applicant as proofthat a valid affidavit is on file far fiatm e peumits or licenses- A new affidavit must be filed oit each year.Whew a home owner or citizen is obtaining a license or permit not related to any business or commercial venime (i.e. a dog license or peumit to bum leaves eta.)said person is NOT required to complete finis 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=a call- The, and fax mmnber: The Deparlmealt's address, ep - - F CUMMOnwealtbE of Ma Mitt l ' Departnenfic&ludusfcialAo iden� - �e 4f Xu�esfig�i�a>� �4� Qn met Fax 9 617`2"-7M Revised¢24--47 � g� TANGU-2 OP ID- OQ ACORD" DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 07/27/2017 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER 508-385-2454 NAMTACT E.J. McGrath Insurance Agency Edward J.McGrath Insurance PHONE 508-385-2454 I FAX 508-385-5991 P.O.Box 1003 (A/C,No,Ext): r INC.No): Dennis,MA 02638 I nDDRESS: E.J.McGrath Insurance Agency ! INSURERS AFFORDING COVERAGE I NAIC# (INSURER A:Citation Insurance Company 40274 INSURED Michel R Tanguay dba MTDrywall INSURERS:The Travelers Insurance Co. 01899 104 Round Cove Foremost Insurance Company E Harwich,MA 0264645 INSURER C: an P Y INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. "LT,SR TYPE OF INSURANCE IADDL"SUB POLICY NUMBER POLICY EFFMM, POLICY EXPrMl f LIMITS C I X I COMMERCIAL GENERAL LIABILITY ( I EACH OCCURRENCE $ 1,000,000 THCLAIMS-MADE I "1 OCCUR SCP030994199 ' 02/22/2017 02122/2018 DAMAGE TO REMISESREoN�TED��)_�$ 300,000 MED EXP(Anv one erson I$ 10,000 P _ I I PERSONAL&ADV INJURY $ 1,000,000 ` 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: j GENERAL AGGREGATE $ POLICY PRO- I I LOC Iif 2,000,000 JECT L 111 ! PRODUCTS $ I I OTHER: i i j A I COMBINED SINGLE LIMIT 11000,000 AUTOMOBILE LIABILITY I acciden $ HANY AUTO ( HG1515 01/1612017 01116/20181 BODILY INJURY Per person) $ OWNED SCHEDULED f C— AUTOS ONLY X AUTOS BODILY INJURY Per accident $ Y I HIRED X NON-, y NED ( PROPERTY DAMAGE It AUTOS ONLY (AUTOS ONLY I Ler accident) $) 1 UMBRELLA LIAR H11 UR OCC I r` I ( I EACH OCCURRENCE I$ EXCESS LIAB CLAIMS-MADE j! ,AGGREGATE $ DIED RETENTION$ B fr WORKERS COMPENSATION ! + PER x I OTH- 1 AND EMPLOYERS'LIABILITY ER—� -- I ANY PROPRIETOR/PARTNER/EXECUTIVE +/N I N/A 7PJUB0466N89517 05/06/2017 05/06/2018 j E.L.EACH ACCIDENT ' $ 500,000 OFFICER/MEMBER EXCLUDED? 1 (Mandatory in NH) I E.L.DISEASE-EA EMPLOYEE!$ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 500,000 � II � DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION CATALYS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Catalyst Wellness 8 Performanc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. Edwsard Geddis, DC 130 North St AUTHORIZED REPRESENTATIVE Hyannis, MA 02601 E.J.McGrath Insurance Agency I - ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD I ,4co v® CERTIFICATE OF LIABILITY INSURANCE F DAM(MM/DDIY M 1 8/7/2017 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 David Crawford Eldredge & Lumpkin Insurance Agency, Inc. PHONE (508)945-0393 ac No:(508)945-4048 697 Main StreetE-MAIL ADDRESS:david@elinsurance.com INSURE S AFFORDING COVERAGE NAIC# Chatham MA 02633 INSURER ANGM Insurance Company 14788 INSURED INSURERB:Travelers Ind. Co of IL-ARWC 13579 Sean Thomas Thibert INSURERC: 197 Follows Road INSURERD: INSURER E: Harwich MA 02645 INSURERF: COVERAGES CERTIFICATE NUMBER:Catalyst Multisport 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 ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER LIMITS S COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE ❑R OCCUR DAMAGE TO RENTED 500,000 PREMISES Ea occurrence $_ MPT0306J 5/12/2017 5/12/2018 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 x POLICY 0 ECT D LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accdent) _ ANY AUTO BODILY INJURY(Per person) $ ALL AUTOS OWNED AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE - AGGREGATE $ DIED I I RETENTION $ WORKERS COMPENSATION P R OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNERIEXECUTNE E.L.EACH ACCIDENT $ 100,000 13 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) 6HUB5B26222517 5/14/2017 5/14/2018 E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500.000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Carpentry Insured has not opted in for Workers Compensation coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Catalyst Multisport THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 130 North St. ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, M& 02601 AUTHORIZED REPRESENTATIVE David Crawford/ELDDCI 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(201401) QUOTE MICHEL E RY T DRY WALL 104 ROUNDD COVE RD. �30 E.HARWICH MA 02645 PHONE&FAX(508)430-7005 PLASTERING CELL PHONE (508)274-5712 HANGING -FINISHING 0 MTDr}nvall@comcast.net METAL STUD FRAMING ACOUSTICAL CEILINGS _ 7/10/17 Customer . . Location # 130 NORTH ST CAPE COD HEALTH CARE TED GEDDIS HYANNIS DESCRIPTION • REMODELING : Sheetrock and tape 3 coats Sand ready for paint Soffit&patch were they remove the walls FRAME: Frame soffit and new wall coming in on left with 3 5/8"metal stud ACOUTICAL CEILING : Install new 15x 16"Grid to match room in the corner In a 18'x 34 section with 704 Cortega tile [Armstrong] $4160.00 LABOR AND MATERIAL TOTAL: 1 $4160.00 Town of Barnstable Regulatory Services "" S�' ' Richard V.Scali,Director �9. � Build ing Division. Panl Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.ns Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, jo� ` D'N1 1 i T- ,as Owner of the subject property hereby authorize - y. ,� t�e-� to act on my behal f in all matters relative to work authorized by this building permit application for. �c7 YUVV4 02,60) � (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 . pections are perfomned and accepted. S' ture of Owner Signature of Applicant 1 Print Name Print Name Date QFORMS:OVNERPERMESIONPOOLS Town of Barnstable` Regulatory Services pUT Richard V.Scali,Director Building Division UxNsresM % Paul Roma,Building Commissioner ass%639. m� 200 Main Street, Hyannis,MA 02601 �� www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: . JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage.an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINMON OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building hermit. (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:\WPFILES\FORMS\building permit forms\EXPRESS.doe 06/20/16 Mass. Corporations, external master page Page 1 of 2 w � Corporations Division Business Entity Summary ID Number: 260697248 Request certificate �Wew search Summary for: BARE BONES, LLC The exact name of the Domestic Limited Liability Company (LLC): BARE BONES, LLC Entity type: Domestic Limited Liability Company (LLC) Identification Number: 260697248 Old ID Number: 000958046 Date of Organization in Massachusetts: 08-10-2007 Last date certain: The location or address where the records'are maintained (A PO box is not a valid location or address): Address: 130 NORTH STREET City or town, State, Zip code, HYANNIS, MA 02601 USA Country: The name and address of the Resident Agent: Name: JOHN WILLIS Address: 130 NORTH ST. City or town, State, Zip code, HYANNIS, MA 02601 USA Country: The name and business address of each Manager: Title Individual name Address MANAGER JAMES BOYLE 130 NORTH STREET HYANNIS, MA 02601 USA MANAGER JOHN WILLIS 130 NORTH ST. HYANNIS, MA 02601 USA MANAGER TIMOTHY KINKEAD 130 NORTH ST. HYANNIS, MA 02601 USA MANAGER IANDREW SMITH 130 NORTH ST. HYANNIS, MA 02601 USA In addition to the manager(s), the name and business address of the person(s) authorized to execute documents to be filed with the Corporations Division: Title Individual name Address http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=260697248&... 8/10/2017 Mass. Corporations, external master page Page 2 of 2 The name and business address of the person(s) authorized to execute, acknowledge, deliver, and record any recordable instrument purporting to affect an interest in real property: Title Individual name Address REAL PROPERTY TIMOTHY KINKEAD 130 NORTH ST. HYANNIS, MA 02601 USA REAL PROPERTY ANDREW SMITH 130 NORTH ST. HYANNIS, MA 02601 USA REAL PROPERTY JOHN WILLIS 130 NORTH ST. HYANNIS, MA 02601 USA REAL PROPERTY JAMES BOYLE 130 NORTH STREET HYANNIS, MA 02601 USA ❑ El Confidential ❑Merger ❑ Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Annual n Report < Annual Report - Professional Articles of Entity Conversion Certificate of Amendment View filings Comments or notes associated with this business entity: New search http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=260697248&... 8/10/2017 Paced 40'•11 5/6" 34'_4" b'•T 516" 1'•8 3116' G'•61/2" 6'•8" 11'.4" GON5ULTATION PHONE Roots ROOM OFFICE BATH Common 6'•5"x 6'-r 6'-7"x 6'-1" 11'-3"x 6'-1" 6'-3"x T-5� Bath _ a.a vs"-� OFFICE - HALL m 6'-?•x�'-5" 30'-T'x 6•_2" " / '" Main Lobby Area 71 +I RECEPTION OFFICE CONFERENCE ROOM EXAM OFFICE OFFICE 10'-2"x l'•11" ROOM 1'-11"x T-10" 1'-11"x T-10" 9'-1" 8'0" 8'•0 1/8" 15'•1318' i Office AREA 1011 54 R New Interior Partition:Steel Studs W o.c. Fiberglass sound batts. 5/0 type-A*sheetrock Proposed Floor Plan, Employee Health Care Gape God Health Care / Employee Health Date: 5-2-2001 Home Improvement Specialists of Gape God Inc. 150 North St. 5cale : None 25 lyanough Rd, Hyannis, Ma. 02601 Hyannis, Ma. 02601 3� 1 77 - - it's cs I /30 1110 r4h IrrA 6 , LO s I le A3 - `1 30 S a ce G- r ,fie✓ e po✓rs� on"!�� ,r2u1oA1, MY/ hoard G! Jaanaarrjs License: CS-100782 Construction Supervisor ` SEAN T THIBERT r 184 JOHN JOSEPH RD HARWICH MA 02645 (�•�.� l� Expiration: �( Commissioner 08/29/2018 ' ��r`r`a�n.arai�rara/l/r,'C'!llir.l;rir�u.Jef, ' �'� '1�?' �qq`Cttatst►mor.��k.Airs•nn�t�,e1�ps�r¢s�/ u�lttt�ba ���, �J 7a�•�:liia'���c$�s,/!b�Y�"`,'�,r;aT��ci ��i��,t�trcaro =�165�� �',goe• i'Hlf R T'H0M JMPR0.V iViS �F�N AFT � �,��•-. ,u:.. f•TN� '�'7'4;f'�fiiti�� =-� ri \ •I i I i i h RCDLI 4L;ICU W. Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of i enclosed space. 1 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this licensc. • DIPS Licensing information visit: VWVW.MASS.GOV/DPS 1 \ i11 I • � I I i NERAL NOTES A gg- g a is smwxs Rna wwa mE mAroaalA Nsx Res,. : gwm,m»x m>, mE,Nsw a �Emi - mmmm..,..,�,,..... _ � `< # j' '.BARTER NYE N awuaoN��A mmosawa Q. R.Nmm9A�as„�„ A � ENGINEERING& m a rm PIIE1.r�(5�• wu 9�MA bIIR N1F'� 9Q M1YS IW MfM AS�OINMK(L G1aAPOUAa dN.Pm mo7nl Uo9Anm mRawnw.uMQMO �M[9am MMMAaWE4li. � y - -p .� tq a saeamRawmsvar Affmwmms .mmNME.N.Ea �_ Na.PmPESAff° NammwPw. t „ SURVEYING No mr ff Nms nE esm moss aAw im�mnam�v m¢w r ra is s.v a�N RaaNmommna msmMta� mnueu P A3' Baum imuw+m T �' `' �stuee Pro/enbwl Enginecs d mrnn NNaEe mm ms�meaeE ovE-..la an. N�Em wAAwmrt �mimn w.x rm s rnm a wcs ra aAm mua smw _ I S ,• a L. surveyors 1 amer mANYK b mim m wB as '' M Rrt0 RUE ww maa Nor mmm wa maem ETP¢R NAI6 A Nq� ..L z mt=pwsmml �i.®obmsixomm�r ooam ieK.mnawa 3 ''� °w 78 NorthAIT Slrcat-7rd Floor Am .. m.C.famaRA mailmen'wums 6 M'd v�Y�N¢x>K Naiwaurs � Nw(Nmm NiNNa a RNm4 M orlon a,a®1Hv omit wr E lea�w[ �.d � � �� NlI,mis.Naamdwmth 02801 x mec mis.Y m Ar,rmunma�l A} a ma ID m A�sen s�rn vwi nw rm wn[a rmreD mum �.� 5 �.f4 PI-.,-(508)771-7502 ,wd',r•, �,,r�.erm g�p1s - mcw W a eolw o sarz AwAcn>a a aa«rWEe emAex s��¢m BuvAis m[wn�a.m sys i ma4.'xvxr mn:o¢w Im A £� 4 w Fm (5W)771-7822 mwr om-aY a•mw IV Locus- as RAm Rammnw mI AEew.0 ao ew+w lmnx fF Scale: -.. 00 m.baYlM-nYAmm %t, .4.Aems.ms.»ammmmm A.srmas anmr Locus Map Scale:l"=2000' POes Dams iaE tans.araenx Rs Ne-Nl ormE ewmes m rm .u v STA.1 umoop m�a wm��a � aam uAs srr nta s orP mN A.wa eAp mme \� 6 t g1 /_ a. ;.. s e2o[or w A�' _ �� _ I •. PARCEL 309-212 ` 95.8583 SF —, �\ cousuirwar P a E—REO FOR: Bare Bones,LLC ` _` } 1'..;1•. \ 1 '� I I 130 North Street Hyannis,MA 02601 ,R /, '�:��/ s� s�' 1 •: i 1 mm w�a,=air � I � � 1 T I "s • o _ � m _._ 1 _ o _ Z w.• �2 S ` m \� .......... O 55A.ta 1 w t:.w m' EET �s ' 5 � „q auk• �( —mom a'., �5 ---�--� - • - SHEET TITLE NCpTN s>e�" —5 �--� � Existing Conditions Plan � _ TSHEET Na —w � —s —s \ / C1.0 �s 1 s �s �— , - DALE:MAY 5.MI5 g —`S —s 1 `` l oA zo o M 10 SCALE:' 111 \ sr.icm FEET s EIT ZONING TABLE NOTES SIGN SUWAARY BAXTER NYE W; 1.ALL LONSIRUCfTON SHALL BE PERFORMED IN ACCORDANCE NTIH-SS.TOWN ORDIEANCEL 8.DSTS.PAVNC EDGES SMALL BE SAWCVf TO CREATE.CLEW EDGE WHERE IT 6 TO BE .UT.CO. SPEOMGTION TEXT, WAN ENGINEERING& 'P�'":r REOMREMENTS,AN.SPEGi1GMN5. RED INTO NEW PRANG,OR W ASPHALT 6 REMOVED ADJACEHi HERE REM TO ASPHALT WHICH IS TO N BER MOM H T GRAPHIC AUAI Pe,ea s z,a Ac RENALN,BROKEN OR UNSTABLE PAVEMENT SHALL BE REMOVED AND SUBBASE REPINED WITH 3.THE COHIRALTOR SHALL CONTACT THE ENGNEETI TO SCHEDULE A PRE-CONSTRUCIION MEETING SURIBIE COMPACTED LINEWAL PER PAVEMEM SECRON DETAIL HERBAL. ANY SAWCUT ONES RI-I 2e 2A• I SURVEYING �+ �By s AT LEh4T TWO(2)BEe6 PRIOR TO Cg ENGNG COAST SOH SHOYN ON THE—ARE APPROX—ONLY. THE EXALT EDGE OF SAWOT SHALL BE -% EEIERMMED BY THE COHDACfOR IN THE TELO TO PROPERLY BLEND TO THE SURROUNDING >m rt O.THE CONIRALTGt SHALL YAIQ Su8MnTALS TO THE ENGINIM FOR ADPROVAL BEFORE ANY GRADES. PROPOSED ASPHALT SHALL BE PROPERLY BLYTEU AND BLENDED TO SUPoiOUNONG Re9Mlercd Prof sioH l NOT B ETgh— FABRICATION OR DELVEAY OF PROOGIS OR MAIfRIALS AS 1 WHICH 6 TO RETA01. THE BLENDED TANSDION BETWEEN DROWSED AHD EX6TIHG HE, 13• IB• PCLO and Land SuMps ,aulRnaWn2 s�7 w n ASPHALT SHALL BE MITI AN MPN._I GRADE UNISS CTQR'M¢TEEMRFlEO. THE �� AROT eAPNO I.PROPOSED PAVekNf SHALL BE INSTALLED AS fOLLDNS: JOINT STALL E ABRUPT. vAIWxc e YAA MDz J slum a a n rµ NT m wbve ro� ODGS AND SIPoPBIG MALL FOLLOW MIITOO STANDARDS. TYPICAL UNE a 78 NorthSbeet, 1d Flom ♦�`y. Sf D,M DUTY PAVEMENT SHOWN AS 7.ALL PAVEMENT MARK O YIIOIH FOR LANE ANDINC STALL STRIPING SHALL BE A INCHES UNLESS VE SE NOTED. WMAi3 Noactluxlb 02601 t IS/xo s- 5.ALL PROPOSED WALKWAYS WILL BE HAImICAPPED ACCESSIBLE ALL PROPOSED RUNNNG PARGNG STALL COLOR SHALL BE WHUTL TYPICAL.UNLESS OTHERWISE NO Phmb-(508)771-75D2 APES ON NAl1fWAK SHALL BE LESS THAN 5i AND ALL CROSS SILPFS<- THESE BOARD.AM THE U.S. W 8Y OMN t ARE B.SITE Y SLOPES WIM NO TOLERANCE ALL WORK WILL BE IN AOWROYGE—THE E LIGHTINGLIGHTINGSEE- E]fIERKKt GHTINO PVN 6BE IED 1-18-tB FDit UGHfINO c F.- ($08)771-7821 GUPRENT IXWEA¢TTS OF ACCESAM_WTITI__ESINF ACf G SPEGFKAImNS Alm PHOTOMETRIC ORMATION. • m,00AleT-r L_ C04MONWFALTH OF MASSALHUSEnS.ARC E",HVI ACCESS BOND. Aw eWAWs .®swTa ELucW - NEv�.( roN� Wan.«NacA AAANND ANv FARAD YNt vcRYAT ( o ( CONSULTANT 1 � � .. Bt.6583 SF __.. y LrAaa,o F,ma,weli W.AmH _ PARCEL 0E10 2i2 Ave .R. .ma.t .;a '• J': 1 '' '. .'C PREP D F +1 Bare Bones.LLC 130 North Street Hyannis,M 02601 - AV A (0, \ 1 �. ..... li I ,x 1 tl _ .... a s off, c YVz am Ate, I 1 1 - •i Meol m �� YO� ; °� NMARWc tv�b�6�;� PAWNN AuTo. I I E,m 6 mPT MET.R o-, i vAK � 1 l u,uoae vAWYdT 4 - - - Qa, x� BIA )PER m.a 1 �.,D�MWBM�MAN I '' I PROPnWD,r d``+• ;, � ; a aP,puTm, ... 14 .�. A �� .'L I':. 'vvxo,ocTwe. Mm�EwWWTR , �v a NEAD.NR _.� y Wm YTsa¢wm og NATw mwl�Dl � EET .. MEET TITLE H+Jz WIIMOWW c i••i . o Parking Expansion Pla pyDRTN S7R - SHEET N o P In Esi aETAA o-,W ,,.::.. 1 .., elMNm ;• _. g 5 V GATE:MAY 5,3016 30 0 30 AO , , SCALE E 6 AS ME Town of Barnstable KAM BARNSTABI,E Regulatory Services 059. Richard V. Scali, Director i639-701a Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 May 10, 2016 Bare Bones, LLC c/o Mr. Matthew Eddy, P.E. Baxter Nye Engineering& Surveying 78 North Street, 3`d Floor Hyannis, MA 02601 RE: Site Plan Review 015-16 Bare Bones, LLC 130 North Street, Hyannis Map 309, Parcel 212 Proposal: Minor modifications to the parking facility at 130 North Street,Hyannis adding 14 spaces, 2 leach pits and relocation of 3 light pole bases and installation of new LED lighting. Dear Mr. Eddy: Please be advised that the above proposal has received an administrative approval subject to the following: •. -Approval is based upon, and must be substantially constructed in accordance with plans entitled: 130 North Street, Hyannis, MA"prepared for Bare Bones, LLC by Baxter Nye Engineering& Surveying, Hyannis, 3 Sheets, Scale 1"=20', dated May 5, 2016; and, "130 North Street, Hyannis, MA,Exterior Lighting", dated April 22, 2016. ❖ Applicant must obtain all other applicable permits, licenses and approvals required. f r-7 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 (Zoning Section 240-105 (G). _This-document shall be_submitted prior to_the issuance of_the.fmal_certificate of_occupancy..____.__. A copy of the approved site plan will be retained on file. Sincerely, Ellen M. Swiniarski Site Plan Review Coordinator CC: Tom Perry, Building Commissioner Page 1 of 1 Shea, Sally From: Dean Melanson [dmelanson@hyannisfire.org] Sent: Thursday, August 18, 2011 4:42 PM To: Shea, Sally Subject: Re: RE: 130 North Street. Auto-reply; Lam out of the office but am monitoring my e-mail off-site. On Jun 28, 2011, at 1:13 PM, "Shea, Sally" <Sally.Shea@town.bamstable.ma.us>wrote: thanks! -----Original Message----- From: Dean Melanson [mailto:dmelanson@hyannisfire.org] Sent: Tuesday, June 28, 2011 12:05 PM To: Shea, Sally Cc: John Cosmo Subject: 130 North Street. Hi Sally, hyFD is OK with the issuing a building permit for wall alterations at this location. Sprinklers may need to be moved and we are working on this with the contractor. Deputy Chief Dean L.Melanson Office 508-775-1300 Fax 508-778-6448 dmelanson(a_),hyannisfire.org 8/19/2011 r--� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �l Parcel (�� ` tIE Application Health Division s Q Date Issued Conservation Division Application Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address 13C) �o� ZS�QA Village 4`4 c\n�l [ Owner ')cce- (2e�5 U- Address 1`� N 't ��' , RNa(v)0 Telephone &!2 1 7 7 Permit Request - (b cSfhGA U -if�!'� Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation`s Construction Type Lot Size 2 • Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family .❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes CM4Io On Old King's Highway: ❑Yes 0lqo, 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 0 new size —Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No --- If yes,-site plan review__#_ Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name CAA> QqZ o� Telephone Number �� l Address 0"l�n c��rec.�` License # CZS - �� 6 ©c5'e-i(U 14k ., PIA c��SS_ Home Improvement Contractor# LP3 7 I y Worker's Compensation # 9 7 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO f^Q Volr 0-100�_n LCAO& G Ii SIGNATURE DATE 6 k S f FOR OFFICIAL USE ONLY z APPLICATION# N Z 3 DATE ISSUED a IMAP/PARCEL_NO., ADDRESS VILLAGE ` � v OWNER 1 'r DATE OF INSPECTION: FOUNDATION', FRAME INSULATION FIREPLACE k� k ELECTRICAL: ROUGH FINAL l PLUMBING: ROUGH FINAL f :T GAS" l<, - ROUGH a u: rt; : FINAL :`. .FINAL BUILDING r Z , .DAT,.E CLOSED OUT ASSOCIATION PLAN NO: c* Sop-09-11 09:57am From- T-502 P.001/037 F-160 CERT AT . IS CERTIFICATE I RIGHTS UPON THE S ISSUEQ AS A MATTER OF lA1FORMATIO� ?�AND��L R� �COVERAGE FORDED- i`RTIFICATE MOLDER_THIS CERTIFICATE DOES NOT AMEND, B i HE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN E ISSUING INSURERS ,AUTHORIZED'11, REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOIDEN, PORTANT: If the Certificate holder is an ADDITIONAL INSURED,the policy(ies)nlusf be endomed. 1f SUBROGATIQN i WAIVED,subject to the terms and conditions of the policy,_certain policies may require and ertdorsernent A statement this certificate does nofi confer ri hts to tite certificate holder in lieu of such endorsement PRODUCER awling&O Neil Insurance 73 lyannau9h Rd v yannis,MA 02601 C4I�PANIES AI°FOPI®11MG INSURANCE COMPANY A GRANITE STATE INSURANCE COMPANY INSURED ^ aul J Cazeault&Sons Roofing Inc 031 Main St sterville,MA 0265.5 COVERAGES. . f HIS IS TO CERTIFY THAT7HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR I HE POLICY PE.R10D INDICATED,NOT WITHSTANDING ANY REQUIREDR ENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER CUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED THE OLICIES DESCRIBED HEREIN is SUBJEGTTO ALL THE TES.EXCLUSIONS AND CONDr[10NS OF SUCH i POLICIES.LIMfTS SHOINId M HAVE BEEN REDUCED BY PAID CLAIMS. _ .A-17 TYPE OF INSURANCE POLICY Nuh48 POLUCY 1-rFEC7IVE DATE PouCY EXPm A-nQm DAT . aA NVOR]E.45 COMPENSATION • � � UMITS iFN_rC51'111CC-R13E_o!_Ps `MPtoYe�S LtA81LrTY 1 9947705 9110/2011 S/-1d12012R�r LwuTsCL❑ arvgc AppIlas m MA ODK;F�cneEACH ACCIDEh7 500,00 EASE POLrcr LLMrr S ISiASE•cACH EMPL NEE , DESCRIPTION OF pPe�RATIONSNEfI1CL>:SJSPEgAL ITEM CERTIFICATE HOLDER ANCELLATION SHOULD ANY OF THEA6oVE D-SUKQED FOUCIES BE CANCELLED BEFORE r�E EXPIRATION DATE THEREOF,NOYIC-WILL BE DEINERED IN ACCORDANCE - W WET`iE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE The Commonwealth of Massachusetts Page 10 of 10 Department of Industrial Accidents Office of Investigations I tr 600 Washington Street i •tiiii i Boston,MA 02111 �- www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Anylicant Information Please Print Legibly Name(Business/Organization/individual): e. careao 19 S ns rS;hc Address: t6-,7 ( City/State/Zip:cr�,4f1'V t t(e MA. c) Phone#: -�" It 77 Are yyoy an employer?Check the appropriate box: Type of project(required): 1.L7 I am a employer with [0 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.$ y Remodeling ship and have no employees, These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I LEI Plumbing repairs or additions myself.[No workers'comp, c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. c Insurance Company Name: �O Policy#or Self-ins.Lic.#: 9 f) Expiration Date: (a l2, Job Site Address: 13c;> NC>Ftl\ City/State/Zip: <TT 1�, MA 0-.)-601 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a f fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of I Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Sip-nature: IIFCJuD� Date: Phone#: 17 7 Of 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#: W Off ce cf consumer Affairs and usiness Regulation 10 Park Plaza - Suite 5 170 NOK/ Boston, Vlassac isetts 02116 Home Lrnp�rovement tractor Registration Registration: 103714 �— Type' Private Corporaaon —�-- - - Expiration: 7l9/2012 Tr# 297676 PAUL J. CAZEAU-LT & SONS, INC.: � — Paul Cazeault 1031 MAIN ST OSTERVILLE, MA 02658 = ; s and return card.Mark reason for change. Update Addres Address 7 Renewal Employment Lost Card 3-CA1 v 50M-04104-G101216 _ �fze �acvnzaruuea`�i a�✓l/`Q°d� �d License or registration valid for individul use only \ Office of Con5UMCr Affairs&Business Regulation � before the expiration date_ If found return to: HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation = _ � Registration: j-K(33714 Type: _ � �c 10 Park Plaza-Suite 5170 _ Expiration -74M19 12 Private Corporation. Boston,11'LA.02116 PAUL J.CAZEAU-T=99`� - ` Paul Cazeault - � 1031 MAIN ST OSTERVILLE MA 07f5B_ .:=' Not valid without squa re —� Undersecretary z _ Massachusetts - Department of Public Safety i *--Y Board of Building Regulations and Standards Construction:Supen'isur i License: CS-026325 PAUL J CAZEA&T i j 1031 MAIN ST OSTERVII I3E MA 02655 rV - Expiration Commissioner 1 012 0/2 0 1 3 Paul J.Cazeault&Sons Inc. Web Site:www.cazeault.com 1031 Main St. Email:office@cazeault.com Osterville,MA 02655 V; _: . Office(508)428-1177 � . Fax(508)420-4555 BILL TO DATE ESTIMATE NO. Bare Bones LLC 3/16/2012 8373 Attention Linda Chamberlain 130 North Street Hyannis,MA 02601 Estimated by: FLAT .Email Address i Description of work to be performed Total End section of building Approx 20'x 100' Remove top layer of rubber roofing. Install V polyiso insulation over existing insulation Install.060 Carlisle sure-seal or RPI rubber membrane,fully adhered. Flash all curbs,pipes,posts and other penetrations in accordance with manufactures specifications. Install.032 aluminum flashing on perimeter edges. All roofing related rubbish to be removed from premise. Workmanship to be guaranteed for five years. i COST 13,000.00 Repair cost will be waived if proposal is accepted within 30 days. } 1/3 due with signed contract,1/3 due when job is half done, 1/3 due upon completion Total $13,000.00 Customer Signature A4 The above prices,speacations,and conditions are satisfactory and hereby accepted.You are authorized to do the work as specified.Payment to be made as Date of Acceptance / outlined above. 4 i In addition to the above,if Customer fails to make payment set forth above,then Customer agrees to pay Paul J.Cazeault&Sons Inc.,all reasonable costs and fef (including but not limited to Attorney's fees)incurred in collecting payment from Customer, s i —Jun. 14. 2012_ 8: 23AM—CAPECOD ORTHOPEDICS 508 775 8280 No, 3091 P. 1 property owner Must Complete & Sign This Form if lasing a Roofer 1 Builder. 1 I-S as Owner / Agent of the subject property hereby authorizes Paul J. Cazeault & Sons Roofinq Inc, to act on my behalf,'in all matters relative to work authorized by this building permit application for: Address of Job Signature of Owner / :'�✓t) Mailing Address of Owner C V -- W D a�� �'Pt*-f)(01-:e Telephone# D "' Date (Please return this form to Cazeault roofing along with your signed contract; It is needed for us to obtain the building permit required by your town, to complete your roofing project,thank you)fax#508-420-4555 4� • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued Conservation Division Application Fee V / a Planning Dept. Permit Fee �- `t v Date Definitive Plan Approved by Planning Board L-�-� 4. Historic - OKH _ Preservation/ Hyannis rL-- v4 v Project Street Address Village , v t Owner - ;d Address Telephone Permit Request e R Square feet: 1 st floor: existingiroposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation$/ 1, COO 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 2 y Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal! tove: 0 Yes No Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑ eitrng ❑ nev sib_ • Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ rn Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number col ��C� Address t � � JZ . A__ License #"I some Improvement Contractor# c� T� / Worker's Compensation # 7&WEGFX3�Sa ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR - DATE 1 FOR,,OFFICIAL USE ONLY APPLICATION# DATE ISSUED ' r t MAP/PARCEL NO. ¢ , ; ; - 1 , ...• r i III t ADDRESS _ VILLAGE OWNER J � � t DATE OF INSPECTION: r FOUNDATION r } FRAME p�►1 �sale. INSULATION : .E FIREPLACE t` ELECTRICAL: ROUGH FINAL F� iL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts l Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 c www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers Npplicant Information PIease Print LegaiblY �TaMe (Business/Organization/Individual): Address: City/State/Zip: (p Phone #: Ar you an employer? Check the appropriate box: Type of project(required): l. I am a employer with 4. ❑ I am a general contractor and I 6. ❑ ew construction employees(full and/or part-time).* have hired the sub-contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet $ emodeling ship and have no employees These sub-contractors have S. Demolition working for.me in any capacity, workers' comp, insurance. 9. ❑ Building addition [No workers' comp, insurance 5. ❑ We are a corporation and its .] officers have exercised their 10.0 Electrical repairs or additions required 3, ❑ 1 am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affiidavitindieating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lConttractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins. Lie, #: 76 ak .3,5aExpiration Date: /0 Job Site Address: ,0:1 City/State/Zip: op�tD� Attach a copy of the workers' compensation policy declaration page(showing the policy num r and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,560.00 and/or one-year imprisonment,as.well as civil penalties in the form of STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: , Date: T Phone#: �"' Official use only. Do not write in this area, to be completed by city or town official City or Town: Perrhit/License# Issuing Authority(circle one): I. Board of Health Z: Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other . Jun ZO 2011 11:38:30 EDT FROM: FZM/78878511364 MSG# 8983Z121-887-1 PAGE 883 OF 883 GCM ACOR CERTIFICATE OF LIABILITY INSURANCE R054 06-20ATE /D20111 THIS CERTIFICATEIS 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 ADDITIONALINSURED,the policy(ies) must be endorsed, If SUBROGATIONIS 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 , PROUCIGER EXINIACI PAYCHEX INSURANCE AGENCY INC PHONE FAX 210705 P- O - F: (888) 443-6112 AIc No E,rt: (AIC,No): (888)443-6112 PO BOX 33015 ADDRESS: SAN ANTONI O TX 78265 CUSTOMER ID s: INSURER(S)AFFORDING COVERAGE NAIC a 011SURED INSURER A : Hartford Ins Co of the Midwest COMMERCIAL BUILDING SERVICES INC INSURER B: 60 ROBB INS RD APT 6 INSURER C: PLYMOUTH MA 02360 INSURER D INSURER E INSURER F; COVERAGES CERTIFICATE NUMBER; REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTA TYPE OF NVSURANCE NVSR WVD POLICY NUMBER fmm/DD/VYYVJ WMIDD/VYYYJ LIMITS GENERAL UA&VrY EACH OCCURRENCE e COMMERCIAL GENERAL LIABILITY PREMISES (Ea Daaurren°e) s CLAIMS-MADE D OCCUR MED EXP(Any one pereon) e PERSONAL&ADV INJURY e GENERAL AGGREGATE a GENIL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG A-...: POLICY JECT L7 LOC AUTOMOeNt LIAeNJTY COMBINED S N'GLE LIMIT ` ANY AUTO IEB acddenS)rq,� ,�;, BODILY INJUft"IPerpereon) IS ALL OWNED AUTOS J BODILY INJURY IPer eccldeni) �. SCHEDULED AUTOS - PROPERTY DAMAGE HIRED AUTOS (Per ecddem) NON-OWNED AUTOS -"q 'e LpY18RELLA LIAB OCCUR EACH OCCURRENCE rri GlCESSLIAA HCLAIMS-MADE AGGREGATE e DEDUCTIBLE s RETENTION s s WORMERS COMPFASA r/ON X WCSTATU- I OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN H/A E.L.EACH ACCIDENT e 1, 000, 000 A OFFICERIM EMBER EXCLUDED? (Mandawyi"1f) 76 WEG FX3529 10/15/201010/15/2011 E.L.DISEASE -EA EMPLOYEE 41, 000 , 000 It DESCRIPTION OFder OPERATIONS WDw E.L.DISEASE-POLICY LIMIT e 1,.000 , 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES IAttaoh ACORD 101,Add/donal Ramadra Schedule,N'monr rpaoa H mqu"d/ Those usual to the InE;ured ' E; Operations . Re : Application # 201103211 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE The Town of, 8arnstable DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, 200 MAIN S T AUrHDR2lD REPRIPSENTATIVE HYANN I S, MA 02 601 7;z'r 01 9 988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD Commercial Building Services, Inc. 60 Robbins Rd. Unit#6 Plymouth MA 02360 (781)585-8666 To:Town of Barnstable Regulatory Services 200 Main Street Hyannis, MA 02601 Attention:Tom Perry, Building Commissioner Dear Tom, Please be advised that David Tanner is employed by Commercial Building Services, Inc.and is authorized to obtain building permits and supervise constructions. Any questions please feel free to contact me at the above telephone number or email me at combuildinc@yahoo.com Si c rely, Edward MacDonald C.B.S. Inc. i Jun 1111 1U:31a Edward 0Uu-14t-tt0u p.z rd,�y 'Town of Barnstable Regulatory Services a r Them s F.Geller,Director Buildincr Division Tam Pm7- , Buildiag Cormub sioaer 200 Main Street,Hy3nais,MA 02601 wWW Eown.barnstabismz.ns Office: 508-962-4038 Fes: 509-790 5230 Property Crier Must Complete and Sign This Section If Usin..a A Builder L jqj!dfWd j ,�6)1- J , as Owner of the subjecr,property ire by authorize to acr on rap'behalf, in all rnattEn .relative to word authorized by this bddiag perm application for:. 14alylli&? lolq- oz�41 (Address of job) Sia-naram of Owne= I a DaLd_ M/ Prim Name If Property wrieris applying for permit please complete.the Homeowners License Exemption Form on 'the reverse side. Massachusetts Department of Environmental Protection Bureau of Waste Prevention . Air Quality 100128619 {� BP AQ 06 Decal Number 1 Notification Prior to Construction or Demolition Important: A. Applicability When filling out pp `7 forms on the computer,use only the tab key A Construction or Demolition operation of an industrial,commercial, or institutional building, or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection III cursor-do not use the return (DEP), Bureau of Waste Prevention-Air Quality Control Regulations 310 CMR 7.09. Notification of key. Construction or Demolition operations is required under 310 CMR 7.09(2)ten (10)days prior to any work being performed.The following information is required pursuant to 310 CMR 7.09. B. General Project Description 1. a. Is this facility fee exempt-city,town, district, municipal housing authority, owner-occupied Instructions residence of four units or less?❑Yes ❑✓ No 1.All sections of b. Provide blanket decal number if applicable: Blanket Decal Number this form must be completed in order to comply with the 2. Facility Information: Department of. CAPE COD ORTHOPAEDICS Environmental Protection a.Name notification 1130 NORTH STREET requirements of b.Address 310 CMR 7.09 H annis MA 02601 c.Citvrrown d.State e.Zip Code (508)775-8282 f.Tele hone Number area code and extension .Email Address(optional) 7,775 1 h.Size of Facility in Square Feet i.Number of Floors j. Was the facility built prior to 1980? ❑✓ Yes ❑ No k. Describe the current or prior use of the facility: DOCTORS OFFICE I. Is the facility a residential facility? ❑ Yes ❑✓ No ®0 m. If yes, how many units? Number of units ®0 3. Facility Owner: ®N DR. MICHAEL MURPHY ®0 a.Name 10 130 NORTH STREET �o b.Address HYANNIS MA 02601 -� ®co c.C /Town d.State e.Zip Code 0 (508)775-8282 ®_ f.Tele hone Number area code and extension .E-mail Address(optional a LINDA CHAMBERLAIN ®Q h.Onsite Manager Name 13 ag06.doc•10/02 BWP AQ 06-Page 1 of 3 Massachusetts Department of Environmental Protection ` Bureau of Waste Prevention • Air Quality 100128619 BWP 06 Decal Number t AQ Notification Prior to Construction or Demolition General Statement: If B. General Project Description cont. asbestos is found during a 4. General Contractor: Construction or Demolition ICOMMERCIAL BUILDING SERVICES, INC operation,all responsible parties a.Name must comply with 160 ROBBINS RD UNIT#6 310 CMR 7.00, b.Address and Chapter PLYMOUTH MA 02360 Chapterer 21 E of the General Laws of c.Citv/Town d.State e.Zip Code the Commonwealth. (781)585-8666 combuildinc@yahoo.com This would include, f.Tele hone Number area code and extension .E-mail Address o tional but would not be limited to,filing an JEDWARD MACDONALD asbestos removal h.On-site Manager Name notification with the Department and/or a notice of release/threat of C. General Construction or Demolition Description release of a hazardous substance to the 1. Construction or demolition contractor: Department,if applicable. ICOMMERCIAL BUILDING SERVICES,INC. a.Name 60 ROBBINS RD. UNIT#6 b.Address _ PLYMOUTH MA 102360 c.Ci /Town d.State e.Zip Code (781)585-8666 combuildinc@yahoo.com f.Telephone Number(area code and extension) g.E-mail Address(optional) EDWARD MACDONALD h.On-site Manager Name 2. On-Site Supervisor: EDWARD MACDONALD On-Site Supervisor Name 3. Is the entire facility to be demolished? ® Yes ✓® No 00 4. Describe the area(s)to be demolished: ®0 100 LINEAL FEET OF INTERIOR PARTITION WALLS ®N ®0 10 5. If this is a construction project, describe the building(s)or addition(s)to be constructed: CONSTRUCT 100 FEET OF INTERIOR PARTITION WALLS ®o ®mod ® ag06.doc-10/02 BWP AQ 06•Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Waste Prevention . Air Quality 100128619 BP AQ 06 Decal Number Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.) 6. a. If this is a demolition project,were the structure(s)surveyed for the presence of asbestos containing material(ACM)? ❑ Yes ❑✓ No If yes, who conducted the survey? S rvevor Name c.Division of Occupational Safety Certification Number 7. Construction or Demolition: 07/01/2011 08/01/2011 a.Start Date(mm/dd/yyyy) b.End Date(mm/ddlyyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding ❑ paving b. If other, please specify: ❑ wetting ❑ shrouding ❑ covering ✓❑ other DUSTLESS HEPA FILTER 9. For Emergency Demolition Operations,who is the DEP official who evaluated the emergency? N/A a.Name of DEP Official b.Title c.Date mm/dd/ of Authorization d.DEP Waiver Number D. Certification ®M I certify that I have examined the JEDWARD MACDONALD ®O above and that to the best of my a.Print Name ®O knowledge it is true and complete. JEDWARD MACDONALD ® The signature below subjects the b.Authorized Signature ®N signer to the general statutes PRESIDENT/OWIWNER o regarding a false and misleading c.Position/ e ®o statement(s). ICOMMERCIAL BUILDING SERVICES, INC ® d.Representing 06/20/2011 pro e.Date(mm/dd") ®�0 ®d ®Q agO6.doc•10/02 BWP AQ O6•Page 3 of 3 E3 r . . 'L Nlastiachusetts - Deliartment ut'Pu61ic Sare.tN hoard of Building Regulations and 1.Standard~ Construction Supervisor License License: CS 74648 7 ,DAVID A TANNER +` 24 RIVER St PLYMOUTH', 'MA 02360 E.0ir`ation: 8/28/2012 ('n nun i>siuner Tr#: 3203 t s t0 a1e REN � Y o € e p e �7 _ ._.................. ................. 4 Y J i, A• S .._. - O Z C i . .__. _ } 01 Pil I XV:,O n e 3 I \ - YV y ^o { Hi 1 a � n ` n a ©2010 Smlm,lm nr�l•<LL lone mwbpr er, 10 � u�i� S S .� VbaVa�mGr1ete.IM �DD°owm�Fiml•. CAPE COD ORTHOPAEDICS i • °eq O1°m ""�'b"n,lfpeY'a0"' Saltcrstal: g�' m•Eb° lbn, m 130 NORTH STREET • • `°`l� ':a°°° v.:em°�m,on°l m•. HYANNIS, MASSACHUSET75 r � z Z � e. e 1� 1 v 4-sn� ObVe f�11 Aj o a 1. 17 7# -775 _ FZFL INI2/4 PROJECT d,/►L • ��' ' `�" i . . ,. NAME: ADDRESS: 1 G vw��S PER M# PERAUT DATE: M/P: 30� LARGE ROLLED PLANS ARE IN: BOX SLOT Data entered in MAPS on: 3 l 3 program BY: q/wpfiles/forms/archive TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Application #Map Parcel Health Division Date Issued 451 c In 1 Conservation Division Application Fee Planning Dept. Permit Fee <X6.4' Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street(A Mu Address J 0 N69±)n 4Udr1n 02 fob 1 Village H L1-G n*y_� Owner 3)gV_E �r�6a1&S L�-C Address i30 �1u_, 'VN ; t1WQYFl2tp m Telephone Viat3 • 77 Z- !KZ Permit Request �.►112i(��- �ea� � oC� CI, -�, ���}=l _ 6�i Square feet: 1 st floor: existing Siyogproposed 3,8 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuat'ion`��5rf)� Construction TypeRoibYb±O/i Lot Size Z •_ aCR-dam Grandfathered: ❑Yes B'No If yes, attach supporting documentation. Dwelling Type: Single Family . ❑ Two Family ❑ Multi-Family (# units) OTi1 t k- Age of Existing Structure 13 11 55 Historic House: ❑Yes ZNo On Old King's Highway: ❑Yes S4 Basement Type: ❑ Full ❑ Crawl ❑Walkout Q Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing Z- new 7- Number of Bedrooms: _ existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and F . Cif Gas ❑ Oil ❑ Electric ❑Other Central Air: Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No DetaNd garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attachh garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # 10t Recorded ❑ SEP 1 7 RECT Commercial dYes ❑ No If yes, site plan review # g �r. Y Current Use L Ohl. 0. Proposed Use CATITT APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name - hyY-)MiNL-A C., (All 6 ah3Q Telephone Number Address —III d ?./] License # � f10 ln�Q�J a)2MQ Home Improvement Contractor# Worker's Compensation # W e•0 2)] 51 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE "-"---" DATE / I �i0 0 I , i 4 - FOR OFFICIAL USE ONLY i APPLICATION# t , ` DATE ISSUED. . .. MAP-/PARCEL NO._.� ; ADDRESS- VILLAGE i OWNER r` DATE OF INSPECTION: r i ?FOUNDATION — — ' FRAME -' ti',•INSULATIONc i FIREPLACE ELECTRICAL: ROUGH FINAL I i PLUMBING: ROUGH FINAL ' ROUGH! _ _ FINAL J'= Fl.NAL B'_U1LDING` , ywa - At' DATE.CLOSED OUT :. ASSOCIATION PLAN NO. } I The Commonwealth of.Massachusetts Y Department of Industrial Accidents Office of Investigations 600 Washington Street t� Boston, MA 02111 yy www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly dame (Business/Organization/In -d iv viidual): Address: �(Q 03 I —)u- AWL Cv�/y City/State/Zip: Q11ll.U► Phone #: �'(36� Are you an employer?-Check the appropriate: Type of project(required): �{ 4. 1 am a general contractor and I I am a employer with. 6. ❑ New construction employees(foil and/or part-time). * have hired the sub-contractors- listed on the attached sheet. 7. emodeling 2-❑ I am a sole proprietor'.or and have workers' partner- ship and have no employees These sub-contractors have 8, ❑ Demolition working for rime in any capacity. employees9. ❑ Building addition comp.insurance.$ [No workers' comp. insurance 10.(] Electrical repairs or addition: required.] 5. [] We are a corporation and its 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑ Pllun bing repairs or addition: myself. [No workers comp. right of exemption per MGL 12.E] Roof repairs insurance required.] t G. 152, §1(4), and we have no employees. [No workers' 13.❑ Other 1 comp. insurance required] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. tCoritractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. n n Insurance Company Name: Policy# or Self-ins. Lic.#: lilJl�f) � Expiration Date; /�.� ZI�� Job Site Address` � Q l7,A �� T1� h�A —City/State/Zip:_ i3 ���D® f Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under.Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the•Officc of Investigations of the DIA for insurance coverage verification. 7Ido hereby certify under the p 'ns an enalties a in ormationprovided above is trice and correct. ture: Date: �� Phone# LJ� 39 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 S. Plumbing•Inspector 6. Other Phone#: Contact Person: • s information and fnsftuctzolls ec Massachusetts General Laws chapter 152 requires all employers 10 provide v oekof an thepemderoanyocontracl oplhire, Pursuant to this s[atute, an employee is defined as '.,,every person m the s r 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 re trustee engaged in a joint enlerprise, and including the legal representatives of a deceased employer, or the of the fo receiver re trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employserthereto Persons shall not becir wrk jling a do use of such employmentce, constniction or F be doeemoed to be aneemployer.'.'o se or on the grounds or budding appurtenant MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall Fvithhold 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 chaplet 152, §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the perforrnanca ofpubliwork until acceptable evidence of compliance with the insivance c 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 s o ion and, if necessary,supply sub-contractors)name(s), address(es)and phone numbers)along with their cerlificate(s) of insurance, Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the or LLP does have members or partners, are not required to carry workers' compensation insurance. If an LLC ve rial employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Indust Accidents for confirmation of insurance coverage, Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that.the affidavit is complete and printed legibly, The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the.permitllicense number which will be used as a•reference number. In addition, an applicant nt that must submit multiple permmit/license applications in any given year, need only submit one affidavit indicating (city or policy information (if necessary) and under"Job Site Address" the applicant should write"all locations in town),"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i,e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-127-7749 06/07/2010. PRODUCER 508.77S.3131 FAX 508.790.1677 THIS CERTIFICATE,IS ISSUED AS A MATTER OF INFORMATION The Fair Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 430 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 619 Main St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Centerville, MA 02632 INSURERS AFFORDING COVERAGE NAIC# INSURED Williams Building Co In _-............._.._..—_—..___— INSURERA: Star Insurance Company 196 Old Townhouse Road _ .-------- '— ------ •---------'-- _ _._.._..._.._..... INSURER B: W. Yarmouth, MA 02673 .............. __-.--"-----_._�..._........... INSURER C: INSURER D: INSURER E: -"--.. COVERAGES IGEN'L IES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING IREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR AIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ""TYPE OF INSURANCE ICY EFFECTIVE POLICYEX-piRPOLICY NUMBER DATE MM/DDIYYYY DATE MMIDDIYYYY LIMITS NERAL LIABILITYEACH OCCURRENCE COMMERCIAL GENERAL LIABILITY -O)MMAA�ETO RENTED— $ CLAIMS MADE OCCUR --- -- --� MED EXP(Any one person) S ___... PERSONAL&ADV INJURY"" GENERALAGGREGATEN'L AGGREGATE LIMIT APPLIES PER: —----------------- PRO- PRODUCTS-COMP/OP AGG $ POLICY JECT LOC AUTOMOBILE LIABILITY i ANY AUTO COMBINED SINGLE LIMIT $ (Ea accident) ALL OWNED AUTOS -----_—'-- --•_--- SCHEDULED AUTOS 80DILY INJURY $ -- (Per person) _ HIRED AUTOS —_.:....__...._.._._._—__---._._._.._ .—_-'--- NON•OWNED AUTOS BODILY INJURY $ -- (Per accident) — ---—_ PROPERTY DAMAGE $ (Per accident) FEXCESS AUTO ONLY-EA ACCIDENT $ ANY _...- .._..._.__.—_.._...-- —-----.............._.......,-.--' -- .. _ OTHER THAN EA ACC $ AUTO ONLY: AGG $ LIABILITYEACH OCCURRENCECLAIMS MADE AGGREGATE $...._.._.$ ..............-_......-'--___,........._.. --... —----- WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY YIN WC0371S16 OS/25/2010 05/25/2011 X TORYLIMITS ANY PROPRIETOCERIMEMBER EXCLUDED? CUTIVED E.L.EACH ACCIDENT — $ — 500,000 _ A OFFICER/MEMBER EXCLUDED? (Mandatory in NH —'--------- —.___. If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 500,000 SPECIAL PROVISIONS below OTHER E.L.DISEASE-POLICY LIMIT $ 500,000 I i DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS 1 t CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL ' IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESENTATIVE _.i f -WI LLAMS BUILDING CO INC / f ACORD 26(2009/01) ©1988.2009 CORD CORPORATION. All rights reserved. . TL_ •I�I�n,1.__.. _ -_J.__._ -__ __-._a__-J-_-_I.._ _C A/./1�t1 , 1 - I FEastern DM CERTIFICATE OF LIABILITY INSURANCE �DATE(MMIDDINYYMY)782-0251 FAX (7g1)261-2099 4/08/2010 urance Group LLC - Commercial ONLYANDICONERS O RIGHTS UPON THE CERTIFIICATESUED AS A MATTER OF ION ark Drive HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Uni">. Bl ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Not ;ell, -- 02061 INSURERS AFFORDING COVERAGE INSUF I Williams oUl ldin CO an NAIC# 9 p Y INSURERA: Selective Insurance Co of SC -" -19259-- 196 OLD TOWN HOUSE RD WEST YARMOUTH, MA 02673 INsuRER B:-1531 Hanover Insurance INSURER C: INSURER D: INSURER"E: COIERAGES TIE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING A:JY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYPE OF INSURANCE POLICY EFFECTIVE 7!" POLICY NUMBER GENERAL LIABILITY S 1850953 10/01/2009 CURRENCE LIMITS COMMERCIAL GENERAL LIABILITY $ 1,OOO,OO TO RENTED $ ZOO,OO CLAIMS MADE �OCCUR A X (Any one person) $ 10,OOL&ADV INJURY $ 1,OOO,OOGEN'LAGGREGATELIMITAPPLIESPER: AGGREGATE $ 3,000,00 POLICY JE O LOC PRODUCTS-COMP/OP AGG $ 3,000,00c AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT ALL OWNED AUTOS AWN3697913 08/06/2009 08/06/2010 (Ea accident) $ 1,000,000 X SCHEDULEDAUTOS BODILY INJURY B X HIRED AUTOS (Per person) $ X NON-OWNEDAUTOS BODILY INJURY X COMP $1,000 Ded (Per accident) $ X COII $1,000 Ded PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY-EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY S 1850953 10/01/2009 10/01/2010 EACH OCCURRENCE X OCCUR �CLAIMS MADE . $ 5,OOO,OO A AGGREGATE $ 5,000,000 !i DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND - $ EMPLOYERS'LIABILITY WC STATU- OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ " OFFICER/MEMBER EXCLUDED? Des,describe under E.L.DISEASE-EA EMPLOYE $ SPECIAL PROVISIONS below OTHER E.L.DISEASE-POLICY LIMIT $ ontractor Equipment S 1850953 10/Ol/2009 10/O1/2010 Cont Equip$15,000 w $500 Ded A Leased/Rented Leased/Rented $25,000 w $500 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Ded i t CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE - EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL +� 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, i ! BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Ronald Cleaves/]ML . ACORD 25(2001/08) , ©ACORD CORPORATION 1988 Town of Barnstable ' RegiAatou Services .. TAOmu F.GeDer,I33reotor 10 ]3acUng Div-talon Tomleem, 8uUdWS Commiaslouer , 200 Main Reef,$Y=uis,MA 02601 ' vnmAown.bjj=AsbIe,)mt.uI Fax; 508 790-6230 OfHoc; 508-862-4038 , property owner Must ' Complete and Sign This Sect10n ' If Using ABuilder IV 197as Owner of the subject property' _ •to�ac on mcybe�alf; cherebgauthor�a:'Gv �� sit:, • � , ,bit i"/,r✓i this bu�Idia�n a r.. on for; all fitters telatave to work iuthos�re y g Pp , �is of . Date S;gn�tw;e Owner , I'rmtRune ` Usti rilru,ct# D�hirri� ni'rS�;Pui�lt4fC Bo.rrtl of Buridin�� Rt uiihnn� It Intl rrttR ^ ConstructiongSuperursorq License-`R 4`t IcenS@: CS 7567 Restricted to:, 0-0Ir— ' *w ' w TIMOTHY C WILLIAMS � `A-196 OLD TOWNHOUS@RD 11V YA RN?OUTH, MA 02673 , lo nnuti�iunr y _ z R strict d�to OO�Unrestncted� s1G,�1 �2 Family H��� s 4;x,{.�, +• ;.q+ten-' '#.t�'+ ^,. ,,. - Failure to possess a carrent edrhon of.the� Massachusetts State Bwldir g Codet _ � z <rs;cause for vre ocahon of:[lus license. Referjtok'= WWV�'Rl► ss S . !. s �� Massachusetts Department of Environmental Protection _ t Bureau of Waste Prevention • Air Quality 1100113321 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition Important: Applicability A. /Q When filling out pp - y forms on the computer,use only the tab key A Construction or Demolition operation of an industrial, commercial, or institutional building,or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection cursor-do not (DEP) B y g use the return Bureau of Waste Prevention-Air Quality Control Regulations 310 CMR 7.09. Notification of key. Construction or Demolition operations is required under 310 CMR 7.09(2)ten (10)days prior to any work being performed.The following information is required pursuant to 310 CMR 7.09. B. General Project Description 1. a. Is this facility fee exempt-city, town, district, municipal housing authority, owner-occupied Instructions residence of four units or less?❑Yes ❑✓ No 1.All sections of b. Provide blanket decal number if applicable: this form must be Blanket Decal Number completed in order 2 Facility Information: ' to comply with the Y Department of Cape Cod Orthopaedics Environmental Protection a.Name notification 1130 North Street requirements of b.Address 310 CMR 7.09 H annis MA 1 02601 c.Cit /Town d.State e.Zip Code (508)775-8282 1pameiab@capecodortho.com f.Telephone Number area code and extension .E-mail Address(optional) 24,317 1 h.Size of Facility in Square Feet i.Number of Floors j. Was the facility built prior to 1980? ✓❑ Yes ❑ No k. Describe the current or :prior use of the facility: Y medical office I. Is the facility a residential facility? ❑ Yes ❑✓ No �O m. If yes, how many units? Number of Units -° 3. Facility Owner: �N Bare Bones, LLC �° a.Name 130 North Street b.Address H annis JIVIA I 02601 c.Cit !Town d.State e.Zip Code �° (508)775-8282 1pameiab@capecodortho.com f.Telephone Number area code and extension .E-mail Address optional a Pamela Bruce �Q h.Onsite Manager Name ag06.doc•10/02 ° BWP AQ 06-Page 1 of 3 O Massachusetts Department of Environmental Protection j1 Bureau of Waste Prevention . Air Quality 100113321 _ (, BWP AQ 06 Decal Number Notification Prior to Construction or Demolition General B. General Pro p (cont.) Statement:If Project Description C011t. asbestos is found during a Construction or 4. General Contractor: Demolition Williams Building Company, Inc operation,all responsible parties a.Name must comply with 196 Old Townhouse Rd 310 CMR 7.00, b.Address and Chapter West Yarmouth MA � 02601 Chapterer 21 E of the General Laws of c.Cit frown d.State e.Zip Code the Commonwealth. (508)394-3644 emily@williamsbuildingco.com This would include, f.Tele hone Number area code and extension .E-mail Address(optional) but would not be limited to,filing an Emily Sheedy asbestos removal h.On-site Manager Name notification with the Department and/or a notice of release/threat of release of a C. General Construction or Demolition Description hazardous substance to the 1. Construction or demolition contractor: Department,if applicable. Williams Building Company, Inc a.Name 196 Old Townhouse Road b.Address West Yarmouth rMA 02601 �� c.City/Town d.State e.Zip Code (508)394-3644 emily@williamsbuildingco.com f.Telephone Number area code and extension g.E-mail Address(optional) William Welch h.On-site Manager Name 2. On-Site Supervisor: William Welch On-Site Supervisor Name 3. Is the entire facility to be demolished? ❑ Yes ✓❑ No N 0 4. Describe the area(s)to be demolished: ME— Interior Renovation/Interior Walls and Doors �O �O 5. If this is a construction project, describe the building(s)or addition(s)to be constructed: Interior Renovation. No Exterior Wall Demolition. i�O ag06.doc•10/02 BVVP AQ 06•Page 2 of 3 Massachusetts Department of Environmental Protection LF�J Bureau of Waste Prevention . Air Quality BWP AQ 06 Decal Number Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.) 6. a. If this is a demolition project, were the structure(s) surveyed for the presence of asbestos containing material (ACM)? ❑ Yes ❑✓ No If yes,who conducted the surrey? b.Survevor Name c.Division of occupational Safety Certification Number 7: Construction or Demolition: 10/01/2010 11/01/2010 a.Start Date(mm/dd/yyyy) b.End Date(mm/dd/yyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding ❑ paving b. If other, leases eci ❑ wetting ❑ shrouding p p ❑✓ covering ❑ other 9. For Emergency Demolition Operations,who is the DEP official who evaluated the emergency? a.Name of DEP Official b.Title c.Date mm/dd/ of Authorization d.DEP Waiver Number _ D. Certification I certify that I have'examined the JEmily Sheedy �o above and that to the best of my a.Print Name knowledge it is true and complete. Emily Sheedy The signature below subjects the b.Authorized Signature .��N signer to the general statutes �— Contractor Administrator o regarding a false and misleading c. Position/I ite �o statement(s). Williams Building Company, Inc d.Re resentin 0 9/1 712 0 1 0 �� e.Date(mm/dd/yyyy) ag06.doc•10/02 BWP AQ 06•Page 3 of 3 eDEP - MassDEP's OnlineFiling System Page 1 of 1 MassDEP Home I Contact i Feedback i Tour i Privacy Policy MassDEP's Online Filing System Usemame:WBC6300 Nickname:ESHEEDY My eDEP! Forms m My Profile Help Receipt Forms Signature Payment Receipt Summary/Receipt printA�eceipt Exit Your submission is complete. Thank you for using DEP's online reporting system. You can select"My eDEP"to see a list of your transactions. DEP Transaction ID: 335454 Date and Time Submitted: 9/17/2010 9:15:12 AM Other Email : Form Name:AQ 06-Construction/Demolition Notification Payment Information DEP code: 48633 Date: 9/17/2010 9:15:02 AM Amount($): 85 Payment Detail: SHEEDY EMILY--AccountType--AccountNumber****9535 Confirmation Number: Contractor Contractor Number Name Address, , Supervisor r Project Monitor Lab My eDEP MassDEP Home i Contact I Feedback I Tour J Privacy Policy MassDEP's Online Filing System ver.9.8.5.1©2010 MassDEP https:Hedep.dep.mass.gov/Pages/PrintReceipt.aspx .9/17/2010 eDEP - MassDEP's OnlineFiling System Page 1 of 1 MassDEP Home i Contact Feedback I Tour I Privacy Policy MassDEP's Online Filing System Usemame:WBC6300 Nickname:ESHEEDY My eDEP I Forms cO My Profile cilill Help LReceipt Forms Sicinature Payment Receipt Summary/Receipt o print receipt, Exit;; Your submission is complete. Thank you for using DEP's online reporting system. You can select"My eDEP" to see a list of your transactions. DEP Transaction ID: 335454 Date and Time Submitted: 9/17/2010 9:15:12 AM Other Email : Form Name: AQ 06-Construction/Demolition Notification Payment Information DEP code: 48633 Date: 9/17/2010 9:15:02 AM Amount($): 85 Payment Detail: SHEEDY EMILY--AccountType--AccountNumber****9535 Confirmation Number: Contractor Contractor Number Name Address, , Supervisor Project Monitor Lab My eDEP MassDEP Home i Contact Feedback Tour Privacy Policy MassDEP's Online Filing System ver.9.8.5.1©2010 MassDEP https:Hedep.dep.mass.gov/Pages/PrintReceipt.aspx 9/17/2010 PROJECT ADDRESS: Z&O /U PERMIT# :;P 64 (> f-3 PERMIT DATE: M/P:-509 -- a / LARGE ROLLED PEAKS ARE IN: BOX 961, ,SLOT Data entered in MAPS program on: . o 0 By: �2. Sign TOWN OF BARNSTABLE ' Permit * BARNSTABLE, * 9 MASS. � i6pr�1 39. A Permit Number: Application Ref: 201002919 20070466 Issue Date: 06/14/10 Applicant: Proposed Use: MEDICAL OFFICE BUILDING Permit Type: SIGN PERMIT Permit.Fee $ 75.00 Location 130 NORTH STREET Map Parcel 309212 Town HYANNIS Zoning District O1v( Contractor PROPERTY OWNER Remarks REPLACING EXISTING 50 SQ. FT. SIGN WITH NEW ONE CAPE COD ORTHOPAEDICS Owner: BARE BONES LLC Address: 130 NORTH STREET HYANNIS, MA 02601 Issued By: PC POST THIS CARD SO TI3AT IS VISIBLE FROM THE STREET .. . 75 i o�t►+f Town of Barnstable Regulatory Services &kRxsTABLA NAS& Thomas F. Geiler,Director Eo39. ,c•`� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit 4f�! Application for Sign Permit ' �� '' Applicant: W_�Q -------5 �L --------Assessors N ' 0q.—� -- ------- ------�— .Doing Business As: CV.1�.c o►i�� 0 C --- p,---A---�i�---TelICS ephone No �J ------------- Sign Location Street/Road:-1 a N�h� vv_� Zoning District:—___ Old Kings Highway? Ye 0. SC>lyannis Historic District? Yes/ ._ Property n T3 avi�S ,�C 7 2 Name:—_ --__—_t------- -----_ __Telephone: Address:_t� --------------------------------------Village:----- Sign-Coat c or . Name:-----`��MU — � N—Cd----- 7�.ry 56 _ —____Telephone: _ Mailing Address—___ --------------- -- -- `C tiA.o. Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Yes' Dote: If yes, a wiring permit is required) .:c( S Width of building face ft.x 10. _ x.10 I hereby certify that I am the owner or that I have the authority of the owner to-make this application,that the information is correct and that the use and construction shall conform to the provisions of§240 59 through§240-89 of the Town of Barnstable Zoning O ance. Signature of Owner/Authorized Agent: Date: Z Size:_�T --------- ---=---------- � Fee.-- Disapproved ?S— ----- --- -----Permit Co Sign Permit was approved:__. ( , ----- ----- SIGNS/SIGNREQU a _ b,C , 3� 10,E _ ' � � ;-� CAPE COD ORTHOPAEDIC _. . & SPORTS�IAEDICINE LJ = `teeUKOSLIPS, ONS 1 - ` W tWILLIAM S. FALLA, '^ ! OR D V _ CAPE. GOD HOSPITAL REHABILITATION CENTER of k1'4_i4_t'� k ait.:��1 G1'"'f'a f'� f'� f1 T46.1 ; F� r _ t A� •r� r � 1 p pn 61 .75" �-1 Y_ CAPE COD ORTHOPAEDICS 9.5" & SPORTS MEDICINE, P.C. CAPE COD ORTHOPAEDICS & SPORTS MEDICINE PHYSICAL THERAPY 74" DR. JOEL HASS CAPE COD HOSPITAL REHABILITATION CENTER WILLIAM S. FALLA, D.M.D. ORTHODONTIST 84" 96" 116" �noff (0(m9 m ) 780=3M Fax sa ncm m IDAFE ® By. 1CLOTOMER I APPFKNED BY. PDL NUMBER f TOWN OF BARNSTAUI:E BUILDING PERMIT APPLICATION QtJ e Map 3 0 2 Parce� 22 Permit# r� 7 i Health Division Date Issued Conservation Division oZ I/OS ApplicationTee Tax Collector Permit Fee* 'vzr.0 Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address �� lVeAeE& L � Village Owner 13 0&0 � �f�U�'/ Address 120 /r/dR/77/ Telephone Permit Request /V 0 S�aG'/t`i�� e Square feet: 1st 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 -�WNo On Old King's Highway: ❑Yes 4 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 i T Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No - Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new.) size- Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# ., t Current Use Proposed Use JA116 L 1,4M P114(,(,�C&BUILDER INFORMATION Name i Z11ML I�' /7 4/6!�� 00, SUS 77c� /.Zy Telephone Number Address /l/.)_� ,M4/7O" License It C,Is, 0 7 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO MCA//W/P1/ SIGNATURE Ai-l" 649�t 5�&Vll DATE /d `7 �� i F FOR OFFICIAL USE ONLY I ;PERMIT NO. DATE ISSUED MAP/IARCEL NO. ' ADDRESS VILLAGE OWNER s�'/DATE OF INSPECTION: FOUNDATION i- FRAME INSULATION FIREPLACE i ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ,r . GAS: ROUGH FINAL FINAL BUILDING 6 f//l DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Epp g'ashington Street ' Boston,Mass. 02111 ' Workers' Cam ensation Insurance Affidavit �G��ral Businesses 0 / � s.� �•`'•r7+=:a.r=j��- we '•�+"e�'s•: :?. .,, "L•.. `,. . MOM address' � state: ziiihz e# 136 work site location fu address a Retail❑ urant/Bar/Bating Establishment [] I am a sole proprietor and have no one Business Tip : O5ce[]Sales(including Real Estate,Autos etc,) orldng in any capacity. am an en to er with eta 1 ees(full& art tin . ❑Other �,�//� i i/�i��i���/��e� Room I am an employer ovi viQ ers' compensation for-my employees worldng on this job. :,� me- 5 33". �:L •� Ott• 's.• � •"� f �sr • ' •'Y'•J •r ••'r ir'• hone il••' • ' •, 4 !^� Ci r •t. r . .. .''.•�'!t�_7:•(C�:y •�• �:�ti. �f1� • r'�' '�v--� .:.'. •i '' '!. r.`r,..t+: e•1• .ris::' OhC.'•iF-.+ .s•e ../ ::' / '^ r- M'AIM,. tractors listed below who have the following vrorkers't It proprietor ' 1 etor and have hired the independent con I am a so compensation polices:am . . ' ;i 7� rt+•°''.j. �,• rrr;.'. ..n:,�.'�f:;�; t'� -�'' "Ct, r.+,n: SIM ad�re7ia' ! �'+7.4,g ,;� • t � •'. r•�: •• �ti '��,��• •' r • ' .� !•", 't. .,. �,,� .i' :':ii't �",•-•„A�•, 5�•�''.'ri lione�:, .. "�":��r: ` . r: ';t•'' ' ^' '• •;r•• :r• :�hA7r:;�•,'q' Y. •.r.• •t''•rr:'•'011�� /'�'r; .� w.'/�• • inaiirsnce co. • •. _ :;.,:;_/ .%/./ /// / / / / ; !. •,(;. .rd'•1...' :.,' .(.•' r rP''�f.( 'il,• 't•'•j.r ••t„ 'J,.' y'y~•'� s� 'n`:..?, r%i•^t,177 ' ar i" :. ;r ^� ..i�.,i,i' o• Y.. .. .i.: .e: �'rlrp: Mi,.�• ',:,.s' :,;��: •c• .i+•• - .i+. _ com e33 Hama,. - address: ; .' ' .%.,.' , r t hone# 1 Cliv'• 4. l• ,. .. 4t.. •','.v +.• ' , '''i+' ti+:•r'P, ',',` Si i• ''+ e UP to he sition Failure to secure coverage M required Hader section 25A olMr OP'R'ORK OtRDER and a fine oit51�0.0 a day agaia+t�m l undeerstand.thatis one years'imprisonment as well etvil penalties in th COPY of this statement may be fa ded to the off of vr3tlgatlons of the DIAfor coverage verlficatiaa f that the information provided above is true and corre I do hereby certify under pains den tie erjury ct r; Date ;> ,J Phone# print name i � •� A • •,; official use only do na t write in this area to be completed by city or town affictal permiHllcense# -_ ❑B�d�g Department city or town: []Licensing Board (3Selectmen's Office ❑chackif immediate response is required ❑HealthDepattment , ❑other • phoner"ri , eontaet person.: (revaed Sept 1003) r - Information and Instructions an employers to provide workers' compensation for their I52 section re wires emp y Massachusetts General Laws chapter Q employees. As quoted from the"law", an employee is defined as every person ill the service of another under any contract lie oral or written. • of hire,express or imp d, . entity, or an two or more of An emp y partnership, association,corporation or other legal ty, y to er is defined as an individual,P P� engaged in a joint enterprise,,and including the legal representatives of a deceased employer,or the receiver or the foregoing l 1 ees. However the owner o trustee of an individual, pa�enh PI assoc�ahon or other legal entity,employing employees. dwelling house hag not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs pmsons to do maintenance,construction or repair work on such dwelling house or on the grounds or. t thereto shall not because of such cmploymeat be deemed to be an employer. enan building appurtenant . MGL chap ter 152 section 25 also states that every state or local licensing agency shall withhold the issuance dr anewa hall of a license or permit to operate a business or to construct buildings in the cbm;nonwealth.for.any apply yr not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance regwrements of this chapter have been presented to the contracting authority. Applicants • situation. Pl ease that applies t 0 Ol1T 5itll _ the box • eckin toy our b ch PP co g Please fill in the workers compensation affidavit mp y, y address and. hone numbers along with a certificate of insurance as all affidavits maybe submitted supply company name, P to.the Department of Industrial Accidents for confirmation of insurance coverage, .Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the-"lave'or if you are required to obtain a wQ=ke1t' comPen�aticnpolicy,please call the Department at the number listed below. o / City or Towns . Pl easebe sum e.that the affidavit is complete and printed legibly. The Department Us 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, 't/license number which wdl b'e used as a reference number. The affidavits may beretmned to . earn be sure to fill m thep • the Depar( mni by mail or FAX unless other airarionents havebeen made. ation and should you have an questions, bite to thank ' in.advance for you cooper y Y The Office of Investigations would y please do not hesitate to give us a call. �/% %�// �� //// The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Oft}ct3 of(e�sttQattans 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 _ phone#: (617) 727-4900 ext.406 { ':, uaelt4 I ✓e�eowt BOARD OF BUILDING REGULATIONS }, license: CONSTRUCTION SUPERVISOR ' Number:CS 076249 t' t , $ Expires:04/10/2005 Tr.no: 10293 ; Restricted 00 t WILLIAM A WALLACE •° r 132 S ORLEANS RD't RLEANS, MA 02653z;='k Administrator ; • r. J C 5084201637 02/01 105 14:29 N0.704 01 eC. ......:.:...... ....".,.... ..as:.eZYe..:...w.,i< •fLA...�. .�;3-0,y N ..•.. �:f.: A.;.:.:... wy:<eGo:i'•�';'wy:j:;'a.o?%`# /YY) NHUDUCER k�.......".µ.:a.µ;,�«ws...•:...,.�. :.^.�° <...-., <�•.:.uee.,, •:" •' az �.;w x.�:Y....... :x..ax. me.µ•": >:;;saa� � DATE w THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION •- ==:Inr:cY.e insurartce agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE c:. U0. 42-1 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. c:v:l io MA U2655 COMPANIES AFFORDING COVERAGE -0427 COMPANY -' INSURED —'- _ A TrAvelers Insurance Cy - '— -- Fenne or SOUCheaACern Mass And Capc C COMPANY od, Inc B American Em.loyery ilia. _F;a imoutl� kd •• - _ _ COMPANY "-- iivannis C Safely Insurance Co, KA 02601• -- -5061 '175 4124 COMPANY '— THIS15 ,. o CY ,,TO CERTIFY INDICATED,N THAT THE POLICIES OF INSURANCE LISTED BELOW I iAVE"BEEN IS U � yY; V i~Y � NAMED '•"'""'`µVE OR POLI' "" OTWITHSTANDIND ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WIDTH RESP THE ECT TO WHICHTIMIS 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_. ..O TYPE OF INSURANCE TR' POLICY NUMBER POLICY EFFECTIVE POLICY E%PIgATION DATE(MM/DD/Y11) DATE(MM/DO/W) LIMITS QI NERAL LIABILITY COMMERCIAL GENFRALLIABILITY I6nU-920YU229 1ND-n3 GENERALAGGREGATE E7.000000 _ 08/01/U4 08/01/05 PRODUCTS-COLINjuRy 1�11 � 00000 I CLAIMS MADE L�OCC:I IR OWNER'S S CONTRACTOR'S PR IT PErISONAL 6 An 0 EACH OCCURRENCE0000 FIRE D"ME ty y one lire) $ 300000 AUTOMOBILE LIABILITY MED EXP(Any one person) S 5000 1 ANY AUTO 34 502 12-04 COMBINED SI►yGLELIMIT $ I 08/19/09 08/19/U5 _ I all OWNED AUTOS _ •X SCHEDULED AUTOS BODILYINJURY (Per $ HIREDAUTOS � ) 100000 NON-OWNS O AUTOS BODILY INJURY — — -- ( (Per 4eeidenq S — 300000 - PROPERTY DAMAGE S GARAOE LIABILITY PROPERTY ANY AUTO AUTO ONLY•EA ACCIDENT $ jA N AUTO ONLY: ACH ACCIDENT S • EXCESS LIABILITY AGGREGATQ S — X 'UMBRELLA FORM RRENCE 21000000 _ ISM-CUP-920YU71-5 IND-02 08/02/04 08/01/05 E UTHER THAN UMBRELLA FORM _• S 1000000WORKERS COMPENSATION AND SEMPLOYERS'LIABILITYpgY UMITB r0000-1339-2239 07/29/04 07/29/05 DENTTHE PNOPRiEtOW 1 X INCL S 1000000PARTNERS/EFECUTIVE LICY UMITUFFICEFS ARE• E%f l- S 10U0V00 OTHER CH EMPLOYEE $1000000 :CRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SP EC JAL ITEMS !NSTALLAT'10NS ATIfiCA�'EHO�(�E1�'� , .., ..µSHOULD ANYµ.:...•,.:.^.;..,:.;:%s=:`�b.�":;r�a,.;,.�.;�."e',�.,Q; �`?�w:eane;K.:�'.::�7�ix;"n,�:.;,;¢s'«e:*�%.^;:r,. Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORENTHE "+ EXPIRATION DATE THEREOF, THE 1"UIN0 COMPANY WILL ENDEAVOR TO MAIL 'r: Of RilrnSLubje 1Q_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, MAIN STREETBUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OOU0ATION OR LIABILITY \N va OR ANY KIND UPON v— COMPANY, ITS AIMENT2 OR REPRESENTATIVES, AUTNORIZLD REPRESENTATIV I LariLa II i n F Town of Barnstable P Regvllatory Services s � wee Thomas P.Geller,Director Building Division Tom Perry, Building Commissioner 200 Main Street Tjymwis,MA 02601 www.town.barustable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder yff�j ,as Owner of the subject property hereby authorize:'. l C ��_ .to act on my behalf, in all rmtten relative to work authorized bythis b 2ding perms application for: (.Address of Job) Signsture of Owner Date Print Narae T 'd LG£I-TLL-80S Ruedwoo aoua_� algellaa dIR:E0 so To ga: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 301 Parcel gig � Permit# d00700(oct Health Division Date Issued d Conservation Division Z aV!Feel Tax Collector ' Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address d e-7-# v7— 0 COIr 6V LW)b Am S-4 S��A V)01�S;)1T Village /&-4(4"6 ll Owner B'-� LLG Address 13D JJo�- 97. )YA O/Zdo 1 Telephone ��t�— �ZS- �'a�e'� X 16I �� I7W,0,9 S�-?e_ibA4 Permit Request ' €hd 1)ALJ-- P)) 7hJ aAk, . WO 266e� Xych 0, J Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Estimated Project Cost 7i 500 Zoning District 0M Flood Plain Groundwater Overlay Construction Type Lot Size A Grandfathered: ❑Yes ❑No If yes, attach supporting doc ° entation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) sv Age of Existing Structure Historic House: ❑Yes 5YNo On Old King's Hi ay: ❑ QWNo co Basement Type: 5d(Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing 3 n&? Number of Bedrooms: existing new Total Room Count(not including baths): existing new 3 First Floor Room Count 34) Heat Type and Fuel: ld Gas ❑Oil ❑ Electric ❑Other Central Air: UJIYes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial Vl es ❑No If yes,site plan review# Current Use 46yi t acyriCF Proposed Use 54r�l�' `A4V)6fL ,.:...B�lJ 11ilJ,L R f 1\I.Y!'1 ION-- Name -.-._•• ... __ __ -.. ..... ' nn f 1..��f' U/ L ; / C Telephone Number Address -_J, d- 6-)C a 7k �LZ i License# GS �/� lZomaID F. L 7-A",J i MA 6aSla Home Improvement Contractor# Worker's Compensation# loG 6 33—73`4 q ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 6.4.S'rZ1_A Ak,577- SIGNATURE DATE t FOR OFFICIAL USE ONLY ; ,1 PERMIT NO. l E.. DATE ISSUED y MAP/PARCEL NO. -ADDRESS "' VILLAGE w - OWNER � ..� ;`:. �% • � - �, - - DATE OF INSPECTION: 3 FOUNDATION ,f FRAME, INSULATION. FIREPLACES - J�. ELECTRICAL: -`ROUGH FINAL PLUMBING: -°ROUGH `FINAL r, GAS: ROUGH FINAL , r FINAL BUILDING DATE1 CLOSED OUT ASSOCIATION PLAN NO. ETti . Town of Barnstable Regulatory Services BUxMAS& a Thomas F.Geiler,Director ''�Enla Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder , as bier of the subject property hereby authorize C�n 6>✓sb-de✓�—d'/P, )d 6 to act on my behalf, in all matters.relative to work authorized by this building permit application for. DACE 6' 014v JS . )30 'V"'e7W- ST- aw av (Address of Job) 11woAA tore f r D Print Name If Properiy Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FO RM S:O W N E RP ERM IS S ION �oF VE r�� Town of Barnstable Regulatory Services SrAB Thomas F.Geiler,Director BAMM MAss. 0.19. +�p Building Division �rfD MA't Tom Perry,Building Commissioner 200 Main.Street, Hyannis,MA 02601 vrww.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOI\4EOWNER 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,Rrovided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies,that he/she understands the Town of Barnstable Building Department. minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner 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 pem it 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 persons)for hire to do such. work,that such Homeowner shall act as supervisor.,. Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fomdcertification for use in your community. Q:forms:homeexempt From:Rose Gillard At:MF&T FaxID:781-261-1111 To:Lois Date:2/20/2009 04:06 PM Page:2 of 5 ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID R DATE(MM/DDIYYI'Y) CONSE-1 02/20/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Macintyre Fay & Thayer Ins Agy HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 77 Accord Park Drive Unit B-1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Norwell MA 02061 Phone: 781-261-2000 Fax:781-261-2099 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Ohio Casualty insurance Co. INSURER B: Hanover Insurance Company 22292 ConSery Group Inc. INSURER : American International Co. P.O. Box 278 INSURER National Casualty Sagamore Beach MA 02562 INSURER E. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NCURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSR TYPE OF INSURANCE POLICY NUI,',BER DATE(CY IM/DFFEDM') DATE(MM/DDA'Y) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X C,:�MMERCIAI GENERAL LIABILITY BKO 0853511978 07/07/08 07/07/09 PREMISES(Eaoccu rue nc0) $100,000 CLAIMS MADE a OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 Pi iLICY P 0- El LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1000000 B ANY AUTO ADN 8111502-02 08/27/08 08/27/09 (Ea accident) ALL OWNED AUTOS BODILY INJURY - $ X SCHEDULED AUTOS (Per person) X HIREDAUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE F (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENTGTHER THANANY AUTO EA ACCAUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $5000000 A X OCCUR CLAIMSMADE USO (09) 53 51 19 78 07/07/08 07/07/09 AGGREGATE $5000000 $ RDEDUCTIBLE - $ X RETENTION $10000 $ WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS'LIABILITY C ANY PROPRIETORlPARTNER/EXECUTI'VE WC 033-73-0404 11/09/08 11/09/09 ELEACHACCIDENT $100000 OFFICEPJMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $100000 If yes,describe under _ SPECIAL PROVISIONS below E.L.DISEASE-.POLICY LIMIT $500000 OTHER A Property BKO 0853511978 07/07/08 07/07/09 BPP $126,000 D Professional Liab ARO 0002848 07/20/08 07/20/09 Prof Liab $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS E: 130 North Street Hyannis CERTIFICATE HOLDER CANCELLATION TOBARNS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN- Town of Barnstable - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Attn: Bldg Dept - IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 200 Main Street .Hyannis MA 02601 REPRESENTATIVES. JAUT SHRED REPWSE ACORD 25(2001108) 0 ACORD CORPORATION 1988 The Commonwealth of Massachusetts 1^ .-zs _ , I , �� '"--••. Department of dndustrial.4ccidents #Nee 911AMS1190®tas - .. --- - t' 600 Washington Street -� Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: location: hone f city G I am a homeowner performing all work rnyseLt ❑ I am a sole p n or and have mo one vv6z - o ic tv rovi ' workers'compensation for my employees working on this job.: :: .:<:<:.;:.:.::.:;:«:>:<:>««:>::::::::::: >,,':"........, , Q�I am an employer p. ding;:.;:;.:.:.:<::;::;:< ?P';:;:> tOnlDani` rime., . .:;.v aR. ddreW. SS phone# .... � .. . . ......:. .:.:. ❑ I am a sole proprietor,general contractor,or homeowner'(circleone)and have hired the contractors listed below who have rkers' ensation olices: ::::::..:. :<.;:.;;;;::<.:.;;;:<:::<:;«::<:::>:<::::::::>,;:::<:<::;::,,,,,<»:.:_<: the followrn wo P..........::. :.::r:::::;. ::::::: .......... g.... ....::.:::::.:CO ..... .:. COMD IN _. _. .............r........ ..r-........ ... :,:................ ...?{.::.�::::::.iii}i:•::"v:i:i4Y:ii:i:3iii�:viiiiiii?.i:.iii:iiiii'.�.;�::::.�.�::�v:::v.�::•:::.�:v.�::::::::::::::�•::•.�..... ,C:}.i:?4:•:4}:?{v ;:;:;:;:::::;Y;k:;;!::;:ist.;:;::»::i:r:>::::2:i:::;':=:?ii::: ::;::i:;>:`: ............:...................:::: :.4{•i:•}iii.�::\rt..............:.,...:{:v::::i:}i4:iY.:.v :::::::::::...:.:::::: ,.::::::::::.:....:..,,.,..........:::....;;:.,..........r bone v....:nw a.•.v::.v: :•:'t��':%::<':•:}hoax ?• :}::v::x?•t:::::c3.....{.....::;:i.:�i•::•:r}:?•::: -'.'::;.;•:::::•:::.:::.;:; . O H ij;TY ?i'r'.:r-f:�}.}lt 4:�r}.::::::::::.5:::::::...n..•:::w:::::::.�:••. .. ........ +; iisiii{:•i}:::i):vvii:iti?{<::ij::;ii:;:j,+.;:;:; i:: i:ii:i�jiiiii::�:::?-i:::•:i^}i:::•:::::::..::.�:::::::•::::::•::...... camDanv W. am address. "" e city: ;':::::. c.. oli'CY ins •nc Lira �i Failure to secure coverage as required ender Section 25A of MQ.152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one years'imprisonment as well as dvfi penalties in the form of a SrO uWORK DIA for coverage aad�fine �o�00 a day against me. I understand that a copy of this statement may be forwarded to the Office of lnvestlgatiom I do hereby c the pours p of perjury that information provided above is true and correct Sigaature Date00 Print name Leal Ct1'T(Cl�✓�l�I 1 Phone# offldal use only do not write in this area to be completed by city or town official dtv or town: permit/license# ❑Bunding Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department Other contact per-son: phone#; — ❑ (tensed 9/95 PIA) i Inforam.ation and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compens�aonafoor their quoted from the"law", an employee is defined as every Person in the service of anotherY uu act emplo�Ies. As q of hire. -%-press or implied, oral or written. An employer is defined as an individual Partnership, association, corpo ration or other legal entity, or any two or more of Lhe ferP^oi_*ig engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, Partnership, as or other legal entity, employing employees. However the owner of a dweilin� 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 , �--1- "n or r€pa r' work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such cnployment be deemed to be an employer. sermon 25 also a states that every state or local licensing agency shall withhold the issuance or�re®has al �iGL chanter 152 of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant h not produced acceptable evidence of compliance with the insurance cocoverage t for required. -Additt o Pnblicwor until commonwealihtnor any'of its political'stibdivisr the ions shall enter into I y performance acceptable evidence of compliance with the insurance requirements of ehaPter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying any names, address and phone numbers along with a certificate of insurance as all affidavits may be company submitted to the Department of Industrial Accidents for confir mation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,Please call the Depart at the number listed below. City or Towns The Department has provided a space at the bottom of the Please be sure that the affidavit is complete and printed legibly. P hcaat. Please affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the app permit/license number which will.be used as a reference number. The affidavits may be returned to be sure to fill in the p arrangements have been made. the Department by mail or FAX unless other The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions• please do not hesitate to give us a call. The D-parrment's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 �'`'' �"' -.k (, �!e -�omirrzo�e.uealll o�✓�.Czaoc�c�ivaet�a � j' met Board of Building Regulatidns and Standards Construction Supervisor License ! License: CS 5157 I Expiration ,5/23/2010 Tr# 23121 j ^:Restriction 00 ROLAND B CATIGNANI - 60,GEMINI DR W BARNSTABLE,MA 02668 Commissioner r. f Workers Corn isation and Employers Liability I, ` prance Policy 00001 Fremont Indemnity Company Information page A Stock Company POLICY NUMBER Home Office-Glendale. California w -0 3 0 16-01 PRIOR POLICY NUMBER NEW NCCI Company No. 1516.4 Entity CORPORATION 1. INSURED AND MAILING ADDRESS FEIN Board File Number CAPE COD HOME IMPROVEMENT (SEE SCHEDULE) Group WC 25 IYANOUGH ROAD Reference HYANNIS, MA 02601 State Unemp ID SIC OTHER WORKPLACES NOT SHOWN ABOVE: See Extension of information Page. 2. The policy period is from: 0 1-04-1999 12:01 A.M. to 07-04-2000 12:01 A.M. at the Insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers' Compensation Law of the states listed here: MASSACHUSETTS Lvj 4e..� L{I43 jr rn ED lilt 14 Aq {z �• 5 r 1. - - � t' c-- I �•P + � � .. .� �• s k-__t— i f _ YL� .�. Cis �§ �� 1 '-� t�•- YV v 1� �� �� 1, � i (� �� � ! ! �_s- � I 1r III li ���` .�• . 3 r - a .? �� Y �ru",r� 1 y ts„� �'s•. ;`� ��' •ys.- .��°'''� �, ?`�' ''' :_,-�� ?2i::sy'yL ti �> =' ,;.� . .x.. `�'• �; � � ,tidi � IS4'"`...c d � - xw „g. s '°'s'�" y- �" ='."*c �' -. .�.�r .r w .kx= .:..... ... . . ... - _ ... _.,:•. ,.. _ _ ...Y• ..tin.,. y P 1 rt ._ .. .1 -r...co- Nz IA 44 t_ S -, 1' I g _✓ o ez I • Page T ,,., 4-1 • �S�..� ��Ill�sss�}-�--�, -'—����,s`� I Y,• j ! 1 {y ..i I�. / j .� 1 - _ _ '•r - • i r X-7 i J fit j `, • `�oFFt 1 Otn 14 K v �•��-T�� ,�G' 'ter � ( To v '� ••s_try-^ ��f�. � - { -. _:�gx�:�:f�"�•s,;�'�' '�'i .M.,{ xu��. �Y�,{* r 1 �{ �'+�',F.t. �c ''r 1 '�'� $'1i L f�.. �.g i Sip- 3f: ,4 Zq f Pk'�T�r"C�V� t+R7C� 44 N Y21 GYQ5JM bD, ; - :tidy ift..��tl.. CO•tEec �l"aIG�, — • sib-k� ' I red% l O ( I I X 3-1 �p i�, In 1• � 1 gyp. 1 1 i/�' -. l t I _ i f 1 1 I x }Y: Y � TT' �t vro � fir• � f�p .� ack.Y �-iY'. ;J,. �7:. �R- ,�.J.�,c�'��. _ ti �T.iny.;.:r• �' .k! �< ��"..�� - £•: t i ¢•,�.`" u'.+ a.a,g.;.^Y�-.,,: ' 'tom-� ''�' 3 a ' � �,,�' § s4'_:.. }ra ,u. :, '; y r" •:.' .da: W .. I •i �.+- ., vr• -- �' '� _ T .,. fir• ,. t _ Aw j'� 9 p 4A?-r,. Vim. p' \ :U ��' ; �• , •__D . :� .. ILI t � _� •o t _. � �mot-' � ��_ — rio FA �� *w ,- I� } Im :-�^`ter. H �� 1 � O-T--- --- _ It � ..\ iP `-•.�„�'-= Y . . 2 t 14 Co •.N 1�2 G`I'p5 il nit �O, `C po i 11 1 I J 1 I I� The Commonweafth of M assacizuseirs + '= =t Department of Industrial Accidents Olfrca01111051192 0S 600 Washington Street .e Boston,Mass. 02111 '— Workers' CnV ompensation Insurance davit ,//i r nisi i i .. n ir�ii/ /�/O ///r�i�i ����� ����/ ���� /i/lily e�lY����� ������20 ��������� ,,,,,. name: location city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in a v capacity rl %//%%///%%/ /////% %%/%//%////%// //i0, /// %� D////% '////////////.0i.��///////////am an employer providing workers cam ensation for my employees working on this job. com nnv name: Cw G address: city: aUA ArV L t i hone ' 'V insurance co. ylJ Fo niicv# wV 0 /Q/////////%// �!////L/ //��/// /✓/////////////////////fir////%/.://i, ❑ I am a sole proprietor, general contractor, or homeown r(circle one)and have hired the contractors listed below who have the foIioning workers' compensation polices: comonnv name• address: dtv. ohone#t .. insurance cm .... y.>. .1////G//// comnanv name' >;: :: ;,...:•,,:..:: :..*x:.<;..;:.: .,. address: city- ... phone#i insurance co. oMW# : }:<: >::: :»'^'»:•... ., aI %%%%///%%%///%/��///%%�/G%% / FaIIurc to secure coverage as required under Section 25A of MCL 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of SI00.00 a day against me. I ttaderstared that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. 1 do hereby terrify under the pains and penalties of perjury that the information provided above it true and correct Signature 2eDate /"/ Print Warne: e ot4- !ae- r Phone Ccontactperran: nly do not write in this area to be completed by dry or town ofildal mob va town: permit/license M Mudding Department ❑Llcetuing Board mmediate response is required ❑Selectmen's Otflce ❑Health Department : phone#; ❑Other 1 information and instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for tliA: employees. As quoted from the "law", an employee is defined as every person in the service of another under any con - of hire, express or implied, oral or written. An employer is defined as an individual partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the rece:z•e: tr utee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds c. building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renews: of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the . commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. MUFF Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and :,supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you :are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and pr aed 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 PIease be sure to fill in the permitllicense number which will be used as a reference number. The affidavits may be retuned io the Depmtmeat by maul or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The DepartZneat's address,telephone acid fax number. �,,'��, . ":�, '°� � `� ` ``. � _ �-�'°��•,. The Commonwealth Of Massachusetts , ' Department of Industrial Accidents Once of Invesduanons 600 Washington street Boston;Ma. 02111 fax#: (617) 727.7749 phone#: (617) 7274900 ezt 406, 409 or 375 J 9 �' � ✓�'Ca,QdGU^�ucae� _- I )MI-1 IqF t�caVf lhl_lU I (,ON I I:hc..TOW2 I�L.I:� f l I:hT I ON ta0<ar l Idi.rIsa ,nd SLr�r�il�,t J Once A-,hk-An t 0ll ('1 ac:e R<,l-gym 1 .:i0 1 Boston . MasFiachusetJ , 021.08 HOME IMPkOVEMENT CONTRACTORF, i t „t:.i t:�ii 06/24/00 t;l,�i :t.rat ion 1.0101.4 ( ype - PRIVATE= CORPORATION CAPE COD HOME IMPROVEMENT SPEC . Robert. A . MacLaughlin 25 Iyanough Road Hyannis MA 02601 c Ale l�'OII[/ItOINIM(LGlI7 6`J• •'^`�^'"`� BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 010350 Expires: 07/23/2001 Tr.no: 11071 y. Restricted To: 00 ROBERT A MACLAUGHLIN - 25 HARVARD ST /•��� S YARMOUTH, MA 02664 Administrator TOWN OF BARNSTABLE -1 CERTIFICATE OF OCCUPANCY PARCEL ID 309 212 GEOBASE ID 22505 1 ADDRESS 130 NORTH STREET PHONE f HYANNIS ZIP LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 84310 DESCRIPTION OCCUPANCY #79698 CC ORTHAPEDICS & SPORTS PERMIT TYPE BCOFIT TITLE OCCUPANCY/TENANT FITOUT CONTRACTORS: Department of ARCHITECTS: Regulatory Services TOTAL FEES: $75.00 t.. BOND $.00 ` CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE, , O * BAMSTABLE, • Mass. 039. RFD MA'S A BUILDI IVISION BY --Z DATE ISSUED 05/23/2005 EXPIRATION DATE VI k, -TOWN OF BARN STABLE " BUILDING PERMIT PARCEL-,Ip 309 2M GEOBASE. ID 2250.5 `ADDRESS ; , 130 NORTH,.,STREET PHONE .nt HYANNIS' ZIP — LOT' $I;OCK LOT: SIZE ry pp DBA. - ,- DEVELOPMENT DI STRICT HY PERMIT 79808 DESCRIPTIONFIT_�OUT CCU. ORTHOPAEDICS &SPORTS` MEI?ICt�T PERMIT' TYPE BREMODC TITLE: COMMERCIAL ALT/CONY CONTRACTORS: ROLAND B CATIGNANI Department oft$', r ARCHITECTS; Regulla4ory4 SejrWtices TOTAL• FEES: $829.00 ttlE BOND $.0.0 �{. CONSTRUCTION' COSTS-` $90`10 0:00.00 437' NONRW./NONHSKP ADD/COW 1 PRIMATE, r ,. B'U D ISION - .: DATE; ISSUED 10/04/2004, EXPIRAT:ION DATE; THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- PERMITS ARE REQUIRED FOR (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. r ;i I: BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL NSPECTION APPROVALS /97 QL/7140 . I 2 2 2 .. i I 3 A Al c j 7 ©� 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT /, (J n t l/i 41 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL i WORK SHALL NOT OCEE UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPEC-i IONS 1NDICAFED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE ORWRI17EN NOTIFICA- TION. NOTED ABOVE. TION. ST('WN OF BARNSTABLE BUILDING PERMIT APPLICATION I t �tx M,ap 3 °I Parcel Permit# t7 7 ' ��18ra �.le• �st�V'�a<STC�BLE Health,Division Date Issued 10/� 4r Conservation Division T s / `U I t �7 ''j ' � Applicatio ee o� Tax Collector Permit Fe' e 9 ® 0 Treasurer Ll 9 1,011 V iS10 ! Planning Dept." SEWER ACCOM Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village Owner L4,4ar-Cr a�'. w i o Avo - S AAky�JgAddress /go Nam - V' j/,�1�/.t/1 Y.W..4 I Z60/ Telephone Q9 115-Sa 89 Permit Request YYCD1 ULZ 00:1G6_ 577--_& OP Xfty 05�'.: i—A// SA� %a�Y�✓ - o wgw rpvs ,� Square feet: 1st floor: existing a&" proposed Reab 2nd floor: existing — proposed Total new sF Zoning District Flood Plain Groundwater Overlay Project Valuation noo, &W Construction Type 66 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: 0 Full ❑Crawl O 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: Utas ❑Oil ❑Electric ❑Other Central Air: 11"Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:0 existing ❑new size Pool: 0 existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial 9d Yes ❑No If yes, site plan review_# A/o-r Aawi*c agw ix rYx4i(0_ Current Use 41,41c*t- Z,6- Proposed Use A4VI 41 L d7r/6 / BUILDER INFORMATION Name_L� ✓ �'� Telephone Number Qg -8ff s Address Pb License# CS Dos/�7 Home Improvement Contractor# Worker's Compensation# $36 n/3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO rC l7Z tZJ__ IAWKTP1 9-5 W- l�' SIGNATUR DATE o't7 FOR OFFICIAL USE ONLY �c PERMIT NO. - DATE ISSUED MAP/PARCEL NO. ADDRESS - VILLAGE OWNER DATE OF INSPECTION: " r _ , FOUNDATION FRAME INSULATION ; FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH 9"' FINAL FINAL BUILDING '''"� ell Al 0/< DATE CLOSED OUT ASSOCIATION PLAN NO. x I COMMERCIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $150.00 Alterations/Renovations $100.00 f O d- 0 0 Building Permit Amendment $50.00 FEE VALUE WORKSHEET NEW BUILDINGS square feet x$140.00/sq.foot= . x.0081= ALTERATIONS/RENOVATIONS-OF EXISTING SPACE., square feet X$96/sq.foot= O�J' d .X.0081= ' STORAGE BUILDINGS ONLY square feet X$32.00/sq.foot= X.0081 Commprojcost Rev:063004 Sl ery 40 GROUP;,INCORPORATED CONSTRUCTION CONTROL''AFFIDAVIT:AT PROJECT INCEPTION' Parcel Number Project Name: Project Owner: Cape Cod Orthopaedics and Sports.Medicine Project Location:-.ion' : North.Street;Hyannis, MA f`Pro ect:'Tenant Expansion to Pro e 'Medical Scope o . J. p fssional Office Building: In accordance with paragraph.116,.0`of 780 CMR,,the Massachusetts State.Building Code,:I. David Vnchon Massachusetts Registration Number 7477 being a Registered Professional Architect:hereby certify that`all architectural.plans,: computations, and:specificatons, and changes thereto; involving the subj Oct.project-will be prepared by or under the direct supervision of a Massachusetts Registered Professional Architect and bear his or her original signature and seal as defined by,Massachuse'tts General Law (M.G.L.) c 112; $81R. I further certify`that I Will be present on the con' struchoi site at intervals appropriate to the stage of construction to become generally familiar with the progress and quality ofrthe� work to determine, in general;if the architectural work,is`being performed in a manner consistent with the construction documents,.' . 8 _ Architect�(Origin d,Steal) Date • . DAV16 J.. VACHON N 1479 WHITMAN � 00f�► Home,Office: Hedges Pond Crossing, 2277:State Rd_, Suite H -.Plymouth, MA 02360 Mailing.Address: P.O. Box 278 + Sagamoee Beach, MA 02562 Phone: 508..888.6555 •, Fax: 508:888,6566 :. The Commonwealth of Massachusetts _r~ Department of Industrial Accidents' 660'Washington Street 1 Boston,Mass. 02111'. V Workers' Com ensation Insurance Affidavit-General Businesses r•J,xSr.Dr. :.�µ;r!"f„y;�`r'�y, .. .'s^ 1: .:3.�,+1m'91 name: •_ .. .. •.�, , • . ;; ._. •. address: ci - state: work site iocatiori full address): I am.a sole proprietor and have no one Business Type: Retail❑Restaurant%BaT/Bating'Establishment ' working in any capacity.❑ ( ❑Office[I Sales(mcluding-Real Estate,Autos etc.) / } El Other 'I am an em toyer with � em to ees full& art time . F 1 employer providing WYprkers7 compensation for my employees working on this fob. com an' 'jai. •`. ti,� just• r:ii. '�,:. fa.. '1''•,, " ' sddre'ss'' � •, t..5. , Swai,. _ ;fnsurarice.cos.:...•.:4 .. ., . I am a sole proprietor and have hired the independent contractors listed below who have the following workers' .compensation polices: • • ,'\'tip.' ♦. ,,'•`;.^''t' .' ,4•:t •r. ti ID}'9II IISme. y..: address:. •ti• •'4.;,; ',�:'� .i• :'j .i,,. i;/:L.S.:,' .4.'.'�?`._t•�:'.I"Yef i`, 'OAC' :}r'' .r•�i''a y,�:• L 9.• insursnce'co. %//%////////%%//• y;�'•:j•::a 't�. :rY: ':,,;, '�;� :M ':r:; `;,.. :r:% °ti+ri. ..i'i' com address: ; Ci. ;•,— - tii,i .:bs.•..•. a:4:: 'd.•.,.� '? +'. 'L'1::+.'t'i y;'• :!_ i'••6' "^•'•• ':5:1'` •:<:".4=,:�.s •^ ••NCO:•':• '•i:^" :c'.•., ..,:�: LOZICY:,Y'i'. - I iiSsiiraace - ///A Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one years'impr{sonment as well as civil penalties!n the form of a STOP WORK OPMER and a fine of$100.00 a day against me. I understand that It copy o}this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby erti near t pai s d pe ties of perjury t the in arm on provided above is Prue d cor ect Signature Date a3 Print /� J f GPI✓. Pam)l0� Phone# official use only do not write in this area to be completed by city or town official � city or town: permit/license# -[]Building Department _ ❑Licensing Board ❑-checkif immediate response is required ❑Selectmen's Office ❑Health Department contact person. pbone#; []Other---- (revised Sept 2003) Inforniation and Instructions' Massachusetts General Laws chapter�152 section 25.requires all employers to provide workers' compensation for their. employees: As quoted from the law', an employee is.defined as every person in the service'of another under any contract of hire, express or implied; oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a�joint enfeiprise, and including the legal representatives of a deceased,employer, or the receiver or association or other legal entity, employing employees. 'However the owher of a trustee of an individual,partnership,. dwelling house havrng not more than three apartments and-who resides therein, or the.occupant of the dwelling house bf - dwellianother who employs persons to do.maintenance, construction or repair work on such dwelling house 6r on the grounds or building appurtenant thereto shall not because of such paployment.be deemed to be an employer. MGL chapter 152 section 25 also'states fhat every state'or local licensing agency shall withhold the issuance or renewal of a license or pern3it to operate a business or to construct buildings in the.commonwealth for any applicant who has not produced acceptable evidence of-compliante with the insurance coverage required. Additionally,neither the ' commonwealth nor.any.of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with tLie insurance requirements of this chapter have been presented to the contracting . authority. Applicants Please fit] in .the workers'compensation affidavit completely,by checking the box that applies to your Situation.:Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted ndustrial Accidents-for confirmation of insurance coverage. A.lsoto the Deparment of I 'be sure to sign and date the ' affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Departrneiit of Industrial Accidents. Should you have any questions regarding'thd`law"or if you ate required to obtain a workers'.compensation policy,please call the Department at the number'listed.below. ONE City or Towns . lete andprinted legibly. The Departmmt has provided a space at the bottom of the Please be sure that the affidavit is comp affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fain the permit/license number.winch will be used as a reference number. The.affidavits;may.be'.returned to the Deparment by�of FAX unless other arrangements havebeen ma The Office of Investigations would]five to thank you in advance for you cooperation and should you have airy questions, please do not hesitate to give us a call.• The Departmeirt's address,telephone and fax number: . , The Commonwealth Of Massachusetts• Department of Industrial Accidents . 8f�ce of tevsstl�atlens . 600 Washington Street Boston,Ma. 02111 fax M (617)727-7749 phone#: (617) 727-4900 ext:406 08/24/2004,_14:36 5087751414 CAPE COD ORTHOPAEDIC PAGE 02 03/23,`2®04 ' 1,,47 5086886566 QDNSERV CROUP INC PAGE 02/07 Town of Bayrn$table " RegulWrY 86rVices m ' Ttrm�exrYy�'sdlcliit�CQ�do�.r . �,GQ ►�c�at, gyaar�,�0260 i . . yrrrw.4atrnfiaraxti►�leara�ui . prop ()wmr Must mVicte and Sim► , r ex If using A.l� d , (7) Y e h F 1 J m u'- OW=r Of the sbla�t proparty �11 r gsdw to votk at&oima b7*is baft 't:s pkc�ti� ea 10 _ S r , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �t Map V;ivision Parcel Permit# 7 SHealt Date Issued ? o Conseion Division Application Tax Collector Permit Fee PS4 Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address �J 0 Mo 12%m ST DQ-- PkA& AJC, SO 1'�c, Village Owner CAR'-- COD WcALXt CA4ILS,_ Address Telephone Permit Request 1 NO i2-- 9-A,00 V At-T""IONS �'�. V_- A14W N W� 1Tet _ Fo 2- " T .1lRtif�S C Q4 — C�c� me�__UA_,o Smell_ Ji_,0QS .10 Square feet: 1st floor: existing US 11 10D proposed A' 2nd floor: existing proposed Total new Zoning District--�� Flood Plain Groundwater Overlay Project Valuation b Oc> Construction Type Z� 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: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION " —' O 1 1b U Name L-- AJ Telephone Number 1,61-3-k7_-- It 00 Address ��� /1'l�{_�V 1 VL5L_ LXA-9 License# C—S C)-f LINJ IVGTOYL) A" _ 01-'4,7A Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �VZX .$Ov �. `C "k)S SZ-�4�'i 0 A SIGNATURE DATE (4c>13b Oct, +. FOR OFFICIAL USE ONLY l w i - PERMIT NO. 1 , DATE ISSUED MAP/PARCEL NO. y y ADDRESS VILLAGE OWNER _ DATE OF INSPECTION: 1 FOUNDATION FRAME INSULATION FIREPLACE f ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL f GAS: ROUGH FINAL FINAL BUILDING r DATE CLOSED OUT ASSOCIATION PLAN NO. c s _• J �tb fI��sd�iiP_Q. �S ifi7esligg&ggs 7>� 60v 3�¢sitin�ton Y _ Stre-0t �> 113.G on, Mass. 02111 CompeasatiOn Insurance AfEid_vit . a•_'t•ra�a�7 r� :arm�r;nrr--'_-_ .�. +ar., a..nz� _ moo, name: L T N B E C K One Ma�iir_e Road LP inn'-on MA. 02421 r 787.-372-1100 1 am a rtcmeowner performing all work myself. I an a Sole proprietor and have no one working in any capacity Q I an an employer providing workers' compensation for my ernvloyees working on this job. L I N P E C K d�ra_S. One Maguire Road rj('y• Lexington, MA 02421 j phone J 781-372-1100 instr^src* Zurich US 209090204 eff. 12/7.0/03-1.2/2(1/04 L� I art a sole cropretor, gener'1 cast:ac,or, or homeowner(c.rc!e one) and have hued the conyactors listed below who have the following workers' compensation polic`s: ca,ytnanv na ae N/4 (subcontractors not yet hired) addr1" in mw rn nc--'(al n019 •,omnanv d d rm-1: cirv: in��r:nre-n ,,nalicvi! etat•a aoatuoaa��L���nr. _ niture eo secure coverage as required Unaer,)ecuoa:5A of 77 i:z" can lend to the imposition criminal lrte •�e�r` iman as prison weiI Q° on o peaalhes of Ifinc up to�`:, OO.UO anddor as civil Pennines in the form orm of 3 S rr CPWORK ORDER and a fine of MOM a day against me_ I und a cony of;his statement may tie forwardea to the Office of Invesngations of the ;tA for coverage yeriGeation. erst�nd that da rere�v ^,IJy llnt{Cl 7Q[ ur' �enQftirr of perjun_,:liar:'ee:nro'rrr=iorr crovided above it true and cc �a ,r iencturc '! 3� V �,t �-- -^'lt .game ?honer :ut+c:a1 ae tnty :;o^ot +nte in this area to�Ic amotcted by c try rr;arm otTivat r'nw ccrmtt./licenae4 3 '? widinQ!Jcnir;:ncnt —t icrr!ir.? 3o2ro — :sleet: -`.'lmrc:arc r_<ronsc �. -coUtrca -Q _ �Hc_ttn [�cnartmcra Q .,[lone,q —(;Ihef Tows. of ]Barnstable h� Regulatory Services I sARNST -ZLI, Thomas F.Geiler,Director KASS 9� 16J91 Building Division ' Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 office; 50&862 403E Fax: 508 790-6230 Property Owner Must Complete and Sign This Section If Using A Builder - - ,;as.Chunet.,ofthe.su*Ctptopertp- .-....._._. .: .... hereby*aut�-otize �_`�l �,e,�„Y�,._.'�, '.�. '..- s:' ���Y� .. . . .to act do�.�b.ehaL,. • in rnattets telative to work au hoiizedbp.this buuding•pe�tt-applicat.on--for. T�AA-V� (L NNr\j Sven (Addtess of Job) tote of Ownet ate J Pint Name I I ✓lie �o�rn-aizcuea/�,li ``�aoaacl BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number:, CS O44609 Expires: 10/31/2005 Tr.no: 12055 Restricted: 00 WARD J JAROS 25 CHARDONNAY LANE PLYMOUTH, MA 02360 Administrator COMMERCIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $100.00 Alterations/Renovations $50.00s0 .c d Building Permit Amendment $50.00 FEE VALUE WORKSHEET NEW BUILDINGS square feet x$140.00/sq.foot= x.0061= ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet X$96/sq.foot= a?i O O G X.0061= STORAGE BUILDINGS ONLY square feet X$32.00/sq.foot= X.0061 r p Thom Mitt Romney �, Com ssones Governor Hopkins Thomas P.Ho Kerry Healey Director /�� ���OD�2�>222 Lieutenant Governor ` www.state.ma.us/aa Edward A.Flynn Secretary / TO: Local Building Inspector ✓ Independent Living Center Local Commission on Disability Complainant FROM: Architectural Access Board oq r r RE.; Cape Cod Hospital Rehab 1 130 North Street Hyannis DATE: 7/14/2004 Enclosed please find a copy of the following material regarding the above location: Application for Variance Decision of the Board Notice of Hearing Correspondence' Letter of Meeting Stipulated Order First Notice Second Notice The purpose of this memo is to advise you of action taken or to be taken by this Board. If you have any information which would assist the Board in this case, you may call this office, or you may submit your comments in writing to the above address. Thank you for your assistance. A i ® = CAPE COD HOSPITAL REHABILITATION CENTER An Affiliate of Cape Cod HealthCare July 9, 2004 Gerald LeBlanc, Chairperson The Commonwealth of Massachusetts Department of Public Safety Architectural Access Board One Ashburton Place, Room 1310 Boston, MA 02108-1618 RE: Cape Cod Hospital Rehab, 130 North Street, Hyannis Docket Number C04 011 Dear Mr. LeBlanc, Please be advised that the work regarding the reported violation for the above referenced has been completed and corrected: Section 30.7.3—Height: water closets shall be 17 inches to 19 inches (1432mm to 483mm) high, measured to the top of the water closet seat. The complainant reports the seat of the patients'toilet measures sixteen (16) inches. .New water closets have been installed at a height of 18" as required under Massachusetts law. See attached photos. If you have any questions, please contact me at 508-790-8376. Sincerely, Patricia I. Wolfe, PT MS Administrative Director gp EARCHITECTURAL SAFETY Enclosures cc: Cape Cod Healthcare Rehabilitation Services 130 North Street, Lower Level BOARD Hyannis, MA 02601 508.771.9600 Fax 508.775.1753 www.capecodhealth.org X� 1 yw_ eyt? Y i, It i+ '�• f j + t ,tvr t •(q yr+ tiij,�i ::: s '`��r w. t r�, �•S,F,e ��n'� rub.. his. N y; yv r ���` .�yx�$�"t �'....�, �7�j k�.�'a*e;�y Cj,�,ar Fti� 5�„sF a"�.. - � r. ��y a'tk 7a-. ,•:_'"�� �'}�,.! �)t ;.,,fir `r�'sk„�`.11;9Y; �A�'""�,.4"f�` t't .3J,�x� � . 1s7 t�- nr.`vtc ri;pMT'7.Y4x',.�'' r y •�, t y a+ -*'r s C° rytyat'tGF'� '*'r � e.__1w' "",�.:s �G�•. ,M i •! 4 •.'T*''�i u` '� e-4-'#h}.:i'a� i "a. :,''tit";: `' `: 1.f"'ka�`• .,._;.: 3 Er,` .f'.. 5.,xx��5}t. .i`. �;�e x tC„'�,`' 5vi - +fr. 4t y ik'�"a.�*" �'P;'�. '++,'X.u � tw',. ''u,.tf,�a.a '��.iD" .g J"- -r_• +'�'.4��+,- -F"�',.g 5a��,'� X'F"�. �''z`'v� �`a '�rrra�"xc,�[' f"�x'Xt�"'•..'",`�'`�a �c a*���'��t � �#"E„v�,��.,�`'��, s< ����`' �ar '� ..p ra'M�3,i!`,."� y � `k F'._ ' a * �• { 4 3 rFz is ir�"al*dfi� ,; alb a "U »�,,. : 'c ✓ .!"ad#�`'.•ix v,.t�$!,'s�N ti x3-°.;l,.y A +M�' '0"3�r ;, zz�aus+�r,''k�"'%:v�a` ,xS� .. ` �, , 74 �, ,'��# RP �7.+ "t `C,'z:. E TM`` °s,� `µ••x ��r`{�'c. t gs;q,:a�1`x ,'r.,;rr,�...sl.£.sa {.y1Ts m t�..y�c .F i.:tiw 5!�." �' '. %; " "�t •p" tz"S#c ., �` es .s n'k4 "a'k ue �'s� .{p'* •!4` e*{in x ar .'st. 33 +. '�"kw c A�+� ad ` 'a.yak,',.. s tf-. r'•ky,'�i'te{'r ➢J�r �''�t t� .._£� �. .�s a+1;3��..`�T��'�,I�f� ^�x>udpi'"-�y�:xyx,'��i 11�,���iZ'��1.r�r � ,�#-�3t� vtrs? t'Fia� '��:'� :,rc�iP 'sx�y�fi' �x`r '���x #� ' 'tier �'.? ti•.,a4.rw `ssh,'c' •L� t'+ - S}szW .�T .rr =,', 'a; xv.` : �t ^"t 'x^ �5�'i7`' 'ewi >?3'�,, � W^',�t.` ,�."=:sy cure, s •'�rrx� c'3 -f`�kr 4 n±'p,"�..- a`, °#.• - s->,-C ��:>.� ,q�. k �F A..a .ys { Nk� ,r A}�.k� { ..�€1,.���y;7 >t #;.��;'. rt ;, �..:: 5 'rT :btu";" x 4 �':sr `Y, x[[h4,r t' h fi..' 'f Er_,,' #C.• . * s s9: �r"�i4:.uu+ die a'k;F''� �,` �,' .��,"• Ya. n.. `t•,y�1 wll a',,C"y1 -:";,e '. n;', F� i. ' t,., .,*. :.�.,s ,r S}�.y�, u#' 4r {t" ? v+ 'q. �• ' '+ s ,z�. m�.#. .� x sf-'�•.�,,�'r .h.'f'+' sx [^ &. ..?•7 I 'K c £ 17 �a. k! 'L�a' y�ytS y�i+ .� 4 e r 3 4 ,• , y Y 4 a ,c.' .i5 t e. �- "'.YY[i' fit• wt, i � � r ter♦ �� � '3-r � s�Ac�'"' . t � ��z TI,. 4 f Y�C go 0 � XY10 0210�xoxp Thomas G. nr P.E Mitt Romney Commissioner Governor Thomas P.Hopkins Kerry Healey � ���OD�2d�222 Duet or Governor Goveor www.a to t s.f na.u sla a b Edward A.Flynn Secretary TO: Local Building Inspector Independent Living Center Local Commission.on Disability Complainant FROM: Architectural Access Board RE: Cape Cod Hospital Rehab 130 North Street Hyannis (� DATE: 6/16/2004 4 Enclosed"please'firitl`a'copy of the following material regarding the above location: Application for Variance Decision of the Board Notice of Hearing Correspondence Letter of Meeting Stipulated Order i ✓ First Notice Second Notice The purpose of this memo is to advise you of action taken or to be taken by this Board. If you have any information which would assist the Board in this case, you may call this office, or you may submit your comments in writing to the above address. Tha'nk:you`foryour assistance. 762 � , r/ 2210P�6�� Thomas G.Gatzunis,P.E Mitt Romney Commissioner Governor �60/1717 Thomas P.Hopkins Kerry Healey Director Lieutenant Governor www.,tate.ma.us,aac Edward A.Flynn Secretary June 16, 2004 Patricia Wolfe Docket Number C04 011 Cape Cod Rehab Hospital 130 North Street Hyannis, MA 02601 RE: Cape Cod Hospital Rehab 130 North Street Hyannis Dear Ms. Wolfe: Upon information received by the Architectural Access Board, the facility referenced above has been reported to violate M.G.L. c. 22, § 13A and the Rules and Regulations (CMR 521) promulgated thereunder. Reported violations, include the following items: Section: Reported violation: 30.7.3 Height: Water closets shall be 17 inches to 19 inches (1432mm to 483mm) high, measured to the top of the water closet seat. See Fig. 30e. The complainant reports the seat of the patients toilet measures sixteen (16) inches. Under Massachusetts law, the Board is authorized to take legal action against violators of it's regulations, including but not limited to, an application for a court order preventing the further use of an offending facility. The Board also has the authority to impose fines of up to $1,000.00 per day, per violation, for willful noncompliance with its regulations. You are requested to mbtify this Board, in writing, of the steps you have taken or plan to take to comply with the current regulations, Please note the current sections may be different from the sections that are cited above. Unless the Board receives such notification within 14 days of receipt of this letter, it will take necessary legal action to enforce its regulations as set forth above. If you have any questions, you may contact this office. Sincerely � Gerald LeBlanc �b , Chairperson cc:Local Building Inspector Local Disability Commission Independent Living Center Complainant I ~® ®®� CAPECOD HEALTHCARE coo Ply' ®vp Marcia L.Jones Corporate Risk Manager January 27, 2003 David V. Lawler, Esquire 336 South Street Hyannis, Massachusetts 02601 RE: 130 North Street Building Dear Attorney Lawler: Attached please find a letter from the Town of Barnstable's Building Inspector, Ralph L. Jones, regarding maintenance issues with the walkway at 130 North Street in Hyannis. I am forwarding Mr. Jones's letter to you since I understand you represent the owner and can see that the issues are addressed. Sincerely, Marcia Jones A/HA CRM Corporate Risk Manager cc: Ralph L. Jones (Town of Barnstable) Enclosure 88 Lewis Bay Road Hyannis, MA 02601 direct 508.862.5031 fax 508.790.0030 e-mail mjones@capecodhealth.org oFt Town of Barnstable ✓q�1 CAB Regulatory Services <'ooBAM 9� 1639. 'OTfpMp�A Thomas F. Geiler,Director JAN 2 4 2003 Building Division Tom Perry Building Commissioner MARCIA L. JONES 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 January 16, 2003 Cape Cod Hospital 27 Park Street Hyannis, MA 02601 Re: Spaulding Rehabilitation 130 North Street, Hyannis Dear Sir: On January 14, 2003, I received a complaint from Mary McGrath of Connecticut. Her mother had a hip replacement in November 2002 and was having rehab services at 130 North Street, Hyannis, when she fell while using her walker entering the building. I inspected the brick walkways and took several pictures. The walkway leading from the parking lot to the employees' entrance on the west side of the building has several areas where the bricks have sunk over 1". Please note the enclosed pictures. Please have your maintenance department place safety cones on these sunken areas and repair the areas when weather permits. Please contact me for reinspection when you have completed this repair. Sincerely, t;2 Ralph L. Jone Building Inspector Enclosure p� Corporate Offices ❑ p p CAPECOD HEALTHCARE w p r 88 Lewis Bay Road,Hyannis,MA 02601 q 'M64I„A„ .�.POQTAAif ° 6033 4 Ralph L. Jones Building Inspector Town of Barnstable 200 Main Street 4:r . Hyannis, Massachusetts 02601 /� �> f; Gii• :3 :� Y;, f�. i .. '� ... i J { k I '� i 1 s ,;�. III f. a � ::_ ,„� y \ ,,' ,� / _ ��. 07/01/2004 09:14 5087786448 HYANNIS FIRE PAGE 02 ANMS FUM DEPARTMENT 95,HIOH.SCHOOL RD. EXT,HYANNIS,MA.02601 qY" ►A, { " ; HAROL® S.+BBRZ RON�ELLE, CHIEF -EP PRE ON BUREAU BUSINESS PHONE:'(508)775-1300 FACSIMILE PHONE:(608)778-6448 - I'T.DONAW IL CNmcpLs an LT,ERIC F.lKV8LE1k,Cn FIF[LE P1 iV'TION.®I:FICElR Fl" PREVI M-ION OMCEYt BUILDING CODE COMPLIANCE FORM THIS FIAT PREVENTION BURL-AU.HAS REVIEWED THE PLANS DATED FOR THE PROPERTY LOCATED Al'ALSO KNOWN- AS:- C kPF' � L_Jx C --- THE CHART BELOW INDICATES. THE STATUS OF OUR REVIEW: '>'Y C1F:'CID T°R IQN, UMENT NA RECEIVED REVIEWED COMPLIES :2�FIRE1 HTIf�}f f' t 11 1-HYRA N1.l:b,ATICJ. /VVAT 4SUf? uo f�LY v 4 P yl'NKLEA'S $ ". 8 '" 5 SPFOi�KL.: l CiNTFhOI' QU10?MENT Fx5Tx1NfJF�I;PE;S ,STE`91AS 71V*. 'bPIPf .:VA"LV. ,LQCAfI I3� dFit~' OAR 10-F.P.S,S. &I+UVNI IVI~IATOKLOC-AT.ION' " 11-SMOKE CONTROL/E"UST 12-SMOKE CONTROL EQUI0.'L0rATIQiV' 13-LIFE:SAFETY SY$'rt~ ,RES 11z•FIFA IXTIOGUISHI 'd 3Y 'EMS 15-F. .8. CONTAO.L.EQUIP LOCATION 1 ;.llfr pi#t1'I~CT I„N FiC1f3NlS . 1�FIRE PROS, CfiICyN QUiP S143NAGE 1 P±LARW TWA14WO6SP0 METHOD 15-$EQUENCO C F60'ERATI0N!FlEPORT _r 9 " ' �O-ACC>rP7ANGE TE�TINC:�Rf�'E�IA ---_-.-- WE BEL•.I�V ,T E b0C M N7 MP ETE AND.COMPLIANT FOR THE ISSUANCE OP A BUILDING ( r O WE HAVt COMPLO-1 1-° ACCI✓PTANC G FOR THE.OCCUPANCY PERMIT AND BELIEVE THAT WITHIN THE SCOPE OF THE BUILDING P�FtRW1T,1'HE ABOVE 15S1JI"S ARE IN COMPLIANCE. FTHE loy, Town of Barnstable O s B"NSTABLE. s Regulatory Services $ AtFD►AA'�p Thomas F. Geiler,Director Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 January 16, 2003 Cape Cod Hospital 27 Park Street Hyannis, MA 02601 Re: Spaulding Rehabilitation 130 North Street, Hyannis Dear Sir: On January 14, 2003, I received a complaint from Mary McGrath of Connecticut. Her mother had a hip replacement in November 2002 and was having rehab services at 130 North Street, Hyannis, when she fell while using her walker entering the building. I inspected the brick walkways and took several pictures. The walkway leading from the parking lot to the employees' entrance on the west side of the building has several areas where the bricks have sunk over 1". Please note the enclosed pictures. Please have your maintenance department place safety cones on these sunken areas and repair the areas when weather permits. Please contact me.for reinspection when you have completed this repair. Sincerely, Ralph L. Jone �Q Building Inspector Enclosure Towns of Barnstable N�P�oF row Regulatory Services Thomas F.Geiler,Director 9 BARNSTABM KAM Building Division �'01Ep Mpi p�0 Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038, Fax: 508-790-6230 COMPLAINUINQUIRY REPORT Date:. mu Rec'd by:_ .5 Complaint Name: �'(—�, �C,� Map/Parcel 30 & i Location 2, Address: / J Originator Name: Street: fl Village: State: Zip: Telephone: -7 2 d Complaint Description: csw 0P� u _ � c s �?Chi t r lM cr.` ,Q arm r-9 ,�,� - YY►�r�nu �1D )G 1/6� S Q,1 :2 J4 q62,c 1V Y`M4 �a "-4 IV1 C" Ilk F R oFFicE E ONLY Inspector's Action/Comments Date: Inspector: Additional Info.Attached Q:forms:complaint & "1.. t -+. 3 r �wr vi �� Jr• y,.: �'VR 1. i br Ce`+ + .a. a�gzes� s r..r� - fit• S :.e ,kk +"��� /1.t!• —�L, J "'+ -sa. y i 1 t y'�•�r r t "� r -^+ rt{) 'sWl'�'4i''+�+St`.e�.. I. '�' iFs� f v.� ..�f''S,f it>4 t •,. t '. n �,� a S J �•, '�. !,L ?�t ��� t t. .�r� > ,x•n 't€r-�..e�i%��,e•r�'-{2e.w t1^"* t,''e'ix.•f y n d,r �f �,r }^w'r �^� ; : ° "y *<- J �• ! .ti a._ t•s.x r t ffx`d. ✓ �,at•> 1�-.� Y ' ,a }ti.tSL�C "a�.^� 3ar ,� s"K` .�r,'� � � f•t +� '} � t:M sL 1_ e .. y "'!1 �t 4.y h �-a "S. � . 1 �"; err `l'�Y fry,.- 't .,w ,� ''� _ ,• "{ �r l5'... n :c�'" y. i pR,"`,. i raw mac*+--�,c � t .. ��,.i'G t� ..'^r m1.� �}-�,�v a �'. T,i-•' y r�,r.; „«�.fi. ?'� � '''�y r 1 .S r 3 � .. �-4 y E.. $2. a. F '7.v�e�"1'7 h �`'Ev°t'"'L�i. `�'C" :so-(a�a ���t� 3 I•,. .Lt-'�+ » �.�"t � :' ( w �, ,• •t r� :..r{` �.ya s �», e^�' i' � a a r }� 1K 1a.,ya4++7`xf t ' ��r r ;, .^Vi G r!, ,�• �.. �✓' .t2 S -i � k� ?�A�♦+�.,4L�a1 c�' � 6 �`'' Y�•� � ��.s r i....- - c. ►�.. en'�.,..::z'.'r•.-5,:.#yi• Sri } ♦ 'a r i'<-1 .' } �,-!'wd i�r���`��,11Ry rt`;+ 1 f ti,s •'�4 t-s,,,�T Sri Ill j�'�#�,��aa}��Wx'�'+r �� �•.;� +.x l; t f.�! Y.S.; ! v:�" .`" ! ` j ! .,r,.s s ; '",r r t. 1t x• a < r ,r Ise.1..3,�,'��' r -Tr .Y ti },,. a-`)'} or-.•c.., `' t a.•:> .� ti t f s#;,tZ- 1. P �Y�2 1� >.r .i•L ".? ''`.:..' � ,�^t}��''� r s t• •3`:x y'i, 1F-... .'`.. d '4�.' 'a"�=`,.k+�i% � _'• �J ^ • �* s,...,,.Y,a�c y�• 1a�J # + �!6''m•X':!' t+s'= ` ..�.c.,,,. � - i E_ r 1 . , Y. _ 'ttt.0�"1�17saxs ua m_ 5 X - . v le > �(� ,.- ,ems" t`t ..,•*,�t,#xF3^�"'��' 'f;°j3n� ,, �, �� �r r - � r ��:;, .,.}ter wt{q.`f�4'r+..(`.'it-�` Sr�:.. dfti';rc+r��y,�f ..Rtt"7ni�.?',:`r r v e�.` .;�'"t` X�f3t?'.•w., d+�-{Y , f�`d cL�F'y� •: P"?{,ra'=�.�Jt H ts... i,� rrv.tYic M1j ' ,.+''y'i,f" ter'. S�Si`;.• ,i_c^!.h �. � t ,�. l•:.t � '•t�t vLt`.�'?ij' t"c4�„`\`"f^4rt^-,.��:t "5.y '�. r(. � ir�x f'1 a..,t�r .a�`:+k �.y�,, t7+�A:, ,,L j;,Jr ���'r`:, `•F t k ..s. �F - :-J4,,sr�.Yfi,v� ,.,tt,,,.. s3`....��t. vR#a ,_;�,f. s<�N,,.�--tt t`' �¢'r�nt.,:'�r�d�¢`�}� w;• �.t,.�1 Fil.� Y '3' t.A'a?td 't"t.'�z� «t-'�� 'w�:f�. t}.< °1S•� :c'-:4� ti'.`-l-.�V � �Z� ��.1/�;Y:1�,' t,•y�?-,. ,.t+'�1 i.s`. d.,^rt E. a,..h1�; �.� �'xx r.rY' r Ty� -F,.'�,q 44 �cs�,`.'r�'��r z�-. r�,gr �,r�,+.r,,r�y }�,`'�y.:. �',^f! L•�r. °e' '•�} lip ., :i rli. �.t". ;<'£t»t'"�.t�r,�%.'�-�• 'J�:'y:,,! ,� ,.! �,�'-',l �'�y,?.x. `A c,�,�• ..ty 'r ,1;..�^� 1'.f:�:5.�i��'F�.t�����gg��.E^�,:�:�t f '".Y�{tT/. `:� h ry,�c:� ` 4'y�.�,�� '��t� 0.��' a•, r ,,,y�` r d � `��tti � y„{�- � ,r` :?7'D ,?-'„r�" .:g •1.��_�-k`f�'t�'y7g �,�Py``r' s'..��� :r 1':t�..i'2:t. �e'`'�'t �'`%.�',k,. �"sE.`•n s; .L�•+yC'�}-'iy,:�'r.�,.�i. ��'">,':aoti�a �•._�"+..�";,,1.•'„�1 "� "�G�i�f+�..,?;.:�Y`�`r.. ;is.,1•'S'S:- �.ei �"y`',.,� `..c ,. >'F '� "gin a'd_ '"'-`r -� 3..r,'°?�,�, r'•t• x�'-�!a :;'6+^.•' s.: r."M i.«4`.. 'i•%tt k '�: �` 'y ..t�^�.�,:.,` .: '^.: µ n t!ss+�f. y..;"' J-r � "•''s i r.� '�y J 'y.�t" }� '� ;• a "r U^d V.i' g*'^ .,.f y'i .j S Sr""im,3, Itr.� "a va'+ 'y`uzyy�.�i'y�' y a 1'ryY ,ir y-e,t.r�� 7 � ?^��: °'.F'F..cp��S'_ .�—c �. e } ''-,M� 4:• }. '". a�; '�.''�,x` "-•�:'n') u ' g:-. 2c1` }.y'rzC '1.� , `, '�� •.+ :' �} -�{•F'±»r. l- .: .,+,e}„ / 1 -. ^y4 'R}�f�-% "" 7t:[}"' +e �yc1�,v,�r `�: y��- �l� e!°i ,i t� cw,y � �. a ci =G��e��k'��"^v��t'�s�^.+-�• "''y�.~`�'� k v4 pity a-��. �'• +' 4 �-X Ja. � c�:� .,�k;,�•.'`t�'�Y'�v �'�`'V�sr ♦y�,,.b ,�57,, d� •z a {".-:(`. �����• .-•�,�y� ,r � a,�. Y r rc L�, �'fe�;..,'.S t =u« � � �ros � ri+�t�«^ � ti Kt'.-"F-" 3� �� e ,r',-••:+ 1 l'A' ..t •;�<�{a�J}4'c'�1KL�, r �� }':k.�d � `° ��7. t a� �t , � cr af:+ ✓ S apt •�. v av :� ,`". t : +"'�,�. °,,,?•�" i•..' � 74 _. t y.T '�t r•''_1.," ' a . 7f`,,,i?S !y, ti ty'^,�- Yt`^: r �:1?tt k:t M j��Et am'� r -''�' P ./'4•�f F <, a �"". 'r+ ` otS rp�tY Sj -c14v' i� ASS � ✓v�yvy t �' � p !' '�tKf+�� •. �41�� tir,."�Y,�,, ...�:..t• k `�,,j. � �rn,' �. 4�'6� �R k �t„ :t y{, qX�`-1yt_� `�1'}t�{,,,y�•'t' '5.1 4'Sr�`< 1, t % 'K ryt�+ '' ��,+5i4� "y d' S" �b�% '� +! `��' h•/ }t�- "P ^jf� Vyvrt1-W �.tu 42,r 'l,"%� t / .f rV 7i1�� :1GZ! Y `"rJ' '� !� f�a t. 'c�yc 4^�l�«tk� +a ''�� �`•� `s1tt1.�g�.# '`if 1-'��.�'' +b ' `%rt �� Y `."'1 Y v� !: n'cS"3 'F+t -•1.:y.,a"ryr4-C is.� -.a�t�� . ,g��� t hp� Z�� 9 � � '..'n• �`� 2� V'" ,ce^^ 4. $i\� t r a.r'.�i� k,�, �� rs ��`'�"' -. "",ah •n ?� ^.ra �� � � s��l '� #ria�'7'� �Y,� "�ey��'*.`�,i.,��r 1,'�^,1���+f.J�,�a�'� �<�`'� 'Rtr��l 7r• > rt<•s+: ,,,a, ,+. �;1e��-^a �=�1 .9' r ,`iv t iVf'� a. '{j',+: i ;f1�D` ,. ��,'.. "�� t .� �}- ��Y��'�,���'�`' i +h,2,c�f�t Jib •� ti�r+-� 'v.19FIl.— L s t=�t y t'L�r�°,'� '�.S�.c�:�'A`A`���y�`=.1 `��g \. '["�?y.r�Pv. t�- a•r l��� -� #zp^yT'?F y� a •� � �� .r � '••��Y,�i r-'>r � ; _v, yN``�`t*?'L t- ��,='y�`�' � 4`{t,�r ��Z, '�r��".'+�r,.:�i ' _ .. 'vr' ♦.y' 3,. 1 1".�+ 4 ` Y 1N/,t'�Y�:12 �� Y'• ._'"'.�.v4r` }^.1 �' ➢ ,t+:? �� !',�ti• .a• •� !.^���,jet f t�i�r� t'i 'reu §ff'i.. t �. r�; •t dt - F t`s3 ry y�T y ke a h?} a � 5�;14 � 'fir �• *t- �'S � '�` y�� y^>•x3 1 •."ti'�, a'��r a a iX+�t. � i %.� mom T3r`.e"�i'rf I �v+. '� d gg'�- � •�,ice-"' r��.! �� '^�..�'t '"Y �r �-.. � 1� .yp.`. �t �sl.��.. c� .rt s � - { -- , 4:��ee a 5`���.-.�1.d. ". \ 1 �� � A�:� A� � ke�5e 7•s :K lan�.,.rfi�F '�M �4�� �� ±} �. +:1 f,y„�•.. .r., \ .i e) {!,, r" ` `�. �,�� 5 ''`.7 + y''t a �.• u. e"J" �' �, 'y"+'r %':�+54' y,.,. � 3.X,� f. _ ! �.`:"lt�� t 1 '*���`6, .. ��',�v�.+ y� ���"+1. "' a"f'�I b+' �,ee�y�sYN• 'W x�i �.�yti ?�i.�'yf"`�c�.T7,= 1 > +•'�*,4' J �f.. � �+J 1.`' 1 1 ti �� , kTi� r �yf s 3rr ;Jty" 7�)�E*H U •Y�+'"•. Y..l, {�r 'i ti; ', '' "Saau 'Y°i1.�' y'#r"•rt°,z.. �,�. .:` dav, � ,.,� eg�� � y,, ,.,. e1T ,TM •lr�r„'+.;,.,-i <. �,�i�ie�h = ,��ii �a�., lt�.r ° �, y• b u ,ib 4 s�r icy? .:5 �, s , ,1�.��c.,�-.m.,b,�,;t'�3��$zrht°CSir�� �,, t,-,�J'�11rti�+..�'';;•d:r.x M` '3',�„�i 1t c,�, {.: �-tr.F_``. rt t �S,a�,•+M�. - ."��.,,,� ... '1'•Xo•a,�` :i��s�.k.y.�}..,�,.<..,:{41,+,r-^5p,`:�r`r'.ML�,i#��4 'r ��, fi>`f�`�'"1'',�.a.�+1:.,. y r ,srr" �- �t _.�"` • � T Als_.s�+'' � .'q4J�K.t�;,'I';''1"'"�-,� - ,4e �'• ?�.3 *; a�*-.<•� t .k�.in. '�'$elr,•,.+�! i�, p r �.'.v,. �t '.t*rr� �..:F'rr 2.� ta. -:s f 1 �.. � .'t Al. �r. �;'�" l ..K .•;w� `✓y'�e.�,:���dir �jq;aN� ,n. ,� A..-t;ei.,� � `.if 'f�t'�,'"�p'. "?'_ ���'4 .1 S;=.r- g�r��a., ..' S�K�r.��4 ,�f'.�rsY��� ���� *' �F�y i ���,� >�*.'11t�`L s��} �'^' �.,5?, � �' 'S�-•"-�r" � � �-... ti �,._ Cit,�`g f r a3 ,�.: .� l {r+ 1"� .^Y e x .i' /fit '... � ..- ..,. �, •.� re �'htr 1 � twarFs*ri•�9P61A�.R,, i 12 FRI. r 1' ��, _ e.' a a` it t ,? hys.:•'�ip? '. • „r ,- t •�,-- �'S' r ` L aye'y# V � 4' �f s.Y"7' - !x or .«,� rya{.G,at.• !(” 1- _. rn�.��. ,�a.r.l,",",- -*n 1� �. .h1 �' -•� �4 't I+ fr r^1 •'A y♦jl�r�'�ti �4 1 C• W t'��t+.(J r.�. ?j• i... � '"L:(� n_.},. _z '°`...«;t't .f r �. ��� • �1�.i�`I \° �• Rtt=< S:;J't n ,r ,y�a�"+'si +L, ratr., "-.,tt ��J' s.x �r "' < �sf. -R9•a t:`t�' ��LR';��+` �ni�''t.l�C:•�:�4\�_♦,,.��,�� �`�n�ta�v. A�+ytk r _ i ti.► 1 i .1 -, b i 'C. ♦ f,i . )l *ti4 da � .� "tir t`" ;'•�.' ,� ' �t 7 4�`!.!#♦ �'+:' 'l�� ti�j1 al •• �\ � t, H' 1. v5',4 '�-���•' $'Str7Y�t� Kr.i�i 1�F �-.*„� - . 'ri-�� � ,d 1 'r( r �'� c"1 S - �•T ? a `a`} C � t "? Y ,`.'f ., -r+'•ti. • �;. . *,+.`'`'• -•♦i I ♦4 f 1 sr x f l`.C� A r` a 1,�, a- c ""^T'"t,"r `, 7 W "";�'... Fv,��.�} o-t 1 1 ^tR �`i1., rtSn .y`C °'��♦ ? n�.w,'� .•.� �. a ✓ �R-Wimm ' x "�3 } lt+-� 'if '-'.;t\�{/ �+�r.S� ,a•t _ y k�;¢ ry•• �y1��'t � ,•"o' �r•:" _�� �~.. MEMO pVi r �. e. �,.a •+ R -C • T iPF �5� r x ct ..i�. w a '� ti 1. `.il;ir•, r j:t.r .�+f.�t ,,py� p;`.'�7` .• l It fit. 4 ] �'j t, '�i`��xYt .+ti- -� i V„ `r �t -t�. r.. 4 �.. r y�.. ! �s xki }}irk'`+{fit h�°� 'n`"e�'`r'�t��.�+;P`'X�✓.t H+.r ``�'.. 4'� '/r",11 i �N- r`4.1 ���:.ra,. _. — � l�.t ty � � y��?•t Lt�"'+l;'.','�', .X�-"d�..'^'rt..Yr`sl��' �a�` :'°;��i.'�sr �!>R{�,P,�2*'.�.+'�n�r a.i'.rh = .3r�'.,:^.sl,�t+ �,..r; •J�'�",,,vi:*°•-��{t1� ' ,-'�;�'� �-- �/ ���� ,�y .�I4,. "� .� 5��=�»�� '�+� r. `fiT�" '�1"''s� �«��+�JrF `�'.'��`,'J�t{f�,i,J C e .. ''��';..- n,�l ' -aa» r}tgG..a. <f lf• %�.;+n:i�rl�t.. '4 •,-� �Ti-' e 'i eF t. �.-' u"'ar f.,. S u (( i •}r 1� tau' ` t,�' `i'. l` .n 3 .�'i'!"..,t•_r,i sn j. • *•, Z}'�°'� „�F+,>.'+• r 3':.c ��. ll,'i„a'•�t .._ , e,�_,,.•�`*,.,a<� �: 'rwv�s ft3C H ,.h g, �t a� `i' `I `' k _s.� ^e�� -�r,�,^+,"F sfi'�`�' 4 t i.�.✓t.vd" ,s ���jni5�•�C'+ .,.,)p7M ; :;t '1� r��'1 .mars °-,-e..,�. j»a :a "rr� ,:rr*y„at,Z`-`.." ' ' '-J ,t .a,X' }a N+,-v',,t� r*:c.ai4. `�...�,if.,f,� {'-„�' �••7. f� tr I h- �.;;�`�ti't"�� ';-•^ ,�, .�.: �, r ., �'� r '`.fa:'.�' k`## wr�4�hs.i . �S�t `'n'�" n. (Kef'� "' r.,.�� � r��• �;.tz ,.�6`,�+� �` h'`L •;s',i{'t•'a{.�F,'a', .�•�r';�?; i k��'�..�1° h .Yt 18��' .�''` t 'r ''� .�`' s''1'"'•-;'�' n.`� . {fi�av ��' 'y�7�"����'i.^-^r,'f cif :k�dY.~�.2,'. .4.;y::vy�9` � "v`'.. r�l.�k�J 'iR4 S X�yua:.�l''.a � 'Ct�4..� �t r"lt,.. r lyri�`,��•+t ra� t i;�}�Rzs.c Yt•4.r'^, �✓a"Q' .,. :t+'y llir(4�.p-iPr:'�"t�! w9''(9r Y'S ]�Y_'` � �4«� �,r �"lr�.}'s`+v`��L t c�.. y �� �r �l } y�y� Uh � :A� 'i:Y � 4' f'... a��1�� 3 F�� � '::n 4s}'��.yd lv 't•'•"{�{ �',i6'� ,'��53, „�l.,t'/;`�g��.a- �?,,<��r.A,� =cL y��t�..,,, 1y�,�"`",�i'!i -� .�,v� !e,a-.k-,- 'f ,,. 'Sr, c J:� ", ,,,�, ��� rT���"c�,�, 'd. ` '�� }�'f;B`i�*`ki i�»�l�C r.�;:^,C w'+cp'c..T �,:•r a i 4` •, �� t�,��. E. `� �> :ems.,+ � �', •�,� ., idles +"� s + + ��..es � � ��; � �iw.vers�kit'r:�r;:s.¢a .�,•.y�,Ynn + w ^i n rs�7 ,�srxe-,.+r•e".l�:�JS"fi,� _ ki"�'.. rg^,�h e, .�' f3 A rya _ .�.III �kE ,.r ,r�. ,,• � i °4 � 1 � � I � t ';� �� le.✓Ire G�J r+ 1 �• r � -fir- � � R � { r . . SS ;' � �• �' � rJ*art �� � {, -� 3.. �.. t 40'-11 SO' 34'4" 1'•8 3ltb'� b'•b 112" b'-8., 1t,4� b'4� b'4� GON5ULTATION PHONEDFFIGE BATH :4 Common Roots ROOM b'-5•X b'-r . b'-7"x b'-7" 1 1'-3"x 6'-7" W-y"x T-5k Bath `� 721/2" a OFFICE HALL / 8'-7"x 7'-5" 30'-7"x 6'-2" Maim Lobby AreaI r itir _ f//L CONFERENCE ROOM EX'�`M OFFICE OFFICE RECEPTION OFFICE ROOM O Ox M9-7 711"x '-10" 10'-2"x7-11 15'-1"x 9'-10" 10'•3 112" 8'-0 14' 8'U 8'-o V8" 15'•2 3!8" 38'-b 518"---- Office AREA 1011 sq R New Interior Partition:Steel Studs 18'o-c. fiberglass sound batts- 518 type•X'sheetrock Proposed Floor Plan, Employee Health Care Gape God Health Care / Employee Health Date: 5-2-2001 Home Improvement Specialists of Cape God Inc. 130 North 5t. Scale : None 25 lyanough Rd. Hyannis, Ma. 02601 Hyannis, Ma. 02601 �'�°��1'•0311b'��` b'•b 1/2" b'•8" —11'•4" b'•4" ----b'•4"— r a'•2 v2" � 15'•3 518" 9'•81/4" —14'3 1/2" 8'a" 8'•0" 8'-0" • 15'•2 3/8" • i • = Sprinkler Symbol; Existing Locations Existing Sprinkler Locations Cape God Health CareEmployee Health Date: 5-2-2001 p ! Home improvement Specialists of Gape God Inc 130 North St. Scale : None 25 lyanough Rd. Hyannis, Ma. 02601 Hyannis, Ma. 02601 E I _ r ,�•_, • _= a 'c •� '� , y t . i�� t��. i _ , ! � _..-• � � � oaf b a � �; • :.. ---h'—_ :. k- Q ,`� �' is ��,. �KW F: ir .q4 .-W' s JI ww �'.,a•c z � k i�per. r.... ! ! • � 1 O � I � 't ��j'{ � �. � � � � � �1—ft�YI .J�40�' +e „ q .: � •! _, ._. tic rye r �� -. ' PA 7 n OS`t xC r ICs�`..�v�d' a "_ n $ 4W `7i •. i K�:xyA'dy'y X T✓ fi `.- s•y ±. 71 '�. k::r '}.f. •r � b� ,r� � - ::t.n}"„r y;;-+�?`'?� �'a r. "+�• � � � �4ti:..r:. Aw a r .,p.e:. » +.<r.• xs.,Fa'tdllp .'aiarx - ,vY•,'� .�u' s ...'�za" M��� "`.�i'oz' � �z �`Ck C i-''Ri d y» :.' ,.. ,. ., , .ar -. :. ',-.' .` e...� ,. ��y;`,;�Ik;,; t t . �•a wr '� rs,.i»,. �,.� al� � U,.�'�-.±nr - �.''�48"y�4�_ - s •: Y '� ",�_: t k �';�g a� ,r3v'+", ,.a°" .�y��*5,. ,qy �r. ;i• v4 k �,� � t �c. »�`�- � �,>- +h. ,�k�..� � �, �. a.�, '` ? a 7k .'1 �::`e,� °yam''; - 'dka •:P $3,�• �^" c°�'i �;o-w!,:. T..,K °,+�, ,. ,� '`�. Y .. P, '°'Ssa '` - y S'� •� 3 •iP'e:.�:�.t i�' .P,.. 'ate.., ?a,-.. • Y'x'c..` ,j 4��s,,:'� �l. � -:•'1,: i t'�' _:7y' uS#' •3. `?, .r» +,. ��, � '1 ? .r_ r"-!t. 'M+ �. 'i� ' i i;ca �. rr ..+�^'� ..p m _ r ,-'ad 4:'.'_,• g .,,..•'--�„� w "'�.wr%+' i•Fx•'`".'3 - ,e 3^`.,. ,�R".. .a-"fir,. '. .. -.4�',., F ..,�•ay. � � =r� �„�'.r`t ' -' C-��. r. '� z• r .,,�i r#•• .,'.�.�Ac � ��7 a€�" •.�s s'�'r ;"" ; ,...a"` "'�' ��. '�r �' ��� '�""*�,� sb.-.�. -�. �;����;v.._ 'r�,i^,"� rY'�` t _ .�'.• �' :�.:a a'ed �-�: r`- �t.r,..:L- '^� e•"` �' :.� -`s; a rx :r ;�^ �,;�. �•+•� .� :1� -.^. ',� ,r, .5,.� r•,� `r+.����. ;� s'�&�°`y '%.�tr�<r� ys, �'" ,�.j— t�.� ��< ;," rr� r�Ft2�, ';:-', a ", � '...rs� ,�t �'+'ri;;.�'�° ki"`=}'�,�"'C .�>ir,, �-aa ,�!F,�. � ✓rsrsir'�^�"� �, s Y^�-` cy' :� `?€`'ryc Y` + .gym r: ��� -� ,t.� �' t*e w. 9. .,;j,; � m,-. �£..} Y`� �::♦ a` .",++' ,.(. 'h 3 SX4.oA 's'^`fc. '�S'�I.+�� �"- �,.�:. ;���' 'D•+4c-i:..�3d'G' ••w � y.t �,� ���s rP�"� '.: a.°M'� J �'g„�,a:` ` �8�'g� �.�,_ � �5�_'4..'-�r.s� '., r•,s,=�, ry�s'�' .�',� .'ra��'= .�.•4s-a �,.� ":. 1. : - ''�+ ?n,y .. •h�n,': r ,rL3-• ar - _'":f - _ .},�-K-tuy 5 .,,, d-,t �•:� �4} .r. w�.yytt'!,,. $4Y ,.,:. ,,...__ ,���J��}.... ,,T.7• ,A,��. �[5� �-:��? :��;" :-.;y :r. a.r ..�". � �.rr _p -, "= o� .y ..:-�. �.•'.a•-�,� :..�,. .� _.;.>.,,� ,�,r:. ,.- "- .ax �4 �'�'�, r� ,-rtrwe,.�-"-^ .ems. w £. - r>'�- - �' :..�".'��'. ,3'k.'-_-.� a �... r. -" F .. ...r. 6 e;.• �w. _6.�' -,w-..., •. -...„ ..:.s,� f 4'F'r; �:...- �'-i'' cL�:� ;_:a 5. - �r!�. > �:�y�r+� _ s ��'.%i_. i -.. ..... ,r-. +, ;jr ., �. ,t.•.:s: � �3 -.r. �. :.�„ :t JN �T' - JT Y.f- �. :�-' e+�,+.� � i••, .., ':�.•+v.• ... ». :r.:.x• T' ".�.«... .. a .,.N � '°� n wC �- ;.. ++r�. is �'. '•^.,. dy'P _ ^_,•� Rom.. ,.� ...�, , x "a.".-,., ^•�':..'wy f ...�°. ax. r..�. y::: _: - w..� yc�'i� Y.S+ ,K 4S: , .� ...._. �.a ,.:: 'fie ,rol: ,,. ., � �:.' .....a�^ .,... +�..�.. .. �.'' ��...., ..-,,.,. :-ter b'�• "�:ar ,.,r".- {�N `•5. _ :ei�'"�. _ ."�:.�.-. t. y}.ircva A .. �d•� t. cw• s.,. ,.. �xS' -. .l Sl. :MM_, •Y-"' c1x, y :ipu.- :"icy fJ ,��.�,p 1 ..,,�. ,.4�. ,.. �"�..+-.. ".E-. ...> .fiF, :�xx.::. r,erg �n' a..I' _- __ :, a�r'�E• r`a 4[- •. '�" '.�,1 _ '2+.i::.� � x �°. - '+¢ f �+���� ., r��' y, .✓iu, _..-°��'=f `h...•�.. �..t':_.rt' � '` � -fir '$�-. A _ .��+, 1...�>-"ro r4^F�/ .. ,.,, ,3-. :,:.J Sv:�u. ,: :.-3%', M„•r v: _ -,:.:., - ,; -.. .x,.x _ ., �._. «.,: i. ..., t R. ,'TSB t, :,.s n. r;•:r. .. t`:.:S = _ '�' '�� �-'�5: - ...._„° ,- r "'1., wa•nw. ,� br'. f� J��' AU�[rSCG'!tt-« .tIVIiT 41 __ 1� PA/3. C } �` e 3U.SITI Vim' A'«JS /CA(. tJ.-aC 5 5 rS%aT!: �.C�}irSC ,r FF �- y » �� 'i:�,f,' c � .. � �.� # * . .. A�s,..�..r ,�r,k�y]v Ft.�S':'.'H�. �*..r+e.., �,"4't�,R p.rP..,�.�r '•a � � �^yM!"�„�,"e`k'",� {. �r� .r ayr tY,�r+. "�*�+', � _ x .. f' r<t • E Y F t a :E tye.�i..0 .... a•.1 "�[{;K Y +ti'• - Low", •� V .��## ".,y '�a 'Cp �"; �*` c q Fy Y.�•h p •� uet �'.,n'�'`a� A r ;.y �, F E t 6t,���t�� b , }, °"• � _. �x .�h._ .:+..v.� �� _!,t p��a' ..� ,:.�"'<..,�' � 'fi;::x.�,�,. .-.' .,�" `+a �_�,9E.ka'�+•s.�73-�.1�'" .. , r 8e 't 14 Z4 A n - Tarr. V,;I ►a 116 a (� '�2 GYPSJM 80, r Ga META- ��O •'� Films �nlST nt. �Tt)c� i I, • I 't TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION lap Parcel Permit# 15 2 Health Division � � � ` Date Issued Conservation Division ' Fee` /,,29,c�o Tax Collector Treasurer 4"'PL1('ANT MUST OBTAIM A SEWER Cox,"- PERMIT FROM THE 4MINZERING DIMON PRIOR xt} Planning Dept. ► Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address -131 Village Owner — Address ,f 3 J �7;V Telephone 7 9e52 ly/ O Permit Request Square feet: 1 st floor:e�sting proposed 2nd floor:existing proposed Total new Estimated Project Cost U000��a Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: �Gas ❑Oil ,❑Electric ❑Other Central Air: Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial Ves ❑No If yes, site plan review# �C� ' Q t -S f' l��SPA• Ie, 2) V Current Use Propolsi Use BUILDER INFORMATION Name t/ 4 ele hone Number �3Pg Address License# Home Improvement Contractor# "" Worker's Compensation# W0 3 0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 47* FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. � i �; y - `,. r ... .• '{ ` ADDRESS VILLAGE r rr OWNER t07 ,� F DATE OF INSPECTIOW FOUNDATION ? ` FRAME Q�dI�UL INSULATION FIREPLACE ELECTRICAL: ROUGH.",4t.?'-'. FINAL t PLUMBING: ROUGH v, FINAL GAS: ROUGHS ZIP FINAL t FINAL BUILDING DATE CLOSED OUT {` ' ASSOCIATION PLAN NO. ' I I •'y �r.' • 1 I I ! I Wow 1 - 1:u1 •i r i/MAW, ■ 11 1 .111-• •• 11.+ .-Irl.lr 11111 I ••lll. 11 ■ .111 �. . . . . U .11 . 1 . • 1 . .Ili ••.I 1.all _ 11 .,, ✓,,IK .II\, //////%///////////////////ii%///////////////i//L//////U/////ll///i!/iZU////.%%%!i////ir%/U/i/////////////%/////iii%////////////////U///////////////////////////////////////////////////////////////////////////////// -� 11 ;11 �11111 l •d / . • .1/1 ••. r�.•1.. •.Illll-,1 '•:11 .,1 i.l II -alll . - .11.411 .11 11 - . , ly M. 4 .W fit• ,•>yty:.. ,fR �•. I RM: r 4,4::.c• I y ........////////%/////////////////////////////////////////////////////////////%/////////////////////////////////////////////��///��///////��/////�/////////////////�/�/������� ■ .111 vl . / .11 �1.1 � UI J 11111 � r11) 11 I 1111. �, I a .11 . 1 1 1 -I 1 «lll lr Y• •1 L1 1 � • 1� IN- 1 - 1 (. I . •' 11 ".1r..-+1. ►.1111.til '✓.11 1,1 I. .irCSC t J "tok, " t �'•::;+.;:%jai}�;iY`;;:a�:};•�: �,y:{;.{>} '•:x);uc:,,y.•:w?±r,.• r. . � '�{): .,�.�" .. .' .•.....;:.., ..•.::f.'t+ fir•••:; , H ... .. � :AL:.:.^::•J. .... vXdx;r;;;vS•..QiCh:�i�n'i;'/ih,�'JLiK4^3'iF.' '�i::`<:<i:v^:+?�?:v�:��lt�4��:.N�){:{.�..j:Jx.r.,:Y,.{..,{vC+7CQ:;<% .:. r,� . .;�,jfv�,. .,. wkq<:.. ;.,�}±�':j:�. .a{�:,,tJ:;`'•`':2;r;:;�)jk;n...,?..; .Y 4 i .:.r• <. •n•r.4.r.::v:.) . v..h�t'�:jj}:itj�.S:v:{fYx{:•.•...�...:};�.,(.•,�•:...r�::� .: ... y Y.�:..�•��; Y�• r.::: '•`. .. .. yy ;,,.; , ..{.�}"•;Y.%::�j:7y:::?�i i•:ti::J::3:�$i�:' ..,:tiS::rr �• $• %[f:�'. )(r,Cif �vt:Vln}• �,u•�:i<±i%{��rij�;4: }'J:4:tj Sf:•tf.\O�;<;..:vkk.. .v.L-:.. .xh 2<.>.I.., .,., ..:•��v Ar v,'�' .�^.).�",v,Y ...k {S..'::f:�}JO::n':•;:.'.7/{''i•�::. .,4' :4 �`'' .i,✓.{. �'�� �..: v.� v... . '<{ri?ti .•.?�. �:.,•..}:..±r ±{.n3�P±?:i•±yL.� �'$�:ni} �.5.{{`:jj�n�., :. r, n/ 4.i. ;: ,v .Y.M'A. R(:�..'tiv:{•'r':vYYi.. <••}„ ..:.. }.iry...S;`. � . {?' .t.M.... �'n'•rC<{Sv::;{5').:i�y n :j'�:i•Y i:J}�}.:^^:4:{v;[•.,.ij�.: r wl , 11 r ,,,o!.:. `:a{{:):j''},•:. 4'� %tx•'r •.r4�°;'y'0�+:24vtr f�.•,.,}3,,,}.; .....: •L - - H V • r �.,,1 ,:III �� !/i : .i i •,.,I_ ■ i ALUJ ■ - o ors oy ilia i�Y name: -- - location city phone 0 ❑ I am a homeowner perfoffiing all work myself. ❑ I am a sole w=etor and bade no one worldna in any O � ❑ I am an employer providing�vor3aets'comeasatioa for my employees worlang an this job. ::::::::.:.:::•.w... :r .... ...........:....:w.AY::.::.}:{S.,�v.•.t.,uw,,,:.}%^!^+'!wa.. :...at.,..:.•... {::..:.;•.'e:f;y.;:::;:::+^.,!<;�?:::,o-+'}v.,v..,..,.::.}.::..,,n,,•.,..;r.,rvv. .... ......... ............... ,tc. ...... .....}.?a.;•: ::•}}...;}:{ttt•+w}y{.»:+.a+!wr::.g.,!:.:q>+`}x;};:;:•:•;;:-!r:-:-:i;•:::-' . .. ... .. .... ...................................hr. ......v.. .. ..,t..,•;•.;...%-0}r.-.:..:.. .n•....n... ... ,..rAK.. vx{:v•f:.?•::ink}}i v}i}:':::}:;::}:::.:. .. .:.::..v::.v:::.v:•.v:;,.,•}.w.v1.t•.v, ::�U. v. .yrr {y}. .. ..,,,.... ..,.. .,}•{.}:3.;{}':r,':•,Vti•iS"}:}:�w'i:v :::}::::.v::.::v......:-:.�..v:.:::.... ::.:::;!.�. ........ .......................,..........};f3xt:c.}..}.;LtC;}h;>%.{.;utrawr....th..{ x.x.';Y` :.•:.... ..........::w::w:::.................. .... 5... .. ..%v............ ....�...:. r� .-.:.,mv. <�t {�..h,•. .:?v::h'{•'�3 w%.yxjf::i:;:{i^%!M:t{'r{{{:}�:i�^•.tv:ri?:f:v:�i'•iii : .. .... .. ................,..-...-....m...t v:::•...,.:.,..,, ..... .. ....v... ..Sn.h,..::::k: 3 A.v'•vv:.•x::::n• •:Y .•. x.Y.}7f;jri'{{' •.:x.:.{3;;:{,nt..vt...:.vvt:•m:w.y:.�::::::.::: :.:::.,.:.:::•:.::v:..................r-.-......h...{,;.;.:.;}h::iv:•:::v.... ...... ..{?"•:?:v}:.Yt•.,:{r.:::::..,...,::'},',.,`kr.,:uvn,r: , .,..yz..,v,n•..:r.,}:D�:}?:,....}`......{:>.:a:v:.............. .:f•{{{}.}hr{•:�n.. �,:?r.xW...vr.:ry,.,.%.,.r. .:.:...:::......:.v:i•}Y.•:{•:3:•:{•}'':::•:'?'C.;.::}::: comoanvname:. •.:�t.:.....�{{�r•}:•}>}:>,::.:..":: ::,.....5::::::.,.,:r.;.:,.,:...:: .. . ;?.::...•.:;3: ..,.:.:...•.:�}.,...�.::.�::•:}:,.::............:....:..:..:....:. . ••- .:,. .. '¢{. ?-:..-.... . } {myn}-•: +{v 4 :.. ..,... :::t4:iriv$5::{ti^'•i3i:..:.'.... ..3:.:+••�3%iv::?:wr.:.. ,-r} +ohoC 4'�RS,{S;• .;'.::v. .... :..::.. .. ...,......... .........................:..x......... , ..:.-...... ..r:}•t•.t.tJ x'Si{•.::77i' ....:1`..itY.{ ... v,.....:.. hw•}. .Lbw:.r.-�..?..t.:::,.i:(•t.;:::;:::::}};:-:{•;:.. .. .:::::.�. :::>:.:v.::::v:::::::v::::::.......:..,.....:v.v;}...:•:w......-x.:.....--.;. .-......;....C!f...;_,.:..........:v:+::• ..rr.•: .. v::.::n:^.SX,W.m\t:•-.v:..v.:•.:v....t. •..-1...{?%+'Yw .. ... h::r •iiM1' :3%{{Si.ti•X{v% :2_:}`.:}:ice:: . ::::�:�.::�:::.;.:........f .... .....}:5st•:;nyt,.h-:..:..a.•%3:!:-:,•..:? asa.-.• .. .}t�h .•, Siff{w:+N¢+:::`.':':'•::{f.£{:::.......... v ...addivs ,`C 'xv{,3•,,.{s,,•£•}} •:. \\.'.n_x;r ,v'{ x{v�, •a13... .... :.:OI {•x+Y:43G:i`v:•}:{y:i i-}}:i':::i:::-. ...............w::::ht•}}:?iv{3."-.:.:%}:v:,:::.:.:...,5:�+::•:%t•:'.�::.vh:,..,;..:: .tMC�C ..•.,�. K,3�} {vY:r?;'f,.t{}'•}I-}yi'-A. ..�.vA.. •. ..•�r ',:v,.•n-. ^'{{i• ....�.�::•.�................:......... ..x':••. qpy��� .., p�.p :•f�£' iv..}%•}}y':qr"::,.�::;{{•.vrw:}i%•'�i'•::ii:•%{Si:�:�Q :i::;�. ;......::•.t:::•3•{'r,'.,Y,.;:f;:!}X;ha3S;:ti 3:v;,{zv;n,'•tQ.{ 'm0.{:t��:G,n^.N,:,,::w}•: '�Y.V•l•• Lr �•:A. •:P.t,3Y.•.:!•}}P4:.w.?•v::f.M.w.:.K.t•.M!f?t...;•::::.:... .. :.:::::..}....-..:. ,.;,r?3:•}'}}i:3i''...,y}:{•i}}:r•:?,tt.... v• ... .•.:r.. ... .. {. ...•ry: �}.{1+. -..� .^.�.-. . .:.\. ..:... .:.}:..i}i::4:4:•h?-%w::.v:::.::..:......::::.hAnn ♦.+.`k}.... •..... .•t t\, •.•.4}.:4 .::. .x 7;;:}:,•vrvv.f.•::x:}::}{•??ti?:rfiv$y� T':k i} .. .,•.S:af:?;riff:::.?;f•:t3%:.: •>wx3xv:;�ro��.as}•-+:aAa&Y'•,f:,�xxr+.•!y.•+�}..<.?+p.,amaAMU-. «x:• ••:x' }:ft#�GSiod••?'::- x:.>••}:a• {gx:S:bi-}:},rr::::<�, . ..:r:::::•:.�::.v.�:3}...;;:,-:::.,}•r.,•x ..n .. •, •.S:.w:tvo,,...� ka}:::' :t:'i;:':•.�f:::;::;;w:,}}:+wcvfit� >`.;:. .::::.;,..:...t•:.+n•{.}::::,,r.t}},m:;•:•.{{:SC:', YhY3}.v} , .r.`{N.' ..?. /..::ni•.. ::.::{:.::??•vi};:•••:•:ti:}}}}}:x:r....-.1..n;..... Sr.... ... ...... ., ..:.} 'Mytq, ..: .}�y<,3�nn% '?. :v'W.•Ahwi?;i}�.:.x:....ham{3{.}•i;.::v:::.�:::. u::--.::•:::.?fir,..,.:: % ..::.r..,,.:-..: �, c"v`i`:�c . ....:: :.r...:.:.v%•.t..:•.%:?g4�^g}y:{a •:�!...!}3-.{,... ..., .-:.•-k x•• ox�x{�'¢•} ••i•`••: ::{rvc:•i' •:+rf:?a�:,••;:2^:•'rxrkt:::i:;;;•...:. • r:...,.;..:•:}...::••:::3}:•::::,,..... .','..•.Ey;.2?-h , .. �:;x..:..•..11 .'•y„3c{$y` .,£, �-.. }xT.ax{!�*•M ••:{t•, t,w;r..;}%3}-.�::::...,},. insurance ca. ..:: .,:•{x:,:•:.t.:rr.,xr:?}•.}:a;r...}•:wiE}Lg:: :.. . .:,-. i. .-.:....rt.:. ��e1► `.::.,.:..cs !F??`!S: ? r•'.ri; t ::i>'d >r?::k•}:?•f:?r5}:t;-:;if ❑ I am a sole proprieto>:,general contractor,or h meowner(dmk aw)and Lave tired the comuactors listed below who have �ohcca. the following workers cosapeasatioa • .}:: :1KS!^hv.n"n}TY1}i.......:.•-. M::.. ..:....:..:. . ....:::•. .:!*ix.......{•::.�r•.::::••.:}.:...-{:.....v..•: ,..•a:,,,..r•„-• ..x.•' #' .:.1?4��ti:?a} «:{o:}cf?u;t.;:;?wxtiC:3:<•::i<•<::>is>'<»:<. •.t•:>:::::::;.... .......:.••:::. 'ti...,;.:-All tt`•,•.'3t;ASr,.•...... 3,�!qF, ..:..•. ••':£t#!::3;:. } V'' ,:,'{'..'•,} .:... .:rvtt?Sx-}.;c•>.s::>;;;;::� .,:::::: ,,,.}......... ;....:.:.x3....W¢y ,s.,, .3'"�•:?;�w+::::�c•:?^S. .;,7;y:. , Y,�:cot,�r...:::f;:f':,th}�'>.Sf>%rM1:f•.':`,x ..;�ri:�•::.,-::•:• .r•,,�a„7x,,, ":•"'ifs n•• "---:: comoanvname: « ::f;>:;.:,..... •.. , ?,., ;.- sc:µtxtnw:_::x:<;:::;::::<:::;:::::: :::•::.:.,,... ,.,... t....... ,,..,�+;,�o�h'• ..., ..-:;•r:• � � sum ..... .:..: �wi..f'>�..•: � '�'i6F.:•.,. �.'• ...-.:. •ram}..,'�.; •''��.;;,�',j�-•'f�crr?yS:oc?;:�`; '.`':::;. •rv.�;.:sfwt:3:;^,.::xp:oa.-33,{.#opcfa .:�. ��'4k'•.�rxca�C .- •. •rya '� �?�. ��tyw.. 'o address-.:.::.:.>:?.;::::?:•:. .. :;: .. ....... OR dtr K. ............::.:::.t::::.v::::::::.,}-v,•}.v.'}f.,v,'•�.:.•.v:v}A.;•. ... .?. •:rot ..-.. ..... }%V{r:4rk •,,}•} S,yf7iiG.+np�r\wJ:;Y:;:yi: Insnrattce•�-::.�,.:;:::�:??.:. :� . ... ..: ... :::-.. .... .... .. .. .. ..... o�ieby#�::: .. .....:.....r.. , •...�� . ..: •;;:;;;::;»>:-:i:::•}:•<=:•:,:x�iten:^Ikc,••'`".=:wXi?`:: ,,.,a'}^"'. ...::. �r:•ii.�G ::_ ... ;:fYih%f`h<;>:?:;;::`•:? i: camnanv name^ :• f. ;:.. ...... ...,..::.:.:,t::;:`.}rtcuN:;�c?,:k;:a:::1•,..-,:iio X`v }.t.::�'••:..;.� ..y #$fjgs}<`•>:: :::. ,.::.v::..{:Si}::ti:+is•r'r?;:Sxt;:3{dd09H;aCdt-0�YCM^C,tpuylS)v4�P.,t}y,Ff(b�'pp� .. ::.�:•:: :•.v.;":`:{:••:•::::.}y,••.,v.: •}}Sr:,...: .�.H'•�'•r•} ..•:.%': W,•t::^N' '??{... .:....;.�::.-.:.::.,;.:•:.,:••:.Swa�.+l?w.:..^•."3:::?};{2: "'MOI •..,-} '.:{ ,n,G." {•ar.,..r. '• .. . •'Y;: ':4•.,r..........,?-•',ti:{,'yht}X, ' .•,•}i,<:r :i i'•3''•'�.:.. t.:.}�PrVC`0-,[,` hC...: .. •}}iYr.�•hi7900iriti. n,,• $,•,.h •ry.,.n}iv.,:h1\<?{{;iiv;ti;i:Jiii:j•. address: :....:....... -.:... ... .......;,:::::::. h.:,,.,,., xoGx,a!ti.. .* 'xoh qak ":`�9r,7�9R :£: t.'t; ,,.x3:•.:;::>:•-:::•::::. ��::�::._::.�:::.�::....}•:.:. ,.,.�cwt-r.},.••f:::.;. ..: •.}f%�:k•,.? :ffr.�• C •..•.ar fS'v:{'�t.asr�#:�3 •tit;...::}:.•. . : :.::..... . ,.3}}%•%•rt�:�o�rr;.;,.y.:sfo:,+'6fi�;:n}•'.>. .. ....{.�.. .,a} �- ^.t .c}JtY3'«:...w::;;::;�:::�:r..:: �a�nrance'ro:• ?:•:r....:.f•.. .... .,.,t ,.: ' • ..}.:-.v {w.:. ..... .,:: ..,. r .... ,i�+��• Fagnm to secore co►erage as req>, under tieetlos =afMG.L lU mind io the tmpodd=of esi6mdnal peoxides of a fte up to SIAOL00 and/or one years'imprisomnent as wen as dtII p—mn in the form of a SLOP WORK OMEB mod a floe of s100 00 a day azdnd ms: I noderstad that s copy of this statement rosy be forwarded to the OMU oflntsattpdms of the MUor co+eraV vedficatim I do hereby certify urrdtr the pabu mid p=tia olPffjW71 gz the inforntodm p+vvidgd aboge is bar and nomad Signature Dale Print name Ccont2ciperson: l use only do not writs in this am to be eompided by cdy or fawn oIDdd town: permit/lttxme 1! ` ' OBd�Bing Deparmtatt QLiees�dnL Board ck if lmmedLte respoma is tgdredQSeh attm's OIDse Deparnaent phtt��: Qothff � lm�9l93 PJN ;JT 0)/.,Ga4"wte& BOARD OF BUILDING REGULATIONS " License: CONSTRUCTION SUPERVISOR Number: CS 010350 07/23/2001 r.no: 11071 j RExpi es o: 00 ROBERT A MACLAUGHLIN 25 HARVARD ST Administrator S YARMOUTH, MA 02664 e � ��ie -Va��n'�onurea� o��/G�aaaa�c�eC�`a a q: T -i ;,r �.!i_1.�i.n r.i n r• ��.l=�.t..i n n^ and S tt.a._n H a r d s F?nnM 1.:c01 n I!`fiid: [11ir>7 (`V 'IfIF:'1'�t. t C7nt,I l:jca_C)r [1P;l,L^t r';:at..iOn 101014 Eypirat.ic;r1: t,OD HOME IMPROVEMENT SPEC . Mac:Lat.Is:ih l .i ti Ivar�ot_tc1h Road Hyannis MA 02601 IIYAN IS FIR DEPARTMENT wa 95 HIGH.SCHOOL RD. EXT. HYANNIS, MA. 02601 HAROLD S. BRUNELLE CHIEF . �rEDZDRHfF�ENt E STUDENT AWARENESS OF FIRE EDUCATION FIRE PREVENTION BUREAU BUSINESS PHONE:(508)775-1300 FACSIMILE PHONE: (508)778-6448 IX.T. DONALD I1.CHASE,JR.,CFI LT. ERIC F. HX-JBLER,CFI FYlZH PREVENTION OFFICER FIRE PREVENTION OFFICER BUILDING:. CODE COMPLIANCE FORM THIS FIRE PREVENTION BUREAU HAS REVIEWED THE PLANS DATED 0R THE PROPERTY LOCATED AT rr36 ; ALSO KNOWN AS:� i. THE .CHART BELOW INDICATES THE STATUS OF OUR REVIEW: TYPE:OF CONSTFUCTIOfJ DOCUMENT.'f. NA RECEIVED REVIEWED COMPLIES 1 NARRATIVE.REPORT 2 FIRE FIGHTING f RESCUE,ACCESS 3 HYDRANT LOGATlON/WAT:ER SUPPLY 4-SPRINKLER SYSTEMS -r-- 5 SPRiNKLER:GQNTROL EQUIPMENT 6-STANDPIPE.SYSTEMS 7=STANCPIPE VALVE LOCATIONS B=F:IRE DEPARTMENT..CONNECTION , 9=FIRE P.FiOTECTIVE SIGNALING SY.,ST 1.U.=F.P.SS &A:NNUNCIATOR LOCATIO4 11-SMOKECONTROL/EXHAUST 12-SMOKE CONTROL EQUIP. LOCATION' . . 13-LIFE SAFETY SYSTEM FEATURES: 14=FIRE EXTINGUISHING SYSTEMS 15-F.E.S.CONTROL EQUIP LOCATION 16=FIRE RROTECTION.ROOMS 17-FIRE PROTECTION EQUIP SIGNAGE 18 TRANSMISSION-METHOD 1.9=SE.QUENCE OF OPERATION REY L. PORT. 20-ACCEPTANCE TESTING'CRITERIA t, = 1NE BELIE ;TH DOCUMENTS T E PL TE AND.COMPLIANT FOR THE ISSUANCE OF A BUILDING PERMIT. , WE HAVE COMPLETED THE ACCEPTANCE TE R THE OCCUPANCY PERMIT AND BELIEVE THAT WITHIN THE SCOPE'OF THE BUILDING PERMIT;THE ABOVE ISSUES.ARE IN COMPLIANCE. 9j GO 11�jD NOA l� gy 04tce TOWN OF BARN .ABLE BUILDING PERMIT APPLICATION Map `� ``�Parcel - - ," Permit# Health Division ^ %D� ��/`�/�� y Date Issued �l 7 Conservation Division t Fees (� Tax Collector Treasurer Oho Planning Dept. 9NMOBSIN1 A iISEwEB N !k i' nti CONNECTION P11=FROM THE Date Definitive Plan Approved by Planning Board =' N/EN!�G,I��pf*�U yyDR=MOB70 Historic-OKH Preservation/Hyannis , Project Street Address 0 a Village O.utJki 77- Ownecc k . l_ Address Telephone — _ e S EV y . Permit Request o-m m l ba_1.2 n c '�i a ,10A A A A rc XP�7)_ A Vl/l.l.Vl V �• r Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cost 160 Zoning District Flood Plain Groundwater Overlay + Construction Type 3A 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 O No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new .size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of AppealsAuthorization ❑ Appeal# Recorded❑ Commercial�Yes ❑No If yes,site plan review# Current Use Proposed Use 7ak �e 5 �' t �ic.. 4 s f r BUILDER INFORMATION Name ,�p, r Telephone Number ? C Address�� 1 � "a v License# / Q - /V"v d Home Improvement.Contractor# Worker's Compensation# Y %� �� `-01 a ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO r i le_ SIGNATUR DATE`_ FOR OFFICIAL USE ONLY PERMIT NO. ' DATE ISSUED MAP/PARCEL NO. ` ADDRESS VILLAGE OWNER, DATE OF INSPECTIBI: FOUNDATION FRAME - INSULATION ^ t, ;; .Y ` `�� ' 1: � _' ... . 4, •. _ ' _ s -. . FIREPLACE ` ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL' - GAS: )' .F ROUGH e FINAL, FINAL BUILDING <' n tg i DATE CLOSED,OUT f; 4 ) ASSOCIATION,PLAN NO. " ' TOWN OF BARNSTABLE SIGN PERMIT PARCEL ID 309 212 GEOBASE-"ID 22505 ADDRESS 130 NORTH STREET PHONE Hyannis ZIP - LOT BLOCK LOT SIZE DEA DEVELOPMENT DISTRICT NY PERMIT 11510 DESCRIPTION CAPE & ISLAND, ORTBOPEDIC SPORTS MFDICT F CTR alth PERMIT TYPE BSIGN TITLE SIGN PERMIT ; epartment of He , Safety CONTRACTORS- and Environmental Services ARCHITECTS: TOTAL FEES: $50. 00 BOND $.00 '{�Qi► CONSTRUCTION COSTS $50.00 750 MISC. NOT CODED ELSEWHERE B►R1vsTpBLE, •' MA88. 1639. OWNER MURPHY, MICHAEL J. TR Epl ADDRESS ACKLAND MICHAEL K TR ' 297 NORTH STREET HYANN[S MAz, yBUILDING DIVISION w DATE ISSUED 11/07/1995 EXPIRATION DATE BY �0�,. .�/ t'7• �%�a/. �� DIVISION APPROVALS FOR r CERTIFICATE OF OCCUPANCY TO BE SIGNED BY EACH DIVISION HEAD UPON COMPLETION ' BUILDING:,* ' _ DATE: COMMENTS:' , PLUMBING: •` DATE: COMMENTS:'`'i- ELECTRICAL: -r DATE: COMMENTS: GAS: DATE: COMMENTS: CONSERVATION: DATE: COMMENTS: OKH: DATE: COMMENTS: HISTORIC: - DATE: COMMENTS: FIRE DEPT.: DATE: COMMENTS: OTHER: DATE: 1 COMMENTS: b TURN THIS IN TO THE BUILDING COMMISSIONER AFTER ALL SIGN-OFFS ARE COMPLETED.A CERTIFICATE OF OCCUPANCY WILL BE ISSUED AT THAT TIME. The Town of Barnstable p t o'd ° .� Department of Health, Safety and Environmental Services MU ,,�= Building Division date .,� 367 Main Street,Hyannis MA 02601 fee� ®,at Application for Sign Permit Applicant: . O N o 04\ 6Vuj �'�% �\, Assessor's no.-;G"(— Z 2 Doing Business As: 0,A41tnQ ec<<-c, Telephone 70— 111 d Sign Location street/road: 1`- co AC)CI 44. AL,/,4 4117��S Zoning District Old King's 11iighway District? yes no Property Owneyt l f Name: Telephone c � Address: 2 r Village Sign Contract QQ nn-- Name: �.-I�i��J1( �, Telephone 3� � Address: (9�� 6 VLt 4tN Village ISO- 042- KA-zJ1117 Description Diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign to be drawn on the reverse side of this application. Is the sign to be electrified? yes no (Note: if yes, a wiring permit is required) I hereby certify that I am the owner or that I have the authority of the owner to make application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinances. l r�� ZZ3G� Date Signature o Owner/Authorized Agent Size (sq. ft.) Permit Fee �d • d�-Cf Sign Permit was approved: ✓ disapproved: Date Signature of Building TOWN OF BARNSTAB]]C,� SITE PLAN REVIEW INFORMATION APPLICATION q I Site Plan Review Process Applicant obtains application by visit/phone See/Can Site Plan Coordinator 790-6227 Building Division Town Hall Review by Building Commissioner Small Projects Medium Projects Large Projects such as such as such as Signs,Parking Change of Use Large Commercial Development Time Line Requires Sketches Requires Requires in or Engineered Engineered Plans WORKING Scaled Drawings Drawings DAYS I Day One Site Plan Coordinator Through Day Five Reviews Application for Completeness and forwards to Staff for Review i Staff Review Period Day Six Through Zonung(Building,Planning,Conservation,Health,Engineering,Fire,Other Day Fifteen 'Note:All Comments negardiagthe Review Shall be Sent to the Building Commissioner Public Site Plan Review Day Fifteen May start with an Informal or Full Review. During this time Staff Comments will be heard and Through responded to by the Applicant. Changes made by the Applicant will be reviewed by Staff. Day Nineteen Applicant will submit a Final Site Plan and Staff will submit it's comments on this Final Plan to the Building Commissioner. 'Note:The Applicant can request an extension in order to address issues involved in the review. Decision Decision Tune within to 20 Days Approve,Approve with Conditions,Extend Hearing,Refer,to CCC or ZBA,Disapprove I l Required Procedures for Site Plan Review 1.At least six copies of completed packages of applications and all supporting documents must be submitted to the Building Division. 2.Within five working days of receiving a Site Plan, copies will be distributed to all Town bodies. having an interest. 3.Within ten working days of receipt by any Town body, detailed comments are to be submitted back to the Building Commissioner. 4.The Building Commissioner may solicit the advice of any other Town agency or department he deems necessary to properly make the determinations required by this section. 5. Site plans shall be reviewed for consistency with zoning and other applicable regulations and standards. Within twenty days of receiving the Site plan, the Building Commissioner shall notify the applicant of any approval, conditional approval or disapproval, stating reasons. 6. One copy of a signed approved Site plan shall be given to the applicant. other copies shall be kept by various Town agencies. 7. Upon completion of all work, a letter of certification by a registered engineer or land surveyor as appropriate to the work involved, shall be submitted to the Building Commissioner stating that all work has been completed substantially in compliance with the approved Site plan. The Building Commissioner may certify compliance when he determines that the scope of the project warrants it. i 2 INFORAAATION SYSTEMS DEPARTMENT SITE PLAN FOR MAP 500 PARCEL 80 GEGGRAPNN INFOVIUUT I SMW ONO STANDARD LEGEND tmltc not a sTmm MN oppem on 0 mop ® GOLF COURSE FAIRWAY t� DECIDUOUS TREES CZ= EDGE of DRUSH ---- • - ORCHARD OR NURSERY mNIFEROUSiREES INJUISH AREA . ......... 77 ,,�;,, _. � ' 35.2 EOGEOFWATER V/ Dial ROAD DRIVEWAYS 1 PAVED � P� ROAD i X�l 8 O� owls/\ 3g D , , t 's _.... PAIN/TRAIT J . . LE ROAD UrouTs PROPERTYUNES WATENPRDPERIYUNE A1V AND►ARffl NUMBERS q 2 Toff CONTOUR UNE • 'i 1 v { , i / /""y' -�, -`� 10 FOOT CONTOUR LIKE � t ' q 0.5 S ROE /\ \ _ \ STONE WALL i \ i —• RETAINING WALL 51 rj / 41. / C . ;;• RAIL ROAD TRACKS TELEPHONE POLE STONE Jun (?` ` I �/ � � %- WATER ELEV. SWIMMING POOL > 34.49 4 0. - 'R , ,/ O• DLHIDINGS/SIIUCIURES µ}1l Dom/TIER/JETTY YEGIIAWN,TOPOGWHY AND PIANIMETRIC DATA INIERPRETED FROM 1989 AERKOYERFUGHTS•PHOTOGRAPHY AT r ROIL.TILE PARCEL LINES ARE ONLY GRAMUC REPRESENTATIONS OF 9rw m � hA sI 1"—$W MAPPED AT I'=100'.PARCEL DATA DIGITIZED FROM I'-100'ENGINEERING ASSESSORS AIAPS 1989 PROPERTY DOUNDARIES,THEY ARE NOT TRUE LOCATIONS anh 8.3.94 s 0 tf 1 Y6�NV Town of Barnstable FOR °J` crUM0MX Application for Site Plan Review Acd=DwRP Location Legal Description: .Planning Board Subdivision Number. .Assessor's Map and Parcel Number: 30`I -- Property Address: 13() IV6,1 Owner of Property Applicant Name: /30/Uo,tC Shz.1 XS .J4 i& Name: Address: 0 Address: Phone: Phone: Engineer Agent tame Name 41�e Address: Address: Plione: Phone: Storage Tanks Utilities Zoning Classification Existing Proposed Sewer District: wJ it,SJ D �- Number. Number. Public Flood Hazard: Size: Size: Private Groundwater Overlay: Above Gr und: Above Ground Fire District Lot Area: a,iaxxs, Sq.Ft. Unde and Underground. Water Number of Buildings ",opt ts: Contents: Public: Eisting: Private: Proposed: Parking Spaces Curb Cuts Fire Protection: ---Demolition: Required: FZosting: ✓ Electrical Total Floor Area Provided: Proposed: Aerial: Residential: Dn-Site To Close: Underground: i/ Office: Dff Site: Totals: Gas ✓ Medical Office: Natural: Commercial: Im Historical District: Yes6 Propane: (Specify Use) Wholesale: :n Area of Critical Environmental Concern Instutional: E.O.E.Aa Yes/1 Industrial: ?roject within 100' of Wetland Resource Area: YesA(i;' i 4 Contents of Site Plan The Site Plan shall include one or more appropriately scaled maps or drawings of the property,drawn to an engineers scale, clearly and accurately indicating such elements of the following information as are pertinent to the development activity proposed. 1)Legal description,Planning Board Subdivision Number Of applicable),Assessors'Map and Parcel number and address Of applicable)of the property. 2)Name,address and phone number of the property owner,and applicant if different from the property owner. 3)Name,address,and phone number of the developer,contractor,engineer,other design professional and agent or legal representative. 4)Complete property dimensions,area and zoning classification or property. 5)Existing and proposed topographical contours of the property taken at two-foot(2)contour intervals by a registered engineer or registered land surveyor. 6)The nature,location and size of all significant existing natural land features,including,but not limited to,tree,shrub,or brush masses,all individual trees over ten inches(10'in caliper,grassed areas,large surface rock in excess of six feet(6)in diameter and soil features. 7)Location of all wetlands or waterbodies on the property and within one hundred feet(1001 of the perimeter of the development activity. 8)The location,grade and dimensions of all present and/or proposed streets,ways and easements and any other paved surface. 9)Engineering cross-sections of proposed new curbs and pavements,and vision triangles measured in feet from any proposed curb cut along the street on which access is proposed. 10)Location,height,elevation,interior and exterior dimensions and uses of all buildings or structures,both proposed and' existing:location,number and area of floors:number and type of dwelling units:location of emergency exits,retaining walls, existing and proposed signs. 11)Location of all existing and proposed utilities and storage facilities including sewer connections,septic systems and any other storage tanks,noting applicable approvals if received. 12)Proposed surface treatment of paved are:, and the location and design of drainage systems with drainage calculations prepared by a registered civil engineer. 13)Complete parking and traffic circulation plan Of applicable)showing location and dimensions of parking stalls,dividers, bumper stops,required buffer areas and planting beds. 14)Lighting plan showing the location,direction and intensity of existing and proposed external light fucwres. 15)A landscaping plan showing the location,name,number and size of plant types,and the locations and elevation and/or height of planting beds,fences,walls,steps and paths. 16)A location map or other drawing at appropriate scale showing the general location and relation of the property to surrounding areas including,where relevant,the zoning and land use pattern of adjacent properties,the existing street system in the area and location of nearby public facilities. 17)Location within an Historical District and any other designation as an Historically Significant property,and the age and type of each existing building and stricture on the site which ids more than fifty(50)years old. 18)Location of site with regard to Zones of Contribution for public supply wells as determined in a report entitled'Groundwater and Water resource Protection Plan,Barnstable,Massachusetts"prepared by SEA Inc.,Boston,MA,dated September, 1985, which is on file with the Town Clerk. 19)Location of site with regard to Flood Areas regulated by section 3.5.1 herein. 20)Location of site with regard to Areas of Critical Environmental Concern as designated by the Commonwealth of Massachusetts,Executive Office of Environmental Affairs. 5 To be reviewed by the Building Commissioner Zoning District: &v&n -u D Jos Old King's Highway Regional Historic District: Listed in National and/or State Register of Historic Places: Perimeter setbacks: Front: Side: Rear: Lot Coverage: Type of Use (Zoning): �3✓_r�rl Flood Plain Zone: Elevation: Number of Floors: 'W a Floor Area: First: Aro,-ro Second: /o� g o o Other (Specify): Parking Requirements: /.,-)9 JA, ,a« Required: le 9 sq�s Provided: Handicapped Spaces: 6 Are there Accessory Buildings? /UO Accessory Building Floor Area: Please provide a brief narrative description of your proposed project. lc.-ram. /��-�i► �IZyn rs �"/� �a«er �h.t J�I � ��' PlAal �taC �,c.cc J d a £ or cause to he completed)this e and the Site Plan I assert that I have completed( d c p ) page RmiewApplication and that, to the best ofmyknowledge, the information submitted here is true. Signature Date 6 �J. ��� 1 .����� '"��`--- w �� k I 1 ,� - . � o . . . ; ���-- Sign per Plymouth Sign Di agram Cement Cap Cape 3 islands Orthopaedic & Sports Medicines Center i Brick Base r Eginee ' or) Map Parcel 2LQr.�i, !ar House# ` LLv Date Issued a pry Board of Health(3rd floor) 8:15 -9:30./1 00"- L/16'� �(A ee ''RW- ® . 16 9 Z*mrd19 APPLICANT MU a CONNECTION P T E TOWN OF BARNSTABL GINEUCTI NDI ° Buil i g Permit pplication p PrMaS .A dress (� Village ' Owner Address _Telephone n — .Permit Request e,', \— - First Floor square feet Second Floor square feet Construction Type n en r .= Estimated Project Cost $ V-4, 4=0 , O o Zoning District LANI�D Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling e: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existin tructure Historic House ❑Yes No On Old King's Highway ❑Yes U'No Basement Type: ❑ 11 ❑Crawl ❑Walkout ❑Other Basement Finished Area(s t.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existin New Half: Existing New No.of Bedrooms: Existing New n 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 Garage: ❑Detached(size) Other Detached Structures: Pool(size) ❑Attached(size) ❑Bar ize) ❑None ❑Shed(size) ❑Other(size) Zoning Board Zes als Authorization ❑ Appeal# Recorded❑ Commercial ❑No If yes, site plan review# Current Use Proposed Use B1 ilder likformation Named �jj 3 S- elephone Number �a• — Address CA ficense# C— Home Improvement Contractor# a�� Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO — ~ SIGNATURE DATE BUILDING PERMIT N D FOR THE FOLLOWING REASON(S) ��� l St s e FOR OFFICIAL USE ONLY PFERMIT NO DATE ISSUED. M'AP/PARCEL NOi 44 ADDRESS 4' $ i , VILLAGES OWNER c r• •t 1 - ' DATE OF INSPECTION: FOUNDATION — } L FRAME ± INSULATION rr r'y FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ' ROU1I z•-; FINAL GAS: ROU�GI� FINAL' + , . ` l FINAL BUILDING cc DATE CLOSED OUT — f ` 7 • s ! a ASSOCIATION PLAN NO. ` f The Conimonwealtlt of Massachusetts HE: Department of Industrial Accidents _ Office offayesti9atfoos 600 Washington Street Boston,Muss. 02111 Workers' Compensation Insurance:affidavit ''/y,"; % ';,/ % /////%///��%%/'//////%��////%%%!l %//////////%%O/%%�%/�%%%��%%%%//%!,;;< name: location: city , I phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole roprietor and have no one working in any capacity �„„ m an employer providi work s' compensauii for my employees working on this job. com any name: - address: ' ` \ , ctty. hone# insurance cn. c7 \ oiicv# C— 0 ❑ I am a sole proprietor, general contractor, or homeowner(else a one) and have hired the contractors listed below who have , the following workers' compensauon polices: ...... company name: address. dtv . phone#• insurance cm. olicv# company name- address: city- Phone#r ......... ACV# insurance co A 'moo Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one year'imprisetun as well as civil ai s in the form of a STOP WORD ORDER and a fine of 5100.00 a day against me. 1 understmtd that a copy of this statem be fo t he 'fnce of Investigations of the DIA for coverage verification. I do hereby certify he pai p er•ury that the information provided abov40 � i d c red Signature DateCo - Print name Phone ) offitiai use only do not write in this area to be completed by city or town official d or town permit/license is ❑Building Department city Ql,icensing Board response is required ❑Seleeuaen's Office ❑checkifimmediateresp q QHadthDepartment contact penon• phone#; ❑�e1�� ltevum 9,95 PJAI Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of rP the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver o. trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewa of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and primed 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 peimit/license number which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 1`OU1VDA7-/ON PLAN /TOP VfM1 19'-8" 0 10" < p OPEN OUTSIDEPE/fi/tlpEft Tr�T WILL l�E GL05ED , o 112" ANCHOR BOLTS OUTSIDE DRAIN I ° co TOP OF FOUNDATION 8" ABOVE FINISH GRADE EXISTING 10' FOUNDATION 2-6" P.T. SILL PLATE a TOP Or I=OUND/tTION 8'—//" I=POI7 SLfFD bo 0 o a o 6 2*12 RIDGE BOARD 1/2' CDX PLYWOOD SHEATHIN ASPHALT SHINGLES 151b BUILDING PAPER 2W-10 RAFTERS 16" O.C. UNDERLAYMENT. 2*8 COLLAR TIES THIS SPACE IS UNHEATED IT'S USE IS COVER FOR A EXTERIOR OPENING. 2�:4 STUDS 16' O.C. 1/2" + 8" ANCHOR BOLTS 2)K6 P.T. SILL PLATE 10" CONCRETE BASEMENT WALLS oO° °° < nrVAfION/FrONf VEIW e t� Q a 1 a e e a b y i 0UND117-101\1 PLAI .l /TOP VEMi 10, O j0 OPEN OUT 5IDE APEA/APEA rr� r WILL I�� cLoS�D 1/2' ANCHOR BOLTS OUTSIDE DRAIN o ° EEO- co oo TOP OF FOUNDATION 8" ABOVE FINISH GRADE EXISTING 10' FOUNDATION 2)K6" P.T. SILL PLATE < r0P O/'::: i"OUN0117-10N 8'-11" /`POI7 S/-A15 i LI L yr •-_ l t 2w12 RIDGE BOARD CDX PLYWOOD SHEATHIN ASPHALT SHINGLES, 151b BUILDING PAPER 2)K10 RAFTERS 16' D.C. UNDERLAYMENT. 2'+8 COLLAR TIES THIS SPACE IS UNHEATED IT'S USE IS COVER FOR A EXTERIOR ❑PENING, 2)K4 STUDS 16' O.C. 1/2" 8" ANCHOR BOLTS 2)r6 P.T. SILL PLATE 10' CONCRETE BASEMENT WALLS V MvMION/FIZONf Ow u� a d 8 6 ' w v ca h m c-. m Pi � 180 �i/\3 6187 N�38.3 `�39. 1 0 17 X' 38P • � , \ 1 i 38. 15 8 � 38 4. 21 i x .4 4 3 P E 3.5 '. i�3 � 38.2: }`�gi 8.2 pA\jE 191 PA -- PAvE X/ 192 }�36.2x/X.. .0 X i X/ X 38.2 x _ X _ 8.5 i }�3 5 P ��8.5 Zoo 213 X 3 37.5`, ��38.5 QPvE .2 ?ABED � � X A3 ®� �., � 223 o }� p PvEo 22 7 G � ��SN}�3 }�37.3 - _ 37. .\36. / 26- '� 226 `•� s, � . 225 \3 3• WO { do N N O �ZE ONLY GRAPHIC REPRESENTATIONS OF Y ARE NOT TRUE LOCATIONS c 8-3-94 t: t-T ,v'r"'iiig; +` �' E5i - -"r' 7.•y �.. 1_7.;'`s'n,'+ ,•, tix.ia'a. >•,1,`t 'xt„s.•o-, "`�5 `! as`• a.F "sY; y^ *S'it'."h -'>�f:'k'S:asa .. t /, �J T y�jy-Y.�afi•+b .� w+C�J^ �,i r w• ��. s� 1-� r Ti ,�+� ��' NO P���'�•. TOWN OF BARNSTABIE MASSACHUSETTSy � ,z In, "+5 .• +et' •S ;:':* . T -- x 309 ,212 July 4 - Z •:1Q -r 86924 ^t f�1.kf k� . DATE Ju i ,�4P.� IA 19 w a PEF2MIT NO APPLICANT Francis E. Mogan S��noDREss CQVe#s' $, and Rt�r Centerville: 026071 7 1- r' t _P _ - v }x"C� der 4•�l �buill�g�E ig � a7Y i 1y :x.- ICONTR'S LICENSE) 31 a Seu + ��p rcc ) . NUMBER OF a Construct renovatyy�ongg axx4®x T!fkd ulz �EDWELLING UNITS PERMIT TO T_7 STORY 1: (TYPE OF IMPROVEMENT) NO. '4, (PROPOSED USE) '+ AT (LOCATION) 130 Norhh Street, Hyannis � t rr '= ` `'` ``''' DISTRICT CT t (NO.) - (STREETI , y „�t raE,g �..+ ' z , BETWEEN � tdh4 AND �e iFada°. (CROSS STREET) '..(GROSS STREET) - T - -k LOT ME, ur r fie. SUBDIVISION LQ�! BLOCK € 512E BUILDING IS TO BE FT. WIDE BY FT LONG BY FT` IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WAy5LLS OR FOUNDATION : c•,s ,, Y� vd' �' « (TYPE) A. -• REMARKS: c"' g. AREA OR no area chap a 600,000 v,L.. ? PERMIT100 VOLUME g ESTIMATED COST .$ FEE $ (CUBIC/SQUARE FEET) OWNER 130 Norhb Street Ventures ADDRESS 1 vur r�:et, 1ltdnnis BUILDING DEPT. - �� PT THIS 'PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK �OR ANY PART THEREOF. EITHER TEMPORARILY OR pPERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED 'UNDER THE BUILDING CODE, MUST BE AP- op. PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS.PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. " 1; r n'�i*`;•' w ''• e�, S.,:;;,b+2YYp::• .� 'k.a",. MINIMUM OF THREE CALL -APPROVED PLANS MUST BE'.RETAINED ON JOB AND„T,HIS 'WHERE APPLICABLE SEPARATE "-INSPECTIONS-REQUIRED FOR __ :'PERMITS ARE REQUIRED. FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL.INSPE.CTION HAS;BEEN 'ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. 'WHERE A' CERTIFICATE OF:.00CU.PANCYyaFS RE-� MECHANICAL INSTALLATIONS. e. .2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALLNOTBE OCCUPIED UNTIL �"�•' ?' z - MEMBERS(READY TO LATH). F FINAL INSPECTION HAS BEEN..MADE `Y - 3. FINAL INSPECTION BEFOREhl�w�, ,�t ,. ".�• OCCUPANCY., X'-::POST THIS CARDNSO IT IS VISIBLE FROM STREET ;= BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS 4;'.`,w/x'' '*A1! ELECTRICAL INSPECTION APPROVALS ' i F•`J fA t �`�' - r. i •sr s.�+ 2.M r i,,, T>s- f �j�oc� �rrC w ;i �9 y 000*Wi to j �,r,,,��= { kk 2L7fj/ �V074�0�/Ll � 3 HEATING INSPECTION APPROVALS ^ ENGINEERING DEPARTMENT at .. I i ry 1♦ l i 'sr j 1 N .�4. r' 4a 7 c + +a to i J •4 - .. e -. rT' -I a,:*'. 'f" FY%�+`"' TS*' #'� t� •�`Y. .: - 2 e ' '� s :` BOARD OF,HEALTH fi. 5 a <; OTHER SITE PLAN REVIEW APPROVAL a -3 WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT WILL BECOME NULL AND,VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE:THE. ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTIQN. PERMIT IS ISSUED AS NOTED ABOVE. ' ` x,�_,-.-•,,- NOTIFICATION. ._..-.__..-__. - - _ _ I � J � �� i ., +j I i �______- -- - --T--_ � J f-oallktontucu[tij of irlg�nc CERTIFICATE FOR USE OF ELEVA7)Ul�ett9 Chapler 143,General Laws,as arnendcd. DEPARTMENT OF PUI3LIC SAFETY-EL EVATt1�R DIVISION ONE ASNBUFtTON PLACE,BOSTON,MA 04108-1618 Located at Capacity: Pound Speed %L'O Feet Per Min State ID#: bo Ins for Issued On: Fireman's Service&Emergency Generator Test: IN CASE OF ACCIDENT i NOTIFY(617) 727-3200 AT ONCE. j AFTER 5:00PM & WEEKENDS i CALL (5 �°v$) 80.0-2121 COMMISSIONER I i I i I i I . i 9 f I i I r i - ��-..—.,..=ram+.. an•T,.. yr�:R•�rr-t._..���tiCT - - �� v.�c� >! ea ! TOWN OF BARNSTABLE',, {1,CERTIFICATE; 0F' 0CCUPA .CYf i I PARCEL ID 309 212 i GEOBASE ID S22505 ADDRESS 130 NORTH STREET., 3Ti i i i PHONE Hyannis ZIP L(]T BLCCK> Fy ' LQ �IZE �3 i)BA' `DEVELOPMENT ; DISTRICT HY PERMIT 10646 DESCRIPTION, MEDICAL COMPA 'PLURAL as PERMIT TYPE; BCOO y TITS E GERTIF..ICATE OF OCDV Mfient of Health, Safety L' cUi�ThJcTORs a i and Environmental Services ARCHITECTS:-,-. TOiil, FEES ' BbND $.OQ CONSTRUCTION COSTS $_00 753 MISC. NOT CODED, ELSEWHERE. OWNER MURPHY, MICHAPL J':.TR AADDRESS `ACKLAND6;' MICHAEL ' TR z97 NORTH STREET " 4 w a U' - HYLNN I S = , - _ �` � :B ,. NG DIVI I �' DATE ISSUED 09 28 1995 EXPIRATION DATE BYK i,-Ji 6w� THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROMTHE 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 APPROVED PLANS MUST BE RETAINED ON JOB AND FOR ALL CONSTRUCTION WORK: WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOST THIS CARD SO IT IS FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. 508-790-6227 .. �.-....._... -...._.._ - ..,._--.-..-,_..-..`..-.. '�-. rs-.�._ � �..� -.•'+f'.ti..--�..-•-.�.�.-.._.,.�'^•.••*-•. -.,�......-.,.ry,��-^..i.... ,,�t�,,,., ,..,;w�"`'- ter.._.-^_...-.�-- -_..�..w._.p-.�-,� sQ�...... .... � )w, Assessor's map and lot number ... . �.. � � .....�. � � �Cs �� �`'.�',� f 9 7l�✓ uPTLC QY TEN ' GE I-PI TAILLE D IN COMMIAME Sew'qpe.Permit number :..� WITH ARTICLE II STAl TAR QFTMEro� TOWN OF BARN" EJHB4TSDLE, i "6 9 BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ......... ... .. ...... ................................................................................................... TYPEOF CONSTRUCTION ............... .................................................................................... �... .............1975 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..........Fi!gh School„Road„�xtensl.QCl,...f{y. lnn'lS.......................... ......................................: Proposed Use ...................Offi.ces..-..Insurance..company..................................................................................................... Zoning District ........... (�tTl,/1e:��................................Fire District ...... ...... .��?7. ./.. ............................................ Kevfitz Trust and Lanfitz Name of Owner .....Trust.................:....................................Address Name of Builder Celadon Construction Com.pany._......Address ?1.§.Tremont„Street,,,Boston,..Mass... 02116 ................ .... ........... Name of Architect Rich, Lang & Cote, Inc. Address �Q28_.Chestnut Stt,..Newton Upper;;F?�:�$.` ........................ .... Mass , 8184 Number of Rooms ....................Foundation ............ Exterior ....................................................................................Roofing ...............................:.................................................... Floors ........................................................:.............................Interior .................................................................................... Heating ...................................................................................Plumbing .................... ......................................................... e Fireplace ..................................................................................Approximate Cost .........14K Definitive Plan Approved by Planning Board -------------------—-----------19_______. Area Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable reg ding t e above construction. Name .... ....... . . ..��• Kavflto Trust & Lanfltz Trust . ^ . No .. Permit for —. ..��z�er�iml ` ---'�#�l�l��—.. � . --..__ . . Location l50�. �����--. ' ..........................^�`=°ni=...................................... ' - Ovvner —Kevf.itz..�zoo]�..&'IA.1Ad itz. ' - Type of Construction ----zaaamnzy----. . --------------------------' r Plot Lot ---------. ----------' .` - - . -- / � Y � . � �� Permit Granted --4��uar��--8---']V ` ( , Dote of Inspection . ------lq /~. ( . Dote Comp��n6 .......lV . . PERMIT REFUSED ' . . ' l�--------.------------.. .--------------------------. . - `^—'-----...—.---------- ---- ' + .\ _.._____.___________,_______. ' , . -----------.---..----.-----. . ' . . . Approved ................................................ lV - ' . ' --------.------.--.—.--,—.--. ---------------------..--.... ,+ ^ / ' �� ��� ICI 0" ' t..: f;� � r-,* � ;2 / Assessor's map and lot number A/..:.. (�........ ..,;,, .�.... CJ "' c G/��i� � � � 9 26 on"1ivL, t) �z .tre.4, �J SewA a Permit number .......................................................... FSNETp�♦ TOWN OF BARNSTABLE 2 BAWSTLELE, i "6 - BUILDING INSPECTOR f%,.. APPLICATIONFOR PERMIT TO •....................-1W........................................................................................................... TYPE OF CONSTRUCTION ................: "I C ........ j................................. ..... �iL,. .}:.. V..............195 TO THE INSPECTOR OF BUILDINGS: - The undersigned hereby applies for a permit according to the following information: Location IIIni� School••Ro.ad•Extensoan�..Hvrnnis................................................................................... .................................................. ....,. ProposedUse .................. ?.:f�+`nR I......ran^p �mm�*ir�1................................................................................................... Zoning District ...........—1r�... . i'�Pr;,Zs �.../'3';YS . • ............................................................Fire District .............................................................................. >>'vfitz Tru3t and Lanfitu Name of Owner .....T�%vr�t........................................................Address 216 Tremont Strect, Boston.. Mass. Q2116 . ...........................................................................I......... Name .of Builder Cel•ndon onStruction Company Address 216 Tremont Street, Boston, Mass. 02116 ............. .... ................................................................. Name of Architect Rich, Lana & Cate, Inc. Address 1028 CI'estnU# Street, Newton per Fal.Est ..............,. ...........:...............n Ui?.... moss. Number of Rooms Foundation z Exierior ....................................................................................Roofing ...........,........................................................................ Floors ......................................................................................Interior .................................................................................... Heating .......... ...:................................ ...... ....,...Plumbing ..... _ . .................... ..... � > r) Firepl.ace_................................................ :..............................Approximate. Cost ...........,.... ...�.... ........................................ Definitive Plan Approved by Planning Board ________________________________19--------. Area.,.......................................... , Diagram of Lot and Building with Dimensions Fee,...: t!................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 5 i 1 � 3 i �3. hereby agree to conform to all the Rules and -Regulations of the Town of Barnstable regarding the above construction. X , Name;. /.. ° !!"„.... '�t •. ' '?.ter �! i? Kevfitz Trust & Lanfitz Trust 1757.n- rem del commercial No ........ .. .�?rmit for building ..............................N... ..�f........ Location d Ext .............................. Hyannis ............................................................................... Kevfitz Trust & Lanf. tz Trust Owner ................................................. ............... Type of Construction son Plot ........................ Lo ............. Permit Granted ....... n ...... .....19 75 Date ns ection .. :................. .......19 tDate pd . 19 PE101T REFUSE ...... ...................... .1. ......... ............ 19 ........ ...............�V.......... ............................. ''i� \Ile, . s Approved ................................................ 19 ............................................................................... ............................................................................... Assessor's map and lot number o / ��' — ....... ......... .... ..... .......... ''1110 S`ISTEt+t! "MUST 13E �j INSTALLED IN CW,!P Y!ANCE " II STATE Sewage Permit number ..Gd�'3.«'i'.@ .... ... ' o e1T= stir:Tu E _ 10, .Q . SkHTARY CODE AND TOWN yOFTBEr T® N . OF BARN9T T E ii • i BAHBSTABLE, i 9� MASS. Am pY�.e�� DILDI,NG INSPECTOR APPLICATION FOR PERMIT TO .....Erect interior partitions ................................. ................................................................ TYPE OF CONSTRUCTION Wood framing .....................................................:.......................................................:....................... Jan. 31 ...............19..74.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............Co•rner..No th..St.....&..High...SchoD1..R ad.........................................:................................................... Retail ProposedUse ............................................................................................................................................................................. ZoningDistrict ............ ....................................................Fire District ........ 5...................................... Name of Owner '...Fitzgerald Investment Trust Address . 216 Tremont St. , Boston, Mass. ................................................... .................................................................... Name of Builder Mars Bargainland, Inc. Address 1,.Riverside Ave. New Bedford, Mass. Nameof Architect ..................................................................Address .................................................................................... stores Numberof Rooms ........ .........................................................Foundation .............................................................................. Wood Framing Exierior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing ................................................. '0 d ............................ Fireplace ..................................................................................Approximate Cost ............./.................. . Definitive Plan Approved by Planning Board ________________________________19________. Area Diagram of Lot and Building with Dimensions Attached Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barn ble regardi the above construction. Name ,. . ....... Fitzgerald Investment Trust ust s. No .....��876 for .........r ...............anterior ....... Permit of building . . .....................Y 3.o.............................................. Location .... ��rth St. J�Mjl Rd. .............................. .......... .....................4YA .......................................... Owner ........Fit?;g p ra.ld..Inve.s.t.me nt... rust .. . .... ......... . . ........ ...... . Type of Construction .................masorAT......... ................................................................................ Plot ............................ Lot ................................ Permit Granted .......February 1.................................19 74 Date of Inspection ....................................19 Date Completed ........ . .................1 97� PERMIT REFUSED ................................................................ 19 ............................................................................... ............................................................................... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............... ............................................................. 3 ! Lot 7 -hAy-c.� 2-A i-- p �ssc sor's Office(1st floor) Map C� Permit# Conservation Office(4thfloor) Date Issued Board of Health Ord floor Im �n inecrin De t. 3rd floor House# y°R �� P 3 SARNBGB[l, t MAA& .. D 19 p 39. (Applications processed 8:30-9:30 a.m.<&1.00-2.00 P.M.) APPLICANT MUST OBUM A SE M TOWN OF ARNSTABLE 'i U aD 7 Building Permit Application CON3Tl1d MOIIL Proiect Street Address 60 wl c./v S-Uf v(- Village /-h7 ` i//Ji j Fire District N YA"'i pit Owner DL8, (k,,j" -r4 Address 7 Telephone 790 - /j/O :'12-33-7,-3s©O Permit Request: rf ru ' Zoning District 1 Flood Plain d Water Protection Lot Size 25, s Grandfathered Zoning Board of Appggls Authorization Recorded f't Current Use• OIrFi C C7 .15® cc- Proposed Use Construction Type %fj?&-'Lt 6Y& Yl T- d,? Existing Information Dwelling T Single Family L/ f' Two family Multi-familyN !"s Age of structure 5-0 Yoltf3' Basement tune R'1'4--D 6k-S Historic House t1i d Finished Old King's Highway /`1 6 Unfinished Number of Baths N l er No.of Bedrooms w tlol- Total Room Count(not including baths) First Floor e Heat Type and Fuel tq-/ Central Air t�'S Fireplaces rN CD Garage: Detached o Other Detached Structures: Pool /`j/fg Attached Fi M Barn None Sheds Other }�- Builder Information Name T i t A.,�—a- oeJ Telephone number 866 -7!S'( Address 38 4-b ST• License# 06,6 CAr--,VyK- YVL4,N- o 2.- Home Improvement Contractor# /J Worker's Compensation #���f})=F/��.✓l.T NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO BEE gi2r04e6-w ✓Prole t Cost `7 5-0 Fee 30 6 < X SIGNATURE DATE Z- -- BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T FOR OFFICE USE ONLY ! '' t 1195 309.002.212 ADDRESS 60 High School Road Ektension VHIAGE Hyannis OWNER Dr. Murphy & Ackland DATE OF(INSPECTION` FOUNDATION FRAME INSULATION FIREPLACE t' t ELECTRICAL: ,ROUGH FINAL - y PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING: ' 2 r ' DATE CLOSED OUT: ASSOCIATE PLAN NO. �� " r+ r ION „. Fs r COMMONWEALTH DEPARTMENT O�t PUBLIC SAFE cpd®1m r OF I ONE ASHBORTO,';:. '.ACE ' o1 this 11eyNb'�' . MASSACHUSETTS BOSTON,MA 0z. L i IY EN'=:E CAUTION EXPIRATION DATE cis ;/:22 19 '/ i f IN'=_;l h SU I::RV I C:;�:i. RESTRICTIONS ! t> �_ EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST c Jc.J ��•:•r n.. } THEFT,104 PUT RIGHT THUMB P19 PIN IN..ARRRE)PRIKrE Ir VJNSE- B .XONLI I H F'E,TEh—:I_( J i B 5 ING•OP RAT _ H IH ST 2 �i1UST INCLUDE PNO F Fp` �. GAGED IN THIS OCCUPATION. .� }Ile. x 11/02'94 17:02 V6177277122 DEFT IND ACCID 06 11 e t ` C.oiizanoci.cUeaA/i o/ Y111a.16ac{'zuseft6 c� n nn ' oUaparfineaf o��nc�fria�,�lccicalenfe 600 WUnjfon Stmef James J.Campbell &fort, V aadmuf d 02 f 1 f Commissioner Workers' Compensadon -insurance Affidavit cao� � with a principal place of business at: �CC62D Pml/c Del vt� , �4 �z� 0 2-0 6 �. (rAyistapizip) do hereby certify under the pains and penalties of perjury, that: I am an employer providing workers' compensation coverage for my employees working on thus job. Insurance Company Policy Humber O I am a sole proprietor and have no one working for me in any capacity. O I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation porcies: Contractor Insurance Company/Policy plumber Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number () I am a homeowner performing all the work myself. I uneerstard that a co;y of&is s=cement will be fonearded to d:e Office of invest prions of the DIA for coverage verification and that failure to secure cc•.•e-age 1s rec,i,-ed under Section 25A of MGL 152 can lead to the Imposition of criminal penalties eonsisdriz of 2 fine of up to S 1,500.00 and/er c: years' impricontnent as well as civil penalties in the form of a STOP WORK 0RRD,E,R and a fine of S 100.00 a day against me. Signed qiiv 2`� day of el 'tree Building Department Licensing Board Seiettmens Office �.�7 6 �/ Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 1 a Home Y .� .. .•+�..�r.✓.tom ..a /` y 1 , V Aprti 8, )!i 5 7ha Ir?sura",:g Pleo 7f MA 101 Aroh tr.wt Boston P.,IA �a ...d.•. vo � ��� R -A P Cor�xrr",; `,r, Corp- 8arf R-,i Flrn >x 3779 r Nsw Ass/ nr,:�n#�"'ec�t've :7?"22/T�5 � �rcN, � ab, l arl fi Attached p!aaSa 6na your 0 '13,';5 u-,d 03f25,V5 '-tiers of de,b,ved pnJresslntg atcrj MIP all!terns lyeviously subm led FIgess be advised that the core -eta OPenr's psyrolr.,{ mctuaed Under ins C+elica.r ciossIfication 8810 1 have also statod hik Je: hoth aapl.Icat`orts Pease process appllcfa;I607 q forward noHcg In enclosed sdtf•addreepod stsrrmpad onvelope ?-hank you Regards DONa!0 F'Sr.HA 4 C;E*Nc;Y INC Elizabeh M, Ryan �,�-ras�ras Cornmerclel Ac ount.T r 1, MA, af.t 1rjfi Pt. a . :.� '..s� A'r F i TO OQ { P ~. E INS AGCY INC � BuReau ��.,_�.� ����9�.3 804 STREET #C—I'd ` FOR RE: WO R5� �r. E ? ^FI{�N A LI SIN R y P,P A P "CON� WE ARE U 2A 1 L TO p°ROCESS THE ABOVE �{A�tEO FOR TW sa5QN(S) ZNGRC TEt1 BELOW,, ALL. APPLICATION � � E CORRECT OR COM�P�_ SUBMITTED I S �tE,ZN E PANED. PLEAS y4:E OEFICISNCY( ES SNIT w IN ORDER TO RETAIN TH BINDING PAT O - ' t .9 . ALL REQ°JESTED IMFOR14ATION A �0P,. ORIGINAL SUBMIS' Z N S� BE RECEIVE AYTI14CL`Y BAS PLAN II5r � „ FAILURE TO RE'�L�#tF �JNFORMAT 10�3 OAT S REQUESTED, WILT. IN THE LOSS OF THE T'EF�TAT:VE P�INiI� ' 'fHE A�+Pl G 4 T TES THAT I" CORf�ORATE C�F� IGER O yz G HORK- P EAS6�g 4ICATE AS TO y CORE HE 15 I •` PLEASEECCTIONS 0 H COPIES 0 THE APB 31 - pf aEYjRFi A CQPY OF THIS LE1•TER 141TH RE4U(,STEO TER#t ie VEq`1 TF JLY YOUR$ QNOEgm;kITING OEPTO R'• tip n 3 { i *TM[>, TOWN OF BARNSTABLE Permit No. 36924........ BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ................... .... . .... . .HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to management a.�n—Za�v-i..xx ,,�r♦..c Address G v N 44I S�uUC> a sc�ci I era ,,,_ o- � HVannzs USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID. AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. I January..9a... . ...... 19..g5........... v 00,11-K"ee�, .. Building Inspector ; Temporary thirty (30) day occupancy permit. Contingent upon full final inspections and Site Plan Review Approval. t Assessor's office(1st Floor): Assessor's map and lot numb q SC c�THE to Conservation(4th Floor v � � ew Board Health flo "S3-dm�I 1; ssa»r►nt � Sewagea Permit numum bs "Engineering Departme t 3rd floor): CPO °o s639. House number Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED•8:30-9:30 A.M.and 1:00-2:00 P.M.only rTOWN OF BARNSTABLE 'BUILDING INSPECTOR . APPLICATION FOR,PERMIT TO T TYPE OF CONSTRUCTION Ly�cQ fs"F'CC,I..-: `• J 6?g" 19 �f TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location St H•j a�.. .� '�(00 14(6W Sctybaz A/J 6� Proposed Use 'Vv't e CQ `�z cam-, 0 4 4,e Zoning District ��5. Fire District Name of OWner13 )JU\ S Address /Ao 17114 Name of Builder iM 05;,�, Address L'f. Gv-k- -Ls, Name of Architect Avs L\; . �c-�yA c-✓S Address .313 YV\A v Number of Rooms Foundation Exterior k N l c.LS Q1�L Roofing �C.l �`�t✓ Floors Interior Heating! Plumbing C r)'J�w Fireplace Approximate Cost v 0&0 0 G G I Area l< SOO X z Diagram of Lot and Building with Dimensions Fee /D4. e+ OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ell Construction Si ipervisor's License Q 2 G G 7/ 130 NORTH STREET VENTURES No — "'—Permit For RENOVATIONS - Location 130 North St, Hyannis Owner' 130 North St Ventures Type of Construction Plot Lot Permit Granted July 28, 19 94 Date of Inspection: = Frame 19 r . Insulation 19 Fireplace ' 19 Date Completed 19 - t s COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY OF ONE ASHBORTON PLACE MASSACHUSETTS BOSTON,MA 02108 i 1 LICENSE EXPIRATION DATE CAUTION C O M S T f2.:._":�U P_E K.V:I.S O li _ 1 0/0 3/1 9 95 FOR PROTECTION AGAINST RESTRICTIONS EFFECTIVE DATE LIC-NU: THEFT, PUT RIGHT THUMB NONE 06/30/1993 026071 PRINT IN APPROPRIATE 6:�1�V BOX ON LICENSE. FRANCIS E MOGAtti a .. :� g 1A COVE ISLAND RD s P , BLASTING OPERATORS � � CE�ITERViI.LE �'�A i�2632 • MUS7P LID PHOTO. Z � a GAGED IN THIS OCCUPATIOI•'. ` MISSIONE I 7' I i t SITE PLAN REVIEW E '2 G STAFF COMMENTS "� 4 Ntl S SP-03-94 Planning Department See enclosure 2 Department of Public works 1. It is recommended that the project be submitted to the Cape cod Commission for their review 2. Of obvious concern are the conflicts of vehicle movements with the Hyannis Fire Department and the potential need for a signal to be activated by the Fire Department requiring vehicles to STOP during egress of emergency vehicles from the Fire Station. Health Department 1. Provide information on abandoned underground tank(s) - i.e. location, size, plans for tank(s) (6 months to remove) . 2. In writing, detail how medical waste will be handled (X-ray-silver recovery) . Conservation 1. No Conservation issues or concerns. Hyannis Fire Department 1. see Enclosure 3 Historic Preservation Department (community character concerns) 1. Provide details of exterior lighting design, i,.e. height, style, area of light coverage. enclosure 1 � � r Town of Barnstable Planning Department h • is Site Plan Review Ho, 03 199:4 Date: February 14, 1994 [Due 02/14/94] I' From: ' Robert P. Schernig, Planning Director Art Traczyk, Principal Planner Dave Palmer, Assitant 21nner version 2 DraftProject/ Applicant: 130 th Street Realty Trust Address: C/O Patrick M. Butler, Nutter, McClennen & Fish, P.O.Box 1630, Hyannis, MA 02601 l i Property Owner: Kevin Fitzgerald, Trustee Address C/O Rackeman, sawyer & Brewster, One Financial Center, Boston, MA 02111 Assessors Map/Parcel: 309-212; Area = 2.2 Acres Zoning: B - Business District Ground Water Overlay: AP- Aquifer Protection District Flood zone: C - Area of minimal flooding Development Activity: Converting existing professional office building to medical offices, 15,344 gross sq. ft. (GFA) Filed: Jan 25, 1994, Building Department SITE PLAN REVIEW CON ENTS: Zoning District: I. This proposal is to re-use an existing commercial office building that has been vacant for some time in the downtown Hyannis business district. The town desires to encourage such proposals to bring economic and pedestrian life back into the village center and will attempt to consider any creative rationale that can be applied to expidite reuse/conversion of existing structures in support of this goal. It is critical however that all actual proposed uses and their impacts remain within the intent of the Zoning ordinance. i 2. Office use in the B - Business District is a permitted use. "Medical office" use is not specifically noted, however it is not specifically excluded from the gatagory "Office" as it is in the HB district, therefore site Plan Review is being conducted on the basis that Medical Office is a Permited use. Parking: 3. Parking requirement: The previous use of the existing vacant structure was office, and the on-site parking capacity was considered adequate. The new medical use should be accommodated fully as well under the Ordinance, including the basement level potential: site Plan Review 03-1994 130 North Street Realty Trust, Hyannis a. Parking calculation for one floor only (using round up formula) : 15,344 gross sf & 300 sf per parking space + 3 suites = 51.1 + 3 = 55 b. If the basement GFA is the same, than total need of: 51.1 X 2 = 102.2 + six (6) enterprize spaces, or 109 spaces. c. Since the current on-site capacity is 113 spaces, it is recommended that Site Plan Review approve the required number of 109 as appropriate for full structure and office activity utilization. 4. The related issue to parking capacity is the mannor and means of vehicular access and exit, particularly on High School Road Extended. This concern is addressed by the Hyannis Fire Department Memo (Item 7 below) . Specifically, the Planning Department requests that the applicant explore all means available to effect a future single joint curb cut access/exit with the adjacent property to the north. The intent is to eliminate one of the two existing curb cuts onto High School Road Extended opposite the Hyannis Fire Department station. 5. The applicant has stated that the intent is to have the primary site entrance (to parking as well) at the east end of the North street frontage. This also suggests that the parking area on the west portion of the lot adjacent High School Road Extended could be primarily for employees, reducing the potential exit / entrance traffic on High School Road. Other Concerns: Traffic generation 6. The applicant has offered to provide the Town with a traffic study to address what if any, new traffic patterns will be generated and what actions might be taken for specific mitigations. This effort will be closely coordinated with the Department of Public Works and Engineering, Hyannis Fire Department, and the Planning Department. 7. The proposed medical office use has been described by the applicant as a less than average medical visit vehicular generator, due in part to the need of the primary doctors to be at other locations up to half a day each day. The medical facilities being proposed are also said to be less intensive on-site visiting services in general. The implication is that parking needs in practice may be less than the ~office" parking requirement. The applicant should provide information if there is any known existing data on the comparison of the proposed facilities vs. office use or other medical office uses. B. The traffic study should indicate the specific types of vehicular traffic to be generated by the medical office use and the previous office use, quantified as to number and time of visits per day, and then analysed as to variances from the existing patterns. Historic & Community Character 9. A separate Memo has already been transmitted to the architect relative to community character issues concerning the building (see Item 6 below, also attached) . In addition, the Historic Preservation Department has requested additional information concerning the lighting plan, light difussion pattern and design characteristics of any new fixtures. This information should be provided as a separate plan or cleary indicated on a final site plan. f site Plan Review 03-1994 130 North Street Realty Trust, Hyannis 10. A major opportunity exists to upgrade the accommodation of the pedestrian environment in the immediate area through landscaping, benches, bicycle racks, public transportion point (stops) and other amenities. The applicant has expressed an interest in providing such facilities as determined feasible. The final site plan should indicate all considerations as clearly as possibe. i Requirements of the Cape Cod Commission Act and Administrative Regulations: 11. A Policy Paper of the 1990 Cape Cod Commission Act requires a regional review of developments that propose to reuse existing [non-residential] structures that j have been vancant for more than two years and meet any one or more of the DRI it evaluation thresholds. The intent of this regional review is to insure that any new proposed use is evaluated on its own merrits and specific activity impacts, especially as it may generate new traffic patterns and/or impact water quality. 'I This proposal does enter the DRI threshold as the GFA (first floor only) is over 15,000 sq. ft. I a. The Town of Barnstable Site Plan Review should determine if local i jurisdiction is warrented given\the work on traffic patterns undertaken by the town and the applicants offer of a trqaffic study. b. In the alternative, The Town of Barnstable and / or the applicant may request a waiver of the Cape Cod commissions jurisdiction through presenting information indicating the limited nature of regional significance of' new impacts, if any. 3 c. In any event, the applicant should provide the necessary information about the period of vancancy and any other data to establish the nature of traffic patterns and impact upon water quality. ---------------------------------------------------------------------------------- Review Materials: 1. Application / Jan 25, 1994 stamp, Site Plan Review 03-94 2. "Plot Plan of Land in (Hyannis) Barnstable, Mass.for 130 North Street Realty Trust, dated Jan. 24, 1994, Baxter & Nye, Inc.; Two sheets: 1) Existing Conditions and 2) Proposed Improvements. 3. Proposed Renovations to 130 North St., Hyannis, MA for Dr. Micheal Acklund and Dr. Michael Murphy, by Brown & Lindquist. Inc. Architects: a. First Floor Plan & Elevations (Sheets SRA-1 & 2) dtd. Dec 10/93. b. Revised Plan showing Common Waiting Area (Sheet SRA-3) c. Revised Elevations (Sheets SRA 4 & 5) dtd.Jan 13, 1994. 5. Assessor Data Card, print date 11/09/92 for Map 309 - Parcel 212. 6. Memo, Subject Preliminary Architectural Review and Comments, from Planning Department to Peter G. Brown, Architect, dtd. Feb. 3, 1994. 7. site Plan Comments re site Plan # 03-94, Hyannis Fire Department, dtd. 2/2/94. J� CAPE COD COMMISSION , .... 3225 MAIN STREET ,. ' PO Box 226 v t BARNSTABLE,MA 02630 j • • $08.362-3B28 j A S`-' FAX:508-362.3136 DEFINITION OF "CHANGE OF USE" 4/15/92 Section 12 (c)(5) states that the Cape Cod Commission has jurisdiction to review a project as a Development of Regional Impact when it involves "Any proposed retail or wholesale business, industrial Tonal development, as well as any private health, recreational or development which has a floor area as follows: .,. Use changes which have a floor area greater than ten thousand square et.11makhea defining what constitutes a change of use, the Commission determination on a case by case basis, examining the following factors: (j ) Whethe r there is a difference, in relation to the resources protected b the Regional Policy Plan and the Cape Cod Commission Act, Y between the proposed use and the use in existence i d diaaelyb prior to the proposed use. Such a determination may be bupon, not limited to the following: (a) the nature and purpose of the use, -act er of use, quality(b) the qua Y or char (c) a material change in the use or appearance of any structure or in the land, (d) any change in the intensity of use of the land itself, suchre s an increase in the number loo dwelling ndustrialnits use' from a less intensive change to a commercial � use: 2 Whether the proposed use results in different or increased impacts ( , from the immediately prior use in relation to its effect on the surrounding neighborhood and/or resources protected by the Cape Cod Commission Act and/or the Regional Policy Plan. 3 In cases where a prior use has been discontinued for a period of time r 'Ji- :ater th an two years, the Commission will presume that,any use of the premises is considered a change.Of us'?- in requirement of DRl review, regarding the eq In order to resolve any Issues fegion to file an application with the the project proponent has the option as authorized by section m Commission for a jurisdictional deternation, 12@ of the Act. r {; 2- 2-94 1 :24PM 5087786448-+ 5087753344;# 2 HYANNIS FIRE DEPARTMENT 95 HIGH scHOOL ROAD EXTENSION HYANNIS, MASS. 02801 PAUL D.C WHOLM.CH1<BF+ FIRE PREVENTION BUREAU , LT. DONALD H.CHASE,JR. LT. ERIC HUMIR Inspector Inspector SITE PLAN COMMENTS SITE PLAN # 03-94 130 North St. DATE 212/94 WE MAKE THE FOLLOWING COMMENTS REGARDING THIS SITE PLAN: The property. in question was the former 'Packaging Industries plant, a multi-use facility and office complex. Back some many years ago, the property was the former First National grocery store a very intense traffic generating use. At that time the total call load for the fire department was somewhat under 2000 runs per year (if that many). The property next door, 80 High School Rd. ext. has had a various number of uses throughout its existence as well. They have ranged from retail shopping to computer disk manufacturing. The property adjacent to the fire station has gone from roller rink to state unemployment office, another high vehicle traffic and high pedestrian traffic generation use. The total call load at the fire station over the past years has now increased to over 4000 calls per year. Most of this ambulance and fire apparatus traffic is generated out onto High School Rd. Ext. and moves in a North or South direction. Both buildings across the street from the fire station have been vacant for some time now, and any intensification of use from vacant to occupied has to be taken into account due to the emergency traffic on this street. FIRE DEPT. 775-1300 1 TOWN LINE 790-6328 1 EMERGENCY 775-2323 FAX •oeou� 5087786448-1 2— 1—y4 1 ;2tPM 0UO77U0440-1 dun »334q+ii J y r I' 1L' r ♦ .j1 �,jr.,1�, LE FE6 21994 site plan 03-94 pg.2 E C E 0 �� The Town's plan for mitigation of traffic, level of service, etc. needs to be considered prior to renovation. The site In question as well as the other two sites mentioned above need to be put into an overall plan of intersection improvement and traffic lights, if needed. The total costs of any improvements, as determined by the DPW and Engineering, should be divided by the three properties and appropriate funds put aside for mitigation when those properties are improved. It is assumed that the vacant properties will not remain so for an extended time and the unemployment property Is about to change hands and undergo some type of renovation. Prior to the fire station being constructed in 1965, the intersection at Stevens St. was improved by' eliminating the island on the S.E. corner for better traffic flow around the corner. in interest f public safety, in our opinion, if some It would be the best to est o ub c s p tY� P • type of signal were installed that could be activated upon an emergency call to stop vehicular traffic so as to prevent an undesirable encounter with fire vehicles that are not capable of quick maneuvers. In other fire departments across the country, this activation occurs from within the fire station and is on some type of timer device that returns the signal to a flashing red/yellow configuration following the dispatch of the apparatus. .x The location of such a signal would be at a mutually agreeable position as deemed appropriate by the Fire Department and DPW/ Engineering. Should there be joint access developed between the two adjacent properties and the subsequent closing of the High School Rd. curb cut, it is our opinion that the time has come to provide some sort of mitigation to the intersection of High School Rd. Ext. and Stevens Street. A possibility that again can be addressed with the owners and the appropriate Town Departments. Lt. Donald H. Chase, Jr. 1W1 Fire Prevention Office 04 Hyannis Fire Department FIRE DEPT. 775.1300 1 TOWN LINE 790-6328 1 EMERGENCY 775-2323 ( FAX 778-8448 b •Notes ;. • Site Plan Review Meeting February 17, 1994 Present: Joseph DaLuz, Gloria Urenas, Kathy Maloney, Building; Robert Schernig, Arthur Traczyk (portion of meeting), David Palmer, Planning; Thomas Marcello, DPW; Dale Saad, Health Department; Attorney Patricia DaleyJ& Sumner Kaufman, Cape Cod Commission; Lt. Hubler & Lt—Chase;Hyannks""Fire Department; Captain Coffin, Barnstable Fire Department; For SP-03-94 - Peter Sullivan, Peter Brown and Attorney Butler. SP-03-94 130 North Street Realty Trust 130 North Street H annis__- .� Attorney Butler submitted additional material and a revised site plan. According to the revised plan, the High School Road curb cut would be for exiting traffic only. The portion of the parcel nearest to High school Road would be designated employee only parking. The front entrance was relocated to shift pedestrian traffic to the east side of the property. He also explained that one very old underground tank exists at the northeast corner of the property. There is no evidence of leakage. Mr. Butler gave a brief explanation of the silver recovery system and medical waste disposal. Mr. Kaufman expressed concern that the heavy metals would just pass through the process and end up in the sludge or the receiving body. iHr. Butler contended the proposed-use-did-not--constitute "a change of use and , did not meet criteria for DRI status. (Ms Daley concurred that the staff Drecommendation would probably be that this would not be-a-change-of-.use-.) - Mr. aLuz reiterated that he saw no reason to refer the project to the Cape Cod_ -� rCommission.� cMr.—Butler noted that the applicant was willing to offer up to $5,000 in' ontribution to the Town for a traffic study.F--- __.-- _ ` Mr. Brown spoke about proposed changes to the building. Drawings were exhibited. It was determined that further Site Plan Review would be required if the lower lever were ever to be used for anything other than offices. conditional approval was granted subject to the following requirements. I. The removal of the underground fuel tank will be coordinated with the Fire Department and accomplished within 90 days. 2. The applicant agrees to contribute $5,000 to the Town for the purpose of conducting a traffic study of the general area. To Date ��� Time WHALE YO ERE OUT of Phone Area Code Nu m r Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT RETURNED YOUR CALL Message 1 Operator AMPAD 23-021-200 SETS �� EFFICIENCYe 23-421-400 SETS CARBONLESS O - v / m v m� El U U 0 OD- 88a ---- e I I all I I I I 00 c c �� 0 T AA� �t�tir v LOWER LEVEL RENOVATIONS for,� o �; t��� A mo .,� s w on ery 4 r t CAPE COD ORTHOPAEDICS Group Incorporated 130 NORTH STREET 110 State Road,Suite 7 Sagamore Beach,MA 02562 �(�t HYANNIS,MASSACHUSETTS Tel:508-888-6555 • CC'111 I\'F\l\It 1,\I( il'1!11l\)(11111111(!1),\, 1 (4'171Cf1(1\\\' '1)NAIISC:I ItF:llll ll(IF'I P a O .7 Q N EXAM RM 7 0 o � OFFICE OFFICE fflNo- Q o0 EXAM RM 5 , o EXAM RM 6 E WJ o a 2 o 2 OFFICE (D % r 00 cr o Lo o CLOS >, in a EXAM RM 4 N _ N EXAM RM 12 B EXAM RM 9 OFFICE EXAM RM 8 EGRESS o RECORDS a Z o WASH EXAM RM 10 F z CAST ROOM W NEW DOOcr R AND FRAME I W EXAM RM 13 STANDARD x 84 ATCH BLDG ® F U x EXAM RM 11 NEW LL TO ACT cr BOqKINCOLIN SERVER RM ® � d ®BOOKING ® NEW WALL TO ACT CEILING I 10'- � U - z ®BOOKING GENERAL NOTES: O d X-RAY ROOM EXAM RM 3 W x CIO 1. NEW WALLS TO EXTEND TO ACOUSTICAL ® v. 4'-0" ® II -0" CEILINGS; PROVIDE FINISH TOP TRACK TO RECEIVE WALL FRAMING AND FINISH LJ 13 NEW DOOR AND AME BOOKING 36 x 84 MATCH BLDG 2. MODIFY SPRINKLER HEADS TO ACCOMMODTAE STANDARD EXAM RM 2 NEW LAYOUT ATRIUM � NURSE 3. MODIFY LIGHTING AND SWITCHING TO REVISIONS ACCOMMODATE NEW LAYOUT ISSUED FOR YERAl1T 1 2-23-09 4. PATCH FINISH FLOORING OR PROVIDE NEW AS DIRECTED BY CAPE COD ORTHOPAEDICS. NEW OPENING IN WALL EXAM RM 1 5. NEW DOORS AND FRAMES TO MATCH FULL HGT TO EXIST'G EXISITNG BUILDING STANDARD. SOFFIT NEW DOOR AND FRAME 36 x 84 MATCH BLDG STANDARD NEW WALL TO ACT WAITING ROOM CEILING NEW OPENINGS IN WALL OFFICE TO MATCH EXISTING FOR - DWG.INFO. ADDITIONAL CHECK IN/OUT DATE 2-23-09 STATIONS INFILL EXIST°G OPENING SCALE 3/16°=V-0° DRAWN CADD 2 3 4 CHECK OUT - '�..� ,.. RECEPTION OFFICE OFFICEOf SHEET TITLE: BREAK FLOOR PLAN SHEET&JQ;B#: . „ A-1 I � N Cn Ocoo Lo EXAM RM 7 o CO OFFICE OFFICE QEXAM RM 6 EXAM RM 5 00 O 2 00 OFFICE : Y o0 c o `n aos -- T � a EXAM RM 4 n N N EXAM RM 12 B EXAM RM 9 OFFICE EXAM RM 8 r EMERG I EGRESS RECORDS { Z V F I� z WASH EXAM RM.10 CAST ROOM W NEW DOOR AND FRAME a W 36 x 84 MATCH BLDG EXAM RM 13 Q CC x STANDARD A C) w U h� EXAM RM 11 NEW LL TO ACT D BOOKING CEWN SERVER RM O a F d o ®® �' oc BOOKING NEW WALL TO ACT A A ZPF x CEILING 10-11 O M Z ®BOOKING EXAM RM 3 GENERAL NOTES: X-RAY ROOM O W a ®® 1. NEW WALLS TO EXTEND TO ACOUSTICAL Q a x 4'-0"' ® -0" CEILINGS; PROVIDE FINISH TOP TRACK aI TO RECEIVE WAIL FRAMING AND FINISH � U ® NEW DOOR AND AME BOOKING 36 x 84 MATCH BLDG 2. MODIFY SPRINKLER HEADS To ACCOMMODTAE STANDARD EXAM RM 2 NEW LAYOUT ATRIUM NURSE 3. MODIFY LIGHTING AND SWITCHING TO REVISIONS ACCOMMODATE NEW LAYOUT ISSUED FOR EEINIIT t 2-23-09 4. PATCH FINISH FLOORING OR PROVIDE NEW AS DIRECTED BY CAPE COD ORTHOPAEDICS. NEW OPENING IN WALL EXAM RM 1 5. NEW DOORS AND FRAMES TO MATCH FULL HGT TO EXIST"G EXISITNG BUILDING STANDARD. SOFFIT NEW DOOR AND FRAME 36 x 84 MATCH BLDG STANDARD NEW WALL TO ACT WAITING ROOM CEILING NEW OPENINGS IN WALL OFFICE TO MATCH EXISTING FOR DWG.INFO. ADDITIONAL CHECK IN/OUT DATE 2-23-09 STATIONS INFILL EXISTG OPENING SCALE 3/16"=1'-0" DRAWN CADD 1 2 3 4 WECK OUTLl C _ • RECEPTION q J. •C OFFICE A 1 c� �ITyEJ4.QP1 �5 OFFICE SHEET TITLE: Of FLOOR BREAK PLAN y SHEET&JOB#: A-1, 4*1 771 ED DD - C -JH k w A a lxmlllill:��� Jan, N-.m. 1-. -1 -5 C-A L-Z--1 1% -, If to p 'Cl I � a �• I I i ,., i n I I I I Ger:eraI rNerecs: ! • I � i,Demo all exst!n,j fi;,""'J. Demo all exl5tlnq counter tors. j n5tail Hein t Cr hlocrinc m Exam - N � � I<oornr>a�,�d 7raiet IZoinns. k. Instal!new cerpet Ir,all otY1er o eal. Future Teriant 5.!nstail ne�wslicovenny border,n waiting area oriy. I I TeVData 1,1 5ecunty System ! I I r - ,nstallat:nn I=,by the owner. I I Install now cove bzsB . n ou-jr gut I - -- — - - — - - -- --- -- -- —�— - --}-- - --- - --- - -- - 5ervc,nU of th existing 1VA(.: eq.j,pmeilt i the.owner. ' Cut Back xl°aun r,7•��, k Nen l inne hu, tel9. Rcor=,Ye 0("') I f In5ta!I Ilea 7010, o Mat.:h trl_.tl� I 3c ks�c!f�Nai,. o..e Invts f om I cw•r'ent Doctor,office to this new \ locai,on. I I 10.An a!lowareea of.$2,500 is I f — being malntamcd fnr modifications# I --J _ rt— new hocks"eitii Gonference,Room. w�ccAlisal ,"Ic:S I I New ACT In - Patient ToiletI ��d»!t�r,y AreaExstlna Walls -- Rea vticn — — — _ne!no VJalle, Lr) it Jvaltiorf — — — -New Waiis treatment I —IN _ Conference R� in I I I� h -c>:.�ting i�oory i. Patent Toilet I b� — u — + I Fx my or To be r 'red �The r ime,� I I i r \ T T —J � -New Uonrs I i New Counter I I Ty p. I d b Treatment Exam Tre.tment `�turage _ L I Exam F'atlent- Patlerit Toliet New Counter Typ. I — —- Exam - — •-- I�sJI I New Counter , Typ• New Courd:e -- _ v p ----- - --- -- ro IY _4 `;toff?o!iei: I j EXattl Tret9tYYl f.',n% I �,. New pposr f'abl tL' ---- - ? at!on o niacc:h[_xlrtlnr - 1-rea�.mant -- D Nev✓Counter - Nev,Upper Cabin;t,^s i I -- To Match bnslany rYp I _ -- I — -- -1------� New Counter I Exam l— J I Pro�ert Name: T Exam r J — Yp. New Coin' �? Exam 'yr; Treatment 011 I Repair Water Damaged GV✓B-Exterior - � Leak To be Repaired by Landlord ` Office- Offlc:c Office Office, 5bafl Lounge Pro,.: D.wn9: ---- I I Of'ICC. I !. LKR4_2004 Office D to e 2004 If Scale i�4 I 0"j AE ' . I v fs.3 �...�i�."Y1ii�ii�IYii.Yii,.'wY Ha► - - - -------_---"----. _.._...___- •ter- t�aar�r�w�rurs arwsaaw c'»n�r►'�rr THIS SITI` IS NOT LOCATED WITHIN NOTES: THE F o0D PLAINT. ASSESSORS: s / i NOTE: cn 1 PROPOSED USE OF,SITE IS AS MEDICAL OFFICES. cn 'j OR MAP 309 PARCEL 212 ALL ELEVATIONS SHOWN ARE EXISTING SEE PLAN .BOOK `.409 PAGE 99 -' 2. TOPOGRAPHY OF PROPOSED AND EXISTING SITE IS LQ(;�$ i ALL LIGHT POSTS ARE SHOWN FOR BENCHMARK PK. 1N UTILITY POLE AN AREA OF CROICAL ENVIRONMENTAL CONCERN. 130 NORTH ST., HYANNIS, MASS. 02601 FLAT' AND BETTER REPRESENTED BY SPOT GRADES. S�. ARE ALL CATCH BASINS ARE SHOWN ❑ LIC SEWER AND - - NUMBER 10914 EL£VAT10N 39.27. 5 5 ARE ZONES ALL POSTS ARE SHOWN o 4. THERE ARE NO WETLANDS ON OR WIAVATHIN 100'OF SITE. GROUND WATER PROTECTION ZONE - A.P. 5. NO NEW CURB. CUTS ARE.PROPOSED. BUSINESS USE ZONE `yQ41 y SQ jN ,37.7 MINIMUMS 37.8 .t FRO14TAGE = 20' G BUILDING s EX1S�I1N o� FRONT SET3ACK = 20` { {loot elev• 38.85 BUILDING HEIGHT = 30' firs �7.9 (OR 2 STORIES IF LESS) i 37.3 E 3. LOCUS MAP tRE TO f AENT 39.2:: a. pEP pR 37.7 .-- / SCALE 1 25,000 .8 .38.8 pG x 38:7 z ®38.8 ` 3$•1 a- IN 36.4 x 38.$ e'-of P--- ..- 4 gh 3 ht v / --- ""- - „�-chain. link fence ._ o0 - ��, 38 8 ; ,.,,,, 8.7 ---- 38.6 / � / BOOK 2138 PI�DE 321 •- .8=--'. .---+�-31f.� - a REMAINS OF C.B. FND. OFF ITZGERALD ��E . 38.6 cr , 37.5 WILUAMG , , OFF Ng�'02 .3WOIr� K T 37.1 36.9F",?.5 37.4 / t�,v / �---.. q 23 48 .8 »39. 389 . /! :rf3.3 eiec. bay paved wa x 38.4 T�7.o 37• o u d:v IN 36.9 37.9 37.01 ----- .::w-� w 8.2 de fence t37. 3T5- -'"" 3T.5 iC�" Gte : F,' stocky �.. , 3' " en t . Ce area_' I TO S .37.3 37.6 `'�7.9 Z 39.1 � �257 , 39.8 : m.. ENTRANCE u? x 37.5 EXEC r p.E.Y o fi Q uj 027. Ec Y U r-x 37.0 Z y�i u. a . o 3s 2 0 m �• ,t h 1 x 388.3 Q x37.5 w ~ ,� z a : o z 7.2 / e%� o o / m 37s, • o D Q O 7.0 37%�r (� ,C� � � �t a ' T� n x .9A � x 37 3 3 '//i �,," ry i U m o �' 37.4 �, ro a- paved parking troa to 3&2 ' 37.7 CO G x 37.5 p z Z 37.1 `� 41 EC .s Q c� 50 37.9 h; X ;; •. sl well p a o 50 Y+ Rs OLD Ol. 3 a : c°� y� x 3'.:� c 38.4 (� S :;BAN 3 11NG BU;LDIN� a� S E ti L ao O x M S l co - -- paved parking a I a 38.? 0 38 3 - -- �7.8 -, � 38.E ' 137.01 N awn " 3$.4 O N o 8 , � 3Z•2 • 38.3 N 38.0 brick ' 38.8 38.4 . INO BUILDING walk I On trt',� 8. 8.3 38.8. EXIST v. = 39.60 377 .b x 37.3 3?.9 first floor ele a , �• green area � brick � 38.4 x • x 38.2 G, walk x 36.0 36.7 x 37.1 38.3 G=� --• r'%' !awn -10 ers 0 36.8 .,p 1 d tree 31.7� 7 x 37.8 can N ..38.2 $a37.3 , x 3&1 37.2 Walk 6 o ' 36.9 x 37. brick / 38.0 .-t R 35.0 37.3 37.7 37.8 �38� 38.1 38.1 38'3 x 38.4 �(ag pole 1 38.0 .5 37.1 \6;t �,e 37.4 x 37.7 7 4'1 treat 38.0 3$.7 c•: 3g. 37.1� tr o 37 37.8 N 38.1 3. o o�P� x 37.6 38.8 12" tree fjo ht .�� G7 38.0 4 N ` x 95,657 S F, " "" o �c 37.2 ��, 37.3 =' N 12 tr x 38.0 38.1 .•"""'... �. 2,20 AC. cam- 10 tree 38.4 30.9 •37.3. • - aac 37.6 1 N x 38.7 \ bumpers �, 3= 1O" tree 38.Q • 37.5. iON' HIT_.._ to parktin 1O" Vee 38.0 BE CN H DOFF' ' --- 37.8 MARK 38.10' .. 37 r-- L 37.2 coneCe 37.510" tree 37.9 -""' / � pIREC�ON PLOT PLAN t�F' LAND �/ ,rye ..1- FOR 000' IN EITH* 1037.7ER 36.4 G=- 37. 6 IN 1.5 x 10" trey �37.6 0' sidewalk ON UNOBSTRUCTEp 1' ®37.3 37.1 ,37.0 „ 37.3 37.1 334,1 r--� VISI (HYANNIS) a x 36.9 10 tree 11 35.9 36.3 i' (036.90. S80 20 8.3 gram cur A �'+► p 36.4 C� 36.3 • 38.8 .•r=°"'"° B A R N�TA B LE , MASS o Cr 36.7 IC WAY 40, WIDE .•• FOR 0 36.1 .3 @ 38.8 PURL APPLICANT 35. QUO, 30. idewatk ., s '. 130 NORTH STREET REALTY TRUST:., 130 NORTH STREET REALTY TRUST �` 36, e • 6.3 curbOWNER 35.4 ,,,v NORTH , SCALE: 1 = 20 DATE: JAN. 21 ,1994 WILLIAM J. FITZGERALD � P436.0 T SPINDAL REV. FEB. 15,1994 wv t-IYD R AN iZ9V. MA1Z.?.I,I°R4 ��'r C/O BROWN &`-LINDQUIST INC. 39.40 �435.9 ELEV• = � $AXTEP. & NYE INC. 926 MAIN STREET ..jt8 oE,y YARMOUTi-IPORT, MA. 02675 - REGISTERED LAND SURVEYORS DEED REFERENCE; BOOK 1459 PAGE 437. 'p35,g �•t��W� � PETER �C-, CIVIL ENGINEERS PLAN REFERENCE: BK. 290 PG. 34 ®36.0 RCHARD $ SULLIVAM OSTERVILLE, MASS. n. No. 29733 ENGINEER. °. �`�-�srxe►�°�4" BAXTER & NYE INC. e'ars� S��ALE�'�' 812 MAIN STREET �'.-- 0265P,ViLLE, MASS. 02655 (508) 428-9131 SHEET 1 OF 2 EXISTING . C,ONDITIONS ' ,¢�93788 - M h M N M O N d o •i 1 1 i CA Q O N. ii 2 EXAM ROOM 13 EXAM ROOM 12 EXAM ROOM II EXAM ROOM 10 EXAM ROOM 9 EXAM ROOM 8 EXAM ROOM 1 — b 12, X 8' 9'-C X 8'-O! 8' X 12' IS'-C X 8' 9'-9' X 12, 9'-9" X 12' 15'-C X 9'-2' a c 4-3 N o Lo OD n o � , L I `�• , , ._... liar__'=c-c:}., _. EXAM ROOM L 10, X 91-8' vi NURSE/;PA-3 R BRACER 131, X 10'-C � EXAM ROOM 11 EXAM ROOM 11 uWi j 10, X 11-C 10, X T-C Y I i1 z EMPLOYEE BREAK ROOM CURTAINS/ PARTITIONS PA EXAM ROOM 15 _'1rr. _____ 10, X 9' II /UNISEXul......_._..__. -- W II LAV I MEDICAL ASST. II II 5'-V CAST L'-2' - 12'-C X 13'-9' fl EXAM ROOM 18 II II I- Lu II OWN G X 13'-C IF= ===------- CAST II uj .-.-------• --'It -•-- ---_._--_- LU EXAM ROOM IL I { II LfL 10, X11L II CAST II e' X C DEXAM ROOM 5 nr/ , n Io' xm ! T EXAM ROOM 19 9CHEOULING; Q V-10- X 1'-C ! f Z t 1� X-RAY EXAM ROOM 20 EXAM ROOM 22 , ;SCHEDULING •-""" -�• 9'-1' X 1' i-L' x 8' S M # EXA f�SOM- -- IL o EXAM ROOM,., EXAM ROOM23 I 2 . NURSE/ PA-I O UNISEX ._ .. .... -•..__._. -- - r H/C LAV Cl05ET._ . ; EXAM ROOM 3 �' u v, c �\ 10' XIll o �cvv ; so f N Orr C N Vl \� c N 0 7 V O 0 �.,,, C•� U �'C u o ti C N E p 5 r O•. O ur t : , C 'O t c O i f NO0001- �0 � :.., 0 C E Q v C �I F Q 0 0 o p 0 -.O `r— U uvc -bw ° Oo EXAM ROOM 2 :; y `u 3 3 a_p N E WAITING ROOM a u U o ; v o _ o a. u)— _ 'i = N v O'Ow0 0ATRIUM !� --- _-6 v c °� ` v000 ' o� � ,,. c v. II 0 LL rn O.N N 51 I: 11 L F- 'o 0 O O 0 { �1 0 O -o O O kf {i� ill EXAM ROOM 1 o g o o o a� 0 12' x 8'-10' N as°v 0,.N v d:)n m O m Ovv vOcQ DATE: 4/5/2011 BUILDING CODE NOTES ' ��,._ _.___ j; _ _ _ ` -- REVISION -USE GROUP: B � REVISION -TYPE OF CONSTRUCTION: 58- COMBUSTIBLES -MAX. OCCUPANCY FOR TENANT SPACE BASED ON ;,. I RECEPTION REVISION _.._ ._._�-....__ 21' X 10'-10' BUILDING AREA: 11 PERSONS -TENANT SPACE AREA, 1,T15 SF (ALLOWABLE: 9.000 SF) REVISION -REQUIRED EXITS (2)- ACTUAL EXITS (2) DRAWN BY: CHECKED BY: MSB WWS NOTE: DRAWINGS BASED ON AS BUILT PLAN DRAWN BY CONSERV, AND SUPPLIED TO SALTONSTALL ARCHITECTS BY CAPE COD ORTHOPEDICS. SALTONSTALL ARCHITECTS _.._ .. ..___._.__.. SCALE : AS NOTED IS NOT RESPONSIBLE FOR INCONSISTENCIES BETWEEN THIS --- -•-- DRAWING AND WHAT ACTUALLY EXISTS IN THE FIELD. _ JOB NO. ---- FILE NO.: CCO-Phe.e 2-Up. we-Opt OFFICE O Is'-L• x 9,—Ir FLOOR PLAN �'' WALL TYPE KEY � \` ELE Top BREAK Roots - `LAV 2� ENTRY EXISTING WALLS PROPOSED NEW WALLS it ------_------::: __. EXISTING WALLS TO BE DEMOLISHED 0 FLOOR 7LAN- OPTION 5 Al ■ l SCALE, 3/rL' - O' --6-6 1/2" -- -- -- -6'-i3" - ------- —11 4"-------- 6 4' - --- 6 4'- PHONE CON5ULTATION OFFICE BATH Common ROOM ROOMs d Bath V—r1"X V—+1c. IN fmW W—pW1 y p Wv 11 �"1—+�I NW y W—✓'11 W— 1 t i 6-2 1/a'" ---__-- CC r r ':,` 1 ! [✓' r �A yJ "- WN X TW 11 --==.V==l U 8'-2 1/2 - -= OFFICE gg � 1 Im «p1 11"' t A "" X 1µmm Sm in 114" EXAr CONFERENCE EhJ i t ROOM OFFICE y gIpWW � +FFI RECEPTION OFFICE y}'1 «y y q P �A` 1"@ F "°� 1 ' "'f•• 9 1a+' ""' ! 0 1A q,-j L/"" p, ® 1®1 ) '-Bmmy Iy 11 — --_ -- 1 a'-3 1/2" ----— --~ — 6'-a 1/4" —1—r--- _—._--8'-a"---- --- - - -- -38'-6 5!8"- ----- - ---- ---- ----- Office AREA � 1011 Sq ft New Interior Partition: Steel Studs 1b"ox. Fiberglass sound butts. ProposedlourI 5/8type "X." sheetrock Cape Cod Health Care Employee Health ate: 5-3-2001 ---____-- —_-- -____._—__-- _ fig. ` Home Improvement pec ialists o Cape ad Inc. 1 No t. Scale; 11411 = 1 ' i` 25 I anon h Rd. Ph. - r15-2 15 Hyannis, Ma. 02601 Designer: Paul lava a -- f,` 1 . Hyannis, a. 1Fax. 506-115-2861 --- 6-6 1l2" -- — 6'-b" — -----11'-4" ------ -- 64"— --6-4"---- ZO a i-- 6-2 1 lb" j U — .�..- 1 l - m — — -------G'-8 114" -------= i a; New Sprinkler 5ymbol - Sprinkler Symbol { Existing Locations � Existing ri I r Layout Proposed Modification GapeCod health Care Employee-Health Date® - -2c 1�------ - - ------ f , ------ _ __ - __-_--------_ __—____..----.- - ---------- - _ ------- _—_ —_ P �' Home I pr�ovement Specialists of a cad Inc. 1 �4" = 1 'North t. 5cale. 1 I anau h Rd. Ph. 508-115-2615 Hyannis, a. b 1 - _ ---- --- -- fJ f'. 2. Hyannis, a. 02601 Fax. 0 - - b °7 Designer: Paul Savage —_----�_. — ---.------ --- 40'-11 5611 - - -- -- ----� — - --- - ----------34'-4" i 5'-6' -- -- 11'-4" -- - — 6-4" _— 6 4„ PHONE KITCHEN ? Room Use BATH IiPl BATH V- DIY X VY T' y! !i ®-°DIY y� �Y' YY v i s1 in ca 'i L ti4 RECEPTIONOFFICE IQ — --- — 151-2 315" — — -- Existing Floor Layout Cape Cod Health Care / Employee stealth Date: -- 5-3-20 1 --- ,, f Home Improvement Specialists of Cape Cad Inc. 130 North 5t. acale. 1/4 = 1 ,� 25 lyanvugh Rd. Ph. 50 -115-2 15 Hyannis, Ma. 02601 Designer: Paul aava e — r'r Hyannis, Ma. 02601 Fax. 50-115-2 'I