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Home My WebLink About0111 OCEAN STREET (6) tb �I"E' ti Town of Barnstable Building Department - 200 Main Street ASTABLE, * Hyannis, MA 02601 9� M"� �' (508) i639, 862-4038 ArFD�A e of OccupancyCert�f�cat Application Number: 200900679 CO Number: 20110096 Parcel ID: 326045 CO Issue Date: 06130111 Location: 111 OCEAN STREET Zoning Classification: HARBOR DISTRICT -Proposed Use: CHARITABLE HOUSING OTHER Village: HYANNIS t . 00. III Gen Contractor: HANLEY, ROBERT P Permit Type: R C CERTIFICATE OF OCCUPANCY RES Comments: Building Department Signature Date Signed tKE TOWN OF BARNSTABLE `�` wilding Application Ref: 200900679&MW9FAB1E1 * Issue Date: 09/03/09 Permit 9 MASS. �ArF6 N39- A�� Applicant: CALDER,KENNETH Permit Number: B 20091620 Proposed Use: MULTIPLE HOUSES ONE PARCEL Expiration Date: 03/03/10 Location 111 OCEAN STREET Zoning District HD Permit Type: NEW COMMERCIAL Map Parcel 326045 Permit Fee$ 331.50 Contractor COLBY D.ROY JR Village HYANNIS App Fee$ 150.00 License Num Est Construction Cost$ 65,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND BUILD NEW STAFF QUARTERS(400 SQ FT)CHANGE OF CONTRAC ORrHIS CARD MUST BE KEPT POSTED UNTIL FINAL 2/2010,2ND PERMIT EXTENSION EXP 3/3/11 INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: TUBMAN, SANDRA L BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 462 TUBMAN RD INSPECTION HAS BEEN MADFV BREWSTER, MA 02631 Application Entered by: SS Building Permit Issued By: � THIS PERMIT CONVEYS NO;RIGHT TO OCCUPY ANY STREET;ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY. ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,-MUST BE APPROVED BY THE JURISDICTION. STREET ORALLY GRADES AS WELL AS DEPTH AND LOCATION bF PUBLIC SEWERS'MAYBE OBTAINED FROM THE DEPARTWv Nf"T,Of.PUBLIC WORKS.,. THE ISSUANCE OF THIS PERMIT-DOES NOT RELEASE THE;APPLICANT FROM THE.CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. - MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS.TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4. PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5. INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING,AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH:UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). My BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 01 2ek� p1,j�-e 7 t—J t—�C: 2 pf'r o 2 4 ' TP 3 0 rC 1 Hea ' g Inspection Approvals Engineering Dept , 1 f Fire Dept 2 r alth IC^l L 7/ J �a _ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # _ Health Division Date Issued Conservation Division Application Fee 4, Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation / Hyannis P oject_-StreetAddress--7 �� n e-Village cewner /45' Address cTelephone= - �Perrnit:.Request--m..�L a-I�Jo_o _>LZIff U0 6_'11_41Y5 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor,96-p n Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Others = c� N Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing woodcoal stov"°: ❑As ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing�l neon size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: d , 10 r,17 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=A-z- r FTdI ph e Numbers / � G�G 2 Address=��G� �zr�_ L�e_nse:#_—,--,7,-? e7" l Z Home Improvement Contractor# Worker's Compensation # ��/f�� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOf� Sj SIGNATURE c DATE �i�� `1 FOR OFFICIAL USE ONLY ti APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION I FRAME INSULATION FIREPLACE c ELECTRICAL: ROUGH FINAL I PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING f r DATE CLOSED OUT ASSOCIATION PLAN NO. i The Commonwealth of Massachusetts r l Department of Industrial Accidents 9 Office of Investigations 600 Washington Street l Y UNU Boston, MA 02111 c www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 14%�� CdiTi6 C®f'�--yam Address: City/State/Zip: �jZ-06� / Phone .6; 5—y �3�Z Are you an employer? Check the'appropriate box: Type of project(required): 1.❑ I am a employer with 4.,KI 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.. 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 1 1..[:] Plumbing repairs or additions self.m ' 152 1 4 Y �o workers comp. c. , § ( )>and we have no 1.2.❑ 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 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. Insurance Company Name: cy 4- Policy#or Self-ins. Lic. #: G U ,?/49 87 f 6 Expiration Date: 9 Job Site Address: City/State/Zip: 1�i�i/✓/ 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 certify un e par and penalt'fe of perjury that the information provided above is true and correct Signature: Date:. Phone#: 636 Z Offtcial 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 inio 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 pennit/Iicense 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 ail 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 proofthat 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 D�parlm:ent of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 0.2111 Tel. # 617-727-49.00 ext 406 or 1-877-MASSAFE } Fax # 617-727-7749 Revised 5-26-05 wwFv.m_ass..gov/dia �srti Towns of Barn-stable ` Regulatory Services suwsxR. Thomas F. Geiler,Director 1639.n '` 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 Us ing A Builder 4 er of the subject,property hereby autbo ' to act on my behalf, in all natters relative to work authorized by this wilding permit application for Address of J b Si4ureof WRW Print Name. . If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:F0RMS:0WNF_*EFNISS)0N , tt ray Town of Barnstable ti� o Regulatory Services swrtxsrwst e Thomas F. Geiler,Director 039. ,�� Building Division eD►�ta't� Tom Perry,Building Commissioner 200 Mairi.Street, Hyannis,MA.02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOINIEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number strcat 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 dots not possess a license,provided that the owner acts as supervisor. DEFINTIION OF BOMEOWNER 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 constrgcts 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 ptrmit. (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. t Signature of Homeowner Approval of Building Official r 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 perfomung work for which a building pcmdt is required shall be cxm'-npt from the provisions of this scction.(Scetion ID9.1.1 -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 arc assuming the responsibilities of a supervisor(see Appendix Q. Rules&Regulations for Liccrising Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In,this case,our Board cannot procccd against the 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 irsponsrbilities,many communities require,as part of the permit application, that the homeowner certify that hdshe understands the responsibilities of a Supervisor. On the last page of this issue is a farm currently used by several towns. You may:are t amend and adopt such a form/ccrtification for use in your community. Q:forms:homccxcmpt A.- CELLA Construction Corporation Town of Barnstable Building Department RE: Hyannis Hostel 490 Ocean Ave Building Permit To whom it may concern, Acella Construction Corporation authorizes Bob Hanley to act on our behalf as it relates to managing construction projects and assuming permits in our name. Regards, Anthony Dirubbo VP Operation Acella Construction Corporation 62 Accord Park Drive Norwell, MA 02061 Tel. 781-681-9240 Fax 781-681-9241 www.acellaconstruction.com Arco' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD"YYY) V 16/1/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT The Driscoll Agency, Inc. NAME:PHONE FAX 93 Longwater Circle A/C No Ext:781-681- A/C No):781-681-6686 E-MAIL P.O. BOX 9120 ADDRESS: Norwell MA 02061 PRODUCER CUSTOMER ID M INSURER(S)AFFORDING COVERAGE - NAIC# INSURED INSURERA:Nat'1 Fire Iris CO of Hartford 20478 ACella Construction Corp. INSURERB:NOrth River Insurance Company 62 Accord Park Drive Norwell MA 02061 INSURER C:Transportation Insurance Co. 20494 INSURERD:Illinois Union Insurance Com a 178978 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1082309503 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. I�TR D TYPE OF INSURANCE D POLICY NUMBER MM/DDIIYYYY MM/DDIYYYY LIMITS A GENERAL LIABILITY C2083108786 4/22/2011 8/31/2011 EACH OCCURRENCE $1,000,000 X COMMERCIALGENERALLIABILITY DAMAGE ( RENTED PREMISES Ea occurrence $100,000 CLAIMS-MADE �OCCUR MED EXP(Any one person) $5,000 PERSONAL BADVINJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 17 POLICY X PRO- RO LOC $ JECT C AUTOMOBILE LIABILITY 4020035368 4/22/2011 8/31/2011 COMBINED SINGLE LIMIT $11000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ - ALL OWNED AUTOS. BODILY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON-OWNED AUTOS $ B, X UMBRELLA LIAB X OCCUR 5530933125 4/22/2010 8/31/2011 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $20,000,000 DEDUCTIBLE $ X RETENTION $0 $ C WORKERS COMPENSATION WC2083108884 4/22/2011 8/31/2011 X WCSTATU- I OTH- AND EMPLOYERS'LIABILITY Y I NCRY L" ER ANY PROPRIETOR/PARTNER/EXECUTIVE© N/A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) - E.L.DISEASE-EA EMPLOYE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$1,000,000 D Contractors Pollution CEOG23879876003 4/22/2010 8/31/2011 Pollution Aggregate $2,000,000 Pollution per claim $1,000,000 Contractors Equipment Leased Rented Equip $25,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Hostel International is included as Additional Insureds for General Liability and Excess (Umbrella) Liability as required by a signed written contract or agreement with the Named Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Hostel International 290 Ocean Street Hyannis MA 02601 - AUTHORIZED REPRESENTATIVE / s / .f[?� ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD I chuSc[t5tocparme�tt tit Publie � ONBoard of Bu►Idtn=Rc��Jtil ttions and-St Construction Supervisor License L _ s ;,�,Mije e cS 7341 ROBERT OS' � :. 8 DUBLIN PLYMOUTH;,MA 02360 Expiration: 11/30/2012 commissimier Tr-,: 7127 I June 21,2011 Town of Barnstable,Building Division 200 Main St Hyannis MA 02601 RE: Permits and Inspections, ill Ocean St, Hyannis 02601 To Whom it May Concern, Please note that the Eastern New England Council of Hostelling International-American Youth Hostels buildin s �-- onst ruction and its subcontractors to complete construction of two g l Inc.,has retained Acella C � at 105 and ill Ocean St in Hyannis. / Please allow the transfer of permits from Cape Cod Technical High School to Acella and its subcontractors,and please also conduct the inspections they require. If you have any questions,please call myself at 508-775-7990,or John Yonce at 617-922-0076. Thank you. Sincerely, CON Jamie Lombardo ; Manager, HI-Hyannis. t -k o ��Lo June 21, 2011 Town of Barnstable, Building Division 200 Main St Hyannis MA 02601 RE: Permits and Inspections, 111 Ocean St, Hyannis 02601 To Whom it May Concern, Please note that the Eastern New England Council of Hostelling International-American Youth Hostels Inc., has retained Acella Construction and its subcontractors to complete construction of two buildings at 105 and 111 Ocean St in Hyannis. Please allow the transfer of permits from Cape Cod Technical High School to Boston Air Mechanical Systems for Plumbing and Charles Perfettuo Electric to finish Electrical work and please also conduct the inspections they require. If you have any questions; please call myself at 508-775-7990,'or John Yonce at 617-922-0076. Thank you. Sincerely, Jamie Lombardo Manager, HI-Hyannis. II � i AcELLA Construction Corporation June 27, 2011 Town of Barnstable Building Department s � SUv 7�p 230 Re: 490 Ocean Ave, Hyannis Transfer of Building Permit To whom it may concern: Bob Hanley is a full time employee of Acella Construction and is authorize to apply, pull,and transfer permits on our behalf. Regards_. =3 �- C tii 5.•.ti i Anthony . Dirubbo VP Operations Acella Construction Corporation p M 62 Accord Park Drive Norwell, MA 02061 Tel. 781-681-9240 Fax 781-681-9241 www.acellaconstruction.corn " TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 2�. ccp� Map �'aLO Parcel. 0�� 'Application # 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 t ,illage Own Y Le /I Addresss 2 0 TelephondTZ& 7 71 — �J fl�et,--ylwd Permit Request " ' ` Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total..newi-�✓ Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type , Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documeriiflion. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new > Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new' size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION - - - (BUILDER OR HO OWNER) Name- _ . -7_J U ICC X' YJ ' �7ephone IVumberr _ . �- :AMd—ess `` c� I ��' L' . �License,#_44*1VI, �.5 r-Home Improvement,Contractor#._.- Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO i l: l j FOR OFFICIAL USE ONLY (,APPLICATION# ' DATE ISSUED MAP/PARCEL NO. s ADDRESS VILLAGE f OWNERf P DATE OF INSPECTION: i?-FOUNDATION; FRAME INSULATION..:'; y : 3 FIREPLACE ELECTRICAL: ROUGH FINAL ., PLUMBING: ROUGH FINAL ' F GAS GAS, ROUGH FINAL ;;'FINAL BUILDING 0 + _ T ' DATE CLOSED OUT _ i ASSOCIATION PLAN NO. 4 - �z �1t€ �$��R�'� ....x .:-r. r,�ct ISSUE DATE(MM/DDIYY)'. q TTI. � ,[� _:� ��`' �. hx .e Fgo�s.�'�'u, �" ' 7)^�/.rma�.w��' �P �i'' F� � t ar.`�.st�..�a4t ,. 6/4/20�0 THIS IS AS A TTER OF AND CONFERS NO RIATE NFORMATION MEGA PROPERTY $ CASUALTY GROUP INC• UPON THEICERTIFI ATE HOLDER THISMA CERTIFIICATE DOES NOTLAMEND.EXTEND OR AL ERTS THE COVERAGE AFFORDED BY THE AGREEMENTS BELOW. Go Cannon Cochran Management Services, Inc. COVERAGE PROVIDED BY 100 Quannapowitt Parkway COVERAGE A MEGA PROPERTY &CASUALTY GROUP INC. Suite 201 PROVIDER Wakefield,MA 01880 COVERAGE R PROVIDER v COVERED MEMBER COVERAGE PROVIDER CAPE COD RTHS COVERAGE D 351 PLEASANT LAKE AVENUE PROVIDER HARWICH MA 02645 COVERAGE PROVIDER c m .vyw.^.�^' sl_ `....:.;zrl '�i'r� d ;?P•- "'rT. IV'�41 ��j' v - +''L f r•s[ to, �t'.�,1"''! ''!� y :r 'e k1.++ THIS IS TO CERTIFY THAT COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE MEMBER NAMED ABOVE FOR THE COVERAGE 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 COVERAGE AFFORDED BY THE AGREMENTS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH AGREEMENTS. - PR EFFECTIVE DATE EXPIRATION DATE LTR TYPE OF COVERAGE AGREEMENT NUMBER (MWDD/YVYY) IMMIDDrCM) ALL LIMITS GENERAL LIABILITY GENERAL AGGREGATE f - COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $ CLAIMS MADE F7 OCCLR. PERSONAL&ADV.INJURY 6 OWNERS&CONTRACTOR'S PROT, f EACH OCCURENCE 6 FIRE DAMAGE(Any one fire) $ MED.EXPENSE(Any ona person) $ AUTOMOTIVE LIABILITY - COMBINED SINGLE ANY AUTO LIMIT S ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) s HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY _ EACH OCCURENCE $ UMBRELLAFORM - ' ' AGGREGATE $ OTHER THAN UMBRELLA FORM a,,,0^r wl WORKER'S COMPENSATION STATUTORY LIMITS X A & WCX3401520010 7/1/2010 7/1/2011 EACH ACCIDENT $ 500,000 EMPLOYERS LIABILITY DISEASE-POLICY LIMIT $ 500,000 DISEASE-EACH EMPLOYEE $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I SPECIAL ITEMS <. ...-.. .f... ..c.. ., �.... ..., ..,5- .. .�e..� � � ... .K..,fk ... , ..,, Jv:.xik�'I.._�„da; E�,u Tt,t`zty...., ,rr�a ..,�,-✓;rj !•.-X T=�.F.':'=�ant Fi�-'f�` 'SHOULD ANY OF THE ABOVE DESCRIBED AGREEMENTS BE CANCELLED BEFORE THE EXPIRATION 2Y ,.DATE THEREOF,THE ISSUING PROVIDER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO CAPE COD RTHS ;THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE PROVIDER,ITS AGENTS OR 315 PLEASANT LAKE AVENUE %REPRESENTATIVES. r HARWICH MA 02645 ��,;J.`� -ip 't+ a .'�;tY'` £7 t.;'"s;h{w. `I}"f}t". xv..r,t; 3;'+', "t. .7 f{7°Yt '.,sy',dj= , `' 41,-.4 '§d f�-'� ti�� ...'ItL, d;Ya; 1 Qr1. .�.ra� y..ter Insured Copy r:. 3 t,' ty �z att G# {ry 1 Lw �aiyM1:j � N4 � �� d' d 1�k°w 5 � ..:•,r"., f'.,.. f•.ad._ a ,.0 ,., Tw.. f.< -f"..n:t °e at 1v +[,'^c.'.E Jx:)c Date: 06/04/2010 CertReclD: 70,397 J:\Visions\Reports\Certificate_of_Covg.rpt PRID: 302262117 THE'o Town of Barnstable ` Regulatory Services f SARNSTABLY- q Mass. g Thomas F. Geiler,Director 619. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508.-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder s �.h-✓✓r0,L 1,",,,�t tart. Vad�- � �kll; as Owner of the subject property hereby authorize '-1-Z-C,L, to act on my behalf, in afl matters relative to work authorized by this building permit application for. 1 1 d , (Address of Job) SignaV Owner J D to I _ Priat'Name If Property Owner is applying for permit please complete. the Homeowners License Exemption Form on the reverse side. Q:FORMS:OVJNERPERMISSION NThe Commonwealth of Massachusetts I Department of Industrial Accidents Office of Investigations �r 600 Washington Street Will Boston, MA 02111 c www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individiial): KoL, ( L Address: �.S Lea. T�Z�G City/State/Zip: ti"Uo ir•CQj U hone.#: [� Z J Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. �Iew construction employees(full and/or part4ime).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. # 7. -❑ Remodeling ship and have no employees , These sub-contractors have 8. ❑ Demolition working for 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.❑ 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. /� �, �Q , Insurance Company Name: i�`''t� �- r 10" �' �"`� C62W J c -711 Policy#or Self-ins. Lic. #:j C- r C Q d Expiration Date: Job Site Address: /1 tO(_04 U-, City/State/Zip: Attach a copy of the workers' compensation policy.declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify r the pains and p ltte perjury that the information provided above is true and correct. Si nature: '� Date: Z- �-✓� f D Phone#: If3 7- o C' .�t !-1 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 withhoid,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 cityor 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, 'y �� •` _ , 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 Massachiusetts - S Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFB Fax# 617-727-7749 Revised 5-26-OS www.mass.gov/cha �� ... .. ,.._ .. :. ..^( --,X� C;.�S. �" I� :.-E"�a -''r�1tL 'G�,s k-.,<, - A-'l ��cc A: ,E; I J i. s _i F J r3 x (1 .,7 y- I r1p{2. -.h a•t t - a .k "`` t t k Irk a•.a n�e� OJ9jO28``yT �k' ,�p-5 -4: ISSUE DATE(MM/DDNY)L :1 6/4/201 0 .f THIS IS ISSUED AS A TTER O INFORMATION ONLY AND CONFERS NO MEGA PROPERTY & CASUALTY GROUP INC. UPON THEIFICATE C CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALT RTS THE COVERAGE-AFFORDED BY THE AGREEMENTS BELOW. - Go Cannon Cochran Management Services,Inc. COVERAGE PROVIDED BY r 100 Quannapowitt Parkway COVERAGE A MEGA PROPERTY &CASUALTY GROUP INC. - - Suite 201. PROVIDER Wakefield,MA 01880 COVERAGE B PROVIDER COVERED MEMBER - COVERAGE A _ PROVIDER C - CAPE COD RTHS COVERAGE D 351 PLEASANT LAKE AVENUE PROVIDER` HARWICH MA 02645 COVERAGE E PROVIDER COVERAGES Y E`a a wba tTw r. yY to?rs. ( rd rr� .'' L� Z.."'sy a t -•n7�7�a'M,k�'-tr.�M A. _ 7 THIS IS TO CERTIFY THAT.COVERAGES LISTED,BELOW HAVE BEEN ISSUED TO THE MEMBER NAMED ABOVE FOR THE COVERAGE 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 COVERAGE AFFORDED BY THE AGREMENTS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH AGREEMENTS. - PR - EFFECTIVE DATE EXPIRATION DATE LTR TYPE OF COVERAGE AGREEMENT NUMBER (MM/DD/YYYY) (MMIDDIYYYY) ALL LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERALUABIUTY PRODUCTS-COMP/OP AGG. - y CLAIMS MADE F7 OCCUR. PERSONAL 6 ADV.INJURY $ OWNERS 8 CONTRACTOR'S PROT. EACH OCCURENCE $ FIRE DAMAGE(Any one fire) : ` MED.EXPENSE(Any one person) s AUTOMOTIVE LIABILITY - - COMBINED SINGLE , ANY AUTO - LIMIT s ALL OWNED AUTOS BODILY INJURY person) - f SCHEDULED AUTOS (Per p ' HIRED AUTOS< - BODILY INJURY NON-OWNED AUTOS (Per soddsnt) _ s GARAGE LIABILITY - - PROPERTY DAMAGE : EXCESS LIABILITY • - EACH 06CURENCE $ UMBRELLA FORM - AGGREGATE S OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY LIMITS X EACH ACCIDENT : 500 000 A EMPLOYERS LIABILITY V�/CX34O152OQ1 O 7/1/2010 7/1/20"11 DISEASE-POLICY LIMIT s 500,000 DISEASE-EACH EMPLOYEE S 500,000 OTHER - - DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I SPECIAL ITEMS C�RTiFICATE HOTLDER 'f"( ; ;; �" w s,ya �-'GANGELLATION' * ,�� r �-t� #"'13• r �� "z�"'" { } :.a 7 .,„t a � ��` ±SHOULD ANY OF THE ABOVE DESCRIBED AGREEMENTS BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING PROVIDER WILL ENDEAVOR TO MAIL N DAYS WRITTEN NOTICE TO CAPE COD RTHS THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE PROVIDER,ITS AGENTS OR 315 PLEASANT LAKE AVENUE REPRESENTATIVES. r HARWICH MA 02645 2 s /.�yr.-s r . 1 f so-3 �e .x VE)°h: j a a -gin. InSUred Cd a c r) t a r r t y x- F as Ni,assachusetts- Department of Public SaM } Board of Buildin- Regulations and,Standaed- w Construction Supervisor License License: CS 73550 " Re§trktedP .00 Fs ROY D COLBY JR - 678 DEPOT°ST HARWICH, MA 02645 Expiration: 2/6/2012 Commissioner Tr#:. 15484 �zt r Town of B arn- t s able "0 Regulatory Services BAxxsreIBLF, v Maas. g Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.t6wn.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder i: .�1 3 :-c as Owner of the subject property hereby authorize_ ��lL• `(�'c-�, to act on my behalf, in all matters relative to work authorized by this building permit application for: 11 I d its a -Y4- ; (Address of Job) Signa e o Owner D to Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:F0RMS:0 WNERPER-MISS10N Oaf the ray Town of Barnstable Regulatory Services BARNSTAB Thomas F. Geiler,Director Huss. Building Division rfo Ma's" Tom Perry,Building Commissioner 200 Main.Sireet, Hyannis,MA.02601 Rrwv.town.barnstable.ma.us Office: 509-862-4038 Fax: 508-790-6230 HOI\H OWNER 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 dwellin s of six units or less and : to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constmcts more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a.form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that.be/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 pern 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 parson(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption an unaware that they arc assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed.against the unlicensed person as it would with a licensed Supervisor. The horn'cowncr acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her rtsponsbilitics,many communities require,as part of the permit application, that the homeowner certify that hdshe understands the responsibilities of a Supervisor. On the last page of this issue is a.form currently used by several towns. You may care t amend and adopt such a form/ccrtification for.use in your connnunity. Q:forms:homeexempt Telglwne: ,�-(1' � j Robert P.Sanborn,III (508)4,12-4500 r, '��11�� "S: Superintendent Director *pe(508)771-2600od Regional Technical High School Erin Orcutt Fax Number: 351. Pleasant Lake Avenue, Harwich, MA 02645-1813 Business Administrator (508)432 7916 ............................................................................ Cape Cod Regional Technical High School will provide.an opportunity to acquire high quality technical,aeadernic,and social skills which prepare our students for success in our changing world To Whom it May Concern, Roy Colby is a full-time employee of Cape Cod Regional Technical High School. Roy Colyby is a Carpentry instructor for our,school. Furthermore, Roy is covered under the school's workman's compensation coverage and he is authorized by our.school to pull building permits. Any questions and/or concerns, please do not hesitate to contact meat the school (Extension 21.4). Sincerely, Robert P. Sanborn III Superintendent/Director - - Barnstable•Brewster • Chatham •Dennis • Eastham •.Harwich• Mashpee •.Orleans • Provincetown •Truro •Wellfleet •Yarmouth 4 ; oF�HE ro,,, Town' of Barnstable Regulatory Services * BARNSTABLE. • . y MASS. g Thomas F. Geiler,Director 1639.Tfn3..s Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF CHANGE OF LICENSED CONSTRUCTION SUPERVISOR owner of property located at 1 4- l o C-e,, S+ , hereby certify that � tnvte,-F� �' i�cr is no'longer Construction Supervisor listed on the application for the project under construction as authorized by building permit# 2 von CL0E-7`1 ; issued on .3 2010 I understand that the project under construction mu'sf cease until a successor.licensed Construction Supervisor, is submitted on the records of the Building Division. P OP RTY OWI E DAT q/forms/newcontr reference R-5 780 CMR rev:110410 CALLA Construction Corporation August 30, 2010 Thomas Perry Building Commissioner SEP 03 RECT Town of Barnstable 200 Main St. y Hyannis, MA 02601 RE: Hyannis Hostel — Permits B 200900679 & B 200903054- 111 Ocean St. Mr. Perry: As you may know the above permitted projects have not,begun construction. The permits are slated to expire on September 3, 2010 and we would like to extend it for an additional 8 months if possible. There are a couple of reasons we are not able to begin construction sooner. The Owner was not able to proceed until recently due to internal issue. The resolution has allowed the team to be released to finalize the documents which have been issued for pricing. In addition to this the Owner is unable to begin until after the.season has ended on Columbus Day weekend. For these reasons we wish to get permission to extend thepermit and begin construction this fall. Thank you in advaince for your anticipated cooperation: Regards, S an Smiley Project Manager Cc: file, Rick Fenuccio , 62 ccord ark Drive Orwell M 02061 Te1, 81-68 -9240 ax 8 -681- 241 w%vw.acellaconstrucrion.com _ TOWN OF BARNSTABLE Building Department - Foundation Permit Date Permit # c�p0900(o�i Name Location Insp. of Bldgs. TOWN OF BARNSTABLE Building Department - Foundation Permit Date / Abo Permit # o?U01,,/ 0 30S`l Name Location Insp. of Bldgs. -MessIge. Barrows, Debi From: Perry, Tom Sent: Tuesday, August 31, 2010 4:06 PM To: Barrows, Debi Subject: FW: Hyannis Hostel - 111 Ocean St. ,: " Importance: High This is ok.Thanks -----Original Message----- From: Sean P. Smiley [mailto:smiley@acellaconstruction.com]'° Sent: Monday, August 30, 2010 4:00 PM To: Perry, Tom Subject: Hyannis Hostel - 111 Ocean St. Importance: High Good afternoon Mr. Perry, Please find attached our formal request for permit extension for per numbers B 200900679 B 200903054. Please let me know if you have any questions or comments that need,to be addressed. We have placed an original copy of-this letter in the mail addressed to your attention. Thank you in advance for your anticipated cooperation. ACELLA C OVStructiaa+C:arporatian Sean Smiley Project Manager ' ACELLA Construction 62 Accord Park Drive Norwell, MA 02061 Office(781) 681-9240 Fax (781) 681-924.1. Cell (781)424-6633 www.A CELLA con structiOn:com Click here to see our Spring/Summer Newsletter Please consider the environment before printing this e-mai.t of r r z 9/1/2010 AcELLA Construction Corporation August 30, 2010 Thomas Perry Building Commissioner Town of Barnstable 200 Main St. Hyannis, MA 02601 RE: Hyannis Hostel — Permits B 200900679,& B 200903054- 111 Ocean St: Mr. Perry: As you may know the above permitted projects have not begun construction,The permits are slated to expire on September 3, 2010 and we would like to extend it for an additional 8 months if possible. " There are a couple of reasons we are not able to begin construction sooner. The Owner was not able to proceed until recently due to internal issue. The resolution has allowed the`team to be released to finalize the documents which have been issued for pricing. In addition to this the Owner is unable to begin until after the season has.ended on Columbus Day weekend. For these reasons we wish to get permission to extend the permit and begin construction this fall. Thank you in advance for your anticipated cooperation. Regards, ' S an Smiley Project Manager Cc: file, Rick Fenuccio (i2 Ar..c:orcf I'ti. 1. ntix°c._'-...i'`io t}cl:l ..N;L ,Q2Ut1 .._' 3e:1<, 7x.1 .G81 !?2f•Q._'._..E.a�.7 .1. 6f3,1,9241 ��%ktiv.acelIaconstrzjction.com � �� d �� Y, � ��. x �, K �. ,,. �� .. �, _ a � R �," F __� �' ,: z y. ,� "' ,,: ,, sue'-r,•. `� - � � '`> S� �r � +� x e r �. �- �' w �-� a .� � � e. � ,. - _' r .� �: �� _ _ �, ,,??gg^^�� ',ram � y tea... r �, 6. a -' s '! .. yx _ k - � �� flfn�TSxTi.`� � Y3T�" �� -' iva z: �_ � � x •�� (� S '"" :7 d� a'.'SY - S 8' '� _ '� r � '°tY -_ � < � � �,. -. � $ A 3 n } 3 *�z � � � �� $ � ,� .. � sad �.h�� s t � � g ',•�9' ' t:. �R- � ° 5 �k �, �,ys. [� K* '�' �ri .. ,y� � vp -� w� 'ti.t� 3 'py S �g c« z � �, � �� a � x _ - 4 P�� ' a .� s�,y � '�� to �� t .� .A � �� `" � �s � .M �°"� � _ �� 4��z s��,R ale'- ��a��§� 'YEz .J `ems" .��i "�T L � y, z d `�v. v- - Po. An 1 .�' qig k �'" _ "r LA� �} �x� �Ay� "Lb zA� t �� . < rv- ::� E`W 3� .�$ � , \� f ' fib. �� r � ,¢� ��` j �V � � � TOWN OF BARNSTABLE ' Bu[[d[ng °* Application Ref: 200900679 BARNSTABLE, I Issue Date: 07/O1/10 Permit MASS. 9� 039• �� Applicant: ROBERT,EVANS D 'OIF��•l A Permit Number: B 20101289 Proposed Use: MULTIPLE HOUSES ONE PARCEL Expiration Date: 09/03/10 Location 11.1 OCEAN STREET Zoning District HD Permit Type: NEW COMMERCIAL Map Parcel 326045 Permit Fee$ 50.00 Contractor CALDER,KENNETH Village HYANNIS App Fee$ 150.00 License Num Est Construction Cost$ 65,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND BUILD NEW STAFF QUARTERS(400 SQ FT)CHANGE OF CONTRAC ORr111S CARD MUST BE KEPT POSTED UNTIL FINAL 2/2010, 1 ST PERMIT EXTENSION EXP 9/3/10 INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: TUBMAN, SANDRA L BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 462 TUBMAN RD INSPECTION HAS BEEN MADE. BREWSTER, MA 02631 Application Entered by: PC Building Permit Issued By: THIS PERMIT CONVEY RIGHT TO OCCUPY ANY S'TREET;,ALLY.OR SIDEWALK.OR ANY PART THEREOF,EITHER-TEMPORARILY,ORA.ERMANENTLY ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED.UNDER THE BUILDING CODE,;MUST BE APPROVED BY THE.JURISDICTION. STREET OR ALLY GRADES AS WELL AS DEPTH AND.LO,CATION;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 APPLICABL•E SUBDIVISION'RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). Or .. e A. U BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # S009 Q 36 Health Division Date Issued Conservation Division Application Feeq_4�� Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address i.. Village ►nr'1.f 5 Owner Address Telephone t , Permit RequestAul tUl _� �r') j Square feet: 1 st floor: existing proposed 2nd floor: existing proposed a r Tonal net Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting tficuriOntation. - M 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: 0 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 w�e-� �. c�/� Telephone Number Address �2 2c.LGf� ,�� License Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE — DATE 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 j ASSOCIATION PLAN NO. � E The Commonwealth.ofMassachusetts :. �t Department of Industrial Accidents 1. I Office of Investigations 60a Washington Street. c �� fl oston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit:'Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): AL.c Address: G 'z I��Cr�r�+ tom '�1 ✓>f�� _�( 1/I City/State/Zip �� %�,��[ U Ct Phone#: .. 79-3/ :7z 11�/b: Are you an employer?Check the appropriate box: : — Type of project(required): 1.El am a employer with- 4. I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors. 6. ❑New construction 2.❑ I am a sole proprietor.or partner- listed on the attached sheet. 7. :[ Remodeling ship and have no employees': These.sub-contractors have g Q Demolition .working for me in any capacity. employees and have workers' [No workers' comp insurance comp. insurance.$ 9. '&8uilding addition required,] 5. D We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have;exercised their . 11.0'Alumbing repairs or.additions myself [No workers' comp. right of exemption per-MGL. q c. 1'52 ) 12.0 Roof repairs insurance required.] t � §1(4 ,and we have no employees. [No workers' 13.[] Other. comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit'indicating they are doing all work and then hire outside contractors must submit.a new affidavit indicating such. tContractors that check this box must attached an.additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees.'Below is the policy,andjob site information. Insurance Company Name: . Policy#or Self-ins. Lic. Expiration Date: ' l� - Z2, - t© Job Site Address: O `` I(� • ,� ` ,� City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ' fine up to$1,500.00 and/or'one-year.irnprisonment, as well.as civil penalties in the form of.a STOP WORK ORDER and a fine of up to$250.00 a day against the violator..Be advised that.a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance,coverage verification. I do hereby certify underthepains andpenalties ofperjury that the information provided above is true and correct. Signature _1 b - Date: Phone#:-' Offkial 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#: Pager 002 ACORD;y CERTIFICATE QF LIARILITY INSURANCE zA2/2010 Yy' PRODUCER (781)681-6656 FAX: (781)681-6686 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Driscoll Agency, Inc. ONLY, AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 93 Longwater Circle ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O_ Box 9120 Norwell MA. 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED IJ, I;t:F;A Nat'l' Fire Ins Co of 20478 Acella Construction Corp... N -. Transportation Insurance 20494 -- __ - - _ __ �,— T_----------- 62 Accord Park Drive gGu;3;:F:c North River Insurance Norwell MA 02061 - ;TH POI 1CIES OF 1NSURANCF LISTED BEL OIN HAVE BEEN ISSUED TO THE INSI IREDNAPIEC AD[Y0/F FOR THE POLICY PERIOD INDICATED.NC?TVATIi.STANDNG ANY oulp, WIEN'L,TFrim oR CONDITIJtJ OF ANY C•CNJI'RACT OF,OTHFR.IiOC:Uf1FNT'-WITN PESPFC-:T TO WHICH THIS CERTIFICATE rAAY BE l3SUEr OR MAY PERTAIN:INSURANCE AFFORDED BY THE. POLICIES DESCRIBED HEREN IS.SUR-JECT TO ALL.THE TERMS. F.XCL.USIONS AND CONDITIONS OF SLICH POLICIES.;?�%' ' •'Hn• >::ADD'L POLICY EFFECTIVE POLICY£KPIRATION R TYPE Of INSURANCE POLICY NUMBER DATE MM;UD.r1'Y GATE(MMiDDrYY) LIMITS - - GENERAL LIABILITY 1,000,000 X CAV.A.; m.F ENT i 100,OOC} A :1:_U`63>tf,^C '1r;;L:F. C2083108786 4/22/2009 4/22/207 0 — - 15,000 000,001) ;Al:; 6 2,000,000 .?•:Yak-io'•-I[ MIT.A' I. .:i FER .. - - - X 000,000 - - - El AUTOMOBILE LIAMLJTY -INGLE Ll%l 1 000 000 ANY A:J:%; ( jvr S r i B A__ovUNECAa7GS '083108741 +1/22/2009 9/22/2010 X �:FEis A:'Oa 1 X 1F%1-0*NEGAI_TOS Lv,y: :Y , GARAGE LIABILITY AN A J,`: ✓ . . A L7•0 ONLY r---- - - .. EXCEsaumr,RELLALIABILITY - , -a^�--:,:.•c;:�,' .. S 10,000-.000 ^;;19 ^_'.'v}3�rn.: 10,000,000 • 6 C. 71C:ieLc 5530922883: 4/22/2009: 4/22/2010 B WORKERS COMPENSATION AND Vr�Tq EkPLOYERS'LIANLITY `, X ,, Y;AT ANY P=cOFFl-n�rcf•.=Tip-i,=X,(C-LT:Vc - - E.i E.a-H WC2083108884 4/22/2009 4/22/2010 ";SEA'z;z . :es.e�er�a:rJ�r E.L� ,;�_��F3FL:,1:c S 1,000,000 �:'�CL4L i�Fi•'.•V:51•:I%:5'C•cCnt' -- --------_____� E._., SHASt t l�Y Liw1 1 $. 1,000,000 A OTHER Leased/Rented C2083106786 4/22/2009 . 4/22/2010 $25,000 any. one item Equipment. from others ; DESCRIPTION OFOPERATIONS/LOCATIONS%VEHICLES:EXCLUSIONS ADDED Wi ENDOR5EM£NTrSFECIAL PROVISIONS - RE:: Hostel international, 1.01-1.L1 Ocean..street; Hyannis; NA renovation of two rliiWi.ngs, including demolition of. Others. Please refer to at.t.ached.a(liendum:" 'Notice of cancellation provision is 30 days, except 10 days applies for nan-payment of"p fermium. CERTIFICATE HOLDER - CANCELLATION SHOULD AIJY OF THE 4BOVE DESCRIBED POLICIE BE:CANCELLED BEFORE THE Eastern New England` Couacil of '. EXPIRATION DATE THEREOF. THE ISSUING INSURER. WILL ENDEAVOR T0.MAIL Hostelling International, 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT American Youth Haatels,Znc. 218' Holland Street FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE Somerville, MA 021-44 INSURER,IISAGENTSORREPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD Z3(2007?08) s ACORD CORPORATION 1988 AcETLLA ' - Construction Corporation To Whom It May Concern: Kenneth Calder is an employee of Acella construction and will'be.representing the company as the Superintendent at The Hyannis Hostel.on Ocean St., in Hyannis.Massachusetts. . Sin ly David Dirubbo 62 Accord Park Drive Norwell, MA 02061 Tel. 781-681-9240 Ea Y 781-681-9241 www.acellaconstruction.com ACELLA Construction Corporation To Whom It May Concern: Acella Construction Corporation is a General Contractor that hires sub-contractors.Acella has been selected to manage the Hyannis Hostel at 111 Ocean St. Attached to this letter is a list of our sub- contractors and their workers' compensation policy numbers. The hiring of all sub-contractors has not been completed yet.As we continue to do so we will provide the Barnstable Building Department with any necessary information regarding their workers compensation insurance. Thank you; D , avid Dirubbo 62 Accord Park Drive Norwell jMA 0206.1 Tel. 781-681-9240 __ Fax 781-681-9241 ivww.acellaconstruction.com AcELLA Construction Corporation Subs List with Workers Compensation policy numbers Hinkley Electric Company,Inc. 108 Parker Road Osterville,MA 02655 Policy#::08WECU0977 Effective: 05/19/09—05/19/10 Asbestos Man Removal Co.,Inc. 929 State Road Plymouth,MA.02360 Policy#:5091807 Effective: 10-3-09 to 10-3-10 : Diaz Construction Co.,Inc. 190 Bodwell Street Avon, NIA 02322 . Policy#: WC8332378 Effective: 7-1-09 to 74-10 62 Accord Park Drive Norwell,MA 02061 Tel 781 681 9240 Fax 781 681 9241 www.acellaconstruction.com D`'t u-tm�nt Puhlrc and`u ds... a��achu�Ctt�" R��Supervisor License. Board Of 13"A in 'Construct 00619 License: CS 1 , Restricted to: i KENN STREET 40 CNURCN 02186 MILTON,MA . Exp 7126f2012 iration: ` ?r#: 100619 c I °FIMME Town of Barnstable Regulatory Services s + x RARNSTABL4 AM.KA98. � Thomas F. Geiler,Director 9 g' `�prEo;p�►`� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF LICENSED CONSTRUCTION SUPERVISOR ASSUMPTION OF RESPONSIBILITY Construction Supervisor License.. # 1 006?i`i , Y hereb certify that'I have assumed responsibility for the project under construction, as authorized by building permit# S,._ mow;., , issued to (property.address) 10,�; I1Lo��l on 2- ' � ',,2006 : Zee 1G i�iAr 3ZC3,n 916 21 2oQrt�07 The following documents are attached: Zcxxyc�p��—7 copy of my Massachusetts State Construction Supervisor's license. or Homeowner's License Exemption form(if applicable) copy of my Home Improvement Contractor registration (if applicable) Commonwealth of Massachusetts Workers' Compensation Insurance Affidavit, Road Bond (if applicable) LICENSE HOLDER DATE °FTME'°�ti Town of Barnstable Regulatory Services MAW. ' Thomas F.Geller Director 1639-DSA3S. o� ! 9o°'OTfp y 1, Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF WITHDRAWAL OF LICENSED CONSTRUCTION SUPERVISOR FROM PROJECT I o Y1 Construction.Su ervisor License ! � P hereby certify that I am no longer the Construction Supervisor listed on the application for the project under construction as authorized by building permit ' , issued to (property address) Y1 r115 N��' on 7200J.. I also certify that onV . 1 , 204 b ,I notified the property owner, that the project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building Division. 20011 6,2.16� 6�� z .z, 6to LICENSE I40LDER DATE �DO� 1 (D7 a6�oyo� I q/forms/newcontr reference R-5 780 CMR � Erti Town of Barnstable Regulatory Services BA IE' MAS& Thoinas F.Geller,Director nss. 9��EDMAI� � Building Division Toni Perry,Building Commissioner 200 Ma ii_Street,Hyan-nis,MA 0260.1 ivwwaown.barnsf:able.ma.us - Office-. 508-862 403 Fax!_ 508-79M230 Property Owner Must Complete and.Sign This Section if Using A Builder John Yonce,for Eastern New England Council of Hostelling International-American Youth ,:as o mer of the subject property hereby authorize Acella Construction Corporation to kvon mybelialf in-all rndtters relative to arork authorized by'this building permit application for.. 111& 105 Ocean St, Hyannis (Address of Jab) u 2/2/10 ignatur of Owrier Date: John Yonce ` Print.Narne If Proeri droner is applying forpermitplease complete the Homeowners License Exemption Form on the reverse side. 'Q 0KMS:0XV,N1kRPFIth9ISSi0N o�IKE TOWN OF BARNSTABLE 400n g Application Ref: 200900679* anxlvsTAsr.E, Issue Date: 09/03/09 Permit 9 MASS Applicant: ROBERT EVANS D rFG N1p't a Permit Number: .B 20091620 . Proposed Use: MULTIPLE HOUSES ONE PARCEL Expiration Date: 03/03/10 Location 111 OCEAN STREET Zoning District HD Permit Type: NEW COMMERCIAL Map Parcel 326045 Permit Fee$ 331.50 Contractor ROBERT,EVANS D Village HYANNIS App Fee$ 150.00 License Num 77751 Est Construction Cost$ 65,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND BUILD NEW STAFF QUARTERS(400 SQ FT) THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: TUBMAN, SANDRA L BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 462 TUBMAN RD INSPECTION HAS BEEN DE. BREWSTER, MA 02631 Application Entered by: SS Building Permit Issued By: THIS PERMIT CONVEYS NO:RIGHT TO OCCUPY ANY•STREET,ALLYOR SIDEWALK OR ANY PART THEREOF,.EITHERTEMPORARILY OR ERIviANENTLY: ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDERTHEBUILDING CODE,'IvIUST BE:APPROVED BY THE JURISDICTION. STREET ORALLY:GRADES AS WELL"AS DEPTH AND LOCATION OF PUBLICSEWERS MAY BE"OBTAINED FRONT THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF,THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APP,LICABLESUBDIVISIONRESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). _ ® 7, t 77r y ,.;m.r 1, i1q, ,r r " ' BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health f Generated by COMcheck-Web Software t Envelope Compliance Certificate Massachusetts Commercial Code Report Date: 02/18/09 Section 1: Project Information Project Type:Addition Project Title: Hyannis Hostel:tB1dg Q, Construction Site: - Owner/Agent: Designer/Contractor: 111 Ocean Street Sandra Tubman Alison Alessi Hyannis,Massachusetts 02601 Trustees of Ruther Rushers Estate A+E Architects,Inc. Tubman Road 2384 A Main Street Brewster,Massachusetts 02631 Brewster,Massachusetts 02631 508-896-0051 alison@capecoddesigner.com Section 2: General Information Building Location(for weather data): Barnstable,Massachusetts Climate Zone: 12a Heating Degree Days(base 65 degrees F): 5884 Cooling Degree Days(base 65 degrees F): 606 Vertical Glazing/Wall Area Pct.: 12% Building Type Floor Area Dormitory-(heating only) 400 Section 3: Requirements Checklist Climate-Specific Requirements: Component Name/Description Gross Area Cavity Cont. Proposed Budget or Perimeter R-Value R-Value U-Factor U-Factor Floor 1:Heated Slab-On-Grade,Depth 4 ft. 80 — 5.0 — -- Exterior Wall 1:Wood Frame,Any Spacing 640 19.0 0.0 0.068 0.089 Window 1:Wood Frame,2 Pane w/Low-E,Clear,SHGC 0.26 76 — — 0.300 0.592 Door 1:Solid 20 — -- 0.400 0.140 (a)Budget U-factors are used for software baseline calculations ONLY,and are not code requirements. (b)Certain building use types require continuous under-slab insulation(see Massachusetts Code Section 1304.2.7 and 1304.2.8). Air Leakage, Component Certification,and Vapor Retarder Requirements: 1. All joints and penetrations are caulked,gasketed,weather-stripped,or otherwise sealed. 2. Windows,doors,and skylights certified as meeting leakage requirements. 3. Component R-values&U-factors labeled as certified. 4. Insulation installed according to manufacturer's instructions,in substantial contact with the surface being insulated,and in a manner that achieves the rated R-value without compressing the insulation. Lj 5. Vapor retarder installed. Section 4: Compliance Statement Compliance Statement: The proposed envelope design represented in this document is consistent with the building plans,specifications and other calculations submitted with this permit application.The proposed envelope system has been designed to meet the Massachusetts Commercial Code requirements in COMcheck-Web and to comply with the mandatory requirements in the Requirements Checklist. Project Title: Hyannis Hostel: Bldg D Report date: 02/18/09 Data filename: Page 1 of 6 Name-Title Signature Date Project Notes: Bldg D R Project Title: Hyannis Hostel: Bldg D Report date:02/18/09 Data filename: Page 2 of 6 OFTHE Tp� � . "0 Hyannis Main Street Waterfront BARARN $ Historic District Commission 9q,A i639. �� Growth Management 200 Main Street - - Hyannis,Massachusetts 02601co Phone: 508-862-4665 /Fax: 508-862-4784 ,- �,r7 Ca %:T, CERTIFICATE FOR DEMOLITION OR REMOVAL Application is hereby made, in triplicate, for the issuance of a Permit for Demolition or Removal of a building or a structure or part.thereof, under M.G.L. Chapter 40C,The Historic Districts Act,for proposed work as described below and on plans,drawings or photographs accompanying this application. TYPE OR PRINT LEGIBLY DATE 0 2 21. 09 ADDRESS OR PROPOSED WORK 1 ` 1 O C FA-i4 S fi f-I`C I ASSESSORS MAP NO. OWNER T'F-VS'T•EC-S r R-UT4 I�l>SN�j�,S ST/`�T� ASSESSORS LOT NO. C' ft tVv min/ 4 HOME ADDRESS �*622 11 PJ R� �FZ��"� TEL. NO. NAMES AND ADDRESSES OF ABUTTING OWNERS: Include names of adjacent property owners across any public street or way. (Attach additional sheet, if necessary). CAPE; 6D P Fh -AWPL 1122SE 10 nJ 119 06C�J S 1J AGENT OR CONTRACTOR lkj N A"t S /N- ' TEL.NO. ADDRESS 2MM A T- W'5�� A I� J DESCRIPTION OF PROPOSED WORK: If building is to be removed, give new location. Snap shots showing all views . of building must accompany application. (Attach additional sheet,if necessary). Note: If approval is granted for relocation, a separate Certificate of Appropriateness is required for new location if within the Hyannis Main Street Waterfront Historic District. C � r SIGNED Owner-Coy tractor-Agent Space below line for Committee use.. Received bv H.D.C. The Certificate is hereby Pyb�e C;;` . _(�� E h W i5 Date \�g . D 'D MAR 0 3 2009 Ti B TOWN OF BARNSTABLE I HIS] -HIC PRESERVATION Approved ❑ IMPORTANT: If Certificate is approved,approval is subject to the 20 day appeal period provided in the Ordinance. Disapproved El ` �low ,*.:� - oil 1 . < G � a g <+' 144 tivU 41 t WON** ll loll o � n, � e « f � k � WON *SON , � 04 *4 ' ` EMU VIA k '14 Wma � AP* ,M*� r A k ^ a t L _yk 44 WAN. . 1 s�ar AA x #4 .. r 4 ' " . w F .7 � 3f ��s z h t�' a , tr. n 0 04 , W6 E.. iZ�� l ' t p r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel:: A plic�tion Health Division �J i s e` Conservation Division ; 0-,Application Fee . 50 Planning Dept: Permit Fee Date Definitive.Plan Approved by Planning Board 1� Historic - OKH Preservation/Hyannis 3 Street Project Address S ee dd ess � Village 1.Di Q i tJ Owner 7rfU4W_.,_6 � Address 4 2 rUbIUF�-R1 � (o -3IZ Telephone Permit Request Square feet: 1 st floor: existing00 proposed 400 2nd floor: existing proposed Total new Zoning District Flood Plain A Groundwater Overlay Project Valuation 75 K Construction Type 1� Lot Size � � Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure _ t Historic House: ❑Yes XNo On Old King's Highway: ❑Yes PkNo Basement Type: ❑ Full ❑ Crawl ❑Walkout X Other J 46 Basement Finished Area (sq.ft.) w 1k Basement Unfinished Area(sq.ft)_ 0 Number of Baths: Full: existing new �_ Half: existing new Number of Bedrooms: existing I new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: A 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 ❑ ti Q i Commercial )(Yes ❑ No If yes, site plan review# i Current Use _� Proposed Use °� l APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1306 ArA Telephone Number 5k 1% Do Address g F - License`# 5, � 0 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE n2I2.o/ O� r FOR OFFICIAL USE ONLY APPLICATION# ` DATE ISSUED MAP/PARCEL NO. ' ADDRESS VILLAGE OWNER j j DATE OF INSPECTION: • FOUNDATION FRAME INSULATION - FIREPLACE F ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL )}'f FINAL BUILDING - f DATE CLOSED OUT- _ ASSOCIATION PLAN,NO. 'D 'THWE Fawn of.Barn-stable Regulatory Services � NAM'SUBM $ Thomas F_Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnftakle.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, as Owner of the subject property hereby authorize A+An;WI?�� c, to act on my behalf, in all matters relative to work authorized by this building permit-application for. MA 02VI (Address of Job) dl., wit, - Signature of Owner Date not Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse -side. Q:FORMS:O WNERPERMISSION �z r 'Town of Barnstable Regulatory Services RA AB Thomas F.Geiler,Director - � t639 .+ Building Division pJED µA'1 A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601_.. _. R'ww.town.b arnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village --"HOMEOWNER": name home phone# worlcpbone# CURRENT MAILING ADDRESS: . i city/town state zip code ., The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual.for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER`. Persons)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to- be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) 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 perfomring work for which a building permit is required shall be exempt from the provisions of this section.(Section 109.1.1-Licensing of canstruction 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 form./certification for use in your community. Q:forrmhomeexempt ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' d 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):-{-E A rU Ity j- l Win Address: MA-`n 5T, City/State/Zip: Qi �r � Phone.#: �� Are 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 employees(full and/or part-time).* have hired the stab-contractors 6. New construction 2.❑ I am a sole proprietor or partner-' listed on the attached sheet. T. �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.❑ I am a homeowner doing all work - officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp.,insurance required.] "Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. xContractors 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 providingworkers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: '74 Ji U15 Policy#or Self-ins.Lic.#: W C(% I g-,6 9() Expiration Date: 0 1-7 Job Site Address: , I Ocean 1�7r, City/State/Zip: &EIrll�� 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 tip to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under the pains andpenalties ofperjury that the information provided above is true and correct Simafore: Date: b ' Phone#: D ®0 7' Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I 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 bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,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 11-22-06 www.mass.gov/dia Client#:21966 2AEAR f ACORDTM CERTIFICATE OF LIABILITY INSURANCE 0DATE 2/18/090 ) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling 8r O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR g y ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 973 lyannough Rd., PO Box 1990 Hyannis,MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Zurich U.S. A 8r E Architects,Inc. INSURER B: 2384A Main Street INSURER C: Brewster,MA 02631 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR OkDD'L POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE- POLICY NUMBER DATE MMIDD/YY DATE MM/DD/YY LIMITS A GENERAL LIABILITY PAS02667337 10/17/08 10/17/09 EACH OCCURRENCE $2 000 000 PREMISES(Ea occurrence)X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $2 OOO OOO CLAIMS MADE ER OCCUR MED EXP(Any one person) $1 O 000 PERSONAL&ADV INJURY s2,000,000 GENERAL AGGREGATE s4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s4,000,000 POLICY F1 PE 4 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION AND WCO261980901 10/17/08 10/17/09 X TWO C STATUS OER TH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT-. s500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?- NO •, E.L.DISEASE-EA EMPLOYEE s500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable-Bldg. Dept. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1n DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601.. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 3 #55549 LS1 0 ACORD CORPORATION 1988 Boa�d of S.k ng enX-d s t juonstruction SupeNisor License . License: CS 77751 r. 10/29/2009 Tr# 9256 i I i) €fr Ex�nation Restriction :00 "Al ROBERT D EVANS � , i ; 7 f , 1 21 GOVERNOR BRADFORD.RC- — �c i,�. -BREWSTER,iMA 02631 Commissioner , 1. v/4 � s S L........� 5 Win• . 3. .. -- R�'v, m m Z \ rm. V/ p ew Y y. ng Iz I D Z / T� m m � o I I vv m z n w• 4 _ _ = rn r '. p m � o En D ' z 'T I Tf�" N 20,_2" — — — — — — C A �'. bo Ca Ii A v a I o I : I _Z II In m m Rao 1'7'7 O"cn Wq ,ivC DI II Rao Z I Cz �On >p 0 �z ap C� �N 0 z nm v ZZ 0 O Ni D Z m z Z Z oz '� o Z y o n pa - _z° m s o z I : I0 Z I : I I I °z yp I ' L.— — — — — —.— 4 — — — - N I. 2 H . y J v > � � om� CD C7 O M x� CD -00 RENOVATIONS FOR: vZZ R1 2384 A Main Street(Rte.6A) D p -i N ARCHITECTS Brewster,MA 02631 D 90 z ; CAPE COD FOUNDATION/ i p 508.896.0051 phone m _� O TRUSTEES OF R.RUSHER ESTATE N Residential Commercial 508.896.6199 fax r O O o Sustainable DesignmwwwVcapecoddesgner.com c Z 111 OCEAN STREET 6 HYANNIS,MA 02601 I • x , FF: a mma NNE ,�c,m �o. b @off ? ' 1 C5 mRig� m81 Sd bi � z m s 0,6 ° Wkx9m 3 Nx..xXz C - Z /A ztj g. g6W= n $!t a V1 5 yV� m"`5° ,gym m o "o" Qa S \ m 0 Pd�s mao sT�o m b m r S $ o v ems'-�'o z��o � �� ; m j °o o m 9:HA. a r r 3� ^�° z m O m A 3==s m Z CO) ° c, < � saP � o - 3305O�.-3 i.7 G� 3 x ci O Z a c Z ZOm z r� � Gl 2 3 r 3. y m � T .� � _.....__ D $ m y m Z DX Z 2 .mom , rm mm o 0 zz� m o z.. - fin. Om m0 r o .,of �0 Dm - mm O�� oP �Om D�3 ;a M AXm X � � m • N , j w b O r 0 ❑Ell m Z 10'-2" 10'-11" 9'-3" 0 O m \ D A \ T \ J J \ \ N \ o � \ N a a _ -nMZ bO AD C O am oD Qr O , ti n mom p Coll m�/ O ? o�v� �� o N " N D >m N ------------ j Z p \ \ N % co) O 0 � \ e C EE I mO ' ` 2 n T T M T W O \ N m A \ m W r O cf) \ mp \ m z \ - N0 \ < O Z Q 17'-5; z'-9Y<" C Z M Q E y M y CD �° - --i RENOVATIONS FOR: w r O r— F N A R CHUECTS Brew t Main Street(Rte.6A) [-]jtlllj l l i 1 Brewster,MA 02631 D CAPE COD FOUNDATION/ p 808.896.0057 phone � TRUSTEES OF R.RUSHER ESTATE N Residential Commefcial 508.896.6199fax Sustainable Design z Z 111 OCEAN STREET gn ww ............K,. "u„ :"u a v ,", 0 rn HYANNIS,MA 02601 w' t , n - r O c A n N m a o n;tea mAo z O z X n -1 zp0 T I o c 1 O �= Z fAi l°o c z m 1 fn r (q�`L r _ D�2__ N O D.� O bm =0 Om A - �AOC N ZC m 5 m 2 x T �1�r1Acl) mo Nm =N O iN O m x m O < D"= 2A zf zz— mD O T m <m O N z z --1 O T T z mr z011 •1 NO GAT rZ N w M a) A�3 �3 w . M N M M M v v m M D �_ NA N NAN r r AT n m NANO {A X DX -10 0" w�n A =X � 9 Q N N D m w_T N X X*m m N�W N ,mp1 o Zm O z°zx m p M zaA : NN 8 zm e N DOw T N ZZ- - - O b O o�O _w O pro A O OT r. N OZ VA - (n m°� y A N DAS O v mmm O A A w z -n m . v A z ' p ° 12'5 r 'n Trn i x f� N m o O ' O m C A g M 0o T 8 O mZ O 0Z DG) !!m11 Q �Z�/) 0 DJ k'J Z p —I O PRE-CUTS UD t 92 5/8" A u 500 D N r r m Xrii� 1:E-O:UA Ill °z�mv Ao�=O n D D _ o M c tri Cn trl . H 9. m n RENOVATIONS FOR: ' N ��i r'�*��T(t 2384 A Main Street(Rte.6A) > r 5 Z IT1 N Val jj�l jj jE 11 S Brewster,MA 02631 0 cn Z CAPE COD FOUNDATION/ c 508.896.0051 Phone m TRUSTEES OF R.RUSHER ESTATE Residential Commercial s� , � t j 508.896.6199 fax coo Sustainable Design www.capecoddesigner.com co 111 OCEAN STREET { 0 ;ma �,U ^„�^�A �,,,,. Ku,,,a,M�� a.,^.wo.,.,,»av,, ,s.o„o.�»„ :.,,.. �a �,., A Z HYANNIS,MA 02601 . / r N P WATER SHUTOFF TIMOTHY J. BRADY P.E.. P.L.S. -101 ' PROPOSED GAL. REINF.COW. ,P ' - CATCH BASIN C.I.GRATE EL.-16.7't .� K`X/L=' t u''Ar.%OF .,W. •N:. I _ SNUTO'FF IO'HOPE PIPE(N J o r.3..:1fV,ANCOR NI-O OR EO. N N 1 LD-• y UPGRADE EXISTING WATER / , SERVICE AND PROVIDE - • ' - PROPOSED 1',6'REINF.COWL.LEACH i 95 c SPRINKLER MAIN - PIT W17N 2.5'STONE(TYP.J ��/ - DATE a / RPWfyB / {r q1"�a. a REMOVE SIDEWALK 3 QYgh GAR P e ` 5'%Sm E AS REQUIRED V' - ' a PAVE O RE51pfJw "c�b'y � rRY Als EXISTING "Of. III�PROPOSED SIGN AT EXIT East'Cape Engineering Inc. /El• e/ :`'I 'RIGNr TURN ONLY' . _ ?t euDFiN e,asirN6 DRIV01Ar 1 CIVIL ENGINEERS y E/'iP'� - e 4 /•Trl MlNlr4T1 W/OTN M N F!'S m I"G IXST. r AND PAVe PR?I 0.'EW 9T f -I' INSTALL SEWER LINE LAND SURVEYORS ' _ * y110 erC E 1ST E 4 4A.9 '�\ 1D BUILD/NG a C IH'MIN.BELOW WATER 6' RAO; aP�GE P) n'i�""J l� I {� SERVICE, OR SLEEVE y� 44 Route 28, Orleans, Maas. PROPOSED 20 X9' r EE 1' g�' SEWER LINE 1417N H' 508 255-7120 _ PARKING SPACE (5 F �T•c •�..: SDR35 OR SW.40 PVC p I pp4p'' 1 ..,�.. '� / S TO 10'ON EITHER SIDE GUY WIRE I (TYP.J /L°IB A S , 4 _ o OF CROSS/AG POINT - - ,'� * TOTAL LOT AREA ,l f / z O P 376126'1 y,�y 5 1916/t S.F. ~• SNUTOFF O V' Q� ^ U f 't O. ��y� .� —� UPGRADE EXISTING WATER ... .. SERVICE AND PROVIDE • � •. � � SPRINKLER MAIN .. STREET 5IGN t0 �� •�/r 1g :' '�`... O - . .. /� ' zt INFO SIGN 4 J0f19'IING 9IICD PPye"l aP'` , `"� I �`�° PROPOSED SITE PLAN . ¢� 0q.ar^Rer zvra .JII 4: A fdul_t" E ./ ., O 4 11 is- '� '` A-01tt >?1w)• .: P�h 4 p f y(1"O RR 50 I O %�T I5.IOP OF MARBLE BOUND - • O \j- _ .^ .gyp ' O \ �' .'r V' 'T ER � - a1 I 'pJfi'9i7PA-s.7ILlt�NfD' 't �\'Y'� f T.O.F. jr J 9t E- 1 UP I2P El..-lH.c' '�P.) RAHPOSED 1)( +, 0 r / r� 0 �dfflEVltli(' ADDOPOSOED ,1. � r - LOCATION: 'V "' Nk � •I 1 � P,➢•,/��. •{ �0 F'Nv"109�O ^C 3 J oP_r1p 6 {\ 55P�E� R.oae I y r r PROPOSED 41ID REINF. I11 OCEAN STREET + ;g'PROAOSED G45 (} Cone• SEWER I'fANNo1E HYANNIS, MA ,� .�„ .,.•� RL .. "SERVICE f^ _FI`• CONNECT OUTLET TO EXISTING ' ` PROPOSED AAT2R ,.. REPLiICE - SEWER LINE EYTENDING TO MAIN REFERENCE: - SERVFf"�T7P•+1 I ( VERIFY EX/STING PIPE ELEVATION - ReV1se FXr9nNG BJfRNYF '. PRDPO$ED'ELECTMC` lam" 1 '•^_� TO DETERMINE rfANNSrA EIGHT - ' MAP 326 AND INSTAL(.PAVB9DIT PAY)'t } y1;C 4 % - 11 PR/OR TO INSTALLATION PARCEL 045 - / SERVICE jTYP f'' A, 'Ou a Y..i fx.A 5E ElTo Df QD fd.GMlr NWD ,T. �" ° - --` F T.M f'i t R - 1b flRST PARKI.IG 9 ALe - r. �1e ..• a' •• .OdE.sb:..N✓.:A%E(3 PREPARED• FOR: RB As 'j 1 SIDENALK A9 ^- CAPE COD FOUNDATION ESTATE TRUSTEES OF R. RUSHER y� , I — ' N05 TIN 2 luri + ir NLp17GEP65�/I BUILDING C RELOCATION PORTIGW OF EX15TING'1 WALL TO BE REMOVED LAN SCALE 1 REMOVE GARAGE O6/10/09 NOTE "A" ii ( 1" zo No. Revision/Issue Dote N I ' NOTE A: - I Praiaa JOB# 09-022 slleei EXISTING GARAGE TO BE REMOVED. BUILDING "C" TO BE RELOCATED TO 09022SP1_dWg THIS AREA AND REBUILT. TOP OF FOUNDATION PROPOSED AT 18.9't TO , BE CONFIRMED ON—SITE WITH BUILDER PRIOR TO CONSTRUCTION. Date 02/26/2009NOTE R, 1 OF 2 PROPERTY LINE INFORMATION TAKEN FROM EXISTING SITE PLAN S-1.FOR CAPE COD FOUNDATION/TRUSTEES OF R. RUSHER ESTATE 12/15/2008. PERMIT SET J7 , N ��y. i i1}� .�� b y.�.n 7•. 11�� n i`` ..ham• � ...,, T w ,,9yll O LL O P4 d —1"RIGID INSULATION HORIZ. Q 1"RIGID Q (� W a! INSULATION 24"D N •/ ae O U � U " qA W Qa > 8"CONC. FOUNDATION J,4" WALL TITLE: d EXISTING DEMO & a a a -- FOUNDATION V-4" - PLAN MAP & PARCEL: 326-045 4 PROPOSED FOUNDATION SECTION o Qj U 3 EXISTING EAST ELEVATION �.0 3/4"=1'-0" 1.0 114"=1'-G" 2 O Q mg - o 00 -- - -- - Q - - -- -- Q � rn � v �r --- 00 _ 3 N m u7 Ln - L DEMO EXISTING GARAGE a� WALLS AND ROOF U N _ o NEW CONCRETE SLAB U) a (level slab as required to accomodate 2x sleepers) Y 4� \ I F r `ax L-- - 4 NEW 8"CONC. Date: 2/20/2009 FOUNDATION WALL REMOVE EXISTING OVERHEAD GARAGE DOORS Sheet: L -- -- -_- -t- - L DEMO EXISTING CONC.APRON EXISTING GARAGE PLAN 2 PROPOSED FOUNDATION PLAN ,Q 114"=1'-0" BUILDING D: A� i SO 111 OCEAN STREET - STAFF HOUSING PERMIT SET 9/12 1 1 1 1 1 1 1 1 9/12 TYPICAL RAKE MEMBERS 1 X 3 OVER 1 X 6Pill I W BODYGUARD TRIM H I.L Z w O 1 X 6 CORNER BD. ❑� Q� �, TYPICAL: BODYGUARD ❑� Z Q a! w N O EASTERN WHITE CEDAR Q (4 F-+ QI 5"EXP.T.W. O > C) vj O U i W O 3 NORTH ELEVATION 2 SOUTH ELEVATION 4 EAST ELEVATION 1.1 114"=1'.p" 1.1 1/4°=1'-0" TITLE: FLOOR PLAN & ELEVATIONS 20'-2" 12'-5Y4' 2'-4%" 5'-3 4" MAP & PARCEL: 326-045 ABOV i Q i y GRES p�,E - (D { 06 00 ((O c a) o j N a) C-4 QX � � 5 zo 07 a � oM O `O CO Q G cM CO cc N N00000 U G 0'0 � GOos A MANAGER'S N m Lo Lo BEDROOM 120 SF: 1 BED V 1 tD � � r N ~ 05 QGR SS �✓ STAFF BEDROOM 120 SF,2 BEDS ti J — co fD WEST ELEVATION 0 � . 1 .1 1/4"=1'0" o :3STAFF r B H COMMON AREA 03 cA CD 02 (D � 5 DOOR SCHEDULE: BUILDING D �D 5 DOOR 01 KEY QTY FRAMESIZE ROUGH OPENING MFG. MODEL TYPE TYPE MAIL FINISH HAND REMARKS a a 2 1 Z-6"x 5-8" 2-8 1/2"X 6-10 1/2 MASONITE CRWN MDF HINGED MDF PNTD FIVE PANEL EQUAL r 1s G x 5 8 MASONITE C 2'-8 1/7 X 5-10 1/2 MA 2t "1A { ^ CRWN dMDF HINGED MDF PNTD FIVE PANEL EQUAL B�BOVE s.. 6 1 1-6 x 5-8 IT-8 1/2"X6-101121 MASONITE CRWN MDF HINGED MDF PNTD FIVE PANEL EQUAL 7'-2Y2' 8'-3Y4" 4'-73Y4" ?,::"t ry.r,. ' �,.;�, ,•F; ''.�'Xffi.-� >�'Il� -talA 3V1 jC�,.�.EC} .2>. Cv+y.;, F', z t.r.;, u�° ,'� '�:, �, 7 4-BY4 T- T NO Ile x� ALL NEW INTERIOR DOORS TO BE 5-PANEL MASONITE DOORS-PRIMED _. .,.._....... .......... _ _....._. .-.... WINDOW SCHEDULE KEY QTY FRAME SIZE ROUGH OPENING MFG. MODEL I STYLE I MUNT.I REMARKS } r� A 9 2'-5 3/8 X4'-83/8" 2-153/8'X4'-87/8" MARVIN CUDH2424 DBLHG 211 1 TEMPERED Dale L�2o/200� 2 2'4"X 2-3 3-111/8 2'-5"X2-35/8" MA VIN CCM 828 AWN 4LITES 1 PROPOSED '1ST FLR PLAN 2 2'-4"X3'-11 1/8" 2'-5"X3'-11 518" MARVIN CCM 2848 CSMT 211 NEW EGRESS,PROVIDE 2"CHECK RAIL,2:1 LITES TOTAL 13 1.1 1/4°=,'o° Sheet: NOTES: ALL WINDOWS TO BE MARVIN CLAD ULTIMATE DOUBLE HUNG,CASEMENTS AND AWNING. ALL MARVIN WIND0INS ANDGLASS DOORS GLAZED WITH HIGH PERFORMANCE GLASS(INSUL.'LOW-E VN%ARGON) ALL MARVINWINDOW$N/ITH MUNTIi SIMULATED DIVIDED LITE r.., (SEE ELEVA110NS),7/8'MUNTIN,INSULSHIELD IG GLAZING,CONFIRM STANDARD HEAD HEIGHT USE TEMPERED GLASS HAZARDOUS LOCATIONS PER MASS.CODE 780 CMR'SECTION 3603.20.4.2. VERIFY EGRESS REQUIREMENTS ' s SCHEDULES BUILDING D: A� l ml 1.1 N.T.S. 111 OCEAN STREET - STAFF HOUSING i PERMIT SET , CONTINUOUS STRUCTURAL RIDGE BEAM - RIDGE VENT CAP BY REF.STRUCT.DRAWINGS 1" TYPICAL ROOF ASSEMBLY-, ENVIROSHAKE 2-1 3/4"X11 1/4"(2 X 10 RAFTERS) 32 2-1 4"X 9-1"LVL(2 X 8 RAFTERS) ARCH.COMP.SHINGLES 15#FELT PAPER [� %"CDX PLYWOOD LO i AT BUILT-UP RIDGE BEAM RAFTERS,REF. 2"X 10"RAFTERS @ 16"O.C. _ W CONDITIONS'INSTALL BEAM r' STRUCT.DRAWINGS 1"LOWER THAN RAFTER T r) w AT PEAK. O 12 / LL F-+ rx TYPICAL MALL ASSEMBLY O o i.r w .WHITE CEDAR 5 T.W [--a TYVEK WRAP C p '"CDX PLYWOOD P 2"X 6"WALL STUDS @ 16"O.C. > O F- �, W W PINE WOC D FLOORING cn 3f4"ADVANTECH SUBFLOOR a I"!.I 1 U E- .--r 1"RIGID INSUL.24"OUT&DOWN L31/2-CONCRETE SLAB P.T.2"X 4"SLEEPERS @ 16"O.C. TITLE: ON 6 MIL VAPOR BARRIER AND 4"CRUSHED STONE FRAMING PLAN Ll SECTION & Tl(P. EAVE DETAIL DETAILS '�- 1112"=1•0" 2 BUILDING SECTION MAP& PARCEL: 326-045 E c m cV x 'tn j c a� a G 0 O L C� (0 (D i CL. ti �. CRco co co 0.7 N m U) to 3 � EINVIRO-SHAKES HI-R38 BLOWN-IN v1 , CELLULOSE INSUL. - L Y2"CDX PLYWOOD ROOF E SHEATHING �'� E 0 ICE AND WATER SHIELD 2"x 10"ROOF RAFTERS @ 16"O.0 0) f @ALL EAVES 2 tQ C CONT.SOFFIT WENT V M 1x N F 'p SO FIT � a AL.GUTTER,half round,WHITE w U) 24'-6" Li LY �5 NEW PLATE HGT. o FASCIA 1x8 1x8(FRIEZE BD USG FIBEROCK AQUA 3 TOUGH INTERIOR PANELS 2"x 10"ROOF RAFTERS @ 16"O. s= ON 1 X 3 STRAPPING 16"O. Af - 100 yQJ WALL ASSEMBLY Date: 2120/2009 Sheet:. TYP. EAV E DETAIL PROPOSED ROOF FRAMING PLAN BUILDING D: A� l 2 111 OCEAN STREET - STAFF HOUSING ■