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Home My WebLink About0082 SCHOOL STREET -��C,400z- -srr- G t�r0-ir►P #-O u see 'gum h' T 0 r y TOWN OF BARNSTABLE TEMP CERTIFICATE OF OCCUPANCY PARCELr`ID 327 239 002 GEOBASE ID 43525 ADDRESS 82 SCHOOL STREET PHONE HYANNIS ZIP ? I LOT 2 BLOCK LOT SIZE r DBA. DEVELOPMENT DISTRICT HY PERMIT r'� 65680 DESCRIPTION 60 DAY TEMP CERTIFICATE OF OCCUPANCY PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY i CONTRACTORS: Department.of ARCHITECTS: Regulatory Services TOTAL FEES: BOND $.00 �tME CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY, I PRIVATE If r. * ■ARNSTABLE, BUIJ=,RINC�jD SION BY DATE ISSUED 12/04/2002 EXPIRATION DATE -� I Department of Health, Safety and Environmental Services * iARlvsrABIA MAM �► 1639. ` BUILDING DIVISION lQ Q BY 4352,5 PHONE Z up j. LOT SIZ11 DISTRICT HY 11,' y rrr{{�9T��yy STAIRCASE/UPGRADE T �x {^r �7��(`��A.y� r r _ •�+ , - '+' i- EXIS11LYG S`.LTAIRCASE/UPGRADE TO i -ITIAL AL,T/C+ONV ' Department of Health, Safety and Environmental Services PRIVATE P Qi► * HARMABLE, • MASS. 1639. Mt�►I BUILDING DIVISION } BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY;NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROMTHE CONDITIONS OF.ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR'CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTE UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS. HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU (READY TO LATH).. PANCY IS REQUIRED, SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. . BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 21) _Zv -62 73P)W) 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH' i OTHER: SITE PLAN REVIEW APPROVAL Lo O T, WORK SHALL NOT OCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. pC� G� �10 i TOWN OF BARNSTABLE TEMP CERTIFICATE OF OCCUPANCY , P a '1 PARCEL ID 32l 239 002 GEOBASE lb 43525 ADDRESS 82 SCHOOL STREET PHONE HYANNIS ZIP I;OTt 2 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PEPiMIT 85680 DESCRIPTION 60 DAY TEMP CERTIFICATE O OCCUPANCY PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY COOTRACTORS: Department of ARCHITECTS: Regulatory Services TOTAL FEES BOND $.00 > } CONSTRUCTION COSTS $.00 756, CERTIFICATE OF OCCUPANCY 1 PRIVATE s *! BAMSTABLE, t 163 A1� FD N1�►'� BU IN SION BY DATE ISSUED 12/04/2002 EXPIRATION BATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER.TEM,PORARILY OR PERMANENTLY.EN- CROACHMENTS ON FUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE.APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- -3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 I 1 ; I 2' f 2 2 9 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 'I 'I I 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL I I WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX . CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. I I I { I i { { i i I { I I I I i i i { { I I i i I I I I I A I I I I I I I I I I I C I f I I I i C I I I I I I I COASTAL engineering co. STRUCTURAL FIELD REPORT #1 To: Barnstable,MA Building Department Project: Egress Fire Escape Replacement Project No: 08114:00 Location: [82.Schoo1 Street;Hyannis;-MAC Date: 08/10/2017 Present on Site: Dan Vineis (DV Welding) . .Mark Adams (Champ Homes) Nicholas (Cole) Bateman (Coastal Engineering) A site visit was conducted on this.date to perform.a final inspection on the referenced project.At the time of arrival,the team was installing the last of the post-installed anchor,bolts and finalizing punch items on the fire escape. This report is to confirm that the"fire escape has been installed in accordance with the structural plans. Please let us know if we can provide further assistance. is fi � i 1012M Submitted by: i Nicholas (Cole) Bateman, E.I.T. Staff Structural Engineer Orleans I Sandwich I Nantucket Q " i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION l G� �j/.'' Map Parce / vv Application # Health Division BUILDIiG DEEPT Date Issued 813� 6- Conservation Division AUG 10 2016 Application Fe Planning Dept. TOWN OF BARN TABLE Permit,Fee S � Date Definitive Plan Approved by Planning Board 2�(Q Historic, OKH _ Preservation/ Hyannis f D LAJJt_n Project Street Address SC-40Q L Village H(A Al)YN I� Owner CAPt LR V OQtn ES k A)C Address Z C 'tco Telephone :YO $— 7 71 O T?�� -Zo Permit Request 4— SKoLe_r_.,(— QaOodAT- 160 . "rWC�, lX)oL 11S ih la T LE -�- - (fop Square feet: 1 st floor: existing 3(o proposed A14 2nd floor: existingq3(a proposed /VA Total new N -. Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type AQAC VA«®^J Lot Size d 'L(p Grandfathered: 0 Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0 Two Family ❑ Multi-Family(# units) Age of Existing Structure 1(02_`f d`�5 Historic House: es ❑ No On Old King's Highway: ❑Yes Basement Type: & ull Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Ak5-r Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 93 existing _new Total Room Count (not incl�u ing baths): existing new First Floor Room Count Heat Type an Fuel: ® Ga ❑ Oil ❑ Electric ❑ Other yp de c e Central Air: ❑Yes ��O_ - Fireplaces: Existing New Existing wood/coal stove: ❑Yes C�J'IVo 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 App als Authorization ❑ Appeal # Recorded ❑ Commercial ®'Yes ❑ No If p ,es site Ian review# .4 Y Current Use 6120-049 400n Proposed Use a00 P T( 3 C APPLICANT INFORMATION -- — ^(BUILDER OR HOMEOWNER) Name Telephone Number Address ScAqvo !S T License # 07 4 2 57 Ao�mw. AkA 0 /Home Improvement Contractor# X/ 17�5Z- Email Worker's Compensation # y04 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO b{-e-. SIGNATURE �O_tZh DATE ��Z h, t . � s ` FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. -f !.z ADDRESS VILLAGE OWNER - DATE OF INSPECTION: i FOUNDATION ' FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 5 27te Corr mo.-rivealth of-4 assaclt-rsetts Depart went cif&dustrid Acddertts - Of, re of 1m..w'irgt dons. ' 600 Washington street A.-y Boston,MA 02111 ` k4ymi attcr ov/dirt y Workers' Compensafran Insurance Affidavit Builder-JCantractars)EIecfricianslPhunbers Applicant Inform:atign Please Print Le�'bIy Dame as�ess,'Orga�zatianlfn v dual}: 3�rtM'� r7 GYM 6:5 1 l) C # At3dt;ess: City/Sta1& f1 Q MA 02�62 I Ph(= 'SD $ 2 7 '-0 �s �`X 20 Are u an employer?Cftecls the a ra i iate ba Jro' PP p. Type of piaject(required).:L❑ I ant a employer with 4 I am a general'contractor and I employees(full andfor part-time)-* have hired:the sub-contractors ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7- ❑Remodeling sit p and have no employees. These mb-contractors have 8. ❑Demolition { working for me in an employees and have workers' o -tn y c�t�`- 9. El Building addition - [No workers'comp.insurance comp.insuranml . 9 1 Electrical r or additions reritaired_] k $. � �J41e are a corporation and its ❑ �$ 3.❑ I am a homeowner doing all work of have emercised their 1L❑Plumbingrepairs or additions Iron mysel€[No workers'comp- - - t of exemption per lMviGL. 13.❑Roafrepaiis , insurance required]Y c.152, §I{4hand we have no employees.IN'a Workers' 13_❑Other I�NOo�T(O/!S comp-insurance required_)' •tluy_W,bcsa-d at chediss box iTl must also flloutthe secticab9owshmring their e a compensation policy iafocmtdon- _ t Hanx-owners who submit this dGdndr m&;catiug they are doer;sllwooer Rail then him outside contractorsamst sahmit anew affidxelt McRtmg sacb_ T fContmctors thst check ibis box must attarhed as additional sheet shouting the 71--of the sub-camt=Wis and state whether or nut those eatitieshave employees.Ifthesub-coatractarshave employees,theymorstpmride their workers'comp.policy ammber. lam are ereep7nJYrr fferct is prm�ding�vorkcts"conrpe:esaticret uuzuarrce f or m}*enrptoy�ees $eloav is fJte ptrticy inure job site irrformcrliarL j • Insurance Company Name: 'Policy 44 or Self-ins.Lic.;h� MxpirationDate: Job Site Address: 12- OD _ city/StawZip: lj4,A/I f7 1- Mv4 02!60/ Attach a copy of the workers'campensation.policy declaration page(showing the policy number and respiration date). Failure to secure coverage as required under Section 25A of MGL c M can lead to the imposition of criminal penalties of a fine up to$UOD 00 an&or one-yeariniprisagmeat,as well as ciT it penalties.in the form of a.STOP WORK ORDER and a,Kne of up to$250-00 a day against the-violator. Be adtdsed that a copy of this statement maybe fi nwarded to the Office of Irrvestrgations of the DIA for insurance coverage verification. Ida hereby c,erVfy a der the p rins aced penaWes ofFerFurp thatfhs infonvatiortptm,-Ued abm a is tears aced correct _ Q Sltmature:` �� Date: Phone Official use only. Do not evrrte in tfds area,to be campfeted by c4 ortonrn official City or Tower.: PermitUcense if Issuing Antharity(circle one): L Board of Health 2.Building Department 3.CitydTown.Clerk 4.Electrical Inspector S.Plumbing Inspector' b.Other contact Person: Phone#: Laformation and Instructions �\ Massachusetts Ge_neral Laws chapter'152 requires all employers to provide workeas'.compmsaiion far their employees. PMM=ttD this ,an employee is defined as-"_.every person in the se:vice of another under any contract of hire, express or mzplied,oral or write" An employer is defined as"an individual,partnership,association,cmpora:don or other legal eddy,or any two or more of the foregoing engaged is a Joint ent mpt.and including the legal representatives of a deceased enrploye�or the receiver or trustee of an individual,partnership,associafion'or other legal entity,employing employees. However the owner of a.dwelling house having not more than three apartments and vvho resides therein,or the occupant of tine- dwelIing house of another who employs persons to do mafi fe,a„ce,construction or repair work.on such dwelling house or on the grotmds or b ildmg appurte thereto shallnotbecause of such employment be deemedto 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 Iicetise,or permit to operate a business or to construct buildings in the commonwealth for any applicantwho has not produced acceptable evidence of coraplianm with the insurance.covearage regnired." Additionally,MCrL chapter 152,§25C(7)states`Neifher the conunanwealih nor 1�3y ofits political subdivisions shall enter mto any contact for the performance ofpublio work uafil acceptable evidence of compliance with the insurance.. r mts of this chapter have been presented.to the contracting aufhozity." equrrem , Applican-fs - Please fill oil the workers'compensation affidavit completely,by chmIcing the,boxes that apply to yom situation and,if necessary,supply sub-contractor(s)name(s), address(es)and phone numbers) along with their cmfficate(s)of „cr„a ce. Lanitzd Liability Companies(LLC)or Lanit(--d Liability Partnerships,(LU)with no effiployees other than the merinbers or partners,are not mquired to carry workers' compensation insurance. If an LLC or LLP does have employees,apolicy is required. Be,advised that this affidayit maybe mbm;n-d t?the Department of Industrial Accidents for con-6rmaiion of finance coverage. Also be sure to sign and date+he affidavit_ The affidavit should be retrtmed to the city or town that the application for the permit or license is being regaested,not the Department of „ � Accldents. Shouldyou have aay question regarding the law or ifyou are regaaed to obtain a vtorkers' compensationpolicy,Please call the Department at fhe ntmiber list!;d below. self-in�companies should enter their s e1f-h saran ce license number an the appropriate line. City or Town Officiais Please be sure that the affidavit is complete and prmt?d 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 pemlifflicewe,number which will be,used as a reference number. In addition,an applicant that must submit multiple peunifflicense applications in any given year,need only submit one affidavit indicating current p olicy info=ation(if necessary)and under"Job site Address"the applicant should.write,"all locations in (city or nwn)."A copy of the affidavit that has been officially stamped or maimed by the city or town may be provided to the applicant as prooftbat a valid affidavit is on file for future petmiis or licanses A new affidavit must be filled out each year.Where a homeowner or citizen is obtaining a license or permit not related to any business or commercial v re (Le. 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 Departmmfs address,telephone and fax number. Megan went cif 1adustzak Accidents Of of k,VeAk. kfio--� �Q4 man Bagton,MA 0�111 ` f,-L 4 617'27-4900 cxt 4€6 car 14M M GAF F Fax 9 617`2'-7M Revised 4-24-07 � .massgci�fdia • snaivsri►sr.�. • BSA-';& Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 . 'Property Owner Must -Complete and Sign This Section. If Using A Builder I, ) EX Was as Owner of the subject property herebyuthorize VYh�IlL l�;d�� to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner ' ,:. Date -.. Print Name Y- If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPFILES\FORMS\building permit forms\EXPRESS.doc ` Revised 040215 I .i1 Massachusetts-Department of Public Safety , Board of Building Regulations and Standards Construction Sunervisnr. License: CS-074295 MARK R ADAMS 24 FASTBROOKAD W YARMOUTH MA Expiration Commissioner 03/01/2017 �e &XIe epaWNY109WW"CeI"'I"a�C�/llc�t c�c�ei�eCGt. ' -\ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only #iOME IMPROVEMENT CONTRACTOR j before the expiration date. If found return to: �2egistration: ��181952, Type: Office of Consumer Affairs and Business Regulation- A Ex 10 Park Plaza-Suite 5170 piration ^5 /201.7 Corporation �— . = , Boston,MA 02116 CHAMP HOMES INC M ARK ADAMS ` t 82 SCHOOL ST HYANNIS,MA02601 ' Undersecretary Not valid without signature CAPEASS-01 KLIGETT ACORO' DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE . 12/30/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - CONTACT NAME: Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 AIc No Ext: A/c No): (877)816-2156 South Dennis,MA 02660 ADDRESS:EMAIL mail@ 9 9 Y•ro ers ra com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:NGM Insurance Company INSURED INSURER B: Cape Associates,Inc. INSURER C: P.0.BOX 1858 INSURER D: North Eastham,MA 02651 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLISUBRI TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MAD= OCCUR MSO41163 01/01/2016 01/01/2017 PREMISES Ea occurrence $ 50,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ .1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY1-7 PRO- 2,000,000 ❑ JEC:T LOC PRODUCTS-COMP/OP AGG $_ OTHER: $ AUTOMOBILE LIABILITY COMBINED Ea ccident SINGLE LIMIT $ 1,000,000 a A ANY AUTO M9041163 01/01/2016 01/01/2017 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS X AUTOS BODILY INJURY(Per accident) $ X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X UMBRELLA LIAB X IoCCUR EACH OCCURRENCE $ 7,000,000 A EXCESS LIAB CLAIMS-MADE CU041163 01/01/2016 01/01/2017 AGGREGATE $ 7,000,000 DED I X I RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,descr be under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER, CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE -THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights"reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Ace CERTIFICATE OF LIABILITY INSURANCE °ATE`MM`°°"""' 01/04/2016 I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S); AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy((es)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), c PRODUCER 00509-001 N� ACT Branch 509-1 Rogers&Gray Insurance Agency (800)553-1801We „No„ (508)398-0246 434 Route 134 XNo SS: — South Dennis,MA 02660 _ INSURERISf AFFORDING COVERAF. _ NAURERA. A.I.M,Mutual Insurance Company _ 33758 INSURED INSUR R B: Cape Associates Inc; Cape Associates Property Management LLC INSURER - P O Box 1858 _ l North Eastham, MA 02651 INSURER E - "- -" 'See Additional Named Insured Endorsement COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ;ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY'PERTAIN, THE.INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED YYBEEYFFFFPAID CLAIMS. ILTR TYPE OF-INSURANCE gj � POLICY NUMBER MM�DDIYYYY AP __ _LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY` 8FMISES ( RENTED $. i CLAIMS MADIE OCCUR MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ i GENERAL AGGREGATE . S JAAUTOMOBILE GREGATE LIMn-APPLIES PER: PRODUCTS_COMP/OP AGO $ CY RO- OC _ COMBIN D.SINGLELIMIT LIABILITY ddenil $ F AUT10 BODILY INJURY.(Per person) $ LL OSSED AUTOSULED BODILY INJURY(Per eccldent) $ i ED AUTOS NOWOVvMEO PROPERTY DAMAGE - $ a — AUTOS — $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ } EXCESS LIAB CLAIMS MADE AGGREGATE — $ DED RETENTION S $ _ nrt4iRo>4' S�C��4f1r x , >�iA!vTi s D ' E'L,EACH ACCIDENT $ 500,000.00 A at l l J$�t r�� s �CEcuTIvL NrA AWC 400-7033617-2016A 1/1/2016 1I1I2017 EL.OiSEASE-EAEMPLOYEE $ 500;000.00 (Mandatory In N�Hd)o� I�J DWCRIP PHT P RATIONS below. E.L.DISEASE-POLICY LIMIT $ 600,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,It more space is required) 1 CERTIFICATE.HOLDER CANCELLATION Town Of Barnstable 200 Main Street SHOULD ANY OF THE ABOVE?DESCRISO POLICIES BE'CANCEL.ED.BEFORE s Hyannis,MA 02fi01 THE EXPIRATION PATE THEREOF, NOTICE WILL BE DELIVERED IN ;. ACCORDANCE WITH THE POLICY PROVISIONS. r 5 AUTHORIZED REPRE$ENTATIVf tt ©1988,2010 ACORD CORPORATION:All rights reserved. ) ACORD 25(2010106) The ACORD name and logo,are registered marks of ACORD p CHAMP Homes Inc. ` 82 School St. Hyannis, Ma. 02601 Care Team Office Room 10 Chapel A ( e00M 11 Wo- C. zoom l -xno..n O ROGH 3 . FXIT E F LJ ROOM S COO>+1 { ROON.3 COON 2 - - Zoom I Existing Floor Plan, First Floor - PULL_ Sip, D CA ANWOWiN ,ATOe 4 rtc��t a - PA26A 'To 16 e JZC_ncujt't Ep CHAMP Homes Inc. 82 School St. ,Hyannis, Ma. 02601 EX 1r • �� fN4E . KtYCNE►t ►cTtvtTT STb(U f.E � OFFtGE h•15-r-- g;/V1 T- , .11 = ARE tSH$f _ r -A -Sox. Existing basement floor plan .CHAMP Hornes Inc. 82 School St. Hyannis, Ma. 02601 'n Rai 12 RU<N't ZS C00v1 19 MUR4L - Cu rwoe F-XI T Z 00-4 16 .RoO+a 0 a,otit Kppoffico M.> ROON� CQON' _ ... Down Existing Floor Plan, Second Floor O'Neill Building - txT�r�+✓. rL n - ANN;ONCIAM", f � �j i ------�-- cf. ro' CX l STjA,)(o N I JC" 1Vutr�teub tPPr t2 j T �lo� toy�,. o o STATtoN Ex 5-T `J,) ETD e0oVV\ �jctS`C�JuC�. Ext�TIN� v � ROOM I S1�o�E�2 S400e� 3` 11' 2 114. 4 C,• l cl cl I 3 2 tP jz TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map � Parcel 1 V MAY 10 2017 Application # Health Division ,-r, Date Issued S ,a� 1 7 4 WN OF BARNSTABLE Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board II11 ElGCA-rG Historic - OKH _ Preservation/Hyannis Project Street Address 32.- Ae.,h 0e cS``T . Village T Owner (Vn.� Address Telephone O — 7 / —0 S- CX 2-0 Permit Request &y10 ' lLxC4e=- 15f In A . , Square feet: 1 st floor: existing proposed *0 2nd floor: existing proposedAL?q Total new AA- Zoning District Flood Plain A/® Groundwater Overlay Project Valuatio !00_ Construction Type EL Lot Size 1Crc--_ Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) 20 Age of Existing Structure F® $ ` "— Historic House: W es ❑ No On Old King's Highway: ❑Yes &lo Basement Type: 01 Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) 2,7 7 Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 2Z existing _new Total Room Count (not incl ❑ ❑ Electric ng baths): existing �� new First Floor Room Count Heat T it Type and Fuel: ® G as� O ❑ 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 res Is Authorization ❑ Appeal # Recorded ❑ Commercial ❑ No If yes, site plan review # Current Use 6&" ®OVP / 1C Proposed Use /VA. , APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name. � "jl Telephone Number �� J`�£x• Address Szsn1®e:� License # w161f 111 Home Improvement Contractor# Email 01--5(P - aill fto0U_,5 0!21 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO � SIGNATURE �',L� � DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. r ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION 4 FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ��Ca�u�•a7n�eat t•� rstre�t�efls , . • . DePaar-Qffeut of rkdkstiia Accudartg S we-Of&W-2619at axss. ' 600 Washington sirmet ` Baxs&M,MA 02111 WGrkers CaMl3ens3tiCn ce .fEdzn-t B'.m'lilexs,C4:mlm�sMw€ k aus hP nbers plit�IIIfnafi[ Please Print Le. .Name' Ai-a wir an employer?Chtekthe appre • T of Pr ett r L❑ Iamaernploye+suth IMna cor�ctaxanc€I' al �1 ': employees(full andfor part-frme�).* 66,�\3ra�el�irecf 4ze su'6-conjza� 6. ❑New con& cEiosa 2.❑ I am a sale prvpiidtof arpartuw- U d aa.the a'Etached sheep 7_ El BrMadeling and a no 1 s These sob-conEractars have _ P emP 8. ❑Demolaion inan � , tvnri� far�se g�tg a a�bave sgo�3cers 9. B.uil adziifiaQ ' 4 iii odm&CA� inn. =M CaDlp. LSCaiI�e$ ❑. required] '5- WeamatoiparaticMaudRs` l'il❑E1ezfdad epafmcr2dQiams 3.❑Iama hamewmar anvork "a ershave rcised fheir 1L glumbin re�� ❑ ,g Pails or$rIc&fiong . mgsei€[No WOrl Me camp- Ti&of cx=pfion per MGL 17�Zer $ c inarrc=er2qu;rnai f c.152.gI(J aadvefi=ana employees•[No wmdoess' 13 -(rt w 6 I15 carol,.;.,m.a,, Ye4 t2 eE 7� �.�xy spg6cr��at cbedcx'6os�l Est also tillwttht sect�aabeTmrsTsatcing�eirzvo�ers'mmpersaSaupaT�p i�caisamL San,eovm�rstch0s¢L tsfris�Liaeu`in [xting `s�dem�slEw�TCsadffienl�rno-utside �^*rmmstsvhmitsnewxMdweitinXr7h� r4=cTi rCautmtYnesfivt Wkth&bmr must xftr'v a sa sd3iSaasl street sbotciagthcn of the su7s camt�cfr�snad sf ewLe&�arnottSnsE eatitiesha e��o�eel.T€tHezvbtaatadnisl eemPlfe?s�ag]F'amsrP2?videtitwaaes'temp.gaTlcga sFt -ram ma eaaicpr tl�rcf ispraura�ug tc�arkeas'camperLsrr�isaracavr �cmmpbes Belota is t7ia pa&cp cared jeh s Fra,�orars�btL • • . . � . IssmaaceCouipanyXLrg= : ' 'PO&Y 4 or Self--ins.Ii ira4iauDafe= lob Eta Address Chg/5tafef�ig- 04 Atf2ch 2 copy nfthe waikere compensafiaapolic t declaration paga(showing the poficp mmzber and taph-2tion da e�, Fail=to semw cov=ge as requisadunder S=6bn 25A of MM am can had fn•the- , ,sit of crimmai.penalls es of a fine up t:o$UOD OU an&ror one-gesrimpnsagmeut.as AIL as rig peualg 3.fix the farm of a STOP WORK ORDMaud a ffna of up to$25Q DCI a clay agggmt the vioWrr. Be.advised ffid a copy of this zbkment=aybe fkwarded fa the Office of . Iwes€egatinns of file DIA fas tntmwzw coverage uedffcafion- I rfa hereby esrvv rutr}vr tFtsparirrs and psrral s Of ver}'f7tatf7as uZar ffUO gU ptm ded abmg fx!rise arrd c crrect SiEnatara-- II�te- Phone i�- 72/- 0 M55— 4 a27clad me WiF. Do nut Errks in fTds atrea,to be-cmnp' Teted by cdg arrtown ig. =*L City or'I'awm l'errmtd iceFrse tag [drcle anal: L Saard of$•eaItb. BT�g Degarfineaf 3.mown.Cork 4 EIectrical I=pector 5.Pfamhmg I fflr ' 6.Offier Con act Person: Ph.arr:¥: 6 � as�DYCMto �e& eon� iF� = •N`��,�]�rzse#Fs Ge:��alLa�s s tea„,�+•fiie seavicc of ano'ditS uod�r any � Putsaanttn this sib,an mj'&n F e is defined as _GYP =q==orimplliA oral orwrift=f _ edafrcra,CMpordjon ar othe[legal a y, my O mare Ioperis dcamd as aknmvid�P ,asso e�fivES of a deceased=TIoYet,or the of f3ie foregoing=.pged.in a3omt e��,as l i rlmgth�legal s � g�lDY� H°wevez$'a z iYer or trCL E of as ind A P A D dation or o$erIegal entiiy, PMt off- notmarethantim;e spmtnc is md.Who_ m P'Q fhS[[ ,orf�te oC CQ owner ofa.dweIlTmgbonsehaving au�on ru dwel�ghoszse &MIag Manse of��who employs P=CM fg do ,�-��or reP ��arbt�dmg�tC=tt immb ffisn=tbecaase of svrli�IopmEutbe deemedtn be an e�pl°Yeo or on.fhe gm §25g6)also stairs that-everysf I,or local Firms a ?�sag , iih oId$ie issaaacE o�C MGL chapf�c ISM, �ire c:D mm anffeaIth for any renewal of a Tccn=or p��opetafe a Nosiness or to mnsEract bmZd�$s co�e�rageregah�-" applicant ho.liss xtotprodncgl acceptable add==of cdmplianm Witk thm ce hm pn�al subdivisions steal[ d I52,§25C[7)sisimEs cWeif]PStl]e _ _ - �ieinsm�ncd.- AdrlitionaIIy,M cbaP m of =wn e�tbr info any conixad for the p c6°fP°btiC venaic=hI arc�tab Ie evidea �� req�renients of-fi r�aptrshaYzbe�Prese�ed in the eo g a o Y='_ ` A•pPfitcanfs - •. , _ b dier�g-Lo booms�apply tD yovr soon and, if Please fill oil $ie cos'compeQsai�nn affidavit comPleIY. Y s)'name(s),add�ss(e:s)andplicmexmmb¢(s):alongwidithcir �c �s)of necessa3:L-yCgP s )w iino.eUployees ogiertip rp the insrn�ce. Limier T ialn7itY Conaties(LIrC)or Irm�d�Parf b%F (j1=anc; EC Or�d es o hZM ' � members or paitneas,arenot . fn�Y�eadvidfhis a$daYy maybe olmi�d tc the Depa-fmcat of ndna �ployes,-polcy is xtquhed .� m ould Accide±s far c ine M � Also Be, re to stn anaEh a be retained to$e dtY or towntbat fl=application for fhe perms or license is being requ , nottlie DeparEmeof of ons regacd'mg the lam or ifyou am wed�obtain a vpo�s' in� �-:eid=fy- Sbo�Y°uba4e any q antes sbnvId eau`�t their belo4P. ampmsafian.policy,P�ecallff=Depat[ntntatth===berlisfnd c pelf-insaredca� self-iasarance Tiecoseimmb�ontlie Imo. City or Town Qiacia's r - 'Ihe;D aiimeathas pro4ided a space at fhc bottE= Please be sore tb at the affidav is aa�pleft andp IIY- bas to co�actYoQgb - offfie affida�for youto frIl out mthe eventthe Office _ - In additi M.agplirmt to fillintTie e�liee:ose�obez�hi�I�.wplbe�ed.as a�i��cernmmber on, please be sore P need.only snlsmit one affidavit ind�ating conent fhat most mbmii multiple p�rJ=r-applications m any givmY� ¢an IBcxiivns i3 ( °r a olicy mfounatian[if n )and nndcr`fob Te ATs" shorld f . ed°rmmlmdbythmcif orinvtnmaybeprovidedini town)_"A copy of ft.affidavifthathas boom.officially sfa=p =stTbe filled ot±a arts appIiran#as proof that a valid affid rt is on file for tta=petits or Pic mw- A naw baffidavit comnlerczal v . r.adhere ahome u enet Cr c$i=ais obfaing a.license orpe=¢not=e7aiad fo any - ia bnm IeavGs efn said =M is N()T=gftCdD= PIefe this affidavit (ie_mdoglicrose'orp=± ,-) P o� swouldl-retnibankpoUina&mmforyonrcaoperafienand sT� d.youhavcany4 °�• . The Office ofIn�o - a calL • please do nothesi�tD�� . ThzD=par=mfS r1&S,t'-I=hone and;kcrmmbcc - Ca�WWZtlr of h ks=hus b-- "Tj� AYE L ��' ' -4 �06 car I- ' YAM Ra9 �-' RDvised4-24--07. €,�,a. a� d - tHE Town: of Barnstable Regulatory Services r � Richard V.Scan,Director i639' 1`� .Building Division.. Paul Roma,Building Commissioner 200 Main Street,Hyannis,Na 02601 www.town.barnstable.ma.us Office: 508-8624038 } _. Fax: 508-790-6230 Property Owner Must o e `Complete and Sign This Section If Using A Builder I ,as Q�gnet of a subject property .�- - �� . hereby authorize to act.on.myYbe!4,, in all matters relative to work authorized by this building permit application for: (Address of Job). r *Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are petformed and accepted. „ i SignatuT_e of Appliczat " Print Name Print Name Date QTORMS:0VNERPERMISSIONPOOLS Massachusetts Department of Public Safety Board of BuildingRe gulations ufations and Standards . 9 License: CS-074295 Construction Supervisor MARK R ADAMS ; 24 FASTBROOK RD,�, � W YARMOUTH MA 02673 i'�J ��t� fMt Expiration: (Commissioner 03/01/2019 a.7:i��.. •R, .p�.Y v ram,,.:. ft N1 G'r l C. , .. 120N POST Li 14 LA G G � f�A'z..a�E • C.j.�,7. �� S �Co• �05 5-•r�� 1 (^"-'-^^�� _ � fir.; 144.1c� • $ ) PL.. 2 r r HAZ.c��D R�IATHAki s bty u0 V I�o3i 34-Z SEAG� c•'3.�.,i ��TA Ps�C-G O'Neill Building 82 School St. Hyannis *--10' _ 36' 771,47 1 V T1 r rDumpster { fenced 7 � a o s a� Champ Homes Inc. 82 School St. Hyannis, Ma. Fire Escape Replacement Set Back Details F 1 ! s � oo� zz Rvcxa.4� i , ROOM i9 RC+OM _O ¢o01-1 24 eta rwro . P Q Z ao�.a �ry Rooav +T c�>oNt tL � ' Exit Plan Second Floor r r 0 K 4 ` n - b a o � - w. all 4 j 0 .N� Adams From: Morales, Michael (SCA) <michael.morales@state.ma.us> Sent: Monday, May 01, 2017 3:28 PM To: Mark Adams Subject: RE: HIC# 173868 Expiration Hello Mr.Adams, The law does not require one to have an HIC if they are working on their own building. Best, Mike Morales From: Mark Adams [mailto:madams@champhomes.org] Sent:Tuesday, March 28, 2017 1:05 PM To: Morales, Michael (SCA) Subject: RE: HIC# 173868.Expiration Hi Mr. Morales, The second question in my email, in regards to my working situation. Working on our own buildings and not charging for a fee, do i really need to have an HIC number? Thank you Mark Adams Facilities Director Construction Supervisor Champ Homes Inc. 82 School St. Hyannis,Ma. 02601 508 7710885 ex. 20 madamspchamphomes.org CHAMP Homes, Inc. Confidentiality Notice: This message is transmitted to you by or on behalf of CHAMP Homes, Inc. It is intended exclusively for the individual or entity to which it is addressed. The content of this message, along with any attachments, may contain information that is proprietary, confidential and/or legally privileged or otherwise legally exempt from disclosure. If you are not the designated recipient of this message,you should not read, print, retain, copy or disseminate this message or any part of it. If you have received this message in error, please destroy and/or delete all copies of it and notify the sender of the error by return e-mail or by calling 1-508-771-0885. For more information about CHAMP Homes, Inc. please visit us at www.champhomes.org Sent from my Sprint Samsung Galaxy SO 6. -------- Original message -------- From: "Morales, Michael (SCA)" <michael.morales@state.ma.us> Date: 3/23/17 4:09 PM (GMT-05:00) To: Mark Adams <madams@champhomes.org> i Subjects RE: HIC# 173868 Expiration Hello Mr.Adams, Thank you for.contacting our office. l will update our records.You should not.be receiving any more letters regarding ° this registration. Best, Michael Morales Deputy Chief of Staff Office of Consumer Affairs& Business Regulation 10 Park Plaza,Suite 5170 Boston, MA 02116 Phone:617-973-8706 Fax:617-973-8799 ° From: Mark Adams [mailto:madams@champhomes.orQ] Sent:Thursday, March 23, 2017 3:22 PM To: Morales, Michael (SCA) Subject: HIC#173868 Expiration Hi Mr. Morales; I am sending this email as a follow up to a voice mail i left you a few minutes ago,on 3/23/17 at about 2:55 PM. The Registration 1 held under HIC#173868, expired because I work for a non-profit that went through a name change. Please be advised our new HIC#is 181952.This new HIC# 181952, listed under CHAMP Homes Inc. is up for renewal on May 12, 2017. May I ask if I am really required to hold an HIC#under my'current working relationship. I work for a Non-profit Organization that work with homeless individuals to better their Life and move on to a more independent living. My lob is Facilities Director and Construction Supervisor on our own buildings. I do not work in the profit sector any longer for the general public and only work on properties that we now own, build for our own use or renovate one that we may buy in the future. So do I really need to pay a 100 dollar fee to work on our self-owned buildings? I am just wondering as it does not make sense to me;and I eagerly await your response. Thank You Sincerely; Mark Adams Facilities Director Construction Supervisor Champ Homes Inc. 82 School St. 2 /Q//6 Ma.02601 mphomes.org :lams@champhomes.org r Al; 508 400.5181 ,Office;508 7710885 ex. 20 I CHAMP Homes, Inc. Confidentiality Notice: This message is transmitted to you by or on behalf of CHAMP Homes, Inc. It is intended exclusively for the individual or entity to which it is addressed. The content of this message,along with any attachments, may contain information that is proprietary, confidential and/or legally privileged or otherwise legally exempt from disclosure. if you are not the designated recipient of this message,you should not read, print, retain, copy or disseminate this message or any part of it. If you have received this message in error, please destroy and/or delete all copies of it and notify the sender of the error by return e-mail or by calling 1-508-771-0885."For more information about CHAMP Homes, Inc. please visit us at www.champhomes.org ' J 3 THE COMMONWEALTH OF MASSACHUSETTS Registration: 181952 Office of Consumer Affairs and Business Regulation f Home Improvement Contractor Registration Program Expiration: 5/12/2017 Y P. O.Box 419291 Received: d Boston,MA 02241-9291 APPLICATION FOR RENEWAL OF REGISTRATION Home Improvement Contractor or Subcontractor MGL Chapter 142A,201 CMR 18 CHAMP HOMES INC. New.Mailing Address (if different) MARK ADAMS 82 SCHOOL ST HYANNIS, MA 02601 - . - REQ.U1RE-DRENEWAL FEE: ONLY CERTIFIED CHECKS OR MONEY ORDERS CAN BE ACCEPTED A Y O"1 HER FORIA OF AYiV16E f, -INCLUDING Bu i NU-f $100, LIMITED TO PERSONAL OR BUSINESS CHECKS, WILL BE RETURNED AS INELIGIBLE. PLEASE OCABR will not process any renewal application if it is postmarked more than 30 days beyond the NOTE: expiration of the HIC Registration, See 201 CMR 18.02(6)(b). Failure to submit a timely renewal application will require a contractor(1)to obtain new HIC Registration card (2)to pay associated registration and Guaranty Fund fees. No. of Employees: If the number of employees stated here is incorrect, please insert the correct number here: CHANGES: If the Applicant is a Partnership, Corporation, or Trust and the name of the individual responsible for the applicant's work has changed, please specify those changes below. First Middle Last Phone Number: Pursuant to Massachusetts General Laws Chapter 62C §49A,1 certify under the penalties of perjury that,to the best of my knowledge and belief, I have filed all state tax returns and paid all state taxes required under law. Signature of Applicant Title held if applicable Date A FALSE ANSWER TO ANY QUESTION IN THIS APPLICATION CONSTITUTES GROUNDS FOR SUSPENSION OR REVOCATION OF THE APPLICANT'S REGISTRATION. DVWELDI-01 CLEDDU E ACORO" CERTIFICATE OF*LIABILITY INSURANCE ` D05/09ATE /2017r) 05/09/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR.ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT,CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S);AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of.the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT - NAME: RogRte 134 ers&Gray Insurance Agency,Inc. (A/C,PHONE 434 Ext: MC,C,No:(877)816-2156 South Dennis,MA 02660 E-MAIL mail@rogersgray.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Maxum Indemnity Company 26743 INSURED INSURER B: DV Welding,Inc. INSURER C: 2 Kyle Drive INSURER D: Pocasset,MA 02559 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BEISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRIN SD MM1DD1YYYYI IMMIDDIYYYYI 1,000,000 A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE F OCCUR - BDG006646105 08131201.6 08/13/2017 DAMAGETORENTED 100,000 PREMI E Ea occurrence $ MED EXP(Any oneperson) $ 5,000 PERSONAL&ADVINJURY 1 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY a PE� LOC - PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED Me .dn'lSINGLE LIMIT $ ANY AUTO - BODILY INJURY Perperson) $ OWNED S AUTOS ONLY AUTOSULED BODILY INJURY Per accident $ HIRED NON WNED dtOPERTY AMAGE AUTOS ONLY AUTO ONLY er accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION - - PER OTH- ERAND EMPLOYERS'LIABILITY YIN - ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES ACORD 101,Additional Remarks Schedule,may be attached if more space is required/ *"*PLEASE NOTE THAT THE WORKERS COMPENSATION CERTIICATE WILL FOLLOW SHORTLY UNDER SEPARATE COVER,AS IT IS BEING ISSUED DIRECTLY BY THE INSURANCE COMPANY- CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Mark Adams,Construction Supervisor THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. Champ Homes Inca 82 School Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE 7. ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 5 . i C�dot1. - \ Qvo9 •53 _ 'Zc»�?o� -2.-h -t- 4-h , by ^�3 N cr-'="e 7 \ p -1' nS •f ' �' I Soy j ��i, -'�/ Z_/�� '�• � � V J 1 S 4� n r 3`Pb'2 � ' tT W _.. I S i I � �; J, o G J I two-L.�I Ccv-7f, p1 N fn IN -3 7 n 'a.= 7i � �•--� ry� v �,� '17�T�Z tti o'er t • • 17-t7 z/17 •� - +{17+.,..�1?(1'S'•w*�Q �t�W4 ��,',+•j ri�iy �.��'�w t -"�`� •� •`i;� €(_ O'Neill Building y "- 92,School St. Hyannis 216' Oft '= � j 24.5' I[ 30 ' +/- 18 5` LF - I - LDunpster fenced W _ y+� _ } 01 m SL Q � f - - ' � j k �,CYCLE•RENg{y mm Homes C140 P I 508-771-1470 82 School Street Paul Hebert Hyannis,MA 02601 508-771-1470 Executive Director/President Fax:508-778-6425 1 www.housingforall.us www.champhouse.org r , n t Q I Barnstable Town. of Barnstable . .�.�,.� ' ,• Department of Public Works 382 Falmouth Road Street,Hyannis MA 02601 http://www.town.bamstable.ma.us 2007 Mark S.Ells,Director Office: 508-790-6400 - Fax: 508-790-6406 June 12,2012 Paul Hebert,President Housing For All Corporation 82 School Street Hyannis,MA 02601 p Dear Paul, I am pleased to offer my support for your proposed redemption bin project. Please use this letter for any grant that the Housing For All Corporation is seeking for this project. To Whom It May Concern: The Housing For All Corporation HFAC)has been a leading advocate within the Town of Barnstable promoting suitainability and environmental stewardship for many years,while supporting their core mission of housing those in need.Their proposed redemption bin project will prove itself as an asset to-both the taxpayers and visitors of B -� ble,by diverting more recyclable material.from the-waste stream and serving to protect precious environment. These ideas resonate with those of the-Town of Barnstable and e'are enthusiastic to be in partnership with HFAC. HFAGhas proven itself as an organization dedicated to helping both the environment and people in need,and would benefit greatly from any funding granted to th to expand operations to meet the needs of our community. Jir E r I r Ob T01.N cF Ya RtVipUTH pROpAN • ��4� .NEB � , � � � t 0 Your �61 le VAMP .Batt � , Love` .Homes Npw.Cham r� �. 508`77 Phones. 9 or 3 1 1470 5 .v _ O r-c-� Y ey THE ULTIP.4ATE RECYCLING EQUIPME W. r J 92 Newark-Pompton Tpke.,Wayne,New Jersey 07470 ��J�./`-� 973 872-0346•Fax(973)872-9010 All Rights Reserved r' y _ - DEPARTMENT OF PUBLIC WORKS M E Waste Management Division. --606-FOREST ROAD*IX— e SOUTH:.'ARMOUTH>1VIASSACHUSE3 S{3266 ,.Telephone_(598)�76QA870°.Fax:•(508).760-4884. nt-(508)394-0141a.Fa ..( . 8)76028de 6Supennen _ Mr.Paul Hebert President Housing For All Corporation 82 School St. Hyannis,Ma. 02601 Dear Paul Please use this letter of support in any grant the Housing For All Corporation may be seeking. To Whom It May Concern. The Housing For All Corporation(HFAQ has worked side by side with the Town of Yarmouth in the operation of the redemption area at the Yarmouth Disposal Area for over ten years. In that time HFAC has removed many thousands of redeemable beverage containers that otherwise would have ended up in the waste stream:The redemption area at this facility is very busy and needs daily attention which HFAC has accomplished with their staff. Over this time period HFAC has expanded their operations to other sites and has increased their staff and,vehicles to meet their expansion.The staff is always well trained and professional in the operation of the area and interacting with our employees and residents. In my opinion,from experience,HFAC is a well run corporation,that is seeking to help people and the environment at the same time and would be much appreciative of a grant or any help to reach their goals. *Roert . ll Waste Management Superintendent Printed on Recycled Paper �CYje eommconweaYtb of j+1aqqa rbUgettq TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF. INSPECTION is issued to HOUSING FOR ALL CORP. QLCrtTfp that I have inspected the premises known as: CHAMP HOME#1 located at 82 SCHOOL STREET in the Village of HYANNIS County ofBarnstable Commonwealth of Massachusetts. Construction Type: Use Group(s): I-1 The means of egress are suff cient for the following number of persons:. Location Capacity Location Capacity FIRST FLOOR 17 SECOND FLOOR 20 TOTAL 37 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 39856 7/27/2005 7/27/2007 327 240 f The building official shall be notified within(10) days of any changes in the above information. Building Official t� 4 COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date oZ 1, d o o S (X) Fee Required$ 83. o c7 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code,Section 106.5,I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: 0110), �C h oo� S7/e eT �)/d h h S� /yfi9 o p� 601 Name of Premises: Al to // a M # Purpose for which premises is used: LI e /"a fe u I.:c Oo7"M vN%Ty Cj✓o jo ff o 41 License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit Abe— Y Elev ation �ErT c 37e 'CUw/,�o a w ea l%� n-c �o,•+c*aoNc.��a17Z. chjSe �[O LI S/N -FD� f✓it C®Certificate to be Issued to: 7T �j � r'f06e-a7%oe7 Address: a o), S C � o o f S T, Ilx a-yl r7 i S, /qj Telephone: 50 g 7 7 I a 0 �s Owner of Record of Building: 11,Ll S N - o g A I L (.fi 7—;p'7' Address: S C- I O O %J ,a h /7! Dot ca Name of Present Holder of Certificate: TO !2 !ALL �( C Name of Agent, if any: Pa, [ �: li� �e/�� eS� �e�T �(� � -q SIGNATURE OF PERSON TO WHOM CERTIFICATE IS ISSUED OR AUTHORIZED AGENT '0" J F. PLEASE PRINT NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. FOR OFFICE USE ONLY: CERTIFICATE# JC C� EXPIRATION DATE: 7/,� 71L J020115a CommmonWealtb of Olao0arbuatto TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to HOUSING FOR ALL CORP... Certlfp that I have inspected the premises known as: CHAMP HOME#1 located at 82 SCHOOL STREET in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: Use Group(s): I-1 The means of egress are suff cient for the following number of persons: Location Capacity Location Capacity FIRST FLOOR 17 , SECOND FLOOR 20 TOTAL 37 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 327 240 7/27/2003 7/27/2005 39856 .. The building official shall be notified within(10)days of any changes in the above information. Building Official F COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date .f u N e a S, oZ 3 (X) Fee Required$ ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code,Section 106.5,I hereby apply for a Certificate of Inspection for the below-named premises locatedat the following address: Street and Number: v ), SC h o o& S T✓e Name of Premises: /J;qpt10�11E � Purpose for which premises is used: License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit Rency CEiE 1 4.ca:ie of Krr► PCP- .To"Pt Dew o-� Abl;4 SA fr7k A.,,tiy A l )aSPecToNs o f F•re A/Rrm C Aivc 4,d 41Ar,% A,v'uurt) 04 SJfr;VIc►e i4•/3• CA tic v Certificate to be Issued to: u S t ma f o 'q L eeeA /10Au 1 ` CARo!W J14 i fT rd-0•rl. Address: S G h 0 0 rrG er ifm /1f 4 O 4 6 0/ Telephone: 7 71 Owner of Record of Building: �d llSi V /"d Address: y A Sc h 0 o,(,., S 1/1c G T Name of Present Holder of Certificate: A us;Lij For 4 L Ohrb I nJ Ay e,-T 6•��r Name of Agent,if any: ,1,1 C. Ile I e'�T� &S -'&-401 SIGNATURE OF PERSON TO WHOM CERTIFICATE IS ISSUED OR AUTHORIZED AGENT �Avl F deb eleT' PLEASE PRINT NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. CERTIFICATE# 6 EXPIRATION DATE: f 2 -71 d J J020115a CAPE SN at ri .We, he U 508-398,- 398 :, December 14,`2011', fi Town of Barnstable n Thomas Perry CBO 4 Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits Dear Mr. Perry, r This affidavit is to certify that all work completed for permit application#201104927, Status A, Parcel 327239002 at 82 School Street,Hyannis,Permit type: RADD, and issued on 9/15/2011 has been inspected by a certified Building Performance Institute (BPI) Inspector. R-49 Cellulose insulation was added to the attic. R-11 Fiberglass batts added to open rafters,walls and kneewalls. Basement perimeter wrapped with R-5 reinforced foil or vinyl faced duct wrap.Walls were dense packed with R-13 Cellulose insulation.All work.performed meets or exceeds Federal and State.Requirements. Sincerely,.` s William McCluskey f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map r Parcel 0, J 7 w v Application # ��i Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Fri 5--v Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address l,,� '0 S-f Village a,n o (S Owner -Soy CA IC +10 A Address Telephone Permit Request�q;,r �ea) ��-t-�°c 9— es �� r» �_ s=t' )) R-49 Ce))c irl e ►' : ,eigS . �� aa1 �arend o'becc�>C.-SO& t) rt 960014�jrl'esn 1Per1Mc+eC �a,r - [,,)< v' e 5 v1 eat ®o r?AA_F t oO - Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 8G Project Valuation 000 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 5 "I 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 4 new U , evY-t Number of Bedrooms: existing —new �� a U Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas _40il ❑ Electric ❑ Other J Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coadtovC-rU Yes ❑ No 2 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 A'Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name V" ' `tl�N) 5�� y Telephone Number 5Vf� Address n License # 1 �&rm I Ser�`�V1 0 wT �' t 0 t'� Home Improvement Contractor# b `� Worker's Compensation # ! q5 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO M Qtti� SIGNATURE DATE �� ' FOR OFFICIAL USE ONLY r w 4 '' APPLICATION# R DATEISSUED MAP/PARCEL NO. ADDRESS I VILLAGE { OWNER S y b 5 ' DATE OF INSPECTION: r� FOUNDATION FRAME ((y INSULATION I`t FIREPLACE t '} ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING 6x r 1 `r DATE CLOSED OUT t ASSOCIATION PLAN NO. i 6 The Commonwealth of Massachusetts � Department of Industrial Accidents Office of Investigations 600 Washington Street .Boston,MA 02111 www mass gov/dia NVorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Auulicant Information Please Print Legibly Name(Business/Organization/Individual): C 14 AE_ '5��i<tt-"a.L� Address: -C, ( ur,�IiniG—rots� City/State/Zip: S YAfl osLu Ma OoWone M 3 9' Are you an employer?Check the appropriate box: Type of project(required): 1.(K I 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 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling v p p These sub-contractors have ship and have no employees 8. ❑Demolition workingfor me in an capacity. employees and have workers' Y ' 9. Building addition [No workers' comp.insurance comp.insurance.' required.] 5. ❑ We exemption are a corporation and its 10.0 Electrical repairs or additions officers have exercised their 11. Plumbingairs or additions 3.❑ I am a homeowner doing all work right of per MGL ❑ repairs myself. [No workers' comp. g p p 12.❑ Roof repairs , insurance required.]f c. 152,§1(4),and we have no employees. [No workers' 13.® Other nst1't 1,4%M comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: C S i-t ( !V Ltr Policy#or Self-ins.Lic.M C- —` = 3 • ( 7 a[kj Expiration Date: Z z 6 r r n � c t Job Site Address: C>C,k°o ' c _' City/State/Zip: I VWks 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 under the pains.Cnd lenaldes erjury that the information provided above is true and correct Signatt►re: Date: Phone#: Official use onAk 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#: �:s ® DATE(tltlN/DDtY M Rr3 CERTIFICATE OF LIABILITY INSURANCE 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 cartificate 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 1 CONTACT INAMe, Shannon Sperraaza Risk Strategies Company ;PHONE (781)986-4400 ;p (781)963-4e20 -- 15 Pacella Park Drive ADDRESS:ssperrasaa@risk-Strategies.com Suite 240 PRODUCER 10018476 Randolph MA 02368 INSURERS AFFORDING COVERAGE 1 NArC# INSURED INSURER A:Seneca Specialty Insurance Cc [INSURERS:Keating Group Ins Services Michael McCluskey, DHA: Cape Save INSURER c:Charti.s Insurance 7 C Huntington Ave hNSUR ER 0. !INSURER E: South Yarmouth MA 02644 I SURER F COVERAGES CERTIFICATE NUMBER:CLI0111.32675 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, i EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MlSR; j POLICY EFF I LlCY EXP ! LTR TYPE OF INSURANCE. POLICY N MBER MOVE ? MM100 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 COMMERCIAL GENERAL LIABILITY PREMISES(Es ocoxrence) $ 50,000 A CLAIMS-MADE OCCUR SAG1002608 ld/16/2010!10/16/2011 I MED EXP(Any one person) :$ _ 10,000 PERSONAL 8 ADV INJURY S 1,000,000 + f GENERAL AGGREGATE $ 1,000,0001 LGEN L AGGREGATE LIMIT APPLIES PER: ) _PRODUCTS-COMPIOP AGG :S 1,000,0001 X ;POLICY `PRO- LOC i $ AUTOMOBILE LIABILITY ' COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO 6208200 2/6/2010 (Esaccioent) 'a1/6/2011 i r— I BODILY INJURY(Per;;;;. {S ALL OWNED AUTOS -s— i X - j BODILY INJURY(Per accident)' __ ,SCHEDULED AUTOS - b ' I i PROPERTY DAMAGE X'HIRED AUTOS { (Per accident) $ XNON-OWNED AUTOS j S $ 'UWIertELLA UAB OCCUR ! ` EACH OCCURRENCE —I$ 1,000,000 EXCESS LIAB CLAIMS-MADE! I AGGREGATE S 1,000,000 DEDUCTIBLE I - 'S g i RETENTION $ P23578601 0/16/2010 10/16/2011: $ C WORKERS COMPENSATION Michael McCluskey O R l AND EMPLOYEEV LUU31LITY i i _ YIN" -•--- ANY PROPRI£TORIPART14MEXECUTiVE ? I 1a excluded from coverage; E.L.EACH ACCIDENT ;$ j OFF{CERItdEMBER EXCLUDED? �I N I A i i 5OO�OOO (Myyersaftm in NNI 9930951 10/21/2010;10/21/2011; E L DISEASE-EA EMPLOYEES 500,000 ©ESLtRIPTION Off OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500LO00 , ? i I DESCRIPTION OF OPERATIONS)LOCATIONS!VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space is required) Issued as evidence of insurance. Contractors-Executive Supervisors or Executive Superintendents. CERTIFICATE HOLDER CANCELLATION (508)790-2425 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN housing Assistance Corp ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Ruth 460 West Main Street: AUTHORIZED REPRESENTATIVE Hyannis, MA 02601-3698 chael Christian/SZSS ACORD 26(2009109) 01988-2009 ACORD CORPORATION. All rights reserved. INS026(loom) The ACORD name and logo are registered marks of ACORD `T Office of Consumer Affai s and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 164432 s Type: Supplement Card CAPE SAVE Expiration: 10/6/2011 WILLIAM MUCCLUSLEY 8201 S. HOURD CT CHAPEL HILL, NC 27516 Update Address and return card.Mark reason for change. OPS-CA1 0 50re-04.104-o101216 L Address � Renewal � Employment C Lost Card ��ie �dn�rraratuea�� o�.��u�ac�Ciaelts . Office of Consumer Affairs&Business Regulation�-_ „--- g License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation \ Registration 164432 Type: 10 Park Plaza-Suite 5170 i Expiration,;10/6LZ011. Supplement Card Boston,MA 02116 CAPE SAVE WILLIAM MUCCLUSLEY". 7C HUNTING AVE.. � -- _ S.YARMOUTH,MA 02664 Undersecretary Not v'ftIiii7w=out signature Massachusetts - Department(of Pul)lic Safet% Board of Building Re-ulations and Standards Construction Supervisor Specialty License License: CS SL 102776 Restricted to: IC :' WILLIAM MC CLUSKY 37 NAUSET ROAD WEST YARMOUTH, MA 02673 Expiration: 6/28/2013 {1.++nni �inncr Tr#: 1027.76 ' t ry rr• ..vrr rr••ter +i rJ�i r./JM rllll �l �i CAPE j SAVE Weatherization , 508-398-0398 s August 22, 2010 To Whom It May Concern: William 1. Mcauskey is an employee of Cape Save. He is authorized to negotiate contracts and building permits for our.company. Michael McClusW Cape Save—Owner 919-593-5939 cell X Huntington Avenue.,South Yarmouth,MA 026" 460 G-Iest lain Street HOUSING Hyannis, MA 02601-3698 .S S I S TANCE ENERGY & HOME REPAIR T (508) 790-7106 F (508) 790- �ORPORATT_ON 2425 HOME OWNER WEATHERVATION WORK PERMIT& FUEL RELEASE: ARE �Lf` THEAPPLICANT HOMEOWNER. / I v C ' 4'41 r1 hereby consent to and agreethat weatherization work may be done by the Weatherization Program of Housing Assistance Corporation (herein after referred as "Agency") on the property locate�rf at: The weatherization work done will be based on programmatic priorities and availability of funding and it may includea]I or some of thefolIowing measures: Weather-stripping& caulking of windows and doors, insulation of attics, sidewalls& basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows In consideration of theweatherization work to bedone at my home I agreeto thefollowing: 1. 1 give permission to the"Agency" its agents and employeesto travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect thefuel or utility bill for the weatherized unit on an ongoing basisfor no morethan five(5) years after theweatherization work is completed. have read the provisions of th' ent as listed and freely give my consent. Home Owner: (Signature). Data 02111111 Agent: (signature) Date. HAC approved Weatherization Company : t" V All Cape Energy, Caliber Budding&Remodeling, Cape Cod Insulatio Cape Save, eswell Construction, Frontier Energy Solutions, Lohr&Sons, Peter Smith, Resolution Energy, Rock Solid Construction TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �-�] Parcel 100a, .'Application Health Division Date Issued Conservation Division Application Fe - Tax Collector Permit Fee Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address_ :5 JL0 o Village i4mnn1YV1 S Owner 00 S14��,�!` CdPfJ Address CvvhjP, Telephone SO E3 - —7 O Permit Request L N 1 e4_, Square feet: 1 st floor:existing proposed 6 2nd floor:existing :proposed _Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio O Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) , `~i M Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑"yes b No Basement Type:JkFull ❑Crawl ❑Walkout ❑Other 'rn 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 Q. 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 ,/,U w.Q BUILDER INFORMATION Name; & Co-4tV0 -e✓r�/yu!C . Telephone Number Address 77 4 W kTe(--) -e License# A/La rs VDAA Mtl P1STAlG_ Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE - DATE C5 3 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED YMAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r, PLUMBING: ROUGH FINAL s GAS: ROUGH FINAL FINAL BUILDING x G DATE CLOSED OUT `F. ASSOCIATION PLAN NO. "1 _ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 9 600 Washington Street a Boston,MA 02111' w>Ow.mass.gov/dia ' Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information .Please Print Legibly C ,vi. ry dividual . . U / f Name(Business/Organization/In )�(' Ue � �� 1'�l]— l��l�tir B .� Address:""` ;: ;; ; • tate/Zi1 Phone t S Q�S ,/�-r� y Ci /S p��1�d1S Al,/"�r, S Are you an employer?Check the appropriate bog: :Type of project(required):. 1.❑ I am a employer with 4. I am a general contractor and I 6 New construction . "employees(full and/or part-time).* have hired the sub-contractors listed on the'attached sheet. 7. ❑Remodeling 2.)qI am a'sole proprietor or partner- These sub-contractors have ship and have no employees 8. ❑Demolition d h e employes and workers' working for me in any capacity. 9. Building addition comp.insurance. [No workers comp.insurance 10.❑Electrical repairs or additions required.] 5. We are a corporation and its 3.❑ I am a homeowner doing all work . officers have exercised their 11.❑Plumbing repairs,or additions myself.[No workers'comp. right of exemption per MGL 12.❑Roof repairs . insurance.required.]t c. 152, §1(4),and we have no 13.❑Other ' employees. [No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners,who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. . $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must providt their workers'comp.policy number. I am an employer that is providing workers compensation insurance for my employees. Below is.the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of 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 copyof this statement maybe forwarded to the Office of Investigations of the CIA for insurance coverage verification. I do hereb ' under the pai nd penalties of perjury that the information provided above is true and correct. Si tare: Date: — Phone# �d 'y� aY U O rcial use only. Do not write in this area, tb be completed by,city or town off cial. 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#: � s � 7 a ✓�ie "lOanvrrao�eiaeatl� a�✓��cr4.tact uae�.6 BOARD OF BUILDING REGULATIONS License ,cONSTRUCTION SUPERVISOR Number" CS 009693 - ' ;Expires; 08/27/2007 Tr. no: 3155 O Restricted: 00 ,;: BRUCE E ROSEWELL ' i 72 WATERS EDGE MARSTONS MILLS, MA'02648 Commissioner - .. I"E'°'yti Hyannis. Main Street Waterfront Historic District Commission saxivsTe Mesa. 200 Main Street v g . �Ar fo.19.t e,`0 Hyannis,Massachusetts 02601 TEL: 508-862-4665/FAV508-8624725 Application to Hyannis Main Street Waterfront Historic District Commission in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate,for the issuance of a Certificate of Appropriateness 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 for: PLEASE CHECK ALL CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building ❑ Addition ❑ Alteration Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑: 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repa' existing sign 4. Structure: ❑ Fence El Elting Flagpole Other W etc) 5. Parking Lot: ❑ New Building ❑ Addition ❑ Alteration avle►►Awc Lad (Please see the guidelines for explanation and requirements) TYPE OR PRINT LEGIBLY DATE Ce U ASSESSOR'S MAP NO.�C7- ASSESSOR'S PARCEL NO. APPLICANT ;one -TEL.NO. 5'040- 771-0685 APPLICANT MAILING ADDRESS_- FoZ SG k e o 1. S-r✓'e c T A y all I f R,9 0 A 01 ADDRESS OF PROPOSED WORK SFr�); ,/yanni s 2.1,9 OaEo/ PROPERTY OWNER lYouj,,ev 5 f/ ee,-r, TEL.NO. 7/-0 OWNER MAILING ADDRESS Nd iU t FULL NAMES AND MAILING ADDRESSES OF ABUTTING OWNERS.Include name of adjacent . property owners across any public street or way. This information is best obtained at the Town Assessor's L . Office. (Attach additional sheet if necessary). AGENT OR CONTRACTOR avve! TEL.NO.E D8-qA?0; (�rue� 2ose�r.0 1UL 0 2 2007 ADDRESS 7a w'dr.r.r GJ4G. MMulya s A '/ls /f1A O �8 T Town of Barnstable. Regulatory Services ' UWASIX$ Thomas F.Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us office: 508-862-4038 Fax: 508-790-62.30 Property Owner Must Complete and Sign This Section If Using ABuilder I 0V ,6 , as Owner of the subject property herebyauthorize 6 ruc—e r6S:e—w:T1 to act on mY behalf, in all matters relative to work authorized-by this"bu�g pernlf application for; . (Address of job) ter. V117 /0 Signature o er Date y O V �4 & - Print Name/ Q:F0RMS:0WN'VERMLSSI0N I pt IL 11,4 r-::A��. 7j-1 6 '(l pool ]ie�ae;� n�I j; �f I .,.�r-e, 1 Klv(.4-1t'10 r .a 51rriot. /TV. 4 RFt Y� C�oG(� V69. Tug To I 1 tNLA11,C.(•.c, wc. *'W. I 1, y s, ST' Al �. . .. ..... 7 ' 70 �W'sJ rvrvN.f! its WNW 1 � ' d � rq f) PON i j I -alys ___ __ I � � 1 i i / Iv 1 i t i ! i I\,f rfi�30�c�1 , r!'d�.l '•��•d«7 )i>>tN)-J�j .�.�v;M.+ :a zr+�y.;} w�s+rvls k•+sb3N 341An-��+a,•c� a+o - ':"c�7i�.ytx"� �t �14M:+''3c1;� Ft�b••�•J�d ��•.� ,,2f+ '�rfv� -:lid -�l�o-�cl �^.d a �i,'•-;,,� ,�91 :ds SdY'•1.; 't5M hv.-'� :r101J.1LZ1`�� "h=)�Y "i`�1-�1d�.1. - :.:_' -------... TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map JAI Parcel;,"'r / Application oaooq�,W&� Health Division Date Issued (A 0J 107, Conservation Division ion Fee Planning.Dept; TV�.�'1!1_ermitpplca Fee: Date Definitive Plan Approved by Planning Board L jca�� S� Low Historic - OKH Preservation/Hyannis to Project Street Address ODL S Village Owner hov5Aigj1 ��or� Address 2 S G�cxi 1 S Telephone 570 0 N.3 Permit Request I'AC,11o, Ise,h o ( it 4 P v in O dv)�% Square feet: 1 st floor: existing proposed '2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio d Construction Type Lot Size Grandfathered: 0 Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family .•❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing 0 new size_Pool: ❑existing ❑ new size _ Barn: ❑existing ❑ new size_ I ' Attached garage: ❑existing 0 new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ - Commercial ❑Yes ❑ No If yes, site plan review# t Current Use y Proposed Use APPLICANT INFORMATION C) (BUILDER OR HOMEOWNER) Name Arenkn PPa4 it Telephone Number _1, 04-- Sj- 6273 �e Address W &Am g �rz;k License# 97165 GSL Home Improvement Contractor# 2S�33 Worker's Compensation # WC W 3.7 S 7 7S CA ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 1�� //��e/ DATE Ge•1'0 9 t FOR OFFICIAL USE ONLY _ APPLICATION# X. DATE ISSUED MAP/PARCEL N0: -ADDRESS VILLAGE OWNER — r h - a DATE OF INSPECTION: FOUNDATION y - .FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL — PLUMBING: ROUGH FINAL j. GAS: ROUGH FINAL r FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. R� r rya . •. The Commonwealth of Massachusetts Department of Industrial Accidents A Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): ptrQdo k �dew 2n G Address:— !:) City/State/Zip: o/fi Phone#: i- i'9-F • C4 73 Are you an employer? Check the appropriate box: Type of project(required): 1.Q I am a employer with 30 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 8. ❑ Demolition workingfor me in an capacity. employees and have workers' y p n'• 9. ❑ Building addition [No workers' comp.insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no I 13.� Other P U. employees. [No workers' Sd oI C 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 and job site information. Insurance Company Name: AhQ� �k4\ A Sri ea, 2n>vfc"19Gt Policy#or Self-ins.Lic.#: L)(G�/ 3 7 6!775— CA Expiration Date: Job Site Address: 6 et sc,�6,6, �S�'rCP� City/State/Zip: �f tn�'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 under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: " C 110 q Phone#: 3 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ' Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as an individual,partnership,association,corporation or other legal entity,or any two or more of the,foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town maybe 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 Revised 4-24-07 Fax# 617-727-7749 www.mass.gov/dia y . �1 z. Hyannis Main Street Waterfront Historic District Commission Growth Management 200 Main Street . Hyannis,Massachusetts 02601 `Q Phone: 508-862-4665 / Fax: 508-862-4784 M Application to Growth Management i j e r Hyannis Main Street Waterfront Historic District Commission _, rio in the Town of Barnstable for a rn CERTIFICATE OF APPROPRIATENESS o Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness 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 for: PLEASE CHECK ALL CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building ❑ Addition 5a Alteration Indicate type of building: ❑ House ❑ Garage ❑ Commercial Other vScN 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing-sign 4. Structure: ❑ Fence ❑ Wall ❑. Flagpole ❑ Other 5. Parking Lot: ❑ New Building ❑ Addition ❑ Alteration (Please see the guidelines for explanation and requirements) TYPE OR PRINT LEGIBLY DATEFe_6uor4 �D01 ASSESSOR'S MAP NO. , ASSESSOR'S PARCEL NO.*2_S 1002 APPLICANT OJStylq ro "r � 19r `�U� TEL...NO So$_ 77�_ �y 70 APPLICANT MAILING ADDRESS 95 2—Jc ACO s4etk&InA`S i ADDRESS OF PROPOSED WORK U1__ S`T+f 2e�� y IA cab 1 PROPERTY OWNERAOt5(!n 0(- 6ior"On TEL.NO.50g—�7I ` 1q7 OWNER MAILING ADDRESS 82—St,�'1010 1 � � � 5 ,mA or)-6o FULL NAMES AND MAILING ADDRESSES OF ABUTTING OWNERSAnclude'name•of.adjacent property owners across any public street or way. This information is best obtained at the Town Assessor's Office. (Attach additional sheet if necessary). AGENT OR CONTRACTOR&CCe— t7 S®'ar TEL.NO. -I /� 513'21�00 ADDRESS20 ] IAIVI "{_Ia1 Nik, F014 Lwelk l ► A 01 gS2— 1/14/00 Draft Copy-Commission Use Only Page 1 y , DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done, including detailed data on such architectural features as: foundation, chimney, siding,roofing,roof pitch, sash and doors,window and door frames,trim,gutters- leaders,roofing and paint color, including materials to be used,if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet,if necessary). l�tl 1CX-% Signed ( • :L , Owner .Contractor-Agent SPACE BELOW LINE FOR COMMISSION USE Received by HMSWHDC Date Time This Certificate is hereby By Date / 1 Signed, IMPORTANT:If this Certificate is approved,approval is subject to the 20-day appeal period provided in the Ordinance. CONDITTIIO�NpS OF`APPROVAL: 1/14/00 Draft Copy-Commission Use Only Page 2 February 12, 2009 Detailed Description of Proposed Work There are currently two options available for the installation of solar panels on the flat roof of 82 School Street: 1) Install a high slope racking system over the existing flat roof with a pitch of (+/-) 6.8/12, which is similar to the existing roofline of the building; 2) Install a low angle racking system over the existing flat roof J with a pitch of (+/-) 2.5/12, which would be a much lower profile and be significantly less visible from street level. HYANNIS MAIN STREET WATERFRONT HISTORIC DISTRICT COMMISSION ***SPECIFICATION SHEET*** ADDRESS OF PROPOSED WORK J)_ ,4"_kW 1 4 , 1't�(�� r A O�Z60 1 FOUNDATION SIDING TYPE �Y 1 COLOR CHIMNEY TYPE COLOR ROOF MATERIAL , _COLOR 1( f < PITCH aWAeA4 On tASW61 11091) vOtl()'I) WINDOW 'V f 1�1 COLOR t� .r TRIM COLOR �\ DOORS 1 V'A COLOR SHUTTERS GUTTERS C X�S n Cu1�l DECK I� GARAGE DOORSU VIG`1 COLOR NOTES: Fill out completely,including measurements and materialskolors to be used. Three copies of this form are required for submittal of an application,along with three copies each of the plot plan,landscape plan and elevation plans,when applicable.The Plot plan need not be"Certified",but should show all structures on the lot to scale. 1/14/00 Draft Copy-Commission Use Only page 4 Al H S ccg 2 z a4 O Mu Ul J O m JCD U 2 Q S �$W aL a_� O r za ao ti J 0 J o� LU N J d N S W t7QQ A N • o �c W aI J dam$ e . 77 T it P I e i r _ ems `: h' 1 �'� �,� �[•.'�. r� r sue._ � � $ : :�.� a r {i 14. p f j SS � FF 5(� L yyj i - ,�y .9#k • s� r 4 1 x At � 4 0,4 Jli 15 vp 3 � i i e?s-.�—�n� . ; .. dam. 6 �T• � a �"a'. � � .� ��-�_ 4 , b ., � r •- �' fir; .,�. 1 F j f ate. z a '•-€_ .. � -x t� '.r tea. •. • � � `X� � t. q 9 p 4 a y p €r C t s .: rz rir5➢�p r 771 �,Jt �'�� d �'y't,,,,,.ay.• `�� _ d' � 4 r '�, b.;,r'Y dray'`. �.a.F :� °a,' ,«e+=�.5',u•f:.sL+ ... L "'."' t � P, ^may �'^�". � ''+ I.�, '�,:.. 4 . x A � �I M • a n �I r m , ° t ` I F Mendian, Dental — Weymouth, MA x0.o,f1e a �5h �5 ��,�� 5 s �c�, O Rackin fora 3.8 kW. stem y � BORREGOSC1LAR 2(Co(o w k ai'CyYr �y s"Y r,N i a x x f r ri ° o' f f r, f ,.. .. s 3 t S y° , v� M y+. s • ` 7C+. '� •.. _. ''�.: � _ fin"' •4 u ..8. � .y s r e .. - ! w. i� -.,C" +} :. - ,fie•� .. r 1 v Y'• a { � r F ✓P e 4� Rohm and Haas - Marlborough, MAx��C� Racking for an. .8 kW System Y BOitREGO sOLAR Z�io IOq +,: '. k �', I t P� •:�t +yI �., i'�''tir�TAn ". E!"as�x�'9��'y�� .�! •'�{ "+: r*�< 4 1 1 Yy ► t�;� ' �i�� t rrhr�+N � •�'+,.� � q�; •,l'�.. �� ..`txN j �� tJ n,N,�t a•y�t ' � ` xr��e>wvy ��• � ,g r �' �'��' �. : 1 �• y Lt ��•� it i� `.'i4'� i tsr ; frr •y SYS+ \ , nr -thew •:r -.. 7 .1 dt:r3/� •-' r} -�- •�[!-��. ��¢_i��33 � �^` y ..`, Groh A \:. � �`_� �y� `T x. ro 4 �y ' `� �"� �_-I�._-- 1-�'�'� _��I�!i IW"�� c�. _ll 'yy� `�. 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Save money using fewer system attachments and racking materials, and, reduce costs by spending less time installing per waft. HIT Power models are ideal for grid-connected solar systems, areas with performance based incentives,.and renewable en- ergy credits. �^ - Power Guarantee SANYO's power ratings for HIT Power panels guarantee customers receive 100% of the nameplate rated power (or more) at the time of purchase, en- E abl.'ing owners to generate more kWh per rated waft;quicken investments returns, and help realize complete customer satisfaction. Temperature Performance As temperatures rise, HIT Power solar panels produce 10% or more elec-. tricity (kWh) than conventional crystalline silicon solar panels at the same ' temperature. Increased Performance with SANYO Valuable features The packing density of the panels reduces transpo'rtatioh,fuel, and storage o$ t MoauieTemP.75-c costs per installed'watt. Approx. 3 ,10%Up - I HIT Quality Products Made in USA 0- 7 SANYO silicon wafers located inside HIT solar panels are made in California a and Oregon (from October 2009), and the panels are assembled in an ISO o 0'5 c=Si 9001 (quality), 14.001 (environment), and,18001 (safety) certified factory. Unique eco-packing minimizes cardboard waste,at the job site. The pan- els have a Limited 20-Year Polnier Output and S-Year Product Workmanship E Kobe(Jar an),4u y 24;2007, Warranty. t 'z Faced due South Tilt angle 30- ( I _ I I I• . _ - • 5am' 7am 9am 11 am 1pm, 3pm. 5pm 7.pm-Time Electrical Specifications Dependence on Temperature Model HIT Power 21ON or HIP-210NKHA5 6.00 ' Rated Power(Pmax)' 210.W Maximum Power Voltage(Vpm) 41.3 V 75°c Maximum Power Current(Ipm) 5.09A 5.00 - -- ------- ---------- -- - :-- -*C--- Open Circuit Voltage(Voc) 50.9 V Short Circuit Current(Isc) 5.57 A - ---- -- 5 2 °c 4.00 - Temperature Coefficient(Pmax) 0:336W°C Q 0°c Temperature Coefficient(Voc) -0.142 V/'C Temperature Coefficient(Isc) 1.95 mA/°C 3.00 ;-- =------------------------- -- - - ----------- NOCT 114.8°F(46°C) CEC PTC Rating 194.8 W U 2.06 -- ---- - ------------- --- -- -- -------- Cell Efficiency Module Efficiency 16.7% Wafts per Ft' 15.48 W i.00 --- --- - -------------------- ---- -- -- ---'-- ------- Maximum System Voltage 600 V Series Fuse Rating 15 A Warranted Tolerance(-/+) -0%/+10% 0.00 _ 0 10 - 20' 30 - 40 .50 60 Mechanical Specifications Voltage(V) Internal Bypass Diodes 4-Bypass Diodes Module Area 13.56 Ft2(1.26m2) Dependence on Irradiance Weight 35.3 Lbs.(16kg) Dimensions LXWxH 62.2x3l Ax1.8 in.(1580x798x46 mm) 6.00_ Cable Length+Male/-Female 40.55/34.6 in.(1030/880 mm) 1609w/m, Cable Size/ Connector Type No.12 AWG/MC4TM Locking Connectors s.00' . ----- ------ Static Wind/Snow Load 60PSF(2880Pa)/39PSF(1867Pa) ....800W/m2 Pallet Dimensions LxWxH 63;2x32x72.8 in.(1607x815xl850mm)' Quantity per Pallet/Pallet Weight 34 pcs./1234.5 Lbs(560 kg). .-. 4.00 r , -=- -- Quantity per 53'Trailer 952 pcs. Q 600W/m, Operating Conditions $Safety Ratings `c 3.00 Ambient Operating Temperature '-4'F to 115`F(-20°C to 46°C)' 40ow/m' ' Hail Safety Impact Velocity 1"hailstone(25mm)at 52 mph(23m/s). U 2.00 Fire Safety Classification ;Class C. Z ; Safety 8 Rating Certifications UL 1703,cUL,CEG u0 00 / Limited Warranty .5 Years Workmanship,20 Years Power Output'. STC:Cell temp.25°C,AM1.5,1000W/mz iMonthly average low and high of the installation site. I. Note:Specifications and information above may change without notice. 0.00 •0 10 20 30 40 so 60 Dimensions section A-A' Voltage(V) Unit: inches (mm) i Q CAUTION! 31.4(798) 1 8(46). i 15.47.i393� 1.5(37) 3 Read the operating Instructions carefully before use of these products 0.205 5.2 o ( ) 0.165(4.2) co co - 0.276(7) �, a '0.276(7) #`,^^•, Co _ 4x mou ti holes SANYO Energy(U.S.A.)Corp. ri IWO a Solar vision a.z76 pj o.z76 p) 2600 Network Blvd.,Suite 600 o 'Frisco,TX 75034,U.S.A. Ground(4 placA(5.2)-_ t www.sanyo.com/solar - solar@ Sec.Sa nyo.com 0.165(4.2) 0. ©SANYO Energy IU.S.A.)Corp.All Rights Reserved. 3/1/2009 front Side Back 1 a � SOLECTRIA lit RENEWABLES DJ-' 000 PlYfl . 4000 LF" D n n a U U a breakthrough in efficiency and quality o top CEC efficiency a DC disconnect a " o string combiner a quick-mount bracket o lightweight t: a 10 year Warranty ' q powerful LCD display .. a latest UL,174111EEE1547 a universal 2401208VAC o positive ground option s ' L to 0` a transformer isolation " a free PC software and RS232&485 parts ` o detachable DC wiring box Solectria introduces the PVI 3000/4000/5000/5300 inverter: kf i exceptional quality and efficiency with more standard features. Product INVERTER SPECIFICATIONS PVI 3000 ': PVI 4000 . PVI 5000 PVI 5300 Input ontinuous Power @240 VAC 305OW 4100W 5150W 5575W 208 VAC 284OW 358OW 452OW 484OW Recommended Max.PV @240 VAC 3600W 4900W 620OW 670OW Array Powrer,STC Rating 208 VAC 340OW 430OW 540OW 580OW PPT Voltage Range 20OV-550 VDC 20OV-550 VDC 20OV-550 VDC: 20OV-550 VDC aximum Input Voltage 600.VDC 600 VDC 600 VDC 600 VDC take Voltage 235 VDC 235 VDC 235 VDC 235 VDC aAmum Input Current 16 A 20 A 25 A 25 A aximum Short Circuit Current 24 A 24 A " 30 A' 30 A used Inputs 3 4. 4 4 O ut Continuous Power @240 VAC 2900W 3900W 490OW 530OW @208 VAC 270OW 340OW 430OW 460OW o[tag e Range @240 VAC 212-264 VAC 212-264 VAC 212-264 VAC - 212-264 VAC @208 VAC 184-228 VAC- 184-228 VAC 184-228 VAC 184-228 VAC requency 60Hz 60Hi 60Hz 60Hz Range:59.3-60.5Hz Range:59.3-60:5Hz Ran e:59.3-60.5Hz ' Range:59.3-60.5Hz Continuous Current 13 A 16.3 A 20.7 A 22.1 A ut ut Current Protection 15A 20 A 25 A 25 A ax.Backfeed Current O A 0 A 0 A 0 A over Factor Utility,>99% Utility.>99% utility.>99% Utility,>99% D <3% <3% <3% <3% fficiency Peak @240 VAC 96.7 96.7 96.7 96.6 208 VAC 96A 96.5 96A 96.3 EC Efficiency @240 VAC 96 96 96 96 208 VAC . 95.5 95.5, 96.0 95.5 General nclosure Rainproof,NEMA 3R ousing Material ` " FPainted aluminum bient Temperature Ran a -25°C to+550C. oolin Convection Convection and fan assist eight 47 lb(21.A kg) 48 lb(21.8 kg) 58.5 Ib(26.6 kg), 60 lb(27A kg) ize(L x W x H) 29.75 in x 17.75 in x 6.75 in(741 mm x 454mm x 175mm) 29.75 in x 17.75 in x 8.27 in(741 mm x 454mm x 210mm) ire Sizes 14 to 6 AWG input and output connections tandards UL1 741/1EEE 1547, IEEE1547.1,ANS162.41.2„FCC part 15 B arran 10 years standard.. INDUSTRY LEADING FEATURES: SOLECTRI/� • Highest efficiency tranformer isolated inverters,in,the industry; R E N E WA B L E S 96% CEC, full line! Lawrence, Massachusetts • Fuly integrated with DC disconnect, 3 or..4 fuse combiner and USA detachable DC wiring box. Easy installation with low weight(47-601b)rwith quick-mount Tel: 978.683.9700 bracket feature, and universal 2401208 VAC operation. Fax: 978.683.9702 . • High reliability,,:10 year warranty and certification to latest. UL1741/1EEE1547. CA: 562.237.0377 •Free PC software and both RS232&485`communication ports "... E-mail:'inverters@solren.com www.toiren.com Alf information subject to change without notice 9 v . N Z N y z . Zz y . Zyy TT - ZO.b9 C O op= y$D __F. c o � a K 0 ILI 7 t °a I SCHOOL SihET b g y y. . N. O O m,:0 3 .. 03: 3 30 yDy O 3 p.C �N TA : .CfA' :L SO �11-p Z. p00 1. 2."O . .Nm 00 S.. 'Z O= 'N N.. g ' s0 ,v H N y REV I DATE DRN ISSUE DETALL' - .. 5 Q OA 9.4.09 HW PREIJMINARY OESIGN.. ��m Cz OB 51 9 RNB UPDATEDDESIGN _ SITE PLAN � z F OB 5N4M RHB CONTRACT DRAWINGS 71, 1 o' BOST' COMMUNITY:CAPITAL CHAMP HOMES, p O _ PHOTOVOLTAIC INSTALLATION 7588YSCHOOLSTREET HYANNIS 1 2 3 1 4_ 5 _ 8 1 T 1 THIS DOCUMENT ISTHE PROPERTY' OF SOiRREGO SOLAR SYSTEMS WC. REPRODUCTION,RELEASE OR, ELECTRICAL COMPONENTS. UTILIZATION,IN WHOLE OR PART, WIIHOUT PRIOR WRITTEN CONSENT A - ,IS STRICTLY PROHIBITED. REF NUMBER QUANTITY DESCRIPTION' 1` 40 175E E umn 2 SOLECTRIA 6KW INV 240V W/INTEGRATED CB 8 DC DISCO 3 1 SOLECTRIA 1.8KW INV 240V W/INTEGRATED DC DISCO B SUMY SIDE POWTOFOJERcaaEcloN 5 90RBE60 SOLAR wACCQ(♦DrWCEWIIHCETJHECWMBLW 6. .1ffi Wo113DM1�flM@El4i M .7 1.. 60A 240VAC NEMA"I PANELBOARD Lem1=P1e Tlmsiae- - Wxwaoa�cosnAAcm- . 8 Y 60A 240VAC NEMA3R FUSED 2P DISCONNECT ' ) � SFRVICEPU 2MA,z4aLzoVSRrtvxASE3wwE 9 1 REVENUE GRAOEMETERING AND REPORTING BORREGO SOLAR SYSTEMS INC: C Dam.us oRwHD �T-1—T-T e vi svMeoLs u, I )uaT3))axn)tlsz)awe )m1 )mI )sm )"I )4M4 )VI )m+ )tsn )TW3 )TDO -(75) - CIRCUIT LENGTH IN FEET -{CB-1 .FUSE CB-7 " COMBINER BO%1.- _ .m O � ".. ummAc mscoM4em. JEW ..JUNCTION BOX 4W - I G "- EQUIPMENT GROUNDING CONDUCTOR = Q~ r —I )1D0/3 —BREAKER W RATING&NUMBER OF POLES" D I, - - - L I 600/3 'DISCONNECT SWITCH(RATING&III OF POLES)" 'W�. Q -�,CO- za-. .Q :Z.. . tj E e ELECTRICAL NOTES Ucn; -THIS PHOTOVOLTAIC INSTALLATION SHALL BE IN ACCORDANCE WITH THE EDITION OF .. .. .. THE NATIONAL.ELECTRICACCODE(NEC),CAUFORNIA ELECTRICAL CODE(CEC)AND .. .. .. .. ." :'LOCAL ELECTRICALCOOES CURRENTLY BEING ENFORCED BY THE AUTHORITY HAVING WJURISDICTION.(AHJ) _ 2 A GROUND FAULT DETECTION AND INTERRUPTION(GFDIj DEVICE IS INTEGRATED WITH W � _" t - - - -- - THE INVERTER IN ACCORDANCE WITH NEGCEC 690 6(A), - r. F 1 m - - 3'DISCONNECT,SWITCHES SHALL BE WIRED SUCH THAT WHEN THE SWITCH IS OPENED - .O - MsiRIIIGst-01 THECONDUCTORSREMAINING,LIVE ARE CONNECTEDTO THE TERMINALS MARKED ODULESSTF.� '�8 .g - - - 'LINE SIDE'(TYPICALLY THE UPPER TERMINALS). .. .- §y,' g �- 4 PROBER NEUTRAL CONDUCTORS SHALL BE COPPER MINIMUM#10 AWG,SOLID GR '0 L__L_J I'a I STRANDED WIRE MAY BE USED.EXPOSED PHASE&NEUTRAL C.OFIDUCTORS SHALL BE USE-2 INSULATED;ALL OTHER PHASE&NEUTRAL CONDUCTORS SHALL BE THW14-2 INSULATED UNLESS OTHERWISE NOTED: �aa 5 GROUNDING&BONDING CONDUCTORS SHALLBECOPPER,MWIMUM#10AWG,SOLID G C.ro �55rFwc S i' "OR STRANDED WIREMAYBE USED EXPOSEOGROUNDING AND BONDING 'CONDUCTORS SHALL BEUWNSULATED.ALL OTHER GROUNDING&'BONDING - u� J - CONDUCTORS SHALL BE.THWN-2 INSULATED UNLESS OTHERWISE NOTED(LION). u" 6 DC CONDUCTORS SHALL BE COLOR CODED AS FOLLOWS: o�. DC POSITIVE-RED(OR MARKED RED) .DC NEGATIVE=GREY(OR MARKED GREY) - o 7 AC CONDUCTORS SHALL BE COLOR CODED AS FOLLOWS: HPHASE A-BLACK OR MARKED BLACKIF A4AWG OR PHASE B-RED(OR MARKED RED IF 94 AWG OR GREATER) PHASE C-BLUE(OR MARKED BLUE IF#4 AWG OR GREATER) NEUTRAL-WHITE/GREY(OR MARKED WHITEIGREY IF#4 AWG OR GREATER) 8 FOUR WIRE DELTA CONNECTED SYSTEMS SHALL HAVE,THE PHASE WITH THE HIGHER VOLTAGE TO GROUND MARKED ORANGE OR IDENTIFIED BY OTHER EFFECTIVE MEANS. " a3 9 GROUNDING&BONDING CONDUCTORS,IF INSULATED,SHALL BE COLOR CODED'GREEN 12 (OR MARKED GREEN IF#4AWG OR GREATER), 10 CONDUIT SIZES INDICATED ARE MINIMUMS INACCORDANCE WITH APPLICABLE CODES - _ AND MAYBE.INCREASED IF REQUIRED. 11 MARKING OF THE PHOTOVOLTAIC SYSTEM DISCONNECTING MEANS SHALL BE PROVIDED IN ACCORDANCE WITH NEC/CEC 690.17. 12 MARKING OF THE DIRECT CURRENT PHOTOVOLTAIC POWER SOURCE SHALL BE " - PROVIDED IN ACCORDANCE WITH NEC/CEC 690.53. - " 43 MARKING OFTHE INTERACTIVE SYSTEM POINT OF CONNECTION SHALL BE PROVIDED .\ ,. .J IN ACCORDANCE WITH NECICEC 690:64. V 14 OC CIRCUIT CONDUCTORS PENETRATING THE BUILDING ENVELOPE SHALL BE IN METALLIC CONDUIT AND MARKED EVERY 5 FEET'CAUTION DC CIRCUIT- i .t 2 3 q 8 8 - 7 8 8 _ 70 THIS DOCUMENT IS THEPROPERT7 OF BORREGO SOLAR SYSTEMS INC REPRODUMON.RREASE OR' A UTILITY UTILIZATION.COMPONENTS UTILIZATION.IN WHOLE OR PART. WITHOUT PRIOR WRITTEN CONSEN IS STRICRV TRwSFORNSR REF NUMBER pUANTTTY DESCRIPTION PROHIBITED•� _ � 1 129�' 210W SANYO MODULE -- sI1PIaYSIDE FGR1r oFINreRcora�cnaN 2 a: SOLECTRIA 4KW INV 208V W/.INTEGRATED OC DISCO. - W ACGORMNCE WITH CETMEC 690.61NI r M� 3 - 1 - SOLECTRW 5KW INV 208V W/INTEGRATED CB B OC DISCO . 4 2 SOLECTRIA 3KW INV 208V W/INTEGRATED OC DISCO e 5 a BORREGO SOL'A SERvn�PAHELmn mvlmvwrE4wvsEawwE E%ISRNC UFER GRDUtID - - .�-- -- � - -. uxr4)xun)faa)4Y2 mf-j 21Y1 )4mz mf 7 1 100A 240VAC NEMA 1 PANELBOARD VIWIIf F90RR[G L61 4o�e )za+ )imI )1vf )Tm )Twa )ss4o I � 8 -1 � t00A240VAC NEMA 3R"FUSED 3P DISCONNECT' - - 9". Y- - REVENUE GRADE METERING AND REPORTING lJORREGO SOLAR SYSTEMS INC D 7 _ a munAc scousc SYMBOLS u FVI3- `� S (75) CIRCUIT LENGTH IN FEET '"0 FUSE: - 3::ti I I JB•1 - COMBINER BOX n' Z o .. O .. .. `-fir\1 _. ENTT GROUNDING CONDUCTOR" JB-1 JUNCTI � J G EQUIPMENT = 4~ I)100/3 BREAKER W RATING&NUMBER OF POLES, •V J zsrz mSTRpVGSi z Z anutEsrsrluxc" y B - ! 60013 -DISCONNECT SWITCH(RATING 8,#OF POLES) ' W - Q Z:- L _ . E T-s wHcsi-i I uz ELECTRICAL'NOTES ._ , _ _ _ _ •1 -THIS PHOTOVOLTAIC INSTALLATION SHALL BE IN ACCORDANCE WITH THE EDITION OF" -.Z -0. .. .. THE NATIONAL ELECTRICAL CODE(NEC),CAUFORNIA ELECTRICAL CAGE(CEC)AND LOCAL ELECTRICAL CODES CURRENTLY BEING ENFORCED BY THE AUTHORITY HAVING lU -.: --Q s - JURISDICTION(AHJ) .• '. .—J F—- 2 A GROUND FAULT DETECTION AND INTERRUPTION(GFDI)DEVICE IS INTEGRATED WITH w-. 0 0" 9- slrslnces-e _ THE INVERTER IN ACCORDANCE WITH NEGCEC 690.5(A). V F C _— �'--"-"'�`--- 2' 3 OISCONNECTSWITCHES SHALL REWIRED SUCH THAT WHEN THE SWITCH IS OPENED TH 10 NODULESSiRWG - �� E CONDUCTORS REMAINING LIVEARE CONNECTED TO THE TERMINALS 0 MARKED . L J 'LINESIDE'(TYPICALLYTHE.UPPERTERMINALS). N 4 PHASE& NEUTRAL CONDUCTORSS HALLBE COPPER MINIMUM#10 AWG SOLID OR '-0 STRANDED - - WIRE MAY BE USED:EXPOSED PHASE 8 NEUTRAL CONDUCTORS SHALL BE - -m EVE USE-2 INSULATED ALL OTHER PHASES;NEUTRAL CONDUCTORS SHALL BE THWN•2 CodbDULGsi•e = INSULATED UNLESS OTHERWISE NOTED. " G 1BSIoouLE vsrwnc , 5 GROUNDING&BONDING CONDUCTORS SHALLBE COPPER,MINIMUM#IDAWG,SOLID OR STRANDED WIRE-MAY BE USED'EXPOSED GROUNDING AND BONDING - _ CONDUCTORS SHALL SE'UNINSULATED.ALL OTHER GROUNDING$BONDING . CONDUCTORS SHALL BE.THWN-21NSULATED UNLESS OTHERWISE NOTEO(UON)." 6 OC CONDUCTORS SHALL BE COLOR CODED AS FOLLOWS: F-iik csi-T .. S =2 DCPOSNNE-RED(OR.MARKEDRED). 7 MOULUES5RRIG _ DS - OC NEGATIVE'GREY(OR MARKED GREY) _ H ' I __t 7 AC CONDUCTORS SHALL BE COLOR CODED AS FOLLOWS PHASE A-BLACK(OR MARKED BLACK IF 94 AWG OR GREATER) �I� PHASE B-RED(OR MARKED RED IF#4 AWG OR GREATER) 52 I � _ PHASE C-BLUE(OR MARKED BLUE IF#4 AWG OR GREATER) . EWE. NEUTRAL-WHITEIGREY'(OR MARKED WHITEIGREY IF#4 AWG OR GREATER)- ' , 8 FOUR WIRE DELTA CONNECTED SYSTEMS SHALL HAVE THE PHASE WITH THE HIGHER q`� 'MTRDOF CSRiWG91.14 Y - T VOLTAGE TO GROUND MARKED ORANGE OR IDENTIFIED BY OTHER EFFECTIVE MEANS., 6 a L .J 9 GROUNDING 8 BONDING CONDUCTORS.IF INSULATED,SKALL BE COLOR CODED GREENJDA � (OR MARKED GREEN IF#4AWG OR GREATER). I _ 10 CONDUIT SIZES INDICATED"ARE MINIMUMS IN ACCORDANCE WITH APPLICABLE CODES 5I14109pq - AND MAY BE.INCREASED IF REQUIRED. - - - RBURROWBRIDGE MtROpF sTwxcs a-i4 .11 MARKING OF THE PHOTOVOLTAIC SYSTEM DISCONNECTING MEANS SHALL BE d.BUSCH CPROVIDEDINACCORDANCE WITH NEGCEC 69017 T MOpULEGhTRWG12 MARKING OF THE DIRECT CURRENT PHOTOVOLTAIC POWER SOURCE SHALL BE L PROVIDED IN ACCORDANCE WITH NEC/CEC 690.53. J 13 THE MARKING OF THE INTERACTIVE SYSTEM POINT OF CONNECTION SHALL BE PROVIDED PV 3".:1 ACCORDANCE WITH NEGCEC 690S4. 14 DC CIRCUIT CONDUCTORS PENETRATING THE BUILDING ENVELOPE SHALL 8E IN METALLIC CONDUIT AND MARKED EVERY 5 FEET'CAUTION DC CIRCUIT' I BILL OF MATERIALS Project: Champ Homes 82 School St,and 75 School St. Project/t: 905-0090 Date: Thursday,May 14,2009 Revision: 1. Designer:Ryan Burrowbridge 82 School St. Item Quantity Part Number Manufacturer Description 1 129 SANYO 21 OW SOLAR MODULE. 2 4 SOLECTRIA . 4KW INV(208V)W/INTEGRATED.DC DISCO 3 1 SOLECTRIA 5KW INV.(208b)W!INTEGRATED CB&DC DISCO 4 2 SOLECTRIA 3KW INV(208V)W/INTEGRATED DC DISCO 7 1 1.00A"240VAC NEMA 1 PANELBOARD 8 1 100A 240VAC NEMA3R FUSED 3P DISCO 9 1 REVENUE GRADE'METERING AND REPORTING 10 ALL HARDWARE AND-COMPONENTS.TO.COMPLETE SOLAR INSTALLATION 11 ALPINE SNOW GUARDS OR APPROVED EQUIVALENT ON ALL SLOPED ROOFS 75 School St. Item Quantity. Part Number Manufacturer Description 1 40 SHARP 1.75W SOLAR.MOD.ULE 2 1 SOLECTRIA 5KW INV(240V)-W/INTEGRATED CB&DC DISCO 3 1 SOLECTRIA 1.8KW.INV(24*OV)W/INTEGRATED DC DISCO 7 1 W 240VAC NEMA 1;PANELBOARD 8 ? 60A.240VAC NEMA 3R_F.USED 2P DISCO 9 1 REVENUE GRADE METERING'AND.REPORTING 10 ALL'HARDWARE AND COMPONENTS TO COMPLETE SOLAR INSTALLATION 11 ALPINE SNOW GUARDS OR APPROVED EQUIVALENT ON ALL SLOPED ROOFS j i Board.of:Building.Regulatio s.and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date.-If found return to: Board of Building.Regulations and Standards Registratto.n 157043 fzp�raWt 81330/2009 Sr# 258833 One`Ashburton Place Rm 1301 - t.,�< r--� -- I — Boston,Ma..0.2108 =Type Prorate Corporation $' B0RREGO SOLAR SYSTEMS;INC BRENDAN NEAGLE 18 ASHBURTON PLr � ,7 ASHBURNHAM;MA 01430 Administrator Not:valid:with u signature. f ALAL wea Y oar d + f u id Dog a iati66s and tandar� s Constructton S.,u,.pe, isor �.�cen icns �Cs 975 , # `` 01 : . 0 ►� � on. . B.Rt, N DA N I ,EAC . :. r 727 Ak��.S4N WA ........... "S l/, t _ BErxmELEY, CA 9471 Commissioner y ACOR®„ CERTIFICATE OF LIABILITY INSURANCE 3 31 200909 PRODUCER Phone: 916-605-3500 Fax: 916-983-9955 THIS CERTIFICATE 15 ISSUED AS A FATTER OF INFORMATION Allied North America Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Brokerage of CA LLC, Lic#OE36391 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2330 Fast Bidwell St., Ste 211 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Folsom CA 95630 INSURERS AFFORDING COVERAGE NAIL# INSNRED INSURERA:National Union Fire Ins Co-Pit19445 Borrego Solar Systems Inc INSURERB: 1365 N. Johnson Ave Suite 102 El Cajon CA 92020 INSURERC: INSURERD: INSURERE: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. OTWITHSTANDING 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 TERM, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AIM POLICYEFFECTNE POLICYE7o'uUiA POUCYNUMBER LIMITS A GENERALLYUKLITY GL0935967 4/1/2009 4/1/2010 EACHOCCURRENCX 61,000,000 X COMMERCIAL GENERAL LIABILITY $ CLAIMS MADE ®OCCUR MED EXP WW one $ PERSONAL&ADV INJURY $ GENERALAGGREGATE S2,000,000 GEtfL AGGREGATE LIMIT APPLIES PEFL PRODUCTS'-OOMPIOPAGG $ PROPOLICY IFL LOC A AUTOMOSLELNBLLTTY AL0934178 4/1/2009 4/1/2010 COMSINED SINGLE LIMIT A IL ANYALITO AL0934179 MA, 4/1/2009 4/1/2010 (Ea4 S 1,000,0010 ALLOWNmALJ1D3 y- BODILYINJURYY $ SCHEDULED AUTOS HIREDAUTOS BODILY INJURY $ NON-OWNEDAVTOS ) PROPERTYDAMAOE S (PereoddeM) OARAGELLABiJTY -AUTO ONLY-EAACCIDENT S ANY AUTO OTHERTHAN EAACC S AUTOONLY_ AGG S A EXCESSIUMBRELIALUBLL7TY BE6798937 4/1/2009 4/1/2010 EACHOCCURRENCE $ 0 0 oowR ❑CLAIMSMADE AGGREGATE $5,000,000 - S DL DwnBLE F S RETENTION : S A WOWLERSCOMPENSATIONAND WC4375775. CA 4/1/2009 4/1/2010 X ITZRITUAMN 09- A EMPLOYERSLLMtrrn C4375776 4/1/2009 4/1/2010 E.L.EACH ACCIDENT 1111,000,000 ANY PROPRIETORIPARTNER/DfSMITIVE OFFICERIME14BEREXCLUDED9 EL.DISEASE-EAEMPLOYEE S 1 Ifyyeeaa,,deeaDe uMer ' SPECWL PROVIS0X below E.L.DISEASE-POLICY LIMIT $ B onyx 57UUMI03593 4/1/2009 4/1/2010 PP $ 6,760,000 Property ented/Leased EQ Max $ 100,000 nstallation Limit $' 4,200,000 lemp Loc Limit $ 250,000 DESCRFPIMOFOPERATKMILOCATWWIVEMCLEBIDLCWSI0N0 ADDED BYENPOROEMEN ISPEGMPROVISIO S - j CERTIFICATE HOLDER CANCELLATION10 day notice -for non-navment- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Proof of Insurance WILL THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTWORQEDREPRESIMTATNE f� ACORD 25(2001M) BACORD CORPORATION 1988 - f r IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). " DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and. the certificate holder, nor does it affirmatively or negatively amend, extend or after the coverage afforded by the policies listed thereon. w ACORD 25(2001108) Thomas Perry Building Commissioner t rTown of Barnstable JA 200 Main Street CNoMEP Hyannis, MA 02601 ..,Hoa. � > Housing.For All Corporation 82 School Street,Hyannis,MA 02601 508-771-0885/paul@champhouse.org www.champhouse.org May 28, 2009 RE: Contractor of Choice Building Permit Aeent Authorization Dear Mr. Perry, Housing For All Corporation wilt'-be requesting a Building Permit for the installation of the Solar Photovoltaic System on two of our School Street buildings that have been approved by the Hyannis Historic Commission. The installation is for the community pavilion at #75 School Street and the main building at# 82 School Street. The contractor for the work will be Borrego Solar of 205 Industrial Ave., East, Lowell, MA 02129 working under License #97365. They have done work in Barnstable previously. The contact person is Brendan Neagle (617-674-2269) bnealeCborre4osolar.com. They will be applying on our behalf for the Building Permit and they are fully authorized to speak for us on all matters concerning the installation of the solar system. If you or your Department has any questions concerning this application please feel free to contact me at: 508-771-1470 or my cell,phone: 774-487-8145 or hfac@champhouse.orR- . As always we appreciate the work of your Department to safe guard the public safety through planning and inspections in the Town of Barnstable. Best wishes for a safe and productive season to all at your office. Re?pecIfully, Paul E. Hebert President/Executive Director F CHAMP Homes is a multi-generational group home program of the Housing For All Corporation, a charitable 501(c)(3) tax-deductible organization registered with the Massachusetts Attorney General's Office [Account# 23602]. Assessor's office(1st Floor): ,n ,t Assessor's map and lot number o� dq,Vk,L_ oi THE toy` Conservation Boart9 of Health(3rd floor): 1i Sewage Permit number sisa3rint t � ru• Engineering Department(3rd floor): 00. s639• House number Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNS-TABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO j2lr P p YIyY•Q — ��✓J Vd Vn k9 TYPE OF CONSTRUCTION _ 1ti�6P FJ-,i m-e �1 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �� C koo l S 1 / �IioIV 3 Proposed Use L Zoning District Fire District hiv a h r.�s A-4ot,.i=ro c- n 1--%co--c10:2 Name of Owner /Tr M,4 Lk;s -e Address -fvn,p,k�e Name of Builder Mayk Her I'Ver6r• Address C/ E/oynN c e s Name of Architect Yy A Address Number of Rooms /V 14 Foundation /9-e Exterior 60 T /l0,2- Roofing Floors E14 X(o ® r �� 5 Interior Heating VA Plumbing , VA Fireplace 1114 4 Approximate Cost a Area Diagram of Lot and Building with Dimensions Fee -dry, OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable/rqarding the b v construction. Name Construction Supervisor's License (0 5- �� THISSE, NICK. i N0 3 9 21 permit For REPLACE HANDI—CAP/RAMP Commercial Location 82 School Street Hyannis �} Owner Nick Thisse Type of Construction Wood Frame Plot Lot i Permit Granted June 2, 19 93 Date of Inspection 19. Date Completed a 4 , ,. - _ -�� RAP►-ROE ,� 1:.a X 6 pT Cl ax�z PY o.Cl �. PT a` xX L I Ft. C:rosS SecTta� �r vd • Goncre'�e Nc P dSED RAMP for HYANN IS. CO.N\/AL�SCENT EXXTkWG RAmp , h \c 9 pevde� T' M 1 _ 440 1. h o te-QAj ttii 1 -TOP VIEW aXtpjo`pt OT rol eevia� 1 t° L.1 concrete YOO��aj3 .�z 0;,,,. �4 fiscp ELEVAT ►ON i i i QN VALESCENT CENTER zp,m P f Y 6 L KiYi r+,4Tsl. Fare e.XXkpe' 4 � c , „ 4 .................. 70P�VIEW p•,t��. i ,,. ;� Mix . b-.a Tyl ! t r x a x._F'B-_a ._._....._._- i ...._--_-.-. _. 7.f ' ry aft yA'T 1 ON HYANN15 C6NV CE c6N� E. r �a s6,00\ is� S(AIE: APPROVED BY: DRAWN BY WW GLC DATES/ Q REVISED . i 1Y5 I C R Q-Y (-"Att-E AGED AccFss { A`.� DRAWING NUMBER !mil 1A P, 1 `Z l-�s. IR,l v ` c � t i� # r What is CIL4MP House?. Our, CIMAIPS Caring, Nurturing. " Paul and Carolyn Hebert have made a life.'s We like to call our family members CHA1l,�PS H®me4ike Envaronmaht. ministry of advocating for the homeless, because to us they are!CHAMPS come froth broken, and forgotten individuals of our many different backgrounds. Hurt, abandoned, community. Driven by their faith in Cod and abused,forgotten people no-one else wants are dowscents and Aduka in their belief in humanity, they created the welcomed with opened arms, and can stay with Need.. Housing For Alf Corporation. In 1992, us as long as it takes for them to straighten out thanks to a most generous endowment by the their lives. ®Watson and MoraQ91y 9n s -late Alice O'Neill, --a staunch reliever in the. __ &ce of street OtaNeso Hebert's vision --Paul and Carolyn founded — CHAMP Houses y ' reducing Contabuting All our our CHAMPS are here Member of Society, CHAMP House is a ministry of love and because, despite what they have sharing It offers hope for the future... it been through, thty all have hopes floc Maintain a safe environment heads... it changes lives It 1v truly "A a better life,gust like • place of hope, built on faith." you and L for homeless youth and adults Faith in God...faith in community... faith in each other. CHAMP House is a program that really worksl - t • Provide a.caring Family-type -- therapeutic environment for,our CHAMPS. Over the years, this unique,faith-based Most, especially our younger CHAMPs, are group home has expanded to meet the intimately familiar with dysfunction, • Offer spiritual counseling and growing needs of the community. CHAMP . abandonment, neglect, substance abuse in all .House now houses 30 men and women in a its forms, and all kinds of mental, emotional, life-Skills training to at-risk multi-generational family setting. Hundreds and physical abuse. Their stories would shock youth and adults in transition. of homeless, hurting indivuals; -- lovingly you! CHAMPS are here because; —just like nurtured and sheltered since the Heberts you and I-- they have hopes for a better life! Continuously advocate for the opened the doors ten years ago --have They are definitely not incorrigible or neglected and abandoned successfullygone from the safe haven of incompetent; --and almost without exception CHAMP House to leadproductive lives, and thrive in a safe, nurturing environment like People of our community. " in turn, help others. CHAMP House when given the opportunity. We've served over 800 Please el ids CIAMPS of all ages and ,�/ backgrounds in our lend a helping hand! �° nine-year history Above aA we stress responsibility to selfand others, and the development ofpositive � attitudes,values, and self esteem. 1 + CIMMP House receives some funding from private non- Your contributions large or small are profit charitable foundations, Your and on occasion small human welcomed!Please send cash,money t `. a y" orders,or checks to: f service grants from the { ;- ;% r .. ` government. For the most part, CRAMP .Mouse however, we rely on the !A Froa Atw�- 82 School Street i kindness and generosity of our Hyannis,.NLA 02601 friends and neighbors for e (508)771-0885 financial donations andgifl&of E (508)862-1652 food, clothing, household ` Fax(508)778-6425 equipment, and other goods. p f CHAMP House is a program of the M Housing For All Corporation(HFAC),a charitable 501(C)(3)tag deductible organization registered with the Mass. Atty.General`s Office(Acct.#23606). ` We-pre truly "teful � s 3r � �Y r Visit our Web Page at: for yDur COntrlbllt1011 € ,, x a - 1; Http:ff�vww.champhouse.org large or s8n" � � I It can n2ake a world of You can also E-mail us at: ' t � difference in the life of Paul@champhouse.org � homeless fndfvrduall or Carolyn@champhouse.org 1 104s: 6 y1.�JILDIN � : V'_ 103 97:>:2 :` ......................................................... BUILDING :::::...:::::::::::::::..:.:..:...:.:.:.:..:::.....::::::.,.:::::::::::::.:.::..::..:..,,.,......,.., >.:;:•".,: K::;::>;::>:>::CHAMP HOE ................ OUS M1'.i4.titi >: :>:82:<'>` :.:SCH`. L STRE.:.. 00 S ETti:tii ...... ....................... ...... .. ................. ... LiY >' ANN :.: :. :. � NEIGHBOR :. :>:. ' .. :. ...:::.:......................... E—SWEARIN NOIS . -.�ax......... G ETS. .. ...... .... ...... REFER TO R.J. x...... v f PCHAMP _HOUSE f STREET HYANNIS, MA 02601-3132 i Office 508-771-0885 Paul&Carolyn Hebert Home 508-778-0568 E Co-Directors Fax 508-771-1278 i - r The fruit of silence is prayer. The fruit of prayer is faith. The fruit of faith is love. The fruit of love is service. The fruit of service is peace. —Mother Teresa Y CHAMP HOUSE 14 MAIN STREET �. HYANNIS,MA 02601-3132 c��M► .-- .; �II .:,; ►►oust L-; (508) 771-0885 9 7 A Multi Generational Group Home Non-Profit Tax Exempt 501(c)3) 0 Printed on Recycled Paper CHAMP THERAPEUTIC APPROACH Champ House Adolescent Program - and Adult Program, are designed to address physical , emotional or mental health issues, learning and educational concerns, We firmly believe that any assistance given an individual will be truly beneficial , long lasting and _ effective if offered in a supportive and inclusive environment. Champ House Programs are lived out in the family model which allows each member of the Program to feel equal within the family unit. Major components of daily life at Champ House are feeling wanted , respected; nurtured and loved. Unlike programs that give status for longevity or capabilities, the Champ Program attempts to provide a sense of security and belonging equally to all 'Program Residents . Since many residents were deprived of basic family care and support it is imperative that a sense of family ties and nurturing be recreated. The family environment created at Champ House is further supported by a wide range of outside agencies and organizations that offer specialized treatments _ -for physical , mental , emotional , educational and career needs . In conjunction with the assistance and support given by Champ House the resident has every possible chance to enhance the benefits` received from outside treatments , therapies and assistance.. Ultimately, Champ House ' s Therapeutic Approach is to sustain the individual -in a healthy environment of family living with responsibilities and to benefit -from the support to become happy, productive and fully human. Wf y��B G From: Cape Cod and the Islands Hunger Network =1 !„ ,, ,;;, 8LIE s To: The List "T JUL 25 F i`r Town Manager, Town of Barnstable I HOMES` Superintendent of Barnstable Schools Housing l=orAn.corporation,—, The Salvation Army 82 s.cnoorstraat,l y nets,MA02601 t s - f`� "---r'r 508-771-08851 paul@champhouse.org Calvary Baptist Church www.champhouse.org American Red Cross Barnstable Health Inspector Barnstable Building Commissioner Council of Churches Re: Placement of a walk-in refrigerator/freezer and additional food storage space Dear Friends oftHungry, The Village of Hyannis has been on the top 20 list of areas in the State of Massachusetts for having hungry children according to the Project Hunger Website. In response the Cape Cod Hunger Network has been awarded a grant in part from Barnstable County to create additional refrigeration/freezer space along with dry storage of food supplies from the Boston Food Bank and other sources. In the pass various social service groups have found that because of the lack of adequate storage and refrigeration they had to limit their abilities to take advantage of utilizing available food offers. We are currently looking at the Salvation Army and the Calvary Baptist Church on Lincoln 2 �'^ Road as possible sites. I would like to invite the Town of Barnstable's input if we have a Q Town or School site that would also be available since this is in service to our citizens. This would bean additional source of emergency food for our community in the event of a disaster while hopefully serving the hungry in our Town. If we had space at our schools it would also serve as a teaching opportunity for our students to know that as a community service project we care for those in need by providing food and care. The proposed refrigerator and freezer could be in-door or out-door and needs approximately 120 square feet and the food storage could be more or less. Service agencies would need to have access to the storage and refrigeration during.normal business hours except for emergencies. Should you or your department have any thoughts or suggestions I would look forward to hearing from you? I would share your information with the search committee. We look forward to hearing from you. We believe we have all the funds in hand for the equipment and could contribute to the cost of the electricity. We continue to seek best practices and to care for the hungry among us. Thanks for your consideration. Very best wishes, Paul Hebert, for the; h Committee CHAMP Homes is a multi-generational group home program of the Housing For All Corporation, a charitable 501(c)(3) tax-deductible organization registered with the Massachusetts Attorney General's Office [Account# 23602]. s �� - � � Y� � ---�� .S'cfool_�S�. _ _ �xZaf,z.�'— - -- - --- Summary of proposal FROM: HOUSING FOR ALL CORP. d.b.a. CHAMP House �-- 82 School Street,Hyannis,MA 02601 508-771-0885 NARRATIVE [YOU would be degly effected by the amount of homeless youth who suffer with mental illness substan buse,physical,emotional and spiritual.needs in the tov>ii of Barnstable. Today at CHAMP House Aaron is successful in Job Corps,Albert who is 18 years old arrives because his mother has chosen her boy friend over lum and his sister,as Adele,who others said was not capable of graduating from Barnstable High School,prepares for her second year at college and Jeff is re-entering the Army after failing to reunite with his biological family. We are caring for the health of homeless children in Massachusetts from the Cape to Boston because they are so neglected,so hurt,so abused and so forgotten that what we often see in their panned eyes is the disbelief that this is their reality. We are a unique,pilot program of the therapeutic family approach to love and healing in the lives of over 600 alumni. We are committed to a$700,000 extension of our facility to share our love and concern to the next generation of children and adolescents. We are humbly asking for ASSISTANCE to directly match an anonymous donor's$100,000 pledge along with the Community Block Grant from Barnstable of$50,000,a HUD Grant request of$250,000 voted#1 priority by the Cape's Homeless Council and thousands from smaller donors and grant requests to other foundations. CHAMP House is experiencing 100%capacity-as a 27 bed,nnultigenerational, conummity home. Across the street two available Captain's homes can house at least 1.4 more adolescents,(perhaps as many as 18 to 20). MWe we had no plans or desire to increase our bed capacity or programs we can no longer acre turning away 25 or more suitable applicants amm�>all�r. Women and adolescents between the ages of 17 and 24 years of age are our fastest growing homeless populations presenting for services at CHAMP House. The 500 children aging out of Foster Care last year alone are creating a modern orphan system. Built on the belief that with faith in God all things are possible and encouraged by the community,we have signed a purchase and sale agreement with the seller for the two homes, .75 acres of land and two garages. One home will be operated by the Bay State Community Services of Quincy to serve the dual diagnosed 13 to 18 year old youth who suffer mental illness and/or substance abuse. They have over 25 years of expertise in this area and will be in partnership with CHAMP House. The second home will be the JAMIE READY CHAMP YOUTH HOME named after a young man from Chatham who took his life after becoming psychotic from the use of the designer drug "ecstacy". CFIA.MP House has a long history of working toward suicide and substance abuse prevention and in loving support for those who suffer from mental illness. The Home will have at least 7 beds and each resident will participate in the operations of the home,have a community sponsor, attend counseling and/or AA/NA, participate in house meetings and contribute to the cost of operating the home and program within their ability to do so. While we must continue to operate the existing CHAMP House programs,the cost of the new project has two phases. Phase I is to purchase and rehabilitate the:facilities. Purchase cost is$395,100. After the deposit and the Community Block Grant from the Tolmi of Barnstable are applied the Seller will carry, a $340,000 Note. When the HUD Grant is applied an additional$200,000 drill reduce the Note to$140,000 early in 2002 and $50,000 from the same HUD grant will be matched by community donations and grants toward the rehabilitation which includes new energy efficient windows and doors and a fire sprinkler system and fire alarms. Total estimated cost of the rehabilitation of the two homes and support buildings is $300,000. Phase II is the development and staring of the JAMIE READY CHAMP YOUTH HOME which would include an outreach program to schools and churches concerning the issues of substance abuse,mental health and suicide. First year budget for the READY HOME is approximately$131,550. n order to take advantage of the o rtunities to teach youn&people about the construction trades w �ropose to contract with JTEC,(JOB TRAINING AND EMPLOYMENT CORP),to provide you etween the ages of 16 and 21 with the experience of real life rehabilitation of buildings. The sam pportunities will be offered to the students at both Cape Cod Vocational Schools,to CHAMP Hous residents and to community volunteers. As a result the homes will have community ownership and pride. Individuals who excel may choose to enter the building trades as a career. CHAMP House will provide an on site construction supervisor to oversee the rehabilitation and training experience and hourly wages will be provided to non volunteer individuals. Once construction has ended we will enter Phase II,providing long term housing with opportunities for participation and leadership development to individuals suffering from mental illness and/or substance abuse. In order to purchase quality materials,pay for the rehabilitation contractor/supervisor and provide wages for our share of the student workers we are seeking HELP from YOU. This is a major undertaking and will result with providing over 40 beds in total for our programs when the two homes are operational. The JAMIE READY CHAMP YOUTH HOME promises to be a Pilot Program capable of being duplicated. We would greatly appreciate any funding,assistance and advice. f JAMIE READY CHAMP YOUTH HOME •S .MISSION STATEMENT To welcome young men age 17 to 24 who accept the reality that they are addicted to drugs and/or alcohol and who have made the conscious decision to take back control over their lives. To provide loving support in a therapeutic environment to individuals suffering from mental illness in any of its forms who have agreed to follow a regiment of prescribed medication,counseling and actively participate in fording hope for living the best lives possible,, To be especially receptive to those who suffer the dual diagnoses of substance abuse and mental illness and to provide supportive long term housing while offering encouragement to use traditional and/or alternative approaches to health and healing. To recogiuze that there may be other factors at work in the individual thatt present great challenges to their feeling of wholeness acid wellness and that every effort will be made to encourage their personal growth as human beings. To celebrate the life of each member of the Home and to honor that life with dignity,respect and love so that each individual will feel the warmth of being connected to others and enjoy the peace that comes from, living in a healthy Family. To allow the greatest amount of independence possible with the development of individual responsibility for the self and for the Family. •3 GOALS Older adolescents who are living in sobriety with positive outlooks about their lives and who are determined to live drug and alcohol free. . Young men who have come to accept their mental illness and who can still live their lives with quality by working programs to maximize the good mental health. Individuals with multiple presenting issues who become men of character and dedication despite their addictions,illness or early life challenges.. 4- OBJECTIVES To encourage discipline,responsibility and sense of purpose in the individuals. To promote quality work slid respect for making an honest effort in work and in life. To demonstrate the benefits in living in family and in community. To live in sobriety one day at a time. To experience healthful living. To respect everyone. To grow in love. CHAMP THERAPEUTIC APPROACH Champ House Adolescent Program and Adult Program, are designed to address physical , emotional or mental health issues, learning and educational I concerns, We firmly believe that any assistance given an individual will. be truly beneficial , long lasting and effective if offered in a supportive and inclusive environment. Champ House Programs are lived out Tn the family model which allows each member of the Program- to feel equal within the family unit. Major components of daily life at Champ House are feeling wanted , respected , nurtured and loved. Unlike programs that give status for longevity or capabilities , the Champ Program attempts . to provide a sense of security and belonging equally to all Program Residents. Since many residents were deprived of basic family care and support it is imperative that a sense of family ties and nurturing be recreated. The family environment created at Champ House is further supported by a wide range of outside agencies 'and organizations 'that offer specialized treatments for physical , mental , ' emotional , educational and career needs. In conjunction with , the assistance and support given by Champ House the resident has every possible chance to enhance the benefits received from outside treatments , therapies and ' assistance. Ultimately, Champ House' s Therapeutic Approach is to sustain the individual in a healthy environment of, family living, with responsibilities and to - benefit from the support to become happy, - productive and fully human. s M rCHAAMP-HOUSE 'Sp„ A Place of Hope,Built on Faith N ► ' ` 82 SCHOOL STREET ' HYANNIS, MA 02601-3118 (508) 771-0885 JAMIE READY CHAMP YOUTH HOME BUDGET ESTIMATED COST OF REHABILITATION 75 School Street Hyannis , MA 02601 508-771-0885 Plumbing kitchen $ 10 , 000 Plumbing bathrooms ( 7 ) 35 , 000 Electrical 25 , 000 Garages (materials ) 307000 Decks and Fire Escapes 20 , 000 Alarm System 10 , 000 Windows and Doors 25 , 000 Sprinkler System 30 , 000 General lumber and materials 207000 Labor incl . General $ Supervisor 95 , 000 Total estimated 300 , 000 r 9 CHAMP HOUSE is a Multi Generatioal Group Home program of the Housing For All Corporation(HFAC),a charitable 501 (C)(3)tax-deductible organization registered with the Massachusetts Attorney General's Office(Account#23602). Please call to learn more about us and to discuss how you can remember the Housing for All Corporation in your will Printed on and the tax saving benefits of Charitable Remainder Trusts and Annuities Recycled Paper JAMIE READY CHAMP YOUTH HOME REHABILITATION BUDGET 75 SCHOOL STREET HYANNIS , MA 02601 508-771-0885 Occupancy : Telephone Water Sewage Electricity Cable Gas (Heat , Hot Water , Cooking) Trash $ 8 , 500 Food ( 10 ind . X $7/day= 70 X 365=) 25 , 550 Staff (Clean, cook & assist ) 2 PT 40 , 000 Benefits 8 , 000 Counseling contracts 7 , 000 (Weekly & on call services ) Administration• Support (Bookkeeping & Support ) 15 , 000 Program Director PT 181000 3 Insurances (Prop"er.ty', Liability) 2 , 500 Mortgage 11nterest 7 , 000 1 Share of Mortgage Note Pay Down 15 , 000 { Total $ 146 , 550 ol CBay State Community Y Services March 9, 2001 Mr. Paul Hebert CHAMP House 82 School Street Hyannis, MA 02601-3132 Social services Dear Paul, Thank you and Carolyn for extending your wane hospitality to Daurice and Mental health services me. It was a pleasure for us to meet you and truly inspiring to,learn of the work of CHAMP House and the Housing For All Corporation. I am writing to confirm that Bay State Community Services, Inc. (BSCS) is very Substance abuse interested in working with you to develop a children's residential program to services be located in one of the two houses adjacent to your current facility on School Street in Hyannis. Residential services From our meetings and conversations, I understand.that you are currently arranging the finances to purchase both of the houses. BSCS would like to lease one of the buildings and be responsible for securing the ongoing Educational services funding to operationalize the proposed program. I anticipate that the annual budget of the program would be approximately$500,000 per year with rental costs of approximately$2000 per month. The arrangement between our two agencies would be a defined partnership based on a shared vision, open communication and mutual trust. I believe that the need for a children's residential program, coupled with the inherent compatibility of our organizational missions, bodes well for the project's eventual.success. BSCS was formed in 1991 through a merger of five community-based agencies that had extensive experience (over 100 combined years) of providing services to southeastern Massachusetts. The founding agencies included Survival, Inc., and the South Shore Council on Alcoholism of Quincy, Mayflower Mental Health Association of Plymouth, Center for Community Counseling and Education of Walpole and Billings Human F Services of Norwood. The consolidation was a total asset and liability 15 cottage Ave. merger with all the operations brought under the governance of one Board of Directors. Quincy, MA 02169 (617)471-8400 FAX(617)376-8910 The stated purpose of the newly named Bay State Community Services, Inc. was to provide programming that would improve the social functioning of BayState high-risk adults, adolescents and children. To this end, the agency's mission has been to develop an accessible continuum of substance abuse, mental Community health and social services within a framework that recognizes the primary Services importance of family and community. Most of our programs offer help based on need, regardless of ability to pay. I ant very proud that all services are provided by knowledgeable, dedicated staff. Many of our programs were established by local citizens and we continually strive to operate within the context of the community. Our grass roots initiatives have helped to break downn the barriers that prevented client access. Over the years, we have developed a variety of traditional and nontraditional approaches to treatment including the siting of one of the first community-based adolescent residential treatment programs. As you know, we also operate one of the few adolescent emergency shelters as well as provide substance abuse services to Father Bil.l's Shelter. Enclosed, please find a.current alphabetical listing of all our services. BSCS employs approximately 125 people and has an annual operating budget of$7,000,000. Most of our funding comes from state contracts, which are fairly evenly distributed between the Department of Social Services, the Department of Mental Health.and the Department of Public Health. I am currently approaching each of the aforementioned Departments regarding the possibility of ongoing funding for our proposed children's residential program: There are several factors that lead me to believe we will be successful in securing funding. Most importantly, there is a need for the program. The Cape does not have marry children's residential,programs. Local children in need of such services often have to go to programs located off the Cape. The resulting distance often creates a hardship for the children and their families-and significantly complicates aftercare planning. Secondly, because of your reputation and standing in the community, it appears that the siting of the facility may not be a major issue. This is a very important factor to potential funding sources. Many proposed community- based residential programs have been significantly delayed and/or defeated because of community opposition. You and Carolyn have established a great deal of goodwill. Social capital is true wealth. I would also like to believe that'BSCS is held in high regard. We have worked with each of the pertinent departments of the state and we have the experience to respond to a variety of needs. Periodically, we have been , asked to develop new residential programming, but could not respond E; because of a lack of a suitable site. BSCS has been successful in providing the programmatic common ground on which to address several priorities BayState simultaneously. The possibility of developing a creative consolidated program may be a viable approach for attracting multiple support. Community Services In closing, I would like to reiterate that BSCS would like to join with CHAMP House to establish a children's residential program. To date, I have spoken with the Department of Mental Health, the Department of Social Services and Comrnonworks. Although, as yet, nothing is definite, there is interest and a documented need for the expansion of children's services. I will keep you informed regarding specific proposals and, of course, you will be invited to participate in any significant negotiations. I believe that the proposed collaboration between BSCS and CHAMP House provides a compelling opportunity for the development of quality programming. I, very much, look forlvard to working with you and Carolyn. Please do not hesitate to contact me if you have any questions or if further information would be helpful. Sincerely, Kenneth Tarabelli Executive Director Enclosure(1) RA Y STA TECOMMUNITYSERVICES. PROGRAMS and SERVICES Adolescent Residential Care Adolescent Tracking AIDS/HIV Services Bay State Anger Management Program Community Batterers' Treatment Services Battered Women's Group Braintree Alternative Center Child Care Services Children Witness to Violence Services- Court Mandated Treatment Community Support Program Criminal Justice Youth Program Divorce Classes Driver Alcohol Education Education for Alcohol and Other Drugs Employee Assistance Program Family Stabilization Gambling Treatment Geriatric Mental Health Services Geriatric Substance Abuse Treatment Girls Action Center Group Treatment for Mental Health Issues Group Treatment for Substance Abuse Home Based Services H2O (Health To Others) Impact Quincy(Community Coalition Program) Intensive Intervention Recovery Program Intensive Recovery Day Treatment Program MassCall Norfolk County Community Corrections Program Norfolk County Pre- Release Substance Abuse Treatment and Reintegration Services Norfolk County Sheriff's Office Substance Abuse Services Outpatient Mental Health Services Outpatient Substance Abuse Treatment Outpatient Dual Diagnosis Services Project Safe Psychophanmacology and Medication Management for Adults Psychopharmacology and Medication Management for Children and Adolescents SEARCH-Substance Abuse Evaluation, Assessment, and Referral Coordination for the Homeless Second Offender Aftercare Program (SOAP) Smoking Cessation Substance Abuse Evaluations. Supervised Child Care Visitations TEAM - Teaching, Education, Awareness, and Motivation Therapeutic Activity Program (TAP) Tobacco Prevention (Asian Population) Training Services Violence Prevention Youth Prevention Program 4-0 v, �C } t ® The Town of Barnstable :snRxsrnBLe, 1M6M J9. Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner May 2, 1997 Paul Hebert,President/Director Champ House 82 School Street Hyannis,MA 02601 Re: 82 School-Street;Hynnis Dear Mr.Hebert: Purchasing 82 School Street for a permanent location of your facility works just fine. We will need to do a yearly inspection after you pass papers. Call me to arrange all this after your closing. Best of luck. Sincerely, Ralph M. Crossen Building Commissioner RMC/km 12 t ,� i CHAMP HOUSE 14 MAIN STREET HYANNIS,MA 02601-3132 c,i,�r��• ®j (508) 771-0885 Champ House 82 School Street, Hyannis, MA 02601 Mr. Ralph Crossen .Building Commissioner Town of Barnstable Hyannis, MA Dear Mr. Crossen, Things are going well at 82 School Street and it appears that it would be less expensive to purchase 82 School Street than to rebuild at 14 Main Street. The purchase and sale agreement is ready but we need your approval for us to remain here permanently before signing the agreement. I have attached your temporary approval letter. We continue to have therapy as our primary. emphasis as attached. Thank you for your assistance. At your convenience I look forward to discussing some improvements to the mechanical systems and your advice for rehabilitation of the facility. Respectfully, ' QPHebert A Multi Generational Group Home Non-Profit Tax Exempt 501(c)3) Printed on Recycled Paper I k The Town of Barnstable • anxrrsrneLE, 69. ,�' Department of Health Safety and Environmental Services rEc►�x�" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner December 17, 1996 TO WHOM IT MAY CONCERN: The CHAMP house is being given approval to occupy the building at 82 School Street. This occupancy is based on the agreement that there will be a primary emphasis on therapy,as I understand,is now the case. The P.R.D.DISTRICT allows therapeutic uses as a matter of right. Since the above address is in the P.R.D.DISTRICT it is lawful. Sincerely, Ralph Crossen Building Commissioner RC:Ib g961217a CHAMP THERAPEUTIC APPROACH Champ House Adolescent Program and Adult Program, are designed to address physical , emotional or mental health issues, learning and educational concerns, We firmly believe that any assistance given an individual will be truly beneficial , long lasting and effective if offered in a supportive and inclusive environment. Champ House Programs are lived out in the family model which allows each member of the Program to feel equal within the family unit. Major components of daily life at Champ House are feeling wanted, respected, nurtured and loved. Unlike programs that give status for longevity or capabilities, the Champ Program attempts to provide a sense of security and belonging equally to all Program Residents. Since many residents were deprived of basic family care and support it is imperative that a sense of family ties and nurturing be recreated. The family environment created at Champ House is further supported by a wide range of outside agencies and organizations that . offer specialized treatments for physical , mental , emotional , educational and career needs. In conjunction with the assistance and support given by Champ House the resident has every possible chance to enhance the benefits received from outside treatments, therapies and assistance. Ultimately, Champ House's Therapeutic Approach is to sustain the individual in a healthy environment of family living with responsibilities and to benefit from the support to become happy, productive and fully human. ife P rewa d l 9 9 G f CHAMP HOUSE ++MA-tN STREET - HYANNIS, MA 02601-3132 Yf � V �lr', MAY.20.200.3 11:13AM HOUSING FOR ALL NO.'084 P.1 CAP ROUSE A Place of Hope,Built vn Faith 82 SCHOOL STREET HYANNIS, MA 02601-W18 (508) 771.0885 FAX FROM: nAS i F�u� C�7�r" j �/ '► 1�j'/�c�' // T S/ a)O J 03 FAX NU14BER: Sd �- 7 7 Jr b 7 c�-S— FAX TO: Wr, .0R v ��1 aS !,'aPecr o FAX T : p �.- 7 7o -- b .�. 3a MESSAGE! TOTA.I, OF PAGES: Q J �J CHAMP HOUSE is a Muni Gcncratioal Group Home program of the HOaSing For All Corporation(HFAC), a charitable 501 (C)(3)tax-deducAblc organization registered with tllc Massachasetts Attorney General's Offlee(Account#23602). Please call to[earn more about us and to discuss how you can remember the Housing for All Corporation in your will n o and the tax saving benefits of Charitable Remainder Trusts and Annuities <�Recycled pt;rttoe papv ° FROM CCR PHONE NO. : 508+398+5666 Dec. 03 2002 03:04PM P2 AAPINR '1drdG�✓a�er�o��tla,��ooearlurae�lllG7� A.T I": Paul Heibert RE: Champ House 83 School Street Hyannis, MA 02601 Please be advised that we at Cape Cod Alarm have installed the fire alarm equipment at the above address. All devices have been tested and all passed. � II Thank you, - Donna Stetson; Office Manager MA Systems Contractor License Number 652C y *INSWUNCI, SERViCINgj ANd MONITORINCI OF SECURITY, FIRE, ANd CCTV SYSTEMS* (508) 398.6316 * (800) 468,8300 * FAx: .(508) 398-5666. MA UcENSE No. 60C TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �a 2 _ Map 327 Parcel - - � � o� .)- Permit# � Health Division _S_ 2 / STD Date Issued Conservation Divisi r -, 04�71 R Feed Tax Collector 4 07 7 _6 9,IZ Treasurer 1jr,%N'f,,l_T"KTAi 1C`N:I N�iON PERMIT FROM"-r Planning Dept. ;,; � ,;��.117I5IoN pxlo2'. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis H) Project Street Address 82 School Street Village Hyannis Owner Housing For All Corp. Address 82 School Street Telephone 508-771-0885 Permit Request REMOVE EXISTING IN=i TOR S^".I-CA:-, and Yen1 DCP with stairca e tr) meek ands. Im-Drove sua4looring wherever necessarv. Square feet: 1 st floor: existing 850+/-proposed Same 2nd floor: existing 850�-/-proposed Sarre Total new -0- Valuation 4s®0 Zoning District Dpn Flood Plain NC) Groundwater Overlay Construction Type V ooden Lot Size 10 ,019 Sq. Ft. Grandfathered: So Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) _=ome 10Eeds Age of Existing Structure 100 + Historic House: ❑Yes No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Partin 1 Basement Finished Area(sq.ft.) -4 s o r r r� +/— Basement Unfinished Area(sq.ft) e.0 0+i— Number of Baths: Full: existing 5 new Half:existing —0— new Number of Bedrooms: existing r, new Total Room Count(not including baths):existing 11 new First Floor Room Count 5 Heat Type and Fuel: Was ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 9 No Fireplaces: Existing 1 New Existing wood/coal stove: ❑Yes xM*o Detached garage:J4kexisting ❑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 To°A`' n`� '=Ou'e - Proposed Use Crow Yome BUILDER INFORMATION Name r/s"N Tor All w . �s c Telephone Number S'D Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C`• AlQ d �JA u �� )��'�v�r- -- - �� W-4 ca 37:1 SIGNATURE __ DATE FOR OFFICIAL USE ONLY } PERMIT NO. DATE ISSUED MAP/PARCEL NO. Ij ADDRESS VILLAGE 7F Af OWNER ti ' DATE OF INSPECTION: FOUNDATION ' ru FRAME cq 0 Ql 02 � G %��¢F�� S� rxS INSULATION FIREPLACE r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL s r ' FINAL BUILDING DATE CLOSED OUT r ASSOCIATION PLAN NO. v r i :j The Commonwealth of Massachusetts ' Department of Industrial Accidents , = = MCC oflovesmootioos 600 Washington Street Boston,Mass. 02111 �`T=r Workers' Com ensation Insurance Affidavit name: OUSA/ r d/9 location SC�OO J r city IIY N S { �,T D a 6 d phone#So 8' 771-'6d J ❑ I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one woridi in ca achy I am an em loyer providing workers' compensation for my employees working on this,job. P........................................................:::::::::::::..:::.......................:::::::.::::.:::::::::.::................:..::::::::::::::::::.::::.:.::::::.:.......................:.:.:..:.::::.:::::. e � r anv n am om ,fir c p T gcidress x , f::«•:< :s i....... �,. «. crr �.�... hone#.::::::::... :.a:..::...:....�......:...::::..::. ::.: ::...........:'.:'.;:.;::;.;:.:;;;.;:.;: r .........:.:.::.:::::::.......fir .. ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers co ensation polices: ess..: .::::,.....::•:....... .... .....:.. ..:.... :::..:...:...:::. :.:.. .: A�tT .......:....:::::::::....:::::::.::::::::.::.::.... ...................::::::::..::;;::;:;.:::.::::::::•.::::::::::::::::::::::::.................:...................................................................: :::...................... X. •X1': ii�:j;:j::;: cfv ..............................................................::::.............. .::....:....::...:::...:....:::.............:..:::......:.:..........:......................:......:.....::. x. 0...: address:>. : ens p h :•:.. .....�— innraice roJx Failure to seems coverage as required under Section 25A of MGL 152 con lead to the imposition of crhWnal penalties of a fine�to S1,S00.00 and/or one years'lmprisomnent as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby c the pains and penalties of perjury that the information provided above is true and coned Signature G, Date eZ LA 7/O°Z. Print name Pq 1 E, e�e�Z T" Phme# Sa P-7 7/ official use only do not write in this area to be completed by city or town official city or town: permit/license# OBuilding Department ❑Licensing Board ❑chedcif immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; .._ ❑0ther Uvvimd 9/95 PTA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to.provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire,.express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal.entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or tiustee`of an in - dual,partnership, association or other legal entity employing,employees. -However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states thaf eV&y state or local hcensing agency shall withhold.the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required.:Additionally,neither the commonwealth"rior zany 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 chapi&have been presented to the contracting authority. r �.. .,4 S• , Applicants Please fills the workers' compensation affidavit completely,by checking the box that applies to your situation and supplyingcompany names, address and phone numbers along with a certificate of insurance as all affidavits may be for confirmation of insurance cove submitted to the Department of Industrial Accidents rage. Also be sure to sign and city or town that the application for the permit or license is affidavit. The affidavit should be returned to the ty pp date the aff the `law or if you you have an questions regardingY be' re requested, not the Department of Industrial Accidents. Should y y qu . mg qu d, eP are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please affidavit for y _ _ - be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned t_ Y r the Department by mail or FAX unless other arrangements have been made-. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions• please do not hesitate to give us a call. The Department s address;telephone and fax number: u • The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investloatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 .s �'� gip;r•• .N y ~LOn.uL tM'��N" ie^M_B S'r,e+•.,J� � ... _ e.-.... � ._u.'. � I M�a,. t.pT' A'LY.N f ,huG! 4n.-4f• --. VI,V• �O,"sT2o urPr-4 "5�. SCWOrL %,rzxxr aoit.? 4SZo/,L (c 4 IV u•S I - r WA i, o Zss3, SEA Ijj F U�l yyy " .rrs4gv CLIME �L�J= ��Soa u•is am - .i - 4o SY' 07 TIi+O. 50u-r" 5TR.6 Fa f � .t•.'.Yl.?.Y CCL^:rv' '}uG:r n.a c.r�r.,G_'�V :...,rc6 e,a..••r,.,� ow.•q.E'u�,:/os au.�o -r..5. �...4> ..� r, .-. .�JT•ZSS..-�i.Ate.? +vv,M s.+.>w.• �>t.« '-�.0•'.i� ,�.' v; v�3,-�c of vz+r.:, s,vfu.+•., ort ..e+s .w,,.r..:r.:- i y�C �jy�yy A�.y ��p.T y 4iv�5•o.� u,*' G.�S-'•.IL�cv.:v6�'s:K�•�7 :�,_. i " �t3+S(f;�A.lPd+J/ 63ii11L.��-f-eW�n�� 1••M�J, r-�K•J K'AY!J. A2L �a-tOV.•u ff}} '. PR.MP A6LTd•O WOW— l I 9i a e 1--Sc,' m4y :5, 1993 2C�1.4 E6 tnAY ZA4,Ig6Y 1�p_T�}Y 'T'MAT ,'41ra f�l.?IJ ..VA3- M.^+i�•'u^T�.: - p•4G4,`4'IN.�GuL. w�Y,y ECO' i:.✓' c?1�' LFiC.i7A ' .' CG..6LI�A'T to r.,}J F:4Fe.0 �.�:.\,Y.1'?•._.�._!5?�•�'.:�. " , ^L•FC.,.f�A - ,�A.0.•w•c•u'M 'M�G S. '3.$-.T . Q fJ v, 39•a5b ' a'r Assessor's office(1st Floor): Assessor's map and lot number of?NE To Conservation `�P •w Board of Health(3rd floor): • Sewage Permit number t BAR23TULZ 7 YYl Engineering Department(3rd floor): oo o630. House number Ito Ysv Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE DUIUDING INSPECTOR APPLICATION FOR PERMIT TO U� SC�O D l 4:�--� Ti <- C) ` 1\e S .j e{-- OVrS k�s UVI1( TYPE OF CONSTRUCTION e Yn O� + p a,y C e i n� S / /I/, 19 9 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location s ��`o o L ST— A i,� Proposed Use N U(5L\- Zoning District Fire District 9��i{�u rJis Name of Owner 1 /� /°�C� TA 1-S S C Address f�rri iks G�d�� A5 Uf i- / 6 - . Name of Builder �la.Ak F KAC�w ecVk- Address_ � �� 9 LC(X aN� ��, 0156 Name of Architect f`t�Y'P�i S S`�v j i S Address S �'u�" ��w last r ►��<�v`l�(r 0�65� Number of Rooms Foundation Exterior Roofing Floors -: Interior Heating Plumbing Fireplace Approximate Cost 9.s-d Area ,Ug x,C E -411 Diagram of Lot and Building with Dimensions Fee d ®o OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable rega' in thVhconst uction. Name Construction Supervisor's License �O J0 THISSE, NICK. No 35214 Permit For REMODEL & REPAIR CEILINGS Nursing Home Location 82 School Street Hyannis Owner Nick Thisse . Type of Construction Frame - Plot Lot Permit Granted ' July 21 , 19 9 2 Date of Inspection 19 _ Date Completed 1913 } F 1 ti The Town of Barnstable w &MMSrnBLe, 9q,A3 .•`q Regulatory.Services 'Eon' Thomas F. Geiler, Director Building Division Peter F. DiMatteo, Building Commissioner 200 Main-Street,Hyannis MA 02601 . ce: 508=862-4038 Pax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: /a 7 6 9- DD nq D JOB LOCATION: Jdoo I _ Al/V.l S number s eet �J ,,^^ / vy village "HOMEOWNER":__/60S I'A)9 I'73/r i"T /• �Of / 7�'��S 7 /r �I oZs name home phone# work phone# CURRENT MAJLINGADDRESS: �oZ IsC.[C p OO i ci /town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an.individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the 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 Depadment minimum inspection procedures and requirements and that he/she will comply with said pr ed e and requir ts. Signature of Homeowner Approval of Building Official. Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states.that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a persou(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming.the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as partt 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:FORMS:EXEMPTN . � Barnstable � The Town of� g. Regulatory se, rvices A,fp . �� Thomas F. Geiler, Director Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 • 08-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction:alterations,renovation.repair.modernization,conversion, improvement.removal.demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors.with certain exceptions,along with other requirements. Type of Work:- Re P&C e `A*I rai r- S P%`� •1�4-L Q Estimated cost 50 0 Address of Work: Owner's Name: Date of Application: °� D I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 ❑Building not owner-occupied owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED. CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL.ca 142A. 4 SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. � a7 002 � - �o • Date wner's Nam Engineering Dept.(3rd floor) Map 3 ` 7 Parcel Permit# 6 House# C Date Issued P iJ r—w AGE ' h(3rd floor)�,($:15 - 9:30/1:00-4:30)- S�s—y-+--J5 Fee 0-0 Conservation Office.(4th floor)(8:30-9:30/1:00- 2:00) f,t 0Q Z j_C1 Planning Dept,(1st floor/School Admin. Bldg.) 1HE►p� D6in pproved by Planning Board 19 BARNSTABLE. TOWN OF BARNSTABLE Building Permit Application Prddress g� St✓ OL Village Owner �} Q 0 1_1T1 Address S'l Si 40'L �. l�I �Jd6/l•`oS, -- Telephone Permit Request S' wprw- U) 0UJ %T- & 64�=� r 4' First Floor square feet Second Floor Z� square feet Construction Type 6WCK Estimated Project Cost $ 000,c1f) Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure so Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: @full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) \,;L d Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 3 New Half: Existing New No.of Bedrooms: Existing_ New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ZGas ❑Oil ❑Electric ❑Other Central Air ❑Yes 01'N' o Fireplaces: Existing New Existing wood/coal stove ❑Yes QWo Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use _WU31/0&- Proposed UseUS�1�p Builder Information Name Gswpvc, Telephone Number __ '7 6—3>i�g— Address_G, � License# Home Improvement Contractor# Worker's Compensation# 106 Q�D310 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 1 9 BUILDING PERMIT DENIED F R THE F LLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. .- 1 DATE ISSUED- F - 4 MAP/PARCEL NO. ' • t ADDRESS VILLAGE OWNER ' I • DATE OF INSPECTION: , i FOUNDATION FRAME , INSULATION ' FIREPLACE ELECTRICAL: ' ROUGH FINAL PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL t FINAL BUILDING ' t DATE CLOSED OUT ASSOCIATION PLAN NO. f ' x t• _ The Commonwealth of Massachusetts i Department of Industrial Accidents exce011Wyes#920ns 600 Washington Street Boston,Mass. 02111 . Workers'Compensation Insurance Affidavit namc Steven J. Bishopric locationo PO Box 687 cily Osteryi l le, MA 02655 phone# 508-420-31 t;5 p I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity v,: I am an employer providing workers'compensation for my,employees working on this job. ssmRaD?.name Sttzv'en 'J $�shopr try, Tnc� same . as phone# Wausau Insurance: Co noltc� #>151.6 02-070355 I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name: phone • I rnce co. � add �y:.. • .. phone#• nce co. .,y3•• #- � 1.4 r• Y�rt t" :r �.-.>"'i'b... A:..,�.y.w.. ttaeb additional s6eeti necessaff. y Sds's� r r` �++ •6 t4 v3 .s., :9rw;,s .s .." .ua cY+�L{ - n... ui�+i. ....�� Failure to secure coverage as required under Section 25A of b1CL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.(10 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of s10o.00 a day against me. I understand that a copy or this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. /do hereby certify under the pains and penalties of perjury that the information provided above is true andcorrect. Signature AV& Date T Print name Phone# mom: official use only do not write in this area to be completed by city or town otricial eiry or town: permit/license N I—IRuilding Department oLicensing Board C]check if immediate response is required pSclectmcn's Office ollealth Department contact person: phone N; n0ther (revised 3/9s P1A) HOME IMPROOEN CONTR 1 RegistratACTOR ion 106141 TYPe - PRIVATE CORpORATION ExPiratioo 07122198 STEVEN J. BISHOPRIC INC Steven �• —�'►"° ��tQb7 Hi h Bishopric A0N�7ROTOR Marstons M illsoad NA 02648 '�, ;EPAflTME?!' CF ?UBL;C'SAFE?Y CONSTRUCTION SUPERVISOR LICENSE Number: Expires: CS - 04'929 ^al;g!+gag 9estricted -'EVEN J BISHOPRIC 'Olt RACE -.ANE M:ARSTONS MILLS, MA O2648 arnstable The Town of B . • ninentaI Services NAM1e� Department of Health Safety and Envlro , Binding Division 367 Main Street,Hyannis MA 02601 Ralph Crosses Office: 503-790-6227 Big Cc=' Fay_- So$-775-3344 For office use only • , Permit no. Date AFFIDAVIT HOME MOROVEMENT CONTRACrORLAW SIIppLEMENT TO FERKMAPKICATION ctio alterations;renovaum repair,��oII'=n= MGL c. 142A requires that the"reconstru n. cd improvement.,rcmotial, demolition. or oonstruaioa of an addition tom . building containing at least one but not more than four dwelling units oat, along with other to such rrsidenee or building be done by rcemered contractors,with certain ooeegu reqmrctnenm Type of Work: ��%�QW(��P l `��U= i-Si'�7ii )#U— Fst Cost Address of Worts: Sc Wo i-- SI!, )44nr��S O%mer.Name: rn,u �/�rr CZ �I�L. Date of Permit Appliauicn: I hatdn•ccrtifs►that: Registration is not required for the following reason(s): - Work excluded by law Job under S1.000 Building not cwrier cd Owner PUT Notice is hereby gh-=that: CONTRACTORS OWNERS PULLING'TAR OWN PERMIT OR DEALING�NOT �' ACCESS TO TFiE FOR APPLICABLE HOME WROVEMI r WORK ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL C. 142A SIGNED UNDER PENALTIES.OF PERJURY I hereby apply for a permit as the agent of the owner: n ::a:ae 4Da4 Registration No. ti OR Hyannis Main Street Waterfront BAMSTMLL i Historic District Commission t6J9• ♦� 230 South Street Hyannis,Massachusetts 02601 508-790-6270--FAX:508-790-6288 Application to Hyannis Main Street Waterfront Historic District Commission in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness 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 for: PLEASE CHECK ALL CATEGORIES THAT APPLY: 1. Exterior Building Construction: New Building Addition z Alteration Indicate type of building: ® House [] Garage ® Commercial • �' Other 2. Exterior Painting: (R 3. Signs or Billboards:0 New sign Existing sign Repainting existing sign 4. Structure: p Fence 0 Wall O Flagpole 17 Other 5. Parking Lot 0 New Building Addition Alteration (Please see the guidelines for explanation and requirements) TYPE OR PRINT LEGIBLY DATE 1— /S— 17 ADDRESS OF PROPOSED.WORK F2 Sckvo S T•ASSESSORS MAP NO. 7 OWNER rp 41� �d'P. ASSESSORS LOT NO. Rees ce• HOME ADDRESS, SAry a' TEL.NO.620 6-7 7` —®8 t?S FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way.(Attach additional sheet if necessary). PLEASE SEE ATTACHED SHEET AGENT OR CONTRACTOR STeVeAi f &S4oerk TEL.NO. So$ " -el 440-3/L Zoi C. ADDRESS PD. �n�l 6 7 ®.S'lelw.'lle �lA 0 65.E DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done, including detailed data on such architectural features as: foundation, chimney, siding, roofing,roof pitch, sash and doors, window and door frames, trim, gutters - leaders,roofing and paint color, including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet,if necessary). We seek a Certificate of NON APPLICABILITY or a CERTIFICATE OF APPROPRIATENESS if necessary to replace windows with same size , color and arrangements with efficient double pane and replace rotting wood . We seek to replace cedar shingles i.n front portion of building 301X40 " with cedar shingles and keep the natural color , trim remains white . Bulk head door to be repaired as is with same green color . Front door to be replaced with plain glass door with aluminum- trim. with safety , tempered glass . In rear of building to construct small bike lter agai s.t the building . NO.T VISIBLE TO PUBLIC . Signed Z 6nDeContractor-Agent Space below line for Commission use. RECEIVE Received by HMSWHDC $EP 2 4. 1997 Date Time TOWN OF BS R ASTAgLNE The Certificate is hereby: n A r-1\ Approved Disapproved Date . IMPORTANT: If this Certificate is approved,approval is subject to the 20 day.appeal period provided in, the Ordinance. a I HYANNIS MAIN STREET WATERFRONT HISTORIC DISTRICT COMMISSION ***SPECIFICATION SHEET*** ADDRESS OF PROPOSED WORK Tavo i fee /�y�AIAJ f s FOUNDATION 0C , Co"Jer-e—Ar _ �/'/iZN fe G C k SIDING TYPE Ce J a P- h a AJg/e COLOR /1f'ATvreQ (, CHIMNEY TYPE Re d ric k COLOR ROOF MATERIAL �1,�1` R v�Ys ey- AS A 40- COLOR k7 J,+C r PITCH � � �' t�1A rr Iry 1 b er- See ov De*cl WINDOW & COLOR Wj TC tv TRIM COLOR �U o�� W a o d e.N DOORS Woo e�/QI+�SS -v- _1)eArl 47- COLOR kl�,'re SHUTTERS GUTTERS v M,"V vH DECK A)0A)e— GARAGE DOORS IV OA) i COLOR NO Al C NOTES: Fill out completely, including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application,along with three copies each of the plot plan, landscape plan and elevation plans,when applicable. The Plot plan need not be "Certified",but should show all structures on the lot to scale. - 1 nd ,. _Fwt. S'�+p ,:`. M�:v�'?! ,. wb;`t.� ��L � i �+e �.'A i '/"'.�-� �'�... •Aa: '<.:GS.y4 �1�, LSAY' ip TEST ZiO. S SS Ce Z. l 1201..+ i I Ley. Ica P o ST S I Q WCTJ t7 —�i dKlt/ I I I I - I' I ,v O cr 13 F7 1h 13 J nAZGG ti... 1 \ I C 1 — -- -- — s ,z-AraS i rqj La - 144.1� 0 ° n9 14-4-. 47_ coZ-cot. c.R3.c., \S ° �. L,>ySPL. 2 x •� rr 9 y � � HAl2.C>�D t�1AT�1All SUt`1 � 1 Co3 i 34-7 Attachment to Application for Certificate from Housing For All Corp . , Champ -House . 82 School Street , Hyannis , MA Names & Addresses of Abutting Owners Ellen R . Tratt , Tr . & Dr . .Gary Tratt 66 School St . , Hyannis , MA ' 771 - 5300 Mr . Nicholas Thisse , 72 - School Street , Hyannis Mrs . Bouchard Tourist Homes , Apts & Cottages 83 School Street , , Hyannis , MA 02601 775 - 0912 Mr . Mausrice M . McEvoy , 56 Pleasant Street , Hyannis , MA 02601 , 508 - 771 - 2640 r Nathanson , Harold & Finkelstein , Ruth , Trustee 42 South Street , Hyannis , MA 02601 . Greenery Rehabilitation & Extended .ICare Ctr . 89 Lewis Bay Rd . , Hyannis , MA 02601 508 - 775 - 7601 Ai $ovc ha,rJ - 93 v Sa 7X 64 ' OO e. alle eAol C rA v 1 ' Fire Tower Engineered Timber - Date: 24-Nov-09 To: Town of Barnstable Building Department 200 Main Street Hyannis, MA 02601 , Re: Final inspection ofPavilion-at Champs; 82 School Street To Whom it May Concern: I am the engineer-of-record for the superstructure supporting the truss roof(by others) for the open air pavilion at 82 School Street. Specifically,my work involved the retrofitting required to bring the gable end walls up wind design load requirements. I inspected the site before the remedial work began,three times during construction, and inspected the finished building on 21NOV09. The work was all done to my specifications and to my design. I hereby certify that the reinforced pavilion has been finished to my design and specifications. Please reach me;with any further questions that you may have,concerning this interesting project. Sincerely, - i: �pLTH OF A9 ROBERT V. BRUNGRABER N v CIVIL dL. n") Brungraber, Ph.D., P.E.' No. r .., _ Xc: Mark Adams -- "Go:.. ..Chani1�l Homes '6i Y. b,ss, 'it c fC,' i 1 it St' JJ_ ;I�t.. .� :r�s 3a th+;�. J z %Jjl 60 Valley Street Unit 1 Providence,Rhode Island 02909 3 4 5 6. 7 8 9 10 THIS DOCUMENT IS THE PPAPER7, - OF BORREGO SOLAf'SYSTEMS INC. - - - - 1 - REPRODUCTION,RELEASE OR PHOTOVOLTAIC SYSTEM INFORMATION ITILIZATIO PRIOR CONSENT WITHOUT PRIOR WRITTEN CONSENT q IS STRICTLY PROHIBITED. (82 SCHOOL STREET) 1 j THE LAYOUT SHOWN IS BASED SOLEY ON A SATELLITE IMAGE AND MAY CHANGE BASED ON ROOF MEASUREMENTS AND/OR THE LOCATION.OF STRUCTURAL B MEMBERS. BORREGO SOLAR NMODULE QUANTITY 129 2051NDUSTRIAL AVE LOWELL,MA 01852 1 MODULE TYPE SANYO 21OW TlWWW.978) ORR OSOL R.CO ee WWW.BORREGOSOLAR.COM _ SYSTEM SIZE(DC) 27KW BORREGO SOLAR SYSTEMS INC. C AZIMUTH ORIENTATIONp' " V" TILT ANGLE l 04 s.t t,fnls F,r..r a3..gr srs e:.,r4 ra'rr PROPOSED RACKING SEE STRUCT DWGs 82 SCHOOL STREET , t D 129 SANYO 21 OW MODULES(27.OKW) LLd J '' �...; L1J Q 0 . o C4 101 MODULES ON PITCHED ROOF HFL 2 STRINGS OF 10 MODULES ON(4)4KW INVERTERS AND U) Q 3 STRINGS OF 7 MODULES ON A 5KW INVERTER ; }` U W Q C „ z 28 MODULES ON FLAT ROOF .. . - ax„ 2 STRINGS OF 7 MODULES ON(1)5KW INVERTER O E w w N st%.. EA U_ ui U) U ARRAY 3 ARRAY 1 O N - J s. Z V O 1 82 SCHOOL STREET e _ J O O. O ARRAY 2 75�SCHOOL STREET U REFER TO 75 SCHOOL STREET PV DRAWING SET FOR WORK 1N THIS AREA "g p � m VIL ION F , ' zA Cn (n m LOCUS PLAN 1 . ARRAY 4 NTS G fWl - ----- �. F ui - Z 0 U y .. �� w w p w � a w H BASEMENT ROOM a APPROXIMATE LOCATION OF INVERTERS o r f SITE PLAN 2 NTS w o DATE 5/22/09 P F. DRAWN TJ REVIEWED TR I d SCALE AS NOTED. pv o SHEET: OF • 2 3 4 5 6 7 8 9 10 THIS DOCUMENT IS THE PPGPERT*Y - OF BORREGO SOLAA SYSTEMS INC. REPRODUCTION,RELEASE OR UTILIZATION,IN WHOLE OR PART, DRAWING NOTES: - WITHOUT PRIOR WRITTEN CONSENT A 1. FIELD VERIFY MOUNTING LOCATIONS OF ALL EQUIPMENT IN IS STRICTLY PROHIBITED. ELECTRIC ROOMS.NOTIFY BORREGO REPRESENTATIVE OF ANY • CONFLICTS. LEGEND: B ❑1 SOLAR MODULE(STRING 1,2,......3) BORREGO SOLAR AC DISCONNECT SWITCH 205INDUSTRVLAVE LOWELL,MA 01852 ® DC DISCONNECT SWITCH T(s78)513-26gG F(617)209-1288 PULL BOX WW W .BORREGOSOLAR.COM PB BORREGO SOLAR SYSTEMS INC. ( .INVERTER ELEOM METER �,. "EEa,n - www.e"neme.ean � Z D (n J - N 0 C) J � O N 0 Q, O 2 Q Cn J O U ui Q cri } 2 z H � Z 00 O Z } 00 Z 2 = E r— ARRAY 3LLJ = Cn U F 13 13, 11 12 O 13 12 12 } 0 Q J cn 13 12 12 Q U U Jp 0 CONDUIT UP TO ROOF(TYP.) ARRAY 2 ARRAY 1 < O 0 �` F 0 PB Q m 1 1 2' 2 2; 21 3i 3 3 41 5 51 5 5 61 6. 7 7 8 8 8 8 ......: .... 1 1 2 i ❑ J _ ; 2 2 31 3: 4 4 4: 5;1 5 6 6 6; 7 7 8; 9 9 `9 9 9 9^ 9 o G 13 14 14 115 _0 0 � 1 1 1 1' 2� 21 3 3% 4 4' 4 5 5j 6 6 6 7 7 8; 10 10 10 10�10 10 1Q REVENUE GRADE Ps 13 I 14 15 15 w PRODUCTION METER 14 14 15 15 1 1 1 26 3 4 4 4 5 5 6 6 T 7 7 T0. 11 11 11 11 11 11L11 I-1 I6 F7 I.2 43 I4 ES 0 14 ' 14 -15— 15 ro w ( ARRAY 4 qC Q. OUTLINE OF ELECTRIC ROOM.. w uj �O INVERTERS SEE PART PLAN BELOW H w. H r h a NEW 120/208V,3 PHASE, i c 4 WIRE,100A MLO PANEL w o ` 240V/100A SERVICE ENTRANCE RATED, o NEMA TYPE 3R AC DISCONNECT SHALL BE 82 SCHOOL ST ROOF PLAN LOCATED WITHIN 10'OF SUPPLY SIDE TAP. w 1 Scale:1116=1-0„ "�82 SCHOOL ST ELECTRIC ROOM DATE 5/22/09 Scale:l/8"=Y-0" DRAWN TJ { REVIEWED TR i SCALE AS NOTED PV 1 .2 SHEET: OF 1 THIS DOCUMENT IS THE PgpPER�I ♦ ..I•, 2 3 4 �5 6 7 8 9 10 OF BORREGO SOA SYSTEMS INC. REPRODUCTION,RELEASE OR ELECTRICAL COMPONENTS UTILIZATION,IN WHOLE OR PART, WITHOUT PRIOR WRITTEN CONSENT A '1 -UTILITY - IS STRICTLY PROHIBITED. I REF NUMBER QUANTITY DESCRIPTION TRANSFORMER 1 129 21OW SANYO MODULE _ SUPPLY SIDE POINT OF INTERCONNECTION 2 4 SOLECTRIA 4KW INV.208V WLINTEGRATED DC DISCO IN ACCORDANCE WITH MEC/NEC 690.64(A) EXISTING LIFER GROUND M 3 1 SOLECTRIA 5KW INV 208V WI INTEGRATED CB&DC DISCO ' 4 2 SOLECTRIA 3KW INV 208V WI INTEGRATED DC DISCO 9 5 BORREGO SOLAR 200/3 MAIN SERVICE PANEL 200A,2081120V WYE 3 PHASE 4 WIRE - ( 6 - - 205 INDUSTRIAL AVE i - { LOWELL.MA 01852 ( 7 1 100A 240VAC NEMA 1 PANELBOARD T(978)513-2600 F(617)209.1288 I WWW.BORREGOSOLAR.COM XXxl3)Xxxl3)125/2 )3012 ).20/1 )20/1 )50/2 )20/1 )4012 )2011 )2011 )15/1 )70/3 )7013 )25013 (3)#4,1!IOG. i 8 1 100A 240VAC NEMA 3R FUSED 3P DISCONNECT I I I I I 1"EMT j BORREGO SOLARSYSTEMS INC. II 9 1 REVENUE GRADE METERING AND REPORTING K K 0 0 O 0 0 a O O vaai uaai O O O O O - O O O O O O ; 7� C UTILITY AC DISCONNECT SYMBOLS ov o His . - 240V SEE NOTE 14 10oA I (75) CIRCUIT LENGTH IN FEET , �— FUSE V ....8. ....m (2 CB COMBINER BOX \ PB_ JUNCTION BOX D 1 (4)f110 USE-2,1#10G.INV'Fi' (4J7#10,1#tOG:INV'N' \\-s (3)70A G EQUIPMENT GROUNDING CONDUCTOR 1/2"EMT $ FUSES I)100/3 BREAKER W RATING&NUMBER OF POLES J J., O 3l4°EMT (2)#10,1#10G. N 1/Y EMT 2512 _ o srRwcs 1-z eoX =s 8 600/3 DISCONNECT SWITCH(RATING&#OF POLES) O N 10 MODULES/STRING o - C Q 3 ELECTRICAL NOTES U Q W W U w Q . 0 1#8 GEC TO BUILDING ` Z 1 THIS PHOTOVOLTAIC INSTALLATION SHALL BE IN ACCORDANCE WITH THE EDITION OF ty �- � (4H#10 USE-2,1#tOG.INV'F7 c- GROUNDING ELECTRODE 3 1#10G. �-- (n Z ( 4'1 EMT THE NATIONAL ELECTRICAL CODE(NEC),MASSACHUSETTS ELECTRICAL CODE(CEC) O ¢ 314-EMT (4)/#10,1#10G.INV'42 _ (2Ni10,1#10G. L Z = Z } E 1/2'EMT 1n•EMr 25/2 s AND LOCAL ELECTRICAL CODES CURRENTLY BEING ENFORCED BY THE AUTHORITY STRINGS 3-a a o HAVING JURISDICTION(AHJ). CL U w 10 MoouLEs sTRINc w 3 2 A GROUND FAULT DETECTION AND INTERRUPTION(GFDI)DEVICE IS INTEGRATED WITH Q F--- i ti THE INVERTER IN ACCORDANCE WITH NEC/CEC 690.5(A). O Q J N .PULL PULL Lli U = O Box Box 1#8.GEC TO BUILDING 3 DISCONNECT SWITCHES SHALL BE WIRED SUCH THAT WHEN THE SWITCH IS OPENED = O o m cRouNDwc ELECTRODE THE CONDUCTORS REMAINING LIVE ARE CONNECTED TO THE TERMINALS MARKED Z U 0 O (8)#10 USE-2;2#10G. o - (,°) 1.1/4"EMT `" _ (2JI#10,1#10G. �\ 'LINE SIDE"(TYPICALLY THE.UPPER TERMINALS). (n O f— t). 1IY EMT 25/2 V �- O U) - F a v`i. �ESISTM�ING `7 g 5 4 PHASE&NEUTRAL CONDUCTORS SHALL BE COPPER,MINIMUM#10 AWG,SOLID OR - U _ 10 o ^ STRANDED WIRE MAY BE USED.EXPOSED PHASE&NEUTRAL CONDUCTORS SHALL 8E w )#10 USE-2, #19G.INV9-3' (4)f#10,1#10G.INV y 3 o o USE-2 INSULATED,ALL OTHER PHASE&NEUTRAL CONDUCTORS SHALL BE THWN-2 w m a 314'EMT 11Y EMT ¢v DAs INSULATED UNLESS OTHERWISE NOTED. 1#8 GEC TO BUILDING >— GROUNDING ELECTRODE (3)74,1#lac, i 5 GROUNDING&BONDING CONDUCTORS SHALL BE COPPER,MINIMUM#10 AWG,SOLID �(4)#10 USE-2,1#10GANV'F4' z` 1'EMT j 3/4"EMr (4)a10,1#10G.INv'14' _ (2)#10.1#10G. a OR STRANDED WIRE MAY BE USED.EXPOSED GROUNDING AND BONDING vz EMT x g 112 EMT zsn CONDUCTORS SHALL BE UNINSULATED,ALL OTHER GROUNDING&BONDING STRINGS 7-8 _v a ^ CONDUCTORS SHALL BE THWN-2 INSULATED UNLESS OTHERWISE NOTED(LION). 10 MODULES/STRING o G w 3. 6 DC CONDUCTORS SHALL BE COLOR CODED AS FOLLOWS: U) PULL PULL 3 DC POSITIVE-RED(OR MARKED RED) w Box Box 1#8 GEC ro euILOING DC NEGATIVE-GREY(OR MARKED GREY) �.' (10)f#10 USE-2;2#10G. m GROUNDING ELECTRODE _ p = 7 AC CONDUCTORS SHALL BE COLOR CODED AS FOLLOWS: 0(2)#10 i-1/4'EMT ,1#10G. o 1/2 EMr 3mz PHASE A-BLACK(OR MARKED BLACK IF#4 AWG OR GREATER) a w n PHASE B-RED(OR MARKED RED IF#4 AWG OR GREATER) w > STRINGS 9-1T - - o -¢ LLI ' " PHASE C-BLUE(OR MARKED BLUE 1f#4 AWG GREATER) . 7 MODULE o w W (6)f#10 USE-2,1#10G.INV'LS' (6)t#10.1#tOG.INV'F5' Jo 7 NEUTRAL-.WHITE(OR MARKED WHITE IF AWG OR GREATER) H w H I'EMT 3/4'EMT ti 1#8 GEC TO BUILDING H a GROUNDING ELECTRODE 8 FOUR WIRE DELTA CONNECTED SYSTEMS SHALL HAVE THE PHASE WITH THE HIGHER Z VOLTAGE TO GROUND MARKED ORANGE OR-IDENTIFIED BY OTHER EFFECTIVE MEANS.�J o(4)#10VSE-2,1#10G.NV'-6 - _ - 314' 9 GROUNDING&BONDING CONDUCTORS,IF INSULATED,SHALL BE COLOR CODED GREEN a, zo FLAT ROOF W (OR MARKED GREEN IF#4AWG OR GREATER). a STRINGS 12-13 a a 7 MODULESISTRING 10 CONDUIT SIZES INDICATED ARE MINIMUMS IN ACCORDANCE WITH APPLICABLE CODES - �N (z)a1o,1#10c. AND MAY BE INCREASED IF REQUIRED. o o - 1/2'EMT 30/2 1 11' MARKING OF THE PHOTOVOLTAIC SYSTEM DISCONNECTING MEANS SHALL BE BOX m o a DATE 5/22/09 a PROVIDED IN ACCORDANCE WITH NEC/CEC 690.17. -1/4"E SE-2,2#10G. O w 12 MARKING OF THE DIRECT CURRENT PHOTOVOLTAIC POWER SOURCE SHALL BE DRAWN TJ . FLAT ROOF ti PROVIDED IN ACCORDANCE WITH NEC/CEC 690.53. REVIEWED TR - STRINGS 14-15 1#8 GEC TO BUILDING a 31MODULESISTRING GROUNDING ELECTRODE I 13 MARKING OF THE INTERACTIVE SYSTEM POINT OF CONNECTION SHALL BE PROVIDED SCALE AS NOTED (4)#10 USE-2, #1oc.wv 17 = ) IN ACCORDANCE WITH NEC/CEC 690.54. 3/4'EMT 14 DC CIRCUIT CONDUCTORS PENETRATING THE BUILDING ENVELOPE SHALL BE IN 3 . 1 METALLIC CONDUIT AND MARKED EVERY 5 FEET"CAUTION DC CIRCUIT" \ /15 UTILITY AC DISCONNECT SWITCH SHALL BE LABELLED"UTILITY CO.AC DISCONNECT PV 3 .-.__ - - - _ - ------ --- -- -..---- - -- - SWITCH.CAUTION!LINE SIDE CONDUCTORS MAY STILL BE LIVE.DE-ENERGIZE INVERTER OUTPUT CIRCUIT BREAKERS IN PANEL'PV-1'LOCATED IN ELECTRIC ROOM." SHEET: OF I , 2 3 4 5 6 T 8 10 THIS DOCUMENT IS THE PRQPERTY OF BORREGO SOLAR SYSTEMS INC. REPRODUCTION RELEASE OR ` T� �A UTILIZATION,IN WHOLE OR PART, c " `� WITHOUT PRIOR WRITTEN CONSENT A Ek GA ll/6 W A BL E$ FAP Ufa, Ufa,ptld the Earth IS STRICTLY PROHIBITED. f » s atc�voltaiC Moduli I qi 19' �i k� � t i Itf�L` �V P�(ral�i�l� 31 E . 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" , �SIMECTRIA 0 R E N E W A t3 L E'S -, SCALE AS NOTED tawranpr hfaxa_huSCrle «""Y f A.� ` E 8anrd rwmry lusA.toa.0 . .I USA r1 .� a� PV 4 . 1 bx., Ph:9TB.683.97-00(MA) S. — �- ! ream Tx IM31L u.sA .J . Ph:562.608.8913(CA) S; .� i ..y i f r r.,�.,. .arncanrada Fax.978,663,9702 i a . GFD:Fuse RS232•'485 interfaces E-meal:inverters(tQsalren,mm 7 !�'.Ra:.� ew.»e.a.aa.aw:ra altpm eo++s.xarm „..w_..»at .r, r_i OC Connections AC Connection - wwvrsot)en.mm nc s sea a' . SHEET: OF 2 3 4 1 5 1 .6 7 $ 9 10 THIS DOCUMENT IS THE PROPERTY OF BORREGO SOLAR SYSTEMS INC. GENERAL''NOTES: REPRODUCTION,RELEASE OR UTILIZATIPN,IN WHOLEOR PART, A 1. ALL WORK SHALL CONFORM TO THE REQUIREMENTS OF 9 WITHOUT PRIOR WRITTEN CONSENT �- Y P THE MASSACHUSETT B IS STRICTLROHIBITED.S STATE BUILDING CODE,SEVENTH STRUCTURAL SPECIFICATIONS - s YP EDITION. 2. THE SCOPE OF THE WORK SHOWN ON THIS DRAWING MODULE: sHaRPsoLAR NT-175U1 `� SHALL BE THE STRUCTURAL FRAMING SUPPORTING THE MODULE WEIGHT(LB) 35,3 MODULE LENGTH 0 62 ROOF-MOUNTED SOLAR PANELS AND CONNECTIONS OF MODULE WIDTH(") 32.5 THE POSTS TO THE.EXISTING STRUCTURE BELOW. �SPGE@9' B 3. ALL EXISTING CONDITIONS SHOWN TO BE VERIFIED BY A�Qse (E)2x4 TOP B O R R E G O SOLAR CONTRACTOR PRIOR TO PREPARATOION OF SHOP ARRAY#1 DETAIL: CHORD,TYP. 2os INDUSTRIAL AVE NUMBER OF MODULES 40 STRUCTURAL LOWELL,MA01852 DRAWINGS AND COMMENCEMENT OF WORK. MODULE WEIGHT(LB) 35.3 TRUSS TOP CHORD (2)2X4 12 +IL T(978)513-2600 F(en)209-:288 4. DESIGN LOADS: io— WWW.BORREGOSOLAR.COM DEAD LOAD:SOLAR PANEL WEIGHT=5 PSF RACKING WEIGHT(PSF) 2.5 TRUSS SPACING 24"o.c. 6� �> SNOW LOAD=22 PSF+DRIFT ARRAY WEIGHT(LB) 1412 TRUSS SPAN 25' BORREGO SOLAR SYSTEMS INC. WIND LOADS: ARRAY AREA(SQ.FT.) 559.7 ROOF PITCH 26.60 19 (E)ROOF TRUSS ELECT—IL E^","EE^,^" C ARRAY LOAD(LB/SQ.FT.) 2.52 ROOFING @ 24",V.I.F.WIND SPEED=120 MPH NUMBER OF MOUNTS 55 MATERIAL COMPOSITE SHINGLE r' g EXPOSURE=B LOAD PER MOUNT(LB/MOUNT) .450 :., BASIC WIND PRESSURE=36.7 PSF — =1.0 STRUCTURAL NOTES LINE @ SYMM. . ^ Cub811f ^" 5. . ALTERNATE CONNECTION DETAILS OR PARTS CUT 12'-6^+/- SHEETS MUST BE SUBMITTED TO ENGINEER FOR 1 DRILL PILOT HOLE FOR 5/16"LAG SCREW USING A 7/32"DRILL BIT. V.I.F. D APPROVAL PRIOR TO CONSTRUCTION. ELEVATION DETAIL ROOF TRUSS J Z o A SCALE:1/4"=1' U H a 1/4-20 SS J 1/4-204-" FLANGE NUT 3/8-164 HEX � (aj W Q z _ I HEAD BOLT W HEX BOL T LT F-. 1 3/8 16 FLANGE U p z E 4"FLAT WASHER NUT U) F- I ul MAXIMUM MOUNT SPACING 4'-0" I _ ROOF TRU ES AT 2'-0" SOLAR MODULE _ QJ d U j B LINE B22 U Q cn 41'11" U O p U Z U > _ LL1 O O cn 04 F I L1J H O 0° Cn azs O = UNIRAC m a R-01 STANDARD RAIL - i — UNIRAC FOOT BLOCK R-02 [ I 5/16"LAG SCREW QUICK MOUNT PV FLASHING MINIMUM 2-1/2"THREAD G II { EMBEDMENT TYP 1 PER MOUNT SS TOP 3 TRUCHORD B ATTACHMENT D OF P-M J W A SCALE' ^'<<'Fe9 �� W o O 1 G LL _ N N ;.� B-LINE B-22 BA' o w ARRAY 57 AIL A """TM ® ®�e�� iS ,,, o s PAVILION ROOF PLAN ® r �� SCALE:1/8"=1' A W 8d COMMON�AIOL @ 0e (E)TRUSS TOP CHORD DATE 5/22/09 RAIL SCHEDULE LEGEND: NOTE: DRAWN ELH VIEW A-A FOR ADD.INFO., NOTE:RAIL LENGTH SPECIFIED INCLUDES 9"OF RAIL(4.5"EITHER END)IN SOLAR MODULE REVIEWED RJF ADDITION TO THE MODULE EDGE TO MODULE EDGE DISTANCE — BUILDING SEE DETAIL B/S1.1 SCALE AS NOTED ARRAY RAIL LENGTH(') #OF RAILS MODULES/BASE RAIL TYPE OF RAIL -- ROOF TRUSS l -. MODULE RAIL 2x4 TO MATCH J 5 R-01 42'-8" 5 BASE RAIL B-LINE B22xl2GA - - BASE RAIL TRUSS TOP CHORD, ' 5 R-02 16'-31" 16 MODULES UNIRAC STANDARD ® MOUNT C ROOF TRUSS DETAIL ALREADY IN PLACE. _ sil SCALE:1" 1 090348WSBLBO I `+• 1 2 3 4 5 6 7 8 9 10 THIS DOCUMENT IS THE PROPERTY OF BORREGO SOLAR SYSTEMS INC. ' . REPRODUCTION,RELEASE OR UTILIZATION,IN WHOLE OR PART, q WITHOUT PRIOR WRITTEN CONSENT IS STRICTLY PROHIBITED. RAIL-SCHEDULE `g NOTE:RAIL LENGTH SPECIFIED INCLUDES 9"OF RAIL(4.5"EITHER END)IN ADDITION TO THE MODULE EDGE TO MODULE EDGE DISTANCE ARRAY RAIL LENGTH(') #OF RAILS MODULES/BASE RAIL TYPE OF RAIL B 190RREG0 SOLAR 1 R-01 52'.0" 6 MODULES. UNIRAC STANDARD 1 R-02 11'-6" 2 MODULES UNIRAC STANDARD zLOWELL,MA L AVE 01&52 � - LOWELL,MA 01852 1 R-03 33'-l" 2 MODULES UNIRAC STANDARD T(978)513-2600 F(617)209-1288 WWW.BORREGOSOLARCOM 2 R-04 19'-7" 8 MODULES UNIRAC STANDARD EXIST OPEN WEB JOIST 10"DEEP TYP. 3 R-05 16'.6" 3 BASE RAIL 2"0 SCHED 40 PIPE BORREGO SOLAR SYSTEMS INC. TYPE 10OW(ADOPTED 1934) 3 R-06 11'-3" 6 MODULES UNIRAC STANDARD E`E`T"""E EN°'"EE"'"E CAPACITY: 4 R-07 2p.g" 3 BASE RAIL 2"0 SCHED 40 PIPE A M allowable=4.67 ft-K 4 R-08 11-3" 8 MODULES UNIRAC STANDARD s2.z 29'-0^+/_ V allowable=1.9 K 53'-6"*/- FLAT ROOF PATCHED HIGH ROOF 22'-6"+/-PATCHED LOW ROOF DIAGONAL BRACE p I— - — - - — g„ R-05 BRACE B o I N R-06 1 I I I Q I I a a -� W Z s I E Q z I W. H � U) E MAXI UM MOUNT SPAC NG 4' 2x6 ROOF;RAFTER AT '-0"+/ J Ln U w 2"0 SCHED 40 co POST I I 3 j ARRAY U O Q J GALVANIZE TYP. I AR Y 3 I RRAY 1 j U = O �o ARRAYS 3&4 _ — — — — -- - (E W BM. W, U O ai 1 F 51'-3' w F— Q CNo I 3 I e 3 ALL I i m a R 0'l 5 e f i i E I f.. i .. If 1 f J - - - - - — .. i G I AR 4 F I D GONAL I j R-07 S2.2 B CE { i E : : R-08 Lu 0 R-02 f BRACE RACE i i O LL H 0 I 1 I Lu Lu I R-03 I f £ a Lu j C f f 1 i N I i I i... _ f '10'-9" I i I 32'-4" 18'-10" 21-0" µ of MA DATE 5/22109 A C DRAWN ELH Ra"cCf'en+ A J" LEGEND: REVIEWED RJF s2.2 z FARAH' . p S1 l;�Tl 09 0 SOLAR MODULE SCALE AS NOTED ING 82 SCHOOL STREET ROOF PLAN ' 180 ROOF J SCALE:1/8"=1' MODULE RAIL S1 .2 ® MOUNT 090348WSBLBO •, _ 1 2 3 4 5 6 7 8 9 10 THIS DOCUMENT IS THE PROPERTY OF BORREGO SOLAR SYSTEMS INC. REPRODUCTION,RELEASE OR UTILIZATIO'd,IN WHOLE OR PART, A WITHOUT PRIOR WRITTEN CONSENT GENERAL NOTES 1 STRUCTURAL SPECIFICATIONS IS STRICTLY PROHIBITED. �Q 1. ALL WORK SHALL CONFORM TO THE REQUIREMENTS OF 1� 6° THE MASSACHUSETTS STATE BUILDING CODE,SEVENTH MODULE: SANYO HIT POWER 210N `, EDITION. MODULE WEIGHT(LB) 35.3 J � 2. THE SCOPE OF THE WORK SHOWN ON THIS DRAWING MODULE LENGTH(^) 62.2 EQ' SHALL BE THE STRUCTURAL FRAMING SUPPORTING THE MODULE WIDTH(^) 31.4 B ROOF-MOUNTED SOLAR PANELS AND CONNECTIONS OF BORREGO SOLAR THE POSTS TO THE EXISTING STRUCTURE BELOW. ARRAY#1 DETAIL: 3. ALL EXISTING CONDITIONS SHOWN TO BE VERIFIED BY NUMBER OF MODULES 73 STRUCTURAL 261NDUSTRALAVE LOWELL.MAD 1852 CONTRACTOR PRIOR TO PREPARATOION OF SHOP MODULE WEIGHT(LB) 35.3 TRUSS TOP CHORD 2"x 6" T(978)5132600 F(617 S12M SOLAR MODULE DRAWINGS AND COMMENCEMENT OF WORK. RACKING WEIGHT(PSF) 2.5 TRUSS SPACING 24"O.C. WWW.BORREGOSOLAR.COM 4. DESIGN LOADS: ARRAY WEIGHT(LB) 2576.9 TRUSS SPAN 9'-6" BORREGO SOLAR SYSTEMS INC. (E)ROOF DEAD LOAD:SOLAR PANEL WEIGHT=5 PSF ARRAY AREA(SO.FT.) 990.1 ROOF PITCH ROOF-PITCH c RAFTER @ 24", SNOW LOAD=22 PSF+DRIFT ARRAY LOAD(LB/SQ.FT.) 2.6 ROOFING E E"J"�".E""'^EE " V.I.F. WIND LOADS: NUMBER OF MOUNTS 100 MATERIAL COMPOSITE SHINGLE LOAD PER MOUNT(LB/MOUNT) 350 B WIND SPEED=120 MPH EXPOSURE=B BASIC WIND PRESSURE=36.7 PSF ARRAY#4 DETAIL: =1.0 NUMBER OF MODULES 28 STRUCTURAL 5. ALTERNATE CONNECTION DETAILS OR PARTS CUT MODULE WEIGHT(LB) 35.3 RAFTER SIZE 2"x 6" D SHEETS MUST BE SUBMITTED TO ENGINEER FOR RACKING WEIGHT(PSF) 2.5 RAFTER SPACING za^O.C. J z o ELEVATION DETAIL-ROOF RAFTER APPROVAL PRIOR TO CONSTRUCTION. ARRAY WEIGHT(LB) ssa.a MAXIMUM RAFTER SPAN 9'-s" Q _p N ARRAY AREA(SQ.FT.) 379.8 ROOF PITCH ROOF-PITCH U H ARRAY LOAD(LB/SQ.FT.) 2.6 ROOFING J NUMBER OF MOUNTS 40 MATERIAL COMPOSITE SHINGLE U N J z LLJ LOAD PER MOUNT(LB/MOUNT) 350 T H- Q U O z = E ARRAY#4 DETAIL: U) z w ui NUMBER OF MODULES 12 STRUCTURAL Q d U w MODULE WEIGHT(LB) 35.3 RAFTER SIZE 2"x 6" U_ ha- N RACKING WEIGHT(PSF) 2.5 RAFTER SPACING 24"O.C. U Q J O ARRAY WEIGHT LB 423.6 MAXIMUM RAFTER SPAN 9'-6" H U 2 O o FLANGE NUT ARRAY AREA(SQ.FT.) 162.8 ROOF PITCH ROOF PITCH W 0 U O N. ARRAY LOAD(LB/SQ.FT.) 2.6 ROOFING W F- O co F 3 co NUMBER OF MOUNTS 15 MATERIAL COMPOSITE SHINGLE _ 1/4 20x4" LOAD PER MOUNT(LBIMOUNT) 450 co a- LOAD HEX BOLT - f FLAT WASHER ARRAY#4 DETAIL: NUMBER OF MODULES 16 STRUCTURAL 3/8-164 HEX MODULE WEIGHT(LB) 35.3 RAFTER SIZE 2"x 6" G SOLAR MODULE \ HEAD BOLT RACKING WEIGHT(PSF) 2.5 RAFTER SPACING 24"O.C. 3/8-16 FLANGE ARRAY WEIGHT(LB) 564.8 MAXIMUM RAFTER SPAN 9'-6" NUT ARRAY AREA(SO.FT.) 217 ROOF PITCH ROOF-PITCH ARRAY LOAD(LB/SQ.FT.) 2.6 ROOFING NUMBER OF MOUNTS 15 MATERIAL COMPOSITE SHINGLE LU LU LOAD PER MOUNT(LBIMOUNT) 450 cc C3 W W H UNIRAC STRUCTURAL NOTES N STANDARD RAIL 1 DRILL PILOT HOLE FOR 5/16"LAG SCREW.USING A 7/32"DRILL BIT. UNIRAC L-FOOT o W ui QUICK MOUNT in PV FLASHING _ I iu DATE 5/22/09 p to DRAWN ELH 5/16"LAG SCREW s" MIN.2-1/2"THREAD ATTACHMENT DETAIL o SN REVIEWED RJF EMBEDMENT B � "45iso SCALE AS NOTED TYP 1 PER MOUNT SCALE:3==1' .o S2 . 1 . 090348WSBLBO 1 2 3 4 5 6 1 7 8 9 10 THIS DOCUMENT IS THE PROPERTY OF BORREGO SOLAR SYSTEMS INC. REPRODUCTION,RELEASE OR UTILIZATION,IN WHOLE OR PART, A WITHOUT PRIOR WRITTEN CONSENT IS STRICTLY PROHIBITED.. I `j� I BRACE BRACE `% BRACE ELEVATION B �� SCALE:1/8"=1' BORREGO SOLAR RAIL AVE BASE RAIL LOWELL,MA01852 T(978)513-2600 F(617)209-1288 2"0 ST.PILE,TYP. 10° 2"0 PIPE WWW.BORREGOSOLARCOM BORREGO SOLAR SYSTEMS INC. SOLAR MODULE ELECT"-1 E °,"EE IIIG — — — — — — — — — — — — — — — sz.z — - - - - - - - - - - - - — `li 2"0 POST,TYP. o III I I . t,., _ .° .•_m _ - Z"BOLT D � I I - I _ J Z o Q O N UNIRAC F— g 2 UNIRAC I SLEEVE _ QU cn J C SLEEVE L1J Q }z4'-0" N WU E I I I I cn w I I ¢ a U U c~n ELEVATION DETAIL-ROOF JOIST I I I I OU = JO o A I I 2"ULA BRACE I I U Z U > 04 SCALE:1/2"=1' o III I I O IFL1J H O °° O = � FLAT I I I I m 1/4 V FLASHED B.O. ROOF I i 5"0 a BASE PL.W/ I I 70 POST TYPICAL BRACE DETAIL G 2-3/8"0 BOLTS I I 1 a'x1&x 1. E (E)2"CEMENT DECKING I I WASHER,TYP. SCALE: 1-112"=1' ROOF SLAB,VIF, 8"0 U BOLT UNIRAC ANGE a a I L2x2xdx7" o 0 H 2"0 RAIL W/2-1140 BOLTS W W y - fq L (2)1"xl"xa O 0 0 q� 2 "0 �j1d Of P.:- Lu TOP CHORD N 1 I 5"0 "TOP PLATE �o�'� RACHID J. � o o FARAHeu 31, c1 STRtiCMW 8 0 �0 DATE 5/22/09 i 2"0 RAIL DRAWN ELH BOT.CHORD (E)JOIST Al. REVIEWED RJF TYP.MODDULE RAIL- SCALE AS NOTED SECTION AT ROOF JOIST (7) POST,RAIL DETAIL PIPE RAIL CONK€GTION v SCALE: 1-1/2"=1'. F SCALE: 1:1/2"=1' S2 .2 090348WSBLBO i � GCS u i SS tYlzlYlz�(8 GALV.GUARD '' PROVIDE 2x{P.T.BLOCKING AA POST O{'-0'MIN SPACING f SUPPORT LOCA710N5 ��11�22 1r��1�,1 O U1MD7 END58 GALV.GUARD POSTS LADDER MOUNTS TO BE FASTENE ERMANENT LADDER UP ALV.ANGLE EXTENDING UP TO EXISTING WALL STUDS COASTAL TO THIRD FLOOR PLATFORM TO THIRD FLOOR PLATFORM Cex9.2 GALV. FIXED TO BUILDING UARD CDNSTRUCTED TO NOT ALLOW THE engineering co. 'ZORO 12'-3'FIXED LADDER W/SAFE PASSAGE OF 4-SPHERE FROM THE WALKING ONTNUWS GUARD CONSTRUCTS TO NOT CAGE'.CAGE IS TO OPEN TOWARDS THE SURFACE TO THE TOP OF GUARD mFmDzry NM• MA owe 4'-3' ALLOW THE PASSAGE OF{•SPHERE FROM PLATFORM AND SHALL BE MOUNTED PER > THE WALKING SURFACE TO THE TOP OF MANUFACTURER'S SPECIFICATIONS WARD ZORO tY-3'Fl)D'D LADDER A SAFETY yr 55 1yzlY2x�(6 GALV.GUARD POST O 1'- CA WGE IS TO OPEN TOWARDS THE m 0'MIN SPACING PLATFORM AND SHALL BE MOUNTS PER GHSSUARD POSTS! GALV. MANUFACTURER'S SPECIFICATIONS - WARD POSTS O WARD1-1 NDO N TO GALV. 3)CM4.5 GALV.JOISTS EVENLY SPACED.COPE TO ENDS I DOWN TO N.FTG `------- — PERPENDICULAR CHANNELS AND FASTEN W/2-MINIMUM -3 ISTING WINDOW EGRESS C6x8.2 GALV. CORROSION PROTECTED FILLET WELD L3z1zY4 GALV.ANGLE BRA ED •� •GALV.GRATING SPOT WELDED GRATING WITH CORROSION PROTECTED WELDS -GALV.GRATING SPOT TE WE C4z7.25 GALV. WITH CORROSION PROTECTED WL7.D5 1'CALV.STEEL > ORIENTATION I i GRATING x8.2 GALV.LEDGER CHANNEL 3 •I FASTENED TO BUILDING W/%'0 GALV." LAG BOLTS O 16'O.C., I 4z4.5 GALV.JOISTS O 4'-C"MAX SPACING.COPE TO {�' m GRATING PERPENDICULAR CHANNELS AND FASTEN W/2'MINIMUM J I 1-CALV.STEEL ORIENTATION CORROSION PROTECTED FILLET WELD ^�E)BUILDING WALL FRAMING V.I.F. ,I •^ I GRATING C6z8.2 GALV. � I D o 1-3z3 GALV.ANGLE U -----J COLUMN CONTINUOUS GALV.FASTENED TO I -30 TO THIRD FLOOR PLATFORM COLUMN W/�q 0 THRU BOLT AND WELDED STE CALV.LEDfdt CHANNEL L3z3>(Y4 GALV.SHELF C{x7.25 CALV. FASTENED TO BUILDING W/`�'0 CALV. ________ L3zNNE GALV.SEAT ANGLE CUSSED TO COLUMN AND LAG BOLTS O 18'O.C., CHANNEL W/CORROSION PROTECTED FIELD WELD 4•-3- a0 E)BUILDING WALL FRAMING V.I.F. HSS 3x3zY4 GALV. ALV.COLUMN PER PLAN 7.25 CONTINUOUS GALV.FASTENED TO OWN TO N.FTG 4•-0- EC N3 4 GALV.DOWN T COLUMN W/-Y4 0 THRU BOLT AND WELDED SECOND FLOOR PLATFORM (2 PLACES TYP) V.ANGLE PER PLAN i BD.�BOLTS ARE FOR ERECTION PURPOSES ONLY.CONNECTIONS NOTE BOLTS ARE FOR ERECTION PURPOSES ONLY.CONNECTIONS ARE TO BE FIELD WELDED AND CORROSION PROTECTED ARE TO BE FIELD WELDED AND CORROSION ONLY. SECOND FLOOR LANDING PLAN A SECOND FLOOR LANDING SECTION B THM D FLOOR LANDING PLAN THIRD FLOOR LANDING SECTION D o SCALE:La•-1•-0• _20 SCALE:In—V• -300 SCALP:,f1•-Y-r '10 SCALE:Ia•-V• _30 o I SEAL PAU R. LMTOCHELLE a CIVIL No 9i9F0 eIEP t� . L212xY4 GALV.SHELF THRU BOL TO STRINGER W/(2)Y2.0f BOLTS E.E. 1'GALV.GRATING$POT 3 WITH CORROSION PROTECTED WELDS F ) CBx11.5 GALV.STRINGER(TIP 5-300 L3x3KY4 GALV.SHELF BOLTED EXISTING COLUMN W/-Y�0 BOLT AND WELDED BUILDING EACH END L3x304 GALV.SHELF BOLTED T H COLUMN W/-Y4 0 BOLT AND WELDED S-30D GALV.BOARD PER PLAN WELDED T OUTBOARD SIDE OF STRINGERS W/ CORROSION PROTECTED WELD GALV.COLUMN PER 'GALV.GRATING SPOT WELDED WITI4 CORROSION PROTECTS WELDS L2x2KY4 GALV.THRU BOLTS M STRINGER W GALV.GRATING SPOT WELDED WITH mil, TYPICAL CALV.BASER (2)Y2- AND FASTENED TO(E)CONIC.SLAB W/ /..9QaY4 GALV.SHELF THRU BOLTED TO c O 0 CORROSION PROTECTED MELDS '0 SIMPSON TTEN HD GALV.SCREW ANCHORS STRINGER W/ 2)X"o BOLTS E.E. . H TYPICAL BASE Q I 1I'. .. Bx11s GAW.STRINGERS STRINGER4 GW/Y(2)SHELF ¢'V BOLTS EACH TO a L'. P i�/i�/ice/ ../i,./i, o O END OF TREAD W A r� F��Ajy1 m - TYPICAL SONOTUBE FOOTING--_, D D W �I V-01 CONE7'-0' SONOTUBE FTG , LLJ f W v O TYPICAL EGRESS FIRE ESCAPE TREADS G TYPICAL EGRESS FIRE ESCAPE TREADS H W - / SCALE:I"_1W _'20 SCALE 1"-1'-0• -30 � � I EGRESS FIRE ESCAPE LANDING SECTION E EGRESS FIRE ESCAPE LANDING SECTION F y SCALP:Ia•-1'-0• -'Z0 SCALE:Ia'_1'-0• a , p OLUMN PER PLAN y ANCHOR BOLTS EMBEDDED DMIN 3ESCALE 0•-9'INTO CONCRETE AS NOTED E)WALL ENE THING DESIGN BY 3 ! NTB $ E)STUD WALL T, A ` //• 4)/5 VERT.BARS DAM 05/05/2017 ALV.COLUMN b DRAWN BY OVIDE FLASHING AROUND BLOCKING PER PUN .-w" 4 CIRCULAR TIES O 10'O.C. NTB }!2'GALV.R Y� CORROSION CHECKED BY U 2.6 P.T.BLOCKING FASTENS TO MINIMUM OF(2)EXISTING H55 1J¢11r,�y18 GALV. PROTECT PRL WARD POST ,WIND ENDS NCRETE FILLED c1 SONOTUSE FOOTING 3 STUDS W/(3)Y4 z0'-4'TIMBERLOK SCREWS O EACH STUD LANDING FRAMING PER PLA 1'-0"0 .i 2 ROPR ETARY PERMANENT CAGED ryx q 5�0 GALV.ANCHOR R LADDER EGRESS PER PLAN )%' i BOLTS W/0-9-EMBEDMENT `6 S-300 U FIXED LADDER MOUNT I TYPICAL BASE PLATE TYPICAL GUARD POST MOUNT TYPICAL SONOTUBE FOOTING 40 SCALE:In•-1W -300 SCALE:,-_F' , SCALE I°-I'HI• SGALE:y•-lw PERMITSET 1DE s$ILEBIS t � 5 "NOT FOR CONSTRUCTION" PRDIECTNO, c)s)w.00 j L 1 ; i . STRUCTURAL GENERAL NOTES FOUNDATION NOTES 1. STRUCTURAL WORK SMALL CONFORM TO THE PROJECT SPECIFlGTONS,INCLUDING THE FOLLOWING GOVERNING STANDARDS: 1.FOOTINGS SWILL BEAR LEVEL ON COMPACTED CRUSHED STONE(AS SPECIFIED)ATOP UNDISTURBED OR PROOFROl1ID,ACCEPTABLE SOILOR A THE MASSACHUSETTS STATE BUILDING CODE 780 CMR,EIGHTH EDITION,AND AMENDMENTS ALONG WITH OTHER AGENCIES HAVING COMPACTED STRUCTURAL FILL(AS SPECIFIED),HAVING A MINIMUM ALLOWABLE BEARING CAPACITY OF 1.0 TONS PER SQUARE FOOT.ACCEPTABLE JURISDICTION. MATERIALS ARE CONSIDERED TO BE PROOF ROLLED EXISTING GRANULAR FILL OR NATURAL MARINE SAND. COASTAL 2.SUBSOIL BEARING STRATA SHALL BE FREE FROM VEGETATION,LOAM,AND ORGANIC MATERIAL.IN NO CASE SHALL FOUNDATIONS BEAR UPON B.AISC'SPECIFICATION FOR THE DESIGN,FABRICATION AND ERECTION OF STRUCTURAL STEEL FOR BUILDINGS',LATEST EDITION. THESE EXISTING SOILS.ALL SILT,FILL TOPSOIL,AND OTHER UNACCEPTABLE SOIL MATERIALS SKALL BE EXCAVATED AND REMOVED FROM THE SITE C.Ad'BUILDING CODE REQUIREMENTS FOR REINFORCED CONCRETE.'(ACT 318-05) engineering co. AT ALL FOUNDATION AND SLAB-ON-GRADE LOCATIONS.SPECIFIED STRUCTURAL,COMPACTED FILL SHALL BE SUBSTITUTED AT THESE LOCATIONS. 3.IF BEARING MATERIALS(OTHER THAN THOSE DESCRIBED ABOVE)WITH A LOWER ALLOWABLE BEARING CAPACITY THAN 1.0 TONS PER SQUARE uO mFWdWIAW.IXWv¢MA 4as9 D.THE CODE FOR WELDING IN BUILDING CONSTRUCTION BY THE AMERIGN WELDING (AWS D1.1) FOOT ARE ENCOUNTERED,THE UNSUITABLE MATERIALS SHALL BE REMOVED AND REPLACED WITH SUITABLE,MATERIAL AS SPECIFIED AND APPROVED �P 59BESfilWF BY THE STRUCTURAL ENGINEER. 2. CONSTRUCTION IS TO CONFORM TO THE INTERNATIONAL DES EXISTING BUILDING CODE 20D9, CI AMENDED BY THE ESE DRAWINGS STATE BUILDING CODE,EIGHTH EDITION AND APPLICABLE PRODUCT AND DESIGN E REQUIRE ABSENCE OF SPECIFIC ITEMS FROM THESE DRAWINGS TIDES NOT INFER {.BOTTOM OF f00TING5 SNAIL BE NO LESS THAN 4'-0'BELOW FINISH GRADE. t TIME THE CONTRACTOR IS RELIEVED FROM THE STATUTORY CODE REQUIREMENTS. ' S.FOOTINGS SHALL BE PLACED ON A 6-LAYER OF COMPACTED CRUSHED STONE ATOP PROOFROLLED ACCEPTABLE SOILS OR COMPACTED J. MATERIALS AND METHODS OF CONSTRUCTION SHALL CONFORM TO THE APPROVED RULES AND STANDARDS FOR MATERIALS.TESTS.AND STRUCTURAL FILL COMPACTED TO 95X MODIFIED PROCTOR DENSITY,AFTER REMOVAL OF UNSUITABLE MATERIALS.BACKFILL UNDER ANY PORTION OF REQUIREMENTS OF ACCEPTED ENGINEERING PRACTICE AS LISTED IN APPENDIX A OF THE MASSACHUSE TS STATE BUILDING CODE. THE BUILDING FOUNDATIONS SHALL BE COMPACTED IN 6'TO B'LIFTS OF 95S MODIFIED PROCTOR DENSITY. 4. THE CONTRACTOR SHALL VERIFY DIMENSIONS AND CONDITIONS RI THE FIELD PRIOR TO COMMENCING WORK.ANY DISCREPANCY BETWEEN WHAT 6.THE STRUCTURAL ENGINEER ASSUMES NO RESPONSIBILITY FOR THE VALIDITY OF THE SUBSURFACE CONDITIONS. IS SHOWN ON THE DRAWING AND ACTUAL FIELD CONDITIONS SHALL BE REPORTED BACK TO THE ENGINEER IN WRITING BEFORE PROCEEDING WITH ANY WORK. 1 7.NO FOUNDATION OR SLAB SHALL BE PLACED IN WATER OR ON FROZEN GROUND.SUCH FOUNDATIONS IOR SLABS PLACED IN SUCH CONDITIONS S. OPENINGS THROUGH THE FRAMING AND FOUNDATION MAY NOT BE SHOWN ON THESE DRAWINGS.THE GENERAL CONTRACTOR SHALL EXAMINE WILL BE IMMEDIATELY REJECTED AND REQUIRED TD BE FULLY REPLACED AT NO ADDTIWNAL COST OR CONTRACT TIME EXTENSION. HE T ARCHITECTURAL AND MECHANICAL DRAWINGS FOR THE REQUIRED OPENINGS AS HE SHALL PROVIDE ADDITIONAL FRAMING AND RDNFORCINC '1 STEEL FOR OPENINGS WHERE REQUIRED. SHALL VERIFY THE GENERAL CONTRACTOR SHA VERIFY SIZE AND LOCATION OF OPENINGS.ANY DEVIATION FROM THE B.ALTHOUGH GROUNDWATER ISSUES DURING CONSTRUCTION ARE NOT EXPECTED TO BE AN ISSUE,THE CONTRACTOR SHALL PROVIDE ALL OPENINGS SHOWN ON THE STRUCTURAL DRAWINGS SHALL BE BROUGHT TO THE ENGINEER'S IMMEDIATE ATTENTION FOR REVIEW. SUFFICIENT MEANS OF SITE DEWATERINC,AS NECESSARY,TO ENSURE FOUNDATIONS AND SLABS ARE PLACED AS SPECIFIED. 6. DESIGN VERTICAL LAVE LOADS 9.FOUNDATIONS SHALL BE DAMP-PROOFED OR WATERPROOFED AS SPECIFIED BY THE ARCHITECT. ,I ROOF' 10.STRUCTURAL'FILL:IMPORTED STRUCTURAL FILL MUST BE FREE OF ORGANIC,FROZEN,OR OTHER DELETERIOUS MATERIAL AND CONFORM TO THE -FIRE ESCAPE:100 PSF GRADATION REQUIREMENTS OUTLINED BELOW.STRUCTURAL FILL SHOULD BE PLACED IN LOOSE LIFTS NOT EXCEEDING 12 INCHES THICK FOR WIND LOAD: SELF-PROPELLED VIBRATORY ROLLERS,AND 8 INCHES FOR VIBRATORY PLATE COMPACTORS, STRUCTURAL,FILL SHALL BE PLACED WITHIN THE -ZONE-S: EXPOSURE-B FOOTING-BEARING(1H:1 V)ZONE AND BELOW ALL SLABS. " WIND SPEED(3 SECOND GUST): 120 MPH SIEVE SIZE STRUCTURAL FILL'(PERCENT PASSING BY WEIGHT) 7. THE FOLLOWING ASSUMED SOIL PROPERTIES HAVE BEEN USED FOR THE FOUNDATION 8' 100 UNIT WEIGHT OF SOIL 120 PCF 3' 70-100 -SOIL BEARING CAPACITY: .5 TONS/SF 3/4' 45-95 ULTIMATE FRICTION FACTOR: 0.45 NO.4 30-90 MINIMUM SUBGRADE MODULUS: 250 PCF N0. 10 25-80 - N0.40 10-50 y 8. WORK SHALL CONFORM TO THE DRAWINGS AND SPECIFICATIONS AND SHALL COMPLY WITH ALL APPLICABLE CODES AND REGUUTDNS.PRESENT NO.200 0-12 IN WRITING TO THE ENGINEER.ALL CONFLICTS BETWEEN THE DRAWINGS,SPECIFICATIONS,AND APPLICABLE CODES AND REGULATIONS,FOR 'NOTES: THREE INCH MAXIMUM PARTICLE SIZE WITHIN 12 INCHES OF SLAB GRADE RESOLUTION BEFORE COMMENCING THE WORK. IT.CRUSHED STONE SHALL BE%*ANGULAR,WASHED STONE(NO FINES)OF LIMESTONE OR GRANITE QUARRY.COMPACTED TO ACHIEVE AN " EQUIVALENT OF 957E MODIFIED PROCTOR DENSITY COMPACTION. + !` DEMOLITION AND DISPOSAL NOTES STRUCTURAL STEEL NOTES ,1f 1. EXISTING METAL FIRE ESCAPE AND CONSTRUCTION MATERIALS WHICH ARE REMOVED SHALL BE 1OOX RECOVERED AND PROPERLY DISPOSED 1. STRUCTURAL STEEL ROLLED SHAPES SHALL BE NEW STEEL CONFORMING TO THE FOLLOWING ASTM DESIGRATIONS: OF BY THE CONTRACTOR AT NO ADDITIONAL COST TO THE CONTRACT.THE CONTRACTOR SHALL SUBMIT AN EXECUTED CERTIFICATE OF DUMPING FACILITY'IF SO REQUESTED BY THE OWNER OR ENGINEER. ASTM A36 ANGLES,CHANNELS,PLATES AND MISC.FRAMING MEMBERS. UNLESS OTHERWSE NOTED 'T 2. DAMAGED TRIM AND SIDING SHALL BE REMOVED AND REPLACED IN KIND (MINIMUM YIELD STRENGTH FY-36,000 PSI). 3. CONTRACTOR SHALL ADEQUATELY AND COMPLETELY PROTECT ALL ADJACENT PROPERTY AND BUILDING CONSTRUCTION DURING THE WORK. ASTM A992 OR A572 WIDE FLANGE BEAM SHAPES Y ANY DAMAGE TO THE PROPERTY.BUILDING,OR SURROUNDING ITEMS AS A RESULT OF THE WORK SHALL BE REPLACED OR REPAIRED BY THE (MINIMUM YIELD STRENGTH FY-50,000 PSI). `! CONTRACTOR TO THE SATISFACTION OF THE OWNER AT NO ADDITIONAL COST. - C ASTM A325 BOLTS USED FOR CONNECTING STRUCTURAL STEEL MEMBERS. 4.SUFFICIENT NETTING OR OTHER MEANS OF SAFE DEBRIS COLLECTION SHALL BE MAINTAINED BY THE CONTRACTOR DURING OEMCIJTION. 1 PROCESSES. ASTM A307 GR.'A' -ANCHOR BOLTS AND LAG SCREWS UNLESS NOTED OTHERWISE. i j 5. CONTRACTOR SHALL PROVIDE NECESSARY MEANS OF PROTECTION FOR THE BUILDING TENANTS AND THE PUBLIC.INCLUDING TEMPORARY COVERINGS.BARRICADES,WARNING SIGNS AND TAPE.ETC.DURING THE COURSE OF WORK. 2, STRUCTURAL STEEL DETAILS AND CONNECTIONS SHALL CONFORM TO THE STANDARDS OF THE CURREN;AISC SPECIFICATIONS FOR DESIGN. i FABRICATION AND ERECTION OF STRUCTURAL STEEL FOR BUILDINGS. 1 SEAL 3. WELDING SHALL CONFORM TO THE CURRENT STANDARD OF THE AMERICAN WELDING SOCIETY(AW.S.).SHOP AND FIELD WELDS SHALL BE MADE BY APPROVED CERTIFIED WELDERS. 1 4. ELECTRODES FOR FIELD AND SHOP WELDING SMALL CONFORM TO ASTM A233(CLASS 70).WELDS N07'SHOWN SHALL BE AWS MINIMUM. 1"OF WELDS SHALL DEVELOP THE FULL STRENGTH OF THE MATERIAL BEING WELDED.SUBMIT WELDER CURRENT CERTIFICATIONS TO ENGINEER FOR - pAU APPROVAL PRIOR TO STARTING WORN. a L.ROCR. HELLE m 5, SPLICING STRUCTURAL MEMBERS WHERE NOT DETAILED ON THE DRAWING IS PROHIBITED. - pVI f Na.4i%0 B. DURING THE CONSTRUCTION PHASE IT6 THE RESPONSIBILITY OF THE CONTRACTOR 70 PROWOE NECE35ARY,TEMPORARY SHORING AND 90",.9PO�erE P`W BRACING TO MAKE THE STRUCTURE STABLE AND PLUMB BEFORE COMPLETION OF CONNECTIONS. s4To AL 4v 7. TEMPORARY BRACING SHALL NOT BE REMOVED UNTIL THE STRUCTURAL FRAME IS PROPERLY SECURED TO THE LATERAL LOAD RESISTING ' I ELEMENTS IN THE BUILDING. , 8. SUBMIT SHOP DRAWINGS TO THE ENGINEER SHOWING SETTING PLANS,ERECTION PLANS,DETAILS AND SIZES OF MEMBERS INCLUDING .��. CONNECTIONS.STEEL FABRICATOR IS RESPONSIBLE FOR FINAL CONNECTION DETAILS AND DESIGN IN ACCORDANCE WITH THE MINIMUM REQUIREMENTS OF THE LATEST EDITION OF THE 0.1.SC.DETAIUNG MANUAL Li y 9. UNLESS NOTED OTHERWISE STEEL SHALL HAVE TWO COATS OF RUST-INHIBITIVE PRIMER PANT.TOUCHe UP WELDS.SCRATCHES OR SCRAPES IN PAINT AFTER ERECTION 10. WELD STEEL CONTACT SURFACES(OTHER THAN BOLTED CONNECTIONS)WITH A CONTINUOUS W.-INCH MINIMUM WEIR,UNLESS OTHERWISE SPECIFIED. 11. TORCH CUTTING OR HOLE BURNING IS NOT ALLOWED,NO EXCEPTIONS. W y a V. a SGTB AS NOTED a } DESIGN BY 9 - NTB DATE 05/05/2017 16 � DAAVM BY NTB 1i CHE(7KBDBY P121., S-100 PERMIT SET t "NOT FOR CONSTRUCTION" PRO BCPNU OF SHEETS «77 CIS)14.00 I I • 1 2 •,3 4 5 10 2- 2- COASTAL engineering co. i8B OwReny ry.BNM 6 MA D2653 ••�`v NM]3SE100 F (E)CONC.FOOTING TO REMN - - 1'-8' 3'-B-' •I 10.-1� ' E)L7x3x'4 COLUMN(TYP) J E)LONG.STEP - 4'-0' Z B IXISTNG DECK TO 1` 2'-Y •�. ., •I REMAIN t DECKISBELOW•I •I I TO REMNN + I -1 (^C — — — — E)EGRESS FIRE ESCAPE TO E)CMU CONC. BE REMOVED AND REPLACED BUILDING FOUNDATION j 1'-B' D (E)CONC.FOOTING TO REMAI �n E)I NDOW WELL i E%Mp V RAMP TO t I REMAIN (E)COLUMN BEARLN •1 o j I •C - RTO REMNN i o DIRECTLY ON CONC. (TYP) L 3'-4$' SEAL I I 1xaF a UROCNE (E)GOING.SLA c - - I CIVILj 4'-0' ,� No.9SM ^ A sSl N EYG EXISTING FOUNDATION PLAN EXISTING COLUMN LAYOUT PLAN. EXISTING SECOND FLOOR EGRESS FIRE ESCAPE PLAN Z SCALE:y,•=,,-0. 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(STING FOOTING •� I' •i REMAIN (TYP) I r�� I I D Y II I 2'0 DIA.SONOTUBE II I L3x3xY•4 GALV.CNEVR _ 1 FOOTING W/M91 - BRACNG BELOW EMBEDMENT OF 4'-0' / p )_ - - - - L3x3x)/4 GALV.SHELF I Ss 3.314 CALV. I Ss 3x3A4 GALV. m (TYP) 1 (r P) ,1 O E%ISTING 11PICAL BASE IZ I I R MAIro „ G I I I I •I — — —��— L3x3xY'4 GALV.SHELF ; 2'6 DIA.SONOTUBE SEAL '# FOOTING W/MIN n 4'-10' L-I E EMBEDMENT OF 4'-0' �wa PAU o R. 55 3x3xj'4 GALV. O E InROCH w(TYP) 1 G CIVIL LLE 1 IN -30 No.45.560 6 4- ti PROPOSED FOUNDATION PLAN PROPOSED COLUMN LAYOUT PLAN PROPOSED SECOND FLOOR EGRESS FIRE ESCAPE PLAN PROPOSED COLUMN LAYOUT PLAN SCALB:y,'-1'-0' SCALB:y•_1'0• SCALE:�'�1'-0" SCALB:y•-I''0• � W RIDGE------ - -- -- ----------------------- ------ - 4 V -----,� �\�- --- 1.4 1-y •I �L E)WINDOW TO BE USED 1'V -Iy AS SECONDARY EGRESS V a I . w w PERMANENT CA CED LE N ' THIRD FLOOR OPENING TO THE NEW .-.......-_ - 3m�l REPOSED THIR iL00 kLAN NDIG L3x3%Y4 GALV.BR ACING �� p' a - 14T O RI f3--4• R O 9 W O sECEND ROOR O ti 3x3xj'4 GALV. `� SC CHEVLRON BRACING AS NOTED a DuIGNBY NTB . 4 r._. .......-- - ------, -- _ _ O DATE 8I �— LJ1Jxj'4 GALV.SHE BI OS/0$/2�17 - N55 3x3xy4 GALV. DRATYNBY Q _ COLUMN(TYP)_ I: 9.5 _ ' Nm I CHBCR"BY 6� I ..1 PRL a — — — (2)CBx11.5 GALV. , STRINGERS , FIRST FLOOR /. -------- ---- ------------- --- SONOTUR BEYON --L3x3x}V44 GALV.SH °i• O 2 01 qq PROPOSED ELEVATION PERMIT SET ONOTUBE FOOTING PER PLAN 10P 3 SlR'E19' � � "NOTT FOR CONSTRUCTION" PROJECT,NO. c)s))a.00 I