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0105 STEVENS STREET
�a •'tr,;r�, F.�.*(A�.., r t �� 0 _'ate � � - � \„ 1 ` ' Vim ,ram, ... .:::: —— — ... I — ,. —, .. . , :': . .. --.J: .1 �'1. I — I , :!:,::: —.1 .. ....-.....:..:.:.:-.1".'--..:-.1...:.p�.::'..-'.-:..'-':.�..-.*:..:-:-:.:::�-::.-.p.:.1:..::'."I'I.�I:'.�..--:.:-..:.::.-I:: —.:..:.....I::.' I.....I�1...,.'...�..\1I..II-....I.1.. �-,I�.....I 11.::1.:;:1:-.--:.1:. hI..i....I:.1� , usetts',.:':-q.�;.-.:...:De'partment of Environmental.Protection' �-I.":--:-�..w.:..:'::.-...:::.:..-:.:..:..;w:..:..�:.-p:..:k:�::..: -,:.:�::::1.;..-:..:.1*!-—:1.:...;b-:.-..�I.-�-:. .. . IP :':..��-;,:".:.:.::...:::..:.::!..:.I:....:,:1.�Y:.-1..:.-.."..'.:-1:!�.:.,:.-�-'�—:-:,.:::�'.:. : '�:�e.:...:I�1:1.:::.:1..::�:p1.:.-'.�-I::.:.: .:.-..:--��.::..�:' :,-.:..:.:..1�,.:� I.:.f.-:.'.:l;.::..:�.b.:.:.�l:....��;::�..'.:'.I Il::....:.I.1::.. . - .-- �-�- . :.::q::::-::: ' . . 1 : Dr. --F:::::'l...j:—...1. �........::::::::...:�;:'. 0 —::4:::::�—.. —.....�. � — .... � I I . ,. .' , —q::.::::p:: : .. . .. 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AQ q6 ConstructionNemolition Notification Size of File:: 243s K Status of Transaction::' in Process. C :: Date'and Time Created "1y2 %2o16.12 1ss2:PM .. Note This fi-fe only includes forms that were part of your aransacti" .was of the date and time indicated abov If YO..::: u need - a more current copy of 100r ira6saction,,feIurn:to eDEP-and . select_to "Download a Copy" from the Current Submittals page: I. NBEEP Ll .. ; ::, ... .. . .. . . . __ . . . . .. _ . . i .. ... .... .. Massachusetts Departmentof 6nvgonmental Protection Ll BWP AQ 06Pr FoNotification Prior to'.Constfuettonor Demolition ... .. 1: 1" Thrs is a revision to an:wdshng;form ''Project ID for e)dMng form to be revised, .,.. .. C` This fob is being conducted under a Blanket Permit MassDEP assigned Blanket AuthonzaUon 1D .. �..�.. _. r-` Thrs.job is being conducted under a Non Traditional Abatement WorkPracUce Pennrt: . Massl?EP assigned Nort.Tradrtional Work Practice--A tl ID SNT164;; C None ofthe above conditions apply;tenerate a new form . i 1. .... i .. .:.. .... .. .... t ).'f .. ... .. .. ... 3: .... ':i.' .: ... .. .. . ..: .... .. , .. . J. J i - .. a r Revised 1 1 713/20 13 Page I of I k: y' .... _ .._ _.._....__ _. .. ......... .. . __.... _ __ . . _... ..._ _ . . _... _. ._ _.. __ ..._ ._. ._.._..... _......... __ .-.. ..._... ......_.... ::::::::: __ _ ... _. _. . _.. .. 1. Massachusetts Department''of Environmental Pro'tectlon loozs69s3 BWP AQ 06 ^ -- 1.. Notification Prtor t ' C - fi,,:ctlori`or Demolttton Asbestos Pro,eet (' r`Project Reyision T iProjedEancellation A.A ,phcab ljty A"Constru...11.or.Demolition operation of an industrial commercial,or mslitutional building or,residential . bwiding with 2. or more units is regulateq;by the Department of Environmental Protection(Mass)EP) Bureau of Waste10; ,en io Air, list Di I i Q. ity:_.,sion under Regulations•31:0GMR 7 09:Notification of:Construdiion or:: Demolition operations is.required:under 31:0 CMR 7,09(2},ten(10j working days prior to any work being , , performed.The'foliowing information is regu!red pursuant to 310 CMR 7 09. .e 1 Is this a fee exempt notifcation,(city town,djistrict municipal housing authority,state facility,owner occupied. ' resid'erttlal property of four units or less)? , O a Yes r b:No 2 Blanket Permit Project Approval;if applicable ; A nova I. . PP 3 Non= .rad►tional Asbestos Abatement Work Practice Approval,�f applicable - $NT1606g1 iD :.. Instructions; Approval ID# B. facility 1)' Hption :: s 1 Ail sections of this ,.form must be 1; Facility Information completed m:order to,: 4 HYANNIS FIRE STATION r 1�,STEVENS.STREET comply wdh the - a Name of facility; - b Street Addrass Department;of Environmental. HYANNI$ im 026010000' - 617A295100,„:• Pcotect�on C.City/Town d State e.Zip Code f.Teieptwne notficatwn -. .:. .... _. :. requirements:of 310 PAULGRIFRN OFtVI:: CMR709 g F,661ilyContadPerson h Faality:ContadPersori;Ti& A M 2 Submit 0'r trial 6174295100 !9 :: PAUL(a�CMS M,MM !N: Forth To: i Facaiitiy Contad:Peison Telephone ! Facility Contact Person Email Commonwealth of Massachusetts k Facility Size P.O.Box 4062, _ . Boston,MAb2211 4700 ', F. 1. . : 1 Squefe Feet ; 2 Number of Floors _. .. Id btp Use,Only I Was th6.5W6.. built prior to 1980? 1, l:Yes r 2 No _. . : ,:::� m Describe the current or poor use of the facility : Date Received FlRESTATION : �,:. p n is the fadiity a readenUal_facdity? (-1 y r 2o.No o lf,yes how.many units? 8 ii �.. ". - ..1, :J .:: 2 Facility Owner: r Same address as Facility . - HYANNISFIRE OiSTRICT 95 HIGH SCHOOL ROAD DffENSION - v:: . .l a Facill Owner Name b.Address:;.. r ..-. .. .' ,fiAYNNIS. MA 026010000 5067751300 : ' c City/Town " d.,State , ::::R o.e f.;Tel,phone : .:: _. _.. _. -.: '3 Facil>ty On Site Manager/Owner i?epresentatt a p Same contact:person as facility :: Same address as facility 1 :Same address as•owner PAUL GRIFFlN 270,MAIN STREET a On Site ManagerlOwner Representative b:Address . :: . :: M1MRLBOROUGH'. MA 01'752 61742951001 c CityJTown d.State, e:'Zip Code f.Telephone a.. . I—— :Revised 03/17J2014: .. .I .. . .'k ,: . __.. ,i�: ....-.. ..-...:-. :. . _.:.:. , iF, ad o e is ii: ii: ., .. .,: n .:,.! .. :, :: ... :. ,.. ... r ...:... .:"Y: ...... ... .. .... .... .. ... .. ......_. .. ': . 1. 1. ..:. ... .....: st ,: .: . ._ . . . _ . __ ..._. . . . .._ . . . . . . . . . _ . . . . . _. . . . . . . . .. _ ._ _._ . __ _ _ _ _ . . _. ... . _ _ __. _ . __ _.. ._ . _ __ .. .. .. .. . _ _ .. .__ .. _. __ . .._ _ _ . ._ _ 1. ._ . __ __. _ __ ....... .__ . . . .. _. _. _ . . .... ... .. . .... _ _ _ _ --_.. . ._. _. _. _. . . _ . 1.Massachusetts Depa ftmenY of Environmental Protection - � P A Ob 100256953 .. ,' . Asbesect.# Notifcation:Prior tb Construction or Dem6h io.n _. :: y , Prgp#e-Revision :: r.PrajectCahoellation C. General Project . chpt><on. _ .. . _. . .. . .- . L.This project is r" New Construction rJ:Demolition r. Renovation 2.Project Dates ,,: :. 1,2/27MI6 1f31/2017 a Project Start Date(MM/DDlYYY17 b:Protect End Date(MMIDD/YYY� . . I G"eneral Contractor, . SOUT}iERNA�DDLESEXINDUSTRiES.:: 5 823P1F�45ANTSTREET a Name b Address:. ., . NORWbOD MA: 620620000 7817699316 . : a CiWT 0 >d.•State e.`ZipCode :: f Telephone . . MICHAEL F1; NCIS Z819297075' ,.. , - g General Contractors On-site Manager/Foreman h.Telephone y: :. . _... _ _, .. ...: .:. 4 Construction or demolition contractor ( Same as:General Contractor SOMERN MIMi ESD 4!N US t8.. 823 PLEASANT STREET . a.Contractor Name `,:; . b.Address : :, NORVIWOD..A:::: .. _ . MA :.. 020620000 I:i 7817699310 s :: :E c cityRown d State a:Tip Code ::: (.Telephone . -: . MICFtA(1FRANCIS 71319297075>: ,_:' " r g CansI M...9n and Demolition On-site Manager h.Telephone _. $ Licensed Construction,Supervisor . >: ... ... .: MICt1AEt FRANC$ .,;: :: ;:". ::: 083584 a.Supervisor Name _., b Construction Supervisor license(CSL)Number .: } . ::i. :,, is the entire faciiity to tit demol Sheds i�a Yes r b.No .. !` - ,' ... i ::. .: 7.]b i— b. the are to be deri1o11shed . .. . -- FORMER'FIREST9110NBUILDING ,:, . . _. ... .: 4: L ;8 Describe the buildings)or addifion(s)to`be constructed,...._ : p`t _... .::.... .. k :::: .: .:. 3 :: 4 9 a W..ere the stivcture(s)sutveyed for the>presence of AcUestos-Co ntaining r 1 Yes IW 2 No, Ivlatenal.(ACM)?: ,: , . b Who conducted the survey .. UNIVERSAL ENVIRONMENTAL CONSULTANTS AI30673 1 Name of Asbestos`lnspector 2..DLS Geitification# :' Revised.03/17l2014! t Page 2,of 3 .. II ... .. .. . ... .. _' Massachusetts Department;of En�ironmt ntal Protectton 1Q0256953 AQ o6 . As: bestos?rotect,# No 1—-.....—. tor to Cons.'truct�on or Demohtian r' project rtevision . " ,I .,. . Project Cancellation . . r" . . _ i C. GeneraI Project Descr><phon (continued) . 10 a Was asbestos contairmg material{ACM)founds 2 No . :: _. __ . l Yes t— Diener,I b:If ACM was found during the surveys please provide t}a Asbestos ioozsss52 statement,;tf Notification Firm(ANF)Project'Nurnber asbestos is fiound during a Construction . For demolition and construction protects,1paJq#t dLstsuppresston techniques to be used o�Demoli6op R operaUon,,ali; r a.Seedrngll�i b Wetting c Co,,p ng�" d ..." -g (� a Shrouding - t responsible.pardes" , r. must comply::with 310"! r f Other -Specify ": CMR 7 00 7,09 715, eW.Chapter21E of . the"General Laws of 1.2 Is this an FI..R ,cy pemotiti,n Operation r a Yes: C"b:No the.Commonwealth , ,REY F7NNEGAN- This would include •' - 0~Name of MassDEP Official who evaluated the emergency but would,not be IimiEed to filing an . ENVIRO*h NTALANALYST . asliestos:removal notificaUori:with the d Title.. - ' Depaitinentand/or a 19/16/2016 r SAW16 388 n..-.1 of a Dafe,of Authorization(MM/DDNYYY) f Megpg Waiver Number ;release/threat of -,:.. . - ; . release of a ; CeiftlflCat1011 hazardous :::: - substance tothe Department 'if. °i certify that I have personally SANDY MACKINNOPI .l applicable `examihetl the foregoing and am 1.Print Na rid: ` familiar-with the'Information SANDY MACKINNON contametl in thls;documerit and p•Authonzed Signature: all attachments°;and that;based r ori.m in ui , those" ADMINISTRATNEASSISTANT ".;• Y, q ry ;individuals irnmadiately 3.PosiUonfFitle responsible for 66t6mtng the SO!JTHEk4MIdDiES INDUSTRIES ir>fonnation I believe thatahe a Representing inforrnation is true,accurate,and 12l21/2018 '::'I complete.I am'aware that there 5 Date(MM/DD/YYYY) ,are significant penalties for submitting false information 083564 including possible fines and 6.P;E# 'imprisonment'Th6:'Uhdersigned :; hereby'states under,the . - penalties of perjury,that l:am : :: :>aware`that this permit ._ application or notification shall not be'deemed valid,unless _ payr.,:ofthe:apphcabiefeeis p made. . . f., itev►sed 03/17/2014'; Page 3'of 3 I — .:, . I Ll .11-1.11......I.........:.....I...11.1...I.....-.....,:. .":::::::�;:, ::,::�::::::::;:::-:::::::::::::::::.: .::.:� -, .. —.::,;..... .—.� .... ............... ....... ., N. .. ::. .. .. ... ::. :::::.....::..................:'.. eDEP-MessDEP'S.OnlineFilingSystem '• 12/21/16,12:18 PM MassDEP.H me (:Contact Privacy Policy MaSsDEP`s Online Filing Sy§tem Usemame'.CSMITH Nickname?SOUTHERN MIDDLESEX INpUS7RLES,INC: My eDEP Fortes My Profile Help l�otifrcatins C Receipt,1 J • �4t4).;n' $19l> �'. Receipt; SutnmaryI eceipt f printreceipt• Exit Yoursubmisslon is complete.Thank you for. using DEP's-.online reporting system You can select."My eDEP"to see a list of your transactions. DEP Transaction ID:�890822 Date•Wand Time:Submitted: 12/21/2 612 '12:53 PM Other Email DEP`Transaction ID:,;890822 Date and Time.Submitted: 12%2.112016.1212:53 PM Other Email Form Namet AQ 06 C;onstnuction/Demolition Notification Form Flame AQ 06 Constr'uctlon(Deinaltlon.Notification Payment information DEP'code Date Amount {$): Payrnenf Detail My eDEP. MassDEP.Home J Contact Privacy Policy Ma;k0E:P s On1"' Filing Sysfem ve,r..12.28.4.0©261, MassD:EP I. httpsJ/edep.dep:mass gov/pageaMdrdRecelpt.aspx; Page 1 of I - 1 r Roma, Paul From: Deputy Dean Melanson <dmelanson@hyannsfire.org> Sent: Friday, September 23, 2016 1:54 PM To: Brunelle, Harold (Chief Hyannis Fire) Cc: Roma, Paul Subject: Re: Sewer 77 High School & 105 Stevens' Chief, I checked with the Building Commissioner. He will be looking for statements from the gas and electric companies that these utilities have been properly secured to ensure no electric or gas is on the lot slated for demolition. I spoke with Michael Gorenstein at the Water company. The demo contractor.must submit a"plan"to Hans Keijser outlining how they will properly disconnect the water utility. The water line must be shut-down at the curb box (this should already be done, documentation for the demo permit is $86.97 through the water co.) and then the contractor must get a road opening permit'and excavate the water connection at the main, shut-off the valve, cut and cap the pipe. The Building Commissioner will not be looking for a letter from the.WPC. You are correct that the contractor will have to arrange to have a witnessed cut and cap of the sewer line. I did not go to the WPC to get the specifics of where the capping must be done. Deputy Chief Dean L.Melanson Office 508-775-1300 Fax 508-778-6448 , dmelansonghyannisfire.org ' On Sep 22 2016, at 9:04 PM; Chief Harold Brunelle<hbrunellenhyannisfire.ore- wrote. Dep., We spoke with Water pollution Control about - disconnecting/capping.the sewer connections at both 77 High School Rd Ext and 105 Stevens St. They informed us that sewer connections are never shutdown. "Everything but". Please check this with the building commissioner. I don't want the project delayed because the building commissioner is looking for a letter from WPC and we don't, have one. Harold S. Brunelle, Chief Hyannis Fire Dept. 95 High School Rd. Ext. Hyannis, MA 02601 508-775-1300 1 z , r "Environmental . Envir nment 1 1 � n f z o a So u o s o the 21 Century" 'E a Y s _ . 823 Pleasant Street • Norwood,MA 02062 ' 781/769-9310 Fax 781/7.69-9775 SOUTHERN MIDDLESEX INDUSTRIES, INC. CA-, - November 21 ; 2016 -Hyannis Board of Healfh Attn: Health Inspector r 200 Main Street Hyannis, MA 02601 4 . h r . RE: t05}Stevens:Sfreef, Hyannis, R Dear Health Inspector, Please be advised that Southern Middlesex Industries, Inc. will be. Y engaging,in demolition and asbestos.renova#ion activities at the above. referenced project. This phase will commence approximately on November 21, 2016, andehd approximately on January21.,,2017. All appropriate state-and federal agencies have been notified. you should have'an If y y questions, please do not hesitate to contact th is . office. Yours truly; Sandy MacKinnon Bid Coordinator /�/\ j,R � f.IP �� ����� ���� i �� � � ���� � U' I � � k„ "Environmental Solutions of the 21s'Century" } 823 Pleasant Street • Norwood,MA 02062 781/769-9310 Fax 781/769-9775 SOUTHERN MIDDLESEX INDUSTRIES, INC. o e NO CA October 12, 2016 Hyannis Board of Health Y Attn: Health Inspector 200 Main Street Hyannis, MA 02601 RE: 105 Stevens Street & 77 High School Road Extensibns y Dear Health Inspector,„ Please be advised that Southern Middlesex Industries, Inc. will be engaging in demolition activities at the above referenced project. This. ; phase will commence approximately on October 25, 2016, and end approximately on November 8, 2016. All appropriate state and federal agencies have been notified. If you should have any questions, please do not hesitate-to contact this office. Yours truly, i Sandy MacKinnon ". Bid Coordinator a \ .1 'TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map— Parcel 6 9 Application �j A Health Division Date Issued /2_7 1? Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Str et Address Village Owner Address Telephone — — Permit Request ) 44- ' _e J I �fi m LA Mild Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. I Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDEft OR HOMEOWNER) Name ' d phone Number Address oor PJ / 1 icense#/ K J) Home Improvement Contractor# Email I M&��<c Od a a— Worker's Compensation #�E,831 ALL CONSTRUCTI EBRI RESPLTING FROM THIS PROJECT WILL BE TAKEN TO �nAnlu 6 M�Af SIGNATURE DATE ��� FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING t DATE CLOSED OUT ASSOCIATION PLAN NO. ��ie� v� # i o` Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-005867 Construction Supervisorh TIMOTHY PEARSON P.O.BOX 519 CENTERVILLE MA 02632 CA-- Expiration: Commissioner , 1111212017 I Ile Commonwealth of-Vassachusetts DVarftaezit af1'rrr ayftid Accidents ' - "`� Offir.e af.i'm.w. igadons . 600 Washiriebu Street ._ Baston,MA 02111 rt on nnas .gavfilin '"rarkers' Ca>mapensatian Insurance Affidavit:Buildei-s/Cuntractors/Elecfri,cianslP'Iumhers Applicant Inf6rmatinu Please Print 'bI NSr73.e(Susineemloiganfin ionffnEvsdnal) ' city/sf te/ R t I Phone u + Are you an employer? a the appropriate b�: Type of project{required}_ 1. I am a employer with 4 ❑I am a genetical contractor and I * liar*e]ire the subcontractors . G. ❑I+te�r co�fiuctsozz . employees(full ar<dfor ar#-fiime�- • , �..El I am a sole proprietor or partner- ship listed o4 the attached sheet I ❑Remodeling and have no employyees. These sub-contractors have g_.,kDemolition x workingg forme in any capacity- employees andbare wodcers' t5`_ 9. ❑Building addition [No`L"or�' camp,insurance comp_tnsurancel required-] 3-❑ We.area corporation and its 10-❑Electrical repairs or additions - 3.❑ I aura homeowner doing all work officers have exercised their 11_❑Plumbing repairs or additions. self. o workers' fight of exemption per MGL 2 �' [N F- 1�.❑Rnofrepairs ,. .. insurance required-]i c.152,§1(4h and we have no employees.(No workers' 13-❑Other camp.insurance requited_) *Any appbcautthatche&sboxrlmnst also M out the section below shuvdngflipkv des'compensation PerryiafarM uaa I Homeoame-s who submit ibis affidat*hdkxtng they are doing aU work and then hire outside contractors nest submit a new affidavit indicating such , ZC7bntrwtm that cbea This b m=mast attached an addibonat sheet shovdng the name of¢be suircaatrzctors and state whether or not those entities have employees.Irthesut-contmctmshave empIcyees,theymustpmv-ide their workers'comp.policy number. lam are entpIoyer that' pr,�Fd' workers'caerrperesafi�xrt insurance for�r}*entpTay�ees Betoav is thR policy razz jots ste information. Insurance Compaq Nance: Policy,4+'or Self-ins_Lic_ DyirationDate. �U Job Site Address_ Citylstatel,: V 1lz O . Attach a copy of the workers'compensation policy declaration page(shoving the policy mimb and expiration date) Failure to secure coverage as required under Section 25A of MGL c_ 152 can lead to the imposition of criminal pena%es of a . fine up to$U00.00 andlor one-year imprisonment,as well as civil peualties.in the form of a STOP WORK ORDERand a fme of up to$230.00 a day against the violator. Be adtdsed that a copy of this statement maybe forwarded to the€flffice of Investigations oftbe DIA for insurance coverage verffication I rfo Fe eh rla tirRprrirrs trrrdperrahFies ofpeer}fliatf7ee infartsecrtiorr prm-'rl�d abowv is true and correct Sumature. Date: Phone;k Offl cal use only.' Do)tat mite in At&area,to be winpleted by city mar town offidat City or Town: Per itUcense 5. ' Issuing Authority(circle one): L.Board of Health 3.Budding Department 3.Qgltown Clerk 4.Electrical Inspector S.Phtml mg Inspector 6.Other Contact Person: Phone#: — —------ - - - 6 Information and Instructions . Massachusetts Geheral Laws chapter 152 mgaires all employers to provide workeas'compensation far their employees. " PMM=ttD this stye,an mIayee is&fa ed as."..every person in the service of another under any contract of hire, express or implied,oral or w " . An.employer is defined as`pan individual,part amsh�p,association,corporation or other legal entity,or any two or more e a-oint e and including the legal sepm atafives of a deceased employer,or the o€the foregoing ngaged J mtr, its , to rece or trastee of an individual,partnership,associafion or other legal.entity,employing eral7 y ees. However the r�r owner of a dvmMag house having not more than three apadments and who resides therein,or the occupant of the - dwelImg house of another who employs peon to do mahteaaance,coust<action or repair work on such dwcMag house or oa the grounds or building appvrtenantthemto shall not becanse ofsach employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or low licensing agency shall withhold the issuance or renewal of a Ecease or permit to operate a business or to construct bindings in the commonwealth for any applicant who has not produced acceptable evidence of compliaucewn the insurance,coverage regnired." Additionally,MGL chapter 152, §25CM states"bTeither the commonwealth njor any of its political subdivisions shall enter mto any contract for the perfmanauce ofpubho work until ar c Ttable evidence of compliance with the i„ z-an ce. requirements of this chapter have been presented to the contacting arbhorlty:' Applicants ' Please fll oi± the Workers'compensatibn affidavit completely,by che61cing the boxes!hat apply to your situation and,if necessary,supply sob-contractors)name(s), addresses)and phonenumber(s).along Vath their cm`bfr-ate(s) of insurance. Limited Liability Companies(EEC)or Li cafe Liability Partnersbips(LLP)with no employees other than the members or partners,are not required to carry woikcrs' compensation insurance. If an LLC or LLP does have employees,a policy is regnu-ed Be advised that this affidayit maybe submit[ed to the Depatment of Indu_sfrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit The affidavit should beretmmed to the city or town that the application for the permit or license is being requested,not the Depar(m.ent of „ ,striai Accidents. Shouldyou have any gaesdons regarding the law or ifyou are required to obtain a workers' compensation policy,please call the Department at the n=ber li_st!:d beIov. Self-tinned companies Should enter their s elf-i„sora ce license number on the appropriate line. _ City or Town Officials Please be sure that th'e affidavit is complete and priced legr ly_ The Departmenthas provided a space of the bottom of the affidavit for you to fill.out in the event the Office of Investigations has to contact You ngaz ding the applicant Pleas e b e sure to fill in the permittlicense number which wM be used as a referemcr nambvx..In addition,an applicant that must submit multiple pennitllicens5 applications in.any given year,need only submit one affidavit indicating cmrent policy iafbmation(if necessary) A and under"Job Site ddress"tie applicant should write"aII locations in (cry or tDwn)_'A copy of the-affidavit that has been officially stamped cr marked by the city or town maybe provided to the . applicant as proof fiat a valid affidavit is on file for futnre'permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permRnot relatE d to any business or commercial V&ntu-0 (i.e. a dog license or permit to buns leaves etc.)said person is NOT required to complete this affidavit The Of 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 caM The Dep tmenf address,telephone and fax nunnber. - 'j_ 6 C_ammanWe�attir of Massachutfs - Ilegart went(if llidustdal AQP-UeutE� 600 WashiV Il Sit Bastua,MA G� I I I T(,-L 4 617 727-4900 Qxt 4€6 or I977-MASSATE -727 77� F ��Z� _ Kevised 4-24-07 �Q��dia z ,a, C�%w YrJnriiiunrur;�r�/�r�C?J�lrl�rrc�iutr.</l� .� . Office of Consumer Affairs&Business Regulation License.or registration valid for individual use only rt before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR >; Registration 100871 Type: Office of Consumer Affairs and Business Regulation Ex iration :6&i4 018 Private Corporation 10 Park Plaza`=Suite 5170' p m Boston,MA•02116 MARKWOOD CORD TIMOTHY PEAR SOW 4A ib 110 BREED'S HILL ROAD UNIT 10 HYANNIS,MA 02601 Undersecretary Not valid without signature '4 R CERTIFICATE OF LIABILITY I NS URA NC E PATE'.tMM!oD1YYYYj THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND-CONFERS NO RIGHTS UPON THE.CERTIFICATE HOLDER 1,6 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,:EXTEND OR ALTER'THE COVERAGE.AFFORDED- BY THE POLICTHIS IES BELOW. 'THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSU.1-BY)', AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT. If the certiftrate holder is an ADDITIONAL INSURED,the:policy(ies).must.ba endorsed. If SUBROGATION IS WAIVED;subject to tertifi at and.conditions of, policy;.certaln policies May nwilre.an..endorsement..A statement on this±certificate>does not conferrights to the' certificate hoidtir in lieu of such endorsement(s):- PRODUCER; . CONTACT SULLIVA.R GARRITY&DONNELLY INSURANCE AGENCY; INC. NAME: Mary Connor , PHONE (AIC.Ng''E , (508)453-2586 FAx" E-MAIL A/C No i 1046 MAIN ST. ADDRESS: mary.connorl)sgdins.com OSTERVILLE INSURERS AFFORDING MA 02655 COVERAGE " N 41C " INSURED INSURER A: LM IN6 CARP 33600, MARKWOOD CO`RP INSURERS INSURER C,: 110 BREEDS HILLRD UNIT 10 INsuREitD: HYANNIS I INSURER E: MA 02601 INSURER F: COVERAGES CERTIFICATE NUMBER- 58973 THIS:IS TO CERTIFY'THAT THE POLICIES OF INSURANER- CE"LISTED BELOW HAVE BEEN ISSUED TO.THE,INSUREDENAMED,ABOVE VISION FORTHE 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 OTH HEREIN IS SUBJECT EC ALL THE TER_ HIS EXCLUSIONS AND.CONDITIONS OF'SUCH:POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED CIE:: S INSR. ADDL BR LTR TYPE OF INSURANCE POLICY EFF POLICY EXP COMMERCIAIG.ENERALLIABILITY PdUCYNUMBER MMIDDMW; MMIDOlYYYY LIMITS CLAIMS-MADE OCCUR EACH OCCURRENCE' D AG E PREMISES:Ea occurrence . .'$. MED EXP(Any one person) g N/A . GEN'LAGGREGATE LIMIT APPLIES PER: PERSONAL&ADV INJURY. S ' POUCY PRO-, GENERALAGGREGATE.. $ JECT LOO OTHER:- PRODUCTS=COMP/pPAG.G s" AUTOMOBILE LIABILITY 5 COMBINED SINGLE LIMI, ANY AUTO: Ee acadenl $. ALL OWNED SCHEDULED BODILY INJURY(Per person) $ AUTOS AUTOS:.. N/A, BODILY INJURY(Per accident) "$ HIREDAUTOS NON-OWNED AUTOS PROPERTY DAMAGE § Peracadent UMBRELLA LtAB' - $ OCCUR EXCESSLIAB CLAIMS-MADE N/A. EACH:OCCURRENCE g " DED RETENTIONS AGGREGATE. g W,ORKERS'COMPENSATION $. AND EMPLOYERS'LIABILITY PER. OTH- ANi PROPRIErOR/PARTNERIEXECUTIVE Y/N X STATUTE ER A OFFIC(Mang RIMEMBEREXCLUDED? NIA NIA NIA WC531SM967.4046, a6/I)f/2016 06/06/2017 .E.L.EACHACC108NT g '100,000" (Mandatory In NH) If yyes,desrnbe under. E.L.DISEASE-EA'EMPLOYE" g. "100,000 DESCRIPTION.OF'OPERATIONS below _.. E.L.DISEASE-POLICY LIMIT '$ 500000 N/A DESCRIPTION OFOF RATIONS 1 LOCATIONS/VEHICLES(ACORD`.101,Adtlltlonal Remarks Schedule,may be attached If more space Is required) Workers.'Compensation benefits'will be paid to Massachusetts employees only..Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured.hires,or t.as.hired"those;employees outside of Massachusetts:. This:cedificate of insurance shows the'policy in force on the date that this certificateWas•issued(unless the:expiration date on the above policy precedes the issue date of this:certificate:of insurance). The-status of.this coverage-can be inonit0red daily by.accessing the Proof of Coverage. Coverage Verification $earch:tool,at www.mass.goV/Iwd/workers-compensationfinvestigations%. CERTIFICATE" HOLDER. CANCELLATION, SHOULD ANY OF THE-ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED."IN TOWN.OF BARNSTAB.L_ E. ACCORDANCE WITHTHE POLICY PROVISIONS. 200 MAIN; T. AUTHORIZED REPRESENTATIVE HYANN18 MA 02601 Darnel M.'Cro�v)ey;CPCU,.Vice.President—Residual Market.--WCRISMA ©1988-2014 ACORD CORPORATION. All rights reserved. AGORD:25(2014/01)'. The ACORD name and.logo are registered marks of.ACORD RC__"RD° MARKW-1 OP ID MC CERTIFDATE(MMIDD/YYYYj LIABILITY INSURANCE 061071.2016 • THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATI 1CATE OF LIAB CE AND C RTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENDYEXTEND OR ALTER:THE TS UPON THE OVERAGE AFFORDEID BY THE POLICIES -THIS BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN'THE ISSUING INSURERS};:.AUTHORIZED. REPRESENTATIVE OR.PRODUCER AND THE,CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED the,po}jcy(ies)-must be end'orsed.'If SUBROGATION"IS WAIVED,subject to I the terms and conditions of the policy;certain policies may require an endorsement: A statement on this certificate does not confer rights t o the Certificate holder In.lieu of such endorsement(s). -PRODUCER CONTACT -PRODUCER Agencies-Osterville NAME: Fredericks Insurance PHONE FAX 1046 Main"Street Arc No E:c:508-42868999 ,,x : Osteru lie,MA 02665 E-MAIL " ADDRESS: INSURERS AFFORDING COVERAGE NAI6# INSURED Markwood Cor INSURER A:NAUTILUS I.NSURANCE.CO. pora tion 110 Breed's HIII Road Unit 10 INsuRER;e;: Hyannis,MA 02601 INSURER.c: .INSURER D INSURER E:. INSURER F:, COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE-LISTED BELOW HAVE BEEN ISSUED TO THE.INSURED-NAMES'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 LIMITS7SHOWN MAY HAVE`BEEN REDUCED BY PAID CLAIMS. INSR D B - LTR TYPE OF INSURANCE SD POLICY NUMBER -POLICY EFF POLICY EXP MM/DD/YYYY MM/DDIYYYY wrts A X 'COMMERCIAL GENERAL LIABILITY _ CLAIMS=MADE OCCUR NN45481.9 :EACH OCCURRENCE $ 1i00Q,000 04/23/2016 04/23l2017 I1iCiE RENTED PREMISES.Ea occurrence $ 100;000 MED EXP,(Ahyone person) $ 51000 GEN'L AGGREGATE LIMIT APPLIES PER PERSONAL:&ADV,INJURY $ 1,000,00C R: , POLICY D JEC LOG GENERAL-AGGREGATE $ 2,000;00 OTHER: PRODUCTS-:COMP/OPAGG AUTOMOBILE LIABILITY' . $ COMBINED SINGLE"LIMIT $ ANY AUTO Eaaccident ALL,OWNED SCHEDULED BODILY INJURY'(Per person) $ AUTOS AUTOS BODILY INJURY Per accident. $ NON-OWNED • ( ) HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA uAB OCCUR $ EXCESS LIAB EACH OCCURRENCE CLAIMS-MADE $, DEO RETENTION$ AGGREGATE" WORKERS COMPENSATION - AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE "Y'/N STATUTEH PER ER OFFICER/MEMBER EXCLUDED ❑ N/rA (Mandatory In NH) E.L.EACH ACCIDENT $ If yes,describe:under- E.L.DISEASE-EAEMPLOYEE $ DESCRIPTION.OF OPERATIONS below , E:L.DISEASE-P.OLICv i m g DESCRIPTION OF OPERATIONS(LOCATIONS/VEHICLES (ACORD 101,:Additlonal-Remarks Schedule;may be attached If more spaceds required) General Contractor CERTIFICATE.HOLDER CANCELLATION TOWNBAR SHOULD ANY OF THE ABOVE DESCRIBED.POLICIES BE CANCELLED BEFORE TOWn`Of Barnstable THE EXPIRATION DATE' THEREOF, ,NOTICE. WILL :BE DELIVERED IN 200 Maln Street' ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©'1988-20 ACORD CORPORATION. All rights reserved. 'ACORD.25:(201`4/01). The ACORD-name and logo are registered marks of ACORD .. i Town of Barn9table Regulatory Serces Richard V.Scali,Director. Building Division r Paul Roma,Building Commissioner, i 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403$ Fax: 508-790-6230 Property Owner Must � Complete and Sign This Section If Using A Builder i { Y,.' l�asOwner o I e subject pxoperty C_ f � hereby authorize l act,on my behalf; in all matters relattiae to work authorized by this building permit application for. .(Address of Job) . **Pool fences and alatrns are the responsibility of the applicant, Pools a:re not to be filled or utilized before fence is installed and all final 4 nspectioias are performed and accepted. � I Signature o ez Signature"of Applicant A Print Name t•145.m.(0 f Print Name bate` QiFORM&OWNMERMISSIONPOOLS E 6 smi CONTRACTOR NUMBER 61762 {. , y PROJECT DIG SAFE NUMBERS 1 5 T'EV NS STREET, n 2.016440 v .7. .. 77 HIGH SCHOOL . AD, EXTENSION . , -9706' f "Environmental Solutions o the 21 st " SKI f ntur� f123 Pleasant Street•Norwood,Mtn 02062 781,769.9310 ®Fax 781.769.9775 NOTIFICATION . ..E BUILDING DEMOLITION This letter is to serve as the required legal notification that our company, Southern Middlesex Industries, will be demolishing the structure located at 105 Stevens Street Hyannis, MA.' Per 7WCMR. 112.0 Demolition of Structures; subsection 1:12.2 we are required to provide notice to adjoining property ` owners. The demolition of the structure will start no sooner than 11.14.15 and will be completed by 2.1.15. Questions regarding this work can be answered by contacting the Hyannis Fire Department @ (508) 7754-300 nationalgrid November 15,2016 Hyannis Fire District 95 High School Rd, Ext Hyannis,MA 02601 To Whom It May Concern RE, 105 Stevens St,Hyannis This letter is to confirm that we have cut back and abandoned the gas service at the main for the,property above. Additionally,it was found that there are no other gas lines on the property to be excavated. I can be reached directly at 508-760-7484 should there be any further questions. . Path eon :. . nationaigrid Sr.Sales Rep.—Complex Gas Connections 127 White's Path S.Yarmouth,MA. 026,64. 508-760-7484 desk r 508-400-5051 --cell 508-394-1109-.fax „ patricia.weldon�national�id.cam . 4 r. e i One NkAR Way Westwood,MA 62090 ENERGY Sep 23, 2016 ; Hyannis Fire District 95 High School Rd. Hyannis , MA 02601 RE: Disconnect electric service 105 Stevens St, Hyannis MA Eversource w/o# 2150005 Dear Deb, Your request to have the electric service disconnected at 105 Stevens St, Hyannis -has been completed as'ot 9-23-16. Please call me if you have any questions at 508-790-9021. Sincerely, Eversourc Department of public Works 47 Old Yarmouth R& Water Supply Division P.C.Box ass t Hyannis,MA.KASIL 02so1.4326 TEL.,508••77 63 Hyannis Qatar System Operations FAX Boa."048'93 October 5,2015 Town of Barnstable Building Inspector ° Town Hall Hyannis,MA 02601 Re: 105 Stevens Street—Account# 605347—Map/Parcel# 309-272 Dear Sir: Please be advised that the above water service was shut off at the curb stop and meter removed on September 23,2016. The owner has informed us that they are demolishing the building. If you have any questions,please-call the office at(508)775-0063. Sincerely, tertarck Hyannis Water System E u ivo s l° nvironment i consultant January 12, 2017 Mr. Todd Costa Kaestle Boos Associates, Inc. 325 Foxborough Boulevard, Suite 100 Foxborough, MA 02035 Reference: Asbestos Abatement and Demolition Project r w Hyannis Fire Station-105 Stevens Street Dear Mr. Costa: Thank you for providing Universal Environmental Consultants(UEC)the opportunity to serve your environmental needs: All accessible,visible and known Asbestos Containing Materials (ACM) at 105 Stevens Street have been removed by the asbestos contractor per scope listed in the asbestos remediation section. Please do not hesitate to call our office if you have any questions. Very truly yours, Universal Environmental Consultants Ammar M. Dieb President UEC:\216 277.00\Clearance Letter-House,DOC 12 Brewster Road Framingham,MA 01702 (508)628-5486 gyp;', 5t 0 ` Massaclhusetts.Deparfrnent of Environmental Protection; ':; .:, , .. , . :. Here is the:file you requested for your records ? �' fl To retain a copy of this ale you;i. - I sage and/or print :N Y . . - . . 5: . .. _ . . _ .Usernarne:: ci:V ITH Transaction ID ssos22 Document;;; AQ OS ConstructtonlDemolition Notificafian. 1S�ze of File. 243.6IK' . . .. . Status of;Transactton: :: „.. to Process :; Date and Time Created;: 12'21/2016.12 16.52`PM ; Note ;This He only includes forms that were:part of your.' . ransaction as of the date and time indicated abode If you need . a more current copy of your transaction, return to eDEP and 1 . select:to "Download a Copy from the;Current Submittals page . -1 _. .. .' -- : : r , :� : Y .. . . . . ... .. <. ., . - .. :. :: .. .. .. ,. .. z.. �.... ..... .. ::: .. .... .... :. ... ..: .. ... ..::::. ..:::.. :. 1::: . .�;: ::: ::: .:: .. .... � ..,.. ,.,: .. :::C.. ::. :: ..:: :::: ... .:..: ... .. .: ::.t:. .. : ... ::: .. ... . .. ... .. .. .. ... .. :: :: :: .. .... ... ... ?: ...::: :?:' ... .::: '. .:: ' q. ..., ..,. .. -.. 3.' ::: :.. :: :: ?,':: A .. Sf .. .._. k :.. .. :: ::: r .. .... .. ..- ..,. ... .. .. X r.... ..... .. ..'G . 4. ... ... ... . ... .... -. ... _ Massachusetts Department of En�ropiriental Protection P A 06:]Pre Forlm: Notification rior. o Constfd. ion or Demolition t`:'. This is a revision to an existing form Project ID for.existing form tote,revised. r` This j9b is being conducted under a Blanket Permit.F Y :MassDEP assigned Blanket AuthorzaUon ID: (✓ This job is bung conducted under a Non Traditional Abatement Work;Practice-:Permit MassDEP assigned Non Traditional Work Practice Autt orzatiot ID SNT16064 r _ ..... .._. . None of the above coridihons applygenerate anew fl " ... .. .. :. .: ...... .. ... . i 4 a .. .: .. ... .. .. ..:': .. .. 1 k 5- .. : Y :: r. .. .. .. Y 4° : .:: ::. �c Revised. 1 l/13/2013 Pagel o.f 1 _.. ... .. k w :Massachusetts Department of Environmental Protection; loozss9s3 B ' A( 06 Noticatton Rrior.:.;I._.:9.::��,..,,:991.:....7�.:r:I1::11I..:.:.::,::�...I:..:C!,:_.:.9:.:::,I.I':d.:�,."..�..:9::1'.1 1.:,..1_::::.�1.:.�99,. o Construct>on or Deraolitton Asbestos Project# t' r. Pole t .:: r c Revision Project'Cancellation • . : A.Applicabl>tty , A Construction'or Demolition operation of an industrial commeraal or institutional building or residential building,with, or more units is,rt3gulated by the Department:of Environmentai!Pratec- (MassDEP),Bureau of Waste:Prevention Air Quality Division under Re ulations 310 CMR 7'09 Notification`of'Construction or 9 Demolition operations is required'under310 CMR 7.09(2}'ten(10j working days prior fo,any,work being performed The followingAnformat'ian is required pursuant to;310 CMR 7.09. 1 is this a fee exempt notficahon,(city town,district;municipal housing authority,state.faciltty,owner occupied t .... residential property of fotir idd ,or less) :`: +{7 a.Yes r b' No - j. ..: .' Lrr . .. . -.. 2 Blanket Permit'Project Approvaij. applicable ,:: Approva .: 3 Non'Tiv itional Asbestos Abatement Work Practice Approval,if applicable - SNT1ti� :ID _ .,.._.... _......_ _._.. _...... .... :::: -. d. ... . . .. .. ... ..Approval iD,#::: instructions B ...Ad! ty Descriptton 1 All.sections of this form must be 1. Faciltty Information completed in order to HYANNIS FIRE STATION �. 105 STEVENS STREET, :... comply month the a Name of facile b,Street Addt®ss Departme.nt;of. b... Erivironmentai HYMN '` .. i MA-:: . 026010000 6174295100,' Protection _., c CityfrOK" d.State a Zip:Code' f.Telephone r:notification requirements of 310 PAULGRIFFIN OPPA i:. CMR 7.09 g Fac lity Conta Person h.Facility Coat fPerson:7itle .. .. 2 Submit 0iiginai 6174295100 PAUI(c�CMS M0.COM ,: Form To. i Facility"Contact Berson Telephone 1 Faa ity Contact Person Email Common..wealth of,';; ._ Massachusetts k Facility Size f' P 0 Box 4062: : 366166.NIA 02211 4700 .: 1 ._ . 1'Square Feet ::: 2,Number of Floors Ma sDEP Use Only 1 Was;the facility built prior to 1980� 1 .y'es 2 No m Describe the current or prior use ofahe facility Date Received . FIRE STATION .. ' .. ... .. n is the fadiity"a residenUai;facility? (-1.Yes- r%2.No I.'If yes,how.many.units? ,: ::'. _ 2: Facility Owne: r Same address as Faciltty ::: ,::: .: . HYANNIS FIREDISTRICT 95 HIGH SCHOOL ROAOEXTENSION C a Facill.ty Owner.Name -r b Address :': ..: '.r .. „ HAYNNIS MAp 026t)10000 5087751300 '. . ` c City/Pown d State a Zip Code f.`Telephone 3 Facility On Site Manager/Owner Itepre, ntattve r Same:contdct,p.erson as'facttity. : " :: Same address as facility.. .. , 1 Same address as owner i. - PAUL,GRIFFlN 270.MAIN STREET __.. .__...__ .........._:... . .. . . ;;:: a On-Site Manaijer1oW60 Representative .'.;' ::: b:,Address MARL.SOROUGH`: ' 'k ` MA 01752 6174295100.., t : c CN/rown d State a Zip Code f.Telephone r I Revised '03/17/2014. W . :: " ....:..... .. .... 4 Yt ... ':. .": . ....... ... ..::: .......... a i L .. Page 1 of3 :: . .. : :: .. . . ... .. .. ._.. . . $: Massachusetts Department of Environmental Protection 100256953 ��Vp' 06 - r Asbestos Project# Not] it: lon i?rior to Construction or.D'emolrtton - "r Projeot Revision :: _. . : r;:i Project;.Canoellation . __ .. C. General.Pro act lDescr>t t><on . , . J . ' A � . .,. ... : I This, rti ect is r.' New Construciton . _...P.. .. _:;v. .._.._.. rJ:;Demolition r...Reriovahom:. ._ ... . _ ..... I Project Dates .. .. 12/27/2016 . . . . 1'f31/2017 a Project Start Date(MM/.P.. ,,� b.;Project End Date(MNUDD/Y_ 3;General:Contractor ;i . SOUii ERNMIP[ESEXINAUSTRIES: *",; FA: ,7 ::REET : a Narrte : .. b.Address_. NO., 0 MA 020620000 7817699310 c CitylTown d.,State 'e.ZipCode , `f,Jelephone.. . . . :, .. a .. .. .a -:: .-.:.: :: MICtfAEL FRAJJCIS 7819297075`-. g General Contractors On=Stte.Manager/Foreman h.Telephone .. ;; ,4 Construction or:demolition contractor ?Same as General Contractor SOIJ MNMIDI)LE INDUST, M.:;. ,.. ..; ... 823PtEASAN7STREET ~;,a:Contractor Name ; . b:'Address NORVLOD MA;; 020620000 ;l 781,7699310 , a CityFfown d Sfate e.Zip Code. :: f Telephone :: : ;. MICtiAEt FRANGIS Z819297075.:` , . :. .:: "5 -.. .. :: .... g Construction and Demol Ifpn On-site Manager„ h Telephone:;:. . w S.Licensed Construction.Supervisor . M O.O&FkMCIS 083564 : . a.Supeivisor Name b.Ganstruchon Supervisor,Ucense(CSL)Number. . 6 Is the entire facility to b�demol shedry r Yes �'".. N: M - 7 Describe the areas)to a e demolished .. FORMER FOE SFATION'BUILDING , -' .: .. . 8 Describe the 6utlding(s)or addltion(s}to:be constructed ; .::: , : 9 a W..ere the structures):surveyed for the presence of Asbestos Containing; we t.Yes r 2.No . : .. 1Vtatenal;(ACM"�: ;,; b UVh:o condiacted'the surveys . YNNERSAL ENVIRONMENTAL CONSULTANTS AI30673 :i 1 Name of Asbestos inspector. ZDLS;Certiftcatton#. . ._. .. .. ... ... .. e ,I:r .. : Revised.,0.3/1,7/2014' Page:2 of,3' _ ... ::: : Massachusetts Department of Environmental Protection jpp25695'3 B� A 06 i Asbestos:Protect:# Notification Pnor to Constructtoti or Demolition r Project Revision! . :: ..a'', i ',. f Proje . nceilation .._: . - C General Project-Dl6giptl n (cont>inued) 10 a Was...I .1 ...containing material(ACM)found? r I,Yes T—2.'No G,enerai b.If ACM was found during the survey please provide the Asbestos 100256952 ' statement 'tf Notification F.iirm(ANF)Project Number asbestos is fdund la For demoht on and construction ro acts �ndioate dust,su resston techm ues to be used during a,Construction..:: _ P J pp _......_ G or Demol�6on, opecabon all r a Seeding b Wetting (. c Covering( d Paving ( e:Shrouding : F responsible parties " must wmply wtth 310'. j f Other -Specrfy CMR 7.00�7;09 715,. x ' +.: i :: and'Chapter 21 E of : the;Generai taws of 12 Is this an Emergency Demotitjon OperaUon0 Y : (�a Yes: h`b No . .. the Commonwealth ,JEFFREY INNEGAN This would include but w' 'id,not' c Name o.M. ''u mciai who evaluated the,emergeni y limited to filing an ENVIRdNMENTAtANALYST :asbestos removal d Title notiftcation with the :: y-: -. Department and/or a ;,< 11/16J2016 SAW16 388.: notice of a Date:of Authorization(MMlDD/YYYY) w f MassDEP Vlrarver Number releaselihreatiof .... . release of a : ]�. Cert�fieat><on .... :hazardous : substance 4oahe . Department,if "I certify that l have personally SANDY MACKINNON r.. appficabie exarilineii the foregoing and am 1_PdntName familiar with the information SANDY MACKINNON - contained in this document and 2 Authorized Signature' all attachments and that based ,on rrmy inquiry of those ADMINISTRAI NE ASSISTANT ;individuals irnmediatei 3.PosiUon/fitle : y. :: responsible for obtaimng`the SOiJTMERNNNDOIESE)CINDUSTRIES ,information I believe that the 4 Representing i`inf I .....I.. Is'true`accurate and complete lam aware that there 12l21/20t6 are si `nificant. enalties for 5 Date(MMJODIYYYI), 9 p 0t33564 subrnitting false information ' :.: .s including possible flnes.antl RE#6 . +( : impnsgnment;Tl e•undeisigned, .. .' . hereby.'states,unifier the : .. .. `.:penalties of;perjury thaF:iam : - aware'ttiat this permit .:application or notification shall :` not be',deemedvalid.unless r _. _. payment of the appitcable'fee Is made." :: . ... ;:. . .. .... ... .. ... _ :: . .. . _ _ .. ... ... _ .. Revised:p3J17/2OI4' i.' Page 3'af 3 i . ..... ... ::. .. ... .... :. .. ..... .. .... .. ..-. . .. ... I.... .. :.. ..: .. . -:.'. :: ::: . :: .. ...-:. ... ....... ..:::.: ..... ....... .. ........... ..... ... .. . .. .:: .... A:: ... .... -... ... .11 . .. ... ... .. ... ., ..%:: . .. :.... ..(:' ... :. _ .. . .. .... .0 :. :.... ::: .. .. .... .. .. :. ': ... .. : f eDEp-MassDEP's;Qnlinefiling�System " 12(2171.6 12:19'PM MassDEP;Home; (;Contact; l Pnvacy Policy MassDEP'S Online Filing System` Username.CSMITH' Nidcnamer$oUTHERN MIDDIESEX.INDUSTRIES,ING: •' My eDEF Forrn's My Profile Help N tif Ica tiio is [,Receipt .. ............ . Forms- nature. Receipt SummaryLRecelpt _ - &t receipt- Exit Your-submissidn,is complete Thank you for using DEP's online reporting; system You can select"My eDEP"to see a Ilst of your transactions DEP'Transaction lD. 890822 Date and Time Submitted. 12/21/�2'Ul6 12 12.53 PM` Other Email DEP Transaction ID. 890822 Date and Time Submitted: 12i 11201612'1 5'3 PM' Other Email Form Name AQ 06,.Construction/Demolition Notification Form Name AQ06 ConstructionYDernQltion Notification Payment lnformatian DEP code `Date Amount ($)` Payment Detail My'-eD P " ' MassDEp Home' Contact Privacy Policy MassDEP s Oni,ine Filing System-ver.i<2 28 4 0©201:'.Mass D;EP hrips//edep dep:mass gov/Pages/FBnlRecelpt.aspz Page 1 of 1 �sessor's Office(1st floor) Map 3 tq Lot Permit# Cord fiW_ _J"rflbar`Y Date Issued of ealth 3rdyfloor)(8:30-9:30/1:00-2:00) .040__vP�J Fee /ov cep engineering Dept.(3rd floor) House#A /O�- �INE,� De ' 'five P n Approved by Planning Board 19 "' s639•�� f0 MAC TOWN OF BARNSTABLE Building Permit Application Prol treet Address A S Village Owner L C Ydre- 2- , f/ �a 2 Telephone C - U ` 2 3151 Permit Request _p Ao, .S t r,4 t k vra/ L ,Oa"t #.;a , `�0 0 DQ h CIS if aC 0- i 0r Total 1 Story Area(include 1 story garages&decks) square feet Total 2 Story Area(total of 1st A 2nd stories) - square feet Estimated Project Cost $ Qe. r Lov -- �� Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM-THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE h /7S BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) - FOR OFFICIAL USE ONLY _ PERMIT NO. #7508 DATE ISSUED June 27, 1995 MAP/;PARCEL NO. 309.272 , ADDRESS 105 Stevens Street VILLAGE Hyannis, MA 02601 OWNER New`Hope Community Baptist Church DATE OF INSPECTION: j FOUNDATION FRAMEr INSULATION FIREPLACE i } ELECTRICAL: ROUGH FINAL i PLUMBING: ROUGH I FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT # , ASSOCIATION PLAN NO. 'Asse..or's..,. ap and lot..number ...a... .. ... ]G SEPTIC SYSTEM, MUST BE INSTALLED IN C OMPLI Sew' e.Permit number .... WITH COMPLIANCE..... . .t1 SAS�ITARY ICLE II STATE 4 - OF-TNETO r A CODE AND TOWM TOWN OF BARNS , i BAHHSTODLE, i "f "A ` t OUP BUILOING . INSPECTOR CE e� , x Y: APPLICATION FOR PERMIT TO ......BUILD„ENCLOSURE < r r z' TYPE OF CONSTRUCTION ......W.QOD.... .............................................................................................................. ...................... ............19�'� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .............1.05„STEVENS...STREET, HYANN.1S.,...NSAU........Q2FQ.1.............................:................................ ProposedUse .............. NTRANCEWQY.,.................................................................................................................................. Zoning District ...........Fire District : . " ;!.. ................................... Name of Owner KOtCOT...Brow il.�.Ung,....13,C•,,..Address .1.05:..Bt.evens...St......Hyannd.&.....Ua..•••••• Name of Builder .Xt...DW&r.IQ.....................................:.Address ..1.05..St.evP-ri�...St..,...Ii�ran.ni�,....AQ�.,...... Name of Architect .............. ....Address ............................................ Number of Roor*PNE.0 ------ ...- 1.........................................Foundation a........4441--lo . .................... Exterior .............�9hingle...-...�( ood..................................Roofing ha1,t....Shiia le.................................... Floors ...............QQMejat.................................................:......In'terior ....Waod..................................................................... Heating ...........NONE.............................................................Plumbing ....NONE. ................................................................. Fireplace ..........NONE. ...........................................................Approximate Cost .:.... $U©. p©...................................... ______19_______. Area ..300 S FT Definitive Plan. Approved by Planning Board ---------------__________ .....�dQ........................ Diagram of Lot and Building with Dimensions Fee /. ' SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules`and 'Regulations of the 'Town of Barnstable regarding the above construction. Name .................................................................................. Kotcom Broadcasting, Inc, No „18480 ' • add to commercial Permit for. .................................... buiididg r;�.��...:....... :',. ............. = i _ ,• - � • Location ...........1....05' Steve....ns...Street......:...................... ' ............ Hyarinf s....................................... = Owner Kotcom Broadcasting, Inc. ......................... .............. , Type of Construction ........frame.....................r............ ..i - •, • . - 4 ........................... ................................................. S Plot ............................ Lot ................................ —Permit Granted .......... Jun....24........,.......19 76 Date of Inspection ...... .............................19 7 Date Completed •.......�C. J.� :.......19 -7 t:7 PERMIT REFUSED .........................: ................................. 19 ........................................ µ M .......................................•'................ _ ........ •... • r ................. ................................ .......................... ................................................ I n Approved ................:................................ 19 ........................... ................................................ _ c YAssessor's map and lot number ........ ...._... .... .. .. ....... Sewgge Permit number ......::.. r. *THE TOWN OF BARNSTABLE i HASBSTADLKABL E, i 7 079. N T OM gPY�'' UJLDI G INSPECTOR 0 - t ' ' APPLICATION FOR PERMIT TO .,,,,BUILD..ENCLOSURE.............................:................................................. T+ TYPEOF CONSTRUCTION ..... '? ............................................................. .................................................... 3 .19� TO .THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............105 STEVENS„STREET., HYA:R)g: .S......1.�A.���a .......??6()i.............................................................. . Prdposed Use .............. NTRANCEWAX ................................................... :............................................................................ T Zoning District ........... .,...J� .........................................Fire District ...... st.>._SI /; -4-'" ................................... " ' . Name of Owner KOt om... n': .��,�?kdp ;�?p , ..Ix?t�'.....Address . !.5 meinp.Rte . �t.. 1T� A,�f�rnnr. „ ........ ..... Name of Builder M.... X' Q........................................Address y I, Name of Architect .............Address ' - � _ -- Number of Room ?f p ...fA -- — . ................................. Exterior S}� na1P — i�Tn c...................................Roofing ......................... Floors ................ . ..............................................Interior ...Bunn!#............................................ HeatingcaNF.................................. ...............~.....Plumbing ....*,n,.r ................................................................. Fireplace .!........r?IMP..............................................................Approximate Cost �� n�*n .�1.�?..............:.... .......... i .. d' Definitive Plan Approved by Planning Board ---------------_---------------19________ . Area A00. SQ FT Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �� . Name ............................................••.................................... , . / Kotcom Broadcasting, Inc. A=309-M' commercial18480 add to ^ ' ` . . � ' ^76 ` ^ . ^ , . Permit ' ' Date of ~~.. . . . . . . . ' . . ' //MT.REFUSE � - ^ ' . -------^�^-- lg , . ' � , . � _______—.,. �nn—' �~ ---`------- -- _------------.. � ^ . � � .'--v --Yv ~—'~—^--^—^---^—' ................. ____. 1« .. � Approved ................................................ 19 ' ---------------~--'--'~—'—^—'' ` --------------------...--.,..`. � ' / a ''s r 1 ' r � ' ' ,/f//// ����6 ~��/`.r - _ _ T`f!"``/`�,ram j. •'t: I , i 1 111 a I ! i ' ; • a I � i t t t 1 • ^ - i 9 '�_�+__ 4 _.�.. •1. L. .. � i. ;. I:. . t` F _ �.. �. t t ' ? , • .ABNB[ABi�. • The Town of Barnstable i6`3¢ � Department of Health Safety and Environmental Services +" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner I January 19, 1995 To Whom It May Concern: After reviewing the documentation concerning 105 Stevens Street, Hyannis, this office is of the opinion that a church use is allowed as a matter of right. Sincerely, Ralph M. Crossen Building Commissioner RMC/de � - 1 %d t� � � � t v � i R328 081 . LOC 0114 SPRING STREET CTY 07 TDS 400 HY KEY 244596., ----MAILING ADDRESS------- PCA 1051 PCs 00 YR 00 PARENT 0 FALANOA, ROBERT R MAP AREA 64AC Jv MTG 2012 114 SPRING ST Spi SP2 sp::3 UTI. t..J T'*,*;i! . 16 ED FT 2520 HYANNIS MA 02601 AY8 1920 EYB 1975 ODE 80 CONST LAND IMP 84600 OTHER 50C.) ------LEGAL DESCRIPTION---- TRUE MKT 106000 REA CLASSIFIED WAND 1 20, 900 ASD LNO 20900 ASID IMP 84600 ASD OTH 500 OBLDG(S) -CARD-1 1 04, 600 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE . 1 500 TAX EXEMPT' *PL 114 SPRING STREET HY RESIDENT"L 106000 10600) 106000 #RR 1516 012o OPEN SPACE *DL LOT 16 & 17 BLK A COMMERCIAl INDUSTRIAl EXEMPTION',3 SALE 12/88 PRICE: I ORB 6555/142 AF0 1: A LAST ACTIVITY 09/10/92 PCR Y