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0320 STEVENS STREET (12)
[3::2:0:�STEV �NS�SREET `- Gbh F Town of Barnstable 0 Building Department - 200 Main Street * EARNSTABLE, Hyannis, MA 02601 9�A 6 A,�� (508) 862-4038 rF0 MA't Certificate of Occupancy Application Number: 201202232 CO Number: 20120085 Parcel ID: 3080040OW ' ' CO Issue Date: 07/12112 Location: 320 STEVENS STREET F2 Zoning Classification: OFFICEIMULTI-FAMILY RESIDENTIA Proposed Use: Village: HYANNIS Gen Contractor: ADVANTAGE CONSTRUCTION Permit Type RC00 CERTIFICATE OF OCCUPANCY RES Comments` UNIT F-2 Building Department Signature Date Signed ` TOWN OF BARNSTABLE = '•� 1HE , BUTIU.Ing 201202232. STABLE, * Issue Date: 04/27/12 Permit y MASS. �A i639• Applicant: ADVANTAGE CONSTRUCTION -- '"- r rF�MAC ermit Number:`B 20120928 Proposed Use: Expiration Date: 10/25/12 [Location 320 STEVENS STREET F2 Zoning District OM Permit Type: SP PROJ RES ADD/ALT Map Parcel 3080040OW Permit Fee$ 570.53 Contractor ADVANTAGE CONSTRUCTION Village HYANNIS App Fee$ 50.00 License Num OT9925 g - er Est Construction Cost$ 111,867 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND t BUILD''OUTrUNIT F-2 CONDO THIS CARD MUST BE KEPT POSTED UNTIL FINAL i .ttiy.x )r, r s.,, 3 BEDROOMS INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: FLAGSHIP ESTATES HYANNIS LLC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: TWO ADAMS PL INSPECTION HAS BEEN MADE. QUINCY,MA 02169 Application Entered by: PR Building Permit Issued By: :THIS PERMIT CONVEYS,NO RIGHT TO OCCUPYANYSTREET ALLEY OR SIDEWALK OR ANYPART THEREOF,EITHER TEMP.ORARILY.OR PERMANENTLY•ENCROACHMENTS ON PUBLIC PROPERTY;NO SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BEAPPROYED BY THE JURISDICTION.`STREET'OR ALLEY GRADES'AS WELL AS DEPTH AND�LOCATION-OF PUBLIC SEWERS,MAY BE ; OBTAINED FROM THE DEPARTMENT OF PUBLIG.WORKS. THE ISSUANCE OF THIS PERMIT DOES NOTRELEASE'THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUB DNISION RESTRICTIONS. ,t MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). � f �r ' n 111 3 BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 P2 1 �Qpvol U?Vtlt,! 15 � �� 2 ll`cS� r lam— 2 rl � 2/w� i �6V D _ 3 �;� 1 Heating Inspecttion Approvals Eggineefing Dept Fire Dept 2 and He Town of Barnstable , Building Department - 200 Main Street BARNSTABLE. * Hyannis, MA 02601 MA 16 .-39SS.w a,��' (508) 862-4038 Certificate of Occup' ancy . Application Number: 201202233 CO Number: 20120087 Parcel ID: 30800400X CO Issue Date: 071.12112 { Location: 320 STEVENS STREET'F1 Zoning Classification: OFFICEIMULTI-FAMILY RESIDENTIA Proposed Use: Village: HYANNIS Gen Contractor: ADVANTAGE CONSTRUCTION Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: UNIT F-1 Z Building.Department Signature Date Signed �SNE� TOWN OF BARNSTABLE Building 201202233 * BARNSTABLE, * Issue Date: 04/27/12 Permit 9 MASS. QUA i639. Applicant: ADVANTAGE CONSTRUCTION rFG MAC A Perm>I�'t�Nu�mber:=B 20120927 Proposed Use: Expiration Date: rjO/25/12 d Location 320 STEVENS STREET F1 Zoning District OM Permit Type: SP PROJ RES ADD/ALT Map Parcel 3080040OX Permit Fee$ 606.23 Contractor ADVANTAGE CONS.1 U TION Village HYANNIS App Fee$ 50.00 License Num :'019925 } Est Construction Cost$ 118,867 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND BUILD OUT UNIT F-1 CONDO 2 BEDROOMS } THIS CARD MUST BE KEPT POSTED UNTIL FINAL L INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: FLAGSHIP ESTATES HYANNIS LLC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: TWO ADAMS PL INSPECTION HAS BEEN MADE. QUINCY,MA 02169 Application Entered by: PR Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO;OCCUPY ANY STREET:-AL LEY'OR-,,sibEwA LK bWANY?PART THEREOF;EITHER TEMPORARILY OR PEII ANt&TtY',.,',&CR&ACHMENTS ON,PUBLIC PROPERTY,NO SPECIFICALLY PERMITTED UNDER THE BUILDByG,CODE,MUST BE'APPROVED BY THE JURISDICTION.:'STREET OR ALLEY GRADES AS:WELL AS DEPTH AND LOCATION OF,PUBLIC SEWERS MAY BE - OBTAINED FROM THE DEPARTMENT OF PUBLIC:WORKS:-THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS:: Ix MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES �F�CON�STR L'I ION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NO TED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). N', BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 ��� � 2r 3 11—� C 1 Heati�g Inspection Ap vals Engineering Dept Fire Dept 2 oar of alt T j /Y tro Town' of Barnstable Building Department 200 Main Street BARNSTAB . : Hyannis, MA 02601 9 MASS 1639. (508) 862-4038 rFD MA'S Certificate of Occupancy Application Number: 201202231 = CO Number: 20120084 Parcel ID: 30800400V CO Issue Date: 071.12112 Location: 320 STEVENS STREET F3 Zoning Classification: OFFICE1MOLTl-FAMILY RESIDENTIA Proposed Use: Village: HYANNIS Gen Contractor: ADVANTAGE CONSTRUCTION Permit Type: RC00 F CERTIFICATE OF OCCUPANCY RES Comments: UNIT F-3 Building Department Signature Date Signed rn SINE TOWN OF BARNSTABLE ■ : ti B u _ ..: 201202231 BARNSTABLE, Issue Date: 04/27/12 Per M�_. 't 9 MASS. �A i639• �� Applicant: ADVANTAGE CONSTRUCTION rFQ .i A Permit Number: B .20120929 j Proposed Use: Expiration Date: 10/25/12 Location 320 STEVENS STREET F3 Zoning District OM Permit Type: SP PROJ RES ADD/ALT Map Parcel 30800400V Permit Fee$ 606.23 Contractor ADVANTAGE CONSTRUCTION Village HYANNIS App Fee$ 50.00 License Num �:.019925 Est Construction Cost$ 118,867 Remarks_ APPROVED PLANS MUST BE RETAINED ON JOB AND BUILD OUT UNIT F-3 CONDO UNIT PER PLANS ON FIRE !k THIS CARD MUST BE KEPT POSTED UNTIL FINAL 2 BEDROOMS r INSPECTION HAS BEEN MADE. WHERE A. CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: FLAGSHIP ESTATES HYANNIS LLC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: TWO ADAMS PL INSPECTION HAS BEEN MADE. QUINCY,MA 02169 Application Entered by: PR Building Permit Issued By: r\ "'`� \ y ✓ .THIS PERMIT CONVEYS NO RIGHT-TO OCCUPY ANY STREET ALLEY OR'SIDEWALKOR ANY PART THEREOF,EITHERTEMPORARILY:OR,PERMANENTLY.;ENCROACHMENTS ON PUBLIC PROPERTY NO SPECIFICALLY PERMITTED UNDER,THE BUILDING CODE,MUST BE APPROVED BY TEIE JURISDICTION ;STREET'OR ALLEY GRADES;AS WELL AS DEPTH AND�LOCF,TION.'OP'P CSEWERSMAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS, THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF°ANY APPLICABLE sUBI)IVISION` RESTRICTIONS.. � x MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED, 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. ,WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 op �-�-UA 2 2 2 v a 3 1 Heating Inspectio Approvals kngi4ering dept Fire Dept 2 a d of alth 71/rv- o� wDaZ_ g .. - ... .� tructur�i ER .he'er p,gr � . . hURUCTURA;L E+IN AFFIDAVIT FOR CONS., TRITCTI ONTI7OL, .. ' Donald O'Neill. Adva-049e Consti°tietioi�; Two Adarns:P"lace,.5uite•,I,,00 uinc MA 02169' Ra ;. Ilyannis Cni�dominiums " gii.dinb 700;Mam Street. llyanriis,111A PRO ECT NO.: hC#0569' PATE; April 4,2U12 To the Building C01-nmiSSlO1Tc.r:'' ln:accordance with Section 107.6 ot'.the Eighth dit"on of zlie Massai,--husetts State 3iu ldin� Gt�de,.this letter sha11 serve a, a Final Affidavit .... above rc to nccd.`buildn grand that tathe best:ofmy I how,1'edg�, the'provrsi�ns of. the b.Ulld nb code have been ..complied, with and ;the, area of work meets the: requirements:of the d.octnTle ,construction; !].CS. A. . � fi{Y Z L,ic #42868 ° ST1sysUbTURAr 012IG SIGNATURE. MASS RLG;NO: Stacy R° Flood;F'E i 6 Laurel Drive, Flucison MA 0174.9: TEL: (97:8') 562-C�499 FAX (.9:75} 56i27,246 r un %"Electric, Inca 15R Commerce Way,Norton MA 02766 PHONE 617-212-0344 FAX 508-285-4415 HANNON�ELECTRIC AFFIDAVIT OF COMPLETION I, Edward.T. Hannon, the undersigned, as the duly authorized representative of Hannon Electric, Inc. make the following affidavit under oath, with full knowledge that I am swearing to the truth of the following statements. • I am a duly authorized representative of said company,and have full authority to execute this affidavit and reaffirmation on behalf of said company • I hereby acknowledge that my company, Hannon Electric, Inc. has installed the electrical systems at Flagship Estates Building F, 320 Sevens St,Hyannis,MA. in accordance with all state building codes including NFPA 70 of the National Electrical Code. , • The terms of this affidavit shallsurvive the satisfaction of the terms of the Contractor/subcontractor agreement.-,,, x - Witness its hand and seal.dated this 271h•day of July, 2012 T 4 w Company: Hannon Electric, Inc . By: Its: Edward T. Hannon/President Subscribed and sworn to me this,- 3 day of 34j tj 2012 ' Notar Public , RODRIGUES Notary'Pubiic Cornmonwealth of Massachusetts - � my.Commission Expires May 17;2013 "Let Hannon do it!" FINAL �T CONSTRUCTION C®TTI JOHNSOt�! HVACtIne. CONTROL AFFIDAVIT Mechanical Engineers Name of Project: Flagship Estates—Unit F# 1 ' Project Location: 320 Stevens St Hyannis Ma ' Permit Number: 13201220804 • Nature of Project: HVAC Installation To the building commissioner of the city of Hyannis,Ma in accordance with Massachusetts State Building Code,I,Kev L Main,Registration No.20068,_being,a registered professional.engineer _ responsible for the following discipline(s): ENTIRE PROJECT ❑ ARCHITECTURAL ❑ PLUMBING ❑ MECHANICAL [j� FIRE ALARM ❑ ELECTRICAL ,❑ OTHER: In accordance with Massachusetts State Building Code;I,Kevin L.Main,hereby state that on behalf of Cotti Johnson HVAC Inc.,I have supervised the preparation HVAC Plans,Computations and Specifications for the above named project. To the best of my knowledge,information and belief,the construction of the trade(s)listed above have been completed to such plans,computations and'specificat'ions meet the applicable provisions of the Massachusetts State Building Code;acceptable engineering practices and applicable laws and ordinances ; for the proposed use and occupancy. Authorized representatives of Cotti Johnson HVAC,Inc.have been present on the construction site on a regular and periodic basis to determine that the work was completed in accordance with the documents approved for the Building Permit. s ' - s SIGNATURE Date:7/2/12. _ ;z s j .S 3 720 Washington Street,Hanover,MA 02339 Phone 781-331-4660 1 Fax 781-829-4405 s FINAL CONSTRUCTION CO TT 1�1�T S®N. VAC, Inc. CONTROL •. 'Mechanical Engineers AFFIDAVIT Name of Project: Flagship Estates—Unit F#2 Project Location: 320 Stevens St Hyannis Ma Permit Number: B201220805 Nature of Project: HVAC Installation , To the building commissioner of the city of Hyannis,Ma in accordance with Massachusetts State Budding Code,I;Kevin L Maui,Registration No.20068,being a registered professional.engmeeIr _._. responsible for the following discipline(s): ENTIRE PROJECT ❑ ARCHITECTURAL ❑ PLUMBING ❑ MECHANICAL FIRE ALARM ❑ ELECTRICAL OTHER: In accordance with Massachusetts State Building Code,I;Kevin L.Main,hereby state that on behalf of Cotti Johnson HVAC Inc.,I have supervised the preparation HVAC Plans_,Computations and Specifications for the above named project. To the best of my knowledge,information and belief,the construction of the trade(s)listed above have been completed to such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code,acceptable engineering practices and applicable laws and ordinances for the proposed use and occupancy. Authorized representatives of Cotti Johnson HVAC,Inc.have been present on the construction site on a'regular and periodic basis to determine that,the'work was completed in accofdance,with the . documents approved for the Building Permit. t SIGNATURE Date: 7/2/12 • z s' 720 Washington Street,Hanover,MA 02339 Phone 781-331-4660(Fax 781-829-4405 h FINAL CONSTRUCTION TT .O S N HVAC, Inc. CONTROL'. AFFIDAVIT Mechanical Engineers Name of Project: 'Flagship Estates—Unit F#3 Project Location: 320 Stevens St Hyannis Ma Permit Number: B201220806 Nature of Project: HVAC Installation; To the building commissioner of the city of Hyannis,Ma in accordance with Massachusetts State Building Code,I,Kevin L Main Registration No..20068,being a_,registered professional engineer,. _ __ responsible for the following discipline(s): ENTIRE PROJECT ❑ ARCHITECTURAL ❑ PLUMBING ❑' MECHANICAL FIRE ALARM ❑ ELECTRICAL OTHER: ' In accordance with Massachusetts State Building Code,I,Kevin L.Main,hereby state that on behalf of Cotti Johnson HVAC Inc.,Ihave supervised.the preparation HVAC Plans,Computations and Specifications for the above named project. k To the best of my knowledge,information and belief,the construction of the trade(s)listed above have been completed to such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code,acceptable engineering practices and applicable laws and ordinances for the proposed use and occupancy. Authorized representatives rof Cotti Johnson HVAC,Inc.have been present on the construction n site on a regular and periodic basis to determine that the work was completed in accordance with the documents approved for the Building Permit. 4 1 }e SIGNATURE ac Date: 7/2/12. A C, "9 y 720 Washington Street,Hanover,MA 02339 1 Phone 781-331-4660 Fax 781-829-4405 - . RAY LAPIERRE PHONE:774-259-US5 MASS DUCT* RAY@MASSDUCTBLASTERS.COM [2 ASTERS WWW.MASSDUCTBLASTERS.COM IEC.2009 & MA Stretch En 'Code Duct Tightness Verification PAS FAR , Date: Permit No: Street Address: Total Conditioned Floor Area: Total cfm loss Allowed Total cfm loss i Certification Number: l �' Signature: Builder: :- \V=4i- Builder Contact: C� HVAC Contractor: �Y- 20091ECC-New Construction Post-Construction test Total Leakage-12 cfm/100ft2 maximum allowed , ❑ Leakage to outdoors-.89 cfmh 00ft2 maximum allowed Testing Results: cfm/100ft2 Rough-in Test Total Leakage UYes-6 cfm/1 OOft2 maximum'allowed ❑ No-4 cfmh OOft2 maximum allowed Testing Results: -`�� cfm/100ft2 MA Stretch Energy Code-401.1 Prescriptive Option for Residential Additions Applies to all systems except those in which the air handler and all ducts are located within conditioned space. LI Leakage to outdoors-4 cfm/100ft2 maximum allowed Testing Results: cfm/100ft2 MASSDUCTBLASTERS 2011 -- - low% RAY LAPIERRE PHONE:774-259-4885 MASS C ®9 i k RAY@MASSDUCTBLASTERS.COM CT BLASTERS ® ASTER wWWAASSDUCTBLASTERS.COM IEC 2009 & MA Stretch Code Duct Tightness Verification FAU Dater - � - Permit No: IE> Street Address: .Total Conditioned floor Area: Total cfm loss Allowed Total cfm loss C,� Certification Number: f Signature: . Builder: �� . Builder Contact: HVAC Contractor: 2009 IECC- New Construction Post-Construction test } ❑ Total Leakage-12 cfm/100ft2maximumFallowed ❑ Leakage to outdoors-89 cfm/100ft2 maximum allowed Testing Results: cfmM00ft2 Rough-in Test Total Le Yes-6 cfm/100W maximum allowed ❑ No-4 cfm/100ft2 maximum allowed Testing Results: �""` � cfm/1-00tt2 MA Stretch Energy Code-'401.3 Prescriptive Option for Residential Additions Applies to all systems except those in which the air handler and all ducts are located within conditioned space. ❑ Leakage to outdoors-4 cfm/100ft2 maximum allowed Testing Results: cfm/100ft2 OAACCMIP712I ACTCQC 9n1i RAY LAPIERRE s PHONE:774-259.4US g RAY@MASSDUCTBLASTERS.COM 1..�NAAS ����� W W W.MASSDUCTBLASTERS.COM IEC 2009 & MA Stretc y Code Duct Tightness Verification, PASS FAU L Date: -� Permit No: .Street Address: t Total Conditioned Floor Area: Total cfm loss Allowed ` Total cfm loss = Certification Number: - l Signature: L/ Builder: . Builder Contact: -� HVAC.Contractor: C 2009 IECC-New Construction Post-Construction test ❑ Total Leakage-12 cfm/100ft2 maximum allowed ❑ Leakage to outdoors-89 cfm/100ft2 maximum allowed Testing Results: cfm1100ft2 Rough=in Test Total Leakage Yes-6 cfm/100ft2 maximum'aliowed ❑ No-4 cfm/100ft2 maximum allowed Testing Results: e 'cfm/100ft2 MA Stretch Energy Code-401.3 Prescriptive Option for Residential Additions Applies to all systems except those in which the air handler and all ducts are located within conditioned space. f ❑ Leakage to outdoors-4 cfm/100ft2 maximum allowed Testing Results: cfm/100ft2 MASSDUCTBLASTERS 2011 RKB - FINAL AFFIDAVIT Project Name: Flagship Estates— Building:"F"Unit F1 Project#: 1040 Project Location: 350 Stevens Street Date: June 29, 2012 Hyannis, MA Project Description Interior Fit-Out Residential Condominium i Project To the building commissioner of the city/town of Hyannis,in accordance with The Massachusetts State Building Code I,Wayne E Benson,Jr., Registration No. 10731, being a registered professional engineer/architect in the following discipline: ARCHITECTURAL ® , STRUCTURAL ❑ MECHANICAL ❑ FIRE PROTECTION ❑ ELECTRICAL ❑ OTHER ❑ For the above named project and_hereby certify that the following services were carried out by me, E or by a representative directly supervised by me: U 1. Review of shop drawings, samples and other submittals of the contractor as required x by the construction contract documents as submitted for building permit, and approval for 3 conformance to the design concept. 2. Review of the quality procedures for all code-required controlled materials. ID QD 3. Special architectural or engineering professional inspection of critical construction components requiring controlled materials or construction specified in the accepted , "'" • engineering practice standards. p To the best of my Knowledge, information and belief the work has been completed in accordance , with the documents approved for the building permit. m + SOAAAA a Therefore, I request a Certificate of Occupancy be issued for the above address. y✓�S�ERED pR W � ��i.G��EDSONe���co�� � z No. 10731 NORTH EASTON, �� B� m Seal: o SIGNAT E, ��F MA ai �►��rN OF M P`'�'��, a SS: On this 29th day of June,.2012 AD before me,the undersigned notary public persa appeared Wayne E. Benson,Jr., proven to me through satisfactory evidence of identification,which were 2 MA State Drivers License,to be the person whose name is signed on the preceding or attached document Cd in my presence. U (Notary Public) My Commission expires: LJ i� 2012.06.29 Final Affidavit.docx � RKS FINAL AFFIDAVIT Project Name: Flagship Estates—Building "F" Unit F2 Project#: 1040'. Project Location: 350 Stevens Street Date: June 29, 2012 Hyannis, MA Project Description Interior Fit-Out Residential.Condominium a . Project To the building commissioner of the city/town of Hyannis, in accordance with The Massachusetts State Building Code I,Wayne E Benson,Jr., Registration No. 10731, being a registered professional - engineer/architect in the following discipline: ARCHITECTURAL STRUCTURAL ❑ MECHANICAL R ' FIRE PROTECTION ❑ ELECTRICAL ❑ OTHER ❑ For the above named project and hereby certify that the following services were carried out by me, E or by a representative directly supervised by me ; V 1. Review of shop drawings, samples and other submittals of the contractor as required Y by the construction contract documents as submitted for building permit, and approval for 3 conformance to the design concept. CD 2. Review of the quality procedures for all,code-required controlled materials. .' •3. Special architectural or engineering professional inspection of critical construction CR components requiring controlled materials or construction specified in the accepted - engineering practice standards. r QD To the best of my Knowledge, information'and belief the work has been completed in accordance co with the documents approved for the building permit. RED AR Therefore, I request a Certificate of Occupancy be issued for the above address. 5�� cy�T r co C.� _ co) No. 10731 .t . � NORTH EASTON, � T Seal: O,y MA �J S G AT REPH OF SS: On this 29th day of June, 2012 AD before me,the undersigned notary public personally appeared Wayne E. Benson,Jr.,proven to me through satisfactory evidence of identification,which were 0 MA State Drivers License,to be the person whose name is signed on the preceding or attached document in my presence. V • •♦ (Notary Public) a - 3 , My Commission expires: 2012.06.29 Final Affidavit.docx �� al^via R1 K B ` FINAL AFFIDAVIT Project Name: Flagship Estates—Building°F" Unit F3 Project*:. 1040 Project Location: 350 Stevens Street Date: June 29, 2012 Hyannis, MA Project Description Interior Fit-Out Residential Condominium Project To the building commissioner of the city/town of Hyannis, in accordance with The Massachusetts State Building Code I,Wayne E Benson,Jr., Registration No. 10731, being a registered professional engineer/architect in the following discipline: ARCHITECTURAL ® STRUCTURAL ❑ MECHANICAL ❑ FIRE PROTECTION ❑ ELECTRICAL ❑ OTHER ❑ For the above named project and hereby certify that the following services were carried out by me, S or by a representative directly supervised by me: U 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit, and approval for 3 conformance to the design concept. m 2. Review of the quality procedures for'all code-required controlled materials. V 3. Special architectural or engineering professional inspection of critical construction components requiring controlled materials or construction specified.in the accepted engineering practice standards. O co To the best of my Knowledge, information and belief the work has been completed in accordance V with.the documents approved for the building permit. to 06 Therefore, I request a Certificate of Occupancy be issued for the above address. pr�GS�tiFEo gR�y�T 'No. 10731 z v e� Seal: ,NORTH EASTON, v s SIGNAT E �o�iz MA zJ� oo�, F M PISS SS: On this 29th day of June, 2012 AD before me,the undersigned notary public persoTf appeared Wayne E. Benson,Jr., proven to me through satisfactory evidence of identification,which were EMA State Drivers License,to be the person whose name is signed on the preceding or attached document in my presence., e _ , (Notary Public);`x" DAVID DIE ion expires:PW* - OF 2012.06.29 Final Affidavit.docx WOORMIS�aaer Zola e . NEW ENGLAND , ti FIRE. SYSTF.M.S , INC. FINAL AFFIDAVIT Permit No. To the Commissioner,Inspectional Services Department Re:1 Flagship Condominiums Bldg. "F"Hyannis, Ma. ' I certify to the best of my knowledge,information and belief,the plans and computations accompanying the attached application concerning the locus at Flagship Condominiums Bldg."F"Hyannis,Ma.' Are in accordance with the'requirements of the Massachusetts State Building Code and,all other pertinent laws and ordinances. f The work is in accordance with the documents approved for the building per pit:.and shall be responsible for the following as specified in Section 116 22 1. Review of shop drawings,samples and other submittal of the contractor as required by the construction documents as submitted for he_buildimg permit,and approval for conformance'to the design concept, 2. Review and approval of the quality control procedures,for all code- required controlled materials 3. Special engineering professional inspection".of critical.construction components requiring control materials or construction specified in: led the accepted engineering practice standards listed in Appendix B, Pursuant to Section 11.6,I shall su6mit'periodically a progress report,) together with pertinent comments,to the Building Commissioner.Upon . completion and readiness of the prolectfor occupancy,, -�: 4. All systems have been tested(a20, for 2hrs p" + Name of Engineer: % w w S' urei . Stamp: gQa��aV oF,�s�c SMIEN E. tiG v FIgE pqQ rulS m NO.46 FAN y • aw a ryn'S° -, ADvANTAGE Construction, c. CONTRACTOR FINAL AFFIDAVIT Tuesday July 2,2012 PROJECT: CONTRACT FOR: General Construction Flagship Condos Phase II 320 Stevens Street Hyannis,MA OWNER: GENERAL CONTRACTOR: . Flagship Estates Hyannis,LLC Advantage Construction Two Adams Place,Suite 100 Two Adams Place,Suite 100 Quincy,MA,02169 Quincy,MA,02169 PROJECT OR PORTION OF THE PROJECT DESIGNATED FOR USE SHALL INCLUDE: Five (3) residential units in the"F"Building F-1 permit#B- 20120927 F-2 permit#B-20120928 F-3 permit#B-20120929 The Work performed under this Contract has been reviewed and found to be in accordance with the 8f Edition MSBC to the Design Builder's best knowledge,information and belief, to be substantially complete. Substantial Completion is the stage in the progress of the Work when the Work or designated portion is sufficiently complete in accordance with the Contract Documents so that the Owner can occupy or utilize the Work for its intended use. The date of Substantial Completion of the Project or portion designated above is the date of issuance established by this Certificate,which is also the date of commencement of applicable warranties required by the Contract Document, except . as stated below WARRANTY: One Calendar Year from Date of Commencement BY: Jo n C. Kelly P esident dvantage Construction,Inc. 1150 West Chestnut St Brockton,MA 02301 f ADVANTAGE Construction,Inc. CONTRACTOR FINAL AFFIDAVIT Tuesday July 2,2012 PROJECT: CONTRACT FOR: General Construction Flagship Condos Phase II 320 Stevens Street Hyannis,MA OWNER: GENERAL CONTRACTOR: Flagship Estates Hyannis,LLC Advantage Construction Two Adams Place,Suite 100 Two Adams Place,Suite 100 Quincy,MA,02169 Quincy,MA,02169 PROJECT OR PORTION OF THE PROJECT DESIGNATED FOR USE SHALL INCLUDE: . Five (3) residential units in the"F"Building F-1 permit#B-20120927 F-2 permit#B-20120928 F-3 permit#B-20120929 The Work performed under this Contract has been reviewed and found to be in accordance with the 8t', Edition MSBC to the Design Builder's best knowledge,information and belief, to be substantially complete. Substantial Completion is the stage in the progress of the Work when the Work or designated portion is sufficiently complete in accordance with the Contract Documents so that the Owner can occupy or utilize the Work for its intended use. The date of Substantial Completion of the Project or portion designated above is the date of issuance established by this Certificate,which is also the date of commencement of applicable warranties required by the Contract Document, except as stated below: WARRANTY: One Calendar Year from Date of Commencement BY: ohn C. Kelly President Advantage Construction,Inc. 1150 West Chestnut St Brockton,MA 02301 f D A TA E V N G Construction, CONTRACTOR FINAL AFFIDAVIT Tuesday July 2,2012 PROJECT: CONTRACT FOR: General Construction Flagship Condos Phase II 320 Stevens Street Hyannis,MA OWNER: GENERAL CONTRACTOR: Flagship Estates Hyannis,LLC Advantage Construction Two Adams Place,Suite 100 Two Adams Place,Suite 100 Quincy,MA,02169 Quincy,MA,02169 PROJECT OR PORTION OF THE PROJECT DESIGNATED FOR USE SHALL INCLUDE: Five (3) residential units in the"F"'Building F-1 permit#B- 20120927 F-2 permit#B- 20120928 F-3 permit#B-20120929 The Work performed under this Contract has been reviewed and found to be in accordance with the 86 Edition MSBC to the Design Builder's best knowledge,information and belief, to be substantially complete. Substantial Completion is the stage in the progress of the Work when the Work or designated portion is sufficiently complete in accordance with the Contract Documents so that the Owner can occupy or utilize the Work for its intended use. The date of Substantial Completion of the Project or portion designated above is the date of issuance established by this Certificate,which is also the date of commencement of applicable warranties required by the Contract Document, except as stated below: WARRANTY: One Calendar Year from Date of Commencement BY John C. Aelly. President Advantage Construction,Inc. 1150 West Chestnut St Brockton,MA 02301 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3a 0- 0O Parcel 60,,4 Application # I ZZ, Health Division Date Issued Conservation Division Application Fee. Planning Dept Permit Fee Date Definitive�Plan Approved by Planning Board P Historic - OKH _ Preservation/ Hyannis Project Street Address • �� '�' Village Owner Address Telephone � Z7!9._ 2 C 9 2 / -3 Permit Request l P ® U C4 A/:' T ( � CO eL+�I d L�A,l T e p1-e &A Vs7 Square feet: 1 st floor: existing- - proposed 2nd floor: existing proposed Total new Zoning District Z' Flood Plain 0- Groundwater Overlay Project V luation Construction Type Lot Size// . At Grandfathered: ❑Yes ❑ No If yes,attach supporting documentation. Dwelling Type: Single Family' ❑ . Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ZNo On Old King's Highway: ❑Yes 21 No Basement Type: ❑ Full „` ❑ Crawl ❑Walkout ❑ Other O Basement Finished Area (sq.ft.) IVIA _ Basement Unfinished Area (sig.ft) Number of Baths: Full: existing new , Half: existing,.. riw Number of Bedrooms: existing new Total Room Count (not including baths): existing O new First Floor Rom Count Heat Type and Fuel: ❑Gas ❑ Oil ❑ Electric ❑ Other Central Air: 2-Yes ❑ No Fireplaces: Existing New Existing woodJcoal star: des ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: 0 existing ❑ new size_ Attached garage: ❑existing. ®'new. size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR.HOMEOWNER) Names LL Telephone Number `� �� C' - Ita Address dt License Q'o y ), PeAwi�s Home Improvement Contractor# v L,9. Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ze �y ) y . FOR OFFICIAL USE ONLY - \ APPLICATION* . DATE ISSUED % .MAP/P RCELNO } 7 - ƒ ADDRESS VILLAGE { OWNER f { � � ƒ DATE OF INSPECTION: � } FOUNDATION f � k , FRAME . / INSULATION ' FIREPLACE ELECTRICAL: ROUGH FINAL �\ PLUMBING: ROUGH FINAL . � \ GAS:- ROUGH FINAL • ) FINAL BUILDING { DATE CLOSEDUT k } ASSOCIATION PLAN NO. � y \ - � � * AA Co check Software Version 3.9.0' Envelope Compliance .Certificate 2009 IECC Section 1: Project Information Project Type: New Construction " Project Title: Flagship Estates Building°F" Construction Site: - Owner/Agent: ; Designer/Contractor: r'350 Stevens Street l Advantage Construction RKB Architects xm (. ,Hyannis,MA 02601 --� 2 Adams Place _ Zero Campanelli Drive Suite 100 Braintree,MA 02184 Quincy,MA 02169 781.848.6600 781.848.8787 Section 2: General Information Building Location(for weather data): Hyannis,Massachusetts Climate Zone: 5a Building Type for Envelope Requirements: Residential Vertical Glazing/Wall Area Pct.: 14% Skylight Glazing/Roof Area Pct.: 0% Activity Type(s) Floor Area Multifamily 5038 Section 3: Requirements Checklist - Climate-Specific Requirements: .Component Name/Description Gross Cavity Cont: Proposed_ Budget Area or , R-Value R-Value tJ-Factor- U-Factorial Perimeter 1st Floor:Slab-On-Grade:Unheated,Vertical 2 ft. 293 — 10.0 -- 2nd Floor:Wood-Framed 747 30.0 .0.0 0.034 0.033 Ceiling:Attic Roof with`Wood Joists 2289 38:0. 0.0' 0.027 0.027 Skylight 1:Vinyl Frame:Double Pane with Low-E,Clear,SHGC 0.60 7 --- -- 0.600 0.600 Front(south):Wood-Framed, 16"o.c. 1954 13.0 3.8 0.064 0.051 Window 1:Wood Frame:Double Pane with Low-E,.Clear,SHGC 159 — -- 0.350 0.350 0.35 Door 1:Wood,Swinging 133 .+ -� - 0.200 0.700 Side Wall(east):Wood-Framed,16"o.c.` 885 13.0 3.8 0.064 0.051 Window 2:Wood Frame:Double Pane with Low-E,Clear,SHGC 51 — 0.350 0.350 0.35 , Rear Wall(north):Wood-Framed, 16"o.c. 1469 13:0 3.8 0.064 0.051 Window 3:Wood Frame:Double Pane with Low-E,Clear,SHGC 346 -- — 0.350 0.350 0.35. Door 2:Glass(>50%glazing):Nonmetal Frame,Non-Entrance'; 125 -- — '0.350 0.350 Door,SHGC 0.35 Side(west):Wood-Framed, 16"o.c.-' 864 13.0 3.8 0.064 0.051 Window 4:Wood Frame:Double Pane with Low-E,Clear,SHGC 51 -- — 0.360 0.350 0.35 (a)Budget U-factors are used for software baseline calculations ONLY,.and are not code requirements. Project Title: Flagship Estates Building F' • � � ,N" .-.Re ort dater 0.��.. 1 9 P g" p 4/27/12 Data filename:P:\1040 Flagship Estates-Hyanis,MA\Building F\COMcheck\COMcheck_Flagship Estates.cck Page 1 of 8 Air Leakage, Component Certification, and Vapor Retarder Requirements: •❑ 1., All joints,and penetrations are caulked,gasketed or covered with a moisture vapor-permeable wrapping material installed iri accordance with the manufacturer's installation instructions. ❑ 2. Windows,doors,and skylights certified as meeting leakage requirements. ❑ 3. Component R-values&U-factors labeled as certified. ❑ 4. No roof insulation is installed on a'suspended ceiling with removable ceiling panels. ❑ 5. 'Other'components have supporting documentation for proposed U-Factors. ❑ 6. Insulation installed according to manufacturer's instructions,'in substantial contact with the surface being insulated,and in a manner that achieves the rated R-value without compressing the insulation. ❑ 7. Stair,elevator shaft vents,and other outdoor air intake and exhaust openings in the building envelope are equipped with motorized dampers. ❑ 8. Cargo doors and loading dock doors are weather sealed. ❑ 9. Recessed lighting fixtures installed in the building envelope are Type IC rated as meeting ASTM E283,are sealed with gasket or caulk. ❑ 10.Building entrance doors have a vestibule equipped with self-closing devices. Exceptions: ❑ Building entrances with revolving doors. ❑ Doors not intended to be used as a building entrance. ❑ Doors that open directly from a space less than 3000 sq.ft.in area. ❑ Doors used primarily to facilitate vehicular movement or materials handling and adjacent personnel doors. F ❑ Doors opening directly from a sleeping/dwelling unit. r Section4: Compliance<Statement Compliance Statement: The proposed envelope design represented in this document is consistent with the building plans,specifications and other calculations submitted with this permit application.The proposed envelope system has been designed to meet the 2009 IECC requirements in COMcheck Version 3.9.0 and to comply with the mandatory requirements in the Requirements Checklist. Name-Title Signature Date - i r Project Title: Flagship Estates Building"F"� �µ:Report date: 04/27/12 Data filename:P:\1040 Flagship Estates-Hyanis,MA\Building F\COMcheck\COMcheck_Flagship Estates.cck Page 2 of 8 CCU c eck So tware'Versicn 3.9. Interior Lighting -Compliance Certificate 2009IECC Section 1: Project Information Project Type:New Construction Project Title: Flagship Estates Building"F" Construction Site: Owner/Agent: Designer/Contractor: 350 Stevens Street Advantage Construction RKB Architects Hyannis,MA 02601 2 Adams Place Zero Campanelli Drive Suite 100 Braintree,MA 02184 Quincy,MA 02169 781.848.6600 ' 781 i848.8787 Section 2: Interior Lighting and Power Calculation A B C D Area Category Floor Area Allowed Allowed Watts (ft2) Watts/ft2 (B x C) Multifamily 5038 0.7 3527 Total Allowed Wafts=` 3527 Section 3: Interior Lighting Fixture Schedule A B C D E Fixture ID:Description!Lamp I Wattage Per Lamp I Ballast Lamps/ #of Fixture (C X D) Fixture Fixtures Watt. Multifamily(5038 sq.ft.), Total Proposed Wafts= 0 ' Section 4:.Requirements Checklist. Lighting Wattage: ❑ 1. Total proposed wafts must be less than or equal to total allowed wafts. Allowed Watts Proposed Watts Complies 3527 0 YES Controls, Switching, and Wiring: ❑ 2. Daylight zones under skylights more than 15 feet from the perimeter have lighting controls separate from daylight zones adjacent to vertical fenestration. 0 3. Daylight zones have individual lighting controls independent from that of the general area lighting. Exceptions: ❑ Contiguous daylight zones spanning no more than two orientations are allowed to be controlled by a single controlling device. ❑ Daylight spaces enclosed by walls or ceiling height partitions and containing two or fewer light fixtures are not required to have a separate switch for general area lighting. _ 0 4. Independent controls for each space(switch/occupancy sensor). Exceptions: Areas designated as security or emergency areas that must be continuously illuminated. LJ Lighting in stairways or corridors that are elements of the means of egress. Project Title: Flagship Estates Buildin `F" ., Report date: 04/27/1 1 9 P 9" P 2 Data filename:PM 040 Flagship Estates-Hyanis,MA\Building F\COMcheck\COMcheck_Flagship Estates.cck Page 3 of 8 6 ❑'5: Master switch at entry to hotel/motel guest room. . ❑ 6: Individual dwelling units separately metered. ❑ 7. Medical task lighting or art/history display lighting claimed to be exempt from compliance has a control device independent of the control of the nonexempt lighting. ❑ 8. Each space required to have,a manual control also allows for reducing the connected lighting load by at least 50 percent by either controlling all luminaires,dual switching of alternate rows of luminaires,alternate luminaires,or alternate lamps,switching the middle lamp luminaires independently of other lamps,or switching each.luminaire or each lamp. Exceptions: ❑ Only one luminaire in space. ❑ An occupant-sensing device controls the area. ❑ The area is a corridor,storeroom,restroom,public lobby or sleeping unit. ❑ Areas that use less than 0.6 Watts/sq.ft: , ❑ 9. Automatic lighting shutoff control in buildings larger than 5,000 sq.ft. Exceptions: ❑ Sleeping units,patient care areas;and spaces where automatic shutoff would endanger safety or security. ❑ 10.Photocell/astronomical time switch on exterior lights.. Exceptions: ❑ Lighting intended for 24 hour use. ❑ 11.Tandem wired one-lamp and three-lamp ballasted luminaires(No single-.lamp ballasts). ' Exceptions: ❑ Electronic high-frequency ballasts;Luminaires on emergency circuits or with no available pair. Project Title: Flagship Estates Building F" �......� � Report date: 04/27/1 1 9 P 9" P 2 Data filename:P:\1040 Flagship Estates-Hyanis,MA\Building F\COMcheck\COMcheck_Flagship-Estates.cck Page 4 of 8 COMcheok Software Version 3.9.0 Exterior Lighting Compliance Certificate 2009 IECC Section 1: Project Information Project Type: New Construction . Project Title: Flagship Estates Building"F" Exterior Lighting Zone: 2(Residentially zoned area) Construction Site: Owner/Agent: » Designer/Contractor: 350 Stevens Street Advantage Construction RKB Architects Hyannis,MA 02601 2 Adams Place Zero Campanelli Drive Suite 100 , Braintree,MA 02184 Quincy,MA 02169 781.848.6600 781.848.8787 Section 2: Exterior Lighting Area/Surface Power Calculation A B ,C D E F Exterior Area/Surface Quantity Allowed Tradable Allowed Proposed Watts, Wattage, Watts Watts Unit (B x C) 0 0 No 0 0 Total Tradable Watts'= 0 0 Total Allowed Watts= 0 Total Allowed Supplemental Watts"= 600 'Wattage tradeoffs are only allowed between tradable areas/surfaces. "A supplemental allowance equal to 600 watts may be applied toward compliance of both non-tradable and tradable areas/surfaces. Section 3: Exterior Lighting Fixture Schedule A B C D . . E Fixture ID:Description l Lamp I Wattage Per Lamp I Ballast Lamps/ #of Fixture. (C X D) Fixture Fixtures' Watt. ` Total Tradable Proposed Watts= 0 Section 4: Requirements Checklist Lighting Wattage: 1. Within each non-tradable area/surface,total proposed watts must be less than or equal to total allowed watts.Across all tradable areas/surfaces,total proposed watts must be less than or equal to total allowed watts. Compliance:Invalid exterior use type ` Controls,Switching,and Wiring: r1 2. All exemption claims are associated with fixtures that have a control device independent of the control of the nonexempt lighting. _ Lj 3. Lighting not designated for dusk-to-dawn,operation is controlled by either'a a photosensor(with time switch),or an astronomical time switch. ` Lj 4. Lighting designated for dusk-to-dawn operation is controlled by an astronomical time switch or photosensor. 5. All time switches are capable of retaining programming and the time setting during loss of power for a period of at least 10 hours. Exterior Lighting Efficacy: P. 6. All exterior building grounds luminaires that operate at greater than 100W have minimum efficacy of 60 lumen/watt. Project Title: Flagship Estates Building"F" Report date:04/27/12 -- Data filename:P:\1040 Flagship Estates-Hyanis,MA\Building F\COMcheck\COMcheck_Flagship Estates.cck Page 5 of 8 Exceptions: , Lighting that has been claimed as exempt and is identified as such in Section 3 table above. Lighting that is specifically designated as required by a health or life safety statue,ordinance,or regulation. Emergency lighting that is automatically off during normal building operation. Lighting that is controlled by motion sensor: � e Project Title: Flagship Estates Building"F" Report date:04/27/12 Data filename:PA1040 Flagship Estates-Hyanis,MA\Building F1COMcheck\COMcheck_Flagship Estates.cck Page 6 of 8 COMcheck Software Version 3.9.0 Mechanical Compliance Certificate 2009 IECC Section 1: Project Information Project Type: New Construction Project Title: Flagship Estates Building"F" Construction Site: Owner/Agent:' Designer/Contractor: 350 Stevens Street Advantage Construction RKB Architects Hyannis,MA 02601 2 Adams Place-.' 3. Zero Campanelli Drive, Suite 100 Braintree MA 02184 Quincy,MA 02169 781.848.6600 781.848.8787 Section 2: General Information Building Location(for weather data): Hyarinis,Massachusetts Climate Zone: 5a Section 3: Mechanical Systems List Quantity System Type&Description r m Section 4: Requirements Checklist- Project Title: Flagship Estates Building"F" Report date: 04/27/12 Data filename:P:\1040 Flagship Estates-Hyanis,MA\Building F\COMcheck\COMcheck_Flagship Estates.cck Page 7 of 8 The Commonwealth of Massachusetts Prmt.;Form - Department of Industrial Accidents Office of Investigations, 1 Congress Street Suite 100 Boston, MA 02114-2017" www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians%Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): 1-'ACC Address:---'U b PV City/State/Zip: �4'\_, Phone #: Z)�A \%�kb Are you an employer?Check the appropriate box: Type of project(required): 1.❑-1 am a employer with .�� 4. ❑ I am-a;general contractor and I •_ employees(full and/or part-time).* have hired the sub-contractors 6. Kew 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7; ❑ Remodeling These sub-contractors have ship and have no employees 8. `❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance' comp. insurance.: 9. Building-addition 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 I.❑ Plumbing repairs or additions myself. o workers' com right of exemption per MGL Y � P 12:0 Roof repairs insurance required.] fi c. 152, §1(4), and we have.no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and 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: o`(� Policy#or Self-ins. Lic.#s: 00���00` Expiration Date: Job Site Address: '?>�;tO S�CWKN5 !�A City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form-of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify n r the pains and enalties of erjur that the in or'mation provided above is true and correct. Si nature: ___. Date: _ 3 la Phone#: Official use ly' 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#: NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA. 0090063-00 WC 004-32-1274 13072 013-82-0611-00 17 NAMED INSURED: MAILING ADDRESS IDENTI FICATION NO.: ADVANTAGE CONSTRUCTION, INC. C H A R T I S TWO ADAMS PLAZA SUITE 100 QUINCY, MA 0210-7456 A Chartis company EXECUTIVE OFFICES: SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE- WC990610 175 Water Street New York, NY 10038 I.D# 9 JS97713 KEATING GROUP OF MA LLC. WORKERS COMPENSATION AND EMPLOYERS 144 TURNPIKE ROAD LIABILITY POLICY INFORMATION PAGE SUITE 150 SOUTHBOROUGH MA 01 2-0000 INSURED IS PREVIOUS POLICY NUMBER CORPORATION RENEWAL 006430048 - OTHER WORKPLACES NOT SHOWN ABOVE: SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE - WC990610 ITEM 2 POLICY PERIOD 12:01 A.M.standard time at the insured's mailing address FROM 06/20/11 TO 06/20/12 ITEM 3 A. Workers Compensation,Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA NH RI B. Employers Liability Insurance: Part Two of the policy applies to the work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 1 ,000,000 each accident Bodily Injury by Disease $ 1 .000,000 policy limit. Bodily Injury by Disease $ 1 .000,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: AK AL AR AZ CA CO CT DC DE 'FL GA HI IA' ID IL IN KS KY LA MD ME MI MN MOMS MT NC.NE NJ NM NV NY OK OR PA SC SD TN UT VA VT WI WV D. This policy includes these endorsements and schedules: SEE EXTENSION OF ITEM 3.D. OF-THE INFORMATION PAGE - WC990612 ITEM 4 The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Premium Basis Rate Per Estimated Classifications Code Number Total Remuneration $100 OF Re- Premium ❑X Annual ❑3 Year muneration Annual ❑3 Year SEE EXTENSION OF ITEM 4. OF THE INFORMATION PAGE - WCM4 TAXES/ASSESSMENTS/SURCHARGES $9,616 { EXPENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) $338- MA MINIMUM PREMIUM $750 NH TOTAL ESTIMATED ANNUAL PREMIUM $1 43,835. If indicated below,interim adjustments of premium shall be made: - ❑ Semi-Annually- ❑ Quarterly ❑ Monthly DEPOSIT PREMIUM 06/29/11 PARS I PPANY 82 Issue Date Issuing Office Authorized Representative WC00 00 01A 39967(Rev'd 04/08) L EXTENSION OF ITEM 3.D. OF THE INFORMATION PAGE Policy Number: WC 004-32-1274 Effective Date: 06/20/2011 TRSMNOTA FOREIGN TERRORISM POLHOLDR NOT-PREM DTMN WC000406 PREMIUM DISCOUNT ENDORSEMENT WC000406A PREMIUM DISCOUNT ENDORSEMENT WC000414 NOTIFICATION OF CHANGE IN OWNERSHIP ENDT WC000421C CATASTROPHE PREMIUM ENDORSEMENT' WC000422A TRIPRA DISCLOSURE ENDORSEMENT WCOFAC NOTICE REG OFFICE OF FOREIGN .ASSET CTRL 107437 PRIVACY POLICY WC58509A WC - PREMIUM CREDIT APPLICATION WC000419 PREMIUM DUE DATE ENDORSEMENT WC200101 MA - TRIPRA ENDORSEMENT WC200301 MA LIMITS OF LIABILITY ENDORSEMENT WC200302A MA ASSESSMENT CHARGE WC200303C MA NOTICE TO POLICYHOLDER ENDORSEMENT WC200403 MA CONSTRUCTION CLASS PREMIUM ADJUSTMENT WC200601A MA CANCELLATION ENDORSEMENT WC200604 MA POLICY DEFINITIOW ENDT. WC992002 MASSACHUSETTS PREMIUM DUE DATE ENDT. WC280601 NH SOLE REPRESENTATIVE ENDT WC280604 NH AMENDATORY ENDORSEMENT' WC380401A RI - SHORT RATE CANCELLATION ENDT WC380601 RI DIRECT LIABILITY STATUTE WC880002 TX EXCLUSION ENDORSEMENT WC990610 -NAMED INSUREDS/ADDRESSES i WC 99 06 12 (Ed. 1/97) (Rev'd 04/08) Page 1 of 1 EXTENSION OF ITEM 4. OF THE INFORMATION PAGE WC 004-32-1274 MASSACHUSETTS 911597713 Policy Prefix&No. Schedule INTRA/Independent State Risk ID ------------------------- 013-82-0611-00 ADVANTAGE CONSTRUCTION, INC. Item 4.Classification of Operations Premium Basis Rates Code Estimated Total Per$100 of Estimated No. Annual Remuneratioi i Remuneration Annual Premiums RATING GROUP: 0002-01 ' PLUMBING NOC & DRIVERS 5183 25,OOC 3.50 875 ELECTRICAL WIRING - WITHIN BUILDINGS & 5190 25,OOC 2.84 710 DRIVERS INSULATION WORK NOC & DRIVERS 5479 850,00 7.78 66,130 CONTRACTOR - EXECUTIVE SUPERVISOR OR 5606 1 ,428,85C 1 .62 23,147 CONSTRUCTION SUPERINTENDENT CARPENTRY - DETACHED ONE OR TWO .FAMILY 5645 875,OOC 8.68 75,950 DWELLINGS ENGINEER OR ARCHITECT - CONSULTING 8601 90,OOC 0.26 234 SALESPERSONS, COLLECTORS OR MESSENGERS 8742 163,060 0. 15 245 - OUTSIDE CLERICAL OFFICE EMPLOYEES NOC 8810 1 , 167,520 0.09 1 ,051 BUILDINGS - OPERATION BY OWNER OR LESSEE' 9015 IF AN 2.72 STATE OF MASSACHUSETTS TOTALS TOTAL CLASSIFICATION PREMIUM 168,E NKET WAIVER 2.00 0930 3,367 INCREASE LIMITS 2.00 9812 3,367 SUBJECT PREMIUM 175,076 EXPERIENCE PREMIUM (ACTUAL) 0.84dC 9898 -28,012 MODIFIED STANDARD PREMIUM 147,064 UNDISCOUNTED PREMIUM 147,064 PREMIUM DISCOUNT -4.70 0064 -6,912 DISCOUNTED PREMIUM 140,152 EXPENSE CONSTANT 0900 338 TERRORISM 3.00 974o 5,050 TOTAL ESTIMATED PREMIUM 145,540 MACHWC (SURCHARGE) 6.80 9136 9,616 ANNUALIZED TOTAL 155,156 EXPERIENCE RATING MODIFICATION •= 0.84 TOTAL PREMIUM FOR TERRORISM COVERAGE INCLUDED IN TOTAL ESTIMATED PREMIUM $5,05 WC 7754 (Ed.4-81)(Rev'd 04/08) Page 1 of 1 EXTENSION OF ITEM 4. OF THE INFORMATION PAGE WC 004-32-1274 NEW HAMPSHIRE 911597713 Policy Prefix&No. Schedule INTRA/Independent State Risk ID ------------------------ 013-82-0611-00 ADVANTAGE.-CONSTRUCTION, INC. Item 4.Classification of Operations Premium Basis Rates Code, Estimated Total Per$100 of Estimated No. Annual Remuneratioi i Remuneration Annual Premiums RATING GROUP: 0001-01 CARPENTRY-NOC 5403 IF AN 16.28 CONTRACTOR-PROJECT MANAGER, 5606 1 ,000 2.31 23 CONSTRUCTION EXECUTIVE, CONSTRUCTION MANAGER OR CONSTRUCTION SUPERINTENDENT CARPENTRY-DETACHED ONE- OR TWO-FAMILY 5645 IF AN 17.99 DWELLINGS STATE OF NEW HAMPSHIRE TOTALS TOTAL CLASSIFICATION PREMIUM 23 INCREASE LIMITS 2.8091 9812 1 TOTAL UNMODIFIED PREMIUM 24 MODIFIED STANDARD PREMIUM 24 UNDISCOUNTED PREMIUM 24 PREMIUM DISCOUNT -11 . 10 0063 -3 DISCOUNTED PREMIUM 2_1 CATASTROPHE (SEE WC 00 04 21C) 0.015 9741 TOTAL ESTIMATED PREMIUM ANNUALIZED TOTAL 21 TOTAL PREMIUM FOR TERRORISM COVERAGE INCLUDED IN TOTAL ESTIMATED PREMIUM $1 WC 7754 (Ed.4-81)(Rev'd 04/08) a 4 F DATE AC40R V CERTIFICATE OF LIABILITY INSURANCE 04/03/2012MMIDDIYYYY) 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 Diane Shaw Fred C.Church,Inc. NAME: 41 Wellman Street PHONE 978 3227272 FAX (978)454-1865 Lowell,MA 01851 AIC No Ext: A/C No (800)225-1865 ADDRESS: dshaw@fredcchurch.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Charter Oak Fire Ins.Co- 25615 INSURED INSURER B: National Union Fire Insurance Company of Pittsburgh,PA 19445 Advantage Construction,Inc. Navigators Insurance Company 42307 INSURER C: _ 1150 West Chestnut Street,Ste 3 Travelers Casualty Insurance Company of America 19046 Brockton,MA 02301 INSURER D: INSURER E. Starr Indemnity&Liability Company 38318 INSURER F: COVERAGES CERTIFICATE NUMBER: 18537 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE - ADDL SUBR POLICY EFF POLICY EXP LTR S WVD POLICY NUMBER MM/DDIYYYY MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 300,000 CLAIMS-MADE E OCCUR MED EXP(Any one person) $ 5,000 A C0464D1464 6/20/2011 6/20/2012 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE ' $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG. $ 2,000,000. POLICY X PRO- LOG $ AUTOMOBILE LIABILITY COMBINED 1SINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ _ D ALL OWNED SCHEDULED 810464D1476 6/20/2011 6/20/2012 AUTOS AUTOS BODILY INJURY(Per accident) $ PROPERTY DAMAGE X HIRED AUTOS X AONO-0WNED Per accident $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ $5,000,000 E X EXCESS LIAB CLAIMS-MADE AGGREGATE $ SISCCCLO1523811 6/20/2011 6/20/2012 $5.000,000 DED I X I RETENTION$0 $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN - T RY LIMIT ER B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A 004321274 6/20/2011 6/20/2012 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ $10,000,000 X of$5,000,000 C Umbrella NYIIEXC7111931V 6/20/2011 6/20/2012 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate is issued as evidence of coverage. Project: Flagship Estates,Ft,F2,F3,Hyannis,MA - - CERTIFICATE HOLDER CANCELLATION Town of Barnstable 1200 Phinneys Lane SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Hyannis,MA 02601 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Client N Mst a 18537 29035 Cert Holder# ©1988-2010-ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD r - }- iM issachusetts = Department of Public Safeth Board of Building Regulations and Standards Construction Supervisor License License: CS '19925 Restricted to: 00 WILLIAM.G KELLY PO BOX 396 S DENNIS, MA 02660 Expiration: 6/13/2012` ('o irim i„iwn•�• T r#: 27030 VANTAGE r iong Int. s March 9, 2011 Tom Perry Town of Barnstable 368 Main Street Hyannis, MA 02601 Re: Hyannis.Toyota 1020 Iyanough Road Hyannis Ma 02601 Dear Tom Perry: Please accept this letter of notification that William G. Kelly, an employee of Advantage Construction, Inc., has been appointed to be our full time Superintendent for the project listed above. If you have any question, please feel free to contact our office at (617)237-1840 ce 1- vant ge Construction, Inc. hn C: Kelly President ADVANTAGE CONSTRUCTION, INC. Two Adams Place, Suite 100; Quincy, MA 02169 Telephone 781.84&87B7 Fax 781.848.3774 www.advantageconstructioninc.com, , q p. Structural =Fngrreerfn , s S'rR�Jcr�J�a� ���AL `rr�Av � � �a c ON�Tuc �� c� �� ;�, TO: Donald..'Neil}... Advanta e.Const uctron, Tw",o.Adams P,,]ace; Suite;100 Quincy,IVIA 02f69 Rh,: HZ<annis-Cgndom�niul�s Ou ld ng F 700.Main Street Hyannis;,, A t PROJECT NO.' FC#0569 DAT& Apri14,2012 "-.� , • � — .. ., is To the'Build....i.ng"Co ninissior er In,accordance:with Section l07 6 of the Eighth :Edition::of t}fie Massacl3usetts State.E3uald7i3g:Code,:th►s letter shall serve-,as a Final Affidavit for the above referenced bwldiiig and that to the befit of any knowledge,the provs�on5 of the bui}long code,havc been complied."wat1� anti the area ot` work: meets,,t}je requirezxierts oC'tle constructzcin documents. ` c 404 FL st; r L,ic.#42868 " ass " C7RICr'.; SIGNAIIJRE°: MAS:S RLCr NO Stacy R Flaod,PE 6 Lauref Dave-:. Hudsan MA 017 9. • TEL '(978} 562= 49 FAX`.(978},, 62 'ti''246 ... �mµ i 1 RIKBCONSTRUCTION CONTROL AFFIDAVIT Project Name: Flagship Estates— Building "F" Unit F3 Project#: 1040 Project Location: 350 Stevens Street Date: Npril 6, 2012 Hyannis, MA Project Description Interior.Fit-Out Residential Condominium Project To the building commissioner of the city/town of Hyannis, in accordance with The Massachusetts State Building Code I,Wayne E Benson,Jr., Registration No.•10731, being a registered professional engineer/architect in the following discipline: ARCHITECTURAL ® STRUCTURAL ❑ . MECHANICAL FIRE PROTECTION 0, ELECTRICAL ❑ OTHER E Hereby certify that I have prepared or directly supervised the preparation of all base building Architectural Plans; Computations and Specifications.for the above named project. U - .. To the best of my knowledge, information and belief, such plans, computations and specifications ` meet the applicable provisions of the Massachusetts State Building Code, acceptable engineering practices and applicable laws and ordinances for the proposed use and occupancy. m I further certify that I shall perform the necessary professional services and be present on the t construction site on.a regular and periodic basis to determine that the work is proceeding in accordance o with the documents approved for the Building Permit. I shall submit periodically, a progress report together with pertinent data to the Building Commissioner. Upon Completion of the work I-shallsubmit a Final Report as to the satisfactory completion and readiness of the project for occupancy. a Therefore, I`request a Building Permit be issued for the above address �S�ERED ARCy� co C. cc n Z 0 No. 10731 NORTH EASTON, Seal: o� MA J SIGNAT RE OF MPS�G� b SS: On this 6th day of April, 2012 AD before me,the undersigned notary public persona I appeared Wayne E. Benson,Jr.,,proven to me through satisfactory evidence of identification,which were MA State Drivers License,to be the person whose name is signed'on the preceding or attached document in my presence. • o Notary Public). u U P(�13 DAVID DtEWSNER NmWpd 2012.04.06 CC Affidavit.docx ^'1 c Bill Kelly' ' From: Scott dwyer[dwyerscott@hotmail.com] Sent: Wednesday, April 18, 2012 3:16 PM To: Don Chase• Cc: Joseph Lambalot; John Kelly; Bill Kelly Subject:. . Re: Flagship Condos Thank you very much , Scott Dwyer New England Fire Systems Inc 508-962-2487 On Apr 18, 2012, at 3:12 PM, "Don Chase"Atdon284@verizon.net>wrote: Hi, Sorry, my email at work has been blocked from yahoo for some reason. OK for permit. Thanks Don . Lt. D. Chase, Jr., FPO Hyannis Fire --This message has been checked by ESVA and is believed to be clean. - y R 1 �TME r Town of Barnstable Regulatory Services * '" E' * Thomas F.Geiler,Director 'OrE 639. Building Division Tom Perry,Building Commissioner_ 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 -Property Owner Must` Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize I/i&q / L�f l to act on my behalf, in all matters relative to workauthorized by.this building,permit.- } 20 --5rievIle&Is 9T Yywjo�c/) S' (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence'is installed and pools are not to be utilized until all final inspections are performed and accepted. Signature of Owner - Signature of Applicant Print Name Print Name Q:FORMS:OWNERPERMISSIONPOOLS } a - TOWN OF BARNSTABLE BUILDING PERMIT,APPLICATION Map ��'�' Parcel _Application Health Division Date Issued Conservation Division '-,'Application Fee S Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address � ® 67f'U°eWS 5TI?�'�T YA1;T 4 Village !7' htw1 .5 Owner Address TelephoneZ/ Permit Request flilr L 1) o U T �D �` F 2 COS 101)Al J. -T feg f`/,?A o A i L Square feet: 1 st floor: existing proposed 2nd floor: existing - proposed Total new Zoning District —r2l Flood Plain C Groundwater Overlay Project Valuation Construction Type Lot Size S. SL C, Z Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old Kings ighway ]YC8 ®"No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other - Basement Finished Area (sq.ft.)_ Basement Unfinished Area OiN. Number of Baths: Full: existing new Half: existing G new Y Number of Bedrooms: 3 existing new Total Room Count (not including baths): existing _ 0 new . First Floor Room CountUJ. Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ,❑ new size—,Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing 0 new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal #' Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # as Current Use it 4 C fir'Al Proposed Use c 9&12c APPLICANT INFORMATION (BUILDER OR HOMEOWNER)- Name D L!i!/4 �, �L�)°` Telephone Number 72 Y d C 9" 1-1 i 3 Address 1, d, P9: 7 f ii License # C'a !`?? -2,4` ✓�r�f �/�a. 0 Y_ Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO e DATE SIGNATURE a� �� ��/� FOR OFFICIAL USE ONLY ,t PAPPLICATION# z DATE ISSUED =� t MAP/PARCEL NO. f ' w ADDRESS VILLAGE OWNER DATE OF INSPECTION: ! FOUNDATION ° FRAME INSULATION j ° FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL a GAS: ROUGH FINAL FINAL BUILDING ` ;0" DATE CLOSED OUT ASSOCIATION PLAN NO. Town of Barnstable Regulatory Services MAMThomas F.Geiler,Director 1639. '�Fcna-° Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, e AI/ 461_P / �! . , as Owner of the subject property hereby authorize W1, `//`y /4 G. /-pelf y to act on my behalf, in all matters relative to work authorized by this building permit. F0 2 R26 VevfA15 5T elluW,� (Address of Job) III **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. SignaLre of Owner Signature of Applicant ' bayAv1� Print Name -Print Name Dat ' Q:FORMS:OWNERPEF MISSIONPOOLS TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map-3ff 0044 Parcel OO` / Application #V Health Division ` Date Issued a l L Conservation Division Application Fee cc, Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/ Hyannis . Project Street Address 1 'lJ * ST R ' Village hoywws Owner Address Telephone Permit Request 7 11 AA'j / "_ COMM ,, UAll,F '��'�: pl/w AT O"'� .fitie, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuational/g g Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family, ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count (not including baths): existing D new First Floor Room;Count = _ Heat Type and Fuel: kt as ❑ Oil ❑ Electric ❑ Other No Central Air: 2 Yes ❑ No Fireplaces: Existing New Existing wood/coal stove:;�J Yeg�❑ No Detached garage: ❑ existing © new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑"Rew size_ Attached garage: ❑ existing M new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # 7,3-U S Current Use /7- 1Irkp Proposed Use C��t76 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name >'ti,' Me-1/f Telephone Number 7-7/ -- 1-4rl llf� Address 9a, 0 d� 3 ;5� License# .C g �®uny Deer Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Co SIGNATURE DATE I9 J FOR OFFICIAL USE ONLY 3. APPLICATION# t . t DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: ' FOUNDATION FRAME `h INSULATION ' a FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ,GAS: _ ROUGH FINAL FINAL RU:ILDING t., DATE CLOSED OUT ASSOCIATION PLAN NO. Commonwealth'of Massachusetts Sheet Metal Permit Map Parcel Date: �Cyr.I Z P rmit# t. 6 Q 03 �d f3•�P /=E Estimated Job Cost: $ P rmit Fee: $ Plans Submitted: YES N Plans Reviewed: YES. NO / Business License#, -Applicant License#` Business Information Property Owner]Job Location- , Location-lnformatiom, Name: Name: T 9,/er!G F0 i�S// le &C Ia. Street: y t.�c,�e�11 Stree - 3 S76W e-� I S`l� City/Town: I iy [ y'11� 000 10. City/Town: M PFN `y Telephone: � I-��t [ S Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES NO S f a J-1/(4-_1)unrestricted license J-2/M-2-restricted to dwellings 3-stories or less and commercial'up to 10,000 sq. ft. /2-stories or less Residential: 1-2 family Multi-family Condo/Townhouses_4 Other Commercial: Office Retail Industrial Educational Fire Dept. Approval Institutional_ Other Square Footage: under 10,000 sq.ft. over 10,000 sq. ft.. Number of Stories: Sheet metal work to be completed: New Work: Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: ' { 4 NSURANCE COVERAGE: have a current liability insurance policy or its equivalent which meets the requirements of M.G:L:Ch. 112 Yesig No ❑ f you have checked)�gj, indicate the type of coverage by checking the appropriate box below- k liability insurance policy Other type of indemnity ❑ Bond C )WNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter.112 of the Aassachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent ly checking this bo I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and .ccurate to the best Any knowledge and that all sheet metal work and installations performed under the permit issued for this application will be 1 compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Progress Inspections Date Comments Final Ins ep ction Date Comments Type of License: y ❑ Master , itle ❑ Master-Restricted IL r" t 9" ityfl'own . � ❑Journeyperson Signature of Licensee ermit# ` ❑Journeyperson-Restricted License Number: 9 1.�c,L ee$ Check at www.mass.gov/dol ispector Signature of Permit Approval The Common we alth ,M as a s chu setts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia ' Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Api3licantInformation & Please Print Legibly - Name(Business/Organization/Individual): Address: 30 W it V e City/State/Zip: la'cJah; Phone.#: '�� � �0•�- 30'�� Are you an employer? Check the appropriate box: 1. I am a employer with -4• ElI am a general contractor and I `.Type of project(required):. r employees(fall and/or part-time).*, have hired the stab=contractors 6 New construction . 2.❑ I.am a'sole pioprietor or partner- _ listed on the-attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g. Demolition working forme m•any.capa 0 city. employee's have workers' . [No workers' comp,insurancc` comp.in.ayranoe, • 9. ❑Building additidn required.] 5• [] We are a corporation and its 10.0 Electrical repairs or additions '3.❑ I am a homeowner doing.in work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp., right of exemption per MGL 12.[]Roof repairs insurance required.]t c.152, §1(4), and we have no employees.[No workers' 13.0 Other comp.insurance required] *Any applicant that checks box#1 most also fill out the section below showing thew 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. rf the sub-contractors have employees,they mustprovidt their workers'comp.policy number. I am an employer that is providing workers'compensation insurance far my employees. Below is the policy and job site information. 'v. Insurance Company Name: Ike Policy#or Self-ins.Lic.# WC OI e[ 3 S"CA , Expiration Date:" o lob Site Address: .390 ,. (Qvv5 SI ��Ct'S�� ld� a„ :R ti ) 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 ofMGL c. 152 can lead to the imposition'af criminal`penatties of'a fine up to$1,500.00 and/or one-year imprisonm�t 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 t e pains•and pen 'es of per' ry that the information provided above is true and correct Signature: _ Date: Phone#: '1'1 - S01 3104S O cial use only . Do not write in this area;to be completed by city or.town official City or Town Permitlhicense# i ~ r'Contact Authority(circle one): d of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector r Person: Phone#• 4 T Town of Barnstable �: . Regulatoi. , Service . . s yes Thomas F.Geiler,Director, i639� _ , ► ' Building Division Tom Perry,Building Commissioner 200 Main Street,.Hyannis,MA 02601 www.town.barnstable.ma.ns Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 31 Ownex of the'subect' ro n .r�r hereby authorize CJT7T' j. U y to act on my behalf in all matters relative to.work autb-oozed by this building permit ~ (Address of Job) Pool fences,and alarms are the responseili ` of the a ty pphcant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. Signature of Owner - Signature of pplicant Print Name ------, -- Z 4LI X-0— Print Natrie Date Q:FORMS:MiWERMISSIONPOOLS �tHE Town of Barnstable Regulatory Services • aaxivsrrABLE, • Thomas F.Geiler,Director Mese. - . A D yg. A. Building Division Tom Perry,Building Commissioner , 200 Main Street, Hyannis,MA 02601 www.town:barnstable.ma.us . Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print r DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: ; city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. 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 buildinIpermit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner 4 Approval of Building Official ' Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a,person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page 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:homeexempt - '4CC>R" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 2/8/2012 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 Norwell Construct South NAME: Eastern Insurance Group LLC PHONE FAX No): 77 Accord Park Drive E-MAIL - - - ADDRESS: Unit Bl PRODUCER D0040506 . Norwell MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA:Travelers Inc of America 25666 Cotti Johnson, HVAC, Inc. INSURERB:Travelers Indemnity Co 25658 WAVERLY STREET REALTY INSURERC-: 30 Waverly Street INSURER D: INSURER E: Taunton MA 02780 INSURER F COVERAGES CERTIFICATE NUMBER:Standard 12-13 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 WAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR IWVD POLICY NUMBER MM/DD MM/DD/YYYY LIMITS GENERAL LIABILITY - - EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 A CLAIMS-MADE-FX]OCCUR X 68037 82R754 1/22/2012 1/22/2013 MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 r GENERAL AGGREGATE - $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: -. PRODUCTS'-COMP/OP AGG $ 2,000,000 X1 POLICY PRO-JECT LOC $ AUTOMOBILE LIABILITY - - - - COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED AUTOS X 0770M074 1/22/2012 1/22/2013 BODILY INJURY(Per accident) $ X SCHEDULED AUTOS X - - PROPERTY DAMAGE - $ HIRED AUTOS _ (Per accident) X NON-OWNED AUTOS - - -- Comprehensive De $ 500 Collision Ded - $ 500 X UMBRELLA LIAB X. OCCUR - EACH OCCURRENCE - $ 5,000,000 EXCESS.LIAB 'CLAIMS-MADE. - AGGREGATE - - $ --5,000,000 DEDUCTIBLE - $ B RETENTION $ 51000 895OY645 1/22/2012 1/22/2013 $ WORKERS COMPENSATION` - WC STATU- OTH- - AND EMPLOYERS'LABILITY Y!N - ANY PROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED? 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(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Evidence of Insurance. • I . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,' NOTICE WILL BE DELIVERED IN FOR INFORMATION PURPOSES ONLY ACCORDANCE WITH THE POLICY PROVISIONS. . ' AUTHORIZED REPRESENTATIVE`. Ronald Cleaves/Jeff.; ACORD 25(2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved: INS025(200906) The ACORD name and logo are registered marks of ACORD f - 38 Vlav—arly Street aunton,, ;rb A 02780 w �81 8 1-. 511 :P Pon e HNSO (791� 821-1599 Fax V f_1NCW ,. �.tPe�yti C ftijohnsonhvac,00m SINCE 1948 2/9/12 RE: Gary St. Clair; License # 8149 Cotti-Johnson HVAC, Inc.hereby grants Gary St. Clair, a Master Sheet Metal Mechanic permission to pull Mechanical Permits on the company's behalf.' Please do not hesitate to contact me with any questions. Thank you. Angelo S..Boccalini V.P./ Controller C C �m LTH OF G�B�SS�;C��i� 4 � Q fl �, Rill. ®p SHEET METAL VyORKERS AS A IUtASTER-UNRESTRICTED iSSUES.THE ABOVE,LICENSE T� GARY J ST CLAIR 1:. UNION: PARK HANSON MA 02341 2069 8149 . 05/28/12 992811 t • '. tr.' �xa°1• o 'n (f i i I . t J DATE(MM/DD/YY) CERTIFICATE OF LIABILITY INSURANCE ��--' 06/10/11 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 Aon Risk Services,Inc of Florida Aon Risk Services,Inc of Florida r NAME: 1001 Brickell Bay Drive,Suite#1100 PHONE 800-743-8130 FAX 800-522-751 A/C No.Ext: A/C,No -. Miami,FL 33131-4937 E-MAIL ADDRESS: ADP.COL �oCenter Aon.com - PRODUCER 10762287 CUSTOMER ID#: r INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:New Hampshire Ins Co 23841 - ADP TotalSource MI XXX,Inc. INSURER B: 10200 Sunset Drive Miami,FL 33173 INSURER Cc ALTERNATE EMPLOYER INSURER G: Cotti-Johnson HVAC,Inc. 80 Cedar St, INSURER E: Canton,MA 02021 INSURER F: COVERAGES CERTIFICATE NUMBER: 308176 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. LIMITS SHOWN ARE AS REQUESTED. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSR WVD DATE(MM/DD/YYYY) DATE(MMIDDIYYYY) GENERAL LIABILITY EACH OCCURRENCE $ ❑COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED $ ❑CLAIMS MADE ❑OCCUR - PREMISES(Ea occurrence) IVIED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ y GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS—COMP/OP AGG $ ❑POLICY ❑PROJECT ❑ LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ❑ANY AUTO (Ea accident) ❑ALL OWNED AurDs BODILY INJURY $ (Per person) ❑SCHEDULED AUTOS - - � � - ❑HIRED AUTOS BODILY INJURY $ (Per accident) ❑NON OWNED AUTOS PROPERTY DAMAGE $ (Per accident) u UMBRELLA LIAB OCCUR - EACH OCCURRENCE $ - ❑ EXCESS LIAB CLAIMS-MADE - - AGGREGATE - $ ❑ DEDUCTIBLE $ ❑ RETENTION E q WORKERS'COMPENSATION AND WC 012438946 MA 07101/11 07/01/12 wc.sTAru OTHER EMPLOYERS'LIABILITY TORY LIMITS ANY PROPRIETORIPARTNERIEXECUTIVE EACH ACCIDENT E.L. 2,000,000 - ' OFFICERIMEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE—EA EMPLOYEE $ 2,000,000 if yes,describe under - - DESCRIPTION OF OPERATIONS below - E.L.DISEASE—POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) All worksite employees working for the above named client company,paid Under ADP TOTALSOURCE,INC:s payroll,are covered under the above stated policy. The above named client is an alternate employer under this policy. rCANTON,MA TIFICATE HOLDER y CANCELLATION I-JOHNSON HVAC,INC. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE DAR ST y THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY.PROVISIONS. 02021 AUTHORIZED REPRESENTATIVE p$an isA{f eltv ce.6, 2ne o f(flotirla Commonwealth Hof Massachusetts r� Sheet Metal Permit Map 3 U Parcel d6' GO Date: C'. � t Permit )®1a 0 Db q P Estimated Job Cost: $ Permit Fee: $ Plans'Submitte&. YES` NO Plans Reviewed: -YES PNO Business License# X Applicant License# Business.Information: Property Owner I Job Location Information:� Name: Name: fi(h C Street.'.30 Street: City/Town y— 1�4 7YO City/Town: j6LA4411 �61 '� 1 Telephone:'- Tele hone:S S I LL�.. lrL 7 Photo I.D. required/Copy of Photo I.D..attached: YES v NO Staff Initial t t J-i/ -I- urestrictedxlicense. J-2/M-2-restricted to dwellings 3-storie8 or less and commercial up to 10,000 sq. ft. /2-stories or less Residential:4-2 family _,:4 " Multi-family Condo /Townhouses Other Commercial: Office Retail Industrial Educational 47 Fire Dept.Approva Al institutional Other Square Footage: under_10,000 sq..ft.. over 10,000 sq. ft. Number.of±Stories: Sheet metal work to be completed: New Work: Renovation: k. IIVAC. M6tal Watershed Roofing Kitchen Exhaust System Metal.Chimney(:Vents Air Balancing Providedetailed description of workto°be done. AAA— &e NSURANCE COVERAGE: have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes No ❑ IF you have checked Xp&, indicate the type of coverage by checking the appropriate box below: >, liability insurance policy K Othertype of indemnity ❑ Bond ❑ )WNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Aassachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent - {•" ly checking this boxA I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and .ccurate to the best y knowledge and that all sheet metalwork and installations performed under the permit issued for this application will be i compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Progress Inspections Date Comments Final Inspection Date Comments Type of License: y Master itle ❑ Master-Restricted ityfTown ❑Journeyperson Signature of Licensee ermit# t� ❑Journeyperson-Restricted License Number: . —11 :e$ ❑ Check at www.mass.gov/dnl 1spector Signature of Permit Approval • Z7ce Commonwealth ofMassachusetts Department oflndustrial Accidents Office of Investigations t 600 Washington Street Boston,MM 02111 www.mass gov/dia , Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leg4bl Name(Busmess/orgaaiz ion/Individual): o,II// Address: 3 0 WaVtk City/State/Zip: Id 440,,; Phone.#:. .7 4 7, - Are you an employer?Check the appropriate boa: a of ro ect(required):., �4. I am a general contractor and I p 1 ( q i .d);: 1.� I am a employer with�� ❑ g 6.• . . employees(full and/or part time).*: have hired the stab=contractors _ New constriction 2.0 I am a sole proprietor or partner-, listed on the-attached sheet 7. Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working.for me in any capacity. employees and have workers' co ;Henri-I ' 9. 0 Buildingaddifion . [No workers'comp:insurance mp• required.] 5. We are a corporation and its . -10.❑Electrical repairs or additions 3.❑ I am a homeowner;doing an work: officers have exercised their 11.[]Plumbing repairs or additions rnysel£ [No workers'comp. right of exemption per MGL 12.[j Roof repairs insurance required.]t c. 152, §1(4), and we have no . employees. [No workers' 13.❑rOther comp.insurance required.] "Any applicant that checks box#1 umst also fill out the section below showing thew 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;ndicalmg such. x Imtractors that check this box must attached.an additional sheet showing the name of the sub-contractors and state whether ar not those entities have employees. If the sub-contcactorrs 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: f h . Policy#or Self-ins.Lic. Expiration Date: O Q lob Site Address: 3�� 1 t�!?�� - VIC15sk, City/State/Zip: Attach a copy of the workers'compensation policy declarafionpage(showing the policy number and expiration date): Failure,to.secure coverage as regaired under Section 25A of MGL c. 152 can lead to the imposition of canal penalties of a fine up to$1,500.00 and/or one-year imprisomnent,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 maybe forwarded to the Office--of Investigations of the DIA for insurance coverage verification I do hereby certify under a pains•and pe e ' that theifomaon n pry rovided above is true arid.correc t. Si tune: - • _ Date: Phone#: Official use only. Do not-wrke in this.area,tb be completed by cin,or town offcciaL } City or Town: Permit/L:icense Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector: 6. Other Contact Person:• Phone#: WE Town of Barnstable egulatory.Services sues Thomas F.Geiler Director , 1659. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstabk.ma:us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must. Complete and.Sign This,Section ' : If Us— ing A Builder as Owner of the subject property herebyauthonze,_ G'0' � To#jt/s0�. to act on my behalf, in all'ma.tters relative to work authotized:by this building pei7nit (Addx6si of Job) - Pool fences-and alarms are the res onsibili o p ty f the appllcant. .Pools are not to be fi11e4'before fence is installed and pools are not to be utilized unttl`aIl final inspections are perforrned'and accepted. 4�Appljc Signature of Signaturant 7 A Print Name — Print Name Date Q.FORMS:OWNERPERMISSIONPOOLS . Town of Barnstable .�. b Regulatory Services • iaBtvsrears, « Thomas F.Geiler,Director v >a.+se 1659. h•�� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street . village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable-to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to co ed g q comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEIIIPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,- Rules&Regulations for Licensing Construction Supervisor;,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 prcceed 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 full aware ofhis/her Y responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a forni/certification for use in your community. Q:forms:homeexempt The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington'Street ' 'Boston,Mass. 02111 R www.nzass.gov/did Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information , _ Please Print"Legibly Name (Business/Organization/Individual): ( �� �0 Address: 1J T ,I City/State/Zip: dul.�_ A 0)9gO,_ , Phone#: IM4` "S0J- 3O7I/ -� Are you an employer?Check the appropriate box: Type of project(required): 1. X I am an employer with 4..b.I am a general contractor and I 6.?Cew construction. employees(full'and/or part time).* have hired the sub rycontractors7.❑ Remodeling 2. ❑ 1 am a sole proprietor or,partner- listed on the attached sheet. ship and have no employees These sub-contractors have " 8.❑ Demolition - Working for me m any capacity. employees and,have workers' 9.❑ Building addition [No workers'comp.insurance comp.insurance.$ required] 5.0 We are a corporation and its 10. ❑'Electrical repairs or additions 3. ❑ 1 am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself [No workers'comp. ;'right of exemption'perm MGL w insurance required]f "c. 152,§ 1(4),and we have no 12. ❑f Roof repairs p' } employees. [no workers 13. ❑ Other comp:insurance required:] *Any applicant that checks box#1 must also fill out the section below showing their workers' _ kers'compensation policy information. , f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contactors that check this box must attach an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If, the sub-contractors have emplovees,they must provide their workers'comp.policy number. I ant an employer that is providing workers'compensation insurance for'my employees.Below is the policy and job site information. Insurance Company Name: T"1(46' h " C .,Ola 43 ��h M LL Policy#or Self-ins. Lie.#: R A .. Expiration Dater Job Site Address: S -eAj City/State/Zip: )s /✓�'� l,. 1, Attach a copy of the workers' compensation•policy,declaration spage(showing the policy number and expiration(date). Failure to secure coverage as required under Section 25a of MGL.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one year imprisonment as well as civil penalties in the forin of a STOP WORK ORDER and a fine of $250.60 a day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the,pains acid pezz ties of uzy that the information)provided above is true and correct. hoSignature: - Date: c!' 0 Print Name: A� Q�o Q oC[d� � Phone#: 9 4,-5'Q P f - Official use only Do not write in this area to be completed by'city or town''offzcial City or Town: Permit/license#: _ Issuing Authority(circle one): 1.Board.of Heath 2.`Building Department, 3.City/Town Clerkt 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#: } �3oarbof •i t'.5tr tt .- of 61jw fitlet4t her '. y A iiltq $Ati!qfieb"tlje, requireme-ut5s, of a'gs'ad)ll5ett!g oelterat RAoa a ter 112 ect P . tort �37 t�ji�atigYj 251 (Col"Ut 7.3) Ob Yjercbp granteb-t1ji,5, certificate.'no." 355,ag ebioeilce to vrActicC''a rat t it C -.5 on tfji5 grlj bap of 0 201-1 > til Yoi�p Yjere®f.`,�i r)ereli11t4: Affi:r°eo tl)c Ilan of,11je (xerti ibe �DO`e ' of41 cu rb r —CohHVIONIMEALTH OF ¢1-MRSA"x`.t•IUS QTS a E I_ s AS A BUSINESS m ;\DOVE LICENSE 10: _NN KEVI14 L• MAIP! -, � z a 4 ' all' s ' CDTT.I—JOHCJSON' NVAC ItJC ua ;27; rcr3 „a 8'0 CEDAR ST �nr ; ' ' Fa ��1tTtc. CANTON 11A 02021-000 e' . s5.b 05/09/13 9984uP} 6 girF a t s.. Ac® CERTIFICATE OF LIABILITY INSF2/8/2012 D ,DD,YYYY, INSURANCE �7 V 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 Norwell Construct South NAME, Eastern Insurance Group LLC PHONE F� No 77 Accord Park Drive E-MAIL ADDRESS: Unit B1 PRODUCER ERID#p0040506 Norwell MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Travelers Inc .of America 25666 Cotti Johnson, HVAC, Inc. INSURERB:Travelers Indemnity Co 25658 WAVERLY STREET REALTY INSURER.0: 30 Waverly Street INSURER D: INSURER E Taunton MA 02780 INSURER F: COVERAGES CERTIFICATE NUMBER:Standard 12-13 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCEINSR WVD POLICY NUMBER MM,DD MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence) $ 300,00M A CLAIMS-MADE FxI OCCUR X 6803782X754 1/22/2012 .1/22/2013 MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 - GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 A0770MO74 1/22/2012 1/22/2013 BODILY INJURY(Per person) $ A ALL OWNED AUTOS X BODILY INJURY(Per accident) $ X SCHEDULED AUTOS - _ - _ PROPERTY DAMAGE X HIRED AUTOS - (Per accident) $ X NON-OWNED AUTOS - Comprehensive Ded $ 500 Collision Ded $ 500 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DEDUCTIBLE $ B RETENTION $ 5 000 8950Y645 1/22/2012 1/22/2013 $ WORKERS COMPENSATION - - WC STATU- I -OTH- AND EMPLOYERS'LIABILITY Y I N - - TORY I IMITR FIR - ANY PROPRIETOR/PARTNER/EXECUTIVE -- OFFICER/MEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ (Mandatory in NH) .. E.L.DISEASE-EA EMPLOYE $ If yes,describe under - - DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Evidence of Insurance. ' l CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FOR INFORMATION PURPOSES ONLY ACCORDANCE WITH THE POLICY PROVISIONS. ' . - AUTHORIZED REPRESENTATIVE - Ronald Cleaves/JNII, rr�/ ACORD 25(2009109) ©1988-2009 ACORD CORPORATION. All rights reserved.. INS025(200909) .The ACORD name and logo are registered marks of ACORD 30 WavTrIv. Taunton, ,MA 278 w 781` 821-y5i1 F'i^�on� 1' "➢� 3 ( 91� 821-1599 Fax VACy, INC. ENCE I da 2/9/12 RE: Gary St. Clair,License # 8149 Cotti-Johnson HVAC, Inc.hereby grants Gary St. Clair, a Master Sheet Metal Mechanic permission to pull Mechanical.Permits on the company's behalf Please do not hesitate to contact me with any questions. Thank you. Angelo S. Boccalini V.P./ Controller f i P �.-_._...Via. � ��t��.,l��f tt� g_�_—l��A A._ T;q g_. t,✓; td 2�4'e�d-55:flHEALTil1 ` F etl ASSACf��U;! SHEET METAL WORKERS AS A MASTER-UNRESTRICTED iSSUES.THE ABOVE,UCENSE TO 1 GARY J ST` CLAIR.l .11 UNIONPARK ` ' HANSON MA 02341 .2069 t: 8149 . 05/28/12 99281I,:- 'r F. 1 ._ 4� DATE(MM/DD/YY) I CERTIFICATE OF LIABILITY INSURANCE 06/10/11 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. i 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 toIt the certificate holder in lieu of such endorsement(s). I PRODUCER CONTACT Aon Risk Services,Inc of Florida Aon Risk Services,Inc of Florida NAME-, 1001 Brickell Bay Drive,Suite#1100 PHONE 800-743-8130 FAX 800-522-751 A/C No.Ext: A/C,No: Miami,FL 33131-4937 E-MAIL ADP.COLCenter@Aon.corn ADDRESS: PRODUCER 10762287 CUSTOMER ID#: j INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:New Hampshire Ins Co 23841 ADP TotalSource MI XXX,Inc. INSURER B: 10200 Sunset Drive Miami,FL 33173 INSURER C: ALTERNATE EMPLOYER INSURER D: Cotti-Johnson HVAC,Inc.. 80 Cedar St, INSURER E: Canton,MA 02021 INSURER F: COVERAGES CERTIFICATE NUMBER: 308176 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. LIMITS SHOWN ARE AS REQUESTED. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS ,LTR INSR WVD - DATE(MMIDDIYYYY) DATE(MMIDDIYYYY) - - GENERAL LIABILITY - EACH OCCURRENCE $ ❑COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED $ - - ❑CLAIMS MADE ❑OCCUR - - - PREMISES(Ea occurrence) - MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS_COMP/OPAGG $ ❑POLICY ❑PROJECT ❑ LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ❑ANY AUTO (Ea accident) ❑ALL OWNED AUTOS BODILY INJURY ❑SCHEDULED AUTOS - - _ - (Per person) $ - ❑HIRED AUTOS BODILY INJURY - $ _(Per accident) ❑NON OWNED AUTOS _ PROPERTY DAMAGE $ (Per accident) u UMEIRELLA LIAB OCCUR - - - EACH OCCURRENCE - $ ' ❑ EXCESS LIAB CLAIMS-MADE - - AGGREGATE $ - ❑ DEDUCTIBLE - - - ❑ RETENTION $ ' $ A WORKERS'COMPENSATION AND WC 012438946 MA 07/01/11 �7/01 WC STATU- OTHER 'h EMPLOYERS'LIABILITY TORY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE - - - E.L.EACH ACCIDENT _ OFFICER/MEMBER EXCLUDED? N/A - $' 2,000,0000 (Mandatory in NH - .. if yes,describe under E.L.DISEASE—EA EMPLOYEE $ 2,000,000 DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) All worksite employees working for the above named client company,paid under ADP TOTALSOURCE,INC:s payroll,are covered under the above stated policy. The above named client is an alternate employer under this policy. Y:< en yPERTIFICATE HOLDER s CANCELLATION kw COTTI-JOHNSON HVAC,INC. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE 80 CEDAR ST THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CANTON,MA 02021 AU THORIZED.REPRESENTATIVE 0401L Cisk i f etv&eb, 2nc o f(flotida Commonwealth of Massachusetts .fix 'Sheet Metal Permit MapParcel 06 6 L&f ✓ ' Date: Permit'# owl C)60� Estimated Job Cost. $ (�,5�� `� Permit Fee: EC S Plans Submitted:AES NO Plans Reviewed-. YES NO Business License# 3 S"S' Applicant License# Business Information: Property Owner/Job Location Information: ' Nave: S n 01_�t '}`i (��jj Name: - �Y oyl CCI Street: 3y Lj aay l J f t t. Street: U 5' City/Town'. "WIT'd /�.✓a� "®l7�F: �. City/Town:. 9Y/�4/.vi S' /Kf1•, - Telephone:' ��" Telephone:, ��' Photo I.D. required/Copy of Photo I.D. attached: YES NO Z , Staff Initial. J-1 /l -1-,inrestricted liceiise J-2/M-2-restricted to dwellings 3=stories or less and commercial'up to 10,000 sq. ft. /27stories or less'. Residential: 1-2 family. Multi-family Condo/Townhouses ` Other Commercial: Office. Retail Industrial Educational Fire Dept. Approval Institutional_ ; Other Square Footage: under,10,000 k. ft. over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: -New Work: Renovation: + HVAC nL Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of workto be done: .. ,.•- ., ��_ I: +. .. a `4 ; IJIN j-'x The Commonwealth of Massachusetts r Department oflndustrial Accidents Office oflnvestigations .600 Washington Street Boston,MA 02111 www.mass.gov/dia. Workers' Compensation IUSU.Mnce Affidavit: Suflders/Contractors/Electr-icians/Plumbers Applicant Information Please Print Legibly Name(Business/Orgmizafionrmdividuni):. VA CJ 1 I/ l C Address: O W 4V e h/N s . City/State/Zip: Id g J!2 hi M 4 22 71P ____ Phone.#: 9.q 4 -~611- 3 0411 Are you an employer? Check the appropriate box: 4. I am a en -Type of project(required):; 1.� I am a employer with�_ ,❑ general contractor.and I • employees(foil and/or part-time).*• have hired the gub=contractors 6. New construction . 2.❑ I am a'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. .❑Demolition working for me in any capacity. . employees and have workers' [No workers' comp.insurance comp.insurance,$' 9. ❑Building addition required.] 5• ❑ We are a corporation and its _ 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing aII work officers have exercised their' , 11.0 Phimbing repairs or additions myself [No workers' comp. - right of exemption per MGL 12.❑Roof repairs insurance required.]t .c. 152, §1(4), and we have no ." employees.[No workers' 13. Other comp.insurance required] *Any applicant that checks box#1 must also fill out the section below showing their workers+compensation policy information. t Homeowners who submit this affidavit indicating they a-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 tht 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"comp ensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: h Policy#or Self-ins.Lic.# WC Expiration Date: o Job Site Address: 390 s CVe-%S '51 ��Q1yS�� //�� M lF? City/State/Zip V , Attach a copy of the workers' compensation policy declaration page-(showing the policy number and expiration date). Failure•to.secure coverage as required under Sectinii25A ofMGL c. 152 can lead to the imposition of camanal penalties ofa fine up to$1,500.00 and/or one-year imprisonmmit 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 maybe forwarded to.the Office of Investigations of the DIA for insurance coverage verification I do hereby certify under a pains•and pen 'es of pe ' ry"that the information provided above is true and correct; Si afore: n Date: Phone 4: Official use only. Do not write in this area, to be completed by city or town official • I City or Town: Permit/License# Issuing Authority(circle one): .1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: i 0•1 t ,t / IKE Town-of Barnstable Re ulaio Se A . g . Ty rvices . 1MABS ®g Thomas F.Geiler,Director y `~ Building Division Tom Periji,Building Commissioner s 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 Usin A BU der. as Owner of the subject ro ; hereby d thoiize "a ` t. y ) Pt.P y p ' to act on niy behalf in allma.tters relative to work authorized by..this-buildin }yam ..ie= t .4 Vry (Address of Job) R Pool fences "and alarms are the responsibili of the a tY pplicant. Poolsare not to be filled before fence is installed and pools are Mot to be, Utilized until all final inspections are performed and"accepted. Y i ignature'of OwnerAi,—lL .A Signatu= .of Applicant -Print Name ' ,` - r,7 9cle-,Y- .. Print Name ' Date , Q:FORMS OWNERPERMISSIONPOOLS:4 " s .- x 'r 'br `•+,.,,^iR W `g" • E f tug_ + y. - a NSURANCE COVERAGE: have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 1 Yes 1 No ❑ , f you have checked ygj, indicate the type of coverage by checking the appropriate box below: 1, % liability insurance policy/ Other type of indemnity ❑ Bond ❑ )WNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter,112,of the i dlassachusetts General Laws, and that my signature on this permit application waives this requirement. s Check One Only Owner ❑ Agent ❑' Signature of Owner or wner's Agent ly checking this box` ,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true`and .ccurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be i compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. s . Duct inspection required prior to insulation installation: YES' NO r Progress Inspections Date Comments, Final Inspection " 1s Date Comments Type of License: y ❑ Master ' itle ❑ Master-Restricted ity/Town ❑Journeyperson Signature of Licensee ermit# �� ❑Joumeyperson-Restricted License Number: :e$ ❑ Check at www.mass.govIdol 2spector Signature.of Permit Approval } i Commonwealth of Massachusetts Sheet Metal Permit Map Parcel Date: Permit# Estimated Job Cost: $ Permit Fee: $ Plans Submitted: YES NO Plans Reviewed: YES NO Business License Applicant License# Business Information: Property Owner/Job Location Information: Name: Name: Street: Street: City/Town: City/Town: Telephone: Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES NO Staff Initial 'J-1/M-1-unrestricted license J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less Residential: 1-2 family Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial - Educational Fire Dept. Approval Institutional_ Other Square Footage: under 10,000 sq. ft. 4over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work: Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing. ;Provide detailed description of work to be done: a v - .t ?qu nton, MA 02780 1.-i.511.Phone .. 781) 82 1599 Fax ,y MM . . z 2/9/12 i 4 RE: Gary,St. Clair, License # 8149 Cotti-Johnson HVAC;Inc..hereby.grants'Gary rSt. Clai'r,`a`MasterSheet Metal'Mechanic permission to pull Mechanical Permits:on the company's behalf. Please do not.hesitate to contact me with'any questions. - Thank you. 0. k " ff� Angelo S. Boccalini x V.P./=Controller c CC���CR�t=�LT�®F A�ASSAC�NSETT� �: _ SHEET METAL WORKERS AS AMASTER-UNRESTRICTED ISSUES THE ABOVE LICENSETCi 1 GARY J ST CLAIR m 11'. t1NI0N. PARK " HANSON MA 02341 2069_ 8149 05/28/12 992811� = ' z 6 P DATE(MM/DD/YY) I CERTIFICATE OF LIABILITY INSURANCE 06/10/11 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 i 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 f the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Aon Risk Services,Inc of Florida ' Aon Risk Services,Inc of Florida `' NAME: 1001 Brickell Bay Drive,Suite#1100 PHONE 800-743-8130 FAX 800-522-751 A/C No.Ext (A/C,No): Miami,FL 33131-4937 E-MAIL ADDRESS: ADP.COI.Center@Aon.com PRODUCER 10762287 CUSTOMER ID#: j INSURER(S)AFFORDING COVERAGE NAIC# - i INSURED INSURER A:New Hampshire Ins Co 23841 ADP TotalSource MI XXX,Inc. 10200 Sunset Drive INSURER B: Miami,FL 33173 INSURER C: ALTERNATE EMPLOYER i INSURER D: Cotti-Johnson HVAC,Inc. ' 80 Cedar St, INSURER.E: Canton,MA 02021 INSURER F: COVERAGES CERTIFICATE NUMBER: 308176 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. LIMITS SHOWN ARE AS REQUESTED. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSR WVD DATE(MMIDDIYYYY) DATE(MWDDlYYYY) GENERAL LIABILITY EACH OCCURRENCE $ ❑COMMERCIAL GENERAL LIABILITY - - - DAMAGE TO RENTED ❑CLAIMS MADE ❑OCCUR q - _ PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ i GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS—COMP/OP AGG $ - ❑POLICY ❑PROJECT ❑ LOC - - - $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ❑ANY AUTO (Ea accident) $ ❑ALL OWNED AUTOS BODILY INJURY $ ❑SCHEDULED AUTOS � � - ,. (Per person) i BODILY INJURY ❑HIRED AUTOS - - $ I (Per accident) ❑NON OWNED AUTOS - PROPERTY DAMAGE (Per accident) $ - Cl UMBRELLALIAB OCCUR EACH OCCURRENCE $- 0 EXCESS LIAR CLAIMS-MADE AGGREGATE $ - ❑ DEDUCTIBLE ❑ RETENTION $ $ A WORKERS'COMPENSATION AND WC 012438946.MA 07/01/11 07/01/12Ix WC STATU- OTHER EMPLOYERS'LIABILITY 7ORY LIMITS ANY PROPRIETORIPARTNERIEXECUTIVE - OFFICER/MEMBER F�(CLUDED? - NIA E.L.EACH ACCIDENT $ 2,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE If yes,describe under - - $ 2,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE—POLICY LIMIT $- 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) All worksite employees working for the above named client company,paid under ADP TOTALSOURCE,INC's payroll,are covered under the above stated policy. The above named client is an alternate employer under this policy. CERTIFICATE HOLDER , ,F CANCELLATION 7 ..' COTTI-JOHNSON HVAC,INC. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE 80 CEDAR ST THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CANTON,MA 02021 AUTHORIZED REPRESENTATIVE on 61;LalC i5d'CV cas; qnc of(floFcidct ell �tHE t°w TOWN OF BARNSTABLE ■ ti Bu. 2011 `024 UP 1 . BARNSTABLE, # Issue Date: 00/20/11 Permit y MASS 1639• Applicant: ADVANTAGE CONSTRUCTION �FG .1 A Permit Number: B 20112027 Proposed Use: CONDOMINIUM Expiration Date: 03/19/12 Location 320 STEVENS STREET Zoning District SPLTPermit Type: SPECIAL PROJECT NEW COMMERCIAL Map Parcel 308004 Permit Fee$ 4,232.24 .Contractor ADVANTAGE CONSTRUCT30' Village HYANNIS App Fee$ 150.00 License Num. 019925 Est Construction Cost$ 465,081 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND i SHELL PERMIT,BUILDING F.FLASHIP ESTATES ON EXIST FOUNDA IOVHIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY.IS REQUIRED,SUCH Owner on Record: FLAGSHIP ESTATES HYANNIS,LLC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: TWO ADAMS PLACE INSPECTION HAS BEEN MADE. SUITE.100 QUINCY,MA 02169 Application Entered by: PR Building Permit Issued By: �` THIS PERMIT CONVEYS NO RIGHT TO:OCCUPY ANY STREET,ALLEY.OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARH.Y,OR PERMANENTLY ENCROACHMENTS ON PUBLIC PROPERTTY,NOT SPECIFICALLY,PERMITTED'UNDER.THE BUILDING CODE MUST BE APPROVED BY THE JURISDICTION.,;STREET OR ALLEY_GRADES AS WELL AS•DEPTH.AND LOCATION OF PUBLICSEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC;WORKS THE ISSUANCE OF TIIIS PERMIT DOES NOT RELEASE THE APPLICANT FROM'THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS:' MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6:FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND'MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL.BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS v( V, .x-J ,+1�8 71� 2 2 2 3 ( ¢ 1 Heating Inspection Approvals Engineering Dept � � Fire Dept 2 Board.of Health s i 7 Structural Engirieering l,g�gp�� gµ-�p(�p9 pg gg g�-l�pg p" ��J7 gg gg 7��@J� I.pg��y{.'�� gp 1:\.®':���T::�161 H.11 �Y' '�� A.�Y'..8DAVIT FOUR CONST. 'J� Il 1 Y:�� :ILL 1\�:x.,• is .. .,. .. TO: Donald O'Neill Advanta,-e Collstri etioD Two Adams;Place,'Suite,1:00 Quincy, M;A 02169 Rh:. Iiyannis Con.damini.ilms Building) 70O:.Mlain Street. Hyaaanis,MA. ' PROJECT NO.: l C:.#0569 L)A E n_ _. �. �.,:. �! i it 4,2U 12 ------------ To the Building Camn� s��ouci In-ace ardance iih Section 1U7.6 ol'the Eighth Edition of.the Massaehusetts State Building CUd , tills letter'shal] serve as. a Final A#fidavit for the above r&f rre:nc.ed'bu�ldurg.:ancl that to.tk�e best of my knowkec1g, th�:.'proyJ,bn5 of... the builili:nl; code have. bran .':compliq. with and the area of work meets xhe requirements;cif. U�e'cUnstructio��r' a i�_4 z rt,s ..:, 00uA, #40868 a spa ORIG SIGNATURE MASS. RAG.NQ: twuxuaAL rstr ' �ra ' tcx ' Stnc y R:Flood,PE 6 Laurel Drive 'Hu.rJson, NM:A 017=19 TEL::(978 64 FAX (9:78) a6°2 F24Fi April ,11 20 z� 1 -ApriW T May 2012 ,.S M .T T F S S M T W T F S 1 2 3 4 5 6 7 1 2 3 4 5 Wednesday 8 910 11 12 13 14 6 7 8 910 11 12 15 1617 18 19 20 21 13 14 15 16 17 18 19 22 23 24 25 26 27.28 20 21 22 23 2425 26 2930 27 28 29 30 31 TaskPad 7 am I ❑✓ TaskPad:1`4 �'_;,,• VW� L— p 00 r goo -- 1000 — 11Ali 00 ccm chipolte frm 12 pm flagship frm _ 15 sq,rig frm 00 26 nancy pool fl 87 pondside fin e 7 Notes 00 9 otter fin 6 twickenham msu f' 3 x 4 00 S 00 _? — Roma, Paul 1 4/11/2012 10:25 AM. 320 STEVENS STREET FEES PAID FEES CHARGED OVER PD BUILDING A 7,202.50 3,682.47 BUILDING B 5,453.11 3,378.05 BUILDING C 3,406.85 1,981.83 BUILDING D 3,331.85 2,056.83 BUILDING E 100.00 4,503.17 BUILDING F 4,557.24 - 2,446.91 BUILDING G 7,872.18 5,422.14 TOTAL 31,923.73 23,471.40 8,452.33 BUILDING G C/O 125.00 8,327.33 I d x r I F7 ,�'�"I'�.�.::'I 11, ,'1 4_ :- !_ _ :�, W � � I �. � � � . I I-L.-.;1 4 �..... ,**_-11-,,.., _-�_;-*'�,,,i,�.:1,_ -; — -_,�'%�� ... - . I 1t-�',: ,�._ i �.�" �. : ' . .. .1, I - I � . 1 C.......1. � - N. .. , * . 1,:.,;,.,-, :"�:".:�.,:�..��.�. ,�,:� . . .1 .��;;�,,�"::.,� r'7 .��,,, `��, .:_,__- I 1, _, _..t,,.., .:',,._�' . ��."�,��,!� ,,,.,��.,.�41,���:,�.�' ..ii ��::t�*.,-F ._1 I . . I 1. � � .1 . I . �'�,.,. ::.��...,.;.�,�,.���,.,... . ...,. :,�-l'-,��i-....;�.�'-...�'....�.� :1.,:- .� I I:- � � I ,t Sxructural E.n ineerm :�,' .,��::tt�' ,� �,�,��, g g:: � y S a, '1 'i -y J l_ �. ! f+ ,,. ]': w' F 6 ". 11r STRUCTURAL AFFI AVIT FOR CONST'RUCT'1ON COIVT'ROL x �74 J Y.- FS. f, d. f t } .y. 4 } II '.;.. . ', i t i�F - § u e -. _ .- t 1 m TO Flagship.Estates LL'C �K ' ' : 4, t k; y t t J. x Two Adams P.Iace,,Suite 1'00 k Quincy; 'MA'02169,.. � , a '� T ' } '�.�,i.1.L,,.�,I--_,:,.��-=.I_4�.'.�.,�,,�:�.�.L;�...._.��,.=,1,:1.�,,,,�,�,..,.,.'��,�,:..:.,�I�.:�,,.'_��.:-:_."i:.:;..�.:,�_�,.,-,1�-,..I-1_1,.,"..�.,...;,:-;;L,'.,..-i.m:,",i':,-.r�,�,z.t'.:4�.t_I��,I.,;'�....�,:.-,L�-�'�o.*;J i1._...,-1.�-"---I.�,�.i,��..',.�In-.,,��.- RE Hyannis Condominiurt� Devet®pment ' ti _ Building«F�, 2V .S �, , ;{z ""Sfevens Streef' y - �_' _ � Hyannis,';`MA . a f ,_ FC PROJECT No 0569 DATE> September,20,`2011 � '" i a fi +'� ,; t. in accordance with the Massachusetts.State Building,Code Section 116 0, the , engineer's authorized representative will:make periodic field visits during the; ` . t: construction period for the_above-referenced project;and.make observations;of work in progress. Observations shall be recorded and furnished �mptly theQ' ; Owner for distribut►on ,, `r•.j s ' -, . s `---' OF r ;. , . .I -, �. - A F . +.oar ?;r Lc #42868 w >~to ` STA R FLOOD MASS REG NO r 9 p �o x ��� i a. /IL Y :; i STRUCTURAL } ;-"_a,; ,. r - , , 1 a .r r. ` f r 1 r- 's y C 9 £s i7 " z t a r 4' k ), a t J i s ? t -�' Lt?. ,p _.,yy,P n i tv .,1 d t �' % c FC#1., �r 5 , Y fs. fv J 1 Ft d y X' i 56 "aure Drive t Hudson fVIA 01749 TEL 978 562=6499 t/kX :{978)`562 246 �.. ,.n....Mt__,�:4t;~_. ..v.. ��,. r. , ..� ¢., r.,., t .. . ,8,, ,t,... .. ,,.. ., :{a .:a.., L. m y °Ft r Town of Barnstable °^ Regulatory Services * snarrsrASLe. « 9 MASS. Thomas F. Geiler, Director 163 p- 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 MEMO TO: Joseph Lambalot FROM: Debi Barrows DATE: September 12, 2007 RE: 350 Stevens Street, Hyannis The following applications 200700489,200700490 and 200700486 were entered as commercial instead of residential. In order to correct this error the following applications 200704737, 200704739 and 200704740 fees have been adjusted to reflect overcharge. See below. Fees Over Pd 200700486 200700489 200700490 Application 50 50 50 Permit 1875 1875 1125 Cert. Occupancy 75 75 75 2,000 2,000 1,250 200704740 200704737 200704739 Permit Fees 1,921.88 1,921.88 1,153.13 Balance 78.12 78.12 96.87 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION J Application #Map Parcel t /0 Health Division Date Issued l� Conservation Division Application Fe I MD Planning Dept. e Permit Fee ��. -a- -7 Date Definitive Plan Approved by Planning Board Historic - OKH �� _Preservation / Hyannis 0-7 Project Street Address ���V�t1S Village Owner 4-N',Q �V/Xyvslz, ac Address--Tjn Gc�o rYlS'?\O.co- Telephone Permit Request ��pq\\ rm�� t ��G�� �\c�a� �S�a�eS can ,�ln� Square feet: 1st floor: existing proposed am 2nd floor: existing proposed &9ql� Total new Zoning District ofl) Flood Plain Groundwater Overlay Project Valuation yU5,C �°-1 Construction Type Lot Size ��� , �V�-1 Grandfathered: ❑Yes L�Ko If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) 3 Age of Existing Structure Historic House: ❑Yes `d No On Old King's�Highway:zEll Ye ❑o Basement Type: ❑ Full ❑ Crawl ❑Walkout dbther ff:�NCL. _ L) `- Basement Finished Area (sq.ft.) _ Basement Unfinished Area (sq(ft') Number of Baths: Full: existing new C) Half: existing new- Number of Bedrooms: existing _new Total Room Count (not including baths): existing new \D First Floor Room Count cD Heat Type and Fuel: W Gas ❑Oil ❑ Electric ❑ Other Central Air: P/Yes ❑ No Fireplaces: Existing New Existing wood/coal stover ❑Yes fa No Detached garage: ❑ existing ❑ nnew size—Pool: ❑ existing ❑ new size — Barn: ❑ existing ❑ new size= Attached garage: ❑ existing 4 ew size 33 Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Au If yes, site orization ❑ Appeal # Recorded ❑ Commercial ❑Yes o Ian review# e p Current Use_ \IacapA k D Proposed Use-, APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name I 11IQ,v-Aao4 C(yyS�r Telephone Number Address c� aL), \��0.CQ- 3 \03 License # \Q(A p� t QA\ Home Improvement Contractor# Worker's Compensation # CY_)U \3Cij £& ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C.L. rs SIGNATURE DATE �� . FOR OFFICIAL USE ONLY Y}. APPLICATION# DATE ISSUED J MAP/PARCEL NO. • 1 1 ADDRESS VILLAGE OWNER' DATE OF INSPECTION: FOUNDATION FRAME INSULATION L' FIREPLACE -C ELECTRICAL: ROUGH FINAL , s, PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED,OUT F ASSOCIATION PLAN-NO. 1 4The•Commonwealth of Massachusetts.:. Department of Industrial Accidents ' i d^ r Office of Investigations d 600 Washington Street .K T Boston,,MA 02111 ' www.mass.gov%dia Workers' Compensation Insurance Affidavit.Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): � a Q � Address: r_ .Tn� ,�C.Q City/State/Zip: , ffA \ Phone#. �. lk �1. Are you an employer? Check t propriaoe box: ¢, Type of project(required):` 1.ElI am a employer with" 4. M/ am a general contractor and I construction employees(full and/or part-time) * -' have hired the sub-contractors , 2.❑ I am a sole proprietor-or partner listed on'the attached sheet: r 7:, ❑Remodeling These sub-contractors have' ship and have no employees ` 8 n Demolitio workingfor in an capacity. employees and have workers' Y P h $ 9. 0 Building addition. [No workers'-comp.insurance comp. insurance. 5. We are a corporation and its IO.Q.Electrical repairs or additions required.] u officer s have exercised their 11:�Plumbin re airs or additions' 3.❑ I am a homeowner do mg all work g P myself. [No`workers'comp.k;` right of exemption per MGL- 12.0 Roof repairs insurance required.] t.°> C. 152,-§1(4);and we have no - employees. [No workers' 13.❑ Other comp.insurance required.] ' *Any applicant that checks box#1 must also fill out,the section.below showing their workers'compensation policy information, t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors rnusfsubmit`a new affidavit indicating such. XContractors thafcheck this box must attached an additionaFsheet showing the name of the sub-contractors and state whether or not those entities have employees. If the.suh-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: 'u Policy#or Self ins Lic #: ,Expiration Dater Job Site Address. �R V R' '�1 .1��5 . City/State(Zip: " Q LC_k�k Attach a copy of the workers'compensatiou'policy declaration page(showing the policy number and'expiratiou 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,imprisoninent,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 Investi ations of the DIA for insurance covera e'verification. I do her by ce nder t pains and penalties of perjury that the information provided above is tr'ue'and correct _ v Si nature: Date: ' Phone Official use only. Do not write m this area,to,be completed by city or town offichi City or Town. Permit/License# Issuing Authority(circle one 1.Board of Health`.2.Building D.e'partment 3.City/Town Clerk 4.Electrical•Inspector 5:Plumbing Inspector.` 6. Other . y' Contact Person. Phone Y , t 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 erate a business or to construct buildings renewal of a license or permit to op s in the commonwealth for any g 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 "public work una�acceptable evidence of compli ance with the insurance enter into an contract for.the performance or p p � Y P requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'.compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the'Department at the.number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to,fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in__(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Comrnonwealth of Massachusetts Department of Industrial Accidents Office of Investigations In esti tuns fi 600 Washington Street Boston, MA.02111 ° Tel. # 617--727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia VS °pSHET � Town of Barnstable- Regulatory Services anxxsrABM 9 Mas9. $ Thomas.F.Geiler,Director �AIFn �a�� Building.Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 wWw.town.barnstable.ma.us Office`. 508-862-4038 ' Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner.of the subject property hereby authorize N�\ycjj���- to act on my behalf, in all matters relative to work authorued by this building permit application for: (Address of Job) i re of. er Date � Print Name Owner is applying for permit please complete the If Property Homeowners License Exemption Form on the`reverse side. Q:FORMS:OWNERPERMISSION ,a " Town of Barnstable �OptHE 1'p�� Regulatory Services " Thomas F. Geiler,Director + BARNSTABLE, Y MASS. Building Division TFD '� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 . www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-.790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER!': name home phone# work phone# CURRENT MAILING ADDRESS: i city/town state zip code ti 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 Department minimum inspection procedures and requirements11 and that he/she will comply with said procedures and requirements. , Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State.Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that-if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page 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:homeexempt ACCO CERTIFICATE 0171IABILITY INSURANCE "` F DATE(MM`DDIYYYY) 9/12/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO`RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER ,THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE.ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies).must be endorsed.'If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may,require an endorsement. A statement on'this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). f ' PRODUCER CONTACT Diane Shaw - Fred C.Church,Inc. NAME: - 41 Wellman Street PHONE 978 3227272 FAl( - - (978)454-1865 .' A1C No Ext: ..4 -' AIC,IN Lowell,MA 01851 • E-MAIL - - _ - " dshaw@fredcchurch com ,+,...r-;, (800)225-1865 - ADDRESS:' u INSURER(S)AFFORDING COVERAGE- _ NAIC# Chartis Property Casualty Company 19402 .• e.,, ,`. INSURER A: - INSURED - ` .0 - - Charter Oak Fire Ins.Co.,',,., 25615 . INSURER:B: . Advantage.Construction,Inc. • � � ' '- r : Navigators Insurance Company < - - '•• • 42307..E INSURER C - - .. , Two Adams Place,Suite 100 -' - - Travelers Casualty Insurance Company of America 19046 - _ Quincy,MA 02169 ,. - - '_ INSURER D: - INSURER Ef -Starr Indemnity&Liability:Company 38318 .. INSURER F COVERAGES - CERTIFICATE NUMBER: 1a 3 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;TERWOR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITWRESPECT'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 =- - ADDL SUBR - - - POLICY EFF POLICY EXP LTR TYPE OF INSURANCE• INSR WVD - POLICY NUMBER MM/DD/YYYY MMIDDIYYYY -` - LIMITS p f - GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 a .,. X' DAMAGE TO RENTED' - 300,000 ' COMMERCIAL GENERAL LIABILITY r " ' - "rY 4 - PREMISES Ea occurrence $ +- CLAIMS-MADE OCCUR. •.., MED EXP(Any one person) $„5,000 B - - 1464D1464 t i•6/20/2011 6/20/2012 1,000000 ' ` - - PERSONAL&ADV INJURY -$ 2,000 000 GENERAL AGGREGATE -$ -GEN'L AGGREGATE LIMIT APPLIES PER: 4 - - - ;PRODUCTS-COMP/OPAGG $ 2,000,000 - 0° a ,PRO- -X : - - .- ,, $.. ,, v .. -POLICY JEC LOC - AUTOMOBILE LIABILITY - . .` ' % `" _ < '.. r ,. •. COMBINEDSINGLELIMIT 1,000,000 _ - - •. - ,.. Ea accident vr, _: .;. $ - ANY AUTO - F, t .R BODILY INJURY(Per person) $ D ALL OWNED SCHEDULED, t810464D1476 �' 6f20/2011R - 6/20/2012 BODILY INJURY(Par accident) ;$ ' AUTOS AUTOS X -X NON-OWNEDOPE Y ;, HIRED AUTOS ,� . ,PR RT .DAMAGE $ _ AUTOS ..Per accident . -$ X UMBRELLA LIAB .X OCCUR - G. _ ^ - •,• ` ' •EACH OCCURRENCE $ $6,000,000'. E EXCESS LIAB >`'`'` • SISCCCL01523811 6/20/2011 - 6/20/2012' - $5,000,000` ..CLAIMS-MADE .g n =� - AGGREGATE - '$ - " DED X.: RETENTION.$0 _; .- 4x •• $,' , WORKERS COMPENSATION - -.- - - _ WC STATU OTH- - AND EMPLOYERS'LIABILITY Y/N - ° - _ LIMITS- t F r A ANY PROPRIETOR/PARTNERIEXECUTIVE - E.L.EACH ACCIDENT $ _ OFFICER/MEMBER EXCLUDED? N/A •., 006430048 6/20/2011 6/20/2012 x '' E.L.DISEASE-EA EMPLOYE ;$ 1,000 000 - (Mandatory in NH) : v -If yes,describe under r " DESCRIPTION OF OPERATIONS below " " "s„. « 'E.L^..DISEASE-POLICY LIMIT $ 1,000,000 - . y. <". .__.a ,.. $10000;000 X of$5.000:000 1 -C Umbrella. f NY11EXC7111931V 6/20/2011= 6/2012012.- _ 4 .. .. DESCRIPTION OF OPERATIONS!L Schedule,if more space LOCATIONS I VEHICLES(Attach ACORD:101,Additional Remarks Schedre ace is required) ' • -<. _ , - Certificate is issued as evidence of coverage. : , s_ s ' CERTIFICATE HOLDER CANCELLATION own otbarnstable , SHOULD ANY OF THE ABOVE'DESCRIBED POLICIES BE CANCELLED BEFORE 1YOOPhinneysLane - THE .EXPIRATION DATE'THEREOF, NOTICE ,WILL` BE .DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 - `q<• - AUTHORIZED REPRESENTATIVE - - r , Client x M,t 18537 29035 Cert Holder# ., ©1988-2010 ACORD CORPORATION. All rights reserved: ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD M1 NATIONAL UNION FIRE INSURANCE,COMPANY OF PITTSBURGH, PA. 0090063-00 WC oo4-32-1274 13072 ------=-------------------------------------- 013-82-0611-oo ADVANTAGE CONSTRUCTION, INC. TWO ADAMS PLAZA SUITE 100 C H A R T S QUINCY, MA 0210-7456 A Chartis company EXECUTIVE OFFICES: SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE.- WC990610 175 Water Street New York, NY 10038 I.D# 911597713 PRODUCERSADDRESS KEATING GROUP OF MA LLC WORKERS COMPENSATION AND EMPLOYERS 144 TURNPIKE ROAD .. LIABILITY POLICY INFORMATION PAGE SUITE 150 SOUTHBOROUGH MA 01 2-0000 INSURED IS PREVIOUS POLICY NUMBER CORPORATION. RENEWAL 006430048 OTHER WORKPLACES NOT SHOWN ABOVE: SEE EXTENSION OF ITEM 1. OF.THE INFORMATION PAGE - WC990610 ITEM 2 POLICY PERIOD 12:01 A.M.standard time at the insured'.s mailing address FROM 06/20/11 TO 06/20/12 ITEM 3 A. Workers CompensationInsurance: Part One of the policy applies to the Workers Compensation Law of:the states listed here: MA NH RI B. Employers Liability Insurance: Part Two of the policy applies to,the work in each state listed in item 3.A.-. The limits of our liability under Part Two are: Bodily Injury by Accident $ 1 ,000,000 each accident Bodily Injury by Disease $ 1 ,000,000 policy limit Bodily Injury by Disease $ 1 ,000,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: AK AL AR AZ CA CO CT DC DE FL GA HI, IA ID IL IN KS KY LA MD ME MI MN MO MS MT NC NE NJ NM NV NY OK OR PA SC SD TN UT.VA VT WI WV D. This policy includes these endorsements and schedules: SEE EXTENSION OF ITEM 3.D. OF THE INFORMATION PAGE - WC990612 ITEM The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Premium Basis Rate Per Estimated Classifications Code Number Total Remuneration $100 OF Re- Premium RAnnual1:1 3 Year muneration Annual 3 Year SEE EXTENSION OF ITEM 4. OF THE INFORMATION PAGE - WC7754 t TAXES/ASSESSMENTS/SURCHARGES $9,616 EXPENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) $338 MA _MINIMUM PREMIUM $750 NH - TOTAL ESTIMATED ANNUAL PREMIUM $143,835 If indicated below,interim adjustments of premium shall be made: Semi-Annually Quarterly Monthly •DEPOSIT PREMIUM 06/29/11. PARS I PPANY 82 Issue Date Issuing Office Authorized Representative WC 00 00 01A 39967(Rev'd 04/08) A .11 t.......... am 3 € 14 a e, SS u. SOT: 1 su tY i Z ' c s en 4": x a " „ a g g00x� - 777 - a , S L"LIAM-G r 1� '771-!:�if- ' Poj 3 E, NN 4 € D s MA, 2660S"P, X:f ktxs- s� t kt. , e TV r�. 3 "�i1�@':itl Flia; ': � S� f ' € ^ € c SEP-16-2011 11:30 CONDYNE LLC 781 848 3774 P.04 I�D—\ The Commonwealth of Massachusetts Prinf•F,'orr�l< ;,' DeparlMent oflndustrialAccidents Office of Investigations I Congress Street, Suite 100 Boston,MA 02114--201 7 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electrieians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address:!'�J o 1AK City/State/Zip: �� � ( ��q Phone #: Are you an employer? Check the appropriate boat: l.Qt am a employer with �'� 4• ❑ m I a a general contractor and i Type of project(required): employees (full and/or part-time).* have hired the sub-contractors 6.`ET�"t'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 working for me in any capacity. g, ❑ Demolition employees and have work workers, o w 9. Build'<rI workers' comp. comp. insurance.Y ❑ to addition P P $ required_) S. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL insurance required.]t; C. 152, §1(4), and we have no 12.❑Roof repairs employees.. [No workers' 13•0 Other comp. insurance required.] 'Any appliegnt that checks box#1 must also fill out the section below showing their workcrs'compcnsation 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 whethcr or not those endues have employees. if the sub-contractors have employees,they must provide their woMen'comp,policy number. 1 am an employer that is providing workers I compensation insurance for my employees, Below is the policy and joh site information. Insurance Company Name: r t L, N� Policy#or.Self-ins. Lic.#: �; � 00��3�Q� - O�G\L Expiration Date.—AD Job Site Address: ',zA(\)-e f1� City/State/zi : Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to $1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine Of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi p#n4er th epafns and penalties o azzu_ry that the in ormatlon provided above is true and correct S i ature: Date: q 1 � Phone#: ( q (� 0J)7cial use ly. Do-not write in this area, to be completed by city or town official City or Town; Permit/License# Issuing Authority(cirele one): LC61,001att ard of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector heract Person: Phone#: �4 ' aejla3An AY r tibfi f n 'was/ September 12,2011 Tom Perry t Town of Barnstable 368 Main Street° F Hyannis, MA 02601 " k 01 lop .q ' " 9. g5 ks'.ro� n .sue a - • 3 }t , "Re: Flagship Estates'-Bldg F&G k s ' �20;Stevens Street Hyannis Ma 02601, - r " ,ray, �; � � -�• - - o ., Dear Tom Perry: --Please 46cept4this letter of notifieation that William G.-Ke11y;an employee of Advantage Construction,`Inc ,has'been4apporr ted to be,our,fuli time Superintendent for the project listed . above _ iz k If you have any questionpleasewfeel'free'to contact our office at(617)237 1840 A Y Sincerely Advantage Construction Inc:' -r € ^r 'J 'K _ C. ell . . Y A qk. r esident � A # , _ .A ...� gL pr Y �bV—p �1�t• q/1. -pp t �p p� p���a �c NTT Two`Adams Place Suite_ 100,-Qwh'c`- 02169 f e, Telephone:781:848,8787 Fax'781 848 3774 www.advantagecopstructioninC.Com "..�c Y i � t,• �� � .fit •P'a ^ir�y.5# � ..n°'¢y a J -. • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION /q41 ,�y3 AA Map Parcel "`' / Application# � -7cT Health Division Conservation Divisionsy ' ' Permit# Tax Collector Date Issued //�f7 -1 Treasurer - Application Feb"' `` 6 Y Planning Dept. ' Permit Fee Date Definitive Plan Approved by Planning Board 117�o t� Historic-OKH Preservation/Hyannis 9i.1�r Project Street Address ® J Village " t �LG Owner Address e' S �1� . � lav, Telephone ,r 7 �c Permit Request Square feet: 1 st floor:existing proposed . 7�� 2nd floor:existing proposedo Total new Zoning District Flood Plain Groundwater Overlay - Project Valuation ¢ Construction Type Lot Size Grandfathered: ❑Yes ago If yes, attach supporting documentation. Dwelling Type: Single family ❑ Two Family ❑ Multi-Family(#units) !�` �seG✓� Age of Existing Structure Historic House: ❑Yes uo On Old King's Highway: ❑Yes ®'No Basement Type: ❑Full 0 Crawl ❑Walkout der 1. G Basement Finished Area(soft) Basement Unfinished Area(sq.ft) a� 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 85 Heat Type and Fuel: &Gas O`Oil a . ❑ Electric ❑Other Central Air: f es a ❑No Fireplaces` Existing r New Existing woodlE9al stove: Yes. i9'IVo Detached garage:Ll existing ❑'new size Pool:❑existing ❑new size Barn:❑1xisting t2new7 size Attached garage;❑existing knew size /Aed:❑existing ❑new size Other: Zoning Board of Appeals Authorization U. Appeal# ' Recorded❑ Commercial ❑Yes - 0 No If yes, site plan review# Current Use e 4 ;� Proposed Se �1� cE's - r. ILDER INFORMATION Name �s %�r , rc� Telephone Number, 7XI A; 07f7 Address / License# /Zz'3� - rG Home Improvement Contractor# Worker's Compensation#Grp -26rhl ei5i iP� Z—exW ALL CONSTRUCTION DEBRIS ESULTIW FROM THIS PROJECT WILL BE TAKEN TO X1W QSI;GNATUR ----* Jk4�QtDATE Al/ 16 FOR OFFICIAL USE ONLY M I PERMIT NO. DATE ISSUED r MAP/PARCEL NO. ' ADDRESS VILLAGE x OWNER i ' Y , DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL , PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ` FINAL BUILDING f r DATE CLOSED OUT r ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents _ Off ce of Investigations K , a ' 600 Washington Street Boston,ALL 02111 'M www.mass.gov/dia Workers' Compensatioii Insurance Affidavit_: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lelzibl Name(Business/Organizationdndividual):((,��,, Address: City/State/Zip: Q%qulPhone:#: e you an employer? ChecV the appropriate box: Type of project(required):. 1. I am a employer with I 4• ❑ I am a general contractor and I i have hired the sub-contractors 6. []New construction . " employees(full and/or.part-time). , 2.❑ I am a'sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees � have ❑8. Demolition working for me i These sub-contractorsn any capacity. employees and have workers' [No workers' comp,insurance comp,insurance. $ 9. El Building addition_ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am ahomeowner doing all work officers have exercised their 1P.❑Plumbing repairs or additions myself. [Na workers''comp. right of exemption per MGL 1 12.❑Roof repairs insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other . Comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infom-lation. 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 ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. lam an employer that is providing.workers'compensation insurance for my employees. Below is.the licy and job site information. Insurance Company Frame: \ (�� Policy#or Self-,ins. Lie.# '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 copy of this statement may be forwarded to the Office of Investi ations of the DIA for insurance coverage verification. I do her , y c rtify u d the pains and penalties of perju that the information pr ided above is true and.correct, Signafore: Date: Phone#: ad 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 =eceiVP.T 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." NGL 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-contractors)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 ibis affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit:or.license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials. Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any question__- please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Commonwealth of Massaohwetts Department of.Indus al Aooidents Office of fnyestigations 600 Washingtoh Street Boston,MA€}2111 Tel. # 617-727-4900 ext 406 or 1-977-MASSAFE Fax: 617-727-7749 Revised 11-22-06 www.mass.govtdla 4 Town of Barnstable. Regulatory Services 9B MASS. Thomas F.Geiler,Director 16.59. 'O�fpH►p,IA10 Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 t 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 �s/✓ zjs as Owner of the subject property > J P P rty herebyauthorize d "p' / , C / to act on my behalf, in all matters relative to work authorized by this building permit application for: . (Address of Job) 1 afore of r Date rkk (! // Print Name Q:FORMS:OwNERPERMIS SION -; ✓10 iv, -Vo%minwm�aJea� oya��aoac�uiaeG�s ..-, .._ ._... . ......__. BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Numbee: CS 019925 - .......... lie BOARQ OF SUILMNG REGULATIONS � �ff �;�#,�''�' �, license CON.STRUCTtQN SUPEEZVI50R j r Number CS OA8722 ' � ., "� Birthd'ate 05l01/1963 Expires 05Y01f2008 Tr.no: 25028 Restricted .0� J6,&EPH E; ;LAMBALs,OT j 2725 ACU$NNET AVE �� NEW B�DFORD, MA (32745 —�—:— j Commissioner ACOR& CERTIFICATE OF LIABILITY INSURANCE 6/19/too PRODUCER (781)681-6656, Fax(781)681-6686 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Driscoll Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 93 Longwater Circle ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 9120 Norwell MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Travelers Indemnity Co. Advantage Construction, Inc. INSURER B:Travelers Property INSURER C: Two Adams Place, Suite 100 INSURERD: Quincy MA 02169 INSURER E: OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING AN REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWNMAY HAVE BEEN REDUCED BY PAID CLAIMS. INS&ADD'L ON TYPE OF INSURANCE POLICY NUMBER POLICY (MWDDIYY) PDATE(MM UD/YY) LIMITS GENERAL LIABILITY DTC0464D1464-IND07 06/20/2007 06/20/2008 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDPREMISES Ea occurrence $ 300,000 A CLAIMS MADE 7 OCCUR MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X JECOT LOC AUTOMOBILE LIABILITY. DTA0810464ID1476-TIL07 06/20/2007 06/20/2008 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 B ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ X HIRED AUTOS BODILY INJURY X NON-OWNEDAUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY DTSCUP464D1488-TIL07 06/20/2007 06/20/2007 EACHOCCURRENCE $ 15,000,000 ` 7X OCCUR CLAIMS MADE AGGREGATE $ 15,000,000 B DEDUCTIBLE $ RETENTION A WORKERS COMPENSATION AND DTEUB464D1440-07 06/20/2007 06/20/2008 y T RSTATU O R EMPLOYERS'LIABILITY Y M ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? If yes,describe under E.L.DISEASE-EA EMPLOYEN$ 1,000,000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS RE: Harry's Bar & Grill, 700 Main Street and Flagship Estates, 350 Stevens Street, Hyannis Evidence of Insurance for work performed within the Insureds scope of normal business operations. Notice of Cancellation provision is 30 days except 10 days applies for non-payment of premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Town of Barnstable EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 368 Main Street 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT Hyannis, MA 02601 FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE _ B. Driscoll/KAD � ---�+�--�� ACORD 25(2001/08) ©ACORD CORPORATION 1988 lucn�a rn,nc�moo, P�nc 1 of� +f' 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 alter the coverage afforded by the policies listed thereon. ACORD 25(2001/08) INS025(0108).08a Page 2 of 2 COMMENTS/REMARKS CIP Hyannis, LLC and Flagship Estates Hyannis, LLC, TD Banknorth, BSC Group, DHS Design and Advantage Construction, Inc. are included as Additional Insureds for General Liability and Excess (Umbrella) Liability as required by a signed written contract or agreement with the Named Insured. CIP Hyannis, LLC and Flagship Estates Hyannis, LLC, TD Banknorth, BSC Group, DHS Design and Advantage Construction, Inc. are included as insured for Automobile Liability on a Primary Basis for the conduct of the (Named) Insured, but only to the extent of that liability. 4 OFREMARK COPYRIGHT 2000, AMS SERVICES INC. Town of Barnstable : CF SHE Tp� Regulatory Services r r BARNSTABLE Thomas F.Geiler,Director . Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Building Permit Procedures for New Commercial Building ❑ Map and Parcel number ❑ Letter of Approval from Site Plan Review. ❑ Site Plan Review number on permit ❑ If Zoning Board of Appeals relief is required for the project,a copy of the decision with proof of recording from the Registry of Deeds must accompany the application. ❑ Plot Plan(Plan of Record)recorded at the Registry of Deeds showing the date the lot was established,its area and boundaries. Site Plan must also be submitted showing the location and setbacks of existing/proposed structures, septic,parking,etc. Copy of deed. ❑ Historic District Commission,200 Main Street,approval required prior to construction/demolition for any properties located in Old Kings Highway Historic District(north of the Mid Cape Highway)or Hyannis Main Street Waterfront Historic District(See map for boundaries) ❑ The following departments, located at 200 Main Street,must sign off on the building permit application: ❑Engineering/Survey Section (located at 367 Main Street,3A floor) ❑Health Department Hours(8:00-9:30 AM or 3:30—4:30 PM) ❑Conservation Department(8:30-9:30 AM or 3:30—4:30 PM) ❑Planning Department Q ❑Tax Collector ❑Treasurer ❑ Permit must contain complete description of the project, correct square footage,estimated cost of project, owner's name and address, contractor's name,address and telephone number. Contractor must sign and date the permit ❑ . ' Construction plans-one complete set of full sized plans and one complete set reduced to 11"x 17"fully dimensionalized must be submitted with the building permit application. Both sets must be stamped by either an architect or an engineer. NOTE: The applicant must also submit a set of full sized plans to the appropriate Fire Department for review.The application.package will not be accepted without prior approval from the Fire Department. ❑ Workers Compensation Insurance Affidavit-State Form must be completed. Copy of Insurance Compliance Certificate must be on file: ❑ Construction Supervisor's License-A copy of the Construction Supervisor license is required. Note: Construction Supervisor's license holders are not entitled to supervise construction of a building or an addition(regardless of size)to a building with a total cubic volume greater than 35,000 cubic feet. In that case,the application must be accompanied by controlled construction documents as indicated in 780 CMR sections 116&1705. ❑ Check expiration date,unrestricted(not 1G)or ❑ Controlled Construction ❑ If sprinkler system or fire alarm system is required,do not accept application package without prior approval from Fire Department(phone call or in writing) Performance Bond($4.00 per foot of road frontage)must be submitted with permit application. ❑ Property owner must sign Property Owner Letter of Permission. ❑ A NON-REFUNDABLE Application fee of$150 must be paid upon receipt of application number. Checks made payable to the Town of Barnstable. Permits are$8.10 per$1000 of value. ❑ Projects'requiring the use of a crane must complete the forms issued by the Aeronautics Commission Q:wpfiles/forms/bldgpermit:CNEW REV:101106 1 , I � 4 r i FL.AGS111P ESTA'.1 ES i 350 STEVENS STREET HYANNI S, MA , BUILDING "Fill J General Contractor: Architect of Record: STRUCTURAL ENGINEER: SITE ENGINEER: Advantage Construction, Inc. OO rkb architects,inc. Flood.Consulting BSC Group 2 Adams Place,Suite 100 56 LAUREL DRIVE 657 MAIN,STREET,UNn-6,ROUTE 28 Quincy,MA 02169 zero campanelli drive,braintree,ma 02184 HUDSON,MA 01749 YARMQUTH,MA 02674 phone(781)848-8787 fax(781)848-3774 p 781'.848.6600 f 781.a48.6660 w rkbarch.com phone(978)562-6499 phone(508)778-8919 CODE ABSTRACT ABBREVIATIONS SYMBOLS LEGEND DRAWING LIST (FOR ARCHITECTURAL DRAWN6s ONLY LETAL NO. .. w•@ A15V ADOVE Fa FACE.OF CONCRETE - PM PRESSED METAL FEw ARCHITECTURAL MASING com. 7W CAR MA"Fswmsum,FATE OIILPW LAC DTH®ITWN WU RC:TIE PROASIONS M UVPrER 9 eVLL'awry MnS�FIRE WNrELTwN KQbTC&CELN5 PM8 POF FAKE OF FMISN PIS PAMTD) TITLE ifRE REF9tF1lGE COPE SIEEr OW9 NnE RNAT0IAi-DILPW OM r/MN 6..AMEA.BNTS) SYSTEMS IRE RE9XtEP AD S1 APPLY TO TIE VEMN"STA.LATION AP ADD ADDS PIN FONT PAGE OF MA60NRY PR PAIR SALE: AJ I CODE ADSTRACr LE6ELEVATIONS &NOTES _ COVE A WERATION Or TIRE PROM&TIM AFF ADOVE FMI4®FLOOR fi75 FACE OF STLPS P5F PLUDS Pest SWRE PQ7f /f� EASTM POOR � PETAL W. AI.2 PROPOSED DULDM6 HEVATIONS F'RE caE: n- wr MATwNAL FIRE STATE FIRE FREYEJIXMN NOTEAL AIR HADLLM&UNIT PP FIREPROMIND) PSI PAWS PER �/// \ TO DE REMAIN UZATION A2.1 FIRST FLOUR PLAN 6 NOTES MAXTIE NTEDR.ATIaNAL rr�cae Zan AS PER TAME 9�1 R-Lsr NCY R Ttv R I AW R 9R RERMITORNTs WIN&A• TKM TMR E MU RLNY AN,A TUN R-I K P L AGORMAT INVN6 NO 4LL AL A_7 INUIv! FTb FELP V Pf PRESSLRE TREATED - A2.2 SECTHIRD DP FL017R PLAN h NpfES AFfttyJIL0.OGLE: 7W LAN nEio"noimL 9 FATE DUDN-LOGE SRf EDII'IRI TNW TIPEL' TVW5 A WJTO ND ILO=TINN F.1 TEM INSMTE S4.rf.IMP FC A:IA1 ALI�APIA1 FV PAD VERIFY qr Q.ARRIaN E%STPl6 OGVR A.NO. A2.1 mIRD FLWR 6 RLUF PLAJ 6 NOTES L 100E DJfF1aJATTONLL MELRVNLA Lae WITh SOON HWE AN R&MEOIL PRE 9PPRE5519N.sY5TEA 4.ER S®N uLORRAIGE gppROA APPR0J9MATE bA bAbE Qr 4NRRY TILE TO De RE OVEP cxAwon w. A9.1 d1LDPJU SECTIONS WITH AST ONE AUTOMATIC. FRaVL®THAT EVERY INL>AmL sPRNnat SYSTEM sAaL HARE A�7 ARO jrrEOT bA_V EA_VANIZEP R RISER A� R.W '% .A51 IXRDM&SECTIONS FLLWODG LO£ tAD OAN MA%GHCCTTs FATE RR 6A5 MD RII.OW AT LEAST LaE N1fLMATV.WATER`APPLY GR A STORED WATER SUPLY r .E N Nt/'LJ LOPE ALCGRDANLE WITH NPA-DD YIIFiR MIIDAM 4LLAMTRY Q FOPt®WATER SEAL EQUSL NT fNTLUNO15 6C 6E ERAL GONTRA,TOR RA RETUIRN AIR EIELTRYAL LaE: 7W CAR MA�AAv1kYIT5 FATE NLDPF COVE DTI®Ir1aJ TTE WRIER DEAIND RATE TIMES 10 MNaES TOWNW6E5 IFE RE4L7f✓®TO Dm CIDCi DULDDdTO GL Ca.A55,6LAZM& RAD RADIUS NEW P ON ARTITWN_ L NAcm ELECTRIC,LOE Tatl PRO WTEP DY AI amm SPRIWLJR SYSTEMS Dar DOTTOM 61$ &YP'a'."WA LDOAR17 RB RESILIENT RASE IX EN&PARTITION �» FIRE A GROIP R AN.WfaMTIL'SPRN SYSTEM NFALLID N KLLRDANOE WITH pSMT BA$rFalr �� ) RD REEF IFORGEQ>)NREPFORCD6 rO De REMN DETAIL w. 1 I EEMY COPE; T009 NTEUJATIaVL Esrey cam me lw% `FLTION"I SWLL DE PROVVEP nNarrtiur AL MPWIS WITH A GRNP R BU2 Burr U°RCL'F ELEVATOR COM 5NA LAN MAS5V4tSEYT5 FATE ELEVATOR REEtLATYMS ram ^ GJ rmTLCONTROL ROM tHPWF KARPWARE REP NALLAN META_ READ REFER EN '---- o ce"5 auwws w. � .�'LncN I�rAL PARrTnON Wi.0 WPA ADD SNRDRLHt SYSTEMS:hTIM ALLOMN .AUTOMATIC SPRINKLER SYSTEMSIOINT ACCEyDL.ITY: 5N OAN AROHITFLTLRAL K4E95 WANED a WrAJJP N ONE AN,TWO AALY WaLDNE6 AND TOWNWXPS SK-DE NSTAJJP OLE, CEILRJ6 HORZ HORIZONWAL RFL RELOCATE acw.t IUA� L MHtONN DSSADLITY9 AGr(APA JT N T MIU& ACC6ROAW.E WITH IRA W. 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HYANNIS,MA BUILDING'F' ADvANTAG:G Conslruclion,fnc. �a161/ rkD architects,Inc. 2.rP wmpsnelf.lNC,Main±tee.rN d2TN • � P%AtRAd.➢NA 1>➢S.Aaa.6db➢ W:kbafch.Com DATE: SHEET NO. 9.7.11 A5 NOTED PROJECt: A2 O/� • 0�0 awH: FIRH PARTITION LEGEND w B MZZZJM .MQ -- ASt 40 RBCt/m pQT/ANY NW.RVAI o+ iA.eVRRKN 9EV1mv T.ii u?AG wR iDD NN rm sm We Otalom ML . {/P RTMXO SIE11,e8(AtR N9L-AS K•LM . -0/ILLNL P,N3t -[RILE IfE 6 eoa A®D RAM DARS/M[ON• uo u' u'd aMR�9KtPY 9 TO TlAi1H! Ifd 6-0• Y-0 iid yd Rd Ifd - ,wray i V, ' r� ems' s-s• r-s• S#� a�.t wit� or.�arorct,�m . .{Pfgsl` ATIBtNTCN pMQDfs N . pTRROA,t.p3RAat NAL9.6G TO lQ.W. iRMTE AgAU✓e W551,M 6NO a AL NET A� ' �[AseCxIB EAtf e u TIID X1E.14 7_ _ --, I' 4H WAL SIIp4 a IC OG r T ❑ I + 1''� L � If}- �� © I I 1 �I •^- __ � j� �� �t -0 I/!'AeHfl WRL RH!MTf ICLLATYM —`y II t I II I � —F M <PR'Nl 5Ar R381A55 AfAnel'i -T-I. I I I I I _ r � - -a..t WAL sNRs o r'oc. 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