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0320 STEVENS STREET (17)
320 STEVENS STREET Sld(r 07 ,a � i w _ . . Town: of Barnstable Buildinn Department- Brian Florence, CB0 ; Building Commissioner 200,Main Street,Hyannis,MA 02601" r, www.town.barnstable.ma us Pr'e-application for Business Certificate Date J 1 Map Parcel bb � Applicant Info`rmafionp .. A Applicants Name Applicants Address Gi P1 n S - Email Address 010✓►1 , 0,l j. JG`{' U <'D Telephone Number; ,`�j C�. 3{ _.b Listed( Unlisted[] °Busin.ess Information New Business? ----=---------=---------------- --------- _ .Yes No Business is a registered corporation? - __ ______ _`_ _____. Yes No If yes Name of Corporation Does business operate under the registered corporate name? Yes No:' Is the business a sole proprietorship or home occupation? _'------ Yes No If yes then a Home Occupation Registration is required See.Building Division Staff Name of Business S S S �, � 0 5+c JCVLs S�'�ee t i3 � l-f � � DES ✓�t� t -. t��6 Business Address. _ Type of Business ',6- Conditi �, ding Commissioner Office Use �nly Building Com, issz e at Clerk Office Use Only G Town of Barnstable' Building Department F1He t�q, Brian Florence,CBO o,• Building Commissioner BMWTABLE. ' 200 Main Street,Hyannis,MA 02601 9 MASS. le39• A www.town.barnstable.ma.us ATfD MA'S Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: _ � F Name: Phone#: `t b 36 3 16 Address: ` �U S �ei� c�T 65 Village: N ti A o n l S Name of Business: DaA o cl [ VA_ S " -f�2 Type of Business: r h �.(( G '" Map/Lot: . lot- v" INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal . residential volumes;and no increase in air or groundwater pollution. After registration with the,Building Inspector,a customary home occupation shall be permitted as of right subject to the Z following conditions: _ 0 • The activity is carried on by the permanent resident of a single family residential dwelling unit,located ' Q within that dwelling unit.< D W rr • Such use occupies no more than 400 square feet of space. U D • There are no external alterations to the dwelling which are not customary in residential buildings,and there ' J OU < w is no outside evidence of such use. W • No traffic will be generated in excess of normal residential volumes. 2 c6 • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular 0 -Z matter,odors, electrical disturbance,heat,glare,humidity or other objectionable effects. _ F= h— • There is no storage or use of toxic or hazardous materials, or flammable or explosive materials,in excess H of normal household quantities. i� w • Any need for parking generated by such use shall be met on the same lot containing the Customary Home w ¢' Occupation,and not within the required front yard. CLCC Q • There is no exterior storage or display of materials or equipment. O z • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one U J pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to 1" w exceed 4 tires,parked on the same lot containing the Customary Home Occupation. J • No sign shall be displayed indicating the Customary Home Occupation. O cc • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. { I,the undersigned, have read and agree with the above restrictions for my home occupation I am registering. Applicant: // `� t,ti � Date:. 3 Homeoc.doc Rev. 10/17 I 1 320 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 0:00P Mark Marinaccio, Architec 508-420-7922 p,1 q m AQJVMAI�C R MAM114CQO, ARCHn-ECT ARCHITECT PLANNER CONSULTANTLriEtintJiisE. . C.�E 19 SO-LWT QRaf- SMUWICK MA 02503 500 420 0922 - - - January.2, 2008Ji�4�l. ;`Gt Thomas Perry Building Commissioner 200 Main Street Hyannis, Massachusetts 02601 Re: Steven._Street-Residential-Condominium P_n-ject"—` ---_7 (Building=B Permit# B20071844, B20071470, B20071469, B20071471,'B2007401 . Dear Mr. Perry: Attached please find finial reports for the residential condominium building B, Units B1, B2, B3, B4, B5 Stevens Street, Hyannis, Massachusetts. The work completed appears to have been done in conformance with the construction documents. In my opinion, at this time the above referenced units are ready for occupancy. If you have any questions or comments lease feel free to contact me - p at 508-420 0822. Sincerely .Mark Marinaccio fJan 01 08 10:00p Mark Marinaccio, Architec 508-420-7922 p.2 c, MARK R MAWNACC6. ARCHITECT ARCHEfECr PLANNER • CONSULTANT 19 SCDM f CIRCLE, SANDWXH, MA 03503 500 410 OS32 - ARCHITECTURAL FINAL AFFIDAVIT FOR CONSTRUCTION CONTROL To: Donald O'Neill Advantage Construction, Two Adams Place, Suite 100 Quincy, MA 02169 Re: Hyannis Condominiums Building B. Permit#B20071844, B20071470, B20071469, B20071471, B2007401 700 Main Street Hyannis, MA Project No.: 30-2005 Date: December 17, 2007 To the Building Commissioner. u In accordance with Section 116.0 of the Massachusetts State.Building Code, this letter shall serve as a Final Affidavit for the above-referenced building and that to the best of my knowledge,. the provisions of the building code have been complied with, and the area of work meets-the requirements of the construction documents. tx- h. t� fir, - �y� IZ A R_7878 ORIG AL SIGNA'TA r ��A. REG. NO. Mark Marinaccio,Archifiect - i Jan 01 0S 10:00p Mark Marinaccio, Architec 508-420-7922 p 3 ARCHITECT'S OWNER AQ44 .- n'Amcao, ARCHITECT FIELD REPORT ARCHITECT ARCHITECT • PLANNER CONSULTANT CONSULTANT 1y SCONSEr E mA 02563 506 420 0822 AIA DOCUMENT G711 FIELD. . ❑ PROJECT: Hyannis Condo Units B1,112,B3,B4,BS FIELD REPORT NO: 1 Stevens Street CONTRACT: ARCHITECT'S PROJECT NO: 30-2005 DATE 8-1-07_ TIME 9:00 AM WEATHER Warm/Sun TEMP. RANGE 80's EST. % OF COMPLETION CONFORMANCE WITH SCHEDULE (+, —) WORK 1N PROGRESS Rough Frame 95% Complete PRESENT AT SITE Mark Marinaccio,David Sig],Bill Kelly, Joe am o 0 No insulation work has been started OBSERVATIONS General: 1. Structural Rough Frame is 95%o ext error sidin and "g trim has bee s n installed roofing i g 1' installed"win ws and doors installed. g 1. UL wall assembly details were given to-the project supervisor, Through plate and sill penetrations to be fire caulked In accordance with the plans ITEMS TO VERIFY 1- Final frame and fire camilk prjQr to incnlafinn inStal]afian INFORMATION OR ACTION REQUIRED 1. Obtain structural engineers frame inspection report ATTACHMENTS Jan 01 08 O:OOp Mark Marinaccio, Architec 508-420-7922 pA Document G711T" - 1972 Architect's Field Report PROJECT:(Name and address) FIELD REPORT NUMBER: OWNER:❑ B5,B4,B3,B2,Bl Report 2 ARCHITECT: Condyne Condominium Project CONSULTANT: 0 Stevens Street ARCHITECT'S PROJECT NUMBER: 30-2005 FIELD:❑ Hyannis,Massachusetts Unit B5 Permit#B20071844 Unit B4 Permit#B20071470 Unit B3 Permit#B20071469 Unit B2 Permit#B20071471 Unit BI Permit#B20071401 CONTRACT: B 141 - 10/29/06 DATE 10/4/07 TIME 9:30 WEATHER Warm TEMP.RANGE 70's EST.%OF COMPLETION 50 CONFORMANCE WITH SCHEDULE(+,-)NA WORT{IN-PRO GRE S S PRESENT AT SITE Rough Frame.Prior To Insulation Mark Marinaccio Bob Stewart Bill Kelly OBSERVATIONS Fire caulk complete in units B5,B4,B3,132. Fire caulk work progressing in unit B I " Fire rated electric boxes have been installed at Fire wall locations, Depth of electric box extensions beyond studs match requirements for installation of double layers of fire code sheetrock on 2 hour partitions and single layer dimension for I hour partitions. Electric work substantially complete in B5,B4,B3. Work progressing in B2,Bl HVAC substantially complete in135,B4,B3. Work progressing in B2,B1 Rough plumbing substantially complete in 135,B4,B3. Work progressing in B2,B1 Sprinkler system substantially complete in B5,B4,133 Work progressing in B2,B 1 t Observed work is in compliance with the intent of the construction drawings ITEMS TO VERIFY Complete fire caulk work in unit B INFORMATION OR ACTION REQUIRED Sprinkler system shop drawings not received Sprinkler system installation in progress ATTACHMENTS - None REPORT BY:Mark Marinaccio A AIA Document G711Tm-1972.Gopyright 01972 by The Ame,:can Institute of Architects. AO rights reserved, %vARNING:This AIA.Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction cr distribution of this AIA''Dccument,or any portion of it, may result i.-r severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the lavo. This document was produced ,bv AIA software at 10:47:19 on 1 0/1 7120 07 under Order No.1000326156 1 which expires on 10IM2006,and is'not for resale. User Notes: — (3932249045) Jan 01 08 10:01p Mark Marinaccio, Architec 508-420-7922 p.5 Document G711 — 1972 . Architect's Field Report PROJECT:(Name and address) FIELD REPORT NUMBER:B2,BI Repott 3 OWNER. Condyne Condominium Project ARCHITECT: Stevens Street ARCHITECT'S PROJECT NUMBER: 30-2005 CONSULTANT:❑ Hyannis,Massachusetts Unit B2 Permit#B20071471 FIELD: Unit B 1 Permit#B20071401 CONTRACT: B 141 -l 0129/06 DATE 1.0/17/07 TIME 10:00 WEATHER Warm/Sun TEMP.RANGE Hi 50's EST. %OF COMPLETION 50 ' CONFORMANCE WITH SCHEDULE(+.-)NA WORK IN PROGRESS PRESENT AT SITE Insulation 'Mark Marinaccio,Bob Stewart OBSERVATIONS Colony Insulation is installing.fiberglass insulation in partitions,ceilings and floors. Insulation work is complete in unit B2 Insulation work is in progress in unit B 1 Firc caulk work is complete in unit B C < Observed work is in compliance with the intent of the construction drawings ITEMS TO VERIFY Verify Completed Insulation work in unit Bl . INFORMATION OR ACTION REQUrRED Notification to the Architect of the contractors schedule of construction. ATTACHMENTS None REPORT BY:Mark Marinaccio AIA Document G711 7"-1972-Copyright®1972by The American Institute of Architects. AU rights reserved. :YARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AW Cocument,or any portion of it, may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 10.51:13 on 10/1 7/2007 under Order No.1000326156_1 which expires on 10/15/200%and is not far rule. User Notes: (314557607) Jan 0 1 08 10:01p Mark Marinaccio, Architec 508-420-7922 p.6 r Till -® IA ' Document G711 -- 1972 Architect's Field'Report PROJECT:(Name and address) FIELD REPORT NUMBER:B5,B4,B3 Report 3 OWNER:❑ Condvne.Condominium Project ARCh7TECT: Stevens Street ARCHITECT'S PROJECT NUMBER: 30-2005 CONSULTANT:❑ Hyannis,Massachusetts Unit B5 Permit#B20071844. FIELD; Unit B4 Permit#B20071470 Unit B3 Permit#B20071469 CONTRACT: B 141 - 10/29/06 DATE 10/10/07 TIME 1:30 WEATHER Warm TEMP.RANGE 60's EST.%OF COMPLETION 50 CONFORMANCE W ITH SCHEDULE(+,-)NA WORK IN PROGRESS PRESENT AT SITE Insulation Mark Marinaccio,Bob Stewart, Steve(foreman) OBSERVATIONS Colony Insulation is installing Fiberglass insulation in partitions,floors,ceilings. Insulation installation in progress in unit B3 Observed work is in keeping with the intent of the construction drawings ITEMS TO VERIFY , Completed insulation installation in unit B3 INFORMATION OR ACTION REQUIRED Notification to Architect of construction schedule for remainder of work. ATTACHMENTS -None REPORT BY:Mark Marinaccio AIA Document G711 TM—19M Copyright m 1972 by The American Institute of Archlects. All rights reserved. WARNING:This AIAA Document is protected'by 11S.Copyright Lam and International Treaties.Unauthorized reproduction or distribution of this ALA" Document,cr any portion of it, may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software W.10:49:17 on 10/17120D7 under Order No.1000326156_1 which expires on 1 011 5/2 0 08.and is not for resale. User Notes: (3976593889) Jan 01 08 10:01p Mark Marinaccio, Architec 508-420-7922 p.7 1A Document G711TII 1972 Architect's Field Report PROJECT:(Name.and address) FIELD REPORT NUMBER:B5,B4,B3 Report4 OWNER:❑ Condyne Condominium Project ARCHITECT: Stevens Street ARCHITECT'S PROJECT NUMBER: 30-2005 CONSULTANT:❑ " Hyannis,Massachusetts Unit B5 Permit#B20071844 FIELD:•❑, Unit B4 Permit#B20071470 Unit B3 Permit#B20071469 CONTRACT: B 141 - 10/29/06 DATE 10/17/07 TIME 9:30 WEATHER Warm/Sun TEMP.RANGE Hi 50's EST.%OF CObIPLETION 60 CONFORMANCE WITH SCHEDULE(+,-)NA WORK IN PROGRESS PRESENT AT SITE Sheet Rock Mark Marinaccio,Bob Stewart,Bill Kell OBSERVATIONS Double 5/8 fire code sheetrock has been installed on 2 hour fire rated walls. Joints are staggered.' Single 5/8 Fire code sheetrock has been installed on 1 hour Fire rated walls. Taping and compound is in progress " Observed work is in keeping with the intent of the construction drawings ITEMS TO VERIFY K Taping in Compliance with UL Standards INFORMATION OR ACTION REQUIRED Notification to Architect of construction schedule for remainder of work. Mechanical engineer certification that work meets code requirements. Electrical engineer certification that work meets code requirements. Fire protection engineer certification that work meets code requirements ATTACEEvIENTS None - w REPORT BY:Mark Marinaccio AIA Document G711 m—1972.Copyright©1972 by The American Institute of Architects. All rights reserved. W ARNINGi-this AIA'' Document is protecled by US.Copyright Law-and International Treaties.Unauthorized reproduction or distribution of this AIA' Document:or any portion of it, may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the lave. This document was produoed by AIA software at 10:5259 on loll7/2007 under Order No.I DOM26156 1 which expires on 10/1512008,and is not for resale. User Notes: _ 42226341715) Jan 01 08 10:01p Mark Marinaccio, Architec 508-420-7922 p.8 NOR � =.ter � , - ® Document G711 - 1972 Architect's Field Report PROJECT:(Name and address) FIELD REPORT NUMBER: OWNER:❑ 1315,B4,B3,132,B 1 Report 5 ARCHITECT: Condyne Condominium Project CONSULTANT:❑ Stevens Street ARCHITECT'S PROJECT NUMBER: 30-2005 FIELD: Hyannis,Massachusetts Unit B5 Permit#B20071844 Unit B4 Permit#B20071470 Unit B3 Permit#B20071469 Unit B2 Permit#B20071471 Unit 131 Permit#B20071401 CONTRACT: B 141 - 10/29/06 DATE 12/20/07 TIME 9:30 WEATHER Cold TEMP.RANGE 40's EST. %OF COMPLETION 95% CONFORMANCE WITH SCHEDULE(+,-)NA WORK IN PROGRESS w PRESENT AT SITE Finish Work Mark Marinaccio OBSERVATIONS General: It was observed that the condensate drains on the attic HVAC units have been insulated with.heat tape installed to prevent freezing_ ` Rigid insulation panels have been installed behind the Spa plumbing on the attic side. Unit B5: Electric outlet cover was removed from exterior wall. No foam insulation was installed. All exterior, wall electric outlets should be insulated with foam outlet seal installed under outlet cover Unit B4: First Floor Closet Clean-out has no cover Dining Room Sliding Door latch does not work properly. , One kitchen island light is not working, Second Floor HVAC closet: Smoke/Heat detector disconnected Third floor wp spa panel not installed Unit 133: Hall closet door right panel does not close properly. Attic stair bottom step has support nut missing _ Unit 132: Second Floor Back Bedroom: Repair work being completed on wall Bedroom exterior wall outlets not insulated Unit B 1. Master Bathroom Spa faucet installation not complete Spa panel not installed ITEMS TO VERIFY INFORMATION OR ACTION REQUIRED Sprinkler system shop'drawings not received Sprinkler system installation is complete: ATTACHMENTS None AIA Document G711TM—1972.Copyright O 1972 by The American Institute of Architects. All rights reserved. WARNING;:This c.IA' Document is protected by U.S.Copyright Lave and international'Treaties.Unauthorized reproduction or distribution of this Ale Document,or any portion of it, may result in severe civil and criminal penalties,and will be prosecuted to the maximum 2xlent possible;ruder the law. This document was produced by AIA software at 14:04:05 on 12/20/2007 under Order No.1000326156_1 which expires on 1011512008,and is not for resale. Jan 01 08 10:01p Mark Marinaccio, Architec 508-420.7922 p.9 '�'� Document G704Tm - 2000 A PAIA Certificate of Substantial Completion PROJECT: PROJECT NUMBER:30-2005/Building"B -OWNER: (Name and address): 13120071844,B20071470,B20071469, Flageship Estates,Condominiums. B20071471,B20071401 ARCHITECT: Stevens Street . CONTRACT FOR:General Construction CONTRACTOR: Hyannis,Massachusetts CONTRACT DATE: TO OWNER: TO CONTRACTOR: - FIELD:.E] (Nance and address): (Name and address): TOWN OF BARNSTABLE: Flagship Estates Hyannis,LLC 'Advantage Construction,Inc Two Adams Place Two'Adams Place Suite 100 Suite 100 Quincy,MA 02169. Quincy,MA 02169 PROJECT OR PORTION OF THE PROJECT DESIGNATED FOR PARTIAL OCCUPANCY OR USE SHALL INCLUDE: Unit 135: Permit#1320071844 Unit B4: Permit#1320071470 - Unit 1313: Permit#132007.1469 Unit 1912: Permit#11320071471 Unit B 1: Permit#1320071401 The Work performed under this Contract has been reviewed and found,to the Architect'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 Documents,except as stated below Warranty Date of Commencement 12/20/2007 Mark Marinaccio.Architectj✓t December 20,2007 ARCHITECT Y DATE OF ISSUANCE A list of items to be completed or corrected is attached hereto.The failure to include any items on such list does not alter the responsibility of the Contractor to complete all Work in accordance with the Contract Documents.Unless otherwise agreed to in writing,the date of commencement of warranties for items on the attached list will be the date of issuance of the final Certificate of Payment or the date of final payment Cost estimate of Work that is incomplete or defective:$0.00 The Contractor will complete or correct the Work on the list of items attached hereto within Seven(7)days from the above date of Substantial Completion. Advantage Construction,Inc CONTRACTOR BY DATE The Owner accepts the Work or designated portion as substantially complete and will assume full possession at (time)on December 26,2007_(date). Flagship Estates Hyannis,LLC OWNER - BY DATE AIA Document G704Tm—2000.Copyright ©1963,1978,1992 and 200D by The American institute of Architects. All rights reserved. WARNING:This AIA"'' Document is protected by U.S.Copyright Law and International Treaties.unauthorized reproduction or distribution of Ibis AIA"Document,or any 1 pa�ion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 11:55:25 on 12126J2007 under Order No.10003261561 which expires on 1 011 5/2 0 0 8,and is not for resale. Jan 01 08 10:02p Mark Marinaccio, Architec 508-420-7922 p.10 Nov 13 07 02:38p Stacy R. Flood 978-662-6246 p.3 FLOOD CONSULTING Structural Engineering STRUCTURAL FINAL AFFIDAVIT FOR CONSTRUCTION CONTROL Too Donald O•Neill Advantage Construction Two Adams Place,Suite.100 Quincy,MA 02169 RE: Hyannis Condominiums Building B 700 Main Street. Hyann is, MA PROJECT NO.: FC 40569 DATE. November 13,2007 To the Building Commissioner: - In accordance with Section 116.0 of the.Massachusetts State Building Code, this letter shall serve as a Final Affidavit for tie above-referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets the requirements of the construction documents. pt OF , f y Lic.#428b8 p RIGMA S NATURE MASS_ REG.NO. MAL Stacy R. Flood, PE - 56 Laurel Drive Hudson, MA 01749 TEL: (978) 562-6499 -'FAX: (978)562-6246 IKE o� own of Barnstable • Building Department - 200 Main Street �sA ASS.. Hyannis,MSS. * Hy ,.MA 02601 MA . �Ar 1639 A (508) 86,2-4038 Certfificate . of Occupancy , Application Number: 200703559 CO Number . l2.0070292 Parcel ID: 30800400B CO Issue Date: 12128107 _. Location: 320 STEVENS STREET Zoning Classification: OFFICEIMULTI FAMILY RESIOENTIA Village: HYANNIS Gen Contractor: LAMBALOT, JOSEPH E. Permit Type: .'RC00 ' CERTIFICATE OF OCCUPANCY RES Comments: FOR UNIT 131 Building Department Signature Date Signed �1HE, TOWN OF BARN STAB LP-,--- ui ldi ng o Application Ref: 200703559 Per BARNSTABLE, Issue Date: 06/18/07 ■ ■ ■it 9 MASS �p 1639• Applicant: LAMBALOT JOSEPH E. rFG �A Permit Number: B 20071401 Proposed Use: Expiration Date: 12/16/07 Location 320 STEVENS STREET A2 Zoning District OM ;Permit Type: SP PROJ RES ADD/ALT Map Parcel 30800400B Permit Fee$" 251.24 _Contractor LAMBALOT,JOSEPH E. Village HYANNIS App Fee$ 50.00 License Num 048722 Est Construction Cost$ 61,277 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND TENENT FIT OUT FOR§ ,B,l.f THIS 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 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 NALLY OR SIDEWALK OR ANY PART THEREOF;`EITHER'TEIvIPORAR[LY OR PERMANENTLY: ENCROACHEMENTSON PUBLIC PRQPERTY NOT SPECIFICALLY P GERIv1ITTEDJUNDER THE BUILDIN CODE MUST BE APPROVED BY THE JURISDICTION. STREET ORALLY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM:I HE DEPARTMENT OF PUBLIC WORKS THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE-CONDITIONS'OF ANY APPLICABLE SUBDIVISION RESTRICTIONS �,. ,. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS: 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE.LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. „ t 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). T; 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).. a _ «?y3r x a' Si F Vie,." BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS Je . px d �7, VsJ '� 3 �g 1 Heati Insp�tion Ap vats Engineering Dept I,-ad lfs /;Frl' Ax Fire Dept 2 - Board of alth TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ry) Ma ?20 Parcel —/ W A lication#ppp Health Division Conservation Division Permit# Tax Collector Date Issued J. Treasurer Application eoa Planning Dept. Permit Fee l � Date Definitive Plan Approved by Planning Board P qA Historic-OKH Preservation/Hyannis Project Street Address Lid /ladfGT /z�r'T Village Owner Address Telephone Permit Request Square feet: 1 st floor:existing proposed�� 2nd floor:existing proposed Total new / Zoning District / ,/�// Flood Plain Groundwater Overlay Project Valuation 7Z7 Construction Type o - r c Lot Size l a f6 7 Grandf thered: ❑Yes ❑ No If yes, attach supporting eo�llumentafion. w G s Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) c01f- Age of Existing Structure Historic House: ❑Yes ClNo On Old King's Hi way: Q YesO No. .ter Basement Type: ❑ Full ❑Crawl ❑Walkout tether Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing neAl w Number of Bedrooms: existing new Total Room Count(not including baths):existing new,- First Floor Room Count Heat Type and Fuel: er as ❑Oil ❑ Electric ❑Other Central Air: 21Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 010--�- Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ,❑new size Attached garage:❑existing ❑new size C2?0 Sheq:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 4 If yes, site plan review# Current Use ���� ��'�d Proposed Use �/v��7A,��S� BUILDER INFORMATION Name Telephone Number Address t /�� License# � � Home Improvement Contractor# Worker's Compensation# !i/e7,F7—Cll/� ALL CONSTRUCTION DEBRIS RESULTIPP FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ,�316rj/ FOR OFFICIAL USE ONLY s• PERMIT NO. DATE ISSUED ' „h MAP/PARCEL NO. ADDRESS' VILLAGE OWNER DATE OF INSPECTION: p� y FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL t GAS: ROUGH 6� FINAL FINAL BUILDING DATE CLOSED OUT ' f b ASSOCIATION PLAN NO. 4 Fz rai, , ._. Town:og Barnstable Regulatory Services y�xrisTASM , * Thomas F. Geiler,Director . -MASS. 1639, ,�� Building DI-vision y plFD}hAi Tom Perry, BuiIdiug Commissioner 200 Main Street, Hyannis,MA 02601 31 Office: 508-862-403 8 Fax: 50&790-6230 Property 0VMer Must 'Complete and Sign.This Section if Using A Builder as Owner of the subject pxoperty I, o hereby auth tize dt w `�' to act on tnybehaLf, in all matters relative to wotk authorized by this building p ett o't applicatiob.fot: (Addtes s;of.job) atute of O t Date , U , Print Name . . Q:FORMS:OWZ3ERPERMI35I01�-. ~ ... .4 "� -,_I �� P�a nd✓ "V Aq.�Y +3 .�ISK�<t� �t�i,,, 5 4 3 t NX 0` ,`i'�T st Tau 28, IMP � � ��tM � ar,1 f 4 + The Commonwealth of Massachusetts - Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Letzibly Name(Business/Organization/Individual): ���� y 9 Address: a\a n�__ CQ M\k 1Q�u City/State/Zip: \nLk` ° (;, 0d\�6 Phone #: Are you an employer?Check the appropriate box: 1.❑ I am a employer with 4• ❑ Type of project(required):I am a general contractor and I 6.- ,, employees(full and/or part-time).* have hired the sub-contractors ,mew 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.t 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doingall work. officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs . insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or-Selfns Li #� ---- - Expiration ate: - — Job Site Address: ��(� Sire City/State/Zip:A , Q� 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 cart 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 cove e rificati . I do here ce ify u der e pains and pert ties f pe tat the info mation provided above is true and correct. Si afore: CC c Date: '� 1 Phone Official use only. Do not write i 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#: Al -OR M CERTIFICATE OF LIABILITY INSURANCE` °06/22/2 06' PRODUCER (781)681-6656 FAX (781)681-6686 ,. THIS CERTIFICATE IS ISSUED AS-A MATTER OF INFORMATION 3 Barry Driscoll Ins Agcy, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 600 Longwater Drive HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 9120 Norwell, MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED Advantage Construction, Inc. ,n` INSURERA: .Crum & Forster Co.. Two Adams Place INSURERB: Transcontinental Insurance Co. Transc Suite 100 INSURERc: National Union Fire Ins Co Quincy, MA 02169 iNSURERD: Continental Casualty Ins co' . _ INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I,TRNSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION . DATE(MMtDDIYYI LIMITS. GENERAL LIABILITY 5437105893 06/20/2006 06/20/2007 EACH OCCURRENCE $ 1,000,000 X1 COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED $ .100,OO PREMISES(Ea occurance.) CLAIMS MADE JAIOCCUR MED EXP(Any one person) •. $ 5,000 A PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG' $ 2,000,000 POLICY X PRCT O- -. JE El LOC AUTOMOBILE LIABILITY SAP2083866837 06/20/2006 06/20/2007 COMBINED SINGLE LIMIT ANY AUTO - - (Ea accident) $- 1,000,000 ALL OWNED AUTOS BODILY INJURY B SCHEDULED AUTOS ?.. (Per person) $ X HIREDAUTOS - 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 $ EXCESS/UMBRELLA LIABILITY • BE495305901 06/20/2006 06/20/2007 EACH OCCURRENCE,: $ 10,UQO,QO X OCCUR CLAIMS MADE AGGREGATE • $ 10,000,000, C $ ADEDUCTIBLE $ -RETENTION--$i-10TOOG WORKERS COMPENSATION AND WC2083866787 06/20/2006 U6/20/2007 X WCSTATU OTH- EMPLOYERS'LIABILITY - - FIR D ANY PROPRIETOR/PARTNER/EXECUTIVE.. E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? - -If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 500,000 - SPECIAL PROVISIONS below ° E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER ,, ,. DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - ithin the Insureds scope of normal business operations. yidence of Insurance for work performed w ' otice 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 EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Standard.Certificate of Insurance AUTHORIZED REPRESENTATIVE L B. -Driscoll/]WN , ACORD 25(2001/08) .. n ©ACORD CORPORATION 1988. 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 s The Certificate of Insurance on the reverse side of this form does not constitute a contract between1 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) CA FA CNA Plaza Chicago,Illinois 60685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT - EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 ror Y..:.:.: ..............................::::.::.::f*rrf.�c r�odo.:::::...:;:..:.;::..:.::...:::..::.: Y sra :I�.;Pra�rzderct.. .::::..::.:.;:.;:.;:.::;.:::::::.;.:.;::;.::::::::::::::: .....::... ..........: ;::.;:.;:: gsncy WC 2 83866787 06/20/06 06/20/07 CONTINENTAL CASUALTY CO 075416120 surd. N rned.I........::::And Address .>:::::>::::.;:.>:.:::::: >.: �AIn EM ADVANTAGE CONSTRUCTION, INC. HE DRISCOLL AGENCY, INC 1 . TWO ADAMS PLACE SUITE 100. 93 LONGWATER CIRCLE ' QUINCY, .MA P.O. 'BOX 9120 ORWELL MA 02061 02169 FEIN NUMBER: 043690302 N_ CCI CARRIER CODE NO: .10243 INTERSTATE ID NO: 911597713 ** S C H E D U L E O F O P E R A T I 0 N S ** SCHEDULE PAGE 1 4 . LOC CLASS CLASSIFICATION OF OPERATIONS EST, TOTAL RATE PER. PREMIUM NO. CODE ANN REMUN $100 REMUN DIFFERENCE ********* STATE: MASSACHUSETTS 001 CLASS 9015 , ADDED. EFF 12/12/06 - 06/20/07 9015 BUILDINGS NOC--OPERATION BY OWNER IF ANY 3 .19 0 THE FOREGOING AMENDMENT RESULTS IN AN ADDITIONAL PREMIUM OF $0 -..11. ,**_,.;.REVISED POLICY TOTALS `=ESTIMATED CLASS PREMIUM $17 ,318 TOAh`='EST-Z'MAfiED: STANDARD: :PREMIUM $15,917 TOTAL ALL RISK ADJUSTMENT ..PROGRAM,. $6,367 .ESTIMATED ;`STAN] ARD PREMIUM''` $22 ,284 PREMIUM DISCOUNT $302- EXPENSE CONSTANT $284 FOREIGN TERRORISM PREMIUM $412 DOMEST3C�ERRORI-SM,-EQ-&--GAT- PR-E�1UM-' - - o. ESTIMATED PREMIUM - $22 578 --- -- - R STATE TAXES/ASSESSMENTS/SURCHARGES $700 ESTIMATED COST $23 ,378 O ZZ N . O ' O O ACCOUNT NUMBER: 3003313920 DATE OF ISSUE: 12/19/06 POLICY ISSUING OFFICE: NEW ENGLAND (WC000001) P-39543-A Chalrmanof the Boaid 1 e � ' - a rwr nrTn nn CNA CNA Plaza Chicago,Illinois 60685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT — EFFECTIVE 12/12/06 ' DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 Pdi Nu '`::;:`:°`.:: ..rnm....E*c�llc Period..> ..r ... Y : : .. .:.......... ......... oura .e.:;I�Pojr�detl: WC 2 83866787 06/20/06 06/20/07 . CONTINENTAL CASUALTY CO 075416120 Na it ,;:.:;::;;:: <........ ...... >:>: :>::<:>:::> >:::>: ' .::<.>.;::>:::::>;::<»:::::<:::>::>::<'::><:>:<:>:<::'>::>:>::>::>::>:: >::>::::>:>:»>::'>::: L ur.. tl:A..ndddrs ...................................:....:.:..:::::::..:..::.::.:.:::.. :.............................. ......A t : . n ADVANTAGE CONSTRUCTION, INC. HE DRISCOLL AGENCY, INC TWO ADAMS PLACE SUITE 100 93 LONGWATER. CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MA 02061 02169 ** E N D 0 R S E M E N T S C H E D U L E ** SCHEDULE PAGE- 1 NUMBER DESCRIPTION EDITION DATE PLEASE READ THE ENCLOSED IMPORTANT NOTICES CONCERNING YOUR POLICY G118166A IMPORTANT NOTICE •01/96 ***** DELETED ***** G1205R7B CONTRACTING CLASS PREM ADJUST' PROG WC PREM CR APP 10/00 ***** DELETED ***** G16519F20 CONSTRUCTION CLASS PREM ADJUST PROG WC PREM CR APP 01/96 ***** DELETED ***** I 0 N m I 0 e n. 0 SN O DATE .OF ISSUE: 12/19/06 POLICY ISSUING OFFICE: NEW- ENGLAND ZZ (WC000001) P-39543-A TT.T CTTTJ VT1 f CNA Plaza Chicago,Illinois60685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT — EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 WC 2 83866787 06/20/06 06/20/07 CONTINENTAL CASUALTY CO 075416120 a Ins3u tt� r Fu And. dre s.... VANTAGE CONSTRUCTION, INC . THE DRISCOLL AGENCY, INC TWO ADAMS PLACE SUITE 100 93 LONGWATER .CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MA 02061 02169 ** 0 T H E R N A M E D I N S.U R E D S ** SCHEDULE PAGE. i WEST GREENWICH TECH I, LLC FEIN=043690302 YPE2 ***** ADDED ***** WEST GREE.NWICH TECH II, LLC FEIN=043690302 YPE2 ***** ADDED ***** WEST GREENWICH TECH, III, LLC FEIN=043690302 YPE2 ***** ADDED ***** WEST GREENWICH TECH I MANAGER, LLC FEIN=043690302 YPE2 ***** ADDED ***** o — m N WEST GREENWICH TECH II MANAGER LLC FEIN=043690302 YPE2 0 ***** ADDED ***** 0 WEST GREENWICH TECH III MANAGER, LLC FEIN=043690302 YPE2 ***** ADDED ***** m� pm DATE OF ISSUE: 12/19/06 POLICY ISSUING OFFICE: NEW ENGLAND (WC00000.1) P-39543-A TAT CTTT?1P n CNA CNA Plaza Chicago,Illinois60685 STANDARD WORKERS. COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT - EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 r.ac€ WC 2 83866787 06/20/06 06/20/07 CONTINENTAL CASUALTY CO 075416120 8 Qtl h r ...:I ...}l* d'dd► ADVANTAGE CONSTRUCTION, INC . THE DRISCOLL AGENCY INC TWO ADAMS PLACE SUITE 100 93 LONGWATER CIRCLE QUINCY, MA P.O. BOX 9120 02169 [IORWELL MA 02061 ** O T H E R N A M E D I N S U R E D S ** SCHEDULE PAGE 2 DASCOMBROAD, LP FEIN=043690302 YPE2 ***** ADDED ***** CONDYNE .INV'ESTMENT PARTNERS, LLC FEIN=043690302 YPE2 ADDED ANDOVER/CIF II, LLC _ FEIN=043690302 YPE2 ***** ADDED ***** it m s N m m O N V n 0 G N _ O' O O =_ DATE OF ISSUE: 12/19/06 POLICY ISSUING OFFICE: NEW ENGLAND (WC000001 ) P-39543-A TNfiTTP FIT) ADVANTAGE Construction,, Inc February 1, 2607 Tom Perry Town of Barnstable 368 Main Street Hyannis, MA 02601 Re: Harrys Bar & Grill, 700 Main Street and:. Flagship Estates, 350 Stevens Street, Hyannis Dear Tom Perry: Please accept this letter of notification that Joseph Lambalot, an employee of Advantage Construction, Inc., has been appointed to be our full time Superintendent of both projects listed above. If you have any question, please feel free to contact our office at(781)-848-8787. Sincerely Lisa izotte Human Resources ADVANTAGE CONSTRUCTION, INC. ,. Two Adams Place, Suite 100, Quincy, MA 02169 Telephone 781.848.8787 Fax 781.848.3774 www.advantageconstructioninc.com Town of Barnstable Building Department - 200 Main Street sARNSTABLE. = Hyannis, MA 02601 MASS. (508) 16jq- 862-4038 . 9� . Certificate of O. ccupancy Application Number: 200703865 CO Number: 20070293 Parcel ID: 308004001 CO Issue Date: 12/28107 . Location: 320 STEVENS STREET B2 Zoning Classification: OFFICEIMULTI-FAMILY RESIDENTIA Village: HYANNIS Gen Contractor: LAMBALOT, JOSEPH E. Permit Type: RC00 CERTIFICATE.OF OCCUPANCY RES Comments: Building Department Signature Date Signed s:.. tNE TOWN OF BARNSTABLE,,.. Building' � , Application Ref: 200703865 • BARNSTABLE, I Issue Date: 06/25/07 Permit 9 MASS. Applicant: LAMBALOT�JOSEPH E. Permit Number: B 20071471 Proposed Use: Expiration Date: . 12/23/07 Location 320 STEVENS STREET$B2 Zoning District OM Permit Type: SP PROJ RES ADD/ALT Map Parcel 30800400I Permit Fee$ 251.24 Contractor LAMBALOT,JOSEPH E. Village HYANNIS App Fee$ 50.00 License Num 048722 Est Construction Cost$ 61,277 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND TENENT FIT OUT CONDO UNIT B2 THIS 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 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:ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY: ENCROACHEMENTS ON PUBLIC PROPERTY;;NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST-BE APPROVED BY THE JURISDICTION. T.REET.OR.ALLY 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 AN APPLICABLE SUBDIVISION RESTRICTIONS.- MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION'BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). ,.-. �,:":< ,,,, .. ,,,.; ^::•, c.... „, a, ,ski 'c4.,, ,, i., ` ,.? ,. ,,.z,, :?.' >s„ 4'� "�.19 y -,1, w BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL.INSPECTION APPROVALS o-7 La � �. r'� _ 2 / e1ti O l� 2 ' 0 2 r� 3 f p -zA-C, _0-7 1 Heating Ins ecti Approvals Engineering Dept ekr AO ® Fire Dept 2 Board of Health ',�� ! TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Mapzpa Parcel iX Application# Health Division Conservation Division Permit# Tax Collector Date Issued as Treasurer Application Fee G v 0 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village Owner S x r" Address Telephone Permit Request lam✓ d�-p/� or�S� ��Si�/ r ` Square feet: 1 st floor:existing proposed 2nd floor:existing proposed r—, Total nevA`Y- Zoning District Flood Plain Groundwater Overlay tw Project Valuation Construction Type Alkol � `= Lot Size Grandfathered: ❑Yes a o If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes 4-110 On Old King's Highway: ❑YE s -dw,0, r Basement Type: ❑ Full ❑Crawl ❑Walkout 9-0fher Basement Finished Area(sq.ft.) Basement Unfinis ed Area(sq.ft) Number of Baths: Full:existing — new Half:existing new Number of Bedrooms: existing new _11S Total Room Count(not including baths):existing new L5' First Floor Room Count Heat Type and Fuel: 66as ❑Oil ❑Electric ❑Other Central Air: O Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes a ll- Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing �w size s,?,O �hed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 9d�o l If yes, site plan review# Current Use ��'��iz 7 �� i7� Proposed Use UILDER INFORMATION .Name Telephone Number Address ++G � « � O License# - e-77 7y7r�- lsC��l�C Home Improvement Contractor# !/OcTc 4w Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTINfmFROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE � �� FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ' i r ADDRESS VILLAGE f ! 1 .OWNER . DATE OF•,INSPECTION: ` FOUNDATION FRAME INSULATION C)(L 'F FIREPLACE , ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r r . P r/ GAS: ROUGH FINAL FINAL BUILDING ® ( `-�7 • 0 ? DATE CLOSED OUT , ASSOCIATION PLAN NO.1 ' oFzr ,ot, a Town of Ba]C'nstable Regulatory Services Thomas F. Geller,Director . 9� 1639, Building Division PEED ]a g TomPerry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office; Fax: 509-796-6230 508-862-4038 Property Ow-aejr Must Complete and'Sign This Section ' If.Using A Builder X-S z, Gd/4'// �we e ,as Owne±of the subject propertq hereby authorize ® to act on mp behalf, in all matters relative to work authorized by this building permit application fob: (AAdtess of Job) - eZOO-U ZZ �e? tote of O r Date Print N me Q:FORMS:Owi`TERPERMI�3IOH . I _ er y OWN- `' a T T 1 NNE m SEE-1 f db Ka ��^.,y7 'a The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): �G� � Address: City/State/Zip: \nL'. \AC, Ud\ Phone #: Are you an employer?Check the appropriate box: 1.0 I am a employer with 4• ❑ Type of project(required):I am a general contractor and I �.��,,,,� employees(full and/or part-time).* have hired the sub-contractors 6—J� w 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.❑Electrical repairs or additions 3.❑ 1 am a homeowner doingall 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.❑ 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: �� i•t P�1iey#t or Self ins�ic # � 3��� � j ,ratio a_n te �—=l`0 Job Site Address: �>:DC7 S e 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 MGh c. 152 cari lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do here ce ify u der e pains and penalties of perjury that the information provided above is true and correct. Si ature: CC c Date: Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health.2,Building Department 3. City/Town Clerk 4.Electrical Inspector.5.Plumbing Inspector 6. Other ' Contact,Person: Phone#: -00,,, CERTIFICATE OF LIABILITY INSURANCE 06/22/2 06' PRODUCER (781)681-6656 FAX (781)681-6686 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION J Barry Driscoll Ins Agcy, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 600 Longwater Drive HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 9120 Norwell, MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED Advantage Construction, Inc. INSURERA: Crum & Forster Co. Two Adams Place INSURERB: Transcontinental Insurance Co. Transc Suite 100 INSURERC: "National Union Fire Ins Co Quincy, MA 02169 INSURERD: Continental Casualty Ins co INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE(MMIDDIYY) LIMITS GENERAL LIABILITY 5437105893 06/20/2006 06/20/2007 EACH OCCURRENCE $ 1,000,000 OOO OOO X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 CLAIMS MADE I OCCUR PREMISES(EaS MED EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 1;OOO,OO GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO- JECT LOC AUTOMOBILE LIABILITY SAP2083866837 06/20/2006 06/20/2007 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS - BODILY INJURY SCHEDULEDAUTOS (Per person) $ B X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY .. - AUTO ONLY-EA ACCIDENT S ANY AUTO ' OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY BE495365901 06/20/2006 06/20/2007 EACH OCCURRENCE $ 10,000,000 - X OCCUR CLAIMS MADE . AGGREGATE $ 10,000,000 C $ DEDUCTIBLE $ -- -RETENTION-$--IO-,OO' - — --- --- $ WORKERS COMPENSATION AND WC2083866787 06/20/2006 06/20/2007 X wcsTATu- EMPLOYERS'LIABILITY D ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $. SOO,OOO If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS vidence of Insurance for work. performed within the Insureds scope of normal business operations. otice 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 EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Standard Certificate Of Insurance. AUTHORIZED REPRESENTATIVE AUTHORIZED Driscoll/JWN ACORD 25(2001/08) ©ACORD CORPORATION 1988 1 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. s I ACORD 25(2001/08) CNA CNA Plaza Chicago,Illinois 60685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT - EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 ..:::.. PcslicyP rwd.::;:.,.;::T�.: Couere H;8::�#QJd ...:..::...:..::.::::::::::::::::::::::::::::::::::::..:::::.::::.:::. .::::::::.:::.:... Inc.:: .............. X.....................................................9........Y...:.:......::::::::::: 1 . WC 2 83866787 06/20/06 06/20/07 CONTINENTAL CASUALTY CO 075416120 .:<.:.... ►ned Insured And Adc[res .... .': ::..::.. .:.:::::::. ,:.::.::.:.:::.::...::�1 g..::........::.;.;::.;.:. :.;: .... . .. ..................................................::::::::::::::::::::.:.:::: EM ADVANTAGE CONSTRUCTION, INC. HE DR-ISCOLL AGENCY, INC 1 . TWO ADAMS PLACE SUITE 100. 93 LONGWATER CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MA 02061 02169 FEIN NUMBER: 04369030.2 NCCI CARRIER CODE NO: 10243 INTERSTATE ID NO: 911597713 r ** S C H E D U L E O F O P E R A T I O N S ** SCHEDULE PAGE 1 4 . LOC CLASS CLASSIFICATION OF OPERATIONS EST TOTAL RATE PER PREMIUM NO. CODE ANN REMUN $100 REMUN DIFFERENCE ********* STATE: MASSACHUSETTS 001 CLASS 9015 ADDED. EFF 12/.12/06 - 06/20/07 9015 BUILDINGS NOC--OPERATION BY OWNER IF ANY 3 .19• 0 THE FOREGOING AMENDMENT RESULTS IN AN ADDITIONAL PREMIUM OF $0 ***,.;.REVISED POLICY TOTALS ***** "ESTTMATED CLASS PREMIUM $17 ,318 TA '=ESTZT�IAfi ,STANDARD;.PREMIUM OT L En,' $15,917 T 1.OTAL :ALL RISK ADJUSTMENT .PRO RAM $6,367 ESTIMATED'STANDARD PREMIUM '` $22 ,284 PREMIUM-DISCOUNT $302- EXPENSE CONSTANT $284 N FOREIGN TERRORISM PREMIUM $412 4 DOM-FS-T-�C-�E1R4F2S�I EQ—&—CA�PREMIUi� _ -0 --- —ESTIMATED PREMIUM $22,578 N STATE TAXES/ASSESSMENTS/SURCHARGES $700 ESTIMATED COST $23 ,378 g oN O O Ee]i f� ACCOUNT NUMBER: 3003313920 DATE OF ISSUE: 12/19/06 POLICY ISSUING OFFICE: NEW ENGLAND (W0000001 ) P-39543-A CMMman of the Board T wTt TTI'lTT ' CNA CNA Plaza Chicago,Illinois 60685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT — EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 I.Pr�3iy Nuribei:::`<: ':.:.:. °m .:.Pal►c�Perec�d€: ... Q....< ....... .... ovra eat)yrovd�ci ::::;.::::::::::::>:.:.::.: :A. c.::.;:::;.:. WC 2 83866787 06/20/06 06/20/07 . CONTINENTAL CASUALTY CO 075416120 N mec Insured A�ael Adtir�s , ADVANTAGE CONSTRUCTION, INC . THE DRISCOLL AGENCY, `INC . TWO ADAMS PLACE SUITE 100 93 LONGWATER CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MA 02061 , 02169 ** E N D 0 R S E M E N T S G H E D U•L E ** SCHEDULE ' PAGE'.. 1 NUMBER DESCRIPTION EDITION DATE PLEASE READ THE ENCLOSED IMPORTANT NOTICES CONCERNING YOUR POLICY G11816GA IMPORTANT NOTICE 01/96 ***** DELETED ***** G120587B CONTRACTING CLASS PREM ADJUST PROG WC PREM CR APP 10/00 ***** DELETED ***** G16519F20 CONSTRUCTION CLASS PREM ADJUST PROG WC PREM CR APP 0?1/96 ***** DELETED ***** e DATE, OF ISSUE: 12/19/06 POLICY ISSUING OFFICE: NEW ENGLAND r (WC000001) 'P-39543-A., TT,70TTn Vn ., _ C NA CNA Plaza f` Chicago,Illinois 60685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT - EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON= ADD-NAME INSUREDS AND CLASS , CODE 9015 EFF 12-12-06 >:::?::: ' :>:>E<:>:;`:<:>:::::>:s:: ">::;:;::.::,:>:::,:::>�:::::: , x:<;; Ft�ita:::Pnad.;:<.:..:To.::::;:,.;.:;.;<:....:. ,. .;;... .::...::.. X ::::::: :::;:;.:: ra e��;:t�rovtdesf.; wxx WC 2 83866787 06/20/06 06/20/07 CONTINENTAL_ CASUALTY CO 075416120 N ed-n r6d.. .?IS1................. j�DVANTAGE CONSTRUCTION, INC . THE DRISCOLL AGENCY, INC TWO ADAMS PLACE SUITE 100 93 LONGWATER .,CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MA 02061 02169 ** O:T H E R F I C A M E; D- I N S .U_ R E D S ** ` SCHEDULE PAGE - 1 WEST GREENWICH TECH I',' LLC F FEIN=043690302 YPE2 ***** ADDED .***** , WEST GREENWICH TECH II 'LLC FEIN=043690302 �5' YPE2 ***** ADDED, WEST GREENWICH TECH, III LLC FEIN=043690302 YPE2 ***** ADDED'-***** WEST GREENWICH TECH .I MANAGER A m LLC FEIN=043690302.., * . N YPE2 ***** ADDED ***** N WEST .GREENWICH TECH II-MANAGER, LLC FEIN=043690302 . YPE2 o **** ADDED WEST,GREENWICH TECH III MANAGER,, LLC FEIN=043690302" , YPE2 ***** ADDED ***** =_ DATE OF ISSUE: 12/19/06 POLICY. ISSUING OFFICEc NEW ENGLAND (W0000001) P-39543-A TT\TCTTV VTl c CNA CNA Plaza Chicago,Illinois60685- STANDARD WORKERS. COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT - EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND' CLASS ' CODE 9015 EFF 12-12-06 ~ Pdiy Nu ;:> : °::.::. ..tortr....::Fv)ic Psraac :;::.:70.,::::;;:.;..:.::;;:::;:...;Cvvera �..::.. ..........:...::....::...:.:: ::::,::::::::.:9 WC 2 83866787 06/20/06 06/20/07 CONTINENTAL CASUALTY CO 075416120 '''`;;::::'`:::.:..:.;.. rneciinsur�d.Arlddldrs .. ADVANTAGE CONSTRUCTION, INC . THE DRISCOLL AGENCY, INC TWO ADAMS PLACE SUITE 100 93 LONGWATER CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MAj 02061 02169 ** O T H E R N -A M E D I N S U R E D S ** SCHEDULE PAGE 2 DASCOMBROAD, LP FEIN=043690302 YPE2 ***** ADDED ** ** CONDYNE .INV'ESTMENT PARTNERS ,. LLC FEIN=043690302 YPE2 *** * ADDED ***** ANDOVER/CIF II; •LLC FEIN=043690302 YPE2 *****_ ADDED ***** o DATE OF 'ISSUE: 12/19/06`° POLICY ISSUING OFFICE NEW ENGLAND (WC000001)` P-39543-A TNSTTP,FT) .A V ANTAGE Con e Y ' sr e. - February 1, 2007 t Tom Perry Town of Barnstable 368 Main Street r , Hyanni.s, MA 02601 ,Re: 'Harrys Bar & Grill, 700 Main Street and., Flagship Estates, 350 Stevens Street, Hyannis Dear Tom Perry: Please accept this letter of notification that Joseph Lambalot; an employee of Advantage Construction,Inc., has been appointed to be our full_ time Superintendent'of both projects,listed above. , If you have any question,please feel free to contact our office at(781)-848-8787. ~ Sincerely - ,,-A4vgntage(Con�tt tion,-4nc. Lisa Lizotte Human Resources :ADVANtAr3r= CONSTRUCTION, INC., Two Adams Place, Suite 100, Quincy, MA 02169 Telephone 781.8,48.8787 Fax„781-848.8774 www.advantageconstructioninc.com . " Town of Barnstable Building Department - 200 Main Street BARNST"M * Hyannis MA 02601 9 MASS (508) 862-4038 RFD MA'S A f - Certificate o Occupancy Application Number: 200703867 CO Number: 20070294 Parcel ID: 30800400H CO Issue Date: 12128107 Location: 320 STEVENS STREET 133 Zoning Classification: OFFICEjMULTI-FAMILY RESIDENTIA Village: HYANNIS Gen Contractor: LAMBALOT, JOSEPH E. Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: 0-7 Building Department Signature Date Signed l f4` �114E TOWN OF BARNSTABLE � Building Application Ref: 200703867* sAxxsTAs>[E, Issue Date: 06/25/07 Permit 9 MASS. �ArFC �A� Applicant: -- - LAMBALOT,JOSEPH E. Permit Number: B 20071469 Proposed Use: Expiration Date: 12/23/07 ��.. Location 320 STEVENS STREETWB ., Zoning District OM Permit Type: SP PROJ RES ADD/ALT Map Parcel 30800400H Permit Fee$ 251.24 Contractor LAMBALOT,JOSEPH E. Village HYANNIS App Fee$ 50.00 License Num 048722 Est Construction Cost$ 61,277 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND TOWN HOUSE FIT OUT UNIT�B 3 THIS 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 . TWO ADAMS PL INSPECTION HAS BEEN MADE. , QUINCY, MA 02169 q z Application Entered by: PR Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT T.O OCCUPWANY STREET'"ALLY`bR SIDEWALK ORANY PA'RT'THEREOF;EITHER TEMPORARILY OR PERMANENTLY. " EM r ENCROACHENTS ON PUBLIC PROPERTY;NOT'SPECIFICALLY PERMITTED:UNDER THE BUILDING CODE,MUSTBE APPROVED BY THE JURISDICTION. STREET'OR'ALLY<GRADES'AS WELL'AS,DEPTH AND'°LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM,THE DEPARTMENT OF PUBLIC WORKS: THE IS q HIS"PERMIT°DOES NOT RELEASE`THE APPLICANT FROM THE CONDITIONS OF ANY,APPLICABLE SUBDIVISION"RESTRICTIONS MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH).. 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). ivyx f BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 0 - (f-b `--r L /Z- 2 hides - s oC� l 3 t+ O GC 1 Heating Inspection Approvals Engineering Dept Fire Dept �� 2. Board of Heal �.. 21; c /07 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �lJ Parcel W . )d 'Application# Health Division s Conservation Division Permit Tax Collector Date Issued a� 6 Treasurer Application Fee` Planning Dept. Permit Fees Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis 4 . Project Street Address - Village Q N Owner `r S �.S��G 'Address Telephone ; Permit Request �it/�! 152, 1 f Square feet: 1 st floor:existing proposed 2nd floor:existing -= proposed �'O otal new V71ZO Zoning District � Flood Plain Groundwater Overlay {,> Project Valuation ` 7 Construction Type Lot Size //r d-a 2 Grandfathered: ❑Yes LK If yes, attach supporting documentation. Dwelling Type: Single Family "0 Two Family ❑ Multi-Family(#units) Ge'�i�i Age of Existing Structure _` Historic House: ❑Yes W-?To On Old King's Highway: ❑Yes O<O Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing. new l First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑Electric ❑YOther Central Air: Ye ❑. s - No Fireplaces: Existing New Existing wood/coal stove: ❑Yes Detached garage:U existing Tq new.. size 'Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new` size . ?D Sh d:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ .Appeal,# Recorded❑ Commercial. ❑Yes No If yes,site plan review# Current Use / •� �/ Proposed Use BUILDER INFORMATION Name s _ Telephone-Number Address /G-� .q � �� i%r� License# 4 / Home Improvement Contractor# !/ v Worker's Compensation#d!/�'o?o ,�'��7�7 4-2W ALL CONSTRUCTION D BRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY 1 ` PERMIT NO. DATE ISSUED r 'f MAP/PARCEL NO. - r - ADDRESS VILLAGE OWNER ,...-.. i -• Tom,r. DATE OF INSPECTION: ' FOUNDATION FRAME f. (� LC - O '7 dp�- r INSULATION K- E FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ; GAS: ROUGH FINAL �• FINAL BUILDING 7-� r DATE CLOSED OUT 1� r ASSOCIATION PLAN NO. t , t • �` - Town'of Barnstable o4Z►�r°yy �_ Regulatory Services uasras , f Thomas F. Geller,Director MASS, %619,� � Building Division PEED NtA �' '.; . Tom Perry, Building Commissioner 200 Main Street, Hyannis,Y-k 02601 Office: 508-862-403 8 Fax: 509-790-6230 Property Owmer Must j Complete and*Sign TEs Section If.Using .A,.Builder e 1� q�-�.� q le�") / � ,as Owner of the subjectproperty � a . b .authorize /rye ele `�' to act on my behalf, here y in all mattes relative to work authorized by this building permit application for: (Address of Job) tore of O Date { Print Name. Q:FORMS,OWi`TERPERMIS5IOI1. m " ,... .. 4 .:r ISO a�cry 7- .p F @mow ¢r;. �� x � t° The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name(Business/Organization/Individual): 1�)VDOc Q- Address:' C� City/State/Zip: a_n(_%-, \Aa Off, fi 'Phone #: 7l \ 7-7�%k Are you an employer?Check the appropriate box: 1.❑ I am a employer with 4• ❑ Type of project(required):I am a general contractor and I ������,,�� employees(full and/or part-time).* have hired the sub-contractors " �v'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.❑ 1 am a homeowner doingall 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.[_1 Other comp. insurance required.] `Any applicant that checks box 41 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: LU —Expiration> ate: Job Site Address: SWc 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 MGt_ c. 152 car lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil-penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do here ce ify u der e pains and penalties ofperjury that the information provided above is true and correct. Si nature: CC Date: Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health.2.Building Department 3. City/Town Clerk 4.Electrical Inspector, 5.Plumbing Inspector 6. Other Contact Person: Phone#: ACORD,*, CERTIFICATE OF LIABILITY INSURANCE 06/22/z6' PRODUCER (781)681-6656 FAX (781)681-6686 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION J Barry Driscoll Ins Agcy, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 600 Longwater Drive HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 9120 Norwell , MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED Advantage Construction, Inc. INSURERA: Crum & Forster Co. Two Adams Place INSURERB: Transcontinental Insurance Co. Transc Suite 100 INSURERC: National Union Fire Ins Co Quincy, MA 02169 INSURERD: Continental Casualty Ins co INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER-DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY 5437105893 06/20/2006 06/20/2007 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 CLAIMS MADE a OCCUR MED EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO- LOC JECT AUTOMOBILE LIABILITY SAP2083866837 06/20/2006 06/20/2007 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY $ I B SCHEDULED AUTOS (Per person) X HIREDAUTOS BODILY INJURY $ X NON-OWNEDAUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $H OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY BE495305901 06/20/2006 06/20/2007 EACH OCCURRENCE $ 10,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 10,000,000 $ DEDUCTIBLE $ -RETENTI0N! $ 1O TOO- --- WORKERS COMPENSATION AND WC2083866787 06/20/2006 06/20/2007 X we STATU- oTH- EMPLOYERS'LIABILITY ER D ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS vidence of Insurance for work performed within the Insureds scope of normal business operations. otice 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 EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Standard Certificate Of Insurance. , F8B. UTHORIZED REPRESENTATIVE Driscoll/JWN ACORD 25(2001108) ©ACORD CORPORATION 1988 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. P ACORD 25(2001/08) CNA CNA Plaza Chicago,Illinois 60685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT — EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 Policy NurYitie ' rortl ..Pci�c par�r�d T..Qouera say .:... ...:........:.::...::.::::::.::.;::::.::.::.:: Prow dOd:f. ::::.:::::::::::::.::::::::::.:::.;:::.;:.;:.;:::::.A a rc.:.:::::::::::::::::.::.: ............................................::::::::.. .:::::::.Y::::::::::.:::.:::::: WC 2 83866787 06/20/06 06/20/07 CONTINENTAL CASUALTY CO 075416120 :::..::.:.:..anted Jt�surcd A6, Address... :..:.;:.;::.. .:: ....:.:..... .. . .. :.:.:::.. . A ..n.Y ITEM ADVANTAGE CONSTRUCTION, INC. THE DRISCOLL AGENCY, INC 1 . TWO ADAMS PLACE SUITE 100. 93 LONGWATER CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MA 02061 02169 !FEIN NUMBER: 043690302 NCCI CARRIER CODE NO: 10243 INTERSTATE ID NO 911597713 ** S C H E D U L E O F O P E R A T I O N S ** SCHEDULE PAGE 1 4 . ✓ LOC CLASS CLASSIFICATION OF OPERATIONS EST TOTAL RATE PER PREMIUM NO. CODE ANN REMUN $100 REMUN' DIFFERENCE ********* STATE: MASSACHUSETTS 001 CLASS 9015 ADDED. EFF 12/.12/06 - 06/20/07 9015 BUILDINGS NOC--OPERATION BY OWNER IF ANY 3 .19 0 THE FOREGOING AMENDMENT RESULTS IN AN ADDITIONAL PREMIUM OF $0 ***** >REVISED POLICY TOTALS ***** °ESTIMATED CLASS PREMIUM $17 ,318 TOTAL'='ESTIT�I'-T :STANDARD;::PREMIUM $15,917 'DOTAL ALL RISK ADJU8TMENT, ..PROGRAM $6,367 ESTIMATED'tSTANDARD PREMIUM $22 ,284 PREMIUM DISCOUNT $302- EXPENSE CONSTANT $284 FOREIGN TERRORISM PREMIUM $412 —ESTIMATED PREMIUM $222,6.7oO --- —— — N STATE TAXES/ASSESSMENTS/SURCHARGES _ $700 ESTIMATED COST $23 ,378 ON O O ACCOUNT NUMBER: 3003313920 DATE OF ISSUE: 12/19/06 POLICY ISSUING OFFICE: NEW ENGLAND (WC000001) P-39543—A. Cha'vman of the Board rwT rvrrn nr� - CNA CNA Plaza Chicago,Illinois 60685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT — EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 ............................ ::........ PoTiy Nuri�tiei;.;:< ...Pofic F'er�cd ::...TQ ...:::::.:;:.::: :.::... ..Covers e': :.:::>:<:::::> ................BX..............................................::...::: .::::::.Y....:::::::::::::::::::::: WC 2 83866787 06/20/06 06/20/07 . CONTINENTAL CASUALTY CO 075416120 15: ;::;�>';:.:<., <;;::';:.. "s;:.:;':;';::.<i: ::E:ii> i;:;i;i:::::>::>;:::>isii:::>>:;:;;:>.;:;;:;:;�>:::»i:i:i<:>::ii:>i::;;i ....::N.sn.....Its,�red;Ar�c9 ADVANTAGE CONSTRUCTION, INC. THE DRISCOLL AGENCY, INC TWO ADAMS PLACE SUITE 100 93 LONGWATER. CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MA 02061 02169 ** E N D 0 R S E M E N T S C H E D U L E ** SCHEDULE PAGE'. 1 NUMBER DESCRIPTION EDITION DATE PLEASE READ THE ENCLOSED IMPORTANT NOTICES CONCERNING YOUR POLICY G118166A IMPORTANT NOTICE 01/96 ***** DELETED ***** G120587B CONTRACTING CLASS PREM ADJUST PROG WC PREM CR APP 10/00 ***** DELETED ***** G16519F20 CONSTRUCTION CLASS PREM ADJUST PROG WC PREM CR APP 01/96 ***** DELETED ***** n 0 N O —CA O r. 8 e SN O DATE. OF ISSUE: 12/19/06 POLICY ISSUING OFFICE: NEW ENGLAND (WC000001) P-39543-A ' TrTcranc�r� C NA CNA Plaza Chicago,Illinois 60685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT - EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 Putic.:.;Pera.od€::::..Ia......:::.::..:;:.;:;..:.;:.;:::: Coveca a":i�::.p.,:o.. WC 2 83866787 06/20/06 06/20/07 CONTINENTAL CASUALTY CO 075416120 :.. .. rueddnsu rid And}ddt s.::.....:::.: .:;:.;..............:.: .:.:;:.:.....:.;: .".:::.::.:....:.::.;.::.:. NTAGE CONSTRUCTION, INC . THE DRISCOLL AGENCY, INC TWO ADAMS PLACE SUITE 100 93 LONGWATER CIRCLE - QUINCY, MA P.O. BOX 9120 ORWELL MA 02061 02169' ** 0 T H E R N A M E D I N S.U R E D S ** SCHEDULE PAGE. i WEST GREENWICH TECH I, LLC FEIN=043690302 YPE2 ***** ADDED ***** WEST GREENWICH TECH II, LLC FEIN=043690302 YPE2 ***** ADDED ***** WEST GREENWICH TECH, III, LLC FEIN=043690302 YPE2 ***** ADDED ***** WEST GREENWICH TECH I MANAGER, m LLC FEIN=04369.0302 YPE2 ***** ADDED ***** N WEST ,GREENWICH TECH II MANAGER LLC FEIN=043690302 YPE2 ***** ADDED ***** O o WEST GREENWICH TECH III MANAGER, LLC FEIN=043690302 YPE2 ***** ADDED ***** DATE OF ISSUE: 12/19/06 POLICY ISSUING OFFICE: NEW ENGLAND _ (WC000001) P-39543-A T\TCTTD T+Tl CNA CNA Plaza Chicago,Illinois60685 STANDARD WORKERS. COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT - EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 Pdie-r:.Nziriibi::: `> ' :.::.;:.. ::::::F?o1�c::W�r�ad.;;::.:..Vie..::..:.:. ...::..:: ..::... ...:..: .:.:;.::.;:::.,.: a>I ::Provtd. .: ::::::::..............� >;::::.;::>::;: WC 2 83866787 06/20/06 06/20/07 CONTINENTAL CASUALTY CO 075416120 amecdlnsured,And ldd►?e� ..•......::;.:.::::..:.:....:.. . . . ..... ...::.::. ..:...:.:.:::..>.;:.:::.. .. .::.::.: . r,Y:.;.:...::.... . .............. ....................................................................:.::::::::: ADVANTAGE CONSTRUCTION, INC . THE DRISCOLL 'AGENCY, INC TWO ADAMS PLACE SUITE 100 93 LONGWATER CIRCLE QUINCY, MA P.O. Box 9120 ORWELL MA 02061 02169 ** 0 T H E R 'N A M E D I N S U R E D S ** SCHEDULE PAGE 2 DASCOMBROAD, LP FEIN=043690302 YPE2 *****ADDED ***** CONDYNE .INVESTMENT PARTNERS, LLC FEIN=043690302 YPE2 ***** ADDED ***** ANDOVER/CIF II, LLC FEIN=043690302 YPE2 ***** ADDED ***** m N m o 0 N .p N r DATE OF ISSUE: 12/19/06 POLICY ISSUING OFFICE: NEW ENGLAND (W0000001 ) P-39543-A TNSTTR P..i1 r ADVANTAGE Construction, Inc® February 1, 2007 Tom Perry Town of Barnstable 368 Main Street Hyannis, MA 02601 Re: Harrys Bar & Grill, 700 Main Street and.. Flagship Estates, 350 Stevens Street, Hyannis Dear Tom Perry: Please accept this letter of notification that Joseph Lambalot, an employee of Advantage Construction, Inc., has been appointed to be our full time Superintendent of both projects listed above. If you have any question, please feel free to contact our office at(781)-848-8787. Sincerely -- Ad- rat e(C-e�t�uEt�on�nG — — — — —— - —-- L _Z5 4--T% isa izotte Human Resources ADVANTAGE CONSTRUCTION, INC. Two Adams Place, Suite 100, Quincy, MA 02169 Telephone 781.848.8787 Fax 781.848.3774 www.advantageconstructioninc.com ACORD DATE CERTIFICATE OF LIABILITY INSURANCE 6/19/2007 ' 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 g y� 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION - TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DDIYY LIMITS GENERAL LIABILITY DTC0464Dl464-IND07 06/20/2007 06/20/2008 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 300,000 A CLAIMS MADE Fx_1 OCCUR MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY }{ JECT LOC AUTOMOBILE LIABILITY DTA0810464D1476-TIL07 06/20/2007 06/20/2008 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 B ALL OWNED AUTOS BODILY INJURY SCHEDULEDAUTOS (Per person) $ X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ _ ANY AUTO OTHER THAN _EA AC AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY DTSCUP464DI488-TIL07 06/20/2007 06/20/2007 EACH OCCURRENCE $ 15,000,000 _X1 OCCUR CLAIMS MADE AGGREGATE $ 15,000,000 B DEDUCTIBLE $ RETENTION p, WORKERS COMPENSATION AND DTEUB464D1440-07 06/20/2007 06/20/2008 Y TDRYLIMITsI JOTH EMPLOYERS'LIABILITY ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE$ 1,000,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL 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. F THORIZED REPRESENTATIVEDriscoll/KAD a �6--�� ACORD 25(2001/08) ©ACORD CORPORATION 1988 I N Cn99:ins nog— P.—1 of 9 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. 4 t ACORD 25(2001108) INS025(oiw.oaa 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. OFREMARK COPYRIGHT 2000, AMS SERVICES INC. r Town of Barnstable Building Department 200 Main Street * snxtvsrnB�. Hyannis, MA 02601 9� MAC (508) 862-4038 s6g S. ifiOccupancyCert cats of Application Number: 200703866 CO Number: 20070295 Parcel ID: 3080040OG CO Issue Date: 12128107 Location: 320 STEVENS STREET 134 Zoning Classification: OFFICE/MULTI-FAMILY RESIDENTIA Village: HYANNIS Gen Contractor: LAMBALOT, JOSEPH E. Permit:Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: ( `a- °7 rt Building Department Signature Date Signed N ' �114Eh�,- TOWN OF BARNSTABLERuilding Application Ref: 200703866 BARNSTASLE, Issue Date: 06/25/07 Permit MASS. Q3A i639• �� Applicant: LAMBALOT'JOSEPH E. . Permit Number: ,B 20071470 Proposed Use: Expiration Date: 12/23/07 Location 320 STEVENS STREET B� Zoning District OM Permit Type: SP PROJ RES ADD/ALT Map Parcel 3080040OG Permit Fee$ 251.24 Contractor LAMBALOT,JOSEPH E. Village HYANNIS App Fee$ 50.00 License Num. 048722 Est Construction Cost$ 61,277 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND TENENT FIT OUT FOR HARRY'S CONDO UNIT B 4 THIS 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 PL INSPECTION HAS BEEN MADE. QUINCY,MA 02169 Application Entered by: PR Building Permit Issued By: - THIS PERMIT CONVEYS.NORIGHTTO OCCUPYANY STREET'ALLY OR SIDEWALK OR ANY PART THEREOF,ETHER TEMPORARILY OR PERMANENTLY: EN.CROACHEMENTS,ON PUBLIC PROPERTY;,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING.CODE,MUST BE APPROVED BY,THE JURISDICTION. STREET OR ALLYGRADES AS.WELL AS DEPTH-AND.LOCATION OF;PUBLICSEWERS MAYBE OBTAINED FROM,THE DEPARTMENT OF,PUBLIC,WORKS THE ISSUANCE'OF THIS•PERMIT DOES NOT'RELEASE THE�APPLICANT FRO'M'THE CONDITIONS OF ANY`APPLICABLE SUBDIVISION RESTRICTIONS MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). - 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED.CONTRACTORS DO NOT HAVE ACCESS TO,GUARANTY FUND(as set forth in MGL c.142A). w. ..® BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS c S J 3 (���t ( �7 1 - lit a ng Inspection Approvals Engineering Dept L ^ Lq — cG `? �J s� - Fire Dept 2 Board of Heal h d ti TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �f � � �3 Map Parcel w 1 d Application# ao7o P(oP Health Division Conservation Division Permit# Tax Collector Date Issued co 1,�A 6—) Treasurer Application Fee Planning Dept. Permit Fee ` . 17 t Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street A ress S Village Gtit� Owner s1,w,r �GAddress oei �/ld Telephone !rl *ef Permit Request { ( Ab_ Square feet: 1 st floor:existing proposed. �— 2nd floor:existing proposed Total new Zoning District L� Flood Plain Groundwater Overlay Project Valuation `�� Z7 Construction Type Ae o rco Lot Size & Grandfathered: ❑Yes RMo If yes, attach supporting doc mentation. P Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes �_: o On Old King's Highway: ❑Yes u4e Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other G4 Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new c::12 Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new v First Floor Room Count Heat Type and Fuel as ❑Oil ❑Electric ❑Other Central Air: es ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new =size Pool:❑existing ❑new size Barn:❑existing ❑new size• Attached garage:❑existing' &new. size oVO She ❑existing ❑new size Other: _ Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use l/�t���� '��i�,�/ Proposed Use BUILDER INFORMATION Name ��U�� s Co.��s/iz Telephone Number 71f/of;e1e"&7e'7 Address �� /�� License# 4' 72 2, Home Improvement Contractor# Worker's Compensation#Ale gar&''�G'717 ALL CONSTRUCTION DEEBRIS-R/ES LTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ���� FOR OFFICIAL USE ONLY ~` PERMIT NO. DATE ISSUED MAP/PARCEL NO. � r i ' ADDRESS' VILLAGE OWNER + DATE OF INSPECTION: FOUNDATION Y ' FRAME ` , INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL f PLUMBING: ROUGH FINAL ` i GAS: ROUGH FINAL t FINAL BUILDING ram_ /�"-7 DATE CLOSED OUT ASSOCIATION PLAN NO. v S i Q0 7 � Town'of Barnstable Regulatory Services sras�e, * 'Thomas F. Geller,Director . y SM 39, ��� BUlldin Dlvis10Il Tom Perry, Building Commissioner 200 Main street, Hyannis,MA 02601 Office: Pax: 509-790-6230 508-862-403 8 Property Owmeir Must Complete and'Sign This Section if.Using A Builder l • / �T I, as Ovnef of the subject pxoperiy hereby authorize„ ��4c' •% e ® to act on=7 behalf, in all taattets relative to wotk authorized by this building permit application for: (Addtess of Job) i atute of r Date , Pont Name Q FORMS:oWNER?ERMISSION N �x� 6 ON Mal h� a '� z t k tag'$� f� ��: P' {�, Usw;{' v� NEW��.7�' S s �P . ��,t�-)o t���?� ���,'� � ` ?n�,�? i yq E The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): HOC Address:- ,f,) City/State/Zip: w',L. Oa,1 Phone Are you an employer?Check the appropriate box: 1.ElI am a employer with 4• ❑ Type of project(required):I am a general contractor and I ����,�� employees(full and/or part-time).* have hired the sub-contractors " s!'-1 w construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers 4. comp. insurance comp.insurance.$ 0 Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doingall work. officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.[_1 Roof repairs insurance required.].t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other Ft 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: Pokey#or-Self=Otis-L-ie # - j x ,ration Date: - P- . =c �--_-- Job Site Address:_ She City/State/Zip: Attach a copy of the workers' compensation policy declaration a \ r P P Y. 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 civilpenalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator..Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do here ce ify u der e pains andpenalties of perjury that the information provided above is true and correct. Si ature: nC Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/Liceuse# 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#: OR TM CERTIFICATE OF LIABILITY INSURANCE 7DOATE zzz6) PRODUCER (781)681-6656 FAX (781)681-6686 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION J Barry Driscoll Ins Agcy, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 600 Longwater Drive HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P.O. Box 9120 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Norwell, MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED Advantage Construction,_ Inc. INSURERA: Crum & Forster Co.- Two Adams Place INSURERB: Transcontinental Insurance Co. Transc Suite 100 INSURERc: National Union Fire Ins Co Quincy, MA 02169 INSURERD: Continental Casualty Ins co INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY 54371OS893 06/20/2006 06/20/2007 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY ' DAMAGE TO RENTED $ _ 100,000 CLAIMS MADE'a OCCUR PREMISES(Ea orr.'re"a) MED EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO- JECT LOC AUTOMOBILE LIABILITY ,.SAP2083866837 06/20/2006 06/20/2007 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY $ B SCHEDULEDAUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY _ AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY BE495305901 06/20/2006- 06/20/2007 EACH OCCURRENCE $ 10,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 10,000,000 C $ DEDUCTIBLE $ - ---j--i_]-RETENTt0N-$ --- WORKERS COMPENSATION AND WC2083866787 06/20/2006 06/20/2007 X WC STATU- OTH- EMPLOYERS'LIABILITY - D ANY PROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ SOO,OO If yes,describe under SPECIAL PROVISIONS below. E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ' vidence of Insurance for work performed within the Insureds scope of normal business operations. otice 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 EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Standard Certificate of Insurance. [AUTHORIZED REPRESENTATIVE . Driscoll/JWN ACORD 25(2001/08) ©ACORD CORPORATION 1988 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(2001108) PlazaCNA A z Chicago,Illinois 60685 STANDARD WORKERS 'COMPENSATION + AND EMPLOYERS LIABILITY POLICY' CHANGE ENDORSEMENT - 'EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON=•ADD NAME INSUREDS AND CLASS ', CODE 9015 EFF 12-12-06 ia2iF :,:.::,:�`: ::: ":;::::::3 i+>i=%..'`ii . :::;::::::;:; _; :; Policy Nriibe€`:>'>'` :.:..; rom Pat�cy F�eriv.,d::.::.::: Tp::; Couera. �::I�.Provtd !.....................................:.............. :::::::::::::::: WC 2 83866787 06/20/06 06/20/07 CONTINENTAL CASUALTY CO 075416124 . ..:.:;.. ..:.. :.... �rned ihsur�d ITEM ADVANTAGE CONSTRUCTION, INC. THE DRISCOLL AGENCY, INC' 1 . TWO ADAMS PLACE SUITE 100. , 93 LONGWATER CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MA 02061_ 02169 FEIN NUMBER.: 043690302 NCCI CARRIER CODE NO 102.43 INTERSTATE ID NO: ' 911597713 w ** S C H E D U� L E.; .0.,F 0 'P E.Rn A T 10 N S .i ** SCHEDULE 4 PAGE' 1 ,. LOC CLASS CLASSIFICATION OF OPERATIONS EST TOTAL, RATE PER PREMIUM NO. CODE . ANN REMUN. $100 REMUN DIFFERENCE ********* STATE: MASSACHUSETTS 001 CLASS 9015 ADDED 'EFF 12/12/06 - 06/20/07 9015 BUILDINGS:NOC--OPERATION BY 'OWNER IF ANY 3 .19 0, THE FOREGOING AMENDMENT RESULTS IN AN ADDITIONAL PREMIUM OF $.0 ,_REVISED POLICY •TOTALS ***** ESTIMATED .CLASS PREMIUM• ' $17,318 -TOTAh'.'EST:ZTvLAfiED `STANDARD,•:;PREMIUM $15,917 TgTAL.ALL RISK ADJUSTMENT, .PRQGRAM, $6,3,67 " ESTIMATED 'STANDARD PREMIUM $22 ,284" PREMIiTM .DISCOUN'T $302- EXPENSE CONSTANT M '$284 FOREIGN TERRORISM PREMIUMco .' $412 4 DOMESTTC-T-ERI20RISM, E.Q-&-EA'-PRA-IUM- -- ESTIMATED PREMIUM $.7 2 c7 N STATE -TAXES/ASSESSMENTSS/SURCHARGES Y` $700' ESTIMATED COST R w $23,378v ACCOUNT NUMBER.: 3003313920 DATE OF ISSUE: 12/19/06 POLICY ISSUING OFFICE: NEW ENGLAND } (WC000001) P-39543-A . TTT nTTTI T.IT CNA CNA Plaza Chicago,Illinois 60685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT - EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 P `Nurritea;'<::>" rom.: :. v)ic ;Werwd.;;;:;..: T :<.:.:.:._: ;:.: >:.:.; _>;.;;::.;::.;,:: ::;::_>;:.:;.. .. X......................................:....::::::.:..:::::::: :::::::.:::::: ouera :i :Prssvded.: .::::::::::::::::::::::::::.:.:.:::::::::.:::.:::'A WC 2 83866787 06/20/0.6 06/20/07 . CONTINENTAL CASUALTY CO 075416120 fed In APtdltlrltess.:.;.:::..:.....-. ..... .... INC... i.::::.::;;;:..:::.;.::.;::.;:.; :.;.::: ADVANTAGE CONSTRUCTION, INC. HE DRISCOLL AGENCY . TWO ADAMS PLACE SUITE 100 93 LONGWATER. CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MA 02061 02169 ** E N D 0 R S E M E N T S C H E D U L E ** SCHEDULE PAGE 1 NUMBER DESCRIPTION EDITION DATE PLEASE READ THE ENCLOSED IMPORTANT NOTICES CONCERNING YOUR POLICY G118166A IMPORTANT NOTICE 01/96 ***** DELETED ***** - G120587H CONTRACTING CLASS PREM ADJUST PROG WC PREM CR APP 10/00 ***** DELETED ***** G16519F20 CONSTRUCTION CLASS PREM ADJUST PROG WC PREM CR APP 01/96 ***** DELETED ***** o - ! N -C9 0 r opp ` DATE. OF ISSUE: 12/19/06 POLICY ISSUING OFFICE: NEW ENGLAND (WC000001) 'P-39543-A TTTCTTT)Vn C NA CNA Plaza Chicago,Illinois 60685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT - EFFECTIVE 12/12/0.6 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 ...........::.::.:.:.::::::..... I" Nirtber: rom Pal c Per�gd..::<:;T :: :::::.::'~oV.ra. e::1�..Prov ded. ..:::::::.:..: :::::::::::::>.::.. :::::.::.:: WC 2 83866787 06/20/06 06/20/07 CONTINENTAL CASUALTY CO 075416120 ,.::: rttec!Insured}�nd.}►ddrs.:: . ... ADVANTAGE CONSTRUCTION, INC . THE DRISCOLL AGENCY, INC TWO ADAMS PLACE SUITE 100 93 LONGWATER .CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MA 02061 02169 ** 0 T H E R N A M E D I N S.U R E D S ** SCHEDULE PAGE 1 WEST GREENWICH TECH I, LLC FEIN=043690302 YPE2 ***** ADDED ***** WEST GREENWICH TECH II, LLC FEIN=043690302 YPE2 ***** ADDED * *** WEST GREENWICH TECH, III, LLC FEIN=043690302 YPE2 ***** ADDED ***** WEST GREENWICH TECH I MANAGER, m LLC FEIN=043690302 YPE2 ***** ADDED--!****' N WEST .GREENWICH TECH II MANAGER LLC FEIN=043690302 YPE2 0 ***** ADDED ***** 0 WEST GREENWICH TECH III MANAGER, LLC FEIN=043690302 YPE2 ***** ADDED ***** DATE OF ISSUE: 12/19/06 POLICY ISSUING OFFICE : NEW ENGLAND (W0000001) P-39543-A TATCTTT?Vr) CNA Plaza Chicago,Illinois60685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT — EFFECTIVE 12/12%06 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 P... Y.Nrnb�r_ ram Patac Pori d€::: :,. �e.:: ,.: ................:.....:....... WC 2 83866787 06/20/06 06/20/07 CONTINENTAL CASUALTY CO 075416120 .......... .......:. Arid;Atlr3tss;.;:.;::.::::.:.::.:...:...:.....:.: :::.:....:::.:::.::.::.:;.:.....:.: .. VANTAGE CONSTRUCTION, INC . THE DRISCOLL AGENCY, INC TWO ADAMS PLACE SUITE 100 93 LONGWATER CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MA 02061 02169 ** 0 T H E R N A M E 'D I N S U R E D S ** SCHEDULE PAGE 2 DASCOMBROAD, LP FEIN=043690302 YPE2 ***** ADDED ***** CONDYNE INVESTMENT-PARTNERS, LLC FEIN=043690302 YPE2 "ADDED ***** ANDOVER/CIF II, LLC FEIN=043690302 YPE2 **** ADDED ***** 0 N m N 7 O O N V N n N O' O O ® I DATE OF ISSUE: 12/19/06 POLICY ISSUING OFFICE: NEW ENGLAND . (W0000001) P-39543—A TNSTTR F.TI � AbVANTAGE Construction, Inc. February 1, 2007 Tom Perry Y Town of Barnstable 368 Main Street Hyannis, MA 02601 Re: Harrys Bar & Grill, 700 Main Street and.. Flagship Estates, 350 Stevens Street,Hyannis Dear Tom Perry: Please accept this letter of notification that Joseph Lambalot, an employee of Advantage Construction, Inc., has been appointed to be our full time Superintendent of both projects listed above. If you have any question, please feel free to contact our office at(781)-848-8787. Sincerely — (- cfv ntagC�fi-m-M io�i;Ins. = - - ---- -——-- Lisa izotte Human Resources ADVANTAGE CONSTRUCTION, INC. Two Adams Place, Suite 100, Quincy, MA 02169 Telephone 781.848.8787. Fax 781.848.3774 www.advantageconstructioninc.com �`HWE'' ti Town of Barnstable Building Department - 200 Main Street •AMSTABLE, * Hyannis, MA 02601 9�A 6 A, ' (508) 862-4038 Certif icate of Occupancy Application Number: 200704067 CO Number: 20070296 Parcel ID: 3080040OF CO Issue Date:. 12128107 Location: 320 STEVENS STREET B5 Zoning Classification: OFFICE/MULTI-FAMILY RESIDENTIA Village: , HYANNIS Gen Contractor: LAMBALOT, JOSEPH E. Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: Building Department Signature Date Signed �VAE TOWN OF BARNSTABLE ti Building Application Ref: 200704067 * :Permit* BARNSTABLE, * Issue Date: 08/03/07 MASS. 9�A 1639• Applicant: LAMBALOT,JOSEPH E. rFG .l A Permit Number: B 10071844 Proposed Use: Expiration Date: 01/31/08 Location 320 STEVENS STREET B5 Zoning District OM Permit Type: SP PROJ RES ADD/ALT Map Parcel 30800400E Permit Fee$ 251.24 Contractor LAMBALOT,JOSEPH E.. Village HYANNIS App Fee$ 50.00 License Num 048722 Est Construction Cost$ 61,277 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND TENENT FIT OUT UNIT#B-5 THIS 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 PL INSPECTION HAS BEEN MADE. QUINCY,MA 02169 Application Entered by: PR Building Permit Issued By: T_Q'tg .THIS PERMIT CONVEYS NO.,RIGHT,TO OCCUPY ANY STREET,ALLYOR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR;PERMANENTLY ENCROACHEMENTS ON PUBLICTROPERTY NOT SPECIFICALLY PERMITTEDcUNDER THE BUI"LDING CODE;MUST BE APPROVED BY THE JURISDICTION. S.TREET.OR ALLY GRADES AS WELUAS,DEPTH AND'LOCATION OF PUBLIC SEWERStMAY BE,OBTAINED FROM THE.DEPARTMENT OF PUBLIC WORKS iFiE ISSUANCE OF THIS PERMIT.DOES NOT'RELEASE THE APPLICANT FROM THE CONDITI0NS"OF ANY"APPLICABLE SUBDIVISION RESTRICTIONS MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH): 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS ' 1 _ �. D I e) $ 3 l 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 , n w 1 p S Board of Health o TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map D Parcel 06 OF Application# Health Division Conservation Division Permit# Tax Collector Date Issued Treasurer Application Feed Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board P/ Historic-OKH Preservation/Hyannis S a;�(I) S46. Project Street Addr ss Village — �G Owner '� S CAddress Telephone Permit Request �rJ�'✓ r/Gss�' / ice/ Square feet: 1st floor:existing proposed 2nd floor:ex' --� proposed Total new Zoning District Flood Plain Groundwate erlay Project Valuation / 7 7 Construction Type '6�2, Z. Lot Size Z Grandfathered: ❑Yes 6No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family -❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes t-No On Old King's Highway: 0 Yes a_90 Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new _ , Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: r3 Gas ❑Oil ❑ Electric V ❑Other Central Air: 0'es ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes a' O Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:0 existing new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization El Appeal# Recorded❑ Commercial ❑Yes �l No If yes,site p n:review# Current Use_1/��l�/� !lam Proposed Use ILDER INFORMATION Name �✓ ml/� Z; lllzoeIZU7 Telephone Number Address o �► cc �7�,i ��d License# , L G y Ile Home Improvement Contractor# fel/ Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING F M THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Z� ,/ FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE r OWNER ° DATE OF INSPECTION: r FOUNDATION �--e -7 � — —7 - 1 FRAME �r C� � � PIZ- INSULATION to -7 FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING _ ®C� DATE CLOSED OUT ► / ASSOCIATION PLAN NO. r , Town of Barnstable •... v`oht�roytio - - Regulatory services xxsres , f Thomas F. Geller,Director . M,►ss, $ q� 1639, Building Division °FFD}AAj Tom Perry, Building Commissioner 200 Main Street, Hyannis,NIA 02601 Fax �509-790-6230 Office: 508-862-403 S r Property Ov e:r Must Complete and'Sign This Section If.Using A Builder LZC 1�„ / Wei ,as Owner of the subject property hereby auth orize 11� �i �/ `� to act on my behalf, in all mattes relative to.work authorized by this building permit application far: (Address of job) r ature of O r Date Print Name Q:FORMS;OWNEAPERMISSION _. _ }� or Via mg spec P `� x +,a'MA C ,.. : tk -? The Commonwealth of Massachusetts Department of Industrial Accidents _ + Office of Investigations . 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name(Business/Organization/Individual): — Address: � City/State/Zip: _rL� (� UdktLfi 'Phone Are you an employer?Check the appropriate box:: Type of project(required): 1.❑ I am a employer with C> 4. ❑ I am a general contractor and I ��� employees(full and/or part-time).* have hired the sub-contractors " . Jew 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 k comp.insurance.$ 9. ❑Building addition required.] 5• ❑ :We are a corporation and its .10.❑Electrical repairs or additions 3.❑ I am a homeowner doingall work. officers have exercised their _ I1.❑Plumbing repairs or additions myself [No'workers' comp: right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below Showing their workers'compensation policy information.,. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $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: _ Paliey-#or—Self-tis:I-ic. Fxp,ratioD te: - - Job Site Address:- �� C Sire City/State/Zip: . 0. Attach a copy,of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can"lead to the imposition of criminal penalties of a fine up to$1,500..00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do here e ify u der pains andpenalties ofperjury that the information provided above is true and correct. Signature: CC Date: Phone#: { Official use only. Do not write in this area,to be completed by city or.town official City or Town: Permit/Liceme# Issuing Authority(circle one): 1.Board of Health,2.Building Department 3. City/Town Clerk 4.Electrical Ins'' ector,.5.Plumbing Inspector . 6.'Other Contact Person: Phone#: AC-0-RA CERTIFICATE OF LIABILITY INSURANCE 06/22/26' PRODUCER (781)681-6656 FAX (781)681-6686 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION J Barry Driscoll Ins Agcy, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 600 Longwater Drive HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 9120 Norwell, MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED Advantage Construction, Inc. INSURERA: Crum & Forster Co. Two Adams Place INSURERS: Transcontinental Insurance Co. Transc Suite 100 wsURERc: National Union Fire Ins Co ' Quincy, MA 02169 INSURERD: Continental Casualty Ins co INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE(MM/DDIYY) DATE(MMIDD/YYI LIMITS GENERAL LIABILITY 5437105893 06/20/2006 06/20/2007 EACHOCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $- 100,000 CLAIMS MADE IF_V__1 OCCUR MED EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,001 POLICY X PROJECT LOC .AUTOMOBILE LIABILITY SAP2083866837 06/20/2006 06/20/2007 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $. 1,000,00 ALL OWNED AUTOS BODILY INJURY $ B SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-0WNEDAUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY BE495305901 06/20/2006 06/20/2007 EACH OCCURRENCE $ 10,000,00 X OCCUR CLAIMS MADE AGGREGATE $ 10,000,000 C $ DEDUCTIBLE $ - 1 WORKERS COMPENSATION AND WC2083866787 06/20/2006 06/20/2007 X I We sTATU- I OTH- EMPLOYERS'LIABILITY IQEY LIMITS ER D ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS vidence of Insurance for work performed within the Insureds scope of normal business operations. otice 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 EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Standard Certificate of Insurance. [AUTHORIZED REPRESENTATIVE Driscoll/JWN - ACORD 25(2001/08) ©ACORD CORPORATION 1988 r IMPORTANT If the certificate holder is an ADDITIONAL INSURED,.the policy(ies)must be endorsed..A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s),.authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2001108) CNA CNA Plaza Chicago,I1linois60685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT — EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 `' 'F.: is.'.;s:.:;:>r ":::;t;:>;:;�.i:i:�:is:: as��:>i;<i! ;;!::a2;: ;ii r:"•(::;t:::=is>:;;i;;:;;:::;:: •.::;::i::;::;::>.::::.;.::r :::::::.....isi::isi: i:i<:itGi:i:i:2:i: Policy:Nur;f '::``:;».. .root.. .fi�li ..Par�szc..;>.:.To.. ,. .:. ,.: Y hPr....Woci 9.:::::::.Y::::.:.: WC 2 83866787 06/20/06. 06/20/07 CONTINENTAL CASUALTY CO 075416120 N..rned:lrtl And Address::: ITEM ADVANTAGE CONSTRUCTION, INC. HE DRISCOLL AGENCY, INC- 1 . TWO ADAMS PLACE SUITE 100. 93 LONGWATER CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MA 02061 02169 FEIN NUMBER: 04369030.2 NCCI CARRIER CODE NO: 10243 INTERSTATE ID NO: 911597713 ** S C H E D U L E O F O P E R A T I 0 N S ** SCHEDULE PAGE- 1 4 . LOC CLASS CLASSIFICATION_ OF OPERATIONS EST TOTAL RATE PER PREMIUM NO. CODE ANN REMUN $100 REMUN DIFFERENCE ********* STATE: MASSACHUSETTS 001 CLASS 9015 ADDED EFF 12/12/06 - 06/20/07 9015 BUILDINGS NOC--OPERATION BY OWNER IF ANY 3 .19 0 THE FOREGOING AMENDMENT RESULTS IN AN ADDITIONAL PREMIUM OF $0 sREVISED POLICY TOTALS ***** "ESTIMATED CLASS PREMIUM $17 ,318 T&T-AI,::,,ST,IMX ED STANDARD;;PREMIUM $15,917 TOTAL ALL RISK ADJUSTMENT, ..PRQGRAM. $6 ,367 ES,TIMATED.STANDARD 'PREMIUM '` • $22,284 PREMIUM DISCOUNT $302- EXPENSE CONSTANT $284 N FOREIGN TERRORISM PREMIUM! $412 D©M-EST-IC--T-ERRORISMI, E$-&-GA3—P-R-E#I-IUM— - Ew_I.. ._ED PREMIUM $22,678 R STATE TAXES/ASSESSMENTS/SURCHARGES $700 ESTIMATED COST $23 ,378 n 8 N ' 8 O e 1 x . ACCOUNT NUMBER: 3003313920 DATE OF ISSUE: 12/19/06 POLICY ISSUING OFFICE: NEW ENGLAND (WC000001) P-39543-A cn+��me�onn<eoara� ... T TT( TTl T1T CNA CNA Plaza Chicago,Illinois6O685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT — EFFECTIVE 12/12/06, DATE PROCESSED=1219O6,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12'-06 RoINritiiEiei:a:::::>::::;.:::rom.: ...Pal�a::Per�c� ..::.:..`CQ.:.;;:::;:.;:.;::;:....... . : .:....Y.............................................:.::..:::.::::: xxCov...era :i�:;Prourcled: .:: : ::.:.�,. py WC 2 83866787 06/20/06 06/20/07 . CONTINENTAL CASUALTY CO 075416120 N............Insiard:And:Adclpss.....................:..........::..:..:.:::::::.......................: . ...::.. ::.....................:.:::.:::::.::.:::::::.::.....:..................... 1 ni :.::::::::.:::.:._.............................:.::::::... ADVANTAGE CONSTRUCTION, INC. TkE GRISCOLL AGENCY, INC TWO ADAMS PLACE SUITE 100 93 LONGWATER CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MA 02061 02169 ** E N D 0 R S E M E N T S C H E D U L E ** SCHEDULE PAGE 1 NUMBER DESCRIPTION EDITION DATE PLEASE READ THE ENCLOSED IMPORTANT NOTICES CONCERNING YOUR POLICY G118166A IMPORTANT NOTICE 01/96 ***** DELETED ***** G12O587B CONTRACTING CLASS PREM ADJUST PROG WC PREM CR APP 10/00 ***** DELETED ***** G16519F2O CONSTRUCTION CLASS PREM ADJUST PROG WC PREM CR APP .01/96 ***** DELETED ***** N N W m ' m 0 m o ' N O O ' O DATE OF ISSUE: 12/19/06 POLICY ISSUING OFFICE: NEW ENGLAND ZZ (WC000OO1) P=39543—A TAT OTTD L+TI C NA CNA Plaza Chicago,Illinois 60685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT - EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 Peiie::�lurrtti� :''.>: .. .ram.; .. a11c . ....::..:.;. +...............................::...:.::::.;::.::::.::.::: :::..:.............:....::::.:..::::::::::::::::::::.:.::: overa e.I Prov1dsd.: .::.::::.:::::::::::::.::::.:.:.:............:... ...:::::::: +.:.:::.::::::::.::: <.;;;::9 e1�:.;:.::;.: WC 2 83866787 06/20/06 06/20/07 CONTINENTAL CASUALTY CO 075416120 rrted Insiu dre A ng:: .::. ADVANTAGE CONSTRUCTION, INC . THE DRISCOLL AGENCY, INC TWO ADAMS PLACE SUITE 100 93 LONGWATER .CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MA 02061 02169 ** 0 T H E R. N A M E D I N S .U R E D S ** SCHEDULE PAGE. 1 WEST GREENWICH TECH I, LLC FEIN=043690302 YPE2 - ***** ADDED ***** WEST GREENWICH TECH II, LLC FEIN=043690302 YPE2 ***** ADDED ***** WEST GREENWICH TECH, III, LLC FEIN=043690302 YPE2 ***** ADDED ***** WEST GREENWICH TECH I MANAGER; LLC FEIN=043690302 YPE2 " ***** AD4ED ***** S WEST .GREENWICH TECH II MANAGER LLC FEIN=043690302 YPE2 . ***** ADDED ***** 0 0 WEST GREENWICH TECH III MANAGER, LLC FEIN=043690302 = YPE2 ***** ADDED ***** DATE OF ISSUE: 12/19/06 POLICY ISSUING OFFICE : NEW ENGLAND (WC000001) P-39543-A TTTCTTR T;n CNA CNA Plaza Chicago,Illinois 60685 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE ENDORSEMENT — EFFECTIVE 12/12/06 DATE PROCESSED=121906,REASON= ADD NAME INSUREDS AND CLASS CODE 9015 EFF 12-12-06 6diey:Nurnbr`: .W�ri�sd..>:..: To.:: ............ .:.>;: 8. s .::... X:..::::::::.:::::::::::..:::.......:.................:.Gv.u..,ra a:I..:Prov�d tc �trc.::.:::::::.::::.:...... WC 2 83866787 06/20/06 06/20/07 CONTINENTAL CASUALTY CO 075416120 ....:....... :::::;"...:N..rnedanstar. d:Anddr� ss.;.. .......... .:::.:.:... .. ............ ... ............................................................ ADVANTAGE CONSTRUCTION, INC . THE DRISCOLL AGENCY, INC TWO ADAMS PLACE SUITE 100 1 • 93 LONGWATER. CIRCLE QUINCY, MA P.O. BOX 9120 ORWELL MA 02061 02169 6 n ** O T H E R N A M E D I N S U R E D S ** SCHEDULE PAGE 2 DASCOMBROAD, LP FEIN=043690302 YPE2 ***** ADDED ***** CONDYNE .INVESTMENT PARTNERS, LLC FEIN=043690302 YPE2 ***** ADDED ***** ANDOVER/CIF II, LLC( FEIN=043690302 YPE2 _ ***** ADDED ***** m s N O m c m N (p ' Q N O O O " 4 DATE OF ISSUE: 12/19/06 POLICY ISSUING OFFICE; NEW •ENGLAND (WC000001) P-39543.-A ' TNGTTR P.T) - -- ADVANTAGE Construction, Inc® February 1, 2007 Tom Perry Town of Barnstable 368 Main Street Hyannis, MA 02601 Re: Harrys Bar & Grill, 700 Main Street and.. Flagship Estates, 350 Stevens Street, Hyannis Dear Tom Perry: Please accept this letter of notification that Joseph Lambalot, an employee of Advantage Construction, Inc., has been appointed to be our full time Superintendent of both projects listed above. If you have any question, please feel free to contact our office at(781)-848-8787. Sincerely �Adv4ntag -ont ctionjnG - - ---- - —-- Lisa Lizotte Human Resources ADVANTAGE CONSTRUCTION, INC. Two Adams Place, Suite 100, Quincy, MA 02169 Telephone 781.848.8787 Fax 781.848.3774 www.advantageconstructioninc.com V b da ?007 08:04 CONDYNE LLC 781 848 3774 P.04 CERTIFICATE OF LIABILITY INSURANCE DATE THIS�ucER ( fi 19/2007/ (781)681-fi656 Fax 7$1)681-6696 TH15 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION /be Driscoll Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE J3 Longwater Circle HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Sox 9120 ALTER THE COVERAGE AFFORDED 9Y THE POLICIES BELOW. Norwell MA 02061 INSURED INSURERS AFFORDING COVERAGE NAIC# j INSURER A,,Travelers IndeRlTlit Co.Advantage Construction, Inc. J INSURER e:Travelers Pro art Two Adams Place, Suite 100 INSURER0. t Quincy MA 02169 INSURER D: uinc INSURER E: 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 8E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. MAY DR INS R AOO'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE MMIODNY DATe MMMIDOIYY LIMITS OENEAALLIABILTIY DTCOd64O1464-IND07 05/20/2007 06/20/2008 EACH RR 11000,000 COMMERCIAL GENERAL LIABILITY DRAMA% b RENTQQ A CLAIMSMADE,F S 300,000 OCCUR MEDEXP lAny one ereon 5 5,000 RE NA VINJ RY 1,000,OQO GEN'LAGGREGATE LIMIT APPLIES PER; LA S 2,000 OOO $ P LOC PR M 5 2,000,000 LI Y AUTOMOBILE LIABILITY DTAOB10464D1476-TIk.07 06/20/2007 06/20/2008 ANY AUTO COMBINED SINGLE LIMIT ALL OWNED AUTO$ (Ea aoddam) S 1,OOOS,000 B SCHEDULED AUTOS BODILY INJURY X HIRED AUTOS (Perperaom) 8 X NON-OWNEDAUTOS BODILY INJURY (Per accldenl) $ PROPERTY DAMAGE 8 GARAGE LIABILITY (Pvr eccldem) ANY AUTO A TO ONLY-EA ACCIDENT S OTHER THAN AUTO ONLY; EXCESSIUMBR13LLA LIABILITY DTSCUP464DI480-TIL07 06/20/2007 06/20/2007 G S OCCUR F7 CLAIMS MADE S 15,000,000 A Te 15 000,000 B DEDUCTIBLE -RETENTION S A WORKERS COMPENSATION AND DTs[r846quid40-07 06/20/2007 06/20/2008 Y T 0 _ EMPLOYERS'LUIBILIT►' ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED? E. ,EACHA CIOENT 1,000,OOO Ifyw,deaulbeunCer E. ISEA E- EMPL V 1,000 flop P LP13 OTHER B. . 19EASE- LICYLI T 1,000 OOO DESCRIPTION OF OPERATIONWLOCATIONSNEHICLESIFXCLUS10N9ADDED BY ENDORSEMENTlSPECIAL PROVISIONS RZ: gaF=y'a Bar 6 Gri11, 700 Main Street and 8lagohip Eetatea, 350 StOvens Street, Hyannis Evidenae of Insurance fa; wort 'PerforMed within the Ineuredy eeop0 of normal busineae operations, NotiaO of pPlies for non- CanO611ation provision is 30 days except 10 days a a P yment of premium, CERTIFICATE HOLDER CANCELLATION 8Yi of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 368 Main Street EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Hyannis, MA 02 601 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT PAILURE TO DO SO SMALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER-(TSAGENTS OR REPRESENTATIVES. AUTHOAI2ED REPRESENTATIVE ACORD 25(2001100) i3. DriBCDIi/KAD Hllcmc, ACORD CORPORATION 1880 I-IN ACORN CERTIFICATE OF LIABILITY INSURANCE 10/24/2 61 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 93 Lon ater Circle HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 9120 Norwell, MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED Advantage Construction, Inc. INSURERA: Crum & Forster Co. Two Adams Place INSURER B: Safety Insurance Co. Suite 100 INSURER C: National Union Fire Ins Co Quincy, NA 02169 wsURERD: Continental Casualty Ins co INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR VD TYPE OF INSURANCE POLICY NUMBER. POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY 5437105893 06/20/2006 06/20/2007 EACH OCCURRENCE $ 1,000,00( X1 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ ZOO OO PR anccu[e CLAIMS MADE a OCCUR MED EXP(Any one person) $ 5,00( A PERSONAL&ADV INJURY $ 1,000,00( T_ GENERAL.AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,OOO,OO POLICY X PRO LOC JECT AUTOMOBILE LIABILITY SAP2083866837 06/20/2006 06/20/2007 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,00 ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) B X HIREDAUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY BE495305901 06/20/2006 06/20/2007 EACH OCCURRENCE $ 109 000,OO X OCCUR CLAIMS MADE AGGREGATE $ 10,000,000 C $ DEDUCTIBLE $ RETENTION $ 10,00 $ WORKERS COMPENSATION AND WC2083866787 06/20/2006 06/20/2007 X I WC STATu- I IoTH- EMPLOYERS'LIABILITY D ANY.PROPRIETOR/PARTN ER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS e: Hyannis Residential Townhouses Refer to Attached Addendum* vidence of Insurance for work performed within the Insureds scope of normal business operations. otice of Cancellation provision is 30 days except 10 days applies for non-payment of premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Flagship Estates Hyannis, LLC BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Two Adams Place, Suite 100 - OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Quincy, MA 02169 AUTHORIZED REPRESENTATIVE IB.--Driscoll/JWN z, ACORD 25(2001108) ©ACORD CORPORATION 1988 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) Additional Coverages and Factors 06/22/2006 Line of Business Coverages for Business Auto Coverage Limits Bed/Bed Type Rate Premium Factor Combined single limit 1,000,000 . Line of Business Coverages for General Liability Coverage. Limits Bed/Bed Type Rate -Premium Factor Products/Completed Ops 1,000,000 5,000 Aggregate Basis: Per Occurrence; Applies: Both BI Personal & Advertising 1,000,000 Injury Each Occurrence 1,000,000 Fire Damage 50,000 General Aggregate 2,000,000 Employee Benefits 1,000,000 1,000/Other Basis: Per Claim; Applies: Bodily Injury Medical Expense 5,000 Flagship Estates Hyannis, LLC . Certificate issued to Flagship Estates Hyannis, LLC 10/24/2006 The Driscoll Agency, Inc. 10/24/2066 Flagship Estates Hyannis, LLC and TD Bank North is included as an Additional Insured for General Liability and Excess (Umbrella) Liability as required by a signed written contract or agreement with the (Named) Insured. The General Liability and Excess (Umbrella) Liability Policies include a Waiver of Subrogation in favor of Flagship Estates Hyannis, LLC and TD Bank North, on whose behalf the Insured is required to obtain this Waiver under a written contract or agreement executed prior to a loss. 9 , i Ou a �_. tiF+, t _ '�' ..... .t .. rl 5�_ _ •'. =t.. MW .0 Raw F i i i -DEA-v)2-2006 01:59P FROM:WEST WIND FLP (508)771-2061 TO: 17818483774 P.1 Y ,f 7175 P Bk 21472 P9225 667176 10-27-2006 a 122590 4 QUITCLAIM DEED Ginsberg Asset Management,LLC,with a principal place of business of 555 Constitution Drive,Taunton,Massachusetts,02780 for consideration of Nine Hundred Eighty Nine Thousand($989,000.00)Dollars grant to Flagship Estates Hyannis,LLC,a Massachusetts limited liability company with a principal place of business of Two Adams Place,Suite 100,Quincy,Massachusetts,02169 with quitclaim covenants The land at the intersection of Stevens Street and Main Street,Hyannis District of Barnstable, d Barnstable County,Massachusetts,more particularly shown as Lot l on a plan entitled"Plan of Land f#350 Stevens Street in Hyannis Massachusetts Barnstable Massachusetts Barnstable County Approval Not Required"dated August 10,2005,revised 9/1/05,prepared for Ginsberg Asset Management LLC by BSC Group,Craif Field,Professional Land Surveyor,Scale 1"_. 40',recorded in the Barnstable County Registry of Deeds in Plan Book 608, Page 35,corrected at Book 21434,Page 34. Said premises are conveyed subject to and together with the benefits of all rights,rights of way, is easements,reservations,restrictions of record,if any there be and insofar as the same are of legal force and effect. Property Address: 320 Stevens Street,Hyannis,MA 02601 Est For title reference see deed recorded at the Barnstable Registry of Deeds Book 20185,Page 147. MASSACHUSETTS STATE EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS Date: 10-27-2006 A 1215908 CEIa 1005 Dod1 67176 f Fee: $3082.38 Conso 0891000.00 BARNSTABLE COUNTY EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS Data: 10-27-2006 A 12:59o„ Ct1:t 1005 Dods 67176 / Feet $2054.92 Cons: SM9400.00 Vd411 D trr,, ;,,DEC,i►-2-2006 01:59P FROM:-WEST WIND FLP C508)771-2061 TO:17818483774 P.2 { t Bk 21472 Pg 226 #67176 9 r � T i Witness my hand and seal this ?:�d day of October,2006. I Bruce Ginsberg,Mana r COMMONWEALTH OF MASSACHUSE77S a Norfolk,ss On this ,y6� day of October,2006,before me,the undersigned notary public,personally appe�cgd Bruce Ginsberg,proved to me through satisfactory evidence of identification,which were`'" <<--,-u'a5 to be the person whose name is signed on the j preceding or attached document,and acknowledged to me that he signed it voluntarily for its stated purpose as Manager of Ginsberg Assct Management. I RICWD D.PASTER Notary PL"Ic e�}f► Commonwealth otMcmactxaom �►v Commwon,EjIrm June 27,MDB i� r i I I BARNSTABLE REGISTRY OF DEEDS y TOWN OF BARNSTABLE Building Department - Foundation Permit Date � - 3 - Permit # ,7 0-0 ,- ,y Name_ t S � f-/ L 0 M f� Ln,-F Location ,I,/ y 0- Insp. of BIdgs. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION LL G Map Parcel �/ J� Permit# Health Division Date Issued 02 1.20� / — 6 Conservation Division �✓ Application Fee�/- ��i Z9 Tax Collector Permit Fee 7 4 a Treasurer P'~ Planning Dept: Date Definitive Plan Approved by Planning Board d Historic-OKH Preservation/Hyannis Project Street Address Village Owner �' r Address ! c C l Telephone Permit Request QA)l _ Sh �- 6142 a Square feet: 1 st floor: existing proposed A/ 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay ro Project Valuation Construction Type o Lot Size _ Grandfathered: ❑Yes CNo 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 Cl Walkout B r,5ther S, Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) —� Number of Baths: Full: existing "—' new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new �� First Floor Room Count Heat Type and Fuel: IrGas ❑Oil ❑Electric ❑Other Central Air: M Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes O�o Detached garage:❑.existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size-- Attached garage:7O existing &'new size ed:❑existing ❑new size Other: -} ' Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ •• cv Commercial ❑Yes ❑ No /If yes, site plan review# Current Use Proposed Use .. .yam"-v-.�.�.- �..:�':..�...e.,..+�.�°. .__..._.�......_=-�:.�.a�.a� :.. +...._ .a.+.�:._.:,__.. ._ y ,r,;�„ia' ��_ '.w.r::�it ��g.✓wz.-.�z-^—._.:.'+-r;-._ �,r��� 1 B ILDER INFORMATION Name / Telephone NumberA Address e < / License# __65/f79Z� e / Home Improvement Contractor# Worker's Compensation#4W?9'Kg<71F7•-6W,4�' ALL CONSTRUCTION DEBRIS RE ULTING FROM THIS PROJECT WILL E TAKEN TO 1/a !//G�✓ /<C� l r�i e i� SIGNATURE DATE f��� c. FOR OFFICIAL USE ONLY ; P&RMIT NO. , DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE !� OWNER DATE OF INSPECTION: FOUNDATION FRAME r , INSULATION _ FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH 'FINAL' , GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED''O'UT . ' (� or ASSOCIATION PLAN NO. r \ \ an 9 1)UISTNG UM TIES WHERE EHOWN IN THE DRAWNGS ME APPROXWAIE.LOCATORS ANp / rrr/ \\ \ ��V T {. F3EVATION9 OF UNOFRGRWIa1 UTDnE9 ARE TANEN"oM RECORE PUNS 1HE ENgNEER..ES / NOT gNANTEE THEN ACCURACY OR MAT ALL UTllTEs AND SUBSURFACE--P.ARE / \ / \ C, .011N.THE CONTRACTOR SHALL BE RfSPW9gE FOR—EPll LOCATNC ANC COGRDINATNG —// \ A A THE PROPOSED COJS1RUCl10N ACTNtt W1H OPSAFE AND THE AP%JCMLE UTUTY COMPANIES AN0 MANTANWG THE EMSTNG"UTY SYSTEMS W 6EFNICE DIFSAFE iMALL BE WTi®PER r \ to 1HE STATE OF MASSACMUSETTS STANIE CHAPTER Bi SECTOR AOB AT TE"12—' blT r———— �.tiya \ �'A z TIE CONTRACTOR SHALL VERIFY SIM IDCATpN AND INVERTS Of UTILITIES AND STRUCTURES AS r / Y \ \ REWIRED P, TO TIIE,STMT D<CONSIRUCTON. ! rr/ / / M \ \ N 2))PROPOSE , TER MD ELECTRIC CONNECIXN9 SHOWN ME SCHEMATC ONLY.FINAL UTIIT D CM WA Y DESIGN SHALL BE DETERMINED BY THE APPROPWATE UPUTY COMPANY.WATER UNE // R .. Po•f \ ^, \ n NSTALLATON PER TOWN OF B—STASIE WATER DEPARTMENT RULES AND REWLATIONS O)ALL MANHOLES AM FRAMES AND COVERS TO BE H-20 LOAOWG. .)SEE PLANS ENTRED'9TE PLAN%TOO MAW STREET PREPARED BY 85C CROUP.INC.FOR SEWER INFORMAn01 TO MAIN ST T. \ // �yy} � ` -�,�•.� f -.� Ar \\ � PROFE590NAI ENGINEER OVE a � -_' SITE PLAN 350 STEVENS STREET / d 'AIN IN // / °. f/ / .�C ✓ �3� \\ \ HYANNIS / C ge'vr \\ MASSACHUSETTS oN \ / //�g +y• y ' y' w`Yf �Y4. \\ (BARNSTABLE COUNTY) ol \ \ UTILITY m ln zA" // ae /J pv ` ` \\ \\ PLAN W-1. ZpH" � � ` \ N \ j •\„�----- y m - _� / �� \ � >� � ❑ IDG.00' \ DECEMBER T2,2005 N /h I.I S CB,2'J5-W /, NO wA I REN90x3: / ' AI ER 1 , I 11MT.W • — _ no. ANTE OESSC. -0'/ % I e -- •W�n 12/2I/0S PER TOWN COMMEM T- cr /T • II In ° --- — dpd� SET MANAN+. �e 11 M�r 1� ® — — — I•� �J alb/�j'�' 9 N�? N GINSBERC P.O.BO% AGEMENT LLC Sm/�p?t .0 N W.BARNSTABLE.MA i V.M" 35' mN Z'O AA BSC GROUP West YermaatH Massa0use4s 02673 , •'S' _ '1 ' `.'�4. J• �_ '4 , soe ne eBTB a,...... � 45 SfuE: 1 =2q • �_•—r—•— �_.—.—r—W—•--v—r PR.....:M.OIBB g v— W •— •—W—r �W v--i• W—r r MIQ 1l1l GTO w r WA — ——————— FIELD:D.CA=O.J.McGR11N STEVENS STREET ir:) DUD./Wsax:M.qBB \ S OMWN:M.OWB B --- --- --------V---- ----------------- ISSUED FOR PERMITTING FLE, 5,15-M . mE: Aeaee-Mnutt.owG a. Ory an oH. DND.N0: 8511-OS SHEET S OF B ig� JOB N0:A-BMB.00 S The Commonwealth of Massachusetts Department of Industrial Accidents Office oflnuestigatfons ' 600 Washington Street, 7th Floor -- a Boston,Mass. 02111 v 'Workers' Compensation Insurance Affidavit:Build mi /Plumbin /Electrical Contractors 1t name: address: S CitV state: work site location full address): ❑ I am a homeowner performing all work myself. Project Type: ew Construction[]Remodel❑ I am a sole proprietor and have no one workin in any capacity. 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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 years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day agOnst.me, I understand that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do here cer ' and r the ins and penalties of perjury that the information provided above is true andicorrect Signature Date Print namePhone# official use only do not write is this area to be completed by city or town official city or town: permit/license# []Building.Department' []Licensing Board ❑check if immediate response is required ❑Selectmen's Office []Health Department contact person: phone#; []Other (revised Sept 2003) f DEC-Gr2006 �12:25P FROM:WEST WIND FLP C5oe)771-2061 TO:17eie4e3774 P.3 I I BIKE Town of Barnstable 200 Main Street, Hyannis,Massachusetts 02601 a,►arterAets. �.� Growth Management Department Thomas A. Broadrick,AICP 367 Main Street,Hyannis,Massachusetts 02601 Director of Regulatory Review Phone(508)862-4785 Fax(508)862-4725 www.town.barnstable.ma.us June 30, 2006 Ginsburg Assets Management LLC C/o Daniel Adams P. O. Box 901 West Barnstable,MA 02668 RE: Site Plan Review 4073-05—Ginsburg—350 Stevens Street, Hyannis Map 308,Parcel 004 Dear Mr. Adams: The Site Plan Review Committee has reviewed the above proposal and the Building Commissioner has.determined that the plans could be administratively approved subject to the following conditions: • Plans dated December 12, 2005, revised December 21, 2005 and March 14, 2006, Sheets 1-8, prepared by BSC Group, West Yarmouth, MA will'need to be finalized and revised to incorporate the conditions of this letter. Said comprehensive revised plan will need to be submitted for administrative approval by the Building Commissioner, prior to the issuance of a building permit. All construction shall be in compliance with this final approved site plan. • The number of bedrooms will need to be added to the Zoning Compliance.Table on the Title Sheet of the revised plan. • A letter of compliance with the Town's Design and Infrastructure Plan will need to be obtained from the Growth Management Department. • Outdoor parking space dimensions will need to reflect a 19 ft. length on the revised plan, instead of 18 ft, length as currently shown. • The garage parking spaces should depict a typical car size on the.revised plan and shall demonstrate adequate vehicular access within the garage of at least fourteen(14)feet • The water main construction shall be in compliance with the revised, approved, signed plans by Mark Dibb,PE dated 2/13/06, which plan.is the basis for the approval letter from Hans Keijser, Water Supply Division,Department of Public Works, as he states that plan incorporates and addresses all issues included in his memo to the applicant dated 02/09/06. • The Hyannis Fire Department.must review and approve a plan showing the water main tie at Stevens Street and Main Street, and the tie at.Stevens Street and North Street. . • The cross pitch of the sidewalk needs to indicate drainage toward the road, as shown in the"concrete sidewalk detail" on sheet 7 of 8 of the referenced plans. DEC=6-2006 12:25P FROM:WEST WIND FLP C508)771-2061 T0:17818483774 P.4 • .All permits, licenses and approvals required,will need to be obtained. 1 • Upon completion of all work, a registered engineer or land surveyor shall submit a letter of certification,made upon knowledge and belief in accordance with professional standards that all work has been done in substantial compliance with the approved site plan(Section 240-105(G). This document shall be submitted prior to the issuance of the final certificate of occupancy. • No occupancy permits shall be issued for any of the 29 units until such time as the developer executes a monitoring agreement and deed restrictions in a form approved by the Town Attorney in which the developer agrees to sell three of the twenty-nine units to a governmental agency or non-profit who shall offer said units for sale or lease to a qualified affordable purchaser or tenant whose income is at 65% of the area median income based upon household size.. The initial selling prices for each unit shall be based upon a formula under which monthly housing costs,including mortgage payments, taxes, insurance, and condominium association fees, shall not exceed 30% of 65% of the area median income based upon household size. The affordable units shall be integrated with the development and shall be compatible in design, construction and quality of material with the other units and otherwise comply with the provisions of Section 9 of the Code of the Town of Barnstable. Such units shall be depicted on the revised plan showing the location and mix of units proposed. ® No occupancy permits shall be issued for any of the 29 units until the developer either 1) deposits $50,000 with the Town Treasurer for completion of the sidewalk or 2) constructs to the satisfaction of the Town Engineer a concrete sidewalk 5.5 feet wide with granite curbing in the area along Stevens Street from Main Street to North Street. This letter is issued for the applicant to proceed directly to a building permit application with the Building Commissioner or toward Regulatory Agreement 2006-01 as scheduled with the Planning Board June 26, 2006. Sincerely, Ellen M. Swiniarski Sec. to Planning Bd. and SPR Coord. cc: Planning Board File Thomas Perry, Building Commissioner Site Plan Review File DEC-6-2006 12:26P FROM:WEST WIND FLIP Goe)771-2061 TO:17e1e483774 P.5 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands �L = WPA Form 5 - Order of Conditions SE3-4489 x�a4 Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 fD µA't And Chapter 237 of the Code of thb Town of Barnstable A. General Information Important: From: When filling out forms on Barnstable the computer, Conservation Commission use only the tab key to This issuance if for(check one): move your cursor-do ® Order of Conditions not use the return key. ❑ Amended Order of Conditions To: Applicant: Property Owner (if different from applicant): Ginsberg Asset Management LLC Name Name P.O. Box 901 Mailing Address Mailing Address W. Barnstable MA 02668 City(Town State Zip Code Cfty/Town State Zip Code 1. Project Location: 350 Stevens Street Hyannis Street Address Village 308 004 Assessors Map Number Parcel Number 2. Property recorded at the Registry of Deeds for: Barnstable 7397 019 County Book Page Certificate(If registered land) 3. Dates:- - - - 06 - - January 25, 2006 February 28, 2006 MAR 17 21M Date Notice of Intent Filed Date Public Nearing Closed Date of Issuance 4. Final Approved Plans and Other Documents (attach additional plan references as needed): Site Plan 1/19/06 Title Date Title Data Title Date 5. Final Plans and Documents Signed and Stamped by: Mark Oibb P.E. Name 6. Total Fee; $1,050.00 (from Appendix B:Wetland Fee Transmittal Form) BWPAFwrn5.doc rev 9121105 Page 1 of 7 11 DEC-61-2006 '12:26P FROM:WEST WIND FLP (508)771-2061 T0:17818483774 P.6 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 5 -- Order of Conditions SE3-4489 uarr�ce Provided by.DEP `°�� �� Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 And Chapter 237 of the Code of the Town of Barnstable B. Findings Findings pursuant to the Massachusetts Wetlands Protection Act: Following the review of the above-referenced Notice of Intent and based on the information provided in this application and presented at the public hearing,this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply:_ ❑ Public Water Supply ❑ I-and Containing Shellfish Z Prevention of Pollution ❑ Private Water Supply ❑ Fisheries ® Protection of Wildlife Habitat ❑ Groundwater Supply, (� Storm Damage Prevention ® Flood Control Furthermore,.this Commission hereby finds the project, as proposed,is:(check one of the following boxes) Approved subject to: ® the following conditions which are necessary, in accordance with the performance standards set forth in the wetlands regulations,to protect those interests checked above.This Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above, the following General Conditions, and any other special conditions attached to this Order.To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, these conditions shall control. Denied because: M. the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations to protect those Interests checked above. Therefore, .vork on this project may not go forward,unless and until a new Notice of Intent is submitted.which provides measures which are adequate to protect these interests, and a final Order of Conditions is issued. ❑ the information submitted by the applicant is not sufficient to describe the site, the work, or the effect of the work on the interests identified in the Wetlands Protection Act.Therefore, work on this project may not go-forward unless-and until-a-revised-Notice-of Intent is submitted which provides sufficient . information and includes measures which are adequate to protect the Act's interests, and a final Order of Conditions is issued. A description of the specific information which is lacking and why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c). General Conditions (only applicable to approved projects) 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations: ) Page 2 of 7 BWPAFom)S.doc•rm,9/21105 DEC-6-2006 . 12:27P FROM:WEST WIND FLP (508)771-2061 T0:17818483774 P.7 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 5 -- Order of Conditions . sE4489 �i as�'g Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 And Chapter 237 of the Code of the Town of Barnstable B. Findings (cont.) within three years from the date of this Order . 4. The work authorized hereunder shall be completedwi h y r unless either of.the following apply: a. the work is a maintenance dredging project as provided for in the Act; or b. the time for completion has been extended to a specified date more than three years, but less than five years, from the date of issuance. If this Order is intended to be valid for more than three years, the extension date and the special circumstances warranting the extended time period are set forth as a.special condition in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash, refuse, rubbish, or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing. , 7. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such t have been completed. an appeal has been taken until all proceedings before the Department h PP � P 9 P P 8. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of Deeds or the Land Court for the district In which the land is located, within the chain of title of the affected property. In the case of recorded land,the Final Order shall also be noted in the Registry's Grantor index under the name of the owner of the land upon which the proposed work is to be done. In the case of the registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work Is done.The recording information shall be submitted to this Conservation Commission on the form at the end of this Order, which form must be stamped by the Registry of Deeds, prior to the commencement of work. 9. A sign shall be displayed at the site not less then two square.feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or, "MA DEP"] "File Number SE3 - 4489 " 10. Where the Department of Environmental Protection is requested to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before DEP. 11. Upon completion of the work described herein,the applicant shall submit a Request for Certificate of Compliance (WPA Form 8A)to the Conservation Commission. 12. The work shall conform to the plans and special conditions referenced in this order. 13. Any change to the plans identified in Condition#12 above shall require the applicant to Inquire of the Conservation Commission in writing whether the change is significant enough to require the filing of a new Notice of Intent. 14. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order, and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evaluation. BWPAFormS.doc•rev.Gal/05 Page 3 of 7 DEC-6-2006 ' 12:27P FROM:WEST WIND FLP (508)771-2061 T0:17818483774 P.8 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands � .AMFML& WPA Form 5 - Order of Conditions SE3-4489 Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c, 131, §40 eo feu+ And Chapter 237 of the Code of the Town of Barnstable E3. Findings (cont.) 15. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this Order, 16_ Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland, the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or water body. During construction, the applicant or his/her designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed.The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission, which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. see attached Findings as to municipal bylaw or ordinance Furthermore, the Barnstable hereby finds (check one that applies):. Conservation Commission ❑ that the proposed-work cannot-be.conditioned-to meet the standards set forth in a municipal- ordinance or bylaw specifically: Chapter 237 of the Code of the Town of Barnstable Municipal Ordinance or Bylaw Citation Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards, and a final Order of Conditions is issued. ❑ that the following additional conditions are necessary to comply with a municipal ordinance or bylaw, specifically: Chapter 237 of the Code of the Town of Barnstable Municipal Ordinance or Bylaw Citation The Commission orders that all work shall be performed in accordance with the said additional conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, the conditions shall control. BW PAFomiS•doc•ray,SMI/05 Paoa 4 of 7 DEC-6,-2006 . 12:28P FROM:WEST WIND FLP C508)771-2061 TO:17818483774 P.9 SE3-4489 Name Ginsberg Asset Management LLC Approved Plan= January 19,2006 Site Plan by Mark Dibb,P.E. Special Conditions of Approval I. Preface Caution: Failure to comply with all Conditions of this Order of Conditions can have serious consequences. The consequence.may include issuance of a stop work order, fuses,requirement to remove unpermitted structures,requirement to re-landscape to original condition,inability to obtain a certificate of compliance, and more_ The General Conditions of this Order begin on page 2 and continue on pages 3 and 4. The Special Conditions are contained on pages 4.1,4.2 and 4.3 if necessary.All conditions require your compliance. IT. Prior to the start of work, the following conditions shall be satisfied: f 1. Within one month of receipt of this Order of Conditions and prior to the commencement of any work approved herein,General Condition number 8(recording requirement)on page 3 shall be complied with. 2. It is the responsibility of the applicant,the owner andlor successor(s) and the project contractors to ensure that all conditions of this Order are complied with. The applicant shall provide copies of the Order of Conditions and approved plans (and any approved revisions thereof) to project contractors prior to the start of work. Barnstable Conservation Commission Forms A and B shall be completed and returned to the Comii7issionmrior to the start of work.- 3. General Condition 9 on page 3 (sign requirement)shall be complied with. ' 4, The Conservation Commission shall receive written notice 1 week in advance of the start of work, 5. The work limit line shown on the approved plan shall be staked in the field by the project surveyor/engineer. 6. Staked strawbales backed by trenched-in siltation fencing shall be set along the approved work limit line, Effective sediment controls shall remain until the site is stabilized with vegetation. III. The following additional conditions shall govern the project once work begins: } 7. General conditions No. 12 and No. 13 (changes in plan)on page 3 shall be complied with. 8. General condition No. 17(maintaining sediment controls)on page 4 shall be complied with, p.4.1 DEC-6-2006. 12:26P FROM:WEST WIND FLP (508)771-2061 TO:17818483774 P.10 9. The work limit shown on the approved plan shall be strictly observed. 10. The Conservation Commission, its employees, and its agents shall have a right of entry to inspect for ' compliance with the provisions of this Order of Conditions. 11. This permit is valid for 3 years from the date of issuance, unless extended by the Commission at the request of the applicant. Caution: a future Amended Order does not change the expiration date. 12. Any fill used for this project shall be clean fill. Fill shall contain no trash,refuse,rubbish, or debris. 13. Drywells or graveled trenches along the drip lines shall be installed to accommodate roof runoff. 14. During construction,no area shall be left unmulched or unvegetated for more than 30 days. All areas disturbed during construction shall be revegetated immediately following completion of work at the site. Mulching shall not serve as a substitute for the requirement to revegetate disturbed areas at the conclusion of work. 15. Groundwater monitoring wells shall be appropriately abandoned when timely. 16. All proposed lawn areas shall be underlain with a minimum of 6 inches of loam. 17. Herbicide,pesticide and fertilizer use is discouraged on lawns within Conservation Commission 1 jurisdiction. If fertilizer is used,only slow=release low-nitrogen fertilizer(with 30-50%water insoluble nitrogen or'W.I.N')shall be applied. Over-fertilizing shall be avoided(not-to-exceed limit= 1 pound of nitrogen per 1,000 sq.ft. of lawn per application),Ensure that no fertilizer is spread on hard surfaces like driveways and sidewalks. IV, After all work is completed, the following condition shall be promptly met: 18. At the completion of work,or by the expiration of this Order,the applicant shall request in writing a Certificate of Compliance for the work herein permitted. Barnstable Conservation Commission Form C. shall be completed and returned with the request for a Certificate of Compliance. Where a project has been completed in accordance with plans stamped by a registered professional engineer,architect,landscape architect or land surveyor,a written statement by such a professional person certifying substantial compliance with the plans and setting forth what deviation,if any,exists with the record plans approved in the Order shall accompany the request for a Certificate of Compliance. At the time of the request for a Certificate of Compliance, an updated sequence of color photographs of the undisturbed buffer zone shall_ be also submitted. p.4.2 DEC-6-2006 . 12:28P FROM:WEST WIND FLP (508)771-2061 TO:17818483774 P. 11 Massachusetts Department of Environmental Protection DEP File Number Bureau of Resource Protection - Wetlands t WPA Form 5 -- Order of Conditions SE3-4489 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by OEP And Chapter 237 of the Code of the Town of Barnstable B. Findings (cont.) Additional conditions relating to municipal ordinance or bylaw: This Order is valid for three years, unless otherwise specified as a special condition pursuant to General Conditions #4, from the date of Issuance. Date This Order must be signed by a majority of the Conservation Commission, The Order must be mailed by certified mall (return receipt requested) or hand delivered to the applicant, A copy also must be mailed or hand delivered at the same time to the appropriate Department of Environmental Protection Regional i Office (see Appendix A) and the property owner (if different from applicant). Signatures: 000 - - - - - - - - - - - - - - - - - - - - On Of Day Month and.Year before me personally appeared to me known to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as his/her free act and deed. Notary Public My Commission Expires This Order is issued to the applicant as follows: } ❑ by hand delivery on Date ;K by certified mail, return receipt requested, on MAR 17 zoos Print Name Signature Date 5WPAFom4.doo-rev.3(21/05 Pape 5 of 7 DEC-6-2006 • 12:29P FROM:WEST WIND FLP (508)771-2061 TO:17818483774 P.12 a Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands 89 WPA Form 5 — Order of Conditions Provided by sEded by ease, DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 And Chapter 237 of the Code of the Town of Barnstable G. Appeals The applicant,the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, or any ten residents of the city or town in which such land is located, are.hereby notified of their right to request the appropriate DEP Regional Office to issue a Superseding.Order of Conditions. The request must be made by certified mail or hand delivery to the Department,with the'appropriate filing fee and a completed Appendix E: Request of Departmental Action Fee Transmittal Form, as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this-Order. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant, The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act, (M.G.L. c, 131, § 40) and is inconsistent with the wetlands regulations (310 CMR 10.00). To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. I7. Recording Information This Order of Conditions must be recorded in the Registry of Deeds or the Land Court.for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information on Page 7 of Form 5 shall be submitted to the Conservation Commission listed below. Barnstable . Conservation Commission BWPAForm5.doc•rev.9121/05 Peoa 8 of 7 DEC-6-2006. 12:29P FRON:WEST WIND FLP (508)771-2061 TO:17818483774 P.13 �T Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions 5E3-4489 • � Provided by DEP '►ID1,4�t�1`� Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 And Chapter 237 of the Code of the Town of Barnstable D. Recording Information (cont.) Detach.on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission, ------------------------------------------------------------ ----------------------------------------------------------•. To: Barnstable Conservation Commission Please be advised that the Order of Conditions for the Project at: 350 Stevens Street, Hyannis, MA SE3-4489 Project Location DEP File Number Has been recorded at the Registry of Deeds of: Barnstable County Book Page for: Property Owner and has been noted in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions issued on: Date If recorded land, the instrument number identifying this transaction is: Instrument Number If registered land,the document number identifying this transaction is: Document Number Signature of Applicant SWPAFom*6.doo•rev.9121105 Papa 7 of 7 { f�S BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Iva- Alterations/Renovations $50.00 Building Permit Amendment $50.00 FEE VALUE WORKSHEET NEW BUILDINGS square feet x$140.00/sq.foot= x.0061= ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet X$96/sq.foot= X.0061= STORAGE BLTIL,DINGS ONLY _square feet X$32.00/sq.foot= X.0061 7Q ,67S- i Commprojeost flFTME r�,ti Town of Barnstable Regulatory Services S STAN . t Thomas F.Geiler,Director s619. .��� Building Division _ Tfn p1A Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 office: 508-8624038 Fax: 508 790-6230 Property Owner Must Complete and Sign This Section. If Using A Builder Irzo •As.Ownet..of the.subject property- ._.._..._. .. hetebg authorize in all mattets relative to tivork authO e4-by this building.pe=nft-application�fot: Q�� 1117 (Addtess of Job) e of OVv wn Date i Print Name a. .; DEE-A22-2006 O1:59P FROM:WEST WIND FLP (5O8)771-2061 T0:17818483774 P.1 7175 P Bk 21472 Pa225 067176 10-27-2006 a 12 n 59p QUITCLAIM DEED Ginsberg Asset Management,LLC,with a principal place of business of 555 Constitution Drive,Taunton,Massachusetts,02780 for consideration of Nine Hundred Eighty Nine Thousand($989,000,00)Dollars grant to Flagsbip Estates Hyannis,LLC,a Massachusetts limited liability company with a principal place of business of Two Adams Place,Suite 100,Quincy,Massachusetts,02169 with quitclaim covenants The land at the intersection of Stevens Street and Main Street,Hyannis District of Barnstable, d Barnstable County,Massachusetts,more particularly shown as Lot 1 on a plan entitled"Plan of Land 11350 Stevens Street in Hyannis Massachusetts Barnstable Massachusetts Barnstable County Approval Not Required"dated August 10,2005,revised 911/05,prepared for Ginsberg Asset Management LLC by BSC Group,Cmif Field,Professional Land Surveyor,Scale 1"_. 40',recorded in the Barnstable County Registry of Deeds in Plan Book 608, Page35,corrected at Book 21434,Page 34, Said premises are conveyed subject to and together with the benefits of all rights,rights of way, is easements,reservations,restrictions of record,if any there be and insofar as the same are of legal force and effect. Pro erty Address: 320 Stevens Street,Hyannis,MA 02601 Est For title reference see deed recorded at the Barnstable Registry of Deeds Book 20185,Page 147. MASSACHUSETTS STATE EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS pate: 1D-27-2006 9 121599a Ctl:t 1005 Dac01 67176 F Feet S3082.3O Cons: 0891000,00 BARNSTABLE COUNTY EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS Date! 10-27-2006 9 12:59ae CtIO: 1005 Doc¢: 67176 Feet $2 054.92 Cons: $989r000.00 ,�0EC:-Q2-2006 01:59P FROM:WEST WIND FLP {508)771-2061 TO:17818483774 P.2 4, Bk 21472 Pg 226 #671. i r Witness my hand and seal this ?:3d day of October,2006. Bruce Ginsberg,Mann r "''-� COMMONWEALTH OF MASSACHUSETTS Norfolk,ss On this r2-Zile' day of October,2006,before me,the undersigned notary public,personally appe�f d Bruce Ginsberg,proved to me through satisfactory evidence of identification,which were`,nh �M� <<�-c-co aQ- ,to be the person whose name is signed on the + preceding or attached document,and acknowledged to me that he signed it voluntarily for its stated purpose as Manager of Ginsberg Asset Management. '��w lo4 �. _ I I Ir-\ PICHARD D.PASTER ; Notary Public Cam ronwoolt Mmmodynoth Jung 37.2C98 1; l I d • BARNSTABLE REGISTRY OF DEEDS TE MM DD YYYY ACOR . CERTIFICATE OF LIABILITY INSURANCE 10/1 24/Z006) 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 93 Lon ater Circle HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 9120 Norwell, MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED Advantage Construction, Inc. INSURER A: Crum & Forster Co. Two Adams Place INSURERS: Safety Insurance Co. Suite 100 INSURER C: National Union Fire Ins Co Quincy, NA 02169 INSURER D: Continental Casualty Ins co INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATMIDDIYION LIMITS GENERAL LIABILITY 5437105893 06/20/2006 06/20/2007 EACH OCCURRENCE $ 1,000,00 IT— OMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 10PR 0 00 CLAIMS MADE OCCUR MED EXP(Any one person) $ 5,00 A PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,001 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ Z,000,000 POLICY X PRO LOC JECT AUTOMOBILE LIABILITY SAPZ083866837 06/ZO/Z006 06/20/ZO07 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,00 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ B X HIREDAUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY BE495305901 06/20/2006 06/20/2007 EACH OCCURRENCE $ 10,000,00 X OCCUR ❑CLAIMS MADE - AGGREGATE $* 10,000,000 C $ DEDUCTIBLE $ RETENTION $ 10,00 $ WORKERS COMPENSATION AND - WCZ093966787 06/ZO/ZO06 06/ZO/ZOO7 X WC DRYSTATU- OTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 500,00 LIMIT ER ]) ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,004 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,004 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS e: Hyannis Residential Townhouses Refer to Attached Addendum* vidence of Insurance for work performed within the Insureds scope of normal business operations. otice 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 EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Flagship Estates Hyannis, LLC BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Two Adams Place, Suite 100 OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Quincy, MA OZ169 AUTHORIZED REPRESENTATIVE �y B. Driscoll/JWN J, ACORD 25(2001108) ©ACORD CORPORATION 1988 i 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) Additional Coverages and Factors 06/22/2006 Line of Business Coverages for Business Auto Coverage Limits Ded/Ded Type Rate Premium Factor Combined single limit 1,000,000 Line of Business Coverages for General Liability Coverage Limits Ded/Ded Type Rate Premium Factor Products/Completed Ops 1,000,000 5,000 Aggregate Basis: Per Occurrence; Applies: Both BI Personal & Advertising 1,000,000 Inj ury Each Occurrence 1,000,000 Fire Damage 50,000 General Aggregate 2,000,000 Employee Benefits 1,000,000 1,000/Other Basis: Per Claim; Applies: Bodily Injury Medical Expense 5,000 1 Flagship Estates Hyannis, LLC Certificate issued to Flagship Estates Hyannis, LLC 10/24/2006 The Driscoll Agency, Inc. 10/24/2006 Flagship Estates Hyannis, LLC and TD Bank North is included as an Additional Insured for General Liability and Excess (Umbrella) Liability as required by a signed written contract or agreement with the (Named) Insured. The General Liability and Excess (Umbrella) Liability Policies include a Waiver of Subrogation in favor of Flagship Estates Hyannis, LLC and TD Bank North, on whose behalf the Insured is required to obtain this Waiver under a written contract or agreement executed prior to a loss. I 1 'd sR al �. ••�<. oo BONI 11 001-0 Will. Wl I", Wv • �� � ^' � _�� �•i1r:} 1 fI .IF s .a .r...''• :r,, s'.t ' �k �.sF .trt• ;�'-y� _�s� a t�� i I I i Structural Engineering STRUCTURAL AFFIDAVIT FOR CONSTRUCTION CONTROL TO: Flagship Estates LLC Two Adams Place, Suite 100 Quincy, MA 02169 RE: Hyannis Condominium Development Stevens Street Hyannis, MA FC PROJECT No.: 0569 DATE: January 12, 2007 In accordance with the Massachusetts State Building Code Section 116.0,the engineer's authorized representative will make periodic field visits during the construction period for the above project and make observations of work in progress. Observations shall be recorded.per the CSI (Constructions Specification I s itute)standard format and fumished promptly to the Building Department and the Owner. sT4Cr R. - Na42889 Lie. #42868 STFWC"FUR& ST CY . FLOOD MASS. REG. NO. o )STE A� RU-C-T-URAL ----- m��l'eS'e2c SS. �"'►r+onwec-�1c�. o� ��i��G1,us'��"s - Subscribed and sworn to me this lam day of , 2007. N A Y PUBLIC MOM My Commission expires EJOA1, M.WORDELL Notary PMAS )- 20AITN OF MASSIICHUSETT3ommission Expires vember 1,2013 56 Laurel Drive Hudson, MA 01749 • TEL: (978) 562-6499 FAX: (978) 562-6246 1 REVISIONS: / \ NO. DATE DESC. N/F f — / PAUUNE HOLMES — / #294 STEVENS STREET ASSESSORS MAP 308 — I PARCEL 6 / I S 81 47'25" I / 29.56 1I HYANNIS VILLAGE APPARTMENTS LLC #372 NORTH STREET o iO ASSESSORS MAP 308 C; � I CERTIFY TO THE BEST OF MY / �o� ! PARCEL 8 �h. ��, o zI PROFESSIONAL KNOWLEDGE, INFORMATION �R AND BELIEF THAT THE LOT CORNERS, DIMENSIONS AND SETBACKS TO THE STRUCTURE AS DETERMINED BY INSTRUMENT SURVEY-AND AS SHOWN ON THIS PLAN ARE,,,G NSF � OFs� �• S #300 STEVENS STRE ETHIP A.CRMO t / ASSESSORS MAP 308 I/ �o PARCEL 5 b S 81.47'25" E 149.79' AUNT BETTYS o14 lid .�� b PROFfSSIONAL LAND SURVEYOR DATE r)° •r d 20.3 ' '0 NEW FOUNDATION POND TOP OF FOUNDATION=26.3 FOUNDATION +°° o ' 20 3 nor 12.5 AS — BUILT PLAN imLOT 1 118,867±S.F. #320 V. 2.73f ACRES �N OM ZONE\ � a� I STEVENS STREET CD 011 RS• \ IN HYANNIS r � , W N/F BITUMINOUS I L MAS SAC H U S ETTS CRABTREE LLC /�� P VEMENT #426 NORTH STREET (BARNSTABLE COUNTY) ASSESSORS MAP 290 �-- PARCEL 96 `O EDGE OF BOITLAND RING o VEGETATED \ _ Z C14 o � � 0413 Lt.l MARCH 6, 2007 � L0 �a W 60 _J �Q EXISTING BUILDING � ' "HARRYS CAJUN BAR" L z--L TO BE REMOVED L NSF \ r� LOCUS INFORMATION CHRISTPHE#710OMAINRSTREETBA w i S81KOCA 08 E* ' dA4 ZON ASSESSORS MAP 308 , r PARCEL 7 041 LL H ZON CURRENT OWNER: FLAGSHIP ESTATES HYANNIS LLC N� —�� 7 PREPARED FOR: .d`f L _j I TITLE REFERENCE: DEED BOOK 21472, PAGE 225 �� Li Mr. Donald F. O'Neill 0 BITUMINOUS I Z PLAN REFERENCE: BOOK 608, PAGE 35 Condyne, LLC PAVEMENT �w I Two Adams Place, Suite 100 ASSESSORS MAP: 308 o iN ' PARCEL: 4 Quincy, MA 02169 r� LOT 1 0 IZ ZONING DISTRICT: OMK ^' SETBACKS: FRONT 20' LOT 2 SIDE 10 ?" is NF PETER do = 18,985±S.F. REAR 10' B,,, C CATHERINE 0.44f ACRES MURRAY HVB ZONE 349 Main Street, Unit D #712 MAIN ST. MINIMUM LOT SIZE: 20,000 S.F. W. Yarmouth Massachusetts ASSESSORS w MAXIMUM BUILDING HEIGHT: 40' OR 3 STORIES MAP 27 OZ673 PARCEL 9 N EXISTING TOTAL LOT AREA: 118,867±S.F. (2.73±AC.) 508 778 8919 •a �ID NITROGEN SENSITIVE ZONE: NOT A ZONE II © 2007 The 6k Group, Inc. Z k FEMA FLOOD ZONE DISTRICT: "C" SCALE: 1" = 40' 1 S 89'36'40" W .4. OVERLAY DISTRICT: AP ZONE 0 5 10 20 M Rs �— — SEWER ACCOUNT NO. 3643 0 20 40 80 FEET 75.16 FIRE DISTRICT: HYANNIS PROJ. MGR.: C. FIELD STREET .,._- MAIN FIELD: P. HAGIST, M. DIBB......... .... .... CALC./DESIGN: P. HAGIST CDRAWN: P. HAGIST SOCHECK: C. FIELD tj o� T FILE: 8648-AB2.DWG _ I G S DWG. NO: 5511 -05 JOB. NO: 0- 4-8648.0 - SHEET 1 OF 1 -