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HomeMy WebLinkAbout0165 YARMOUTH ROAD (4) i f i 4 J r� r TOWN OF BARNSTE BUIL G PERMIT APP ICATION '� �d �y 6 Map Parcel 3�5 . �f 1a{;� n - y i ,' � Application # t E,N ABLE Health Division Date Issu Conservation Division , r�JVv�' Application lee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board I' , - y i Historic - OKH _ Preservation/ Hyannis n 1 Pr Project Street Address --S Village uann►5 Owner F-1wys .t c-e-- Address Ora- f� Telephone 4AEq Y L b9s i Permit Requester,r(Z&1a i I.-A U 16- fin W zTVY - a, 1,11 i J-e.Z q0*0Zhr& . can t C� — I a nn(S Square feet: 1st floor: existing proposed nA 2nd floor: existing n proposed _Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type A , Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) n I A Age of Existing Structure 0 Historic House: ❑Yes- Flo On Old King's Highway: ❑Yes,�01\lo Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other h K} Basement Finished Area(sq.ft.) ( Basement Unfinished Area(sq.ft) n 1 �' Number of Baths: Full: existing_ new Half: existing new Number of Bedrooms: n 1 existing _new Total Room Count (not including baths): existing nF new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No f)rireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Y) Detached garage: ❑3Pin% st' ,(\p new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ `❑ new size _Shed: ❑existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use 0_4 l In ( Proposed Use u: �,Olt APPLICANT INFORMATION ,1 (BUILDER OR HOMEOWNER) Name T a W_ Telephone Number Address r(U G &,) S+ License # C S 5(co &\1 ey , rn (A 03W Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO6ams(Q I Le, D�r (� I1�CtJ1'► SIGNATURE DATE a k oo FOR OFFICIAL USE ONLY APPLICATION #."- DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE I' OWNER ve . DATE OF INSPECTION: Q FOUNDATION INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL o PLUMBING: ROUGH FINAL GAS: ROUGH = FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r . E,I rr ��� Otte NSW Way,NWBEbiso . w I� w Westwood,Massachu,re fta2090 ENERGY D. December M 2,01507 - - Attentions Stateaitd Municipal Permitting Authorities, PERMTS OFFICE Re:l[nitill Authorization for Verizon VJii eless'to Attach to NSTAR pales To Whom It May Concern: fiversoti`ce Energy dfb/a NSTAtL Electric("NS`TAft"}is;aware that VertzArt;Wireless is in the process of J.. permitting for the.instailation of necessary te,lecommumcations cquipment:agd correspoiidin aerial fibr~r optic cable m various locations art NSTARgowned poles Ehroughoutiaur service t®rritory As.part of the approval.process,we understand that'there is a requiretitient fo'r NSTAR to review these locations artd provide the, 6w' with confnmation,a�`its,apprdyal irx advance ofVerizon VJ re less'&proposed attachment; . - Mcordingly,NSTAR:hereby submit's its tattled autboxiza an for Ver non l'Virelass to install its equipment' and"corres " ndin aerial h w rputes"to NSTAR" les in the eo a laic l4.cat'ions as.do`icted•orrthe tans. Fo g Po �, �' p P F , submitted by VertZq V4�trelesa;and on-,f le with the Towns The installations on NSTAR poles wdl be subject to the underlying terms and cotidittons of agreeinen#s byand between NSTAw'dad V.eriI �F 6tbss.as the safer ay be ut effect from time to torte, If ttterc is anything fuxtb that 1 can provide you with for your analysis,please do not hesitate•to.contact rne.at.50.S-44]-5$8l StncerelyJ: • . ': a Li :Steven M Owens- _.. Supei�v 80r,-Rights,Perintts 8�Public �4?oriC Eversource Energy,(NSTAR)electric) C}ne NSTAR Wny,4mmg l80 Westwood MA 02090 ;q4$p Ph (508)44T•5:881 h .b° ,i 14 . Fax:.(50 ). t 8 441-5842 i�a 2-C CERTIFICATION. - Client: Turning Mill Consultants,Inc. ' 68 Tupper Road, Unit 3 a Sandwich, MA 02563 Site Name: Hyannis MA SC03 (Candidate: Pole 36-16-S Yarmouth) Site Address: 165 Yarmouth Road Hyannis, MA 02601 Project#: Type of Survey: X GPS Survey X Ground Survey Horizontal Datum: NAD83 expressed in degrees of Latitude and Longitude Vertical Datum: NAVD88 -expressed in feet Above Mean Sea Level (AMSL) Structure Type: Self-Support Tower Monopole Tower Guyed Tower X-- Wood Pole Water Tank Smoke Stack Roof Top Church Steeple -. ..Temporary Site Silo Other , • Center of Utility Pole: Latitude 41°39' 34.78" N Longitude -700 16'35.23"W _ Ground Elevation at Structure: 0' (AGL) 34.7' (AMSL) Top of Structure(Top of Utility Pole): 29.4'(AGL) 64.1' (AMSL) Center Line of Proposed Antenna 35.7' (AGL) 70.4' (AMSL) ' Top of Proposed Antennas: 37.3' (AGL) 72.0' (AMSL) .` Overall Height of Structure,Including appurtenances (Top of:Proposed Antenna): fi' 37.3' (AGL) 72.0',(AMSL) Certification: I certify that the latitude and the longitude are accurate to within+/-50 feet horizontally,and that the ground elevation is accurate to within+/-20 feet vertically. The horizontal coordinates are based-upon-the North American Datum of 1983 (NAD 83) and are-,expressed in degrees of Latitude and Longitude.The elevations are based on the North American Vertical Datum of 1988 and are expressed in feet Above Mean Sea Level ' t 4 r Signature: Bryanarmenter �4��oFa�ssa 4: Professional Land Surveyor#48193 0�� oyG c BRYAN G. O PARMENTER, —1 Date September 1, 2015 0 NO.481a3 cn r f �FG/STER�� " u LAW ° _ 20 Balch Avenue b Groveland;MA 01834 (978)891-5203 r www.pfsland.com .. + ryR r r 4 s Mass. Corporations,external master page Page 1 of 2 r -c Corporations Division Business Entity Summary ID Number: 753000423 W Request certificate . �New search] Summaryfor: NEW ENGLAND ELECTRICAL CONTRACTING CORPORATION The exact name of the Domestic Profit Corporation: NEW ENGLAND ELECTRICAL CONTRACTING CORPORATION The name was changed from: TIMBERLINE ELECTRICAL CORPORATION on 03-04-2002 Entity type: Domestic Profit Corporation Identification Number: 753000423 Old ID Number: 000810913 Date of Organization in Massachusetts: 02-13-2002 Last date certain: Current Fiscal Month/Day: 12/31 The location of the Principal Office: Address: 21 MARION DRIVE City or town, State, Zip code, KINGSTON, MA 02364 USA Country: The name and address of the Registered Agent: Name: KEVIN FARRELL Address: 21 MARION DRIVE City or town, State, Zip code, KINGSTON, MA 02364 USA Country: The Officers and Directors of the Corporation:, Title Individual Name Address PRESIDENT KEVIN FARRELL 21 MARION DRIVE KINGSTON, MA 02364 USA TREASURER KEVIN FARRELL 21 MARION DRIVE KINGSTON, MA 02364 USA SECRETARY KEVIN FARRELL 21 MARION DRIVE KINGSTON, MA 02364 USA DIRECTOR KEVIN FARRELL 21 MARION DRIVE KINGSTON, MA 02364 USA Business entity stock is publicly traded: ❑ http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=753000423&... 4/28/2017 Mass. Corporations, external master page Page 2 of 2 The total number of shares and the par value, if any, of each class of stock which this business entity is authorized to issue: Total Authorized Total issued and Class of Stock Par value per share outstanding No.of shares - Total par No.of shares value CNP $ 0.00 200,000 $ 0.00 0 ❑ ❑Confidential ❑Merger ❑ Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Administrative Dissolution ^° Annual Report Application For Revival Articles of Amendment v A• 1-1 L/L�..L�.. View filings Comments or notes associated with this business entity: New search http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=753 000423&... 4/28/2017 `$ #g.,s "' t fa..3 `, , e n fi "`tts ,,',. y ,' # ,,,r�„ ;& t .d •x# s as ''�5*Y^ R a ��"pkk ,ai,A''' asa''`x. a�; NO- 4 t"' _ rs +?��,''.'g,.: i,�;;e.:. 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'� ..'tPci '.R>�•, ,MRk� 3'�. � _ : p $,."" �- r ,�' a?� "� � € �,� _Mawr*'`�, �� ,.�;"� _ ..,�. �s��� c +'� o, `�,° ,�d '� ,•.,' �*R e The Commonwealth of Massachusetts Print r Department of Industrial Accidents Office of Investigations I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov%dia Workers' Compensation Insurance Affidavit: Builders./Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual);:New Engl0d.Electrical Contracting.Corporation " Address:21 Marion Drive City/State/Zip:Kingston MA 023.64 Phone#.781-585-0040. Are you an employer?Check the appropriate box: Type of.projeck(required) 1.2 I am a employer with 48 4. I am a general contractor:artd I employees(full and/or part-time)#' have hired the sub-contractors 6. ❑New construction 2.E1 I am asole proprietor or partner listed on the attached sheet. 7. ❑ Remodeling These sub-contractors have. ship and have no employees 8. Q Demolition. ein lo:"ees"and have Wor'kers'' working forme in any capacity, P y 0. ❑ Building addition [No workers' comp..insurance: comp,insurance:* required.] 5..ElWe,are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner,doing all work officers have exercised their 11.❑.Plumbing repairs or additions myself. [No workers' comp: right of exemption,per MGL 12.,n Roof repairs insurance required.]t c. 152,§1(4),and we have,no employees. [No workers' 11EI Other comp.insurance required.] *AnyappEcant that checks box 41 must also fi11 out'the section below showing their workers'compensation policy information, t Homeowners who submit this affidavit indicating they are doing all work and then hire outside-contractors.must submit anew affidavit indicating.such. :Contractors that check this box'must,attached an;additional,sheet showing the.name.of the sub-contractors and state whether or not those entrties.have employees. If the-sub-contractors have employees,they must;provide their"workers'comp.policy number. I am an employer that is pr.oviding workers'compensation insuranee for my employee& Below&tile,policy.and job site information. Insurance Company Name:Zurich American 'Policy#or..Self ins.Lie.#:WC0161691. Expiration Date) /1'3/2017 Job Site Address:: City/State/Zip: Attach a.copy of the.workers':compensation,policy declaration.page(showing the policy numb r 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 eopy of this statement may be forwarded to the Oifice of Investigations of the DIA.for insurance coverage verification. I do:hereby cerdj'apdef th& ains and enalti , o er,ur that the!n ormation.provided above is true and correct. Sx ature Date Phone# w`�tJ Official use only. .Do not write in this ar"ea,to be completed by city,or town of aL City orTown Permit/License,# Issuing.Authori y(circle one): 1.Board of Health 2,Building Department. 3.City. own Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other.. Contact"Person: Phone#: Client#:23780 NEWEN16 ACORDr. CERTIFICATE OF LIABILITY INSURANCE DAT(:(MMI 11/15/2DIY016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT J Smith NAME: Sullivan Insurance Group,Inc. PHONE 508 791-2241 FAX 508 797-3689 1 Mercantile Street E-MAIL E:t: vc'Na • ADDREss: Jsmith@sullivangroup.com Suite 710 Worcester,MA 01608 INSURER(S)AFFORDING COVERAGE NAIL# INSURER A:Gemini Insurance Company INSURED INSURER B:North River Insurance Company New England Electrical Contracting Corp Zurich American 21 Marion Drive INSURERC: Kingston,MA 02364 INSURER D:Hanover Insurance Company" INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MMIDD MM/DD - A GENERAL LIABILITY X x VCGP081520 11/13/201611/13/201 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY PREMISES ERENTED Eocccu ence $50 000 CLAIMS-MADE �OCCUR MED EXP(Any one person) $10 000 X BI/PD Ded:5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - PRODUCTS-COMP/OPAGG .s2,000,000 POLICY F JECT LOG $ D AUTOMOBILE LIABILITY x x AWNA947880 11/13/2016 11/13/201 COMBINED SINGLE LIMIT Ea accident 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS - AUTOS _ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident B X UMBRELLA LIAB X OCCUR x x 5611075702 11/13/2016 11/13/201 EACH OCCURRENCE S5000000 EXCESS LIAB CLAIMS-MADE AGGREGATE s5,000,000 DED. I RETENTION$- - $ C WORKERS COMPENSATION X WC0161691 11/13/201611/13/201 X WCSTATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? � N/A ' (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,descbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Cert Holder named as additional insured. Policies are primary and non contributory.Policies include Waiver of subrogation. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 4 ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #303267 KM D F I r VerI a1'1 wireless 4 May 1,2017 Dear Sir/Madam: Re: Kevin Farrell/NEED Please accept this letter as notification that Keven Farrell working for NEEC, of Kingston, MA has been engaged to perform research on certain properties and real estate including submitting for zoning approval, building permits,and construction for Verizon Wireless'ongoing network enhancement. Keven Farrell / NEEC is authorized to act on Verizon Wireless behalf for the purpose of filing and , consummating any zoning and/or building permit applications necessary to obtain approval of the applicable jurisdiction for the installation and/or,modification of Verizon Wireless' communication Facilities. Should you have any questions regarding this please contact me at 508-942-7503 or via email-at nPeiletier@trmcom.com. Respec ully, x Sean Conway Verizon Wireless Project Mamanger—Real Eastate I �o.nn:rS SCd� APPENDIX IV r Form 1 APPLICATION AND POLE ATTACHMENT LICENSE Licensee Verizon Wireless Street Address One Verizon Way,Mail Stop 4AW 100 City,State and Zip Basking Ridge,NJ 07920 Date 1owis In accordance with the terms and conditions of the Pole Attachment Agreement,application is hereby made for a license to make 1 antenna,RRH/Cabinet and meter attachments to poles and 1 Power Supply(ies)and other attachments located in the municipality of Barnstable in the State of MA This request will be designated Pole Attachment License Application Number HyannisMASC03-383795 Attached are my power supply specifications if applicable.The cable's strand size is 0.5 and weight per foot of cable is 0.2. ❑Communication Space X Power/Supply Space Licensee's Name(Print)Barbara Kassabian Signature BcWI>"CE Xa2labf. NSTAR d/b/a EVERSOURCE Power Company Title Site Acquisition Tel.No. 603-303-8001 Fax No: E-mail bassabian@trmcom.com *********************For licensor use,do not write below this Pole Attachment License Application Number is hereby granted to make the attachments described in this application to attachments to JO'poles, attachments to FOZ poles, attachments to 10 poles, Power Supplies and other attachments located in the municipality of , in the State of as indicated on the attached F. Form 3. - Licensor's Name(Print) tJ r Signature (AGREEMENT ID#) Title ,�t D--e(- Date Tel.No. The Licensee shall submit an original copy of this application to Verizon New England Inc.and NSTAR Electric Company d/b/a EVERSOURCE ENERGY. ' Revised 02/23/2015 NSTAR d/b/a EVERSOURCE Form 2 AUTHORIZATION FOR FIELD SURVEY WORK Licensee: Verizon Wireless In accordance with Article III&Appendix I of the Pole Attachment Agreement, following is a summary of the charges which will apply to complete a field survey covering Pole Attachment License Application Number I-IyannisMAsco3-383795 in the municipality Of Barnstable in the State of. MA FIELD SURVEY CHARGES Field Survey Moles Unit Rate Total Field Survey Application Fee I pole $139.00 $ 139.00 (includes 1st pole) Field Survey 2-200 Poles,. $ 13.45 per Pole $- Additional Travel Time*" ' $20- 0.00 per Day $ + TOTAL Charges . .$$139.00 *Based on average of 75 poles surveyed per day,add$200.00 travel time for each additional day required to complete survey. Please note,if you calculated the cost incorrectly,your check will be returned and a new check for the correct amount must be received by this office in order to schedule the survey. If you need assistance,please call the HOTLINE on 800-340-9822. The required field survey covering Pole Attachment License Application 4 HyannisMAsc03-383795 is authorized.I am enclosing an advance payment in the amount of$ 139.00. Licensee's Name(Print)Barbara Kassabian Signature 3cr v'bCu W ka41 &a*V Title Site Acquisition Address 16 Chestnut St,Suite 420,Foxboro,MA 02035 Tel.No. 603-303-8001 Date t 111/6/15 • Revised 03/06/2015 Eversource Energy FORM 3—EVERSOURCE ITEMIZED Pole Make-Ready Work Charges PAGE OF_ RCE to Complete:Total Poles Surveyed Total Poles Requiring NSTAR Make-Ready Appendix 1V Form 3 >._ .... ..•. .. .•:..-;::=. ._.. - :..:. •FIELD SURVEY:' _,MAICE READY WORK-FORM SURVEYORS: DATE OF SURVEY: CWO#: Verizon I MUMC:Barnstable STATE:MA Exch Code: Munic Code: Licensee I Craig Cody LICENSEE NAME:Ver(zon Wireless LICENSEE APPLICATION#:HyannisMASC03-383795 EVERSOURCE ELCO NAME:EVERSOURCE NSTAR APPLICATION# POLE::# ATT. O.WNERSH7P. _ CHARGE WORK DESCRIPTION TEL RTE/STREET NAME Tel EI F/C J.O. J.U. F.O. YES NO TASK#S / 'Height List one pole per line P.S. Tel El Tel El Tel El REMARKS ofAtt. Rise r 165Yarmouth Road(cross at [eet 36-16 N/A 1 nnou Rd -S a TOTALS! Height of Attachment=Height or Licensee Attachment shall be 40"below ELCO MGN unless otherwise noted hereby Vedeon and EVERSOURCE surveyor. Revised 03/06/2015 t i i S I OZ190/£0 Pasi401 vmou31 /UOJJ u o ul djljlJVUMO OP140V IUO MWO Paalalloi/P1*4 aaal o0 0;as WPOI r i EVERS'.URGE - Work Order Application FOR KEN KENDRICK: Customer Request In-Service Date: 1i6/2016 WO Received Date: Service Address:Street: 165 Yarmouth Road Suite:—Town: Barnstable Zip: 02655 Customer Of Record: Customer Responsible for Payment of Monthly Electric_ Bills Name to appear on Monthly Bill:Verizon Wireless DBA—C/O Name: Billing Address: One Verizon Way, Mail Stop 4AW100. Basking Ridge. NJ 07920 Telephone:508-320-2017 Tax ID Number: TB D Existing Account or Meter Number(if applicable): Property Owner Name(if different from above): Owner Address: Owner Phone Number: Party Responsible for Construction costs associated with work order(if different from above) Name:Verizon Wireless Address:400 Friberg Parkway,Westborough, MA 01581 Phone Number: 508-320-2017 Please Note that Articles of Incorporation are required for new commercial EVERSOURCE Customers Type of Service Requested: (Circle Appropriate) X New Service Service Upgrade Service Relocation Temporary Service Pole Relocation Disconnect/Reconnect Service Removal Metering Only OH Service from Pole, Pole#: UG Service from; Riser-Pole#: Padmount#: Customer Loading: Brief Description of Work Attach (1) antenna. (1) RRH/Cabinet and (1) Type of Load New Connected Load in KVA meter to the pole. Will require 60 amp single Single Phase Three Phase phase service. I Lighting Electric heat Air Conditioning Refrigeration . Cooking Electric Dryer Water Heater Computer Process Equip. 14.4 Motors/Elevators Miscellaneous Totals 14.4 Number of Meters Required: Residential: Commercial: I Public: Main Switch Voltage: - Amperage: Phase: Service Voltage: Amperage: Phase: Facility Type(ie:school, hospital): Telecommunications New Building Square Feet: ALL 480V SERVICES REQUIRE COLD SEQUENCE METERING(DISCONNECT SWITCH ON THE LINE SIDE OF THE METER If more than 1 meter is required, how will meters be labeled?(ie: Unit 1,2, etc, Unit A, B,etc.) Additional Equipment: Generator: KW: Phase: Purpose: Motor(S) : Total#: Largest HP: Phase: Locked Rotor AMP: Type of Starting Compensation(choose one): Hard Soft Capacitor VFD *See Article 802 of EVERSOURCE Information and Requirements Book for Maximum LR current and Three Phase Protection* z Contact Name(circle appropriate): Customer/Contractor/Consultant:Craig Cody Street Address: 16 Chestnut Street,Suite 420 City,State, Zip: Foxboro, MA 02035 Telephone: Best Time to Call:Monday-Friday 9:00 a.m.to 5:00 p.m. Pager: Fax: Cell: 781-831-1281 Electrician: TBD License Number: Business Name:Verizon Wireless Street Address:400 Friberg Parkway City, State, Zip: Westborough, MA 01581 Telephone: 508-320-2017 Best Time to Call: Pager: Fax: Cell: Please note that by Interconnecting with the EVERSOURCE Distribution System the Customer of Record acknowledges that they have reviewed and are in compliance with the EVERSOURCE Information & - Requirements for Electric Service(Blue Book). For New Commercial Services, New Residential Developments, New 13.8 kv Two Line Station Electric Service, please provide (2) copies of City/Town approved site plans that illustrates the new facility location and the proposed location of the new utilities(electric,gas,water,sewer,telecommunications)and a One-Line Diagram. For Service Increases at existing facilities;please submit a One-Line Diagram if available. t. For New Residential Services.where a pole must be set,please provide(2)copies of a site plan that illustrates the , proposed location of the new facilities. For Temporary Service Requests,please provide(2)copies of a site plan illustrating service location. You may Fax this Form or mail any additional correspondence to: EVERSOURCE ENERGY Electric and Gas One NSTAR Way Westwood,MA,02090 Tel: (781)441—3851 Fax:(781)441-3194 Cell:339-987-7059 , H.Kendrick SW340 FOR NSTAR USE ONLY EVERSOURCE Revenue Allowance: EVERSOURCE Rate: KVA or rating of Existing Loads(if applicable): Existing Winter Peak Demand: Month/Date/Year: ' Existing Summer Peak Demand: Month/Date/Year: i • 1. J 1 VICUM MAP rota LEASE LOCATION EXHIBIT a HYANNIS MA_SC03 , y �{4 uc Jml .I - :11 - .i�C-'.` ■ TgRNING MILL coa_mu SULTAN[e,INC w6rnxv w Jm Jmms 165 YARMOUTH ROAD . BARNSTABLE, ! MA 02061 loos Jars N[L ss-u-s N�1' Xn• *sv Ic au• � JaE LEASE EKHBIf SUfiURTNS IJi-JN _ � a/Je/IJ an bllJ/11 tl9ln IOI IO.b 00.5W■f� R CIgF[O B� 1IJ � FOIE MAUS. NEW CO. #35-16-5 . caoxwv�ns: AERIAL MAP N 41' 39' 34.78" svJo naHE 1�-1 suns W 70' f 6' 35.23" . �. - 1.JrnM a wwomuJc . L @1PWrt VWMw N9 O0.pIN41 VDmuF • SJgT 1RIL' • SrtdCJINl NUlK6 AVD CCYlI , Lwxsmms an uwxo w om ai•.xoJ sa VICINITY 8 4.Jwm A TOCO TO OWE mW EO W oloow AERIAL MAP . � . ulsJrc Jsn.sorxa w x oowxlrsl - . P S.SRE J1/J1 IMI 1 BArtD oN SIJE m V J1nIPp YlL Co."cuV1:.W. SIRT MNBw: I 6.KM1 JqE WOMO/NOS 6T•SO OM fFJD YFAnJmwrs YrsIt11C�HIILIEID M]Utf. LE-1 1,AI-NJufafI40J1 MT LOEdE 7 msm P Qn' LEASE EXHIBIT 01, Icr°mar eaa` g��/A . HYANNIS MA SC03 oamc 1]r: - oemR/0",� % U LL ,RNINGMD.L CON4ULT�1HI3 Iw'a 1 �� cRlea�icrnll�`R�.�,ia tl 188 YARMOUTH ROAD wns fala Cr BARNSTABLE, xnerco.lu•Ia•s x n•ss a.a R rd fe'ssa• u /, �et°NGw`.� MA 02881 LEM ExxmR sueumus SITE PLAN_ n LCOR,G 1 �a� � e a]yrf�w4 wb+ z Ilnerm".jie-le-smt g NR'rCe..I-S S MWI ILNf R f0 t0'S.il' Q S p R TR le'15.1]' 1 Im-. , NETki CO..d76-16-5 1.x]IIM6IPPIIOHNIL � 1 Sd61D]ll Ye,a11Me AM dRle]mx iallaa] CO0A9MI6: . • ]1altMVL/X!L]]6 SNe e6p1. axavuo usst[ a.Ras oaa]mR rox u/.mlo vu.esls exv. µlone N 41' 39. 34.78" xor rm mamuclon. ]t,o,r ar x.lad ou u]II I �.ooeni a mco m mua mou a]mrc � Y/ 70' 161 35.23" , 'owoue wm uRt srxecc fo sE naofosm • ���' 1[SS�IWQa60 _ . a srtr Tlµ a nlvuwvs ssm a s�Rm var 1mc er aawxc uu.nM Um oc SITE& DETAILED . VW1RtLfN1]ulaap a���nror. • EXISTING SITE PLAN 1 PROPOSED SITE PLAN s SITE PLANS swc q.•_1b• ¢-a scua,i/e_11-01 a-a • � .• sxur xuww, o Y e e' Y ] e LG�G weer 1 f ' S , LEASE EXHIBIT viavosln 165CE EaGpolCe 1851E NnaeN tov a IN1dN a 1fY ML 1111W—1 .. anl[1e11 se.r w i 5:n•al �c a x.a•acs,-{rof'ual vexosm uss¢ . .. wuxt�miaEr Oj-5�jii laisa� [HYANNlSL-Mk$r03 1'u-oum OwsoEl 11RINC sEcuan o uort v5saosm SasEE roam 11P we 5w ryiencr 10 vrun aara'ir) TUHMNGMQ.L CONSULTACMt QiC aw. . —w—w—f[A611A SILOMNf flm 0 13YE ALL ^NTCNYM1Y�fB w^ywvo��� j—w—w—w �w—w—J E>r5lwe lRtO/GlelE t1E501L72 AGL ' a� 1.1 YABMO ,IITH ROAD E16 cA esn a I.V-ant.— BARNSTABLE, FRWM s99 1. MA 02061 1RaGSm IES]EE LEASE E)HHff SUBUMALS 1AIRI16 1eWOAD IaSEF 1 IOeLI Obau1 I 1eew15Cn I[SSLC ' a'Cda4lifn 11R'A E1YNG nl' _ Ir�R 1RJ51ER rxaoolID I65R - e W+Yn L nw _ - 1eeE'n5[O 1Iti<A SRF w i'Y-QWD _ ' UIRR}1R11n OMMI Bh A Ea W1 aroum vac aWeESc - NET&T CO,#36-16-5 , ure55r laws va5c aev. wormwu5s x1n5mJsa-Se-s �"s x n•ss s..ae• _ n 10'Ic air orolw ulu N 41' 39' 34.78" W 70' 16' 35.23" • v1a'osm lase - �eoos s�mr POLE PHOTO 8 CONCEPTUAL UTILITY POLE PHOTO , CONCEPTUAL POLE ELEVATION : ELEVATION -svle roxE fc-s srxc l/5c•.f-a' I[-s E e' LE-3 w,me1 f I P � , t d LEASE EXHIBIT J 11'P6 • • 1 ` HYANNIS MA SC03 mopom AMR" Iw m URNING MILL CONS[fLTMl1'S,IlXC - P SCCO,CVtI N 5n<I0EIiMl 1BSYARMOUTH ROAD ' Pcwusm as ' BARNSTABLE, e a . n• �� 7d MA 02061 , Q, la• LEASE EXHtW SUBWaTAS L wnl PROEM WM91M su L P wnvn""m Pw alo - - VUPVoIIvua - > O ovum en ss wi 1 u tlCw� PqF Mm®1: NE&T CO. @36-16-5 _ caowPlars: ANTENNA DETAIL 1 RRH DETAIL a GENERAL WIRING DIAGRAM s N 41' 39' 34-78" W 79 16' 35.23" EQUIPMENT DETAILS r LE-4 } 4 i ";. ,APPLICATIONS POLE ATTACHMENT LICENSE=FORM'=1 � Licensee VERIZON WIRELESS Agreement No. AMA140012 Pole Attachment License AMA 140012645 Customer License Number H annisMASC03-383795 State of IMA IMunicipality IBARNSTABLE Type of Attachment Number of Attachments Billing Description Anchor 0 Antenna 1 MA CAE-ANTENNA-JO Cable/ADSS 0 Cable/Strand 0 Decorative 1 MA CAE-POWER METER-JO Drop 0 ERUV 0 Mise 1 MA-JOINT OWNED URBAN TELECOM Overlash 0 Power supply 1 MA-PS URBAN TELECOM Riser 0 Total Attachments 4 Total Attachments Billable 4 Total Attachments-No Bill 0 Licensor's Name (Print) DEBORAH TOBIN ' Signature Ap roved by DEBORAH TOBIN on 12/23/2015 Date 12/23/2015 Title SUPERVISOR Phone 617-743-4511 VICINITY MAP . ' LEASES. LghRa POLE LOCATION EXHIBIT Barnstable f` r b a� f a { ��...: wd -. s�m ,' r a h�:. �a '�:i,, ,; - �- � r �5 '� ,� 8€ .;'� ^c,•. SITE - 7 4,.r :. . x *k� b �/.�"�. �74' ,.:...,.,..+✓"'(�` W ^M.,.,e'"+s: 4 X'' .V'. n .�. °'1 ,a:. .... x84 x x:: .:. :t•. t ,. a `-0„'t � jy^. #.r.�., ° � r 'x4 'Irt jam' _ SCO HYANNIS MA AF — 3 NET&T CO. r n x ` #150-12W g r a � k&E FIRM TURNING M ILL CONSULTANTS, ANC rus v� our � r coNSTRUCTION MANAGr.R:. 68 x" _ b, •�: PPER ROAD,UNIT 3 'i " ..:r*'p,>., ° #-4�,,; ,; ;-c;,,•.='. ,. .. �': a"-' " -v 1� PO BOX 1 MA 025 63 TEL:(508)888-4383-FAX:(508)88842 46.—turningmillconsultants.com ol : d .. 'r s till• - SITE ADDRESS: a _ ; " a « _.,, .. . •,: � r �, � �: « sl� ` �:., � ;�- ,�. ,... � _ - x ° 165'=YARMOUTN ROAD m � 4 f . o p -; MA 02061 a LOCUS POLE � ' NET&TCO. 36-1 u N 41' 39' 34.78" a' EXISTING POLE LEA E EXHIBIT SUBMITTALS 7 W 70' 16' 35.23" �,, NET&T CO. t ,. ¢. .:' �- h rya. •. : ., A 16A E ,x k. ;.: "., ✓°. * 11 +.'' ." i_�°.'�a, A 09/15/15 ISSUED FOR REVIEW wed . '. .s,, - , �-. ii., .T - r •a r ,P g °� ' - W ° # d DRAWN BY: SS r ' ;. � .a. �.� .: � "°:. � T �; -_ � � .g. •. � �" CHECKED BY: MFJ u - r POLE NUMBER: N ET CO. #36-1 6—S 4 COORDINATES: N 41 ° 39' 34.78„ 'AERIAL MAP NOTES:, W 70° 16 35.23>> SCALE: NONE' LE-1 1.- NORTH IS,APPROXIMATE. ° '2. EQUIPMENT MOUNTING AND ORIENTATION PENDING SHEET TITLE: STRUCTURAL ANALYSIS AND DESIGN. 3.'.THIS DOCUMENT FOR LEASING PURPOSES ONLY. NOT FOR VICINITY $ - CONSTRUCTION. 11 4. POWER & TELCO TO COME FROM EXISTING OVERHEAD AERIAL MAP UTILITY LINES. SERVICE TO BE- DETERMINED. 5. SITE PLAN & ELEVATIONS BASED ON SITE VISIT BY TURNING MILL CONSULTANTS; INC. • SHEET NUMBER: 6. UTILITY POLE COORDINATES' BASED ON FIELD 'MEASUREMENTS UTILIZING A HANDHELD 'GPS UNIT. ■ �-� _7. AERIAL PHOTOGRAPH VIA GOOGLE. } VW15.167 �a LEASE EXHIBIT ya �, o h ho4g \� A / { EXISTING POLE ���/ SITE NEW CO. #150-12W HYANNIS MA SC03 oy 'EXISTING 131'f OVERHEAD WIRES ° ni E FIR TURNING MILL _� CONSULTANTS,INC 103 f ..a \ , '•.�'�.,• •- DGVI.I,OPFRS,.FRairwrIZSAND CC)NSTRUf_'I'IQN MAILAGrR: novi 68 TUPPER ROAD,UNIT VV�+ PO BOX 1159,SANDWICH,MA 02563 t TEL:(508)888-4383-FAX:(508)888-4246 /)♦ �m�wturningmillconsuttants.com Ike -.. SITE.ADDRESS: 1 AD 65 YARMOUTH ROAD LOCUS POLE B.ARNSTABLE, NET&TCO.#36-16-5 • N 41' 39' 34.78" EXISTING POLE MA 02061 - W 70' 16' 35.23" O" NET&T CO. ' #36-1'6A LEASE EXHIBIT SUBMITTALS SITE PLAN _ SCALE: 1" = 40' LE-2 e f 0 23' 20' 40' n EXISTING + i OVERHEAD EXISTING WIRES OVERHEAD, ` WIRES ,.:' _ A 09/75/15 ISSUED FOR REVIEW �' LOCUS POLE ` DRAWN BY: SS ' LOCUS POLE \ NE4&T 39#334.78—S ED ;BY EXISTING CHECK MFJ NET&TCO.#36-16-S W 70' 16' 35 23' SECURITY.LIGHT o EXISTING DISCONNECT POLE NUMBER: N 41' 39' 34.78" z W 70- 16' 35.23 � SECURITY LIGHT SWITCH & RISER DISCONNECT NOTES: NETT CO. #36-16—S SWITCH & RISER 1 1. NORTH iS APPROXIMATE. COORDINATES:' 2. EQUIPMENT MOUNTING AND ORIENTATION PENDING STRUCTURAL ANALYSIS AND DESIGN. o PROPOSED LESSEEEXISTING , , 0 3. THIS`DOCUMENT FOR LEASING PURPOSES .ONLY. SECUISTIRITY ANTENNA_ N 41 ' 39 34.78" EXISTING NOT FOR CONSTRUCTION. LING GHT I 38.7" H X 12.0" DIA SECURITY W 70' 16 35.23 LIGHT I 4. POWER & TELCO TO COME FROM EXISTING OVERHEAD UTILITY LIMES—SERVICE TO BE DETERMINED. PROPOSED LESSEE RRH2X60 SHEET TITLE: 5. SITE PLAN & ELEVATIONS BASED ON ,SITE VISIT r BY.TURNING MILL CONSULTANTS, INC. SITE 6. UTILITY POLE COORDINATES BASED ON FIELD MEASUREMENTS UTILIZING A HANDHELD CPS UNIT. DETAILE❑ EXISTING SITE,PLAN 2 PROPOSED SITE PLAN 3 SITE PLAN SCALE: 1/4" 1'-0" LE-2 SCALE: 1/4" = 1'-0" LE-2 SHEET NUMBER: 0 2' 4' 8, 0 2' 4` 8' LE-2 VW15.167 , LEASE EXHIBIT PROPOSED LESSEE PROPOSED LESSEE ANTENNA TOP OF ANTENNA @ 37.3' A.G.L. (72.0' AMSL) ANTENNA s 38.7" H X 12.0" DIA PROPOSED LESSEE ANTENNA � @.35.7' A-G.L.. 70.4' AMSL Z - SITE PROPOSED LESSEE 4; ANTENNA MOUNTING BRACKET PROPOSED LESSEE COAX(2)-1/2"0 IN HYANNIS MA SC03 — — 2" U—GUARD (FARSIDE) EXISTING SECURITY wEXISTING TOP OF POLE @ 29.4'A.G.L. 64.1' AMSL LIGHT' PROPOSED LESSEE -POWER TAP A&E FIRM (SUBJECT TO UTILITY COMPANY) TURNING MILL CONSLTANTS,INC P .a _ - ' - - ,.IAPCH Ub.EuM1`Ci 1.9f '. RS ANIO �. - .. E:`ONSI'RUCTION MANAGER; 4 a a =rF' µ ( ��Jb' =onW—oHW -EXISTING SECONDARY LINES @ 25.2't A.G.L. 68 TUPPER ROAD,UNIT 3 BOX 1159,SANDWICH,MA 02563 r �;', - L:(508)888-4383-FAX'(508)888-4246 TE n -turningmillconsuftants.com Al 44% ;1z r lid p ¢ UHW-=OHW oHw Hw oHw--oHw= �� EXISTING TELCO/CABLE LINES @ 22:7't A.G.L: SITE ADDRESS: 41 ,d„ � 4-o 165YARMOUTH ROAD ADMIu ^" BARNSTABL , �u L EXISTING S/L DSW @ ,1.1t-A.G.C. �, ' F PRO ED . 14 =T.1:* 'ry. `- 'SAR�OSMOUNTEDE TO MA 02061 k BACK OF RRH I I PROPOSED LESSEES II Q. - LEASE EXHIBIT SUBMITTALS RRH2X60 PROPOSED'LESSEE- r�. POWER-CONDUIT r I� III ' PROPOSED LESSEE , _ I DC CONVERTER FIBER DEMARC BY F FIBER PROVIDER PROPOSED LESSEE — @ 15''AGL 30,AMP DISC SW " _ E - - _ - 9X15X15 ISSUED FOR REVIEW PROPOSED LESSEE �.. van- k4• _. . R BY. POWER CONDUIT PROPOSED LESSEE a o FIBER IN 2" U 'GUARD' _ PROPOSED'LESSEE " y_ s UTILITY METER .,•. DAWN SS PROPOSED LESSEE CHECKED BY: MFJ ' I ' T EQUIPMENT GROUND POLE NUMBER: r: 1 7' OR NET&T .CO. #36-16—S _ PER UTILITY COORDINATES: COMP. LOCUS POLE c RQMTS NET&TCO.#36-16-S- N 1 3� 7 N 41' 39' 34.78" I n ' W 70' 16' 35.23" GROUND LEVEL 39 8'» # @ 0'-0"t A.G.L. 34.7' AMSL) " - PROPOSED LESSEE GROUND RODS . SHEET TITLE: POLE PHOTO 8 CONCEPTUAL UTILITY POLE PHOTO � - CONCEPTUAL POLE ELEVATION 2 . - ELEVATION SCALE: NONE LE-3 SCALE: 3/16" = 1'-0" LE-3 SHEET NUMBER: d VW15.167 LEASE r EXHIBIT p 11" REF SITE r HYANNIS_MA_SC03 PROPOSED. ANTENNA s i s A&E FIRM. .• 1'2.0" DIA III TURNING MILL CON�U RTAa rIRS AND p p c<a� rHuc*HOr;l n>r•aroAcEa. } PC BOX 1159,SANDWICH,MA 02563 38,7" TE�* L(50818884383—FAX(508)8884246 `< f SECONDARY ww turningmliconsuftants.com ti ' .. i �"'' �, �'aY`�'`�� n`• I � �i e "' SITE ADDRESS: FI B ER 165 YARMC3UTH ROAD .. `� � PROPOSED GND .. x b FIBER - ' BARNSTABLE, Cj FRONTHAUL & o BACKHAUL N J MA 02061 m O ® , 'PROPOSED REF TSAR_0 LEASE EXHIBIT SUBMITTALS 1.3 o _ 3, # t PROPOSED 'RRH q PROPOSED r a AC/DC - - VER }_ CON TER - s -:`i - A 09/15/15 ISSUED FOR REVIEW F 30A SERVICE d F EQUIPMENT' < DRAWN BY: SS a ' CHECKED BY: MFJ e GROUNDNUMBER. METER _ ,. POLE e — SOCKET NET&T CO. 36-16—S ' COORDINATES: ANTENNA DETAIL RRH DETAIL 2 GENERAL WIRING DIAGRAM 3 N 1 ° 39' 34.78" SCALE: NONE LE-4 SCALE: NONE LE-4 SCALE: NONE LE-4 W 70° 16' 35.23„ p SHEET TITLE: Y i F EQUIPMENT ° r : DETAILS SHEET NUMBER: LE VW15.167 P