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1577 FALMOUTH ROAD/RTE 28
. y v n , , d i $ST. CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT DEPARTMENT OF FIRE-RESCUE&EMERGENCY SERVICES �. 192 1875.Route 28-Centerville, MA 02632-3117 508-790-23M x1 - FAX: 508-790-2385 Michael J.Winn,Chief Martin O'L.MacNeely, Fire Prevention Officer Byron L. Eldridge,Deputy Chief e Michael G.Grossman,Fire Prevention Officer March 11, 2019, Robin Anderson, Zoning Officer .Town of Barnstable Building Department 200 Main Street y y Hyannis,MA 02601 Re: Response to the MSPCA on March 7, 2019 o Dear Robin, On Thursday March 7,2019,this department responded to a call of the MSP A at.15-t7 Falmouth Road in Centerville which required the response of multiple agencies. ob quijW response to my request to send gas,building, and health inspectors to the scene was aY tremendous help to the fire department. The relationship between our departments makes for excellent inter-agency cooperation in the time of an emergency. The quick response by all the inspectors was extremely helpful to the emergency personnel at the scene. Respectfully, Michael Grossman Fire Prevention Officer COMM Fire Department cc: Town of Barnstable Board of Health Town of Barnstable Building Commissioner Florence Town of Barnstable Gas Inspector.' "Commitment to Our Community" Town of Barnstable i Posi This Card So That�t is Visible From the Street Approved Plans Mustzhe�Retamed on Job and this Card Must'be Kept anxr�xeea� s ^ Posted Until Finallnspection HasB.een Made �. r r;, �. R .,e as Where a Certificate;of Occupancy is Requiyred,such Bu�ldmg shall Not be Occupied uri#�I a Final Inspect�onxhas been made .a nIe ld tg Permit NO. B-19-2539 Applicant Name: Andrew,Layman Approvals Date Issued: 08/07/2019 Current Use: Structure Permit Type: Building-Sign Expiration Date: 02/07/2020 Foundation: Location: 1577 FALMOUTH ROAD/RTE 28,CENTERVILLE Map/Lot: 209-083 Zoning District: SPLIT Sheathing: Owner on Record: MASS SOCIETY FOR PREVENTION Contractor Name: ANDREW C LAYMAN Framing: 1 Address: 1577 FALMOUTH RD. ;: Contractor License- CS-055189 2 M ,. CENTERVILLE,MA 02632 S: Esf'Project Cost: $9,000.00 Chimney: Description: Install new freestanding sign per attached plans Permit Fee: $75.00 Insulation: Project Review Req: Fee Paid $75.00 Date 8/7/2019 Final: Plumbing/Gas Rough Plumbing: b,.... Zoning Enforcement Officer Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized;by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and tfie'approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning'by laws and codes. This permit shall be displayed in a locatiorrclearly visible from access street or road and shall be maintained open for public inspection This for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by he Building and`Fire Officials are provided on this;permit. Minimum of Five Call Inspections Required for All Construction Work: ' , . '..:: Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A).. Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: $ST. CENTERVILLE-OSTERVILLE-MARSTONS. MILLS FIRE DISTRICT DEPARTMENT OF FIRE-RESCUE&EMERGENCY SERVICES 1875 Route 28•Centerville, MA 02632-3117 1926 508-790-2375 x1 • FAX: 508-790-2385 Michael J.Winn,Chief Martin O'L.MacNeely, Fire Prevention Officer Byron L. Eldridge,Deputy Chief Michael G.Grossman,Fire Prevention Officer March 11, 2019, Robin Anderson,Zoning Officer Town of Barnstable Building Department 200 Main Street Hyannis, MA 02601. Re: Response to the MSPCA on March 7,2019 Dear Robin, On Thursday March 7, 2019,this department responded to a call at the MSPCA at 1577 Falmouth Road in Centerville which required the response of multiple agencies. Your quick response to my request to send gas,building, and health inspectors to the scene was a tremendous help to the fire department. The relationship between our departments makes for excellent inter-agency cooperation in the time of an emergency. The quick response by all the inspectors was extremely helpful to the emergency personnel at the scene. Respectfully r Michael Grossman Fire Prevention Officer COMM Fire Department cc: Town of Barnstable Board of Health Town of Barnstable Building Commissioner Florence Town of Barnstable Gas Inspector✓ "Commitment to Our Community" --l�, ,,eating contractor at MSPCA adoption center on Cape Cod found rushed t... Page 1 of 2 15�7 :Wdw Metro Heatingcontractor at MSPCA ado tion p center on Cape Cod rushed to hospital By Sabrina Schnur GLOBE CORRESPONDENT MARCH o8, 2019 A contractor at the MSPCA on Cape Cod was rushed to the hospital Thursday after he was found unconscious near a boiler he was working on, and the incident is now under investigation by the Occupational Safety and Health Administration, officials said Friday. -A veterinarian at the adoption center on Falmouth Road in Centerville found the heating contractor unresponsive around 8 a.m. Thursday, according to the MSPCA and fire officials. n ADVERTISING https://www.bo stonglobe.com/metro/2019/03/08/heating-contractor-mspca-... 3/11/2019 h 11 iI 1 The veterinarian performed CPR while waiting for emergency responders and the man was taken to Cape Cod Hospital, said Rob Halpin, director of public relations at the MSPCA. Firefighters from the Centerville-Osterville-Marstons Mills Fire Department responded and took over providing first aid to the man, whose name was not released. . Town of BarnstableBuildin e Post°ThisCard So Thai:,it isUisible From the"Street=A rovedPlans•Must be�Retamed.on;Job and this Card Must be••Kept +: HARIN'.TC'ACtL4 " � ' •k �'" ., � �� '"i,a �v � � � �Pp� '' �.< ,l ; �,: ��,, '�. ,g �� x a \� �N �y�•': �,i� ,; Permit M p Posted Until''Final°.Ins ection Has Been Made �':' '§Wh'ere a�Cert�ficateof®ccupanc as Re uired,such Bu�Idmg;shallsNot berOccupied intil�a�Final Inspectionhas=been made ,.a C..�>._.�:,� - at-_ o-`�. ,is ';�_�..��nv,..y� ...ar ..��.��,..1z•�::;�... . .:�� .�. �e,.u� _RM_ �.: `�t_.�...;,�,..�.,.:.�,�• �€a...�'.,��`� .:..g,.As�.: „a�-a>�,���::':� .>,._:�..,_':_..,o. _m,.,a Permit No. B-19-9 Applicant Name: McGRATH POST&BEAM CO. DBA PINE HARBOR Approvals WOOD PRODUCTS Structure Date Issued: 01/28/2019 Current Use: Foundation: Permit Type: Building-Shed-Residential-200 sf and under Expiration Date: 07/28/2019 Sheathing: Location: 1577 FALMOUTH ROAD/RTE 28,CENTERVILLE IVlap/Lot209 083 Zoning District: SPLIT x Framing: 1 Owner on Record: MASS SOCIETY FOR PREVENTION Contract�r Name 10SEPH A CHAMP x 2 Address: 1577 FALMOUTH RD _ .> �_ContractorDense�,CS053655 I Chimney: CENTERVILLE, MA 02632 Est Proie�ct Cost: $4,500.00 ' Insulation: Description: construct 10 x12 storage shed i :A PermitFee: $ 135.00 Fee Paid: $ 135.00 Final: Project Review Req: 1/28/2019 Plumbing/Gas Rough Plumbing: w5 •. Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and tepproved construction documeforwh ch this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning bylaws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. ; ,F Electrical s 4 � The Certificate of Occupancy will not be issued until all applicable signatures by the-Building aa°nd Fire Iffi ials are provided on this permit: Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.foundation or Footing c 2.Sheathing Inspection Final: . 3.All Fireplaces must be inspected at the throat level before finest flue lining is installed 4.Wiring&Plumbing Inspections to be completed priorto frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health 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. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT pApplicadon M—her.... ...............................:..................... fie. Pecmrt Fee...... ..... ..........:............Other Fee...........:.....:...... ' G DEPT. TotalFee Paid..................................................................... 0� �A1g ' TOWN OF BARN� ABLE Pmmit AFpmval by..........................:......on........................ _ TOWN OF BARNSTASLE BTJIELDINO PERMIT MV...'2 `' ................. .......... ..............:....... APPLICATION Section I - Owner's Information and.Project Location. Project Address ' 7 jWLM CU�4 fel Village l �V 11 E 0wners Name fil S r- -4 M th S S c C1 Uz- I 1h�'YV`1 Owners Legal Address 15 -7 fkt-Lm cul-14 C - State iM A zip / owners Cell# 5 E-mail 1 ►�1 L �:, C�, ��1 . -�" `- s; Section 2-Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section 3-Type of Permit New Construction ❑ Move/Relocate �,Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ . Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other-Specify ection 4 -Work Description A-se eJ( 1 i Z u' )C w o UT1 L-i 11 C J 5,.�3> �"Z C t�:- - A A T Act nniahad_2/9/2018 Application Number.................................................... Section 5—Detail X I Z • i Cost of Proposed Construction Z10 0 Square Footage of Project l 2 Age of Structure Dig Safe Number # Of Bedrooms Existing Total# Of Bedrooms(proposed) r 110 MPH Wmd Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist Design Section 6—Project Specifics ❑ Wiring i ❑ Oil(tank Storage ❑ S=4 Detectors ❑ Plumbing ❑ Gras Fire Suppression Heating System ❑Masonry Chimney ❑Add/relocate bedroom Water supply Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site d Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: j NCO 3,06JM S I am using a crane ❑ Yes No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage r f Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required J Proposed ZO6 " + Rear Yard Required. Proposed -8 Side Yard Required Proposed 5 U Has this property had relief from the Zoning Board in the past? ❑ Yes No Lastmiatm 2/9=18 Yarmouth Rd. I Hyannis,MA 02601 1508.771.5007 I Fax 508.771.7070 I hyannis@pineharboccom PINE HARBOR �' 2�, Queen Anne Rd. I Harwich,MA 02645 1 508.430.2800 1 Fax 508.430.1115 1 info@pineharboccom Schedule Date WOOD PRODUCTS 1 1.800.368.SHED I Customer Service1.866.SHEDKIT I www.pinehaFborcom )3: m Sold By ` U r� ' Branch Date O('_ e r 1(�ty Invoice# Name 1 1 1�\(. ' '08 Whivilof Email O—SO ne 1 11 /Y aisZt a •ty-& Address I J7--Olm6ah Phoney l i l-) A1 8 32-8577 city (Ul l StateM 14 Zip Phone i Size&Style S ion Foundation (b Special Instructions z� Floor 8 S t Doors Windows •r r �,+[• � y F Siding v , card r , 1 ' Trim Roof Shingles l i Cupola&Weathervane Other a i So?a• °�� • Sub Total t Tax Installation a Delivery TOTAL ° r Slb p° Check Cash Credit Card BALANCE AJ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass gov/dw Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Apyficant Information Please Print Legibly Name(Business/Organization/Individual): AC ma-&A-ffi %4 + &PARI CA=UdiW_ Address:9!Hayan .pL ?=J City/State/Zip: >r Lmh o (ML Phone#: Are you an employer?Check the appropriate bog: Type of project(required): 1.EI am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hued the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' � 9. ❑Building addition [No workers' comp.insurance comp.insurance. 10.❑Electrical repairs or additions required.] 5. ❑ We are a corporation and its 3.❑ I am a homeowner doing all work officers have exercised their I L[]Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152,§1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. r Homeowners who submit this affidavit indicating they are doing all work and then hive 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 mployees. If the sub-contractors have employees,they must provide their workers'comp.policy number. am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. L Insurance Company Name: Inviralle Policy#or Self-ins. Lic.#: C�� Al Expiration Expiration Date: lob Site Address: City/State/Zip: !1,ttach 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 E'me 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 )f up to$250.00 a day ag=insu=rance Be advised that a copy of this statement may be forwarded to the Office of Investigations of the Dov a verification. l do hereby certify u der the a' a al s of perjury t"the information provided above is t e and c rrect 3i afore: Date: �� Phone#: ° Official use only. Do not write in this area,to be completed by city or town ofciaL 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#: + r Office of iconsumer,Affairs and:Business Regulation 10 Park!Plaza-:Suite 5170 Boston,'Ma- husetts 02116 Home�Improveml tractor Registration Fes. Type: Corporation �MCGR,ATH iPOST&'tBEAM°iCO. Gjul ; J` Registration: 132935 Expiration: 10/30/2018 .259Queen Anne'Rd. I I Harwich, f1liA D2645 4.`=���` ►-.1 Update Address and return card.'Mark reason for change. SCA 1 0 20M-05/11 ❑:Address ❑Renewal ❑;Employment ❑lost:Card p� V�ze pdmmw�uaea�2eB-#,crooactucaetC �\ Office of Consumer Affairs, Business Regulation WOME IMPROVEMENT CONTRACTOR Registration.valid for:Individual:use only Type: Corporation before'the,expiration date.if+found return to: ion it i Office of Consumer Affairs and:l3usiness'Regulation 3¢ 10/30/2018 10:Park1Plaza-Suite'5170 Boston,'MA 02116 McGRATH DB/A Pine Haiaa� lft Products James`McGRATK;. 259 Queen Anne Fed. Undersecretary iNotwalid without,signature Harwich,'MA 02645 r .x.-.�,_. -.+'r�..ra.o�....-_�.�,�n,.�:-,..�......t-�,,,.,...�.,-.....�.w—,�•<-.>-.,,.-,.u.�.....m,,...�,�,.,s.�....�,,.,__�.,�.t.<�_..:�. I ..yam... PINE HARBOR WOOD PRODUCTS Its all about the wood" 326 Yarmouth Road,Hyannis MA 02601 259 Queen Anne Road,Harwich MA 02645 508-771-5007 hyannis@pinehabor.com 508-430-2800 harwichoffice ineharbor.com Owner's Authorization �z � �- --) �s owner of the property located at ���� �ar,-r��✓"7.. fid, C� �-��,e o �a� (Property Address) authorize Pine Harbor Wood Products to act on my behalf in all matters relative'to work authorized by this building permit application. f I Owner's Signature Date: ��/•��/��� i Mckechnie, Robert From: Mckechnie, Robert Sent: Friday, January 18, 2019 9:59 AM To: INFO@PINEHARBOR.COM' Subject: Application T13-19-9, 1577 Falmouth Road, Centerville, MSPCA Good Morning, Your application is denied for the following reason: 1.) Commercial sheds over 120 square feet have to meet the Commercial Wind Code Requirements. This would require a stamped plan (by an engineer or architect)with the appropriate details showing compliance. Also, it would appear from the site plan that you are installing this where the emergency generator is. This application will be reopened for review when the appropriate documents are submitted. Contact me with any questions. Thank you, Robert McKechnie Local Inspector Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 PINE HARBOR WOOD PRODUCTS 326 Yarmouth Rd. I Hyannis,MA.02601 1 508.771.5007 1 Fax 508.771.7070 I hyannis@pineharbor.com 259 Queen Anne Rd. I Harwich,MA 02645 1 508.430.2800 1 Fax 508.430.1115 I info@pineharbor.com 1.800.368.SHED I Customer Service 1.866.SHEDKIT I www.pineharbor.com 1/9/19 Town of Barnstable Joseph Champ is a Massachusetts licensed builder under the employment of Pine Harbor Wood Products. Joseph has been a full time employee for over 8 years. Sincerely, 1^ James R McGrath 1 IIACGRP05-01 ZHELLWI CERTIFICATE OF LIABILITY INSURANCE DATE QW228120 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rt hts to the certificate holder in lieu of such endorsements. PRODUCER 1 C 'ACT R ers Rte 134 ay Insurance Agency,Inc. PHONE - _ FAX 2156 _ South Dennis,MA 02660 ; mail@rogersgray.cont _ T,.,.,INSURER(SI AFFO__RDING COVQtAGE_...._.._.,..__. ' _"A 9•—•- _,,. . _:`►NsuRER 4:Travelers.indemnity Company of America , _25666 INSURED „INSURERS:Travelers,Indemnity Company_- ._ _. _- .25658 ._. McGrath Post&Beam Corp INSURER c New Hampshire Employers Insurance Compan .13083 dba Pine Harbor Wood Products - - 259 Queen Anne Rd INSURER 0: Harwich,MA 02645 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE-TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE.BEEN REDUCED BY PAID CLAIMS. INSR' TYPE OF INSURANCE ADDLIMSO'IUBR POLICY NUMBER POLICYMM EFF POLICYEXPLTR LIMITS - A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ - 1,000,000 _ CLAIMS-MADE '. X OCCUR 4 1-660-03688196-TIA-18 011311201810113112019 DAMAGE TO RENTED 100,000 ...PREMISES(Ea occurrence) .„3 .--_ _......._ ( i �. j r MED EXP(Any_oM Ps!sOn) .,.$ _. -5,000 i -- # .: .,. _v j;PERSONAL 8 ADV INJURY .1;S _ 1,...... 0 _. GEN'L AGGREGATE LIMIT APPLIES PER: s GENERAL AGGREGATE.—_:$. a 2,000,000 i PRD- FF 2,000,000 i X:POLICY i_ JET i T 'LOC 4 } PRODUCTS-,COMP/OP AGG!S OTHER: 1 COMBINED SINGLE LIMIT 1,000,000 13 AUTOMOBILE LIABILITY ` ¢ (go acoderrl) ANY AUTO �BA4487B686-18SEL 0113112018,01131/2019 BODILY INMRY(Per person) $ - OWNED 1 X SCHEDULED t AUTOS ONLY AUTOS t BODILY INJURYSPer accident) S, _ _ �p��� µpyy�Ep PROPERTY pAMAGE y X-AUTOS ONLY X.ArUiOS O L i (Per UMBRELLALIAB ;OCCUR i - I EACH-OCCURRENCE,_.__. i EXCESS LIAB i .CLAIMS-MADE, i- AGGREGATE I$ DED RETENTION$ Ci 'WORKERS COMPENSATION ' X _�7-UTE 't RH- i AND EMPLOYERS'LIABILITY Y 1 N_ ECC-600-4000957-2018A 07/OW018 i 07108/2019' - 100,000 ANY PROPRIETORIPARTNERIEXECUTIVE ' _„E.L.EACHACCIDENT-_,— _ .$ p[FI ERIMEMg�)EXCLUDED? N ;,NIA: 1 (M 'C=I^NH) � E.L DISEASE-EA EMPLOYEE_$ 100,000 It y�describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT i } i i � I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Addiflonai Remarks Schadule,may be attached I more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable ACCORDANCE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main St Hyannis,MA 02601 AUTHORQED REPRESENTATIVE 'lot, ACORD 25(2016103) ®1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Application Number........................................... Section 9-.Construction Supervisor Name :ZaC�f(-} CAP Telephone Number Address DJy_�C_B �LBV.'20_ City w°C( State Vn zip License Number CS-06' (55 License Type U Expiration Date 2(J l 7 Contractors Email i C..h`�r+�� '�- e ly\ 4V bar CEM Cell# L f3�-Z� `- a OZH I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Bamstable.Attach a copy of your license. Signature Date Section-10-Home.Improvement Contractor NamePUS v t i-- ?C� 6-Kf Telephone Number 0— gr %, � c_ Address Qo VI c� vlr► V- a City ��•w�c� V State zip ��- Registration Number t 3'L Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and docamentation re=�bY780and Tof le.Attach a copy of your H.LC.. SignatureV1 Date Section 11-Home Owners License Exemption Home Owners Name: Telephone Number s'�Cell or Work Number I understand my responsibilities under the ivies and 'ons for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building, ode. I construction inspection procedures,specific inspections and documentation required by 7 0 C]VLi and the own of Bamstab . Signature Date APPLICANT SIGNATURE Signature Date Print Name MC 4_*AiW Telephone Number '30-Zvi E-mail permit to: Q_ VV ,✓l(Iv� CUM Section 12—Department Sign-Offs Health Department © Zoning Board(if required) ❑ Historic District ❑ Site Plan Review Of required ❑ Fire Department ❑ Conservation ❑ " ` For commercial work,please take your plans directly to the fire department for approvab Section 13—Owner's Authorization, L (A as Owner of the'-subject property hereby authorize tj ' to act on my behalf, in all matters relative to work authorized by this building permit application for: I STI (Address of job) ' F Signature of Owner date Print Name l B t i ,t Last uadated.2J92018 °ZT"Erti Town of Barnstable MUMS ABLE. = Building Department-200 Main Street 9 " �•0p Hyannis, MA 02601 Tel. (508) 862-4038 Certificate Of Occupancy Permit Number: B-17-1495 CO Issue Date: 10/15/2018 Parcel ID: 209-083 Zoning Classification: SPLIT Location: 1577 FALMOUTH ROAD/RTE 28, Proposed Use: CENTERVILLE Name of Tenant: Sprinklers Provided: YES Gen Contractor: MOSES M CORDEIRO Permit Type: Commercial- Non-Profit Type of Construction: Design Occupant Load: 40 Comments: MSPCA / /SI v 1 l8 Building Official Date: A Certificate of Occupancy is Required Prior to Occupying Space Building Code: 780 CMR 8th Edition Town of Barnstable Buncting is Post.Thrs Card So Thai rttrs Visrble.Fr>omythe Street�A rovedPlans,:1111ust be=Retained onyJob and,this Card;Must bewKe"t + oARNtfii►I2LE::•' - ,st ✓ is "4 q a� , .� ,; z _fir Pp x p 6:> aosted UntrlFinal Inspection Ha s.BeenMade, .g Permit PWhe made Permit NO. B-18-208 Applicant Name: Tim Hathaway Approvals Date Issued: 03/08/2018. Current Use: Structure Permit Type: Building-Sheet Metal-Commercial Expiration Date: 09/08/2018 Foundation: Location: 1577 FALMOUTH ROAD/RTE 28,CENTERVILLE Map/Lot 209 083 Zoning District: SPLIT Sheathing: r Owner on Record: . MASS SOCIETY FOR PREVENTION aContractorName Timothy B Hathaway Framing: Address: 1577 FALMOUTH RD Ab Contractor Ucense �1085j� " trier CENTERVILLE,MA 02632 ( Est Protect Cost: $80,000.00 Chimney: Description: Install duct systems for 4 roof top units Q Permit Fee: $160.00 AA h, Ins ulatio sky Fee Paid $160.00 Project Review Req: , Date Final 3/8/2018 0 1��15/cS a - c ` Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six monthsafter issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the,approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structuresithall be in compliance with the local zoning by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or'^road and shall be maintained open for,public inspection for the entire duration of the ork until the completion of the same. ,s� w Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are proved d on this permit. Service:. RN Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or FootingRough: . 2.Sheathing Inspection - Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health 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. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A)., Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Q LU Main Office: WEE Nantucket Office: 49 Herring Pond Roadmucj& N 19 Old South Road Buzzards Bay,MA 02532 Nantucket,MA 02554 Tel(508)833-0670 ° Tel(508)325-0044 Fax(508)833-2282 3 October 11, 2018 Barnstable Town Hall c/o Mr. Brian Florence Building Commissioner 200 Main Street Hyannis, MA 02601 J RE: 1677 Falmouth Road,Centerville Letter of Certification Dear Mr. Florence; , Per the request of our client, the MSPCA, Bracken Engineering, Inc. (BEI) has prepared the enclosed Final As-Built Plan dated 10/10/2018. 1 hereby certify made upon knowledge and believe in accordance with professional standards that all work has been done in substantial compliance with the approved site .plan(Zoning Section 240-105G), dated September 1, 2016, and revised on September 27, 2016 Thank you for your assistance on the project. Should you have any questions or require any further information,please contact me at our office via 508-833-0070 or donabrackeneng com. Sincerely, BRACKEN ENGINEERING, INC. N OF.�ygss9c �o DONALD F. . BRACKEN, JR. m Donald F. Bracken, Jr., PE -0 ciurL ' No.37071 President 9 FG/aTFa FSS�ONAL EG�a Town of Barnstable T""'`ST''B`E Building Department-200 Main Street MATS. a "rfnM+ Hyannis, MA 02601 Tel. (508) 862-4038 Temporary Certificate Of Occupancy , Permit Number: B-17-1495 CO Issue Date: 6/22/2018 Parcel ID: 209-083 Zoning Classification: SPLIT Location: 1577 FALMOUTH ROAD/RTE 28, CENTERVILLE Proposed Use: Permit Type: Building- New Construction - Commercial General Contractor: MOSES M CORDEIRO Comments: Approved for a TEMP CO, applicant stated that the site will not be completed until the demo of the old building is complete and then the site work can be completed.. Septic permit 2016-405.' approved for temp c/o. 6/22/2018 Building Official Date: f to Building Town of Barns �Ye ' • ;Pas#This Card Sa Thai it is Visible Frnm#he'S#ree#; Approved Plans Mush ae Retained'on lob and#his;Card Must be Kept Posted �• ss$resr,�ais. r 3 € s 4�w. ���` �Unt�l Final Inspection Has Been Made 3f '�__ ;; ' ,;�xaxa <Where a Certificate of Occupancy is RequEredF such Bwlding shall Not oe Qccupied until a Final Inspection has been made. Permit e Permit No. B-17-1495 µ Applicant Name: MOSES M CORDEIRO Approvals Date Issued: 07/05/2017 Current Use: Structure �'. Permit Type: Building-New Construction-Commercial Expiration Date: 01/05/2018 Foundation: Location: 1577 FALMOUTH ROAD/RTE 28,CENTERVILLE Map/Lot: 209=083 Zoning District: SPLIT Sheathing: Owner on Record: MASS SOCIETY FOR PREVENTION ' Contractor Name,: MOSES M CORDEIRO Framing: 1 Address: 1577 FALMOUTH RD Contractor License .CS-074674 2 CENTERVILLE, MA 02632 Est: Pro�e:ct Cost: $4,000,000.00• Chimney: Description:, CONSTRUCTION OF NEW BUILDING .ANIMAL SHELTER AND CARE Permit Fee: $36,500.00 ADOPTION CENTER FOR MSPCA DEMOLISH EXISTING ANIMAL SHELTER Insulation: �y Fee Paid $36,500.00 Final:. ' Project Review Req: CONSTRUCTION OF NEW BUILDING ANIMAL SHELTER AND Date. 7/5/2017 L CARE ADOPTION CENTER FOR MSPCA DEMOLISH EXISTING _ ANIMAL SHELTER Plumbing/Gas Building Official Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzed by this permit is commenced'w;thm 5Fx months;after issuance. Final Plumbing:G� All work authorized by this permit shall conform to the approved application a`nd the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures'shall;be in compliance with the local zoning by laws.and codes.-M Rough Gas;/,T/lam/�(y U/I'1J This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for pu'bhc mspeetion for the entire duration of F" the work until the completion of the same. in al Gas The Certificate of Occupancy will not be issued until all applicable signatures:by the$u.ildmg.and,Fire Officials arse provided on this permit." Electrical" Minimum of Five Call Inspections Required for All Construction Work Service: 1.Foundation or Footing Sheathing Inspection ! Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lirnng is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final:- _./ 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final:. Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. r Work shall not proceed until the Inspector has approved the various stages of construction. Healthy-, "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Departm nt All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT LV� " Town of Barnstable y `�iiexa6s3rya,s.t"��, �. PPv�ogs..ss„tt&,�e'.,•T,d°h'�ai s�==>�C�t...a_i,.rt lr dFifi��inSc�aoa.l,t T,eI�",,nh�o sa�pft$�'eO ictc=t"icsi;ou��U na'`�sM"�+ba,.�ls..,�e:'•'6�Fae:"rg"aeo nm..'x:;.a,M yut�fia�re'�kd.eY�•�eS�d�t x.ri�se�-u e.vcrt h�3BA„.0 p.::%i`:ip ld.r.,.o.m_.,u.�e.:s.h�3aP'l°lah.°n.N,,.o,M,t_ bu<;e�s tO�,bc�_ec�u R,e�'�itead'm^2u e.,n,�dzt,�:2iol.n ai�.J�F.;o�m.b.a..al.n�I\.`nd�."�"�'s�°'tGhe���:`ic sat��C.�baan r dh��a M's'u.�b6s''e t��„b .ev}``_K�e•i."�.pF t�'s*e`�.'�°ra=.x Permit Un i11C1n o Ce&.here � m panty�s Req p p n en made Permit No. B-18-2176 Applicant Name: Jay.Miller Approvals Date Issued: 07/09/2018 Current Use: Structure Permit Type: Building-Demolition Expiration Date: 01/09/2019 Foundation: Location: 1577 FALMOUTH ROAD/RTE 28,CENTERVILLE Map/Lot 209 083 Zoning District: SPLIT Sheathing: c Owner on Record: MASS SOCIETY FOR PREVENTION �;} Contract r Narne JAY MILLER Framing: 1 Contractor License CS 111594' Address: 1577 FALMOUTH RD i 2 CENTERVILLE, MA 02632 Est�roJect Cost: $20,000.00 Chimney: Description: Demolition of existing animal shelter building�aber con5trction of Permi�F e: $182.00 the new buildingproperty address. Insulation: at same P Pert Yb � � �Fee PId $182.00 g114. 0, Final: Project Review Req: DEMOLITION OF OLD EXISTING BUILDING.- Date 7/9/2018 Plumbing/Gas wy r . �u Rough Plumbing: _ . Building Official � 4 Final Plumbing: - e- : Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. g All work authorized by this permit shall conform to the approved applicationand theapproved construction documents for which this permit has been granted. 111K, "' " Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws�and codes. This permit shall be displayed in a location clearly visible from access streyx7eto rbadd and shall be maintained open for�public inspection for the entire duration of the work until the completion of the same.,; T r " Electrical Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Build ng and Fire 0 kills are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing ._ r• . 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed priorto Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health 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. Final:. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT=ISSUED RECIPIENT f C'le fammolnc 191&1 0 0-'1&a:�6a 1X1e et1Z 527 CMR 1 .00 C� Section 1 .12.8.2.1 FP-056 Form 1 (Rev. 1.26.2015) Application for Permit, Pen-nit, and Certificate of Completion for the Installation or Alteration of Fuel Oil Burning Equipment and the Storage of Fuel Oil C&te(L1�1 z)Vd 201�1 (City or Town) (Date) Permit#'s: FD Elec. FDID#: Fee Paid: $ � �� Tel.#: - `_-- --- Owner/Occupant Name: ISAO (; %tZ1 Installation Address: 1S� �mw`m Serviced Floor or Unit#: El Heating Unit Domestic Water Heater ® Power Vent Other Burner: ® New C1 Existing 1/ Location: Txtua� _ Mfg: Typp Model#or Size: Nozzle size: lfll I OiIN ® Kerosene ®Waste Oil Removal ca Cr Sto4e TaIiR: 0 N w ( Existing Location: Tye _ Capacity: Z. gallons No. of Tanks: S 00ial Auirementl(or additional safety devices) /0 — #ts; OSV-`''valve (1Oil Line Protected Co. Name: Lo./<D 1 Q Tel# Address: SS'L q-Ch utgz� City: iT�l W►�•• Zip: QLSDO Completion Date: 2 [YVwl 2�$ Combustion Test: Gross Stack Temp.: Net Stack Temp.: CO2 Test: Breech Draft: Smoke: Overfire Draft: Efficiency Rating %: I,the undersigned certify that the installation of fuel burning equipment has been made in accordance with M.G.L.Chapter 148 and 527 CM 1.00 currently in effect.Furthermore,this installation has been tested in accordance with such requirements,is now in p oper operating condition and complete inst .ons as to its use and maintenance have been furnished to the person or whom the installation alteration)was made. Installer: . r Print Name L Cert of C# L4Qnarure(no Stamp) Address: City: W ff Once signed by the firiq a rtment,t i is IT for storage o goillIte oil burning equipment. Approved by: Date: 2 Y vv---v Keep original as application. Issue d plicate as permit.This form may be photocopied. Final Construction Control Document v To be submitted at completion of construction by a w Registered Design Professional ,ea for work per the ninth edition of the Sy0 Massachusetts State Building Code, 780 CMR, Section 107 Project Title:MSPCA-CAPE COD ANIMAL CARE AND ADOPTION CENTER Date:June 21,2018 Permit No. Property Address: 1577 FALMOUTH RD.,CENTREVILLE,MA 02632 Project: Check(x) one or both as applicable: •X New construction Existing Construction Project description:Veterinary Hospital I William P.Faucher,P.E,SECB,MA Registration Number: 37528.Expiration date: 06/30/2020,am a'registered design professional, and I have prepared o'r directly supervised the preparation of all design plans, computations and specifications concerning: , , Architectural . X Structural. Mechanical Fire Protection Electrical Other:Describe for the above named project. I, or my designee, have performed the necessary professional services and was present at the construction site on a regular and periodic basis. To the best of my knowledge,information, and belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit and that I or my designee: 1. Have reviewed, for conformance to this `code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 7 MR_107. Enter in the space to the right a"wet" or electronic signature and seal: W1 R. Phone number:207.221.2260 X107 Email:wfaucher@allied-eng.com Building Official Use Only Building Official Name: Permit No.: Date: Version 01 01 2018 (UAA)4 ' TbWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel (DO-7)-'-�"15"-"-OF. BAR�ISTABLE pplication # — V Health Divisiono Date Issued Conservation Division ,�—1 -l7 Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board`` a� Historic - OKH _ Preservation/ Hyannisla�c� �� Project Street Address / S7 IL 'M 2�11�/ 12D yt Village �� ffe Owner ! S Cif Address / 7'7 //eo Telephone Permit Request 72 Tab Ac C o Square feet: 1 st floor: existing Z 'proposed 2nd floor: existing ro osed Total new � q 9.ALg—proposed 6 Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other _ Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) _ Number of Baths: Full: existing new Half: existing new _ Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count _ Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ _ f Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use _ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 49 Telephone Number Address �C�f6gf License# 6-7 b 7 & 11f0d- 7_6 Home Improvement Contractor# Email4&� — bf ;{�l/d� Worker's Compensation # ALL CONSTRUCTION QESPIS RESULTING FROM THIS PR OJE T WILL BE TAKEN TO4 _ 11.G, CT /1� IZ SIGNATUR DATE 5—/)S 7 FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ! - Oo DATE CLOSED OUT ASSOCIATION PLAN NO. ' t 1 i Town of Barnstable : . Regulatory Services KAM ► Richard V.Scali,DhvgWr Bnihiing Division Paul Roma,Banding Commissioner 200 MWn St=4 Hyannis,MA 02601 Wwwtown.barnstable m ate Office: 509-962-4038 Fax: 508-790-6230' Property 07mer Must Complete and Sign This Section. If Using A Builder Joseph Silva as Owner of the subjectpropezty hereby authorize Del lbrook/JKS to act on my beh4 in aIl matters relative to work authorized by this bm ding perttrit application for. 1577 Falmouth Rd, Centerville (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is install d and all final inspections are perfon ned and accepted. " tztrc of Owner Sigaa a of t V[, ✓ fi e 64je IA0 Print NimA Print N=e Da Q:FoaMs:owNMUW.hffsrora'oors I The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia «rorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Ledbly Name (Business/Organization/Individual):Dellbrook JK Scanlan Address: 15 Research Road City/State/Zip:East Falmouth, MA 02536 Phone#:508-540-6226 Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. ✓❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $, ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition r 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 E]Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 1 1.❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs ' These sub-contractors have employees and have workers'comp.insurance. 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp:insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Travelers Indemnity Company of CT Policy#or Self-ins.Lic.#:DTE-UB-3H613658 Expiration Date:7/1/17 Job Site Address-1577 Falmouth Road 4} City/State/Zip:Centerville, MA 02632 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date): Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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.A c statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under th ai s a ies of perjury that the information provided above is tru nd correct. Si ature: Date: ' Phone#:508-540-6226 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#: I DATE(MMIDD/YYYY) ACOI CERTIFICATE OF LIABILITY INSURANCE �� 4/10/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.- IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must 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 endorsements. PRODUCER CONTACTNAME: Maria McNulty Alliant Insurance Services, Inc., PHONE 617-535-7200 FaJAIy 0 617-535-7205 131 Oliver Street,4th Floor E-MAIL Boston MA 02110 DRESS,Maria.McNulty@alliant.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Starr Indemnity&Liability Company 38318 INSURED - INSURER B:Navigators Insurance Company 42307 Dellbrook JK Scanlan INSURERC:Allied World National Assurance Com 10690 One Adams Place INSURER D:The Travelers Indemnity Co 25658 859 Willard Street Quincy MA 02169 INSURERE:Travelers Indemnity Company of CT 125682 INSURER F: COVERAGES CERTIFICATE NUMBER: 1298050303 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE - ADDLIbUtili POLICY EFF POLICY EXP LIMITS LTR - INSD WVD POLICYNUMBER MM/DD/YYYY MM/DDIYYYY C X COMMERCIAL GENERAL LIABILITY Y 0308-4515 7/1/2016 7/1/2017 EACH OCCURRENCE $1,000,000 FX OCCUR DAMAGE TO S(RENTED CLAIMS-MADE PREMISES Ea occurrence) $300,000 x XCU MED EXP(Any one person) $10,000 x Contractual PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 . POLICY�JECT LOC PRODUCTS-COMP/OP AGG $2.006,000 OTHER: $ ED D AUTOMOBILE LIABILITY Y BA-3H608114 7/1/2016 7/l/2017 EaaBcident IN L LIMIT $1000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ $ A UMBRELLA LIAB X OCCUR Y 1000022893 7/1/2016 7/1/2017 EACH OCCURRENCE $10,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED I I RETENTION$ $ ` E WORKERS COMPENSATION DTE-UB-3H613658 7/1/2016 7/1/2017 PER OTH- AND EMPLOYERS'LIABILITY YIN X STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1.000,000 OFFICER/MEMBER EXCLUDED? �N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $1,,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Excess Liability IS16EXC7114561V 7/1/2016 7/1/2017 Each Occurrence 15,000,000 Aggregate 15,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) / Re: JKS Job#1721, Cape Cod Hospital Microwave Ablation 27 Park Street, Hyannis, MA 02601. Cape Cod Healthcare, Inc. and Cape Cod Hospital 27 Park Street, Hyannis, MA 02601 are included as Additional Insureds as required by written contract and executed prior to a loss,but limited to the operations of the Insured under said contract,with respect to the Automobile, General Liability and Umbrella/Excess Liability policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Healthcare,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 27 Park Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE Y V ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Massachusetts Department of Public Safety 7 Board of Building Regulations and Standards s F License: CS-102901 Construction Supervisor _ z F PALMER L MICHAEL 207 TURNER ROAD EAST FALMOUTH MA 02536 k H � E Expiration: Commissioner 08/26/2018 Initial Construction Control Document To be submitted with the building permit application by a d Registered Design Professional t for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: MSPCA-CAPE COD ANIMAL CARE AND ADOPTION CENTER Date: 30 MAY 2017 Property Address: 1577 FALMOUTH RD.,CENTREVILLE,MA 02632 Project: Check one or both as applicable: j pp New construction Gl Existing Construction Project description: NEW CONSTRUCTION OF A 12,700 SQUARE FOOT FULL SERVICE ANIMAL SHELTER WITH ANIMAL HOLDING AND ADOPTION SPACES, In House Veterinary clinic,masonry construction with full fire protection,future demolition of the current and existing animal shelter. I William P.-Faucher,PE,SECB MA Registration Number: 37528 Expiration date: 06-30-2018 am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: PArchitectural Structural [ ] Mechanical `Fire Protection [ ] Electrical [ ] Other for::the_above named project and.that to the best of my knowledge, information,and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: Review,for;conformance to this code and the design concept,shop drawings, samples and other submittals by the contractor in-"accordance with the requirements of the construction documents. ;2:: Psrforn the'duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress'and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing-in this document relieves the contractor of its responsibility regarding the provisions of-780 CMR 107: When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. �Tpt. completion of the work,I shall submit to the building official a`Final Construction Control Document'. O, Enter m the space to the right a"wet"or elootron'c signature and seal: muaviv P Onrr n. ber: 207221.2260.X107 ,.Email: wfaucher@allied-eng.com Building Official Use Only Byildmg Official Name Permit No.: Date: Version 06'11 2013' , Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: . MSPCA-CAPE COD ANIMAL CARE AND ADOPTION CENTER Date: 30,MAY 2017 - _,__,_• Property Address: 1577 FALMOUTH RD.,CENTREVILLE,MA 02632 -''.'Project: Check one or both as applicable: N(New construction ❑ Existing Construction . `Proj6ct description: NEW CONSTRUCTION OF A t2,700 SOi/ARE FOOT FULL SERVICE ANIMAL SHELTER WITH ANIMAL HOLDING AND ADOPTION SPACES, In House Veterinary clinic,masonry construction with full fire protection,future demolition of the current and existing animal shelter. j`Catherine A.Faucher,PE MA Registration Number: 39057 Expiration date: 06-30-2018 ,am a " `-registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Architectural Wectrical ructural [ ] Mechanical Fire Protection [ ] Other for the above named project and that to the best of my knowledge,information,and belief such plans,computations and .<specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1... Review,for conformance to this code,and the design concept,shop drawings,samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. `3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CUR 107. When required by.the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,Ma form acceptable to the building official. Upon completion of the work,I shall submit to the building official a `Final Construction Control Doc *OF it Enter in the space to the right a"wet. or o� CATHERINE A. :electronic signature and seal: FAUCHER a f`t ECTRICAL r Ewd� Phone number: 207221z26ox106 Email: daucher@allW-eng.com tONAI Building Official Use Only Building Official Name: Permit No.: Date: Version 06 11 2013 CIX Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 8a'edition of the s Massachusetts State Building Code,780 CMR, Section 107 Project Title: MSPCA-CAPE COD ANIMAL CARE AND ADOPTION CENTER Date: 30 MAY 2017 .Property Address: 1577 FALMOUTH RD.,CENTREVILLE,MA 02632 Project: Check one or both as applicable: `/New construction ❑Existing Construction - Project description: NEW CONSTRUCTION OF A 12,700 SQUARE FOOT FULL SERVICE ANIMAL SHELTER WITH ANIMAL HOLDING AND ADOPTION SPACES, in House Veterinary dinic,masonry construction with full fire protection,future demolition of the current and existing animal shelter. I Ian A.MacDonald,PE MA Registration Number: 40N4 Expiration date: 06-30-2018 am a - regutered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Architectural [ ] Structural Mechanical Fire Protection [ ] Electrical [ J Other for the above named project and that to the best of my knowledge,information,and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review,for conformance to this code and the design concept,shop drawings,samples and other submittals by the r. contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a`Final.Construction.Control Doc Enter in the space to the right a"wet"or , LAN A. electronic signature and seal: N A - f MECHAN _ Phone number: 207.221.2260 X114 Email: Imacdonald@allied-eng.com Building Official Use Only j. BuiIdIng Official Name: Permit No.: Date: Version 06'11 2013 y Initial Construction Control Document . To be submitted with the building permit application by a o Registered Design Professional for work per the 8 b edition of the t Massachusetts State Building Code, 780 CMR, Section 107 Project Title: MSPCA-CAPE COD ANIMAL CARE AND ADOPTION CENTER Date: 30 MAY 2017 Property Address: 1577 FALMOUTH RD.,CENTREVILLE,MA 02632 Project: Check one or both as applicable: `/New construction LI Existing Construction Project description: NEW CONSTRUCTION OF A 12,700 SQUARE FOOT FULL SERVICE ANIMAL SHELTER WITH ANIMAL HOLDING AND ADOPTION SPACES, In House Veterinary clinic,masonry construction with full fire protection,future demolition of the current and existing animal shelter. I Stephen Jensen MA Registration Number: AR 9020 Expiration date: 31 August 2017 am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Architectural Structural Mechanical ToT Fire Protection [ ] Electrical [ .] Other for;fhe-above named project and that to the best of my knowledge,information,and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: l . Review,for conformance to this code and the design concept, shop drawings, samples and other submittals by. the contractor in accordance with the requirements of the construction documents. ` 2:;.:_Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upor completion of the work, I shall submit to the building official a`Final Construction Control Document'. Entei,in the'space to the right a"wet"Or �e��oDDD�s lFnf electronic signature and seat: ' r r� w No.9020 N BEVERLY i MA Of MP'�PGr F Phone number: 978-232-0326 Email: sj@blueskyarch.com Building Official Use Only Building Official Name: Permit No.: Date: Version 06_11 2013 TOWN OF BARNSTABLE BUILDING PERMIT APPLICA11ON Map Parcel Application # Health Division Date Issued./ Conservation Division Application-Fed Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street�Address1 Ir?7 Village 4 444)e Owner � .`'� Address Telephone 11�� Permit Request 'TA13WV1 eXISTkybsue ��N S� tAS S Q Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new T Zoning District Flood Plain Groundwater Overlay BtJILDING ` ►� . Project Valuation Construction Type OCT 2 4 2016 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting-documentati& Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION ($UILDER OR HOMEOWNER)_ Name &&r/ /`h SG h Telephone Number 1 a7 700 Address S 4O go,rr I'Sj2,O) !,v ^e License # C_S^-�` c�� QoS/cn r?�, ®off/l 0 Home Improvement Contractor# Email r 4 (2 C/W (.Zrl / Cain Worker's Compensation # VI UO-IC,12167-Z'l; ALL CONSTRUCTION DEBRIS`RESULTING'FROM THIS PROJECT WILL BE TAKEN TO If SIGNATURE ` .�, DATE 010 /1 ? FOR OFFICIAL USE ONLY APPLIQATION # ,y DATE ISSUED w F MAP/PARCEL NO. , ADDRESS VILLAGE OWNER DATE OF INSPECTION: 4: • is FOUNDATION FRAME � INSULATION t ` FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 2 1 FINAL BUILDING i r 'l DATE CLOSED OUT ASSOCIATION PLAN NO. Y r nationalgrod • r t July 21, 2016 ' Susan Hathaway Allied Engineering Inc. 160 Veranda St. , Portland, ME 04103 To Whom It May Concern , RE: 1577, 1569 Falmouth Rd.,Centerville This letter is to confirm that we have field verified there are no natural gas services at property named above. I can be reached directly at 508-760-7484 should there be any further questions. Patti Weldon , nationalgrid Sr. Sales Rep.—Complex Gas Connections 127 White's Path t S.Yarmouth, MA. 02664 _ 508-760-7484 desk 508400-5051 --cell . 508 394-1 109 -fax -p4iij Weldon c na iona�to d.corn t Centerville-Osterville-Marstons Mills Water Department P.O.BOX 369-1138 MAIN STREET OSTERVILLE,MASSACHUSETTS 02655 www.commwater.com OFFICE OF u WATER i BOARD OF WATER CON IISSIONERS WATER SUPERINTENDENT #y�DEPT.�y TEL.No.508-428-6691 S Ns FAX.No.508-428-3508 October 14, 2016 Barnstable,Town of Building Department 200 Main Street Hyannis, MA 02601 Re: Account#2330 Massachusetts S.P.C.A. 1577 Route 28 (Falmouth Road), "House" Centerville, MA To Whom It May Concern: On Friday, October 14, 2016 the water service was disconnected at the curb stop for the "house" building mentioned above. It is our understanding that the owner has plans to demolish the existing house, rebuild and install a new water service at a later date. If you have any questions,please call our office at 508-428-6691. Very truly yours, �y Glen Snell Assistant Superintendent GS/jw URCE eversourceEnergy EVERS� One NSTAR-Way,.Westwood Massachusetts 02090-9230 ENERGY October 24,2616 MS•PCA 1577 Falmouth Road Centerville ,Mass 01612 RE: 1577 Falmouth Road: To Whom It May Concern: At Eversource, we're committed to delivering great service: This letter serves as confirmation that,,as of October 24,.2016 the electric service to the address listed above has been disconnected. If you hav In. q 'ons,please contact me at(781)441-8747 Since c_1Y; . t Buii'ders and Shawmut Design and Construction Construction Managers 560 Harrison Avenue Boston,Massachusetts 0211a Telephone 617.622.7000 Facsimile 617.622.7001 + i September 13,2015 Re: Verification of Employment for Robert Hudson a. To Whom It May Concern: This letter is to verify that Robert Hudson is currently employed at Shawmut Design and Construction as of June l% 1993. Mr. Hudson is a Superintendent out of our New Design and Gnatmniea England division. If you need any other information,please do not hesitate to contact me at RTougas@shawmut.com. Thank you. Sincerely, Roger'Tougas Chief Financial Officer Town of Barnstable Regulatory Services dF Richard V.Scali,Director Building Division `* BARNSTAISIX Paul Roma,Building Commissioner i659. M� 200 Main Street, Hyannis,MA 02601 p www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION . Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# , work phone# CURRENT MAILING ADDRESS: cityhown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,`or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures, A person who constructsmore than one home in a two-year period shall not be considered a homeowner.'Such`homeowner"shall.submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under�the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the.State Building Code and other applicable codes,. bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official ` \ * t Note: Three-family dwellings containing 35;000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. `�� '< > ; HOMEOWNER'S EXEMPTION t. r The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section•109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.1.5) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require;as,part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor..'On the last page this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS..doc 06/20/16 a Town of Barnstable Re lator3 Services Richard V.ScaIi,Director - ►`� Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder ,.as Owner of the subject property hereby authorize_;3c� Qedi dl' t act on my behalf, in all matters relative to work authorized by this building permit application for. l57 (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. S ture of er Signature of Applicant Print Name Print Name e QYORMS:OWNERPERMISSIONPOOLS / 1 1 l t r • t ` , _ Ili y Massachusetts Department of Public� Safety� Y � Board of Building Regulations and Standards'. .. ' License: CS-058567 * ..; Construction Supervisor a'v, ROBERT E HUDSON 116 MARSH RD PELH AM NH 03076 •fi Expiration: ' Commissioner 09/23/2017 f The,Cominoii> e'alth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington ,Street Boston, MA 02111 ►vww.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/C®ntractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (I3ttsiness/Organization./Individual) Shawmut Woodworking & Supply, Inc. dba Shawmut Design and Construction Address: 560 Harrison Avenue City/State/Zip: Boston, MA 02116 'phone #: 617-622-7000 Are you an employer? Check the appropriatFl Type of project(required): 1.❑ 1 am a employer with 4. am a general contractor and I employees(full and/or part-time). have hired the sub-contractors o• F1 New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling . ship and have no employees These sub-contractors have g• ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.Eli am a homeowner doing all work officers have exercised their 1 LEI 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 71 must also fill out the section below showing their workers'compensation policy information. ' 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 eniplosttyer that is providing workers'compensation insurance for my employees. Below is the policy,and job site iiiforination. The Charter Oak Fire Insurance Company Insurance Company Name: Policy#or Self-ins. Lic. #: VTRO U B 1 C791 0721 5 Expiration Date: 1 1/01/2016 Job Site Address: �s mo k � _ City/State/Zip: eyMSl0.MC.I1zn', d2G32 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 S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of tip to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of . Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjuiy that the information provided above is true and correct. Sig*nature: Date: October 19 2015 Phone#: 17-62 -7114 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#: TRAVELERS J� ' WORKERS COMPENSATION ONE TOWER SQUARE AND KARTPORD, CT 06183 EMPLOYERS LIABILITY POLICY TYPE V INFORMATION PAGE WC 00 00 01 { A) POLICY NUMBER: (VTROUB-1C79107-2-15) NJ TAX IDENTIFICATION NO. : 042759985000 RENEWAL OF (VTRKUB-IC79107-2-14) INSURER: THE CHARTER OAK FIRE INSURANCE COMPANY NCCI CO CODE: 15318 INSURED: PRODUCER: SHAWMUT WOODWORKING & SUPPLY, AON RISK SVCS NORTHEAST INC. ONE FEDERAL ST 20TH FLR 560 HARRISON AVE BOSTON MA 02110 BOSTON MA 02118 Insured is A CORPORATION Other work places and identification numbers are shown'in the schedule(s) attached. 2. The policy period is from 11-01-15 to 11-01-16. 12:01 A.M. at the insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s)listed here: AK AL AZ CA CO CT DC DE FL GA HI ID IL IN KS KY LA MA MD ME MI MN MO NC NE NH NJ NM NV•NY OK OR PA RI SC SD TN TX UT VA VT WI B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident:. $ 1000000 Each Accident Bodily Injury by Disease:. $ 1000000 Policy Limit Bodily Injury by Disease: $ 1000000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: AR IA MS MT WV D. This policy includes these endorsements and schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE 4.. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required information is subject to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: 11-19-15 LP OFFICE: HARTFORD 084 PRODUCER: AON RISK SVCS NORTHEAST G9651 ' E LMassachusetts Department of Environmental Protection � eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: TDIAMOND Transaction ID: 865128 Document: AQ 06-Construction/Demolition Notification Size of File: 226.48K Status of Transaction: In Process Date and Time Created: 9/19/2016:8:52:05 AM Note: This file only includes forms_that were part of.your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. f - Massachusetts Department of Environmental Protection - BWP AQ 06 Pre-Form Notification Prior to Construction or Demolition r This is a revision to an existing form. Project ID for existing form to be revised: 17 This job is being conducted under a Blanket Pen-nit. MassDEP assigned Blanket Authorization ID: This job is being conducted under a Non Traditional Abatement Work Practice Permit. MassDEP assigned Non Traditional Work Practice Authorization ID. None of the above conditions apply,generate anew form. r z ` Revised: 11/13/2013 Page 1 of 1 Massachusetts Department of Environmental Protection ' 100251063 } . BWP AQ 06 Project Notification Prior Pro or to Construction or Demolition J # r� Project Revision Project Cancellation A.Applicability A Construction or Demolition operation of an industrial,commercial,or institutional building,or residential building with 20 or more units is regulated by the Department of Environmental Protection(MassDEP),Bureau of Waste Prevention,Air Quality Division,under Regulations 310 CMR 7•.09.Notification of Construction or Demolition operations is required under 310 CMR 7.09(2)ten(10)working days prior to any work being performed.The following information is required pursuant to 310 CMR 7.09. Is this a fee exempt notification(city,town,district,municipal housing authority,state facility,owner-occupied residential property of four units or less)? �i Yes No 1.Blanket Permit Project Approval,if applicable:, Approval ID# 2.Non-Traditional Asbestos Abatement Work Practice Approval,if applicable: Instructions: Approval ID# 1.All sections of this B. General Project Description form must be completed in order to 1.Facility Information: comply with the Department of MSPCA-CENTERVILLE 1577 FALMOUTH ROAD Environmental Name of facility Street Address Protection BARNSTABLE MA 023620000 5087750940 notification requirements of 310 CitylTown State Zip Code Telephone CMR 7.09. JOE SILVA VICE PRESIDENT 2.Submit Original Facility Contact Person Facility Contact Person Title Form To:Commonwealth of 6175415176 JSILVA@MSPCA.ORG Massachusetts Facility Contact Person Telephone Facility Contact Person Email P.O.Box 4062 Boston,MA 02211 Facility Size: 5600 1 , Square Feet Number of Floors Was the facility built prior to 1980? FF Yes 17,No Describe the current or prior use of the facility: ANIMAL SHELTER Is the facility a residential facility? ) ;Yes r`.No' If yes,how many units? 2.Facility Owner: MSPCA 350 S.HUNTINGTON Facility Owner Name. Address BOSTON MA 021300000 6175227400 Cityfrown State Zip Code Telephone JOE SILVA 350 S.HUNTINGTON AVE On-Site Manager/Owner Representative Address Boston MA 62130 6175415176 City/Town State Zip Code Telephone Revised:03/17/2014 Page 1 of 3 I � _ Massachusetts Department of Environmental Protection 100251063 BWP AQ 06 Asbestos Project# lr Notification Prior to Construction or Demolition °' Project Revision rF Project Cancellation B. General Project Description (continued) 3.General Contractor: SHAWMUT DESIGN AND CONSTRUCTION 560 HARRISON AVE Name Address BOSTON MA 021180000 6176227000 City/Town State Zip Code Telephone BOB HUDSON 6178396176 General General Contractor's On-site Manager/Foreman Telephone Statement:If asbestos is found C. General Construction or Demolition Description. during a Construction or Demolition 1.Construction or demolition contractor: operation,all SHAWMUT DESIGN AND CONSTRUCTION 560 HARRISON AVE responsible parties Contractor Name Address must comply with 310 CMR 7.00,7.09,7.15, BOSTON MA 021180000 6176227000 and Chapter 21 E of the General Laws of City(Town State Zip Code Telephone the Commonwealth. BOB HUDSON 6178396176 This would include, Construction and Demolition On-site Manager Telephone but would not be limited to,filing an asbestos removal 2.Licensed Contractor Supervisor: notification with the Department and/or a BOB HUDSON CS058567 notice of Supervisor Name License Number release/threat of release of a �� Yes �No . hazardous 3.Is the entire facility to be demolished? substance to the . Department,if 4.Describe the area(s)to be demolished: applicable. EXISTING RESIDENTIAL HOUSE AND SHELTER. MassDEP Use Only Date Received 5.If this a construction project,describe the building(s)or addition(s)to be constructed: 6.Were the structure(s)surveyed for the presence of Asbestos-Containing r"'Yes �;No Material(ACM)? Who conducted the survey? ; Name Department of Labor Standards Certification Number •T Was asbestos containing'material(ACM)found? 17 Yes r,_�lNo- Revised:03/17/2014 Page 2 of 3 Massachusetts Department of Environmental Protection 0 —�-- 1025 BWP AQ 06 1063 .... Asbestos Project# it Notification Prior to Construction or Demolition r7. Project Revision r7i Project Cancellation C. General Construction or Demolition Description (continued) The Asbestos Abatement Notification Number for this address is: This project i Construction Demolition is: 9/29/2016 11/30/2017 , Project Start Date(MM/DD/YYYY) Project End Date(MM/DD/YYYY) d 8.For demolition and construction projects,indicate dust suppression techniques to be used rv7 Seeding r' Wetting (`, Covering r,, Paving r' Shrouding n Other-Specify: 9.Is this an Emergency Demolition Operation? ,Yes Pi No Name of MassDEP Official who evaluated the,emergency Title Date of Authorization(MM/DD/YYYY) MassDEP Waiver Number A Certification "I certify that I have personally NICHOLAS CASSARO examined the foregoing and am Print Name familiar with the information NICHOLAS CASSARO contained in this document and Authorized Signature all attachments and that, based on my inquiry of those PROJECT MANAGER individuals immediately Position/Title . y_ responsible for obtaining the SHAWMUT DESIGN AND CONSTRUCTION information, I believe that the Representing information is true,accurate,and 9/19/2016 complete. lam aware that there Date(MM/DD/YYYY) are significant penalties for 09/19/2016 submitting,false information, including,possible fines and P•E# - imprisonment.The undersigned hereby states,under the penalties of perjury,that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is made." . Revised:03/17/2014 Page 3 of 3 No. � �_.. 3 s®- Fee tog ' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal Opstem Construttion Vermit Permission is hereby granted to Construct( ) Repair( ) Upgrade(' ) Abandon(>e) System located at and as described in the above Application for Disposal System Construction Permit. The applicant re cognized'his/her duty to comply with Title 5'and the following local provisions or special conditions. Piovided:Co s�tructio must be completed within three years of the date of this permit _ Bate Ls�J ! Approved by •" �'' --_ `" ��••� SIP - -. - - : , 1 � Main Office: A AM in Nantucket Office: 49 Herring Pond Road XLKJN19 Old South Road Buzzards Bay,MA 02532 Nantucket,MA 02554 Tel(508)833-0070 ' Tel(508)325-0044 Fax(508)833-2282 PARKING AND TRAFFIC MEMORANDUM J5 Date: September 1, 2016 To:Town of Barnstable Site Plan Review Committee Project: MSPCA Facility 1577 Falmouth Road,Centerville, MA` Existing Site Description: The site consists of two buildings used as an animal care/adoption facility consisting of approximately 5,600 square feet of floor area.The site has a combination of paved and gravel parking areas.The site has two entrances/exits onto a State Highway(Route 28). Traffic and parking counts were taken on June 25, 2016 during a typical Saturday with normal staff and volunteers. Parking counts indicate a maximum parking count of 8 during operating hours of 1:00 pm to 4:00 pm.There are approximately 22 to 25 parking spaces on the site.See attached parked car survey. Traffic patterns show that the majority of the vehicles enter the site at the westerly driveway and exit the site at the easterly driveway. See attached traffic count survey. Proposed Site Description The existing buildings will be removed and a new single building of approximately 15,570 square feet will be constructed with associated driveway and parking areas. It proposed to have a single entrance meeting MassDOT design requirements. The parking requirements were established based on the anticipated use of the building including staff,volunteers, adoption,visits and classroom trainings that would occur simultaneously. There are also grass over flow parking spaces that can be utilized during any special events. See the attached table for parking calculations. Emergency Vehicle Turning The site has been designed to accommodate a KM AERIALCAT fire truck based on the vehicle information provided by the COMM Fire Department.See the attached Vehicle Turning Analysis Exhibit. Respectfully Submitted, Bracken Engineering, Inc. Donald F. Bracken,Jr. P.E. President Parked Car Count Survey 1577 Falmouth Road, Centerville, MA 15 Minute Intervals Date: Saturday, June 25, 2016 Time of Day 1 :00 P.M. 5 1:15 p.m. 8 1:30 p.m. 7 1:45 p.m. 7 2:00 p.m. 8 2:15 p.m. 7 2:30 p.m. 7 2:45 p.m. 8 3:00 p.m. 6 3:15 p.m. 8 3:30 p.m. 15 3:45 p.m. 6 [4:00 P.M. 7 I Traffic Count Survey 1577 Falmouth Road, Centerville, MA 30 Minute Intervals Date: Saturday, June 25, 2016 FALMOUTH ROAD (ROUTE 28) A ,1B11 Time of Day Enter A Enter B Exit A Exit B 1 :00 - 1:30 p.m. 4 2 0 5 1:30 - 2:00 p.m. 3 0 0 1 2:00 - 2:30 p.m. 2 2 0 4 2:30 3:00 p.m. 3 1 1 3 3:00 3:30 p.m. 3 0 1 2 3:30 - 4:00 p.m. 2 1 0 1 . TOTALS 17 6 2 16 I MCape 30 August 2016 MSPCA Cape Cod /Staff Counts for Parking Persons parking factor spaces Shelter Staff 12 1 12 Volunteers 8 1 8 Intakes 3 1 3 Adoptions 3 1 3 Clinic staff 6 1 6 daytime trainings 10 1 10 general visits 20 0.5 10 total spaces 52 short term or off hour use clinic drop offs and pick ups evening trainings vaccine clinics i 49.5'R / 45'R / 28.5'R MIN. \ I I W TURNING TEMPLATE m HYANNIS LADDER TRUCK I J Lu bi PLA RM ANCE CURB TCOLEARANCER R 42' R (45' SHOWN) I 28.5' MIN R (27' SHOWN) N TEMPLATE MADE SYMMETRICAL I I 248" WHEELBASE o ' TURNING RADIUS 40'3 CURB TO CURB 40'10" NOTE: THESE ARE APPROXIMATE DIMENSION THAT DO NOT TAKE IN AFFECT THE WEIGHT OF THE VEHICLE OR THE SURFACE THE VEHICLE IS ON. WALL TO WALL • `tA 3'1 011 SYM DATE PENSION OESCRI-ON APP'O KOVATCH MOBILE EQUIPMENT >- ONE'VOL-E-COUPLE% NEEQUEBONINC,PA—10 j TOLERANCE UNIEss OTNERMsE EPEIFlEO Z EECINKs —EE PLACE:*O TOnsPLACE: .11 :Sl �,O PLACE 3.¢�o CLEs:.1, DATE SCALE I.`I ORANN BY ].l.M. mas WALL TO s—BB—oo NONE APPRO£0 BY M. m WALL @ KME AERIALCAT F PLATFORM TURNING RADIUS z 47'-7„ o BASE 248" Main Office. 1M A An WP W Jq Nantucket Office: 49 Herring Pond Road 19 Old South Road Buzzards Bay,MA 02532 Nantucket,MA 02554 Tel(508)833-0070 ' Tel(508)325-0044 Fax(508)833-2282 SEWAGE FLOW MEMORANDUM Date: September 1, 2016 To:Town of Barnstable Site Plan Review Committee Project: MSPCA Facility 1577 Falmouth Road, Centerville, MA Existing Sewage Flow: The existing buildings are served by a private on-site sewage disposal system upgraded in 2006. The design flow of the system is 1,539 gallons per day(GPD) based on the number of kennels, office space and a four-bedroom dwelling. The septic system was inspected by this firm and found to be in good working order. Water meter readings indicate an average flow of approximately 470 GPD. Proposed Sewage Flow: The existing soil absorption system shall be utilized for the proposed project.A new septic tank will be installed. Sewage flow calculations are based on 24 kennels with veterinary office, classroom/training for 20 people per day and 20 visitors per day are as follows: Per 310 CMR 15.416 Design Flow Use: Kennel/Veterinary Office Design Flow: 50 GPD per kennel Calculated Flow: 24 kennels x 50 GPD/kennel= 1,200 GPD Use: Classroom/training Design Flow: 5 GPD/person Calculated Flow: 20 x 5= 100 GPD Use: Adoption Center/visitors Design Flow: 3 GPD/person Calculated flow: 20 x 3 =60 GPD Total Calculated Flow= 1360 GPG < 1,539 GPD design Respectfully Submitted, Bracken Engineering, Inc. Donald F. Bracken,Jr. P.E. 0 4 President Town of Barnstable Regulatory Services BARNSTABI, MUMS?�. ., Richard V. Scali,Director '�" ` BAMSPABM s53axoia Building Division Paul Roma Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us October 14, 2016 MSPCA c/o Attorney Michael F. Schulz ' 7 Parker Road Osterville, MA 02655 RE: Site Plan Review#021-16 MSPCA 1577 Falmouth Road;Centerville " 1V1ap 209 Parcel 083 Proposal: Demolition of existing structures on site. Construction of a new 15,570 s.f. animal care, education and adoption facility with on-site parking, drainage improvements, and landscaping. Project will also consist of closing one of the two existing curb cuts and widening the remaining single entrance to 25 feet. Siltation fence and construction fence will be installed to demarcate work areas and minimize erosion. Dear Attorney Schulz: Please be advised that subsequent to the formal site plan review meeting held September 9,2016, revised plans for the above proposal were approved subject to the following conditions: Approval is based upon and must be substantially constructed in compliance with the plans entitled"MSPCA#1577 Falmouth Road".consisting of 5 sheets, Scale 1"= 30', dated September 1, 2016; and Stormwater Report prepared for"MSPCA—Cape Cod Animal Care and Adoption Center and Construction Pollution Prevention Plan& Operation; and Maintenance Plan all prepared by Bracken Engineering Inc., Buzzards Bay for MSPCA and last revised September 27,2016. Site Lighting Plan and Lighting Levels, SL-1 and SL- 2, dated 9/26/16; Floor Plans and Elevations A100, A200 and A201 dated 7/21/16 all prepared by Blue Sky, Beverly,MA. • At the building permit stage,Applicant must demonstrate that the design of the septic system meets the required Title V sewage flow design for the proposed uses. Y q g � P P • Location of FDC and Fire Lane striping as determined by COMM Fire Department must be indicated on the final plan. J • Applicant must obtain all other applicable permits, licenses and approvals required. 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(Zoning Section 240-105 (G). This document shall be submitted prior to the issuance of the final certificate of occupancy. A copy of the approved site plan will be retained on file. Sincerely, t Ellen M. Swiniarski Site Plan Review Coordinator CC: Paul`Roma, Building Commissioner Health Department COMM FD } OCT/14/2016/FRI 01 : 15 PM COMM Water Dept- FAX No, 5084283508 P• 002 Centerville-Osterville-Marstons Mills A Water Department P.O.SOX 369-1138 MAIN STREET OSTERVU.LE,MASSACHUSETTS 02655 0 sr www.cOmmwater.com C BOARD OF WATER coWGSSIOMPS WATER W,AMR SUPSRINTENAENT DEPT, TEL.No.503-428-6691 oN5 FAX No.508-428.3568 October 14, 2016 C> Barnstable,Town of Building Deparunent 200 Main Street ' ` Hyannis, MA 02601 Re: Account#2330 �r+ Massachusetts S.P.C.A.. 1577 Route 28 (Falmouth Road), "House" Centerville,MA To Whom It May Concern: On Friday, October 14, 2016 the water `service was disconnected at the curb stop for the "house" building mentioned above, It is our understanding that the owner has plans to demolish the existing house, rebuild and install a new water service at a later date. If you have any questions,please call our office at 508-428-6691. Very truly ggyours, �.Jll�-• ,Y1�j Glen Snell Assistant Superintendent GS/jw TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION I - Map ®o Parcel Application # Health Division Date Issued %Z 9 /w Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board YY\ Historic - OKH _ Preservation/ Hyannis Project Street Adddress\ is`�� fo,\M Av % _1001. ��l`Village ctav t Owner Address0 Telephone ( ' 522' T 146,9 Permit Request 00 Atu Th�il�CS —b -Cc 1 r Square feet: 1 st floor: existing proposed 2nd floor: existing - proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:7j t -ems Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# to Current Use Proposed Use r APPLICANT INFORMATION s (BUILDER OR HOMEOWNER) Name� ► M�fii � � +od1 Telephone Number eo"'/7 Address re r era h— License # C 1-Q C ct s'/c n Go'\, f l Home Improvement Contractor# Email r&."n Qc_,�Awok,(Off) Worker's Compensation # VRKUI13' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT //WILL BETAKEN TO a7 Ce 5 h G rM4, o,a // SIGNATURE `f�( b,� DATE �J FOR OFFICIAL USE ONLY `APPLICATION # DATE ISSUED MAP/ PARCEL NO. f ► r ADDRESS VILLAGE cl OWNERr DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL .. t GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Z_ r • r Town of Barnstable Regulatory Services ` Richard V. Scab,Director - i639. Nua Building Division. . PauI Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601.. www.town.barnstable.mans Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder t I. 46e �_tY yQ , as Owner of the subject property hereby authorize ob K Sov� d t t act on my beb4 in all matters relative to work authorized by this building permit application for. ti��7 -�4t1ry10w�11.'Ro�' (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. )Ignatune oi6wner 'Signature of Applicant t a aai A i ' Print Name Print Name , i a QYORMS:OWNERPERMISSIONPOOLS Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division tm Paul Roma,Building Commissioner MAW ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 w Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code P The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be.responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire-to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing-Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible, To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that be/she understands the responsibilities of a Supervisor. On the last page- this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 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): Shawmut Woodworking&Supply, Inc. dba Shawmut Design and Construction Address: 560 Harrison Avenue City/State/Zip: Boston, MA 02118 Phone #:' 617-622-7000 Are you an employer? Check the appropriate b Type of project(required): I.El am a employer with 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. [:] Newconstruction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. _ employees and have workers' 9. ❑Building addition [No workers'comp. insurance comp. insurance.' required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 I.El Plumbing repairs or additions myself. No workers' com right of exemption per MGL Y � P• 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: The Charter Oak Fire Insurance Company Policy#or Self-ins. Lic.#: UTRO U B 1 Ci7910721 55 Expiration Date: 11/01/2016 Job Site Address: F�hno4l City/State/Zip:`l,- tV�S�C1�b�G��` � r �2(,32 Attach a copy of the workers' compensation policy,declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a. fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si nature: QDate: October 19 2015 Phone#: 17-62 .-7114 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#: TRAVELER5 JW WORKERS COMPENSATION ONE TOWER SQUARE AND KARTFORD, CT 06183 EMPLOYERS LIABILITY POLICY TYPE V INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (VTROUB-1C79107-2-15) NJ TAX IDENTIFICATION NO. : 042759985000 RENEWAL OF (VTRKUB-109107-2-14) INSURER: THE CHARTER OAK FIRE INSURANCE COMPANY 1 NCCI CO CODE: 15318 INSURED: PRODUCER: SHAWMUT WOODWORKING &SUPPLY, AON RISK SVCS NORTHEAST INC. ONE FEDERAL ST 20TH FLR 560.HARRISON AVE BOSTON MA 02110 BOSTON MA 02118 Insured is A ,CORPORATION Other work places and identification numbers are shown in the schedule(s)attached. 2. The policy period is from 11-01-15 to 11=01-16 12:01 A.M. at the insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to.the Workers. Compensation Law of the staie(s)listed here:; AK AL AZ CA .CO CT DC DE FL GA HI ID IL IN KS KY LA MA MD ME MI MN MO NC NE NH NJ NM NV NY OK OR PA RI SC SD TN TX UT VA VT WI B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: r Bodily Injury by Accident: $ 1000000 Each Accident Bodily Injury by Disease: $ 1000000 Policy Limit Bodily Injury by Disease: $ 1000000 Each Employee C. OTHER STATES INSURANCE: Part Three of the.policy applies to the states,if any, listed here: AR IA MS MT WV s D. This policy includes these endorsements and schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE 4. The premium for this policy will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans. All required information is subject to verification and change by audit to be made ANNUALLY. a DATE OF ISSUE: 11-19-15 LP OFFICE: HARTFORD 084 PRODUCER: AON RISK SVCS NORTHEAST G9651 u f r f n i®f Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-058567 Construction Supervisor ROBERT E HUDSON 116 MARSH RD PELHAM NH 03076 Vf - Expiration: Commis sioner r 09/ _23/2017 r Builders and Shawmut Design and.Construction Construction Managers 560 Harrison Avenue Boston,Massachusetts 02118 Telephone 617.622.7000 Facsimile 617.622.7001 September 13,2016 Re: Verification of Employment for Robert Hudson To Whom It May Concern: This letter is to verify that Robert Hudson is currently employed at Shawmut Design and Construction as of June 11, 1993. Mr. Hudson is a Superintendent out of our New o.,i,p and emwoueftil England division. If you need any other information,please do not hesitate to contact meat RTougas@shawmut.com. Thank you. Sincerely, Roger Tougas Chief Financial Officer r . 4 Massachusetts Department of Environmental Protection Ll e®EP Transaction hY Here is the file you requested for your records. To retain a copy of this file you must save and/or print. 1 Username: TDIAMOND, Transaction ID: 865128 Document: AQ 06-Construction/Demolition Notification Size of File: 226.48K Status of Transaction: In Process ' Date and Time Created: 9/19/2016:8:52:05 AM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy"from the Current Submittals page. _ a r Massachusetts Department of Environmental Protection BWP AQ 06 Pre-Form ' Notification Prior to Construction or Demolition Lit n r This is a revision to an existing form. Project ID for existing form to be revised: This job is being conducted under a Blanket Permit. MassDEP assigned Blanket Authorization ID: r This job is being conducted under a Non Traditional Abatement Work Practice Permit. MassDEP assigned Non Traditional Work Practice Authorization ID: r None of the above conditions apply,generate a new form. Revised: I1/13/2013 Page 1 of.I Massachusetts Department of Environmental Protection B 100251063 Wr AQ 06 Notification Prior to Construction or Demolition Asbestos Project# f Project Revision r Project Cancellation A.Applicability A Construction or Demolition operation of an industrial,commercial,or institutional building,or residential building with 20 or more units is regulated by the Department of Environmental Protection(MassDEP), Bureau of Waste Prevention,Air Quality Division,under Regulations 310 CMR 7.09.Notification of Construction or Demolition operations is required under 310 CMR 7.09(2)ten(10)working days.prior to any work being. performed.The following information is required pursuant to 310 CMR 7.09. Is this a fee exempt notification(city,town,district,municipal housing authority,state facility,owner-occupied residential property of four units or less)? . P Yes r No 1.Blanket Permit Project Approval,if applicable: Approval ID# 2.Non-Traditional Asbestos Abatement Work Practice Approval,if applicable: Instructions: Approval ID# 1.All sections of this B. General Project Description form must be completed in order to 1.Facility Information: comply with the Department of MSPCA-CENTERVILLE 1577 FALMOUTH ROAD Environmental Name of facility Street Address Protection BARNSTABLE notification MA 023620000 5087750940 requirements of 310 City/Town State Zip Code Telephone CMR 7.09. JOE SILVA VICE PRESIDENT 2.Submit Original Facility Contact Person Facility Contact Person Title Form To:Commonwealth of 6175415176 JSILVA@MSPCA.ORG " Massachusetts Facility Contact Person Telephone Facility Contact Person Email P.O.Box 4062 Boston,MA 02211 Facility Size: 5600 1 Square Feet Number of Floors Was the facility built prior to 1980? (V—Yes r No Describe the current or prior use of the facility: , ANIMAL SHELTER Is the facility a residential facility? r Yes (:/ No If yes,how many units? 2.Facility Owner: MSPCA 350 S.HUNTINGTON Facility Owner Name Address BOSTON MA 021300000 6175227400 City/Town State Zip Code Telephone JOE SILVA 350 S.HUNTINGTON AVE 'On-Site Manager/Owner Representative Address Boston MA 02130 6175415176 City/Town State Zip Code Telephone Revised:03/17/2014 Page 1 of 3 Massachusetts Department of Environmental Protection '100251063_ BWP AQ 06 Asbestos Project#� L771 Notification Prior to Construction or Demolition f Project Revision f Project Cancellation B. General Project Description (continued) 3.General Contractor: SHAWMUT DESIGN AND CONSTRUCTION 560 HARRISON AVE Name Address BOSTON MA 021180000 6176227000 City/Town State Zip Code Telephone BOB HUDSON 6178396176 General General Contractor's On-site Manager/Foreman Telephone Statement:If asbestos is found C. General Construction or Demolition Description during a Construction or Demolition 1.Construction or demolition contractor: operation,all SHAWMUT DESIGN AND CONSTRUCTION 560 HARRISON AVE ' responsible parties must comply with 310 Contractor Name Address CMR 7.00,7.09,7.15, BOSTON MA 021180000 6176227000 and Chapter 21 E of the General Laws of City/Town State Zip Code Telephone the Commonwealth. BOB HUDSON 11783/6176 This would include, Construction and Demolition On-site Manager Telephone but would not be limited to,filing an asbestos removal 2. Licensed Contractor Supervisor: notification with the Department and/or a BOB HUDSON CS058567 notice of Supervisor Name License Number release/threat of release of a P Yes r'No hazardous 3.Is the entire facility to be demolished? substance to the Department,if 4.Describe the area(s)to be demolished: applicable. , EXISTING RESIDENTIAL HOUSE AND SHELTER. MassDEP Use Only ti Date Received 5• If this a construction project,describe the building(s)or addition(s)to be constructed: 6. Were the structure(s)surveyed for the presence of Asbestos-Containing f`Yes Ir No Material(ACM)? Who conducted,the survey? - Name Department of Labor Standards Certification Number 7.Was asbestos containing material(ACM)found? r Yes (✓No Revised:03/17/2014 Page 2 of 3 I Massachusetts Department of Environmental Protection 100251063 � _ BWP AQ 06 Notification Prior to Construction or Demolition f- Project Revision Asbestos Project# {— Project Cancellation . C. General Construction or Demolition Description (continued) The Asbestos Abatement Notification Number for this address is: This project r . Construction f✓ Demolition is: 9/29/2016 11/30/2017 Project Start Date(MM/DD/YYYY) Project End Date(MM/DD/YYYY) 8. For demolition and construction projects,indicate dust suppression techniques to be used W Seeding W Wetting f-- Covering 1— Paving r Shrouding f Other-Specify:_ 9.Is this an Emergency Demolition Operation? j Yes P/No Name of MassDEP Official who evaluated the emergency Title y Date of Authorization(MM/DD/YYYY) MassDEP Waiver Number D. Certification "I certify that I have personally NICHOLAS CASSARO examined the foregoing and am Print Name familiar with the information NICHOLAS CASSARO contained in this document and Authorized Signature all attachments and that, based PROJECT MANAGER on my inquiry of those individuals immediately Position/Title responsible for obtaining the SHAWMUT DESIGN AND CONSTRUCTION information, I believe that the Representing information is true,accurate,and 9/19/2016 complete.I am aware that there Date(MM/DD/YYYY) are significant penalties for 09/19/2016 t submitting false information, including possible fines and RE# imprisonment.The undersigned hereby states,under the penalties of perjury,that I am aware that this permit application or notification shall ' not be deemed valid unless payment of the applicable fee is made." Revised:03/17/2014 Page 3 of 3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �o� Parcel a063 Application #��/5 9e 53 Health Division Date Issued Conservation Division /lAKAJ Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village Owner _ �� Address 35 o S° h Telephone 5,0e 0/5' S2 36 Permit Request 7iyo 7,42AIX&dS Ae@. S,04 C 9— /,o R_ AU° Ty Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District `/0 Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size /- 36 19 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No . On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address License # 0-6 3 :2 Home Improvement Contractor# Email 4'7',C& /77S�O Ca ° 01!29 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. r ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. CB/OH F,q �o N FND. Ty (STq -H/py1Yq R oq O w E #7597 FALMOUTH ROAD -MAP 209 PARCEL 84 FND. 8p,P,9DEf - .04 If7617 FALMOUTH ROAD - H 199 X/ST/N EX/S 404,pq. EX..E�F 0/- h MAP 209 PARCEL 85 ENT w U/LO/N nNC Pq�-M PqENT 7 EX`GBAin "��7 — 8.555° E i CB/bH - _ i \`I PARKLNG AREA i N 6 g1' FND. I 70 HELD EX/S7jN� _ AP. FND. - SHED BU/LD/NC �� #� v E HELD - KppO 78' _ 15 N r `3 os 06 MAP 209 FENCE SHED r a o 0 6 136 a° PARCEL 83 " v - 189,840i• s. m-A 4.36j' oc. _ - ®GAZEBO (2) PROPOSED TEMPORARY �. N CONSTRUCTION TRAILERS "` N x 44 t —FNO ') m RC �CnN'� Z. RS ABU Tf SHED O'e.9126 OLD POST ROAD w w (AY191sal,— MAP 209 PARCEL 91 CB/OISK f CB/DH FND. 1FN0. - S 8875 38'E 799.18' - ZON£HO - y Cr FXF OF PA{E'M£NT ZONING SUMMARY OLD P O S T R O A D REODULED HC RC - (COUNTY LAYOUT— 40'WIDE) - CB/DISK MINIMUM LOT AREA 87,120 S.F. 43,560 S.F. Z FND, MINIMUM FRONTAGE 200'. 20' =� `SN OF Mgs�cs MIMMUM FRONT YARD 45' 20, ( ��•� O L V MINIMUM SIDE YARD - is, 10, ALAN M. MINIMUM REAR YARD 20' 10, -GRADY - MAXIMUM HEIGHT 30, 30, � ND.37732 y Notes: . MAXIMUM FLOOR AREA RATIO 0.3 NIA R p mac$ 1. OWNER: THE MASSACHUSETTS SOCIETY FOR FG]STERo THE PREVENTION OF CRUELTY TO ANIMALS 5: LOCUS DOES NOT FALL WITHIN ANY NATURAL HERITAGE and ENDANGERED SPECIES PROGRAM PROPOSED SITE PLAN 2. DEED REFERENCE: Deed Bk: 638 Pg: 9 (NHESP)AREAS OF ESTIMATED HABITATS OF RARE WILDLIFE or PRIORITY HABITATS Of RARE SPECIES. IN CENTERVILLE, MASSACHUSETTS PLAN CA E 3. PLAN REFERENCE: Plan Bk: 72 Pg: 41, 9wriPlan Bk: 216 Pg: 101 6. LOWS FALLS WTHIN THE SALTWATER ESTUARY Prepared for. 0 12 24 36 48 60 90 120 180 Plan Sk: 80 Pg: 127 PROTECTION OVERLAY DISTRICT: Plan Sk: 249 Pg: 31 IVISPIi/•.A Plan Bk: 365 Pg: 44 7. LOCUS FALLS WITHIN THE RESOURCE PROTECTION 49 HERRING POND ROAD 19 OLD SOUTH ROAD 1 inch = 60 feet Plan Bk: 363 Pg: 36 OVERLAY DISTRICT. BUZZARDS BAY,MIA 02532 NANTUCKET,NIA 02554 #1577 FALMOUTH ROAD - (tel)608.833.0070 (tel)608.325.00" MAP 209 PARCEL 83 Dme: D.— Cnearad: 4 LOWS DOES NOT FALL WITHIN ANY SPECIAL FLOOD . HAZARD ZONES. xwr �.e, (fax)508.833.2282 www.bmCkenen!"cc:n, DECEMBER 31, 2015 RMM/ERC/DLH DFB/AMG _ .� w�em..�•v��.«=vs».mod,.w..nnn ra�.0 /? ®A D (R TE. 28) (STA TE HIGHWAY LA POUT —f 80 WIDE) - -------------52-� N 663025".E 404.04' ,- v EX/SANG PAMfENT '---— �_ - I i I 4" .� d^" �e... •----- i, e ` ` CQ/ EXISTING i \ BUILDING. / ��. , tv \ •,$� `:�' � EXlSANG BUILDING \mZ i 1 \ � I r ABUTTERS / SHED FENCE woos SHE `-———— / ® ———__ AD GAZE -- ---------------'--s4 5 \ _ 52-— /// / \\ � , — /// /// /.// ` pi \\ ri \\%F,p SAS/�'97cr ^� ��1 O✓S �./i� Ivl OYVLf'T�`"' � r 1 V It ——————— so\\ ZONE 140 _— HITCH Desktop END w overhead Desktop EOs eff w/ove hea File Cabinet shelf r - CD File C bine LJ . UNIT # l e 4 31 Floor plan updated 7/1/13 sc Town of Barnstable Regulatory Services P4pFTHE rocy� Richard V.ScaIi,Director ° Building Division BARN M Tom ferry,Building Commissioner $ 1639. �� 200 Main Street, Hyannis,MA 02601 ArEDra www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: 1-5 number street >> village ..HOMEOWNER": name g home�ph'one# work phone# CURRENT MAILING ADDRESS: ------ city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEF]NITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. _ The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection proc ores and re is and �/she�will omply with said procedures and requirements. ature of Ho caner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0.Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor," Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. ' To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may caret amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 THE ra,� Town.of Barnstable -_,✓ Regulatory Services �anxM I% Richard V.Scali,Director �A 1639• �Q+ ' TEo��a Building Division Tom Perry,Building Commissioner (�✓ 200 Main Street,Hyannis,MA 02601 �7 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section. If Using A Builder I, 5,40 as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature o er Signa hcant 'E Tint Name Print Name oe Date Q:FORMS:OVdNERPERMISSIONPOOLS Ile Corr monivealth of-V assach=efts Deparamewt o,f rndustrial Accidews �_-- l3,ffrce o,f JmwshWad07ZS. 600 Washington Street Boston,CIA 02111 H 4 fl-'rvts rlrassgovIdia 'Warkers' Campensatian Insurance davit:Bmldeis/Cantractars/EIectdcians/P umbers' Applicant Infar-natian Please Print LegibIv I`a=(Bosmemuiganizationa&vi mi �S/°C09'/-1 Address: City/Sfate/ziP- ,U o,��: �A ® /3 P'lian� Are . an employer?Check the appropriate box: Type of project{required}: I am a gen�esal contractor and I 1. I am a employer with ❑ 6. ❑1'+Ieu�construction employees(full an�dfor part-timed*, have hired.the sub.-contractors 2.❑ I am a sole proprietor orpartner- listed on.the attached sheet, 7. ❑Remodeling These sub-contradors have soup and have no eaiplo��ess. S. F1 Demolition worlring forme in any capacity employees and have workers' END Uorlcerg' comp.insurance comp.insurance-19. Building addition required_] 5. ❑ We are a corporation and its 10_0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1L❑Plumbing repairs or additions myself.[No workers' camp. right of exemption per I'1+fGL 12.❑Roofrepairs• insurancereq=ed]i c.152,§1(4),and we have no �� employees-[Na workers' 13-N/ot,her "711^o0o/24�2y comp.insurance required.Z *tiny ap H antCnt cbedcsbox 91 mmst also fill cut the section beIawshmsing fl euworkeie campensafiaaporieyiafarrrtWUML ]3omemvners who Smbmit Qi17S affidae u indicating they are dniq;all vial anti then bim at�de coat maors:rm submit a new affidavit Ir alF9-sacIL Icontmctoesffittchecicthis bout mast attached au addi&nQ sheet showing the none of the stib-camtrw-tors and state whether or not those eatitieshave employees.If thesub-contractorshave employees,they imrsrKnide their=rkers'•rxrmp.policg number- lam an emplarr that is prm din it�arkers'cangw&,;atiorn irunrance-for MY employees.. Moov is the paticy and job site in formadom Insurance CompanyN"amie: • , 7 'Policy 4 or self ir1S.Lic_4: WCC 025-9/:39`09,5 apnratioaDate: Job`Sites Addtesr /5 3 9 City/Statel4p:aw'—' €, 129--0;243g�) Aftach a copy of the workers"cornpensationpolicy det -aration page(showing the policy number and expiration date). Failure to secure coverage as required.udder Section 25A of MGL c 15'7 can lead to the imposition of criminal penalties of a fine up to$1, 40 OQ andfor one-year imprisonmentas we11 as civil penalties,ine fog of a.STOPWORK ORDER and a frme of up to$250.00 a day against the-violator. Be advised that a copy of this statement May be forwarded td.the Office of Invesftgatioms of the DIAL far insurances coverage verification. I do hereby _ raatdtrr ttis piunns ndpxnnahFie ¢t jrmt �flratf is inn,f brmadon prmided abm a is true acid correct Sitaafure: Date: Phone#: 4,i: Official use arn£y. Do not avy ite in fins area,ter be co-inpFeted by city arfi?rnn officnal City or Town: PernritUcense# Issuing Authority(circle one): 1.Board of Health.2.Building Department 3.City1rown Clerk 4_.FJech ical Inspector S.Plumbing Inspector G.Other Contact Person: Phone#: formation and fastrnctions Massachusetts Gehe-al Laws chapter 152 re-�all employers to provide workers'compensation for their employees. PaMUMUttO this ,an anplayae is defined as- _.every person in the seavi.ce of another under any contract ofhire, express or implied,oral or vri tem" An e7npkyer is defined as"an individual,pmtnersb�p,association;coiporafion or oilier legal entify,or any two or more of the foregoing engaged is a Joint entL r, e,and inchtdi og the legal representafives of a deceased employer,or the receiver or trustee of an individual,parinmrship,association or other Iega1 entity,employing employees. However the owner of a.dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work.on such dwelling house or on.the groimds or building appurtenant lhcmto shall notbecanse of sash employment be deemed fin be an employer." MGL chapter 152,§25C(6)also stags that"every state or local Itemising agency shall withhold the issuance or renewal of a License or permit to operate a business or to construct b Zdings in the commonwealth for any applia;of who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL ehaptrr 152,§25C(7)states"Neither the commgawmIth nor airy of its political subdivisions shall enter into any contract for the perfarmance of public workuntl anceptable evidence of compliance with the i71mna ce.. requirements of this chapter have been presented to tiie contracting aL thozity-7 Applicants Please fill out the wormers'compensation affidavit completely,by checlQng the boxes that apply to your situation and,if necessary,supply sub-contractors)name-(s), addresses)and phone numbers) along witH their cent faca e-CS) of inm=c.o. Limited Liabilky Companies(LLC)or Li mited LiabiTty Partnerships(LLP)withno employees other than the members or partners,are not r�quiied to cant'workers' compensation ins��ce. If an LLC or LLP does have employees,a policy is required. Be advised that this a$tdayk may be submitted to the Department of Industrial Accidents for confnmaiion of fi soranoe coverage. Also be sure to sign and date the a idavit. The affidavit should be retumed to the city or town that the application for the permit or license is being requested,not the Department of r A ccid�s. Should you have any questions regarding tb e Iaw or if you ai e regma ed in obtain a workers' compensation policy,please call the Department at the numiber listed below. Self-insured companies should enter their s elf-mM�ce license number on the appropriate line. City or Town Officials Please be sore that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fDI in the permit/license number which will.be used as a reference number. In addition, as applicant that must submit multiple peImit/liceasa applications in any given year,need only submit one affidavit i odic afmg current policy i ofomation Cif necessary)and under"Job Site Ad T-css"tie applicant should wrifi�_-"all locations in (city or town)-"A copy of the-affidavit that has been officially stamped or marked by the city or town maybe provided to the ' applicant as proof that a valid affidavit is on file for future permits or licenses- A new affidavitmust be,filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venfsn-e (i_e. a dog license or permit to bum leaves eto-)said person is NOT required to complete ties affidavit: The Office of Investigations would at to thank Yuma advance for you¢cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone and fax nn ber: C�o;=:kQtWt-,�attbE of M ssaclhusztb-, Ilegartm L-nt afliidnsfdal Accid enta QMCe of Igveatg-atlo= �Q4in�tan S'frQ;tt T6L#617 -49QO Qxt 4-06 ar I-V MA.SSAFE Fax 9 617-727-7M Revised 4-24-07 snagc�gf dia I Revised Confirmation of Terms and Conditions to be Bound PREPARED FOR: Massachusetts Society for the Prevention of Cruelty to Animals 350 SOUTH HUNTINGTON AVE. BOSTON,.MA 02130 EFFECTIVE DATE & PROGRAM STRUCTURE: Worker!'Compensation WCC-Z11-258138-085 10/31/2015 to.10/31/2016, Small Deductible Employers Insurance Company of Wausau Commercial Auto AS2-Z11-258138-045 10/31/2015 to 10/31/2016 Guaranteed Cost Liberty Mutual Fire Insurance Company General Liability TB7-Z11-258138-055 10/31/2015 to 10/31/2016 Guaranteed Cost Liberty Insurance Corporation w COMMISSION: Workers Compensation $ 13,600 Commercial Auto $ 6,106 General Liability $ 12,843 PAYMENT PLAN: Workers Compensation WCC-Z11-258 1 38-085 MONTHLY 25.0%0 6 installment(s) Premium will be billed directly to the policyholder: r AS2-Z11-258138-045 MONTHLY 25.0% 6 installment(s) ,Premium will be billed directly to the policyholder. General Liability TB7-Z11-258138-055- MONTHLY 25.0%.6 installment(s) Premium will be billed directly to the policyholder. SUBMITTED BY: _ RISK STRATEGIES CO r 160 FEDERAL ST BOSTON, MA 021101700 PREPARED BY: Jenneth Janikas -Underwriter email:Jenneth.Janikas@LibertyMutual.com Brian Gunning - Territory Manager email:Brian.Gunning@LibertyMutual.com PREPARED ON: 10/27/2015 REVISED ON: 10/27/2015 Liberty Mutual, i Town of Barnstable Regulatory Services S Richard V.Scab,Director NAM . suss Building Division Tom Perry,Building Commissioner 200 Main Sheet,Hyannis,MA 02601 www.town.barnstable.ma.us Fax. 508-790-6230 office: 508-962-4038 Property Owner Must Complete and Sign This Section If Using A Builder • / ,� as Owner of the subject property hereby authorize to act on lny.bebalf, in all matters relative to:work-authorized by this buMng permit applicarion for. (Address of job) "Tool fences and alarms are the responsibIty of the applicant. Pools are not to be filled or utllized before fence is installed and all final insp 'ons are performed and accepted. ignat<,ne of owner Signs o t 7C --4 Print Name Pnnt IN 2-- Due Q.roRMs 0WNWM%MM0WMor s animal care a r c h i t e c t u r e 30 December 2015 Thomas Perry, Building Commissioner Town of Barnstable, Massachusetts MSPCA/Permit Application for Temporary Offices(Trailers) Dear Mr. Perry, We thought it would help to add some description to the attached Building Permit Application. The MSPCA finds itself in a crisis to provide space for staff with the sudden need to vacate the existing house. As there is no builder or General Contractor involved,we offer the following: 1) The attached building permit application is submitted with the Property Owner(MSPCA) as the permit applicant and ultimate permit holder. The permit is to allow two temporary office trailers on the property to house MSPCA staff in lieu of the house used by these employees until recently. 2) The MSPCA will be renting the trailers from a vendor who will set them in place. Power will be brought to the trailers by a Massachusetts licensed electrician under separate permit who will be contracted.directly by the MSPCA. One trailer will have toilet facilities that will be connected by a licensed plumber under separate permit and contracted directly by the MSPCA. 3) The trailer size and basic layout is attached with their.proposed location on the. property..The MSPCA has included their Workman's Compensation certificate. A General Contractor is riot anticipated. Thanks for your consideration of this application. Regards, Stephen Jensen,AIA Architect i SCHULZ LAW OFFICES, LLC WILLIAM CHARLES PLACE 7 PARKER ROAD OSTERVILLE, MASSACHUSETTS 02655-2034 TELEPHONE(506)428-0950 FACSIMILE(508)420-1536 ALBERT J. SCHULZ MICHAEL F. SCHULZ aschulz@schulzlawoffices.com mschulz@schulzlawoffices.com January 26, 2015 Thomas Perry Building Commissioner Town of Barnstable 200 Main Street Hyannis, MA 02601 VIA HAND DELIE VERY RE: MSPCA— 1577 Falmouth Road (Route 28), Centerville, MA 02632 Dear Mr. Perry: I am writing on behalf of my client, Massachusetts Society for the Prevention of Cruelty to Animals ("MSPCA") regarding its plan to redevelop 1577 Falmouth Road (Route 28), Centerville, Massachusetts 02632 ("Locus"). Before the MSPCA finalizes its plans and begins to move through the various departments within the Town of Barnstable, a threshold determination is whether the MSPCA is an educational non-profit exempt from zoning requirements pursuant to M.G.L. c. 40A § 3. Based on the facts that follow, I would respectfully submit that the MSPCA is an educational nonprofit corporation exempt from local zoning requirements, and accordingly request your concurrence on the same. Referred to as the Dover Amendment and codified at M.G.L. c. 40A § 3, no zoning ordinance or by law shall prohibit,regulate or restrict the use of land or structures for educational purposes on land owned or leased by a nonprofit educational corporation. See M.G.L. c. 40A § 3 (2015). There are two requirements which must be met in order to qualify for this statutory zoning exemption: (1)the land and/or structure used for the educational purposes must be owned or leased by a nonprofit educational corporation and (2)the corporation intends to use its land or structures for educational purposes. See Gardner-Athol Area Mental Health Association, Inc. et i al. v. Zoning Board of Appeals of Gardner, 401 Mass. 12, 15-16 (1987) citing Worcester County Christian Communications, Inc. v. Board of Appeals of Spencer, 22 Mass.App.Ct. 83, 87 (1986); see also Whittinsville Retirement Society, Inc. v. Town of Northbridge, 394 Mass. 757, 759-760 (1985). I. The MSPCA is the epitome of nonprofit whose purpose is based in education. The MSPCA was organized in 1868 and has been recognized by the Internal Revenue Service as a 501(c)(3) exempt organization since November 1934. See Exhibit 1. In 1987,the MSPCA filed Restated Articles of Organization with the stated purpose to provide effective means for the prevention of cruelty to animals and to provide education to the public concerning the humane treatment of animals. See Exhibit 2. From its inception to date, the MSPCA's purpose and mission of providing education of the humane treatment of animals has been carried out, which can be seen at any MSPCA center or its website (www.mspca.org). See Exhibit 3. Educational activities offered by the MSPCA include, but are not limited to: various training programs to pet owners to help them understand, control and enjoy their pets; classroom programs and tour programs at the shelter for children that focus on teaching good animal care and responsible pet ownership; through media, publications and in person aggressively teach responsible pet ownership. Simply put, the MSPCA is the epitome of a nonprofit whose purpose is based in education. II. Locus is owned by the MSPCA and used for educational purposes. With respect to Locus, the MSPCA has been the owner since 1945. See Exhibit 4. Locus is comprised approximately 4.36 acres of contiguous upland and is presently improved with two buildings. See Exhibit 5. The first building dates to at least 1945 when the MSPCA acquired the property, while the second building dates to approximately 1969 according to Town of Barnstable records. See Exhibits 5 and 6. From 1945 to present, Locus has been utilized to provide education of the humane treatment of animals and for effective prevention of cruelty to animals. The plan to redevelop of Locus includes the razing of the existing two buildings (which total about 6,000 sq. ft.) and the construction of one new building (which would total < 10,000 sq. ft.). With this increase in space at Locus, the MSPCA is specifically planning to provide better: (1) spaces for people who are either adopting an animal or bringing in an animal to speak with staff, (2) spaces for education programs such as dog training classes and behavior classes, and (3) spaces for children's programs, including a summer camp. Based on the foregoing, I submit that use of Locus by the MSPCA meets, and will continue to meet, both requirements of M.G.L. c. 40A § 3 to be exempt from zoning requirements. The MSPCA will of course continue to meet all other requirements (i.e., building, health, etc.) in redeveloping Locus, including adherence to Section 240-8(A)(3)(a) and M.G.L. c. 40A § 3 concerning the bulk and height of structures and determining yard sizes, lot area, setbacks, open space, parking and building coverage requirements. As always,please do not hesitate to contact me should you have any questions. Very truly yours, Wael F. Schu z MFS:law Enclosures 11 omas Perry, Buildi g Commissioner EXHIBIT 1 Deparhnent of the Trea ury �P I Inteona1RevenueService P.O. Box 2508 In reply refer to : 1000571575 Cincinnati OH 45201 May 09, 2014 LTR 4168C 0 04-2103597 000000 00 Input Op: 0752139620 00029080 BODC: TE MASSACHUSETTS SOCIETY FOR THE PREVENTION OF CRUELTY TO ANIMALS a 350 S HUNTINGTON AVE `- BOSTON MA 02130-4803 000062 Employer Identification Number: 04-2103597 Person to Contact : CUSTOMER SERVICE Toll Free Telephone Number: 1-877-829-5500 Dear Taxpayer : This is in response to your Apr. 30, 2014, request for information regarding your tax-exempt status. Our records indicate that you were recognized as exempt under section 501 (c) (03) of the Internal Revenue Code in a determination letter issued in NOVEMBER 1934. Our records also indicate that you are not a private foundation within the meaning of section 509(a) of the Code because you are described in section 509(a) (2) . Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. Please refer to our website www.irs.gov/eo for information regarding filing requirements . Specifically, section 6033(j) of the Code provides that failure to file an annual information return for three consecutive years results in revocation of tax-exempt status as of the filing due date of the third ret_rk for organizations required •moo file . We will publish a list of organizations whose tax-exempt status was revoked under section 6033(j) of the Code on our website beginning in early 2011 . i 1000571575 May 09, 2014 LTR 4168C 0 04-2103597 000000 00 Input Op: 0752139620 00029081 MASSACHUSETTS SOCIETY FOR THE PREVENTION OF CRUELTY TO ANIMALS 350 S HUNTINGTON AVE BOSTON MA 02130-4803 If you have any questions, please call us at the telephone number shown in the heading of this letter . Sincerely yours, J. " Kim Da Bailey Operations Manager, AM Operations 3 EXIIIBIT 2 FORM CD-180-s.7-1 2500-12/81-D907815 �j OZ Zhe (90mmonfutalth of Maganc4usetts OFFICE OF THE SECRETARY OF STATE FEDERAL IDENTIFICATION/ ONE ASHBURTON PLACE, BOSTON, MA 02108 NO 04-2103597 >t/ Michael Joseph Connolly,Secretary l REST FOE ARTICLES OF ORGANIZATION General Laws, Chapter 180, Section 7 This certificate must be submitted to the Secretary of the Commonwealth within sixty days after the date of the vote of members or stockholders adopting the restated articles of organization.The fee for filing this certificate is $30. Make check payable to the Commonwealth of Massachusetts. We• Frederick J. Davis . PresidentMdOaPdafi%algl . and Robert S. Cummings retary X*MA§ KQKrXof MASSACHUSETTS SOCIETY FOR THE PREVENTION OF CRUELTY TO ANIMALS ....... ........ ..... ................................................................................................................................................. lNeme of Corporation) located at...... ...350 South Huntington Avenue, Boston, Massachuselrt,s,,,Q � Q ............. ............... ....... ..... do hereby certify that the following restatement of the articles of organization of the corporation was duly abopted at i a meeting held on March 11, , 19 87 by vote of........8......members...............shareholders, being at least two thirds of its members legally qualified to vote in meetings of the corporation(or, in the case of a corporation having capital stock, by the holders of at least two thirds of the capital stock having the right to vote thereon): 1. The name by which the corporation shall be known is:- MASSACHUSETTS SOCIETY FOR THE PREVENTION OF CRUELTY TO ANIMALS 2. The purposes for which the corporation is formed are as follows:- To provide effective means for the prevention of cruelty to animals throughout the Commonwealth of Massachusetts and elsewhere. l.. NOTE:if provisions for which the space provided under Articles 2,3 and 4 is not sufficient additions should be set out on continuation sheets to be numbered 2A,2B,etc.Indicate under each Article where the provision is set out. Continuation sheets shall be on 81A"x I I"paper and must have a left-hand margin I inch wide'for binding. Only one side should be used. i 3. If the corporation has more than one class of members, the designation of such classes, the manner of election or appointment, the duration of membership and the qualification and rights, including voting rights, of the members of each class, are as follows:— See Attachment 2. 04. Other lawful provisions, if any, for the conduct and regulation of the business and affairs of the corporation, for its voluntary dissolution, or for limiting, defining, or regulating the powers of the corporation, or of its directors or members, or of any class of members, are as follows:— See Attachment 4. 0 If there are no provisions state "None". Attachment 2 Presently, the Society has only one class of members who are designated as Overseers and have all the powers, rights and privileges afforded to members of a corporation organized under Chapter 180 of the Massachusetts General Laws. The Board of Directors may designate such other classes of members with such relative powers rights and privileges as they, in their sole discretion, 'may from time to time determine. ATTACHMENT 4 To accomplish the purposes set forth in Paragraph 2 hereof, the Society shall have the authority to exercise all powers conferred upon corporations .formed under Chapter 180 of the Massachusetts General Laws, and in addition shall have the powers specified in paragraphs (e) , (f) , (g) , (h) , (i ) , ( j ) , (1) , (n) , (o) and (p) of Section 9 and all of the powers of Section 9A of Chapter 156B of the Massachusetts .General Laws, provided that no such power shall be exercised in a manner inconsistent with the Massachusetts General Laws and only such powers shall be exercised as are permitted to be exercised by a non-profit corporation which qualifies as a corporation described in section 501(c) ( 3) of the Internal Revenue Code of 1986, as amended (or the corresponding provision of any future United States Internal Revenue Law) . No part of the net earnings of the Society shall inure to the benefit of, or be distributable to. its members, directors, officers, or other private persons, except that the corporation shall be authorized and empowered to pay reasonable compensation for services rendered and to make payments and distributions in furtherance of the purposes set forth in paragraph 2 hereof. Upon the dissolution of the corporation, the Board .of . Directors shall, after paying or making provision for the payment of all of the liabilities of the corporation,. dispose of all of the assets of the corporation exclusively for the purpose's of the corporation in such manner, or to such organization or organizations organized- and operated exclusively for charitable, educational, religious, or scientific purposes as shall at the time qualify as an exempt organization or organizations under section 501(c) (3 ) of the Internal Revenue Code of 1986, as amended, (or the corresponding provision of any future United States Internal Revenue Law) , in such manner as the Board of Directors shall determine and in accordance with the General Laws of the Commonwealth of Massachusetts. To the fullest extent permissible under the laws of the Commonwealth of Massachusetts, as such laws •now exist or hereafter may be amended, no director shall be personally liable to the corporation or its stockholders for monetary damages for any breach of fiduciary duty as a director. The By-laws of the Society may be altered, amended or repealed by the Board of Directors in accordance with the General Laws of the Commonwealth of Massachusetts, these Articles and the By-laws of the Society. -2- • . 'We further certify that the foregoing restated articles of organization effect no amendments to the articles of organization of the corporation as heretofore amended, except amendments to the following articles ..................... ................ ..... ......... ........ .......... .............. ...... .............. .Four...(.L4.).............................................................................. (*If there are no such amendments, state "None".) =i IN WITNESS WHEREOF AND UNDER THE PENALTIES OF PERJURY, we have hereto signed our names this !l t4 day of /�LCGfG� in the year 19 C7 ................................. ... c 1 Jgyy ggi�gg ederi Davis ..................................................... . .................. .................................................BRA" Secretary Robert S. Cummings 95 THE COMMONWEALTH OF MASSACHUSETTS 1387 NAR I')' R !I' 10 RESTATED ARTICLES OF ORGANIZATION (General Laws, Chapter 180, Section 7) I 1 hereby approve the within restated articles of organization and, the filing fee in the amount of 30 having been paid, said articles are deemed to have been filed with me this f* day Of r MICHAEL JO EPH CONNOLLY Secretary of the Commonwealth State House,Boston,Mass. TO BE FILLED IN BY CORPORATION PHOTO COPY OF RESTATED ARTICLES OF ORGANIZATION TO BE SENT "'�M'Jld R. 61 UCA* TO: n..berc C G;mminnC _P.C. Peabody & Brown ...........One....Bost-on.,..P 1.a c e................................................... Boston, MA 02108 6..17'0-2 3-8.7 00..................... ........................................ .............................. .........................................................I...................... In order to assist the Corporations Division process your Restated Articles as quickly as possible, please address all documents to: Office of the Secretary of State ATT: In-put Section One Ashburton Place , Room 1717 Boston , MA 02108 Cuµy Maded o i � ?1y FORM CD-tao-9.7-1 2500•12/81•o907e15 the alIItttlttDpitlPtllfh of MgStICh1tSP $ op,W6 61LIJ FEDERAL IDENTIFICATION OFFICE OF THE SECRETARY OF STATE ONE ASHBURTON PLACE,BOSTON, MA 02108 NO 04-2103655 Michael Joseph Connolly,Secretary 4" RESTATED'ARTICLES OF ORGANIZATION r General Laws,Chapter 180,Section 7 This certificate must be submitted to the Secretary of the Commonwealth within sixty days after the date of the vote of members or stockholders adopting the restated articles of organization.The fee for filing this certificate is $30;Make check payable to the Commonwealth of Massachusetts. We. Frederick J. Davis President/Vice-President, and Robert S.-Cummings Irlerkh4sts+saterr�tVerk-o4 AMERICAN HUMANE EDUCATION SOCIETY ................................................................................................................................................................................................. (Name of Corporation) located at........350 South,Huntington Avenue, Boston, Massachusetts 02130 ........................................ .. ............................................................................................... f do hereby certify that the folowing restatement of the articles of organization of the corporation was duly adopted at TlX" a meeting held on March l l, , 1987 ,by vote of...............members...............shareholders, being at feast two thirds of its members legally qualified to vote in meetings of the corporation(or, in the case of a corporation having capital stock, by the holders of at least two thirds of the capital stock having the right to vote thereon): 1. The name by which the corporation shall be known is:- AMERICAN HUMANE EDUCATION SOCIETY 2. The purposes for which the corporation is formed are as follows:- To provide education to the public concerning the humane treatment of animals throughout the United States and elsewhere. .f NOTE:If provisions for which the space provided under Articles 2.3 and 4 is not sufficient addition&should be set out on continuation sheets to be numbered 2A,2B,etc.Indicate under each Article where the provision is set otit. Continuation sheets shall be on 8t/,2"x 11"paper and must have a left-hand margin 1 inch wide for binding. Only one side should be used. I If the corporation has more than one class of members. the designation of such classes. the manner of t election or appointment, the duration of membership and the qualification and rights, including voting rights, of the members of each class. are as follows:— See Attachment 2. .r r' 04. Other lawful provisions, if any, for the conduct and regulation of the business and affairs of the corporation, for its voluntary dissolution, or for limiting, defining, or regulating the powers of the corporation, or of its directors or members,or of any class of members.are as follows:— See Attachment 4. 0 11 there are no provisions state "None". tip Attachment 2 Presently, the Society has only one class of members who are designated as Overseers and have all the powers, rights and priveliges afforded to members of a corporation organized under Chapter 180 of the Massachusetts General Laws. The Board of Directors may designate such other classes of members with such relative powers, rights and priveliges as they, in their sole discretion, may from time to time determine. ATTACHMENT 4 To accomplish the purposes set forth in Paragraph 2 hereof, the Society shall have the authority to exercise all powers conferred upon corporations formed under Chapter 180 of the Massachusetts General Laws, and in addition shall have the powers specified in paragraphs (e) , (f) , (g) , (h) , (i) , (j ) , (1) , L (n) , (o) and (p) of Section 9 and all of the powers of Section 9A of Chapter 156B of the Massachusetts General Laws, provided that no such power shall be exercised in a manner inconsistent with the Massachusetts General Laws and only such powers shall be exercised as are permitted to be exercised by a non-profit corporation which qualifies as a corporation described in Section 501(c) ( 3) of the Internal Revenue Code of 1986, as amended (or the corresponding provision of any future United States Internal Revenue Law) . No part of the net earnings of the Society shall inure to the benefit of, or be distributable to its members, directors, officers, or other private persons, except that the corporation shall be authorized and empowered to pay reasonable compensation for services rendered and to make payments and distributions in furtherance of the purposes set forth in paragraph 2 hereof. Upon the dissolution of the corporation, the Board of Directors shall, after paying or making provision for the payment of all of the liabilities of the corporation, dispose of all of the assets of the corporation exclusively for the purposes of the corporation in such manner, or to such organization or organizations organized and operated exclusively for charitable, educational, religious, or scientific purposes as shall at the time qualify as an exempt organization or organizations under section 501(c) (3) of the Internal Revenue Code of 1986, as amended, (or the corresponding provision of any future United States Internal Revenue Law) , in such manner as the Board of Directors shall determine and in accordance with the General Laws of the Commonwealth of Massachusetts. To the fullest extent permissible under the laws of the Commonwealth of Massachusetts, as such laws now exist or hereafter may be amended, no director shall be personally liable to the corporation or its stockholders for monetary damages for any breach of fiduciary duty as a director. The By-laws of the Society may be altered, amended or repealed by the Board of Directors in accordance with the General Laws of the Commonwealth of Massachusetts, these Articles and the By-laws of the Society. -2- 'We further certify that the foregoing restated articles of organization effect no amendments to the articles of ` organization of the corporation as heretofore amended, except amendments to the following articles ..................... ...............................................I....I.......c:O.l:r.(.S.)................................................................................................................. J'If there are no such amendments. state "None".) IN WITNESS WHEREOF AND UNDER THE PENALTIES OF'PERJUR(Y. we have hereto signed our names this / t4 --�V of ����"( in the year 19 r `-g .................... President/Woe-Pwidenc F\ erick J Davis ............................... ...1. ......... ....... ....... ..t .............................................. ' LFIM Robert S: Cumming bTecretarY THE COMMONWEALTH OF MASSACHUSETTS 1387 PAR !33 ►;.1 4 RESTATED ARTICLES OF ORGANIZATION ' (General Laws, Chapter 180, Section 7) 1 hereby approve the within restated articles of , organization and, the filing fee in the amount of 3.0, do having been paid, said articles are deemed to have been filed with me this day �Bf day of % 2 � t 19�7 MICHAEL SEPH CONNOLLY Secretary of the Commoaweafth State House,Boston,Mass. TO BE FILLED IN BY CORPORATION PHOTO COPY OF RESTATED ARTICLES OF ORGANIZATION TO BE SENT '-0c_,jk6 R. G fL�c K To: Rob Peabody & Brown On•e....Bost-on....Place......................................... Boston, MA 02108 ....................(.6.1.7)... 7'23•-8-7-00..... ........................................ ..................... ................................. ........ ......................................... .. In order to assist the Corporations Division process your Restated Articles as quickly as possible, please address all documents to: ' Office of the Secretary of State ATT: In-put Section One Ashburton- Place, Room 1717 Boston, MA 02108 Copy Mailed I 1/26/2015 MSPCA Homepage nlspca angeil SEARCH LOGIN 30IN OUR COMMUNITY )(indness and Gore forAnimalse ANINDEPFNDENTORGAN17ATION FOUNDED IN 1868 t• REFILLS&PET PORTAL ALUMNI CENTER ONLINE STORE CONTACT S f." 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ACCREDtTEO , aVlt�17r�w,a]@' F�F v� IN THE NEWS Give,monthly. _ I %F CONVENIENT ANGELL aid °»�° � � APPOINTMENTS imspica° ' sua s ns Evenings MSPCA-Angell Rescues Homeless Kitten Born Revolutionary 71 Dachshunds from without Eyelids Gets Treatment Helps Westminster Home Sight-Saving Surgery Beloved Cat Bounce Dogs Settling into Organization's Angell Animal Medical Center Back from Cancer MAKE A DIFFERENCE Boston and Methuen Adoption Ophthalmology Team Gives"Phil" Angell Animal Medical Center is the FORA AL5 IN Centers,Health and Behavior a Whole New Outlook only Veterinary Hospital in New F. M�►SSACHUSEp Evaluations to Follow England with"IMRT' g i III -. r r Q FEATURED EVENT BRAVO ANGELL9 "DOG' NG Spin for Animals Tobi Lou Saved by Angell y Play, Join us on Saturday,February 21st Dog Lands in the Animal Emergency Obedience,oa1kr,''i' to spin for the animals at Nevins Room after Devouring Spice Cabinetena rticre-, S ' Farm.Check out participating gyms, Contents join a team,and create your own fundraising webpage! I rMIM A` ©2014 The MSPCA-Angell I Home I Tell A Friend I Jobs I Webs�ite Feedback I Privacy The Mission of the Massachusetts Society for the Prevenaon of Crusty to Animals-Angell Animal Medical Center is to protect animals,relieve their suffering,advance their health and welfare,prevent cruelty and work for a just and compassionate society.©2014 MSPCA-Angell http:/Avww.mspra.org/ 1/1 1/26J2015 Programs&Resources MS C® af1E'll ]OIN OUR COMMUNITY SEARCH LOGIN Kindness and Care(arAwmake AN INDEKNOENrORGANMArrON FOUNDED IN 1868 : ' REFILLS&PET PORTAL ALUMNI CENTER ONLINE STORE CONTACT 11! Home>Programs&Resources> Programs&Resources Print ShareThis PROGRAMS & RESOURCES Programs&Resources trinenii in W am 240,EmergencySe vrvic The MSPCA-Angell provides direct hands-on care to a wide variety of animals 1AinaniExottc Medldne Cruelty Prevention through our adoption center,hospital and animal protection programs.Through . .n ¢ e` [7ermatology ' - ----- -- --- these programs for people of all ages,we promote respell and kindness nationally - InternatMedicine and international) man effort to create better lives for people and animals. �Animal Protection$ Y p p _. Cardiology Legislation �€Q - - — ------ -- Additionally,the MSPCA-Angell serves as a resource for communities within the Surgery --- Commonwealth and beyond our borders.Our programs,including Pets in Housing, Dog Training Pet Care Assistance and Dog Training,have helped to keep families and their pets —- --- __ .— _—_.____ together over the years. Equine Safety&Ambulance ANGELL&OF KINDNESS Please view the navigation choices on the left to learn more about all the Spay/Neuter P Programs the MSPCA-Angell offers. Y Wrt Boston Spay/Neuter Clinic aa�ctHa7d:. —- --- ---------- Cat Campaign ` -- - - —- --- -—-------— -- Give monthly; Humane Education -- — -------- — ------—.-- CONVENIENT ANGELL Pet Care Assistance APPOINTMENTS — - - --- —--- -------------------- Pet Owner Resources Saturdays Sundays ` ---—------— - Evenings Wildlife Resources M ���---- - — —----------------------- Hillside Acre Animal Cemetery fiAKE A OW€FERENC€ 4� FOR M] IN To Report ■ - 2 Cali MSPCA Law En4mment � {aott}� al saga DOG TRAINING I tIft ��`#UtipyPlayiN Click to bra more -: Gii dlla ca,ASQ€ - - - -- - Pius more ©2014 The MSPCA-Angell I Home I Tell A Friend I lobs I_W_ebsite Feedback I Privacy The Mission of the Massachusetts Society for the Prevention of Cruelty to Animals-Angell Animal Medical Center is to protect animals,relieve their suffering,advance their health and welfare,prevent cruelty and work for a just and compassionate society.©2012 MSPCA-Angell http:/ANww.mspca.orgtprograms/ 1/1 EXHIBIT 4 f Northerly by land now cr formerly of one Denson I.ninety-seven and 5/10 (97.5) feet, more or less; 638¢ Easterly by land now or formerly of one Loveland two hundred seven and 3/10 (207.3) feet more or less. 8 . Containing an area of seventeen thousand seven hundred sixty (17,7eO) square feet more or less. For my title see deed of A. Adelaide Bahrenburg to Anna X. Vose, of even date, to be recorded herewith in the Barnstable County Regis- try of Deeds. ;he,'above sescrib�d• premise.s are conveyed upon the following re- strict_ens imposed.�or<• the benefit of the Grantor, her heirs, and assigns, and binding upon the Grantee, her heirs and assigns; (� No building., erected, placed or maintained on said land shall be d .use; for an;; purpose other than those of a private residence or private 0 -arage, and, in no event as a hotel or boarding house' and any dwelling 0 house erected, placed or maintained on the granted premises shall not be designed or adapted for use by more than one family. : _............__._........_................_._...................................:.................._........._..............__.............._.......................... _ 7QlCX�I99SC . ........._ ........._...... ........_.._.__ ............_.._....-- �y�wrspyttYt.Sd�dl"�i6�E@Y'.�aKt�,�{�'itid :aTi��tkrYixclaSSrx �G3ft7fd��' a t� Uttq6....._my._............Snnd and seal this.__ _�..................day ofIIQ.V.Qr,b.PT.____......_.........___19 45 --Kay • �lpt lIInnatnatttnrul� of �x�t�lpceat!ffi - ........................._..........,. Theapersonally appeared the above named..Ar a...h....._Moze._......._......_........_.. .:. t c;._ ........_..._..._..... ...._.......... ........ ....... an owQYee O'thb foregoing instrument to be.....k?e.F.._._.._-free as a deed,before me i r ?� G of m—Ta&NrX7ri7�E�.3aE ' ?'y :�•5,.> yr Commissio xpire 42 Barnstable, ss., Reoelved December 5, 1945, and is recorded. lop,1W `?."1L:fd�._M?., )__S? .R)1.:y...._..-_.--_-......._........_... _..._.._..._ .. ..__ -arnsta:�le Centerville _ of _.3._ _.__.__.. ..1._...._,_..._.._..._-..__)_.__... .—......_._�arr:,$t_a'21 eCotutty,Massachusetts, being q6w.r;ed,for consideration aid rani to_.: �e,,,_r;as sa c;z•.yet s r paid,g ...._..... ..C._� _tr�[_..L'4.... e..�ZEYent�on to _rir..a3�._.a._::.✓lssac� e .�s_...90 ?4rBti,2il�.hlr. �. 'v a�a� gc� setts- tnarrutttg rocrtraats �f the land inaaic _-arnstut;._e..,.(dent-erville_).,.._to_et:�,Er^a,it.n._tiAe o..tiir r_^s 038 t: erec r bounded s described as folio is _....._..._..._._...._a... _._...._ ....._.._ .._._.... _ _..._.._ _..._ _.._......_.__ ..._ - tDeseriDtioa and ea.u.br c.,if aoy] 10 i�e.-inn' • at.tne So•:taeast Corner of ca'le ,-ranted. �rer^ises at a Stone bound at the County :load an,: at land of J. John J Pendergast; thence r.L '_.::- So'utl 750 1�' 1. 47" `:lest by said County ;Road nine hun,;red tvrelve and 56/1J:: (912.50) feet 'to a store bound; thence runra-r:- South.3 o 30, Lr7� ; est still by said County :Road one hurclrer, secs^teen and 51/1JO (117.51) feet to land of T. ':;alter ;n.nrie; thence rune n7 ':orth L;_30 11' S1" ..est by lancl of ss.ici ':;ar_nie fear an 1,1/lJJ (:';..17) feet to 1f:rd of Lila ;•:crttrick Heirs; thence running :orth 1.!60 1,1' OJ" East by lards of said 3'.;cyttricic 1=sirs, C:1oe 1.ar..hlir, tti_:. Joseo}1 ]r:c:;air thro::;^'r. six (o} iron i-es to a ce:::ent bound at t'�e State Hiryhway- thence r*,ir�-. .:;;- .:orth u60 301 2r1'( Last by said State iii�'rt°ray four hundred three Lind 35/1Uo (Lc.—351 feet to'a eerient bound at land of Join J. Pcnder;ast- j thence run: '_n,- South "00 31' 50" Last by land of sa_.d Pender,,ast t::o hund-red fi_t,r-five and 28/130 (255.20) feet to the ,stone bound at the County woad, it bein7 the point of beginning. . $�s,��ss�x�nce�ltixxX3�xxXXxS�ixZ�4� . ^ortion o= t::e ?rer i ses conveyed to tie by Charles.C. r � �'�, r. �V � `'� dated SE`)l:C:'i:.%er 1?'th l_t?1.;� recorded with Barnstable � _ocre._ b, ..ee • amount., e2_str�r. oiy)eeds r. roc:: 365, _a>e�69• For a more pE:.rl:. w1E_ .:escriot_on of t,e crantec t:reniCa3, reference :jade to :1^r. entItIcd of ;and in Ocntervilie, -.3ar,:st ie a ie_c s _:, tc _._c olcry, scale l inch T 7e :ce•,. I-ollo , Civil I„s, Co tervi?lc, :..ass." to l� he husband ..............................,r_.5_:...................................................r,......._._..._...._...__......_................._..._.....,.._........_..._._ xgj= of said grantor, - t . a nor.......... release to said grantee all rights of n�a�ncy bey the cu�rtery and other interests therein. � yt Riftarals......o.:kL_.••_hand 6 and seal this._.__.-__..-_.s OZ jfi......._...._..._day of_.___._:,:_..:._..._...__J_L1].;Z..........._19 L5• ......_.........._ ....................... '- — -- Tip TVIn=a=aIt4 of 9410 artiusrtts i '.all _st&L... .................._. ss. ..........................._.._._.._......... -_..._19 ,r• o 0 l� Then personally appeared the above named......................_...._.._.... r.':1: ._..':_olOnY...._....... ___.._._— .__.__... l l � and acknowledged the foregoing instrument to be..........h. .X.....__.free act and deed,before me al/7 � Notary Pnblio X�Yd&Y.Df,7th7($nYrX Barnstable, so., Reoeived'Deoember 5, 1945, .and is .recorded. Ak-am �I EXHIBIT 5 L N. W E - LOW 19 D/ p S R T E. Z 8 J LOCUS MAP cA e,=zom2 FALMOUTH ROAD ( LdP..9PARCELs, . Lsrn rr McxrAYurour-eo'IRD[) „� L fDsrWc / ---.•• A0m m<s 5 q R.rM r®xnj°" ®uLmD - ®iRV ' , lay sxrt �C � 54yi9N ttav etaisAm.` S - 03AB MAP 209 •_ PARCEL 83 d 0,A p R_ riRb. 2w • (um x[.sa.Mre rAar[cmw OwwAr anacl FIP�S l' _ nQ�$� fJ 1 L«W SHDMN AS PARCEL 93.ON ASSESSORS MAP 209 P n ;U .. O'-D (c0 2. OMnEE MASSACNUSET1s SGOETr FOR THE PaX xO w - PREVENTION OF CRUELTv TO ANIMALS Pa6 Ac - ' - J. GEED REF:DEED Bk 630/9 1 , ®?� - - . PLAN REFERENCES: PLAN Bk. PLAN Bk.2161101 . PLAN M.80/29 - PLAN Bk.249/31 PLAN Bk..1/44 PLAN Bk.363/W _ _ � r� �i� .. ZONING REWIREMFNTS 20 SF LOT ID- 5 PLAN OF LAND RD ARO SETBACK 20' Y Hf� .wa,se0 s.F. ,N i..lmv BARNSTASLEA MASS. MLM Ra :.2� ONNfD BY v MR "ar ",1) BAeRsrAB E P ARAZYB B°""° THE MASSACHUSETTS SOCIETY I—M 101 MD�N._..._...........:..10a APPR°YAL LANCER AT.ALBD,W9DW RONT.um v At...................a mvn9a uw v°r vcpa9La FOR. THE PREI/ENT/ON OF CRUELTY TO ANIMALS ,IIE RELYS,£RS Q�BfIIIS LY•!)ff LgBIOVNEAL)//O' SVBDMS/ON OF LAND FROM , - PLAN BOOK 72 PACE,41 e_ PREPARED BY - - - BRACKEN ENGINEERING, /NC. GRAPHIC SCALE 49 HERRING POND ROAD IBC BUZZARDS BAY, MA 025J2 " • (CB/bN FND.)CONGRER BOUND MTI DRILL ROLE FOUND (SB/LR END.)STONE BWND MIN DRILL ROLE—ND AW BE,Lm an l,[Y/AS 10 COIbUAB(£. lb, /5O8I 83J- MI£ R7,D E55QYAL LnAO R49w— O (I.P.iND.)IRON PIPE E0UN0 - 1 IocB 40 tt - NAS BEDl YABF AP/N>t IXD,B 3 X:�SOB�833-2282 282 ABBI£Bmmmmvr SCALE.- 1'-40' APR/L 25.20IJ EXHIBIT 6 4� I j '9 T F iw n. 5 L l O . 1 es _ L a L m ioo.63 fAca Ho _ w p 2 1 p, 1, _ To dyarisrn�e r 1 r FLAN OF.LAND IN E CENTRVILLE,&giVFTA8[2,MASS- ' arr;�rer mTay BYLGN61 To 1 T;.BLIi AN N I E M OLONY or l».e1n OEC-51915 Sine llrxw�40 fr..�Jucr 6.1945. /(.nffnA..m � - B.�ne.'Ka�.occ.Gv�.L:6¢s. .J:7CDRDN:D...J r Initial Construction Control Document To be submitted with the building permit application by a d Registered Design Professional A for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: MSPCA-CAPE COD ANIMAL CARE AND ADOPTION CENTER Date: 30 MAY 2017 Property Address: 15771FALMOUTH RD.,CENTREVILLE,MA 02632 r r Project: Check one or both as applicable: N(New construction ❑ Existing Construction Project description: NEW CONSTRUCTION OF A 12,700 SQUARE FOOT FULL SERVICE ANIMAL SHELTER WITH ANIMAL HOLDING AND ADOPTION SPACES, In House Veterinary clinic,masonry construction with full fire protection,future demolition of the current and existing animal shelter. I Stephen Jensen MA Registration Number: AR 9020 Expiration date: 31 August 2017 , am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Architectural [ ] Structural [ ] Mechanical Fire Protection [ ] Electrical [ ] Other for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 21 Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a `Final Construction Control Document'. SEiFD.AROh, Enter in the space to the right a"wet"or ����000Gcgs rFc� electronic signature and seal: �� t w No.9020 N 3`m BEVERLY i!_ MA q4 Y OF,wP G� Phone number: 978-232-0326 Email: sj@blueskyarch.com. Building Official Use Only Building Official Name:, Permit No.: Date: Version 06 11 2013 , Initial Construction Control Document Z To be submitted with the building permit application by a s Registered Design Professional for work per the 8th edition of the s" Massachusetts,State Building Code, 780 CMR, Section 107 Project Title: MSPCA-CAPE COD ANIMAL CARE AND ADOPTION CENTER Date: 30 MAY 2017 Property Address: 1577 FALMOUTH RD.,CENTREVILLE,MA 02632 Project: Check one or both as applicable: VNew construction ❑ Existing Construction Project description: NEW CONSTRUCTION OF A 12,700 SQUARE FOOT FULL SERVICE ANIMAL SHELTER WITH ANIMAL HOLDING AND ADOPTION SPACES, In House Veterinary clinic,masonry construction with full fire protection,future demolition of the current and existing animal shelter. I Catherine A.Faucher,PE MA Registration Number: 39057 Expiration date: 0&30-2018 am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Architectural [ Structural [ ] Mechanical Fire Protection { Electrical [ ] Other for the above named project and that to the best of my knowledge,information,and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review,for conformance to this code and the design concept,shop drawings,samples and othe i submittals by the contractor in accordance with tl�e requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work,I shall submit to the building:official a `Final Construction Control Doc OF r, E sst Enter in the space to the right a"wet''or o�� CATHERINE A. electronic signature and seal: FAUCHER ELECTRICAL 3 Phone number: 207.221.2260 X106 Email: cfaucher@allied-eng.com NAL 4N�� Building Official Use Only Building Official Name: Permit No.: Date: Version 06 11 2013 i j Initial Construction Control Document To be submitted with the building permit application by a - Registered Design Professional for work per the 8th edition of the V Massachusetts State Building Code,780 CMR, Section 107 Project Title: MSPCA-CAPE;COD ANIMAL CARE AND ADOPTION CENTER Date: 30,MAY 2017 Property Address: 1577 FALMOUTH RD.,CENTREVILLE,MA 02632 Project: Check one or both as applicable: N(New construction Q Existing Construction Project description: NEW CONSTRUCTION OF A 12,700 SQUARE FOOT FULL SERVICE ANIMAL SHELTER WITH ANIMAL HOLDING AND ADOPTION SPACES, In House Veterinary clinic,masonry construction with full fire protection,future demolition of the current and existing animal shelter. I Ian A.MacDonald,PE MA Registration Number: 40N4 Expiration date: 06-30-201e am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Architectural [ ] Structural J/Mechanical Fire Protection [ ] Electrical j ] Other for the above named project and that to the best of my knowledge,information,and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Revi w,for conformance to this code and the design concept,shop dpwings,samples and other submittals by the contractor in accordance with the requirements of the 0ristruction'documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a`Final Construction Control Doc +�a�e rArt��` Enter in the space to the right a"wet'or LAN A. electronic signature and seal: M ►ICAL 44 207.221.2260 X114 imacdonald allied�n com `Phone number: Email: G g. Building Official Use Only Building Official Name: Permit No.: Date: Version 061.12013 Initial Construction Control Document IL To be submitted with the building permit application by a d Registered Design Professional for work per the 81h edition of the Massachusetts State Building Code, 780 CMR,�Section 107 Project Title: MSPCA-CAPE COD ANIMAL CARE AND ADOPTION CENTER• Date: 30 MAY 2017 Property.Address: 1577.FALMOLITH RD.,CENTREVILLE,MA 02632 Y _ N w M Project Check one or both as applicable: N(New construction' ❑ Existing Construction' Project description. NEW CONSTRUCTION OF A.12,700 SQUARE FOOT FULL SERVICE ANIMAL SHELTER WITH ANIMAL HOLDING AND ADOPTION SPACES, In House Veterinary clinic,masonry construction with full fire protection,future demolition of the current and existing animal shelter. I William P.Faucher,PE,SECB MA Registration Number: 37528 Expiration date: 06-30-2018 ,am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, . computations and specifications concerning: Architectural Structural [ ] Mechanical Fire Protection [ ]' Electrical' [ .].Other for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State.Building Code, (780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction'site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable1 3. Be present at intervals appropriate to the stage of construction to become generally familiar'.with the progress and quality of the work and to determine if the work is.being performed in,a manner consistent with the approved ` construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 1.07. When required by ffie building official,I shall submit f eld/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official: Upon completion of the work,I shall submit to the building official a `Final.Construction Control.Document'.. Enter in the space to the right a"wet",orWILUAM r• � electronic signature and seal: FAY - A € Pf0 t Phone number: 207.221.226o X107 Email: wfaucher@allied-eng.com Building Official U§e Only Building Official Name: y Permit No.: Date: Version 06 11 2013 �ZHETQ,,y - Town of BarnstableSTASM r a Building Department-200 Main Street e Hyannis, MA 02601 p . Tel. (508) 862-4038 4 s Temporary Certificate Of Occupancy Permit Number: B-17-1495 CO Issue Date: 8/30/2018 Parcel ID: 209-083 Zoning Classification: SPLIT Location: 1577 FALMOUTH ROAD/RTE 28, CENTERVILLE Proposed Use: Permit Type: Building- New Construction - Commercial General.Contractor: MOSES M CORDEIRO , Comments: 30 DAY TEMPORARY CO FOR SITE WORK. Septic permit 2016-405. approved for temp c/o. . 8/30/2018 Building Official - Date: MSPCA(Cont.) -3- 5-2016-0553 The Grantee(s)are responsible for assuring that all work associated with this Permit involving pressure washing, pumping,or any other activity causing water to accumulate in the roadway,is closely monitored to avoid icing conditions during the winter season. If necessary,the Grantee(s)will be required to address the issue by spreading salt or other de-icing materials at their expense. If MassDOT is required to respond to an icing condition as a result of the work performed,the Grantee(s)will be billed for all costs incurred by MassDOT, Highway Division to correct this safety issue. The Grantee(s)will be responsible for the clearing of ice and snow on the State Road(s)where work is performed within the project limits. The roadways shall be reasonably maintained(plowed and chemically treated),to insure safe travel and avoid any conflict with MassDOT Snow and Ice Operations. PROPOSED SIDEWALK RECONSTRUCTION I The Grantee(s)shall construct the sidewalk with granite curbing as shown on the plans. To install the granite curbing,the roadway shall be sawcut in neat,true lines. The granite curbing shall be installed according to MassDOT,Highway Division standards..All abutting edges of the existing pavement shall be coated with RS-1 emulsion immediately prior to the placement of the permanent hot mix asphalt. The proposed sidewalk must be graded in such a manner that no ponding of water occurs within the, Highway Layout. If such ponding results,the Grantee(s)shall be responsible for its correction. The Grantee(s)will install concrete wheelchair ramps in conformance with the Architectural Access Board Regulations within all sidewalk areas included in this project. The Grantee(s)shall be responsible for the maintenance and repair of the portion of the proposed sidewalk located within the State Highway Layout and shall routinely inspect the sidewalk for deficiencies such as settling,heaving,cracks etc. This responsibility shall remain in effect until MassDOT,Highway Division reconstructs the sidewalk. The Grantee(s)must contact the appropriate utility company to remove and reset any utility pole(s),hydrants or any other item located within the proposed sidewalk area. The Grantee(s)may be required to pay the utility company for all cost associated with relocating said items. TR%4E RESTRICTIONS AND NOTIFICATIONS ' DUE TO HEAVY SUMMER TRAFFIC,NO,WORK SHALL BE PERFORMED ON THIS PROJECT BETWEEN MEMORIAL DAY WEEKEND AND LABOR DAY WEEKEND WITHOUT PRIOR APPROVAL FROM THE DISTRICT HIGHWAY DIRECTOR. No work shall be performed in the hardened surface of the roadway between November 15th and April 1 st of any year without prior written approval from the District Highway Director. No pavement shall be laid between November 15th and April 1st of any year without prior written approval from the District Highway Director. No work shall be performed on this project on Saturdays, Sundays,and Holidays,or on the Friday after a Thursday Holiday. Work is also restricted on the day before and the day after a long Holiday weekend without prior written approval by the District Highway Director. N. CB/17H N FND. Fiq / tilpvT O . W E Zz / �ST,q h/GyK,q V1597 FALMOUTH ROAD FND. FN Cq ypUT_ O. MAP 209 PARCEL 84 BO' '46„61 �- .04 2 V #1617 FALMOUTH ROAD 199 e MAP 209 PARCEL 85 EX/'SnNG F„gME .I• A OD S/�ctIENT EX. ORAI�EL 68.56'S0 E FND.OH (`; / .`i PARKING AREA N •-�0 81 HELD a, I.P. FND. SHED BU/,0//(/G' i "o E HELD K, �8. o v 3'O8�8 MAP 209 -- pp° FENCE / D N 6 136'40 SHED PARCEL 83 i o� i 189,840E S.f. N �• \ 4.36E ac. `. ® GAZER N o o ------ cr o a -A --- --------------- ------- t., �z (3) PROPOSED TEMPORARY �EhO . vA' CONSTRUCTION TRAILERS o cam, ZO,yE �,c` o o Afro (10' x 44') GALS- ABUTTERS t,a OTECT/pN O�fRz p ;�Gi� � ! SHED 126 OLD POST ROAD MAP 209 PARCEL 91 CB/DISK CB/DH _ .. FND. \FND. S 8875:38"E 799.48' EX. EDGE OF PAVEMENT ZONE HO ZONMG SUMMARY 01 D. P O S T ROAD REQUIRED HO RC (COUNTY LA POUT — 40' WIDE) CB/D/SK MINIMUM LOT AREA 87,120 S.F. 43,560 S.F.: £ FND. MINIMUM FRONTAGE 200, 20' y MINIMUM FRONT YARD 45' 20' MINIMUM SIDE YARD is, 10' MINIMUM REAR YARD 201 . 101 ' MAXIMUM HEIGHT 30' 30' - Notes: MAXIMUM FLOOR AREA RATIO 0.3 N/A 1. OWNER: .. THE MASSACHUSETTS SOCIETY FOR THE PREVENTION OF CRUELTY TO ANIMALS 5. LOCUS DOES NOT FALL WITHIN ANY NATURAL PLAN SCALE . HERITAGE and ENDANGERED SPECIES PROGRAM an PROPOSED SITE PLAN 1AMW0 12 24 36 48 60 90 ' 120 180 WILDUFE or PRIORITY HABITATS OF RARE SPECIES. �IRAXAJ&JUN- IN CENTERVILLE, MASSACHUSETTS 3. PLAN REFERENCE: Plan Bk: 72 Pg: 41 _Prepared for: Plan Bk. 80, Pg: 127 6. LOCUS FALLS WITHIN THE SALTWATER ESTUARY ' � _ _. ;.; 1 inch 60 feet Plan Bk: 216 Pg: 101 PROTECTION OVERLAY DISTRICT. Plan Bk: 249 Pg: 31 49 HERRING POND ROAD 19 OLD SOUTH ROAD MSPCA Plan Bk: 365 Pg: 44 . 7. LOCUS FALLS WITHIN THE RESOURCE PROTECTION Revised: Plan Bk: 363 Pg: 36 OVERLAY DISTRICT. BUZZARDS BAY, MA 02532 NANTUCKET, MA 02554 #1577 FALMOUTH ROAD MARCH 2, 2016 (tel) 508.833.0070 (tel) 508.325.0044 MAP 209 PARCEL 8.3 Date: Drawn: Checked: 4. LOCUS DOES NOT FALL WITHIN`ANY SPECIAL FLOOD (fax)508.833.2282 www.brackeneng.com DECEMBER 31, 2015 RMM/ERC/DLH DFB/AM HAZARD ZONES. G 5:\Autocad Drawings\8ornstable\Falmouth Road\1577 Falmouth Rood\1577 Falmouth Road—Site Plan(trallers).dwg j, Y O COPYRIGHT 2016 R E USE OR REPRODUCTION OF THE CONTENTS OF THIS PAGE 15 NOT PERMITTED WITHOUT WRITTEN PERMISSION FROM BLUE SKY ANIMAL CARE ARCHITECTURE BUILDING KEY/LOCUS 1 FALM0UTH ROAD ( RTE. 28 ) I CONSULTANT 777 T EXISTING SHELTER TO BE RAZED AFTER -—-—-—-—---—-— , e - a COMPLETION OF NEW BUILDING N Ag --- �\ EXISTING HOUSE TO BE RAZED 6 ° ♦$ -- „{o _—_°"�s' ♦\• _ /i `pC1 I L ,DOGS •,.5� `\ /,/• /"/'/°S,, I ' I (OF.F LEASH) $ ♦\, Blue Sky \ I \ ♦\ animal care architecture �Y - .. Stephen Jensen � s� // t - -a o \ ♦\♦\ � J \ ° Streetashington t 2 �\ °, _� Werly DOG.'. Beverly,MA 01915 978 232 0326 �- - phone / -- _ ' ' blues rc com ._._- .- � www / sr-- .t / ' BUILDING o `. FOOTPRINT' �y: —y=-'"�- ' APPROXIMATE SA.S. / • d � / PER RECORD AS-BUILT - Cape 44 4¢1. / / ky Q, ZONEH� Animal Care ando D L .Zo�R- ,_- .' Adoption Center / , 49 ° M' r�-�`' '� 1577 Falmouth Road Centerville,MA .'%i j•, -/, _ °a - -— o— APPROXIMATE ZONING LINE—— — — ✓;',- -� SCALE: 1° =30' - --- DATE ISSUE ZONE HO— — — — — — — — — — —— — — — 7/21/16 DESIGN DEVELOPMENT _ 8 R ♦\'� ^(ALSO RESOURCE PROTECTION OVERLAY DISTRICT) 1♦� e` ', - m - ♦\ $♦ ARCHITECTURAL 4�6 SITE PLAN j N w E A003 PRINTED D 30' 60' 6 7/21/16,12:05 PM - ?f 1 O COPYRIGHT 2016 I REUSE OR REPRODUCTION OF THE CONTENTS OF THIS PAGE IS NOT PERMITTED WITHOUT WRITTEN PERMISSION FROM SLUE SKY ANIMAL CARE ARCHITECTURE 1 10 T T A201 � 6 4 3 1 BUILDING KEY/LOCUS 1 A300 _-�4 I._._._.-._._ .......................... CATS l CATS 3 3 I I a I 2 Fl-4-81 BREAK ---/ 735 �\ T CAT RECEIVING T I SUPPORT 2 3 132 / � CONSULTANT 2 147 R I I I I / 2 3 2 503 \ CAT 3 I 150 3 UTILITY _—_—_ _—_—_— —_—_—_—___ ..I.. _—_— ' —_3 -_— __133 _ _�_—_—_—_—_— / HALL 134,' 3 2 I 17 3 3 3 __ 136 AR 2 2 157 I % rH I i I ;I DENTAL RECOVERY ( 7 T. 2 ;{ 7 i 7 55 2 i s6 11 12 1 5 14 2 8 e 8 I c-- 2 HALL 2 9 ENNELS2 K NNE L 1 S02 i PACK 111 I 14L 2 BEHAVIOR 19 130 10 129 13 _ G I 1 &0 A301 :I i i IS LAB 156 ION -- A301 I/ O�S•(�J \I ;i 2 TREATMENT 2 ILj 9 8 N i 2 I 2 2 -- 2 OFFICE FOOD PREP 2 I 1 9 BAT 2 9 SURGERY I 143 R 2 142 18 9 127 HALL 9 153 3 __— 2 _ —_ —_ __ 126_ 17 —_ — '—// 8.8 Blue Sky �- 4 - z- 2 LAB ,-�--,I 1 OUIET —— DO�ADOFTION — �— � i l I LAUNDRY 9 1z1 6 animal care architecture ----------- Y WARD SMALL 12 \J 3 3 1 2 ANIMALS 5B 1 3 —3 —_ 137 ' 12 12 B B 12 8 I Stephen Jensen \ 3 IOUIET I STORAGE I \ 1 E 14 TA HOLDING 3 9 . 124 RM I Layl 7 Washington Street,Suite 2 164 CLASSROOM —'—'— 134 — - - 10 8 Beverly,MA01915 Azoo I 62 i — — _ — — — 2 z ! I phone 978•232•0326 19 1 I CLINIC LOBBY 9 QUIET e 8 12 I i 3 19 I M e Azol www.blueskyarch.com161 R 3123 3 ADOPTION" TAK ' 8 \ I 760 1 I COUNSELING 2 12 I 2 —I 3 \. — — 2 L----- 103 9 300 I I E 2 9 766 7 �.— I A300 J.__.\ I 3 TRAININGB 3 3 2 MSPCA- Cape Cod i EDUCATION FOLDING WALL 163 \ \� 2 V S;ZBOULE 2d• UPPORT 9 /� O\ I Animal Care and 3 STACKED \'--• 4 '—'- -_.J. -/ /// 4 122 2 �! 1,Q SPRINKLER I 4 , Adoption.Center 167 _ _ _ _ _ _ _ _ _ ___ ___ ___ __ _ 1 MAIN LOBBY I-----' 4 2 WORKSPACE ' 101 I RECEPTION 2 10fi I 1577 Falmouth Road i 3 3 - FFOOLLDING WALL IN 2 I I 104 i Centerville,MA ADOPTION �p _ _ ___—_—_—_—_—_—_—_—_—_— _ _— _—_ I LOBBY OFFICE 2 2 2 — SCALE: 1/8" = 1'-0" I 1 2 2 2 Q I I 102 705 OFFICE OFFICE I i I 2 2 107 2 z 109 i DATE ISSUE KITCHEN ENTRANCIE I OFFICE Q� I 1fi5 TOILETI 2 LET 100 i i 4 108 1,Q Mens. Women ' _ •_I E e i 1 4 4 4 I____ ..___--________________________----___ _ —_ _ _ _ _ _ _ M1� ,NI MFl-'ZI M131 4 2 2 SMALL / I I I ANIMALS ' I I 2 3 119 I I I I 4 2 CAT ADOPTIO 2 R 110 3 I . —G 4 —_—_—_—_—_r _ . U 19 TI I \ I 1 I 3 COLONY 2 71-141 1 --._._._.�._._._._._._._._. ._._._._._.-'-'-'- A2DD I— 11-7 I I MAIN LEVEL 1 I I I i i I 3 _Az - 4 2 3 FLOOR PLAN _ A300 j i I 1 PORCH KITTENS G.A. 3 5000 \ 110 116 115 Q \ J 5- --- --j- - --- - - --- - - -- --- - - - - - - - j- - _- _---_ _.- - -.-.-.-.-._._.- - -1- o A 100 T w E 1 1 PRINTED 8/3/36,9:14 AM 10 9 8 7 A200 6 5 A300 2 1 N j " >=ront Elevation Left evasion _ NE OR 1 2 PI _ WOOD PRODUCTS .. SCALE: 1/4 1'-0 PINEHARBOR.COM -� 1 80 8 SHED 0 36 259 Queen Anne Road Harwich, MA 02645 - _ 10/-12 Pitch . a P: cso8) 43o zsoo barns@pineharbor.com f• (508)430 1115 _ . •: ENGIN EER'S STAMP • L PROJECT•14-0 - 10 ----�'. 10' x 14- Quivett - x . CLIENT• i n R . .ht : Elevation _ Rear Ele . o. . g I . SCALE:'1/4 1'70' SCALE 1/4 l` 0 • r r - PHONE: • .. E-MAIL: • ADDRESS OF PROPOSED WORK: i . l REVISION DATE: DRAWN BY: NOTES: GB - Scale., 1 0 Unless otherwise noted , AlPage , I . - HANDICAPPED RE51]TVED PARKING SIGN lPARKING SIGN FOR HANDICAPPED PA RKING SUMMARY SYMBOL LEGEND 23 _ HANDICAP .. .- IN P 12'.16- - .. - .. ST.TII MARY RC REQUIRED �..PROPOSED ZONDVG"SUMMARY" EUCE TariwPRovmEo BaepncEs _ HO.(HIGHWAY OFFtCE) A pe[§8I�21 CI�Mlt .E: . �7NlUM IATARFJL REDUIItID HP HANDICAPPED SKEN C AD .. 1 87,1208F. C9.9608F.' - 198WSF..- ' VY`>r - .. - .. .. .- I .. MIENm••I[IM ERONEXCE ,aw,. _ LS - LANDSCAPED AM .1 ACE 404L - 20' - - - ". .. _ TVTAL PAFx=SP "-SS .. 18• - "PA' - - ,--N« ICC INEECRAL CONCRETE CO!® - : -- - IVIIHMMMBEY . _ ..". ARD 1S' 10 8T" PCC PRECAST CONCRETE . -VAN AO�IE• - ,'vAN .. MAMMUM HEIGHT. 30'' -- 9V 2898' CCB CAPECODBERM ACES . MN..ACCESS®LE SPACES REOITBIBD=9 (ABN.of 1 VANACCES®I�' Cie [—6 .1. 6•—I-'6'-1-g'=1-=8'-:1 _ _ - _ .eA.c- -. (11) ACCESSIBLE�SPAACE - _ - .. .. TS TRANSMONs1� - .. METAL POST MR81MUId FLOOR AREA RATIO 0.9 N/A. 0.07 . NOTE: '. - ." - `M' - .. .FES FLUSH EDGE SmEWAi$ STEEL POST. GRADE TO BE 28 MA)OMUM IN ANY DIRECTION ACROSS "' .. .. .. .. .- ' - 6`0 MOLL. .HANDICAP STALLS AND LOADING AREAS. ".. :• > .. WSL 12•wiDEWHITESTOPUNE WOOD POST,t UAM RAM HANDICAP PARKING DETA]I,, � OIA..STEELPIPE .. .,• I=TO seALe .. -. - - W TIER tf MA,NM .F.A -" .. - - PENCE . NOIE'BElOW. i'i 0 REIAII7INc wOWd. _ MO U L. . � A- NANDICAPRAL>P , aios• a ` �Oq ss PRGPo9�s1oP fficN-. pJer cAtAF-00M ROAD. .. - . .. .. ,,,.,`. ^ ., 'R#. PROEO9ED PEDEMMM LIGHT POLE... 0.12'IN ebsx. SIGN. of, .• NOR;-SON LAYOUT,OMDR SYMBOL AID IETIEAMo F t A1NNQ1 c - - 9NL ff STAIDMB.. pen FALAMIN RQAO ":.. . -_4 ♦ - -'S2" .. - /A1,. HANDICAP PARTING SIGN NOT d. ,..,E a as zs - N fit' 9 pI, _ / �i "�` a�^.•M A'a` �- - . . C W E 4` - .. I F JY u- ARwili.vum - �' 2F J "YM.ZW P°6tJ A1YIX/!R � ? - A1PCE(BP "'e'er- ttNc• -I / . = - .. YAP IY19 PARNZZ 6X'� - •'Nb / �\ 'F �(/r�, - .. MAP 209 PARCEL 83 4.J6t oc: _ '.ao P"r ROAD - - IUAN .. YAP 1P➢ PARQL'9! �. •.. � ., .. - .. .. � - .. Xa I•: �. v - .` _. . , . a aYr a rAtDEA• SAw AV, . . PQS �' '. B - r �«raFJ /Q � PLAN 'SCALE, O'L SO D 1 Euce 90 reeL l PRECAST Of KEN CONCRETE CURS $@ BRAG EN k NO7ES .. .. TOP.000RSE. .. Fl/Rs)1 GRADE Ca B TRUNCJQD DOPES. �, .. 1.. .THE MAIOYUM BE.I.BiF 90E IN •AND WRfI RMIP gi055 .. - tl 1@RMIO ID ROAD ..tY OLD SOUTH.ROAD @A AT WALKWAY TO _At.) .. - SLOPES SHALL BE'1.ST(1:Oi YD/.). .. .. • .. .. _ BA9E COURSE - BE�ARDe BAY,MA SSW ..NAMNCKET.MA ete31' .(jZ0 .. ROADWAY RAMP - .. .2 THE MANMUM ALLOW SLOPE DF ACCESSIBLE ROUTE "J•81T.CONC..PAVEMENT - .. v - EXCLUDING CURB RAMPS SMALL BE A .- - (MDPW SPEC, TYPE I-1" .. : - .. - .. 0M1 SIMMILW/0 (yq Q09.226.DNA. - �,' 'J. .THE MAMMUM ALLOWABLE SLOPE OF AOLESSIDLE ROUTE CURB _ - - .. PLACED N TWO LAYERS. - *4 W023TJ76S WY btl�ptWm RAMPS.SHALL BE B.J3IL, 2 _ ,. _. .. SEE IAYYT AND ZX - 1 1/2-TOP..1 1�2•'61NOER). . Z N..'A MINIMUN DISTANCE OF J'CLEAR'SHALL BE MAINTAINED AT ANY .. PWI FOR M`IH OF Y .- .PERMANENT OBSTACLE NI i11E ACCESSIBLE ROUTE(I.E.OYDRANTS." SOEWAUt d. .B• 18' - .. . z@99 b - `. - UTILITY POLES;TREE WELLS.sr,M ET0). °o°NC - :- N07ES. s . . 2A' LAYOUT and ZONING PLAN if E AY :. 1'UP.MAX S. W�1REA71¢NT VARIES,SEE PW15 fOR CURB TYPE: I- 1:)"W_NTRAC70R. .. .. - .. ''C .. . Z8 @W .. y . pY SEE NOTE P. 6.'DAMP,PREVENT AND ADJACENT PAVENENIS SMAl1:8E GRADED TO _ - W,W MFN NEETTA T .. - .. SNWLDER - IN CENTERVIL.r� MASSACHUSETTS "•1E ,p 7. MIWL S WALK licCT10.V FOR RAMP CONSTRUCTION. e-..IS• '• AL' .. .• INSPECT SUBBASE ;_;I2•WEMINC COURSE - PIBPOr60 GOf: 'Itl AREA Rm -�° .. _. .& MIERE.ACCESSIBLE ROUTES.ARE LESS THAN W IN WIDTH -.. .. PPoOR TD:" - _ /Y BINDER COURSE - - yy "(EO(CWDINC WRBINCYA S'•S'PASSNr AREA SHALL,BE /p INSTALLING I�.SPUA Z B - SURFACE .: ..FRONDED AT INTERVALS NOT.TO EXCEED 2W. .. .. .. �� l��/SU,B6�./+ \..��.' PAVEMENT BASE CEMENT CONCRETE COYPACTEO BASE CWRSE .. ��NN t, x g$ 9. ELIMINATE CURBNO AT RAMP:WHEE.IT ABUTS ROADWAY.EYCEPT .. - _- Y WNPACIiD NxAv¢W `• - 'COURSE' .. -Sli80RADE '-' W1577 .FALMOUTH ROAD - - u yyQ@ B1 _ WHERE VERTICAL WRRNG.IS INDICATE ON THE DRAWING TO BE WUSIRD smw(M..) - - - +. . INSTALLED AND SET FLUSH. - .. 10 GRAVEL BASE COARSE ik .. TO IS�BE YT,� - MAP.209 PARCEL 83 ' m. 10.. DETECTABLE WARNINGS SHALL CONTRAST NAIALLY AND A_UOIBLY _ .-(MDPW SPEC.M1.03.0 GRAVEL -AFTER BASE AND/ 2'GRAVEL . y - p-P PRaWo[WARS. AT 2V QQ OWN.) -� R� :. �., OR BINDER COURSE BASE CWRSE �9 e °. .. .. .. .. r CONTR0.:DIIl9 AT S.0.G DEL) SY� i WITH A0.101MNO SURFACE& VOL BORROW OR RECWME BASE COL' •- ... . vsm• ar G HANDICAP RAMP.DETAILTRUNC0U!D WINES TRUNCIGED DOMES SUBGRADE (PUN wM !CWTOSCALS _ _. PAVEIYIENT SECTION a a/3D T aoEAse N.a' arl ( INTEGRAL SIDEWALK<CURB DETAIL 6 : - NOTTOSCAI.E. "NOTTO,sGATE. .. - - .. 1 9/27/Ie - 1SM MR RUSE CUCONSTRUCTION OroVn: ChedM:'Sh2 o .. -.. . PRECAST.CONCRETB CURB _ NOTTOSCN8 CAPE COD BERM NarroBCAia, . _ .. SEPTEYBER 1,2N6 RYM/PRC W OFE/APO 2 or A 1� I - .. ISSUED FOR CONSTRUCTION . _ f PROJECT NOTES: 7o rw row of BARNsrA&f. PARKING SUM AARY ZONING SUMMARY SYMBOL LEGEND 1. LOCUS: #1577 FALMOUTH ROAD 7 C£RRFN*A r 7NE s7RUC7UREs AND f TOTAL PROVIDED=fig SPACES ASSEESSORS'MAP:209-PARCEL.83 /I/PROWAOV75 SNOMV ARE ACCURATE AND ( HO v R},uOHWAY-OFFICE) RC(RESIDENCE C) 04 GONG BOUND/D1EW.HOLE POUND 2. OWNER: TED:MA89ACHUS1:17B SOCIETY POIt'1'FfE ARE:SHE R£SML r OF AN ON 7N£GROUND I ADA PARKING SUMMARY RBQUTRm S7/RIEr.` REGLIII3En EXISTING _ 43.660 S.F. 189.890 SF. DOUBLE CATCH HABII4 PREVENTION OF CRUELTY TO ANIMALS �D � per§621 CMR 29.2.1 MEIDMUM LOT AREA 87,1208:F. EXISTING 80' 404.04' • E)tIETmo SINGLE CATCH BASIN 380 HUNTINCTON AVENUE 1N vi kts � ' MINIMUM FRONTAGE -200' 20'. BB't BOSTON,MA02130 Vic' REOUQiID: MINIMUM FRONT YARD 45' /a AIAf4 AJ TOTAL PARSING SPACES=62 M@EMUMSMEYARD Is, 3. DEED REFERENCE.- Deed BIC 838-Pg B GRADY_ hm.ACCESSIBLE SPACES REQUISED=3 REAR 8T3 ® EBLS'71NG DRAIN MANHOLE MRW0IUM:41 MAXIMUMHEIGHT 30' Plan k 818 Pg:101 eR QaIIf7.of 1 VANACCEBSBE.q 4. PLAN REFERENCE:PIen Sk 72 Pg L0'YARD My 8B't ..20' 20.88 B ' ® EXISTING ELECTRIC MADB{oLE Plaii Bic BD Pg:107• t(+ PROVIDED: MAXIMUM FLOOR AREA RA'RO• 04 N/A 0.07 Plea Bic 244)Pg 31 - (3)ACCESSIBLE SPACES TOTAL ® EXISTING 8Fd7TC COVERS Plari Bic 386 Pg.44 (1)VAN ACCESSIBLE SPACE' Plan Bk,383 Pg:36 ALAN CRAOr,'AS - EXISTING DRAINLINE S. ZONING DEMCtS: 'HO(EI[GFIWAY OFFICE) pd EXISTING WATER VALVE RC FENCE C) - AQUIFER PROTECTION OVERLAY DISTRICT EXISTING HYDRANT SALTWATER ES7UARYPROTEC ION - OVERLXYDISTRICT 8. SEAMNC'SYSTEM: MASS COORDINATE SYSTEM _ ,----�— — EXISTING WATER LINE ' - - I�L EXISTING UTILITY POLE 7. VERT[CAL DATUM: N.A.V,D.88 S. ALL EXSTING UTILITIES SHALL BE VERIFIED FOR SERVICE.SITE. - / ERI87'B•IC CUT POLE MVERTELEVATIOMLOCATTONS, ETC.MORTONEW - 1 R T E 2 8l 310 CONNECTIONS OR RELOCATION OF SAME.CONTRACTOR MUST u R O A D . —M ___o EXISTING GUY WIRE NOTIFY DIC-SAFE AANY N1-68"44-7233 AT LEM 72 HOURS PRIOR TO VGG- C L A,T O u T r7 I �W Wes.. -OHM EWS'pB4G OVERIIBAD WEtE4 9. ,LOCUS RI NOT LOCATED INANYSPECIAL FLOOD HAZARD ZONES 339+00 TY� INYLAWU7/1749_8p•NOFJ ;g777,t.At ,AAyT ab& .5C' � ' .. AS INDICATED ON COMMUNITY PANEL NUMBER 28001C-OSBI) and 28001C-0882-I.HAVING AN EFFECTIVE DATE OF JULY,18,2014. (S R - .PA✓.6.P�' tR pd- E7fL8'1'RTC CAS VALVE .. 341+00 - kEV7ICAL OPANI E ..014V P " - EXISTING CHAIN-LII48 FENCE IO.,LOCUSDMtED SP CIBE PROGRHINAM MMHESTHENATURAREASOF EM94GE LURE(vG C) ENDANGEREDBPE WILDLIFE LORRY AREAS OFF A7A'l'BD 91E BETE ND - O7AVY A0O7 .. EBISTING STOCKADE PENCE HABITATS OF RARE tNEDLUE OR PRIORTPY HABITATS OF RARE TOP C 4."(-BOUND r - - a.=sa.4s(r4aM>eR) aaaa' SPECIES; (payY yKY80fR -EA PAkD 9D£Rall' - G EXIBTINO LIGHT POST N ASVD'aJ`E It. LOCUS DOES NOT FALL WITHIN KNOWN IWPA;ZONE E.ACEC —, . H-CAP I HP EXIMWO HANDICAP PASSING SIGN AND/OR OlNft BASED UPON REVIEW OF THE MASSACHUSEITB - RAMP ffIYNESS GEOGRAPHIC INFORMATION SYSTEM. _ L1v/bN A N_CA/,) ^ 9GN `° EXISTING TREE /ND. RAMP y !:l + BREAK IN CURB TYPE {L ORA/N MANIOMC �0 All _ Mo-Sa7 INV.W-47.0 A � WV.AV-46.9 At 'N �. ,'N .:NV..OI/rn 46.B � s /l577 rALMOUN ROAD p MAP 209 PARCEL 62 4; ;s., PIS97FALMOUtH ROAD E b �M EA7s7U4G PA4£6/ MAP 209 L•� MAP x9 PARLL2 B! £ - CAF (G B' GR/VEWAY .., � 7-P�fOST PARCEL 8J i i t Q1 l89,8401-s f Ly 9� m w 1� % � c� s 4.J5t oc. W E - t / CAMP RASA + i / / o RIM-sae ---_ Z xtLL O•e'�AA 1 1 f j ay.our a7o y ! L DR® cauaLE j7rs7rP d car+�esos b C RW AM�a'_ cO, wLic CA�SA SIN } t Nv o/ m 47a1 y\_ ' (y / MY.out=47.6 �� /NV.(X/J e 487 y`j, O'"'!" ,1T' BADE R0L7,f0 4(. A? :.'' 1 + tt ^aYC• 0_ `S A917 FALMa/IN ROAD �,� INPEAN� ){t J jpt � ,^•-''+. � / MAP 109-PARCEL 8.1 T # cNA/N uax —,1 / 11rC FENCE l I 53w I ELECIhyC� l f /..:. MAAW04F, T19) l r T/C (\ T\ SRWNj yi 42 6ti I,o "2d'i,� h{'c STATUE / \ Hv WV-467 OUMPSlFR 1 d 10' •:;� ,1 PAO p/ .`F�g SF +NV OUT e64 CC.Q O. BXcAROS •' v QaG.. # CAS `'® O/Smlovr v mANSPa4MER A/E7270 / ' L�5 QPY COKC BL� BOX `J r 6,Ga7 CAL RIP PAP / L SEPDC TANK {{ D i- SWMA'J / "S7LS4MlvA MRFA'D SECRON ,,,,,,,. •�^_"'"'^"" �� RE�neN // /NY.a 4d8w � „s, ,w.•..w+A^^' mm pQ R .�...,_�... WPAKE C_,.,. A $: A77RGsvA 1 tOP a es 53 / -� D w CA R 6 LArmsmc0 ROrnwFL.=as7�/ O E P6 7�MP4�L AD N 7420�E f your 40 Prepared By. 0 Yrr 49)4FMG POND Roan N oto sour"Aoao BUZZAM&1�70W MU NAIU9 60!]320.000OP7Q19 nooYXe R Eo L (fax)eoaa34s2ss w,ne.L an eaeaB4A m MAP x9 PARCC,91 FlNAL. AS—BUILT IN CENTERMLLE, MASSACHUSETTS rc Y �� Prepared For: rfi MSPCA zI gz ��� - ##1577 FALMOUTH ROAD aV MAP 209 PARCEL 83 Qg PLAN SCALE 2 7'- 4 30. 45 60 DO - t:E 1 faah m.30 teat S,,tt No. Date ,RaNei?n.Dewptka oe<.. ocroBER 10.7At8 REDA2 /8D chedvex snaea uu oFe/auc 1 a 1 d CB/DH r N FND. BUILDING DEPT. (srq ti iQ OCT 2 4 2016 W E # Z,4 _�Q �'QI�N OF BARNSTABLE 1597 FALMOUTH ROAD Cg y/c .47' - • D MAP 209 PARCEL 84 FND. r B0 61.ph 146 85 a? e 2 J v 01617 FALMOUTH ROAD 199' ¢04 04• E,r EDG e MAP 209 PARCEL 85 ��N EX/S77Nc Pq�iE,y/E -Y g1'fOP�Pfti/FNT ye NT K' p" E % t, `\ EX. GRA kEL CB/OH 6 FND. iT / ,\—F—T PARK/NG AREA N ' -�p•81 HELD INC --- ' \ /.P. FND. SHED BU/zD/�{/(,l -" ,; i . HELD `y Z �\ 1$ �. o .p$'ps MAP 209 _ 63 p N E 4 _ SHED � t 36. PARCEL 83 r 15, N�, OD 189,840E s.f. 6; _.....::.... :....::.......... GA4.36E cc. - ------------ ----- -- -- (..:3.. ) PROPOSED TEMPORARY 1, CONSTRUCTION TRAILERS'E�C am o�o (10' x 44') �o�c,a lESOUPC CT/-C L/NE �S`�GFo� ABUTTERS #126 OLD POST ROAD O �/A SHED MAP 209 PARCEL 91 CB%DISK CB/DH FND. 1 FND. - I S 887538"E 799.48" EX. EDGE OF PA DEMENT ZONE HO ZONMG SUMMARY O L D_ POST R O A D REQUIRED HO RC (COUNTY LA YOUT — 40' WIDE) CB D/SK MINIMUM LOT AREA 87,120 S.F. •43,560 S.F. FND. MINIMUM FRONTAGE _ 200' 20' MINIMUM FRONT YARD 45' 20' MINMIUM SIDE YARD 151, 10' t MINIMUM REAR YARD 20' 10' , MAXIMUM HEIGHT 30' 30' Notes: MAXIMUM FLOOR AREA RATIO 0.3 N/A 1. OWNER: THE MASSACHUSETTS SOCIETY FOR THE PREVENTION OF CRUELTY TO ANIMALS 5. LOCUS DOES NOT FALL WITHIN ANY NATURAL PROPOSED SITE PLAN PLAN SCALE 2• DEED REFERENCE: Deed Bk: 638 Pg: g HERITAGE and ENDANGERED SPECIES PROGRAM AAACKEN (NHESP)DUPE AREAS OF ESTIMATED HABITATS OF RARE MASSACHUSETTS o 12 24 36 48 .60 90 120 180 WILDLIFE or PRIORITY HABITATS OF RARE SPECIES. IN CENTERVILLE, - 3. PLAN REFERENCE: Plan Bk:_ 72 Pg: 41 ..v 'EAS+v. a3Y�{- �•`, !Mie+}+n4-,.ve4if' t Prepared for: j `� '" Plan Bk. 8 • 127 6. LOCUS FALLS WITHIN THE SALTWATER ESTUARY ENGINEERING, INC Plan Bk:. 26 P g: 101 PROTECTION OVERLAY DISTRICT. 1 inch = 60 feet Plan Bk: 219 Pg: 31 49 HERRING POND ROAD 19 OLD SOUTH ROAD M S P C A Revised: Plan Bk: 365 Pg: 44 7. LOCUS FALLS WITHIN THE RESOURCE PROTECTION ^ BUZZARDS BAY, MA 02532 NANTUCKET, MA 02554 •- 1577 FALMOUTH ROAD Plan Bk: 363 • # MARCH 2, 2016 - Pg: 36 OVERLAY DISTRICT. I (tel) 508.833.0070 (tel) 508.325.0044 MAP 209 PARCEL 83 Date: prawn: Checked: 4. LOCUS DOES NOT FALL WITHIN ANY SPECIAL FLOOD (fax)508.833.2282 www.brackeneng.com DECEMBER 31, 2015 RMM/ERC/DLH DFB/AMG HAZARD ZONES. 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B _::::.:.:::..........._..._.............- ::::...:.:: _ d O .. :,::::c�:x��.asp:_�:�:�:�;:- :: :::_::.__:::::._�;a�;::�x�::�:nsr....:_ : :.-�:.:::_::.::: \ S ti _ ...::.:...... ........_.:::-. .....::::.. SWIIA 1 DOGS OFF D \ LEASH AREA -As APPR O � -- / - •J :.:..:.:................ E nc' zv OU/TC!'PROTEC/7 SON/NG O A i Y S 3 O 0 RAIN GARDEN WIAA � EXISTING F O ABSORPTION SYSTEM >` S1NdA 2 v MAP 209 \ - PARCEL 83 189,840E s.f. 4.36E oc. Ell CKE VEHICLE TURNING ANALYSIS LEGEND NIN BOURNE, MASSACHUSETTS WHEELBASE PATH IVPrepared for: _ PLAN SCALE M S P C A 120 — — — LIMIT OF VEHICLE OVERHANG 80 0 8 16 24 32 40 60 49 HERRING POND ROAD 19 OLD SOUTH ROAD VEffNO[ VEHICLE .� BUZZARDS BAY, MA 02532 NANTUCKET, MA 02554 #1577 FALM OU TH ROAD (tel) 508.833.0070 (tel) 508.325.0044 MAP 209 PARCELS 83 Fawn: Checkei: 1 inch = 40 feet r�SEPTEMBER (fax)508-833.2282 - www.brackeneng.com 1, 2016 RMM/ERC/DLH DFB/AMG. S:\Aulocad Drawings\Barnstable\Falmouth Rood\1577 Falmouth Raad\1577 Falmouth Road—LZ.dwg .�