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HomeMy WebLinkAbout1600 FALMOUTH ROAD/RTE 28 (18) � I mil ` 76 , 1P. 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TOWN OF BARNSTABLE BUILD jtNG RM T APPLICATION Map Parc-V - V/ 1 rAk4 Application # _I j19 el, Health Division oZ v" to Issued +L Conservation Division .. PL.�/t4pplication Fee Planning Dept. �6. Permit Fee ' Date Definitive Plan Approved by PI��Pq Board Historic - OKH — Preservation/ Hyannis Project Street Address / -Okk- k At V1V11 7 ` Village ✓��/I2 1�1. Owner '�� JA ('_RQ 1q04^, Address Telephone �(J� Permit Request enwl_ ~ b -t' Square feet: 1 st floor: existing 8p roposed �2nd floor: existing--proposed—- Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type l 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: 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 1C C� 1� � ��V License # G'.3 6���J�1 t Al f I/ 04-6ol Home Improvement Contractor# �6 ySo1 l Email S 2 Worker's Compensation # F ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE=% Dorb DATE .�-oZ 4 ppp- FOR OFFICIAL USE ONLY .J APPLICATION# DATE ISSUED MAP PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION � t FRAME INSULATION FIREPLACE t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. the Commornvealth of-Massachusetts _Massachusetts Deparment-af r4dustrial Accidents ©ffl-ce of1mw igations. 600 Washutgion Street , y Raston,?AMA 92111 nl.�rvau nra-,mgov/dia Yorkers' Cumpensatia><n Insurance Affidavit:Bgilder/Contractors/EIectricians/Phunbers APPEcant Infarmatinu ` Flease Print LeU'h �an1e�Susinessfl�rgauiza4ionlln�dnal} -�Q214�L�� �iGt()f�C[Gl . Address: /D!z a r o`tra City/State./ c► ' Phono w. S-D Are you an employer? eckthe appropriate box: Type of project(required),- I am a general contractor and I 6. ❑New construction I.El I am a employer with 4. ❑ employees(fish andfor part-time)-* have hired the sub coaitractors 2.14 I am a sole propnetar orpartner listed au the attached sheet~ 7. ❑Remodeling ship and have no employees - These sub-contactors have g_ ❑Demolition wort ing far me in any capacity employees and have hookers' [Noorl=s'comp.insurance, comp.imuranre. 9. ❑Building additio>r v,- reqcred_ 5. ❑ We are a corP oration and its 111❑Electrical repairs cr additions 3.❑ I am a homeovamer doing all work officers have exercised their 11.0 Plumbiag repairs or additions see€ o workers' >iht of exemption per MGL �' � �F- 12.❑Roof repairs insurance required-]o c.152, §1M andwe have no employees.(No worlrem' 13.❑Other comp.insurance required.) •Any W1iCMVdastChedsbax P1 Bmst also fillootthe sectionbelowshawiag tbei vulkeas'compeasatioupeucybrFo Siam ' #Fiameaauners also submit dais af5davu indiraimg they eie dais 81l W�and then hoe antside CoatlHCtarS Ilmst submit a new affiderft indicaitiag sm fCalatxctors 11=cbe,ck this boa must attached sac aAditiooal sbeet shoving the axone of the sub-cis and state whether or not tbose eraddes hsre e=ployees.Ifthesub-cm taactnssbaue employees,theymustpasauide their workers'camp.paHU number. lane art erripi �r tlerrt ispratztiirag workers'corrrperasrdiart irtsuratace for asry*cnuplo}}ees petoty is floe policy curd job situ irformrrlion a � ,. Insurance Company Name: Policy 4 or Self-ins.Lic. F_xpiration Bate: Job Site Address: City/StateIMP: Attach a copy of the workers"compensationpolicy declaration page•(showing the policy number and expiration date). Failure to secure coverage as required.under Se-ctiba 25A o€MGL c 15 can lead to the imposition of criminal penalties of a fine up to$1,50D.OD anWor one-year imprisonmeui,as well as ci-vil penalties in the form of a STOP WORK OPDER and a line of up to$250-00 a day against the violator. Be ad.,,dsed that a copy of this statement maybe forwarded to the Office of laavestigations ofthe DIA for insurance coverage vefficahoa Ida hereby cettiAKRhdrr the pains andpenaNes afpeditq fliattlte infotmadvapmvW aboi a is true arnd correct Sizaature: Date: Phone ik Ojgldd ass only. Do rtvt write in this area,to be crrnspleted by tdty ortoirn ofj dad , City or'?Eomu• PerugitlLitense Issuing A.ntlwrity(drde one): L Board of Health 13 BuMing Department 3.CiiytTown Clem 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phene#: -Information and Instruefions ' h f�sacbusetfs General Laws chapter'152 requires all employers Yn provide workers'compensation for their employees. �pto this sf�e,an�layee is defined as."_.every person.in$ae service of another under any contract ofhire, =press or implied,oral or wriftcrL" An ezr�vlayer is defined as'can.individual,partnership,association,corporaion or Other Iegal entity,or any two or more of the:foregoing engaged is a joint entoi j e,and including the legal represen afives of a deceased employer,or the receiver or trastee of a a individual,partnership,association or other Iegal entity,employing employees. However the owner of a.dwelling house having not more than tbree apartments and who resides therein,or the occupant of the - dwaIling house of another who employs persons to do maTntm ce,construction or repair work.on such dwelling house: or on thie grounds or building appurtenar¢thcmfx)sh0notbecanse of such employmentbe deemedto be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold ffie issuance or renewal of a ficen e,or permit to operate a business or to construct buildings in the commonwealth for any applicant':who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152,§25C(7)states-Neither the commonwealth nor ray ofits political subdivisions shall enter into any contract for th,permmi ance 0fpubhc work until acceptable evidence of compliance with the ins. ran ce. ter have been presented to the confracting authoity." recpurenients of dais chap A-ppliranfs ' Please fill out the worker'compensation affidavit completely,by cherkirig the boxes that apply to your sitnation and,if necessary,supply sob-contactors)name(s), address(es)and phone numbers) along with their crsiifrcafe(s)of hmrr,nce. Limited Liability Companies(LLC)or LimitedLiabi-ay Partraerships.(LLP)With no employees other than the mertibers or parfners,are not required to carry workers' compensation insurance- If an LLC or LLP does have employees,a policy is requited- Be advised that this affidayitmaybe subm;tt--d to the Department of Industrial Accidents for confamaiion of fiISUraI1ce coverage: Also be sure to sign and date the affidavit The affidavit should be retomed to the city or town that the application fur the permit or license is being requested,not the Department of a1dristiial A ccide:nts. Should you have any questions regarding tha lave or if you arm required to obtain a workers' compeasationpoliey,please call the Deparment at the nirmber listed below. S(--lf-insured companies should enter their s elf-h sT-ance license number on the appropriate line. City or Town Officials Please be sore that the affidavitis complete andprartedlegiibly. The Depaitrarnt has provided a space at.the bottom of the affidavit for you to fill out in.the event the Office of Investigaf%ons has to contact you regarding the agpIicant Pleas e be sine to fill in the pen it/licrose number which will be used as a reference number. In addition,an applicant that must submit multiple perr itllicense applications in any given year,need only submit one affidavit indicating current p olicy, m inforation.(if necessary)and under".lob Site Address"tie applicant should write"all Iocaticas in (may or town)-"A copy of the-affidavit that has been officially stamped or marked by the city or town may be provided to the ' applicant as proofthat a valid affidavit is on file for fatare.PM=#s or licenses A new affidavit must be,filled of t Each year.Whew a home owner or citizen is obtaining a license or permit not related ffl any business or commercial 4entaffe (i e,. a dog license or permit to bum leaves etr.)said person is NOT required to complete this affidavit 'Ihe Office of Investigafrons would Iike to bank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call- The Departments address,telephone and fax mmmber: �a�Gnw�th of Massach�lts ' Department of hidustcial Accidents Office Of kVe9ULMti0)3.,1� ��4Qn BQsto-n,MA 02111 ' Te1..'617 T27-49W'=t4fl6 or 1-977 IL &SAFE Fax 9 617-727 7M IKevised 4-24-07 WW . 1 THE t' EARNSMULE, Town of Barnstable QED MA't� Regulatory Services Richard V. Scalii Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnsta b le.m a.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section: If Using A Builder I, hvl �c �G t2({,f't , as Owner of the subject property hereby authorize TT�i'D)Orw✓an to act on ray behalf, in all matters relative to work authorized by this building permit application for: u�14 (Address of Job) Sityztape of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPFMES\FORMS\ ading.permit forms\EXPRESS.doc Revised 040215 J rina'Wd s action Control Document ;l?f 11 lTo.pe s bmittedtat completion of construction b a a - ... p1 J p y Registered Design Professional for work per the 8th edition of the tIVhusetts-Tate Building Code, 780 CMR, Section 107 Project Title: �-L 0MLL MA(L.ftl sgoW)ZVed Date: Permit No. !4A Property Address: bELL• TjgWFIZ HPrJ L I,600 6ALMe-17H 2D. , 6&J7ERV►LLE YAK DZ�32— Project: Check one or both as applicable: 0 New construction ❑Existing Construction Project description: OV oN5 0 — E 1 yTl N4 NI GlA L 5 i2 y4 l; 45 A- —4I4b�W M41901,15 .t IA^ 144. LJ VPf_ ^I6LA) 01hPLA !. �S�—L L.1.1nNG. -2EwoI2K �i►,JILI► ) o 1 1�^of?�t;, 1 12o(LVV6. NI cl+0L-AEr-F MA Registration Number: 6Co2Z— Expiration date: , am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [/rchitectural [ J Structural [ ] Mechanical [ ] Fire Protection [ ] Electrical [ ] Other: for the above named project, 1,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 o t'k5m C. ity regarding the provisions of 780 CMR 107. '(V QF ��NICy0 Enter in the space to the right a"wet"or o o No.6622,T N electronic signature and seal: 3 B05TON, D MA h �J • \\ ��`�glTN Of M*SS�� Phone number:65'o 9 +Z 0 Email: 200VE 6►JI CA-O-A EFf. &.&4 Building Official Use Only Building Official Name: Permit No.: Date: Version 06112013 _ .Y _ r1 A6O L DATE(MMDD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE 2/1/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Melanie Begley NAME: g y The Fair Insurance Agency Inc. PHCN E. xt: (508)775-3131 A'� No:(508)790-1677 619 Main Street E-MAIL melanie@thefaira en 'com ADDRESS: g Suite 1 INSURERS AFFORDING COVERAGE NAIC# Centerville MA 02632 INSURER AAIM 26158 INSURED INSURER B Frank Donovan INSURER C: 104 Carlotta Ave INSURER D: INSURER E: Hyannis MA 02601 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1510701109 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. IPOLICY EXP LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM DDPOLICY EFF MM DD//YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JECTPRO ❑ LOC PRODUCTS-COMP/OP AGG $ PRO- OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? N/A A (Mandatory in NH) VWC10060199012015A 3/12/2015 3/12/2016 E.L.DISEASE-EA EMPLOYE $ '500 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Jackie Stewart/FAIMT1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 1NS025(201401) Massachusetts -Department of Public Safety Board of Building Regulations and Standards construciiuii Supervisor License: CS-091391 ^ FRANK DONOVA14 104 Carlotta Avenue Hyannis MA 02601 �J-.�•..� �e�i tag Expiration Commissioner 10/28/2016 J �/ze�p�arrr�naa�¢�dea�a�C��ic�acfuaeC�i�Y Office of Consumer Affairs&Business Regulation License or registration valid for individul use only r ( HOME IMPROVEMENT CONTRACTOR II; before the expiration date. If found return to: Registration 164521 Type: Office of Consumer Affairs and Business Regulation Expiration `_10/19/2017 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 FRANK DONOVON FRANK DONOVAN 245 SO.MAINS• CENTERVILLE,MA 02632 Undersecretary Not valid without signature i Initial Construction Control Document To be submitted with the building permit application by a _ d Registered Design Professional for work per the 8 h edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Global Marble&Granite, Inc. Date: 2/1/16 Property Address: 1600 Falmouth Road, Centerville,MA 02632 Project: Check(x)one or both as applicable: New construction X Existing Construction Project description: Interior renovations to 1600 Falmouth Road, Centerville,MA 02632 I Doreve Nicholaeff, MA Registration Number: 6622 Expiration date: 08/31/16 , am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': X 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 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 Construct' ontrol Document'. ,0 NICAyo Enter in the space to the right a"wet"or o� 9� electronic signature and seal: o c No.6622.T. � BOSTON. �O M A Jy . f Pss�o Phone number: 508-420-5298 Email: doreve@nicholaef£com Building Official Use Only c Building Official Name: Permit No.: Date: Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen, provide a description. Version 06 11 2013 VERTEX 400 L b'Dey Pa r6va< WEvrE ouil t,1,1A 02180 PHONE 8 .9S2:6G00 I FAX_79_.a 5.3543 February 22, 2016 Cape Cod Craftsman Bell Tower Mall, Unit 9 Centerville, Massachusetts 02632 Attention: Mr. Frank Donovan Reference: Pre-Renovation Inspection Summary Report Bell Tower Mall, Unit 9 1600 Falmouth Road Uri Centerville,MA k ; VERTEX Project No. 38498 Z= � Ln Dear Mr. Donovan: w r The Vertex Companies, Inc. (VERTEX) is pleased to provide you with this letter report summarizing the visual inspection and bulk sampling results from the Pre-Renovation Asbestos Containing Materials (ACMs) Survey performed within Unit 9 at the Bell Tower Mall located at 1600 Falmouth Road in Centerville, MA(the Site). Asbestos Containing Materials Inspection The purpose of the inspection was to identify ACMs that may be disturbed during the renovation activities. The inspection and bulk sample collection was conducted by Massachusetts Licensed Asbestos Inspector, Jason Mohre (Al000262) on February 16, 2016. A total of six (6) representative bulk samples of suspect building materials were collected and analyzed for asbestos. The building materials observed and undertood to be disturbed withnin survey area included 2' x 4' Ceiling Tile, Drywall, and associated Joint Compound. The collected bulk samples were submitted under a chain-of-custody to EMSL of Cinnaminson, NJ. The bulk samples were analyzed via Polarized Light Microscopy (PLM) in accordance with U.S. Environmental Protection Agency (EPA) 600/R-93/116 recommended protocol-using PLM. EMSL of Cinnaminson is accredited through the National Voluntary Laboratory Accreditation Program(#101048-0) and is a Massachusetts certified analytical laboratory (AA000048). Representative bulk samples were collected randomly and analyzed in order to determine the identity of suspect materials and their composition. Bulk samples were collected in the following sampling scheme which is derived from AHERA (40 CFR 763): For friable and non- friable miscellaneous materials, two (2) or more samples were collected and analyzed to determine asbestos content. t r' A"A { ' f Please refer to Table I below which summarize the sample locations and analytical results. Please refer to ATTACHMENT A which includes the Laboratory Report. Sample Locations and Results Table I B-216-OIA 2' x 4' Ceiling Tile (Speckled/Dot Main Area None Detected B-216-01B 2' x 4' Ceiling Tile (Speckled/Dot Main Area None Detected B-216-02A Drywall Main Area None Detected B-216-02B Drywall Main Area None Detected B-216-03A Joint Compound Main Area None Detected B-216-03B Joint Compound Main Area None Detected Conclusions Based on the observations made during the inspection and review of the attached analytical results, asbestos was not detected within the representative bulk samples collected and analyzed. Reasonable efforts were made to determine the locations suspect ACMs. In the event additional suspect materials are discovered during future renovation activities, VERTEX recommends collecting/analyzing samples of the materials for asbestos content prior to disturbance. Limitations Professional opinions presented in this summary letter are based on information made available to VERTEX either by review of data provided by others or data gained by VERTEX personnel. VERTEX affirms that data gathered and presented by VERTEX in this summary letter was collected in an appropriate manner in accordance with generally accepted methods and practices. VERTEX cannot be responsible for decisions made by our client solely on the basis of economic factors. Conditions described in this summary letter were observed at the time of the inspection, unless otherwise stated. VERTEX observed only the conditions and locations described in the summary letter at the time indicated. VERTEX analyzed only the substances, conditions, and locations described in the report at the time indicated. Please do not hesitate to contact us at your convenience, should you have any questions or comments regarding this summary letter or our recommendations. Sincerely, The Vertex Companies, Inc. Jason Mohre Senior Project Manager Attachments: Attachment A: EMSL Analytical PLM Analysis Laboratory Report ATTACHMENT A BULK SAMPLE ANALYSIS RESULTS BY PLM M EMSL Analytical, Inc. EMSL Order: 131600653 7 Constitution Way,Suite 107 Woburn, MA 01801 Customer ID: VERT51 Tel/Fax: (781)933-8411 /(781)933-8412 Customer PO: http://www.EMSL.com/bostonlab@emsl.com Project ID: Attention: Jason Mohre Phone: (617)939-3823 Vertex Air Quality Services Fax: (781)335-3543 400 Libbey Parkway Received Date: 02/16/2016 11:15 AM Weymouth, MA 02189 Analysis Date: 02/16/2016 Collected Date: 02/16/2016 Project: Unit 9, Bell Tower Mall, Centerville, MA Test Report:Asbestos Analysis of Bulk Materials via EPA 600IR-931116 Method using Polarized Light Microscopy Non-Asbestos Asbestos Sample Description Appearance %Fibrous %Non-Fibrous %Type B-216-01A Belltower Mall,Unit 9 Gray/White 60%Cellulose 10%Non-fibrous(Other) None Detected /1st Floor/Main Fibrous 30%Min.Wool 131600653-0001 Room-2'x4'Ceiing Homogeneous Tile(Speckled/Dot) B-216-01 B Belltower Mall,Unit 9 Gray/White 60%Cellulose 10%Non-fibrous(Other) None Detected /1 st Floor/Main Fibrous 30%Min.Wool 131600653-0002 Room-2'x4'Ceiing Homogeneous Tile(Speckled/Dot) B-216-02A Belltower Mall,Unit 9 Brown/Gray 15%Cellulose 85%Non-fibrous(Other) None Detected /1st Floor/Main Fibrous 131600653-0003 Room-Drywall Homogeneous B-216-02B Belltower Mall,Unit 9 Brown/Gray 15%Cellulose 85%Non-fibrous(Other) None Detected /1st Floor/Main Fibrous 131600653-0004 Room-Drywall Homogeneous B-216-03A Belltower Mall,Unit 9 White 100%Non-fibrous(Other) None Detected /1st Floor/Main Non-Fibrous 131600653-0005 Room-Joint Homogeneous Compound B-216-03B Belltower Mall,Unit 9 White 100%Non-fibrous(Other) None Detected /1 st Floor/Main Non-Fibrous 131600653-0006 Room-Joint, Homogeneous . Compound �j Analyst(s) Alexander Maxinoski(6) Alexander Maxinoski,Asbestos Laboratory Manager or Other Approved Signatory EMSL maintains liability limited to cost of analysis. This report relates only to the samples reported and may not be reproduced,except in full,without written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations. Interpretation and use of test results are the responsibility of the client. This report must not be used by the client to claim product certification,approval,or endorsement by NVLAP, NIST or any agency of the federal government. Non-friable organically bound materials present a problem matrix and therefore EMSL recommends gravimetric reduction prior to analysis. Samples received in good condition unless otherwise noted. Estimated accuracy,precision and uncertainty data available upon request.Unless requested by the client,building materials manufactured with multiple layers(i.e.linoleum,wallboard,etc.)are reported as a single sample.Reporting limit is 1 Samples analyzed by EMSL Analytical,Inc.Woburn,MA NVLAP Lab Code 101147-0,CT PH-0315,MA AA000188,RI AAL-107T3,VT AL998919,Maine Bulk Asbestos BA039 Initial Report From:02/16/2016 11:54:25 PLfvt-1.67 Printed:2/16/2016 11:54 AM Page 1 of 1 OrderlD` 131600653 t 3 1 6 0 0 6 5 3 t�LttTe � Bulk Sampling Log Form Project Name: 49/fi ,��� , �'es.+.j►OIA Project ": Page: of C,iient Date:l� L%�j �— Fri! Building Floor Room Description / Field." Comments Non-Fri —71 IJelnered t3v hate #Sant tes Receitied By Date Time >Samples DES 1 rajr,,41 t y By r � j ... I' 1, G A B` � �& IiBALIMiR ISLE _ _ (�GRANITEIII NC r u�� IPI _ a BELLTOWERPLAZA -` - �CENTERVILLEMA 02632 III .. � r e it , �GENERALNOTES: ,e el r _ r _ I - • r h , - r I s' , a e , 'Y , i < x r q t i. i'- _ Y., r - i » R x.x 5 u .,. r ,,, _ `. � -..,. %: -- tip. o. ,. — .- ,.� ., � a •r� ..' _- _- , Y . f F wr n r r. .- :: .. ..,... •_ '. .,. i _ -. �- grip.- _. v r LL w, }� NICHOLAEFF { y •j: syi q e: _ _a n .i' - - w'.� r 'f .. y: 'y , , .�'•x'r"'+.w Ga,;ie r � =v ARCHITECTURE .n .a. t. '',• .. 091 l t eel _ _ j•: - Ostewdrville,e�MA 02655 FLrl F 5004202240 .` i rl io -. -. .. - .- � � -.. Y ,:. '•. ., .. .... - -. .,'7 n T n , -.�: - - rncholaeff.co ..r f.« ♦w,v mr 1 �s...� r i �.�w t� - ,:. ." 5 ,- -o-'„ • r µ_. .. ,4 ..., T n .. 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' - - F 508 420 2240 i ~ - nicl-olaeft.com _ 2 • r, O ' . - a, �r r--r--rs+mra•scmr�r—ter—� ,r.,r,.[ - d • _ ' PR NUMBER: - '- DRAWN BY: as _. SCALE:AS NOTED - DATE:JANUARY 29,2016 RA TITLE Wr a A1 . 1 PROPOSED FLOOR PLAN SCALE:1/4 • A�.GLOBAL A.RBLE & GRANITE I , C 1800 FALMOUTH RD , BELLTOWER PLAZA I - All _ - l GENERAL NOTES: ALL EXPOSED ROOF FRAMING, DUCTWORK,CONDUIT,PIPING,ETC TO BE PAINTED BLACK. _ . _ Ae.M os.w NKna..n,aAnmonw.N• _ iae ga.r,,.mo.,n.n.r oo,.u.eo,A..m�wwc•++.M PAINTED PLASTER I o, PAINTED PLASTER PAINTED PLASTER PAINTED POPLAR/ PAINTED PLASTER PAINTED PLASTER w>x w.�mmaow • .vo.au..�'.me. mo I 1.5'SQUARE TUBE MED COLUMNS I I e mre TEEL BRACKETS TYP. J•THICK%3•WIDE STEEL ' ANGLE STRAPS(2)PER -- TOP ,IL. -U: n:. `ll: a , IC. n;:;•:ai. j I, I Al I, m mom -.*1 a SLaas l !: ' l l I 25-T W DE:$LA ILj 14 :12" LE$ (( I f I Pro PILASTER, PP I ,Il ' ..ai• II• '...li: ,U: '1� .u.:`�.al:, .0 • '-U:" :n:•, ;ar: j j �p t l t lsop •, i PAINTED PLASTER j• PAINTED PLASTER L-PAINTED POPLAR PAINTED PLASTER - j PAINTED PLASTER 4 _m " - SILL r %4•STONE BAY %4'STONE BAY - - %4'STONE BASE - - %4'STONE BASE 6• 1 0' 6• 14'-6• 6' 1•D' 6' 14'-6• - fi' I'0' 6' 6'-6' 6" T-3%* PROPOSED ELEVATIONS SCALE:1/2'=1'-O° �'1 NICHOLAEFF ARCHITECTURE+DESIGN ,. . - 891 Main Street • .. . • OsteMlle,MA 02655 - - - - T 508 420 5298 ' - - - F 508 420 2240 PROJECT NUMBER: / ... - ALL EXPOSED ROOF FRAMING, DUCTWWORK,CONDUIT,PIPING,ETC TO DRAWN BY: - ' •" , BE PAINTED BLACK. • - PAINTED PLASTER 4 - SCALE:AS NOTED - DATE:JANUARY 29,2016 - •:' , _ PAINTED PLASTER - PAINTED PLASTER. +7 PAINTED METAL /_ \ W9NDOW/DOOR FRAMES / \ • . TYP / \ - PROPOSED ELEVATIONS"" x- \ / • \ / 111 p, 3. PAINTED PLASTER \ / _ PAINTED PLASTER _ %4'STONE BAY A2 . 1 PROPOSED ELEVATIONS SCALE:12°=1'-0' _ b GLOBAL MARBLE • � • &`vGRANITE.INC BELLTOWER PLAZA ' - � - • - CENTERVILLE MA'02632iru3� '� � • � t - - GENERAL NOTES: ALL EXPOSED ROOF FRAMING. - DUCTWORK,CONDUIT,PIPING,ETC TO ' - BE PAINTED BLACK. - . - i_w M°ro wmm,nrm o.=°ms.e>,a°m•mm°.:�q - I- - PAINTED PLASTER I I n2ma.Y.°,Ow •w°„i°°a,am.N,w o-.o..rvoNn..m ' ` PAINTED PLASTER I PAINTED PLASTER ' PAINTED POPLAR/ PAINTED PLASTER 1.5"SQUARE 4 - PAINTED PLASTER w° °°re,mm °m°. °renim°ienwm° THICK X 3"WIDE STEEL - MDF COLUMNS STEEL BRACKETS B TYP. w ANGLE STRAPS(2)PER SLAB - I • . wre.wem°,.m°O uOptl°� TOP TYR - El 11 � F .�:......:..:. ... ......:.... ..'�..'.�.'.:.:; .;';..,.:'_:.:.. F4!k-- �'Ill:,aJ"'r''.9J:.' �,'It•'.>.:..r:l{.� ;,:II:•.":`..�.: .:Ia.:.._:.:.ai`: 'I:I'^',,..'.II� 'TI`:i�:i��1:4:: EEELi� J IFIffIll .o I. I tz• x 1z ,I Es. I ,^,.•. s-iJz w(D 6v+s5. mm a §LAeS I 1 - ,i • (C r PLASTERPTO � H P_.., .; ..• ,. . ,,..,, ., _. ", •.•IJ" H. IJ• `.II� .If `,Il 'I,I. II:, .}I I6.: El L� I I : PAINTED PLASTER PAINTED.PLASTER PAINTED POPLAR PAINTED PLASTER PAINTED PLASTER SILL - A•STONE BASE %4"STONE BASE %4"STONE BASE 4•STONE BASE 14•-6• ..6• 1,O, 6• • B._6• 6• - . PROPOSED ELEVATIONS SCALE:1a"=1,_D,' 3 NICHOLAEFF _ ARCHITECTURE+DESIGN • - - - - • 891.Main Street^ - �.., Ostery lle.MA 02655 T 508 420 5298 - - . - F 508 420 2240 ni _ ' 'cMlaeff.com ,., - - _ PROJECT NUMBER: ALL EXPOSED ROOF FRAMING, DUCTWORK,CONDUIT,PIPING.ETC TO DRAWN BY: - • - BE PAINTED BLACK. s - - PAINTED PLASTER - , SCALE:AS NOTED _ __—___—___—___ - _ _ _ _ __---_-----_ • , j •/�'�T OT A T -- DATE:JANUARV 29,2016 MARBLE&G'iSJLRANrrEE INC. TITLES"ai`� ,, :.; � ��� .•�aT:4. - PROPOSED ELEVATIONSVp Pr II �• 3S - PAINTED PLASTER • _ %4•STONE BAY ,e _ � A2 . 2 1 PROPOSED ELEVATIONS SCALE:12"=T'-o° 4 IS WARBLE t ._ 4 - : & G RAN ITEM N C 1600 FALMOUTH-RD. BELLTOWER PLAZA CENTERVILLE MQ 02632,, II - - ` - ilk, a, i i r t� �ZIV I pI GENERAL NOTES: . mwM owvvervbndnex,acnbn.o.rvo - ' - _ -ee Went wAnn.nrm orcapreoil.�eMC�n:ameol n r m d a, t — — _ — — — - — — — — - NICHOLAEFF - - ARCHITECTURE+DESIGN • - -C - .. - , { cuuer n ' s 891 Main Street85• • - Ost—ille,MA 025 T 508 420 5298 .. n c 08 420 2240 t . ho WC we - PROJECT NUM BER: . •- � 'a MBER� DRAW BY: - - - SCALE:AS NOTED. • - _ - ' - — DATE:JANUARY 29,2016, EX1 I EXSITING CONDITIONS PLAN SCALE:1/4'=V-0' GLOBAL:MARBLE & GRANITE INC144,1 L - i v % • r-�''' �" 11•. U • °. - ' I „ GENERAL NOTES: - w.c.MdOe...rvn'nd.se,mm�mot:c.rvo wn e�weotw.- ' • i - - _oa byam wmw.lmm waww.m�b.mwP'®'mwd - - wE - xnommc� , x r rrrsun , • sues - L—J L—J Lu'JR°e=J L—J L—J , •, u ,. - �J`O c O , 6'- 4 �' 11'-Oy r 6'-6- 0 6 14'-6' c 0 6 1 114'-6- 1 1 6'-6- 1 6 1'-5 - , i ` STORAGE _ • . 0000 NICHOLAEFF ARCHITECTURE+DESIGN 891 M treet..s OsterviIle M A 02655 � F T 508 420 5298 F 508 420 2240 lch 1 • - - . �nolaeH.com e • O I - - --- --- ------ - - • - - - • r MC Am. a PROJECT NUMBER: + DRAWN BY: .• - SCALE:AS NOTED .,. z. • ° s _ .S. i - -• x - _ .. DATE:.JANUARY 29,2016 ... I if 41, . i z ; �,• - _ _ . . - Al .1 ° PROPOSED FLOOR PLAN SCALE:1/4 7 GLOBALIlMAR'BLE' 11600 FALMOUTH.RD - BELLTOWER PLAZA( y' p T . r" • - , - - - CENTERVIL'LE,MA 02632 I� ,l" 1i - - ( l a ap'f�$ I.q z - GENERAL NOTES:. ' ALL EXPOSED ROOF FRAMING, t - • o :.,y.,.o.m,eoom...e wr. DUCTWORK,CONDUIT,PIPING,ETC TO BE PAINTED BLACK. - I..• Nemmn- I PAINTED PLASTER I nANNaN "PAINTED PLASTER PAINTED PLASTER PAINTED POPLAR/ PAINTED PLASTER PAINTED PLASTER - I 1.5'SQUARE TUBE MDF COLUMNS . j TEEL BRACKETS TYP. - J•THICK X 3•WIDE STEEL - m.,,.=,,,.nmm...o..e,em..,.�.•nmm m, ANGLE STRAPS(2)PER SLAB ------------- IL•.' i kl II U' I � k ,. I .: .I. 7.z k a �Ltes 411, I,. l l zsri vilo@;Sias I 7,z :i " "LE6 t 'Pm ��_o _ PLASTER .. .II. .. .I. .H. .I. .IL... .I. .tl.... .I .IL... .I. .il., .I.' •. ',�• : j PAINTED PLASTER PAINTED PLASTER PAINTED POPLAR PAINTED PLASTER PAINTED PLASTER - _ - SILL �e " %A'STONE BASE %A-STONE BASE %�'STONE BASE %A'BTONE . 6• 6•_6., 6• 1.O. 6• 14._6. « 6. 1,D. 6..' 14._6. fi• 1'0' 6• 6'-6• 6• '2'-3�• SCALE:1/2"-1'-0' PROPOSED'ELEVATIONS - 1 NICHOLAEFF " ARCHITECTURE+DESIGN. 891 Main Street - - • _ OsteM le,MA 02655 - . - - - - - - - - T.508 420 5298 F 508 420 2240 , .. .. -. - A. �. F n " PROJECT NUMBER: r ALL EXPOSED ROOF FRAMING. DUCTWORK,CONDUIT,PIPING,ETC TO i' DRAWN BY: BE PAINTED BLACK. - • - -- ., .. -PAINTED PLASTER _ y SCALE:AS NOTED ` - - - DATE:JANUARY 29,2016 . • ' PAINTED PLASTER PAINTED PLASTER II ICI � �llJ PAINTED METAL / \ WINOOW/DOOR FRAMES / \ TP / \ ' ♦ \ TITLE j t �' r \ / PROPOSED ELEVATIONS ' 7 i[ PAINTED PLASTER PAINTED PLASTER \ / _ - %A-.STONE BASE _ A2 . 1 PROPOSED ELEVATIONS. SCALE:1/2.=1'-0° 2 GLOBAL; AARBLE &GRANITE INC - 11600 F/aLMOUTH RD �_ • - - ' BELLTOWER PL ,ZA - - CENTERVILLE MAA 026321fir1 �' a li � JI ' - GENERAL NOTES:' ALL EXPOSED ROOF FRAMING, ,• - ` - ` • •^e m.o DUCTWORK,CONDUIT,PIPING.ETC TO - ._ ...•.o• o.oM•mo.,,we M.�a i.m.m ' BE PAINTED BLACK. w ��w'��pormavmw a'vryaomn Mv,ry wvvwa:am•d_ ` - • - M•cac la dm•Nm Owwo rvond••v .PAINTED PLASTER I I n2Nma.mo. L • _ _.___. A„r.,:w.we<w.v..•�wu.m..::w.wma,.wnc+..e _ _ ..m e•e,w•emm me.m.mo.a».mmn m�,.u. PAINTED PLASTER I PAINTED PLASTER_ I PAINTED POPLAR/ PAINTED PLASTER PAINTED PLASTER - _ r THICK X 3-WIDE STEEL MDF COLUMNS STEEL BRACKETS TYP - N ANGLE STRAPS(2)PER SLAB • _ - • m .e.ommenm��.� A _____�__ __ _ __ __.� —- __—____ + TOP T1'P. _ _ Ld'- _ , - .. :t1�;Y��.'Ir� I I I tt' 'rl� .,II••..•:`!I` 'll ' I! 'l1`•:•:'•11•, •!I +11 _ Io �., '., DID ,.:.� .:.....: :. :... �.,�..:.:.'::;. .•.>.,i•:.•':;:�: .,;::;'.:.;•.::i`: .,`..'•�'�:.;,: ,,..`,.:'.:."..c,:' `„`;.7•:i is ': j iir T2 E9 I s:.1z'�(o SLA65 , I �r.'. .'w PTO El �� j _I MUM ml I PLASTER ..' .. •: ...... I -. .., •. .' :` .' I i)~:-.'H 14 'fr ..1f••',.,fl,. •rl ,Il`: lI:`-• .fl', [I`' "14 I P P O O F f I _ �:.. .., ,. .. ,.. ...., 'iJ.,.,.'W I} II' If '17 II ,..I!`. •II<'- 'If, .[I` �14 _ q , � Lj I , V PAINTED PLASTER PAINTED PLASTER PAINTED POPLAR PAINTED PLASTER 'PAINTED PLASTER SILL A•STd1E BASE X X•STONE BASE X 4'STONE BAY 4•STONE BASE - __ 2-3?�g 6' 6-6' 6' i'0' fi' 14 fi' 6' 1 0' 6' - 14 6' 6' > - PROPOSED ELEVATIONS _ SCALE:1/2'_1.a, 3. NlcHo AEFF - ff - . . .. ARCHITECTURE+DESIGN -. - • 891 Main StreeI - - t Osterville,MA 02655 . - - T 508 420 5298 F 508 420 2240 _ - . _ Y, : : nicholaeH.wm .• i ,.- .. `. •. - it -. .. +• - J- - iH * .. ° .. .. ...�. • - - ' - - PROJECT NUMBER: S ALL EXPOSED ROOF FRAMING, - 4 DUCTWORK,CONDUIT,PIPING.ETC TO - n9 - BE PAINTED.BLACK. DRAWN BY: `'�' - _ «. PAINTED PLASTER A w. SCALE:AS NOTED - - -------___________ a ____ _______- ... Y . - ./^I T OT AT DATE:JANUARV 29.20t6 /V-LL{ L MARBLE&GRANITE INC. _ Fk - _ ; TITLE: ' a >'. PROPOSED ELEVATIONS E � , I I - PAINTED PLASTER , X 4"STONE BASE � A2 . 2 PROPOSED ELEVATIONS SCALE:1/2 =''-0 4