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0120 SOUTH MAIN STREET (6)
7 r. 17y:.-«{`c '� �.' ..r ✓ c�t''.v ,�p d, t� �,•, Rom. 3,i.,,, ,y, � r,.s b r � , o , i k e y a . is a s architects Tel (508) 626-3680 Fax (508) 875-8583 John Ciccariello &Associates, Inc. 22 Aberdeen Road Framingham,MA 01702 November 15, 2007 4 Jeff Lauzon NQ� Building Inspector 2 Town of Barnstable Building Department 200 Main St. Hyannis, MA 02601 RE: Cape Regency, a Radius HealthCare Center 120 S. Main St. Centerville, MA 02632 "Final Affidavit" The undersigned, being duly sworn, deposed says: a 1. I have made regular and periodic site visits to observe the construction carried out at 120 S. Main St, Centerville, MA for the interior renovation project for which a Building Permit was issued to Nauset Construction. 2. All required approvals and material affidavits have been submitted; the construction has been satisfactorily completed in all respects in accordance with plans and specifications submitted for permit purposes, any field changes made during construction, and, to the best of my 1 the Commonwealth of Massachusetts State Building Code 780 , excluding any work performed by the Owner. � �c%cc,4R��CF�� o � A p� NATI MASS. ate Orii ' F Seal Then came the above named, John Ciccariello, and swore that the statements made in the foregoing affidavit are true,to the best of his knowledge and belief before me. Date Notary`Public My commission expires: 12113 architecture engineering nt YOU WISH TO OPEN A BUSINESS? For Your lnformatio'n: Business certificates (cost$30.00 for.4 years). A business certificate ONLY REGISTERS YOU R''IVAME in town (which you must do by M.G:L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk'.s.Office, 1 FL., 367 Main Street, Hyannis, MA 02601 (Town Hall] MoW18 walff' 'g, DATE: U In S Fill in please: APPLICANT'S YOUR NAME/S: BUSINESS p YOUR HOME ADDRESS: Cei . .w4 JAI{�,u.��'. i �a9".��"3 r�az . `�©U)�'�29 1 p?jCa• ' _.V. � r . TELEPHONE # Home Telephone Number v `:,�v `t c NAME:'OF CORPORATION: NAME OF NEW.BUSINESSt^ae�c TYPE OF BUSINESS =Q { , N IS.THIS A HOME`OCCUPATION? YES f / , ^ O AODRESS.:OF BUSINESS' 1 �,� h � � �a � � Mp,p PARCEL'NUMBER oZ "V x / G1 c0 [Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need You MUST GO TO 200 Main St._- (corner of Yarmouth . Rd. & Main Street] to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S Off4CE This individual has been i d of any ermit requirements that pertain to this type of business. uthorized ignature* COMMENTS: , 2.. BOARD OF HEALTH Th is individual :.has b en i f ALL med the e it re YWITH p �rr�. ,q ents that pertain to this type.of business. ���� C� �> HAZ4=US MATERIALS REGULATIONS A64orized SignVre COMMENTS: ' '� nwlT'C ivr' !ter u�ti w� 3. CONSUMER AFFAIRS LICENSING AUTHORITY) This individual has cn =�of the 'lic i e irements that pertain to this e of business. P type Authorized Signature* COMMENTS: R A: D g U S 4 MANAGEMENT SERVICES, INC. 0 C 1 38 October 6, 2008 Thomas Perry, Building Commissioner Town of Barnstable, Building Division 200.Main Street Hyannis,MA 02601 RE: Brookside at Regency C120-S0__uthfMdin-Street-- Centerville, MA 02632 Dear Commissioner Perry, . It was a pleasure meeting with you on September 26, 2008 to review our Assisted Living project, Brookside at Regency: As discussed at the meeting, it-will be our intention to lease our apartments to individuals capable of self=preservation. When any individual is deemed incapable of self- preservation, he or she will be transferred to a more appropriate setting; either within Cape Regency, a Radius Healthcare Center or to a similar facility as chosen by the . individual or their family. On behalf of our design and construction team, thank you for your time on this matter. Sincerel / (0 C Thomas C. Lavallee - Regional Director of-Operations CC: David'Dunlap,w President, Dunlap and Associates Anthony Papantonis, President, Nauset Construction Corporation 1671 Worcester Road,Suite 300,Framingham,MA 01702 ph:508-879-4050 fx:508-879-1534 www.radiusmanagement.com cubellis 0 .'11 OF 8AiFZN`r TIA8LE architects interior designers TRANSMITTAL engineers Attn: Thomas Perry t 1V i I0 Pate: 06.06.08 Director— Building Division Project Name: Cape Regency Company: Town of Barnstable Project Location: Centerville-. Address: 200 Main Street Project No: 080346 Hyannis, MA 02601 Sent Via: USPS For Fax Transmissions: Fax Number: There are pages of information in addition to this cover page. If you experience any problems with the transmission please contact sender. Transmitting: ® As Requested ❑ For Your Use ❑ Note&Return ® For Approval ❑ For Review,&Comment ❑ Reviewed as Noted ❑ No Exceptions Taken ❑ Rejected: Resubmit ❑ Revise& Resubmit Attached: Dated Copies Description 06.02.08 2 Foundation As-Built Plan Remarks: enclose wet-stamped prints of the foundation certification plan for the addition at the Cape Regency Nursing Home. Please don't hesitate to call if you have any questions. t Sender's Name: Steve Dyer Phone: 781.803.9122 Email: sdyer@cubellis.com 97 Libbey Industrial Parkway Sender'sSignature: --- Suite 210 Prepared By: SPD Weymouth,MA 02189 t 781 803 9100 . f 781 337 0827 www.cubellis.com ✓ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map` Parcel c I� w%-, Application Health Division f 1 y- 0 6 Date Issued Conservation Division JF3P5 b g °1l Z L 04 P r�� �� }e ilgla6 Application Fee 10D. CO Tax Collector Permit Fee ,' LAC),�3`') Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Addre s vso aim S a G e h Village i C3 r- � 5�. 1671Ocrcesto Owner v5 h P.� vi G Address TelephoneV' Permit quest e �AQ Or O e i t� ' k1!`%� � d01 a e wa 'fineQildyw1 t Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new .ow Zoning District i ' Flood Plain Groundwater Overlay Project Valuation 970 1 000 , Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) See C5 Age of Existing Structure a-5 Vebv g Historic House: ❑Yes A No On Old King's Highway: ❑Yes �No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other N0 Basement Finished Area(sq.ft.) AI//'7 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 9e Xew%- 5 new First Floor Room Count Heat Type and Fuel: XGas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing 10 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# VA_ Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# =10 Current Use Si %C,XA9 Proposed Use SIB BUILDER INFORMATION u NameJ nJfUcLAA r�r Telephone Number V�' -153 Address D Keclllrlt V �Vi License# Cgqqq Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RE ULTING FROM THIS PROJECj WILL BE TAKEN TO Ike v;a or cis (p,n iv1e� SIGNATURE DATE ?-G-O FOR OFFICIAL USE ONLY A, APPLICATION# ' ATE ISSUED _ MAP/PARCEL NO. ADDRESS' VILLAGE F_ OWNER ` DATE OF INSPECTION: FOUNDATION FRAME .. f INSULATION FIREPLACE ELECTRICAL: •ROUGH FINAL PLUMBING: "ROUGH :FINAL - GAS: ROUGH `'FINAL - FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ACQRPM CERTIFICA", _ OF LIABILITY INSURAK ;,E °06/20/z 0) ISRODUCER.(978)392-4567 . FAX (978)392-9696 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION E. J.' Wells Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Regency Park HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 238 Littleton Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Westford, MA 01886 INSURERS AFFORDING COVERAGE NAIC.# INSURED INSURERA: Acadia Insurance 11295 Nauset Construction Corp. INSURERB: Firemen's Ins. Co. of Wash. D.C. 21784 10 Kearney Road INSURER C: Suite 307 INSURERD: Needham, MA 02494 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION _ LIMITS DATE imminnmy) DATE IMMIDgrin GENERAL LIABILITY -CPA 0121404 06/20/2007 06/20/2008 EACH OCCURRENCE $ .1,000,OO X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,00( CLAIMS MADE a OCCUR MED EXP(Any one person) $ 15 00 A PERSONAL BADVINJURY $ 1,000,00 GENERALAGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,OO POLICY X PRO- JECT LOC AUTOMOBILE LIABILITY _ MAA 0180307 06/20/2007 09/20/2008 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,00 ALL OWNED AUTOS BODILY INJURY $ A X SCHEDULED AUTOS (Per person) - X HIREDAUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSPJMBRELLA LIABILITY CUA 0138270 06/20/2007 06/20/2008 EACH OCCURRENCE $ 10,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 10,000,000 A $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND WCA 0149456 06/20/2007 06/20/2008 X I wC STATU- oTH- EMPLOYERS*LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,00( OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ SOO,OO S PECIAL PROVISIONS below H yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,00( OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH'NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. Insured's Copy AUTHORIZED REPRESENTATIVE Paul Coffey/NAM ACORD 25(2001/08) ©ACORD CORPORATION 1988. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations •" 600 Washington Street 91w `:.= 11 Boston,M4 02111 www.mass.g ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): /YNys,T /S12OC y7w` Cor2� Address: /4 f479.� t1 So y y /t/ZA60V cr GW'09, City/State/Zip: OZ` !FV Phone#: 7,0/. qg'3.2220 Are ou an employer?Check the appropriate box: Type of project(required): 1.F am a employer with .30 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. t 7. ❑ Remodeling ship and have no employees 111ibse sub-contractors have.. 8. ❑ Demolition working for me in any capacity. workers' comp.insurance. 9. gBuilding addition [No workers' comp. insurance 5. El.We are a corporation and its ' required.] - - officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 1.❑Plumbing repairs or additions myself. [No workers' comp. c. 1521, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers.' 13.❑ Other comp. insurance required.] *Any applicant that checks box#I 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ,e�niGv'S /tiS�i.4NP�CE Co. of Gr// s�s�iv�To�+ .l�•G'. Policy#.or,Self--ins.Lic.#:_ u1614 D/elf Us'G /3 Expiration Date (�/08 Job Site Address::/ZO SOaTff.,oWV1 , S`l City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure"to secure coverage as required under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un the pains,andpenalties of perjury that the information provided above is true and correct. Si ature: Date: -7-01: Phone#:_7,0 450. ,ZZ0 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 Dep' artment_3.City/Town Clerk. 4..Electrical Inspector 5.Plumbing g Inspector 6.Other Contact Person: Phone#: _. �e T1 e. BOARD OF BUILD[ G REGULATIONS !.License: CONSTRUCTION SUPERVISOR NumbetCS 063611 � ,Bi Fidat® 1p/it71962 0 Expires �11%20083859: ' .. Ret ; t70 ? ANTHONY N PAS�O�-NISty 8 GRACE DR a 4 ff G— j MEDFIELD, MA 0205 Commissioner ( I i 1 00 35,000 cf enclosed space y (MGL C 112 S 60L) 1A-Masonry only l I-1&2 Family Homes Failure to possess a;current edition of the 1 Massachusetts State Building Code (s cause for revocation of this license. i l DIG SAFE CALL CENTER: (titi8)344-7233 . I SEP706-2007 THU 05:47 PM Radius Mgmnt Services FAX NO. 5088791534` P.' 02 AP r 'town of Barnstable. Regulatory Services I n wa Thomas F,Geller,Direetar I Biffldlng Division 'Tom Perry,, BuildingConimissianuz 200 Main Strctt,rTiyaimis,MA 02601 ,to�Yn.barhstable,ma.us - office: 50-862-4038 Pax; SO8.790-6 30 Property Op rty Owner Must Complete and Sign This Section If Using A BuRder r ,as Owner o4*he subject propzty, haebyaux-40=. e io act on my bahalf, in a]I smatters re1_tive to work authoziZed by this bitudiag per nit'application for, 1 50 . MQ11A � Address Qf o ) c r jSc)TO D to P t N'atne l Q�'4RM5:QRPER.t+ddSSTON Nutter Eliza Cox Direct Line: 508-790-5431 Fax: 508-171-8079 E-mail: ecox@nutter.com October 13, 2006 #106.700-1 Robert Gatewood, Conservation Agent Town of Barnstable 200 Main Street Hyannis, MA 02601 Re: Radius Regency Operating, LLC - 120 South Main Street, Centerville DEP File No. SE3-4537 Dear Rob: Enclosed please find proof of recording of the Order of Conditions issued on October 2, 2006 under your File No. SE3-4537 to Radius Regency Operating, LLC. As indicated thereon, we have recorded the Order with the Barnstable County Registry of Deeds in Book '21425, Page 269. This Order.allows construction of an addition to the Cape Regency Nursing { Facility together with associated site improvements. Please do not hesitate to contact me with any questions. Very truly s, Eliza Cox EZC:cam Enclosure cc: Tom Lavallee, Radius Management Services (w/enc.) Jon Truslow, Owner's Representative, Radius Management Services (w/enc.) Norm Hayes, BSC Group (w/enc.) Stan Szczurko, SS Designs (w/enc.) David Dunlap,DH Dunlap Architects (w/enc.) Patrick M. Butler, Esq. (w/out enc.) 1569981.1 Nutter McClennen&Fish LL.P ■ Attorneys at Law 1513 lyannough Road,P.O.Box 1630 ■ Hyannis,MA 02601-1630 ■ 508-790-5400 ■ Fax:508-771-8079 ■ `www.nutter com I MassachusettsDepartmentf Ei tal Protection onvronmen - -, .af� �. h tt DEP File Number: Bureau of Resource Protection -Wetlands WPA Form 5 - Order of Conditions Y sE3-4537 Provided b DEP •�e ,:•.fie$, Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 And Chapter 237 of the Code of the Town of Barnstable D. Recording Information (cost:) Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission. --------------------------------------------------------------------------------------------------- --- ---- -------- To: Barnstable Conservation Commission Please be advised that the Order of Conditions for the Project at: 120 South Main Street SE3-4537 Project Location DEP File Number Has been recorded at the Registry of Deeds of: Barnstable County Book Page for: Property Owner and has been noted in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions issued on: Date If recorded land,the instrument number identifying this transaction is: B k 21-;25 Pu 269 ; 635+.2 Instrument Number 1 U-12-20106 8 1 1 : 17tn If registered land, the document number identifying this transaction is: Document Number Signature of Applicant 6WPAForm5.doe•rev.9121105 Page 7 of 7 :Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File number T ° WPA Form 5 - Order of Conditions SE3-4537 Provided by DEP :Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 And Chapter 237 of the Code of the Town of Barnstable A. General Information Bt: 21425 Rvo 269 �63.5�:2 10-12-2006 a 1 1 = 1.70L Important: From: When filling out forms on Barnstable the computer, Conservation Commission use only the tab key to This issuance if for(check one): move your cursor-do ® Order of Conditions not use the return key. ❑ Amended Order of Conditions j To: Applicant: Property Owner(if different from applicant): Radius Regency Operating LLC Name Name ; 1617 Worcester Road Suite 300 Mailing Address Mailing Address Framingham MA 01702 City/Town State Zip Code City/Town State '7rp•Gode 1. Project Location: 120 South Main Street Centerville Street Address Village j 208 89-1 Assessors Map Number Parcel Number 2. Property recorded at the Registry of Deeds for: Barnstable 9231 246 County Book Page Certificate(if registered land) 3. Dates: .July 18,2006 September 12,2006 . OCT ,, 2 2006 Date Notice of Intent Filed Date Public Hearing Closed Date of Issuance 4. Final Approved Plans and Other Documents (attach additional plan references as needed): Assisted Living Addition to Cape Regency Nursing Facility shts C-1,2,3,4 EC-1,2,3 9/9/2006 SP-1,2,3,4&A-1,2,3,4,5 Date Title Date Title Date r 5. Final Plans and Documents Signed and Stamped by: Thomas.A. Ryder, P.E. Name - 6. Total Fee: $1050.00 (from Appendix B:Wetland Fee Transmittal Form) BWPAForm5.doc•rev.9/21/05 Page 1 of 7 Massachusetts Department of Environmental Protection DEP File Number. `... Bureau of Resource Protection -Wetlands WPA Form 5 - Order of Conditions sE3-4537 ;Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP { And Chapter 237 of the Code of the Town of Barnstable B. Findings Findings pursuant to the Massachusetts Wetlands Protection Act: Following the review of the above-referenced Notice of Intent and based on the information provided in this application and presented at the public hearing,this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act.Check all that apply: ❑ Public Water Supply ❑ Land Containing Shellfish ® Prevention of Pollution ❑ Private Water Supply ❑ Fisheries ® Protection of Wildlife Habitat ❑ Groundwater Supply ® Storm Damage Prevention ® Flood Control Furthermore,this Commission hereby finds the project,as proposed, is:(check one of the following boxes) Approved subject to: . ® the following.conditions which are necessary, in accordance with the performance standards set forth in the wetlands regulations,to protect those interests checked above.This Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above,the following General Conditions,and any other special conditions attached to this Order.To the extent that the following conditions.modify or differ from the plans,specifications,or other proposals submitted with the Notice of:Intent, these conditions shall control. . Denied because: ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations to protect those interests checked above.Therefore,work on this project may not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protect these interests, and a final Order of Conditions.is issued. ❑ the information submitted by the applicant is not sufficient to describe the site,the work, or the effect of the work on the interests identified in the Wetlands Protection Act.Therefore,work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the Act's interests,and a final Order of Conditions is issued.A description of the specific information which is lacking and why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c). General Conditions (only applicable to approved projects) 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal,state,or local statutes,ordinances, bylaws,or regulations. f, BWPAForm5.doc•rev.9121/05 Page 2 of 7 -Massachusetts Department of Environmental Protection DEP File Number: ;,Bureau of Resource Protection Wetlands °WPA Form 5 - Order d.Conditions sE3-4537 W Provided by DEP '-;.�r Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 -,And Chapter 237 of the Code of the Town of Barnstable B. Findings (cont.) 4. The work authorized hereunder shall be completed within three years from the,date of this Order unless either of the following apply: a. the work is a maintenance dredging project as provided for in the Act;or b. the time for completion has been extended to a specified date more than three years,but less than five years,from the date of issuance.If this Order is intended to be valid for more than three years, the extension date and the special circumstances warranting the extended time period are set forth as a special condition in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill.Any fill shall contain no trash,refuse, rubbish,or debris,including but not limited to lumber, bricks,plaster,wire, lath,paper,cardboard, pipe,tires, ashes;refrigerators, motor vehicles,or parts of any of the foregoing. 7. This Order is not final until all administrative appeal periods from this Order have elapsed,or if such an appeal has been taken,-until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Order has become final and then has been recorded'in the Registry of Deeds or the Land Court for the district in which the land is located,within the chain of title of the affected property. In-th6- case-of-recorded land, the Final Order shall also be noted in the' Registry's Grantor Index udder the name of the owner of the land upon which the proposed work is to be done. In the case of the registered land'the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done.The recording information shall be submitted to this Conservation Commission on the format the end of this Order, which form must be stampediby.the Registry of Deeds, prior to the commencement of work. 9. A sign shall be displayed at-the site not less then two square feet or more then three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or,"MA DEP"] "File Number SE3 4537 _ 10. Where the Department of Environmental Protection is requested to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before DEP. 11. Upon completion of the work described herein,the applicant shall submit a Request for Certificate of Compliance(WPA Form 8A)to the Conservation Commission. 12. The work shall conform to the plans and special conditions referenced In this order. 13. Any change to the plans identified in Condition#12 above shall require the applicant to inquire of the Conservation Commission in writing whether the change is significant enough to require the filing of a new Notice of Intent. 14. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours . to evaluate compliance with the conditions stated In this Order, and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evaluation. BWPAFormMoe•rev.9121/05 Pape 3 of 7 : .. ;Massachusetts Department of Environmental Protection, DEP File Number :)Bureau of Resource Protection -Wetlands 'aWPA Form 5 — Order of Conditions sE3-4537 Provided by DEP (. "Massachusetts Wetlands.Protection Act M.G.L. c. 131, §40 ,And Chapter 237 of the Code of the Town of Barnstable B. Findings (cont.) 15. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this Order.. 16. Prior to the start of work,and if the project involves work adjacent to a Bordering Vegetated Wetland, the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging.Once in place,the wetland boundary'markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully. stabilized with vegetation or other means.At no time shall sediments be deposited in a wetland or water body. During construction,the applicant or his/her designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed.The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission,which reserves the right to require additional erosion and/or damage prevention,controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this.Order. see attached Findings as to municipal bylaw or ordinance Furthermore,the Barnstable hereby finds.(check one that applies): Conservation Commission ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: Chapter 237 of the Code of the Town of Barnstable Municipal Ordinance or Bylaw Citation Therefore,work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards,and a final Order of Conditions is issued. ❑ that the following additional conditions are necessary to comply with a municipal ordinance or bylaw, specifically: Chapter 237 of the Code of the Town of Barnstable Municipal Ordinance or Bylaw Citation The Commission orders that all work shall be performed in accordance with the said additional conditions and with the Notice of Intent referenced above.To the extent that the following conditions modify or differ from the plans,specifications,or other proposals submitted with the Notice of Intent, the conditions shall control. j. BWPAForm5.doc rev.9/21105 Pape 4 of 7 Massachusetts Department of Environmental Protection DeP File number Bureau of Resource Protection -Wetlands 3 WPA Form 5 - Order of Conditions sE3-4537 x�sa Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 And Chapter 237 of the Code of the Town of Barnstable B. Findings (cont.) Additional conditions relating to municipal ordinance or bylaw: This Order is valid for three years,unless otherwise specified as a special condition pursuant to General Conditions#4,from the date of issuance. Date ' This Order must be signed by a majority of the Conservation Commission.The Order must be mailed by certified mail(return receipt requested)or hand delivered to the applicant. A copy also must be mailed or hand delivered at the same time to the appropriate Department of Environmental Protection Regional Office(see Appendix operty•owner(if different from applicant). Signatur l On � . Of Day Month and r before me personally appeared to me known to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as his/her free act and deed. Notary Public My CominIssiorf Expires This Order is Issued to the applicant as follows: ❑ by hand delivery on Date ❑ by certified mail,return receipt requested,on OCT 2 2006 Print Name Signature Date BWPAFon 5.doo•rev.9 IMS Pape 5 011 00, SE3-4537 Radius Regency Operating LLC Approved Plan=Revised Site Plans (7 sheets)by Thomas A.Ryder,P.E.,signed September 9,2006 Special Conditions of Approval I. Preface an serious Caution:Failure to comply with all Conditions of this Orderof Conditions c have consequences. The consequence may include issuance of a stop work order,fines,requirement to remove unpermitted structures,requirement to re-landscape to original condition,inability to.obtain a certificate of compliance, and more. The General Conditions of this Order begin on page 2 and continue on pages 3 and 4. The Special Conditions are contained on pages 4.1,4.2 and 4.3 if necessary.All conditions require your compliance. II. Prior to the start of work,the following conditions shall be satisfied: 1. Within one month of receipt of this Order of Conditions and prior to the commencement of any work I approved herein,General Condition number 8(recording requirement)on page 3 shall be complied with. 2. It is the responsibility of the applicant,the owner and/or successor(s)and the project contractors to ensure that all conditions of this Order are complied with. The applicant shall provide copies of the Order of Conditions and approved plans(and any approved revisions thereof)to project contractors prior to the start of work. Barnstable Conservation Commission Forms A and B shall be completed and returned to the Commission prior to the start of work 3. General Condition 9 on page 3(sign requirement)shall be complied with. 4. The Conservation Commission shall receive written notice l week in advance of the start of work. 5. The work limit line shown on the approved plan shall be staked in the field by the project surveyor/engineer. 6. Staked strawbales backed by trenched-in siltation fencing shall be set along the approved work limit line. v i controls shall remain u e i t vegetation. Effects a sei sediment ce toss 1 until the site s stabilized with 7. A sequence of color photographs showing the undisturbed buffer zone shall be submitted to the Conservation Commission. Note:the strawbales and siltation fence must show in the foreground pAl (or bottom of)the photographs. III. The following additional conditions shall govern the project once work begins. Note ( especially special condition no.14,requiring verification of the locations of the foundation and strawbale line. 8. General conditions No. 12 and No..13(changes in plan)on page 3 shall be complied with. 9. General condition No. 17(maintaining sediment controls)on page 4 shall be complied with. 10. The work limit shown on the approved plan shall be strictly.observed. 11. The Conservation Commission,its employees,and its agents shall have a right of entry to inspect for compliance with the provisions of this Order of Conditions. 12. This permit is valid for 3 years from the date of issuance, unless extended by the Commission at the request of the applicant.Caution:a future Amended Order does not change the expiration date. 13. This approval is contingent upon the approval of the Board of Health for the subsurface sewage disposal system. 14. Upon completion of the foundation,the project surveyor or engineer shall verify in writing or by plan to the Commission the correct location of the foundation and work limit line and note any discrepancies from the approved plan. If verification is in the form of an as-built plan,the plan provided shall be drawn at the same scale as the approved plan. 15. Any fill used for this project shall be clean fill. Fill shall contain no trash,refuse,rubbish,or debris. 16. Drywells,graveled trenches along the drip lines or approved alternative shall be installed to accommodate roof runoff. 17. During construction;no area shall be left unmulched or unvegetated. for more than 30 days.All areas disturbed during construction shall be revegetated immediately following completion of work at,the site. Mulching shall not serve as a substitute for the requirement to revegetate disturbed areas at the conclusion of work. 18. All proposed drainage and landscaping improvements shall be implemented. 19. In consultation with the Conservation Agent,a fence shall be placed along the common property line with the Kelly residence.The disturbed portion of the property shall be allowed to revert to natural growth,with no cutting. > 20. Also in consultation with the Conservation Agent,the brush and clippings dump to the right of the driveway shall be removed and replanted. p.4.2 21. Herbicide,pesticide and fertilizer use is discouraged on lawns within Conservation Commission jurisdiction. If fertilizer must be used,only slow-release low-nitrogen(with 30-50%water insoluble nitrogen or`W.I.N') and low-phosphorus fertilizers shall be applied. Over-fertilizing shall be avoided (not-to-exceed limit= 1 pound of nitrogen per 1,000 sq.ft.of lawn per application).Ensure that no fertilizer is spread on hard surfaces like driveways and sidewalks. 22. Work limit markers(wood stakes)shall remain until a Certificate of Compliance is issued for this project. IV. After all work is completed,the following condition shall be promptly met: 23. At the completion of work,or by the expiration of this Order,the applicant shall request in writing a Certificate of Compliance for the work herein permitted. Barnstable Conservation Commission Form C shall be completed and returned with the request for a Certificate of Compliance. Where a project has been completed in accordance with plans stamped by a registered professional engineer,architect,landscape architect or land surveyor,a written statement by such a professional person certifying substantial compliance with the plans and setting forth what deviation,if any,exists with the record plans approved in the Order shall accompany the request for a Certificate of Compliance.At the time of the request for a j Certificate of Compliance,an updated sequence of color photo rgraphs of the undisturbed buffer zone shall 1 be also submitted. p.4.3 `► '.Massachusetts Department of Environmental Protection s o 7 Bureau of Resource Protection -Wetlands DEP pile Number: 1�WPA Form 5 - Order of Conditions sEs°4537 Provided by DEP l,- •� �-,Massachusetts Wetlands Protection Acf M.G.L. c. 134, §40 - = -:And Chapter 237 of fhe Code ofahe Town ofiBarnstable •_ C. Appeals The applicant,the owner,any person aggrieved by this Order, any owner of land abutting the land subject to this Order,or any ten residents of the.city or town.in which such'land is located, are hereby notifi ed of their right to request the appropriate DEP Regional Office to issue a-Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Department,with the appropriate filing fee and a completed Appendix E: Request of Departmental Action Fee Transmittal Form,as provided in 310 CMR 10.03(7)within ten business days from-the date of issuance of this Order.A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant,if he/she is not the appellant. The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act, (M.G.L.c. 131, §40)°and'is inconsistent with the wetlands regulations (310 CMR 10.00). To the extent that the Order is based on a municipal ordinance or bylaw,,and not on the.Massachusetts Wetlands Protection Actor regulations,the Department has no appellate jurisdiction. , D. Recording Information This Order of Conditions must be recorded In the Registry of Deeds or the Land Court for the district-in which the land is located,within the chain of title of the affected property. In the case of recorded land,the Final Order shall also be noted in the Registry's.Grant6r Index under the name of the owner.of the Land subject to the Order. In the case of registered land,this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions.The recording information on Page 7 of Form 5 shall be submitted to the Conservation Commission listed below. Barnstable ConservaUon Commission BMAFormS.doc•rev.921105 Pape 6 of 7 .:;'Massachusetts Department of Environmental Protection DEP File Number. c - .�: .�. ..,_Bureau of Resource Protection Wetlands f WPA Form 5 - Order of Conditions sEidedby :? Provided by DEP `-Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 1And Chapter 237 of the Code of the Town of Barnstable D. Recording Information (cont.) Detach on dotted line,have stamped by the Registry of Deeds and submit to the Conservation Commission. •-----------------------------------------------------------------------------------------------------------=-------------- To: Barnstable Conservation Commission Please be advised that the Order of Conditions for the Project at: 120 South Main Street SE3-.4537 Project Location DEP File Number s been recorded at the Registry f Deeds of: Has reco g try o Barnstable County Book. Page for: Property Owner and has been noted in the chain of title of the affected property in: . Book Page In accordance with the Order of Conditions issued on: Date If recorded land,the instrument number identifying this transaction is: Instrument Number If registered land, the document number identifying this transaction is: Document Number Signature of Applicant BWPAForm5.doc-rev.9121105 Page 7 of 7 1 k 1 • ° SAM ZAX ASSOCIATES Phone: (781) 303-1700 CONSULTING ELECTRICAL ENGINEERS Fax: (781) 303-1705 E-Mail: mzax@zaxassociates.com 14 Wood Road Braintree, MA 02184 ELECTRICAL DESIGN AFFIDAVIT To the Commissioner, Centerville Building Department Re: 120 South Main Street, Centerville, MA. That to,the best of my knowledge, information, and belief, the Electrical plans:an.: ;come ato -__ accompanying the attached application concerning the locus at 120 South Main S reet, Outer- ;;Ile, MA are in accordance with the requirements of the Massachusetts State Building Code and all other pertinent laws and ordinances. 0:.1-. � JAMES P. STROKE 20068 ENGINEER MASS. REG.NO. t 5:c r Sam Zax Associates COMPANY 14•Wood Road, Braintree, Ma. 02184 ADDRESS . (781) 303-1700 a PHONE November 30,2007 " Then personally appeared the above-named JAMES P. STROKE and made oath that the above statement by him is true. j Before'm , My Commission expires CD - Z� �oB F10t3,ERT F.KRIM JR, Notary Public Ca;nmonwealth of massachusetts l My commission Expires ,/ (coder 24,2008 CONSTRUCTION CONTROL AFFIDAVIT PROJECT NUMBER: DATE: Nov 29, 2007 PROJECT TITLE: Assisted Living Addition to Cape Regency Nursing Facility PROJECT LOCATION: Centerville, MA NAME OF BUILDING: Cape Regency Nursing Facilitya SCOPE OF PROJECT: Addition to existing facility v, c-s =1 IN ACCORDANCE WITH SECTION 116.0 OF THE MASSACHUSETTS ST BUILDING CODE, 6T" EDITION, I, Robert F. Griffiths, MASS. REGISTRATION NO. 33 BEI AV. REGISTERED PROFESSIONAL ENGINEER HEREBY CERTIFY THAT I HAVE ` REP/U�ED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIG PLUS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: !:4 ENTIRE PROJECT ARCHITECTURAL - STRUCTURAL X MECHANICAL FIRE PROTECTION ELECTRICAL OTHER (specify) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEDGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACTICES AND ALL APPLICABLE LAWS FOR THE PROPOSED PROJECT. ..I •FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL 'SERVICES AND BE PRESENT, ON THE CONSTRUCTION SITE ON A REGULAR-AND 'PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEDING IN,,ACCORDANCE 'WITH THE -DOCUMENTS APPROVED FOR THE BUILDING PERMIT'.;AND SHALL.-_BE 'RESPONSIBLE'FOR-THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2: 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit, and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials: 3. Special architectural or engineering professional inspection of critical construction components requiring controlled' materials or construction specified in the accepted engineering practice standards listed in Ap4endix B. PURSUANT TO SECTION .116.2.3, 1 SHALL SUBMIT PERIODICALLY, A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I SHA SUBMIT A FINAL POR AS TO THE SATISFACTORY COMPLETION AND READI F T P JE FO C ANCY. -4 Signa e On this 29th day of Nov 2007; before me,,the undersigned notary,-public, personally appeared,Robert F:, G iffiths (name of'document signer),,proved to me through satisfactory evidence'of identification;,,which� Was Verson knowledge of the identity of the principal, to be the person whose name is.sgned .on.�the _ preceo;ng or attached document in my presence. 't ' ' " . (Offciai signature and seal of notary) %w i " illy commission expires May 23, 2014 CONSTRUCTION CONTROL AFFIDAVIT PROJECT NUMBER: DATE: Nov 29, 2007 PROJECT TITLE: Assisted Living Addition o Cape Regency Nursing Facility PROJECT LOCATION: Centerville, MA NAME OF BUILDING: Cape Regency Nursing Facility SCOPE OF PROJECT: Addition to existing facility IN ACCORDANCE WITH SECTION 116.0 OF THE MASSACHUSETTS STATE BUILDING CODE, 6T" EDITION, I, Robert F. Griffiths, MASS. REGISTRATION NO. 42984, BEING A REGISTERED PROFESSIONAL ENGINEER HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT ARCHITECTURAL STRUCTURAL MECHANICAL X FiRE PROTECTION . ELECTRICAL OTHER (specify) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEDGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACTICES AND ALL APPLICABLE LAWS FOR THE PROPOSED PROJECT. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2: 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit, and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Special architectural or engineering � ofessional inspection of critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix B. PURSUANT TO SECTION 116.2.3, 1 SHALL SUBMIT PERIODICALLY, A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE B ILDING INSPECTOR. UPON COMPLETION OF THE WORK, I SHA UBMIT IN P RT AS TO THE SATISFACTORY COMPLETION AND READIN F T T CUPANCY. Z. OnAhis 29th day of Nov 2007, before me, the undersigned notary public, personally appeared Robert F. Ariftiiths (name of document signer), proved to me through satisfactory evidence of identification, which e ` ".waspersonal knowledge of the identity of the principal, to be the person whose name is signed on the preceding.or attached document in my presence. (Official signature and seal of notary My commission expires May 23, 2014 ANDERSON STRUCTURAL ENGINEERING, INC. 764 PLAIN STREET MARSHFIELD, MASSACHUSETTS 02050 781-837-6949 FAX 781-834-6253 November 29, 2007 Thomas Perry, Director Building Division Town Hall 367 Main Street Hyannis, MA 02601 Re: 06-164 Cape Regency Assisted Living Centerville, MA Dear Mr. Perry, This is to advise you that this office will provide construction administration services and be present on site periodically to determine that the work is in accordance with the approved construction documents in accordance with Section 116.2.1 of the Massachusetts State Building Code, 780 CMR 6rh Edi i F.PbSH OF hlgsS Sincerely, °c .BER AR m DICKS N -+ qLj� TRUC A .e .273 • Thomas Anderson TEA/tea tit r.. .r)� i / ,�' '. i. 1'_7 Ci ACV,1:. ,.i r-cv ,"AlIt..•' { b_Uh�.�..f cv) r cep David W. Oawlap oi(jdociated, Ate. ARCHITECTS-ENGINEERS-PLANNERS 105 Webster Street, Units 1 &2 Hanover, MA 02339 (781)878-0066 FAX(781)878-7060 E-mail:david@dhdunlap.com November 20, 2007 Thomas Perry, Director Building Division Town Hall 367 Main Street Hyannis, MA 02601 Re: Cape Regency Assisted Living Addition Dear Mr. Perry This is to advise you that this office will provide construction administration services and be present on site periodically to determine that the work is in accordance with the approved construction documents in accordance with Section 116.2.1 of the Massachusetts State Building Code, 780 CMR 6th Edition. Sincerely yours, DAVID H. DUNLAP ASSOCIATES, INC. %ED AR�y�T D UN44AF�� David H. Dunlap, Jr., NCARB, ARA No.3929 AM. o w President ^� P W. Oaaeap a4jdvciated, Ave. ARCHITECTS- ENGINEERS-PLANNERS 105 Webster Street, Units 1 &2 Hanover, MA 02339 (781)878-0066 FAX(781)878-7060 E-mail:david@dhdunlap.com November 20, 2007 Thomas Perry, Director Building Division Town Hall 367 Main Street Hyannis, MA 02601 Re: Cape Regency Assisted Living Addition Dear Mr. Perry 1 This is to advise you that this office will provide construction administration services and be present on site periodically to determine that the work is in accordance with the approved construction documents in accordance with Section 116.2.1 of the Massachusetts State Building Code, 780 CMR Oh Edition. Sincerely yours, DAVID+-1--.JUAP ASSOCIA T , INC. David H. f ,Jr., NCARB, A Presider NOV/15/2007/THU. 12: 42 COMM FIRE DEPARTMENT FAX No. 5087902385 P, 002 FIRE DEPARTMENTS OF THE TOWN OF BARNSTABLE Fire Prevention Office Hinckley ]Building 200 Main. Street,Hyannis, MA 02601 (508) 862-4097 BUILDING- CODE COMPLIANCE FORM plans-dated�"S f . the property located at �dclV =V,�✓ (�-�. : � , also known as have been reviewed,by. „ of the' .C] Barnstable COMM ❑ Cotuit ❑ Hyannis- ❑ West Barnstable ,. Fire Department. THE CHART BELOW INDICATES THE STATUS OF THE REVIEW:, TYPE OF CONSTRUCTION DOCUMENT N/A RECEIVED REVIEWED COMPLIE 1. Narrative Report 2. Firefighting.& Rescue Access 3,Hydrant Location &Water Supply a. Sprinkler Systems 5. Sprinkler Control Equipment 6. Standpipe Systems 7. Standpipe Valve Locations ., 8. Fire Department Connection 9, Fire Protective Signaling System 10. F.P.SZ. & Annunciator Location` 11. Smoke Control/Exhaust 12. Smoke Control Equipment Location 13. Life Safety System Features 14. Fire Extinguishing Systems 15. F.E.S. Control.Equipment Location, 16, Fire Protection Rooms 17. Fire Protection Equipment Signage 18, Alarm Transmission Method ' 19. Sequence of Operation Report A 20.Acceptance Testing Criteria We believe this document to be-complete and compliant for the issuance of a building.permit. tu We have completed the acceptance Mfing for' the occupancy permit and believe that within the scope of the building permit, the above issues are in compliance. KEVIN SCRIMA PROJECT SUPERINTENDENT NAUSET C N TR UC N CORP. BOSTON, MASSACHUSETTS • O LAND,MAINE 10 KEARNEY ROAD,SUITE 307 NEEDHAM,MA 02494 TEL:781.453.2220 FAx:781.453.2250 MOBILE PHONE:617.990.6830 KSCRI MA@NAUSETCONSTRUCTION.COMWW W .NAUSETCONSTRUCTION.COM i Nutter Eliza Cox Direct Line: 508-790-5431 Fax: 508-771-8079 E-mail: ecox@nutter.com December 13, 2006 #106700-1 By Hand i Ellen Swiniarski, Coordinator , Town of Barnstable Site Plan Review n 200 Main Street Hyannis, MA 02601 i Re: Site Plan Review #050-06 'i Cape Regency Nursing Facility 120 South Main Street, Centerville, MA c Dear Ellen: The above-referenced expansion and redevelopment project was heard at a formal Site Plan Review hearing on September 28, 2006. At that hearing, administrative approval was anticipated pending submittal of updated plans which addressed the Committee's concerns. Subsequent to the Site Plan Review hearing, our project team met with members of COMM to review their concerns regarding turning radii, aisle width and the parking spaces. In addition, Patrick Butler and I met with the Building Commissioner at the end of November to review with him the plan revisions. At that meeting, the Building Commissioner requested that we provide the revised plans to him for administrative review. In that regard, I enclose two (2) full size and seven (7) reduced sized sets of the revised plans. Our civil engineer is in the process of finalizing two of the plans, Sheet C-4 (site plan) and Sheet EC-1 (sedimentation control) and we will be forwarding those under separate cover. However, all of the proposed revisions are shown in detail on Sheet SP-1 (site plan - zoning) and Sheet SP-3 (traffic circulation). The changes to the plans include: 1. Confirming fire apparatus turning radii; 2. Increasing the number of proposed parking spaces to 97 (78 existing and 83 proposed at the SPR hearing); 3. Eliminating the originally proposed canopy by the front door; 4. Enlarging the travel aisles to accommodate COMM; NUTTER McCLENNEN & FISH LLP ATTORNEYS AT LAw 1513 Iyannough Road P.O. Box 1630 o Hyannis, Massachusetts 02601-1630 a 508-790-5400 m Fax: 508-771-8079 www.nutteccom Ellen Swiniarski, Coordinator December 13, 2006 Page 2 5. Enlarging the size of most of the parking spaces; g g P g 6. Fencing and gating the proposed dumpster; 7. Including a notation that the generator will be placed on a concrete pad; 8. Showing the painted fire lane; 9. Confirming the locations of the proposed hydrants with COMM; and 10. Providing drainage calculations (by letter dated September 29, 2006 to Steve Seymour). This redevelopment project is scheduled for the January 3, 2007 Zoning Board of Appeals (the "Board") agenda. As such, we would respectfully request administrative Site Plan Review approval prior to that date so that we may proceed on January 3`d before the Board. By copy of this letter, we are submitting copies.of the updated site plans to the Board thru its planner. Please do not hesitate to contact me if you have any questions, comments, or should you require any additional information. Thank you very much. Wishing you a very happy holiday season, I remain, Very truly yours, Eliza Cox EZC:rh Enclosures cc: Tom Lavallee, Regional Director of Operations, Radius Management Services (w/out enc.) John Truslow, Owner Representative, Radius Management Services (w/enc.) Stan Szczurko, SS Designs Environmental Consultants (w/out enc.) David Dunlap, David H. Dunlap Associates, Inc. (w/out enc.) Patrick M. Butler, Esq. (w/out enc.) Art Traczyk, Principal Planner, Zoning Board of Appeals (w/ enc.) 1587398.1 o�tl • y PROJECT NAME: ADDRESS: in!e PERMIT# Cab a55 7T EV157 04 i PERMIT DATE: /� p W A'ST� lit AT�.�Z M/P• 2 06 —G O t —6D1 JC7�64 LARGE ROLLED PLANS ARE IN: BOX 960 1 SLOT B I - Data entered in MAPS program on: 51.2114 BY: q/wpfiles/archive PROJECAT� /� NAME/��d�tL1 ADDRESS PERMIT#__a PERMIT DATE: M/P: c� LARGE ROLLED PLANS ARE IN: BOX SLOT -- Data entered in MAPS program on: BY: q/wpfiles/archive f7T�n 1414T17T1 - 2� 1.0' DETAIL A SCALE.• 1"=20' .' p 1 4.3' Cl) OR Y ��- oa n 3—ST BRICK BUILDING N/F \ 2.5' / 0.2' HCR/ MASSACHUSETTS PROPERTIES TRUST ASSESSORS MAP 208 PARCEL 89— 0.2' DEED BOOK ` 19217 PA GE 213 a•� 1op 6� n2 LOT AREA 19.54f ACRES TOTAL :.. ! o.s 0.1 Ile (SEE DETAIL B) o 1.0' EXISTING FOUNDA TION ADDITION o 10' BUILDING SETBACK LINE 210.21' S 89:59'23" W CAPE REGENCY NURSING HOME / 120 SOUTH MAIN STREET \ 3-STORY / BRICK BUILDING \ EXISTING \ FOUNDATION � ADDITION . (SEE DETAIL A) SSA"�0 \ C. ` . CD-_ N ` • U N N/F o HCRI MASSACHUSETTS PROPERTIES TRUST ll ASSESSORS MAP 208 PARCEL 89-1 �- DEED BOOK 19217 PAGE 213 LOT AREA 19.54± ACRES TOTAL �0 \ �• 1�1' ,05 �, o - ACK LINE , • SE TB 10' SUILOING \� 148.69' W 1 �. ! 8�;18 05 .. - S 83'3514 6 �' 5 I HEREBY CERTIFY THAT THE "EXISTING FOUNDATION ADDITION„ IS LOCATED ON THE GROUND AS SHOWN, HEREON AND COMPLIES 190 WITH THE DIMENSIONAL SETBACK REQUIREMENTS OF THE TOWN p° OF BARNSTABLE. GRAPHIC SCALE 40 o 20 40 80 ,so L C PHEN �G r q 1 Elms DETAIL B T 32742 2 6$ ( IN FEET ) OVERALL PROPERTY LIMITS s E i inch 40 ft. 013r�ft PLAN BOOK 349 PAGE 30 , ,,, STEPHEN P. DYE S #32sl o,sT � DATE.• = , PLAN BOOK 429 PAGE 93 uaL LA SCALE., 1"=150' Na DATE REMSIDNS MADE CHECKEDBY BY PROJECT TITLE: SHEET TITLE: CAPE REGENCY NURSING HOME4 b e 11T FOUNDATION - ADDITION 120 SOUTH MAIN STREET ar pyct e r p i FY +.63�,n�QP�2:.b.r F.+.n interior6.f rw+�3��� ;oT �i��i�i5.+ers � �i' AS-BUILT PLAN 97 t..it-,c;� Industrial y Endrial Parkway 17t11 FAQ,.c,Ti?t) CENTERVILLE, MASSACHUSETTS Weyrnoul,,M 02189 t781331 �;B._7 c FILE NO. PROJECT NO. SCALE APPROVED BY CHECKED BY DRAWN BY DATE www.cubellis.com MA ME NJ PA VA • MI • IL • FL 080346ASBOOl 080346 1"-40' S.P.D. S.M./S.P.D. 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SIAMESE _ 0 •Q `� \ / /�/�' / / \ Z w"` CONNECTION_- \ / - � TRANSFORMER tt m 0 '''• � 1-9 SHED ° 00 FIRE LANE NO C30 \3g• \ �^ --� / -�� �/ \ d � z y o¢c� O I a w PARKING SIG I \ ° 0 \��•\ �� // / = U w r 5 UT °�'°o PAVED PATIO AREA O �+, 0 0 ` 4p �\ J --'_ - '- • /_ '- �• \ IZ ry I- ��10 l/ `� Jose— n ° `'o. 5 �` 0 \gyp \ \� • ` ._...- • • \ w Q LANDSCAPE 0 �/ \ o0 0 WALL UNDER Q 0 O O OC L'- ° •\1 _4�_ — L-. �—±— AIR E S . I 0 T A w �- Y Z o\ O�oo°O° { \ CONSTRUCTION fi \G `"-- --" \ 0 Q m AVEL ROAD°\ C> ,P, --44 .�• \ _ \� 5 -- _ � • � z Ld ~°\o O°O O O °IR O 4_0 PVC A� - - ,` ` '`Kam, �� tiC 'I / l • '� '`�. • • '"' ' _ !Y U PARKING SPACES PROVIDED SS — I ' — �, ' _ r ' w w FIRE ROAD ACCE � a ,,,, = .•., = ^�. .� �_ x \o = �•. 1. : . C 98 PARKING SPACES 5 H. C. = _ �t o 0 z w mQ 00 \ 4 (n NOTES: EL. 49.08 �\°\ ` \ �+ �` �` w" \ Ld I— zzz SOIL C � ` � -�� ` � � C`o �, ` \ VEMENTS \ \\ _� J `' 0 Q 1 . THE PURPOSE OF THIS PLAN IS TO SHOW SITE IMPRO STOCKADE-- �� !y ``� AB RPTION ` ` ., \ �o LANDSCAPING AND ADDITION ASBUILT FOR 120 SOUTH MAIN STREET, FENCE `�°\ �� TEM —``` ` ` ` � J C Q m CENTERVILLE, MA \° \ _ f 0 2. PLAN REFERENCES: �C1° \°�° C ;' C .� .,, zz, 6 \O �cS, m ~ � » \o �J \ �[ %' ABSORPTION \� I— W CD A. ALTA/ACSM LAND TITLE SURVEY �9 \ SYSTEM N Z:BSORPTI0bL S�OL� c =a _ \cill 120 SOUTH MAIN ST, BARNSTABLE (VILLAGE OF CENTERVILLE) DATED JANUARY 18, 1999 Q °\ ® O Z ° \ d N3 lb \� W (n BY HIDELL�—EYSTER TECHNICAL SERVICES. °\°. \ q , = ' \ \6� U o `0r B. PLAN ENTITLED, "SEWAGE SYSTEM DESIGN FOR 120 BED NURSING HOME LAND IN BARNSTABLE, MASS" /� \°�� 4 1 o �.. /- -y � O BY DOWN CAPE ENGINEERING CIVIL ENGINEERS AND LAND SURVEYORS. C. PLAN ENTITLED, SITE PLAN BY SS DESIGNS FOR CAPE REGENCY REHAB AND NURSING CENTER o\ . O, z = 120 SOUTH MAIN STREET, CENTERVILLE, MA DATED 8/31 /06 REV. 3/8/08 ' o �� � \J \ � O W �9 o ,{° - S � ¢ Lli LEGENDEl : LAND COURT BOUND FOUND EXISTING LIGHT \ . �\ K LI N -- o \, Q \ , _ 1 FIRE HYDRANT XISTING CATCH BASIN R U LQ N E tiY0 E \1 0_- . - v ((^^ a — -- BUILDING SEWER EXISTING TREE Q \' � • 16 crm ° 0 J —FM--- FORCE MAIN _ 1 4 8 W WATER LINE NEW 2" DlA TREE c ° �, ,� 9, \�' G Fj � G GAS LINE NEW LANDSCAPE PLANTS `� JN W J E/T ELECTRICAL LINE '�F�� GRAPHIC SCALE o OW WA TER GA TE 0 z (u G �\\ 30 0 1S 30 80 120 P� v �+ o TANK Q J O CLEANOUT MONITORING WELL C \ ( IN FEET _ --- — 1 inch _ 30 ft. SHEET 1 OF 1