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HomeMy WebLinkAbout0120 SOUTH MAIN STREET (9) a �-76 I i I a i l UUILMNG—DIVISION 200 MAIN Town of Barnstable HYANNIS,CIA 02601 Certificate of Zoning Compliance Certificate No. 2021-65 Map 208 Owner Name as of 1/1/21: Parcel 089-001 Address 120 S Main St Village Centerville CAPE REGENCY LANDLORD MA LLC 135 SOUTH ROAD Zone RC-2 FARMINGTON, CT. 06032 Zone AP Water Protection Year Constructed Lot Size 19.54 Acres Property Use: Nursing Home/Assisted Living Facility Setbacks: Cert of Occupancy Issued: YES Front Yard 20' Side Yard 10' Rear 10' Date: July 1982 (120 Beds) Permit NA Date: 06/19/2009 (Addition) Permit 20080343 Open Permits: E-2015-01781 Permit issued in 2015 to replace breaker for generator—status now expired. New permit& inspection required to close out. Code Violations: No current violations on file. Special Permits: 1980-91 • 2007-002 The Building Division does not receive or maintain information regarding municipal liens. Municipal Liens - Tax Office 508-862-4054 Refer to the Planning Dept.for information pertaining to the Zoning Board of Appeals filings and decisions. 9 Property Description: Map 208 Parcel 089-001 is situated with its driveway entrance on South Main Street in Centerville. The lot consists of 19.54 acres and is configured in an irregular shape. It has been developed by special permit SP#1980- 91 in the front half of the parcel with a 3 story commercial nursing facility and associated parking area. Special Permit 2007-002 was subsequently granted to allow for the construction of 29 assisted living units. The site is limited to 120 nursing home beds and 29 one bedroom units with 10% of all beds reserved for eligible Medicaid residents. Reviewed by Title Date: Robin C. Anderson Code Compliance Manager 08/23/2021 i Commonwealth of Massachusetts � y �,�° Town of Barnstable I BARN9e_ 1 % `0ea 200 Main Street(508)862-4038 vATE°""AAA PERMIT REPORT BY ADDRESS Address: 120 SOUTH MAIN STREET,CENTERVILLE PIN Status Permit For ParceFj Ap'llicant Work Description Inspection Inspected on Inspection Inspection f Wit:: Status Comment > . B-12078 Closed Sign 208-089-001 Nardini,Richard CAPE REGENCY NURSING HOME B-2006-4313 Closed Addition/Alteration- 208-089-001 PAPANTONIS. SITE IMPROVEMENTS Building Final 10/3/2007 Fail JLAU: Commercial ANTHONY AND INTERIOR RENOVATION TO CAPE REGENCY- NO CHANGE TO FOOTPRINT B-2006-4313 Closed Addition/Alteration- 208-089-601; PAPANTONIS. SITE IMPROVEMENTS Building Final 6/13/2008 Pass JLAU: Commercial ANTHONY AND INTERIOR RENOVATION TO CAPE REGENCY- NO CHANGE TO FOOTPRINT B-2006-4313 Closed Addition/Alteration- 208-089-001 PAPANTONIS. SITE IMPROVEMENTS Building Frame 3/16/2007 Pass JLAU:WALL Commercial ANTHONY AND INTERIOR PENETRATION RENOVATION TO S ONLY CAPE REGENCY- NO CHANGE TO FOOTPRINT B-2007-00561 Closed inspection Certificate 208-089-001 COI CONTRACTOR CAPE REGENCY B-2007-05589 Closed Addition/Alteration- 208-089-001 PAPANTONIS. NEW COMM ADDITION Building Final 6/10/2009 Conditionally JLAU:ADD Commercial ANTHONY TO EXISTING,W/SITE Approved PARKING IMPROVEMENTS PROTECTION, AND WASTE WATER WASTEWATER TREATMENT FACILITY METER INSTALLATION Custom Status: Conditionally Approved 1 of 11 J THE Commonwealth of Massachusetts Of Tp� Town of Barnstable t • BARNSTABLE. MASS. 200 Main Street(508)862-4038 �$ 1639. �0 ""A�� PERMIT REPORT BY ADDRESS PIN Status ' Permit For Parcel ID Apilicant Work Description Inspection. Inspected on Inspection Inspection Status Comment B-2007-05589 Closed Addition/Alteration- 208-089-001 PAPANTONIS. NEW COMM ADDITION Building 4/15/2008 Conditionally JLAU:PARTIAL Commercial ANTHONY TO EXISTING,W/SITE Foundation Approved ONLY IMPROVEMENTS AND WASTE WATER TREATMENT FACILITY Custom Status: Conditionally Approved B-2007-05589 Closed Addition/Alteration- 208-089-001 PAPANTONIS. NEW COMM ADDITION Building Frame 2/6/2008 Conditionally JLAU: Commercial ANTHONY TO EXISTING,W/SITE Approved BASEMENT OF IMPROVEMENTS EXISTING ONLY AND WASTE WATER (NEEDS NEW TREATMENT FACILITY SPRINKLER HEADS) Custom Status: Conditionally Approved B-2009-00387 Closed Inspection Certificate 208-089-001 COI CONTRACTOR CAPE REGENCY B-2009-02854 Closed Sign 208-089-001 PROPERTY OWNER REFACE EXISTING 15 SQ SIGN CAPE REGENCY B-2009-04218 Closed Inspection Certificate 208-089-001 COI CONTRACTOR BROOKSIDE AT RECENCY,ASSISTED LIVING B-2011-00891 Closed Inspection Certificate 208-089-001 PROPERTY OWNER CAPE REGENCY B-2013-00772 Closed Inspection Certificate 208-089-001 PROPERTY OWNER PROPERTY OWNER/CAPE REGENCY REHAB.& HEALTH CARE 2of11 THE Commonwealth of Massachusetts ILI of .l°� Town of Barnstable w ta�ss m 200 Main Street(508)862-4038 rE°^^A�' PERMIT REPORT BY ADDRESS A Il�cant Work Descri "tion Iris ection" lns "ected on Ins ection Ins ection PIN Status Permit F,or Parcel ID p p p p p p Status Comment B-2013-01213 Closed Addition/Alteration- 208-089-001 CAROLL,STEVEN A REPLACE INSULATION Building Final 4/1/2013 Pass JLAU: Commercial AND DRYWALL REMOVED DUE TO WATER DAMAGE INTERIOR ONLY! B-2013-01213 Closed Addition/Alteration 208-089-001 CAROLL,STEVEN A REPLACE INSULATION Building Insulation 3/14/2013 Pass PFRA: Commercial AND DRYWALL REMOVED DUE TO WATER DAMAGE INTERIOR ONLY! B-2013-03404 Closed Sign 208-089-001 PROPERTY OWNER TEMP SIGN 36 X 60 4 WKS CAPE REGENCY B-2013-04139 Closed Sign 208-089-001 PROPERTY OWNER` CAPE REGENCY SIGN 15.97 SQ FT (MONUMENT. UPDATED PANELS) B-2014-07501 Closed Inspection Certificate 208-089-001 PROPERTY OWNER BROOKSIDE AT REGENCY ASSISTED LIVING B-2015-01174 Closed Inspection Certificate " 208-089-001 PROPERTY OWNER CAPE REGENCY NURSING AND REHAB CENTER B-20-3410 Closed Building- 208-089-001 Giovanni Colafrancesco Remove existing roof Siding/Windows/Roof/Door down to concrete deck. s Install minimum R-30 insulation and 60mil EPDM roof system fully adhered. B-21184 Closed"" h" Inspection Certificate 208-089-001 COI CONTRACTOR CAPE REGENCY REHABILITATION& NURSING CENTER I 3of11 Commonwealth of Massachusetts Op THE 1p� Town of Barnstable 9 26 . �0�q 200 Main Street(508)862-4038 AlfDMA�A PERMIT REPORT BY ADDRESS ' PIN Status Permit For. Parcel ID Apllicant, Work Description Inspection> Inspected on Inspection Inspection Status Comment B-22313 Closed Conversion 208-089-001 JOHN CLANCY WALKWAY AND RAMP Building Carnival 12/17/1997 Pass TPER: B-47859 Closed Siding/Windows/Roof/Door 208-089-001 R&R ROOFING STRIP/REROOF s COMM.APPROX 140 SQ. i B-86226 Closed Sign 208-089-001 HCRI MA PROPERTIES 11.48SF TRUST II REPLACEMENT SIGN E-2007-00913 Closed Electrical-Add/Alter 208-089-001 GLYNN ELECTRIC, WIRING FOR Electric Final 9/6/2007 Pass WAMA: INC. NURSING HOME ADDING NEW RECEPTACLES IN THE PATIENT ROOMS.3 RECEPTACLES PER ROOM REMOVE/REP FIXTRS E-2007-00913 Closed Electrical-Add/Alter 208-089-001 GLYNN ELECTRIC, WIRING FOR Electric Rough 3/16/2007 Fail WAMA: INC. NURSING HOME ADDING NEW RECEPTACLES IN THE PATIENT ROOMS.3 RECEPTACLES PER ROOM REMOVE/REP FIXTRS E-2007-05589 Closed Electrical-Add/Alter 208-089-001 PAPANTONIS. NEW COMM ADDITION Electric Final 4/3/2009 Pass WAMA: ANTHONY TO EXISTING,W/SITE IMPROVEMENTS AND WASTE WATER TREATMENT FACILITY E-2007-05589 Closed Electrical-Add/Alter 208-089-001 PAPANTONIS. NEW COMM ADDITION Electric Final 4/23/2009 Pass WAMA: ANTHONY TO EXISTING,W/SITE IMPROVEMENTS AND WASTE WATER TREATMENT FACILITY 4of11 Commonwealth of Massachusetts OF THE Tp� v .y AB, ° Town of Barnstable BARNST 9$ i �0roq 200 Main Street(508)862-4038 ArE°""AAA PERMIT REPORT BY ADDRESS `' PIN Status 'Permit For Parcel ID: - Apllicant Work Description Inspection Inspected on Inspection Inspection Status Comment E-2007-05589 Closed Electrical-Add/Alter 208-089-001 PAPANTONIS. NEW COMM ADDITION Electric Rough 2/5/2008 Pass WAMA: ANTHONY TO EXISTING,W/SITE IMPROVEMENTS AND WASTE WATER TREATMENT FACILITY E-2007-05589 Closed Electrical-Add/Alter 208-089-001 PAPANTONIS. NEW COMM ADDITION Electric Rough 10/8/2008 Fail WAMA: ANTHONY TO EXISTING,W/SITE IMPROVEMENTS Reinspection AND WASTE WATER 150824 created TREATMENT FACILITY on 10/08/2008 by amaraw E-2007-05589 Closed Electrical-Add/Alter 208-089-001 PAPANTONIS. NEW COMM ADDITION Electric Rough 11/7/2008 Fail WAMA:Created ANTHONY TO EXISTING,W/SITE from inspection IMPROVEMENTS 150823 on AND WASTE WATER 10/08/2008 by TREATMENT FACILITY amaraw E-2007-05589 Closed Electrical-Add/Alter 208-089-001 PAPANTONIS. NEW COMM ADDITION Electric Rough 11/24/2008 Fail WAMA: ANTHONY TO EXISTING,W/SITE IMPROVEMENTS Reinspection AND WASTE WATER 153509 created TREATMENT FACILITY on 11/24/2008 by amaraw E-2007-05589 Closed Electrical-Add/Alter 208-089-001 PAPANTONIS. NEW COMM ADDITION Electric Rough 12/2/2008 Pass WAMA:Created ANTHONY TO EXISTING,W/SITE from inspection IMPROVEMENTS 153508 on AND WASTE WATER 11/24/2008 by TREATMENT FACILITY amaraw 5of11 THE Commonwealth of Massachusetts pp 1p� y Town of Barnstable 9p- 16 9 `fro 200 Main Street(508)862-4038 pTfDMA<a PERMIT REPORT BY ADDRESS PIN Status Permit For Parcel ID Apllicant Work Description Inspection Inspected on Inspection Inspection Status Comment E-2007-05589 Closed Electrical-Add/Alter 208-089-001 PAPANTONIS. NEW COMM ADDITION Electric Rough 12/15/2008 Pass WAMA: ANTHONY TO EXISTING,W/SITE IMPROVEMENTS AND WASTE WATER TREATMENT FACILITY E-2007-05589 Closed Electrical-Add/Alter 208-089-001 PAPANTONIS. NEW COMM ADDITION Electric Rough 1/2/2009 Pass WAMA: ANTHONY TO EXISTING,W/SITE IMPROVEMENTS AND WASTE WATER TREATMENT FACILITY E-2007-05589 Closed Electrical-Add/Alter 208-089-001 PAPANTONIS. NEW COMM ADDITION Electric Rough 1/9/2009 Fail WAMA: ANTHONY TO EXISTING,W/SITE IMPROVEMENTS Reinspection AND WASTE WATER 155251 created TREATMENT FACILITY on 01/09/2009 by amaraw E-2007-05589 Closed Electrical-Add/Alter 208-089-001 PAPANTONIS. NEW COMM ADDITION Electric Rough 1/14/2009 Pass WAMA:Created ANTHONY TO EXISTING,W/SITE from inspection IMPROVEMENTS 155250 on AND WASTE WATER 01/09/2009 by TREATMENT FACILITY amaraw E-2008-05818 Closed Electrical-Add/Alter 208-089-001 US EDGE LOW VOLTAGE Electric Final 6/10/2009 Pass WAMA: CABLING E-2008-05818 Closed Electrical-Add/Alter 208-089-001 US EDGE LOW VOLTAGE Electric Rough 12/12/2008 Fail WAMA: CABLING Reinspection 154315 created on 12/12/2008 by amaraw 6of11 Commonwealth of Massachusetts Town of BarnstableT • BARNSTABLE. - a. v� i I `0m°i 200 Main Street(508)862-4038 AlE°MA<° PERMIT REPORT BY ADDRESS PIN Status Permit For Parcel111 Apllicant Work Description Inspection Inspected on Inspection Inspection Status Comment E-2008-05818 Closed Electrical-Add/Alter 208-089-001 US EDGE LOW VOLTAGE Electric Rough 12/15/2008 Pass WAMA:Created CABLING from inspection 151397 on 12/12/2008 by amaraw E-2009-01872 Closed Electrical-Add/Alter 208-089-001 SINCLAIR,WADE WASTE WATER Electric Final 5/8/2009 Pass WAMA: TREATMENT PLANT MOTORS AND CONTROLS E-2010-04949 Closed Electical-Minor 208-089-001 RISE ENGINEERING REPLACE LIGHTING Electric Final 8/12/2011 Pass WAMA: (THIELSCH) WITH ENERGY EFFICIENT FIXTURES E-2011-03885 Closed Electrical Service 208-089-001 GLYNN ELECTRIC, REPLACEMENT OF Electric Service 7/28/2011 Fail APUL: INC. BUILDING MAIN BREAKER.NSTAR TO Reinspection DISCONNECT/ 204081 created RECONNECT ON on 07/29/2011 by THURS 072811, pulleya #1838442 E-2013-06839 Closed Electrical-Add/Alter 208-089-001 BURGER,REX A INSTA;; 120 V Electric Final 9/30/2013 Pass EFOU: RECESSED RECETACLES FOR NURSING KIOSKS E-2015-01781 Issued -N Electical-Minor 208-089-001 SOUTH SHORE REPLACE BREAKER GENERATOR SERVICE FOR GENERATOR INC. E-53980 Closed Electrical Service 208-089-001 FULLER ELECTRIC REWIRE EMERGENCY Electric Final 7/16/2001 Pass RWES: CO.,INC. GENERATOR,OUTLET S RM 211-221 7of11 SHf Commonwealth of Massachusetts T°�� Town of Barnstable BARNSTABLE. 9 MASS. 0 200 Main Street(508)862-4038 "vp rE0 M i639• �0 ,P'�A PERMIT REPORT BY ADDRESS Permit For 'h .Parcel ID 'A yllicant Work`Descri 'fion fns. ection Ins ected on .Ins ection Ins ection PIN Status }, p p P p p P Status Cornmen.t . . E-58297 Closed Electrical-Add/Alter 208-089-001 ATLAS ALARM CORP. INSTALL POWER Electric Final 1/16/2002 Pass RWES: SUPPLIES& BATTERIES CK#38714 E-80502 Closed Electrical-Add/Alter 208-089-001 FULLER ELECTRIC EMERGENCY CO., INC. PANEL/TRNASFER CIRCUITS G-2007-05589 Closed Gas 208-089-001 PAPANTONI& NEW COMM ADDITION 'Gas Final 4/2/2009 Pass EJEN: ANTHONY TO EXISTING,W/S'ITE IMPROVEMENTS AND WASTE WATER TREATMENT FACILITY G-2007-06483 Closed Gas 208-089-001 HARDER,TIMOTHY UNIT HEATER Gas Final 11/9/2007 Pass RBUR: G-2007-07721 Closed Gas 208-089-001 SAGAMORE RELOCATE EXISTING Gas Final - 12/6/2007 Pass RBUR: PLUMBING& SERVICES HEATING, INC. - G-2008-02386 Closed Gas 208-089-001 SAGAMORE RELOCATE EXISTING Gas Final 5/2/2008 Pass RBUR: PLUMBING& PIPING HEATING, INC. G-2008-06320 Closed >. Gas 208-089-001 SAGAMORE TEMP HEATERS(2) Gas Final 4/1/2009 Pass RBUR: PLUMBING& HEATING, INC: G-39726 Closed Gas 208-089-001 COLONIAL GAS 1OVEN Gas Final 10/29/1999 Pass RBUR: COMPANY IC-16-362 Renewed Building-Certificate of @ParcellD Cape Regency Certificate of 8/3/2017 FAIL Occupancy loads Inspection Rehabilitation& Inspection for tv,dining and Healthcare Center outdoor patio areas must be listed 8of11 Commonwealth of Massachusetts vOE SHEVI lOh y Town of Barnstable 200 Main Street(508)862-4038 4 ATf°"" PERMIT REPORT BY ADDRESS 4� Status ; ;Permtt For,- Parcel ID A Ilicant . -Work"Descry tio.n Ins ection . fns ected:on .Ins ection Ins ection.` PIN, p p p p, p p, .. - ti .: �� - :Status Comment ; > , a IC-16-362 Renewed Building-Certificate of @ParcellD Cape Regency Certificate of 8/10/2017 Pass OCCUPANCY Inspection Rehabilitation& Inspection LOADS TO BE Healthcare Center POSTED ASSEMBLY SPACES WITH OCCUPANT LOAD GREATER THAN 50. IC-17-13 Closed' Building-Certificate of @ParcellD Brookside At Regency Certificate of 12/23/2019 Pass Inspection. Inspection IC-19-212 Closed Building-Certificate of @ParcellD Cape Regency Certificate of 7/31/2019 PASS No violations Inspection Rehabilitation& Inspection observed Healthcare Center P-2007-05589 Closed Plumbing 208-0897001 PAPANTONIS.' . NEW COMM ADDITION Plumbing Final 3/24/2008 Pass EJEN: - ANTHONY TO EXISTING,W/SITE IMPROVEMENTS AND WASTE WATER TREATMENT FACILITY P-2007-05589 Closed Plumbing 208-089-001 PAPANTONIS. NEW COMM ADDITION Plumbing Final 4/2/2009 Pass EJEN: ANTHONY TO EXISTING,W/SITE IMPROVEMENTS AND WASTE WATER TREATMENT FACILITY P-2007-05589 Closed' Plumbing 208-089-001 PAPANTO'NIS. NEW COMM ADDITION Plumbing,Rough 5/9/2008 Pass = EJEN:;' ANTHONY TO EXISTING,W/SITE IMPROVEMENTS AND WASTE WATER TREATMENT FACILITY P-2007-05589 Closed Plumbing 208-089-001 PAPANTONIS. NEW COMM ADDITION Plumbing Rough 7/10/2008 Conditionally EJEN: ANTHONY TO EXISTING,W/SITE Approved IMPROVEMENTS AND WASTE WATER TREATMENT FACILITY Custom Status: Conditionally Approved P-2007-05589 Closed Plumbing 208-089-001 - PAPANTONIS. NEW COMM ADDITION Plumbing Rough 8/28/2008 Pass EJEN: ANTHONY TO EXISTING,W/SITE IMPROVEMENTS AND WASTE WATER TREATMENT FACILITY 9of11 Commonwealth of Massachusetts �pF 1WE 1p� y Town of Barnstable '. BARNSTABLE. 9� MASS. 1 . �00 200 Main Street(508)862-4038 ""A�' PERMIT REPORT BY ADDRESS PIN Status Permit For Parcel ID Apllicant Work Description Inspection inspected on Inspection Jnspection Status `Comment P-2007-05589 Closed Plumbing 208-089-001 PAPANTONIS. NEW COMM ADDITION Plumbing Rough 10/22/2008 Pass EJEN: ANTHONY TO EXISTING,W/SITE IMPROVEMENTS AND WASTE WATER TREATMENT FACILITY P-2007-05589 Closed Plumbing 208-089-001 PAPANTONIS. NEW COMM ADDITION Plumbing Rough 10/31/2008 Pass RBUR: ANTHONY TO EXISTING,W/SITE IMPROVEMENTS AND WASTE WATER TREATMENT FACILITY P-2007-05589 Closed Plumbing 208-089-001 PAPANTONIS. NEW COMM ADDITION Plumbing Rough 12/8/2008 Pass EJEN: ANTHONY TO EXISTING,W/SITE IMPROVEMENTS AND WASTE WATER TREATMENT FACILITY P-2007-06480 Closed Plumbing 208-089-001 HARDER,TIMOTHY LAVS(9) Plumbing Final 11/9/2007 Pass RBUR: P-2008-02646 Closed Plumbing 208-089-001 SAGAMORE PIPING Plumbing Final 4/2/2009 Pass EJEN: PLUMBING& HEATING,INC. P-2008-02646 Closed Plumbing 208-089-001 SAGAMORE PIPING Plumbing Rough 5/14/2008 Pass RBUR: PLUMBING& HEATING,INC. P-2008-03630 Closed Plumbing 208-089-001 BLUE WATERS KITCHEN FAUCET Plumbing Final 7/8/2008 Pass EJEN: P-2009-02839 Closed Plumbing 208-089-001 SAGAMORE BACKFLOW Plumbing Final 6/18/2009 Pass EJEN: PLUMBING& PREWIRRIGATION HEATING, INC. 10 of 11 Commonwealth of Massachusetts OF THE tp� LL ` y Town of BarnstableMARR s ve 1 `0m 200 Main Street(508)862-4038619. t ATfDMP�A PERMIT REPORT BY ADDRESS PIN Status Permit For Parcel ID Apllicant Work Description Inspection inspected on Inspection Inspection Status Comment P-91251 Closed Plumbing 208-089-001 CARL F.RIEDELL& ONE MIXING VALVE Plumbing Final 4/5/2006 Pass EJEN: SON, INC. Total Permits: 72 18246400 180707 11 of 11 Jane Goins From: Barrows, Debi <Debi.Barrows@town.barnstable.ma.us> Sent: Wednesday,August 4, 2021 12:26 PM To: laneyGoins Subject: FOIA 2021-0396 Good Afternoon, in order'to process your request a check in the amount of$75 made payable to the Town of Barnstable is required. Thank you, Debi Barrows Office Manager Building Division 200 Main Street Hyannis, MA 02601 508-862-4032 BUILDING DEpT AUG 23 202, TOWN OF BARNST ABLE 8/3/2021 https://www.townforms.com/FOIADirect-BarnstableMACitizens/Public/Request/PublicRecordRequestForm.aspx bee%d Home Make a Request Search Requests Search Documents Citizen's Login tic Public Records Request Form Instructions: You may use this screen to submit your first Public Records request from this website.If you have previously submitted Public Records request using this website then please login.After login you may submit additional Public Records request(s). We may be able to locate the document record that you are looking for.In describing the record please be as specific as possible including;Names,Dates,Numbers, Key Words,etc.,so that we can identify the specific record for you. Request Description Describe the records you are requesting.Please be as specific as possible including;Names,Dates,Business Names,Numbers,Key Words,etc.,to avoid delays in processing your request.* Cape Regency Rehabilitation&Health Care Center,!920'South Main Street,Centerville!MA 02632,PIN:208-089-001,Municipality:Barnstable County Building.16formation Request All records need be only two yea�s_-old- Zr ffi today's.date. I as,requesting_the most recent building inspection report;any open__building-code-violations,most recent certificate of occupancy issued,and any permits for aliove/underground storage tanks. **Please confirm if there are any records of open building code violations** **This information is URGENTLY needed and REQUIRED by HUD.** Select a file to upload Choose File No file chosen 'Upload Person Requesting Information First Name* Jane Last Name* Goms House No. 201 Street D3G-201 Wylderose Drive City Midlothian State VA Zip Code 23113-_ Email* i.goins@d3g.com Phone (804)665-2912 Organization Name D3G Dominion Due Diligence Group Mode of Delivery* Email Request to Department Department* Building Department User Registration Registering yourself to the site is mandatory for submitting your request. Registering allows you to view your request(s)history by logging into the system in future and also submit additional Public Record request(s). The email address entered in"Email'field will be your User ID for Registration. Password* ""' Confirm Password* Please Note: There will be a charge for printed documents of 5 cents_per single sided r8-112 x 11 page, 10 cents,per double sided,8-1I2 x 11 page.Other s¢ed copies https:/twww.townforms.com/FOIADirect-BarnstableMACitizens/Public/Request/PublicRecordRequestForm.aspx 112 J I- 8/3/2021 https://www.townforms.com/FOIADirect-BarnstableMACitizens/Public/Request/PublicRecordRequestForm.aspx ,,, dire �IHome Make a Request Search Requests Search Documents Citizen's Login wr[rrourorrrea�on-arneoeray an 1a w[• En rr[errcarenoar-a-aya:rne-resporia-c-rrros[va-ermerarroiier-ro-prov[ac-o-re-requesteo-[r[a[c�rmsor—a citing the the applicable exemption(s). I'm not a robot reCAPTCHA Privacy-Terms St[tf'n*IZ"unt ©Copyright 2009-2016 Stellar/Vistiny- All Rights Reserved. https://www.townforms.com/FOIADirect-BarnstableMACitizens/Public/Request/PublicRecordRequestForm.aspx 2/2 I Date: August 7, 2018 To: Building File RE: Lagre unpermitted sign/banner Address: 120 South Main St, Centerville Originator: Unknown Owner: Cape Regency Landlord MA LLC Complaint: Huge Banner Enforcement Process Steps 13 1. Initiate local investigation: RA 13 2. Document/enter into system Yes 13 3. Contact 13 4. 5. Seek access to subject property 6. Seek administrative warrant(if necessary) ? 7. Notify state authorities of findings NA ® 8. Document conclusion OPEN ® 9. Referred Bldg/Jeff Property R208-089-001 Property is developed (1982)with a commercial use (nursing home). 08/06/2018 Caller advised there is a large sign on canvas(banner)seeking help for hire. Caller stressed it is a huge inordinately large sign in a residential area. There are no permits on file for temporary signage. There were no inquiries about size restrictions. Dispatched Jeff to photograph sign. PROJECT NAME: (' ADDRESS: 12 a PERMIT# o DATE: f °Z Iq o LARGE ROLLED PLANS ARE IN: BO X `Z i D13 SLOT DATE: /J-//3 0 n N u t to J�... +.r,,,A,,,. . T, I)LE , Eliza Cox �006 D EC 19 FIM 3: 18 Direct Line: 508-790-5431 Fax: 508-771-8079 y E-mail: ecox@utter.com; GI VISION' December 18, 2006 Fn #106700-1 By Hand t Ellen Swiniarski, Coordinator Town of Barnstable Site Plan Review 200 Main Street Hyannis, MA 02601 Re: Site Plan Review #050-06 Cape Regency Nursing Facility 120 South Main Street, Centerville, MA Dear Ellen: Pursuant to my recent letter to you dated December 13, 2006, I enclose herewith the two plans, Sheet C-4 (site plan) and Sheet EC-1 (sedimentation control), that were not submitted with the revised plans on that date for the above-referenced project. I also enclose an updated Sheet EC-3 (sedimentation control and site plan). The only changes on this updated EC-3 plan is that it now depicts a detail of the enclosed dumpster and a hydrant detail. As stated in my previous letter, the revisions since the site plan review hearing are shown in detail on Sheet SP-1 (site plan - zoning) and Sheet SP-3 (traffic circulation) that were previously provided. The enclosed plans, Sheet C-4 (site plan) and Sheet EC-1 (sedimentation control) were revised to correspond with the plan set provided to you last week. As this redevelopment project is scheduled for the January 3, 2007 Zoning Board of Appeals (the "Board") agenda, 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 Sheet C-4 (site plan) and Sheet EC-1 (sedimentation control) and the revised EC-3 (sedimentation control and site plan) to the Zoning Board of Appeals 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. Nutter McClennen & Fish LLP ® Attorneys at Law 1513 Iyannough Road, P.O. Box 1630 ■ Hyannis, MA 02601-1630 ® 508-790-5400 ® Fax: 508-771-8079 ® www.nutter.com i Ellen Swiniarski, Coordinator ' December 18, 2006 Page 2 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.) 1588968.1 ZONING CERTIFICATE September 2004 Health Care REIT, Inc. One SeaGate, Suite 1500 P. O. Box 1475 Toledo, Ohio 43603-1475 Radius Providence Realty, LLC 591 North Avenue#3 Wakefield, Massachusetts 01880 Ladies and Gentlemen: I am the duly appointed Building Commissioner for the Village of Centerville, Massachusetts (the "Village"), and am responsible for the enforcement of the zoning laws (the "Zoning Ordinance") of the Village. I am familiar with the 120 bed nursing facility known as Cape Regency Rehabilitation & Nursing Center located at 120 N. Main Street, Centerville, Massachusetts 02632 (the "Facility"). Based upon my review of the Zoning Ordinance, and the other records applicable to the Facility, I hereby certify the following: 1. Use. The Facility is currently zoned under the Zoning Ordinance. The use and operation of the Facility as a 120 bed nursing facility is a permitted use in such zone. The Facility is not a nonconforming use. No special use permits, conditional use permits, variances or exceptions have been granted nor are needed to use the Facility as a 120 bed nursing facility. The Facility is not located in any special districts such as historical districts or overlay districts. 2. Dimensional Requirements. The Facility is in compliance with all dimensional requirements, including, but not. limited to, minimum lot area, height limitations, maximum floor area ratio and setback requirements. w 3. Parking and Loading Requirements. The Facility is in compliance with all parking and loading requirements, including number of spaces, handicapped spaces, subcompact spaces, and dimensions,of spaces. a 4. Screening and Landscape Requirements. The Facility is in compliance with all screening and landscape requirements. 5. Sign Requirements. The Facility is in compliance with all sign requirements. 6. Driveway Permits. Access to the Facility is from . A curb cut permit was duly issued on , a copy of which is attached hereto, 7. Certificate of Occupancy. A final, permanent and unconditional certificate of occupancy was duly issued for the Facility on , a copy of which is attached hereto 8. Violations. There are no existing violations of the Zoning Ordinance or any other applicable laws, ordinances, rules, regulations and codes, including, but not limited to, building codes, fire codes, environmental codes and safety codes. This Certificate is being given to you in connection with the purchase and future operation of the Facility. You may rely upon the contents and accuracy of this Certificate in closing the transaction. (Signature) (Title) Building Commissioner (Date) ZONING CERTIFICATE September_, 2004 Health Care REIT, Inc. One SeaGate, Suite 1500 P. O. Box 1475 Toledo, Ohio 43603-1475 Radius Providence Realty, LLC 591 North Avenue#3 Wakefield, Massachusetts 01880 Ladies and Gentlemen: I am the duly appointed Building Commissioner for the Village of Centerville, Massachusetts (the "Village"), and am responsible for the enforcement of the zoning laws (the "Zoning Ordinance") of the Village. I am familiar with the 120 bed nursing facility known as Cape Regency Rehabilitation & Nursing Center located at 120 N. Main Street, Centerville, Massachusetts 02632 (the "Facility"). Based upon my review of the Zoning Ordinance, and the other records applicable to the Facility, I hereby certify the following: 1. Use. The Facility is currently zoned under the Zoning Ordinance. The use and operation of the Facility as a 120 bed nursing facility is a permitted use in such zone. The Facility is not a nonconforming use. No special use permits, conditional use permits, variances or exceptions have been granted nor are needed to use the Facility as a 120 bed nursing facility. The Facility is not located in any special districts such as historical districts or overlay districts. 2. Dimensional Requirements. The Facility is in compliance with all dimensional requirements, including, but not limited to, minimum lot area, height limitations,maximum floor area ratio and setback requirements. 3. Parking and Loading Requirements. The Facility is in compliance with all parking and loading requirements, including number of spaces, handicapped spaces, subcompact spaces, and dimensions of spaces. 4. Screening and Landscape Requirements. The Facility is in compliance with all screening and landscape requirements. 5. Sign Requirements. The Facility is in compliance with all sign requirements. i r I. 6. Driveway Permits. Access to the Facility is from . A curb cut permit was duly issued on , a copy of which is attached hereto. 7. Certificate of Occupancy. A final, permanent and unconditional certificate of occupancy was duly issued for the Facility on , a copy of which is attached hereto. 8. Violations. There are no existing violations of the Zoning Ordinance or any other applicable laws, ordinances, rules, regulations and codes, including, but not limited to, building codes, fire codes, environmental codes and safety codes. This Certificate is being given to you in connection with the purchase and future operation of the Facility. You may rely upon the contents and accuracy of this Certificate in closing the transaction. (Signature) (Title) Building Commissioner (Date) l i � �,� {; `� �. �. � � 1 � I c I E; � A ® I US MANAGEMENT SERVICES. INC. December 20, 2004 Town of Barnstable, Building Division Thomas Perry, Director 200 Main Street Hyannis, MA 02601 RE: Cape Regency and Nursing Center 120 South Main Street Centerville, MA.02632 Dear Mr. Perry, My company recently purchased the above named property and I am writing you to seek written confirmation that a nursing home, long term care facility, or skilled nursing facility, is allowed to operate at this address. Please direct correspondence to my attention at: Radius Management Services 1671 Worcester Road, Suite 300 Framingham, MA 01702 Thomas C. Director of Operations „c i :.. �.t � 3 .5.,�<. 1671 Worcester Road,Suite 300,Framingham,MA 01702 ph:508-879-4050 fic 508-879-1534 www radiusmanagementcom SET Town of Barnstable Regulatory Services 9BARNSTABLF. Thomas F. Geiler,Director. 0 ,3 ,u9. Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.ba rnstable.m a.us Office: 508-862-4038 Fax: 508-790-6230 September 21, 2004 Tarlow,Breed,Hart, Murphy&Rodgers,PC Attn: Geoffrey E.Norman 21 Custom House St. Boston,MA 02110 RE: Cape Regency Rehabilitation & Nursing Center 120 South Main St., Centerville,MA Dear Mr.Norman: This letter is in response to your zoning certificate letter of September 8, 2004. I have answered your questionnaire but would like to clarify a few,points.of your letter in case, for some reason, it should become an issue. Centerville is a village of the Town of Barnstable and my appointment is with the town, not just the village of Centerville. The address of this facility is located at 120 South Main St., Centerville not North Main as your letter refers to the property. 1. The area of the town that this property is located in is zoned RC-2. The facility exists in this area because of the benefit of special permit#1980-91. The site is not located in a historic district or an overlay district. 2. The facility meets,the height and setback requirements for this zoning district. Floor area ratio is not a requirement in our residential zoning at this time. 3. The facility meets parking and loading requirements. 4. The facility meets screening and landscape.requirements. 5. The facility was issued a sign permit on December 5, 1995. 6. Curb cuts were not required before 1995. 7. The certificate of occupancy was issued in July 1982. 8. There are no existing violations,to my knowledge, at this time.. 9. The Certificate of Inspection was issued on February 18, 2003 and expires on February 18, 2005. If I can be of any further assistance please let me know. Pnly Thomas Perry Building Commissioner TP/AW TARLOW B RE E D X1 HART MURPHY & RODG E RS,PC. Counsellors at Law Geoffrey E.Norman Direct Dial:(617)218-2019 E-mail:gnorman@tbhmr.com September 8, 2004 VIA OVERNIGHT MAIL Building Division Village of Centerville 200 Main Street Hyannis, MA 02601 Attn: Tom Perry RE: Cape Regency Rehabilitation & Nursing Center 120 N. Main Street Centerville,Massachusetts Dear Mr. Perry: We represent the future operator in the purchase of the above-captioned nursing home. In this regard, we are required to provide the Purchaser (Heath Care REIT, Inc.) with certain representations regarding the zoning of the particular property. We are therefore requesting that the Zoning Board/Building Division of the Village of Centerville execute a Zoning Certificate. Enclosed please find two (2) counterparts of a Zoning Certificate that we have prepared for this purpose. We have completed the information on this document in accordance with our records. Please review the document and, if necessary, make any corrections. Thereafter, kindly execute both counterparts of the Zoning Certificate and return directly to me at the address above. Please ensure that the foregoing is undertaken as a matter of urgency. If you have any questions regarding the enclosed, please do not hesita o call me. Cordiall , Ge ffr orm G EN/tep Enclosures cc without enclosures: Ken Behar, Esq. Mr. Jonathan Banton 1 Mr. Erik Jones ` Un' 21 Custom House Street■Boston,MA 02110■Telephone 617.218.2000■Fax 617.261.7673 ■www.tbhmr.com NOGi06/20l 00;5'9 COMM FIRE; DEPARTMENT FAX lk 5007901 05 F. COl cud- TOW jT' U. Af;msrA6 LE FIRE DUARTNIEN78 OF THE TOWN OF I3AR �T' A� Fire Prevention Office-Fdine' kYey Building 9. 46 200 Mainz Street,Hyannis,MA 02601 (508) 862-4097 ............... ._.� �17ISfiO BUILDING CODE COMPLIANCE FORM Plans dated for the property located at ( U_ lAllf AKA JAC y have been reviewed by of the Fire Department, THE CHART BELOW INDICATES THE STATV5 OF THE REVIEW: TYPE OF CONSTRUCTION DOCUMENT NIA -ECEIVED RE\Il lVEp CCMi'LIES j 1. Narrative Report — �2—Firrefightirig&Rescue Access 3. Hydrant Location&Water Supply AZ Sprinkler Systems I 5.Sprinkler Control Equipment 6. Standpipe Sy.stel •7.Standpipe Vialve'Locations S. Firs oepartment Connection — -- 9. Fire Protective Signaling System 10.F.P.S.S, &Annunciator Location 11.Smoke Control/Exhaust 12.Srnoke Control Equipment Location 13. Life Safety System Features 14. Fire Extinguishing Systems 15. F.E.S.Control Equipment Location 16, Fire Pmtectlon Rooms t 17. Fire Protection Equipment Signe.ge �. 18.Alarm Transmission Method 1.9. Sequence of Operation Report 20;Aoceptao3 a Testing Criteria We believe this document to be complete and compliant for the.issuance of a buildingg"°perrnit, We have completed the acceptance testing for the occupancy permit and believe that Within.the scope of the building permit,the above issues are in compliance. West Barnstable cotuit Barnstable Hi-dnnls C.O.M.M, Chief John R Jenkins Chief Paul Praxler Chief Robert Crosby Lt Eric Hubler FPO Glen S.Wilcox PCs Box 466 Captain DaAd Pierce PO Box 94 Lt Donald Chase Jr. FPO Mal MaeRlsaly W.Barnstable,02s388 PO Box..1632,02635 Sametable,02630 95 High School Road l;xt 1875 Route 23 (508)362-3241- (508)'4213-Z2t0 (508)362-3312 (508)775.1300 (508)7W-2380 r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map, ` Parcel 60 06/ ;Ytl, Application# Health Division �2m 5 5 7��•� Conservation Division Permit# J Tax Collector C6U f01 L �l Date Issued _ O Treasurer —(/V� fi�CICTL4° Application Fee Q D Planning Dept. CQ�0.. ' Permit Fee U d ©d Date Definitive Plan Approved by Planning Board V � Historic-OKH Preservation/Hyannis c Project Street Address c> e Village CeAiteryi��e- t Owner Il liuS 4A1AA2M2.N1 skrViCeS Address I 'lI loco r �c1 Svi O�Fc�cn;�hgM r Telephone SOS- ?g-46SQ Permit Request _ ► S q JeX-' i S k Square feet: 1st floor:existing 7.7?,27— p*pssed 2nd floor:existing ,prgpese4 Total new Zoning District Flood Plain Groundwater Overlay Project Valuation t,&X)_0Q0 Construction Type T -2— Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. or �u Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ®,No On Old King's Highway: ❑Yes A3 No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other A 4 Basement Finished Area(sq.ft.) 04,1 1A, Basement Unfinished Area(sq.ft) A44 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 4 Heat Type and Fuel: P.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# N Recorded❑ Commercial ❑Yes El No If yes, site plan review# A I� Current Use i teJ Lovc, Proposed Use Sane -BUILDER INFORMATION Name �quSel C,pSTc�c�ic,a Telephone Number :71RI-`f53 'Z2Z-b Address II -7 License# ed 02 ` Home Improvement Contractor# Worker's Compensation# WCA C314 fS'ro ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO T �e ov C ec ca iN S . SIGNATURE DATE P, ?114 C' LIN&TOMY PCI P�bljis FOR OFFICIAL USE ONLY _M f + J PERMIT NO. - y DATE ISSUED MAP/PARCEL NO. AJ t ,ADDRESS VILLAGE r ` OWNER r r. DATE OF INSPECTION: ' FOUNDATION + FRAME INSULATION ; � r r FIREPLACE i r ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL - i GAS: ROUGH FINAL C FINAL BUILDING 3 DATE CLOSED OUT ASSOCIATION PLAN NO. architects Tel (508) 626-3680 Fax (508) 875-8583 John Ciccariello`&-Associates; Inc: 22 Aberdeen Road Framingham,MA 01702 November 29, 2006. . Jeff Lauzon Building Inspector Town of Barnstable Building Department 200 Main St. Hyannis, MA 02"601 RE:,..., Cape Regency, a Radius HealthCare Center 1120'South Main St. Centerville, MA 02632 Building Permit Application Dear Mr. Lauzon, As a followup to our telephone discussion yesterday,please find enclosed herein the Construction Control Affidavit prepared and sealed under my signature as the Architect for the Project. I will be performing periodic inspections and will forward reports to you. 1 trust this meets with your approval and will,assist in expediting the Building Permit Application submitted by Nauset Construction. Very trul ours, John Ciccariello Cc: Jason Richards—Nauset Const. Jon Truslow—Radius Mgmt. Chris Bassett—Radius Mgmt. Enclosure architecture engineering construction management f CONSTRUCTION CONTROL AFFIDAVIT PROJECT NUMBER: 5-1475 DATE: November 29, 2006 PROJECT TITLE: Cape Regency—Interior Renovations& Exterior Improvements PROJECT LOCATION: Centerville, MA NAME OF BUILDING: Cape Regency, a Radius HealthCare Center NATURE OF PROJECT: New Interior Finishes to include ceilings, carpeting, tile work, painting, wall covering, new cabinetry, new light fixtures and hvac/plumbing related work. IN ACCORDANCE WITH SECTION 116.0 OF THE MASSACHUSETTS STATE BUILDING CODE, I, John Ciccariello REGISTRATION NO. MA 5514 BEING A REGISTERED PROFESSIONAL ARCHITECT HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS,COMPUTATIONS,AND SPECIFICATIONS CONCERNING: X HVAC X ARCHITECTURAL STRUCTURAL X MECHANICAL X PLUMBING X FIRE PROTECTION X ELECTRICAL _ OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEDGE,SUCH PLANS,COMPUTATIONS AND SPECIFICATIONS MEET THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERNG PRACTICES,AND ALL APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. 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 780 CMR 116.0,6`h EDITION OF THE MASSACHUSETTS STATE BUILDING CODE. SEAL Al AR�y7T �k��c1cc.4 F� ° No. 55.14 �o O NATICK, MASS. ��Fq SPG�J� OF MPS SIGNATUR On this 29th day of November 2006,before me,the undersigned notary public,personally appeared John Ciccariello ,proved to me through satisfactory evidence of identification,which was a Massachusetts Drivers License,to be the person whose name is signed on the preceding or attached document,and who swore or affirmed to me tha th contents th docu nt a truthful and accurate to the best of his knowledge and belief. (Official signature and seal of notary) My commission expires August 30,2013 z' 0 �•m= �'°���9;4Yp118�;�G'• � llillll\\\\\ s .f 12/04/2006 iE-:14 7814532250 NAUSET CONSTRUCTION PAGE 01/01 N�;y-,NAUSET CONSTRUCTION CORP. 10 KEARN[Y ROAD,SUtTF 30.7.N rDHAM,11A 02494 TFI_,781.453,2220.FAX'781A53,2250.W$B;WWW,NAUSF-TCON5TRUC-I0N.COM MY)NIO FAX: 508.790.6230 To: M.r. Jeff Lauzon, Building Inspector From: Anthony N. Papantoms, President Re: Cape Regency.Nursing 1.-lome, Centerville, MA Date: December 4,2006 Please be advised that.Mr.Anthony Papa.ntonis is the President of Na.usct Construction Corp. and is duly authorized to apply for and:receive n.1.3uilding Permit for the interior renovations of the Cape Regency Nursing Horne protect Located.in Centerville, NIA. Should you 1-mve any questions,please do not hesitate to contact this crr:.i�.ce at78 1._453.2220 x 102. i f ATE(MMIDD[YYYY) ACOR TM CERTIFICATE OF LIABILITY INSURANCE 10/30/20 6 PRODUCER ,(978)392-4567 FAX (978)3.92-9696 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION E. ]. Wells Insurance Agency, Inc.. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Regency Park HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 238 Littleton'Road Westford, MA 01886 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Acadia Insurance 11295 Nauset Construction Corp. INSURERS: Firemen's Ins. Co. of Wash. D.C. 10 Kearney Road INSURERC: Suite 307 INSURER D: ` 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.NOTWITHSTANDIN( 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 ADDT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS TFmm"GENERAL LIABILITY CPA 0121404 06/20/2006 06/20/2007 EACH OCCURRENCE $ 1 OOO OO X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,00( PR occCLAIMS MADE F_X]OCCUR MED EXP(Any one person) $ 15,00( A PERSONAL&ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO- LOC JECT AUTOMOBILE LIABILITY MAA 0180307 06/20/2006 06/20/2007 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ - 1,000,00 ALL OWNED AUTOS BODILY INJURY $ A SCHEDULED AUTOS (Per person) -X--HIRED AUTOS BODILY INJURY $ X NON-OWNEDAUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY CUA 0138270 06/20/2006 06/20/2007 EACH OCCURRENCE $ 10,000,00 X OCCUR CLAIMS MADE AGGREGATE $ 10,000,00 A $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WCA 0149456 06/20/2006 06/20/2007 X ^�' sTATJ- o R EMPLOYERS'LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ SOO,OO If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Project: Cape Regency Nursing Home. Radius Regency Operating LLC; Radius Management Services I, Inc. Health Care REIT, Inc; HCRI Massachusetts Properties Trust II are listed as additional insured with respect to General Liability where required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL Radius Management Services, Inc. 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn• ]on Trusl ow BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 1671 Worcester Road, Suite 300 OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Framingham , MA 01702 AUTHORIZED REPRESENTATIVE Paul Coffey ACORD 25(2001/08) ©ACORD CORPORATION 1988 JASON RICHARDS SENIOR PROJECT MANAGER 3 NAUSET CONSTRUCTION CORP. 1 BOSTON, MASSACHUSETTS • PORTLAND, MAINE 10 KEARNEY ROAD,SUITE 307 i NEEDHAM,MA 02494 13I TEL:781.453.2220 FAx:781.453.2250 MOBILE PHONE:617.293.7631 JRICHARDS@NAUSETCONSTRUCTION.COM i WWW.NAUSETCONSTRUCTION.COM 1 . r The Commonwealth of Massachusetts r r Department of Industrial Accidents. �.�_U I; Office of Investigations MN 600 Washington Street Boston, MA 02111 www.mass.gov/dia ` Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers C't Applicant Information Please Print Le 'bl Name (Business/organization/Individual): Ca' Jt' CA 1 Address: City/State/Zip: ► Phone#: -7 1` t53-2Za.0 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I = 6. ❑New construction employees(full and/or part-time).* have hired the'sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. $ 7• RRemodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity, workers' comp.insurance. Y P tY 9. ❑Building addition [No workers' comp. insurance 5. ❑ 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 11:❑Plumbing repairs or additions . myself. [No workers' comp. c. 152, §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#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and 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. I Insurance Company Name: ACQ s " Sy r-Z Policy#or Self-ins.Lie.#: kAlllc/ 4-1 Expiration Date: Job Site Address: City/State/Zip: 8 ?fir 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 insuranc erag erification. I do here,,,--e v under_t s penalties of perjury that the information provided above is true and correct Signature;�' — N;�.Y Date: 10 i1a 16. Phone'. Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Z -Information and Instructions Massacl=usetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. p-.Krsuant'to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An emp?oyer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual;partnership, association or other legal entity,employing employees. However the owner of a dwelling'house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license 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 any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone numbers)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance, If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accid-.nts for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department.of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pleas-e be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city 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 proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. Tne Department's address,telephone and fax number: i-----•=--' - !. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washir�n Street Boston,M-A 02111 Teal, # 617-727-4900 ext 406 or 1-8.77-MASSAFE Fax#i 617-727-7749 Revised 5-26-05 www.mass.gQvfdia II 00-35,000 cf enclosed space (961-C. 12 S.60L) 1A-Masonry only 1 G-1&2 Family Homes Failure to possess a:current edition of the Massachusetts State_Buildmg Code. j is cause for revocation-of this license. i' i 'i— DIG SAFE CALL CENTER: (888)344-7233 i +' � I ✓fie � ..,�caaaac`icca aonirrea�izcae � BOARD OF BUILDING REGULATIONS i ! License: CONSTRUCTION SUPERVISOR f 1 Number CS 063611 I Birthdate 10/11/1962 j #'.• � L�1-'tom-t--� �{ � .... �, 4T Expire 0%11y/2008 Tr no 3859.0 Rests t d i00 v J ANTHONY N PAPANTO,NIS I 8 GRACE DR MEDFIELD, MA 02052 'i C Commissioner .i . f Town of Barnstable ti Regulatory Services ' B^RM Thomas F.Geiler,Director j 039. a`e� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 t Property Owner Must Complete and Sign This Section If Using A Builder , as Owner of the subject property hereby authorize A to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name�e l lea C�S Q:FORM&OWNERPERMISSION TOWN OF BARNSTABLE BUILDING PERMIT f PARCEL ID 208 089 001 GEOBASE ID 12729 ADDRESS 120 SOUTH MAIN STREET PHONE; QENTERVILLE ZIP LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CO PERMIT 86226 DESCRIPTION 11.48SF REPLACEMENT SIGN PERMIT TYPE BSIGN TITLE SIGN PERMIT a CONTRACTORS: PROPERTY OWNER Department Of i ARCHITECTS: Regulatory Services TOTAL FEES: $25.00 BOND $.00 �tt1E ` CONSTRUCTION COSTS `... $.00 753 MISC. NOT ,.QODED ELSEWHERE 1 PRIVATE * B!►WSTABLE, MASS. ' RFD MA'S A i - BU INO ISION BY ,I DATE ISSUED 08/18/2005 EXPIRATION DATE Town of Barnstable oFt►+E rti Regulatory Services Thomas F.Geiler,Director snaxsrna[.B, 9� Mb 9 Building Division ArFnMp't° Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 - Fax: 508-790-6230 Permit#V L9 2 2 co Application for Sign Permit Applicant: &�k Q '-+A cn-uni Gy-ta . Assessors No. Doing Business As: Telephone No.- Sign Location Street/Road: C &r)U--RA I T) ST. Zoning District: Old Kings Highway? Yes/No Hyannis Historic District? Yes/No Proper y Owner Name: `T 1 _ (�` �, Telephone AddreY -1/ ►— Sign Contractor Name: TC�YI1 C�,i(1 Telephone: Mailing Address: t�f Description ! ` Please draw a diagram of lot showing location of buildings and existing signs with dimensions,location and size=of the new sign. This should be drawn on the reverse side of this application. , l , Is the sign to be electrified? Yes o (Note:If yes, a wiring permit is required) 73 FtSr Width of building face ft.x 10=;a� V_Q x.10=,,2 6=� , I hereby certify that I am the owner or that I have the authority of the owner to make this applicatio2ough at the ct t M r� information is correct and that the use and construction sh 11 conform to the provisions of§2 0-59 §240-89 of the Town of Barnstable Zoning Ordinance. lee ¢ Signature of Owner/Authorized Agent Date: U b� . Size: Permit Fee: Sign Permit was approved: Disapproved: Signature of Building Official: Date: Q Q:I WPFILESISIGNSISIGNAPP.DOC i 50 -41 .�- - Nr nL so 7�0 ZA 3 5 N -AN VdL V69 Vol ,a GPI q �ZZ t s Xl Y FLee Existing �F.. VM M M ;. b . b u •_ ,ter.. ��_ 1 p�R. sue, S 3 v 27" x 10" x 1/2" stroke 1 .84" toll NEW 1`.5" 51 .511 tall _ toll a r x y , ,, a 4.4 _ (2) 1/2" MDO (wood) - . V. xk � �: tall = Sign Panels Painted 32" Blue-Gray with ° _ . k Gold Painted 4. 2.1 " talf - Acrylic Letters/Logo ti H to Overlay Existing Sign Faces 1 .6" tall 1 .22" tall 1 .65" tall ® Boston Sign Co. 7 J4 sl 6 = 1 C 40 Plympton Street go.to. Boston,MA02118 P,.o;ectNar„e, Radius-Centerville sign M DO/Ac Type: ryl iC SIGN Tel.617.338.2114 ...... Fax 617.482.4825 Drawing number: 1.0.0 Drawing Date: 7/18/05 1 Approved By: Date: �+ 4 '> TOWN OF BARNSTABLE,BUILDING PERMIT APPLICATION -9 Map Parcel O Permit-# 44 5 Health Division - Date Issued ��� "0 Conservation Division ;` ' Fee 3!!, -7/ Tax Collector Treasurer f Planning Dept. Date Definitive PlarApproved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address I f11�1P Village �AP� Owner J 1)dW D D 17 _/V!!7 q C'e`I fe-k'.s Address / m� o9q Telephone 4 Permit Request S Square feet: 1 st floor: existing proposed 9 proposed ro osed 2nd floor: existing Total new Valuation 151, tna Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfatliered: ❑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 Cl new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board 4Ye eals Authorization ❑ Appeal# Recorded❑ Commercial ❑No If yes, site plan review# Current Use bfs�1—+rn� Proposed Use S � BUILDER INFORMATION Name °� �4!'/!L LO Jt Telephone Number Address ri �D L[,�� /yt" License# 10,4 Home Improvement Contractor#di/M MWorker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY POMIT NO. . DATE ISSUED MAP/PARCEL NO. � ADDRESS , ; VILLAGE OWNER g F r - f • t ± ! 1. • 1 DATE OF+INSPECTION: - FOUNDATION " FRAME , INSULATION _ f FIREPLACE - - ELECTRICAL: ROUGH FINAL- PLUMBING: ROUGH FINAL' i GAS: ROUGH FINAL FINAL BUILDING DATE CLOSEDtOUT ASSOCIATION PLAN NO. ' " --}' ccz "--`— Department of In - '�- - =- Oftfce of/ayestf�auaas a . ;fix•l � - 600 Washington Street Boston,Mass 02111 Workers'/�Com ensation Insurance av t :fin n t l��L.i Tit L7L'?IIQ name: locauon' hone# city I am a homeowner performing all work myself. [ I am a sole arovrietor and have no one working in=7 Capacitv , on for my empkayees v°°ridng on this job.::,..::::::::..::.,:{..}}:.;.,:tyyT',,:,:{.}:;.:: lover Bing w°rlsers com�Pcasatt ::.......... em :....:?:.:::.. :... i I am ...t......... oanv na :............. 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M • 1 �.•Y.1 1111 • t1 .1• • ••f111 • •y • - - • •,� �1 /• •.1 l:1111.. Y.l.•. 111111 J.. •'/1 MI •' �. J S. 1 Vim• �/1�• �•r Y •1 111.t y. 11. 1 • ' 1�-- 11.Y. 1 • ../11 11• •• ' • 1H�•••1 • • /t •I Ilt • •• .•/ •1••%11 •,w•1 w•Ir. 1 . ww1 •t✓• . •� • •• • I w • L:II •1/ •'• 1 • 1• U ,11 • 1 11 r ' .11 r 1.1 • 1 r•• •� •U •11 .11 1 1 • 1 • • 1 .11 • 1 :. • •• • - • •tt./•1 •• I • 1 •11 .11 • Y•. Illltl •� ' / •11 1 1 1 1 • t 1 1. I I I 1 1 1 1 1 III � 1 1 ' 1 1 t �• / , 1 1 1 1 1 • ' III � ' I I 11 1 I pArC.O I `D _: ;.;::: .:.. _ TE- i, "': .. I L�.Ti............................ ........... ...... .Y' � `.. :i: .: .:..:::::`:i';:ii;i:i:i:::?i;;:;:; DATE(MMIDOIYY( CEf T(FECQ OF h AB . SURAh�CE PRODUCER (50S)832-9896 FAX (508)832-9151 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Winchester Ins. Agcy. , Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 101 Auburn Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Auburn, MA 01$01 COMPANIES AFFORDING COVERAGE COMPANY United National "Ins.Company Attn: Sandi LaVenture Ext: A INSURED COMPANY Arbel l a Protection Co- R&R Roofing Co. ,I"nc. , Etal e' P.O. Box 316 Worcester Insurance Co an Millbury, MA 01527 corvsPAroY I r Y C COMPANY D ... COVERAGES:' ..... ....:`....:: ....... .. ......... ... . ..... c:::.....................................................:.....::::::::.: :::::::::::..........:;:::::...::;:::...-............::::::::..:.::... 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 NIAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE i POLICY EXPIRATION' LIMITS LTR: DATE(MM/DDIYY) DATE(MMIDDIYY) GENERAL LIABILITY _ GENERAL AGGREGATE S 2,000,000 ......:......................................................................... X COMMERCIAL GENERAL LIABILITY - - PRODUCTS-COMP/OP"AGG i S 2,000,000 .. ...: CLAIMS MADE X 'OCCUR - PERSONAL E ADV INJURY S 1,000,000 q L7134505 OT/0.7/2000 O1/07/2001 ...... .. ..... .. ....... ...... OWNER'S C CONTRACTOR'S PROT EACH OCCURRENCE S 1,000,000 - FIRE DAMAGE(Any one fire), .S 50,000 ........ .................................................. . __..........................._......................6.1............. MED EXP(Anyone person) :S excl uded i AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S ANY AUTO 1,000,000 i......: - : ... ..... .................. .:....... ............................ ALL OWNED AUTOS- - : INJURY BODILY IN RY B X SCHEDULED AUTOS (Per person) S B ...... 02459400000 06/04/2000 06/04/2001 ..... ...•......................_...... _._.._.......... X HIRED AUTOS BODILY INJURY S X NON-OWNED AUTOS (Per accident) .......i..................................................... ' i PROPERTY DAMAGE i$ GARAGE LIABILITY i AUTO ONLY-EA ACCIDENT S .............................................. ANY AUTO - - "OTHER THAN AUTO ONLY: .......................:.............. EACH ACCIDENT:S ................................................... ....:........................................ AGGREGATES " EXCESS LIABILITY - EACH OCCURRENCE S _ ...................................................................................... UMBRELLA FORM AGGREGATE S .._... .... ............ OTHER THAN UMBRELLA FORM S WORKERS COMPENSATION AND WC STATU- i :OTH-i.i.:.i : TO EMPLOYERS'LIABILITY - _. ,,._ ...... .RY LIMITS ER -EL EACH.AC C WC811673 03/12/2000 : 03/12/2001 ACCIDENT s 00,000 1 THE PROPRIETOR/ :INCL EL DISEASE-POLICY LIMIT S - 500,000 PARTNERS/EXECUTIVE ... ... ... .. .... OFFICERS ARE: EXCL: EL DISEASE-EA EMPLOYEE S 100,000 DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/SPECIAL ITEMS ertificate Holder to be listed as Additional Insured .......:...:...:.....:...:.........:....................:....:..........::.::..: :. .: : . ............................. ::::. ;r .. : CANE L...............CERTIFICATE:HOGDE.R::. <>;. ... CLATION .............; ..... ...... ... ...... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANC;.E..L..L..E..D...BEFORE THE ::::......... 't EXPIRATION OATETHEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL n0 -� DAYS WRITTEN NOTICE 1.0 THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESS IVE tC ey .....:..... ........... a WE A The Town of Barnstable KAM� De artment of Health Safety. and Environmental Services .659. 59 �' P Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Coinmissione. Permit no. ' Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION r MGL c. 142A requires that the"reconstruction,alterations,:renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent t. such residence or building be done by registered contractors,with certain exceptions,along with other requirements. n - Type of Work: -4t"G L A- 6"iea `l' Cost Address of Work: Owner's Name: /,[J Z At Date of Application: d I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. uAl ii, Contractor Nam Registration No. Date OR Date Owner's Name q:forms:Affidav P.02Pagel of 5 .� 1 Q THE STATE BOARD OF BUILDING REGULATIONS AND STANDARD'S AMENDMENTS TO THE STATE BUILDING CODE FOLLOWING CODE CHANGE PROPOSALS HEARD AT THE NOVEMBER , 1997 PUBLIC HEARING NOTE: THE EFFECTIVE DATE OF THESE CHANGES IS MARCH 1, 1998 building code amendments effective march 1, 1998 Of the 68 code change proposals filed at the November 1997 Public Hearing 38 were approved, 14 denied and 16 tabled. The 38 changes were filed with the Secretary of State,Regulations Division on February 5, 1998 and published in the February 20, 1998 Massachusetts Register-thus providing legal notification of a change in regulation. The effective date of the changes is March 1, 1998, This date was selected because many of the changes affect the one and two family dwelling code and the date coincides with the date that the fifth edition one and two family dwelling code was withdrawn. A synopsis of the amendments is shown below. Please note that the actual corrected pages are issued by the Secretary of State Regulations Division-THE SYSNOPSIS IS NOT A SUBSTITUTE FOR THE ACTUAL REGULATIONS. For availability of the changes contact the State Book Store. Telephone(617)-727-2834. SYNOPSIS OF CODE CHANGES EFFECTIVE MARCH 1, 1998 http://www.magnet.state.ma.us/bbrs/march9g.htm 6/12/98 Page 2 of 5 r w-y, i • Section Number S o xis of Code Change Section 1 —Mdsed to read;A construction a is not required for: 1idth)�eermevctdIoznLof` roofia siding,erection of rooftop solar collectors,construction of swimming pools, ' signs,installation of replacement windows not involving structural ifications,the erection of teats; b)projecty which are subject to construction control(section 166.0); )agricultural buildings which are not to the public or otherwise made available for 108.3.5.2 public use; d)Massachusetts registered professional engineers and Massachusetts registered architects provided such engineers and/or architects comply with the construction supervisor oversight requirements set forth in 790 CMIt R5,generally,and 780 CMR R5.2.12,as applicable; e)the practice of any trade licensed by agencies of the commonwealth(see MCL c 112 s 81R),provided that any such work is within the scope of said license,including but not limited to wiring,plumbing,gas fitting,fire protection systems,pipe fitting, HVAC and refrigeration equipment Add new section 116.1.1 to read;Specialized structures requiring construction control: 116.1.1 Telecommunications towers and sinWar structures are engineered and shall be b'ect to the requirements of 780 CMR 116. Add exception 2 to read;Exception 2:Where the head of the fire department or his/her 917.9 designee determines that partial or selective evacuation is not desired,but rather total evacuation is muired'then a distinctive signal,in lieu of a voice alarm,is permitted. Sections 1301.1,1309.1,1310.4,1310.7.2,1311.6,1311A 1311.8.1&2,Table Chapter 13 1311.6minimally amended to provide consistency with the adoption of the CABO Model Energy Code. Change Item 1 to read:One-and two-family dwellings:At least one(1)thermostat for 1310.7.3 regulations of space temperature shall be provided for each separate fiVAC system. In addition,a readily accessible mantra)or automatic mean shall be provided to pa,rtiall restrict or shut off the heating and/or coolie in ut to each zone or floor. Chapters 21 & Sections 2114.6,3610.4.7,Table 3610.6.4.1,Figures 3610.4.7a&b amended to 36 harmonize both the main Code and One-and Two-Family Code sections regarding clearances to combustibles for chimneys and fireplaces. Table 3403 Amend the Phese"Notes to Table 3404"to read"Notes to Table 3403". 3409.2.1(1) Change reference from Section 3409.4 to 3409.2.2. _ Change the definition of Installer ofManufactured Homet to read:"An individual,who on the basis of training and experience,has been certified by a specific manufacturer . f manufactured homes as competent to supervise the placement and connection 3502 required to install the manufactured homes of that.manufacturer.Said certification by the manufacturer shall be in writing,additionally,the certified installer shall possess picture identification in the form of a drivers license or other picture identification&see table to the building official" Add new definition:Clear spore:For simple,continuous and cantilevered bending 3602.0 members,the span shall be taken as the distance from face to face of supports,plus 112 e required hearing length at each end Reviw section to read:Roof spaces:Enclosed attics and enclosed rafter spaces formed here ceilings are applied directly to the underside of roof rafters,shall have cross 3603.6.8.1 Ovation for each separate space by ventilation openings that are protected against the entrance of rain and snow.The openings shall be covered with corrosion-resistant httpJ/www.magnet.statc.ma.us/bbrs/march98.btm 6/12198 h rr—= " LL co 1 . „�7 P•J•nGE-4fdA`!G To .� F, (� sri;ru,� z I i la '\ `. •, .i- ue-x , ... a•`�es� �p \fj�...-" - t �(` !T?.., ascaroCrcrew �' raEE`i�nv rs•-o• ..- (M).Swart • V i Y 3 of on' r —.. — d•n t�'; ua� ^�+ 6' \ .'�... �O / n2 Yl of`uI � - - p Exisrinc anens •9w99asEu O \\ - I q ¢ m r r .„ 'i �GEnEAATOR nwrr smut\ p E>asr n 90.csi�. r- - — w 1 P r� ol Ir lal ¢ z w' seY u / :'• 1 1 " STORY a 3 STORY I �- BRICK \.` _u.a.Ez• 1 BRICK \ �\ r ., �' ` y• J�C '�\' ',Z N�¢� �' u�i� I �¢ \:• a BUILDING I BUILDING7' HIGH \ 32' HIGH I 17' HIGH EXIST' (EXIST) J`<� \ \ ._. EgSi.vnuESE l �O,O \ •_.\ \ ~� •7 Ga,nccna: O O F� �esv a•we £ �wc.,ncw r./- ' /... o' I m m oi. Q 17Bi3±S•F. GROSS �. _ _I 9.54f ACRES TOTI! AREA rmE Y ?aa', *i-��`,. x4•o r s nM4� -,•� / a � '� col -t Ecsnnc P.•xn rex unc- ,":r (EXIST) _nosror, tr' - wnn �. _.,_ .- .... .• --.. .,., �\�ti n..m I m!�;i %3O En`T 9 G4L L _ ♦ _ >9.55' \,� 1 �y ... h'�, •. _ ..' �l �my'±l.� lei �sCRS b, / r C 1 , 62 mu ai. *'Farm~oio,�g ¢ .. Jj I'm f ear \ \ Q 0 CAI— .. ,G�• w _ _ `r •.lP z W !n� n W m ¢F w :,; r ' T°Ra°osn a•Mert>, - /' 'v `.� Of r_- �\ FRONT SETBACK AS �(/) 9�w \ �. •� PER BOOK 464, PG 410 Z zQ �I Q i J LLJ w1-�Q' Q v . a¢vE°oyQ�,� � •„r Lr P \- C-) ¢ - mjNeE s SEA =o z \\ l_� K l_i,r �� p�� e P,� � : _ o�5'14" W f 5�' W o 5 85 - I•�_GiTNO: - i .f P,\�� S EXISTING W N d X 40" OVAL SIGN 0 �i LAND COURT EOUntn FOUND• ON BRICK PIER Q ICsi PI' - / r+ nsnnr rvrr:cecnlCR IrnN Ir. _om14r R 9 L SUv / "CAPE REGENCY" U If '^ - j rrrsrlW LlrH7 °CPC TCS7 4 ti GG C lsriNG CON'lquRs - d PROP')fD J/GJ/r OF1Ali +I,MP,FR PROPOSY-0 CthVJOJXS UF'I A'L .__ } APPROVED IV/CR(JN( � IXIS LING C47C'II(3.1$lN C' _- •^'' V MASSACHUS=lTS DEPARTMENT OF -- L'---- fn�uNC � PRO"DSCLr CA rCI'RAiIN ��REFI RFNCI. SHUT PIJMHL"R • EN IRO ,. AL PROTECTION rlNn i LVrnNc erON(rDR1N('writ - - t 'Q"y GRAPHIC SCALE CXJ 7/NC 1/FCEI;LONE Qy(@�7-L S�b�j _ 1 Q N t7 F.YIiT/NG FIRC IIYDRANi a---• 4 b x PROPOSED s1 w2'R MnJJ1i0i L' EXISTING FCNCC ' PROPOSED rlRC H)DRANT - - - --- —-- SHEET OF 16 _Tti' a wa ICR f,4 rJ � t7�S7h'G PI;P � � (IN FEET) 1 inch m 30 7L. i d \ : �.• V SPILLWAY 3 • \� TYP - •aVN HAYBALES { BA I ... In � , I— s f \ Lo _. 1 _ Ld LLJ PROVIDE SHORING TO . Lli y tt _. ..PROTECT TAN: WHILE, - .► X �,.. i:.. i. �h : \ XCAWATIN �' \�` r" 7 O O Z 4, 0-p \ < F= tvn a3 S H 4 .. - 0— a ?�, 2 s \` - _ 6 QSEb EX p 8 � . "�. �°mod , < . \ .� .,•• ,,-�..__ _ \ � �s y� O) TE'RIOR LIGHT V � ;� � U • . �H�,' , c. DISCONNECT LAUNDRY f 16'-0' r, CO Ld Z Q . •� ,;. �"'...- FLOW FROM TANK_. DIESEL T'ANK�` �ti:, ury DRAINETO ROOF SrORMWA \ W r._ 3? UN TER..,.' Q Z tr "^► IN FIL R DERGROUND \ Z > 1 .r, BLDG SEWER \, T ATION S' O — TEM .---• t F; ti J ", � /' _ / . -• - EXISTING\BY OTHERS Pfl,�ED YC: . y 3 a GENERATOR - - WWTF STRUCTURE Q '"�'h '� \ ;\,� l Z � Z r XI O GAL W u c > y: . _rTIC TANK - - �, / V�� W Q - l` Ck;AMBERS 4 , I - w • 1 ,.\ •. PC� n ry a Wz 1 1 2 STORY CO3 STORY BRICK QBUILDING vBRICK WzBUILDING ry H I s �, s ` 17 GH o 32' HIGH EXIST I ( ) (EXIST) a a a Q � w ROOF O 1 1� o ` �..: � EXIST. SIAMESE I 1, ,_,��; ;C' � . � `' '`;r',. 24'-0' C_ _ . ....... / ^�� Q Q Q Q m � `✓ L \ CONNECTION '. \yy a ; , \ W A SBUILr a �,` GAS :" :1 1 EXIST. 8" WATER ,.'," �- a, � CATION �,-- _ - / '\. .- .- _,_ . 1 7,B 1 3±S.F. I TAP '; �, 9 / /, ' CUSS �� . W � �• •�' . 54- - ACRES TOTALi /� \ GROSS _ ti o N O G G g G C�_ ��� 24 0 FOUR REL { f PARK OCATED \ AREA l PR p ., A�&.SS +, (; SPACES ' O OS. FIRE 1rr;4 rn') "i h \ RE \ H _. ER L EXIST Nr EXISTING PAVED FIRE E \ y 2' LE Fs?,t thlf�4,,li, GK ;t S STRIP 1N THE MIDDLE ROOF �, R� ;....._ _.. i.. : �<< WITH GRASS EXIST 9,00 I'GAL - c- tu FIRE { EL T `. " T f - R.QLOT a SEPTIC ANK ,. PP aq, FC , W W P COW A f nON n/r , , SMH RIM EL. 49.24' \ _ RELOCATE[, .\ ` ,\ Y r S FROM > m y SHED 9�r1• ., �,` � � ,� ,' '\ � �••i r BUFFER ZONE , `ram , 0 BM1 �ir \ 1 r I - EL. 49.08' �• ��a, `\ \e��1`j,� � r," � \ � ��. � �� t .- `� r� � _ y'� V 20 FEET L \ \ W Co 4 , WATERLIN MIL PO!YETHYL Z- �1.�S !y �� \ i` _ I ( � E ENC ENE q \ \ ASEMENt WRAP \� �� .\ \ ` ° (, :'. �q '\ L P P S G U \\ PROPp \ ,: : u —ANDC C ILING \ 0 GAZE60 FOUR v o , R RELOCATED l', � Li—PARKING SPACES '\ , r:� � Q3 9 I : I I PROPOSEDLJ s WA WATERLINE E t 1 � FRONT SETBACK AS0TAP, SLEEVE xlsrING FIRE vAL J Q YORANT O PER BOOK 464, PG A-10 � Q l, I � � f „ '--,' CD - w' 0 z \ PRbP 'I •O �J�..'`` C�,�. P�1.� J % v� � W cn W Q SLEEVE eVALVE NEOSED8" WATERLIN EXIST 10" U l J C 0 T K i �, cn Ld 1 48 . 6 S 83°35 W oe oe LEGEND: a. <[ LAND COURT BOUND FOUND TEST PIT � EXISTING U EXISTING TREES GREATER THAN 10" DIAMETER PERC TEST 5' X 40" OVAL SIGN 9 1 EXISTING LIGHT '�� A — ON BRICK PIER —600 EXISTING CONTOURS DETAIL NUMBER ED LIGHT � cjo "CAPE REGENCY" 600 PROPOSED CONTOURS PROPOS DETAIL W WA TER LINE EXISTING CATCH BASIN G GAS LINE mI PROPOSED CATCH BASIN REFERENCE SHEET NUMBER • E/T ELECTRICAL LINE EX/STING MONITORING WELL EXISTING BVW GRAPHIC SCALE / [ �t z Cu 0 o TANK EXISTING BUFFER ZONE 30 0 ,s 30 60 120 {— EXISTING FIRE HYDRANT o = A- a0 S PROPOSED SEWER MANHOLE EXISTING FENCE U L� 0 0 PROPOSED FIRE HYDRANT EXISTING PIER ( IN FEET ) 1 �W WATER GA TE 1 inch = 30 ft. SHEET 2 OF 1 co CD ui 00 ` v z o w� D € a� o � C zLu L>NJ O v O 00 , , I�r • •,•�, t k 4 V • f LL- 00 HAYBALES l! �• •• `"�r!� >=t a,>,� 'ti \ `•'J I (n I I ' I I r LLJ T • ` I , � i Ld � I Q Y , I W € • • �� • ,�;,: —1 ZI lo J jl O wY I � C PROPOSED EXTERIOR LIGHTo_ TYP) W Z VQ16'- ~ }' O •?' CONNECT ROOF STORMW TER Q INFILTRA ON SYSTEM DRAIN UNDERGROUND .. wWO I J i I ' .....- ....w..... .. / ... : V I \.. / € Q O V) UI I it Q ' - -r - '^ aI V I , wI J Zit :j BM 3 ... 1 LLJ {{ SMH RIM i::{:':�:'.. ''�\ t- LLJ � i Z 11 Of QCL r W w H ; .. QI ,�.� �. v\1 1 \; 7511 \ cn • ... ROOT.' --^--_"'—__"'`-i �' :..: , , SIAM m } - - 3 ' \ 24, 0' y ......... T o y \ O � tY / ' I � aLLI .:.. / Ld r EXIST. ,Ic;;4 t� {- 6 WA \. \ .. r I W TER NES •.... #. • y ....�.,• •l t € '1 CV \ cV t \ } { N II TAP ; ✓ ;< \ \� �ay s , <_ ' \. ,_ OUR R \�\ Qr PARKING Sp i ;.,. :... >: AGE 01 O I I TED # PROPOS FIRE ` f ai i ���. S i � 7�C RE.. , 1 / � Z \ r.. € i RANT H ,- RE \ _:. .. ,. s...:.. ,.,.,; TIED FIR , SE ! G� ir' YDRANT H /Z O 1 f E .a. : �• •#Q y �; / / 'moo ' I r AZ� \` W x I it C / •wrs � � 5.� S < 4.1 ,r x BM #2 ' `•• � SMH RIM \ \ � .;, ., ,,,) , \ R \ \ \ r r .., EL. 49.24 � \ \ \ \ C x s' � ' J ,M \ :)4e� • ;;. i �. \ \ \ �' '�• C.Y. J I is , \ \ \ \ ANT i \ \ All �_- 20 FEET-4 MI WATERLINFENCASEL POLYETHYLENE /� PR p G�� ...... - WRAP fff..— Q��MENT gC�tiq \ \ C \ D-STOC PILING �, O i Y .< m .% Li, n( ` Y yr LL PROPOSED GAZEBO 0 rr r { I THREE RELOCATED PARKING SPACES \ s i I r \ , - ONE GRAVEL SPOT -- r — RO \ �I O C� . ... •, ��_, P POSED 6.. A cSETBACK ;.r.,.: TA SLEEVE L _ 1 . .. ' I ,,., VWATERLINE L TER I �,.�.,j Cl� EXISTING RE \ / E. \r :,. . Y ANT LD LIJ 3 s . '.... S.S.+ S f t � 2 G� f• Fs _ 1 , LLJ EXIST - ST. 10•r (f} AP WATERLINE i•SLEEVE & VALVE \;�1 _ PROPOSED 8•. WAT LIE '� .. �^,, , 5<��S4s {.:�;\�\ 4, _ ER3. G a C r. \Y LI LLI _ f W r' f€ ? U I t cj uJ QV, U <r 3 > <ON u u 1 -I LAND COURT BOUND FOUND TES' PIT F, � i {` EXIS TINE TREES GREA TER THAN I i?' n AUL TER PERC T t S T FXItiTING LIGHT _ --QF-TAIL NUMBF R EXISTING CONTOURS a PROPOSED LIGHT ;j - - ----- PROPOSED CON'TO!IN` - DETAIL cT I I ii N -r OF ] Y/S TING CA T II BASIN W11 TER LINE �aF'a : .- J -- - - �, ._ -1 hROPi7SED CATCH BASIN REF EREIJCF. SHED: T NUMBER C-11% ' :.� T�L. �� ®��LT�ON ! -- !,AS L,Nf � I ( T T - ' /��''- �— � L./I I..J TIr'�1�� BV��� GRAPHIC SCALE�J RAP CAc; - I -- - — EL EC;TRIC�A� _ ,�c € rn vv ,._�,. EXISTING MONITOR/II WELL G G� l`.r R �o so ' Iz f TANk' EXISTING BUFFER. ZONE -- �. : - -I K.^ fl TING FIRE II Y.TIRAPI T �ROPOSLD SEbUFR V41VHOLE o--- fENCE U EXISTING ( IN FEET ) �• PROPOSED FIRE H>'DRANT OF EXISTING PIER 1 inch = 30 ft. 7_--