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0120 SOUTH MAIN STREET
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L,I z e�,, � I� l^ rr.. •.r 4 , r e. .... .. M1 0 C Sign !t� ti TOWN OF BARNSTABLE Permit * BARNSTABLE, MASS. t6. A Permit Number. Application Ref: 201304139 20070870 Issue Date: 06/21/13 Applicant: CAPE REGENCY LANDLORD MA, LLC Proposed Use: NURSING HOMES Permit Type: SIGN PERMIT Permit Fee $ 50.00 - Location 120 SOUTH MAIN STREET Map Parcel 208089001 Town CENTERVILLE Zoning District SPLT Contractor PROPERTY OWNER Remarks . CAPE REGENCY SIGN 15.97 SQ FT (MONUMENT UPDATED PANELS) Owner: CAPE REGENCY LANDLORD MA, LLC Address: 135 SOUTH MAIN STREET FARMINGTON, CT 06032 Issued By: 5 7..7. 7.7... 7. ...7.. 7- .... ......................................................................................-...................-.I .:: I.......................1.1..1.".................-..........'..'.................... ...............-....... .I..I.I..........................-...,........ POS:.T THIS CARD SO THAT IS VISIBLE FRAM TFYE STREET oFIKE Town of Barnstable �0� Regulatory Services BAMSTABLB. " Thomas F. Geiler,Director 1639. 'DrFnNu►�s Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit# ' 4 �� BuildingOfficial approving cal PP g-=---------- Apphcation for Sign Permit ApplicantAiq,w 4_-_1_ _ 1111 IYL -____---Assessors No. b �UU-1 �oo t. Doing Business As:_ Q, �Oj1q�_4 �))6 j V1 -Telephone No. 5aS_3q _ 0 - Sign Location` Street/Road: _1 � -- vzk+----------------------------- Zoning District: C_a VC Old Kings Highway? Yes Hyannis Historic District? Ye�o Property/ )wner Name:_l(1. ��_t�_1C _LaVlj1�r M LLC a_Q Telephone: _ Address:i35__1 _�/Y1 n_ �� _fC�Y i ��VilCl-arge:--------_------------ -- Sign Co tractor �,I,, r Namejy - - -_Siat, - 4 - -------Telephone 11 3-QM2'�I - ----(- MailingAddress: _L�J_Y_1�(�ty_�_ __ drb�VO rnY -------_ I Description Please follow the cover directions.You must have an accurate rendition of sign with dimensions and location. Is the sign to be electrified? Y s/N (Note: If yes, a wiring permit is required) Width of building face. - fL x 10= x .10= f Check one Reface existing sign �//or New Total Sq.Ft. of proposed sign (s) `15.91 SF Nwble SidPck If you have additional signs please attach a sheet listing each one with dimensions ��'t5't"iJ mo►�uwvr v�� If refacing an existing sign please provide a picture of the existing sign with dimensions. I hereby certify that I am the owner orEAW have the authority of the owner to make this application, that the information ism--otiec�id-tha� t t ie use and construction shall conform to the provisions of §240-59 through §240-89 of the I'ow Barnstable ZQo� ' g Ordinance. Signature of Owner/Autho , h%t ✓�f _ Date 5 A w 6 � SIGNS/SIGNREQU revised12110 The Commonwealth of Massachusetts Print Fo m 'Department of Industrial Accidents --'- Office oflnvestigations I Congress Street,Suite 100 r_ Boston, MA 02114-2017 wrvW.niassgOvIdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Ledbk Name (Busir,ess/Or;anizatio4ndividual): Expansion Opportunities dba ViewPoint Sign&Awning Address: 35 Lyman Street Suite 1 City/State/Zip: Northborough, MA 01532 Phone#: 508.393.8200 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with q 1 4. ❑ 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6• ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g; Demolition working, for me in an •capacity employees and have workers' y P 9. Building addition [No workers' comp.insurance comp. insurance. required.] 5. ❑ We are a corporation and its " 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MG 12.❑ Roof repairs insurance required.] T c. 152,§10),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *any applicant that checks box rl must also fill out the section below showing their%vorkers'compensation policy information. r Flomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new afRdavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contracturs and state whetheror not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp.policy number, Lain an employer that is providing workers'compensation insrrance for my employees. Below is the policy aitd job site information. Insurance Company Name: Traveler's Insurance Companies Policy 9 or Self-ins. Lic. UB-4A698605-12 `` Expiration Date: 09-14-13 Job Site Address:_ ��� ���`YV1. �(Yl �J ICtt7�� City/State/Zip: &,k),vt le f) - Attach a copy-of the workers'compensation policy declaration page (showing the policy number and expiration date). Failure to secure coveraaz as required under Section 25A of.LMGL c. 1_52 can lead to the imposition of criminal penalties of a fine.up to S 1,500.00 and/or one year imprisonment;as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 3250.00 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 lrereGy certify arrder the pains and peru ie�ofperjury that the iuforvrtation provided above is true and corre<ct. Si-unature:' ._ Date: 28 Z013 Phone#: 508.393.8200 - Qfjicial use only. Do not write in this area, to be completed by city or town offciirl. City or`fotivn:. Permit/License# Issuing Authority (circle one): 1.Board of Health 2, Building Department 3. City/'fo)tin Clerk 1. Llech•ical Inspector 5. Plumbing Inspector 6, the Contact Person: Phone m: / , a DATE(MMIDDlYY1f'!) �' CERTIFICATE OF LIABILITY INSURANCE 9/13/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). ' PRODUCER CO NANTACT Elizabeth Bortone ME: FM Walley Insurance Agency Inc PHONE F (781)326-8383 ac Nat(721)325-8387 475 High Street E-M ess ebortone@walleyinsurance.com P. 0. Box 469 INSURER(S)AFFORDING COVERAGE NAIC it Dedham MA 02026 INSURERA:Travelers Indemnity Co of CT 25682 INSURED INSURERB:Travelers Prop Cas Ins Co 36161 Expansion Opportunities Inc INSURERC:Travelers Ins Cos DBA Viewpoint Sign & Awning INSURERD: 35 Lyman Street INSURERE: '* Northborough MA 01532 INSURERF.- COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT.WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADOL SUER POLICY EFF POLICY EXP. LTR POLICY NUMBER MMIDO MMIDONYYY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMI ES(Ea c ren el S 100,000 A CLAIMS-MADEFO OCCUR 6305609C939 /14/2012 9/14/2013 MED EXP(Any one person) S 5,000 PERSONAL BADVINJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Eaaccidentl 1 000 000 B X ANY AUTO BODILY INJURY(Per person) S ALLO`NNED SCHEDULED 8100123T720 9/14/2012 9/14/2013 BODILY INJURY(Per accident) S AUTOS AUTOS NON-OWNED r PROPERTY DANIAGE $ X HIRED AUTOS X AUTOS (Per acddAntl X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 5,000,000 B EXCESS LIAB CLAIMS-MADE AGGREGATE S 5,0004000 DED •X RETENTIONS 10,.Doc UP767SC707 9/14/2012 9/14/2013 S C WORKERS COMPENSATION WC STATU- OTH• ' AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT S 1,000,000 OFFICERIMEMBER EXCLUDED? N I A (Mandatory In NH) 4 • B-4A698605-12 9/14/2012 9/14/2D13 EL DISEASE-EA EMPLOYE S 1. 000,000 II yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1, 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION'. (508) 393-4244 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED W" Expansion Opportunities, Inc. ACCORDANCE WITH THE POLICY PROVISIONS. DBA Viewpoint Sign & Awning 35 Lyman Street AUTHORIZED REPRESENTATIVE Northboro,' MA 01532 Frank Walley III/BETH ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INSn25 oninn.;i ni Tho A(`opn name and Innn arc rnniclornA marlec of Ar0Pn h r U ce n-5 e� CS-076718 DAVID J RAINDA` " 8 CIDER HILL LN fl, x SIIERBOR_N1bIA 01�7® ` cpr l iss 03/15/2014 Y ' � � - 4 1 �' � • � 1, Monument Update Panels 1 1/2"x 1 112"Bent Corner Moldings -.040 Aluminum -VHB Tape Mounted 5'-3/16- (60 3116") r 6 1/2"1 ® Brookside at Regency Assisted Living V _ 381/16., I.. _. ,.. r e Brookside at Regency m=- Caye 'Regency - AsAs md Lhv g �c"� T :.•3 "#�- �� ➢ E Re E1l%l� Rehabilitation & Health Care Centerµ Cap g - ��, (x2) (x2) �' Elevation:#4641.1 (0 4)Monument Update Panels Alft Side View: . x Scale. 1"-1' Scale. 1"=1' �< ,:y•} y:.� �Aky P a' Description: Colors: III (0ty 4)Monument Update Panels for(1)existing Overlay Panels- White Hand(stock) I'I monument sign. Graphics- paint to match PMS Process Black at 65% ., '- Overlay panels are 3mm DiBond. Icon Returns- pointed White ' Existing: Graphics are 1/4"acrylic,mounted flush with VHB tape. Icon Face- digitally printed at 720 dpi on 3M Ul 80c Controltac vinyl Not To Scale Icons are 1/4"acrylic with digitally printed graphics on face. with 3M 8518 Clear Gloss over-laminate. (mounted flush with VHB tape) (Printed(MYK embedded in supplied file.) - - (4)Bent corner moldings are.040 Aluminum,VHB tape mounted. Corner Molding- White aluminum(stock) Overlay panels are mounted with screws and adhesive. Existing Molding 8 Ughts• painted blue to match existing address oval TBD 'w `gam Paint existing top molding and light fixtures on site: , Installation: Logo: By Viewpoint. Supplied by Customer Proposed: Not To Scale Job Acmal tkmger. Dote: NMI= R■lm: ■ ■ UW-v Approvd Am.Mawgu Approval hodaabn Approval iED FROPOSAL BYWEPOINTRWINAND WNING.AINMes RISE , iewPomt Alhenoxedkare Mdcevwse os.1s.13 IUol.s 1.508.393.8200 rAEUED BY 4IEWPBINTAGN ANB AWNINGAII RIGNa REB[RYfD. (oration: File: Devgmr. TBD 120sMain9..tamemlb,MA IRxacN(f_tagRegBr6a6(hr�e_Mooegv laa Mah.Houd uNAun1DR¢moulalunon°RRE4Rooum°nlsvaBxlBNEo. SIGN nNo AWNING FAX 1.508.393.4244 C � � �' I of Bq • S< BLS 4 SIGN OFFICIAL O 20 BUIL ING DIV. Ul NDT DO Op REGULN" I mot, Sign TOWN OF BARNSTABLE Permit MASS. s6:9. � ApFD�p Permit Number: Application Ref: 201303404 20070864 Issue Date: 05/24/13 Applicant: CAPE REGENCY LANDLORD MA, LLC Proposed Use: NURSING HOMES Permit Type: SIGN PERMIT Permit Fee $ 50.00 Location 120 SOUTH MAIN STREET Map Parcel 208089001 Town CENTERVILLE Zoning District SPLT Contractor PROPERTY OWNER Remarks TEMP SIGN 36 X 60 4 WKS CAPE REGENCY Owner: CAPE REGENCY LANDLORD MA, LLC Address: 135 SOUTH MAIN STREET FARMINGTON, CT 06032 Issued By: p F0,.... OS TINS CARD SO,TI3AT IS vYSIBLE FROM TAE S REST