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1545 IYANNOUGH ROAD (3)
©uIM -- , e a n� y , 5 w . e , 4 . i y I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel I Application #'Cvf? Health Division Date Issued Conservation Division Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / HY annis Project Street Address y l"0 U 6 �AOSIIA(E (1 Village ALL( Owner �-� L 6 ; W, Address_ � �o y�n'/Vo (1 kI Telephone Permit Request G N#I V6-)ay poogs #-T &VKf T/! Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type 4VE Lot Size l g � Grandfathered: ❑Yes ❑ No If yes, attar ipporting3doc>nentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) ' Age of Existing Structured Historic House: ❑Yes ❑ No On Old Kings Highway: owes ❑ No 73 Basement Type: ❑ Full ❑ Crawl ❑Walkout Other O A'c - Basement Finished Area(sq.ft.) Basement Unfinished Area (4. ` Number of Baths: Full: existing new Half: existing ~°new , Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use F r - = - - - - - - �Y � - Proposed'Use- - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name MUM G ouffN10 Telephone Number Address M 000X V AZ'' �.�1-Tr License# C S V I 6�fory R N Q Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 0 SIGNATURE DATE I FOR OFFICIAL USE ONLY Y' '1 APPLICATION# y DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER 'r DATE OF INSPECTION: -.-FO.UNDATIONS . : t FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT 4 ASSOCIATION PLAN NO. 1 k • 1 r The Commonwealth of Massachusetts Department of IndusVialAccidents Office of Invafigations 600 Washington Street Boston,MA 02111 www.mass.gov/din - Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Auulicant Information Please Print Legibly Name(Business/Organization/IndividuaI): M• Y011 A'lUQ 50K 60 4 V S-Md� , F ry C Address: V q �16*yy 5L � 0-Mr ,- 0 U City/State/Zip: b6sIdAl Mfl o-dPf Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.W I am a employer with �L r 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. XRemodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity,acit3', employees and have workers' 9. ❑Building addition [No workers'comp, insurance comp.insurance., required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their I L Plumbing repairs or additions 3.0 I am a homeowner doing all work ❑ g P myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required_]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box W1 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 hue outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they mast provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: (Aggr:z� c(� �• Policy#or Self-ins.Lic. 1;0 ! Expiration Date: Job Site Address: I SY City/State/Zip:_ � C 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 cerdfv un the/avandenaldes ofperjury that the information provided above is true and correct Si afore: / Date: 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#: . a. o® CERTIFICATE OF LIABILITY INSURANCE /30/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS BELOW.CERTIFICATE AFFIRMATIVELY THIS C RTIF CATE OFIN R NEGATIVELY AFFORDED INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING NSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)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 Ileu of such endorsemen s. PROWS Gail Paling Risk Strategies CompanyPHONE (781)986-4400 (781)963-4420 15 Pacella Park Drive 1IAI :gpaling@risk-strategies-com Suits 240 INSURE S AFF"COVERAGE Randolph MA 02368 INSURERA:Selective In INSURED INSURER 13Chartis InsuM Holland 6 Sons Construction Inc. INSURERCCNA Insuranc 519 Albany Street INSURER o Suite 200 INSURER E: Boston MA 02118 INSURER F: COVERAGES CERTIFICATE NUMBER CL12122756311 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. NOTVNTHSTANDING 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. LTR TYPE OF INSURANCE POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE s 1,000,000 ENTED X COMMERCIAL GENERAL LIABILITY s 100,000 A CLAIMS4AIADE FX OCCUR 1995940 /3/2013 /3/2014 MEDEXP(An arm E 10,000 PERSONAL b ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 F L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMPIOP AGG 5 3,000,000 POLICY PRO LOC S AUTOMOBILE LIABILITY ".ow'.emnts 1,000,000 X ANY AUTO S A ALL ED SCHEDULED 9095221 /3/2013 /3/M'4 ) i S HIRED AUTOS AUTOZ 5 000 X UMBRELLA U AB OCCUR EACH OCCURRENCE S 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE i 5,000,000 A 0 X R T NTION 10,00 1995840 /3/2013 /3/2014 _ B WORKERS COMPENSATION X WC STwTU- OTH AND EMPLOYEW LIABILITY YIN ANY PROPRIETORIPARTNER/FXECUTIVE Q Nf A E.L.EACH ACCIDENT _5_— '1 000,000 , OFFICERMIEMBER EXCLUDED? 006515073 - /3/2013 /3/2014 (Mandatory In NN) E.L,DISEASE•EA EMPLOYEE S 1,000,000 —•.. Ryyas,daal09trl0er E.L.01sEASE•POLICY LIMIT s 1,000 000 DESCRIPTION OF OPERATIONS below C Fidelity Bond 87179559 0/31/2010 0/31/2013 Until $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES (Attach ACORD 101,Addlffonal Remarks Schedule,S more space Is required) Issued as evidence of insurance additional insured to general liability per written contract. MICHAEL HOLLAND 519 ALBANY STREET,SUITE 200 BOSTON,MASSACHUSETTS 02118 f T EL 617.556.2900 PAY 617.556.2901 CANCELLATION CELL 781.953,1752 mike.holland ta:thehdiandcomnanies.com ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN HOLLAND ACCORDANCE WITH THE POLICY PROVISIONS. CONSTRUCTION THEHOLLANDCOMPANIES.COM C?eiigrr 5'.Coarrrucr:an M.HOLLAND B SONS CONSTRUCTION,INC. i AUTHORIZED REPRESENTATIVE l Michael Christian/GZ �6 ACORD 26(2010105) 01988-2010 ACORD CORPORATION. All rights reserved. IN9025mirm%nf Tho ar:nan nama and Innn nro mnletararl marke of Arnan 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 for the property.located at also known as have been reviewed by. of the U 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 COMPLIES 1. Narrative Report 2. Firefighting & Rescue Access 3. Hydrant Location &Water Supply 4. Sprinkler Systems 5. Sprinkler Control Equipment 6. Standpipe Systems V/ 7. Standpipe Valve Locations ✓ 8. Fire Department Connection 9. Fire Protective Signaling System 10. F.P.S.S. &Annunciator Location 11. Smoke Control/Exhaust 12. Smoke Control Equipment Location 13. Life Safety System Features 14. Fire Extinguishing Systems vle- 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 20. Acceptance Testing Criteria We believe this document to be complete and compliant for the issuance of a building permit. ❑ 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. N Signature The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 1 of 2 The Commonwealth of Massachusetts William Francis Galvin ➢'F ,'&j Secretary of the Commonwealth,Corporations Division One Ashburton Place, 17th floor Boston,MA 02108-1512 Telephone: (617)727-9640 LAKESIDE CENTER, LLC Summary Screen 0 Help with this form Requestilolc rtificati The exact name of the Domestic Limited Liability Company(LLC): LAKESIDE CENTER,LLC Entity Type: Domestic Limited Liability.Company(LLC) Identification Number: 203024947 Old Federal Employer Identification Number(Old FEIN): 000899267 Date of Organization in Massachusetts: 06/24/2005 The location of its principal office: No. and Street: 1436 IYANNOUGH ROAD City or Town: HYANNIS State: MA Zip: 02601 Country: USA If the business entity is organized wholly to do business outside Massachusetts,the location of that office: No. and Street: City or Town`. State: Zip: Country: The name and address of the Resident Agent: Name: JOSEPH P.KELLER No. and Street: 683C MAIN ST. City or Town: OSTERVILLE State: MA Zip: 02655 Country:USA The name and business address of each manager: Title Individual Name Address (no PO Box) First,Middle,Last,Suffix Address,City or Town,State,Zip Code MANAGER JOSEPH P KELLER 1436 IYANNOUGH ROAD HYANNIS,MA 02601 USA The name and business address of the person in addition to the manager,who is authorized to execute p documents to be filed with the Corporations Division. Title Individual Name Address (no PO Box) First,Middle,Last,Suffix Address,City or Town,State,Zip Code SOC SIGNATORY JOSEPH P KELLER 1436 IYANNOUGH ROAD HYANNIS,MA 02601 USA The name and business address of the person(s)authorized to execute,acknowledge,deliver and record any recordable instrument purporting to affect an interest in real property Title Individual Name Address (no PO Box) http://corp.sec.state.ma.us/corp/corpsearch/Corp SearchSummary.asp?ReadFromDB=True... 7/24/2013 The Commonwealth of Massachusetts William Francis Galvin - Public Browse and Search Page 2 of 2 First,Middle,Last,Suffix Address,City or Town,State,Zip Code REAL PROPERTY JOSEPH P.KELLER 1436 IYANNOUGH ROAD HYANNIS,MA 02601 USA Consent Manufacturer Confidential Data _ Does Not Require Annual Report Partnership _ Resident Agent _ For Profit _ Merger Allowed Select a_type of filing from below to view this business entity filings: ALL FILINGS IP Annual Report ll Annual Report-Professional Articles of Entity Conversion ti 11 Certificate of Amendment Ne' ' wSearch VIew;Fllings � 4 Comments ©2001-2013 Commonwealth of Massachusetts All Rights Reserved Help _ I http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... 7/24/2013 CONSTRUCTION CONTROL DOCUMENT Project Title: Bank of America - Merrill Lynch Date: 7/15/2013 Project Location: 1545 lyannough Rd., Rt. 28 Scope of Project: Remove existing pair of doors at 1 st Floor Main Entrance to tenant suite and replace with glass doors. In accordance with Section 116.0-116.2.4 of the 7th edition of the Massachusetts State Building Code: I, Bruce W. Bisbano Mass.Reg.# 31810 Being a registered,professional Engineer/Architect hereby CERTIFY that I have prepared or directly supervised the preparation of all design plans,computations,and specifications concerning: ( )Entire Project 0()Architectural ( )Structural ( )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. Furthermore,I understand and AGREE that I shall perform the necessary professional services and be present on the construction site on regular and periodic basis to determine that the work is proceeding in accordance with the documents approved by 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 the building permit,and approval for the conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work,and to determine,in general,if the work is being performed in a manner consistent with the construction documents. I shall submit periodically,in a form acceptable to the building official,a progress report together with pertinent comments. Upon completion of the wor shall subm' the building official.a final report as to the satisfactory completion and adi ss of the roj t for occupancy. Signature and Seal of registered professional: o � 31 10 O RO ENCE RI J`O `LFq[r' OF MPS`'PG IKE Town of Barnstable Regulatory Services Thomas F. Geiler,Director Building Division Thomas Perry,CBo Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder i i I. 1 be' as Owner of the subject property hereby authorize- l+`�l 1 Imo{ �(j l G{.(/1 � ✓LS CG/J act on my behalf, I in all matters relative to work authorized by this building permit application for: 1545 (Address of Job) A�- S' e 0f Owner ate Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. i C:\Users\deco11ik\AppDataVLocal\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\QRE6ZU13NIEXPRESS.doc Revised 053012 MICHAEL HOLLAND I 519 ALBANY STREET.SUITE 200 BOSTON.MASSACHUSETTS 02118 TEL 617.556.2900 FAX 617.556.2901 # CELL 781.953.1752 mike.holland a thehollandcompanies.com } f HOLLAND ! . CONSTRUCTION THEHOLLANDCOMPANIES.COM Doign&Cons"ctwn M.HOLLAND 6 SONS CONSTRUCTION,INC. .996 Massachusetts-Department of Public Safety Board of Building Regulations and Standards C'omstruction Supcniawr License:CS-055103 MICHAEL J 1126 r soutb Wcymittb r �71TW Expiration Camn0ssioner 01J28J2014 PROJECT p � NAME: c I`'l�✓'� 11 ADDRESS: c Q. ✓t l ✓�l L �S Sa cA vV..o x�-► PERMIT# �O13o� Sa PERMIT DATE: LARGE ROL.LE PLANS ARE IN: BOX SLOT Data entered in MAPS.program on: t bILA BY: . x , I q/wpfiles/forms/archive I �jME Sign TOWN OF BARNSTABLE Permit ' * BARNSTABLE, MASS. Fp39�- A` Permit Number: Application Ref: 201305263 20070908 Issue Date: 08/05/13 Applicant: SIDE LAKE REALTY, LLC Proposed Use: GENERAL OFFICE BUILDING Permit Type: SIGN PERMIT Permit Fee $ 75.00 Location 1545 IYANNOUGH ROAD/RTE132 Map Parcel 253015 Town CENTERVILLE Zoning District SPLT Contractor PROPERTY OWNER Remarks NEW 34 SQ WALL SIGN MERRILL LYNCH WEALTH MANAGEMENT Owner: SIDE LAKE REALTY, LLC Address: 1436 IYANNOUGH ROAD/RTE132 HYANNIS, MA 02601 Issued By: p ..POST TINS CARb SO THAT IS RISIBLE FROM THE STREET :r. e 'PERMIT PAYMENT RECEIPT. TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 08/05/13 TIME: 15:39 -----------------TOTALS---`--------------- PERMIT $ PAID 75.00 AMT TENDERED: 75.00,,E AMT APPLIED: 75.00' � CHANGE: 00l APPLICATION NUMBER: PAYMENT METH: CHECK' PAYMENT REF: r '` IHE Town of Barnstable V c, _ Igulatory o Services *�na;axsrestE. � 9\ 'nrAss ,1�$ Tomas F.Geiler,Director '�. Building Division _' s T' - Tom Perry, Bolding Commissioner , 2001vS_iin Street, Hyannis,MA 02601 c WvVW-t0vmbarnstab1e.ma.us Office: 508-862-4038 Fax: 508-790-6230 e P rmit# � Building Official approving \� Application for Sign Permit O` Appc VLM L cH Assessors Nc, Doing Business As:-.. Telephone Sign Location C c � Street/Road: Zoning District Old King;Highwag Yes/No Hyannis IE for c 1 istrictP Yes/No Pro perty Own �' e Name: k 60 Telephone:_ Address:- IILC -3t A AJO Village: Sign Contractor Telephone: i. .,,-iliug Address: ( '3 Q :\-U4 ( ' Description . Please follow the cover directions.You must have an accinrate rendition of sngr -:_i.dimensions and location. - the sign to be electrified? Yes ote-•IfFes,'a yvinngpermitls'requ-,er1J �Ati •67idth of building face \5; ft x 10-�5 0 x.10 a C .e one Reface existing sign or New Total Sq.Ft of proposed gn Ifyou ?ave additional signs please aka .a sheetlisdng eacb one w b dirnez?m6zu; ` It reLlyd'1g an existing sign.Please provido a picture of the existing sign with dmmeruons.- I hereby certify that I am tine owner or t_at I have the authority of the owner to m ."re this application, that the:information is correct and tha ti;e use and construction sht.d orm to , .e provisions of §240-59 through§240-89 of the Town.c Barnstable Zonm SUX i 4nattae of Owner/A.uthorized Aunt-__ ,�, '11 BLAIR COMPANIES ARCHITECTURAL IMAGING - - SIGNS- FIXTURES • LIGHTING address: 5107 Kissell Avenue Altoona PA 16601 telephone: 814.949.8287 fax: 814.949.8293 ya web: blaircompanies.com rproject information ' c client: Merrill Lynch a . # , T address: 1545 lyannough Rd. Barnstable,MA02601 store#.MA9-545 t I -$�.tr , " _ram ( .M • m number: 32975 _ ire �yt riu em I� date: 06.04.13 '6 � �� rendered: RJP i file name: MRL 32975 13 v sl revisions t I y k A.06.07.13 RJP:ADDED GOOSENECKS. + g ✓ D. e� These drawings are not for construction.The information contained herein is intended to express design intent only. This original design is the sole property of the Blair Companies,it cannot be reproduced,copied or PROPOSED VIEW scale: nts exhibited,in whole or part,without first obtaining written consent from the Blair Companies. �� nec ow is 1/4" f A -�� BLAIR COMPANIES ARCHITECTURAL IMAGING 1/4" SIGNS - FIXTURES . LIGHTING 12-10" address: 5107 Kissell Avenue WWI Altoona PA 16601 ® telephone: 814.949.8287 O 1 I-211 fax: 814.949.8293 m web: blaircompanies.com ��ul rn project information CV h HV a M a n 9 7/8i client: Merrill Lynch _� address: 15451yannough Rd. Barnstable,MA02601 store#:MA9-545 m number: 32975 date: 06.04.13 PLATE LETTERS W/ OUT ATTRIBUTE LINE - (ML-LNIP-I4-S) SIDE VIEW rendered: RJP Me name: MRL 32975 13 Scale:1/2"=1'-0" 34.3 Sq Ft. revisions A.06.07.13 RJP:ADDED GOOSENECKS. B. C. • D. 1..LETTER AND SYMBOL TO BE#4 HORIZONTALLY BRUSHED ALUMINUM PLATE HYDRO JET CUT AND CLEAR ANODIZED.USE ARTWORK SUPPLIED BY DESIGNER.DRILL AND TAP BACKS OF LETTERS TO 1 ;;w RECEIVE THREADED STUDS FOR MOUNTING.REFER TO TABLE FOR PLATE THICKNESS.A MINIMUM OF These drawings are not for THREE ATTACHMENT POINTS ARE REQUIRED FOR STAND construction.The information OFF LETTER MOUNTING WITH THE EXCEPTION OF THE contained herein is intended to DOTS ON T LETTER FORMS.USE SLEEVE SPACER TO express design intent only. CONTROL LETTER STAND OFF DIMENSION FROM WALL, DIAMETER OF SLEEVE SPACER NOT TO EXCEED LETTER propeThis original design is the sole STROKE WIDTH DIMENSION AT STAND OFF ATTACHMENT cannot tbe reprftheoduced, Blair Companies,it cannot be reproduced,copied or POINTS. exhibited,in whole or part without 2.WELD THREADED STUD TO BACKSIDE OF LETTER, first obtaining written consent VERT. SECTION Cal SYMBOL VERT SECTION (ED LETTER 3.SPACER AS REQUIRED.SEE TABLE.SPACER TO MATCH - from the Blair Companies. LETTER FINISH. 4.FOR LETTERS 21/2"CAP HEIGHT AND UNDER USE CLEAR 1/16"THICK VHB TAPE AND FLUSH MOUNT �n nec 008 LETTERS TO WALL. LL TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 5-3 - Parcel. > 17. --- Application # � s r Health Division ` Date Issued Conservation Division Application Fee ®f� Planning Dept. _ Permit Fee / Date Definitive Plan Approved by Planning Board + s0@ Historic- OKH Preservation/Hyannis Project Street Address e/S �--' / N/Q U R tZ� r 3Z Village Owner .,osc�� �( � Address 6 SJPr(J,ae Telephone !;70�E5 c Permit Request e r". i��v�►S b � rock (,�i�,GQoui S -� �� •1�r-► �S�o�;� �!$e- .J YS�Cvn /fircPl r , Square feet: 1 st floor: existing fO proposed 10 2nd floor: existing 2U proposed Total new &ci o Zoning District _ 1 �� Flood Plain Groundwater Overlay Project Valuation So.cx>o Construction Type.5-�,e� Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure c T. . Historic House: ❑Yes 2 o On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) 0 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: WGasnc/ ❑ Oil 3Electric ❑ Other Central Air: Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: D Yes �lo 4)e#aeled garage`❑ existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑existing ❑ new size_ A##aehed-gmage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of A peals Authorization ❑ Appeal # Recorded ❑ Commercial Yes ❑ No If yes, site plan review# Current Use O ru Proposed Use ®. •��.t' APPLICANT INFORMATION =^ , (BUILDER-OR HOMEOWNER) Name 1 Jr--IC, C`ly, P Telephone Number Address 30/ L✓-soi ` r Flow S. R License # C_ 5 S61 �" c(c P re_ q. Home Improvement Contractor# Worker's Compensation # t,Jc_'(DO62- 0/ G ALL C NSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO .r SIGNATURE DATE / 0 FOR OFFICIAL USE ONLY APPLICATION# J DATE ISSUED `- `< MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME _ i • INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT , ASSOCIATION PLAN NO. ti The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, M-A 02111. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors(Electricians/Plumbers A licant Information Please Print Le bl- Name(Business/Organizationandividual): Address: 22 o, AA/1" City/State/Zip: Phone.#: � Are you an employer? Check the appropriate bog: Type of project(required): 4. I am a general contractor and I 1.El I am a employer with � 6. ❑New construction. w1emp loyees(full and/or part-time).* have hired the sub-contractors 2. am a-sole proprietor ro rietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees' t These sub-contractors have g• Demolition working for me in any capacity. employees and have workers S Building addition [No workers' comp.insurance comp.tns'��$ required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.�]Other comp•insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'conVensation policy information. t Homeownen who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the subcontractors and state wbether or not those entities have employees. If the subcontractors have employees,they must providt their workers'comp.policy numbs. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: 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 vio=arage ed that a copy-of this statement maybe forwarded to the Office of Investigations of the WA for' Ification. I do hereby certify the penalties perjury that the information provided above is true and correct " Si tore• - Dater �` ��• — Phone k 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: Pursuant 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 employer 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 number(s)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 Accidents 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 Please be sure to fill in the permittlicense 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 bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would lice to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone-and fax number. The Ummonwealth of Massachusetts Deparbnent of Industrial Accidents office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 4-06 or 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia r Rau Are Afolof v 4,'o 7 N ' CONFERENCE ROOP1 3 �� l 12 Fa t ' ROBERT'S OFFICE EX15TING WALL cl D P RE IDN. s WAITING LOBBY m� FILE STORAGE L.� W/KITCNENETTE PROPOSED FLOOR PLAN o � o EX15TING WALL EXISTING WALL oiuxn sr. ae t .R - I] .RaEcir. C=4a PROPOSED LAYOUT FOR LAWLESS 6 LAWLESS PC Al 1 l L ill 4 J `` �Bo�d""of m, mg egu ahoifs an n ar s � 1 Construction Stipervisor License Lice e: CS 54081 Birthdal 9/20/1960 j Expiration 9/20/20U9 Tr#.5705 �l • i .. s esfnct ,n � jj s �tt LAMENCE S D IN k t 301:SIMONS`NAR{ S �. MASHPEE,MA 02649.E 5=4 Commissioner P l J pFZKEro,,t, Town ofBarnstable Regulatory Services sAxxeai.E Thomas F.Geiler,Director 019. rFnMn�a Building,Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403.8 Fax: 508-790-623 0 Property Owner Must Complete and Sigh This Section' , If Using A Builder r C P44 ?I � �� , as Owner of the subject property hereby authorize to act on my behalf, - I in all matters relative to work authorized by this building permit application for: S S , , ( iWA A dress of Job SignaWre of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable mop the tp�� Regulatory Services " Thomas F.Geiler,Director t BARNSTABLE,D+ �. T' MASS. q, Building Division �jED I"�'rp Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 vtnv.town,barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. , , DEFINITION OFHOMEOWNER` Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION . The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. AY/06/2008/TUE 12: 11 COMM FIRE DEPARTMENT FAX No. 5087902385 P• 001/001 FIRE DEPARTMENTS OF THE TOWN OF BARNSTABLE Fire Prevention Office - Hincldey Building 200 Main Street, Hyannis, MA 02601 (508) 862--4097 BUILDING CODE COMPLIANCE FORM I d d� I cated at :. }Mans dated � for t e property. o- - _ .._ a.Isg. known,as. 4,f have'baen reviewed bv - _ -o`f the� C] Barristable �COMM " ❑ Cbtuit'- L Hyannis. ..C] .West:aarnstabl*e- Fire DEpaIMt nep THE CHART BELOW INDICATES THE STATUS OFTHE REVIEW: TYPE OF CONSTRUCTION DOCUMENT N/A RECEIVED REVIEWED COMPLIES 1. Narrative Report 2. Firefighting & Rescue Access 3. Hydrant Location & Water Supply 4. Sprinkler Systems wtl pC/L 5. Sprinkler Control Equipment 6. Standpipe Systems 7. Standpipe Valve Locations U' 8. Fire Department Connection 9. Fire Protective Signaling System 10, F.P.S.S. & 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 20. Acceptance Testing Criteria We believe this document to be complete and compliant for the issuance of a building permit. ' We have completed the acceptance testing for the occupangy� ep rm{i±t nW-1 elieve,that within the scope of the buildingpermit, the above issues are in compliance. P p 90 : '1 In"8 9 VV1€i00 r r r r � a a . r ' r ❑ r r O O r O r O il"P �r Zc SECOND FLOD PLAN ce, TOWN OF BARNSTABLE BUILDING PERMIT PACEL ID 253 015 GEOBASE ID 16551 ADDRESS 1545 IYANNOUGH ROAD/ROUTE PHONE CENTERVILLE ZIP - LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CO PERMIT 91436 DESCRIPTION 4 x 8 Temp Sign Future home Merrill Lynch PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department Of ARCHITECTS: Regulatory Services TOTAL FEES $50.00 BOND $.OQ pf CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE sARNSTABLC, MASS. `��'` Fp M�'►l A B` U' ING DIVISION DATE ISSUED 04/11/2006 EXPIRATION DATE --------------------------------------------------------------------------------------- �'1 r FED-27-2006 09 :52 AM P. 02 L _� cuYJo LJ•» P.02iO3 ,y Town of Barnstable ,(($ ,a, -FABLE / IS Regulatory Services i Thomas B.Ges7er,Director 7 01, MAR 31 PN 2: 38 Building Division Tom Forty, Buildtog Commissioner 200 Main Stm!k Hyamig,MA 02601 ' i I $ rvww.town.b arnatebla.mans )itice: Fast: 508-790-6230 Pernit* ` A `/ lfcation for Sip Permit ( � � PP /. v �p�licetrt: ���--l.t-�C.��� _ ��s:e�ers N�►_��6 L`� ,/j� �` Doi ag Busivaas Aa: L i(V-t u LunLn Telephone No. (tea Sig a Location \ d� Sin;et/toad: 1 R I Zap Ling District Old MAP Higbway7 Yo Hy=nis Historic DistricO YC FropeTV Owntw Name, J Telephone: 42iB - 1 14<0 M drou: Village: _ Sinn Coibjwtaar N:Q: Fj tzna fr"rr - r tvei~t`el�>, e: D1 � I - G(o M ailing Address: C•LeI f Description Pi:aae drMW a&aptm oflot shoo*location of bu0dinp eud m&ft signs with dimensions,location end site of th+t sew sago. Tbia should 6e chtatrn on the raverae aids of thie`�,pliaatioa b the 60 to be decMfieW Y aaro (Rots:Jf yu.o wiring y"tt it rep �w \1Idtb of bufidiug face ft.110 I:weby mliff OW I em the awnec:or dw I have the au&wlty of the owner to m o1w this VPliamtian,that VA tr fc =6W ie coma end U1 t o we mad conetnsCd=shall coafaim to the provisions of 1240-59 through§240-89 0,1 the Tows of Boawft Zof 5ipature of Cw=eAnflrorlaeA A$entt Date:- �. I X � Pezmit 1te�s: / t" ��i�n Fermat was RppQovod: i� `� '�� Dimpptoveti U°of9t aft Of ldad: Dam i ne,;1 A'PP�S�SJGNS1sIGNdPP.bOC Lr wc@PEEED Cape c�adl & The Eskands go O0 0 p p � O O O � ��� I MWerrilfLynch Jeremy F.Gi1•Inore,CFM Global Private Client Financial Advisor 9731yanough Road Hyannis,Massachusetts 02601 800 568 9440 Toll Free 508 7719842 Direct FAX 508 7719815 jeremy_f_gilmore@ml.com . APR706-2006 08 :05 AM P. 02 s]- .L 1 a�.V . W. '� \ 1'�„ c�"►. LOCUS NAP In dr< ♦ \1 \4 a�>x :1• /'�, ` uw IU.tt a ]orK••c\cEcu xi,zxoe K.a :r�Z' r.�• ,. ��.J!4 v1•�artr i a_ �. ; � /,..�,�� / ) ,1��' \�'��un,l.r. CD �uY. ' r y' , mow° I /' ,�','�•;ii-�.� 1�-f-/w Qq :i' r I I I , '�,iR v�' {a+r+'� ..o�o'"'..�•o.YOe•s.""�.o`:.�. ��'7•\ \` 11# � I �,�, ...eJ,.�„,fir=��`��°- . M1 � 1�+` /^� �•� jl OB 1° / 1 .a�.�.o��M1rt M•ns6 9..rra i � _ L r.nlWa w�ir�lllr�w°'r.U.W nW M�a.0 M.ar.w �•R. �q�N Mo�p�y y�ly yyp / \"\ «ae )• ��']'I,�''�i! y«�y«ryry,�,w�ppb,�YyM,�.{y.�N�rA]Y�MMrM MWo-tgWl+eGnRD•f 1•Yr.Tfla rO.WrAR�r�.J 1w1w]•wwwnituw arw�.bYn.ixM,me�YeeYsi+C %. "\\ 1\ / ] a. rr .. mw�"ryp trr••'�arw•�i'•itr�m r�er]'i°'i re.u �• ED URIC(BViLpuG \�` ... C� I / '�.�.sw .�1 I r r]r.lr0 rr•w xrlw eee.na a.1s•wuw w raa. '•// �n.x �Eaa•au�E�Ewrd wa 1 - ,},�- )�(` UTILITIES&GRADING SITE PLAN #1545 RT. 132 OFFICE BUILDING J HYANNIS, MA «E«5ED:]-I D OS gs((MMES cot YYEYR) -r1F01'( Fn SITE:PLAN -- — ---- smYE� kT•MB is SHALLOW POND r � I� 2. r ! Chrtstoher BBean ' 3723 ` . MSMf ; � � Pamyla Haseltvn can a ' ' Twenty GlassT err4ce� , y _ t3rr to nna�, t = t s rs 3 3 20(%"(p _ MsssUo x Duxbu Mfl 0�g 32 s , 'ig Ir "� * �' ra fi x�L � # s '..�4 PGA r jig �,.?"F....i'€ N ism5c 0D s+p,AY TA 2'F�ORDER OF r M.-{f ' *2, n 5: '0 Y ^ rr a z, Wff177 r D an coWAMeraca A� 0f1000138 �.: + k� > x r, I . �4 .w ,€ ¢¢ €a G?t h :to r 7 TJ s � ra s t� r •+ �� p �r i'� ¢,x I�. � �,�4 g � *� � �5' b. � 0 VQ0"O'4'381: 00000'S934 !86i' .37. 23 7 i wr Town of Barnstable Building Department - 200 Main Street BARNSTABLE, * Hyannis, MA 02601 MASS. 9�A ib,�. . (508) 862-4038 rFD MA'S A Certificate of Occupancy Application Number: 20061256 CO Number: 20060161 Parcel ID: 253015 CO Issue Date: 12108106 Location: 1545 IYANNOUGH ROADIROUTE132 Zoning Classification: Proposed Use: COMMERCIAL Village: CENTERVILLE Gen Contractor: HERSEY, CHRISTOPHER Permit Type: CC00 CERTIFICATE OF OCCUPANCY COMM Comments: FOR UNITS Al AND 131 10 G Building Department Signature Date Signed n TOWN OF BARNSTABLE ���E Building Application Ref: 20061256 • �}- - BARNSTASLE, Issue Date: 08/02/06 ' Permit MASS 9�pr 039. A�� Applicant: HERSEY,CHRISTOPHER Permit Number: B 20060808 FD MA'1 Proposed Use: Expiration.Date: 01/30/07 Location 1545 IYANNOUGH ROAD/ROUT2g District SPLI Permit Type: COMMERCIAL ADDITION ALTERATION Map Parcel 253015 Permit Fee$ 4,050.00 Contractor HERSEY,CHRISTOPHER Village CENTERVILLE App Fee$ 100.00 License Num 092149 Est Construction Cost$ 500,000 r- Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND RENOVATE TO OFFICE SPACE 1 ST AND 2ND FLOOR WORK INCLUI ES THIS CARD MUST BE KEPT POSTED UNTIL FINAL SOME PARTITIONS,PAINT&MIKNOR MEP TO COORDINATE WITH FINIMPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: LAKESIDE CENTER LLC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 683 C MAIN ST INSPECTION HAS BEEN MADE. OSTERVILLE,MA 02655 Application Entered by: DB Building Permit Issued By: A/1' THIS PERMIT CONVEYS NO RIGHT.TO`OCCUP,Y ANY STREET;ALLY OR SIDEWALK OR A PART:THE H TEMPORARILY OR PERMANENTLY. ENCROACHEMENTS ON PUBLIC PROPERTY;NOT SPECIFICALLY,PERMITTED+UNDER THE`BUILDING COD ,MUST BE APPROVED BY THE JURISDICTION: STREET OR ALLY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC.SEWERS,MAY.`BE OBTAINED;FRONI;THE DEPARTMENT OF PUBLIG.WORKS. THE,ISSUANCE,OF THIS-PERMIT DOES NOT RELEASE THE-APPLICANT FROM THE CONDITIONS OF AN'Y`APPLIGABLE SUBDIV,ISION.RESTRICTIONS , MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS > 1 -?_ 1s- a" „ _gs1:1 )Z- L?Q ksv A n� L_ .. 3g I Heating Inspection Approvals Engineering Dept :D-`' v Fg— F.i r De t 2 Board of Health 6 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map .253 Of- Parcel Application# Health Division Conservation Division Permit# Tax Collector Date Issued Treasurer Application Fee Planning Dept. Permit Fee $1-/020t 01 Date Definitive Plan Approved by Planning Board ` Historic-OKH Preservation/Hyannis 1 p Project Street Address 4141 NANNouG1A 9OA4 1",J 2^a F'L00AS Village 941ANNtS, /AAA 0A-01 Owner ,Sot.€PH P. KEL4Ef2 - 16ELL1;(L. Co .. I tic. Address WC NIA,M S-r. o3-t69-JiLL6 mA 01655 Telephone J'�$ 4� It 4 C Permit Request a6 Aso JAtztatj 7o orFf ciF :*INcE A—, 4! 45 IyAOMOUGµ R-D i5VJe4 Fi aA.T '��' woR-l� i Ncl.u0�5 SAME �� PA2T I'TlpNS-, cA2PE i I PAIa i I M t mg 4 MEP T- Ccof-Pi►�iNT6 waiH A(ZC1A%VrCT0itAL Ftniw46-s Square feet: 1 st floor:existing SO proposed' q_12nd floor:existing Z12b5 proposed Total new 9,145' Zoning District Flood Plain Groundwater Overlay ProjecfValuation_ ; 00 O Construction Type comM62c(AL Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: Cl Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing 0 new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial %l Yes ❑No If yes,site plan review# NSA Current Use oFF((,9 5AACE Proposed.Use �rrlcC SPt�CE BUILDER INFORMATION Name C.NRISTOPNFQ. P Telephone Number 6��'590- 5546 Address 26 NAJW SaN AVE, License# '[S- O92 4 49 SwAMP5C.o?7 MA 04901 Home Improvement Contractor# Worker's Compensation# WC-1 - 625-J9 413 4-3 55 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE t • FOR OFFICIAL USE ONLY t; PERMIT-NO. DATE ISSUED MAP/PARCEL NO. ADDRESS, 'VILLAGE l _ OWNER DATE OF INSPECTION: _ . FOUNDATION FRAME O INSULATION FIREPLACE - ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ,t , FINAL BUILDING O P DATE CLOSED OUT ASSOCIATION PLAN NO, a t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map i53 Qi5 Parcel 412 Co u.( Application#(,, " (QX73 Health Division of Ut ,5 02`] C)e Conservation Division - -rto, f�-Iam"c fi Permit# Tax Collector s °�`'� t Date Issued Treasurer Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 154S `�A N w0 u G%A f2 Ab 134 A 0bP Loots Village A NN IS rmA 260 Owner S P KELLG-e - KELLER CJ• 10C• Address 6 13C_ ►Jla ' Os� Jn CIA 0ASS Telephone (50 2$ - 44 4 b Permit Request ja NZonk-e ce. a I sys L ( 15, 2114 Fads. wok WA-AeS Gorvte e.&j nor A' C 0.rm n k en A mi'vior ME(° A0 ccQr A%Na k\ %-4A 11 AC C In-,AnO.-C AX-a I ANA Square feet: 1st floor:existing 6 O proposed 2nd floo :existing 2126S proposed Total new 9� 45�9 ��• Zoning District ood Plain Groundwater Overlay Project Valuation 50o I a o Con uction Type MW (LC i L Lot Size andf ered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Fa y ❑ Multi-Family(#units) Age of Existing Structure Historic Ho e: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) B ement Unfinished Area(sq.ft) Number of Baths: Full:a sting new Half:existing new Number of Bedrooms: isting new Total Room Count(n including baths):existing new First Floor Room Count Heat Type and Fu I: ❑Gas ❑Oil ❑Electric ❑Other Central Air: 0 Yes ❑No Fireplaces: Existing New Existing w d/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑ isting ❑new size Attached garage:❑existing ❑new size Shed:Cl existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial Yes ❑No If yes, site plan review# 0/A Current Use OFFICE 4- 'Phcl Proposed Use OF Ftc le -5e AcC' ,/1\4q,;,qA ry„ ,� BUILDLW INFORMATION Name C�\C%5 c aP I4 11�(Z P. AE-R-s a 1� Telephone Number !90-55 4 6 Address kre• License# CS 09214 9 Swar. Sco�4 MA 0001 Home Improvement Contractor# Worker's Compensation# WC-7- 625-091131 - 366 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURECb&�(&r C�m DATE 45/261 , 6 FOR OFFICIAL USE ONLY PERMIT,NO. DATE ISSUED �y MAP/PARCEL NO. ADDRESS >' .VILLAGE OWNER DATE OF INSPECTION: fy. FOUNDATION F FRAME INSULATION FIREPLACE 1 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING `� r DATE CLOSED OUT ` ASSOCIATION PLAN NO. - O"1010 FIRE pROr�c� NORTHEAST �� '0 AUTOMATIC SPRINKLER CO., INC. m w 150 RECREATION PARK DRIVE,SUITE 1,HINGHAM,MA 02043 N 2 TEL(781)7404205 FAX(781)7404209 y 2� v U�A<<ATION ' FAST TRACK BUILDING PERMIT PROGRAM FOR COMMERICAL OFFICE BUILDINGS DESIGN AFFIDAVIT (CONSULTING ENGINEER) To the Inspectional Services Commissioner: RE: - Merrill-Lynch 1545 Iyannough.Rd... Hyannis, MA ,(Ward) (Application No.) I certify that to the best of my knowledge, information and belief: (a) the plans conform to the Massachusetts State Building Code, and Boston Zoning Code, and all other applicable codes, laws and regulations; (b) the proposed work does not constitute a substantial alteration of an existing building; (c) the proposed work does not involve a change of use, as defined in the Boston Zoning Code and Massachusetts State Building Codes; (d) the structural alterations and floor loading shown on the plans comply with the Massachusetts State Building Code; (e) the plans conform with applicable fire codes and that if required, the installation of fire alarms, smoke detectors, etc. have been or will be provided and indicated on the plans specifications in accordance with the code. Engineer Name: .. Robert T.Odell,Sr. Company Name: Robert T. Odell Associates, Inc. Address: 150 Recreation Park Drive, Suite #1, Hingham, MA 02043 Mass. Registration Number: 18025 Date: December 7, 2006 Then personally appeared the above named Robert T. Odell, Sr. Subscribed and sworn before me this 7th day of Dec.. 2006. Notary Public: Kerrie Haye My Commission Expires: 8/24/2012 - ODELL AU No,18025 FP, ism � ISD AF I FINAL AFFIDAVIT ARCHITECTURAL DESIGN Application No. B20060808 To the Commissioner,Inspectional Services Department. Re: Merrill Lynch, 1545 Iyanough Road, Is`&2❑d floors,Hyannis,MA_ Ward BB Zone_ I certify that to the best of my knowledge,information and belief,the plans and computations accompanying the attached application concerning the locust at Merrill Lynch, 1545 Iyanough Road, IS`&2nd floors,Hyannis,MA Ward-are in accordance with the requirements of the Massachusetts State Building Code and all other pertinent laws and ordinances.This project is complete and complies with all of the above. MLIlAM ��� aOayA#7419 JOHN O'i.PARY 7419LARC EC - AS .REG.NO. NO' State Stree , oston,MA 02109 �0 MA ADDRESS OF 617 371 —0800 PHONE Lt (v 2006 Then personally appeared the above-named William J. O'Leary, AIA And made oath that the above statement by him is true. Before m +W mar: 4 My Commissio expires Y lV gr 200 xrsr �� ISD AF 1 AFFIDAVIT ENGINEERING DESIGN Application No. 20060873 To the Commissioner,Inspectional Services Department. Re: Merrill Lynch Tenant Improvement Project Ward:HB Zone I certify that to the best of my knowledge,information and belief,the plans and computations accompanying the attached application concerning the first floor tenant improvement project at Map 253015 Parcel 1 and 2 ' ` 1545 Route 132 Hyannis,MA Ward:HB Zone are in accordance with the requirements of the Massachusetts State Building Code and all other pertinent laws and ordinances. 33914 MASS.REG.NO. °� '�sr��, 2126 DEFOaR 30 R Y RD ATLAWTA . G ADDRESS Lure 0 81-6565 PHONE J U LY 24- 2006 Then personally appeared the above-named WY 'f. LU�4 DS-T'ROM And made oath that the above statement by him is true. Befor, e, My Commission expires Notary Public,Clayton County,t3eorgla My� Feb.20.20'g 200 ISD AF 1 FINAL AFFIDAVIT MECHANICAL ENGINEERING DESIGN Permit No. B20060808 To the Commissioner,Inspectional Services Department Re: Merrill Lynch Tenant Improvement Project Ward:HB Zone I certify that to the best of my knowledge,information and belief,the plans and computations accompanying the attached application concerning the first floor tenant improvement project at Map 253015 Parcel 1 and 2 1545 Route 132 Hyannis,MA Ward:HB Zone are in accordance with the requirements of the Massachusetts State Building Code and all other pertinent laws and ordinances. This project is complete and complies with all of the above. MASS.REG.NO. o arIrti 2/L6 DEP06RS �E Y 13 19 a M ADDRESS w 3914 (�Q¢)$t �565 `PHONE DECEME)ER 15 2006 Then personally appeared the above-named And made oath that the above statement by him is true. • Befor le,,, My Commission expires Notary Public.Clayton County,Georg 200 y n Ex�Feb.20. ISD AF 1 FINAL AFFIDAVIT ELECTRICAL ENGINEERING DESIGN Permit No. B20060808 To the Commissioner,Inspectional Services Department Re:Merrill Lynch Tenant Improvement Project Ward:HB Zone I certify that to the best of my knowledge,information and belief,the plans and computations accompanying the attached application concerning the first floor tenant improvement project at Map 253015 Parcel 1 and 2 1545 Route 132 Hyannis,MA Ward:HB Zone are in accordance with the requirements of the Massachusetts State Building Code and all other pertinent laws and ordinances. This project is complete and complies with all of the above. 3391¢� MASS.REG.NO. 2126 DEFGbRS FERRY RD.� ° AT LA NTA . GA 30318 c ADDRESS LUNDST '=+ v �3914 ~ Q 681 J 6565 HON Gist ffs�o�j D1=12EM E)ER 6 , 2006 Then personally appeared the above-named l� L ncs And made oath that the above statement by him is true. Before e, My Commission expires Notary Publln,Clayton 200 ISD AF 1 FINAL AFFIDAVIT PLUMBING ENGINEERING DESIGN Permit No. B20060808 To the Commissioner,Inspectional Services Department Re:Merrill Lynch Tenant Improvement Project Ward:HB Zone I certify that to the best of my knowledge, information and belief,the plans and computations accompanying the attached application concerning the first floor tenant improvement project at Map 253015 Parcel 1 and 2 1545 Route 132 Hyannis,MA Ward:HB Zone are in accordance with the requirements of the Massachusetts State Building Code and all other pertinent laws and ordinances. This project is complete and complies with all of the above. 33 9/¢ ��`td1 sq MASS.REG.NO. D rr. G 2126 DEFOORS FERRY RDA ATLANTA GA 30318 D — N . 4 /ADDRESS .�FSSIO 'PHONE DECEIkM 15ER F, 2006; Then personally appeared the above-named And made oath that the above statement by him is true. c Before e, i C My Commission expires Notary Publlo,Clayton County,Norgia, MYCommissionEx*es-Feb.�fl..= 200 RECORD OF COMMUNICATION ' Company: Merrill Lynch Date: December 6, 2006 ATLANTA CIO GREENVILLE Turner Construction LITTLE ROCK Address: 1545 I annou h Rd F Tim Campbell LOS ANGELE Road From: am y p ORLAND O g O Hyannis, MA 02601 Attention: Stanley Melo Telephone: 404-881-6565 Telephone: 617-212-4935 Meeting: ❑ Fax Number: Memorandum: ❑ Project Name: ML-Hyannis Transmittal: Project Number: 2006621 Facsimile: Page(s)transmitted Transmitted Via: Fed Ex Copies To: 2006621.0 7922 5224 4681 Subject: Affadivts Transmitting, signed, sealed and notarized MEP affidavits. PA2006\2006621 ML-Hyannis\xmit-20061206a-tc-ljolley.doc This Record of Communication confirms decisions,requests for action, and transmits or confirms information. If this information appears to be incomplete or inaccurate,please contact us immediately. KLG,J1C • 1-126 Defoors Ferry Road NW • Atlanta,G'A 30318 ■ r 404.861.656 i • f:404.874. 970 • «ncw.1dg1JC.Ct111 12/07/2000 11:11 FAX 6172475456 TURNER SPECIAL PROJECTS Q 001 ISD AF 1 FINAL AFFIDAVIT ARCHITECTURAL DESIGN Application No._0200608M To the Commissioner,inspectional Services Department, Re_ Merrill Lynch, 1545 Iyanough Road, I"&god floors,Hyannis,MA_ Ware--ND Zone_ I certify that to the brat of my knowledge,information and belief,the plans and computations accompanying the attached application concerning the locust at Merrill Lynch, 1545 lyanough Road, I"&2°d floors,Hyannis,MA Ward-am in accordance with the requirements of the Massachusetts State Building Code and all other pertinent laws and ordinances.This project is complete and complies with all of the above. SIP gAR - A1#14 REG.NO. 7419 L on,MA 02109 MA ADDRESS MOF 617 08QQ PHONE 'Chen personally appeared the above-named William J.O' AI And made oath that the above statement by him is true. ` Before ti My Commissi0 expires r r z00 DEC-07-2006(THU) 13: 45 northeast automatic sprinkler co (FRX)17817404209 P. 001/001 c*V AUTOMATIC SPRINKLER CO.. INC. - 180 RECMAnoN PARK CRNF-SUrM 1,HING►1AM,MA 02043 T U TELrMI)7404= FA7U7807404208 Z ;� FAST TRACK BUILDING PERMIT PROGRAM FOR COMMERICAL OFFICE BUILDINGS DESIGN AFFIDAVIT(CONSULTING ENGINEER) To the Inspectional Services Commissioner: RE: Merrill Lynch 1545 Iyannoughh Rd_ Hyannis.MA (Ward) , cuplica 'on No 1- _ I certify that to the best of my knowledge,information and belief: (a) the plans conform to the Massachusetts State Building Code, and Boston Zoning Code, and all other applicable codes,laws and regulations; (b)the proposed work does not constitute a substantial alteration of an existing building; (c) the proposed work does not involve a change of use, as defined in the Boston Zoning Code and Massachusetts State Building Codes; (d) the structural alterations and floor loading shown on the plans comply with the Massachusetts State Building Code; (e) the plans conform with applicable fire codes and that if required, the installation of fire alarms,smoke detectors, etc.have been or will be provided- and indicated on the plans specifications in accordance with the code. Engineer Name: Company Name: Robert T. Od ll Ass iates I c. Robert T.NO,Sr. Address: 1 SO Recreation Park Drive Suite#1 Hingham MA 02043 Mass.Registration Number: 18025 Date: December? 200 Then personally appeared the above named Ro T. dell Sr. Subscribed and sworn before me this 7"' day of Dec'• 2006. Notary Public: &I Lis. ��l k 1 Kerrie Haye �s My Commission Expires: 8/_24/2012 WAM RL F-A 1603 r rots ° Turner .E. Special Projects Turner Construction Company Two Seaport Lane Boston, MA 02210 phone:617.247.6400 fax:617.247.5456 June 8, 2006 Hyannis Building Department 200 Main Street Hyannis, MA 02601 Attn: Jeff Louson Gentlemen: Turner Construction Company authorizes Chris Hersey to represent the Company as licensed builder on the Merrill Lynch fit-out project at 1545 Iyannough Road in Hyannis, MA. Please call me with any questions at 617.247.5555. J W. Darley PO j ect Executive Cc: Chris Hersey Building the Future 2 t Town of Barnstable Regulatory Services " Thomas F.Galier,Dl =tor Building Division Tom Perry, 8nildtng Commissioner 200 Main Sheet, $yannis,MA 02601 www.town.barmstable.ma..ms Office: 508-862-40.38 Fax: 508-790-6230 T Property Owner Must Complete and Sign This Section If Using A Builder � las Opener of the subject property herebyaithorize'�� YI -LpUIYL(,(C1 lOtA to act on my behalf, in all matters relative to work authorized by this building permit application for; S48- 2 nq� Address of Job) C Lila, z� o Signa of r D Print Name Q:FORMS:oWNMUMn,1Ss1o14 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 092149 Birthdate: 10/22/1974 Expires: 10/22/2008 Tr.no: 92149 Restricted: 00 CHRISTOPHER P HERSEY 26 HARRISON AVE SWAMPSCOTT, MA 01907 omr issioner 00-35,000 cf enclosed space (MGL CA 12 S.60L) 1A-Masonry only g 1G-1 &2 Family.Homes Failure to possess a current edition of.the Massachusetts State Building Code is cause for revocation of this license. Z DIG SAFE CALL CENTER: (888)344-7233 1 Certificate of Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT A INSURANCE POLICY AND DOES NOT AMEND,EXTEND,OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. This is to Certify that TURNER CONSTRUCTION COMPANY THE TURNER CORPORATION Name and erty 50 TICE BOULEVARD address of AI WOODCLIFF LAKE, NJ 07677 Insured. Mutuilm Is,at the issue date of this certificate,insured by the Company under the policy(ies)listed below. The insurance afforded by the listed policy(ies)is subject to all their terms,exclusions and conditions and is not altered by any requirement,term or condition of any contract or other document with respect to which this certificate may be issued. EXP.DATE * ❑ CONTINUOUS TYPE OF POLICY ❑ EXTENDED POLICY NUMBER LIMIT OF LIABILITY ® POLICY TERM WORKERS COVERAGE AFFORDED UNDER WC EMPLOYERS LIABILITY COMPENSATION 11/1/2006 WC7-625-091131-355 LAW OF THE FOLLOWING STATES: Bodily Injury By Accident $2,000,000 Each ALL STATES EXCEPT Accident STATE FUND STATES Bodilv Iniury By Disease $2,000,000 Policy Limit Bodilv Injury By Disease $2,000,000 Each Person 11/1/2006 RG1-625-091131-395 SCHEDULE LIMITS OF LIABILITY GENERAL LIABILITY COVERAGE INCLUDES❑X OCCURRENCE PREMISES-OPERATIONS, PERSONAL INJURY AND PROPERTY DAMAGE LIMIT INDEPENDENT CONTRACTORS $2,000,000 Each Occurrence (PROTECTIVE), RETRO DATE BLANKET CONTRACTUAL, GENERAL AGGREGATE LIMIT COMPLETED OPERATIONS, BROAD FORM PROPERTY $4,000,000 DAMAGE,PERSONAL INJURY AND XCU PRODUCT COMPLETED OPERATIONS AGGREGATE LIMIT ❑ CLAIMS MADE HAZARDS. $4,000,000 Other Other AUTOMOBILE LIABILITY 11/1/2006 AS2-625-091131-405 $2,000,000 EachAccident-Single Limit ❑X OWNED B.I.and P.D.Combined Each Person ❑X NON-OWNED Each Accident or Occurrence ❑X HIRED Each Accident or Occurrence OTHER ADDITIONAL COMMENTS LOCATION:MERRIL LYNCH HYANNIS,1ST&2ND FLOORS FIT-OUT,1545 IYANNOUGH RD.,HYANNIS,MA 02601 JOB#114320R ADDITIONAL INSURED:KELLER COMPANY,INC.;MERRILL LYNCH PRIVATE CLIENT GROUP 'If the certificate expiration date is continuous or extended term,you will be notified if coverage is terminated or reduced before the certificate expiration date SPECIAL NOTICE-OHIO: ANY PERSON WHO,WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER,SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD. IMPORTANT NOTICE TO FLORIDA POLICYHOLDERS AND CERTIFICATE HOLDERS: IN THE EVENT YOU HAVE ANY QUESTIONS OR NEED INFORMATION ABOUT THIS CERTIFICATE FOR ANY REASON,PLEASE CONTACT YOUR LOCAL SALES PRODUCER, WHOSE NAME AND TELEPHONE NUMBER APPEARS IN THE Liberty Mutual LOWER O ERIGHT HAND CORNER OF THIS CERTIFICATE THE APPROPRIATE LOCAL SALES OFFICE MAILING ADDRESS MAY ALSO BE OBTAINED BY CALLING THIS R. Insurance Group NOTICE OF CANCELLATION:(NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WI I NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 30 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: KELLER COMPANY,INC. ALAN LAWROW CH nFICATE 683C MAIN STREET HaCHR OSTERVILLE,MA 02655 AUTHORIZED REPRESENTATIVE NEW YORK (212)391-7500 6/12/06 bl OFFICE PHONE NUMBER DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by Those Companies BS 772A R9 The Commonwealth of'Massachusetts Department of Industrial Accidents ' Office of Investigations 600 Washington,street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contlractors/Electncians/Plumbers Applicant Information F Please Print Leglbly �t -- NaIl16 (Business/Organization/Individual).: ' Tu"IN e_ �•ONS'TtZVCT 04 CaMA�!NY - C 14R S 06j0Sf_Y' Address: 26 to leAkSaN AVI City/State/Zip: S•-sAMP.sc -rT-1-.M ok_ . . Phone#: 6 i - 530 -S5 4 6 Are you an employer? Check the-appropriate box: Type of project(required): 1.❑ I am a to 4. I a general contractor and I 6 employer with am ❑'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 $ Remodeling ship and have no employees i These sub-contractors have ..8, ❑ Demolition working for me in any capacity.' workers' comp.insurance. 9. ❑ Budding addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their ME] Electrical repairs ®r 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 anew affidavit indicating such lContractors 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 sage information. Insurance Company Name: 1AGEA T 4 My TUAL WS. CO. Policy#or Self-ins.Lic. #: w C 7 L2_6—J9!4 3 3 55 Expiration Date: Job Site Address: 1545 I Y JUtiouGN 4DA0 I� I FLW,23 City/State/Zip: (44ANNi S a MA M2 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$1,50Q.00 and/or one-year imprisonment, as well as civil penalties in the form of-a.STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of- Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of per ury that the information provided above is true and correct Signafore: Date: o 5/1- 0 Phone#• 55-4 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 e.Electrical Inspector 5:Plumbing Inspector 6. Other j Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant 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 employer 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 employmenfbe deemed-to be an employer." MGL chapter 152, §25C(6)also states 6k—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 requir=ents 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 number(s)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 Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be retained 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. Please 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 fixture 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 af5davi. 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. The Department's address,telephone and fax number: The Commonwealth of Massachusetts-,' Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. 617-727-4900 ext 406 or 1-0077-N ASSAFE Fax #617-727-7749 Revised 5-26-05 WWtiJ.Il3aSS.cfl v/dhzt Turner's Potential Subcontractors for 1545 lyannough Road Hyannis, MA project 0620-FINISH CARP. MILLWORK Northeastern Architectural Millwork 0811-HOLLOW METAL Northeastern Architectural Millwork 0881-GLASS&GLAZING Salem Glass 0925-GYPSUM WALLBOARD Skillcraft Finish Systems 0951-ACOUSTICAL CEILINGS American Acoustical Contractors 0965-CARP/RES FLOORING Strategic Flooring 0990-PAINTING Wood Commercial 1500-HVAC Limbach Company 1540-PLUMBING Limbach Company 1550-FIRE PROTECTION JC Cannistraro 1600-ELECTRICAL Glynn Electric r , 4t ISD AF I AFFIDAVIT ARCHITECTURAL DESIGN Applicati)No. To the Commissioner,Inspectional Services Department. Io Re: Merrill Lynch, 1545 Iyanough Road, I"&i2"d floors,Hyannis,MA_ Warki I certify that to the best of my knowledge, information and belief,the plans and computations accompanying the attached application concerning the locust at Merrill Lynch, 1545 Iyanough Road, ls`&2`11 floors,Hyannis,MA Ward are in accordance with the requirements of the Massachusetts State Build' g Code and all other pertinent laws and ordinances. q, N MA#7419, REG.NO. aLAtY n,MA 02109 No.741 _ ' 617) 371 —0800 ' PHONE.. •2006 _ t Then pe ly Tappe.Na�redt above-named William J.'O'Leary,JAIA' And made oath that the above statement by him is true.' .>r. Before in t My Commiss expires" aTOV-, 204 0 I'p. s 780 CMR: STATE BOARD OF,BUILDING REGULATIONS AND STANDARDS THE MASSACHUSETTS STATE BUILDING CODE 5. Greenhouses: A building permit.or notice to minor nature. When the quality of the materials is the building off cial is not required for the con- essential for conformity to 780 CMR, specific struction of greenhouses covered exclusively with information shall be given to establish such quality, plastic film(in accordance with St. 1983,c.671). and 780 CMR shall not be cited,or the term"legal" (This exemption does not apply if the greenhouse or its equivalent used as a substitute for specific is to be used for large assemblies of people or us- information. es other than normally expected for this purpose.) 110.8 Engineering Details,Reports,Calculations, 110.4 Form of application:The application for a Plans and Specifications: In the application for a permit shall be submitted in such form as permit for buildings and structures subject to con- determined by the building official but in all cases struction control in 780 CMR 116.0,the construc- shall contain, as a minimum, the information tion documents shall contain sufficient plans and de- required on the appropriate sample uniform building tails to fully describe the work intended,including, permit application forms in Appendix B. The but not limited to all details sufficient to describe the application for a permit shall be accompanied by the structural,fire protection, fire alarm,mechanical, required fee as prescribed in 780 CMR 114.0 and light and ventilation,energy conservation,architec- the construction documents as required in 780 CMR rural access and egress systems.The building official 110.7 and 110.8,where applicable and as required may require such calculations;descriptions narra- by other sections of 780 CMR. M W 71 tives and reports deemed necessary to fully describe the basis of design for each system regulated by 1105�By whom_applicahon is_.-_ e:App— licat o 780 CMR. In accordance with the provisions of for a permit sha11 beinade by the owner or lessee_0ff M.G.L. c. 143, § 54A all plans and specifications [the building or_structure, or agen[of either:. If shall bear the original seal and original signature of application is made other than by the owner,the a Massachusetts registered professional engineer or written authorization of the owner shall accompany registered architect responsible forthe design,except, the application.Such written authorization shall be as provided in M.G.L. c. 143, § 54A and any signed by the owner and shall include a statement of profession or trade as provided in M.G.L. c. 112, ownership and shall identify the owner's authorized §60L and M.G.L.c. 112,§8IR. agent,or shall grant permission to the lessee to apply .When such application for permit must comply ! for the permit. The full names and addresses of the with the provisions of 780 CMR 4 or 780 CMR 9 or owner,lessee,applicant and the responsible officers, 780 CMR 34, the building official shall cause one if the owner or lessee is a corporate body,shall be set of construction documents filed pursuant to stated in the application. 780 CMR 110.7 to be transmitted simultaneously to the head of the local fire department for his file, Note: It shall be the responsibility of the review and approval of the items specified in 0 registered contractor to obtain all permits neces- . 780 CMR 903.0 as they relate to the applicable sary for work covered by the Home Improvement sections of 780 CMR 4,780 CMR 9 or 780 CMR l Contractor Registration Law, M.G.L. C. 142A. 34. The head of the local fire department shall An owner who secures his or her own permits for within ten working days from the date of receipt by such shall be excluded from the guaranty fund him, approve or disapprove such construction C provisions as defined in M.G.L.c.142A. Refer to documents. If the head of the local fine department 780 CMR R6 and M.G.L.c. 142A for additional disapproves such construction documents,he or she information regarding the Home Improvement shall do so,in writing citing the relevant sections of Contractor Registration Program. noncompliance with 780 CMR or the sections of the referenced standards of Appendix A. Upon the 110.6 •The securing of a building permit by the request of the head of the local fire department,the owner,or the owner's authorized agent,to construct, building official may grant one or more extensions reconstruct,alter,repair,demolish,remove,install . of time for such review provided,however,that the equipment or change .the use or occupancy of a total review by said head of the local fire department building or structure, shall not be construed to shall not exceed 30 Calendar days. If such approval, relieve or otherwise limit the duties and responsibil- disapproval or request for extension of time is not ides of the licensed,registered or certified individual received by the building official within said ten or firm under the rules and regulations governing the working days, the building official may deem the issuance of such license registration or certification. construction documents to be in full compliance with the applicable sections of 780 CMR 4,.780 CMR 9 110 Gonstructronmen ;The application for or 780 CMR 34 and,therefore approved by the head permit shalt be accothpanied by not less than three of the local fire department. sets of construction documents.The building official is permitted to waive,or modify the requirements 110.9 Existing Buildings: The application for.a for filing construction documents when the building building permit to reconstruct, alter or change the official determines that the scope of the work is of a use or occupancy of existing buildings or structures 20 780 CMR-Sixth Edition 11/27/98 t. 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS THE MASSACHUSETTS STATE BUILDING CODE 1115 Debris: Asa condition of issuing a permit for six months each,may be granted in writing by the the demolition, renovation, rehabilitation or other building commissioner or inspector of buildings. alteration of a building or structure,M.G.L.c.40, Work under such a permit in the opinion of the § 54 requires that the debris resulting therefrom building commissioner or inspector of buildings, shall be disposed of in a properly licensed solid must proceed .in good faith continuously to waste disposal facility as defined by M.G.L.c. 111, completion so far as is reasonably practicable under § 150A. Signature of the permit applicant,date and the circumstances. It is the sole responsibility of the number of the building permit to be issued shall be owner to inform, in writing, the building indicated on a form provided by the building commissioner or inspector of buildings of any facts department, and attached to the office copy of the which support an extension of time. The building building permit retained by the building department. commissioner or inspector of buildings has no If the debris will not be disposed of as indicated,the obligation under 780 CMR 111.7 to seek out holder of the permit shall notify the building official, information which may support an extension of time. in writing,as to the location where the debris will be The owner may not satisfy this requirement by disposed. informing any other municipal and/or state official or department. 111.E Workers' Compensation: No permit sha117 For purposes of 780 CMR 111.7 any permit issued be issued to construct,reconstruct,alter or demolish shall not be considered invalid if such abandonment a building or structure until acceptable"proof'of or suspension of work is due to a court order �inr ance pursuant to M.G.L._c..152,_§25C(6)has " prohibiting such work as authorized by such permit; r bedn"provided to the building_official. s T provided, however, in the opinion of the building commissioner or inspector of buildings,the person 111.7 Hazards to air navigation: Application for so prohibited by such court order, adequately building new>structures or adding to existing defends such action before the court. structures within airport approaches as defined in M.G.L.c.90,§35B and any amendments thereto or 111.9 Previous approvals: 780 CMR shall not language substituted therefor, must include a require changes in the construction documents, certification by the applicant that; construction or designated use group of a building 1. Either_a permit from the Massachusetts for which a lawful permit has been heretofore issued or otherwise lawfully authorized, and the # Aeronautics Commission is not required because construction of which has been actively prosecuted the structure is,or will be;a)In an area subject to within 180 days after the effective date of 780 CMR airport approach regulations adopted pursuant to and is completed with dispatch. M.G.L. c. 90, §§40A through 40L or; b) in an approach to Logan International Airport, or, c) 111.10 Signature to permit:The building official's less than 30 feet above ground level,or; . signature shall be attached to every permit; or the 2. A permit from the Massachusetts Aeronautics building official shall authorize a subordinate to Commission is required pursuant to M.G.L.c.90, affix such signature thereto: §3513 and a copy of said permit is enclosed with the application. 111.11 Approved construction documents:When Applications for permits to build anew structure or the building official has determined that the add to an existing structure requiring the filing of a proposed construction conforms to the provisions of Notice of Proposed Construction or Alteration(FAA 780 CMR and other applicable laws;by-laws,rules Form 7460-1) with the Federal Aviation and regulations under his/her jurisdiction, the Commission shall mail a copy of the completed building official shall stamp or endorse in writing the FAA Form 7460-1 to the Massachusetts Aeronautic three sets of construction documents "Approved". Commission within three business days after One set of the approved construction documents submitting said form to the FAA. shall be retained by the building official,one set by the head of the local fire department and the other set y 1 = f shall be kept at the construction site, open to 1)<i18: Expiration of_pe�t�mtt� Any permit issued p i °shall be deemed abandoned and invalid unless the inspection of the building official or an authorized work authorized by it shall have been commenced representative at all reasonable times. within six months after its issuance; however, for cause,and upon written request of the owner,one or 111.12 Revocation of permits:The building official more extensions of time,for periods not exceeding shall revoke a permit or approval issued under the 1 22 780 CMR-Sixth Edition i 1/27/98 t,> I�_ a _off„--_ _ - - -- t { i .:;,� ,_ . . t` f� ' � ,i f ti `� �.._ _ t ,�,1 {' ...._ F '� J' --�, S. ! r � ��l ,w� , ' 1.' _i r .�� - 3e ; �y �— i _ �' .j � R ,•fir F -f e t` . f j' �-= t ,r � ;v.� {_ - i { tiw . +` ' �� �{ /' �/, �� Building Division 200 Main Street Hyanhis,MA 02601Town of Barnstable Tel: 508-862-4038 Fax:508-790-6230 Izax To: Joyce Smith From:. Debi Barrows Fax: 860-691-4173 Pages: 1 Phone: Date: 2/21/2008 Re: Bond Cancellation 02BSBDE3744 CC: ❑ Urgent - ❑ For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle The above mention bond number is attached to permit#86345 that is still active and cannot be cancelled. Thank you, Debi /JO S/'O r �_. . 0. THE HARTFORD Notice of Can cellation/Non-Renewal Town of Barnstable 200 Main St. Hyannis, MA 02668 BOND NUMBER: 02BSBDE3744 WHEREAS, on or about July 26, 2005 the Hartford Casualty Insurance Company as Excess weight and Other Highway and Street Permits Surety, executed its in the penalty of One Thousand Dollars ($ 1, 000 ) on behalf of Callahan Hoffman. Co, Inc of 341 Washington St. , Norwell, MA 02061. as Principal, and in favor of- Town. of Barnstable as Obligee. WHEREAS, said bond, by its terms, provides that the said Surety shall have the right to terminate its suretyship thereunder by serving notice of its election so to,do upon the said Obligee, and WHEREAS, the Surety desires to take advantage of the terms'of said bond and does hereby elect to terminate its.liability in accordance with the provisions thereof. Cancelled for Underwriting Reasons NOW, therefore, be it known that the Hartford Casualty Insurance Company shall, ❑ At the expiration of days after receipt of this notice n Effective 2/28/2008r r consider itself released from all liability by reason of any default committed thereafter by-the said Principal. ~= -;�.. SIGNED and DATED this 19th day of January` ,2008 Hartford Casualty Insurance Company rq PO By � 5 - Brian Turner , Attorney-in-Fact CC: Callahan Hoffman. Co, Inc 341-Washington St. Norwell, MA 02061 SMITH INSURANCE INC' 15 LIBERTY WAY NIANTIC, CT 06357. DNOCfi(3/2004) PROJECT NAME: ADDRESS: ✓`— PERMIT# PERMIT DATE: M/P: c> LARGE ROLLED PLANS ARE IN: k BOX SLOT DATE COMPLETED: BY: � q/wpfiles/archive