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0270 COMMUNICATION WAY (21)
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(508) 862-4038 Certificate Of Occupancy Permit Number: B-18-2493 CO Issue Date: 10/26/2018 Parcel ID: 314-041-OOM Zoning Classification: IND ZD Location: 270 UNIT 2E COMMUNICATION WAY, Proposed Use: R-4: Residential care/assisted BARNSTABLE living (16 max) Name of Tenant: Sprinklers Provided: Gen Contractor: STUART A BORNSTEIN Permit Type: Commercial - Business Type of Construction: VB: Any building material permitted by code Design Occupant Load: 6 Comments: Fellowship Health Resources Inc 2 � Building Official Date: A Certificate of Occupancy is Required Prior to Occupying Space Building Code: 780 CMR 8th Edition Massachusetts Region Kimberly Mello,Regional Director 43 Tower Drive Behavioral Healthcare Services New Bedford,MA02740 www.fhr.net Fostering Hope and Recovery t:508-994-2511 1 f:508-994-5264 ........................... . .:: .....: .....-------------------------- ..---------------------. ---------_ ___ --------- -------.- .. -------- ---- ----- --- ----.... -..- _. --_ ................ --------------------------- FELLOWSHIP ._.. HEALTH. RESOURCES Board of Directors and Officers To; Jeff Lauzon June 22, 2021 Chairperson Alan Wichlei Lexington,MA Vice chair I Sorry the information you requested was sent in an email but somehow ended up in Kelly McGee,Esquire I my spam folder. I am dropping a copy of the original Occupancy permit and this letter to Pawtucket,RI you. My Director Kim Vinal attended a site review plan meeting at some point prior to President 10/26/2018.We moved in one week after the Occupancy permit was issued on Debra M.Paul,MBA Cumberland,RI I 10/26/2021. Prior to our taking over the site the prior uses were as Day Care Center and Treasurer An Adult Day Habilitation Center. I hope the helps please contact me with any other Stephen M.Duggan questions. Cranston,RI Assistant Treasurer Robert G.Colucci,CPA,MBA South Kingstown,RI Secretary Colin Murphy,RN,MBA Providence,RI Michela Coffaro,Psy.D,ACSW Respecqully Yours, Milton,DE William T.Emmet r Washington,D.C. Joseph E.Lundy,Esquire PAul'J�Rozario Site Coordinator Philadelphia,PA Cape Cod and Islands Respite Program Charles S.McLister,MA,MBA 270 Communication Way Hyannis Ma 02601 Haddonfield,NJ Tel#508-790-5714 Fax#508-790-5786 Jeffrey McLoud Email proza�rio@fhr.net Kinston,NC Michael B.Owen Chapel Hill,NC Richard Sheola,MA Brookline,MA Russell J.Sylvia,SPHR,SHRM- SCP Sutton,MA I Regional Locations • Delaware • Maine • Massachusetts • North Carolina • Pennsylvania • Rhode Island • Virginia A. I CQ# FHR is accredited by CARF International. Application Namber .......... .................. ` ��/ �J: Pe®it Fee.......................................Other Fee...............o......... sueMASIL ¢ TotalFee Paid..................... ........................................... TOWNOF BARNSTABLE Permit approval�... .... .. ................On...... . ...... ........... `S BUILDING PERMIT T` 6 �......�..1... .............Pam........................................... APPLICATION Section I —Owner's Information and Project Location Project Address C2 rl0 Zl1rla� gat v�lage ►'oIV �f S Owners Name AA2,8L� , =a Owners Legal Address C* Jg h state M,4 zip 1 6 01 �� qq Owners cell## Section 2—Use of Structure Use a0up Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Do/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System Addition ❑ Retaining wall ❑ Solar Renovation ❑ of ❑ Insulation Other—Specify if 1 Section 4-Work Description 1 T s►ct Tmdatrd:919201 9 'Application Number........................................................ Section 5—Detail Cost of Proposed Construction 10 C Square Footage of Project o?, d&O Age of Structure o7v f ;, ' Dig Safe Number # Of Bedrooms Existing _ Total#Of Bedrooms(proposed) (� 110 MPH Wmd Zone Compliance Method .❑-MA.Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wining ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney IRAdd/relocate bedroom Water supply Public ❑ Private Sewage Disposal ® Municipal '❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: ,m % „ ,r I am using a crane ❑ Yes No Section 7—Flood Zone Flood Zone Designation Aeytt— Within or adjacent to a wetland,coastal bank? Yes ❑ No Section 8-Zoning Information Zoning District bitSitub Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required _ Proposed Rear Yard Required , Proposed Side Yard Required � Proposed S Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last dated.2/9/201 S Application Number........................................... a> Section 9- Construction Supervisor k f Name__�1 Telephone Number 0 L 776:-�a�� Address lJor . City State t LY k4 Tap M41 D/ License Number CS-O 4 2'* License Type( yd- ✓UEY-piration Date Contractors Email b/1qJD&W •MYrt Cell I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Bolding Code. I understand the constuction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date - t� Section-10—Home Improvement Contractor Name Telephone Number Address City State zip Registration Number Expiration Date r I understand my responsibilitiesunder the tales and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Budding Cods. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town ofBamslable.Attach a copy ofyour IUC... Signature Date _.._ Section 11-Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and docunieentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Si tore i r Date Print Name Cg� ,/'f- � �� �'�i� Telephone Number E-mail permit to: - 6 Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if mquir'ed) ❑ Fire Department ❑ { Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13—Owner's Authorization as Owner of the-subject property hereby authorize . to act on my behalf in all matters relative to work authorized by this building permit application for: ess of job) ignature of er daze s i= Print Name �1 J P I I I it Last undated:2/92018 ► , Town of BarnstableBuilding o..,sz�`tt .,� Permit� *" �Wher Permit No. B-18-2493 Applicant Name: STUART A BORNSTEIN Approvals Date Issued: 09/11/2018 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 03/11/2019 Foundation: Commercial Map/Lot 314 041 OOM Zoning District: IND Sheathing: Location: 270 UNIT 2E COMMUNICATION WAY, BARNSTABLE 1113 - 3 Contractor NameE STUART A BORNSTEIN Framing: 1 Owner on Record: COASTAL SUN LP i q 3, ContractorIicens' CS 018226 2 Address: 270 COMMUNICATION WAY,7-B K'' �`�Est Project Cost: $0.00 Chimney: HYANNIS, MA 02601 £ �perrnit Fee: $ 100.00 Description: AMEN MENT-PARTITIONS FOR TENANT FIT OUT SE'CHANGE �� Insulation: � Ee`e Pald $ 100.00 Building 2 Unit D&E z g Final: Date 9/11/2018 Project Review Req: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: e .J Rough Gas: This permit shall be deemed abandoned and invalid unless the work a6thonz4', his permit is commenced within six months after<issuance. Final Gas: All work authorized by this permit shall conform to the approved application aril the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local iopirig by laws and codes. Electrical � .- r ��s This permit shall be displayed in a location clearly visible from access street or road and shall bermaintarned opo for publicjri ion for the entire duration of the work until the completion of the same. � Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and'Fire Officials are providedon this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work:' - 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed _ Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Ins"' tion 7.Final Inspection before Occupancy Health i. Final: 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. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Town of Barnstable Building Department Services °FII E r Brian Florence, CBo BARNSTABLE %lSiO`5 HWS•65rcRVi4E•WEST Bi�15U.0!E Building Commissioner 1639-2M4 575 9sn MMns 200 Main Street, Hyannis, MA 02601 1639.r A www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 \1 September 7, 2018 L Mr. Stuart Bornstein 297 North Street Hyannis, MA 02601 RE: Site Plan Review#021-18 Hyannis Office Park Center 270 Communication Way,-B instable Map 314, Parcel 041 CND Proposal: Applicant proposes to reestablish residential use in vacant Units 2C and 2D. Non- structural interior modifications, clean-up, painting and new carpet is proposed. Proposed tenant is an educationally exempt non-profit organization that runs a residential 30-day educational program designed to assist individuals who have experienced a life disruption. Dear Mr. Bornstein: The above proposal was found to be approvable by the Site Plan Review Committee subsequent to the informal site plan review meeting held with staff on August 28, 2018 subject to the following: • Approval as a congregate/group home and educational use for disabled residents under M.G.L. c. 40A, s.3 is based upon the following information provided by the applicant: (attached) o Fellowship Health Resources, Inc. Articles of Organization listing the primary purpose of the corporation as charitable, educational and scientific programs specifically: "to develop programs for patient care, for education and for research in areas of interests in the care,recuperation and rehabilitation of persons suffering from mental illnesses, emotional illnesses or mental retardation"; schedule of resident curriculum& description of the Therapeutic Respite Program(TRP); and, exemption from taxation under Internal Revenue Code Section 501 (c)(3) as an educational and charitable organization. • Revised floor plans, 2 sheets "270 Communications Way, Building 2 D & E" depicting all proposed bedrooms containing a window, reviewed and approved by the Health Department. • Must comply with all requirements of Barnstable Fire Department Chief Pulsifer at the building permit stage. A change of use building permit as well as electrical,plumbing and sprinkler system alarm • permits are required. Applicant must obtain all other applicable permits, licenses and approvals required. Sincerely, Ellen M. Swiniarski Site Plan Review Coordinator CC: Brian Florence, Building Commissioner, SPR Chairman Health Department Barnstable Fire Chief Pulsifer Ms. Kim Vinal, Clinical Director, Fellowship Health Resources, Inc. Attached: Articles of Organization&Program Therapeutic Respite Program (TRP) TRP is an up to 30-day program promotes choices and empowers individualized decision-making, while helping individuals restore community-based living after experiencing a life disruption. The program milieu is clinically focused with 35+hours of weekly structured psycho-educational individual and group activity. FHR's staff comprises highly-trained professionals. At the core of the work being done in FHR's Respite Program is a commitment to the recovery of all Persons Served and the belief that everyone, with appropriate and adequate supports, can and do recover. To support individuals upon their recovery path individuals enrolled in the TRP are provided with 35+hours of psycho education,training and coaching to promote activities of daily living in and vocational training. The TRP utilizes the PRISMModel® establishes the framework that ensures that every interaction within FHR's Respite Program occurs in a manner that is: Person Centered, Respectful, Individualized, Strengths Based and Mission Driven. This model emphasizes the full and continued assessment of Persons Served strengths, including character and personality attributes, intellectual and cognitive capacities, artistic talents, educational and vocational preferences and accomplishments, social and interpersonal abilities, cultural interests and spiritual beliefs, familial support, connectedness to friends and acquaintances, and practical skills. We are unwavering in our belief that the PRISMModel® encourages individualized expression and self-advocacy, and promotes engagement in a self-directed recovery process, thereby, minimizing resistance and maximizing engagement. ,Dtate of 31- bobe 5S�Ianb anb �P robibenre �)Iarltatinn5 OFFICE OF THE SECRETARY OR'STATE 1001rorth Main Street Providence,Rhode Isinnd ' OM3-1335 NON-PROFIT CORPORATION PLEASE TAKE NOTICE that the corporation must be in good standing prior to filing DUPLICATE ORIGINAL-OF ARTICLES OF AMENDMENT TO THE ARTICLES OF WCORPORATION OF The New England Fellowship For Rehabilitation Alternatives, Inc. jrsu ant to the prow isionsofSection7-6-40 of the General.Laws,1956,as amended,the undersigned corporation adopts io%.ing Articles of Amendment to its Articles of Incorporation: ' The New England Fellowship For Rehabilitation, ' RST: The name of the corporation is.. . . ................................................................................................ ..,.. Alternatives $ Inc . :-COND: The following amendment to the Articles of Incorporation was adopted by the corporation: (Insert Amendment) The name of the corporation is hereby changed to read as Follows : Fellowship Health Resources , Inc. . 4 :3 The amendment was adopted -at a meeting of the Board of Directors of the corporation held on September 30, 1996 and - received the vote of a majority of the Directors in Office , 'there being no members entitled -to vote in respect thereof. October 96 The Anew England Fellowship. For Rehabilitation I............................................... > 19 Alternatives , Inc . ..................... .............................. ...................................................(Noce z) $ IJ.�'..!tl... .... .... ............ . . Dz ' bek, FresIdent Its.............................I......President or Y-Vnxom and �.� '. 1 .C n' ia':A'. ...0 M f1', ".Secretax..... ..(Noa3) Y Y Its............................. Secretary or A t 3c ary. sS: 1. Insert whichever of the following statements is applicable: (a) "The amendment was adopted at a meeting of members held on at which a quorum was present,and the amendment received at Least a majority of the-votes which members present or represented by proxy at such meeting were entitled to case." (b) "The amendment was adopted by a consent in writing signed under date of by all members entitled to vote in respect thereto." (c) "Inc amendment was ado pidd at a meeting of the Board of Directors held on and received the vote of a majority of the Directors in office,there being no members entitled to vote in respect thereof.". 2. Exact corporate name of corporation.adopting the Amendment. 3. Signatures and titles orofficers signing for the corporation. ., �� �� �� . 1 .4. a •i•i i, o S h.� M r • ,� I i ,, • � �� • � •. rt N NO►! State of Rhode Island and Providence plantations OFFICE OF THE SECRETARY OF STATE STATE HOUSE PROVIDENCE 02903 Kathleen S.Connell Secretary of State I, Kathleen S. Connell, Secretary of the State of Rhode Island . and Providence Plantations, HEREBY CERTIFY that The New England fellowship for Rehabilitation Alternatives, Inc. a Rhode Island non_profit corporation, filed Articles of Incorporation in this office on the twenty-sixth day of May A.D. 1977 ; and I FURTHER CERTIFY that said non-profit corporation is now of record and has a legal existence in this office. IN TESTIMONY WHEREOF, I have I ereunto set my hand and ° 41.• 1 � affixed the seal of the State of Rhode Island this seventeenth ' kt ,. '_� day of December , A.D. 1991 I A." of�!. * '•+,'`���I �� i-D n F ,� L, �•9�'y Secretary of State By AcWingl-D:�e�pputyy Secretary of State ' .... The...t�eW...En91and_..Eaa.l.o.Ks.hfn.-.----• . for Rehabilitation Alternatives. Inc. Sotatr of Niilljlr 33ittnb mth Prvoibrllrr Plantations Bppartlllpnt of Stair Offire of Ills Serrelaril of Stale �irnulArnrr � • ..._.............._......... ................_.__ ' ? '=1-�Lr .:,+c::�i ek?�rat�.�K.w+i. �'`�'y�"�?pF•.i�,i;' ,;;.:...�n�t� ... it _ t ORIGINAL ARTICLES Of ASSOCIATION (NONZUSMESS CORPORATION) F Linuul all f{irn bl! Illrsr JJrrsrals, That we.,•James-McGavern.,-Wviawoiushlcy, Har Louise Kenned Audria J nni_ •...._.• . . ��I[Ir—_— f all of lawful age,hereby agree to and with eacb other: FIRST. To associate ourselves together with the intention of forming a corporation under and by virtue of the powers conferred by Chapter 4-G of the General Laws-of Rhode Island,as amended. SECONA Said corporation shall be known by the name of____.�... l Eu81;Ind-Eell0wship_..f0r Rehahilitatl,n Altesaatives..Txic. ITarsn. Said corporation is constituted for the purpose of-- The purpose or purposes for which this corporation is organized }! shall be to use its funds and property exclusively for the carrying out of charitable,educational and scientific programs as follows, including for such purposes the making of distributions to organiza- tions which qualify as exempt organizations under Section 501(c) (3) of the Internal'Revenue Code of 195.4 (or the corresponding provision of any future United States Internal Revenue Code): t (a) To solicit funds for the establishment of half way houses and group houses in Rhode Island primarily and elsewhere in New England for the purpose of assisting members of the public recuperating from mental 1 and emotional illnesses-and mental retardation. 1 (b) To establish an office and to maintain offices in Rhode Island and elsewhere in New England for the exchange of scientific or educational information concerning the functions and operations of half way houses and group houses. (c) To encourage and to furnish scientific information and training of half way houses and group houses personnel. (e) To develop programs for patient care, for education, and for research in areas of interest in the care, recuperation and rehabilita- tion of persons suffering from mental illnesses, emotional illnesses or mental retardation. r (e) The carrying on, encouagement and the aiding of research and benevolent and cooperative activities in furtherance of the above stated purposes. (f) To assist Rhode Island and other states or local communities in providing effective programs in the operation and management of half way houses and group houses. (g) To acquire by purchase, gift, grant, donation or otherwise, property of every kind, character and description, and to maintain offices, houses and facilities for the purposes of'prompting or carry- ing on any of the objects and purposes of the corporation. Sad togp jinn►ball be mLILW ro roke bold,tnouait a►d co— vd"a pr r ,it►te to w►meant eat a►,,.MM is all ace buodr:d F!ry tMw+.ed deUan tl lStUtYll;yne idd bo.e.v.that tb loa•teina 6mitnMa oboe net aW?to enrpvrtinm erpoixed ht the NT^e►al h+.tM.4 itmnRirp,atd a++wiap the vb7•kd 6nmtiwt,.r,JemeN m..�tdnm:et nt inAud rimt r.n1 anelaamfna cntaq,i.ea.rNbia the nay an.l ro r►me manlrn oo OtoW dull rn.r�11 aa,t. niwa whjre t.the{rr.t�in� .t by amwdtaeotroarab pri.il•—fie ebaa bebe gmted only by tba imeenl—bi mt lwkhlw lbe+ete l►n t{ISe.Otl01 eitlw erfFiw117 . a ffir,rl ••:•`-/'fit:. I Fotrnrti. Said corporation shall be loeatcd in,�Q.snxldenee.._...._.,Ithodo Is)an d. (Portlier provisions not incaasistent with lain) F1F7H—KQ.P.act...aft-thg._aet:,.earnin gs.� to • .h"-����•�-o�.A.,�t�d}s ributab a to It members directors trustees, �.___.__- .........�._._..�..__.._.__.a...__...._._......._..._.r..._........._. officerst or other„private on exec t Ehat the cot oration shall be ers authorized and a owered to a _..._.....,_..........._.. '-""'^--�•--•-•--••�-- reasonable com nsation for services " rendered and to make ...... ---------_�___._�p_yrnents and,•dlstrfbutions.fn furtherance of oses p ---set forth -.--_-_.. ...._,-.•_theypur- •- ._ Art'c,}�7.g TAIRD- hereof. No substantial art of the - _ ..._......_.P,___ .. actsy.,� ��..s�..E�ktle�CArB.a.rat3.oa...sha --,-....__....... . 1L.1 ..th'.car�.ying.on---f:-psopaganda,.-or othezwis.e_attemptting__to m4LUencP slat3aa._and..the_.easperat#o _.shal! not a gartBhtt tt._Rc_ nk�sS A•�-.-i,t1.�:inil,ud9.0.4.�ha....pubLishiilq_.flr_.dis.tri.- t bution of statements}' an, litical c i4�.on behalf of and nandidate for publiclic o� Notwithstandin provision o Xhes _Ark3Sles,the•co ration ahall�c$�an�o�e� ��[..be-Carri.ed-oa•,(•a}.•-.by-�corparation.,.eueiapt..f mm..�ederal_._Lncome Tnx.wade.r_..saction.�QlfcLL32�f_the.-#sternal.-Reuenue...Code...Of�.1954. .... - . corze5pondiag_.,,, ion_6.f-any.l.fs_ the ` uture-Uni Led.StateyteLriaL Revenue.(or-.Law) or (b),�K_a �orparation._coataibutions;te-which,ar"eductsbLe-undep-_ section 170(c} 2 of the iota ) ' pondin (a.r.._kkte...corres.. 1 ' _....g_Q;'ovision„•o£„any�utytre_�l��tgd_.SLia,Xe�..LO,kerndL...lieYenuQ-_Law)...._.. SEVENTH.:w The_corporatf an_.sha ll_not_. shalt LSsu9-stock,--and...lts...members 1._.cons.is.t�f,...those_persous....selected,.is_aecxrdance;._with...the._hy-laws. I� Of the_corporatio.n__ -majosi.ty of. the...members-maY:amead,_the_a.rticlo;._ Of as.soc a"t 4.o..r�t-Any .40an ..the_.membe[s....¢r_at.. mee tkng....satl.].ed_.i.P..r_.k �.t. aIXY--sPecial..- P°ra.tion,...the.rise.ts._shall-be:.:dlstribuLed' to such organization or or a ization , spit_:.. ' Diresloss, which shad I )Ze aX ;cqf.. ..o£_the._.dnternaL..Re.venuo coae.�othcr thaw? .p�_�xate h,i 9.�h.._sha.LL_bc.... .arrY. •ir,actly„ic•iasLml.lat{p_thAs _.for....ttb.iah...this_.co B...on_ t I Ju ur,liucopu 3I111rrruf, We have hereunto set dur hands Ind Mated out•residences this € A3/ day of m . E A. U. 19 77 Ao y� � -Q ttrsi�F:ncF: Ja - 3-��'•-°•�-• �v lQv+�t 7xR .lei o zq l a � C<((t�•C�/�.%r,••e t u:.J-• ....�`LY 1XXy}�'��Sf �?'.:, er_ ��- - /.1Ci.b'u,u_�)it•v.fv:,,�.Y-:2:�•e�la.,c;:.�,;1'�;,: , k W,4 0.279/ ahich.,_stall.,•.p tax-%KnternaL.xKevenue Code,_other,_than.a,_pr, Y.et4_�.9kD.daki,Q ..._.ansl t�hcla sb. l.l_.b6 C.azryin.g....4n 1, ±lu uruiimanu 191irrruf, WC have hereunto set our halids and stated our residences this ►�3 Aj:- day of m� _ A.D.19 77 N1 E ItFSiDEN(;F 1CC7iLN..0 f vr.:}�._.1:1..�itLlsxuw./�e.� 94•6 r (J .,t r L STATE OF RHODE ISLAND, COUNTY OF PROVIDENCE In the City T,e%4i- in said county tbis...____..A3.A.4......_.day of......}�0 A D.191.7,then personally appeared before me....James McGovern,..(.:.:David•..Corbishley,-IUry._.._.... Louise_Kennedy,....Audri"ennings_. .. _ -... ..__... i l i t ............_....... each and all known to me and known by me to be the parties executing the foregoing instrument,and they severally acknowledged said instrument by them subacribed to be their free act and deed. f t •' i i - i 1 , i flair of 1 Ilnlr Jslanl aul 'Jrouilrurr Plaultfliono Drpurluirnl of Nair (9mrr of 14t EirarlarLi of Ointr FREOERILK A. MASSARO: First Deputy �� �cq/, ��� ,aa �Vwde Alavul and�Jro �acc O�Jla�4/a�co�r6; 4rrrbg OrriifH tddllmala yoi? G1at~xgr99 ar phic ��� O thn original Articles of Aaseciatinp of The New Fellowship fpr Rehabilitation Alternatives. n I(al l'I�oIn 6cc meoxo(J in 4 191-?l `�`' an !M1 MOW41 UVWX /�ic OIL/LCLE/articles.of association filed in this office on the twenty-sixth day of May. A.D. 1977. — a�zd 9io�a xe��uu�u��a�af�anal�i�cai�ilr./fu.'� o��.tco. , 310 �ratinlnog �Ilrrrnf, .J' �taBl�/crrvt„!o O first August First Deputy Secremrp /State. Non-Business Corporation ORIGINAL. ARTICLES OF ASSOCIATION. OF .............................................................................................. ................................................................................................. ................................................................................................ aRy Ell FILED IN THE OFFICE OF THE ItP�,TARY OF STATE AY ............................................................... . - .. �� Brea. ast/ edicatro 8reakfas ,meets ,;,. Breaakfast/ eds ;, Breakfastfinecs Breakfa . ds . ; ..BreakfastBreakfast m ds st. /rye,«. / Al mum .IVleetiri `: ,Coin n M ,� • Community Meeting Comrrurnty Meeting Com ty g, mu ity eet ng _ Community Meeting YCommumty Meeting , Communty g `F7e6g�pu3$erY�cE/� Building {i r 4V I f , �, b �s� , .� Buildin Resilience �� Quality of Communication ; M na�fngCh�or�i:;� �- .� � anrngpe�rsoalreas� (Workbook) s � � Satisfaction (Workbook) Managing Thoughts S tr uafUell e s Living a Balanced Yoga wrthKim or Lunch/prep$lunch � � Feelings&Behaviors Lifestyle Interpersonal �* (Workbook) Boundaries/Conflict resolution. 3, _ :_ r `_.:.: (Workbook) Lunch prep : Lunch r2 Lunch: r " urich _ :Ou in n r e3Ram P P P P P t g l u chpa b Lunch LunchrLun�ch Lunch` pu#mg Lunch' vzYe Laundry/:common} Physical/Wellness Physical/Wellness Physi66l/We1`I64§s Physical/Wellness Outing E ; areas ,, Activity Activity Activity . Activi � tYi ,,.... .._ _ Laundry%'common Dual Recovery Expressive Arts Practical Life Skills Understanding Outing areas (Workbook) (Workbook) Relationships (Workbook) Socrahzation,Grou .:.: ,SociahzatronGrou ,Socrahz,tton,Gr'oup/w'WI,,, W pf3 _ /�, S�ciaizatabnG _/��°.Socialtza i nGrou m��Soc�dltzatronGrou ._.S.ocializatron. :> „ �tGam Game,. ;..Grou /:Game ' Dlnnei WE- ! tnnewrtPrQ}�' Dinned Pr ptnne a Ml iIN nerPre Dinne 'a drone I?fi44 P � � r ,Droner , Dinner! I Dinned' Dmne'r Droner i 11 Din6 er Dmner�r • � : rem r�n��fof�eetl"n re arI� fti "� Pce ai-tn a�' � - � ��� a tt g�.. meetrng.` ee rig w, r, r tee-tt?g r t6011 f pa1lr of New Bedford[OD]— Fairhaven[OSPYP Fairhaven[OBB12 New Bedford[O]— Onset[OD]— • Freedom of Speech ]—Young Peoples ]—There Is A Whaling City Lighthouse ...St.Martin's Ch., ...Trinity Lutheran, Solution ...United Church of ...Spiritualist County&River Sts. 16 Temple Street ...Trinity Lutheran Christ(School& Church,17 7:00pm 7:00pm Church,16 Temple Purchase)7:00- Highland St. Place 7:00pm 8:00pm House Game Night House Movie Night 7:00pm Or Or Or Or Or Relaxation Group and Practices Mindful Narcotics Anon Mindfulness Narcotics North End Practices Anonymous r Community Center (Workbook) ` 360Coggeshall Saint Paul's United ' ` Street New Bedford,s � ' Methodist Church , � - Massachusetts,2746 � � r �� � 884 Kempton Street �'. New Bedford, s Or Massachusetts 02740-1520 Arts and Crafts Or Baking Group :..��;t•6'2.'�.:. - Vim;. ;�<.. -z-.;;;�.' a:;�--� _ '.�,g. � -"�:-.�r�- .�= `,.,, " 7�� .�.,.�;,_ � _ ;._..:;� :'.=?='.. ;�w 'cr:., �T".,", m �s�='", _.,, "" -',F' .,. • �Med�t�a „„� J�nac'�c/ �;. e��e�atians/ p aelrl` [.c�xa s e icatic�r���S acid' _:-. edito.;ms/ '.<acic�� _ � �c �ons/� lC/ � ��Irc� o ' 7e ewsi�n car�b�nxr-� := eieu�s,dn Via:•: ,; , +5' •`>t i rig, .m . e, n . �Telev� r:�n �n • Bedtime routines Bedtime routines Bedtime routines Bedtime routines Bedtime routines Bedtime routines Bedtime routines THE DEMPSEY GROUP, INC. 1 8 Beaumonts Pond Drive Foxboro, MA 02035 Tel. (508) 543-5499 STRUCTURAL ENGINEERING CONSULTING: CIVIL ENGINEERING. .INVESTIGATIONS REPORTS August 23,2018 Mr.Edward Bauer Town of Barnstable:Building-Inspector C/o Mr.Stuart-Bornstein,President Holly Management&;Supply Corp. One Financial Place Hyannis;MA 02601 Re: Unitsi 2D&2E-276 Communicarions.Way.-Hyannis,MA TDG 41,8231 Dear Mr.Bauer, . This letter is presented as a brief'narrative of the work performed recently at the subject address. The work is in compliance with .IEBC/2015 Section 301.1.2 "Work Area Compliance Method" and more specifically,Chapter 8"Alterations—Level 2". Ilistorically, the recentlyrenovated space had been utilized as an Alcohol and Drug, 24 Hour Holding and Observation.Center,with an R4.occupancy per 1.RC/201:5.Section 310.E Its new use is unchanged,but upgraded after years of vacancy,with an 114 occupancy sti11;;and six'(6)or fewer.occupants.. The area.renovatedi encompasses:approximately 1870 square feet of a 7 000 square foot; single story, mixed.use, wood-framed structure. An adjacent space;encompassing 3,000 square feet.plus/ninus,is utilized for general office use. The remainder of the building floor:space is vacant. The scope of work completed iodate includes new HVAC units,construction of.two(2)non-bearing partition walls, painting,new carpets,and upgrades to smoke alarms. Upgrades to the existing sprinkler system were also made but must be certified by the.sprinkler contractor to confirm that,the new'partition walls do not interfere with their performance. Also, the,project.is.subject to site plan review. Tinally,there is no change to the building structure, either to gravity load bearing elements or.to existing structural.elements:resisting'lateral loads.in accordance with IEBC/2015 Section 807. Should you have any questions about this.letter.or if we can be of°further assistance.to you irr this matter,please do not hesitate to contact us. Respectfully; THE DEMPSEY GROUP,INC. .RICHARD J. o o DEMPSEY � STRUCTURAL. ' Richard J. D ps E. No.29173 President 2447 Main Street SWest Ba nstable MA 02668 508-362-4.283 FIRE PROTECTION TEST REPORT Name of Premise: " Address.—2 71�0 'telephone Number: Contact Person: Number of Units Date of Control Panel ok Service Annunciator ok Service Stand-By Battery ok Service Smoke Detectors Service Smoke Detectors(Elevator kfte Lock) ak Service Heat Detectors ok Service Pull Stations -- lG ok Service BellsiGornsUghts ok Service Spriwer ok Service Tamper Switch j ok Service Comments: ,DW.. D I ! have inspected on date. gh l P1�Ftir►t PMmiso and the above t=W items arc wig a=rftg to t>mfhomm's o Si �,. Date D 1 Tech I.i=w Number. � J Compaw lble Company,address: ?4 V 7 ;111 u `E) 5 �_ �ii /)zJ f,r., e Ft 4 4w Vic .ram �rl, &&z M,O- &mo& awl). A'v 'e-uze 1 i Form for Inspection,Atingntenance of U� Sprinkler Systems This form covers the minimum requirements of NFPA 25-2002 for wet pipe fire sprinkler systems connected to water supplies without tanks or fire pumps. Separate forms are available for inspection,testing and maintenance of fire pumps,tanks,and other fire protection systems. More•frequent inspection,testing and maintenance may be necessary depending on tVconditions of tlne occnpancy'and the water supply. The work covered oathis form is(check one): O Monthly a-Quarterly Arununl U Third Year U Filth Year Owner Ao llg;� ��,r- Owner's Phone Number: Owner's Address: If✓ L''f�5i Al Y 1,9 6lli_� Property Being Evaluated: n ,r Property Address- Date of Work: 4S A1I respogses refer to the current work(inspection,testing and maintenance)performed on this date. Notes: N)All questions are to be answered res,No,or Nor Applicable. All"Nd'answers are to be explained in Pait III of this form. 2)Inspection,Testinng and Maintenance are to be performed with water supplies(including fire pumps)in service,unless the hnl airment procedures of.Chapter 14 of NFPA 25 are followed. Part I—Owner's Section 3.QuarteHy Inspection Items(contlaucd) d.Hydraulic nameplate(calculated systems) // A.Is the building occupied? U Yes U No securely attached to riser and legible? 0 Yes WNo U NIA B.Has the occupancy classification and hazard of contents 4.Annual'Inspection Items(in addition to abov items) remained the same since the last inspection? 0 Yes Q No a Propel'riuinber and type of spare sprinklejV2 Yes 0 No 0 N/A C.Are all fnre,proteetion systems in service? U Yes ❑No b.Visible sp",ers: . D.Has the system remained in service without 1.Frci'of corrosion and physical damage? aXes ON U NIA modification since the last inspection? 0 Yes U No E.Was the.system free of actuation of devices 2.Free of obstructions to.spray patterns? 0/Yes U No 0 N/A or alarms since the last inspection? ❑Yes U No 3.Frce of foreign materials inncluding paint? es 0 No 0 NIA 4.Liquid in all glass bulb sprinklers? Yes❑No 0 N/A c.Visible.piM —.——� - Z 1.In glad conditiordno external corrosion'? es U No 0 N/A 'Owner or Representative pent Hanna). Signature and 2.No Mechanical damage or leaks? ryes 0 No❑N/A Part I1 Inspector's Section I,Properly aligned and no external loads? Q Ycs O No U NIA A.Inspections it.Visible•pipe hangers and seismic braces 1.Daily and Weekly Items not da*ged or loose? ayes U No 0 NIA a.Control valves supervised with seals passed itVection e.Hose,hose couplings and nozzles on sprinkler in accordance with II.A.2.a below? Of Yes❑No U NIA systerti passed'inspection per NFPA 19627 ❑Ves.0 No C�NIA b.Hackilow preventers: f. Adequgte heat in areas with wet piping? Cif yes 0 No 0 N/A 1.Accessible and isolation valves'open? g/ycs 0 No U NiA g.Has an;intenna!inspection of the pipe been 2.Sealed,locked or supervised? es.U No 0A performed by removing the flushing 3.Relief port on RPZ not discharging? . U Yes U No Q NIA connection and one sprinkler near the end 2.Monthly Itnspectlon•Items(in'addition to above Items) of a branch be within the last 5 years? Yes U No 0 N/A a.Control valves and valves on backflow �(/ 'No';conduct internal inspection) preventers with locks or electrical supervision: 5.Fifth Y,bar Inspection Items(in addition to above items) 1.in correct(open or closed)position? ii� es U No 0 N/A a.Alarn:valves and associated strainers,filters and - 2.Lock or supervision in place? U No U NIA restricted orifices passed internal hnspection7U Yes 0 No 0 N/A 3.Accessible and free from external leaks? Yes 0 No❑wA b.Chick-valves internally inspected,all parts 4.Provided with appropriate wrenches? U Yes 0 No Gf MIA operate properly and are in good condition?0 Yes 0 No❑N/A 5.Provided with appropriate identification?0 Yes U No U NIA o.Lnterr'41 pipe inspection performed per 4.g'l 0 Yes O No U NIA b.Sprinkler wrench with spare sprinklers? 0 Yes C7 No U NIA B.Testingc.Gages on system in good condition and Report any failures on.Part III of this faun. showing normal water supply pressure? Yes U No U N/A 1.Quarterly Tests d.Alain valve free fmm physical damage,trim a.Mechanical watertlow alarm device passed in correct(open or closed)position and no tests by opening the inspector's test connection leakage from retarding chamber or drains? Yes 0 No U NIA with alarms actuating and flow observed? Ycs U No U N/A 3,Quarterly Inspection Items(in addition to above Items) b.Post indicating valves opened until spring or to on a.Pressure reducing valves in open position,not leriking, felt in the rod then closed back%turn? Pf Yes U No U NIA with downstremn•pressure per design Criteria,gad In good c Main drai»test for systemdotivznstru�nnn of t►ackClow device or condition with hryndwheels not broken? Q Yes❑No 0 N/A pressun;reducing valve: b.Fire department-connections visible,accessible, couplings and swivels not damaged,gaskets in place and in good condition,identification sign(s) 1.Record the static pressure psi in place,check valve is not leaking,clapper in pl ce and operating properly and automatic drain va e in place and operating properly? Yes U No U N/A 2.Record the residual pressur� psi (If plugs or caps are riot is place, inspect IntelYorfifrobstructions) 3.Was flow observed? /U No U N/A o.Alarm devices o-ee from physical damage? es U No U NIA 4,Are,results comparable to previous tests?Q;Yes❑No❑NIA Rhode Island Fire Protection, L.L,C., Cranston, RI Customer•White insurance-Yellow State-Pink Otfice-Goldenod r 2 " 2.Semiannual Tests(in addition to previous items) IAnnual Maintenance itetgs(in addition to PM. 1ous items) a.Valve supervisory switches indicate a.Operating stem of all bS&Y valves movement? O Yes 0 No 0 NIA lubricated,.completely closed,and reopened?Or es a No 0 NIA b.Electrical waterflow alarm devices passed b.Sprinklers and spray noz7Jcs protecting tests by opening inspector's test connection conimereial cooling equipment and ventilating with alarms actuating and flow observed? Q Yes 0 No 0 NIA systems replaced except for bulb-type which 3.Annual Tests tin addition to previous Items) shown signs of grease btdld-uNT O Yes O Np Q6111A a.Main drain test for systems not tested quarterly: Part III—Comments'(Any"No"wisivars,test failures es or other 1.Record Static.,, psi and Residual Pressure_,,psi problenisfound with the sprinkler system must be a rplainerl hem. 2.Was flow observed? O Yes U No O N/A also note here any products noticed on the syytarn drat have been the 3.Are results cotnpambte to-previous tests?0 Yes O No 0 NIA subject of a recall or roplacement pr ognam.) b,Are all sprinklers dated 1920 or laterl 0 Yes 0 No 0 N/A N c.Fast response sprinklers 20 years old or more replaced or 1-�-f-� " 0 e GAP ie r�I ca i1i successfully sample tested-in:last 10 years?0 Yes Q No 0 NIA d.Standard response sprinklers 50 years old or more replaced or successfully sample tested in last 10 years?'Cl Yes 0 No 0 NIA _,e,A) L) a, e.Standard response sprinklers 75 years old or More replaced or d - successfully sample tested hi last 5 years? 0 Yes 0 No O N/A J d 6r� D t, �T ti f. Dry--type sprinklers replaced or successfully 01j I sample tested In last 10 years? 0 Yes 0 No 0 NIA / g.,Specific gravity of antifreeze correct? 0 Yes 0 No Q NIA 5 R r 1 ���'v� ;OCC. IL All control-valves operated through ftdl range and returned to tnonnal position? 0 Yes 0 No 0 N/A � —�'�A��� i. Backilow devices passed backtlow test? 0 Yes 0 No'U N/Ap/J f" �,�/��r j. Back-flow devices passed forward flow test?O Yes U No 0 NIA �f—� IL Pressure reducing valves passed partial Row?OYes 0 No U NIA �� d C 4.Test for every third year(In addition to previous items) ps�� e Hose more than 5 years old connected to the system F= has been service tested per NFPA 1962, Water &iQ9 u R!17 - j-S discharged rand water Row alarms operated? 0 Yes 0 No 0 NIA g.Tests for every fifth year(in addition to appropriate Items) '�s �'� � � a.Sprinklers above high temperature tested? U.Yes 0 No U N/A 1 y t . is b.Gages checked by calibrated gage or replaced?QYes ONo ON/A c.Pressure reducing valves passed fbll flow test?OYes ONo ON/A A,1 C.Maintenance ? A 6?4 . 1.Regular Maintenance Items ?��' _ J�� S i�.•n/ /�•� .z '� .�, � S/x�/ � a.if sprinkler have been replaced,were they proper replacements? Q Yes U No 0 N/A /'0le,107 r.Id69C S` :5 2161 A) b•Used hose was cleaned,drained and dried before being placed back in service? ❑Yes 0 No O/A �— 1� �' ' f S ( '� C`r'om�." ' c.Hose exposed to hazardous materials was disposed of or decontaminated in an approved manner?DYes ON O'N/A d.Systems normally filled with fresh water were drained and refilled twice if raw water.got into the system?UYes ONo f(A e.If any of the following were discovered,was inn obstruction investigation conducted? 0 Yes 0 No A<A Explain reasons fs)and obstruction invastlgatfon findings fit Part III 1,nefeotive intake screen on pump supplied from open sources 2.Obstructive material discharged during Row tests 3.Foreign material in dry-pipe valves,cheek,valves or pumps 4.foreign material in water during drain test or Plugging of Part IV—Inspector's Information Inspector's test cotunection �- 5.Plugging of pipe or sprinklers found during activation or work Inspector: P ^9Corupany / - 6,Failure to flush yard piping or surrounding mains following new installation or repairs Company Address: 7,Record of broken mains in the vicinity I state that the information on this fonn is correct at the time and 8•Abnormally frequent false-tripping of dry-pipe valves place of my Inspection,and that all equipment tested at this time 9.System is retuned to service after an extended period of time was left in operating c9nditio. pon completion of this inspection out of service(more than one year) except a$noted in Part III ve. 10.There is reason to believe the.system contains sodium silicate or its derivatives or highly corrosive fluxes in copper pipe Signature of r f. if conditions were found that required flushing,was flushing of system conducted?0 Yes U No 0'N/A License Ce 'freation Number(if applicable);r<-L—o ; Rhode Island Fire Protection, L.L.C., Cranston, R1 Customer-White insurance-Yellow State-Pink Office-Qoklenod �® DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 04/26/2018 S CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 'RTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES IELOW. 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). CONTPRODUCER r NAME: Linda Sullivan - NAME: DOWLING &O'NEIL INSURANCE AGENCY PHONEWC,No,E , (508)775-1620 Fnc No: ADDRESS: Iullivan@doins.com 973 IYANNOUGH RD INSURERS AFFORDING COVERAGE NAIC p HYANNIS MA 02601 INSURER A: ATLANTIC CH RTER INS CO 44326 INSURED INSURER B: FRONT END CONSTRUCTION CORPORATION INSURERC: INSURER D: 297 NORTH STREET INSURER E: HYANNIS MA 02601 INSURERF: COVERAGES CERTIFICATE NUMBER: 261865 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MMIDD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAM E TO RENTED $ CLAIMS-MADE OCCUR PREM SES(Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ JECT POLICY❑PRO ❑ LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS I AUTOS Per accident $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED F RETENTION$ PER $ WORKERS COMPENSATION X STATUTE ER H AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 500,000 A OFFICERIMEMBEREXCLUDED? NIA NIA NIA WCV01306602 01/12/2018 01/12/2019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 701,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE �� f'' j•t J.5`o Hyannis MA 02601 Daniel M.Cr, y,CPCU,Vice President—Residual Market—WCRIBMA @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD Leparirnen£of lnaustnat acccaems Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit:B>1Uders/Contractors/Electricians/Plumbers Applicant Information j ,Q ����7 �j�.P�Please. Print LegibIY Name(Business/or�ganizafimVffidM&aI: Trot End �ans ft " ho' P d— i, Address• O? ` 1 Q V�h St• City/State/Zip: AA •Do1 D Phone 775- geld Are you an employer?Checkthe appropriate box: Type o projeef(required): mP Y 1.❑ I am a e to er'with 4. I am a general contractor and I 6. ❑New construction employees(full and/or part time)* have hired the sob-contractors 2.[] I an a sole proprietor or partner- listed'on the attached sheet. 7. ❑Remodeling ship andhave no employees These sub-contractors have g, 0 Demolition working for mein any capaci{y. " employees and have workers' 9. Building addition [No workers'comp.insurance comp.m 'sce. required.] 5. utan 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 L bm once required.]t c.152,§1(4),and we have no employees.[No workers' 13. Other 1"Q,{')D1/ T GlJ n comp,insurance required.] *Airy applicant that checks box 61 mast 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 than hire outside contractors mast submit a new affidavit indicating such. Contractors that check this box must attanhcd an additional sheet showing the name of tho sob-comtraotors and state ryhether or not those cnti6es havo employees. If the sub-contnctnrs haYe employees,they must 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. sm-ance Company Nme: Ay ladxt Mattertter l nj, r� -- Policy#or Self-ins.Lic.#: Expiration Date: l—1,�—1"1 Job Site Address• ` &"fiwu C 411 W G�� :ity/S'{ate/7.ip: oa&oj ECG/ Attach a copy of the workers'compensation policy declara 'on page(showing the policy number and expiration date). i 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 imprisomaent,as well as civil penalties is the form of a STOP WORK ORDER.and a fie 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 ytrificafion. I do hereby certcfy under the pairs and penalties ofpedury that the informadonprovided above is true and correct, ' c I Si e• Date: d Phone#: '31(,o I official use only. Do not write in rs area,to be completed by city or town ooMaL City or Town: PermitlLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Towu Clerk 4.EIectrical Inspector 5.Plumbing Inspector. 6.Other Contact Person: Phone M. } Commonwealth of Massachusetts y�� Division of Professional Licensure t ulations and Standards Board of Building Reg l Constr,u',&W Supervisor k, If 1=�pires: 10/3112019. CS-018226 ~ -ii-r i STUART A BORNSTEIN xE tl 297 NORTH STREET r, HYANNIS MA 02601 �* Commissioner v _ r °Ft"ETA Town of Barnstable - r M s awxxsrwsze. : Building Department-200 Main Street , Hyannis, MA 02601 '°rEn Max°r Tel. (508) 862-4038 Certificate Of Occupancy Permit Number: B-18-2493 CO Issue Date: 10/26/2018 Parcel ID: 314-041-OOM Zoning Classification: IND Location: 270 UNIT 2E COMMUNICATION WAY, Proposed Use: R-4: Residential care/assisted BARNSTABLE living (16 max) Name of Tenant: Sprinklers Provided: Gen Contractor: STUART A BORNSTEIN Permit Type: Commercial - Business Type of Construction: VB: Any building material permitted by code Design Occupant Load: _ 6 Comments: Fellowship Health Resources Inc 2 � Building Official Date: A Certificate of Occupancy is Required Prior to Occupying Space Building Code: 780 CMR 8th Edition 270 COMMUNIATION WAY HYANNIS, MA 02601 ATM 1R1>l�ED EQ J# / 10 ♦ ♦ % / % / ° ♦ ° ` / ° 40 ` mr-r UM 2D UNIT 2C r _ t 1 /� 1 1 /♦ 1 1 i '1 t i s IL b t t 4 ioyl-y 1 BUILDING 12 - SECOND FLOOR PLAN , ° .. Town of Barnstable Building r RP,ost„Th�s;Card So�That rt is V,�sible From�the Street_..A roved PlansnlYlust�be,Retamed on�Job ands`this Card'Must be Kept � i •M� Posted Until t=mal Inspection Has BeenMade � � ��� �� � '� �' 1 el 1111t Where a;Certificate of�Occup�ancy�ls Required,su.chyBuildmg shalCNotbe Oceupied�until a Final Ins'pection.; ,as�b s, �• Permit No. B-18-1292 Applicant Name: STUARTA BORNSTEIN Approvals Date Issued: 05/21/2018 Current Use: Structure Permit Type: Building-Addition/Alteration-Commercial Expiration Date: 11/21/2018 Foundation: Location: 270 UNIT 2E COMMUNICATION WAY, BARNSTABLE Map/Lot 314 041 OOM Zoning District: IND Sheathing: Owner on Record: HYANNIS OFFICE PARK CENTER LP �" Contractor Name STUART A BORNSTEIN Framing: 1 Address: 297 NORTH STREET �- Contractor License CS 018226 2 000.00 HYANNIS, MA 02601 EstProlect Cost: $ 18, Chimney: Description: new window, painting,cleaning one 8'wall, replace damaged Perrni Fete: $263.80 Insulation: ceiling tiles all non structural work Fee�Paid $263.80 Final: Project Review Re - 0 1 q. Da �j: 5/21/201 to 8 Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: ,3 5 This permit shall be deemed abandoned and invalid unless the work authonzedby this permit is commenced within six months afterissuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for wh0i i s permit has been granted. Rough Gas: t' All construction,alterations and changes of use of any building and structures�shall be incompliance with the local zoning by7laws and codes. This permit shall be displayed in a location clearly visible from access street or oad and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are§provided onthis`-permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing z Rough: 2.Sheathing Inspection : 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). � Building plans are to be available on site Fire Department ! All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: c� r - � 0 -�' Application Nimmber.......... .. • BA8N6TA87,E� s 163 Permit Fee....... 63� Al ./ s m •f�/••l! ..........Other Fee..................... .. TotalFee Paid.....................................� � .�,,- �....Z . .... ...... TOWN OF BA RNSTABL E Permit oval by.. � ............................... ..... .......T l� BUILDING PERMIT 1V.......................................P ! APPLICATION arcel......... Y ..... Section I-- Owner's Information and Project Location Project Address cz 11 �"1� - , �lIf'1U'f 1uYllm 4lm'n Village Owners Name - uS us �G�tCG Paar1L L�cnfer I-V- (3imt Owners Legal Address City S State Jv + �n zip G�2 0 l Owners Cell# Vv3-6ag aka E-mail , Dmb C!o1'Y� Section 2—Use of Structure -A Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,00,0 cubic feet ❑ Single/Two Family Dwelling Section 3—Type of Permit ❑ New Construction [] Move/Relocate ❑ ❑ Change of use Accessory Structure I� ❑ Demo/(emire structure) El Finish BasemFamily/Amnesty Elent ❑ Rebuild Fire Alarm ❑ Addition ❑ Deck Apartment ❑ ❑ RetainingSprinkler System w� ❑ Solar Renovation ❑ Pool ❑ Insulation Other—Specify Section 4- Work Description p n r C � tits AH k7ln, S Ll ;t-J �. t Taf m1dat6d:719/20l$ Application Number................................................. Section 5—Detail Cost of Proposed Construction t E, Square Footage of Project a d&O Age of Structure 40+ Dig Safe Number #Of Bedrooms Existing (� Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑.biting ❑ Oil Tank Storage ❑ Smoke Detectors [] Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney Add/relocate bedroom Water Supply Public , ❑ Private Sewage Disposal Municipal ❑ On Site Historic District [] Hyannis Historic District [] Old Kings Highway Debris Disposal Facility: d u,.tyW 5�er I am using a crane ❑ Yes ® No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No Section S—Zoning Information Zoning District-baSit1e-9, Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard ,Required Proposed Rear Yard Required Proposed -Side Yard Required Proposed , Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No 9 Last undated_2/92o 18 Application Number......................................... Section 9—Construction Supervisor 1. Name 3 � ft D&rnSt4� Telephone Number M- o?q,1 ill©r 775 — Address— ( City l S State AA Zip License Number S' 1 kao2 G License Type�WL.J fSKExp lion Date /d Contractors Email U 5 ®hill n7 /Y1P/)t•CD rn Cell# JrD ;3a�'-�0 qa I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Budding Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CUR and the Town of Barnstable.Attach a copy of your license. Signature Date Section.10—Home Improvement Contractor Name Telephone Number Address City State zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and docrmrentation required by 780 CUR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the roles and reg ulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature ` Date Y-a 5-1 � � t l3�rrl<sfrecn —0 _ Print Name Telephone Number 1 775-- Q31(. E-mail permit to: U Sh /2a// �1 CO7rt T e..r.....7..a_.7. jjAmn,0 I s Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Constr' i ,dt1'6n 1�bpgrvisor t CS-018226 i es: 10/31/2019 STUART A BORNSTEIN ' 297 NORTH S*REET'• � { HYANNIS MA 02601 .; s Commissioner e r Section 12—Department Sign-Offs Health Department ® + Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑. For commercial work,please take your plans directly to the fire department for approval Section 13—Owner's Authorization I, 572;i� as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name r fA Department of InduslrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 wli'li.mass gov/dia Workers' Compensation Insurance Affidavit:Sulders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/organizationandmduai): Trot End ��on pry�i07i Address• a{ 1 �j p-r 'h 3t. City/StatelZip: AA -bXoQ1 Phone#: Are you an employer?theckthe appropriate bow Type of projecf(required): 1.❑ I am a employerwith 4. ❑1 am a general contractor andI . * have hired the snb-contractors 6• ❑New construction employees(fallmid/or part-time).* . 2.[] I am a sole proprietor or partner- listed an the at#ached sheet 7. ❑Re modeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp.fimm ice t' 9. ❑Building addition required.] S. We are a corporation and its 10.[]Electrical repairs or additions I El officers have exercised their I am a homeowner doing all work 11.[]Plumbing repairs or additions rayselt:[No workers'comp. right of exemption per MGL 12.[]Roof repairs fionanca Ted ed]t 0.152,§1(4),and we have no 13 r� employees.[No workers �fwYl comp.bisur nce requited.] *Any applicantthat checks box#1 must also 5I1 out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and thon hire outside contractors rant submit a new affidavit indicating such. #Contractors that cbeck this box must attached an additional sheet showing the name of the sob-cout actors end state whether or not those entities have employees, If the sub-contractnrs have employees,they must provide their workers'comp,policy number. lam an employer that fs providing workers'compensation insurance for my employees Below is the policy and job site information.insQraace Company Name: ._ A f l�ttt, Utz e Policy#or Self-ins.Lic.#: t) O."V013OU0A Expiration Date l"4a—J"1 Job Site Address: `� &MMAM e&h 0, Ulbi ACb ,,V-st MA 0,�(O0' Attach a copy of the workers'compensation policy de".on page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL o.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 inthe 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 maybe forwarded to the Office of Investigations of the DIA for fiLwanca coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided chive is true and correct Simiatare.: Date: SIG d Phone#• 50 Official use only. Do not write in is area,to be completed by city or town official City or Town: Permit/License# issuing Authority(circle one): 1.Board of Health 2.Bm1d ng Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector. 6.Other Contact Person: Phone#: :4C �® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 04/26/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Linda Sullivan DOWLING &O'NEIL INSURANCE AGENCY PAICHON Ell: (508)775-1620 alX No): AD REss, Iullivan@doins.com 973 IYANNOUGH RD INSURER(S)AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURER A: ATLANTIC CHARTER INS CO 44326 INSURED INSURER B FRONT END CONSTRUCTION CORPORATION INSURERC: INSURER D: 297 NORTH STREET INSURER E HYANNIS MA 02601 INSURERF: COVERAGES CERTIFICATE NUMBER: 261865 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE A=WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE11 OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ MOTHER: L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ POLICY PROJECT ❑ LOC PRODUCTS-COMP/OP AGG $ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED L SCHEDULED tid P N/A BODILY INJURY(Per accident)AUTOS AUTOS ( ) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X1 STATUTE EORH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBER EXCLUDED? NIA N/A NIA WCV01306602 01/12/2018 01/12/2019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool.at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601 " Daniel M Crowey,CPCU,Vice President—Residual Market—WCRIBMA @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABIY BUILDING PERMIT APPLICATION Ma t Parcel Q Q . �O M . se�- p Permit# scle _�� ,hit�saon ® - 7 Dda ; Date Issued l© `7 Conservation Division Fee / •/ r Tax Collector 6#310/ (,t� ��/ 00 Treasurer l/a tCf '®BTAIIJASE�VER QO CTION�T FROM THE Planning Dept.�Q2 ©35'a1 f 1O# UItt 0DMONPEIORTO COfVMUCTIOIL Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis $7q Project Street Address Zoe ewer Village � r3rJi9s �Fp_ Owner C� Address 017 Aj 51 Xt a tS Telephone Permit Request +WAL-`itt VM -Tom rw'r- L i1-!J ;31 tt)i7 hA) 24 STrn�6 Square feet: 1st floor: existing ®oo proposed 2nd floor: existing proposed _ Total new Valuation%aa Zoning District Flood Plain Groundwater Overlay Construction Type &Mown Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) d mod, Age of Existing Structure "Wyuft � Historic House: ❑Yes )�No_ On Old King's Highway: ❑Yes o 'Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other_ Basement Finished Area(sq.ft.) - °gBasement Unfinished Area(sq.ft) ~ d II Number of Baths: Full: existing new `FC14 Half: existing _` new Number of Bedrooms: existing new ��� -- rl TT Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: $Gas ❑Oil ❑ Electric ❑Other Central Air: ' Yes ❑ No Fireplac Existing New !J0 Exist' es ❑ No Detache We: ❑existing ❑new size Pool: ❑ ting ❑new size Barn:❑existing ❑new size Attache � age: ❑existing ❑new size Shed: ❑ x tang ❑new size Other: Zoning Board of Appeals Authorization eai �� Recorded❑ Commercial I§SL ❑ No If yes, site plan review# ; i r y 10- 6 Current Use- ems_ RAT' 6d0:n9!r_--?0 Proposed Use � 1 °70-Gh�� 714 BUIL ER INFORMATION Name tt-_L.Mevv �' Telephone Number.- -?`�S—/Scad Adtlress l� l�Ce°t License# _I-91b rf'f C�►•'1t�fUi Ut� W-5- 9 02kP32 Home Improvement Contractor# / Worker's Compensation#' U(&D _?q)l ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO a SIGNATURE DATE FOR OFFICIAL USE ONLY ft PERMIT NO. l t DATE ISSUED MAP/PARCEL NO. n ' ADDRESS VILLAGE OWNER is DATE OF INSPECTION: ..' y ; FOUNDATION ; FRAME INSULATION FIREPLACE ` ELECTRICAL: ROUGH FINAL ,PLUMBING: ROUGH ;FINAL GAS: ROUGH FINAL FINAL BUILDING- DATE CLOSED OUT ASSOCIATION PLAN NO. , i - The Commonweauft o Department of Industrial Accidents -_ — Sure ollooestlAstloos -- -- 600 Washington Street Boston,Mass. 02111 Workers'Com ensation Iayurance Afridavit location GOI�1/GIr4rG�� Ct15LUp aZG_ city 3nSAL ohane# ❑ I am a homeowner ptdorming all work myWL I am a sole etor and have no one worldng.in aw r���%/I >s 'ob. �vorkeis easation for my empia9as v°°ziang o::.. :th :.j...:.::::::::::::. :.;'::}}::;..:.::;.,.;.;:•: ;:..>.:.;. �.; .......... ... .. ......... ..........:w::::::::v:::::::$%?^>:{4;n};.Y:.v:n......"•' .:••.vv..hx•:• vw.w.:.......... ............... .......... .......... ...-........................t...........v:., t.... r::::}i?}•m:m:::n}}W:::::::v}::.i::^:vN.ivm?.'G:i::.?::v}':::.;:::v.. .... ....... ...... ....................... ..v::.v.:..x"&Et..:i^}:::.....:.:Y:::}}}::.i:..::::d:•?v:•}:??Y.:r:::i::�:v:..,..:::.:.;..-... .. .... ..... ... .. .........:w.t...... .n. .::.. ::::i%v is is - :':vt;{:ri}'::}'{:}}?.Y�iiiijj}•:i:•:hj;i:: ................ ..... ..... .............,.........a... v r...-. h}hiix•�'•ICN•.d r':: .:.;-.... ..u::: ........ ......... ............. ..... ........ ... ...... ..:.: ......,... ..ant contractor,or bnmeowner(cbcle one)and have bhrd the contractors listed below who .- ❑ I am a sole Proprietor,general I have ' msation olices: workers {,,?:....:....:...:..:.......: :.::.:.:: the owing .......... <: :>ti?'i?TixiiiiY?iG iiY•:•:i:tii:::ti:':• ......................................:::::.............................. .......::-.::. ::tom{<•::' ....::.:nv:::::::::::::::::::.vim•.:v::::;:::�:::::w.:v::w:::::::::::•::v::i:; .:}?:.. v:::::::.vi•??::?}:ii::-:vi?}:i?}:i}:-::n-..-.n.:yv}}?ii:':4i:�}}:•i}?}??:'?:i??i}}i}}}:9}:?{{v?}::::•::.:::•::w:::-::::::: .t..:�:::......::::tv:i:::i:i:;:,:;i:; ....... .....:::.:v:nw::.v:::::::::::::::::::.?:vi}i?}i?+x-}?}}:i4:-}??}}}i:??i'•iY}i}?'^::4'}..:nv,.::......... ...........:;........::,. - ...............:.. ....... ....... ....-..... ....r....... ......nn .. ...ox•..: .t vA n}. .. .\.-..-.. v.:w:}i?:Y•.v:::.J,w:.::%:................::.�n�::.�::::.::.r.:i>"v'': ........... ........... .............:......:.:vl.............t.-...;.:-..;{;r.:-.:.. .:::: ..... .... +ti•:{•::-n4 ....v;.......0 wn•.v4.+.. .......... ............ .. .....:.. ............. : ..-.:....::.:.v. ....x{LS}-w.;v.,:....}..KK.t?:?.:v::•....•. .+.v:v..,:{:. x:Gp)}. .9!$,CM%,:M...}.{.r.•:?xtittxxv::::.L;y}?x:. .........:w:n........v::..............::•...................}::n... ...nr .... n...........• ..}...n:.:.::::.... .........:......, .............. .................. ....t..:.. .......,....t,...........-...:•.:.......r::::::•::::::w:::::{•}:: •v::;; ..::: +.v.. ......M..v.:w:}:-}?}:'::{av:v:::}v.:r?•??:..:... ::.. ...........::::• .. ...v:'^ixiG!+•:x-v:.ty- .. .vv v.,... .. ...:::...... v;.i}?:...nx...:.n...,...-.,M?x.?}:?•}'+4:v+w'+:hx?}:vi::.r........n.... ........................ �.,. .r.v.v:....;y., :J:?+'•}'i" {?ii}}:;v}'v?^:;):A%•:46+:�4-',M-}{Y•{•}:h: .. ....::...:....:............. ....................t...:.,.,;... ..r. tow .,< YxF.-r...x�f•°<•�"�7'y'° ..:,,.. ............:.r...:....:... ....:}:t....x.<...., v. t....-..,.... .:t ... •bAkts+}+ ...... .}J. .,.F.{. ..::..;.y,:.•:.YtiC:t�i}}.}::..•:. -:o:.}{::;•.}'•}}:�:it�;;.t•..: •:•:..........::n.....:..r.at v:..............:4xvti:..- ..•..,...x,•}:}::...Yt.•....�.G�%rtlfiY- .......^45• v'$�Q. 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'' .n..v.v...:::.1...?}`;:.......: ... ... -..... ...... .... ........ �F............ ....x..:•}i;{.v::nvwv+::.v:p}•:::::::::{:i:::i•;'v......................... w::?!ij,G•::'v}::::•:.:... :............:�::...........:::..........::.:::::...............::...:....-....... ...-:::n•..,,..r...,....,..sw.w.......,h.{.....< ...::•._� .v::..;};.>:.}•::{,.•.,}•:.:{i.?:.:c;::.tr:,o.>.,;.;.;,:.;stt;<:a:: .>}?:?v::i^?::•:n. ..... ...v.:v ......::...,}:;•?}?:-}>:};:??frnxh J.•J".}•.,fit;... 7 ..:..:... - •..............:::.v::::t+tJvv.v: ...:::•:fw:rn..v. , Fannie to secure Coverer as req�ed order Seedon2SA of MGL ISZ eau Ind to the impo of crhnh i pemltia of a lisle a;to Si,'00.00 andlor one ears'imprisor®nt as wen as civil pemltim iu the form of a STOP WORK ORDER and a Itm o[5100.00 a day a;dnst ma I mtderst>md that a copy of this statement may be forwarded to the Office of 1westigWons of the DIA for eovefIV veriIIadm I do hereby certify under the Pdw turd penalties olpajwy dui the mjon advirpro+'t�above is truce and corrcd Date _ Sig<laiurc ' • Phane# print name oincW use only do not write in this area to be completed by city or town official ❑Bnildin4 Dep'�'c" persnitAicense# Bow city'or town: — ❑I,l¢ensittg ❑Selectmen's Office ❑cheeicif immediate response is required ❑Health Depxruneot DOther contact person: phone#; (svam 9195 PIA) 'I Information and. Instructions r s all employers to rovide workers* compensation for their Massachusetts General Laws chapter 152 section 25 requireP employee is defined as every person in the service of another under any contr_ employees. As quoted from the"law", an of hire- express or implied.oral or written. An ernP lover is defined as an individual,partnership, association, corporation or other legal entity, or any two or more c the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the re=ve truste e of an individual,parmership,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, constzucti°n or repair work an such dwelling house or on the grounds building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapt er 152 section 25 also states that every state or local licensing agency shall withhold the issuance or rene e a business or to construct buildings in the commonwealth for any applicant who of a license or permit to operat . not produced acceptable evidence of compliance with the insurance coveiagfre�rerfo�ce°opublic n�work� commonwealth nor any of its political subdivisions shall eater into any contract P resented to the caacun acceptable evidence of compliance with the insurance required of this.chapter have been p oa authority. WEEM, FINE MINIMA Applicants ation and letel checheckingthe box that applies to your situ Please fill in the workers compensation off iayt Y�tiY supplying company names,address and phone numbers along with a certificate of insurance as all be sure a may be Of insurance coverage, Also be sure to sign ant submitted to the Department of Industrial accidents for cow liverag for the permit or license is date the affidavit. The affidavit should be returned to the city or town that the application regarding the`Jaw"or if being Accidents, Should you have nay questions requested,not the Department of Iadustrrai at the number listed below. are required to obtain a workers'compensation policy,please call the Department City or Towns legibly. The Department has provided a space at the bottom of Please be sure that the affidavit is complete and printed egig Y has to ceatad you regarding the apPli� please affidavit for you to fill out in the event the Office of Investigations be retm�tc fill m the ei midlicease number which will be used as a reference number. The affidavits may be sure to P . the Depa rtment by mail or FAX unless other arrangements have been made. The Office of Investigatio ns would like to thank you in advance for you cooperation and should you have any question- please do not hesitate to give us a call- . WERE ��ME 11A The Department's address,telephone and fax member. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of layesduadons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 l . �1hE' ti Town of Barnstable Regulatory Services BAMSTABM ' Thomas F.Geiler,Director HAS& 9�AtF1 MA.SA � Building.Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 April l 20, .. Marty Martini Vinfen Corporation 950 Cambridge Street Cambridge, Ma. 02141 Re: SPR 030-01, Vinfen, 270 Communications Way, Unite 2D & 2E Proposal: Establish residential treatment program for teens Dear Mr. Martini: r ' Please be advised that this application was approved at the Site Plan Review'hearing on April 19, 2001 with the following condition: The applicant shall display the street and unit numbers on the side of the building for emergency access. In the event that the applicant shall acquire a dumpster, compliance with the local regulation is mandatory. Refuse containers shall be located 10' from the property line, perched on an impervious surface and screened from public view. Sincerely, Robin C. Giangregorio SPR Coordinator Q:B 1dg\sitepIan\200l\vinfen r �1ie 7 ,ac%uaella I a BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR NumbeG 016981 ; r _ 03I07t194T rtttei�te� Pq h 07r2002 Tr.no: 18603. Restricted Tos F 1` t DOUGLAS L WILUAMS SR . PO BOX 1069 CENTERVILLE, MA M32 Administrator a; r F BARNSTABLE FIRE_DEPARTMENT �y�Peusy�o:� 3249 Main Street=P.O. Box 94 192? Barnstable, Massachusetts 02630 t. * 508-362-3312 `=C'= FAX:'S08-,362-8444 .. ' WILLIAM A. JO NES III HAROLD M. SIEGEL FIRE CHIEF DEPUTY FIRE CHIEF September 21, 2001 Town of Barnstable Building Department 367 Main St Hyannis MA 02630 Commissioner: I have reviewed the plans for 270 Communications Way Building 2 Units D & E dated 08/08/01 and have approved them for permitting. I"also advised'Doug Williams Custom Building that plans for an upgraded fire detection system and for renovations to the sprinkler system would be needed to be approved and permitted prior to_installation. Respec lly submitted, Harold M. Sie Deputy Chief RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 ° Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= (g ( f.Z2 x.0031= *tr 9, �? plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft.F >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee projcost September 8, 1989 Mr. Warren Davis Executive Director New Bedford Center For Human Services, Inc. 848 Pleasant Street New Bedford, MA Dear Mr. Davis: Please be advised that it is permissable to have an Out-Patient Mental Health and Substance Abuse Clinic at Independence Place, 270 Communication Way, Hyannis, MA. If you should have any further questions, please do not hesitate to call. Sincerely, Joseph Daluz Town of Barnstable Building Inspector Law Offices Of STEPHEN C. JONES, P.C. 973 Iyanough Road, Suite 9 Hyannis, MA 02601 STEPHEN C. JONES Telephone: 508-790-2655 LISA LEO HOULIHAN September 13, 1989 Penafax: 508-790-4391 Joseph Daluz, Building Inspector Town of Barnstable Town Hall Hyannis, Massachusetts 02601 Re: Robert M. Shields, Jr. , Trustee of Independence Place - Rental to outpatient and mental health and substance abuse clinic Dear Joe: Please be advised that I represent Robert M. Shields, Jr. regarding the property in Independence Park. The premises are located in an Industrial District which, in my opinion, allows the use of the premises as a clinic as set forth above. An Industrial District allows for any use permitted in a Business District. A Business District lists a wide vari- ety of uses and further provides that "any other business use of a similar nature" is permitted. Under Section 3-31 B 1(C) , offices are permitted in a Business District. This includes lawyers, accountants and other professional offices, including, as in our case, the office of a psychiatrist. Although "office" is not defined in the by-law, an "Office District" is defined to include professional offices, clinics and therapeutic uses. Since these are in an Office District and offices are permitted in a Business District, obviously clinics are permitted in a Business Dis- trict, and again, therefore, they are permitted in an Indus- trial District. Industrial Zones also permit uses which are allowed in an S & D District. These uses include professional/business offices and personal service uses. Again, our use fits into either of these categories. Therefore, in my opinion, the proposed use . of the above property is in conformity with the perm tted,/ es. Veryr +y ours, '•-St'`Jhen C. Jones S CJ/ne f �a ` •A TOWN OF BARNSTABLE RES.TRTMNT.CTR. CERTIFICATE OF OCCUPANCY--LIMIT 12 BOTH SIDE I PARCEL ID 314 041. OOM GEOBASE ID 41109 ADDRESS 270 COMMUNICATION WAY PHONE BARNSTABLE ZIP - LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT BA PERMIT TYPE BCQOS �F� IPTION RfiI§ICRT C8FRC88UPAg6gATE OF bCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services .TOTABOND FEES: $.00 Ox INE CONSTRUCTION COSTS $.00 �'1 APt 756 CERTIFICATE OF OCCUPANCY 3 � PUBLIC PR;7*.?,F__:`_ } BARN BM • MASS. �► Ep M1`►l�` I BUILDING DIVISS ON BYL--- �� r DATE ISSUED 01/24/2002 EXPIRATION DATE a`— - w r PAktC l 'zID 314 041 00M QEOBASE ID , 41103 ADDRESS _.270 COMMUNICATION WAX a PHONE ` ' BARNSTAB'LE ZIP BLOCK LOT SIZE ' DBA DMLOPMENT DISTRICT BA . PERMIT 56 534; DESK."RIPTIONREMODEL EXISTING SPACE FOR RES-TREATMENT CTR; PERMIT TYPE BREMOD TITLE; RESIDENTIAL ALT/CONY } E.. CONTRACTORS: .WILLIAMS, DOUGLAS L. Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $214.57 BOND $._04 SINE I CONSTRUCTION COSTS �'$61,1.52-00 i I' 439 RESID ADD/ALT/CONV 2 PRIVATE P BARNSTAB%TT *'1 I * MASS. I BUILDING DIVI N BY DATE- ISSUED 10/18/2001.= EXPIRATION DATE - THIS PERMIT.CONVEYS NO RIGHT TO OCCUPY ANY.STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION'RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED - FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF•OCCU- -. - (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE'- ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS 1 ELECTRICAL INSPECTION APPROVALS I �o 3y f i 2 2 2 s L ✓v6/ ✓/�i. ��✓ f C 3 1 HEATING INSPECTION APPROVALS A F G EERING200�DEP SENT .611 Ik 2 H BOARD OF HEALTH OTHER: '/�' SITE PLAN REVIEW APPROVAL '4 I W"/—,A WORK SHALL NOT.P CEED U TIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. 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