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HomeMy WebLinkAbout0270 COMMUNICATION WAY (26) 270 COMMUNICATION WAY � gym;r: -z-,?s' 0.13a.27es M4fiii--/i.ae". &i.e....if/e.g. lif„,) • c. • • • • n 4 n TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 Li Parcel ©6 Parcel !) I ApplicationDl DV Health Division Date Issued .3 ( I �7�') Conservation Division Application Fee 41, (00 Planning Dept. Permit Fee !v© Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address '2�'a Co E41 1446/vt+ C A-{ Wcl 7 (,k.r t ,2 Village ( ' t 11 O2601 P -1`) Owner 141 Mc-c ILr,',AA LL L Address .2 9? f1)0.- NI Oak 1N(I4-0 / Telephone SO - 7 7c- Permit Request - (, to -e o {. .Z door*g oboe sdcc1w cos-e 4vd Oh -e 0f? li- (; 10..1 Lj";r4:;:"';:=P:P:f slr (/_ t- l �� � ItJ�� c f b/4l B.WI;Ve 111/mc. 4cista4T a ti .tq 'GL I rl co strvz ',09 . I Square feet: 1st floor: existing 1600 proposed LOC C) 2nd floor: existing 310 proposed 300 Total new Zoning District I Flood Plain Groundwater Overlay Project Valuation f0 0 oo Construction Type 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: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout lifDther S l4 Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing ,-4 n new -4 Number of Bedrooms: — © '" existing new Total Room Count (not including baths): existing Li new First Floor Room Count) Heat Type and Fuel: Yas ❑ Oil ❑ Electric ❑ Other Central Air: 1114s ❑ No Fireplaces: Existing New Existing wood%coal stove: OYYYs ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size Barn: ❑`existing O new' size_ Attached garage: ❑ existing 0 new size _Shed: ❑ existing 0 new size Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 5tv 00-4 "S011 kt i *1 Telephone Number 50 p- 775--q 3( L Address oc q'7 ,WO�` �`¢�4 License # C S I '2 a. 141 4 n 1,i S WI, Y O l ,O i Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE . DATE / ! G Z, V) f FOR OFFICIAL USE ONLY ' y APPLICATION# DATE ISSUED / MAP/PARCEL NO. • ADDRESS VILLAGE OWNER .DATE OF INSPECTION: ' FOUNDATION FRAME INSULATION • FIREPLACE • ELECTRICAL: ROUGH FINAL • PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. IT,/ • The Commonwealth of Massachusetts Department of Industrial Accidents ti— __,« Office of Investigations • ItABIE ,.,gg,,,�0 600 Washington Street P Boston, MA 02111 1 www.mass.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): v w J I`I(f ,d Address: ac1 .3 ifthhA-ik S fie 0e- 1 City/State/Zip: la-Y k "VI t r.I W1 V O b0 I Phone#: S U? - .771 - g 31. 6 Are ou an employer? Check the appropriate box: Type of project(required): 1. I am a employer with r 4. 0 I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction listed on the attached sheet. 7. remodeling 2.0 I am a sole proprietor or partner ship and have no employees These sub contractors have 8. El Demolition working for me in any capacity. employees and have workers' comp. insurance.$ 9. 0 Building addition [No workers' comp. insurance required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 Must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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 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. Insurance Company Name: A S S v C i 4 4-e tnryp�.e . v h S v N k ' c Policy#or Self-ins. Lic.#: .W E. L OOa 54 i Ur I a0 i i Expiration Date: ) 1 ) 1 I I ), Job Site Address: A 7 D (wh tm tl y1 i e sir:rr4(1 ifiky l (,ivl;f '2 8 City/State/Zip:itl f a4 v]n;'S 141 ill 02 6 6 1 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury tha tom.. : a-on provided above is true and correct. Signature: `� Date: G )__41:),, Phone#: cbg - 775= /3i1 - 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#: Client#:16170 2SIPPEWISSETTCO ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YY1fY)01/19/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:ff the certificate holder is an ADDITIONAL INSURED,the policy(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 lieu of such endorsement(s). PRODUCER NCOA CT Joanne Sullivan Dowling&O'Neil PHONE )_508 775-1620 FARNo),508-778-1218 Insurance Agency E-MAIL(A/C,No, jsuilivan@doins.com 973 lyannough Rd., PO Box 1990 INSURER(S)AFFORDING COVERAGE NAIC a Hyannis, INSURER A: MA 02601 Associated Employers Insurance . m Pto Y INSURED INSURER B: Hard Hat Construction INSURER C: 297 North Street INSURER D: Hyannis,MA 02601 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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 EFF POLICY EXP TYPE OF INSURANCE i W/D POLICY NUMBER (MMND (MM/DD/YYYY) UMW GENERAL LIABILITY EACH OCCURRENCEC $ — COMMERCIAL GENERAL LIABILITY PREMISEES(&ocaurence) $ CLAIMS-MADE I l OCCUR MED EXP(Any one person) $ - PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1POIJCYnJECaT nwc $ Ea AUTOMOBILE LIABILITY (Ea accident) LIMIT $ BODILY INJURY(Per person) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS O OWNED PROPERTY DAMAGE (Per accident) $ HIRED AUTOS AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ — F EXCESS LIAB CLAIMS-MADE AGGREGATE $ • DED RETENTION$ $ A WORKERS COMPENSATION - WCC5000549012011 12/07/2011 12/07/2012 X TORYTt s ER TH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N EL EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A EL DISEASE-EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes.describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $1,000,000 . DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Operations performed by the named insured subject to policy conditions and exclusions. Regarding work being performed at 294 Stevens Street in Hyannis,MA 02601 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable-Bldg Dept. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE I AI /is 4/E d ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #590586/M90585 JRS Massachusetts- Department of Public Saifet i 'Or Board of Buildin2 Re!ntlations and Standards Construction Supervisor License License: CS 18226 STUART A BORNSTEIN _ 297 NORTH STREET CZ HYANNIS, MA 02601 ft ; Expiration: 10/31/2013 5910 44 • ��TME Town of Barnstable Regulatory Services •y7747/ Thomas F. Geiler,Director ED A Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 . . www.town.barnstable.ma.us Office: 508-862-403.8 Fax: 508-790-6230 Property Owner.Must Complete and Sign This Section If Using A Builder I, , v vt-t�C`�N c7 P' , as Owner of the subject property hereby authorize S`-v u'4 1�3d�n S'4 to act on my behalf, in all matters relative to work authorized by this building permit. , 270 (o14114iO4,`[a` ',o r Oa ii. (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. Signature of Owner ' attire of Applicant Print Name Print Name 6 ! 2— Date • Q:FORMS:O WNERPERMISSIONPOOLS . , Rev, . , Awl 0 sir may, P-0) 1, COMMON AREA _ - . . Mill ,,. rit - im- . ..... 1k .. , , _ . . . L. -, 19=c'- 1 t9-3' r' 19'-5 1/7" 1wbili+ i, • a • 0 t4 iii6 Clcc e of - . coy 320 617 u s-# • o da f [[•�] • YII i II T UNIT 2B UNIT 2A i m . UNIT 0.,2C �r 7. III . . .__._ }Mill .4 • = . . . ... :,. ._. _,. .. " � r� _ • , •....,. • o,,,..oke -- : _. _ . . . ... . ... . _. .. ,_ ..--„,,•:._ ,:111.111b_ri.•:,.41•••• 'OP.1M•-..a....,ii.,IM,-,MO:...r...... . i 14 il.41 lotOte fil- 6 s' 811 1 --,x,,,,,,,z.s,_ .....- , . . IFNI J _ E. Rinilitiniiiiniiniiuiui en�nr:_ 7 Q Coln. u s� c nci - C• ���u:c 1 s. seat 1MiALer 1 • -. - .--..-. r . - `• / t ♦ / / ` ♦ _ / / ♦ - / ♦ / ♦ / k' t / ♦ / ♦ / ♦ ' • / ♦ / \ / - ♦ / \ / _ ■ g 21 12 07: 05a Debbie Ratcliffe 5082444236 p. 1 ,■ Sdlitwui Ala Staining Sclw4 270 Communications Way unit 2B Hyannis MA 02601 Phone: 508-000-0000 Fax: 508-000-000 DATE: 8-f I I ;2,_ • Cell. Send to: From: Mindy Rutty =C! Q 3 l� _ ) j 0 9 Attention: Office Location: Office Location: Phone Number:(508)000-0000 Fax Number: Number of Pages, Induding Cover: ❑URGENT 0 REPLY ASAP ❑PLEASE COMMENT 0 PLEASE REVIEW ❑ FOR YOUR INFORMATION COMMENTS: ---Pt CU.S e Cc\, • ,mod All: Information in and attached to this Fax may be proprietary ,confidential ,privileged and otherwise protected from improper or erroneous disclosure.If you are not the intended recipient you are not-authorized to intercept read,print, retain,copy, forward or disseminate this information. If you have erroneously received this information via fax please notify the sender immediately at (508-000-0000)Thank you Aug 21 12 07: 05a Debbie Ratcliffe 5082444236 p. 2 Office of Private Occupational School Education f = Division of Professional Licensure 1000 Washington Street,Suite 710,Boston,Massachusetts 02118 - Telephone-.617-727-5811 WWW.mass.gov/dpl Fax 617-727-9932 BUILDING INSPECTION REPORT Please submit this form to the Building Inspector in your city/town and return to: Office of Private Occupational School Education Division of Professional Licensure 1000 Washington Street, Suite 710 Boston, MA 02118 The Regulations, 603 CMR 3.03(5), for Massachusetts General Laws c.75D and c.93 require buildings to be inspected. We would appreciate it if you would arrange for the inspection of the school listed below and advise us whether all locations serving students meet all standards for the building code. Record of inspection may be documented on this form or one provided by the city/town. Please be sure to include the school's use group code where indicated. Name of School/Facility Address City/State/Zip Inspector Remarks Required information: School Use Group Code as defined by 780 CMR 304 or 305 regulations for building codes: Frequency of inspections necessitated by the Use Group: B F-- MUST BE PROVIDED Is this facility in compliance with applicable building and safety codes/regulations? Yes ❑ No Cl Date of Inspection Next Inspection Date Name of Inspector Signature of p Ins ector Address Phone # Please return the completed form to the school that was inspected. The school will forward the completed form to the Office of Private Occupational School Education. L-Ir Aug. 29 2012 1 : 00'' 10 t , ' w -z PO Box 94 (Ravi/state gi TOVI3249 Main Street Bamstable MA 02630 +` OF RARTAR(r: 1E," fe Phone: (508) 362-3312 Depwitmeht Fax: (508) 362-362-8444 L1,112 Mg 29 R1 : 4 FaA)( To: Paul Roma From: F.M. Pulsifer Fax: 508-790-6230 Pages: 2 Phone: Re: 270 Communication Way, Unit 2B 0 Urgent 0 For Review 0 Please Comment 0 Please Reply 0 Please Recycle Please Find attached the Building Code Compliance Form for 270 Communication Way, Unit 2B for the proposed Nurses Training School. Please call with any questions, Francis M. Pulsifer Deputy Fire Chief 508-362-3312 I Aug 29. 2012 1 : 00'T io. I ' . '. 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 . a 1O Co vl,.)iC./-7-ru,)W '-r L7i'r a1 also known as Mu 1 -1vA-,atiu(, Scxtoo(_, have been reviewed by .>,,L.Stk1Z of the Ai Barnstable ❑ COMM ❑ Cotult U 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 µ{•t 5. Sprinkler Control Equipment 6. Standpipe Systems r/ 7. Standpipe Valve Locations t/ 8. Fire Department Connection 9. Fire Protective Signaling System q , ,S 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 Slgnage 18. Alarm Transmission Method 19. Sequence of Operation Report 20. Acceptance Testing Criteria µi;mot) ik We believe this document to beA completeand compliant for the Issuance of a building permit. Cl 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. 11ee Signature ` ,1%.€ &set- I i i =e ' I lit„Pr\ i c. I i 270 Communication Way Hyannis,MA 02601 • Phone:508-827-7398 r S u t_L i y A N Fax: - a 33 www.sultivantrainingschool.com ASSISTANT TR A I N I N G SCHOOL • Fax To: CrJL.0 Fax O1?— tW 1 C�3 �1cs>s PI a-r. pages Urbane 0 For Review El Please Comment lease Reply 0 Please Recycle c-L0Dr• • plar) wa •,? ito-dszit ror-r-N _ ( ) r•fs)._ \NmL pcAQ— c-)v) )1) 77. rn 1 Lk_pcico-,Qd cicty- N1; sul1;v, c.e.i . sO2- a 3--)- • �.d d6£:60'L6 06