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0767 INDEPENDENCE DRIVE (5)
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''''''''::::-" 'if: ''.•'''''' 1-:,:'.:';'•.:: '-'1',v..,::,.."::',:,'1,:r5::,:,:;,i;,'!,', • , . . .. . . , „ ., , Lev �.� 4L - Di/ri • Town of M..,A!•�. . f kkI Barnstable aPwlarn'"r,''s�nnz� s t'a, be, ta�in ed# '%a-. n;�.J o b,..a,L-`C'd pp h cs x oha!r•da Ms uste ea bnern..Kaept Builds n.P ;x }• Y xW � r „.:: PostThisCardSoTh�att, sp be om tt Seet App o » � ;�* ,>„wh A t 4 ! - t.:eF:z=,...x v.�.,�i"x.. .:grS,.:x...r.,.at,..<...•:.mfi�..? ic..<:. ue,>r.;,r.>„. ..i.,.<n.y<>z::.e:b�a`i,�,»�.a<. As...-:,:r`.:. .iT>.; .t.,.,, n 5 s ; P.ersrwes� t d �� �3.�ar5�a4M t i " t oilivn V � �� z i � � �" rmi16. dksu chBdingshal tbeOccupied nt hs 44.r'.&,.: Permit No. B-16-80 Applicant Name: Map/Lot: 332-010-001 • Date Issued: 06/03/2016 Current Use: Zoning District: IND Permit Type: New Construction-Commercial - Expiration Date: 12/03/2016 Contractor Name: FRANCIS M BRACHANOW JR • Location: 767INDEPENDENCE DRIVE,BARNSTABLE .. Est Project Cost: $2,669,000.00 Contractor License: 028360 Owner on Record: VILLAGE GREEN I LLC Permit Fee $24,512.90 Address: 767 INDEPENDENCE DRIVE Fee Paid $24512:90 HYANNIS, MA 02601 Date. ' 6/3/2016 • Description: NEW CONSTRUCTION OF A 3 STORY,30 UNIT MULTI FAMILY BUILDING C • .7rti� Project Review Req : Building Official • • This permit shall be deemed abandoned and invalid unless the work authonzed by tFiis permit is commenced witbm slz months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall'l e m compliance`'with the4local zoning by laws,and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open fd?public inspection for the entire duration of the work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures'•by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work ' 1.Foundation or Footing 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue fining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy • • Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. "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 All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ;: a Town of Barnstable a Building Department. -200 Main Street omgt. ; Hyannis, MA 02601 Tel. (508) 862-4038 Certificate Of Occupancy Permit Number: B-16-80 CO Issue Date: 3/22/2017 Parcel ID: 332-010-001 Zoning Classification: IND Location: 767 INDEPENDENCE DRIVE, Proposed Use: BARNSTABLE Gen Contractor: FRANCIS M BRACHANOW JR Permit Type: Commercial - Multi Family 3 or more Units X-/} C- Comments: al-LA y 3 �z1/./ 2 Building Official Date: • "--te,AI.A. Document G704TM — 2000 Certificate of Substantial Completion PROJECT: PROJECT NUMBER:09035-15061/ OWNER:❑ (Name and address) CONTRACT FOR:General Construction Village Green II,LLC CONTRACT DATE:January 24,2014 ARCHITECT:.❑ 767 Independence Drive CONTRACTOR:❑ Barnstable,Massachusetts 02630 TO OWNER: TO CONTRACTOR: FIELD:❑ (Name and address) (Name and address) OTHER:0 Village Green II,LLC Dakota Partners,Inc. 1264 Main Street 1264 Main Street Waltham,MA 02451 Waltham,MA 02451 PROJECT OR PORTION OF THE PROJECT DESIGNATED FOR PARTIAL OCCUPANCY OR USE SHALL INCLUDE: Building C,and the immediate adjacent site and parking The Work performed under this Contract has been reviewed and found,to the Architect's best knowledge,information and belief, to be substantially complete.Substantial Completion is the stage in the progress of the Work when the Work or designated portion is sufficiently complete in accordance with the Contract Documents so that the Owner can occupy or utilize the Work for its intended use.The date of Substantial Completion of the Project or portion designated above is the date of issuance established by this Certificate,which is also the date of commencement of applicable warranties required by the Contract Documents,except as stated below: Warranty Date of Commencement All 3/31/2017 LaFreniere Architects,Inc. hr 2/22/2017 ARCHITECT BY DATE OF ISSUANCE A list of items to be completed or corrected is attached hereto.The failure to include any items on such list does not alter the responsibility of the Contractor to complete all Work in accordance with the Contract Documents.Unless otherwise agreed to in writing,the date of commencement of warranties for items on the attached list will be the date of issuance of the final Certificate of Payment or the date of final payment. Cost estimate of Work that is incomplete or defective:$49,000.00 The Contractor will complete or correct the Work on the list of items attached hereto within Thirty five(35)days from the above date of Substantial Completion.Dakota Partners,Inc. , � � �.3 \ I ^." CONTRACTOR BY DATE The Owner accepts the Work or designated portion as substantially complete and will assume full possession at 12 noon(time)on 3/31/2017(date). Village Green 11,LLC OWNER BY DATE The responsibilities of the Owner and Contractor for security,maintenance,heat,utilities,damage to the Work and insurance shall be as follows: (Note:Owner's and Contractor's legal and insurance counsel should determine and review insurance requirements and coverage) AIA Document G704T1°-2000.Copyright @ 1963,1978,1992 and 2000 by The American Institute of Architects.All rights reserved:WARNING:This AlAe Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlAe Document,or any portion of it,may result In severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 17:42:03 on 02/22/2017 under Order No.2026103781_1 which expires on 06/27/2017,and is not for resale. User Notes: (1299853945) TOWN OF BARNSTABLE 71117 FER, 23 PM 14: 02 -.5,-........„,.........„ OIVISION - . 1 . . .• , .. : . , . . . • . , .- . _ . ta 13 1 (—�art . e __ _ - . -Commanwealfh. of:Massachnsefts ". . . • , . —016-001 Sheet Metal Permit - Map Parcel j i Date: I I-� I— 110 - Permit--# b 1(O'3c S ( . . Estimated Job Cost:3 i tt i. 0 c.9 Permit:Fee:$ ge - Pirms submitted... irEs No. PIAns Reviewed: YES NO-1-if—-- • Business License# C> Z 3 - 10 OF BA Appfi L,ce# a !C o: - -- ' Business Information . . Property Owner/Jtib,Location Womsation: Name: Z e o !t e- o)l)eel- ivl e+o- I Name" lit, 113 e 64�e-n P 4 S , - ' ` C' v4,4 iJ r ire ce Or(,�,� N� lT Street .Li'lc � tl u ' ``� I. 1 ->Yr? b'I. ! City/To svn: IZ oc, t nc1 t Cityfrown: 3, 5 Telephone: 7 1, '2 1 1 5 07 Telephone: . Photo ED.required/Copy.of Photo.�.D. attached: YES ( . NO ,�,6 . . f . - Sidi ini al : • E/M-1-unre • • . 11in 3-stories or less and commercial to 10;000 s, .ft./2-stories or less .�-2�142-2 re�4n:cted�to dwe � rip q O Residential: 1-2 firmly Multi-f ity V/ Condo/Townhouses. Othei.' • •Commercial: Office . -Retail Industrial Educational 0 • Fire Dept Approval .. . ' Institutional_ Other - Square Footage:•under 10,000.•sq.ft. over 10,000 sq.ft. , Number of Stories: -3 Sheet metal workto be completed.: • New Work: lZ Renovation: HVAC / Metal'Watershed Roofing. . Kitchen Exhaust System Metal Chimney/Venn -Aif Bal.ancing Provide detailed description of work to be done: ' • • • ,=leV:a -*k. V8111-i • i , • i INSURANCE COVERAGE: ,A n, J • `' I have a current Iiablittv.insurance policy or its-equivalent which meets the requirements of PLG.L Ch.112 Yes . 'No ❑ if you have checked Igs,:indicate the type-of coverage.by checking the appropriate box.below: . A liability, insurance policy L ' . Other type of indemnity 0 Bond 0 • • OWNER'S INSURANCE WAIVER:1 am Aware•that the licensee does.rrof have the insurance coverage required by Chapter 112 of the Massachusetfs General Laws,and that mysignature on•this•permit applii atiorrwalves•this requirement: . , •. ' ' - ' ., • Check One Oniy . • '. • • • Owner- ❑ Agent ❑ • . Signature of Owner or•Owner's Agent • • • I . . +I . . By checking thisbnx0,I hereby certify that all of the details and Infomration1 have submitted(or entered)regarding this application are true Mid ; •} accurate to the best of my knowledge and'thaf ail sheet rrista.]work and insteps{ions•performed under the permit issued•forthis.application will' be ' In compliance with all pertinent provtsibni•of the Massachusetts'Building Code and Chapter 112 of the General Laws, • • ' Duct Inspection required priorto-insulation Installation:YES • . NO • . . :�rogleess.Insnectiens . Date - Comments • • . • . . • • • ring Inspection _ - • • ' Date - Comments - •- T • ype of-License: -p Master • • . • • roe • • ❑Master-Restricted (� • . • 1ty/Town ❑Joumeypeisof•. ' • Signature of licensee 'etmtt# •DJoumeyperson-Restricted License.Nurriber:, =ee$ . . ' - Qheckkat www,rriass,gr vldpl . ns! r Signature of PermitApI C . a a 4 ', � ` ` "� k um- am q eiv ?Et .Mai i. "='-�, _.l- 8'�1 1 +... "'+` .9 y lea �®and— i• APP(ELR t t 9�z l' ,, il.k - `' rf °F— 02188 f 3 L 4'=t • ,4:em' !S. ,.iiiiio-or.--,- - 'IC ENSU A t"' '7 SNE � S/®�qS � ffQuP 3rW/jgG"s .1 wTRIeT 'SSA r y otg , sn4ras :.o'..... ; •5 3o s131—: -I33 Ax,j}3,11133AD-s TrougazaKE X t [ H C'._'a.-C • auo wpm)L or uussai :luau.o I • • i,.r t ,a twlat to 3jp fq P1trw3 v4 4*yarn anjj 111 a y m'C ff : F?I-CO . 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FP Igo,,,�'Mg i_dt203 a :&smoo om.9 4 E s' �L"'t1 ❑ 11 .sT abs.gA p8 s 1kra. ] i8 4S 3GQ30� a0 ?IcalLI❑ s aaetl -qos I, saairo/cicaa as a veil gar riFis . .go Joppdosd alas z tam' ❑•- ±taYasuag❑ " P AT cm PSI *( 1P�Tt33}sooSo/clozo t s m Raw 0 -9 -33°1 �• T PEa I I❑ sd0jdzFa Ez7) P2Je qdnTTn -�Su Luann da 0 ..'" E "'ME era 1 .-)°,71 : s/km • • -c�_I t!Un , f5 1,-+0owkAdP') Q01 3 • s xar i Maas . . q 4.21• �r' y alary ,sal lma s-777-LO{ • ida9 • r33Y�i v 3 , • 1 1 Information and instructions Massachusetts aerneral Laws chapter 152 regnires all employers to provide workers'compensation for their employees. Ptasuantto this statrrte, an employee is riefmrYi as"__every person in the service of another under any contract of hire, express or impTirT, oral or-mitten." An employer is defined as"an individna],partnership,association,corporation or other le gal eatitY,or any two or more of the foregoing engaged in.a joint enterprise,and including the legal retuebentaiives of a deceased employer;or the receiver or trustee of an individual,partnership.,association or other legal entity,employing employees_ However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the . dwelling house of another who employs persons to do maintrnanr.,construction or repair work on such dwelling house or on the groimric or building appurtenant therein shall not because of such employment be deemed to be an.employer." MGL chapter 152, §25C(6)also states that'every state or Iocal licensing agency shall withhold the issuance or renewal of a licence or permit to operate a business or to construct buildings in the commonwealth for any . applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance• requirements of this chapter have been presented to the contracting authority." Applicants. • Please fill out the workers' compensation affidavit completely,by cb.eckbag the boxes that apply to your site-Pt-ion and,if ner'p eSmy,suPPlY sub-cen or(s)name(s),addresses)and phone number(s)along with their ce cate(s)of insurance. Limited Liability Companies(LLC)or Limited TiabiityPartnerships(LLP) wifllno employees other than the' members or partners,are not required to carry workers' compensation insurance_ If an LLC or LLP does have • employees, apolicy is required. Be advised that this affidavit maybe submitted to the De a�-�eut of pIndustrial Accidents for confirmation of insurance Coverage. Also be sure to sign and date the a$davit The affidavit should be renamed to the city or town that the application for the permit or license is being requested,not the Department of Tndustrial Accidents_ Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below Self insured companies should enter their self-insurance . City or Town OfffriaTS • • Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office ofInvestigafions has to cant-Art youregarding the applicant • Please be sure to fill in the permit/license number which will be-used as a reference number. In addition,an applicant that must submit multiple peamit/lirrnse applications in.any given year;need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in. (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof.tt,at.a valid affidavit is on file for futrnepermits or licenses. A new affidavit must be filed of t each ' ' '• year.Where a home owner or citizen is obtaining a lire or permit not.relat 1 to any business or commercial venture (i.e.a dog license or permit to bona leaves etc.)said person is NOT required to complete this affidavit • • The Office.of Investigations would Ere to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a calL', The Department's aiidress,telephone and fax number_ • 'Fhh Corastaraveattli of Massach Departmemt oaf lndhxs a A o cderts - Q• . ceo fkves u • • 600 Washingi-an are:el $ostar4 MA.G2111 . Revised 4-24-07 Fax#617-727-7749 1'e goy/dia . • 0 Town of Barnstable 'a'-'wi+,i,r ° Regulatory Services Richard V.Scali,Director , - 1-• 6,1' 2.1t "Egrawl:41121h I Building Division • Paul Roma,Building Commissioner • • 200 Main Street,HyanQis,MA 02601 ' www.towa.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 • Property Owner Must _:_. Co :Iete and'S� is This Section • If Using A Builder • „as Owner of the subject property hereby authorize Zg:51,--- E S t4 E€[ ;& tkL t.']�jL. to act on my bPh21f in all matters relative to work authorized by this building petasit application fon • o e1Da NJ.`AR\V ! GiVki , IAA . (Address of Job) r • * pool fences and alarms are the responsibility of the applicant Pools • are not to b- afaor utilized before fence is installed and all final I;ecti rrns are per.•, . ...ed an. accepted. • ,^ ----- SignatZue of o .,.d Signature of Applicant • 1 ! £(2o lh9/ot Print Name Print Nance I I i i 1:1(4,: _ _ Date Q:FORMs:OWNERPERMISSIONPoop - Mass. Corporations, external master page Page 1 of 2 Wiliam Francis Galvin sbz Secretary of the Commonwealth of Massachusetts ' v Corporations Division Business Entity Summary ID Number: 042837048 Request certificate I New search Summary for: ZEOLIE SHEET METAL, INC. The exact name of the Domestic Profit Corporation: ZEOLIE SHEET METAL, INC. Entity type: Domestic Profit Corporation Identification Number: 042837048 Old ID Number: 000211628 Date of Organization in Massachusetts: 09-05-1984 Last date certain: Current Fiscal Month/Day: 09/30 Previous Fiscal Month/Day: 12/31 The location of the Principal Office: Address: 200 ROOSEVELT RD. City or town, State, Zip code, WEYMOUTH, MA 02188 USA Country: The name and address of the Registered Agent: Name: WILFRED ZEOLIE Address: 200 ROOSEVELT RD. City or town, State, Zip code, WEYMOUTH, MA 02188 USA Country: The Officers and Directors of the Corporation: Title Individual Name Address PRESIDENT WILFRED V. ZEOLIE 200 ROOSEVELT RD., WEYMOUTH, MA 02188 USA TREASURER WILFRED V. ZEOLIE 200 ROOSEVELT RD., WEYMOUTH, MA 02188 USA SECRETARY DOUGLAS HAGAR 100 APPLE TREE LN., WEYMOUTH, MA USA Business entity stock is publicly traded: ❑ The total number of shares and the par value, if any, of each class of stock which this business entity is authorized to issue: Class of Stock Par value per share Total Authorized http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?F❑N=042837048&... 11/3/2016 rom:TWINBROOK INSURANCE 7818486100 11/03/2016 14:36 #980 P.001/001 DATE(NMIDOYYYY) ICGRo CERTIFICATE OF LIABILITY INSURANCE 11/3/16 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: It 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 Carol McHugh Twinbrook Insurance Brokerage PHONE FAX (781) 848-6100 IAIC_No.EMI: (781) 843-7000 (A/C,No): 400A Franklin Street E-MAIL Braintree, MA 02184 ADDRESS: cmcHugh@twinbrook.cam INSURER(S)AFFORDIPG COVERAGE . NAIC1t INSURER A:Travelers Insurance INSURED INSURER B: Zeolie Sheet Metal, Inc. INSURERC: 200 Roosevelt Road INSURER 0: Weymouth, MA 02188-361 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - _ — - - --- TRSR --------'--------'-----'-'--'-'----___.._at36ZSGeR_.....__............................_..._...._......._.._...-i50—iLCP-E�---tiouCV.Ek6_"___..._.._.._....... LTR TYPE OF INSURANCE INSR WVD POUCY NUMBER (MMIDDrYYYY) (MM/DD/YYYY) LIMITS A GENERAL LIABILITY y 680397D10861442 2/23/16 2/26/17 EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES DAMAGE fEa occurrence) S 300 000 PREMISES(Ea ocarrrencel � CLAIMS-MADE X OCCUR MED EXP(Any one person) S 5,000 PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 7 POLICY ri E Q n LOC S A AUTOMOBILE LIABIUTY y BA8A95513214SEL 2/23/16 2/23/17 (CEaONEacadert)INEDSINGLELIMIT s 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per cident) S AUTOS x accident)AUTOS NON- WNED PROPERTY DAMAGE S X HIRED AUTOS X AUTOS (Per accident) A X I UMBRELLA LIAB X OCCUR CUP0E9825031542 ( 2/23/16 2/23/17 EACH OCCURRENCE S 2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED RETENTIONS 5,000 S A WORKERS COMPENSATION IEUE-7C85887-2-16 2/23/16 2/23/17 X TORYH? TS W- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y 1 N EL.EACH ACODENT $ 500,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION CF OPERATIONS below - EL.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES {Attach ACORD 101,Additional Remarks Schedule.if more space Is required) • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE TI-E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Joseph P Rizzo/LD • ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Phone: Fax: (508) 790-6230 E-Mail: if ; Town of Barnstable RECEIPT, ` w 200 Main Street, Hyannis MA 02601 508-862-4038 ��a . Application for Building Permit Application No: TB-16-80 Date Recieved: 1/25/2016 Job Location: 767 INDEPENDENCE DRIVE,BARNSTABLE Permit For: New Construction-Commercial Contractor's Name: FRANCIS M BRACHANOW JR State Lic. No: 028360 Address: North Reading MA 01864, North Reading, Applicant Phone: (781) 899-4002 MA 01864 (Home)Owner's Name: VILLAGE GREEN I LLC Phone: (Home)Owner's Address: 767 INDEPENDENCE DRIVE, HYANNIS,MA 02601 Work Description: NEW CONSTRUCTION OF A 3 STORY,30 UNIT MULTI FAMILY BUILDING C Total Value Of Work To Be Performed: $2,669,000.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have" • been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: 1/25/2016" (781)899-4002 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $2,669,000.00 Date Paid i Amount Paid Check#or CC# Pay Type Total Permit Fee: $24,512.90 1/25/2016 $150.00 1049 Check Total Permit Fee Paid: $225.00 2/23/2016 $75.00 I 1048 Check • V4TI3IS�I T A PETIT T TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ``)1O� ' 6_10 -�� U Q�3 Application # Health Division Date Issued ? :ht1c Pic Conservation Divisions Application Fe lS3 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 7j i 7 // ! 1( [ 7,,/p 2 'i /e " /5/� , C Village 9//V ,�-4 Owner ,//G y.c gt„em - LLe_ Address `c)/ / ,1 Qt 677 `J1M -7 Telephone 7Y/- $ 99- ‘/O(1,2- /txfa,A4s7 Permit Request /V et.) Ll&747 )/ jp ' 7 3 V ey 3e) 0/'l/� /224.1/ '-/2Cr729i7V �6///c/i%JJ c` �c ///a3 Square feet: 1 st floor: existingr /���.3 "Apo �� �"�3 q 0 p oposed' 2nd floor: existing b proposed Total nem.4 Zoning District %/I/" Flood Plain /line Groundwater Overlay ,1/Pi Project Valuations 19 '#y tZ onstruction Type (4.)100//jy206/e/h/- Lot Size /7/ /2? c5 L' Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) L0 Age of Existing Structure /()%9 Historic House: ❑Yes *'No On Old King's Highway: ❑Yes C ICIo Basement Type: ❑ Full Jo Crawl ❑Walkout ! (Other �Jlrii ./ v2-2",7 t Basement Finished Area (sq.ft.) 6/go ts, Basement Unfinished Area (sq.ft) C) Number of Baths: Full: existing Q new L53 Half: existing a new D Number of Bedrooms: 0 existing new Total Room Count (not including baths): existing 0 new K5- First Floor Room Count 07 Heat Type and Fuel:yGas ❑ Oil ❑ Electric ❑ Other Central Air CA'es ❑ No Fireplaces: Existing () New U Existing wood/coal stove: ❑Yes;yiNo Oirvi9 7 /lc 672/t/ Detache garage: ❑ existing ❑ new -Size_Pool: ❑ existing ❑ new size 0 Barn: ❑ existing ❑ new sized Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size U Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ,'Yes ❑ No If yes, site plan review # ( np ,ems /7 6700.3—))9O Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) 71--r4/C�,s /27• / 1C 617 6/keii3,_/ ,e Name E. ii1 7 Telephone Number 7)7(- X 5 0o Address S%c�/�-e-C-i License # 61.9 —403 m e/0 /I/b. (466%/4 j M L)/ Y(9XL Home Improvement Contractor# /V/T Email cGr.nlr d LcJ 0 Cl /Z'(}�Ccpir�e4brker s compensation #CJCO2A,VDG5'MWO ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO i SIGNATURE DATE / // /15 FOR OFFICIAL USE ONLY 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. £3i5, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map L 133o? Parcel UFO--Oe 9 Application # ciog /&T Health Division Date Issued 5— r -R Conservation Division ASV` Application Fee 0,,wm Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address 767 .2. 7 / 9d.f4c /TLi �/ , /3 Village oorfSV"Gd( cJ Owner V i)1oq.( Cyzein 77 Z 4., , Address /alb - 4)4 37- 1C,1-7926/n"7,9 Telephone 71 -,,g)1 �l 9l- VW t 0,3? 5 Permit Request ✓tip£ ) CD/ /,1(-i? nCJ a S z i c3U di /cm i j O/)iJdi ©Iry //,ra,..3 M/a7,3 //►► �,,. Square feet: 1 st floor: existing © ro osed 2nd floor: CJ 2.3 q oo existingro 0 g p p p p sed/ Total nevg-3260, Zoning District // i/3 Flood Plain /1//)f7C. Groundwater Overlay Project Valuation (Ab' 9 It,L) Construction Type 4./D(,//jl2,je/e/A,-- Lot Size / 7 /25 (;c' Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) c ) Age of Existing Structure /04 Historic House: ❑Yes ,e"No On Old King's Highway: ❑Yes , No Basement Type: ❑ Full ❑ Crawl 0 Walkout ❑ Other Basement Finished Area (sq.ft.) ��0 0 Basement Unfinished Area (sq.ft) 6 Number of Baths: Full: existing Q new Half: existing ,O new Number of Bedrooms: U existingiew Total Room Count (not including baths): existing 0 new tS75- First Floor Room Count 42 Heat Type and Fuel: %Gas ❑ Oil ❑ Electric ❑ Other Central air: Yes ❑ No Fireplaces: Existing 0 New 0Existing wood/coal stove: ❑Yes , No ('4/nn26 .4i t4 Cl/7/j/ Detached garage: U existing ❑ new size_Pool: ❑ existing ❑ new size Q Barn: ❑ existing ❑ new size 6 Attached garage: 0 existing ❑ new size ?Shed: ❑ existing ❑ new size 0 Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ) (Yes ❑ No If yes, site plan review #6i 7/p liy),- 02 " 3-S f f Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) �s rr) • 6y66h67 Jle, Name Telephone Number VIA Y1�1�-. h�l1DoZ Address (_ License # .S —�� X 3(000 /5(i // 29 /)2 /7(,S/ Home Improvement Contractor# A1/4 Email - b2WP/G/1 O.61Gl07 72e /2e/Worker's Compensation #42aZadd``- » Z) ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE /�LL� /� DATE /_ __ FOR OFFICIAL USE ONLY , 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. - Roma, Paul From: Patterson, Amber Sent: Friday,June 03, 2016 11:19 AM To: Roma, Paul Subject: RE:Village Green Permits Confirmed. Thank you, Paul. From: Roma, Paul Sent: Friday, June 03, 2016 11:18 AM To: Patterson, Amber Subject: RE: Village Green Permits Hi Amber, This is to confirm that Charlie just told me to issue the permits without taxes having been paid.The permits have been paid for and issued;the checks for the taxes were to be brought to your office to be held in escrow. Thanks, Paul From: Patterson, Amber Sent: Friday, June 03, 2016 10:33 AM To: Roma, Paul Subject: Village Green Permits Hi Paul, Slight change of plans from our earlier conversation. When Peter Freeman or anyone comes in for the Village Green Building Permits please call and check with me to make sure the Tax Collectors Office has received the check for the owed taxes. Thank you for all of your assistance on this matter. Best, Amber Amber E. Patterson Legal Assistant Town of Barnstable 367 Main Street Hyannis,MA 02601 508-862-4620(telephone) 508-8624724 (fax) 1 F,. Roma, Paul From: Patterson, Amber Sent: Friday,June 03, 2016 8:47 AM ' To: Roma, Paul;Jenkins, Elizabeth; Buntich,JoAnne; Callahan,JoAnna; McLaughlin, Charles Cc: Weil, Ruth Subject: Village Green Permits Good morning, Please note that no building permits shall be issued for the Village Green until all taxes are paid in full and permit fees are paid. Thank you, Amber Amber E. Patterson • Legal Assistant Town of Barnstable 367 Main Street Hyannis,MA 02601 508-862-4620 (telephone) 508-8624724 (fax) The information contained in this electronic transmission ("e-mail"),including any attachment(the "Information"),may be confidential or otherwise exempt from disclosure. It is for the addressee only. If you have received this e-mail by mistake, please notify the sender and delete it from your system. Please do not copy or forward it. 1 • Shea, Sally From: Shea, Sally Sent: Tuesday, February 23, 2016 10:44 AM To: 'Ekuczarski@dakotapartners.net Cc: Perry, Tom; Barrows, Debi; Franey, Patrick Subject: Money owed for Village Green Hi Eric, I have sent you the break down for buildings B and C in that breakdown it was indicated that there would be common areas being assessed and that was paid for with the extra $75 that you will see for each building.So the total paid per building was$225 each building. The balance is not identical per building because the project values were slightly different. Please also send the$1500 total for all of the c.o.'s for each unit(at$25 each). BUILDING B COST OF PERMIT 24,518.36 .BUILDING B PAID$225.00 BUILDING B OWED$24,293.36 BUILDING C COST OF PERMIT$24,512.90 PAID$225 BUILDING C OWED 24,287.90 C.O.'s for 60 units at$25.00 each is$1,500 Balance Due$50,081.26 Thank you. Sally Shea Division Assistant Building Department 508-862-4031 1 r k Commonwealth of Massachusetts • i► Manufactured Buildings Program-Plan Identification Number Assignment • Name of Manufacturer R.C.M. MODULAR INC• MC Identification Number 448 Third Party Identification Number 02 Project Title d U16-09-C Use Group R2 BBRS\DPS Identification Number 0 184- 16 } Review by Program All plans are reviewed by MA and should be Director Required stamped as below when approved Date: 05/24/ 16 Manufactured Buildings Program From: Linda Shea Manufactured Buildings Program Re: Confirmation of Receipt of Building Plans &Assignment of BBRS\DPS Identification Number (BBRS\DPS I.D. Number) ' The Board of Building Regulations and Standards and Department of Public Safety (BBRS\DPS) has received your building plans for the referenced project and has assigned the identification number noted above (in the block marked BBRS\DPS I.D. Number). This number has been assigned for purposes of internal tracking methods. This number shall be used in reference to this project and on all future correspondences, inquiries and plan revisions. ACCEPTED MASSACHUSETTSMANUFACTURED BUILDINGS PROGRAM STATE BOARD OF ILDINOS RE TIONS STANDARDS OMMNAN DA BAS 0 THIRD RTY CE !CATION ONLY Thank you for your cooperation with this matter. 13.IECT TO FURT ER REVIEW. Send all correspondences,inquiries and plan revisions to: BBRS/Dept.of Public Safety Linda Shea 50 Maple Street,Suite One Milford,MA 01757-3698 Bbrs\forms2\manufacturedbldgplanid-April 28,2015 DAKOTA PARTNERS To Whom It May Concern: Dakota Partners will provide all contractor workman's comp certificates before commencement of work at Village Green II, 767 Independence Drive, Barnstable, MA. Jim Christie, Project Mgr. Date 1264 Main Street,Waltham,MA 02451 Phone: 781-899-4002 Fax: 781-899-4009 • ?lie Commonwealth ofiMussacaltusetts lepararteut of Industrial Accidents Office of Investigations 600 Washington Street S Boston,MA 02111 , ' www.massgovIdia Workers' Compeniatian Insurance Affidavit~Builders/ContractnrsJElectrkians/Plumbers Applicant Information Please Print Legibly Name(BasmesstDrg—' anizitionffndividnal} / trr..74 Address:.-F$ /1 /io//-7 ,- City>r tattl �Nh7rl A` 42 ys7 Phone# 7y/- y —e/ -e)a- Are you an employer?Checkthe appropriate box:— t Type of project(required): I.❑ I am a employer with .barn a g Feral contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El New cans / on 2.❑ I am a sole proprietor or partner listed on the attached sheet. 7. ❑Remodeling These sub-contractors have ship and have no employees These ❑Demolition employees and have workers' wading for rat in any capacity. 9. ❑Building addition. [No workers' comp.insurance comp.insurance# required.] • 5. ❑ We area 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'camp- right of exemption per MGL 12_❑Reofrepairs insurance required.]o c.152,§1(4),and we have no . employees.[No workers' 13_0 Other comp.insurance required.] `Any applicant that checksbos tl mast also filloutthe section below showing theiworkers'compensationpalrcyinformation_ Homeowners who submit this affidavit iiiczthcating they undoing weak and then hhe outside contractors must submit a new affidavitindirs*i =such. `-rCaffiactors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not Those entities haVe f emfiler ees.If the sub-cantuactnrs have employees,they must provide their workers'vamp.policy aunaher_ I am an employer that is providing workers'conTensniion insurance for my employees. Below is the policy and job site information. Insurance Company Name; Policy or Self-ins.Lic. EEpirati ••Date: Job Site Address: Ci /State/ fY gip= 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 penatti s of a fine up to$1,560_OQ andlar on-6 yearimprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a file of up to$25O.1)O a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ida hereby cerli ' the pairs i penalties ofper,jury that the information prodded above Lc bare and correct Si _ l(r Phone A: ; / 9c/'— Official use only. Do not write in this area,to be crrmpletesd by city or town official City or Town: Permit/License i Issuing Authority(circle one): L Board of Health 2.Bukling Department 3.City/Town Clerk 4-Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person Phone#: r — — -- -- — — — 6 • iformation and Instructions Massachusetts General Laws chapter 152 requires all eerployers to provide workers'compensation for their employees. Pursuant-to this statute,an employee is defined as.".every Person in the service of another under any contract of hire, express or implied,oral or written." An errpIoy r is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and incTnriing the legal tau. sentatives of a rl ee-s set employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dweTTing 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,construct on or repair work on such dwelling house or on the groan ris or brnlrirng appurtenant thereto shall not because of such employment be deemed to be an.employer." MGL r hat ter 152,§25C(6)also states that"every state or local licensing agency shaTT withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coYexage required_" Additions Tly,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter in t e any contract for the performance ofpublic work unt i acceptable evidence of compliance with the insurance.. regnirern.erats of th;c chapter have been presPntril to the contracting anihozity_" Applicants Please El ant the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sob-contractors)name(s), address(es)and phone nnmber(s) along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited T.;abilityPartnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or T.T.P does have employees,apolicy is required. Be advisedthatthis affidavitmaybe svbmi'fed to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affida YiL The affidavit should be returned to the city or town that the application for the permit or limn ce is being requested,not the Department of lndestrial Accidents. Should you have any questions 1 GM/ding the law or if you are rerun ed to obtain a workers' compensation policy,please call the Department at the mamba listed below. Self-insured companies should enter their self-in Nara,ce lirrnce number on the appropriate Ime. City or Town OffiriaTs Please be sui c that the affidavit is complete and printed legibly. The Department has provided a space at the bottom • of the affidavit for you in fill out in the event the Office of Investigation has to contact you regarding the applicant P lras e be sure to fill in the peunitllicrnse number which will be used as a refcz cuce number. In addition,a .applicant that must submit multiple pennit/lir n e applications in any given year,need only submit one affidavit inriirating coseut policy information(if necessary)and under"Job Site Ad 1Lress"the applicant should.write"all locations in (may or town)."A copy of theaffidavit th st has been ru officially stat,ed or marked by the city or town may be provided to the • applicant as proofthat a valid affidavit is on file for!Uwe permits or licPnmes A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves eta.)said person is NOT required to complete this affidavit, • The Office of Investigations would Tile-t o threnle you in advance for your cooperation and should you have any questions, plPs ce do not he -it-All'to give us a call. The Department's address,telephone and fax mmmber: • - • Ih of Maa-chrtt,T . •- . , - fie�a�manSt • Degartrn ut G}fIsd za1 Amide l:a Gfaca of hve gation • 60.0 Washintan Streezt Bastar.4M&&2111 Ta.4 617 t. t-4 xt 406 or 1-&n mA GAFF . Fax# 617-727 7749 Revised 4-24-07 Initial Construction Control Document To be submitted with the building permit application by a v�l Registered Design Professional IE for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107.6.2 Project Title: Village Green Apartments Phase 2 Building C Date: 12/14/2015 Property Address: Independence Drive,Barnstable,MA Project: Check(x)one or both as applicable: X New construction Existing Construction Project description:New Aparment Building I, Robert A.Johnson,MA Registration Number: 38492 Expiration date: June 2016, am a registered design professional, and hereby certify that I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': Entire Project Architectural X Structural Mechanical Fire Protection , Electrical Other: for the above named project and that such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a `Final Construction Control Document'. '‘N:OF MA ssq Enter in the space to the right a"wet"or electronic signature and seal: ERe�,�� go ✓� ..4 isw- Phone number: 508-892-4884 Email: rob@jsengineers.com AFrSsppla �'\� Lo Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other' is chosen, provide a description. Trial Version 10 09 2012 f 1 Initial Construction Control Document N At L To be submitted with the building permit application by a AO Registered Design Professional ‘A 1 1 1 g9 for work per the 8th edition of the i Massachusetts State Building Code, 780 CMR, Section 107 Project Title:Village Green Apartments Phase 2 Building C Date: 14 December,2015 Property Address: 767 Independence Dr,Barnstable,MA 02601 Project: Check(x)one or both as applicable: X New construction Existing Construction Project description: 30-Unit three-story wood framed apartment building I John LaFreniere MA Registration Number: 7242 Expiration date:Aug 31,2016 , am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerningt: ( X) Architectural ( ) Structural ( ) Mechanical ( )Fire Protection ( )Electrical ( ) Other: Describe for the above named project and that to the best of my knowledge, information,and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the buil �n official a `Final Construction Control Document'. ,,�Obi" Anc,, V , JOHN vo Enter in the sp. e to the right a"wet" r ; Qt H. electronic si ar,, u e and s FRENIERE No.7242 o i�.� CAMBRIDGE , :: %: Phone number: (617)661-4222 Email: JL4 rycintects.net Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen, provide a description.