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HomeMy WebLinkAbout0060 PERSEVERANCE DRIVE • 60 PERSERVERANCE DR! _.STATE OFFICES w •�• g . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION OW Map il 5 �' Parcel' eier1/9 `� ' .� , Application# d6e:a/� t LE Health Division 27 � z0115 o'2; f + Conservation Division 3 3 Permit# F Tax Collector ""`--- -- .„____ Date Issued 1' fs1d '—' , .0 Treasurer Application Fee 0 Planning Dept. Permit Fee'f g7. a O Date Definitive Plan Approved by Planning Board el-- 9:14/ 1 5/®Z Historic-OKH Preservation/Hyannis 1 Project Street Address I6D Ii4.I J/o i11 £//97' r� Village �79`- 1 nS� /C Owner 1/ 7 8 ,76) g/T Address /7 �da1>l:/ ,%— Telephone 5D& q./ - !- Permit Request eor- 41 vialao,' ,2' 'he r, &i`g OM--461-E,1_ "04-1_71--"O.4 /al/ Square feet: 1 st floor:existing /13 ODOt proposed /V/!' 2nd floor:existing 4 am proposed ///� Total new ,a�� Zoning District Flood Plain Groundwater Overlay Project Valuation /0/6040 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 ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No , Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site Wan review# Current Use Proposed Use BUILDER INFORMATION Name i2iid' 6,/46/0- '� Telephone Number s---e/a 6/e 9 Address '7P #ifire 66 License# 6)6 z//>"96 -‘1,/4 He Home Improvement Contractor# /CL53 6/ ,W27/0 Worker's Compensation# �y ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO cp loct SIGNATURE DATE J//Z' q 1 0 4., e." • ' k, --.1 • FOR OFFICIAL USE ONLY - 1 •,.. 1 e-,. 1 PERMIT NO. ( . . , • . , , 1 ,-- DATE ISSUED. , MAP/PARCEL NO. . . , . . . . . . , , .."_. 1 ADDRESS. . , • VILLAGE f- . . OWNER .. . • si , ' . 1 1 1 '' i• . . ) . • , . , . . .. DATE OF INSPECTION: • , . . . , FOUNDATION 1 . .. , .. , FRAME INSULATION ' FIREPLACE . •: ELECTRICAL: ROUGH FINAL . . ) PLUMBING: ROUGH FINAL ; • ' . .. . i . GAS: ROUGH . .. FINAL . . .itett......„...7 , FINAL BUILDING I '''''‘)..41t....... 0) ok-. . • ; . .. . .. ... DATE CLOSED OUT - : ASSOCIATION PLAN NQ. . . i . . t , ' :-\ The Commonwealth of Massachusetts I , 1 -• ( ' Department of Industrial Accidents 1 -a, ,c.4 ; , Office of Investigations. e r '�` / c t, r 600 Washington Street .- Boston,MA 02111 '�c ,' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly' • .Name.(Business/Organization/Individual): TYR t . 6.. Ne e• cy.„ Address:- -7 707 n�jr�>IZ 5 7 CityStat Z I-A l�lOf���I ,99 ,02.?yo phone"##:„. 17'/ g 10 - 6/6 9 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with ' 4. 0 I am a general contractor and I 6. ❑New construction employees(full and/or part-time).*' have hired the.sub-contractors 2. I am a sole proprietor or partner- ; listed on the attached sheet. t 7• ❑Remodeling ship and have no'employees These sub-contractors have 8. ❑Demolition working for me in anycapacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp. insurance 5. El We are a corporation and its re uired 0p. ,,-. officers have exercised their 10.❑Electrical repairs or additions 3.❑.lam a home ewner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.-[No workers' comp c. 152, §1(4), and we have no 12.❑ Roof repairs insurance-requ`ired.].t— ''- employees. [No workers' 13.0 Other t• • 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: . Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the 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 unde he pains and penalties of perjury that the information provided;above is true am/correct. LL Si�natur :e -- 444 t 1"--'-"- Date- / 12 7 ` a 6 Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.BuiIding Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector •- 6. Other v_ Contact Person: Phone#: Information and Instructions , Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees, Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold,the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if - necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance, If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each .year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727 4900 ext 406 or 1-$.77-1 rASSAFB Fax.#617-727 7749 . Revised 5-26-05 www.mass.gov/dia Town of Barnstable ' ',k? ,' N Regulatory Services 9B^ ' AB '$ Thomas F. Geiler,Director tb,, o M I Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1, 511K T®✓i1,s `- ✓. ,as Owner of the subject property • hereby authorize sTitvid Nei of, to act on my behalf, in all matters relative to work authorized by this b "cling permit application for: (00 feA.... .IV-Ot (Address of Job) 106 Signature of Owner Date Print Name Q:FORMS:OWNERPERMISSION 1 CAI ',., 3 . • ,;', Aec11s" kNX 0 ?.�{ • tx ;, r g ' 2 it,♦ ..o "Do'g.+tom _ a, a4„�, r ?c 'DOUOLAS SANFaiRU i' - ;{ `�.: k • " . - . t '.;w ,�•, •r t '':. li� d 1� ASSOCIATES INC. . �'f'T I' +3 3Ct azcuvxaL DatvE .[.. ��" • x ,c'}f.�r v '4 ^ rL tsaeli+i-raoojj;. 'µ�� � �• v L Ili f V,� - • I ' t'- �Tl Y (5 l „,„'S"' ,plt - I i.. rk `F kt<. 5 F .� .. <T p, ,,tom _ x$."-ut1,4. i., I i 4'•4't 5 ? 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It is not adequate for legal Map:295 Parcel:008 boundary determination or regulatory interpretation. Enlargements beyond a scale of Selected Parcel Owner:PERSEVERANCE,LLC Total Assessed Value:$2441500 1"=100'may not meet established map accuracy standards. The parcel lines on this map 'k7� are onlygraphic representations of Assessor's taxparcels. Theyare not true roe Co-Owner:CIO SWITCH-GEARS CORP Acreage:2.07 acres Abutters r 9 P P property rtY boundaries and do not represent accurate relationships to physical features on the map Location:60 PERSEVERANCE WAY Buffer such as building locations. ° ,.".. r ,,,, ..---- ---71k .,,,: MICHELE C. TUDOR, P.E. Consulting Structural Engineer 123 Cottonwood Lane•Centerville,Massachusetts 02632-1979•(508)771-7601 •Fax(508)771-7163 '4 mctudor@comcast.net DATE: August 29,2006 K.Nicastro LICSW FCP INC. 60 Perseverance way Hyannis,MA 02601 RE: Proposed Residence 195 North Falmouth Hwy.,Falmouth,MA -- PROFESSIONAL.SERVICES RENDERED 08/11/06 Site mtg.w/Client representative,re: obtain as-built information; 1.50 08/22/06 Engineering analysis and calculations; 1.00 08/29/06 Stamped engineering sketches,SK-1,2; 1.25 TOTAL DUE=$600 Thank you in advance. i /2006-142 • ) • 1 t ' fill i, V t • ..,P�HOF.MgSS v _ f, ? 7c MICHELE 7cA,v , t TUDOR O No.34774 cn, 4�.q STRUCTURAL A �� 9GISTEP �, :l' atiIONA\-t, e i 7-frAi4 t9t/Z7 @7 ' % (-=) / - „,./ \/ ll U r --fit,701 _. -3 n _X_3 o_ ±1 cNl -ft 1\l / 6)171,1 y s , ' ValN \Iwiwb-exX/ 'IR,2 ''' } (2) L -3'1? x 3 1)2- 114- --.STS y LL 1--1 0- , litlz__11,1b C“'-eA,_JAP-APD i] h 1 ---f it r- I �. r . 7 - �1 �� k -30,,r I V�R_,F,f / , F i,* CI �, uALF (4-4_`k ' PROPOSED MODIFICATIONS fo'r 'N .\ ,, MICHELE C. TUDOR, P.E. NEW WINDOW OPENINGS �`, • . Consulting Structural Engineer 123 Cottonwood Lane, Centerville, Massachusetts 02632 •FAMILY CONTINUITY PROGRAMS Drawn By: MCT r`: Date: 08/22/06 - - Drawing 60 PERSEVERENCE WAY Scale: i AS 1NOTED Rev. 0 HYANNIS, MA 02601 SK- Lor2 File Name: Nicostro Project No.: 2006-142 • Demolition Notes: I. Provide sufficient temporary bracing and shoring to permit the safe installation and dbrripletion of all work 1 without damage to property, the existing building,and without jeopardizing the safety of any person(s), 2. Demolition to include the cutting out of existing masonry walls and concrete floors,.as required to install new work and/or reinforcing; and the patching of these places after installation of the new;work•.where required. Concrete 1. Minimum compressive stength at 28 days, Pc= 3000 psi. 2. Reinforcing steel bars: ASTM A615, grade 60. • Structural Steel 1. All workmanship to conform to the requirements of the American Institute of Steel Constructors, Manual of ', Steel Conntruction, latest issue. tt 2. Structural steel: ASTM A'f quare tubular pipe sections: cold formed ASTM A500B, Fy=46 ksi; shop paint with rust inhibitive paint. I .,,•' . - _ E 3. Welds: E70xx electrodes. _, 4. Connection bolts: ASTM A325. -. 5. Anchor bolts: ASTM A307. CONTRACTOR NOTE, Prior to the commencement of.all work or fabrication of components,Contractor shall investigate and verify in the field all conditions, dimensions anddelevations of the existing construction, and reportanydiscrepenciesr Structural Engineer.. The use of(+%-)y\...,% (V.I.F.),and(E)indicate the assumed existing conditions, to the �w. 5HOF q� ayiq MICHELE 10 e C. ti s h�� TUUOR cn 41 c-0.34774 �. TRUCTURAL �' • o414 � ,9F ,�i eC �/s r EON"ANAL Atra,,... „,.. , ,,,,,--, 0 5/2-47/°6 PROPOSED MODIFICATIONS fo'r MICHELE C. TUDOR, P.E. . NEW WINDOW OPENINGS Consulting Structural Engineer 123 Cottonwood Lone, Centerville, Massachusetts 02632 FAMILY CONTINUITY PROGRAMS Drawn By: MCT ,Date: 08/29/06 Drawing • 60 PERSEVERENCE WAY Scale:A AS NOTED Rev. 0 HYANNIS, MA 02601 S u_ 2 File Name: Nicastro Project No.: 2006-142 11 r '. Fite -e , or,//aaoac`i,�lae�a Board of Building Re._,lations and Standards 1r - HOME IMMPP:ROVE NT CONTRACTOR • / Ili= ,i-z" Registca:finn 53361 e �.�,a� f =bra i© 1 2,1/2008 Tr# 253407 ;, ${q y y,I, DAVID S McCAR a -� - HOMES . DAVID MCCARTH, 704 MAIN APT 30 .>,4,- `' • FALMOUTH,M' 12540 Administrator I; . i_- _.: - -: E?TAe eommonivectiti ar,flamacfuaet7d st BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR :U!%E.6O9\798 ,I; g-itre •,0 ,t 010 Tr.no: 94798 Res _! ? D.VID S MCCAR" ="_, i 70, AIN ST APT�3 ---5� „ �' 1 FAL ► TH, MA 0254 Commissioner .sue"`..- r _ �4.�- k'� *'' - . F _ . u t. ,." ... - ..,...,.' 5 ' -. al 7 -. ����� ate"` s E 1. c' • • • , ,,..,. ,,4 !" II ,,,... 1 il I r yr • 7#'fix'):i -' - ''.' _ : , '..,..,,‘,,,'-‘-- ,,.,'-' ...'' ''''IltrAt7'..t-7N i , --4 ' _ r �. k .. 60 Perserverance Way, Barn . 7/20/06 i . • 60 Perserverance Way, Barn . 7/20/06 �m ego' t. 4 - .1 ik4•`R f W+ a .7sfliiir. ,Fes` • K` Al ` 7. 4. • F / 1 oillimpirv, _ 7. • ,I 6,41 _ F �` s 1 ' :tea ►,..� 1 ?far ,• 'rr r ;. * - • .r - -A - . a•• ••'ii� 11 •- • - h r -Farys° - • _ iirillilli4111"1111P.-,' N, -4, 60 Perserverance Way, Barn . 7/20/06 i • • • • • • ;k __ ' _ "..\\71800.40.0.0 ' �•� t' r — i _ _ III I , M , p lli*. 11 1Oi It1NZi 1 I i _i (its ' All . \ • • \r. - A r* '4 Ot 60 Perserverance Way, Barn . 7/20/06 1 ! 1 1 A 111 60 Perserverance Way, Barn . 7/20/06 • PROJECT NAME: GU 0"tS ADDRESS: (400 -Pe✓5 PJIIeccy,c.�. PERMIT# I (4 027Ck PERMIT DATE: Sj 1 a ) M/P: LARGE ROLLED PLANS ARE BO 1 SLOT Data entered in MAPS am ro p � on: °f BY: 1 ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION O -'Application #1D :CJ /�J{/1�� �• Parcel.' �i t. Map 7 Health Division ' 'Date Issued 1 k-C "b�-,�G_ Conservation Division ;;Application Fee I O(1 i c Planning,Dept; -Permit Fee 7 7; 45 Date Definitive:Plan Approved by Planning Board Fe_ Historic - OKH Preservation/Hyannis , Project Street Address to: PeA 3 r c 6c.. t Ay I • Village ,% L( Owner tYllrvt.i Cam T ,Eo ') 5/i C CI Address 02/7 ' A/oA-` 5 ,4 1694901s Mi. Telephone c- P 7 7 ( lam )cPprregueSt 2 C- . K.-4Ac/CA/► S (Jv�l. ,v4e,,,,,,, - L. .,:.:gx-fro rt,.4-/,-e t„,.,,„ ,(,_,,.._ ‘ r �n Square feet: 1st floor: existing proposed :2nd floor: existing proposed Total°i-w r�I Zoning District, Flood Plain Groundwater Overlay . isi ._ roject Valuation fJ 0 Construction Type o �, Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supportin docunlentattoon. Dwelling Type: Single Family LI Two Family ❑ Multi-Family (# units) N Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) '-': Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing 0 new size_Pool: ❑existing ❑ new size _ Barn: ❑existing ❑ new size--i Attached garage: ❑ existing 0 new size _Shed: ❑ existing ❑ new size _ Other: 4-.) Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ nCommercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ~` ,Name CALM 5. /n e(,i��/ Telephone Number 7 / V ?/ (;/ ‘ Address le t-/ NI/v7 zi / AP 7L J°3 License# G 6. 0 9Y 7 f r 7 41,n ®v A /Mfr e CYO Home Improvement Contractor# /15 �,.�6/ Worker's Compensation # '7O F 41193 c SW ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ' DATE /0/4516 r , K FOR OFFICIAL USE ONLY e , APPLICATION# r - , DATE ISSUED - ' i '` MAP/PARCEL NO. , ADDRESS ' VILLAGE I . OWNER , DATE OF INSPECTION: i t ' FOUNDATION . ' FRAME 7 . ' t -INSULATION FIREPLACE 4 • ELECTRICAL: ROUGH FINAL 1 PLUMBING: ROUGH ` FINAL . • GAS: ROUGH - FINAL ram. FINAL BUILDING . ° DATE CLOSED OUT , i ASSOCIATION PLAN NO. 4 : 4 r ,� a The Commonwealth of Massachusetts 1 Department of Industrial Accidents ;Vill' +M � • Office of Investigations • 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): i,P1(// 0 c.s In Ce.'2 ,/ • • Address: '�4 4-7 f/7/f/n / . // City/State/Zip: �ig//r'l t7t/A In do 62ryy9 Phone.#: 7 7 7 0/40 416 9 • Are you an employer? Check the appropriate box: Type of project(required): 1.H I am a employer with 4. ❑ I am a general contractor and I 'riployees(full and/orpart-tim.e). * have hired the sub-contractors 6. ❑New construction Z. I am a'sole proprietor or partner listed on the attached sheet 7. ❑ Remodeling ship and have no employees These sub contractors have 8.. [j rnolition . workingfor me in anycapacity. employees and have workers' P tY 9. ❑ Building addition [No workers'comp. insurance comp. insurance.$ 10 ❑ Electrical repairs or additions required.] 5. ❑ We are a corporation and its P 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 T insurance required.] t C. 152, §1(4), and we have no 2.T ' ‘ employees. [No workers' 13.[G].�ther, ,9c iw (f1 d;} !t�'C!� comp.insurance required.] ..L' 4'7 1-- 1 rAl *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy info 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 emp oyees. Below is the policy and job site • information. Insurance Company Name: 6 1 iPAci/ / /i/el ve ��3 • Policy#or Self ins. Lie. #: 0 gc lJ Expiration Date: //�3 ®? • Job Site Address-�j�j'�'i $C U `mod/ nC`t „Au— v G— City/State/Zip: II y-.i M/l / S ' .0266 f 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 tip 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 1 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 certit rider the pains anndd�penalties of per'ury that the information provided above is true an correct. Signature: ��� . ,/��(e� (7664.3 ,- Date: /®/i Oer Phone#: 7 7 L/ 1S O ai' ? Official use only. Do riot write in this area, lb be completed by city or town official City or Town: • Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: • Phone#: • Information and Instructions truction Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. ' Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." • An employer is defined as "an individual,partnership, association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,,association or other legal entity, employing employees. However the owner of a dwelling house having not mare than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any • applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states `Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." • Applicants • Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s)name(s), address(es) and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. . The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts - Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4400 ext 406 or 1-877-MASSAFE Fax.# 617-727-7749 • . Revised 11-22-06 www.mass.gov/dia (4, 0 /{c Gcy /\ r"1 7/1-eA glitcXe// / /7-1 7 "�1�%�cc • FAMILY l�t�I h1 • CONTINUITY OUR VA1.u:IsS: hAwuLY I C()r;INtu•NI'I'Y I ADV(ic.:Ai:1' LI;AUtiltsI 11,1 C IIn.NG• supporting ramify euccuue In nvnry cam'r tuthy. Stuart Bornstein, President EARL N. STUCK Switch Gear Limited Partnership. Executive Director 297 North Street Hyannis, MA 20601 • Offering effective oorrununily-Gasvd Dear Mr. Bornstein, hurnan.Jrvicr,s to individuals As a tenant at 60 Perseverance Way in Hyannis, we are applying for a permit and familiaN in from the Town of Barnstable Regulatory Services to make some modifications Mtassacnusatts. to the space that we occupy. Due to program growth, we would like fo reconstruct our office space to accommodate additional staff. This construction would entail building the remaining cubicle walls up to the ceiling to create • From offices in: closed in offices, inserting a doorway from one room to another to access additional space, dropping more computer cables into areas not yet occupied, I3`'i'r''(1' and installing an entrance into one of our current program spaces for added security. As usual, we have contracted with Bayside Electric and Cape Cod I!pc„rail Alarm company for adjunct work with Blue Water Contractors. f Jr�r>>�,rr. The Town of Barnstable Regulatory Services Office is requiring that we obtain a letter of permission from the property owner. As the property owner, your signature below acknowledges that you are aware of the work being done and Pomiii/f' authorizes permission for us to do this work. Lrhiiitspd/1- Attached is the quote that outlines the work to be done. If you have any questions,please feel free to contact me at 508-273-3086. Thank you for your immediate attention to this matter. Respectfully, Kevin Nicastro Regional Director Family Continuity Stuart Bornstein,President Date FAMILY CONTINUITY ADMINISTNATION (j(1 PD.ttsl',Vlilt•ANCT, WAY, `IIYANNI , MA (12601151)N 62-02741wWw,rA9fll.1'c;(iN'I'INVI'I'Y.utt(; I'(:I;Inc • • Z0/Z0 39dd 06SOZ98805 Eb:60 800Z/E0/OT /fl • • ai °"zy�ayltf °��iaxu lruaetfa BOARD OF BUILDING REGULATIONS , ' ° i--ii4 s License: CONSTRUCTION SUPERVISOR K. irx` Numbe Cr S\ 094798 I i s � ' Birthdat 04/07/-1960 I 8> , Expires: 04/07/2©10 Tr.no: 94798 ' Restricted" 00 k DAVID S MCCARTH -., 704 MAIN ST APT 30 !f� ! I I r FALMOUTH, MA 02540 r C t Commissioner1 — y ti • f(' • piping systens Inc. 32 Mill Street(Rt.79) P.O.Box 409 Assonet,MA 02702 TEL:50B/644-2221 3 Fax:Sos/644-2447 E-tnn�u pSi@piping-systems-inc.com weeseE:www.plping-systems-Ine,com January 7,2009 • Ms.Eileen BuBois Family Continuity Programs,Inc. .. . . 60 Perseverance Way,2niftloor HYANNIS,MA 02601 Re: Letter of completion Dear Eileen: On 1/2/09,the relocation of a sprinkler head was completed to accommodate office renovations, located at 60 Perseverance Way,2nd Floor,Hyannis,MA Yours truly, PIPING SYSTEMS,INC. • Greg Brewer, Service Manager C_. .. Cii a' Q =' ao .. CO r cn ri • Piping is our Passion Serving you is our Promise • ' d 1668 ' 0N d8 en 318V1SNdV WVOI : ll 600Z ' 9Z ' uer mot ' . Town of Barnstable ` 'j�' _ �� Building Department - 200 Main Street * I3ARNSTABLE, * Hyannis, MA 02601 9� . 'h.�A (508) 862-4038 Ar�O Certificate of Occupancy Application Number: 20062007 CO Number: 20060160 Parcel ID: 295008 CO Issue Date: 12107/06 Location: 60 PERSEVERANCE WAY Zoning Classification: INDUSTRIAL DISTRICT Proposed Use: INDICOMM Village: BARNSTABLE Gen Contractor: ROBERTS, MICHAEL Permit Type: CCOO CERTIFICATE OF OCCUPANCY COMM Comments: Ja / 2—er Building Department Signature Oat Signed 1 0,-,--i.r..ti TOWN OF BARNSTABLE Building�, .. Application Ref: 20062007 -� •,. * BARNSTABLE, * Issue Date: 07/27/06 Permit 9 ...76A39. A �ArFG �a��� Applicant: ROBERTS,/27/06MICHAEL Permit Number: B 20060772 Proposed Use: IND/COMM Expiration Date: 01/24/07 Location 60 PERSEVERANCE WAY Zoning District IND Permit Type: COMMERCIAL ADDITION ALTERATION Map Parcel 295008 Permit Fee$ 810.00 Contractor ROBERTS,MICHAEL Village BARNSTABLE App Fee$ 135.00 License Num 053861 Est Construction Cost$ 50,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND TENENT FIT-OUT-3 NEW STATE OFFICES THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: PERSEVERANCE, LLC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 297 NORTH ST INSPECTION HAS BEEN MADE. HYANNIS, MA 02601 P(Lkil eXliiAeji___-- Application Entered by: NL Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT.TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY. ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLY GRADES AS.WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. • 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). Y ` ‘P®ST 111IS ARC'SOS TT fi :AIMS VISIBLE R 0 ' 'THE °� :� t BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 /' 1 g Q'it5 1 pa*G>a(6 1 o6c of l64/"C _fa ?L o,r d7 v o6 1 13 i /41 "G( 4 .tom 47444igi sza,.).z &....),,,..„ 2 2 2 ,9 r o (of 7(j0704 'a4-rie.a-f-- ,(6.1 7(736 a6 0 3 r 1 Heating Inspection Approvals Engineering Dept t 1 I O (o Co G Y :2.- La _e . 5 7;1.5 ,5 GK Fire Dept Lai 2 1 1—3.=:)"0 b "TT-,A L G iikS Board of Health tk,A ) /71 • • • 41. • • • • • rr• .11 s _ -,• :, - `FEDERAL ; . SQUARE IN DOWNTOWN ft WORCESTER • 40 SOUTHBRIDGE STREET SUITE 2 5 0 WORCESTE-R _ i, , MASSACHUSETTS 0 1 6 0 8 PHONE: (508)799-4977 FAX: (508) 753-7377 \nt' \c\ 10/16/08 TO: Jen FROM: James Soffan RE: Copy of a set of plans for State Offices at 60 Perseverance rd—Hyannis Enclosed is the $5.20 fee for a copy of the plans and a copy of the occupancy permit for the State Offices at 60 Perseverance Rd. hJ �s O ' i 1 -- fV cn° � O Please mail to: James Soffan ry ,o Suite 250 r- 40 Southbridge St LL m • Worcester,MA ti` Town of WrcetBp0Main BARNSTABLE. Hyannis, MA 02601 9�69��' (508) 862-4038 FpMA� Certificate of Occupancy Application Number: 20064816 CO Number: 20070010 Parcel ID: 295008 CO Issue Date: 01124/07 Location: 60 PERSEVERANCE WAY Zoning Classification: INDUSTRIAL DISTRICT Proposed Use: IND/COMM Village: BARNSTABLE Gen Contractor: DAVID S. MCCARTHY BLUE WATER HOMES Permit Type: CCOO CERTIFICATE OF OCCUPANCY COMM Comments: 10 BEDROOMS UPSTAIRS - BEACON POINT L2c /01,1i o'er Building Dep ent Signature Date Signed t a. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel a C63 Permit# (Z1 14€ Health Divisionf1b/'57)2iY) Date I ed q"2_143s- Conservation Division Fee Tax Collector n 5 1 goite , — Treasurer 4 Planning Dept. ��� Checked in By O Date Definitive Plan Approved by Planning Board V Approved By Historic-OKH Preservation/Hyannis Project Street Address AGO f 2f-S-e,r V 2Ce.rsit.Q. I) Village / Fao!V 7 /e- Owner 1 h C>'�43.r $ Address 917 ,t,hi 5 Telephone S°5-7 7.S-- A 9/.6 J 1//O/vAiJ 0 2.4.8 I Permit Request /3 v,/,D m/4 i C, 0 (:), ' jr.6px 3 2" /00/1 t 0 l a/7 024 -5-' wf✓/ .Cf/v A.45t46—n Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new ** Valuation 19 0047 4" — Zoning District CiOr t 6 C CAI Flood Plain Groundwater Overlay Construction Type -�j/cr'i o-{ fc. ,- ,o�/'S ���'�"�"� �' ��a�� Lot Size :7?i 07 Grandfathered: ❑Yes 0 No If yes, attach supporting documentation. 1 Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) I j ,1 Age of Existing Structure Historic House: ❑Yes 0 No On Old King's Highway: O_Yes ❑I,o Basement Type: ❑Full ❑Crawl 0 Walkout ❑Other I (-No 4-- Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) ' `/ - Number of Baths: Full: existing new Half: existing new r,., • c.a Number of Bedrooms: existing new - ;' Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: Gas 0 Oil ❑Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: 0 Yes ❑ No Detached garage:0 existing ❑new size Pool: O existing 0 new size Barn:❑existing O new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ - Commercial- 0 Yes- 0 No - If-yes, site plan review# Current Use AC Proposed Use "-- liLe GD t v.,1Lp° e.1S 3,L4 44e$ BUILDER INFORMATION Name ae.sre\C_ 19.•YAa Telephone Number SO SO? S2. 1 0 Address • / S 7 Ali tth # �/ /9✓e-- License# Oc? 54 6 1 I. Mfa5" 4— ..i.2 .4 e, ‘L/9 Home Improvement Contractor# // ' /ri/ - . I- J Worker's Compensation# ALL CONSTRUCTION DEBRIS SU ING FROM THIS PROJECT WILL BE TAKEN TO /' ' & / ?y 2 SIGNATURE DATE A FOR OFFICIAL USE ONLY !PERMIT NO. • 1 3• i' • DATE ISSUED MAP/PARCEL NO. yi ADDRESS VILLAGE I OWNER DATE OF INSPECTION: ����,a''�J ( FOUNDATION ' FRAME ' dr INSINSEN3Fu ION FIREPLACE ELECTRICAL: ROUGH FINAL • PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING • DATE CLOSED OUT • • ASSOCIATION PLAN NO. - . 1 .OF1HE rqy, Town of Barnstable •%/ , Regulatory Services BARNSfABLE, „ �,, Thomas F. Geiler, Director i639• �� 1°TFor� Building Division Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 MEMORANDUM TO: File FROM: L. Barry DATE: 12/8/05 RE: Beacon Point Joe Medeiros of Beacon Point called. They will be moving from 270 Communication Way to the second floor of 60 Perseverance Way, Barnstable (87146). They will have 9 residential beds (temporary shelter, psych. Evaluation, 3-7 days) and a day program for 8 students. When the building permit is finalized, Ralph Jones should make a capacity inspection. Mr. Medeiros will then send in the Certificate of Inspection fee.