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0210 AIRPORT WAY
t o A.I R.P 62T YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates.[cost$40.00 for 4 years]. A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. k. r DATE: 3 - ZC Ib Fill in please: APPLICANT'S YOUR NAME/S: BUSINESS / YOUR HOME ADDRESS: ( W �ti� t �� 1,00 /2r) L•, ,,,, ���, �ti�,� C Sc "h i; Mf Y,✓J ` ''�XA Ltd _�c�' ,00 -X' TELEPHONE # Home Telephone Number `-- 3 6 2- `-y C C-S NAME OF CORPORATION: NAME OF NEW BUSINESS K-C w- TYPE OF BUSINESS L p„ IS THIS A HOME OCCUPATION?______YES NO ADDRESS OF BUSINESS 2(7- Y x i MAP/PARCEL NUMBEq515'O (d �0 L) [Assessing] When starting a new business there are several tlhi ngs you must o in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: i I �- 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature COMMENTS: I' j TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1 Parcel .� Application # 9g00 Health Division Date Issued Conservation Division � . Application Fee CD Planning Dept. ® © Permit Fee I - Date Definitive Plan Approved by Planning Board 4.1 a z Historic - OKH _ Preservation/ Hyan s'� Project Street Address 2/0 r41APo1e_T Village i�t°(�4,❑/�t S �=ec>_�o;p Wit'-��Rb—�P�A.�4._:.._.�p:�� e Owner SCIPPtSl AAQY>A7f_-k i"_S Address _DRAW!fA•. U) /1YWk)11_ -(A ©'z& I Telephone 5_0 fiel- 3(0, 1�! '7 21 Permit Request f,f t9®0�-_ I O 7�&-/QR WA A L. — A`t )-t S r r f, r 2 SLeP/4,-I)A i ABC 00 t7iCOAD ®F X)610 i' irAkt L l WA&L 7'D Square feet: 1 st floor: existing Sieo proposed b 2nd floor: existing 7 50 proposed —Total new Zoning District Flood Plain Groundwater Overlay Project Valuation (/000 Construction Type 5Tf - wern 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 JONo 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 plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 6)A e !U 21?e W g J ✓4 Telephone Number ��$- `�� -2 3 Address 324, /e-t0c )13 i-,J/n b�<a k License # (°:5 V 3 � I l iX r E. I-lA - Home Improvement Contractor# YS 3 Email_ 7_9f-i012te'/'_Zt-lz._31 �C oA.)2; Worker's Compensation # Atie- Yeo -7,bis,963-dotC. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO L7t.cMi° SIGNATURE 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. 41,_c TOWN OF BARNSTABLE BUILDINGRERMIT APPLICATION :tom-: . ;Ire Map. �� `� Parcel t I { I" ° . Application # Health Division v . '` ` "" , l'y Date Issued Conservation Division 'iy� - Application Fee T Planning Dept: Permit Fee J 1�710 U Date Definitive Plan Approved by Planning Board • �� f, Historic - OKH _ Preservation / Hyannis Project Street Address 210 41k PC>R! WA-1 9A, 1 'Village FAQ Of S :Owner SURD/ 15Ar- ,t1aNi�V�f 'i lLuS i Address. RAW-P u) mL1A0J)11 WA 01601 Telephone S©f�- 3 CoZ- - t Permit Request tQf1�100le-007�k!0!�./, ,451C -- ATjT�+ �'ry�L j-b2 S4r�l•�/?; 'i - l 1L7t�4- SS�7+l�� c `•' s'!rr JCSr2 NaN (-A R r.4,� CXMC..C. 'T'C ' y e ►�& ,' np z xry �A0�,r2�-®Pxyr & 19 S ' x, gquare feet: 1st floor:-existing.3`urx� proposed 2nd floor::,4isfing 750 proposed Total new Q Zoning District Flood Plain �: b Groundwater Overlay µ - Project Valuation V`000 � Construction Type S-rk k •'sue a `; t ,. ,Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. "S Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes „ No On Old King's Highway: ❑Yes ❑ No r 'Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other F Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new / A ` �'-s Half: existing new E+ 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:0 existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# ,. - Current Use Proposed Use fin, APPLICANT INFORMATION '- Al t r (BUILDER OR`HOMEOWNER) Name ?1 � Telephone Number C� - '�U U Address 21, 40 6)r t)3 J License # C-5 " 0 3 S )--1`,4X 14P�r /�-9�1 • d C° 7.' Home Improvement Contractor# r ©k/e cjS i Email is p A-)1v 7- Worker's Compensation # Atie--yad ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE. N 4 ' DATE /0 ' y•1 70. lr • VVV 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. F 27m Coznwompeaht a,f M ssadTrusetts Department ct,f rrstrid Acciderm-, Qfte of imesfigadom. y 600 Was)Vwgton jfreet Boston,MA 02HI rtvPmmas&go?1dia Workers' CotnpensatkinInsurance Affidavit BmldersdContract trs/ElecfricianslPhunbers Applicant IufarmatFan Please Flint Le�'blY Name Address: '9 D Kf�7'7/��S�.�� f,P A'r-T -Z CitylStil 1 W, W 2&'73 Phone-4: Are you an employer?Checkthe appropriate box; Type of project(required): I. I am a employes with I ?-' 4. ❑I am a general contractor and I . employees(full andfor part-time)-** have fired the mla-contractors 6. ❑Ides oozss fiian 2.El, I am a sole proprietor orpartner- listed oathe attached sheet. 7. 2(Remodeligg ship and have no employees , These sob-confractors have g- ❑Demolition woding for me in anycapacity- employees and have wod:ers' INoWodners,comp-insurance comp-Msura t # g- ❑Buildiag addition regnired 1 5. ❑ We area corporation and its 16-❑Electrical repairs or additions 3-❑ I am.a homeou mer doing all work officers have exercised their 1L❑Plumbing repairs or adchtions myself[No work 'Wig- right of exemption per MGL L_❑Roafrepairs insurance required-]t c-152,§1(4�andwe have no employees,[No woAers' 13-0 other comp_insaramm mqaired-) *Any appficzotfat cMdmbos ff1 umst also fiIlout the section he7owshucQug tfieirwodcers'ca®p�+m++M*pa&epinformaaon Hnmeooraels who submit This affldavu i F dwy am doing zU wa k sad than.hira outside contmctosamst submit a new affidselt indieatir�sorb rconwmt rsffui aecf this box sgust attached m additional sheet shavdngtheaame•of the sous-ca MtrM0bxa and state whether or notthnsa-en6teshaV employees.Xthesnb-caai m hx a empIoSeP_%tfieymnstpmvide their workeW tamp,policy 4�sry I am are erripr Heat is prerui'ding n�rrkcrs'caarperesrdz�rt ursriratrce f yr icy entpf �ees $eloav is Elie patiry a jala sits irr�ar-rnrrlinn, Insurance Company Name: A1W7V f L Policy or-Self--ice Luc. _AW& 7W T k(o 3-20/6 A FxpiaationDate: /-I- 20 7 Job Site Address: i2&2.T Ge'Ay C¢pl5taterg: fR[,�1J�S. It-/i4 Attach a copy of the workers'compensationpolicy dec:Iaration page(showing the policy number and expiration date). Failure to secure coverage as required.undet Section 25A of MGL c- 152 can lead to the imposition of criminal penalties of a Sine up to$UOD 00 andfor one-yearimprisanmcent„as soap as civil penalties.in the farm of a STOP WORK ORDEKand a time of up to$250-00 a clay against the violator. Be aciiased that a copy of this statement maybe fkwarded to the Office of Invest ga#ioms of the DJ.for insurance coverage verifica#ion. T Aa hwi- 6y cattrjy muter tha pains and per:atffzs a f gedW7&dthe inforwa6w;proviiW abm g is bare acid correct Phone P S© L/00--7 3 Qjlkid am only. Do rtat mite in dds area,to be ce mpieted by chF artotr-n oajoic&L City or Taws: PerndtT&ense: Issuing Authnr€ty(drde one): L Board of Health 1 BuffTmg Deparlmeat 3.CRy/Pown Clerk 4.Electrical hispector S.Phrmbing Inspector + b.Uther C'onimct Person: Phone,#- Taformation, and Instructions ; Y,,a,s_r s,ttS GXexal Laws❑hVtm'M regn=all"`P'oYerS to provide workers'compensation for flea employees. pursamt-tD this ,an CznPIopee is dsfined as."_eveay peasan im the,service of another mder any contact ofhire, ezlx=or implied,oral ar WCh=f association,corporation or other Ieg2I city,or any tWD or more Au FIoyC is defined as�aa individual,partnegsh�, Wives of a deceased employer,or the of the f roguing eagag d in a Joint ,and including fie legal 5 receiver or ixustee of an iadividasl,per,association or other legal entity,Toying emPIDY=r However the owner of a.dweIIimg house having not more than three apartments and who resides therein,or the 0000pant offie- dweT_ing house of anon who employs p=ous to do maiaten am,construction or repair work on such dwelling house I be deemedto bean employer_" � urteaa�thereto shaIlnotbecanse of such;enzp o9� i or oa the grotmds bmldmg aPP . MOL cbaptrr 152,§25C(6)also sbdzs that aeverystaff or local licensing ag cy shall hold ffie is - anr�or renewal of a license or permit to operate a business or to construct bwldings in the commonwealth for any apPlicant:who has not produced acceptable evidenm of compliance with�insurance•coverage regafr�ed- Additionally,M(H_chapter I52,§25C(7)slams fiNeftfirz fie nor nay ofits political snbdiv%sions shall eninr into any contact for the perfvrmaac c 0f1nbho Work u�acceptable evidence of compliance With the ms�ance. ttr have been euted to the co—nf,a�g aufhoiRY:' 'ergs of this� P� �-FPlicants Please flI out the woriaas' compensation affidavit completely,by checking the boxes aPPIY r Yon'situation and,if necessary,supply sob�°ntractnr(s)name(s), addre$s(es)and phone-M— (_i-(s)along with their certfficaf e(s)of insurance. LinithdLiabBity Companies(LLC)or Limited LiabfityPartnerships.(LLP)withno en3PIoyees other than the members or parine as,are not required to carry workers' compensation insurance. If an L LC or LLP does have empIoyees,a.policy is rmpi=L Be advised that this affidayk may be snbmittcd to the;Department of Industrial Accidents for confamaiion of Dance coverage Also be sure to sign and date the affidavit The affidavit should not the D arf be retrnned to fie city or town that the;application for 13ie permit or license is being regaest�d, ePinent of . u are to obtain a workers' Should you have any 'ons regarding the law or ifyo requ>red - Indu., '�T A_ccideats. yo �h _ compensationpoliey,Please call the;Departmentatfien=bezIrsti-d below: Self-msm-edcompamesshoulden,`rstheir s eIf-T„crnan ce license rr�.ber an the appmpriafe Iiae_ City or Town OfFidals Please be Sure;that the affidavit is complete and pry IegiiRY. The Deparfinenthas provided a space at,rite bottma of the affidavit for you is fill out in the event the Office of Inv estian�has to contact you regarding the applicant Please be, ure s to f LI is trio peunitllicease nmmber which wM be used as a r�fermw number_ In.addition,an applicant that must submit multiplem pedlicease applications is any given.year,need only submit one affidavit indicating cnnmt olicv iafornnation,Cif necessary)and under`nob Sit Address*the applicant should write"all locations in (may or- town)-" e ded to the " ,. Stamped or maimed Ahe city or town may b provi town)_ A copy of been officially stamp by applicant as.proof that a valid affidavit is on file for fatare permits or licenses_ A new aiidavit must be f cti oiit Baca W year. here a home owner or citizen is obtaining a license or permit not related ter any business or commercial (ie_ a dog license or permit to bum leaves etc.)said person is NOT regaimd to complem this affidavit Tb_Office of Investigations would IUe to thank you in advance for your cooperation and should you have any qu ons, please do not hesitate to gim us a call- Departments address,telephone and fax number= - 6O4�ashn � �os�o-a,I�fA E�II� T6L 4 617' -49OG eft 406 or 1977 MA&R-� Revised4-24-07. ��4M a Z 9gEM �WE Town of Barnstable Regulatory Services & Richard V.Scali,Director Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize &A C"A. � 9 WAS'J to act on my behalf, ` in all matters relative to work authorized by this building permit application for. (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools . are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of OwnVr Signature of Applicant Print Name Print Name Date QYORMS:OWNERPERMISSIONPOOLS PASrAT:529JCA� /S �o � ►� ����L� �� � 5�� � e /l,a 0 G,/4--/1 / Cr�- (�>,4sn �� �� ems eld,),a o N--./LAc77 k)j, CIA 0 piq 0 g 40 NM�l Sol�o I t Job#: It,^ �J 1� 1279 Millstone Road Job Name: CA�C CAD FA�� Brewster MA 02631 Site: 210 A%%Z tT w "�t Aw�NtS C K N Z 18E t 774 353 z144 ENGINEERING f'774-353-2142 Engineer's Initials:_ Dates(s): CONSULTANTS 9mctam1 civil environmental mckengineers.com V� P(tD6tf—( Aj ItJffrrDoo Lu�ci, OPWIA & 1 (n O a - x ' � Ew. 5> - -I T- Lauzon, Jeffrey From: Deputy Dean Melanson <dmelanson@hyannisfire.org> Sent: Wednesday, October 05, 2016 8:46 AM To: Roma, Paul; Lauzon,Jeffrey Subject: 210 Airport Way, Cape Cod Panel Good Morning, Cape Cod Panel moved into this location around August of 2015 if my memory serves.They are now expanding there operation within the building.The last occupants in these areas was Cape & Islands Steel and the back part was vehicle storage. Does this wood panel manufacturing shop trigger any change of use change of occupancy hazard or anything else that might cause a discussion about sprinklers? They only thing they have right now is some fire extinguishers. Deputy Chief Dean L. Melanson Office 508-775-1300 Fax 508-778-6448 dmelanson@hyannisfire.org 1 f Job#: l Cr^ ~ 1279 Millstone Road Job Name: C�`PE C� Brewster MA 02631 Site: 2to i��RxL't 4 �..►�ts M c K E N Z 1 E t 774 353 2144 ENGINEERING f 774-353-2142 Engineer's Initials:_ _Dates(s): '9 5o IL CONSULTANTS saudtvnl•dvil emim—cmul mckengineers.Com 4456tf—f A-5 IV!=,=p6O a Z 1 tP rs Gi a _ f � m 06 iL , Office of Consumer Affairs&B siness Regulation THOME IMPROVEMENT CONTRACTOR Registration: -41-127453 Type: Expiration: =N11,112016 Individual ERWAERC.BRENNANjiR• WALTER BRENNAM�3 � � 80 MATTAKESE RD#2= -y`= t'y W.YARMOUTH,MA`02673 Undersecretary 5 ®� Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-004389 Construction Supervisor WALTER C BRENNAN 80 MATTAKESE RD UNITE 2 . W YARMOUTH MA 02673 '�_/►("^^ v�-- Expiration: Commissioner 01/2112018 9/ 12/2016 10 : 29 : 20 AM 8790 ® 02/02 DATE Ac r CERTIFICATE OF LIABILITY INSURANCE U9112I(MMrDDf6DDmvv) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 04507-001 CONTACT NAME: Branch 4507-1 Minuteman Insurance Agency AH�No.EA): (781)229-1555 AIC.No.: (781)273-6644 1 Burlington Woods Dr Ste 203 EMAIL Burlington,MA 01803 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURERA: A.I.M.Mutual Insurance Company 33758 INSURED INSURER B: Genesis HR Solutions Inc INSURER C One Burlington Woods Drive Suite 203 INSURERD: Burlington, MA 01803-0000 INSURERE: 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE AINSR SWVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMIODNYYY) (IMMIDD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PREMISES Ea occurrence CLAIMS-MADE ❑OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 3EN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $ ULICY ROT- OC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per., er accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION X TORY LIMITS 0 R AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $ A OFFICERIMEMBER EXCLUDED9 ® NIA AWC-400-7015863-2016A 1/112016 1/1/2017 1.0 00 000.00 (Mandatory in NH)) E.L.DISEASE-EA EMPLOYEE $ 1,000-000 DESOCRIf719N OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 000 000.00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional.Remarks'Schedule,-if`m-6fe space is required) Jobr210 Airport Way-Hyannis';MA 02601. Approz.Hpurs 80,:,Client.Name:,;Bcenniek Building SysEems;LLC.Coverage is restricted to employees leased to:Brennick Building,$.ys#ems,ALL.C..a..;.,x.-.,,':�g` .._..�_�.--.-�•• CERTIFICATE HOLDER CANCELLATION Town of Barnstable Building Divison 200 Main Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Hyannis,MA 02601 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 6102 09/12/2016 9 : 30AM (GMT-05 : 00) Mass. Corporations, external master page Page 1 of 2 RMIR ♦ s Corporations Division Business Entity Summary ID Number: 743073172 Request certificate New search Summary for: BRENNICK BUILDING SYSTEMS LLC The exact name of the Domestic Limited Liability Company (LLC): BRENNICK BUILDING SYSTEMS LLC Entity type: Domestic Limited Liability Company (LLC) Identification Number: 743073172 Old ID Number: 000830923 Date of Organization in Massachusetts: 12-31-2002 Last date certain: The location or address where the records are maintained (A PO box is not a valid location or address): Address: 80 MATTAKEESE RD. UNIT 2 City or town, State, Zip code, W. YARMOUTH, MA 02673 USA Country: The name and address of the Resident Agent: Name: WALTER C. BRENNAN, JR. Address: 267 MAGNET WAY City or town, State, Zip code, BREWSTER, MA 02631 USA Country: The name and business address of each Manager: Title Individual name Address In addition to the manager(s), the name and business address of the person(s) authorized to execute documents to be filed with the Corporations Division: Title Individual name Address SOC SIGNATORY WALTER C. BRENNAN JR. 267 NAGNET WAY BREWSTER, MA 02631 USA The name and business address of the person(s) authorized to execute, acknowledge, deliver, and record any recordable instrument purporting to affect an interest in real property: Title Individual name Address http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=743073172&... 10/4/2016 Mass. Corporations, external master page Page 2 of 2 ❑ ❑Confidential ❑Merger ❑ Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Annual Report ' Annual Report - Professional Articles of Entity Conversion Certificate of Amendment ; I View filings Comments or notes associated with this business entity: IV E New search r http://corp.sec.state.ma.us/Corp Web/CorpS earch/Corp Summary.aspx?FEIN=743 073172&... 10/4/2016 Town of Barnstable 'gECE�PT MASS: 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: cTB-16-2900 Date Recieved: 10/4/2016 Job Location: 210 AIRPORT WAY,HYANNIS Permit For: Building-Addition/Alteration-Commercial Contractor's Name: WALTER C BRENNAN State Lic. No: CS-004389 Address: W YARMOUTH, MA 02673 Applicant Phone: (Home)Owner's Name: MACGREGOR,J BRUCE TR Phone: (Home)Owner's Address: 270 COMMUNICATION WAY, HYANNIS,MA 02601 Work Description: remove interior wall-add steel for support.Remove section of exterior non bearing wall to access.parking lot.Add 3 2x20 Header-opening 18x5 Tenant Fit-out for Cape cod panel Total Value Of Work To Be Performed: S4,000.00 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: WALTER C BRENNAN 10/4/2016 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost: $4,000.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $160.00 10/4/2016 $160 00 433 Check ........ .. ..... . ........ .... .... ..... . .... _....... ......1 .. ............ ...................................... Total Permit Fee Paid: $160.00 z W'.,tm, F Nauset Environmental Services, Inc,. an Air Quality Company. 10 January 2017 NES Job# 2-330 Report No. NES/ASB-17/1964 Walter Brennan Cape Cod Panel 326 Willowbend Drive Mashpee, MA 02649 Re: Post-remodeling asbestos inspection& sampling at 210 Airport Way (Hyannis) — a Dear Mr. Brennan: U1 In response to written authorization Nauset Environmental Services, Inc. (NES) s nt a cer' ed c� Massachusetts Asbestos Inspector, William M. Vaughan, PhD to perform a pot-remodeling asbestos inspection and sampling at 210 Airport Way looking for indications of sus ect asbe tos- can containing building material (ACBM) that may have been overlooked during reni 1vation. 4his authorization came after the remodeling had been completed. z rn This inspection included photographic documentation found in Attachment A. [Since no samples were taken for analysis,there is no Table 1 of results or any attachment with a laboratory report.] INSPECTION& OBSERVATIONS On 6 January Dr. Vaughan conducted a post-remodeling inspection at 210 Airport Way. Dr. Vaughan is an accredited Environmental Protection Agency (EPA) AHERA (Asbestos Hazard Emergency Response Act) asbestos inspector (#16-0251-106-230916) and is certified by the Commonwealth of Massachusetts as an asbestos inspector(#AI 040812). SITE — The remodeling was complete before the parties became aware that a pre-remodeling asbestos inspection was called for. That remodeling at this metal building used for warehousing and manufacturing consisted of removing a center partition where vertical posts had supported the roof, installing an I-beam across the building to support the roof and removing the metal paneling that had divided the building. This reconfiguration led to an open floor for expanded panel manufacturing(see photo). The remodeling included removal of the vertical sheet insulation along the former dividing wall. Some the ceiling and wall insulation was impacted as well. 1) Thermal Systems: No thermal systems were involved with the remodeling. The same gas blower/heaters are still serving the now-opened space. The internal thermal barriers between the two sections consisted of curtains of yellow fiberglass insulation sandwiched between paper layers with remnants still visible at the edges of the new opening and across the ceiling where the I-beam was installed (see photos). P.O. Box 1385, 508/247-9167 [800/931-1151] East Orleans, MA 02643 FAX: 508/255-0738 f Post-remodeling asbestos inspection&sampling at 210 Airport Way(Hyannis) NES/ASB-1711964 Page 2 The exterior thermal barriers consisted of pillows of yellow fiberglass insulation wrapped in plastic/fiberglass and installed between beams and rafters (see photos). None of these insulation barriers were considered suspect ACBMs requiring sampling and analysis. The only disruption of thermal materials was limited to the renovation in the center of the building and hence no suspect ACBMs were involved with the renovation. No sampling was called for. A few of the pillows had been damaged or loosened over time and showed consistent yellow, fiberglass fill confirming the earlier observations. 2) Surfacing: Flooring: The flooring on both sides of the center renovation area was poured concrete. No flooring was involved with the renovation. Ceilings & Walls: The center wall that was removed was sheet metal, consistent with the building's overall construction and would not have involved suspect ACBMs. No sampling was called for. 3) Miscellaneous No roofing was involved in the remodeling. No roofing sampling was called for. SUMMARY Since an Asbestos Inspector can use his professional experience and discretion to identify non ACBM fiberglass insulation in the field without laboratory analysis, this inspection found no suspect ACBMs that would have been present before the renovation and hence disrupted by the renovation. RECOMMENDATIONS No asbestos removal concerns are applicable to this renovation. -------------------- I trust the above information is satisfactory for your planning needs at this time. Please call if there are any questions. Attested by: William M.Vaughan,PhD, QEP Asbestos Inspector(Massachusetts Al 040812) QEP=Qualified Environmental Professional(since 1994) C:\BV Files-Dell\Asbestos-200s\2-329 Crossen pre-remodeling AI+AS.RPT.docx Post-remodeling asbestos inspection&sampling at 210 Airport Way(Hyannis) NES/ASB-1711964 Page 3 t Commonwealth of Massachusetts: Department of Labor Standards: I William D.,MdOnnej Director Asbestos Ihspector WILLIAM M. .AUGHAN -t. Eff:Date 06/09l16 f Exp.Date 06/16/17 , A10408.12. Memberof GORES. ; $ NBR NB-RENEWAL "7 i Et ATTACHMENT A Photographs taken during site inspection I Select Inspection Photos IN °-o..�� ` p. 210 Airport Way(Hyannis) k. h pts YlA'��#" View across renovated open space frcipq:t h Ya j t p b 41 14 Pr Left, front of manufacturing space [Note yellow fiberglass insulation upper right.] s :. x } Ik 3. SIT + Ss € +raf,` n a Right, front of manufacturing space [Note plastic wrapped pillows of insulation in upper walls and ceiling] Close-up of remaining left side portion of centerg� wall revealing the original construction with a curtain of fiberglass insulation between the metal walls. Cut off fiberglass insulation is also evident ; ` at the top of the opening. b as. L , _ a a a mar 3 y vra � 9 1 E View of cut off fiberglass on left side just above the new beam s x . ' ,tom �th & �,° # am k Cut off fiberglass insulation of right side above new beam S d „y h ss fie, " i Pfi4 S fia. 94 19 ...� ✓� ,,h q •.,t s �'�,-� �. # , � � si �,ice $' �, � '�. -• t � � �' a c . 4" W: Fiberglass insulation evident in right side wall insulation r , 4 1 s e , ' �!�„� �`'z'»�.,.�`g„Ti,�4,i�(wN� 4� •'�fL,`.s�a ��€� z='� i`x 3 -.�: a Fiberglass evident in pillow on ceiling t Massachusetts Department of Environmental Protection Bureau of Waste Prevention .Air Quality BWPAQ06 Notification Prior to Construction or Demolition B. General Project Description (continued) 3. General Contractor: Name Address 4)- Mr4. -0 2*73 ,S09- j/oo-73 City/Town State ZIP Code Telephone General Contractor On-Site Manager/Foreman Telephone General C. General Construction or Demolition Description Statement: If asbestos is found during a 1. Construction or demolition contractor: Construction or 1 T /� Demolition AM 1�i2 0. /�f IJiP�e9 o �� �O HpJ7 I,�1 h4_5E AD. U P/%Z operation,all Contractor Name Address responsible v parties musty/�/Q.�J®C!5'7f comply with 310 City/Town State ZIP Code Telephone CMR 7.00,7.09, 7.15,and �,/®N/ � Chapter 21 E of Construction&Demolition On-Site Manager Telephone a ,1 the General Laws of the 2. Licensed Contractor Supervisor: Commonwealth. �/ /� This would �eT�� 0. ]3&4v,4J ✓� G �' �� `�3 _ include,but Supervisor Name License Number would not be limited to,filing 3. Is the entire facility to be demolished? ❑ Yes 9 No w an asbestos tat removal th ib D. Describe e area notification with 4 (s)to be demolished: the Department and/or a notice of release/threat of release of a hazardous substance to the `f ��,(`t?i.cd/o pif- /A-I& /0 �11,t'�Aze T+ Department,if applicable. 5. If this is a construction project,describe the building(s)or addition(s)to be constructed: 6. If this is a demolition or renovation project,were the structure(s) ) Yes ❑ No surveyed for the presence of Asbestos-Containing Material (ACM)? 7. Was asbestos containing material (ACM)found? ❑ Yes K No If yes,who conducted the survey? Name Department of Labor Standards Certification Number 08/15 BW P AQ O6-Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Waste Prevention .Air Quality BWP AQ 06 Asbestos Project Number Notification Prior to Construction or Demolition A. Applicability Important: A Construction or Demolition operation of an industrial,commercial,or institutional building,or residential When filling building with 20 or more units is regulated by the Department of Environmental Protection(MassDEP),Bureau out forms on the computer, of Waste Prevention-Air Quality Division,under Regulations 310 CMR 7.09.Notification of Construction or use only the Demolition operations is required under 310 CMR 7.09(2)ten(10)days prior to any work being performed.The tab key to following information is required pursuant to 310 CMR 7.09. move your cursor-do not Is this a fee-exempt notification(city,town,district,municipal housing authority,state facility,owner-occupied kuse ey.the return residential property of four units or less)? 7 �.V ❑ Yes ❑ No "' Y Type of Notification:❑Project Revision ❑Project Cancellation g 3 Blanket Permit Approval,if applicable: Approval Number Instructions: Non-Traditional Asbestos Abatement Work Practice Approval,if applicable: —" Ca') 1:.All sections of Approval Number C this form must B. General Project Description be completed in order to comply -with the 1. Facility Information: Department of _ Environmental ��Pt coo �� L /® /Q�p� t Protection notification Name of Facility Street Address requirements of 1GIA A1A �� ®y/o0/ 5a 9 s S 21 7,�t, 310 CMR 7.09 City/Town //��� State Zip Code Telephone 2.Submit 'J-0,., 14471-1/3 aA) Original Form Facility Contact Person Contact Person Title To: So-9-3z7 23/ '70N<9 e VIA Pt ea O PA A Commonwealth Facility Contact Person Telephone Facility Contact Person Email of Massachusetts P.O.Box 4062 Facility Size: Boston,MA SO Square Feet Number of Floors t,e Was the facility built prior to 1980? Yes ❑ No Describe the current or prior use of the facility: Is the facility a residential facility? ❑ Yes )1e No If yes, how many units? Number 2. Facility Owner: Facility Owner Name Address f—/YX NQ- /1 0/ Sog--362 a 2721 City/Town State ZIP Code Telephone 7evLi-- �P-t-e-e -_7), Awc-A iL) On-Site Manager/Owner Representative Address /?!fS Hog_ 50S-51 — 019I City/Town State ZIP Code Telephone 08/15 BWP AQ 06•Page 1 of 3 LIMassachusetts Department of Environmental Protection Bureau of Waste Prevention •Air Quality BWPAQ06 Notification Prior to Construction or Demolition C. General Construction or Demolition Description (continued) The Asbestos Abatement Notification Number for this address is: Z— 3 3 This project is: Construction Demolition /W¢S/AS ` 1,,9 /-1- 2,0/-7 2- Project Start Date(MM/DD/YYYY) Project End Date(MM/DD/YYYY) 8. For demolition and construction projects, indicate dust suppression techniques to be used ❑ Seeding ❑ Wetting eCovering ❑ Paving ❑ Shrouding ❑ Other-Specify: 9. For Emergency Demolition Operations,who is the MassDEP official who evaluated the emergency? Name of MassDEP Official Title of MassDEP Official Date of Authorization(MM/DD/YYYY) MassDEP Waiver Number D. Certification °I certify that I have personally examined the foregoing Am i ww� and am familiar with the information contained in this Print Name document and all attachments and that,based on my inquiry of those individuals immediately responsible for Au horize Signature obtaining the information,I believe that the information //�� is true,accurate,and complete.I am aware that there 0,41�1/4>7W6 are significant penalties for submitting false Position/Title information,including possible fines and imprisonment. �4s,�p�/ ce�izq�,v� y5i�f7S LLL. The undersigned hereby states,under the penalties of Representing perjury,that I am aware that this permit application or �_Zo/7 notification shall not be deemed valid unless payment Date(MM/DD/YYYY) of the applicable fee is made." P.E.# 08/15 BW P AQ 06•Page 3 of 3 P �e�rn�»un�rtuec�lt�n�C�/j�tcdd«c�uveCld Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Individual --Registration Expiration T1 -27453 , 10/31/2018 ' WALTER C.BRENNAN JR`t ; WALTER BRENNANNJRWri 326 W illowbend Mashpee,MA 02649�_ u Undersecretary 4� i 1"�a 1r9'f /2f�fCo r Jul S7/ (,o I)� �� � --.>' AT,)`(D fi 64'-0" 85'-01, 23'-1 3/8" El FRAMING TABLE � o 60 OPENING TO F&OVE PANELS c\, CONVEYORS TO OUTSIDE o COMPONENT TABLES r STEEL COLUMNS �r- 41'-7" o 5 -2„ 40'-8 1/2" 5'-2" STORAGE COMPRESSOR AND HEADER STATION N r 13'-9 1/2" 24'-9" 13'-9 1/2" 40'-8 1/2"STORAGE ABOVE r 29'-0" Lo Llml� 12' OVERHEAD DOORS op CV 60'-6" I I l i I 64,_0„ 85,_0„ _ 23'-1 3/8" _ FRAMING TABLE o N °00 CONVEYORS TO OUTSIDE -OPMIM TO PAt IS STEEL COLUMNS COMPONENT TABLES 41'-7" o STAIR; 5 -2° 40'-8 11/2 5,_2„ STORAGE COMPRESSOR AND HEADER STATION 13'-9 1/2" 24'-9" 13'-9 1/2" 40'-8 1/2"STORAGE ABOVE 29'-0" 12' OVERHEAD DOORS 00 60'_6„ ,I i I i I I ------------- 'i II 64'-0" 85,_0„ 23'-1 3/8" FRAMING TABLE o N °�-° CONVEYORS TO OUTSIDE °�""G TO "�0� P' RS STEEL COLUMNS COMPONENT TABLES � I 41,_7„ CDi i STA I j 5 _2,. 40'-8 1/2" 5'-2„ STORAGE COMPRESSOR AND HEADER STATION -r 13'-9 1/2" 24'-9" 13'-9 1/2" 40'-8 1/2"STORAGE ABOVE T 29'-0" i 12' OVERHEAD DOORS III N I I'I 60,_6„ I 'i i I i I I a � I I i l I i i I i i p i 64'-0„ 85'-0„ 23'-1 3/8" El FRAMING TABLE l o N °T° CONVEYORS TO OUTSIDE —MING To MAM MaS i STEEL COLUMNS COMPONENT TABLES i d- 41'-7„ o i i STA i i I I 1 ❑ 5 -2„ r p 40'-8 1/2° 5'-2„ STORAGE I COMPRESSOR AND HEADER STATION N 13'-9 1/2" 24'-9" 13'-9 1/2" 40'-8 1/2"STORAGE ABOVE r 29'-0" 12' OVERHEAD DOORS i { I 00 N 60'-6"