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0617 BEARSE'S WAY (3)
r/7 f e-�sks Gv4 � n Nb cam. NO. �. c rn z PROJECT ADDRESS: .PERMIT# PERMIT DATE:' 4 I LARGE ROLLED PLAITS ARE IN: :BOX SLOT , Data entered in MAPS program on: BY. q/tivpfiies/foil sAa ch ve.. Town of Barnstable o� Building Department - 200 Main Street Hyannis, MA 02601 9� ib��. .�' (508) 862-4038 Certificate of Occupancy Application Number: 201407690 CO Number: 20150007 Parcel ID: 293001 CO Issue Date: 01120115 Location: 617 BEARSES WAY, HYANNIS (SEW Zoning Classification: SPLIT ZONING Proposed Use: MUNICIPAL IMPROVED Village: HYANNIS Gen Contractor: BASSO, LOUIS N Permit Type: CC00 CERTIFICATE OF OCCUPANCY COMM Comments: —00 /S Building Department Signature Date Signed is TOWN OF BARNSTABLE ■- Building " 201407,690 BARNSTABLE, Issue Date: 11/18/14 P e.rm I t 9 MASS. �pr16 A� Applicant: BASSO,LOUIS N Permit Number: B 20143180 Proposed Use: MUNICIPAL IMPROVED Expiration Date: 05/18/15' [Location 617 BEARSES WAY,HYANNIS (SEilZ14'lg District SPLTPermit Type: NEW ACCESSORY STRUCTURE COMM Map Parcel 293001 Permit Fee$ 2,193.10 Contractor BASSO,LOUIS N Village HYANNIS App Fee$ 150.00 License Num 067366 Est Construction Cost$ 241,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND MODULAR BUILDING INSTALLATION LOCKER ROOM FACILITY THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: BARNSTABLE,TOWN OF(MUN) BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 367 MAIN STREET INSPECTION HAS BEEN MADE. HYANNIS,MA 02601 Application Entered by: PF Building Permit Issued By: -DE THIS PERMIT CONVEYS NQRIGHT TO OCCUPY ANY YSTREET ALLEY OR SIDEWALK ORANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY,ENCRO kC7ITITS. N PUBLIC PROPERTY;N0 SPECIFICALLY PERMITTED UNDER THE BUILDING CODE MUST:BE APPROVED BYTHE JURISDICTION STREET 0R ALLEY GRADES AS WELL AS DEPTH AND LOCATION'OF PUBLIC SEWERS MAY BE ."a OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS THE ISSUANCE OF THIS PERMff DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONIS;OF ANY APPLICABLE SUBDIVISION 3 MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING 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. 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). * ® out. MET Q ® • i f , BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 f' I rtb l 2� �T �J�G✓ � �x 1 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 r'.�,a�„ B d of . -L 9_ f 6 _ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION R• Map Parcel Application # A(Health Division ,�►`�N Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board J Historic - OKH _ Preservation/ Hyannis _Project Street Address _ ——- _ea✓S�S to -- Village ►7 "��f Owner Tows'l 6AY-A5PO/Address 646 .Telephone J �� 9U- 6. a1 ,[ ,( Permit Request A0WWll f-'r 1/�/ .ir �f�`J/°' AO, emul ;Square feet:1 st=floor: existing ' proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project-Valuation o? OW Construction Type .17 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting docum ntation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) � rc�0.l Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full Acrawl ❑ alkout ❑ Other Basement Finished Area (sq.ft.) A Basement Unfinished Area (sq.ft) LEI 510 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 0 Electric ❑Other Central Air: Yes ❑ No Fireplaces: Existing New Existing w /coal stove: es ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Bar existing,❑ n;w size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: r Z Zoning Board of Appeals Authorization ❑ Appeal # Recorded U. Commercial *Yes ❑ No If yes, site plan review # ,, rn Current Use (41_�rc.4 Proposed Use 61__...c �l APPLICANT INFORMATION (vQ ah �--r (BUILDER OR HOMEOWNER) C c�. ,,Name Q S ��Je Telephone Number / 91' 'M MO Address 3 " �~��`� License# C S vrr�s�o" / CT 66� lO Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTn DEBRIS RESULTING FROM THIS PRQJECT WIL E TAKEN TO 10W rc'1 SIGNATURE DATE FOR OFFICIAL USE ONLY l APPLICATION# ' c. DATE ISSUED MAP/PARCEL NO. 1 s J i _ " f ADDRESS VILLAGE it R OWNER Al DATE OF INSPECTION: �FOUNDA .IO,Ng .,}vz �FRAME"— INSULATION FIREPLACE u: ELECTRICAL: ROUGH ! FINAL g PLUMBING: ROUGH r FINAL GAS: ROUGH FINAL FINAL BUILDING.' =� _ DATE CLOSED OUT may, ASSOCIATION PLAN NO. 4 S, i r - .... .. . .. ... ..... _.. ... .... .... ' �Ita.'�t7ASLrIQ7lrtf�i G,�'�a!55at�11�SE�S �e�t of shz+arlAccide�r OrCe ofInVM 0M 6"watskill aytt,SYreet Boston,Aft 02M wtmma=gotVdx'a Workers' Compensation(insurance Affidavit Bum"IdersJ cbrs/Ek%-hici-3n&Tkmbers "cant I�"iarmat an Please Print nt Name _ 1 A146YA J A44AR .f9/Calil&- Z r6,Al ess J 0AE4r ►����� kw,4�T u1rc /70 Qty«wz�p_-�&�E 3 SS- PIHM : �a a _ yOR_b Are you an employer?Check the ahrupriate bo= Tytre of rmiect(kevired): L❑ I am a employer with 4.� general am a aral contractor and I employees(full aadfor pact-time}• have hired.the sdtpm tmcfors. 6 [ Near e5o I❑ I azn a sole pmpsietor orpartner- listed on the attached sheet; y- ❑Remodeliag ship and lame no employees Them sob-contracmn have 8. []Demolition VMddng frnr me in MY rapacity. eup�s and have wodw s' 9. Bm7din addition (No wodom'comp:insurance E0mp- Zrevimd- � g j 5.❑ We area corporation and its 10.0 Electrical repairs or additions offiem have emermsed their 3.(] I am a homeowner all Zvo>t 1 L[]Plnmbmg tepasCs of additions rwjsdf o wadms'comp right of ememption per MM- 12�Roof ]T c.15Z jl(41andwekceno s emPlayem[No wodoeW13 Other/eEPt,f}C` comp-in=ance requinAl 1456LW6 S I1r_ •luxe,—' +'AeT ayltic+�Hat checks bos#1 omit also 5llaat Bit sscfioa belowshosriag t6eor vradters`aom�atinn I�7 . &ameo9ra�s vda sntxK Phis zMd*M=&uUq they are daring allvok=d&M Me oUW&caetaesms mme mbn*anm xffdtcst in&Utmx wk fCaatflctoar tlmt dsec)c t1Ss b�mast snacbed an addi8ond sheet chvaemg t�e»vne of t§e mdAa6e v'bc�ar orm�t t6acx ewi6ieshazz! eaptny m Ifthe s-,�Ircmn ctms bzv'e empToyaes,they tmnt provide*Aw wwkas'comp.policy mmbet l Gin an empinyer tFW ispmtddhW»wrkers'congmnsrt is n insurance for my empJnydres BdAm is the gamy and job site irrfornrotion. - //"" IsuaanceCyAIame:T�e,9yC LE/1S t�lSN1q j7r a/y//�Ny OF c� JbTicg#or Setf oars iia ?b/,t'_�-6 C 1 Sj j 0 -A-l 3 F.aqatatma7 Date Z7 Job side Address_(O/7 6MASp-S WAY _citpl5tatdTsp: /Q N IS 2 O/ Anach a Dopy of the workers'comp easafin poBry den bur ou page(showing the policy nmuber and e�tion date). Fame to secure,coverage as required ate Section 25A of MGL c. L52 can lead to the imposition of criminal penalties of a Sane up to S 1,,500 DD and/or ome yearimpriso�as w A as civil penalties is the fosm 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 stiftment maybe forwarded to the Offm of bn eskSations of the DL4 for i mwannce covemp verification_ I do hmiaby friar dwpairrs and pena'' �flirp thati is informatcon provided above is ciao and correct �- t7,�ciat rest ant}: Da,not iO t r in-this arek is bit comp&arl by-c*or torn of ciaLiaL City or Town: Pcense S Issuing Authority(drde orae): 1.Board of Health I Bnffifing Department 2,City-frown Cleric 4.Electrical Inspector S.Plumbing fospeetor 6.Other Contact Person: phone S: 6 f VANGMOD-01 GORC CERTIFICATE OF LIABILITY INSURANCE F DAT1212D/YYY1r) 611212014 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 endorsemen s). PRODUCER (610)280-0410 NAME:c Christine E Gordon Engle-Hambright&Davies,Inc. PHONE , 800 627-3732 236 a No). 350 EaglevieW Blvd EMAIL Suite 110 ADDRESS:cegordonQehd4ns.com Exton,PA 19341 INSURER(S)AFFORDING COVERAGE NAIC 0 INSURERA:Charter Oak Fire Insurance Company 25615 INSURED Vanguard Modular Building Systems,LLC INSURERB:Travelers Property Cas.Co of America 25674 3 Great Valley Parkway,Suite 170 INSURER C:Travelers Casualty Company of CT 25666 Malvern,PA 19355 INSURER D:Atlantic Specialty Insurance Company 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER M ADM SUOR MIDD EFF MMMIIDPOLID EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X -630-6C153573-COF-13 12131/2013 12131/2014 PREMISES(Ea occurrence) $ �0,00 CLAIMS-MADE X❑OCCUR Certificate holder is noted s Additional Insured MED EXP(Any one person) $ 10,00 on the General Liability poi Icy if required by PERSONAL&ADV INJURY $ 1,000,00 itten contract and to the Went reqt fired by GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: *ritten contract,subject to policy's toms,,* PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY X PRO- X LOC conditions,limitations,an exclusion . $ AUTOMOBILE LIABILITY COMBINED atSINGLE LIMITCE, $ 1,000,0 B X ANY AUTO X 810-6C153573-TIL-13 12/31/2013 12/31/2014 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NO"WNED PROPERTY DAMAGE HIRED AUTOS AUTOS PER ACCIDE $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000100 B EXCESS LIAB CLAIMS-MADE X CUP-SC163573-TIL-13 12/31/2013 12/31/2014 AGGREGATE $ 10,000,00 DED I X I RETENTION$ 10,000 $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN X RY I E C ANY PROPRIETORIPARTNER/FXECUTIVE YTUB-6CI6910-A-13 12131/2013 12/3112014 E.L.EACH ACCIDENT $ 1,000100 OFFICERIMEMBER EXCLUDED? N N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEd$ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,0 D Installation Floater 710033173-0001 12/31/2013 12/31/2014 Limit:$1,000,000. Deductible:$10,00 D Leased/Rented Equipment 710033173-0001 12/3112013 12/3112014 Limit:$150,000 Deductible:$5,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space is required) Town of Barnstable and its employees are noted as an Additional Insured on the General Liability,Automobile,and Umbrella policies only if required by written contract and to the extent required by written contract,subject to policy terms,conditions,limitations,and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Procurement and Risk Management ACCORDANCE WITH THE POLICY PROVISIONS. 230 South Street Hyannis,MA 02601- AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010106) The ACORD dame and logo are registered marks of ACORD VANGUARD MODULAR BUILDING SYSTEMS ' www.vanguardmodular.com November 3,2014 Town of Barnstable Building Division Attn: Thomas Perry,CBO 200 Main Street Hyannis, MA 02601 RE: Louis Basso—Confirmation of Workers Compensation Insurance and Employment Dear Mr. Perry, - Please allow this letter to serve as confirmation that Mr. Louis Basso is covered by the Workers Compensation Insurance of Vanguard Modular Building Systems; LLC. Mr. Basso has been employed as a site superintendent and/or project manager by Vanguard Modular Building Systems,LLC since November,2006. Yours truly, Carl R. Bennett Assistant Secretary l - 3 Great Valley Parkway,Suite 170• Malvern, PA 19355 ph:610.240.8686 . 800.448.6772 •fax:484.244.5062 t t • S - rt � t � � T � ' 1 I 4 , The Commonwealth of Massachusetts Executive Office for Administration and Finance Division of Capital Asset Management and Maintenance One Ashburton Place Boston,Massachusetts 02108 DEVAL L.PATRICK GLEN SHOR GOVERNOR Tel: (617) 727-4050 SECRETARY,ADMINISTRATION& FINANCE Fax: (617) 727-5363 CAROLE CORNELISON COMMISSIONER First Amended and Restated Prime/General Certificate of Contractor Eligibility CONTRACTOR IDENTIFICATION NUMBER:060S This Amended and Restated Certificate Shall be Used for Submitting Prime/General Bids Only The prior Certificate of Contractor Eligibility with an Approval Date of 5/23/2014 is hereby superseded,amended and restated by this Certificate with changes to the information contained in the following Section(s): 3 1. CERTIFICATION PERIOD: This Certificate is valid from 5/23/2014 to 5/23/2015 2. CONTRACTOR'S NAME: Vanguard Modular Building Systems,LLC 3. CONTRACTOR'S ADDRESS: 3 Great Valley Parkway,Suite 170,,Malvern, PA 19355 4. WORK CATEGORIES' This Contractor is certified to file bids under Massachusetts General Laws Chapter 149, Chapter 149A and Chapter 25A in the following checked Categories of Work: Alarm Systems Elevators n Historical Masonry [] Painting ❑Asbestos Removal []Energy Management Systems ❑Historical Painting Plumbing Deleading ❑Exterior Siding 0 Historical Roofing Pumping Stations Demolition [;Fire Protection Sprinkler Systems ❑HVAC [j Roofing Doors&Windows ❑Floor Covering Masonry Sewage&Water Treatment Plants Electrical E%e]General Building Construction Mechanical Systems J Telecommunication Systems ID Electronic Security Systems Historical Building Restoration C Modular Construction/Prefab ❑ Waterproofing S. EVALUATIONS: Number of Projects Evaluated: 16 Average Project Evaluation Rating: 92 Number of Projects Below Passing Score: 0 6. PROJECT LIMITS: Single Project Limit(SPL): $3,616,000.00 Aggregate Work Limit(AWL): $30,000,000.00 General Building Construction Limit: $3,616,000.00 7..SUPPLIER IVERSITY O C E IFICATION: N/A reya S.Bernstein,Deputy General Counsel, Approval Date for Carole J.Cornelison,Commissioner NOTE TO CONTRACTORS: Complete Applications for Renewal of Contractor Eligibility are due no later than three months PRIOR to the Expiration Date of the Certification Period shown above. Failure to submit Completed Applications timely may result in a gap in Certification or a lapse in Certification altogether for your company. Reviewer's Initial t� L t __ i w RADC�O 0 Oct 16, 2014 0 COMcheck Software Version 3.9.4 a m Envelope Compliance Certificate 2009 IECC Section 1: Project Information Project Type:New Construction Project Title:FSS-3036-A/624x60-Ma-1440Sq-13us Construction Site: Owner/Agent: Designer/Contractor: First String Space Inc James Bradley Pearson,MA 31642 Engineer 912-243-0370 212 Fox Trail Parkesburg,MA 46528 (610)857-2458 s bradley<opustpuffin@outlook.com Section 2: General Information Building Location(for weather data): Hyannis,Massachusetts Climate Zone: 5a Building Space Conditioning Type(s): Nonresidential Vertical Glazing/Wall Area Pct.: 8% Activity Tvue(s) Floor Area Office 1440 Section 3: Requirements Checklist Climate-Specific Requirements: Component Name/Description Gross Cavity Cont. Proposed Budget Area or R Value R-Value U-Factor U-Factor(a) Perimeter Roof 1:Attic Roof with Wood Joists 1440 60.0 0.0 0.017 0.027 Exterior Wall 1:Wood-Framed,16"o.c. 1344 22.0 0.0 0.061 0.064 Window 1:Metal Frame with Thermal Break,Perf.Type:Other 48 — — 0.450 0.550 testing/cert.Product ID:N/A,SHGC 0.25(c) Window 1 copy 1:Metal Frame with Thermal Break,Perf.Type: 60 — — 0.450 0.550 Other testing/cert.Product ID:N/A,SHGC 0.25(c) Door 1:Insulated Metal,Swinging 80 — — 0.292 0.700 Floor 1:Wood-Framed 1440 22.0 0.0 0.044 0.033 (a)Budget U-factors are used for software baseline calculations ONLY,and are not code requirements. (b)'Other'components require supporting documentation for proposed U-factors. (c)Fenestrations product performance must be certfied in accordance with NFRC and requires supporting documentation. Air Leakage,Component Certification,and Vapor Retarder Requirements: 1. All joints and penetrations are caulked,gasketed or covered with a moisture vapor-permeable wrapping material installed in accordance with the manufacturer's installation instructions. 2. Windows,doors,and skylights certified as meeting leakage requirements. Lj 3. Component R-values&U-factors labeled as certified. 4. No roof insulation is installed on a suspended ceiling with removable ceiling panels. 5. 'Other'components have supporting documentation for proposed U-Factors. Project Title:FSS-3036-A/B24x60-Ma-1440Sq-Bus Report date: 10/09/14 Data filename:C:\Users\Kenneth Sapp\Documents\COMcheck\FSS-3036-A\B-24x60-Ma-1440-Sq-BusXX.cck Page 1 of 9 6.'Insulation,installed according to manufacturer's instructions,in substantial contact with the surface being insulated,and in a manner that achieves the rated R-value without compressing the insulation. Fl 7. Stair,elevator shaft vents,and other outdoor air intake and exhaust openings in the building envelope are equipped with motorized dampers. 8. Cargo doors and loading dock doors are weather sealed. 9. Recessed lighting fixtures installed in the building envelope are Type IC rated as meeting ASTM E283,are sealed with gasket or caulk. 10.Building entrance doors have a vestibule equipped with self-dosing devices. ���® D Exceptions: W Building entrances with revolving doors. Oct 1 s, 2014 p Doors not intended to be used as a building entrance. d C a m EJ Doors that open directly from a space less than 3000 sq.ft.in area. Q p Doors used primarily to facilitate vehicular movement or materials handling and adjacent personnel doors. ❑ Doors opening directly from a sleeping/dwelling unit. Section 4: Compliance Statement Compliance Statement: The proposed envelope design represented in this document is consistent with the building pla edfications and other calculations submitted with this permit application.The proposed envelope system has been designed rye ECC requirements in COMcheck Version 3.9.4 and to comply with the ma ire ents in the Require men ` ist. 'f'9 James E. Bradley, PE O\ JAMES �y Consulting Engineer E. LAJames 1765 Carnegie Avenue m Name-Title /na0tu ate CIVILNo.24147 Ober 15,2014 9 9 ccQ or. FG/STER� Fss��NAL Project Title: FSS-3036-A/B24x60-Ma-1440Sq-Bus Report date: 10/09/14 Data filename:C:\Users\Kenneth Sapp\Documents\COMcheck\FSS-3036-A\B-24x60-Ma-1440-Sq-BusXX.cck Page 2 of 9 r W ®�® Oct 16, 2014 0 COMcheck Software Version 3.9.4 a m Interior Lighting Compliance Certificate 2009 IECC Section 1: Project Information Project Type:New Construction Project Title:FSS-3036-A1l324x60-Ma-1440Sq-13us Construction Site: Owner/Agent: Designer/Contractor: First String Space Inc James Bradley Pearson,MA 31642 Engineer 912-243-0370 212 Fox Trail Parkesburg,MA 46528 (610)857-2458 s bradley<opustpuffin@outlook.com Section 2: Interior Lighting and Power Calculation A B C D Area Category Floor Area Allowed Allowed Watts (ft2) Watts/ft2 Is x C) Office 1440 1 1440 Total Allowed Watts= 1440 Section 3: Interior Lighting Fixture Schedule A B C D E Fixture ID:Description/Lamp/Wattage Per Lamp/Ballast Lamps/ #of Fixture (C X D) Fixture Fixtures Watt. `Office(1440 sq.ft.) _ -r _ _ _ -. _ AIncandescent1:Incandescent60W: 1 3� 60 180 Linear Fluorescent 1:48"T8 32W:Electronic: 1 36 32 1152 Total Proposed Watts= 1332 Section 4: Requirements Checklist Lighting Wattage: 1. Total proposed wafts must be less than or equal to total allowed watts. Allowed Watts Proposed Watts Complies 1440 1332 YES Controls,Switching,and Wiring:. 2. Daylight zones under skylights more than 15 feet from the perimeter have lighting controls separate from daylight zones adjacent to vertical fenestration. 3. Daylight zones have individual lighting controls independent from that of the general area lighting. Exceptions: Contiguous daylight zones spanning no more than two orientations are allowed to be controlled by a single controlling device. Daylight spaces enclosed by walls or ceiling height partitions and containing two or fewer light fixtures are not required to have a separate switch for general area lighting. I] 4. Independent controls for each space(switch/occupancy sensor). Project Title:FSS-3036-A/B24x60-Ma-1440Sq-Bus Report date: 10/09/14 Data filename:Q11.1sers\Kenneth Sapp\Documents\COMcheck\FSS-3036-A\B-24x60-Ma-1440Sq-BusXX.cck Page 3 of 9 W MOW Exceptions: > ❑ Areas designated as security or emergency areas that must be continuously illuminated. a Oct 16, 2014 0 ❑ Lighting in stairways or corridors that are elements of the means of egress. Q G ❑ 5. Master switch at entry to hotel/motel guest room. Ej 6. Individual dwelling units,separately metered. ❑ 7. Medical task lighting or art/history display lighting claimed to be exempt from compliance has a control device independent of the control of the nonexempt lighting. ❑ 8. Each space required to have a manual control also allows for reducing the connected lighting load by at least 50 percent by either controlling all luminaires,dual switching of alternate rows of luminaires,alternate luminaires,or alternate lamps,switching the middle lamp luminaires independently of other lamps,or switching each luminaire or each lamp. Exceptions: ❑ Only one luminaire in space. ❑ An occupant-sensing device controls the area. ❑ The area is a corridor,storeroom,restroom,public lobby or sleeping unit. ❑ Areas that use less than 0.6 Watts/sq.ft. ❑ 9. Automatic lighting shutoff control in buildings larger than 5,000 sq.ft. Exceptions: ❑ Sleeping units,patient care areas;and spaces where automatic shutoff would endanger safety or security. ❑ 10.Photocell/astronomical time switch on exterior lights. Exceptions: ❑ Lighting intended for 24 hour use. ❑ 11.Tandem wired one-lamp and three-lamp ballasted luminaires(No single-lamp ballasts). Exceptions: ❑ Electronic high-frequency ballasts;Luminaires on emergency circuits or with no available pair. Section 5: Compliance Statement Compliance Statement The proposed lighting design represented in this document is consistent with the building plans, ecifications and other calculations submitted with this permit application.The proposed lighting system has been designed t CC requirements in COMcheck Version 3.9.4 and to comply with the mandat ryry e ents in the Requireme ist. SS James E. Bradley, PH �1 Consulting Engineer OC, JAMES y 1765 Carnegie Avenue g E. N James Clearwater, FL 33756 Name-Title Si to ate CIVIL ri October 15,2014 -09 0.24147 �� FG/ST Fss/GIVAL ECG Project Title: FSS-3036-A/I324x60-Ma-1440Sq-Bus Report date: 10/09/14 Data filename:C:\Users\Kenneth Sapp\Documents\COMcheck\FSS-3036-A\B-24x60-Ma-1440-Sq-BusXX.cck Page 4 of 9 W 0 Oct 16, 2014 p COMcheck Software Version 3.9.4 a m Exterior Lighting Compliance_ a Certificate 20091ECC Section 1: Project Information Project Type:New Construction Project Tile:FSS-3036-AB24x60-Ma-1440Sq-Bus. Exterior Lighting Zone: 3(Other) Construction Site: Owner/Agent: Designer/Contractor: First String Space Inc James Bradley Pearson,MA 31642 Engineer 912-243-0370 212 Fox Trail Parkesburg,MA 46528 (610)857-2458 s bradley<opustpuffin@outlook.com Section 2: Exterior Lighting Area/Surface Power Calculation A B C D E F. Exterior Area/Surface Quantity Allowed Tradable Allowed Proposed Watts Wattage Watts Watts /Unit (B x C) Main entry 3 ft of door width 30 Yes 90 60 Main entry 3 ft of door width 30 Yes 90 60 Other door(not main entry) 3 ft of door width 20 Yes 60 60 Total Tradable Watts*= 240 180 Total Allowed Watts= 240 Total Allowed Supplemental Watts"= 750 Wattage tradeoffs are only allowed between tradable areas/surfaces. A supplemental allowance equal to 750 watts may be applied toward compliance of both non-tradable and tradable areas/surfaces. Section 3: Exterior Lighting Fixture Schedule A B C D E Fixture ID:Description/Lamp/Wattage Per Lamp/Ballast Lamps/ #of Fixture (C X D) Fixture Fixtures Watt. Main entry(3 ft of door width):Tradable Wattage Incandescent 1:Incandescent 60W: 1 1 60 60 Main entry(3 ft of door width):Tradable Wattage Incandescent 2:Incandescent 60W: 1 1 60 60 Other oor(not main entry)(3 ft of door width):Tradable Wattage i Incandescent 3:Incandescent 60W: 1 1 60 60 Total Tradable Proposed Watts= 180 Section 4: Requirements Checklist Lighting Wattage: 1. Within each non-tradable area/surface,total proposed watts must be less than or equal to total allowed watts.Across all tradable areas/surfaces,total proposed watts must be less than or equal to total allowed watts. Compliance:Passes. Project Title: FSS-3036-A/B24x60-Ma-1440Sq-Bus Report date: 10/09/14 Data filename:C:\Users\Kenneth Sapp\Documents\COMcheck\FSS-3036-A\B-24x60-Ma-1440-Sq-BusXX.cck Page 5 of 9 Controls,Switching,and Wiring: C] 2. All exemption claims are associated with fixtures that have a control device independent of the control of the nonexempt lighting. 3. Lighting not designated for dusk-to-dawn operation is controlled.by either a a photosensor(with time switch),or an astronomical time switch. 4. Lighting designated for dusk-to-dawn operation is controlled by an astronomical time switch or photosensor. 5. All time switches are capable of retaining programming and the time setting during loss of power for a period of at least 10 hours. Exterior Lighting Efficacy: 6. All exterior building grounds luminaires that operate at greater than 10OW have minimum efficacy of 60 lumen/watt.Exceptions.ceptions. W RA®`�([� ® � Lighting that has been claimed as exempt and is identified as such in Section 3 table above. 0 Oct 16, 2014 Lighting that is specifically designated as required by a health or life safety statue,ordinance,or regulation. d C a m EJ Emergency lighting that is automatically off during normal building operation. Q p Lighting that is controlled by motion sensor. Section 5: Compliance Statement Compliance Statement: The proposed exterior lighting design represented in this document is consistent with �. ns,specifications and other calculations submitted with this permit application.The proposed lighting system has been desi CC requirements in COMcheck Version 3.9.4 and to comply with the mar it ants in the Requir Ch S 9l' .Tames E. Bradley, PE E. yN Consulting Engineer f Carnegie Avenue O BRADLEY M James Clearwater, rwater, FL 33756 Name-Title natu6r � .24147 Q October 15,2014 FSS�ONAL ENG Project Title: FSS-3036-A/624x60-Ma-1440Sq-Bus Report date: 10/09/14 Data filename:C:\Users\Kenneth Sapp\Documents\COMcheck\FSS-3036-A\B-24x60-Ma-1440-Sq-BusXX.cck Page 6 of 9 f LLI 0 Oct 16, 2014 0 COMcheck Software Version 3.9.4 a rC ¢ v Mechanical Compliance Certificate 2009 IECC Section 1: Project Information Project Type:New Construction Project Title:FSS-3036-AB2440-Ma-1440Sq-13us Construction Site: Owner/Agent: Designer/Contractor: First String Space Inc James Bradley Pearson,MA 31642 Engineer 912-243-0370 212 Fox Trail Parkesburg,MA 46528 (610)857-2458 s bradley<opustpuffin@outlook.com Section 2: General Information Building Location(for weather data): Hyannis,Massachusetts Climate Zone: 5a Section 3: Mechanical Systems List Quantity System Type$Description 2 HVAC System 1(Single Zone): Heating:1 each-Other,Electric,Capacity=36 Muth No minimum efficiency requirement applies Cooling:1 each-Other,Capacity=34 kBtu/h,Air-Cooled Condenser,Air Economizer No minimum efficiency requirement applies Fan System: None 1 Water Heater 1: Electric Storage Water Heater,Capacity:1 gallons w/Heat Trace Tape Installed No minimum efficiency requirement applies 1 Water Heater 2: Electric Storage Water Heater,Capacity:1 gallons w/Heat Trace Tape Installed No minimum efficiency requirement applies Section 4: Requirements Checklist Requirements Specific To: HVAC System 1 None Requirements Specific To:Water Heater 1 0 1. Water heating equipment meets minimum efficiency requirements: No efficiency requirements for water heater with storage capacity less than 20 gallons. 2. First 8 ft of outlet piping is insulated 3. All heat traced or externally heated piping insulated 4. Hot water storage temperature controls that allow setpoint of 90°F for non-dwelling units and 110°F for dwelling units. 5. Automatic time control of heat tapes and recirculating systems present 6. Heat traps provided on inlet and outlet of storage tanks Requirements Specific To:Water Heater 2 : 1. Water heating equipment meets minimum efficiency requirements: No efficiency requirements for water heater with storage capacity less than 20 gallons. Project Title: FSS-3036-AB24x60-Ma-1440Sq-Bus Report date: 10/09/14 Data filename:C:\Users\Kenneth Sapp\Documents\COMcheck\FSS-3036-A\B-24x60-Ma-1440-Sq-BusXX.cck Page 7 of 9 i 2. First 8 ft of outlet piping is insulated LLJ? "�"DC� P 9 3. All heat traced or externally heated piping insulated O OCt 6, 2014 10 4. Hot water storage temperature controls that allow setpoint of 90°F for non-dwelling units and 110'F for dwelling un w C 5. Automatic time control of heat tapes and recirculating systems present a m 6. Heat traps provided on inlet and outlet of storage tanks Q Generic Requirements: Must be met by all systems to which the requirement is applicable: 1. Plant equipment and system capacity no greater than needed to meet loads Exception(s): Standby equipment automatically off when primary system is operating Multiple units controlled to sequence operation as a function of load 2. Minimum one temperature control device per system 3. Minimum one humidity control device per installed humidification/dehumidification system 4. Load calculations per ASHRAE/ACCA Standard 183. 5. Automatic Controls:Setback to 55°F(heat)and 85°F(cool);7-day clock,2-hour occupant override,10-hour backup Exception(s): Continuously operating zones 6. Outside-air source for ventilation;system capable of reducing OSA to required minimum 7. R-5 supply and return air duct insulation in unconditioned spaces R-8 supply and return air duct insulation outside the building R-8 insulation between ducts and the building exterior when ducts are part of a building assembly Exception(s): Ducts located within equipment Ducts with interior and exterior temperature difference not exceeding 15°F. 8. Mechanical fasteners and sealants used to connect ducts and air distribution equipment 9. Ducts sealed-longitudinal seams on rigid ducts;transverse seams on all ducts;UL 181A or 181E tapes and mastics 10.Hot water pipe insulation: 1.5 in.for pipes-1.5 in.and 2 in.for pipes>1.5 in. Chilled water/refrigerant/brine pipe insulation: 1.5 in.for pipes-1.5 in.and 1.5 in.for pipes>1.5 in. Steam pipe insulation: 1.5 in.for pipes-1.5 in.and 3 in.for pipes >1.5 in. Exception(s): Piping within HVAC equipment. Fluid temperatures between 55 and 105°F. 0 Fluid not heated or cooled with renewable energy. Piping within room fan-coil(with AHRI440 rating)and unit ventilators(with AHRI840 rating). Runouts<4 ft in length. D 11.0peration and maintenance manual provided to building owner 12.Thermostatic controls have 5°F deadband Exception(s): 0 Thermostats requiring manual changeover between heating and cooling Special occupancy or special applications where wide temperature ranges are not acceptable and are approved by the authority having jurisdiction. 13.Balancing devices provided in accordance with IMC 603.17 14.Demand control ventilation(DCV)present for high design occupancy areas(>40 person/1000 ft2 in spaces>500 ft2)and served by systems with any one of 1)an air-side economizer,2)automatic modulating control of the outdoor air damper,or 3)a design outdoor airflow greater than 3000 cfm. Exception(s): Systems with heat recovery. Multiple-zone systems without DDC of individual zones communicating with a central control panel. Systems with a design outdoor airflow less than 1200 cfm. Spaces where the supply airflow rate minus any makeup or outgoing transfer air requirement is less than 1200 cfm. 15.Motorized,automatic shutoff dampers required on exhaust and outdoor air supply openings Exception(s): 0 Gravity dampers acceptable in buildings<3 stories 16.Automatic controls for freeze protection systems present 17.Exhaust air heat recovery included for systems 5,000 cfm or greater with more than 70%outside air fraction or specifically exempted Exception(s): Hazardous exhaust systems,commercial kitchen and clothes dryer exhaust systems that the International Mechanical Code prohibits the use of energy recovery systems. Systems serving spaces that are heated and not cooled to less than 60°F. Project Title:FSS-3036-A1B24x60-Ma-1440Sq-Bus Report date: 10/09/14 Data filename:C:\Users\Kenneth Sapp\Documents\COMcheck\FSS-3036-A\B-24x60-Ma-1440-Sq-BusXX.cck Page 8 of 9 r • ❑ Where more than 60 percent of the outdoor heating energy is provided from site-recovered or site solar energy i p Heating systems in climates with less than 3600 HDD. QCt 16, 2014 Cooling systems in climates with a 1 percent cooling design wet-bulb temperature less than 64°F. d C a m Systems requiring dehumidification that employ energy recovery in series with the cooling coil. Q p Laboratory fume hood exhaust systems that have either a variable air volume system capable of reducing exhaust and makeup air volume to 50 percent or less of design values or,a separate make up air supply meeting the following makeup air requirements: a)at least 75 percent of exhaust flow rate,b)heated to no more than 2°F below room setpoint temperature,c)cooled to no lower than 3°F above room setpoint temperature,d)no humidification added,e)no simultaneous heating and cooling. Section 5: Compliance Statement Compliance Statement: The proposed mechanical design represented in this document is consistent with the buildin I lions and other calculations submitted with this permit application.The proposed mechanical systems have been desig CC requirements in COMcheck Version 3.9.4 and to comply with the mandato E. ments in the Requirements 0 stJAMES q�'y g James E. Bradley, PE c BRADLEY Consulting Engineer Rt James 1765 Carnegie Avenue 6ieaxvaGa�-33�56 y Name-Title Sig ure .o No.24147 Q Section 6: Post Construction CompliaMe5"IfiJAMlent TER�N�`�`�` 4NAL HVAC record drawings of the actual installation,system capacities,calibration information,and performance data for each equipment provided to the owner. HVAC OEM documents for all mechanical equipment and system provided to the owner by the mechanical contractor. Written HVAC balancing and operations report provided to the owner. The above post construction requirements have been completed. Principal Mechanical Designer-Name Signature Date Project Title: FSS-3036-A/B24x60-Ma-1440Sq-Bus Report date: 10/09/14 Data filename:C:\UsersWenneth Sapp\Documents\COMcheck\FSS-3036-A\B-24x60-Ma-1440-Sq-BusXX.cck Page 9 of 9 BARMABLE, Town of Barnstable Regulatory Services Richard V.Scali,Interim Director .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 Property Owner Must Complete and Sign This Section If Using A Builder I, John W. Juros, AIA, Town Architect ,as Owner of the sub)ect property hereby authorize Vanguard Modular Building Systems, LLC to act on my behalf, in all matters relative to work authorized by this building perinitapplication for: 617 Bearses Way, Hyannis, MA 02601 (Address of Job) /OA9 i V i ture of O ner Date 014m J J fZ S Print Name If Property Owner is applying for permit;please complete the Homeowners License Exemption Form on the reverse side. f Commonwealth �of Massachusetts Manufactured Buildings Program—Plan Identification Number Assignment Name of Manufacturer FIRST STRING SPACE MC Identification Number 446 Third Party Identification Number 14 Project Title FSS-3036-A/B-24x60 Use croup B BBRS\DPS Identification Number 0511 Q V-14 Review by Program All plans are reviewed by MA and should be Director Required stamped as below when approved Date: 11/12/14 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. 'T ACC8P7EQ MASSACHUSETTSMANUFACTURED BUILDINGS FROORAM STATE BOARD OF UILDINGS RE O MIONS STANDARDS jZ13JECT DAT0 THIRD RICATION ONLY Thank you for your cooperation with this matter. TO FURY. ER REVIEW.. Send all correspondences,inquiries and plan revisions to: BBRS/Dept.of Public Safety Linda Shea 1380 Bay Street Building B Taunton,MA 02780 Bbrs\forms2\manufacturedbldgplanid—June 30,2009 v Topofl-Bean Edstfng FoutFoundationA-2 a a1.8 tt7' - ••• . ncmto 1>rocka } Wet Typo"A*(W) Top of FcundaUon 3 3/ Ar-14 Reyufretl - I ® �®� ((. Ell T 1A� Too of Foundmfon 11�f F.aiat4g B Acha¢G \ II I I t I O `Fa mdatlon § Foundation 4YGr-II b \\) bBeam#a 3-3W atwvo foundfftm wag i it _ 3 I 2 EO.BAYS. �a t ertall Exis Found d.. Plan -7�4.8"UF6R.Fig, C Scale: rion -0, A 2 Scale:W.1'-0 Fwgimmn p6w.Shoe!t of a A-2 Scale:t'a t'0 OuMm of New Trailer Outfom of New Trager _ Fawufmfon..Wall _ Catagte oww- - nma � f 0. EE Foc" .. 3 r Foandatlon Section West to East I Osalhn3 of NOW T141Nr OAS"of Ne.Ttagat.:, t mwd Tap of FBesm Top of foundation - Orioutttl Q :m i oumintas plan e Dmpga Hof MA � G, o 5to� Footing Foundation Section Nw1h to South A'2 Ld A-z Scale:W 1*-0* it - d TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel LJ v Application # C)D y10 7a6 Health Division Date Issued /o-z` -11-t' Conservation Division Application Planning Dept. Permit Fee J Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address.. Village W A-M N 6 S Owner 0f J551'' &C Address 61 Telephone S015 -�7 q0 &?JY�2 Permit Request DEMO f0(2- LOU-'Ce Val Lluk)(IH` (L`R, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay "„ h -*Project Valuation ✓ Construction Type E Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting docume'(;atior Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes 9tNo On Old King's 14ighway:_ Q Yes,- No � � Basement Type: ❑ Full ❑ Crawl ❑Walkout O.Other TPA(� 1 I�t 1 r A 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) `.�� tic/ �t+t►Ycr=�25 32�j ``r3I12_. Name Telephone Number Address 2 i�u�-caa ��— \�CY License # C s o( 22 00( Home Improvement Contractor# 1 Email Offa:ka robP(+r h I OS 1))6, (C)M Worker's Compensation # (��i�i r4► �� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �� DATE \C 2< FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED F" MAPS/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: ti FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL-: ROUGH FINAL PLUMBING: ROUGH -FINAL ` GAS: ROUGH FINAL r FINAL BUILDING; $ DATE CLOSED OUT €_ ASSOCIATION PLAN NO. i - 27te CanwmawaIM ofHassachustg Dqw&g rgfhzdrrsfti- d Acciden-& e ' 600 iYmhiqgoa Street Boskw,MA 02 wnwanamgmaldia Worke& CampensatianLmuranceAffidavit:$ldlders/Cantractors/Dec.td.ciansTlumbers Applicant Information Please P'rir I ibly Na=c iQ �: DAY V f / e-w. I Z CDOCC P, i\�k� \i\J I tsta&zip: V , Deg�) 15 14 h 26 X Phone g-- Are you an employer?Checkthe appropriate be= T of o ect r L❑ I am a employer with 4 �C=hireathe a ge�$1 contractor and I 6— N�a f o es fall and/or *. � Ye { pMt-��-) 7. Food ing 2_❑ I am a sole propietar orpartner- listed on the attracted sheer ❑ �-a ship and have no employees These snb�ntrarrs have 8. ❑Demolition worming forme is any Capacity. employees and have workers' 9. El Building addition [No wor�ELS' comp.mmnmce Comp.m¢rtrar� �°ue&1 5. ❑ We are a corporatimand its 10�Electrical repairs ar additions I❑ I am a hvmwwner doing all worli officers have exercised their I I-0 Plumbing repairs or additions myself [No workers'comp. right.of exemption per MGL 12-0 Roof insaimce T C_15Z§1(4},andwehaveno repatzs r -] 13_❑other mil -[No workers' comp-insurance required.] "lkxtys pli at&atchecksboatltmstalsoflloutthe sectionbeiowshming['he vTi rwolken,rompensationpcpinf�utc i£o-meowners who snbm it tbis s av't i cstiag they are damg sII z=�I-erg tlM t,;re thu l&e contractors Est submit a new sffidsc t ink mrh tCznt cmrs that check this box must sttarhed sa:rldific al sheet showh g the name of the sorb-mxtmclon and state vrbether wxnotihose emibeshave uVWyees. If the employees,they Tut pzwide then warps'comp.p alley mmbrr. I am arz employer that is protadfzrg itorkers-eongxznsat%a.n izmzrrutce for rtzy emplayem 13eICw is fhapaEcy and job site 27ifotYftQ2iGrtL lns: nCe CompatryName: L J lxohcp;#arSeLf-sns_Iz� (�, U �b cJqq��� Fxplsats9lLDate: / Job Sit--Aidd ess:w Cit 4State/Zip S Attach a copy of the workers'compeusati,on policy declaration page(shoving the policy number and exp?ratwn date). Failttre to secure:coverage as requiredundes Sectioa 25A of MGL c 152 can lead to the imposition of criminal penalties of a fine up to$I.50G.OG and/or one pearim as well as c i%il penalties in ihe foam of a STOP WORK ORDER-and a$nor of up to V-50.00 a day against the violator. Be advised That a copy of this statement maybe f xvwded try the Office of Ifrve*ptions of the DIk fnr insmanm coverage verifzcation- I do hereby underMT widpenah!&s t fpet,Jurp that the in f orr t67a prinide£abmra i s 6ua and correct Si tore: n4u) , Bate: Pbom o- E;ftiol use only. Da not wri&in th&area,tar be completed by cit or town o ic&L City or,Tows• PermWLicense# L-,�Amtharity{circle oney: . L Ba2ird of Health 2.Ruff&ug Depa lmeut 3.Cityfrawn O=k 4_Elect rical Inspector 5.PhrmbingEupector 6.Other Contact Person: Phone#_ 6 Wormation and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant-tn this statute,an employee is defined as"_.every person in the service of another under any contract ofhire, express or implied, oral or wiitte&" . 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 e employer,-or th receiver or trustee of an individual,pariaesbip,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides thereir�or the occupant of the dwelling house of another who employs persons to do mainteaaace,construction or repair work on such dweUiag 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((7 also states that"every state or Iocal 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 in su ante requirements of this chapter have been presented to the contracting authority." Applicants Please fim out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certi_ricaie(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(I.LP)withno 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 maybe submitted to the Department of Industrial Accidents for confirmation of in m-ance 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 12 you are required to obtain a arorkers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insura:a=license number on the appropriate line. City or Town Officials . Please be see 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 ye m ar.Where a hoe owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidayit 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: ao Gomm aawWth of Massachusetts Depa�ment of In&usizia1 Aocideats Gff!Ve of kyf,-�gatFGrui Wo Washingtan Bastda.,MA Q21 I I Tel.#617 727- )5 W±06 or 1-977 MASSAFE Revised 4-z4 D7 F # f 17-` 27- 49 m=,gov/dia r Client#: 123398 ROBERTCHIL1 YYYI() ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDI E(MMIDDI 110212014 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 NpMEA Suzy Prouix HUB International New England PHON 505-235-2283 222 Milliken Blvd E a° Arc,N°: 866-841-4930 ADDRESS: Susan.proulx@hubintermational.com Fall River,MA 02722 INSURER(S)AFFORDING COVERAGE NAIC# 508 235-2200 INSURER A:Acadia Insurance Company 31325 INSURED INSURER B:Union Insurance Co 25844 Robert Childs,Inc. INSURER C PO Box 1431 169 Great Western Road INSURER D: INSURERS: South Dennis,MA 02660-1431 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 CONTRACTOR 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. LTRR TYPE OF INSURANCE NSRL SUBR WVD POLICY NUMBER MM/LDID E (MMIODNYM EXP LIMITS B GENERAL LIABILITY CPA019895017 D110112014 01101/2015 EEACMH�OECTCURRENCE $1 0009000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea orrNTEence $250,000 CLAIMS-MADE 51 OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY X JEa X I LOC $ BINED A AUTOMOBILE LIABILITY MAA019895116 1/01/2014 01/01/201 Ea accident SINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per aaadent A X UMBRELLALIAB X OCCUR CUA019895217 1/01/2014 01101/2015 EACH OCCURRENCE $1,000,000 EXCESS UAB CLAIMS-MADE AGGREGATE $1,000,000 DED I I RETENTION$ $ A WORi�RSCOMPENSATION WCA031676514 1/01/2014 01/01/201 X WORYAMI Ea AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y r N E.L.EACH ACCIDENT $5OO OOO OFFICER/MEMBER EXCLUDED? � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS belovu E.L.DISEASE-POLICY LIMIT $500,000 A inland marine CPA019895017 1/01/2014 01/01/201 leased/rented equip$100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Town of Barnstable is listed as additional insured with respect to general liability as required by written contract. CERTIFICATE HOLDER CANCELLATION ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ,^ 'Dept.of Public;Works "' ACCORDANCE WITH THE POLICY PROVISIONS: 230 South Street: = Hyannis,MA 02601:0000 AUTHORIZED REPRESENTATIVE u c CORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1' The ACORD name and logo are registered marks of ACORD #S1051469/M1050695' SP002 Oct 22 14 12: 46p Turtle Rock 5083750303 p. 2 Client#:23554 WYNGE DATE JMWDDrmY) ACORD. CERTIFICATE OF LIABILITY INSURANCE _I 1012212014 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 poliey(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 ,NAME _ Sullivan Insurance Group,Inc. PHONE 'F�-5087973689 A/C Noel;508 791-2241 iAA1C.±aJ: _ 10 Chestnut Street AOAIIEss: —�- Suitt)1010 iNSURER(S)AFFORDING CCVERAGE Worcester,MA 01608.2804 'INSURER SURER A!Travelers —^� ^ I INSURED INSURER_8: David W. Lammers dba INSURER C: Wynot's General Contractors --"i INSURER D: _---- 12 Buccaneer Way — 1NSURER E West Dennis, MA 02670 INSURER F �- COVERAGES CERTIFICATE NUMBER. REVISION NUMBER: _ 'iIS IS TO CERTIFY THAT THE POLI IES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHiCH THIS CERT'FICATE MAY BE ISSUED OR MAY FERTAIN, THE RSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, _ INSR S OF UBRI POLICY F POLICCY- LIMITS LTR TYPE OF INSURANCE ly yyVO POLICY NUMBER MMIDDIYYI MM1DClYYYY_ _ GENERAL LIABILITY j I c.4CH OCCURRENCE COMMERCIAL GENERAL LlAB!L!TY -O0-gqMMpp��EE77 RENTED . i pREMiSES Ea occurrance i 5 !"LAMS-MADE OCCUR I I MED EXP iAny one oerson) *5 _-_- I PERSONAL&ADV INJURY 8 '(�GENERAL.AGGREGATE 8_ GERL AGGREGATE LIMITAPPLIES PER: I ! 'PRODUCTS-COVP/OPA f PRO• __ FUtIC'I I JECT 1 C_D_C --•-f---- { ------"-j�— -.--�--- C ;JcD•- SINGLE LIMIT I AUTOMOBILE LIABILITY — I I IEa accident) I lANY AJT0 BODILY INJURY(Per person) $ _— F—I ALL OWNED SCHEDULED - BODILY!NJURY)Per accident) S AUTOS I AUTOS - NON-OWNED PROPERTYDAMAGE NiREG AUTOS ( AU7C5 { I. Per accoen: I$ _ - UMBRELLA LIAe -I OCCUR I EACH OCCURRENCE xcEsa UAB AGGREGATE ET _$ fDEO ENTIONS A �61`11UIBOB05444613 -- WORY,ERS COMPENSATION j 6/1812014 06118P201 X WC'STA,LI Vi '' IEDRTH-t--IL- _ AND EMPLOYERS'LIABILITY ANY PROPRIETOMPARTNER'EXECUTIVEI�-Y�-II N��I E.L.aACH ACCIDENT !$100 000 OFFICERIMEMBER EXCLUDED? I N,IN I A! (MandatorylnNMI —I I E_.L,DISEASE-EAEMPLCYEE 51Do000 i[ppes.deactlbe under r DESCRiPTIGV OF OPERATIONS below EA.DISEASE•POLICY LIMIT S5®3,dO0 _ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Artach ACORD 101.Additional Remarks Schedule,If more span Is required) Evidence of Insurance I CERTIFICATE HOLDER CANCELLATION _ Robert Childs Inc SHOULD ANY OF THE ABOVE 7E$CRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED N P.C.Box 1431 ACCORDANCE WITH THE POLICY PROVISIONS. South Dennis,MA 02660 AUTHORIZED REPRESENTATIVE - 0 1988.201C ACCRD CORPORATION.All Tights reserved. ACORD 25(20%05) i of 1 The ACORD name and logo are registered marks of ACORD NS232912PM232760 LNC of BAaNSTW"MA- • �� Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Strom Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 F=- 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I *I&2 '� ,as Owner of the subject property P Pay hereby authorize V 1p L 4/n*7�9 r. to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) l C( Signature o Owner -- 2� -- ����yA.✓ �u zcry Pant Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:1UsersldemlliklAppDataU-ocalM=softlwindovrs\Temporary Intenet FilcslContenLOudookAQRE6ZUBME)TMS.doe Revised 053012 national iron October 10, 2014 RE: 617 Bearses Way Hyannis This letter is to notify you that the gas service located at 617 Bearses Way in Hyannis, Ma was cut off at the property line on 10/10/14 ljjank you, eamey Gas Customer Fulfillment National Grid 40 Sylvan Road Waltham, MA 02451 ' J V�e rp2Jrv�1�O�rZCoca;GC�a�C%/�G�iJocrc'I UJ�GLd-I - Office of Consumer Affairs&.Business Regulation. .. ME IMPROVEMENT CONTRACTOR; j e egistration: ,,1`08082 Type: xpiration:,;_.8/12L261,6_., Individual DAVID W LAMMERS , '" I David Lammers ; 12 BUCCANEER WAY yQ� W. DENNIS,MA 02670 `- Undersecretary k r 1 Massachusetts - Departmentof:Public,Safety e' � 1 Board,of Building_Regulations antl.'Standards 1 k Constrbt�.tion Sups r��eor "�` License: CS-012209-' j DAVID W LAMM_:RS ',•� `r*' t� a 12 BUCCANEERUA West Dennis MA 702670 A. r� ` Ezpiratioli . Commissioner .0111112016 , �` ------------- , it Existing structural Existing Foundation y frame to remain to remain Remove BUIIQresd —_— —— — ———— —— --—— , doors and walls II I �I I - II II II III I II II II II I a I I I I I I Existing Bulkhead I I I I Foundation to remain I II I II II II yo c I� II II II il. III > > II II II II I CO�,2r?3 I p.o I I Ocym IJIr �r a n2o xiating Traller(outline) O O to be removed NOTE: 1 Existing Support Plan DemollOon work to be done under " q_Z 114'.1'-0' separate mntract by owner. c 0 O a �. U ti c p• 02 8'-1112" 7 ~ 42W 12" 34'-11 1/2" i Q —28'-11 12' rd o �i g 23'-21/2' ,1'-4 12 A -3 1117m= .3"typ, �. Foundation Plans 3'-4112 �'g" ry NNew Trailer Ground Ground Provide New Skirt - Around Exising Foundation ." Using Footings Existing Concrete Block 18'x 3'x 8"Concrete Block Support Foundation to Remain Owl Z Existing Foundation Plan 3 Section A A-2 q_� 1/4'm 1.-0" q-2 1f4'a r-o" - - -- � • - nrn1rnlo Y(AItM JY6ItM 96118 P. 001/002 Department of Public Works 47 Old Yarmouth Rd. P.O.Box 326 �► Water Supply Division Hyannis,MA. TEL:508-77S4063 NAM es� �.� Hyannis Water System Operations FAX:50&790•1313 Via Facsimile#508-790-6325 October 16, 2014 Town of Barnstable Building Inspector Town Hall Hyannis,MA 02601 RE: 617 Bearses'Way(Locker Building)Hyannis—ACCT#604152-1 Dear Sir: Please be advised that the above water service was shut off and the meter#83916921 removed. The water service at the above address is going to be cut and capped by Robert Child Trucking. The town has informed us that the building is going to be demolished. If you have any questions,please call the office at(508) 775-0063. Sincere Kishan(Chris)Manhas Hyannis Water System C/C Edward Engelsen Chief Plant Operator Town of Barnstable Water Pollution Control Division Facsimile: 508-790-6325 C/C Peter Doyle DPW 617 Bearses Way Hyannis Ma Facsimile: 508-790-6325 1vhlbYrab.r•ti.etdr.r�e Operated and Malntatned by WhlteWaw.Inc.and Panntchuck Water Services Corp. �DVANTAG YO(!R ftEC7y@IgCAt CONTRACT/NB Roger A Medeiros Advantage Electric, Inc. Hyannis,MA 02601 October 17,2014 Edward Engelsen Water Pollution Control Division 617 Bearses Way Hyannis,Ma. 02601 This letter is to inform you that all electrical connections to the trailer located at 617 Bearses Way have been disconnected. If you have any questions,please feel free to call or email me. Respectfully submitted„ r Roger A Medeiros` Advantage Electric,Inc. . 508-428-1231 office 508-428-1231 fax ramedeiros@comcas.net ADVANTAGE PROJECT • NAME:����0� —' ADDRESS:&/ ll s, PERMIT#�" DATE: l M/P: LARGE ROLLED PLANS ARE IN: BOX SLOT I DATE: q/wpfiles/archive , i a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION p 01 ] Application# Ma Parcel � I joojo,53 Health Division Conservation Division Permit# Tax Collector Date Issued 3 Treasurer Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address (� �'� ��► t2 S�,� l��A Village Ay(^k V1,� � C Owner i OW v\ LZ I R—t-A Kt _ Address Telephone r/ i u i v� Permit Request v1_kn Square feet: 1 st floor:existing proposed 2nd floor:existing proposed k'_16 Total new l 3 Zoning District Flood Plain Groundwater Overlay Project Valuatio b,GCX_�_0(-)Construction Type ►/l � � C,�v��Qc�� 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 °ew Number of Bedrooms: existing new 'Y Total Room Count(not including baths):existing new First Floor Room Count rL U Heat Type and Fuel: ❑Gas ❑Oil Electric LJ Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/cial 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_O Commercial -❑-Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION`-' Name c�IATF-e.W��. g-_VA L�!n kF 2L-,A C. Telephone Number Address SR_g%oA ft(� SF w ce rv\ N License# -7 `7 �3 E3: _ Home Improvement Contractor# C -iR-L)crI Q,-A V iS,0 tom—Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE 2 (� t" FOR OFFICIAL USE ONLY PERMIT NO. R DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE i OWNER f DATE OF INSPECTION: I i FOUNDATION FRAME INSULATION FIREPLACE I I � 3 ELECTRICAL: ROUGH FINAL i PLUMBING: ROUGH F FINAL , GAS: ROUGH FINAL ` FINAL BUILDING DATE CLOSED OUT ' f7 i ASSOCIATION PLAN NO. s G . J M fi s -� V-9 �v I_Al p `1l S C C or : VIJ3S — • V r. 06/07/2007 03:59 7819333506 IEC PAGE 01 The Commonwealth of Massachusetts Department of Indrtstrial Accidents Duce of Investigations. 600 Washington Street Boston,MA 02111 www massgov/dia Wo><kers' Compensation Insurance A.ffiidavit: Builders/Contractors/F-lectricians/Nlumbers ADP 'c Information leas Print Le 1 Name (Bu4mswDrgani7adodlt&viduai)- Interstate Engineering Corp. Address: 193 Jefferson Ave. City/State/Zip: Salem,, MA 01970 Phone#: 978-744-8883 Are you an employer? Check the-appropriate box:. Type of project(required):' 1.❑ I am a employs with 4. I am a general oontracaor and I 6. 0 Ne w eo'nstrudon emrQlc yoes (full and/or part-time).* have:hired the 5Vb-contractor15 7. EIRcmodcling 2.Q 1 am a sole proprietor or paormer- listed on the attrtchcd sheet I ship and have no employees l iese sub-contractors have B. [] Demolition working for me in any capacity. workers' comp. bouiance. 9. Building addition [No workers' comrp. insurance 5. El we are a corporation and its 10.0 Electiical repairs or additions regtlirod] of5ccr's have exercised their 3.❑ I am a homeowner doing all work right of cxcmq�tion per MGL 17.0 Plumbing rcpails or additions myself. [,No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs bnurance t employees. [No workers', required.]. comp.insurance roquIIod] 13.[] Other . •Any applicant fiat chedw box*1 nma also fill oid the seat®below mhowbeg flew wor1w='aowPeo=nioa policy infotw%APw t Hon mimmt Who mubtmt fWa sfdevit iz is timj tray an doing eM work and then bee outside oonvacton must subudt anew.Mdsvit such tCamnonon that Wheel*Lis bog nual etaobed an additiamal sheet abcdma fie rem of Ste sub-coeftb on mud tbsnr wodws'oomp.policy iafarnratiM I ant an employer that is providing workers'compeesarion insurance for my employees'Below Is the policy and fob site information. . IDst met C=Vany Nam; NorGUARD Insurance Company Policy ii or Self-ins.Lic..#. INWC801715 Expiration Date: 10/1/07 Job Site Addresa: l City/Statrfl0Y•Q►yli/kL1 K 1R_�?'2_GQ I Merck a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Scction 25A of MGL e. 152 caoo lead to the imposition of criminal penaltics of a floc up to S.1,500.00 and/or ono-year finprisonment, as well as civil penalties in'thc form of a STOP WORK ORDER and a fine, of ijp to$250.00 a day against the violator. Be advised that it copy of this statemcnt maybe forwarded to the Office of Investigations of the DIA far insurance coverage verification. I do hereby certo under the slur a penalties ofpe►fury that the information provided above h true and correct tnae r D. 7/20/07 SifMA Debora Lamou x, ice r. . �itc�nr At 978-744-8883 QAOff siucial.use only. Do not write In thh area,to be co►aplded by city or town of)'ieipL City or Tonne: Permit/I.lcense# Issuing Authority(circle one)[ 1.Board of Health Z.BuAdtng Departmestt 3.Ctty/Yowa Clerk 4.Electrical Lmpoctor s.rrwmblug Ynapator 6.0ther Contact Person: Phone 0: ✓lie C�o�ea o��/UGaaaac�uc6e�6 ^;I BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number'.',,CS"<. 077885 ? Expires 08/3112Q08 Tr.no: 1780.0 Restricted RUSSELL HAZEL"ON PO BOX 1976 "J G— N FALMOUTH, MA 02556 Commissioner s1 DATE(MMA]OIYYYV) - • s _ '�ACORD Dou CERTIFICATE OF LIABILITY INSURANCE INOR1 TE 7 07/23/07 SOD_ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION "3 y ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE r 'HUB International New England HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR } 299 Ballardvale St ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Wilmington III 01887 .Phone: 978-657-5100 Fax: 978-658-9185 INSURERS AFFORDING COVERAGE NAIC# NsuRED NEURERA: Travelers Insurance Co. N �' INSURER B: EastGuard interstate Engineering Corp. INSURER c: 193 Jefferson Ave. PO Box 687 INSURER D: Salem MA 01970 INSURER E: , COVERAGES THE POLICIES OF INSURANCE LISTED BELOW RAVE 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 RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POUCHES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DDL POLICY EFFECTIVE POUCYEXPiRAT10N LIMITS LT., NSRD TYPE OF INSURANCE POLICY NUMBER DATE(MMMD DATE(MMIDDNY) EACH OCCURRENCE E 1000000 GENERAL LIABILITY DAMAGETORENTED 300000 A X X COMMERCIAL GENERAL LIABILITYDT-CO-463D8853-IND-06 10/01/06 10/01/07 PREMISES(Ea E - CLAIMSMADE OCCUR MED EXP("-s Perron) E 5000 X Addl Insured PERSONAL S ADV INJURY E 1000000 X Waiver of Subro GENERAL AGGREGATE E 2000000 ` PRODUCTS-COMPIOP AGG E 2000000 GENL AGGREGATE LIMIT AP PLIES PER: - PR6 LOc Deductibl 2500 POLICY X JECT- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT E 1000000 A XX ANY AUTO DTAP-a30-e63Da085-TIL-06 10/01/06 10/01/07 (Eaaeaaem) ALL OWNED AUTOS BODILY INJURY E (Per person) SCHEDULED AUTOS HIRED AUTOS - - - BODILY INJURY (Pe-eddenl) NON-D.DAUTOS _ PROPERTY DAMAGE E • Ali (Perecd&.0 AUTO ONLY-EA ACCIDENT E GARAGE UABILITY EA ACC E ANY AUTO • OTHER THAN AUTO ONLY: AGG E EACH OCCURRENCE E 10000000 EXCESSIUMBRELLA LIABILITY A X X OCCUR ❑CLAIMS MADE DTa eeM...TT-TITS-oho 10/01/06 10/01/07 AGGREGATE E 10000000 S E DEDUCTIBLE E X RETENTION E 10000 WC STATU- OTIR- ..ERSCOMPENSATIONAND X TORY LIMITS ER EMPLOYERS'LIABILNY INWC701060 10/01/06 10/01/07 E.L.EACH ACCIDENT E 500000 B ANY PROPRIETORIPARTNEIVEXECUTVE OFFICEREMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE E SOOOOO IM It yes.Cesv sUM' © E.L.DISEASE-POLICY LIMIT E 500000 SPECIAL PROVISIONS Eebw OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Project: Hyannis WPCF improvements Project Additional Insureds: Town of Barnstable and Stearns 6 Wheler, LLC CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION - DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Town of Barnstable IMPOSE NO OBLIGATION OR LIABILITY OF ANY MIND UPON THE INSURER,ITS AGENTS OR 367 Main Street H REPRESENTATIVES. Hyannis MA 02601 A RE Arn ACORD 25(2001/08) ©ACORD CORPORATION 1988 IMPORTANT =,L If the certificate holder is.an ADDITIONAL INSURED,the policy(ies)must be endorsed.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s),authorized representative or producer,and the certificate holder,nor does it affirmatively or negatively amend,extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2001/08) lat AcoRD E{MI; �`�R C: M®nF P°ROP�ER{T�Y�INSURANIC�EOp 07/23/07 ID OU DATE(Mh4OD YY( FRIE'S EVIDENCE THAT INSURANCE AS IDENTIFIED BELOW HAS BEEN ISSUED,IS IN FORCE,AND CONVEYS ALL THE RIGHTS AND PRIVILEGES AFFORDED UNDER THE POLICY. PRODUCER PHONE/FAX (A/C,No.Exli;978-657-5100 1978-658-9185 COMPANY HUB International New England St.Paul. Ins•. Co. - 299 Ballardvale St Wilmington MA 01887 Michael Oleson CODE: SUBCOOE: AGENCY CUSTOMER ID INTERI7 INSURED LOAN NUMBER POUCYNUMBER Interstate Engineering Corp. BINDER/BARNSTABLE Any/All SubContractors EFFECTIVE DATE EXPIRATIONDATE CONTINUED UNi1L 193 Jefferson Ave. PO Box 667 07/20/07 01/20/09 TERMINATED IF CHECKED Salem MA 01970 TMS REPLACES PRIOR EVIDENCE DATED: LOCATIONIDESCRIPTION 001 Hyannis WPCF Improvements Project 617 Bearse's Way Hyannis MA 02601 CGVERAGFJPERILS/FORMS AMDUNTOF INSURANCE DEDUCTIBLE Hard Costs Limit 6,155,000 2,500 Temporary Storage 250,000 2,500 Transit 250,000 2,500 Flood 2,500,000 50,000 Earthquake 2,500,000 25,000 . Wind and Hail - Deductible 3% w .. . °aEMARKS Includin S'ci C tlrtionsMAP & • t £a fw x Equipment Breakdown Coverage (Startup 6 Testing) Included Occupancy Clause Included x - - sCANCEL'LATION THE POLICY IS SUBJECT TO THE PREMIUMS,FORMS,AND RULES IN EFFECT FOR EACH POLICY PERIOD.SHOULD THE POLICY BE TERMINATED,THE COMPANY WILL GIVE THE ADDITIONAL INTEREST IDENTIFIED BELOW 30 DAYS WRITTEN NOTICE,AND WILL SEND NOTIFICATION OF ANY CHANGES TO THE POLICY THAT WOULD AFFECT THAT INTEREST, IN ACCORDANCE WITH THE POLICY PROVISIONS OR AS REQUIRED BY LAW. NAME AND ADDRESS MORTGAGEE ADDITIONAL INSURED, LOSS PAYEE X -pro•ect Owner - Town of Barnstable LOAN# 367 Main Street AUfNORDTDRREEEPPRESENNTTAATIIVEE Hyannis MA 02601 - a...� f Workers' Compensation and Employer's Liability Policy U ARD NorGUARD Insurance Company - A Stock Company SURANE Policy Number INWC801715 Renewal of NEW GROUP NCCI No.[25844] ----- ---- —_--_ — ---- Policy Information Page [1] Named Insured and Mailing Address Agency INTERSTATE ENGINEERING CORP. HUB INTERNATIONAL NEW 193 Jefferson Ave. ENGLAND P.O. Box 687 299 Ballardvale Street Salem, MA 01970 Wilmington, MA 01887-1013 Agency Code: MAMCCA10 Federal Employer's ID 04-2272323 Insured is Corporation Risk ID Number 000128153 Locations on Policy (1-2) 2200 North Federal Hwy #223, Boca Raton, FL 33431 (04/01/2007 - 10/01/2007) ---..................................._..----._......_...- -.............--..._.....- _......._..._......._....:...-------....--_....... ........._.......... [2] Policy Period From April 01, 2007 to October 01, 2007, 12:01 AM, standard time at the insured's mailing address. 1 [3] Coverage A. Workers' Compensation Insurance - Part One of this policy applies to the Workers' Compensation Law of the following states: Florida, Massachusetts B. Employer's Liability Insurance - Part Two of this policy applies to work in each of the states listed in item [3]A. The limits of our liability under Part Two are: Bodily Injury by Accident - each accident $500,000 I Bodily Injury by Disease - each employee $500,000 Bodily Injury by Disease - policy limit $500,000 C. Other States Insurance - Part Three of this policy applies to all states, except any state listed in item [3]A. and the states of North Dakota, Ohio, Washington, West Virginia, and Wyoming. D. This policy includes these endorsements and schedules: See Extension of Information Page - Schedule of Forms [4] Premium The Premium Basis and therefore the premium will be determined by our Manual of Rules, Classifications, Rates, and Rating Plans. All required information is subject to verification and change by audit. (Continued on.another page) Total Estimated Policy Premium 11,309 Total Surcharges/Assessments $ 572 Total Estimated Cost $ 11,881 INTERNAL USE M6 Page - 1 - Information Page MGA : INWC801715 WC 000001A Date : 05/14/2007 MANOTE 16 South River Street*P:O. Box A-H•Wilkes-Barre, PA 18703-0020•www.guard.com I 1 L Subcontractors for the Barnstable, MA project. Anchor Excavating Adan Corp. Precision Steel Placers Heritage Iron Works P.J. Riley & Company, Inc. Wayne J. Griffin Electric, Inc. Ite: 8/28/2007 Time: 4:16 PM To: ® 9,1,9787441792 R&G Ins. Agcy. Page: 001 e Client#:48249 ANCHEXC ACORD,. CERTIFICATE OF LIABILITY INSURANCE 08/28107D`YY'"' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rogers&Gray Ins.Agency,lnc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 434 Route 134 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 1601 South Dennis,MA 02660-1601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A. Acadia Insurance Anchor Excavating Corporation INSURERB: Evanston Insurance Company Patriot Equipment Corporation INSURER C: One Beacon Insurance Group 16 Industrial Way INSURER D', Hanover,MA 02339 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMBS LTR NSR DATE IYY MMIDD DATE MMIDD/YY A GENERAL LIABILITY CPA016919611 01/01/07 01/01/08 EACH OCCURRENCE S1000000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED S25O OOO PREMISES Ea occurrence' CLAIMS MADE F—IOCCUR MED EXP(Any one person) S5 000 PERSONAL 8 ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG s2,000,000 POLICY F1 PRO LOD JECT C AUTOMOBILE LIABILITY CB1E03154 08/05/06 08/05/07 COMBINED SINGLE LIMIT $1,000,000 ANY AUTO (Ea accidenO ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person $ X HIREDAUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident;; $ PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG $ B EXCESS/UMBRELLALIABILITY XOGA229707 01/01/07 01/01/08 EACH OCCURRENCE s5,000,000 X OCCUR CLAIMS MADE AGGREGATE s5,000,000 S DEDUCTIBLE $ X RETENTION $10,000 $ A WORKERS COMPENSATION AND WCA017038512 01/01/07 01/01/08 X Wc'-,%TT OTH- EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTNE E.L.EACH ACCIDENT S1,000,OOO OFFICER/MEMBER EXCLUDED? E.L.DISEASE EA EMPLOYEE $1,000,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Interstate Engineering Corp.,Town of Barnstable and Stearns and Wheler, LLC.are listed as additional insureds for general liability coverage per written signed contract with insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Interstate Engineering Corp. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL _J DAYS WRITTEN 193 Jefferson Ave P.O. Box 687 NOTICE TOTHE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Salem,MA 01970 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #S30634/M26348 DAC o ACORD CORPORATION 1988 Aug 29 07 10: 48a P• 2 Client#: 13951 2ADANCO 7131/ A-CORD- CERTIFICATE OF LIABILITY INSURANCE MlDD/YYW) 07/31l07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Marshfield ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 891 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 1025 Plain Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marshfield,MA 02050 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Travelers Insurance Company Adan Corporation 270 Communication Way INSURER B: Associated Employers Insurance Compa Unit 1A INSURER C: Hyannis,MA 02601 INSURER 0: INSURER E: COVERAGES 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,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DAT .' WDDIYY DATE MM/DDlYY LIMITS A GENERAL LIABILITY POLICY 02/04/07 02104/08 EACH OCCURRENCE S1,000,000 X COMMERCIAL GENERAL LIABILITY PREMGET ERENTEDnc $300 OOO CLAIMS MADE a OCCUR MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1 OOO 000 GENERAL AGGREGATE s2,000,000 . GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY PRO JECT LOC A AUTOMOBILE-LIABILITY 1680912D5041 02/04107 02/04/08 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY IN S SCHEDULED AUTOS (Perperson) X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ RANY AUTO OTHER THAN EA ACC IS AUTO ONLY: AGG S A EXCESSIUMBRELLA LIABILITY .ISMCUP912D5483INDO 02104107 02/04/08 EACH OCCURRENCE 54 00O 000 X OCCUR ❑CLAIMS MADE AGGREGATE s4,000,000 DUCTIBLE S [jXLR TENTION s 5000 $ B WORKERS COMPENSATION AND WCC5001552012007 02/09/07 02/09/08 X we I IPA IT OTH- EMPLOYERS'LIABILITYORY ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $500 000 OFFICERIMEMBER EXCLUDED? NO E.L.DISEASE-EA EMPLOYEE $500 000 If yes,describe under SPECIAL PROVISIONS below L.L.DISEASE-POLICY LIMIT s500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS RE:Hyannis WPCF Improvements Project, Barnstable, MA Certificate holder,Town of Barnstable,and Sterns&Wheler, LLC are named additional insured for general liability. Insurance coverage is limited to the terms,conditions, exclusions,other (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATI( Interstate Engineering Corp. DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL .__30_ DAYS WRITTEt 193 Jefferson Avenue NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL PO Box 687 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Salem,MA 01970 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE J��� ACORD 25(2001108)1 of 3 #48603 LS1 © ACORD CORPORATION 1, -ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID J DATE(MM/DDNYYY) PRECI-2 08 29 07 PROI UCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Marchionne Insurance Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 11 Independence Ave. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Quincy MA 02169- Phone: 617-471-5010 Fax:617-471-1386 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Utica Mutual Insurance Co. 25796 INSURER B: Arbella Indemnity -Ins. .Co. - Precision Steel-' Placers - INSURERC: Safety-Insurance 39454 28 Lavender Lane INSURER D: Walpole MA 02081 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATEPOLICYMM/DD EFFEC/YY E POLICY MMPDD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 UAMA X COMMERCIAL GENERAL LIABILITY CPP3963691 08/01/07 08/01/08 PREMISE�S(Eaoccurence) s50,000 CLAIMS MADE a OCCUR MED EXP(Any one person) s5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY X PRO LOC JECT AUTOMOBILE LIABILITY C ANY AUTO 0183397 05/25/07 05/25/08 COMBINED SINGLE LIMIT $ 1 000 000 (Ea accident) , � ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per.accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN. EA ACC $' AUTO ONLY: - AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $5,000,000 A X OCCUR CLAIMS MADE CULP3963693 08/01/07 08/01/08 AGGREGATE $ 5,000,000 HDEDUCTIBLE $ X RETENTION $ $ WORKERS COMPENSATION AND X TORY LIMITS I ER B EMPLOYERS'LIABILITY 9099120506 05/15/07 05/15/08 E.L.EACH ACCIDENT s 500000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE $500000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Proj: Hyannis WPCF Improvements Project, Barnstable, MA. *** SEE ATTACHED HOLDER NOTES *** Partners Kurt Schuetz and Paul Abely are excluded from the Workers Compensation and Employers' Liability. 20 Days Written Notice of Cancellation for Non-Payment on the Auto policy. CERTIFICATE HOLDER CANCELLATION INTE00 8 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Interstate Engineering Corp. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 193 Jefferson Avenue REPRESENTATIVES. Salem MA 01970 AUTHORIZE�ES rA�y ACORD 25(2001/08) ©ACORD CORPORATION 1988 Pr Hyannis WPCF Improvements Project, Barnstable, MA. Interstate Engineering Corp. , Town of Barnstable and Sterns & Wheler LLC, and their respective officers, directors, partners, employees, agents,consultants are included as Additional Insured on a primary basis on the General Liability. Utica National shall indemnify and hold harmless the Town of Barnstable, its elected or duly appoint officers, directors, and employees against liability, losses, damages or expenses resulting from any claim based upon negligent or intentional acts or omissions of the provider, its employees or its agents in providing its services to employees of the municipality or their dependencts pursuant to the agreement. 08/29/2007 16:24 7817697730 PAGE 01/03 DATE(MMIDD/YYYYJ A,CqRP. CERTIFICATE OF LIABILITY INSURANCE 08/29/2007 PRODUCER (781)762-0042 FAX (781)769-7730 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dempsey Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 145 Railroad Ave. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Norwood„ MA 02062 INSURERS AFFORDING COVERAGE NAIC t! INSURED Heritage Iron Works,Inc. INSURERA' Worcester Mutual Insurance Co. P.O.Box 609 INSURERS American Internation Group Centerville, MA 02632 INSURERC: INSURER D, INSURER E COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DID' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS N113GENERAL LIABILITY GL 230144 05/16/ZO07 05/16/2008 EACH OCCURRENCE $ 11000,00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTFD S 100,000 Pa 'ECLAIMS MADE a O F OCCUR MEXP(Any one Person) S 5,00 A X CIS 2010 07/04 & PERSONAL 6 AOV INJURY $ 1,000,000 X CIS 20 37 07/04 GENERAL AGGREGATE E 2 00-0,000 GEN*L AGGREGATE LIMIT APPLIES PER. PRODUCTS COMPIOP AGG S 2,000,000 POLICY PRO. JECT LOC AUTOMOBILE LIABILITY BA 230144 OS/16/2007 05/16/2008 CO1811CD SINGLE LIMIT ANY AUTO (Ea acodonl) R 1,000,000 ALL OWNEC AUTOS BODILY INJURY S A X SCHEDULE()AUTOS (Per person) X HIRED AUTOS BODILY INJURY S X NON-OWNED AUTOS (Per accloent) PROPERTY DAMAGE S (Per eocident) GARAGE LIABILITY AUTO ONLY-FA ACCIDENT 0 ANY AUTO EA ACC S OTHER THAN AUTO ONLY' AGG S ERCESSIUMBRELLA LIABILITY BE 210144 OS/16/2007 05/16/2008 EACH OCCURRENCE 11 5,000,000 X OCCUR Q CLAIMS MADE AGCREOATE S 5,000,000 A DEDUCTIBLE S X RETENTION a 10.000s WORKERS COMPENSATION AND WC 684-63-43 05/20/2007 OS/20/2008 WCSTATU• OTTI- EaPLOYERS'LIABILITY F L.EACH ACCIDENT S 500 000 B ANY PROPRIETOR(PARTNF,RIEJIECUTIVE OFFICERWEMBER EXCLUDE07 NO E L DISEASE-EA EMPLOYEE S S00,000 IP yyes,desunee under SPECIAL PROVISIONS below _T E L DISEASE•POLICY LIMIT M SOO 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ROJECT- HYANNIS WPCF Improvements project, Barnstable, MA DDITIONAL INSUREDS;Interstate Engineering Corp. ;Town of Barnstable 230 South St.Hyannis, MA & terns & Wheeler, LLC 1S45 Iyannough Rd, Hyannis as respects liability arising out of work performed or the Certificate Holder by or for the Named Insured and shall included the respective officers, irectors,partners,employees,agents,consultants and sub-contractors/ CONTINUED ON PAGE TWO CANICELLATIQN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THERCOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL INTERSTATE ENGINEERING CORP. 19 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ATTN; HUGH ALLEN, Project Manager BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 193 JEFFERSON AVE. OF ANY KIN THE INSURER,ITS AGENTS OR REPRESENTATIVES. SALEM , MA 01970 AUT149PCtV EP S N ATIVE ACORD 25(2001108) FAX; (978)744-1792 &)ACORD CORPORATION 1988 CSR PR DATE(MMIDD/YYYY) ACORN CERTIFICATE OF LIABILITY INSURANCE RILEY-3 1 08 20 07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MF&T-ins. 'Construction Div. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Construction Division HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 77 Accord Park Drive Unit B-1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Norwell MA. 02061 Phone: 781-261-2000 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Transcontinental Ins. Co. INSURER B: Transportation Insurance Co. P.J. Riley & Co. , Inc. INSURER C: MT. HAWLEY INSURANCE COMPANY Attn: Charles Riley 295 Highland Street INSURERD: Boston MA 02119 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSR TYPE OF INSURANCE DATE MM/DDIYY DATE MM/DDIYY GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL LIABILITY C1079965085 09/30/06 09/30/07 PREMISES(Eaoccurence) $ 100000 CLAIMS MADE a OCCUR MED EXP(Any one person) $ 10000 X Contractual Liab. PERSONAL&ADV INJURY $ 1000000 X X,C,U GENERAL AGGREGATE $2000000* GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 1000000 POLICY X P J ECTRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A ANY AUTO 9951932 09/30/06 09/30/07 (Ea accident) $ 1000000 ALL OWNED AUTOS BODILY INJURY rXXX SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ No Physical Dam— PROPERTY DAMAGE a e on Vehicles (Per accident) $ GARAGE LIABILITY AUTOONLY-EAACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 5,000,000 B X OCCUR CLAIMSMADE C1079965071 09/30/06 09/30/07 AGGREGATE $ 5,000,000 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND X TORY LIMITS ER B EMPLOYERS'LIABILITY WC179965054 09/30/06 09/30/07 E.L.EACH ACCIDENT $ 1000000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 1000000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1000000 OTHER C Excess Umbrella MXU0302627 12/11/06 09/30/07 Occurren $5,000,000 Liability Aggregate $5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Hyannis WPCF Improvements Project - HVAC Interstate Engineering Corp. , Town of Barnstable and Sterns & Wheler LLC are named as Additional Insured on GL, Auto, Umbrella policies. CERTIFICATE HOLDER CANCELLATION INTERST SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Interstate Engineering Corp. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 193 Jefferson Ave. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR P.O. Box 687 Salem MA 01970 REPRESENTATIVES. AU T OGLED REP S TATI�(� ACORD 25(2001/08) /�� ©ACORD CORPORATION 1988 08/29/2007 11: 10 FAX GRIFFIN ELECTRIC 2 002/002 Tbia der it oc a utecuredby Liberty MwuW In uram Omp ii a cu ruoh-nanmrt,m is Affmclod by those couilvalco. BM0068 Certificate of Iasurnocc This caMficale is leetted as a utamer of ioforinatioa only rand eonim ca tights upon you the omo6cam bolder. •ibis w6Lcsm Is not au w1urmc u policy and does aot mmd,extend,or niter the oo cmp afforded �o --ties lined below Thu is to certify that(Name and gddress of Insured) Wayne J Griffin Electric Inc 116-•lopping Brook Road Holliston,MA 01746-1497utrd rs,at the issue dam of tbrs cero6aamr,innsod by the Compuy undo the policy(ic%)limed below. The iosuraoee afforded by tho lined po6eylie 1 it rubjcet to all their terms oxelustons and coodioons and is not Wound by any ro uLmoicm rcma or condition of any comad or other donuaeat wrdt Trtmccat to which this ccmbum may be Issued. Expiration Tnm Eft./Ex pat s Policy Numbs s Limits of Liability Continuous' 03/31/2007/03/31/2008 WAS-1 I D-205606-017 Coverage afforded under AVC law of Employers Liability Extended the follovrioC d thee: Bodily Injury By Accident X Policy Tcrm AL.CT,DE,FL,GA MA,ME NC,NH,RL $500,000 faeb Accident SC,TN,VA,Vr Bodily Injury By Disease $500,000 Policy Limit Workers Compensation Bodily Injury By Disease $500,000 Each Person 03/31/2007/03/31/2008 TB1-111-205606-027 General Aggregate-Otlier than Prod/Completed Operations General Liability $2,000,000 Products/Completed Operations Aggregate Claims Made $2.000,000 X Occurrence Bodily Injury and Pro arty Damage LiabilityPer $1 000.000 Occurrence Rctro Date Personal and Advertising Injury Per Person/ $1,000,000 Organization Other Liability Other Liability $300,000 Fire Legal $10,000 Medical Payments 03/31f2007/03/31/2008 AS2-1 1 1-205606-037 Eaeb Accident-Single Limit-B.1.and P.D.Combined Automobile Liability $1,000.000 Each Person X Owncd X Non-Owned Each Accident or Occurrence X Hircd Each Accident or Occurrence Emccas Umbrella 03/31/2007/03/31/2008 TH2611-205606.247 S5,000,000 Bodily IyUury $5,000,000 Aggregate $S 000 000 products compltted OpemEton Automobile Physical Damagc Dcducbblcs—PP&Light Trucks/$1,000 Comprehcnaivc&Collision—Medium Trucks&Trailcra/$2,500 Comprehensive&Collision— Heavy Trucks,X-Heavy Tracks&Tractors/$5,000 Comprehensive&Collision,The workers'Compensation policy mcludcq Deductible Bndofsement with$300,000 deductible limit per occurrence for Workers Compensation with the provision that Liberty Mutual will advance paymcr t of the deductible amount.—Job Number: 1303For C electrical work performed at Hyannis WPCF Improvements,Hyannis,MA-WJGEI Job 01303.Interstate Engineering Corp.,Town of Barnstable,and Sterns&Whcicr,LLC 0 arc additional insur-cd as rtquired by signed contract for this project Waiver of subrogation in favor of the Town of Barnstable as required by signed contract for this M project M E N T S Nour of earwallsoon (trot aoolrtablo unlos a number of dbys rr entered below) Hofore the tasted onpleauon dodo Ac eompaby saU not caoeal or reduce tba i MJranre aMordcd under die abo a pohom unol w loa-t 30 dnys nobw of web catedhnon hrN baea salted w' Office: W ESTON,MA Phone: 781-891-8900 Certificale Holder. COURTNEY WALSH Interstate Engineering Corp- AuthorizcdRepresentative 193 Jefferson Avenue PO Box 687 Salem, MA 01970 Date Josue&- 08/14/2007 PrepmedBy- CW TOWN OF BARNSTABLE NOTICE TO PROCEED DATE: August 8, 2007 SUBJECT: CONTRACT: . No. 03-000-07-002 , Hyannis Water Pollution Control Facility Improvements Project TO: Interstate Engineering Corp. of Salem, MA 1 .. You are hereby given formal NOTICE TO PROCEED in accordance with the provisions of the subject contract . 2 . In addition, until such time as the formal pre-construction meeting is completed, no actual construction work may commence. Permission is grant for mobilization and other related work. 3 . It is requested that acknowledgment I of this NOTICE be indicated by endorsement hereon, and that the original be returned to this office. The duplicate should be retained in your office files . R. W. Breault, Jr. Assistant Director FIRST ENDORSEMENT A TO: Town of Barnstable Department of Public Works 230. South Street. 4th Floor Hyannis, MA 02601 Receipt is hereby acknowledged of the above NOTICE TO PROCEED under Contract By: Q Date : CJ 21 2/00 40,14620 . 1 The Commonwealth of Massachusetts For Office Use Only AERONAUTICS COMMISSION ❑ Airspace Analysis Initials ❑ Comments Received REQUEST FOR.AIRSPACE REVIEW El AIMS Updated MAC File No.: FAA File No.: (For reference only) Notice is required by 780 CMR(Code of Massachusetts Regulations) 111.7,Hazards to air navigation. Pursuant to Massachusetts General Laws(MGL)Chapter 90,Section 35B,the Massachusetts Aeronautics Commission(MAC)agrees to perform an AIRSPACE ANALYSIS and render a determination for the project listed below. IMPORTANT: All shaded areas must be completed. Sponsor(include name address&telephone number) ponsor's Representative(same data if applicable): (mil A �? �j �i l$C)1'14 C, cr)8 -)a4 &P83 (� rrti. cZvgs ytoZ-�`Tc. Project Description(please type or print clearly): Location.Height&Elevation Data: t Nearest City,State: 12,00,T b MA e- Latitude Degrees Minutes Seconds Longitude Datum ❑NAD 83 or ❑NAD 27 Site elevation above MSL(ft.): msl Maximum height above ground(ft.): agl RLQUIRED: Attach 8%x I 1 inch map(e.g.USGS Quad sheet)showing location of project Maximum elevation above MSL(ft.): 1 1 S msl Nearest Public-Use Aviation Facility: Print`or type,below,the name of person filing this request tot•review Signature Date" ****************DO NOT WRITE BELOW THIS LINE — FOR MAC OFFICE USE ONLY **************** MAC's AIRSPACE ANALYSIS concludes the following: J Closest Runway: Distance from RW end: Offset from RW CL: ❑Left ❑Right ❑ Project violates MGL Ch.90, §35B by ft. [Runway Horizontal Plane-3,000'x 2 Statute Miles, 150' above RW] ❑ Project violates MGL Ch.90, §35B by ft. [Runway Approach Plane-3,000'x 3,000' @ 20:1 slope] ❑ Project violates 702 CMR,§5.03(l)(a)by . ft. [Runway Approach Plane/Land-500' x 10,000' @ 20:1 slope] ❑ Project violates 702 CMR,§5.03(2)(a)by ft. [Runway Approach Plane/Water-500' x 10,000' @ 20:1 slope] ❑ Project does not violate MAC Airspace Laws or Regs. MAC hereby issues the following DETERMINATION: ❑ Permit is required*pursuant to MGL Ch.90, §35B,for: ❑ Runway Horizontal Plane ❑ Runway Approach Plane *Sponsor must submit a separate written request for a MAC Airspace Permit. Request should be addressed to MAC Chief Legal Counsel,Massachusetts Aeronautics Commission, 10 Park Plaza,Room 6620,Boston, MA 02116-3966 ❑ Permit is not required pursuant to MGL Ch.90, §35B ❑ No violation of Laws or Regs ❑ Ch.90 violation=30'agl ❑ MAC has the following additional concerns: ❑ FAA Standards ❑. Noise ❑ Traffic Pattern " ❑ Wildlife ❑ VFR Route ❑ Other This determination is based on the foregoing description of the proposed project including the location, height and elevation data provided by the Sponsor. Any change in the data provided to the MAC from that which is shown herein will render this determination null and void and will necessitate a new request for review. Mgr.of Airport Engineering,Massachusetts Aeronautics Commission Date MAC Form E-10 Last Revised December 2000 P,6ase!',�^ or rirtt on 7iiis Form Form Approved OMB No.2120-0001 Failure To Provide All Requested Information May Delay Processing of Your Notice FOR FAA USE ONLY Aeronautical Study Number U.S.Department ofTransponation Notice of Proposed Construction or Alteration Federal Aviation Administration 1. Sponsor (person, company, etc.proposing this action): o Attn. of: � N 9. Latitude: Name: �Z Ica _ a 11 U 10. Longitude: o Address: 11. Datum: ❑NAD 83 ❑NAD 27 ❑Other City: ��j-t 1r rv� State: _Zip: 01916 � Telephone: c1'7`8 794 Fax: 9-28, -744 j9qZ 12.Nearest: City:� ea St�� State: 13.Nearest Public-use(not private-use)or Military Airport or Heliport: 2. Sponsor's Representative (if other than 01): Attn.'of: 1 2_� 't.] v,`b k, `cel Name: 1 (k 14. Distance from#13.to Structure: Address: 15. Direction from#13.to Structure: I City: sai-r M State: 6dA Zip: 16.Site Elevation (AMSL): —ft Telephone: CI�%B aV - 1tl C�Fax: / 17.Total Structure Height (AGL): ft. 3. Notice of: ❑New Construction Iteration ❑Existing 18. Overall height(#16.+#17.) (AMSL): ft 4. Duration: ❑Permanent emporary( months,4days) 19. Previous FAA Aeronautical Study Number(if applicable): 5. Work Schedule: Beginning l End OE 6. Type: ❑Antenna Tower Crane ❑Building ❑ Power Line 20. Description of Location: (Attach a USGS 7.5 minute ❑ Landfill ❑Water Tank ❑Other Quadrangle Map with the precise site marked and any certified survey.) 7. Marking/Painting and/or Lighting Preferred: ❑ Red Lights and Paint ❑Dual-Red and Medium Intensity White ❑White-Medium Intensity ❑Dual-Red and High Intensity White ❑White-High Intensity ❑Other ' IL 8. FCC Antenna Structure Registration Number(if applicable): 21.Complete Description of Proposal: Frequency/Power(kW) Notice is required by 14 Code of Federal Regulations,part 77 pursuant to 49 U.S.C.,Section 44718. Persons who knowingly and willingly violate the notice requirements of part 77 are subject to a civil penalty of$1,000 per day until the notice is received,pursuant to 49 U.S.C.,section 46301 (a). I hereby certify that all of the above statements made by me are true, complete, and correct to the best of my knowledge. In addition, I agree to mark and/or light the structure in accordance with established marking and lighting standards as necessary. Date Typed or Printed name and Title of Person Filing Notice Signature Rp WE ME •,; Wil�0 t,.��.: ,�• ' �!�-.•..1 r .� ..cy Jai ""'.�S�r`�'� .� � �1�r� ioll WE �F r•►� f;,,,:+ : � ors _ �� � �• �� ,. Aw _�:r� ;. 4-9124 sew '1r /,1 •a S �1 ��t 1r.. 31�I.�R '"�i►r WIN .,m it �..r` "c +4♦t i ��>• MR ti COMMERCIAL ADDITION/ALTERATION , Letter of Approval from Site Plan Review (if necessary) If located in OKH or Hyannis Historic District- Certificate of Appropriateness required Plot Plan Map &Parcel number Full Description of project(U-value of replacement windows if applicable) If sprinkler or fire alarm system is required, do not accept application package w' t prior approval from Fire Department in writing. DEP let r attesting notification, hazardous materials results , if necessary Sign- om: Health Tax Collector Conservation Treasurer If ZBA relief(Special Permit or Variance is required for project: ❑ Copy of Decision ❑ Documentation proving that the decision was recorded at the Registry of Deeds w/in one year of ZBA decision date. Street address of project Correct square footage Estimated Cost Owner's name & address Contractor's name, address &telephone number Contractor's signature Full sized plans, stamped plans (1 full size and 1 reduced) Workman's Comp. form. Copy of Insurance Compliance Certificate must be on file. Construction Super's License OR ❑ Controlled Construction Documents Check expiration date on license i 00 next to restrictions I Application Fee Permit e Pr erty Owner must ign Property Owner Letter of Permission. 7 a�� fiD 7 q-forms Idg'e is/permitchecklists -_J rev.071 7 �►1{Yn El Russ Hazelton Project Superintendent 193 Jefferson Avenue P.O. Box 687 • Salem, MA 01970 (978) 744-8883 Fax(978) 744-1 792 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Mfp. Z 9,3;r Parcel ®0/ Permit# 163 9 TOWN CIF B j�,RNSTABLE _ Health Division ) (/ Date Issued /3 Conservation Divisions•S 7 0� � ��� 2� �Wa Application Feed�-00 Tax Collector Permit Fee �0 7 ' 0� -- ,,VlSIO� Treasurer APPLICANT MUST OBTAIN A SEWER Planning Dept. CONNECTION PERMIT FROM ENGINEERING DIVISION PRI T;IE OR TO Date Definitive Plan Approved by Planning Board CONST►afCTION Historic-OKH Preservation/Hyannis Project Street Address R en&seS W�`� Village J).(zM 461e— 4 a ono Owner I 0 wv1 0 ea.tz A 61 e Address Telephone Permit Request Geld e-C VA-C.yuww.- Le,wy►2 (wi 5 a-4?o J Square feet: 1st floor: existing b 3 U proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation )VO4000 Construction Type CoIV c/?�'C Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family Cl 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: Q.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 7Yes peals Authorization ❑ Appeal# Recorded❑Commercial ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name ii, BE OWE:C\ 3-Q , Telephone Number Address P.b . BOX 4 g� License# 011(AS P66S&,0wd�, Kl yi, Home Improvement Contractor# Worker's Compensation# Q,C 2-3 1 531112 3 0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO L)AsIE MAoJA G G AAE-K;l SIGNATURE DATE 6 7 FOR OFFICIAL USE ONLY C PERMIT NO. DATE ISSUED - MAP/PARCEO f O. l� - ADDRESS VILLAGE OWNER DATE OF INSPECTION: i + FOUNDATION' FRAME ' INSULATION . FIREPLACE ELECTRICAL: ROUGH FINAL - PLUMBING: -'ROUGH FINAL, + GAS: ROUGH FINAL' FINAL BUILDING DATE CLOSED_OUY -� ASSOCIATION PLAN NO. i e ✓� '(pp7Y1/I)t09ZU1/eeQ.GLiL 6�i/I�GQ.d6Q�LOE� BOARD OF BUILDING REGULATIONS License., NSTRUCTI©N SUPERVISOR Numt� 071185 - r 2p03 Tr.no: 21668 Res ited' c RANDALL i 136 GREEN �3 RAYMOND, NH 03877 Administrator { May 07 02 12: 03p Albanese Bros 978 454 8850 p. 2 DATE INWD1:'YY P DD �a4Cl)R� GERi"��F�G T 1-N!S roY-1 04�25�02 �r PReouCER THIS CERTIFICATE IS ISSUEC Aa A MATTER OF INFORMAT10Pd ONLY ANq CONFERS Pao RIGHT UPON THE CERTIFICATE besanctie Insurance 3�,gcyF IasCo HOLDER.'THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 01801t Rill park ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Ten Walnut . COMPANIES AFFORDING COVERAGE burr. nu _ I COMPAN\'-`� A Liberty Mutual Insurance Co. PhoneNoi 7B1-935-8480 FexN�. 781-933-5645,_._—__^___.____ - IiJSUHED -_ CC14PANY .OMPANY Randy Construction Randall Bennett - p,0, Box 4420 ..._COMPANY j Portsmo xt�, ITFz 03802 CCVERAG:F$ .. 777777777777 THE INSURED NAMED ABOVE FOR THE POLICY THIS INDICATED,TO NO�PY THAT THE POLICIES OF HSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT O WHICH R THIS CERTIFICATE CE USTED BELCW HAVE BEEN ISSUED TO CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY SHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, �— EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. --- -- I PDUCY EFFECT\'E POL!C/EXP1HATICN LIMITS CO TYPE CF iNSI;R.aNCE I POLICY NLN3ER DATE(MMJOD!YY) CATS(MPoUDDIYY) L-R GENERAL kGGREGATE j��jI�_ERnLI LIARII.ITY ��__� I I P OUCTS' COAPlOP a0 COMNIERCAL GENERAL LIABILITY PERSONA_&ADV!NJURY CLAIMS MADE OCCUR EACH OCCURRENCE _OWNER'S 4�;ONTRACTOR'S PROT j i -� ��. FIRE DAMAGE(Any cne 11, $ I VED EXP(Any one Person) $ I 1 AU'CMOBILE LIAGILITI' I COMBINED SINGLE LIMIT I$ ANY AUTO j I �`-�- - I SOD LY INJURY g .ALL OWNED AUTOS ( (Per person) j �1 SCHECULED AUTOS BODILY INJURY �-- H,REDAUTOS (Per,accident) I--�tiDNOWNEDaJTOS i ,' PROPERTY DAMAGE $ _^ ` AUTO ONLY-EA ACC DEN- S GARAGE LIABILITY OTHER THAN AUTO ONLY: ANY AU-0 I I EA `_ 5CH ACCIDENT . AGGREGATE S EACHOCCURRENCE EXCESS LIABILTY _!� i I AGGREGATE` I UM2RELL A ORIA 5 OTHER THAN UMBRELLA FORM WC STATJ• 0 j-11 TORY LIMITS ER _ WORKERS GGMPEFiSP.TION AND I I EL EACH ACCIDENT S1.00000 EMPLOYERS'LIABILITY - -- A I THc PROPRIETOR( `J iNCL I j EL DISEASE•POLICY LiMkT I$ r 0 00 00 _ PARTNERSJEXEC'JTIVE ' 04 f 21/02 ! 04/21.J 03 I E.'DISEASE•EAEMPLOYEE'a 100000 I OFFICERS ARE: 1 •"LI W0231S321683012 - _THER + I 17. �l I CrSCRi�710N OF CPERATbDNSILOCA710NSlYENIGLESfS'PECIAL ITEMS Various projects as specified CA.NCELLA710N CERTIFICATE HQ't.7 DER Al� -L SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CAIJCELLEO BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL'ENDEAVOR TO MAIL Albanese Brothers, Inc. 30 DAYS YVRITTEN NOTICE TO THE CERTIFICATE HOLDER NAlviED TC•THE L_FT. p,0. Box 516 SJT FAILURE TO MAIL SJCH NOTICE SHALL IMPOSE NO OBLIGATILYJ ON LIA6 CTy 28 Loon Hill Road, OF AVY KIND UPON TI IE CCNPAW,ITS AGENTS OR REPRESENTATIVE: Dracut MA 01826 AU'HCRIZ EPRESENTATIVE L4CORD 25-5 The Commonwealth of Massachusetts _ De artment o Industrial Accidents P Of/�ce oflnsestigations . - ' 600 Washington Street Boston Mass. 02111 Workers' Compensation Insurance Affidavit name: / location: & l city i 'i phone# - ❑ I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one worki>1 in capacity %% %%N %�%/ I am an em to er roviding workers' compensation for my employees_working.on this job. P...y.....P...............::::::..:::.:::.::::::.:..::::.. t�CeSS �{l� aEl f . : 't:: : ;:i?',.;:.':j:;y:::'<::;::':�`::::'•:,:::::::':: ::f::' 1liStlrance:citi:;«:::.;:. .«.:: ::.::;: ?:: ':,:::::::.:::::,:::.::,::.... ................................. %/ ❑ I.am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who nsation olices: coni an >nam ..... ........................... ' :;i:: J:t ...:.....�: : : : ' i ^ :i::^iti : : i :i '?fiviv;'ii::;t::bjt>:i.;j•:i4v :;i iYi'i:i•i:�% ..::............................................:............................ ii•J;:r :.::::::•::.::::::::::::::::::..::::::::.:;•.;:t.i:.;:.i;:t•:3:;tt;•;:.;:.J::t•J:.;:t•:;.i:::;;:;;•J J:•JJ:t.::.i:.;:.::::•::.:JJ:.:;:.J:3;:.J:;:.:::<:;::..... . .. .>..:. 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Fafiure to secure coverage as required under Section ZSA of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification --- - ---I do hereby certi -under-the pains-and penaMes-of perjury that-the-information-provided-above-is_true_and-cooed Date CS Signature 0 �� Print name Phone# ---------------- official use only do not write in this area to be completed by city or town officialrn city or town: pedt/license# ❑Bufiding Department ❑Licensing Board AV ❑checkif immediate response is required ❑Selectmen's Office _❑Health Department contact person: phone#; ❑Other (revised 9/95 PJfa ` Information and Instructions , s` Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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 inajoint enterprise, and including the of a deceased employer,legal representatives 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 section 25 also states that every state or local licensing agency shall withhold the issuance orrenewal 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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 f.You are required,to obtain a workers' compensation policy,please call the Department at the number listed below:. City or Towns Please be sure that the affrdavit"is complete and printed legibly.. The Department has provided a space at the bottom 0. affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please. 4........_.��.,....�..,.....n .... �_..... .� .... -..0 e..d. ►.. be.sure to fill in the permrt/hcense number which will be used as a reference number. The'affidavits may be returned't the Department by: mail or FAX unless other arrangements have been made.. The Office of Investigations would like to thank you in advance for you 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 fax#: (617.) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 Stearns&Wheler,LLc ENVIRONMENTAL ENGINEERS &SCIENTISTS One Remington Park Drive • Cazenovia, NY 13035 (315) 655-8161 • fax(315) 655-4180 April 20, 2000 Mr. Buddy Martin Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street Hyannis, MA 02601 Dear Mr. Martin: Thank you for your assistance in interpreting our code needs during the preliminary design of the Barnstable Vacuum Station at Bearses Way and Route 28. I would like to follow-up our telephone conversations and receive written confirmation on the code decisions that have been made for this project. The most important decision was the classification of this structure as Use Group U (Utility and Miscellaneous) because of its `accessory characteristics'. Upon making this decision, it was then decided that we did not need to meet the State energy code, enclose the stairs, or provide a second means of egress. As we progress towards final design and construction of this project, I would appreciate your final review and concurrence with the above decisions, including any requirements that must be met to satisfy the above. Once again, thank you for all your assistance. Very truly yours, Jeffrey D. Barnard Senior Architectural Designer JDB/dld Enclosure ].\0000\00014.30\WORDPROC\LETTERS\Martin,Buddy•Town of Barnstable JDBOI.doc ���Stearns&Wheler t�Companies _{�_iversary Stearns&Wheler,LLC is a member of the Stearns&Wheler Companies. °FtNE The Town of Barnstable • snxxsrns - 9� Department of Health Safety and Environmental.Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner July 20,2000 Mr.Jeffrey D.Barnard Senior Architectural Designer Stearns&Wheler,LLC One Remington Park Drive Cazenovia,NY 13 035 Dear Mr.Barnard:_ I agree that the Use Group classification in the question you posed would be"U'and as such strict compliance with energy and egress requirements will not have to be met. Best of luck. Sincerely, �t rossen Building Commissioner RMC:cah g000720c f I �ff 4 s-v 'V- 7 '., wi.rar3.INC! I7P: .i'; ' � � • . -rya:. . h, - ' - "� k.�, PARCEL ID 293 001- GEOBAtE 11} :L0505 ADDRESS 382. FALMOUTH ROAD (ROUTE P ON� - I' HYANNIS Z . P 4 LOT 'yBLOCK _ LOT 2 S,I ZE)__� DBA DEUE oP ENT 'Dll '..kRICT HY PERMIT` 61.039 DESCRIPTION SEWER VACUUM PUMPING STATION ?ERMIT' TYPE . BUILDC TITLE COMMERCIAL BUILDING �- CONTRACTORS BENNETT,' RANDALL A Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL .FEES: $1,vf4-00 ' ' BOLD $-,00 ' CONSTRUCTION COSTS $240,000-00 328 ETHER NONRESDEA7TIAI} IiL'3G 1 PRIMATE ^at P. * s I * 1ABNSTABLE, : . MASS. I 1639. • Y. I T i " BUI .D WISIO�N DATE ISSUED 05/13/200.2 EXPIRATION DATE ~� i THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY�STREET,-.ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY,OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY.PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). ', PANCY IS REQUIRED,.SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. ' 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. •. = ® uy Iffe BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2: 2 P;VA I 3 1 HEATING INSPECTION APPROVALS GINEERING DEPARTMENT 2.• BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. I I I I I II o f Engineering Dept. (3rd floor) Map cnl� Parcel (90.Permit# House#. Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee 13 Conservation Office (4th floor)(8:30- 9:30/1:00-2:00), Planning Dept. (1st floor/School Admin. Bldg.) Defi ' ' Ian Approved by Planning Board 19 ' BAR ABLE, 19WN OF BARN5TAB � mew 8�- �3 Building Permit Application / Pro ect Street Address '1ee.�-cst Villagec ►��S ,� . Owner -1 aun f5c&nn s LQA/i Address Telephone o� ,�o-Q -t 6y's (2z-\+V6—q bi Permit Request GS First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ �(J� Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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 No.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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number `Address � License# Home Improvement Contractor# / (508) 428-2292 Worker's Compensation# Lt1C'f 3 S1/5d-'�d 3 0-7 9 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO YZ4-4AIA, ' 11-� -,-%\e;'P SIGNATUREJ DATE �']� BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) . FOR OFFICIAL USE ONLY ' PERMIT NO. DATE ISSUED "= MAP/PARCEL NO. � ADDRESS VILLAGE OWNER Y DATE OF INSPECTION: - t t FOUNDATION FRAME1 INSULATION - - 'FIREPLACE - ELECTRICAL: ROUGH FINAL , PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. t� e a m m Kr y t �11 A r► a'9 V O A s , oco cc g c s N gS � o � CD 99 18 o _ 9 o e RA /wIL M i� yQ- .-[•-' :Z 'p�:'�:iib.:.'-:vim � - 1 HOME IMPROVEMENT CONTRACTORS.'REGISTRATION E3oard of Building Regulations and •Standards ;.- ` One Ashburton Place — Room 1301 ' '!f':'•Y..,'`_. n..-Massachusetts-:' ' BOStO02108=. . aA 1 r HOME.'IMPROVEMENT CONTRACTOR ___________ Resistratio 36 Yr-.-• , n- 1125 t. Expiratiorxz04/Ob/9 ��� �` TYPe., — :DBA Sir ��z- as INPRO VENENT CONTRACTOR Registration . 112536 F' �.RA SER .�.. ..� .. .CONS :�- . .TR ,- .. _UCTIO _N :r C �° :s DEAN _ ERASER is Tree OBA";- , r::, o, T - 71 TARRAGON ::;. <� �. :: �'- YP •r= O4/Ob199 . - •...�,_ meµ..-: :• :n. :Y "z. z.� .r. IT' '� :. a . SER. CONSTRUCTION �wMdoT", C. FRASER Lir i �ARRA60N CTR COTUYT NA 02636 a� t :r The Town of Barnstable Department of Health Safety and Environmental Services Eo w Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6730 Building•Commissioner Permit no. Date 4 AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: 4e Estimated Cost &O —" Address of Work: -6 '' Owner's Name: �c�W� �.Q -.i�✓�S �j.� Date of Application: a L) 1.79 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law oJob Under$1,000 ❑Building not owner-occupied (]Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR Date Owner's Name g1orms:Affidav j i I �� I .. A - - - _. _ __._ _,__ I - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION u/ �2 a. resS Map F.Wcel D Q/ Permit# Health" iv n U Sic s i o Date Issued _ _9 Conservation Div' ' Fee 10 Tax Collector Treasurer G� Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis -Project Street ddress -, (017 A o 2:6 O I' Village } .Owner �0��7 /-�� gr�t,:s46 b _ Address 367 9 -- 3 Telephone }�®8'� � � • ' Permit Request O0,rnrjJ ��07 O� �X'+S`f1t nG � ��'�r� Gp�A �r�+)a� , J » ,. . And O'®lNg{ Square feet: 1 st floor: existing . proposed 2nd floor:existing, proposed Total new Estimated Project Cost 77 Z V 700 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type:_ Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Stru ture Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes El No Basement Type: ❑ \I ❑Crawl ❑Walkout ❑Other Basement Finished Are sq.ft.) Basement Unfinished Area(s . Number of Baths: Full: ex new Ha - ing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor-Room Count Heat Type and Fuel: ❑Gas• ❑O' Electric ❑Other Central Air: ❑Yes ❑ Fireplaces: Existing New Existing wood/coal stove. ❑Yes ❑No Detached garage' existing ❑new size Pool:❑existing ❑new size- Barn:❑existing ❑ne size Attache 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 p Proposed Use BUILDER INFORMATION uw Ke/ �� Ha c.c:y0 X 'f( Name f ,r Ci '� S��i-j-� Telephone Number PIDO Address ' R 612mo.r A ve. License# - 2 (b_(o Mcd o6 le , MA ®jog i Home Improvement Contractor# Tf„ete/-S Worker's Compensation# V B —/070- /Z'l-3-9�' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE g DATE /o2�oZ M FOR OFFICIAL USE ONLY PERMIT NO.' DATE ISSUED T i MAP/PARCEL NO., ADDRESS ''-'VILLAGE OWNER L � .. '* '' ` i �. ' + rM " • �+ k • _ � i ?•;,.. DATE OF INSPECTION: FOUNDATION FRAME � � � .• � � . - x s , INSULATION : FIREPLACE r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINALOf GAS: 'ROUGH 'FINAL FINAL BUILDING DATE CLOSED*OUT, , ASSOCIATION PLAN NO. Y Maloney Kathy From: Higgins Ann To: Maloney Kathy Subject: RE: aeration project Date: Thursday, March 04, 1999 9:15AM Mark Ells will authorize a transfer of funds ASAP to cover the permit fee of$10,545.07. From: Maloney Kathy To: Higgins Ann Subject: aeration project Date: Thursday, March 04, 1999 9:05AM Ralph has given the go-ahead to issue the permit for the aeration project. This is based on the agreement that Mark Ells will authorize a transfer of funds to the special project account as soon as Mary Blake issues an account number for the project. The permit fee is $10,545.07. 1 can release the permit as soon as you verify that this information is correct. Thanks! 1 Page 1 hL(,U 6 L v z 6 ISS8 I�ti�t��♦. �I IF'IG�T� OF . : ISM (IT MM/ODlYE DATE 09/25/98 ::::: .................................. PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION COMPANIES AGENCY INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 25 BURLINGTON MALL ROAD HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. BURLINGTON., MA 01803 COMPANIES AFFORDING COVERAGE COMPANY CODE QUINN AReliance Insurance Company INSURED COMPANY HARDING &SMITH INC BTravelers HARDING AND SMITH CORPORATION 27 RENMAR AVE COMPANY Athena Assurance Company WALPOLE, MA 02081 ATTN: SANDRA HUNNELWELL COMPANY D VER/C .:::.::.::.::.::.::.::.::........ .:::::.:.::.::.:... CQ ..... X. ............................................................::.........................................::.............:::..::.........::::......:....:....:..::...:....:::::..........::::::::::.:.:::::::::::::::.......:..:.........:::::.....::::.....:........:..::.:::...:...:............ 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICYEXPiRATION LIMITS LTR DATE(MM/DD/YY) DATE(MM/DD/YY) A CIENERALLIABIUTY QB8544360 06/01/98 06/01/99 GENERAL AGGREGATE s2,000,000 X COMMERCIALGENERAL LIABIL PRODUCTS-COMP/OPAGG s2 000 000 CLAIMS MADE❑X OCCUR PERSONAL&ADV INJURY $l OO O 000 WNER'S&CONTRACTOR'S PROTEACH OCCURRENCE $l 000 000 FIRE DAMAGE Any one lire 3 50,000 ME EXP(Any one person) S 5,000 B AUTOMOBILE LIABILITY 810107D1261 06/01/98 06/01/99 COMBINED SINGLE LIMIT S1,000,000 X ANY AUTO ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON OWNED AUTOS (Per accident) TX COLLISION $500 DEDUCTIBLECOMPREHENSIVE 500 DEDUCTIBLEPROPERTY DAMAGE s GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ....................................... ....................................... ....................................... ....................................... ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT S. AGGREGATE $ C EXCESSILIABILITY 900BA3466 06/01/98 06/01/99 EACH OCCURRENCE $10 000 00 X UMBRELLAFORM AGGREGATE $10 000 00 OTHER THAN UMBRELLA FORM RETENTION S lO 00 B- WORKERS COMPENSATION AND UB106D9855 06/01/98 06/01/99 X I STATUTORY LIMITS EMPLOYERS'LIABILITY EACH ACCIDENT $ 500,000 THE PROPRIETOR/ X 71 INCL DISEASE-POLICY LIMIT s1 O0O 000 PARTNERS/EXECUTIVE OFFICERS ARE: EXCL DISEASE-EACHEMPLOYEE $ 500,000 OTHER A INSTALLATION QB8544360 06/01/98 06/01/99 LIMIT: $1,728,700 LOATER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS *10 DAYS NOTICE OF CANCELLATION FOR NON PAYMENT OF PREMIUM THE TOWN OF BARNSTABLE AND STEARNS & WHEELER ARE ADDITIONAL INSURED FOR (See Attached Schedule. ) CEHTiF(CAT NOLDER:> ... CANCI.EATIfSN . .... ..... .. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE TOWN OF BARNSTABLE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 367 MAIN STREET *3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, HYANNIS, MA 02601 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY AIND THE COMPANY ITS AGENTS OR REPRESENTATIVES. AUTHOR ED NTATIVE 66, ...................................................._..........................................._...................:..................,. :..:. ..::::.:::::.:::::.' `:::.:.-,::..:.:.::::.::::::::::::::......... .. . ACORD 25;S; Q AGORD CORPORATION1.993: ,.... . DESCRIPTIONS (Continued from page .) ...........................................::..,:::.... GENERAL LIABILITY AS PER FORM CGBI 7504 BUT ONLY AS RESPECTS WORK PERFORMED BY THE NAMED INSURED RE: BARNSTABLE AERATION AND PUMP EQUIPMENT REPLACEMENT CONTRACT 04-000-98-075 GISGEM:ZS;Z; 2 .:at::2 #5613 22 jM5186B.,< . -=- - The Commonwealth of Massachusetts SITM, Department of Industrial Accidents A• =- Office ollnlirestfoatioos �i4 � � 600 Washington Street Boston Mass. 02111 Workers' Comyensation Insurance Affidavit name: location: city phone# ❑ I am a homeowner performing all work myself: ❑ I am a sole pro rietor and have no one working in any capacity %/%%%%%//G���%%%%%/%%%/%////%/%%%/l//%%/%%%%%/%%//%%%/D%/%%/%%%%%%/%%%%%��%%%%/%%%%%%%//%%/%/%%%/%%%%%%%%��%%%%%%%/;;;�;; ❑ I am an employer providing workers' compensation for my employees working on this job. company name: address: city phone#: insurance co. nolicv# ❑ I am a sole proprietor, general contractor, or homeowner(circle one) d have hired the contractors listed below who have the folloning workers' compensation polices: com anv name: address: city: insurtince ca. company name: _.. address: city- phone#r ... ..... ... :..:.. :., .: insurance co. .::.::.::..::.•:::,....:,. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. I do hereby certify under the pains d penalties of perjury that the information provided above is tru,.and correct Signature Date a� Print name Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license q ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone q; ❑Other w. .:......; :... (rrmec 9i95 P1A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contr-: 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 receive: 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 section 25 also states that every state or local licensing agency shall withhold the issuance or renewa: 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, 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 in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns 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. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you 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 lavesugauOns 600 Washington Street Boston'Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 It i sNi ' mj it. . i it v t T if it s It 1 I. . lit c } BE N t... �. � �Y� N � m Yl •'p 7C Y � O' N :� T ' j rn F � � • 1 _:R._ __— . ' TOWN OF BARNSTABLE ,- z CERTIFICATE OF OCCUPANCY PARCEL ID 293 001 GEOBASE ID 20505 ADDRESS 382 FALMOUTH ROAD (ROUTE PHONE HYANNIS ZIP - LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 30827 DESCRIPTION PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: . and Environmental Services , TOTAL FEES; BOND $.00 SINE CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY 3 PUBLIC PR * 1ARNSPABLE, MAss. 039. A�0 FD MA'S � BUILDIN, IVI I ` _ DATE ISSUED 05/11/1998 EXPIRATION DATE BY w` a3 s- TOWNf)F 14ARNPTABIX 4 _ BUILDING. PERMIT � I YARrEL-'ID 293 003, GEOBASE ID 20505 1 l ADDRESS 382 FALMOUTH ROAD (ROUTE PHONE I HYANNIS ZIP I I,OT BLOCK LOT SIZE W_ � DBA DEVELOPMENT a IDISTRICT HY �� ^� j PERMIT 215284 'DESCRTPTION MAINTENANCE GARAGE (METAL BLDG, ) PRRM1T TYPE BREMODC TITLE COMMERCIAL ALT/CONV CONTRACTORS: RUNCI , STEVEN Department of Health, Safety ARC'�i1TECTS: and Environmental Services TOTAL FEES' $`l,930.GC) BOND $.40 Ox THE CONSTRUCTION COSTIS $1 ,300,OOQ.00 437 NONRES./NONHSKP ADD/CONY 3 PUBIJC Phi- *:aR. * BARNSTABLE, • MASS. OVINER F3AN.N.�`E'ABL TOWN .OE {MUN) >tbg9. ADDRESS ED MI�►� 367 MAIN STREET, HYANNIS MA � BYIL �DI�SION DATE ISSUED 03/27/1997, EXPIRATION DATE r I I THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE-SUBDIVISION RESTRICTIONS: MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS-BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET I BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS �75 ,u� 2 2 � j C 3 1 EATING INSPECTION APPROVALS ENGINEERING DEPARTMENT `1 I 2 5 1 1-91 BOARp OF HEALTH �kyll OTHER: SITE PLAN REVIEW APPROVAL D k WORK SHALL NOT F40CEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS j THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. B' �. /, ��. ,Y .,.� � Fyn;^.' � .. �r._� � ` "�.�^. fir' 1 I ~?� ``,�. `-_ �C. -�Y=�y 1 `' 7 .� �- �^ TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 293 001 GEOBASE ID _ 20505 ADDRESS 382 FALMOUTH ROAD (ROUTE PHONE HYANNIS ZIP - LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 30827 DESCRIPTION PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: BOND $.00 Ok THE CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY 3 PUBLIC PR * BARNSTABM # MASS. 039. FD MA'S BUILD IVI BY DATE ISSUED 05/11/1998 EXPIRATION DATE _OWN I)IF d'�-�'•._ .,LJ . it-..� -P ..._.. .. ._ .. Department of Health, Safety I.' and Environmental Services IME + 1J►RN3TABLE, • MA'S BUILDING DIVISION _. . :A'e.. THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED APPROVED PLANS MUST BE RETAINED ON JOB AND FOR ALL CONSTRUCTION WORK: WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOSTTHIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 3 h�ll 1 EATING INSPECTION APPROVALS ENGINEERING DEPARTMENT �Ialliv 2 J — e r 9 B BOARD OF HEALTH dy �^�UOant1 OTHER: SITE PLAN REVIEW APPROVAL . b WORK SHALL NOT NOCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. Engineering Dept. (3rd floor) Map ParcelA,/ Permit# _/2,f�!>,42C>J House# �6/.- ��_S _ Date Issued _,/v2.��p`g� Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee_ ✓�/ S� Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) 1 CL� ' a Planning Dept. (1st floor/School Admin. Bldg.) — 1HE ''rrffe ir�'tive Plan Approved by Planning Board 19 RARNSTARLE. TOWN OF BARNSTABLE C6/ Building Permit Application 6a-�sys 6JA-�l Project Street Addres Village Owner ��y�� i A����� L Address 36 7 ,!�2-,A/AV _S r Telephone Permit Request -First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District X C/ 4, Flood Plain ZD,cr Water Protection G Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure I 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 No. 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 0,No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) a ❑None ❑Shed(size) ❑Other(size) Zoning Board of Ap eals Authorization ❑ Appeal.# Recorded❑ � °Commercial es ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number Address I License# C 5- 0 Cep¢-6 6 8 U n rt St r 6Grtl rc rut Lr: tj . t��Q _ �g�t L� Home Improvement Cdn ractor# p� � Worker's Compensation# 0 U,-B- NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ADATE, /6S,AV e 5 A 6 BUILDING P MIT DENIED FOV THE FOLLOWING REASON(S) ' FOR OFFICIAL USE ONLY PERMIT NO. - DATE ISSUED ' } PMAP/PARCEL NO. I i ADDRESS A VILLAGE t OWNER DATE OF INSPECTION: FOUNDATION FRAME + INSULATION - FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS:'' ROUGH FINAL FINAL BUILDING DATE CLOSED OUT R I r ! ASSOCIATION PLAN NO. c �! i 1 V i i t The Commonwealth of A1assac•husetts Depnrtntutt of Industrial.9ccidcnts i Office oliovestigations 600 11 ac hi toff Street Bostoii, A1u.ys. 02111 Workers' Compensation Insurance Affidavit �hrltcant information: "Please PRINT Ie��i)v""" name• location: Cit.,- Phone# , I am a homeowner performing all work myself. 1 am a sole proprietor and have no one working to any capacity L P,^� s..- ..+.w ro...�.... ...r.+ . +}�+•"?^"+^ ..2 M ._.. :c.:.: �.c..�t+- 1 am an employer providing workers' compensation for my employees working on this job. company name: address: cite: Phone#: insurance co. Policy# 1 am a sole proprietor, general contractor, or homeowner(circle are) and have hired the contractors listed below who have the following workers' compensation polices: company name: address: city: phone#: insurance co. Policy# � .. '•:. • .. .' 1 Lam'.,_ __..__._..._. ._._..._.�_.�.....-_- ._I_L:.+e...y:.._...�_..w.�.ilr.ryr'JW'.ru� u�•flr.rr.:IL.►L'a:1'� _.-r..l'•..i:Or✓aE►1' — company name: address- city: Phone#: insurance co Policy# ,Attach additional sheet if necessary; -- •- -----.. '.`- `='- ....«®'.•.. :r�.fi.. ,-....::- •>�e..:�� as:•tiraa�cs_+-+s'�— =�.�.:`r:.::s�.:�auir':.t,�;�i,.k-.. ..,z. Failure to secure coverage as required under Section'_5A of 111GL 152 can lead to the imposition of criminal penalties of a line up to S1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. 1 understand that a cop% of this statement ma% be forwarded to the Office of Investigations of the D1A for coverage verification. 1 do hereby certify under the pains and penalties of perjure•that the information provided above is true and correct. SiEmature Date Print name Phone# _ _• official use u h" do not write in this area to be completed bi city or town official J� ` city"or town: permit/license# rIBuilding Department 1. ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office f•: ❑Ilealth Department contact person: phone#: M01her ?: 4: f,e,,sej 3:11;NA) r Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers- compensation for their employees. As quoted from the "lacy", an enrploree is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An enrplot•er is defined as an individual, partncrship, association, corporation or other legal entity, or anv two or more a; the forcuoin- enraged 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 _rounds or bUlldlnL appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that even, state or local licensing agency shall -,vithhold 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. 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 in the workers' compensation affidavit completely, by checking the box that applies to your situation and Supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coyera`e. 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 anv questions regarding the "law" or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns 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 Investibations leas to contact you regarding the applicant. Please be sure to fill in the permit/license number wlticll will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. }^*•�.v.-.•-...._..: _...._.+_•..i:..... .-��..+..'�.r.�.S..::vt.�.. .r--:�v.,r...a�.......^T.`tX.As'A+.•.'...y.w:ash?v.mr\dT�..,,�;+iv..+•`r7w_Tr.�-.slwaM-.....:'.^I.n *�►..I T'.+Vi t?'. -s•1�1•IWs�- . The Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of investigations 600 Washinaton Street Boston, Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 37-555 a � I I Lon v7 _ o cn o I �_rm CD ,1y a 97. o 0 I � zG'. . I � zrTa rN is crrl an Z N II . cam I —, � � / III 'lj Lon 70 rrl z rTli - - CD GD m O 70 70 II I 1 O m o Rg: i \ v' fll II ;i � z i 1 1 0 ^ m o f � o r1 I m C:) vnO Q lilt I I -G I !i I r 14p�r 3 I 1. £315-70, A i — — — — _ —s_?r — — _ _ — — — — Cy- CDO O I m !� IOLN RD. L Ieta� I I I f\ I j I -BUCKIyO O EX1. f p 1 I 14. � po OErH T+W v C�CIE I I = ,i .`.... 1 E , CD Lq g$ o co = r / ,= z O x a z 4'S 1XJC E r ENiERPRgfPRDNffOLE lN. O C z r— 70 z n a d�c OtlOU]M15 = MOEPENOENCE i 3sno -- r= , 0 ;, /--------—----- , N .. 1 Efl Ul _ Ul U1 D S A 1 � C W ,C2, fY► C O q� I "I • l + s eo �o c �. i J a c ono .`e w• ram-• sr-a � ' w �. PAGE 1 PO # 97007359 VENDOR 592377 ------------------------------- PURCHASE ORDER DATE 12/19/96 1 P U R C H A S E ORDER I REQUIRED DATE ------------------------------- APPROVED DATE 12/19/96 VENDOR SHIP TO TOWN OF BARNSTABLE DPW - ENGINEERING BUILDING DIVISION TOWN OF BARNSTABLE 367 MAIN STREET 367 MAIN STREET HYANNIS, MA 02601 HYANNIS, MASSACHUSETTS 02601 BUYER BLANKET NO CONFIRMING NO CONTACT PHONE # TERMS FREIGHT VEND PROD NO ITEM COMMODITY NO _ QUANTITY UNIT MEASURE UNIT PRICE EXTENDED PRICE 1 15250. 00 N/A 1. 00 15,250 . 00 616-02- - LEGAL/LITEGATE/LABOR CLARIFIER PROJECT-7296159 BUILDING PERMIT SUBTOTAL 15 250 .00 FREIGHT 0. 00 TAX 0 . 00 PURCHASE ORDER TOTAL 15, 250. 00 TOWN OF BARNSTABLE of o 230 SOUTH STREET eenx, HYANNIS,MA.02601 331576 _ TEL 508-790-6210•FAX 508-790-6224 ORGANIZATION ACCOUNT PURCH.ORDER INVOICE NUMBER AMOUNT DESCRIPTION 7200C - 61602 97007359 293- 01 15r250.00 ENG-PERMIT 592377 . TOWN . Of BAR STABLE REMITTANCE ADVICE ATTACHED IS OUR CHECK IN FULL SETTLEMENT OF ITEMS SHOWN HEREON. DETACH T IF NO CORR T. ANT ON,PLEASE RETURN WITH EXPLON. BEFORE DEPOSITING s. --------------------------- ------ PAGE 1 1 R E C E I V I N G R E P O R T ----------------------------------- PURCHASE ORDER NO 97007359 BLANKET RELEASE NO CHANGE ORDER NO DEP/DIV/SEC 7200C PURCHASE ORDER DATE 12/19/96 REQUIRED DATE APPROVED DATE 12/19/96 BUYER PO TYPE PO DESCRIPTION BLANKET N CONFIRMING N FINAL VENDOR NO 592377 . SHIP TO VENDOR TOWN OF BARNSTABLE DPW - ENGINEERING BUILDING DIVISION TOWN OF BARNSTABLE 367 MAIN STREET 367 MAIN STREET HYANNIS, MA 02601 HYANNIS, MASSACHUSETTS 02601 PAYMENT TERMS FREIGHT VEND PROD NO CURRENT ITEM COMMODITY NO RECEIVED UNIT MEASURE UNIT PRICE EXTENDED PRICE 1 15250 . 00 N/A 1.00 15,250. 00 616-02- - LEGAL/LITEGATE/LABOR CLARIFIER PROJECT-7296159 BUILDING PERMIT SUBTOTAL 15, 250.00 FREIGHT 0.00 TAX 0.00 RECEIVED ITEMS TOTAL 15, 250.00 DECLARATION: I hereby certify that the quantities of goods and/or services shown as 'RECEIVED' are correctly stated and that all items were received in good condition. (Note exceptions on reverse side. ) DEC 2 T 1996 ' ------------------------------ !-- = - -- --`.-- ------------- Date Received ; r/ Rece ver's Signa RECEIVINGv DEP TMENT PAGE 1 PO # 97007359 VENDOR 592377 ------------------------------- PURCHASE ORDER DATE 12/19/96 P U R C H A S E ORDER I REQUIRED DATE ------------------------------- APPROVED DATE 12/19/96 VENDOR SHIP TO TOWN OF BARNSTABLE DPW - ENGINEERING BUILDING DIVISION TOWN OF BARNSTABLE 367 MAIN STREET 367 MAIN STREET HYANNIS, MA 02601 HYANNIS, MASSACHUSETTS 02601 BUYER BLANKET NO CONFIRMING NO CONTACT PHONE # TERMS FREIGHT VEND PROD NO ITEM COMMODITY NO QUANTITY UNIT MEASURE UNIT PRICE EXTENDED PRICE 1 15250.00 N/A 1.00 15, 250.00 616-02- - LEGAL/LITEGATE/LABOR CLARIFIER PROJECT-7296159 BUILDING PERMIT SUBTOTAL 15,250.00 ` FREIGHT 0.00 TAX 0.00 PURCHASE ORDER TOTAL 15,250.00 Engineering Dept. (3r4 floor) Map # 2�� Parcel #1 Permit# House# 4'-/5 - 6/ 7 Date Is-sued 2S Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) .�•Q� ^ Fee �S, Q Conservation Office(4th floor)(8:30-9:30/1:00-2:00) i Planning Dept.(1st floor/School Admin.Bldg.) �t►u,q Definitive Plan Approved by Planning Board 19 • BAMWABLE.p` TOWN OF BARNSTABLE Building Permit Application Project Street Address f a_414t �lDY Village _&Y,0X1A1/_J A:Z,9 - Owner .�9,A/ n& owa l_ ,r lnp5z.& Address f6 7 / Telephone j"p,4 ?S - ?/Ca Permit Request 1 First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection G P Lot Size 8 Z- 3g !�' ras Grandfathered ❑Yes ❑No 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 No. 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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use Builder Information Name �- ('�,� C�� -r-;� Telephone Number of.,- 505— �3� Assessor's Office(1st floor) Map :: Parcel VZPeiinit# Conservation Office(4th floor)(8:30- 9:30/1:00- 2:00) I Date Issued m —,—9s--- Board of Health(3rd floor)(8:15 -9:30/1:00-4:45 Fee $r /Engineering Dept. (3rd floor) House#, z �,g �77 Ai-4-goo", Planning Dept.(1st floor/School Admin.,Bldg.) Definiti e OnAved by Planning Board 19Tp TOWN OF BARNSTABLECON* Building\Permit Applicati� )Project 3� r IiLJ t (.UG� Village S Owner � ,�,A Z 0® �r�� 1�_Addresstq ,a Telephone Permit Request aj it First Floor V square feet Second Floor square feet — Estimated Project Cost $ �- Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name il Telephone Number 5-0 F — Zra `laq—o?3E? Addr ss License# ~ Home Improvement Contractor Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE✓ DATE BUILDING PERMIT WENIED40& FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED _ MAP/PARCEL NO. ADDRESS i VILLAGE i OWNER DATE OF INSPECTION: FOUNDATION FRAME + i ! INSULATION FIREPLACE ELECTRICA&r ROUGH FINAL - PLUMBING: '% ROUGH FINAL GAS: R FINAL FINAL BUILDING DATE CLOSED OUT Z3 ASSOCIATION PLA �. ` JTlie Commonwealth of Atassaclluscitt Department of Industrial Accidents »� ; ; : •;a' 6011 ciasithigton Street �'t:��`��-•; Boston.Alum 02111 �• Workers' Compensation Insurance ARdavit AFw cnn'�fot a :o—n-- PlettSe PRINT,;,�iL name, Ai l A 1J V�- Incntinn• p city I` AYC""I I d, ®D'(T— y0 6 q G nhnne# 1 am a homeowner performing all work myself. (] 1 am a sole proprietor and have no one working in any capacity � 1 am an employer providing workers' compensation- _g on � p p � for my employees working on this job. m L addres /A it cih•: nhnne#: 7 O� —I oc " ��(��(+ insurance rn_ nnlicy# GJC, 31 — y'2 T O�`�—d 13 rl 1 am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices comnanv nnms- address: cih•• nhnne#: insurance Co. neiin•# i-�..:ii._ ---..:�:-• - .. ..c.,r:.:..s,.:.sa-s.-�-�._+►.-�•:Tmr,«sr+x'�+�==• _ __-_- •-T�itfP+.Ty7�^�:+r�'f?�R47�aa►.�•�!--,Y..+�n.,-M�.+�•-^.ter -- cammov name- address: cih•• phone#: insurance cn_ nolicv# _ .Atiach additional sheet if tiee •�..2: y -�-;+��-•►�'+, :.'<t...: •• • F'siiurc to secure coverage as required under Section'SA of h1GL 152 can lead to the imposition of criminal penalties ofs fine up to S1300.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a floe of SI00.00 a day against me. I understand that a Copy of this statement may be forwarded to the 011ice of lnvestigatioas of the D/A for coverage verifteation. l do herebtr certij•under t pal and p altia ofperjurt•that the inform don pm-ded above is trae and corriecc Sianatttte Zate Print name ,Q!L�f��/ f�a SF 1n// Phone# r oftcial use only do not write in this area to be completed by city or town oflicial city or town: permitAieense# riBuilding Department OLiceasing Board check if immediate response is required QSeleetmea's 011ce 0I11allb Department contact person: phone!!; Mother_��_ 4 .IMF/-1�•� 711 01M, i� +,} r „� ,,,,y' ram ,,. h'' �. ` .��* ✓"3 .iF�,. � a'"3.*� 9.:..at"..'.4.:e ,w t . ,< ""U T ,. wt 4 i '..b ,+."'•.8f f*ar c,�.e tv :'�„''" 4 v t r 117 ya f a � r.1 l V n N r+ a tJ Assessor's office(1st Floor): q , Assessor's map and lot number k/'Z/ 001 of INC to Conservation(4th Floor): Board of Health(3rd floor): x Sewage Permit number : ssa»r�ncc ; � rua Engineering Department Ord floor):' House number o Ysv Definitive Plan'Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 AM'.'.and V00-2:00 P.M.only , TOWN OF BARNSTABLE ' BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION v Vi 4��1 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: i Location �, .S�S Gt/4% r00'eI!,5-J Proposed Use c �' ws9yf iw 7-0 �G'r/!'�j�vN9 Zoning District Fire District Name of Owner%QG(/A/ a/' 4/9041V-S';--7 11 Address L/i /'?z Name of Builder ° /®/®SO �5 3 �Y/� Address 15�9 SRr-v S voe. ST �h�.r2�►Mrk Alk 0z.13C Name of Architect e�s/d VJW 7tWxJeD -Q Address /9� SOrl�2 s1 LPG'//yiej Af p 2/7S' Number of Rooms Foundation ��e e7- Q Exterior�yP—e�S i Ga�vcre7�P Roofing ^-e 74 Floors yG-e Interior Heating Kj /�zPlumbing / f! / �'Ql'Y rr✓1�i � !/iL�. Fireplace /y/ Approximate Cost ®®® Area Diagram of Lot and Building with Dimensions Fee J'. OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. C �Construction Si ipervisor's License / -r. TOWN OF BARNSTABLE No 36764 PPermit For CONSTRUCT PUMPING STATION Location RPAY gin C way,Hyannis I , Owner Town of Barnstable _ Type of Construction Plot Lot - Y Permit Granted June 8 1994 Date of Inspection: - r f { Frame 19 Insulation 19 ` Fireplace 19 Date Completed 19 " 41. •� s B�11 I�L D l�I��:G- I��E_ R M IT 's '.F.a^'.':+.�..•-ri—,^.r3i *u.'. asw�. 1. �`+ -,r�+�".. k TOWN OF BARNSTABLE, MASSACHUSETTS A=293 001 DATE June 7 C(c�� 19 94 PERMIT NO. N• —U764- APPLICANT P. Gioioso & Sons, Inc. ADDRESS58 Sprague St, Hydepark MA 047966 IN0.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO Construct pumpi g( stpats-adPfl DWELLING UNITS (TYPE OF IMPROVO�ENT) NO. (PROPOSED USE) AT (LOCATION) Bearses Y�Ay, Hyannis ZONING d DISTRICT— (NO.) (STREET) BETWEEN - - AND - - - (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: AREA OR PERMIT VOLUME ESTIMATED COST $ 588,000 FEE No Fee (CUBIC/SQUARE FEET) OWNER Town of BArnstable ADDRESS 367 Main ST• / Hyannis BUILDING DE PT. BY �Q/ `.""�'�-.r.+�,��►:•---•`"�+s✓Zr-+�---4:,.-,4 s: ^w:-..--��-er-�-r'rs�--ww--.►-w--`•.r•�.:r-.�*..r P'�" 1--', �# ...t ..i'`d g.:•vy�e�fr}'�#�^-�'� :..,,TOWN OF BRRNSTABLE, MASSACHUSETTS RI�IWING PERMIT A=293 001 DATE I 19 PERMITNb.June 7 94 Q �367�64 ' APPLICANT P. Gioioso & Sons, ne• - ADDRESS58 .Sprague St, Hydepark MA 047966, IN0.) (STREET) (CONTR'S LICENSE) PERMIT TO Construct pumping( styits+49p NUMBER OF (TYPE OF IMPROVEMENT) N0. (PROPOSED USE) DWELLING UNITS Bears es YYA, Hyannis ZONING AT (LOCATION) i] DISTRICT (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE r' BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION R TO TYPE - USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) M REMARKS: J AREA OR VOLUME = ESTIMATED COST $ 588/000 FEE ARE $ No Free of DARE FEET) � OWNER Town of BArnstabae ADDRESS 6 ftu In 6r. , .hyannis BBUILDING DEPT1 � ! r f THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY -THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS)READY TO LATH 3. FINAL INSPECTION BEFOREE FINAL INSPECTION HAS BEEN MADE. OCCUPANCY. ` POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 a 2 2 2 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 1 2 BOARD OF HEALTH OTHER SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. � w me � r � v_ - z � � Assessor's office(1st Floor): _ p Q �, tf SEPTIC SYSTEM MUST BE Assessor's map and lot number INSTALLED IN COMPLIANC Board of Health(3rd.floor): I Sewage Permit number WITH TITLE , Engineering Department(3rd floor): - ` 'ENVIRONMENTAL CODE A DAaa9TADLL `c rus House number _ ct a TOWN REGULATIONS va +639• Definitive Plan Approved by Planning Board - 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only ' 'r > TOWN -, OF BARNSTABLE i ' BUILDING INSPECTOR t APPLICATION FOR PERMIT TO /�(�1L!l7 APy)%•IU TYPE OF CONSTRUCTION A m2 1T1 p , 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 1 S' Proposed Use L Qr; - 7W4'/d o L Zoning District Fire District Name of Owner -a w hi ti r� �.4r.Alt;va rye f Address L/W TP. Bfs A44151.S IL/A+l Name of Builder aS o C-0:e �s�%�-:� �a��tn�� �nrs Address f 35- 1_: Name of Architect Address .214 1j 1A1604n I 57 J3os-r`oN � ��A Number of Rooms l Foundation C014C.2,0 Exterior i\1l c_Ae- 'vr rp i zt C. Roofing at- 1?-0,,1= Floors , Interior Heating Plumbing 4 Fireplace Approximate Cost aQv)P..,gi4-r jsgl Oro ____-._._Area g � Diagram of Lot and Building with Dimensions Fee EAisri JJA �LUrJG/ 1��11-dCC.➢�►C, oaO)Lx)iAtR -del ��r A.DDIT0 a OCCUPANCY PERMITS REOUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License TOWN OF BARNSTABLE • I No 34 2 S 'Permit For Build Addit , nn - Wastewater Treatment plat ` Location, - Bearses WayL ~` ,• -� Hyannis Owner. Town _.of Barnstahl P ~' F Type of Construction Frame r' t Plot �! ' Lot Permit Granted' Marc 26 , 19 91 Date of Inspection } i—19 14 Date Completed 19 S. .tea T t gTV T i•} ! i t • J Assessor's office(1st Floor): 3 Q t Assessor's ma�nd lot number „ . �o�TWE Board of Health(3rd floor): Sewage Permit number • Z DMUSrADLL i Engineering Department(3rd floor): roves House number °O 039. Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN - OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TOy�L�rQ� yoll-/gL�L S r♦[� c- �trr �C'tdRA �atLiIAGG��t. �/ et TYPE OF CONSTRUCTION 1�9�Cp- /S 19 ?9 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location go! Lae 44-1-Se 5 GcJ A-u Jl YAAi N Proposed Use A AI V l r L �'/AGi �� 3`Le Zoning District /? C " Fire District I-1V A k N t s . k, Name of Owner7r-0 WA6 ®Ar �RB'.t�S1�'�-1 �� Address a.".y i�-r�• Name of Builder '. E90 A!/X A7T'/ L.c9 ..�svC Address 160 I CE $/. . . wef eucs�,� Mfg. 0,U.6-9— Name of Architect 1,1L 1 t&W '- CqgEj Address ' w,�1-a14 M S7k OeC ,e_ zQU. !� Number of Rooms I S Foundation C Exterior �A-5;6 Roofing !`' �-- 4'AoPqP— Floors �trcaeLs-e.7�� Interior �� +Ik Heating � rrG � �Wi4-�� aActN lumbin Fireplace Approximate Cost Ze5, Soo Area Diagram of Lot and Building with Dimensions Fee 6))e, OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ¢ Construction Supervisor's License 4 7�� �-` TOWN OF BARNSTABLE i No 33330 Permit For ENLARGE FAC I F.;I TY Polution Control Bldg. ,y Location 617 Bearses Way ` Hyannis Owner Town of Barnstable r - J Type of Construction Frame Plot Lot k. Permit Granted November 2, 19 8 Date of Inspection 19 Date Completed 19 j �. r TOWN OF BARNSTABLE Permlt No. 333 9....... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash 7 Yl a679• ''rarer` HYANNIS.MASS.02601 Bond ....N/A...... CERTIFICATE OF USE AND OCCUPANCY Issued to Town Of Barnstable Address 617 Bearses Way Hyannis, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID,.AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. December20 19 90........................ ........................................... Building Inspector �{`y�'� y_�..yr .. .�, ...�w..tii. •,,,,......11r�.. Y aN�.,"/t�,�� :^•yy.�.��, ,'��j;�'31n�W����� +''�p� {�',♦ ��Y ems,` TOWN OF BARNSTABL9\ 33\Permit-!9,o 3�0. .................... BUILDING,CIEPARTMENTA �TOWma,Ny.OFFICE BUIL:DING`y , % "" Cash HYANNIS.MASS.02601 Bond N/A • � 1 I� t CERTIFICATE OF USE AND OCCUPANCY . , .�, F-. .•. . .. Issued to Town Of .Barnstable Address 6,1� BearSes Way .Hyannis, Mass.1 � USE GROUP r` FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOTIBE VALID; AND TIIE BUILDING`SHALG NOT BE OCCUPIED'UNTIL'•, SIGNED BY THE^BUILDING INSPECTOR UPON SA• TISFACTORY,COMPLIANCE WITH' TOWN .,; REQUIREMENTS AND"[N'ACCORDANCE`WITH"SECTION'119.0 OF THE MASSACHUSETTS'STATE BUILDING CODE. k Decembek`.2'0 19 90 .. . .. . .... ..... ..... .... . .... Building Inspector tLL 5 - y`+cam_^L.� 'ti.•.y♦.r,��}i",��'�} Jry w.`: •Yi�'� �.'1„ .1 r v ..• .y'Y��"�...�*'•r�r„_•�,,.�.^...�"^r.,,w� ":.J�n•.e.• .rT"+�.`�-r-... .._. _ ,FINE>, TOWN OF BARNSTABLE: Permit No. 33 BUILDIN_G,DEPARTMENT # TOWN OFFICE BUILDING Cash _ Ml f ' aw• NSA 'Traur HYANNIS.MASS.02601 Bond a . CERTIFICATE OF USE AND OCCUPANCY Issued to Town Of Barnstable Address 617 Bearses Way Hyannis, Mass. Y,a USE GROUP- FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL.NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS.AND IN ACCORDANCE WITH SECTION'1.19.0 OF THE MASSACHUSETTS STATE BUILDING CODE. December '20; I9 90 Building Inspector t �` a Assessor's offioe (1st floor}: ��— Assessor's map and lot number �....�......:�....L.��` ���' Q��f �i° f� 11 ��r ST¢NIEtO� Board of Health (3rd floor): "�`" ' � O�� " MPL° � Sewage Permit number ............ .:. ........�,`� VAT H TITLES : BAUgTSDLL, Engineering Department (3rd floor): .. 3'.'t9!11VEN AL C0)1, House number ......... 'Gf-........................ ` ulk APPLICATIONS PROCESSED 8:30-9:30 A.M. and, 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING I-NSPECTOR APPLICATION FOR PERMIT TO ..... �/L 'T9GC .4elfr`�Bc�/« ....... ................................................................................................. TYPE OF CONSTRUCTION .. A, F��?l.0.!� .� ...."� .6a� �����.... .... ................................. ............................. ........... ..- ..........................19.5� TO THE INSPECTOR OF BUILDINGS: The undersigned //hereby applies for a permit according to the following information: Location ...........D...�.7........ A�f� f ��. ../ /v � ��/............................................. ..... .... . ............................ Proposed Use L OC/TF_/� D lJ — /i!/..., ...... .....%............................................................................ .............................. ...... ................... C Zoning District .......................................................Fire District ........................................................... Name of Owner ..........F..................Gf ....'Address `l ��//l/.....��' i /�ifi/Ii,C/' C,C ��2 / - ..................... ........r................ Name of Builder .............................................Address .!PDX.. ... �....,.,:S.C.................... . ....................... 7et�14 Nameof Architect .......................................�Zc .....................Address .................................................................................... Number of Rooms ...... .G...r '���...........................................Foundation . ..................................... Exterior ... ......... / / <fi.��..............................Roofing �4 f'!y 4L. ..._Sn'/�liG G�./' .................................................. Floors ...... L .Interior � .Y�.....�6c-".....I... G ................l....... ......../. Heating �ftgf ,f.......2........S fl/�/�G .................... ..... ............................. Fireplace .........................Approximate Cost / Definitive Plan Approved by Planning Board _____________ _------------19 '�. Area ..�.G�C`0...�� -....... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. J Name .. .fL.f..0. ........................................................... Construction Supervisor's License ..�.f..!C'..��. .. TOWN OF BARNSTABLE 31 Install Pre-Eabr-icated No .3.56.... Permit for ..................... .... .. .... .............. Commercial Bldg. Locker Rms. ......................................................................... Location ...617 Bearses Way ............................................................. annis .......................Hy ...................................... Town of Barnstable Owner .................................................................. Type of Construction Frame .......................................... ............................................................................... Plot . .......................... Lot ................................ October 28, 87 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ....... M.ak----------- 19 k% C, L z q..Assessor's map nd lot..num♦yer .'✓ •��� 1 �. /� - 1 �7' 77 " �c�T .rsr',Ev�/-��r` " j, ifs Nn`� 01 - J�•1�d.c T� o : ' , Ser3Gage _4ermit num�r • ............................................. ®WIIT OF IBARNSTABLEN° 3. Iz 3 STiDLE, rf < r3a ib79• £= � DUILDIN-G INSPECTOR 90p 00 APPUCArTION FOW ERMIT TOU•��TI ••AAA•ITZO�IS..TfJ..PQT�LtZTIOD�..CON.TROL..EACII.ZTY.;...... TYPE OF CONSTRICTION REINFORCED CONCRETE ••.. „......• .... ......NgMemhax 4. .............19.7.7. . .� TO THE INSPECTOR OF;BUILDINGS: The ucdersigned,hereby applies fora_permit_according--to--the-following-information: Location Route 28,•.Bearse's WaY..:at?d..P . .Chex.:. ..W,ay...-..Hamstabla,...Massachusetx ......................... ......................................................... Proposed Use ..:... Additions to Hyannis Pollution Co11.C.....7.ro................................ ........................................ .. s*��a,Xy.... .. Zoning District .... ...............:............. ......Fire District Name of.Owner Town of Barnstable F c 6 ...................................................................Address ...........Haxnsi;able,..Ma sachusetts................. Name of Builder Titan Northeast Constr. Cor F.ramin. ham, Massachusetts ................................................ ....................Address ....................:.:........................................................ Whitman and Howard Inc. Wellesley, Massachusetts l Name of Architect '......................Address ........................... .............::.............................. ...,... Number of Rooms See Plans .•.•.,,,•,•..,_Foundation ........See Plans ............ Exterior See Plans Roofing See Plans ............................................:..................................... .............. ............................................ Floors See Plans .Interior See Plans ..... ......................................... ................................................................. iumbn ... ...S..ee-Plansreatg See Rlan& ........................._......._.w.�..._...._..._.._...w.. .....S........... F. Fireplace See Plans Approximate Cost $.$.,.346,000 p .. ................ ....... ....... ......................................... Definitive Plan Approved by Planning Board --------------------------------19--------. Area ••.10,500 s.f.building area Diagram of Lot and Building with Dimensions Fee F'fNM +.................... SUBJECT TO APPROVAL OF BOARD OF HEALTH y nI ,_I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable reg rding the above construction. Name ........:.. ...... ..... .... ........ . ................. wn of Barnstable' / M 293 L 1 ' r No. ..1..9XM.... Permit for Add n to .............................. Pollution Control i .............. FaCily....... Location ...Rte 28 Bearses Wap & --- 1 annis y.:.......p... F Owner ..Town of..a$ stable ....................... Type of Constructs on Rein ' Plot ......................... .. Lot ........ ! 4 { " v 28 Permit Granted .......N....o............ember..............:..19 7� i e Date of Inspection 19 Date Completed ......................................19 PERMIT REFUSED 19 # ........................................................ ............ .......................................................... ............ Approved ................................................ 19 t ........................................................................... .► . ...................................... w 's `r - - : e _ THE TOWN OF BARNSTABLE 1639- BUILDING INSPECTOR TO THE INSPECTOR OF BUILDINGS: ,,/The undersigned hereby applies for a permit according to the following information: ' Zoning District ------.---..----,--------.RneDisthc -------------------------- | 'Name ofOvvner --'�p��..ot—J������^}��-------�A66res -----.���Cn�J��—.���.��:.��---------. | ' Name of Builder Ti1ao @ortbeaet Con etz^ Corp^ A66 I�aaacbuu�` I%itman and Howard, Inc. '!as z;aefluSet L See Plans See Plan& See Plan. "e"m.y -------------,---..----------numbmg -------------.---------~____ Fireplace ----------�S��—Plans----------.Approximate Cos -- ........................................................ ' . Definitive Plan Approved by Planning Board ------------------- -----------lQ--------. Area ...lJ.!.3."u ........................... �� Diagram of of Lot and Building with Dimensions Fee ___.r .. --� ^� � 6U08Z TO APPROVAL OF BOARD OF HEALTH � � ' ' ' .. " . ' ' . Y � � ^ ' ' ' | hereby agree to conform to all the Rubs and Regulations ofthe Town of 8unnsto6|a regarding the above | construction. Nome —.—.~,...—.—..~.—..—...-----------.^ � � � Town of Barnstable M293 L 1* X- P T 197&6 ............ No Permit for ...A44.'A..tQ...... Pollution Cant w ............... Facility Location ... Pi chers W y.....py ........................ ............. ........... ...A Owner Jown of Barnstable ................................................................ Type of Construction ....Ae-i4fuced-Coxxr-re te ................................................................................ Plot ............................ Lot ................................ November 2 Permit Granted .....................................§.19 77 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 .................... ....................... I/ WL w ........ ............... ...... .............................................. /P o ........................ 14n Approved ................................................ 19 CO CIS ............................................................................... �h ,J TITAN NORTHEAST CONSTRUCTION CORP. November 9, 1977 Town of Barnstable Town Hall Barnstable, Massachusetts Attention: Building Inspector Re: HYANNIS WATER POLLUTION CONTROL FACILITY Route 28, Bearse's Way and Pitcher's Way Barnstable, Massachusetts Reinforced Concrete Construction Gentlemen: We are enclosing herewith, in duplicate, Application for Permit for the above- referenced project construction and await your approval of this permit. Very truly yours, TITAN NORTHEAST CONSTRUCTION CORP. John S. Marsella Pro'ect Manager JSM:j s Enclosure: Permit/2 cc: S. R. Rupolo i 1661 WORC ESTER ROAD, FRAMINGHAM! MASS. 01701 (617) 620-1165 November 22, 1977 Titan Northeast Construction Corp. 1661 Worcester Rd. Framingham, Mass. 01701 Attention: Mr. John S. Marsella Project Manager Re: HYANNIS WATER POLLUTION CONTROL FACILITY Route 28, Bearse's Way and `• Pitcher's Way Barnstable, Massachusetts Dear Mr. Marsella: ' We have received your Application for Permit for the above referenced project. The Permit can not be approved by the Building Inspectors office until we receive a copy of the plans. Thank you, isilding e h D. DaLuz Inspector Town of Barnstable Assessor's map and lot number .......................................... c1/� 7 SEPTIC SYSTEM MUST BE Sewage Permit num r f............ ....... .. .... INSTALLED IN CONIPLIANCE WITH ARTICLE II STATE IE T IN E s TaS.T TOWN OF i BARISTA►DLM"a 01 ra I N G INSPECTOR E, i 9DUILU 0 MPY a' APPLICATION FOR PERMIT TO ........ a6......V014...... 5 ......61. ee .....737 . TYPE OF CONSTRUCTION ...., rmmi:.........9 ....rA nAu .....(r mh`fro1.....<..�i4ci�t. ............ ............®G s........I`.......... 19..74 TO THE INSPECTOR OF BUILDINGS:, The undersigned hereby applies for a permit according to the following information: Location .........../.I. - hKKL.C........ ......ivi ......�Jl.?a��...A ...���yJe1....f►�fa�.. l���t�4!f.l�... Proposed Use ........... �...... >t< lyiWc .....v ... q} ................................................ ZoningDistrict ........................................................................Fire District ..............t.................................................................. Name of Owner .......1.°. .,gF.....r' Ile .....Mo?;K.......S�.�y...t .�h��./...�`�!�f............. Name of Builder .C:!K . LK""tllh ......4-4,ii�.4`-,....-zoddress ...�.0t....�?O?f.....174', Name of Architect ..� !. !!1 ....../.F�?.W..�!t's ..�-?...........Address ..R.. ... Y..�.R.¢...� . ' ....... .m� ... .✓....1u1/.� l , ANumber of Rooms .Z..lsti r.�A. ...��}.?t'�s.r!t .... Faunion ............^.........................16. Exterior ..............( `p!�c.+" .............vJ.....�........................Roofing .............Gas?►^ ................................................. Floors ................G •v}cry ..............................................Interior .............. ...........................:................... Heating ........: /Tc. "1.t......114JAA. ..1..t.C.� Y„T.............Plumbing .....in!? ... ..o .!.. ...r��,�f....L`�`' ... ao - Fireplace �.....................'...................— ..........................................Approximate Cost .... .....�. ..9 7.�Q.....?c ...................... Ekr---�X-----19 7�_. Area .... ..:..?�.5. ............ Definitive Plan Approved by Planning Board __ Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....... ..... .. ................. '1-.................. Town of Barnstable ! 16816 permit for water pollution No ............... .................................... control facility ............................................................................... Location 4....Bearses....................W�............................ 1. ...........................H.yall ii .................................... Owner ...............Town...of..Barnstable .................... .... ...................... Type of Construction ............... oncrete 1 ................................................................................ Plot ........................ Lot ................................ December 27 73 Permit Granted ...............�... ...............19 x Date of Inspection ...... ....... .... ..........19 Date Completed ..��...7 5.................19 PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ i .......................................................................... . ♦ ) i 1 Approved ................................................ 19 Z ............................................................................... i ............................................................................... 1 F W O1 O O m> DUI G)N O o Cp0 A ( m 0 o ZOn m m � >„ M MN O 0 rn �� m 0 zC m s o 2 -I II O 10 a rn p o0 o 0 N N �2 cNOO AUI O+ O DN tl n �j K= O p'I W �20 �D j X p) N O 1 n N 0 O o' .... ................................................. O m r � O n O J N OD II " X_ M O O AO O \rI/� Cn o N II 0n coin co �TN C wm >0 A r ono O� MD 0 OVA D0 N O� � n 'V D 213, 0 J V � O D Q m A � m pj m y n r m A Cn ;0 �m cn Z II =•� w L o O O O O D D v Z A A D I ✓r N i H n (D. N -D O ' Cf)F � D C A 71 o_ C OTI D o= O z z _ -r1 o � z 0 m D O TI -rl n m M o z �a �O SJiNbl ON'00H(2) �bM S,3sa'V38 Z �? E "E a� go DPW Water Pollution Control TOWN OF BARNSTABLE Locker Room/Lunch Trailer Replacement Department of Public Works 617 Bearses Way Structures&GroundsBARMABM �l v w Hyannis, MA 02601 800 Pitchers Way, Hyannis,MA 02061 1"g. y 'gFp Nlp'4� i z t a �l III�IIIII -- -- ---- -- --E--xist�inIIIIg 1�IIIII Stru—ctu—ral ,IIIII-�Existing Foundation frame to remain to remain co II nII iIII IIII Remove Bulkhesd _==— doors and walls - - — ,____it — — — — �WQ� � �N - - - - - - - � — o Existing Bulkhesd Foundation to remain L n0Z�I— M = �I II II II II II I� � E 2 c II II II II II II � o � � I I Z t- —=== 1=======il-z====JIJ M Q- �xisting Trailer(outline) O � o 0 U) 00 to be removed NOTE: 1 Existing Support Plan Demolition work to be done under A-2 1/4"=1'-0" separate contract by owner. a> O E 0 � y� U co O Q 5'_4„_ U c g `m 4'-0"_ .0 'c` e 6'-111/2"_ : ~ � L 2'-7 1/2"- 0 N «1 34'-11 1/2"t y E Q 28'-111/2"_ o a 23'-21/2 CC CU vi 18'-8 1/2"_ r3 a`> ) c 1 V-4 1/2"_ a -3 1/2"_ Q J C.0 _ '-g"typ. i Foundation Plans r fV T-4 1/21 g. N i NNew Trailer o L Ground Ground Provide New Skirt Around Exising Foundation wn e�r� Exising Footings x"AS N.1.1 ` onr 02/13/2014 Existing Concrete Block 15"x 3"x 8"Concrete Block Support Foundation to Remain (typ.) y 2 Existing Foundation Plan i 3 Section A A—2 A-2 1/4"=1'-0" A-2 1/4"=1'-0" - _ r SEPTIC N 4 u PROCESSING BLDG Hid, 5 56 3_�`S rrr 60� 85 2 E 0 (0 59 N- GARDEN GRASS Q Q AREA 63.04 _ i SECONDARY - ,. _ O •c 60. PUMP cu e CLARIF Water s 3sl\ BLDG ... - Phone , 5e j c 59 ' • - - ' N Electric onnection d LOCKER ROOM GAS c ion MH (0 U i BLDo s r a RIM=58.00 ; it ca «�. CL _ GARDEN' 49 F AREA OF W K 0 A 1j ASPHALT DMH a (� 0 C� 00 >�+ PARKING RIM=57.96 t 5798 f aw low ; g QC CLARIFIER <12' <12' O 5787 ZE O EMH CD r c RIM=60.25 z E Water Connection G) O d �. ss oe <12' <12' n a Z CID 1 BOX A PHALT .. RIVE LJ �a 5717 � O ^ able Connection• ICU DMH s 24 O c >` RIM=60. able GRASS RIM=56.56 a J o o ?3' DIA PUMP AREA qC " E w WITH VENT SMH© CHLORINE MH ; C�`s 00 CO)4 RIM=61.12 S CC cd uj rn` ly�f" RIM=58.80 O CD •c 54 SLUDGE HANDLING a" o c GRASS SMH Q IRRIGATION 5460 CLARIFIER ILDING OFFICE J A co 2 AREA RIM=64.31 s TMH 1 ATIO 63 oa..,raT RIM=63.29 OX <12' CLEAN OUT ; RIM=54.70 Site $Utility Plans „63X6 1 er DETENTION AA DRIVEWAY 61 2 54.18 POND Water , Cable CONC STEPS 5 N VFW — $5 < C V-15`0' wr a2/1320142 ' D w'• 1 Utility Location Plan 2 Site Plan SI-1 Scale:1-0"=15'-0" SI_i Scale:1-0 40'-0" S µ I-1 59'-4" 1'-2" 1» EXP. JT. N - — — —— — — ——— - - -- - -- - - - - --- �}--- - - - -- - I I i I II II { 1 I + I I + + ' I + + ( I II II I I I 11 II I L- - - -- - - - -- - i + I i + + ! + i O ODOR CONTROL ROOM + I + I HIGH I I I I I I EQUIPMENT PAD 00 �— J L- - - - - J L - -- - - - - IF- - - - - - - -- - - - - - /� N \ � 2 TON MONO BELOW { I I I 2'-0» / i Ii II I { o I I I.I { I II II I M V-0" SQ. COLUMN 7'-0" REMOVABLE ALUMINUM ' HANDRAIL, 3 SIDES ' - ROOF PLAN � -N- I — H.PT. T/SLAB 43.92 SCALE:1/8"=1'-0" � I � PUMP ROOM I � VC102 I 00 I 0 I ' I ' ACTIVE I 1 X�l ; �c -N- BASEMENT PLAN `\ N-, SCALE:1/4"=1'-0 PIPE BOLLARD I °� 3'-0" SQ. X 3'-0 DP. SUMP. r >- C� i ,d. o - i / ITT to L. PT. T/SLAB 43.50' AT I ! GUTTER ALL AROUND o I / UP ALUMINUM STAIRS AND HANDRAIL 3 R 6RO6.54"=3'-3 1/4" 4'-0" 5TO11"=4'-7" 3, 0" 40'--4" MONORAIL BEAM INSIDE 7-1 1 YZ ® E3r - - -- -- - - �-- - - ---i—I --- BOTTOM OF BEAM I I I CEILING I I co o I I I 'CO - -- - EL. 43.50' I - - - -) I I I I o co I I I I -- - --- - - - -- -- -- --- ----j EL.37.50' {.-- - - -t- - -- -- - 1 — - - -- --- - j — —— — — — ——— -- - - - ----- - -� -- ---- -- - - -- --- -- - - - -- SOUTH ELEVATION WEST ELEVATION SCALE:1/8"=1'-0" SCALE:1/8"=1'-O" 0 0 0 Cu m O ti (T7 LC) O L n t ~" X—�F \\FS2\[1ATA1\CAD,1S€\o4o143o\xR�E'\00014xo1,DwG, 40o14X02_Dwc W JDB 4/00 m \\12\DATA1\CADUSE\0001430\ARCH\00014AS2.DWG '.. TOWN OF BARNSTABLE, MASSACHUSETTS Cu En NOTES: o Underground facilities,#k% ctures, and utilities have been plotted from BEARSES WAY AND ROUTE 28 VACUU EWER o o available surveys ands, and therefore their locations must be considered opproximotThere may be others, the existence of 1 4t(WOD f r�LLL `' NANEVATIONS 7 which is presently not Anyone using utility information and FOR APPROVAL ' VAC 'A'1'ION data provided herein shot 1 "Dig Safe" at 1-888-344-7233 as well as the local Water Co and Cable Company seventy two 4/00 w Q (72) flours ►`n advance to verif a location of utilities prior to E DRAWN DATE C ED DESIGNER PPROVED DATE ENVIRCJNMENTAL. EN ERS & SC� NTISTS �� PLANS CD start of construction. See Spe ial Conditions for specific information. PROJECT SUPERVISOR DEPARTMENT SUPERVISOR MASSACHUSETS — CONNECTICUT — NEW 'YORK — — ,ISSUE DRAWN DATE CHECKED DESIGNER APPROVE01 DATE JOB NO. 0001430 cowma 03-000-00-001 SHEET AS-2