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1220 IYANNOUGH ROAD/RTE132 (13)
G1,4 CJl�G�ril 1 ��2 L= Project Name: �_ Qin D - aV1 VIA Address:--�-----�--�-�----------� �• Permit#:- =15 --- - Permit Date: . -� - ---------------- M/P:-------------- LARGE ROLLED PLANS ARE IN: BOX: SLOT: Date entered in MAPS program on: By 4r__ _ Town of Barnstable Building-, � HAIW"�S"rT�,,uAcHe L�E�. • �e o sx tce....l,e�:T'P 'st' !63 P Uh'4e''.Fh s1fG'a„iU s.naaC ut'ar.i.lr.:�:..:'d�F"°✓r ir-n S{A aor z l TInc:h e,-sra pt e,i.t.c,7.t�,.i1.:si.3v.o.::V�G;n�"r�'iUN j srHv"7i I'{bai..:lsi'e��furB+�"aFz1�.+Te,.tr�.zy.eos.lt-}nm��.#tW.Ft���M;�t`a"'hY�ae.oe�d,nj..eS1 t Ft�r�.�.Te�•g.ri e;.a:,V:+:t.t;t k l�".,tto-kY x'A_�{pj.:p�:..�.,ro�r ��v s}e tid P.s:i Ll a+no-x,.�s�r['��.`jk•�M,..�..'F k:..*nr.f�Ji�4xu.'�.s>��S�srf.i'�e1ti t'h�4w^'".��mbY 4�.rt�:e..�,r.�:x—r;:.c'.R9'.<."s.�r.e�.N�t.a°1.a.mv..�:r•�.e,;.:,r.!d«��++�o�1 n,Jr�,o'qF.:.. pg y .m l t !� - . .. Permit No. B-16-1343 Applicant Name: Map/Lot: 274-007-H00 Date Issued: 05/18/2016 Current Use: Zoning District: HB Permit Type: Sign Expiration Date: 11/18/2016 Contractor Name: Signarama Location: 12201YANNOUGH ROAD/RTE132, HYANNIS Est.,Project Cost: $200.00 Contractor License: Exempt 121 Owner on Record: P&LL INC '.Fermiffee', $200.00 Address: PO BOX 1776 <`Fee.Paid. $200.00 HYANNIS, MA 02601 Date:' 5/18/2016 Description: Freestanding ladder sign for plaza 90 scl multi-tenant Project Review Req : ry, Build Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced;within-six months,after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or.road;and shall be maintained open for public inspection for the entire duration ofthe work until the completion ofthe same. The Certificate of occupancy will not be issued until all applicable signatures by'the;Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Works.; 1.Foundation or Footing 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed priorto Frame Inspection, S.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable RECEIPT '"�`",STABM 200 Main Street, Hyannis MA 02601 508-862-4038 i6sv� , Application for Building Permit Application No: TB-16-1343 Date Recieved: 5/18/2016 Job Location: 1220 IYANNOUGH ROAD/RTE132,HYANNIS Permit For: Sign Contractor's Name: Signarama State Lic. No: Exempt 121 Address: 12 Whites path Suite 6, S Yarmouth, MA Applicant Phone: 02664 (Home)Owner's Name: P& LL INC Phone: (Home)Owner's Address: PO BOX 1776, HYANNIS,MA 02601 Work Description: Freestanding ladder sign for plaza 90 sq multi-tenant i Total Value Of Work To Be Performed: $200.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: 5/18/2016 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $200.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $200.00 5/18/2016 $200.00 1762 Check i Total Permit Fee Paid: $200.00 i THISASNOTA PERMIT Town of Barnstable Regulatory Services 9MRNSTMAS& Richard V. Scali,Interim Director °rF1639.ta Building Division b" Tom Perry, g Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit# &IL- i2y(3 Building Official approving------------ Application for Sign Permit Applicant: C'jr-_`C7cot4_AR-cNt-v Gay t- G' oVV 2�41067��00 pp _ _ -- - ---------- �_--Assessors No. Doing Business As: U jZ-G'-6T C^IZ 0 ---Telephone No.-7 -71_407-(62 20 Sign Location Str-eet/Road:__� F41� Zoning District: Old Kings Highway? Y /No)Hyannis Historic District? Ye: Property Owner . Name:------- LL 1 N G ---------------Telephone:------------------ Address:--_c2 1710 Village:- 4If i%>q A Sign Contractor Name:-------5 G)►--R—TLA04 ------------Telephone: A-t tN- M FLz�;1Co1-'t Mailing Address:-------___ .O _- p3----) 7__M C?K P M f5-R7 Description Please follow the cover directions.You must have an accurate rendition of sign with dimensions and location. Is the sigii to be electrified? Yes o (Note:Ifyes, a wiringpermitis required) C--p>j rF G. Width of building face 9 g ft.x 10- 99Q x.10- 8 () �v Check one Reface existing signer or New Total Sq.Ft of proposed sign(s) Ifyou ha ve additional signs please attach a sheet listing each one with dimensions If refacing an existing sign please provide a picture of the existing sign with dimensions. I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is con-ect and that the and construction shall conform to the provisions of §240-59 through§240-89 of the Town of B istable Z ri g Ordinance. Signature of Owner/Authorized Agent: Date SIGNS/SIGNREQU revised l 10413 F a 1220 t k IYANNOUGH RD. y' TENANT SIGN s M # a'. Uff@@m CAM CACHE COD HEALTHCARE a fi TENANT SIGN �. TENANT SIGN Min x r t r � t w . w TENANT SIGN TENANT SIGN s r 0. + • ? j � MEDICAL& COMMERCIAL New Exterior Signs ARCHITECTURE CAPE COD HEALTHCARE P-1 a ARCHITECTURAL GROUP t:(508)759-9828 f:(508)759-9802 1220 IYANNOUGH RD. _ 118 Waterhouse Road Bourne,MA02532 HYANNIS, MA DATE: 03-25-16 ' DUIN iullh! '� D��NUTS" Urgent CareVc Nil NOW _ - - - ye. �-'�► $ v-' a '�+-�► �a b+�a�'""` Amr �J.t ..��...���� � a �y'a-�'3s •31r -'•f'.� ��FI�-�-. _��,j�� SS` � '"..�..�et"�4.�f t�l• � i -�,i �4r ary y+f,. 0�`6.�sy?�t� �.� ✓.Iq..,+'�,a'r,�t+.a}+�y�w��5.-.��..,�. '��, .'•'Ee��,:�'4a„� '�,�'v�'"w A� 7j,�•,�- . .r ♦ air �,e, :'ice' � � a°. �... d?{�' �«�'+p '*w �a�, ,fir: °}��'�f'" ��:,� . . ¢'' Mi d 4 [O wt J,'.` t; !�)_t.t. 4v J ��� iffG.]L. tlSir•�;^�+3: n8fi4 .tip.-'�&gkt�+!t. .Y.-.,]9. �1 • • New Exterior Signs P-1a CARE - . . Option 1 ARCHITECTURAL GROUP 118 Waterhouse Road Bourne, DATE: O IL o CV �c Irp r tr o � � - emu ` �� . vacarion- Seminar or Class Medical Leave Bereavement Other,"Explain While in-this assignment did the temporary worker use or do any of the Phones �� - Payovers Take Dictation *.. Use CB, R Transcribe Minutes Other duti Filing UsethFe'' �ccess , :�Mail'sy Did the temporary worker operate any of the following: (place a chec Copier Fax Postal Machine Did the temporary worker interact with other departments? Yes Did the temporary worker help the public either from their desk or w ' Did the temporary worker: (place a check mark next-to those that ap Fill out the Department Time.Sheets 'Do research for a staff member Make appointments or set up meetings for a staff member Run errands within Town Hall (deliver papers,;interoffice Comments: ' -r,Nr/forms/timefor`m'.d'oc ;x ! 7-7777777777 220 IYANNOUGH RD. TENANT SIGN t UM@M Cam �• CAPE COD HEALTHCARE E 4 TENANT SIGN 0 � Z. o � TENANT SIGN TENANT SIGN { TENANT SIGN 11 prigli MEDICAL& COMMERCIAL New Exterior Signs �j MEDCOM ARCHITECTURE CAPE COD HEALTHCARE P-l a _ ARCHITECTURAL GROUP t:(soa)759-9828 f:(508)759-9802 1220 IYANNOUGH RD. 118 Waterhouse Road Bourne,MA02532 HYANNIS, MA DATE: 03-25-16 } ® NKt awuTs .d+` '�w.ny �c- w��0�.; �`�+ti� `�'"�'` ��`ate'ry ,d i•• r.r�, , �,1�. $Br'�.�� �"b.::,,�/�"' `�{,,"w�'>.+�+ ��y-Y�^a��'-aK 1���►(.�""�,�„klt�'��.%Y� �''�+�- ��ib..td� �"" ,fliy�Y �9 i N-0 1220 IYANNOUGH RD. .+'�6F. �`"w�'S bbffi j�•N�r �,,�'!4 �►li•p 9�O� - � ws" ./ lF.., �t'i i���V �?g.�� �" i i ' pq»�� ♦ a J�+ ..{'�; .l,.( '".,yy'; d "!li&vll,l'hl •yy':Y '' '1�E.. }� �rV2D'?" 14'.`adR[i('+'�i' lrsjM�`•%"/.+.'!i,".Hti1(c` i�r`!1'�Gt' ..�L�l;�.�_a.l �1r�fC!liuYk2v�M l..r... MEDICAL& COMMERCIAL P-la MEDCOMI . - . , HEALTHCARE Option ARCHITECTURAL GROUP :. - . 118 Waterhouse -._. :. 4 a �s �t` � �'° �,�- ti� � � � r �� -�,,,Ia f! I �wi � j• ,'iLtw�j ,'fi,y�*��,�j��r� t. 333, a: wp� WA, ,!# teRe ��x ions• Ne 1 Y, s e. t R C WOO ue ' jllS�a,.r�"11'.inaEa, t " Town of Barnstable Buildin g r - Snx�+s�rssa Post This card So That it is Visible From the 5tr eet A rove d Plans Must be`letned"bn Job and this Card Must be'Kept Posted Until Finallnspect' Permit Mwss y�s Req ade' r v Where a Certificate of'Occupan� ^ � - ° . -c Beerr uired;'such Buildm shall NotbeOccu°pied until�aiFinal Inspection has been made Permit No. B-16-1269 Applicant Name: Urgent Care Map/Lot: 274-007-H00 Date Issued: 05/12/2016 Current Use: I Zoning District: HB Permit Type: Sign Expiration Date: 11/12/2016 Contractor Name: Signarama Location: 12201YANNOUGH ROAD/RTE132, HYANNIS r Est. Project Cost: $0.00 Contractor License: Exempt 121 Owner on Record: P&LL INC Perrriit Fee. $ 150.00 Address: PO BOX 1776 Fee Paid: y\$ 150.00 HYANNIS, MA 02601 I � ` Date:' +w� 5/12/2016 ➢. *' � 4 Description: Urgent Care-CC Healthcare ) 14 sq tenant sign 32 sq wall front 20 sq wall rear 1.5 sq directional Project Review Req f/ s a , Zoning Enforcement Officer This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shallbe in compliance with the local zoning by-lawsand codes. This permit shall be displayed in a location clearly visible from access street or road*and sh'all�be maintained open forpublic inspection for the entire duration of the work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures by the'bu'ilding and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work.-� mom., 1.Foundation or Footing 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest 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. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT :._ .. . ...... ... �oFz►+e Ta,,ti Town of Barnstable Regulatory Services BUILDING $ Richard V. Scall,Director ®�pT �'pTE1659.MAC 0. Building Division APR 2 6 2016 Tom Perry, ding 200 Main Street, Hyannis,Hyannis,MA 02601JWN O '� S � www,town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit# Building Official approving Application for Siga-Permit Applicant.—CA? o y As No. 2 OD7 �DD- 220 Doing Business As: URG1rW CAR-6 "CC-NCTelephone No. 6%7 _g47-'q'?j 04 Sign Location Street/Road: 12 Zn ( 'NJA Ho 6f1 lZoNZ> Zoning District Ok U. Old Kings Highway? Yes(5 Hyannis Historic District? Yes, V�o Property Owner Name: P 'r 1.L I-A G. Telephone: Address: P. 0 • SOX 1776 0 MAtAOI r4A Village: N`I '}- A)Ak' Sign Contractor Name: !Si GN -)V IZA A Telephone: 50f3 - 3 9 -�J0o M r7pwty Mailing Address: ?-0. 96BX 037 MDHyMjz. 894CAl MA o256-3 Description Please follow the cover directions.You must have an accurate rendition of sign with dimensions and location. Is the sign to be electrified? &No (Note:Ifyes, a wmngpermitisrequired) 1 Jg f=y�'hT/N6 Width of building face 9 fL x 10= { By x.10= Check one Reface existing sign-?(-or New Total Sq. Ft. of proposed sign (s) 1 Ao 41 X 3Z,a0 Ifyou have additional signs please attach a sheet listing each one with dimensions If refacing an existing sign please provide a picture of the existing sign with dimensions. I hereby certify that I am the owner or that I have the authority of the owner to make this application I a that t'_ze information is correct and that the use d construction shall conform to the provisions of .fD §240-59 through§240-89 of the Town of Barn table Zo ' g O dinance. Signature of Owner/Authorized Agent Date "� ' �1 S V raw arch . 60-M SIGNS/SIGNREQU revised110413 oFZME r Town of Barnstable Regulatory Services BAHNST"LE, 9 MASS. g Richard V. Scali,Director i639• �� '°TFD Ml•�" Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 SIGN PERMIT REQUMEMENTS 1. A photograph showing the existing facade, on which has been indicated the proposed sign location. The photograph is to include a portion of adjoining stores or building. For a proposed building or new facade, an architect's elevation may be submitted in lieu of a photograph. 2. A scale drawing of the proposed sign. A scale drawing indicating: 1) The type of proposed sign(wall,hanging, free standing) 2) Dimensions of the proposed sign and any designs, logos, or lettering 3) A cross-section with dimensions showing edge detail. Minimum scale 1"= 1'. Minimum sheet size, 8.5 x 11". 3. A scale drawing of the bracket. A colored scale graphic indicating dimensions, showing colors, materials and method of affixing it to the sign and to the building. Minimum scale 1"= 1'. Minimum'sheet size, 8.5 x 11". 4. A completed Town of Barnstable Sign Application, including scaled diagram showing location of sign on building or location of free-standing sign. Show dimensions. 5. The width of the building face or the leased area. NOTE: the map/parcel number is required on the application. c SIGNS/SIGNREQU revisedl 10413 E:+ 9'_8.. FIELD COLOR: TENANT SIGN BEN. MOORE 2066-10 BLUE 2-1/2"WHITE LETTERING MINION BOLD C&M7"WHITE LETTERING � � CAPE COD HEALTHCARE FRUTIGER ROMAN TENANT SIGN i NOTES: TENANT SIGN 1. Double sided sign 2. Verify size of exisitng sign before fabrication. TENANT SIGN TENANT SIGN Cape Cod Healthcare-Sign Prof Review Approved 0 Approved with Comments 0 Revise and Resubmit \ (S� 1 SCALE: 1/2"= 1'-4" MEDICAL& COMMERCIAL New Exterior Signs HEDCOMI ARCHITECTURE CAPE COD HEALTHCARE P_1 ARCHITECTURAL GROUP t:(508)759-9828 f:(508)759-9802 12201YANNOUGH RD. 1 118 Waterhouse Road Bourne,MA02532 HYANNIS, MA DATE: 03-17-16 �e 508 0 ` ! » COrh horela • • �. Realty �. ti i± »4L i �y �� .. t .•/ � \ � � t \ l'',5w'{—.. �at��`k i � ''"!+I s.t k ` c a .x� r r . T y .�- Cal dp At 741 6 yvpq- -.*:�fi .c... ' -ice .bn.: ` 'Y�Y•X`lt.. ..t. /, ... "._a GOOSENECK LIGHT FIXTURES TO MATCH BUILDING STANDARD o AS Ab N SIGN COLOR AND LETERING TO MATCH BUILDING STANDARD 3-1/2"WHITE LETTERING MINION BOLD 9"WHITE LETTERING FRUTIGER ROMAN Cape Cod Healthcare-Sign Proof Review S� ❑Approved 0 Approved with Comments 3 Revise and Resubmit SCALE: 1/2"= 1'-0" H MEDICAL & COMMERCIAL New Exterior Signs UH, Mll " Il E ® CO ARCHITECTURE CAPE COD HEALTHCARE P_2 ARCHITECTURAL GROUP t:(508)759-9828 f:(508)759-9802 1220IYANNOUGH RD. 118 Waterhouse Road Bourne, MA02532 HYANNIS, MA DATE: 03-17-16 W tf t� to `S 4f 1 T' g It '' "� '*fin Yl r. IF w � y � .v a _a - ., �. ...,, : .. ."' i:� :fie^k�fi s -� a)b a .t.rt,,..t '• y � , , w � � 7- I t 1 y1111 I a a .e'C'�E itt 6 1 Yix� S'i Yt., F".f` ilf� �Y `�'.l3�^•2t�1^r.j� $ �' F�4� i J • j 5 :,f4k 3`M�. 1',AP Y F'. ��. �,. ^h3$` P'sg4�' � �� 7 ;`tyn'S' ��r•'. v i` j^ yl[ �4 �..,:,,FJ� :31 4��q�,�;�� .,��'•A✓.` _, .y;:..,. .:.. '" � x :� �8�'"3 Yr-.� \� D� `x p'�``�"� � t a z; �1 .1•: 'S z } "asp Fl : J�` , �}: - a `:v,`� ,R ,,U c •,' ri '� k^C g" x t ;., ._ �. .: F w :"• ,. � � ��'v ma y:fi,.t�r § ""'°w �rfe?„• r h�" r� - f w-E9 � a ,,. �. v yl ' MA z w - s .1 G 9 1� :v �. x•w F Sq 1� s a5v ks �^Yt i i z r r � GOOSENECK LIGHT FIXTURES TO MATCH BUILDING STANDARD SIGN COLOR TO MATCH BUILDING STANDARD o ® m N 2" LETERING MINION BOLD 7" LETTERING FRUTIGER ROMAN 10'-0" SCALE: 1/2"= V-0" Cape Cod Healthcare-Sign Proof Review ❑Approved Approved with Comments 00 0 Revise and Resubmit MEDICAL& COMMERCIAL New Exterior Signs MEDCOMI ARCHITECTURE CAPE COD HEALTHCARE P-6 ARCHITECTURAL GROUP t:(508)759-9828 f:(508)759-9802 1220 IYANNOUGH RD. 118 Waterhouse Road Bourne,MA02532 HYANNIS, MA DATE: 03-17-16 w 777 77 nitWON-x t TO M OKAY v vv d ^ . :J >zn. ea..4 ..� . g , .. .. ffi _._c.�.�.,o-'�.. ., k Ely OIL .,.. »- ry a r 5 r _ f f y a 1 rr: t VIA , «, �'. s pp i ;s r 5 fT -4.r�:fl•:y.- .u. �.. � .. �,- :. 'yN.�a r! W vM t �' �i k�., +•+ .? 7 r ... ...k :v w .c Vt .. f.. 5 x4. :..<Mr w. .".�R%+.,. t w" n£.,.. .:.'•xv _l,.a...m � ,.t. �' ,,: ^, �f ,. i,,.:o..a,. 'W�-b.. ,. ,.. :. a. �;,.�.< Y"...-.. R.✓2 ,-.. _ .,� �� p fq +.c,." Q... .. ...n .:. ..., .. 'F 1 .'. ,.a�. 3. X ..ti r'�y, $x�4 A,ik�..�E.a ..... ._. #.. 'M.. .�..•: r f. :...-„-: r`F*., r : .. - r* ..:-::. I .e ✓ .,, ry k ..f.,,... ..,f..a ," i a.. .., .,. ... s. S - s .:, ..... P.,.,,..P ., �.,t,:'( .�.✓4 ...4.,.. -.� ,..... 3•. .. ....�,;. T.. ... r.-S.a, x. W `^,1. ...x ,.. Sv .Y.. - .,.. t .✓ :r- •' ,,,., '..:.. <.-...... . F 3- a.,1.,. ......:. Six. .,. ,.. � ,..v y� r r... ".. .-.a �.: .:Sr #,.-.s r.5�,:.. , :: ".,._c �k• r ,�.,. ,_. .. .: .r:-:� : �. __ ... "��. a ,ls�� 'r:. ..... Y. .,.:,, ,,,,�., 4.,..d�u,,...ili; 1 E,,..�� ,:.....: ,,....3.. _. .. ♦ M'�1,:.: -».- .. ._....: C.. y?i L ''t, _ TENANT SIGN 3" BLACK LETTERING ; Urgent Care Urgent Care FRUTIGER ROMAN TENANT SIGN [ 2'-6" NOTES: TEMPORARY SIGN BANNER 1. DOUBLE SIDED SIGN TENANT SIGN TENANT SIGN TENANT SIGN J Cape Cod Healthcare-Sign Proof Review 2'—6" ❑Approved � Approved with Comments Revise and Resubmit SCALE: 3/4"= 1'-0" MEDICAL& COMMERCIAL New Exterior Signs ME Dey C 0 H ARCHITECTURE CAPE COD HEALTHCARE ARCHITECTURAL GROUP 1:(508)759-9828 f:(508)759-9802 1220 IYANNOUGH RD. 118 Waterhouse Road Bourne,MA02532 HYANNIS, MA DATE: 03-17-16 . � � A k 3A1ti4 sAa 3.,�x3 j � � zi � ���,c:, r _. .. i, .� ,�•,.r.. .. 7c ri!°'��'; n. •A,yG zf s,��°a .=� �},4 � u ",� s�3; ,� a 'Y�� - + h `'-' R� v, 4 am. '• £ r 1 Now 1 77"7777777777JI, 3 - � •:p -' ,. �: r'a r K_D.� rr�'.� uc',Xr' - 4 at ._ ,..�:,. j� � � �a. � �".tea"�"�P'wr #"'-e.. j a�����+.v;»A.i,.�4"a, �'`f `'�L. •� n4 y�R._ �..r��,It�'i:N�. �� ro�..�y � s:�thy' i.-"- Opt . �:M i r d. � ��.•; s +"���� ,.'t �' m..� _; Fla;r M� �" r.�'d`' .``^,�'� ' s-y "*i L f yr^1 v ++fir', �' „•aq�"�+y"�"�� 1 r; �. �fC w�,:. �✓ l'kx .� � �° a+ ° �. � -ZA Wil �- $ ,..r{ kr k 4s'`S'°s,er4 � '':l»� iF j4 r^,.` n ' � a +ti. .+*✓:,v' ',,y .q'4 4„ .,� r „�ivwSws.:�` v... � LA �°+�1 Anderson; Robin To: Florence, Brian Subject: ; 1220 lyannough Rd, Hyannis Brian, I had a recent inquiry concerning a proposed medical use to be installed in the former EMS location on lyannough Rd. This site is in the HB zone. While the associated records appear to discourage or prohibit medical uses for that site & zone, I couldn't help but wonder how the Urgent Care.facility got into the Liberty Plaza at 1220 lyannough Rd — also within the same zone. I checked to see if a ZBA decision was issued and was advised that no relief or request for relief was on file for this site nor had a site plan review application been filed or entertained. As we subsequently reviewed, Chapter 240 Section 125 (1) (C) does not authorize the issuance of use varianceswithin 300' of Route 132. You should also be aware that a building permit was issued on,1,/41.6., specicallyforthe Urgent Care tenant (Permit 2015-08875). Please let me know if you require additional information or if I can assist in any fashion. pF........ .y._<, �b1n Roi"n Anderson Zoning Zoning Enforcement.Officer 200 Main Street Iiyannis,MA 026oi 5&-1862-4027 : t �oF."Erb Town of Barnstable &AWMABLF4 Building Department-200 Main Street eoMp+ Hyannis, MA 02601 Tel. (508) 862-4038 Certificate Of Occupancy Permit Number: B-2015-08875 CO Issue Date: 4/29/2016 Parcel ID: 274-007-H00 Zoning Classification: HB Location: 1220 IYANNOUGH Proposed Use: 3220 ROAD/RTE132, HYANNIS Gen Contractor: CORDEIRONOSES Permit Type: Commercial - Comments: Urgent care 04/29/2016 Building Official Date: -Commanwealth of Massachusetts .. Tn Coo y , Sheet Metal Permit coo,`� r ` Map � Parcel Date: oZ-9 -I6 Permit: Estimated Job Cost: $ �i 000.o ° Permit.Fee:s Plans Submitted: YES NO Plans Reviewed. YES NO Business License# 6 6 Applicant License# 17 Business Information: Property Owner/:Job„Location.Information: _ w Name: s I-Otl 5A ee f C,1 Name: ATO Street: 3 3 i cJn Wt IM C-1 S t4 Street: 11--ah o i V G n City/Town: City/Town: z Telephone- S b$15 6 5 3 7-6!& Telephone: , Photo ID.required/Copy of Photo.I.D. attached: YES NO staff Initial I /M� unr-stricted.license J-2/NI-2-restricted-to dweIl n s 3-stories or less and commercial up to 10;000 sq. f� /.2-stories or less g i Residential: 1-2 family Multi-family Condo/Townhouses Other Commercial: de Retail trial Educational r CFire.l) pt. pproval _ Inshtutlonal_ Other Square Footage: under 10,000 sq. ft. ✓ over 10,000 sq.fI. Number of Stories: i Sheet metal work`to be completed: New Work: Renovation: HVAC ✓ Metal Watershed Roofing. Kitchen Exhaust System Metal'Chimney/Vents Air Balancing i Provide detailed description of work to be done: I .INSURANCE COVERAGE: I have a current[iabilitv.insurance policy or its_equivalent which meets the requirements of M.G.L.Ch.112 Yes❑, No ❑ If you have checked Y0,1ndicate the type of coverage:by checking the appropriate box.below: - ! A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSl3RANGE WAWER:'I am-aware that the licensee does not have the insurance coverage required by Chapter 112 flf the Massachusetts General Laws,and that my:sfgnature onthis-permit application-.wafyes this requirement Check One Only owner ❑ Agent Signs re of Owner or Owner's Agent By checking thks.box❑,I hereby certify that all of the details and Information:[have submitted('or entered!)regarding this application are true.and accurate to the best of'my knowledge and'.thafall sheet metal work and Installations,performed under the permit issued for this,application will be In compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws, Duct inspection req uired prior insulation installation:YES NO P rogLeess.Inspections • Date Comments Baal IngRection Date Comments 'c s Type of License: e 3y L�, ,/Master r' Fide ❑Master-Restricted 'Ity/Town ❑Joumeypersdn'. Signature of Licensee ❑Joumeyperson-Restricted L'IcenSe.Nurnber , co =ee Gheckat www.mass.gov/dpl nspector Signature of Permit Approval 1 . `CO, 1 n i r x t Town of Barnstable Regulatory Services _ banes �, Thomas F.Geiler,Director Building Division Tom Perry,Budlding:Commissioner 200 M,in Street;Hyannis,MA 02501. wwwlown.barnstable:ma.ns Office: 508-862-4038 Fax: 5.08-790-6230 Property Owner Must Complete and.Sign This Section If Using A Builder Independence Park,Inc. P.O.Box 1776 Hyannis,MA 02601 I, ?"(rA,.('� a6c n ,as Owner of the sub)ectproperty hereby authorize 4- e to-act.on my behalf, in all*matters..relative-to work.authorized by this building,permit t _ -- — �— �" �- (Address f.Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized.until all final inspections are performed and accepted. S' tore of Owner Signature of Applicant. l � Print Name Print Name Date Q--F0RMS:0wrrM?MZNMS7..0NP00c9 C��lrtcmt'usar�u��assc�eFu�� e hmmt q fh dz- 3&TdAcciderrts 600 Wm-*wgtaa&reaf WfV7f1 Jf1I1SS:�,fi�dltl Workece CumpensatiunInsmrance davit Builders/ContractorsMectrician&Mum'bers Applicant Iafarnix6 n Fleme Fria#L ihF Name(Basine s! nrrrhnnlFnrfivich,ai7_ 1/l `D t S �+ s ,.Orc.0 C— r7 C SA City/StateJZap: (/� D a os l -Phone gr '7$ 1 —75�-4 k4 QI H fire you=employer7 check the apgrapr-iate.ba= Type of IrOI-a(rtq�re4= �I am a employer vritTi S 4. ❑ I aata geoeal canfractor=0 Z � * lzave}siresfi�tlie ststr-co�nfrat�tors. 6_ �New ccm��ort . emp•Ioyees{fall andforpart�me}_ ��, deling 2.❑ I am a sole propfietar or partner- listed on the aftched sheet 7- E =o ship and bane no employees sob-contractors have g_ ❑Demt}l EDC. we Aing forme in afuy Capacity em&Yees and have workers' g_ ❑Building addition PTO Worker,[omp:insurance cam-'*snmml �L�-1 5:❑ We are a corparafic�artdi fs 1tY..[]metrical regaiis�additions 3-❑ I am a hom�ner doing all work ofcers have exercised their 1LQ Plumbing repairs or additions . tight of e�pfionper MGL My-el' [No warl2rs'ootnp_ 12.0 Roe/repass, iumn- re TegLliied 3 c-1-52.§1(4} and we hn-L-,no 13-0 Other employees_[Na comp_imsmance requ red-I 'Amy wptivxmff that checks box WI=Kt also fill ord t�sr�fiaat�eTac�ch�v des�or3c�'r��ati 6a goitip i 1 HnmeQatnaS�rlID submit t71is affida� '$trey ace damp aI'IimrTC sad tbPa hi¢g G'^*;�eoohsetar5�msisalxitrta�ai�dsrst' �r�+a snrE� asr5 that rheck ibis box Mua attached M xr,,Tifi rmsi sheet sI1bwhxg tRe name of iTm =d.stde vrhether praut lhagE Mdfies hx9a rm Iuyees_ If the sAb co�t�ct�sl�ee empIvy�es,Chap must p�avide tlxeir warps'Comp-pvlics avmher- Iatrr art srrrpinyt fhatisprfr}ddisg *orlrers'c-oxcrp�rzsniian aiurtrrsrece for rti}^emp£oy�e� Helat>?is thepaficY arcdlob ants irtforrr{rrfiu,rr. Insurance Gomgauyl�Iame: Policy m Self-ins-Li(--4kFxgiratio�Date: Job Site Address_ CifgfSfaft lZrp: Attach a mpy of the workers'compensation:palm derlarstion page(wag the pfficy m=ber aid e4pna#an flate). Failure to secare•covr-sage as re T iredunrler Section 25A of MGL c 152 can lead to the imposition.of criminal pmalties of a fine up to SL50D 00 and/or one-year inapHsonme t m well as civR perms is the forma of a STOP WORD ORDEPLand a fins of up to r250.00 a.day against the violator_ Be a$vised that a copy of this statement may be f=warded to:the Office of Isrceul ptiotfs of the DIA for i„e,ranee co-zerage-miffcation_ I da liereb cetti under tkepmns art snalfies u ps urY fJfatf}ra irzformrWaa prauidzdahave is bus and correct SiEnatam- D te: Phone 9- ©ff cLmE use anly. Da nat writs hi this area,to bs arMPL-red by city at tartar of IC&L City or Towa: Permi#lLiceuse a Issuing 'cl_3utharity{circle onr`}: L Board of Health. 2.Buffd"in g Department I City Lavm Clark 4_Elecfrical Fnspeetor 5.Plambiug Iaspecter 6.Other Contact Person" Phone A-- 6 Information ancd Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees• Pursuant•to this statute, an employee is defined as"--_every person in the service of another under any contract of hire, express or implied, oral or writtem" An employer is defined as"an individual,parfnerShip,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the Iegal 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,constriction or repair work on such dwelling house or on the grounds or binding appurtenaut thereto shall not because of such employment be deemed to be as employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildiiLgs in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance q coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliapce with the insurance requirements of this chapter have been presented to the contracting authority" Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their cerificat*)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the' members or partners, are not required to carry workers' compensation insurance- If an LLC or LLP does have employees, a policy is required- Be advised that this affidavit may be submitted to the Department of industrial -Accidents for confirmation of incttrance coverage- Also be sure to sign and date the affidavit The affidavit should be retuned to the city or town that the application for the permit or license is being requestecL not the Department of Tndustrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number oa the appropriate line. Cityor Town WU621s 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 peruitllicense number which will be used as a reference number. In addition,an applicant that must submit multiple.pmmitllicense applications is any given year,need only submif 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 e permits or licenses- A new affidavit must be,filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i-e,a dog license or permit to bum leaves etc)said person is NOT required to complete this affidavit The Office.of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a tail The Department's address,telephone and fax number; , ' nhO COMm=*ealth of Massachusetis- Depalt meat Qf Ii dusttlal Acci{i(.-nts 0-ffice of k ve�PtiGa-5 600_Wa shzn&toz.Sizes Roston,IAA G21 I I T64 4 617'27-4M ext 406 4r I-&T7 MALQSAFE Revised 4-24-07 Fax 9 617-727-7-749 - W�R'r.�as�gacr�dza - Date: 2/11/2016 Time: 2:28 PM To: Morse Insurance Page: 02 \c0 CERTIFICATE OF LIABILITY INSURANCE F °ATE`MMD°",Y,f' 2/11/2016 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. RODUCER CONTACT NAME: Karen Forrest lorse Insurance Agency, Inc. PHONE E (781)784-8444 FAX No: (781)784-4147 .2 Post Office Square ADDRESS:karenforrest@morseins.com INSURER(S)AFFORDING COVERAGE NAIC f !haron MA 02067 INSURERA All America 20222 LSURED INSURERB:Central Mutual Insurance Company 20230 ,ASTON SHEET METAL INC INSURERC: .33 RICHMOND ST INSURERD: INSURER E: :AYNHAM MA 02767-1377 INSURERF: :OVERAGES CERTIFICATE NUMBER:2015-2016 Master 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. POLICY rR TYPE OF INSURANCE S B POLICY NUMBER MM/DDY EFF MM ID EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR DAMAGE TO N 300,000 PREMISES R occurrence $ CLB 7943128 10/27/2015 10/27/2016 MED EXP(Any one parson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X PRO POLICY LOC PRODUCTS $ 2,000i000 OTHER: GLPLS $ 0 AUTOMOBILE LIABILITY Ea COMBINED I NeDtSIN LE LIMIT $ 500,000 3 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BAP 8607664 10/27/2015 10/27/2016 BODILY INJURY(Per accident) $ AUTOS AUTOS X N NON-OWNEDPROPERTYDAMAGE $ HIRED AUTOSAUTOS Perac.d.n[ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ _TIDED RETENTION$ $ WORKERS COMPENSA71ON X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory In NH) AC 7943129 10/27/2015 10/27/2016 E.L.DISEASE-EA EMPLOYE $ 100 000 If yyees,describe under DESCRIPTIONOFOPERATIONSbelow E.L.DISEASE-POLICY LIMIT $ 500,000 ESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) :ERTIFICATE HOLDER CANCELLATION SOS)790-6230 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Hyannis THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 367 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Karen Forrest/SAMy�: at.,:.,rr�o' - !3 9�.���•�%- O 1988-2014 ACORD CORPORATION. All rights reserved. tCORD 25(2014101) The ACORD name and logo are registered marks of ACORD 4S025(201401) f DIVISION:OF PROFESSIONAL LICENSURE1,5 0+ a. .� dl• DIVISION OF PROFESSIONAL LICENSOR_ Nt �w �a Oil�ill I I I I LICENSENUMBER: EXPIRATI DU DATE' - SEPIALNUMBEft roF .mac a3'•�L-�-�.ss�^ ..,str{wti..0 �-,c�n�"aanvoms2ara - _` "-'='3f-.: y EXPIRLICENSENU,14SE. A ON DATE SERIAL NUMIBEP , �t TOWN OF BARNSTABLE Building 201508875 * EMMSTABLE, Issue Date: 01/04/16 . - Permit 9 MASS �pr16 339�- A�� Applicant: Permit Number: B 20160019 Proposed Use: DEPARTMENT DISCOUNT STORE Expiration Date: 07/03/16 Location 1220 IYANNOUGH ROAD/RTE132oning District HB Permit Type: COMMERCIAL ADDITION ALTERATION Map Parcel 274007B00 Permit Fee$ 5,197.01 Contractor CORDEIRO,MOSES M Village BARNSTABLE App Fee$ 100.00 License Num 74674 Est Construction Cost$ 571,100 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND BUILD NEW EXAM ROOM URGENT CARE FACILITY SCOPE INCLUDE FtM®$ARD MUST BE KEPT POSTED'UNTIL FINAL ING,DRYWALL PAINT_ACT, WINDOWS DOOR MILLWORK UPGRADE INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: P&LL INC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: PO BOX 1776 INSPECTION HAS BFKN MADE. HYANNIS,MA 02601 ) ti Application Entered by: PF Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,EITHER'TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUB PROPERTY,'NO SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,.MUST BE APPROVEDBY THE JURISDICTION..STREET OR ALLEY GRADESAS WELL AS DEPTH AND LOCATION OF PUBL SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE of THIS PERMIT DOES NOTRELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. _ r MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MIDST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. IOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). SULATION. 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). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS �1ELLECTRICAL INSPECTION APPROVALS ar ro 2 i� 2�✓ 3 1 Heating Inspection Approvals Engineering Dept Fire Dept j 2 Board of Health L? xr��a1 T, PERMIT PAYMENT RECEIPT T F BARNSTABLE BU ING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 01/08/16 TIME: 11 :02 -----------------TOTALS---`------------- PERMIT $ PAID 5197.01 AMT TENDERED: 5197.01 AHANAEPLIED: 5197.01 .00 APPLICATION NUMBER: 201508875 , PAYMENT METH: CHECK PAYMENT REF: 15053 FIRE_CERTIFICATE OF IIYSPECTLON In accordance with the requirements of General Laws,Chapter 111,Section 51,this Fire Certificate of Inspection issued by the head of the local Fire Department certifying compliance with local ordinances is a prerequisite for an original or renewal license. NAME OF CLINIC 121 d ( yaOt\-)OU IZD, , S . "A • O"Z �0 o) ADDRESS OF CLINIC T— was inspected on '- ZB by � r Date Name of Inspector I HEREBY CERTIFY THAT THIS INSTITUTION COMPLIES WITH THE LOCAL ORDINANCES. YES NO If answer is"NO",indieate violations and recommendation, Violations: Recommendations: ISSUED BY: Signature Hea of Local Fire Department INSTRUCTIONS: FIRE DEPARTMENT TO RETURN TWO COMPLETED COPIES TO CLINIC CLINIC TO RETURN ONE COPY TO: Division of Health Care Quality 99 Chauncy,2nd.Floor Boston,MA 02111 Rev. 12-13-2005 DPHCQ117 Contractor's Material and Test Certificate for Aboveground Piping PROCEDURE Upon completion of work,inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative.All defects shall be corrected and system left in service before contractor's personnel finally leave the job. A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities,owners, and contractor.It is understood the owner's representative's signature in no way prejudices any claim against contractor for faulty material,poor workmanship,or failure to comply with approving authority's requirements or local ordinances. Property Name:CCH Urgent Care Date: 3-28-16 Property Address: 1220 Iyanough Road Hyannis,Mass Plan Approval/Acceptance The Sprinkler plans were submitted to the following entities for review prior to installation: ❑ Building Dept M Fire Department ® Owner Does the system installation conform to these accepted plans? ®Yes ❑ No If No,What was added or changed?g Instructions Has person in charge of the fire equipment been instructed as to the location of the control valves and the care and maintenance of this new equipment? M Yes ❑ No If No,explain: Sprinklers Manufacturer&Model Year of Manufacture Orifice Size Temp. Quantity Victaulic QR Pendent Heads 2015 1/2" 155 67 Pipe and Fittings Typically piping 2 Y"and larger shall be schedule 10 black steel pipe with grooved ends and grooved Victaulic fittings. Piping 2"and smaller shall be schedule 40 black steel pipe with threaded ends and threaded cast iron fittings. Piping and fitting to comply with NFPA requirements. Is this a typical installation? M Yes ❑ No If No,explain System Identification&Initial Testing. Are there any wet systems installed? M Yes ❑ No If yes,how many systems? If installed,how many zones are on each system?l Are there any dry systems installed? M Yes ❑ No If yes,how many systems? Are there any pre-action systems installed?[]Yes M No If yes,how many systems? Are there any deluge systems installed? ❑Yes M No If yes,how many systems? (See the initial testing section) Test Description Hydrostatic: Hydrostatic tests shall be made not less than 200 psi for 2 hours or 50 psi above the static pressure in excess of 150 psi for 2 hours. Differential dry type valve clappers shall be left open during the test to prevent damage. All aboveground piping leakage shall be stopped. Pneumatic: Establish 40 psi air pressure and measure drop,which shall not exceed 1'/z psi in 24 hours. st-piessur-e-tanks_at-aormal w_ater_Ieve1 and_ai_r_p essure_and_measure air pressure drop,which-shall not exceed 1% psi in 24 hours. Tests Conducted Page 1 of 3 All piping hydrostatically tested @ 200 p'si for 2 hours. ®Yes ❑ No All dry or double interlock pre action systems pneumatically tested? ❑Yes ® No If no,explain: Do you certify as the sprinkler contractor that additives and corrosive chemicals,sodium silicate or derivatives of sodium silicate,brine,or other corrosive chemicals were not used for testing systems or to stop leaks? ® Yes ❑ No Initial main drain test is provided to set the bench mark for the system.This test is provided to allow for the monitoring of the water supply in the future. Initial static pressure: psi residual pressure with drain wide open: psi Underground mains and lead-in connections to system risers flushed before the connection was made to the sprinkler system. Verified by a copy of the Underground M&T Certificate. ❑Yes ® No Flushed by the installer of Underground sprinkler piping ❑Yes ® No Flushed by this contractor,but not installed. ❑Yes ® No If all are"No",explain: Existing System addition Was a hydraulic nameplate provided? ❑Yes ® No If no,explain Date the System was left in service with all control valves open. 1-14-16 Initial Testing Report Alarm Valve or tjow indicator Alarm Device/Type/Model&Location Operation Time Dry Pipe Operating Test Water Pressure Air Pressure Trip Pressure Water to test conn. Valve#1 Q.O.D.#1 Valve#2 Q.O.D.#2 If quick opening devices are installed trip e dry system with and without the Q.O.D.in service. Record the results above. Dry Pipe Operating Test(continued) .N ' Was the High/Low pressure switch tested?(Potter PS-40A) ❑Yes ®No "explain If yes,What are the initial system setting?Air Compressor on @ PSI,Air Compressor off @ PSI and Low pressure alarm @ PSI. Deluge and Preaction Valves Page 2 of 3 r � r Type of operation ❑Pneumatic ❑ Electric ❑ Hydraulics Is the piping supervised? ❑ Yes ❑ No Detecting media supervised? ❑Yes ❑ No Does valve operate from the manual trip,re to or o ? ❑ Yes ❑ No If No,Explain. What is the Make and Model of the Valve. Does each circuit operate supervision loss alard Yes ❑ No Does each circuit operate valve release? ❑ Yes ❑ No Maximum time to operate release? Additional Remarks: ti Tests witnessed by ! �Z Yan ee-prinkler Co.,I Title Date (Representative's signature) General Contractor/- er Title r , Date (Representative's signature) Page 3 of 3 Final Construction Control Document _ Z To be submitted at completion of construction by a Registered Design Professional for work per the 8ffi edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Cape Cod Healthcare Urgent Care Date: 4-25-2016 Permit No. Property Address: 1220 Iyannough Road Project: Check(x)one or both as applicable: New construction X Existing Construction Project description: Renovations to Firs Floor for Urgent Care I Gregory B Siroonian MA Registration Number: 9748 Expiration date: 8-31-2016 , am a registered design professional, and I have prepared or directly supervis�d the preparation of all design plans,computations and specifications concerning: X Architectural Structural Mechanical Fire Protection Electrical Other: Describe for the above named project. 1,or my del signee,have performed the necessary professional services and was present at the construction site on a regular and periodic basis.To the best of my knowledge, information,and belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit and that I or my designee: 1. Have reviewed,for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance iwith the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. f Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. Enter in the space to the right a"wet" or electronic signature and seal: P -0 Phone number: 508 759 9828 Email: gbs@MEDCOMarch.com i Building Official Use Only Building Official Name: Permit No.: Date: i 4 i Vcrsion 06_11_2013 f Final Construction Control Document = W To be submitted at completion'of construction by a Registered Design Professional V '' for work per the Bch edition of the JO Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Hyannis Urgent Care Date:April 26, 2016 Permit No. Property Address: 1220 Iyannough Rd Project: Check(x)one or both as applicable: New construction X Existing Construction Project description: Remodel tenant in strip mall I Joseph Davey MA Registration Number: 39188 Expiration date: 6/16 ,am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Architectural Structural Mechanical Fire Protection Electrical x Other: Describe Plumbing for the above named project. I, or my designee,have performed the necessary professional services and was present at the construction site on a regular and periodic basis.To the best of my knowledge, information, and belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit and that I or my designee: 1. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. OFF \ Enter in the space to the right a"wet"or electronic signature and seal: o`� �c z: JOSEPH M. U, — E: DAVEY r� 0. NO.M-39188 Phone number: 781 948 8720 Email: J.davey@daveyengineering.com Building Official Use Only Building Official Name: Permit No.: Date: Version 06 11 2013 Final Construction Control Document H To be submitted at completion of construction by a Registered Design Professional e for work per the 8th edition of the a e� Y Massachusetts State.Building Code, 780 CMR, Section 107 Project Title: CCHC Hyannis Urgent Care Date: 4-25-2016 Permit No. Property Address: 1220 Iyannough Road,Hyannis,MA Project: Check(x)one or both as applicable: New construction (X)Existing Construction Project description: Renovation I William C. Creed MA Registration Number: 34709 Expiration date: 06/30/2016, am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [ ] Architectural L] Structural [X] Mechanical [ ] Fire Protection L] Electrical [ ] Plumbing for the above named project. I,,or my designee,have performed the necessary professional services and,was present at the construction site on a regular and periodic basis. To the best of my knowledge, information, and belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit and that I or my designee: 1. Have reviewed,for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. o • Enter in the space to the right a"wet"or CAEE!) `A electronic signature and seal: MECHANICAL No.347" y`�Q�11AL E�6 r Phone number: 781-569-6525 Email: bereed@esiboston.com Building Official Use Only Building Official Name: Permit No.: Date: Version 06 11 2013 f t GLYNN electric 11 Resnik Road Plymouth, MA 02360 Phone: 508-732-8933 Fax: 508-732-8934 CCH - Urgent Care 1220 Iyannough Rd Hyannis, MA 02601 Fire Alarm Record of Completion Glynn Project #: 16DM02 Customer: J.K. Scanlan Company, LLC Falmouth Technology Park 15 Research Road East Falmouth, MA 02536 t i Final Construction Control Document To be submitted at completion of construction by a ' Registered Design Professional for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107.6.4 Project Title: CC—HC-Urgent-C--are-Hyannis Date:-4-221-6—Perrmit-No. Property Address: 1220 lyannough Rd., Hyannis Ma Project: Check one or both as applicable: ❑New construction ® Existing Construction Project description: Fitout of shell space. 1 Stephen DesRoches MA Registration Number: 45861 Expiration date: 06-30-16 ,am a registered design professional, and hereby certify that i have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [ ] Entire Project [ ] Architectural [ ] Structural [ ] Mechanical [ ] Fire Protection [x] Electrical [x] Other: Fire Alarm for the above named project. I certify that 1,or my designee,have performed the necessary professional services and was present at the construction site on a regular and periodic basis to determine that the work proceeded in accordance with the requirements of 780 CMR and the design documents prepared by me and approved as part of the building permit and that I or my designee: 1. Have reviewed,for conformance to this code and the design concept,shop drawings,samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the wor performed in a manner consistent with the construction documents and this code. STE Enter in the space to the right a"wet'or NDE SA electronic signature and seal: V E CAS.. w 48 T Eby AL Phone number: 508-503-2225 T"Kv Email: stephendesrocheslglynnelectric.com Building Official Use Only Building Official Name: Permit No.: Date: Trial Version 10 09 2012 w 11 Resnik Road,Plymouth,MA 02360 G r.�I Phone:508.732.8933 www.glynnelectric.com CCHC HYANNIS URGENT CARE 1220 IYANNOUGH RD HYANNIS, MA FIRE ALARM SYSTEM NARRATIVE IN ACCORDANCE WITH THE MASSACHUSETTS STATE BUILDING CODE, EIGHTH EDITION 780 CMR,SECTION 901.2.1 January 15, 2016 Revised February 18, 2016 Prepared by: Glynn Design, Inc 11 Resnik Rd Plymouth, MA 02360 �N OF PHEN v, 4 e GLYNN DESIGN INC. ELECTRICAL ENGINEERS f 11 Resnik Road,Plymouth,MA 02360 I Phone:508.732.8933 www.glynnelectric.com General: As required by 780 CMR 901.2.1,this narrative report is a written description of the proposed fire alarm system to be installed as part of the renovations proposed at 1220 Iyannough Rd Hyannis, MA. Design Responsibility: As engineer of record, Glynn Design, Inc has engineered and specified the fire alarm system to be installed. Glynn Design, Inc shall review the installing contractor's shop drawings for conformance to the approved construction documents. Furthermore, Glynn Design, Inc. shall provide construction control services in accordance with 780 CMR 107.6. Fire Alarm System to be installed: Provide a new automatic and manual, auxiliary connected fire alarm system,to be wired, connected,tested and left in first class operating condition.All equipment shall be Underwriter's Laboratories approved for the intended use and shall meet with the approval of the local authority.The complete system shall be as manufactured by Silent Knight. The system will connect to spare zone in the house Silent Knight Panel. The complete system shall be installed in accordance with applicable sections of NFPA standards,section 72, 101 Life Safety,and all State and local codes and requirements. The new fire alarm system will consist of a fire alarm control panel, annunciator, - smoke detectors, manual pull stations, sprinkler tamper and flow switches, audio/visual devices and visual only strobe devices. Panel will also be provided with a drill switch to disconnect from existing fire alarm panel for CCH fire drill. The scope of work associated with the installation of the fire alarm system includes: • Installation of a new FACP with dedicated 120V power feed, located in the main electric room. • Installation of a new annunciator located in the main vestibule. • Installation of smoke detectors, manual pull stations,heat detectors and remote LED indicator outside the electric room Sequence of Operation: The general sequence of operation is described below. A. Activation of any manual pull station, system smoke detectors,heat detectors, or CO detectors shall initiate the predefined fire alarm system alarm sequence. w GLYNN DESIGN INC. ELECTRICAL ENGINEERS f 11 Resnik Road,Plymouth,MA 02360 G Phone:508.732.8933 • www.glynnelectric.com 1. Display alarm condition at the fire alarm control panel and remote annunciator. 2. Energize audible and visual (synchronized strobe) occupant notification circuits. 3. Perform auxiliary fire safety functions such as damper activation, door closures,AHU shutdown, etc. 4. Will pull in spare zone at existing fire alarm control panel 5. Transmit alarm condition via existing fire alarm control panel to call the Hyannis Fire Department via the UL listed internal DACT/Central station. B. The operation of in-duct smoke detectors shall initiate the predefined fire alarm system sequence. 1. Display supervisory condition at the fire alarm control panel. 2. Shut down the corresponding AHU. C. The new system will monitor the new wet system and upon activation trip the existing fire alarm control panel call the Hyannis Fire Department via the UL listed internal DACT/Central station. D. Normal power failure to the fire alarm system control panel, remote power supplies,ground faults, short circuits and open circuit conditions shall initiate the predefined fire alarm system "trouble" sequence. 1. Display trouble condition at the fire alarm control unit. E. The drill switch will disconnect the Form C alarm contact of the new FACP which will in turn put the existing panel into a trouble condition. 1. The CCH staff will need to contact the Landlord's central station prior to utilizing the disconnect switch because of the trouble condition being generated at the existing panel. F. Upon tripping of the existing FRCP,the CCH panel will trip by means of an addressable module monitoring the alarm contact of the existing FACP and programmed as general alarm at the new panel activating all audio/visual units. G. The Landlord's Central Monitoring Station will be given a protocol that any signal that comes in from the CCH panel,the Monitoring Station will call into CCH Security indicating the event. 1. The three conditions that will be identified at the Central Station are Alarm,Supervisory and Trouble. Building Life Safety System: Means of egress evacuation lighting shall be accomplished with self-contained emergency battery packs.The exit signs are self-contained LED models with battery back-up. Testing Criteria: The following fire alarm system inspections and testing shall be performed is described below. A. Confirm integrity of circuits (free of grounds, shorts, opens) prior to the installation of devices, appliances or equipment. GLYNN DESIGN INC. ELECTRICAL ENGINEERS 11 Resnik Road,Plymouth,MA 02360 G `I Phone:508.732.8933 • www.glynnelectric.com B. Visually inspect system installation for completeness,presence of defects or damage, and confirm system is placed into "all normal" operational service. C. Confirm correct system supervision of wiring faults, missing devices and status of normal and standby power supplies. D. Functionally operate devices installed as part of work and confirm correct sequence of operation and address /zone identification at the fire alarm control panel. E. Confirm audibility/intelligibility and visual synchronization of notification appliances. F. Confirm correct operation of circuits under fault conditions in accordance with installed circuit style and class. Documentation to be submitted to Engineer and AHJ: The following is a list of the documentation to be submitted to the engineer of record and AHJ. A. NFPA 72, "Fire Alarm System Record of Completion",accurately completed and endorsed by installing contractor's signature. Close out Procedure: The following is the close out procedure A. Upon Completion of work and receipt of the appropriate close-out documentation,the Engineer of Record shall certify completion to the extent required by 780 CMR 901. B. The contractor shall then schedule a final acceptance demonstration testing with the AHJ in order to obtain approval for a Certificate of Occupancy. Final Approval Requirements: A. The contractor shall obtain written acceptance of the installed system from the AHJ prior to the owner request for a Certificate of Occupancy. B. The contractor shall replace and/or repair each system or component of a system that fails to pass the Final Acceptance Test satisfactorily. Preliminary and Final Testing shall be rescheduled and testing shall be conducted until compliance is fully demonstrated. C. Final certification shall be provided from the contractor that the installation is in accordance with the approved construction documents and applicable codes.The Engineer shall certify that the installation complies with the approved construction documents per 780 CMR 901. D. Operation and Maintenance Manuals and Record As-built drawings shall be submitted with any modifications as the resultant of changes that were dictated from the Final Testing process. E. The owner shall provide an emergency contact list for use by the AHJ in the event of an emergency at the protected property. End of Narrative GLYNN DESIGN INC. ELECTRICAL ENGINEERS FIRE ALARM AND EMERGENCY COMMUNICATION SYSTEM INSPECTION AND TESTING FORM To be completed by the system inspector or tester at the time of the inspection or test. It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Attach additional sheets, data,or calculations as necessary to provide a complete record. Date of this inspection or test: 4-8-16 Time of inspection or test: 7:OOAM 1—P-R0P-E-R-TY-INFORMATION Name of property: URGENT CARE Address: 1220 IYANNOUGH RD HYANNIS,MA 02601 Description of property: URGENT CARE Occupancy type: COMMERCIAL Name of property representative: Address: Phone: Fax: E-mail: Authority having jurisdiction over this property: FIRE DEPARTMENT Phone: Fax: E-mail: 2. INSTALLATION,SERVICE,AND TESTING CONTRACTOR INFORMATION } Service and/or testing organization for this equipment: GLYNN ELECTRIC �! Address: 11 RESNIK RD PLYMOUTH,MA 02360 Phone: 508-732-8933 Fax: 508-732-8934 E-mail: SERVICE@GLYNNELCETRIC.COM Service technician or tester: MELVIN AVILES-HERNANDZEZ Qualifications of technician or tester: JOURNEYMAN ELECTRICIAN A contract for test and inspection in accordance with NFPA standards is in effect as of: The contract expires: Contract number: Frequency of tests and inspections: Monitoring organization for this equipment: Address: Phone: Fax: E-mail: Entity to which alarms are retransmitted: Phone: 3. TYPE OF SYSTEM OR SERVICE ®Fire alarm system(nonvoice) ❑Fire alarm with in-building fire emergency voice alann communication system(EVACS) Mass notification system(MNS) ❑Combination system,with the following components: ❑Fire alarm ❑EVACS ❑MNS ❑Two-way,in-building,emergency communication system ❑Other(specify): NFPA 72, Fig. 14.6.2.4(p. 1 of 11) Copyright 0 2009 National.Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 3. TYPE OF SYSTEM OR SERVICE(continued) NFPA 72 edition: 2010 Additional description of system(s): ADRESSABLE 3.1 Control Unit Manufacturer: SILENT KNIGHT Model number: IFP-100 3.2 Mass Notification System ®This system does not incorporate an MNS. 3.2.1 System Type: ❑In-building MNS—combination ' ❑In-building MNS—stand-alone ❑Wide-area MNS ❑Distributed recipient MNS ❑Other(specify): 3.2.2 System Features: ❑Combination fire alarm/MNS ❑MNS ACU only ❑Wide-area MNS to regional national alerting interface ❑Local operating console(LOC) ❑Direct recipient MNS(DRMNS) ❑Wide-area MNS to DRMNS interface ❑Wide-area MNS to high-power speaker array(RPSA)interface ❑In-building MNS to wide-area MNS interface ❑Other(specify): 3.3 System Documentation ❑An owner's manual,a copy of the manufacturer's instructions,a written sequence of operation,and a copy of the record record drawings are stored on site. Location: 3.4 System Software ®This system does not have alterable site-specific software. Software revision number: Software last updated on: l ❑A copy of the site-specific software is stored on site. Location: 4. SYSTEM POWER 4.1 Control Unit 4.1.1 Primary Power Input voltage of control panel: 120V Control panel amps: 5.2A 4.1.2 Engine-Driven Generator ®This system does not have a generator. Location of generator: Location of fuel storage: Type of fuel: 4.1.3 Uninterruptible Power System ®This system does not have a UPS. Equipment powered by a UPS system:'. Location of UPS system: Calculated capacity of UPS batteries to drive the system components connected to it: In standby mode(hours): In alarm mode(minutes): r NFPA 72, Fig. 14.6.2.4(p.2 of 11) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. jj 4. SYSTEM POWER(condnueaq t 4.1.4 Batteries Location: AT FACP Type: SLA Nominal voltage: 12V Amp/hour rating: 18AH Calculated capacity of batteries to drive the system: In standby mode(hours): 24HRS In alarm mode(minutes): ®Batteries are marked with date of manufacture. 4.2 In-Building Fire Emergency Voice Alarm Communication System or Mass Notification System ®This system does not have an EVACS or MNS. 4.2.1 Primary Power Input voltage of EVACS or MNS panel: EVACS or MNS panel amps: 4.2.2 Engine-Driven Generator ®This system does not have a generator. Location of generator: Location of fuel storage: Type of fuel: 4.2.3 Uninterruptible Power System ®This system does not have a UPS. Equipment powered by a UPS system: Location of UPS system: Calculated capacity of UPS batteries to drive the system components connected to it: In standby mode(hours): In alarm mode(minutes): 4.2.4 Batteries Location: Type: Nominal voltage: Amp/hour rating: Calculated capacity of batteries to drive the system: In standby mode(hours): In alarm mode(minutes): ❑Batteries are marked with date of manufacture. 4.3 Notification Appliance Power Extender Panels ❑This system does not have power extender panels. 4.3.1 Primary Power Input voltage of power extender panel(s): Power extender panel amps: 4.3.2 Engine-Driven Generator ®This system does not have a generator. Location of generator: Location of fuel storage: Type of fuel: 4.3.3 Uninterruptible Power System ®This system does not have a UPS. Equipment powered by a UPS system: Location of UPS system: Calculated capacity of UPS batteries to drive the system components connected to it: In standby mode(hours): In alarm mode(minutes): NFPA 72, Fig. 14.6.2.4(p.3 of 11) Copyright 0 2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 4. SYSTEM POWER(continued) 4.3.4 Batteries Location:: Type: Nominal voltage: Amp/hour rating: Calculated capacity of batteries to drive the system:. In-standby-mode-(hours): In-alarm-mode-(minutes): ®Batteries are marked with date of manufacture. 5. ANNUNCIATORS ❑This system does not have annunciators. 5.1 Location and Description of Annunciators Annunciator 1: MAIN ENTRANCE Annunciator 2: Annunciator 3: 6. NOTIFICATIONS MADE PRIOR TO TESTING Monitoring organization Contact: NEMEC ALARMS Time: 7:OOAM Building management Contact: Time: Building occupants Contact: Time: y, Authority having jurisdiction Contact: H.F.D. Time: Other,if required Contact: Time: 7. TESTING RESULTS 7.1 Control Unit and Related Equipment Visual Functional Description Inspection Test Comments Control unit ❑ Lam s/LEDs/LCDs ❑ Fuses Trouble signals ❑ Disconnect switches ❑ Ground-fault monitoring ❑' ❑ Supervision ❑ ❑ Local annunciator ❑ Remote annunciators ❑ Power extender panels ❑ ❑ Isolation modules ❑ ❑ { Other(specify) ❑ ❑ l NFPA 72, Fig. 14.6.2.4(p. 4 of 11) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. i 7. TESTING RESULTS(continued) 7.2 Control Unit Power Supplies Visual Functional Description Inspection Test Comments 120-volt power ❑ Generator or UPS ❑ ❑ Baste condition ❑ [ — Load voltage ❑ Discharge test ❑ Charger test ❑ Other(specify) ❑ ❑ 7.3 In-Building Fire Emergency Voice Alarm Communications Equipment Visual Functional Description Inspection Test Comments Control unit ❑ ❑ Lam s/LEDs/LCDs ❑ ❑ Fuses ❑ ❑ Primary power supply ❑ ❑ Secondary power supply ❑ ❑ Trouble signals ❑ ❑ Disconnect switches ❑ ❑ Ground-fault monitoring ❑ ❑ Panel supervision ❑ ❑ System performance ❑ ❑ Sound pressure levels ❑ ❑ Occupied ❑Yes ❑No Ambient dBA Alarm dBA (attach report with locations,values, and weather conditions) System intelligibility ❑ ❑ ❑CSI ❑STI (attach report with locations,values, and weather conditions Other(specify) ❑ ❑ ( \ NFPA 72, Fig. 14.6.2.4(p. 5 of 11) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 7. TESTING RESULTS(continued) {+ 7.4 Notification Appliance Power Extender Panels Visual Functional Description Inspection Test Comments Lam s/LEDs/LCDs ❑ ❑ Fuses ❑ ❑ Prima _ ower_su . 1 ❑ ❑ Secondaty power supply ❑ ❑ Trouble signals ❑ ❑ Ground-fault monitorin ❑ ❑ Panel supervision ❑ ❑ Other(specify) ❑ ❑ 7.5 Mass Notification Equipment Visual Functional Description Inspection Test Comments Functional test ❑ ❑ Reset/power down test ❑ ❑ Fuses ❑ ❑ ] Primary power supply ❑ ❑ UPS power test ❑ ❑ Trouble signals ❑ ❑ Disconnect switches ❑ Ground-fault monitoring ❑ ❑ CCU security mechanism ❑ ❑ Prerecorded message content ❑ ❑ Prerecorded message activation ❑ ❑ Software backup performed ❑ ❑ Test backup software ❑ ❑ Fire alarm to MNS interface ❑ ❑ MNS to fire alann interface ❑ ❑ In-building MNS to wide-area ❑ ❑ MNS NFPA 72, Fig. 14.6.2.4(p. 6 of 11) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 7. TESTING RESULTS(continued) 7.5 Mass Notification Equipment(continued) Visual Functional Description Inspection Test Comments MNS to direct recipient MNS ❑ ❑ Sound pressure levels ❑ ❑ Occupied—❑—Yes—❑-No Ambient dBA Alarm dBA (attach report with locations,values, and weather conditions System intelligibility ❑ ❑ ❑CSI ❑STI (attach report with locations,values, and weather conditions Other(specify) ❑ ❑ 7.6 Two-Way Communications Equipment Visual Functional Description Inspection Test Comments Phone handsets ❑ ❑ Phone jacks ❑ ❑ Off-hook indicator ❑ ❑ Call-in signal ❑ ❑ System performance ❑ ❑ System audibility ❑ ❑ System intelligibility ❑ ❑ Radio communications ❑ ❑ enhancements stem Area of refuge communication ❑ ❑ system Elevator emergency ❑ ❑ communications system Other(specify) _ ❑ ❑ - I NIFPA 72, Fig. 14.6.2.4(p. 7 of 11) Copyright©2009 National'Fre Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or'distdbution. 7. TESTING RESULTS(continued) 7.7 Combination Systems Visual Functional Description Inspection Test Comments Fire extinguishing monitoring ® ❑ devices/system Carbon monoxide detector/system ® ❑ Combination firelsecurity system ❑ ❑ Other(specify) ® ❑ 7.8 Special Hazard Systems Visual Functional Description(specify) Inspection Test Comments ❑ ❑ ❑ ❑ ❑ ❑ 7.9 Emergency Communications System ❑ Visual ❑ Functional ❑ Simulated operation ❑ Ensure predischarge notification appliances of special hazard systems are not overridden by the MNS. See,VFPA 72,24.4.1.7.1. 7.10 Monitored Systems Visual Functional Description(specify) Inspection Test Comments Engine-driven generator ❑ ❑ Fire pump ❑ Special suppression systems ❑ ❑ Other(specify) _ _ ❑ ❑ NFPA 72, Fig. 14.6.2.4(p.8 of 11) Copyright O 2009 National Fre Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or dislribubon. 7. TESTING RESULTS(continued) S 7.11 Auxiliary Functions Visual Functional Description Inspection Test Comments Door-releasing devices ❑ ❑ Fan shutdown ❑ ❑ 8-moke-mane ement/smoke-contr-ol E] ❑ - Smoke damper operation ® ❑ Smoke shutter release ❑ ❑ Door unlockin ❑ ❑ Elevator recall ® ❑ Elevator shunt tri ❑ ❑ MNS override of FA signals ❑ ❑ Other(specify) ❑ ❑ 7.12 Alarm Initiating Device ® Device test results sheet attached listing all devices tested and the results of the testing 7.13 Supervisory Alarm Initiating Device ® Device test results sheet attached listing all devices tested and the results of the testing 7.14 Alarm Notification Appliances ® Appliance test results sheet attached listing all appliances tested and the results of the testing 7.15 Supervisory Station Monitoring Description Yes No Time Comments Alarm signal ® ❑ Alarm restoration ® ❑ Trouble signal ❑ El Trouble restoration ❑` ❑ Supervisory signal ❑ ❑ Supervisory restoration ❑ ❑ NFPA 72, Fig. '14.6.2.4(p. 9 of 11) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 8. NOTIFICATIONS THAT TESTING IS COMPLETE i Monitoring organization Contact: NEMEC ALARM Time: Building management Contact: Time: Building occupants Contact: Time: Authority having jurisdiction Contact: H.F.D Time: Other,if required Contact: Time: 9. SYSTEM RESTORED TO NORMAL OPERATION Date: 4-8-16 Time: 3:OOPM 10. CERTIFICATION 10.1 Inspector Certification: This system,as specified herein,has been inspected and tested according to all NFPA standards cited herein. Signed: Printed name: MELVIN AVILES- Date: 4-8-16 HERNANDEZ Organization: GLYNN ELECTRIC Title: JOURNEYMAN Phone: 508-732-8933 ELECTRICICAN 10.2 Acceptance by Owner or Owner's Representative: The undersigned has a service contract for this system in effect as of the date shown below. jt Signed: Printed name: Date: Organization: Title: Phone: I t^ I NFAA 72. Fig. 14.6.2.4(p. 10 of 11) Copyright 0 2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. DEVICE TEST RESULTS (Attach additional sheets if required) Device Type Address Location Test Results .I L l I NFPA 72, Fig. 14.6.2.4(p. 11 of 11) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. f FIRE ALARM AND EMERGENCY COMMUNICATION SYSTEM RECORD OF COMPLETION ' To be completed by the system installation contractor at the time of systein acceptance and approval. It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Attach additional sheets,data,or calculations as necessary to provide a complete record. 1. PROPERTY INFORMATION Name-ofproperty: --URGE.N_-LCARE - Address: 1220 IYANNOUGH RD.HYANNIS,MA 02601 Description of property: URGENT CARE Occupancy type: COMMERCIAL Name of property representative: Address: Phone: Fax: E-mail: Authority having jurisdiction over this property: HYANNIS FIRE DEPARTMENT Phone: Fax: E-mail: 2. INSTALLATION,SERVICE,AND TESTING CONTRACTOR INFORMATION Installation contractor for this equipment: GLYNN ELECTRIC Address: 11 RESNIK RD,PLYMOUTH MA 02360 License or certification number: Phone: 508-732-8933 Fax: 508-732-8934 E-mail: SERVICE@GLYNNELECTRIC.COM Service organization for this equipment: Address: License or certification number:. Phone: Fax: E-mail: A contract for test and inspection in accordance with NFPA standards is in effect as of: Contracted testing company: Address: Phone: Fax: E-mail: Contract expires: Contract number: Frequency of routine inspections: 3. DESCRIPTION OF SYSTEM OR SERVICE I]Fire alarm system(nonvoice) ®Fire alarm with in-building fire emergency voice alarm communication system(EVACS) ❑Mass notification system(MNS) i4 ❑Combination system,with the following components: ®Fire alarm ®EVACS ❑MNS ❑Two-way,in-building,emergency communication system ❑Other(specify): NFPA 72, Fig. 10.18.2.1.1 (p. 1 of 12) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 3. DESCRIPTION OF SYSTEM OR SERVICE(continued) NFPA 72 edition: 2010 Additional description of system(s): ADRESSABLE 3.1 Control Unit Manufacturer: SILENT KNIGHT Model number: IFP-100 3.2 Mass Notification System ®This system does not incorporate an MNS 3.2.1 System Type: ❑In-building MNS—combination ❑In-building MNS—stand-alone ❑Wide-area MNS ❑Distributed recipient MNS ❑Other(specify): 3.2.2 System Features: ❑Combination fire alarm/MNS ❑MNS autonomous control unit ❑Wide-area MNS to regional national alerting interface ❑Local operating console(LOC) ❑Direct recipient MNS(DRMNS) ❑Wide-area MNS to DRMNS interface ❑Wide-area MNS to high-power speaker array(HPSA)interface ❑In-building MNS to wide-area MNS interface ❑Other(specify): 3.3 System Documentation ®An owner's manual,a copy of the manufacturer's instructions,a written sequence of operation,and a copy of the numbered record drawings are stored on site. Location: } 3.4 System Software ®This system does not have alterable site-specific software. f Operating system(executive)software revision level: Site-specific software revision date: Revision completed by: ❑A copy of the site-specific software is stored on site. Location: 3.5 Off-Premises Signal Transmission ❑This system does not have off-premises transmission. Name of organization receiving alarm signals with phone numbers: Alarm: NEMECS ALARM Phone: 508-362-4283 Supervisory: Phone: Trouble: Phone: Entity to which alarms are retransmitted: Phone: Method of retransmission: If Chapter 26,specify the means of transmission from the protected premises to the supervising station: If Chapter 27,specify the type of auxiliary alarm system: ❑Local energy ❑Shunt ®Wired ❑ Wireless I NFPA 72, Fig. 10.18.2.1.1 (p.2 of 12) Copyright 0 2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. ! 4 t 1 4. CIRCUITS AND PATHWAYS 4.1 Signaling Line Pathways 4.1.1 Pathways Class Designations and Survivability Pathways class: A Survivability level: 0 Quantity: 1 (See NFPA 72,Sections 12.3 and 12.4) 4.1.2 Pathways Utilizing Two or More Media Quantity.: I)pscription: 4.1.3 Device Power Pathways ®No separate power pathways from the signaling line pathway ❑Power pathways are separate but of the same pathway classification as the signaling line pathway ❑Power pathways are separate and different classification from the signaling line pathway 4.1.4 Isolation Modules Quantity: 0 4.2 Alarm Initiating Device Pathways 4.2.1 Pathways Class Designations and Survivability Pathways class: A Survivability level: 0 Quantity: 1 (See NFPA 72,Sections 12.3 and 12.4) 4.2:2 Pathways Utilizing Two or More Media ( }} Quantity: Description: 4m i 4.2.3 Device Power Pathways ®No separate power pathways from the initiating device pathway ❑Power pathways are separate but of the same pathway classification as the initiating device pathway ❑Power pathways are separate and different classification from the initiating device pathway 4.3 Non-Voice Audible System Pathways 4.3.1 Pathways Class Designations and Survivability Pathways class: A Survivability level: 0 Quantity: 1 (See NFPA 72,Sections 12.3 and 12.4) 4.3.2 Pathways Utilizing Two or More Media Quantity: Description: 4.3.3 Appliance Power Pathways - ®No separate power pathways from the notification appliance pathway ❑Power pathways are separate but of the same pathway classification as the notification appliance pathway ❑Power pathways are separate and different classification from the notification appliance pathway NFPA 72, Fig 10,18.2.1.1 (p.3 of 12) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. r 5. ALARM INITIATING DEVICES 5.1 Manual Initiating Devices 5.1.1 Manual Fire Alarm Boxes ❑This system does not have manual fire alarm boxes. Type and number of devices: Addressable: 3 Conventional: Coded: Transmitter: Other(specify): 5.1.2 Other Alarm Boxes ®This system does not have other alarm boxes. Description: Type and number of devices: Addressable: Conventional: Coded: Transmitter: Other(specify): 5.2 Automatic Initiating Devices 5.2.1 Smoke Detectors ❑This system does not have smoke detectors. Type and number of devices: Addressable: 6 Conventional: Other(specify): Type of coverage: ❑Complete area ®Partial area ❑Nonrequired partial area Other(specify): Type of smoke detector sensing technology: ❑Ionization ®Photoelectric ❑Multicriteria ❑Aspirating ❑Beam Other(specify): 5.2.2 Duct Smoke Detectors ®This system does not have alarm-causing duct smoke detectors. j Type and number of devices: Addressable: Conventional: 1 Other(specify): Type of coverage: Type of smoke detector sensing technology: ❑Ionization ❑Photoelectric ❑Aspirating ❑Beam 5.2.3 Radiant Energy(Flame)Detectors ®This system does not have radiant energy detectors. Type and number of devices: Addressable: Conventional: Other(specify): Type of coverage: 5.2.4 Gas Detectors ®This system does not have gas detectors. Type of detector(s): Number of devices: Addressable: Conventional: Type of coverage: 5.2.5 Heat Detectors . ®This system does not have heat detectors. . Type and number of devices: Addressable: Conventional: Type of coverage: ❑Complete area ❑Partial area ❑Nonrequired partial area ❑Linear ❑Spot Type of heat detector sensing technology: ❑Fixed temperature ❑Rate-of-rise ❑'Rate compensated NFPA 72,Fig. 10.18.2.1.1 (p.4 of 12) Copyright 0 20C9 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 5. ALARM INITIATING DEVICES(continued) C 5.2.6 Addressable Monitoring Modules ❑This system does not have monitoring modules. Number of devices: 4 5.2.7 Waterflow Alarm Devices ❑This system does not have waterflow alarm devices. Type and number of devices: Addressable: 1 Conventional: Coded: Transmitter: 5.2.8 Alarm Verification ®This system does not incorporate alarm verification. um er o eviees su ject to a anrivenvenKcation EAlaim oerificafion setTo seconds 5.2.9 Presignal ®This system does not incorporate pre-signal. Number of devices subject to presignal: Describe presignal functions: 5.2.10 Positive Alarm Sequence(PAS) ®This system does not incorporate PAS. Describe PAS: 5.2.11 Other Initiating Devices ❑This system does not have other initiating devices. Describe: 6. SUPERVISORY SIGNAL-INITIATING DEVICES 6.1 Sprinkler System Supervisory Devices ❑This system does not have sprinkler supervisory devices. Type and number of devices: Addressable: 2 Conventional: Coded: Transmitter: ^� Other(specify): / 6.2 Fire Pump Description and Supervisory Devices ®This system does not have a fire pump. Type fire pump: ❑Electric pump ❑Engine Type and number of devices: Addressable: Conventional: Coded: Transmitter: Other(specify): 6.2.1 Fire Pump Functions Supervised ❑Power ❑Running ❑Phase reversal ❑Selector switch not in auto ❑Engine or control panel trouble ❑Low fuel Other(specify): 6.3 Duct Smoke Detectors(DSDs) ®This system does not have DSDs causing supervisory signals. Type and number of devices: Addressable: Conventional: Other(specify): Type of coverage: Type of smoke detector sensing technology: ❑Ionization ❑Photoelectric ❑Aspirating ❑Beam 6.4 Other.Supervisory Devices ❑This system does not have other supervisory devices. Describe: h r NFPA 72. Fig. 10.18.2.1.1 (p.5 of 12) Copyright©2009'National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. { - 7. MONITORED SYSTEMS 7.1 Engine-Driven Generator ®This system does not have a generator. 7.1.1 Generator Functions Supervised ❑Engine or control panel trouble ❑Generator running ❑Selector switch not in auto ❑Low fuel ❑Other(specify): 7.2 Special Hazard Suppression Systems ®This system does not monitor special hazard systems. Description of special hazard system(s): 7.3 Other Monitoring Systems ®This system does not monitor other systems. Description of special hazard system(s): 8. ANNUNCIATORS ❑This system does not have annunciators. 8.1 Location and Description of Annunciators Location 1: MAIN ENTRANCE Location 2: Location 3: 9. ALARM NOTIFICATION APPLIANCES 9.1 In-Building Fire Emergency Voice Alarm Communication System ®This system does not have an EVACS. } Number of single voice alarm channels: Number of multiple voice alarm channels: Number of speakers: Number of speaker circuits: Location of amplification and sound-processing equipment: Location of paging microphone stations: Location 1: Location 2: Location 3: 9.2 Nonvoice Notification Appliances ❑This system does not have nonvoice notification appliances. Horns: 10 With visible: X Bells: With visible: 5 Chimes: With visible: Visible only: 2 Other(describe): 9.3 Notification Appliance Power Extender Panels ®This system does not have power extender panels. Quantity: Locations: t I NFPA 172, Fig. 10.18.2.1.1 (p.6 of 12) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 10. MASS NOTIFICATION CONTROLS,APPLIANCES, AND CIRCUITS ®This system does not have an MNS. 10.1 MNS Local Operating Consoles Location 1: Location 2: Location 3: 10.2 High-Power Speaker Arrays Number-ofrHPSt-speaker-initiation-zones: Location l: Location 2: Location 3: 10.3 Mass Notification Devices Combination fire alarm/MNS visible appliances: MNS-only visible appliances: Textual signs: Other(describe): Supervision class: 103.1 Special Hazard Notification ®This system does not have special suppression predischarge notification. ®MNS systems DO NOT override notification appliances required to provide special suppression predischarge notification. {f it 11. TWO-WAY EMERGENCY COMMUNICATION SYSTEMS / 11.1 Telephone System ®This system does not have a two-way telephone system. Number of telephone jacks installed: Number of warden stations installed: Number of telephone handsets stored on site: Type of telephone system installed:. ❑Electrically powered ❑Sound powered 11.2 Two-Way Radio Communications Enhancement System ®This system does not have a two-way radio communications enhancement system. Percentage of area covered by two-way radio service: Critical areas: % General building areas: % Amplification component locations: Inbound signal strength: dBm Outbound signal strength: dBm Donor antenna isolation is: dB above the signal booster gain Radio frequencies covered: Radio system monitor panel location: NFPA 72. Fig. 10.18.2.1.1 (p.7 of 12) Copyright 0 2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. I 11. TWO-WAY EMERGENCY COMMUNICATION SYSTEMS(continued) 11.3 Area of Refuge(Area of Rescue Assistance)Emergency Communications Systems ®This system does not have an area of refuge(area of rescue assistance)emergency communications system. Number of stations: Location of central control point: Days and hours when central control point is attended: Location of alternate control point: Days-and-hours-when-alternate-control-point is-attended; 11.4 Elevator Emergency Communications Systems ®This system does not have an elevator emergency communications system. Number of elevators with stations: Location of central control point: Days and hours when central control point is attended: Location of alternate control point: Days and hours when alternate control point is attended: 11.5 Other Two-Way Communication Systems Describe: 12. CONTROL FUNCTIONS This system activates the following control fuctions: -� ❑Hold-open door releasing devices ❑Smoke management ❑1 VAC shutdown ❑F/S dampers ❑Door unlocking ❑Elevator recall ❑Fuel source shutdown ❑ Extinguishing agent release ❑Elevator shunt trip ❑Mass notification system override of fire alarm notification appliances Other(specify): TRIPS MALL FACP 12.1 Addressable Control Modules ❑This system does not have control modules.. Number of devices: Other(specify): 13. SYSTEM POWER 13.1 Control Unit 13.1.1 Primary Power Input voltage of control panel: 120V Control panel amps: 5,2A Overcurrent protection: Type: FUSES Amps: 20 Location(of primary supply panel board): IN REAR OF BLDG ELECTRIC RM. Disconnecting means location: BREAKER 13.1.2 Engine-Driven Generator ®This system does not have a generator. Location of generator: Location of fuel storage: Type of fuel: NFPA 72: Fig. 10.18.2.1.1 (p.8 of 12) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 13. SYSTEM POWER(continued) 13.1.3 Uninterruptible Power System ®This system does not have a UPS. Equipment powered by a UPS system: Location of UPS system: Calculated capacity of UPS batteries to drive the system components connected to it: In standby mode(hours): In alarm mode(minutes): ��-- Location: AT FACP Type: SLA Nominal voltage: 12V Amp/hour rating: 18AH Calculated capacity of batteries to drive the system: In standby mode(hours): In alarm mode(minutes): ®Batteries are marked with date of manufacture ❑Battery calculations are attached 13.2 In-Building Fire Emergency Voice Alarm Communication System or Mass Notification System ®This system does not have an EVACS or MNS system. 13.2.1 Primary Power Input voltage of EVACS or MNS panel: EVACS or MNS panel amps: Overcurrent protection: Type: Amps: Location(of primary supply panel board): Disconnecting means location: 13.2.2 Engine-Driven Generator ®This system does not have a generator. Location of generator: Location of fuel storage: Type of fuel: 13.2.3 Uninterruptible Power System ®This system does not have a UPS. Equipment powered by a UPS system: Location of UPS system: Calculated capacity of UPS batteries to drive the system components connected to it: In standby mode(hours): In alarm mode(minutes): 13.2.4 Batteries Location: Type: Nominal voltage: Amp/hour rating: Calculated capacity of batteries to drive the system: In standby mode(hours): In alarm mode(minutes): ❑Batteries are marked with date of manufacture ❑Battery calculations are attached t.- NFPA 72, Fig, "10.18.2.1.1 (p.9 of 12) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. f 13. SYSTEM POWER(continued) 133 Notification Appliance Power Extender Panels PP ®This system does not have power extender panels. 13.3.1 Primary Power Input voltage of power extender panel(s): Power extender panel amps: Overcurrent protection: Type: Amps: Location(of primary supply panel board): Disconnecting-means-location: 133.2 Engine-Driven Generator ®This system does not have a generator. Location of generator: Location of fuel storage: Type of fuel: 13.3.3 Uninterruptible Power System ®This system does not have a UPS. Equipment powered by a UPS system: Location of UPS system: Calculated capacity of UPS batteries to drive the system components connected to it: In standby mode(hours): In alarm mode(minutes): 13.3.4 Batteries Location: Type: Nominal voltage: Amp/hour rating: Calculated capacity of batteries to drive the system: In standby mode(hours): In alarm mode(minutes): ,i ❑Batteries are marked with date of manufacture ❑Battery calculations are attached 14. RECORD OF SYSTEM INSTALLATION Fill out after all installation is complete and wiring has been checked for opens,shorts,ground faults,and improper branching, but before conducting operational acceptance tests. This is a: ®New system ❑Modification to an existing system Permit number: The system has been installed in accordance with the following requirements:(Note any or all that apply.) ®NFP.4 72,Edition: 2010 ®NFPA 70,National Electrical Code, Article 760,Edition: 2014 ®Manufacturer's published instructions Other(specify): System deviations from referenced NFPA standards: Signed: Printed name: RAYMOND THORP Date: 4-8-16 Organization: GLYNN ELECTRIC Title: JOURNEYMAN ELECTRICIAN Phone: 508-732-8933 i NFPA 72, Fig. 10.18.2.1.1 (p. 10 of 12) Copyright 0 2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 15. RECORD OF SYSTEM OPERATIONAL ACCEPTANCE TEST ~� ®New system All operational features and ftutctions of'this system were tested by,or in the presence of, the signer shown below,on the date shown below,and were found to be operating properly in accordance with the requirements for the following: ❑Modifications to an existing system All newly modified operational features and functions of the system were tested by,or in the presence of the signer shown below,on the date shown below,and were found to be operating properly in accordance with the requirements of the following: ®NFPA 72,Edition: 2010 ®NFPA 70,National Electrical Code, Article 760,Edition: 2016 ®Manufacturer's published instructions Other(specify): ®Individual device testing documentation(Inspection and Testing Form(Figure 14.6.2.4)is attached] MELVIN AVILES Signed: Printed name: HERNANDEZ Date: 4-8-16 Organization: GLYNN ELECTRIC Title: JOURNEYMAN ELECTRICIAN Phone: 508-732-8933 16. CERTIFICATIONS AND APPROVALS 16.1 System Installation Contractor: " This system,as specified herein,has been installed and tested according to all NFPA standards cited herein. Signed: Printed name: RAYMOND THORP Date: 4-8-16 Organization: GLYNN ELECTRIC Title: JOURNEYMAN ELECTRICIAN Phone: 508-732-8933 16.2 System Service Contractor: The undersigned has a service contract for this system in effect as of the date shown below. Signed: Printed name: Date: Organization: Title: Phone: 16.3 Supervising Station: This system,as specified herein,will be monitored according to all NFPA standards cited herein. Signed: Printed name: Date: Organization: Title: Phone: NFPA 72, Fig. 10.18.2.1.1 (p. 11 of 12) Copyright 0 2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 16. CERTIFICATIONS AND APPROVALS(continued) 16.4 Property or Owner Representative: I accept this system as having been installed and tested to its specifications and all NFPA standards cited herein. Signed: Printed name: Date: Organization: Title: Phone: 16.5 Authority Having Jurisdiction: I have witnessed a satisfactory acceptance test of this system and find it to be installed and operating properly in accordance with its approved plans and specifications,with its approved sequence of operations,and with all NFPA standards cited herein. Signed: Printed name: Date: Organization: Title: Phone: NFPA 72, Fig. 10,18.2.1.1 (p. 12 of 12) Copyright 0 2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. f ALARM INITIATING DEVICES T YNN electric 11 Resnik Road Plymouth, MA 02360 (508)732-8933 (508)732.8934 Fax TESTED BY: MELVIN AVILES-HERNANDEZ DATE: 418116 TRIPS TO MALL FACP LOCATION: URGENT-CARE 1220 IYANNOUGH RD HYANNIS,MA 02601 Number Number Number Device Type Description Total Tested Failed Not Tested PULL PULL STATIONS 3 3 0 0 SD SMOKE DETECTORS 6 6 0 0 HD HEAT DETECTORS 0 0 0 0 SH SMOKE AND HEAT DETECTOR COMBO. 0 0 0 0 DS DUCT SMOKE DETECTORS 0 0 0 0 TS SPRINKLER TAMPERS 2 2 0 0 FS SPRINKLER FLOW SWITCHES 1 1 0 0 MM MONITOR MODULES 1 1 0 0 RM RELAY MODULES 0 0 0 0 H/S HORN/STROBES 0 0 0 0 Color Key: 2ncf Ot rt�r�C �- 3rd.Quarter XXX 4th Quarter)0= Detail of Test Results Device Type Description Zone Pass Fail Comments FACP SILENT KNIGHT IFP-100 X IN REAR OF BLDG BATTERIES 2 X 12V 18AH X I AT FACP ANNUNCIATOR SILENT KNIGHT RA-1000 X FRONT ENTRANCE SD ELECTRIC ROOM 33SO1 X SD HALLWAY BY EXAM ROOMS 33SO2 X SD HALLWAY BY EXAM ROOMS 33SO3 X SD FRONT WAITING ROOM 33SO4 X SD HALLWAY BY LOUNGE ROOM 33S05 I X SD HALLWAY AT REAR RIGHT EXIT 33SO6 X PULL REAR RIGHT EXIT 33MO7 X PULL MAIN ENTRANCE 33MO8 X PULL REAR LEFT EXIT 33MO9 X FS URGENT CARE WATERFLOW 33M10 X TS URGENT CARE TAMPER 33M11 X TS DRY SYSTEM TAMPER 33M12 X MM TRIP FROM MALL FIRE ALARM SYSTEM 33M13 X i ALARM INITIATING DEVICES Ao"CYNN { electric M 11 Resnik Road Plymouth, MA 02360 (5O8)732-8933 (508)732-8934 Fax TESTED BY: MELVIN AVILES-HERNANDEZ DATE: 418/16 TRIPS TO MALL FACP LOCATION: URGENT CARE 1220 IYANNOUGH RD HYANNIS,MA 02601 Number Number Number Device Type . Description Total Tested Failed Not Tested PULL PULL STATIONS 3 3 0 0 SD SMOKE DETECTORS 6 6 0 0 HD HEAT DETECTORS 0 0 0 0 SH SMOKE AND HEAT DETECTOR COMBO. 0 0 0 0 DS DUCT SMOKE DETECTORS 0 0 0 0 TS SPRINKLER TAMPERS 2 1 2 0 0 FS SPRINKLER FLOW SWITCHES 1 1 0 0 MM MONITOR MODULES 1 1 0 0 RM RELAY MODULES 0 0 0 0 H/S HORN/STROBES 0 0 0 0 Color Key: 1 st Quarter X 2nd Quarter XX 3rd Quarter XXX 4th Quarter XXXX Detail of Test Results Device Type Description Zone Pass Fail Comments FACP SILENT KNIGHT IFP-100 X IN REAR OF BLDG BATTERIES 2 X 12V 18AH X AT FACP ANNUNCIATOR SILENT KNIGHT RA-1000 X FRONT ENTRANCE SD ELECTRIC ROOM 33SO1 X SD HALLWAY BY EXAM ROOMS 33502 X SD HALLWAY BY EXAM ROOMS 33S03 X SD FRONT WAITING ROOM 33SO4 X SD HALLWAY BY LOUNGE ROOM 33505 X SD HALLWAY AT REAR RIGHT EXIT 33SO6 X PULL REAR RIGHT EXIT 33M07 X PULL MAIN ENTRANCE 33M08 X PULL REAR LEFT EXIT 33M09 X FS URGENT CARE WATERFLOW 33M10 X TS URGENT CARE TAMPER 33M11 X TS DRY SYSTEM TAMPER 33M12 X MM TRIP FROM MALL FIRE ALARM SYSTEM 33M13 X M t � DEC 2 2 2015 TOWN OF BARNSTABLE BU ff t fAttPON Map 2-7 Parcel Application* Health Division Date Issued Conservation Division ( Application Fee ( o .06 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 12-2-0 1)Lh_NN0UG1+ kQ Village Owner P 4 t-L I Address Yd 5m- 177611+yANN(S.Mt�- UZWl Telephone 5�8— 775' 1?fib Permit Request B,►gpi- I�ewtT AW.I(AT'to0 — '6yiLD 0) Ne-i r=:mmRzy o,, UR-etj T Ca4RE FACIL.tTy- Sca F_ wcL-vocS FLWl4JtMYWA(.C1 PQwT /4(_T , LotNuvw5 DZe-S Aid >✓1tcc.woKK VP��ES Square feet: 1 st floor: existing5,00 proposed 2nd floor: existing proposed Total new Zoning District 4b Flood Plain NO Groundwater Overlay PS CAPZaNE) Project Valuation 5 71 CQO,LO Construction Type Rf-N1D\TGtJ Lot Size 1.26 AL Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure 25 yes Historic House: ❑Yes M/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: 2(Gas ❑ Oil ❑ Electric ❑ Other Central Air: 2(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 2rYes ❑ No If yes, site plan review# Current Use tVA(NNT Proposed Use VjR64JT CARL FAut.11> APPLICANT INFORMATION (BUILDER OR HOMEOWNER) (p12(v Name 3f. LA+J p>I+ yAdMoSES C. Wlzo Telephone Number rJ 5�.� Z-� Address �fJ5 � License# T FN1VVUa+ Home Improvement Contractor# Email 1i(pmwW-,T6(41 M,0Yvk Worker's Compensation # O&F-065891 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO bww1= L SIGNATURE DATE I� �� r FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OVMER DATE OF INSPECTION: � FOUNDATION r FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL I; PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. • • BARNSTABLE, • MASS. ,�� Town of Barnstable '°TEp�► Regulatory Services Richard V.Scali,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, ( WT4oU noo , as Owner of the subject property hereby authorize JCA Jt-� (A!1ftP4 U—(— to act on my behalf, in all matters relative to work authorized by this building permit application for: t2zo TYANNoUG q Rop'p (Address of Job) Signature of Owner ' Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 I } Initial Construction Control'Document ` To be submitted with the building permit application by a + Z +' Registered Design' Professional. � d for work per the h edition of the Massachusetts State Building Code, 780.C1V-'Section 107 s•e_ Projecf Title: Cape Cod Healthcare Urgent Care. Date 12-22-2015 Property Address: 1220 Iyannough.Road Project Check(x).one or both as applicable:: New construction X Existfng;Consttuctio'n. Project;description:New Exam Rooms;X-RayRoorir and Support Space renovations I Gregory-B. S roonian MA Regtstra0 A Nurr ber. 9748 Expiration date: 813112015 -am a registered design professional; and Ll ave�prepared or directlysupervised,the preparation ofall design plans,computations and specifications concerning;I . x.-Architectural. Structural: Mechanical 1 Ftre Protection Electrical Qther forthe above named project�md that to-the best of my knowledge;information,and belief such plans, computations:and pectficattons`-beet the applicable,provisions,.of the Massachusetts State Building Code,.(780 CMR),and-accepted i engineeruig":pract ces.for the proposed'prgject. I. understarid:and agree that L(or,m %designee)shall pezform the necessary K professtonaTservices and be.present on:tl e construction site on a regular and.peribdic•bas "s to.: l:. Review,forconformance to thiscode and the design concept, shop drawings, samples and other subrittals by the ,'. contractor in accordance'with the requirements of the,construction documei ts,. 2.. Performthe duties for regstered,.desigri professionals in 780 CMRChapter 17,as applicable. I Be,present at intervals appropnate to the stage of construction to become.-generally familiar with-the prggress and• quality of the work:and to'determine if the work ts:;.beingperformed;in a manrier'consistent with.the approved Coastruction dOCUmeD.sand this.'codey Nothing;--this document relieves'the contractor ofits responsibility regarding the provisions of'7$0 CMR 107., When required bythe building official,L shall submit f eld/progress reports(see item 3:)together with pertinent comments,'in-a.form acceptable't6the building,official' Upon:completion of the work,I shall submit to.the building official a`Final Construction Control Documerif A Enter in the:space to the right a `wet' of electronic signature:and.sea}: - • d 3 • - yy�s.yy �� }yy Pho=,number. SO&759 9.828 Emai(-gbs@MEDCOMarch.co!P. Building Official Use Only F Building Ofliciat Name: Permit No.: Dater Note I. Indicate'with an`x'project design plans,computations and;specifications that you prepared or directly supervised.If`other'is chosen, prove de-a description. " V&s on.66' 1.t 2,6JI r Massachusetts Department of Publlc Safety.:, Board of Building,Regulations and Standards,^`. Conctruchon Sune lcor License CS-074674 MOSES M CORD)ft 45 PEACH BLOS6O51 ¢ ACUSHNET MA�1127 Expiration f .- Cotnmissloner-t Q6/l18/2017 f - AC�® DATE(MMIDDIYYYY) ��. CERTIFICATE OF LIABILITY INSURANCE 12/21/2015 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 endorsements. PRODUCER CONTANAME: Christina Jaeger Alliant Insurance Services, Inc., P"°NE 617-5357200 FAX 617-535-7205 131 Oliver Street,4th Floor - (A/C, Boston MA 02110 E-MAIL cjaeger@alliant.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Allied World National Assurance Com 10690 INSURED -INSURER B:Starr Indemnity&Liability Company 38318 J.K. Scanlan Company LLC INSURER C:Navi ators Insurance Company 42307 15 Research Rd INSURERD:Twin City Fire Insurance Company 29459 Falmouth, MA 02536 INSURERE:Hartford Accident&Indemnity INSURER F: COVERAGES CERTIFICATE NUMBER: 1735795455 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDIIYYYY MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y 0308-4515 7/1/2015 7/1/2016 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X�OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $300,000 x XCU MED EXP(Any one person) $10,000 x Contractual PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY F_x1 ECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ E AUTOMOBILE LIABILITY Y 08UENQT6583 7/1/2015 7/1/2016MBINED LE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ AUT OWNED SCHEDULED BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ _ AUTOS Per accident $ B UMBRELLA LIAB X OCCUR Y 1000021903 7/1/2015 7/1/2016 EACH OCCURRENCE $10,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED RETENTION$ $ p WORKERSCOMPENSATION 08WEQT6584 7l1/2015 7/1I2016 PER OTH- AND EMPLOYERS'LIABILITY X STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Excess Liability IS15EXC7114561V 7/1/2015 7/1/2016 Each Occurrence $15,000,000 Aggregate $15,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:JKS Job#1542, CCHC Hyannis Urgent Care 1220 lyannough Road, Hyannis, MA 02601. Cape Cod Healthcare, Inc.27 Park Street, Hyannis, MA 02601 and Hyannis Urgent Care 1220 lyannough Road, Hyannis, MA 02601 are' included as Additional Insureds as required by written contract and executed prior to a loss, but limited to the operations of the Insured under said contract,with respect to the Automobile, General Liability and Umbrella/Excess,Liability policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape Cod Healthcare, Inc. ACCORDANCE WITH THE POLICY PROVISIONS. 27 Park Street Hyannis MA 02601 AUTHORIZED REPRESENTATIVE JAA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD r The Commonwealth of Massachusetts Department of Industrial Accidents 'Office of Investigation 600 Washington Street Boston,MA 02111 �I Worker's Compensation Insurance Affidavit Applicant Information: J. K. Scanlan Company, LLC PROJECT NAME: Cape Cod Healthcare Hyannis Urgent Care LOCATION: 1220 Iyannough Road CITY: Hyannis STATE: MA PHONE#: ❑ I am a homeowner performing all work myself ❑ I am a sole proprietor and have no one working in any capacity. ❑ I am an employer providing worker's compensation for my employees working on this job. Company Name Address City State Zip Code Phone# Insurance— --- :_Co. Policy# Expiration Date --- — --------- ----- --- _--- -------- ® I am a sole proprietor,General Contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation policies: Company Name J.K.Scanlan Company,LLC Address Falmouth Technology Park, 15 Research Road City East Falmouth State MA Zip Code 02536-4440 Phone# 508-540-6226 Insurance Co. Twin City Fire Insurance Policy# 08WEQT6584 Expiration Date July 1,2016� Company Name Address City State Zip Code Phone# Insurance Co. Policy# Expiration Date Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one year's 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 Investigation of the DIA for coverage verific I do hereby cer ' under t pains and penalties of perjury that the information provided above is true and correct. Signature Date: December 21,2015 Print Name: Seth Adams Phone#: 508-540-6226 ext. 626 Official use only—do not write in this area—to be completed by city or town official City or town: Permit>license# El Building Department ❑Licensing Board ❑Selectmen's Office ❑Health Department ❑Other ❑check if immediate response is required Contact person: Phone#: IX T YANKEE SPRINKLERPAN 4 f Hvd 'idle CalculaL1011S I'o r Project: Narrle: Cape Cod Healthcare: Hyannis Urgent Care :Location: 1220 Iyannough Road, Hyannis, MA 02601 Drawing Nunl..ber:1 of 1 Date: 12/16/15 Design Inforrrlat.i011: Retn.ote Area nurrtber: 1 of 1 Remote Area Location: Renovated Urgent Care Space Occupancy Classiflcaiort: Light Hazard Den.si y:.0.1 gpm/ft'- Area of applicat:ioll: 900 fL2 Coverage per sprinkler: 196 ft2 Type of sprinide:rs calculated: Quiet: response, standard spray Nurll.ber of spr.ink1ers calculated: 11 t In Rack sprinkler dernarld: Ogallons Bose stream allowance: 250gprtl Total Wa'ter� Required (Including hose streams): 490.52 gp111 @ 43.10 psi. Type of System: Wet Volume of dry or pre-action system: gallons Water Supply Ififorrrtatiorr: J Date: 12/10/15 Location: On Iyannotigh Road in front of the existing building. Source: Static = 65 psi, Residual = 53 psi, Flow = 965 gpm Name of Co11'tractor: Yaiil.ee Sprinkler Co., Inc. Address: 612 Rear Plymouth Street; Suite#11 East Bridgewater, MA 02333 Phone Nurrlber: 508-378-7212 Name of Desi.g:ner: Stephen Nelson,PE Authority having jurisdiction: The Hyannis Fire Department Notes: (Including peak111g 1'nfoa7n.a'tiou of grid.ded systems here) -MOFMass STEPHEN q�yG NELSON FIRE PROTECTION N NO.41842 0 �90 �ST�P6 612 Rear Plymouth Street,Suite#I •East Bridgewater,Massachusetts 02333 Phone(508)378-7212 9 fax(508)378-7215 Yankee Sprinkler Co. , Inc.' 612 Rear Plymouth Street, Suite #1 East Bridgewater, Massachusetts 02333 H Y D R A U L I C C A L C U L A T I O N S C O V E R S H E E T a 4107 CCH Urgent Care, renovation 12/16/15 W A T E R S U P P L Y STATIC PRESSURE (psi) 65 RESIDUAL PRESSURE (psi) 53 RESIDUAL FLOW (gpm) 965 B O O S T E R P U M P S NUMBER OF BOOSTER PUMPS 0 S P R I N. K L E R S MAXIMUM SPACING OF SPRINKLERS (ft) 14 MAXIMUM SPACING OF SPRINKLER LINES (ft) 14 SPECIFIED DISCHARGE DENSITY (gpm/sq. ft. ) .l THIS SPRINKLER SYSTEM WILL DELIVER A DENSITY OF .1 gpm/sq. ft. FOR A DESTGN AREA OF 900 SQ. FT. OF FLOOR AREA THIS SYSTEM OPERATES AT' A FLOW OF 240.52 gpm AT A PRESSURE OF 34.50 psi AT. THE BASE OF THE RISER (REF. PT. 5) k, P,EPES USED FOR 'THIS SYSTEM 111 DUCTILE IRON (350) 001 SCHEDULE 4,0 tvi, 002 SCHEDULE 10 r i 4107 CCH Urgent Care, renovation 12/16/15 (1) STATIC PRESSURE (psi) = 65 (2) RESIDUAL PRESSURE (psi) = 53 (3) RESIDUAL FLOW (gpm) = 965 (4) ELEVATION OF RESIDUAL PRESSURE GAGE (ft) = 0 (5) OUTSIDE HOSE FLOW ( AT SUPPLY ) (gpm) 250 (6) C-FACTOR = 140 (7) DENSITY (gpm/sq. ft . ) 1 (8) MAX. SPACING BETWEEN SPKL 'R. HEADS (ft) = 14 (9) MAX. SPACING BETWEEN SPKL'R. LINES (ft) = 14 (10) MIN. FLOW (PER SPKL'R. ) (gpm) = • 19 . 6 (11) NUMBER OF BOOSTER PUMPS = 0 ADDITIONAL FLOWS : REF. PT. gpm NONE DESIGN AREA No. 1 K FACTOR (For Pressure Measured In psi) = 5 . 6 OPERATING SPRINKLERS : 20 21 22 23 24 25 26 27 28 29 30 r FROM TO PIPE DIA. HW-C LENGTH FITS EQV.- ELEV. TYPE in ft ft ft f`=1 2 111 6 . 400 140 150 . 0 352 72 . 6 0 . 0 _2 3 111 6 .400 140 100 . 0 352 72 . 6 1 . 0 '3 4 1 4 . 026 120 3 . 0 522 15 . 6 2 .0 4 5 1 4 . 026 120. 2 . 0 53 18 . 0 0 . 0 5 6 2 3 . 260 120 6 . 0 4262 48 . 2 6 . 0 6 7 2 3 . 260 120 26 . 0 22 13 . 4 0 . 0 7 8 2 3 . 260 120 92 . 0 22 13 . 4 0 . 0 8 9 2 3 . 260 120 10 .. 0 0 0 . 0 0 . 0 ''9 10 2 3 . 260 120 7 . 8 0 0 . 0 0 . 0 10 11 1 1 . 610 120 7 . 0, T 0 . 0 0 . 0 11 12 1 1 . 380 120 11 . 0 0 0 . 0 0 . 0 012,' 13 1 1 . 380 120 12 . 0 0 0 . 0 0 . 0 L20 - 13 1 1 . 049 120 10 . 8 222T 6 . 0 1 . 0 13 1 1 . 049 120 2 . 8' 23T 7 . 0 1 . 0 122 12 1 1 . 049 120 2 .8 23T 7 . 0 1 . 0 23 11 1 1 . 049 120 1 . 0: 23T 7 . 0 1 . 0 Fig 14 1 1 . 610 120 7 . 8 3T 8 . 0 0 . 0 14 15 1 1 . 380 120 10 . 3 0 0 . 0 0 . 0 I15 16 1 1 . 380 120 12 . 0 0 0 . 0 0 . 0 24 16 1 1 . 049 120 9 . 8 22T 4 . 0 1 . 0 25 16 1 1 . 049 120 1 . 8 23T 7 . 0 1 . 0 2'6 15 1 1 . 049 120 3 . 0 23T 7 . 0 1 . 0 27 14 1 1 . 049 120' 3 . 0 23T 7 . 0 1 . 0 8 17 1 1 . 610 120 6 . 8 3T 8 . 0 0 . 0 17 18 1 1 . 610 120 1 . 0 0 0 . 0 0 . 0 18 19 1 1 . 380 120 10 . 3 0 0 . 0 0 . 0 Z8 19 1 1 _049 120 1 . 8 2.3T 7 . 0 1 . 0 29 18 1 1 . 049 120 5 . 0 23T 7 .0 1 . 0 30 17 1 1 . 049 120 4 . 0 223T 9 . 0 1 . 0 Lt .• Y , Yankee Sprinkler Co. , Inc. 612 Rear Plymouth Street, Suite #1 4107 CCH Urgent Care, renovation 12/16/15 PAGE 1 HYDRAULIC CALCULATIONS AT SPECIFIED DENSITY THE FOLLOWING SPRINKLERS ARE OPERATING IN: / [ ] TEST AREA 1 [ ] TEST AREA 2 [ ] TEST AREA 3 [V REMOTE AREA Elevation of sprinklers = Elevation above water test. REF. PT. K ELEV. FLOW PRESSURE ft gpm Psi 20 5.60 8.00 20.21 13 .03 # 21 5 .60 8.00 20.86 13 .88 22 5.60 8.00 21.91 15.31 23 5 .60 8.00 24.07 18.47 2A 5.60 8.00 19.60 12 .25 25 5.60 8.00 20.06 12.83 ".0'26 5.60 8.00 20.97 14.02 27 5 .60 8.00 22.75 16.50 " 28 5 .60 8 .00 23 .43 17.51 29 5.60 8.00 23 .37 17.41 30 5.60 8.00 23 .30 17.30 THE SPRINKLER SYSTEM FLOW IS 240.52 gpm THE OUTSIDE HOSE FLOW AT REFERENCE POINT NO. 1 IS 250.00 gpm [ THE INSIDE HOSE [ ] RACK SPKLR'S. [ ] YARD HYDT. FLOW IS 0.00 gpm THE MINIMUM DENSITY PROVIDED BY THIS SYSTEM IS 0.100 gpm/sq. ft. THE FOLLOWING PRESSURES & FLOWS OCCUR ---> AT REF. PT. 1 <--- STATIC PRESSURE 65.00 psi RESIDUAL PRESSURE 53 .00 psi AT 965.00 gpm TOTAL SYSTEM FLOW 490.52 gpm AVAILABLE PRESSURE 61:57 psi AT 490.52 gpm OPERATING PRESSURE 43 .10 psi AT 490.52 gpm PRESSURE REMAINING 18.48 psi THE ABOVE RESULTS INCLUDE 6.00 psi FRICTION LOSS AT REF. PT.' # 3 FOR A [ .1Q BACKFLOW PREVENTER [ ] METER [ ] DETECTOR CHECK VALVE [ ] OTHER DEVICE a PC c. . 0"'«: Yankee Sprinkler Co. , Inc. 612 Rear Plymouth Street, Suite #1 ' 4107 CCH Urgent Care, renovation 12/16/15 . PAGE 2 FITTING Equivalent Length per NFPA 13 1994, 6-4 .3 ' - ' Indicates Equivalent Length. 'T' Indicates Threaded Fitting 1=45 Elbow, 2=90 Elbow, 3=1T' /Cross, 4=Butterfly Valve, 5=Gate Valve, 6=Swing Check Valve FROM TO FLOW PIPE FITS EQV. H-W PIPE DIA. FRIC. ELEV. FROM TO DIFF (gpm) (ft) (ft) C TYPE (in) (psi) (psi) (psi) . (psi) (psi) l 2 2,40.52 150.00 352 72 .59 140 111 6.400 0. 001 0.000 43 .10 42 .77 0.33 ' 2 3 240.52 100.00 352 72 .59 140 111 6.400 0.001 0.433 42 .77 42 .09 0.25 •3 4 240.52 3 .00 522 15.60 120 1 4 .026 0.019 0.867 42 .09 34 .87 6.35 4 5 240.52 2 .00 53 18.00 120 1 4 .026 0.019 0.000 34 .87 34 .50 0.37 5 6 240.52 6. 00 4262 48.24 120 2 3 .260 0. 052 2 .600 34 .50 29.05 2.85 6 7 240.52 26.00 22 13 ;40 120 2 3 .260 0.052 0.000 29.05 27 .01 2.05 7 8 240 .52 92 .00 22 13 .40 12.0 2 3 .260 0.052 0.000 27.01 21.53 5.47 8 9 170.43 10.00 0 0.00 120 2 3 .260 0.027 0.000 21.53 21.28 0.25 9 10 87.05 7.75 0 0.00 120 2 3 .260 0.008 0.000 21.28 21.22 0.06 10 11 87 .05 7.00 T 0.00 120 1 1.610 0.246 0.000 21.22 19.50 1.72 Ill 12 62.98 11.00 0 0.00 120 1 1.380 0.286 0.000 19.50 16 .37 3 . 13 12 13 41.07 12 .00 0 0.00 120 1 1.380 0.129 0.000 16.37 14 .81 1.56 -20 13 -20.21 10.75 222T 6.00 120 1 1.049. 0.132 0.433 13 .03 14 . 81 -2 .22 21 13 -20.86 2 .75 23T 7.00 120 -1 1.049 0.140 0.433 13 .88 14 . 81 -1.37 22 12 -21.91 2 .75 23T 7.00 120 1 1.049 0. 154 0.433 15.31 16.31 -1.50 23 11 -24 .07- 1.00 23T 1.00 120 1 1.049 0.183 0.433 18.47 19.50 -1.46 ==9 14 83 .37 7.75 3T 8.00 120 1 1.610 0.227 0.000 21.28 17.71 3 .57 > 14', ' 15 60 .63 10.25 0 0.00 120 1 1.380 0.266 0.000 17.71 15.01 2 .70 15 16 39.66 12.00 0 0.00 120 1 1.380 0. 121 0.000 15.01 13 .53 1.47 24 16 -19.60 9.75 22T 4.00 120 1 1.049 0. 125 0.433 12.2.5 13 .53 -1.72 25 16 -20.06 1.75 23T 7.00 120 •1 1.049 0. 130 0.433 12.83 13 .53 -1.14 26 15 -20.97 3 .00 23T 7 .00 120 1 1.049 0.142 0.433 14 .02 15.01 -1.42 27 14 -22 .75 3 .00 23T 7 .00 120 1 1.049 0.165 0.433 16.50 17 .71 -1.65 8 17 70.09 6.75 3T 8.00 120 1 1.610 0.164 0.000 21.53 19. 11 2 .42 11 18 46.80 1.00 0 0.00 120 1 1.610 0.078 0.000 19.11 19. 05 0.05 18 19 23 .43 10.25 0 0 .00 120 1 1.380 0.046 0.000 19.05 18.60 0.46 28 19 -23 .43 1.75 23T 7.00 120 1 1.049 0.174 0.433 17.51 18.60 -1.52 29 18 -23 .37 5.00 23T 7.00 120 1 1.049 0.173 0.433 17.41 19. 05 -2.08 30 17 -23 .30 4 .00 223T 9.00 120 1 1.049 0.172 0.433 17.30 19. 11 -2.24 t .. y--A MAX. VELOCITY OF 13 .71 ft./sec. OCCURS BETWEEN REF. PT. 10 AND 11 �- Sprinkler-CALL Release 7.2 Win By Walsh Engineering Inc. North Kingstown R.I. U.S.A. zo, `2 v M1 I J WATER SUPPLY/DEMAND GRAPH 4107 CCH Urgent Care,•ren va i��n 12,11Er15 i v- - - - - _.... 140.00 13I I,0I J 120.00 ' - � - R 1 oo.oo m.. 00 00 E 40.00 10.00 10.00 0.00 _ I �# ,- 0 500 1000 1500 2000 �r S upp�y 53.0I I p .i tD 965.00 gpm N FLOW �D em and 43.1 I -p:iQyQSgpri), j. rinkl r-CALL 7.2 Win 5, Spi t s `t f I , 4 { i { j i/ f YANKEE SPRINKLER COMPANY Hydraulic Calculat:i.orts For Project Name: Cape Cod Healthcare: Hyannis Urgent Care Location: 1220 Iyannough Road, Hyannis, MA 02601 Drawing Nurnber:l of 1 Date: 12/16/15 Design In.forrnation: Rentote Area nt:truber: 1 of 1 Remote Area Location: Renovated Urgent Care Space Occupancy Classifi.catio.rt.: Light Hazard Density: 0.1 gprn/ft' Area of application: 900 ft2 Coverage per sprinkler: 196 ft' Type of sprinklers calculated: Quick response, standard spray Number of sprinklers calculated: 11 Itr Rack sprinkler dern.a►d. Ogalloas Hose strearrt. allowance: 250gp:rn Total Water Required (lncludi:rtg hose st:rea:rns): 490.52 gprn @ 43.10 psi. Type of Systelrt: Wet Volume of dry or pre-acl::ion System: gallons Water Supply Infor•rnai:iou: Date: 12/10/15 Location: On Iyannough Road in front of the existing building. Source: Static = 65 psi, Residual = 53 psi, Flow = 965 gprn Narne of Contractor: Yankee Sprinkler Co., Inc. Address: 612 Rear Plymouth Street,Suite#1, East Bridgewater, MA 02333 Phone Nu-nber: 508-378-7212 Narrte of Designer: Stephen Nelson,PE Authority having jurisdiction: The.Hyannis Fire Department Notes: (I.ncluding peaking irrf'orrnation or gr►.dded systen•ts here) _ t�A oF,y,�ss STEPHEN 9�yG NELSON FIRE PROTECTION N No.41842 0 • � z J�U�i 5 612 Rear Plymouth Street,Suite#I •East Bridgewater,Massa:hUSCUS 02333 Phone(508)378-7212•Fax(508)378-7215 Yankee Sprinkler Co. , Inc. 612 Rear Plymouth Street, Suite #1 East Bridgewater, Massachusetts 02333 H Y D R A U L I C C A L C U L A T I O N S, ' C 0 V E R S H E E T 4107 CCH Urgent Care, renovation 12/16/15 W A T E R S U P P L Y STATIC PRESSURE (psi) 65 RESIDUAL PRESSURE (psi) 53 RESIDUAL FLOW (gpm) 965 B O O S T E R P U M P S NUMBER OF BOOSTER PUMPS 0 S P R I N K L E R S MAXIMUM SPACING OF SPRINKLERS (ft) 14 MAXIMUM SPACING OF SPRINKLER. LINES (ft) 14 SPECIFIED DISCHARGE DENSITY (gpm/sq. ft. ) .1 THIS SPRINKLER SYSTEM WILL DELIVER A DENSITY OF .1 gpm/sq. ft. FOR A DESIGN AREA OF 900 SQ. FT. OF FLOOR AREA THIS SYSTEM OPERATES AT A FLOW -OF 240.52 gpm AT A PRESSURE OF 34 .50 psi AT. THE BASE OF THE RISER (REF. PT. 5) P,I'PES USED FOR THIS SYSTEM 111 DUCTILE IRON (350) 001 SCHEDULE 40 Ia)', 002 SCHEDULE 10 c Y if 4107 CCH Utgent Care, renovation 12/16/15 (1) STATIC PRESSURE (psi) = 65 (2) RESIDUAL PRESSURE (psi) = 53 (3) RESIDUAL FLOW (gpm) = 965 (4) ELEVATION OF RESIDUAL PRESSURE GAGE (ft) 0 (5) OUTSIDE HOSE FLOW ( AT SUPPLY ) (gpm) 250 (6) C-FACTOR = 140 (7) DENSITY (gpm/sq. ft . ) _ . 1 (8) MAX. SPACING BETWEEN SPKL'R. HEADS (ft) = 14 (9) MAX. SPACING BETWEEN SPKL 'R. LINES (ft) = 14 (10) MIN. FLOW (PER SPKL 'R. ) (gpm) = 19 . 6 (11) NUMBER OF BOOSTER PUMPS = 0 ADDITIONAL FLOWS : REF. PT. gpm NONE DESIGN AREA No. 1 K -FACTOR (For Pressure Measured In psi) = 5 . 6 OPERATING SPRINKLERS : 20 21 22 23 24 25 26 27 28 29 30 (`,.) FROM TO PIPE" DIA. HW-C LENGTH FITS EQV.- ELEV. ' TYPE in ft ft ft (==1 2 111 6 .400 140 150 . 0 352 72 . 6 0 . 0 -2 3 111 6 . 400 140 100 . 0 352 72 . 6 1 . 0 `3 4 1 4 . 026 120 3 . 0 522 15 . 6 2 . 0 4 5 1 4 . 026 120 2 . 0 53 18 . 0 0 . 0 5 6 2 3 . 260 120 6 . 0 4262 48 . 2 6 . 0 6 7 2 3 . 260 120 26 . 0 22 13 . 4 0 . 0 7 8 2 3 . 260 120 92 . 0 22 13 . 4 0 . 0 8 9 2 3.260 120 10 . 0 0 0 . 0 0 . 0 ."'9 10 2 3. 260 120 7 . 8 0 0 . 0 0 . 0 t 10 11 1 1 . 610 120 7 . 0 T 0 . 0 0 . 0 11 12 1 1 . 380 120 11 . 0 0 0 . 0 0 . 0 !�12' ' 13 1 1 . 380 120 12 . 0 0 0 . 0 0 . 0 :L20 - 13 1 1 . 049 120 10 . 8 222T 6 . 0 1 . 0 13 1 1 . 049 120 2 . 8 23T 7 . 0 1 . 0 1,22 12 1 1. 049 120 2 . 8 23T 7 . 0 1 . 0 23 11 1 1 . 049 120 1 .,0 23T 7 . 0 1 . 0 �`k 9 14 1 1 . 610 120 7 . 8 3T 8 . 0 0 . 0 14 15 1 1 . 380 120 10 . 3 0 0 . 0 0 . 0 'Ii5 16 1 1 . 380 120 12 . 0 0 0 . 0 0 . 0 24 16 1 1 . 049 120 9 . 8 22T 4 . 0 1 . 0 25 16 1 1 . 049 120 1 . 8 23T 7 . 0 1 . 0 26 15 1 1 . 049 120 3 . 0 23T 7 . 0 1 . 0 27 14 1 1 . 049 12.0 3 . 0 23T 7 . 0 1 . 0 8 17 1 1 . 610 120 6 . 8 3T 8 . 0 0 . 0 17 18 1 1 . 610 120 1 . 0 0 0 . 0 0 . 0 18 19 1 1 . 380 120 10 . 3 0 0. 0 0 . 0 "28 19 1 1 . 049 120 1 . 8 23T 7 . 0 1 . 0 29 18 1 1 . 049 120 5 . 0 23T 7 . 0 1 . 0 30 17 1 1 . 049 120 4 . 0 223T 9 . 0 1 . 0 .; r r Yankee Sprinkler Co. , Inc. 612 Rear Plymouth Street, Suite #1 4107 CCH Urgent Care, renovation 12/16/15 PAGE 1 HYDRAULIC CALCULATIONS AT SPECIFIED DENSITY i 1 THE FOLLOWING SPRINKLERS ARE OPERATING IN:• � [ ] TEST AREA 1 [ ] TEST AREA 2 [ ] TEST AREA 3 [vJ REMOTE AREA Elevation of sprinklers = Elevation above water test. REF. PT. K ELEV. FLOW PRESSURE ft gpm psi 20 5 .6 0 8.00 20.21 13 .03 , 21 5.60 8.00 20.86 13 .88 22 5.60 8.00 21.91 15.31 23 5.60 8.00 24.07 18.47 24 5.60 8.00 19.60 12 .25 25 5 .60 8.00 20.06 12 .83 , 430 26 5.60 8.00 20.97 14 .02 27 5.60 8.00 22 .75 16.50 28 5.60 8.00 23 .43 17.51 29 5.60 8.00 23 .37 17.41 30 5.60 8. 00 23.30 17.30 THE SPRINKLER SYSTEM FLOW IS 240.52 gpm THE OUTSIDE HOSE FLOW AT REFERENCE POINT NO. 1 IS 250. 00 gpm [ THE INSIDE HOSE [ ] RACK SPKLR'S. [ ] YARD HYDT. FLOW IS 0.00 gpm THE MINIMUM DENSITY PROVIDED BY THIS SYSTEM IS 0.100 gpm/sq. ft. THE FOLLOWING PRESSURES & FLOWS OCCUR ---> AT REF. PT. 1 STATIC PRESSURE PRESSURE 65.00 psi RESIDUAL PRESSURE 53 .00 psi, AT 965.00 gpm TOTAL SYSTEM FLOW 490.52 gpm AVAILABLE PRESSURE 61.57 psi AT 490.52 gpm OPERATING PRESSURE 43 . 10 psi AT 490.52 gpm PRESSURE REMAINING 18.48 psi THE ABOVE RESULTS INCLUDE 6.00 psi FRICTION LOSS AT•REF. PT.` # 3 FOR A ( 1� BACKFLOW PREVENTER [ ] METER { ] DETECTOR CHECK VALVE. [ ] OTHER DEVICE x t• i Ir I Yankee Sprinkler Co. , Inc. 612 Rear Plymouth Street,' Suite #1 4 107 CCH Urgent g Care, renovation 12/16/15 PAGE 2 FITTING Equivalent Length per NFPA 13 1994, 6-4 .3 ' - ' Indicates Equivalent Length. 'T' Indicates Threaded Fitting --1=45-Elbow,-2=90 Elbow, 3='T'/Cross, 4=Butterfly Valve, 5=Gate Valve, 6=Swing Check Valve FROM TO FLOW PIPE FITS EQV. H-W PIPE DIA. FRIG. ELEV. FROM TO DIFF (gpm) (ft) (f t) C TYPE (in) (psi) (psi) (psi) (psi) (psi) 1 2 240.52 150.00 352 72 .59 140 11l 6.400 0. 001 0.000 43 .10 42 .77 0.33 2 3 240.52 100.00 352 72 .59 140 111 6.400 0.001 0.433 42 .77 42 .09 0.25 3 4 240.52 3 .00 522 15.60 120 1 4.026 0.019 0.867 42 .09 34 .87 6.35 4 5 240.52 2 .00 53 18.00 120 1 4 .026 0.019 0.000 34.87 34.50 0.37 5 6 240.52 6.00 4262 48.24 120 2 3 .260 0.052 2 .600 34 .50 29.05 2.85 6 7 240.52 26.00 22 13 .40 120 2 3 .260 0. 052 0.000 29.05 27.01 2 .05 7 8 240.52 92 .00 22 13 .40 120 2 3 .260 0. 052 0.000 27.01 21.53 5.47 8 9 170.43: 10.00 0 0.00 120 2 3.260 0.027 0.000 21.53 21:28 0.25 9 10 87-05 7.75 0 0.00 120 2 3 .260 0.008 0.000 21.28 21.22 0.06 10 11 87.05 7.00 T 0.00 120 ' 1 1.610 0.246 0.000 21.22 19.50 1.72 !11 12 62 .98 11.00 0 0.00 120 1 1.380 0.286 0.000 19.50 16.37 3.13 12 13 41.07 12 .00 0 0.00 120 1 1.380 0.129 0.000 16.37 14 . 81 1.56 -20 13 -20.21 10.75 222T 6.00 120 1 1.049 0. 132 0.433 13 .03 14.81 -2 .22 21 13 -20.86 2 .75 23T 7.00 120 •1 1.049 0. 140 0.433 13 .88 14 .81 -1.37 22 12 -21.91 2 .75 .23T 7.00 120 1 1.049 0. 154 0.433 15.31 16.37 -1.50 23 11 -24.07- 1.00 23T 7.00 .120 1 1.049 0. 183 0.433 18.47 19.50 -1.46 -9 14 83 .37 7.75 3T 8 .00 120 1 1.610 0.221 0.000 21.28 17.71 3 .57 1'4' 15 60.63 10.25 0 0.00 120 1 1.380 0.266 0.000 17.71 15.01 2.70 115 16 39.66 12 .00 0 0.00 120 1 1.380 0. 121 0.000 15.01 13 .53 1.47 24 16 -19.60 9.75 22T 4.00 120 1 1.049 0. 125 0.433 12 .25 , 13 .53 -1.72 25 16 -20.06 1.75 23T 7.00 120 1 1.049 0. 130 0.43.3 12.83 13 .53 -1.14 26 15 -20.97 3 .00 23T 7.00 120 1 1.049 0.142 0.433 14.02 15.01 -1.42 27 14 -22 .75 3 .00 23T 7.00 120 1 1.049 0. 165 0.433 16.50 17.71 -1.65 8 17 70.09 6.75 3T 8.00 120 1 1.610 0. 164 0.000 21.53 19. 11 2.42 17 18 46.80 1.00 0 0.00 120 1 1.610 0.078 0.000 19.11 19. 05 0.05 18 19 23 .43 10.25 6 0.00 120 1 1.380 0.046 0.000 19.05 18.60 0.46 28 19 -23 .43 1.75 23T 7.00 120 1 1.049 0.174 0.433 17.51 18.60 -1.52 29 18 -23 .37 5.00 23T 7.00 120 1 1.049 0. 173 0.433 17.41 19. 05 -2 .08 30 17 -23 .30 4.00 223T 9.00 120 1 1.049 0. 172 0.433 17.30 19.11 -2 .24 A MAX. VELOCITY OF 13 .71, ft./sec. OCCURS BETWEEN REF. PT. 10 AND 11 3 Sprinkler-CALC Release 7.2 Win By Walsh Engineering Inc. North Kingstown R.I. U.S.A. 23 t ' f i ''•.-.ATER 'JUPPLYIGEt,i.LND GRAPH 4107 17 CCH Urgent rgent Care;fernov+ tip n 12 1 Gil F 140.00 130.00ELI 120.00 E go.CIo j .. _ it .- ..., .: ... - - 00 � I I IU FBI I I - - _ 30.00 � 20.00 I IIJ j' 10.00 0.00 0 500' 1000 1500 20I0 SuFPly: 53.0I psi Q-z 965.00 s f er �rn : ��.1 I F �:i @1 490.F2 g FrnFLJt � � rir�kler-CALC 7.2 Win •J y I i { f j . 1 ' t i r i EXrUNC;,PRINKLER PIPE 10 REM- (nrlGau BAR 101ST HANGER DETAIL •/�—p,e�.,�,... _'MISTING f DOUBLE NECKB FLMI EREVENIEP.A PENSION NEW f YICIAJUC SEPIES%D5 CRDMD CONROL x I OSAY VALVE.RELOCATED f0 MG UOCAVON. ® LOP BGw cL VALVE VIM WEAINERPROOF AGMATOR. .� / , . ■ -4L RLSFIDED R00 - t.e�4 CONNECT THE 1V."TEST S DRAM LINE,FROM ONE S!ONE (�/ BURDIN;LOCUS EFSTING ORY VALVE t0 REMAIN.—�I I 1�I I RISER NODULE,INTO ME DUSIINC Y ORNN LINE. AQNSfAf0.E HAND H>NCER 4.. J / L----__——_,W _I fW S YICiwUC SEINES]I]CHOOVFD CHNECK VALVE A \J J Cali A OPnCNAL WCTAVUC SPRESSURE 'LIE ZONE RISEH NODULE WITH ME NEW 1'.S VIC B50 LONE) /l (n —E CIMIROI ASSEMBLY FOR ME COT TENANT SP—T �I HEY;i M WEAL SERIES]OS ACTUATOR. CONTROL W 4 VALVE VWM WFATNFRPROOF M;RUtOft. -n r IXISTMG ORY SPRINKLER MAN TO RELLNH. k' 'Y ONDIiKW wT lkA mar 2, &EI W UP') TO I / 3W"PPL x0i tESS mAx T tiDOOIMl 4@M f 5 PPE III VN - I -- em41NA V o"NOO.OF2W'P_RE BOnOu FOR—C. li 4, LEGEND: LNES.NYAIW T MW NE O] N FOR NNN ONES.ORPONx. MIS IdMRQUATTEM mpx TOPI ONOT F i1EEL,TO OR ROCXET NAIIxC I IE _ - hryryphp�wn.n _ I .I � I I jfU:�•NWeen / w 7 n r- ® 0 '•_A=;AwxyVt g I -_ `(nYia a'x y yF - Lail 11' p,aNw+x pq-Nae-I a.Ab x N _ E ,•L ��-,,;'� WOOD HANGER DETAIL PN•xbs:rt IT -- _ 6 - - HATCHED AREA SHOWS ME NIDRAUUC CALCUUTIONS MOST REMOTE DESIGN AREA 900 SO-Ft REQUIRED.924 SO-9 SHOWN. ® I d O I� EL BAR J06 R--- TIE BUILDING 6 CURIENILY PROTECTED WIN AN EUUMG DRY PIPE SPRINKLER SYSTEM.N0 N'ONNIION 6 PROYIOED FOR MS EISDNG SYSIEM.MERRY-E,I1 WILL NOT BE USED TO PROTECT THIS RENOVATED SPACE. ME EXSONG LINES THAT SUPPED PERCENT SPRNKOERS MHOUGHOUT THS SPOOF.THAT ARE NO LONGER NEEDED. SHAH 9E RD 5uID AXD THEIR OJTLETS PLUGGED OFF.ME ORY SPRINKLER MANS SHNL REMAIN.BECAUSE THEY TRAPEZE H R DEAL-PAR JOIST SUPPLY SPRINKLERS IN OTHER AREAS O ME BUILDING.THE EXISTING SPRINKLER IDES IN ME AREA NNN ME �_�-�•� co.EOSNBIE ROOF JOISTS SHALL REMAIN.THOSE UNES SHLLL NAPE colt I®LE CONGEALED,SPACE UPRKOR NNI N.VP �� pO,p SPRINKLERS N N_ED ON MOO ME 9ISM3 ONES SHAL BE SHOWN ON ME AS-BUILT gAVPNS. + FIRE SUPPRESSION SYSTEM GENERAL NOTES. I.THIS(HAWING SHOWS THE PROPOSED FIRE SUPPRESSION SYSTEM CHANGES FOR THE RENOVATED AREA. 2.SPRINKLER DEFLECTORS NEED TO BE POSITIONED ON ACCORDANCE WITH THEIR LSRNCS. . 3.DUCK RESPONSE SPRINKLERS SHALL BE INSTALLED THROUGHOUT ME PROJECT. -AND ONFUE 4.WET SYSTEM PIPING.PIPING 142'AND LARGER SHALL RE SCHEDULE 10 BLACK STEEL PIPE WITH GROOVED ENDS AND GROOVED soul ror luN mm WCTAULIC FIRELOCK FITONGS.PIPING 1 V"AND SMALLER SHALL BE SCHEDULE 40 BUCK STEEL PIPE WITH THREADED ENDS AND THREADED CAST IRON HTTINGS.(UNLESS OTHERWISE NOTED ON THE PLAN 5.ME SYSTEM SHALL BE INSTALLED IN ACCORDANCE WITH ME?MASSACHUSETTS STATE BUILDING CODE 780 CMR BUT EDITION.NFPA 13 2013 EDITION AND ANY LOCAL FINE OR BUILDING DEPARTMENT REQUIREMENT, 6.ALL HANGERS SHALL BE INSTALLED IN ACCORDANCE WITH NFPA REQUIREMENTS, 1"&l Vi-12'-Cr.I AND LARGER-15'-0- BETWEEN HANGERS. "�°°R I" O mrslwE wo wrAR i ].SPRINKLERS SHALL BE INSTALLED UNDER FIXED OBSTRUCTIONS OVER 4'WIDE SUCH AS DUCTS.DECKS.OPEN GRATE FLOORING. Y znxevn Fa F, CUTTING TABLES.AND OVERHEAD DOORS.(ADDITIONAL SPRINKLER HEADS SHALL BE SHOWN ON THE AS-BUILT DRAWINGS. sSITEm.' .ON SPAN OF . I. Y f Y , HYDRAULIC DESIGN DATA CONTRACTOR JK SCANLAN COMPANY LLC _ SPRINKLER SCHEDULE&LEGEND CAPE COD HEALTHCARE cALCUu1an 'i cALtuunon GENERAL CONTRACTOR 4' rRWxnarx mzPvrPx Pw,u '" °"° ^®' Rn. PWINR'Aeg NORTH O CJ�LJ ora O«s LI r INNRD I swan VICTAULIC OR RWC.PEN. V2)04 N' 5.6 15YF CHR 67 4R'0 2 I V (� I I Z �y�''tN AODRESStS RESEARCH RD EAST FAUNOUTH.W 02536 { e` T220 IYANNOUGH ROAD,HYPNNIS,MA 02601 REVISION 'a DESIGNER S.E.N. �° N cAIP I.L.a A 900" wuP. HYANNIS URGENT CARE SOLE ,.REfiN1TECIION nr A,aa ., ie m : . asLproN N0.41842'f Demon4 ,� PMO 431 CPMO' OPYO' MPv IP)B CHECK BY B.G. �� YANKEE SPRINKLER CO., INC. FILE NYYBER Y—+1o) ROw TEST INFO:F CMO Psi Dots:I3 0 n _ HFD «aIP: oN NANxNwH Row m N,,T Dr NE660E — 612 REAR PLYMOUTH STREET, SUITE {/1 °°R° /15 /A/JS 1 OnTIAA Sire o Outlel PI vas PN Bblie Te U C Pi W® TO PREVENT FREEZING OF wM�ORN WHET PIPE SPRINKLER PIP VC, �( AO 2 66 i1 OWNERS TO PROVIDE SUFFlCIENT HEAT THRWCHDUT MEALS WHERE ROMDEO ) JC.EOo9x DR 12./161 SI 0 SPRINKLER PIPES ARE INSTALLED.UNLESS AIN ANTI-FREEZE SYSTEM. EASf ORIIJGEWATER,NASSACHUSETTS 02333 DRAWING NO. OF F 1� II. t EXISTING SPRINKLER PIPE TO REMAIN. --- (TYPICAL} BAR ,,JOIST HANGER DETAIL ,WIM w HRRIQumm PMT=N I5 XQUIPEO. € WORK AREA ! 1 c 4LWxC 04 ,—EXISTING 4" DOUBLE CHECK BACKFLOW PREVENTER & a Y NEW 4" VICTAULIC SERIES 705 GROOVED CONTROL t OS&Y VALVE, RELOCATED TO THIS LOCATION. ----TOP BEAM CLAMP VALVE WITH WEATHERPROOF ACTUATOR. r ' % i. , I r ALL THREADED ROD I Lill, r 1 ; IM9.Il CONNECT THE 11/4" TEST & DRAIN LINE, FRCM THE 3" ZONE BUILDIN LQCUS EXISTING DRY VALVE TO REMAIN. 1 `r L"'xa 5 I RISER MODULE, INTO THE EXISTING �' DRAIN L 1NE. ADJUSTABLE BAND HANGER A r t 3LW VIEW A7A r/ I -i - NEW 3" VECTAULIC SERIES 717 GROOVED CHECK VALVE & L- A _/ / S' VICTAULIC SERIES 747M ZONE RISER MODULE WITH THE .NEW 4 x3' VIC :;�50 CONE OPTIONAL PRESSURE RELIEF VALVE. .. _. (NEW ZONE CONTROL ASSEMBLY FOR THE CCH TENANT SPACE) i NEW 3» VICTAULIC SERIES 705 GROOVED CONTROL VALVE WITH WEATHERPROOF ACTUATOR. l l --EXISTING DRY SPRINKLER MAIN TO REMAIN. DIMENSION NOT LESS THAN 2" NOMINAL WIDTH (11/") UP TO 31/z" PIPE; NOT LESS THAN NOMINAL WIDTH & S' FETE I "SUM "Y' DIMENSION OF 2t/" FROM THE BOTTOM FOP. BRANCH x a ! MINI,. <,� , I _ I 1 LW ,[M3.1 "+ tl , LEGEND LINES. MINIMUM 3' FROM THE BOTTOM FOR MAIN LINES. EXCEPTION: THIS REQUIREMENT SHALL NOT APPLY TO 2 OR "MICI(ER I,nILING 'TING RES. C TOP OF ,TEFL BE4MS. S1AF P ENT ' sT 51 RACE M R '<TI i1ES1M IL m v I (4-SxI-10?ri CUM Y € € I 1511 "1 E » c� a I (8}c3LWx2-11, Q/G X �. . r r N I - _ IMs.<T .,_. `..... - _� .. � i � ( I m J!, sra,>tirrsu�trsc+rw I I - lsr 4f 10 wx1-1Yi C G swczs3ec �CVVsQ 4Y• 11 t 1 z. N 1 t, r - .� ccrw I / I (1,T-.l2xo 3 z I _ _ - __. —_ tx2 �. w 8s.1 ,A a 1 _ # I � 3L L M5. ( IM5.8��LW i [2) l (13�1 h>,0-3Yz - 7-8Y� I 3- 1h -4V MS_3 4-9 r K22 ^I 10-s 3-i1+,. t 3ja�4 6-9V4 I I 1U3h 5r-4'"i 3 93r4 [....__ I I (t4Nta4x2-3 *SWG 25-3 ? UP TO A - f-- 3 wx0- (}5 1x2-Bth .p C I { ,.- �13 �W 3LW h c/c _._. ,� �.., , -;R€,. , , I c � }� � MAXIMUM 4 PIPE 5{ZIr €I ! }�11 I ! r I ( 1 i Y , I I {16}=1x4-2Pi } 31Wx0- /4 I t =t yxx0-3+h i �o,ia tJJ wam 21 3LWO-8 C C l I aaJUSTFW.ERING XMIGER I r � I I�,.� � { � I I � � .i 24,. , ,- (22k3LW><4-9 C/G ;�EamMlnrTravEzr f J {16}t 1 11 I .. . (23)-3LWxt-4;4 C/G 4-11 I -- (24)-3:Nx2-1DV4 G/t; s"n ; - (25)=3V94-sv4 G/c I .t'` (26)�X%0-6 G/c -- I s I I I 1 4�5wy-v G u -914 11VOOD HANGER DETAIL (23)=44LLWz0-5 G/GJ 1 a B 5 } � L r I I a � 1 . _ - L - I � � I I o r ---- -- - - 1 7 ,. BfD 7 f3Eb 8 V I I MED ON p } HATCHED AREA .`... 1 � rr � �I i I } I 11 I I h . . SHOWS THE HYDRAULIC-.CALCULATIONS MOST U I 14-0 ! I s REMOTE DESIGN AREA. 90 - 1 - _I I 0 SQ FT REQUIRED, 924 SO-FT SHOWN. 1 � I � NJ i r I I : Y f I_ t-•— _ t• 1 I _ Li 2-4111111, P uc r --- - - i I STEEL BAR JOIST -; DOD ROOF JOISTS---- ---- PROTECTED THE BUILDING IS CURRENTLY . ROTECTED WITH AN EXISTING DRY PIPE SPRINKLER SYSTEM. NO INFORMAT10N IS PROVIDED FOR THIS EXISTING SYSTEM. THEREFORE,S IT WILL NOT BE USED TO PROTECT THIS RENOVATED SPACE S THE EXISTING LINES THAT .SUPPLIED PENDENT'SPRINKLERS THROUGHOUT THIS .SPACE THAT ARE N6 LONGER_N I .NEEDED, SHALL BE REMOVED AND THEIR OUTLETS `PLUG R ET PLUGGED OFF THE DRY SPRINKLER IN 7 MA S SHALL REMAIN,;BECAUSE THEY : TRAPEZE , 1 A I: RA E�E HANGERR JOIST i DETAIL 8 Ja s J N SUPPLY SPRINKLERS !I OTHER AREAS F` ;. I 0 THE BUILDING. THE EX€ST€IJG SPRINKLER IN IN E LINES THE AR WITH T!'J t COMBUSTIBLEROOF JOI S SHALL N I ST L REMAIN. LINES SHALL NAVE...COMBUSTIBLE CONCEALED 5F*A ,Er1 CE UPRIGHT I TOP BEW COMP TOP BEAM CLAMP SPRINKLERS INSTALLED ON THEM. THE EXISTING LINES SHALL BE SHOWN ON THE AS BUILT:DRAWIfJGS. - FIR._ SUPPRESSION ',YSTEM GENFR.AL NOTES. •,nT 1. THIS DRAWING SHOWS THE PROPOSED FIRE SUPPRESSION S1 I EM CHAIN GES FOR THE RENOVATED AREA. 2. SPRINKLER DEFLECTORS NEED TO BE POSITIONED IN ACCORDANCE WITH THEIR LISTINGS. ALL THREADED POD TRAPEZE BAR ALL THREADEDIROD a. QUICK RESPONSE SPRINKLERS SHALL BE 'INSTALLED THROUGHOUT G OUT-THE PROJECT. 4. WET SYSTEM PIPING, PIPING 11/2 AND LARGER SHALL. BE SC14EDULE 10 BLACK STEEL PIPE WITH GROOVEDT VICTAULIC FIR 1 " I ENDS AND GROOVED FLOCK FITTINGS. PIPING 1 /4 AND SHALL BE SCHEDULE 40 BLACK STEEL PIPE WITH .THREADED ENDS AND THREADED CAST IRON FITTINGS: UNLESS( OTHERWISE NOTED. ON THE PAN) T P BEAM CLAMP T 0 to ,OP BEAM 5. THESYSTEM YSTEM SHALL I3 INSTALLE D ED IN ACCORDANCEWITH T G I H HE MASSA HU TA B SETTS STATE BUILDING CODE 7 1N O CM E 8G R tt h DI 110 t E N NFPA 13 013 + 2 EDITION :EI) AND RPlY_ LOCAL F(RE I OR BUILDING DEPARTMENT S REQUIREMENTS. TOLCO FIG. 200H HEAVY DUTY c a , ' , 6. ALL .HANGERS SHALL BE IN ACCORDANCE WITH NFPAREQUIREMENTS, 1 _ _ 1 _ _ i &1 /4 12 a , 1 /2 AND LARGER 5 a BMID HANGER{FOR TRAPEZE} f BETWE EN HANGERS, U"T ND HANGER PIPE) ARf o ABLE BA SPRINKLER7. SPRINKLERS SHALL 'BE INSTALLED UNDER FIXED OBSTRUCTIONS OVER 4' WIDE SUCH AS DUCTS DECKS OPEN GRATE FLOORING, CUTTING TABLES AND OVERHEAD DOORS. (ADDITIONAL - aRi G, , � DD _ ._ SPRINKLER HEADS .SHALL BE SHOWN ON THE AS BUILT DRAWINGS. PIPE SIZE REOUIRE] FOR TRAPEZE BAR SPAN OF 2 AND UNDER IS SCHEDULE 40 PIPE, 2 1/-- AND UP IS SCHEDULE 10 TRAPEZE I" 1w I 2' 2w 3" 4' 6" 2' - IY 1" 1" 1" 1" 1" 1V4 ISO Ph" 4' - U* IMe t Vi r 4:" I w t+i4" t+h" 2" Y 6' _ 0" 2" 2" 2" 27 :f 27 2" 244' 8, - O" 2. 2" 2" 7 2, 2eh• 2SR' i HYDRAULIC DESIGN DATA -- CONTRACTOR: JK SCANLAN COMPANY LLC SPRINKLER SCHEDULE & LEGEND CALCULATION 1t 1 CALCULATION Z CALCULATION 5`fA •SP IN m N it # 3 GENERAL CONTRACTOR EsoL R KLER DESCRIPTION ORIFlCE K"- 7EMp. FINISH QTY. SyRI ]Kr CAPE GOD HEALTHCARE Hazard Class.. . LIGHT HAZARD G, ---- - -- ------------ - ----- I 1 a t 2 ADDRESS. 1� RESEARCH RD. EAST FALMOUTH MA 0� a, VICTAULIC OR RUC. PEN. ld7C! . !_ 5.8 155 F CHR h7 /� C ., NORTH Z ey' 4K DF Hazard Class. �1EDICAL OFFICE , s _536 } a 1 c2O IYANIN�UGH ROAD, HYANNIS, Iv1A 0260� $ stem Type- WET TREE � I~ ~ , C► HEty) REVISION � � DESIGNER S.E.N. Densit 0.i GPM � .GPM � GPM � Is., c? DATE DESCRIPTION BY ,. " �d NELSON `� Calculated Area 900 � dl � � ' � ' HYA(�I N I S URGENT CARE SCALE �,�� -1 --o 1 FIRE�PROTECTION r Area per Sprinkler. 196 41 1a�2 Demand, 490.52 GPM9 43.10 Psl GPM@ psi GPM PSI CHECK BY B.G. 1976 O G'r A Fire urn . GPM* Date. 1 1 1 Time:7• est B :YS �r'(� T N K CO .� c P P M Psi 2 0 5 .30 A.M.A.M Y�l� dl�� SPRINKLER Lr 4..! �T FILE. NUMBER Y-41 c01 ._ `F`�sr �` FLOW TEST 1NFC1. Location: ON IYANNOUGH ROAD IN FRONT OF THE SITE . . IMPORTANT T APPROVAL HFD Orifice Size No of Outlet 'Static R al I `___ Pitat .Press Psi Psi Residual Psi Flaw ..PM L C Pipe: ��•. 1 ,. 6 2 REAR PLYlVL4UTH STREET, QUITE 1 / TO PREVENT FREEZING OF WATERI W PIP SPRINKLER -[PING, O N ET E SPR, NKLEI DATE 12j16,/15 T" 1! 1 33 53 950 �4p _ �� 3� 2 fi5 Ft OWNERS TO PROVIDE SUFFICIENT HEAT THROUGHOUT AREAS WHERE 6 HEAD cat3T s� WRENCH(ES) . ROVIDED OTAL COVNT THs SHEET = 07 C. # oQ -sEa,I. Musr BE:sICNED.a,ND DATED _ EAST BRIDGEWATER 1�iASSACHUSETTS 233 To BE VALID i SPRINKLER PIPES ARE INSTALLED UNLESS AN ANTI--FREE SYSTEM. O 3 DRA4VING N0. 3 SAFETY PS 0 ANTI-FREEZE EIV{. FiroAcad Design Softwa?e , PHONE 508 378-7212 FAX 508 378-J215 � �� P - I _- -7 i ! ` I —tea � S� (`;. � < >/✓. . ;".:r r?/1-4 SrORES - R&R) - .'RGP BIT. CONC. - �;'AVEMENT �� F�� ��� /• ' GR \ AVEM�EN�T � \.\ \ / IO �"1 r rOP j 131 1 ^ 000 I STA(F &S REMOVE EXIST PAVEAENT 1 ; LSTAEND P.S.B. ANDSEED - O /2REDGIN 6r,*,I\ w „f. 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