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HomeMy WebLinkAbout0089 LEWIS BAY ROAD (6) V - � � I � � � \ � � l� t. ..t I"E►�,w The Town of Barnstable Barnstable Growth Management Department 1" i "KBM Jo Anne Miller Buntich,Director Eesu+►`� 367 Main Street,Hyannis,MA 02601 -Phone 508-862-4678 Fax 508-862-4782 2007 www.town.barnstable.ma.us/growthmanagement k x t e) September 9, 2011 i To: Gail Hanley, Clerk of the Cape Cod Commission =1 c Linda Hutchenrider, Town Clerk, Town of Barnstable .mom Perry, Building Commissioner, Town of Barnstable k,p From: Art Traczyk, Regulatory/Design Review Planner, Growth Management Department File"M 09-08-11 transmittal notice-RA Modification 2-89 Lewis Bay.doc" Reference: Modification of regulatory agreement for 89 Lewis Bay Road & 42 South Street, Hyannis MA Enclosed please find a copy of the Second Modification to the Regulatory Agreement between the Town of Barnstable and 89 Lewis Bay, LLC. The modification revised paragraph 4 of the regulatory agreement originally entered into on July 22, 2007. The modification provides for a reduction in the mitigation fee assessed to the Developer and prescribed the manner for payment of those fees to the Town. Enc: Copy of Second Modification to Regulatory Agreement Notice of Modification to Regulatory Agreement copy: Jo Anne Miller Buntich, Director,Growth Management Department Barbara A.Ford,Acting Administrator for Town Council c IZ - o ^ � a p i r SECOND MODIFICATION TO j .REGULATORY AGREEMENT 101 89 LEWIS BAY ROAD AND 42 SOUTH STREET HYANNIS This second modification to a regulatory agreement("Agreement") is entered by and between the developer, 89 Lewis Bay,LLC ("Developer") and the Town of Barnstable ("Town"),a municipal corporation, on this May of August,2011 pursuant to Section 240-24.1 of the Barnstable Zoning Ordinance and.Section 168 of the Barnstable Code; WITNESS: What'must be done regarding the change in ownership from the original regulatory agreement? WHEREAS, 89 Lewis Bay,LLC, as the Declarant, has converted the Property to Lewis Bay Court Condominium by a Master Deed recorded October 20, 2010 at the Registry of Deeds,Boob 24923 page 77, said Master Deed established 42 Residential Units and 4 CommerciaiUnits,and as the Declarant owns the majority of the Property, 89 Lewis Bay,LLC is a`Qualified Applicant' as defined in Section 168 of the Barnstable.Code to Amend the Agreement. WHEREAS, the Developer under this Agreement; is the predecessor in interest to the Greenery Development LLC, the original developer of the subject parcels, which Regulatory Agreement was dated July 22, 2007, recorded at the Barnstable Registry of Deeds,book#22250 page#286. ("Hereinafter 2007 Regulatory Agreement") WHEREAS this Agreement shall vest land use development rights in the property for the duration of the agreement as modified, and such rights shall not be subject to subsequent changes in local development ordinances, with the exception of changes necessary to protect the.public health,safety or welfare. WHEREAS,the Town is authorized to enter into this Agreement pursuant to Chapters 168 and 240 of the Barnstable Code. WHEREAS the Developer is the legal owner of the property ("Property") at 89 Lewis Bay Road and 42 South Street, Hyannis, consisting of approximately 91,346 sq ft, shown on Barnstable Assessor's Map 327 as Parcels 241&223, and desires to develop the Property pursuant to a regulatory agreement. WHEREAS,in addition to the improvements cited above, the Developer has contributed to the overall revitalization of Downtown Hyannis through continued investment, rehabilitation and redevelopment of properties on Main Street,North Street and Center Street which resulted in creation of jobs. 1 WHEREAS,Developer is willing to commit itself to the development of the project in accordance with this Agreement as modified and desires to have a reasonable amount of flexibility to carry out the Development and therefore considers this Agreement to be in its best interests; and WHEREAS,the Town and Developer desire to set forth in this Agreement as modified their respective understandings and agreements with regard to development of the Property; WHEREAS the Development will not require regulatory review under the Massachusetts Environmental Policy Act(MEPA) or the Cape Cod Commission Act; WHEREAS the Developer has made application to the Planning Board pursuant to Section 168 of the Barnstable Code; WHEREAS the Development is located in the Hyannis Growth Incentive Zone (GIZ)as approved by the Cape Cod Commission by decision dated April 6, 2006, as authorized by Barnstable County Ordinance 2005-13, Chapter G, Growth Incentive Zone Regulations of the Cape Cod Commission Regulations of General Application; WHEREAS the Development is not subject to review by the Cape Cod Commission as a Development of Regional Impact due to its location in the GIZ and due to the adoption of Barnstable County Ordinance 2006-06 establishing a cumulative development threshold within the GIZ, under which this development may proceed and the Developer has submitted a Jurisdictional Determination to the Town of Barnstable Building Department to.confirm the same; WHEREAS.,the Development is serviced by municipal sewer and does not impact resources protected by the Barnstable Conservation Commission; WHEREAS the Developer has undergone at least two public hearings on the Agreement modification application and received a majority vote on March 15, 2011 from the Planning Board approving an alternative modification to the Agreement; WHEREAS the Developer has undergone a public meeting on the Agreement modification application before the Town Council and received a majority vote . approving the application on August 4, 2011; NOW, THEREFORE, in consideration of the agreements and covenants hereinafter set forth,and other.good and valuable consideration, the receipt and sufficiency of which each of the parties hereto hereby acknowledge to the other,the Developer and the Town do enter into this Agreement, and hereby agree and covenant as follows: that the regulatory agreement dated July 22, 2007 and recorded at the Barnstable Registry of Deeds,Book#22250,Page 286 be amended as follows: 2 1. Paragraph Number 4.of said Regulatory Agreement shall be deleted in its entirety and replaced with the following: "Mitigation shall be paid by the Developer in the amount of$150,000.00 for the benefit of the Barnstable Department of Public Works, Water Supply Division. Said amount shall be payable in$5000.00 disbursements upon the transfer of title of the first thirty individual.condominium units,which are sold by the Developer after August 4, 2011. Developer shall transmit each$5;000.00 disbursement to the Town Treasurer,230 South Street, Hyannis, MA 02601, within fourteen (14) days of the transfer of title for each of said units, Annually, on or before August 41h of each year, the Developer shall provide the Town Treasurer with an auditing statement, signed under the pains and penalties of perjury, listing the number of units sold during the preceding year and the payments made to the Town. Upon the sale of the 30th unit,Developer shall provide the Town with a release, suitable for recording,to be approved by the Town Attorney, which, once approved, shall be executed promptly by the Town Manager. Developer may, at Developer's discretion, pay the$150,000.00 in mitigation.prior to the sale of the 30th unit,at. which point the Developer shall provide the Town with a release, suitable for recording, to be approved by the Town.Attorney, which, once approved, shall be executed promptly by the Town Manager. WITNESS WHEREOF,the parties have hereunto caused this Agreement to be executed,on the day and year first above written. Dated this a)/_ day of August, .20.11 Otx�� To of Barnstable 89 L is Bay C, By/John John C. Klimm 1 Barnstable Town Manager J _ y: Charles Doe, Principal 3 Notice of Modification to Regulatory Agreement for redevelopment and reuse of 89 Lewis Bay Road & 42 South Street, Hyannis MA Pursuant to Chapter 168 of the Code of the Town of Barnstable,the Town of Barnstable ("Town") and 89 Lewis Bay, LLC ("Developer")have entered into a second modification of the regulatory agreement originally entered into on July 22, 2007. The original agreement provided for the redevelopment of 89 Lewis Bay Road and 42 South Street, Hyannis MA into 42 residential units and 4 commercial units. The second modification provides for a reduction in the mitigation fee assessed to the Developer and prescribed the manner for payment of those fees to the Town. The subject property is commonly know as "Lewis Bay Court Condominiums", and is located at 89 Lewis Bay Road and 42 South Street, Hyannis MA. The property is shown on Assessor's Map 327 as parcels 241 and 223. Copies of the Modification are available for public inspection at the Planning Board Office, 200 Main Street, Hyannis, MA or at the Office of the Town Clerk, 367 Main Street, Hyannis, MA between the hours of 8:30 a.m. to 4:30 p.m., Monday through Friday. 4 PROJEc ADDRESS: PERMIT# PERMIT DATE: ATJP- LARGE ROLLED PLANS ARE : BOX I] SLOT � Data entered in MAPS program on: �-- BY: -0L-200 .+ a 02 d 19P REGULATORY AGREEMENT 89 LEWIS BAY ROAD AND 42 SOUTH STREET,HYANNIS This regulatory agreement("Agreement") is entered by and between the developer, , Greenery Development, LLCZay veloper") and the Town of Barnstable("Town"),a n� municipal corporation, on thi of July,2007 pursuant to Section 240-24.1 of the 5 Barnstable Zoning Ordinance and Section 168 of the Barnstable Code; WITNESS: WHEREAS, the Developer under this Agreement will contribute public capital facilities v to-serve-the-proposed-development-and the-municipality or-both; WHEREAS this Agreement shall establish the permitted uses, densities, and traffic �'' within the Development, the duration of the agreement, and any other terms or conditions mutually agreed upon between the Developer and the Town. �o WHEREAS this Agreement shall vest land use development rights in the property for the duration of the agreement, and such rights shall not be subject to subsequent changes in local development ordinances, with the exception of changes necessary to protect the public health, safety or welfare. WHEREAS, the Town is authorized to enter into this Agreement pursuant to Chapters 168 and 240 of the Barnstable Code. WHEREAS the Developer is the legal owner of the property ("Property")at 89 Lewis Bay Road and 42 South Street,Hyannis,consisting of approximately 91,346 sq ft, shown on Barnstable Assessor's Map 327 as Parcels 241&223, and desires to develop the Property pursuant to a regulatory agreement. WHEREAS,the Development will rehabilitate a large,blighted and vacant building that was formally a nursing home, located on a highly visible parcel at the corner of South Street and Lewis Bay Road. WHEREAS,the Development will result in a substantial reduction in water use, sewer use and traffic as compared to the previous nursing home use. WHEREAS,the Development will renovate the existing building, including the existing brick fapade,and will create a visual benefit to the South Street, Lewis Bay Road,and Hyannis Harbor area. WHEREAS,the Developer demolished two blighted residential structures and will improve the lots upon which they were located with parking, lighting and landscaping; 1 Bk 22250 Pg 279 #46846 WHEREAS the Development will improve blighted lots and a vacant building and will provide newly renovated office space and residential units, and the rehabilitation of the building will add economic and aesthetic value to the area; WHEREAS,in addition to the improvements cited above,the Developer has agreed to provide financial mitigation to offset project impacts as set forth below: WHEREAS, Developer is willing to commit itself to the development of the project substantially in accordance with this Agreement and desires to have a reasonable amount of flexibility to carry out the Development and therefore considers this Agreement to be in its best interests;and WHEREAS,the Town and Developer desire to set forth in this Agreement their respective understandings and agreements with regard to development of the Property; WHEREAS the Development will not require regulatory review under the Massachusetts Environmental Policy Act(MEPA)or the Cape Cod Commission Act; WHEREAS the Developer has made application to the Planning Board pursuant to Section 168 of the Barnstable Code; WHEREAS the Development is located in the Hyannis Growth Incentive Zone(GIZ)as approved by the Cape Cod Commission by decision dated April 6,2006,as authorized by Barnstable County Ordinance 2005-13, Chapter G, Growth Incentive Zone Regulations of the Cape Cod Commission Regulations of General Application; WHEREAS the Development is not subject to review by the Cape Cod Commission as a Development of Regional Impact due to its location in the GIZ and due to the adoption of Barnstable County Ordinance 2006-06 establishing a cumulative development threshold within the GIZ,under which this development may proceed and the Developer has•- submitted a Jurisdictional Determination to the Town of Barnstable Building Department to confirm the same; WHEREAS,the Development is serviced by municipal sewer and does not impact resources protected by the Barnstable Conservation Commission; WHEREAS the Developer will require zoning relief from maximum density,building height and story limitations, front setbacks (for the existing building),parking stall size and parking lot buffers, and vegetated buffers to residential properties,all as further defined in paragraph 38 below; WHEREAS the Developer has undergone at least two public hearings on the Agreement application and received a majority vote from the Planning Board approving the application on July 9,2007; 2 Bk 22250 Pg 28,0 #46846 WHEREAS the Developer has undergone a public hearing on the Agreement application before the Town Council and received a 2/3rds vote approving the application on July 19, 2007; NOW,THEREFORE,in consideration of the agreements and covenants hereinafter set forth, and other good and valuable consideration,the receipt and sufficiency of which each of the parties hereto hereby acknowledge to the other,the Developer and the Town do enter into this Agreement, and hereby agree and covenant as follows: 1. If the development rights granted hereunder are exercised,the Developer agrees to construct the Project in accordance with the plans and specifications submitted to and approved by the Town,listed as follows and made part of this Agreement by reference: a) Plans entitled"Mixed Use Development, 89 Lewis Bay Road&42 South Street, Hyannis,MA"all dated April 25,2007,revised through June 14,2007, sheets 1 through 7,prepared by BSC Group, as further detailed as follows: Title Sheet, Sheet 1 of 7; Existing Conditions Plan, Sheet 2 of 7; Layout Plan, Sheet 3 of 7; Landscape and Lighting Plan, Sheet 4 of 7; Grading and Utility Plan, Sheet 5 of 7; Site Details, Sheet 6 of 7; Site Details,Sheet 7 of 7. b) Plans entitled"Project, Lewis Bay Court,Exterior Elevations", dated April.10, 2007,prepared by JGA Architectural Design and Judd Brown Designs,Inc., including a South Street elevation,Lewis Bay Road elevation,and second, third and fourth floor plans,and Plans entitled"Lewis Bay Building Renovation""Left Side Elevation Looking from South Street"and"Right Side Elevation Looking from Lewis Bay Road", Sheet A5.2,by JGA Architectural Design,undated, and"Lewis Bay Building Renovation" "Proposed First Floor Plan", Sheets A1.1 and Al.IB,by JGA Architectural Design,undated. c) Such other plans and plan revisions as may be required by the terms and conditions of this Agreement; 2. The Developer proposes to renovate an existing building to create a mixed use development as follows: renovate the building facade and renovate and enhance site amenities, add a fourth floor, create 21,000 s.f. of non-residential space on the first floor to be developed as not more that four commercial condominium units, and create a total of 42 residential condominium units including 84 bedrooms with said residential units to be located on the second,third,and fourth floors. In addition,the Developer proposes to create additional parking with landscaping on the 42 South Street lot, and Developer demolished two blighted,residential" structures to accommodate said additional parking. The 89 Lewis Bay Road lot is located within the Medical Services(MS)zoning district. The 42 South Street lot 3 Bk 22250 Pg 281 #46846 is located within the Harbor District(HD)zoning district. Both lots are located within the Growth Incentive Zone (GIZ) of Barnstable(the"Development".); 3. Ground-floor uses shall be business and professional offices or medical/dental clinics, as allowed within the MS Zoning District, Section 240-24.1.4 of the Barnstable Code; 4. In addition to the rehabilitation of the existing structure and parking area and the reduction in impacts from the former nursing home use,mitigation offered by the Developer includes but is not limited to: $250,000 toward improvements within the layout of South Street in Hyannis; $150,000 toward improvements for the benefit of the Barnstable Department of Public Works,Water Supply Division; $34,421 toward improvements within the layout of School Street in Hyannis; 5. The development rights granted hereunder shall be exercised and development permits may be obtained hereunder for a period of two years from the effective �2 date of the Agreement,provided,however,that prior to the expiration of said two 0 year period the Developer may request one six month extension to obtain development permits. Upon receipt of necessary development permits construction shall proceed continuously and expeditiously,but in no case all construction exceed 2 years from receipt of necessary development permits. The Developer estimates that construction will commence on or about August 1,2007 and will be completed on or about July 31,2009; 6. The Developer shall establish a condominium association or associations to carry out the terms and conditions of this Agreement which association(s) shall 'include all residential and non-residential condominium units. For the purposes of this Agreement,the term"Developer" shall mean the Developer and/or Developer's successor condominium association(s). The Developer shall remain a voting member and fee payer of any unsold condominium units. The form and content of condominium association documents, including the condominium master deed and association bylaws,shall be approved by the Town of Barnstable Legal Department for the purposes of ensuring compliance with the terms and conditions of this agreement,prior to the sale of any condominium units; 7. All building access,but for deliveries as discussed below, shall be through the main entrance with all commercial tenant use (i.e. office waiting areas)to be contained within each commercial tenant condominium; $. All commercial tenants shall receive large deliveries via the separate,ramped entrances located on the north and west side of the building; 9. Developer agrees to renovate the fire hydrant on South Street to current standards; 4 i Bk 22250 Pg 282 #46846 10. Developer will remove the existing utility poles that serviced the two demolished residential units at 42 South Street so long as those poles do not service other lots/structures; 11. The proposed crosswalk shall align with the sidewalk ramp accessing Cape Cod Hospital property on the opposite side of Lewis Bay Road. The Developer shall. perpetually maintain the crosswalk with thermo plastic paint; 12. The Development shall eliminate 2 curb cuts on South Street and shall utilize one curb cut on South Street and one curb cut on School Street, as shown on the Plans. Developer shall install a"No Right Turn"sign at the South Street parking lot exit and a"One-Way"arrow sign across South Street in the vicinity of the South Street curb cut, as may be permitted by the Town. The sidewalk shall be reconstructed in areas where curb cuts are eliminated,consistent with Condition 13 below; 13. The Developer shall replace the sidewalk and sidewalk curbing along South Street between the proposed South Street curb cut and running west to School Street and then around the corner and up School Street to the edge of Developer's property on 42 South Street. The newly constructed sidewalk shall be constructed Of concrete (brick accent is allowed)with granite curbing and shall be constructed at a width of not less than five(5) feet, and the Developer may upgrade other areas of sidewalk along the frontage of the Development consistent with this agreement; 14. Developer agrees to provide an easement for the placement and maintenance of new municipal street lights on South Street if so requested by the Town; 15.Developer intends to reuse existing light fixture bases and shall install new light poles and fixtures,to be installed in accordance with the Downtown Hyannis Design and Infrastructure flan; 16. Lighting for the Development shall be contained on-site, shall be down cast and shall not contribute to light pollution of the,area; 17. Developer shall be responsible for snow plowing and snow removal on the Development site in perpetuity; 18. All landscaping within the development shall be low water use and shall minimize the use of fertilizers and pesticides; 19. Developer shall provide an eight-foot high wood fence to screen the Development from neighboring residences,and shall provide landscaping to abutting properties as shown on the Plans; 5 Bk 22250 Pg 283 #46846 1 20. The dumpster shall be located and screened as shown on the Plans. The dumpster shall be serviced solely between the hours of 7:00 a.m. and 7:00 p.m.,Monday through Saturday; 21. Bonds: Prior to the issuance of a foundation building permit Developer will provide a performance bond in an amount to be approved by the Planning Board or its designee, said bond to be expended on the replacement of landscape materials if such replacement becomes necessary. Any unexpended portion of said performance bond (including interest)may be released by the Planning Board to the Developer or his successor(s)after three years from the date of the initial. landscape plantings, such date to be determined by the Building Commissioner, upon the request of the Developer; 22. Bonds: Bonds shall be provided as required by applicable regulation(i.e. for road openings); 23. Developer and its successors will participate in the Town of Barnstable's Transportation Management Association(TMA)upon its formation. Participation shall include: (a) distribution of materials provided by the Town to all tenants, lessees, and purchasers of condominium units within the development; and(b)the identification of a representative for the development who will serve as the contact between the inhabitants and tenants of the development and the Town's TMA; 24. All plumbing fixtures shall be low water use fixtures and other water conservation measures are encouraged in the design and development of the project; 25. Consistent with approved plans, Developer shall construct a Passive Stormwater Maintenance and Infiltration System to service the Development; 26. Developer will provide a bicycle rack at the Development site; 27. Construction and demolition debris from the Development shall be removed and reused or recycled to the maximum extent possible; 28. Developer shall provide calculations demonstrating adequate water flow for fire suppression,and standpipes,as required.by the Hyannis Fire Department; 29. Ground-floor tenants shall not use,store, generate, treat or dispose of hazardous waste or hazardous materials in quantities greater than 25 gallons(or the dry weight equivalent) or less, and shall not generate hazardous waste in quantities greater than the Very Small Quantity Generator level as defined in the Massachusetts Hazardous Waste Regulations, 310 CMR Section 30.353. In addition, all ground-floor tenants shall comply with state and local regulations regarding medical materials and wastes including the use of a licensed disposal company,as required by law; 6 I Bk 22250 Pg 284 #46846 30. Developer is responsible for obtaining all applicable permits and licenses, including but not limited to the following: foundation permit, building permit, street excavation permit (necessary for work in all public spaces), sewer permits and water permits. Contractors are required to have the insurance stipulated in the Street Excavation Rules and Regulations(SERR)and all work on town property must comply with all provisions of SERR; 31. Developer will make best efforts to complete construction work in accordance with a construction schedule and sequencing plan submitted to the Town prior to the execution of the Regulatory Agreement. To the extent construction impacts public property or public rights of passage,changes in the schedule, if needed as work progresses, are subject to the approval of the Town. The developer shall notify the Town of Barnstable Growth Management Department and the Department of Public Works at least 48 hours in advance of working on Town property. (The construction sequencing plan shall identify those areas of public street layout and sidewalk that may be used by the Developer at various points in the project construction and where barricades and fencing will be installed during construction.) The Developer will be responsible for all construction signage, directional signs, and police officers necessary for the performance of the work; 32. Exterior construction impacts shall be minimized,and construction shall be limited to the hours of 7:00 a.m. to 6:00 p.m. weekdays, and 8:00 a.m. to 51,*00 p.m. Saturdays. No exterior construction shall occur on Sundays. The Building Commissioner shall establish protocols to minimize the location of staging;noise, dust,and vibration; 33. To the extent that the referenced plans do not depict all of the findings and conditions as set forth in this Agreement,revised plans and/or notations shall be provided. In addition to permits,plans and approvals listed above,any and all permits and licenses required shall be obtained; 34. Upon completion of all work, a registered engineer of land surveyor shall submit a letter of certification, made upon knowledge and belief in accordance with professional standards that all work has been done in substantial compliance with the approved site plan. This document shall be submitted prior to the issuance of the final certificate of occupancy; 35. Each residential condominium unit shall have at least one dedicated parking space; 36. In order to maintain the use of the Development as a residential condominium development,the rental of condominium units shall be restricted to not less than thirty(30)days tenancy; 7 Bk 22250 Pg 285 #46846 t 37. During the construction of the Development,the Developer shall provide a contact number,to be clearly posted on the Development site,the purpose of which shall be to receive and respond to comments and concerns that may be raised by neighboring property owners during construction; 38. Town hereby grants a waiver from the following zoning restrictions: Building height: Relief is granted from Section 240-24.1.4.C,Maximum building height,and permission is granted to construct the building at a maximum height of four stories with the maximum vertical distance to the average height of the highest roof plane not to exceed forty-eight and one- half feet(48.5'),plus or minus,as shown on the plans, with the exception that structures containing stairwells/elevators shall not exceed 61 feet from grade, as shown on the Plans; Density: Relief is granted from Section 240-24.1.4.B to allow 42 units and 21,000 s.f. of commercial mixed use development on 91,346 s.f. of land; Parking: Relief is granted from Section 240-24.1.7.A to allow parking at 42 South Street as an accessory use to the mixed use structure at 89 Lewis Bay Road; from Section 240-24.1.10.A.4.a.2.to allow parking located less than 30 feet from the base of the multi-family dwelling;and from Section 240- 24.1.10.A.4.c.2 to allow existing parking spaces of less than nine feet by twenty feet and to allow new parking spaces with a minimum size of nine feet by nineteen feet,all as shown on the Plans; Setbacks: Relief is granted from Section 240-24.1.4.D.1. to allow a perimeter of green space of less than ten feet(10') in width due to existing conditions layout of the building and parking lot at 89 Lewis Bay Road; and from Section 240-24.1.10.A.4.d. 1 and 4 to allow less than 10%of interior parking lot landscaping and less than one tree per five parking space, due to existing conditions layout of the building and parking lot at 89 Lewis l3ay Road; from Section 240-24.1.4.0 to allow a front setback of 19.9' instead of twenty feet due to existing building location; from Section 353-4 to allow the placement of a dumpster within a property line, as shown on the Plans; and from 240-24.1.10.A.5.c to allow less than twenty feet(20')of landscaping from all residential property lines; Fences: Relief is granted from Section 240-24.1.10.A.8 to allow a fence of eight feet(8')abutting a residential district; , Si�gnage: Relief is granted from Section 240-64 to allow signage greater than twelve(12)square feet as further approved by the Planning Board or its designee. 8 Bk 22250 Pg 286 #46846 IN WITNESS WHEREOF,the parties have hereunto caused this Agreement to be executed,on the day and year first above written. Dated this day of�, ( , 2007. ownL1 � i of Barnstable Gr nery Development, LLC By: John C. Klimm By: Joseph Keller, Manager Barnstable Town Manager 09�910 By: Char es Doe, ager U BARNSTABLE REGISTRY OF DEEDS 9 t� P Jefferson Group .Architects, Inc. Wayne J. Jacques, AIA. ISD AF 8 ARCHITECTURAL FINAL AFFIDAVIT To the Inspectional Services Commissioner: I certify that I, and/or my authorized representative,have inspected the work associated with the Second Floor at Lewis Bay Court located at 89 Lewis Bay Road,Hyannis,MA, on the dates noted below during construction, and that to the best of my knowledge, information, and belief the work has been done in conformance with the permit and plans approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and all other pertinent laws and ordinances. Wayne J. Jacques,AIA, Architect—Mass. Reg.No.6935 Jefferson Group Architects. Inc. 700 School Street,Unit 2 Pawtucket,RI 02860 401-721-2245 Inspection Dates: 8-10-2011 Then personally appeared the above-named V71e(-4v1 S and made oath that the above statement by him is true. Before me, Aq My Commission expi es: y 20 NG. 3MN W-A �1 Tk Cr"RM��SPG 700 School Street Pawtucket,R102860 (401) 721-2245 Fax (401) 721-2238 AFA-200662-2nd Floor.doc •r 9 � 1 as I j�ii ��a1 t{ areaz e l Jefferson Group Architects, Inc. Wayne J. Jacques, AIA ISD AF 8 ARCHITECTURAL FINAL AFFIDAVIT To the Inspectional Services Commissioner: I certify that 1, and/or my authorized representative,have inspected the work associated with the Second Floor at Lewis Bay Court located at 89 Lewis Bay Road,Hyannis,MA,on the dates noted below during construction,and that to the best of my knowledge, information, and belief the work has been done in conformance with the permit and plans approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and all other pertinent laws and ordinances. Wayne J. Jacques,AIA, Architect—Mass. Reg.No.6935 Jefferson Group Architects. Inc. 700 School Street,Unit 2 Pawtucket,RI 02860 401-721-2245 Inspection Dates: 8-10-2011 Then personally appeared the above-named l U and made oath that the above statement by him is true. Before A% My Commission expi es: y 20 /. BOSTON MA U �t Th OF 700 School Street Pawtucket,RI 02860 (401)721-2245 Fax (401) 721-2238 AFA-200662-2nd Floor.doc 4 � Jefferson Group Architects, Inc. Wayne J. Jacques, AIA ISD AF 8 ARCHITECTURAL FINAL AFFIDAVIT To the Inspectional Services Commissioner: I certify that I,and/or my authorized representative,have inspected the work associated with the Second Floor at Lewis Bay Court located at 89 Lewis Bay Road,Hyannis,MA,on the dates noted below during construction,and that to the best of my knowledge,information, and belief the work has been done in conformance with the permit and plans approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and all other pertinent laws and ordinances. Wayne J. Jacques,AIA, Architect—Mass. Reg.No.6935 Jefferson Group Architects. Inc. 700 School Street,Unit 2 Pawtucket,RI 02860 401-721-2245 Inspection Dates: 8-10-2011 Then personally appeared the above-named lqAY,0 q e<-4v1-5 and made oath that the above statement by him is true. Before me, �oSS � i,, My Commission expi es: J40 �Ln _ ® % 20 As U' 308TOON MA �qC Pk OF W��gF 700 School Street Pawtucket, RI 02860 (401) 721-2245 Fax (401)721-2238 AFA-200662-2nd Floor.doc n, jt.���l }j�= c�7 � ���� Z 1 :�1�a ���v L Jefferson Group Architects, Inc. Wayne J. Jacques, AIA ISD AF 8 ARCHITECTURAL FINAL AFFIDAVIT To the Inspectional Services Commissioner: I certify that I,and/or my authorized representative,have inspected the work associated with the Second Floor at Lewis Bay Court located at 89 Lewis Bay Road,Hyannis,MA, on the dates noted below during construction, and that to the best of my knowledge, information,and belief the work has been done in conformance with the permit and plans approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and all other pertinent laws and ordinances. Wayne J. Jacques,AIA, Architect—Mass. Reg.No.6935 Jefferson Group Architects. Inc. 700 School Street,Unit 2 Pawtucket,RI 02860 401-721-2245 Inspection Dates: 8-10-2011 Then personally appeared the above-named � q e<-iv1-5 and made oath that the above statement by him is true. Before me, My Commission expi es: STON MA �l?N OF 0- rp 700 School Street ,. Pawtucket,RI 02860 (401)721-2245 Fax (401) 721-2238 AFA-200662-2nd Floor.doc 011-3,1 l C Jefferson Group Architects, Inc. Wayne J. Jacques, AIA ISD AF 8 ARCHITECTURAL FINAL AFFIDAVIT To the Inspectional Services Commissioner: I certify that I,and/or my authorized representative,have inspected the work associated with the Second Floor at Lewis Bay Court located at 89 Lewis Bay Road,Hyannis,MA,on the dates noted below during construction, and that to the best of my knowledge, information, and belief the work has been done in conformance with the permit and plans approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and all other pertinent laws and ordinances. Wayne J. Jacques,AIA, Architect—Mass. Reg.No.6935 Jefferson Group Architects. Inc. 700 School Street,Unit 2 Pawtucket,RI 02860 401-721-2245 Inspection Dates: 8-10-2011 Then personally appeared the above-named ZyAoto and made oath that the above statement by him is true. Before me, `0.R�,� My Commission expi es: 440 0c, sn % 20 /b NO.M36 �o BOSTON sC MA G �l Pk CF fiA��SP 700 School Street Pawtucket,RI 02860 (401)721-2245 Fax (401)721-2238 AFA-200662-2nd Floor.doc 3-19USNM :110 HAMI Jefferson Group Architects, Inc. Wayne J. Jacques, AIA ISD AF 8 ARCHITECTURAL FINAL AFFIDAVIT To the Inspectional Services Commissioner: I certify that 1,and/or my authorized representative,have inspected the work associated with the Second Floor at Lewis Bay Court located at 89 Lewis Bay Road,Hyannis,MA, on the dates noted below during construction, and that to the best of my knowledge, information,and belief the work has been done in conformance with the permit and plans approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and all other pertinent laws and ordinances. Wayne J. Jacques,AIA, Architect—Mass.Reg.No.6935 Jefferson Group Architects. Inc. 700 School Street,Unit 2 Pawtucket,RI 02860 401-721-2245 Inspection Dates: 8-10-2011 Then personally appeared the above-named Z(/1 olu J• y4a5 and made oath that the above statement by him is true. Before me, My Commission expires. 20 l AR BOSTON Mrs 700 School Street Pawtucket,RI 02860 (401) 721-2245 Fax (401)721-2238 AFA-200662-2nd Floor.doc i c � r b... IA1 Eh --ol d Z , F Jefferson Group Architects, Inc. Wayne J. Jacques, AIA ISD AF 8 ARCHITECTURAL FINAL AFFIDAVIT To the Inspectional Services Commissioner: I certify that I,and/or my authorized representative,have inspected the work associated with the Second Floor at Lewis Bay Court located at 89 Lewis Bay Road,Hyannis,MA, on the dates noted below during construction,and that to the best of my knowledge,information,and belief the work has been done in conformance with the permit and plans approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and all other pertinent laws and ordinances. Wayne J. Jacques,AIA, Architect—Mass. Reg.No.6935 Jefferson Group Architects. Inc. 700 School Street,Unit 2 Pawtucket,RI 02860 401-721-2245 Inspection Dates: 8-10-2011 Then personally appeared the above-named �j!/, n( �J� T!}C and made oath that the above statement by him is true. Before me, ' My Commission expires: ho 20 ls� � JA: G I0. e B06TON O AAA .� 700 School Street Pawtucket,R102860 (401)721-2245 Fax (401)721-2238 AFA-200662-2nd Floor.doc TMUN OF BARINSTABLE 11 AIIJIG62 AMI043 WTVISl0N 4 Jefferson Group Architects, Inc. Wayne J. Jacques, AIA ISD AF 8 ARCHITECTURAL FINAL AFFIDAVIT To the Inspectional Services Commissioner: I certify that I,and/or my authorized representative,have inspected the work associated with the Second Floor at Lewis Bay Court located at 89 Lewis Bay Road,Hyannis,MA, on the dates noted below during construction,and that to the best of my knowledge,information, and belief the work has been done in conformance with the permit and plans approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and all other pertinent laws and ordinances. Wayne J. Jacques,AIA, Architect—Mass. Reg.No.6935 Jefferson Group Architects. Inc. 700 School Street,Unit 2 Pawtucket,RI 02860 401-721-2245 Inspection Dates: 8-10-2011 Then personally appeared the above-named 4 `/ s and made oath that the above statement by him is true. Before me, My Commission expi ARc d 20 / 1O.0893s TBOSTON og� MA �iq�TH OF gP 700 School Street Pawtucket,RI 02860 (401)721-2245 Fax (401)721-2238 AFA-200662-2nd Floor.doc TO E-N OF BAR TABLE I AUG 12 AID 10: 43 F l x , Jefferson Group Architects, Inc. Wayne J. Jacques, AIA ISD AF 8 ARCHITECTURAL FINAL AFFIDAVIT To the Inspectional Services Commissioner: I certify that I, and/or my authorized representative,have inspected the work associated with the Second Floor at Lewis Bay Court located at 89 Lewis Bay Road,Hyannis,MA, on the dates noted below during construction,and that to the best of my knowledge,information, and belief the work has been done in conformance with the permit and plans approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and all other pertinent laws and ordinances. Wayne J. Jacques,AIA, Architect—Mass. Reg.No.6935 Jefferson Group Architects. Inc. 700 School Street,Unit 2 Pawtucket,RI 02860 401-721-2245 Inspection Dates: 8-10-2011 Then personally appeared the above-named Iv, `/ 6 and made oath that the above statement by him is true. Before me, My Commission expi JOHN 20 !S NO.06M BOSTON O MA ��TH OF gP 700 School Street Pawtucket,RI 02860 (401)721-2245 Fax (401)72172238 AFA-200662-2nd Floor.doc r F J Jefferson Group Architects, Inc. Wayne J. Jacques, AIA ISD AF 8 ARCHITECTURAL FINAL AFFIDAVIT To the Inspectional Services Commissioner: I certify that I,and/or my authorized representative,have inspected,the work associated with the Second Floor at Lewis Bay Court located at 89 Lewis Bay Road,Hyannis,MA, on the dates noted below during construction, and that to the best of my knowledge, information,and belief the work has been done in conformance with the permit and plans approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and all other pertinent laws and ordinances. Wayne J. Jacques,AIA, Architect—Mass.Reg.No.6935 Jefferson Group Architects. Inc. 700 School Street,Unit 2 Pawtucket,RI 02860 401-721-2245 Inspection Dates: 8-10-2011 Then personally appeared the above-named J.- JVeoyZ f and made oath that the above statement by him is true. Before My Commission exp' es: 20JA icy NO. s 130STON M G i of P 700 School Street. . Pawtucket,RI 02860 (401)721-2245 Fax (401)721-2238 AFA-200662-2nd Floor.doc . r OISTSIG Jefferson Group Architects, Inc. Wayne J. Jacques, AIA ISD AF 8 ARCHITECTURAL FINAL AFFIDAVIT To the Inspectional Services Commissioner: I certify that 1,and/or my authorized representative,have inspected the work associated with the Second Floor at Lewis Bay Court located at 89 Lewis Bay Road,Hyannis,MA,on the dates noted below during construction,and that to the best of my knowledge, information,and belief the work has been done in conformance with the permit and plans approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and all other pertinent laws and ordinances. Wayne J. Jacques,ALA,, Architect—Mass.Reg.No.6935 Jefferson Group Architects. Inc. 700 School Street,Unit 2 Pawtucket,RI 02860 401-721-2245 Inspection Dates: 8-10-2011 Then personally appeared the above-named V�4/�► and made oath that the above statement by him is true. d re me, '> Y � My Commission ex fires: ' 20 /s 4 No.06935 BOSTMA � AAA rH OF 700 School Street Pawtucket,RI 02860 (401)721-2245 Fax (401)721-2238 AFA-200662-2nd Floor.doc NI , j+±F g $ r, _ ...- ,..... _., .e. „- -..t. ...., ti..y"... ..,-.ry;ti..:F�-K*--...!'pr... ,....y;.. .r^�n... -'.rc ,.,` ,r,. 'fi^'T!"•r✓w.a1s^.t;...w y. TOWN OF BARNSTABLE BAR-W 00 3125 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager . Address of Offender MV/MB Reg.# Village/State/Zip ,p .+A Business Name °� r-rT ' ~ ' ;}'4, am/pmr; on "' ? 20`6 Business Address e Signature of Enforcing Officer Village/State/Zip 1_94 0 If f Location of Offense ""` ' Enforcing Dept/Division Offense "' r '` 4 jv Facts This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve . voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. _ N T. t"J _�,�...+•, J6'�'6' .�. r�G � 1„W2 ' y 01 ,F'.tf+ .+jr� �� � ,......✓" �. (✓L l Siii7 �F 4l'z� j 11 s1J�.lt ii`. `Mlip t• y I� I Foil.. . N Y% • W 1{i _ _ now, 6 ir"f� rY ll lwi Will E ' F „��,. 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'^t '4 `a.,.a t'.:vi r'" 3y e ,4 a.. d` ram.+ _"b' ��, f •P` �il'I�F 1� �i��� �„ �.r....$;�� �•2"".•��ri,�.�,.�,i. •ri''.� Y+.�,1�"��� �P"Ii'`-..� •�+s���j�`e •1 .i4 ok .� ' ,e' `e :.. �[a•,.'.6 ,r R,.. �. f � � �; �. � tfr �S:A c � .f.:•ar� •.�24 !s; � ;ww•_ �Rmi�-+ •i c�� �! _ ��•.,.- � I �"f r-'•..1' �,�T ,�% y.+�: `.s �.,� ,1� r �� i, ��,,:s'..I.• ' � .�I �."'C ia,:is-�rs;„�.. �y�,i ��i . :'. e,.,a-,s•� A�"y'�t Ax rFs", "77:: rl @ `,`'.^.;-� �btty. tY�kitr 'a !> ^s51� lrap' 'F . W � v . Y #�` ., y ;� RIO /{,�,� I .'_ _ j♦� '. • . i '�F 1�� > �;:'a"h n'�a•t'!*` ;�. `� �s;:l�'"'"'.t �A,. _�Y r ,*" t�,. ��. `": --- {_.- 1. , '\$�j. '`� SQL' ( 3•. 'r �.T 51 4 rt J6 snt<ay 1l-;. #tsF �1 - ..:'P" ''','. r ®a�,m C M r:Fwa � :'fig t �;�k7, � � � � �`� ,a�(`;i.��{! ` ii+",��'41�s� ,_'"` �r;� l�, r';`•<—�` �- ...� a�`nt. 'a' � � : J • 1 , ' 4 n S.i`'4 14741 C „» ...'tss 9 t t 'fop. � -�•�.:,,,i r" +�C��+, .� ;'`a r"w �l-�f>• a'r['" to� �t e.i r_��~ x`&•,�, ".a. `\), ,i� ••t�• � t y, • r I a. 3} l>. ._:i Z �,.���... ... `, _ YeEe�;,"�••�: r7t »�U ..'.. I P /� zAll, i- ` �, �> ��� ® I Ki 4 FA. �'�,��[t M#i•`.�' {•,� t., 4 y, `;,� k y q ��;..'" : r�'`�,: �.lj�i• JTS� i�: *U�a' •?�'' �`!Kfi^ ;�-_y, �"• r�a'Cwt.�.�.arxt ��` � '> �r .� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map' 32-7Z Z 3 Parcel "f +Z Permit# y Health Division �7 ��� Date Issued a110 O nservation Division -'41'71,05 Application Fee Tax Collector � I-) hermit Fee Treasurer Planning Dept. CONNECTED SEWER ACCOUNT Date Definitive Plan Approved by Planning Board "3 Historic-OKH Preservation/Hyannis Project Street Address Y ec)4 Village Owner SJ2C — N Y14A,10/3 /AJC . Address Telephone 4ermit Request IOU / vX/ ^�G /�uT, Z — ;Q oy / �XiS7/�G ice✓�_ A4771i 7-1o,U Square feet: 1 st floor: existing proposed SA!1� 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Cc­v" Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes UNo 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 _ i Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size II Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# —Current Use Proposed Use- ------ - — BUILDER INFORMATION Name ! '/4&0-/-r EU1C,06�Z S X-X - Telephone Number 3� Address �� �-_. CG"'i'1'� y� License# a(/?- 3" / A . OZ !3S Home Improvement Contractor# Worker's Compensation# I ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �j,c� _ ��-nPs o,--, S)7'9 SIGNATURE ee DATE >- 16-Q�_ FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER " DATE OF INSPECTION: FOUNDATION FRAME 6 fX M h a L C Z. INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH _ FINAL GAS: ROUGH fn FINAL r� r. ol ' FINAL BUILDING Al j yr-i l Fri DATE CLOSED OUT .rr e_y E CZ ASSOCIATION PLAN NO. 0 s cv A i COMMERCIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $150.00 Alterations/Renovations $100.00 / Building Permit Amendment $50.00 FEE VALUE WORKSHEET NEW BUILDINGS square feet x$140.00/sq.foot= x.0081= ALTERATIONS%RENOVATIONS OF EXISTING SPACE square feet X$96/sq.foot= '7 S-0 O —X.0081= STORAGE BUILDINGS ONLY square feet X$32.00/sq. foot= X.0081 Commprojcost Rev:063004 S f BARD O B.UNLDING RE;GULATION'S Sl1 LicenseNSTRUCTI®N pERVGSpR ( i Numiber- 049349 = i . f .. Tr.no: 13099 Red s i I ROMORT P wIULC y ,' PO,iBOX 48215ti1':� � HANSON, MA 023°%3 Atlrrirristrator I 1 Aloe AP�K'cx S 70 � ! 7--loXO -+--OLD 4CD, - , Town of Barnstable Regulatory Services 9 muss. T)iomas F.Geiler,Director , �, i69s• �• Building Division TomPenry, Building Commissioner , 200 Main Street, liyaanis,MA 02001 www.town.barustable.ma.us Fax: 508-790-6230 ' Office. 508-862-4038 Property Owner Must Complete.axed Sign This Section If Using ABuilder as Owner of the subject property .to act on mY behalf; � hereby authorize: i� ��� r 4 c in all matters relative to work authorized bythis building permit application for, cc---u r (Address o 'Job) a 7 Zo Signature of Owner Date v t'c Print Nurse The Commonwealth of Massachusetts Department of Industrial Accidents 600 Washington Street — Boston,Mass. 02111 Workers? C . ensation.•Insurance Affidavit-General Businesses ZMMMM a� •' ,`��'(�(/'C�js!i�.;�.?:�;_�'�°MB.N 'Sry .. � �, _ =�::lniiti . name: _ address: 7s - city. ? '�' � state: , zip.6 Z � phone# J3 work site location(full address): ❑ I am a sole proprietor and have no one Business Type: ❑Retail❑RestaurantBar/Eating Establishment working in any capacity. ❑ office❑ Sales(including Rral Estate,Autos etc.) ❑I am an emplo er with em to ees(full& art time.). Other /%%%% ❑%%/%�% I am an.employer,providing workers compensation for my employees working on this job.. tco7mpanV IIaIIie. f Z' ad" "e'ss:' OG -1 f ansurance.co. :::.. . . � ./-:>`:':. ::... � <.. .. .. . ._ . ..,.. '.:.'• ol '..,',#::, ...(�:�, �.:"`' f•.: � . 0111 I am a sole proprietor and have hired the independent contractors listed below who have the foilowing workers' compensation polices: comU-i name: i - . . is .... .. ad .essi dr C: - .. it1C:. hone- A insurance co. '-• '�- - : co pan. '•eiiie: inn v n �<:� ,,.....:•.. :'�' city: .nhoni'.#. insurance co. - - "o1ic:�:#�: 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 s1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that p copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify d e ' s sit' of er' ry that the information provided above is true and correct Signature Date Z— �� OAS Print name Phone# official use only . do not write in this area to be completed by city or town official city or town: permittlicense# ❑Building Department check if immediate response is required ❑Licensing Board ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revised Sept 2003). Information and Instructions Massachusetts General I;aws the 152 section 25.requires all employers to provide workers'compensation for their.. employees.. As quoted from the"law", an employee is.defined as every person in the service'of another under any contract of hire, express or implied; oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in ajoint enterprise, and including the legal.representatives of a deceased,employer, or the receiver or trustee of an individual, partnership,,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the.occupant,of the.dwelling house of another who employs persons to do.maintenance, construction or repair work on such dwelling house or on the grounds or building.appurtenant thereto shall not because of such employment.be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency.shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the.commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage requited: Additionally,-neither the commonwealth nor.any.of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting . authority. , Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation..Please supply company name, address.and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding-the"law"or if you are required to obtain a workers!compensation policy,please call the Department at the number listed below. . City or Towns . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill.in the permi0icense number.which will be used as a reference number. The.affidavits maybe returned to the Department by mail or FAX unless othei arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: . The Commonwealth Of Massachusetts Department of Industrial Accidents BMW of wesugatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 exL 406 GflEEN8EUG ' A T T O R N E Y S A T L A W -- IUflUUIG Marc Middleton , 617-310-6024 middletonm@gtlaw.com April 16, 2002 VIA 1sT CLASS MAIL AND FACSIMILE Thomas Perry Act ing Cornrnksioller Building Department Town Hall 367 Main Street Hyannis, MA 02601 Re: 89 Lewis Bay Road,Hyannis,MA Letter of Zoning Designation and Compliance, and Certificate of Occupancy Dear Mr. Perry: In:connection,.with:an,anticipated transfer of title of the above-referenced property located in the Town of Hyannis, please find attached copy of a zoning designation and compliance letter received from the City'of Marlborough `Massachuse fs, forinothef transaction.. In order to satisfy our due diligence requirements, we would appreciate your providing a similar zoning designation and compliance letter, as well as a copy of the certificate of occupancy to the attention of William Sclarsic at Senior Residential Care, Inc., One Charles River Place, 63 Kendrick Street, Needham, MA 02494, with a copy to my attention at Greenberg Traurig, LLP, One International Place, 3rd Floor, Boston, MA 02110. If you have any questions, please do not hesitate to contact me. Your assistance in this matter is greatly appreciated. Sincerely, Marc Middleton MM/mm I. Attachments (1) r. cc. William S. Wilson, Esq., Greenberg Traurig, LLP (w/ attachment) \\bos-srv01UvIIDDLETONM\53878V01\15KM01?,DOC\4/16/02; ,. GREENBERG TRAURIG, LLP -` ONE INTERNATIONAL PLACE 3RD FLOOR BOSTON, MASSACHUSETTS 02110 _ 617-310-6000 FAx 617-310-6001 www.gtlaw.com MIAMI NEW YORK WASHINGTON,D.C. ATLANTA PHILADELPHIA TYSONSCORNER CHICAGO BOSTON PHOENIX WILMINGTON Los ANGELES DENVER .FORT LAUDERDALE BOCA BATON WEST PALM BEACH ORLANDO TALLAHASSEE f, - 1 f DWD Engineering Inc. 5 Michael Road East Bridgewater, MA 02333 (508)378-9602 (P)/(508) 378-2922 (F) Field Report Date: 10-4-07 q Present: Domenic DeAngelo John Hutchins(Super.) .Formwork Subcontractor Location: Lewis Bay Road Hyannis, MA Building Permit# Remarks: 7:00 am-7:30 am 67 degrees cloudy The following was observed: -Formwork for the exterior wall (corner of South Street and Lewis Bay Road) has been completed. The width and height were in conformance with the design drawings. The bottom of the formwork was free of debris and standing water. -Reinforcing steel was in the process of being placed and was approximately 98% complete. The horizontal steel consisted of 245 top and bottom (continuous) as noted on the design•drawings. The top steel was placed approximately 12" below the top of wall to facilitate the placement of the column anchor bolts (epoxy bolts). Randomly measured splice lengths met or exceeded the required minimum (36 bar diameters). Vertical steel (#5s at 18" on center)was also in agreement with the design drawings. -A concrete pour is scheduled for approximately 10:00 am. No deviations or omissions to the design drawings were observed. Cc: Barnstable Building Department Oceanside Development and Construction ..._ DOMENIC W. DeANGELO STRUCTURAL y No.35062 t DWD Engineering, Inca 5 Michael Road. East Bridgewater, MA 02333 (508) 378-9602 (P)/(508) 378-2922 (F) Field Report Date: 4-2-08 Present: Domenic DeAngelo John Hutchins-Super. Robert Daly-Daly Const. Location: 89 Lewis Bay Road Hyannis, MA Building Permit# Remarks: 7.30 am-8:30 am 43 degrees sunny The following was discussed: Because the existing building is out of plumb in many locations the original field dimensions used (before the roofing was removed) to fabricate the metal stud roof_trusses were inaccurate. In addition, the existing column locations varied slightly from what was shown on the original design drawings and field measurements taken. As result, the exterior stud:walIs at the South Street/Lewis Bay Road corner addition do not bear entirely on the founditionJwaVbelow� Also, the iinterior.=supportApoints.for'the trusses do not,have enough bearing on the.roof t steel`to provide'the required 5"'of weld fromthetruss clips to the structural steel: Yf.-'L { -To rectify the situation with the structural steel 3/8" thick.plates (12" wide),were field welded along the-length of the affected steel beams. In some cases the truss bearing is totally.on.the 3/8 plates. The attached 8-1/2" x 11" sketch indicates the stiffner plate size and spacing required for these areas. In all cases,the plate shall be welded to the top flange of the steel beam with 3" of'/"fillet weld spaced at 12" on center(staggered on either side of the plate). -To rectify the situation at the exterior walls, 8"-16 gage studs spaced at 16" on center were being framed from the top of foundation wall to the underside of the first floor steel. In addition, a galvanized steel angle (L3x2x3/8 with the long leg vertical) will tie attached to the foundation wall with %" diameter stainless steel expansion bolts .'spaced dAW oncenter(4":minimum embedment) for the areas where the stud wall extends beyond the exterior face of the foundation more.-than-2..°Becau'se etFi 0ected,.furs out from 0', to.approximately. 2-1/2 ;;.the angle suppdR may stop.once-the stud overhangs the foundation wall less than 2";since the centerline of bearing will be located directly on the foundation. .318W, V'4 :'di �I..F0.a -The exterior stud wall framing was reviewed for general conformance to the design requirements. Daly Construction provided 6"-16 gage studs at16" on center.in lieu of the 6"-18 gage studs that were noted because of the proximity of the.building to the harbor.The studs were tied back to the structural steel at each floor and the roof to provide the lateral restraint as well as decrease the unbraced length of the studs. The framing to date meets or exceeds the design requirements. -In addition, the framing for the balcony roofs was reviewed because it was stick framed instead of using pre- fabricated trusses. This was done for ease of erection. The header sizes consisted of 6"-16 gage boxed stud beams with a 14 gage top runner to attach the.roof framing to. The framing is structurally sound and no further modifications are required. This office was requested to review-and come up with an alternate framing.scheme.to the balconies at some of the.living areas due to the existing conditions. A design sketch will be issued shortly for review and comment. Once the design has been approved a final sketch (stamped by this office)will be provided. Cc: Barnstable,Building Department. Oceanside Construction &Development Daly Construction Company ®�®,OAAA444 ® g DOMENIC W. a� o OeANGELO �. STRUCTURAL ti. W. No.3566 JOB 16W14 13AY p-) a DWD ENGINEERING, INC. SHEET NO. !SL ,ac OF ' 5 Michael Road EAST BRID.GEWATER, MA 02333 CALCULATED BY DATE �•�i �� (508) 378-9602 CHECKED BY DATE E SCALE C � ii [c - � ) to w �p �_I� i i �.. ... .. ... . . ............. .. k - .. .. ....... ..__ ... ........... q T ... ...:_ .... -... .. .. & 5 �J-�. . . ....... AT J Q .. . I . .......... ............... .< :.. .,.:::.. :...:.::.........: t ...... .... ... ... ............. ... .. i .... .. — - pp t ; . � =Li .. oy� plc rye ,: i .. .... FJ x I�. }u PRODUCT 204-1(Single Sheets)2051(Padded)' .. .. DWD Engineering, Inc. 5 Michael Road East Bridgewater, MA 02333 (508) 378-9602 (P)/(508)378-2922 (F) Field Report Date: 3-21-08 Present: Domenic DeAngelo.. John Hutchins Location: 89 Lewis Bay Road Hyannis, MA Building Permit# Remarks: .7:00 am-7:30 am 37 degrees mostly sunny . The following was discussed: 3 .-Because the existing building is out of.plumb vertically .(it rides out approximately 2 over the height of the building) and because the roof trusses were fabricated according to the design dimensions, the vertical studs of the,Lewis Bay Road/Ocean Street corner do not bear 100% on the floor beneath. As a result, a detail was required to provide continuity down to the foundation. The attached sketches give the metal stud subcontractor a method to provide the necessary support. Any deviation from the sketches should be discussed with.this office to determine the structural implications. Cc: Barnstable Building Department - Oceanside Construction and'Development ®® P�1N OF MA So ®�® a DOMENIG W: DeANGELO m c STRUCTURAL N0.36062 } 6� � ga � `'IU A9p�RF6l T I - DWD ENGINEERING, INC. Structural Engineer SHEET NO. -- -..... _. _-.. .._ ........ y 1{ 5MlChael Road BY 19 DATE East Bridgewater, MA 02333 Phone:(508)378-9602 Fax(508)378-2922 1 � @lt r _ e-mail:domdean @ aol.com JOB—t S'�" f - - -- a- 4' Zv �;► -- - A. fig rJ.. r,om?EBB 192 i Pif&E-.air A':P'S,;r_ t :v.r.0 7t,:-:4 ,8...0-195"Y6@'26 DWD ENGINEERING, INC. Structural Engineer SHEET No. 5 Michael Road BY DATE .a G East Bridgewater, MA 02333 Phone:(508)378-9602 Fax(508)378-2922 e-mail:domdean @ aol.co J0B _ — Lt.la tiff- IJI s jY. i j 1; I � • _ II : t � O 1 71 - -- _- P r -R?c r r•c+m+`FE35 CUSS'VM print.Tng sea vke � � � , � � � ' c I �v � � DWD Engineering, Ind. G ' 11 (s`1 k� r, b�� IrA 3L 5 Michael Road 7€1 FEB 25 AM 11: 29 East Bridgewater, MA.02333 ,(508) 378-9602 (P)/(508) 378-2922 (F) Field Report_ f , C i1510f Date: 2-19-08. Present: Domenic DeAngelo John Hutchins Various Subcontractors Location: Lewis Bay Road Hyannis, MA Building Permit# C� 2 �� Remarks: 2:00 pm-2:45 pm 44 degrees sunny. The following was observed:. -Erection of the pre-fabricated roof.trusses was in progress although the process has been slowed considerably due to the weather conditions. There has been an unusual amount of rain and wind which has hampered the lifting operations. Approximately one fourth of the roof trusses along Lewis Bay road have been installed along with the horizontal bracing to keep them in place. They have been connected to the structural steel with field . . f..�'''',.4;'rt � e�. �-,.�t;.�,.:'1't> cr�n -: <•, r,ti. f '. .- ,r:: r. ' rdc; .r ' f: [:: t,'? c i r welded clips;and.to'the outside walls with screwed clips. The quantity of screws used was.in accordance with the shop drawing details. A small area of the roof.has been plywooded which has remained attached in spite of the high winds. The hip roof truss,over the stairwell is set to be erected tomorrow. Erection of the structural steel for the addition at the corner of Ocean and Lewis Bay was also proceeding slowly. It appears as though the steel was fabricated so that the floor framing would not match the existing (it is 1-1/2"too low). As a result, the floor.decking, which had already been welded, needed to be removed. The fabricator is worki g 'o�i"`'n resolving the issue since the steel was not esigned-toN .upport=the=extra-weight of the concrete (1- -John Hutchins and I reviewed the framing for the balconies:which will be part of some of the units..The original design sketch issued by this.office included metal stud-framing with structural steel around the perimeter. This. steel was, in turn, supported by structural steel columns down to foundations. John suggested that the framing could. be completed with,pressure treated`wood (framing and columns) which would facilitate the construction i�.'jr1 ja'.�. tt..,: fj "'tt ` .t :.' `ry ',•" N.k.aA,�® process I agreed and suggested he contact the architect to make sure there were no other issue_skth�y�� re not aware of /erg" DOMENiC s DeANGELO Cc: Barnstable Building Department " STRUCTURAL y Oceanside Construction & Development No.35os2 ,� o�FFGIST R . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Maps 2 / Parcel a Application# Oo�U���S Health Division Date Issued Conservation Division Application Fee G f' Tax Collector Permit Fe b Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address ZAP Village W/A 4 K 15 Owner Co y s Et-\,AigV 1bGvst1j9wnfejT LL(-. Address Telephone LUS �a Permit Request A®o WV, �\. �� � a�1te�,v� "��'� ��� ���a gi u S 1\,e c `t Square feet: 1 st floor:existing- �N DL%S, proposed 2nd floor:existing proposed ` '� Total'new Zed Zoning District Flood Plain Groundwater Overlay Project Valuation 916 600 Construction Type Pt) Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) !J a Age of Existing Structure 3"N V LEAKS Historic House: ❑Yes Flo On Old King's Highway: ❑Yes �CNo Basement Type: ❑Full ❑Crawl &Walkout ❑Other Basement Finished Area(sq.ft.) t5' i Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑ Electric ❑Other Central Air: Ales ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes Flo Detached garage:0 existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:0 existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization I]_Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use` 0V M\MC R%-:�r" Proposed Use M M)r O , J L( Oks' BUILDER INFORMATION Name Telephone Number l-Is .5,106 Address Pa d ,* ks� m lkotd &I t License# 042A ?— Home Improvement Contractor# �� Worker's Compensation# ,kNk ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Q1 G�t(% WA5i�g' SIGN RE DATE 1V2-.1 C, FOR OFFICIAL USE ONLY t -APPLICATION# A* , DATE ISSUED ' MAP/PARCEL NO. r ADDRESS. VILLAGE T OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION i FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING i . DATE CLOSED-OUT ASSOCIATION PLAN NO. �r r 1 ,per The Commonwealth of Massachusetts Department of Industrial accidents Office of Investigations 600 Washington Street Boston,M4 02111• • �, •�' w>vw.mass.gov/dia ' Workers' Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plumbers _Applicant Information Please PrintLegibly Name(Business/Organization/Individual): .b LcA t4,io ���"s `� tfbs�t♦\7 e�111 •Address - O City/State/Zip: Phone t'-7 1 4 2-bb �i k I Are you an employer? Check the appropriate bog: :Type of project(required):. 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6 ❑New construction . * have hired the sub-contractors employees(full and/or part-tune). • �-Remodeling 2.❑ I am a'sole proprietor or partner- listed on the attached sheet. 7• ship and have no employees These sub-contractors have g• ❑Demolition employees and have workers' • working for me in any capacity. $, a 9. �Bui7ding addition [No workers' comp.insurance c mp, insurance. 10.❑Electrical repairs or additions required:] 5.` e are a corporation and its 3.❑ I qu a homeowner doing all work . officers have exercised their 11.❑Plumbing repairs or additions ' myself.[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance.required.]t c. 152, §1(4),and we have no 13.❑ Other employees. [No workers' comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners.who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. tcontractors that check this box must attached an additional sheet showing the name of the Sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is.the policy and jab site information. ' Insurance Company Name: NI t. WLV 0061�" Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: M Levi is ?>! l pbpo City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investi 'ons of the DIA for insurance coveragya verification. do her erti un r t e ains•and penalties of perjury that the information provided above is true and correct Si afore: Date: td Official use only. Do not write in this area, tb be completed by.city or town official City or Town: ' Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Phone#: Contact Person: I e tio� _ray Town of Barnstable. Regulatory Services # ASM Thomas F.Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barn.stablepa.us Office: 508-8 62-403 8 Fax: 5 08-790-62-3 0 Property Owner Must Complete and Sign. This Section If Using A Builder as Owner of the subjectproperty J hereby authorize �� �i(,�1 p°� to act on my behalf, in all matters relative to work authorized bythis liiulding permit application for. , Lamas _3Ad. R&Ao (Address of Job) ignOwner Date Print Name Q:FOP MS:OWNEVERMISSION i F � u i T^ 7 It 'PA w f N /o �c�J .z^k'�'s,' ,�.•+w�.ra. t 1 Ti ;�, �k4&k T?�,� �•'a t t"�m`�` �a�,t�. F� � f'Zr�,r�C }� r. �. 4 . co N � CD: 0. m N � � VV Jam^ r f r 1 Sep 13 07 091: 16a Ryder Insurance 781SG39274 p. 1 rX. ...,...:....,:.:,n.n.,:.:.:a a»a:..nse::4<s;:•::.,:,:...:......,:,,...:.. , :•,.,n,.r4:a;•tt^e'..v.,....:..:n..nw..:..n...^..n . .DATG(MMDDW). 09 10 07ACORD n e• .:a.. wn .. PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND NO RIGHTS UPON THE Ryder Insurance Agency, Inc. HOLDER. TH SONFERS CERTIFICATE DOES NOT AMEND, E EIND OR .247 North Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 201 COMPANIES AFFORDING COVERAGE Randolph MA 02368— . COMPANY { (781_) 963-0390 ( ) - - _ A CAPITAL SPECIALTY INSURANCE _ INSURED COMI'ANY Oceanside Construction, Inc. BATIANTIC CHARTER INSURANCE CO. 205 Marine% Circic COMPANY C Cotuit MA 02635- ; COMPANY (508) .470-' 841 D Q� :,<..:k+e4.>.t..e<.:<.,:.i:•:+..t.t:.:'.n...,n..,,,......r...,..;.n.......:v.,:�>;Yan..,�;...;n+.•:e.:.::.:},.,n:,•..�: .,..,....K.+..v.,n n„v.v. +,v....+;n,:;...,;r.:nn.,:,n+.;,......^. :.:n.... . � ..:<nN4%O:}'}v vn••.:.t•' „i•r�tn SV t:}}'Y�4.xa»Y:Inn„vw.,nt.4r.t};}:.rw,i•nvr•«•••/'v.v..+:,...,.rnvnv,•TV.trvY.v:E:ax�XY4»X•7x•�xa»,4vn.4Y.:Hn nv vv4R«taL.;4'<,•:,n.nv.vKYttnn.},:}r.r n.nr+v+vy�ny..` .. !�J.Ji>xx.NJ�•:.:x..}n.i+� Q `,:<x�+Ott t�%•f :, ... ... ♦.: ........}...:",O.,'.r,•n;.,i i':...�: w .S:fS.v :van,+ vvn.v.t• .t.�:xi} ,...........:.•.':n v.:.w.v + Xt,,.t....:...:...y,a'4»<w 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 REQUIREMtNT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY,BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED 13Y THE POLICIES DESCRIBED HEREIN I$SUBJECT TO ALL THE TERMS, _ eXCLUSIONS ANdCONDITIONS OF SUCH POLICIES_LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLCY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LYR DATE(MM100MV) DATE(MMIDOr Y1 LIMITS A GENERAL LIABILITY GENERAL AGGRECATF $2 Q Q O, 000 X COMMCRCUAL GENERAL LIABILITY C S 0 0 31 S 5 4 5 12/O 1/0 6 12/01/0 7 YHODUCTS-COMI'/OP AGG $2,'0 0 0, 0 0 0 CLAIMS MAik I XJ OCCUR liERSONAL A ADV INJURY $1, O O 0, 0 O 0— OWNER'S&CONTTI ACTOR'S PROT ' EACH OCCURRENCE $1, 0 0 0, 0 0 0 FIRE DAMAGLt(Any ona[Irv) A100, 000 MED EXP(Any orm Immm) $5 0 0 0 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE EMIT S �ALL OWNED AUTOS I I BODILY INJURY $ SCHEDUL170 AUTOS (I'er person) —_HIRED AUTOS r n001LY INJURY NON•OWNED AUTQG (Per ecMenq —• -- ''•_ PROPERTY DAMAGE 6 GARAGE LIABIUTY ttt AUTO ONLY-EA ACCIDENT_ $ ANY AUTO / / / / OTHEn THAN AUTO ONLY: " _ ...................,.__._...—_. rAGH ACCIDENT L I _ AOCREGATC $ r t'EXCESS LIABILITY EACH OCCUHHFNCE' f UMtiHtLLAF'ORM ACOHhOATE S' OTHr.R THAN UMBRELLA FOI;M WORKERS COMPENSATION ANQ X T U SI IMIT^ q" a- . ...........:....... .......... CMPLOY�Rs'LIABILII WCV00617202:_ 02/03/07 02/03/08 EL EACHACCID(:NT _ $1, 000, 000 1'nIC•THE 11n0 FV I INCL EL Dl;EASE-POLICY LIMA I B 1 O PARTNERSIE&CUTIV[ I .. ._ .! OOO_. 02 J_ OFFICERS AR( t%CL i 1 GI_DISnASF-EA EMPLOYEE s 1, 000, 000 OTHER 1 DCSCRIPYION OF OPERATIONSILOCA7IONSrVEH1cUE5/sFECIAL ITEMS The Certificate holder is an additional insured for general liability only. .` •.. •.: .a:}....;,;;}t:.::`::..........::..,.•:.:..Ya•^:4>•.v4•na.Yx'n+ta:4..v,.}:.:;:.,}.>•nv;v.�>.,r. .,<.:.....,:': ► t•:G a'< .:..+...;;:;....;'; u:;xao 4+:4;nv.v•:.r.n:}4:n ..n,...,.nY..:.. ......, : .r. �. +v.... } }. v.l�IAN��1.L�1'1'1,M►f} ..::«;;..:;:,:}.::':::::::::,. ..........................r.}.}...t.raa}....:.+'.+...n �...n.nv:wn+,vn,}x.,a•}:.,.>.»x.Ytrtr Y .....V1Y v::iia+i .. .. H , .................,.v,:.....w.n,..•.,,.>:'}a}»O.>::N'i..yS:.:.::G}......}u}•}n+.}'}.vn.}aa}y:.Y/..Y.:.:�Otn•r;<:::,.r4Y>Y'....,.v.,,..n.v .'•.•ta>o• ...............,n.vnvn wnv.a:•S.'+.:+tttr»Y..,:t::M:;t�t:%S'^,:�::::.. +.:>44Y• SROULD ANY OF THE ADOVC DESCRI15ED POLICIES BE CANCELUo BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Greenery Development LLC I_Q_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ` 6 8 3' Mel i n Street BUT FAILURE TO SUO�i\NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILI Y Unit C OF ANY KINp UPON THB COMPANY, ITS AERT3 00 REPRCSCNTATIVES, Barnstable ,:MA 02655 AUTNORIZEOREPRE NTATIV �A /^� Rry.� .: •:.,::.:a}:•a4nr•rrynt5a:ax....,nr+....,..n.nr•n.w�^:::•.:.<id,ft:}:<a%.r.>.�»r:rno�,,.wn•.::'C.;;:::i>Y.}•'a:GAa»x.xa:aa�.:n.nv:+.. .:•;,.'r:o,44,4n.x4:4 .ea,,.:n.,.•,:..a.. .. ':{1C.K.RM•'h11t�,,,''�� tfqq ;b•::}:a<:4.6rw>,+Xav%,ra4e.v,4,t.x„n+etr. ..,:.o t• ........,Y..'a.r.<tae.t,.6::%}...;..,,..,,..�n:+,.v.oa.n: .Fa ..wM7:Y.a+lw.11 ..2. ,.......,..n.n.x,,,x. :.:..:....: rt r•r ........ Y.P. "f`f`...•, ... ..........:0.^(r:x............................aY.,f.G}'••:.:5�::t:.........��C.':th�.hl:rrrn•:.�::::::::•........ ...... +v A�s�ryp�. .. ...:..:.::.:..:.y:.Z.tu2wn.n,..v....::::...;�;1.!•.{,;• 't:.��:::;%::?.?:::::•::�iR�3.fi?$;�•dial,Mf:73,T:is... .. dlr:��l�'•1'i�Yi'►'+'r7VV 1Aov 2 t aZ �LMar"s tl.)" ec..1 �V�LM-t J �1RRS?�tyS �t11S MA O-L4qIb 2�F 84� 'T�►v L t2ow�r� v �,.JI��,�l �rt��,.►�� t � o! inn��.•j �" ��s u ti �Av� ttl �dL 160 out Sic�v o AS ? �2a+-'��� S oe �20� 11/L1/4UU1 "rIV 1J:41 rHA 4U1 JL1 LLJO %J Uvi/vvi Jefferson Group Architects, Inc. Wayne J. Jacques, AIA CONSTRUCTION CONTROL AFFIDAVIT Project: Lewis Bay Court In accordance with Section 116.2.1 of the Massachusetts State Building Code, 780.CMR, 61' Edition,'I, Wayne J..Jacques, Massachusetts Registered Architect/Engineer #6935 of Jefferson Group Architects, Inc., hereby certify that I-have prepared or directly supervised the preparation of all design plans,computations and specification concerning: , E � Entire Project Architectural _X_ Structural Mechanical _ Fire Protection — Electrical _ { Other(please specify) For the above named project and to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts Building Code 6"' Ed., all acceptable engineering practices and all applicable laws and ordinances for the proposed use and occupancy. I further certify that I shall perform the necessary professional services and be . present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents approved of the.building permit and'shall be responsible for the following as specified in Section 116.2.2: I. Review, for conformance to the design concept, shop drawings, samples and other submittals,which are,submitted by the contractor in accordance with the requirements of the construction documents. 2. ; Review and approval of the quality control procedures for all code-required controlled E materials 1 3. I Be present at intervals appropriate to the stage of constriction, to become generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. I. • Pursuant to Section 116.4, I shall submit periodically, a progress report together with pertinent comments to the town of Hyannis Building commissions.,Upon satisfactory completion of the work, I shall submit a final report as the satisfactory completion ad readiness of the project for occupancy. 00' 207 ,nk ORIGINAL SIGNATURE AND SEAL DA ' p mac, 700 School Street Q �, 'Pawtucket,RI 02860 A1Q.06935 ' (401)721-2245 Fax (401)21-2238 BOSTON J MA Construction Control Affidavit-MA.doc '��gtTN of t�he,SPG� i I Jefferson Group Architects, Inc. Wayne J. Jacques, AIA CONSTRUCTION CONTROL AFFIDAVIT Project: Lewis Bay Court In accordance with Section 116.2.1 of the Massachusetts State Building Code, 780 CMR, 6'h Edition, I, Wayne J. Jacques, Massachusetts Registered Architect/Engineer #6935 of Jefferson Group Architects, Inc., hereby certify that I have prepared'or directly supervised the preparation of all design plans,computations and specification concerning: Entire Project _ Architectural _X_ Structural _ Mechanical _ Fire Protection Electrical _ Other(please specify) For the above named project and to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts Building Code 61" Ed., all acceptable engineering practices and all applicable laws and ordinances for the proposed use and occupancy. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents approved of the building permit and shall be responsible for the following as specified in Section 116.2.2: 1. Review, for conformance to the design concept, shop drawings, samples and other submittals, which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials 3. Be present at intervals appropriate to the stage of construction, to become generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the constriction documents. Pursuant to Section 116.4, I shall submit periodically, a progress report together with pertinent comments to the town of Hyannis Building commissions. Upon satisfactory completion of the work, I shall submit a final report as the satisfactory completion ad readiness of the project for occupancy. i ORIGINAL SIGNATURE AND SEAL DA D ARC�y�r 700 School Street Pawtucket,RI 02860 NO.069365 (40]}721-2245 Fax (401)21-2238 BOSTON MA Construction Control Affidavit-MA.doc ogq� GF QdPc,SQ�' ._..f Engineering Design Services, Inc. Raymond W. Dusseault III CONSTRUCTION CONTROL AFFIDAVIT Project: Lewis Bay Court In accordance with Section 116.2.1 of the Massachusetts State Building Code, 780 CMR, 6`h Edition, I, Raymond W. Dusseault III, Massachusetts Registered Engineer #40709 of Engineering Design Services, Inc., hereby certify that I have prepared or directly supervised the preparation of all design plans,computations and specification concerning: Entire Project _ Architectural _ Structural _ Mechanical _ Fire Protection Electrical X Other(please specify) For the above named project and to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts Building Code 6"' Ed., all acceptable engineering practices and all applicable laws and ordinances for the proposed use and occupancy. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents approved of the. building permit and shall be responsible for the following as specified in Section 116.2.2: 1. Review, for 'conformance to the design concept, shop drawings, samples and other submittals, which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials 3. Be present at intervals appropriate to the stage of construction, to become generally familiar with the.progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. Pursuant to Section 116.4, I shall submit periodically, a progress report together with pertinent comments to the town of Hyannis Building commissions. Upon satisfactory completion of the work, I shall submit a final report as the satisfactory completion ad readiness of the project for occupancy. \\\\�" �El Of 9 • • RAYMONO W. F a • DC�'U'SSrS�EEA}A�pU�}L�T III AL 1 91 No.40709 O GINAL SIGNATURE AND SEAL '�, �s17 ow � '\\ .�� D TE 't'''I/I/HIHIIHNI�``\ 141 Industrial Drive Slatersville,RI 02876 (401)765-7659 Fax (401)765-2984 Construction Control Affidavit-MA Engineering Design Services, Inc William T: Mayer III CONSTRUCTION CONTROL AFFIDAVIT Project: Lewis Bay Court In accordance with Section 116.2.1 of the Massachusetts State Building Code, 780 CMR, 6`h Edition, I, William T. Mayer III, Massachusetts Registered Engineer #46021 of Engineering Design Services, Inc.,hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specification concerning: Entire Project _ Architectural _ Structural _ Mechanical _ _X_ Fire Protection _ Electrical Other(please specify) For the above named project and to the best of my knowledge, such plans, computations and specifications meet the, applicable provisions of the Massachusetts Building Code 6" Ed., all acceptable engineering practices and all applicable laws and ordinances for the proposed use and occupancy. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents .approved of the building permit and shall be responsible for the following as specified in Section 116.2.2: 1. Review, for conformance to the design concept, shop drawings, samples and other submittals, which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials 3. Be present at intervals appropriate to .the stage of construction, to become generally ' familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. Pursuant to Section 116.4, I shall submit periodically, a progress report together with pertinent comments to the town of Hyannis Building commissions. Upon satisfactory completion of the work, I shall submit a final report as the satisfactory completion ad readiness of the project for occupancy. Of �"LUNT. MAYERft.46M iI 0 ORIG AL A URE AND SEAL DA E 141 Industrial Drive Slatersville,R102876 (401) 765-7659 Fax (401) 765-2984 Construction Control Affidavit-MA i } } CONSTRUCTION CONTROL Project Number Project Title Project Location Alibis DA-q UFQ dd�A Name of Building _ Nat re of Project cayff4ipa 6� �Czs i .�UILIldzf '!b rfiy& /�3/bE><!TA_ COA166/+/�/dAtJ, In 4ccordance with Section 116.0 of the Massachusetts State.Building Code, I w"41c W, �6A6�0 Registration No. 175o62 being a registered professional engineer/ApGW�eLGI; hereby certify that I have prepared o► directly supervised the preparation of all design plans, computations, and specifications concerning: Entire project Architectural Structural Mechanical Fire Protection Electricnf o Other For the above-named project and that, to the best.of my knowledge, such plans, computations, and specifications meet.the applicable provisions of the Massachusetts State Building.Code, all acceptable engineering"practices' and all applicable Iaws and.ordinances for the proposed use-and occupancy. 1 further certify that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents as specified in Section 1.16.2.2: r 1. Review of shop drawings,samples and other submittals of the contractor as required by the construction contract documents as submitted for"building permit, and approval for conformance z to the design concept. 2. Review and approve f of the quality control procedures for all code-required controlled materials. _ a 3. Special -chitectural or engineering professional inspection of critical construction components requiring controlled materials or constriction specified in the accepted engineering practice standards listed.in Appendix A. 4 Pursuant to Section 1.1.6.2.3, 1 shall submit required progress reports together with pertinent comments to the Building Official. ; t Upo comhlction of tliE:v�ork, 1$shall submit a final repot•r as to the satisfactory Completion and readiness of the III t for occuaan 1'his report.shall include.date of final.iiispcction and an original stamp.. All VY S.i�;nai�rre '9�yG� 1 tn DeA�ita �. SIRUSJ1lRP01 n, FFSslotJ Form 7460-1 for ASN: 2007-ANE-1824-OE Overview Study(ASN): 2007-ANE-1824-OE Received Date: 10/26/2007 Entered Date: 10/26/2007 Prior Study: Status: Determined Completion Date: 11/28/2007 Expiration Date: 05/28/2009 Letters: Determination'® Map: view Map Sponsor Information Sponsor's Representative Information Sponsor: Oceanside Construction&Development,Inc. Representative: Oceanside Construction&Development Attention Of: John Hutchins Attention Of: John Hutchins Address: P.O.Box 159 Address: PO Box 159 City; Marstons Mills City: Marstons Mills State: MA State: MA / Postal Code: 02648 Postal Code, 02648 Country: us. Country: USA Phone: 774-238-8411 Phone: 774-238-841.1 Fax: 508-778-5700 Fax: 508-778-5700 Construction Info Structure Summary Notice Of: Alteration Structure Type: Building Duration: Permanent (Months:0 Days:O)- Other Description: Lewis Bay Court . Work Schedule: 11/01/2007 to 06/01/2008 NACO Number: FCC Number: Date Built: Structure Details Height and Elevation Proposed. ONE DET Latitude(NAD 83): 410 39'10.48"N 33 Longitude(NAD 83): 70°16'30.79"W Site Elevation: Datum: NAD 83 Structure Height: 56 0 56 Accuracy: Total Height(ASML): 89 0 89 Marking/Lighting: None Other Description: Frequencies Name:,. Low Freq High Freq Unit ERP Unit City: Hyannis State: MA Nearest Airport: HYA Distance to Structure: 6148 feet On Airport: No Direction to Structure: 166.8 Description of Location: 89 Lewis Bay Road Hyannis,MA Description of Proposal: workingding aheight to floor to eerect building will beng building. 159'159' above sea level. 12/3/2007 6:32 An l of 2 Federal Aviation Administration Aeronautical Study No. Air Traffic Airspace Branch, ASW-520 2007-ANE-1 824-OE 2601 Meacham Blvd. • Fort Worth, TX 76137-0520 Issued Date: 11/28/2007 John Hutchins Oceanside Construction&Development, Inc. P.O. Box 159 Marstons Mills, MA 02648 ** DETERMINATION OF NO HAZARD TO AIR NAVIGATION ** The Federal Aviation Administration has conducted an aeronautical study under the provisions of 49 U.S.C., Section 44718 and if applicable Title 14 of the Code of Federal Regulations, part 77, concerning: Structure: Building Lewis Bay Court Location: Hyannis, MA Latitude: 41-39-10.480N NAD 83 Longitude: 70-16-3 0.790 W Heights: 56 feet above ground level (AGL) 89 feet above mean sea level (AMSL) This aeronautical study revealed that the structure does not exceed obstruction standards and would not'be a hazard to air navigation.provided the following condition(s), if any, is(are) met: Based on this evaluation, marking and lighting are not necessary for aviation safety. However, if marking and/or lighting are accomplished on a voluntary basis,we recommend it be installed and maintained in, accordance with FAA Advisory circular 70/7460-1 K Change 2. The structure considered under this study lies in proximity to an airport and occupants may be subjected to noise from aircraft operating'to and from the airport. This,determination expires on 05/28/2009 unless: (a) extended, revised or terminated by the issuing office. (b) the construction is subject to the licensing authority of the Federal Communications Commission (FCC) and an application for a construction permit has been filed, as required by the FCC, within 6 months of the date of this determination. In such case, the determination expires on the date prescribed by the FCC for completion of construction, or the date the FCC denies the application. NOTE: REQUEST FOR EXTENSION OF THE EFFECTIVE PERIOD OF THIS DETERMINATION MUST BE POSTMARKED OR DELIVERED TO THIS OFFICE AT LEAST 15 DAYS PRIOR TO THE EXPIRATION DATE. This determination is based, in part, on the foregoing description which includes specific coordinates, heights, frequency(ies) and power. Any changes in coordinates, heights, and frequencies or use of greater power will Page 1 of 2 r void this determination. Any future construction or alteration, including increase to heights, power, or the addition of other transmitters, requires separate notice to the FAA. This determination does include temporary construction equipment such as cranes, derricks, etc., which may be used during actual construction of the structure. However, this equipment shall not exceed.the overall heights as indicated above. Equipment which has a height greater than the studied structure requires separate notice to the FAA. This determination concerns the effect of this structure on the safe and efficient use of navigable airspace by aircraft and does not relieve the sponsor of compliance responsibilities relating to any law, ordinance, or regulation of any Federal, State, or local government body. A copy of this determination will be forwarded to the Federal Communications Commission if the structure is subject to their licensing authority. If we can be of further assistance, please contact our office at(847) 294 7575. On any future correspondence concerning this matter, please refer to Aeronautical Study Number.2007-ANE-1824-OE. Signature Control No: 544827-101038599 (DNE) Vivian Vilaro Technician ti r Page 2 of 2 L TOWN OF BARNSTABLE Building Department - Foundation Permit Date %,0 - ► - v .-7 Permit # Name c; Lc A- 6 S i C o el, Location -0 RLJ Insp. of Bld s. Y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. Map Parcel �� Application# b Health Division - M, Date Issued: d Conservation Division Application Fee �® Tax Collector Permit Fee7 -0 Treasurer �1 v Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis WOO Project Street Address 69 Lrnu.I t5�l y 2®r-A.9 Village Owner (� T1iA�'w LA— Address Telephone Permit Request 460v- a 4Law Sft (—'c Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family #units Y( Age of Existing Structure g g � Historic House: ❑Yes ZQlo On Old King's Highway: ❑Yes etfRly Basement Type: 00ull ❑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 Fueas ❑Oil ❑ Electric ❑Other Central Air: des ❑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❑ p Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use C>LtyS�� C��Vs BUILDER INFORMATION Name-�ZN Telephone Number Address p o License# RAK'"-�5 Home Improvement Contractor# `u Ya Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO CASesz--Ln, SI ATURE DATE 2� �' i FOR OFFICIAL USE ONLY AP fATION# DATSISSUED MAP/PARCEL NO. ADDRESS VILLAGE 1 OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH '�" FINAL r " PLUMBING: ROUGH FINAL GAS: ROUGH FINAL y ' FINAL BUILDING r * DATE CLOSED OUT - ASSOCIATION PLAN NO. " 3_ r � The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations • 600 Washington Street Boston, MA 02111 www.m ass.gov/dia Workers"Compensation Insurance.Afflidavit;.Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (13-usiness/Organization/Individual):.(iG-%a,�tiS.�ne �Cay�� (�CS.s�t•�r?�t-ems' �Atdr-es pS ' "C� w t51 City/.Stat M•a Phone.#: -7,1`t 2 3`3 o 4 0 �F�__jFr employer? Check the appropriate bog: Type of project(required):• 4. I am a eneral contractor and Ieloyerwth_ ❑ g 6. ❑ New construction . ployae (fullaud%orpart.time).* have hired the shb-contractors 2.❑ I am a'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me,in any capacity. employees and have workers' $• 9. (�Building addition [No workers' comp.insurance comp.insurance.t' Electrical repairs or additions required.] 5. [] We are a corporation and its ❑ P 3.❑ I am a homeowner doing all work officers have exercised their 11.[I Plumbing repairs or additions myseX [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'eompmsation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tNntractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must providb their workers'comp.policy number. , Iam an employer that isproyiding workers'compensation insurance for my employees Below is.thepolicy and job site inform ation. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date),• Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a :fine up to$1,500.00 and/or one-year imprisonment, as well as civil penaltirs in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby fy:ender he pains-and penalties of perjury that the information provided above is true and correct tSit7naAte; =Da�te:� �—t Phon�� � [6. cial use only. Do not write in this area,'tb be completed by city or town o�ccial or Town: Permit/License# ng Authority(circle one): oard of Health 2.Building Department 3. City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector ther act Person: Phone#: + '0*•°FINE Tp�y Town of Barnstable. Regulatory Services *� CAB $ Thomas F.Geller,Director � 26 9- B � �p 7 AlfD uilding Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town,barnstzble..ma.us Office: 508-8 62-403 8 Fax: 508-790-62.3 0 Property bier Must Complete and Sign This Section g r If Using A Builder I, C Doe ,as Owner of the subject property hereby authorize� �n` � to act on my behalf, in all matters relative to work authorized bythis building permit application for: , 89. Lek�L S (Address of Job) 5igna - olOwner Date Print Name Q FO P M-S:Oirtt TFURY ERM IS S ION CONSTRUCTION CONTROL Project Number Project Title t1t / Project Location 1i�Wly I/ITl IWky Name of Building Nat re of Project COf�� �bl� Q� w-yid6 l�mlL o6, Jb I -a it, IZ��IDEx1TlyL CO�iJ�bh/�JIya�c1, 01 6 CNE T�r,- In ccordance with Section 116.0 of the Massachusetts State Building Code Registraticn No. 15062 y being a registered professional engineer/arm,, hereby certify that I have prepared of directly supervised the preparation of all design plans, computations, and specifications concerning: Entire project Architectural Structural Mechanical Fire Protection Electrical Other For the above-named project and that, to the best of my knowledge, such plans, computations, and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws and.ordinances for the proposed use and occupancy. I further certify that I shall perform the necessary professional ser✓ices and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents as specified in Section 1.16.2.2: 1. Review of shop drawings;samples and other submittals of the contractor as required by the constniction contract documents as submitted for building permit, and approval for conformance to the design concept. 2. RevieW and approval ofthe quality control procedures for all code-required ccntrolled materials. 3. Special architectural or engineering professional inspection of cri?ical construction components requiring controlled materials or constriction specified in the accepted engineering practice standards listed in Appendix A. Pursuant to Section 11.6.2.3, 1 shall submit -cquired pr6gress reports together with pertinent comments to the Building Official. U)o cci��lrlction of the work, 1 shall submit a final repai! as to the satisfactory completion and readiness of ih: `1 )r�t for.occupan This:report. shall include date of filial inspcctioir and an original siatnp.` 'Sigiiat��rc gcyUs�v 1 t DowpNGELO - SSRUDTURAI. �. No.35062. \ a :0 RF q GIS ��FSSI ON Pk,\L f Oct 09 2007 9: OORM Oceanside Development 508-420-7841 p.2 Massachusetts Department of Environmental Protection Bureau of Waste Prevention .Air Quality 1100062478 Decal Number BWP AQ 06 Notification Prior to Construction or Demolition statewnt:If B. General Project Description (cont.) asbestos b found during a Construction or 4. General Contractor. Demolition loceanside Construction&Development,Inc. operation,all respmust comply parties a.Name must cornprywith JP0 Box 159 310 CMR 7.00, b,Address Chapter and Cha Marstons pterer 21 E of the Mills MA �� 02648 �� General Lays of c• 1 R• _ LZk Code the Commonwealth. 779 238-8411 This would Include, f.Tel n N extension E-mail but would not be —-- limited to,filing an JJohn Hutchins asbeetos,removai h.On-site Manager Name notification with the Department andlor a notloe of release/ofa of release of a C. General Construction or Demolition Description hazardous substanos to the 1. Construction or demolition contractor Department,if applicable. Oceanside Oonstructlon&Development,Inc. a.Name �PO Box 159 D.Address Marstons Mills I IMA 02648 � c• fate e.7J Code (774 238.8411 f.Telephone Number(area code and extension . -mai!Address Lo�tiona John Hutchins h.On-site Manager Name 2. On-Site Supervisor: John Hutchins On-Site Supervisor Name 3. is the entire facility to be demolished? ® Yes Q No N c 4. Describe the area(s)to be demolished: o Removing flat roof. N C 5. If this is a construction project,-describe the building(s)or addition(s)to be constructed: Building 4th floor , °D 42 residential condos o O a ag013•doc•10102 BWP AQ 06-Page 2 of 3 Oct 09- °2007 9:OORM Oceanside Development 508-420-7841 p. l Massachusetts Department of Environmental Protection _ Bureau of Waste Prevention •Air Quality 114006062478 r� BWP AQ 46 Decal Number Notification Prior to Construction or Demolition t" n A. Applicability Whwenn filing out p P tY . farms on the computer,use only the tab key A Construction or Demolition operation of an industrial,commercial,or Institutional building,or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection Cursor-do not use the velum (DEP), Bureau of Waste Prevention-Air Quality Control Regulations 310 CMR 7.09. Notification of key. Construction or Demolition operations is required under 310 CMR 7.09(2)ten(10)days prior to any work being performed.The following information is required pursuant to 310 CMR 7.09. B. General Project Description 1. a.Is this facility fee exempt-city,town,district, municipal housing authority,owner-occupied hnstrucus o" residence of four units or Less?El Yes 0 No 1.a1 seaions of b.Provide blanket decal number if applicable: this form must be Blanket Decal Number completed In to comply vWth the 2. Facility Information: Depof artmentEnvironmental Lvel Bay Court Protection a.Neme 1 notification 189 Lewis Bay Road requirements of b Address 310 CMR 7.00 Hyannis IMA 02 001 (508)778-5700 � -eM Code . � -E�{riail Ad�rsiss(oat7onaD 80,000 4 h.Size of Facility In Square Feet 1.Number of Floors j.Was the facility built prior to 1980? R1 Yes El No k. Describe the current or prior use of the facility: lFormerly a convalescent home I. Is the facility a residential facility? © Yes [) No r ° m. If yes, how many units? Number or Units ° 3. Facility Owner: a Greenery Development,LLC a.Name ° 683C Main Street - - b.Address osterville I IMA � � 02 555 e.ZioCoo a (508)42$-1146 C7 Joseph P. Keller 4 h.Orsite Manager Name agD6.doc•10= BWP AQ 06•Page 1 of 3 Oct 09 2007 9:018M Oceanside Development 508-420-7841 p.4 ,6_eDEP;Print Receipt https://edep.dep.mms.gov/Restricted/webpages/printreceipt.aspx Submittal Summary& Receipt Your submission is complete. Thank you for using DEP's online reporting system.You can select"My Homepage"to review your status. DEP Transaction ID: 150463 Date and Time Submitted: 10/4/2007 2:01:01 PM Other Email Form Name: BWP-Demolition Form for AQ-06 Payment Information DEP code:26924 Date: 10/4/2007 2:00:36 PM Amount($): 85 Payment Detail: Deborah Hutchins--Card— 1019 Contractor Contractor Number Name Address, , Supervisor Project Monitor Lab 1 of 1 10/412007 2:00 PM Oct 09 2007 9:01AM Oceanside Development 508-420-7841 p.5 e EP-Payment Confirmation h s://ed de .mass.gov/Restdcted/we ttP eP• P bpages/PaymeMConfirmation... :. Payment Confirmation DEP Transaction ID: 150463 . y Payment Date : 1O14120O7 2:10:45 PM $85.00 has been charged to Credit Card***"*••**"*1019 Transaction Information DEP Payment Code#26924 Payment Confirmation#23118 Please note that payments received after 3:30 pm will not be posted until the next business day. MassDEP Horne o Contacts <> Feedback e, Tour o Privacy version:6.5.11.0 of] 10/4/2007 2:00 PM ` Oct 09 2007 9:OOHM Oceanside Development 508-420-7841 p.3 Massachusetts Department of Environmental Protection _ r ' Bureau of Waste Prevention •Air Quality 1100062478 BWP A 06 Decal Number Q Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cunt.) 6. a. If this is a demolition project,were the structure(s)surveyed for the presence of asbestos containing material(ACM)? [l Yes Z No If yes,who conducted the survey? b.Surmvor Name c.Division of Occupational Safety Certification Number 7. Construction or Demolition: 10I1812007 JOSl15/2008 �� a.start Date(mm/dd/yyyy) b.End Date(mm/dd/yyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: seeding paving b. If other, please specify: ✓ wetting shrouding covering olher 9. For Emergency Demolition Operations,who is the DEP official who evaluated the emergency? a.Name of DEP Official b.Title c.Date mm/dd/ of Authorization d.DEP Waiver Number D. Certification " I certify that I have examined the lJohn Hutchins � � o above and that to the best of my a.Print Name ®o knowledge it is true and complete. I The signature below subjects the 'b.Authorized i nature a signer to the general statutes Owner �o regarding a false and misleading -C os O statement(s). 10ceanalde Construction&Development,Inc. d.Representing e.Date(mm/dd/yyyy) ®o �v �a ag06,doc•10/02 BWP AQ 06•Page 3 of 3 Sep 13 07 09: 16a Ryder Insurance 7819639274 p. l %. ;. <.. o DATE MM lDli A R ( m► C� D PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Ryder znSuraricc Agency, Inc. CONFERSONLY AND CERTIFICATE HOLDER. THIS CERT CERTIFICATE DOES NOT AMEND, EXTEND OR 247 North Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 201 _COMPANIES AFFORDING COVERAGE , . Randolph MA 02368- COMPANY (781)_ 963-0390 ( }_ - A CAPITAL SPECIALTY INSURANCE INSURED -- ..._..._...__....._ .. COMPANY — .._.._. _.._.. Oceanside Conetaruction, Inc. BATLANTIC CH7IRTER INSURANCE CO. 205 Mariner Circle COMPANY C Cotuit MA 02635- _....._.:.___—_ COMPANY (508) .42o-7841 D r ,IC THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE L157CD 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 70 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED©Y THE POLICIES DESCRIBED HEREIN IS SUt)JECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, _ L R TYPE Of INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE(MM/001Yh DATE(MM/DONY) LIMITS A aENERAL LIABILITY GENERAL AGGRECA1t__ S2 000, 000 X C_O_MMI7RCIAL GENERAL LIABILITY CS 0 0 316 5 4 5 12/01/0 6 12/01/0 7 19iODUCTS-COMPIOP AGG $2, 0 0 O'..0 O 0 CLAIMS woo I OCCUR PERSONAL R AOV INJURY $1, 0 0 0, 0 0 0 OWNER'S&CCNTf1ACTOp'S PROT EACH OCCURRENCE _ $1, O 0 0, 000 _...... •------- --- -•—•I ••• - FIRE DAMAGL'(Any Ono nm) _$1 0 0, 0 0 0 I MED EXP(Any Ann Imm(m) $rJ O 0 0 AUTOMOBILE LIABILITY ANY AUTO / / / / COMBINED SINGLE UMIT S ALL OWNLO AUTOS I BODILY INJURY _ S SCHEDUI,I D AUTOS (Per person) HIRED AUTOS QS BODILY INJURY NON-OWNED AUT (Per scmlent) PROPERTYDAMAGC7 $ GARAGE LIABILITY / AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHE_---- --- _ R THAN AUTO ONLY: r.ACH ACCIDENT $ ACCRECATEY $ EXCE93 LIABILITY 4 EACH OCCUHHFNCE $ 'UMtJHtLLAFORM I I I l A001ILGATE $ OTHER THAN UMBRELLA FOI;M - '— WORKERS COMPENSATION AND X T FYI MIT; R EIAPLOYBRS'LIABILITY WCVOO617202 O2/03/07 02/03/08 EL EACH ACCIDENT _ $1, 000, 000 THE HERS/E -CU I I INCL I EL DI,En$E-POLICY LIMI 1 S 1, O Q OJ O O O PARTNERS1EXtCUTIYC OFFICERS ARr; hXCt I GI.DISFASE-EA EMPLOYEE S 1, 000, 000 OTHER I \ DCSCRINYION OF OPERATIONS/LOCATIONSNFHICI.ESI%FECIAL ITEMS The Certificate holder is an additional insured for general liability only. ...................,,...:.:.>. ......==M .. .: .,.,.»:.�.>•,,�.Y ON•rY::.:.:;,::,:t;;.,:< ;�:�:K: >�.:�x��x:.;'::?.� 'i ..„.......nv.n.vnvn:,.vn5»:v\«O:.»:v,,:;,iv::•<•<:::<Y^t9;^•::vM%V+:n•..:.'•%"' 9HDULD ANY OF THE ADOVC DISCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUINQ COMPANY WILL ENDEAVOR YO MAIL Greenery Development LLC I_Q-DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT, 683' Main Street BUT FAILURE TO SU \NOTICE SHALL IMPOSE NO OBUGAMON OR LIABILITY Unit C OF ANY KIND UPON THB ,COMPANY, IYs ' ENTS OR REPAESCNTAYIVES. Barnstable MA 02655 AUTHORIZEDREPRE NTATIVb' ..,....:................0 ..,::.v.:,n.<v.v%•+ ....Y�rrA,«. .:..:..::>Y.9'0:4S.9w%.%P:PVv.vn•wv,.. .. .....'t'.i4:0...........................�Y.;f.¢r.....................S:i'}a.hf,rttn•:::::.........:•::::h'�Q rlrfi ......::::::::Y91i,71j5•�• ....... ...t..:az.�,.,, ... ...::x'„;?!':::+�''ui}`:::i:::::•�•".•iS:2�1S'.Sis�:�ICpRi'��pJ.�p!k�liA7f4�t�:'a988` y rt I Board of Building Regulations and Standards I y construction Supervisor License License: CS 48102 I �Eepiration.-9f16008 Restrtction�OO i ' JOHN J- HUTCHIN�— a" 419RIVER'RD 11t � ` ? Commissioner MARSTONS MILLS�<v10264 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma /� Parcel, ^� p Application # Health Division Date Issued Conservation Division Application Fee (� Planning Dept. Permit Fee I 'l' dD Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis /mod. Project Street Address °S �vJtS-$AM 20� Village Owner ' LLL Address 040 rnAknIn' uAl i 7t'1 Telephone 60`a 1`7 e) S7 60 Permit Request COS,mot-A ARC y3v o L> ok i• L��V�orh12_ . S►"�4�lAa�'L�S_ E'CT flR�AW Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation CW*'_ Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) .21�) Age of Existing Structure 20+ Historic House: ❑Yes �S(No On Old King's Highway: ❑Yes of No Basement Type: ❑ Full ❑ Crawl >d 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: It Gas ❑ Oil ❑ Electric ❑ Other Central Air: �Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use MVx,�D use nn®►w�6 Cd�AJ00`S APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number `71 S^ S-70y Address 'Mc /y !S5` UN<< ��1 License# 04 ak(oZ. Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO CASEC.r� SIGNA URE `✓�� DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER x f DATE OF INSPECTION: FOUNDATION FRAME i INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massach ttsetts Department of Industrial Accidents Office of Investigations t500 Washington Street Bos1022, MA 02 111 wives,mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumt Applicant Information Please-Print Le Name (Business/Organization/Individual): i L�►�ttS�gt ��`��''� Address: City/State/Zip: Phone #: Are you an employer? Check the appropriate box: Type of project(required),, 4. ❑ I am a general contractor and I 1. am a employer with 6. New construction employees (full and/or part-time).* have hired the sub-contractors Remodeling 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7, ❑ ship and have no.employees These sub-contractors have g, Demolition employees and have workers' 9. Building addition working forme in any capacity. comp.insurance.l [No workers' comp. insurance 10.❑ Electrical repairs or 2 . required.] 5. � We are a corporation and its 3.❑ I am a homeowner doing all work officers have exercised their 11.[] Plumbing repairs or z right of exemption per MGL 12.❑ Roof repairs. myself. [No workers comp. insurance required.] t c. 152 §1(4),and we have no employees. [No workers' 13.❑ Other` comp,insurance required.] - *Any applicant that checks box M must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating: iContraclors that check this boX must attached an additional sheet showing the name of the sub-contractors and'state whether or not those entities ha' employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. p am an erirployer that is providing workers' compensation insurance for my employees. Below is the policy and job information. Insurance Company Name: Policy# or Self-ins. Lic.#: Expiration Date: Job Site Address: �� �'�—=� ��+ City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration Failure to secure coverage as required under Section.25A of MGL c. 152 can lead to the imposition of criminalpenaltil -year imprisonment, as well as civi fine up to$1,500.00 andlor one l penalties in the form of a STOP WORK.ORDER at copy of this statement may be forwarded to the Of of up to$250.00 a day against the violator.. Be advised that a Office of ' Investigations of the DIA for insurance coverage verification. 1 do hereby certify rm the pains and penalties ofperjury that the in irFr provided above is true and correct. Si nature: Date: AdtlD Phone#: Official Ilse only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# IssuingAuthority (circle one); A r--t— S Pl;,mhinv Inspecto I f information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract hire, of express or implied,oral or written." An employer is defined as "an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner.of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, constriction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applieantwho has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublicwork until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone numbers)along with their certificates)insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees otthh er than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be,returned to the city or town that the application for the pen-nit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to.fill out in the event the office of Investigations has tocontact you regarding the applicant. Please be sure to fill in the pcMIMicense number which will be used as a.reference number. In addition,' an applicant that must submit multiple permiUlicense applications in any given year, need only submit one affidavit indicating current the applicant should write locations i policy information(if necessary)and under"Job Site Address" "all n (city or town)."'A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year. Where a home owner or citizen is obtaining a ercial venture license or permit not related to any business or comm (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's'address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111. Tel. 4 617-727-4900 ext406 or 1-87.7-MASSAFE Fax 9 617-727-7749 Ppwleert 4-24-07 _ a Massachusetts- Department of Public Safet} _ Board of Building,Regulations and Standards Construction Supervisor License License: CS 48102 Restricted to: 00 JOHN J HUTCHINS ,x. 419 RIVER RD MARSTONS MILLS, MA 02648 Expiration: 9/16/2010 ('onunissiuncr Tr#: 4320 ®®06/02/2010 10:25 FAX B174886501 UNDERWRITING 4 001/002 ® 9/100110 CORD. I ®e�UCER THI CERTIFICATE I6 ISSUED A MATTER OF INFORMATI N ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Paul Petors Agency,Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 680 Falmouth Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Mashpee,MA 02649 OMPANIES AIFFORDI G COVERAGE COMPANY A Atlantic Charter Insurance Company Compgny VDAC WSURED _ COMPANY Oceanside Construction,Inc, B COMPANY 419 River Road C Marstons Mills, MA 02648 COMPANY D a,N1u I�fa ,Ir ,I�$r 5� r b~I THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITH8TANDINO ANY REOUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 13 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. GO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR - - DATE(MMI)DrYY) DATE(MMlDPIYY) _ (in Thousands) GENERAL LIAISILJTY BODILY INJURY OCC S COMPREHENSIVE FORM BODILY INJURY AGG B PREMISES/OPERATIONS PROPERTY DAMAGE OCC i UNDERGROUND PROPERTY DAMAGE A00. - $ EXPLOSION R COLLAPSE HAZARD - 81 6 PO COMBINED OCC b PRODUCTMOMPLETED OPER B16 PD COMBINED AOG b CONTRACTUAL - - PERSONAL INJURY AGO b INDEPENDENT CONTRACTORS - - - BROAD FORM PROPERTY DAMAGE PERSONAL INJURY - AUTOMOBILE LIABIUTY - BODILY INJURY ANY AUTO (Perpemon) 6 ALL OWNED AUTOS(Pnrale Peso) BODILY INJURY ALL OWNED AUTOS (Per eeddene b (Other than Pdvete Paesenge0 HIRED AUTOS - - PROPERTY DAMAGE i- - NON-OWNED AUTOS BODILY INJURY 6. OARAOE LIABILITY - PROPERTY DAMAGE COMBINED S. EXCESS LIABILITY EACH OCCURRENCE Y UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FORM b WORKERS COMPRNSATION AND WCVOQ6172OS 2�3/2OlO. 2I3IZO11 X STATUTORY LIMIT6 A EywLore�sLIMIUTY EACH ACCIDENT ® 1,OO11,000 DISEASE-POLICY LIMIT i- 1,000,000 - DISEASE-EACH EMPLOYEE ,000,000 OTHER. - W DESCRIPTIOM OF OPERATIONSILOCATON7NgMICLIWSPECIAL ITEMS - Job::89 Lewis Bay Rd ig h w b SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Town Of Barnstable EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Attu: Paul Rosa 12 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. 200 Maui St BUT FAILURE TO IL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Hyannis,MA 02601 OF ANY KIND HE COMPANY,IT G NTS OR REPRESENTATIVES. AUTHORIZED RE i R• :fir ,•� `�: r, j, 3 7 Project: Lewis Bay Court- Hyannis, MA In accordance with Section 116.2.1 of the Massachusetts State_Building Code, 780 CMR, Th Edition, I, Wayne J. Jacques, Massachusetts Registered Architect/Engineer #6935 of Jefferson Group Architects, Inc., hereby 'certify that I have prepared or directly supervised the preparation of all design plans, computations and specification concerning: Entire Project Architectural X Structural Mechanical Fire Protection Electrical Other(please specify) For the above named project and to the- best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts Building Code 7rh Edition, all acceptable engineering practices and all applicable laws and ordinances for the proposed use and occupancy. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with_the documents approved of the building permit and shall be responsible for the following as specified in Section 116.2.2: 1, Review, for conformance to the design concept, shop drawings, samples and other submittals, which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials 3. Be present at intervals appropriate to the stage of construction, to become generally familiar with the progress and quality of the work and to determine, in general, if the work is. being performed in a manner consistent with the construction documents. Pursuant to Section 116A I shall submit periodically, a progress report together with pertinent comments to the town of Hyannis Building commissions. Upon satisfactory completion of the work, I shall submit a final report as the satisfactory completion ad readiness of the project for occupancy. &1"e1 OS�'�5 ry FF Bf?y-TO?d 'mac? MA .taF��ts ZI May 19, 2010 GINAL 'AND.1forAL DATE Jefferson Group Architects, Inc. Wayne J.Jacques,AIA,NCARB 700 School Street-Unit#2 Pawtucket,RI 02860 T:401-721-2245 F:401-721-2238 Construction Control Affidavit-MA Lewis Bay Court.doc Doc i 1 s 140 s ns Ofs 05--27-2010 • 2:21 BARNSTABLE LAND COURT REGISTRY ASSIGNMENT OF MORTGAGE and of ASSIGNMENT OF LEASES AND RENTS Lewis Bay Road and South Street Hyannis,Massachusetts TD BANK,N.A.,formerly known as TD Banknorth,N.A.,holder of (a) Mortgage and Security Agreement and Financing Statement, dated November 30, 2007 recorded with the Barnstable County Registry of Deeds at Book 22511, Page 177 and filed and registered with the Barnstable County Registry District of the Land Court as Document No. 1,078,276(the"Mortgage'),and (b) Collateral Assignment of Lessor's Interest in Leases, Rents, and Profits also dated November 30, 2007 recorded with said Deeds, Book 22511, Page 193 (the "Assignment of Rents"),and filed and registered with said Registry District of the Land Court as Document No.' 1,078,277, both from Greenery Development,LLC to TD Banknorth,N.A. covering property on Lewis Bay Road and South Street,Hyannis,Massachusetts hereby ASSIGNS the Mortgage,the Assignment of Rents and the notes and claims secured thereby,without recourse in any event,to 89 LEWIS BAY LLC,a Massachusetts limited liability company, �a 5h;P5 F.t-��I t'� GCcO C C6-`(5r'0! the Yv)k D without warranty or representation of any kind-or nature hereunder,either express or implied,but without denigration to any warranty or representation made separately by assignor to assignee by instrument in writing signed by assignor. EXECUTED as an INSTRUMENT under SEAL,as of the 5th day of April,2010. TD BA N.A. By: a Name: Christo er Lippert Its: Senior Vice President Muftwouffift LLP 600UniwmPvkDr1ve Wobmn,Massachusetts 0180I 3343 oF�HET� Town of Barnstable Regulatory Services BARNSTABLE, t Thomas F. Geiler, Director - q� 1659. 5o Building Division °T t *�a Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Fax: 508-790-6230 Office: 508-862-4038 Property Owner Must Complete and Sign This Section If Using A Builder I, 17 ► - , as Owner of the subject property herebyauthorize� to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of J b) S na e of to Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the. reverse side. Town of Barnstable 0 Regulatory Services 3natrs17asr Thomas F. Geiler,Director. v htAss. $ �A 1639. Building Division lfD '�a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-623.0 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone/t CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not-possess a'license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Persons who owns a parcel of land on which-he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner, Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be r_esR 2ni le for all such work performed under the building permit. (S ection 109.1.1 ) -- The undersigned "homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. , Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." - Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as.it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for,use in your community. Q:\WPFILES\FORMS\homeexempt.DOC S'A Prd —c c-� PROJECT NAME: i/ ADDRESS: ez PERMIT# (� -7 d 73 %1 PERMIT DATE: LARGE ROLLED PLANS ARE Ili: V/ BOX Data entered in MAPS program on: BY: / �a� Town of Barnstable Planning Board Notice of Public Hearing June 9, 2008 2008 JUN -2 PM 3. 31 New Town Hall, Second Floor Hearing Room 367 Main Street,Hyannis,MA _ To all persons deemed interested in the Planning Board acting under Section 168 of the Code of the Town of Barnstable,Regulatory Agreements and the General Laws of the Commonwealth of Massachusetts, and the Zoning Ordinances of the Town, specifically Section 240-24.1 Hyannis Village Zoning Districts, you are hereby notified of Public Hearings for: 7:00 P.M. Regulatory Agreement 2008-01 Weiner/Guaranteed Fresh Produce or Nominee Regulatory Agreement Application 2008-01 has been filed requesting relief from Barnstable Town Ordinance Section 240-24.1.4 Hyannis Medical Services District to authorize the use of a produce wholesale business with offices and retail components which is not a permitted use in the Hyannis Medical Services District and to retain existing non-conformities in terms of required setbacks, street trees,natural state impervious coverage and parking requirements. The applicant is Adam Weiner/Guaranteed Fresh Produce or nominee. The property is addressed 35 Iyannough Road(Rte. 28) Hyannis,MA and is shown on Assessor's Map 343 as Parcel 003 in the Hyannis Medical Services and Wellhead Protection Overlay Districts. 7:15 P.M. Regulatory Agreement 2008-02 Greenery Development,LLC Regulatory Agreement Application 2008-02 has been filed as a.Modification of Regulatory Agreement 2007-02 previously approved for the Greenery Development,LLC. The applicant seeks to modify the existing agreement for a change of use from the approved 42 residential condominium units with 20,000 square feet of medical office space,to that of an 82 unit assisted living use on the second,third and fourth floors with support offices,recreational rooms,lounges and cafeteria on the first floor. Additionally, applicant seeks to build a 2,504 sq. ft.residential apartment structure containing ten apartments. Requested relief is for the uses, density,lot coverage,length of roof mass greater than fifty feet as per Design Infrastructure Plan,building set back for apartment building, setback and parking buffer,building height and maximum lot coverage. The applicant is the Greenery Development, LLC. The properties are addressed 42A and 42B-South`Stree.t H_yann s,-MA;located in the Hyannis Village Harbor District and 8,9 �L w-is,Bay Road,Hyannis;MA located in the Hyannis Village Medical Services District and shown on Asse" s o s-Map-327 as-f els 241 and-223,respectively. Copies of the applications and plans are available for review in the Office of the Planning Board, 200 Main Street,Hyannis,MA between the hours of 8:30 a.m.to 4:30 p.m.,Monday through Friday. Barnstable Patriot Marlene Weir,Chairman May 23 &May 30, 2008 Planning Board 3 �3 Lie Town of Barnstable Planning Board Ey ,v; BPftE'ti3 SAi3L f Notice of Public Hearing 7/008 Ff N 2 PM 3 June 9;2008 New Town Hall, Second Floor Hearing Room 367 Main Street,Hyannis;M.A To all persons deemed interested in the Planning Board acting under Section 168 of the Code of the Town of Barnstable,Regulatory Agreements and the General Laws of the Commonwealth of Massachusetts, and the Zoning Ordinances of the Town, specifically Section 240-24.1 Hyannis Village Zoning Districts, you are hereby notified of Public Hearings for: 7:00 P.M. Regulatory Agreement 2008-01 Weiner/Guaranteed Fresh Produce or Nominee Regulatory Agreement Application 2008-01 has been filed requesting relief from Barnstable Town Ordinance Section 240-24.1.4 Hyannis Medical Services District to authorize the use of a produce wholesale business with offices and retail components which is not a permitted use in the Hyannis non-conformities in terms of required setbacks, street Medical Services District and to retain existing q trees,natural state impervious coverage and parking requirements. The applicant is Adam Weiner/Guaranteed Fresh Produce or nominee. The property is addressed 35 Iyannough Road(Rte. 28)' Hyannis,MA and is shown on Assessor's Map 343 as Parcel 003 in the Hyannis Medical Services and Wellhead Protection Overlay.Districts. 7:15 P.M. Regulatory Agreement 2008-02 Greenery Development,LLC Regulatory Agreement Application 2008-02 has been filed as a Modification of Regulatory Agreement 2007-02 previously approved for the Greenery Development,LLC. The applicant seeks to modify the existing agreement for a change of use from the approved 42 residential condominium units with 20,000 square feet of medical office space,to that of an 82 unit assisted living use on the second,third and fourth floors with support offices,recreational rooms, lounges and cafeteria on the first floor. Additionally, applicant seeks to build a 2,504 sq. ft.residential apartment structure containing ten apartments. Requested relief is for the uses, density,lot coverage, length of roof nass \ter than fifty feet as per Design Infrastructure Plan,building set back for apartme i ding, setback a arking buffer,building height and maximum lot coverage. The applicant is Greenery Development, C. The properties are addressed 42A and 42B South Street,Hyannis,MA 1 Ic ted in the Hyannis Vill arbor District and 89 Lewis Bay Road,Hyannis,MA located in the Hyannis e Medica es District and shown on` Assessor's Map as arcels 241 and 223,respectively. Copies of the applications and plans are available for review in the Office of the Planning Board, 200 Main Street,Hyannis,MA between the hours of 8:30 a.m. to 4:30 p.m.,Monday through Friday. Barnstable Patriot Marlene Weir, Chairman May 23 &May 30,2008 Planning Board I - -' Town of Barnstable Planning Board f` ;�FABLE Notice of Public Hearing /�Fr�� �n1 f'`y, 7 PM /{� ^( f s June 9, 2008 New Town Hall, Second Floor Hearing Room 367 Main Street, Hyannis, MA To all persons deemed interested in the Planning Board acting under Section 168 of the Code of the Town of Barnstable,Regulatory Agreements and the General Laws of the Commonwealth of Massachusetts, and the Zoning Ordinances of the Town, specifically Section 240-24.1 Hyannis Village Zoning Districts, you are hereby notified of Public Hearings for: 7:00 P.M. Regulatory Agreement 2008-01 Weiner/Guaranteed Fresh Produce or Nominee Regulatory Agreement Application 2008-01 has been filed requesting relief from Barnstable Town Ordinance Section 240-24.1.4 Hyannis Medical Services District to authorize the use of a produce wholesale business with offices and retail components which is not a permitted use in the Hyannis Medical Services District and to retain existing non-conformities in terms of required setbacks, street trees,natural state impervious coverage and parking requirements. The applicant is Adam Weiner/Guaranteed Fresh Produce or nominee. The property is addressed 35 Iyannough Road(Rte. 28) Hyannis,MA and is shown on Assessor's Map 343 as Parcel 003 in the Hyannis Medical Services and Wellhead Protection Overlay Districts. 7:15 P.M. Regulatory Agreement 2008-02 Greenery Development,LLC Regulatory Agreement Application 2008-02 has been filed as a Modification of Regulatory Agreement 2007-02 previously approved for the Greenery Development,LLC. The applicant seeks to modify the existing agreement for a change of use from the approved 42 residential condominium units with 20,000 square feet of medical office space, to that of an 82 unit assisted living use on the second,third and fourth floors with support offices,recreational rooms, lounges and cafeteria on the first floor. Additionally, applicant seeks to build a 2,504 sq. ft.residential apartment structure containing ten apartments. Requested relief is for the uses, density, lot coverage, length of roof mass greater than fifty feet as per, Design Infrastructure Plan,building set back for apartment building, setback and parking buffer,building height and maximum lot coverage. The applicant is the Greenery Development, LLC. The properties are addressed 42A and 42B South Street,Hyannis,MA located in the Hyannis Village Harbor District and 89 Lewis Bay Road,Hyannis,MA located in the Hyannis Village Medical Services District and shown on Assessor's Map 327 as Parcels 241 and 223,respectively. Copies of the applications and plans are available for review in the Office of the Planning Board, 200 Main Street, Hyannis,MA between the hours of 8:30 a.m.to 4:30 p.m.,Monday through Friday. Barnstable Patriot Marlene Weir, Chairman May 23 &May-30, 2008 Planning Board S V6 Z LC , t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ;9�; Application#a?0(, (p:;�1 Y& Health Division Conservation Division Permit# Tax Collector Date Issued JI)l Treasurer Application Fee 106?` Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address �W r$ R>PLy a®Vq1> Oinn C kP Village l f YA i-A t1\.5 Owner L LC. • Address Telephone `7_7 4 `ZSS 61(k Permit Request 1�"`��iPt�� NON GM'--C` U'�, i f Square feet: 1st floor:existing proposed 2nd floor:existing proposed _� TotaH w T—" Zoning District Flood Plain Groundwater Overlay r c:, M w Project Valuation ® 0 O Construction Type q COY �/y Cu Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supportin cumentation. Ev'3 Cn} ! Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) s- + Age of Existing Structure 20 y�z.S Historic House: ❑Yes ).No On Old King's Hi way: O�'es Flo 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: 46as ❑Oil ❑ Electric ❑Other Central Air: (6Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No O Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:O existing ❑new size Attached garage:0 existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use __10kA" BUILDER INFORMATION Name Oc-'s-A Telephone Number 6kic( Address q it PL U(SZ License# C>4b1 C Z_ Home Improvement Contractor# NIX Worker's Compensation# WCV00b 0 2.0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO tS SIGNAT RE DATE `�� 8 f ' FOR OFFICIAL USE ONLY i F PE9MIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE > OWNER DATE OF INSPECTION: FOUNDATION FRAME t INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL y GAS: ROUGH FINAL t r: FINAL BUILDING s S 1 DATE CLOSED OUT ASSOCIATION PLAN NO. i :r The Commonwealth o 'Massachusetts Department of Industrial Accidents Office.of Investigations 600 Washington Street Boston,MA 02111 ',M 5•• www massgov/dia Workers' Compensation.Insurance Affidavit: Builders/Contractors/Electricians/P1umbers Applicant Information Please Print Legibly Name (Business/organization/Individug): ( t- ;6 i Q = CANS . �DS:�V G=L(a (A Address: City/State/Zip: Phone#: —714' '"Ll 3. ;EN L% A.re you an employer?Check the-appropriate box:. Type of project(required):- 1 am a employer with .4. I am a general contractor and I 6. employees (full'and/or part-time).* have hired the sub-contractors New construction .❑ I am a sole proprietor or partner- listed on the attached sheet t 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. E9-Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5.-�e are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or.additions �.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself.[No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp.insurance required.] any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: `• ' Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such ;ontractors.that check this box must attached an additional sheet showing the name of the sub-contactors and their workers'comp.policy information. am an employer that is providing workers'compensation insurance for my employees.'Below is the policy and job site iformation. isurance Company Name: A1N1jA e&(_ C 04e-FmD L ei S C e,, o icy.tt or Self ins.Lie. Expiration Date: ab site Address: Lzn,;y 13AI RU� City/state/Zip: ow,�y��y attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). ailure to.secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a me up to$.1,500,.00 and/or one-year imprisonment; as well as civil penalties in the form of a STOYWORK ORDER and a fine f up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of avestigations of the DIA for insurance coverage verification. do hereby a un r the pains and penalties of perjury that the information provided above is true and correct i 'tare:. Dater 'hone#: . 71-1 w 'Z:`a 91i t t Offccial use only. Do not write in this area,to be completed by city.or town offu;iaL City or Town: Permit/License# . Issuing Authority(circle one): I.Board of Health 2..Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and. Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individuat.partnersbip,.association, corporation or other legal entity,or any two or more of the foregoing-engaged in a joint enterprise,and including the legal representatives ofad ceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. Howcver the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair woik-on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence-of compliance with the insurance coverage required." Additionally,MGL chapter 152;§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable.'evidence.of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es) and phone number(s)along with their certificates) of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners; are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of . Industrial Accidents..Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below, Self-insured companies should enter their. self-insurance license number on the appropriate line. City or Town Officials . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that moist submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"'the applicant should write"all locations in (city or town)."A copy of the.affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that-a valid affidavit is-on file for,future permits.or-lic' enses..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 (ie. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation.and should you.have any questions, please do not hesitate to give us a call. The Department's address,telephone and.fax number: , The Commonwealth of Massachusetts . . -. Department of Industrial.Accidents a, ..Office of investigations 600-Washingfor•Street a Boston;MA 0211 L. "Tel. #617-727-4900 ext 406 or-1,877-MASSAFE Fax#617-7274749 tevised 5-26-05 www.mus.gov/din y . taE� Town of Barnstable �P ti Regulatory Services �B"RNBI'EMAS& Thomas F.Geiler,Director s6 �A�BD 39. p, Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 fice: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, L� �� , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) ature of Owner Date Print ame QTORMS:OWIQERPERMISSION Oct Is 06 08158a Rtjder Insurance 7819639274 P. 1 E(MM/DO^ 'ATE'. U A CO .RD PRVDuaFn THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION . Ryder insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDFR. CERTIFATE DOES NOT EXTEND OR 247 North Main Street ALTER THETHIS COVERAGE IC AFFORDED BY THEAMEND POLICIES BELOW, Suite 201 COMPANIES AFFORDING COVERAGE Randolph MA 02368- COMPANY ...... (781) 963-0390 A CAPITAL SPECIALTY IrfSURALNTCR INSURED-- COMPANY Cccanside Construction, Inc. B ATLANTIC C14ARTER INSURANCE CO. 305 Mariner Circic COMPANY C Cotuit MA 02835- COMPANY ...... (508) 420-76C11 THIS IS TO CERTIFY THAT THE POLI61i-i OF INSURANCE LISTED BELOW HAVE BEEN' ISSUED To THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NO'rW:THSTANOING ANY REQUIREMENT,TERM 08 CONDITION OF ANY CONTRACT OH OTHER DOCUMENT WITH RESPECT TO WHICH TH13 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS$UI3Jr-OT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE SEEN REQVCED BY PAID CLAIMS. POLICY F.XPiFIATION LIT" 1- UNITS Co TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MM,'DO,`YY) DATCIMM1001M A ..GcNrFIIAL LL4111UTY GrNERALAGGqEQA 000 X CMIMI'.-HCIlV-U�:NIzHALLIABL!-Y CS00316545 3.2/01/05 12/01 /06 PROlUCTS-COMpic CLAIMS MADE J'x.. OCCUR Pr.FLqCNAL h AD.V INJURY $1'0 0 p -j-LCL0. OVVNIiHt),%CON-AACjQR',,PINT l EACH OCCUPIFENC!" sl 000 000 Fm—nE DAVACC(Any ove fil!) I t'166" 000 MCI rxP(Any t-u Porson) $5, 000 AUTOMOBILE LIABILITY ANY AUTO COMBINED 8IN0l-k,.jmiT ALL 04'1411-0 AUTOS, nODtY;NJURY t�UKhIJULi:DAurm I (Per person) 1-411 ILI)ALTOS UODLY INJUnY -1, NON CMNrD Aij 08 ....... PnOrl=OWIAG17 QARAQE LIABILITY AUTOO -Y-EAACCIOI7Vr I ANY AU'O OTHER TIm AUTO ONLY: ....EXCHACCOLNT is II tt_EXCESS LIABILITY AoGpr,-.ATr s I-NAMPI-1 I A FORM AGGREGATE. $ OTHI:HIHANUUKA:LEA rORM WOrtKERSCOMPCN9ATIOf4 AND WColA EMFLOYEr?5'LIACILITY lim LL-311111 1 WCV00617201 021/03/06 02/03/07 P.EACH ACCUENT s 1 C 0 0,000 T-il-.UROPRrTORo U- I:X-C INCI.LITNE Lr�?IAEASS-IlOJCY LIw'r $ 0.0 0 0 0 0 C.rrl(-,FRR ASE EXCI.i EL OltiEASL-LA EMPLOYEE $1 c 0 0 0 0 0 DESCRIPTION OF OPEZRATIONWLOCATIONSIVCHICLCSISPECIAL ITEMS ONLY FOR THE CQNTRACTUAIJ OBLIGATIONS OF WORKED PERFORM20 AT 68 CENTER STREET CONDOMINIUM :CEATIFICATC b"OuLo ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED QGFOR6 THF. EXPIRATION OATS THEREOF, THE ISSUIN01 COMPANY WILL ENDEAVOR TO MAIL TOWN OF BARINSTABLE JD_DAYS WRITTEN NOTICE TO THE rp"riFICATE HOLDER HAMEDTO THE LEFr, T-74ONLAG PERRY BUT FAILURE TO MAIL SU� CE SHALL IMPOSE NO ODUGATION OR LIABILITY 200 MAIN STREETOF ANY KIND UPON CO._ RNY, ITS A OR REPRESENTATIVES.. 14YANNIS KA 02601 I AUYHQRIZFD flEPRESCNTATIV ---------------- co ra41" . ......... a Standar . 7A, alld at$ ilka�m,: o1 L:icsnse � .oard tibM S�Perv'@stir 1 . ConstM G5 4002 ��+ ►,i. ��� pp � r_ - t Tc ER FAO _ Comiwmloner 419 RI ILLS; .' ,e r ONs M a A l ' 4 �FIME ram, Town of Barnstable Regulatory Services • BARNSrABLE, « v MASS. �, Thomas F. Geiler, Director �A t6g9. A�0 lF039 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 3/2/11 John Hutchins Ocean Side Construction 540 Main Street, Unit 17 Hyannis, MA 02601 RE: 89 Lewis Bay Road, Hyannis Dear Mr. Huchins, Our office has previously inspected the above referenced property for electrical work performed. As a result of our inspection we found the work was in violation of the electrical code NEC 2008 Chapter III Required Outlets 210.60 (E) (3). After being informed of our findings, you were to produce a letter that would allow for the balconies without outlets. I have reviewed the letter you produced to our office on February 28"' 2011 dated November 22, 2010 from David Lawler and the information provided does not include information that supersedes the electrical code. Should you desire to appeal this decision you must do so with the Board of Electricians. Sincerely, William Amara Inspector of Wires 508-862-4089 I cc: A.S. Jones David V. Lawler Q:\WPFILES\AMARA\891ewisbayroad201 l ele.doc r ,. c LAWLER � ASTREET, SUITE 8 )y ASSACHUSETTS 02601 V T('t7' OF BURNS'lil"ILE The Law Office of DAVID V. LAWLER %`' h i : 36540 Main Street. Suite 8 Hyannis, MA 02601 Telephone: (508) 778-0303 Facsimile: (508) 778-4600 962 Main Street Email Address: Osterville,MA 02655 Dlawler.atty@verizon.net Telephone:(508) 428- 0542 November 22. 2010 John Hutchins Ocean Side Construction 540.Main Street,.Suite 17 Hyannis, MA 02601 RE: REGULATORY AGREEMENT- 89 LEWIS BAY ROAD AND 42 SOUTH STREET, HYANNIS, MA- Dear John: This is follow-up on,our conversation concerning electrical outlets on the balconies of the residential condominiums. The condominiun.'documents prohi pit the use of electrical appliances on the balconies for safety and insurance reasons. With the hi`A winds off the water and other potential hazards it was determined,that'best practice would prohibit such uses on the balconies. Though it has been a few years, I believe this prohibition was discussed with the Planning Board; prior to the approval of the Regulatory Agreenlen'. As such�h...ir�stillatien of electrical outlets on thesobalconies s1iould ve c:vo.,ded for obvioOs c,afet`i reasons. should you wish me to address tills issue with Tom Perry, I would me than happy call him or set LIP a meeting to address any concerns the Town may have. Again, I would be more than happy to assist where possible. I look forward to future communications. Ver •ulv'v,urs, F ''�av d Lawler ' UxrDtcAnox: a consuLrAnrumc: s,eA• ��ROOM I LMNG �DROO BEDRODM �' sore s�",M Bm0.00A1 _ LRTU — NVPO BOOM 10 RAM ^g !P BwRWM — e,m 0. IH6DPAWB:G3A PART OFANINIEGMiFD O'ETOF a®qpO consrnurnox mxmACr DaclmuA'Is.BPW ._._._ g UNIT UNIT 9 AUDRAwwannn seECG,cmans wcumBvc .. 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JUDD RRO':,'N DESIGNS,INC. 401 711 . 0977 LEGEND LOCUS INFORMATION REVISIONS: 50.9 X SPOT ELEVATION #89 LEWIS BAY ROAD #42 SOUTH STREET NO. DATE DESC. 28 C.B. CATCH BASIN CURRENT OWNER: GREENERY DEVELOPMENT, LLC. GREENERY DEVELOPMENT, LLC. — DMH ® DRAINAGE' MANHOLE TITLE REFERENCE: CERT. 181420 BOOK 21529, PAGE 199 — SMH OO SEWER MANHOLE TMH (D TELEPHONE MANHOLE PLAN REFERENCE: L.C. 14337—B PLAN BOOK 238, PAGE 45 N LIP LIGHT POLE PLAN BOOK 161, PAGE 135 — �p�N 5� / UPL7 UTILITY POLE / LIGHT PLAN BOOK 435, PAGE 91 — MAIN STREET UPLT* UTILITY POLE / LIGHT & TRANSFORMER — / UPT UTILITY POLE / TRANSFORMER ASSESSORS MAP: 327 327 — LOCUS ; y UP UTILITY POLE PARCEL: 223 241 m -r —04 — OVERHEAD ELECTRIC LINE ZONING DISTRICT: MS HD a� z EHH ELECTRIC HANDHOLE 5ouTH ST � �t � o SETBACKS: FRONT 20' FRONT 20' O GMET GAS METER SIDE 10' SIDE 10' —G— GAS LINE REAR 10' REAR 10' cv GAS GATE MINIMUM LOT SIZE: 10,000 S.F. 20,000 S.F. LOCUS � I CERTIFY TO THE BEST OF MY EXISTING TOTAL LOT AREA: 79,874tS.F. 11,472tS.F. j NOT TO SCALE WG © WATER GATE BENCH MARK: —W— WATER LINE PROFESSIONAL KNOWLEDGE, INFORMATION E TOP OF CONC. BOUND NITROGEN SENSITIVE AND BELIEF THAT THE LOT CORNERS, _mw TEST PIT ELEV. 33.53 (NGVD 1929) ZONE: NOT IN A ZONE II NOT IN A ZONE II DIMENSIONS AND SETBACKS TO THE STRUCTURE AS DETERMINED BY p CB/DH CONCRETE BOUND W/ DRILL HOLE N/F FEMA FLOOD ZONE C AS SHOWN ON PANEL ZONE C AS SHOWN ON PANEL INSTRUMENT SURVEY AND AS SHOWN ON Q CB/LP CONCRETE BOUND W/ LEAD PLUG WOODS HOLE MARTHAS VINEYARD STEAMSHIP AUTHORITY ZONE DISTRICT: 250001 0005 C DATED 8/19/85 250001 0005 C DATED 8/19/85 THIS PLAN ARE CORRECT. ASSESSORS MAP 327 CB/DISK CONCRETE BOUND W/ BRASS DISK CB/DH PARCEL 2214 FRONT YARD LANDSCAPE SETBACK: 10' 10' DECIDUOUS TREE FND _ MAXIMUM LOT COVERAGE: 80% 70% i CHAIN LINK FENCE VEGETATIVE SETBACK: 10' CONIFEROUS TREE N/F r--- — _ y ° X X ��► ELLEN R. 1'RATT TR. X NM 39f1!!0 X X3 CO ASSESSORS MAP 327 ` � S ttT39'O�p.:X _j N Q PARCEL 238 LP 00 E LP f UPA LP 1 ---_ LP I r " LP CB/LP PROFESSI15NAL LAND SURVEYOR DATE # FND ANQ_HEL 1 N/F ( Hj LCB_ JANE H. WALLH I R!M-32.2 PLAN OF ASSESSORS MAP 327 _ SUMP=24.1 PARCEL 239 LP #89 LEWIS BAY ROAD /- N F �I LAND GREENERY DEVELOPMENT, LLC. ASSESSORS MAP 327 ' PARCEL 223 79,874±S.F. -- LCB CO'I'�+ RIM=32.0 f �-- 89 LEWIS BAY ROAD SUMP=23.0 q I ---_ 0 3 AND O � J MULCH CON � I ooN CB/DH #42 SOUTH STREET :�. C. WALK p-- FND CB/DH BIT. WA = } LP ^ I 3 I N FND -----> ,.-� '"-- I o ' g 5 19.9' Q m HYANNIS N/F Z a W HOUSING FOR ALL CORP. I S ASSESSORS MAP 327 ` PARCEL 240 ° I MAS SAC H U S ET�f S o I �,.r � _ 1 1 CONC. WLK '82 7�2 " W .� I - CO ONE OF COM N oRs 2--- 3 (BARNSTABLE COUNTY) l z N LAWN AREA �// co _ CB ° 1 v ". �_ O 9 MULCHED C C- WALKEXISTING CONDITIONS $ ° LP ' Q I '. �I -- WITH I I MS ZONING —'---- 3 DISTRICT FLAG MULCH STOCKADE FENCE f : zu o ND ZONING rn POLE f .. 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AND EDISON LIGHT COMPANY .0' AREA t KI 129.03' ,r .- I DOC.#194072 OF NEW ��� I U) ` _-`'"-•--- S `�_ `'—„---�- r] G-* CB C LP FOUNDATION�"�"....-..:e,"'.^P. ""`i..'riu+.. O l .4 �*c _ '� .., W �JY�' L 2p. TRANSFORMER 10 J �, 5, HYD � 13'.00' f�D cli T N 82.100 .0 A/C SMHGG' o I Mc11 �CINLC UIllt D00 J�y-- __ _ � ,. it ; W. Yarmouth Massachusetts _ ---- S 1---- -`--� / s UPL --� y` i y a MS ZONING DISTRICT- Lv-- ``-` t� �= �- �` e ) CO SMH SMHAil I O�O/�3 , ---- S „'"""'rr�.. `"`---- N LAWN A C UP � : / s210 " AREA 508 7 8 8919 s `HD ZONING D,STRiC—"" .,. WG G_ 00. 0 =y 146.80' —"�- : �'� `L' h � 2007 The BSC Group, Inc. -- _ '� ti �_-- cV CB/DH R�^3 i'1. c� j `J P. c iO -_ ______ CONC. SIOEW �1'' FND T� ('� UPL SMH t - fftxftftwwa � UTH S ��' `� ""^- -- WALK GRANITE CURB �l SCALE: 1" = 20' - � I 2.5 5 10 METERS ''USLIC �/ 0 o f 4p' WIDE)�`"`1.-� l-. UP - --- __� 5 0 .1 Nonni TREETiArE`� M,v_ r I o 10 am 20 40 FEET .. �` I PROJ. MGR.: C. FIELD � �— �, NOTE: UPL -- --- _ _ � .. .. j \ FIELD: D.GAZZOLO/J.MCCARTIN/N.P,IERCIER NEW FOUNDATION FIELD LOCATED ON OCTOBER 10, 2007 ---_ �`` -- s' NEW EXTERIOR WALLS ARE NOT A STRAIGHT EXTENSION CALC./DESIGN: P. HP,GIST OF THE EXISTING EXTERIOR WALLS. '--- — EMH - IF�� - J DRAWN: P. HAGIST/K, HEALY "'�—•• ., , 6l ifs SMH 010 CHECK: C. FIELD z FILE: 49197ABF.DWG CB/DH Z FND O DWG. N0: 5782-03 SHEET 1 OF 1 JOB. NO: 4-9197.00