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HomeMy WebLinkAbout0051 MAIN STREET (HYANNIS) 1 /11,sc, who le­b -4-5 <Prev Next> Page 1 of 1 Rows/Page: Parcel. Location Owner Village Index Map 342-033- 51 MAIN STREET (HYANNIS) FATER, MARC TR HYAN 0952 34203300A OOA UNIT 1 342-033- 5.1 MAIN STREET (HYANNIS) OATS, MICHAEL F TR HYAN 0952 34203300B 0OB UNIT 2 342-033- 51 MAIN STREET (HYANNIS) HILL, C EUGENE & GAIL P HYAN 0952 34203300C OOC UNIT 3 342-033- 51 MAIN STREET (HYANNIS) LYTLE, ROBERT A HYAN 0952 34203300D OOD UNIT 4 342-033- 51 MAIN STREET (HYANNIS) LYTLE, ROBERT A HYAN 0952 34203300E OOE UNIT 5 - 342-033- 51 MAIN STREET (HYANNIS) REFINED-PROPERTY HYAN 0952 3420330OF OOF UNIT 6 GROUP LLC 1 i Application number Qe► Fee ......... ......... . ... ..................................... MAY 0 KAM ,`.., ' Building Inspectors In ....................... , ,. In� M� BARNS SABLE113.I..�.�Date Issued......... .................................... u a .o o� oo4 Map/Parcel ..........:................................................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: MAf ,N S4, ER STREET VILLAGE Owner's Name: ,. Phone Number Email Address: - Cell Phone Number Project cost $ Check one Residential Commercial OWNER'S AUTHORIZATION. .As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK Siding Windows (no header change)# 0 Insulation/Weatherization ❑ D rs (no header change)# Commercial Doors require an inspector's review oof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name- Home Improvement Contractors Registration(if applicable)# (attach copy) T Construction Supervisor's License# attach copy) Email of Contractor r V Phone number ALL PROPERTIES THAT HAVE STRUCTURES OV R 75 YEARS OLD OR IF THE SUBJECT PROPERTY-IS IN A HISTORIC DISTRICT; YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ . *For Tents Only*.. Date Tent(s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece-of paper. " Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes -----Nu - Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or>Yes No if yes, a gas permit is required. Natural Gas Yes No ,if yes, a gas permit is required. If food is being served at.your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab f Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. w y� The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ( Please Print Le 'bl Name (Business/Organizadon/Individual): I ( h (�0 �/ , e -T 462 0 Address: , _ S �14 L / City/State/Zip: 2 L Phone Are you an mployer?Check the ppropriate box: Type of project(required): . 1. am a employer with `� 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am.a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition working for me in an capacity. employees and have workers', . g Y P tY• # 9. ❑Building addition [No workers'.comp.insurance, comp.insurance. 10. Electrical repairs or additions required.] 5. ❑ We area corporation and its ❑ P 3.0 1 am a homeowner doing all work officers have exercised their 11.❑Plum�* repairs or additions myself. [No workers' comp. right of exemption per MGL 12. oof 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'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: r Policy#or Self-ins.Lic•#: ``J�--.-N c� � -I i Expiration Date: o )/0 Job Site Address: 6I�,inJ City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date)., Failure to.secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a. fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby tify under t e pains an1dnrvfpffjV!T Sian1 a information provided above is true a correct Si a e: ena Date: / Phone#: CP l (r Official use only. Do"not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of.Health 2.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 individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in.a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)-also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage.required." . Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority.". Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their,certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation_a_nd 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 Q2111 Tel.#617-727-4900 ext 406 or 1-877-MASSAF2 Fax#617-727-7749 Revised 4-24-07 www.mas.s.gov/dia i • fARNBTABL$ r Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Paul Roma Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize P �,.—C�ACOA to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) a� Signature of O ner Date ,P A _ Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\LN69LF2\EXPRESS(2).doc 01/25/17 ACCO CERTIFICATE OF LIABILITY INSURANCE °ATE'MMIDONYYY) 12/13/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND`OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED. REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,.certain policies may require an endorsement. A statement on this certificate does not confer rights-to the. certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Anne Sanzo, HUB INTERNATIONAL NEW ENGLAND LLC PHONE o (508)945-7863 FAC No ADDRIESS: anne.sanzo@hubintemational.com 265 ORLEANS RD INSURERS AFFORDING COVERAGE. NAIC# NORTH CHATHAM MA 02650 INSURER A: TRAVELERS PROPERTY CAS CO OF AM 25674 INSURED INSURER B HITCHCOCK THEODORE DBA TL HITCHCOCK CONSTRUCTION INSURERC: INSURER D: 2 QUINNS WAY INSURERS: MASHPEE MA 02649 INSURER F: COVERAGES CERTIFICATE NUMBER: 347907 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID.CLAIMS. ILTR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP POLICYNUMBER IMMIDDNYYYI (MMIDOMIMLIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Me occurrence S_ MED EXP(Any oneperson) S _ NIA PERSONAL&ADV INJURY S GEHL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY❑JECTPRO- 0LOC PRODUCTS-COMP/OP AGG S OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT § Ea accident ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED N/A BODILY INJURY(Pei accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident S S UMBRELLALJAB OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE N/A AGGREGATE. S DED RETENTIONS �/ § WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS'LIABILITY YIN -- ANYPROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBEREXCLUDED7 NIA NIA NIA 7PJUB1K64731818 10/10/2018 10/10/2019 (Mandatory in NH) EL.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS ILOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 8,no authorization Is given to pay claims for benefits:to employees in states other than Massachusetts If the Insured hires,or has hired those employees outside of Massachusetts. This certificate of Insurance shows the.policy In force on the date that this certificate was Issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance. The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govAwd/workers-cbMpensatidnTinvestigations/. HITCHCOCK:THEODORE has elected coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE.CANCELLED BEFORE _ THE EXPIRATION DATE THEREOF,. NOTICE: WILL BE DEL NERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Daniel M.Cr ey,CPCU,Vice President ResiduatMarket-WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD.name and logo are registered marks of ACORD t Construction Supervisor Specialty Restricted to: CSSL-RF-Roofing CSSL4VS-Windows and Siding Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Constructio 'tdOtuss-or Specialty v SSL-099828 4pires:06/01/2020 Failure to possess a current edition of the Massachusetts TED L HITCHCOCK 2 QUINNS WAY x > State Building Code is cause for revocation of this license MASHPEE MA 02649 ` For information about this license q f$T � • _it�� ' Call(617)727-3200 or visit www.mass.gov/dpi Commissioner CL GF IME The Town of Barnstable snaxsTasi.E. 9 �a3�. Department of Health Safety and Environmental Services �A .0 �En wu►�" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner April 21, 2000 Dr. Lawrence McAuliffe Cape Cod Cardiovascular Associates 51 Main Street Hyannis, Ma. 02601 Re: Captain Allen Brown House Dear Dr. McAuliffe; It has come to my attention that Daniel McAdams, a neighbor of yours in Hyannis, recently applied for approval to relocate the Captain Allen Brown house. Apparently, Mr. McAdams owns the property directly across the street form your medical complex. In addition, I have been made aware of a letter submitted by you to the Hyannis Historical Commission acknowledging this proposal. The text refers to the prohibitive expense and time constraints as factors in your decision to create this arrangement with Mr. McAdams. I must inform you that because the original site plan included this facility, the removal of this building dramatically impacts your approved site. This scenario also creates a number of unanswered questions. Although, I don't wish to discourage an innovative and cooperative solution, I must advise you to return to Site Plan for approval. You should be aware that the permitting process is subject to and contingent upon site plan approval. Therefore,both projects shall be held in abeyance until this matter is resolved. With this in mind,you are respectfully advised to submit a revised plan and petition for a new hearing. Your attention to this matter is greatly appreciated. Sincerely, Ralph Crossen Building Commissioner The Town of Barnstable '+ sARNSTABLE, 9� 1639. Department of Health Safety and Environmental Services Building Division - 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner June 6, 2000 Lawrence McAuliffe, M.D. Cape Cod Cardiovascular Associates 51 Main Street Hyannis, Ma. 02601 Re: Site amendments/relocation of Capt. Allen Brown House Dear Dr. McAuliffe; This letter is to confirm that I have reviewed the proposed changes to the Cape Cod Cardiovascular project, including the relocation of the Capt. Allen Brown house with Attorney Patrick Butler. I am in agreement that these changes are minor and incidental when considering the entire scope of the project. I:am now satisfied that the proposed amendments shall not adversely effect the project or neighboring area in anyway. With recognition of this,please be advised that you are welcomed to commence work and apply for all necessary permits. Sincerely, .009"', Ra ph Crossen Building Commissioner t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION .. Map 3 `foZ Parcel 03We Application # Health Division Date Issued Conservation Division Application Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic OKH Preservation /Hyannis Project Street Address 51 Village ao n ni S , MA- �C�b2�v( �,, Owner C aL . /Y)r nh CAP, % Sw R�bdl ireSs�``�+ P @mom M�F Telephone 5o& '7 3 7 - &71 Permit Request q2p laCSL —Scc m-g— Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlaya Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documtation. 4- Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other I CD rn r-- Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use _ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name K 2 1�6u. r 2 Telephone Number 50b� 7?5-- I T)k Address 1��1 )k VIAS to we License # C5 �toY3 <<S, MA og.(,2 4 t Home Improvement Contractor# C b 3 7S 7 Worker's Compensation # &�C 700y`7g3G(a.GJ6 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �Clr r SIGNATURE DATE t Oti I FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. . ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING I� U G DATE CLOSED OUT ASSOCIATION PLAN NO. 'Town of Barnstable ,. Regulatory Services 'M Thomas F.Geller,Director fn.19 ��� Building.Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete, and Sign This Section: If Using A Builder as Owner of the subject property hereby authorize Sor,'nkAI e to act on my behalf, in all matters relative to work authorized by this building permit application for (Address of Job) -71CJ Signature of Owner - Da 1 i e�al, b A15 Print Name If Property Owner is applying for permit please complete thef ' Homeowners License Exemption Form on the reverse side. Q:FO RM S:OVV NERPERMISSION The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information 'i Please Print Leeibly Name(Business/Organization/Individual):S(1 r,►)K-t2 tt W Zcrn Address A ,_&,r✓1S bJ2 City/State/Zip: 4VIAt5 Ma od(001 Phone* 5C4- -7 7.5 1-7-7 g Are you an employer?Check the appropriate box: Type of project(required): 1.t� 1 am a employer with�_ 4• ❑ I am a general contractor and I have hired the sub-contractors 6. ❑New construction employees(full and/or part-time).r. 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance.= required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions ' officers have exercised their 11. Plumbing repairs or additions 3.❑ I am a homeowner doing all work ❑ g � myself. [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.R3 Other R"Ia m Q,`ncra.JS comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that Is providing workers'compensation Insurance for my employees. Below is the policy and job site information. (� Insurance Company Name: Q SSO C�& . I_rANL f 4GS Policy#or Self-ins..Lic.#:AUc 700 9 9 q 301 kb[0 Expiration Date: ni 10( Job Site Address: 51 YYIc, A, S fr f j City/State/Zip:AQ VL y1 L S: m A t2 Co o Attach a copy,-of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investiptations of the DIA for maumrae coverage verification. I do hereby t and ns and penalties of perjury that the information provided above is true and correct Si nature: Date: ' a Phone#: 775- I-A Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: R� CERTIFICATE OF LIABILITYINSURANCE . OP ID Ds' °ATE`MM/°°"'"Y' m SPRIN-1 01/05/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Bryden & Sullivan Ins Agency '. - HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 88 Falmouth Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis MA 02601 „ Phone: 508-775-6060 Fax:508-790 1414 INSURERS AFFORDING_ COVERAGE NAIC# INSURED _ INSURER A -- --_ T 1..° Associated Industries of MA - _ INSURER B.." - ---- — ,--E-, � Spprinkle Home Improvement Inc wsLiReR C 139 Barnstable Rd INSURER D "* Hyannis MA 02601 4 ------- — - --#--__ — - - INSURER E — - COVERAGES : THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY ISSUED OR: ;- . MAY PERTAIN;THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN iS SUBJECT TO ALUTHE TERMS.-EXCLUSIONS.AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR NSR TYPE OF INSURANCE POLICY NUMBER i DATE MM/DDIYYYY DATE MWDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE - a -- COMMERCIAL GENERACLIABILITY 'f "� :•'j PREMISES(Ea occurence)4 $ CLAIMS MADE OCCUR f' MED EXP;(Any one person), $ ' PERSONAL&ADV INJURY $r GENERAL AGGREGATE` S. GEN'L AGGREGATE LIMIT APPLIES PERT• ' .k t v I w 3 "PRODUCTS-COMP/O—P G$` POLICY. " I PRO- LOC a — -- f JECT AUTOMOBILE LIABILITY ' COMBINED SINGLE LIMIT a ANY AUTO? ' Ea accident) $'; kr ALL OWNED AUTOS rY = BODILY INJURY a SCHEDULED AUTOS. _ ` * , (Pei r person) $�, HIREDAUTOS 3' g t a3 s I, ODILY INJURY r. (Per accident) I NON-OWNED AUTOS.. # i $ _ - PROPERTY DAMAGE, a "''i' r i •� I,- '` ,` - (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT, $ ANY AUTO „a .h_ 3. .. y`E 'OTHER THAN A ACC! AUTO ONLY: AGG :EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE, $ OCCUR 'F CLAIMS MADE{ A AGGREGATE $ _ DEDUCTIBLE. — RETENTION $ WORKERS COMPENSATION a. TORY LIMITS ER' AND EMPLOYERS'.LIABILITY. M f YIN j> ANY PROPRIETOR/PARTNER/EXECUTIV ' AWC7OO4943O1ZO1.O O1/O1/1O= E L EACHCCIDEN j ,O1/O1/11 AT $SOOOOO OFFICER/MEMBER EXCLUDED? " — (Mandatory in NH) _; , , " .r�, _: � E.L.DISEASE•EA EMPLOYEE S SOOOOO SPes If yyes,describe under :- . IAL(PROVISIONi�61ow '� a _ �E.L.DISEASE-POLICY..LIMIT $.500000*- - OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/,EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER ` CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Yl SPRN<HO *DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL'S O^ DAYS WRITTEN x: g s NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL. Sprinkle Home Improvement,- InC' » , _ ,,, •• IMPOSE NO OBLIGATION OR CIABIUTY OF ANY KIND UPON THE INSURER,ITS AGENTS OR� Fax #508-775-1350 REPRESENTATIVES. Margo Mack AUTHORIZED REPRESENTATIVE 199 Barnstable Rd. Kelley A.Sullivan annis MA 02601 ACORD 25(2009101).., ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Dep-artment of' puhltt `,rtcn 1. E3o,u+.1 rrF l rniclin Re"ohitions and >tan�l a rl; ' Construction Supervisor License License: CS 6643 Restricted.to: 00 BRADS K SPR•INKLE. 19.0 LOTHROPS LANE W BARNSTABLE MA 02668 Expiration: 10/8/20.11 ('irnmi. i..mc•r Tr4: 5478 Restricted to: 00 00- Unrestricted 1G-1 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Refer to: WWW.Mass.Gov/DPS' is Ce.�omr�mo�uueaa.!f� o�✓�«clurdel�' , Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Re01st(J§S 103757 r _..._ 9/2010 W# :17103:3 4 ' —_ to Co,FRbr"Etot SF'Ft1C5lc'L>i.-hi0 FmNC. =6ratl E,pr+tele to 109 Ba iastd. a Rd 404 " , •L�etase., r regts r ry .., 'heforeahe expiratio�i: ate If founts return to $oard of-8uilding regulations and Standards one Ashburton Pace Rni 1301. . Boston .021:08' t; ` Not trglid wit out Sig t`ur-e Page 1 of 1 Shea, Sally From: Lt. Don Chase [dchase@hyannisfire.org] Sent: Thursday, December 23, 2010 4:53 PM To: 'Brent Heinzer' Cc: Shea, Sally; Perry, Tom Subject: RE: Quest Diagnostics 51 Main Street Hyannis �. Brent, Plans look ok.There looks to be two horn strobes added on the proposed drawing—A101. A permit will be needed for changes to the fire system. Reading the General Notes on page A101 (item #25) states sprinkler to be provided and installed. Is this planned or just "boiler plate" notes? Have a nice holiday. Thanks, Don Lt. Don Chase,Jr., FPO Fire Prevention Officer Hyannis Fire Department 95 High School Rd. Ext. Hyannis, MA 02601 (c)508-648-5806 w 508-775-1300 x106 From: Brent Heinzer [mailto:bheinzer@bthassoc.com] Sent: Wednesday, December 22, 2010 11:40 AM To: dchase@hyannisfire.org Subject: Quest Diagnostices - 51 Main Street Hyannis Don, Attached please find a PDF file of construction documents,for your review and approval,for the above mentioned project. If you have any question please give me a call. Regards, Brent Brent T. Heinzer, R.A. President B. Thomas Heinzer Associates, Inc. 975 Merriam Avenue, Suite 201 Leominster, MA 01453 (p) 978.466.6560 (f) 978.466.6565 www.bthassoc.com 12/28/2010 Assessor's map and :lot 'number ....:...��5 .y� . `3� Sewage Permit number ............ ................................. k T"ET°��o N TOWN OF BARNSTABLE Z -BASB9TeDLE • G 1 .f 7i "A ` i63qi. DUILDIHG INSPECTOR �� OD . , r 0 YPY{► to 1 •4 ` Af�PLICATION� FORS PERMIT TO .. /( J.v.d.. .. S ........... G...�".....1. r; �. ` TYPE OF CONSTRUCTION ..........w....... .. . ..... ...................... . ........................................... ... ........ TO THE INSPECTOR OF. BUILDINGS: The undersigned hereby applies for a permit according to he following information: Location / f L S /........... � f /✓/V,�`1...............................�....ry..��� .d.11/�{/......: ProposedUse .............................................................................................................................................................................. ZoningDistrict ...�..j..n...>.�.....y....................................... ...............Fire District .........,/...:................................................................. Name of Owner ^�./.�.�7.!,14N...���L�� 1 .O. Add ress,3d4 ill Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ...............................4..................................Foundation .............................................................................. Exierior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior . .................................................................................... Heating ...........................Plumbing ............................................................ Fireplace ..................................................................................Approximate Cost ...................................................... Definitive Plan Approved by Planning Board ________________________________19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee ............. SUBJECT TO APPROVAL 'OF BOARD OF HEALTH � k ' I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam r . .. ... .....f . ...l�s i �� Braman Realty Trust - ` 18066 ' ' demolish buildings ' No ................. Permit for.-----------.. . .---------.-----.-----.-----. _ .~ 49 'East Main Street Location --------.----.-------- - ( ; ` Hyannis .----.---------------------- ` ` Braman Realty Trust � O^wna, ......................................................... . / . ~ frame Type of [onstrucdon ............................. ---- , —.---~-----.---------------. . . - � p�� -----.�-- �� . ~ —.. ----------.. ` _ . Permit Granted -- 2O—'—.lA 75 - � Date of Inspection .....................................lq ` - ~~~- -� ^ Date Completed —`�z������-----'lg7�» � ' ' PERMIT REFUSED ' ( ,---.---..—..�.---_-----. lV . ` -'---'------------~---'------ � ........................................ --'-------'--- ' ....................................... -------..—^��--...—.-----..--,—.—` ' ' Approved ................................................ lQ -------------------------... ` . � . ----.---------------------.. . ` - Assessor's map and lot numberR./. ......:..'......... SeL-c-e--1 f , 7 - ' I -r - A- THE < L�l- � - IF, - el -j C 7-0 Sewage Permit number .......................................................... ro BARNSTABLE, House number .............;.............41,-17-7 NAM 11639' CA 16 1A, TOWN OF BARNSTABLE BUILDING INSPECTOR CO... APPLICATION FOR PERMIT TO . uct a Professional 11. .... n.S.t...r...................................................................................�1...... ............ TYPE OF CONSTRUCTION ...............1.aa:L.:7 -2 rc4 ............................................................................................... ..................:5... ...... 19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......!ai.n...S.t..re...t.....(Bet.w..e...en. .P..ar.kw...a...v.....P.lace...&...Yell.o...w.'. B..ri.c ,...Road.)............................ Proposed Use !iedical Off-ice ...........................h.................................................................................................................I......................... Zoning District ;Ilrofessional Residental ......................................................................Fire District ... ........................................................ Dr. Laurence Rlieingold 28 Otter Lane, Cummaquid, MA Name of Owner Dr. Jack Chalf:. ............................Address n ..................................... .................................................................................... John B. Lebel Construction . Name of Builder' ..................................... ................Address e i-1A 02655 Name of Architect rml.r. ...5-I-t�-AbAU�E .... ...Address :suites -Lnc 02061 Number of ;R66rh's ..........t?.....................................................Foundation ........................... . I Flat-Carlisle Exterior ........ ................................................Roofing ....... ....SA F. K..................... Floors ....... P. I? n C-.1 .....................Interior ....... -.nr) ......................................................... Heating ...... .......................................................Plumbing .....2... .............................................................. Fireplace ..�>in- Approximate Cost .............................................. Definitive Plan Approved by Planning Board -----------------------------19---I---- Area ... ......... Diagram of Lot and Building with Dimensions Fee ..RFZ.45. .................... SUBJECT TO. APPROVAL OF BOARD OF HEALTH C—I N V pi OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and.Regulations of the Town of Barnstable regarding the above construction. zlz Lyc) Nameli.......................... . .......... DR. LAURENCE PHEINGOLD & DR. JACK QHP-�L.FIN A=342-33 ;..� 3qZ-43 No ,.26371 Permit for PROFESSIONAL BLDG. ......... EDICAL BLDG. ................................................................... Location ..,49 East Main Street ................................................ ......................yannis........................................... Owner ..Dr. Laruence Pheingold & Dr. Jack Chalfin Type of Construction ...Frame .............................. ............................................................................... Plot ............................ Lot ................................ Permit Granted May 2, 84 Date of Inspection ....................................19 Date Completed 1 3 F Assessor's map and lot number ...............4!."......'..... .. ! Sewage Permit number .......................................................... �Qy�FTMEt��o TOWN OF BARNSTABLE ro � Z BJHHSTSBLE, i "039. •�Cb _ BUILDING ' INSPECTOR v ��..�/�1�........j................................... ..... .......... ..,.....,.........,...... APPLICATION: FOR PERMIT TO ..... .......:......... 4 T . (f 0/) TYPE OF CONSTRUCTION TO THE INSPECTOR OF BUILDINGS: The undersigned herebyherebby` applies/flfoo�r'' a permit according to the following information:. , 4 •/ . T / VA J 17 'Jyi° Location ..... .. .... .. ........................ ..... ......: .......................... ............... ....,...,........... ProposedUse ............... .......................................................................................................................................................... V ZoningDistrict .........................................................�...............Fire District ................................................................................. Name of Owner ft� /`1 1/1�...f � l %..y....�fi,��:57'.Address ....../,'� S,!;f-/F�1....: !:... )),4'�1'�.... Nameof Builder ....................................................................Address ..................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof .Rooms .................................................:................Foundation .............................................................................. Exterior ....................................................................................Roofing .....................................................:.............................. Floors .Interior ................. Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost .................................................................... Definitive Plan Approved by Planning Board ________________________________19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD Of HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. . Name...• ../ . � :'c c� `..`.1?o5 %_ E Braman Realty Trust A=342-.33 No 18066 Permit for ......d.emo.1 i.s.h...buildings ............. ......... ............... ................................ Location 'gl -,44-**E s.t Main .f t$tree ............... ................ ....................... ............Hyannis.................. .............................. Braman My Realty Trust Owner ............................ ..................................... frame Type of Construction .......................................... ....................... ........................................................ Plot ...........................��Lot ................................ n 1*s Braman ........ .................... Permit Granted .......Noxembex.. . .........19 75 10 Date of Inspection ................. ..................19 Date Completed .......................................19 PERMIT REFUSED . .......................... ................................... 19 ........................... .....—.1 ............................ f !.. .l./ ............................. ............................................................................... ............. Approved ............. .................................. 19 . . ............................................................................... ............................................................................... kL