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Home My WebLink About0540 MAIN STREET (HYANNIS) (23) - PHYSICAL THERAPY 200806919 ST- 121 - - - _ S� 7�5-evy -IlkTOWN OF BARNSTABLE BUILDING PERMIT APPLICATION,,,,_, Map Parcel 6 `� pplication# . 00 U Health Division Date Issued Conservation Division pplication Fee Planning Dept: .Permit Fee Date Definitive'Plan Approved by Planning Board P Historic =OKH; Preservation/ Hyannis Project Street Address S Ab MASH ' uN rt 0 Village AYAMht6 Owner LUC. Address _Sys W1iAt" Isr Telephone_ C `178 V?60 Pe1>irmit Request S,100 t Mrygac rf� Now STVek3C UTA& $UtI,06A - Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater.Overlay Project Valuation 4a600 Construction Type Lot.Size Grandfathered: ❑Yes Flo If yes, attach supporting documentation. Dwelling Type: Single Family r,❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes YNo On Old King's Highway: ❑Yes CQl` o Basement Type: ❑ Full ❑Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.), Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new ?w A PA- Half: existing new Number of Bedrooms: 2 existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: 9Q Gas ❑ Oil ❑ Electric ❑ Other Central Air: *3 Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size"jj�Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size )*Other: r Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ ED � =y Commercial ❑Yes ❑ No If yes, site plan review# `—" ` ' Current Use Proposed Use APPLICANT INFORMATION. - - -- - - ` (BUILDER OR HOMEOWNER) Jdlnn�il�In►NS Name (\(%ttS10C COW'' 08910A1G 14AGA' Telephone Number 7774 238 84k 1 Address —P•U �' 1$� License # 0\t&O Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNAT RE DATE 1 3- Ml 08 1 FOR OFFICIAL USE ONLY APPLICATION# 4DATE ISSUED MAP PARCEL NO.. ADDRESS VILLAGEt-2 E OWNER .01 DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL&I PLUMBING: ROUGH FINAL -v GAS: ROUGH FINAL FINAL BUILDING th DATE CLOSED OUT ASSOCIATION PLAN NO. . -(/LG LV/!A!!AVlL ryG!-LALIL VJ - Department oflndustrirdAccidents Office of Investigations 600 Washington Street Boston,.4M 0211 www.mass.gov/die Workers' Compensation Xusurance Affidavit: wilders/Contraetors/Electri.cialas/Plumbers .Applicant Information Please Print LeLyibly Name (Business/Organization/Individual):O(GAMSO1MC_C6 tIS917 I (fti 1 Address: aboo City/State/ZT: ka AM" MI � - Phone 23PA Are yo an employer? Check the appropriate box: Type of proj ect(required)-: 1 am a employer with- 4. ❑ I am a general contractor and I * have hired the sub-contractors 6, ❑ New construction employees(full and/or park-.tiro.( El I am a •sole proprietor or partner- listed on the attached sheet 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees arid have workers' • Y P" y 9. ❑ Building addition [No workers' comp,-insurance comp. insurance.$ required] 5. ❑ We are a corporation and its l0:❑Electrical repairs or additions officers have exercised their 11. Plumbing re airs or additions .❑ I am a homeowner doing a1lwork ❑ g P 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.❑ Other comp.insurance required_] ny applicant that checks box to must also fill out the section below showing their workers'compensation policy information. lomeovmcrs who submit this affidavit.indicating they are doing all work and then.hirc outside contractors must submit a new affidavit indicating such. ontractors that check this box must attached an additional sheet showing the name of the Wb-contrartors and state whcthcr or not those entities have iployces. If the sub-contractors have employees,they must pi-mridt their workers'comp.policy number. un an employer thcd is providing workers' compensation insurance for my employees. Belaty is the policy and job site Formation. - ;urance Company Name: licy#or Self-ins. Lic. #: Expiration Date: Site Address: S40 MAIN City/State/Zip: d�d` tack a copy of the workers' compensation policy declaration page(sbowing the policy number and expiration date). ilurc to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a e up to 51,500,00 and/or one-year imprisonment;as well as civil penalties in the form of a STOP WORK ORDER and a fine up to $250.00 a day against the violator. Be advised that a copy of this statement may be fom'arded to the Office of estigations.of the DIA,for insurance coverage verification. o hCeby de he ains•and penalties of perjury that the information provided above is true and correct na Date: eL Me#: -?fficial.use only. "Do not write in this area, to be completed by city or town officiaL --ity or Town:` Permit/License# - - :ssuing Authority (circle,one): Board of Health 2.Building Department 3. City/Town Clerk 4.EIectrical Inspector 5..Plumbing Inspector Other ,ontact Person: Phone#i 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'a2t individual partnership, association or other legal entity, employing employees. However the owner of a dwelling house`hafdia g{i,Ts? a'��'t�t''inn e'apart ents,A, hQ resides�th ere+d or the occupant of the i tit . . 4 t r dwelling house of another who emp oysjpersonS 1`o°do maintenance, co tfuctio�t W"6Pa v�gk.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 thata 1 tkMeryltatii or4o_zv ?al,dicensi.ng agency shall withhold the issuance or renewal of a license or permit to operate a business or to conhruet buildings in the comnian ve?ayl h Qd at t"' 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 anti; acceptable evidence of carapliance�dth 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,.supplysub-contractor(s)name(s), address(es) and phone niunber(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 carryvrorkers' 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 pemut 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 niunber 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 Icgibly. 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 numbcrphich will be used as a reference number. la addition, an applicant that must submit multiple permit/license applications in any gii en year need only submit one affidavit indicating current • . �v licant should write"all•to a t + ,.*. , or, policy information(if necessary and url`d'et X ,Site Address fhe app ; , , town)."A copy of the affidavit that has been officially stamped or marked by the city or town may` e provided to each applicants p as that a valid affidavit is on file for future.perznits or licenses. A new affidavit must be filled out ea 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 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 The Coinmoz wealtla of NlassaGhusefts Departmamt of Industrial Accidents Office of Znves-ftp-h.ous 600 Washington Street Boston, MA 02111 Trl. # 617-.727-4900 ext 406 or 1-877-MASSAFB Fax# 617-727-7749 ased 11-22-06 WWW.Mass,gov/dia THE T • �,. ,yam Town of Barnstab,le LiARN3rAHLE, ' * _ Regulatory Services AIFb �p 'Thomas F. Geiler,Director Building Division Thomas Perry, CBO Building.Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508162-4038 Fax: 504-790-6230 Property Owner Must Complete.and Sign This Section If Using .A.Builder as Owner of the subject property :-eby authozize VIU}teW Ns to act on my behalf, tll matters relative to work authorized by this building pernut application for: Soh ffiA to 51 t (Address of job r e of Owner Da e .t Name 'FILES\FORMS\building permit forms\EXPRESS.doc ;e020108 Town oi- Barns.taole Regulatory Service Thomas F. Geiler,Director « BA.RNSTABLE, 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 HOMFOWNFR LICFNSF EXEMP-TION Please Print DATE: JOB LOCATION: village number street "HOMEOWNER": work phone name home phone�/ P CURRENT MAILING ADDRESS: city/town — — state zip code The cuarent exemption for"homeowners''was extended to include owner-occupied dwellings of six to its or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as suueivisor, DEI+INITION OF HOMEOWNER person(s) who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to r be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm stnrctur ,...�A-- ��',Y "%,.;I person who constructs more than one home in a two-year period shall not be considered a homeowner. "homeowner" shall submit to the Building Official on a form acceptable to the Bu�lgir Q�ffi aialr that be/shQ shaoll be " re,s onsible for all such work performed under the building pernut;__(Section 109.1.1 f The undersigned "homeowner" assumes responsibility for compliance With the State Building.Code and other applicable codes,bylaws, niles and regulations, - li i 9 ♦ . The undersigned"homeowner"certifies that he/she tuiderstantd�l��iwPfuld>, '� iryt3ncnt A Elul minimum inspection procedures and requirements and that lie/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings contanung 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 log.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire told su'h 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 otlen'results in serious problems,particularly vihen 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 oft he 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/certifica6cin for use in your community. Q:\WPFILESTORMS\homeexempt.DOC r JUN-26-2008 12:34 PAUL PETERS MASHPEE 5084776498 P.002 ACORD. 3/18/2008 PRO�lCEII TM TE IS A3 A MATTER RMA'nON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICAY E Paul pt�g A ODOy,1n� MOLDER T{B6 CERnFlCATE noEs NOT AMEND.ExMb 04 680 Falmouth Rosd AL.M THE COVERAGE AFFORDED BY THE P01.3011E3 BELOW. MAskpec,MA 02649 COMPAMEG APP COVERAGE c z—ww A Admxdc Qmrla lnsumce VDAC OWANY VCeanside Cant cdon,Inc. 0 COWAMI' ` 419 Rivet Road C MaMns Mills,MA 02643 oowANY D TNB*TO CERTIPY 7NAr THE POU=OF WILMNCE LILTED BELOW NAVE BEEN MKW TDTLIE INSURED NAMED ASOK FOR?NO POLICY PERIOD NDICATEL NOTVMWANOINC AMY REQUIEMENT,TERM OR COMMN OF ANY COMRACT OR OTM D=EWr WITH RMPEGT TC WMCH WO CER7i9CATE MAY=ISL;M OR MAT PSLTAIN,7HE MURMOC APPoRD>:D BY THE POLM A OEOMM HEREIN O VUVJ GT TO ALL THE TERMS, ExeLumoN9 AND cohor mw or 11uCH PDL.I um Lmm mom MAY HAwl i92N RL VA IM AY PAID CLAIMS. co YTPsoRDBURANC! ►oUCNUMM POLZVEMCW4 PDLur MTV LTR DATE plume" DATA PMVDD M P yrmww do sENOW UADRM EODILY va mom s WmPRD1msrm MW BODILY KRW ACG i PRcmivE=pERATIONS PROPBA7Ymwrmow s UNMUROUNO PRQMWV GAMA66AUG a EXPLOSION a COLLAPSE KVARO N A PD COMN E:D OCC s PRODUCIMU MPLETED OM I R A PO COMOR40 AGG a PERSONAL ULIURT Apc A INV"DW CDNiRACTORS BROAD F004 PROPWIT DAMAGE PERSOMM INMRV ,LUTOnoalue iIABILTfY •Op1Lr INnIRr ANY&M � (POf OlJ00P1 a ALLOWNt;nk=0w'A vsesp soapyINJUw ALLOWNOAVM j fPeaA�denu a lover elan Pmmle Psmenoa! I MRCD WT4s I PrOMM'D"Ga a I NON-OWNEDAUM ; eOOAr IR�IIRY a GARAGG UAELIV I PROPERn'BAI�ADE caren,ED a avcm MINIM I.: EACH oawRREN a LAVIREL APO W i AGGAMATE S OTHERTHM/VN3ARIAK�RM i s waraFMOCCgB,lATIDMAM6 i WCV00617203 2/3/2008 - 2/3/2009 RrLeurs s 1 000000 a�Lv.eTrswwl►nY tr*M•POucr Lw ft s 1,000,000 j *$"$o.aacr, wry s 1,000,000 anaa,e nescrlornam OF DPeMTNx1 *rA "EMS SMOW D ANY Or THE ABOVE aL6 MOM rO"-g BE CANC�D BEFORE THE Tovan Of Ba nslable EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MA0. A,tIn-Sally Shea I 12 oays wRn-EN NOTICE TO THE�T�ICATE HOLDER NAMER Tp TNH LEFT. r 200 Main St 8LIT FAILURE TO MAIL SUCM NOTICE SWILL IMPOSE NO OBLIGATION OR LLASILWY Hymais,MA 02601 OP ANY KIND UPON THE COMPANY.ITS AGENT OR R RESENTATIVES. AUTNORM PAPMORAIN L I Z00/L00 9HIIIa&I ONIQ L09980VLL9 XVJ 06:8Z 90OZ/LL/EO TOTAL P.002 L_ • C r =• Massachusetts - Department:of Public Safety Board of Building Regulations and Standards Construction'Supervisor License License: CS 48102 Restricted to:, 00 JOHN J HUTCHINS 419 RIVER RD MARSTONS MILLS, MA 02648 (Y Expiration: 9/16/2010 ('ununissiuncr Tr#: 4320 i i CERTIFICATION: r P� q ✓ f 41Y5 ° N 0. 1935 � a CONSULTANT LOGO: LA - - - - - - - - - - - - - - - - - - - - - - —i— - - - - - i 0 TREATMENT ROOM = TREATMENT ROOM TREATMENT ROOM STORAGE /� MEN / \� 10'-0"x 12'4" 4 V-0"x IV-0" 4 s'-o"x 10'-0" , " _ " WOMEN a o x 10 o I r o°x s'�" I T-0"x s'-7" 101-011 10'—V" 10'-0" 6'—V" r 1 7'-01 k 4 IL — — — L - - -r-j i d� s� THIS DRAWING IS A PART OF AN INTEGRATED SET OF CONSTRUCTION CONTRACT DOCUMENTS. REFER TO i ALL DRAWINGS AND SPECIFICATIONS INCLUDING BUT NOT LIMITED TO"GENERAL CONDITIONS", "SUMMARY OF WORK"AND ANY APPLICABLE i MANUFACTURERS TECHNICAL SPECIFICATIONS. REFER TO ALL OF THE DRAWINGS FOR COMPLETE` SCOPE OF WORK. THIS DRAWING IS NOT TO BE SCALED AND/OR USED AS AN AS-BUILT. o TREATMENT ROOM 10'-0"x 12'-0" i s REVISIONS 12'-0" i No. DATE DESCRIPTION d 01 11-10-08 REVISED COMPLETE LAYOUT HALF WALL 4'-0" HI6HT v 12'-0II " o STAFF ROOM d�, 8'4'x 12'-0" TURF ROOM i PROJECT NAME: i 12'-0" m i FIVE HUNDRED BLOCK f ERR MANAG 00M HYANNIS 14'-0"x 12'-0" NORTH STREET BUILDING Q HALF WALL i 5'-0" HIGHT i _ Q �r i i i 8'-O" A 101-0" Ar WAITING I PREPARED BY: i COL. m ENTRANCE CD CLINIC ANAGER ROOM Q 10'-o"x 10'-0 i i ARCHITECTURAL DESIGN Jefferson Group Architects, Inc. 700 School Street Unit 2 Pawtucket,RI 02860 Phone: (401)721-2245 Fax: (401)721-2238 ❑ i • ❑ SHEET TITLE: i PHYSICAL THERAPY OFFICE FLOOR PLAN 1 PHYSICALTHERAPY OFFICE- FLOOR PLAN ��8SCALE: 1/4"=V-0" i L JOB NUMBER: 2008 05 .7 . k GENERAL NOTES: DRAWN BY: STM I. THESE DRAHIN65 HAVE BEEN COMPILED FROM THE BEST AVAILABLE INFORMATION AND ARE NOT INTENDED TO 10. ALL INTERIOR HALLS SHALL BE TYPE I UNLE55 NOTED OTHERHI5E. LIMIT THE 50OPE OF THE kJORK. THE CONTRACTOR MAY.EN000NTER HIDDEN OR COVERED CONDITIONS, NOT CHECKED BY: STM INDICATED IN THESE DOCUMENTS, REQUIRING THE CONTRACTOR TO PROVIDE ADDITIONAL HORK FOR THE 11. THE GENERAL CONTRACTOR SHALL COORDINATE WITH THE OWNER ART HORK LOCATIONS AND PROVIDE FIRE COMPLETION OF HIS OR HER CONTRACT. IT HILL BE A55UMED THAT THE CONTRACTOR HAS INSPECTED THE SITE TREATED IN-WALL BLOCKING A5 REQUIRED. DATE ISSUED: AGU.27,2008 y P PRIOR TO BIDDING AND VERIFIED THE INFORMATION SUPPLIED HEREIN. 12. PROVIDE I/2" DENS-SHIELD MOISTURE RESISTANT WALL BOARD SHEATHING AT ALL RESTRODMS AREA WALL 2, THE GENERAL CONTRACTOR 15 REQUIRED TO FIELD VERIFY ALL EXISTING CONDITIONS AND/OR DIMENSIONS PRIOR LOCATIONS. SCALE: Noted TO THE START OF CONSTRUCTION AND IDENTIFY ANY DISCREPANCIES TO THE ARCHITECTS AND DE5IGNER5 13. ALL DIMENSIONS ARE TAKEN TO FACE OF FRAMING UNLE55 OTHERN15E NOTED.AT AREAS OF MA50NRY 3. THE GENERAL CONTRACTOR SHALL COORDINATE ALL STRUCTURAL, MECHANICAL 4 FIRE PROTECTION 5Y5TEM5 CONSTRUCTION , DIMENTION5 ARE TAKEN TO THE FACE OF MASONRY,UNLE55 OTHERWISE NOTED PRIOR TO THE START OF CONSTRUCTION 14. PROVIDE PRESSURE TREATED HOOD AT ALL FRAMING LOCATIONS WHERE HOOD 15 IN CONTACT WITH CONCRETE. 4. ALL HINGE 51DE OF DOOR FRAMES SHALL BE LOCATED 6" FROM IN51DE FACE OF WALL FRAMING UNLE55 NOTED 15. ALL PLYWOOD 5HEATHING AND CONGEALED IN-HALL BLOCKINO SHALL BE FIRE TREATED i OTHERWI5E. 16. OMIT GYPSUM HALL BOARD 5HEATHIN67 ON THE CHASE 51DE OF ALL NEWLY CONSTRUCTED HALLS. 5. ALL HORK SHALL CONFORM TO ALL GOVERNING CODES AND ORDINANCES UNDER HHICH THEY ARE PERFORMED. 11. ALL PENETRATIONS THROUGH RATED HALL ASSEMBLIES SHALL BE TREATED WITH AN APPROVED "FIRE5TOP" 6. THE GENERAL CONTRACTOR SHALL LAY OUT ALL WORK AND BE RE5PON51BLE TO VERIFY ALL DIMENSIONS 4 MATERIAL TO MEET THE SPECIFIED HALL CONSTRUCTION. DETAILS PRIOR TO 5TARTING CONSTRUCTION. 7. FIGURED DIMENSIONS TAKE PRECEDENCE OVER 50ALED DRAWING5,EXCEPT WHERE NOTED 8. IT SHALL BE THE GENERAL CONTRACTORS RESPONSIBILITY AS COORDINATOR TO CHECK ALL DIMENSIONS AND DETAILS ON SHOP DRAWINGS BEFORE SUBMISSION TO THE ARCHITECT. 9. THE GENERAL CONTRACTOR SHALL COORDINATE AND VERIFY WITH OWNER THE LOCATIONS OF ANY INTERIOR AND EXTERIOR MUSIC AND/OR PAGING SYSTEM,CONTROL PANE15,5PEAKER5,ASSOCIATED EQUIPMENT,ETC. AND SHALL COORDINATE THE INSTALLATION ACCORDINGLY WITH THE ELECTRICAL CONTRACTOR. SHEET NUMBER: SHEET SIZE:30x42 Al 0 8 ......--------- � I