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1189 PHINNEY'S LANE
t/ S9 � } `i I PROJECT _ NAME: �� C ADDRESS: 6�K V, PERMIT# c> 3 PERMIT DATE: 7 M/P: y LARGE ROLLED PLANS ARE IN: BOX SLOT Data entered in MAPS program on: 3 3 BY: q/wpfiles/forms/archive ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION t 41 15 Map 2- 7 Parcel G 20 Application #9 v Health Division Date Issued Conservation Division 15 Application Fee Planning Dept. Permit Fee 60 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address f h pt ' Village �, 6 �- YA44 N-r-zS f nn p Owner lawrr o`er F �^���.�o Address /%wt Telephone 56< _-7o 0- e� Permit Request •� tJ' � �;,o b cd �� „ s� 4A©oe/ & , Square feet: 1 st floor: existing&oadproposed 2nd floor: existing proposed: Total net 060 Zoning District Flood Plain Groundwater Overlay '` , Project Valuatior5�� 0��®( !Construction Type �� Lot Size Grandfathered: ❑Yes ❑ No If yes, attach su porting docurWentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure '9 f Historic House: ❑Yes )(No On Old King's Highway: ❑Yes VNo Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑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 0alr�c<e, /�' �+ �, Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �C a 11L . /T l h.���S Telephone Number T_O g—3 Z T G l 7 Address l 30 License # 3 [ Mat Tt a26 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE J FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ' ADDRESS 7 VILLAGE - = OWNER } _ DATE OF INSPECTION: f I FOUNDATION FRAME INSULATION r FIREPLACE ELECTRICAL: ROUGH F FINAL r. PLUMBING: ROUGH FINAL F GAS: ROUGH FINAL FINAL BUILDING r DATE CLOSED OUT f ASSOCIATION PLAN NO. . . ... .... ... cl Hie Coax monweakh of-Massachusetts Deparhnent of lfndresft ial Accidents o_Investigaiioris 600 Washington&reet Boston lei 02 I wnm mas&gonIdia Workers' Compensation Insurance kf'fidavit:Builders/Contractors/E;IectriciansIMumhers Apphcant Information Please PrintLep_ibly CPWSta�Zip`_ _ „ Phone 47 7CIQ 6 Are you an employer?Cheik the appropriate b°7c: Type°#project(required): 1_[ I am a employer with 4. ❑ I am a general contractor and I 6- ❑New construction. employees(full and/or part-time)* have hired the sub-contractors. ❑ I am a sore proprietor or partner- listed on the attached sheet; 7- ❑Remodeling ship and have no employees These sub-contractors have g_ ❑Demolition w for me in an ct r_ employees and have workers' orking Y� � 1 9_ ❑Building addition [No workers' comp_insurance off-insurance_ required_] 5..❑ We are a corporaticm and its 10.❑Electrical repairs or additions -o$cen hne exercised their I I_.❑Plumbin airs or additions I❑'I am a hameou�n�es doing all w°rk g mP , myself. [No workers'comp- right:of exemption per MGL 12.❑Roof repairs insurance required-]1 c_152, §1(4),and we hzwe no employees_[No workers' 131:1 Other comp_insurance requir _J. *Any appticaut that checks bam tl oust also fill out the section below slowing di&wodcers'compensatiou police wfnmafimi Homeowners who submit this sffidsvit indi cmmg they ate doing all pork and then hoe outside contractors nmA submit anew affidavit mdicat such- =Gout mcwrs that check this bcx mmt attached as additional sheet shawing the name of the s po ors m3 state trhether°root those entirres have employees- If the sub-contcactors have employees,they ist pnmde their workers'comp.policy number. -Taman employer that is prvtdrIing it�orkers'co.trgmruafion insnranca for my e.mptoyem Relotr is Ste policy and job site h7formatLum Insurance Company-Name: Pf o_1zcJ`-•r- r e� ' �•f/�So.i Expiration Date: Job Site Address: City/Stat&Ztp: Attach a copy of the workers'compensation policy declaration page(Shoving the policy number and expiration date). Failure to secure cG eraage as requiredunder Secticam 25A of MGL c. 152 can lead to the imposition ofcrimival penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as ci ril penalties in the form of a STOP WORK ORDER and a fina of up to$250_00 a.tray 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- Ida hereby certify cinder thepains and enalties ofpetjury thatthe informationprovidedabmte is bmf and correct Signature:~ � llTate" qi z C)` {Phone - OjEciai use on[y. Do not twite in this Area,to be completed by city or form officiaL City or Town: PermitUcense ff Issuing Authority,(circle one): 1.Board of Health .2.Building Department 3.City-II`owu Clerk 4.Electrical Inspector 5.Plumbing Inslector 6.Other Contact Person: Phone#: 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an erVloyee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." Au 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-Iocal licensing agency shalt withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in?the commonwealth for a.uzy applicaut.who has not produced acceptable evidence of compliance with the insurance.coverage required.-' Additionally,MGL chapter 152; §25CM states"Neither the commonwealth nor any of its political,lubdivisioas shall enter into any contract for the performance of public work until acceptable evidence of compliance wide 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 c:erincatc(s) of insurance. Limited Liability Companies(I-LC) 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 aff d2Vit 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 obUlin 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 L> e 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 pemitihm se applications in any given year,need only submit one aff davit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations M (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 co;rm- ercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a calla The Department's address,telephone and fax number: The Gommanvalth of MassachusettsDepartment of Industrial Accidents Office of ftvestigatioas 600 Washingtaa Stet Boston.,MA 02111 Tel.4 617-727-49-00 W 4-06 or 1-977 MAAASS FE Revised 4-24-07 Fax## 617-727-7749 www.massgov/dia �I E r Town of Barnstable Regulatory Services * 'MAS& Thomas F.Geiler,Director 9�i°lFDµp.Ia $ 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 J.. ��>t//�/__�1�/ , as Owner of the subject property hereby authorize �a v. �/: �- 1'.At C% to act on my behalf, in all matters relative to work authorized by this building permit (Address of job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signor 51,11 Owner Signature of A licant i r T LAC;j Print Name Print Name Dat Q:FORMS:OWNFRPERMISSIONPOOLS 6/2012 eDEP - MassDEP's OnlineFiling System Page 1 of 1 M 4'd MassDEP Home i Contact i Privacy Policy MassDEP's Online Filing System Usemame:GENERALFOREMAN Nickname:BUMBLES My eDEP: Forms My Profile Em Help Notifications Receipt Forms Signature Receipt Summary/Receipt ° print receipt: Exit Your submission is complete. Thank you for using DEP's online reporting system. You can select"My eDEP"to see a list of your transactions. DEP Transaction ID: 719202 Date and Time Submitted: 2/4/2015 1:31:16 PM Other Email DEP Transaction ID: 719202 Date and Time Submitted: 2/4/2015 1:31:16 PM Other Email : Form Name: AQ 06 -Construction/Demolition Notification Form Name: AQ 06-Construction/Demolition Notification Payment Information DEP code Date Amount($) Payment Detail My eDEP MassDEP Home i Contact i Privacy Policy MassDEP's Online Filing System ver.12.12.1.0© 2015 MassDEP https:Hedep.dep.mass.gov/Pages/PrintReceipt.aspx 2/4/2015 .V 34 Massachusetts Department of Environmental Protection L\ e®EP Transaction . copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: GENERALFOREMAN Transaction ID: 719202 Document: AQ 06-Construction/Demolition Notification Size of File: 218.98K Status of Transaction: In Process Date and Time Created: 2/412015:1:32:26 PM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality BWP AQ 06 ' Notification Prior to Construction or Demolition F This is a revision to an existing form. Project ID for existing form to be revised: f" This job is being conducted under a Blanket Pen-nit MassDEP assigned Blanket Authorization ID: F This job is being conducted under a Non Traditional Abatement Work Practice Pen-nit. MassDEP assigned Non Traditional Work Practice Authorization ID: 17 None of the above conditions apply,generate a new form. Revised: 11/13/2013 Page I of 1 t Massachusetts Department of Environmental Protection Bureau of Waste Prevention• Air Quality L11, B VV P AQ 06 100214890 Notification Prior to Construction or Demolition Asbestos Project Number# A. Applicability . A Construction or Demolition operation of an industrial,commercial, or institutional building, or residential building with 20 or more units is regulated by the Department of Environmental Protection(MassDEP), Bureau of Waste Prevention,Air Quality Division,under Regulations 310 CMR 7.09. Notification of Construction or Demolition operations is required under 310 CMR 7.09(2)ten(10)working days prior to any work being performed.The following information is required pursuant to 310 CMR 7.09. Is this a fee exempt notification(city, town,district,municipal housing authority,state facility,owneroccupied residential property of four units or less)? Is this a fee exempt notification(city,town,district,municipal housing authority,state facility,owner-occupied residential property of four units or less)? r Yes r No Type of Notification: r Revision of an Existing Form Cancellation of Project Instructions: 1.Blanket Permit Project Approval,if applicable: Approval ID# 1.All sections of this 2.Non-Traditional.Asbestos Abatement Work Practice Approval, if applicable: form must be Approval ID# completed in order to comply with the B. General Project Description Department of Environmental 1.Facility Information: Protection notification MARINE ENVIRONMENTAL AFFAIRS 1189 PHINNEYS LANE requirements of 310 CMR 7.09. Name of facility Street Address BARNSTABLE MA 026010000 5087906272 2.Submit Original City(Town State Zip Code Telephone Form To: BRYAN LAUZON DPWS&G GENERAL FOREMAN Commonwealth of Massachusetts Facility Contact Person Contact Person Title Asbestos Program 5088891159 BRYAN.LAUZON@TOWN.BARNSTABLE.MA.US P.O.Box 120087 Boston,MA Facility Contact Person Telephone Facility Contact Person Email 02112-0087 Facility Size: 4800 1 Square Feet Number of Floors Was the facility built prior to 1980? R Yes r No Describe the current or prior use of the facility: GARAGE AND OFFICE SPACE Is the facility a residential facility? r Yes F No If yes,how many units? 2.Facility Owner: TOWN OF BARNSTABLE 367 MAIN STREET Facility Owner Name Address HYANNIS MA 026010000 5087906320 City/Town State Zip Code Telephone BRYAN LAUZON 800 PITCHERS WAY On-Site Manager/Owner Representative Address Hyannis MA 02601 5088891159 City/Town State Zip Code Telephone Revised:03/17/2014 Page 1 of-3 f Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality BWP AQ 06 10iJ214890 Notification Prior to Construction or Demolition Asbestos Project Number# B.General Project Description(continued) 3.General Contractor: N/A N/A Name Address N/A MA 026010000 5087906320 City/Town State Zip Code Telephone BRYAN LAUZON 5088891159 General Contractor's On-site Manager/Foreman Telephone C. General Construction or Demolition Description General 1. Construction or demolition contractor: Statement:If asbestos is found DPWS&G 800 PITCHERS WAY during a Construction Contractor Name Address or Demolition operation,all HYANNIS MA 026010000 5087906320 responsible parties City/Town State Zip Code Telephone must comply with 310 BRYAN LAUZON 5088891159 CMR 7.00,7.09,7.15, and Chapter 21 E of Construction and Demolition On-site Manager Telephone the General Laws of the Commonwealth. 2. Licensed Contractor Supervisor: This would include, but would not bw BRYAN LAUZON 065007 limited to,filing an asbestos removal Supervisor Name License Number notification with the Department and/or a 3. Is the entire facility to be demolished? F Yes r No notice of release/threat of 4.Describe the area(s)to be demolished: release of a hazardous SOME INTERIOR SHEETROCK substance to the Department,if applicable. 5. If this a construction project,describe the building(s)or addition(s)to be constructed: MassDEP Use Only SOME ADDITIONAL OFFICE SPACE TO BE ADDED Date Received 6. If this is a demolition or renovation project,were the structure(s)surveyed for the presence of Asbestos-Containing Material(ACM)? Yes r No 7.Was asbestos containing material(ACM)found? r Yes 1✓ No If a survey was conducted,who conducted the survey? WILLIAM M VAUGHAN A1040812 Name Department of Labor Standards Certification Number Revised:03/17/2014 Page 2 of 3 - Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality % 100214890----------------I BWP AQ 06 Notification Prior to Construction or Demolition Asbestos Project Number# C.General Construction or Demolition Description(continued) The Asbestos Abatement Notification Number for this address is: This project 17 Construction (" Demolition is: 2/17/2015 5/31/2015 Project Start Date(MM/DD/YYYY) Project End Date(MM/DD/YYYY) 8.For demolition and construction projects,indicate dust suppression techniques to be used F Seeding F,,- Wetting r Covering r Paving r Shrouding r- Other-Specify: 9.For Emergency Demolition Operations,who is the MassDEP official who evaluated the emergency? Name of MassDEP Official Title Date of Authorization(MM/DD/YYYY) MassDEP Waiver Number A Certification BRYANLAUZON "I certify that I have personally examined the foregoing and am . Print Name familiar with the information BRYAN LAUZON contained in this document and Authorized Signature all attachments and that, based GENERAL FOREMAN DPWS&G on my inquiry of those individuals immediately PosifionRtle TOB responsible for obtaining the information,I believe that the Representing information is true,accurate,and 2/4/2015 complete.I am aware that there Date(MM/DD/YYYY) are significant penalties for submitting false information, including possible fines and P.E.# imprisonment.The undersigned hereby states, under the penalties of perjury,that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is made." Revised:03/17/2014 Page 3 of 3 i M p Y Massachusetts -,Department of Publ Safef 2 >: #Fx Board of Building Re ulations a ,rl, < E g nd Standrt9�s Construction.Super-visiir License: CS-052139 FRANK A ZIBUTlt 130 RASPBERRlG MARSTONS MIELS 14 I s I Expiration x?I Commissioner 06/18/2015 ; i Unrestricted -Buildings of any use group which contain less"than 35,000 cubic feet (991m)of .enclosed space. Failure to possess a current edition of the Massachusetts g.State Building Code is cause for revocation of this license. " .DPS Licensing information visit: www.Mass.Gov/DPS PROJECT NAME: ADDRESS: Lnn"sL-,Ik�. i CA,10V-k LS PERMIT#__ PERMIT DATE: 1 O L M/P: -1 Q 3 O .BARGE ROLLED PLANS ARE : BOX SLOT— Data entered in MAPS program on: BY: I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION pp Ma ' o1 I Parcel V A lication p 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 I/ / i ww eY,r L.CI.✓� Village .✓.✓is Owner $UG✓.J a 6 CARiys,+. 131e 'DPW Address Telephone SUS-�tSe? SOU Permit Request 40V mARD13 9441 mg,a a-ir bat�, t&d!.± -j wr_ Square feet: 1 st floor: existing proposed _2nd floor: existing proposed Total new Zoning District _Flood Plain Groundwater Overlay 6 , a� Project Valuatioi elOff(! _ construction Type SUM Lot Size _ Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. n Dwelling Type: Single Family. ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King'zs`gHighway:��Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other m r Bas.I�.nent Finished Area(sq.ft.) - _ Basement Unfinished Area(sq.ft) a Nun"'.jer 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 IrC/ eae mN Telephone Number SDI F9a -!W& Address 6-7 6e-Ik e T-,*' License # L'S 7y 5-96 ,dlew 13 ed Ft,RA , _M1 6a 9 Home improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL. BETAKEN TO s9/3 a DiSeorat. SIGNATURE c' ve?4 _A DATE G /Z / F -3 FOR OFFICIAL USE ONLY ` t APPLICATION# DATE ISSUED. . =MAF_/_PARCEL NO: _R �-pl ADDRESS r0" VILLAGE -r OWNER . DATE OF INSPECTION: 9 FOUNDATIONLL4 Al FRAME ; ` 'INSULATION - FIREPLACE ELECTRICAL: ROUGH ;FINAL PLUMBING: ROUGH FINAL GAS t_5 ROUGH FINAL -FINAL BUILDING ,-..,-DATE CLOSED OUT: i ASSOCIATION PLAN NO. - 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 Legibly Name(Business/Organization/Individual): Kri K2 ',1kir . Address: 5'7 �EL1-.yu P_ ST, O Z'144 City/State/Zip: — r-ow WA Phone#: 8- 2- Are you an employer?Check the appropriate box: Type of project(required): 1.9 I 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 workingfor me in capacity. employees and have workers' any P ty- 9. ❑Building addition [No workers'comp.insurance comp.insurance.: required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their l l.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.g Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box 91 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. $Contractors 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 Insurance Company Name: t_G,M)l l U C tl INSU leA N c. C6 . — Policy#or Self-ins.Lic. #: 16 $Ub U H U 16 3 1P 9 x 11 Expiration Date: A Job Site Address: 1 181 f�kj Y s I A)E AtgUN)3 City/State/Zip:4YAAJM15 M.A' (M-60 1 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 ,certify under the pains pains and penalties of perjury that the information provided above is true and correct. Signature: 0. . /y i/M L a Date: C1r 7- �I Phone#: tS0 S--11 2-q S Z(o ` 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 I 6.Other Contact Person: Phone#: OP ID:TR CERTIFICATE OF LIABILITY INSURANCE DAT 09106DIYYYY, 09106l11 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 508-998-3008 CONTACT Gramlich Insurance Agency,Inc PHONE FAX 3263 Acushnet Avenue A/c No Ext: AIC No New Bedford,MA02745 EMAIL ADDRESS: PRODUCER KELKO-1 CUSTOMER ID is INSURERS)AFFORDING COVERAGE NAIC; INSURED Kelkor Inc INSURERA:Commerce Insurance Company 34754 57 Bellevue Street INSURER B:Travelers Insurance 10804 New Bedford,MA 02744 INSURERC:St Paul Travelers 25615 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LTR POLICY NUMBER MMID MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 C X COMMERCIAL GENERAL LIABILITY 1680622HO463PHX11 01/19111 01119/12 DAM TOR N ED PREMMISES Ea occurrence $ 300,00 CLAIMS-MADE ®OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERA-AGGREGATE $ 2,000,00 GEN'L AGGREGATE UMITAPPLIES PER; PRODUCTS-COMPIOPAGG $ 2,000,00 POLICY PRO- ECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 _ (Ea accident) A ANY AUTO RXP904. 03/17111 03117112 BODILY INJAJRY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTYDAMAGE X HIREDAUTOS (Per accident) $ X NON-OWNEDAUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION WC STATU- I OTH- AND EMPLOYERS'LIABILITY_ YIN TORY LIMITS ER B ANY PROMEMBER ARTNER E) CUTIVE ❑ NIA KUB0155N7"-11 02121/11 OV21/12 E.L.EACH ACCIDENT $ 500,00 (Mandatory In NH) EL DISEASE-EA EMPLOYEE $ 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 367 Main St ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA02601 AUTHORIZED REPRESENTATIVE O 1988-2009 ACORD .CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD Kel Igor Inc. 57 Bellevue Street New Bedford MA 02744-1902 Tel.508.992.9826 Fax 508.999.5508 Website www.kelkor.com E-mail kelkor(a�comcast.net i1V KELKOF! 1 1 October 11 Regulatory Services Building Division 200 Main St. Hyannis MA 02601 Attn: Mr. Thomas Perry (Building Commissioner) Dear Mr. Commissioner, Please let it be known that Manuel C. Martin III acting in his capacity as the President of Kel Kor Inc. a Massachusetts Corporation does hereby allow the Corporation to use his Construction Supervisors License to conduct the construction work on the Marine& Environmental Affairs Building located at 1189 Phinney's Lane in Hyannis MA 02601. The subject licensee is Manuel C. Martin IlI, 57 Bellevue St.,New Bedford MA 02744# GS 74580. Respectfully Submitted, M. C. Martin III Pres. .,r • Nlassacbusctts- Departmcnt'of Public Safch tiai.d of Building Regulations and Standard Construction Supervisor License License: CS 74580 MANUEL C MARTIN III gat t 57 BE ,LLEVUE.,ST NEW BED DMA 02744 - j Expiration: .12/29/2012.j ('onuuissiuner Tr#: 9157 k The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 1 of 2 5.tea-s The Commonwealth of Massachusetts William Francis Galvin � i Secretary of the Commonwealth,Corporations Division One Ashburton Place, 17th floor Boston,MA 02108-1512 Telephone: (617)727-9640 KEL KOR INC. Summary Screen 0 Help with this form Request a Certificafe The exact name of the Domestic Profit Corporation: KEL KOR INC. Entity Type: Domestic Profit Corporation Identification Number: 043466442 Old Federal Employer Identification Number(Old FEIN): 000658627 Date of Organization in Massachusetts: 05/06/1999 Current Fiscal Month/Day: 12/31 Previous Fiscal Month/Day:00/00 The location of its principal office: No. and Street: 345 UNION STREET City or Town: NEW BEDFORD State:MA Zip: 02740 Country: USA If the business entity is organized wholly to do business outside Massachusetts,the location of that office: No. and Street: City or Town: State: Zip: Country: Name and address of the Registered Agent: Name: MANUEL C MARTIN No. and Street: 57 BELLEVUE ST City or Town: NEW BEDFORD State: MA Zip: 02744 Country: USA The officers and all of the directors of the corporation: Title Individual Name Address(no PO Box) Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term PRESIDENT KELLIE MARTIN 345 UNION ST.,NEW BEDFORD,MA 02740 USA SECRETARY KELLIE MARTIN 345 UNION ST.,NEW BEDFORD,MA 02740 USA TREASURER MANUEL C MARTIN 57 BELLEVUE ST NEW BEDFORD,MA 02744 USA DIRECTOR MANUEL C MARTIN 57 BELLEVUE ST NEW BEDFORD,MA 02740 USA DIRECTOR KELLIE MARTIN 345 UNION ST http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... 10/12/2011 The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 2 of 2 II I NEW BEDFORD,MA 02740 USA I I business entity stock is publicly traded: The total number of shares and par value, if any,of each class of stock which the business entity is authorized to issue: Par Value Per Share Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding Num of Shares Total Par Value Num of Shares No Stock Information available online. Prior to August 27,2001, records can be obtained on microfilm. Consent _ Manufacturer _ Confidential Data _ Does Not Require Annual Report Partnership _ Resident Agent _ For Profit _ Merger Allowed Select a type of filing from below to view this business entity filings: ALL FILINGS Administrative Dissolution Annual Report Application For Revival Articles of Amendment 7-1711 �.View Ftlln s # %w Ne Search Comments m 2001-2011 Commonwealth of Massachusetts Q All Rights Reserved Help http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... 10/12/2011 �0pIHEJoh Town of f of Regulatoly.Servccs �UA&PP-"is-•+Fs�x•/ Thornns.la.Oiler,Director 16 4 �0 Eo Btiilditig Division Toni Perry,Dudding Corp"ssicnier ,00 Ma'sn Street,Hyannis,MA 0260 town.harnstable:nia.its F-ax: 568-790-62.;3ty Ofitcc:: 505-962-403$1 "property C?v��aer 11!1 i:�st C,;oxlx��.l.et; and Si�:r.�This Section f'l.lsirn, t),Bui.lde.r• '.' as (Dwtler Of t}ae Subject 0r01.)ell f, _ . .4 t:c a�:t ci) my bed?C,. in all.rmners reiativ . o1,orl d bythis bttjldiar,permit applica60»for: j4'jf&AAM(i MA (Addr6s of]rib)_ S MaWl of cr Date 17�'t:1r.�aiT1G. If 1'ro e t�C}�vner�s :i��plying for l�ernZit please co.rnplet�: di :[1.onle-ow ael--s �1_,icense Exemption Form on the rep=e rye s d4. <., TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Z27 Parcel 030 Permit# yzz Health Division NaE&Ulbon� SDa�- Date Issued /6 Z 7ZZq Conservation Division Fee 0 1 - Tax Collector e � 4 Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village Lee& eva Owner Address v r Telephone Permit Request / o4 y/ Square feet: 1st floor:existing proposed 2nd floor: existing proposed Total new Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type vo A 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 Cl No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count r 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 BUILDER INFORMATION ,J Name-4" i ' Telephone Number Address,I License# ® .S�/ �F 7 A-C Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE t DATE /L4 "��' FQR'OFFICIAL USE ONLY _ PgRMITNO. DATE ISSUED p MAP/PARCEL NO. ADDRESS VILLAGE OWNER t DATE OF INSPECTION: t - FOUNDATION _ I FRAME l INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: - ROUGH FINAL FINAL BUILDING ' DATE CLOSED OUT " ASSOCIATION PLAN NO. 6 ran. /r C7 S 1R we e w i irr .1.x/1 J' A / y o i-I.2j F/o o 2. p I /we'ev 4^oorn t lAve. CArpe�- i� 6 /�/7ix�XJCys' /e9r�t� t �--�ol J� J-IH♦i�. A)o �•� �J�� ��e.c� �wctLi�.o tv� a j 12'•0 .. -:UP C�c1+4� -SQu !s0 IfG oo 14 -D f p 1 t E. •4, o o x ci ter. �[T RIA. V. 'i'3j in j NOT NlA7ER I3AATL4Z- I 413� k ' FW i I!8 t. 1'SdY A,' R A. G ' E w o a 1c A a;..A !o♦ IOS �i LA p: Ltfl WALZ-IM GOOLLM14 _� r 1-!p < �� t 10 A i L a. i C4'1 STDr% to &b4T 04 y W j uer tii4l'I G, ac.r.Pt/c ta.�. I� 1 [ ,., ..., _ bARD CIF E{U LD1iPiG'REGULATIOiNS Ucens9: CONSTRUCTION SU ERV15OR Number-CS_ 051497 Sirtt�date 11f13(1� 7 € Expires "11h I2t l'O Tr.no: 4645 Restrklvd 'o. 00- # JOHN F GtL1.0 LEDA-ROSE LN MARSTONS MILLS. MA 02648 A minis#r for I +� I ngzneering Dept. (3rd floor) Map Parcel 0 3{ �� .Permit# _o CP `� ram.. - ?/?& 7 „r - House# j Date Issued Board of Health(3rd flooi)-(8:15 -9:30/1:00-4:30) e7g.Fee P_lane.ing-DepL-�1-44loer4Scho&Adrnin-Bldg:)- APPLICANT MUST EWER ' CONNECTION THE -Definix-v-e p..z la�pproved-by Planning-Board 19 ENGINEERING TO CONSTRUCTIO ' B""M ss LE' ' QED 39. TOWN OF BARNSTABLE Building Permit Application Project Street Address Ph i ti ry E tij s L,4 Ai e Village E► -,t c,c- v: I L P, Owner O wN c iAc &J Address 5 Telephone Ss D $- 7 9 D - (.,Z'7 3 Permit Request C D n+t-v, c-+ e-,o o�Qn�L p ' X 1 p ' D • � g ;ti Rtv i b o N IJ y `t r v e'Ev Rs +V�O v n�C 1J a �O��+R IJ �Cl T+rPO r 1M L.JY✓ e First Floor 10 D square feet Second Floor square feet Construction Type w G o D -st veQ / }ti•e R o Estimated Project Cost $ t 2-00 f Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No - Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board;;es ppeals uthorization ❑ Appeal# Recorded❑ Commercial ❑No If es, site plan revie # - Y Current Use Proposed Use V�,- Builder Information � Name Ate-\t I c.s Telephone Number '7 CFO L ��� //�Address t� �.e _ems c_ _ License# ,`(f ..... Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO r - SIGNATU DATE BUILDING PERMI ENIE OR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. _ DATE ISSUED MAP/PARCEL NO. ADDRESS ,VILLAGE OWNER DATE OF INSPECTION: '' r FOUNDATION FRAME INSULATION " FIREPLACE ; ELECTRICAL: ROUGH - FINAL Y PLUMBING- GH FINAL t" GAS:- JGH FINAL' ' . FINAL BUILDING E-CD DATE CLOSED Op-t ASSOCIATION PLAN NO. E � i � � i i .p � � i i i �-Cl� GIN oo ZE v J (� � z• n >\`� s Ir Xv— TF (V Isti 94 Pdog-r,c,AT r a s G s p � x 31 O prIC�i2S /\76.5 82° �, r/ ti 6.9 Tl / /84.8 61 Y . 7) ,2 ------ /\81.5 --- - ----- ------ -- — 51 2. .78 7 �. i\ '( 14 � \ 2. 79. i\7 ell 75.4 .,..1 '7 .9 j / 5.2 ;37 //77.0 LI 1, J 11 i�. ,/ �• z { 7 .5 - M 274 f'operty fines shown on.this plan are for assessing purposes only 7JG and do not represent actual relationships to.physical objects a/7 J,. Assessor's Office(1st floor) Map Lot 30 Permit# Conservation Office(4th floor) \��f ®---� �`�I��h`�' Date Issued /s 5 Board of Health(3rd floor)(8:30-9:30/1:00-2:00) �' "'l o 8 Engineering Dept.,(3rd floor) House#1 Planning Dept.(1st floor/School Admin. Bldg.) RNSTABLE,MA �` Definitive Plan Appr ed b lanning Board > 19 �-C�.�' 039. rE0 MA'S� TOWN OF.BARNSTABLE, p r_ Building Permit Application Project Street Addre `� p YI e-n, Lane.., r Village Owner va n► #�2 NS i A Address `5(cY7 (1 ^ 2,-- 1- ",)��5 Telephone �/�o�naS p�1 Y 4 o r� r19d-Co 2(�5 Permit Request t Q S Total 1 Story Area(include 1 story garages&decks) '41/ square feet Total 2 Story Area(total of 1st& 2nd stories) square feet Estimated Project Cost $ 00 Zoning District Flood Plain Water Protection G., P. Lot Size Grandfathered ? Zoning-Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential -DWe mg mg a amily Two_ _� Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Awz—,�S-Folz (�7 C�10 Jan. Telephone Number ' �g�P 7Y Address 'r _Li5 License# ,F)e,s P,a"e n'e 5 T) /n h n l lO Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATA. `53 LIV BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) 'Roe.. FOR OFFICIAL USE ONLY PERMIT NO. 9737 DATE ISSUED August 15, 1995 . MAP/PARCEL NO. 2 T4.030- M I ADDRESS 1189 ,Phinney's Lane VILLAGE Hyannis, MA 02601 OWNER Town of Barnstable DATE OF INSPECTION: FOUNDATION FRAME ; INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL _ PLUMBING: ROUGH FINAL y GAS: ROUGH FINAL FINAL BUILDING t (iD E CLOSED OUT ASSOCIATION PLAN NO. ---- - -_ - --- -----_ ;;', x 81.5 / - _ 1/77.0 76.6 rr 5�. 31. Ar 76.9 l \87 78.8 5 \/7 / , 14 // ,0 7$, --- X 7 .2 ;;�+ 1 ,`��. }�7 }�75.6, E t, \/7675.4 �1 6, } Li \ .5 '' •• M 274 " 36 " TOPOGRAPHY AND PLANIMETRIC DATA INTERPRETED FROM 1989 AERIAL OVERFLIGHTS, PHO.TOU n APPGII AT 1 " - 1 An' DADrm nATA nirIT17r_n rnnnx i �� _ i not rm,%ukerr_nme-` ACCCCCnDC AA A DC ' l0 C A 1 10N // S E W A G E PER, IT NO. lei 30 '"ryt•4Aar ` gtiti�s 4:; NSTA LLER'S NAME i ADDRESS t :A U I L D E R OR OWNER C Qdc �� , /�/,M g. •sys�.•� s r / s J DATE PE-RMIT . I SPED DATE COMPLIANCE ISSUED 2'zpa , j %✓ f a-04-1995 13:05 HAZ STOR 708 298 9716 P.03/04 HAZARDOUS MATERIAL STORAGE . Approved Haz . Vault 6 Drum Lockers For Hazardous Ma- teria s Store e Available to you at a special price of $2685.00 by contacting THE MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION Call (508) 727-7500, Ext. 302 Reference Contract #A501102-00 .5......)M. i'Ii4M4F?fi .d:+T, '��{4 Jf.;4:.iY'i",:1:.f<'•:r::•;{:.r'..'Y'1hi:iF,Y,i:'.�ilij'J'ti!,.;.}: Yb{�iF. ,r!71dc`ry::Y.:t: Yf:N'.�!t, w ••s'� ki;'r','Ss�:,s�'z:`s,.�h..`�r'ni'ow.•''t•,: °�I;`rE u::s?�r:x,. 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'3i§�3i;••::'�i i t �:Si�F Model LK08 Hai-Vault Locker, Capacity: 6•55 gallon deems- ' (Inset) Locker is easily set or relocated with a fork Oft, s5 i Haz-VaultTm Hazardous Materials Storage Lockers are high quality,prefabricated,weatherproof structures that provide vault- IikeSafety,Security,Segregation and Secondary ContainmentTM Provide 7" Spill Containment storage for smaller quantities of hazardous materials, chemicals and waste. • Meet NFPA 30-1993 Fire Code These super economical, portable lockers are constructed of • Ideal for multiple purchase for unitized-welded, heavy gauge steel specially coated for chemi- segregation of incompatible chemicals cal and weather resistance for safe outdoor storage. .s..kXi, The leadirio innovatui in supoying quaiity, cost cffident spcondary Qontainn)ont systems sati_-fying th&worldwide env4onmental @nd safety need�i of our C:LlStoMer�. 6 Drt,m tiG-04-1995 13:07 HAZ STOR -a 708 298 9716 -P.04iO4 HAZ•VAULT 6 DRUM LOCKER STANDARD FEATURES LK06 Dimensions This kocker offers high value in a small - Heavy gauge sheet steel construction Outside 8'H x 718'W package and is ideal for indoor or outdoor -Secondary spill containment sump Inside 72'H x S7 W storage of limited quantities of hazardous •Steel grate floor,250 psf loading Tare Weight: 1700 materials in drum, can,or box containers. -Welded steel W wide door Sump Capacity (55 Gel.): 160 It is constructed using the same premium -3 point keyed latch for security materials and exacting quality standards - Exterior surfaces coated with weather OPTIONS as all Haz-Vault lockers,'then shipped resistant urethane The following options can be fully assembled to the site. - Interior surfaces coated with chemical ordered separately if necessary for The 6 Drum Vault can be used for resistant epoxy your.application. Cal!Haz-Sfor's . individual or pallet loading of containers. -Gravity ventilation system Representative John Omellas All Haz-Vault lockers are FM approved? - Static bonding/grounding system of Commonwealth Sales at comply with NFPA 30-1993, and exceed - Risers for crane sling or fork truck (608) 586.8874. industry standards. -Seismic hold-down plates -Wood or metal shelving kit Featuring cabinet size capacities and -Safety signage #Steel or aluminum loading ramp external handling of materials, it is exempt . instruction manual and drawings from Model Building Codes applicable to permanent structures. 'Rotor to Haz-Vaultld drum and larger lockers. Vault-like safety, economy, and portabil- 2FM label not applicable to indoor use. ity are primary benefits of this locker. 'May be subject to local authority approval. 7, V t3- 4- _r I n a e- 6 DRUM SERIES l � I 9 ,Z• + ' W i SERIES T ONLY .l:axtl/; rvvT`!n^"yy, rrrwww ��•'�-:.• A�:S ;::i,' I I I� 'tsfil� Skb. �4...?,y j9 •Ih:��iu<: ..LSti /$ : ` •n!j� .a :.A>!. •..s,,,•k Aso?,.'o';�� r •i^. �� ')irrn;7j. ,�� ,tom•, Optional IS*widemetal shelving for Shown above 6 drum lockers shipping fully Wide front opening door allows pallet loading storage of i-5 gallon containers. assembled direct to ontomefs site. or easy manual loading with an optional steel ramp. Mn73 F-95 ©.fustrite Manufamuring CamWj LL0.1995 TOTAL P.04 y ' yA f efTHE 1 TOWN.OF BARNSTABLE Permit No. .2§983....... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash HYANNIS,MASS.02601 Bond N/A i CERTIFICATE OF USE AND OCCUPANCY Issued to Town of Barnstable Address 1189 Phinneys Lane Hyannis, Massachusetts r USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ..`�!......, 19.. ....... Yam........ Building Inspecto 46 --- Al L4 (, 1� r o v, f I o o N rn ° (� I - . � m IO _ w d�r o to m ro • 0th may D (A (A �o 70 I rn ol CIRD sso p and lot number --2-1P THE ewagePermit number ................... ....... 3-� SEPTIC SY INSTALLED 2 House number ........................... 9 ......... ............. ....................... CE WITH MV&PIMETA E n TOWN OF BARNSTAB " AND A7T 05 BUILDING INSPECTOR, APPLICATION FOR PERMIT TO ... ..................... ............................................... TYPEOF CONSTRUCTION AA............ . ................................... ................................................................ # j . ................Z�/.7................19.1f TO THE INSPECTOR OF BUILDINGS: The un rsig e hereby applies for a permit according to the following information: ............... ...... ......... .. d by a,rlhere . AA y IV/ Locatio ......................... ...... .......�............................... .............. ............. ................................... jt .......... ......................... .. . ...... Proposed Use -Nalv. . ..... Zoning District ........................................................................Fire District ........... ............................................. Nameof Owner7 . .. ....�A...............Address .................................................................................... Name of P Builder Ca.r. . .............Address pabey.,.415�..M.av; ..V�Al A .. .............. Name of Architect . .......... .......... ...................................Address ........................................................... . ... .............. Number of Rooms .......... .. . ..........................Foundation ................ Exierior ................... ........................................Roofing. .... .... .......................................................................... Floors ........C—,� 1W .............................................................................................Interior", .... . .... ............ Heating ............... ......................................................Plumbing ...........I's................................................................... Fireplace ....... L . .............................................................Approximate Cost ..,9 . 0.. .... .......6 . ........................................ (�z � 0 Definitive Plan Approved by Planning Board -------------------------------19--------- Area ............ 1 (1 ....�-j Diagram of Lot and Building with Dimensions Fee ..........Xl�'. ......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH V0 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. . .................. Name ............. .. ........................ 003c) Construction Supervisor's License ......................1.3..... TOWN OF BARNSTABLE Ile" BUILD MOP 289.83.... Permit for .................................... Metal Buidling ............................................................................... Location 1189 Phinneys Lane ................................................................ r Hyannis ............................................................................... Owner ......Town of Barnstable ...............................................:�........... Type of Construction Frame .......................................... ...............................................;................................. Plot ............................ Lot ........... ................... February 28, 86 Permit Granted ................... ...................19, 1A Date of Inspection ...;........................11.......19 Date Completed ......... -ssessor's—map dnd lot number .... ......C-................ 1 ��5 - �`'" l,..� -'�/.._ - CDRc'°/r�%c,%�.� � ;�� imp/ •� � '✓i,�rir.J _. p.(, Q�OFTHET��. ewage Permit number ......................................�................... , /� f C Cr3...................... Z B9HB9TODLE, i House number ................................................'. r rasa .. 5 �p,o�1639• 9� 'FO YpY Or TOWN OF� w BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ,�1 ...........................I.... ........... ..... ..... .. . TYPE OF CONSTRUCTION ?...... ...... ........... .......... ............................ .................11 ..r?................19 �./ TO THE INSPECTOR OF BUILDINGS: The undeisigne hereby applies for a permit according to the following information: Location` . i -. ( ........ - . ...... . � `.............: ....................................( . . . ... Proposed Use Fire District ..........,4A,NNI. ZoningDistrict ...................................................................... . ............................................... Name of Owner l.tn .. !....................Address .............: Name of Builder ... .............Address . .! ': S.. . ..... �' °'''.. Name of Architect Address .. . ..... ±!!.......:................................................... .. ....... .......... .............................. i Number of Rooms ....... ............................Foundations �a .. . .. - . ... Exterior .............................................................Roofing .... 1. ..........................:............................................... Floors `................................................Interior .:............................ . ................................................................. Fireplace ....... V ''..........................................`.................Approximpte. Cost ..4.9 030.®OC ..::.......:........................ -k Definitive Plan Approved by Planning Board ---------------_---------------19_=_____ . Area ....... .0 d......-! ' -Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH /V/0 ' b" p", �,(, tv 1�` 1 4 � i , t' OCCUPANCY PERMITS REQUIRED,,-FOR NEW DWELLINGS r I hereby agree to conform to all the Rules a_nd Regulations of the Town of Barnstable regarding the above .construction. ' Name .,.. ............ ... .� .:...................... ' 1 Cons?ruction Supervisor's License .......; jj� TOWN OF BARNSTABLE A=274-030 � ~ � Owner .........T}!�M.'�j�.B4�����ble-.�---- * Type of Construction -.��AgY�-.-------. p ' -------------------------.. � � plot ---------. Lot -�---------. . ` - � ` February 28, 86 Permit Granted / l0------ ------ . Dote of | ..;----------..lg . Date Completed --=--...-----..lV _ - � ' ~ ' ' - - ' ' ^ ` ` ^ ~ , ' _ . . . . . - ' ' ~ ^ ' � |