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Home My WebLink About1070 IYANNOUGH ROAD/RTE132 - FESTIVAL MALL THE VITAMIN SHOPPE ,, C7 � 1 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost EB40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.=it does not give you permission to operate.] You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FL, 367 Main St.,.Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. T DATE: Fill in please: is •.; _'F !. I;,I v >ti APPLICANT'S YOUR NAME/S: : BUSINESS. YOUR HOME ADDRESS:aI(O 91s4 G-6f , ap!L24 3q(� n IN""::::+:l TELEPHONE Ik Home Telephon Number 0,01 -(,oQQ a13 ir< tivac:�!tv��7Hsti5� I _ E—MAIL r\Sk P—04 rn EIN #: NAME OF CORPORATION: V a e NAME OF NEW BUSINESS TYPE OF BUSINESS V IS THIS A HOME OCCUPATION? YES ADDRESS OF BUSINESS-10 ,n PA MAP/PARCEL NUMBER - j Z C' l , ssessing]. When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CDM ISSIO R'S OFFICE This individua he e i e a per req irements thot pertain to this type of business. t oriz Signatur COMMENTS: 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensingrequirements that pertain to this type of business. Authorized Signature** COMMENTS: YOU WISH TO OPEN A BUSINESS? -ert ficate NAME in tNvn h you a For Your information: Business certificates(cost$40.OD for Y`�ar"su.5 A�b tsob�a n thelne e O r}Lsignatlures on tFUR orm at 200 Ma n St., Hyan]i, must do by M.G.t -it does not Hive you permission to operate.) Tak e the completed form to the To:�rn Clerk's Office, 1st F1., 3G7 Main St..Hyannis,MA 02601 'ro�vn Hall)and get the 8usines�Certificate ia required by law. GATE: S a f 3 Fail in please: Nm YOUR NAME/S:�i re m APPLICANT'S YO A RESS: 1A M BUSINESS C) N 'TELEPHONE # Home TelephoneNum r IT ~o ui f.Vp:.,,,'t�a7,.s��,�es F!! Nx,aE.W.�15�1U..'SC�Ui.�..Ar.<f i lli1�-d-^s.�h•!1 4'l..l;i: .4 tittt �`,iti�!u!•fl 4�- .I�(II l.!,•.. .,.!:.I�' A'_I4��•'fi�r:rB+IIl}F]I~s,IS��I,F WNW. LT*%ESSE 1'1I'.gin.!..-.t:l,s.%l,i JE�.b:,;I,:°a;'` �!ii;•(,r. .!:e .�r,. �A•I.!s. Is"l : � 'I r .. 'I I When starting a newbusiness ther e are several things you must do m order to be in compliance with the rules and regulations of the Town of intended to assist you in obtaining the information you may need. You MUST operate D Yp M�u's Hess to this mown of Yarmouth Barnstable. This form is rote permits and licenses required to legally N Rd.&Main Street) to make sure you have the appropriate to CD M a- 1. BUILDING COM SS10 R'S OFFICE of business. M This ind��idu ha en i farmed f a pe it uirements at penal to this type m u' uth rized ignature" COMMENTS: 0 • 2: BOARD OF HEALTH This individual has been informed of-the permit requirements that pertain to this type of business. -7 o Authorized Signature" COMMENTS: z • e 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) require that pertain to this type of business. ii This individual has been informedof the licensing req IT; Authorized Signature* m COMMENTS: M m N ! Cu ! } Q l .: ACORDM CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2 12/05/2008 PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS'A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willis HRH „ HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 26 Century Blvd. 'ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 305191 Nashville, TN 372305191 INSURERS AFFORDING COVERAGE NAIC# INSURED ACG Enterprises, Inc. INSURERA: Indian Harbor Insurance Company 36940-001 85 Copeland Drive Mansfield, MA 02048 -INSURER B: National Union Fire Insurance Co."of Pitt 19445-001 INSURERC: - •,,. INSURERD:' 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 ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS., INSRADD' TYPEOFINSURANCE POLICYNUMBER POLICY EFFECTIVE POLICYEXPIRATION - - LTR NSR DATE M DD -DATE MM/OD/YY •.-LIMITS - A X GENERAL LIABILITY ESG0027005 8/l/2008 12/7/2008. EACHOCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurence $ " 100,000 ., CLAIMS MADE: ".00CUR _ , _ •,y __ _ - -�;.._ ;!�IEDEXP(Any one person) �'.$. 5 00.0 -_ ., PERSONAL&ADV INJURY $ 1,000,000 GENERALAGGREGATE $" 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY ]( PE LOC . A AUTOMOBILE LIABILITY ESGO027007H' 8/1/2008�. 12./7/2008 COMBINED SINGLE LIMIT f. $ 1 ANY AUTO (Ea accident) 000,0»0 0 ALL OWNED AUTOS ' BODILY INJURY - $ SCHEDULED AUTOS (Per person) X HIREDAUTOS BODILY INJURY $ X NON-OWNEDAUTOS (Per accident) PROPERTYDAMAGE $ t r Pr e accident GARAGE LIABILITY AUTO ONLY-EAACCIDENT $ ANY AUTO EA ACC $ OTHERTHAN - AUTOONLY: AGG $ B X EXCESS/UMBRELLALIABILITY BE2705218 . 8/1/2008 '12/7/2008 EACHOCCURRENCE $ j 000 0Q0 X OCCUR F—ICLAIMSMADE AGGREGATE $ 1,000,000 RDEDUCTIBLE � g X RETENTION $ 10 00 $ WORKERS COMPENSATION AND - WC STATU- OTH- EMPLOYERS'LIABILITY TORVLIMITS -ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT' $ , OFFICER/MEMBER EXCLUDED?. _ _ • - -- E.L':DISEASE=EAEMPLOYEE $ � •» If yes,describe under SPECIALPROVISIONSbelow E.L:DISEASE-POLICYLIMIT $ OTHER DESCRIPTION.OFOPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re:C The Vitamin Shoppe," 1070'` Iyannough>Road-,—Hyannis'-MA 02601. This certificate voids & replaces previously issued certificate., It is agreed that Town of Barnstable is included as an Additional Insured as respects to General . Liability and Excess Liability, but solely in regards to work being performed by or on behalf of -' the Named. Insured. CERTIFICATE HOLDER CANCELLATION ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ^ DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Town of Barnstable IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Attn: Building Department - REPRESENTATIVES. ' 367 Main Street AUTHORIZED REPRESENTATIVE Hyannis, MA 02601 ACORD 25(2001/08) Coll:2554832 Tpl:817678 Cert:11745137 ©ACORD CORPORATION 1988' Sign TOWN OF BARNSTABLE Permit MkP.NnABLE, 9 MASS. i659' A Permit Number: Application Ref: 200804933 20070210 Issue Date: 09/08/08 Applicant: FESTIVAL OF HYANNIS LLC Proposed Use: SHOPPING CENTER- MALL Permit Type: SIGN PERMIT Permit Fee $ 150.00 Location 1070 IYANNOUGH ROAD/ROUTE132 Map Parcel 295019X01- Town BARNSTABLE Zoning District SPLT Contractor PROPERTY OWNER Remarks REPLACE EXIST SIGNS W/2 WALL 35 SQ EA THE VITAMIN SHOPPE Owner: FESTIVAL OF HYANNIS LLC Address: BILLBOX 01 8726 1053 PO BOX 7522 HICKSVILLE, NY 11802-7522 Issued By: PC POST THIS CARD SO.THAT IS VISIBLE F ..0 TIDE STREET Town of Barnstable vTME rho Regulatory Services 3 Thomas F. Geiler,Director Btasrws� MASS. g Building Division ��. a639 �� iOrEo rMt s Tom Perry,Building Commissioner -- 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Permit# Application for Sign Permit Applicant: LAAMlN S�d�Q�Q�. Map &Parcel# �CCXO L Doing Business As:y ,"4V:�-M Telephone No. Sign Location Street/Road: M-10 'T Jj \4 ougy.- V- i� cA-v\N L)6 L�AA Zoning District: Old Kings Highway? Ye yannis Historic District? Ye /No Property Owner Name: ST L',J AL. O l �Ahv\�,S ��L Telephone: 119 O13ox o% 9a . .Uo 53 Address: p c 1 Village: �-E icksv�ll� I.> I Sign Contractor t 2"2 Name: �?k`t QO Telephone: -Scb 3 9 Q 4-1d-c Mailing Address: '' u SO y �R. C3 Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions,location and size of the new sign. This should be drawn on the reverse side of this application. ` Is the sign to be electrified? Yes o (Note:If yes, a wiring permit is required) Width of building face (Cj�,' ft.x 10= x.10= Sq.Ft.of proposed sign I hereby certify that I am the owner or that-I have the authority of the owner to make this application,that the information is correct and that the use and construction shall conform to the provisions of§240-59 through§240-89 of the Town of Barnstable Zoning Ordinance. G �) Signature of Owner/Authorized Agent: Date: Permit Fee: Sign Permit was approved: Disapproved: Signature of Building Official: Date: In order to process application without delays all sections must be completed. Q:I WPFILESI SIGNSI SIGNAPP.DOC Rev.9/12/06 1 Thy in Sh o 0 f 1 O EXTERIOR SIGNS S F. -- _--____-- ----__----: ----- -- © - =- - _ ------------------====-==== ----------------------------==-------===---�- 6 BMW r•.—�� rarai lrar. ---------------- 53.76----- ---- f fff f f f •f f , �- This it reserved is ed y ted es co gns I t CUSTOMER APPROVAL __�.�.y. NMI itamin Shoppe accEssrights 411 reserved b Access Signs Inc ao�stnnon za sox k race co inc L anoU h RdYour Sign peartment �_ . Non Stantlamcle•seffifcontalnee a�) 08-06-19 a^ N „�. Hyann9]MA PRELIMINARY 2008-0e-13 F I N A channel letters an 3 tht raceway(A.t.) Des nption Sid El�eVaOF-0p�tlon,.y1, - j-.r- Date:OS 02 26 2371 Fernand lafontame v—,� BI d,Longueud Oc Jai•7l d7�., educe awning height to 32 tR.R.) 2008.08-18 Draw b.C:Marcotte.• Acc Re Jammi UL;#E783093 Order#1039 Pa e 2 �r t#h [ c._. y_ __ e tw._n. P....tel�506f43M, 88.655.6866/,fax:450674.4098, - s �+.ffii... - •..,_.e,,...3._9,.: 0„_ •? Gewr: �arromrza;,Y v try s n xxa• ranm xart+t��rtena� 2�9" v a..p n. +.".,m x_,.�s ems. r, rs�w c#��,asx�af•' >i ',cv"f ,r: 4 6-, i i i r ,. r -_ _ - _ - - t ----- ---=----------------- - - --- ----_---- - ----- -- ------- - ------ ----- - ------ --- ---- - -------- - ------ - ------- -- - - --- ------ - - ----=- -- -- -- ------ -- --- - ------=----=======___-====___====_____====_====-_=-----==_==__-===="== _==_= _===_==___ ____=_==_-==_==_=--= - -- ---- - - ------------------------------------------------------- - - - - ----- - ----- - - - - --- --- - --- - --- -- _-- ----_---===-==----=-===_-_--= �-- =-==_=_=_=__ _== 4t EXTERIOR SIGNS S.E _-=_==='- == =======-- -'======_- =_--_- - __= -==_= ===-___ ==--- =- - = :__ i c--=-------------------------------- -__ _ -- - - __--- _ - -=_ - = = _ - _- -_ _=-=- =---- -_ ----------------- -- --- - --------- - I• I © MMMMM=M= MMMMM====W-- Emu mme .�. :�i�l�l�l�l�l�l��_:�I�ii�l�l�l�l�l�l�l�L'—:__I�I�i�l�l�l�l�l•'__i. Total „ tr This artwork is protected by copyright CUSTOMER APPROVAL �i �� •�• �� Vitamin bn ppe ACCESS All rights reserved b Access Signs Inc. ��c� / /7 �/ �h /��/� y g y g No sr a e u ett comemea �•(°d'�1��/ � ��N N�" 1070 L annou h Rd ��_� ch.—hatters-a•mLr�ceway(A.L.)"`2008-06-19 '-•�'�^'�'— � Hyannisiml' YMW SiNoepartment NonStanoarol8'selfcontalnetl 2008.08.13 -- P R E L I M I NA R Y channel letters on 3"Ihk raceway(A•Ld rDescdption: front Elevation Option:1._ Date:08-02-26 .,.,.�.o- .. x, 2351,FamandL2fongme8lvtl'LonguwlOcJ4tJ1tJ7 +� FINAL �.Heduceawningheightto32"(R.R.) 2008.OB-18„k Draw by:CxMarcotte'.. •Acc RepTammi� UL-..#E183093 �, :Order,#103 �;:. Pagel/4 - let:450.674.33331,888.655.6866/fax:450.674.4093; ... . .c. .x•az t+-tc t-':.... ..re -«4,. .e. .. >r ei�-cr k`a�ra°aats+�5�<m,�sx +.- #•..�-4:t,.•r.s:r..,,.,,g.❑ .� ,��-b.<..., }..; R9 �c+s...a... _ t .6gx ra�.:,..a, f"s -n .... s;N,6►�!;:gaay'aaa� ' r•?'+ass* .�.. :�5s= ;3. .,.,...�. .-..,,.::,.- "-�• ,�,xsr�,...�;,....._..,, .«...e.�w..-.,* Lag bogs&shlelds 1/2•181 p 60°c/o min. \ 1°x 11 x 1/81 square Secure screwed to watt with 1/2•x 6•lag bolts aluminum tubing structure &shields(if required)Q 60"center to center Eradicable translucent blue#2114 1°black Syhratrim•- Dooley-brite 11 awning material 3'dewp.064°aluminum spacer with Interior 1°X 1°X 1/8° --_,_�—y gerpmoi fluorescent ihlures r' welded square alum.tubing structure �—ykvilgrapcyppensufa b vinyl graphics applied o surface White acrylic egg crate Glass tube support ao N 12mm white noon&accessories a Electronic 30 MA transformer inside letters raceway enclosure for wirinngg between letters disconnect switch on letter'N° 36' 7 Prepainted black aluminum returns 11 x 1•square aluminum Liquid the going to Interior junction box 420V AC Cross Section awning structure = "- 125'aluminum cut out oval painted yellow PM Scale:112" t'-0" S#116 �1/8°x 1°Oat bar ` with UP vinyl graphic applied on surface s alumium bracket O Since 1977&®'/:thick cut out black sintra-letters with Letters spaced'A horn aluminum surface(SINCE f 11//2'x 11"Q 50'We Watt (14 required) Cross Section fixation Details Scale:N.T.S. Scale:N.T.S: � . l Self contained channel letters on 3"thick oval Illuminated AWnina �' . � . .. iteNslats - ys08_t pft MA rerai , aww.ac•casstgns.c0M % Signoture Min" p Printed . name please '► TOWN OF BARNSTABLE BUILDING PERMIT„APPLICATION_ Map �r Parcel~ . Application # 60 > i 3� „E Health Division Date Issued Conservation Division 'n Application Fee Planning Dept, Permit Fee Date Definitive Plan Approved by Planning Board Historic- OKH Preservation/ Hyannis Project Street Address 1010 AA1kLo Village 4 Owner Address 3 S �� Telephone n(o 0' � ®�1 0 Permit Reques ano ,/, 1 101 W pi7- Iq e��_ C2 -4 Square feet: 1 st floor: existingproposed _2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type_=�� , Lot Size' Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family., ❑ Two Family ❑ Multi-Family(# units) 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 it new LJ Number of Bedrooms: existing _new Total Room Count (not inc uding baths): existing new First Floor Reim Coin Heat Type and F el: Gas ❑ Oil ❑ Electric Other m Central Air: Yes ❑ No Fireplaces: Existing New Existing woo Q ` oal stoke: ❑des *'No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑e isting,4Q ne'W,-size , Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ App eal Recorded ❑ • .. Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Pc—A Telephone Number Address License # ka Home Improvement Contractor# Worker's Compensation # ALL CONSTRU TION DtRRESULTIN FROM THI ROJECT WILL BETAKEN T SIGNATURE �_ DATE ( o FOR OFFICIAL USE ONLY APPLICATION# yow I DATE ISSUED MAP f PARCEL N0. F ;f ADDRESS VILLAGE -'OWNER ' 'x DATE OF INSPECTION: FOUNDATION I FRAME O ct — b P�- I INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 7 - FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 1 Roma, Paul From: Shea, Sally Sent: Friday, June 13, 2008 8:28 AM To: 'Lt. Don Chase'; Roma, Paul Cc: Roma, Paul Subject: RE: Vitamin Shoppe, Festival Plaza DON ACCORDING TO THE BUILDING PERMIT IT WAS FOR THE FIT OUT WHICH HAD NO STRUCTURAL CHANGES. IF YOU ARE GETTING PLANS THAT PART -IS UNKNOWN TO US AS THE GUY PULLING THE PERMIT HAS NO CONSTRUCTION LICENSE AND IS NOT ALLOWED TO DO ANY CONSTRUCTION. IT WAS A FIT OUT PERMIT THOUGH NOT DEMO ONLY. SALLY -----Original Message----- From: Lt. Don Chase [mailto:dchase@hyannisfire.org] Sent: Thursday, June 12, 2008 4:57 PM To: Shea, Sally Subject: Re: Vitamin Shoppe, Festival Plaza on 6/12/08 2:46 PM, Shea, Sally at Sally.Shea@town.barnstable.ma.us wrote: > DON I ALREADY GOT AN OK FROM YOU ON 5/27/08 FOR THIS. HOPE THAT'S > STILL THE CASE. > SALLY Yes', that was for the demo. We just got the building plans on the llth of June. Don • 1 °7 NORTHEAST REGION • �ggg} 7177 `D- ° p � � .• .. / .� = IIIIIIIILIII. 1 I I - Q 11I�• a� /I o � wQPs r�+ :ywNu/>,7JIIL`F : C�yG�:¢AyI�:7 �JJ:�JI,:I I �K_ • 1 r • I/I 1 r / Verizon 1 Rugged y.� Bear 1 O. a LW El F Old Country y Buffet N G- N Rent A I Center 1 t 2007/ravage Inwme I� -- .� . By Block Groups C�w UPS StorPayless e 1 qgz $100,000 or more$. - 75000to$too.000.''� Q' .$50,000 to. $75,000 p $30,000to $50000 -* ' fl l l l l l l l l l l l l l 1.1 l l l l l l i l l l l l�l l i i�l 11 l'�h. 1. N+ Less than$30,000 ,• l. -^•^-°_^'^".°.'-"� / sl J s �,(?Au.:>y_" fl Yarm this • �_ � (1111111111111111111111111111SIIIIIIIIII�h ��® v 1 •� 'W 78quM s '—'! . c' �. �"" • / C fllllllllllllllll!IIIIIIIIIIIIIIIIIIIIIII� 1 �� ,� _ �� '+� I (llulllllllllllilllllnllllllluulnul� Pa YU i ,urns b e T n)�� cwe coo t,, So� t t ►. y P�•�a West r � 1 .x q � O� Unlvemrse a L�r'! Cold Stone Creamery Quiznos. fl Southwind Plaza t► D ` �GLA: 225,634 SF//:ACREAGE: 27.16,ACRES//PARKING:TOTAL SPACES 1206//RATIO PER 1000sf: 5.34. COLLIER 1860.561.06071 tcollier@kimcorealty.com I Hartford,Office.:433.South Main Street, Suite 32Z West Hartford, CT 061,10 J z • - - o Few t�ivc�l cat H annis S'ho r in Center t .. 1 '�+, . .i"ro.. ".�"�' a '' __..,_ •'Y` C2'.-T- d^•:.. air, •-'. �j;�"--'� �T-- _ �,4i�"-..'t � .� � � T..t 3!T,.2�i"'^' - ��-"' ,-. - f.�dd�.. �'. �. - r i�1 -•e" _�,:• k�a,_r-` Remit �' rJaS,a. ��,. �.. `,-Y.••�- �+` ..,dr�.s s��"F�V± ..�� ^"w'-'ct .�,• :w�1� .-�i'�._�:r. 6�v�`�.. � `:^�"•ke.e. r 4 .+�lt'. e ,1.: •[III "'" � '��s,S�+' ��. �,�„:, � •ems �• '�►'.zr3yC _ ,.$',y�` UPS 1 *,{,��--/:-�.�'.��,�■ IF!•� F;a �� ws MAW •+$+� .r�A-c�' r��.t11,` �� _ '"n- �'.�= a .'- y,r' �� -'�:�i'7Gi ,sc ' - �! 1 I:i � h � e;3 a .� �` .tom:• .,r -`,p. �-�-� � � ✓' C� 11' 1. r )� .- ',�I��1 t�� --c�----�1 �' �� :;"m. _ r CONTACT INFO: TIM COLLIER 8G0.56JO6Q7.71 tcollier@kimcoreaIty.com Hartford Office: 433 South Main St Suite 322, West Hartford, CT 06110 " (TUE)JUN 0 2008 22:28/ST.22:27/No.7500000318 P 2 I Town of Barnstable . Regulatory Services- KAM Thomas F.Geiler,Director* Building Division � I Tom Perry,Building Commissioner i 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 • - i I jI Property Owner Must I Complete and Sign This Section j If Using A Builder i • - DF i Shy Wf V-V-" I- I, - Owner of the subject property hereby authorize � to act on my behalf, I in all matters relative to work authorized by this building permit application for. i 0 v� ��o a,vi�no•i��k e a.�. , ICI G�.VS l �fiv� of- QI'a(5,( (Address of Job) �i vk l 6 Owai s It I 0, uc, u 12 wv.al�,4x,r G. b� � og it er Date j � I 7D S KwL Ike,n K r ct,Vl -L Print Name I If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. . I. , i Q:FORMS:OWNERPERMISSION 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/Conti"ictors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): �' V Address: t1 City/State/Zip: 02o4 Phone.#: 2f,,;.l _70D?S Are you an employer?Check the appropriate b Type of roject(required): 1.Are am a employer with 5 4. am a general contractor and I employees(full and/or part-time).*' have hired the sub-contractors 6. �w 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; E]Demolition workingfor me in an capacity. employees and have workers' y p �' t 9. ❑Building addition [No workers' comp.insurance comp. insurance. 10. Electrical re airs or additions required.] 5. We are a corporation and its ❑ P 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL ; 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no . employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'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: M I1-K Policy#or Self-ins.Lic. #:_ y UXOI 2 31!!� C)I.2 oc Expiration bate: Job Site Address: h1 b 1 W`V&n` ; " ° 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 lip 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 da ainst the violator. advised that a copy of this statement may be forwarded to the Office of Investi ations of the for insuran cov r e verification. I do hereby certify n e p e ti perjury that the information provided above is tr and correct Si afore: Date: l01 fas Phone#: 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): Y 1.Board of health 2.Building Department 3._City/Town Clerk 4.Electrical Inspector.5.Plumbing Inspector 6.Other Contact Person: 'Phone#: '_ j 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 not any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone number(s) along with their 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 Departmentof 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 s ubmit 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 and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-72774900 ext 406 or 1-877-MASSAFE Revised 11-22-06 Fax#617-727-7749 www.mass.gov/dia I ACORD CERTIFICATE OF LIABILITY INSURANCE CSR BL DATE(MAA/DDMlYY) ACGEN-1 06 11 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Smith Buckley & Hunt Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency, Inc HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 500 Forest Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Brockton MA 02301-5749 Phone:508-586-5432 Fax:508-587-4935 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: First Mercury Insurance Co S10657 INSURERB: Evanston Insurance Co S35378 ACG Enterprises Inc. INSURERC: Associated Industries of MA 33758 85 Co land Drive INSURER D: Safety Insurance Company 39454 Mansfield MA 02048-1263 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 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INbK AUEXP LTR NS TYPE OF INSURANCE POLICY NUMBER PO CY M M/D EFFECD DA E PDATE OLICY MM/DDIRATI N D LIMITS ATE GENERAL LIABILITY EACH OCCURRENCE $1000000 A X COMMERCIAL GENERAL LIABILITY F14IL003337 04/09/08 04/09/09 PREMISES(Ea occurence) $50000 CLAIMS MADE X❑OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $1000000 GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000 POLICY X PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT D ANY AUTO 3952176 05/17/08 05/17/09 (Ea accident) $1000000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Peracddent) PROPERTY DAMAGE $ (Per accident) - GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $10000000 B X I OCCUR CLAIMSMADE EXGA1482-06 04/09/08 04/09/09 AGGREGATE $10000000 RDEDUCTIBLE $ X RETENTION $O $ TA U WORKERS COMPENSATION AND TORY LIMITS_ ER C EMPLOYERS LIABILITY VW6012314012008 04/09/08 04/09/09 E.L.EACH ACCIDENT $1000000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1000000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $1000000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Job: Vitamin Shoppe, Hyannis CERTIFICATE HOLDER CANCELLATION BARNS-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Town Of Barnstable IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Attn: Wiring Inspector 367 Main Street REPRESENTATIVES. Hyannis MA 02601 ACORD 25(2001108) ©ACORD CORPORATION 1988 k nz\ Construction Management June 11, 2008 Building Department Town of Barnstable 200 Main Street Hyannis, MA Dear Sirs: Please consider this letter as a confirmation that William S. Patten is a full time employee of ACG Enterprises Inc and is in good standing with employment and licensing. Please feel free to contact our offices at any time with any questions or concerns. Si cer y, Attilio LaPira ACG Enterprises Inc. ACG Enterprises, Inc. 85 Copeland Drive Mansfield, MA 02048 9 Phone: 508.261.7003 • Fax: 508.261.7006 L7�1Massachusetts Department of Environmental Protection Bureau of Waste Prevention .Air Quality 1100073443 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition Important: A. Applicability When filling out PP ty forms on the computer,use only the tab key A Construction or Demolition operation of an industrial, commercial, or institutional building, or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection cursor-do not use the return (DEP), Bureau of Waste Prevention-Air Quality Control Regulations 310 CMR 7.09. Notification of et key. Construction or Demolition operations is required under 310 CMR 7.09(2)ten (10)days prior to any work being performed. The following information is required pursuant to 310 CMR 7.09. B. General Project Description 1. a. Is this facility fee exempt-city, town, district, municipal housing authority,owner-occupied Instructions residence of four units or less?❑Yes ✓❑ No 1.All sections of b. Provide blanket decal number if applicable: Blanket Decal Number this form must be completed in order to comply with the 2. Facility Information: Department of THE VITAMIN SHOPPE Environmental Protection a.Name notification 11070 IYANNOUGH ROAD requirements of b.Address 310 CMR 7.09 Barnstable MA 02601 c.Ci /Town d.State e.ZiD Code 5082617003 bill@acgenterprise.com f.Tele hone Number area code and extension .E-mail Address(optional) 3400 1 h.Size of Facility in Square Feet i.Number of Floors j.Was the facility built prior to 1980? ❑✓ Yes ❑ No k. Describe the current or prior use of the facility: COMMERCIAL(BLOCKBUSTER) I. Is the facility a residential facility? ❑ Yes ✓❑ No �O m. If yes, how many units? Number of Units �c) 3. Facility Owner: -N KIMCO REALTY �o a.Name �o IGLEN WILSON b.Address 433 S. MAIN STREET CT I 06110 (0 c.citvrrown d.State e.Zip Code �0 18605610245 f.Telephone Number area code and extension .E-mail Address(optional) d GLEN WILSON �Q h.Onsite Manager Name ag06.doc•10/02 BWP AQ 06•Page 1 of 3 f Massachusetts Department of Environmental Protection Bureau of Waste Prevention .Air Quality 1100073443 Decal Number BWP AQ 06 Notification Prior to Construction or Demolition General Statement If B. General Project Description cont. asbestos is found during a 4. General Contractor: Construction or Demolition JACG ENTERPRISE INC. operation,all responsible parties a.Name must comply with IWILLIAM PATTEN 310 CMR 7.00, b.Address Chapter 7.er 21 and 85 COPELAND DRIVE MA 02048 Chapter 21 E of the - General Laws of c.Ci /Town d.State e.ZiD Code the commonwealth. 15082617003 1 lbill@acgenterprise.com This would include, f.Tele hone Number area code and extension .E-mail Address(optional) but would not be limited to,filing an 1ATTILIO LAPIRA asbestos removal h.On-site Manager Name _ notification with the Department and/or a notice of release/threat of C. General Construction or Demolition Description release of a hazardous substance to the 1. Construction or demolition contractor: Department,if applicable. JACG ENTERPRISES INC a.Name 85 COPELAND DRIVE b.Address MANSFILED MA [02048 c.CitVrrown d.State e.Zip Code 5082615007 bill@acgenterprise.com . f.Telephone Number(area code and extension) g.E-mail Address(optional) ATTILIO LAPIRA " h.On-site Manager Name 2. On-Site Supervisor: WILLIAM PATTEN On-Site Supervisor Name 3. Is the entire facility to be demolished? F1 Yes 71 No �0 4. Describe the area(s)to be demolished: �o REMOVAL OF INTERIOR WALLS AND.ACOUSTICAL CEILING �N —�0 5. If this is a construction project, describe the building(s)or addition(s)to be constructed: � EXISTING RETAIL TO BE SPLIT INTO TWO STORES. o �Q ag06.doc•10/02 BWP AQ 06•Page 2 of 3 r Massachusetts Department of Environmental Protection ■ V' Bureau of Waste Prevention •Air Quality 100073"3 Decal Number BWP AQ 06 Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.) 6. a. If this is a demolition project, were the structure(s)surveyed for the.presence of asbestos containing material (ACM)? ❑ Yes 0 No If yes, who conducted the survey? b.Survevor Name c.Division of Occupational Safety Certification Number 7. Construction or Demolition: 8/1/2008 8/5/2008 a.Start Date(mm/dd/yyyy) b.End Date(mm/dd/yyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding ❑ paving wetting ❑ shrouding b. If other, please specify: ❑ ✓❑ covering ❑ other 9. For Emergency Demolition Operations,who is the DEP official who evaluated the emergency? a.Name of DEP Official b.Title c.Date mm/dd of Authorization d.DEP Waiver Number D. Certification I certify that I have examined the IWILLIAM PATTEN =o above and that to the best of my a.Print Name �o knowledge it is true and complete. 1william s patten The signature below subjects the b.Authorized Signature -N signer to the general statutes IGENERAL PARTNER �o regarding a false and misleading c. Position/I Me �o statement(s). ACG ENTERPRISE INC. 7771 d.Representing 06/11/2008 �o e.Date(mm/dd/yyyy) �o �d �Q ■ ag06.doc•10/02 BWP AQ 06•Page 3 of 3■ Massachusetts Department of Environmental Protection Bureau of Waste Prevention •Air Quality 100073443 BWP AQ 06 Decal Number Ll� r Notification Prior to Construction or Demolition Important: A. Applicability When filling out pp y forms on the computer,use only the tab key A Construction or Demolition operation of an industrial, commercial, or institutional building, or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection cursor-do not use the return (DEP), Bureau of Waste Prevention-Air Quality Control Regulations 310 CMR 7.09. Notification of key. Construction or Demolition operations is required under 310 CMR 7.09 (2)ten (10)days prior to any work being performed. The following information is required pursuant to 310 CMR 7.09. B. General Project Description 1. a. Is this facility fee exempt-city, town, district, municipal housing authority,owner-occupied Instructions residence of four units or less?❑Yes ✓❑ No 1.All sections of b. Provide blanket decal number if applicable: Blanket Decal Number this form must be completed in order to comply with the 2. Facility Information: Department of The Vitamin Shoppe Environmental Protection a.Name notification Ken Martin requirements of b.Address 310 CMR 7.09 1070 I annough Road MA 02601 c.C' /Town d.State e.Z71D Code (508)261-7003 bill@acgenterprise.com f.Tele hone Number area code and extension E-mail Address(optional) 3,400 t h.Size of Facility in Square Feet i.Number of Floors j. Was the facility built prior to 1980? ❑✓ Yes ❑ No k. Describe the current or prior use of the facility: commercial(blockbuster) I. Is the facility a residential facility? ❑ Yes ❑✓ No �o m. If yes, how many units? Number of units �c) 3. Facility Owner: �N Kimco Realty �o a.Name =o Glen Wilson b.Address 433 S. Main street CT 106110 �(0 c.Citvrrown d.State e.ZD Code =o (860)561-0245 f.Tele hone Number area code and extension .E-mail Address(optional) O Glen Wilson OQ h.Onsite Manager Name ag06.doc•10/02 BWP AQ 06 Page 1 of 3 L7�1 Massachusetts Department of Environmental Protection Bureau of Waste Prevention -Air Quality 1100073443 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition General Statement:If B. General Project Description tion cont. asbestos is found during a 4. General Contractor: Construction or Demolition ACG Enterprise INC. operation,all a.Name responsible parties must comply with William Patten 310 CMR 7.00, b.Address and Chapter 21 E of the 85 Copeland Drive MA 02048 —� Cha 21 General Laws of c.Citvrrown d.State e.ZiD Code the Commonwealth. (508)261-7003 bill@acgenterprise.com This would include, f.Tele hone Number area code and extension .E-mail Address(optional) but would not be limited to,filing an Attilio LaPira asbestos removal h.On-site Manager Name notification with the Department and/or a notice of release/threat of release of a C. General Construction or Demolition Description hazardous substance to the 1. Construction or demolition contractor: Department,if applicable. JACG Enterprises INC a.Name 85 Copeland Drive b.Address Mansfiled IMA 102048 c.Ci /Town d.State e.Zip Code (508)261-5007 bill@acgenterprise.com f.Telephone Number area code and extension g.E-mail Address(optional) Attilio LaPira h.On-site Manager Name 2. On-Site Supervisor: William Patten On-Site Supervisor Name 3. Is the entire facility to be demolished? F1 Yes ✓1 No N �0 4. Describe the area(s)to be demolished: �o Removal of interior walls and acoustical ceiling �N �c) 5. If this is a construction project, describe the building(s)or addition(s)to be constructed: Existing retail to be split into two stores. N a �a I �Q ag06.doc-10/02 BWP AQ 06-Page 2 of 3 Massachusetts Department of Environmental ProtectionLl ■ Bureau of Waste Prevention .Air Quality 1100073443 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.) 6. a. If this is a demolition project, were the structure(s)surveyed for the presence of asbestos containing material (ACM)? ❑ Yes ❑✓ No If yes, who conducted the survey? b.Survevor Name c.Division of Occupational Safety Certification Number 08/01/2008 008 7. Construction or Demolition: 08105/2 a.Start Date(mm/dd/yyyy) b.End Date(mm/dd/yyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding ❑ paving ❑ wetting ❑ shrouding b. If other, please specify: ❑✓ covering ❑ other 9. For Emergency Demolition Operations,who is the DEP official who evaluated the emergency? a.Name of DEP Official b.Title c.Date mm/dd of Authorization d.DEP Waiver Number D. Certification cl I certify that I have examined the will Patten �o above and that to the best of my a.P-nt Name . �O knowledge it is true and complete. The signature below subjects the b. thon Signature �N signer to the general statutes General Partner �o regarding a false and misleading c.Positioni I itle o statement(s). JACG Enterprise Inc. d.RepresenWq (0 e.Date(mm/ d/yyyy) �o �Q ■ ag06.doc•10/02 BWP AQ 06•Page 3 of 3■ CONSTRUCTION CONTROL AFFIDAVIT PROJECT NUMBER: FTA 7618 PROJECT TITLE: The Vitamin Shoppe PROJECT LOCATION: 1070 lyannough Rd,Hyannis,MA NAME OF BUILDING: NATURE OF PROJECT Interior Remodel IN ACCORDANCE WITH SECTION 116.0 OF THE MASSACHUSETTS STATE BUILDING CODE 1, Jeffrey Taylor,AIA Registration No. 9626 BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECT HEREBY CERTIFY THAT 1 HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS,COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT ( ) ARCHITECTURAL ( XX ) STRUCTURAL ( ) MECHANICAL ( ) FIRE PROTECTION { ) ELECTRICAL ( ) OTHER(specify) ( ) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEDGE,SUCH PLANS, COMUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRACTICES AND ALL APPLICABLE LAWS AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2. 1 Review of shop drawings,samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit,and approval for conformance to the design concept. 2 Review and approval of the quality control procedures for all code- required controlled materials. 3 Special architectural or engineering professional inspection of critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix B. PURSUANT TO SECTION 116.2.3,1 SHALL SUBMIT PERIODICALLY,A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE STATE BUILDING INSPECTOR. UPON COMPLETION OF THE WORK,1 SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. ��RED Agcy T. �C*A No. 9826 o, OF 1AA SIGNATURE SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF L 20 MY COMMISION EXPIRES V 01 9L010 LORI ARMSTRONG Notary Public,State of New York No. 01 AR6044755 Qualified in Putnam County Commission Expires July 10/20_ ✓die -�'oz��.w�uiieal� o��/�,aaaaclzuaella Board of B"uilding'Regulations and Standards j { Construction Supervisor License License CS 87436 i a. �,Expiitti6n 4/30/2009 Tr#. 10716 -. Restnction Q W # i WIL.LIAM S PA TTEN ,20 FRONT:ST#2 `1/VEYNIOUTH MA 02188 ., i Commissioner TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 611 �_y I Application# Health Division Conservation Division Permit# Tax Collector Date Issued 5 -Z Treasurer Application Fee Planning Dept. Permit Fee A— Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 1070 Tyanough Rd Hyannis, Ma ti1M Village Hyannis Ma Owner xi,,n Realty Corporation Address 41 S Main St Sete 322 W Hartford C Telephone 8 6 0 5 h 1 0 2 4 5 06110 Permit Request To devide the existing space in to two retail units by:`adding a new partition wall with one hour fire pateing acree the existing •space.. The fit out will be by the tenant. Square feet: 1st floor:existing 7, n 1 6 proposed n 2nd floor:existing _o proposed 0 ' Total'-new 7 016 Zoning District Flood Plain no Groundwater Overlay Project Valuation 5� nnn 0 0— Construction Type masorary steel steel studs Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family, ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure 20 Years Historic House: ❑Yes LJ No On Old King's Highway: ❑Yes ®No Basement Type: ❑Full ❑Crawl ❑Walkout i]Other S 1 ab Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing 2 new n Number of Bedrooms: existing 0 new Total Room Count(not including baths):existing 9 new 1 First Floor Room Count 3 Heat Type and Fuel: �d Gas ❑Oil ❑Electric ❑Other Central Air: W Yes ❑ No Fireplaces: Existing 0 New Existing wood/coal stove: ❑Yes W 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❑ Commercial1 Yes 0 No If yes, site plan review# Current Use Beta}1 SterA Proposed Use RPiZa i i Store BUILDER INFORMATION Name Bill Croston Telephone Number 508 989 1464 Address_p.o. Rox 1 3 8 License# 01 41 1 9 osterville, Ma o2655 Home Improvement Contractor# i, Worker's Compensation# AWC 701341901 2007 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Yarmouth Transfer Station i SIGNATURE DATE May 14 2008 r r f _ FOR OFFICIAL USE ONLY 1 PERMIT NO. - DATE ISSUED MAP/PARCEL NO. ' r ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ,A FRAME INSULATION FIREPLACE ( ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO. r 05( S%2009 TUB 14: 41 FAA e6o 561 0426 ximcq aeal Ey : tYJ;. FROM ',BV.L GRC$70`1 :LCE S FAX, N0. 'SIB(C 1,� 31, [lay. 04 20Et'E3 10:410AM f 2 Town o 'B trnstable Regulaton$+n Cswr.sns d'if a..emoce s�gD•.f, Tim pfrm> �C Mdiu Strl=14 141;�mis.MA ME'." Fax: 508-790-62AO Property O mex Must t:;r r"Pl.ete and gi.;n This Section. If Using BuUder ,A�i® y fir' ALY,ymarCol t-v'i�n✓ E Owner 7 L exklpvat izr�cixe rt s rPKc , +n_- ire:al mat ass sek vm to work auzho.� ed kp tti; Duill �C�x,:,.it�p�i-a.;.o�� /� kAd&m v job} A are (• �. is(_ '�_-. __. .._�_._-- . -Peat N=C k YAf f 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): Rill Croston Building Contractor Address: p_n_ Rix 1'3 8 City/State/Zip: psterld 1 1 e. Ma 02655 Phone#: 5 0 8 771 3.891 Are you an employer?Check the appropriate box: Type of project(required): 1.® I am a employer with 4 4. ❑ I am a general contractor and 1 * have hired the sub-contractors 6: ❑New construction employees(full and/or part-time). • 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling ship and have no employees These sub-contractors have g• ❑Demolition working for me m any capacity. employees and have workers' [No workers' comp. insurance comp.insurance.1 9. ❑Building addition required.] . 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no 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. $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 Company Name:_ A_ T M_ M > >a l Insurance Policy#or Self-ins.Lic.#: ATgc 701341901 2007 Expiration Date: 9/8/0 8 Job Site Address: 107.0 TTannngh Rd City/State/Zip: Hyannis, Ma 02601 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 certi nder the pa' s d pen of perjury that the information provided above is true and correct Signstore: Date: May 14 2008 Phone#: 508 771 3891 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#: Y -s � Z ems ' w ..�' ', ,lir. , CERTIFICATE OF xINSiTRfANCE �F � r ISSUE DATE 09/04/2007 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Miller McCartin CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE ba Dowling&O'Neil Ins Agcy DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 22 West Main Street Hyannis,MA 02601 COMPANIES AFFORDING COVERAGE INSURED William W Croston ba William W Croston BuildingContractor COMPANY A A.I.M.Mutual Insurance Co O Box 138 LETTER Osterville,MA 02655 # '1 --2 � :'- �r�. ,��*f'-�� 1"tt^-`�+" '-� i�' -?- '_"�— '�` COVERAGES _ '61- 3 9�� :: , .•: d 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 ANTCONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POCKY NIIAH3ER POLICY EFFECTIVE POLICY EXPIRATION LIMITS - DATE(MMIDD1YY) DATE(MMIDD/YY) GENERAL LIABILITY • _ GENERAL AGGREGATE PRODUCTS-COMPIOP AGG. Q COMMERCL4L GENERAL LIABILITY - - - _ PERSONAL&ADV.INJURY O=CLAIMS MADE=OCCUR �. EACH OCCURRENCE OWNER'S&CONTRACTOR'S PROT. FIRE DAMAGE(Anyone tire) Q MED.EXPENSE(AnyoM pmm) AUTOMOBILE LIABILITY COMBINED SINGLE _..-. LIMB ANY AUTO .... - ..„ .. .. BODILY INJURYALL OWNED AUTOS (Pa person) SCHEDULED AUTOS - HIRED AUTOS NON-OWNED AUTOS BODILY INJURY GARAGE LIABILITY - (Pa aceidot) ` PROPERTY DAMAGE EXCESS LIABILITY EACH OCCURRENCE UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND STATUTORY LIMITS OTHER EMPLOYERS LIABILITY X E PROPRIETOR/ , - EL EACH ACCIDENT S 1,000,000 A ARNERS\EXECUTIVE FFICIERS ARE: 7013419022007 09/08/2007 09/08/2008 EL DISEASE--POLICY LIMIT S 1,000,000 INCL ®EXCL EL DISEASE—EACH -EMPLOYEE 1 000 000 , COMMENTS/DESCRIPTION OF OPERATIONS OR LOCATIONS: ILLIAM W CROSTON IS NOT COVERED BY THE WORKERS'COMPENSATION POLICY. WORKERS'COMPENSATION COVERAGE APPLIES TO MASSACHUSETTS EMPLOYEES ONLY. ERTIFICATEHOL_DER = _ w .,rss c CANCECIATIONzt x�� . _ .? '�. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE HEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 WRITTEN NOTICE TO THE CERTIFICATE OLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION R LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. 6 < UTHORIZED REPRESENTATIVE • L ✓1ze Vomvniaruueccl o�✓Glaaoac/zuael�a I ` f, *� Board of Building Regulations and Standards j Construction Supervisor License ` License CS.. 141,12 + � Expiration 4/25/2010 Tr# 22290 71 itrl 4 ke-sotion 00 4 WILLIAM W CROSTON `55 SUOMI HYANNIS MA 02601 Commissioner I Barrows, Debi From: Barrows, Debi Sent: Thursday, May 22, 2008 1:31 PM To: Houghton, David Cc: Perry, Tom Subject: 624 lyannough FY 06 17,513.44 as of today, after today they need to add 5.58 daily after today. FY 07 16,843.29 as of today, after today they need to add 5.44 daily after today. FY 08 10,848.43 as of today, after today they need to add 3.92 daily after today. FY 08 Sewer Acct#2397 $50. Grand total if paid today: $45,255.16 1 f i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ' ' Parcel OAWO �- Application # Health Division "i Date Issued i Q` Conservation Division Application Fee !' 'P r/t9 c Planning;Dept r Permit Fee � . Date Definitive Plan Approved by Planning Board Hi -Historic OKH _ Preservation/ Hyannis Project Street Address 1070 A/,a vS4 `/� 2 Village Owner FE'ST ly4Z C1 �n,�.� LLC Address 33 So•�l/¢� Telephone Permit Request v<_ A14w A7 7., 3 7 0 ;. Teo 0 7 &146 Pv�,( 0 j4 MIA Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type -� ' fia Lot Size Y Grandfathered: 0 Yes ❑ No If yes, attach supportin docurmetation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) _ may, Age of Existing Structure Historic House: ❑Yes 0 No On Old King's High\A : ❑Yes.,❑ fro Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other c� Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) " Number of Baths: Full: existing new Half: existing ne, 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 0 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 41,aL 4.c�� .,�c�i� Telephone Number !J2i 4_7 6 Y1,_7 Address cR� /try ap,e A-L &A-t r 0/ License iN Ol Y7_? Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO L'L- SIGNATURE DATE /� "�1 1 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER t , r f DATE OF INSPECTION: } FOUNDATION FRAME INSULATION FIREPLACE sy .,ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL , / GAS: ROUGH FINAL + FINAL BUILDING v S 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): IJ4 GW �iyf�i9z• /f �`- ' '�c Address: (/.�� , y City/State/Zip: -IPWA— _ Phone-#: Are you an employer? Check the appropriate box: Type of project(required): 4. I am a general contractor and I 1. I am a employer with �� 6. ❑New construction employees(full and/or part-time).* have hired the stab-contractors 2 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, E]Demolition working for me in any capacity. employees and have workers' 9 []Building addition [No workers'comp in. suuance comp.insurance.$ 5. We are a corporation and its 10.❑Electrical repairs or additions required-] 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12 [ ktoof 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#1 must also fin out the section below sbowing their workers'corrparsation policy infom-ation. t Homeowners who submit this affidavit indicating they am doing all work and then hire outside contractors must submit a new affidavit indicating such. Tcantractors that check this box must attached an additional sheet showing the name of the sub contractors and statr 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.#:_f�/�iy��L� ��`'U Expiration Date: Job Site Address: O e"51, �� City/State/Zip: rdP 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 crimirial penalties of a fine tip 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 Tngrance coverage verification. I do hereby certify under a pain •and penalties of perjury that the information provided above is true and correct Si afore: Date: — Phone# Official use only. Do not write in this area, tb be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Ins&uctions 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 hue, 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 fok 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,i.f necessary,supply sub-contractors)name(s),address(es) and phone numbers)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 Bq 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 permitdicense 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" (he 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 burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would Re to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone-and fax number. The Cammanwean of Massaehuse:m Drrgarhnent of Industdal Accidents Office of Inveshgatlans 604 Washington.Street Boston,MA 02111 Tel. #617-727-4900 ext 4-06 Qr 1-977-MASSAFF Fax# 617-727-7749 Revised 11-22-p6 www.mass_gov/dia RightFax N3-2: 7/21/2008 1 :03:30 PM PACE 3/003 Fax Server ACORD. CERTIFICATE OF INSURANCE DATE(MMIDD',YY) 07-21-08 PRODUCER THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT'S UPON THE CERTIFICATE THOMAS GREGORY ASSOC HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 601 EDGEWATER DR#235 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 55_ COMPANIES AFFORDING COVERAGE WAKEFIELD,MA 018810 COMPANY 73DJJ A H:ARTFORDGROUP INSURED COMPANY ' g NEW ENGLAND INDLT.STRIAL ROOFING CO INC COMPANY 25 THEODCRE DRIVE IINIT#4' C 1iTSTMINSTER,MA 01.473 COMPANY D COVERAGE THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FORTH POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOC UNI ENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN.THE INSURANCE - - AFFORDED EYTHE.POLICIES DESCRIBED HEREIN IS SUBJECTTO ALLTHE TERMS,E%CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DATE(MWDDIYY) DATE(MIMDD1)'Y) LIMITS GENERAL LIABILITY GENERALAGGREG.ATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS COMPIOP AGO. $ CLAIMS MADE OCCUR. PERSONAL&&ADV.INJURY $ OWNERS&&CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE(Anyone fire) $ VIED.EXPENSE(Anyone person) $ AUTOMOBILE UABIL17Y ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY(Per Person) $ SCHEDULE AUTOS BODILY INJURY(Per Accident) $ HIRED AUTOS PROPERTY DAMAGE $ NON-OWNED AUTOS GARAGE LIABILITY ANY AUTOS AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGREGATE $ EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE $ OTHEF THAN UMBRELLA FORM AGGREGATE $ WORK ER'S,,OMP ENS ATION AND A EMPOLYER'S LIABILITY UB-4068B386-08 01-01-08 01-01-09 STATUTORY LIMITS X THE PROPRIETOR/ -EACH ACCIDENT $ 1,000,000 PARTNERS/EXECUTIVE X INCL DISEASE POLICYLIMIT $ 1,000,000 OFFICERS ARE: EXCL DISEASE EACH EMPLOYEE $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIRESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING FVORKERS COMP COVERAGE. THEINSURED'S 1.tA WORKERS COMPENSATION POLICY AND ITS LIMITED OTHER STATES ENDORSEMENT AUTHORIZES THE PAYMENT OP BENEFITS FOR CLAIMS MADE BY THE DISLI ED'S NIA EMPLOYEES IN STATES OTHER THAN MA. NO AUTHORIZATION IS GIVEN TO PAY CLAIMS R)R BENEFITS IN STATES OTTER THAN MA IF THE INSURED HLRES,OR HAS HIRED EMPLOYEES O T[SIDE OPMA.THIS POLICY DOES NOT PROVME COVERAGE FOR ANY STATE OTHER THAN MA. - RE:PO#1409 REPAIR FLASHING R SEAMS SITE 1114 FESIIVAL AT HYANMS.HYANNIS.iMA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABODE DESCRIBED POLICIES BE CANCELLED BEFORE THE KMICO.hEALTY CORP EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 ". , DAYS WPITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT CORPORATE CENTER WEST FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY 433 S.A.WM ST STE 322 KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. WEST iAR'1'FORD,CT 06110 AUTHORIZED REPRESE14TATIVE ACORD 25-5(3(93) Ramani Ay.^r Kimco Realty Corporation Nancy Elliott Writer's Direct Dial: 860-561-0356 Property Management Department Writer's Direct Fax: 860-561-0426 Email. nelliott(21-imcorealty.com Website: fvivmkimcorealty.com VIA Is' Class Mail August 8, 2008 Mr. Tom Bratko New England Industrial Roofing Co., Inc. 25 Theodore Drive/Unit #4 Westminster, MA 01473 RE: Festival At Hyannis - 1114 Dear Tom: Enclosed please find your copy of the fully executed Purchase Order to Replace the Roof at Vitamin Shoppe at Festival At Hyannis in Hyannis,.MA. We look forward to working with you on this job. If you should have any.questions, please do not hesitate to contact me at the number above. Sincerely, Nancy Elliott Property Management Department New England/Northern New:York Enclosure Corporate Center West, 4.3 South Main Street, Suite 322, West Ilartford, CT 06110 PURCHASE ORDER DATE: July 14, 2008 PURCHASE ORDER#: 1408 SITE M SMAH1114A MASTER JOB#: JC081114A PURCHASER: Festival Of Hyannis, LLC CONTRACT#: VNEW/EN02P1408081114 Festival At Hyannis Hyammis, MA JOB CODE#: - JC08R1114 VENDOR# VNEW/EN02 VENDOR: New England Industrial Roofing.Co., Inc. Eric H. Darlington (� 25 Theodore Drive/Unit#4 Westminster MA 01473 - 978-874-6347 SCOPE OF WORK: Vitamin Shoppe Roof Replacement SUBJECT TO THE TERMS AND CONDITIONS ATTACHED HERETO AS EXHIBIT"A"; EXHIBIT "B and "C" MADE A PART HEREOF. Contractor to furnish necessary labor, material and equipment to perform Vitamin. Shoppe Roof Replacement at Owner's Site SMAH1-114A, Festival At Hyannis Hyammis, MA, as stated in the attached Proposal dated July 14, 2008 to Glenn W. Wilson, Property Manager, which becomes part of this Purchase Order. CONTRACT CANCELABLE BY WRITTEN NOTICE CERTIFIED MAIL. RETURN RECEIPT REQUESTED. TOTAL: $25,000.00 Initial: Buyer: Vendor: 1 Contractor to furnish us with a Certificate of Insurance PRIOR TO COMMENCEMENT OF ABOVE NOTED WORK. (Material only suppliers are exempt in this regard.) Please refer to Recommended Minimum Insurance Requirements for Contractors, copy attached.. INSURANCE CERTIFICATE TO BE FORWARDED TO: Glenn W. Wilson Festival Of Hyannis, LLC c/o Kimco Realty Corporation 433 South Main Street/Suite 322 West Hartford, CT 06110 KIMCO REALTY CORPORATION, AND Festival Of Hyannis, LLC SHALL BE NAMED AS ADDITIONAL INSURED AS WELL AS CERTIFICATE HOLDER.' Hold Harmless Agreement to be executed by Vendor. (Material only suppliers are exempt in . this regard.) If using subcontractors please submit a list on your letterhead. Final lien waivers will be required from each prior to final payment. PURCHASER: FESTIVAL OF HYANNIS, LLC Festival of Hyannis Holdco, LLC, its Sole Member Kimco Income Fund I, L.P., Sole Member Kimco Income Fund I GP, Inc., General Partner SIGNED BY: By: Name: ti Title: p l Date Signed: ACCEPTED BY: VENDOR: Eric H. Darlington New England Industrial Roofing Co., Inc. B y: �i -7� Name: Title: Date Signed: �v��0/ t r Vendor:Initial: Buyer:. :R / f For Purchaser Office Use Only JOB CODE: COST CODE: AMOUNT: CHECK ONE: RECURRING COST NON-RECURRING COST: FOR NON-RECURRING COST: BUDGET CATEGORY: G/L ACCOUNT#: SUMMARY OF CHARGES: INDICATE ALL ACCOUNT NUMBERS AND.THE RESPECTIVE CHARGES. ALL CHARGES SHOULD TOTAL AMOUNT OF PURCHASE ORDER. G/L A/C #: AMOUNTS: G/L A/C #: AMOUNTS: G/L A/C #: AMOUNTS: Initial: Buyer: Vendor. 3 a MINIMUM INSURANCE REQUIREMENTS FOR CONTRACTORS 1. Workers Compensation and Employers Liability Coverage • Statutory Workers Compensation coverage • Employers Liability- $500,000 each accident/$500,000 each employee/$500,000 policy limit • 30 days notice.of cancellation • Name Owner and Kimco Realty Corporation as additional insured's 2. General Liability Coverage Limits of Liability: $1 million combined single limit for bodily injury, personal injury or property damage per occurrence/$2 million aggregate per projector location "Occurrence" form, including: • Premises/Operations Liability • Blanket Contractual Liability, including coverage for all liability assumed under this contract • Products & Completed Operations •- Pollution coverage for losses arising out of a hostile fire • "XCU" Hazards must be covered • 30 days notice of cancellation to owner as a condition of cancellation 3. Business Automobile Coverage • Limit of Liability: $1 million combined single limit per accident for bodily injury or property damage • Business Auto policy form, including: • Coverage for"any auto" which includes autos owned, hired, and non-owned autos • 30 days notice of cancellation 4. Umbrella Liability Coverage • Limit of Liability: Not less than $5 million 30 days notice of cancellation 5. Property Insurance All contractors and subcontractors shall be responsible for all loss or damage to contractors' tools, equipment sheds, and any other materials or supplies, which do not become part of the finished project. The.owner and its agents take no responsibility for said equipment. Initial: Buyer: Vendor: {: 4 Additional Requirements • Insurances specified in items 2, 3, and 4 shall name the Owner Festival Of Hyannis, LLC and Kimco Realty Corp. as additional insured's. • All insurances shall contain a provision allowing insured to.waive subrogation rights against other parties prior to loss. • All insurances shall be secured from financially responsible insurance carriers . qualified to do business in the state in which this operation is located. Certificates of insurance in form and substance acceptable to Owner and Kimco Realty Corp. and evidencing all insurances must be presented to the owner prior to the commencement of any work of operations at the project and upon request. Such certificates shall provide that the insurer shall not cancel or terminate coverage without thirty days prior written notice to the Owner and Kimco Realty Corp. Initial: Buyer: Vendor.'':, 5 i TERMS AND CONDITIONS DEFINITIONS: The word "Contractor/Seller" when used herein means the party who furnishes the material or performs the work described on the face of this order. The word "Purchaser" or "Owner" means the entity that executes the attached document as "Purchaser" on page 2. ACCEPTANCE: This order shall not be binding on Purchaser or Seller unless accepted in writing by Seller and returned to Purchaser within ten(10) days of the date hereof. QUALITY: All materials furnished and work done hereunder shall be in first-class order and in strict accordance with the Plans, Specifications and General Conditions of contracts referred to herein. Payment to Seller will be subject to inspection by and approval of Owner. PLANS, SPECIFICATIONS, AND GENERAL CONDITIONS: Any Plans, Specifications and General Conditions of contracts referred to in this order are hereby made a part hereof as if fully set forth herein. DELIVERY AND COMPLETION: Both this order and the work are subject to the approval of Owner. CONTINGENCIES: In the event of fire, labor troubles, accident, flood or other casualty, Governmental regulations or any cause or condition beyond the reasonable control of Purchaser, the materials and/or work herein described may be rescheduled by mutual consent or failing mutual consent., Purchaser may in its sole discretion and without liability to Seller reduce, suspend or cancel the work. LIABILITY FOR DAMAGES: Seller does,hereby agree to indemnify, save harmless and defend Purchaser from all liability for loss, damage or injury to person or property in any manner arising out of or in incident to the performance of this order(including all expenses relating thereto). PROPRIETARY RIGHTS: Seller warrants that the materials and work herein described do not infringe upon any letters, patent, licenses or other proprietary rights, and agrees to defend any suit that may arise in respect thereto and to indemnify, defend and save Purchaser harmless from any loss and expense which may be incurred by the assertion of any claim of infringement. WAIVER OF LIENS: Seller waives the right to file mechanic's liens for materials furnished or work done. Seller further agrees that if he or anyone claiming through him files such a lien,. Seller will immediately at his own expense take all action necessary to remove it from the record: SELLER'S RISK: All materials furnished and work performed,under this order shall. remain at Seller's risk until final acceptance of the completed work by Owner. LABOR: Seller agrees that.all.work will be'done by labor which is acceptable in quality and affiliation to Purchaser. Seller will save Purchaser harmless from loss by reason of Seller's failure to comply with this condition. 6 Initial:. Buyer: Vendor: . COMPLIANCE: Seller will comply with all applicable Federal, State and local laws and regulations including but not limited to those concerning prices, work permits and security requirements. Seller agrees that prices charged under this order are complete and final for the materials to be furnished and the work to be performed and include every Federal, State and local tax in effect at time of delivery or performance. PAYMENT: Subject always to due performance and.compliance by Seller hereunder, payment to Seller for work done shall be on the customary basis of 90% monthly, balance 30 days after acceptance of the work by Purchaser. Each application.for payment under this contract shall be accompanied by partial lien waivers by Seller in said form as shall be required and directed by the supervising architect; properly executed and notarized on behalf of every entity which has supplied labor and/or material and/or services to the Work as of the date of each application. The final application for payment shall be accompanied by all final lien waivers as directed by supervising architect(s), properly executed and notarized on behalf of every entity which has supplied labor and/or materials and/or services to the work as of the date of final application. CANCELLATION: Purchaser may, in its sole discretion and without liability to Seller, cancel .this order(or any portion hereof) if Seller fails to comply with the terms and conditions hereof. This contract shall be subject to the approval of the Board.of Directors of Owner and in the . event that within ten (10) business days from the date hereof the Board determines that this contract is not in the best interest of Owner, this contract shall be cancelable forthwith on notice to Seller within such ten (10) day period. In addition, either party shall have the right to terminate this agreement on twenty-four(24)hours written notice to the other.party. No modifications, waivers, alterations or other changes in or to this contract, the Contract Documents or work shall be binding or valid unless effected expressly in writing by the party against whom the same shall be asserted. RIGHTS: Enumeration herein of certain legal rights.shall not exclude other such rights given by law. BILLING: Unless otherwise stated, bills to Purchaser are to be sent to the following address: Kimco Realty Corporation, Billbox #01-6185-1053, P.O. Box 7522, Hicksville, NY 11802-7522. ADVERTISING: Any and all advertising concerning work or materials furnished under this order, including signs at the site of the work, publication in trade journals or other media. must be submitted to Purchaser and approved by Purchaser prior to its use. GOVERNING LAW: This Agreement shall be governed by and construed and enforced in accordance with the laws of the State of New York. Seller hereby agrees to submit to the personal jurisdiction of the state and federal courts located in the State of New York with respect to any dispute arising hereunder and hereby irrevocably designates the Secretary of State of New York as its agent to accept and acknowledge on its behalf service of process as valid service of process upon Seller. Initial: Buyer: Vendor: 7 NOTICES: Any notice that either party may give shall be given by mailing the notice, Return Receipt Requested, or by sending the notice by nationally recognized overnight courier service (e.g. Federal Express or UPS) to the other party at the following addresses: To Purchaser: Festival Of Hyannis, LLC c/o Kimco Realty Corporation 433 South Main Street/Suite 322 West Hartford, CT 06110 Attn: Glenn W. Wilson Fax No.: 860-561-0426 To Vendor: Eric H. Darlington New England Industrial Roofing Co., Inc. 25 Theodore Drive/Unit#4 Westminster MA 01473 978-874-6347 r Initial: Buyer: 8 Vendor: ' EXHIBIT«A HOLD.HARMLESS AGREEMENT This HOLD HARMLESS AGREEMENT pertains to work to be performed at: Site#: SMAH1114A Hyammis, MA Effective Date: July 14, 2008 Contractor Name: New England Industrial Roofing Co., Inc. (hereinafter referred to as the"Contractor" and is part of the contract with Kimco Realty Corp. (hereinafter referred to as the"Owner, dated for said work pursuant to plans prepared by (the"Architect".) The Contractor will and does agree to INDEMNIFY, SAVE & HOLD HARMLESS this Owner, the Architect, their agents and employees, and assigns of and from all liabilities, claims, losses, damages, injury causes and actions, suits of whatsoever nature for personal injury, including death resulting there from, and for property damage, alleged to arise out of, or any conditions of the work performed under this Contract, whether by Contractor or by any sub-contractor of the aforesaid Contractor and whether any claim, cause of action, or suit is asserted against the Owner or the Architect, their respective agents and employees or assigns or the Contractor severally,jointly, or jointly and severally. .The Contractor will and hereby agrees to INDEMNIFY, SAVE & HOLD HARMLESS this Owner, the Architects, their respective agents and employees or assigns from all costs of any nature, including without limitation investigation, adjustment, attorney's fees, expert's fees, court costs, administrative costs, and other items of expense arising out of anyclaim, cause of action or suit of the kind and nature set forth in the preceding paragraph, The Contractor hereby agrees that it will obtain insurance to cover its liability hereunder in the minimum amounts necessary to cover potential liability under this agreement but not less than the limits of liability shown.in "Minimum Insurance Requirements for Contractors" shown on.page 4 and 5 of this agreement. It is agreed that Certificates for all Insurance will be submitted to the Owner or its broker before the actual commencement of any work. Such Certificates must indicate that the "HOLD HARMLESS AGREEMENT"contractual indemnity as set forth in this agreement is insured and, among other things required by Owner, must provide that no less than 15 days advance written notice will be given to the party to whom such Certificates are issued in the event of cancellation of the policies or a reduction in the limits of liabilities set forth above. At Owner's request Contractor will immediately furnish`Owner with a true.and complete,copy of any insurance.policy Owner wants to renew. Under no circumstances will any invoices for progress payments or final payment be honored by the Owner unless such Certificates of Insurance(or the policy, if requested) have been filed with this Owner at 3333 New Hyde Park Road, Suite 100, New Hyde Park, NY 11042-0020. IN WITNESS THEREOF, this.Contractor has executed this Agreement this day of 206-P. CONTRACTO . g By: n ( ignature Required) Name: ,/�`�m o�,�s Y. / CJ Title: � �oc Initial: Buyer: 40 Vendor:. -/ 9 f NEIR NEW ENGLAND INDUSTRIAL ROOFING CO., INC. June 24, 2008 Kimco Realty Attn: Glen Wilson Corporate Center West 433 South Main Street Suite 322 West Hartford, CT 06110 RE: Old Blockbuster Video Festive at Hyannis Rt. 132 Hyannis, MA 7,370 sqft. Dear Glen: We are pleased to.present to you the quote on the following work for the installation of a new roofing system for the location referenced above. 1) Clear a 10' X 100' section of roof ballast and disperse across the remaining roof surface. 2) In the area that the roof ballast was displaced, remove the existing EPDM roof membrane and dispose of off site. The cost of waste removal and dumpster rental has been included in our price. 3) Inspect the existing 3.25" polyisocyanurate roof insulation for wetness and replace any damaged insulation at an additional cost to the project of$3.507sgft. 4) Over the existing exposed roof insulation supply and install a .045" non-reinforced EPDM roof membrane. This shall be done per the roofing manufacturer's details and specification for&ballasted roof system. 5), Over the new roof membrane,re-distribute the existing roof ballast. f) Repeat steps 1-5 until new membrane has been installed over the entire 7,370 sgft area. 25 Theodore Drive, Unit #4 Westminster MA 01473 (978) 874-6347 Fax (978) 874-1090. 7) Flash the following roof penetrations into the new roofing system per the manufacturer's details and specifications: (1)Plumbing vent (1)Heat cone (1) 2'- 6"x 3% 0" roof hatch (2)Roof top HVAC units (4)Elect/gas lines 8) Apply EPDM membrane up the entire height of the parapet walls and terminate below the existing cap stone per the roofing manufacturer's details and specifications. 9) Supply and install (6)walkway pads as required by the roofing manufacturer to be located at the roof hatch and 14VAC service doors. 10) Flash(2)thru-wall scuppers into the new roofing system and supply and install (2) associated downspouts. 11) Provide the roofing manufacturer's 15-year total system no-dollar-limit warranty for the above work. The total cost for the above work will be $25,000.00 If you have any questions please feel free to contact me. Sincerely, NEW ENGLAND INDUSTRIAL ROOFING CO., INC. Eric H. Darlington Estimator. EN@R NEW ENGLAND INDUSTRIAL ROOFING CO.,INC. THOMAS BRATKO a PHONE:(978)874-6347 25 FAX:(978)874-1090 WESTMINSTER,MA 01473 CELL:(508)331-4812 EMAIL:tom.bratko@neir.net _ l f _ PROJEC 1` NAME: ADDRESS: I�O — PERMIT# �" �3 13,5� PERMIT DATE: O M/P• LARGE ROLLED PLANS ARE IN: II BOX SLOT Data entered in MAPS program .on: -�07 BY R= r q/wpfiles/archive -C: . ' ., - - - .. • - .^rl' - y 1 ( _I' _ \ ' . _ e 7 1 - ni . .. ., M - ttt _ .r ;7; s ?. In: i 1. � 3 7. i ! I n (. i, ; i 1 1 1 � - . I . . I I . 7 . I , .. r I 1 �307r I' - I _ I I / { T v IA k % N .r 't - I J t ... II - , - . \ .' I� l>5 .n 1. . 1. 1� - - _ I� z .. 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