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0300 SMOKE VALLEY ROAD
a0/ 30 oaf Town of Barnstable *Permit# Regulatory Services X-PR96—S900—ft MASS Thomas F.Geiler,Director APR - 2 i639. �• 2013 Building Division Tom Perry,CBO, Building Commissioner TOWN OF BARNSTABL E(] 200 Main Street,Hyannis,MA 02601 pm www.town.bamstable.ma.us I� Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 100 Not Valid without Red X-Press Imprint Map/parcel Number 07` /� -. � yy� Property Address 3 0 J M D >° do�1 ey 2 7� d- /i / � Residential Value of Work . 7 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 7:Z�.o h h CO3 1� S S o o S M,b ee i�z 0-p- C, Contractor's Name J b j rA +-f- Telephone Number Yo( y 6 g/- a Y- 7 Home Improvement Contractor License#(if applicable) (D y Construction Supervisor's License#(if applicable) 7 06 -7 7 F ❑Workman's Compensation Insurance Check one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name -7r�z Ve-14-r S --t$• C y , Workman's Comp.Policy# Copy of Insurance`Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side of doors Replacement indow /doors/sliders.U-Value (maximum.35)#of window ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\building ermit forms XPRESS.doc Revised 053012 j t + - y j� n a .1vo n 7!,�tij )c rN i%o r c e �. �-:- UARx_ GOP #3 "U"'A21 5 7 r}t Mx r Commt n e t f e 0 ce. of consumer Affairs -R ME IMPROVEMENT CONT AC M- .-. a i tratro n. : xpi rati n: 1111/2015 - J 5 Duarte ,+`s c , St 77- WOW Wa ma 02571 reham r _ Vr -} i h ' .d ° Glle�Parnmra�uaea�co�C>�ac�uraetYb ed tfice of Consumer Affairs&Business Regulation License•or registration valid for individul use only ME IMPROV NT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation egistrati Type. 10 Park Plaza-Suite.-5170 gs 1 Supplement•:ardd'-Boston,MA 02116 The Home Depot MARK NIADNA 2690 CUMBERLAND. S )k%M.GA 30339 Undersecretary of valid with ut signature r �, 0 i a August 17, 2012 Barnstable Building Dept. The following is a list of our approved sub-contractors for The Home Depot: Ericsson Torres—CSSL# 100546 HIC# 163528 Michael Viola —CSSL#099403 HIC# 140993 Robert Reposa - CS # 60526 HIC# 147080 Timothy Thomas-CS # 51899 HIC# 152121 Joseph Duarte - CS # 70077 HIC # 132349 Douglas Szynal - CSSL# 103950 HIC# 146142 Brian Laroche - CSSL# 100478 HIC# 152612 Joseph Mckeon - CSSL# 98863 HIC# 132614 If you have any questions please contact Mike Bedard our permit coordinator at 508-962-6942 or myself at 617-438-9017. S' cer y, ussel Jo t e Branc ,tnstallation Manager THD At-Home Services, Inc. 908 Boston Turnpike- Unit 1 •Shrewsbury, MA 01545 Phone:774-275-2139•Fax:508-845-6076•Toll Free:800-657-5182 $ ' The Commonwealth of Massachusetts Department.of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 wwminass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/El lease Print Le Ibly AP licant Information Name(Business/Organization/Individual): `f `a.Q lx 0(t�''2.1 I ., Address: City/State/Zip: A l ie_-bo'-a me b 234b Phone#: � 9 g- q y3 Are you an.employerI Check the appropriate box: Type of project(required): I.❑ I am a employer with 4. I.am a general contractor and 1 6 E]New construction employees(full and/or part-time).* have hired the sub-contractors Remodeling 2.� lam a sole proprietor or partner- listed on the attached sheet. ❑ ship and have no employees These sub-contractors have g. ❑Demolition employees and have workers 9, ❑.Building addition working forme imany capacity. comp.insurance [No workers' comp.insurance 10.0 Electrical repairs or additions required.] 5• ❑ We are a corporation and its 3.❑ I am a homeowner doing all work officers have exercised their I I.[]Plumbing repairs or additions right of exemption per MGL 12,❑Roof repairs Myself.[No workers' comp. c. 152,§1(4),and.we have no insurance required.]t 13.R Other ►��0.CQlw►�i";l' employees.[No workers' t,J t1 �vWs 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. lContractors 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 t�vorkers'.compensation insurance for my employees. Below is thepolicy and job site information. QI'SS J Insurance Company Name: rt;"J R' - Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: 43 ob � S Ni a fCt Ua ll e R8 City/State/Zip: ����V��� �1'►'G� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). ies lead to the'imposi 10 Failure to secure coverage as required under Section 25A of MGvil penalties in the form of a STOP WORK ORDER tand a fine fine up to$1,500.00 and/or one-year imprisonment,as well as c p of up too$1, 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 covers e verification. �Idoherebycerti under the pains and penalties ofperjury that the information.provided abio[ve is Prue a�td correctDate: `tature: Phone 7her only. Do not write in this area, to be completed by city or town official. n: Permit/License# hority(circle one): Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.9t rson: Phone#: i I Simonton Windows 6500 VantageRointe }-RC Casement Vinyl 1/8"Glass-Argon•Low-E-No Laminated Glass No Grids =:a?atiiF�rrsrrrt�2 . Ventana batiente Vinilo 3.18 mm Vidrio Argon Low-E Sin vidrio Rniiigc `r"t-. laminado-Sin rejillas ICPD,SSP-A-61-10832-00001 08-09 CS ENERGY PERFORMANCE RATINGS EVALUACION DE RENDIMIENTO ENERGETICO U-Factor Solar Heat Gain Coefficient F2Ctoi%U CoeSciarte:Ganancie de Energ;a Sofa 0.26 1 .48 0.23 i (U.S./I-P) I {MEtfICe/SI� I ?n ADDITIONAL PERFORMANCE RATINGS EVALUACION SUPLEMENTARIA DE RENDIMIENTO Visible Transmittance i Transmision de Luz Visible I 0.44 Manufacturer stipulates that these ratings conform to apPlicab!e NFRC procedures for determining whole product performance. NFRC ratings are determined for a fixed set of ervronmenta!conditions and a specific product size.NFRC noes not recommeno any product and does not warrant the suitability of any product for any specific use.Consult:manufacturefs literature fcr other Este fabricante estipula qua va!ores cumplen con los procedimientos aplicales de NFRC Para determiner e!rendimiento:ota!del ! oroducto.Los veto,as usados por NFRC son determinados por un conjunto fijo de condiciones ambiertatas y un tamaro ee f product esoecifico.NFRC no recomienda ningun product y no garantiza que el product sea adecuado pare un use especifico. Consulte con el folleto del fabricante Para at use apropiado de este product.ww.v.nfro.org i Unit qualifies for ENERGY - f %� �r U STAR®region(s):Northern., North Central,South Central, Southern. STC:29 Qt2tifi.ed IND:Rein 00/Glass ProSolar/C-R55 DP:+55/-55 Tested Size:36"x 72" Florida Product Approval:FL107 Applicable Test Standard(s): ANSI/AAMA/NWWDA 101/I.S.2-97,AAMA/WDMA/CSA 101/I.S.2/A440-05,AAMA/WDMA/CSA 101/I.S.2/A440-08, A440S1-09 Canadian Suppl 9664606/04-1 J0049 BABOFS THD Shrewsbury 8842340 1 Keep this label for possible ENERGY STARD rebates.To learn more visit vrvyw.energystar.gov. Guarde esta etiqueta posibles reembolsos ENERGY STAR&Para conocer mas acerca de esto,visite y I— HOME IMPROVF,MENTCONTRACT PLEASE READ THIS 'L Sold,Furnished and Installed by: Branch Name: Roston Date: 3 ' ct THD At-Home Services,inc. d/h/a The Home Depot At-fiome Services 908 Boston Turnpike;Unit 1,Shrewsbury.MA 01545 Toll Free(800)657-5182;Fax(508)845-6017 Branch Number:31 Federul IT)k 75-2698460;MF.Lic 8 C 02439;RT Cont.Lic#16427 CT L,ri1c#1-1IC..056552 :MA H'ne Impn vemcnt I nntmctur cg.#126893' Installation Address: dQ ��i State Zip Purchas r(s): Work Phone: ITome Phone: Cell Phone: dirt_ . Home Address: (IfdillercnlfrominsiallaliunAddress) City State Zip E-mail Address(to receive project communications and Home Depot updates):_. ❑1 DO NOT wish to receive,any marketing entails from The Home Depot Proiect information: Undersigned-("Customer"),the owners of the property located at the above installation address,agrees to buy, and THU AI-Home Services,Inc.("The Home Depot")agrees to lumish,deliver and arrange for the installation("Installation")of all materials described on the below and on the.referenced Spec Mcct(s), all of which are incorporated into this Contract by this reference,along with any applicable Stale Supplement and Payment Summary attached hereto and any Change Orders(collectively, "Contract"): P ducts: Spec Sh #: Protect Amount Roofing ❑Siding iadows ❑Iluulalion / �— ❑Cullers/Covers ❑h:ntryDoors ❑ I Ie 1e, ❑Roofing DSiding ❑Winditwg LJ Insulation ❑Goners/(:ovens ❑Entry Doors ❑ �— Roofin Sldin� Windows l i S ❑�� 6 ❑ ❑Insulation I [:]Gutters/Covers ❑Entry Doors❑_„ _ $ ❑Reuling ❑Siding Windows El Insulation ❑row.en/Covers ❑6ntry Doors ❑ $ Minirnim25%Deposit ofCmnract Amount due upon execution ufthscontract Total CuntractAmount $ MRine.Purchasers may not deposit.more.than one-third of the Contract Amount Customer agrees that, irmu)ediately upon completion of the work for each Product.Customer will execute a Completion Certificate (one for each Product as defined by oil individual Spec Sheet)and pay any balance duc. As applicable,each Customer under this Contract agrees to be jointly and severally obligated and liable hereunder. 'ncc Honnc Depot reserves the right to issue a Change Ordcr or terminate this Contract or any individual Product(;)included herein,at its discretion,if The I lumc Depot or its authorized service provider determines that it cannot perform its obligations due to a structural problem with the home,environmental hazards Such as mold,asbestos or]cad paint,other sal'uy concerns,pricing errors or because work required to complete the job was not included in the Contract. Pavment Summary: Tile Payment Summa_ ( _ included as part.of this Contract, sets forth the total Contract:rnnnunt and payments required for the deposiLS and final paynlen s by Product(as applicable). NOTICE.TO CUSTOMER You are entitled to a completely lilled-in copy of the Contract ut the time you AV ,n. Do not sign u Completion Certificate(note: there is otne.Completion Certificate for each listed Product as defined by Individual Spec Sheets)before work on that Product is complete. • In the event of termination of this Contract,Customer agrees to pay The[Lome Depot the costs of materials,lubor,expenses and services provided by The Home Depot or Authorized Service Provider through the date of termination, plus any other amounts set forth in this Agreement or allowed under applicable law. THE HOME DEPOT'MAY WITHHOLD AMOUNTS OWED TO THE HOME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LIMITING THE HOME DF,POT'S OTIIER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. Acceutance and Authorization: Customer agrees and understands that this Agreement is the entire agreement holwcen Customer and The I Ionia Depot with regard to the Products and Installation services and supersedes all prior discussions and agreements,either oral or written,relating to said Products and Installation.This Agreement cannot be assigned or amended except by a writing signed by Customer and The Home Depot.Customer acknowledges and agrees that Customer has read,understands,voluntarily accepts the terns of and has received a copy of this Agreement. Accepter / p I Ct'tamer'sSignature Irate Sales on.uhanL's(1 laatuu pate X _ Telephone No. Customer's Signature Date Sales Consultant License No. CANCELLATION: CUSTOMER MAY CANCEL TIIIS (asapplicuhle) AC:REF.MF.NT WITHOUT PENALTY OR OBLIGATION BY DFI,1VERINC WRITTEN NOTICE TO TiIEOME DEPOT BY MIDNIGHT ON THE THIRD BUSI HNFSS DAY AFTER SIGNING TIUS AGREEMENT THE STATE SUPPLEMENT ATTACHED IiE.VTO CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRTRED BY LAW IN CUSTOMER'S STATk;, NIJ'I'ICF:ADDITIONAL'1'ER.NIS AND CONDITIONS ARESTATED ON TIIL REVERSE SILL AND ARE PART OFTIIIN CONTRACT 05.10.12 White..Rranrh FiIN vAumu_fl wr o. LA d SHV aodaa awoH << tiL)_ L5W0S 3N0Hd'8i0dX3ZL9Z W LL ZL-£0-£L02 , ' A The,Commonwealth Massachusetts. Department of 1A id, ts,�Ihdustrla, cc- en 0fo e 6fInvestigations 600'Mishinit6n Street Bostoit,MA 02111 www rrmass.'g'ovldi ta Woikers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): � 0 01 ,a j0p.o D �CiC� lec� Address: City/State/Zip:_ -4- L. G� bA j�Phone Are you an employer?Check the appropriate box: Type of project(required): 1. 4JR:4 am a general contractor and I El I am a employer with 6. 0 New construction employees(fall and/or part-time).* _gave hired the sub-contractors 2.E1 I am a sole proprietor or partner- listed on the attached sheet. 7. E] Remodeling ship and have no employees These sub-contractors have 8. E]Demolition employees and have workers working for me in any capacity. 9. E]Building addition [No workers'comp. insurance comp: insuranceJ required.] 5. E] We are a corporation and its 10.[:]Electrical repairs or additions 3.[:] 1 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.F Roof repairs insurance required.]t C. 152, §1(4),and we have no employees. [No workers' 13.X Other. Reek.ce- comp. insurance required.] I I *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. IContractors 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: W pc�,W-1,0 � Policy#or Self-ins.Lic. D 33 57 Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number.and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil 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 pains and of perjury that the information provided above is true and correct. .fy under the ry Sign 011 Date: . 9 - 2 - 13 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):, 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: Mas achusetts Department of Environmental Protection j Burl u of Resource Protection - Waterways Regulation Program x267 Transmittal ittal No. Ch , Ater 91 Waterways License Application -310 CMR s.00 Wate +Dependent, Nonwater-Dependent,Amendment G. I unicipal Zoning Certificate John D. &Ardell C. Callas Name of Applicant 300 Smoke Valley Road Warren's Cove Marstons Mllls Project street address Waterway City/Town Description of use or change in use: To relocate, expand & maintain an exsiting timber ramp&float. To be completed by municipal clerk or appropriate municipal official: "I hereby certify that the project described above and more fully detailed in the applicant's waterways license application and plans is not in violation of local zoning ordinances and bylaws." TL Pew Printe ame of Municipal Official Date rIA 51 0Jo2 i a ure of aunicipal Offi ial Title City/Town CH91 App.doc-Rev.08/13 Page 6 of 13 ;! TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map / f Parcel ��� Permit# 436 Health Division C .� /a-2-9 —�IC Date Issued Conservation Division 1 C. like]07 ` ew Fee 2� Tax Collector Treasurer /� - - SETIIO SYSTEM S BE A�.� /� 9� Planning Dept. INSTALLED IN COMPL WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address 300 SJ-t o ,cE V ikLA-.(--- Y 49,,o Ar 7 Village Owner Address 2-4—c-1 KO L.L. t �05 ra� h-t � bZ ( 3a Telephone � _ (o Z �Z`f t 'S� Permit Request Pert- PLAnJ -DfLAvJt-) 6-1 Q� T L) Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new 0 Estimated Project Cost o®o,° Zoning District, Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: O Yes O No If yes,attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ElYes 9s)No On Old King's Highway: ❑Yes U40 Basement Type: ❑Full O Crawl ❑Walkout O 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: O Gas ❑Oil ❑Electric O Other Central Air: ❑Yes O No Fireplaces: Existing New Existing wood/coal stove: ❑Yes O No Detached garage:❑existing ❑new size Pool:❑existing .O new size Barn:❑existing O new size Attached garage:O existing ❑new size Shed:❑existing Cl new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes O No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name_ ��oH }� S4 t-� Telephone Number Address -`3 5 C= -� � �, License# & -7 6 Home Improvement Contractor# 3 U O Worker's Compensation# 5 t_� PGA 0PrZ(CT-0 �- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE _ 1 1`T 5` FOR OFFICIAL USE ONLY PERMIT NO. - A DATE ISSUED - MAP/PARCEL NO. _ r - ADDRESS VILLAGE OWNER , LLL 6 DATE OF INSPECTION: FOUNDATION FRAME . INSULATION `(r(` FIREPLACE `? ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH 3 'i FINAL GAS: ROUGH') FINAL FINAL BUILDING "+ m 1 s: DATE CLOSED OUT ASSOCIATION PLAN NO., . c"! r,1 ' ,1 0 1 , I17.1 / � I I • u v i I I I • 1 1 11 1 1 1 1 1 1 1 1 1/ • • •• • .11• 1 1 • • 1 ••• •.� 1 1 1 KI•. ■ 11 1 /1 • • • vill 1011A(sibI li•, A .• 11..11 • • 1 • 11 :111U • '• •n /_ • 1 1 . • 1 ■ • • •• •1 gal ' 11 • M1 • 1111 �11 / 1. 1 1 �• 1 • 1 • • .I •' • 1• t . •1 11 1 1 1 :� H �� � �i�� 1 �� f�pp 6 / . 1 • 1 1 1 1 ♦ • 11 1 � official use oni do not write in this arm to be compigted by city or town offlAM] �: • 1 1 II ■E3BuOding Department city or town: LILIcensing Board ■ . • 11■ check if immediate response Ccontact person: lHeattliDepartment ; ■ • .:...._..........._. K .\{..\%<��::...:C!!;?:;.vii:ii4.v.::::-i":. ^-:vi;:i:::..ii:................ . . K•\;,is\\i(•`•i�i:<Siii�i:v.vi.J^�y:.�:«<y;... Op 1HE Tp� The Town of Barnstable RAMSrn M - �� 1 ��� Department of Health Safety and Environmental Services rE �tA Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre:-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work:Qrl' c'' t3 u cr 4f_; ►b S, Estimated Cost Address of Work:_ 08 fin At c= V �'�'�Y '�� ���✓�G�� Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 wilding not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY.FUND UNDER MGL c. 142A.. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: ! ' /'n O d Da t Contract r Name Registration No. OR Date Owner's Name I q:forms:Affidav I ! file �Q771/I�?>yl2llIPCGI'rX __ corset f' oard of Building Regdlations. and Standards. One Ashburton Place f '•° — Room 1301 Boston , Massat�usetts• 02108 t Home Improvement- Contractor Registration Registration:' 130009 !'Expiration:, 12/13/01, ! Type: ' Individual f John Hanson John Hanson I' 353 Carriageshop. Rd . f East Falmouth MA 02536 9ES10 YN 1011P] ise3 -pa dogsa5Ppjv3 E aioavalslrvlwav ,.I uosueN uosueN ugof r ienptntpuI MAI TO/ET/ZT :oot)eIldx3 = �, 6000ET :ooi�e�Tsi6a� _=' � d SOIJUi1N071N3N3f108dNI3NON — a urn �»mu' o > nor-nrcwaio% rr�^ \� • 41 DEFARTHENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Nudbet Expires: }Y ON ` ' `, �la'if�ff ` ' ism , Restncted TO '00 . z r� �: 1 �':..: II ' 'X eT$4.e SOHN A HANSON l 353 CARRINBESHOP RD E FALHOUTH, HA 02536 Gf a d - tq C A. O R1 N O 6a C ti• n � C R�O 9 y- o a. O O 4t' � ppy .pl fir." 110 `.-p•,h �: '\.1^Ff4SC� �34i V Co ................. .................................... .................. ...... ....... ...... ....... ...... .... : ........ (MM/DDABCDEFERTIFIME RAN- /Y Y . . ............. PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE THE WAQUOIT INS AGENCY DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 516 WAQUOIT HIGHWAY POLICIES BELOW. P 0 BOX 3099 COMPANIES AFFORDING COVERAGE WAQUOIT, MA 02536 COMPANY A LETTER — GU COMPANY B INSURED LETTER CAPE MARINE CONTRACTING COMPANY C T.M. DOYLE LETTER P.O. BOX 279 COMPANY D FORESTDALE, MA LETTER 02644 COMPANY E LETTER RAG ................... ....... ........ ................................... .................. ........ .............. ..... .......::::::..... ... ...... . .......... ...................................... ...... .......................... . ............... ........ ............................ . .................................. ..... ..... 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DATE (MM/DDNY) DATE (MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE COMMERCIAL GENERAL LIABILITY 3CA8919 0 9 01 9 9 0 9 0 1 0 0 PRODUCTS-COMP/OP AGG. ........... LAIMS ........ MADE OCCUR.Fx PERSONAL&ADV.INJURY $ I., no 0 jaU OWNERS&CONTRACTOR'S PROT. EACH OCCURRENCE $ 7L F 0 0-0,—LU PRO_T_&_JlMEMN FIRE DAMAGE(Any one fire) $ —5-o-,Qwo MED.EXPEIISE (Anyone person) $ c; 00n AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM ....... ........ ................. ............. ..... . . ........*** *...... ......... _........................................................................ .........................................................................:::::*:::::::.. ......... ............... ...... .... .................................... ........................................... ..... ....................................I....................... ......... WORKER'S COMPENSATION STATUTORY LIMITS ............ ....................... ....................................... ....... ................ ... ......... ............................... ...................................... AND NO EMPLOYEES EACH ACCIDENT $ EMPLOYERS'LIABILITY SOLE OWNER DISEASE-POLICY LIMIT $ DISEASE-EACH EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS ....................................................................... .......... . .................... .................. .......................... ... ..... ............................................... ....... ..................................... . ...................... ............ ERTIFICAT.t..:�HOLDEA.::::::::::::: ...................... ............. :C .... . ...................... .................................... .... ....... ...... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE JOHN CALLAS EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO 300 SMOKE VALLEY RD MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE OSTERVILLE, MA LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF A KIND UPON T REPRESENTATIVES.�IVE PAN A RE*,TS AGENTS 9 02655 AUTHORIZED REPRESENjA'TLV_l�-,j.%j ................. . .... .......... .................:.:. .... . ........A . . ............ ....0...�.i.C...O....R...P..O....O..O......I............9..%...... : ................... �a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma 1 Parcel V`� 1 r ,, P Application # � l� Health Division Date Issued Conservation Division Application F 2 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board EEC A l e- S r Historic - OKH _ Preservation / Hyannis Project Street Address 3 oo � Village ��Qc�'te V i If r Owner .\l�� �Vl Ca � Address � � �C�1�-`� V(4((_) q 1�y Telephone )o — q g�z r L111 y Permit Request ( ��O �o�C"`" Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Val uatio# Construction Type XOPIRESSit Lot Size Grandfathered: ❑Yes ❑ No If�IARa1 L�10porting documentation. 1 ' Dwelling Type: Single Family ❑ Two Family ❑ Multi-Fa10 K., UVni � ABLE 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 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 U 1 11� Q��! / ((� c��� Telephone Number AddressP1U��U�-� �` 'l License # Home Improvement Contractor# / & d * Email Worker's Compensation # V.0 LA3-=-(,�GI 1/109•-ZO ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJ CT WI BE TAKEN TO SIGNATURE DATE 'y FOR OFFICIAL USE ONLY APPLICATION# ' DATE ISSUED t F MAP/PARCEL NO. " r 1 ADDRESS " VILLAGE OWNER R DATE OF INSPECTION: ` 3 FOUNDATION - FRAME INSULATION t FIREPLACE ELECTRICAL: ROUGH FINAL r. PLUMBING: ROUGH FINAL - - GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. - w � Federal ID q 05-0405629 RISE Engineering RI Contractor Registration No 8186 �/ MA Contractor Registration No 1T0979 RISE a' A division of Thiclsch Engineering CT Contractor Registration No 620120 ENGINEERING 5 Dupont Avenue,South Yarmouth,MA 02664 CONTRACT 508-568-1926 X-6613 FAX 508-568-1933 Page 1 PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE CLC-RCS ENGINEERING AND THE CUSTOMER FOR WORK As DESCRIBED BELOW ....._ ----- .._ .........- ._-___.........__ CUSTOMER PHONE DATE CLIENT 0 WORK ORDER John Callas (508)428-4110 03/03/2016 217340 00002 SERVICE STREET BILLING STREET 300 Smoke Valley Road P Box 837 SERVICE CITY.STATE,LP BILLING CITY,STATE,LP ' Osterville, MA 02655 Osterville, MA 02655 MAR - 4 2016 • jig ,, JOB DESCRIPTION ` OVERHANG:Provide labor and materials to install 10"R-37 densely packed Class I Cellulose insulation to(135)square feet of- _ exterior overhang located below a heated floor area,by drilling holes in the overhang from below. Holes drilled will be plugged. Plugs will be sealed with exterior grade spackle and left in a relatively smooth condition.Finish sanding and touch-up priming/painting will he the customers responsibility. $276.75 CRAWLSPACE:Provide labor and materials to install(300)square feet of 6 nil polyethylene over open ground in designated crawlspace/carthen basement areas. $231.00 CRAWLSPACE:Provide labor and materials to install(740)square feet of R-21 closed cell spray foam insulation to the cmwlspace perimeter wall,sill and band joists. Then install a spray applied ignition barrier over all exposed foam. Any cmwlspacc access within the perimeter wall will be wcatherstripped and insulated to R-21. Any present crawlspacc vents will be pennancntly sealed. $4,070.00 INCENTIVE:RISE Engineering will apply all applicable,eligible incentives to this contract. You will he billed only the Net amount. Currently for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$4,000 per calendar year,and an" incentive of 100%for the Air Scaling mmures. For the safety and health of your home's indoor air quality,we will be conducting a blower door diagnostic of the available air flow in your home both before the work is begun,and after the weatheri7ation work is complete.We will also conduct a diagnostic assessment of the combustion fumes in the exhaust flue ofyour heating system and water heater.This has a value of$90 and is at no cost to you. $90.00 Total: $4,667.75 Program Incentive: $3,581.06 Customer Total: $1,086.69 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***One Thousand Eighty-Six 8r 69/100 Dollars $1,086.69 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING,CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION.SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BL+SNK SPAC l( AUTHORIZED SIGNATURE•RISE Engineednp CUSTOMER ACCEPTANCE ! �� L> IV:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE .__�... - ....—.. - ._._ •• ACCEPTANCE OF CONTRACT-THE ABOVE PRICES.SPECIFICATIONS AND CONDITIONS ARE DAYS. SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WOR I AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE i i v row n of Barnstable Regulatory Sen ices �''&T"3 ' Riebard'V' Scala,Director 6�� Building Division Tom Perry,.Building Commissioner 200 Main Stied,Hyannis.MA.02601 www1own.barnstable-ma.ns Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete-and Sign INS Section. If Us� A Builder Y, as Other of the:subject pmPeny herebyaurhorize.�M nn� % to action: lybehalf,. in L-mamrs relative to work authorized by this building permit application for. 3OD Smo�2 11�..����� t. {Address,of j ob) '*Pool fences and alarms ue the responsi%lty of the applicant. Po&s are not to be fined or utiliixd Wore ft nce is.installed and all final inspections are performed and accepted. Sign of Owner Si nature.of Applicant "J cd . a — Print Marne Print Name Date Q:FOnIS:OWNFRP)E RbtISSIONPW1S The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a 1 Congress Street, Suite 100 J.. Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Inc McMahon and Son, , Name (Business/Organization/Individual): M.T. _ Address: 19 Fieldstone Way City/State/Zip: Plymouth , Ma 02360 Phone #:781-831-1234 Are you an employer? Check the appropriate box: Type of project(required): 1.❑■ I am a employer with 9 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' insurance. 9. ❑ Building addition comp.[No workers' comp. insurance 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 I LF] 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 Weatherization 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-contradtors 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:Aim Insurance Policy#or Self-ins. Lic. #:VCW-100-6014109-201 Expiration Date: 12/08/2016 Job Site Address: (Y10� ' I City/State/Zip: Ne( I'l fe.- 61714 W6-5 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 here ify nder the pains and penalties of perjury that the information provided above is true and correct. Si ature: Date: 2 , Phone#: 78 8311234 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#: fJ2li, , rrtuc al/o cifG.uac/rrseld { ?�j Massachusetts-Department of Public Safety WExpiration. OfticeofConsumerAifaus&Dusiue�a:ieufaGun Board of Building Regulations and StandardsOME IMPROVEMENT CONTRACTOR Construction Supen'icnr egistration: v 11816 Type: License: CS-068111 . 1112412016 Private Corporatic `" MICHAELTMC#'AHON`' MICHAEL T.MC N kSON-IC. r• y r � * , 19lEIELDSTONE,'WA,'�f PLYMOUTH MA:02360 MICHAEL 19•FIELDSTONE WAY' PCYMOUT.H,MA 02360 „ ,U g r�� �,,�,.,, �1J�Ge�c. �` Expiration Undersecretary P Commissioner 08N7/2016�. e � , ,Unrestricted-Buildings-of any use group which L!,ees?nr registrarion valid for individul use on:y con ain.le'ss than.35,000 cubic feet(991 m3)of'. . t, before the expiratiu.i date. ff and return to: a enclosed space. Office of consumer Affairs and Business':tsoulation 10 Park Plana-Suite '17U Boston,NIA 02116 tl Failure to possess a current edition of the Massachusetts State Building Cade is cause for revocation of this license. `{ •Not valid without signature For DPS Ucensing information vlslt: www.Mass.Gov/DPS � CERTIFICATE OF LIABILITY INSURANCE DATE( 2 la ) ACORO ls ® 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 endorsemen s. PRODUCER CONTACT NAME: Thompson Insurance PHONE F FAX 781 335-1890 I No: (781) 335-9782 and Financial ServicesE-MAIL ADDRESS: JJTins@Comcast.net 389 Union Street INSURERS)AFFORDING COVERAGE NAIC# Weymouth, MA 02190-316 INSURER A:Travelers INSURED INSURER B:AIM Mutual MT McMahon and Son Inc. INSURER C:Torus National 19 Fieldstone Way INSURERD: Plymouth, MA 02360 INSURERE: 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. rLT ADDL SUER POLICY EFF POLICY EXP TYPE OF INSURANCE POLICY NUMBER MIDDY MMIDD/YYW LIMITS GENERAL LIABILITY y NPP8082574 8/26/15 8/26/16 EACH OCCURRENCE $ 1,000,000 X COMMERCIALGENEPALLIABILITY PREMISES DAMAGE (Ea occurrence)RENTED $ 100,000 CLAIMS-MADE �OCCUR ME EXP(Anyone person) $ 5 000 PERSONALBADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2 000 000 GEN'LAGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG $ 2,000,000 ,7X POLICY PRO LOC $ A AUTOMOBILE LIABILITY BA 2C882729 8/31/15 8/31/16 EOeBGD�SINGLELIMIT $ 1 000 000 ANY AUTO BODILY INJURY(Per person) $ ALLOWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS _AUTOS P $ C X UMBRELLALIAB OCCUR 80313L140ALI 11/24/15 11/24/16 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ $ B WORKERS COMPENSATION VWC-100-6014109-201 12/8/15 12/8/16 WCSTATU- X OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE �Y/N N/A E.L.EACH ACODENT $ 500,000 OFFICERIMEMBER EXCLUDED? .• , (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If YYes describe under DES�RIPTIONOF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Insulation installation and carpentry. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE John J. Thompson CLTC ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: DEBRIS DISPOSAL AFFIDAVIT In accordance with the provisions of M.G.L. c. 40, s. 54, Building Permit # was issued with the condition that all debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by M.G.L c. 111, s. 150A. The debris will be disposed of in: ABC Disposal Name of Waste Facility 1245 Shawmut BLVD New Bedford Address of Waste Facility 111.5 Debris: As a condition of issuing a permit for the demolition, renovation, rehabilitation or other alteration of a building or structure, M.G.L. c.40 s. 54 requires that the debris resulting therefrom shall be disposed of in a properly licensed solid waste disposal facility as defined by M.G.L.c. I I I s. 150 A.Signature of the permit applicant, date and number of the building permit to be issued shall be indicated on a form provided by the Building Department and attached to the office copy of the building permit retained by the Building Department. If the debris will not be disposed of as indicated, the holder of the pen-nit shall notify the building official, in writing,as to the location where the debris will be disposed. 780 CMR—61h Edition Signature of Permit Applicant Date t c� c � 1� r� ••;•-.,_.,.�..__. ""f/ �rs:-•.^..po �• (�� ,,fir` t AAff ! t L O C U+ +lam 1 cr -..w� FOP PRO E f Y L1PvE 1� F oRmATIONY c I i SEE i AND COURT PLANS K72S� 5� J uj 9 259 E3A1P#5 '• L. }�E 3►S R` Or ,. o E D S. ai .� �4;Iltlt� I sw let �, Fr)R PROPOSED 9UI..li+EhD 6 /' 'ra -,TA,R5 SCE SE3• w4£38 W wr` ( 1 ?' cam u; �•Orp �),,f�ALL SITE PLAN SEE` r` ` l3 of W ea t , s 1 tnuja 1 ( a 'i L1 Lf tt to s !^ 1 ol ( ILI it1 � 11 d 1 } f G'4.ish�� $ WTI 2911N f". I 1CIVIL S-SVWI 3 ltrlb,, ISO :1''• "� a yyp;yia+w+r+o-aXvsqua>it i. 0-3 PJOHN �. rSMOKEVALLE'� R0Ah � ERVILLE , MASS FOR roNt;-RUCfION a iN`fit I RIVE IN THE MAPSTON,'S, i V •�,.•� p99 (y � x e r i A A C C * m..:,�r&cptswnmrce,.umtrs+euruaun+a+^A�+uec ut�r."zr a-:a _ I • f 1 ( i { � ALL .-� � � lT ..Jx.:.....�.:.r..,..r...,....•r.r.n.:.11�x n � LOCUS PLANt Pat p k: f 7 -- ,� •I #.r .�t Ft I i f r k. , iai ._. .a --`~-�.•,.� _� i � � 'ice Orin �e i Lw5 YIE99i �Y�'Pa? • 111 1 � ♦ s1 ..,sj ,�--..—•....-�� ._....__.._.-._..-.--�-----------^�.t .�..�.....+---.._�-- '/ lye ail; ff •��slL�b6 .''� 4P!�� ��.�f sndii'��5:�. Y'��/,('/P.�� ' 6. 0Ira- to S� . p 2 V _ a !ON R � - q � .. ,....:�. .- s.{ T t t h Vi L L,t I-IVIAN �KMIII` 17 CW G H", JULY 340,1,a'i,�,L.11 tog" e 4 N c A V ;j ww h w 0 C5 <q rt FI: Li x .� cc Ip 14 J ir I"I -j > j LA T, LQ V) Lij r 4 uj a o 00 0 0 io- 0 J j., (L Lj X 40 v::;- t U_lij 4 1 Qom.- . 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T�..��_i...... j � -'• i 1 � �` u � tY,t:� Z� � frt � • N Pw ��' t y Urn > x �IJ Lo w.wu=.NtlGsi'�s,5�i .mu�,x.xvr9J&w\elo7l i'19 ddd7itY' �:G;'i¢nctF3+v[ta .+°�ru-t 7urisv.�;%N'CiDr�latl.'WJ,�TraJu!1sALS�'laitarn-N.6a4:.r:11� ,gisN;eF;.irtali.'i #�alrnw�auv:�sa�,..ra+�r��hwuu ear atv��.��ttuttz�,�"�euWwu;�;t; �. . r'1f:. ) � �.�J C`� I �'iktwx 9R ��µjr �� ITI no �N _ �w�.. '' � �'�? � 'f � ,£ fix` „�r:.. -�,� ,✓•,,, �+ ��, �,An , {: s 4 •`^" m > �`...:. - .—r,w... '`+�-��_<.� „�o �� �` ""M" a .A"'r t��� 1 { } 1 j "ej �k � j„ st+•• � ' p ff � f'r Xt�f� q♦ � r - r _ fI I M,4RSTONS MILLS RIVER _n EBB -:-' FLOOD 445'± TO R O L 2 � O� ,+ 200'+OVERALL LIMITS-OF EXIST BULKHEAD W=D OUTCROPS F 118 PROPOSED WOODEN rA © '� SALT MARSH O N -r O C7 c =OOpOz z BULKHEAD 9 STAIRS U) r- rnvz� O to< 3 z-4-A9Sp — �Z{ _,•+ram<(Tl� D c H �/0 /2 _-- COASTAL BAN �Zo ziOrDm cn _ rnm_ cnmZmrrz /B CANOE RACK ir imp 3DSA rmn o�� TOP Viz`° spvm-mcn �x> Zo PLAN wwzwmn j umw SCALEI 50' cZi DDpDr z ciao < �— r ' pD Z rn u z n Cn 6 THREADS (a B"=4I-Ou Y Tm v� SEE BULKHEAD DETAIL w d SHEET 2OF3 `n STAIRS TO BE3-OWIDE. . xis SOLID RISERS ARE NOT EXISTING HOUSE w ~ PERMITTED, •e GARAGE io �a mymo p SECTION A-A rnx D� mmrnx -1 n 0 x -4< zm Par m rn r � E SCAL I/4'�=I'-O�� cnm v'faax T rn .0 rno aPrn - a rnb �Px ro � y r wrn zoo a i =tea nxT Y� a we vZir C o a ~ _ �z o < ZM rn Ax mrrn N mrn r -" o kt ►" CA 0 31s3� p 2 4 8 FT. w fa _4"n y o C oCA L O o c 0 25 50 IOOFT. n '� I � 1 11 J) � \�,": • � Z. LOCUS PLAN Scale: l"= 2000' Assessors Map 97 Parcel I 4'-3" I .�„x 6, f, REQIIIRFD A A _0 Z",x ti' FRAMtNCa I I III PLAN I MtN. ExIgT• / _ rip—17, l— G-RNIDE SECTION A-A PROPOSED REBUI LTCANOE RACK Scale 3/8"= I'-011 5UUNUINUb BASED ON M.-L.W. DATUM. MARSTONS � DATED 07/28/99 MILLS R/VER EBB �Z FLOOD 1 *+j .Q* ih lb 0� PROPOSED 0 6 STAIRS H•'N' 0- F� 4 0} PROPOSED }9 4� 6 6 µ \ \ WOODEN 0 0 �\ \'� �Q i 6 +Qlb �Q� �Q\ BULKHEAD + 3;�l Q PROPOSED 8"0 PILESP 8'O.C., 14'LONG(TYR) I 125'1 28, 47'= \ 200'�'-OVERALL LIMITS OF EXISTING BULKHEAD TAPER FIRST 30'OF BULKHEAD FROM EL.3.BtTo EL.4.8'. BULKHEAD PLAN NOTE SCALE: I"=20' FI ELD ADJUST TH E ELEVATION OF THE TOP OF BULKHEAD SOTHAT THE EXPOSURE-OF THE BULKHEAD FACE VARIES FROM A MIN. OF 20" TO A MAX.OF 40. PLANT WITH BEACH GRASS(c) 2x 10" 18"O.C. ELEV.4.8 SEE NOTE £XIST.GRADE 3"x 8"x 14'TaG �` �� �� BACKFILL WITH CLEAN H.T.L.3.3 SHEETING rT _ I�€1�' „ GRANULAR MATERIAL M.L.H. 2.5 g"xB��WHALERS �I ui' �11tF- tn, ;I�'1� EXIST. BULKHEAD,PORTIONS :II I TO REMAIN ` N o Or M.L.W.0.0 •':?~ �� FILTER FABRIC `�`\. C[nC rnr �:,54 6 +, -if ALL HARDWARETO r^r� BE GALVANIZED 8110 PILE, 8�O.C. �` FZ'T�R oma mr 14*LONG SSLLIVAR r-z <� N-..2S-733 mZ r GfVi: " r �" m : FCISTEREc 'e vi m. BULKHEAD DETAIL �`':�l ,� `�M n SCALE: 1/4"= C-0" p 2 4 8 Q z 0 10 20 40 Engineering Dept. (3rd floor) Map Cj y 7 Parcel 401 �� Permit# � (��o � G House# 1300 Date Issue `��� '" — , LW Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) -10 yS�9 gip- Fee 441�`e,��i��� 37 Y +b; Conservation Office(4th floor)(8:30-9:30/1:00-2:00) —Fill ZS 9� �0 �i1/� �Q�4B Planning Dept. (1st floor/School Admin. Bldg.) ��� 4� 4A.IA- JC Definitive Plan Approved by Planning Board 19 � ®�a BARN AB '�.�y{,o, 4% MASS CEO 9. TOWN OF BARNSTABLE Building Permit Application Project Street Address Village Owner ��IT/ ) .(� y9�(�1J5 Address Telephone 4-T-) —_71�RgCQ _ Permit Request First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ �— 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) X C P l�1¢-i Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use � _�� Proposed Use Builder Information I Telephone Number �-/77—75!P( Address License# / (p&j4-.JE> Y7 Home Improvement Contractor# L2f�{gS� Worker's Compensation# 4. ,ICU 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 C� SIGNATURE DATE / BUILDING P R ITIJANIEVF6 THE FOLLOWING REASON(S) Tak CoLIPctor t Sc- FOR OFFICIAL USE ONLY T PERMIT NO. DATE ISSUED • - t MAP/PARCEL NO. f ADDRESS VILLAGE , OWNER DATE OF INSPECTION: FOUNDATION - FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL - PLUMBING: . . ROUGH FINAL GAS: ROUGH FINAL + FINAL JUILI#NG DATE CLOSED QUT ' t"1 .� ASSOCIATION PLAN NO. A(iog, tn 04 ob in LOCATION MAP I COTUIT QUADRANGLE SCALE: 1:125,000 ASSESIURS MAP 97 PARCEL 1 C Design Boat: Herreshoff 14'• v~ LOA 17'3", LWL 14', B 5'10", D 2'6" 4. o.c: 2x4: l-lA►lv¢A'L. B4T't-1 51 2 X G DEd-14-% CA vcuc EGL�V PeTI(�1.1 - � 3ht0 .F�AMthdGt � 5•S +� I•lzrD �. E�c.'��G.. 1'tuNS 3 K% SeAL►►46% - 7 T T! -T-•• -Pr - •T31••.7 ..r YLT I ff �t• ' �f.7 ��� !•, r.1 ll•"�3'�"S�o�r 'h�c�' ,....�,,t,7 ...L•�.�.. �tr.. Jf fa4 i., i w�i+rl.. •r.+d• �'I !•MBA'' �•� �'�.i .(,•l� S.wu;�s� ,.•Ar NOTES1 FOR PROPERTY LINE INFORMATION SEE LANDCOURT PLAN 572538 5TZ58 BARNSTABLE REGISTRY OF DEEDS. Epp ' FOR PROPOSED DOCK,FLOAT 8 PILES SEE SE p0 FOR OVERALL SITE PLAN SEE SHEET 3 of 3. 2�y �O • PG LOCUS PLAN., I EXISTING HOUSE 8 v _ GARAGE U) clal 3'WIDE PATHWAY A f � • OAK i RAMP,STAIRS 8 TER POST .p J �i.e BLS / I I ♦J I • —D.B E/ -52 61L� •. -s.o PROPOSED 6'x dFLOAT 8 RAMP STQN� PLAN �QAR SCALE 0 0 d0 120 ETIof3 PLAN ACCOMPANYING.PETITION OF 1 PLAN NO.�� ® ANDELE C. CALLAS 300 VALLIEYRD.,OSTER ALLE,MA ►bl►• d Ple a �, `$. TUaDCi RIAM�N THEAtNIN4 �qmike1 t 1 N SULUVAN ENGINEERING INC. PARIKCR-AW OSTERVILLE,MA 02655 ly RAM� � s _�i �.. �kl .� a• 't s MLW • • -WOODENH BULKHEAD ANDRAIL r 4j. C15 MARSH ir PILES uj DECKING .. 7� . SIDES •• • • • ( y • 0 v LEDGERS 0 ,yJ F • WOODEN ±M BULKHEAD Sx i wt WRAMPSECTION A-A 3 PLAN VIEW • • • FTC' + i•` a 4 F W rj k 1 :: • � �e w� sf ► 1 ' i +-.,+}�.�' • 5 10 20 7 t I � z 3 N/F C.MCGREGORY a MARY M.WELLS OSTERVILLE,MA y N 6V 39'45" o to < W 544.00' ` c r In D r d a 1 i� a oN � t obi rVIP coo { 1 00 o Z ® � o Dv 4 • mo = r mm y Z; a=X �^¢ cin -4 mZ N7V4316W 261.12 N 1 i.+ 1 W \ G) N1orm 4� r x�(A 1p • r fn CZ)a;• tad d'� ec to r L •5�la�a Dr '"�# ► ^�� .fir` � '� � .. +..-.t llh..i..�l w..._• ..~ •w •JCrI�V..+i .� 1�r ..T.+nw...�cr...�a,.e.L•:.:�G,,.ry'"t r � _•tx�� .. �.-.-��. ,r J• _,r r, .t' iir;•.k;�4:iPw ''� ,h�..- .'�.Y � 1.� .ti'+iK ..f.^$�. w SUBDIVISION PLAN OF LAND IN BARNSTABLE 57P.5�� T. H. Stegrnaier, Surveyor October 20, 1964 0 4 / lop O� \ aR , a� 1 .0 20. �2 so 15. L. C. PLAN 5925-3 CERT. Z9441 � t J oOw SCAvuiT INc . C i \ih 00 A0. \ 00 9 � 2 �LEY(40 v*ffo) RD., \��oo ��► c. .► 8.69 - C.S. i c.e. e.8. Subdivision of Parl of Lot J Shown on Plan 5725 Sheet 2 Filed with Cert. of Title No. 1858 �' Registry District of Barnstdble County i ' •fin _ !w. �..�y�♦•�A, r R • ► •�.nE' _'a...�,.,} . .{�" Y+ - ... Jla' • M.i.►. 1'� . .Tr fLW i �� 5725-73 ; SUBDIVISION PLAN OF LAND IN BARNSTABLE T. H. Stegmaler, Surveyor May 9 p 1962 ... :. . ) D A tom' 4 � i i H o0 41 1(1 U Co N 1 ro +' 41 C '0 ]�U 0.17 J a ° ti • ! :Oo Op I .0 R 0\\ LL \a ' `� / 3 78 ZZ �,"•off` rya 315 o F 1itZ6•� ;�Sy z p - 5 9� a �\• •p6''97 A rtls��l�L�� o ' No-to: hp Denotes C.e• unless 0t►14--r•w18e spec;+ied Subdivision of Part of Lot J Shown on Plan 5725J Sheet 2 Filed with Cert. of Title No. 1858 Registry District ^f Barnstable County i Plan ref. LCPlan 5725 r k \ i tco SZ8'-. \b7 N U ' J Proposed Dock Ramp & Float ��� 6 G� Area to MHW 8.05 ac. m 3' wide path to 0 �O Q cc TER a V5�1k` SULIMN IIIU.�733 > CIVIL L / Cn �- existing dwelling 9 9taIle/ t2.ZCa• 97 aril i 2id's `x ro �s IX/0 9, Overall Plan At: 300 Smoke Valley Road For: John Callas scale: none Date: December 26 , 1997 JAB, .% Sullivan Enginee ngsInTc. 7 Parker Road, Osterville 02655 l.smAi 42R-1344 W 4 P �`QAM P p TO 'to PoF VZA%5-rk I-A CA. eALAIG ,� . � 1-`�►_,,0 4� SAPS L W . -5 '6 ag,. / T,^eve wa LX-wA-�Y, 617A,►z-s a c�srs • rr / f • ��1r f • • • ..,ice ..� /•`' / 'y •:• � � � eA. a To • /' �; � Tt�P cv *OPP f x �2•ZG�4-7 CG O in � 3 rg z � rn 0 IN 0 � p r co n N . '� 6x�yr'�r.its�. 'i5vucrip. I y v, Al 0 MARSTONS MILLS RIVER -n EBBS FLOOD _ O L 445'± TO R Z *0 WQ� IIB„ 200'-'OVERALL LIMITS•OF EXISTING BULKHEAD OUTCROPS = D PROPOSED WOODEN rA 0 :m SALT MARSH F c = OOQOZ z BULKHEAD 9 STAIRS cn r I'*1OZ��p <Z� -N-�r-�<n1:V� Q - - —8 i0— " . cogs BAN r-Zo zi�rDm m l2 of I rAL % \ mm_ c»mZmrrz CANOE RACK \ m 3 a�„ r r*�c' TOP NZ� v3 rnc�m �X> 20 PLAN N� r Cp>>-<0 Docr SCALER"=50' (n(A Z(n m -� CO n DD�Dr z ciao < ;0 r LL mwz 0>0 _ (n 6 THREADS (a�B"=4'-O" Y m Ga m cn SEE BULKHEAD DETAIL -� W SHEET 2OF3 c" " STAIRS TO BE 3-0 WIDE. �. SOLID RISERS ARE NOT EXISTING HOUSE w r' FS PERMITTED, 'a GARAGE in w o a(a-n z z .o SECTION Q-Q mm v� rrnnwrmn� o n 0 X \ m v vw m SCALE I/4 I'-0" c rn (no Nsv0 w m o J t; v C fir': _n R,a mc,m r tramp N c-< 0 0 `) nxc Y' � Wm s-Jr 0 � • c�r-� -4 wr, ��m w v mi mzz n i 20 z D c.�z f, n mD rn�o �i p ; z v o a c �a 0 IL 31i3� 0 2 4 8 FT. m U ra y o C O n rn =! 2� y V, oto o c 0 25 50 IOOFT_ "n z Pox LOCUS PLAN Scale: I"= 2000' Assessors Map 97 Parcel I ,I 4,-3" .�„x 6, REQUIRFD A A o FRAM1Nb- I P I� PLAN �1 • 1� M\N. � Ex18T• I I IT— GRn,pE P SECTION A-A PROPOSED REBUI LTCANOE RACK Scale 3/8"= I'-0" SUUNDINGS BASED ON M:L.W. DATUM'. MARSTONS MILLS RIVER DATED OT/28/99 EBB �� FLOOD h 1 3 M.L W •0 0 0*1 oil • . . - p*�`• 0*1 PROPOSED *3 *p *� PROPOSED *9 *1 6 STAIRS NNW• p- \ \ p WOODEN p 0 *\ V1 6 *Q �� BULKHEAD I0 0 0 u o 0 o o PROPOSED 8"0 PILES(7a S'O.C., 14'LONG(TYP.) 125'* 28, 4T*`- 200':'-OVERALL LIMITS OF EXISTING BULKHEAD TAPER FIRST 30'OF BULKHEAD FROM EL.3.8*TO EL.4.8=. BULKHEAD PLAN NOTE: _ SCALE: 1' =20' FIELD ADJUST THE ELEVATION OF THETOPOF BULKHEAD SO-THAT THE EXPOSURE'OF THE BULKHEAD FACE VARIES FROM A MIN. OF 20" PLANT WITH BEACH GRASS.na TO A MAX. OF 40" 2x 10" 18"O.C. ELEV.4.8'SEENOTE W �� �'� £XIST.GRADE 3"x 8"x f4'TaG ���� �E BACKFILL WITH CLEAN H.T.L.3.3 SHEETING rf _!Ii5aw- GRANULAR MATERIAL ell M.L.H. 2.5 B"xB"WHALERS ;1:'1� EXIST. BULKHEAD,PORTIONS _ " ' Z37 :1I ( TO REMAIN `oN on.I " . FILTER FABRIC �`� ��� cn> M.L.W.0.0 S}'.G !<mr -if ALL HARDWARETO 8��t� PILE B�O.C. � �,,M� Mr', BE GALVANIZED FCTR ova MD 14 LONG s SULLIVAR rZ <cn ClVi; ;c) r fn CISTEaEc .f Nm BULKHEAD DETAIL ����, cam D ''� o Z cn SCALE' I/4"= C-O" 0 2 4 B �z A 0 10 20 40 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel .00 Permit# Health Division sT ©—/�=�� .� Date Issued Conservation Division /b f&J n ieto�c�S✓1/,vat F,,f Fee Tax Collecto A a I Treasurer`:_' SmSrTID SYSTEM 30�ST EE INSTALLED IN COOPLIANCE Planning Dept. - VjI'TH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND .-TOWN RF-GULATIONS Historic-OKH Preservation/Hyannis ' Project Street Address o d VA CIL-6�7 /V Village O S ✓ L-� Owner To rF 0-A Address a CoO M o 5 5 if< Telephone /e, i 7 Zo l-✓aS i--D tjA- 0 ar 36 Permit Request `X 5 ,5` =�� R ; S �x S PiL�27f 674J ' Ti DQ SE i S �2so I � Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new 3g 3 Estimated Project Cost ') o o , ov Zoning District Flood Plain Groundwater Overlay Construction Type -Cg• box Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. 1 Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: El Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full 0 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: ElGas ❑Oil ElElectric ❑Other Central Air: ❑Yes 0 No Fireplaces: Existing New Existing wood/coal stove: 0 Yes ❑No ' Detached garage:0 existing ❑new size Pool:0 existing ❑new size Barn:❑existing 0 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 Name Telephone Number �� � �'Zf Address 0 job ,v 'z Z� I License# Wt vna o Home Improvement Contractor# D 00� Worker's Compensation# C 6 D ALL CONSTRUCTION DEBRIS SULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE a FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED° MAP/PARCEL NO: - J ADDRESS a s • VILLAGE ram, •:� .- OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE e ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING , F DATE CLOSED OUT ASSOCIATION PLAN NO.. 1�� The Town of Barnstable " Department of Health Safety and EnvirbnmentnI Services Building DiVW00n 367 Main rivet,Hyannis MA=01 RWph cross= WE= 509-790.6=7 Budding Cam:uissio::: Fax: 509-790-6Z30 For aRlce use only permit no. Date AFFIDAVIT HOME 31PROVENEWCONTRACTORhAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A squires that the onu=ustrucdon, alterations, rcoovation, repair, moderni=tion- convermon. improvement, removal, demolition, or construction of an addition to any pre-ezistiag owner occupied building containing at le;W we but not more than tbur dwelling units or to structures which are adja cent to such residence or building be done by registered contractors, with ong with other requirements. certain czccptions.al F uric.. Est.Cast'�l l o 0o a o ,�YPe of Work: o / Address of Work:_.^�� S F-t o rC S T�+�V 1 L--f ,owner's Name_y ' • �'L� of Permit Applicodon: / 6 1 I hereby Certify that: Registration is not required for the following renson(s): ark ezduded by law _Jab under 51.000. _Building not owner-occupied caner pulling own permit tfMC Notice RS PU�G THEIR OwN PERMIT OR DEALING WrM UNREGISTERED CONTRAC?ORS FOR ARBITRATION APPLICABLE OR GUARANTY FUND UNDER MGL 142A � ACCESS TO TBE•� %GM UNDER PENALTIES OF PER.TUItY Q�rt n;;=r I hereby apty o a' v Marne Date OR Date owners Nume } ®ffAee 011WLIOSM--8P1afe 600 Washitagtooa Street -_ Boston,!mass. 02111 i �f+ Workers'Compensation Insurance AffidavitMANA All n in Ancity ❑ I am a homeowner performing all work myself. ` ❑ !am a sole r ictor and have no one workinanyg in a capacity„ • rri ., ray/�:%,- ,/,lll�.;'2,!///.!�/�.1//�; /.��/�!ZG,//..�G,�G///%G%/'/%/.l✓%/,l'/l/1.1//,/L'%�l�///.//,�/,�!//%C/G/�/.�///�'( l�'�l.�'�' din workers'compensation for my ctnployer wor V,War king on this job.....:.:.::.:!.:,:. Q I am an employer providing ,:... p :> m an name.. f✓Jul o. . i -#�: F. k. nlic- j//!✓llG/a,✓/7,77//.6N�/.uw%/lG/ ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have tared the contractors listed below who have followin workcls compensation polices: , ... . . . : ....,..;; the B .... .. . :. . .. name: :.. ,..:...• ... .. ..... ;<.�<;� :..,:::;�;: .... . .::::;:;is •. . ,..; ... / addres7 ..:... . ..... '% ..:...::;•:x.;r:45i'`.':.;;a;;:•:.>:,'....• :i.,::.1' .;•.. � S, 4. r ..j..�'�,SYr��.v ri4��'Yi/�i honeOtt # IInIUMFIEe'ta QQ''.�. ''/ ✓ .�4.6 / N, i ...:::..::... %! _._ :jir. �r !h•N. ddre ::. .:..:: ::.:.::....... ....:..:::..............::.... ...... :.:... ...... .. ::::. .......:.::... ......... .........:........:. ..........:.:......:.::.v:.::........::.�::::::::n�::.::.?:4.}.?ii i'::::n...:n•::....i}:�:i:Li:}:!:ii'!4:v.::::is. ... ............ ........... ...... .......:v::::.�::.........::!.:......... ...... n.,:•}i}:i::::iii:i`$ii:C.%/.4:!•..........tn./..Y/yM.':�. g :: . ... sI,S93Ji�liln e i' ,�' JItkP� i4Al2t a:c G r/. rFAMIT11107102, es of a fine a to$1,OAeO e�loa Fuibupe to oeem�e coveeag0 n required under Secdoa 2.5A of MGL 152 can lead to the lmpaaltlon of c:failrml penmlil p out yem,tmprtsotimemt b�as�pejWtiez in the Oinctc of form of a tioa�STOP the 0 roUr c�oveeve end a aver ori0catloa 00.day egatnst ate Y understand @cJ a copy of thin datemmt may j y e h, a PaLw an ei..•�o fperJ he information protdded above is trtao and cor► ct Date O 9 Signature ,. Print name Phone N 47 ,,,,,• roy%q�ayr,vnw..y, oMdd use Only do not vnito In ttdv Wren to be completed by city or tmm 011M i 4 perrLUa:ems H _ ntflding Nparbu-nd dty or tocm: - ❑t r mAng tlonrd ra ones!,re ulevd (.�Sefrctrnea'o Ot'..ce 1]duelttf hnnwdloto p q 011tolth Deporitnent contact person: PhOnz h. — ❑Other (te,cma W95 V JN A CORD. DATE(MM/DD/VY) � \�00 10/16/1998 PRODUCER (508)540-2400 FAX (508)540-6671 HIS CERTIFICATE IS ISSUP-0 AS A MATTER OF INFORMATION urray & MacDonald Insurance Services 0"NLYMND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 406 Jones Road ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW. ' Falmouth, MA 02540 COMPANIES AFFORDING COVERAGE ................................................................. .............. COMPANY Maryland Commerci al Group Attn: Douglas MacDonald Ext: 24 A INSURED ': COMPANY Maryand�Insurance Group Thomas Pappas B DBA Falmouth Builders ........................................................................................:.................................... ......................:.................................................. PO Box 2231 COMPANY Mashpee, MA 02649 ..........._ ...................................................................................................................................................................................... COMPANY 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ..............................................................................................................................................................................................................................................................—.......................................................................... CO i TYPE OFINSURANCE POUCYNUMBER i POLICYEFFECTIVE POLICY EXPIRATION LTR i e DATE(MM/DD/YY) 3 DATE(MM/DD/YY) '• LIMITS t:'GENERAL UABIUTY i i GENERAL AGGREGATE is 2,000,000 X ;CIXNMERgALGENERALUABIUTY € PRODUCTS-COMP/CPAGG 3$ 2,000,000 ��. .....1 ;......... _ I.........—.....................................................................................I........... \�\\CNN CAIMSMADE I X OCCURI ' PERSONAL&ADVINJURY $ 1,000,000 A r ;•-•L "SCP32318686 11/14/1997 i 11/14/1998 •- -- •••---,• - -„ -••• ••- •••• -••--•••- OWNER'S&CONTRACTOR'S PROT` i '•,EACH OCCURRENCE $ 1,000,000 .........: :.............................................................I.................................................... ?FIRE.DAMAGE(Any one fire) j.$.........................50_,000 i........ ....................................................................... MED EXP(Any cne person) $ 10,000 AUTOMOBILE LIABILITY i i ' ?•••--': COMBINED SINGLE LIMIT Is , I i ANY AUTO i i I q..................................................... I ALL OWNED AUTOS t I 1 BODILYINJURY $ t ; _ =SCHEDULED AUTOS E ;(Per person) I ;........I ..................................................... .............................................. 'HIRED AUTOS i......... ? I I I BODILYIN U,Y S NON-OWNED AUTOS '' (er acd nt i t i �........i.......................................................................i i i :PROPERTY DAMAGE $ i 1 GARAGE LIABILITY 1 AUTO ONLY-EA ACCIDENT tw���� ANY AUTO ? e OTHER THAN AUTO ONLY:. .............................................................����� E?........I .................. EACH AOGDENTI$ ....................... ........................ .............. .......... y .,................................................ 1 I ' AGGREGATE: I EXCESS LIABILITY EACH OCCURRENCE i$ 1,000,000 ,000,OOO A i X j UMBREUAFORM !INCL. ON GL = 11/14/1997 '_. 11/14/1998 2.AGGREGATE L........I i i y............................................................I............ ......... ...... ............ .............. OTHER THAN UMBRELLA FORM i 1100000U i S 1,000,000 ,OOO,OOO WORKERS COMPENSATION AND j 4 TORY UMITS i - ER i EMPLOYERS'LIABILITYME I >..E...L...EACH ....ACCIDENT 09/12/1998 09/121 !. ............... .. .............. ........B TBD $ S THE PROPRIETOR/ i t INCL t t :ELDISEASE-POLICY LIMIT '$ PARTNERS/EXECUTIVE I...... � .i i i j,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,•,.i;.,.,.._,..,,.......,.,.,.,,...•,,.,..,.,..,...,.,., i OFFICERS ARE: i EXq_ EL DISEASE-EA EMPLOYEE $ i OTHER F i f I i t I i DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPEaAL ITEMS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE " EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, John Callas BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NOOBLIGATION OR LIABILITY 300 Smokevalley Road OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. Osterville, MA 02655 AUTHORIZED REPRESENTATIVE Douglas MacDonald/DDM �� � ' I ✓h6 Z^O lN.9lt4�tlOP.QI�� •.• ., R" DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Nu�ber: Expires: ` Restricted To 00 w THOMAS C PAPPAS i71 COUNTY ROAD — ,.; Wdp"W BOURNE, MA 02532 s _n*.j C•�tkl i xC t•,5. 3 t S• 1 � ;:r ..�,,.,ti 'Rtl sy.,ixtlw�'�7(.ti.`�-•wt-� _--�^t� •�1 `��.a 4C'. f• � b �f�):'"Wr�DkaY.1) HOME r� .« ff�=� IMPROVEMENT r C .t CONTRALTO 3, _•`Registration. 108989 -Type INDIVIDUAL n.'' t :{ r Expiration`,- -08/ 0 �� r iF,. r� r� 1 R 5;. +;�;n�� -�' F � Z 5...,5^.t•(•, � '' Ar' 'f y,+ t ,! 'it a sh r ,•KTf10MAS 'PAPPAS n �{ LL .r f ,1 COUNTY RDur ERNE MA 02532 ` a x; NisigAroa 1." F..: k f, r •r 4 x: w i�T�,," t4�''"�5ve"sr ys F 1• is r ,.x l .inµ r The Town Barnstable : . Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 I 1 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: a V lL Est. Cost Address of Work: c=' / � f � �-v7' Owner's Name �,J � )q Date of Permit Application: a I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I her by a ply for a permit as the agent of the owner: at Contractor Name Registration No. OR Date Owner's Name Tlrc• Cunrnruttlrcalt/t of:'1 tastachusctts Department of ludrrstrifrl.4cciticttn t.... \ ;: :4' ; 601111 ifxlii,i;tna Slrrct BUJ7U,l.1lfrc>x 0?.111 �- Workers' Comncnsation Insurance Afridatvit ........ dPnlic-tm ntorm-* i •� PtcRsr i'RINT lertE�s...,�-�: �---� • whnnr� 1 am a homeowner performing all work myself. 1 am a salt:proprietor and have no one work11 ing_in an.,=paciry PI am an employer providing workers' compensation for m}•employees workingon this job. ennrn•tm nnme nt. c7J/T- nhnne 1t• ��' - �� Infnrinre M C-v db •[� I am a sole proprietor. ;eneral contractor,or homeowner(circle oite)and have hired the contractors listed below who ha•. the following workus compensation polices m snv nefnc• fiMft! , t� nhnne N• intrrnner en ter••«. .. «� .���...« y�...�rr•��• mn,inv nsrnr• itlrrft• tf nhnne t" • U d faun _ -- Attachadditionafsheetirnetesiary �� ri^.:._._.- •.. _�......•�. •r«•��...'.��...a���H� '�.���� �•� �r��^ Faiiure to seenre cuveraee as required under ZcCttOn 3A of�IGL 132 can lead to the tmposttioa of trttOtnil penaltio of a line up to SI300.U0 aadrur une years•impmonment as%veil as civii penalties in the form of a STOP«•ORK ORDER and a fine ofS100.00 a day against tile. 1 understand that a top.•of thin autement mad be furnarded to the Olnce of Investications of the D1A for coverage verifieatioa 1 do lurrbt• if•rrrrder rlr . i pcnai„cs of pt ryun•char the infamustion protided ahm+e it rrtre and eo nI Date Print name �l Phone 0 official use only do not write in this arcs to be completed by tits or towo official tits er town: permit/lieense d rlttuiltlint:Depatttneut Ot.ieenstnq 1]oard a cheek irimmediate response is required: emen's Om i tee 011ea�d lth Depattmeat phone tt• _••it)tber___. r: contact ptrsnn• r f 1• Information and Instructions Massachusetts General Laws chapter 15_' section 25 requires all employers to provide workers.l ctunPeIts. for employees. As quoted irom the "12w-.an enrplt{ree is defined as every person in the service of ::neither under sny contract of!tire. express or implied. oral or-writteut. An emplt rcr is defined as an individual. partnership. association. corporation or other legal entity. or any two or the foregoing em_aued in a joint enterprise,and including the legal representatives of a deceased employer. or the rccci%•er or trustee of an individual . partnership. association or other legal emity. employing employees. HoWe-•cr rn%•ner of a dwelling house havhtg not more than three apartments and who resides therein. or the occupant of the dwcllin`_house of another who employs persons to do maintenance, construction or repair wort: on such dwelling or out tile_:rounds or building appurtenant thereto shall not because of such employment be deemed to be an etnpio\ MGL chapter 15? section 25 also states that even•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 Cor:tn} applicant i%-Ito ltns not produced acceptable evidence of compliance with the insurance covc=gc required. Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements oft his cltacter been presented to the contracting autltorin•. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situ--non anc suppi�•in_ company names. address and phone nur hers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date flue affidavit. 111e a :.. .vit should be returned to tite cin• or town that the application for the permit or license is being requested. nuc :e Department of Industrial Accidents. Should you have any questions regarding the "law"or if.You are reeu;rt to e- ain a workers* compensation polic}•. please call the Department at the number listed below. Ci tv or Ple_se be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding -lie applicant. P'. be sure to f:i in tite permit/license number which will be used as a reference number. The affidavits may be rett:rnea tite Department by mail or FAX unless other arrangements have been made. T11e Office of Iutvesticatiouts would like to thank ou in advance for you cooperation and should you have any questic ;,_ease do not hesitate to _live us a cell. •11te Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents ... office of Investigations- 600 Washington Street Boston,Ma. 02111 fax "": (617) 727-7749 •asooll sr41 to UO11e30AIJ col asnea $r apo3 6urplrn9 aieiS sllasanaessep 341 to uoprpa Tuaiin a ssassod.01 ainl.rej . saooH Ainej I Y 1 - ST V1 � auoN - 00 96.068 00 :01 p1l3l,ls3n ' 010 YA • 1I0103 380N11I901b 39 039 '"`1�"""`'' r . S3 aa�ldx3 ' 3S1331180SIA83daS WAS 3118ad 10113N108 a3 81SN03 i .1 �//at'n��unni��•..���/'i�+►axw�a�ao�. a��r. • HOME 'IMPROVEMENT CONTRACTORS REGISTRATION Board of Bui'lding Regulations and Standards One Ashburton Place - Room 1361 Boston, Massachusetts 02108 HOME IMPROVEMENT CONTRACTOR Registration 123494 Expiration 02/26/99 Type — PRIVATE CORPORATION Gillmore Marine Contracting., Inc. George -R. Gillmore 37 Bowdoin Rd Mashpee MA 02649 { � C Itp o 0 i ONS 11�1/L L S RIVER R/ 14 4 �� ;1 � ° \� MA R S T - �(,,x z -- _ _ tl o u REnnovE ExtsT, 'r"IM6ER p'►-reap. 1_x1sT.T1MUeR (3'NEAP. CAM - - A N/%ARS1a �\ V _rO REMAIN - 7S PROPo5Ep TIMBaR BULKHEAD ze V V" _a �o6E1N5TAt-LEU RtVt3R SIDS IF OF EAIST, 'FROM PROPOSED STAIR. To L-KID OF (3ULK"GAp Ta-G• SHEETING- �, � � ` J _ B To 55 "THE LAST 2.01 of SER PLAN 13ELOW FOR PROPOSED f 0l1l.Kl-�EAO TC� R!ii TAPVRIZP r•RONI _°%' -AG Bt hr{1 RK S' b�AGN o Try tl�t_. �,O _ See Note No. { -TIMBER BuLKNEhDInITN15 AREA ' . o CL. 4 LIt✓11T.1✓.. .1. - 4 - / o S U � - �,•� 6 D - - B --� 1 o OAg . oh Cf- • , _. /2 /4 1 TAL %DANK B \ LOCUS PLAN IzEPLAcc Ex1sT. 4 r ToP STEPS (WOODMN Rebuild Existing p Canoe Rack \. Scale:I" 2000' w tTH NEW C."x� \ \\y Assessors Ma 97 20 I \ \ \ Parcel I 1 I � Exlst f ing:. _ Path I N m 41_31I r ` O .-1 1 to „x 6 3 O (, REQUIRED 5 Existing 9 a House A A o �_ De I, cc \2_ fz fT3 r- 11_l_S 0 O U'O � Z"X 4,, U Existing FRAMING- Garage iI LL t. - Exist- in 2 Drive g Gravel . I PLAN VIEW PLAN Scale:1 40' 4251+ 2B' EXIST T SAIRS rAo { -- ------- - - -- --- -- — ------------ -- - ------.-I BE. RiMOV►SD REMOVM EXIST. TIMP1 it BUL_%,,,I�EA.� TI-115 rA ONL\/ TYP. i _ -- �- - _�- cr— u o N EScARPmENT PULK1-IEAO G 'X L, WDODeN 12 ! PARTIAL PLAN RISERs(Tvh.� Ty�� EL-.1-t.0 a EXIST• � IlII11 Not to Scale See Note No.l dill lil TAPER PI RST '-SO I OP DuLKI- r-AD r9Gn1 EL. 3.0+ To FL. H,o I Ij11 See Note No' 3 F3' TAG SECTION A—A SNEETI Nv PROPOSED REBUILT CANOE RACK Scale 3/8�r= I.—Ord NOTE No. I FIREADS TO aE CEDAR ply APP(�O�/ED EQUAL Field Adjust The Elevation of The Top of Bulkhead so That The Exposure of SECTION B— B The Bulkhead Face Varies From a Min.of Not to Scale 20"too Max.of 40". PLNNT AREA WITH Z.XIo,, F�.�.►+ GRASS 1$ o•c• �- Direction- to Site: ROLite'28 towcard Osterville; Take a left onto South 1 rl i TOP of wALL EL, y,o ��� �', i f 1 - cX1 sT. GRAUE Conlnt�i Road: T I<e right onto Smoke Valley Road; House is on the right c 1 ,_ n --- --.._._--- � See Note No.I i! 8"A 6"WHALER5 �,'J ' Ex15T. RULK41EAp PORTIONS TO 3 'X 8"K 14'-0' Th- REMAIN MAX TOPE L• 3. S SHEETING Iv1 N W I,616' I 1 PROf 05nD F'IL.L, APPROA 100 C.Y. CLc-_AN GryhNULNP, MATERIAL TO PTZ rL_Ar D V IA E5oF5CI1\T- 1111`=u�1 �I SITE PLAN e' 0 PiLCZ, 8,0.0 pETlrl`t - PROPOSED BULKHEAD REPLACEMENT ' I4�LONG ---- '�-- FILTER FAF�RIL �� AL ARIA NO L HWARE TO . 97,3 , n� AT BE GA<_VANIZED FLEV BASED Ota �C{VIL33 300 SMOKE VALLEY ROAD c7 ,1s7 - OSTERVILLE , MA ��'u n.. . r �(,','✓ FOR TYPICAL SECTION THRU - �oHN ARDELE cALLAs :AS SHOWN DATE: PROPOSED BULKHEAD SCALE SULLIVANENG NEER NGCIN 01 1998 Not to Scale OSTERVILLE,MA ATTACHMENT A 97014