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HomeMy WebLinkAbout0580 WHISTLEBERRY DRIVE i Town of Barnstable *Permit# �. Expires 6 month ro sue date Regulatory Services Fee BAMSTM,E, II Thomas F.Geiler,Director MAM .0� Building Division iOrEn MA'+" Tom Perry,CBO, Building Commissioper 200 Main Street,Hyannis,MA 02601 �. www.town.bamstable.nia.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY: p�/�Il Not Valid without Red X-Press Imprint (J Map/parcel Number i 0 Property Address Z; z Residential Value of Work Minimum fee of$25.00 for work under$6000.00 l Owner's Name&Address Contractor's Name l.) J�>� Telephone Number Home Improvement Contractor License#(if applicable) l�J Workman's Compensation Insurance Check,one: a sole proprietor ® �� �� �� ❑ o I am the Homeowner �" . ❑ I have Worker's Compensation Insurancce,� MAY — 8 2008 Insurance Company Name TOWN OF BA TALE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file.. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) I �e-side ❑ Replacement Windows/doors/sliders.U-Value (maximum,A '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 is regw ed-_ 'al"l__ 3`, SIGNATURE: QAWPFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 CVACITE STATE INSURANCE COMPANY_ 70285-0000 WC 638-88-43 ------------------- --------------=----------- 31102 013-66-il'07-00 o • , • e PENNSYLVANIA DOUG MULLEN rift Member Companies of PO BOX 1274 American International Group MARSTOWS MILLS, MA 02648-000o . p EXECUTIVE OFFICES: 70 PINE STREET, NEW YORK, N.Y. 10270 SEE NAME AND ADDRESS SCHEDULE - WC990610 I.Di'r MA UI#: •• •o OCEANSIDE INSURANCE AGENCY INC WORKERS.COMPENSATION AND EMPLOYERS 52 WEST MAIN ST PLIABILITY POLICY INFORMATION PAGE HYANNIS, MA 026ol-0000 INSURED IS PREVIOUS POLICY NUMBER INDIVIDUAL RENEWAL 008855933 OTHER WORKPLACES NOT SHOWN ABOVE:SEE NAME AND ADDRESS SCHEDULE - WC990610 ITEM 2 POLICY PERIOD 12:01 A.M.standard time at the insured's mailing address FROM 1 1/21/07 TO 1 1/21/08 ITEM 3 A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to the work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ SOO.000 policy limit Bodily Injury by Disease $ 100,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: SEE ENDORSEMENT - WC200306A ITEM a The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Estimated Total Rate Per Estimated Classifications Code Number Remuneration 5100 OF Re- Premium aAnnual 3 Year mutieration Annual 3 Yeas SEE EXTENSION OF INFORMATION PAGE - WC7754 TAXES/ASSESSMENTS/SURCHARGES $150 EXPENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) $3 1 8 MA MINIMUM PREMIUM $5oo MA TOTAL ESTIMATED PREMIUM 13,065 If indicated below, interim adjustments of premium-shall be made: Semi-Annually El Quarterly Monthly DEPOSIT PREMIUM ENDORSEMENTS(FORM NUMBER) SEE ATTACHED FORM SCHEDULE WC990612 12/29/0.7 ASSIGNED RISK 66 Issue Date Issuing Office Authorized Represent ive wC Do 1)0 01 ✓lze TDarrvnwotcuecu�L z °.�' Board of Building Regulations and Slan6rds" HOME IMP�ROVEMENTrCONTRACTOrt �ceuse or registration'valid for indmdul use only,, r before the expiration date. I found retu n to Re istratio 9 _ 138368`,• Board ql 3UtldiprRegulation§and Stan ds : Exprrat n 37/2009 Tr# 128181 i One Ashberton:Pace Rm 1301` } t�" �? Vmgzgnge=DBBoston"Ma 02108 sr' c.. MULLEN BUILDING s=REMO LING (<f . UGLAS.MULLEN� I 5J HOBBY LNoz : �' z +PEST YARMOUTN MA 02673 m �{ A�nunrstratu -Y^ Not val ahoy s1gnature h ji 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 A Plicant Information Please Print Legibly Name(Business/Or; ng� intion/Individual): t�Q Q k) A441 Address ,-d , C,C-� 127 y City/State/Zip: 1Vybe-f7 ld^tS . A4/Ly5 Phone.#: 7 -2-7']5 Z Ar�e, an employer? Check the appropriate box: Type of project(required): am a employer with 4. I am a general contractor and I 6. ❑New construction . employees(full and/or part-time).* have hired the sub-contractors 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 working for me in any capacity. employees and have workers' 9 Building addition [No workers' comp.insurance comp'insurance t 5. We are a corporation and its 10.0 Electrical repairs or additions 3.Elrequn homeowner doing all work] I am a h 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 13.❑ Other employees. [No workers' comp.insurance required.] *Any applicant that cheel¢box#1 must also fill out the section below showing their workers'con parsal;on policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew 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 employccs. If the subcontractors have employees,they must providh 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 informative. Insurance Company Name: G/7-�� I�—� — Policy#or Self-ins.tic.#: 17�� y o Expiration Date: Job Site Address: �!W Q lfW �� 1- �I 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 rrimirial 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 statamerit may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer under the pains•and penalties ofperjury that the informative provided above is true and correct tify Si attae: Date: Phone k Official use only. Do not write in this area,to be completed by city or town officiaC City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter into any.contract for the performance of public work until_acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),addresses) and phone number(s) along with their certificates)of insurance. Limited Liability Companies•(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a'workers' compensation policy,please call the Department at the nurgber listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Towu Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where-'a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit- -The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number. The C6mmonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 TO. # 617-727-4900 ext 4d?6 or 1-S77-MASSAFE Fax# 617-727-774.9 Revised 11-22-06 www.mass.gov1dia i • �FIKET Town of Barnstable Regulatory Services r • r Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403.8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder r L 7"1-4 A �✓ Zc�,�v as Owner of the subject property hereby authorize 1'y l)61 /Vl? "a � to act on my behalf, in all matters-relative to work authorized by this building permit application for: (Address of:Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption.Form on the reverse side. Town of Barnstable Epp'VHE Tp�� Regulatory Services saxivsrAe Thomas F. Geiler,Director v MASS. �P ,639. p Building Division rf0r Tom Perry,Building Commissioner 200 Main Street, Hyannis, Na 02601 Rrvnv.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on'which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building hermit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official . Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner.shall act as supervisor." Many homeowner who use this exemption are unaware that they are.assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. • Assessor's office(1st Floor):: ;9C , Assessor's map and lot nu�1er y ^ SEPTIC SYSTEM MUST BE poi TN[>o� Conservation(4th Floor): YII -�� `� -\ DM-Lj .9j INSTALLED IN COMPLIANCE Board of Health(3rd floor): `y- AA /° - WITH TITLE 5 Sewage Pemut number %. V (Q ' t ssaNAAL ENVIROMME1�TAL C0nF 1 �91 .o .... Engineering Department(3rd floor): ' j oe39.``°d° House number o asY Definitive Plan`Approved by Planning Board APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only t o TOWN 1 OF BARNSTABLE �`'"" BUILDING INSPECTOR APPLICATION FOR PERMIT TO S I I—F� ,I�r ' pL�� 21 -- TYPE OF CONSTRUCTION _ WOC2) s 1 t \ �c_NC 19QI TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Lc-� Proposed Use Zoning District \\ Fire District CIO I Name of Owner 1 Address- PC)• Name of Builder I \U-� Rkg: 1`1 Address P� \C�m�C�Q1 �(���1�� rn Name of Architect kTLL XSLj,Tkk) �)2SI(,A) Address �O�C�J�< <��•�( � (�(r( Number of Rooms �mS a 1�� �S Foundation PCIX,921 C-OkJC CP Exterior C-CR)?k SLV\&X-x(P-S Roofing Floors ; Cm�, k1'(y0 Interior ��' C P��• �(1��5 Heating F-mcm 04 Plumbing Fireplace Approximate Cost `f Area Diagra• of Lot and Buildi g ifh imensions ✓,�%��M /� � Fee nb � I N t � I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name / - Construction Supervisor's License �`1 � KERINS, CHRIS No 3—& -O Permit For TWO STORY ' Single Family Dw ll ; n" Location Lot #63, 4We Whistleberry Drive Marstons Mills Owner Chris Kerins Type of Construction Frame a ' Plot Lot Permit Granted April 25 , 19 94 I Date of Inspection:.- Frame 19 f Insulation Q' 19 Ml Fireplace 19,- _ Daae,Compi�eted l 19 lfyr1 i j y - • TOWN OF BARNSTABLE Pefr,,It Noy:('; BUILDING DEPARTMENT I: l"OvvN OFFICE BUILDING Cash \- •"` •••.•.•......... I 0°~� 'Y HYANNIS.MASS.02601 Bond `........... i CERTIFICATE OF USE AND OCCUPANCY Issued to Chris Kerins Address Lot #63, 588'.Uhistleberry Drive - j ML stons Mills, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD_ THIS PERMIT WILLNOT BE VALID. AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE iBUILDING CODE. IOctober I 14 94 !19................. /L. ..... ................. Buildi Ins ector ! 1 I I PAYABLE TO: ?(NA,'N OF I AR INSTAKE ::viJI�MISS10 -S OFFICE William Abbott P. 0. Box 309 Mashpee, MA 02649 J� . `. TOWN OF BARNSTABLE, MASSACHUSETTS . BUILDING PERMIT • DATE 19 PERM;` NO. 1 APPLICANT `.f I rr� 1 �,1 ADDRESS IN0.) IS 7 R EE TI COnI F'S UCE':SEA NUM&ER OF PERMIT TO (�) STORY GWELr..ING UNITS (TYPE OF IMPROVEMENT) NO. ((PPRQIoOSEO USE) / r, ZONING AT (LOCATION) l� __ DISTRICT (NO.) (STREET) BETWEENxm AND _ `{! (CROSS STREET) (CROSS STREET! LOT 1. SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION V TO TYPE —USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) •t REMARKS: i, % AREA OR PERMIT VOLUME ESTIMATED COST $ FEE S (CUBIC/SQUARE FEET) OWNER l(a�1� > " BUILDING DE PT. ADDRESS BY ' I,5 PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN F_�,:T RIrc• ANO 1. r-0•JN ATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE-I MECHAN!CAL INSTAL'ATION5.� 2. PRIOR TO COVERING STRUCTURALIQUIREG,SLICH SUILOING SHALLNOTBE OCCUPIED UNTIL MEMBERSIRF.ADY TO LATH).3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. E` OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS rc 41 1 �HE ING INSPECTION APPROVALS ENGIN VING C.A I,1=N 1 2 /y BOARC OF•_HEALTH � SITE PLAN REVIEW APPROVAL / 6 r­ K:EE0 UNTIL THE INSPEC PERMIT W!Ll BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS!^:DICATED ON' 'HIS 1. .l .;is N H 'HI VARIODU,SIAGFS OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARIiANGEf FOR BY TELEP'IONF Ids :hl'IT'-W Y PERMIT ;S ISSUED AS NOTED ABOVE. NOTIFICA'ION �ILL yy:{ --a..�.-.�-�..-v .+..: °K,�+t;,..-v:.a'v.�+-•..+...r'. . ..; � ..�,. •^,�..-._,,.. �, -� -..v.,.,�.,,^'-•... v..+r+s:w-w�.-•.^.-. .:�. ... ^-°-.... p�TMf7p TOWN OF BARNSTABLE 36650 Permit No. ................ BUILDING DEPARTMENT Cash TOWN OFFICE BUILDING 7 .Yl 6)0 V HYANNIS.MASS.02601 Bond 4 I CERTIFICATE OF USE AND OCCUPANCY Issued to Chris Kerins Address Lot #63, 588IWhistleberry Drive , Marstons Mills, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID. AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. . October 14, 94 19.. ..................� '................. Builcliqj Inspector ; i S Zl '00•pO S g0.p1 00 E 90.00 89. 73 a� Nll o ° LOT 63 52, 399 SF. 3 a N � ti ro 6E o s11''�oNt0• 34.%` m Fp A' QA 00 c 9e.00 6 00% Z _'t a •,� �Z.0 oti°h� 4 0 tip. "TO THE BEST OF MY KNOWLEDGE.' THE PLOT PLAN OF LAND FOUNDATION SHOWN ON THIS PLAN IS AS LOCH TED IN IT ACTUALLY EXISTS AND IT CONFORMS TO MA AS TONS MIL L S - MASS. THE ZONING REGULATIONS IN THE.,T,QW .OF . BARNSTABLE, REGARDING YARD W PREPARED FOR S,• , DATE:APR.21. 1994f_':'. DAV!D A BBO T T CONS TPUC TION t'•'li'i• -�?r.- S /:' !r �� DATE:APR.21, 199 E.' 1 u 4 SCAL -50 FT. - - — — — — — — — — ` A: ::;Si ; . A % CAPE 6 ISLANDS ENGINEERING FL OOD ZONE C (NON-HAZARD D-50 MA SHPEE — MASS. �f,, �T ;I�i •rye-, SEA - �_ Jrftir TJ�'J O3 7?�'DUS�CCIDS -01 -James-: Ga-lox' i30STO'N- T1SSACH US3-=S 02113 -WO R laRS'COMPENSATI O TI INSURANCE AFFIDAVIT 1, - Qiccnscdpermictcc) with .2 principal place of business/residcnoc 2C <GtyfSt=(c2ip) do hereby ccrtifj; under the pains and paialtia of perjury char. [ 1 am an emplovcr providingthe following workers'.co g mpcnsation coverage for my cmployccs work ing on 6-IS 1°b- - ��� +CA��ig/ C)� �y a �g Is9 lnsumncc Comp2ny Policy Numbcr 1 am 2 sole proprietor and have no onc wonting for rnc. 2m s sole proprietor,gcncrJ eontraor or homeowner (arde one)and have hued the eontraaors listed belo.,. K"ho hzvc the following workc.^compc=tion iusurarncc politics: Yanx OfConmcror Ins =cc Comp=yMolicr Number - 2mc ofContr2aor Insurance Company/PolicyNcmbcr X2mc ofContnaor Insurance Comp=y/Polky Numbcr . 0 I 2m s homcoK-ncr performing ell thc work mysdL N07 E Pic_-be aM_ c t!ctJ,�c lcc<o�cn wbo cr:ploypcesoos to Zo raaictccsacc,cccrcrvct:oo oc rcpair«csric on z 1` clf�nb of AOt f.70r<L_r tLrc<ccits is•�i�L<bor,<o•oer slso r<sides or oo eSe�rouaL tpptutrczct cScrcto art rot�eoersSJj' «nr:r<rc2 to be c.JCccc tc c Ic[j tic�cr:<fs Corpccs_tioc Act(GL.C 152.s<cL.1(5)),applic:tioo by borxcv-�ucrfor2 tic<asc or perr�it r.._y c"i�cccc L^c l<tJ <r__lo r t:acr Lac Gor1c<rs " - 7c 'Cor�pco:at,oc A<L i copy of arms ra_ —r.,.-Z ix to ti.< Dcpz.--cnt of lndustri_l Accdcnu'Or,«o!lntc.zncc for.co--r c serifc:cron sd th_t f_,�lcr<to sc<c,<ccrc:�c�rcSuiu�Urdu S<ction?5/t of MGL 152 e:.n lead to u irrpouaon ofltinina3 pcn_Juc: contistinb of 2 fine of vp CO tip to onc year and C;Q p«„jt;u L-1 Lac form eft Stop W0&Ordct sd= fin<of S 100.00 t day z �r,st Signed this &y of o� . 19 L CCn;cc/PcrmiucC Licensor/Pcrrnittor , =� COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY OF i 1010 COMMONWEALTH AVE. d v MASSACHUSETTS BOSTON,MA 02215 LICENSE EXPIRATION DATE y y C O N S T R. SUPERVISOR CAUTION 05/31 /1994 t ' �it(G 10 I FOR PROTECTION AGAINST RESTRICTIONS I EFFECTIVE DATE LIC NO. THEFT, PUT RIGHT THUMB NONE -z05/31 /1992 045260 PRINT INAPPROPRIATE f ' WILLIAM F ABBOTT l' e>�J° "'I BOX ON LICENSE. 11A MELBA LN = STONEHAM MA 02180 BLASTING OPERATORS r MUST INCLUDE PHOTO. PHOTO;(BLASTING OPR ONLY) F �1.•^. NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY •`�'? HEIGHT: STAMPED-OR•SIGNATURE OF THE COMMISSIONER - :: : THIS DOCUMENT MUST BE r a SIGN NAME IN FULL ABOVE SIGNATURE LINE _ }r;',• CARRIEDONTHEPERSONOF SIG A RE OF LICENSEE • ?' "•'•'��'''•�`'''�4� THE HOLDER WHEN EN- � .OTHERS-..RIGHT THUMB'PAINT' GAGEDINTHISOCCUPATION. N.j .�' C1rY I I/ C.OMMISSIONER y` .. ( �F1'• 12 8� LLIIIU 0 0 Al 1� / 1 \ -- FRONT ELEVATION RIGHT SIDE ELEVATION SCALE 1/S o 1'-W WALE:11 r=1•-c ® 12 6 FI-I Ell 0 FBI On FEII© 00111- IEEr SIDE ELEVATION REAR ELEVATION SDXE-1/4'-1'd 6•-N/ 16'a 1a-r s'-r I ®� MSTR BATH " WINDOW SCHEDULE m KEY QTY. DESCRIPTION ROUGH OPENING REMARKS p .� BEDROOM #2 I BEDROOM #3 h LIK © A B 2'-4 7 C x 4•-0 1 ANDERSEN M4 7 B 8 ptp16 4'-B'x 4'-0 1127 ANDERSEN OR24 T-C r-Y 3'-' 2'I 14'-0 3 4' C ♦ 2'-4 7 C x 4•-0 112 ANDERSEN 014 r D 3 2'-4 7 8'x S'-0 1 ANDERSEN aR13 ® I x1 a 1�1 Ip{ E 2 CAS 2'-D b C x 3'-0 1/ ANDERSEN 013 ro E I ® I� I `� P 2 4'-0 1 x 4'-0 1 ANDERSEN OP24 0 7 0 1 pOUgL CASEMEM 4'-B"x Y-5 J C ANDERSEN 2R11 b B n i CIRCLE p 5'-7 13 1C x 3'-0 1 ANDME EN 07N2B-2 ti fi (D Q HALL QO�'® DK� STORAGE BATH IXQ 0 b b 0 n CLOSET CIDSET O •T 0 m '-C 5'-p S-4 3'- 4'-C 6'-7' 7'-4' 3'- 20-9' Fs OPEN- I' BEDROOM #4 EJEL)ROUR - e UP 4-1 4'-S 6'-5! 5'-6 5'-1 1, 6•-6 21'-(r El'-MF 26'-T SECOND FLOOR PLAN 24,-MY WALE: ,/a•a,•-a DECK p 7"o, © e o �VM rvF1 1S-IO' D.W. B'-111 - 'P m FAMILY BREAKFAST UFUTCHEN 11001' ® b ROOM AREA b W. bj GAS MEPLACE i1 I o ;O IN WOOD FRAMED RlP. omeNLv b � r-a ® �, b E , STEEL nEVE ABOVE DOOR SCHEDULE 8+Nrt7Yaa�r HALL n O ____SIZE TaD_BY LIONUYACTUR6R DESCRIPTIONKEY QTY Z REMARKS ELtl SHEL J GARAGE " 1 1 STEEL-FRENCH/2 61DF1K:M9 3'd x 6'-C 1'-7 SUNLEY IN 2 1 STEEL-FIRE PATED 2'-0 x 6'-C STANLEY �I ®�I 3 1 STEEL-9 LftE 2•d x G'-6' STANLEY f 4 1 6'SLIDER 6•-d x 6'-C LIVING ] DINING vy 5 1 6 PANEL DTTEMIOR r-C x 6'-C ROOM 6 1 6 PANEL MUZIO i 2'd x 6•-d p ROOM m -r o-a r-4 ' ® 7 4 6 PANEL DfnER10R Nx b e 6 6 PANEL DDERIOR 2•d x 6'-C FOYER ! 9 1 6 PANEL INTERIOR 3' x 5'-C 4 15'OVEIIHEAD 10 5 61-FOLD 4' x 6'-d e IS-tT1 6'-1" DOOR 11 1 BF-FOLD 5'd x 8•-Ir 12 1 9FFOLD Ird x 6'-C © 13 2 CASED OPENING 3'-e x 61-C 14 t CYERNfAD QARALE I6'd x 7•d D' 6 8•-C 1a-6' 1a-C B•-6' 3'-C 36•_a OT-C FIRST FLOOR PLAN WALE:I/4'a 1-a . 2s'-17 1'-1? 9'-i'1' 1B-? 3'-7 7-16' r------ ----------------------CAT T I I ` I I I LOION SIZE AND NUMBER I I DECK OF SONCTUBES T.O.D.BY GC. Wxr.FUDGE VENT I � I I I � ]3•-S I CROP WALL TMCAL ROOF CONSTRUCTIOM I I FOR BLW m ASP1417 ROOF FLES/t"VW PAPER/ BUL NFAO _ 2`rB RAFIER9 ODI SMG011N0/ ti MO.2313 AND.2BI3 ATTIC h d -- COLLARD.sr S It 1vOROP WALL WIO6 PLYWOOD END-END FOR DOOR OF ATFIO COW.METAL VENTED�®OE ' n � v TMCAL NAIL CON5LESMO0M #3 o x,%ER ALL�alars ;bl - MASTER BEDROOM BEDROOM n sc OR IDJUAL BUILDING FULL BASEMENT PAFVR/t/7 COX FWAOOD sxrwr SNDS O e�-a• - B'-e IP-a e•-a• B'-C B'-r 3'-Y 2a-9' 1C 0.i /J 1/2^FIBERCLASS - xdSUlArpN —r SR2L BFMI A6D1K - b r 1 r 1 r 1 r 1 r 1 r , 1 _ 2z1D50 lir D.C. t L_J L_JI iL_J _J L_J GARAGE b 4 I I (3)2.12 6Da (r caLTaRErfi sLAB N/w.a.u/ DINING R M. KITCHEN I �E I MILL SC z Sff[10' b VRCII TD CVDTN6AD OOCS) i ' I sraxs I to CONCRETE COWMN PAD 1 AtDi 2813 ° I I F 6�5/M ERCIASS TYPICAL 3/4•r°o I I 0 0.W�DOD SMBIDOR I I - GLUED A N�LED TO dSiS. I I 1•tI's°Ir O.C. 2 x 12-S O IDRO O.C. WALL FOR PDOOR 3 2 i 12 CIFRr(TYP. 13'-6' 14'-f TYPICAL IT CONCRETE(BALL L----- FULL BASEMENT TWILL 9 CONCRETE FOINDADON WALL btFICTING1 MONOURIIC 1 CONCRETE STAB LALl LOL(rnXVAM-PILLPO ON 19'•S'CONT.CONCRETE YDORNO W/1B.ftld.h 6 MPARETE FROST IYA11 ON 16 IT DOW..COW TO Yd MIN, "AS GRACE TW.16 z C CONT.FOOTING 16•-0' 6'-a t6•-1r S-Y t6•-6 t'- w z W z ICr COND.DOL PAD 38•-? CROSS SECTION FOUNDATION PLAN _ SCALE:1/.-1'-W SCALP:11 r v 1'-a NIM tgOFY KNAUER AND IDCIQION OF OA5lMCNf WINDOWS YAIM OBNER.SLIME CONSTRUCTION