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0025 SEA VIEW AVENUE
5 S �� r/rew I - _ i r _ I ING DEPT. Application number �`' -Q 6 _ :3 ................................................ BUILD Fee ��SS ° �D ....................... ...................................................... � OCT 15 2020 MASS Building Inspectors Initials....................................... Ar +►` TOWN OF BARNSTABLE DateIssued................................................................. Map/Parcel................ ...........................�.�........ SCANN D s 826 TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: CC-k,- vau DA �1 C Owner's Name: Too /q 0\[t jj QI hone NumberL 1�V� l 0 Email Address: Cell Phone Number Project cost$ 10q, W 'CO Check one Residential Commercial OWNER'S AUTHORIZATION SCANNED As owner of the above property I hereby authorize B 11—D I N G CDT to make application for a building permit in accordance with 780 CMR Owner Signature: Date: OCT 1 5. 2020 'BARNSTA1311�—] TYPE OF WORK TOWN r 0 Siding ED Windows (no header change) # E-1 Insulation/Weatherization oors (no header change) # Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingle Construction Debris will be going to c 11(Y 7 � CONTRACTOR'S INFORMATION Contractor's name H rava&-L Home Improvement Contractors Registration (if applicable) # 0 (� (attach copy) Construction Supervisor's License # o 1,q Jff�\ attach copy 1ViJ\ �n�(� .Co� Email of Contractor „r�u�vA �(j���"1 Phone n be ��-1 R9 ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. i APPLICATION NUMBER ............................................................ *For Tents Only* Date Tent (s) will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X , X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location (s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: O��l.� ✓V l�� �(� C� Telephone Number l N ld� Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date 10 _ a- d O APPL 'S SIGNATURE Signature 7 Date 10-���� All permit applications are subject to a building official's approval prior to issuance. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations kv 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information `n Please Print Le ibl Name (Business/Organization/Individual): � `�V" Cv . [-- Address: O�e1 (� A4ulr� 411 A4 &one#: ��City/State/Zip: vl W1� 00 3K 6.fl Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.: 9. Building addition required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. 1 am a homeowner doing all work officers have exercised their 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 checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. +Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. ' ^ Insurance Company Name:_ W J Policy#or Self-ins.Lic.#: C W ( �CJ 6 Ad 2(piratio te: J � ' ` ` �e l� Job Site Address: ( `J '& w Crty/State/2� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the air penalties of perjury that the information provided above is true and correct. Si ature: Date: 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 5.Plumbing Inspector 6.Other Contact Person: Phone#: 1 ACC CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) #% � 1 08/06/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTANAME: Linda Sullivan DOWLING & O'NEIL INSURANCE AGENCY a/c°NN Ell: (508)775-1620 ac No: AOAIL DRE ADDRESS: Iullivan@doins.com 973 IYANNOUGH RD INSURERS AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURER A: AIM MUTUAL INS CO 33758 INSURED INSURER B EMMANUEL CONSTRUCTION INC INSURERC: INSURER D: 286 STRAWBERRY HILL RD INSURER E: CENTERVILLE MA 02632 INSURER F: COVERAGES CERTIFICATE NUMBER: 561436 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR EXP LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM/DD/YYYY MM DDPOLICY EFF Y/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE F—IOCCUR DAMAGE ( RENTED E — PREMISESS Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ PRO JECT ❑ LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident $ AUTOS AUTOS ) HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT I$ 500,000 A OFFICER/MEMBER EXCLUDED? I N/A N/A N/A AWC40070343862020A 04/05/2020 04/05/2021 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 500.000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601 a" Daniel M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 'Office of Consumer Affairs . and Business Re u l.ati o n .CABR HIC -Registration Complaints Registration # 194042 Registrant EMMANUEL CONSTRUCTION, INC. Name Hector Sanchez Sanchez Address 286 Strawberry Hill Rd City, State Zip Centerville, MA 02632 Expiration Date 12/26/2020 .Complaints Details N6.complaints found for this registrant. You can also view arbitration and Guaranty Fund history,. Back To Search Site Policies Contact Us 1 of 2 1/6/2020,8:33 AM i Commonwealth of Massachusetts i- Division of Professional Licensure Board of Building.Regulations and Standards } Construct' Specialty i �• , j CSSL-0993 -� x ,pfires:09l14l2021 . HECTOR R gXCnEZ. - r - 296 STRAWBERRY�M i i CEN ERVILCV Mkojffi' �jIle ? f '�0 v , i • COMMissioner �®® i` EMMANUEE CONSTRUCTION 608-367-1 679 Name: Vahan Martirosian Address: 25 Sea View Ave Osterville MA Phone# 781-690-3907 Project: Osterville Red Cedar -Strip entire red cedar roof of house -Nail Every loose board back. -Install ice and water on entire roof. -Install cedar breather on entire roof. - Install Red Cedar roof, with 1 % stainless nails. -Use copper pipe boots. -Use copper on all valleys. - Use red cedar to install ridge cap. -Clean all Rubbish. Total for I bor and material: $109,000.00 Please Sign if agree: � �J ------------------ Date _ / _a D------------------------ - I � I , f 4 . ' .� Town of Barnstable _ Building P•yy„wp..p.. v..+.wr.wy.` '"• ^^ ...,.....+Mr+w.....n...-u .. ... ».w`wa..rv`.-..a'u"--...�`".".-. ���py.'r.y Post This Card So That it is Visible From the Street-Approved Plans.Must be`Retained'on Job and this Card Must be Kept 63 `� Posted Until Final Inspection Has Been Made., • Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final-Inspection has been made: Permit Permit No. B-19-2838 Applicant Name: SCOTT S SHIELDS Approvals Date Issued: 09/24/2019 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 03/24/2020 Foundation: Residential Map/Lot: 162-026-001 Zoning District: RF-1 Sheathing: Location: 25 SEA VIEW AVENUE,OSTERVILLE "�.. Contractor Name:'-.�SALVADOR U ZAMORA Framing: 1 Z � Owner on Record: MARTIROSIAN,VAHAN&ROSEMARY TRS Contractor License: CS-096416 2 Address: 6 CLARIDGE DRIVE - -M-. Est. Project Cost: $27,500.00 Chimney: WESTON, MA 02493 } Permit Fee: $225.25 Description: Remodel Existing Recreational Room with Suana,by adding steam, i Insulation: HVAC enclosure,Linen Storage, Half Bath, Half Refrigerator Counter Fee Paid: $225.25 and Storage Area. -� _ -�-�'`/ Date: 9/24/2019 Final: /2.0 CHANGE OF CONTRACTOR ON 2/12/2020 FROM SCOTT SHEILDS TO� SALVADOR ZAMORA 4 mac✓. y--- Plumbing/Gas Rough Plumbing: Project Review Req: SMOKE DETECTORS ADDED TO EXISTING AS PER PLAN. r� ',-Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after-issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. i Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:1 t Service: 1.Foundation or Footing 2.Sheathing Inspection N J_ Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) h:Low Voltage Rough: 6.Insulation g g 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: r Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement C'6ntractor Registration Type: Individual �K `1 r `?U Registration: 182118 SALVADOR ZAMORA � - Expiration: 05/25/2021 1010 PLEASANT ST { BELMONT, MA 02478I - F fin Update Address and Return Card. SCA 1 C, 20M-05/17 Office of Consumer Affairs 8 Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Individual before the expiration date. If found return to: Registration _ Expiration Office of Consumer Affairs and Business Regulation A821T8=== - 05/25/2021 1000 Washington Street -Suite 710 SALVADOR ZAMORA'": = - Boston,MA 02118 SALVADOR ZAVORAy_ 1010 PLEASANT ST;::'~'%' �/wn��fGG•�a/.fr1�i BELMONT,MA 02478 Undersecretary Not valid without signature i f Commonwealth of Massachusetts �f Division of Professional Licensure Board of Building Regulations and Standards ons';t?�t din Sii'_rvisc,r CS-096416 E4 1res: 09/06/2020 r3,isF SALVADOR U ZAMORA�i a. . 10.10 PLEASANT STREET UNIT 4 BELMONT MA d2d78 'ti;. Commissioner - .. - . . ?fig.• .,::, •�. J ZeA aa— e--fl2�i I-e a b i el- -sue- —N� ,��?�1 � Gil a r� 9K ire - �� ♦' • 4� i .�.,� ' c' `. ., 4 ' ' 1 � ` sx* a\ y 1� � _ �� _ _ _ { { ra •1 � J i� •. y • ` ' � � • � � �. • .. r • The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations IF 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizarion/individual): 2WAJArV9O✓C_ dC_A Address: 10.1 O Sr City/State/Zip: FALww N r k It O2%}-+g Phone#: t-_7 33�L 330_7+ Are you an employer?Check the appropriate bog: Type of project(required): 1.❑ I am a employer with- 4. ❑ I am a general contractor and I e�yees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.Z, am a sole proprietor or partner- listed on the attached sheet. 7. emodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.ins=ce comp.insurance t required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance ram]t C. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: �� S V 1 City/State/Zip: ���� M� - 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 der the pains and pe erjury that the information provided above is true and correct. Si atone. Date: Z3 Phone#' 3 yt � o 4— Ofj'icial 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#: 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' compensaton affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cant'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 number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit(license number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense 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 firture permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Or»ce of Investigations 600 Washington Street Bastin,MA 02111 - Tel.#617-727-4900 ext 406 or 1-877-MASSAFB Revised 4-24-07 Fax#617-727-7749 www;maw.gov/dia BUILDING DEPT. _ _ ZZ p Application Number.................�..... .. 4�'.���......... ' )sARNSI'A$IE, FEB 12 2020 ,� � a MASS. � Permit Fel.....................................Other Fee:....................... a639• 'OrFc.rt'' TOWN OF BARNSTABLE TotalFee Paid............................................................... ...... TOWN OF BARNSTABLE Permit Approval by.................................On........................... BUILDING PERNUT Map........................................Parcel............................................. APPLICATION Section 1 — Owner's Information and Project Location - 1�Project Address V5- Owners Name �J ik-S WA-tJ lu A-v?-`C1 YLo S'1 Owners Legal Address 0-Ukg-,,0 Q;15. r?- - City. N Mate tit/1 >Zip C) 2`f� X—OwnersCell#. 711 (0 t-O 3 6L O'+ E-maip4 Section 2 -Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet 0 Single/Two Family Dwelling Section 3 — Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ . Solar ❑ Renovation ❑ Pool ❑ Insulation Other-Specify Section 4 - Work Description n q rb % T.AM nnrlsitPA• 11/1 inni R Application Number.................................................... Section 5—Detail Cost of Proposed Construction Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total# Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom i Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation I Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information i Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No j i li Last updated: 11/15/2018 Application Number........................................... Section 9- Construction Supervisor Name �v�l9�►a�a 4wuel -A Telephone Number Address OWCity State Vt-�_O" Zip 0Z' � License Number C S 01(P-41--- License Type (1 S Expiration Date Contractors Email Z GQkA��9S:�-ov pQ—� , C-0�ell # (s 0-33 If 330'�- I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation re a 780 CMR and the To arnstable.Attach a copy of your license. Signs tie r Date Section 10—Home Improvement Contractor Name Sr-Uv"oY&_ Telephone Number Address City Stater ` Zip Registration Number -1,IR 2--t I 'k? Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation requir by 80 CMR and arnstable.Attach a copy of your H.I.C... Signature - Date Z3 �Z Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signatur Date 112-7-5 12 o Print Name ►��o� �- ^-��— Telephone Number E-mail permit to: 2 ��� ��'"��- Last updated: 11/I5/2018 Section 12 —Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department 0 Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Se 'on 13 — Owner's Authorization I, Ua , as Owner of the subject property hereby authorize PO Z_ �C,64 to act on my behalf, in all matters relative to work authorized by this building permit application for: 2'C' PgA V ew 'ayL - ,19,a MA (Address of job) �/� cla6i l► iA r)Si iln C9t 23 2o2o Signature of Owner date Va& Print Name Last updated: 11/15/2018 Boise Cascadelffi� Quadruple 1-3/4" x 9-1/2" VERSA-LAM® 21b69020 PASSED I FB01 -Opt 1 (Floor Beam) BC CALC®Member Report Dry 11 Span i No cant. TOWN OF BARNSTARLE'20,2020 11:39:53 Build 7295 Job name: File name: Address: Description: City, State, Zip: Specifier: Builder: Designer: Kevin Lavoie Code reports: ESR-1040 Company: Boise Cascade 1 0 L L B 1 13-06-00 B2 Total Horizontal Product Length=13-06-00 Reaction Summary (Down / Uplift) (Ibs) Bearing Live Dead Snow Wind Roof Live B 1, 5-1/2" 3786/0 1077/0 B2, 5-1/4" 377410 1073/0 Load Summary Live Dead Snow Wind Roof Tributary Live Tag Description Load Type Ref. Start End Loc. 100% 90% 115% 166% 125% 0 Self-Weight Unf. Lin. (lb/ft) L 00-00-00 13-06-00 Top 19 00-00-00 1 Standard Load Unf.Area(lb/ft2) L 00-00-00 13-06-00 Back 40 10 14-00-00 Controls Summary Value %Allowable Duration Case Location Pos. Moment 14568 ft-Ibs 52.2% 100% 1 06-09-02 End Shear 3963 Ibs 31.4% 100% 1 01-03-00 Total Load Deflection U360(0.425") 66.7% n\a 1 06-09-02 Live Load Deflection U462(0.331") 77.9% n\a 2 06-09-02 Max Defl. 0.425" 42.5% n\a 1 06-09-02 Span/Depth 16.1 %Allow %Allow Bearing Supports Dim.(LxW) Value Support Member Material B1 Wall/Plate 5-1/2"x 7" 4862 Ibs n\a 16.8% Unspecified B2 Column 5-1/4"x 7" 4847 Ibs n\a 17.6% Unspecified Notes ' Design meets Code minimum (U240)Total load deflection criteria. Design meets Code minimum (U360)Live load deflection criteria. Design meets arbitrary(1") Maximum Total load deflection criteria. Calculations assume member is fully braced. BC CALC®analysis is based on IBC 2015. Design based on Dry Service Condition. Connection Diagram: Full Length of Member b r d e c e Page 1 of 4 i ®Boise Cascade f Quadruple 1-3/4" x 9-1/2" VERSA-LAM® 2.0 3100 SP PASSED FB01 -Opt 1 (Floor Beam) BC CALC®Member Report Dry 1 span I No cant. January 20, 2020 11:39:53 Build 7295 Job name: File name: Address: Description: City, State,Zip: Specifier: Builder: Designer: Kevin Lavoie Code reports: ESR-1040 Company: Boise Cascade Connection Diagram: Full Length of Member a minimum = 1-1/2" c=6-1/2" b minimum =4" d=24" e minimum= 1" Calculated Side Load=400.0 Ib/ft Install screws from both sides, staggering screws by half of the spacing to avoid splitting. Connectors are: SIDS 1/4 x 6 Disclosure Use of the Boise Cascade Software is subject to the terms of the End User License Agreement(EULA). Completeness and accuracy of input must be reviewed and verified by a qualified engineer or other appropriate expert to assure its adequacy,prior to anyone relying on such output as evidence of suitability for a particular application.The output here is based on building code-accepted design properties and analysis methods. Installation of Boise Cascade engineered wood products must be in accordance with current Installation Guide and applicable building codes.To obtain Installation Guide or ask questions,please call(800)232-0788 before installation. BC CALC®,BC FRAMER®,AJSTm, ALLJOISTO,BC RIM BOARD-,BCI®, BOISE GLULAMTM,BC FloorValue®, VERSA-LAM®,VERSA-RIM PLUS®, Page 2 of 4 Town of Barnstable Building s Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept ""SS Posted Until Final Inspection Has Been Made.. Pit i639 �� Permit Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. erm Permit No. B-19-2838 Applicant Name: SCOTT S SHIELDS Approvals Date Issued: 09/24/2019 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 03/24/2020 Foundation: Residential M---aap/Lot: 162-026-001 Zoning District: RF-1 Sheathing: Location: 25 SEA VIEW AVENUE,OSTERVILLE Contractor Name: SCOTT S SHIELDS Framing: 1 Owner on Record: MARTIROSIAN,VAHAN& ROSEMARY TRS Contractor License: CS 065898 2 Address: 6 CLARIDGE DRIVE � Est. Protect Cost: $27,500.00 Chimney: WESTON, MA 02493 4 Permit F e: $ 190.25 Description: Remodel Existing Recreational Room with Suana, by adding steam, Fee Paid } Insulation: :r 5 190.25 HVAC enclosure, Linen Storage, Half Bath, Half Refrigerator Counter Final: and Storage Area. I Date: pp 9/24/2019 Project Review Req: SMOKE DETECTORS ADDED TO EXISTING AS PER PLAN. �r— Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approvedconstruction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. I I J� IElectrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Applicadon ...... .. .. l✓ ......... NAM Peoffi Fee................... ..Odra Fee...... k ee Paid......... ..:. ........... Total F ••� . k ............On.....,.zy�� ...._ TOWN OF BARNSTABLE PermitApproealby... ••••••• BU ELDING PERNIIT — Map.. /0Q"1. ....P=CL. .......... _. .�................... APPLICATION , s -r- Section 1 — Owner's Information and Project Location Project Address a 5 S e A V e;ev A✓�n u i_ Vide ���-�=R>>> L-L c Owners Name M ig RT 1 gr)S 1 A n e'4 LT al Z�l�ST Vi4 µEau e IZoS u t t w RBI P'(,g rrr r� s i.9 n T�t�ST c=S ' Owners Legal Address to C-L-cL R�� e c State P'l I�. zip o Z(4 Owners Cell# 431 -&qo - 39 04. E-mail (D31 an CoYnCsST Section 2—Use of Stractare Commercial Struct=ove135,0qq; is fegUse Group ❑ Commercial Structure undbic fRt eSingle/Two Family Dwelling Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure .❑ Change of use ❑ Demo/(eutae structm) Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—specify Section 4 -Work Description I 0.2CPl2aTj,7%ncLL 12, SS&L- 1C? ts;1 0-&AI S_ �q T /4yigc- enc \e n4P SmAE ex—TlT �nLi= ��FR►9P_RQi-o/C; C 0 c.,>- at R T sect nnd>he&-719201 9 ,f �I Application Number.................................................... Section 5—Detail Cost of Proposed Constructi : Square t - , Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method'"❑ MA Checklist ❑ WFCM Checklist ❑ Design - Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression I ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private a Sewage Disposal ❑ Municipal ❑ On Site Historic District ; ' ❑ Hyannis Historic District ❑ Old Kings Highway ,Deb Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation C. Within or adjacent to a wetland, coastal bank? Yes- ❑ No\❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed. - Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No 1astmaatad-29Ao19 I Application Number........................................... Section 9—.Construction Supervisor . Name Sc_o-rr S.S yk k e, ctS Telephone Number S o 8 - Z2 -Z q Address cz w�rt 1`��►�c_ RolCity 6= ,Ryr1z1 State /` �- zip License Number (�6Sg icense Type C-S i ;Expiration Date Contractors Email Cell_# So S - a 7Z, -Z 9 6 2 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation by 780 CMR and the Town of Barnstable.Attach a copy of you license. Signature - Date eF_ �a Section.10—Home=Improvement Contractor r Name' � ;,e, o,A�Q n r Telephone Number 2. Address ;Z.) &j A a i�o r[k WA City 0ZM,0,V(r-[.2 State 66V- Tip b Z 6 9 5 Registration Number I'4 O:Z 3® Expiration Date \ q I understand my responsibilities under the rules and regulations for Home Improvement COntraCtors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CCMR and the Town of Barnstable.Attach a copy of you HSC... Signature 5av_ Date S— 3 0 - ( 5 f Section 11—Home Owners License Exemption Home Owners Name: i Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature e - Date 3o--,- Punt Name 21 J9 ,S°h Telephone Number cSo -73 E-mail permit to: yl. ':v i A V1 n o (Z,C :. Or, 4— T e.4....A-6—a.ot mnn,0 Section n —Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ E storic District ❑ Site Plan Review Of required) ❑ Fire Department ❑ Conservation ❑ For commercid work,please take your plans direetly to the fire department for approval ; Section 13—Owner's Authorization I, l� AIJ VAoQ'�'i Ro 541 as Owner of the-subject properly hereby authorize to act on my behalf in all matters relative to work authorized by this building permit application for: f job)/5L 9, R e o er date A) ` 4180 40 Print Name . i laq=ate&2/92018 The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations IF 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lee bly Name(Business/Organization/Individual): T if' l - S 7 ,f T 1 C)P VLI [:� �o r- P Address: `? (3 r i c-, r c?A City/State/Zip: ®S+c r f e kAa pZC 5`7 Phone#: 5-,-6- Are you an employer?Check the appropriate box: Type of project(required): 1.�-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, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance# required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 11. Plumb' repairs or additions 3.❑ I am a homeowner doing all work ❑ � P myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *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 subcontractors 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: IA S S i e-d to g a ark`C r S l(&S y ra,�\-C C- Policy#or Self-ins.Lic.#: iy C `S'6 6 -S o 7 Z Expiration Date: S Job Site Address: Sr 5 ra.v c` c w A U L-,t y t' City/State/Zip:0S`-e 6u A(1P Wd-A-a2 C 5 j—j -- 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 cerWfy under the pains and�pennalties of perjury that the information provided above is true and correct Siifin Date: Phone#: G 7 3 7 �' G 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#: 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),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia _ FEMA Flood Zones - Effective July 16, 2014 O. sO Town of Barnstable This map represents a subset of the information found on the official FEMA FIRM maps. GI.S Unit The full FEMA FIRM maps can be viewed on the Town website using the QR code to the right: �� 367 Main Street,Hyannis,MA orath ://www.town.bamstable.ma us/Conservation/InsuranceMaps asp ❑� (508)862-4624 Special Flood Hazard Areas (SFHAs)Subject to Inundation by the i%Annual Chance Flood i`55M ® ZoneAE-BaseFloodElemtions determined.3� / ■ Zone.90-flood depths of'to 3 feet (usually sheet flrnv on sloping terrain);aiwage depths determined. UA S�C Zone VE-Coastal flood zone pith �0:'°o.=.R1NL � + � t� calocitylamard(wave action);Base Flood Elerationsdetermined. The i% annual chance flood (roo-year Crystal Lake ��---- �`: flood),also imo%%m as the base flood,is the flood that has a i%chance of being equaled y ' c cr exceeded in any given year.The Special r 3s �` ' ''� 15, Flood Hazard Area is the area subject to 1 j' - flooding by the i% annual chance flood. Areas of Special flood Hazard include Zones AE,AD,and VE.The Base Flood Elevation is the water-surface elevation of the i%annual chance flood. A :: E '' Other Flood Areas Areas of annual�anceflood; i �� ,t�'•:,:, � areas of r%95 annual chanceflood with axvxagedepths of less than r foot or uith drainage areas less than f 1 , i square mile;and areas protected by �;... .: r � /+��`- �•=�...:- levees from i9Gaanual chance flood. lJ l.:•::, 1� r Ivan tucke t r Coastal Barrier Resource System l•' �3 +�' `�.�� _ •` � "� Sound •.�� (CBRS)Areas l4� ® Otherc+ise Protected Areas(OPAs) f f .ss yL NOTE:The flood zones shrnca here are from f' �•• W /\ the July hb, 2oi4 FEMA Flood Insurance Rate Ilaps(FIR11s).These maps represent a ! subset of the information shown on the Wj G� i actual FIRM maps. The original FIRM m scale is i=500. Enlargement be}md that scale may not meet established map aazaacystandards. THIS MAP IS FOR PLAYKNING PURPOSES r 0NLY FOR SITE SPECIFIC FLOOD HAZARD DETER31MIA11OWS, CONSULT THE OFFICIAL MIA FIRI D-WS. `1 CIO OPS Legend Parcels Railroad Tracks Buildings Miles This map is for planning purposes only. It is not adequate for Parcel lines on this are o rJ nDpmx eundinp adeq map my graphic representations of ❑BhdidInye 0 0 0 legal boundary determination or regulatory interpretation. Assessor's tax panels.They are not true property Painted Lines This map does not represent an on-the-ground survey. boundaries and do not represent accurate relationships to Approx.Scale:1 inch= 167 feet Map printed on: 8/21/2019 Physical objects on the map such as building locations. Parking Lots Office of Consumer Affairs Business Regulation HOME IMPROVEMENT CONTRACTOR Registration vaTld for individual use only TYPE: dion before the expiration date. If found return to: 1e 7 10E irati Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 TRIS DEVELOP • - Boston,MA 02116 SCOTT SHIELDS 72 BRIAR PATCH R, OSTERVILLE,MA 02 '�'t undersecretary Not valid without Signature Commonwealth of Massachusetts - Division of Professional Licensure Board of Building Regulations and Standards Cons �ru>t't�iS bop visor i CS-065898 ��` i pines:07/10/2021 SCOTT S SHf,KLDS 72 BRIAR PATCH RDA„ " OSTERVILLE-,! A 02655 j -�. Commissioner i Saco CERTIFICATE OF LIABILITY INSURANCE °A04;�TE(=1°19" 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 INSURERS] AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). _ PRODUCER 10083-002 INTACT 10083 10083/2 Dowling and O Neil Ins Agcy ATC.No. : (508)775-1620 NC.No.: 9731yannoughRoad ss: claaiA@doins.com Hyannis,MA 02601 AFFORDING COVERAGE INSURERA: Associated Employers Insurance Company 11104 INSURED TRI-S Development Corp 01SURERB. I C- 72 Briar Patch Road Osterville, tAL 02655 INSURER D: INSURER E INSURER IF 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. ILTR TYPE OF INSURANCE INS POLICY NUMBER M IC LWITS GENERAL LIABILITY EACH OCCIAtRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PREMISES Ea occurrence CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ Cy I Mr Floc AUTOMOBILE LIABILITY COMBINED SINGLE.UMIT $ Ea accident__ AN AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY KIUIRY(Per ac ided) S HIRED AUTOS NON-OWNED PROPS DAMAGE $ AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR HCLAIMS MADE AGGREGATE $ DED RETENTION $ yy�g T $ �pnp� X TORY Uk OER� /mayQ� S LIA811f1 Y Y/N A O 1&QMtMctKNMDED7 'FN`] N/A WCC-500-6007148-2019A 6/1/2019 5/1/2020 EL EACH ACCIDENT $ 600,000.00 I(rrWn��d��atory in NH) EL DISEASE-EA EMPLOYEE $ 500,000-00 D SCRI I N�F OPERATIONS treim E.L.DISEASE-POLICY LIMIT $ 50 00.0 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(AttaCA ACORD 101,Addifiorral Remade Sdredtde,*more spxe is required) PROOF OF COVERAGE CERTIFICATE HOLDER CANCELLATION TRI-S DEVELOPMENT CORP 72 BRIAR PATCH RD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Osterville,MA 02665 THE EXPIRATION DATE THEREOF, NOTICE WUl BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD oFt„E, Town of Barnstable *Permit# 63 3 Expires 6 months from Issue date 4l' Regulatory Services Fee r s �m�' Thomas F.Geller,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 X-PRESq P 7 m,- - Office: 508-862-4038 Pax: 508 790-6230 F E B .j 2004 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Bed&PressImprint TOWN OF BAIRNS-fAL.: _t_ Map/parcel Number 6�2' 0 2 lq - O U r Property Address rAll R1 Residential �( Value of Work17 .n 0 Owner's Name&Address lZa,k" a 1,1,, / ' < CA - , (+r` S j o. ✓_ C D-Z Q".4 - l Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ® I am the Homeowner ❑ I have Worker's Compensation Insurance — — Insurance Company Name Workman's Camp.Policy# Permit Request(check box) l Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) *where regaled: Issuance of this penal,does not exempt comiplimma with other town deputment regulations,Le.Historic,Conservation,etc. ***Note. Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. Signature emu- - - - - -.,--_mow ----- - _ ..s l Y r' 7 .io (!32'rio..� a� } - v. - - r • `- S4./EHE�✓7— r { 2• @Is8 - ' y� ' ��.0" �� �t a ry ...__.,--.8 'x �a�.9/82�-j 1 -` JSO•r`__ f.��y���G A4Vlll7l7+T'�_��1 �t , �1�- .z.:' Z�s►8= � `�"' _20/ —1 3EPf�c S-_ i8'� _ .. /. .�1} O??�b Y . G EZ ES/N T/O.V TLP I�IG/1/1/i 7�/ Q � __ �'"'�' Fv✓.vORrlUn/ /s' /� 3 N �► 77 P TTsi�iEL•A r!c o/Z�/ /e- �-� .. .. "_.._•=`_I� - __ - � r P.G -� ;8:� � N�� w ' 3 F Tom•-,Y y p/._... ... .._.._.\\ ..... ._.,.r o k F/`2ti - -- " --- - - - — 20 /T _ � : E /4-Z y Q �s _ .. Assessor's office(1st Flo-V Assessor's imap and=tof'number �� UU o�-lug>o�. Conserafon(4t Floor): a SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE board of Health(3rd floor): ., Sewage Permit number =: �19eTIH TITLES t ssa»raatc yo rua Engineering Department(3rd floor):' `1 3MVf RONMENTAL CODE AND r J House number f �` ` t 1N REGU� ®NS r,►r Definitive Plan Approved by Planning Board ' 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00=2:00 P.M.only , TOWN ' OF -BARNSTABLE BUILDING ' INSPECTOR APPLICATION FOR PERMIT TO Renovation and Addition ' i t TYPE OF CONSTRUCTION R e s i d e n t i•a 1. October 6 , 19 93 k TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:\ Location 25 Seaview Ave. , Osterville Proposed Use Single Family Home Zoning District Fire District C.O.MM 6 Carding Mill Rd . Name of Owner Vahan Martirosian Address Sudbury, MA 01776 619 Main St . NameofBuilder Silvia & Silvia Address Centerville, MA 02632 Box 1034 a Name of Architect Doreve Nicholaeff Address Osterville, MA 02655 Number of Rooms Foundation PIGL. t^_o(I*-- Cedar �E Exterior Cedar Roofing Oak �l� i L Floors Interior �6 f Gas Forced Air � �A-TgS Heating Plumbing Existing $500 ,000 .00 Fireplace Approximate Cost Area Diagram of Lot and Building with Dimensions Fee __ 1312, 7K_ SEE ATTACHED SITE PLAN & PLANS OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Names Registration No. 10162V'# I ff `f /�JJrrr Construction Si ipervisor s License MARTI ROS IA1T, VAHAN �~ REMODEL & ADD -No 3a226 Permit For TO DWELLING , t_ ►,r Single Family Dwelling Location 25 Seaview Avenue (Lot 1) ! Osterville , Owner Vahan Martirosian Wood frame Type of Construction ' Plot Lot f Permit Granted October 8 19 93 Date of Inspection: _ Frame 3 19 Insulation �� 19 Tireplacei 19 Date"Id"-npleted 19 40 r 22-q�� ,perp+•-. �iN '�+ , r� •eg Old � ! . 1 , ~ �f "t 1 } 1 . Assessor's office(1st Floor): r• // �r + J � ���� ����� ��� Assessor's map and lot m �lD a� G a� Y �c t p INSTALLED IN COMP °�• Cdnservation Board of Health(3rd fb r): - WITH'TITLE 5 Sewage Permit number e °' : /'.✓ _ ��I�®� � t�L CO TOWN REGULAATI4a .ego: Engineering Department(3rd floor): �5,— , House number ' J`f- Definitive Plan Approved by'Planning Board 19I' APPLICATIONS PROCESSED 8:30-9:30 A.M.-and.1:00-2.W P.M.only TOWN ".. OF ' BARNSTABLE ' t r i BUILDING INSPECTOR APPLICATION FOR PERMIT TO / f/- ,f7C/o ✓ v C�t�IS ��Z� �2�/ �1rjG� e TYPE OF CONSTRUCTION i 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Proposed Use Zoning District ,T Fire District C' -14M Name of Owner �,Omo' iOS��� Address �,7��GP�.J AA-( /IV 111� � Name of Builder Ale 1,32dr;?? 6z,J"1ivrX4f7 Address 1117 100'5�07 Name of Architect �DlCG� /S�,C�O��G�� Address,C"4'"`t,"" Number of Rooms Foundation Exterior d04 ��`nr`� Roofing Floors /; �� �Ti� Interior l,A Heating //7G /�/� �Gl �'� Plumbing 1�` /�'�/ �t/i7O/�'leleq ok Fireplace Approximate Cost Area ` Diagram of Lot and Building with Dimensions 0 Fee 'Al M 'HAM) t � OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regardin a ove constru ion. Name Construction Supervisor's License o/I�1(0-)69 MARTIROSIAN, VAHAN R 4 . No 35654 Permit For REMODEL & ADD TO Single Family Dwelling Location 25 Seaview Avenue Osterville _ Owner Vahan Martirosian Type of Construction Frame Plot Lot R Permit Granted February 9 , 19 93 Date o ApWbcfion��&, 19 Date Completed .0 ? 19 Jr{ � � r /ICTJJ�\ � [91 FBI MI ,,I Hid PR IF-lng ON., IIimi -��° - ooQa a000 I 1- PRELIMINARY c i I i 6J eel.� !r *d'f•'�' ...i'i 1 I I � - \ i , i • , vm '`•. �3 .v,+,++cn t .en cn t...,:�o, "i�- .�.. .:-�T_ =•41.-- s.l IT .s.r�•.,M' v.,�'.1:tti• .ems .1.,�. - ti.. _ � ,j - , - -DoKF� I-tia.lov-APR ':PF��rft°�7 I.•io., _ �._ ..----.....--��-�--�--------R�+c,�l. Gt�an'(vlrr _ PRELIMINARY ,t I 'LJ HC(L9.w'I J� I r � ,y M�f1t� --g�lTatil.:�Pam:`---------..., . .. .. �-GT�-'C•.G BB - .{�RB� •.. -lictlo�ACPF-.--:, ------------...... .. PRELIMINARY 1 • /o �'o�x�,:o�uoer�{/i�•/uaaoac�uaelG HOME IMPROVEMENT CONTRACTOR _ _.. nagistration 110216 TYPe - PRIVATE CORPORATION EXPiration 10/09/94 T ; NELSON CONSTRUCTION INC THO►i I A. NELSON ADMINISTRATOR 1112 MAIN ST OSTERVILLE MA 02655 I COMMONWEALTH _ - . DEPARTMENT OF PUBLIC SAFETY 'i 1010 COMMONWEALTH AVE. OF 4 MASSACHUSETTS BOSTON,MASS.02215 ENCLOSE CHECK OR;MONEY.ORDER x, LICENSE. : * FOR REQUIRED FEE, EXPIRATION DATE 1:. JICr ? C 0 N S T I2. S U P E R V I S O R 06/30/1993 EFFECTIVE DATE LICNO. MADEPAYABLE'TO RESTRICTIONS 6 d NONE = 06/30./1 991 009889 a "COMMISSIONER OF PUBLIC SAFETY'l T H OM A S A N E L'S U h _ -,(DO N6T SEND CASH). 14 ICE VALLEY RD OSTERVILLE MA 02655 f IEA)� Aj( TE 1�'�Jt JNCREASE-•=. ` PH,o.1 Irl FEE: ' 100.00 F FEET E(JFEB 1 ' 1 989 . HEIGHT: NOT VALID uNra NED BS,I(({ENSEE AND OFFICULI�' i 1 •��• ' ' STAMPED OR SIGNATURE OF-THE COMMISSION" � ' „i t NOT 'DE,TACH: LICENSE: STUB ,- �•;: THIS DOCUMENT Musr 1 t SIGN'NAME IN FULL•ABOVE-SIGNATURE LINE CARRIED ON THE PERSON C 1• I F.LICENSEE.' OTN THE HOLDER WHEN ENOA'• •, --• +~ PAINT EO AN THIS OCCUPATR 4. COMMISSIONEP 20OM•2-87.81429 v TOWN OF BARNSTABLE Permit No. .. 36226 BUILDING DEPARTMENT I ' I TOWN OFFICE BUILDING w Cash y `�y>cul HYANNISWASS.02601 Bond ................ REMODEL & ADDITION ` CERTIFICATE OF USE AND OCCUPANCY F' Issued to Vahan Martirosian Address Lot #1, 25 Seaview Avenue Osterville, 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. August 19, 94 .......................... 19................. ........... ........ Building�nspector mum ., The Town of,Barnstable Conservation Departi' ent smrr�n S 367 Main Street, Hyannis, MA 02601 Office 508-790-6245 Robert W. Gatewood FAX 508-775=3344 Conservation Administrator . TO Jos3 Daluz, Building Commissioner FROM: Robert Gatewood RE: Occupancy Permit/Final inspection DATE: The followir_u project has been granted an Order of Cordirioas by the Conservation Commission. Applicant: Project- Location: n Map/Parcel: 07(a Our Permit #: SE 3- a aZ v We. would kindly ask -that- no Occupancy Permit or Final Inspection (as may apply) be granted by your department until a Certificate of Compliance for the project has issued from the Conservation Commission. Your assistance is very much appreciated.. 1 - ' n. _ COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY Patfr►�toposssss'sesnsat .. - OF ONE ASHBORTON PLACE � ttsSY2tlf3slfdt� MASSACHUSETTS - L I C E N S.E - -CAUTION EXPIRATION DATE CONSTR. SUPERVISOR 0 2/2 4/19 9 6 FOR PROTECTION AGAINST EFFECTIVE DATE - LIC-NO. RESTRICTIONS 0� I THEFT, PUT RIGHT THUMB NONE �F..� 06/30/1993 016931 PRINT IN APPROPRIATE o BOX ON LICENSE. Z FL9YD SILVIA Z 0 61 MAIN S T RE ET o BLASTING OPERATORS "k' ' C.ENTE.RVILLE MA •02632 _ U. : _ . m m MUS UDE.PHOTO. PHOTO BLASTING OPR ONLY) FE I NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: STAMPED-OR•SIGNATURE OF THE COMMISSIONER � - ._�.' .'�"'•`.'::.'_ _� �• 19463 _ _ _ - THIS DOCUMENT MUST BE ...' . . -•• - .. - __.. TURE OF Sr"'E SIGN NAME 1 TUAE UNE: -•_..� _ CARRIED ON THEPERSONOF - - .. .. . THE HOLDER WHEN EN- OTHERS- GAG EDINTHISOCCUPATION. - � �► IONEA -.__ _ _, la `D (fR�G^���{-/+a ' .• . _ :'Y' .F'.. - "-1 _.sY..,'T�..+� nia+-'t - :f•f.. �^ '."+'^r+M'�+'�'v'':'...Ly'._._.v' Y „� 41 _ _-_ HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston , Massachusetts. 02108 HOME IMPROVEMENT CONTRACTOR -• Registration 101627 Expiration 06/26/94 Type - PRIVATE CORPORATION Silvia &Silvia Associates , Inc . Ronald J . Silvia i 619 Main Street , Centerville MA 02632 1 HOME IMPROVEMENT CONTRACTOR Registration 101627 f Type - PRIVATE CORPORATION i Expiration 06/26/94 Silvia 3 Silvia Associates;•.I:k Ronald J. Silvia. =- - 619 Main•Street _ ADA"'"'STR""'R Centerville MA 02632.. ...__ r ....ate Y ,; s>•:''-�?. _�_ - -" -' '-• - - - -- - - - __._. - -- - -- MART610SrAN I. / f ..RESIDENCE �% _ ..' '\ ¢/1_OKY.•mLff ��' �K}O!f�_nwt_ t - �e+rr ' c/.yf/ J w. -� �^ ;do-•u� — `.� `dy tu_ +n�K w noo •_;.• • ! r r ��•, �. I, _ .: _ _.Y_ _ ter--�,-v.-:•.-. ��•�. -- � ray CD -----'----- - _ _ .__----�-�-_---__ ter•—=--♦�---=- --" .-�-_- _ - -- -_— � I�IY----': II f '��'-/ ., r �_, .-ect• $; R-,rf oa•r ^.i�I� o'.co.+s� -• � . .......... ° � I I ; L �Iry _;,•�� �-� -�-;� t--_-,.. _.. ._ ; I ( al'M MARiIROSIlW • - .. .. 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' I 1 I n ' c.rHLr� I �o; .� I f �fr+Nr cw, I �f It I :ram..rr.:L,."vwr•.,en...� 'I •S,�� n"ta'ew K � � II i 1' � .>o. 1 I I-��'-I I — ———— :.L.e I '�';��^-Z' I.._.�I •tom:�x�''I' — .•.r..:..� 1 i���_�_I' iwl— �.. - .' .. .' - .. .. ``nr�Y.f•Kill r✓.c SEri1oN A_Ar•)?:M -__` �_GTIOIJ.o-D- v `o"'a wr.n rs - .. . � d ,, ,.. —M•1 WL s.•r.'..au[0 e•f/�� \ [L a-a.�q. •w�.we A, or[;,,.e .1.• —yam•¶i;�,.,,,n„+.p,e DCaEVE NOC AER c6LC ARCMfTECT. Na .. � _ - i j Ir E Li ppj'• [FF I`�,. /1 i%aZ� G _ �,,-- I i.j� i,iil I• .I _ll'(�:;�—_-— I I � aj ` is !j I q�!�I� I �� c— —!I I unaa+J I, II! !II �!II7d i;'I I �il I IIj� �I I I II �� I ' II ^''_`�-^jII I II"••e+Lu ",w' �I II; I;Ij L��aII II: 'Ii Ii I I .10 `-1.'IJB � _—..I_.•_ _� -.,_J I 'II� D.:O� I�I I ILJ ' 'OEtTION D-D - }'... - ••�, =__n.y,n. - �`I .R�� - MARTIROSIAN RESIDENCE `7 �U ry � 7iirY� . Lit t I' 1 "t - b' I 't ,I �. i�I I'• �� II�Iti''.r�il Q Vill DOREVE ARCHMEC ip .. - >. . • 5w .O`1'.. E. 1,v.•.i �GD 1' .il'>'••s G�O� C-� �,i':.d _ IR1t.p . I MARTIFOSIM RE9ff.1JCE , .� �; I I :awl G 1 }1 �i* �• "i�`.-. . . . �`� cc<� CD I� i I I rr'.'m' scon'I -_ w..!~ /..•} � I - Jyi 'mow' �l�y;@w:��� ( �;.:d O��O OCREVE wpque-f ARCH EC WC. — — . ILII - - ------- --- o ...� .:'..•., _ ��" �..�..': �a GOJr{__ .:' RV r,Ys Sc�a K;rsi-/fu.+1 r,�.�n.,. � .. _ .. ..w...n�,.ec�J O••.•t< p n.L 11�J1.tD �L- � • nV . � R�-.f.'�-�.a� �I;J;L'f tl-2'k`ar-Er{ ._ m .riJJ W sass-w(�ro•+Kl .rfHL'�YLlt.i�r✓��✓i�. !, 6.Y 31 nOi4 ' Lvr_l-c �Lti .�^,• y,Vb tt r.'rrr '_ _ .. -. - �-�(> p�K wL eti e� :' '._�- '' - ;��� - r _. _ - R+Gr '�.JU.`-"� o>. m.L r�r,.. a.•+4 N.A;m mac J.�io~n�ra. .. - MARTROSIAN RESIDENCE I '.' I .. .• : :. ��"� �� xaa.rt♦ Boa a 1 .. . 1 1 ♦a`i,.e_ .. I v r - •'i DOREVE NO.OLAEFI ARC1rtTECT, Na 1 • .. sue• _ 1 , , i _ 1 1 l i+ a. I _ mARnAosm .. - .. RESIDENCE 1 - _ �9�'_'_ ✓�I✓n tic. 0 PACHR� WG ILL `--ft1++.-.:� zt ___-_ � '- _-__.._ .T-.—_ __-__ __-- �-__._ _._____—_._ _ - .-.. .__. ._ _-..._.. .__. •'r.. u..-. _-_,�.. .,._._. r.�....�-ems' -.� _..._. ._._ ..-i___• _._..�.- i` R COMMONWEALTH OF MASSACHUSETTS DErAR,MENT OF INDUSTRIAL ACCIDENTS 600 WASHINGTON STREET' fames Canooev BOSTON, MASSACHUSETTS 02111 ;o-'n:ssione, WORI_RS' COMPENSATION INSURANCE AFFIDAVIT 1, -- El—o-yd Silvia . (lice nsee/perminec) with a principal place of business/residence at: 619 Main St. , Centerville, MA 02632 (City/State/Zip) do hereby certify, under the pains and penalties of perjury,, that: (� I am an employer providing the following workers' compensation coverage for my employees working on this job. Travelers Ins . 28C814878793D Insurance Company Policy Number ( J I am a sole proprietor and have no one working for me. ( J I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed bclo.w who have the following workers' compensation insurance policies: Name of Contractor Insurance Company/Police Number Dame of Contractor Insurance Company/Policy Numbcr Dame of Contractor Insurance Company/Policy Number Q I am a homeowner performing all the work myself. NOTE: PJcasc be a.vue that while homeowners who employ persons to do maintenance,construction or repair work on a • dwelling of not more thaw three units in which the homeowner also resides or on the grounds appuruaaat thereto arc not generally considered to be employers under the Workers' Compensation Act(GL C. 152,sect. 1(5)), application by a homeowner for a license or permit may evidence the legal sutus of a.n employer under the Workers' Compensation Act 1 understand that a copy of this statement wil] be for,,2-rdcd to u)c Dcpa:::�cn: cal.du:::c �.ccc�cns' Orice el!^surancz for eovcrgc verification and that failure to secure coverage as required under Section 25A of JAGL 152 cut lead to the imposition of-r6minaJ pcnaltics consisting of a fine of up to S1500.00 and/or imprisonment of up to one year and civil penalues in the form of a Stop Work Order and a fine of S100.00 a day against me. Signed this 6 day of October , 19 93 X' Licensee/Per c Licensor/Permiaor Segistration No.101627 f I m NOTES- let §a 1)f01p EOC lA"ACBF./R NULL RNAIIiLi,blY 7Np `xt �I �� �QAEAR16O01"'THEF0IMMT101°RPhDCA'E 1.) CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS G C FFF■ [ ��+��d+CCnE FOIE "m"THIE WALL &DIMENSIONS IN THE FIELD � Q ALTuA n0Mm d1T1ni, ,.m a"yi qmw WALLowrmous I LAM OFR6.IBA"3CAVR,le TT)1IMRonF)Alms „E 2.) CONTRACTOR TO VERIFY ALL INTERIOR&EXTERIOR MATERIALS. saso">lollnoNnNuvnrl""T►IweuwnwwreeMdfAl!ffi _C 6 2)OO SHAU OklHi1NF LOCA"M AMTVK OF AN C V~ DETAILS,8i FINISHES IN THE FIELD WITH OWNER �. . e"�aroTI,*WMOFTM W aeroFneernucrulaf"e 3.) TIMBER FRAMING TO BE SPRUCE/PINE/FIR NO.2 GRADE,900 PSI MIN. s s a aWtOdmneGRATEATE V nEnawc a„m>rruoaA,e,� 1 4J ALL CONSTRUCTION TO CONFORM TO 780 CMR MASSACHUSETTSa iw,N,NFALED9"T7 NrBAATM I STATE BUILDING CODE;9TH EDfT10N AMENDEMENT 8 IRC2015 BB ,•, �,,.,�,,,,,,,,�„�) 5.) VERIFY ALL PLUMBING&ELECTRICAL DETAILS W/OWNERS ON THE SITE U ",PHESM MFOUMg10Nd DURING FRAMING CONSTRUCTION J Jr rw onnvALL a et.u&eo"no � v )PANSPAM x� F�B M OR�mE j SMOKE DETECTORS REVIEWED ` �a i Ir BMII B 4 Vf 201 80rM FUTE NU CO Q 0 ! MCOIIiAfNUNMCp11Q�TE . S BLE BOIL G DEPT. DATE ' Barnstable Bldg. Dept. W N lu •2AILEQR BASEMENT FINICHIN. FIRE DEPARTMENT DA E Approved by, BOTH SIGNATURES ARE REQUIRED FOR PERMITTING Permit Wes' ra ra r4r BASEMENT VA DOw H CC< L J I J CLOS. I ..J Sw WE j ; EXIST. NrAo 000R es STORAGE J EOSTING I W SAUNA 9 -; EXIST. E CRAWLSPACE CO. O, O TILED n Z Tv .W NEW 2 old• Z:.... E109T.GIRT. BATH (2)IV DOORS (2)IV DOORS ————— R)IV DOORS O � W Nw I I I / LW STEM REC. I I I BENCH LIN. T ROOM J . LIN. � � •� P ELXGTRJCAL 5. (2)IV DOORS � � O Q REF II UP W I I WETBAR //� . 11 3Ir DOOR W Of Q VI 1 Z2N SCALE : wuroow wlRoow 1/4"= 1'-0" 37-V DATE : a A' 8/13/2019 BASEMENT P LA �d DRAWING NO.: • i ©SMOKE.DETECTOR Q CARBON MONOXIDE DETECTOR Al