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0432 WIANNO AVENUE
�, — � \ 3 o �. ,. o. o _ o � co ,. ,.. p � "� � _ ,S � � � o o .. o ] o v� � � 9 � � n e � ` ,� � c � � � o ��0 � �. � r�. L o ���o � .. n a � i .� u � „ � .� - o ,. .. o .. � r � o � n .. �3 � o ., .. � ' c �. a c .c ,� o '. n � o o ,� v � .. .. a i�� � o ,. .� � .� a .� - �... o � a ,. �o. o �o ^. _ .. o c. r. � o o �. �. o o U � o �,o 0 o o � o r .o o � P o o '" o � ,, o „ e o o - , o 'a o- � ,� � � � a�, - ,, e _ a �� o� � o ,� _ � a o o a ., � o ,� - o �, o a ,. o '� � � �.. o .. P 0 i8 ,. s o ,. � � ,- o �' .. <� ,. o � o ., _ s � >� c.. a - � _ � �. v � � � .. o , 'o - ,.. �- .. a .. .. .. rf i a oo .. a . - o � � - � �. ,. .. o � n � .o o i r, ,. A � 4 o a ,. ., o' .. a .., �. . �. o �, � .,.�, �� � n o a „- s ',. � � - P, � � � �� � .. � ., ° o � a ,. A,: o, ,. _ ,, _ a o � ,., o o o ,v 0 a a .. .� � � � ,� a n ,. � a '� �. c ` � � � .. .. � .. n � o .. a _ _ � � ,� ., o + ° o �. o � � � � � � � �'. �� � .. '. �� � � a a o � �. � tz.o ., �� � ., 0 .� � a � x e., n a a i• o. .�' o , � _ 0 o� a � � _ � � o 0 4 0 a n TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma pli Parcel bcZ� I A catio l #` P _ Health Division Date Issued Z l Conservation Division �- Application Fee _ Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village. iocye_� Owner Sc,���W D r��� Address 3Z Winn O Telephone 5-D 5 U Permit Request (-6'Y\ZV A M 6�9 S i 1 0 C4 22 A-4 .0;_: 3 Square feet: 1 st floor: existing proposed ""'O 2nd floor: existing Proposed � Total new =Zoning District / Flood Plain l Groundwater Overlay Project Valuation 0 10-6 a Construction Type I,(� (� kA h C Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure 12-D Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: XFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) `O b Basement Unfinished Area (sq.ft) ` Number of Baths: Full: existing (0 I L new Half: existing new I l Number of Bedrooms: existing, new Total Room Count (riot including baths): existing new S First Floor doom Count Heat Type and Fuel:. Gas ❑ Oil 0 Electric 0 Other . � 00 Central Air: AII Yes ❑ No Fireplaces: Existing New Existing wood/ oal stove ❑Yes ❑ No Detached garage��� " g ❑ new size— ❑ existing ❑ new size _ Barn: 0 existing LYnew-size_ m Attached garage existing ❑ new size _Shed: ❑ existing 0 new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # LA fr Recorded q Commercial ❑Yes ❑ No If yes, site plan review # Current Use �ES `4 `��� Proposed Use 6AYlne APPLICANT INFORMATION (BUILDER OR HOMEOWNER) G Name �= - \� Telephone Number J v o 3 V-) Address ��L v License# S y J� q 4 Home Improvement Contractor#- 1 0 31 2$ Email . toSG_P4E�0" Worker's Compensation # ALL CONSTR U ION DEBRISqSULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY k APPLICATION# DATE ISSUED MAP/PARCEL NO. r i ADDRESS VILLAGE OWNER DATE OF INSPECTION: �AFQUNDA I.ON U � :uUA4&; L)*r _ FRAME J t INSULATION 4 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING- DATE CLOSED OUT ASSOCIATION PLAN NO: � n y 1"he Commompwl&ofMassachuseits De7arorAwt of huhtsmW Accidents Q,fce ofInvestigations 600 Washington Street Boston,M,4 02111 wnnv.7na,,mgm,1dia 'workers' CtzmpensatianInsurance Affidavit:Builders/Contractors/Elect icians/Plumbers Applicant Information Please Print Legibly Name 0 smess1OrganizationQdividuaq: Address: city/Statefz;p: i MA o�-� Phone 4 - 5zi 7 Are you an employer?Ch ck the appropriate box: Type of, r Pr'o 3 e.ct(required): L❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New eonsfructioa employees(full and/or part-time)* have hired the sub-contractors. 2-f I am a sole proprietor or partner- listed on the attached sheet y- ❑Remodeling slip and have no employees These sub-oontractors have 9: ❑Demolition w for me in an c city employees and have workers' offing y apa. ty. - I g_ ❑Building addition [No workers' comp.inevrranre comp.insurau required•] 5. ❑ We are a corporation and its 10-❑Electrical repairs or additions 3.❑ I am a homeowner doing all work offices haw exercised their 11.0 Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12_0 Roof repairs insurance required-]F c.152, §l(4),andwe hzn a na employees.[No workers' 13.0 Other comp.insurance rewired.]. �Aayappti�attbatchedcsbosRlmastalsoflloutthesectionbelowshowingFhea- woxkmI compensation poaTinformatian- Homeowners who sabmit ibis affidavit indicsting they Rm daing all-rode and then hire amzide contractors must snit anew affidsrit inXr�tinv srub_ rContzacmrs thst check this boot must attached an additional sheet showing-the name of the sub- rs and state whether or not those entities have employees. If the sub-contradws have employees,they must provide their warkers'Comp.police number. I am an employer chat is prm idbtg tt,orkers'comp,errsation irrsuraace for my amplayeas. Below is Ste policy and job site information. Insurance Company Name: Policy 4 or Self-ins.Lic.4: Expiration Date_�� i+ Job Site Address: City/State/Zip: Attach a copy of the workers'compensation polies declaration page(showing the policy number and expiration date). . Failure to secure'coverage as requiredunder Section 25A of MGL r 152 can lead to the imposititm of criminal penalties of a fine up to$1,500.00 and/or one yearimlxisonment,as well as civil penalties in the form of a STOP WORK ORDEEL 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 Im estigati f the DIA for umurauc a coverage verification- . I do Isere c i t s andpenalties ofpedury that the information protzded abm c istrue and-correct S,ttmattue: Date: )A `® `i l q Phone#: O f}uzaI use only. Do not write in this area,to be completed by city or town o i'ciat City or Town: Pertmtucense It Issuing Authority(circle one): 1.Board of Health 2.Binding Department 3.CitVrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other A Contact Person: Phone 9: 6 r + N 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 Iocal 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 auy 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 in=mce 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 ceri..ficate:(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 17he affidavit should be returned to the city or town that the application for the permit or license is being requested,riot 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/licease 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 future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would 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 Tndustdal Accidents Office of kvestxgafiGm 600 Washingtan Street Boston=MA 02111 Tel.#617-727-4M ext 406 or 1-�7`�MASS.AFB Revised 4-24--07 Fax# f 17-727-7749 www.massgov/dia I ; owy ,i of Barnstable �, Regulatory Services �.; „ Thontas V. =ectert t�ircc ar Bu* ding Divi: inn Tim Perry,BuiWittg Commivsfinner !t� 4air� ftxt,11}anni%Nf,N(0,61 t • �vr,toe+��_Eesrnzt�tite.irsm_r�q -Propert.y Owner. M us t Complete an(3 Sig "11jis Section Jf Usituy A Builder �� •\•.ifr►��'�7{ .S f i1.:: �J�s'J�It:1 {i� �lr !�l:��i�^l:.t:f.r.��tit ;wrOty aurhorixc _ � ... W tic, DIT5 Iry m alt nrmw•tc�t4 relative to work amhonzcd by rL!s hailAing P_rmir. (:At►ddi-ess, Of Jf)b) ' **]koof fences and idarrn.s are the responsibility (if the app.Iic_am. Pools before not try be filled or utilized �fnre fenceis inst. ;d arad atl fnal inspectio.us :ire performed and aecc..pted. SfOl;I f."rr.o :)Urns. Sign2l•urr of A pphcuat 11tii1I Muse Prinst Mane Ulzs �p r Af airs&r/l/a�6 -ulatiocael�. License or registration valid for individul use only Office of Consumer Affairs&Busifiess'R�gulation g� y j OME IMPROVEMENT CONTRACTOR. before the expiration date. If found,return to: egistration: 403928 Type: Office of Consumer Affairs and Eusiriess Regulation xp!ration:,=.71IW2014- Individual 10 Park Plaza-Suite 5170 , os MA 02116 PETER E. KELLY Peter Kelly 50 RUSTIC AVE. 'r'�'M %V HYANNIS, MA 02601 Undersecretary Not valid without signat'u"re M i i i . !, Massachusetts -Department of Public Safety Board of Building Regulations and Standards Cunstruction'Supen'isrir License: CS-015044 PETER E XELLY=` 50 RUSTIC LANK Hyannis MA 02601 I J.•�..� Jj . ,� �" �� Expiration Commissioner 08/15/2015 r 's y✓I oiQh� 3xli w } hoW " CW y Co ry) oo � - - GP/t.Pn a d y _ , a R 3 v r r r e . 11 ' 4,1 Z`I r ti �.x Y q ii 9 1r'a to r '•` M1 ---------------------------------------------------------- -------- ------------___"._-_________"____-__--'.__"_--------.-_______-----_-___._--------.-...-----__....------_-------_--.-___--_-_'___..___-----------.._.__.-------._..___-----_._---_-__-. r r Town of Barnstable *Peffiit -7 F 6 Expires 6 mondhs from issue date Regulatory Services Fee • BasLsrABLE /vl MASS. ��� Thomas F.Geller,Director gEo�� ,PREC RMiT Building Division Tom Perry,CEO, Building Commissioner 200 Main Street,Hyannis,MA 02601 Oct,j 6 www.townbamstab]e.tm.us Office:,,"508.862-4038 Fax:508-790-6230 TOWN OF SAR T � S PEPaHT APPLICATION - RESIDENTIAL ONLY Map/parcelNumber N q Valid witltotu Red X-Press Lnprint ? Property address I-//J e tX1 h/10 AU& Residential Value ofWork S Minimum fee of S35.00 for work-underS6000.00 Owner's Name&Address 11 w) ht7o Contractor's<�4amer'1(l TeL Number r! Home Improvement ContractorLicenseT(ifapphcablen) �l p� J Pn-All �� �Con�"I �{�d1y,1C10 6LCOM Construction Supervisor's License#(ifapplicable) Workman's CompensationI+s+ranCe Check one: ❑-I ama sole proprietor Ramthe Homeowner /111have Worker's mpensation Insurance Insurance Cou�panyNarm EE__ II I J )afe qsu I�(J�v%e-, Workman's Comp.Policy_ W 00 1060 Copy of Insurance Compliance Certificate must accompany.each permit. Permit�st(check box) �/Ac Y t, Re-roof(hurricane nailed)(striq�piu>°old shitL]es) Allconstructiondebris wzllbe takento_ ..Q ❑Re-roof(hurricane nailed)(not strippi m. Going over existing layers ofmof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Vahte (maxi MM.35)r ofwindows #ofdoots: ❑:.Smoke/CarbonMonoxide detectors 4 floorplans marked with red S and inspections required. Separate Electrical&Fire Permits required *Whesc requied:Issuance oft-is permit does not excr:Pt conPliance with other town depmtmentregulatnms;ie.Historic ConsavadoA etc. ***Note: Property OwnermmtsignProperty OwnerLetterof Permission. A copy of tote Home Improvement Contractors License&Construction Supervisors License is required. t I SIGNATURE: C�Users\decollicNAppDara\I.ocatLN4ieroso$\W iodows\Tcmporary luternetFilns\Ccate=Outlook\$276BDVA\ZxT�RESS.doc Revised 061313 .l ne Commonwealth of 1'�Sczssachzrsetts .Department of Industrial Accidents Olfce of Investigations 500 137ashington Street Boston, A 0211.1 _ wK mmass.gov/dia Wor.ker•s compensation Insurance Affidavit:Builders/Contractor s/Mectricians/Plumbetts Applicant Infolmation Please Print Legibly Name (Business/Organization/Indi-vidual): 7D4 L i Address: City/State/Zip: ' [Alt .1Mla Od (o35 _ Phon.e#-. �® � C &,_0 qa_� Are you an employer?Check the appropriate box: Type of project(required): l- 2 .i am a employer with— 4•❑ I a L a general contractor and I have 6. New ecnstr¢etion employees(fall and/or part-time).* hired the sub-oo,:tractors listed on tae IIed.-sheet�_- 7• ❑Rcmodelmg 2. I am a sole proprietor orpartuersbi These 8. Demolition ' p sub-cotthacto>;s have • and have no employees worlang for employees and have workers'comp. 9. Building addition mein any capacity.[No workers' insurance.$ comp insurance required.] 5. •We are a corporation and its 10. ❑Electrical repairs or additions n1—� officers have exercised their right of I1 Plumbing repairs or additions 3 i__I I am a homeowner doing all work exemption per•MGL c.152§(4),and 12.Q Roof repairs myself.Ni o,workers'comp, we have no employees.[No workers' insurance required.]i comp.insurance required.] 13.❑ Other +Airy applicant iltdt checks pox=1 tr.Lst also ya out the&ecdoa below soo g their wsker5'.compensation policy ixionrAot. t Homeowners who snbmit:}xis affidavit indicating thty ar=doirg all work and then him Mtsid;contractors tnttst submits new affidavit indicat n� the sub coaszctors hatractors that ve rattthiy box must attach ail addz•=punt sheet sflowing the name of the sub-contracte.s and state Nvhcthe.or not those catiEies have�trployaes•;f P Yes,they must provide their;votkcrs coaop.policy number. I am an employer that is propiding workers compensation Lnsurance for my employees.Below is the policy and job site infornzatitsn• D � Ins 4q5uy-al urance Compaay Name, �n• 1 C(, Policy;`or S61 ins.Lic.!-I: v D qq 301 a 0 Ezpi-ation Date._ Job Site Address: 31 1//a n"no AUF City tV Attach a copy of the workers'compensation policy declaration page showin the oti lStr and e C� Failure to secure cov go as p g ( S P cy.nttraber and expirafion date).etas rcgaited tracer Section 25A of MGL c_152 can lead to the imposition of criminal penalties of a fmc up to$1500.00 and or one-yar imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of ap to$256.G0 a day agaiostthe violator, 0 advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage v;Acatim I do hereby certifi the it enakies of perjury•that the informduon r vrded above is true and correct. Signature: Date: ������� Ph3one#: i OfACW use only.Do not write in this a-rea,to be comp?e_-d by city or town official I. City or Town: PermitrUcense4 Issuing Authority(circle one): 1.Board of health 2.Building Department 3.City/Town Clerl- 4.Electrical Ins 1 J 6.Other pector S.PlumbingIrspector l Contact Person: Phone#: FRASCON-01 pgp,S CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDDIYI^M 9/1912013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and.conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 508 676-0309 CONTACT Viveiros Insurance Agency,Inc. PINE Ashley PaiVa FAX 375 Airport Road Arc No Exr: 508-676-0309 127 WC,No): 508-324-9147 Fall River,MA 02720 ADDRESS:APaiva@Viveirosinsurance.com INSURER(S)AFFORDING COVERAGE NAIC 8 INSURER A:Granite State Insurance Co INSURED INSURER Construction LLC INSURERS: PO Box 1845 INSURERC: Cotuit, MA02635 INSURER0: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I SR LTR TYPEOFINSURANCE IN R WVD POLICYNUMBER D MIDD EX LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL UABILITY PREMISES Ea occurrence $ CLAIMS-MADE MED EXP(Any one person) $ PERSONAL&AOV IWURY $ GENERAL AGGREGATE $ GENL AGGREGATE LIMIT APPLESLIES PER PRODUCTS-COMPIOP.AGG $ POLICY � PRO LOC AUTOMOBILE LIABILITY SIN LM % (Ee accident) $ AWALITO BODILY INJURY(Per aerson) $ ALL TNT. AUTOS ULED ` AUTOS ED BODILY IWURY(Per accident) $ NON-CWNHIRED AUTOS AUTOS Per ecclder4 $ $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LiAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION is WC STAT L OTH- AND EMPLOYERS'LIA- TORY LIMB ER A OOFFICEORIMF�M9eRPExcNE�wEo,CtmvE YIN NIA WC009930601 9/26/2013 9/26/2014 E.L.EACH ACCIDENT $ 500,000 9 an.yes.d tory le and E.L.DISEASE_EA EMPLOYEE $ 500,000 tt yes,describe urger DESCRIPTION 0=OPERATIONS below E.L.DISEASE-POUGY LIMB $ 500,000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Aftch ACORD 10i,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable Building Division THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA026O1- AUTHORIZED REPRESENTATIVE J 1988-2010 ACORD CORPORATION. Ali rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD a Massachusetts -DepAttment of Public Safety i Board of Building Repiations and Standafels Construction Suporsisor ? License: C"97668 QL 104 MEW VUW LAT s EAST FAUN O �� r i t • ��...-JJ-f_,�� n n��� r_ypir,ition Commissioner 06/07/2015 ! i eoz-11,le ey Office of Consumer Affairsand Business Re�Iatio b n _ 10.Park Plaza- Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 112536 Type: DBA FRASER CONSTRUCTION CO. Expiration: 3r2312015 7r'' 237059 DEAN FRASER P.'-O. BOX 1845 COTU IT, MA 02635 UpdateAddress and return card_Mark reason for chance. J1147 zonsry, [j Address Renewal 0 Employment Lost Card Otrcc of consumer AtioSrs&Sasinecs Rcsulagon License or registration valid for individul use only OMS IMPROVEMENT .�,r �"•'—7. � CONTRACTOR before the ex iratian data Iffound return to: ` 112536 Type: ice of Consumer Affairs and Business Resulation 323/2015 DBA 10 Park Plaza-Suite 5170 FRASER CONSTRUCTION Co. Boston,NTA 02116 DEAN FRASER• • E04 TWNN LMOU H,MA: ANE 0253 E FALMOUTH,1v1A 02$36 Undersecretary Not valid w' rthout signature Y-7s Fraser Construction, LLC CONSTRUCTION P.O. Box 1845, Cotuit MA. 02635 ' ' '1:1 1,11HF.WN IIIEmail: info(Z�fraserconstructioncapecod.com www.fraserconstructioncapecod.com 508-428-2292 FAX 1-508-428-0123 HICL#112536 CS#97668 RE-ROOFING PROPOSAL ADDENDUM DATE: September 18, 2013 PHONE: 508-367-7893 NAME: C/O Peter Kelly S ( bbO ,/ y@ca e.com EMAIL: kell P P MAIL ADDRESS: f\D d Qk`' ) 0,5 ` I V-D rN'CD JOB ADDRESS: 432 Wianno Ave. Osterville Ma 02655 FRASER CONSTRUCTION hereby proposes to perform the following services in a neat, professional like manner in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. *****RED CEDAR RE-ROOFING**** Supply &Install 18" #1 Perfection Blue Label Quality, 30 year Warranty Red Cedar Shingles At 5.5" TTW. When installed by Fraser Construction, LLC a certified Contractor. Supply & Install Aluminum White/Brown Drip Edge if needed. r Supply & Install Carlisle Residential Water & Ice Protection- Is a self adhering roofing underlayment that is designed to provide premium waterproofing protection for a variety of roofing and waterproofing applications. Waterproof Underlayment Paper Installed- 36" Eves, 18" perimeter, cheeks, skylights, 36" valley Supply & Install REX Synfelt is a high strength woven synthetic roof underlayment- the most slip resistant underlayment in the industry, 20 times stronger that felt- won't tear - off or buckle when wet. Supply & Install Stainless Steel Fasteners- 1 %" Stainless ring shank nails only. Supply & Install Cedar Breather- Cedar Breather protects the beauty and life of wood roofing by providing a space for continuous airflow between the solid roof deck and shingles. Clean & Remove Debris from work area daily. ' TOTAL INVESTMENT: PRICE-$16,500 Initial Additional Work 46 I 1) Supply and install Copper Valley and Copper Cap on upper section. I Price: $1,500 Initial: - Supply and install Copper Cap for remainder of use. Price: $1,100 Initial: 3) Supply and install White Cedar Siding.on Dog Wouses. Price: $1,125 Initial: 4) Install 36 ft. of Boston Corners on Dog Houses. Price: $575 Initial: 5) Install (4) Copper Pipe Flanges. Price: $240 Initial: 6) Repair EPDM Rubber Roofs between Dog Houses. Price: $450 Initial: PAYMENTS ARE DUE IMMEDIATELY AFTE JOB COMPLETION. 1/3 initial payment, remainder to be paid upon completion Payments accepted are: CASH- CHECK- MASTERCARD -VISA-AMERICAN EXPRESS * Any payments not immediately paid upon job completion will be charged 0.005%for every day after the given 5 day grace period upon day of job completion. Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$75.00 per hour, plus 20% mark-up materials. i Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: 6 o e wn r Fraser Construction, LLC 0,2 -tc-� i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 6c?S Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village Owner �� \'��.��'A �r�h Address �\rl � �► • y�GYV��.1 � Telephone 1-0 3 (9i S ( 0 0$ Permit Request b nJdl� t r00 TA -tQ- ' 0 Y1 �10 0�•, are 1 :Square feet: 1 st floor: existing4Mroposed � 2nd floor: existing 0 proposed Total new Zoning District Flood Plain Groundwater Overlay :Project'Valuation o c Construction Type �cD Lot Size kL�- Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure LA( Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl N'Walkout ❑ Other Basement Finished Area (sq.ft.) ® Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new ® Half: existing new Number of Bedrooms: 19 existing 0 new I Total Room Count (not including baths): existing UP new � First Floor Room Count Heat Type and Fuel: N Gas ❑ Oil ❑ Electric ❑ Other Central Air: AYes ❑ No Fireplaces: Existing 3 New O Existing wood/coal stove: ❑YesXNo Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ �1 Attached garageexisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: C� Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes l No If yes, site plan review# i Current Use f+p 07 Proposed Use �1 APPLICANT INFORMATION N (BUILDER OR HOMEOWNER) C Name �E Telephone Number 62)7 ,367 7\ 0 Address f5D Y1UuS ,, foe License # S 5b ©0 00 Home Improvement Contractor# Q Worker's Compensation # (dip* ALL CONSTRU TION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �- �� s FOR OFFICIAL USE ONLY -APPLICATION# bATEISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: ..,FOUNDATION ift,. :UME1 FRAME —. — — — — INSULATION. !+ 1 FIREPLACE ELECTRICAL. ROUGH FINAL 4 PLUMBING: ROUGH FINAL s , � I GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED.OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations UV600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ' Applicant Information Please Print Legibly . Name(Business/Organization/Individual): 1�) TU.6 cekl Address: 5D P—CAI L 11" V City/State/Zip: )�hft4\�) 4 Phone#: I -?e6 9 Are you an employer?Check the appropriate box: Type of project(required): 1.El 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.'XRemodelmg ship and have no employees These sub-contractors have g, ❑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.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do her fy der t e nd penalties ofperjury that the information provided above is true and correct. Si afar . 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#: 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-contractor(s)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 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 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 From: "Morphy,JamesC"cfulorphyJ@sulicrom.com>&V Subject: FW:Scan to PDF for James Morphy Date: June 24,2013 12:02:13 PM EDT To: "Peter Kelly(pkelly@cape.com)"<pkelly@cape.com> 1 Attachment,25 KB Here you go. Thx From:accurtadmin[mailto:accurtadmin@sullciom.com] Sent:Monday,June 24,2013 12:01 PM To:Morphy,James C. Subject:Scan to PDF for James Morphy To: E-Mailed to: MorphyJ@sulicrom.com Saved to: Printed to: Faxed to: This e-mail is sent by a law firm and contains information that may be privileged and confidential.If you are not the intended recipient,please delete the e-mail and notify us immediately. town of Barnstable Ir Regulatory Services "m'r'•�' rm»e F.E;dkr•nlrrm"r •` j Building Division Tam".RvOdfee Come.isdnvv 200 Mein1-4 hf)w.MA 01_601 v/sR.tvwvh+m�mDlemr.m Of1k.50A.-62-038 Yaa:iMI)0-6230 I Property Owner Must Cornplete and Silm-i'his Section If s A Hutlder l...f=t¢Jr.r(�/J-�L%t7CC•� ----•,s rlurer ni the wl,jece p-ntxrn i hcrchy am2R,rizc N-lbe AWe y in am nnrrars rchive m ormt,nlhmiirl hq rhis h,.iMirlq pmm�. (AArlrrsa n!)ph) **Yuul fences and alarms are the msponsitrility of the apptic:uv.Fouls are out to be filled or utilized herorr frn6e is iostallcd and all Gnal inspectiuns are Iterfurmcd and accepted. f .�,x�,..� ., vwxce� ��ua�rcolnpyuaam •�.NR[.O.f.4NJAH�RunV nnpp.��.w11: Peter z c ME Ill mme Ill III MEE EliTijillmmillmillm Ill mom MMmmMMMMMMMMM ME MMMMMMMMMMMLIM MmM ME MM MMmMMMMIlP0MMMmMMMmmMM Ill ME Ill wMMmmMmMMwMmmvMMMMMMM Ill ME ME MMMMMMM ME MOM MMMMMMMMMMM ME ME MEE lMMMMMM Ill F, Ill iiiCi■�iCiii■�■�C i�i � i���a■ i MMMMMMMMMMMM=MMlllilMMlM all 00111 Ill MMMMMMMMMMMMW,AMM ME Ill Ill Nis Ill ME ME MMMmMMMmMMlMMMMMM mmmmmmm MMMMMMmmMMMMMMMlM MEE immm MMM ME mmmmm9mmmmm MMMMMMM ME ME � ME Ill MMMMMM Ill —WE = Emomm Go ME MMMMH MMMMM I Ill i6c MmmMmMMMmMMMMMMMMM MEE Ill MMMMMMMMMMMmMMMMMmM Ill MMMMMMMMMMMmMMMMM IN Ill MMMMMMMMMM I MEE MMMOMM Ill ME I mmm Ill imm �■�iCIll■■�■ iiiiCi C��� �i ENO ■ iMiiiiii � i ■C■ru��Ill ' ■ MMM SEE Ill ME MmMmmMmMMMMMMMMM ����mmmmmmmmmmmmmmm W� • � t � 1 , r • f F f 4, f j f • •1 IL r- AIL W w t � Office•of Consumer Affairiand Business Regulation 10 Park Plaza -:,Suite 5170 i Boston, Massachusetts 02116 Home Improvement Contractor Registratio,n Registration: 103928 Type: Individual Expiration: 7/10/2014 Tr# 226879 PETER E. KELLY Peter Kelly 50 RUSTIC AVE. HYANNIS, MA 02601 . Update Address and return card.Mark reason for change. ;CA 1 Ca 20M-05/11 Address Q Renewal Employment Lost Card ' Office of Consumer Affairs&B s ifies� ula one License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR . before the expiration date. If found return to: egistration: ,403928 Type: Office of Consumer Affairs and Business Regulation 0 xpiration:,.:.7/:1'012Q:14: ; Individual 10 Park Plaza-Suite 5170 os MA 02116 'ETER E. KELLY 'eter Kelly _r_ i1 i0 RUSTIC AVE. 1YANNIS,MA 02601 Undersecretary Not valid without signatUY6 •. rtiti>chusctts- Dc rrr-t Board of Buildin„ I m_nt Olt,Public Safct} ' Construction Su c�rpery sons and Standards 15044 License: CS or License PETER E KELLY 50 RUSTIC I-ANE HYANNISPpRT, MA 02E47 r - onunissi,iner EXPiratio n: 8/15/2013 Tr#: 1601 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION P p ZC5-D01 Map Parcel Application Health Division Date Issued �— Conservation Division Application Fee SS Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board p{� 2)/Ol(t Historic - OKH Preservation /Hyannis Project Street Address 14:31 GJ=Atj` 0 �E Village a5ryy0-aLe_ AA Owner 41RHCS, C.• 1 400,-M Address 1-4ZAA SA f AW Telephone !o� 'y °%�C�� � //� 06Z30 Permit Request ='�� LA-�a"� OF 1x 361 ACC7_4,jds iG4 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation '��� @� Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other _N r N Q Basement Finished Area (sq.ft.) Basement Unfinished Area (rqrn . ) Number of Baths: Full: existing new Half: existing 7 new o0 co Number of Bedrooms: existing _new -� Total Room Count (not including baths): existing new First Floor Ro)m Count_ Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other C m Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No IS'X5r, Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ew size _ BBarn: ❑ existing ❑ new size_ Attached garage: 0 existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION J (BUILDER OR HOMEOWNER) NarYie 5A&4Z2T-'�;E- 1' LS_ .�►� Telephone Number Address 2OZ �4 ;�^p/C=7- 40.0 A-4 License # gtkti=t,4 144 OZ6 �� _ Home Improvement Contractor# P Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C' E" AE�&�Z5 SIGNATURE-' DATE ; �L4 FOR OFFICIAL USE ONLY f•Y a ` APPLICATION# DATE ISSUED , MAP/PARCEL NO. ADDRESS r VILLAGE ' OWNER DATE OF INSPECTION: , FOUNDATION FRAME INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL , GAS: ROUGH FINAL. FINAL BUILDING DATE CLOSED OUT ' ASSOCIATION PLAN NO. r The Commonwealth of Massachusetts k 1 Department of Industrial Accidents '-d M Office of Investigations • +� 600 Washington Street •iii ii i � • ii i� ' Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 1— Address: -!5—n,�tQ City/State/Zip: C fIff t Phone #: � Ar�yon employer?Check the appropriate box: Type of project(required): a employer with 16. 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. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9• ❑ Building addition [No workers' comp. insurance 5. [:1 We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL 1 1.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §](4), and we have no 12.❑ R of repairs insurance required.] t. employees. [No workers' 13.[her �—!MX"G f'w� comp. insurance required.] *Any applicant that checks box N I 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. xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. y Insurance Company Name: ��C IJtVO 4V6/ 1i` Cc) #or Self-ins. Lic. #: TiJG3 Z 7 /S9 / Expiration Date: Job Site Address: 1412 WsA✓NO Ift 65 C,A4 City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA fo ' surance coverage verification. I do hereby certify u t e s an enalties o e 'ury that the information provided above is tr a and correct. St nature: Date: 8 � ✓ Phone#' �0� 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#: f T _.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-contractor(s)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. I The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 0.2111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass,.gov/dia r Sep. 11. 2012 2: 34PM No. 2041 P. 3 Client#:60392 SHORP00 ACORD CERTIFICATE OF LIABILITY INSURANCE rOATE(MwooftYY1) 8/16/2012 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE ODES 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 INSURI R(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the pollcypes)must be endorsed.It SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require ah endorsement.A statement on this certificate does not confer rights to the certlllcate holder In Ilau of such endorsomenl(s). PRODUCER NAME cT Ann Pell Rogers8i Gray Ins.So.Dennis aONE F 877-818-056 434 Route 134 EMAIL South Dennis,MA 028604001 ADDRESS: $Q8 399-7880 N3lIR1:R(8)AFFORDING COVERAGE NAIc If INBURERA:Arbeila Protection Cc 17000 INSURED INsuRER e:Technology Insurance Company Shoreline Pools Inc 202 Queen Anne Road Realty Trust INSUKRC: 202 Queen Anne Road INSURER D: Harwich,MA 02645 INOURERE: INSURER F I 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, EXCLu510NS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NA013L sues TR TYPEOLINSURANCE POLICYNUATBERLIM-00% LIMITS A GENERALLULBIUTY 8500052095 7/26/2012 071261201 EACH OCCURRENCE S1,000,000 X COMMERCIAL QENfRAL LVieluri pREMfSES o T�r,Dy,m S 10o D0o CLAI14.MAOS a OCCUR MEDEXP(My orle peraw) $10 000 PEABONAL 8 ADV INJURY S11,000,000 oe404ALAGOREOATE s2,000A00 GENLAGGREGATELIMITAPPLrESPER PRODUCTS.COMP/OPAGG s2000000 POLICY PR0 JECT LOC S A AUTOMOBILE LIABILITY 52707400004 07JOSM12 02/08/2013 COI0IN1 SINGLE LIMIT 1l 000 000 (GaANY AUTO BODILY INJURY(Perpar=) i ALL AUT008NE0 OCKEDX AUTOS BODILY INJURY(Pet eccident) S Ix HIREDAUTOS X AUT S � PerApa"ll AOE $ IFROPERTY i UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAe HCLAIMS-MADE AGGREGATE S DO L_LRETOMNS S S WORKERS COMPENSAYMN TWC3308450 2/1012012 02/10/201 X WCSTATU. OTH. ANb EMPLOYERS•W►BIUTr ANY PROPRIETORIPARTNERIEKECUTNE IF Y/N E.L.EACH ACCIDENT 1 000 OOO OFFICERIMEMBFJ �fCtIDF�'1 © NIA lMmdAWryMNH) F�OLSWE-FA EMPLOYEE $1,000,000 '(yes,09mme under OE8CRIPYION OF OPERATIONS below EL DISWE-POLICY LIMIT $1 000 000 bE8CRiPT1oN OF OPERATIO1431 LOCATIONS I VEHICLES(AIIsch ACORD 101,Addido031 Remake Saheduls.if mote Since is re(aired) Workers Comp Information Excluded-Kelly Dlttrlc Included Officers or Proprietors-Chris Olttrlc Excluded Officers or Proprietors-Kelly Dittric CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,' NOTICE WILL BE DEL(VERED IN 200 Main St ACCORDANCE WITH THE POLICY PROVISIONS, Hyannis,MA 02601 AUTHORIZEO REPREBWATIVE ®19@ -2010 ACORD CORPORATION.All lights reserved. ACORD 25(2010/05) 1 oil The ACORD name and logo are registered merits of ACORD #S857031M84579 TLH J(!:�7� -Comwwwaleaa Office of Consumer Affairs and Ifusiness Regulation 10 Park Plaza .Suite 5170 Boston, Massachusetts 02116 r� tip. Home Improvement Contractor.Registration --- Registration: 161240 (�+ Type:.. Private Corporation Z� y. Expiration: 10/7/2012 Tr# 204270 SHORELINE POOLS INC CHRISTIAN DITTRICH 5 HALLMARK LANE E. HARWICH, MA 02645 Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card DPS-CAI 0 5OM-04/04-GIO1216 ✓fie earrinzaruu o�✓�aaaac�ivaella License or registration valid for individul use only Office of Consumer Affairs&B siness Regulation y - - HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration:- 161240 Type: Office of Consumer Affairs and.Business Regulation _. Expiration: .10%7'/2012 Private Corporation 10 Park Plaza-Suite 5170 — = Boston,MA 02116 • �ice.._.-_.._ S ELINE P000O C — CHRISTIAN DITTRICH K�. 5 HALLMARK LANE E.HARWICH,MA 02645 :4 `a—z y Undersecretary No I o t signature New Shrubbery Bed New Retaining Wall Against Foundation Faced w/ Fieldstone I Morphy o � mesidence ® House �a - - • o Lawn ustery lie 10 Existing a Terrace ® ®� 3 , %ao+ � Road to io Gregory/ McCarthy Revised Pool Concept Fence to Code 12 . Properties Surrounding Pool; August 1 , 2011 2' Setback from New Pool errece c 38'x 18, ��o E ow vet Hedge Masking Fence New .hack Olive Travertine Terrace � � Property Surrounding Pool Boundary Landscape Design G gory Res dance j Scale Based on July'08 J CapeSury Survey North PLISH PUSH cum DOVYfd 9OLAOM GAZE FPAME ciffle FRAME INSERT + J Poor ----� goer SELF-LATCHINGg",,,;a, ms�de o .� o a �-'' , ALLOWS GATE � TO SWING IWERT BOTH WAYS ��. • _ -----� i ■ u vtiv or - sue_ r�"l r--�� —��. ♦ i i PADLC=F0 � I I w ----- Y EITHER SIDE 4 �"'aid D w°nae and atrech AUTO-LATCH oowr. for ORNAMENTAL FENCE P" . —•.--, PRODUCT FRAME WE POST SIZE AUTO-LATCH . . 191l.CUM . . . . . .1. . . . . . . . 1 Y2 for CHAIN LINK FENCE/GATES No.2020 . . . . . 1' . . . . . . . 2" No.2025 . . . . . 1' . . . . . . . 2$,V PRODUCT FRAME SIZE POST SIZE No.2215 . . . . 111V . . . . . . 1 W No. 1500 . . . . 1w . . . . . . .I%' No.2220 . . . . 1 VV . . . . . . . 2- NO. 1502 . . . . 1W . . . . . . . 2' No.2225 . . . . 1 W . . . . . . 2W hln 1 G9G a_Iuso w.•■ AI^ •=.1C eft• ...■ No. 1527 . . . . 1 W . . . . . . . 3' No.2520 . . 1 Ifs' . . . . . . . 2' No. 1562 . . . . 1 W . . . . . . . 2' . (40.2526 . . . . 1 W . .. . . . . 2,A• No. 11%5 I W 2 . . . . . . . . . 'h' No. l6 No.2529 Adapter Kit lus fad No. 1572 . . . 29 . . . . . . 2. 2� AUTO-LATCH 'w°° No. 1575 . . . . . 2' . . . . . . . , . AWndwWftAcm No. 1577 . . . . . 2' . . . . . . . 3" INDUSTRIES Joe PROJECT GATE of I o S ' FE if rml P o � • A sA y ;. z IPA a S p zz �y ImA se VIC a :a . �• kL 8 a c TZ � s1 2 _ $ <Q a s j a$ tlot $ s � b ses It` sus -smalls, Town_ of_Bar-nstable=I Regulatory Services y SEMO ti I'E Thomas F.Geiler,Director •_Building Division -':% ram. Tom Perry,Building Commissioner`' �200 Main Street,Hyannis,MA 02601., , _wwivaown.barnstable.ma.us�' Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder p9_r_:S Cam-L� /`1"1441 y as Owner of the subject property hereby authorize S 4N,62-r-J CF7 YIIQI_S =IJ C to act on my behalf, in all matters relative to work authorized by this building permit: 432 01-4-�-O 4V,6- /41 (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. a wrier Signature of i t O C ,/�/LGsc IU.4 Print Name Print Name Date Q:FORM&OWNERPERMISSIONPOOLS 6/2012 SHEr, Town of Barnstable Regulatory Services swtwsrnat E Thomas F.Geiler,Director. MAS19 A•�� Building Division . fFD MA't i Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.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 sik 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 permit (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 inimum 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 homeowners 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 foma/certification for use in your community. Q:forms:homeexempt i CR �p by ,� r} ; ��" r y '��" r +•��� a L.1,,Y ..� il f 4" '7 � `� �j�.'t'y��f,:.rT .-awn!• v,• .��{`R",�r► ^�•C...' 1ff-� �`�.+wl IAJ- I 1 r [:.k, si Rho ?' n� ' •_ f n�. ' - 1 w " � ''�•C� w .� �. .__ �_ `i s:W a•�� ,�irrrypc-,+�w7F� r .- T. �(• ..�.�• " � ' .r � � x�ia?�`��6° lIr'. ••.Vv�il!+ ,tC'IIR�` j.Lf" ; 1 .ism � .i-' f' t• �., �- � ;�,•,_, �- - Is j —I Q - y�a.�'•-'�._--�� �st� , L-, o �1 •► + -3Ur- d! CC �- •; �l ncasara�I 3itean/ ]C . �t � — 1i[3t:J� .10t t]antlo �IaFp3�k-t r^' iA �Es �.����1 � +� �, t��1t .�t• � Y. � -r�r;� J1, �m ' � 1"1 ' i on MY, �` � '� v :`Q 4 � iJ• � ��,, ... � 1� �`M �. f` U{ ,f�� r �^, .. y a fj t., ► . \ a•.je ri i�+�1 i_�y/ �y� r `n �; .� y R 17G®� L7 •�i .' >il ~ t�R ►4.rj S,r I• 1•c4 + ► .r�J�'C�. ,� r IIL�Q �I CM.ri� i; ���• - Ja,; ''�s� .r . - - ��,,.5 •�,S%Ii��� � —� � — .��J yl���J LI '.��`�•�;._•i1� Q i,�t � ' a l SiT1�Li y� •� �� —'�� �:.i'.�. .r .—f � !' ti �ix'1,'"J '•+/•r;, `J.Lr , {4�y1.3 ;. i'�+' Y•; 1.Y n•Y' •i-•r r_`t. . • � :tis 7f . r.t •..... . r , y• �',�+�. L f,r to �'� M�r-•�.`• 1Fr•,j:�iS �." ry .`.SAS 'ti r�s� �t�"t•�t'�t=� •��-•"_� I `•�.��. •fir '� ,! fit�� '*�.•'tt i.�: � _:$� r:.�.;, '�., � - -z,'.,,,r+...�o -S' � .)� -;. .Y.• " _ (,r �. /�' ��r '.•' y . 1l '� • ,1 - � tie J y• ,.. � - oa . � 'at `� •� ^,t•t iY.y?f!'{�'it .,..•� ��'*�. _,. 1 `i ��• � -i *..f" � '. •• i( ► .�, +`{•• _ 1 � • ORNAMENTAL IiZ N FENCE tNCE �' �� www.MontageFence.com B � To The American Consumer: "Ornamental Fence is the fastest growing fence product in-America over the last decade. No other fence product offers the value, strength, security and maintenance-free ownership of an ornamental fence; if you get what you pay for. As the market grows, so does the number of manufacturers and choices. Ev- eryone wants to get their 'slice of the pie'. While there are some very high quality fence products avail- able, there are even more that are equally as poor. The latest entries into the market are lightweight, low quality products being imported from several foreign countries, mainly China. Many consumers are falling prey to the lure of extremely low prices, only to discover that the product does not match the investment made. The fragile structure, lightweight construction, poor coating and the need for periodic maintenance far overshadow the cheap price paid. This brochure provides the facts, so you can choose wisely." Po A Product You Can Trust from A Company You Can Be Proud Of At Ameristar, our demonstrated commitment to product quality is first and foremost in everything we do. Montage is the culmination of over 25 years of demonstrated manufacturing excellence of innovation. No other product on the market today offers the value, features and performance of Montage. V,C� Leading The Way In Environmental Responsibility Ameristar Fence Products has long been a leading manufacturer in the area of environmental responsibility. We are leading the industry in programs and practices in all areas of manufacturing that reduce our carbon footprint and demonstrate our commitment to environmental stewardship. • Montage is produced from 100% domestic steel • Montage is produced from steel containing up to 97% recycled content • Montage packaging material contains a minimum of 66% recycled content • Montage coating process greatly reduces and in some cases, eliminates emissions of harmful gases into the atmosphere • Ameristar constantly monitors air emissions, storm water runoff and waste water discharge • Recycle programs for ail scrap steel, scrap aluminum, wood, cardboard, plastic scrap, paper and oil products • Developed programs for reduction of energy consumption Ameristar has invested tens of millions of dollars in the areas of technological improvements to allow us to reduce our energy consumption and our carbon footprint. Ameristar will continue to make these investments well into the future. h 'r Page 2 I MONTAGEO The Largest Selection of Features for the Widest Variety of Applications For Any Enclosure Although most manufacturers still offer fences with almost a 4"space f ( ti between pickets as their standard,these designs may put the safety of children or the containment of pets at risk,particularly with aluminum or vinyl (pvc) pickets that can flex 2-1/2 times more than steel. The condensed 3" picket-to-picket spacing of the Montage@ Pool, Pet& Play@ design exceeds most pool and playground safety codes,keeping _ pets and children contained without an undue increase over the cost i of typical fences that try to economize with the wider spacing. _: 'era° • For Any Climate Ameristar's maintenance-free "E-Coat" finishing process delivers the surface protection necessary for Montage®endurance in any climate, x1 hot or cold,wet or dry. Ameristar® employs the same cyclic testing �, ~ technology used in the automotive industry to ensure that Montage® fences will not only endure harsh environments, but will withstand the repeated shifts in weather and temperature and the seasonal changes that amplify the extremes of the meteorological spectrum.The galvanized and e-coated fence system is backed by a 20 Year manufacturer's warranty. r - IT GOp • 30„N For Any Terrain As land availability has become more and more scarce,architectural design and construction technology have progressed to enable new facility construction on rough and uneven terrain that was previ- ously considered unfeasible for permanent structures. Montage® ATP(All Terrain Fence)maintains its rigid strength,while adapting to slopes as severe as a 30 inch rise in an 8 foot run. y' For Any Project Montage®is crafted with an inherent beauty that adds a decorative touch to any residential landscape, whether an individual home, a gated community, or a series of multi-family dwellings. The rigid welded steel construction,enhanced with the Montage Plus®3/4" picket,makes the fence system structurally suitable for commercial applications such as retail businesses, storage facilities, schools, _ health care facilities and golf courses and recreational parks. Proudly Made in the U.S.A. From Recycled American Steel Page 3 Technologically r AmeriCoafm Total Submersion Coating Process Montage® ornamental panels and posts are actually coated ®a0utetdo inside and outside. Major corrosion problems start from the in- side. Acrylic Topcoat . Galvanized steel framework is subjected to a multi-stage pre- Epoxy prhm treatment/wash (with zinc phosphate), followed by a duplex �� ZIM phoophatp cathodic electrocoat system consisting of an epoxy primer, OctvantcZinc which significantly increases corrosion protection, and an acrylic topcoat, which provides the protection necessary to ��"� ''� withstand adverse weathering effects. • THIS ' Maintenance-free Surface Backed by i r 20 Year Warranty. AI — a NOT THIS Painted Steel- Destroyed After 2 Years ' ProFusion - Automatic Panel Welding Process Montage® fence panels are fabricated using Ameristar's revolutional _ ProFusion process that combines fusion and laser technology to auto- / C matically weld strong, virtually invisible, structural connections without 1 unsightly or insecure fasteners. Lawn equipment, falling limbs, meter -•. readers, rough-housing teenagers-all these can damage or demolish -- a light-weight aluminum fence. Only welded steel construction stands ' al. an chance of surviving such abuse. Y 9 _ THIS Welded Steel Rigidly Withstands ' Severe Impact NOT THIS Light.U-Channel i Aluminum Ruined by Minimal Impact Proudly Made in the U.S.A. From Recycled American Steel Page 4 Structurally Superior Montage TM Ornamental Welded Steel Aluminum Strength of Posts Attractive BoulevardTm brackets mate to all post edges, Punched posts,already weakened by losing a fourth of the passing the load to adjacent panels. Fence panels and circumference,cause a severe concentration of load at the posts act as single line, flexing only slightly under load. post-to-rail junction. The panel,held only by a small screw, 1 bows away from the post, threatening to break free. 's •I - Concentrated Load Severe Bow;Possible Separation t Distributed Load Slight Flex In Fence line F THIS NOT THIS + r5 I Rails Held Weakened Post Firmly- Breaks Under +u► ) Cannot Concentrated O Pull Out Stress s iY Steel post, 2-1/2 times stronger than aluminum, remains The holes in punched posts allow water to enter. When this sealed from the elements, uncompromised in structure. expands during a freeze,the post could burst apart. Strength of Picket Connections 44 (:THIS NOT THIS Invisible Unsightly ° Rigid Loose ° Secure - -- _ Insecure Weld p' Screw ° -Test It Yourself Find Installed Examples SHAKE Each Fence Fee! The Difference! The rigid ProFusion welded panel has permanent connec- The fragile screw connection can be removed in seconds tions, making it invulnerable to disassembly attempts.. by a child or vibrate loose from turbulent winds. Proudly Marie in the U.S.A. From Recycled American Steel Page 5 Intelligently Engineered Alternatives 000 I ' Montage ATFTM (All Terrain Fence) ATFTM (All Terrain Fence)panel designIenables the maximum bias for all Montage TM styles. It is the only welded steel fence with the capability to follow severe grade changes and follow uneven ground contours like a second skin. THIS Capable of A— f JL 30" Rise In 8' Run ISO NOT THIS Unsightly Stair-Step V Installation Leaves Gaps Standard MontageTM or Deluxe Montage PIuSTM In addition to the stout Montage TM fence system suitable for most applications, Ameristar® offers the deluxe Montage PIusTM for applications requiring extra strength or a more substantial look. Montage® Montage Plus® j Material Steel Steel Picket 5/8" Square 3/4" Square • ICI! Rail 0.790"x 0.075"Top 1.4375"x 0.072"Top r 1.235" x 0.075" Sides 1.500" x 0.072" Sides Post 2" Square 2-1/2" Square Construction Welded Welded [Flusli..Bottom Rail+ Pool, Pet & Play® 3" Spacing For some applica- In many cases tions like pools, a related to pools, flush bottom rail pets, or children, ',! may be necessary r ' � a narrower space. may be required to meet local build- for safety or con- ing codes or simply tainment. The to meet an aesthet- - Pool, Pet & Play° A is preference. design offers the " "optional 3" space. Proudly Marie in the U.S.A. From Recycled American Steel Page 6 II Distinctively Styled �, jit :'II'IIIII Itlrlll iLir r ri cEHZF.rr;k G�•I�CyI�, t['Ci }�; .• • •- •• -• • - Ili��ll����,��'�1,:�1 ` � �r'' rr�' , uy- E�zaLl ���tiblt°�e�.��:w �i I • • • •• • • I�� i��r �is jn � r ••• •- • • to { '1'tr si . ro. 1�, h • -•-• • •••• IYex^>r, , Itr tat jh„n a r I■�t�'r � F'' . ilia �! �-• !mummm � 3 • III lop an i��l�}}���sp �Sc�l���l��-tt�er.- .. - - .• • v„! f rr y�' �r� 'wi 1, J`'=r 'st sl�� °�'Yt1E 1'tkf•. ko, •• • g4 t3 _ —�:� ..I�'+:4�? fi{ ,>. «rig • • _ - r„���•,.ty�N Ye i.•1 .71�' �A�arif� ��rr yp.�R Y� ' -r t � � r ��`l;s�,;.i� �1��,,,,,,,�JDii�i'rrar{, �1 f ter.` ti,,,,, • ••- `- `- - � �' 'rF".Yi�.��''..s'�"cN�,� re'q--�.s�•�7�.. ,, 9�'�i'jk,, t� -J%��- �" �'u II • •- • - y�''•4t .a�;�t,�a' �;�;•i.N� �.. �i:v� MIR 4-1---w -7-1 gggg=�: cam-- BO41 c•sBBEEllYtlCL`�L@ IIJ : sue" QE �• ������'I: `�� P��j"•� _ s.<�r,' �3- - • •• ••• - • I I 0 � r [MONTAGE .50 ] t by AMERISTAR' • •. .• •. .•- . • - • � '�'•� tit IL_ 63 2 C@:Cowi CIO,C*i%Cei Cd.11911 Al O.®a A s; NX '; � .. 1- [ fFiS� Y • SEEGERS.ON � i 111.:C �ji j 111 i':L1 ` LLi:L� M1�t:1 i�I kirr i 1-�'i�r�i►�fivlr ' 1x "'�1�I.p6ll.I.:i.l FFFF 1.r �� �y ��?yV � Rd i iti I 1 a 1 � ; 1 a • � if „1 c� i F "A�� _. •. �� ! � S I nul��l'.IIII�n111 1�����Illliiiiiai .��_D F �66 � ate � , � el�� �-� fc �ii"i11111111 11111111111►1s�31aS, t '�i�'/,/� ` �Illiitlllll►ile����1��+;� � ' �i� `'. "' , SEARS S A I O R N /-\ IVI E N T A L �; ��' of ���°��`��� '� � f [Z O N FENCE �+a 1555 N. Mingo Road AGAG7 www.MontageFence.com Tulsa, OK 74116 1-888-333-3422 Printed in U S A Rev. 03"09 HAVWAR[Y .�� PUMP' ��SUPER HIGH PERFORMANCE PUMP SERIES source.One pool. 77 f r Sc' - i f y : High performance, quiet operation . Pumps Filters The Hayward® Super Pump series of large- capacity, high-technology pumps blends cost-efficient design with durable corrosion- Heaters proof construction. Designed for in•ground pools and spas of Heat Pumps all types and sizes, Super Pump features a large see-through strainer cover, super-size Cleaners debris basket and exclusive service=ease design for extra convenience. Like all Hayward products, Super Pump Lighting F' ,5 combines advanced technologies with high performance for quiet, efficient and (Controls dependable operation. ' ElectronicChlorine Generators ` Total System, ` r Exclusive,Swing- See-Through All Components Heavy-Duty, High- Away Hand Knobs Strainer Cover Molded of Corrosion- Performance Motor make strainer cover removal lets you see when basket Proof Thermoplastic with air-flow ventilation for easy. No tools required... needs cleaning and eliminates for extra durability quieter,cooler operation. no loose parts... no clamps. guesswork.Special self-adjusting and long life. seal ensures dependable sealing. I Heat-Resistant,Industrial- Mounting Base provides Size Ceramic Seal stable,stress-free support, plus is long-wearing and versatility for any installation _ drip proof. For fresh or requirement.Adapts 48- �_j saltwater use. and 56-frame motors. Super-Size Housing and diffuser ensure rapid priming. l=.. t f Corrosion-Proof = Service-Ease Design Impeller �'-' ' gives simple access to all has smooth,wide openings internal parts.Motor and entire to prevent fouling or clogging. '� drive group assembly can be Energy-efficient design removed,without disturbing produces more flow at pipe or mounting connections, equivalent horsepower. by disengaging just four bolts. r r r rr Maw Rpm nmmv Standard Efficiency Max-Rated Single Speed SP2600X5 0.60 1/2 0.37 1.20 11n 131/4 337 / SP2605X7 0.75 3/4 0.56 1.00 11/2 13778 352 Ta/Y I.5/8' SP2607X10 1.10 1 0.75 1.10 11n 141/4 362 , SP261OX15 1.50 11n 1.12 1.00 11/2 153ie 391 ti ILL] m �(2"mm SP2615X20 2.00 2 1.50 1.00 2 157/8 403 \\ ®' dw.m S132621X25 2.50 21n 1.88 1.00 2 16378 416 __ cr/e ts/a� Standard Efficiency Max-Rated Dual Speed - - &5/a -- R79 mN --- - -- - -- SP2607X102S 1.00 1 .75 1.00 2 13 330 1 SP261OX152S 1.50 11n 1.12 1.00 2 133/4 349 SP2615X202S 2.00 2 1.50 1.00 2 141/4 362 SUPER PUMP Super-Size 110-Cubic-Inch 100.00 FLOW VS.TOTAL HEAD Basket has extra leaf-holding capacity and extends time between so.00 cleanings. Rigid construction with load- 80.00 extender ribbing ensures free-flowing 70.00 operation for heavy debris loads. 0 60.00 - Super Pump Series Pumps are listed by: 50.00 x s 40.00 ~ I CIP ® '°.°° - - 20.00 SP261SX202S w Speed) ! s Ox5 \�_ _SP261(xis SP2621 SP261SX20 10.00 sPZ607X1o25.0.ow-s _ 0.00 SP261OXISIS wS PY60 V SP2607X10 00 200 400 &0 MID )000 M0 1400 ROW(GPM) www.haywardnet.com HAN" MAR®®Pool Products • Hayward and Super Pump are registered trademarks of Hayward Industries.Inc. 0 M Hayward tMustries,Inc. _ 1-888-HAYWARD One source. Every pool. LITSUPER07 III e D ••• .. P r� o F n Pumps High performance. Filters Operationalconvenience. Hayward SwimClear reaches new horizons in Heaters cartridge filter technology. A cluster of four reusable polyester cartridge elements provides a choice of Safety 225, 325, 425 and now 525 ft' of heavy-duty, dirt-holding capacity and extra-long filter cycles. SwimClear filter tanks are made from a Cleaners reinforced co-polymer material for the ultimate in strength, durability and long life — even for Lighting the toughest applications and environmental conditions. Discover crystal clear results and reliable maintenance of SwimClear by Hayward Controls —the first choice of pool professionals. Electronic Chlorine Generators Total System Combination Pressure and Cleaning-Cycle-Indicator Gauge gives visual indication when cartridge filter elements need cleaning. Manual Air Relief is a high capacity, rapid release manual air relief r valve that bleeds air with a quick quarter turn of the lever. Noncorrosive Top Closure Plate prevents elements from lifting and �< unfiltered water from backing to pool or spa during operation. Quad-Cluster"" Cartridge Elements provide 225 325 425 or 525 ft' 9 p of filter area and extra dirt-holding capacity for long filter cycles. Precision- engineered core provides extra strength and superior flow. I 1 Heavy-Duty,Tamper-Proof One-Piece Clamp securely fastens tank i top and bottom together and allows quick access to all internal components - without disturbing piping or connections. Self-Aligned Tank Top and Bottom make access to servicing Qua&Clustef 11 , cartridge elements quick and easy. P I High-Strength Filter Tank is made from extra durable, glass reinforced II co-polymer to meet the demands of the toughest applications and environmental conditions, includingin-floor cleaning systems. 9 Y Uniform Low-Profile Tank Base Design makes removal of cartridge elements fast and simple. Full-Size 11/2" Integral Drain provides fast clean-out and flushing. Noryl® Bulkhead Fittings for extra strength and heat resistance. PVC Union Coupling Connection provides plumbing options of 1 Y2" or 2" piping with 2" full flow internal piping for maximum performance. SPECIFICATIONS—SWIMCLEAR QUAD-CLUSTER CARTRIDGE FILTERS FILTERTYPE Quad-Cluster cartridge elements: I 225,325,425 and 525 ft?total(20.9,30.2,39.5 and 48.0 m2) FILTERTANK Injection-molded glass reinforced co-polymer FILTER ELEMENTS Reinforced Polyester PERFORMANCE RANGE 1/2 to 3 HP(30 to 150 GPM).37 to 2.24 kW(114 to 568 LPM) C2025—23"W x 32 1/2"H(58 cm x 81 cm) DIMENSIONS C3025—23"W x 341/2"H(58 cm x 87 cm) C4025—23"W x 401/2"H(58 cm x 102 cm) C5025—23"W x 461/2"H(58 cm x 117 cm) PVC Union Connections PERFORMANCE DATA 30 MODEL EFFECTIVE DESIGN TURNOVER �.0 40 FILTRATION AREA FLOW RATE' GALLONS KILOLITERS NUMBER m 1 %P MP a 01� 0la s ma aba 10 50 C2025 225 20.9 84* 318 40,320 50,400 153 191 l} 60 C3025 325 30.2 122* 462 58,560 73,200 222 277 PsiHAY W® C4025 425 39.5 150** 568 72,000 90,000 273 341 C5025 525 48.8 150** 568 72,000 90,000 273 341 Pressure and Cleaning Gauge .Based on NSF recommended rate for commercial use of.375 GPM/ft.z «"Determined by pump size and piping system hydraulics;2'piping is recommended for flow rates equal to or greater than 90 GPM(341 LPM).Hayward doesn't recommend flow rates above 150 GPM. �Hayward,One Source.Every Pool.,and NoM are registered trademarks and www.haywardnet.com HS f HAYWARD Pool Products Ouad-Custer,and Swimgear are trademarks of Hayward Industries,Inc. ° 02009 Hayward Industries,Inc. 1-888-HAYWARD One source. Every pool. tMM9 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map J Parcel �` Application # Health Division Date Issued 0 Conservation Division Application Fee Planning Dept. Permit Fee O(-D Date Definitive Plan Approved by Planning Board (:E) I z)ab Historic - OKH Preservation / Hyannis Project Street Address 2-- i.' n n Q - s Village Ale Owner Y� S �1 y`Wh �\C�rrJl� Address `� -25Z \ftR b TV C Telephone :7�� o�� 00-1 1 Permit Request 0 �J t �.p��. u VY1r\ - Square feet: 1 st floor: existing�roposed 2nd floor: existing proposed Total new /_ Zoning District C.1 Flood Plain Groundwater Overlay Project Valuatif J v 0 ®® ® Construction Type 0�D Lot Size I -!I� Grandfathered: YYes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Ild Two Family ❑ Multi-Family (# units) Age of Existing Structure 1,5 L Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: PdFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 3 Jag-1 Number of Baths: Full: existing new Half: existing new Number of Bedrooms: % existing 0 new Total Room Count (not including baths): existing new-First Floor Room Count Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other Central Air: 9Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage. existing Elnew size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # LA A Recorded ❑ P `r' a Commercial ❑Yes No If yes, site plan review# nn f � •w- Current Use \ &2 vo cz i,�' A Proposed Use 4 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) . Name �� Telephone Number 5 Address � License # c AT)\ �d Home Improvement Contractor# Worker's Compensation # I ALL CONST 10 DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �^ r SIGNATUR DATE 1 :2-5 I\l, h _ `Z a 6 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. I ADDRESS VILLAGE OWNER _ < e DATE OF INSPECTION: FOUNDATION _ f�SE J { FRAME .kXTC"3 0�9 ( _ INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL � PLUMBING: ROUGH FINAL- . .. ., GAS: ROUGH I FINAL IC FINAL BUILDING Sc L DATE CLOSED OUT f ASSOCIATION PLAN NO. 3 i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ` 600 Washington Street Boston, MA 02111 www.mass gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/orpniza on/Individua.D: � �,Ekk Address: _A-f7VL>, City/State/Zip: 1 ►� �' �� Phone Are you an employer? Check the appropriate box: Type of project(required): . 1.❑ lam a employer with 4• ❑ I an a general contractor and I employees(fall and/or part-time).* have hired the sub-contractors 6 ❑New construction 2. I am a sole proprietor or partner- listed on the attached sheet 7. [�Remodeling ship and have no employees These sub-contractors have g Demolition working for me in any capacity, employees and have workers' t [No workers'comp. irnarrrance comp.inmranCe.t 1 9. Building addition required] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑-I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself- [No workers' comp. right of exemption per MGL 12 Roof insurance required]t c. 152, §1(4),and we have no repairs employees. [No workers' 13.❑Other COMP.Insurance required.] *Any applicant that checks box#1 must also M out the section below showing their workmrs'compensation policy information. t Homeowners who submit this affidavit indicating they art doing an work and then hire outside contractors mast submit a new affidavit indicating such. �Contractors that check this box mast attached an additi cmploonal sheet showing the name of the sub-contractors and state whether or not those entities have cmplvyea If�e sob-contractors have er�rloyees they must provide their workers'camp.policy oli mmzber. I am an employer that is praviding workers'compensation insurance for my employees Below is the po&cy and job site information. Insurance Company Name: Policy#or Self-ins.Lin# Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Faihu-e 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 fowl 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 Investi the DIA for insunance coverage verification. I do her certi u th d penalties of perjury that the information provided aboveis it and 1 correct Si fzse: ` Date: �' ` Z J �1 1 . Phone# SV 0 3(� Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health Z.Bnilding Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone ff: Town of Barnstable „ Regulatory Services • �111Wh-i1�t1t, • NAM f Thomas F.Geiler,Dbwtor Building Division Tom Perry,Building Commissioner 200 Nfim S` eti Hyannis,NIA 0260 i www_town.barnstable-ma.us C)':*--9ce: 508-863-4018 Fax: :08-%90-6 20 Property Owner Must Complete and Sign This Section If Using A Builder 1; �( � �— — -- ,as Owner of=-L: suo"ec-t L ropeny hereby author_z--_A*W Alwy — —— — — _to act or my behaL in all,mane:s re?anvc to work authr)r ed by this b1ii4lice permit AI-6 y U�A-,vvo A./- - — — — (address of Job)._r.._� — .—— **Pool fences and alarms are the responsibility- of the applicant. Pools arc not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. $ignatutc of Uccner Sig natare of AppL+cant s-e 1[C A 12, 1' t Lane P::at game. Uatr—. — — --- Nlassachusctts - Department of Public Safct�' Board of Buildiii Rc!-ulations and Standards Construction Supervisor License License: CS 15044 PETER E KELLY 50 RUSTIC LANE HYANNISPORT, MA 02647 ... Expiration: 8/15/2613 ('uuunissiuncr Tr#: 1601 ✓die Uanvnzoniueal /�a udea Office of Consumer Affairs&Business Regulation License or registration valid for individul use only -_== HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: — : Registration: ,;>1.03928 Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Expiration: r7/;1:OL2012 Individual on, A 02116 P R'E.KELLY Peter Kelly 50 RUSTIC AVE." HYANNIS, MA 02601( ;`r :�✓:> Undersecretary Not valid without signature i Round PERMACase Columns ` Tuscan Cap l � ROUND PERMACAs-e COLUMN DIlmNNSIONS (IN INCIIES) i r =, I '►� COL. B l. LENGTH —o(tisnape0 s sizE A B C D E F G J K L O N I R I T A11A1L(e) —o 6" Sri" 4ri" 9" 1�f6" 1'/16" '%6" W 1'/," Ph" 8" t" 6%" 3rfb" 4'%6" 4,6,s 1 "` 8" 7s/" 6%" 10%" W 1'/" %" '/" 1%" 1%" 91/." %" 2%" 4%" 4%" 5,6,8,9.10 W ' a 10" 9%" 8%" 13%" 26" Z'A" %" %" 1%" 1%" 11%" %" 2'/." 51/+" 5" 6,8.9,10,12 ~ ,�l Is^ 1 , ; s^ IJ ^ .s^ 1 s^ %" 2h" 6%" 5%" 68,9,10,12,14 12" 11A 9'A" 16/" 2A" 2A" A /6 1/ 2A" 13/. 16,18 11} 14" 13%" 11'A" 19h" 3'/e" 3%" W '/e" 2" 2%" 17" W 2%" 7s/e" 7" 6918,12 14 16" 15'A" 13'11" 22%" 4" 31" 1%" 1" 2%" 3" 19'/" 1" 3" As" 8" 8'8101214,16 —s,n 1 ,2, — 18" INS" 15%" 24'A" 4" 4" I%" 1%" 2'/." W22'A" 1W 10'/4" 9%" 8% 20" 10,a14,1618 ,22,24,26 20" 19%"17%6" 27" 4'A" 4%" 2" 1%6" 2'/s" W24'%s W1 0'/" I I W 9" 20,E,24'1618 S 1 I n 3 7^ 7 3 1 ^ 1 1 I n 16,18,20,22, 22" 21%" 19/," 30A 5A" 4/, 2" lb" 3" 3A" 27h 1%" 10'/" IN" 10/ 2426 11j12,14,16.18,20, 4 24" 23h" 1121%" 33W 5%" 5%" 2%6" 2'/6" 3%" 4%6" 30%" I%" t0'/" 13%6"I1%6" 22,24,26a8,30 1 28" 28" 24%" 38" 6%" 6" 2'/+" 2%" 3%" 4'/+" 33%" 1%" 10'/" 15%" I1%" 204,24,26,28 Z f { 30" 29'A"26%" 41%" 6%" 5s" 2'/=" 3%6" 4" 4%" 38%" 1%" 10'/" 14%" 14%" 20=4a6.28 30 'There may be a variance of up to 1/4"in all dimensions.Fluted columns available in -*--A--* N all diameters.See page 14 for Parallel dimensions.See page 16 for Ornamental Capital —F(Ck=n) dimensions. Eu—) n DVROO � —e_, Tuscan Base 1 i 1 - I R°UN & 1'MMAC ST" ROUND PERMACASI0 INSIDE DIMENSIONS " LOAD BEARING SPECIFICATIONS ( Split columns are not load bearing Inside diameter may vary up to 1/8". Splitting a column will decrease inside dimension 1/8". i COLUMN STRUCTURAL DIAMETER LOAD COLUMN SIZE TOP I.D. BOT I.D. 6" 8,0001bs.Max 6" W 4%6" 8" 10,0001bs.Max 8" 5h" 6b" 10" 14,000 lbs.Max 10" W 87/," 12" 18,000 lbs.Max 12" 8%" 10'b" 14" 10'A" 12b" 14" 20,000 lbs.Max � l2'/6" 15" Inside 16" 20,000 lbs.Max `` 18" 14%" 16'A" 18" 20,0001bs.Max I 20" 16%" 19" I 20" 20,000 lbs.Max 22" 18%" 20'/6" 22" 20,000 lbs.Max 24" 20%" 22%' 28" 20,000 lbs.Max 28" 22" 26%" 30" 20,000 lbs.Max 30" 25%" 28%" i «� t SPLIT COLUMN ASSEMBLY KITS ` HB&G now offers a split column assembly kit that utilizes a mechanical fastening system for easy and secure assembly. This kit can be purchased separately when ordering a factory split column or they can be ordered pre-installed on factory split columns. This new kit is available on select sizes. 1 i■iMiM ■■■■■■■■ ■ M ■,7 ONE No ■ ■M■MEM■ ■■■. ■n . ■■■ MENEI ■■ IMENEE■■■ ► . _ ■L�i 1 ■■■ ■■■■ ■■ I■i ■■■■ E ■�1■ ■■■ ■E■ ■■■1O ,■■■■■ ■ 4_■ ■liM� ■ME ■■■■ �, ■■■I■ AMEMEMA GEM ■I�El"M■■■ ■■■ ■■ ■■■i■�1■E■■■■if G�■E■©■ ■■■MEM ■ UNMEMEM MEN W.WMEMEN N■■ ■ ■■ l NEMESES wmM ■o ■■■■ MEN■EN ■■■l■/ ■■■■■�;� NI■S■■■�'J■■■■■ ■EN■M■ _ ■■■I ■EM■■■ anomm■■t�■■■■■ MEMO■ ■■ I■ EEO■Mil �"EM■MEE■■M■■ SOMME SEMEN■ EEmi ■ENNEN ■MMEMEMMM■■ EMEND i _ ■l lMMMMMML%i ■■MEM■MEME No no ol NOOSE■ ■18 ■M■E■MMEV■MMM■MM■MM■ MENEMM - ■ElF� MMMM■■MMMMMMMM■MMMM■ ■■■E■■ ■M■IMEMEME■■MM MMMEM■EMME ■■■■M■ ■■■lL_rliiiMMSMMMM iMM■M■■■■■ �; ■ .M■ �1M■■lS►rSS■■■■■■■■ENS■■■■■■■ MORMON MENNEN ME l " EN�■■■■■■i■■■■■■■a!■■■■■■■ ■ 1,00EEO il- ME EEE ■MEMMEREM■ME dsom ■E■NE■ MENNEN NO SMM■M■M■id■MNMM■ MSE■■■■■ ENE ■Nn.' ■�EMMiE■SMi■M■ESE■!ESN■■■■■■■ ME"., MEMEEEEME _ Sv�EEvIE■■■■■■■■ � \ 'r \. � �\ � !�. I ii� � 1 ., ' fl 1 s_ r,, � 1 M t J11 .� I• � � f Y. 1 .� i 1 �� /+� i A �..� /�- t«f i • f •.�. � I I ti, , '.!! 1 - ice_. �, . �Z , �. } i �- c � c 6tf0 5!S-4� FV*>� Town of Barnstable *Permit# �O F.spires 6 mandhsfrom issue date ' Regulatory Services FeeMASS sz 9 , Thomas F. Geiler,Director S Building.Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY // Not Valid without Red X-Press Imprint Map/parcel Number W D® 2-•:b0 1 Property Address y--5 2. LL) i ^c-,n .o Residential Value of Work pot) Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address C) Contractor's Name E\1� L Telephone Number j(� 7 ?`6 9 3 Home Improvement Contractor License#(if applicable)--A 0 Construction Supervisor's License#(if applicable) t t570 Lj L ❑Workman's Compensation Insurance Check one: I am a sole proprietor ❑ I am the Homeowner ,.7 'SS PERMIT ❑ I have Workers Compensation Insurance Insurance Company Name l } O C T Workman's Comp. Policy# i.1' TOWN OF BARNSTABLE Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Q #of doors 0 " .Replacement Windows/doors/sliders. U-Value tZZ? (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note Property O must sign Property Owner Letter of Permission. A copy ome Improvement Contractors License& Construction Supervisors License is qu SIGNATURE: �1 Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 070110 I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations k9i 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl Name (Business/Organization/Individual): Address: 5V �� �� A 6a.loo I City/State/Zip: Phone #: Are you an employer? Check the appropriate box: Type of project(required): 1.El am a employer with 4. � I am a general.contractor and I % employees (full and/or part-time).* have hired the sub-contractors 6 ❑New construction 2 I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' [No workers' comp,insurance comp.insurance.$ 9. ❑Building addition required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp.insurance required.) *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1 500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$2 0.0 day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigatio s of th DIA for insurance coverage verification. I do hereby=ernd penalties of perjury that the information provided above is true and correct Si pure: 1 Date: Phone#: Of 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#: From: "Morphy,James C."<MorphyJ@sullcrom.corro Subject: FW:Scan to PDF for James Morphy Date: September 27,2011 10:57:01 AM EDT To: PETER KELLY<pkelly§cape.corru ► 1 Attachment,27.1 KB Here you go. From: accurtadmin [mailto:accurtadmin@sullcrom.com] Sent:Tuesday,September 27, 2011 10:56 AM To: Morphy,James C. Subject: Scan to PDF for James Morphy To: E-Mailed to: MorphyJ@sullcrom.com Saved to: i Printed to: Faxed to: This e-mail is sent by a law firm and contains information that may be privileged and confidential.If you are not the intended recipient,please delete the e-mail and notify us immediately. Town of Barnstable ��. Regulatory Services ettss Tbomos F.GeOer,Director wly. FD ' Building Division Tom Perry,building CommiWoner 200 Main Street,Hyannis,MA D2601 "w.towu.barosta ble.m a.us Office: 4108-862410'S r ae: 508-790-62:0 Property Owner Must Complete and Sign This Section If Usi.n,.,AJBuilder 1,atsalAl'_ Q01k`� _,as Ownta of the subject properq f 1C_'eb7 acrho.—.ze to ac:or= bey, in 01 =:::.e:=_:cia=-c::work a_6nr2ed!..v-!ss bad_ng pe=:. (Address of Job) **Punl fences and alarms are the responsibility-of the applicant. Pools ace not to be filled before fence is installed and pools arc not to be utilized until all final.inspections are performed and accepted. Signearre of Ov c -- Sibmatt:rc of Applicant _— 1'int-Name �— Prn_\a.:.c Date «=otcv��:unEa�e:acss;rsw_c�s I; i' Zile Office of Consumer Affairs ad usiriess Regulation 10 Park Plaza - ,.uite 5170 Boston, Massacht,setts 02116 Home Improvement Con ctor Registration Registration: 103928 Type: Indiv dual E=iration: 7/10f20 Tr# 205535 PETER E. KELLY ' Peter Kelly 50 RUSTIC AVE. I HYANNIS, MA 02601Ar ' �'q e Update Address and return card.AfArk reason'for change. i Address .Renewal F. Esryrnent Lost Card PS-CA1 0 5OM-04/04-G101216 O° &�`�d°�7Ude License-or registration valid for individul use only Office of Consumer Affairs&Business Regulation - g Y HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: WP� W Registration: _1.03928 Type: Office of Consumer Affairs and Business Regulation Expiration: <7•t1A[2012 Individual10 Park Plaza-Suite 5170 oston, A 02116 KELLYi1 = Peter Kelly 50 RUSTIC AVE. HYANNIS, MA 02601� N � 'C Undersecretary Not valid without signature s i -'� Massachusetts- De111111� p:u-tment of Publi C Safety Board of Building Rc�'ulations and Standards Construction Supervisor License License: CS 15044 PETER E KELLY 50 RUSTIC LANE r' HYANNISPORT, MA 02647 ✓�_ �y� Expiration: 8/15/2013 r ('ununis�iuner Tr#: 1601 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION f U Map 1 P Parcel Z Permit# - Health Division 09 B &W(o a�� Date Issued Conservation Division � s l� �6 ��` Fee ��s• O� cq0 \�o Tax Collector A a r t . t a \� �=� ` - a� oJ5 Application Fee Treasurer Q\XG Planning Dept. oe��� Checked in By Date Definitive Plan Approved by Planning Board �`\.cO` Approved By Historic-OKH Preservation/Hyannis Project Street Address ''A-))Z 'Rn n D \R= Village W�N • 6a,(05 S �� ddressOwner rf!a 3� AAAc C` \&Cn O 1 A Telephone Z C1 (o V(01 P it Request ' Square feet: 1 st floor: existing.711 proposed"}t6 2nd floor: existing3�� proposed t TotaRew v� Valuation D (� Zoning District A Flood Plain Ground ter Ove�Tay Construction Type �� o Lot Size I ' Li l Ae—, Grandfathered: C Yes O No If yes, attach supporting documentation. Dwelling Type: Single Family . Two Family O Multi-Family(#units) Age of Existing Structure i Z� Historic House: ❑Yes *No On Old King's Highway: ❑Yes No Basement Type: JkFull ❑Crawl ❑Walkout O Other Basement Finished Area(sq.ft.) t- Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Ut Half: existing new Number of Bedrooms: existing at new Total Room Count(not including baths): existing new U First Floor Room Count 3 Heat Type and Fuel: Vas ❑Oil ❑ Electric D Other Central Air: ❑Yes *No , Fireplaces: Existing New Existing wood/coal stove: Cl Yes XN0 Detached garage:O existing ❑new size Pool:O existing ❑new size Barn:❑existing ❑new sizeIT Attached garage:l�existing O new size Shed:D existing ❑new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial ❑Yes 4No If yes, site plan review# Current Use _4Tp e- Proposed Use BUILDER INFORMATION c Name �- ���\�'1 Telephone Number Address cv;�, p�E rwN-7 Wvk, License# �Home Improvement Contractor# 3�� Worker's Compensation# S 5 U `7 /T b ALL CONST N DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO7T �K�Si - SIGNATURE DATE 0 FOR OFFICIAL USE'ONLY PERMIT NO. e DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER k DATE OF INSPECTION: FOUNDATION _ca FRAME ; INSULATION FIREPLACE ELECTRICAL: �ROUGH FINAL PLUMBING: ROUGH FINAL' " GAS: ROUGH FINAL ' FINAL BUILDING DATE CLOSED.OUT ' ASSOCIATION PLAN NO. - r Town of Barnstable Regulatory Services 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 Permit no. Date AFFIDAVIT I HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation;repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Estimated Cost ii__ . 'ape.of Woxk:��flf P141]� A `�' Address of Work:4 3-72— W W�NCSa e " Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 []Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH.UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name Q:forms1omeaffidav i 1.1./2.1/2005 10:09 FAX 21.2 558 3299 S&C LLP 28FL 1.25 BDST 91001/001 Nov-18-2005 02:18pm From-SULLIVAN & CROMWELL LLP 125 BROAD ST T-612 P-001/002 F-697 Town of Barnstable Regulatory Services t< 7U1N F.t3etler$pier Toga Pony, 13a ftsCOMMIUTAlaer 200 Mafia Street, H,gdaaiS,MA 02601 �rww<to�.bs�r>7stable.lua.tu ?f oe: 508-862-4038 Fax-, 108-7904230 Property Owner Must Coinplcte and 53p This Sec�Lon If Using A Builder 4 darr.,abyl as Owuer of 13ae subject property heo`elyp aurhosize,o.,FAlki, to aet o==7 b eh4 in Z matte Jdative to-Wotk 0asho'162dd by this bufldingpe=it application for: . (Address afYob) SiS=tvze of Owner Date. F�sitName i Q�scz�vss�wx»>�s�to» :d Wd2.1=:£8 S00Z 87 '^ON 8TTRISLL8SS 'ON 34OHd 1431SAS XH.:1 -- 33t.Ef9D WO�11 zoo/zooIrj 1S08 .9ZL 'ldeZ d7i Ole we 999 ZLZ 11V2 90:t1 SOOG/81/L1 �/C e� CoAz R(jC�/oFG,u pl SUpFt _. PFT p 19,5 Sp44 RViSoR 5;l 93 FR F R r c HFgs,kFC� TF qNT Tr G� / Oro�isslon_�t LIP (N i Results Page 1 of 1 Home Improvement Contractor Look Up Enter Search terms separated by spaces. Search terms can be Town/City,Name, or License number Select Search type: r AND G OR 'iSgarcf `; Search Results Reg. No. scant Street City State Zip Name Title ' ation E.TER E 93 Kelly, �92 PETER KELL Pheasant Centerville MA 02632 peter Owner Way Y F E ON MA PETER' OWNER 3/30/ 7 ST Total of 2 Records matched. Back to Home Page BBRS Privacy Statement http://db.state.ma.usibbrs/hic.pl 11/16/2005 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION p Parcel"C �. 'Application # Health Division Date Issued Conservation Division VIC 5�3 -'1?13 ,.Application Fee Planning Dept: ."Permit Fee / Date Definitive Plan Approved by Planning Board oK ((I12�la Historic - OKH _ Preservation/ Hyannis Project Street Address 0 S ?tiV�Village t , A L L l A s NW)c1l caner /LJ � /mil l� 1 . Address Telephone Permit Request R[ G{ I-AeOMtiW9j Or 814- I ' 7-641114 F Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District, Flood Plain Groundwater Overlay Project Valuation ODD Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0 Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other et'entral Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No -Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: o o a Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ 0 N 'n No w Commercial ❑Yes N(No If yes, site plan review # Current Use Proposed Use — w ; AP ANT INFORMATION UILDE>RR HOMEOWNER) NameC"ECINIT,RCD��_Telephone Number Address �� �� L � � � License # A11 4 AMD 233 q Home Improvement Contractor# AJ 4 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE I ®boho FOR OFFICIAL USE ONLY APPLICATION# » DATE ISSUED - MAP/PARCEL NO. d ADDRESS - VILLAGE OWNER DATE OF INSPECTION: r FOUNDATION WQ cOf l �Zq�to FRAME 1 INSULATION r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL = _ ° FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. _ . i WTC_SCH40_LP_ChainLink_R02.x1s Page 1 of 1 .M1 ASTM F1083 Sch 40 Steel Pipe and ASTM F1043 Group IA Wind Speed MPH Inch-Pound Metric b 110 110 Mph 177.0 km/h l" Fence Height-Feet 8Ft 2.4m Line Post O.D. -- Inches 2.875 2.875 in. 73.0 mm Mesh Size -Inches (mm) 2.3 << If value to the left is zero, Height/Line 1 3/4 (44.5) Post combination is Fabric Wire Gauge invalid #8 (0.162) 5 gg << If value to the left is --- zero, Mesh Size/Wire Wind Exposure Category Gauge combination is C 0.67 invalid Icing Effect** No Icing Effect 1 FALSE **Icing Effect Factor is as selected Feet Meters Line Post Spacing »»»» 9.08 2.77 Maximum Post Spacing --Center-to-Center--10 Feet I:D wma,Duce M&$w J H OF S S MICHELE ° CUDILO c m NO.34774 STRUCTURAL gFr/STF 0 4 L F https://www.wheatland.con/windcalc/WTC_SCH40_LP_ChainLink RO2.htm 10/25/2010 T(�'0 I \ 107 105 , 108 +.115 , ; r 109 \ X �9 0 ; ® 110 4. ------ 112 ' CapeSury 7 Porker Rood ti Osterville MA 02655 (508)420-3994 (508)420-3995 fox copesurv@copecod.net C146_4g 1 141JUL108 113 0 20 40 60 80 120 160 FEET 10/26/2010 . 02: 28 7818269228 _ 10/_25/2010 13: 19 7818269228 BOSTON TENNIS COURT PAGE 01 h' C_ COURT PIMEN51ON LINE !M° N FENCE P05T . T s FENCE FA6 u o. pp RIC 50TTOM RAIL OR f, TEN51ON WIRE 11/2"(TYP TENNI5 COURT PAVEMENT,) 3/4"(TYP,) OR SURFACE 5Y5TEM 01 J TOP OF FOOTING TYPICALLY _ I 5ELOW COURT SYSTEM OR CONTIGUOU5 TO i l I I I II CONCRETE EDGING a � IL •( I.1— -�— COMPACTED CRUSHED f w I I I STONE BASE GOUR5) z a �I I I-1 LL tit I—I i_I I II '- N 5ET POST IN 51-EEVE(OPTIONAL) . ' CONCRETE P05T FOOTING i I I `' 10"DIA.FOR 21/2"P05T(TYP.) ' 12"PIA.FOR 3"POST(TYP,) 1 II �-1III�IIIII III��II ' oS � i Gr �75" '1 ��G /he, R �(�e rLu t>l A-, 'f!e: vl NOTE#2: tH OF M FOUNDATION DEPTH MAY VARY WITH p2 MICHELE � SOIL TYPE.P05T SIZE,WIND LOADS, m WOOD TYPE.5PACING,HEIGHT, p p NoU3477O4 OPENNE55&FA5RIC SELECTION. v STRUCTURAL ° ��- - ����• (ems/4 . FENG pO5T5 5ECTION5 - TYf ICAL CLF p A NOT TO SCALE 1"(inch)=25.4mm 1'(foot) 305mm P G%r P 42FP05T1.AVL.09 AMER1CAN BVILDERS 9RAWING5 ARE ILLUSTRATIVE ONLY AND A56A AND USTA y tL1 r ACCEPT NO RE51PON5IBILITY FOR THE'.R USE. r Oct 21 10 09:26p James C.Morphy 203-618-0977 p.2 10/2e/2918 17:00 7818269228 BOSTON TENNIS rcaur uc _ . Town of Barnstable ti Regulatory Services way ThosnaeF, Geiler,Director, >e3o • BuRd.ing Division Tom Perry, huildiag Commissioner 200 Main Suer,, Hyannis.Y.A 01601 v�v,town.barnstable.ma,us Offico: 50S-862-4039 Fax: 508-7A9-�230 Property Owner Must Complete and Sign This Section If Using A Builder Nstl�,, /'G es Owner of the subjec' roPeny _ • • c � hereby authorize Aiy)01 !4Pv ASA R4)���►�(v��,►to act on�y h—LI-z, . is aiI matters relative to worn authorized by this building permit application for . 412 y1l��N� w�• 0arMW1 t,; (Address o job) sip atwe _07mer Date . • 1�iseriLfj. � ��o2Py� • • . Prirt� ' QFORAiS:GWhTERP6ttA45S10T� • i r ,per The Commonwealth of Massachusetts \ Department of Industrial Accidents W Office of Investigations a 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers'*Compensation Insurance Affidavit: Builders/Coiitractors/Electricians/Plumbers AppUeant Information ..Please Print LejZibly Name(Business/Organizati.on/Individual): D S rV A) TiF Co fis C V' , g h d, Address: '0tK,"foa City/State/Zip: . 04!mvck, AA oa%3 7 Phone.#: Are you an employer? Check the appropriate box: .Type of project(required):. 1.❑ I am a employer with to 4. MAlaI am a general contractor and I 6. ❑New construction ' . employees(full and/or part-time).* • ve 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 employees and have workers' working for me in any capacity. 9. Building addition [No workers' comp.insurance comp. insurance.$ 5 We are a corporation and its 10.❑Blectdcal repairs or additions . required.] � ' 3.❑ I am a homeowner doing all work . officers have exercised.,their ❑heir 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 er •f4w C G employees. [No workers' 13.( Oth 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 isproviding workers'compensation insurance for my employees. Below is.thepolicy and job site information. Insurance Company Name: W 1'1� L N � Policy#or Self-ins.Lic.#': U y C 10 l Expiration Date: Job Site Address: 911 X 14AM(o ke- City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby certify der the pains-and penalties ofperjury that the information provided above is true and correct Si afore: 1 ShO Date: / L�q lID — ' Phone#: D 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): J.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: 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 ehapter..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.cornpliauce with:the insurance requirements of this chapter have been presentedto 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-contiactor(s)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 pernut/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 Coxnz, oawealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,.MA 0.2111 TO. # 617-727-45QO ext 406 or 1-977-MASSAFE Fax# 6-17-727-770 Revised 11-22-06 www.mass.gav/dia i cDv t.AioqAfii A4 l A) 676 r- i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION OX Map Parcel Application# DIV) Health Division Conservation Divisions Permit# Tax Collector Date Issued 3 d� Treasurer Application Feel —� Planning Dept. Permit Fee 0i I Date Definitive Plan Approved by Planning Board a t� /ria" Historic-OKH Preservation/Hyannis G } rJ to Project Street Address V 3 Z- / ftn n o 14tJc , Village (ry1 d� (0s-5- Owner r t Address Telephone 3 IS 06 09 d 4 3 d 34142 Permit Request NO c..e FCe CA Si ft4�6A Square feet: 1 st floor:existing 3 9�1• proposed Ind floor:existing proposed �� Total new Zoning District ON Flood Plain '� �" Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: O Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure c4(^ Historic House: Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: Full O Crawl O Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 31 9 Number of Baths: Full:existing new LA 14 Half:existing ( new 14 Number of Bedrooms: existing Cf new (4 1 A Total Room Count(not including baths):existing ` new First Floor Room Count Heat Type and Fuel: �Gas ❑Oil Cl Electric ❑Other Central Air: ❑Yes O No Fireplaces: Existing Z New Existing wood/coal stove: O Yes �J No Detached garage:O existing ❑new size Pool:O existing ❑new size _Barn:O existing O new size 4f] 4 Attached garage existing O new size Shed:O existing O new size Other: L4 A Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial Yes XNo If yes, site plan review# Current Use E_�VO c>,,N Proposed Use' BUILDER INFORMATION Name P —M/L Telephone Number SD F 367 7793 Address C1 P�EI°Co vory-\'� License# / y y 0D,63 Home Improvement Contractor# fd 9 2S Worker's Compensation# I ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TOC n�"C1Pr�J SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS r. VILLAGE OWNER DATE OF INSPECTION: :. FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL u "s. FINAL BUILDING Y r DATE CLOSED OUT ASSOCIATION PLAN NO. n ! \ ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' a 600 Washington Street Boston,MA 02111' wivmmass.gov/dia ' VVorkers - Compensation Insurance Affiddvit: Builders/Contractors/Electricians/Plumbers Applicant Information .Please Print Le ibl Nrame(Business/Organization/Iudividual): . Address: City/State/Zip:C,n T -O, \4�- Mh Phone.#: 3 6—) -o Are you an employer?Check the appropriate bog: general contractor and I ' :Type of pioject(required):. ,❑1 I am a employer with ❑ I am a g • 4.employees (full and/or part-time),** • have hired the sub-contractors6. El New construction . 2.//� lam a'sole pioprietor or partner- listed on ttie'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 • co We are insurance a $' 9. ❑Builaing addition [No workers comp,insurance �' ,corporation and its 10.❑•Electrical repairs or additions required.] 5. [] officers have exercised their 3.❑ I am a homeowner doing ill-work . I I-❑Plumbing repairs or additions ' myself [No workers' comp, right of exemption per MGL c. 152, 12.❑Roofrepairs insurance.required.]t §1(4), and we have no employees, [No workers' 13.❑ Other comp,insurance required.] *Any applicant that checks boa#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners,wbo 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 ornottbose.endties have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site information. Insurance Comp any Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Ad6ress: 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 reqaired under Section 25A of MGL c. 152 can lead to the imposition of crimiml penal es of a i ne 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 _ne of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the.Office of Lvestigatio s of the DU for insurance coverage verification. I do herAeir r p ins and penalties of perjury that the information provided above ire true and correct. Si atur C Date: 26 Pone If Offleial use only. Do not write in this area, tb.be completed by,city or town official i City or Town: ' Fer tUcense# Issuing Authority(circle one) II� fi :1.Board of Health 2.Building Department 3, City/Town Clerk S.Electrical Inspector 5.Plumbing Lr spEctor 6.Other i Contact Person: Phone#: I Massachuset'us General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this.statute, an employee-is defied as"...every person in the service of another under any contract of bile, 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 d v ellng house having not more than three apartments and who resides therein;or the occupant of.the d-,rellin=-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 ofpubliaworkuntii acceptable evidence-Of•compl atrce +ith'tlie instance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes thatapply to your situation and,if necessary, supply sub-cont=actor(s)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 instance 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 peimit.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 appropriateline. City or Towli 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 permitilicense 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 aff davit 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 of 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 tc give us a call. The Depa;tment's address,telephone-and fax number:. The Co.mmozwWih of Maswhuwtts : Dtpartmmt of hdustdal Acddmts -glee of lay'vestigations 600 Wa3hingtom Street Boston,MA 02111 • TO.#f 17•-727-000 ext 406 or I 477 MASSAFE Fax#617-72747-494 Revised 11-22-06 W .Ma=&QV/din i ZHE�°�y . Town of Barnstable. Regulatory Services Baa,A-ca Thomas F.Geiler,Director Mess. D;A �$ Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 wym.town,b arnstable.ma.us Office: 508-8 62-403 8 Fax: 5 08-790-62 3 0 Property Owner Must Complete and Sign This Section If Using ABuilder O A ,as Qwner of the sub'ect property e�hereby authorize �ef�� /��°/% to act on my behalf, in all matters relative to work authorized by this building permit application for: . (Address of job) o2DD Signature of Owner/ / Dat Print Nz me m s } Q10FUS:0 19NERPERNISSION ✓!ze TDam�inza�rause� o��/�aaoacluaeka --------- ••� _ Board of Building Regulations and Standards �.. HOME IMPROVEMENT CONTRACTOR License or registration valid for individul use only V before the expiration date. If found return to: Registratior% ,�03928 Board of Building Regulations and Standards Expiratrorr 7410/2008 Tr# 125595 Ole bu n Place Rm 1301 v, Type Individual Bos on,Ma.0 108 PETER^9.KELLY � x I Peter Kelly 93 Pheasant Way Ce�terGille;MA 02632 Administrator Not valid without signature ' J ' �fze Vr anvrizooz�ue� a�,�aac�iuoeQ2 a Board of Building Regulations'and Standards Construction Supervisor License ,j i Lice'e'CS�� 15044' .. 1 Expirafion=g/0512009 Tr#'11960 estrictiorf=o:'" I . r 6 PETER E KELLY 93 PHEASANT 1NAY\ v CENTERVILLE,MA'02632 Commissioner 1 ' V `oFt Town of Barnstable XV&W 6 mbmths from is a date t �: Regulatory Services Fee ;, 6 ss Thomas F.Gellert Director j ED N1°� Building Division Tom Perry, Building Commissioner 200 Main Street,.Hyannis,MA 02601 Office: 508-862-4038 X.PR p1m, Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLyAUG " 2®05 Not Valid without Red X Press Imprint ap/parcel Number 161 y Z 5 0 0 1 TOWN OF W Qe operty Address Residential Value of Work y (3. 6 6 0 Minimum fee of•$25.00 for work under$6000.00 wner's Name&Address r- Apt o r y ti ontractor_s_Name . G' L— ` Telephone Number - O �p� :ome Improvement Contractor License#(if applicable) oC onstruction Supervisor's License#(if applicable) 'TO A ' Aworkrnan's Compensation Insurance Check one: • ❑ I am asole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance q(� � isurance Company Name ►n 1 �. `"' `30AA lorkman's Comp.Policy#_- 6-9 0 6 — 7"I 3 3 P'o'7 6 Z 0 :opy of Insurance Compliance Certificate must be on file. 'ermit 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) Re-side ❑ Replacement Windows. U-Value (maximum.44)- *where required: Issuance of this pemrit does not exempt compliance with other tows department regulations,i.e.Historic,Conservation,etc. ' ***Note: Property Owner must sign Property Owner Letter of Permission. ovement Contractors License is required. signature 2Forms:expmtrg Levise063004 C ' Board of building Reguidtions and Standards 1 One Ashburton•Place - Room 130-1'.' ' Boston, Ma achusetts 02108 Home Im)roveme . - _ tractor Registration ::Registr0ti6n: . 103928 e: Individual Expira� 7/10/2006 `R E. KELLY — Kelly -leasant Way - W I :rville, MA 02632 ' .i •.'�'' update Address ao 4 return card.Mark reason for change. ✓ Address ❑ Rmewal ❑ Employment n Lost r'l— • ;tea ` e. oF '°wti Town of Barnstable Regulatory Services BARNSTABr � i E'MASI � Thomas R Geiler,Director q'ptE 639. Building Division 7- Tom Perry, Building Commissioner d' 200 Main Street, Hyannis,MA 02601' www.town.barnstable.ma.us Office: 508-862-4038 Fax: -508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby authorize P to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) S Signature of Owner Da Or ' Print Name QTORM&OWNERPERMISSION �►,. �.5�' � �� � M � v- �o � � � � � M C� �� "�' . . ' . � r . , d <.. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map '! Parcel d�5^�� �.�j Permit# Health Division Date Issued Conservation Division Fee vt - Tax Collector ' Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board , Historic OKH = Preservation/Hyannis ; Project Street Address Village Owner 46i, i (3 Dr, Address 5AMe Telephone jq Permit Request , Bd 5 -rre,o O ti Square feet: 1st floor: existing 6y proposed /if2nd floor: existing proposed� Total new Valuation Aoning District 1 Flood Plain �t 1�" Groundwater Overlay Construction Type Lot Size Grandfathered: OYes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family C Two Family Cl Multi-Family(#units) Age of Existing Structure 1 _Z ® Historic House: ❑Yes )40 On Old King's Highway: O Yes ❑ No Basement Type: V Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) °A Basement Unfinished Area(sq.ft) 55-37 Number of Baths: Full: existing / new Half: existing new Number of Bedrooms: existing 1 new Total Room Count(not including baths): existing � � new First Floor Room Count Heat Type and Fuel: C Gas Cl Oil Cl Electric ❑Other 4 Central Air: ❑Yes Oflo Fireplaces: Existing -_ New 4'14 Existing wood/coal stove: ❑Yes O No Detached garage:O existing ❑new size Pool: O existing ❑new size 61 Barn:O existing O new size Attached garage: xisting O new size Shed:Cl existing ❑new size Other: Zoning Board of Appeals Aut horization O Appeal# Recorded Cl Commercial ❑Yes If yes,site pllan review# CCurrent Use ��i� {'g'/ Proposed Use BUILDER INFORMATION Name �- fzrA Telephone Number 3 Address License# 0 l ��6 q �c> < Home Improvement Contractor# U 3 9 Z� Worker's Compensation# w c qd j- �F ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE L� FOR OFFICIAL USE ONLY ... IT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS_ ' VILLAGE s OWNER DATE OF INSPECTION: ' ti FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL a PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 1" FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Cofnmonwealth of Massachusetts .- -� -' _;::; -:ter Department of Industrial Accidents "L 600 Washington Street — i Boston,Mass. 02111 Workers Com ensation Insurance davit name: iocaticn: hone# city I am a homeowner performing all work im'self. I am a sole proprietor and have no one worldng in any capacity I am an employer providing workers' compensation for my employees working on this job. comoanv name: address: ::.:...:..: .. hoi incve city: or homeowner(ccle one) csiaoil/e propriet/manur/n •##:�....:::. :.:..:...:. and have hired the contractors listed below whc ha •e the follo«1ng workers compensation p ices: comnanv name , ............. v.. address. .:. •' .. ' :.:...::::... insurance cn. ::.;•: ..:.:.... . camp v ham ............... .... address: ......:.:: citti^ .. ....:...... : ... ...... oiicv insurance co. ,, ,...... n of criminal penalties of a line up to S1,S00.00 and/or Failure to secure coverage as required cruder Section IS?�of MGL 152 can lead to the impmitio one Years'imprisonment as well As civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that 9 copv of this statement may be forwarded to the Onlce of Investigations of theflIA for coverage vetifiwtion. 1 do here*_ cent the p ' and es of perjury that the information provided above is trw and correct Date �7 — Sirntature phone# �®��� b � � •�� Print name �� c oItici l use only do not write in this area to be completed by city or town official �. permitNcense# � ❑Bttiiding Department s city or town: ❑Licensing Board ❑Selectmen's O ce r1 check if immediate response is required ❑Health Department Other contact person: phone ft; ❑ "S Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their quoted from the "law";an emPloyee is defined as every person in the service of another under any cow employees. As qu . 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 ci the foregoing engaged in a joint enterprise, and including the legal represses of a deceased employer, or the receiver trustee of an individual,partaership, association or other legal entity, employing employees. However the owner of a . dwelling house having not more than three afar who therein, or the occupant of the dwelling house of another who employs persons to do maiaieaance, construction or repair work on such dwelling house or on the grounds c building appurtenant thereto shall not because of such employment be deemed to bean employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renes of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who h: not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the co�ract for the performance of public work until commonwealth nor any of its political subdivisions shall eater into any have presented to the co^**� n� acceptable evidence of compliance with the insurance been of this chapter p j authority. , Applicants ` the box applies to your situation and Please fill in the workers, compensation affidavit completely,by be hone numbers along with a certificate of insurance as all affidavits may `;;4 supplying cc��'names,address P Accidents for confirmation of insurance coverage. Also be sure to sign and j`::: to the D artmeat of Industrial date the affidavit. The affidavit should be returned to the citY or town that the application for the permit or lic�se is being requested,not the Department of industrial Accide�s• Should you have any regarding 'law"or if yc Y oli please call the Department at the number listed below. are required to obtain a workers compe�oh P c5'� s P _. . . City or Towns complete and printed legibly. Mie Department has provided a space at the bottom of t Please be sure that the affidavit is comp you regarding the applicant. Please affidavit for you to fill out in the event the Office of . c to fill in the peimrt/Iicease number wbich will used a be s a reference number. The affidavits maybe returned t0 be sure the Department by mail or FAX unless other have been made- The Office of Investigations would IOce to thank you in advance for you 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 Invesduadons 600 Washington Street _ Boston;'Ma. 02111 fax#: (617) 727-7749 phone #: (617) 7274900 eat 406, 409 or 375 oFIME snxnsrnsr.e. The Town of Barnstable 039. �0� Regulatory Services rFo rrw�" Thomas F. Geiler, Director Building Division Ralph Crossen, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied -_.- building,containing--at least one but-�not;more,.than.four dwelling-units or to structures which are.adjacent to :.such residence or building be done by registered.contractors,with certain exceptions,along with other requirements. a Type of Work: Estimated Cost v f :-Address of Work: Owner's Name: tV\ P �� - Date of Application: � ` no I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner:�/ Date Contractor Name Registration No. OR Date Owner's Name q:forms:Afdav F �1e -�omvnzauuea/� o�✓�aaoac/u�aelto i BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 015044 Birthdate: 0a/15/1957 { E*pires:.08/15/2001 Tr.no: 3418 Restricted To: 00 PETER E XELLY' 93 PHEASANT WAY. `. L• .ar�i l CENTERVILLE, MA 02632 Administrator y HOME IMPROVEMENT CONTRACTOR Registration: 103920 Expiration: •7110102 Type: Individual PETER E. KELLY Peter Kelly ADMINISTRATOR '93 Pheasant Vay Centerville MA 02632 *TNE TOWN, OF BARNSTABLE I EARNSTAX 39- BUILDING INSPECTOR a MPR APPLICATION FOR PERMIT TO TYPEOF CONSTRUCTION .....V�.. ................................................................................................ ...................... ........kl,^^.::�...........................19 TO THE INSPECTOR OF BUILDINGS: 7 The undersigned hereby applies for a perrM according to the following information: Location ....(A! kA �,( 0 ................................................................................................ ................................................................................... ProposedUse ..................................................................................................................................... Zoning District .....K ,.V- V ..................................................................Fire District v o6se Name of Owner ltno!0*14.40....Address J4 . .. . .................................... Name of Builder !.........Address ...WA 6%......V^*A&*.. C.-solipa.- 0 ................. ................. . .... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exterior .....................................................................................Roofing ........................................................ ............................ Floors .......................................................................................Interior Heating ..................................................................................Plumbing ................ ...................... .................................. Fireplace ..................................................................................Approximate Cost ........ a... i� ......................................... Difinitive Plan Approved by Planning Board --------------------------------19--------- C Diagram of Lot and Building with Dimensions 41 11--t 1 THE Ho Or V01 - DISPOSAL SANITARY WATER SUPPLY, I ' AND DRAINAGE IS HE-REB A D I-Ow 0 IB3 A NSTABLE, BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the To n of Barnstable regarding the above T construction. Name. .. . ... .............. . ... I .... ............... ..................................................... Pro,;,thero, S. Richa d Ll lR v ef 4a 4w;;/- Ale Svesveld, 11 No ...1..2.4..5..1...... Perm for .......remo e................... single family dwelling ............................................................................... Wianno Avenue Location ................................................................ ..........................0.stervill.e....................................... .......... . Owner ............S. Richard Prothero ...................................................... Type of Construction ...................frame ....................... ................................................................................. Plot ............................ Lot ................. jgdft Permit Granted .........June 20...............................19 69 Date of Inspection ....................19 Date Completed ..... .............19 PERMIT REFUSED ................................ 19 16 oil ................................................................................ ................................................................................ ............................................................................... 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ENGINEER■UN■EiiiM®i�i�e■■o■ia©■®ii■■iio�■NONE i°��■° , ■■©®eN■■■■■■■■■■■■■----- -- ■■■_■■■■®a>��■■�n■ I■u ■■ J , � w V WALL2 i I 1 I 1 I I I � I I � I � I � I � I � 1 I 1 1 - I J � J I Q I WA 3 ' FT I i � I I I • , I e I W --------------------------J `1 - 1 � I , I , I I WALLGEl �11 "F] n 1 b I — 7Uf I i I I , . I I I I ILI------------- I I , I I 1 I 1 , 1 1 ^ I O N 1 D I O p = A e I i I 1 , , I 1 I , I r---------------- --------- I I , I I I I I N I J t-nvm Horgan Millwork rn Cl) �, MORPHY 30 Cit Ave,Hyannis MA 02601 m N c Ph:(508)778-6941 -Fax:(508)778-9110 _ i • I 9 Q 1 - - d Q P�r. u - �l r- a d � s a r -7; o -S' i m D m -t V A O m m m > m z Z f Q m Z (� m m m m THE ENGINEER'S STAMP ON THIS DRAWING QUALIFIES THE STRUCTURAL DESIGN ONLY AND ASSUMES THAT THE FOUNDATION/FOOTING CONTINUOUS BOND BEAM @ BEARING SURFACE IS UNDISTURBED, OR TOP OF WALL w/(4)44 BARS PROPERLY COMPACTED, NON-ORGANIC SOIL WITH A MINIMUM BEARING ALLOWABLE OF 3000 COPING (TYP.) (TYP.) PSF AND THAT ALL CONSTRUCTION WILL BE PERFORMED BY QUALIFIED CRAFTSMEN IN WATER SURFACE ACCORDANCE WITH THE 8TH EDITION OF THE SKIMMER(TYP.). SEE DETAIL 77� MASSACHUSETTS BUILDING CODE. ALL DIMENSIONS AND ELEVATIONS ARE FOR DESIGN '26/S-2'FOR MORE INFO. CONTINUOUS BOND BEAM @ AND REFERENCE PURPOSES ONLY AND SHOULD TOP OF WALL wl (4) #4 BARS MIN. WHITE 'MARLITE' BE VERIFIED AND APPROVED BY THE OWNER, CONTRACTOR AND FRAMER. ON SITE (TYP.) POOL FINISH(TYP.) VERIFICATION OF CONSTRUCTION IS LIKELY POOL COPING (TYP.) FT 7 REQUIRED. IT IS THE CONTRACTOR'S OR 4" z OWNERS RESPONSIBILITY TO ASSURE THAT TIMELY NOTIFICATION OF THE PROJECT ER 5URfACE WAT PROGRESS IS PROVIDED SO THAT ADEQUATE ON 2"MIN. CLR. SITE ENGINEER PRESENCE IS OBTAINED. 1811 oc 3/8" MIN. WHITEMARLITE' (TYP. -WATER SIDE) LIABILITY IS SEVERELY DIMINISHED IF POOL WALL(TYP.) W a POOL FIN15H (TYP.) ENGINEER 2"MIN. CLR. ON SITE VERIFICATION IS NOT FREE-DRAINI� PERFORMED. STRUCTURAL (TYP. -WATER SIDE) #3 6" O.C. (VERY. AXIS) cq 0' V 41' FILL(TYP.) 40 PROPOSED POOL I i i , O #3 @ 12" D.C. EACH WAY (TYP.) #3 @ 12" O.C. (HORIZ. AXIS) j^21 FREE-DRAINING 3" MIN. CLR, 5TRUCTURAL fi (TYP. SOIL SIDE) OF 104SS, FILL (TYP,) 40, II I - t PAUL A. V_ PHELAN JR, POOL ST�,IRS. SEE SECTION 3" MIN. CLR. STRUCTURAL FgR MORE INFO. (TYP. - SOIL SIDE) I N0�42538 '21/S-2' MAIN DRAIN. SEE DETAIL I '25/S-2' FOR MERE INFO. V_ 12" MIN. GUNITE' PROVIDE ROCK PACK. SEE SECTION r2 7 2 i/5-2' FOR MORE INFO. 12" MIN. 'GUNITE' THICKNESS (TYP.) THICKNESS (TYP.) LIGHT(TYP.). SEE DETAIL Q i II '24/S-2'FOR MORE INFO. DESIGN& PLANNING REVISIONS P. L �L TYP. �C!� J�PETAIL PROVIDE ROCK PACK. SEE 5EC7ION NO, DATE DESCRIPTION rr '21/5-2' FOR MORE INFO. 381-011 HIGH WALL DETAIL NOTE: SEE SHORELINE POOLS INC. DRAWING *'yp.APPROx. sc E_- FOR 432 WIANNO AVE, OSTERVILLE, MA FOR POOL PLAN MORE INFORMATION PLASTER TIGHT TO RING ANTI-VORTEX COVER COPING 38'-0" MAX. LENGTH 00, 40 181-0" MAX. WIDTH SEE DETAIL '22 & 23' FOR TYP. POOL WALL REINF. PROVIDE#3 TIE BAR -011± 121-01t± 121 141-0't± AS SHOWN J* 2011 40 AUTO-COVER PROVIDE ADD'L#3 (TYP.) DEEP END TRANSITION SHALLOW END HYDROSTATIC VALVE j } BENT BARS AS SHOWN —\ VAULT WATER LEVEL PROVIDE 0 CONDUIT (3 EA. WAY- 6 TOTAL) STRUCTURAL & TO DECK BOX 12" MIN. ABOVE WATER.LEVEL CIVIL CONSULTANTS r COLLECTION TUBE H 12 SLEIGH ROAD - cn 1 2" LINE VACUUM BREAKER RiF,--(F NEW POOL LIGHT c� TO 2nd MAIN DRAIN OR Y2" STONE CHELMSFORD, MA -H w r (I I ov 500W). SIDE SUCTION NOTE: DRAIN COVERS GROUND PER LIGHT PROVIDE ADD'L #3 BENT SHALL BE VGB COMPLIANT TEL. (978) 256-4014 N�6' MANU. SPECS. BARS AS SHOWN (2 EACH FAX. (978) 250-3764 CONC.WALL/FLOOR 3:1 MAX. SLOPE WAY-4 TOTAL) MAIN DRAIN DETAIL - SEE DETAILS (TYP.) APPROX. N.T.S. R SCALE.'22 &23/S-2' FOR MORE INFO. ROCK PACK: PROVIDE 4" MIN. THICKNESS OF IY2" STONE FLOOR OF POOL (TYP.) DE�TAIL, NOTES: T s POOL LIGHT 1.FOR ADDITIONAL POOL INFORMATION SEE POOL SUBMITTAL PROJECT FILE BY THE POOL INSTALLER. 2. POOL TO BE CONSTRUCTED IN ACCORDANCE WITH THE 8TH SHORELINE POOLS EDITION OF THE �A��SE MASSACHUSETTS BUILDING CODE,APPENDIX tG'. SWIMMING POOL POOL SC�Al/�41 432 WIANNO AVE 3. POOL STRUCTURE TO BE CONSTRUCTED ON UNDISTURBED OSTERVILLE, MA PROCIFROLLED NONORGANIC i AND NON-EXPANSIVE SOIL WITH A MINIMUM BEARING POOL AUTO-COVER ALLOWABLE OF 3000 PSF AND (BY OTHERS) 2-011 COPING A MIN. 4" LAYER OF IY2" COMPACTED STONE. ALL WORK TO BE IN COMPLIANCE WITH THE AMERICAN CONCRETE INSTITUTE ACI-318-02. 311 4. SKIMMER, MAIN DRAIN,POOL LIGHT&RELATED DETAILS @ POOL STRUCTURE TO BE DESIGNED BY OTHERS AS REQ'D. 4" / / 5. THE SHAPE AND DIMENSIONS OF THE POOL MAY BE 1-011 ALTERED WITH THE FOLLOWING CAVEATS: COPING I I -011 JJ# A. THE MAXIMUM LENGTH WILL BE 40'-0". ol PROVIDE HEAVY DUTY B. THE MAXIMUM WIDTH WILL BE 28'-0". SEE DETAIL 'I 2 & 13'FOR E: NOTED TYP. POOL WALL REINF. STAINLESS STEEL C, THE SHAPE MAY BE RECTANGULAR OR IRREGULAR. BRACKET(BY OTHERS) D. THE DEPTH SHALL NOT EXCEED 8'-6 DO NOT SCALE OFF DRAWING = j� � d E. THE RADIUSES SHOWN FOR THE DEEP END AND SHALLOW % END SHALL BE AS SHOWN 4" TOE HOLD. SEE PLAN 10 PROVIDE (2)#3 TIES FOR LOCATIONS. 44 BENT BARS @ 6" O.C. BUT MAY BE INTERPOLATED TO DEPTH. DATE: 11/28/12 AS SHOWN EA.WAY CENTERED F. THE PITCH FROM THE SHALLOW END TO THE DEEP END (TYP.) SHALL NOT EXCEED THE PITCH SHOWN. DRAWING TITLE M %/ �/ /j SO, 6. THE POOL CONSTRUCTION IS TO BE IN FULL COMPLIANCE POOL SKIMMER WITH THE 8TH EDITION OF THE MASSACHUSETTS POOL PLAN, BUILDING CODE, APPENDIX G. LISTED IN SECTION AG108 OF �4" GRAVEL DRAINAGE APPENDIX G ARE THE ADDITIONAL SECTIONS BED BACKFILL STANDARDS THAT WILL BE ADHERED TO, INCLUDING BUT /� /! 2" 0 PVC PIPE NOT LIMITED TO THE FOLLOWING. AND DETAILS 1 OY21 11-211 811 AG 104.1-ANSTNSPI-3, STANDARD FOR PERMANENTLY EQUALIZER OUT TO PUMP INSTALLED SPAS.AG103.1-ANSI/NSPI-5, 4" STANDARD FOR RESIDENTIAL IN-GROUND SWIMMING PROVIDE ADD'L#3 POOLS.AG106.1-ANSI/APSP-7, STANDARD FOR SEE DETAIL '22 &23' FOR BENT BARS AS SHOWN SUCTION ENTRAPMENT AVOIDANCE IN SWIMMING POOLS, CONSTRUCTION DRAWINGS TYP.POOL WALL REINF. @ 6" O.C. WADING POOLS, SPAS, HOT TUBS AND CATCH BASINS.AGIO3.3-ASCE/SEI-24,FLOOD RESISTANT DESIGN AND 27 UT COVER VAULT SECTION DRAWING CONSTRUCTION.AGI05.2,AG105.5- DRAWING NUMBER A AUTO R��C!�3 4�Ml STM F 1346, PERFORMANCE SPECIFICATION FOR SAFETY SKIMMER SECTION COVERS AND LABELING REQUIREMENTS FOR A_LL 26 APPROX.SCALE: N.T.S. COVERS FOR SWIMMING POOLS, SPAS AND HOT ITUBS.AGI05.2-UL-2017, STANDARD FOR GENERAL- 12228-S- 1 PURPOSE SIGNALING DEVICES AND SYSTEMS ----------