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HomeMy WebLinkAbout0282 CHURCH STREET r, 4 • C f i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map I�J Parcel D D U �'�'�V! OF,RARNT IA p f' U application # I 65 V Health Division 1t SDate Issued U Conservation Division . Application Fee Planning Dept. Permit FeeIT �S Date Definitive Plan-Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village �/��.5/ Owner c`/�T�1��1� ��� Address - Telephone� � /? , Permit Request /u' Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation j`6D U Construction Type//ate 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 ANo On Old King's Highway: ❑Yes A�No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths:, Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use i APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Q � ��!�,11 Telephone Number Address/IS ,Zg�L�l��/ �/�i License # 14 Home Improvement Contractor# Email Worker's Compensation'# kG D4 I ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE.ONLY APPLICATION# DATE ISSUED ' MAP/PARCEL NO. r ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME r - INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL , II' .PLUMBING: ROUGH FINAL _ _ - ` GAS: ROUGH FINAL is FINAL BUILDING r S, DATE CLOSED OUT ASSOCIATION PLAN NO. a i r r Town of Barnstable °• Regulatory Services MASS. Richard V.Scali,Director Building Division Tom Perry,Building Commissioner 200 Maiu Street,Hyannis,INLA 02601 mvw.town.barnstable-ma.us Office: 508-862-4038 flax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder !, Jeremiah Fitton as Caner of the subject hrop,_ny licreby authonZx_ p ` I to act on my behalf, in all matters relative to w rk authorized by this building permit application for: 282 Church Street West Barnstable MA 02668 —� (Address of Job) Pool fences and alarms are the responsibIty of the applicant. Pools are not to be filled or uticed before fence is installed and all final inspections are Performed and accepted- '-Jeremiah Fitton(Aug 14.2015) /U7r-- f Signaturz of Owner Si Applicarl Print Name Print Natnc,� Date Q:FORAIS:ONLT'FK PF,.RM 1$SION POULS Massachusetts 06parfinent.of Public Safety. ..Board of Eiuildin9 RLIgulations and Standards Construction Supervisor License: CS-100988 HENRY E CASSMV 8 SHED ROW 1 2`0 WEST YARMOU M —V Expiration Commissioner 11/11/2015 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement C.oj actor Registration ' Registration: 153567 Type: Private Corporation Expiration: 12/15/2016 TO 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SO. YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. SCA 1 di 20M-05/11 Address Renewal Employment ❑ Lost Card ...............-— -- -.. �j __......... - ..........-....................... . �e ep.11.aiuuec"N'11lb-�cataceeluveerd Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: :1:53567 Type: Office of Consumer Affairs and Business Regulation j xpiratiop: ;;:121:15/20:1.6 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULAT-0, ' ;INC'; HENRY CASSIDY 18 REARDON CIRCLE`.,": g , SO.YARMOUTH,MA 02664. Undersecretary No/valid wi ut sign e I ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street is aY_ •,�-- :� ; Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): L"i Address: tY p: �/ � ,1n/��` Phone #: Ci /State/Zi � �a � • Are you an employer? Check th appropriate box: Type of project (required): 4. I am a general contractor and I l. ,I am a employer wither g 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors listed on the attached sheet. 7. ❑ Remodeling 2.❑ 1 am a sole proprietor or partner- ship and have no employees These sub-contractors have g• ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp, insurance comp, insurance.t required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions officers have exercised their I I.❑ Plumbing re 3.❑ I am a homeowner doing all work f gairs or additions p myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] ; c. 152, §1(4), and we have no , E employees. [No workers' 13.? Other comp. insurance required.] *Any applicant that checks box 91 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number, I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site irrforrnation. ; Insurance Company Name: Policy # or Self-ins. Lie. 4: Expiration Date: Ito Job Site Address: °Z �� C�Y of 40� i /0�1-f 3 City/State/Zip: 4" zl)7 G G 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 $1,506.00 and/or one-year iitiprisonment, 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 insurand covera e verification. I do hereby certify ad the pal an penalties of perjury that the information provided above is true and correct. e � Signature: Date: Phone#: re only. Do not write in this area, to be completed by city or town official. wn: 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 D,...,.,.... PhnnP#- I CAPECOD-27 BDELAWRENCE CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 6/30/2015 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(les)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 endorsements , PRODUCER CONTACT 434 RteNAME:ers&3 ray Insurance Agency,Inc. PHONE E South Dennis,MA 02660 EMAIL n/c No:(877)816-2156 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC 9 INSURER A:Peerless Insurance Company-see LIBERTY MUTUAL INSURED INSURERB:ATLANTIC CHARTER INSURANCE GROUP Cape Cod Insulation,Inc. INSURER C 18 Reardon Circle INSURERD: South Yarmouth,MA 02664 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. INSR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR CBP8263063 04/01/2015 04/01/2016 EACH OCCURRENCE $ 1,100,000 PREMISES Ea occurrence $ 00,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY a $ 2,000,000 X JECT LOC OTHER: PRODUCTS•COMP/OP AGO $ 2,000,000 AUTOMOBILE LIABILITY n COMBINED SINGLE LIMIT $$ Ea accident _ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per person) $ AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PRO AUTOS AMAGEPERTY D AUTOS Per accident, $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE DED I I RETENTION$ WORKERS COMPENSATION S AND EMPLOYERS'LIABILITY STATUTE ER H B ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N WC E00431901 06/30/2016 06/30/2016 OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ 1,000,000 (Mandatory In NH) II yes,describe under E.L.DISEASE•EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES ORD 101,Additional Remarks Schedule,may be attached if more apace Is required) Workers Compensation includes Officers or Proprietors. Additional Insured status Is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18 Reardon Circle ACCORDANCE WITH THE POLICY PROVISIONS. South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD N S Uy j ',OAN . t� ®® Illl[Ol•{7 7[p MASS SIl GY 10>M {USY[MGIC 3♦tTT{ IWA,j i.{-TIQ [SIIINO .® 1-800AP619;686611 Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date: Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance .Institute ,(BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village T4t1C.W14A JCI V� .2 ?dt Ca"cN sT Alz6y' vss�'i4 Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings Slopes ( ) ( ) ( ) ( ) ( ) 1 Floors ( ) ( ) ( ) ( ) ( ) Walls C'/L.awc. 4 iv,e r--j Gvo r )CO r.41e o/ Sincerely H ry E ssi r, President pe C Ins ation, Inc. Vie Project/Application1 1 My File Edit Tools Help I + -;i Detail Application 190261 +1 Applicant . Owner 91912 i F7, - I Collect Status �� ACTIVE - - E DEPARTMENT T + Project/Activity 751 STOVE RESIDENTIAL FITTON,JEREMIAH & a Close/De ny Contractor PROPERTY OWNER Department ; - _ Workflow Description 1 JINSTALL NEW STOVE "Business ,ParkinglMisc I- Description 2 .,Fees effective 102/13`/2006`` . -- -- - -: Assigned to — � Property I - _ Property/Use t Non Conforming I Dates/Misc Permits I N � Business Mast = - 71 Location 282 r Unit F Existing use 1010 SINGLE FAMILY HOME _. Reactivate ° Street ICHURCH STREET zoning RF-RESID F ' _ _ _ - Parcel 153008 - - 1 Adjust Fees arce T memo Escrow Municipality WEAR -WEST BAR NS TAB LE Subdivision - flood zone Misc Chgs �-----�; - - - . --- - _.- Lot/Section/Phase I tl�; Proposed use 1010 ! SINGLE FAMILY HOME ui Paymt History Between _ zoning RF RESID F T ! and memo #, Audit History Location desc Summ Permit flood zone Copy APP J 0Prerequisites 23Hazrd/Restr 13Names ( Bonds f3Sub-Addrs 1f3Text f3 Plan Review Permit Alerts _ 23Prior History 23Inspections OViolations f3Reviews E3Open Items [3Warnings #4 Find Related Link Insps �t 1 of 1 Maintain projectlactivity detail for the current application, 7 OV P, r �- I r � / � I � r t r W ' ' i �, � � I I Y 1 i Town of Barnstable Permit cr o a-C'r Regulatory Services ate: Thomas F.Geiler,Director � � Building Division ee:� p0 F1 3 6 Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: 1 a.h +on Phone:_ 509-36 Z- 5—q 2-3 Install at:' 23 2 arc St_ Village: IW Map/Parcel: i 5-3 008 Date: 2—f 10/06- Stove �'7 A. e /us jv6 B. Type: ZR�aQdianttirculatin C. Manufac S Lab.No. _ - o D. Model No.: es o L, e Chimney < U- o M A. 6�/Existing .(If existing,please note date of last cleanings �, a B. Flue Size " C. Are other-appliances attached to Flue? -YU0 .. r , - D. Pre-fab Type and Manufacturer Ut- _{4 0 - jhA(( 5 ! UL p E. Masonry: Lined/Unlined ''''' Hearth A. Materials: B. Sub Floor Construction. Ol-fc ova P l7 Wc2 iD Installer Name: OW/�--(L - rINf Q t—� Address: Phone: Location of Installation: APPROVED BY: Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map r Parcel Permit# O q Health Division 00— l37 �h Date Issued d3 Conservation Division —.5i 7/2-=/0-3 Application Fee Tax Collector Permit Fee Treasurer SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board %NITFI TITLE 5 ENVIRONMENTAL CODE ANC Historic-OKH Preservation/Hyannis TOT!REGULATIONS Project Street Address 2-91 r L� Village Owner c91r7 Address 5 a mf Telephone 3 Permit Request 0 O f G d- e•2(-Md I I Square feet: 1st floor: existing�� proposed 16& 2nd floor: existing r proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size 2. 1 a_ra^QS Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure —r F istoric House: ❑Yes X No On Old King's Highway: AYes ❑ No Basement Type: Wull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) JAD 4, 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 VWil ❑Electric ❑Other Central Air: ❑Yes Flo Fireplaces: Existing New Existing wood/coal stove: ❑Yes )4 No Detached garage: existing ❑new size � J6L Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:A existing ❑new size[Q)I2 Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes $,No If yes, site plan review# Current Use Proposed Use _ BUILDER INFORMATION Name .J f�-/�I 'In o- �oMfoakFp Telephone Number Address G License# &Ln 4o-L Home Improvement Contractor# O LL6,5 Worker's Compensation# LL J ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO nsT SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT-NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: t FOUNDATION d, FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL l a , PLUMBING: ROUGH- -FINAL GAS: ROUGH- :' FINAL FINAL BUILDING r , ° DATE CLOSED OUT ;4 't' ASSOCIATION PLAN NO. The Commonwealth of Massachusetts -- = =— Department of Industrial Accidents Office ofloyesff al/oas _ 600 Washington Street -_ _Boston,Mass. 02111 Workers' Com ensation InsuranceAffidavit name: location: ci w , , n leg C' Z am a homeowner performing all work myself. ❑ I am a sole rietor and have no one workin in ca acitp %/ / %%//%%%///%%/�S%//4O/Or/////////�o///G%//////S///b%%//%%///�%�%/�%%//%/////%///�/�%�%%/%% co din ensation for my P ..........:.:r:. .:.,-...::::4. : ::.a ?:ii<:Y+,: jf::;:w} .:`•:; '`:^:::z workers mp ^4C{::.<.:'v<:5?:.}•i::iS';:i;>}}:i}:.... +:..L.: .:-.::..:,y..a: :,:.,h+;:::.::.};; ........... ....:.:. ...... ...,..:<.}:.}�.:;.}:-}:.:<::<:>::rt?:i ti:i$}:.•}:?:.;ift.;•:i<'?:}:�:..},}>::::>:}:•::::.,:.i:?;•,?::%•Yii:{:;7�::::..,,t...,.:.t.+t I am an em oyer ..... .....:+.::::.,::.:....::::.r.:4:^.:..i...n.....}.........}.:j..,.:...:.....::.Y.:�:^.: r...t...�:.:�Y::.:.. .a,a\ ....... ......... .......... .r.. ...n.• .....?n.... ........... .......... ..... ...rv.n.rr.+i•{{?.y^.;:-:i:?8::v.;;.v...:.....: v ... .. ... ... ....... v.:-.n..}::v:... :.x.,w:..:vvv:,\y.Y v:.;h>•ji;+,^<4k{:�i. yy .....:. ....... ......... ......... .,.,n.....• ............ .........t.. .....x.,..........•nv.v::::::::.::}>in•.v::.v:nw{•:v:.v:`:4i:4}Y::??•}}is:•.:,.........:::::.:•^....\^.:}::::v:..,,............•.v; �..+.•:•.w::.:,-..,L,•'•v}- v.4K::?•.?}:::}•. ..::.::}:w.v:::::nn•:v:-.:v::..-.•:. ...:::•:v;v,....:::n•: W::::.:^:w....•w::x::.:....:•:^•.v w::•,v:::}.v:•:r.•...-..:.:r..:::••:..... .:......................:.....-....4:...n:..--n.:.n.••,............:Y'•}?}:4y}:h;:::•:................r..... .....n....+•........n....nw••n....:-..x....:::tv:...............,•{?i•:;4:•}•{4}:•i}::•:: r.>.:::vv..v ..r::.w:,K} v..4 ..:.... .....:• ....n.. vrn.. 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I do hereby certify under the p ' and pen of perjury thad the information provrded above is true and corral Date Signature �., If S 41 Phone# Print name r t official use only do not write in this area to be completed by city or town official permdt/liceme# ❑Building Department city or town: ❑Licensing Board osdectmen't Office ❑check if immediate response is required ❑Health Department phone#; ❑Other contact person: (ceviaed 9195 PIA) • f Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", 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 section 25 also states that every state or local licensing agency shall withhold the issuance or'renewal i 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,neitherthe 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 in the workers' compensation affidavit completely, by checking the box that applies to your situation and 'address and phone numbers along with a certificate-of.insurance as all affidavits maybe supplying company names, submitted to the Department of Industrial Accidents for confirmation of inst ante 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. City or Towns 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 Permr cease number which will be used as a reference number. The affidavits may be retarhed'tn the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like 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 1nYestlDatlons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 nhone #: (617) 727-4900 ext. 406, 409 or 375 �pFZHE To`P'PIl of Barnstable y� Regulatory Services t BARNsress E, _ Thomas F.Geller,Director uAss. 1619• Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-$62-4038 • Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME ny2ROVEMENT 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 mort than four dwelling units or to structures which,are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type.of Work: t4 Estimated Cost Address of Work: ZG, Z tnr) � 1 F-7i Owner's Name: �1C M I • n 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 rQOwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IlYIPROVEMENT 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 a RegistrationNo. n,�e waer's Name Town of Barnstable "o Regulatory Services aARxszns Thomas F.Geiler,Director i .0� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: Isf JOB LOCATIO 2A 2 (f_ 1 tl Ir c_ number street (� 2 village "HOMEOWNER": L I �, ✓1 �D8 76 — �y2 name home phone# work phone# CURRENT MAILING ADDRESS: f P� city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building 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 minimum inspection procedures and re q ' ements and that he/she will comply with said procedures and requiremen Siptre/HomeovAer 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 form/certification for use in your community. Q:forms:homeexempt ~' Application to '1-QV+ N CLEP'tK ®YjY �.iYCg'� �tQTj�oap �R.EgiD11RY �I�tDrct �f�trtct���rrt''l��pe ' - In the Town of Barnstable 7(01 JUL 10 PM 3: 35 CERTIFICATE OF APPROPRIATENESS pplication is hereby made, with four complete sets, for the issuance of a Certificate of Appropriateness under Section of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described.below and on plans, rawings, or photographs accompanying this application for. :HECK CATEGORIES THAT APPLY: Exterior building construction: ❑ New Addition ❑ Alteration Indicate type of building: ❑ House ❑ Garage ❑ Commercial � Other . Exterior Painting: New ❑ w Sign ❑ Existing Sign ❑ Repainting Existing Sign Signs or Billboards: ❑ Wall Structure: ❑ Fence ❑ Flagpole Other ❑ -YPE OR PRINT LEGIBLY: DATE__ ADDRESS OF PROPOSED WORK 28 2 Lhurr,h Sf_ 1n). ASSESSOR'S MAP NO. 15 3 )WNER f"tl�� '� , J h�� 5- F l ++o1) ASSESSOR'S LOT NO. _ TOME ADDRESS -IJ.M TELEPHONENO. 50 "3GL'S9Z3 =ULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any iublic street orway. (Attach additional sheet if necessary.) NIL NHS C R O v rc- S� W F COLL �15AN Qr&l A H 0E— Zr-3 C.hv rah St —Nft)Ly -10H125 i AGENT OR CONTRACTOR OI/V/VF — TELEPHONE NO. ADDRESS DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. 00 ((o Pf Ot,C,bc �- Sc P F Ede PORCR -TD 11 F- SIDE OF rIN A 0 o I i 10tJ I N PP-Z RES . POeZH 14'X i Z pEZK 18' IaPRo7� r8 Signed Owner- ontractor-Agent For Committee Use Only This Certificate is hereby Date 03 p d/D nied �fa6a / embers' Signatures: Town of Barnstable ` Old King's Highway Historic District Committee SPEC SHEET FOUNDATIO SO TO SIDING TYPE S�•R-I�r� COLOR CHIMNEY TYPE COLOR ROOF MATERIAL_. P3yo LT— y COLOR_ CGDA�L PITCH �2 (2 WINDOWS COLOR SIZE TRIM COLOR DOORS 1 T- V_ COLORS 6 Q SHUTTERS COLORS GUTTERS COLORS DECKS CJ MATERIALS 1 )C 0A HOG BAN oN. NON-19 RSN 1- P- r • �C GARAGE DOORS COLORS SKYLIGHTS SIZE COLORS SIGNS COLORS FENCE COLOR NOTES: Fill out completely, including measurements and mat arials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when, applicable. N WEST BARNSTABLE •0 ows LOCUS MAP Nrs NOTES; • LOT AREA 1 . DATUM IS ASSUMED 89,400t SF 2. ASSESSORS MAP 153 PARCEL8 3. FLOOD ZONE: C. ��'�tx h APPROX. LOCATION LEACHING AREA EXIST. ��HOUSE v TF=EL.49.29 JL \ `APPROX. G��y :• �� ?ss LOCATION h� SEPTIC TA �P a 24 LO ST LOT 4 ES 1—47, 48 C H FND GAR. A 'DIRT/GRAY i V DRIVE o• /,� --- --� / �` ! �' PROP. ADD'N (HATCHED AREA) , d— T~ POLE off, s`�D 6 / � NE� �1Vomol ) 0 1' , O� ,��:�ft 1C� O A=0.62' s R=1576.23 - - SITE PLAN OF 282 CHURCH STREET IN THE TOWN OF- . (WEST) BARNSTABLE of 414;J• PREPARED FOR: JEREMIAH FITTON ARNE yG DEBORAH SHIFLETT—FITTON down cape engineering H. Inc. o OJALA 40 0 40 80 120 y CIVIL ENGINEERS o No. 6 8 LAND SURVEYORS 999 main at yarmcuth, ma 02875 Fs/p T� Y*DTE � SCALE: 1" = 40' DATE: APRIL 23, 2002 99-368 ARNE H. OJALA, P.P., P.L.S. q TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel tsr Permit# � Health Division 1,M ?�C��c�2 Date Issued to Conservation Division 7 /3 /o D. Fee �• — Tax Collector 2 &20�03— = y�Oc o20�, 3 SEPTIC SYSTEM r�^, �i r_ Treasurer ��- �'�y 6 v SYSTEM IN COMPLIAP,-, 0 r/ -- Planning Dept. WRH TITLE 6 ENNIROI�E ENTAL CODE AEI: 1 Date Definitive Plan Approved by Planning Board TO Tr .,,, M REGULA• ;, Historic-OKH Preservation/Hyannis Project Street Address 2 Gh A St. Village )A) _ ILL 11 �-f� �e M � ! � QUG� Owner �erewlt h Fit t+o tj Address 282 -�(Irc.,� s�- . �/�� tt���5ruke Telephone - 3 "PI 2_3 Permit Request Square feet: 1 st floor: existing proposed 11370 2nd floor: existing proposed Total new ,F Valuatio Q Zoning District Flood Plain A9 0 Groundwater Overlay Construction Type tnic9A Prlam ir" Lot Size Al,4V06,t_ �2.05_pca.eA)Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family > Two Family ❑ Multi-Family(#units) Age of Existing Structure 60 Y!. Historic House: ❑Yes VLNo On Old King's Highway: kl(es ❑ No Basement Type: )k Full ❑Crawl ❑Walkout ❑Other rawTo`rrrf- Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) r P7- AlCC 55.r) �t w Number of Baths: Full: existing new Half: existing S1 n6p 1 Number of Bedrooms: existing new c�� ry Total Room Count(not including baths): existing 1:� new First Floor Room Coi nt co M Heat Type and Fuel: ❑Gas IXLOil ❑ Electric ❑Other Central Air: ❑Yes %No Fireplaces: Existing New Existing wood/coal stove: ❑Yes A No Detached garage:0 existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:;;existing ❑new size Other: —Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ANo If yes, site plan review# Current"Use RQ'5'c ea1�'j Proposed Use U IN A,iZ BUILDER INFORMATION Name (- Telephone Number - 2- _ 9 Z3 Address 2A 2 G ✓r, License# ue,, AM Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE e DATE v OZ x FOR OFFICIAL USE ONLY PERMIT NO. a G DATE ISSUED MAP/PARCEL N.O. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION Fo Q I��`//e;t- FRAME D j'�0f QrG / f0 O S �� INSULATION / S U L. o FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROU If FINAL GAS: ROUGH ":i FINAL FINAL BUILDING DATE CLOSED OUT e z ASSOCIATION PLAN NO. a , T The Town of Barnstable RARNSTARLE. „Department of Health S afety and Environmental Services Y ?LASS: m 1 0 Building Division� 367 Main Street,#Hyannis, MA 02601 Office: 508-8624038 Fax: 508-790-6230 /Jf PLAN REVIEW '4 f / Owner: s D 6tTTo N Map/Parcel: �53 Project Address: R0tiA4 Builder: a-�v,cl,C✓L-�l•�- �f�t.r1CF•!,� 6J�� �4 The following items were noted on reviewing: l C Q�571ZU c_ o tr �W 812 s T I�nO(/1D L/fzK" NG tLG 6 ,4-;r, -35 0,A/ 6 g ,.ivb OIrmr _ ;2S-Gg-' 0 it l D,C P,4rq r�/4r4 '�LTi9/e-s Ti.��G• Hd4C t5-y5 Teir�, 402 �_0n Ale. 5"y=7ep,-7 ��Y�NT ��--o�/t�55'�yyr�3L�/ 5v��s��r•�/DG� � So�FiTO,�L�4yi� l/L�.Ti,v� b/�N Sy' GG � T A To iv rs ��lD t��y UN�/F� SGIq� 510G le T g e.,-ass Ar V r 0 1 5,W,r 9r,W zs It �' ✓-FTJD �av 2 Su. 2� W7-- DO-O /o i?S w F Reviewed by: 4 \ Date: q:building:forms:review i RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 `®0 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW I.IVING'SPACE l 60 'square feet x$96/sq.foo = v x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.i'tC , >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building Permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (der) Deck _x$30.00= (munb )er Fireplace/Chimney __x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee projcost i N `PEST BARNSTABLE 2� 0 ocws LOCUS MAP N LOT AREA 1 . DATUM IS ASSUMED 89,400t SF 2. ASSESSORS MAP 153 PARCELS 3. FLOOD ZONE: C t a Gj APPROX. LOCATION LEACHING AREA 57 4 A EXIST. o HOUSE . TF=EL49.29 ti � APPROX. 2a. LOCATION Gj S SEPTIC TA LOT 4 24 LO ST TR ES +� 46 W $ C H FND � � GAR. 'DIRT/GRAY ;� 1 / A DRIVE O .� -- �� iF ——— 'h'------ PROP. ADD'N (HATCHED AREA) N UTILITY cgs h f, I ti N ; N Fay poles ® —> A=0.62' R=1576.23 ril �N% SITE PLAN OF 282 CHURCH STREET IN THE TOWN OF: (WEST) BARNSTABLE �N OF Mq PREPARED FOR: JEREMIAH FITTON ARNE ti� DEBORAH SHIFLETT-FITTON H. J own cape engineering, inc. OJALA �, 40 0 0 40 80 120 ,,, (� CIVIL. ENGINEERS o No. 6 8 V Lnxn SURVEYORS 999 mem ffL yarmnnt.N ma 02875 .r�0 ' . Y*DTN � SCALE: 1 = 40 DATE: APRIL 23, 2002 99-368 ARNB H. OJALA, P.B., P.L.S. Application to Old Kings Highway"Regional Historic District Committee in the Town of Barnstable for a '12002y � � �> CERTIFICATE FOR DEMOLITION OR REMOVAL Application is hereby made, in triplicate, for the issuance.of a Permit for Demolition or Removal of a building or a structure or part thereof, under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973,for proposed work as described below and on plans, drawings or photographs accompanying this application. TYPE OR PRINT LEGIBLY GATE ADDRESS OF PROPOSED WORK Z8 Z C �)rGh �� W ( rns�`1-�3�ASSESSORS MAP NO. 3 OWNER 7:1e f;M1 �_ Oei[I r A ( I �Ql'1 ASSESSORS LOT NO. y HOMEACDRESSZR7 Grlurvil �t�l rn54oble p w TEL. NO. 'j ?Z-36Z- NAMES AND ADDRESSES OF ABUTTING OWNERS: Include names of adjacent property owners across any public street or way. (Attach additional sheet, if necessary). cy 30 2= -x n 5_fa Le-JU0--5__1 R 1 E OF El MA Ul M 0 C L Z 60 n o IIg l J O(_ AGENT OR CONTRACTOR O W A f- 2 7 TEL. N0. SC '36 - S 3 ADDRESS DESCRIPTION -OF PROPOSED WORK: If building is to be removed, give new location. Snap shots showing all views of building must accompany application. '(Attach additional sheet, if necessary). o E N O W T I ON OF - EMT w11J& OF HOvSE 12' x l L' Note: If approval is granted for relocation, a separate Certificate of Appropriateness is.required for new location if within the Old King's Highway Regional Historic District. SIGNED Space below line for Committee use. Owner-Contractor-Agent Received-by_H:D:C: ­The` icate i ereby �� Date — oz-- Date (��J Time, �� &Y.�_7 2002 TOWN ApprovedOLQ ING' 1 � i= IMPORTANT: If Certificate is approved, approval is subject to the V0 day appeal period provided in the Act. Disapproved ❑ ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION FORA CERTIFICATE OF APPROPRIATENESS 3'he four categories for which a Certificate of Appropriateness is required -are: (application for demolition or removal is a separate form). 1. EXTERIOR BUILDING CONSTRUCTION fnew'or existing buildings): An application is required for any exterior of a wilding to be erected or altered including windows, doors, siding, roof, light etc., that will be visible from any public street,' rvay• or public place. The following scale drawings are required in duplicate with application: plot plan (if addition — show .xisiing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions or dterations are to be made. No plot plan is required for addition or alteration which does not touch the ground. ' t. EXTERIOR PAINTING: An application is required for any portion .of a building,,structure or sign to be.painted that is Visible from a public street, way or public place. Color samples must be attached to these applications. An application is not -equired when repainting existing colors, changing to white, or using colors approved.by the Town Historic District Committee. 3. SIGNS OR BILLBOARDS:. An application is required for any sign or billboard to be erected within the District, with the `ollowing exceptions: a. Existing signs or billboards on November 27, 1974 shall have until November.27, 1977 to secure an approved Certificate of Appropriateness. b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they are removed within three days of the event: Certain other temporary signs that the Committee feels does not detract from the Act may be allowed with the prior permission of the Committee. c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are erected or displayed. d. A single sign of not more than 1 square foot in area showing the name, occupation or address of the occupant of the premises on which they are erected or displayed in a residential zone. 1. STRUCTURE: An application is required to build.or alter any structure within the District which is defined by the Act as a :ombination of materials other than a building, sign or billboard, but including stone walls,flagpoles, hedges, gates, fences, etc. GENERAL REQUIREMENTS i. Work on projects requiring approval shall.not be started until the Certificate of Appropriateness has been filed with the Town ;lerk by the Committee. Approval is subject to the 10 day appeal period provided in the Act. i. No'changes shall be made from the original approved specifications without advance approval of the Commission on an amended application filed with the Committee. ►. A separate application must be filed with each project requiring a Certificate of Appropriateness. 1. Under heading of "Detailed Description of Proposed Work" give detailed data on such architectural features as: foundation, :himney, siding, roofing, roof pitch, sash and doors, window and door frames, trim, gutters —leaders, roofing and paint color. ' I. Unless application is complete and legible and all material required is supplied, application will not be``accepted or acted upon. Copies of the Act establishing the Regional Historic District may be obtained at the Town Hall. i Application to ®Yb Ring'o J19igbWap Regional JbiotAric �Biotrict Committee In the Town of Barnstable 2 00 2. , 1 1 CERTIFICATE OF APPROPRIATENESS Application is hereby made, with four complete sets, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings, or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior building construction: ❑ New Addition. ❑ Alteration Indicate type of building: ® House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other TYPE OR PRINT LEGIBLY: (( DATE ADDRESS OF PROPOSED WORK ?-8 Z 66rA itM. 6rt)45 b A SESSOR'S MAP NO. I S n OWNER 7C_re-.rA I f)-I� I o 60rn-k Ei if(�(O ASSESSOR'S LOT NO. HOME ADDRESS 2-92 AurA 5f AJ_ EJ&1^n G We nN . TELEPHONE NO.,�PR 362-- Z 3 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any public street or way. (Attach additional sheet if necessary.) G5Z1=1TF OF F-MILY 15AML)EL P(Z[5GtLY'1 6 (( 5, 260 church AVio QP-15CoL-L ';Q2 Chorc,h , 1;-t. S056AJ MNAHvE 263 ChOrch S-t K) arn If hA AGENT OR CONTRACTOR U VJ NC= (2 - f�i TELEPHONE NO. SOR- 3G2 - SJ 2 ADDRESS DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used: Please include locations of proposed signs. �c PL))(—t v T ©� t=�ST w WG c�� i-fuv5F 67-' ,c 14' w «r► �x�Ws f oN Z� 3O� ' 5THPDIARD F�ZI�C �(NG - (�1lgTct}i�1G 1= c�;p�R 5 (ar�IGU=S , 1�J-I 11-� TIC10 W(NOM5 d 00 s `�Fpsi2 Bozot7V�i=Y> S t t/J6 �S Signed Owner-Contractor-Agent For om.mitfee Use Only ° L� lJ ' This Certificate is hereby Date Cq—(1�� MAY -7 200 Approve '-d- o mittee Members Signatures: 9, TOWN OF BARNS BLEB 0L® KING'S H9C`4rt!�JAV Town of Barnstable Old King's Highway Historic District Committee 11jr Q® 2 s �I SPEC SHEET FOUNDATION FULL (365 MEN ( GL M c-L I SIDING TYPE L-r- nA rL_�5fl (NGLE COLOR N AT)" )" L CHIMNEY TYPE /\)c) COLOR ROOF MATERIAL n goi - i9S fth. 1 COLOR (3gQi L CEDr12 PITCH WINDOWS ANDI17-601% COLOR VJH (TF SIZE(Zg4x46d)Z4x41j��L,Kl•6,Clf)Z01-36 TRIM COLOR w B T DOORS ANO;(�SDI� COLORS V\! H ( TE SHUTTERS 0 IMF_ COLORS GUTTERS NO N E COLORS DECKS NCB 1\T MATERIALS GARAGE DOORS fV) N I_ 'i� CO.LQRS SKYLIGHTS /U()/� SIZE ""CO•L•mL) f L!V 7 2002 i(7)WNj O COLOR SIGNS /Ulm 4,. KIND FENCE kJ 0 6\J; COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. SPECSHT Revised 11/98 The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: (( JOB LOCATION: Z�i Z C-h V r G number streetstreet village "HOMEOWNER,: s) �_ f' f M( 1 ( c2n "- -3 name home phone# work phone# CURRENT MAIUNG ADDRESS: S (M Z city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building 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 minimum inspection rocedures and requirements and that he/she will comply.with said procedures and re ^nts. S' a f Home weer 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 I unlicensed personas it would with a licensed-Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN • Taala.fS.Zib(enstlnnad) F,� . p'rescriptlre Paekign for0"and Twe-Familf RUW=dol B with Fo�1 IH47DMUM ficu"mUh! ' (3lariag Glaring t.eiling Wall Floor 8aaemeat Slab 1A Arta'(•/.) U-value= R-valULJ R-values 1��'+lyd wadu t1 8t►valuar Pack aae 5"1 to 6500 Heatta�De�ea Dow Nor Q 12!'• . 0.40 3E 13 19 t0 6 mal Normal R 12% 032 30 19 19 10 6 6 SS AFVE 9 12% . 030 3E 13 19 10• Normal T 15% 036. 3E 13 2S WA W 6 Normal U 15% 0.46 3E 19 19 10 NIA ES AFiJE V 13% 0.44 38 13 25 N/A ES AFUE w 15% 042 30 19 19 10 S N/A NomW X 13% U2 38 13 25 WA Normal Y 18'/. 0.42 3E 19 25 WA 6 6 90 AFi,TE Z I8•/. OA2 3E 13 19 10 E AA 18% 0.50 30 l9 19 10 6 I', ADDRESS OF PROPERTY: 21 Z C_1 or 7 rA 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS- 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): '`t 5. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERNSINN G ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FORTIES INFORMATION. i • BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-1980303 a Footnotes to Table J5.2.1b: ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross area. expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example;3 ft2 of decorative glass may be excluded from a building design with 300 fl of glaring area. Z acturer in accordance with After January 1, 1999, glazing U-values must be tested and documented by the manuf the National Fenestration Rating Council (NFRC) test procedure, or taken'from Table J1.5.3a U-values are for whole units: center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction: If the insulation achieves the full insulation thickness.over the exterior walls without compression, R 30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must.be placed between the conditioned space and the ventilated portion of the roof. if use Do not include 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (� exterior siding, structural sheathing,and interior drywall.For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus K-6 insulating sheathing. Wail requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-flame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. TF.e entire opaque portion of any individual basement wall with an average depth less than 50%below grade must mcct the same R-value requirement as above-grade walls. Windows and sliding glass.doors of conditioned b...,ements must be included with the other glazing. Basement doors must meet the door U-value requirement d-scribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R 2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3;4, or S. If you plan to install more than one piece of heating equipment or more-than one pie of cooling equipment, the equipment with the lowest ce efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.la NOTES: a) Glazing areas and U-values are maximum acceptable levels.Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components: b) Opaque doors in the building envelope must have a U-value no greater than 0.35. .3. Door$om the door U alues must be tested and documented by the manufacturer in accordance with the NFRC test pro in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c) If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). - 43 The Commonwealth- of Massachusetts Department of Industrial Accidents == � _ OfllCC 0lIDYCSUg8U0DS . _ 600 Washington Street Boston,Mass. .02111 Workers' Compensation insurance Af£davit une jP_I"e-M 11- an k hone# 2�- 2 and a homeowner performing all work myself 3. 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'•r.>. :. v...... r..v:::•,/..... ...r.v...... :rwf w.vv>r.wn:v;:;:. r:rt {:..L.............1+.}?•:{:;r...Y:.v:}....::.. ...{t... .......J. ...r..... ...r. .:v:. .......t. 1........r. .,.v...... .. ................... ... ......: ....... .:. ,v..... •... •.:::::J:.t.:t.....:'r?i:?:.....}}:...........).:::.:vv4 .}}{.}>:•>Yii:yj:;:v}:?•}:4:?.}Y+.-> ...r...ri.... : .rn.. ..r......... ... t ... .. r..............r... .: ;::il?}iiii:}ni:... .. ......... ...... ... .:t......... r ...... :}}; •. ... .....:...... ; .::v::4::::•:• ':.t.S:iii:4:4}.,?;.;Y...::•:�v::.:.....v?}: . ......::w....:...•vv.t: .. ... ....r...... .yy,;.,..,. .::•-- :: .v{J.v:'.:. . ;r......!..}:i>:4+;:`:.'::::::>:i:�iiii:��{;{ni:•..... ddr :::::.v:::::.::.::.Y':..�.:.::::..�m:t}Yri:•';iv'v}i}kr.:::::::::::::::.v:::::v..:: .............. ............. :::........:rvY'ri?•}}:?•Y:r.•x?ir•>}: l..vnv• ..:•::::. •}:x}}:i ........... ::4}:v: Dine. ................:r.•r-:.•.:.........._.r.............. ....r....:-.:. .:r .. .r t. .. •} .......,.........r......... ,...... r•r...:.;...::>.;;...�:}>y:':;;:}<::}:L .... ...... .... ................x............r.. .,. ,.v :•:•:w:n...:::::{{.....r.•..........}:v.v.)._:.}}:i.}:r•.........::•:•}}i::i'::lt.?ir?X:r:?.Ti:•'i::�~?i:}+>::i}?ii::: .... ..r..... .... r.n............. n...v..... .. ii:�...� ..`4.�'.+ •�.'•�.. r:r:f.4: •:v..:-.t}v- 4}X{.?:}:'vfi`:?;?!?{Y�:?•:::::r v: .......v..........4.........:f.......,............�.:. .::'v... .r. v:''.•Js�:'.".:'>:•}} 4 .:.kv.J ..... ..... .t. .r......... ..r :..:. ....v: .::....,.... ..-.. .v ur.t ...r.n..:..,.r r...::•}.....}.p:.:.:•:::ii'4:•}:{?4: -:::' ......v..!..r r.r........... t .. r .. ... .. r r. ::...i h. ....... �r :..a?•.'�;..:.::}. ........r..::.:............. ... r v ... r .. .. v ..YF .. {::: :. •. .4>}:{L: •r:yi:;:}};i.}}+,::,}Y?.}: .:?•>Y>%?::?:?i::;>:;?:::2 : gaflrtre to accnre eoverate as regdred mnder•Section 25A of MGL 152 can lead to the itnpositlon of etlminal penaltin of a Sne to 51,500.00 and/or one y�,�imprisoivaeat as weII a,eivIl penaltln in the form of a STOP WORK ORDER and a 1lne of SI00.00 a day:gamut me. I m�deratand thad a copy of this statement may be forwarded to the Office of Inveitigattons of the DIA for coverage veriIIcation I do hereby certify trader flit p�� aird�enalti of perjriry the the infor/no�ion provided above is try mid eorred . Signate Date er i a- ^► 17 --oA i hcme# Hof' -3�2-5�1 Z - Print name ---------------------- _ f official use only do not write in this area to be completed by city or town official city or town: pexI nit/iicense# C3Building Department ❑Licensing Board ❑checkif immediate response is reguIred ❑Selectmen's OYnee [3Health Department contact person: phone#; ❑ � Ov4sed 9/95 Pi ACORD-T.. DATE(MM/DDIYY) CERTIFICATE OF LIABILITY INSURANCE o8 13 2002 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION McShea Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 9 Y� HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 749 Main Street, Suite#H ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Osterville, Ma. 02655 5 0 8-42 0-9 011 INSURERS AFFORDING COVERAGE INSURED R & H Construction, Inc. INSURERA: National Grange Insurance INSURERS: AIG Insurance Co P.O. BOX 511 INSURER C: Marstons Mills, MA 02648 INSURERD: 508-428-5054 INSURERE: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $1, 0 0 0, 0 0 0 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Anyone fire) $10 0, 0 0 0 CLAIMS MADE a OCCUR IVIED EXP(Any one person) $5, 0 0 0 a MPI93748 02/15/02 02/15/03 PERSONAL&ADV INJURY $1, 000, 000 GENERAL AGGREGATE s2, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2, 000, 000 X POLICY ECT LOC AUTOMOBILE LIABILITY ANY AUTO Ea acINED ccident)SINGLE LIMIT $1, 0 0 0, 000 ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) a X HIRED AUTOS M9I93748 02/17/02 02/17/03 BODILY INJURY X NON-OWNED AUTOS - +. . (Per accident) PROPERTY DAMAGE _ $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $1, 0 0 0, 000 X OCCUR F-CLAIMS MADE AGGREGATE $1, 0 0 0, 0 0 0 CUI93748 02/15/02 02/15/03 $ A DEDUCTIBLE $ X RETENTION $ 10, 000 $ W STATU- OTH- WORKERS COMPENSATION AND TOR C Y LIMITS ER EMPLOYERS'LIABILITY WC6748571 12/21/01 12/22/02 E.L.EACH ACCIDENT' $100, 000 b E.L.DISEASE-EA EMPLOYEE $1 0 0, 0 0 0 E.L.DISEASE-POLICY LIMIT %5 0 0, 0 0 0 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION r Jeremiah Fitton DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL lO DAYS WRITTEN 282 Church S t. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL -W. Barnstable, MA 02668 IMPOSE NO LIGATION OR LIABILITY OF KIND UPON E I RER,ITS AGENTS OR REPRE E ATIVES. AUTHO D P S N TIVE ACORD 25-S(7/97) 0 ACORD CORPORATION 1988 ....... ........................... ... .......... .................... ............................................. ............................................................... DATE(MM/DDNY) F-1-1111111-11 L n ABI ITY"Iff" ..:.:.N`URA A C 1. E..... ic....... . C ...........0 ......... .............. 8 21/02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER-OF INFORMATION ALMEIDA & CARLSON INS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.!THIS CERTIFICATE-DOES' NOT AMEND, EXTEND OR ALTER THE COVERAGE 'AFFORDED.BY- THE POLICIES BELOW. '92' TUPPER RD -BOX- 719 COMPANIES' AFFORDING. COVERAGE ---SANDWICH MA 02563 COMPANY 4 A NORFOLK & DEDHAM' GROUP INSURED COMPANY MARK G HARNEY DBA B TRAVELERS INSURANCE CO R & M CONCRETE FORMS COMPANY 161 WHITE MOSS DRIVE C MARSTON MILLS MA. 02648 COMPANY D .......................... ............................. .....XXI-1.1".................... ...................... ................................ .............. .... .............. ................... .......................:::::M . ......... ........ ...........x'.........xxx.......... ............. X ....x.x.x.:.: ... ................................. .............. ......................... ............................... ... ...................................... . ...... .......**............ .................................... ...... ...... . .......................................................... THIS IS TO CERTIFY THAT THE POLICIES-OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MMIDDNY) DATE(MMMOfYY) GENERAL LIABILITY R0105170 5/31/02 5/31/03 GENERAL AGGREGATE $1, 000, 000 COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 500, 000 CLAIMS MADE r OCCUR PERSONAL&ADV INJURY $ 500 000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE ", i­ 500, 000 FIRE DAMAGE(Any one fire) $ 50, 000 MED EXP.(Any one Person).—` AUTOMOBILE uABiLrry'-- xorbf�:tx -ELT. COMBINED SINGLE LIMIT,' $', C;Cr —ANY AUTO- -DeITP 7142 _ Lc ALL OWNED AUTOS 4' Uc BODILY INJURY' SCHEDULED AUTOS $ .(Per person) 'f� HIRED AUTOS BODILY INJURY $.. NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ .............. ..................... ANY AUTO OTHER THAN AUTO ONLY: ............. ............. ................ EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ -PUMBRELLA FORM -AGGREGATE- $ OTHER THAN UMBRELLA FORM $ ............... ... ............................... E ................. ....B WORKERS COMPENSATION AND 7 PJUB 7 5 7 X l l 9 2 0 2 6/06/02 6/06/03 X T TAMI TTj JORTH EMPLOYERS'LIABILITY EL EACH ACCIDENT $ 100, 000 THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ 500, 000 PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 100 , 000 OTHER DESCRIPTION OF OPERA'nOl4S/LOCATIONSNEHICLES/SPECIAL ITEMS MASONARY CONTRACTOR .......... ................... ........... ................................... ............ .......... .............................. . ....... ...............................4 ............. ......... : : ..... .. . ............. ............. ... ..... .................. ........ ................................MRO.A.M...................... ........... .......... ................ ......................... . ............. ...... ........................... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE GARY FITTON EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WR%TEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 282 CHURCH STREET UR S BU RE TO MAILS OMICE SHALL IMPOSE NO OBLIGATION OR LIABILITY W BARNSTABLE MA 02668 e'-'OF�ANY KIND UPgU-TRr COM%�&Y, �GENTS OR REPRESENTATIVES. R ENTA ' Shaw Alm da A SA A ........................... ........... ........................... . ... ....... ...................................... 1:100 ..... ...... 1".t .............ARX ........... ............... . q The Town of Barnstable Regulatory Services Thomas F. Geiler,Director Building Division Peter F. DiMatteo, Building Commissioner 200 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. J ) Type of Work:�Cp I � yll rCr[Je►1 wt-I 11 h I&9 a OrrC_Estimated Cost Address of Work: 7-6 2 C n i rGh 51. w_ r 11 S�l� L e i , n7_6M Owner's Name: ..J r-C-0 I f I ©n Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law OJob 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. _ P OR I owl q:forms:Affidav :rev-122001 Py"�:r'p�'.*ei'^'-..r• -•�.- • a.,.-._ .,.. .. - FSP':wa..p,.r,�:r.'z-r yq.T :r_.'-:..•.r. r-.. - _ '.•"� - - - - -'^^ —._. 1 ✓ +1 i t_ t t A.L. Ow >� ���� X`, ;�_ . ' _ { - � '�♦ t` •• �fit. . ;, , j I 1 i ! f ♦K� 1 _ t—' t/T 1 \l J(J ✓:.S�1`� 1 ly,4 19 1�61, pp � f • g j t = , k t i ; , 1 1 } i j t / } R, r,\TJ bl -- DATE �4 LD 1• MEYER REVISED , Professional . f a P.O.Box 532 s So.Yarmouth,MA 02664 . R_ ) ..__. DRAWING NUMBE A a i. T t err _T_ r ,- 1 a -- - , - - - j � A 1 - 1 1 Ip xv � ' ,��L 4kF7: -� �\i �i mar 3✓ �� �,.�.; �� --r•. ILI ti � i - _ - - - 4a „ oil 00 L; 002 , 112 o , "` CIO Ij , n V H SAY — ° zaQz d Lb 1 D ATE �. �^ 0 0 V_� Ll DONALD I. MEYER REVISED Professional Building Designer a Q - F'-O. Box 532 So. Yarmouth,MA 02664 DRAWING NUMBER 3 w z � Y r f ! �. , : , ;TI -11 jj f i41I � E , j < ! _. T T. n ' _-- -- - - - - - - 1 L r 1 h! }NRJ L t"> f L�Wed Gc'-1 .Q r �� � L.,�J �1✓ E,�l�'�c�C,/ � `�� ! ....:-- -,.. --._,_,--;� — i I --�>!�':,r i 1a!��+� �( �is U'� � '�.!Ys`* �'` Gj N1 t e.{ �✓PG�/2�' � '� -'` <. .d _ L 4-4-1 ,'+ - =:: w•..-': ter = ,4'... .._.:. ►. . ,:.; _ _ / , • ur Y • of ors �! r 1� , i r - . . , • �� .. V ./ '+,./ t/ Y �f .., i.�.Lr'"7 i../tJ'7;p , .,- /,_.. s —..!*.� �,.1 ... •. _ t.._ - tau t, ':�il» 14 f. ..+ ,;);i u MAY -7 2002 DATE DONALD I. MEYER REVISED z Professional Building Designer ' TK P.O. Box 532 ® O 2 - �° °� So. Yarmouth,MA 02664 DRAWING N�u °- 2 1 z (508) 394 5296 ,�