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0099 CROCKER ROAD
99 d Oxforcr NO. 152113 ORA M M N U" ESSEln Y 1 2 4 9' � \ r ,� w j i i I � i (/ I�U��� �' i L ONE ASNg T OF PUBLIC SAF "TONrMA 02110gPLACE ETY r , i. Aiai/i�araPOSsoBga _ aoAdtsrra at���rJt cod *&&*f rn/lb/gp =:r.iE• ��tA, EFFECTIVE pgTE LIC_No. CAUr1ON 014221 OR PROTECTION HEFT, PUT AGAINST AID'THLI • PRINT RIGHT THUM m !lAf-H R WILLIA,%p BOXpNPPROPRIATE6 �='EN TEh V j`BEET LICENSE. I L . mij 02 :-.:. BLASTING I NOT VALID UNTIL SIGNED BY I t OPERATORS I STAMP LICENSEE MUST INCLUDE PHOTO_ f j END'OR-SIGNATURE OF T}¢C, FFON OFFICIALLY 001. Imo:-.�is f; I t �• ; TURE OF LICENSEE « SIGN N y T_ AMEIN FULL Agpy`E.SIGNATUR �..,;yv... NER l r � � ., ?HOMEIMPROVEMEHI,C NTRACTOR �k # ^R, ���Registration�100317�a��p �f�:Mr ";� Ezplration u CORPORATION 0 1 rthur' �Williaes, IncSx�s�'I "�sran � entervii! `02632 M..,. f/ Fn+e r Town of Barns-table *Permit o17ill,51 E ee s 6 months from issue dare Regulatory Services, ., nAxtvsT" MASS, �A Richard V.Scali,Director �� t 16 9 ' Building Division ��®l� Paul Roma,Building Commissioner, i�pN -200 Main Street,Hyannis,MA 02601 �114J y � www.town.bamstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERAHT APPLICATION - RESIDENTIAL ONLY j Map/parcel Number Not Valid without Red X-Press Imprint /,�® / Q JS l Property Address C V a [�P d- ��J ►� z - C7 , esidential Value of Work$ 00 LN �Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address es �e--��y �� t, iC9 W 4� Contractor's Name / Telephone Number Home Improvement Contractor License#(if applicable) IVIA Email: t -E T VZ 14A6t)r ee tM CtC. Construction Supervisor's License#(if applicable) / "-A ❑Workman's Compensation Insurance Check one: ❑�, I a sole proprietor FJO am the Homeowner ❑ I have Worker's Compensation Insurance pp Insurance Company Name Sc?.�.� " -�„ -- U=k to ue Jflr,�j._ �c �I�_+ 14a.ee-0-W Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Requ (check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 13 ire"5-�. ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter,of Permission. A copy of the Home Impro meat Contractors License&Construction Supervisors License is re fired. SIGNATURE: C:\Use,s\decollik\AppData\Local\Microsoft\WindowsUNetCache\Content.OutlookUJU69LF2\EXPRESS(2).doc 01/25/17 .� 11 r�C�s Le.,� re - va�f 5��.� S-f��Q�it, )e ,s ✓ta. �S �ealccr bd�: 1 R�'l� W�x.�/tCZ H+�..bFti `� e Town of Barnstable Regulatory Services oFIME ryr Richard V.Scali,Director Building Division anRrMI3114 ' Tom Perry,Building Commissioner 39. 200 Main Street,`Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION O Please Print DATE: JOB LOCATION: number street / village "HOMEOWNER": � v+- C.tC�rd. f.+` � -' .b •� name home phone# work phone# CURRENT MAILING ADDRESS: G c: 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 buildingpennit. (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 proce s and requirements and that he/she will comply with said procedures and requirements. Sign om er 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. r oF"E tgyti Town of Barnstable Regulatory Services * saRtvsraBM Richard V.Scati,Director 9� 16 9. ,0�' Building Division RFD►'�`�A Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.townotbarnstable.us Office: 508-862-4038 Fax: 508-790-6230 Owner's Liability Insurance Waiver Owner Name: �-L r-I W :. /-1 00 Owner Address: Telephone: Sy E-Mail: Z�f J zylM e�.,a jM CLC Property Location: Sd Permit#: I hereby certify that I am the owner of the property. I am aware that the licensee does not have the liability insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Si tur of wner Date i Town of Barnstable Regulatory Services Richard V. Scali,Director S snnxsrnai.e. Building Division BARNSTABLE MWISi/.BIE•6JIB'rtliE•CO'IOi•MAh'sR 0 9. Paul Roma ^ '� �'1034 s639. �0 � ifi79-2014 Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us January 25, 2017 Jeffrey Moore Re: 99 Crocker Road Leyla E. Nickerson West Barnstable, MA 02668 99 Crocker Road Map: 110 Parcel: 015 West Barnstable, MA 02668 Dear Jeffrey Moore and Leyla E. Nickerson, This letter shall serve as notice that this office has observed a violation of the Massachusetts State Building Code 780 CMR. Upon a recent inspection of the above referenced property, work has been observed being done without the benefit of permits or the necessary approvals. The property can be brought into compliance by obtaining the necessary approvals and proper permits. Your immediate attention is necessary. Sincerely, Robert McKechnie Local Inspector 508-862-4033 robert.mckechnie@town.barnstable.ma.us Town of Barnstable Regulatory Services °FWE Richard V.Scali,Director Building Division ' BAMSTABM ` Paul Roma,Building Commissioner MAss, 1639• 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION DATE: 1 r �� Please Print , �:�17 JOB LOCATION �r numb r stree �y q village "HOMEOWNER": name home phone# work phone# r- CURRENT MAILING ADDRESS: -5-C, `w C _ 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 undersig "home ner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures re/%y d that he/she will comply with said procedures and requirements. Si ure Ho owner 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. C:\Users\decollik\AppData\Local\Microsoft\W indows\lNetCache\Content.Outlook\L7U69LF2\EXPRESS(2).doc 01/25/17 i y / Ile Comynorriveaith of Massachusetts Dep arb nit of rndHstria!Accidents 0,f, re of Investigations 600 Washington Street ti Baston,CIA 02111 mm-nnia-mgovldia MTorlmrs' Compensafian Insurance Affidavit Builders/Contractors/EIectricians/Plumbers Applicant Information Please Print f egibiy Name(Bus wmtOMmi23 ionlfndivi&Ld): �e_•� �i1�y l,✓. ,/`2n�,� Address: City/ tatel k/V t �a r s �-ic �i �-e- Phone Are you an employer?Check the appropriate b • Type of project(required): 1.❑ I am a employer with 4. ❑I am a general contractor and I 6- ❑New construction employees(full and/or part-timed* have hired the sub-contractors 2.❑ I am a sole proprietor orpartar- listed outhe 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.I 9. ❑Building addition r d_] 5. ❑ We are a corporation and its l0_❑Electrical repairs or additions 3. am a homeoumer doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No woi1=s'comp. right of exemption per MGL 13 fr c.152,§1(4�and we have no �++��n�eret}nuEdj c employees.[No workers' 13.❑Other camp.insurance mquired-) •Any appluar&&at checks box 91 must also fill out the sectioubebow sbm4ing then w odere compensatinapoliey information- I Homeowners who submit this afidavdt indicating they are doing&U weak and then hire outside coniractors omit submit a new affidavit indicating such tConnactors that rhxt this box must attached m additional sheet showing the name of the sub-camtrsctm and state whether or net those entities have employees. If the sub-contattnrs have employees,they masr pmuide their trorkers'romp.policy number. I ant nit enepIo}�er tJtat is prarztiutg iyorkers'conrpettsatiart insurance for my entpl��ees Beloty is flte policy artd job rite information Insurance Company Name: Policy 4 or Self-ins.Uc.-t- F.xpiratioaDate: Job Site Address- CityfStatelTp: 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 imiposifiion of criminal penalties of a fine up to$1,50D: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 drat a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage tirerfflcation- I do hereby certify nailer pains a ' s ofpedury that the ittforma&n-prtrt hW abm�e is true wid correct Sienaiure: g Date: , Y 17 Phone lk Sv —OR�4 U 9� Official use only. Do not write in this area,to be cotnpWed by city or town official'_ City or Town: PermitUicense if Issuing Authority(tarde one): 1.Board of Health 3.Budding Department 3. ity/rown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#.- Information and Instructions Massachusetts Geheral Laws chapter 152 requires all employers to provide woikers'compensation for their employees. Pursuantto this fie,an employee is defined as.- ..every person in the service of another under any contract of hirf, express or implied,oral or wrh=" An employer is defined as"an mdividnal,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 pegsons to do mah temance,construction or repair work on such dwelling house or on the grounds or building appurtenaitt thereto shall ndt because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also sues 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 toot the commonwealth for any applicant who has not produced acceptable evidence ofczimpliancewith the bsnrance.covexageregnired." Additionally.MGL chapter 152, §2SCM sues"Neither the commaawealth nor auy of its political subdivisions shall emter into any contract for the performance ofpublic workuatl 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 checI®g the boxes that apply to your situation and,if necessary,supply sob-Contractor(s)name(s), addresses)and phone number(s).along with their certificates)of incTrrance. Limited Liability Companies(LLC)or Limited Liabz7ityPartnerships(LLP)with no employees other than the members or partaers,are not requk(-,d to cauy workers' compensation insurance. If an LLC or LLP does have employees,a policy is regnired..Be advised that this affidayit may be submitted to time Department of Industrial Accidents for confirmation of insurance coverage. Also he sure to sign and date the affidavit The affidavirt should be=etzuned to the city or town that the application for the permit or license is being requested,not the Deparmeat of Jada. a Accidents. Should you have any questions regarding the law or if you are requited to obtain a workers' compensation policy,please call the Department at the number listed below. Self-fimued companies should enter_t heir self-insurance license number on the appropriate line. City or Town Officials t Please be sure that the affidavit is complete and pried.IegrbIy. The Department has provided a space at the bottom of the affidavit for you to fill out is the event the Office of Investigations has to contact you reg xUng the applicant Please be sure to fill in the permit/license number which wzll be used as a refer mce number. Iu addition,an applicant that must submit multiple pemit license appli-cations in any given year,need only submit one affidavit indicating current policy imfbnnation.(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 madced by the city or town maybe provided to the ' applicant as proof that a valid affidavit is on file for ft1tare'permi!3 or licenses. A new affidavit must be filled out each year.Where a homeowner or citizen is obtaining a license or permit not related to any business or commercial ventzzre (Le. 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 iu 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 nmaber_ TIC Ga=Qnwealtbt of Massachusetts . Degaztment cif 1ad�ial Accidents : - office of f ve&tintio.= 600 washftOGn.stye-t , Bostou�MA Oil 11 T61.#617 727-4900 Qxt 06 or 1477 MASSAFFE Fax#617`27-7M Revised 424-07 mas-gavidia i i U.S. Postal Service'" ra • _o Domestic mFor delivery information,visit our website,at www.usps.comO. m OF ICIAL Eala�- Er Certified Mall FeeCr 3 {� Extra SeNICBS&Fees(check box,add lee as eppropdate) ❑Remm,Receipt(hard copy) $ ❑Return Receipt(electronic) $ y� Postmark }a' C3 ❑Cedi led Mail Restricted Delivery $ Here V1 p ❑Adult Signature Required $ �11 ❑Adult Signature Restricted Delivery$ 0 Postage C7, � Total Postage and Fees 7 �26� r-i J• Ln Sent Ta— �Qf e /✓1 � L eA c<c ems N 9iieet an"A-i:----,----p8$ox No:----------- ------- ............................... 7 C FOCI P/ _�d -��------------------------------------ rry;sia"re,zip+"d�"""' .................... a�egl,�g� :r. r ,r rrr•r. Certified Mail service provides the following benefts:' 0 A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail 0 A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no ad*onal fee,pr2seht this delivery. USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the recipients' retail associate. C), V signature)that is retained by the Postal Service- Restricted delivery service,which provides r" for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent f'1 Important Reminders. Adult signature service,which requires the a ■You may purchase Certified Mail service with signee to be at least 21 years of age(not ^(j First-Class Mail®,First-Class Package Service®, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 2f years of age r International mail. and provides delivery to the addressee specified,l ■Insurance coverage is notavallable for purchase by name,or to the addressee's authorized agent 3 with Certified Mail service.However,the purchase (not available at retail). p of Certified Mail service does not change the ■To ensure that your Certified Mail receipt Is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a] certain Priority Mail items. USPS postmark If you would like a postmark on rt'i ■For an additional fee,and with a proper this Certified Mail receipt,please present your -ri endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for F, the following services: postmarking.it you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion u of delivery(Including the recipients signature). of this label,affix it to the mailpiece,apply F-+ You can request a hardcepy return receipt or an appropriate postage,and deposit the mailpiece. L1 electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Retum Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT.Save thls receipt for your records. Ps Form 3800,April 2ol5(Reverse)PSN 7530-02-0004W7 SENDER: COI�PLETE,THIS SECTION' COMP LETE THIS SECT,-)N ON DELIVERY ■ CompleCe items 1,2,and 3. A Signatu ■ Print your name and address on the reverse ❑Agent so that we can return the card to you. ❑Addressee ■ Attach this card to the back of the mailpiece, B eceiv by(Printed Name) C. Date of Delivery or on the front if space permits. (,�'s4—`_ 1 1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes If YES,enter delivery address below: ❑No V't qe4tcj� nx/ II I IIIIII III III I II II II I I I IIII I I II I II II II III 13. Service e 0 Priority Mail Express@ ❑Adult Signature gRestricted Delivery ❑Registered Mail Restricted Certified Mall® Delivery 9590 9402 1933 6123 1646 92 ❑Certified Mail Restricted Delivery %etum Receipt for O Collect on Delivery e.handise 2. Article Number(Transfer from service labeq ❑Collect on Delivery Restricted Delivery ❑Signature ConfirrnationTM insured Mail ❑Signature Confirmation 7 015 1730 0001 4993 3261 Cnsured Mail Restricted Delivery Restricted Delivery �e over$500) PS Form 3811,1July 2015 PSN M0-02-000-bbW 1 '1 ' Domestic Return Receipt USPS TRAC � • o First-Class Mail f PostagQ-&-Fees•Paid Permit No.G-10 9590 9402 1933 6123 1646 92 United States - •Sender: Please print your name,address,and ZIP+4®in this box•N Postal Service TOWN OF BARNSTABLE BUILDING DIVISION 200 MAIN ST. RYANNIS, NIA 02601 Irf !tt►ii � i � 1 !�i► � )i►i� Lli►il � I i l� � � i Town of Barnstable THE Regulatory Services o Richard V. Scali,Director aniuvsreste, Building Division BAMSTABI;E wuisna�t•grrtrm�•mwr•xntiros Paul Roma, ° s =.�;.gym Building Commissioner 575 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us January 25, 2017 Jeffrey Moore Re: 99 Crocker Road Leyla E. Nickerson West Barnstable, MA 02668 99 Crocker Road Map: 110 Parcel: 015 West Barnstable, MA 02668 Dear Jeffrey Moore and Leyla E. Nickerson, This letter shall serve as notice that this office has observed a violation of the. Massachusetts State Building Code 780 CMR. Upon a recent inspection of the above referenced property, work has been observed being done without the benefit of permits or the necessary approvals. r The property can be brought into compliance by obtaining the necessary approvals and proper permits. Your immediate attention is necessary. Sincerely, Robert McKechnie' Local Inspector 508-862-4033 robert.mckechnie@town.barnstable.ma.us f - I Parcel Detail Page 1 of 6 3 M A i II.ASiti S"f a1t1F. ' �„. r. y)yr ii+ 1. 1P miez�t::n Logged In As: Parcel Detail Wednesday,January 25 2017 Parcel Lookuo Parcellnfo Parcel ID 110-015 r I _ Developer Lot ILOT 277�.._........I Location 199 CROCKER ROAD I Pri Frontage 1427 . �.....�I Sec Road KETTLEHOLE ROAD sec Frontage 119I Village West Bamstable ' Fire District W BARNSTABLE—I Town sewer exists at this address NO I Road Index 0379 ' Asbuilt Septic Scan: interactive Map 110015_1 Owner Info Owner IMOORE,J Gwner� Streets 199 CROCKER ROAD I strew Clty WEST BARNSTABLE I state MA I zip 102668 1 Country I Land Info _... Acres 1.97_....--...._...-. --...--.......-....I Use....Single FaW MDL-01�� I--zoni"g_.Ip�_.......... I...Nghbd_...0107................._.....- Topography Level I Road 6Paved utilities JiGas,Wel1,Septic I Location I Construction Info Building 1 of 1 Built 1978 I sc uct Bowstring Trus wM fbapboard LMng 2126 r.Wood Shingle I Central I - Area � Cover Type PTgi. style Cape Cod Wali Drywall Roos 3 Bedrooms wax t I ;� Model Residential Inc Plne/Soft Wood Bath 2 Full-1 Half B a Ic Sri Floor�� ` Rooms� . .... Grade,Average Plus I Type Hot Air I Rooms 9 Rooms storiesFuel ation 1 1/2 Stories Heat Mixed FO0"d" Poured Conc. Gross 4778 .r. Area Permit History Issue Date Purpose Permit# Amount Insp Date Comments 12/5/2011 ADDITION TO EXIST 2 5/31/2011 Addition 201101707 $40,000 12:00:00 CAR GAR-NO AM HEAT/INSULATION-NO CHNG TO BLDG HEIGHT http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=6310 1/25/2017 Parcel Detail Page 2 of 6 4/26/2011 New Siding 201102135 $8,500 6/30/2011 RESIDE 12:00:00 AM 1/15/1996 12/1/1994 Addition B37300 $20,000 12:00:00 WB ADD'N AM 1/15/1989 12/1/1987 Addition B31479 $10,000 12:00:00 WB GARAGE AM 1/15/1981 6/1/1978 Dwelling B20335 $0 12:00:00 WB 2 STOR AM -- Visit History...................._...........-......._-----._._._._...................................................... ..................................................................................................................................................._...............-.......................-_.....-.......................... Date Who Purpose 3/12/2015 12:00:00 AM Susan Ricci Cycl Insp Comp 8/22/2014 12:00:00 AM Jeff Rudziak In Office Review 4/30/2013 12:00:00 AM Pamela Taylor In Office Review 2/15/2012 12:00:00 AM Robin Benjamin In Office Review 8/11/2010 12:00:00 AM Denise Radley Change of Address 12/15/2009 12:00:00 AM Jeff Rudziak In Office Review 8/15/2006 12:00:00 AM Paul Talbot Cyclical Inspection 9/10/2003 12:00:00 AM Paul Talbot Meas/Est 3/3/2000 12:00:00 AM Paul Talbot Meas/Est 1/15/1996 12:00:00 AM ML Meas/Listed-Interior Access ....Sales.._Histo.rY_..........................__....................-....-. Line Sale Date Owner Book/Page Sale Price 1 12/30/2009 MOORE, JEFFREY W& NICKERSON, LEYLA E 24272/68 $485,000 2 12/15/1992 DEMARTINO, JOSEPH M &SUSAN S 8352/293 $1 3 6/15/1985 DEMARTINO, JOSEPH M TR 4574/83 $1 4 12/13/1977 DEMARTINO, JOSEPH M & SUSAN S 2632/72 $0 Assessment His - ----_..... ........ ......... ........ ......... ......... __................................... Save Year Building XF Value OB Value Land Value Total Parcel # Value Value 1 2017 $189,100 $43,100 $56,000 $217,000 $505,200 2 2016 $189,100 $43,100 $56,000 $216,900 $505,100 3 2015 $182,300 $37,500 $48,400 $167,400 $435,600 4 2014 $165,700 $37,500 $60,100 $167,400 $430,700 5 2013 $165,700 $37,500 $61,000 $174,100 $438,300 6 2012 $169,400 $36,100 $27,200 $249,900 $482,600 7 2011 $200,300 $11,400 $18,500 $249,900 $480,100 8 2010 $219,900 $11,400 $19,600 $263,800 $514,700 9 2009 $267,800 . $10,200 $14,700 $227,500 $520,200 10 2008 $283,000 $10,200 $14,700 $249,000 $556,900 12 2007 $310,900 $9,900 $14,700 '$249,000 $584,500 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=6310 1/25/2017 Parcel Detail Page 3 of 6 13 2006 $291,800 $9,900 $15,100 $273,500 $590,300 14 2005 $263,200 $9,800 $15,500 $244,200 $532,700 15 2004 $195,500 $9,800 $15,700 $166,000 $387,000 16 2003 $199,400 $9,800 $16,000 $74,600 $299,800 17 2002 $199,400 $9,800 $16,000 $74,600 $299,800 18 2001 $199,400 $10,000 $16,000 $74,600 $300,000 19 2000 $160,400 $3,500 $16,100 $47,900 $227,900 20 1999 $160,400 $3,500 $13,700 $47,900 $225,500 21 1998 $160,400 $3,500 $13,700 $47,900 $225,500 22 1997 $125,600 $0 $0 $41,900 $181,800 23 1996 $103,500 $0 $0 $41,900 $159,500 24 1995 $103,500 $0 $0 $41,900 $159,500 25 1994 $99,000 $0 $0 $48,500 $162,000 26 1993 $99,000 $0 $0 $49,400 $162,900 27 1992 $112,500 $0 $0 $53,900 $182,900 28 1991 $137,600 $0 $0 $83,900 $241,400 29 1990 $137,600 $0 $0 $83,900 $241,400 30 1989 $137,600 $0 $0 $83,900 $222,400 31 1988 $125,900 $0 $0 $32,900 $159,800 32 1987 $125,900 $0 $0 $32,900 $159,800 33 1986 $125,900 $0 $0 $32,900 $159,800 11 Photos YY I�t 9 777 aa!" os �r r 1 P, �K z http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=6310 1/25/2017 Parcel Detail Page 4 of 6 L1hL a b r � n M r J, iI MEN 7. Y gym.: 'ft http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=6310 1/25/2017 Parcel Detail Page 5 of 6 r L k ? f � ewt r1� http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=6310 1/25/2017 Parcel Detail Page 6 of 6 .t p e; I http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=6310 1/25/2017 \y\ >« 0/16 7111 �� I: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ® Parcel '. Application # Health Division Date Issued Conservation Division Application Fee IV Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ts) Historic - OKH Preservation/ Hyannis NIA Project Street Address �� Cocker Ragel Village Wes* %mSW514E Owner TP-4 Am®fe Address 401 Croc16r ROCA Telephone ro Zqj 81q& Permit Request aiil �bOA -6 em kiiaw 2 dear *� . .Pas�@_ file ,A►_PA 4�-©lT COY i�Sul�lCid�1. �(j YlA t� 4b 4) i Id a � to �. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District ;: Flood Plain la Groundwater Overlay tAO AIP Project Valuation 4%O06) Construction Type Lot Size Grandfathered: ❑Yes ANo If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure 11 Historic House: ❑Yes �(No On Old King's Highway: b"Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout Other Wei b -in A rci d e Basement Finished Area (sq.ft.) JO 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 NO Central Air: ❑Yes XNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes XNo I Detached garage-A 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 ❑ ~= y Commercial ❑Yes ❑ No If yes, site plan review# Current Use - - - Proposed UseCD -- - Y nt APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1'C-k Rye/ Co p���'fV C���®� ���. Telephone Number ®�" 4 31— (o Addr r`ess 12,jA Qu,*PnV Afgage R&Arol License # l 713 mirwAkki Xx olfpgr Home Improvement Contractor# I Il 060 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �n�Ua� ��i a►�S�� ��,�`a s�Cl SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# U DATE ISSUED r ' MAP/PARCEL NO. - l ADDRESS VILLAGE I OWNER - , DATE OF INSPECTION: FOUNDATIONY)LO14Q FRAME@ �12 qo c� Rllit gee Lis{ INSULATION i F1{ FIREPLACE ' -` • ' ELECTRICAL: ROUGH FINAL ? r PLUMBING: -ROUGH FINAL GAS: ROUGH FINAL- • FINAL BUILDING s DATE-CLOSED OUT ASSOCIATION PLAN NO: . t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street �? Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electrician sip lumbers Applicant Information Please Print LeLyibly Name (Business/Organization/Individual): Address: Q 2 3 A ue Pen A,nn2 Ranck City/State/Zip: .IkArwotV\ , tA*\ Phone #: v8- y3 2' (ogl-1 U Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. X 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' 9. V Building addition [No workers'comp. insurance comp. insurance. VW required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I aril a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 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#I must also fill out the section below showing their workers'compensation policy information. F 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 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. 1 pp Insurance Company Name: CIX(edle Lumpki,n A !IeexCy Policy#or Self-ins. Lic. #: C��0 Z.$ °�y� Expiration Date: t 1 Zr1 [ Job Site Address: Locker 94wek City/State/Zip: W. 6&td\S�vbte. ho, Attach a copy of the workers' compensat:ien 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 coverageyerification. I do hereby certify er he p ins and nal ' of perjury that the information provided above is true and correct. Signature: Date: V///2/ Phone#: L1 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone#: 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 certificates) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation.of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the-permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the 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-tl'ecessary) 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 d6g 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 Teo:9.617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 4-24-07 www.mass.gov/dia ACOI D,,, i CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYY`) 12/27/2010 PRODUCER 508.945.0393 FAX 508.945.4048 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eldredge & Luepki n Ins. Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 697 Main Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Chatham, MA 02633 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Alan Long INSURERS AFFORDING COVERAGE NAIC# INSURED Rick Roy Construction LLC INSURERA: Scottsdale X56007 123A Queen Anne Road INSURERS: Ace Property & Casualty Ins Harwich, MA 02645 INSURERC: INSURER D: INSURER E: 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. ICTR INSIR TYPE OFINSURANCE POLICY NUMBER POLICY DATE Mc mEUDD/T DATE MffEL WDpNyM LIMITS GENERAL LIABILITY BCS0023728 12/23/2010 12/23/2011 EACH OCCURRENCE $ 100000 01 X COMMERCIAL GENERAL LIABILITY _07WGE TO PREMISES(Ea RENTED nce $ 100 0 CLAIMS MADE OCCUR MED EXP(Any one person) $ A PERSONAL 8 ADV INJURY $ 100000 GENERAL AGGREGATE $ 200000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ ZOOOOO POLICY PRO- JECT LOC AUTOMOBILE UABIUTY ANY AUTO COMBINED SINGLE LIMB $ (Ea accdeM) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) WAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE. AGGREGATE $ $ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITYC46288944 04/29/2010 04/29/2011 wcs YIN TORY LIMITS I ER ANY B OFFICERIME BER�EXC EXCLUDED? E.L.EACH ACCIDENT $ S0O 0O (Mandatory to NH) �—f K yes describe under E.L.DISEASE-EA EMPLOYEE $ 500,000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT S 500 00 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS neral Contractor - Carpentry CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO LIABILITY THE L , UT FAILURE TO 00 80 SHALL IMPOSE NO OBLIGATION OR LIATY 0 ANY KIN INE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE -7 ACORD 25(2009101) 01988-2009 ACORD CORPO ION. All rights reserved. The ACORD name and logo are registered marks of ACORD r 04/04/2011 04:13 5083982224 PL&B INS PAGE 01 Righ>:FaL. C2-1 1/21/2011 9: 28;09 AM PAGE 21003 Fax Server ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MNM7DDrYYYY) 01/21/2011 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 POuGES BELOW. CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 1N8URER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:if the certificate holder Is an ADDITIONAL INSURED,the pollcy(IeS)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,eeflein pollcle5 may require and endorsement, A statement on this certificate dons not confer rights to the certificate hold er In lieu of such endorsement(s). CONTACT PRODUCER NAME; PAX FASSARO L,EVERONF R.BUCK JAM,xo,Ext>: FAX (AfC,No): 239 ROLE 28 E ADDDRDR ESS: PO BOX 160 PRODUCER DIRIWISPORT,MA 02639 CUSTOMER ID J3: 28W7W INSURERS)AFFORDING COVERAGE NAIOV INSURED INSURER A: TRAVF..LERS DIRECT ASSIGNMENT INSURER B: Toy MATTKEW A. INSURER C: IN5URER D: PO BOX 694 INSURER E: SAGAMORE,MA 02561 INSURER F: CONBRAGES CERTIFICATENpTVrlr}tBfANgNG ANY NUWMER: REVISION NUMBER: Is TO CERTWY THAT THE POLICIEB OF WSURANCE USTE9 BELOW HAVE BEEN 15s=TO THE INDUR6D NAMED ABOVE FOR THE POLICY PERIOD WDICATEO• REQUIRBI,rENT,TERM OR CONDITION OF ANY CONTRACT OR OTHM OOCUMGNT WITH RI�VPCT TO aAHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAW.THE mURANaE AFFORDED BY Tf+£POLICIIFA DESCRIBED HEREIN 19 SUBJECT TO ALL THE TERM,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY NAVE BEEN Rk'DUCflO By PAR)GL ASM MOR ADOLSUUR POLICY EFF DATE POLICY EXP DATE LETS TypeOP>!`>BURANCE POLICY NUMBER (MYaDDIYYYY) (MNn0D1YYYY) LTR �R WVO EACH pccURRENCE 8 GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY DAMAGE TD RENTED S CLAIMS MADE OCCUR. PREMISES(Ea occurrence) MED EXP(Any one p nwri) $ PERSONAL&&ADV INJURY $ GENERAL AOGREQATE GERL AGGREGATE LIMIT APPLIES PER; PRODUCTS•CO $MPIOP AGO $ POLICY PROJECT LOC COMBINED SMDLE $ AUTOMOaa.E LJABIWTY LIMIT(En weEeno ANY AUTO BODILY INJURY S ALL OWNED ALROS (Perperuoo) SCHEDULE AUTOS BODILY INJURY $ HIRED ALITOS (Per aocidenq PROPERTY DAMAGE S NoN-OWNED AUTOS (Per accident) UMBRELLA L1AB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS WAB CLAIMS-MADE DEDUCTIBLE S RETENTION $ WO STATUTORY LIMITS pYHER WORKER'S COMPENSATION AND EMPOLYER'S LIABILITY YIN UB-003ON28B•11 01117/2011 01117=12 E.L.EACH ACCIDENT $ 100,000 YIN ANY PROPERITOWPARTNERIEXEOUTTVG Y E.L.DISEASE•EA EMPLOYEE $ 100,000 OFFICER4I%MBER EXCUJDE07 Y E.L.DISEASE-POLICY LIMIT $ 500.000 PAarwrery In Nlq II yap,depathe under DEscAlPTION OF OPERATIONS Del0w DESCRIPTION OF OPERATIONSILOCAT(oNmEmr-LEMEBTRICTIONSISPItCIAL ITEMS ROMA ANY A IS IOP C Y TITT?wORKPRsECTR T'pTC Ol.CY.n� hF AECTINO WORKERS MMP COVIDRAOR TOY CERTIFICATE HOLDER CANCELLATION RICK ROY CONSTRUMON SHOULD ANY of THE ABOVE DESCRIBED POLICIES DIE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BF DELIVERED IN ACCORDANCE 123 A QUEEN ANNE RD WITH THE POLICY PROVISIONS, AUTHORED REPROSENTATIVtE HARWICH MA 02645 Chazles d Clark DATE(MNU°°"""' 'CERTIFICATE OF LIABILITY INSURANCE PRODUCER 2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION X ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 749 Main Street, Suite#H ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Osterville, Ma. 02655 508-420-9011 INSURERS AFFORDING COVERAGE NAIC# INSURED Peter W. McIntire & Sons, LLC INSURER A: Travelers Ins Co. INSURER B: PMC 50 Martha Kendrick Drive INSURER C: Chatham, Ma 02633 INSURER D: 508-945-2846 INSURER E: 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 R POLICY EFFECTIVE POLICY EXPIRATION LTR NSRD POLICY NUMBER D TE MM/ DATE /DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 -_ - X COMMERCIAL GENERAL LIABILITY ICU PREMISES Eaoccurence $ 300. 000 _ C—,I.-- X ------ CLAIMSMADE .]( OCCUR -- - — -- -- -- - -_ .__ ---. -. MEDEXP(Anyonepersonj A. I-680-2648C578 1/26/2011 JU .1/2'6/2012 PERSONALBADVINRY $ 1 OOO OOO 1/26/2010 1/26/2011 GENERAL AGGREGATE $ 2 00O 000 GENT POLICYF_ PRO- AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY ECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS X SCHEDULED AUTOS B(Per person) $ (Per person) A X HIRED AUTOS BA-3033C705 1/26/2011 1/26/2012 BODILY INJURY X NON-OWNEDAUTOS 1/26/2010 1/26/2011 (Peraccident) $ X 500. ded comp PROPERTY DAMAGE X 500 ded Coll. (Peraccident) $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANYAUTO OTHERTHAN EAACC $ I AUTOONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMSMADE AGGREGATE $ 1 000 000 ISM-CUP-3012Y545 1/26/2011 1/26/2012 $ A DEDUCTIBLE 1/26/2010 1/26/2011 $ RETENTION $ $ RKERSCOMPENSATIONAND -- ----- ------ T RYLIMLS ANY PROERS' RIPARITY WC006894005 2/2/2011 2/2/2012 E.L.EACH ACCIDENT $ 100.000 ANY PROPRIETORlPARTNER/EXECUTIVE B OFFICER/MEMBER EXCLUDED? dtyes;describeunder 2/2/2010 2/2/2011 E.L.DISEASE-EA.EMPCOYE $' 100 0'00<- , SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1$ 500 .000 OTHER . DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 123AQueen Ann road y Construction DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL10 DAYS WRITTEN 23A Harwich, MA 02645 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUT 0 IZED REPRESENTATIV 508-432-4812 ACORD25 2Q01/Q8)._ _ _ ._- _ _ ,�(�j.-� - - - -- - --. . .�.--- - _.�.---- --- ©ACOR C0�2RORATION 1988- 7 r From:Faxserver80 To:Rick Roy Construction Date: 1/12/2011 Time:3:11:04 PM Page 2 of 2 ACORQ CERTIFICATE OF LIABILITY INSURANCE I DATE(MMIDDNYYY) 01/12/2011 PRODUCER 508.945.0393 FAX 508.945.4048 THIS CERTIFICATE IS ISSUED AS A.MATTER OF INFORMATION Eldredge & Lumpkin Ins. Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE r)7 Main Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. �jatham, MA 02633 INSURERS AFFORDING COVERAGE NAIC# INSURED Eldridge Electric, Inc. INSURER A: Commerce Group CIG001 400 Airline Rd. INSURERS: Citation Insurance Co (MA) 40274 South Dennis, MA 02660 INSURERc: Hartford Insurance Group 00914 INSURER D: INSURER E: 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 OD' POLICY EFFECTNE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMI00 DATE MIDD LIMITS GENERAL LIABILITY BCJLMP 12/24/2010 12/24/2011 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE To HI:-'NI= PREMISES Ea occurrence $ 100,000 CLAIMS MADE a OCCUR MED EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO- LOC AUTOMOBILE LIABILITY LW8804 12/24/2010 12/24/2011 COMBINED SINGLE LIMIT ANY AUTO (Ee accident) $ ALL OWNED AUTOS BODILY INJURY B X SC $HEDULED AUTOS (Per person) 250,000 X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ 500,000 PROPERTY DAMAGE $ (Per accident) 500,000 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ ANDEMWORKERS COMPENSATION 08WECIV1559 12 24 20 / / TORY LIMITS ER AND EMPLOYERS'LIABILITY Y/N / / 10 12 24 2011 C OFFICER/ME BER EXCLUDED?ANY ECUTIVE ❑ E.L.EACH ACCIDENT $ 100,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 100 000 If yes.describe under _ SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Electrician The certificate holder shown below is also added as an Additional Insured for Liability coverage under policy #BCJLMP. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Rick Roy Construction, LLC REPRESENTATIVES. 123—A Queen Anne Rd. AUTHORIZED REPRESENTATIVE Harwich, MA 02645 Alan R. Lon President ,10RD 25(2009/01) O 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD r 01/20/2011 4:41 5083982224 PL&B INS PAGE 01 Policy Number. A46& Data Entered: 8/26/2010 CERTIFICATE OF LIABILITY INSURANCE DATtVMMONYM THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEIHOLDER. THIS /20/2011 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; H the cartifioat® holder is an ADDITIONAL INSURED,the pollcy(las) must be endorsed. If SUBROGATION I5 WAIVED, subject to the terms and condklons of the policy, certain pollclefj may require an endoreement. A statement on this certificate does not confer a tho certificate holder In Ilau of such endorsement{s). PRODUCER CO PASSARO, LBVSRONS & BIICKS,EY 2Nt3 A6CY INC Ante: PHONE 239 ROUTE 28 .MaIL (508)398-2223 �Kpl; (508)398-2224 P.O. BOX 160 aDEsy: DENNISPORT, MA 02639 INSURE AFFORDING cpvMAce NATO R UJSURERA;SCOTTSDA7jE INSURANCE CO�RN)r INSURED :COY 31DIMr-, DECKS G WINDOWS INSURER B: MATTHEW TOA DBA INSURER C; V „ 092 SANDWICH INSURER D; P 0 BOX 694 SAGAMORE, MA_02561 INSURER E; COVERAGESINSURER F 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. LTR TYPt OF INSURANCE POLICY NUMB FA GENERAL LIABILITY -17 F fLDD1YYW MIDD LfNITB A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 31,000,000 CP81206928 /31/2010 /3%/2011 MISEsrEaoclx,rlenre 5100,000 CLAIMS-MADE OCCUR MED EXP one Paroon) $5,000 PERSONAL&ADV INJURY 91,000,000 GENERAL AGGREGATE S2,000,000 OEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO' LOO PRODUCT.•COMPIOPAOG $2,000,000 AUTOMOBILE UA131UTY s LVMBINED LE LfMrr ANYALI710 (Ee ecdtlent ALL OWNED SCIJEDULEO BODILY INJURY(Par person) S AUTOS AUTOS BODILY INJURY(Per acddwgl HIRED AUTOS AUTOS RTYOWNED ` S er ecdtlenll UMBRELLA LIAR OCCUR s EXCESS LIAR CLAMS-MADE OCCURRENCE S ! DED RETENTION E aWREGATE WORKERS COMPBNSAIfoN : AND EMPLOYERS'LIABILITY Y/N WC STATU O lm. ANY PROPRIET OFMCERIMEMBE�R UCLUDED?ATNERfEXEC�� � N I A (Mandatory In NH) EL.EACH ACCIDENT y If ne.despribe under E.L.DISEASE-EA EMPLOYEE 1 DESCRIPTION OF OPERATIONS Celow 121,DISEASE.POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(AKeph ACORD 101,Addltfongl game&SchadUle,If more aPI[ca(a requfredl CARPENTRY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE RICK ROY CMAwRU=z0p THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 123A AUR&N Alm RAW ACCORDANCE WITH THE POLICY PROVISIONS, HARWICRr MA 02645 . AUTNORt7.�v ACORD 25(201DIOS) The ACORD name and logo are registered marks of ACORDCORD CORPORATION. All rights reserved, "dulled using Forma Boss Plum poft"ra•Www,FOM18808e.eom;Imprsr6SIVe Publishing SOD•208.1977 4 of�ram, • aaxxs•rist,e. MASS. Town of Barnstable prEp Mp'(A Regulatory Services Thomas F..Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 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 A Builder I, 16 6 -f - as Owner of the subject property hereby authorize nick goY Cons 64cL ,iUr L LC. to act on my behalf, in all matters relative to work authorized by this building permit application for: oil Crocker Ro"CA (Address of Job) i tur f Own r Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Out)ook\DDV87AAZ\EXPRESS.doc Revised 072110 Town of Barnstable Regulatory Services t��rtrzsr�at:e Thomas F.Geiler,Director t6)9. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Off-ice: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor, DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling, attached or detached structures accessory to such^use and/or farmistructures: A person who constructs more than one home in a two-year period shall not be considered a"hortteownr. "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.perrrliO.(Sentigpjj l.I.1).ys'r � x The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations._ I The undersigned"homeowner"certifies that he/she understands the To,W-n of Barnstable BAilding Department minimum inspection procedures and requirements and that he/she Will'compty'wi[k•said procedures and requirements. Signature of Homeowner t 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 requiFed shaltbe;cxempt from'the Arovisions of this section Section 109.1.1 -Licensing-of of construction Supervisors); rovided that if the homeowner cn es a" cr'soti s• for hire to do snch ( gP !gig P (�•) 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 ofawareness 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 fomn/certification for use in your community. Q:forms:homeexempt l Nlassachusetts- Department of Public Safety Board of Buildim- Re!-ulations and Standards Construction Supervisor License License: CS 47185 Restricted to: 1 G RICHARD J ROY PO BOX 25 S CHATHAM, MA 02659 ��- Expiration: 7/14/2011 ('ununissiuncr Tr#: 18528 Otfice0�ons Airsfieiness egu ati'�one License or registration valid for individul use only TOY HOME IMPROVEMENT CONTRACTOR before the expiration date. If.found return to: Registration: 111696 Type: Office of Consumer Affairs and Business Regulation Expiration: Qf2013 Ltd Liability Corporati 10 Park Plaza-Suite 5170 Boston,MA 02116 CONS I /7, RICHARD ROY 123A QUEEN ANN^ HARWICH,MA025.�a% �, J Undersecretary Not valid without sig a re I C;HU (.0,`KLH HOAU . . 273-37 i - i g9 S� PARCEL A Q �'f3-t 7��f i. 0 �t 34 i 138.03 PARCEL ' ;; PLOT PLAN OF LAND /N �B BA RNS TA L E, MASS PREPARED FOR YANKEE SURVEY CONSUL. TANTS l4/ RDUTE /49 JOSEPI�-�l DeMARRNe MARSTONS M/LL$. MASS. 0 40 e0 120 02648 SCALE. /"= 40 feel November /; /987 RE$. ZONE: RF FL OO40 ZONE: C ' PLAN BOOK 39/— 97 i0 Wn i i f HEro Barnstable o . . Old Kn s High trict ConimitteeWa Ds . . ' 2001V1ain.Street Hyannis, MA 02601;TEL: 508-862'4787 Fax 508-862-4784 �p i6J9. `0ro APPEYCATION, 'CERTTFICATE OF APPROPRIATENESS Application is hereby made, with four(4) complete sets, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 47A,Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans,drawing s,:or photographs accompanying this application for: Chdck all categories that apply; 1. Building construction: ❑ New Addition ❑ Alteration. 2. Type of Building: ❑ House ® Garage/barn ❑ Shed ❑ Commercial ❑ Other. 3. Exterior Painting, roof new roof color/material change, of trim, sidin' 'window, door 4. Sign : . ❑ .New Sign ❑ Existing Sign ❑ Repainting Existing Sign 5: Structure: ❑ Fence ❑. Wall. ❑ Flagpole ❑ Retaining wall ❑ tennis court ❑ Other 6: Pool ❑ swimming El'-Other man-made pool. 'Type or Print Legibly: Date: 3=214— 1 1 Address of proposed`work: House# °« Street: CcoGl�pt:��cid�. Village �Qg� �rrfs blt Assessors Map Lot# 1 � Descripfion.of Proposed Work:.* Give parti/c�ulars of work to be done: o C�X .j (AV' VGA POt q�CAq'e;� �Y�a.� �S �aS�` mod^ 0i ��n�l� ��•r��� � �wP��i�1a to onol�i 1c�nP� SOG�2 , nn i1�5u,a �v; no nce in bpi/of+n airin� 1JPj,j UQ ,n Agent or Contractor.(piint): I�i C� 'Rpv t6i,gl�ty(_� Cq) Telephone Address: 12 3 A U PA rx ANAR 0,W11 A Contractor/Agent''signature: NOTE.411 applications must be.signed by*the current owner Owner(print): Telephone#: So 8' 4 to- 914(a . Owners mailing address: °I CraC�Ap r V,00.elt Owner's signature: or.committee use only. This Certificate is hereby ROVED DENIED RECEIVED Date Members signatures MAR'2 4 2011 �. TOWN OF BARNSTABLE HISTORIC PRESERVATIO Any c ns o a val: APR 13 Town of Barnstable Old Kings Highway Committee ICMD=GroiVslMld'Kui sHi hwa IOK/ilVewA 10KHCertA ro riatenes07.doc ':Q�. G '. � 8. 8 Y PP PP P Town of Barnstable Old King's Highway Regional Historic Distrigt Committee CERTIFICATE OF APPROPRIATENESS SPEC SHEET Please submit 4 copies Foundation Type: (Max. 18"exposed) (material-brick/cement, other) CO ne f-C t e_ Siding Type 1 A 12 S i A i n a material: Ctod et r Color: n e, Chimney Material: Color: N A, Roof.Material: (make& style) -- Ck(-(_ ��reh(AN OSPVNA\ "' Color: bI.Qe,k Trim material lnN0 ock170,i^ P Color: tNA)a m "c� eki; sur Roof Pitch: (7/12 minimum) Window: l make/mode J ( ) :� cS��t, �� 2&�°`V� material .Wood �_ color enb64r_ Meik� Size(s): I Z'-- •• n �`•_ $•. Door style and make: q `�;_}� � p kc material F;bera1A55 Color: _pg �c� WI^, ke, Garage Door, Style (_oqcjA,,...ci1 (_b3v Size 9X Material +ee (aM os� Color N.Aw ts� e �-,p Iv�afcb. 3r i +h Shutter Type/Matetial: .N Color: Gutter Type/Material: NLA Color: Decks: material NHS j A Size Color: Skylight, type/make/model/: fixed V t1 VeOt-material Color: \,dt�k Size: Z$ x 3� Sign size: A Type/Materials: RECEIVED--. Fence Type(max 6') Style_NIA A material: Color: AR Retaining wall: Material: NJ 1 A TOWN OF BARNSTABLE HISTORIC 5��� .Lighting, freestanding N A on building 2 wAtt Bann,- illuminating sign Please provide samples of paint colors and manufacturers brochure of style of windows,doors, garage.door, fences, lamp posts etc ADDITIONAL INFORMATION: APR. 13'2011 Town of Barnstable f Old K'dZjejttegehw Signed...(plafrpreparer) print name ael :no:_ g -y�a- ;/C) . Loea :o of a cation: Street no: 3 X} Street _cDy �u AWAA(s i� Village /G(� 2 QrIGMDCro..psl01*dKings Highway 10KHHewApplOKHCeri Appropriateness 07.doc . RRcR EXISTING CEDAR ROOF RICK a ROY TO REMAIN ON EXISTING CONSTRUCTION ' GARAGE ADDITION 1. LLC I "1 ^ \\ IIIIr�J��/—I1jfII —• —.RktR.yCarobueti-- RICK CONSTRUCTION ST U N R 'I'I'I---"'ttilll���(((III 1 r/ J' \•!) IILJJJ G��! RICK QROYUEENA NERD D 771A QUEEN ANNE ROAD EXISTING I DEMOLITION NORTH HARWICH,MA D PROPOSED NORTH ELEVATION 1 ELEVATION 508-432a840 508-432-4814 RROVCONCCOMCAST.NET NEW ADDITION AND EXISTING MAIN ROOF TO RELIEVE NEW 'ARCHITECTURAL ASPHALT SHINGLES i I NEW DOUBLE HUNG WI APPROVED NDOW TO MATCH c EXISTING Twxas � Ll SIDINGTOOVERLAP =1III�III f= ''� APR. 13 201 A` CONCRETE FOUNDATION EXISTING/DEMOLITION EAST A�V\ WALL.EXPOSED PORTION pROPOSED EAST ELEVATION E" 2 ELEVATION __ _ _ _ �I VV OF FOUNDATION WALL 8 NOT TO EXCEED 18" Town of Barnstable Old King's Highway Committee REMOVE EXISTING SIDING TO OVERLAP TRIM AND RAFTER CONCRETE FOUNDATION ENDS WALL EXPOSED PORTION OF FOUNDATION WALL NOT TO EXCEED 18" Description Dass Rio-r-ni rM �_ �— EXISTING/DEMOLITION SOUTH 7 PROPOSED SOUTH ELEVATION 9 ELEVATION JEFFMOORE y 99 CROCKER ROAD NEW 9'X8'GARAGE DOOR . EXTERIOR ELEVATIONS ® — NEW DOUBLE"8 LITE DOUBLE DOOR dQ QO d PERMIT SET EXISTING/DEMOLITION WEST 8 PROPOSED WEST_ELEVATION_ ELEVATION Drawn by AG 1'-E" -- 4 1/8"=1'-O" Cneckea M AG i A2.1 swro 1/8"=1'-0" 99 CROCKER ROAD RICK ROY JEFF MOORE CONSTRUCTION_ LLC w RkkRoyCombueton.mm PROJECT INFORMATION CONTRACTOR/DERIONER RICK ROV CONSTRUCTION - < 123A OUEEN ANNE ROAD y HARVACH.MA C 508d3268d0 PROJECT ADDRESS:99 CROCKER ROAD,WEST BARNSTABLE,MA arso c4814 CA6T.NET PROPERTY OWNER:JEFF MOORE _ PROJECT DESCRIPTION:ADDITION TO AN EXISTING GARAGE r t r •' w�`t=., - - i� ZONING INFORMATION:RF ' ,._`"5- •-, %' FRONT SETBACK: 30' SIDE SETBACK: 15' REAR SETBACK: 15' ,�. FLOOD INFORMATION:NOT IN FLOOD ZONE AUTHORITY HAVING JURISDICTION:TOWN OF BARNSTABLE r i - 9 CODES:MSBC,7TH EDITION Sheet List ' Sheel Number Sheet Name No. Descrl bon Dbm AO.1 PROJECT INFORMATION A1.1 SITE PLAN A1.2 FLOOR PLAN A2.1 EXTERIOR ELEVATIONS A2.3 INTERIOR ELEVATIONS A3.1 FRAMING SECTIONS A4.1 SCHEDULES A5.1 EXISTING PHOTOGRAPHS VICINITY MAP LOCATION MAP JEFF MOORE I�SITE ` .. �•� � I "- 99 CROCKER ROAD J PROJECT INFORMATION RECEIVED MAR 2 4 2011 ©L tom[ .,.� ay� �.` � i�`�� PERMIT SET BLE '� �.. r e� �` —��`• OmD.—y AG TOWN OF BARNSTA HISTORIC PRESERVATION a � mp, , J t G^eekabby AG •�aEl`�y-��.i34•J-1S,•" �`.i''(.��ti :�i �` J• ,/ /� AO. 1 e �I I•I��_l. �l �� .. —+a \ — •� � some 1 RJR PICK ROY CONSTRUCTION � � b / v .RickRoyConeaucuon.com / _—————-_—__—___ ___ �' � ——7 / CONTRACTOR/DE610NER RICK ROY CONSTRUCTION 123A QUEEN ANNE ROAD HARIMCH, / 508-43248 0 508-032-081414 RROYCONGCOMCAST.NET EXISTING 2 STORY HOUSE / EXISTING GARAGE HATCHED REGION / SHOWS AREA OF NEW WORK0. No. Deacriptlon Dote SITE PLAN BASED ON ATTCHED SURVEY RECEIVED � JEFFMOORE o. � y � 99CROCKER ROAD / �M 4R 2 4. 2011 SITE PLAN / TOWN OF SARNSTABLE HISTORIC PRESPE VATION \ PERMIT SET 1 Site Plan Dmwnty AG 1"=30'-0" Chocked by AG�. ... p A1 . 1 seek, 1.. 301-01, . RJR RICK ROY CONSTRUCTION LLC A2.1 W ..RlckReyCeemt—don.mm 5 1 A3.1 CONT a TOR/D SIGNER _ RICK ROY CONSTRUCTION 123A QUEEN ANNE ROAD t08-432 MA .. .. 505-03241&40 508 4324814 RROYCONOCOMCAST.NET A2.1 S El8 A2.7 ti W. P No. Deacrl don Date F, ro r' JEFFMOORE RECEIVE® Eno• 24•3 I 99 CROCKER ROAD MAR 2 4 2011 / FLOOR PLAN A21 TOWN OF BARNSTABLE HISTORIC PRESERVATION n First Floor PERMIT SET Checked by AG 10 A1 .2 Sale 1/4"=1'-0" RICK CEDAR ROOF RIYf GS L ROY TO REMAIN ON EXISTING CONSTRUCTION GARAGE ADDITION LLC fr r RlckRoyCamo ton.mm FRE E! `—I� I M MO E610NER RICK ROY CONSTRUCTION 123A QUEEN ANNE ROAD EXISTING/DEMOLITION NORTH HARWCH,MA n PROPOSED NORTH ELEVATION n ELEVATION 5084328840 508432-4814 1l8"=1'-0" RROYCONOCOMCAST.NET NEW ADDITION AND EXISTING MAIN ROOF TO RECIEVE NEW ARCHITECTURAL ASPHALT SHINGLES NEW DOUBLE HUNG - WINDOW TO MATCH EXISTING _ iw2e4e SIDING TO OVERLAP CEIVED - CONCRETE FOUNDATION ~— WALL.EXPOSED PORTION EXISTING/DEMOLITION EAST OF FOUNDATION WALL 6 PROPOSED EAST ELEVATION 2 ELEVATION NOT TO EXCEED 18" 1/8"=1'-0" MAR 2 G. 2011 TC YN OF BARNSTABLE SIDING TO OVERLAP HISTORIC PRESERVATION CONCRETE FOUNDATION WALL EXPOSED PORTION OF FOUNDATION WALL NOT TO EXCEED 18" ---------------, No. I D—llpft Oaae EXTEND PAVEMENT TO GARAGE DOOR APRON ��.'` ' . •' �i 1=1 — ��—���—� �®_emu® ®'—� Ilia I=1II-III=III=III=1I1= EXISTING/DEMOLITION SOUTH 7 PROPOSED SOUTH ELEVATION 3 ELEVATION ..f JEFF MOORE d 99 CROCKER ROAD NEW 9'X8'STAIN GRADE EXTERIOR ELEVATIONS ® DOOR TO MATCH EXISTING NEW 60"X80"9 LITE DOUBLE DOOR NEWPAVEMENTTO ...; ...., ... .. .; . .., .•.. .. ALIGN WITH APRON '. PERMIT SET EXISTING I DEMOLITION WEST n PROPOSED WEST ELEVATION 4 ELEVATION 0.—by AG 1/8"=1'-0" Cnacked by AG A2. 1 RCR RICK ROY CONSTRUCTION ' — — — — Roo f�A-,, LLC 18'-WT—Ky viww.RlekROYLonaoucuon.mm NEW 2X4 WALL (/ EXISTING 2X6 @ 16"O.C. CONT ACTOR/D cl N R NEW 2x10 @ 18"O.C. — EXISTING 2X8(B 18"O.C. RICK ROE CONSTRUCTION 123A QUEEN ANNE ROAD NEW 2%8 @ 16"O.C. 508- � 432-48 1443Z•aata 50 to I RROYCON®COMCAST.NET h - T.O.PLATEEAQ 9'-B 1/2" V EXISTING 2X4 @ 16"O.C. STUD WALL WITH CDX rm.. SHEATHING 9 LLUEXISTING 8"CONCRETE m b WALL,T-9"HIGH POUR WITH m 16"X 8"FOOTING F. b EXISTING 4"CONCRETE SLAB Foundation 1'.0 " \—1 . .. . — — — �- First Floo_r_.n 0. V 7. T.O..Footi�_n B.O.Footin - 1 Section 1 �I W. Desarlptl- out. JEFF MOORE I R ER ROAD FRAMING SECTIONS MAR 2 4 2011 TOWN OF BARNSTABLE HISTORIC PRESERVATION PERMIT SET D.—by AG Chnk.d by AG A3.1 NEW ADDITION ON THIS SIDE OF EXISTING GARAGE � `,����� CONSTRUC"TION - `. vnvx.RbkR.yCommwtion.eom --- -- — — --- --- - ~ -" CONTRACTOR/DE6IGNER J I RICK QUEENA NERD D 723A QUEEN ANNE ROAD H 8432-S,MA .. lr� t 60B•a3266e0503432-0614 RROVCONOCOMCA6T.NET - f — � GikC1 � �� •. 1 i No. De.orl Don Date f� IF �w t( '4' � JEFF MOORE ` n D R ROAD EXISTING PHOTOGRAPHS l U MAR 2 2011 TOWN OF BARNSTABLE HISTORIC PRESERVATION PERMIT SET Dr.—by AG Checked by AG A5.1 6wk Swdreson Structural, Inc. Paul W.Swanson,P.E. 116 Forest Street Engineering Services Franklin,MA 02038-2579 commercial Phone 508-520-1333 residential Fax 508-520-1334 heavy timber Pau nsonStructuraLcom IWO 0 it K -L a4s P T---T- Ojj I IY2/11 1 A, L IA laka cA iV !P EE s�� _ ', _- __?`►—�-- !-�—T- _� _L- p 54 L Is 5 !7V ! Ae S(57- L.VA P 1 7-b sq,,r)if I AVA Wick z PA r i —i - ..i._ 'V - -- 4- 15 . j u- 7 PROPOSED WEST ELEVATION T 4*UIVY WA Low ;rroi?GE. aAJ Job Name Oke4Qc ADNTwl Job Number 4105- Location 99 C-AC?6V-t-f9 P-I>. Sheet of Client AIC16 AOY e-vwc.'r. t.t-c- B, PWS Date 7—/ Main Wind Force Resisting System—Method 1 h:5 60 ft. Figure 6-2 Design Wind Pressures ' Walls & Roofs Enclosed Buildings F E a :H O , © \ Transverse � E z —--- Longitudinal 4 - Notes: . I. Pressures shown are applied to the horizontal and vertical projections,for exposure B,at h=30 ft(9.1 m),for 1=1.0. Adjust to other exposures and heights with adjustment factor X. ? 2. The load patterns shown shall be applied to each comer of the building in tam as the reference corner.(See Figure 6-10) 3. For the design of the longitudinal M WFRS use 0=0',and locate the zone E(F,G/H boundary at the mid-length of the building. 4. Load cases 1 and 2 must be checked for 25'<0 5 45'. Load-case 2 at 25'is provided only for interpolation between 25'to 300. 5. Plus and minus signs signify pressures acting toward and away from the projected surfaces,respectively. 6. For roof slopes other than those shown,linear int erpolation terpolation is permitted. � 7. The total horizontal load shall not be less than that determined by assuming ps=0 in zones B&D. 8• The zone pressures represent the followings Horizontal pressure zones—Sum of the windward and leeward net(sum of internal and external)pressures on vertical projection of A- End'zone of wall C- Interior zone of wall ' B- End zone of roof D- Interior zone of roof ! Vertical pressure zones—Net(sum of internal and erttemal)pressures on horizontal projection of.. i E- End zone of windward roof 0- interior zone of windward roof Y F- End zone of leeward roof H- Interior zone of leeward roof 9• Where zone E or G falls on a roof overhang on the windward side of the building,use EoH and GoH for the,pressure on the horizontal Projection of the overhang. Overhangs on the leeward and side edges shall have the basic zone pressure applied. 10. Notation: 10 percent of least horizontal dimension or 0.4h,whichever is smaller,but not less than either 4%of least horizontal dimension or 3 ft(0.9 m). - • h: Mean roof height,in feet(meters),except that eave height shall be used for roof angles<10'. 0' Angle of plane of roof from horizontal,in degrees. '• roimum Design Loads for Buildings and Other Structures 41 '' ' • z Main Wind Force Resisting System-Method 1 h<_60 ft. . Figure 6-2(cont'd) Design Wind Pressures Walls & RO®fS Enclosed Buildings Simplified Design Wind Pressure , ps30 (psf) (Exposure 8 at =30 ft.with *to,115 Zones Basic Wind Horizontal Pressures Vertical PressuresOverhangs Speed A BCpEFC H EoH Gom (mph) 11.5 -5.9 7.6 -3.5 -13.8 -7.8 A.6 -0.1 -19 3 -151 12.9 .5.4 8.6 -3.1 -13.8 -8.4 9.6 .6.5 -19.3 -15.1 14.4 -4.8 9.6 -2.7 -13.8 -9.0 -9.6 -6.9 -19.3, -15.1 85 15.9 ■3.2 10.6 •2.3 -13.8 -9.6 -9.6 -7.3 -19.3 -15.1 14.4 23 10.4 2.4 6.4 $.7 �:6 -7.0 -11.9 -10.1 -2.4 -4.7 -0.7 -3.0 1 12.9 8.8 10.2 7.0 1.0 -7.8 0.3 -6.7 -4.5 -5.2 12.9 8.8 10.2 7.0 .5.0 3.9 4.3 -2.8 -4.5 -5.2 0 to 5° 1 12.8 -6.7 8.5 -4.0 -15.4 -8.6 -10.7 -6.8 -21.6 -16.9 10° 1 14.5 -6.0 9.6 -3.5 -15.4 -9.4 -10.7 -72 -21.6 -16.9 15° 1 16.1 -5.4 10.7 3.0 -15.4 -10.1 10.7 -7.7 -21.6 -16.9 9® 20° 1 17.8 4.7 11.9 -2.6 -15.4 -10.7 -10.7 -8.1 -21.6 -16.9 25° 1 16.1 .2.6 11.7 2.7 -72 -9.8 52 -7.8 -13.3 -11.4 2 -27 -5.3 -0.7 -3.4 - 30 to 45 1 14.4 9.9 11.5 7.9 1.1 -.8 0.4 -7.5 -5.1 -5.8 2 14.4 9.9 11.5 7.9 5.6 -4.3 4.8 -3.1 -5.1 -5.8 0 to 5° 1 15.9 -8.2 10.5 -4.9 -19.1 -10.8 -13.3 -8A -26.7 -20.9 10° 1 17.9 -7.4 11.9 4.3 -18.1 -11.6 -13.3 -8.9 -26.7 -20.9 15° 1 --12.9 _ -0.6._ _ 8 -19.1 =124_ -13.3 -9.5 -26.7 -20.9 �® 20° 1 22.0 -5.8 14.6 -3.2 -19.1 -13.3 -13.3 10.1 -26.7 -20.9 25° 1 19.9 3.2 UA 3.3 -8.8 -120 -6.4 -9.7 -16.5 -14.0 2 -3.4 -6.6 -0.9 -42 - 30 to 45 1. 17.8 122 14.2 9.8 1.4 -10.8 0.5 9.3 6.3 -7.2 2 17.8 122 14.2 9.8 6.9 -5.3 5.9 3.8 -6.3 T2 o to 5° 1 192 -10.0 12.7 -5.9 -23.1 -13.1 -16.0 -10.1 323 -25.3 10° 1 21.6 -9.0 14.4 -5.2 -23.1 -14.1 -16.0 -10.8 32.3 -25.3 15° 1 24.1 -8.0 16.0 4.6 -23.1 -15.1 -16.0 -11.5 -32.3 -25.3 110 �® 20° 1 26.6 -7.0 17.7 -3.9 -23.1 -16.0 -16.0 -122 -323 -25.3 25° 1 24.1 3.9 17.4 4.0 -10.7 14.6 -7.7 -11.7 -19.9 -17.0 2 - -4=- -13.1 1 -79 -1.1 5.1 - 30 to 45 1 21.6 14.8 1T.2 11.8 0.6 -11.3 -7.6 8.7 2 21.6 14.8 17.2 11.8 72 -4.6 -7.6 -8.7 0 to 5° 1 22.8 -11.9 15.1 -7.0 -27.4 -15.6 -19.1 -121 -38.4 30.1 10° 1 25.8 -10.7 17.1 6.2 -27.4 -16.8 -19.1 712.9 38.4 30.1 1 15° 1 28.7 -9.5 19.1 -5.4. -27.4 -17.9 -19.1 -13.7 -38.4 -30.1 20° 1 31.6 -8.3 21.1 -4.6 -27.4 -19.1 -19.1 -14.5 38.4 30.1 25° 1 28.6 120 4.6 20.7 4.7 -12.7 -17.3 -9.2 -13.9 -23.7 20.2 2 -4.8 -9.4 -1.3 -6.0 -- 30 to 45 1 25.7 17.6 20.4 14.0 20 -15.6 0.7 -13.4 -9.0 -10.3 10.3 2 25.7 17.6 20.4 14.0 9.9 -7.7 8.6 5.5 -9.0 0 to 5° 1 26.8 -13.9 17.8 -8.2 -32.2 -18.3 -22.4 -14.2 -45.1 -35.3 . 10° 1 30.2 -125 20.1 -7.3 -32.2 -19.7 -224 15.1 45.1 35.3 15° 1 33.7 -11.2' 22.4 -6.4 -32.2 -21.0 -224 16.1 -45.1 35.3 g �?J® 20° 1 37.1 -9.8 24.7 -5.4 32.2 -22.4 -22-4 -17.0 -45.1 -35.3 25° 1 33.6 5.4 24.3 5.5 -14.9 -20.4 10.8 16.4 -27.8 23.7 9 2 _ -5.7 -11.1 -1.5 30 to 45 1 30.1 201.6 24.0 16.5 2.3 -18.3 0.8 -15.7 -10.6 -12.1 2 30.1 24.0 16.5 11.6 -9.0 10.0 -6.4 -10.6 -12.1 3 ( Unit Conversions-1.0 ft=0.3048 m; 1.0 psf =0.0479 kN/m2 C ' B 6 ti ASCE 7-02 42 ara••^••.auua �ruu vcuv uauwa a.va .•va.w w+�taa wa..i +�jv + �+ + tom"" Maximum Span Calculator for Wood Joists & Rafters www.awc.or Species SpnceneFr=ice=-E: Size 3z o== m— _=- Grade _== Member Type ;iRaRer�.;(5n0.w�4oad)= ___= Deflection Limi Spacing (in) Wet service conditions? nro-v =_===s= _ _= Exterior Exposure Incised lumber? Snow Load (psf)1130 Dead Load (per iao = = A -., . Calculate Maximum HortzonLal Span�, �� Go-to Span OpSons CalcvlaYor Fo�'Wood?oisFs&Rafters- TIN1TiSOFOSE�� _�_ �JE�P _ � =RESTART= Span Calculator for Wood Joists and Rafters F` � available'for the i0hone. The Maximum Horizontal Span is: 18 ft. 5 in. with a minimum bearing length of 0.77 in. re uired at each end of the member. Property !Value Species Spruce-Pine-Fir Grade Size 2x10 Modulus of Elasticity(E) 111400000 psi Bending Strength (Fb) 1272.91 psi Bearing Strength (FCp) 425 psi Shear Strength (FV) 155.25 psi While every effort has been made to insure the accuracy of the information presented, and special Comments? info@awc.org. effort has been made to assure that the information reflects the state-of-the-art, neither the American Wood Council nor its members assume any responsibility for any particular design prepared.from this Online Span Calculator. Those using this Online Span Calculator assume all liability from its use. http://awc.org/calculators/span/calc/timbercalestyle.asp?species=Spruce-Pine-Fir&size--2x l... 5/2/2011 Swdnson S.1ructural, Inc. Paul W.Swanson,P.E. 116 Forest Street Engineering Services Franklin,MA 02038-2579 commercial Phone 508-520-1333 residential Fax 508-520-1334 heavy timber* Pau l(a)SwansonStructuralcom .......... 171 2 IAA P -7 f 7 2V`166LA ig_ A. -511 T7.0 j 1 1,L! 517' IOAV f d04 20 IIV �'- t - 1 i I -l-l-Zf i II 0 �A__LL S LW-44 1 1 All. f pe- Oka -V VIL ........... nn/ Aft: PROPOSED WEST ELEVATION Pet C-I A-L_ 60A�5 Mc/rl .0 S WAIt !I�pAcg�- ....... Job Name GMAQ6 A06117061 Job Number Location 99 C_AVCIV_eIz 21). W _AA 9)V5T_"L6_ AM —Sheet / of Client Alck /toy ( .Vjvsr I.u- By PINS Date 5 211 Main Wind Force Resisting System—Method 1 h 5 60 ft. Figure 6-2 Design Wind Pressures ~� Walls & Roofs Enclosed Buildings O O O O TZ - eWflBf\ O - •r• •e \\i T - Transverse m . o E O cow ---- ALongitudinal . � F Notes: I. Pressures shown are applied to the horizontal and vertical projections,for exposure B,at h=30 ft(9.1m),for 1=1.0. Adjust to other exposures and heights with adjustment factor k , 2- The load patterns shown shall be applied to each comer of the building in turn as the reference comer.(See Figure 6-10) 3" For the design of the longitudinal M WFRS use B=0°,and locate the zone E(F,G/H boundary at the mid-length of the building. 4- Load cases I and 2 must be checked for 250<B<—450. Load-case 2 at 25°is provided only for interpolation between 25'to 30°. - 5. Plus and minus signs signify pressures acting toward and away from the projected surfaces,respectively. - — 6• For roof slopes other than those shown,linear interpolation is permitted. , 7- The total horizontal load shall not be less than that determined by assuming ps=0 in zones B&D. 8- The zone pressures represent the following- Horizontal pressure zones—Sum of the windward and leeward net(sum of internal and external)pressures on vertical projection of A- End zone of wall C- Interior zone of wall B- End zone of roof D- Interior zone of roof ' Vertical pressure zones—Net(sum of internal and external)pressures on horizontal projection of. i E- End zone of windward roof G- Interior zone of windward roof F- End zone of leeward roof H- Interior zone of leeward roof •- 9• Where zone E or G falls on a roof overhang on the windward side of the building,use EoH and GOB for the.pressure on the horizontal Projection of the overhang. Overhangs on the leeward and side edges shall have the basic zone pressure applied. 10. Notation: f a: 10 percent of least horizontal dimension or 0.4b,whichever is smaller,but not less than either 4%of least horizontal dimension ' or 3 ft(0.9 i h: Mean roof height,in feet(meters),except that eave height shall be used for roof angles<10°. g• Angle of plane of roof from horizontal,in degrees. ? ':':"Minimum Design Loads for Buildings and Other Structures 41 z Main Wind Force Resisting System-Method 1 h<_60 ft. . Figure 6-2(cont'd) Design Wind Pressures Walls & Roofs Enclosed Buildings Simplified Design Wind Pressure , ps30 (psfl (Exposure a at h=30 ft.with 1=1.0) m Zones Basic Wind Roof U Horizontal Pressures Vertical Pressures Overhangs Speed Angle e A B C p E F H Eon+ Gw _ (mph) (degrees) 0 to 5° 1 11.5 5.9 7.6 3.5 -13.8 -7.8 9.6 -6.1 -19.3 -151 10°, 1 12.9 5.4 8.6 3.1 -13.8 -8.4 9.6 6.5 -19.3 -15.1 15° 1 14.4 �.8 9.6 -2.7 -13.8 -9.0 -9.6 6.9 -19.3, 15.1 �5 20° 1 15.9 -4.2 10.6 -2.3 -13.8 -9.6 -9.6 -7.3 -19.3 -15.1 25° 1 14.4 23 10.4 2.4 -6.4 $.7 4:6 -7.0 -11.9 -10.1 2 -2.4 .4.7 -0.T 3.0 -- 30 to 45 1 129 8.8 10.2 7.0 1.0 -7.8 0 3 6.7 �.5 5.2 2 1 -9 8.8 10.2 7.0 .5.0 -3.9 4.3 -2.8 -4.5 5.2 0 to 5° 1 12.8 .6.7 8.5 -4.0 -15.4 -8.8 -10.7 6.8 -21.6 -16.9 10° 1 14.5 �.0 9.6 .3.5 -15.4 9.4 10.7 72 •21.6 -16.9 15° 1 16.1 -5.4 10.7 -3.0 -15.4 -10.1 -10.7 -777 -21.6 -16.9 90 20° 1 17.8 -4.7 11.9 -2-6 •15.4 -10.7 10.7 8.1 -21.6 -16.9 25° 1 16.1 26 11.7 2.7 -72 -9.8 52 -7.8 -13.3 -11.4 til -2.7 -5.3 -0.7 -3.4 30 to 45 .4 �9.9 115 �7j9 1.1 -8.8 0.4 -7.5 5.1 -5.8 .4 11.5 5.6 -4.3 4.8 3.1 5.1 5.8 0 to 51 1 15.9 -8.2 10.5 -4.9 -19.1 -10.8 -13.3 -8.4 -26.7 -20.9 10° 1 17.9 -7.4 11.9 4.3 -19.1 -11.6 -13.3 8.9 -26.7 -20.8 15° -1 --19.9 - _ 6.6- 8 -19.1 =124_ -13.3 -9.5 -26.7 -20.9 ®0 20° 1 22.0 -5.8 14.6 -3.2 -19.1 -13.3 -13.3 -10.1 -26.7 -20.9 25° 1 19.9 3.2 14.4 3.3 -8.8 -12-0 -6.4 -9.7 -16.5 -14.0 2 -3.4 -6.6 -0.9 -42 -- 30 to 45 1. 17.8 122 14.2 9.8 1.4 . A0.8 0.5 -9.3 -6.3 -7.2 2 17.8 122 142 9.8 6.9 -5.3 5.9 -3.8 -6.3 -72 0 to 5° 1 192 -10.0 12.7 -5.9 -23.1 -13.1 -16.0 -10.1 32.3 -25.3 10° 1 21.6 -9.0 14.4 -5.2 -23.1 -14.1 -16.0 -10.8 32.3 -25.3 15° 1 24.1 $.0 16.0 -4.6 -23.1 .15.1 -16.0 .11.5 -32.3 -25.3 110 �® 20° 1 26.6 -7.0 17.7 -3.9 -23.1 -16.0 -16.0 -12.2 -32.3 -25.3 25° 1 24.1 3.9 17.4 4.0 -10.7 -14.6 -7.7 -11.7 -19.9 -17.0 2 -4.1 -7.9 -1.1 -5.1 -- 30 to 45 1 21.6 14.8 17.2 11.8 1.77 -13.1 0.6 -11.3 -7.6 •8.7 2 21.6 14.8 17.2 11.8 8.3 -6.5 72 -4.6 -7.6 $.7 i 0 to 5° 1 22.8 -11.9 15.1 -7.0 -27.4 -15.6 -19.1 - 221 38.4 -30.1 10° 1 25.8 -10.7 17.1 52 -2T.4 -16.8 -19.1 -12.9 38.4 30.1 -27.4 17.9 -19.1 -13.7 -38.4 30.1 15° 1 28.7 -9.5 19.1 -5.4. 1�® 20° 1 31.6 -8.3 21.1 -4.6 -27.4 19.1 19.1 -14.5 -38.4 -30.1 25° 1 28.6 4.6 20.7 4.7 -12.7 -17.3 -9.2 -13.9 -23.7 20.2 2 1t.8 -9.4 -1.3 -6.0 --- -- 30 to 45 1 25.7 17.6 20.4 14.0 20 -15.6 0.7 -13.4 -9.0 -10.3 2 25.7 17.6 20.4 14.0 9.9 -7.7 8.6 -5.5 -9.0 -10.3 p to 1 26.8 -13.9 1 .8 -82 -32.2 -18.3 22 -142 �5.1 35.3 . 10° 1 30.2 -12.5 20.1 -7.3 -32.2 19.7 -22.4 -15.1 45.1 35.3 15° 1 33.7 -11.2- 22.4 -6.4 *-32.2 -21.0 -224 -16.1 -45.1 -35.3?J® 20° 1 37.1 -9.8 24.7 -5.4 2 224 -224 -17.0 45.1 35 3 25° 1 33.6 5.4 24.3 5.5 .9 -20A -10.8 -16.4 -27.8 23.T 5 2 .7 -11.1 -1.5' -7.1 -- 30 to 45 1 30.1 20.6 24.0 16.5 2.3 18.3 0.8 15.7 -10.6 2 30.1 20.6 24.0 16.5 11.6 -9.0 10.0 -6.4 -10.6 12.1 E Unit Conversions-1.0 ft=0.3048 m; 1.0 psf =0.0479 kN/m2 i . t E ASCE 7-02 A 42 a.au^• +•iuu �Yuia vuavuauwa tva .•va.w w avaawa. +�jv + "+ + " Maximum Span Calculator for Wood Joists & Rafters www.awc.or Species ;Spruie;PirieFr_L— Size 2X1o _` Grade Nd2= -'--G_-=` Member Type RaRer ;(Snow:oad)= Deflection Spacing Wet service conditions? Exterior Exposure _=-- --Incised lumber? Snow Load (psfI)II30 Dead Load (per 3'_9 -_" Calculate;MaximumHonzontal Span Gorta span Olidons Calculator forWo tl 7oists&Rafted �• — :s 3NTR QFOSE . 7 _FjEEP-- Span Calculator for 0 . e Wood Joists and Rafters r ;_, available for the i0hone. The Maximum Horizontal Span is: 18 ft. 5 in. with a minimum bearing length of 0.77 in. re uired at each end of the member. Property 11value Species Spruce-Pine-Fir Grade IINo. 2 Size 2x10 Modulus of Elasticity(E) 1400000 psi Bending Strength (Fb) 1272.91 psi Bearing Strength (Fcd 425 psi Shear Strength (FV)=155.25 psi While every effort has been made to insure the accuracy of the information presented, and special Comments? info@awc.org. effort has been made to assure that the information reflects the state-of-the-art, neither the American Wood Council nor its members assume any responsibility for any particular design prepared.from this Online Span Calculator. Those using this Online Span Calculator assume all liability from its use. http://awc.org/calculators/span/calc/timbercalestylp.4sp?species=Spruce-Pine-Fir&size--2x l... 5/2/2011 Town of Barnstable BAE. Regulatory Services MASS. a''. Building Division '°fFn rAP'� 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection " Location q9 Cl�OG1� Permit Number -2a Owner otywE Builder AO 1-7 One notice to remain on job site, one notice on file in Building Department. The following items need correcting: W N 6/iv &—e 79/.yG- T -7"0 az� � o.c��i�N cc��4 G L 64� ��-k o c -3 G } o� or /I �c J 1 /�$ / �<<J�' `\`� fle L TES �O �?Ll�S. �•AUL �- i i ' y 6Ja33 Please call: 508-8624VWfor re-inspecti n. Inspected by 4--- Date 99 CROCKER ROAD RICK ROY JEFF MOORE CONSTRUCTION LLC www.R ickR oyCanstructio n.com ,} °`' • i" PROJECT INFORMATION 4 � ; . :-f CONT RAC RICK ROY QUEEN TO CONSTRUCTION 123A OUE NANNE ROAD F _ HARW ICH,MA 508-432- RROY8840 r y PROJECT ADDRESS:99 CROCKER ROAD,WEST BARNSTABLE,MA I r'•A. ' - RROYCON@NQCOMCAST.NET `+ PROPERTY OWNER:JEFF MOORE ' PROJECT DESCRIPTION:ADDITION TO AN EXISTING GARAGE V. ZONING INFORMATION:RF FRONT SETBACK: 30' x,.. SIDE SETBACK: 15' REAR SETBACK: 15, FLOOD INFORMATION:NOT IN FLOOD ZONE ` AUTHORITY HAVING JURISDICTION:TOWN OFBARNSTABLE tk -r�—�Illr cJ PAUL CODES: MSBC,7TH EDITION SWAl"in N q{^ 00 �t i, WIND DESIGN:ASCE 7 110 MPH EXP.B c;> STRUCTL}F;gl v; 353 Lv 3 ii Sheet List Sheet Number Sheet Name No. Description Data A0.1 PROJECT INFORMATION A1.1 SITE PLAN A1.2 FLOOR PLAN A2.1 EXTERIOR ELEVATIONS A5.1 EXISTING PHOTOGRAPHS S1.1 FOUNDATION PLAN S1.2 FRAMING SECTIONS VICINITY MAP LOCATION MAP JEFF MOORE SITE 99 CROCKER ROAD PROJECT INFORMATION PERMIT S E T }• tlwnMi q + i `t. Drawn by AG od" p �' � r� 6?.y, '• � ' y �' • a. Checked by AG Scale �1C-K ROY - - - - - - - - - - CONS TRVC, TTON / www.R ickR oyC on struction.com —7 / CONTRACTOR IDES IG NER RICK ROY CONSTRUCTION / 123A QUEEN ANNE ROAD HARWICH,MA 508./3 -88402-6840 / 508-432-4814 RROYCON@COMCAST.NET EXISTING 2 STORY HOUSE VA OF PAut W. SMVANSON EXISTING GARAGE // / c�S $=RUCTURAL e; o. 353' HATCHED REGION / / SHOWS AREA OF NEW WORK No. Dascription Data JEFF MOORE 's• o / •o. 99 CROCKER ROAD \ / \ � SITE PLAN SITE PLAN BASED ON ATTCHED SURVEY PERMIT SET 1 Site Plan 0 Drawn by A 1°= 30' " Checked by AG a A1 . 1 Scale 1"= 30'-0" RICK ROY e•-111/4• 24'-3. CONSTRUCTION LLC i A2.1 www.R ickR oyC onstructio n.com 5 1 S1.2 ........ ... ........._. RICK ROY CONSTRUCTION 123A QUEEN ANNE ROAD ' r. HARWICH.MA _— _ I - 508-432-6840 RROYCON@COMCAST.NET �.� I OF 0. 1 l- i. PAUL W. :... ANIS . t c ... STRUCTURAL ('.. No. 35 '� Fcsi�P1A No. Description Date m IF �— JEFF MOORE a..,.-: Moo 99 CROCKER ROAD 24'-3- /,- FLOOR PLAN T A2.1 First Floor PERMIT SET 114°= i$ Drawn by AG Checked by AG A1 .2 Scale 114"= 1'-0" _ EXISTING CEDAR ROOF RICK ROY' TO REMAIN ON EXISTING TOREMAINONEXI CONSTRUCTION AGE ADDITION �y nstruction com _Mir \pu�tr I I r :::::_::.::.:...:::-- -............. ..__.. i`'�_] .�_ CONTRACTOR IDE SIGNER r 1 ""' ""' �� 123A QUEEN ANNE ROAD EXISTING /DEMOLITION NORTH HARWICH•MA PROPOSED NORTH ELEVATION ELEVATION 50a•43z-sa4o 5 50a•432.4814 1/8"= 1'-0" 1/8"= 1'-0" RROYCON@COMCAST.NET NEW ADDITION AND EXISTING MAIN ROOF TO RECIEVE NEW ►���\ �'� ARCHITECTURAL ASPHALT SHINGLES \• \ // Q �\ _ NEW DOUBLE HUNG WINDOW TO MATCH EXISTING t _' C::1f1� OF n • ' �'ml i ,�I li�I I SIDING TO OVERLAP - I l--, "- LI L' PQL1L W. Gr I-III-III-� � �- ,,, : .. :. . : -:II �I� CONCRETE FOUNDATION SWl+NSON a� WALL.EXPOSED PORTION EXISTING I DEMOLITION EAST TURAL OF FOUNDATION WALL 6 PROPOSED EAST ELEVATION ,1 ELEVATION $TFUC NOT TO EXCEED 18" 1/8"= 1'-0" U 118"= 1'-0° NO 35334 O FSSlOA aL -- — — REMOVE EXISTING SIDING TO OVERLAP t � TRIM AND RAFTER CONCRETE FOUNDATION I ENDS WALL.EXPOSED PORTION OF FOUNDATION WALL NOT TO EXCEED 18" — -- __ - --------------- No. Description Data EXISTING /DEMOLITION SOUTH PROPOSED SOUTH ELEVATION „)ELEVATION 1/8"= 1'-0" 1/8"= 1'-0" JEFF MOORE 99 CROCKER ROAD NEW 9'X8'GARAGE DOOR EXTERIOR ELEVATIONS RHI NEW 60"X80"9 — LITE DOUBLE DOOR j -- H I. I �i PERMIT SET EXISTING /DEMOLITION WEST Drawn by AG 8 PROPOSED WEST ELEVATION „1 ELEVATION 1/8°= 1'-0" �l 1/8 /8"= 1'-0" Checked by AG A2 . 1 Scale 1/8"= 1'-0" II RICK ROY CONSTRUCTION 123A QUEEN ANNE ROAD HARWICH,MA 46840 Al Q 4' i"! 0 OF y....��_ i'�fit`�t a s 4. SWANSON STnUCTUIRAL No 4ft i Neil :. r �50 '�': �F� .�^.'u x��� + A � �i► ',fig `�».?'. _x..�..... .w., A JEFF x. tti"{7 �7 s �.Y. MO ORE f�f,aly T,r f- Y ,,,�fir�+ ,,.+�- - •,. k fi$: V .k'�' ':s^r99 CROCKERROAD ow w .v-wr�r�w Ll RCR------_-...... _...__._._ RicK Roy. CONSTRUCTION LLC www.R ickR oyC onstruction.com 9'-11 114• 24'.3' CONTRACTOR/DESIGNER RICK ROY CONSTRUCTION NE ROAD — _ —.— HARWICHQUEEN N - 508-432-88 508-432-4814 �� --- -- -- — --- ---- •:��-+•-�;----- ------- — .i RROYCON@COMCAST.N ET . �t r tf L. EXISTING 3'-9"FOUNDATION WALL WITH 16"X8"FOOTING { OF . L�� k ! PPAUL Vv. SNAN. N _a j. STRUCTURAL en . 4 ! o. 35334 f --- INAL S 3 � L ;�'—:_.._..•. —.._..— _- _ =�: -- N E W AND EXISTING _...; ... T ....:...._.,._.__..... FOUNDATION TO ALIGN / NEW AND EXISTING I ' --- -- — FOUNDATION TO ALIGN NEW 8"X4'-3"FOUNDATION WALL WITH 16"X 8"FOOTING No. Description Date NEW 8"X 4'-3"FOUNDATION WALL WITH 16"X 8"FOOTING SEE'S1.2 FOR MORE INFORMATION_ NEW 8"X V-9"FOUNDATION WALL WITH 16"X8"FOOTING NEW 4"CONCRETE SLAB SLOPED TO DOOR. JEFF MOORE 99 CROCKER ROAD a FOUNDATION PLAN 24'-3' I 1 FOUNDATION PLAN j 114"= 1'-0" 1 PERM IT SET I Drawn by AG Checked by AG I ; n Scale 114 1'-0" H2.5A CLIPS"RAFTERS RCR---- TO PLATES AND PLATES --- TO STUDES I Cr- - ROYNEW 2X4 WALL NEW 2xl0@16"O.C. 2X10CLEAT CONSTRUCTION _ _ _ _ _ _ _ _ _ _Roof LLC A 18'-0° `- www.R ickR oyC on slruc tic n.cam NEW 2x8 @ 16"O.C. EXISTING 2X6 @ 16"O.C. CONTRACTOR ID ES IGNER' EXISTING 2X8 @ 16"D.C. RICK ROY CONSTRUCTION 123A QUEEN ANNE ROAD i HARWICH.MA H2.5A CLIPS"RAFTERS S�2 508-432-4814 TO PLATES AND PLATES RROYCON@COMCAST.NET TO STUDES I �i T.O.PLATE -�—�— EXISTING 2X4 @ 16"O.C. 5-10d NAILS:STUD TO STUD WALL WITH COX EXISTINGING RAFTER OR SHEATHING DOUBLE 2X6 PLATE CEILING JOIST I EXISTING 8'CONCRETE WITH 518'DIA.ANCHOR Z WALL,3'-9"HIGH POUR WITH BOLTS AND PLATE 16"X 8'FOOTING WASHERS 4'O.C. � EXISTING 4'CONC LAB GRj1nuo 1A-DFE AI I - — _ —.��..' I _.. — — — — First Flood OF ��1H R 0 0" Cl� PAUL W. C� . T.O.FootingSWANSON "' STRUCTURAL Zg ' B.O.FDDting /1 No. 353 3'- 1 Section 1 No. Description Data 51.2 DOUBLE 2X6 PLATE _ _ _ I _ _ _ _ _ T.O.PLATEA[�, WITH 518"DIA.ANCHOR 0- 9'-9112" BOLTS AND PLATE WASHERS4'O.C. JEFF MOORE GRAD_ E n 99 CROCKER ROAD 1 0 FRAMING SECTIONS \ \\P T.O_Footing r -2'-9° B.O.Footin -3--5° PERMIT SET 2 Section 2 Drawn by AG 114"= 1'0" Checked by AG a S1 .2 Scale 114"= 1'-0" P oE. r Town of Barnstable *Permit# Expires onths t ue J e Regulatory Services Fe ELAMSTABLE, "'ASS Thomas F.Geiler,Director lk_p Building Division 2011 Tom Perry,CBO, Building Commissioner ABLI� 200 Main Street,Hyannis,MA 02601 Q �#JR www.town.barnstable.ma.us \PNOTf 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid x,ithout Red X-Press Imprint Map/parcel Number 0 �S Property Address i 7 C r o c ke,r i w• 6 A r n s d /t 4 U a t;G esidential Value of Work8,S 610 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Z_�CF_Frey w. 1- ` e)arc `in„ 1 a 4c. /V i-k-e,rso s C, ,,- /'TA oac6d' Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor OTam the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) 9-1&side -C4 cedA,, elo( 4, / redo" S lti,Wiles. as naeo(c., #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,•ete. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is req 'red. SIGNATURE: C:\Users\decollik\AppDataV_ocal icrosoft\Windows\Temporary Internet Files\Content.OUtIOOk\DDV87AAZ\EXPRESS.doe Revised 072110 . Town of Barnstable Regulatory Services ` °A MAS&� Thomas F.Geiler,Director 39. Building Division 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:T1 67 sr, JOB LOCATION: !q Gruc-ke y mil• AlhS I*l �� number street r village "HOMEOWNER": J l ,t��Odre (cj'lw AJ c,ka✓5,. —a Y-6 0-1 16 name C� home phonne'# work phone# CURRENT MAILING ADDRESS: / C'r o C. 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"homeo er"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures V0 requ' m ;,a he will comply with said procedures and requirements. gna of Ho owner 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 unlicerised 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. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRFSS.doc Revised 072110 The Commonwealth of Massachusetts Deparmient of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 somnniass.go►/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plnmbers Applicant Information Please Print Legibly Name(Busineworganiationthi&idud): Address: C re c ke r City/State/ : Lv. 6arh r l-U cat``Y Phone# Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I s have hired the sub-contractors 6. ❑New construction employees(full and/or part-time). 7 ���g 2.El am a sole proprietor or partner- listed on the attached sheet ship and have no employees These sub-contractors have g_ ❑Demolition workingfor me in capacity. employees and have workers' 8IIy � t3`• ❑ [No workers'comp.insurance comp-insurance,1 9_ Building addition' r ] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]Y c. 152,§1(4),and we.have no employees.[No workers' 13.0 Other comp.insurance required.] *Any applicant that checks ban#1 must also fal oat the section below showing their workers'compensation policy information. t Komeownas wbo submit this affldaiit indicating they are doing all work and then hire Outside contracmrs must submit a new effidacit lndlCA such. koatracmrs that check Ibis box mast attached an additional sheet showing the name of the sub-contractors and state wbether or not those entities bare employees. If the sub-contractors have employees,they muse provide their workers'comp.policy number. I am an employer that is praitiing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ` Policy#or Self-ins.Luc.#: 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 coveragee as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a Sue up to S1,500.00 and/or one-year imprisonment,as well as civil penalties.in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify unt the s a n ojperjary that the information provided above is true and correct. Si tore. Date; oZS1,R 0 Phone#: 70 8'—d 6 Official use only. Do not unite 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.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 n+e ' 639. Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 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 A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner' Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Qutlook\DDV87AAZ\EXPRESS.doc Revised 072110 -- Application to1.994 , .194 tI Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a Y CERTIFICATE OF APPROPRIATENESS Application is hereby made, iri triplicate, 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 Building 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 (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE 11-10-94 ADDRESS OF PROPOSED WORK 99 Crocker Rd . W . Barnstable ASSESSORS MAP NO. 1 10 OWNER Joseph and Susan DeMartino ASSESSORS LOT NO. 015 HOME ADDRESS Same as above TEL. NO. 362-4041 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). 109/40 Mr .& Mrs . Mark Frenzo , 57 Crocker Rd . W . Barnstable , Ma . 02668 109/59 Mr .& Mrs . Christopher Sinn 161 Kettlehole Rd . W . Barnsta_hlP 109/60 Mr .& Mrs . Wi11igmn S . Arthur 1R9 Kett Iehole Rd _ W _ Rarn ,tnhlP See Attached Sheet AGENT OR CONTRACTOR R . Arthur Williams , Inc . TEL. No. 428-5717 ADDRESS 2 Oak Street , Centerville , Ma . 02632 DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8, other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). Proposed 16 ' x 20 ' single 'story wood frame addition to the East side of an existing B w� Ro© Dal he addition will be used as a family room . Signed ' Owner-Contractor-Agent Space below line for Committee use. Received by H..D..C=mn, /J c� r .fi lil ✓P/1 0 l Date The Ce tl Cate is hereby ate i'��m�e NOV41eu 1g94 �a 6t,4 ( By Approved ❑ IMPORTANT: If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act. J ADDITIONAL ABUTTERS 109/88 Mr . & Mrs . Robert Sennott 60 Crocker Rd . W. Barnstable , Ma . 02668 110/16 Mr . Frank Woodworth 29 Paine Rd . South Yarmouth , Ma . 02664 1,10/21 Mr .& Mrs . Theodore J . Myers 10 Wayside Ln . W.: Barnstable , Ma . 02668 110/22 Ms . Kerry Darigan P .O . Box 275 W . Barnstable , Ma . 02668 110/23 Ms . Judith L. Meskinis 120 Crocker Rd . W. Barnstable , Ma . 02668: 11-0/15 Mr .& Mrs . Joseph DeMartino (applicant ) PP PrIL. DYED Town of Barnstable _ Old King's Highway Historic District Commission SPEC SHEET FOUNDATION 10" Poured Concrete SIDING TYPE Red Cedar Clapboard COLOR Natural To Match Existing CHIMNEY TYPE -N/A- COLOR ROOF MATERIAL Red Cedar Shingles COLOR Natural PITCH 10: 12 WINDOWAnderson Casement & Double Hung SIZE Ac 1;hnwn Fixed Skylights TRIM COLOR Colonial White DOORS 1 Full Lite COLORColonial White SHUTTERS Brown To Match Existing GUTTERS -N/A- DECK . -N/A- GARAGE DOORS -N/A- COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application, along with three copies each of the plot plan, landscape plan and elevation plans, when applicable. Plot plan need not be "Certified" , VV ould show all structures on the lot to {} U O • Z 1 i A. ti f1N } r Y t' , f„' 1 t 1 4( 3 � v t r � ,•r t .� t. 7i u, I • t t - I - ! Ili ' j ! 1` ! ► II ' 1�' i � .''i ; III _ j {�Iilj1 I i i ► ' jl I ! Q o j F h aFNq�.6�i ToIEL_ 3 El i 94 inE ANOOW _ �cCjocrjev P.r>dl'floN 6XIyT, �Fhlr>er+�E`j1 _ �. �`' i F Nof�r►-� E t�v�-r I� �,�, ,o��r, : �}ZGYGr�Ep ITIr.N Ta 1 E t P2 r 1 E - ` - //" > '� I."� A�Y� •�Ste.•'G�! Il --.► f. r. k �J a. x 0 0 I ull Q � , cD �- D j -� CD _X 4t c r i O m _ DEMARTINO FAMILY ROOM ADDITION R.ARTH TI UR WILLAIMS, INC. m PROPOSED WINDOW FENESTRATION #2 OAK STREET, CENTERVILLE 99 CROCKER STREET, WEST BARN. DESIGN - BUILD CONTRACTOR r • S rn rn r rn 0 z DEMARTINO FAMILY ROOM ADDITION R. ARTHUR WILLIAMS, INC. 0 PROPOSED WINDOW FENESTRATION #2 OAK STREET, CENTERMLLE 99 CROCKER STREET, WEST BARNSTABLE DESIGN - BUILD CONTRACTOR 1 �I r i Y � ••ir, t:a ,J f �i ,y. vs +: Y l '� � t • 1 Ll • I t R. ARTHUR WILLIAMS DEMAR'��NQ RESIDENCE ADDITIQN INC. u FAMILY ROOM - ENTERTAINMENT #2 OAK STREET, CENTERVILLE 99 CROCKER STREET, WEST BARNSTABLE DESIGN - BUILD CONTRACTOR I Assessor's offioe (1st floor): Assessor's ma and lot number ... ....�� ...:.. .�-�:�.... Q` �� �9���ETO� P 3F,: TIC SYSTEM.MU37 WQ o Board of Health (3rd floor): 42- G� P:'�U37A LED IN COMP U Sewage Permit number ......7................................. WITH TITLE 5 t BABasTOBLE, J Engineering Department (3rd floor): ,� "t 'oo ' A & B ♦� 39 House number ..y.9........... 1. >,, .r C1R�e . r ................................. _ APPLICATIONS PROCESSED 8:30-9:30 A.M. an 66 1:00-2:00 P.M..only .�/h���,tf �-•C� �� f�r� iea P` TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO . .........; ..........6.0'.r.f.�.. .. ...................................... TYPE OF CONSTRUCTION .....LAID.O..d....�►�4YI:1.fL.. .................................................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: qGq� ��o.�..... . ....... ....�.r..... .... . ......:}�.� ei.slliz_4/�........................ .. ............ Location ...... ...1................ �/� /�- 1....�G'..S 4..J ....... ' ProposedUse .......QV.4t. ........................................................... Zoning District ......!\ .........................................................Fire District ...W s.�LO'e. ................. Name of Owner ...J.Q 5��o l 1..►'�p.......Address ...`� ..... 0.ct4e'(.'....K9t,.................................. cc ...p... ...... ..� .... Nameof Builder .......J.Gt .✓truer........................................Address .................................................................................... Nameof Architect ..... ..........................................Address .................................................................................... Number of Rooms ....... ...........................................................Foundation .....f"D.rr 2 ..cOan.�i�. ..�.............. Exterior ...� tl 0.I�..... 4pCl.............................................Roofing l cX- Floors ....CQ.!L.C.. ..................................................Interior ....)V111....................................................................... Heating .....(Y .14..................................................................Plumbing .... ................................ Fireplace .... .. . . .................................................................Approximate Cost ... .�f: ..............:........ .................... Definitive Plan Approved by Planning Board _W .C_!_____________________19________ . Area y ... :..T.....� Diagram of Lot and Building with Dimensions Fee ..:J ...... SUBJECT TO APPROVAL OF BOARD OF HEALTH i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam .. ...... ............ Construction Supervisor's License .................................... 2MARTINO, JOSEEPH No .31.479 Build Garage Permit for .................................... Accessory to Dwelling . ................................................................ Location ........99...Crocker Road ................................................. West Barnstable ............................................................................... Owner ......Jose h DeMartino .............................................. - Type of Construction ..... Frame ............................................................................... Plot............................... 'Lot ................................ Permit Granted .........Dece. .m.ber. ....7`, ... 19 87 .. .... .. .... .. . Date of Inspection ....................................19 Date Completed ...........z �.............19 sses�s�or's map and lot number 1f 0......j..../..� ...... FTRE ' � N SEPTIC SYSTEM Qom° Sewage Permit number ...... 7�.....` 3 INSTALLED IN COMPLY `� lJ ...... 4% WITH ARTICLE AN •, LE 11 STATE BasaSTaDLS, . r , House"lnumber ..............TR...:................................................... SANITARY CODE AND TOW 9o,o�M6 I 6 REGULATIONS. YPY z TOWN OF BARNSTABLE q n fS I.J " Gl S� ni t?. NUILDIAG INSPECTOR , r e APPLICATION FOR PERMIT, TO ........... r Cct � ........................................................................................... .1 n i TYPE OF CONSTRUCTION ..........6000�K,CC�d".�..... ..r. .. . ..............................:............................................ c E ...... .�.e.....sr..............i9..79 TO THE INSPECTOR OF BUILDINGS: A¢ �4 The undersig�nyed hereby applies for a permit according to the following information.:: j Location ......CN......4 f�C3 «.4�... ......�S..de'Sd... r 4?i!'�K!n.�..........� �.k.:..E?�7 TA/l.. 4i iz f ProposedUse .......... .......................................................................................................................................... Zoning District ......!>. ..........................................................Fire District ......................... Name of Owner .. G5��Tt<!.{ t�SY�. <.:( !� !!1�'�......Address ..LQ..I...�p"1.�(?V�.. ...n` y'� �.�................... Name of Builder .... 1pu��'19.5... 1..//...................Address ........ ??`�CtUl'C'G ....�!1� �M1.S.............. Name of Architect ...41 (,. >�..../ 4!$ - 0.L.................Address .&vS%!'(.�f/. �-o �� 071�......................... ...... ............... Number of Rooms ...... ..5M......3...14.. .......Foundation .... to ................. .............................................................. Exterior ..... ..................................................Roofing ........ ........................................... Floors /...� ........................................Interior [._ .. dGK...A�!� ............ ..................l.,....? ... rK LLw�,- Heating A./'C59C.. CfA�i;' �3� Cyr/..............Plumbing ...car.��..G��.l�1On1�....-XIA6 Fireplace ..................a........�:.�/b�s�/.4?/UC.. se`11P?9Approximate Cost ....:.4J.S .............................. Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area .......�3a� S '................................... Diagram of Lot and Building with Dimensions Fee .......... .. ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH �Q A0 oM� • c off✓ �� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...... ........... ...... �.... ............................. DiMartinol Joseph & Susan 20334 two story N,t................... Permit for .................................... single family dwelling ............................................................................... 99 Crocker Road Location ................................................................ West Barnstable ............................................................................... Owner ......j.o.s.eph...&..Su.an..D.iMar.t.i.no........... . . ...... .. .... . .. .. ........ . . .... Type of Construction ...........frame ............................... ................................................................................ #27 Plot ............................ Lot ................................ Permit Granted ....... June 21 ...........9 78 Date of Inspection 9 Date Completed ........................................9- sP PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... ............................................................................... Approved ................................................. 19 ............................................................................... ................ ......................................................... Town Of Barnstable Permit: Regulatory Services ate: Ovo��/ �o THE Thomas F. Ceiler, Director Building Division snxtasrnats: Tom Perry, Building Commissioner V rwss. 200 Main Strcct, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 TOWN OF BARNS TABLE c SOLID FUEL STOVE PERMIT Y, c) Owner: ��/ /1 / (JJO Phone: 5�0!F 3�i'7! ,y �� Install at: 911_ _���d�� Village: A/f 7'�4 M Map/parcel: rate: Stov A� Ne Used - R. Type: Radiant/ _icculating //vr m, 7'c /z� C. Manufacturer: Lab. No. _ 2 V_ D. Modcl No.: Chimney A. Ne =xis ' "f exis in , please note date of last cleaning) �R- 13. Flue Size C. Are other appliances attached to Flue? v _ D. Pre-fab Type and Ma cturer &__4V l-e _ E. Masonry: Line nlined Hear(h A. Materials: /L ' B. Sub Floor Construction: — Installer Name:_f� VC /4L,4Ce _ Ad.dress':2 /11�toX/ f� Phon /! -4 Location of Installation: Gfi. 5,41t.v1 TA � H.I.0 Registration 9 Construction Supervisor# OR check_ Homeowner Installing, no lice e re • e APPLICANTS SV3 E _ APPROVED BY: Please make checks payahle to the Tama of Barnstable This cnnslitules an of'rial stove permit after inspection, photographed, and approved by the Building Inspector Q:fornlsMove Rev 103107 The Commonwealth of Massachusetts c I Department of Industrial Accidents _ ��,,,,. 1 Office of Investigations 600 Washington Street Boston, MA 02111 �c P4 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):__� t �v (�► creJ '� Address: 1' `� G rd c lac J- gd u264K i City/State/Zip: W. a Phone #: so 8— ay-4 T f,� Are you an employer?Check the appropriate bWKType of project(required): L❑ I am a employer with 4. 01 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. x ❑ 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. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof rre airs , insurance required.] t employees. [No workers' 13.�ther-Vkcj ye %�s��� comp. insurance required.] *Any applicant that checks box€11 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 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. 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 hereby certify un he s a c of perjury that the information provided above is true and correct Signature: q Date: 02 /- o o Phone# L!�0 I'02 C� g Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual, partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and`who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth'nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-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 Va 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mass.gov/dia Town of Barnstable ti Regulatory Services ttr,�,�� : Thomas F. Geiler,Director MASS. t659� a•,��' Building Division PIfD µA't Tom Perry,Building Commissioner 200 Mairi..Street,_Hyannis,MA-02601 www.town.barnstable.ma.us Office: 509-862-4038 Fax: 508-790-6230 HOI11EOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: C.v a k11 Rai . W 7 T Y/"-my`�_i I',-- number M street �1 village "HOMEOWNER': r 1 "—f -'� 1-, / toot'— S� mac. name !� phone# work phone# CURRENT MAILING ADDRESS: 1 Cd m C_ /1 A- city/town / —' state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellin>rs 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. DEFUNMON 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 constrgcts more than one home in a two-year period shall not be considered a bomeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that be/she shall be responsible for all such work verformed 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 minknum mspec 'on pro s and requirements and that he/she will comply with said procedures and requirements meowner 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 perfotrning work for which a building pernvt is required shall be exempt from the provisions of this section.(Scction 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a pason(s)for hire to do such wofk,that such Homcowncr shall act as supervisor." Many homeowners who use this exemption are unaware that they arc assurring the responsibilities of a supervisor(see Appendix Q, Rules&Regu)ations 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?licensed Supervisor. The hotncowncr acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/hcr responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the msponnbilitics 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 fonn/certification for use in your community. Q:forr s:homccxcmpt IKEr Town of Barnstable ` "Regulatory Services a • BARNSI'ABLE, MAss. g Thomas F. Geiler,Director BuiIding Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property�Owrier Must Complete and Sign This Section- MP Using A Builder as Owner of the subject.property hereby authorize to act on my behalf, is all matters relative to work authorized by this building permit application for. (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete:the Homeowners License Exemption Form on the reverse side. Q:FORM S:OWNERPERMISSION 1�. (`t tvptntrsrtuir �ttr/r r,//. Au��,../{��i ell Board of Budd 1 Regulatrufis and Stand�a�s H.OME IMPROVEMENT CONTRACTOR } Registration 110668 Exp��aU��n��11�n�/3/2©10 Tr# 276835 ; 11 3 < 4�*S�TiyPe,'S lllr'"',ideal LARRY F CARBO,NNE="W v ' 'Sj+S aR Aoi 2l Fy LARR>Y C'ARBONNEAUIt �' d e 4 4 s 41,, P 15AWS'ANif LA�KE�A� HARW,ICH MA 02645 tCUmnuSirat�r t 4 • h A 11a"arltu.c[t. - Uiltartntcnt (.If PUI)IiC �afct% ��gBoard pf Buildin- Rc,u lilt i6n.,n d �t:tndaviI Construction Supervisor License License: CS 15911 Restricted to: 00 LAURENCE CARBONNEAU ff 484 LONG POND DR s:;, ilti itkE HARWICH, MA 02645 � •. { Expiration: 3/7/2012 ,a ( ••iuwi..i nor Tr=: 20892 i • ::.Y Restricted to: 00 00- Unrestricted iG-1 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Refer to: WWW.Mass.Gov/DPS The Commonwealth.ofllfasstachusetts Department of Industrial Accidents Office oflnvestigations _ 600 Washington Street _ Boston, MA 02111 www.nnass.gov/dia Workers' Compelnsation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizatiott/Individual): ye- Z ev) c-p— —� Address: oc t- /ViY ©G e 7— City/Stale/Zip: ��/�it�JtC/y� 7' PtlUlle.#: 3� -7-7 Are ou eu employer?Check the appropriate box: Type of project(required): a employer with & • 4. I am a general contractor and I mployees(full and/or part- me). « have hired the sub-contractors 6. ❑New construction ti ..2 a•sole proprietor or partner- listed on the'attached sheet. 7.. Q Remodeling ship and have no employees These sub-contractors have S. Demolition working for me in any capacity. employees and have workers' 4 Building addition [No workers'-comp.•insurance comp. Insurance.= required.] S. We are a corporation and its 1Q.� Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right 6f exemption per MGL 12.❑Roof repairs /`�� insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.00ther W w Oo /: comp.insurance required.] /'/V J 20 LL 'My 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 inditating wth. 1contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employers. If the sub-contactors 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. /� Ynsurance Company Frame: / ' `f`f lOC/�T y �1�0(i0 �-C/Z .T `/t,(,-A A/ LPG' Policy#or Self-ins.Lie.#: a C C Expii�ration D te: 01— C 4V_'-1 Job Site Address: �wC. City/Sta c!f Zi : Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration Bate). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to S1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is tr a and coT sect. Signature: )I( / Date: V , ` a Phone#: y C 7 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 onc): L Board of Health 2.Building Department 1 City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: AUG-27-2010 13:31 ROGERS GRAY P.02iO4 NOTICE NOTICE TO TO EMPLOYEES EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT -OF 1NDUS T RIAL A C IC3DENTS . 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ASSOCIATED EMPLOYERS INSURANCE COMPANY NAME OF INSURANCE COMPANY 54 THIRD AVENUE, P.O. BOX 4070 BURLINGTON, MA 01803-0970 ADDRESS OF INSURANCE COMPANY WCC 5007552012010 09/08/2010 - 09/08/2011 POLICY NUMBER EFFECTIVE DATES ~ 305 Forest Street The Fairway Agency Inc Bridgewater, MA 02324 (508) 807-0380 NAME OF INSURANCE AGENT. ADDRESS PHON.h Larry Carbonneau dba Slove Place.II 2=G N?ro!d S!reet 1-{?rWirhnnr MA(?7646 EMPLOYER ADDRESS i 07/22/2010 _ ' EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer,if the treatment is nece,sary and reasonably connected to the work related injury. In cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY NAME OF HOSPITAL ADDRESS 'TO BE POSTED BY EMPLOYER u Q. Who is responsible_for making application for the: permit?' Application for a permit is required to be made by the owner or lessee or their agent of the building (e.g.; the HIC registrant ). If application is made other than by the owner, written authorization of the owner must accompany the application. Such written authorization shall be signed by the owner and shall include a statement of ownership and shall identify the owner's authorized agent, or shall grant permission to the lessee to apply for the permit. The full names and addresses of the owner, lessee; applicant and the responsible officers, if the owner or lessee is a corporate body, shall be stated in the application. Please note: It is the responsibility of the registered HIC to obtain all permits necessary for work covered .by the Home Improvement Contractor Registration Law, M.G.L. c. 142A. An owner who secures his or her own permits for such shall be excluded from the guaranty fund provisions as defined in M.G.L. c. 142A. Back to Top Q. My contractor told me I need to obtain the permits for, My construction. May I_obtain the relevant permits from my local building department, or is the contractor required to do that? While you may certainly obtain your own permits, be aware that if you do, you will fall into a homeowner exemption that will disqualify you from being eligible to receive recourse through M.G.L c. 142A, the HIC Law, or the statutorily authorized Guaranty Fund, should a problem arise. It is the responsibility of the registered HIC to obtain all permits necessary for work covered by the Home Improvement Contractor Registration Law, M.G.L. c. 142A. If the HIC you are contracting with refuses, you may wish to reconsider using that contractor's services. Town of.Barnstable Regulatory Services BARNSIABLE, MAB.4 �, Thomas F.Geiler,Director �639• ♦0 i Building Division Torn Perry,Building.Commissioner 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 A Builder I, !Ci/C/��� `% 0�-� , as Owner of the property subject�- ) hereby authuril A'�4� —e ve // to act on my behalf, mall matters relative to work authorized by this building permit application for. 2.1 �• (Adda>vss of Job) QQ�� OoZ ` (o fv 6�Aell Owner Date Print Name If Property C�evner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FO RM&OWNERPERMISSIOH r -' - Assessor's offioe Ost floor): Assessor's map and lot number s Ito . THE to` Board of Health Ord floor): [ Sewage Permit number .. 3 � ......�..�......................... Z BARISTABLE. i Engineering Department (3rd floor): moo NAG& \0� Housenumber ................................. .. . .......................... Mo rav a' . APPLICATIONS PROCESSED 8:30;9:30 A.M. and 1:00 2:00 P.M. only rn �_71t7AJ TOWN OF AARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .. ✓t 5 ✓ t✓L..C. ....a......... .... .ap.............................................. TYPE OF CONSTRUCTION ......read().c..... ��t..►'h.tZ.. ................................................................................. .....De. ...... ....................19. 7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 7 9 �lro c-ke/' 4 w S B .;r Y►..,T „�7 .................................................. Location .......... ............................. .. .... .........s...�r..........P-.,... ...... . � �a ......:..........................................Proposed Use ....... .�..........�.�... . ........................................................................................ Zoning District ..... ...........................................:.............Fire District t. .....l,.). .r.N11.C.. 2A��'— ..I-) .................. Name of Owner ...J.Q 52 1!1.....,.Pe...Aa.1-6. Address ... ..... '�cl�2r.....:1. .................................... c Name of Builder .......` -.........................................Address i Name of Architect .....54 - Address ............... .. ................................................................. Number of Rooms ........................................................Foundotion ...../"D.r'•?!C. ...Co Exterior ... ..0..a. ..... .!.R.................................... Roofing.......... ,�Qe... ...... ., .r'.......................................... Floors .... .................................................Interior :...:!0........................................................ Heating .....�1� .�`t. y� - /., . ... ....Plumbing .... � .�.f1.............. Fireplace ....A.Y.J. /.................................................................Approximate Cost .../. f........................... Definitive Plan Approved by Planning Board ___________________19________ . Area !:!! .Jc`/..:.. � , Diagram of Lot and Building with Dimensions Fee ��• ,....... .............. SUBJECT TO APPROVAL OF BOARD OF HEALTH w OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. � 7/ Name ......I....�.....��_.........._�..�.!sc- ............ Construction Supervisor's license .................................... r- .j DPMARTINO, JOSEPH 110 015 No ... Permit for .Build Garage..................... ............. Location .........9.9....Crocker....Road................. West Barnstable ..................................................:............................ Owner ..... DMrtino . ea ........................................... Type of Construction .....Frame ................................... ............................................................................... Plot ............................. Lot ................................ If Deo�her 7 87 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed .................... ...................19 Ali" Assessor's office st Assessors map anld lotlnurmber 1 v Ul — SEPTIC SYSTEM MUSTTALLED OM COMP p "E to Conservation(4th Floor): Board of Health(3rd floor.): +.�j /� /� ����.� ' 1 ."' .�✓' !�: // . r,�r.rFrati� . . �i/ I� t`�R� Drfl1�7T��LLL i Sewage Permit numbers / »Z �> r �o rua Engineering Departure t(3rd floor): U v�wW'J "� W `' ie3q House number ' Rio�►r► Definitive Plan Approved.by�Pfanning Board 19 APPLICATIONS PROCESSED 8:30--9:30 A.M.and 1:00-2:00 P.M.only 4 TOWN OF BARNSTABLE y BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE,F CONSTRUCTION19 Q.n TO THE INSPECTOR O'F;BUILDINGS: The undersigned hereby applies for a pefmit ac cording to the following information: �o Location c — _ � " 1 a Proposed Use t',4. f o4-r Zoning District Fire District Name of Owner VDS��p 'P�r��aA9 �,ll�f%ur�.�D Address- Name of Builder AF, IA,,�e Address Name of Architect cc b Address Number of Rooms ���+ Foundation /�ca1 01-/ C191A,)r,;77e Exterior F`c��'r�� 4'lU(R:X-2a—caL Roofings Floors LYoa Interior Heating I-A71A-11 c4P., r" Plumbing _/An A--)'A_ Fireplace 424"Z* , Approximate Cost Area d Diagram of Lot and Building with Dimensions Fee S� Gl� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstab egarding the above construction. �rAWIApr �l /,r4/tCJ Name Construction-Supervisor's License 1 �ld-P�3 No Permit For /-Z -IW-4�`/ Location ' Owner Type of Construction Plot //D Lot 016 r Permit Granted 19 f 1 Date of Ins ection Z- p.�K Frame 19; Insulations w� 19 Fireplace - 19 Date Completed B - 19 ' Assessor's map and lot number P.a...... r... ........... STNE Sewage Permit number ...... ........................................... 33AEXSTABLE, House number ............T.?.................................................... SAM t639- TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ............. ........ ........................................................................................... TYPE OF CONSTRUCTION .......... ............................................................................. .......... ................1q..,7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......r�p (- -,, 4-,�V, R', Q /, -,,4.../ � ...........................t.......................................... ...................................................................... ' Proposed Use .......... r............................................................................................................................................ ....... . .. ............ Zoning District ..... ...../1)Ir .... ..........................................................Fire District .................................. Name of Owner >)-mur-rl,'�......Address ... 1&,4 44 14 ............. .................. .....................i .................................... Name of Builder ....�nQ!7,ks... ...................Address ........ .............. Name of Architect .................Address ........................................... Number of Rooms ...... ....847%...........................Foundation ...... Exterior .....C*kiln'tr-........................................................Roofing ........ ........................................... ................................................ Floors ......... .........A11,7 r ........................................................Interior Aint Heating .... A674 A ............Plumbing .............................................../............... .............................................................................. Fireplace .................. 7,,v-,j o. 5'. i,1!kf Approximate Cost ..... ......................................................ch Definitive Plan Approved by Planning Board ----------------------------- Area .........�............::�3.............. Diagram of Lot and Building with Dimensions Fee ........ ......I..................... .......... SUBJECT TO APPROVAL OF BOARD OF HEALTH A),C I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....\ .......................................... / . ^ DiMart1nov Io�eoh 15 . 20335 two story � No -----.. Permit for ---.+-------. ` ' � single family dwalli-�uQ | -----.�------�-----�..�------- ` ' ' Location --.��..�����p�.�K%4�-------.. ~ ` West / ----.-----------. . ....................... . . . . Owner ����e�� /� � ' Type or Construction / ) ...................................../.................................... � #27 ^ | Plot' ` | Gro ` 21 ' �Date Date of lnsplection,,�. /. :..............................19 .../................................19 PERMIT REFUSED - ' ------- ' ! ����' . / . .� . . . . .................. ' . ' i —'--~ ' . ..................... , ` ............................ ` � 19 � i' 'r ~` � ~-- --'' —'' ---- --------^------^—''-----^--'—' ` ---------------------.--..-- ` e _ iCK e 273.37 » g,9 ,y /g -957 PARCEL A a � t • �e 20 /43-t lop Q • � o vim, o N� _ � 744 N 22 p� 0 Of ( !� J a PAUL A, 340•88 � A•�FESSt��'��. 138.03 Rca B PA PLOT PLAN OF LAND U i IN ' u BA RNS TABL E, MASS. PREPARED FOR YANKE'E SURVEY CONSUL TANTs 14/ ROUTE /49 JOSEPH D #A4A R TINO MARS TONS MILLS, MASS. 0 40 90 /20 02648 1 SCALE l'= 40 feel November l/, /987 RES. ZONE.' ' RF FL OO.0 ZONE.• C PL BOOK 39/- 9 7 . t l278 . ';ram,.-.-:..-.. v"^•w"+;:,*.,�..:'aaf�...v't-• .•'-s++:�;- - .. _._».r .. -- �*:..- ._._ -__ �,�_s..4,. -- ..,5.�.,W:...�. .-• -"-w-• - -- - 'e" "�" '-.,w..a�a _ .. .a. .� - s