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HomeMy WebLinkAbout0114 LOMBARD AVENUE UPC 12543 No. 53LOR HASTINGS,MN �;1 4 ib _ ..-�• -� �! �x�s--. `aid. - Wrw tt 11 ; ;�� .�,+' ��. `"� �•'• a�. � „r'vnii�th�!f''trrotr�Pt�trflt q_�a y�+n � (flflll fine..- f. .✓ �"•r�fi �� t a 1' i 0 b • i ter 1 s' q =-mr' W �. �,s..r.•�6iY. J2tNM.P� { , d�t ;ML 'Awe 111111 7 YJ •11 � PK_. ,� ; ice* 1 1 - { s 1 k�uYi s i sP17 ,yam Town of Barnstable Permit: Regulatory Services Date: la�{l 13 �oemE►oq Thomas F. Geiler,Director Building Division Fee: 3S ewaxsTAELF, Tom Perry, Building Commissioner MAM • 66. 200 Main Street, Hyannis, MA 02601 AIFo � www.town.barnstable.ma.us Office: 508-862-4038 Tax: 509-79.0-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: , I�.1.��. .-_ Phone: 4-v r 3 6 F Z Y� Install at: _(t y /�tL - Village: Map/Parcel: ­J r 0 Li? Date: Stove A. New/6se (9 Sr B. Type: adianJJ Circulating --------� C. Manufacturer: Lab.No. D. Model.No.: S Pf _ _. iS Zc, i ,,� ter• Chimney A. New L E ist' g (Ifexisting, please.note date of last cleaning) B. flue Size C. Are other appliances attached to Flue? 1^-0 - D. Pre-fab Type and Manufacturer E. Masonry: L ne nlined Hearth A. Materials: , t k'ke B. Sub Floor Construction: G7 ex"tLe _...__.......__ _. Installer Name: , _ 11 Address: rl ky-/ys tom-- Phone: _ �C• z tsti Location of Installation: 141C Registration# _ Construction Supervisor# OR check_Homeowner installing, no license required APPLICANTS SIGNATURE APPROVED BY: o Please make checks payable to the Town of Barnstable y �" *This constitutes an official stove permit after inspection,photographed, and app o ed by thA - Building Inspector Q:forms:stove y Rev 103107 .� w Y a Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations IN 600 Washington Street Boston,MA 02111 tivn*w.masxgov/dia Workers' Compensation Insurance Affidavit: Baders/Contractors/EIectricians/Plambeis Applicant Information Please Print L e ibly Name(susine�s/oigan�adionllndivdnat):�( /�G�v.� �,.� Address: City/StatrJZip d 62(�G Ph# F- Are you an employer?Check the appropriate boa: . I am a general contractor and I Type of project(required): El 1. I am a employer with ❑ g 6. ❑New constriction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor orpartner- listed on the attached sheet. 7. ❑Remodeling ship and hate no employees These sob-contractors have g_ ❑Demolition working for me in any capacity. employees and have wodoers' 9. ❑Building addition [N orkers'comp.insurance COS' ' 10. Electrical r or additions ��ed.] 5. ❑ We are a corporation and its ❑ 3. I am a homeowner doing all wont officers have exercised their 11_❑Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12❑Roof w insurance required.]i c. 152, §1(4),and we ha,%T no employees.[No workers' 13.0 Other comp.insurance required.], *'Any appincazzt that checks boa;#1 nmst also fill out the section below showing their workers'compensation policy information T Homeowners who submit this affidavit indicating they are doing all woo}and then hue outside contractors nms'submit anew affidavit indicating arch_ rCoatractors than check this boa must attached an additional sheet shaming the name of thLe sub-canuactors and state whether or not those entities bm% employees. If the subcontractors have emiployee%they nnrstprovide their workers'comp.policy number. lain an employer that is providing ii orkers'compennsadon insurertce 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 far insurance coverage verification. I do hereby certify under the pains andpenalfies of peduty that the information provided above is true and correct Sigoture: Date: Phone#: 42 G ,,O'icial use only. Do not write in this area,to be completed by city or town gA4ezaL 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#: 6 y . Town of Barnstable Regulatory Services T Thomas F.Geder,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4039 Fax: 508-790-6230 HOMEOWNEB LICENSE 0MMMON DATE: Z Please Print JOB LOCATION: //� w�5�� /3 nmber street village ..HOMEOWNER": l u F�� %- ;(, Z Via_ name y // home phone' work phone 4 CURRENT MAnJNG ADDRESS: �/ !� z i cityhdwn stets 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, t bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. 4, Sign of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control_ HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Usms\decoU&\AppDaffi\I.ocal\Mcrosoft\Windows\Temporary Internet Ffles\ContcntOutlook\QRF.6ZUBN\EXPRESS.doc Revised 053012 Town of Barnstable 0 Regulatory Services � RaRNcr'AAT.17 s ' r nfass. g Thomas F.Geiler,Director 059. 16 Building Division Tom Perry,Building Commissioner j 200 Main Street,Hyannis,MA 02601 www.town.barnstable.maxs Office: 508-862-403 8 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 beb2lf, in all matters relative to work authorized by this budding permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS 62012 c% 1-26 -. Town of Barnstable Permit: Regulatory Servicest Date:�la'�I� �oFmE rO�Y Thomas F. Geiler,Director.; �°* Building Division :f Fee: 7) anxKsrnei.e, Tom Perry, Building Commissioner s . `0$ 200 Main Street, Hyannis,MA 02601 AIFo �a www.town.barnstable.m.us Office: 508-862-4038 Pax: 509-790-6230 TOWN`OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: Phone: 6. z- F',) i/ Install at: �L��-szl� l�, � /yyc_ Village: 4(AJ—: Map/Parcel: Date: - Stove A. New/ se i�g d�-ec��e (,Fry B. Type: ad' /Circulatina C. Manufacturer: Lab.No. D. Model No.: wk �i� .4 Chimney A. New/E.Cisting (Ifexisting, please note date of last cleaning) -7B. Flue.Siz C. Are other appliances attached to Flue?- D. Pre-fab Type and Manufacturer . E. Masonry: Line nlined, Dearth A. Materials:— B. Sub Floor Construction: . ,,,I- t7 Installer Name: o Address: S`b-/ 14- /4i.5? Phone: t Location of Installation: ���„ o H.I.0 Registration i# Construction Supervisor 4 rrI OR check_Homeowner Installing,no license required a o APPLICANTS SIGNATURE V-�APPROVED-BY: ✓ o� N 3:� Ptease make checks payable to the Town a Barnstable ^� rn *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove 2cv 103107 - yI I ne Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 ivww.masxgov/dia Workers' Compensation Insurance Affidavit: Bugders/Contractors/EIectricians/Plambers Applicant Information Please Print Legibly Name(Business/Organization/fndividual): /l�.r�- ���^ •�_ Address: *-cam City/State#Zip: 61 Ph# IiN y Are you an employer?Check the appropriate boa: Type of project(required): L❑ I am a employer with 4- ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g_ ❑Demolition w for me in an employees and have wormers' °fig Y capacity..� �' Y 9. ❑Building addition [No workers' comp.insurance comp-insurance• 10. Electrical r or additions ed.] 5. ❑ We are a corporation and its ❑ �s 3.P4 am a homecrwner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12❑Roof repairs insurance required.]i c. 152, §1(4),and we ha-vT no employees.[No workers' 13.0 Other comp.insurance required.]: *Any applicant that checks boa#1 must also ffi1 out the section below showing their workers'compensation policy infetmxdm I Homeowners abo submit this afi5danzt indicating they are doing all eo&and dum hie outside contractors must submit a new affidavit indicating such TContrac:tors that check this boa must attached as additional sheet showing the name of the sub-comtractors and state whether tsnot those entities hM employees. Ifthe sub-contractors have employee%they must provide their workers'comp.policy number. I am art employer that is providing workers'compensation insurance for my employee& 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 under the pains and penalties of perjury that the information provided above is tore and correct aigmture: Date: �Z / Phone#: Z Q,oicial use only. Do not write in this area,to be completed by city or town officiaL City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 I w 4- Town of Barnstable Regulatory Services MAFA ' Thomas F.Geiler,Director 163 1. 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 Q DATE: Please Print _T'Z-�3 JOB LOCATION: �j t 't, numb6r sheet village G� "HOMFAwNW: L 72/ 7-,>)L-� r--- W T?iG"L P.2 f vy name / home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a twoo-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signar=of Homeowner a 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. C:\Usms\decoUik\AppDataU.om Microsoft\wmdows\Temporary Internet Files\ContentOudook\QRE6ZUBN\EXPRESS.doe Revised 053012 Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 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 (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date QTORM&OWNERPERMIssIoxPooLs 6/2012 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION I 1 � Map ` Parcel Application # Gj 3q Health Division Date Issued �'1 ( �-- Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation /Hyannis Project Street Address f/�1- I Village A) -fz�— Owner Address Telephone Z Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation�/o a, O Construction Typed i dw Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 2r-- Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes _a Nlo On Old King's Highway: ❑Yes JD-No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count a`. Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other o Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: O�'es No :-,I UJ Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: ', Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ G. Commercial ❑Yes ❑ No If yes, site plan review # Current Use - ' Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name � z� �O�/,%�U�f9✓%D1c1 Telephone Number Address 1,40 License # D D 9Ja ,1Jld Zi Home Improvement Contractor# A3 c-9 Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO i SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE , OWNER' c ; F y ti DATE OF INSPECTION: FOUNDATION FRAME 1 INSULATION FIREPLACE ,L ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO.=" OWNER AUTHORIZATION FORM cc �Q I �A n S o r-) (Owner's Name) owner of the property located at 1 L OM &kJ X-4e (Property Address) (Property Address) hereby autho rize Qa -e Co AJ , (Subcontract ) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. ��4 Owner's Signature y�z?�Z Date 9A4 — 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2012 Tr# 206433 CAPE COD INSULATION, INC . ;. HENRY CASSIDY .' 455 YA R M O U T H R D. HYANNIS, MA 02601 _:Update Address and return card. Nlark reason for change. Address [__I Renewal l:.I Employment L.I Lust Card JPS-CAI ii 'WNW4/U4-GIU1216 i 1 Liccuie or registration valid for individc! use 0.^_!•, tll"ficc u1 Sumer Affairs 13w ne's/-Ke'g-'ul itiau g HOME P�'1 L_"tf lfl=`wM Ftt�Tt�"�"its t�cfurc the expiration date. if found return to: Registration: 153567 Type: office of Consumer Affairs and Business Regulation k.Plaza-Suite 5170 Expiration: 12/15/2012 Private Corporation 10 Nar Boston,MA 02116 P ; OD INSULATION,. INC HENRY CASSIDY 455 YARMOUTH RD, ��`� � - HYANNIS,MA 0260:1 — -" - -- - '-- Uudersecretary t alid ith t si tune ' \la.+�.tihUSl'[Ix-�cpartn)cnt of Pul)lic Safct� Bward of Building Regulations anti ltand:u tls" 4onstruction Supervisor License License: CS 100988 ft hiy HENRY CASSIDY 8 SHED ROW WEST 1-ARMOUTH, MA 02673 c— - Expiration: 11/11/2013 (iunnm>i„nrr Tr#: 7620 r c• �vIL �: IIrIVi No. 1605 P. Client#:4597 CCINSUL ACORD,,, CERTIFICATE OF LIABILITY INSURANCE DATE(MMID()NYYY) 07/02/2012 THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURFR(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the cerllflcata holder is an ADDITIONAL INSURF.O.the policy(ies)must be endorsed.IF SUBROGATION IS WAIVED,subJecl to the terms and conditions of the policy,certain policies may reyulro an endorsemanl.A statement on this certificate doer not cunfer rigl)ls to the ceI'tlflcale holder in lieu of such endorsemenl(s). PRODUCER Roflers&Gra Ins.-So. Dennis NAME: Mar aret Youn 434 Route 134 ac°Ne EXI:508-760-4602 �c No:877-816.2156 E-MAIL South Dennis, MA 02660-1601 ADDRESS- 508 398-7980 INDUR911(0)AFFORDING COVERAGE NAIC N INSURtRA;Peerless Insurance 18333 INSUREU� INSURERa:Evanston Insurance Company ••`� Gape Cod Insulation Dic 455 Yarmouth Road INSURERC:Atlantis Charter Insurance Hyannis,MA 02601 INSURER D:Commerce Insurance Company 34754 INSURER E: IN6URERF: COVERAGES CERTIFICATE NUMBER: __ REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 15CLOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. rt TYPE OF INSURANCI3 ADD SUBR POLICY EFF pOLICY EX PaLICYNVh+BER (MMIDDNMI IMMjOftNyYYILIMITS A GENERAL LIABILITY CBP8263063 0410112012 04/01/2013 EACH OCCURRENCE $1 OUO 000 X COMMERCIAL GENERAL LIABILITY Pf7EMI5ES occu nca $100()Do CLAIM3•MADE OCCUR MEO EXP(Any Ono Oaten) s5,000 PER80NAI.&ADV INJURY $1 000 000 OENERALAGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER; PRODUCTS•COMP/OP AGG s2,000,000 POLICY PRCT O- LOC $ p AuroraoelLEL1ABIuTY 12MMBCKVMK 4/0112012 04/01/201" A,M2IIEDswGLEUMIT 1 OODUUU AIJY AUTO BODILY INJURY(Pe,peron) $ ALL OWNED X SCHEDULED BODILY INJURY(Per&:ident) $ _ AUT03 AUTOS •X HIRED AUTOS X AUTOSWNED PROPERTY A C' S (per accumaLL- B X UMEIRFLLALIAO OCCUR XONJ453512 4101/2012 04/01/201 EACH OCCURRENCE S1,000,000 EXCEgy LIAR CLAIMS-MADE AGGREGATE $1 OUO UUO oEO X RETENTION 10000 C WURKERSCOMPENSATION WCA00525902 6/30/2012 06/30/201 X WCSTATU• OTH• $ ' AND EMPLOYERS'LIABILITY ANYPROPR r q�}��7N BY11Y OFFICER, IEMBOER EXCLUOTg�ECVTIVR� NIA E.L.EACH ACCIDENT $1.000 000 (Mandatory in NH) E E.L DISEASE-Ea MPLOYEE $1 000 000 It yae,deacrioe Irnde� DESCRIPTION OF OPERATIONS Uelo. E.L.DISEASE.POLICY LIMIT 1$1 00U 000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(ALlaah ACORD 1111.Addlllonal Rom ,ks Schedule,It mere spree IB regnlfe(O -Workers Comp Information°" InrlUded Officers or Proprietors Certificate Holder is included as an additional insured undor General Liability when required by written contract or agreement. CERTIFICATE HOLDER CANCELLATION Cape Cod 1118Ulation,Inc SHOULD ANY OF THE ABOVE DESCRIBED POLICIES FIE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL 13E DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRLSENTATIVE ®188 -2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo aro roglstered harks of ACORD 9$838491M83848 MAY I The Common i I ,-,dih of Massachuseits- Departatent r inchistrial Accidents Office, .,j lavestIgatt ons Al W 600 Vto.,-Iiington Street Bosl, .,.:. AIA 0211.1 IV l+'I I .f..;:IS)%g 0 V/C11 0 1Vol-kul`s Coll I pe 11sation Insitrance Affi.J—:i: pkk�ase Print Legibly PL Phonek C- Z2.5 AI't:)o)LI4IICjIIljkIuyCl-? Check (11t; appropriatebOX: Type of project(yetillirc(l): 1 1.4 [,kill zi rillploycr wigs. 4. am a i�,rii-.-,.-Icontractor and I have 6. 1:1 New C011SIII-LIC.6011 (f[III and/or hired ilic iih.,,ttitiractors listed oil 7. E] Remodeling - the a[taJic,,.I 8.I aill �, Solt-, Proprietor or partnership These sw--iiinictors have and llavc 'it.)employees work-Iril-, for employLv—aid have workers' comp. 9. F-] Building addition nic III any caf)acity. [No workers' insuranrc.i 10. El EUCC(rical rolmlis ur addiliulls COMI) msmancc i*c-qLIiI-CCI.j 5. We arc.j cotloia[ion and its 11. M Plumbing i-Cpail-S Of addiliolls officers jim cx(fi*cised their rio-Ait of -I § I llw lio0wilet. I , all work exempii.tm N(GL c. 152 (4),and 12. Roof repair myscll' [Ni) work-ri-s' comp. we havc ji,-ciiijiloyees.[No workers' 13. od-ml- 00111P, uL.t iaiiict 1'el.11.1ifed.] Ilial L-11CCh-S I)OX It I MUSt also fill OLII the section below 11,111 workers'compensation policy information. MW-41611lit this akffiduvit iridicuting they are doing all woo, -i dwit him outside conENCIol'S IIIUSL submit a now affidavit inkficalii%ski0i- awachn thill chcck this box II1LISt attach an additional sheet showing of the sub-contractors and state whether or not those entities have ellitiloye.ei 11 .mmaclvta 11avc Giliploycr M—N, they USE pt-oyide their woi*Kefs'coit.1, p•I.,) numbef. I am an employer that is pro vielirig workers'compensation iiis,i,,,mcefor my employees. Below is lire policy anti job site 11-mint t-('0tupany Nar.e: At� (1,V) It: WrA Expiration Date: -66 Iq /S v 'Itill SILC City/State/"Lip: Attach j copy oit'the wl,jj*lcel.S, compensation policy declaration page t.-a...wing the policy number audexpiratickki(late). "IlUIC I0,CCUI'C 1:UVC-,J'a6r-OS CC(.ILiirCCI Under Section 25A of MOL c. 15., 11ALl to the iInPOSiti011 Of Clinlilltil penalties of a finc,up to$1,500.00 m0u, Ilitc-mil IIIII)i IsUlllm-,Ilt, as well its civil pCI1@ILieS in the form of a STOP Nt(11(K*ORDER and a fine Of Lip to$250-00 it day against(lie violatkic. Be advised Forwal-ded to the Office of lnvesti,,.a.........I'die DIA for inSLII'QIICe coverage verification. I du here c under the�)Iairis arjel penalties qj'p,.-,.-piq that the information provided above is true and correct. Dale: '7 UJficied 14se oldy. L)u itut write in this are([, to be completed I.,v-'aY or loirn official I du here gf umllethe FCity 01-TUNVII: # Issuing Authority (Circle 011c): I- Boat if ot'llealth 2. buildiiig Departmeal 3,Cil,i/Tomi Clej:k 4,Electrical Inspector S. Milimbing Inspector 0.Other 0 Contact PVI.Sul.k: Phone#: CAPE COD �O'�'J,'-� O'FiaRNsTaBL INSULATION 2"12SEP 12 �'l610; CZ2 FIBER OLASS SEAMLESS SPRATEOAM .SUSPENDED BATTS GUTTERS INSULATION CENINOS '_==w"--=s'=s-r-=:� ,� 1-800-696-6611 Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date: Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by"a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village .1 1a�irlsoN �//y lv�v►-b�. -- G,I;�.. ✓r�s �1 � Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings Ow) ( ) ( ) ( lCJ ) (X) ( ) Slopes ( ) ( ) ( ) ( ) ( ) Floors ( ) ( ) ( ) ( ) ( ) Cc�i�n 5�1cll k1nj ip�l Sincerely "Insu esident nc. V� i CAPE COD TO VI!' k .`�;IADLE INSULATION � � 1�, ` _ #` f 9 : 2 nM OIAO SIAMIISS SPRATlOAM SUSPINDID "Trs OUAIGS INSUTATON "I 'Na' 1-800-696-6611 Town of Barnstable Regulatory Services Building Division D r 200 Main St (� Hyannis, MA 02601 Date: 12/30/2011 Dear Building Inspector I Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed& completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village Carol J Johnson 1,14 Lombard Ave W Barnstable Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) (X) (30) ( ) (X) Slopes ( ) (X) (18) (X) ( ) Floors ( ) ( ) ( ) ( ) ( ) Walls ( ) ( ) ( ) ( ) ( ) Sinc y r my ssi Jr;President ape od Ins ation, Inc. ;= TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION TA Map Parcel Application # I Health Division t' ' 22 -� �0• 7Date Issued -aZ � Conservation Division Application Fee Planning Dept. -- -= � Permit Fee Date Definitive Plan Approved by Planning Board­ Historic (r Historic - OKH Preservation / Hyannis Project Street Address . e®,,op Village T 4W_ze i Owner/`A�1 � i�, i tau Address //#1or�A�cS b Telephone Permit Request g 14 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation P2,13 4T Construction Type I&J�/�/���� Lot Size Grandfathered: EllYes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family a/ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes U'*N o On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name � Telephone Number Address �U/c9 yi9� a!,� .��� License # /4 6 ot Home Improvement Contractor# Worker's Compensation # G��6v'J cr Zo ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE F FOR OFFICIAL USE ONLY � APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER. ' A DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ' • ELECTRICAL: ROUGH FINAL k PLUMBING: ROUGH FINAL GAS: ROUGH FINAL t FINAL BUILDING r , DATE CLOSED OUT ASSOCIATION PLAN NO. ` The Commonwealth of Massachusetts Department of Industrial Accidents l Office of Investigations 600 Washington Street t ` Boston, MA 02111 wwly.rnass,gov/dia Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / Please Print Legibly Name (BusinesslOrganitation/Individual): A4� rA2 Sll 1 a "if f2'.- �/l9 f ` Address: C/ City/State/Zip: C( Phone #: roe Are you an employer'?-Checic th appropriate box: Type of project (required): l. I am a employer with _ — 4 ❑ I am a general contractor and I 6. ❑ New construction eiriployees'(full and/lir'patt-time).* have hired the sub-contractors . . listed on the attached sheet. 7. ❑ Remodeling 2.❑ I am a sole proprietor.or partner- ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' q ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.) 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions i 3.El I am a bomeowner.doing all work officers have exercised their l l.❑ Plumbing repairs or additions right myself. [No workers' comp. , exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152 §1(4), and we have no employees. [No workers' 13.❑ Other&Nve4 Izl 1;JA i�h comp. insurance requi-red.) "Any applicant that cheeks box fit 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. lContractors 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 / ��c� " 1,a Insurance Company Name: 1 -A ZI Cl , 7�-- ��5�21�—�1�1 // '— Policy# or Self-ins. Lic, 9: (&)(14 Expiration Date: �D 3G L Ci /State/Zi .r 11G�1OG� Job Site Address: h 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 fore 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 u e pa' and penalties of perjury that the information provided above is tr4te and correct. Si nature: / Date: Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority (circle one); L6. oard of Health 2. Building Department 3, City/Town Cleric 4. Electrical Inspector 5. Plumbing Inspector thertact Person: Phone#: t(c)(Jurs. k Gray-.Lns. Vdge: vu_ Clienrl#: 4597 CCINSUL AEC}F2c�'� CERTIFICATE 4F LIABILITY INSURANCE OAI* l"Itv"UU/YYYYI THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER1 THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR N2011 EGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ie5)must be endorsed,if SUBROGATION IS WAIVEp,subject to the tcnn�and conditions of the:policy, rertain Policies may require an andorsament.A statement on this certificate does not eonl'ar rights ro the ccnlhcute holdcr ill lieu of such endorsement(s). rIIUUUL'L'N CONTACT Ruyurn s Gray Ina. -So. Dannis NAME: _Margaret Young a Pt10NE 508-760-4602 ...._._.._ - ----.............�._.-_....---•--s I r uutc 134 uc.ua 1: �(AVC-NQ: 508 • 58-2102 hTA�' --------— -- r U tiu> 160 l ADDRESS: Ycungma@0ragersgray,Corn -PROD-RER SULIM Ucnnls. NIA 02660-1 G0-I CUSTOMER ID - - INSURER(5)AFFORUING COVERAGE Ir;pUKco — _ NAICa Ca(-le Cocl Insulation Inc INSURER A:Peerless Insurance -- 18333 455 Yarmouth Road INSURER a:Ohio Casualry Insurance COrnpalny Hyannis, MA 02601 INSURER C•Atlantic Charter insurance INSURERO;Comnlerce Insurance Company A -- •- 34754 INSURERF: _r --- �UvckAGcS CERTIFICATE NUMBER: Y rl-I�,r rHE POLICIES OF INSURANCE LISTED BEt.OW HAVE BEEN ISSUED TO THE IraSURED NAMED ABOVE REVISION THE POLICY PERIOU ot,:,Tl.it rIV I'YYI I l-t6TiVVDIING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPCCT TO WHICH THIS I.UK I1rIC;11 E MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT 1.0 ALL THE'I'ERndS. t,kl,.LUsli N:,AND CUNL')I PION S OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IfISR IR , rYVE OF INZUttANt.k SR 0 POLICY NUMBER oLICYEFF POLICY EXP rrrM10UIYYYI wedualYYYY LIIYII I'S A �eN R LLlaalury CBP8263063 04101/2011 Q41011201 EAcr10CCUkRENCE b1 000000 _XI,.Ur.mler;i:�AL ticN�W',L I_IAttn.I Il' OANlAGETt)RENTED —""— �� PRCML I°S = p t100 UUO .-eo e.xl trv, ww Vvinon) $5,000 _-- ...-.--- --_-- - - PERSONAL.-Cl,AOV INJURY $1,000,000 GENERAL ACGRecATe y2 000L0UU RId,:Ar L,ti„r AI>r•uta rER. PaooUCTS CoNliwl AciG k2,000,000 -- I Q nU rOrAUtSILE LIAB0.1'1'I 11 MMBCKVMK 4/01)2011 04)01)2012 COMBINED SINGLE LIMIT All,AllK) (Ea acrJd."Q ---- $1 ,.I r.QvvrVl:Q AV'rOS- I BODILY INJURY(P.,per::un) s SC'14-UUII'U ALIT O$ BODILY INJURY(PC,eccl0onl) S ---`--- X u. co nuu,.; I PROPGRTY DAMAGE S --- - (P:,r uc iaanr) X NMUOMIukn AIII US E Uf,InItCLLA L,Ah X QCCVR UU6254514645 4101/2011 0410112012 EACH OCCURRiNCG $1 U00 000 �n Ensuau —.__�__ _.. .._...__..._...--- CLAIMS-MADE AocREinre $1 000 000 _.__IvIS.......E lit nucl,ulr --- ------- I, 10 U U U ----'— --^----'------ C 'VORKL15 CUMPL-N$ATION $ AND EhIYLOYER$'LIAatLn-Y WCA00525902 6/3012011 06130/201 X VVC STATU- I I OTrb YIN NaI PRlirn;C I OWPAR INtii/E-YECU'r IV[ .?I`F,LtwMtnIBER EY.CLLIOLD? a NIA E L.EACH ACCIDENT $500,000 if,4n,,uruly lu NI11 I V w,Joxnba unow E.L.DISEASE EA CKIPI_.OYEE $500Ol I IA-5,'PIPIION I t t19FRA(IONti _____....._.._ E.L.OISEASE-POLICY LIMrI $500,000 l u�at:nu•UUra Ur ureltAl IUnJ I LUCAl1ONJ 1 VEYIICLES(Attain ACOHO tt11,Additional Rpmnrxs Scnaduk,a nwre spaca IS rcquvctlr Workers Conip Information Included Officers or Proprietors (Sea Atrachad Qnscriptions) CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOIt'ED REPRESENTATIVk „7) 01988-2009 ACORD CORPORATION.All rights iesarved. ACORD 25(2009/09) 1 of 2 The ACORD name and logo are registered marks of ACORD AS68575/NI68179 MEY uite 5170 10 Park Plaza - S Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2012 Tr# 206433 CAPE COD INSULATION, INC HENRY CASSIDY 455 YARMOUTH RD. - HYANNIS, MA 02601 ' Update Address and return card.Mark reason for change. fU~[j Address Renewal Employment Lost Card • ,mot -.�� DPS-CA1 0 50M-04/04-G101216 Of ice zutncr Affairs us nc ReguI ttion License or registration valid for individu!use cn.!; HOMRO`C/'��'�1`� 1 � d before the expiration date. If found return to: -__—_— Registration: 153567 Type: Office of Consumer Affairs and Business Regulation Expiration: :2[15/2012 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 _- OD INSULATION;LNC_ HENRY CASSIDY 455 YARMOUTH F HYANNIS;MA 0260.1';= Undersecretary t aIid ith t si tune Massachusetts- Deportment of Public Sufet% Board of Building Rowlations and Standards Construction Supervisor License License: CS 100988 HENRY CASSIDY 8 SHED ROW WEST YARMOUTH, MA 02673 o-- J Expiration: 11/11/2013 ('onunissiunrr' Tr#: 7620 OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at (Property Address) Pos,,-±S di--," 6 2,1"n G (Property Address) hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Owner's Signature Date ' D DEC 19 2011 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1 Map Parcel 0 Permit# s U Health Division A Date Issued Conservation Division i5 Z 0 �� Fee 60')-00 Tax Collector - L SEPTIC SYSTEM PAvST E JF� y Treasurer INSTALLED IN COMPLIANCE WITH TITLE 5 ENVIRONMENTAL CODE AND irnt TOWN REG Historic-OKH Preservation/Hyannis Project Street Address 14 Village Owner CAf;L TCNNgON Address ��' �.4)M0Ae0 Telephone 5©a 342 8 2 5 1 ' Permit Request c�q X a �/ Qavt �gr11 - ,, Wit)vY 112 'V 44 Square feet: 1 st floor: existing proposed 2nd floor:existing proposed 2 2 4 Total new '4 4 8 O Estimated Project Cost �Ining District Flood Plain Groundwater Overlay Construction Type CotNUTIONAL LUM5C9 f?QdMINC Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family Two Family 0 Multi-Family(#units) Age of Existing Structure /A0 YkS ! Historic House: ❑Yes ❑No On Old King's Highway: )kYes ❑No Basement Type: 1t Full I Crawl ❑Walkout Cl Other Basement Finished Area(sq.ft.) NON Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 2 new Half:existing d new d Number of Bedrooms: existing 3 new 0 Total Room Count(not including baths): existing 8 new 2 t loor Room Count 5 'Heat Type and Fuel: ❑Gas ,Oil ❑Electric ❑Other Central Air: ❑Yes Di No Fireplaces: Existin- _ New Existing wood/coal stove: 1AYes ❑No Detached garage:❑existing I%new sizi 2 ool:❑existing O new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: N Zoning Board of Appeals Authorization El Appeal# LA Recorded❑ Commercial ❑Yes W No If yes,site plan review# Current Use DES, Proposed Use �i 4�' gym,eoom APN,� Q;g4p. BUILDER INFORMATION Name CART J,014dSaN Telephone Number Address SAME License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO A5 f E com4f do CD or a, r. SIGNATURE f DATE 7' 8' 99 CA L To C14)41- Say FOR OFFICIAL USE ONLY _ PERMIT NO. DATE ISSUED MAP/PARCEL ADDRESS VILLAGE OWNER DATE OF INSPECTIO " FOUNDATION 'S } FRAME ` r INSULATION FIREPLACE ELECTRICAL: ROUGH 5 FINAL t t PLUMBING: ROUGH=i 0 FINAL GAS: ROUGHQ FINAL _. 5 r FINAL BUILDING- Q fit! n "" r cx' 0 It m DATE CLOSED�OUT 5 ASSOCIATION PLAN NO. , J�t 6199 f 'row, 9 � l TO: OLD KING'S HIGHWAY REGIONAL HISTOR C°�D.Kt,-c" DISTRICT COMMITTEE FROM: CARL JOHNSON, 114 LOMBARD AVENUE, WEST BARNSTABLE, MA DATE: JULY 5, 1999 RE: APPROVED ADDITION MODIFICATION AND SCALE DOWN OF PROJECT. -- r WE THE ABUTTERS OF MR. JOHNSON, 114 LOMBARD AVENUE ,a WEST BARNSTABLE MA, HAVE SEEN THE ATTACHED PLANS 70 FOR A SCALE DOWN OF HIS APPROVED ADDITION AND HAVE �•,� : , NO OBJECTIONS TO THIS MODIFICATION. LOT 4- EGILA LITTLE-LEX, 105 LOMBARD AVE, WEST BARNSTABLE MA � p . f 1 LOT 5 - ROBERT COLLINS, 121 LOMBARD, AVE, WEST BARNSTAB , MA C LOT 12 - PAUL PACELLA, 132 LOMBARD AVE, WEST BARNSTABLE, MA j;Zojp LOT 14 - DENNIS NYDAM REPRESENTING BUILDING PRODUCTS INC/ BIRD CORP., 1077 PLEASANT STREET, NORWOOD, MA �7 -------------------------------------------------------------- ---------------------- s ° D ° o 18'-0" ►� - - - - - - - - - - - - - - - - - ' II I I I existing II ' back II porch i I II I II 1 existing open entrance to kitchen I bnLn 6068 SGD � _ _ _ Existing resi ence I I co I, I I I proposed Proposed`'.::::•, .: .i I Existing Family RoomJ,I field stone .Famy � R00m.:+.N I _ v, , / fireplace Addit1o11` ` ::,' 0;:�, � I I ' cathedral:ceilin �. 1 Ll g': I Existing open 7b'oVej 'r Ij I entrance to hall co I�I Existing and stairs LI Front n ....... {L - - - - EntLance - J L - - __ . J g=J— - - - - -I- I ' 3046 3046 1 1 NOTE#1 I I Remove existing wall to I I out to out of window frames I I provide multiple 2x 12 header Existing Front Porch I as required I I L — — — — — — — — — — — — —I 14'-5" Proposed Addition FIRST FLOOR PLAN for Mr.& Mrs. Carl Johnson 14 Lombard Ave.,W. Barnstable, Ma. 1/8 If = 11 - 0 if FIRST FLOOR PLAN �. Designed by: Al R.A.Faelten (508)866 2104 Field stone chimney 25 year asphalt roof to match existing F - - - - - - - - - - - - - - r 1 \ I ' - Existing . ' ' All pine trim work ' �a�lly i to match existing Design ' and color rr ffi � F2bom . � 3046 3046 - - - - - - - - - - - - - - ' 16"-0" North East Elevation outh West Elevation Proposed Addition for: Mr.& Mrs. Carl Johnson ; 14 Lombard Ave.^ Barnstable,.Ma. NORTH EAST AND SOUTH WEST ELEVATION Designed by: «� R.A.Faelten (508)866 2104 A3 All new pine trim to duplicate the same design as the existing residence and be painted field stone chimney - - — — — — —.— — — — — a matching color i , 1 Existing i cricket residence L — — — 6088 SGD • Ir Ir I I ' I I rr Clear W.C. r� r� si ewall,5"t.w. North East Elevation 1/8"= 1'-011 Proposed Addition �© for: Mr.& Mrs. Carl Johnson 14 Lombard Ave.,W. Barnstable, Ma. QNORTHEAST ELEVATION QDesigned by: R.A.Faelten (508)866 2104 A4 Field stone chimney 25 year asphalt roof to match existing F - - - - - - - - - - - - - - r Existing� . ' All pine trim work (- FarrZlly to match existing Design Room , , and color r rr 3046 3046 - - - - - - - - - - - - - - 16-4- North East Elevation south West Elevation 1/8"=1'-0" ® Proposed Addition for: Mr.& Mrs. Carl Johnson 14 Lombard W. Barnstable Ma. . lets put some optional o Ave., , NORTH EAST AND SOUTH WEST ELEVATION . skylights in both these elevations o Designed by: R.A.Faelten (508)866 2104 A3 i vented ridge Ins?Insulation waft faced 2x12 ridge 25 year 3 tab asphalt shingles to match adjacent existing residence 200 rafters @ 16"etc with VY'cdx sheathing eave detail to duplicate existing residence tripple 2x8 headers \ ir beams @ 4'Gc 2x6 @16"c/c — — — _ with 1/2"CDX multiple 2x12 beam to Tyvek and clear white cedar I replace removed exterior wall shingles,5 to weather 2x10 �Gr. _ 2x10 ledger lagged to existing structure using 1/2"dia.x6"long galv. lag screws with washers 8"foundation Q16"c/c • on continuous 16"x8"footing — 2x10 floor joists�16"Gc * Adjust header height to finish with 5/8"CDX sub floor. windows at the same level - adjust elevation of these as existing below frost joists so as to obtain a level finished floor between old and new. Cross Section Proposed Addition for: Mr.& Mrs. Carl Johnson • 14 Lombard Ave.,W. Barnstable, Ma. Cross Section Designed by: A5 R.A.Faelten (508)866 2104 �t �9 i — — —Rebuild existing-roof— — — — — — T All new pine trim to duplicate I in this alcove,restructure the same design as the existing I with a flat roof and a field stone chimney residence'and be painted I 060 EPDM membrane ` a matching color I and new clapboard siding, \ \ I �✓ I I 1 \� cricket Existing Residence �1 I Front View I - - - - - - - - - - I I I I I I I I I I 1 I I 1 I I � ClearW.C. r L - — J L — — J L - - -L - - I I r Gr. sidewall,5"t. . 3046 3046 L _ _ J New Ballastered Cap rail I Proposed Addition North West Elevation 1/811= 1 9-011 Proposed Addition for: Mr.& Mrs. Carl Johnson 14 Lombard Ave.,W. Barnstable, Ma. NORTHWEST ELEVATION Y Designed b : . Q 9 A2 R.A.Faelten (508)866 2104 i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �� S Parcel S Permit# .r� SST Health Division - i Cv `t RSTALLE,1N C®OUST®ate Issued -9 1�✓17- rC LIANV Conservation Division !v ,(� �-- AIVIOn,V'—fiVIVI r LE 5 �� 3 0 AL CODE Tax Collector Treasurer OME Planning Dept. Date Definitive Plan Approved by Planning Board �� /� P�►� Historic-OKH Preservation/Hyannis Project Street Address 114 L o M eA r_b A\/E Village W• �AI�I.�TA�I. Owner C AE L 10 N5 Address A M E ; Telephone 3 Co 2 8251 Permit Request �^ G ►^^ r\J -z f/`so �- � � �-e h �,(e �/ Z& Square feet: 1 st floor: existing proposed Z 24 2nd floor:existing proposed fJ A► Total new Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Gonstruction Type S116 P_Awl E: Lot Size 5 289 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family J1 Two Family ❑ Multi-Family(#units) Age of Existing Structure )0 0 Y126 -� Historic House: ❑Yes 14 No On Old King's Highway: �4 Yes ❑No Basement Type: Nk Full $a Crawl , ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 2 new 0 Half:existing ' new D Number of Bedrooms: existing new L) Total Room Count(not including baths):existing ® new First Floor Room Count Heat Type and Fuel: ❑Gas P Oil ❑Electric ❑Other Central Air: ❑Yes No Fireplaces: Existing New Existing wood/coal stove: Yes ❑No Detached garage:CO existing ❑new size 24 Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# N �� Recorded❑ Commercial ❑Yes %,No If yes, site plan review# Current Use �7• Proposed Use 74 M 1 L� F o o M 4 p y I T I m4 BUILDER INFORMATION Name Q ®'"� ✓ Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE \ DATE -V- '7 1 �, / a} '� r] FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS - VILLAGE OWNER a f DATE OF INSPECTI : FOUNDATION FRAME i IT(Q q vO INSULATION FIREPLACE ' ELECTRICAL: r "ROUGH. FILIAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. . e mown oi j5arnStaDie & Department of Health Safety and Environmental Services �es� .0 Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph'Crossen Fax: 508-790-6230 - Building'Commissioner 2211 Permit no. J Date 3 —ze) AFFIDAVIT + 'HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION , MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work:4DolyoN,4Wr-Q,a ro"&EYV CotilSr,�,�►; Estimated Cost I Address of Work: 114 •,, L omiwp Sr. W, 8Q RN5 7*A6L C0 14A, Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): J Work excluded by law blob Under$1,000 Building not owner-occupied CKOwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. 2.8•g 9 64 a rowiJ anal OR C Dated Owner's Name q:fbnns:Affidav f :--_- -- The Commonwealth of Massachusetts _� =-- :_:3� Department of Industrial Accidents i4 - 600 Washington Street +� Boston,Mass. 02111 Workers' Comyensation Insurance Affidavit '/rn6cau . nrutctl %%///////%%//%%%�%��%�///.//////%% 25 , name: location: 114 L ol!6a&r—,, A city LZJ' 4 �>ll� T d���i-- hone It I am a homeowner performing all work myself. I am a sol rietor and have no one working in any capacity %%/%%///%%%%//%/////%/D�%/%%%%//%%///%%%%%%%//////%//%%%/%%%%%%%%%%%%////%%%%%%%%%%%//%�///%/.;��;;; ❑ I am an employer providing workers' compensation for my employees working on this job. compnnv name address: ..... city: phone#•. insurance co. Pn1icV# r ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors Iisted below who have the folloning workers' compensation polices: company name: address: dtv phone#: insurnnce cn. oltcv#.. :.::•;:•::::;:.::<:>:.>;::;:>:;;::. comnanv name: ;..............: ::....,:.:::...:::::::.:.. :.:.... address. city: ... phone#' .:.< :..>.......:.:.::.: . olicv# ::; insurance co. ........: :;:;:•;:::•;.::•:::: ::>:::;. >::;:>:>.:.:..:>:>;;;:.;:: Failure to secure coverage as der required un Section 25A'of MGL 152 can lead to the Imposition of criminal penalties of aline up to S 1.500.00 and/or' one years'imprisonment as well as dvil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage veriflcation. I do hereby certify under the pains and penalties of perjury that the information provided above is tru,-and correct Signature �l/'� Date a`�( g4 _ Print name C C.t✓1 G h r,Sorg Phone# oMcial use only do not write in this area to be completed by city or town ofllcial city or town: permit/license# DDepartmentrtittmtdcheck if immediate response is required f9eementcontactperson: phone#; ................ .:...... : ....... (mvea 9i95 PJA1 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any co=--= 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 receive:c. trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewa 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,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 in the workers' compensation affidavit completely, by checldng the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made.; The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of lmrestioauans 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617).727-4900 ext. 406, 409 or 375 SHOWN—ON Tnib rLmm rsn �..L��•� 49 DIVIDING EXISTING OWkERSHIPS AND �ecrieS r1��` .4A~S THE LINE OF'THE -ST-REET. SHOWN °,R S ° r4B Iq' ARE THOSE OF PUBLIC STREETS t 72. 3 4 .. /0/ <F ALREADY ESTABLISHED,AND NO d 9 C 63.75 NEW LINES FOUR DIVii+ION OF + ' S 45°53' 30°E d li ti 83. 11, 4 �O ~T EXISTING OWNERSHIP' ARE_SHOWM. QTopl v R 35.289 Sq.Ft. 3h d _ OM� 0.810 Acres p2QR^5ED 2 ' ---- y . STa�`( A�D►TioN 3 ul � G2A4R xA GE pPP�r.lP D 5E D 4 a o Q C 03d P- , IZ DECK " . G 72 1 In I ^ z I 'nCa 20 MhN -WELL �PI�� y 229.94 N 52045 3O W y •, , :c,,` ..�.�r.;' FOR REGISTRY USE LOMBARD 3 pLAN OF LAND IN w.BARNSTABi..E MASS 1" SCALE I CERTIFY THAT THIS PLAN HAS BEEN PREPARED IN ACCORDANCE WITH THE RULES ALL CAPE-ENGIf�iECRRiNG AND REGULATIONS OF THE REGISTERS OF DEEDS. HYANNIS, MASS -' SCALE 11•Vr30FT 6/2 1 /84 - • v de se 7� The Town of Barnstable FTt+e �o Department of Health Safety and Environmental Services Building Division ' SEL MAsa ` 367 Main Street,Hyannis MA 02601 9 059. g' �AtFD MA'I t. Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: 2�I�� / ,, JOB LOCATION: 1 `l//— (API 1640 14T number p street village "HOMEOWNER": 4^19 name / home phone# work phone# CURRENT MAILING ADDRESS:. I"I [ 4 l 6 M 0 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER , Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building Hermit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he will comply with said procedures and require nts. A Signature of Homeo 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 to amend and adopt such a form/certification for use.in your community. Q:FORMSIXEMPT r AIPApplication to Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS i Application is hereby made, id triplicate, for the issuance of a Certificate of A I 470, Acts and' Resolves of Massachusetts, 1973, for proposed work as described below andon plans, drawings s or Chapter accompanying this application for: g CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ® New Building E9 Addition M Alteration Indicat-a type of building: ® House Garage g ❑ 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 ADDRESS OF PROPOSED WORK 1 1 4 L o M aAF P AVE 5ASSESSORS MAP NO. _ OWNER GAP. U J°o H N 5o N PaRG@I� AVE, ASSESSORS LOT NO. 15 HOMEADDRESS 114- LOV18A�d V TEL. NO. 508 3�2 Ig25 � FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). &Trf;�..., ;...►�. , AGENT OR CONTRACTOR �a VE R T I' A LT TEL. NO. 8GG _01+ ADDRESS ��-- P�YMoUTH �T �.1 . GA�'VE� hN�� , t1?�,� � m DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8,other sl e), includ g materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing sigra�and proposed locations of new signs. (Attach additional sheet, if necessary). R C FE(z To ii�LOFE ; OF WOIZK A TTAit C) o 1 _/5-1 Owner-Contract -A rtt Space f�efow�efCommittee use. _.- O u he Certificate is hereby _ 3 Q T4i 1998 BLE .+ r -. ING' HI HW 'a,z Approved ❑ IM ORTANT: If Certificate is^nproved, approval is subject to the 10 day appeal pe iod provided in the Act. O;�nonrs±YPd L_7 82 Plymouth Street Box 591,N.Carver,Ma.02355 508 866 2104 Bittersweet@adelphia.net ons_ January 13, 1999 Carl and Carol Johnson 114 Lombard Street West Barnstable,Ma. Abutters: Lot 4 Egila Lex, 105 Lombard Ave. West Barnstable,Ma. 02668 Lot 5 Robert Collins, 121 Lombard Ave.West Barnstable,Ma. 02668 Lot 12 Paul Pacella,Lombard Ave.West Barnstable,Ma. 02668 Lot 14 Atlantic Building Products,Inc./Bird Corp., 1077 Pleasant St.Norwood,Ma.02062 ys . . . . . . . . . . . . . . . . . . . em 'n ode :d ro tt Herat' -ry =-Ge C January 13, 1999 Page 2 - Scope of Work: 1. Construct a 24'x24' 2 door garage with a concrete foundation,concrete floor, second floor with a shed dormer to the rear and 2"dog house"dormers on the front roof.Framing to be conventional wood studs with plywood sheathing.Garage doors to be sliding barn door design, sidewall finish to be cedar clapboards and white cedar clear shingles,and 3-tab,25 year asphalt roof shingles. 2. Construct a 14'xl6' 2-story addition to the rear of the existing residence,the first floor will be an addition to the existing family room and the second floor will be the owners remote office with a separate external entrance and an entrance to the roof over the existing family room which will be reconstructed to provide a flat(minimal pitch)with an EPDM membrane roof and a loose laid pressure treated walking surface and a balastered handrail.Foundation, framing and sidewall treatment to be as described in item#1 3. Construct a 13'-9'/z"x 18'-0"enclosure over the existing open air deck.Wall framing to be post and beam with 3'-0"sill walls and vinyl or aluminum sliding windows,relocated existing doors, 3 32"x48"sky lights will be on the roof which will be covered with asphalt shingles. 4. All painting will be on trim work and the color will be a pale yellow to match the existing color of the trim on the existing house. 5. Robert A.Faelten President � + I •I ` Town of Barnstable I Old King's Highway Historic District Committee � SPEC SHEET i FOUNDATION �I) rCdl �p 6OHa rE ON GgodT, SIDING TYPE COLOR I CHIMNEY TYPE I E l.D Ya IJ t✓ i COLOR Q p►T U IZk L • ROOF MATERIAL P t1 L."r COLOR L A G PITCH I 2 /I'L , WINDOWS QPII7ERdjEa1 P/� �N ' kJWOLOR /ALE EI.LOWSIZE I�ErEfF TO V12,4A lII CT1 ' TRIM COLOR ?,kLE `(ELLOVJ DOORS 15 LITE COLORS PQ.L� `(ELL oyJ SHUTTERS COLORS N — - � GUTTERS L LIN f ' COLORS "G I E LLO W DECKS ��'41COP (11tr-, ro Dw(:- '� MATERIALS I 55UP.6 TgC-A6Td® rCEK41LM '5•Y,P GARAGE DOORS �'� ���Q Q COLORS PA TU CAL. SKYLIGHTS �oYO )Y I SIZE 4'8 COLORS PAV- SIGNS N O N C' COLORS FENCE ® COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plane, when applicable. SPEC HT Revised 11/98 �[ sue. • ZZ e Q• Q `p % � 1V. �e�1 a .. • Q I ED Ao Nl IV CJ as s• Flr �sa `� ��- �, o, c. i I�,J TOWN OF BARNSTABLE LOCATIOAI �ji �;f r I/C SEWAGE . VILLAGE��[j _ ASSESSOR'S MAP LOT _; INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) P/+ (size) 1 NO. OF BEDROOMS .1 `.PRIVATE WEbL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: 5- - j � •. PS7 VARIANCE GRANTED: Yes No v d Ne w Z-U lk?b a r )'ve . . LINES SHOWN ON THIS PLAN ARE THE 6 DIlfIDING'.EXISTING..OWNERSHIPS .AND ►L� 4R�6' THE LINE OF'THE STREET SHOWN • /.oGwv�3., i,a st c JC`sL� 1� S m o � ARE THOSE OF PUBLIC STREETS $ �2.34 ► a o of® � C ALREADY ESTABLISHED,AND NO 53.75 , S 45"53' 30°E ��S OG NEW LINES F0�3 DIVISION OF 83-11' p �P} EXISTING 0W10E�SH11� ARE_SHOd1�1. ClSb1 W¢� 35.289 Sq.F3. - - ®d R° 0.90 Acres .. W I �p�S.ED..,• Peo PDSc D C T E in - - - Al2 -DK � mnZ 7�2 � 1yi1�Gl, - 2 PtT4. 4-, 2 2 9.9 4' 04 5' 3 0' W c 52 .• <'' `� _ lYc. FOR REGISTRY USE PLAN OF. LAND LOMBARD 3 a y �. IN q- W.BARNS•TABLE MASS 3' SCALE oww:_n_ sY cJ I CERTIFY THAT THIS PLAN HAS BEEN GAIZ L TON�SON _ PREPARED IN ACCORDANCE WETH THE RULES ALL CAPE EPIGiNEERRING' , b AND REGULATIONS OF 'THE REGISTERS OF DEEDS. HYANNIS, MASS _ SCALE 1 1.V=30FT 6/Z 1 /84 • 4.T uilding DIVISIon 367 Main Street,Hyannis MA 02601 iffice: 508-862-4038 Ralph Crossen ax: 508-790-6230 - BuiIding'Conuniss'=2- Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered conum mrs,with certain exceptions,along with other requirements. Type of Work: -j;AM I Ly K470M A004-rlOiJ Estimated Cost IV a00 Address of Work: 114 L D M 6A, Owner's Name: C A 5Z L TD H I.l 50tJ Date of Application: 74�. I hereby certify that: Registration is not required for the following reason(s): [3 Work excluded by law C]Job Under S1,000 Building not owner-occupied (ROwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contr==Name Regisnation No. / C ` OR Date.. Owner's Name q:fams:Affidav 600 Washington Street Boston,Mass. 02111 �� Workers' Com ensation Insurance davit �innc:nf:•rt:sQc =aaxtr;:;� ,//////,%%'�/��%/'/��/////i'///��„ / ,��/i�///i'�/�.•!'///.%,•�...._. name: location- I I4 LoM 6k eo A V t:. City PEA?W 5TA OL IO:�* hone 0 3 402 $2 51 CK I am a homeowner performing all work mysei£ I am a sole proprietor and have no one working in any achy i I am an emplrner providing tivatiters' compensation for my employees tivotltiag oa this jab. comnnnv name- address: city: hatiC#' insurance cn. eiiev*71 I am a sole proprietor, general contractor, or homeowner c&dz one)and have are hued the connectors listed below who the folIoning Nvorkcrs' compensation polices: omonnv rtsme: z. �inrnrvce�cn. Kiev!! •.:.;: ,y ... < ....:.s�' y;.w� .» "�;y"•:�,:.. ..i.'iii�.�iW.V "'i•~ •:Mt i>' .+p.:i�MYf.�'•:.n'w000ic.Mw+w. •- i."s ^narty name- :: '.` :i:! 2�^>\•s ;s«.;:. ; stance <„:.::•>:fa+.. ,.. :.:.w....� co. Lav to secure coverate as requited corder Section ZSA of MGL 152 can Lead to the impezjd=ofdn*up a> -ears;lmproonment as well as civil penances in the form of a STOP WORK ORDER and a lira o[StOt�.00p a Bata to SISt1tL011 and/or r of chit statement may be forwarded to the Mce of Investigations of the DIA for covmge verukatim Nit t� I understand that a herrbv cerTify under the pacts a#penalties ojpetjurr that the information provided about is/true and eorresr. azure Date ✓ lP, 1 -t rtattte p 3 Co 2- 02 5 ) - )IMC l use only do not write in this area to be completed by city ortown umbel tp or town: °ma Mudding Department check if Sntnediate response is required Dldeemsiag Board • ❑Seleettten's OLIIu ntact person: MealthDepuutent phone d; �Other- „vs FIAT _.. ..._ .... . ersplovees.. As quoted from the "law", an employee is defined as every person in the service of another under tine° of hire, express or implied, oral or written. An employer is defined as an individual. partnership, association, corporation or other legal entity, or auv two or-- _ c the foregoing engaged in a joint enterprise, and including the legal represcnM%i es of a deceased employer, or the: ti=c-- of an individual, parmership, association or other legal entity, employing employees. However the or,=of a dwelling house leaving not more than three apartments and who resides thersin, orthe occupant ofthe dwelling house another who employs persons to do e , or repair work:on sash dwelling house or ant the=uz�z building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance-air rereFr: of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who not produced acceptable evidence of compliance with the insurance coverage required. Additionally,ncid=rthe commonwealth nor any of its political subdivisions shall eater into any contract for the performance of public work•.r.---. acceptable evidence of compliance with the irm rtnce requiremeais ofthis chapter have been presented to the coffi-.:.-- authority. Applicants PIe:se fill in the workers' compensation affidavit completely, by ebedong the box that applies to your sit atiaa and SUP plying company mines, address and phone numbers along with a cqtM=of hwn==as all affidavits may be submitted to the Department of Induseial Accidents for confizmatien of; coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or tom that the applicuion for the permit or liceasc is being,requested, not the Depat4rtent of IndusaW Accidents. Should yva have nay questions regarding the 'law"or if c are required to obtain a workers' compensation policy, please call the Departaaeat at the muaber listed below. City or Towns Ple:se be sure that the affidavit is complete and printed legibly. The Departm=has provided a space at the boom of f'. iJEdavit for you to fill out in the event the Office of Investigations has to contact you regarding the appiirnit Pl=e ze sure to fill in the permitlliccase number which will be used as a reference number. The affidavits may be rtunnei io he Depar==t by mail or FAX unless other arrangements have been.made. Che Office of Investigations would film to thank you in advance for you cooperation and should you have any gaesd=. )I=e do not hesitate to give us a call. :be Deparaneat's address, telephone and fax nlimber: The Commonwealth MIassachuseW Department of Industrial Accidents Omce of tmresdoadoas 600 Washington-street ' Boston;Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 eat 406, 409 or 375 JI PrFuripdre PzdmM for Oae and Tne•Famill Reaida mW Bo1Wlap gaud with Faad.Lam. MAXIMUM MliVm1UM Gu=g � � am s wan Hm Bmeat Slab Atmi('A) U-value= R Wur' R-vaivar 94WI as Wall Pleeimsoe: p Q R.vaiule &vacua' 5"1 to 6300 DAW Q 12% 0.40 3E 13 19 10 6 Normal R 12% OM 30 19 19 10 6 Normal 9 I2% 0.30 3E 13 19 10 6 ES AFUE T IPA 036 3E 13 23 WA WA Norma! U iSY• 0.46 3E 19 19 10 6 Normal V IS•A 0.44 38 13 25 WA WA Ei AFUE w IS"• 0.m 30 19 19 10 6 aS AFUE x 19% 0.32 38 13 25 WA WA Nomml y 19% 0.42 3E 19 25 WA WA Normal Z 19% 0.42 3E 13 19 10 6 90 AFUE AA Ia% 0;50 30 19119 10 6 90AFUE 1. ADDRESS OF PROPERTY: 4- L om L,; A(Zr p `I L W , 5A rzi-4 sTo bLL> 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 4 -1 3. SQUARE FOOTAGE OF ALL GLAZING. 4. %GLAZING AREA(#3 DIVIDED BY#2): S. SELECT PACKAGE —AA-see chart above): (Q ) I NOTE: OTHER MORE INVOLVED METHODS OF DEI RMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMA?ION. BUILDING INSPECTOR APPROVAL: YES: NO: q-farms-i980303a '.Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights; and basement windows if located in walls that enclose conditioned space, but excluding opaque doors) to the puss wail area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requiremeizt. For example, 3 ft of decorative glass may be excluded fiom a building design with 300 fl of glazing area. ' After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R 30 insulation may be substituted for R-:8 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall For example,an R 19 rzquirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or.mass(concrete,masonry, log)wall constructions,but do not apply to metal-flame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces, basements, or garages). Floors over outside air must meet the ceiling requirements. `The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-Z for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.11a NOTES: a) Glazing areas and U-values are maximum acceptable levels. Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 035. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table 11.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c) If a ceiling, wall, floor, basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of ail windows or doors is less than or equal to the U-value requirement(035 for doors). �- 43 Department of Health Safety and Environmental Services Building Division MAMMAJ= 367 Main Street,Hyannis MA 02601 truhsa Office: 508-962-4038 Ralph Crossen Fax: 508-790-6230 Building Commissione: HOMEOWNER LICENSE EXEMTION Please Print DATE: JOB LOCATION: ! ( v. r c ^� J c . �cJa s ,. amber ge � / / steal tilla "HOMHOW M (--`'� 2 ? S-g - acme home phone# work phone# CURRENT MAQ.ING ADDRESS. �1 L� Q^� b ��•� A J-- dtyttown state rip code The current exemption for"homeowners"was extended to include ed dwellingS of six units or less and to allow homeowners to engage an individual for hire who does not possess a license =Mdded that the awner acts aQ sanervLim DEF NMON OFHOMEOWNER Persons)who owns a parcel of land on which brishe resides or intends to reside,an which there is,or is intended to be,a one or two-family dwelling,attached or detached structum accessory to such use and/or farm stract rm A person who construes 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 - resnonci'ble for all such work performed neder the building jimmaftf Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,roles and regulations. The undersigned"homeowner"catifm that he/she understands the Town of Barnstable Btulding Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signaaue of fldiii ma Appmval of Building Official J 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 Comm/. HOMEOWNER'S EJETION The Code stares that "Any hameowna performing work for which a building permit is requh-I shall be AM the provisions of this section(Section 109.1.1-Iioensing ofcogstroction Supatisour provided that if the homeowner engages a person(s)for hire to do such work.that such Homeowner shall act as supavisac" Many homeown=who use this aeemptioa are unaware that they am tmumiog the responsibilities of a supervisor(see Appendix Q. Rules&Regulations for Ltoensiog Construction Supervisors,Section 2.15) This lack of awareness often results in serious problemss, ps ucub ly when the homeowner hiss tmliaased persons. In this case.oar Board camtot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is Wdmrmeiy responsible. To ensuue that the homeowtxr is fully aware of bb ha responsibilities.many amities require,as part of the permit appiic�ation, that the hotowwric certify that he/she understands the responsibilities of a Supervisor On the last page of this issue is a form oorztndy used by several towns. You may care to amend and adopt such a formloertification for use in your community. SHOWN ON THIS PLAN ARE THE LINES 6 DIVIDING. EXISTING OWNERSHIPS AND Lo t ur3 ��� 4e'f'S THE LINE OF'TH E STREET SHOWN ��t� ° Toe Iq- ARE THOSE OF PUBLIC STREETS t 72.34 , ° o �O/�F ALREADY ESTABLISHED,AND NO '�•. d 63.7 S 4505:S' 30'E .1$J c0 NEW LINES. FG•R 'DIV'S10N OF ti 5 83. I t ' ? G~T EXISTING O•WRE--SHIP ARE-SHOWN. Q pI S 14 To She d •o 35.289 Sq.Ft. R 0.90 Acres P2��-.��� :�►J \�7 E�ISYI Nza o vN � v � �AGE o'• _ � � G _ r' __�_ '„ � I c, _ o WELL ` 7. on W '` yiyt •� S.tY LOMDARD A VE, -1 FOR REGISTRY USE s 3 of LAND C 1 1N IN 5 ` 4 3" Scr.LE W.6ARNSTABi:E M AS S owNr•q By 1 CERTIFY THAT THIS PLAN HAS BEEN CARS.. gip{-jt�150N PREPARED IN ACCORDANCE WITH THE RULES ALL CAPE ENGINEERR►NG AND REGULATIONS OF THE REGISTERS OF . DEEDS. HYANNIS, ►MASS. SCALE 1 I.4.30FT 6/ 2 I /B4 ------------ .s> aim JULF 1999 ro D �F SNSTgs G.ylrq� t TO: OLD KING'S HIGHWAY REGIONAL HISTORIC � J DISTRICT COMMITTEE FROM: CARL JOHNSON, 114 LOMBARD AVENUE, WEST BARNSTABLE, MA773 DATE: JULY 5, 1999 RE: APPROVED ADDITION MODIFICATION AND SCALEr DOWN OF PROJECT. ILI x WE THE ABUTTERS OF MR. JOHNSON, 114 LOMBARD AVENUE�,-� WEST BARNSTABLE MA, HAVE SEEN THE ATTACHED PLANS FOR A SCALE DOWN OF HIS APPROVED ADDITION AND HAVE NO OBJECTIONS TO THIS MODIFICATION. LOT 4- EGILA LITTLE-LEX, 105 LOMBARD AVE, WEST BARNSTABLE MACa f I � LOT 5 - ROBERT COLLINS, 121 LOMBARD, AVE, WEST BARNSTAB , MA ( � I • r7 J LOT 12 - PAUL PACELLA, 132 LOMBARD AVE, WEST BARNSTABLE, MA LOT 14 - DENNIS NYDAM REPRESENTING BUILDING PRODUCTS INC/ BIRD CORP., 1077 PLEASANT STREET, NORWOOD, MA ---------------------- APPROVED - - - - - - - - - - - - I I I I existing II back II l porch II • I 11 existing open 11 entrance to kitchen 6068 SGD I Existing - - - - - - - - ;....,::::(� Rear residence Entran I I Mil II I I II ^u� proposed ` . Existing Family Famlyo[ ,*, 11feld stone ..0 co fireplace Addition . Roo II II cathodia[ceilin N 1 U 9`: I Existing open is above) i L I entrance to hall I,I and stairs t. LI Existing n tof jont L _— — — "- - € rtce — JL - - - - I I 8046 3046 I 1 NOTE#1 1 1 Remove existing wall to I i out to out of window frames I I provide multiple 2x 12 header Existing Front Porch I as required I I L — — — — — — — — — — — — —I 14'-5" Proposed Addition FIRST FLOOR PLAN for: Mr.& Mrs. Carl Johnson 1/8" = 1' - prr 14 Lombard Ave.^ Barnstable, Ma. FIRST FLOOR PLAN Designed by: Al ` R.A.Faelten (508)866 2104 Field stone chimney 25 year asphalt roof to match existing �c\ — — — — — — — — — — — — — r Existing I All pine trim work Pan I I to match existing Design and color rr s 3046 3046 I ' I - - - - - - - - - - - - - - I North East Elevation outh West Elevation Proposed Addition . . for. MrA Mrs. Carl Johnson OO 14 Lombard Ave.^ Barnstable,,Ma. O� :. NORTH EAST AND SOUTH WEST ELEVATION Designed by: e R.A.Faelten (508)866 2104 A3 Field stone chimney 25 year asphalt roof to match existing F - - - - - - - - - - - - - - r I , ' I Im • i � EXIStlflg� . ' � i All pine trim work Pat 1Y I to match existing Design TM Room . I and color r F ' I 3046 3046 - - - - - - - - - - - - - - I >< North East Elevation South West Elevation Proposed Addition O� for: Mr.& Mrs. Carl Johnson let's put some optional O� 14 Lombard Ave.^ Barnstable, Ma. O� NORTH EAST AND SOUTH WEST ELEVATION skylights in both these elevations Q Designed by: A3 R.A.Faelten (608)866 2104 All new pine trim to duplicate the same design as the existing residence and be painted field stone chimney - - — — — — — — — — — —I a matching color i i Existing i cricket residence I I � � I L — — — 6068 SGD TF TF FF Tr rr TF Clear W.C. r f sl ewall,5"t.w. i i i North East Elevation 1/8to 1'-019 Proposed Addition for: Mr.& Mrs. Carl Johnson 14 Lombard Ave.,W. Barnstable, Ma. NORTHEAST ELEVATION Designed by: A4 R.A.Faelten (508) 866 2104 vented ridge R30C craft faced 202 ridge Inautatlon 25 year 3 lab asphalt shingles to match adjacent existing residence 2x10 rafters @ 16"Gc w th 1/2 cm sheathing eave detail to duplicate existing residence tripple 2x8 headers 4x6 fir beams @ 4'Gc 2x6 @16"c/c _ with 1/2"CDX multiple 2x12 beam to Tyvek and clear white cedar replace removed exterior wall shingles,5 to weather 2x10 `Gr. _ 2x10 ledger lagged to existing structure t using 1/2"dia.x6"tong j galv. lag screws with washers 8"foundation @16"c/c on continuous 16"x8"footing Z,2,xi0 floor joists @16"Gc * Adjust header height to finish with 5/8"CDX sub floor. windows at the same level - adjust elevation of these as existing below frost joists so as to obtain a level finished floor between old and new. Cross Section Proposed Addition for. Mr.& Mrs. Carl Johnson 14 Lombard Ave.,W. Barnstable, Ma. Cross Section Designed by: A5 R.A.Faelten (508)866 2104 9. i - - -Rebuild existinVoof- - - - - - T All new pine trim to duplicate I in this alcove, restructure the same design as the existing I with a flat roof and a — field stone chimney residence and be painted I .060 EPDM membrane \� a matching color I and new clapboard siding, \ cricket I �� 1- - - 1 - - -I \` ' L Existing Residence Front View I - - - - - - / I I I I I ® I I / Clear W.C. I �- Gr. sidewall,5"t. 3046 3046 IL _ _ -i New Ballastered Cap rail I Proposed Addition North West Elevation 1/8 If= 1 1-011 p® Proposed Addition for: MrA Mrs. Carl Johnson 14 Lombard Ave.^ Barnstable, Ma. NORTHWEST ELEVATION Designed by: A2 R.A.Faelten (508)866 2104 r 2 ALL 6jtD�vVAI.L - _ QAMG FESN ,.,4 AT tun 9A�TrlQ 5-5 �oo /2" cvx oil ' r,\j t i, @ Ito c.4, E.xTe PEP cd F AT DFFFF � � 303�0 3Y2 Z4 r-51 lqi [ED1 I I . � GAQAbL. po��5 � tt }�j 3n��• 30� T44 24 21'.( x8 p , pLAN <SoQ CSTe ArCI OQ 6I?or56 SE.cTj0 4 .. two IDS LEy�,TIDN i ZA FFFF t 3o3ta 3�3to ALL S',PEMLL NoV. c. 1 " PROP-0SEo A D15)I TION FOKF RA,+IZ E L ENAT I O> (S 4rA 65 frEPMSD BY: 6� 10 4�A . FA rM N o6 s s i ; "' o i I II � ` QDTE Q goy �' - r-4�>c 6 EI:IS¢A►JG� � I---- - -- l--- -� J �Et�od6 611,5TIQri WALL 'fo cu-r To OJT OF µlls►v�w �2A?Ae _ t7EGK ` + ` � ----- �XI�aT1NC{ ���ip� LE PQoJ►D� 'f'RIPP�<; '2 ,c i2 HEAD" 6. E X I'S7►t1!, n�El.l- .A► tile; Tn F,c. 4 1/.l ,Vt� :i�l�l:�'k� '40 'Yiiv:r: i ;. .� I ! , ScRe��1 WALL. Amp `6wep Coop VJ/3 SK a E�, d I I, 3. 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A 6rHALT I '2%L8 PAFtEr�s '• � T�- P F-D I ► ar pN cMEr2 i 3�2 GotJG.. FILLED. GOB Or.1 I 30310 � ; � ,/�-P,PE col,• 4 f : P5 Tlzlfr E 2F12 f i 90�0 0VE9�f:Ap 3/2 G01 ' i �• GA2AG� paoCS � " - i �. _ •�\ ,= f''� � 1 CAP,,. _ ,�a�. + Qt � w. � _'. � ` _ � WN' �• r 'VQ a !� _ I • - 9L -1*0TcP cIDE �y 3 wy ERE e• IrFLL _ A • ' q•3 3�31 - _ LL ! .AC7 C•E1NAl l- . a , r ; • t r D 3 , ADP -7-l0N. Fob' t. i . rCA 0 L. T7H t 9 I ol p , A►� i tJ�-a _ I T L EV - � N T f H �SVtJ . . I It - : - �f Y, v Ps AAP, f 0 , iFA � ,n r - } t