Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0084 MINTON LANE
Q 1 a YCLF0�o22 UPC 12543 CVO °�SRCON'J HASTtNGS, MN �i i r d w Town of Barnstable RECEIPT ` fAet 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: B-18-2463 Date Recieved: 7/31/2018 Job Location: 84 MINTON LANE,WEST BARNSTABLE Permit For: Building-Home Occupation Contractor's Name: State Lic. No: Address: , , Applicant Phone: (Home)Owner's Name: NESE,ANTHONY& KOPHAMMER, Phone: KATHLEEN (Home)Owner's Address: 84 MINTON LANE, WEST BARNSTABLE,MA 02668 Work Description: Sandy Neck Building and Remodeling Total Value Of Work To Be Performed: $0.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). 1 understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: NESE,ANTHONY& KOPHAMMER, 7/31/2018 KATHLEEN Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $0.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $35.00 7/31/2018 $35.00 - Cash ..... ..... ..... ..................... ._....... ...._................................ .._......_......_.............. .............. ........ .................................. _.__.........._.._._._,_........._......__._..__._.....__..............._.........._. Total Permit Fee Paid: $35.00 .zTHIS. IS NOT�'APEHMIT YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. - Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE:n 5 Fill in please: '.':;'�,,: ,.;;:•:;�L,Lt '1� I -L, APPLICANT'S YOUR NAME/S: ty*'„�;","d)d Jr:� BUSINESS YOUR HOME AD DRESS: /\ ✓�� -Z you/u -774 �� R.. r M. n� TELL-PHONE # Home Telephone Number D a���-FJt9r��JKI 'I E-NAIL: Mar cov`-- NAME OF CORPORATION: )Pe4 NAME OF-NEW BUSINESS tI 11 TYP F BUSINESS j IS THIS A HOME OCCUPATION? YES NO I ADDRESS OF BUSINESS. C /'✓1. ,. U' MAP/PARCEL NUMBER (Assessing] Z.6 When starting anew business there are.several things you ust d in order to be in compile rice with the rules and regulations of the Town of Barnstable. This form is intended to assist you In obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. "I. BUILDING CO MIS NER'S IC This indivi uak as b an m o - it a uig, r�merits)thht pertain to this type of business. MUST COMPLY WITH HOME OCCUPATION RULES AND REGULATIONS. FAILURE TO uthor' e ! r ** COMPLY MAY RESULT IN FINES. OMMEN S. �— aA 2. BOARD 0 HE THL(} V f business. This individ al has been informed of the permit requirements that pertain to this type o I Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS [LICENSING AUTHORITY] This Individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: ' I I i V 11 Jc,a V-� i/ -�l ilu a.lw.hJ.Rv • Building Department Services FTHE rp� Brian Florence, CBO o� Booking Commissioner ' aAxxszAsr�, 200 Main Street,Hyannis,MA 02601. . buss. wRvw.town.barnstable.ma us Office: 508-862-403 8 Fax: 508-790-6230 Approved: Fee: Peyrm,it#: HOME OCCUPATION REGISTRATION ate 3 ► 1 � ( 1 G Name: Phone Address: s v/r�c?:-� LGP✓�Q Village: We.%,-- <IYr/1S,4x44_ Name of Bnsine'ss: 7 - e—L� / k U. TypeofBusiness: (P( "fiiyt�`�� Map/Lot r INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation family within single dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the,dwelling: there shall be no increase in noise or odor,no visual aIferaiion to the premises which-would suggest anything other than a residential use;no increase in traffic above normal residential voluanes;and no increase in air or groundwater pollution After registration wifh the Building Inspector,a customary home occupation shall be permitted as ofright subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling nut. •" Such use occupies no more than 400 square feet of space. • There are no mdzmal alterations to the dwelling which are not customary in residential buildings,and there is no'outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat;glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,.or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or egnipragt • There are no commercial vehicles related to the Customary Home Occupation, other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing-the Castamary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall bg employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read d agree with the above restrictions for my home occupation I am'mgistering. Applicant: Date: 3 l 1. Z/� Homroc.doe Rev.0612,0116 OG'Z�I�GI Y ¢�G�lQ1,�� � �� �� � ,4 _ - - �� � . TOWN OF BARNSTABLE BUILDING PtMIT APPLICATION Map Parcel (' Z. 4 Application # Health Division Z Date Issued OZ Le /ca Conservation Division PEJ Application Fee Planning Dept. co Permit Fee Date Definitive Plan Approved by Planning Board `l V Historic - OKH _ Preservation/ Hyannis . Project Street Address / ✓ 40►-, Village Owner Address gy l'�►,n�n,., GanR� 3 Telephone - Sg Permit Request Square feet: 1 st floor: existing proposed X 2nd floor: existing 7g U proposed '� Total new k Zoning District Flood Plain Y Groundwater Overlay k Project Valuation 00 a Construction Type Lot Size Z-O4 Ac_r&S Grandfathered: ❑Yes No If yes, attach supporting documentation. Dwelling Type: Single Family'AET� Two Family ❑' Mufti-Family (# units) Age of Existing Structure 3 Z Historic House: ❑Yes V No On Old King's Highway: ❑Yes 'd No Basement Type: &<ull ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 7�a C7 Number of Baths: Full: existing new k Half: existing �` new Number of Bedrooms: 3 existing _new Total Room Count (not including baths): existing 7 new k First Floor Room Count Heat Type and Fuel: LYGas ❑ Oil ❑ Electric ❑ Other . Central Air: LY1es ❑ No Fireplaces: Existing New Existing wood/coal stove: 8'Yes 0 No Detached garage: &Oe'xisting 0 new size—Pool: 0 existing 0 new size - Barn: ❑existing ❑ new size_ Attached garage: 6le"xisting ❑ new size _Shed: ❑ existing 0 new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes 4 No If yes, site plan review# Current Use 2_ Proposed Use ZO'- _ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ok' Telephone Number Address. l'✓I A40n ��, _ License # 1� C, O`i 0 3 3 S� L.►)Q�S-�- a inn 5:16 M-A a7-6 Home Improvement Contractor# 7!7 73 Email -C-- (f vto • G0"`" Worker's Compensation # -7( C) ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE -7"S' 7 T FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED , MAP/ PARCEL NO. . ADDRESS VILLAGE OWNER { DATE OF INSPECTION: _ r FOUNDATIO ®� �1 3 FRAME �� ��0�' �$ INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. t The Cowmwnweakh qfMasmadmisei& Deparftment gfLudamaidAadder& 600 Wasb>an Slreet Baseon,MA 02111 '. tvrvium� �a Wcwlm& Cuiaqpensa mInsn-mce tffiLwi -B derslE tr rsfEl ers Applicant Iafarm=fiDu Please Print feu • l�tame - h /� . A,ddres= y w1 / o r, La l%t., Citgf � nSlablc_ 6� Phoneme ,DJ7 Are you au employer?Checkthe appropriate bow TyPN f 'eat(rid}: I.El am a employer vrh 4. ❑I ass a general c�onfractor and I 6. e�oonstir�Eion employees(full andfor part-dimes* have l�edi fce subAx mt�bom 2.El am a sole propfietos arpartaer- fisted onttte attached sheet; 7- ❑ReTodeling sbip and have no employees , These sub-cMA=tos have g ❑DemolikDa wad-Ing fxme in any capacity. employees andhave wodzers' a WOOMcs'Comp_;na ., comp. ,��# 9. ElBazildiag addifioa I 5_ ❑ We are a cmapoodian and its 16-❑Elul repaics or adcroins 3_M I ama homeotwer doing all wo of om have exe=ed their 1L❑Plumbiagrepaim or addifiams Myself[No woxknm'comp. right of per M(M L?❑RocEfrepaim ,s,�requir d-]1 c-M MA andweheweno emFloye=[No wmda!& 13.O'Other cow-insnrance ] •Aayapg€�t6atrbedsbosMmastalsoMaut*esacff=belaw &e vu&e 'om:pe�anPcIuk5—s5m l eoaraea�xo snha��s afi;dac i g ace all Wow sad h a�ideco Est submitanewzMdx1ed iadirvim sari TCaatcsctoatSrS Ythrsbmcmawattached=arst'H9 shEashoxiagtban,ofthesab-caonutmg�aad state vhetherornmthnseemitieshzv� eqloy-r-Ifthesolo-coda kwemwbyee%dLey=srpmmde•ffiar sndm'—MP.PGIkY —bey I eun me eeiip�ar t7it¢is pretuitlieeg workers'caeerpeexsaiiare iresriraecca far�emglaj� Below is the paficy and job site Issnxan£e Company AEame: . •Poficy I cr Self-ins.Li-t abate: Job Site Address: /S Attach a copy of the workers'cbmpensationpolicg declaration page(showing the policy number and aspiration date). Failare to secure coverage as requited under Section.25A o€MM c�M can lead to the imposition of caiminal penalties of a fine up to$L,5oalDQ mUor one-yewimpFisonmeot,as we4 as civil peualfie=s Ju flee form of a STOP WDRK ORDERand a fine o€uP t O$250M a clay against the violafnr. Be advised that a copy of fb is stated swag be forwarded to the of ffm of Iavestkpafions offle D.T4€nr coverage vim.. Ida&arzby esrdrfy under[he andpenaWw 4 $fpz4 7 thattics informa€iaapro 0ed abort B tree and carreet // Date- 1-7 PhMe fr . d -7 7 46, - 02Wd aw a nly. Do not emits in ffd3 area;to be wwpTeted by cep artetva o,,ukiat City or Town: p � Leg Anfharify(cirde one): L Board of$eahk J.Rd-krmg Dew 3.CAyffowa clerk 4 Electrical Inspector S.PbEmbing Iaspeeter C.ter Contact Person: Phaue P- luformation and Instructions ; � won fnr fbea emplaYees- M s�efs CTeaal Lames cbqy=M r q=w an emp°Ycm tD Pie�0��cc p �ffiis ,an m p&y=is defined am'�.evag p¢Sdn in ff3D service of�otbe:�any coact ofl e qz=or mrplied,Dial'or wr>f =7 An=VTaym-is &tEmed as`=mdxvidm;I,per,asso on`ccmPm`aftm or officr legal entity,ar EV two or mine offfie firrego g cagaged is aJdiat mljm� ffie leg-A mjU,&m ofa doceased amployer,or$u receiver or t us=of m P as ociafion or ofhca legal entity,a laying�Pmy�s- however the owner of a.dweIPmg hawo havmg-not more fhan lb=apartments amiwho resides ffi in,or th c occapant offfie - dwedImg house of mx&w who employs Perms to do mabtmancr,cmsftuctim or repair work on sin h dwrMing home, or on the gaumds or b ldmg qTurfuua=tfam7cfo sbAnnotbecanse of smrli employmrmtbe deemedto be an employers" MC$.chapter 152,§25C(6)also sides that=every sWn or local��agency Shall wiffihold ffie xsslaan ce or renewal of a&cease or permit to opmmfe,a business or to construct bwIdmgs in the commmnwedfh for any applicantwho has notprodurrd acceptable evidence of cumpL-mr-with the hnmance coverage r - Adffiimmjly,MCrL chapter I52,§25C(7)shies-Neifhrr the c=m-mwcabh nar;Ly ofits political mbdivi=w shall ear mfo any contract for the pact ofpublio wccdc umI able evidence of complia�uce with 4ie fim ranco.. req==eEts of this chimp a have been.preseand to the wog anffitlt Appliczir s , Please fail obf liar ems'compensation affidavit completely,by g the bm=ihaf apply to your si nation and,if n Y,supp Sy s)name(s), addresses)anti phamerammbm(s) along witht1am cet1acate(3)of msmrance. LnnitzdLiability Comp - (ILC)or Lk itadLiability`Pmtcu= ps.(LLP)ono cmpbYecs other fhaafhe mc±bC s or pardncz-s,are not rbquaEd to cry wori-rss' comper safraa If an LLC or LLP does have employees,apolicy is regaiiui Be advisedf dth s affidaq¢maybe smbm>f�d in the Deparbnevt of Indastxial Accid�for confsmafim of ft=m oe mva� �o li-sure to sign and da femme affidavit Tito affrdaYit should be retied in ib e aityy or town that the appfic as for fie to or license is being requested,not the Department of ; Iuol A cm mts nld Shayou have Hay garden regarding the law or i[fyou me;regmred in obtain a wm�s' � compensation.pofiey,please Ma ffie Depar�ent at the r�ber listed below: Self-insoo Eti conrpani cs should ear their self-n,smmjcelicaasenmnbmanfhe lime_ City or Town offErialc t Please be sore fast the affidavit is campletm andprmcEDdlegibly. The Dcpa tnenthas provided a space at.fic botizma of the aft.davit for you t[)fffi out k the event the office of1mye5tigstiom has to cambactYMM913rdmigthe,a=icant Please be sure�M n.the pent/ icm=member whichwlll be used as a�frscace mmmbcr. Im adeiitinn,an appliC2Tt that must submit multiple pemudI-ceose applibs ibns in any given year,nee&only smhmrt one affidavit mdicatng cunt policy infozmation (if necessary)and under"Job Shm A.ddre&*the applicant should write:-all locations in (�5'or town)-'A copy of the-affidavit that has beca officially steed or marked by the cry ar town may st provided it the applicant as proof that a valid affidavit is on fie for fofine pew or&ceoses. A new affiftk be filed o1rt earth year.'7lhere a home owner or cBi=L is obtaining a h=n=or pcnnrtnot rrja#zd to any busmcss or camnim=al veMtmm a dog license or permit to burn Ieaves eta.)said person is NOT rcgCmzd to complete this affidavit The of=- of Investigafom would IBM to thank you is advance fur your cooperation and sboulld yam have any questions. please do not hest to gf m ns a call i The Depsrtm s address,telepbane and fan rummbM- - Thhe commmwealft of MassachuseM- Departmmt of Y&shdal Acidenta office of Investfgaiio= M&02111 -Te1-4617-' -4 eft4fl6 w 1477 M SSAF F9x9 617-727-7749 R=ised 4-24-07 ww xaas5-gPVI(Fa i AWC Guide to Wood Construction in High Wind Areas:110 mph.Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 Q Check Compliance 1.1 SCOPE . WindSpeed(3-sec,gust)...................................................................._.............................................110 mph — WindExposure Category..._..........................................................................................................................B 1.2 APPLICABILITY Number of Stories ........................................................._...Fig 2)............................ stories 5 2 stories Roof Pitch ....................... — ....... ........................(Fig 2)........................................... 512.12 MeanRoof Height .............................................................(Fig 2)_........................_....................._ft 5 33' BuildingWidth,W......................_......................................(Fig 3)................................_..............—It 5 80' BuildingLength,L ..............................................................(Fig 3)........................ ......................._ft 5 80, Building Aspect Ratio(L/W) ..............._..............................(Fig 4)................................_............... 5 3:1 _ Nominal Height of Tallest Opening2 ................._.......__.....(Fig 4)................................................ 5 6'8' 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2)......................................................._....... 2.1 FOUNDATION Foundation Wails meeting requirements of 780 CMR 5404.1 Concrete.............................................................................................................................. _ ConcreteMasonry.................................................................................................................................... 2.2 ANCHORAGE TO FOUNDATION1'3 5/8'Anchor Bolts imbedded or 5/8'Proprietary Mechanical Anchors as an alternative in concrete only BoltSpacing—general..........................................(Table 4)........................... in. .................... Bolt Spacing from endfjoint of plate ............................(Fig 5)................_................... in.s 6"—12" —_ Bolt Embedment—concrete.........................................(Fig 5).............._................................. in.Z 7" Bolt Embedment—masonry.........................................(Fig 5)......................... — PlateWasher...............................................................(Fig 5)...............................................2 3'x 3'x'/." 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 55).................................... _ Maximum Floor Opening Dimension...................................(Fig 6).............................____ft 512'or L/2 or W/2 _ Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6).................................. Maximum Floor Joist Setbacks — Supporting Loadbearing Walls or Shearwall................(Fig T).................................................... ft 5 d Maximum Cantilevered Floor Joists — — Supporting Loadbearing Walls or Shearwall................(Fig 8).................................................... ft 5 d Floor Bracing at Endwalls................................................;..(Fig 9)......................................:............... ......... — Floor Sheathing Type ........................................................(per 780 CMR Chapter 55).................................... _ Floor Sheathing Thickness.................._.............................(per 780 CMR Chapter 55)....................... in. _ Floor Sheathing Fastening............................_....................(Table 2).._d nails at in edge/ in field 4.1 WALLS Wall Height Loadbearing walls........................................................(Fig 10 and Table 5).........................._ft s 10' Non-Loadbearing walls.............................................. (Fig 10 and Table 5)...........................—ft 5 20' _— Wall Stud Spacing .......................:..........I.....................(Fig 10 and Table 5)................... in.5 24"o.c. Wall Story Offsets ........................................................(Figs 7&8)................................. ft 5 d _ 42 EXTERIOR WALLS' Wood Studs Loadbaadhg walls........................................................(Table 5)..............................2x—-_ft in- Non-Loadbearing walls ...........(Table 5)...................... - ft Gable End Wall Bracing i — — — — Full Height Endwall Studs............................................(Fig 10).................._......................................... _ WP Attic Floor Length..................................:.............(Fig 11).......................................:....._ft zW13 _ Gypsum Ceiling Length(if WSP not used)...................(Fig 11)........................................... ft z 0.9W _ 2 x 4 Continuous Lateral Brace @ 6 ft.o.c...(Fig 11)......................................... :_. Double Top Plate Splice Length ........................................................(Fig 13 and Table 6)....................................._ft _ Splice Connection(no.of 16d common nails)..............(Table 6)....................... .............................. AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Massachusetts Checklistlor Compliance(780 CIMR 5301.2.1.1)t Loadbearing Wall Connections Lateral(no.of endnaled 16d common nails)..............(Table 7)........................................................ Non-Loadbearing Wall Connections Lateral(no.ofendnailed 16d common nails).._...........(Table 8)........................................................ Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans ................................................:.. able 9).................................. ft_In.511' Sill Plate Spans ........................................__._.......(Table 9)................................._ft_in.511' _ Full Height Studs(no.of studs)............................_..... able 9)........................................................ _ Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans.............................................................(Table 9)................................ ft_In.512' _ SillPlate Spans...........................................................(Table 9).................................. ft_in.512 _ Full Height Studs(no.of studs)....:.............. .................(Table 9)........................................................ Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously, — Minimum Building Dimension,W Nominal Height of Tallest OpeningZ ..............................................................................._5 61ir _ SheathingType..............................................(note 4)...................................................... Edge Nall Spacing........................................ (fable 10 or note 4 if less)....._....._............ in. Field Nail Spacing p g..........................................(Table 10)................................................. in. Shear all (no.,of 16d common nails)(Table 10)....._................................................. Percent Full-Height Sheathing........................(Table 10)..................._................................ 5%Additional Sheathing for Wall with Opening>61'(Design Concepts).............. Maximum Building Dimension,L Nominal Height of Tallest Opening2.................:..................................I................... 5 6V _ SheathingType.....:.................................._..(note 4)...................................................... Edge Nall Spacing.....................:...................(Table 11 or note 4 if less)........................ In. Field Nail Spacing..........................................(Table 11)..................................... .. in. — .......... Shear Connection(no.of 16d common nails)(Table 11)........................................................ — Percent Full-Height Sheathing.......................(Table 11).............................. ....,............... % _ 5%Additional Sheathing for Wall with Opening>6'8'(Design Concepts)..................... Wal Cladding — Ratedfor Wind Speed?......:......_......:........................................ ................................. ........ ....................: 5.1 ROOFS Roof framing member spans checked?.......................(For Rafters use AWC Span Tool,see BBRS Webshe) _ Roof Overhang ...................................................(Figure 19).............._It 5 smaller of 2'or L/3 Truss or Rafter Connections at Loadbearing Walls — Proprietary Connectors Uplift................................................(Table12).............................................U= plf _ Lateral.............................................(fable 12).............................................L= plf _ Shear.........................................._..(Table 12)............................................S= plf Ridge Strap Connections,If collar ties not used per page 21.....(Table 13)...................... - pif _— Gable.Rake Outlooker.........................................(Figure 20) _ft 5 smaller of 2'or U2 ........... .............. Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift_..............................................(Table 14).............._............................U= Ili. Lateral(no.of 16d common nails)...(Table 14)...............................k...:.:L=lb. _ Roof Sheathing Type...................................................(per 780 CMR Chapters 58 and 59).................. RoofSheathing Thickness................................_......................................................._in.a 7/16'WSP — Roof.Sheathing Fastening..........................................(Table 2)........._...................................._......... Notes: — — 1. This checklist must be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.21.1 Item 1.If the checklist Is met in its.entirety then the following metal straps and hold downs are not squired per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. Al Straps per Figure 17 e. Comer Stud Hold Downs per Figure 18a. 2. Exception:Opening heights of up to 8 ft.shall be permitted when 5%is added to.the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2.in.nominal thickness:pressure treated#2-grade. i AWC Grtide fo Xbod Comihfcdott ur l{i [r KmdAreas_IZD ntph f3-rudzOnp- - Massachusetts Checklist for CompU2nce gm mn-caDi.2L,$)4. m From Tables ID and 11 and iocafion cfwall sh-eafhing and BuDdng AspeciP.An,determine Percalf Futl-l-telght Sheafrcing and Nall Suring� - b. Wood Structural Panels shall be.rrrbimrnn thldrness of 7/16'and be inslallad as follows: - - L Panels shall be installed W5 s6-engitr arcs para al fn studs. I X horlmruial johrds shall o=ewer and be naiad to flaming. Z Dn single stofy cmnstmflon,panels shall be attached to bofinm plates and tnp.inmber of the double --._ M Dn at-ached.bbe t*marnber.afthe upper double,to fate and to band Dist at botbm of U P-- ---- P } � t��- Pperaftadmretrt of lower pane!strap be made to band joist and lower affachmarit made to lowest plate at fret fibnrfiaming. v. Hortmntal mail spacing afdmbte top plates, band joist3r and gudem shall-be a double now of ad - staggered at 3 inches on carder per fines below=vertical.and Hmtmnial Naurmg for Panel Aiachment S. GlEeng prc;h or a)'new house orhortmr'rWadOon—required lfprojed'is i n-Ma orcioser•tct shore an Rta.Za or north of l�5) (9 Tt south of b)m1cal addfon—not reqLdfad unless there Is wdar renodon to$he fust fioo_r c)r eplaaamentiwidows—needs energy consmv4=cmnprmncr only(chap 93) ti.Wood Frame Canst UCHOIn Manual(�+►►FCM)fbr 110 MPH, Fxpos�a$maybe obtainedfrom the Americdn Wood Caunc$ (AWb)wabsi<-_ . • sox • TL�sdb1R9� . It l - - w tt - • i[ 1l i - f if ,l. a 4o tI H i• c _K I • i( .11 T. )l [ a t i 1t ;j o fl. d it tI K it ff•to � i r - _ a [ It [ [ i[ I I I r � tf � it I L! nz • � !t a[[,j I t • • Z � �t p rr UK- It I Y [ a 1! if [ T' s z_ 5�.�k[�JG - �i i�PRTrl�ht PJt2�13 �- • Pi373E DOUSE=wan gDG:ESPACNMbEr&L See DHIQ on NWCt Page Verl?d and Horimrrfal NarTrrg = Debfi for 1'anl-I Rffarhrnent VU5�1 Arfd -fWtMn�I Nailing . fnF Panel Af)amhmant _ Town of Barnstable Regulatory Services dF Richard V.Scab, Director Building Division • Paul Roma,Building Commissioner MASS. 16 200 Main Street, Hyannis,MA 02601 - www.town.barnstable mans Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION f .�1 DATE: Z& Please Print (. JOB LOCATION: ell JAA,j4g,,V., U...— (^A-S4 �p r n6r4 naffiber street village "HOMEOWNER": f 7�bS�S� name c/ home phone# work phone# CURRENT MAILING-ADDRESS: 6 v 6 cityhOwn 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. I The undersigned"ho eowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspecti procedures and requirements and that he/she will comply with said procedures and requirements. Signsturegf1lorneowner Approval of Building Official I 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. � P E Town of Barnstable ; Regulatory Services KAM Richard V. Scali,Director. 9. Building Division Paul Roma,Building Commissioner ` 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Coinpleie aiid•Sign This Section If Using A Builder I ,as Owner of the subject property hereby authorize to act on my beh4 in all matters relative to work authorized by this building permit application for. (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 C, of FILE 440 20011 7 N/F PJAIJERSFE'D N 9318' 'I 8� LOT 20 46,1831 S-F, LOT 21 N/F PARKER ® I vli r�� �r •GFs i`1 7 69' +O5.go• m 1N of T4J s JDIiN S d LAURETANI 11 34 3,1 ,p MORTGAGE LENDER •`�.a•J1t�44� �aC USE ONLY plotplans.com DEs LAURIERs I-ASSCMATP�INC 101 CONSTfiUYIUN B_YC.NIT.D .. FWXUN.NA 020M (600)287-0600 FAX(50.)52E,4011 THERE.ORE NO OEEULO EE N MORTGAGE INSPECTION PLAN THEEABOVE REFEREVC£U DEED OR OF ENCROACHSITUA RESPECT f0 ADDRESS 84 MINTON LANE, BARNSTABLE. Y�l _ DxE(slNc SITUATED ON DAIS col LENDER NMI) EXCCPI AS STATED ON THE DEED 0, '. A!IORNE r•GILL DIVINE P.C. 12-2M RECORD SHOWN - 0141:ER. it<IiERT RFIOCATION RESOURCES INC. THE LOCATION OF SHE C%%ELUNC AS { APB TCAIrT�N�1�ONY NESE A_D KATHLEEN KOPIiAA�ER SHOSSN HEREIN HINER WAS IN DA12 1 2/2013 scALE: 60' couNTY:BARNSTABLE COMFUANCE EFFEWITHCT DIE EN zornNO i � , - BYE.A'NS LV CFFECT WEN CONSTRUCTED(WInl RESPECT TO UNREGISTERED LAND STRUCTURAL SETBACK REOLIREUENIS FL00D HAZARD INFO-. GEED BDCK 20501 PACE:244 ONLY),OR IS EXEMPT FRCA:VIOLATION PLAN DOOR PACE Al LOTS: 0 ENI ORCEME141 ACTION UNDER MASS C S ZCN£:�C_DATED 9 985 � ( )3-• nN£K,,CHAPTER 49A.SECHOA I CCMIJ i,N7Y PANEL 250001 0015C PLAN NUMBER' OF it LOCATION of THE OWE116VC show, REGISTERED LAND CERTIFICATE OF TITLE: ._ ACES HOT FALL%NID0N A SPECIAL RCCISTRATION W(W: PACE: ASSESSORS MAP: I FLOOO IWAIC ZOWE.EXCEPT AS MAY BE INDICATED. PLAS NUMBER. 101(S): FLOCK: LOT CENCRAI NOTES: (1)T-IE DECIARAnONS MADE ABOVE ARE ON THE OASIS Of ICY HIIOYA.EWE XFORMATiON.AND BEI AS NE REW OF A MMTCAOE NSFECn04 TAPE SURVFT,P.11 Pt RE:41; AT: RS(RUM--:•I"VLY MADE TO THE NORMAL STANDARD OF CARE OF KQSTERCD LAND SUR4YORS PRACIR014G N MASSACHUSETIS (2) DECLANAYONS ARE'MADE TO THE ABOVE NAIAD CI0T ONLY AS OF THIS DATE (3) DNS PL44 WAS NOT MADE FOR RECORDING PUWOSES,FOR USE 114 PREPAliNG DEED OESCRIFTIONSIOR FOR Cm:SIRWW,T.Z• (4j VEkFICA'iCe4S OF PROPERTY LINE WENS10NS B4{4L0WG OFFSETS,FENCES.OR LOT=F*AATION?JAY BE ACCOMPLISHED BY AN ACCURATE NSTRUWIE NT SSiRVT.Y ISt 1:0 FF;PO;;Sliuh I:MIS'tI'G'.HEREIN 10 THE LANTI 174ULH OR OCCUPANI Sr./+t r1 yea.fV,:ulv,4 i•_'!C ,r ,ac RO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 11/21/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Nancy y Bums CLEARY INSURANCE INC. PHONE 617)723-070o AAIC No: EMAIL DDRESS: nbums@clearyinsurance.com 226 CAUSEWAY ST. INSURERS AFFORDING COVERAGE NAIC 0 BOSTON MA 02114 INSURER A: AMGUARD INSURANCE CO 42390 INSURED INSURER B: SANDY NECK BUILDING AND REMODELING LLC INSURERC: INSURER D: 84 MINTON LANE INSURERE: WEST BARNSTABLE MA 02668 INSURER F: COVERAGES CERTIFICATE NUMBER: 105117 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AODL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVn POLICYNUMBER MMIDDlYYYY MMlDDNYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR REMIDAMAGE T RENTED PREMISES Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONALS ADV INJURY $ GEN1 AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ POLICY JERCOT- LOC PRODUCTS-COMP/OP AGG S OTHER: S AUTOMOBILE LIABILITY COMBII tlEeD SINGLE LIMIT S II ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED WA BODILY INJURY(Per accident) S AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per attiden11 UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR HCLAIMS-MADE N/A AGGREGATE S DED I I RETENTION$ �/ $ WORKERS COMPENSATION X STATUTE ERµ AND EMPLOYERS'LIABILITY Y/N •— ANYPROPRIETOR/PARTNERlEXECUTIVE E.L EACH ACCIDENT $ 500,000 A OFFICER/MEMBEREXCLUDED? N/A N/A NIA R2WC760743 08/14/2016 08/14/2017 (Mandatory In NH) E.L DISEASE-EA EMPLOY s 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govAwd/workers-compensabonriinvesUgafions/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE _ Hyannis MA 06010 Daniel M.Cro�;y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD i CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 11/21/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER COONNTACT Nancy Burris NA Cleary Insurance Inc PHONE (617)723-0700 FAX IAIC No: (617)723-7275 226 Causeway Street AIL ADDRESS:nburns@clearyinsurance.com Suite 302 INSURERS AFFORDING COVERAGE NAIC k Boston MA 02114-2155 INSURERA:Ohio Security Insurance Company 24082 INSURED INSURERB:bWFRE Insurance Sandy Neck Building 6 Remodeling LLC INSURER C: Anthony Nese INSURERD: 84 Minton Lane INSURER E: West Barnstable MA 02668 INSURERF: COVERAGES CERTIFICATE NUMBER:2016-2017 PKG AUTO REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVQ POLICY NUMBER LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE ❑X OCCUR DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ BKS56425157 3/2/2016 3/2/2017 MEO EXP(Any one person) S 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 X POLICY❑ PRO ❑LOC JECT PRODUCTS-COMPIOPAGG S 2,000,000 OTHER: Premises IiaMlity S 30,000 AUTOMOBILE LIABILITY GO aBINdEDISINGLE LIMITlEa S 1,000,000 B ANY AUTO BODILY INJURY(Per person) S ALL OWNED X SCHEDULED BG2704 3/23/2016 3/23/2017 BODILY INJURY(Per accident S AUTOS AUTOS ) X X NON-OWNED PROPERTY� tDAMAGE HIRED AUTOS $ AUTOS P $ UMBRELLA LIAB OCCUR EACH OCCURRENCE IS EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE SEE ATTACHED ❑ E.L.EACH ACCIDENT $ OFFICERlMEMBER EXCLUDED? N 1 A (Mandatory in NH) E.L.DISEASE-EA EMPLOY S If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 06010 AUTHORIZED REPRESENTATIVE Nancy Burns/NAB ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(20in01) i Massachusetts Department of Public Safety ��• Board of Building Regulations and Standards License: CS-090335 ®BRAS Construction Supervisor This card acknowledges that the recipient has successfully completed a ANTHONY M NESE /' 10-hour Occupational Safety and Health Training Course in im 84 MINTON LN Construction Safety and Health WEST BARNSTABLE MA 02668 `' I Anthony Nese i ,, - r""p n l nn� Expiration: (Peter lice 66873 8/6/2014 Commissioner 11/09/2018 (Trainer name—print or type) (Course end date) C//ee�a�zznrarzraeul!/a�P/`L'it.�stic�u.feth ' Office of Consumer Affairs&Business Regulation ! HOME IMPROVEMENT CONTRACTOR Registration:"- 178731 Type SAFETY CERTIFICATE Expiration:, 5/13/2018 Corporation Anthony Nese SANDY NECK BUILDING&REMODELING LLC Has completed Excellence In Safety=s Elevating Work Platform& ANTHONY NESE Construction Forklift Operator Training at Shepley Wood Products, 84 MINTON LANE Hyannis,MA. W.BARNSTABLE,MA 02668 Undersecretary Richard Hughes,C.E.C.M. August 17,2006 Trainer _ Training date a Commonwealth of Massachusetts Department of Public Safety License: HE-128057 Hoisting Engineer I :' ANTHONY M NESE 84 MINTON LN WEST BARNSTABLE MA 62668 Expiration: Commissioner 11/09/2018 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map '7 Parcel Application # �s Health Division Date Issued �'1 Conservation Division Application Fee Planning Dept. Permit Fee lQ O Date Definitive Plan Approved by Planning Board O� Historic - OKH _ Preservation/Hyannis /p Project Street Address �'7 /✓�"/, /LL_ Village t Owner Address Telephone Permit Request �! n ICl.� ti-,66 1-I-F on Square feet: 1 st floor: exis in proposed 2nd floor: existing proposed Total new X ZoningDistrict r Flood Plain Groundwater Overlay � y Project Valuation$�S; ° Construction Type Lot Size 4 wS Grandfathered: ❑Yes 0`�o If yes, attach44pgtindocumentation. Dwelling Type: Single Family. ;��_Two Family ❑ Multi-Family (# units) s � Age of Existing Structure v e�rS2alkout toric House: ❑ Flo Yes R On Old King's Highway: ❑Yes 0'No Basement Type: ull ❑ Crawl ❑ Other Basement Finished Area (sq.ft.) .. Basement Unfinished Area (sq.ft)��U -�h/�4' Number of Baths: Full: existing, new X Half: existing x new Number of Bedrooms: existing X new Total Room Count (not including baths): existing 2 new >Ir First Floor Room Count "7 Heat Type and Fuel: &1 as ❑Oil ❑ Electric ❑ Other Central Air: 91 es ❑ No Fireplaces: Existing New Existing wood/coal stove: d es ❑ No Detached garage: J'ex'isting ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:Qexjsting ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes o If yes, site plan review # Current Use r= Proposed Use J'S APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address 7V /N"yn _v► License # &xon,_s4 L�, � 0A Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE J: FOR OFFICIAL USE.ONLY APPLICATION# t DATE ISSUED MAP/PARCEL N0. ADDRESS -t VILLAGE ' OWNER .1• 5 DATE OF INSPECTION: FOUNDATION FRAME ACR �(( �� fS !Z 1L�• � i INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r , PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' r FINAL BUILDING y) DATE--CLOSED OUT ASSOCIATION PLAN NO,'.. r I Town of Barnstable Regulatory Services IIAJPMM& ` Thomas F. Geiler,Director 39. 16� Building Division Thomas Perry,CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us i Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW --#:r vol il 073 8& Owner: ESE Map/Parcel:l7y' 0 2.7 Project Address 9' NIAVA9rJZ*Z-- Builder: e The following items were noted on reviewing: 6)eE;ec DE Aft- /5-77�6,5- 4-wr,!rs& 1&5-7s- 16 /o . /LAAJ -5;YeuJs /3 'Y �• JUo 7 WO ra-4 7. z A-Fr ('Dh4&X1 c AFML-1MC-6 T- F11-e- C"ais'= e�-r 42 Reviewed by: Date: A- — I Q:Forms:Plnrvw The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations vi 600 Washington Street Boston,MA 02111 www.'mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): SG Address: O e/ lA✓I-e-1 OL66 City/State/Zip: Phone Are you an employer?Check the appropriate box: Type of projecti(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. Q�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 workingfor me in an capacity. employees and have workers' y p �'• t 9. ❑Building addition [No workers' comp. insurance comp. insurance. Electrical repairs or additions r aired.] 5. ❑ We are a corporation and its 10.❑ 3.V1 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.]t c. 152, 4),and have no 13.�ther /,✓,�c employees. [No workers' � Q comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under t pains and penalties ofperjury that the information provided above is true and correct Si ature: ��— Date: O Z Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1:Board of health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds.or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia 1 , Town of Barnstable OFTHE Tp�_ - '�j• Regulatory Services >Artsrwsu, : Thomas F.Geiler,Director MASS ,.0� 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: Jt�( 7i I JOB LOCATION: O G� /�'/,/tl7J►� l�Av+�� S� / /y� numiler street village "HOMEOWNER": ) 6z)g j name 0home phone# work phone#_ CURRENT MA]LING 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 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 l09.1.1) 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 pr edures and requirements and that he/she will comply with said procedures and requirements. Signature of H eowner .I Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages'a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt Town of Barnstable -' Regulatory'S ervices ' Thomas F.Geiler,Director mass. 94iprEDM`0$ Building Division Tom Perry,Building Commissioner 200 Main Street Hyannis,MA 02601 www.town.b arnstabl e.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby authorize 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. Q:FORMS:O WNERPERMISSION 1 � - - Office of Consumer Affairs&Business l�aJac�aacllo ME IMPROVEMENT CON Regulation egistration: 178731 TRACTOR xPiration: ,5/13%2016 Type: CorPoration SANDY NECK BUI LDING&REMODELING LLC ANTHON9 NESE 84 MINTON LANE W.BARNSTABLE,MA 02668 - Undersecretary 1 Massachusetts -Department of Public Safety Board of Building Regulations and Standards C'umstructiun Supemkor License:csllr 5 ANIMONY M NESR , 35 BISCAYNE DRIVE', Marston Mips WA 02648 Expiration WORM Commissioner Unrestricted-Buildings of any use group Which contain less than 35,000 cubic feet(991m)of enclosed space. •.: , Failure to.Possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DIPS licensing information visit: www.Mass•Gov/DPS iLacgnse o;registration valid for individul use.only before the expirifi&dstM ff foupd.return to: Off ec ef:Coasumer Affair's and Business Regulation 10 Park Vaia-Suite 5170 Boston,MA 02116 'Not valid without signature , J ' a O ZC o � cr NA I ' DIV tya 0\ I ( ( / / ;h-f' /.� ` ' SSE a . I"i•� g:.. 2yPJi4jryi� `jrJi7l6 �n' IWI S� # d , • og rl "t jyy �k ; � '(xJ {� '('`'S^ t� 'q r rJ�jt t9+ t h ii t .N 1 T�1: � • $$�� �; j`3� �+�"4s�'+f ;,b•�d'P'�°R �� d'd'��r,'�+��e�rY"li�,�r��� d�&'r�Y�M}�� � �y.,�' �:'dr��'t�,y F k-µrJ s���,y r��i'f 11,`� �*1� { '• G t t� ��� rcaren, ti r P.�af` fl t4e� t � y z� YS +k� �� '>y fri�tt '�.,,yr`� ��'�'"af_ tz_ 'a�� �i itr 'hf L � lr �r. "�•" { •� 1 i�a h'it �� •t k' '� C 1 t G�'tR >'�� �„J3Z tJ f% •YL w �' `r 'J!�+•i3 ay Dj Cidt4'��tl; t:.t ^a ws a',ty,� - �a` � t }$`f � �.�, �1 .d'4 M I..Y... Jk' ✓tF�"�'df 9�i7tWla�f.,Y�'JY3S �y �..1d6'tN'2RC .y�a��( 4 %��.� k k 3 ° '4d ����Y'a"m+•w <p 3 Etf t 6 ', t, s , Mgr T ��r7�+rr� ?'a b t �t�td�'Ylti�w� siYi •r �' i�,�°� '. al.�8-.e�ee�y�r 1" c� �A .a x f r"y a �'Y`�r} ����� v.�Y4t'Rt- �+_th ��L �y �� ,s.� i?• s t9��'d1`_' W t y �tY.• '�� $iir _�cLl fl'y.+I".r5 �> � � tF' 'r` 4 ti.(� - S�� ,� 4�1 rp;yt�]'¢pt } iy!'f, �q Ka : ttjf °J t { � ".{ 4����' IJ. + � y Ui Q}:,•f ,�I@����YR`� ,54�� e j � i�? � s�Tt. J,•� �},�'�J;� _'i� 1'.' f 4 "z $$td f91 ��(�... 3•�r�' �r W:v' t5.t j , -.: y ni. �d�i.A• Fi}'�I§�B n 3� L -� 41" 6,y1�,P ��o��^''S''"�Y'(r r. �+ �r i ati�• :'Y�"�a�e' t�S '� �t r,��.�•. Grhi} � ta � � }e ad Yt }� v}r His f 7rttt� s �-P ,b�`�� �rH t R t irr LJe "4 n3� t p � ' �" r 15 ����' x h�i Y i g x*� } tta, �Y�p�Ya i'Arhik R4Ifi ran s, z , ;} 6 i0�rlf htt� e;•i.5r�yn �1 JI f u 7�jG r�� 9 t II / ?' +'F�:t� y t� �,��� �' i62f ".�a''y-t�{�! 'a'J•. t .�'�.+a} 'Pi;i�l�l�,�lnY'J•�� ��i1��.5t,'�} •e���, 5:����'n¢. yh``i_- ��„� � t 'C �}F�tyr �6pJZ{ 4$ £ty ayetfiR 4�, 'v xi' S `` �17�' II�O��MP.tt{J���kt�i'i�41' f• f!'Aw•tr�s 'i.V.� ��3y�t �� 5 ��Vli� �� 3'.. � ����t��'#���''�;'rWtRr'{1�y`u..� �' RR� ,��,'f•� � ,"jy'�tr`9�§ �Y �`t'��'k "°i '�;d�i�lMg'��¢��! f +yy ��'�S, kcY'� �357hh�'' ��• ''Y�,y,.}tI � 't� �.pt 'q' n. k^�`Y� � *�� m''" R't�•�ti'�} ��k �f�YF{t�l�.�:� ��� . r�,�'f[I-Fy}�ai>^,� 7��w`s�a#ZY�' ��Jf�S"lf�s %�JtttUgi�BA� �,F�S •+ �� �, 1 `ps 11� 'Fr �t'F�p k ,J .:f„fgy� ��;.r Jh 7 ,f t -a.G ,Y4 ,s�C�<. 1L �t�', i h t t•�� �tl�`;" �'�'g Gxj '�4<Ks.J i c9$x 5 y tt� NO din '7 ek 1n5tt. s tiYs�V�`: �rs-� its?7 7';�+j:C�t+`�{k S"l�'f(�� �,� �% ��1 yti �� � � i�" `y45R�'�''• �9�"�,'{y yy, '� ' `°t,L���. ,�•� �';�`` "�lr' Sll• co SUN { jJf6tiD✓ }� ����'�t �'J ,74�5}a'� ,r ,t`'J �N,�Dt�t� tz<�ti `�s lltt :i ?', t} 1D 4 y� ' h Wb 1t [ Jtf}e rt the G�YtV�� �j�a 't'�C � i� tti vlr� � s��.•,a�5�?; r���§ h:�ZI-. , �;,��j 5•� �+,�,}. }4 '�y��lt•� I '*;, J.:,�' ��rl} �sr "?� �� £��r^�'�}��!'; 1'�i+��M1n'�3' L ,e -,� .r ^-x t, +ti S. c +3 tr 4 ""t a Y C '^••b "y,.t k ?'. s r,r 3 0..._ y�R�,a, sN�k:e'T�-f i5-�.1J r'"•vr^<,q -` 5 .t � � '•"Fr`H�ji �n`-t �„� rr ...`Y""i•' `�.k, �.e- �}- L d"' '`E _.n MZ h�'� sy`�<•^SC �-��, r.•'+ a d��.��s> a. � :y .�9� � • 4 �14..•.�a �` `: .�4:. ,roe-c`r�c-'6i ,�ry+ct e �' f��.,, > t' �., a• 4 � � Ex�j y��EF�g�se f�.'�}y}7 � E�.�.•3 � �. e '� x ��:.. �' ��':,��`-3C,�r.�K.�..1..�s C EYG t'3--�Fa C.i��:�� -}�. �__ -f, ,�:13x���t y25 �6':�':3��a..��•S�� 3 E� �� -�^;z"`s`3'�r � .r 3 F�.S�.F`�:�.�aT���sS:.Efx�t•:5_z'i�.�'T.c'a�e�r'��L'�.�f>��-.� s a�- _ .;r k r -t: . ,.-•t =+�+'r� •""`° r� . .r> d d;�:6: Q®'�i��r��iTffi�!'GBS�H CI.@' 'Y � '� 6.;,..r�' �D. �o S i gam -'^'C.B:^m.E�.-ice, is z. 'Y^ •'-r-F<7t.1�- r7 '•,�.. •�'<"'� x��E a��s.'`�'� �m $�, � � .: .r'- a a � �-�'s.. ++ff f3 i K'..K - 'rs'` - rJ,� r.-0�_ �. _,.�rA•4;t rt'S, - z�"`�. •5-. —..�b�-.: 5:-,,,•<•:�r-..•..T ..'.Fa. a� t .r5..-mm -• •- i�t. . . . •. �--4�.�R��� :�-i4•'i�:.a:�' 'c' ,ert�'"a• .>�_,.s�•c?� `�:-�' -'.x.�. .;s✓•3-e- -.mz_--.� — - _ - ...-z�+ �wig -v.1. �i � �. `S_�.�_-,x ..s�El:?� �,'�.-G'-: !•�'k=t' 3 b��r�� S, ,u ""''r, .e:�` Tom.•. '?s- °�°ao'�4:a-.. 3 G:'-.'1 as -:,,r F:. •`'` :t�_ ' ..ysS..-±• t,. ^t :+ F` s#�a;--�1, o-' - X..`'^ `v .-r �`+"`.E _� `w. - -; `,ram _,:arr: .p ; - .. "L �:"-'�tt='-E'.:.,€.- .xsti --�s...•�4 -:.t3- x�/=`~ ,{-'�*.t ,••< ;> ��. r^.r �- - oar .r•c :�-.f`.- `'fie' _ :9c• - ,.F r y, ,,, «: a•.:: . _ .ram_ n �,,�:•�,�,:r„..z„S�' •i'' ���'`_�a..,-. :.a•'�`:•a ��.� a-- z�'"'�Y.��,:.='a^ �.�v -+•' ��,r? ����� -'�+"= y�i�L"�+ =:.c•�-��-_ r•�"�'•"'- �,"» •��,3�r""�-s`'.�$� .t��s-3.;." �-�w .MQ, .,�i-,+;�:�,�.n`a1�}�z^";•�.>r�`�;:_ ��a?'-�3.d.���4�t'-_=y.�.�:.��:rn�!_ .K:yi�h!_.k�'-.'c.F-"i;w�a`�-"`�`_rm,-."i-�- £.r='y.;...�..,;4���.y'�r�^��^•:.'.��-r"..,.;.,�''-�c p•�kt=' -z'a-t"r_�^L 5.'.i ,.,:�W_�,,,•yµ���,,...i s�m_�'�"-�-E",a,^`-4.��i....,t--7.'•+-•t�'-�"-ySf:�'-e�,....�.a??t^i`t� s:eT.'c. -<i.t.!.•*.2•-_-•.��:<*�'�.+�,�-sf'�''.�ue'"F s?.-°-. : �fz".:��J-•Y.�:�c,�. �„rtza�,-,3-.�4.Y.-.4�a;{�cv„3^'s.,�z'.?yi'-'r'�.c.,":•�,�E BF ,.-. .�i. .. -... �N" 4 9 � -.n.+,'�. at.�•'Y� �."... ;�•�� x^S� ':`Yr• - - ."•i` �k�.4y�Yr�a;:;5 5'��'� .�>•� yest?"�•.Y��.•_' EN i,i,,5'u'- .+yam 4: =�= `q„ �i''.- .i. 'Y. `1 - +• -x �,c, fi::•ao- 'y°•�; Y'._ *Za '�.. r� �=-,�'S._r"' 3rrS - .,ri 4.4'.-. ¢�t 'S•�a_ .�cF.: �q,e�� ,�;:,.� ,X+�",_. �� _ ,�;, {3 �:.' „�-"..f.__.� x�•...+�'�' �'Ys-�'a.-, `'�- rr.-r: .•,ri. .E:r-r4 _ - � �:r�: _ ^�'��.' Ebz ^^-fi'"''TjY�'. v�_'•}fi- _ g �'„i,:'. r �. : ....—. :t,C._,..�st�.-.:�,.- ^+'- - r --a-�}'-y Via:' ,:'„- -�.<•_ ��,.� �?�'"�._.�.�k -�. '�'.��€�. - .� -�,"+.c. v^cev--��,.tom_. - �+,x;... � :..� _�B`=K;.`-:��� �-�'�-.i�`.`� r. 3-.,ram.-„"'7•f_ �S�� -S�.s�.F-r-`�'- �••x,-: •,.�I-'�• _ :.�:Y Y '-5�.��!�,'_. .Y � �� `� 'at.:rEpT4 ._y.�_LCc.#rE�' ai•.. Y':;cx-'t'�+�-�'l'-`�' -^=�.-; L�x: '.i =-Ls <„z'���.: .r_�' •'�,.F: ir.s;�, 14 - ^^s"� - .,r�'„ +�'�`�,'�'- �..4, „y__�.yc.��sc!�,,,�--•Snr's"'�:k�.:*•y�T+°'-. w.'�v.,..�,T'` -K ,,;.r ':`sv>,-_ rr v...:��-3=� "- �' ate- * --�1•,t:.- k- .>-: �, �- - �- �<� -�.�i•.,;_._-��:�'n—� '�"`r`•:s "'�a'�.",-" Loa+n '��'3 <c _ ,:' .fir,' '''F# n� _��j�`'' � �fsy<��'�• �r �-�'_- .=�fc��'.�'�`��',��..+.�..�- ��'' s �+: 2+ .3•r a ,c �;�, �i .,yr'''. _` .ry.. r.. _ ..-�3s '���:,.5{` 5�"� S_�"._-�.1 -e'-w;,.tfT+C:,.'h�'.t�' .�2�esa*^+� ��' .: }�.��� ?s.•' 'yi:- �p'°' '"at -��- �-�`=�_ �a. �.^ A:K +�,. � -aa'�°+X��,.y-,. _ .� ^-��'�:. sx. - �..-.•.,�.d-.'ael�ck`�..tti,�r_"=u^c::c?- .�C'�.�....' .�,•�, Ana- -- _ - - �'u.,�•S•f..,...._.:� ....a�'1..-���•:: �. �� F.__ .: -� «. �"s-'�-.-rs3.'�� ���"�.fw:..--• � _•'�-ram - ..:� "�" ".S �- "����'`�f�a�`'.a�. n �*<v,•-a,t����;�-�,'h'L:Y,i'.,�.r� ��'--�-:t�._ ���� :}.: .-.f.=/ ..-.,�,�� sa• '�� � '' -s, '� '���.:�x... �„P"d'2; -�.:i.�.�'r...F •�-x�:.s '" •,..fs - On"I e �" _ �. Y. £ 'm :=.. + „.F .`� - .-a .�+.3-i' '•`�.- Y _z ,.,.,•tio -� iae.•J W' ,. . I= house. Z - , sfiOm:. yC s�•- y�•� 't'. q ar'S��'°'•�i', "F�.}-' .�&�` ,,.`.y��,y,...�. :cr 1. `'.rR.-'� -.#�- ' l For Anthony NeSe,84 Minton Lane, x 'a'Y''"- yyeFL ••`d" -t ,_:✓7.._' ,o �c €`-� J � aS:,� ryi da _�.-,=.'� -g - & Y P :. u 7Vfihg�t _st 508-776-5955 r Specs contionning to the AFPAI, rem Rejjde�tjal Wood Deck Construction G � _i �kS/^ p T•iYJ'�.�p Ska b 8 .y 9c F.j aC ti31+ �:":YR r a- K%+�•.�4� L-ycY ai�'-- a....°.3" +•y � '•S'r. �."r!' '' '� u q���� .aT'+s"�:'ynrs�� mt'-;"`<+d��'•mv.srt' r:`� x•srs ��_•_ ••r��'� r s j-^�' - a, �� - -nO _- a".•>:.uuq'.+�.s'. -';7'`x'-a�_ i3...�,.t` �`�z+a��,.•F,K- ..+�� �"��= -_ _�-s.`n,-:.- " _ �,* - - - _8•' _, �n� �'�5"_-•` ��, s.�.��-q��. -:�._'P,_v'�"�� ��..-�c'���+Fyji,°�,'��ry e' ��•�� ! .«� - � .. 'r'6'"'`�`�r, _ .-r-v.��r,�,-"_+r�.�y.3e -�'n.,13�r ,:�K'.w-�� ..,.-,rBN. ci'�Ycn- �-•tA4��: _ .._ -7Y-'�'��%..« «e-� d �.ea. -.��^ �n,� _ - .�,-:s,a9� � _• "°sts.��,--F'�.-.._� `.a-.-� _ _ '>x` a m ' 1 gig a E.' 13, co At: 5 03 4.-T • t 10 cn 4 �y N 3'-7"W 9Rz 10"T S S. i Deck Sectional Views, 1 of 3 guard decking ledger board fasteners ' existing house floor construction guard post ledger board attachment attachement to existing house rim joist joists beam Post-to-beam connection (flush,tight bearing) footing joist-to-b post connection Figure 1A.Joist Span—Deck Attached at House and Bearing Over Beam optional overhang existing wall —�rim joist fledger ------------- beam(flush, tight-bearing) joist d ' post - La/4 maximum_ _ Joist Spari(Li):see Table 2 overhang Figure 3:Beam Span Types jotsts.'abpve optional overhang(may occur at each.end)' IYI IVI IVI IYI IAI IAI IAI IAI I geam.. beam splices at Interior post locations' post,.typical. Le/4 nlax. beam.span(Le):see`Table 3 beam span(Lae Tabe3 La mak: el overhang overhang Table 5.Fastener Spacing for a Southern Pine,Douglas Fir-Larch,or Hem-Fir Deck Ledger and a 2-Inch Nominal Solid-Sawn Spruce-Pine-Fir'''Band Joist or EWP Rim Boards Deck Live Load=40 psf,Deck Dead Load=10 Ds 3,e Rim Board 6'-0" 6'-1" 8'•1" 10'-1" 12'-1" 14'-1" Joist Span or and to to to to to to Band Joist less 8'-0" 10'-0" 12'-0" 14'-0" 16'-0" 18'-0" Connection Details On-Center Spacing of Fasteners' %;'diameter lag screw withEEa 24. 18" 14" 12" 10" 9" 8" u172'maximum sheathing' 78 28" 21" 16" 14" 12" 10'. 9" 30" 23" 18" 15" 13" 11" 10" 'A"diameter bolt with 24" 18" 14" 12" to. 9" 8" 16I,,"maximum sheathingsa28' 21" 16" 14" 12" to" 9"36" 36" 34" 29" 24" 21" 19" W diameter bolt with 1 EWP 24" 18" 14" 12" 10" 9" 8" 75132"maximum sheathinp,and 1-1/a-,EWP1 28" 21" 16" 14" 12" 10" 9" W stacked washers'B 1-y."Lumber'" 36" 1 36" 29" 1 24" 21" 1 18" 1 16" ' The tip of the lag screw shall fully extend beyond the Inside face of the band Joist. • ' The maximum gap between the face of the ledger board and face of the wall sheathing shall be h". ' ' Ledgers shall be flashed or caulked to prevent water from contacting the house band joist(see Figures 14,15,and 16). ' Lag screws and bolts shall be staggered per Figure 19. , Deck Sectional Views, 2 of 3 Figure 14.General Attachment of Ledger Board to Band Joist or Rim Board exterior sheathing remove siding al ledger prior to Installation existing stud wall threshold carefully flashed and existing 2x band joist caulked to prevent water intrusion or 1"minimum continuous flashing' EWP rim board extending past joist hanger 2"min. oeck joist. 1-5/8"min. ' 5"max. 2"min. 1/2"diameter lag . 2x floor joist, screws or wood I-jolsl, through-bolts with or MPCWT washers joist hanger existing 2x ledger board;must be greater foundation wall than or equal to the depth of the deck joist and no greater than the depth of the band joist Figure 11.Rim Joist Connection Details joists secure decking to top of rim joist with f/ threaded nails or x minimum wood strewss @(�8"o.c. " attach rim joist to end of each joist with ® (3)10d threaded nails or(3)#10 x 3' ® minimum wood screws rim joist Figure 25.Guard Post to Outside Joist Example see FIGURE 24 for guard 'guard posts can be installed as guard posts may be ! component attachment shown in Figure 26(between joists) located on either side requirements if blocking is installed as shown below of the outside-joist within 12"of each side of the post i at first interior bay,provide 2x blocking at guard posts guard post with hold-down anchors;attach blocking with 10d threaded nails top and bottom,each side (2)1/2"dia.thru- ! bolts and washers outside joist 2"min. oo Y<<• 2-1/2"min.and 2"min. outside-joist SECTION guard post' PLAN VIEW Figure 26.Guard Post to Rim Joist Example see FIGURE 24.for guard hold-down anchor component attachment iequlrements joists guard post guard post align guard post at joist locations rim joist i hold-down anchor rim joist rim joist joist minimum(2)1/2" 0 2"min. hold-down anchor diameter thru- 2-1/2"min.and 5"max. bolts and washers ".min. at joist location between joists SECTION PLAN VIEWS �k e, Deck Sectional Views, 3 of 3 Figure 33.Miscellaneous Stair Requirements Figure 34.Stair Footing Detail t a cut post at bottom tread (2)'/"diameter thru-bolts m E at elevation when no stair with washers required only `e guard is required If guard is required;otherwise F Co 9 use(2)#8 wood screws z3-'/� long or(2)16d threaded nails C a t� Attach W bearing block using; handreil stair (8)#8 wood screws z3-W long handrail shall stringer o or 8)16d threaded nails return at each E end post E post •� 6 E 36'min.stair width minimum N '°""" frost depth � - 10 7"x10"square or.I • 12"dia.footing Figure 30.Stair Guard Requirements Figure 31.Stair Stringer Attachment Detail %-0"maximum rim joist or etwean posts oulslde iolst stair guard Is required for stairs with a total rise of 30"or'more;see GUARD REQUIREMENTS for more Information eloped joist hanger, 77 minimum download capacity of e26lbs; see JOIST HANGERS for more requirements ' stair guard height: o ATTACHMENT WITH HANGERS 34"min.measured ' 0 from nosing of step 0 0 Openings for required guards on the Triangular opening shall sides of stair treads shall not allow not permit the passage a sphere 4-31e"to pass through. of a 9"diameter sphere. Lumber species: 0' Pine 5 r 0 r -r r a r him or "I -1 I r r 2 x LQ ledger C —' L Ba nd J board with Min dia. 8 bohAag screwslanctiors e @-on center 0 N v N 0 joist hanger: Ibs c , S doubt or triple y °off': t3xt3 2 x p trimme'r post trimmer hanger:J3LC)lbs Com rim joist M. o stair strip s: oils Ll I round or square fooling: ld4 max. (.°dia.or-x_I.x g"thick-W deep Le14 max. overhang beam span(Le): , overhang treads: 2 x single, u r triple 2 x 1a;Le=f' Cav?esre`Amer�can W^odCcu+dl. ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma 0- O-1 f� p 1 Parcel App ication # Health Division Date Issued Z Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address 62 V l r Village Owner \ L R eb►!: C Address U b Telephone Permit Requ st SZ 1 � wt l Q Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Z� Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Ax Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old Kings ighwaV, YEM ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq, Number of Baths: Full: existing 'new Half: existing new, Number of Bedrooms: existing new � 1 Total Room Count (not including baths,): existing new First Floor RooA Count C") 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) 7U� Name ` CJ Telephone Number j Address License # 4;� Home Improvement Contractor# ej Worker's Compensation #J�n�,S' ALL CO l RUCTI BRIS RESULT G FRO THI PROJECT WILL BE TAKEN TO SIGN E 4 DATE f r� FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: ; - FO..UNDATION _ r FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO --gyp e � The Comnionis-ealth of Massachusetts Department of Inditsoial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 nmv.mmmgov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name ak4nessiorganizationtlndividuap: Richard Tupper Address: 79B Mid Tech Drive City/StatelZip: W. Yarmouth, MA p}lone g- 5 0 8-2 8 0-6 2 8 0 Are you an employer?Check the appropriate boa. 1.(AI am a employer with 4 4. ❑ 6. ❑New construction am a general contractor and 1 Type of protect(required): d} employeesfull and/or s have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g_ ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance. reqti�red] 5_ ❑ We are a corporation and its 14.❑Electrical repairs or additions 3.❑ I 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.]t c.152,§1(4),and we have no employees.[No workers' 13.0 Other comp.insurance required.] "Any applicant that checks boa;#il mug also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit mlicatiag they are doing all wa¢k and then hire outside contractors mo submit anew afftdawit indicating such. +Contractors that check this box must attached an additional sheet showing the name of the sub-comxacton and state whether or those entities have employees..If the sub-coaaactots have employees,they rmrst pmvide their workers'comp.policy number. lam an employer that isprvWding workers'compensation insurance for my emrpk yem Below is tyre policy and job site information. Insuuance Company Name: AEIC (Associated Employers Insurance Company) Policy#or Self-ins.Uc_#: WCC 5 0 0 5 5 9 012007 Expiration : 10/3/2 013 Job Site Address: LVD Citwstate/Zip:�L 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. 1.52 can lead to the imposition of criminal penalties of a fine up to @-tin or one-year imprisonment,as well as chril penalties in the form of a STOP WORK ORDER and a fine of day ago the violator. Be advised that a copy of this statement may be forwarded to the Office of estigatioms the DIA insurance coverage verification. do here certify cruder hepains and penalties ofpediity that the inforniationprotdded a e is and correct. lure:. Date: l 2 Phone#: of]'acial use only. Do not write in this area,to be completed by city or town official City or Town: Perm tUcense# 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 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 11/07/2012 PRODUCER (508)9§7-6061 FAX (508)990-2731 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Southeastern Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 9' HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 439 State Rd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 79398 N. Dartmouth, MA 02747 INSURERS AFFORDING COVERAGE NAIC# INSURED Tupper Construction Co LLC INSURERA: Arbella Protection Insurance INSURER B: AEIC 27 Roberta Drive INSURERC: CNA Surety West Yarmouth, MA 02673 INSURERD: I 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. ILT R DD' TYPE OF INSURANCE POLICY NUMBER AT.CYEEFFECTIVE POLICY EXPIRATION LTR NSR DATE MMIDD/YYYY DATE MMIDD/YYYY LIMITS GENERAL LIABILITY 8500008743 11/01/2012 11/01/2013 EACH OCCURRENCE $ 1,000,000 AMA N COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 CLAIMS MADE � 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- JECT LOC AUTOMOBILE LIABILITY 56662400002 12/01/2011 12/01/2012 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) A X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per accident) $ INC GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER.I'I IAN AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WCC5005593012007 10/03/2012 10/03/2013 X I TDRYLIMU- X O R AND EMPLOYERS'LIABILITY ANY PROPRIETOIVPARTNER/EXECUTIVE RICHARD TUPPER IS E.L.EACH ACCIDENT $ S00,000 B OFFICER/MEMBER EXCLUDED? Y/N (Mandatory in NH) LUDED FOR WC COVERAGE E.L.DISEASE--EA EMPLOYEE $ 500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 OTHER 71068813 02/28/2012 02/28/2013 Limit of $10,000 Bond for theft of C oney &/or property. DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 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 REPRESENTATIVES. "For Information Purposes Only" AUTHORIZED REPRESENTATIVE I Lora Lowe ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD - iviassacnusctts- Ucp,:i.ntcn( of PUI)Iic SafctA:: =p Board of Buildin_ Re-ula,;ons and Standards . Construction Supervisor Lice-.-.se Lirense: CS 69058 _ RICHARD S.-TUPPER 79 B MID-TECH DR, WEST YARMOUTH,' MA 02673 Expiration: 12/31/2012 • i „mmis.i.uicr Tr;#: 8340 I. Fl. ell Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OHOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: -;121845 Type: Office of Consumer Affairs and Business Regulation Expiration: 6/19/2014 Individual 10 Par uite 5170 Bo 0211 RIC79ARDTUPPER..';'.< RICHARD TUPPER 29 Roberta Drive W.YARMOUTH,MA 02613. Undersecretary Not valid v, ithout signature i TUPPER CONSTRUCTION CO.LLc 79B Mid-Tech Drive West Yarmouth, MA 02673 Phone 508-778-0111 Fax 508-778-5010 Registration#121845 License#069058 PRIME CONSTRUCTION CONTRACT Date: Nov 3, 2012 Name: Jason Leonard Job Address: 84 Minton Lane Mailing Address: Same City/State: Marstons Mills, MA City/State: Estimator: Rick Tupper Home Phone:508-272-7571 508-280-6280 Fax: O Contractor will furnish all labor to draw plans for deck to rear of house O Contractor will furnish 3 sets of plans for town and one set for homeowner and seek permit approval • Contractor will Refund the payment for plans on contract for deck job • No engineering supplied for this contract-if town requires engineering it will be on a cost plus basis Owner agrees to pay Contractor the total sum of: $375.00 Payments to be made as follows: $ 375.00 Funds to be disbursed by owner. r Contractor's signature Date , ) /3 V Owner's signature Date Page oT 1 Jason Leonard 84 Minton Lane Marstons Mills ...... ...... O . . . . ol new landing to be framed with 2x6 P.T. ,joists Posts to be 6xro P.T. connected to 10" sauna tubes .4'deep band around deck to be 2x10 stair stringers to be 2x12 with 11"tread balluster spacing to be 4"O.G. I . CAPE COD TOWN OF SARINST'AILE INSULATION 20;g FEB 26 P 2� 35 R...Ou3[ 3lpMl[SS WAAT[OAM 3O51[NO[O 3An3 OHTT[3i lN3YlPtN[H "'"No, q[ee��_ _ 1-800-69&6611 Q�1,'i--. a 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 (BRI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address . Villa/ge�,, F C1 M,A 4 & Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) ()( ) ( yZ) ( ) (K) Slopes ( ) ( ) ( ) ( ) ( ) Floors Walls ) ( ) ( ) ) ) Sincerely He ry E Cas y Jr, President C• e Cod I ulation, Inc. I• r ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �Zplp ion # Health Division Date Issued L Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project StreetAdd're s ll� Village WJZr Owner Address Telephone Permit Request 10E f�i�tl� �(/A �1 ►UG' (/ (� ° L ZGI MK ; Yt WAL 0yV'?0k ', F-P� AMak�;6(aA -6 '50 CAM -&A1WAV94-- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ( Construction Type �rYL-) Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's.9i hway: UYesc-] No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft I e Number of Baths: Full: existing new Half: existing nevv-,- Number of Bedrooms: existing _new :° w r- Total Room Count (not including baths): existing new First Floor Room Count %0 M 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 AppeaYNo thorization ❑ Appeal # Recorded ❑ Commercial ❑Yes If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ��� / ���sv, �rr,�O Telephone Number c s ,7 27 / Address ,/! ,���i�id�/� ,� License # Home Improvement Contractor# Worker's Compensation #Gf/AM-L `5'9oI ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �YIo, SIGNATURE DATE f"I r s FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED t MAP/PARCEL N0. 4 t ADDRESS VILLAGE - OWNER 3 DATE OF INSPECTION: FOUNDATION 1 FRAME j INSULATION `4 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL i GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO: = ` 3 w? r ' Massachusetts -Department of Public Safety i Board of Building Regulations and Standards Construction Supervisor License: CS-100988 HENRY C CASSIO 8 SHED ROW _ WEST YARMOIFIH %pl Expiration Commissioner 11/11/2015 P :;:1`i; :i. . � ,�.�6,1<' ��:'C,��l'�i7:la:f'�./(./C'i�l('��L.• C-''.••�'!'C. �' ! C)I.t lCl' Cl I`L,onSUI-tler Altatit-s and 131.131ness Regl.11all'c*rl 10 Nit Plaza - SLlite S 170 Boston, Mass-ichwetts 02116 H-011le lrrrprovement Contractor Registration Ileyltill'E111011: 1535(5/ l vile: Private Curl.)irrrafi�.ln Expiration: 12/15/2'014 'rr1/ 23JO31 COE) INSU1-_.A-1-I0N, INC IWANY CASSIDY _.........__..__. . ... . ........ ... Iti I�I::AI=�DQN CIRCL...E YARMOU-I H, MA 02664 Upd,ltrAllclruss autJ r�auru cnrtl. 11'lurlc rcusou litrrhange. ' 1...1 Acldress 1nlluynuntL laud • i ��'i"'�l r r.r.ti n.'r�irrusil� u„ .,i t. ur,unu:r'r�lluirs 1lusiness Regulu'liu,l Lircnse or regiitrtniuu v;llitt for iiidividul use.unll, i ; 4�7�t+Illlu&1r. -[�OR hclurc the es piratiun date. 1l'Ibuutl return Lk):I MhkGVk.M N CONfFAl ` 153_d 1Ype: 01'keofLonsinncrAfliirsruin ltusincss ltc6ululluu Private Corporattrii lU P:u'k Plaza-Suite 5170 y Iiustuu,MA U2116 1 i . 4_.-. rrCi.'.,��:r iLlr1 U1lil,i4 c. Ilnil�rsrerctliry Orvill 11'it110 I 11A 're The Commonwealth o1F iVassachuserts I, Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, IVA 02111 www.mass.gov/dia Workers' 'COMFIentsaltioa Insurance Affidavit: Builders/Contractors/Elect riciansiPItiixibers ) )licatyt: Cr1fnr1-1:latityti Ploluse 1''ri.rlt Y.,e ibl `J.Httc 113u�u�c�sJOrganizatiot�/Lndiviclual): ��f��� D G/ 21 rltltllCss:..�J�"--y/�iL/G:� � �^� s� tom' i • �7 G / Phone #: Z Arc you may culployer7 Checdc the appropriate box: :rtii a c:tn to er p y with. 4. ❑ I am a general contractor and I Type of project (required): I. I _ ctnploycc.t (full andstor psrt-time).* have hired the sub-contractors 6• ❑ New construction i -' LJ l :trtt a sole proprietorror partner_ listed on the attached sheet. 7. [] Remodeling ship w.id 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.t 9. ❑ Building addition rt yturtd:) 5. ❑ We are a corporation and its •.10.❑ Electrical repairs or additions 3.[] 1 am a homeowner doing all work officers have exercised their A-113 Plumbing repairs or additions tny,self. [No workers' comp. right of exemption per MGL 12 ❑ Roof repairs insurance required.] .t c. 152, §1(4), and we have no 3a.❑ 1 atn a homeowner acting as a employees. [No workers' 13.R0ther f,4, 5,.. _ general contractor(refer to #-4) comp.insurance required-) �A11Y Vpbcsnt that checks box#,I must also fill out the section below showing dteirworkera'compcnsatioi 1 iicy infonm.tion. t H0,,,cuwucr3 who submit this affidavit indicating they aro doing all work and then hire outside contraeton must submit a new affidavit indicating such. :Cutuuiturs that check this box OIL st attached an additional sheet showing the natm of the stab i ontrttc[ors and stave whether or not those entities have cu1pluycca. If the sub-contrctors have employees,they must provide their workers'comp.policy number. !um an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site irtforrriunuir, � •�/ Insurance Company Name: 1'Oltcy W or Sclt=ins. Lic. #: �'G.i!/'l� L? / Expiration Date: !�6z_'_'�— tub Sire.address: 1`l City/Sate./Zip: &`I W / tiV attach:e copy of the workers coin pensatdoa policy declaration page(showing the policy Lit uLuber and expiration date). Fatlurc to securc.covcrage as required under Section 25A of MGL e. 152 can lead to the imposition of criminal penalties of a Fine up to 31,500.00 and/or one-year imprisonment, as well as civil penalties is the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. Bc advised that a copy of this statement may be forwarded to the Office of lnvestigations of thic DIA for inaur&oce coverage verification. I do herebyecr;,� ruder the (? nd penalties of perjury that the informadon provided a ova is true and correct 1 Si� •ut• � a� • Date; G i1 Ujjk'iul we only. Do not write in this area, to be completed by city or towns official City ur'1'uwo: _ Permit/LIcense# kitting authority (circle oae): l 1. tio„rd of Health 2, Buildlug Department 3. City/Town Clerk 4. Efectrical Inspector 5. Plumbing Inspector I 6.Other I l''outuct Person: -- Phoae#; CAPECOD-27 MYOUNG_ C>Yi 1:> I enrr.INM1DercYYY) CERTIFICATE OF LIABILITY INSURANCE 71812U13 THIS CER)WICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS t:ERI'IFICAI'I_ 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. i IMPOR IANT: If thu Certiticato holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subjdcttu I plc turim, Alld cofldltiolls of tilt) policy,certain policies may require an endorsement. A statement an this certificate does not confer rights to IhU -(lihcalu holder in lieu of such ondorsoinent s . - 11•1.a11l:Ll( Licerlsu 'IF PC--514062 NONrACT Mar aret Young ..-- -•---- _ ---- lkugcls(X Gwy Insurancu Agency, Inc. PIONE I FAX"' 1434 Rtu 134 QIC o E(: -----•-----•.-._..__ -_._...IAIC,Nqt..__.... 1SUuUI Unnuls,IVIA 02660 EMAIL AnOREss:m Oung cerogersg rayxon'i INSURER(S)AFFORDING COVERAGE NAIC Y_- _... _._•. _..,, --_ INSURER A:PEERLESS INSURANCE COMPANY INSURER El:COMMERCE INSURANCE COMPANY C«),U L:Od Insulation, Inc. msuneRC:Evanston Insurance Cornpany 18 l;cardofl Circle INSURERD:ATLANTIC CHARTER INSURANCE GROUP "Cloth Yarmouth, [VIA 02664 INSURERE: _-_.._--b•"---..._..---•---_.___.._-._..._..__. _ INSURER : ----•-----.-__.-____.... ............--- COVERAGLS CERTIFICATE NUMBER: - REVISI-- ON NUMBER: nn', IS 10 i'LR I'iFY T HAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUL=D TO THE INSURED NAMED ABOVE-"FOR THE POLICY PERIOD I,vuu:Alt:U NOI'VATNST'ANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECr70 WHICH THIS CtcKUl•ICAIL' MAY 15E IS;S'UED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERE-INIS'SUBJECf TO ALLTHE TERMS, I AL:LU5U)NS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .A150'SDBR— _ PbTrCVErF- POLICYERP LIMIT'S LfR TYPE OF INSURANCE POLICY NUMBER IMMIDDIYYYYI IIAMIOD/YYYY) UkNERALJJAUILITY L:AChIOGCURftENCE b 1,000,00 A X (:(iAaMt-HL:tALCENErtALLIAUILITY CBP8263063 41112013 411bZ 0.14 -lAM CZ-TO•RENTED ,100,00 .. P IEMISES IEe oC_ay(T!1 .-•__L-- —„-„ L't AIMS-MADE OCCUR M-0 EXP(Any ona Porwn).. ..3 5,00 IIII PERSONAL&POV INJURY b 1,000,00 i 000,00( GENERAL AGGREGATE_ b z,00o 00 +d•N'l nlild�tC�AI;E.LIMIT APPLIES PER: •-'- PRODUCTS-COMPIOP ACiG^ b--___---i I'0Hk:Y I 1 k0- II LOCI_ C•OMDINtLTSINGTELIMIT 1,000,00 AU IUh1UtlIlC l.1AtlILIIY -••----.__.-_---_-- U AN%AUILI 13MPABCKVMK 41112013 41112014 BODILY INJURY(Parpoison) b ' ,u,l tPrMtLU - SCFIEUULED BODILY INJURY(Per(ACCIUOM) b AUfU� X AU'ros ..... ...._.---- .. NON-OWNED pR_OTTE�'TY•DI�MAri�----- b X 1-11*1.1 AU I'OS X AUTOS )( UAIt1tiuLLA IJAtl _X OCCUR EACIJ OC.CUIgRL-NCE LIAFI CLAIMS•MADE XONJ453512 4)112013 4/1/2014 AGGREGATE I Utl1 X likl'LN�1--ION 1O OOO WC$TA'fU-L. OTh I:OMPtNVeN I• •"- 13 ..__.__...._. wU1t,�EKj SA'f1UN -- •� � _ ' AND tAiPLClYERS-LIABILITY YIN 'I,000,00^ I) AM't'nul'r(IC10t(/PAIiINEWEXtCUTIVE I"-" WCAU0525904 613012013 61301:.0'14 E.L.EACh1ACCIDENT_-- b_ - (lrhlt:CRIAtEMUEN EXCLUDED? l- NIA 1000,00 IAlandalury In NHl E.L.DISEASE-EA IiMPLUYE b___ ., _,__-- ,I wa.donnUa ur(Uer - - 'I,000,UU l..l.DISEASE-POLICY •l1cSCRIPPIONOFOPEttA'I'IUN3brilow - •------- ""'-'--" 'ur iCKn'nUN Or UYt:KH I'IUNS 1 LOCATIONS I VEh11CLES (Attach ACORO 101,Agal(ienal Rmm�rhe Scheaulu,II mere apaoe In requtrad)- IWolAdls CoUI)1.11satlOn includes Officers or Proprietors. 1AUUU(NIAI II W UI Cd Status is provided under the Generyl Liability when required Dy written contract or agreement with the Certificate Holder. CER1IFICAIE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE:DESCRIBED POLICIES BE CANCELLED OEFORE e COCI IIlSlllatlUll, (ItC THE EXPIRATION DATE THEREOF, NOTICE-' WILL BE DELIVERED IN L;a N ACCORDANCE WITH THE POLICY PROWS1ONS. AUTHORI ZED 11FFRESENTATIVL- - ©1988-2010 ACORD CORPORATION. All rights reservad. ACORI)25(2010/05) The ACORD name and logo are registered marks of ACORD OWNER AUTHORIZATION FORM (Owner' (dame) owner of the property located at t (Property Address) ' (Property Address) hereby authorize_ (mac. �;y %,�,�, ►� (Subcontractor) an authorized subcontractor for RISE Engineering,to ad on my behalf to obtain a building permit and to.perform work on my property. Owner's Signature Date iy Assessor's map and lot number ...l.�.y.-.a . ........o)v Sewage Permit number ............ d`�Q '+► 1 Z B>BBSTABLB, i Rouse number ........... .. .... /!f............................... y� MM6 ............. p f639. M p. TOWN OF BARNSTABLE BUILDING INSPECTOR c6 APPLICATION'FOR PERMIT TO .........................................S/ ...............:...G....Jl............................. TYPE OF CONSTRUCTION ............................................... ........ '�'�� .............................. ' ..............w. .r.........19.T1..7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: w Location .......................... ...........�..�............!<.'...........................�...........................0............ . ................. Proposed Use ....... .......... *1�. **.. �/.ZC. .............r„/I�LI•. �................................................................ ..3..a.................... ...........Zoning District �.,... 5....... .,,. ' ...........................................Fire District ................. ........................./.�..:.. Cd Nameof Owner .....................................................� .........Address ........,................. ............ ............. ...../..t.:............... Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .........................,............................................................ /' D - Number of Rooms ............6.................................................Foundation ............. ................ ........cn/1�l....../........ Exterior tAl'..e........ �!c!Yf(.`2�.5.............................. /7..�. �� Z Roofing .................. /.., . ............................................... Floors ..............!iNr ..... .�'`l.�/....................Interior .....................yS.�. ... n.. . ,, :::..............•............... Heating ................. ..... ....0 Plumbing .. -�-? f'147�� i. Fireplace ..................................................................................Approximate Cost ........................ ......��....�...0...U Definitive Plan Approved 'by. Planning Board ____ ___________19_ __1. Area .......................................... i Diagram of Lot and Building with Dimensions .` Fee ............................................. \ SUBJECT TO APPROVAL OF BOARD OF HEALTH -3 2 X ? "� 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. Name ............. .. .................... Construction Supervisor's License .......... GREENBRIER CORP. A=174-2- No . .7.2.1.3... Permit for 1.�,...s.t.ory...single . .. .. .. ...... .. ..... family-...!4��q�,;�ing................... .................. ..... ............... Location LQt-...#.2.Q...........8.4-Miritoa-Lazie -3.Q -9- 14-fe Owner .....Greenbrier p�t................... Type of Construction ...................................frame........ ............. .................................................................. Plot ............................ Lot ................................ Permit Granted ....November 14- 84 ....................................19 Date of Inspection.........................................19 Date Completed .................. ..................19 .`,, "r►o, TOWN OF BARNSTABLE Permit No. __ 27213 - `� Ow - - -- --- Building Inspector uasa+m Cash 1°)0. OCCUPANCY PERMIT Bond Issued to ^Sa-ibrzT Corp. Address :i n)-r--N T-nn z_ i Jk— / 1 Z J Wiring Inspector ,; _�; r/; Inspection date Plumbing Inspectors f*� y Inspection date Gas Inspector Inspection date J, Engineering Department Inspection date ' Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 17 ( ,/ ......................................................, .... ................ .................. ............ ..... Building Inspector ~ A FROM - TOWN OF BARNSTABLE BUILDING DEPARTMENT Mr.. Francis Lahteine - ZjC�A1t1 Clerk Tr}:iObMYM4etg iMM}���4-0►Pr7Wd/R�lXf867 MAIN STREET HYANNIS, MA 426Qt F•w.re.spas wF ww,wr:ta r.rams N4eW4i Phone. 775-1120 SUBJECT: FOLD MERE DATE January 18 .-1985-._ _ _ .. WE S S-A G E- Work has,-beer}-ampleted-under-Pemit #27213 d rier rp)w wl'Fs»�F.;CKv C3mO.kP�vV ii Yf4 a + aMe•. �1XNwi>•! •v ar�. -Please release Bona. �. , 41'bliz•Pe•ow.v+a•wrs.oNYtrFN.�wswer�•nw a4 s+�..r"4�Fr Vw'o"reb 6r+:�F ` h • r i SIGNED - - �. V. f DATE f REPLY - SIGNED . •- r Nei.RMl RECIPIENT: RETAIN WHITE COPY.RETURN PINK COPY PRINTED IN U.S.A. r SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. ;t 93,��. v Lo r z Q 6,. 1,Y 3 S. F. 8, \'ss s, V t7.�s n. /o TZ_ Is Up., �u„�. �s� 'T2�rrr�E • .-.CERTIFIED PLOT PLAN p R08ERT G� EIDREDfa y { I td :p rQ by su%4 SCALEt DATE= 3 c E 0 EE /NO Ir .! c2 CLIENT 1 CERTIFY 'THAT THE�0vn/�� � /-ivn _ EOISTERED REGISTERED SHOWN OK THIS PLAN 18 LOCATED CIVIL LAND. ' JOB NO. ON. THE GROUND AS INDICATED AND ;a ER 8URVEYOR DR; E{--�} �' CONFORMS TO THE ZONING LAWS EIdO VE BY• 0F; ARNSTA®LE AMASS 712' M A I N S T R E.E.T CK BY& R'/3•E_ 9 A� ' i 44 ,,hYA-,N R i S, MASS. B:MEET OIF - 4 eL DAT REG. LAND SURVEYOR J S. z8 F� 93,/g LO T 2 0 46,43 ' F o r Z/ � 1 I< ^ \ - \� -� Wv. .o r �k �• 00 •� .. . � I r i so . ``�J j .Ate?G ° I S ' Z s 2S 23 S , 0 t^ 01 30 O ,o ISO �,eo A/TA 4 4� /N9/aT0 N L 14 NE � a \�HOFMAssNOE CERTIFIED PLOT PLAN LU 7 20 /1�1/Al T0 Al L.A n/E rc r)l s f•.rt'f y� a9 .:,1 CCU T C iC'✓/LLB ELDRGU ,a ORSE. ti ,t; No.10951 /s eik • 1 A 1 SCALEI D DATE 1 LDREDGE ENGINEERING CQ /N GREcSti/13R«2 CLIENT I CERTIFY THAT THE PROPOSED EGISTERE REGISTERED JOB NO. 14 '::BUILDING SHOWN ON THIS PLAN CIVIL LAND DR.BY � CONFORMS TO THE ZONING LAWS ENGINEL.ER R E OF BARNSTABLE , MASS Y 712 MAIN STREET CH. 8Y /3 �kATE MYANNIS* MASS. SHEET-1 OF ' EG. LAND SURVEYOR ,/8 2� LC° AssIssor'S map and lot number ... ....... -0) THE c q Sewage Permit number ... ..................�� .. / � F�si 6f� ��' ""' ��.."" ..... ...........:...... O�ER 4 A pUS V te'I "RY Z BASBSTADLE. i Flbuse number � ..: `^/.�/ �r� `�'" p t•.�-C-Ay Ll g .� rAet639 .......................... �rT�C............................., d� TOWN OF BARNSTABLE-fir BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............................ .... / !Lr�/f /I............................. �� TYPE OF CONSTRUCTION ...............................................�.(�.�........ .................. .............................. U.`'..0 ...r.........19.�.y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 00 tiro�� L w-� LocationCal..........�. v..........:! !. ......................... ........................... ...... .. .. / Proposed Use .................... /. f(...2'............ /I�I!l. � ..................................................... ...................:.................... ..................................................... ZoningDistrict :. ...... ...F...............................................Fire District .................5�.......�...................................� ... .. Name of Owner � �%�^' /lff«.....�.0/'' l ..b...:..�1 .............. .........Address ..................... Nameof Builder ....................................................................Address. .................................................................................... Nameof Architect .................................:................................Address ........................ Number of Rooms ............1d.................................................Foundation ............. �.,/........ Exierior r •••.. •..•�/V........... .. .�. .....................Roofing .................., .. ...4 .. Interiorly f ,`Floors �/� ^ �.. ......:�/.��.1.'`� ,,�.. �.�.E. ............... ' Heating F ...................Plumbing `� .. -Kil Fireplace ( O, 0 O U p Approximate. Cost ............................... ................ . Definitive Plan Approved by Planning Board ----1 -- - - 19 -y• Area ........5 .•s•�. -?.� ..... Diagram of Lot and Building with Dimensions Fee � SUBJECT TO APPROVAL OF BOARD OF HEALTH W—e— �3 X � V OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstpble�egbrding the above construction. , Name ................�%-.... .... ...................... Construction Supervisor's License .......��.�..�. . <..., .,. qR-EENBRIER CORP. 74-2 A �7213 sin le 'am o .................. Permit for ...Ingle,,,........ ......1, (.j�a...S.tor )..................... Y. Location Lqt....#.2.Q......8.4...Mi.n.to.n...L.ane...'.. .. ..... .. .... .. .. ....... U Owner .......G.re.eb .nr.ie.r... ................. .......Greenbrier.. ....... .. Type of Construction ..............frame............................ ................................................................................ Plot ............................ Lot ................................ Permit Granted ....November 14.......1984 ............................. Date of Inspection.....................................19 Date Completed ...(J: ...... ............ FILE 2ft' CENSUS TRACT CLIENT: Cape Cod DEED 450K 39 PAGE 91 rkor K at LO APPLICANT: ASSESSORS L N jL74 PLOT z7 ;I 1l0R16A6E I N S P E C T 1 0 N PLAN of LAND B A R N S T A B L E SCALE: 1'= 80' SEPTEMBER 21, 1987 93 a C�1 oA 2? 4 28 New 3 MI N`0ON 32 I CERTIFY TO BANK OF CAPE COD, AND ITS TITLE INSURANCE COMPANY, THAT THERE ARE NO VISIBLE ENCROACHMENTS OR EASEMENTS EXCEPT AS SHOWN AND THAT THIS PLAN WAS PREPARED UNDER 14Y IMMEDIATE SUPERVISION. THE LOCATION OF DWELLING AS SHOWN IS IN N=*. INSPECTION LIMITED IES TO COMPLIANCE WITH THE LOCAL ZONING BY LAWS WITH RESPECT. TO HORIZONTAL DIMENSIONAL REQU I RFIMENTS. THE DWELLING SHOWN HERE DOES NOT FALL Of WITHIN A SPECIAL FLOOD HAZARD ZO�lE,,AS K DELINEATED ON A IMAP OF COPMITY C 1C, a DATED 8/19/85 BY THE F.I.A. E LOT CONFIGURATION TAKEN FROM �;c..:�. •,,.��.`, SE ASSESSOR'S MAPS OF RECORD AND IS NOT �a ,, f CNN E„ORMS NECESSARILY ACCURATE. •:n)E THE EXACT LOCATION OF THE BUILDINGS SHOWN �(Dt; ai~!on D o�� �In.,Inc CANNOT BE DETERMINED WITHOUT AN ACCURATE 172 IMilliam ail. INSTRUMENT SURVEY. rtorD. 02740 iElfRAI DIES: (1) Ibe declarations Saar above are on the basis of BY hnorledgt, imfor"tion, sod belief as the result of a parlgage plot plan tape survey inspection Seat to the moreal standard of urn of registered land srrrefora practiciaq iu llasstchvsttts. (2) otelarations art made to the above "seed c►tMt only as of this Salt. tl) This plan was Sol Sale fen recording purposes, for use in prtpariSq deed descriptions or for cen- structiems. (�) �trificati0as of property lint dtae■siems, building offsets, femces, or lot coafiquratioe may, be accoayli�be6 only bt an accurate lestroaent w►ref.+ f Town of Barnstable *Permit o&OSoiW Expir 6 montlss from issue date Regulatory Services Fe , Thomas F.Geiler,Director Building.Division T JUV.� � � Tom Perry,CBO, Building Commissioner � 0�,`� ow/V , 008 200 Main Street,Hyannis,MA 02601 �0 8AR www.town.barnstable,ma.us Office: 508-$ �FF Fax: 508-790-6230 EXPRESS PERAUT APPLICATION - RESIDENTIAL ONLY Not{valid without Red X-Press Imprint . Map/parcel Number Property Address ZResidential Value of Work �� Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address U-1m&d j Contractor's Name 3� eSI�'.1 Telephone Number .-19 0 -4R v Home Improvement Contractor License#(if applicable) (V1143 1 V Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance 91ePkone: [ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) [�Re-roof(stripping old shingles) All construction debris will be taken to PfFfiq OKPQSM . ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Prope - wne ign Property Owner Letter of Permission. A py the om provement Contractors License is required. SIGNATURE: Q:Fa=:expmtrg Revise061306 . The Commonwealth ofVlassachusetts Department oflndustrial Accidents Office oflnvestigations IS 600 Washington Street .Boston,MA 02111 www.mass.gov/dia ' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information Please Print Le 'bl Name(Business/Organization/Individual):. :T&MR—C, I •Address: 0. X City/State/Zip:fy mn 1S, (�)f}. ()O koO phone.#: •7 9 Q - 'i 50 Are you an employer? Check the appropriate box: 4 I am a Type of project(required); 1.❑ I am a employer with ❑ general contractor and I mployees (full and/orpartttime).* have hired the syb-contractors 6. El New construction . 2. Tama'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity, employees and have workers 9. Building- addition [No workers' comp,insurance comp.in urance.$ 0 g required_] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right 6f exemption per MGL 12 [�'Roofrepairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' . .13.❑ Other comp.insurance required] . *Any applicant that checks box#1 must also fill out the section below sbowing 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. rContractors that ebcck this box must attached an additionalshcct sbowmg the name of the sub-contractors and state whether or not those entities have employees. Tf the sub-contractors gave employees,they must provide their worlccrs'comp.policy number. an employer that is provtding workers'compensation innffoormation. insurance for my employees Below islhe policy and job site - 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 ofMGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.60 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 WA for insurance coverage verification. I do her y rti antler t e p ns•and penalties of perjury that the information provided abov ,is true and correc4 Sienature: Q Date: Phone #: � I 0 —`Y -- Official use only. Da not write in this area,'fb be completed by city or town official City or 'own: Permit/License# Issuing Authority(circle one): .x.Board of Health 2.Building Department 3.City/Town Clerk 4,Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone#: 1 �FTHE� z" y Town of Barnstable. Regulatory Services ►ss �* Thomas F. Geller,Director sdgq, y� �lF1 A Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 "V-town.barnstable.ma.us Office: 508-862-4038 Fax: 50B-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder . 1, M�1ss� L�-�t�ct • . as Owner of the subject property herebyauthorize wkg l•W (k to act on rn bh �. ye alf, in all matters relative to work authorized by this building permit application for: PA 1(1 1) L(l, (Address of Job) Signature of Owner Date L C (L d Print Name WOMM S bW NERP ERM IS S 10N 7/. �✓! l Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registra4:iin Board of Building Regulations and Standards __a,24310 One Ashburton Place Rm 1301 Ezpira4ion-_6%1/2009 Trll 130873 Boston,Ma.02108 -=.-Type�Indi,vidual James Curley - =__ James Curley 287 Fuller Rd. _ Centerville, MA 02632 Administrator Not valid without re s; Massachusetts- Department of Public SafetN Board of Building Reg,Julations and Standards Construction Supervisor Specialty License License: CS SL 99138 Restricted.to:. _RF,WS. JAMES CURLEY 287 FULLER ROAD. CENTERVILL•E, MA 02632 Expiration: 1/28/2012 c�. Commissioner Tr#: 99138 rqN, Town of Barnstable �*Pemit# Expires 6 months from issue d Regulatory Services Fee snnxrtsraets, ` MASS. 1639. Thomas F.Geiler,Director �0 �fD MpI to Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Lf 0-"C Property Address 84 Minton Lane, Marstons Mills, MA ®Residential Value of Work $ 3, 900. 00 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Jason Leonard .84 Minton Lane, Marstons Mills, MA Contractor's Name Tupper Construction Telephone Number 5 0 8-2 8 0-6 2 8 0 Home Improvement Contractor License#(if applicable) ' 1218A 5 Construction Supervisor's License#(if applicable) 69058 ❑Workman's Compensation Insurance X®PRESS PER MIT Check one: ❑ I am a sole proprietor NOV - 7 2012 ❑ I am the Homeowner [ I have Worker's Compensation Insurance i I Insurance Company Name AEIC (Associated Employers Insurat i 8eBARNSTABLE Workman's Comp.Policy# WCC5005593012007 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) ❑x Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. lectrical&Fire Permits required. Where required: Issu of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: rope Owner must sign Property Owner Letter of Permission. A copy o the Home Improvement Contractors License&Construction Supervisors License is required SIGN U C:\Users\decollik\AppData ocal\ crosoft\Windows\Temporary Internet Files\Content.Outlook\QRE6ZUBMEXPRESS.doc Revised 053012 i The Cominomvealth of Massachusetts department of Industrial Accidents ' Office of Investigations 600 Washington Stmet Roston,MA 02111 ivtvw.ntassltigmldia `Yorkers' Compensation Insurance Affidavit: Builders/Contractors/ElectiicianMumbers Applicant Information Please Print Lexib�y Name(Basieesfiorganizationllndividual): Richard Tupper Address: 79B Mid Tech Drive City/State/Zip: W. Yarmouth, MA p}yotle j!k 5 0 8-2 8 0-6 2 8 0 Are you an employer?Check the appropriate boa: T of project r 4 �&. I am a contractor and I 3'1� p I ( �� t.® I ama employer with ❑ � 6. ❑New construction employees(full and/or part-time)s have hired.the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity_ employees and have worms' 9. ❑Building addition [No workers'comp_insurance comp_insurance.I 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required] officers have exercised their I Plumbing airs or.additions 3.❑ I am a homeowner doing all work ❑ g�P myself[No workers'comp- right of exemption per MGL 12.❑Roof repairs insurance required.]l c.152,§1(4),and wehavena employees.[No workers' 13.❑Other comp.insurance required.] 'Any apphtant that checks beta#1 mn also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affulsm it indicating they are doing all weals and then hire outside camtractors.o submit a new affidavit indicating such- tGantractors that check this box must attached an additional shot dhowiog the cams of the sub-contactors and state whether or not those entities hate employees. If the sub-conuactoa have employees,they must pmvide their workers'comp.policy nuunber. lam an employer that is providing workers'cot gwnsation insurance for my employees. Be1mv is tiepa&7 and job site information. Insurance Company Name: AEIC (Associated Employers Insurance Company) Policy#or Self-ins.Lie.ft- WC C 5 0 0 5 5 9 3 012 0 0 7 Expiration Date: 10/3/2 013 Job Site Address: 84 Minton Lane Citv/State/Zip: Mars tons Mills, MA gF e wor rs'compe ation policy declaration page(showing the policy number and expiration date). re covers as required Section 25A of MGL c. 1.52 can lead to the imposition of criminal penalties of a 1>D.Ot} or ane-year' nment,as well as cicdl penalties iu the form of a STOP WORK ORDER and a fine _00 a y against the violato Be advised that a copy of this statement may be forwarded to the Of ice.of o DIA for insurance c im ge verification. rt thepains an penalties ofperjit►y thatthe information provided a e' to and correct.Date: / l Phone#: Official use only. Do not twice in this area,to be completed by city or tonvi official City or Town: PermitUcense# Issuing Authority(circle one): j 1.Board of Health 2.Building Department 3.City/Toum Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact.Person: Phone#: 6 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) T^� 11/07/2012 PRODUCER (508)997-6061 FAX (508)990-2731 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Southeastern Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 439 State Rd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 79398 N. Dartmouth, MA 02747 INSURERS AFFORDING COVERAGE NAIC# INSURED Tupper Construction Co LLC INSURER A: Arbella Protection Insurance INSURER B: AEIC 27 Roberta Drive INSURERC: CNA Surety West Yarmouth, MA 02673 INSURERD: INSURER f_: 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. IN SR,,AADD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR SNSRD, DATE MM/DDIYYYY DATE MMIDDIYYYY LIMITS GENERAL LIABILITY 8500008743 11/01/2012 11/01/2013 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO-RIN PREMISES cur Ea ocrence $ 100,000 CLAIMS MADE I 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 n JECOT- LOC AUTOMOBILE LIABILITY 56662400002 12/01/2011 12/01/2012 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUl'OS BODILY INJURY $ A X SCHEDULED AUTOS ( (Per person) X HIRED AUTOS \ BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) INC 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 $ $ WORKERS COMPENSATION WCC5005593012007 10/03/2012 10/03/2013 X ORY L MITTS X OTF R AND EMPLOYERS'LIABILITY ANY PROPRIETORWARTNER/EXECUTIVE Y I N RICHARD TUPPER IS E.L.EACH ACCIDENT $ S00,000 B OFFICER/MEMBER EXCLUDED? (Mandatory in NH) I LUDED FOR WC COVERAGE E.L.DISEASE-EA EMPLOYEE $ 500,000 11 yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER 71068813 02/28/2012 02/28/2013 Limit of $10,000 Bond for theft of C ,money &/or property. DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 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 REPRESENTATIVES. "For Information Purposes Only" AUTHORIZED REPRESENTATIVE Lora Lowe ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD i rOeS TU PPE R CONSTRUCTION CO.LLc 79B Mid-Tech Drive West Yarmouth,MA 02673 Phone 508-778-0111 Fax 508-778-5010 Registration#121845 License#069058 PRIME CONSTRUCTION CONTRACT Date: Nov 3, 2012 Name: Jason Leonard Job Address: 84 Minton Lane Mailing Address: Same City/State: Marstons Mills, MA City/State: Estimator: Rick Tupper Home Phone:508-272-7571 508-280-6280 Fax: Contractor will furnish all labor and materials to construct and complete the following project in a good workmanlike manner: o Install house wrap over existing clapboard siding in front and back of garage and front only of home. o Install Certainteed vinyl siding as per manufactures recommendations color to be selected by owner o Builder to pull permit and supply extra copies to homeowner for inspection report All construction debris to be removed from site and site to be swept with magnet to remove nails. Owner agrees to pay Contractor the total sum of: $ 3,900.00 Payments to be made as follows: - Deposit $ 2,000.00 - Balance upon job completion $ 1,900.00 Funds to be disbursed by owner. 5l Contractor's signature Date Date Owner's signature Page 1 of 1 9UILDING FERFURMANGE INSTITUTE, INC 107 Hermes Road,Suite 110 4 Board of Building Re-lula;ons and Standards Marta,NY 12020 Construction Supervisor License- (877)274-1274 "License: CS 69058 i www.bpi.com MICHARD S JUPPER r'I ;79 B MID-TECH DR` Richard Tupper zWESi YARMOUTH, MA'026731' op BPIIE39:5040940 Mow- :CERTIFIED PROFESSIONAL Nk" Expiration: 1 2131/201 2 } ' ®(SEE REVERSE SIDE FOR DESIGNATIONS AND EXPIRATION DATES) •„���i�i»iiniu`: w Tr#: 8340 1 o�./�aaoac%uaek2 Office of Consumer Affairs&Bdsiness Regulation People Helping People Build a Safer World- _ HOME IMPROVEMENT CONTRACTOR Type: _ Registration ,F121845 INTEANAT + Expiration: 6/:1912014 Individual CODECOIJNWMEMBER RI AR6 TUPPER, � Richard TupperI� PPER Tupper Construction Roberta Five W.YA OUTH,MA U26,13 .i Undersecretary l Building Safety Professional, I Member#: 8158119 Exp: 4/30%2013 - � 4 Ii N Q CL Qd l�lJ7 , I\ N ch. ` V S:5 I _• . . , po` 1 ' ` I it ` ;. . l \ \ � � W �� cr 14 th of � ( /• .�// / ; �� /, � �1 � i / . lJJJ � Ial / � � � AD /►'r S's, e,'o. o � b' -/w U. Lj ale Y4•t'+iqd{+W✓Q•IV\ ''41 n�.+�..r d4-1 Lt:.i:ia- ei�r.r wiMr••r•ro •V-i yp,Fy�b8 6 �'i' C/l fi�•M�uR.�i•9•ti 'O' "......a..... V �Ca.tgyaa� -iupaa�.yam .44 - = .o,. ..�... .o. �,��•• —.4 uo!4!F7Y meoJ.t!!wv i :t f09d 1 arpar a} ygS; ..................... ri �;`• . i..... -------- U J 3 A a I o { o i ili i lii i ill i : iil l i lip i i i lil I ; l i;i i; I ;`•,� z l:l l i�i EEID Utij S lit ........................ :......................... MVT EEO nTn d' - i ii roe pd' 'd 0/1 .u. yc.. .. ...w"n u, - t ♦-,w�vn(AN Z a..eo yr .V9 _ --. ,n_•s p,.an.(AN . ,n,ow w.•yY...ie i•m. C . V3 I fit' i i - i.,w..a.,r.F MN I•��i�.w +7...n..nnn..en..n __—�-D lln.a.e�f/.s.- s_DJ?•d-_�"n.:4/, •t 1 � .•IS. tb( ._+e/�� �: ...e.•wrYn -- va.,..,i�Y.a•oota(..a•r s:$ ,E .0' bil..n•ut,oh•.y. YYr..�+,K•aA.:"4 '-;�, �� . Y1' I.T.o-o.aR".r IM IOO 1 P�aY...gnr.w.n AFCDO = 1p i •1.NJ� Y...bm1 M• C ,TO...wrab.r✓(AN TYPII.AL t--un..IwrrJcl heGTtoN - — o=rw,vc,Tn soo �-J..•.-. � i.�.-..--. rrrar w+�a ester. ' � i.0 ri.w•..,•nt..o�.,.tten.�.ro- b..it•va•�P�N t+Y G••:ar•I.!.or,ir•cta' , -4 oO r _ L IF 7H • a j pI w � � ;•� _. ......... �weTNalt9�H/ Y Y�Y.'Wb1 w{. O 'L -' - ' ♦ ♦ ♦ ♦ '��is soe aaE - µ F9.00R-Pt-/�►�! 1�6�'�ppi§ql �� • r�>� ,w. fnn,euAauc W IZ.MI"wm.M�10'er*'eM�.to As.i.v.rif�by 4.�.r.�.�prirr.Grq m .._-_---.----___---___------------------------_.__--__..._...---_-...--___. �.___---_.__. '' :t .v1 • H.vy. O •-- D z ............... ........ :......_............................-_........................................- £i p, Fourdakion�LP.N :, U I��.p k iq{i �5 • ..� � duwdcnm �wnddtsn PL'. ' }Iola: SHQI MUN.4lR All Iya�Yananl.l O�nwd'i oM.ra to 8a•ilaveriAad by Qa�aral.Goaf'r'wG'tr j� / Ov ' �ti Ytraofca..IruNion 1"� ` r 1 f e '�Oarrvirrarrureul� o`✓?�lrwac�rwelld Restricted To: 90 7 � `� d 1 C J. DF,pAF 1. i'1?f:;?f OF iuShIC WETY - C9;If!`! UPFRGISQE i,IGi aSB 90 11Cne. idurher:^ -- S,.pires: 1G - 1 & 2 Farily HUBS ?� t reed T : 0!3 Failure to possess a current edition of the Nassaohusetts State Wilding Code ' JOSSPN C F01CP.RO is cause for revocation of this license. 3111 F,LMOUTH 4D "rO91 451 �— NARSTONS P(IhbS, NA 02648 �. �,rr�,luf y�.�faeeria6raeaa .I HOME:IMPROVEMENT .CONTRACTOR Registration'. .01960` Type PRIVATE CORPORATION Expiration 06/30/96 . License or registration valid for individual use-only before expiration date. If found Polcaro Construction Co.,- Inc return:to:One Ashburton Placc Rm'1301 Joseph C. Potcaro Boston Ma.02108 -A' zy,.,s,,Po Box 457, 31-11 Falmouth Rd. ` "°""N:s7aaroR Marston 14i.11S MA'02648 f , ) 1 I: 1 ' w The Cummonwealth qf Afassacbusetts Department of Industrial Accidents 6011 1f ashitinwun Street �,�,���,;�'�• Buston.Mass. 02111 Workers' Compensation Insurance.AlMdavit 4A�nlican ntormation� Please PRi1VT icy ii,ly ~�"'� - name* POLCARO HOMES, INC. lnrnrion• 3111 Falmouth Road P 0 Box 457 city Marstons Mills 1 s MA 02648 nhonc# 420-1232 ❑ I am a homeowner performing all work myself. ❑ 1 am a sole proprietor and have no one working in any capacity ( 1 am an employer providing workers' compensation for my employees working on this job. emmnnny'name! POLCARO HOMES, INC. address: Same as -above s iir: ohnne#: insurance co LIBERTY MUTUAL nolicv# WC2-31S-302083-016 L.... .r. r... ..�r.�,........t�r�w+moo:oJP^'�"�w'"�'�w "••' _ ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who h; the following workers' compensation polices: compam• nnme! address• . cetx- nhon #- i.lsurnncc�� neticv# •' 1:^+��?c:� "";�!:.�.. -_ .- �.snr✓.-r;a:..•.a��.•�!.=.''.T,�'�^.5F-`�:r� ,,,off 'TJRFC•yn.=R:'!r�:T.7tRlPl4}�►�.'^S'n❖.�X.AMT2Sr7'^�' ctimnInv name: address: city: Rhone#t insurances en nolicv# .Atiach addiiiii"afsheet if tueessa �Y w:.c a.;_I} 'r�r •"` '•�YL.. �:., Fuilurc to secure coverage as required under Section 25A of INCL 152 can lead to the imposition of criminal penalties of a line up to S1.500.00 and/a une rears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a lane ofS100.00 a day against me. I understand that: copy of this statement may be fonvarded to the Orrice of Investigation of the DlA for coverage verification. I do hereht•certifj•under tine paiirs and penalties of petyuq•that the information protided above is ime and comer. Signature ate April 11, 1996 Print name Joseph C. Polcaro one# (508) 420-1232 r 4 ; official use on1v do not write in this area to be completed by city or town official city or town: permit/license# r'tBuilding Department O1.1censing Board check if immediate response is required ❑Selectmen's Orrice C311ealth Department contact person: phone ir; ROther Inf'orruatton 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 enrpl({tee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An empinrer is defined as an individual• partnership, association. corporation or other iL-gal entity, or any two or more the fords,, hip 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 tite dwelling !rouse of another who employs persons to do maintenance , construction or repair work on such dwelling hous or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 1'S2 section 25 also states that every state or local Iicensing 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. 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 haN. been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the boa that applies to your situation and supplying company names. address and phone numbers 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. Tile 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. .:, :'• :i 'uS Ldi:+,w..... .. { ,-J•ir:. ".''e•: .? S.e' L 77 ':'''` `'' ;:7-'tir 'a�i.�'.�.•«�,...:.r:.w::.r.+S��r....:.ras,ri' (�•. .'r'+use',•�i'"�; ... - City or Tovvns 'Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at tite bottom of :he affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pleas( )e sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to :he Department by mail or FAX unless other arrangements have been made. T1te Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, :)iease do not hesitate to hive us a call. : :r •t.--... .v .wc.<....;.��.')f�:si_ �:.w�::����.::...i.%i_•+.w.:rv... ' •�+aw..�.wrrw���.�e. ...�...: .�_ ...a....l+;• .... .. .. •.1'!:...r.. •'. •. .•tv - ice..::-r,•.• -• - T'he Department's address, telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations �. 600 Washin;ton Street - -- Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 ext. 406, 409 or 375 . The Town of Barnstable $ Department of Health Safety and Environmental Services 1 Ma Building Division 367 Main Street,Hyannis MA 02601 Ralph Crosses Off= 508-790-6227 Building Commis Fax: 508-775.3344 For office use Only Permit no. Date , AFFIDAVIT HOME.IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,aite:ations,renovation,n�air,modaai�ation,oonversi°n, improvement,.removal, demolition. or construction of an addition to any ptOas �°°�adjacent building containing at least one but not more than four dandling units or to stnt�s which to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: k0t9 4Q L i D I D%l� Est Cost �(9- Address of Work: C��' I %�� 'C' G72YL�-�- . Oarner.Name: ,��' S4�'1f��G>/B Date of Permit Application: I hereby certify that: Registration is not required for the following rtason(s): Work excluded by law _ _ob under$1,000 Building not owner-occupied Owner pulling own permit Notice.is hereby green that: CONTRACTORS OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH FOR APPLICABLE HOME WROVMv'ENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c• I42A SIGNED UNDER PENALTIES OF PERIURY I hcrcby apply for a permit as the agent of the owner. lqlC /D Gd D to Contractor name Registration No. OR T, ,a Owner's name " Stove FO TPRINT NEW ARAGE a���� zo t /4/ 2 FOOTPRINT EXISTING HOME 4 . on NEW GARAGE EXISTING HOME NEAL A. PRATT PRESBREY RESIDENCE one: of—o4-02 Pecs 1 of 3 Bi�D�t/D�SIGNSR SCALE None A ,n84 MINTON LN, W. BARN 11M1�PHOJPls 8M am-a92 6 BY: NAP NEAP GARAGE 1111 '1111 i •--��1111 �IIU —��\\ -- �1111 '1111 ----- ___:_ ......... ..._..... RIGHT ELEVATION ='rl cmi:7x_rra�c;:�x;;oi�rarrs�:ssrc rs:r_ra•:nu,.:,i'raa.��,� r�:c`rµ:rr�:+sl.:�ax,c:r.•r.��;�._as:n�r/.r..a n.:o.•,�-.s>'ia REAR ELEVATION 12 LEFT t Ns 1111 \ 1111 11/1 111�. 'I \ f n y ,� � ��1{li\73:::n'lalti.la.�H1:Lc_.'-^q::,•:;-.icc r���:>;w.;cz.' .l4'.^{t�.7.CR�fNi4K ft`:,wtL?7t'GY.:t!GJii.^'.!�:a��raamsrr�:'::�.-+.•:+rrestir.�� :,.3:a ELEVATION NEAL A. PRATT: :�' MEh Y. 'I,I i 1 N: MA. 02537 PHOM& rl. sea-awe -4 B'x6'wall 8'x4'wa4 Notes, 1 10-1 1/2, 8' was a 813", factIng woUNfcotbtg 425M teat , Flaor03000 tent flosrnwsh Floor to be perfectly flat Mw slaped apron •- - _._ _ Control cuts-quartered Drop wall 12' 9. 10'- ve• '-8'_ '-6 9' 32' Apron ROOF SYSTEM Asphalt shkdzs 1/e Advantach e�1D rafters 16 DC FOUNDATION PLAN ewle rage 0t4 catlor ties 16'.!>C 12 FLOOR SYSTEM �1D 3/4'Advantech T&G subFloor ewu Joists 16'DC-1e'spon 8'-1 1/2' VV12x22 gyrt-24'span 6'R19 fiberglass halation Pull down stairs VALL SYSTEM 2*4 stud 16'OC w plate Dbl 240 garage Qr headw-s PT ex6 96l a sealer Lyy2ppaarradppvnnappnvvbrach sle tHM Clwboard/wMte cedar sldhg 3'RU fiberglass Insulation Le'drywaa FOUNDATION 41/61x8'concrete wall w bolts e1s16'concrete footb+g CROSS SECTION NEAL A. PRATT PRESHREY RESIDENCE DATE: 01-04-02 PAGE 3 OF 3 B czm Rc" one SCALE: N" D& a � �,� Roan 84 MINTON LN, W.HARN A S. smiYlQi]/A. =37 9Y: NAP PROM- (WB) 888-98OB NEW GARAGE TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �L ���Z 7QW1.I OF BARNSTABLE Permit# ` 73q'l Health Division (� � t� 9 Date Issued ��040 Z Conservation Division 1If 0 ' Fee Tax Collector ClVlSION OC SYSTEM MUST BE Treasurer D k �Tf�Tpa -- l� INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE$ ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/Hyannis ' Project Street Address Village Owner A Address S Telephone S'v � ' y�0 3'��0�• Permit Request y X a Y, 1:r4,� -- i Square feet: 1st floor: existing proposed (5:) 2nd floor: existing Da. proposed d Total new Valuaticpe�,'9D® Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size 601,000 Grandfatliered: ❑Yes O No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family O Multi-Family(#units) Age of Existing Structure Historic House: Cl Yes ANo On Old King's Highway: ❑Yes �Oo Basement Type: Full O Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) O Basement Unfinished Area(sq.ft) Number of Baths: Full: existing Z new Half: existing new Number of Bedrooms: existing new 0 Total Room Count(not including baths): existing new ® First Floor Room Count Heat Type and Fuel: 0 Gas W Oil ❑ Electric ❑Other Central Air: ❑Yes Pd-No Fireplaces: Existing New Existing wood/coal stove: ❑Yes O No Detached garage:0 existing ;4 new size Pool:O existing ❑new size Barn:O existing ❑new size Attached garage:0 existing ❑new size Shed:0 existing Cl new size Other: Zoning Board of Appeals Authorization 0 Appeal # Nk Recorded❑ Commercial ❑Yes l No If yes, site plan review# Current Use Proposed Use 6,2!I6��E� ' BUILDER INFORMATION Name AA00i Telephone NumberO Address L S License# 0.3.e)5?Y9 l Home Improvement Contractor# 2 Worker's Compensation,,# )-5_-S ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO K�S���2 — /�,lliz._� - Q SIIL ) SIGNATURE G DATE %a�D } r . FOR OFFICIAL USE ONLY PERMIT-NO. DATE ISSUED MAP/PARCEL NO. � ADDRESS VILLAGE OWNER DATE OF INSPECTFION:: FOUNDATION v FRAME INSULATION 1 r f . FIREPLACE ELECTRICAL: ROUGH„, FINAL PLUMBING: ROUGHS FINAL - GAS: ROUGHS _C,- FINAL FINAL BUILDING ' `"' " DATE CLOSED OUT ASSOCIATION PLAN NO. RESIDENTIAL: SHEDS - POOLS -DECKS-OPEN PORCHES- GAZEBOS DETACHED GARAGES FEE VALUE WORKSHEET ACCESSORY STRUCTURES >120 sq.ft.(Sheds,detached garages,gazebos,etc.) > sf-500 sf $35.00 $ 500 sf-750 sf 50.00 $ $D >750 sf- sf 75.00 $ >1000 sf- 1500 sf 100.00 $ >1500 sf—USE NEW BUILDING PERMIT APPLICATION DECKS x$30.00= $ (Number) PORCHES x$30.00= $ (Number) IN GROUND SWIMMING POOL $60.00 $ ABOVE GROUND SWIMMING POOL $25.00 $ RELOCATION/MOVING $150.00 $ (Plus above fce if applicable) . o0 PERMIT FEE $ �— Q:forms:dkcost eff:082301 _ _: Th lth e Commonwea of Massachusetts Department of Industrial Accidents •� = �; , _� ; 0ltfctollo�asllOstlOas 600 Washington street . Boston,Mass 02111 Workers' Compensation lmmrm=A "vit vidamom e, Al ., locatiotz /",//7 city ❑ I am a h=WWnrrpednrmiag all WMkmyself: . ® I am a sole etor mad have no one waddng in any cx�acity ' I am an ding wed= 'omen form9= W Ces em this jo ..r r........ .,...........v. ....Y...nr.. .r ....... .. ...... ...... r .n..., „t rlr...... ............. .....)?x., ......,v....... ......:•,........vx ... :�.nw•... i.• ..:.t+....APv:- ... ...W.♦•w.n w..,:K:• v:.; :.+Y r. r,w :.v:-v«-. ✓ ..1,SrMYAA ^ w,y ,aYhnxQ� :: r} ?.:J}:•}}':{.}::;:v'v.: .v...... ....})}}/ i}' :-h'4}}v.r' :... :'.xn:•:%j2.- ... .: r.?....n.:: Y'/..e �• :>'' •:nvv:}}:.:<.......:%....:::^>:.v.•.: .f.. n w.. .r :n:t..,.........,.... , !k.'+:.»lP.v: ^.-- k., scum amrrEm�. : ... ...n..:. �.: . .:.: ..;•.�;;.�,,;:,.:.:w?.TT.. '.... ?�,. ............ .............................. ..x.... .....,.....,.::•, ...).x. .}"::.....� ... ... ...::-: ':..!rm;c<':..;h..},•}:•;'-}::.:::;F>.;!L.a.::.};%is`.' µ<`: :::%'.::{::>:::: n,P::::::;.}:• x:f rk::n}... J:r...r. O .�.,.:r ry,'. >?^S:,W':xn).Y.\,+:.:...;.)p:?h:.., •x♦.::- ..:::•,•:::::...::::�v:4:4'r'i!}}•:;-}.na4 -.x} r•.)>}.'.�':}nv v?.!?.%iJ}i}}::A..':�'F�:?ti"' .. ♦O,.v. - 2� Q :..}...r.♦.........:::::.:.........a,.........r..... ...:..... ....r..v.......::•:•::::.r. ,... r......a°oaw„w .::. ......�,.!^!...,,... x..Sk>�?;ft:!:anN.::}%.},•:.♦}:'x:,,:•}:Pw•::�:::..:.::.:µ.:_ ;..,..a.......::::.:•.....,.:..,.:;.:,., ..^.-.,..:,.{... -.:....... ..;;......:n•:.,. t♦.... .. .... ,Yw„•.ww!r.♦wW'♦x♦.♦w.., : :o.?!•>rr!omg:+:::'!i�J:::.irp::�::y�;�::- 9,... a,'�?v^-/2.,2:?} �. >x;}rt.::ar!4 �''%� ';\7•ii::+ �nr-:c.%ar�e..vnw.,.;.a:.x, :::::n•.....r•::-wY.•• .r...•fi. .. .:..'}"' ..{%'•:•h"?sins;::. y...'&t,?Y,f' ,�'.Pw'Y?Svr,';.y G« '%'.;i:•.;:;.+:.,::•: .... Jo�-•:ram••:r. .. :r,...yb,,.,. wow.,2-..:-.. .-.'+. :•}:x:.:. yo n,Z: �Y.^" ��:. ..�.. .:.: .' ..... .:. ta ��'�%:x:.t,:rF:.�:»%.�.:.;t.�.<?.::;:.a.::.�•:•}}:�:�: •:n,•n..:::.rnr:::•. r.•.hs,y!;n ...... yr., '• .r;;•..?J.nP.::::..-::.. ., ..fir.%:':`:Sn?.?� �vx� :}:,,;r;a.;;}: w..v::......•:!a::•. x•�r.:..,:v:... ...n:•.3::•;r .....h,i•.A �:: :r..:-: .:�-r:m{SS:}JvA♦, � .. ��v�?�'Pi�\•,r <• F,.. rCis`,'vj: {+i>.v�'?$}i:i:�:C:'. •:n::w.v:+A;tr•:,r:- ...,+ .,.,.•?,•.}:}}}!?:: W:. ..%:. ' 'rW!:fY\+.L�i'3.. H.7n;%-P,•`,?�?{.,a,,}}:?:•:!i?i: ..r .. .. .. ,. '. .. tap'" dS�Y.31F ::?4 .`•vY�'k}Ce--:a\i�••�.:-•`�i�"...... fix• : -.:::r.-:.,:. .....:-::::-::.:::..:•..........::!r::•r:.•:.�:... ....n::• w.r.x.,,,♦•:•::r:-:.,... ....r.♦ ... o, r!s{2�oaw. ,.t.1,-.r•..�v,.,r ..xo:' i:'r' `i:.riii:�;::+.;:.}}:�: ::::.r.....,........:}}::::..-,«•:..r...,..h. ,.%yF:`;•}�<;iw^�;;:i?u.v.....}i..,...3:w}x�\.�w�•„w:�r}.r::n.....`x'::•:r�>.R�,. ..>.3c'�Y .- �: .. �: ,3, '?\ :v>�.r .�::::.,•:::.,•:+}:::•r:::::::n-.Prr ...,...r r -::-x.wr>} ,�:::�».:.♦..:..,r..♦:••:e:.:.:::... .:.,..♦ ....:. r"i�:t`•%.. '! �F. ....n•.�.:.::... ..........,::•......r.:::n•::;...::.... ..-.:.::. -::.t{... r.,.... «..... .:P.?w•f•.a ':t�.iti t•�R` \P}:t:�Sn;;.':t.;:;•:}:a:•:-:-i::;• ...,•:::::::...,:..... :..... ,.r• ....:•.,-.r6':..:n:�x.a:: a:F.}...x ..a.%w73xi!�r..�J {:<".nae.. \. ,�5., f ,. 2"�"�r .. .. w v:�-.:. �::::(�:h ::: {.b.: :.- .-- /%,.j�.�}}rJ.•.{3 v.v:�.:.♦:.h.::::-�-nv^.�.�.py�..:,,,C•:.�.}>!!RTF. :•yyp!'TJ, _ Qi•aa.+IILC"LO:n.m.:: :t:-;:S::nyjF.... :.hb:•r. .}........ih.'�L!{:.......:....n.n.•........w. ..,.}..,..1K:.W..:•.... ....... � !.�.-..'-. :.:. '. ❑ I am a sole Pam•Eeaeral coatractar,or homeowner(a3r+de ane�mad have hi><ed the t�nuacta:s listed belaW who have . emmrion - foII woriaets' : the � owing •goIitxs .....:.:x:..r.:,..nx,,:. :.:::::..:.n.,.w.,..:�:::}sort.♦:.:::.-.... ... .•>„... ..... ...::::::::::....... .vmx ..... ................. ......5.}.n.r....v.r... .........k,J.vv ........ .. ....:v..' .... �-. ,♦....w-�:{:y'fi t%.;{i:i?;: .:};:" ..vrwvn♦w.♦ww ....%{!..n... .. ..... i!............... ....... .........n....... ...n. .....,hr:. .....�':^:•:::•:.:•:..'.:.. .................n\... ......................... .. J....r.r........ .av�...wMO^Y�•MOD'o .....x:::. -,:vrJ ......♦.... ... ..:.,.-r...: ::.......:.........n?.».w.. .•} :.a,•s.,'CwT 5...:?'•'?}:wi:;•:::}:C:•:;.;•;:;:t•^ •.,•h,%: :}'.^.:}6:::::;j:;:;:::::is ...w..... ::.�.. . :.,.,...,.n•::nfi............-:•.!?•:n•::nx.....:.:...,..r.rn:..,:•.aP::::::,♦•.,•-.::r:..•::•+.•:- >:::•.... n.�..•.nn:..,.«............. r ....r.....,...... ....... ....... ...... ........ ::::.�:ak.., :... ..::.�-.... a•�.«„•:::._.... �'.: .., .::.:... •a.♦\^•,,:t . ....... ................ .. ......�.....,.................♦r........:. .:%......,.....x:..♦ ...}♦, ,.,....♦.Y. � \. "Y? r•r, 'J ;Nr.....AV,-••:..-:.:-}T'-:a:: ....w.................vh.,............................-............. .r..... ..%:«.,..n:wn .v:v.,-:wk < .}:L•O}�'??:':'�)V^>�;V}:P': ':}}}.1\',"!ii'�♦}}yi^`• v.'. r;.,Y;::?.}.•::hvT»}}:h.•.:,iK•:.:...?:::,vw....�.. r$, \a.w:nv'%LG:r%:r,.n? :?:Yw>:::%i:??a•::<•Y•Fj`?`♦,:.....!�wcFih.'?•\ Qc"!°"a",{�•' OfaY7.7\�:. x��? :.c\iae.?vaYc�E�Fi�*�\v.3 Z<a•:a:r.:...:.}•:.... E C""• }"-%m}x:?}/:�}%rr-%cP}}. xrr,r)..P�rctGw-::•}, r..t.-n-:rtxF:'N.k4�9rcd,;a:};•.Tv:nkfi•:..,:«: <�r �comosuve to •.aa.n,. .:.r. :::::..;.:.. .. . r wfftK\\ a 3: sty-{?•}: % %:aaay.>xeo?.'.xiSAFR.a.C"F,e?.2YAR°�+\L .49RF�'21 :a`..:,..-:. ..IIy, .. `Q`\\�::5':a:i:.rf�C:•:^•.`iv::.i:!? }}:•}:•:y}}}}}}. ,.a:••x r?.....iep }_ ^.�•::..w.oar :; "•-\,♦„n.n.r:n., C"�is'a''P :ao,?!�?�'K -:na,.n�a'��' ""T T�•�:'�:.:vtA:l!^:!>..,w;•YievV•i ta��VQR<t•:v ,r. .4.^h: '! r'n:.:•w: �.\ ,;,.\'!a:c0.v+:.a:.:}:::::::::. 'Sat�l`C!!""+.:tttkYYn }v�e±D.::.. .... ...�➢: •m.�.0'�. Fr ..... , .••:-:. �...:':•.�:.:...............:.,...:•..:.}.yy,•w.rory.y„• .... .... .,..r...n,..•..;...,rr.. ar �a:au:--;.. ♦♦;r '\a.c;a ::, . a�:,?+i.•..•. .a>x...,.:t•.....:.:�`..:•`�.�.5.�::•.��' ,••...:::,.•r.:.:".' a.,w�>rw•ri:.:�::: r ;.....�a,T...i.�.::�:n•e'eLu":`'.,"uC, �A�.". � 'f°Q`p;:o?:iw�r,,-}„-.,._.;i w:::.::: '• .: .!\>3�`�w'i •-•\7?:;r.•:. v. :o``Y' ...�;`','<>i.: )�i.ri:?P:..:: . tsaw•}... .µ :Y1laLnllCLoCd",;^:7•.^.•rx..w.,...... r. ...:. •„.}�+::,.;r.;,.. .••)::.>.P:J: w. ..,)%^. .aiv.\.Ax-`!w:•xwoAU.x�6.Dr:\...•;e3; .. - �ti-•aaa.,,.rye{.w:}x:•:%:.}xi�:;::•}':}:::::. 4\?....3.:•}:x':"•P}>;} :T..:::.�r.••«♦y.�>�Y }},,Sc•...:.".:�:�n�..?'::. �},r. r.,, n:•h•.,,,. ?•:t3C•}:'v??tits;.,}:...i Sh:•:.:-::{:T:D>%•.. { •C^•+:.......,},{.-.�:.x-..}♦?•Z•.::-v.. , .;-.... ..: .. ` > ^yp♦ p??y^..,.r.;}.. .« >.v?+ay.:v L `�•:`::.i:.i:�i r?:;:Cy,'i:vO,F. r.}}$}i})�.'?va ,SFFJJCFy:�'NVJF• .. .: l\v< v 3., � /{aj♦ kny.3Y":rw.v .. ., ,•nV.• - M-.A-'T\:..-.•:v-.v.-f�i 'n?J:?.'4}�.r,?;nv.�v;.:y%•:,C\ZL}�-iv�:r' '' •, '� Y.�^C!K<i..:. •�DIInV•11E�C:°°''y'}T:,a`k�1e�{aR`oY•75?N. e?>>�gcc�}77*�'c:'�.':'".:: .. ..::rri:.:?oa:... }. ^cxhy^w. ...:�:;?•:�i�'9.. ,.>)LEy;)J%.'r '\'6.Q•�:/�i*l;.F:?i?*T..,......... .w..., YW:..r-.,.P.!rn,x:•.vi?AHDNoaA,�>,:.a>r!w.a;«♦.}.;;.w}_:rP.k,• ..�S?9?.;, ..;!yt.: Ax::� „>.ixr�3r.�'}?, ...,..:.:.:•::....... .,...r..:.:::::.... :...v ....:.vh.-.t;..:::.::::::T;.`:`:.}}-•Y"•i'-}i:??•}}:�:{;•`:•'i-!�::.>,:•:.Yw?}'}3$ppCe:..Jvxr:,�.-•♦�'..«ixX�� 1v���:;vCJ.. `��C,\xa,.,Av}i}:.:.v,M!\?,}}>T}\(^i:1i}'{:}.^;r:!w ..,..... ........r•\w:::nv.........va.....0.♦,n.•. n.....n.....v.J.♦ ♦ A- .... atldre� Y {.. .n... ........« ..r.. z •V ... ... .... ... .n ..av .fi. , ..... «.n ... .....a....�. : ...♦v. w .... .. .r ax,d.'->hP::;nv..n ....T.. .... .v n.. xx3v •:-v.v ♦vwx"n•:nw �..n.. .,. Yxo. ... .:x:♦.,r♦..L,...}� .......0 r �` ... .r: .,,xw. :fin.... .... ............... ....::....::..,.,. R` .......... .......... .. .,.. .. .:....... .. ........ ..vW .� ....n.«�:rtt.}........fie« .:::.::....::>:. ;,t��t......}\..},,r. ..\ wYr-a n+v2.7'X• 7- ?h�SeY.A' •}.�xl�.. ab� .r wpy,\\>. n v�sc..w»yy♦;::i:-:.I:hi%l:t;x qypp <P•/wmoe3he^aM' a ♦Qr:J.. •rkYrY::•i •:!haN} 0"KPfn '?•:<H.-::.v:n♦t},}ti;•n•.:•'r,'ix`,'.w:�: :��::;...... v♦W1v x...-v}....,,....v.v ..: ...;.,.,.?:P?)«:-.v-::CL{�ya•,..........:.,...;.::•. ., 4pypp�pp�pyp .�,..tJw•Y• •n♦v:......-J:;•i'r'cA.P:•. .na n.. „f..,v,.}w ?...r : .v.n.>% ,.6.. .,T}, ,-.P.. ..».... na.Y�.-wr.•ee2 ek,at•.Y 'fix ••tx �`, v}}+},:. .:v:•. rP!. .e:.r♦rrFyY.OY.•: d>XP•!�.d.• ) C? ..........'•:;nx F.:)?.y^�:?;:'.>Y.�9.<?•r.. .. ?^aa^e^?n?>.�, S :AF9lYh4 . �a>n,•�\•,..:�...v:n......... .••vSKA� Q%-}w00e:L� ♦ R< \' -'OCL(C¢•O[A.ZYr'XS. ,.,, r smaure to manse eorerap as regmeed mrdar Bee!!oa 2SA otDdQ.LSt eaelaad to efta d pesaWe d a ftaa ag to fi1.S00.00 aaiilor �teaw bRabougmut ar Vied aadftapauldwfatha form ota6TOP Ioadmt "Mat' ="of Wit statement may be foswarcW to tba ottke otIaeetf otWa DIAtaa).t P aalari t do hereby certify the paiw mrd pzw mtfixafm aoW, pmvidsdabat�r it trine mtti carted oin"use only do not wrtta in Wit am to be completed by city or Can OMM" dtyortown: r a ❑BuadineDepasancol Board cckif i,neclate response Ls required p ma ❑d 's ofnce _❑HnithDepuUX3e0t contact person: pia : (pro 9l93 PIN 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 cam of hire, e.-cpress or implied._oral or written. An einplover is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the'foregoing enraged in a joist enterprise, and including the legal represematives of a deceased employer, or the rec.:s e: ,: trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apar=►rt¢and who rcddes them,or the occupant of the dwelling house of another who employs persons to do mabnena=, Con=Lti jn or repair wok an su&dwelling house or on the F=nu s.c. building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also stairs that every state or iocal.lieensing 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,"FT+ the commonwealth nor any of its political subdivisions shall eater i=any cm=ct for the performance of public work um:d acceptable evidence of compliance with the insurance rcgmrcments of this chapter have been presented to the romxacring authority. - 111 ;,;7 Applicants Please fill in the workers' c ompeasatioa affidavit completely,by checlig the.boxthat applies to your simatiaa and supplying company names,address and phone nambers along with a=t& ate c 'Of fi=M ce as an affidavits may be submitted to the Department of Industrial A=deats for ofiasuraacx wverage. Also be sere'to sign and date the affidavit The affidavit shcuId be.retained to the city or tow n that the applicaman for the peffiit or license is being requested,not the Department of Industrial Accidents. Should yea have any questions ingrding the"law"or if 5-cu are required to obtain a worer ks'cempensatiaa policy,please call the Department at the number listed below• lip %`„:.. City or Towns Please be'sure that the affidavit is complete and legibly. M=D has ded a space at the bottom of the �P pad�. ��� p� . Pleaseaffidavit for you event the fill out in ev the Office of �has to contact you regarding applicant to be sure to fill in the petasiilIicease aambet which wM be used as a refcrmce at Iicr. Tlme affidavits racy be the Department by mail or FAX unless other have be=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 Deparunent's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Me of lavesucatiods 600 Washington street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 7274900 'exL 406, 409 or375 i 1HE �' •,L°� The Town of Barnstable 1A g Regulatory Services .� �as9 .m pTE1659 � Thomas F. Geiler, Director Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction.alterations,renovation,repair.modernization,conversion, improvement.removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors.with certain exceptions,along with other requirements. �el Type of Work: y Address of Work: g L Owners Name: Date of Application:_/ �— I hereby certify that: Registration is not required for the following reason(s):. ❑Work excluded by law QJob Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED. CONTRACTORS FOR APPLICABLE HOME IWROVEMENT W ORK DO NOT ARBITRATION PROGRAM OR GUARANTY UNDER MG HAVE ACCESS TO THE 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Dace Contractor Name Registration No. OR Date .o Owner's Name q:forms:Affidaw rev-070601 r . � - - ✓fie 1°omtrnzon...ea� a�✓�aaoacluaetla BOARD OF BUILDIFG RE6ULAYiONS License CONSTRUCTION.SUPERVISOR NumbeikCS 030908 i ,Expire_' �To: Tr.no: Y0347 tti e c e 00 NEALA PRATT _ F r.. l " 42 CHASE RD -. .� -.,' E SANDWICH, MA 02537 Administrator OTflm(.0 P� HOME INPROVEMENT CONTRACTOR Registration: 103690 I Expiration: 719102 Type: 08A NAL A. PRATT, CUSTOM BUP. Neal Pratt ADMINISTRATOR 42 Chase Rd E Sandaich MA 02531 f I i � � � � � � � � � � � � � ' � � � � � ;� _ _ ; _ __ i commonwealim of massacnusetts Department.of Public Safety / 4. --2-Z_7 ,—lfJ j Board of Building Regulations and Standards LICENSE RENEWAL APPLICATION LICENSE TYPE: CS LICENSE NUMBER RENEWAL FEE CONSTRUCTION SUPERVISOR LICENSE CS00030908 $100.00 Construction-CS, 11/24/2001 `, - Hoisting-HE must have. PLEASE RETURN THE ENTIRE FORM WITH PAYMENT TO THE ADDRESS BELOW. 1" X 1 114" Photo. ❑ Check Box if you have a change of address- print new address/corrections below. NEAL A PRATT 42 CHASE RD E SANDWICH, MA 02537 �S v LICENSE NUMBER CS00030908 Il /oil / . d Restrictions Description: 00 00-(MGL d 12 S.60 d space /e / 2� L/ l�C.��''G�-�/`✓�/ (MGL CA t 2 S.60t) / 1A•Masonry only 1G-1 8 2 Family Homes Failure to possess a current edition of the Massachusetts Slate Building Code Is cause for revocation o1 this license. Instructions: 'LICENSES NOT RENEWED BY THE EXPIRATION DATE SHALL BECOME VOID,AND SHALL AFTER ONE YEAR BE REINSTATED ONLY BY RE-EXAMINATION OF THE LICENSEE.' (Authority C.43,C.146, C.148,MGL) ENCLOSE CHECK OR MONEY ORDER FOR THE REQUIRED RENEWAL FEE(PLEASE SUBMIT A SEPARATE CHECK FOR EACH LICENSE RENEWAL WITH THE THE LICENSE NUMBER WRITTEN ON THE FRONT OF THE CHECK.DO NOT MAIL CASH). MAKE PAYABLE THE "COMMONWEALTH OF MASSACHUSETTS'. MAIL THE ENTIRE RENEWAL FORM WITH PAYMENT TO THE ABOVE ADDRESS.ALL CHANGE OF ADDRESS REQUEST MUST BE SUBMITTED IN WRITING. Remit to: Department of Public Safety P.O Box 414376 Boston MA.02241-4376, I certify under penalties of perjury that to the best of my knowledge and belief the license information above is correct and I have filed all state tax returns and paid all state taxes required by law. (Authority: C. 62C,, S. 49 MGL, as amended by C. 233 Acts of 1983) Signature of Applicant Required —� Date The Construction Supervisor application must include a recent photograph of the applicant.The picture should capture the head only and measure V By 1 &1/4`. Photocopies and old photos are unacceptable.Please write the license number on the back of the picture.before taping to the application.Failure to submit a complete application with picture will result in the license being placed on`inactive'status until the.proper documentation and picture is forwarded to the Department for processing. 174 -Parcel 07. 76apermit# Conservation Office(4th floor)(8:30-9:30/1:00-2:00) /Z cl� �i rr1 Date Issued / '9 Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) �"��'/��' j� Fee Engineering Dept. (3rd floor) House# AJ-1,11�9( _ �t„E BQNW 19 SEPTIC-SYST R B TALLED IN C a. CE TOWN OF BARNST VWTH TIT�.E • ; MENTAL CODE AND Building Permit Application Project Stre Address �H 1147W A e/ Village + =u / L i—t1'N/J jvl �i -r4-L-'rL�T VS &Y Owner yam/ QA-M'91a �t -M� ,t�'�E �f,!/, �GSAddress Telephone Permit Request AO 4 /LT� 41 1/i///lf- G?OM First Floor V3 -square feet Second Floor square feet Estimated Project Cost $ r10 22 . -7 /S, C-26 Zoning District /PF Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board(if Appeals Authorization Recorded Current Use 4 jES/;Q"/J��_Proposed Use S14 4,) ,_' Construction Type 1y6VA rk ,Al;1 _ Commercial Residential Dwelling Type: Single Family N Two Family Multi-Family Age of Existing Structure �� �/�S, pf^ Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel 16.S 1�d T kk Central Air Fireplaces AyJ6iC` Garage: Detached Other Detached Structures: Pool Attached i� Barn None Sheds Other Builder Information Name �0/_ �� /'✓J � ,�/IJf�: Telephone Number 1-1 2 Address JaZ F/)V_-A0La 2, License# 001 ter( / d- 1&"Y %�J Home Improvement Contractor# 10/q/e,U i' f� Worker's Compensation# w6-2 3IS JOQ-002-01 i NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �, 4' DATE YZ///�/�/� BUILDING PE'M1 IT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL.USE ONLY ' - PERMIT NO. TE ISSUED MAP/PARCEL NO ' DRESS VILLAGE i s � '�; OWNER .- � DATE OF INSPECTION: FOUNDATION FRAME., INSULATION FIREPLACE ELECTRICAL: ROUGH; FINAL PLUMBING: ROUGH ' FINAL GAS: ROUGH • FINAL FINAL BUILDING 'S DATE CLOSED OUT ASSOCIATION PLAN NO. � a i s" ffl� fiii ffr�fm ell, •••- i �n •�a� - • ';,Its r � PORCH PLANS / s I • 1 • r — - r s�:.saysE7:y arm: ..� / ._�:s1,:"�"::r.=s.�"�i'�•:ins�syz»r" � _ a. �,%:�-s.z °"a..r-rr�E.'.�•e:r's"'s�" ems' ® 3 -r�.�.so =sc• s 2 .. 5«.r �•_.:: .: a ur -�;1Lriri_3 r_= ■■ _ �rl urn]11"jp rotiii1iNo iiii,u1- - .^_.-s�szr�::ss'"� ....wry��..",• �-�3 � ��'c •r�� � ` 0 24'-0" 8'-0" ASIDE ELEVATION • Al Va•-r-o- s r • n3 . N ++ X, CD U) Co a(n O \� O �m ;p 17 0 'm b (7 II N • i C r _ ' Jt_J O z f, 8Y2" 4'-0"MIN. T- XD � 00 XDO O p0O N � � � _ � T (n Tl o D m rn F{`.r �N vo vv noC G O c O Z 1 v • F 8'-0"th - 10 � ?tiz�• lit '.F i v '. a ,-3•�4 e b z z - D =DO z ,p if I Y.� o `er i E _� �e^v i'. ri t � O EHEHI r O t.Fgt+ rt(r 1 r dt i m v -4 AN ADDITION FOR: iD 831 Main street ' i Dennis,MA 02638 r O `(" F a Ch.item . � nc s08.6s4.7887Phone D ,� THE NESE FAMILY '}' N Residential Commercial Net Zero wwwa3arch(tecainc.com n $4 MINTON ROAD (''� N I:ITfI1TOFfl1i'1ltP:iff WEST BARNSTABLE MA 02668 • �1. t7 'IIIKIMI.\N'I\GK'n1P IROPIH'IY OI"IHP ARCJfi1C1'NA$gIV IpIAUIII SKQIICAl1Y IOR'IM'0%""10 MK PROP CI'%11111S A IP."D K�01' 'I(J Ri lt411x'fl Nf.Ul'IMIPx F:iO`61 J.'1'p'1 M�1RCIQIICI' • V oA�EnwunUSR:C IIIIb ' 4*-W MIN. 11-6' . 1 N� Zv _ N O., C T - .• cu J En a, O bD O 0 ♦r O aa; m gf p^ 8'-0" • " N N X OD 16" o cn cn v v • m v v m D D i t'J -11 fn R r NO y�Z. D - o z m f r Z. . o v a ' t W N N " N ;• X x OC to M v v X -o f o v a) m D D Y f,- 't I ) m —4 AN ADDITION FOR: I �p i ,,I Main Sueet r A3 architects, nc s08.694Jaa7 phon e Demds MA 0 D �.m THE NESE FAMILY hon N Residential Commercial Net Zero vwvwA3amf9w dncxom ('Z/� $4 MINTON ROAD i N " ���,� N �\717fFf1F(ftl'1AIf7(f WEST BARNSTABLE MA 02668 'ITASIAIAM'I\G6}Yry'YM.11'Iwry ccmir1RCMllil^M^1V RIPUII momAILY 10f1'IN,01"A lol"Im,moll Cl'1'1"IT'r A IT"DS X01' T• 'IT)pIN]\Wflflf.Nfl'\YIIffI1 f�C0`N�'1'p'IW \ouna, .• -4 O.NIE AP[7 IIRlmINcz^