Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0015 BIRCH DRIVE
r t T r1F: awn of Barnstable G iL �� ATM, it ib e.Fhd ., eta»Aoved;.Plans.,Must,.be Retaihedyc�n}ob and:thls Car , :us .b,e..Ke t..... i' P,ns..T:hs,„Card_Sa f€# s�Yis. .1.,4 m>t • .S, a 1� d!�l!._.k t , y" >.; p , ca s NS. u._, : ,. a �i.- ,x.,,.3%.. ... . .. ..... .n... a-. ., .S -.:a:..J. "'3�. .f t:.,•..<.,« ',gm y, ,a',<.. fG :F Y`' , Ra` . 3J.�. .,._.. ..{x......d .. s ed n ihf.nal lns ect on tias.- ee ..Made. y 3A by . .__ � � . , ifi--ate-• �, •c ts- a uired;:§u-#�• uild sha11:IN�ii be.Occu iedu�tal'a;Final�:lns ct'ion.ha��beenx made-�:r. .•'.. Perrriit=No B-17-3107 °Applicant Name WELLEN.CONSTRUCTION CO, INC. Approvals Date)ssued. 09/21/2017 ::Current Use }..' Structure Foundation Permit.Type:_;Building'-Alteration INTERIOR Work Only-` ..Expiration Date: . 03/21/2018 ' Residential Map/Lot 245434 Zoning District: RB Sheathing: Location: 15 BIRCH DRIVE, HYANNIS o N b Contract ame Charles E Gad ois Framing: 1 Owner on Record: QUINLAN,RAYMOND L TR r ' � =r ContractorLicense CS-057805 2 Address: PO BOX 536 :- WEST HYANNISPORT, MA 02672 `y Est Project Cost: $ 10,000.00 Chimney : Permit Fee: $ 101.00 Description: ' renovate bathrooms Insulation: - Fee Paid: $ 101.00 x Project Review Req: renovate 2 bathrooms r Date :. 9/21/2017V. Final: ' x 7 .. ` y Plumbing/Gas Rough Plumbing: uildin Official g Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzecJ by this permit is commenced within six months after issuance. • ;: ice �. Rough Gas: All work authorized by this permit shall conform to the approved application�andAhe approved construction documents or which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws a,nd codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for£public inspection for the entire duration of the � w r work until the completion of the same. p Electrical The Certificate of Occupancy,will not be issued until all applicable signatures by the uilding and Fiee t f,I alsQare p ovided on this permit. Minimum of Five Call Inspections Required for All Construction Work u� N.. Service: 1.Foundation or Footing 2.Sheathing Inspection Rough. 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed P p g� Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) LOW Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final Where applicable;separate permits are required for Electrical,Plumbing and Mechanical Installations: Health Work shall not proceed until the Inspector has approved the various'stages.of construction a '-'Pe:rsons,contractln '_vitrth:unre utered;contraetors,do not have:;access to<the: uaran : fund'• as,- forth'n--:MGL c.142A �- w Fire:Department 'Building plans are to be available on site ,AII:Permit Cards the property of the APPLICANT-ISSUED RECIPIENT . . Final, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION i Map Z�S Parcel t3 ! Application # Health Division Date Issued 700�77 Conservation Division Application Fee Planning Dept. Permit Fee � Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 6; Village /� I Owner (1 mvy 00 Address F)OX "3 PC Telephone 1-0 CPI2" q��. ►►� Permit Request Z� S SOS C_ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed ® Total new Zoning District Flood Plain Groundwater Overlay Project Valuation to V00 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure 5 Historic House: ❑Yes No On Old King's Highway: ❑Yes No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing 2- new Z" Half: existing new Number of Bedrooms: existing�new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: X Gas ❑Oil ❑ Electric ❑ Other Central Air: Yes ❑ No Fireplaces: Existing New 0 Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: 0 existing9i w new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ �� & Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �� usv �s N Tele hone Number -J 06- D" 45 0 b /� Address 4N(�d'Cws License# Home Improvement Contractor# 0-3 5 3 Z, Email ccm,40J,5 k-wcit efo auS 40 410N .Ga\ Worker's Compensation #LdQ,500�_0037K'Z` 04- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO P(Cf SIGNATURE DATE W FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' Tlr�C'omrrxarnc�ea$rit�,f 1srtcfitrrsetts . Dv,=tlffent q,f&rlrurstrid Acdda Office ofmr-wgtstims $90 WaS7rh,,[gt0u&hW6t Boston,RA 02HI Workers' Cumpensafrmn Insm-mce Affidavit Buildex-lCunfractarsMech cianslPhmhers AllplIaII Pl SeFFinF Name omihzR }ate �6&&F, �iQpj�jcll S - AK u an employer?Cfrecktheappropriatebo T of project r $ I am a general confz$ctor and I � p a � �� I_ am a employer� 2- 6. New c mshuction mployees(fzi11 andfor part-3imc,).* I awe 1�etifTr�e sub coIIkraofoss ❑ Mi cl ou the attached s 'I. Remo - 2_ I am a sole 'etas;ar - delsng ❑ propzs park' ship and have as employees Tlteae sob-confractars bane . S . Demolition o tvor�ng for.cae in any capacity. �1 yees and have xva&M, 9- ❑H.uilding sddifiata • INO VUP 05& Camp,iusurz a COOP-insatraaTm$ r ed. 5_ ❑ We are a cmrporafian and ifs 1� Rl e "ca repairs ar a dcf�iotss 3.❑ I am a homeowner doing aU work officsrs,have exa=ed their 1L❑Plumbingrepairs or awns eaemFfi f o on per MGL sxtyse�€�° '�- �t 12.❑Roafrepairs . incan=e required-]i c.1.52,§1(4k andwe have w employees-[No Workers` 13_❑o&er cow_insurance requred 'Any app5cmtfutdiedsboaisl=2AalsaUoattheswffoabrlowshrcndngVie¢wo�cex �peasatin�pori�yia��ms'uon $ame0 erswhosmhhnTitthisaffLdnAi lFdneyased�ngallwau$andgumlireautsidecont3u:b rsamst69bmitanew9��➢t sacTi FCb=&d=ffhA chec r fl,1 baac Mast at d, ffiad916-21 sheet shomaugHtenmteof the sub-caurttsctomzad she wltdhes arnotilme eatideshati-p- employees.Ifthesnh- tack lose-Ticy-A they=stp--Ae tILek wad—'•munp.policy mtmbm lam an employer that;is praurdvr,,-markets'cang7m- srrliah inmarartce for trey'cHW& ces ,Beloov is rho paNcy and f ab sile ittfonizatiam It=Snca CompanyName: 'Pooficylor^,pelf--ins.Iic_ IAX6`S00!G' p`A 7T piFatioaDate: 11 IT 70( Job Tife Address ' Arch a copy of the workers compensation policy'declaration page(showing the. mzmber and Nation date). Failure to secure coverage as required nudes Section 25A o€MQ.c.1572 can lead to the iffipasiliaa r f csiminai penalties of a tine up to$l,5QQOU an&lGr one-year impsisomneat,as vdtell as civil penalties in the farm of a STOP WORK ORDER and a free of up to$2510a a day agaiud fhe violator. Be adtised that a copy of this stafep 'maybe fonaarded to the Office of In-estigations o€1he,DIA far insurances Coverage L-eafrbaian. -Ida hats ry c s mtdtpsrtaIrces a.flrer�xct}t fliatf�ts"ucfo t prm-&fkd abvre!s bars acid correct Sit�taturer Date: Phone ik: 8 -(�l Z--UV-Z. Officicd uss anTy Do tort wrke in dds AMC,ter be coottspleted by cdty ar rout 0Jgk L Ctiy or Towm PerrmiffIcense g b Authar4(ci de one): L Board of$ealth 1 Ru ffng Deparfm.•ent 3.CkYlTuwa Clerk 4.Electrical Fuspector S.Plmmbnrg Incliector 6.Other Contact Person: Phone#: — -- - - 6 laformatio)a and Instructions, MRscar] G&henlLaws chaptm-M reds all enlploy=to Provide W015 $ compensation farfbjtir employees_ p to this sty,an Iayee is defined as¢:e�ypersonm.$�e service of aunty cadet any card of ice, empress or implied,oral or waft=.7 An.Moyer is dCf ned as"art m�ffiA P�nMip,associsii cm,corporation or afi�IegaI may,or�Y two or m= of the foregoing in a Joint eoterpasa,and inclndmg 1ho legal selves of a deceased emplayea,or foe reC.eiYcr or trastee of an mdrviCTnaL PattIMsblP,associafinn or ofaer Iegal enf dy,emgln9iMg=3PIoY=g- B:OWDVer fhe owner of a dweIIim�honsehavmgnQtmoref�fbr���eais aad�ho residesfi�erem,orfi�e occ¢�ofthe- dWeJlmg house of anoffier who eoiploys pemons to do mace,cons ac 6on or repair wolk on such dweIImg house or on.the grounds or btuaft apput{enarLttTierefo shaRnotb=mlw of such employmentbe denedto be an employe" MGL c2apfer 152,§25C(6) also states that¢everp state or local Hcensj3gagency shall withhold$te issuance or renewal of a ficease or permit to operate a jamSmess or to contract bm7dh gs in the commonwealth for any applicant-mho has notprodnced acceptable evidence of comprancevPitIi the iasnranc�covexageregIIired." Additionally,MCrL chapta-152,§25C(7)states-V6Ia er the comnumcwcalth nor airy of its poIiiical subdivisions shall contac enfPr into any t for theperfo manse ofpublic Worl-m3tij acceptable evidence of compliancevrn fhe inscllmce.. rcq==exffs of this dhapfeshavebeenpresentedto the mIt=titzg.anfhouty." Please fOl oiof the Worker's'compensation affidavit completely,by checkiag tha bmees that apply to your sifrmiian and,if necessary,supply sob-co±mctor(s)mmne;s), addresses)aodPh.one'n= er(s) aIongv'hf==td'cKb*)of instlraace LnnitedLbbMty Companies(LLC)orLmated.Liabi7ityParfn=s S(LIP)Wino =:EPIDY=s other tianffie members or partneas�are not rbqmired fn casy vworl=-s'compe saiian insoranm If an T LC or LLY does have empIoyees,apolicyisrequi�d. Be advisedtfaattlusaf6tdayk maybe snbm�dtotbeDepatmentofrndusftial Accidents for conf=ation of msm-ice coverage .Also be sure to sign and date the affidavit The affidavit should beret=ed to ine city or town that the agplicafion for the permit or license is being rcqucstxL not the D eparimeuf of T„d ctr a1.A Shouldyon have any gnes-taons reg�g the Ian or ifyon are re Ed to obtain a vrorlcers' compensation policy,please call the Deparimem at the rnmmbes listed below: Self-insured companies should eater their self-ms-ai`�ce license�.ber®.the approF¢iafe line. City or Town QfEcials - Please be sore that the affidavit is complets andprinted Iegll'y. The Departmeathas provided a space of the bottom ofthe affidavitfbr youto fill out inihe eventthe Office oflnv���has to comactyouregardmgfie applicant Please be sure to fillinfloepe�dllicemr,ntrnberwhichv2Mbe used isareferencent?mbcr.In addition,an applicant that must sabmit muhiple pemaitllicense appHjadons in any givpa year,need only Mbmit.one affidavit policy it o=ation-Cif nr y)and under"]'ob Slte Address"the applicant should er nett locations in (�' town)."A copy ofthe;:'ffidavitthathas been officiaIly sfa='Pe'd crpi byAie'cit3'ortnv�im '�be provided to foe applicant as proofthat a Valid aff davit is on file for fatale'peetmits or Ii senses_ A nevi,affidavit must be filled out each year.Whore a.home ov7neg'or can is obtammg a Iicease or peaait not related (i..e.a dog license orpemit to b=Ieaves etc.)said perm is RIOT �P this affidavit The Office of Inyesfig�i-s would hjce to thank you in advance fur your cooperation and should you bane any gnesiZons, please do nothesifateto givens a call. The Departmeufs address,telephone and fax=mber a dth of oh s , „ ••`,].�egaztm�t Qf1�d�sfrzak���nts _ ` . TeiL 4 617-' -4900=t 406 or 1-977 MA S,SAF Fay#617-`2'-7M A�E0 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 9/6/2017 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 House Account NAME: CAV Insurance Agency, Inc. PHONE (781)237-4107 A/C No:(781)998-5558 31 Washington Street ADDRESS: P.O. BOX .81314 INSURERS AFFORDING COVERAGE NAIC q Wellesley Hills MA 02481-0003 INSURERA:Ohio Casualty Insurance Company 24074 INSURED INSURER B:Ohio Security Insurance Co. 24082 Wellen Construction Co. , Inc. INSURER CAssociated Employers Ins. Co. PO BOX 5967 INSURERD: 488 Boston Post Road East INSURERE: Marlborough MA 01752 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1731602355 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE A CLAIMS-MADE Fx_� OCCUR PREMISES(Ea occcurence) $ 500,000 BKS56516445 2/22/2017 2/22/2018 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- 1-1 JECT ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Schedule Mod Factor 1 $ AUTOMOBILE LIABILITY COMEaBINEDident SINGLE LIMIT $ 1,000,000 acc B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BAS56516445 2/22/2017 2/22/2018 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Peraccident $ Uninsured motorist combined $ 40,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I X I RETENTION$ 10,000 US056516445 2/22/2017 2/22/2018 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NIA C (Mandatory in NH) WCC5005003775-2016A 11/17/2016 11/17/2017 `E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 11000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/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 367 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE S Bridgman/CAVSBI ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD INS025 onl4ntl Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-057805 Construction Supervisor CHARLES E GADBOIS 4 ANDREWS WAY SOUTHBOROUGH MA 01772. M.ten Expiration: Commissioner 02/26/2018 Construction Supervisor Restricted to: Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to posse ss a current edition of the Massachusetts I State Building Code is cause for revocation of this license. DPS Licensing information visit:WWW.MASS.GOV/DPS I -« ��e�po�rurrtanusea z`�C%vccruoac�ucse, office of Consumer Affairs&Business Reguiationl lugHOME IMPROVEMENT CONTRACTOR 1 ype: Corporation e tration Exai_ r� ?ton I. t t y 10/13/2018 Wellen Constrli` o~~ 1\ Charles Gadbo�s, >- 488 Boston Post3 " f Marlborough, Undersecretary Registration valid for individual use only before the expiration date. If found return to: j i Office of Consumer Affairs and Business Regulation I. 10 Park Plaza-Suite 5170 Boston,MA 02116 j i Not vaii without signature i I OFI E Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must ' Complete and Sign This Section If Using A Builder I. Raymond Quinlan ,as Owner of the subject property hereby authorize ICharies Gadbois to act on my behalf,. . in all matters relative to work authorized by this building permit application for:. 15 Birch St.West Hyannisport (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. giggnature of Owner r Signature of Applicant Raymond Quinlan Charles Gadbois Print Name Print Name Date t INTEROFFICE MEMORANDUM TO: BARNSTABLE BUIL EPT. FROM:CHARLES GADB SUBJECT: 15 BIRCH ST WEST HYANNIS DATE: 9/6/2017 CC: I will be renovating (2) bathrooms at the above address. I am not sure that I am required to pull a building permit for the work but would prefer to do so to be safe that I am not in violation. I do not plan to move any walls. I do plan to remove ALL fixtures (both electrical and plumbing) and replace them with new in the same location. I do plan to remove the existing shower stalls and replace them with tile. I calculated my permit fee as follows: $50 application fee plus ($5.10 * 10 ($10,000 in work) _ $50 + $51= $101 If you have any questions or need added information please call me at 508-612-6972 ONST0.UCTION Page 1 .r 1 Sunroom Bedroom #1 Bedroom #2 Bath Family Room jFirplace Eating Area Kitchen Renovated Bath Area - new shower, toilet, vanity, floors, paint, trim, and electrical fixtures. 15 Birch Street West Hyannis - Permit to Renovate (2) Baths - Cosmetic Only First Floor wJ �j. Renovated Bath - new shower, new vanity, new toilet, � ----- new floor, electrical fixtures and paint Bedroom #3 Attic Space over •-' Family Room LO Bath t 'r n Closet t I Bedroom #4 j is 15 Birch Street West Hyannis - Permit to Renovate (2) Baths - Cosmetic Only Second Floor _ The CoMmonwealth of Massachusetts Department of Industrial Accidents Office oflnsesaffatfans _ 600 Washington Street Boston,Mass. 02111 'Workers' Coin eusation Insurance Affidavit Iocation: itV hone# c❑ I am a homeowner performing all work myself I am a sole 'etor and have no one wo:ddng in a ca aci rwidin workers' compensation for my employees warldng on this job. em 1 :},477:4 .:w;:fd?,{$:Y,f{o::+,rL;>];::Y't£,:}.:#}:#;: ,',>.;4 fl^ ny:l+. a�x:.^•.,>. ,:',#>< f>,'2 y#1 „{:�.}. :K..:}rn`+.A•r.,:4} ,::}.. .ak,...:L•.a.;.}.."4:,, x, �a ❑ � •.}}},.v KR]Y'..: %•.}.. .f�ti•T :.:s. ..y,.<ina yvx . . ......... ......:..:: . ,.,.. ..x?.r.......: n.. :n,..7T:.3::.:,::Jx;.}.,.: r.:riN}+::.:x•::.r:7'.3:.....;:..... . £. .-.� :,� .n..r.r:.v.r :.,...........n..J ,..r},.r .... .}... .. ........... ,.n...k]::......?v::•:n,• ,^••: rr ,: ...Y'ny\!{::•.:.;.:n.,;:•Ni:::::.{v f:{r,yr. h.4,.{+r/. ..v.�W,.wv$kStiE�:•,:ti!: h .fi{v;Qf?{n ..f::•»: v:f•n•�, 4�. 4n: }v •:.h: n.L}, :.+b.r. ::. .t4?.,L.;. ;4rr •i.Qi•: :•:}.. •vh.. L.x::•54• ..4`:%i:• ..i. .{. �'. •rh ..{•'{b..,. L. :r.•,q'..,,}}.'+,{tv:}.a '•S.. ,L•::'•:>.`.;:.,:.{:, ••artirb•- ..tt'•+vra.,•Yr»' .�.,::, ,izt .. r7i•.•<;• K. .:L:?�: •:R• ?K• •:J{z. ,x .'', •?:: :.r.r...,+::ay.y;•:. n+aT:.;:;.;${qr..$•. y. ,•::. ` }...:: nfi.^ •� ::X:•z.. :,t,.,,, y� }..?.r..$3:: v;i#•.. ..h,�•• 3}•::J: T:•i: .'.•.4+:r 3r.^.}• v.7i^,`n\' ,k:{i; y O$f Y•+••::•. {�.: r..;+ .:•X•. .•+.}' ^:}ji: n1,K4:}+ ':a#•? +✓iv:Y+'{> :vn•nv}ar v.,4.:• `•}L, :,n ..r.?R':.+ •.a:T]:+»?n?f}i,..nr 1•. L:2,. +F. }}}�•, .E:•fi�Yv. +}•i Ez•...\ n:}C•::u:2.n?,.,..wx;! :f�{;:Yv'vn•.., vvT].•`+:::r !rx{n+ • ...J.v:.i.::.ra.a.n..,{.r.,r.. i.�,,,t•.,vv.•...:}}::-•;•.:.•.:::4:{v...•:r:;':} n}.v`�{.....:. i$T:�3}$x L+.rJ...,:.. a 3Y } 11.[ t } a. }£+ h J Yy U+dt+hK• ♦ u fl e •V r•. z } an � r..{. Y• +. ) r:OnI i E h 3 zr a r\ h�•i� '$ h S' 'N} r h k 7, L a 3' ^z r aY7 x h X � .?. i.:.•:.3• ..vt,: yr{ •+A :.•Tyr .2 �y .L. ''?n'n.. xy�'K;?ar•. `z•v. •i Av: v :}t• L6.. `.K}'7}}.,n;a.n... •..x+..nr.a ts., � .,Y. n!$T rnx is}n,..., `r,j� :1 p+ 4'• +C d€re � • �`•a } rTr.• 1{L+. {ah }:h i. ..N.�{f. :'•\�i fist•:+: r;err... .H.. n3•:` }z,::•• {.SJ:?:,£ •::�x:;:`,•iY•3}x;:i 'sit$., .�.•.... ..J: �:��.,•. +:,•,• .L+.x;},i}`•3:v�:i :n.Y. •x.r. :3... : 4:`v?: .J*•. Y' v.�.� •:r.•x•$. r..h•:, r,irn!;:..:n••nn^:•3:`.t., .v..?,-x..?:,•+i •`•,n;.{.. ..{::<i•x.., ... a}:{+:?`t`;•:•.{, .r..... ?. ``i ..»..r. :.,: .,.......r.: r•:»: .r.:.. K.: nr :}v: ..r n..;;w:.?: 'i.. ..... :•x•.•. :n,.,•.v ).L':v`. yY�:4�. ,�+ ..r: :{S}\... .... ... ^tiivn.,....:::...v:.. nh•v:•:::.::..::.. •..:�.J::•n....x ..:}...v., ... :;»;}}:+• rv.}• } :�T.s ,v,S.•.!i�K A+X�A•. :r...,.r. :..,..'.>::..ra•:.r.. a.13n...:. .. ..,... ..,.,....,....:.%S. :....... .....w,,,.... ..... •. !ri'?3Sa?• :�S'n ..3 ..}'t:L::. ?c.. ,\``.r :. :.{,,.v4.... ..:r. .. A• .:....... ........, ...t,, ....n.....:. .... ..t.: ...Jr.:h..x ...r.R....,..7 $�"i.'•:i•<'•$::•.R:t:•`•,:., :.}.,`r:{?:;:`;Y,n.`,:}:..,. :.,fi:::f; ,y{. Y} '4 C !' y FT 4h �j h h } i Q�Qn ----'3}Cr•;J]n: } fi t '• h `•h4 •h fi W I} F p 4 ${ > ry L J G 2.2....4 .L... .J• .u. aX7n:••r U r ::..tar ••:w3••i{L^.},4};{.: '•$,., ..r+:: na?�xir,y .n.'y�3}�.;o)Y'. �. :' }rr ?vx•}.w::n;v.. xpv.n:} :+,y .:3:'{'.}nr•, x.•r{:..... )•.i•: ..:•x.......i.....,:.};r•x•x•:n .,. .{,..:. .,, .... .rn .., :.::.:r:}... .:.4.^•..Y.,h.r.: : ...,.• .at....r,r....,. Kar:4:^•:{.}??•.}:+::}.,..:...:•,-.`:n•S•:: :.•..r:.{..;.,..»r::a cr + + ££•:,n,..•:z;•:::>}:i;?,.-n a::7:••....a4.,•:r.+ : •..:,:„�.<'; •r2�•):�`x•.:` •'•.`-0�''•t''•:<�1`.+4:v:. • :•v: +i?:;;}:::::.:Ki4}'.,}4::n•::V{}F.•h„•.v:lii:?>.i.,•:.:... Q1�`'�:�'T ❑ I am a sole proprietor;,general contractor, or homeowner(circle one) and have hired the contractors listed below who have a following workers' co ansation polices: ►u �}� �7 :r}:rgga+,:;v»r}:•t:t-rt?ayz•,4+x;.•?c>{.^.::`•`.;:., r..^�^,:fi�: {:.h'"rhv'�i.;`�t�w�3icfi.+ .�::>tr��%:; g '-F...... .:.vr.,.vtE...:wx{.}?}X{..ny w•:{.y {..NT:•fpffi}??:$3:::•'•>.^•. ,,: ...n,,,?.}. ::a .:.L::n. .n .:.F.Ya ,.:w:Y:7.v».,. }::?:•.:::.:.. ,:u•t„•., :•:r.•:•::•:::.?w.{.;...,•:,:•:.£:•.•}:.•r.r•.{;•4Nn°+•.:..:•$.LT;n:z } .;^a.•L4,}:;zz.: ...{.. `.R:•w3}:•,:•::•:•,as:L..gY.}!:•i;:+•++}}},+•:•:.3:..... +•r?a:•., .} r ,..:..•:.:•.„t;xn • ":$::};}} iz�f+.•:.x:'.`;n.:..,. .r. .3.. .a:.r. ^•.,a.,J}.::xr••3Y':,... .;.K.:;..}.•.. :+g.., ,..t .,r. Y . ,.tt•. r..rn.......r:,:•::•,•:..:.::., ...t... •xL••,•...;x••r.':?:••}:.,..:.....:.,<,.,r.}K:L:•}.a :.:...{.;G:G::.},{L+•::•.,,a•.Xr,+•:{, k KL.•:...,.,. .:{.•>n'-•3t}.^•. 4f..a1,y, 'v •.;.::jx.. k:.. i.fir..$::.{.;•:: .a•::::3...r::r r,..::•.a:, •z:?r,..•::+x•... [�• .r{ :�. •'zL:•rt••.a�.:}:r£%#•<•�:^.z�'•;:zJ:,3+;3fi .�.;K•�., .{4Lr�u,a..1;: .1 r:}.•}'•i7}:67`:•i 3S:i v.$.•.j?C,+•,n n •.J::n........L:{yi4}$)':v{:}'^ ..\h:.n:{.,1•}'•. ..$,.:..r}:• .a .Y+.��?;;..}; •:.Cvyi. win •x::,•..v.;v .L t .fi r•r.:. f:•} r.� .a........:}.': }.•:•.;:+• . �r .qzr i.} r.. .z+.a••: •t.},••;vz•: •.Y 5.'4hS.. t•x,,.{.izf.K. :r..rr.:.;t,••'+:::r :{..:::. .Y:•r... `•.:•T:n :.:. r:..hR{,. .x. •Yz}: .r. 3',...:,•.an af!$?• :::{. i•.R•';e, •{.',L..o4 ••r,,,c•.,•a•7x•v3::$ :.X. ,ta,S, .:a:`•:.t•:». �:zz :.... .v............r.nh. t .. .n:..�?:.. ha.:..x.... ,.. ... ::a•-r:.v;:..'.,.•r.,3:;:::; ,v {•+•r•}n; }.^.': .,.}....{}• {: •`•;ti r:.J?•:4 ir.}}k:$Y:L,<...w.}.x nr}..v:x f r.{;,.}?•?.-:::.,•:•::.:.::n• 3 •r::.;•xLi•:>.a J:a:? .::,{•:. ::+it;a•:aT::. :a:......<4. •::h:•.•x::...,}7.,5i:•' i.+::}.,,n.<.t r r: t;`.,:..)z•.:::: Y^$:n:•7.,,:..rr:..U.;......:.. K..:,.;Y,.;.; a.,.,:•,....rt•:?.•:::.•x..•r.,.rr.T:.a•::>•r.+•r::.in i:..}:..... %#:;$?`•3 � ...?...::. n. Y+•vL•.L+n+7r::•:•.. z .,•..•:.b•.:}:7:.. ....r....::..::>..:,•:::t. .��.rrLt.•r. fun ..:....:::... ..::•:»:•:.,•:.,.:>,::v:L::Y:?•}}• ..}}f.;..,�L3:; •!�:;xf:. ;;,:n._•,},::$.;;; nay:.�4"t3.'y��::- t.,�c"'?,nz�:;:a ,arHla. .Q .........: :...:...::.n:..v:::v.;....,....,)"i.,}Y'J..:r.,..v•f,.;Y.}::vn•r: •nv.•.,v.}:..,{.,:;+: "fy.7}5;.,:h,+•+w:•n.vnw:r.:,.h;�.R\;t.:•:L?i}1#•n:,x^t ,'(4?+ }, :4 F':t' x{+::{. ?•:.zzw. •z.}a:X•X•z z,};.>::.3t•.v;:.:}z.., ,:?::.33xa.\,z.n..K,•-:�:}3., x{{)..,, �'yyr.t;.{.3.,,}•: ;e:t,+.v..J x�•Fk:. r •`;'�ayyvv;�.yXt�{x:.,;..v:�ry•.:4'+'r,.• ,••}f.K<. 3:.?6:•?§:•:F.};h}. ..LF,fi:7v a .:>v.s.h...... a»•.`N:ta n .:fN ..{:•.}:{ {•}•{{•wY. .{.,.�.;i£.:. v �h.J. { - "avh.. h. ! v...:or"•7$tG:':t:$rX•9i•:S;ctt}a�.3;}:;,y,.x'H?•,r9:•.,.,:.:{{•}+:•. ,a.,••r,: x,.r:•....:.nz.;N,,• •+3:?�};{•.,n+rD' ..+:kv.:} .}•fiaY?k F.:,r:....:.,,;:..fi.h}.}. .h:.-.. ]:z Y:+.a,.r•:ta.....,r,..::::.,..,.r..,..Y.a.. :{.;./..t,,,,.3.:r;t.?;7.:{;zna}3}^+;?$$9�•:.;,+}.•.:. , x••3.`s�r`??$.'-3:�$:ztiz;, ..};•`.,. x .a.. a,": ..r .,{; �n•:i53'.. .� ..k.:. ,$�'.:}...a:}::.•<:• a'•x}••, {Yr :.t r.„»,-,.•.. .:.a:{„t :tt.};•:i.x, ..,`.: •+., •T;ai,.k•a. '.>.•}d'.4,.4. i:3'• ;`-:aL•]9.:#.k{ ,.a:.X '1: ,#5:.: .3y:r�,• .•:y{.• ,r;?:: •:`k,^fififi#o n:•r:.;`£•iroE• .3> <:i+••'z':•zC?• r.a.{ :;t.-: ..Ji'•. .,,{ RL'fir"'••2x+•£ '' per:c, } z q• :.tt;k: •Lt• h,.. „t•.;n•.,•:7.; :+•'•�.rv:a••r{i4^`.•., k?. ,w`t.;. nzK•fi•. :{R. r••.'�`q.•:•$ ^'�'a. ,z3s: , .y)$i;.,,.Sk:A. J}.`• }` ; C•{v •,z-{.$KY 2;3,#}x%3Si,x-ax}4}}£:a: i ...... .a••.n..{Y••::` L:£r. ;x: , hv;4}f£.'J.4'r •:...}'iz:.., ',^{;r.•.:::r'•:n"'�.a + :.. •.}�::.. .r. ... ,•,,.. {• } + x3•{ti.}.,.•tC'?za{}ti.:?::a?+i•':',L,t•£a•:M:,:+:r.•:n,.. :r7..z,r�.,;aY#�f'J... ,..t:z`::T.. ...{;:•:{t rlyr<t.A.{'. ...... };...:;.y..,;,},.• h ..;}.. .. • v..rv.:. {. .....:n.: ...........:7• .m:v»:{..X;na•{n,,r:,.,':•,+.a:;ff'r•!T^+.',+` ....r.hK{ R h }•.•a•,vv .ilit ... �]>.••+••;+,) r, qx.z., {...i, .;,,,,'•na.•:Lw: L'� ..3.m ... .............. •: {<:•}:}x•.•t?•`r}•:••}. o}.::?;?t::::{i}+..n,..r.., .,.:;.• .v'tz ;x'Y. •.• •':. ,L..},l}% +.'T`''r;;+:ifa3cP'ifix'Ys%-ci.•: ,;+ice'`'\�'s:{ `¢ ....„.,..::.�:•rn•.•::•::........J..^:. ,t,r:+.+}•.}•;.•:,{..:rYr':}n;•4,::t: .: ••r2•:.q.}.a.L+..Tk}rk n{{,axa;,n}??R:...R£3k+'4#.R`:�.#'x.xKj','+k. ik :'Ft.,.�?!�c1S.y.{J?:i.,�'tx, : a4wN.Y�• .:.a'\wr�.x' i.•).xy. :,�.,. ,y ..,t. {.;.:}:{. i ..3j' v:.�,.Lrr;r :xs{.:�f{.}.- r. .L•: ar..a H ,r#. :r.,+•N»r`::•r;N:4K*Ii:%:4x••• a•.?,i••.!• a:.Y•'},:.•0... 7k• .:.t}.,4*' ,3:;;,R.}x.,;•Y•xk:oc.fht.}4:..•.g:'::t:,..,,.a:, ;}�,,.7an• •'£`?saio.;•{. Y.•. . .rM. r 3�fiX' ? 3• :r:n• %:• J: •.,..,n4:•:$z'r.'•,++' r x?f,.:nwJ:•3•vn..;/.;.; :{}..v .,r•}.4}.: ry >:j;;atii}j•.:; t:rn:w. :.r}..• r :.•:+r•�T. .$Y.,..}?:: :x ?::r J!'r'+.' '}?X,. vN» >}rv,.by +:yn.?. r /.,R:•rrrd.J»: ••, :r.a,.t, r .:•G.?r. .,.£,!,{zs: +.#J •;'rry,#`+.. ::$}:`•J7.3:,r}?tTF:L";•?{!.,..'C 'w.. •tfir .tr FEs,`fi4t?4.v. r•<Ef:•'• }}:}}3#:?x.};..z,}.;i+i;•;r.•'.r,. F.M. .;.,.J,}4:>x:}t•}Yr:. •^,.3}.,5'?<:•.yJ::..:.:};.{.},•i<•i;:••.?r.,t.3;Jv.'K:;13•..,.iY:'^••�+`t}.,.r'R. +•:,^ " 'k••,,,..,ncc�.•.+�'".J>..n.s..,�i. ''�;�"'�tGbr,{rt+•'Y:'!ti`•F .T'• ?:3•x•::•:•a•{.{}A? iSinW,. a....:......:.:.::...xa:..,x•{a.:;�Tna.ara3'x•}k3.{E:z•..:: :...n,. ........;; ....;;: .. ...r., ,....r.,v 4.n TtaY•..r ..t.,. ... ... r..�):+. :�4{.t4,yv;iy:;r Y•ah}tp{Y•:z1r..: ,...,•£, � ♦„',h) rb;�.zt3:?k ..............................:::. .:::•.:n-:•r:<?•rr+:+{•r::^•::a}}{.•i•}h:•{n, cz;;{i;;;; ,:.iEu•,ti•: tz•; a:•..4> �'S:::•..a: !L',`•{%:•N',}Y`.„Y{.r•:x::i ............. ....::::�:�:-:::::..., t•.. :,a f: .,.. .,..i,�•.,:r..i{Rrt?;J•:..;?;:t;:<;zNy},c, aC{.. nr, ,:?:tz`.,,;:{{:.5.�'..a ,3F... ar Y:{J k:•`+.$' •:Tf};v: �t;� ,::.!:;�i, ..r..,,:•,a.::^ •:J..v{:a$;}.r�.:?.... .,L .. .,N---:, v:.,;;.. :. :`:r.an••rY,• t{3.v:•T!:. ..z::., .,;. 3.{,;.0.n+ }.:.y wx fix;:. •r•'t}t.}r'+5'v• zo:;:;:.} .K.t?•:•i{Jrir••.,... ..c:{..,f•}}.:. _.gig r. }S;vfi�$•z,:wS9�;. ax:r.,n:-x:.gr.x?aJ";•::£•:,:/r}`.;{•:: ra.:a:�. •:n:'<fi`t'3}.`�.� �!;^b''� •,E;4Y;•`,} :•:]•+x,'}`.Li}r :::rwr.•:+•.r`::r:.•<3N.n:. .w+ •4:`fr.$}K,, .. yyi}:?r.`{?s 5;... »•?}:n•:: •- .r ,. ..:n:...:. �t ,,x:: >,. :Y•z:2•, }"i: •3..:.L, r{l.^;L. r•.4;{:::^•:}. n r ar:•, a. na}#T$ ++3r;}r r.t„r,';Yh:4: ..{.:A':i :{...{», $.:•.,3 S }{�{{ {+4:• •.Y..a$ v }++" w::•,{:rxa ...r.:+K'`r xh•n..•7.^' ;K... M1 {rh•:. •[ !.?.••<{•.- "'.a?}\•., ::i{3:L'{zfi+r;" :^+,' Y•;a{.;'a;?r:,°},}•b,;. qi..� ••{,'/.:3 z+xa,.^.•r7 {••.i+ v?�• �:r'7w.f+:L•:�.�i:3:z�1'v:r3' $rrti,; :.,sLi...,»n.33'J.L.vx;+.k;::3�,:4•. iz?;:w2R£ R.,t:ax n..i•:,:}�x;:z:'.>L:T:•::t:.,•..Y•S.'rn:•?!+••T3�4:$:?ti,}?{?+.;h,:!x?)J4a� }?fi.>�z��,�f{�»���+�ty�t�{f thlan2,;:x:b,'E#`};tJn��:;{:•:c�`% st�.;x}7'•},f3:•Y1?�;F J, ..r.,.}..... bISG��fF:.,�: �/J �Y�l'QaaCe:•.�''Q:a}}:{•:-::nvJ,•., 5.:..}:.:.::}.. •.: .n.,lr.}:.t• .... .. p �%n •wx;", }":{�tii'r+i Y{?+ i'r':Y:$,::isii•Y%:4::�i:3L•$}:'Y::}i��}ifF:�...}v{?S,:�k;?:'K,?•+.?}.:::•`•� :•`bfi;:^f•r fi+4•:,r t:;•:y Y::= :K+.ivocb i<.....;r;{ 3;. `11,1 r•�{��Ya�:`•{2. .:x?..>?.x.$y:zaT a.; .�; h+a:'4 •.M;,;: r{L;}z: .. .....:.q-..n..;;.:;{:•{{:::;{.t:•:a:h•Y:i:'c;::$$R:?;'{:.?:'::::r?zff:++#?U°:.#?..C, ,t•.,.,,�}.i •»u:+r r. .a.. :r,.,• ..:,,••. .,T....•. n�•.r ..:?.J.4 •:!# :.•4+'•.+.L::•x:r.}?„+ w�a•}n'Z?L.av,}}.:. K;::•za+:x.. {$.• :.r:•.••.:.:'�:c;+-: ..•,4.L +.%:4}:} ..}:i•,• r:??:. :z,,..{,..,z . N. .w�:,x!K:•. Y'•}}?rhh+i+;'•?Y;{}'•''+,'r:;:;:'�i Yti;{..y:;;x ..pp fJ'.. ,...:ri.+i..rn?2•:'^tfif. r...X. "' v:f.!4.^.,.:T:: 4. `}'4]. .$..: }r..•v\,i•.xX Fr..:. ....r.. v {d.•:•.r. .nv.•,�::•»....}.....v. ..]:::::• :.,. ::+::;3$'+••..... nrA`¢N++.:3:v:•v::...a:•}}..,n.R:...::�?v:::...+.v''f,.•?s+3'^•!.• {.F•X•;,;:vv,1:r'h•++ ,� i• + 44+•,{•wYrr{{ .r•rr:-a :E•}::r•::X•.:{^•::..}:..:$t!C'g�}:.¢ ,•n<((•.:.?vn•.r.r,. ::n.}.v:x?a.:•n•}.v/::.w..r.; ..raFt: N ... .....:..v..:...t... r:,+..{.+n�{ }7..r ..r .,... .....x ...'{... w.Q, r{:.,v...v v. n+ ..i.,.,^!;::•.x. .{.{.;.'f:;r n\^Q'fi.$Y :xaLv.S.:T?t•TR+N'� •aY. R,'•"'`v`.•8X'+v.T\3r r..:n•7:r.:..{. ...,.f?:•...» :..»::••::•n• ......+: :,++:...rn...•::nf;.. . J .:....,r,...:$+:r`Y+. w•xR....:. ;}# J+:W:v}:.}X?¢:�tr'.-!; 'G' ,?.an , ,z,•:r ,.r.....:.:,,•}7:T::n..,. :,•:.tV:. .r.,. -rrJ.d::. XS'., ....:••::.,......?x,}rna;.3••r::•r...Y „:.;m{..{.'n:n a.?a ,T'•r..n .h••+.:••r"' ,Zt h`#' a•>. r J.} •,::R•::•. ..C.- r?,•:.a..?:•r..3...1`.{•..,J:..?•L.,fin, ::•,:::: r.r•nKa...� .:y n:..?a; ,::.. rf:.,N.ysr;; L+t++y`.,�a,',£t +, ,k•4�,;`'+,�:.4a ' r .. ...•L:,,•n•»....:.,?.,,••:r�•.6�: ...r..:..n., :•:.,,•... x...;., .�.�,. J} .:,.v.,;{...ra r .x}..:.•:%�:::::::}.•��c:. .•.L.`.:':.'aw:�.:..x... . ,L.•:... r,a... ........... : QV.....� 'a.+i...:,.;;}LR:v. .:'3::: ....{.vKf:•O' '+ Jv}.{ ::,,, `'•:•.,.r{..;{.;:•.•3:}.v:»..'"{':.,fd:•: n..• .»}:¢v+4}'.+.7.., "••+•:v:.•::•..,.....a..::}`:;r.:::f`.R}:a;{f,.::a}.::.::•\., r.• •..n...... ... .: ~>.`•:�:, r •: :•.:titi.vv.,x X•::iZ?{?•.•................... ...}'•.x+,•;,.MY{• ............ y ;}�'�t;3K•:n :: ..r} �.n in :••....C ,n.. $:;R }K{?•:i?;.�fa•.?};^r;:•r. F:;cYn;,•::,•:.v,,..,{•;:?:::.a:;:;+.'n•'fi;y`.•.':•,•:}:" �+:}..:R•4 y`::; ,:$:$Syr n.,+ {•}X:•.4:;:.}+3+:•+K•.z•••.'•�<??•:i:%?Y{J:,•nr'• ::.: ..;}.,ty. ..F..ri E.a;�::S,.:'3]:•;z,,,. :•.;r,.;:7".'+.o:••.tza•:..::?:E•�T'v. a 'lbw. �s'.�'..':i�t'<J ..•:x•.:x+•::F:..•,.+.,,... .•:Ei. }+., ..hY, $}'.. .L.,a::: •.. .......:..:x:»r• •:n.::.}r•?4 'n+T?N'•Y'x:4:3'•n.....{v;. ...r.,fi::. 4.., x....rn 1•.:r.v.....v.vh+]}}:{•nv Ki'+{ ,•7.• .{... .�ii`� E,$'7+:4.. ..x .:aJ'F� .v•:4 .•ra.... Jr.. .{•..} v.r.xgr,n :.S, a+ {+,d:.+v?xKviL'r.•^.• ::s. .�•::• :•?..a.:ic. .fhfi.':..,, •n.Q.,. r,:{,v,;{$via:i:•: ...({:p+ •a'•K{+ti.. ,:n`�'a:{;:b?+ vXri. .r•. •. i vX:E+• /:. ,.x wv.:{.,r,;., }},, .i,'.:+.L•"•+1�%:?{.;K. .J:YFn^�-Y t.. ,.•Ya'iv '+:4i{:t•:+C{i?i'i5•.,v• .hn^.•`r'• r.T }•.;:.i{{. .y} .'{ i{:} r.?ry,;(.LT:•:.+•.}..x,.}:X;T. 'aY4,, :�+, .:?';r;{•Y:{i,......nh.,: v O.J ::C{:`{n.w:».•:. ..N•ti•'};v, "r•+ .n.v W' l+v;4+r} :aT.ar;,Z nv:n.v., ?;•'...; ... f R» ,rK:•. .}? w:?:•}?a:3:. .4.: ":�:•i?i'}i'z},. .•3•., .}.•;. nz.+ h`.�• {).?:'�i :R.{... ::K•R •3•r'•t}i'{}T{;?a+t}+.a t•:{•L.;{...\,Ynyn.4`:•x:!','•i:+ti\a:ti:}'w....z., .c.,ri:;:r{..:r;•,+x{: £.+�'�a3$;.r{. n.:.; :.•.3r:]i$7`•.a...:?.v:r7 ^•r::v. r..:.,.,rr•v.; ;}r.. i }.r.: ...s4'4,`^''?•:•+...v v:•Clvrn?J.:: �,,:)...1.}..:.t.• .X..at'•'''�!•`>,•':'C.':.}.'.wR'k$:4 :'.$ry{r•^}:Y:wra>Y.;.,t,:•'.}}2•: .:K•:•:i:...r:••r?. 3::�•.. ,nt?.hn:..:... . R•.::n•:.,.r.h.:.n:.,•.,wnr::�i'•}.,. •.:z 3..,. �.�.rn{.n.:, r...;:•� ,•:}.r..,,:.y:;:„•,,,..•:}:•fi,{.4•Y•:;•ro-r?.}3:L:Y<3'•:i f'•-::.....•?"' i.3 r;+?:dr:::.} .M'rn•:4:a:'7:•:i}»z.�it`:,::.•z3}n..X.:.3 .. .... k .: ... ..:. ....,».v.,........ ......,..; •,.. ,. ,:... :.n:rn.... tt3i$%'tz':'•�`+•.�'.n-'z3$r:^.''i;:!r.,:3y`w::.'"!�:`3.•'3•"••r e� 'S,.L'.++c£,?{::Y :t:.r., :':L:.,•}$.{,.X :r:J •;5:,•%. .z;<#`� y}"`.hc•••: h}}`{:•,":•?;:`;si ,^Y.a f...:{a?: \..,asx. i)i•?T:.n .{M}vrwn, '{{$.. v:•F.:rn},:ri •,vn•{34.v.{ii}?•. ':`hti" .. ... .v�::.v:::v.,:r•:Yv:v'•w•:x::•:v.n:tvY••7:i}}]::•K{ax?IX'>+,K::•Xtiv}tv.+ ]}i!: {..{•.: •$7.•.W. •�T•. •'.vi.J^i mKh. r }. 4, f ..v. ?� •' .: �v: v.4.�v;}•?.xJ: ,rk' '�':•' ... .., .....,r..rr r:. ,...... .. ....,:.... w t... ..,•.,4Xi is+L:,••.. ....::^• ..'k.,,;.r:.:{.:.:.. ..,.,. ......r•::•,?;•:•:.:?<,'$°;:,;;:z.? r:}+,:'$�,•} n r. {. ..ra,r .,F r1z r.,t.:{:? .nr., ,•t;. ..??:•::.,$>:;: `�'}tR#U�zr3''?,: in� {a r,,;{.;'. {.+,z•::+.. :.,.:•'••r .:..:::::. ,::.•,::?,:.:.:•:.max•. r..x•..X•r.;r h.. Y:.z�>:ca . :t. rr i+Ea,+n •3?6r:R]" ha.. ,R.t�r•. .?nv. 7,.rr.;{.r..:• :,h+:a .. .r•:{•/..:.n:+.•Y$>'r:�:•n 'v:.,:..:h:::n,...4:•r�....... „ ., ,..,...... r'n .. v.vr v:n, :.... .»...... .: ...:•........ ....,F.r.v....R.:.:+i;.:;vn:,•vK:::n. ;.,F; '+?:v;x• • n•.i•a..r : .r.....r... .G:J.. ...,.. r. ..n,. :....r :rn,.::. :?.:,{.7?;;:r, .#•;. :•;{#•�';..; .. ,..4..•:.. L^^"• .} a:,L.ff,Q.'�n}•,vx.; �(::3 ..!# ...J-n..,n:..M.�i .A : ».:}•.vhv,.... r.iK v »..i.....{h;, 1+};4••;;•:}`$'?L:..},}�?••''•,n n}'F,.h if:}}}:•?'})]+:'3'?,!:j•x.X+.•:?:•`.?k.t�. K /.}::+ixat•�:z K+z•Y:r ••:•::.:: r t:Jn•Y•'r"..:...,::•r:: .:•.: r• >r. ..... ., ,... .N{:3•..v h 4}:•:%{J•:•'+:�:�:•Y.;}...r.w::.}3r..vY,.;nv;:f,..x::}x}::s?;Nv..Y`.43}K:a:.,'+itt{{MS.v:}•in::$x� }. {.A .F•::...,v..n..• ..iJ+.?•..x ..,.....,.{,•• :.n.•v:w•.:;......... .a;{v:Xi�L•.:•x•h+,?.;y ...!v::.v;•.t•%:A}v;d• ll�LLG] .•;7},::.n ..$.{ n�$•a�•`}�{��4y .. ...:::r•...+r:.. r/.r::.T.zz.ar..., ..n:3: :.:....., .{.:.a.::..}Yr}............... r..::,...3.... ,.:#, r�%^ r r.:].}, .x}is r...r:::v: �•.:: ............x:. ..'£. .....F i4:.. .irv::;}::n•....i.,r.•::::: r».K....nY. ..}::::•........:..... .... ..;:..v..v,:xr..,3...... .r...... ::.:v:.r...... .......... ....x::.:..•. .... .:,,•.:}•.?:J:}}N':::rwv^^"+ : vv.:}. Y.,:r.,,; fa.4,i,}•,.`•#3:o}:•.A•1.'� .� .:...a.:....» .......... ...vv:•:••:r+r•vr. :.v•;.,?..»4Y•.a•i •?:.vi h,n..n::v3n+Y.+.L. :•3Y.1U.Q{:•:;:}v...;.ry:,`,•';Y2t'tn;t3':.5:{:2>•r?<"::ti;4r... �K- ,• ..................•:.....a.:.,..?:•:::. r.. .. x,•�..;,iK$. ..,. {•}z?r,...:,...:•:... ...::!d.n:.::..}r•:Y}:•,•}r°n+t:•r{•Ry:{..?:....:r?.x,•:..9 •:4:,;:+333.k:4. �tr3}Lr{>k`']c{;}`;i't. .. ... ........ ::....:.,. ..,,...•. „•:,.,:n:r•t•:::. ••::+.�:n..r.:n..,K;.ntj}@•}}:,•+}Y•.•..,R:;:fr..??•}..n..,.:..::.:i•... .:,}.,v...;. ; h ,; .:; :i,?4:• +;?�:f{ ,{ R:•}.$Y ,\.h.:z .. .a: .v.3 ,Krh•::v.F}.^`:x.R.;..,a.,.. .:Aa.n;;^:n....v:::.. ..{.;xv:•.a.. /.{.;v vn<, v 4?xfi�$%^' YT K r } vM::.C.:.{.?•.%.${S.-.}.,:,;:•rn.QyFa .,.,,} •h , :}•T, '•+••.•r^+: }:•fin...i3:-4•:i rr:. ::.h:,, .in•.; .};E•�,, ;:£:a:.ntx,•J:•\3::,+ ..;L..�nrn:w.a) ..,{n:.4;M`^.i.x .}. %:zz;f;3r•?•}fix,,..:.r.,a•:. m.4. •,r,:.»n,,::^. :::{{.?:::,a�::}:}:••:r:.••;.�?3}};.,,..,.....r•..n .:.t22„•::•,,,r.,. .4. .:..+x:nN.. ..k^ 5`•,:..a •:.,• .. ..... ....F.. ., ,ar::•S-::r.v•k•':.r••.:+::+:»:•.::...n.;..:»:x,t.:..+:.:. ..:{.xr`.Nan:.,•.,,••:•'.z•};{+•::v:•v:hnn.• .::.,.;t.,o.:,.:+:... 3 rx..r;., t: r•err.:..f}5.:3,fF.:...r :?•.J} r••}>a .rx.. :.a ...tt.:.... $a ,;{:.; t i„t; i< > ,••'�:a ,,••. .{r] .,•:r.•n :....:,-:: .n+..•..4.:..}.:.:•.44••r` :'2F7i7R(•`.:.:L!{. .}.«.,%";':r.,.,.f••„ a. } ... <•. .r +`�i'2o}/Rr.}3?.•:a••.^:• x +{ax3x"ai+':'° ..}.. •+.{++.:�� 6{?;:. }'h rC,•3?rF,,,r.}: ...:.g{:+3,•xriYi,,.^,n;;f••rr,ys4.•F.;{•:: •:is•.,•:•::� n{ ,,,r. 'r• .,{r...}a+••:::v:?.n :s.,K i;St•+:, •,#:`•'.. n):? •rxw +<:;d:•::.N..:#..,.:•R•.sd._.?ir .{,.{xn;J�}?:Jfx.{h,,.}}!,.?•'.}:$:•w:•Ylr,•r'-i^ib.`;,7N:•?{1:•.a,.z?:+r.G}:+. f.:,. •;+ r.rf:,;nf,}, K,.::z.,,. 4r:x};::•::::}` :}:J`3$???ri:zz-:,•x:;•::{.}.y.<...4,b}�•:it:3w.Tnv.f;r,.v3..{.xL>:zLi{,..}ta?Rr:.: 'p�'.,:•.?#,}.�:Y:. I17A'['Sr2CC:�U✓,3$i$:z>'d:R}f...r :yK:.,:•;,,; / $situ a to secure coverage as required under Section 25A o[MGL 152 can lead to the imposition of abnhud penalties of a one up to 51,500.Q0 and/or one yam,tcnprisonmmt a,well as dvli penalties in the form of a STOP WORK ORDER and a one of$100.00 a day against me: I uld that a copy of tMs statement may be forwarded to the Office of Investigations of the DIA for coverage verideadon. I do hereby certify under the pains and penalties of perjury that the information provided above is trim.and tarred Date - Signature Print •^- phone#_ 7 5' 27 00 name ofodai we only do not write in this area to be completed by city or town otHdal city or Town: perrndt/llcense# ❑Building Department ❑Licensing Board ❑5elec4nrsn':Office ❑ mm checkifiedtate response is required ❑Health Department contact person: phone#; ❑Other U viged9rosPrra °FIHE, � Town of Barnstable Regulatory Services . . BARNSTABLF, ` Thomas F.Geiler,Director MASS' �,0$' lEc 3+ Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Estimated Cost !Ull�c s Type of Work: 1��� `mom - Address of Work: 1 1i Owner's Name: �� y Date of Application:_ 1 I hereby certify that: Registration is not required for the following reasou(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: �/L61 Date Contractor Name . Registration No. OR Date Owner's Name Q:forms:homeffidav °F t0wti Town of Barnstable Regulatory Services `�BAMSWMMAM ;' Thomas F.Geller,Director Apr M;j•`0 Building Division _ Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder the.subject propett - ._...:..._ . .. hereb authorize . .to`act on m behalf p Y in all matters relative to work authoiized-bp this building-permit-application for: (Address of Job) Signature f Owner Date Print Name O:F0RMS:0WNERPERM1SSI0N \ I H e_� � '\• \ � \ \AL us dr. \\�. \ \\ \ \ II ~ LOCUS PLAN scale:I"=2000, Cross No //J Parcel 133 \_ ,� \ \ \ _ I I Asses s or 'Porvice 45 13. 13,863.*SF \ \ \\ \\ -lino 2 St WA \ I I10, H 1 \ 1 O \\\4a\\\\X j I \\ \\ 3hd F\ \ 1 1 rr canf•o,.rfau \\\\\\\ / 1 \\\ Dose n 1 AAvndt \ \ 4Q4' 2 ►.s \ d 1tp 1 I Rwhed Pion.afrbmRtal eh« A° \\S 877135e E\ °� lJl�rll 1 SE9.8662 ! / 0 I W- \ RUP.5�to.o u 100.00' Too o/ r�ho. y. 1r AooUkamerlmna: �teo y h `�\ Prgecllams= 15E W1�at am \\ \\\ a Qe i / �� w)Q)a II This paged han aaeadr been IMUed and onea of GwIftwis 2 14,177.*SF Order°I ConStlona notwLissLed \ r / Tffiaplanr 0baound mdw I N 877135'1 W / lilt 165.83' / / II 1 \\ Birch \Street t.wAn.,,a (40'lede-Nhc, Way) ro II _... . . _. Oiraceonn to Site:Fawn Well fsa Rota -- —-s / SaaMer Are.to"an Sfdat Sffeat w / II wfnhdo CtalgM Beach Road.Take Rnh AYaute ad a Left fruo BfCh DAN / /15 7711e; .... PREPARED 81" PREPARED FOR: Noteall?aWa/art: SITE PLAN Sullivan EngineerUtg,hw. ®��� Raymond Quinton PROPOSED PLAY HOUSE PO eanr ass 7 Parker 655 22H Path Avenue 15 BIRCH STREET O426-m" °�^�855 Oaterv0le MA 07655 yyagt Hyenni'sport, Mass o W.HYANNISPORT,MASS. (�)e:e aa«(soe)ao-ans an (weHaea+fsmNlo a»a ro. 20 0 10 20 40 e0 I held: OroIE ` Date: Seole: Camp.: gwhW; April 3,20t?3 1".a20' Pro}/ VrVwN9/ ' i ' J SOL Board of Building Regulations and Standards :HOME I114PtOVEMENT CONTRACTOR Reitration 0718 WTI 2312004 'nyate Corporation MOGAN 8,CO I t- r l Francis Mogan Jr�, ^—a ' 68 JOYCE-ANNE RD':��-15�� Cente.Fville,MA 02632 Administrator TIONS IN G REGULA • I. ' BOARD OF BOIL D. CONSTRUCTION,CUPERVISOR License*-y \ 026071 Nwmbe[ ` Tr.no: 7319.0 cob Res,��tE i ( FRANCI'S E MOGAN e hi 'C ,,,, y a•'f 68 JOYGE ANN RDA _ Administrator ILLE, CENTERV MA TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 5 Parcel Application# o2dd 7d���� Health Division Conservation Division Permit# Tax Collector Date Issued Treasurer Application Fee Planning Dept. Permit Fee ( � Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address / //Z C /z , Village Owner rl�li��f S L ls� A dressGJv�uic� - � l c' Telephone Permit Request C36'/212e)a,o-7 Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new/VY _ c-1 Zoning District `L� Flood Plain Ground ater Overlay Project Valuation ` Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 8' Two Family ❑ Multi-Family(#units) Age of Existing Structure L/S-- Historic House: ❑Yes a o On Old King's Highway: ❑Yes ®�o Basement Type: mull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing 3 new Total Room Count(not including baths):existing 7 new First Floor Room Count Heat Type and Fuel: U Gas ❑Oil ❑Electric ❑Other Central Air: 0 Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑newt 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 BUILDER INFORMATION Name ��G � �l�d� t Telephone Number Address 11 Y 3 License# L Home Improvement Contractor# Worker's Compensation# ZCO/ L.' 0", ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE / FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED _ r MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ,�j FRAME �tC. -' �-I 0-7 � INSULATION P�� - a-7 FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT r ASSOCIATION PLAN NO. i v The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' d 600 Washington Street r Boston,MA 02111 www.mass.gov/dia r Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information i Please Print Legibly Name(Business/OrganizationUdividual): . 6�26V C47d04, 90`L• i Address: City/State/Zip: AP�J?W�st6-_I)W Phone.#: Are you an employer? Check the appropriate bog: Type of project(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. ❑New construction . 2.F] I am a'sole proprietor or partner- listed on the attached sheet. 7. P-Itemodeling shipand have no employees These sub-contractors have 8• ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp,insurance comp•insurance.$ required.] e are a corporation and its 101_1 Electrical repairs or additions 3.❑ I am i homeowner doing all work officers have exercised their l l.❑Plumbing repairs or additions ' myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs c. 152 1(4), and we have no insurance requed.]t � § . employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet sbowing 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 the pains and penalties of perjury that the information provided above is true and.correct, Si afore: ���—� Dater l 7 _ Phone#: S� Z 7 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ------------- t Information and Instructions . Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee-of an individual.partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein; or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that"every state or local licensing agency shall withhold the issuance or _renewal,of a license or permit to'operate a business or to construct buildings in the commonwealth for any applicant who has not produced.acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for:the performance of public work untilacceptable 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-contcactor(s)name(s), address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permiVhcense number which will be used as a reference number. In addition, an applicant that must submit multiple permit(license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,,- :please do not hesitate to give us a call. The Department's address,telephone-and fax number; The Commonwealth of Massachusetts pepaxt=ct of Industrial Aecidems Office of Investigations 600 Washington Street Boston,MA 02111 TO. #617-727-4900 ext 406 or 1-977-MASSAFE Fax:9 617-727-7749 Revised 11-22-06 www.mass.gov/dia !_ pF REgulatory Services 9r t Thomas F,Geller,Director Building]Division . Tom.Perry,Building Commissioner .200 Main Street, Hyannis,MA 02601 www.tow3,b arnstabl e.m a.0 s ice: 508-862-4038 Fax; 508-190-6230 permit no. Date • AFFMAYIT HOME IMPROVEMENT CONTRACTOR LAW -SUPPLEMENT TO PERMIT APPLICATION MGL c, 142AregmTes that the"reconstruction, alterations,renovation,repair,modernization, conversion, improvement;removal, demolition,or construction of an addition to any pre-existing ovrnei-occupied binding containing at least one but not more than four dwelling units.or to Structures which'are adjacent to \ such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of work:_ _ c . Estimated Cost Address of Work: owner's Name: U lication ! — `7 Date of App I hereby certify that Re&tratign is not required for the following reason(s); [],Work excluded by law []•Job Under$1,000 Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWIERs puLIMG TEEIR OWN PERMIT OR DEAIJNG'P=UNREGISTERED CONTRACTORS FOR,APPLICABLE HOME ZIPROVEMENT WORK DO NOT HAYE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY-YUND UNDERMGL c.142A, SIGNED UNDER PENALTIES OF PBRJURY I hereby apply for a permit as the agent of the owner; Date - Contractor Signature. RegistratlonNo, OR Date Owner's Signature Q y�pfiles.forms:homeatiidzv Rev: 050bDb ' RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 ' Alterations/Renovations $50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= L 2—of ,. plus from below(if applicable) x.0041= J 6 ALTERATIONSIRENOVATIONS,OF EXISTING SPACE L! b square feet $64/.sq,foot= *3 x.0041= plus ftam below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x,0041= ACCESSORY STRUCTURE>120 sq.ft. , >120 sf-500 sf $35.00 >500 sf-750 sf 50,00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq,foot= x.0041= STAND ALONE PERMITS Open Porch x S30,00= (number) Deck x$30.00= ' (number) Fireplace/Chimney x$25.00=' (number) Inground Swimming Pool $60.00 ' Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Prajaost Permit Fee Rev;0b3004 • ���He: ,� Town of Barnstable. y� Regulatory Services BAMUrABLE, Thomas F.Geller,Director MAM �`bplF 039. a � Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable..ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, f � �v�-Y� l.�irL•d ,as Owner of the subject property hereby authorize C.� �r.�-� ��C �`^� �' to act on my behalf, in all matters relative to work authorized by this building permit application for: . (Address of Job) ature of Owner Date Print Name Q:FORMS:0 W NERP ERM IS S ION I I MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 I I I I I Checked by/Date I I I CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 4-17-2007 COMPLIANCE: PASSES Required UA = 39 Your Home = 21 k Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 144 30.0 30.0 2 WALLS: Wood Frame, 16" O.C. 272 13.0 13.0 13 GLAZING: Windows or Doors 16 --- -----0.340---- -5-- ------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1 d 4.4. �+ Builder/Designer Date El • y MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 DATE: 4-17-2007 Bldg. l Dept. l Use I I I CEILINGS: [ ] I 1. R-30 + R-30 I Comments/Location I I WALLS: ( j I 1. Wood Frame, 16" O.C., R-13 + R-13 I Comments/Location -- ------------------- I I WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.34 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? ( ] Yes [ ] No. i Comments/Location I AIR LEAKAGE: ( ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or- I gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: [ ] I Required on the warm-in-winter side of all non-vented framed I ceilings, walls, and floors. I I MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R-values and glazing U-values must be clearly I marked on the building plans or specifications. • I DUCT INSULATION: [ ] I Ducts shall be insulated per Table J4.4.7.1. I I DUCT CONSTRUCTION: [ ] I All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. I I TEMPERATURE CONTROLS: [ ] I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: ( ] I Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified I in Sections 780CMR 1310 and J4.4. I [ ] I SWIMMING POOLS: I All heated swimming pools must have an on/off heater switch and I require a cover unless over 200 of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I [ ] I HVAC PIPING INSULATION: I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in.) : I PIPE SIZES (in.) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 i Low temperature 120-200 0.5 1.0 1.0 1.5 I Steam condensate any 1.0 1.0 1.5 2.0 I COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 [ ] ( CIRCULATING HOT WATER SYSTEMS: I Insulate circulating hot water pipes to the following levels (in.) : I PIPE SIZES (in.) I NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS I HEATED WATER. TEMP (F) : RUNOUTS 0-l" I 0-1.25" 1.5-2.0" 2.0+" I 170-180 0.5 I 1.0 1.5 2.0 I 140-160 0.5 I 0.5 1.0 1.5 I 100-130 0.5 I 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only)------------------------- I ✓fie 1°aonint�aulea�i o���2�aaaae�u.,delta � , BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR �. Number;CS 015834 Expires: 10/30/2.007 Tr.no: 7709.0 Restricted" 00 HOWARD W WOOLLARD PO BOX 263/3219 MAIN"ST C i BARNSTABLE, MA 02636 Commissioner w - _; ..�..LndllL))ZlYl2l��". Q.1✓���tYrQ�t ZC // hoard of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration:. 106615 E;ipiration:- 7/24/2008 TYPe:. Individual HOWARD W.WOOLLARD Howard.Woollard ���` 236 CENTER STREET D uty Administrator YARMOUTHPORT,MA e 02675 . P 3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION)l fJl) Map ! S Parcel Permit# fqq Health Division r 0 3 "-'L Date Issued S 9 O Conservation Division � � � G � ,.,, �;, t�� Application Fee - Tax Collector J, I Permit Feed S r 6 Treasurer �'t, fJV . 1—1 ` SEPTIC SYSTEM MUST ge Planning Dept. - INSTALt-IC iN COMPLI WjTN TITLE 5 Date Definitive Plan Approved by Planning Board WARONIVIENTAL CODEAJ Historic-OKH Preservation/Hyannis REGULATIONS Project Street Address Village 4- 4h , Owner ��,� Q,,..�� e.-�. Address 2 Telephone 77 513 ii Permit Request t ✓c z - 19 t(_0 . ,--f- 3 ®� /mz felm Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation /d v OO Construction Type Wooto Lot Size /44 .f"17 f Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. t r Dwelling Type: Single Family Ca' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes 9-No On Old King's Highway: ❑Yes &No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other S I'L" Basement Finished Area(sq.ft.) Basement Unfinished Area.(sq.ft) _ Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: Cl 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 BUILDER INFORMATION - Name f=D vvkocz a ,, Telephone Number - J 2-706 Address License# 2 G U 7 / P�t�✓✓�,� tAAP, 0-2-C 31-- Home Improvement Contractor# /00'7 J v Worker's Compensation# G R 23 taS G J k 605 �" 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE ,3 /. FOR OFFICIAL USE ONLY _L PERMIT NO. DATE ISSUED -..y MAP/PARCEL NO. j . ADDRESS VILLAGE OWNER, DATE OF INSPECTION: - FOUNDATION, -� FRAME ' INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL le - v PLUMBING: ROUGW Co FINAL ' s t GAS: ROUGUUy FINAL rn FINAL BUILDING r, , , y �� • .��r � 4T1 l7 M i , N ; 00 1 F► MS DATE CLOSED OUT cc A A v t ASSOCIATION PLAN NO. I oF'THE r Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services Fee A,�5 as t;p MASS.LE � ��a 5�o[ r '""�' Thomas F.Geller,Director �A 1639. a�0 TEo � Building Division Peter F.DiMatteo, Building Commissioner PERMIT 367 Main Street, Hyannis,MA02601 w X-PRESS R 11��'' Office: 508-862-4038 JUL 2 5 2001 �/M Fax: 508-790-6230 t`'► EXPRESS PERMIT APPLICATION TOWN OF BARNSTABLE / Not Valid without Red X-Press Imprint Map/parcel Number :2 5 J Property Address Residential OR ❑Commercial Value of Work Owner's Name&Address Contractor's Name p `L�v Tele hone Number ��" y/ c� � �`�'y Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance - Ch k one: ' F,am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name `.Vorkman's Comp.Policy# Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) 0' Re-side [Replacement Windows. U-Value . 3 (maximum.44) ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature Q:Forms:expmtrg:rev-070601 I� G n Y WI 2 St F Grass O Dwelling Gross # 222 / CB/DH FF= 13.5' Fnd a, L� 0 Wood WIF Shed Garage #g ' � I 6. 0 m I N 30.3'_ 0 Grass o 4 Asphalt �a la.D Drive CB/DH Fnd o \l CB 1DHd #15 RM#15 E1=10 0' MSL 1-112 Sty Top of CB DN W/F Dwelling 11 1.0 � � FF-13.5' � Flog i { 0 Po/e oGrass 14, 177±SF . ` n Approximat Location a Septic S tem / #4 os--_S . M � RR Tie 0 5 10 15 20 30 40 FEET Re—wall w TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �. d'f hd— Parcel / Permit# SQ26 11( Health Division / Date Issued f o Conservation Division cc u- A��Zq ewl fe4,m Fee 0 DO .s�l,,� w � Tax Collector o "171 �1a7'01 (,/ti TEM MUST BE r'�� a.J. Treasurer ,�� ���� INSTALLED 114 COMPLIANCE Planning Dept. WITH TITLE 5 ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board T'eOVYN Historic-OKH Preservation/Hyannis Project Street Address Ir 3/,ecA/ r)-?/.? yc� Village If, , �ti,�rsparLT ��i� Owner le �e,6ei�,�, !7 �_ Ca�ur�,il 1�/ Address Telephone Sree-7,7/- -13 Permit Request _rlas,- / Z Grid&'®� f /� �'til4 r4E' �l>�v�-vq CFO A0cnf VJ Square feet: 1st floor: existing /S«0 proposed 4/0 2nd floor: existing �-2/ proposed Total new 4,06 4 Valuation f//1<d 0 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0"" Two Family ❑ Multi-Family(#units) Age of Existing Structure rs Historic House: ❑Yes W o On Old King's Highway: ❑Yes 9IN o Basement Type: Erfull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) L1/2 Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing ;3 new D Total Room Count(not including baths): existing new First Floor Room Count 151— Heat Type and Fuel: &as ❑Oil ❑ Electric ❑Other Central Air: ❑Yes CYNo Fireplaces: Existing /" New Existing wood/coal stove: ❑Yes Gg<o 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 Et'(o If yes, site plan review# Current Use s l� _u;,-ffe_ Proposed Use BUILDER INFORMATION Name &Z4 Telephone Number 5"U�- �i'O,, U9 ' Address �'_6 J��, License# 66) W,( Home Improvement Contractor# //66� Worker's Compensation# lei e5 69-d, ,,r,2 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE '~ FOR OFFICIAL USE ONLY k PERMIT NO. DATE ISSUED 't MAP/PARCEL NO,.- ADDRESS i VILLAGE OWNER ` s DATE OF INSPECTION: FOUNDATION ' FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH. .. FINAL FINAL BUILDING DATE CLOSED OUT ` ASSOCIATION PLAN NO. i __ ie omm r r Department of Industrial Accidents Office otlonestf�rado�s -_- -=- 600 Washington Sheet fi-='- Boston,Mass. OZIll v4�'7 Workers' Com easation Insurance t ❑ytne: 1pC2tI0n: ��(JJJ ZL� ' lJ. / /1 A w (� / B!/ [� I am a homeowner performing all work myself. (� I am a sole roprt'etor and have no one worlds is anvpacily /p//// �///�'��////////%/"/�/ Dl%%Gv: � wadiug this on n ,: job. for ........ . ...... ....... .;:.;:..::.........::': ' ...........,:::;.:::::::::::::::::: din workers ::;:.;;:.:. .: >;; em laver rove g .... >:::::::::......::...:;:::::::::.:;:::.;;,:;: :coma ::.;:::.;:;:;.::.;:::::•..:..:•..:........}::::::.�::::.:..:.:::.::::::::......::•::............::::::•..............:::::::.::.<..:.::.;::>:::.:::...::. ....................... ........................................................ ' Tess.: ... `on>;h C IM ............. >isii:ivi:•ii'isi.'isi:i!•:i•>:v;{•}:{{{{{rX:.;n;{!{O:•........ :<i>ti:•i::+{?i5<•i:"i::::v::........ :::.��'.'.'.';..) :is{?+::�'Fii:: .<:-:.:J:ii:>?i ::i::'?�::.`i.::?::'j�i:::i:;:i•: ;i::�_::?>.: .::.:::::::::::::::::::.:':.i:::•::ii Ci:::_:::':::is i: ::i:i?`:::�:�:::::�.:::%.;;:..;:.:ii:::i::Y:::•.:::.:`::::.:•::.v::::.:....::........... .::.... � eral contractor, or homeowner(circle o�te)�have hared�CO��o�listed below who I am a sole proprietor,Ben have , co ensation oli owls w mP ..:.._::.�. . the following..........:.:::::::::::.:...::.:,:,.::.:.._:... .:::::::::::.::,:.....: :::.:.::::....:::::.:::.:.... .: cum ....... ............. ...:.::..... 1s .. ... ..........::::�:..... ......�::.�•::•:•:...•:v::•:v.Y,X•i}Su•:9}::..:5... ...�•:�:{..v:.:::�� .:v.vmv..:..i:X4::;:;{;ti nii:.N.v.:::::^`:t?•.�>::�:� itdtire ,......:....:.:..:.,. ............ ark.. }::1}:FF:•;:;•:::::::•:••:•::-:�:;•:;•:;•:•}c;>;:;,•,;::;..;;:;;';:•:;�:� ........:•...........:.......:v.........:r:::::::::.:?::::::::::::::::':':::':::'::::.:.v.::v:v.•::.:v:vr:.;.::: I}....:•n,.: .}.v:;{•}}}'t•:•:::... vii>;i}................................ :::::............ ................................... ................................................................::.:::......... ................................ • .................. :...:::::::n..•vrw:::.�:::v::v:;{.;.}Y{.:. ',t. ..a:y.}v.•Xv:i{.{v::�' ':rh,% x.-..v}:w::::..., .............:................:v..............:•:h.........................:.........,}r...v ..., .. nky} � }�'ij�.�:}4,::.....�,v.;{n•.::..;h' ..,wi}::{:::rn:;:�;:i:�iTiT:}::'v....::: .......... ::i^{ii::i 4^i:is i;::•i:•.......... -•,w::::i:?:::::::::::r:?}�::.:}'^}.t:v.::•.t}Y{:.:.:}..::.Yhw.tiO;.:.::.fi.:.. .. ............. ............................ .......................... }. ........................... .....::.;;::•::;:::•;:.:.:.:::::::.... ...... .....:::::...::::::....:.�:i;!!+i�•}i}::4:rii:•}:G:{�:�?`:);?:}r:i:::�i:ii:?:'1;.:y::;%:;:<':•:;::`:�:i:::�:is i::�::�:;.:�.. nv:. �...:.. ..... ... ..::::..:.::.�::.ii:::invi:?•isw:.v::-w'.....•:::v.:.nv..;.;.••:?.:....;.:v-r.v::::.}:v::::::::........:;.:.:.,.:.:•;iv-•::.,:;.:..,..:•.:.....:.- . nBfII ::::..........:. }:F:titi Y::F':ri'•'::i:rFi':}: .....�?i:ij:L;iiii:}Y::<:•is is;is:-i:2:}i:::?::.::}'i:::tv::::.�::......... a �::..:.:�:+.�:::'::`:.. ::.?ii:Y:?:iiY�FFi:is}r::iiF:iri•i;:}:?i:•}ji'ri�:`v:C}:<•}:•}:•}}: ............. ....:..:.....:.:......................................TIP ..:...,..�:::::::::;;:::::. ........ oil i II]vTsaCe con:': :: _ / to S1rso0.Qo sadlor Faif�a to fecoze,overage as required under Section M of MGL 152 can lead to the itap of anal peaaitln of a Hue np one yew,imprisonment as well as civil penalties in the fora of a STo of the K ORDER coverage am of S100.00 a day against tae• I uaderst>nd�a copy of this s may be forwarded to the OMce of Invesdgatlom Trader the airs mid peaallies of penury that the information provided above is trees mid correct 1 do hereby certify p Date ge oz�6 � slgnatnre �� _ Phone# s°P-2 e-�r�s�/ Pont name `` 4 InJIMIN official use only do not write in this area to be completed by city or town OMWA . • (]Building Department peradtAbcense# (]I,teensing Board city or town:— o Selectmen's OpIIce C3 check if inw edbate response is required ogesith Depatunent - ❑other_ -- � phoneN; contact person: Uryu a 9/95 PIA) Information and Instructions efts General Laws chapter 152 section 25 requires ail employers to provide workers' compVnsauou..for the Massachus in the service of another under any come employees. As quoted from the "law", an emplovee is defined as every Person of hire. express or implied, oral or written. An ern lover is defined as an individual, Partnership, association, corporation or other legal entity' or any two or more c p - the le representatives of a deceased employer, or the receive: the foregoing engaged in a joint enterprise, and including > lo. employees- However the owner of a trustee of an individual- partnership, association or other legal entity, emp ving erne Y who resides therein, or the occupant the dwelling use of dwelling ho use having not more than three apartments and eP use or on thethehogrounds another who employs persons to do maintenance , construction or rnP deemed to be as employer. building appurtenant thereto shall not because of suchemployment MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or rene se or permit to operate a business or to construct buildings in the commonwealth for�ypp o i of a license not produced acceptable evidence of compliance with the insurance coverage required. perfoanance of public work uffi ,neither the commonwealth nor any of its political subdivisions shall eater into �� chapter have been presented to the comractin= acceptable evidence of compliance with the insurance requirementsauthority. ' / //Applicants ' compensation affidavit completely,by checking the box that applies to your dMa"M and Please fill in .he workers comp with a certificate of insurance as all affidavits may be supplying company names,address and phone numbers along a Also be sure to sign anc submitted to the Departimeat of Industrial Accidents for of insurance coverage. overag for the permit or license is that the date the affidavit. The affidavit should be returned to the . S have any questions regarding the "law"or if not the Department of Industrial Accidents. Should S"0u number listed below. being at the ' are required to obtain a workers' compensation policy,please call the Department City or Towns rimed legubly. The Department has Provided a space at the bottom of Please be sure that the affidavit is complete and p has to contact you regarding the applicant• Please affidavit for you to fill out in the event the Office of Investigations number. The affidavits may be retnrne3 tc be sure to fill in the permitllicense number which will be used as a reference the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any Vestm please do not hesitate to give us a call. 's address,telephone r. and fax number. The Department ' The Commonwealth Of Massachusetts Department of Industrial Accidents pace of Inresdgadons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 Table J=b( ) Saaead with Fosd Faeb ,. Presuiptln Paeikagm for One aad Two-FiN*RaAWWNCW Soi~ MAXIMUum Calia6 RIa1( floor Baatmeat Slab �°� Acoofing DmnI ( -) U�ial R valet R•vatuo' lGVahmi wall Package TM I to 6500 Hestia;Degeee DAW Norami Q 1018 0.40 3E 13 19 !0 6 N 19 19 10 6 - � R lZ% OS2 30 6 U AFUE g 1Z•/. OS0 3E 13 19 10' Normal T 15% 036 3E 13 73 WA 6A Natural U ISYe 0.46 3E 19 19 10 a AFUE y 15'/. 0.44 3E 13 2S WA WA u AFUE R► IS% 0.52 30 19 t9 10 6 X 18% 032 3E 13 ZS WA WA N�mal mwnw WA WA y 18•/. 0.42 3E 19 13 90 A� Z 18% 0.42 3E 13 19 l0 6 90 AFUE AA 18Ye 0.30 30 19 19 l0 6 1. ADDRESS OF PROPERTY: 167 ARE FOOTAGE OF ALL EXTERIOR WALLS: 2. SQUARE f t , 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY 92): . 3 U S. SELECT PACKAGE(Q—AA see chart above): po-7- Ji5� NOTE: OTHER MORE INVOLVED METHODS OF DETERM MINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a 780 CMR Appendix 1 Footnotes to Table J5.2.1 b: azing assemblies (including sliding-glass doors, skylights, and , ' Glazing area is the ratio of the area of the. gl basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross.wall area. expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 fl of decorative glass may be excluded from a building design with 300 it,of glazing area. Z After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units: center-of-glass U-values cannot be used ' The. ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R 30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated.ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall.For example,an R 19 requirement could be met EITHER by R-19 cavity insulation OR R 13 cavity insulation plus R-6 insulating sheathing. Wall requirements aPPiv to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or`arages).Floors over outside air must meet the ceiling requirements. Tf:e entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade wails. Windows and sliding glass doors of conditioned br.,ements must be included with the other glazing. Basement doors must meet the door U-value requirement d_scribed in Note b. ' The R-value requirements are for unheated slabs.Add an additional R 2 for heated slabs. ` If the building utilizes electric resistance heating use compliance approach 3,4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1 a NOTES: a) Glazing areas and U-values are maximum acceptable levels.Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 035. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c) If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(035 for doors). 43 p THE r The Town of Barnstable � g Regulatory Services i659. �`° Thomas F. Geiler, Director'. TfD MA'S Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 Fax: 508-790-6230 Office: 508-862-4038 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. l Type of Work: A e�N Estimated Cost mD U= D C) �a�� Address of Work: 5 /3 Owner's Name: Pti� U l Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED ACCESSCONTRACTORS HE ARBITRATION PROGRAM R GUARANTY FUND UNDER MGL cPLICABLE HOME IMPROVEMENT WORK DO NOT c..142A. ACCESS SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav:rev-070601 k 4 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE O square feet x$96/sq.foot= 3er yd x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.flt.l >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00 (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) �7 Permit Fee / projcost .41 . I0910 YN SINNtl1H daiva�siN�vav 3NV1 H1HOASi K HOO 111I0 13H10V3 3.A11I8 jenptAtpOl :zeal d0ova/90 :1101 MY03 609911 :001�e�Ist6al 1013VIIN03 103AWRI 3410H 1 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number GS' ,,,,. 009975 Expires 08l1312003 Tr.no: 2479 Res dtod 00 BILLY E CAUTHEN 86 BETH LN HYANNIS, MA 02601 - Administrator NEW DORMER EXIST.DORMER NEW DORMER - EXIST.D ._..� ',;... ,:. � ... __._... ,. � ROOF NEW DORMER :.. ..... .. ROOF ..... NEW DORMER MER WALL EXIST.DORMER SET BACK - SET BACK NEW DORMER '�' ....... ............ ..":: 11 VNEWDOP SET BACK 8" .. NEW DORMER ISIE1 - _ . - SIDING TO ---- • ..: ......... .... - .... __........ .. MATCH EXIST. _ .. El SIDE ELEVATION 29-0 g.r SCALE I/4" = I'-0" FRONT ELEVATION ' SCALE 1/4" = 1'-0" . :.............._:_.. � EXIST.DORMER _ ....... _ :..._ ROOF ... .: ... .... .. ... . NEW D ORMER ROOF DORMER :. ..:.: _: i.. ... .. .. .:: -:.. _-...... .... EX15T.D WALL : .............. .. �� NEW DORMER _ .... ... ... ::.:::.. '. ET BACK DORMER . SIDING TO .,. MA TCH EXIST ._ .__ ........ ...... .... .... ..... ____ - ._ - _.._ ....... ........... __.... NU55 RESIDENCE 15 51RCH 5TREE-W. HYANNI5PORT,MA. II - 5CALE A5 NOTED APPROVED DRAWN BY D.O. REAR ELEVATION DATE FEB.21.200, REVISED e Wr NEW SECOND 0 ul I I— 5 ELM AVEINUE0ANNI MA.02rOI SCALE 1/4" = 1 FLOOR DORMERS soaps i300 .1F d j} DRAWING NU ELEVATION MBER A- I 1 29- EXIST.DORMER +'-Io +•-Io ��, TO REMAIN - r-99M• NEW 2X 10 RAPTER5 Q I G'O.C.W/1/2'CDX 5HTG. ii / EXIST.RIDGE <`ICE t WATER"Q ENTIRE ROOF-SHINGLES TO MATCH EXIST.. / EXIST.CIEL.JOIST D EXIST.ROOF NEW R-301N5UL. A55EM5LY NEW SOFFIT-ALUM.DRIP EDGE I X8 FASCIA BD.-I X8 SOFFIT - BD.W/CONT.VENT-I XG FREEZE / / 2-2X8 HDR.-CIEL JO15T / / HGR5.4 SNOW P05T TO RAPTER5 NEW 2X8 CIEL.JOST W/ ' IX3 STRAPS.Q 24"O.C. „ EX15T.DORMER / - _ WALL TO REMAIN / <1/2"GYP,8D.CIEL. / NEW 2X4 FRAMED DORM.WALL5 EXIST.ROOF _ R-I I MIN.IN5UL.- W/1/2'CDX 5HTG.-TYVEK t // EXIST.FLOOR A55EMBLY ' - SIDING TO MATCH EXIST. EXIST.FIRST FLOOR EXTERIOR WALL`✓ 29'-i• - I ' FRAMING SECTION @ NEW SECOND FLOOR DORMERS SCALE 3/8" = 1'-0" NU55 RESIDENCE 15 BIRCH STREET- W. HYANNI5P0RT MA. ,J SCALE AS NOTED APPROVEDDRAWN BY D.O. DATE FEB.3,2007 REVISED ,, NEW rJECOND - - OL50N D15ICN A550CIATE5 55 ELM AVENUE.,NYANNI5,MA.02601 FLOOR O MERS 508-7754300 oleo+a —�onm . �I DRAWING N MBER FRAMING SECTION A-� I' ATTIC STORAGE I I I I TO ATTIC S in 1— a. ' PX15T.DR IN �,wNtY IN QD. _________ ___________ _ __qy___ ;9--'ST EX T. O. __ _ ___ 5T. 4 . T RE IN --- _-- T RE AI —_____ m HALL EX15T.ROOF N D PM R OF ••/ \ N D R O EX15T.ROOF BEDROOM No ENLARGEDC ' ABED ROOM TO REMAIN • / �'�• TO REMAIN - a; ENLARGED Y _ENLARGED 4 LEDGEND EXISTING WALLS TO RE ........... MAIN --------------- EXISTING WALLS PATCHED TO MATCH EX151TING - = I / zz I a _ I NEW TERIOR 2X4 STUD WALLS- BATH NEW INTERIOR 2X4 STUD WADS _ IXDORMOt DDRMCR [AfA1CR DDRMCR I.-0 Ib�s/eu mxN.xw. •rz m�.ex..++: -0I 1�1 ,.. .. I I ' 29-1051a' - 1211/16' - 1 Ll 211/16' 1211/16' I211/16' 9bi' Sbi' IY I NEW FLOOR PLAN ROOF FRAMING PLAN @ EX15TING SECOND FLOOR SCALE 1/4" = 1'—O" SCALE 1/4" = 1'—O" A NOTE:THE GENERAL CONTRACTOR 5HALL VERIFY ALL 51TE CONDMON5 AND ALL DIMENSIONS AND NOTE5 ON ALL DRAWINGS IN THI5 5ET MOIR TO START OF ANY WORK AND 5HALL NOTIFY Dt51GNER OF ANY DE5CREPANCIES PRIOR TO START OF ANY WORK.THE GENERAL CONTRACTOR 5HALL IN5URE THAT ALL WORK CONFORM5 TO THE LATE5T MA55 STATE BUILDING CODE AND ALL OF THE LATE5T LOCL BUILDING CODE REOUIREMENT5(.DWG5,A-I,A-2.A-3.) " NU55 RESIDENCE 1 5 BIRCH STREET—W. HYANNI5PORT MA. SCALE AS NOTED APPROVED DRAWN BY D.O. DATE FE5.I5.2007 REVI5ED NEW SECOND 0LEQN 0SIGN A550CIATE 55 ELM AVENUE.,HYANNI5,MA.0210I FLOOR DORMERS — 506775-1300 a5ow�, N D9.a�L QFLOOR PLAN DRAWING NUMBER I ROOF FRAMING PLAN A-2 h _ _ - _. . H . . . . . . - - .'. - . . . r . " . r, t I . -- — `. , 1 . j 1 .. .. . i . t . . :. , _ . . . • .'. . . : . . (- 1. 1 , . • . _ . . . . , , . --- - ,, . 1. . vtu4F Ra7r - . . - is . --- - — - . . L-' '� . -: r---= I . . .� . . .,. - _ . . _ I i YOl ,r.E - .r — t,_ : —Or{. u9N CIZILLC�i . btrCf • . . , - I � . - : - . - .-.' I .. % , . . 1± , .. I . ., . . � . I I � I I � . . / . . I . . � I L�j :% ..', � . . . : 1 . . � . . . . I f. ��FoiN4-V nA,-ZH )�6T•-'T(P.1. . . . . .. . . .. , • . .�Z.ACD r .. . - . � _ _ , �d t� L.tuX. )d r .- _. .. .. . . . _ _ . . I/q d . , .X.. . P. 2 S izl— . . ... _ , , _,,- . _ . _. s 1, . Q zx�,e lh o.c. .Pr tee) -r Tt- r to r-__ , t 1 - �4 S/ A �' -- - _/2 Ox PtifLE9 TU M TY ESdST R1X.r.t. I. ._ _ _ Y.- , -- -- _a. _ -: .-:: -.:. , ..., ... QT r;-n�s I� o c. . ..: , zx . -. . _ : .; . _ s _ .: .. _ _ -T -- noJ , ,-. L .� ,: E. O H .: ,,; N' �('u "t tr. , :.. .: ALly, ,4 t sMe�o.L .. 1G1IN.11hL: I'11LTGl1,ES�tST'�7� XkL .: .: . . X,5 :S1a i6G1�D .;' . . p 1' 4 UR 6 , FOS- , . . . -. _ . . �DNtoN:�hLE -, . �,_fig,aK,l*'O# . 1tP'mA., 1. goor4P- . 6Y NtnFGPtFf/ - . . , - �.. E - . . it C'j�6E �I _ .. 8 �w1C, P 1 . . - , 1 ; - .. - . . _ . : .. .'. . .. , 1. y. . . , .:... i i. b=qgo Ys-1: _. vTu _.. ��pT �� :; ` � . .. R6 1'!X = H5t FL: x4crthl4 . - .., k,: , .. _ 7 . _ - .0 . I : -�_ . 0 . I , :._,��,- " � ' ' -r :. r :: q., . : - . . . .. . . t .. ::.. I� 11 , R..flt �.. G�. 1.,.. ;, , . r. ., , , _ Q v w v GIZOVI .. - - .. _.. ,, N -�7 .:. . . .. .. .. . , .. , . ,. .: .- .:. .r. . .-. r ,. .1. _ - 4 .. ,, ., .., - .. , t :.- ,.. ,.. , . 1. FLN R- : 7*IS Tl)R86p .,,.. .. -. ... ., �EI.1 f7i .f'IJITC.!"1 Y7C1 ST -. _._ .. _ :. .._.. - -. ,. ., . .. .. .' .. a ,. .� .. - TG 6 r�t -ra nx. �a 51� a t� ? 'rrP , r. _ ; , ;, .,. .- - t,. w .,r .. ., , -.,...n _ ..-. - - % i ..., . r' ..„ - .. S { _ y� ��'n , ,_.. ._._. , _s ..,.>. .. .. .r ,....1.,. - v a _. -• ;x. r - ,. : t , .. _. _.,r.. r •x N ..,. ...,_-. .... _. - x._. 5: :., .. .. i n a ::�a,.,._ _ „ ,. ... , i.t � ��� 5'r 1 : cN t }.. f x. a . . r. ,., :.. ..- ..-.r.. .: .... ... i L _. .... _ .� _ ... _. -... r - r.. ... .r. w J _ ., .. __. _.v ✓, G/ .. . .. ... ,., _ ... _. >. .,_.. _a .1/. a .. ".M. :•d :_; ���,r.�1�� AMI�DVED BY - _ _. . „ r-i-,4-. _�. .�!� �. .- -:.. .5,. -,. rt_ .. .. 4.. .. .i.-. .._., .. .. r.-, -.. 2 .K T� i ,f .>a...3 L.' yy�y -r�.,s:. n.r• a. .. t ,.. r -.e _ ....t w -t , r..„, ..,(.S. r4 7 ,°Y'., ['. ...' ..-. , ..,....t. ,t ,t `^,k, .FRS Cam. ,.r:r!-�: ?'c' lr. C as ,.t Y ..n.,. v .- _., !... _ ,._... .. r. .i ,,... ... .c t. 1 .�..-., ..I-L- .. .� . M, - 'J„' ,: .. �• ce.� f .,:.,3'Fv..' a .:-. i ..r , \. _.._ - .i±, ,. ,._. -. .. .n , ,.. _ ... .Y ._ .. 1. . -_.. h. dry sa, ., ,. < .. ._...., .-:, _. ..A .. .. ..,. 1. ,Y+. fr,. Xrf- _ s > � _ .,.. .. __.. ,_, w• .. � - ems', .. _ �, .. �.. f ,,.. _, o� r_ -::=... .._. ,e-_ -4- _ ..a.. . .. i .. - _._..._.. .. .. .:. , ..... _, ..,., a -s,r -. i..-- ..,, _.. .. 1_ a.x,E�_ 'ii'- -rif- ,t .� a' x � .teT. , .... I. - :� -. r .. .. _ __ -... �. :_. ., ._ .:.. ,._.. .. .. _. ...._. ,`, c r�-ace« <�© s s. ._. rr_.. _.,. ..._ _ .. ., _.°s'. ... t.� - _. _: ..-_. f. ..w ter,. _. - ..• ., .r,- •'-+w.. ?>s-. .. i,,. a ,, .., ....: ,,.t.,,. -. a _ _,. + ,.. .... - k. ..,,..i "',^ Gt r .s .i ... a... _., _.,. .. .w,. .. _- ^. - a .. ..r. S._..a. .. ..7 ra,sE. .. v3,. .,�. a,Cfi A,..r\a- .},. �ro• - ... . .. , ... t . ... :.._ a, x .. . fir, !tom ,..Y .�.,..., -t'. .-. \„n. _n.,v-...... :F. , v' ...e _ ... .�. a_ .,:. -„t 3 c,. .,: ,a,.. t.5.. - ? n7.r._` F.r ... ,. �. ... .. --. •, A ,.. . _. . .., � 'far. , >� .,,rrr � , ,..., _ ._ .s .t-. a: T+ r ..-. .. .. , ,. `-. .» Y... .. x., - t. x t_,. •rtn- xh_.r� .. Y. �. .. a w.: -. .... .-� .. -.,.. ..__. ,.. .. ., -_.a .. .. '..,..`5e_ ... z -..,, ,... ..,,.,..; .-.Y:.y.. ....',Y :,•� C`,��• y 23.. . 1Y. .. , .• 4. .L. K.' .a,. _ .. . .. _ €_ .. .. ...a �._. o.-...-.S na_-L .. .._,F,.. .w^... ,e <,.Pj 'T _ ..., , : ... -.,. ... ... ry ,.. "ems- .°^r3.� . .:: .>. -.-a. ?s- v .v,. ?c•: c� ..,.. , .?(r -. W ., ..- -K J ,. a 1� , ,. ... _ c YS .' .«. t, - ) - r ,,.--..!. -,-.. - }..n. ,fir, 1..Y. __. -,a s. --. a , ..-. ..-,1 1 a.-_..x.-r , .. . ... A. . 1 - a, .. W � wra. ,. .- .,_:3_ _ a _- _y L ._-. _. ,. .,.. .`2?. [, .: >-: 42 S :,.•ii••. '..Lm}� .r_. .., - r A. -, ... -.... __. ., ..: T� _ c .,. ,r- t r..v. _..... ...» _. vs.,- -."5 ... .4 - y .: ,�5.. .. -w ...a. » � ... ,�- '�.. - .. ,.. _ ,_ .. .,.,,. ,.. 4. ....t. ..- .. c t`k.- f ,+SK.. -S" ..s'�A.ff k` f ,„� .,. ,.._ �_✓..-.r • _... r-. ,•__ ...,n Fey ��.. si Y .,,. ... L.. .- .. a .4 �_ r ».�. w- n.. .. ..r _ f .- >~.i -..0,i'R..• .',,-Y, rC n. _ .. '... i..:. .r. ✓ � , .. .. , _ .. r ,- -...w- .. ... -.-.. ,-. -... .tubW59 uk.a �E H .. .G .- - .. _ _. _,�', _ a t.. ..b _ ... .k �. „: r['.'� .b�. „' t+'n_ ._ a.1a1.'.. tri �. �.,.. a . m _ _ ., _,- _ _. n - -..-... -f.. .. .�. � .., _ s.i, n .�. fit" . . �f.,�. •'.. ,a. +�ri.... .. '-'z1" ,. .. _r .�.. _ : ., .o.. .. C ., ta,.._. ..�.. w , •... _: -?i r .`t'. e. r t ,. r , - . i . - .. • ems. -, .. ... x k •. ._- .. 1. ,.... A ... _ -,.- 1 .. _, ..... r.. .'.. , Tn. ...> -, a - v ....:-..- ,. ,.. -.. .« _ ,.. -., -ry �... .. ... .. .. ,.. n._r,.� .nvy 4 ��.,.;may.. .r. .. a 4. .,VY{HF' J .'w 7- ..-._ .,r - .n m z .r .FT 9_ .:. 'Yi.. yy - .4 n,'' V•,, _,r.::"" ... .r ... .«� .< r '# u v .. ... 1,�,.. .- .z .a. t 'r2 , : ... ,t. .. .._ .. .Y -. -x Y' ,�T!� r .. 3,. 7 .j:-. ,3. .^1? -..tF' g... .. ,.. �n r .-,. .. : » ... w ., k �. ^G.Y ... .-. - e,.. , .-a` S:✓. � �.� dt -_r^. ,}.:' .:4'-. -',�' .l �- - •.�: 4.,qW ,r�- 1. .. .4t .... r.. ." e.. :,.-._ ... '. ._ � +a .__ ,,,.f' : -_. .. .+.a1`4v. -,,s.. .T ... :s S't `N. I. y�_ 'S'ti-..' ... - k'Y �, .-.. c...... 1', a t. J. , -, 5.. _ Q, .t.. ,-. T.. _lY' a ''L". ._ _. J.,:1•";,'r' k cfi .-, ... ., ., ,P'iif,.... .. - - ff. --<ti _ �. .,.. r yi•••• .-•.., ..... ..- a � v.r v.. .x .,.t -xE` >.F�=•, p -, ,.9..,...,,: , P.t .cfi '�^S...a rs. ..x. .a_ r .r .,_.r... � ... ... ..... r ,, -g� ,.x rb r- ,. .. ,-+.,Y ,.. a... "�. r .,. .. 8 - .,., .@c., _a ,✓ t., h.. �S �^ i a .'ti. +,. t _;% } ••Y• ». '�..., _. .,'3wsb xa,oELr�. _,_.,x!. F!°l.elarA',sw';.�'4_ a. i. ..r>af._, .:Y•:''�.` e•' ,:t"rfF e< ^._. <,.ss-_..n_,. .na _._•!:.2a. S.ve. „. . .Y.. ,.�. 14 •; s.fl"C .>L._ +d� , ...h•ui':A_. ,-:2`.2y.•r .-..r a: _:_».'.u' .:.3a.t5.. + .to? a„: . .,aa7,art...,�.k. _ , •.R .S'. ' fy�, . _._ . _,. . ---. .- L . f' . , - I ,� ' . . �� - ------_.- ."_- , . . �- f �.:,, . . I i ---- -- -- _ '% . . . I i------ --- - / . \\ . .. — • E - e:_.. . . - ::� I . , . ,�---,.�' - � .f] .� �, I I _ t \ - . . r \ , , . ,� :`� . . . : _o . - . . . . y.,. . , _, r r •5 i - . a I' . . 9. . , r . ' .- . a- VTV E ice+ . i. , I . j . _ __ , - - . 1 . —, . . L.. a i . . , / . ., . . . . . . . . . -- - ' < //p� — - -,: — . - w.. .. ♦ .,; «. - - Y .. .. .. _ '. - - .._ .._,r , :. j - .. .., -. l " � .,'I,, � , ..�.. ' .- . . - -; .- , . . - -_ - . -�: - . �A 1%I ". , �'. . . . ... ',. , - , , - •' - .. - / / , . , ' .. . , . . I / .a'', _ - _ J _ _ e . I FF�:I'3f•fi�F. . E— . L. ��7 1.:. .,, .. . c-.:. . r . , _. ". — I) , I ` - .. . . . _. ]� L .... , , : .ea- id . L f .. P.'_cIt " Wtt _. .: ,r .: .. .... .. .r .. c. .. .., e : .. ..... .._.. _. .. , .. - r..,, ., ... MAX „ 3 , _ _ ...-,-.. - is-.,.e, :...,,. _ , _ .. _ . i 1d�1bT t ..: .. ... _:. a _._. ,..,:.... AMS1 ,..,: 3 Y= a t . .. -,� .. ,. -,...,. r. ,.:...: -. �.r r .. .. _. r- ..,, .. .. .... a,_ .. _J"A .u., .... .. ... .. ,. .. ,.,,ti r ,. , .. ,:,. i. ..... .:.:... . . t- s. +. .... , .. .. �n .. , .. .... __.r-, -s t . 4 i': ,r r ..,: ,.., _ _.. ,. _ ., a r. ..r. -`n ...,.. ._ - .. x: .. , .. , .. :. , a..,.. .. :. ,. ?: 7 3..n _ a „ N .:, � ...1-11—, _.is t. ,.:_. _ .. .. ..:.. ..: . „. JLRD :. , . ,. ..v 4 .. ,:• , I. _. „ .,. . -SO -;,. , ,:,.. ._ A slob; rYlizY -r > .OWNS , '._. , . , y.L {� ., .. _ '� ,. .. ...v ... a .. ....., ... s .J. .. ., },tt.� v .... .. ,. .. ,. ... .. ,., „ - - 1•,.. v.. M. , ... , .T .-,. .. .. n , ` � �!stow_ :N ,.. �' - .. .,:.... ., .r w.. .. ... .-r l ._ d ., ... .... _ ... ,_ ..-., .1.. ..><, .rt-, . .., .. I. .-.. ..._.. _ F.J.: _. -.... ,.__ .,.. .<. . I^Y,!_ .. - ...., ♦ .. r. .,_ .._..- _.-,,.. �:< AL6 99999L. J . ..., - .s v-3� ,. .. _..... - ., .,_., ... .. ,k.- _ _ s n..a .,.-ar. - - _ - ..Y .. .. -_ _ __ _ , _. s - ., t , ~. x yw._ 1. i4. , -.r , .- .. - .. n.,... h :... _ -. r,. u .,.. .+ _a ^xc. VATE. e r - O -'.u"'E-' 111111 X- J xs- ..F 5. !,,, �'h iAW ..t....s , s s .: .. _ .L.-..n .3 e. .s ,-•3.. d ., c.r n. __,. ... ,.:._.a ?°3. :`gEN1idD r _ .< e . .. .. -, 41 .:<.w n,._ -_ x _t, �_ r� -- . l ,. . .hl,, .,_ <. ..1 �_. 1. ,•. n �-..... >. o . .. ...-. - .-.. .'t4 -.s. .m....'a. x t.- 4 f.�., -r.. " pKK a �..W .. a .. .. ... r. .. �,y - ,n ... x.,. l. .._ .. ... i is ,_ E., _4 .i ._. a _. ... - :'b... ',.. „ e.., K,,.. .. .. .. ,.>. .... ,.�....F rr� �r s _ _ ., �BT. ...r *� �x'�"'1.ia v�. _ '> ,_. ./ ....t -. �„�: .. ., .. .t v,._ t .,. r,-..,.�.. ,.. .,. _ .:x ... , t.... .,rr t ,.. .. f ,- 4 ':"?,-=..,cv- �Jy� ,t ?. - _. _ - _., r _. .. _ _. ., ., ,., _I _ , ... .. ._ a .- _ _t ,-- _. . ., ... 3:' U .. a s..a. . r.. ....- .c _. Ik ..ram . 2 a. .t,.. . . ._ _ .r. .. ...:x., _ -„M _ :w < 'd'. T: ., 1 _ .. ..-.. .. .., -t� .i.. �.. e ...sem .+... ., ri e 'tw. ,3,- C/IC:t - tiu(%1 .. ._. t _ _ -:.. ._._- _ .. _ ..-� -_. <.._:�.. x. :- ._ ..'-`�,,i':'..Ali >.. .. .:. �,,...:.•r ., !#a,":1,ty _. ._ .. .. _ s _ ,:. ..n. d.. i..... ... _ft .. , .Y P .._...a r, r .. .Yr .. - .._. h. lip mil_ - .. ,... - .c. _..,. .e_ ., _. C..a s.`-s. .ay. - .......A .. r.. F:n F' -q,.� a4-_,t-•s. <;' r. .• a F c t ,. .+.. ,.-, .., .F- _ , a N. -n rn••..t .n ,! F :DU., [ 3- ..C;.. _z.., ,. c _ �. _. "-sl r a _ .. a', s r. .. t i- a ., cam- .r. w <...,.. s _ n e _, .. +_.. n ..,� __: s... n k t . .aa `5.ns.., .s- -Tt,.,. , a.. f.{'H rX wS.,: -h_. W -0 �± x�.,F-..xsk.. ,.......,�.�v w.tr, .. _ . .s.. �. .:,, .. :. „_. _ _ .. _. . e .: .- _•=1�-i-v�rc13�e3FF1F`3`r" r_-:,♦:3.f11Ls,.,....,�§ , < „sv��isw,..,rla,vt��,*���fn..`T�,.,..�..�2'6.r s.t,..L�.,3,.ar.�-, ,,.. .. z.,-rs.,....... -t ��,r�:a�`'#, ,..r_+.3i.,'�,+. •r _. , a _ .. ..... <- ,_...._.�..a.. s,......,r. ., i.. ..r:'Llrrw�-.-7er<3r�.--,4_�:r:ls�.-v3�T,- a,.�:h+d...�h".t.a- .e�.p.�,..,w.,.•_... ,_+tx�:)�.�..-L,::c,..wr, -.::..�.-t-.,. .:rsm,al�.r. _R«,�,.5.,+ y,,�a<-Sr., .�.r.:.. ..e:ti�:. .. _. �+rs ,,. Al .. n,... .. . _ - - -- >, - _ _ _ --,t _ n_ , ,..... s. .. _ 4._ _ , ._ ,., ' 'mow z:: X, > h ,_ <. r__ a_�. ._ .: - _..- , ._ .rr ..,'»fir - ]..,. . .v ._ -r^ ._ <,.., ,. k _ max. . _..v_ , _ ., -•--' .•--`-M _... .s `.'k� 5.,�'"' ..' ;, �_ , ..,_ _,_ <. ,r_ _ . , � _-. „ _.. .. 2 ,._ �.- 7 .., z - _. . .. _ .. r _ _,. _, ... r... _. .. - -,. .. ., f .... z... . . . ._.- _ _ _ ...,.. .. ., - s.v th_ _�- _ Z'i ...-.. .... -.. ._ .. L .. _ -. ... ,. .., .... - , v... . .. _.s .. .. .. ...,�v. a^ _,,. , .,3,r ..R u.r -. > __ -, . r„4 t -.. ...._ _.. . . .... ... .. :. - C -. .- t. - _. .. ... .. ... . .. _.... C.., .., ..... -..._. ,. >. a.. .,.... ...... .. ... ,. "r ,. ....,... t .. hx ,�.. ... .... .,.. .... ..,_ l ,. :.. , ^.:. ..f , 1. : .. .. _ _ �_ .f - , . ...... .. -. .. ... :: „ .. „ - < ... :s' .: :: •: ... : .. -.. . . L . ... � ....-..:. . . ._ - _ .. :: r,_:.. _ _ , ,. - - . .• ., . . Y. F.'.. :. I .,. ..,...... .. ..: .:. .: , ..r >. 4 ,:., I , .., .. ...... ,h .... '.f .. ... �. 4 .: ,. ,..- Y,. .. : .. , _ . r , ......., .. ... ... e.., .. .... v. .- .. , ., .. - .. - - .e _ r ... .. a. ,. :. ... .,.. _,. ,,. .. . . .. .. .:.. .. .. , ._. . .. ::c ,.. .. r .,. . .... e.. ... .-. .. ,. ...... .. .. .. - ... _ 1. - : •.<: �. :. ... .. .. ...v. .. .:.. ... .,:..: ...... .... .. -.. - R r, - , .., .. .. 5 ...., ..t _ .,. .. .. .. .... _....- _ ... a .. .. .... .. ,. . .a ... ..... ., _ .. 1. ... ,.. I. .. . .. ,. - �il ;4{ F, .:' v` } .. .. - r ,,., . ., ... .. .:. .... .., ,L. .: . . _. T�+IS.u. LJ. ro �6 , .. i. !>Ot'- 5'o Jri3�E .�., .. ,. -. - - I. ., _ , .. _ - ,. :_ .. .. ....._ _ .. , .. 1.,.,: .. .. .- .. : - .. - �. .,:. , _ -- , a i ...-: .. . , .. - .. 1. % - , ... _ r;; : —. - . .. F ... - j:- . , , � 1 . ,. , .ff .E�. Q: . . . �- , , . % :... . .. >. :,.. . >... , . ,r c gQ 2UOr? k:Uoh z-J' 1ZpOr7 Fro'. r,, Ewb-f i gmcvcn POOR . . .' . - it, w. i. 1. _ j -: . , . - ( ' 1{ - . . : I _ 1 /l „;. ' - '-.. ..' . is r t I E, F'e-r "PLAceo wow ' % 1. i .yo I I .. I ':�*". 91 - .. ��N : : r. iv I. . . , . . . ., , . ST. . .I I9-ZxL ND25 A$OVi: . �� p. — - rlsl' uAiLe eEnkvty �x ura+. vovreta,��vo ?A'r6Fi G[:+11 .m ' . uNu/FiDOK •PpG%CTr B�wcEN GA-wow r .' . -. Q - WALL'5 To u I. . � - d - I I . ¢ 1�>�LN F3i1�jT OR - . Q NL I`IAT. AS �jELEC•r. Wlci .� , I . . —, - . O p.: RCf' 6XtbT' P&OSo r Gcwls N.I . . - - . . rx z�IxG� - - . I CA- . Tit�lI .1 STef� \g i ITt KoyAL 1. ' Z-ZcaWwi _ ve - . .. AT EQ W.DR.LIX.' _ mr� / i NEw 2 -w m _ 71 z l Z I !x%'75r ICI?GN��•l �NEH lcra✓t) Aa" 7w21o4+o{' cn 4 - O ---- -- _ - -il F-. - n. . . R - G �N .,. L. H _ Z G ... ,._ .. U<. NOW.FFDQ - R ,_ __ t - I/ i Q` 8 _ —--I OO r Z S�[�O 't . % r ,..-nvLo4l� + . 2 Tw 2 Q j , 't I i , . - Neu. ( .( - 8 y° gI-9u± j 51-0°+ g-,I�. EERY Z�4kI± _Q &J L�rJl��N9. . I I . fi lz"eo WALL Tzt, . A MAZU-H kFx41 . . I . -- ---- �XlSrT:.W.tiLLs To . — — E I e k-ey �� �nai�� - I_ I G o P�rec+t i. . + . l , . . . I 5-2 - . i + Do ; I 1 . _ - . . . I 29. 43 19 7 . --� _ _.. -- - --..-_. �rq 31I-, --- . 11 — -- ------...- --..__ ... - --- --— - - . ' ,. .. f L T .- _.._, ..-.. ,. VLX . . . i. 1 -. . _ - _ SCALE �4l'd,�.1'�1''APrFOVEO BY: ORAWNM-c:;V _ - .. OAS[.: '[_01..:. NFV19.6D .. _ _ �1 , G , . I� tPp ,r :.Lt �r Krc1 P WIAWIN6 NUMgCp,. rr`.. - , < 1. t l rail G7G?R N , F S:- i I AL I \\ AL AIL AL Gross .\ \� \ \ \ \\ .. 8 \ //�. // \ '•-. `� \\ \\ \ Ills - /c (� \ \•. 0��0�0� �o / f 1 / Parcel 133 \ \\ ,\ \\ II DPP®®P 13,863-+SF /10 / \ \ Gross O / ° 2 Sty W/F ` 1 �a\''•, \ Gross 222 213 FF 13.5' °B m 87 19 AL Cs o \ / AL AL AL _. . \1 ao l \\ \ Gross I N 1 1 \ a\ \ \\\\j 1AIL 1 Asphalt45.4' Z1/ `\ tno \ - . Drive Sal tmorsh- - - - � Md o \S 8721 35" a3 dn5 //�l 1 AL Md RM/15 FI=10.0'MSL 100.00' 1-1/?Sty 11 U I ALLai - . To of CB H \ d W/F Dwelling ll l I d5 1 ng AL 2 I 14,177tSF\\\ \\`/ /° I S.pk s°i.°t«vrra, //� l 1 N 87 21 35"I :' lll W 165.83' s •__ ° _ll : h��tl4 0 'L ti PETER '` SULLI I N m — — / I t I I // `q h 22733 — CIVIL ... \ - - D. ��C (40' W/de- Pr/vate Way)' - - • ees°°r .a �4 1�5 W ----- _ { AL 71t1e: PREPARED BY ! PREPARED FOR: Notes/Revis/oni OVERALL SITE PLANCD M�'/ .,> �ulhvan engineering, Inc. Raymond Quinlan at C��p�� PO Box 659 7 Parker Roed 222 Fifth Avenue. 15 BIRCH STREET & •222 FIFTH AVENUE ' Ostervllle, MA 02655 Osterville MA 02655 Wes Hyannisp WEST HYANNISPORT, MASS (508)428-3344(508�26-?115 tar (506)420-3894(508)420-J885.1vr t 01t, Ma ss I'I Date: Scale: !w 20 0 10 20 40 Field: Draft: September '1,'.1999 .• 1"c20' Comp.:. ;: Review: - Pro; Drawing ...._ _._ D D _4 a — 1 4 i 1r I i f jj � F•C?N� GM 1(r'W � � I �N� � � xel>MONO L-tll4V- (01 i 3 4-C'' �� •` '- r �a U N P,�+T�!O N "��.-.�,t•.� �',,�..��:: --��'...,��.4 � �'�7' �!C���� �v� w�...�.,r a�:.�i r,�! �ti_; t5t QCH S . SCALE �� �y..� _ APPRdVED BY: DRAWN BY DATE REVISED DRAWING NUMBER