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0436 BISHOPS TERRACE
TP.lrot2 . ,, Town of Barnstable Building \vim�. �, ^x• � TM^� �r � � "�, tA PostThis CardSoTahatateis 1/isible FromYthe:Street �ApprovedPlans.Must beRetamed on,Job and this Card Must be Kept • RAttiTAW.i. • �.3t. , ,'RP' ...-�cl3at� � �"� P.osterr d UntilFinal3lnspection HasBeenMade3 ` 4 s ,sir :� .' s631► a yamjlil +; ;Wh°ere a Certrficate of;Occu 'aoc��isYRe° wired suchBuld�n shall Notbe�Occu ied�until a,Fina(Irispect oo�has been�made =� �j t Permit No. B-18-2414 Applicant Name: Rebecca Collins Approvals Date Issued: 08/01/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 02/01/2019 Foundation: Location: 436 BISHOPS TERRACE, HYANNIS Map/Lot 250-069 002 Zoning District: RC-1 Sheathing: Owner on Record: BARNSTABLE HOUSING AUTHORITY C reactor Name REBECCA L COLLINS Framing: 1 Address: 146 SOUTH STREET o , ' �C ntrac tq License CGS-072020 2 Jk HYANNIS, MA 02601 Est Protect Cost: $22,342.00 Chimney: .; Description: SIDING,TRIM &WINDOW REPLACEMENT W1, Permlt Fee: $ 160.00 Insulation: �r g . Project Review Req: AT Fee Paid $160.00 Date 8/1/2018 Final: 37 Plumbing/Gas � Rough Plumbing: Building Official 211 & Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. � .� - Rough Gas: All work authorized by this permit shall conform to the approved application and theapproved construction documents for which thi's permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zon&ng by laws ann_d 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 inspector for the entire duration of the work until the completion of the same. ` V, IZIC Electrical The Certificate of Occupancy will not be issued until all applicable signatures permit. Service: Minimum of Five Call Inspections Required for All Construction Work: �� *F R 1.Foundation or Footing �`,; � � Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 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. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT r�. e Town of Barnstable � RECEIPTw 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-18-2414 Date Recieved: 7/25/2018 Job Location: 436 BISHOPS TERRACE,HYANNIS Permit For: Building-Siding/Windows/Roof/Doors Contractor's Name: REBECCA L COLLINS State Lic. No: CS-072020 Address: FALL RIVER, MA 02722 Applicant Phone: (508) 678-5201 (Home)Owner's Name: BARNSTABLE HOUSING AUTHORITY Phone: (508)771-7222 (Home)Owner's Address: 146 SOUTH STREET, HYANNIS,MA 02601 Work Description: SIDING,TRIM& WINDOW REPLACEMENT 'Na V W A Total Value Of Work To Be Performed: $22,342.00 w ^n Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants.no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Rebecca Collins 7/25/2018 (508)678-5201 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $22,342.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $160.00 7/25/2018 $160.00 XXXX-XXXX-XXXX Credit Card ., 1._.._...... 1239 ........ ............ .......'. _.......... Total Permit Fee Paid: $160.00 THISIS OT A Pr ITT 3 r , ' 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map C) Q Parcel Application # -" �u Health Division Date Issued 12-1�/L I Conservation Division Application Fee Planning Dept. Permit Fee oVS Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis ` �M F'Z,-L- S EAJ T Project Street AddressC-e— Village Owner Z K41 N � 05% Address Nti Co J�S4q ft KK%'15 Telephone Permit Request �e.Mo v'z '��'�Cv� V} 'llh� '�S�Q tot-+•ate`l��-�0��� w Y� - Square feet: 1 st floor: existin, !o O proposed � 2nd floor: existing%�32D proposed Total new d Zoning District Flood Plain Groundwater Overlay Project Valuation ` +vim Construction Type wo®k Lot Size Flo SSS56- 'A%5L Grandfathered: C(Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) CD Age of Existing Structure o2�_k WO Historic House: ❑Yes XNo On Old Ki '"s! Highway ❑Yes 14No Basement Type: )I-Full ❑ Crawl ❑Walkout ❑ Other =E - `' Basement Finished Area(sq.ft.) O Basement Unfinished Area (sq.ft ) - Number of Baths: Full: existing new Half: existing new c� Number of Bedrooms: existingb new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: §I Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes Q!IkNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# ,^,`` l 1 Current Use ��J1(�2F'l�' �"1 Proposed Use � � - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name V�-�r\- . sl�'� P Tele hone Number Address �s License# �3 Home Improvement Contractor# Email S� fi��5°L�c 'l Fr\(XnO •Cc;lt& Worker's Compensation # ALL CONSTRUC ON DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO %,A f AA O o�h SIGNATURE DATE T FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. - ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE F ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH ,1 FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Comm mvealth 4 jrMassadhaetts D eparbwmt of1kdksbidAcddmdr Orke of gado=. 600 Washizz&d x,S`re e Bastin,ALA 02111 Wurl & CCMpeasalinInsnrzixce Af ffiizvit BvffderslCtM -S edXiC clPE ers Please Prfid C16 Address: Are YOU an employer?Qpeck.the apprepriafe bcm Type of praject(required).: I_�k-ant a employer wiffL r 4. ❑I mn a genund conimctur.and I 6. ❑New c onshuction employees(fall an°dfor part-fime * 1mve,Im-ed S&e sub-ConbEa;Eom 2:❑ I am a sole propsiekc orpartnw- listed Omthe att9ched shy 7- ❑Re— ship odelffig and have no These sub-cazfractam have �1�� S_ ❑Detnaliiioa - wa king Bume is any capacity- employ and have world rs' [No Wodoers'cflmp_h ate*e wrap.insmanm—1 9. ❑Smldmg addifior< required I 5. ❑ We are a cmpom im and its lb-[-]Electdcdrepaimorad&Eons 3_❑ I am.a bomemm2er doing all words offit:ers have eseressed ffiek 1L❑Flumbingrepaim or addificans myself[No warlmrs' ❑ 1?of emunp6=per MW- rqnin ia d-]i F- c_M,§Its sadwe have no Eflai` so e emloye [NoWolklme13_O Otfier camp.limxance require&] •hap spy&�B�at c�e F�aa mast eLsa fiIlooEthe sec@aabeTow�auiag�e¢umn�es'�mpaupaTitgiaa� #�arn�s s�o subs�s�das�ig 8ney sse daia�sg taa�c and�hixe aozsid�caamst sQEFmit anesv�da�t india�in�sacSL FCaatmcfta*d theclrthis bow mast attacheIl=sddiff sheaf shammgthenxmpof die su3s�a Zad state Vrhedm arnotthese eat sha�� employees.Ifthe sub t tx��Ise e�gIvfers,tizepamstpms*L-thek webs'—R.Fly meet I am me ezjfpZaisr tliaf is pr y ry vrkers'coa peesrdfcrn uasrirarrca for emlvfay�es �eTnav is Elba p�r�cy jQFa e isform�crt l - Iasr�ceComgaame:�NCye-\�r5 Pa&cy 41,or Self--�11c_ '� �V � �� S I giratiau Dade �Cj" D_ 1`( Job ate Addre .'� o�- hS"b 0'S T'`h'�Ce✓ ^ AA C415 Attach a cagy cif the warkwe compensafioapolicp decEwafioa page-(shawkg the�policy�b and espa-ation date. Fare to serum coverage as regniredunder Sw6m 25A of MCL c_157 can lead to Sie imposifiaa of cairnical peoalti of a fide up to$I,5Of}OQ and/or one-gexrimpris=nenf:as well as civil penal/-s m the faint c f a STOP WORK OR DERattd a f me of up for$250- Q a dap ab-ainst ffie violater. Be advised flrata coP'y offfim sfiatement maybe finwasded to fhe Office of. firvesffgafions of fhe DIA.for imsmmm covexage Fdo hffeby the $erjury dwt trio infarwi6=pralid dabmw h true and carrect S+iMm3tar- Date_ f I 7do Phow ik �C/F —&tc-)�F U,oiai uss aRTY. Do curt write in dds urea,fit be c ompfe nd by city rar toopm*Xk-&L City or Town: Permsifficense# Lxsnffig AUBarity(Cink tine): L Baand of health y Buffiring Degarfrneut 3.Cityffavm clerk 4L Decfrical hmpeetor S.Ph bi g hpecto, 6.Odw Camlact Person: MOW#: 6 NMI J,/: •.I: _tltl.Alt. t : .■.t/t� :•t•1 i.. 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J � :)_ • ' A WC Guide to Wood Construction in High Wind Areas. 110 mph.Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 EZ check 1.1 SCOPE Compliance Wind Speed(3-sec.gust)............................ ...................................110 mph WindExposure Category............................................................. ..............................................................B 1.2 APPLICABILITY Number of Stories ..............................................................Fig 2)............................_stories S 2 stories RoofPitch .........................................................................(Fig 2) .........................................._ s 12:12 MeanRoof Height ..............................................................(Fig 2)............:....._..........._..................—ft :5 33' BuddingWidth,W................................................................(Fig 3)........................:7............... -ft sw BuildingLength,L ..............................................................(Fig 3).......................I........................-ft :580, Building Aspect Ratio(LNV) ...............................................(Fig 4)........................:........................_:5 31 Nominal Height of Tallest Opening ...................................(Fig 4)................................................ 5 618* 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2).............................................................. 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete............................................................................................................................... ConcreteMasonry.......................................................................... .............I..........I...................... 2.2 ANCHORAGE TO FOUNDATION1,3 5/8'Anchor Bob Imbedded or5/8"Proprietary Mechanical Anchors as an alternative In concrete only BoltSpacing-general......................I....................(Table 4).............................................- in. Bolt Spacing from endfijolnt of plate ............................(Fig 5)....................... in.5 6 -12" Bolt Embedment-concrete.......................:.................(Fig 5).............:................................... in.;_*7' Bolt Embedment-masonry........................................(Fig 5)........................................_.. in.'e-15' PlateWasher................................................................(Fig 5)...............................................Z 3'x Yx V4" 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 55).................................... Maximum Floor Opening Dimension...................................(Fig 6)............................._ft:5 12'or L/2 or W/2 Full Height Wall Studs.at Floor Openings less than 2'from Exterior Wall(Fig 6).................................. Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall................(Fig T)...................................................._ft :5d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall.................(Fig 8).............:................................ —ft :5d FloorBracing at Endwalls...................................................(Fig 9)......................I.....................................I.......1. 1 Floor Sheathing Type .........................................................(per 780 CMR Chapter 55).................................... Floor Sheathing Thickness.................................................(per 780 CMR Chapter 55)....................... in. Floor Sheathing Fastening.................................................(Table 2)..__d nails at—in edge I—in field 4.1 WALLS Wall Height Loadbearing walls........................................................(Fig I b and Table 5).......................... ft 5 io. Non-Loadbearing walls................................................(Fig 10 and Table 5)...........................= ft :5 2'6' Wall Stud Spacing . .........................................................(Fig 10 and Table 5)...................—in.:5 24"o.c. Wall Story Offsets .........................................................(Figs 7&8)..........................;................—ft :5d 4.2 EXTERIOR WALLS' Wood Studs Loadbearing walls........................................................(Table 5)..............................2x ft in. Non-Loadbearing walls................................................(Table 5)..............................2i_-_ft_in. Gable End Wall Bracing FullHeight Endwall Studs........I..................................(Fig 10)............................................................ WSP Attic Floor Length................................................(Fig 11)................................................ ft kW/3 Gypsum Ceiling Length(d WSP not used)...................(Fig 11).......................................... . ft z 0.9W 2 x 4 Continuous Lateral Brace @ 6 fL o.c...(Fig 11)............................................................ Double Top Plate Splice Length ........................................................(Fig 13 and Table 6)..................................... ft Splice Connection(no.of 16d common nails)..............(Table 6).......................................................- • , T , AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Mass achasetts Checklist for Compliance(780 CMR s30 .z.l.1)1 Loadbearing Wall Connections Lateral(no.of endnailed 16d common nails)..............{Table 7).................................I...................... Non-Loadbearing Wall Connections Lateral(no.of endnaled 16d common nails).._...........(Table 8)...................................................... Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans .............I..._..................................:...(Table 9).................................._ft_in.511' SillPlate Spans ._........................................._.......(Table 9)................................_ft_in.511' Full Height Studs (no.of studs)............................_._(Table 9)........................................................ Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans... .......................(Table 9)................................._ft_in.512' Sill Plate Spans.........................................................(Table 9). .......................... ft_in.5 Full Height Studs(no.of studs)............_......................(Table 9).................................... Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously" Minimum Building Dimension,W Nominal Height of Tallest Opening2 ..............................................................................._5 6W Sheathing Type............................. ..(note 4)......................: Edge Nall Spacing........................................ (fable 10 or note 4 if less)........................Nap Spacing........................................ T —in. .. .........................................•...... _ in. Shear Connection(no.,of 16d common nails)(Table 10).................„..................................... Percent Full-Height Sheathing...........:...........(Table 10).......:........................................ % 5%Additional Sheathing for Wall with Opening>67(Design Concepts)..................... Maximum Building Dimension,L Nominal Height of Tallest Openlng2 ....I......_.... Sheathing Type.......................... ... ...... ...__.(note 4)...................................................... Edge Nail Spacing.........................................(Table 11 or note 4 if less)..... Field ...................—in. eld Nail Spacing..........................................(fable 11)........ in. ......... Shear Connection(no.of 16d common nails)(Table 11)...............•........................ Wail Cladding .................. Percent Full-Height Sheathing.......................(Table 11).........................._..._..................... 5%Additional Sheathing for Wail with Opening>6'8"(Design Concepts)... .*.............. Ratedfor Wind Speed?.....................:........................................ ................................................................ 5.1 ROOFS Roof framing member spans checked?.......................(For Rafters use AWC Span Tool,see BBRS Website) _ Roof Overhang .................................................. (Figure 19).............._ft:5 smaller of 2'or L/3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12)............................................U= plf Lateral able 12 =Shear...............................................(fable 12).............:..............................S= pl Of _ Ridge Strap Connections,if collar ties not used per page 21.....(Table 13)..............................T= pif Gable.Rake Outlooker.............................. . (Figure 20 — ( 9 } —ft s smaller of 2'or L/2 ......... .............. Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift_..............................................(Table 14)............................................U== lb. Lateral(no.of 16d common nails)...(Table 14)................................1...:..L=lb. Roof Sheathing Type...................................................(per 780 CMR Chapters 58 and 59).................. RoofSheathing Thickness.............................................................:.........................._in.2 7/16"WSP — Roof Sheathing Fastening...........................................(Table 2)........._.................._................._. Notes: .."....-- 1. This checklist must be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1.ff the checklist Is met In its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Comer Stud Hold Downs per Figure 18a. 2. Exception:Opening heights of up to 8 it shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2.in.nominal thickness.pressure treated#2-grade. - ' y �t�F`C Grade to Fi��ad Consiructiott u7li¢�fr j��uzdtlreas_IZD rrtr f3'`rndZarxe Alassa.chusets Checklist for Compliance(na Cmiz-gaD, TJ 4. a. From Tables ID and 11 and loon of waU Wmd[ring and gur7dmg A;p Rafio,determine Perrint Full-Helghf Sheafffmg and Nail Sparing requirwzrrfs b. Wood Structural Panels shall be rntftum thidmess of 7116'and be installed as folioWS: L Panels shall be hstalled Wr strength ass parallel to siuk - ii. M horizmTM jotzis 3M=r over and ba:narled to fry- g. uL Dn single stafy cansfrucson,panels shall be at33ched to bottom plans and topinember of the doubleIDP -----_-----_-_-.--- -.—ivt Dniura- affachadtoJhefapmernberzffhe.upper double top-- ---- plate and to band joist at botbm of panaL Upper affac ment of tower panel shad be mada to band joM and lovverattachment made to lowest pfada-at first Morframl g. . ' V. Horimntal nmr7 spacing at double top pheh--,band joists,and girder;shd-be a double r:yw of Bd - staggered it 3 bdzes on marder per figures below:Varffml•and Hxtmnial NaTrng for Pane!Attachment 5_ Gking pmta�anew house orhQr¢ontaladd"tfion—required Fpojecfls'f n-Me ordosarto�shore(generally.south of Rte,ZB or north of Me%0 - � b)VeT�aI a!ddffian—oat requ6�d unless(here b wive:rgrrr�on to$ze lust floor c)replan mentkidows—needs azergyconsev aiion comnpfrafrce only(crap 93) - fi Wood Frame Cormtruc9on Manual(1AFCM)for 110 MPH,Exposure B may be obtainedfrom the Ameririin Wood Caunc3l (AWC)wahsiie: V ' r�urn "RrVIt Li i - IL tl [ ill K l ,i - it Ll s F L � i ti . - s jrI,•Q L[ . o • i - d Ll I Ur it `r L i . s[ [f [ - d..f� rJ. 1 1 1 Lc • t + iT,c _ II Li to tl� ► c t E It AL 1 t cl S ` Se s Bard on Next Page ' v r5C3J and Hr4mrAall lwTrng - �ernrral sod Noliz�NaiCmg . for Panel Attarhrnt foF Pretzel Affachme if -oh— ;lu,00 IInn 3 = U V' N ro•S�+ - . o :�jci�-f�►s c--r �l � >7 ��Ll D� T.Co Z�•7 •* S Z� SQ } 60.00 �o 'L, AS PR Pg eE p FoR; CAP LE: .�_ 7.Z-7 . EFE,eC,vCE: aATL�: S I Z B� 1ZEv 11(7J e� L ) l _ /�ECEBY CFGT/Fy T,ygT- T.t/E BV/LDi.V� O.V TNiS .oL q�/ 'oci.�ia qs S L O C q TE a O,t/ THE Q� � ENO W.t/ ,te7 Tc Tl-f.b f �E-Y_du1 EMC,vTS OG Ti-F� Tow..! w;-4E,.! `N OF , �tt/r7 CB�e Cn /r�Gr'/rj �� ARNE OJALA LA- a .TcitvEYov3 s�e? r �e p Nq 2634& Q s �: r f , 3Cp y . e 14LX4� , ve ZF sel � a'sT�ee AC�® DATE(MM/DDNYYY) - CERTIFICATE OF LIABILITY INSURANCE 10/31/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A.CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Kathleen Geddis NORTHWOOD ESHBAUGH INSURANCE AGENCY, INC. PHONE Exth 508 771-1632 A No: aDOREss: kgeddis.north24@insu mail.net 540 MAIN ST. INSURERS AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURER A: TRAVELERS PROPERTY CAS CO OF AM 25674 INSURED INSURER B DEAN F STANLEY BUILDING CONTRACTOR INC INSURERC: INSURER D: 359 CAPT LIJAHS ROAD INSURER E: CENTERVILLE MA 02632 INSURERF: COVERAGES CERTIFICATE NUMBER: 98719 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD MWD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE 7 OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO ❑ POLICY❑ LOC PRODUCTS-COMP/OP AGG $ PRO- OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED (Per accident)AUTOS AUTOS )N/A BODILY INJURY(Pident $ NON-OWNED PReOPa�Rde DAMAGE $ HIRED AUTOS AUTOS UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X1 STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 A OFFICER/MEMBER EXCLUDED? WA WA N/A 7PJUB2E49857516 10/08/2016 10/08/2017 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached it more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.ggv/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 230 Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601 G� �.� Daniel M.Cro y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Town of Barnstable Regulatory Services ` MAM Richard V.Scali,Director. c►�� Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder. y I, ::�C)V,,,�r1. N.1-1c, , as Owner of the subject property hereby authorize r, to act on my behalf', in all matters relative to worm authorized by this buil " . permit application for. ti `\ (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 accepte I � "&6V Signte of Owner Signature of Applicant , Print Name Print Name 4 Date Q:FORMS:OWNERPERMISSIONPOOLS Town of Barnstable /g Regulatory Services oxTME Richard V.Scali, Director Building Division �+ t Paul Roma,Building Commissioner NAM F�� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# _ CURRENT MAILING ADDRESS: ` city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. i DEFINMON OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached'structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be,considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required . shall be exempt from the-provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a,person(s)for hire to do such work,that;such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require, as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Al € sA� f�: aa < ,� \ � # w yam' �. . -, m 1 t v i r � 5 s a� s � a 6f-ilPA s 4a as iw+e \ x �f yva IN, e a aZ x a E3*a `� `„shy ` " • 44. a c; E Sao a A r' p< .. i ts mild END FA � a m y\nP 4 �x E o.. 8 Ysoma, t k .� 0801 e as ro : WHOM I I o•TME�o TOWN OF BARNSTABLE P 32185 r � s Permit No. ................ • BUILDING DEPARTMENT D°8:a f TOWN OFFICE BUILDING Cash X HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Bayside Affordable Home Division Address Lot #13, LC 126, 436 Bishops Terrace Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. D.ecember. . �. 19..... 7 88 ......... .. .... ...... .. .... . r � ....A� ................... Building Inspector I.alu TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING tg ■6 9 �'oruY►� HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has1 been issued for the building authorized by Building Permit #..�; cl,/. ................. _... ........... ..... _ _. y ! issued to //l 'l/,� / ........ X fll� ....... .............._.._ Please release the performance bond. i r�' DATE CONTINUATION OF ROAD BOND BUILDING PERMIT - The undersigned owner/contractor hereby agree 'to Mz S 3'i:R r0aJ bond in force until the following wor items ary yo satisfaction of the Engineering- Section 0y. the 14orks. / loam and se--dshou ders as soon as weather permits. other (explain) <404ED ner/Contras or EN INEERI fTHORIZAT N q� TOWN OF BARNSTABLE, MASSACHUSETTS DATE j 19 Eri.A 1 T N 0 12 APPLICANT f, d 0 Al I j d i ft Q 117 C ADDRESS ill �2 ;00564:5 (NO.) (STREET) (CONTR'S LICENSE) i NUMBER OF PERMIT TO STORY Siil��.le � 1 DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING AT (LOCATION) ,at 413 , 4 3,6L. '-.3.1 i-lvarnlis DISTRICT (NO.) (STREET) Terrace BETWEEN AND (CROSS STREET) (CROSS STREET) LOT, SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT; LONG BY FT. IN HEIGHr;ANO SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: sowor �2325 f3ond AREA OR 76i� 000. PER VOLUME ESTIMATED COST $ 8 4 00 FEEMIT (CUBIC/SQUARE FEET) OWNER BUILDING DEPT. L ADDRESS BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES As WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL M EMBERS(READY TO LATH). 3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS y�J�� 2 2 2 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT _54'q#:Z7— M OTHER BOARD OF HEALTH W!LL ECOME NULL CON B AND VOID IF CO WORK SHALL NOT PROCEED UNTIL INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIOULIS j; IS NjT S'rARTED WITHIN S:.'. iAONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. NOTIFICATION. F BARNSTABLE, MASSACHUSETTS BU®L®'NG PERMIT DATE _ ..._19 �— PE:rn'AIT NO APPLICANT :.:c. ..` '..';t.. ADDRESS e. •>iar >:, �Y:r, =1 L.3.1. �`l..J__:l i!UU5V�i.J (NO.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT 70 .�i.i i - lil;d• (_I STORY ,'•,�',.:�.%. :'.4 DWELLING UNITS _ (TYPE OF IMPROVEMENT) NO. (PRO'POSED USE) ZONING AT (LOCATION) ""'� •``; '"" `� — DISTRICT - (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT: LONG BY FT. IN HEIGHTIANO SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: ., d AREA OR :.);J ,__ . Q. i 41 y l,)l�U r;;.i - PERMIT (•j� JU VOLUME • ESTIMATED COST $ FEE (CUBIC/SQUARE FEET) OWNER .��!; r I BUILDING DEPT. ADDRESS By THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET. ALLEY OR SIDEWALK OR ANY -PART THEREOF. EITHER TEMPORARILY OF PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- ► PROVED.BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH.AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINEE FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE:APPLICANT FROM THE CONDITION' OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH). FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 6 2 3 HEAYAG 1 PECTION APPROVALS ENGINEERING DEPARTMENT 7a OTHER BOARD OF HEALTH r:FFII�!T 'NILL BECOME NULL AND VOID IF CONSTRUCTION WORK SHALL NOT PROCEED UNTII +� :��:;OFI: j INSPECTIONS INDICATED ON THIS CARD CAN TOR HAS APPROVED THE VARIODUS S 'r,.-r, ' "'•• 1S NOT STARTED WITHIN S:.`': !ONTHS OF DATE THE AQRANGED FOR BY TELEPHONE OR WRITT CONSTRUCTION. .i! I' I S SU`. U 'i 'i' ,:' `•'7 NOTIFICATION. L...... .................... ...... • � i JV.00 I, Ur J Lam; i I 7 t. 60.00 i �,vMMclr.lcT'Y PA��t Z.-,t=pvv1 -oovS C • " g7-0 ( 7 PREPARED Fo R: L ocATio.v: RtsNn�s -f�¢.e� ,a-J��4�a��5 .2EFEe�.c/cE: Tzj-=v. $c..11c..�1�...cC-� = i,/FCEBY CECT/FY 7-AAg7- TtIE 49U1Z- �I.V�r Sa/ON/ti/ O.V Ts-//S PL<i.V /S LOCAiTEa. O.V TA/E .9BOc/.VD AS 3.a/OK/.V /-/EGEO.V H OF , Z&OU i f-S McAj7-S OG T TOt.J-J L-1. 4 ExJ Go v STQcJLTB7 . y�E4 `rqC ! o�' ARNE tiG 1 H.c8�e �n9inecr-�r�9 0 oJAtA o� No. 26348 Q �i✓iL E.VGi,tJEEL3' ,Q 4, cOc/TE GA -Yne,V10C/TAI, .t.1�73�. t r .e�G. sc�tvrYore i l PLANNING BOARIS .� � (0 �. P I'C�Gt,Y- ��/� { j r1i I Or I_ �OLl DR_ 1 N O 7� U Lra _ 60.00 1 T��Eerl s+��..1 u�s �•.� F�o� C<+M M tlr.1 t TY PAntE-t.. Zjc;,or+v t -acvrs G .aL 07 /=L/Q/V PREPARE FOR: R: ,2 EFEe��/G E: v4��7) _ AV&-"eBY CELT/FY TNgT TA/E BCJ/L��4/ri 5<.✓Orv..1 O.L/ T/-//S vL 0':i.V iS LOO�iTEa O.V T.tIE yBOLJ,Va AS 3NOW.t/ NELEpy�/ '&.itt..pty� �il.IoWti/ Cor.t�oPu-aS To Tc�� �,E�'a4c..�_ Q�E>'�?t1 t e.E Mt:..rT S OG Talmo TOw.v t.�l H&..J Goer YTtLUGr�7 . a�`tH OF j ; o� ARNE tiG ' �t.C/r7 C8H. �n9in�e�rin9 OJALA GO No. 26348 O Q Lsa.�a sci�v6Yoe3 /5 � Fs '� E' C/TE Gq=`iz7e�✓lOC/Ts-/� M�4SS. _ - - t BC�i. scit�/rr-GC AsseAor's offioe (1st floor): TWE 'Assessor's map and lot number ....... .���.®.� �L. Board of Health•(3rd floor); ���o�s �/Z� � UST CONNECT TO TOWN SEWER Sewage Permit number ........... �...1....1. .... i easa99AXILE, i Engineering Department (3rd floor):j� ��o t6 9 House number ............................................... ej�o�Aya' APPLICATIONS PROCESSED 8:30 9:30 A.M. and 1:00.2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR CD.�15 /�qPC . ........��/C� G,fl i� y 174�'jZ.g....... APPLICATION FOR PERMIT TO .................�.................. ..... ........... ......... TYPE OF CONSTRUCTION ........ I GO J>......j.r-.7!e ................................................................................. i ..........."�/. 1:...�-�'..........19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit a ording to^the following information: 11 - Location %'.�. .. /E ..`.L�..1... lS ! .~:` . ...........7.0................................................... ProposedUse ......�....�..... ..............f'...................................................................................................................................... � l Zoning District ............ . .. ..I.............................................Fire District ........ �/l//�l� ...................................................... Name of Owner ....t ..y��.� ... ... . ..... ...............�ddress ..........P..�,P1X. jS C�it/.7 ............... ... ... Name of Builder }...�..!� ...................................Address ..........:�f}..?!l!1�......................................................... ..................... Name of Architect ....P:..11?1! W5b,0gA/............................Address .............. ................................................ Number of Rooms ..................................................................Foundation /9,4f.�"fA-7b ....CoAle"e,67,�............. d a �./ r Exterior ,.L�nW?P VM� ) `.6..... ":5�ff��&....................Roofing .......1./..SPA.I.�L�................................... J Floors ...Cm.P.�T....� .1/Gi`✓Y....................................Interior ......1'//Yll�... `.. �.. Y�5(J� .............. ..................................... Heating .... L�G7 �L Plumbing ...C..✓. if CUP/��/� //✓' :..... ............................................... ..............:..:. Fireplace .............../ ;l ......................................................Approximate Cost ..... ... Definitive Plan Approved by Planning Board _ _:� ________19__ Area .../�........ � ...:............... Diagram of Lot and Building with Dimensions Fee . ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ......C/ I�Gt' .....:................ ............................. Construction Supervisor's License ...�.�. (E..yJ......... - lA 4 BAYSIDE AFFORDABLE HOME DIV. s J r i, :No ...321•$,5. Permit for 12L...S.tor�z............... S�l I7g�..�...E. mi.l y. ..Dw.e1.:Lin ^ Location ..1r.Q ... ` .........13.6...Bj s.ho T .............;$ ............................................ Owner .$.�yS.J,de...Aardable...Borie..Div. " i + `•' _Type of Construction � r ...F..name.......................... 11 .......................................................... 1 ..................... . . Plot ............................ Lot ................................ , • Permit Granted ..--,Aucfust •.16.a..•-..Jq 88 s Date of Inspection ....................................19 r Date Completed .......................19' Sz C-1) .% IN, t Assessor's offioe•(1st floor):` T f t t y0F THE TD` Atssessor's map and lot number ....... ����/,,,,,,,,, Board' of Health (3rd floor): 46 Sewage. Permit number .......... BASII9fODLE, Engineering Department (3rd floor): °o t639. e� House number ..............................:...................... ................�. . APPLICATIONS PROCESSED 8:30 9:30 A.M, and 1:00-2:00 P.M. only, .� TOWN OF - BARNSTABLE 91) [LDING INSPECTOR APPLICATION FOR PERMIT TO ...(-,0 57..!2 Z/ .....�....... �� ... ''`f�l!1�L..y....... U!'Yl ....... TYPE OF CONSTRUCTION ..........�W.CJ.?. ...... ........t91n!£................................................................................. s_ .............�/.. 1:... .......... TO THE INSPECTOR OF BUILDINGS: - I The undersigned hereby applies for a permit according to the following information: Location .�. � � ...LC�. . /5 .......�... ............. ..... .................................................. ProposedUse ....... ...........................................................:.......................................................................... i ZoningDistrict ........................................................................Fire District ..............Y.!' N.N...�S............................................. X S C' .c/ Name of Owner �>'..........................................:Address .......... ........�/ T ,q Name of Builder ............. 54 MF- ..................................Address .................................................................................... Name of Architect ..... ..40..c/............................Address ..............CO.?V/T..........................................;..... Number of Rooms ..................................................................Foundation ......... dl /.. .......... OGvCRET .............. Exterior Pi?7Q�}/2!'.... ..5 /t/�.` ....................Roofing ......../1.5fHd,,-...........;..............:....................... Floors ... .Pr.7.... .. //✓YL-..................................Interior ...... ...` Yp5 p ............ .. ..................................... s f Heating -:.- 4-F-(; -A1C...............:;:.<. .--� r--�Plumbing ::.r: C.. .:.CGP � :................!�:P� .. .... ....... Fireplace ................N.... ..................................................:..Approximate Cost ....� 00�J............................................ Definitive Plan Approved by Planning Board - ---------19__ Area ...:....:................................. - I Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH F fjlf 1 V OCCUPANCY PERMITS. REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...... .....+ .............................. r 1 � Construction .Supervisor's License ... Q S,,IP,,Y�J........ 7No IDE AFFORDABLE HOME DIV. A=250-069 cu1.8.5... Permit for .1•1...Story_Ingle...Fam�.ly...1)WQ.li.,ng........... ...Lot...#1.3.,.......43.fi...B.jS.hop•.Torrace .....................H.y ann i.s........................................ Owner ...DI v. T e. of Construction Frame........................ t - YP ••••• ............................................................................... Plot ............................ Lot ................................. ' Permit Granted .....August 16 , 19 88 Date of Inspection ....................................19 ' Date Completed ......................................19 I k . -.y Town of Barnstable *Permit# .a 060 s�- of ra,. Expires 6 months from issue date K Regulatory Services Fee. \ fc ob �snxivnat,e,� Thomas F.Geiler,Director r` �A 1639. .0 Building Division TfD MAy A - f Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT.APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number CP d 00 Property Address `��lP l \5, � \cR�, \mrl ET-Residential Value of Work (470 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address kl(`l1. , S t yV\ rA �e(`�S ; Telephone Number Contractor's Name , Home Improvement Contractor License#(if applicable) DIWorkman's Compensation Insurance Check one: PERMIT ❑ I am a sole proprietor ❑ I am the Homeowner FEB 1 1 2008 C3 I have Worker's Compensation Insurance Insurance Company Name ✓K J^"_0kL),AA TOWN OF BARNSTABLE Workman-'s Comp.Policy P'� Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) DlCe-roof(stripping old shingles) All construction debris will be taken to C 1,09 ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35) *Where required: Issuance of this permit does notexempt compliance with other,town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: . Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 ;r The Commonwealth of Massachusetts Department of Industrial Accidents . Office of Investigations 600 Washington Street Boston,MA 02111' www.mass.gov/din ' Workers'Compensation Insurance Affiddvit: Builders/Contractors/Electricians/Plumbers _Auplicant Information ` ' Please Print Le0bly Name(Business/Orgmm ation/ludividual): 1{�Pt C V � e (�q cb Address: d City/State/Zip: C Phone.#: Ln 'l (a Are you an employer?Check the appropriate bog: Type of project(required): a e , 4. (] I am general contractor and I 1.['�Ism a employer with 3 6. El New construction . employees(full and/or part time).*• have hired the sub-contractors 2.❑ I am a'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling These sub-contractors have g, Demolition ' ship and have no employers-. ❑ _�vorldn for me in an capacity. employees and have workers' g Y P tY• 9. ❑Building addition [No workers' comp.insurance comp.msurance.t required-) 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all•work . officers have exercised their 11.❑Plumbing repairs or additions ' myself.[No workers'comp. right of exemption per MGL 12.[. -Roof repairs . d t C. 152, §1(4),and we have no insurance required.]e ] employees.[No workers' 13.0 Other • comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t go== vocn,who submit this affidavit indicating they are doing all work and then him outside contractors must submit anew affidavit indicating'such. #Contractors that check this box mutt attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees, if the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is proylding workers'compensation insurance for my employees. Below is the policy.and job site, information. Insurance Company Name: ✓� 1� 1913- ( — Policy#or Self-ins.Lie.# lc D trl ®� Expiration Date: I in lob Site Address• 0 3 b0 if City/State/Zip: otl1 (,YI✓ll A = Attach a copy of the workers' compensation policy declaration page'(showing the policy number,and expiration date). Failure,to secure coverage as required tmder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine rip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORKARDER and a fine of up to$250.00 a day against thq violator. Be advised that'a copy of this statement maybe forwarded to the.Office of Investigations of the CIA for msuranc covers a verification. I do hereby certify under th sins d p s of perjury that the information provided above is true and correct Si afore: Phone#• �'� (� `� �?' Official use only. Do not wrtte 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#: $ -e`>, � } �. >_ `l rr- ,� 1•'v, �t. q y£� a k .,e 'k ,.a` � 9 A. R� r, e MARK HERBST r " 35 PEEP TOAD ROAD 41 , , ' CENTERVILLE MA 02632 08-420-6216 CELL PHONE 774-238-2938 # www. MarkHerbst.com PROPOSA S r TED TO: WORK PERFORMED AT: Barnstable Housing Authority ATT,•David Hart 436 Bishops Terr. : x, South Street Hyannis MA k3 ! Hyannis MA We herby propose to furnish the materials and perform the labor necessary for the completion of the following;New Roof #.y Remove 1 laver of existing shingles a Install 8"'drip edge tµ g Install 1 Slb.felt paper ' ` •, Install Certainteed Woodscaj2e 30yr. algae resistant shingles Color( )*Please fill in, Thank You Cut ridge&install cobra vent T Replace plumbing boots w Storm nail all shingles All debris cleaned daily Price includes material, labor&dump fees All material is guaranteed to be as specified.The above work will be performed in accorandance with �+• r a the specifications submitted and completed in a substantial workman-like manner for the sum of; r Two-Thousand Seven-Hundred&Sixty , dollars($2,760.00)with,payments as follows;full amount due upon completion - *Any alteration(s)from above proposal involving extra costs will be added under a separate written- agreement and become an extra charge RESPECTFU Y SU T %` 02 .05-08ti ., Mark Herbst - A. ACCEPTANCE OF PROPOSAL , a The above price,specifications and conditions are satisfactory. We herby accept.this proposal You, are authorized to do he wor nd ayments will be as specified above. f SignatureAQ *This proposal may be withdra n by said.coinpany if not accepted within 30 days x K . , gt j t' Ow . 'S -> , aw Y 4 3� T '4 "" t "�°' ifi 4 ,�3 ,� � a r a �� 0 y � r � � rye. �,�, �rp yr� � a `� F z• ��Ft F �` ""+ �„3w l a. £ �y- S�' a }. b` � ? "X �' �r F f -a � 4 � �` C =, � �,,. ram• � ..,�'a.. - .�.s�.N,9..s. .,�1,:+.t4. ��;'.. 21 er ..�t`,a, �s:.yam ae„ ,}•... ...v.,l�.� Ott ..tu., ,_ <>,,,:..e..<.,. ..SL _, NOTICE NOTICE TO TO EMPLOYEES EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston,Massachusetts 02111 617-727-4900 As required by Massachusetts General Law,Chapter 152, Sections 21, 22 & 30, this will give you notice that I(we)have provided for payment to our injured employees under the above,mentioned chapter by insuring with: ASSOCIATED INDUSTRIES OF MASSACHUSETTS MUTUAL INSURANCE COMPANY NAME OF INSURANCE COMPANY 54 THIRD AVENUE, P.O. BOX 4070, BURLINGTON, MA 01803-0970 ADDRESS OF INSURANCE COMPANY AWC 7016215012008 01/10/2008 - 01/10/2009 POLICY NUMBER EFFECTIVE DATES P O Box 494 Leonard Insurance Agency Inc .Osterville, MA 02655 (508)428-6921 NAME OF INSURANCE AGENT. ADDRESS PHONE Mark Herbst 35 Peep Toad Road Centerville, MA 02632 EMPLOYER ADDRESS 01/04/2008 EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE . MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital.and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician... The reasonable cost of the services provided by the treating physician will be paid by the insurerJM,&-treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention,employes are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY. NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER .77 Board of Building Regulations and Standards j. HOME IMPROVEMENT CONTRACTOR License or registration valid for individul use only before the expiration date. If found return to: Reglstratlon126480 T Board of Building Regulations and Standards Expiration -62812008 One Ashbu 1-ton-Place Rm 1301 BOStOn air Type Individual ,Ma.021'08 j .MARK HERBST ' t MARK HERBST .35PEEP TOAD RD j CEfvTERVILLE MA 02632 _ Beputy Administrator ( Not valid Wltlio t +nature