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0075 CAMP STREET
�s ��� � �� ��� I; k i I k \1 Town of Barnstable 1 In Post:This CardsSo That rt is Visible From tfe Street Approved Plans"Must be Retained on Job and this Card Must;be Kept * uaturttr „ .. I e W Posted UnUl'Final Inspection`Has Been Matle a.R,'.,'�; �.'iP ` `; ,. . %' '..: r s Where a Certificate of Occupancy is".Required,such Building shalLNot be Oxccupied until a Final"Inspection has been made ei 1t Permit No. B-19-2969 Applicant Name: Ed Lyons Approvals Date Issued: 03/03/2020 Current Use: Structure Permit Type: Building-Detached Accessory Structure- Expiration Date: b9/03/2020 Foundation: Residential Mapo/ t328-189 Zoning District: MS Sheathing: Location: 75 CAMP STREET,HYANNIS �' > Contractor Name ,,a 24 RESTORE NE LLC. framing: 1 Owner on Record: EDWARDS, BRUCE E f Contractor License "174907 2 Address: PO BOX 660 z Est. Project Cost: $21,351.00 Chimney: WEST HYANNISPORT, MA 02672 Permit Fee: $208.89 Description: Replacement garage for the one that burned'down � 4 Fee�� Insulation: i s Paid = $208.89 Project Review Req: As-built showing zoning compliance must be submitted , Date 3/3/2020 Final: before framing s ' 2. k Plumbing/Gas s we,, Rough Plumbing: >e�Building Official " Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzedby this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application andythe approved construction documents', r wh ch th_is permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and strues shall be in ctur pliance with the local zone g by laws`arid codes. This permit shall be displayed in a location clearly visible from access seet o trr road and shall be maintained open for public mspectio"n for the entire duration of the Final Gas: work until the completion of the same. x " . z ' Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Bwldmg and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work; Service: 1.Foundation or Footing ' Roug h' 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 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). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: 24RESTO-01 GHOUGHTON ACORO® DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 2/24/2020 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 have ADDITIONAL INSURED provisions or 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 License#1780862 CONTACT Gretchen Houghton NAMHUB International New England PHONE FAX 600 Longwater Drive (A/C,No,Ext): (A/C,No): E-MAIL retchen.hou hton@hubinternational.com BUILDING DEP Norwell,MA02061-9146 T. ADDREss:g 9 INSURERS AFFORDING COVERAGE NAIC# INSURERA:Western World Insurance Company 13196 INSURED FEB 2 5 2020 INSURER B:Arbella Protection Insurance Company 41360 24 Restore NE LLC -INSURER C:Ohio Casualty Insurance Company 24074 10 Church Street INSURER D:Axis Surplus Insurance Company 26620 South Easton,MA 02375 TOWN OF BARNSTABLE INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE X OCCUR EVP100335700 2/20/2020 2/20/2021 DAMAGE TO RENTED X X PREMISES Ea occurrence $ 100,000 X CPL-Pollution MEDEXP(Any oneperson) $ 10,000 X Environmental Impair - PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: F GENERAL AGGREGATE $ 4,000,000 POLICY a JET LOC PRODUCTS-COMP/OP AGG $ 4,000,000 X OTHER:Professional Liability Per Occurence $ 2,000,000 B AUTOMOBILE LIABILITY - - Ea OM accctlentSINGLE LIMIT. $ 1,000,000 ANY AUTO X . X 1020094653 2/20/2020 2/20/2021 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY Ix AUTOS BODILY INJURY Per accident $ X HIRED NON-OWNED Pe�aE.R DAMAGE $ AUTOS ONLY AUTOS ONLY Hired&Non Own $ 13000,000 A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 X EXCESS LIAB CLAIMS-MADE X X EVX1003358-00 2/20/2020 2/20/2021 AGGREGATE $ 1,000,000 DED RETENTION$ $ C WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY STATUTE EERH XW061039279 2/20/2020 2/20/2021 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N X E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D Excess Umbrella X X EMX2000051001 2/20/2020 2/20/2021 Policy Limit 4,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The Western World Liability Policy#EVP100335700 also includes the following: Contractors Pollution Liability Each Pollution Condition:$2,000,000 Contractors Pollution Liability Aggregate:$4,000,000 Transportation Pollution Liability Each Pollution Event: $2,000,000 Transportation Pollution Liability Aggregate:$4,000,000 Environmental Impairment Liability Each Pollution Condition:$1,000,000 Environmental Impairment Liability Aggregate:$1,000,000 SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:24RESTO-01 GHOUGHTON LOC#: 1 .4CC:)R O° ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY License#1780862 NAMED INSURED HUB International New England 24 Restore NE LLC g 10 Church Street POLICY NUMBER South Easton,MA 02375 EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECnvE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability insurance Description of Operations/LocationsNehicles: Professional Liability Each Wrongful[Act: $2,000,000 Professional Liability Aggregate:$4,000,000 Specified Professional Services Endorsement-Professional services means project management or supervision;or construction means,methods,techniques,sequences and procedures in connection with the named Insured's contracting operations performed by the Named Insured in its capacity of a specialty trade or artisan contractor The Western Word Liability Policy#EVP100335700 includeds Blanket Additional Insured,Waiver of Subrogation and Primary and Non-Contributory Endorsements and apply when required by written contract or agreement. The Commercial Auto Policy includeds blanket additional insured when required by written contract and Waiver of Subrogation. Worker's Compensation policy includes Waiver of Subrogation. Umbrella Policies are follow form to the General Liability ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD f l/LG l.v/1LL/L wL rvcuLL/L Vf lYl LLJJLLI-/L LLJGLLJ Department of Industrial Accidents Office of Investigations 10/ Lafayette City Center FFB �Oo a/ 2Avenue de Lafayette, Boston,MA 02111-1750 T��� 9 FAQ ey9 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumber�'c9 �� Applicant Information M L Please Print Legibly NsT,9�C Name (Business/Organization/Individual): Address: 20 Lkzra!/t City/State/Zip: - �J451 DA Oo326" Phone#: _'S —036- 3 CC 6 Are you an employer? Check the a propriate box: Type of project(required): 1.E� I am a employer with IK-h 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition workingfor me in an capacity. employees and have workers' y p �'• $ 9. ❑Building addition [No workers' comp. insurance comp. insurance. 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 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ 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 showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. [,j— � Insurance Company Name: [/ /6 C�Ct.S �l l s-a rQMcV_- at �(�l Policy#or Self-ins. Lie. #: 10}� y Expiration Date: � Job Site Address: G�( _017�� C7 5�►�2� City/State/Zip: yd "(,S_ 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. Signature: Date: off'pZlj�—oZ�d Phone Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): 1❑Board of Health 20 Building Department 3LICity/Town Clerk 4.0 Electrical Inspector 50Plumbing Inspector 6.❑Other Contact Person: Phone#: �J - I�pING pEp� �v BAN 0� ti014 � i'�Woo rY _v ✓fie C�amneo�uret���o��Ga�ac��de�fi " �'!O�W' Office of Consumer Affairs&Business Regulation HOME IMPROV MENT CONTRACTOR TyPnplement Card ,a_ ' Reaistratiyint,� Exairation }17 907 F03/26/2021 } Yt 24 RESTORE NE@CLC�' 4 ED LYONS 10 CHURCH ST S,EASTON,MA 02375� U,nderse0retarYi ` se onlY Registration valid for individualund return to.. Regulation 3 -ration date. before the exp Suite 710 Office of Cons on street Affair and Business e9 `i 100o Washington Boston,MA 021" o,l signature Not vaii wtt d r I _ Information and- Instructions - Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like_ to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston,MA'02111' - Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): �� ��51 U rZ4_R _ Address: City/State/Zip: S - ��St`'''� M P d a r15 Phone#: 5-08 �9 y ®(6 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with a 4" 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y P h'• 3 9. ❑Building addition [No workers'comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions ] officers have exercised their 11. Plumbing repairs or additions 3.❑ I am a homeowner doing all work ❑ g P myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.[1 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 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. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: � kio Tr1 ( f-&4 C 1e q e—, Policy#or Self-ins.Lie.#: XVV d 51 3 Expiration Date: 9 ) d l T3 Job Site Address: cd yq City/State/Zip: T"1yGZw1KS �e�11, 0c 16o/ 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. Signature: Date: Phone#: �� Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: , t uivtsion of Nrotessionai ucensure " ✓r Board of Building Regulatiooq nd Standards onstr 6r1'§ rvisor r, CS-103111 ' Ji xpires: 0511312021 JASON R FREITAS 0,• 5 MCINTOSH DR 3 TAUNTON MA 02780, 4 Commissioner C1 • } Z v2 O j cJ� -a;A r f ACC>V CERTIFICATE OF LIABILITIOINSURANCE o2na2019 2019 THIS CERTIFICATE IS ISSUED AS A MATTER OFINFORMATION 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(les)must have ADDITIONAL INSURED provisions or 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 Vivian an Vaudreuil FIAI/Cross Insurance PHONE (603)669-3218 (803)645-4331 AIC No Eat: A No 1100 Elm Street ADDRESS: waudreuit@crossagency.com INSURERIS)AFFORDING COVERAGE NAIC 0 Manchester NH 03101 INSURERA: Colony Insurance Co. 39993 INSURED INSURERB: West American Ins Cc 44393 24 Restore NE LLC INSURER C: Ohio Casualty Insurance Company 24074 10 Church Street INSURERD: Merchants Bonding Co(Mutual) 14494 INSURER E South Easton MA 02376 INSURER F: COVERAGES CERTIFICATE NUMBER: 19-20AI1lines 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE VIVOPOLICYNUMBER MMOWY" (MMIDDNMI LIMITS X COMMERCIALGENERALLIABIUTY EACH OCCURRENCE s 2,000,000 CLAIMS-MADE ®OCCUR PREMISES Ea occurrence s 300,000 MED EXP one person) S 5,000 A PACE306750 02/20/2019 02/20/2020 PERSONAL t:ADVINJURY $ 2,000,000 hXGENLAGGREGATEUMITAPPLIESPER: GENERALAGGREGATE S 4,000,000 POLICV JECT LOC PRODUCTS-COMPIOPAGG S 4,000,000 OTHER: Prof/Poll.Liab(CPL) 1,000,000/claim s 2,000,000Agg AUTOMOBILE LIABILITY COMBINED SINGLE LIM S 1.000,000 Ea aoddent ANYAUTO BODILY INJURY(Per person) S B AOMED UTOS ONLY SCHEDULED BAW57057192. 02/20/2019 02/20/2020 BODILY INJURY(Per accident) S AUTOS HIRED NON-OWNED P O RTY DAMAGE S AUTOS ONLY AUTOS ONLY Peraccldent H Business Auto s UMBRELLA UAB M OCCUR EACH OCCURRENCE s 5,000,000 A EXCESS UAB CLAIMS-MADE EXC306751 02/2O/2019 02/20/2020 AGGREGATE s 6,000,000 DED I I RETENTION S s WORKERS COMPENSATION PER OTH (3a.)NH RI AND EMPLOYERS'LIABILITY YIN STATUTE ER 1,000.000 C ANY OFFICERIM MBR/PARTNER/EXECUTNE N/A XW057833533 3a. CTMAME 02/20/2019 02/2012020 E.LEACHACCIDENT s (Mandatory In NH) EXCLUDED? ( ) 1,000.000 (Mandatory to NH) E.L.DISEASE-EA EMPLOYEE S It yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS bebwv E.L.DISEASE-POLICY LIMIT S Fiderdy Bond Limit 100.000 D 5299 1012712018 10/27J2018 � DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Additional Remarks Schedule,may be attached It more space Is mqulred) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN For Informational Purposes Only ACCORDANCE WITH THE POLICY PROVISIONS. Informational Purposes Only AUTHORIZED REPRESENTATIVE v d ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD Construction Supervisor Re:Address ��J � i0 S�- �"l`�� ��� S' (or)application# —(�( —d 90 S Telephone Number Address 1bC6(ArC� 3T- City s` s�o State Zip License Numbers _W I► License Typee-S�— Expiration Date S�"/3�a7OG1 0 om Contractors Email _�-��I A;R4g res` 6(eAS'�Cell# I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation re uired by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Id 1 f i 24 Restore 10 Church Street S. Easton, MA 02375 508-238-3060 To Whom it may concern Construction Supervisor Jay Freitas is and Employee of 24 Restore NE LLC and is covered under our Workers Compensation Insurance Policy which is attached. Sincerely, Ja s l l { 24 Restore 24 Restore Q 10 Church St oa*E � South Easton,MA 02375 j Tax ID: 46-1518241. Sketch Roof Annotations SKETCH3-Main Level Face Square Feet Number of Squares Slope-Rise/12 F1 293.84 2.94 12.00 F2 293.84 2.94 12.00 Estimated Total: 587.68 5.88 BUILDING DEPT. JAN 0 7 2020 ..TOWN 4 v BARNSTABLE BRUCE_EDWARDS 1/6/2020 Page: 63 SKETCH3 -Main Level uw J 00 1a- Lu C/� 0 N CD m � Z O J Q Z m O F— 221811 20' 8" _ 20' M N Fl(A) Garage, -� °° Fn F2(B) -"N uV Main Level BRUCE_EDW,j.R S 5,,_�. 1/6/2020 Page: 57 Wall Framing SKETCH3-Main Level Co ® � z N CL '2 G_ O m Z o J a z Ca o 2 -, `.�A ?� wkPX k 5Ir c A A k a'dv f4 &: oil b. :: y rrr3" 4, 3 e Am- x :� { f( 4 C ktp�C , n k ,r C G q�.. tl7LX '"N k�7c n ,{ c."n 2u "'I r ;r "✓� Off GIs: tali " n i X ask4 A ia4 ,t. nnn�. x d 4 n , F> B k .,.ram eerw ee4% M+xwr �. M n7: gg n8 �,tl 2 r ° k k °k A`°' A }fIn ,,, n..,,k s,•X- niE�s k°" p y clock; F 2, »t � rr armx '1 .GY::X%N 5 ,� A.a».,rr• .,. 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Permit NO. B-19-2969 Applicant Name: Ed Lyons Approvals Date Issued: 03/03/2020 Current Use: Structure Permit Type: Building-Detached Accessory Structure- Expiration Date: 09/03/2020 Foundation: Residential Map/Lot: 328-189 Zoning District: MS Sheathing: 77 , Location: 75 CAMP STREET,HYANNIS . Contractor Name 24 RESTORE NE LLC. Framing: 1 Owner on Record: EDWARDS,BRUCE E Contractor License 174907 Address: PO BOX 660 ._ h Est$Mject Cost: $21,351.00 Chimney: WEST HYANNISPORT MA 02672 h . , Perrnit,Fee. $208.89 Description: Replacement garage for the one that burned down Insulation: Fee Paid $208.89 Final: Da#e � Project Review Req: As-built showing zoning compliance must be submitted 3/3/2020 before framing y L � Plumbing/Gas Rough Plumbing: 3 i - ;;' ,Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized'by this permit is commenced withmsa monthsafter issuance. All work authorized by this permit shall conform to the approved application andithex aapproved construction documents forwhich this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and sVuctut&shall'be inni compliance with the local zong;by laws and codes. This permit shall be displayed in a location clearly visible from access street bCroad'and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire,Officials are provided on this,permit. Minimum of Five Call Inspections Required for All Construction Work: y, Service: 1.Foundation or Footing ;, . 2.Sheathing Inspection <,. - F, �.. Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 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. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: I 24 Restore 10 Church Street AWME South Easton, MA 02375 RESPOND REMEDIATE•REBULD 508-238-3060 March 3, 2020 Barnstable Building Department Attention: Mr. Edwin Bowers Subject: 75 Camp Street Hyannis, MA 02601,Application No. TB-19-2969 This Statement is to affirm that the replacement garage to be constructed on this site is going to confirm with all required property setbacks applicable to the current zoning requirements of the Town of Barnstable and will be confirmed upon completion by an " As Built Plan". Attached separately is a copy of a Certified Plot Plan dated Dec. 12, 2019 which shows the approximate location of the original structure that burned down. It is our intention to move the structure inside of the right property line 10-15 feet and approximately 60 feet in front of the rear property .line. Sincerely, Edwin R Lyons III Project Manger ���� �R�� �y ��� ��b�i � . "�' . Town of Barn, PostThisCard So That rt is Visible From the Street Approved Plans Mt M"M �` Posted Until F al Inspection Has Been Made � � �' �� '�' Wherea�Certificatof Occupancy is'Requ�red,suchBuildmg shall Not h Building plans are to be available on s All Permit Cards are the property of the APPLICANT- f. x 'I{ qua C! *Permit# - Town of Barnstable Expires 6manthsho issue date �- Regulatory Services Fee txsr�+s . nsess. � o s F.Gefler,Director Ec�+&�� 0Silding Division FE 0 200 Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 TRWN OF BARNSTABLE Office: 508-862-44 38 Fax: 508-790-6230 EXPRESS PERIVIIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red%Press Imprint Map/parcel Number Property Address Value of Work 4Residential Owner's Name&Address r . Telephone Number Contractor's Name ��� r l�� Home Improvement Contractor License#(if applicable) ��✓� Construction Supervisor's License#(if applicable) to orkman's Compensation Insurance PERMIT �" Check-one: -PRESS ❑'I am a sole proprietor ❑ I am the Homeowner FEB 2009 have Worker's Compensation Insurance Insurance Company Name fiU . L 5 N OF BARNSTABLF. Workman Comp.Policy# Permit Request(check box) ❑'Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side' maximum.44) Doer ❑ Replacement Windows. U-Value ( *Where required Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Pr must sign Property Owner Letter of Permission. rovement Contractors License is required. Signature Q:Forms:expmtrg Revise053003 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 0S0o Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pluriibers licant Information Please Print Leeibly lame(Business/otganization/Individual): .ddress: R� 5� 'ity%State/ ip: t5 Q Phone.#: �-� «�� e i ou a employer?Check the appropriate box: Type of project(required): ] a employer with 4• ❑ I am a general contractor and I 6 ❑New construction employees(full and/or part-tim.e).* have hired the sub-contractors listed on the-attached sheet. 1. ❑Remodeling ] I am a sole proprietor or partner- These sub-contractors have ship.and have no employees 8.employees and have workers' ❑Demolition working.for me in any capacity. 9. ❑Building addition comp. insurance.t [No workers comp.insurance 10. Electrical repairs or additions required.) 5. ❑ We are a corporation and its ❑ ,p ] I am a homeowner doing all work officers.have exercised their 11.❑Plumbing repairs or additions right of exemption per MGL 12.❑myself. [No workers comp. Roof repairs insurance required.)t c. 152,§1(4),and we have no employees; [No workers' 1'3` Other comp. insurance required.] applicant that checks box#1 must also:fill out the section below showing their workers'compensation policy information. neowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have iyees. If the sub-contractod have employees,they must provide their workers'comp.policy number. an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site nce Company Name: w► 1 P / l(� Q I i` y#or Self4ns.Lic.#: ID U "la L4---Do[07 ev 1 Expiration Date: I D Ite Address: �� �.l(�i��7`WJ'l "-�` City/State/Zip: C1 jami) -h a copy of the workers'compensation policy.declaration page(showing the policy number and expiration date). re.to secure coverage as required under Section 25A of MGL c. 152 can dead to the imposition of criminal penalties of a ip 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 to$250.00 a day against thq violator. Be advised that a copy of this statement may be forwarded to the Office of - ti ations of the D ce e verification. tereby certify un s a enalties of perjury that the information provided above is true and correct. ture: (Date: r 9 v�a — (� �7 -(77 Fcial use only. Do not write in this area, lb be completed by city or town official ry or Town: Permit/License# uing Authority-(circle one): 3oard of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector Nher ntact Person: Phone#: I y t/ 12/3]/2008 14: 18 Bryden & Sullivan Insurance Donna Seviour-*Margo 1/2 ACORy. CERTIFICATE OF LIABILITY INSURANCE OP DS DATE SPR IN-1 12/3/31/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Bryden & Sullivan Ins Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 88 Falmouth Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis MA 02601 Phone: 508-775-6060 Fax: 508-790-1414 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER Associated Industries of MA INSURER B: S rinkle Home Improvement Inc. INSURER C. 1�9 Barnstable Rd INSURER Hyannis MA 02601 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN,REDUCED BY PAID CLAIMS. r-R DD'L POLICY EFFECTIVE POLICY EXPIRATION NSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM(DD/YY) DATE IMMIOD/YY) LIMITS GENERAL LIABILITY - EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea occurence) S CLAMS MADE ❑OCCUR MEO EXP(Any one person) $ ' PERSONAL Z AOV INJURY $ GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ POLICY PR LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO - (Ea accident) ALL OWNED AUTOS ' BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY S NON-OWNED AUTOS (Per accitlent) PROPER TY DAMAGE $ (Per accitlent) GARAGE LIABILITY - AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EAACC ITAUTO ONLY. AGO $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ - OCCUR EI CLAMS MADE AGGREGATE $ DEDUCTIBLE - $ RETENTION $ $ WC STATU- OTH- WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNEPlEXECUTNE AWC7004943012 OO9 01/01/09 01/01/10 E.L.EACH ACCIDENT $ SOOOOO OFFICER/MEMBER EXCLUDED? E.L DISEASE-EA EMPLOYEE $ 500000 II yes,describe under SPECIAL PROVSIONS below E.L.DISEASE-POUCYUMIT $ 500000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SPRNKHO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Sprinkle Home Improvement, Inc NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Fax #508-775-1350 Margo Mack IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 199 Barnstable Rd. REPRESENTATIVES. Hyannis MA 02601 AUTHORIZED REPRESENTATIVE Kelle A.Sullivan ACORD 25(2001/08) O ACORD CORPORATION 1988 i /r �� {io ii d of B'uilnrng.Regul�tioiis wd S.tnxlarcls . Construction S.upervisor;:Licens'e w a x s z:. Liaehse•.. C S 1 643 Expi,'ration: 1:078/2009 Tr#: 9427 RedWi'cti n: 00. BRAJ.K SPRINKLE 190 LOrHROPS LANE W f3ARN STAB LE,MA 02668 Citmmissioiirr :r .I I 00 35;'O�0;0 cf ericl'osed P;ac:e• 1•.A r asOVpy WAY i 1=G-1 ..2.Farn4ly1`101ts :n@h'e Fail u•re Rf massacl.usetts State Building Code i is cause for revocation of this lie ease: Board`-of Building liegulafi.ons and Standards HOME IMPROVEMENT CONTRACTOR Registration: 103757 i Ezpiration;: 7/9/2010 Tc# 271;033 Types: Private Corporatipb " SPRINKLE"sHOME IMPROVEMENT, INC. Bract Sprinkle 190,Barnstable Rd: Hyannis,MA:02601 AdministrafOr ------------- License or registration valid for individul use only before the expiration date. If found return to: t Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,.Ma:02108 f;t Not vali4wit t sig ture +_ 8. Fencing, carpentry,painting,plumbing, electrical, dry wells, etc., and all other work necessary that is not contained in this contract, shall be the responsibility of the Homeowner. RIGHTS TO CANCEL The Owner may cancel this Agreement if it has been signed by the Owner at a place other than the address of the Contractor, which may be his main office or branch thereof,provided that the Owner notifies the Contractor in writing at his main office, or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this Agreement. WARRANTIES The Contractor warrants that the work furnished hereunder shall be free from defects in workmanship for a period of two (2) years following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship, or damage caused by the Contractor, his subcontractors, employees or agents; is discovered within two years after completion of any job, including clean-up,the Contractor shall,at his own expense, forthwith remedy, repair, correct, replace, or cause to be remedied, repaired, or replaced such damage or such defect in workmanship as long as the owner has paid their agreed contract in full. The foregoing warranties shall survive any inspection performed in connection with the agreed upon work. All warranties for product supplied by the Contractor under this Agreement shall be those given by the manufacturers of such product, which shall be and hereby passed directly to the Owner. Such manufacturer's warranties, the Owner may be required to register or mail in a warranty card or other evidence of ownership, and use of such product in order to activate such warranties. The Owner's failure to send in or register such documentation, which failure voids that manufacturer's warranty, shall not create any responsibility for the Contractor to warranty such product. Note: Any changes in the contract during the duration of the project which results in additional monies due will be paid in full to the contractor at the time of the change. I authorize Sprinkle Home Improvementto act on my behalf in all matters relative to the work to be performed on this job (i.e. permits, applications etc.) if necessary. "YV�-A �1\1 H.AL to Brad K. Sprinkl Date Celebrating 62 years in business!! Town of Barnstable *Permit# �7�� _7 Expires 6 months from issue date Regulatory Services Fee Thomas F.Geiler,Director Building Division W__ 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 PERNUT APPLICATION - RESIDENTIAL ONLY GNot Valid without Red X-Press Imprint Map/parcel Number Property Address � 90'lYil`. ,Residential Value of Work ZO, 06C) Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address � C jc n� A-A yLAE Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance X-PRESS PERMIT Check one: ❑ I am a sole proprietor ,J U N 2 2 2007 I•amthe Homeowner I have Worker's Compensation Insurance TOWN.OF BARNSTABL.E Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to r f�, tic, yy ❑Re-roof(not stripping. Going over existing layers of roof) PIRe-side ❑ Replacement Windows/doors/sliders. U-Value (maxiTmum.44) *Where required: Issuance of this permit does not exempt compliance with other town departmentregulations1'e-ILWCQliS� s JYation,etc. ***Note: roperty Owne must sign Property Owner Letter of Permission. A copy of the me Improvemen ontractors License is required.90 SIGNATURE: f/ n Q:Forms:expmtrg Revise061306 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations . + a 600 Washington Street Boston,MA 02111 M 5 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly '—N Business/Organization/Individual): . �Acldress� G1ti� °�-� .Cityl-hale/Z g. `S Y` O Phone.#: �I Are you an employer? Check the appropriate box: Type of project(required):. 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. New construction . employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a'sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity, employees and have workers' Y P tY t. 9. ❑Building addition [No workers' comp.insurance comp. insurance. +equired.] 5. ❑ We are a corporation and its 10.7 Electrical repairs or additions - officers have exercised their 11. plumbing 3' ` `I—am a liameowner doingg all works h id ❑ g repairs or additions �niy`self [No workers' comp. right of exemption per MGL 12.❑Roof repairs c. 152, 1(4),and we have no insurance_required:]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 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 isproviding workers'compensation insurance for my employees. Below is.thepolicy 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 Investisations of the DIA for insurance coverage verification. I do her y ce fy under the p sand penalties o perjury that the information provided above is true and correct Si_nature Pho Official use only. Igo not write in this area,to be completed by city or town of iciab City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other - Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two_or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to*operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage._ Also be sure,to sign and date the affidavit. -The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you_have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all-locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to 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 Massachuw#s Department of lndttrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-N ASSAFE Fax#617-727-7749 Revised 11-22-06 www.mass.govldia I .f CFTHE T Town of Barnstable Regulatory Services BAMSTABLE, ' Thomas F.Geiler,Director MASS. s639. A Building Division AjFp�.I Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATIO _ gvllmmls number r p st�reet(� 1 village L 7 .,HOMEOWNER": � _ � l u��i�. � 6C � 901 V�f name e hom phone(# work phone# C CURRENT MAILING ADDRESS: J rr[m n t> city/town ,C state ip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and•regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection p cedures and requirements and that he/she will comply with said procedures and requir ents. S ature of o o ner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt Property Location: 75 CAMP STREET MAP ID: 328/189/// Vision ID: 27940 Other ID: Bldg#: 1 Card 1 of 1 Print Date:0910712001 14:11 11"46 UPTON,GEORGE L Descri tion Code Appraised Value Assessed Value RESLAND 1010 27,600 27,600 801 115 IYANNOUGH RD RESIDNTL 1010 64,000 64,000 HYANNIS,MA 02601 7- RESIDNTL 1010 2,600 2,600 LIVE DATA-Barn.,MA &P-Af Additional Owners: Account# 245620 Plan Ref. Tax Dist. 400 Land Ct# Per.Prop. #SR Life Estate NDL I Notes: RENTALS VISION ffDL 2 GISID: 27940 7 Totali 94,2001 94,200 UPTON,GEORGE L 13161/270 08/02/2000 Q 1 65,000 00 Yr. Code Assessed Value Yr. Code Assessed Value Yr. Code Assessed Value DANTOS,PHEDUS G 10756/244 05/19/1997 Q 1 65,000 00 2001 1010 27,600 2000 1010 32,0001999 1010 32,000 BEARSE,FRANK&ROBERT 10510/150 12/03/1996 U 1 1 1A 2001 1010 64,000 2000 1010 43,5001999 1010 43,500 BEARSE,ABBIE K 481/153 Q 0 2001 1010 2,600 2000 1010 2,7001999 1010 2,300 Total: 94,200, Total., 78,2 1,800 This signature acknowledges a visit by a Data Collector or Assessor Year TypelDescription Amount Code Description Number Amount Comm.Int. bom W I Appraised Bldg.Value(Card) 64,000 Appraised XF(B)Value(Bldg) 0 Total.I I I Appraised OB(L)Value(Bldg) 2,600 Appraised Land Value(Bldg) 27,600 Special Land Value 22111111 TIP W 'E *LAND ADJUST.FOR RESIDENTIAL..... ................ Total Appraised Card Value n 94,200 Total Appraised Parcel Value 94,200 Valuation Method: Cost/Market Valuation �et Total Appraised Parcel Value 94,200 W,.33 6 J Permit ID Issue Date Type Mcription Amount Insp.Date %Comp. Date Comp. Comments Date ID Cd. Purp se/Result B# Use Code Description Zone D lFrontage Depth Units Unit Price L Factor S.I. C.Factor Nbhd. Adf. Notes-AdIlSpecial Pricing Ad'. Unit Price Land Value 1 1010 Single Fam PRD 4 0.27 AC 237,000.00 1.00 5 0.50 P015 0.83 SPCL(.27,U10)Notes:10 IBLD 102,355.70 27,600 Total Card Land Units 0.27 AC�—Parcel Total Land Area: 0.27 AC Total Land Val-41 27,600 Property Location: 75 CAMP STREET MAP ID: 328/189/// Vision ID:27940 Other ID: Bldg#: 1 Card 1 of 1 Print Date: 09/07/2001 14 CO, .4 .. a _ y CT ON7)E " S y Element Cd. ICh.. Description Commercial Data Elements Style/Type 4 Cape Cod Element Cd. Ch. Description Model 1 Residential Heat&AC UST 10 Grade C Average Grade Frame Type aths/Plumbing tones .4 Story F A 5 5 Occupancy 0Ceiling/Wall AS 12 ooms/Prtns Exterior Wall 1 5 Vinyl Siding /o Common Wall 2 Wall Height Roof Structure 3 able/Hip Roof Cover 3 sph/F GIs/Cmp CONDU/MUB HU' T�! 16 1 nterior Wall 1 8 Typical 2 Element Code Description Factor l nterior Floor 1 0 Typical Complex Floor Ad' 2 J 6 6 Unit Location 30 eating Fuel 2 Oil Heating Type 9 Typical Number of Units C Type 1 None Number of Levels /o Ownership Bedrooms 4 4 Bedrooms FAT Bathrooms Bathroom �� Q ", SETS:" iTQ . ; S BAS 2 10 1 Full nadj.Base Rate 60.00 222 Total Rooms Rooms Size Adj.Factor 1.19971 88 ath Type Grade(Q)Index 0.97 2 Kitchen Style Adj.Base Rate 69.82 30 Bldg.Value New 85,390 Year Built 1900 ff.Year Built (A)1975 rml Physcl Dep 25 uncnlObslnc 0 I �USF con Obslnc 0 Spec].Cond.Code F m 1010 Single Fam 100Spec]Cond% } e z Overall%Cond. 75 1 � s , eprec.Bldg Value cA nnn E „ F €€ 3 $ TO <. x : s : Code Description LIB I Units Unit Price Yr. Dp Rt %Cnd Apr. Value FGR1 GniagezFuur L 240 18.UU 19bU 1 lUU 2,600 Code Description Livin Area Gross Area E .Area Unit Cost Unde I prec. Value BAS First Floor 868 868 868 69.82 60,604 FAT Attic,Finished 330 660 330 34.91 23,041 UST Utility Enclos'u,e 0 70 25 24.94 1,746 TtL Gross Liv/Lease Area 1,198 1,598 1,223 Me Val: 1 85,390 i Town of Barnstable �FZME Tp�,t, Regulatory Services Thomas F.Geiler,Director saxxsznsLE, MAW g Building Division s6;9. ♦0 Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 COMPLAINTANQUIRY REPORT Date: I Rec'd by: Complaint Name: , ��_e� Map/Parcel Location Address: 75 Originator Name: , Street: Village:, State: Zip:0 Z6p ( Telephone: S Complaint Description: 7 r d A FOR OFFICE USE ONLY . • Inspector's Action/Comments Date:_, oG� Inspector: 3 o Z �5p,6 kr 10 L5-7-P0��` r4iw 0-10 � N�,�aaay 1"W' " Ver* CLAGrn x-P R_9T T��x,& Axh-�- 11cNCz 5vAgw r-r Iiyr �- Add'tional Info.Attached a X Q:fonns:complaint 41 3-2 Office Districts 3-2.1 PR Professional Residential District 1) Principal Permitted Uses : The following uses are permitted in the PR District: -- A) Single-family residential dwelling (detached) . B) Two-family residential dwelling (detached) . C) Professional Offices . D) Licensed real estate. broker' s office. E) Nursing home. F) Rest home. G) Medical/dental clinic . H) Pharmaceutical/therapeutic use. I) Hospital (non-veterinarian) . J) Multi-family dwellings (apartments), subject to the following conditions : a) The minimum lot area ratio shall be five thousand (5, 000) square feet of lot area per each apartment unit for new multi-family structures and conversions of existing buildings . b) The maximum lot coverage shall be twenty per cent (200) of the gross upland area of the lot or combination of lots . c) The maximum height of a multi-family dwelling shall not exceed three (3) stories or thirty-five (35) feet, whichever is lesser. ` d) The minimum front yard setback shall be fifty (50) feet or three (3 ) times the building height, whichever is greater. e) The minimum side and rear yard setbacks shall be not less than the height of the building. f) A perimeter green space of not less than twenty (20) . feet in width shall be provided, such space to be planted and maintained as green area and to be broken only in a front yard by a driveway. g) Off-street parking shall be provided on-site at a ratio of one and one-half (1 . 5) spaces per each apartment unit and shall be located not less than thirty (30) feet from the base of the multi-family dwelling and be easily accessible from a driveway on the site. ' 4 V y h) No living units shall be constructed or used below': ground level . i) The Zoning Board of Appeals may allow by Special " K Permit a maximum lot coverage of up to fifty per (500) of the gross area of the lot or combination'.of 1 o t s . K) Personal Service Business such as the following: barber,�� beauty shop, shoe repair, tailor and dressmaker. (Added by 11 yes vote of Town Council on Oct. 26, 2000) . 2) Accessory Uses: The following uses are permitted as ��Al accessory uses in the PR District: H r. A) Renting of rooms to not more than ten (to-) persons by .a family residing in the dwelling. . a B) Bed and Breakfast operation within an owner occupied ;tom single family residential structure, subject to the `fi_ provisions of Section 3-1 . 1 (3) (F). except sub-paragraph b) . No more than a total of six (6) .rooms shall be rented to no more than a total of twelve (12) guests at any one time. For the purposes of this Section, children .y under the age of (twelve) 12 years shall not be considered in the total number of guests) . (Amended by 11 yes vote of Town Council on Oct. 26, . 2000) 3) Conditional Uses : The following uses are permitted as conditional uses in the PR District, provided a Special Permit is first obtained from the Zoning Board of Appeals. .. subject to the provisions of Section 5-3 . 3 here,*n and the a¢ specific standards for such conditional uses as required in this section: ` A) Renting of rooms to not more than ten (10) lodgers in one ` (1) multiple-unit dwelling. B) Public or private regulation golf courses subject to the provisions of Section 3-1 . 1 (3) (B) herein. a C) Family apartment subject to the provisions of Section 3- 1 . 1 (3) (D) herein. D) Windmills and other devices for the conversion of wind energy to electrical or mechanical energy, but only as an ; accessory use. 4) Special Permit Uses : (reserved for future use) '= 5) Bulk Regulations: Y�. Cr Hh 43 •t -- ZONE MIN.LOT MIN.LOT MIN.LOT MINIMUM YARD MAX.BLDG. MAX.LOT AREA FRONTAGE WIDTH SETBACKS IN FT. HEIGHT . COVERAGE SQ.FT. IN FT. IN FT, ------- -- IN.FT. AS o OF FRONT SIDE REAR LOT AREA _ PR 7500 75 -- 20 7 . 5 7 . 5 30 # 25 # Or two (2) stories, whichever is lesser, except that hospitals are exempt from height restrictions in the PR District . Front Yard Landscaped Setback from the road lot line: PR: 10 feet, Existing trees and shrubs shall be retained within the road right of way and within the required Front Yard Landscaped Setback, and supplemented with other landscape materials, in accordance with accepted landscape practices . Where natural vegetation cannot be retained, the Front Yard Landscaped Setback shall be landscaped with a combination of grasses, trees and shrubs commonly found on Cape Cod. A minimum of one street tree with a minimum caliper of three (3 . 0) inches, shall be .provided per 30 feet of road frontage distributed throughout the front yard setback area. No plantings shall obscure site at entrance and exit drives, and road intersections . All landscaped areas shall be continuously maintained, substantially in accordance with any Site Plan approved pursuant to Section 4-7 herein. (Added by vote of Town Council item 99-056 on 3111199 by a Unanimous Roll Call vote. ) Town of Barnstable Assessors Division Page 1 of 3 It woo s BARNSTAL:LE,tk Your Location : Home : Town Departments : Administrative Services : Assessors Division : Property Results <<Back - Forward>> Monday, March 18, 2002 Assessors Division- Property Results Data is based on Fiscal Year 2002 Assessor's database and is provided for informat purposes only. 75 CAMP STREET Vie Map/ Parcel/Parcel Extension: Mailing Address: 328/189/ UPTON, GEORGE L Owner of Record: UPTON, GEORGE L 115 IYANNOUGH RD Property Location: HYANNIS, MA 02601 75 CAMP STREET Parcel ID:328189 Vie Map Fiscal Year 2002 Assessed Values Appraised Value Assessed Value Building Value: $64,000 $64,000 Extra Features: $ 0 $ 0 Outbuildings: $2,600 $2,600 Land Value: $27,600 $27,600 Totals: $94,200 $94,200 Sales History Owner: Sale Date: Book/Page: Sale Price: DANTOS, PHIDIAS G 5/19/1997 10756/244 $ 65,000 BEARSE, FRANK& ROBERT 12/3/1996 10510/ 150 $ 1 BEARSE, ABBIE K 481/ 153 $ 0 UPTON, GEORGE L 8/2/2000 13161/270 $65,000 Land and Building Description Land Building Lot Size (Acres): 0.27 Year Built: 1900 Appraised Value:$27,600 Living Area: 1198 Assessed Value: $27,600 Replacement Cost: $ 85,390 Depreciation: 25 Building Value: $64,000 http://www.t wn.b rnst ble.m .us/c me nin/ ep rtments/Administr tive_ ervices/ in no... 3/18/2002 Town of Barnstable Assessors Division Page 2 of 3 s_r Construction Details Style: Cape Cod Interior Walls: Typical Model: Residential Interior Floors: Typical Grade: Average Grade Heat Fuel: Oil Stories: 1 Story F A Heat Type: Typical Exterior Walls Vinyl Siding AC Type: None Roof Structure: Gable/Hip Bedrooms: 4 Bedrooms Roof Cover: Asph/F GIs/Cmp Bathrooms: 1 Bathroom Total Rooms: 7 Rooms Outbuildings & Extra Features Code Description Units/SQ FT Appraised Value Assessed Value FGR1 Garage-Poor 240 $2,600 $2,600 Building Sketch I Vill eYj>Map Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area (Unfinished) BMT Basement Area (Unfinished) FTS Third Story Living Area (Finished) UHS Half Story (Unfinished) CAN Canopy FUS Second Story Living Area (Finished) UST Utility Area (Unfinished) FAT Attic Area (Finished) GAR Garage UTQ Three Quarters Story (Uni FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story (Unfi FHS Half Story (Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story (Finished) http://www.t wn.b rnst ble.m .us/c me nin/ ep rtments/Administr tive_ ervices/ in no... 3/18/2002 Town of Barnstable Assessors Division Page 3 of 3 Back - -=+� Home I Departments Town Information Contact Town Hall Website Developed and Maintained internally by the Town of Barnstable Information Systems Department Town Hall-367 Main Street- Hyannis,MA-02601 -508-862-4000 DISCLAIMER: Although we strive to provide accurate information,we are only human. Please consult directly with the appropriate department if there is a question of accuracy. Copyright 2001©Town of Barnstable. All Rights Reserved. http://www.t wn.b rnst ble.m .us/c me nin/ ep rtments/Administr tive_ ervices/ in no... 3/18/2002 - S.. / �^ ��� s�� � �,;,, �. r • I, < a ,1 •� ;I r'f xx0y7 +, ti �� N�� , ti,�„ �. I —:.ay. -�J�d �� ww' I v • �- / J ' ��'� ����� � � �� �' I �'�n.� r Engineering Dept. (3rd floor) Map `? Parcel j''Permit# 9 7�6 9 House# '�.S P� Date Issued 02 _9'7 Board of=�3rd floo)(g:15 - /1: -4:30) t R76 1:W Fee � ?5_1 �— Conservation Office.(4th floor)(8:30-9:30/1:00-2:00) r Act pt. (1st floor/School Admin. Bldg.) THE ]an Approved by Planning Board 19 • BARNSTABLE. TOWN OF BARNSTABLE Building Permit Application et Address Village 1-9i5 Owner., Address 709 Cam. .�� Telephone 7V^ Z> Permit Request Dth First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ _ p � Zoning,District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure 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 New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No - Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use Builder Information Name� f-iG /�` � Telephone Number 195�:7Gf O1S'v Address License# D,y 7 7jC7 1 ,�' X� z 1,3Z Home Improvement Contractor# 16�66, Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO��-h6� SIGNATURE DATE ) BUILDING PERMIT DENIEDfOR THE FOLLOWING EAS (S) ®' FOR OFFICIAL USE ONLY PERMIT NO. 1 �- 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. i Health Complaints 21-Sep-01 Time: 8:30:00 AM Date: 9/21/2001 Complaint Number: 3084. Referred To: DONNA MIORANDI Taken By: DANIELLE ST.PETER Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: Business Name: Number: 75 Street: CAMP STREET Village: HYANNIS Assessors Map-Parcel: Complainant's Name: ROGER FELTUS Address: 85 CAMP STREET, HYANNIS Telephone Number: 508-790-4165 Complaint Description: THERE IS A TRAILER IN THE YARD THAT TENANTS ARE LIVING IN..THERE ARE EXTENSION CORDS RUNNING TO THE TRAILER.THE YARD IS FULL,.OF GARBAGE, RATS; TOILETS, AND ANIMALS AND THEIR FECES. IT IS A DISGRACE TO THIS NEIGHBORHOOD. Actions Taken/Results: Investigation Date: 9k) © ( Investigation Time: V omp Date: o� Reed by: Assessor's No- Dawn— Name: Location ` Address: wP Originator Name: Street vliage: ware: :- Telephone:WE Complaint -� Description: � r Inquiry 0 Description: t Far OBae Use Only. Inspector's Action/Comments Inspector. /�,Z CW -�c ra.Aj 4r;2..Lx fni, Yea{ y�c,,J (b 1 '►� �f�L � a c cQ r y ,..ram Q �Ci�r9 \¢ Follow-up Action Additional Info.Atmached Qpr Distrihutton: White-Department File Yellow-Inspector . Pink-Inspector(Return to Olfce Afana;er) THE The Town of Barnstable • 1AMSPABL& • ,19MAM Department of Health Safety and Environmental Services �''0rE 039. �,e Building Division 367 Main Street,Hyannis MA 02601 l� Office: 508-790-6227 r Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only 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. Type of Work: A- Est.Cost �d Address of Work: i Owner's Name Q Date of Permit Application: -1 7 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 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 hereb. apply,for a permit as the age" he owner: 2 , Xate'l Contractowwame Registration No. OR Date Owner's Name The Commonwealth of Massachusetts _.__ :_ Depart of Ltdustrial.4ccidutts Office OfAlFeW9,71lans "'':_ h00 11'asltin ton Street ` Boston, A1uss. 02111 Workers' Compensation Insurance Affidavit AhPlicant information: Please PRINTIe� location: city <' 41/1/S nhone 0 tam,P14omeowner performing all work mvself. I am a sole proprietor and have no one working in any capacity .. ..:. .�.•....; -,s .,.,,r....-s-s7�-�r�-+.-.�*-; +r..+: a.-..-r-.r-.-+'ems.-s+�..�...�.,.�:...-...�. , -..,-.-...•.--....�.,�_....___•.... Cj I am an employer providing workers' compensation for my employees working on this job. contpanN• name: address- city: 11hone#• insurance cn. nolicy# [� I am a sole proprietor. neneral contractor,or homeowner(circle ate) and have hired the contractors listed below who have In the following workers' compensation polices: comnam• name: address: city: 2hone#: insurance co. noiicy# _..__._.... _._ ._.___....._. _i.i may..—_... � .r....��.. _- _- -_ __ _ ..1�_ _ _ __ __ _�a:1':o..r•-.. .�._—.� ennlnany natne: address: rin•: Phone#• insurance co. policy# Attach additional sheet if necessary; .. _-_«. ...__—. ...--._ .iL�..��Y�.rY�fu..�r.•J�/!ZS/.'�.�'� .— - �- •Npt•� —wlfilrV�-- �-T-'.��a'I' t'i.J.��il..1KYc ii�L F:cilure to secure cnver:tge:ts required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a tine up to S1.500.00 andiur une N cars' imprisonment as %ell as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. 1 understand that a cope of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. 1 rlo hereby certifl utt the pains a cna es o perjure•that the information provided above is true and c rrecnt. 100 DatoSi„nature r Print mine Phone# :. 'official use only do not�s-rite in this area to be completed by city or town official ` r �• city or town: permit/license# r'tliuiiding Department Licensing Board check if immediate response is required C]Selectmcn's Office f' [31lcalth Department contact person: P hone#: mother . r n a�i3:1,;NAI F: information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation 'Rv tlhcir employees., As-quoted from the an emploree is defined as every person in the service of another under anv contract of(tire, express or implied, oral or written. An enrph rer is defined as an individual, partnership, association. corporation or other legal entity, or any two or more : the foreuoing 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 hous or oft tite urounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance ot- renewal of a license or permit to operate a business or to construct buildings in the commonvealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha been presented to the contracting authority. ... .. • T' .: .t. �lP�7a'M�..'1lRwwr-l'. Applicants Please fill in the workers- compensation affidavit completely, by checking the box that applies to ;'our situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. Tlie affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are.required to obtain a workers' compensation policy, please call the Department at the number listed below. . City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pleas be sure to fill in the permit/license.number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. Tile Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call Z. The Department's address. telephone and fax number: The Commonwealth Of Massachusetts r '2. Department of Industrial Accidents Office of Investigations 600 «'ashingion Street Boston,Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 Town of Barnstable F1"Elmo Regulatory Services Thomas F.Geiler,Director BARNSrAaLe, 9 MASS. g Building Division j°tEp Mp(A Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 COMPLAINVINOUIRY REPORT Date: 12 Rec'd by: Complaint Name:C1o�a Map/Parcel Location Address: 5 - Originator Name: Gg �.a- . Street: �$ Village: State: "� Zip: Z(p Telephone: Complaint Description: 2.1 30 4 V)1A U"Vzw 4 -1:9— e C, ""a LW� FOR OFFICE USE ONLY Inspector's Action/Comments Date: sector. �- Inspector: k 6 A)f sT�o�.� �dw �� Qt, 4- � ,��,��a y 7'�r�� orltLi4Grn � T f�T T��t�2� �li ��Y Cz� Tv� kT3 Add'tional Info.Attached a Q:forms:complaint a � Certified Plot Plan in Barnstable MA Address: 75 CAMP -STREET Pre pred For:. EDDIE LYONS Assessor's Map: 328 Lot.: 189 Baxter. Nye 'Engineering, & Surveying Community Panel Number 250001 0567 J `Registered Professional F.I.R.M. Map Zones: X Engineers and Land Surveyors Deed Book: 16452 Page 20 : 78 North Street, 3rd Floor Plan Reference: Plan book 352 Page 12 Hyannis, .MA 02601 Phone — (508)'771-7502 Fax - (508)-771-7622 Owner: Bruce Edwards Project Number: 2019-046 Scaler 1 =''30' Date: 12-17-2019 N/F' BRUCE EDWARDS _ DEED BOOK 16452 PAGE 20 PARCEL ID MAP 328/189 I — ---- GRAVEL — DRIVE 41.53' CB DH FND 51.50' — — — N 08'22 07" IN I o. L T.; D o AREA 11,732 N/F CAMP STREET' f .F. o 0 oo PROFESSIONAL BLDG LLC ti . 27 ACt r o DEED BOOK 20471 PAGE 291 o PARCEL ID MAP 328/188/002 \ ' CA o o ,, N APPROX. SIZE v p v v 4 WAND LOCATION N _U N I µOF BURNT D N H- STRUCTURE \ m D REMNANTS 39PGBa OD I GARAGE I I :GRAVEL DRIVE----- ' 11.801f �4 co mn00 � n -. ; "p`I EXXI LNNG I �p #75 .. 11.91'f Nb �o Y . I+ S 12'24'03" E m 12169 0 ' GUY" ........... _._.... P __.�.. �._ .._ UP Z C A VCC Wo , CAMP STREET v 4 rq BITUMINOUS SIDEWALK o z LAYOUT OF 1929 rn (PER PLAN BOOK 39 PAGE 11) EOPWe S 12'24'03" E rn ® - ..._ .._.:..®.. ...... ._.. N 12'24'03" W 110.73' 311,18' CB DH F CB DH FND Notes: • , i 1. A TITLE SEARCH HAS NOT BEEN PERFORMED FOR THIS.SITE. THERE MAY BE RIGHTS BY OTHERS; EASEMENT, TAKINGS, MORTGAGES, RIGHT OF WAYS_.ETC. NOT DEPICTED. IF DETERMINED TO.BE NECESSARY, "A TITLE SEARCH SHALL:BE PERFORMED BY OTHERS AND SUPPLIED TO,BAXTER NYE ENGINEERING & SURVEYING. 2. THE PROPERTY LINE INFORMATION SHOWN IS BASED ON CURRENT AVAILABLE RECORD INFORMATION CONSISTING OF PLANS AND DEEDS. THE EXISTING FEATURES SHOWN HEREON WERE OBTAINED FROM AN ON THE GROUND FIELD SURVEY PERFORMED BY BAXTER NYE ENGINEERING & SURVEYING ON OCTOBER 30, 2019. 3. POTENTIAL ENCROACHMENTS — GRAVEL DRIVES, LANDSCAPING ALONG SOUTHERLY AND WESTERLY PROPERTY LINE. I CERTIFY THAT TO THE BEST OF MY "KNOWLEDGE THE EXISTING STRUCTURES SHOWN HEREON"IS LOCATED IN RELATION TO THE MONUMENTS SHOWN AND IS NOT LOCATED''WITHIN :A SPECIAL FLOOD HAZARD AREA. THIS PLAN IS NOT TO BE RECORDED NOR IS IT TO BE USED TO,ESTABLISH PROPERTY LINES. ' S9g N1 ;tea MA � v No.46687�REGISTERED PROFESSIONAL LAND SURVEYOR N BAXTER NYE ENGINEERING & SURVEYING DATE i t 4. R BUILDING DEPT. DEC 3 0 2019 TOWP d OF BARNST,�gLE 9 Certified Plot Plan in Barnstable, MA Address: 75 CAMP STREET Prepared For: EDDIE LYONS Assessor's Map: 328 Lot: 189 Baxter Nye Engineering & Surveying Community Panel Number 250001 0567 J Registered Professional F.I.R.M. Map Zones: X Engineers and Land Surveyors Deed Book: 16452 Page 20 78 North Street, 3rd Floor Hyannis, MA 02601 Plan Reference: Plan book 352 Page 12 Phone - (508) 771-7502 Fax - (508)-771-7622 Owner: Bruce Edwards Project Number: 2019-046 Scale: : 1" = 30' Date: 12-17-2019 N/F BRUCE EDWARDS DEED BOOK 16452 PAGE 20 PARCEL ID MAP 328/189 I GRAVEL DRIVE 41.53' CB DH FND j 51.50' N 08'22 07" W I 0 L T C m AREA 11,732 A X N/F CAMP STREET co .F. > m o M PROFESSIONAL BLDG LLC N .27 ACf o DEED BOOK 20471 PAGE 291 PARCEL ID MAP 328/188/002 � z I N c� D 0p -n 1v PAPPROX. SIZE � J O v co WAND LOCATION N -0 Ln I 0o µOF BURNT Oo D N I I" STRUCTURE ,,, Gn> REMNANTS (Drri m D 3gpjv(;B��WC O D I GARAGE GRAVEL — - _--- •-— DRIVE l ' Coco z I 11.so'f00 \ V -J y i 00 EXISTING DWELLING rri #75 I 11.91'f CP S 12'24'03" E 16M I 69.0 ' GUY ---....____.._._...._.:...._____.. _____ _ uP Ai voc 30 r BITUMINOUS CAMP STREET � g o C: ® SIDEWALK LAYOUT OF 1929 , Z (PER PLAN BOOK 39_ PAGE 11) u E� VCC S 12'24'03 E m N 12'24'03" W 110.73' 311.18' CB DH FND CB DH FND Notes: 1. A TITLE SEARCH HAS NOT BEEN PERFORMED FOR THIS SITE. THERE MAY BE RIGHTS BY OTHERS, EASEMENT, TAKINGS, MORTGAGES, RIGHT OF WAYS ETC. NOT DEPICTED. IF DETERMINED TO BE, NECESSARY, A TITLE SEARCH SHALL BE PERFORMED BY OTHERS AND SUPPLIED TO BAXTER NYE ENGINEERING & SURVEYING. 2. THE PROPERTY LINE INFORMATION SHOWN IS BASED ON CURRENT AVAILABLE RECORD INFORMATION CONSISTING OF PLANS AND DEEDS. THE EXISTING FEATURES SHOWN HEREON WERE OBTAINED FROM AN ON THE GROUND FIELD SURVEY PERFORMED BY BAXTER WE ENGINEERING & SURVEYING ON OCTOBER 30, 2019. 3. POTENTIAL ENCROACHMENTS - GRAVEL DRIVES, LANDSCAPING ALONG SOUTHERLY AND WESTERLY PROPERTY LINE. I CERTIFY THAT TO THE BEST OF MY KNOWLEDGE THE EXISTING STRUCTURES SHOWN HEREON IS ,,,�. LOCATED IN RELATION TO THE MONUMENTS SHOWN AND IS NOT LOCATED WITHIN A SPECIAL yb 2, r � A,, FLOOD HAZARD AREA. SHANE '� THIS PLAN IS NOT TO BE RECORDED NOR IS IT TO BE USED TO ESTABLISH PROPERTY LINES. i„V" .0 MALi_O f ,I� .,�3 r No.4'0 JO 5.X EGISTERED PROFESSIONAL LAND SURVEYOR N BAXTER NYE ENGINEERING & SURVEYING DATE L 3'-0" OENERAL NOTES MAX OPENING 04 • ALL DIMENSIONS AND ELEVATIONS TO BE VERIFIED IN THE FIELD (V.I.F.) BY THE CONTRACTOR S1 A36 THREADED PRIOR TO START OF NEW WORK (MERE MEREED SIMPSON TYPE SIMPSON TYPE ROD (WHERE • ALL CONCRETE FOR WALLS AND FOOTINGS SHALL OBTAIN A MINIMUM COMPRESSIVE N 2 2x6 �_ REQUIRED) ) OF 3000 psi AT THE AGE OF 28 DAYS. ALL CONCRETE EXPOSED TO WEATHER HOLD DOWN HOLD DOWN EQUIRED VE S THE GTH , SHALL BE AIR Q I DIAMETER TO PROVIDE SIMPSON TYPE PROVIDE SIMPSON TYPE DIAMETER TO ENTRAINED 5 TO 7 PERCENT. ALL CONCRETE FOR SLAB ON GRADE SHALL OBTAIN 3500 psi AT • COUPLER WHERE COUPLER WHERE ••' MATCH THREADED 1f a< MATCH SB •• THE AGE OF 28 DAYS. ALL FOOTINGS SHALL BE A MINIMUM OF 3-6 BELOW FINISH GRADE. o I NCHOR, PROJECTION IS PROJECTION IS ROD. MAXIMUM HEIGHT FOR BACKFILL FOR ALL 10" AND 12" THICK FOUNDA1ON WALLS SHALL BE { INADEQUATE. INADEQUATE. 8'-0". BRACE ALL WALLS OVER 4'-0"HIGH PRIOR TO PLACING ANY BACKFILL. PROVIDE 2-#5 S1 :: t° `0 ¢ SIMPSON TYPE SB CD Q `D Q CONTINUOUS REINFORCING BARS IN TOP AND BOTTOM OF ALL CONCRETE FOUNDATION WALLS. THREADED ROD o I HOLD DOWN ANCHOR. FOR ALL FOUNDA1ON WALLS LESS THAN OR EQUAL TO 8'-0" IN HEIGHT, PROVIDE 1-#4 N S1 CONTINUOUS REINFORCING BAR NEAR MID HEIGHT OF WALL STORY. FOR ALL FOUNDATION a �( (A36)THREADED cr o • EMBEDDED SIMPSON-SET EPDXY ANCHORING • I _ o o I I WALLS GREATER THAN 8'-0" IN HEIGHT, PROVIDE 1-#4 REINFORCING BAR NEAR THIRD POINTS Z ROD EXTENSION o o ANCHORS Y n o l IN THE WALL STORY. z �, I DIAMETER TO SPECIFIED I o 0 wI COUPLER ANCHOR TYPE ANCHOR TYPE EMBEDMENT �' w 2x10 RIDGE BOARD v MATCH SB HOLD DOWN I ( N • IN AREAS LIKELY TO HAVE EXPANSIVE, COMPRESSIBLE, SHIFTING OR OTHER UNKNOWN o N c� ANCHOR a HDU2 12" I I w = I I SOIL CHARACTERISTICS, THE BUILDING OFFICIAL SHALL DETERMINE WHETHER TO x¢ I N w ( . SB % x 24 9" A36 T.R. " ( ° REQUIRE A SOIL TEST TO DETERMINE THE SOIL CHARACTERISTICS AT A PARTICULAR SIMPSON TYPE HDU4 CNW ( 12 I I U_ `�' IT ° LOCATION IN LIEU OF A COMPLETE GEOTECHNICAL EVALUATION. THE PRESUMPTIVE COUPLER HDU5 18" I I M m LOAD BEARING VALUES IN TABLE 18 4. � o I � � � r- � ' L 0 3 OF THE 780 CMR SHALL. BE ASSUMED FOR o aol °►y ° HDU8 CNW SB x 24 "� A36 T.R. 18" ``' w c THIS PROJECT. A 3000 PSF ALLOWABLE SOIL BEARING PRESSURE HAS ,BEEN ASSUMED FOR SANDY GRAVEL AND/OR GRAVEL SOIL TYPES. NOTIFY ENGINEER PRIOR TO S1 REFER TO PLAN AND/OR DETAILS FOR HOLD DOWN LJ.` / p z a SIZE AND LOCATION ? z :, . ° . CONSTRUCTION IF ACTUAL CONDITIONS DIFFER FROM NOTED ASSUMPTIONS. o ( CJA " n ° ' ' PROVIDE AND INSTALL DIAMETER x 12 LONG ANCHOR BOLTS AT 4-0 ON CENTER IN TOP8 IN. T.R. INDICATES THREADED ROD 8 MIN tr " " "• • • • OF FOUNDATION WALLS. MINIMUM OF TWO (2) ANCHOR BOLTS PER WALL SECTION.00 S1 ( ° ` a COORDINATE EXACT LOCATION WITH STUD R b ° • ALL FRAMING LUMBER SHALL BE DOUGLAS FIR NO. 2 AND BETTER UNLESS OTHERWISE NOTED. LAYOUT, PRIOR TO POURING CONCRETE. SECURE• : TO FORMWORK WITH SIMPSON TYPE ANCHORMATE ALL PRESSURE TREATED WOOD SHALL BE SOUTHERN YELLOW PINE NO. 2 AND BETTER MEETING ° . HOLDERS FOR PROPER ALIGNMENT. a THE REQUIREMENTS OF AWPA-C1 AND C9 SPECIFICATIONS. ALL FASTENERS IN PRESSURE PROVIDE (8)12dTREATED WOOD SHALL BE HOT DIPPED GALVANIZED OR STAINLESS STEEL. NAILS RAFTER S1 ADJACENT TO TYPICAL TYPICAL ADJACENT TO Q TO CEILING DOOR DROP I CENTERLINE INSTALL ONE HORIZONTAL ROW OF CONTINUOUS BLOCKING AT MID-HEIGHT OF ALL BEARING EACH.END- REFER TO FOUNDATION DOOR DROP DETAILS FOR ALL OTHER JOF STUD WALLS Y _ REFER TO FOUNDATION REQUIREMENTS. DETAILS FOR ALL OTHER • ALL FASTENERS SHALL BE INSTALLED IN ACCORDANCE WITH 2O15 IRC CODE AS INDICATED IN REQUIREMENTS. CHAPTER 6 AND AS NOTED IN PLAN. ROOF FRAMING PLAN �. �.` .,. 11 CORNER. MID �ALL 5" DOOR DROP • FASTEN BUILT. UP POSTS TOGETHER USING TWO (2) VERTICAL ROWS OF 16d NAILS SPACED AT SCALE 1/4"=1'-0" MIN. INSTALLATION INST LLATION MIN, INSTALLATION ALTERNATE 8" ON CENTER IN EACH PLY OF 2x4 OR 2x6 MATERIAL. STAGGER ROWS OF NAILS TO AVOID 0 �, ti.-. . o SPLITTING WOOD. O,- „ HOLD DOWN DETAILS ALL WALL STUDS AND POSTS SHALL EXTEND FULL HEIGHT BETWEEN LATERALLY BRACED SIMPS 01 02 Q O�o� POINTS AT ROOFS, FLOORS AND CEILINGS, UNLESS OTHERWISE NOTED. � ON S1 S1 ����G� NOT TO SCALE HDU2 HOED iDo TYP. S1 - -- ---- ----- -------- P • ADD PLYWOOD FILLERS TO ALL WINDOW AND DOOR HEADERS SO THAT SURFACE OF HEADER IS ANCHOR - �T I Q FLUSH WITH WALL FRAMING. - ----_ -'-_-- ---- - 1 P I ALL HANGERS AND CONNECTORS NOTED IN PLAN, ARE SPECIFIED FROM THE SIMPSON STRONG i TOP OF WALL 11E CATALOG OR APPROVED EQUIVALENT. ! 0 sI S1 { I TOP OF WALL " HOLD DOWN POST FASTENER SCHEDULE+0-8 SHEATH THE. ENURE ROOF INCLUDING UNDER ALL OVER BUILD ROOF AREAS, USING J" THICK L -o'-10Y11 I I s� TOP OF WALL 1 at HIGH SLAB I ( ALTERNATE APA RATED PLYWOOD. FASTEN ALL PLYWOOD USING 8d NAILS AT 6" ON CENTER AT EDGES +0-8 G POINT AND 8 ON CENTER AT ALL INTERMEDIATE SUPPORTS. IF, 2r LONG AIR DRIVEN NAILS WITH A 0oll, +0'-0" I- ( SIMPSON TYPE SDS SCREWSHOLD DOWN STUDS 10d NAILS�C I I I I ((STAGGERED) SHANK DIAMETER OF 0.097" TO 0.099" ARE USED, SPACE NAILS AT 3" ON CENTER AT PANEL P� " EDGES AND 6" ON CENTER AT ALL INTERMEDIATE SUPPORTS. { I 4 THICK CONCRETE SLAB REINFORCED ( ( HDU2 (2) 2x (2) at 16" O.C. 1/4 x 3" at 24" O.C. WITH 66-W1.4 x W1.4 WELDED WIRE _ 00 I I MESH OVER 6 MIL VAPOR BARRIER ON I 0 „ „ " ALL PROPOSED SUBSTITUTIONS SHALL BE SUBMITTED TO CIANCI ENGINEERING LLC FOR J HDU4 (2) 2x (2) at 12 O.C. 1/4 x 3 at 16 O.C. APPROVAL PRIOR TO INSTALLATION S1 12" COMPACTED STRUCTURAL FILL. TOP OF WALL SLOPES J�"per FOOT I ( HDU5 (2) 2x (2) at 8" O.C. 1/4 x 3" at 12" O.C. POST ALL LOADS DOWN TO FOUNDATION OR BEAM BELOW. PROVIDE LVL BLOCKING BETWEEN { -0-1oY TOP OF WAL ( FLOOR AND UNDER ALL POSTS. y0 I +0'-8" Y" THICK PLYWOODREFER TO PLANHDU8 (2) 2x (2) at 8" O.C. 1/4 x 3" at 12" O.C. ROOF SHEATHINGivv A H�p0 I i ( ) S1 FOR AND FRAMING HDU8 (3) 2x N/A USE SIMPSON 1/4 x 4 1/2" at 8" O.C. TOP OF WALL ( ( 12 SIZES LOCATION TYPE SDS SCREWS +0'-8" TOP OF WALL I ( 12� o.. SOLID BLOCKING BETWEEN SI S1 I I------ --- +0,-81- RAFTERS ATTACHED TO '.N TOP PLATES with 8d •+ +81_0" Cade el NAILS at 6" O.C. —— ——— —_—————————— ————— — -$ CODE: NINTH EDITION MASSACHUSETTS RESIDENTIAL CODE FOR ONE and TWO — y�G�,os, IfniSIMPSON TYPE FAMILY DWELLINGS. (EFFECTIVE OCTOBER 2017) 2015 INTERNATIONAL H2.5a HURRICANE RESIDENTIAL CODE, AS MODIFIED BY THE 780 CMR NINTH EDITION. 0' CLIPS TYPICAL o,� o Deshn Grayly Loads �. �„ PLYWOOD OR OSB SHEATHING FASTENED PROVIDE BLOCKING AT Live Dead WITH 8 ©8d NAILS at O.C. ALL.HORIZONTAL JOINTS ROOF 30 pSf 15 pSf FOUNDATION PLAN ALONG PANEL EDGES and 12" O.C. ALONG ATTIC 20 10 sf 10 sf SCALE 1/4"=1'-0" INTERMEDIATE STUDS. 2x4 at 16" O.C. � p p STUD WALL REFER TO PLAN z-#5 coNT 1 . SLAB BEYOND " TYP. OR DETAILS TOP BAR Design Wind Loads -- - --'} - - -- - - - -- - Building Category II ---• 9r i 1r -- -- ( Wind Speed V ult= 140 mph SECTION at ROOF ( 1 -9 wind Exposure C 04SC. 3/4"=1'-0" - R TO _ 3' 0" EFER ARCHITECIURALS 3' 0" et 2-#5 CONT. - - - - - - - - - - - .' 2x4 PRESSURE TREATED WOOD PLATE FASTENED WITH VO ANCHOR BOLTS WITH - - - - - - - - - L - - - - - OF 8" INTO REFER TO PLAN A MINIMUM EMBEDMENT FOR FRAMING CONCRETE. PROVIDE A MINIMUM OF TWO ELEVATION Y2" PLYWOOD OR OSB SIZES AND (2) ANCHOR BOLTS PER SECTION OF PLATE AND 12" FROM END OF EACH LOCATION SHEATHING FASTENED SECTION. INTERMEDIATE ANCHORS SHALL MAX. at 02/S1 sim) UILIDIAIt L © BE SPACED AT 4'-0" O.C. MAX.(2'-O" O.C. A WITH 8d NAILS at 4' O.C. REFER TO PLAN FOR ALONG PANEL EDGES. TOP OF SLAB AND TOP and 12" O.C. ALONG FIN. GRADE PREMOLDED JOINT FILLER r OF WALL ELEVATION FEB s5 I 00 INTERMEDIATE STUDS. FIN. GRADE W OVV 0 Ls ,. 1 { (3)16d NAILS at 16" O.C. o ao +�u. 2�_p" W - ALONG LENGTH OF a I I! E I I-III--! CORNER BARS z BRACED WALL PANEL LI;III � !llll��L! COMPACTED SAME AS U_ COMPACTED z � �. STRUCTURAL 20 at 16 O.C. HORIZONTAL o STRUCTURAL FILL U. �! BACKFILL ZBARs W 2-#s CONr. GSM 2.17.20 GENERAL REVISION STUD WALL 00 TOP & BOTr. 0 2-#5 CONL 1 2-#5 CONT. REFER TO PLAN FOR m REFER TO PLAN FOR rev. no. b date remarks „ ----- z BOTTOM OF FOOTING 2 COVER o BOTTOM OF FOOTING g �i TYP. o ELEVA110N _ f, ••• ELEVATION 5 CAMPAGARAGE at q 1 PROVIDE BLOCKING AT 1-4 I of �- ALL HORIZONTAL JOINTS NOTE~ DETAIL SHOWS REINFORCING HYANNIS, MASSACHUSETTS AT CORNER CONDITIONS ONLY. REFER TO PLAN FOR PILASTER 101, " INFORMATION, IF ANY. 2-#5 CONT. 11 01 2-#5 CONT. FOUNDATION PLAN and ROOF FRAMING PLAN 1'-8" EFER TO FOUNDA ON 1 WALL SECTIONS FOR , drawing no. Q REQUIREMENTS , � SECTION at ROOD Tyl/2*4-0" P. FOUNDATION Cianci Engineering, LLC 03TYP. CORNER DETAIL WALL SECTION EXTERIOR DOOR SECTION 53 Hurlbut Street �` West Hartford, Connecticut_06110 a SC. 3/4-1-0 SC. 1 2 =1-0 02 SC. SCOPE OF SERVICE BY CIANCI reuse of this drawl i/ (FOOTINGS & WALLS) �� - _ rig n any manner is strictly SC. 1/2 -1 0 ENGINEERING, LLC IS LIMITED TO THE prohibited without the written approval of S-1 STRUCTURAL WORK SHOWN ON THE Cianci Engineering, LLC DRAWING(S). ALL OTHER WORK IS NOT BY CIANCI ENGINEERING, LLC. Checked by drawn by Scale date Job no. I PG/CSC - GSM I AS NOTED 1 02/06120 20 104 01 FOUNDATION CERTIFICATION PLAN Address: 75 CAMP STREET � Y N N N L' _5 I Prepared For EDDIE LYONS Assessor's Map: 328 Lot: 189 BUILDING Baxter Nye Engineering & Surveying Community Panel Number 250001 0567 J MAY 0 12020 Registered Professional F.I.R.M. Map Zones: X Engineers and Land Surveyors Deed Book: 16452 Page 20 TOWN OF BARNSTABLE 78 North Street, 3rd Floor Plan Reference: Plan book 352 Page 12 Hyannis, MA 02601 Phone - (508) 771-7502 Fax (508)-771-7622 Owner. Bruce Edwards Project Number: 2019-046 Scale: : 1" = 30' Date: 04/22/2020 N/F CAMP STREET PROFESSIONAL BLDG LLC DEED BOOK 23188 PAGE 236 PARCEL ID MAP 328/187 41.53' CB DH FND 51.50' N 08 22'07" W 0 LOT m AREA=11,732 n m N/F CAMP STREET v ±S.F. �rn rn � PROFESSIONAL BLDG LLC -►� .27 ACt w r- 0 M DEED BOOK 20471 PAGE 291 ^' o PARCEL ID MAP 328/188/002 D 0 M -14 30.2' CA v N OD 39 AN e�OK 15.7 M PG 11 0 N � rn o � � N V N 15.7'� OD AS—BUILT 10.7 GARAGE FOUNDATION LOCATED 04/20/2020 co o !� z .• �r �P I Cl) I EXISTING rri DWELLING #75 I S 12'24'03- E 69 0' z CAMP STREET v .p. m cWi, o LAYOUT OF 1929 m (PER PLAN BOOK 39 PAGE 11) — S 12'24'03" E m _ — — _ N 12724'03'" W 110.73' 311.18' CB DH FIN CB DH FND Notes: 1. A TITLE SEARCH HAS NOT BEEN PERFORMED FOR THIS SITE. THERE MAY BE RIGHTS BY OTHERS, EASEMENT, TAKINGS, MORTGAGES, RIGHT OF WAYS ETC. NOT DEPICTED. IF DETERMINED TO BE NECESSARY, A TITLE SEARCH SHALL BE PERFORMED BY OTHERS AND SUPPLIED TO BAXTER NYE ENGINEERING & SURVEYING. 2. THE PROPERTY LINE INFORMATION SHOWN IS BASED ON CURRENT AVAILABLE RECORD INFORMATION CONSISTING OF PLANS AND DEEDS. THE EXISTING FEATURES SHOWN HEREON WERE OBTAINED FROM AN ON THE GROUND FIELD SURVEY PERFORMED BY BAXTER NYE ENGINEERING & SURVEYING ON OCTOBER 30, 2019. 1 CERTIFY THAT TO THE BEST OF MY KNOWLEDGE THE EXISTING STRUCTURES SHOWN HEREON IS LOCATED IN RELATION TO THE MONUMENTS SHOWN AND IS NOT LOCATED WITHIN A SPECIAL NOFMgss FLOOD HAZARD AREA. o� SHANE GN THIS PLAN IS NOT TO BE RECORDED NOR IS IT TO BE USED TO ESTABLISH PROPERTY LINES. M. MALLON No.48687 Pv A9�FES5��� lqH� SUPN�y�Q REGISTERED PROFESSIONAL LAND SURVEYOR N BAXTER NYE ENGINEERING & SURVEYING DATE J:\2019\2019-046\SURVEY\PLOT\2019-046 FCC.dwg,4/22/2020 1:25:26 PM,Bluebeam PDF