HomeMy WebLinkAbout0075 CHESTNUT STREET OWNER OF RECORD I HEREBY CERTIFY THAT THE EXISTING
Brian W. Woods GARAGE SHOWN HEREON,15 LOCATED Y
Deed Book 13988,°Pa4e 38 j, AS IT EXISTS ON THE GROUND.
Plan Book 87, Page 95
Assessors' Map 309, Parcel 1 19 DATE'
x LAN�F MgSS
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6733 �
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BENCHMARK:.
Top of,Concrete Bound
m n� ti EL=50.4± (Assumed datum)
° LOT 20 to.
k
/2 -LOT 2 I °
'Area=8,800 SF±
N
n
... 89
CB(FND)• CB(FND)
AS-BUILT PLOT PLAN a.
SHOWING-NEW GARAGE BUILDING
'AT
75 CHESTNUT STREET,., HYANNIS, MA
+ LEGEND F PREPARED FOIR L
CB Concrete Bound t I , E.W 5 LC
FND Found
5H Shed
s step 0 30 GO 90
SCALE I"-30"', JULY 22, 20.1 5
G:\AAJobs\Franze70 19\dwg\70 19As Built:dwg �.+ Drawn by JFM, JMO-701 9.
_.
J.M UREILLY &ASSOCIATES, INC: 1573-Main-Street, P.O. Box 1773
Professional Engineering&_Surveying.Services Brewster, MA 02631 (50.8)896-6601-
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel Application ®�
Health Division Date Issued "s t s 00OL3
Conservation Divisio Application Fee n
Planning Dept. Permit Fee I d
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation/ Hyannis
Project Street Address 15 O 1f1A
Village �I a 1AA
Owner P'1� viool Address
Telephone 250 —
Permit Request CQckg c o,4'a A. Po . mvu ktoeIlked awe
( 4- q 124G
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation 0 Construction Type[
Lot Size TOO �� `�1 Grandfathered: ❑Yes ❑ No If yes, attac pporting,documentation.
Dwelling Type: Single Family. WL Two Family ❑ Multi-Family (# units) sr)a
Age of Existing Structure Historic House: ❑Yes #No On Old Ki g'' Highwal ❑�s VNo
Basement Type: VtFull ❑ Crawl ❑ alkout ❑ Other _
Basement Finished Area (sq.ft.) Basement Unfinished Area (s .ft)
CD
Number of Baths: Full: existing new Half: existing new m
Number of Bedrooms: existing _new
Total Room Count (not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑ existing new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
• Commercial ❑Yes ❑ No If yes, site plan review #
Current Use Proposed Use
APPLICANT INFORMATION _
- "(BUILDER OR HOMEOWNER)
Name Telephone Telephone Number � — —'����
Address �Ce1iT�jCC1A 6 License # 'N'b T2,
`1%,&)k 6A 6A' l Home Improvement Contractor# `
Email 4_A ) C0 M • Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKE TO
SIGNATURE DATE
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
M R/PARCEL NO.
ACORESS VILLAGE
� F
OWNER .
tk —
va
F "
DATE OF INSPECTION:
FOUNDATION 0.4or�ms
'h FRAME
,4
3
k
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
G
FINAL BUILDING
a
DATEuCLOSED OUT
AsS.QOIATION PLAN NO.
I>
� 4
The C'rrmrrmmc ffi of—VassacT uselts
Deparftnmt of fadusuid Accidents
- fffiwe ofrnves wivas
600 W shungto Street
Bostarz,MA 02111
wmv.rrtuss:gm,1dia
Workei-s' Campens:atianInsm-ante ftdavifi BuildersfCantractursMectricians/Plumbers
Applicant Infarmatian / Please Print,Lef�ibly
I�Tam��BttsineBslOrganizaiionlb�ivi�ai)_ �`�,! °^"'G
City/Stat t-JZip: `�4%ej� P1' (�Z Phone t J
Axe on an employer? Check appropnate box: Type of project r
4_ I�a contractor and I 3'� � I (required):
1_LIXt I am a employer with 9 6 �T
employees(full and/or paa-time)* have hired the sub-conb ctors
ew cDnsirY-tou.
2_❑ I am a sole proprietor or partner- listed on the attached sheet 7_ ❑Pem,odelmg
ship and have no employees These sob contrartors have g_ ❑Demolition:
w for me in an c cr r_ employees and have workers'
orkiug y � t5 1 4_ ❑Builriing addition
[No�workers' comp_in +�xanre, cutup_insuranoc
reTliced-I
5_❑ 'We are a corporation and its 10..0 Electrical repairs or additions
3_❑ I am a homecrwner doing all work of cers ha-m-exercised their 11-0 Ploxnrmg repairs or additions
MIS-9j [No workers'coruIj right of exemption per MGL 1�
insurance requited-]F c.152, §1(4)�and wehH'MnD �Roof � c
employees_[No workers'
comp-insurance required-]
*tiny app twat checks boa ttl nmsi also fill out the section betaw shoeing theirwoikeze compensatingpolicy infx rmatian
T Hnme.,.s who submit this affid in&cating dwy ate dying.R trade d then huE outside eorttraetors roost sr a affidav$inrftCsiin�'siirli
LConttacrors that clieck this box taint sttwhed an-Addition]sheet dun mg the name of ifte Wb-omfr. and state whether or not those EMdthes have
emgluyees. If the,sulr{ontmctors hn a empicytes,they must pmvide thdr waders'comp.policy ntm2HL
I am art employer that is pm-i&1gg norlsers'cottrperlsYckon insurarcca far my employees Befvt+:is thepo&y and job site
informa6vit.
Insurance Company Name: reto-e l`c t(
Policy#or Self ins Lin_4` � � �1J '� Expiration Date:
Job Sites Address: IT CV ,,Ioot City/StatelZip: 4444 C k k
Attach a copy of the workers'compensation policy'declaration page(shoving the policy nu ber and expo ration date).
Failure to secum cm-r-rage as required under Section 25 fit of MGL c. 152 can lead to the imposition of criminal ponies of a
fine np to$1,500.OG and/or one-year impri ,as well as civil penalties in the fixm.of a STOP WORK ORDER and a fine
ofup to$250.00 a day against the violator. Be advised that a copy of this stab mmt may be f awarded to the Office of
Investigations of the DIA for incurzertce coverage verificatim
Ida hereby cerh;fy r.. the pains andpenaWas ofpedwy thatfhe irr,formaiianprcn idedu . Te is truce and correct.
Sitmaturrn: Bate:
Phone 9 "1''
Off E aI use only. Da not write in this area,to be completed by city or town ofi5'ciaL
Cite or Town:. Permit/License
Issuing ri utharitjy(drde one):
1.Board of IlezItti 2.Binding Ikpartment 3.CityfFown Cleric 4.Electrical Inspector S,Plumbh g Inspector
6.Other
Contact Person: Phone 9--
6
r
'P
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 Iocal licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the common-rvealth for arty
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 ofpublie 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 check i g the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s),address(es)and phone ni mber(s)along with their ceit ficatc-(s) of
insurance. Limited Liability Companies(LLC) or Limited Liability Partiersh ps(L LP)with no c-amployees 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 submit`Led to the Depa�-meat of Industrial
Accidents for confirmation ofiasurance coverage. AIso be sure to sign and date the affidavit 71re afiida-%rit should
be returned to the city or town that the application for the permit or license is being requested, not he Departinent of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtaM a�rorkers'
compensation policy,please call the Department at the number listed below. Self=insured companies should enter tHeir
self-insurance license number oa 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 peimit/liccuse number which wiD be used as a reference number. In add ;ion,an applicant
that must submit multiple pewit/hcense applications in any given year,need only submit one ai davvit 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 fiitze 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 affida�vr t
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 aad fax number: -
The Cornm_onwealth of Mnsachusttts
impartment of Ind al Accidents
Gffli e of kvestiotlaas
640 Washingtan Stet
Eas on=MA 02111
Tel.9 617 727-49R{1 ext 406 or 1-8 2��S E
Revised 4 24-07 Fax#617-727_7749
Fa .rnas�gQ���ia -
r" 41FVC Guide to FYood Currst5-ucfi�orr ur High Fir&Ar'errs: IIO rrrph WrridZane
Alfassachusett ChcckBt for CoR iARCe(7sa CLMR_301.Z.r_r)r
Loadbearing Wall ConeCUDnS -
Lateral(na-of 16d n common (Tables 7)_____-_ _.._----_--.___._.__-_--
NDri-L'aadbeating Wag Connections
L-hi ral(no_of 16d cDmman narTs)-- -._.__ (Table 8)---------.------------___-- 'L
Load Bearing Wag•Ope'nings(record largest opening but check all openings far mrripliance to Table 9)
Header Spans (Table 9) ff—in <11•
Sill Plate Spans- -----------.........-_______._-.------_--(Table 9)------__:---•--------------�ft_in 11'
Full Height Studs (no.of studs)------ ...(Table 9)-_--___.-._-___ ..__
NDn-Loaad Bearing Wall Openings (Hurd largest opening but check all Openings for comprtance to Table 9)
Header Spans_. ----------- ---(Table 9}---------------_._ft_irr-_<12`
Sig Plate Spans.----------------------�____ _�_�(Table 9)_ --------______._ft_iri s 12`
Full Height Studs(no.of studs)--.--•-____-- _-_-(Table 9)___-----,-----_._- _ 2-
Exterior Wall Sheathing to Resist Uplift and Shear Simultaneaus:v
Minimum-Bilt1ding Dimension,W -
NDniinal Height of Tallest Openingz ------
-.--._-.._t �-..-____..__._----_- _____ s E'j
Sheathing Type-_----------------------(note 4} --- - --------- X o wd S
-Edge Nail Spacing-___.•----•------__-__--(Table 1 D or note 4 if Less)_---..-__-_- in_
Feld!fail Spacing -- ---- --_ ____.....(Table 1D)-•--Shear Connection(no.of 16d common nails)(Table 1D): ._-_~
Percent Full-Height Sheathing.._-._--.__--.-(Table 1D)-_.-------_________-----__-_-
5%Addibonal Sheathing for Wall with Opening>6'r(Design Concepts)
6li2ximum Building Dimension, L
Nominal Height of Tallest Openingz-------------------------------------------------------------------- 6'S'
Sheathing Type -- ---- ---__- -_(note 4) _-- -- ------ - ----
Edge Nail Spacing------------_--------__ ----__--{Table 11 or note 4 if less}-_�.--_-.- rn.
Feld Nail Spacing.__-_._._-.__._-...._ __.(Table'11)_-__
Shear CDnnec5Dn(no.of 16d common nails)(Table 1 i_)_------�_,_-__---------------•_--._
Pete=ent Full-Helght Sheathing_- ---_--.(ra61e 11)-__.--_ -----------__----_�,�
5%AdMDnal Sheafhing for Wall v.,M'Opening>6'8'(Design-Concept=)_----__-;--
Waif Cladding
Rated fix Wind Speed?-_-_-_-_---_----------------_-_-_ -_-.-_ -_
5-1 ROOFS
RDof framing member spans checked?._.__-_-___..(For Ratters use AWC Span Tool,see RBRS Website)
RDof Overhang ._-----------------------_______.____-__-..(Figure 19)._---------- A s smaller Df 2'or U3
Truss Or Rafter Connections at LDadbearing Walls /
Proprietary Connecters /
Uprrft- --=-- -------- (Table 12)----- - -- - ---U= ptf..
Lateral...__ __^______- __------(Table.12) pff
12)-----------= -- ---- off_
Mdge Strap CDnneCtiDns,if collar ties not used per page Z1... (Table 13)__________________--T= plc
Gable Rake Out1DDker_._---------.__:-:---_--.-------(Figure 2D)------------_fts smaller of 2'Dt L12 .
Truss or Rafter CDrin—riDns at Non-inadbearing Walls
Proprietary Connecters
Uplift _______U= lb.
Lateral(nD_of 16d common nails)__(Table 14)--------------------------------------.L= . lb. -
Roof Sheathing Type----_---:.--•--�-----___--(per TBD.CMR Chapters 58 and 59)___._,_-,__.
RDof Sheathing Thickness-___--- _in_?7116 VVSP
Roof Sheathing Fastening (Table 2)-_----.-,------._,__--_._-.-----.--•_
dotes:
i, : This Checldisf shall be met in cis entin=fy, excluding the com speDiTtc exxeption nDted in Z< to ply With the tequitE� en mts of
7SD CMR-i iD2 1. 1.1 Item 1. if the checkfisf is met in its entirety then the following metal straps and hDid dDtvns arm not
required per the WFCM 110 mph Guide
a. Steel Straps per Figure•5
h. 2D Gage Straps per Figure 11 ;
Uplift Straps per Figure 14
d All Straps per Figure 17
e Comer Sind Hold Downs per Figure 18a and Figure i Bb.
Exraption:Opening heights of up to 8 th shall be permifiad when.15% is added tD the percent full-height sheathing -
requir�bnfs shut in Tables 10 and 11.
The bottom sill plate in exferiw waifs shall be a minimum 2 in_nominal Nck iE� pressure treafed 92-giade,
AWC Guide to Wood Cony&wcdort L7 High Wiad Areas:110 brph ff,'Fnr4Zoei.e' • •
Massachusetts Checkd&t for COMp�iaace_ pEo arrt 3ot2_r.I}r -
Compliant.
1.1 .SCOPE
Wind Speed(3-sec gust)_-_---_._ ---•---------=-- ._ _ ;-------------•-- ---_-___.110 mph
Wind.Expasure Category_..__..----___ �-�_-_.---.__--
Wind Exposure Cafagory................Engineering RegVined For Entire Project._._..________.__... .....0
1.2 APP-UCAB[LrIY -
Number of&-bries(a roof which exc-_ ds B In 12 slope shall be-considered a story) stories _<2 stories
1of f'R=h Fig 2)
Mean RDof Height'----------------_---- -- -(F9 2)----_------------� ------fi <33'
Bulding StVidth,W__-._____.._.-_._-_---------__- (Fit
g 3}__-_-___---_-----_-__--- _._tt BiJ'
Build-rng Length,L _-------- __ -- ----------(Fg 3)------------- -Ft 5 80'
Budding Aspect RaUD(LNV) _.-_:___.-_.__ _.___..---------Fig 4)__- --- _-----__-- _<3.1 1.
Nominal Height of Tallest DpeningZ .___-___ (Fig 4}_.-----------------__----
1-3 FRAMING CONNECTIDNS
General compliance wfth framing ciorinediDns__---__._.-.(Talife 2}_-------_---------------------_---•_----------
2.1 FdUNI7ATiD1Q -
Foundation Walfs meeting requirements Df 780 GMR 541)4.1
Concte....................................................-.-___-.------_-_--.__.,_-_-.--___--_-.___-_-..______--__ _ ._-._.r
CDncrete-Masonry.......-------- — -- ----- --- -__-- --=- --
22 ANCHORAGE TD FOUNDATIDN'- _
5/8`An char SDfts;imbedded or 5/8`PTDprietary Mechanieal-AnchDrS as an'altemafTNe in concrete only
Bof Spacing-general..................................._-.(Table4)----------------------------- in. lqvl
13DIt Spacing from endjDint of plate-__.____--- -__---_-_-•(F9.� -=------------=--------- in.<_6`-12`. ivift
Solt Embedment-cDnrxete------ - ----- (Fig ------
BDIf Embedment-masonry - -- --_=_ - -=----(Fig 5} �.-_--- - - ---- in -'15
Plate Washer - --:.- -- -------- ----(F9 3'x 3`x%`
3.1 FLDD RS -
Floor•f taming member spans checked'_-----------_-.__(per 7BD CMR Chapter 55)---_______________--
Maxirnum F1DDrOpening'Dimension_-_.-.-__-.-------_.(Fig6)__-_---_-------------____-- _ - Jr `
Full Height Wall Studs at Floor Dpeni r ngs less than Z from E)tPd Wag(Fig 6)------
--- -•_-..-
M xanum.FJDDr Joist Setbacks --
SuppDitng LDadbearing Waifs Dr Shearwalf___---_--(Fig 7).__--_------- --_--- -_ {{ <d
lAaximum Cantilevered FIDDF JDistS T
Supporting LDadbearing Walls Dr Shearwall-._._--_.__-(Fig 8}-- -----_-- -_- ft -`d
FloorBracing ai Fdvrall —_.______---------- ._ (Fig 9)_. '
FloDr Sheathing Type •- ----_ - --(par 780 CMR•Chapter 55)------------------ -----
F1DorSheathfng Thidmess ---_-----.--(per7BO GMRi;haptarS5)_.._.-__--_--_,-- in-
FIDDr Sheathlri F4sterirn `' g - g__•_----------._.-•-__- - (fable 2)__d nails at in edge!_in field
4.1 WALLS. . -
Wall Height
Lnadbeafing crags. '__---____-- _:_--.(Fig 10 and Table 5)
NDn-Lnadbearing walls-.----__.-----------.(Fig 10 and Table 5) ....... $'s 2D' $�
Wall Stid Spacing -------____---(Fig 10 and Table S)- in <_24`n_r~
Wag Story 01fsets- _------ -------- ___.(Figs 7&8)---- --:--- - --- d
42 EXTERI D1Z•wALLS' _
WDDd Studs
• LDadbearingvralls:___.__.._.----__..._.___.-------_--.(TaI�la . � � � i -
Non�aaribearing walls._ _.-----------------------••----.(Table S)_- •----------zx -_;t_ n.
Gable End Wall Bracing t
Full Height Endwall Studs_ _.__._.__.____—.-----.__.(Fig
WSP-Afflc Floor Lengifr_ ----_---_-_ _-:______�Fg ---.__-- ft�:W13-
'Gypsum Ceifing Length(If WSP not used) -(Fig 11)__---.-----�----__---- _ft>-D_9W
ahii 2 x4 GonfrnuDus Lat&ra[Bran-@ B fL D_c--(Fg t1�......................-__,_,__-------____--
br 1 x 3 ceiling fining strips @ 16'spacing min.vdb 2 x 4 blocking 9 4 ff-sparing in and joist ar foss bays
DDuble TQp Plafi� I
Splice Length -----.-:-----_-.-------(l 1913 and Table 6}------ --`1�L(iL _ft
' _ 5pgce�nnec`uDn (nn.of 16d raDmmDn rr�1s)_-...___.(Table
r
THE r � Town of Barnstable
Regulatory Services
x x
x BARN BL'E' x Richard V.Scali,Director
y Mass.
�
Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I --b4-V"4-A W b645, , as Owner of the subject property
hereby authorize e [��. to act on my behalf,
in all matters relative to work authorized bythis building permit application for.
(Address of Job) l
'`'Pool fences and alarms are the responsibility of the applicant. Pools
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepted.
Signature of Owner SignaiuYe'Of Applicant
Print Name Print Name
Ic
Date
Q:FORMS:O WNEUERMISSIONTPOOLS
Town of Barnstable
Regulatory Services -
�oF royyy Richard V_Scali,Director
Building.Division
= snxxsrnsrE Tom Perry,Building Commissioner
MAS�$ 1 � 200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 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.
DEFINrrION OF HOMEOWNER
Person(s)who owns a parcel of land oa 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 vwho 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 sucYwork performed under the building pL=t. (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
r
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 Constructioa Control. -------_— _ 1.
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,RuIes &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 fuIIy 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:\WPFILES\FORMS\building permit fom,s\EXPRESS.doc
1 Revised 0 613 13
l
rAo,
M
THE COMMONWEALTH OF MASSACHUSETTS
OFFICE OF CONSUMER AFFAIRS AND For OCABR Use Only.
BUSINESS REGULATION Registration No:
10 Park Plaza, Suite 5170
a Boston , MA 0 2 1 1 6 Effective Date:
7 Application for Registration as a Home Improvement
r` Contractor or Sub-Contractor Expiration Date:
� (MGL c. 142A;201. CMR 18.00)
1. NAME OF APPLICANT: L)
(MUST BE EITHER AN INDIVIDUAL,C RPORATION,LLC,LLP,TRUST,OR OTHER LEGAL ENTTM
2. NUMBER OF EMPLOYEES:_L
3. APPLICANT TYPE: _INDIVIDUAL CORPORATION _PARTNERSHIP _TRUST
(CHECK ONE-MUST BE SAME LEGAL ENNTITY AS THE ENTITY IDENTIFIED IN#1)
4. FEDERAL TAX ID#:
5. APPLICANT PHONE#: 50�- Q7 Z�� APPLICANT EMAIL ADDRESS: c3 11 C✓ L ��DO Qd1M,,
6. MAILING ADDRESS: 2gL4 d w�o�, _ --f�-ekq\4- 6'S�
STREET CITY STATE ZIP
7. PERMANENT ADDRESS: 7 fl J.JQ U)Ct ,
STREET CITY STATE ZIP
PLEASE NOTE THAT A P.O.BOX IS NOT ACCEPTABLE FOR PERMANENT ADDRESS. YOU MUST LIST A STREET ADDRESS.
8. IF THE APPPLICANT IS A CORPORATION OR A PARTNERSHIP,PLEASE PROVIDE THE NAME,ADDRESS,SOCIAL
SECURITY#AND TITLE OF THE INDIVIDUAL WHO WILL BE RESPONSIBLE FOR THE CORPORATION'S THE
TRUST'S O,,R11 THE PARTNERSHIP'S WORK(Please review the Instructions before answering this question):
LAST FIRST TIME
9. IF APPLICANT IS DOING BUSINESS UNDER A D/B/A,PLEASE STATE THAT D/B/A,AND ATTACH A COPY OF THE
FICTICIOUS NAME CERTIFICATE FILED WITH THE CITY OR TOWN CLERK:
DBA NAME:
10. (a)DOES THE APPLICANT OR RESPONSIBLE INDIVIDU L OLD ANY OTHER CONSTRUCTION-RELATED STATE,
CITY OR TOWN LICENSES OR REGISTRATIONS? K YES_NO
(b)IF YES,PLEASE FILL IN INFORMATION BELOW.ATTACH ADDITIONAL SHEETS IF NECESSARY.
LICENSE TYPE ISSUED BY LICENSE/REG.# EXP.DATE LICENSEE NAME
11.LIST ALL PARTNERS,TRUSTEES,OFFICERS,DIRECTORS,AND MAJOR OWNERS(10%OR GREATER OF
OWNERSHIP)OF AN APPLICANT PARTNERSHIP OR CORPORATION,BELOW.USE ADDITIONAL PAPER IF
NECESSARY AND INCLUDE NEEDED PAPERWORK(SEE INSTRUCTIONS).PLEASE INDICATE BY AN"X" IN THE
LAST COLUMN THOSE INDIVIDUALS WHO REQUIRE AN APPLICATION FOR ADDITIONAL REGISTRATION I.D.
CARDS.USE ADDITIONAL SHEETS IF NECESSARY.
FULL NAME TITLE % OWNER ADDRESS SUPP.CARD
12. (a)HAVE YOU BEEN REGISTERED PREVIOUSLY AS A HOME IMPROVEMENT CONTRACTOR?RYES_NO
(b) IF YES,PLEASE PROVIDE THE NAME AND REGISTRATION NUMBER UNDER WHICH YOU WERE
PREVIOUSLY REGISTERED:
NAME: HIC HIC REGISTRATION#:
11(a) ARE YOU CURRENTLY OR HAVE YOU EVER BEEN AN OFFICER,PARTNER,OR CO-VENTURER OF AN
APPLICANT WHO PREVIOUS Y APPLIED FOR OR HELD A HOME IMPROVEMENT CONTRACTOR
REGISTRATION?—YES NO
(b) IF YES,PLEASE PROVIDE THE NAME OF THE APPLICANT/REGISTRANT AND THE REGISTRATION
NUMBER:
NAME: HIC REGISTRATION#:
14. (a) ARE YOU CURRENTLY OR HAVE YOU PREVIOUSLY BEEN EMPLOYED BY A REGISTRANT OR APPLICANT
FOR REGISTRATION AGAINST WHICH DISCIPLINARY ACTION WAS TAKEN?
YES No
(b) IF YES,PLEASE PROVIDE THE NAME OF THE APPLICANT/REGISTRANT AND THE REGISTRATION
NUMBER:
NAME: HIC REGISTRATION#:
15. (a)HAVE THERE EVER BEEN ANY FORMAL COMPLAINTS AGAINST YOU WHERE DISCIPLINARY ACTION WAS
TAKEN BY THE DEPT.OF PUBLIC SAFETY OR CONSUMER AFFAIRS,OR ANY COURT JUDGMENTS OR
ARBITRATION AWARDS,ISSUED AGAINST YOU?
YES No
(b)DO YOU WE MONEY TO THE GUARANTY FUND?
_YES_XNo
IF YES TO EITHER,PLEASE IDENTIFY BY DATE,CASE NUMBER,OR DOCKET NUMBER:
IMPORTANT FEE NOTICE: CHANGE IN LAW ABOLISHES CSL's HIC REGISTRATION FEE
EXEMPTION. As a result of a recent change in the law (Section 80 of Chapter 27 of the Acts of 2009), the holders
of Construction Supervisors Licenses are no longer exempt from the HIC Registration fee. CONSEQUENTLY,ALL
CONTRACTORS, INCLUDING CSL's WHO ARE APPLYING FOR A HIC REGISTRATION MUST PAY A
REGISTRATION FEE OF$150.00,AND A GUARANTY FUND FEE. (See instructions for Guaranty Fund
fee schedule.)
16. REGISTRATION FEE ENCLOSED:$ GUARANTY FUND FEE ENCLOSED: U-
PLEASE INCLUDE TWO Q SEPARATE CERTIFIED CHECKS OR MONEY ORDERS,ONE MARKED
"REGISTRATION FEE"AND ONE MARKED"GUARANTY FUND."ONLY CERTIFIED CHECKS OR MONEY
ORDERS CAN BE ACCEPTED.ANY OTHER FORM OF PAYMENT,INCLUDING BUT NOT LIMITED TO
PERSONAL OR BUSINESS CHECKS,WILL BE RETURNED AS INELIGIBLE.MAKE BOTH CHECKS PAYABLE
TO"COMMONWEALTH OF MASSACHUSETTS."
I hereby swear, under the pains and penalties of perjury, that all information set forth on this
application and submitted in support hereof is true and accurate to the best of my knowledge.
Further,Icertify under G.L. c.62C,§49A, that I am in compliance with all laws of the
Commo alth relating to taxes, reporting of employees and contractors, and withholding
and re 'to g of child su ort.
Signature 6TAWlicant If a corporation or partnership,position held. Date
MA SOC Filing Number: 201405238810 Date: 12/10/2014 1:27:00 PM
The Commonwealth of Massachusetts Minimum Fee:$500.00
William Francis Galvin
.a
Secretary of the Commonwealth,Corporations Division
r One Ashburton Place, 17th floor
Boston,MA 02108-1512
fit,. ' S yti� Telephone: (617)727-9640
T-�` '€'"i� 1 a'i�'�E'E�j viT4• f l _�`! ?Y } `�" k i '"�': j '.` g s � 4i
n
Federal Employer Identification Number: 472414741 (must be 9 digits)
Annual Report Filing Year: 2014
1.a. Exact name of the limited liability company: FEW,L.L.C.
1.b.The exact name of the limited liability company as amended, Is: FEW,L.L.C. `!
2a. Location of Its principal office:
No. and Street: 744 HARWICH RD
City or Town: BREWSTER State:MA Zip: 02631 Country: USA
2b.Street address of the office in the Commonwealth at which the records will be maintained:
No. and Street: 744 HARWICH RD
City or Town: BREWSTER State: MA Zip: 02631 Country: USA
3.The general.character of business, and if the limited liability company is organized to render professional
service,the service to be rendered:
CONSTRUCTION
'i
i
s 4.The latest date of dissolution, if specified:
S. Name and address of the Resident Agent:
Name: DANIEL BECOTTE
No. and Street: 744 HARWICH ROAD
City or Town: BREWSTER State: MA Zip: 02631 Country:USA "
6.The name and business address of each manager, if any:
Title Individual Name Address(no Po Box)
First,Middle,Last,Suffix Address,City or Town,State,Zip Code
MANAGER DANIEL BECOTTE
744 HARWICH RD
BREWSTER,MA 02631 USA
MANAGER WILLIAM E.FRANZE,JR. 121 SWAMP RD.,P.O.BOX 294
BREWSTER,MA 02631 USA
MANAGER NICOLE FRANZE 28 OLD TOTE RD.,P.0.BOX 1526
ORLEANS,MA 02653 USA
7.The name and business address of the person(s)in addition to the manager(s), authorized to execute
documents to be filed with the Corporations Division,and at least one person shall be named if there are no
managers.
Title Individual Name Address(no Po Box)
First,Middle,Last,Suffix Address,City or Town,State,Zip Code
SOC SIGNATORY DANIEL BECOTTE 744 HARWICH RD
BREWSTER,MA 02631 USA
8.The name and business address of the person(s)authorized to execute,acknowledge,deliver and record
any recordable instrument purporting to affect an interest In real property:
Title Individual Name Address(no PO Box)
First,Middle,Last,Suffix Address,City or Town,State,Zip Code
REAL PROPERTY DANIEL BECOTTE 744 HARWICH RD
BREWSTER,MA 02631 USA
9.Additional matters:
SIGNED UNDER THE PENALTIES OF PERJURY,this 10 Day of December,2014,
DANIEL BECOTTE, Signature of Authorized Signatory.
0 2001•2014 Commonwealth of Massachusetts
All Rights Reserved
MA SOC Filing Number: 201405238810 Date: 12/10/2014 1:27:00 PM
THE COMMONWEALTH OF MASSACHUSETTS
I hereby certify that, upon examination of this document, duly submitted to me, it appears
that the provisions of the General Laws relative to corporations have been complied with,
and I hereby approve said articles; and the filing fee having been paid, said articles are
deemed to have been filed with me on:
December 10, 2014 01.:27 PM
WILLIAM FRANCIS GALVIN
Secretary of the Commonwealth
Massachusetts -Department of Public safety
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License: CS-043624y ti
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Expiration
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OWNER OF RECORD I HEREBY CERTIFY THAT THE EXISTING
Brian W. Woods DWELLING SHOWN HEREON 15 LOCATED
Deed Book 1398(5, Paoe 38 AS IT EX15T5 Qa Itgff ROUND. .
Plan Book 87, Page 95 DATES _
Assessors' Map 309, Parcel 1 19 y
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LOT 20 o0
112 LOT 21
a Area= 8,800 SF±
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/ CERTIFIED PLOT PLAN
SHOWING EXISTING DWELLING
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75 CHESTNUT STREET, HYANNI5, MA
LEGEND PREPARED FOR
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5H shed
5 Step 0 30 GO 00
SCALE 1"=30' NOVEMBER 13, 2014
G:WAJob5\Franze70l 9Wwg\7019cpp.dwg Drawn by: JFM JMO-7010
J.M. OREILLY & ASSOCIATES, INC. 1573 Main Street, P.O. Box 1773
Professional Engineering & Surveying Services Brewster, MA 0263.1 (508)896-6601
Rightfax N3-2 12/18/2014 6 : 26 : 31 AM PAGE 2/002 Fax Server
CERTIFICATE OF LIABILITY INSURANCE D 1211%12014 Y)
T.. TIFICATE 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, D TdE CERTIFICATE O DER
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 and endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsements.
PRODUCER CONTACT
NAME:
ROGERS R GRAY CO. PHONE FAX
434 ROUTE 134 (kC.No.Ext): (A'C.No):
E-MAIL
SOUTH DENNIS.MA 02660 ADDRESS:
26FXY INSURER(S)AFFORDING COVERAGE NAIC#
INSURED INSURER A: TRAVELERS PROPERTY CASUALTY`COMPANY OF A\fERIC.A �
FEEL`LLC INSURER B:
INSURER C:
INSURER D:
P.O. BOX 293 INSURER E: ?
BREWSTER.MA 02631 INSURER F:
I
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
LS IS`TO CEFITIFYTHATTHE 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 ADD SUB POLICY EFF DATE POLICY EXP DATE
LTR TYPE OF INSURANCE L R POLICY NUMBER (MM;DD';YYYY) (MM\DDIYYYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE IS
COMMERCIAL GENERAL L IABILTTY DAMAGE TO RENTED is
CLAIMS MADE OCCUR. PP.EPAISES;:Ea o.^.currence) I
ED EXP±Any one persm)) is
PEP.SCNAL d ADV INJURY j5
GEN'L AGGREGATE LIMIT APP=_IES PER: ENEP.A_AGGREGATE i S
POLICY PRCJECT LCC PRCDJCTS-CCMP/OP AGG i S
AUTOMOBILE LIABILITY COMBINED SINGLE is
ANY AUTO LIMIT(Ea accident)
ALL OWNED AUTCS BODILY INJURY IS
SCHEDULE AUTOS Per person)
BCDILY INJURY S
HIRED AUTOS Per accidern.)
NON-OWNED AUTOS PRCPERTY DAMAGE is
.Per 3cCiden7.)
f
UMBRELLA LIAR OCCUR EACH CCCUF.RENCE !S
EXCESS L IAB CLAIMS MADE AGGREGATE IS
DEDUCTIBLE IS
RETENTION S Is
A WORKER'S COMPENSATION AND :WC STATUTORY i OTHER'
EMPLOYER'S LIABILITY Y/N IJB-4261 P618-14 06 14/2014 06114i2015 1 UMJS
ANY PROPERITOFVPARTN°R/EXECUTIVE WA E.L.EACH ACCIDENT j S 100,000
OFFIC=RIME61BER EXCLUCED?
E.L.DISEASE-EA EMP,CYEE;S 100000
(Mandatory In NH) I
It yes,descrio°uncer [—E-.DISEASE POLICY'_IMff i S 500;000 j
DESCRIPTION OF OPERAT'ONS oelow
DESCRIPTION OF OPERATIONS%LOCATIONS/VEHICLES/RESTRICTIONS%SPECIAL ITEMS
THIS REPLACES ANY PRIOR CERTTFTC.ATE ISSL EI)TO THE CERTIFICATE HOLDER AFFECFTNG WORKERS COMP COAT-RAGE.
CERTIFICATE HOLDER CANCELLATION
TOWN OF HYA.NNIS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED
200 MAIN ST IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENT/AWE
HYANNIS.MIA 02601
ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reserved.
pEVE ram, Town of Barnstable *Permit#
Expires 6 months from issue date
+ HAMSPABLE,
Regulatory Services Fee aS .e d
vMAW.
19-. Thomas F. Geiler,Director
i6 ��
r�D Mp,�a Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 -
Fax: 508-790-6230
EXPRESS PERAUT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
,?
Map/parcel Number 01 I U z&i y2 vF
Property Address —7 S 014 1 N u T �S T
®Residential Value of Work
Owner's Name&Address -Ee f
Contractor's Name �jA'1'u�� Telephone Number S b"2� 7 f O O(n f 6
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable) d
❑Workman's Compensation Insurance X-PRESS PERMIT
Check one:
❑ I am a sole proprietor OCT U 4 2002
21 am the Homeowner
❑ I have Worker's Compensation Insurance TOWN OF BARNSTABLE
Insurance Company Name
Workman's Comp.Policy#
Permit Request(check box)
[2"'Re-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof]
UKRe-side
Replacement Windows. U-Value (maximum.44)
❑ Other(specify)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
Signature eWA
v
Q:Forrns:expmtrg
Revised121901