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0135 FIRST AVENUE (HYANNIS)
135 Fcs+ Ave -- — - i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map,�300/ Parcel ,� � 17 Permit# Health Division 06 - v Date Issued Conservation Division e o`er�? Application Fee ® ' Q� Tax Colle or Permit Fee �� oZ,�. 4 Treasurer Planning Dep EXISTING SEPTIC SYSTEM Date Definitive Plan Approved by Planning Board LIMITED TO_,5 0 OF BEDROOMS Historic-OKH Preservation/Hyannis Project Street Address 135 `/,.,t tot 44,12e� Village LJ Z �y1;1� pt02 Owner da./- , Y Alanyu� �htvb_tp�—Address _Po, .6� Ufa 0 %U�Q1UZ eP0- 6 Telephone 5-0 3 7 2 1 Permit Request J6 IO Square feet: 1st floor: existing/200 proposed - 2nd floor: existing S® proposed Total new Zoning District- P P / Flood Plain Groundwater Overlay Project Valuation 550M Construction Type Lot Size Grandfathered: ❑Yes Goo If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) , Age of Existing Structure Historic House: ❑Yes Mlo On Old King's Highway: ❑Yes IN% Basement Type: JZPFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 0 Basement Unfinished Area(sq.ft) SF Number of Baths: Full: existing new Half: existing © new Number of Bedrooms: existing_ new _0 Total Room Count(not including baths): existing 9 new (D First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric Git"ther Central Air: ❑Yes *0 Fireplaces: Existing �_ New Existing wood/coal stove: ❑Yes _�ilRto Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size — Attached garage:❑existing Cl new size Shed:❑existing ❑new size F— Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes rAo If yes, site plan review# Current Use (,O±LaaK. Proposed Use 6&tta a e_ J BUILDER INFORMATION Name_.,�JA& Atl4 Telephone Number Address _(�� License# &/a7 92? 9 &7 Home Improvement Contractor# /Do2/aY Worker's Compensation# �"2 00/A (e / ay ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ,/ 7 FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. " T ADDRESS VILLAGE ry OWNER DATE OF INSPECTION: J� FOUNDATION /Ci!D FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL p PLUMBING: ROUGH « FINAL GAS: ROUGH FINAL \v FINAL BUILDING OI L11 Wtoco J n trr^' � trt DATE CLOSED OUT m m U ASSOCIATION PLAN NO. N IMPORTANT MESSAGE For A.M. Day .--g�Time S I1 �d P•M• .L/ tc M -y� ip iNl G P Of E e I-,j [7 l'i rG4 A� ye Phone � I q <g,3(, (p -I P73 FAX Area Code Number Extension MOBILE Area Code Number Extension Telephoned Returned your call RUSH Came to see you Please call. Special attention Wants to see you Will call again Caller on hold Message I LA NAr � t I Signed universal-48023 LITHO IN U.S.A. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 60/P el 19 1 D Permit# Health Division 21� �� 3d Date Issued Conservation Division za O s'& Fee 3 Tax Collector Application Fee S 6 oO Treasurer Planning Dept. X Checked in By SING S�TIC SYSTEM Date Definitive Plan Approved by Planning Board X AgrovMrr D Historic-OKH X Preservation/Hyannis X Project Street Address �%rS f VY n(J-2 Village h00 ►'-E Owner &Al j fi Address B y)y (g) • Telephone e� ? ag Permit Request ��(�t4A.Z1ihi, Square feet: 1st floor: existing DOO proposed�� 2nd floor: existing 9SO proposed /Y Total new Valuation Zoning District ICFE77 Flood Plain ZCYC— Groundwater Overlay 1P Construction Type Lot Size J A Grandfathered: ❑Yes @�No If yes, attach supporting documentation. Dwelling Type: Single Family '�P Two Family ❑ Multi-Family(#units) Age of Existing Structure Y Historic House: ❑Yes Flo On Old King's Highway: O Yes Flo Basement Type: 0 0 ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing 69 new d Number of Bedrooms: existing new Total Room Count(not including baths): existing new C) First Floor Room Count Heat Type and Fuel: O'Gas ❑Oil ❑Electric 2/Other Central Air: ❑Yes O,4o Fireplaces: Existing New Existing wood/coal stove: ❑Yes �JAo Detached garage:Pexisting ❑new size Pool:0 existing 0 new size Barn:❑existi g ❑neW size Attached garage: ❑existing ❑new size Shed:0 existing ❑new size Other: Ma ' Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ a� Commercial 0 Yes k0iljVo If yes, site plan review# Current Use i2ILL Proposed Use BUILDER INFORMATION Name 4/.Y/9U,D ,/% U&_ 496U6G(I Telephone Number Address 16o-xz,o License# a/�? ga 9 `�'M lf2x 75' Home Improvement Contractor# Z(� �/off Worker's Compensation# 0?m //�ZJrf ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 2el/ SIGNATURE DATE 6 ZAI 0 FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED M /PARCEL NO. - ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 11 PLUMBING: ROUGH FINAL cj GAS: ROUGH ►�-- FINAL FINAL BUILDING f� +O DATE CLOSED OUT ASSOCIATION PLAN NO. 0 cU f — f, _ I� � -- -- - i Al C� ---------- _ __I I I 11 s� ------------ ij t i� ii � S � by AF-1rAST i'� I� ----- --- Ij �I ii r o�1HE, Town of Barnstable r • Regulatory Services sa[ ASS. a Mass. Thomas F.Geiler,Director M 'OIf039. 1, � 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 as Owner of the subject property hereby authorize �C'4GLC to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) �NNID Signature of Owner 6ate A" Print Name Q:FORM&OWNERPERMISSION SGS U.& 'Testing Company Inc. LISTED PRODUCT - Cat o 111 Approval NumberLA111. 107 ® 1994 Uniform Building- Code Ch. 26 Sec. 2602.3 Serial . Number 3 4 7 53 4 This product is a part of a two-component foam insulation System is certified by SGS USTC as complying with the standard indicated above when prepared as directed, CORBOND CORPORATION CORBOND 11 32404 Frontae Road Bozeman, AST 59715 FOAMED PLASTIC INGREDIENT - Surface Buming Characteristics Material Thickness Flame Spread Index(FSI) Smoke-Developed Index (SDI) 1.599 25 3�0 4.0" 20 46 Fax r� To. Tony From. David Weitz Fax: 781-857-1054 781-857-1000 Rate: March 14, 2001 Page: 2 (including this one) Re: unvented roof assemblies • Comments:Our Board approved the unvented roof amendment yesterday, including some modification to.the language as submitted. Here it is. The se will,not take effect until they are printed as amendments tot he code by the Secretary of State's office; my guess is next January. However,we will run a Codeword article to alert building officials to the adoption by the Board. Unvented Roof System Amendments Section 121.0.1 (Ventilation of Special Spaces, Roof Spaces)and Section 3608.6.1 -(Roof Ventilation): Enclosed attics and enclosed rafter spaces formed where ceilings are applied directly to the underside of roofs rafters, shall have cross ventilation for each separate space by ventilation openings that are protected against the entrance of rain and snow. The openings shall be covered with corrosion-resistant mesh not less than 1/4-inch (6mm) nor more than 1/2-inch (13mm) in any direction. Exception 1: Roof a semblies where an expanding 'o s ra ifoam insula material, providing at least 40%'of the total R-value of the required insulation is in direct contact with the underside of the roof deck and adjacent framing members. if the permeability of the fogm material is less than 2 oerrn-inch no vapor barrier is necessary. Exception 2: Roof assemblies where a board foam plastic ins 'on material providing at least 40ya of the total R-value of the required insulation is placed on top of the roof deck. If the—permeability oftbe foam -material s less n 2 peaminch, no vapor barrier is necessa 1 d 9181996Z£9 'ON/9Z:ti 1S/LZ b 900Z 1 fld W1) WOdj Board or B "ding d y�cura Regulations and Standarl a�'✓� .�uaeC�a s HOME IMPROVEMENT CONTRACTOR Registration: 102128 Expiration: 6/30/2006 TYPe. Individual JAMES N.BASLER James Basler Box 366/923 RT 6A _ Yarmouth Port,MA 02675 Administrator flze ortvrrcwru.."ZI4 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number;,,CS 012929 Bi hc��te 03/08/1946 ons o _ EjXp�S�� 3�p$/ Qti -' � 1 r.no: 1.7345 JAMES N BASL�R PO BOX 366 YARMOUTHPORT`M� 6?5 Acting-C:: �oner w Town of Barnstable Regulatory Services S s ?sr $ Thomas F.Geiler,Director 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 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:,/�9?t//�/.4� � -� � Estimated Cost Q • Address of Work: Owner's Name: n-Q- Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 []Building not owner-occupied ❑Owner pulling own permit i Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH.UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: ate Contractor Name Registration No. • 0 D afe Owner's Name ` Q:forms1omeaffidav Department of Iridusti ial Accidents s Office.of Investigations, 600 Washington Street : < Boston,MA 02111 www mass.gov/dia Workers' Compensation bmurance Affidavit: Builders/Contractors/Electriaiaris/Plumbers applicant information ]Please Print Leiibly Name (Business/Organization/b&vidua) /��l' Address• City/State/Zip: Phone#• 37SD81/S. Are you an employer? Check the,appropriate boa:. Type of project(required): 1.❑ I am a•employer with 4.F I am a general contractor and I ' 6. ❑New construction to ees fbr and/orpart-time)-* have hired the sub-contractors 2. I am a sole proprietor or p artrier- Y ( listed on the attached sheet$ 7. ❑ Remodeling [� ship and have no employees These sub-contractors have 8. ❑ Demolition 'vworkmg for me in any capacity. workers' comp.insurance. 9, ❑ Building addition (No workers' comp.insurance 5. ❑ We are a corporation and its 10.[1 Electrical repairs or.additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL ME] Plumbing repairs or additions mysei£E(No workers' comp. c. 152,§1(4), and we have no 12.❑ Roof repairs t employees.(No workers`' insurance r aired. ❑ �' comp.insurance required.] 13. Other *Amy applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: '6 ' t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must subaut a new affidavit indicating such. tconvactars that check this box must attached an additional sheet showing the name of the sub•contzabtors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below,is the policy and job site information. ' Insurance.Company Name:�G -�'YI Policy#or Self-ins.Lic.#: Q Q./ AlP Pq Expiration Date: 31 0 Job Site Address: ^ ' 6r*/State/Zip: 49 Attach a copy of the workers' compensation policy declaration page(showing the policy number and eV ation 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$1400,.00 and/or one-year m3prisoament, as well as,civil penalties in the form of a STOP"W ORK ORDER and a.fine of .p to$250.00 a day against the violat�ar. Be advised that a copy of thus 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: Signafore: 2- (�f� Date:'- s Phone#• D 3 7�'C� Official use only. Igo not write in this area,to be completed by city.or town official, City or Town: PermitUcense# , 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#: Informations and Instructions , General Laws chapter 152 requires all employers to provide workers' compensation Massachusetts for then employees. Purs�t as"...every person in the service of another under any contract of hire, to this sMtute, an employee is defined express or implied,oral or written." , association,corporation or other legal entity,or any two or more loyer is defined a :`_`an indzvi¢ al,pa tpers�iip'_ r of the foregoing engaged in a joint enterprise, s of a deceased employer,or the An emp and including the legal representative ' receiver or trustee of an individual,partnership,association or other legal entity,employing employees. How er:tile• dwelling hous a having not more than three apartments and who resides therein,or,the occupant of the owner of another who employs persons to dwelling house do maintenance,construction or repair woiYbn such dwelling house or el the grounds or building appurtenant thereto shall not because of such employmentbe 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 therommonwealth for any applicant who has not produced acceptable evidence-of compliance with the insurance coverage required." ter 152, 25C states"Neither the commonwealth nor any of its'political subdivisions shall Additionally,MGL chap .. § (� enter into any contract for the performance of public work until acceptable'evidence of compliance with the insurance iequirements oft s chapter have been presented to the contracting authority." Applicants ' Please fill out .the workers' compensation affidavit completely,by checking the boonxe�t�applyeir �c e(s)our situation and,if necessary,,supply sab_contractor(s)name(s),addresses)and phone numb () g insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(L•LP)with no employees other than the does have members or partners; are not required to carry workers Cartmeor a of Industrial employees,a policy is required• Be advised thats ers affidavit may be to the Dep 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' compensationpolicy,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 legr`bly. 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/hcense.number which will be used as a reference mrmber. In addition, an applicant that mist submit multiple permit/license applications in any given year,need only submit one affidavit indicating current Site Address"'the applicant should write"all locations is (city or policy information(if necessary)and under"Job »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'lceases..A new affidavit must be filled out each a license or permit not related to any business or commercial venture year,Where a home owner or citizen is obtaining (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit ance for your cooperation and should you have any questions, The Office of Investigations would like to thank you in adv please do not hesitate to give us a call. The Department's address,telephone and•fax number: The Commonwealth.of Massachusetts . Department of IndustrialAccidents 1, Office gf jnvestigatio,115 b00 Washington Street . Boston,MA 42111. #617-727-4900 ext 406 or'Is877-MASSAFE Fax#617-727,.7749 Revised 5-26,05 wwwmass.gov/dia l BUILD,ER INFORMATION Name G✓t-- �41� Telephone Number ��/ GC4 / Address _�i JI✓J'�/�C (� /, �� ense# � aAe?4 11' �1OJ'� Home Improvement Contractor# ,/,z Q t Worker's Compensation# ALL,CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO z SIGNATURE DATE — ,� GJ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map c2c-5 Parcel oa! Permit# d Health Division 0,9 Date Issued Li- 03 ' Conservation Division �� vJ� �/ Y Application Fee Tax Collector a� 05 Permit Fee c- 00 Treasurer , OZ' S'0 �VISIOf •.-��f�► � a�':7 � 4GT CE Planning Dept. W'GTA!LL) I:,B CO, PL1AiNCE Y&M; TtT!J-E s Date Definitive Plan Approved by Planning Board EN%rh N0",.`0,r: f TA,L CODE AND Historic-OKH Preservation/Hyannis TOAW REGUL TIONS Project Street Address Village lam, (/i�a�.r✓es.1��G�T Owner J1/S'l`✓�Lc�y Address Telephone S'� �� / �"a�'—/ t� � s a4-- 'Perms ew eu Permit Request �_�o�,�i�c�" X�.FTi•�9 '��,r - ®-+� �,�.I�y>�_ ry 't�R%1/ Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation -5 0 Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family , Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes VNo On Old King's Highway: ❑Yes 4No Basement Type:XFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number.of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: WGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing A-0, New Existing wood/coal stove: Cl Yes ❑No Detached garage;�existing ❑new size Pool: ❑existing ❑new size Barn:❑existing Cl new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes <4'L�`No If yes,site plan review# Current Use ��1 .v� Proposed Use BUILDER INFORMATION - Name c�-d Telephone Number Address / "T� License# Y -2-1-2 3' Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO E. O-d�,-mi Z y SIGNATURE yam- DATEs"-O`; FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL IYO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: / �. k d Fo d 3/2710 FOUNDATION �/to ID 6 za a La 3 1, 1,bl A doa b FRAME & leg In PR— FIREPLACE � INSULATION p�L 1 '- � '8 S^ ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH' FINAL GAS: ROUGH' a ' FINAL . . FINAL BUILDING DATE CLOSED OUT ; z ASSOCIATION PLAN NO... . r' " irw IV r. Lieere: �RITt7 SUPS 1�k1: R R- I�ufinlr� � 01a©?161 _ Birtif�d-�- 3Q�1;960 E RI 1 72Q03 Tr.nG: 5357 JawNi AifminiitGarr? IrIx a<> fie vi ammzanurea/�C a� aaac�iuoe�a Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR RegistrafionX lug 117872 Expirataa 2m,/2004 hype Intii 'rcival JOHN A. L.EBOEIIF k � JOHN LEBOEU 35 PRINCESS PINE R® HYANNIS,NIA 02601 Administrator 2. oFz►,E, . Town of Barnstable ~ Regulatory Services faxxsrws Thomas F.Geller,Director NAM 9�pT 1639• a��� Building Division Ep MAC Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the`_'reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied which are adjacent to than fou r dwelling units or to structures wlu ] building containing at least one but not more g b g such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type,of Work: /�%C,�t'°/d11' ! ` �,�ll t111/d A-mated Cost Address of Works Owner's Name: 6, Date of Application I hereby certify that: Registration is not required for the following reason(s): 7Work excluded by law []Job Under$1,004 OBuilding not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the or : Date Contractor Name Registration No. 1 OR T, +e Owner's Name The Commonwealth of Massachusetts - _ Department of Industrial Accidents - Office ollasest 9811oos 600 Washington Street Boston,Mass. 02111 name: , location: city hone# ❑ I am a homeowner performing all work myself. ❑ I am a sole protmetor and have no one working in ca achy %%%��%%%/��%//%////%%%%%//%%%/%%/%%%/%%%%%////%%/a//// /// %%/G%%%%%%/%%%/%%/%/%%%%%%/%//%%%///%%%/%%%%%%G/%%%///%////O%%%%/%%//�i,. rovidin workers' compens n for my em toys: .: ;g n this I am an em toyer P g.......................::.::.:::::::. ... 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❑Other (devised 9/95 PLC Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any 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 section 25 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 acceptable evidence of compliance with the insurance coverage required. Additionally,neither the t produced p . no . p ce of public work until commonwealth nor any of its political subdivisions shall enter into any contract for the performance acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. . Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and j.' companynames, address and phone numbers along with a certificate of insurance as all affidavits may e supplying a:. submitted to the Departmerrt of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and d_ date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is of Industrial Accidents. Should you have any questions regarding the"law"or if you being requested, not the Department n policy,please call the Department at the number listed below. are required to obtain a workers' compensatio 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 e event the Office of Investigations has to contact you regarding the applicant. Please- ' or you to fill out in the - ... . vrt for y . be sure to fill in the permrt/license number which will be used as a reference number. The affidavits may be ret aned�tn the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any 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 Investlgallons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 pfrTME goy, Town of Barnstable Regulatory Services Bnxxsrn LE, v MA93. Thomas F.Geiler,Director �prE039. ,O Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner lust Complete and Sign This Section If Using A Builder I, n0PR I �Ie W , as Owner of the subject property hereby authorize�uc u-)L�' to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Lm7 Signature of Owner Date R��}itil E c5��n le Print Name Q:FORM&OWNERPERMISSION f oFrow a Town bf Barnstable do • Regulatory Services i Thomas F.Geller,Director 10 ���� Building Division TomPerry, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby authorize: to act on my behalf; in all rnatters relative to work authorized by this building permit application for: /35 -a t o ° daNd'1�,O POA . (Address of Job) 0 a-as-a.5 Signature of Owner Date 1�&i/LTO►U -- Print Name The Commonwealth of Massachusetts Department of Industrial Accidents ON0001/nesdozooss 600 Washington Street Boston. Mass. 02111 workers' Compensation Insurance Affidavit Applicant information: PleasePRiI�TT a1,d.� o / locadom phone# O- 75 V39 I arr6a homeowner performing all work myself. I am a sole proprietor halve no one workine in any capacity I am an employer pro.%iding.workers• compensation for my employees working on this job. compani• name: address: city. phone 0• insurance co. policy# �7 I am a sole proprietor. _eneral contractor. or homeowner(circle one) and have hired the contractors listed below ho ha\,e the following \%orrker_ :ompensatioJn polices: company name: ✓I( U /�/ address )60 �q3 ,o �D - 67—16phone t insurance co. i •p company name: address: _ citx: phone 1!• insurance co. Roney D Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine rap to S1¢00.00 aad/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a floe of S100.00 s day against me. I anderstaed that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby cerrify under the pains and penalties of perjury that the information provided above is true and correct Signature 02 ..dQ, flJ� Print name . Phone# OM621 use only do not-A rite in this area to be completed by city or town oflieial city or town: YARMOIITIi _ permitAicense# nBuilding Department �Ucensiog Board check if immediate response is required 2fi1 ❑Selectmen's Ogee �Healtb Department contact person: phone#:_ (508) 398—Z231 ext. MOther oFSHe roe Town of Barnstable Regulatory Services �# B rs, Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-403 8 Permit no. Date AFFIDAVIT HOME LWyRO'VEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Estimated Cost 5 Type of Work: Address of Work: l �' Owner's Name: cx Date of Application: o/2 -aZ 2 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 PERIYIIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDERMGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: tu;f l 9 a' — Registration No. Date Contractor Name OR Date Owner's Name Q..forms:homeaffidav • � Tl� .� ✓Glaoa Board of Building R g Iadonnd Stand ards HOME IMPROVEMENT CONTRACTOR Regipkr1 9n: 102128 Expiration: 6/30/2006 TYRe: Individual JAMES N.BASLER James Basler Box 366/923 RT 6A _ Yarmouth Port,MA 02615 Administrator ✓ate (Jori�ruyjyurea��z o��i� p,� r: jc ,' BOARD OF'BUILDING REGULATIONS License: CONSTRUCTION SUPERVISORNumbedCS 012929Blrthdate 03/0$11.946 -P LPWg `93/08/2006 Tr.,n9: 17345 s Rgstriy cted QO JAMES N BASLER .,✓ PO BOX 366 YARMOUTHPORT "MA pzs75 Acting-C�Mjsener c - A W CERTIFIED PLOT PLAN LmATm: 11�5 FIRST AVF., FtYAt I WORT, MA G �j z PRB'ARB)raa JIM LF�OEI� ffORE✓T v TREE T LU> c�I" AO' �--� DRANRJ 6Y:Tw JOD M,)CM. DATE: *wr-. 191.4d oz-tiz I nPM u, z000 cr-2 WELLER & ASSOCIATES V 1 W-0 FN.Maim RD 6tm AG CagawILLE, MA 4un TEL: (WD) 'TJ5-.d195 - FAX: (Wei) TF d154 UL PROF 55{ONAI_ BJ61 5 & LAW 9-RVEYOR6 N 4 .42' 5.od Ill.o�' Hi \& m ri N —� )-+--EXGTIN6 ; FDUND. 'pro lose d Po,rrh � ---�.�'t_- FOUM. a UL Ex5T. M6ARA6E OF 272.a1' TEVEN w �. um �! $SSiO�A� ��'�suRv °Q f Daniel E. Braman, P.E. ©�T 189 Harbor Point Rd C Cwumagaed, MA 02637-0361 Y,e. �-e. ►--t. cS � M 1� n V-,�V `cam ���� • (gin,�.vJ � t`��Z. a �t �'� 6z--a off'. 2 2.5 ��Ma_cr� z C2 �38 2 ivt3 -� > DANIEL E. BRAMA STNR!1C I TUAA N � �AL oois ~ BC CALC@2003 DESIGN REPORT - US Friday, February 18.m00s1uu7 Triple 1 3/4" x 9 1/2" VERSA-LAM(E) 3100 SP File Name: J Basler-Shepley RuutBCC: RBO1 Job Name: ' Description: Address: ' City,State,Zip: . Joe Madera Customer: : Shepley Wood Products Code reports: {CBO5512 NERO29 Mi 12 1106 lbs LL 3245 lbsLL 426lbsDL 1805lbsDL Total Horizontal Length'1*o7-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. Member Type: Roof Beam Dead 15 psf 05-00-00 90% Right Cantilever: Yes Controls Summary Slope: 0/12 Control Type Value %Allowable Duration Load Case Span Location Partition Load: 0 psf Live Load Defl. 2xL1251 (0.462") 95.6% 5 2-Right Support O|oc|owura o �� n�oxuvn� u '� 5/./m o z'Right uuppv The completeness and accuracy uf Notes the input must be verified by anyone Design meets Code minimum(2xU180)Tmu|load deOoodnn criteria. who would rely on the output aa Design meets Code minimum(2xU24O)Live load deflection criteria. � evidence u[suitability for a Design meets arbitrary(1")Maximum load deflection criteria. particular application. The output Minimum bearing length for BOio1'1/Z' above io based upon building Minimum bearing length for B1io3^ code-accepted design properties Member Slope~0.consider drainage. and analysis methods. /»»taUad»» Entered/Displayed Mnhznntu|Span Length(u)=Clear Span+1/2 min.and bearing+1/2 intermediate bearing of80GE engineered wood products must ba in accordance User Notes with the current Installation Guide STEEL TD WOOD CONNECTION NOT DE8|GNED and the applicable building codes. � To obtain un|noUu||adon Guide orif ' you have any questions,please oa|| (8UU)282'U7O8 before beginning product installation. ' BCCALCO. 8CFRAMERO. BCI9, BC RIM BOARDTM, BC0SBRIM BOARD TM, B0GEGLULAM~". VERSA-U\MVy.VERSA'R|MVy. VERSA-RIMPLUSo0. . | VERSA-STRAND-. | VERSA-8TUDoD.ALLJ08nOand ' AJGTm are trademarks of Boise Cascade Corporation. K Page 1uf2 | r .-1301SE' BC CALC® 2003 DESIGN REPORT - US Friday, February 18,2005 10:27 Triple 1 3/4" x 9 1/2" VERSA-LAM® 3100 SP File Name: J Basler—Shepley Roof.BCC: RB01 Job Name: Description: Address: Specifier: City,State,Zip: , Designer: Joe Madera Customer: Company: Shepley Wood Products Code reports: ICBO 5512, NER 629 Misc: Connection Diagram Consult project design professional of record or BOISE technical representative for connection design Nailing schedule applies to both sides of the member. Member has no side loads. Concentrated loads are not considered in side load analysis. Connectors are: 16d Sinker Nails a=2" b=3" c=2-3/4" e=3" o o C • — • � e o o / I LL KNI -� b - Page 2 of 2 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE- - : - - - New Buildings $100.00 . Residential Addition $ 50.00 Alterations/Renovations. $50.00 S o : ... r. Building Permit A ment $25.00. .. yk =FEE VALUE WORKSHEET . . _ NEW LIVING SPACE square feet x$96/sq.foot= x.0041= - plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE40, — /- - - square feet x$64/sq.foot= x.004.1= -21 plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0041= ACCESSORY-STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf • 50.00 >750 sf- 1000 sf. 75.00 >1000 sf; 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open Porch x$30.00= (number) 00. $30 = Deck.... ... _. :_ x . (number) Fireplace/Chimney . x$25.00= (number) -" Ingrodnd Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee Projcost Rev:063004 The Commonwealth of Massachusetts , -i= De artment of Industrial Accidents - _ P -••, ; •� , .0�17crctlQras�tlaas _ 600 Washington Street Boston,Mass 02111 Workers' Com lruSati n Tnmmm Affldavk n MUM -J� ��:tiU� �Jp ����T��� �a*•��✓� li,`''.L��.�.�fT/O l'✓ �Cl J°7 ff7.l Ii, off G J'Y City f i hid ❑ I asa a hnmeaw=perffirrain all work nlYSCIE ' Iama Sole, 'eta=d have ne ane vcddng in an farzapgs wag am this job. Mtn:}-.. 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N•wN .1 .• 11•••r•d jjj �jj���jj���j��j��jjj��� • • •.• sell 0 It ••• so. • •••••M• • 1 ►• .•/.• w•r It•••1•.1 1 • 1 •• • • so • 1 .. .....•1 ... .► •••1• ... r goes••\.1 A I a.i. 1 1 1 all of • • • 1 4 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 115-0;.a (plus above if applicable) �® Permit Fee OIL License: CONSTRUCTION SUPERVISOR Number: CS 060349 <: Birthdate: 01/05/1956 Expires:01/05/2005 Tr.no: 6571 Restricted: 00 JAMES T LEBOEUF 71 BETH LANE HYANNIS, MA 02601 Administrator � flee-Po�rvinv�uae�/,� o�✓�ac�raeCt� . Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registraii an:.;115211 Expiration 1110/04 Type: DBA BARNSTABLE COUNTY'CONST%C JAMES LEBOEUF ;- 21 WINTER ST - Gl.-.—• HYANNIS,MA 02601 Administrator SHEPLEY WOOD PRODUCT E08 771 S321 02/2S/03 02:24pm P. 001 INGE Town of Barnstable Regulatory Services HARNsrABLH. + Thomas F.Geiier,Director NAM '639.F„sn+''0� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 0V 0 Property Owner Must.Goinplete and.Sign This Section If Using A Builder as Owner of The subject-propen7 herej�y authorize = � to act on naybehalf, m all matters relative to work authorved by this building permit application for(address of )ob) Signature of Owner + Date Prim Name �•d r r t t - qi. Anq i inaoga-1 w z f- •-jW d62:81 co so qe A uai t_ai t•uua uu.is rnn W.j vs Ass soar MAP: Z TEST HOLE LOt F PaR ? 0!! �) -_•___ \�O SOIL EVALUATOR: Z FLOQ ZONE: fo A,/oTEa \� 9rITt1ESs: REF ENCE:�I fD ' \GT DATE: ���j •�� PERCOLAT•I tNt RATE:AX' L No ww� '` TH-1 LOCATION MAP 1S} � Y SEPT It SY: FLOW ESTIMATE 110\ BEDROOMS SEPTIC.-TANK EP � L , USE-_j6Qp.GAL so I L aSdR-tT I - <A 0 \ � N\ p c .'SIDE AR BOTTOM � � r 9 ,, SEP l:C%:SY \ / o 1 D s. Y. �V `t Of10 10 i � � -- S -, �/ : I�y.r,�,. .dry,..lwr!' - g► / O Q TOWN OF BARNSTABLE Building Department= FOundation Permit 'a ID ^1 ' gate a I Name Le 6 a ep. ; Location 3 +S rurs+ Ove., �� r „� Insp. of Bldgs. GERTIEIEP PLOT PLAN LOL+�TIOPt I55 FIRST AVE, HY"HEWoRr, MA vr�n Marc JIM 1 F64E1F of JOD r41�IDFR DATE: 191.�D az-nz A L IA, wog c�z I— WELLER & A�OGIAM3 W Mmaim RD — SIM AG F�08, IOA 0114 We � � ~5 #- Lr1 v OR5 Ql _ �5510NN_ 5.od IIi.o6' H �I \,-.--EXr7TIN6 i FO(INP. V / ' EXSTINC� FOLW. Cl- Ex5r. -H g 6ARA6E W N of Masi 272.41' 4 r 10 yG �N9OffSS1�N c� i i 4'-0" 13'-01/8' 4'-01, 13'-11' I I I i I ^ I I Existing cottage foundation I Drill # 5 rebar into existing foundation Drill #5 rebar into existing foundation i 10'-01 ' New foundation E atidn & woof 135 First Avenue min plan Hyannis,1Massachusetts raine & Hamilton Shepley Cottage 22, 2005 scale 1/4" = 1' drawn by: jnb i t i Porch Section 135 First Avenue Hyannis, Massachus]jnb Lorraine & Hamilton Shepley Cottage February 22, 2005 scale 1/2"= 1' drawn Fropooed front porch addition C510 oc ram 2x4 Stud wall to support rafters 31/4" m 6 5/8" i 3- 91/2 LVL per engineering pitch porch floor 1/4" per foot Treated 2x5 joists 16" oc Grade 2x12 Ledger anchor with I/ xT i wedge anchors 24' oc Existing uninoulated cottage o 8" poured concrete wall 2500 pound concrete anchor bolts 6 oc j 10x16 concrete footing 4'concrete dust cap I ' i 41 211 21/2" Hot rolled Steel arch cut from 1/2" plate ° 1/4" x 2"web ------------- ° ° - - NK ° 11 3/4" 3" ° ° 2-9 1/2 LVL 3" 31/4' 1/2" 5teel brackets w holes for 1/2" bolts FArchbeam details 135 First Avenue Hyannis, Massachusetts raine & Hamilton Shepley Cottage February 10, 2005 scale 1"= 1' drawn,by: jnb i .ura.soumm�u,.ew�,�,wm ilrr tN l ■r !i ® ■ir ! ®� !r ■I ■Nr ■ ® ■m➢ llmE9rha rrr ■I■Irsm➢ ■i rIm➢ ®// ! lBi➢r■/ !➢ rrtl ■ mitt ■/ I. ■rr ! ® ■r rl 1■ ■mr ! ■r ■I� !m0 ■ !B ■r ■t 'r■ir e! !Yr r// ! ®� !r .l0 r/➢I ■ ■r rl•//Y mamma ■i ill 7Y/ Pe/ r/ ■rl ➢� rYr ®�!r rl ® ri/ r 01 M !II■ ■YY r ➢■ !i rt " ■ fir/ r rY rt iYY '! !rmi r/ 'fit rrr -/S. i r'o. m➢N➢ i ! m/ rY !S' ■mm ■! ■i ■➢ 'mr ■ir ■ ■r ■I � !rr ■ � _ ■m rltl� IrN'�Ir- ■ rl Y@9 ■1 ■rN M S■ ■r ■Ili ■mN ! 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I I son I I M I FM I MIN I o .r rrrIN 0 M INS N ■r ■tit! •� ■m !I � M 11 I I i I I Am ➢! rr�.a,.a:me `®® ■s r I I atp N — I I I I I ' _/��re t I ii!® ■1®' ■r I aim !rr ! mimmummium NO IN On MEMNON INN ' i I I I I I I I i y I I I I I plou'll i l i li i Screen Porch r h ! Ope Po c I II � I I new Steel beam a ���'n' See engineering � ' Outoide:ohower .r 0 0 � �f9 � O 00 5torage Bedroom 1 5 00 O Down O p window Seat i I I i I I I I I I i illll I I II Open Pori h j I ! 7771ii l 135 First Avenue Existing 1st Floor Hyannis, Massachus]jnb Lorraine & Hamilton Shepley Cottage May 3, 2005 scale 1/4" = 1' drawn I Bedroom 4 Bedroom 3 bedroom 5 Bedroom 2 O a Up I � 135 First Avenue Existing 2nd Floor Hyannis,iMassachusetts Lorraine & Hamilton Shepley Cottage June 4, 2005 scale 1/4" = 1' drawn by: jnb � b AssEssoRs MAP : k'('& - -- --- \ TEST HOLE LOGS - - 1 ,� ' PARCEL : NOTES; G� LTV LIU I FLOOD ZONE : A/0%eD \ SOIL EVALUATOR : %4/1 ' fV1L�5��-i WITNESS : 1. The installation shall comply with Title V and Town of Barnstable BOH Reg's. .r p J" , i REFERENCE �1�i1/� ��1 - �� DATE : 2. The installer shall verify the location of all utilities, cesspools and inverts prior to PERCOLATTN RATE: 1�1 t installation. (�/ G ` � 3. This site design does not represent any structural or foundation design -- 1 considerations. Such to be prepared by others. TH- I TH-2 4. Zoning setbacks to be confirmed by owner/contractor [builder prior to Q �Awt � � � construction. r'� r 2 5. All septic piping to be 4 inch schedule 40 PVC at 1/8 per foot. \ '� 6. Existing septic components to be pumped and filled per Title V Abandonment 25& I procedures. LOCAT 1 ON MAP ��I �Z 7. Installation of utilities to comply with specific regulations and service provider �y-� specifications. 8. At the time that the reserve septic area is required the water service and other / Y -I utilities to be relocated. 9. This plan shall not be utilized for property line determination. 10. Notification for staking foundation location shall be a minimum of 3 days prior to request. 11. This plan does not represent approval for relocation of identified structure. Approval by local code enforcement required. 12. All septic components must meet Title V specifications. SEPT I C SYSTEM DESIGN FLOW ESTIMATE BED ROOMS AT (� GAL/DAY/BEDROOM - 1/N GAL/DAY SEPTIC TANK DAVIDMAD GAL/DAY x 2 DAYS - GAL q V 1066 r ° �_� -.` -� , USE I1 � GALLON SEPT 1 C TANK , Y �� SOIL RESORPTION SYSTEM ITH ° / \ SIDE AREA: �X (..JZ. ��- L xZx ,-7 _ NZ a BOTTOM AREA• �= X X 0 F ' {� 0 �t�1�j1HrCv o ,� /z 10 SEPTIC; SYSTEM SECT I ON CF Lot S 1 V v•• I / " GAL I l9 I Z SEPTIC TANK SITE AND SEWAGE PLAN zoo, 6772UC7v2E, 7D ZE- Ev/EWEr'> o L _ lP !20 f,� 3 OGuc�/E� a G� '� L 0 C A T 10 N : �U (>` U�% �, -I�—�'-� V 16T PREPARED FOR : I 'n o �6A' - 10 �� r {/ C 467Z?rL g_..cud cw" _�`1ij6 rrv� ?Q _Q _ 14-W/ �E'TIj14C4K-Z SCALE : Z -_a_.__ DAV I D B . MASON,R6 DATE : Z DBC ENVIRONMENTAL DESIGNS w L DATE H TH A ENT EAST SANDWICH . MA ( 508 ) 833- 2177 w Z