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Home My WebLink About0043 IYANOUGH AVENUE -a- -�"- ty ` :r, " OF TQ�lm 9, ' ST ' � : s N S U L A T I O N {� S:.27 F—k Q"S SIA---•ESS5 SPgAT FOAM SVSP[N4EP RAM 44TTSYS W64WFIow WuN4y -' 1-800-696-6611 p ilsi 'Town of Barnstable. Regulatory Services Building Division 200 Main'St Hyannis, MA 02601 Date: l Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insrulation, Inca performed .& completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit. application.-All work has been inspected by'a certified Building Performance Institute - (BP•I) inspector. All_work preformed meets or exceeds Federal & State Requirements. R Property Owner Property Address Village Insulation Installed: Fiberglass . Cellulose R-Value Restricted Unrestricted Ceilings (39') ( (X). Slopes Floors Walls ( x) Sincerely 'k He ry 1 as y.Jr,' President C, e Cod I , ujation, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 4 Map Parcel 6-1 Application # •,kz� Health Division Date Issued 3 Conservation Division Applicatio e Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board VC ti-23—►3 P Historic - OKH _Preservation/Hyannis Project Street Address f Village � Owner Address Telephone. !r b 7 W Permit Request " u hV�L � f l l ,4& mall Uvz, � Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuationyr Construction Type /GG Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) O Age of Existing Structure Historic House: ❑Yes ❑ No On Old Kingly' ighway�_ Yes ❑ No � �a Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Yp Basement Finished Area (sq.ft.) Basement Unfinished Area (sqA) i Number of Baths: Full: existing new Half: existing I p� Number of Bedrooms: existing _new Total Room Count (not including bath;): 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 Au orization ❑ Appeal # Recorded ❑ Commercial Y Zo If yes, site plan review#Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name {6 6 Telephone Number 6-4 77S-- ►�t J/Address �� "U License# Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO A& SIGNATURE DATE �2 FOR OFFICIAL USE ONLY • APPLICATION# r 3 DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER ti DATE OF INSPECTION: FOUNDATION FRAME t INSULATION FIREPLACE �i ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. >r 4 , f ;t 1 , ffW*;' mass mass save Wl�R .ns.uryt lhC+wY1 i't.;r�:rlJ..++>'4r PERMIT AUTHORIZATION FORM owner of the property located at: (Owner's Name, printed) C" + (Ffroperty St(eet Address) (City own) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. Owner's Sig ature 3Zz7 ZI 3 Date FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Particiliating Contractor 6ate Rev: 12132011 w ;f NIANsuchusetts - Departmcttl of Public SA'CIN Board of Builtlin" Ile-Illations and 'Standards v Qonstrutction Supervisor License Nicene -CS o 100988 HENRY CASSIDY si& 8 SHED ROW WEStT IJARMOUTH, MA 02673 �P Expiration: 1 1/1 11201 3 uu�iis�i u�cr TrFi: 7620 ,ti C? `c�• ( �z n>y�ca -c��a l L Ma; Jcze/ee,j6?off Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/9_1b14 Tr# 233831 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SO. YARMOUTH, MA 02664 Update Address and return card. Mark reason for change, L� Address ❑ Renewal .(_I Employment Lost Card ��r- `ff'nncrienrrrefc:rrll�n!`C.3 jl'r��rre'�u,lr'CC •- :a�\ Ot1i�c.ul'Cousunuer Affairs& Business Regulation License or registration valid for individul use only `j� F OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: registration: 153567 Type: Office of Consumer Affairs and Business Regulation •' - ;iExpiration: 12/15/2014 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAP[COD INSULATION,''INC.. tii:NkY CASSIDY 18 REARDON CIRCLE CIO YARMOUTH, MA 02664. — A Undersecretarywitho t mat re f h The Commonwealth of Massachusetts P{rint Form ' Department of Industrial Accidents Office of Investigations b 1 Congress Street, Suite 100 �r Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 5d 114e7u landpil Address: &/daL lii!Y� City/State/Zip: U!l4G IMA' Phone #: WJ Are you an employer? Check4tappropriate box: Type of project(required): l. I am a employer with Zed 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp.insurance.: I ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their I LEJ Plumbing repairs or additions myself. o workers' com right of exemption per MGL - y � p• 12.❑ Roof re airs insurance required.] t c. 152, §1(4), and we have no q ] employees. [No workers' 13. Other V`�eaff twl z hOYQ comp. insurance required.] *Any applicant that checks box#1 must also till 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: �o hc, Policy#or Self-ins. Lic. #: WCA 05 2'5 Oi Expiration Date: - Job Site Address: { City/State/Zip: w u WV Attach a copy of the workers' compensatE n policy.declaration page(showing the policy number and a piration 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 cer ✓ figer the ains_ynd penalties o er'ury that the in ormation provided above is true and correct. Si nature: Date. '7 Z 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#: OIIenC1l': �1;iU7 cow),-��, C:L'INSUL. 4=�.I�IVIC�ATE OF LIABILITY INSURANCE -_ - ----._—_ '� "•" I L!i 1 l(hll 11111117'11 t I I L t:L k I II-, Fl I r I`;11 al)l:C)H:i A INgY7kR OF INFOIihIAItuIN(nVL)'ANL)CCINFER9 NO RIUlir9 Ur'QN TIiG CEI�TIFIC T' tl`hl'1'U'I;i Lr rlrl(.�1T1-(:Lj-001;:, Nc1) 6\1'F Ir<IwA-rIVLI_Y OR NEGA'fI\JEL Y AIM HO,FXVEND OR ALTER THE COVLRACL AFFORDED UY'rI1E PQLICIt:z; T i A to I-lU(.L)I^I,, Illlti UVV IIIIS CL1.hl1;1 Al E- r F IN8URANCE 00ES NOhGUI\'SIr1UIE AGUNrRACTBEIWiEN'IHL--1 ;,i1,11N(a INSUi�1:iIt(G),AU IIIQKI4Lu I LI'RL 11:NIAIlV1 1)F1p 1104'.)IlLFI2, pNn IllFC, RTIFICA EIIl.)uicI Ilr >tIItT\IJ1`:It thu llYlr:u[u lu,l4lur iv 4,11 ADUIIIUNALIN:iUKt Li Iirol!uhCy(Iel)ulLlxl hu cuditrx ll.II'alJLlh(1(:,L'___... ..._ .-_.. .- -_-_-. ulll c l n(Illlc!II h of llu, I,,UIICY, I:altyln I!oll[lue May I.,, \PION 1,4 WAIL la.),sul,luci,�t r , ��,�.,n uu4lglhnulnnL A nWlrrlronL Un 1111=i CA'lI III14a1IA:III,,N;I Ilul Glllrltif IluUla(.1(I,c uu,.,l„ "Ad of ul Ilu( 1,1:rush andvr;}4nlr:nl(;f). Wur W — ---- --_-_� ra, ri, t.l ,y hr y So Or1n,1t v,lnlr Mau )uuL Yr,un LI I've ;li)tl 1CiU�IfiU') lr'Ak -... enwu- -..------__..._.-'-----.._.__............_.LIn!S,_rvyl)_ It/1•fllli•21:)li ?nnul Ilunl nc,, IVI i\ U Li t,i(I.1 liU l . �i1.Ll1E;al-..._.... !')I j'.)h /:)ilii uJ5lueLr/l; 4VIIc..r,, 11151r r4)rICO - LI;1:Ll t:,,(!l,: I,uil Insul,:tCll,n Irlt; IrlsurcRrl:Lvanislc>n Inr:urruiL:e) L:qu,l.Iarny wsuitci; ;Alltl(1114.. hr...... InyurLUlce: (lyullili'.,, MA l)?_1'i0l Y-_Ik11tU:C(lllllll rGclllCillfr9tlCc C 01171),Illy ;1tl:it uayulerlt r -' ..__....-. .-._ .......... LI II FICA I'LNUMl1Eh - -----" -" -_ -- rr, V I11 f FIIU +t)--t l u, r uv U - -"- hG'VI:IION IVt.11lllll It i RNNIr LItiIC I„LI. ,v rril/k ULLN 1$ (I[(1 IL IIIL IN UItI:Lf IJ;1MI;a:)Al1lV\'1: I OIt IIIL-I't)Lh_1 L'L lout. IAIVUuvi: .IrJY rur.r.tL.lu r..np N1 Iph41 C1h tsim.,llilrlUF AIVY CONTRACI'OR 01111 R UQCUhII::NI WIIJI 4:L-.t:il'kCl 'I(,) 4vllu;rl un:; I:Irt,, (SI I,i tll l.) lali MAl r'L:RIAW. 111E INSUhA1V(t nrr,112UCU8'' 1 (tl�POLICIES DES%I;IHEU W.-:RoN 15 SUl),IL.GI- 10 Al].. II(F hkmj. l)1 SUC'I•I ..... ,l(_S I.IMII;) SNp WIv 11 r,,1 r;, __.._._..... .... 11'F nuN hI OUCFf1 BY PAICI CLAlh1a t'• I Tr1 .IF IN.IURHN(t. Af]Di_:luria .. - -----.. -_-.__. PQr ICY CFF Mill ICV 4 kf��""'•'"`"'—_—___.,__-_ _ _.. ._.. .....__-.............. --��"9 ............- - III infhllC!pM1N1 h1hUr1D Y7Y 1 In,l'I,: 1.1ILI I, .._._.._.___ .. l.L--..._n _L . _..__._ I c.RPf)1.G3Utf� r11U'Il2ll'Il U41U 111Q 1.; cnc'rlocclnlrtLurl-_ y 9 UIIU UIIU - r\+! 161rlt ru,a%L IA-N(I(A_[LIAbILIIY —._.-__ ._ _..--.._.__. a_._.......__.. I __.._ rl H (INA„a AUV uv)inlY 11 U1111 000 _......___....._.._............._..._......_...:....,. OI'iMk -----1r11iL;(_Lllll .. . .. . ... ................. .I I 1.1_ I l NIt0001 1 1•1 Uhlr Il)1'AL l 7.� lll)-U,11111I f (( LC7_.....A _Il. L 'I ('C)htl]INII)51NGLr'l ll�ll1 ,.MM CKVrmh C�U112U12 p4(U•I/=U1; e,ur,drnn�_ ._. J,I Hu(IOU 0 MIN ..''{ AV rl.ry UQL)141'INJL1111'lP'.rr:a;,a.lanll.._A... xi ....... XON.145.1a 1-1IAlll'11211 l� U4/U'112U 1' c gu l nc l ul I t Nc l N I,ODU LIQU IIUU r 1 1 unn I:IVa N W('�IAI11 11111 I nu l 0 1 its I l sulI'JILI ly WC AUl1 11;i lU' 613U12U'12 11G13U12U'I' h t I t N I L l!M1I,hlul-h L C11.��pil�`)<h (;L Lac I I AG(Il1r N I '�'LlU tl ll UUA sw.u�ony Nrt, ,,:: ,;��.,n,o, „1.. G.L.❑ISf_Ai:C..�:a r:r,uu.nv�C. •h•I LlIUUIUUU - 1 i a.Iw�n.,n,Jr U('rr<ill li)N)lL.('Ji:AIIIfN$lVLirIICLIdS(AUauh ACOALI,u I,Ad,11,1 �.J io, w..c6•h uul I I -mm— `1Nuilu;r:. l;,nnL, Irlfurrnrill�an +'„ � M tl,111VIV tlppGY lb Itli11111YU1 L,rlvli4il i)Itlt;urc! Crr h1'(rhl'IdCUI':i - j ' L.v,uIl,:aLr, IIuliJ c, icf i,Iclucl r.cl XI:1 U11 u(Idiriallal in ura(1 unLlul (;unuial Lil Ulli(y Wtiuii roqulru(t lay wrltton i,.,ultr,l�t ur,:IYII'�crlx:lll. i ---- - -- _ CANCELLATION l..dl,UI;LM�IIIIr;l1lIlUN1,I11C SHOULD ANYOF THE ANQVl Qt!ACRII34rIP0L.IGlk%iIlkGANGI:hLIa]PhJUlil; TH8 EXPIRATION DATE THEREOF. No.I.IcL. WILL. ku1 ualvt-IktU IN I ACCORDANCE WITH THE KAJOY PrWVWIoN13. I Aulti(MI:LL)RkNHkSkNIA'IIVN ,2za-2 _ - 619111 --'�'UIU AC0110 C014PONA110N,All rl(illl:)IGIIGIra(I. iwv,l) I Or 'I I1w ACORL)HBflla antl 1000 zuu nl,)Is(uru(I marks 0ACOR0 GS:13U�Ui(V9H3U�lU I'd EzY - �V Town of Barnstable *L'ermi 016 -� xgir`s 6 n o the orz issu dote Rega lat®ry Services ]r Pee p�m Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601` www.town bamstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PER30T APPLICATION - RESIDENTIAL ONLY /) Not Vaud wdlmut Red X-Presslmpn& leap/parcel Number v Property Address 0 - Residential Value o1FWor& 1 U3Jmum fe of$25.00 for work under$6000-00 Owner's Name&AAA -ess Z� �l Contractor's Nance ., L C elephone Number Home Improvement Contractor License (if applicable) 1 1 oZ `J 3(o , Constriction Superviscr's License#Cif applicable) ✓[,Worlanan's Compensation Insurance Check one: FEB 12 2013 ❑ I an a sole proprietor I am the Homeowner I have Worker's CompensationIussnance ' TOWN OF BAR(VST W union r y __� ABLE Lnsuraace Company Name a�toe�Gi� L �'"> �"i Pe `TM�Si3'r n C�2 �p Workanan'sComp.Policy4 �C-60c, Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) S Re-roof(stripping old shingles) All con--Irucxion debris will be taken to Q Re-roof(not stripph� Going over existing layers of roof} ❑ Re-side of doors Q Replacement Wmdows/doors(sliders.U-Value (maximtjTa.44)#of windows '"Where rcquh%x: Issuance of this penny dots not exeuapt compliance with other town deparmcew resulatlow%i.e.Eli w4q,Conservation,etc.. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the ado lfmprovement Contractors License&Construction Supervisors License is eqUOEr /. . SIGNATURE- - QlWPF=\FO MMI ' RESS.doc Revised 09080 t r 1 The Coms"nwe&&k,0f�fASSmkuSet�S ®f,{rre afInvesligagm 600 WbsAbTwn st eet Easton,MA 62-7.0 ! ramLgovldfir r workers,C�ntgens4ffiaJmsW'ance IieantlEformation Affidavit erslCal�rsetorsJ ectrici pl fibers Name tB�ess/o Please Pr�L rgamza�onllnarricit�,y' Ca n s-lf't� Address: . i CityltarelZi Ar�e�eat aR e'000 Er?Cheer tine approp tiate b,. i acu a empIayer wI�1 4 I am a„ aetal and I TyPe of prOjeef(i'equered): �I 2-0smpioyees(fhu az3d/orZsmt time}* havebfiedthe sublvatactom 6 1 am asoieproprietm-of pm - listedostthe atEmherl C N c chon sidp and have zto emplory These sob-coufraaors have 7 Remodelh a worlang foraaz~is zany rapacizq emplayees andbave workers' 8 Demolition INo workers'c ° -assurance D c,=p ire t 9, 0 Bailding adaition 1 3' T meowrrerda" - We are a.cmWmd n and its 10.�E tical or additions jNa'cvoz errs'�an wak officers have exezuised t myself 11_Q Plmabingrepahs or additions right of m mptim per MCA iirsnraazce reg t .. a 152,§1(4) mud we}nave no MO Roof repairs emPioyees-[No warkets' 13.0 0&m i R iasrrrance zequheci] ! "raPP afzacebtcksbox Imes:ahroas�loutrhese:coube�c�showmgth Y `oo oa j 1Eoaareowaeawhosabrmta[risg arsdaagsl[�varTcaadahea bi�odeso hem-lhatclteoJ[1 60:cmtesLa ecl�danzdaiuoDeid0b9 O SRbumaaew8fud3vuip j fly.-es If b thca�coFtBvsv sub cat acEors�ave empluYecs,�z9>akstptavids their svadcers Cumin mbrsaad sCue whetHeror4ot taose eatikes Save DalieYas¢mHcr, law apt�vrployer�a`is pmairirirg averlrers�c� � rnfornsrrtmrt 'aeon�ance.�orprry�ieyeSs.•.8elm��the•�Iiry a►xd job site •-- r iosncance Company Name• Policy�or Self-i1as.Tic.#: W�b�c�� - Evh- m Data: OJob �: g Z 4 aoi3 � s�eAda c.. Attac)D a copy oftlaewo eoai Caty� p_ �e Fazes to secure coverage as x p°h 'declaration gage(slrowiag&e policy za and e4 SectioaZSA ofN1GL c 1�2 can Ieadtotiaeiut =Pimtioan dare), fine iata$I,�00 00 and/flr one-year intluisonme ss vreT[as civil Phu ofI penalt es of'a f of up to 3 50 00 a day%zimtfaevzolatar. Bead ' Penalties ia*e form Of STGP WORK D�and a f&me f vrsed that a copy offlsis statement may be aed m the C+ffice of Invesfigaxious offt DTA fiori�raarrce mvemp veai&ation. 1 da herabV cer , 'rs d pena�eR ofYgfizrp Mar.the' I'IvIIhpg r T paovided tabave is true arrdcnn ones: ate: _.. mad useortty» 3Ja r�aatavzifeiir this are¢,foie co>,rplded by czdy ortom qhia'd 1� city or,Town: ! PCI'mittUeemse i(SSTr1mg A thorny(,arc.$e OA9): _ • ,. _ 3.Board o€'Heam Z B9ff&m9Dep3rtane f 3.Cit5,)fOwrr Merle 4 Edeetrics$S..0t3iea respectos S.PIrattbingluspector• CoxafacEl'ersaar. . i , MOS FRASCON-0t DATE(MMIDDNYYY) 11 '4�- CERTIFICAT E OF LIABILITY INSURANCE 101512012 THIS CERTIFICATE 1S 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 PRODUCI=R,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate, holder is an ADDITIONAL,INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WANED,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 ofsuch endorsement(s). PRODUCER (508)676-0309 CONTACT Suzette Moniz V•ry Airport Insurance Agency,Inc. (AIico.No.Ext:508-676.0309 a c•No:508-324-9147 375 Airport Road Fall River,MA 02720 ADDRESS:SMoniz Viveiroslnsurance.com NSURr:NS)AFFORDING COVERAGE NA]Cw INSURERA:National Union Fire Insurance Company INSURED Fraser Construction LLC .. INSURER B: P.O.Box 9845 INSURERC: Cotuif, MA 02635- INSURER 0: INSURERS iNSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR C LTR TYPE OP INSURANCE rN RL WvO POLICYNUMBER NM1DDPOLICY F POMM1LIY EXP JC LIMITS GENERAL L"J TIY EACH OCCURRENCE S COMMEP.C[ALGENERALUABILfTY PREMISES(_Eaoaurrencel ,5 CLAIMS-MADE OCCUR - _ MEO FXF(Any one person) 5 PERSONAL$ADV INJURY S GENERAL AGGREGATE S GENL AGGREGATE LIMITAPPUESPM - I _ PRODUCTS-COMPIOPAGG S POLICY Ra J LOC S AUTOMOBILE LIABILITY COM3INED SI GLE LIMIT Ea aoctident S ANY AUTO _ BODILY INJURY(Per penmen) S ALL OWNED ' SCHEDULED AUTOS AUTOS BODILY INJURY(Peraccldent) S HIRFDAUTOS NON-OWNED PROPERTY DAMAGE AUTOS S er accident _ 5 UMBRELLA LU16 OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE 5 DED RETENTION S S WORKERS COMPENSATION T RYSIIM 0 R + AND EMPLOYERS'LIABILITY YIN _ X - A ANY PROPRIMRIPARTNERMxECUTIVE WCOOSS30601 W2612012 9126/2013 E.L.EACH ACCIDENT S 500,000 OFFICER1MEMBER EXCLUDED? -FNIA (Mandatory'b NH) EL DISEASE-EA EMPLOYE S 500,000 Ifyes,desenbeunder - 096RIPTIONOFOPERATIONSbelow E.L DISEASE-POLICY LIMIT S 500,000 OESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remaft Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE OESCRIBED POLICIES BE CANCELLED BEFORE Fraser Construction LLC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 31 13oWdOin Rcl ACCORDANCE WITH THE POLICY PROVISIONS. Mashpee,MA 0Z649- AUTHORIZED REPRESENTATIVE ©1988 201 D ACORD CORPORATION, All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD f. I , • g Office of Consumer Affairs and Bus Regulation, 10 Park Plaza- Suite 5170 Boston,Massachusetts 02 116 Home Improvement'Ca2a \\ctor Rej stration _ '__'•'____- Registration: 112536 -7 Type: DBA F_xpiration: 3/23/2013 Try 205024 FRASER CONSTRUCTION CO. DEAD FRASER P.O. BOX 1845 COTUIT, MA 02635 Update Address and return card.Mark reason for change Address 0 Renewal Q Employment Lost Card DPS-CAI is 50M-04/04-3401216 nesss. Z o a License or registratiou•valid for inditvidul use only ` HE IMPROVEOENT CONTRACTOR before the expiration date- OM I£found return to: Registration: 112536 Type• Ofuce of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Expiration: 31.23Z013 D6A Boston,iV1A 021I6 WJR CONSTF7UCTION-CO. '� DEAN FRASER 104TVVINN VIEW LANE E FAf MOl1TH.11riA DP53n Uudexaccretary Not wall wrt utsi' re , . ', •. iyitissi►CEitisetts-Depf>9'tmeut of Pubiic`Sa�h' Bom-d of-Building- Regulations and Standat•ds Coln truolfbn Supervisor License Llcerise:-CS 97668 104 TU�fll�fll�W,<<OE EAST i�AL k(t A(12536 ' Expiration: W71=3 C:ammissinti�s' Trtt: 16692 i ®J' Feb, -Y7. 2013 1 :49PM No. 7939 P. 1 a . Fraser Construction LLC CONSTRUCTION � P.O. Box 1845, Cotuit MA. 02635 ' ' FINC, & SIVINGEma.il: fraser constructionOverizon.net SPECIALIS IS www.fras xroofPg.com FAX 1-508-428-0123 � 508-428-2292 HICL#112536 CS#97668 f RE-ROOFING PROPOSAL , ' DATE: December 19, 2012 PHONE: 508-771-4498 NAME: Mike Baker C/O: EJ Jaxtimer MAIL ADDRESS: N/A JOB ADDIREPS: 43 Iyanough Avenue, Hyannis Port, MA 02647 FRASER CONSTRUCTION hereby proposes to perform the following services in a neat, professional like manner in,accordance with the manufacturer's specification and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheatbing as needed. Fraser Construction will include a 4 Star Upgraded warranty with the selection of any 30 year shingles or any Lifetime shingles. ,CertainTeed SureStart Plus- The extra measure of protection when a credentlaled company installs an Integrity Roof System. 4 Star warranties have a 50 year Non-Prorated Coverage for any lifetime shingles, which will coves incase of any in warranty repair, Labor and Materials, any Tear-Off, *and any Disposal Fees. Upgraded wind warranty available on the following products when special application methods are used. See description below and in the CeatainTeed SureStart plus brochure enclosed, ASK US ABOUT OUR OVERHEAD CARE CMEMI Partial Re-roof Shingled areas only. Does not include rubber roofing. iSutyyly and InstaU - CERTAINTEED LANDMARK: LWETIIVIE WARRANTY CLASS A FIRE RATED,ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, Architectural Style, Fiberglass Based Asphalt Shingle vith New England's Exclusive COPPER/CERA HC,Stones with a bull 10 Year Warranty ag - ContalX)]OC).ent_ . Vrith a SureStart Plus upgrade custeme receive 10 year 130 uxph wind-resistance warranty with six nails in common and area, Fraser construction includes six nails in common bond area Qti NO addiflonal eogt. See actual warranty for specific details and hrrAtattons Color: £^g N t PRICF,$14,875.00 lnit,44t�:� 1 I • I nlrn •n►I IISpl 1 WUTA14 rIA7 .7 •uvr Feb, .'7. 2013 1 :49PM No, 7939 P. 2 ,i n IV and Install - CRRTAIIITTEED LMDMARR PRO: CLASS A,FMFI,RATED, ALGAE Resir tart, Extra Heavy Weight, Self Sealing, Multi-Layered,Architectural .style,Fiberglass Based Asphalt Shingle with New England's EXclusive. COi'PER/c=AMIC stones with a Full 15 Year Warranty against AY-GAB CQntAw=ent. Landmark PRO is engineered to outperform ordlnaty goofing in every category, keeping you comfortable, your home protected, and your peace-of-mind -intact for years to come with a transferable warranty that's a leader in the industry. -WIba Max Def colors, a new dimension is added to shingles with a richer mixture of V' surface granules. You get a brighter, more-vibrant, afore drama appearance and depth of color.And the natuxal beauty of your roof shines through. With a Sure9tart Plus upgrade customer will receive 10 year 130 mph wind-resistance warranty with six nails in common bong area, Fraser coustmetlao.includes six nails In common bond area at NO additional cost_See actual warranty for specific details and limitations. Color: PRICFi815,750.00 Initial Supplyand Install - CERTAINTEED LANDMARK PREMUM:Limited Lifetime Warrauty, 10 year sure start protection, CLASS A FM RATED, ALIGAE Resistant, Extra.Heavy Weight, Self Sealing, Multi-UVer.ed, Laminated Architectural.Style, Fiberglass 13ased Asphalt Shingle with New England's E�ciusive COPPER/CERAWC Stones with a Fill 16 year Warranty agaiust.ALGAE ConTainrnent~ x.0 year 11.0 mph wind-resistance warranty Wind warranty upgrade to 130 mph when CertainTeed starter& CertainTeed hip & ridge are used. See actual warranty for specific details anal limitations. praser construction includes six nails in cocoon bond area at XO a"Houal cost. Color: PRICV$18,375.00 Initial Supply gnd Install - CERTAINTEED`LANDMARK TL:Lifetime Warranty, 10 year sure start protection, CLASS A FIRE RATED,ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, triple-layer thielmoss,Laminated Architectural.Style, Fiberglass Based Asphalt Shingle with New England's Delusive COPPER/CERAMIC Stones-with a Full 15 year Warranty against ALGAE Containment. 10 year 110 mph win&resiistance warranty, Wind warranty apgrade to a�90 mph when Certa)ATeed starter& CertainTeed hip &ridge are used. See actual warranty for specific details and limitations. Fraser construction includes six nails in common bond area.at ' NO additional cost. Color: PRICE-$19,750.00 Initial Price includes rain.&Venter above lealuing chimney. Edge vent soffit venting where Note: price tore-sheath main roofw/ 3/8- CD x plywood to provi olid nailing base Price - $3t495.00 Initi tall proper vents in attic to provide buffer for blovm in in m�'tb roof only. Ins p p p . Price - $275.00 Inidai Remove &replace white cedar eiding on all dormers on main house to allow for up of new sheatbing. ce includes new copper-faced fiashing Price of Raw White Cedar: $2,295.00 Initial Pn1ce of Tate-11Qatch 100 Whito: $2,675.00 Ymitial 2 III,,,A-/ I'I n7 17 guar Nov. 11,,.2012 01:12 PM Stephen Baker"' 7072060162 PAGE. 3/ 3 this would be charged for as an extra at the rate of$6.00 per panel including. Mfrt.eriiiis Rs 1.4.rhor. There are 6 I-lar cls per sh.cet of hl,ywood Possible Extra-Any rotled'or otherwise deteriorated trim-boards,-plywood' ahenthing, lend flashing, or other c HrIp retry nt'c'ding re.placenlent will be'..done and charged for as an extra at, the rate of$110.00 per hour, plus 20%mark-up materials. r Possible Extra - If ice & water is found on current roof sheathing-removal of ,plywood will be needed as the existing ice fir, water ciannot he removed, Due to its melting to plywood. L'rice is lime. and.nlal.eritil at. 01c a'cttt'.ol,$1 .10.00 per hour, plus 20%mark-up materials. Any.deviation or alteration from"auove,specilication will be exec:u.l.ed upon written orders And will become an extra charge,over,and above the estimate. All figrecrnents conlirige.nt t.ipon strikes, kwcidents or,dclayg al'C beyond Qtal' -control. 0W11Cr %haulci Carry tire, to 'n.ado and othennecessary Insurance Upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workman's.Compensation and Public Liability.Insurance on the above work, certificate available upon request.. DATE OV ACCEPTANCE: omqownrpr Fr er Construction, LLC �c ,l l _ k IC,http://corp_ser state.ma.usJcorp/carpsearch/CorpSearehSummary.asp?ReadFromL78=True&llpdateAElosrred= FEIN= its b Bing P F -... ..:..7. s � k � �, .- ��{. .a -sow n ,�" -..... sw�k'..Ik' '"�.„,. .� ", - �B > y,.._ - �'^ - ,�. ar,.+ *,.. ��.. � •e: x •� The exact name of.the Domestic Limited Liability Company(LLC): HP ASSOCIATES LLC Entity Type: Domestic.Lunited Liabili T Company (LLC , e i Identification Number-: 461671313 Date of Organization in Massachusetts: .01/03/2013 � The location of1ts principal office. No. and Street: 43 IYANOUGH AVENUE _ PO-BOX 535 ' City or Town: HYANNIS PORT State: MA ' Zip: .02647 Country: USA" If the-business entity is organized wholly to do business outside Massachusetts, the location of that office: No. and Street: City or Town: State: Zip: Country: ! ,1 The name and address of the Resident Agent: Name: STEPHEN E. BAKER _: . • _J_.. 1.<t'Yl _ _ __A_'f T�T::A 1�Tl1T.T.!"�T T_A.T lTL.T.TTT' _:_- _., :��._.._ ,-.: ....._ --_: ,. - _ R :. }(a� t{ , ;,r .; .: n ., __ M Corn titer M =[�letwtrrk=PEa� ,Start Main.S stem..., Iicat�on,E ..I ,The=C�ranmo » Y p Y I a. l�� > G l �F G Assessor's map and lot number .. .. . .. ... FTHE TC Sewage 17ermit pumber .....Q.[.lc......,n.e......... ... S6PTIC SYSTEM aj� p ' STALLED Z 89HB9TADLE. i House number ........ �� compu 90 M"L ............................................. WITH TITS o,�=39.a\0m y N►►�IAO 0 Y TOWN OF BARD ' BUILDING INSPECTOR r APPLICATION FOR PERMIT TO .... ............... . .... ............................................................................................... TYPE OF CONSTRUCTION � ................... ....................... .T" ""' p. .......1911 TO THE INSPECTOR OF BUILDINGS: a The undersigned hereby applies fora'/ permit according to the following information: Location .G C �' sQ�� /..., .4."�L....... !....!.� ..... .,... ProposedUse . . ........^......... .............. ... .................................................................................... ZoningDistrict ..... ...... .................................................Fire District .............................................................................. Name of Owner oeTw--k... 1�1 � ,d;,.. - �1 /.21.'.y1��Address .................................................................................... .. 1 Name of Builder j ��/-I�,�.Address /L . Name of Architect .. .. ...Address ..q. ��...�! % .. .. � 'h � Number of Rooms ..................................................................Foundation Exierfor .. .:r.....................................Roofing ........ .... ...... . `. ........................ M� U Floors !► ..................................................................Interior ..........................:......................................................... Heating ................................................................ .................Plumbing ................ .......................................................... Fireplace ..................................................................................Approximate Cost ... ...... ram.. v- ........................ , n Q Definitive Plan Approved by Planning Board ________________________________19--------. Area Diagram of Lot and Building with Dimensions Fee 6-0....ice................. SUBJECT TO APPROVAL OF BOARD OF HEALTH Y III I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............ .... ... ....... t...... / �e~ BAKER, BERMAN & J\NNE W. = 23r68 ADDITION ` ,,No ................. Permit for ------------ ' "� ----. Iv ----'_ -...---.._^.----.-~-------.. ' ---''�-' �........................................ . _--..-. . . B ` ^ Ovvner .��zoza�l.._�..��_T�|.. ........... � _ ` Type of. Construction . ........................... - . -------------------------- Plot ..... Lot ----------. - � ' - � June 3 ' | Perm it �,onx,6 _-----._..� -' ]A Rl ' 1 - ��. Date of |napechon -----.� ..lV �� ' ' J Date Completed -----_..,��lP �/ � . PERM ^ _ ' . - {� - ^ _ �� .---. ` l� - - . . ' 0 �� . _ �: �� . ....................~ �. . . --. ----.~---.-- -? �' -. -..`�.��' �� . . ~ . . .. . �� . ..��..--.._...~---.-.-.-.. � .................. ......... ............................................. - we ~ ^ ---^' ~'' ------------r~-. . | | ---------------- lg ' . . ---------'--'---^-^~~--'-^'---' [ ...................................... � � � Assessor's map and lot umber . 4 ../................ A//)j 'f Sewage`Permit number ..... !./.G.....,�... r 33AUSTAM E, i House number .............................................................../........ ro raea po,1639. \00� TOWN OF BARNSTABLE BUILDING INSPECTOR T � APPLICATION FOR PERMIT TO .......::......�f?!E.:.......................::..................................................................... TYPE OF CONSTRUCTION ....f�� ::........................................................................... ......................... ..................1911 TO THE INSPECTOR OF BUILDINGS,,,. The undersigned hereby applies for a permit according to the following'`information: p Location �.. .. �.,.. �............ ,•... r! ...... 14-1, ............................................... ProposedUse ...: ..............................................................I......................... ZoningDistrict ........... ...... .........................................Fire District ... ...................................................................... Name of Owner �� .. y!�ta3.' !1MfLY1�Address .................................................................................... Name of Builder .. ry .... /I�Lt�?!!!Is .Address .1.. Y. :✓ ,P/1.:....� 1.. /.. ... ....... :1. �/v,�u/`S Name of Architect .. .. .. ! .1 ,A ...Address ..:d. ..... �>.. t �! ...� Number of Rooms ..................................................................Foundation Exierior .....................................Roofing ...a41461 ........................ Floors ...,I,C, ..................................................................Interior ....................... Heating ....... ... .................................................. .Plumbing ................ ,. .......................................................... r p Fireplace .............."........................... Approximate Cost . ?!?....................,..... ". .. , Definitive Plan Approved by Planning Board ________________________________19________ . Ared � ... � .. . Diagram of Lot and Building with Dimensions �d 9 9 Fee ......../....,��...,�................. SUBJECT TO APPROVAL OF BOARD OF HEALTH U J l hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .�..en . �'!......... 23168 ADDITION Single Family Dwelli/n�g Locatio'4 ........ Hyannisport Herman & Anne W. -Ba.ker PERM111T REFUSED ....................................................xj ..... 19 ApproveJ ---------------- lg --------^^----'—~----------'- - ' --------------------^^---^—' 1 790115 rr, ^ 1 W To G Q ` Z 1 cn Polo- .. ' a "-.r-"�•Fr. t>.(.,1t x•'�1 4' YIC.1J r=**-L-:' h�.lj �y... 1 =� li � cc A. )VT _ y -- - Lt6_11c_ To '-:2 f5+ /9'lrt� �� ... .-�[._.._�..__'�•�' ��,i1� c��r--i �I.c>r^G-' AWEsaS �! � ` � j I � i ) � � ; -Tr' r�A-Tc�►'Wr�c "�r.' A.iv ! I I I i I ea x 4JAL� _ 31 r � �' ,i � �j �-i_F�•�"TC''�1 .,a.Fi .t'N::✓r'11.1G! GE-I-K-• �'� i l - ��__ _- � i I l rr r � AF CHITECTS I f � N3� Y j i ,c�c r-.cu^ u_; z VAAMOL) IY tg PORT_ VA !~ j ENGINE E � ALAN n r ll - - -- - r--------- : �M ,._I 6 CAR' f. �� Dd Uf lVE q1i s'_�a •+ ;' ' I E SANDWICH. MA r: � i - - �-/ /ti+iJl�^,T�_:i.� Cis-�u->-•,/�<, - � r I t ,' \t M - F9., I {, I:rJ C• t --t; -q-..- - wi ,:' � P1�'✓!: -- ---i i-- L _ --� � z; � f t _-_l- " r � i , I TV � �, A'i T f TITLE- q iit- 4 G oA J ; ar,w a, _ - - - r '1 Gl'• ' , -,- ,ram✓= fnr-11�►L•L+ r l� t"�F'''��j`>'vld►Jls c`r, - SCAL L f ( -Tr, } IF � !t� --�--�----- 3'#-rF-A �,,•,,�,- �L�cj'r'a !'f'•i C:i:+�.1GXJ�..d f��Gfi-- � �t K''� a 1 r i ' Town of Barnstable Building PostT �rx hrs Card So;That tt,is Ursible From he Street;-TA roved,Plans Mustbe Reta,�ned on Job andH;this Gard Must.betaKept:,. attewrii;�;. ,':% • WAS& Poste�,d Until Final Inspection Has.Been Made . , uµ r + R ,Where;a Certificate of Occu`ark rs Red erred,such Burldm shall No ,be Occu red.un#d aFinal Ins ectro.n has b'eenmade Permit , , Permit No. B-19-1994 Applicant Name: WHITNEY P WRIGHT Approvals Date Issued: 06/20/2019 Current Use: - Structure Permit Type: Building-Deck Expiration Date: 12/20/2019 Foundation: Location: 43 IYANOUGH AVENUE,HYANNIS Map/Lot 287-074 Zoning District: RF-1 Sheathing: z f. Owner on Record: HP ASSOCIATES tLC Contractor<Name ,WHITNEY P WRIGHT Framing: 1 a .x Address: PO BOX 535 ContractorLicense CS-010366 2 HYANNIS PORT, MA 02647 ° Est ProiectCost: $3,000.00 Chimney: Description: Remove Old Deck Surface Wood Repair Framing and Rail Install Permrt Fee: $110.00 New Foundation Piers Install New Pressure Treated Deck,Protect Insulation: i x Fee Paid: $110.00 Existing Foam Insulation, Under Building,Install+new=Lattice, Final: Distance From Deck to Lot Line to be Increased!,Foot.+ Date 6/20/2019 4, b'n G Project Review Req: '� — - Plumbing/Gas um r ,,��,�i�.�� PI Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work a6th6riied,by this permit is commenced within sa months after issuance. All work authorized by this permit shall conform to the approved application aend the'approved construction documentsfor whic this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall'be in compliance with the local zoning by taws and codes. • Final Gas: This permit shall be displayed in a location clearly visible from access sti;666 t road and shall be maintained open for public mspection for the entire duration of the work until the completion of the same. xr ` Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the tulding and Fire Off,.icials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: .° - Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy -Low Voltage final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department �I Building plans are to be available on site g! Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT �. 7a ... .. .... ....Applic� �.. . on Number. : ..... .............. j..... qq BUILD' e .......................................other Fee:.. ............... 1, ,►` h� G (� �. JUNK .. . :. v Fee Paid......... . ..... TOWN OF 8q, � - TOWN OF BARNSTABLE BUILDING PERMIT , ' '? Mv.... P ei APPLICATION Section 1 —Owner's Information and Project Location Project Address 3 �� _ ( ��'� Village l-�`�' \ i'��;,� Owners Name lkP LW l L T GS LLC- Owners Legal Address__ g city, 14YAOaS?OR7F zip ) 6 owners Cell# Section Z —Use of Structure Use Group_L�J fj ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet —Single/Two Family Dwelling Section 3--1':�6 e of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment Sprinkler System ❑ Addition ❑ Retaining wall (] Solar Renovation ❑ Pool ❑ Insulation Other-Specify a(,Q-Ulf r. -t r-- LAC.� � IV C- Section 4 - Work Description R r-t? QFLK 512E r-UL LJ DQ L P ASP HUMU)& ONT.�._ LU r-OWO&T 1W Cyr-_2S - \)4- - T Sv AT 0k) D : :.. ...... . . ... . T sat,,.,.iowd• t t n cant a ApplicationNumber.................................................... Section 5—Detail Cost of Proposed Construction 0 0 000SQuare Footage of Project Age of Structure t � S Dig Safe Number #Of Bedrooms Existing Total#Of Bedrooms(proposed) G 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specificsww � L ❑F— Wiring ❑ OR Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply Public ❑ Private Sewage Disposal ❑ Municipal On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: �%MT(M -fi I am using a crane ❑ Yes 19 No Section 7—Flood.Zone Flood Zone Designation J N OE tiTumu (,-'L00 O 147AR1) �?SO O N Within or adjacent to a wetland,coastal bank? Yes ❑ No ❑ UWtSOWV Section 8—Zoning Information i .. qq ZoningDistrict 1 Pro osed Use.- Lot Area Sq.Ft. r P Total Frontage Percentage of Lot Coverage # of Dwelling Units(on site) 0 Setbacks Front Yard Required _Proposed (v0 C t�(WG'ry Rear Yard �� Required_ Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes No Last updated:11/152019 f (2 3 Application Number........................................... j Section 9- Construction Supervisor I 3 Name ,i TM-1 1,.)'(� U'l RX TelephoneNumber Address s� V�IU R Q, City t+A(�,T C P State_ Zip 0 License Number 010366 License Type� RE$� T,CCflxpiration Date �6 Contractors Email L)PTTQEyj WR t4nootlC&S T Cell # 'J Y 36 D y e I understand my responsibilities the es an ations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts S the construction inspection procedures,specific inspe 'ons and documentation require y 7 f Barnstable.Attach a copy of your license. Signature Date 3 I V S 'on 10—Houle Improvement Contractor Name �� ."S � G� ��_ Telephone Number ""77V Address 51 t�kOJA 1hy UR-U104 tate H A Zip 0: 6 Registration Number Expiration Date ` 6 I understand my responsib' ' ' es and regulations for Home Improvement Contractors in accor ce with 780 CMR the Massachusetts de. I understand the construction inspection procedures,spe ific ins ections and documentation req ' d the Town of Barnstable.Attach a copy of your H.I.C... Signature Date G Section 11—Home Owners License Exemption i � Home Owners Name: Telephone Number Cell or Work Number 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 required by 780 CMR and the Town of Barnstable. Signature Date SRGN Signature Date l? Print Name Telephone Number 71�V 9 0 Y7 / E-mail permit to: (0 m(,A S r r. VJ LI Section 12—Department Sign-Offs { 1 Health Department ❑ Zoning Board(if required) ❑ Historic District Q Site Plan Review(if required) 0 Fire Department ❑ Conservation ❑ For commercial work please take your plans directly to the fire depart rent for approval Section 13— Owner's Authorization I ��e•� t. t3 � , as Owner of thee subject property hereby authorize QJAD3f.'? U RY f FE TIUL to act on my behalf, in all matters relative to work authorized by this building permit application for: Fill (Address of job) Signature of Owner date Print Nime I Lag updata: i i1isn018 r Tke Commonweah*of Massachusem Department of Industrial Accidents Office of Investigations 600 Waskington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit:Baulders/Contractors/Fkctricians/pimubers Ap Information Please Print Lb Name(Business/Orgenrraiimbdividual): LA.�-�j v►N�� 1 (?JGI- l ,y,N� Addms: 5-� QUE-W M O rL RP. , C Phone#: `7 Y ?3 G O� & 1 Are you an employer?Check the appropriate box: Type of project(required): 1.[1i am a employer with- 4. ❑ I am a general contactor and I employees(full and/or part-time).* bave hired the sub-contactors 6• ❑New construction 2. I am a sole proprietor or partner- listed on.the attached sheet. 7. Pff Remodeling These sub-caatactiom have ship and have no employees '� S. ElIkmolition worlang for me emin any capacity. P1o3'ees and have warkers 9. ❑Building addition [No workers'comp.insutsnce comp'insurance.: 10. Electrical airs or additions �] 5. We are a corporation and its ❑ rep 3.❑ I am a homeowner doing all work officers have exercised their 11-El Plumbing repairs or additions myself[No workers'comp. right of exemption per MOL 12.[]Roof repairs msurnm requhrA]t c.152,§I(41 and we have no employees.[No workers' 13.❑Other comp.insurance required.] ¢Any appllcent that checks box#1 most also f ll out the section below showing their workena'coapen�an Pere►i�� cy i t Homeowners who submit this aff davit indicating they are doing A work sad then hiss outside contractors must submit a new affidavit indicating such, t-=ftactns that check this box must attached an additional sheet showing the narrar of the sub contsBcrors and state wbesha or not those entw=have employees. If the sub-contractors have anproyees,they mast provide them warkens'comp.policy number. f am-an employer that is providing workers'compensation insurance for my employees. Below is tke policy and job sde informadem I mmince Company Name: Policy#or Self-ins.Lia#: Expiration Date: Job site Address: Lt 3 `I &P—W l)G 1-4 L14 city/St aajp: .l(UU 70AT-_ Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Falgure to secure coverage as required.under Section 25A of MOL c. 152 can lead to the imposition of crimirri raI penalties of a fine up to$1,500.00 and/or one-year imprisonm well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day 'o ed that a copy of this statement may be forwarded to the Office of Investigations of file D —a— I do hereby ccgYy p of perjury that the information provided SkAw is and correct S' Dates- Phone owl use on#R Do not write In this area,to be completed by city or town o,Q°Wd City or Town- Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City1rown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M Town of Barnstable Building Department Services BARNSTABLE. Brian Florence,CBO MAM 1639. Building Commissioner i a 200 Main Street,Hyannis,Mk02601 www.town.barnstable.ma.us II H K � s. Office: 508-862-4038 Fax: 508-790-6230 4 Property Owner Must Complete and Sign This Section If Usi= A Builder I, 1 ,as Owner of the subject property hereby authorize �.0 � � �•� �� ---to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) a ' * Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is ins d a1 inspections are performed and accepted. t� SLLC� Signatuit of Owner Sign e of Ap scant Print N Print Name G Date Q:FORM&OWNERPERMISSIONPOOLS Rev:08/16/17 i Town of Barnstable Regulatory Services ►.: x Richard V.5cali Director MMSTABLM 9 165� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 i www.townofbarnstable.us ` a � ! f j Office: 508-862-4038 Fax: 508-790-6230 k 1 Owner's Liability Insurance Waiver Owner Name: Owner Address: r. Telephone: 33 2 ! E-Mail: ST evf Property Location: 3 �/��U �)�-� �u� l�y�y� S W, Permit#: I hereby certify that I am the owner of the property. k t I am aware that the licensee does not have the liability insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. ^ — lo �yi� __ Signatle of Owner Date 4 .. .orr°m no uiassacnuse•.s Construction Supervisor w IF Division of Professional L censure v w. ' Unrestricted-Buildings of any use group which contain . Board o;B�;ildirg Regulations and Standards less than.35;000 cubic feet(999 cubic meters)of enclosed ?nor space. F i . CS u9�3Ef t ' Expires 08/26/20 9 jr j WHITNEY P WRIGHT, 67 QUEEN ANNE RD , ). f HARWICH MA 02646 i t Failure to possess a current edition of the Massachusetts "State Building Code is cause for revocation of this icense. t , . For informatiori about this license ' ommissione.r ✓ 1 Call(617)727-3200 or visit www-mass-gov/dpl rj Office of Consumer Affairs&a3usiness Regulation HOME IMPROVEMENT.CONTRACTOR r~ TYPEs Corporation :Bern---stration 184494 ,.,w,wrw v,. a uawa „w,..-'.Ms.,s ,.i -:,a .,�-�.av.g,•.r ..w.w,.rT' rnnae...r,s. d..w`ff'°"c.,,'.0 J1.;r i f . ru: n O /06/2020 WHTNEY WRIGHT fNC P ; .w t R istretion vaM.for individual use only WHITNEY WRIGHT p k 57 QUEEN AN before the expiration date:.ff found retum;fo., HARWIC H MA (72645 Office of.Consumer Affairs a Business Regulation Undersecri One Astiburt ce u 1, �� i Boston,. a i - Not d Without,signat�re r 1 i i i i I i, t t j, .._. � ... ,: gym_._ - �._ ------ - - -- -- ---- - - --- - ---- ----- ---- -- - — - - -- ---- -- A%ENE 1 0 N fee m a vj Bit.805 5 83• 83 Ob I80' co �f e,yonla Coo ao. ogles ar+ °� W N • Cher Ste w 'P t d•o Qp W ;N oo. m /r 8 9�0074 0 Z N Ws 0 0t 22•10•5 $ 13. w .Op W fp3'19 0 e+lvnde/tA o ` $. 1 s. p� 8•FI�� oberl�URF'ffpOt. P o R ye L o� ek6,e Wl ti\ p 16.800 a #4 i .. 4 01 I�l I x j. Q�I.•�� 6ARNSTARLE ; �--- C i REGISTRY OF UGEDS JUL.241954 RECOR _'.?I:]A��__ —Ps.-AN Or L"ANoltw---'^ iii u 14YANN13 PORTB BLEfVIgSS aa NSTA 104 q d n�l�G r As GuAvavao FOR NYANNIS pORTvzIV upwtS,INm his Plan does not require SCALO IN-3OFT} JUNr IQ 1959. �ytx the appr val of th a d OP Survey NELSON BcAR86`Rtcu nu LAw. S�taveYORs. CENTCFYI II.E!., MASS. � NEl80N �. BfMSE BOCff ODF BA TABL _ ssoa ' JUL6- 1959 � 149 i05" 6/12120'19 Town of Barn a Sketches y 1 ! S d Nx { C i 1 II t , t h 3 As Built Cards :Clickcard # to view:Card #1 B2N Barn-any 2nd story area FPC Open Porch Conc ;k e BAS First Floor, Living Area. FTS Third Story Living EST Basement ,area (unfinished) FUS Second Story Livir i t' (Finished) BRN Barn GAR Garage CAN Canopy GAZ Gazebo LP Loading Platform GRN Greenhouse FAT Attic Area (Finished) GXT Garage Extension F'CP Carport KEN Kennel IMP PnHntori Pnri-h Iltl 74 ��#�-�►-,.��.:�.,� s t�.�:�,:, WRIG H-T P.0 Box 1,045 9-", T(NWOO&W /'W�l ble �1 ? / 13Z026' J.y 11- 77q V�G 040t 1 �100 fj G I-T, T9 PT 5 TS 10 LL LL I F-L- fk-'- CA Lf-- lc 7:� p v CAPE COD INSULATION IISIA SS SPRAY 10AN SU7YSNOSC " ,SATTS TT! OUTTI OUI/IY! IN UIITION ClIlINOl ... . 1-800-696-6611 r Town ofBarn"stable Regulatory.Services Building Division 200 Main St ; Hyannis, MA 02601 Date: 71Q1I •" s' Dear Building Inspector Please accept this Affidavit-as documentation that Cape Cod Insulation, Inc. performed & coinpleted the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance"to the specifications listed on the building permit application:All-work has been inspected by-a' certified Building Performance .Institute (BPI) inspector, All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village fro I bias °.Ve tl�AlSQ.uEw /lD pia J s y °Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) (X ) Slopes Floors 10U(A (.}�) Walls �,,e►^�y Gvor l� /perFlor, '�Cl • _q,� ,(-�` Sincerely H ry E ssi r, President pe C Ins ation, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �� Parcel Application #a o( �U7 Health Division a Date Issued Conservation Division Application Fee 2 IPlanning Dept. rs -Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 41•1 yA Io ?A Village Owner elz ,& eea/-O U/Z Address 4/e Telephone rd R 9i� e if- Permit Request /��,t�,�i�f; fed L'�U 72 ��'�s, /�/� ��% /31��✓ 10 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation J?Ot�: v Construction 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 j(No On Old King's Highway: ❑Yes WNo 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 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___ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ��'� Telephone Number5�-- Address License# 44 -04) Home.Improvement Contractor# /,..s � Email Worker's Compensation # !!�9eo ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCELNO. S ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO. OWNER AUTHORIZATION FORM (Owner's Name) Towner of the property located at (Props A ress) ` roperty Address) hereby authorize!' (Subcon ctor). an authodied subcontractor for RISE Engineering,,to act on my behalf to obtain a building -permit,and to perform work on my property. A AA- 0 errs Signature Date The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www,mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A licant Information Please Print Ise ibly j 1 Name (Business/Organizadon/Individual): 1 Address: �� V 61�� b(✓l% City/State/Zi : r�v V kba (�� Phone #: 1; 6 j Are you an employer?Ch a he appropriate box: 1. I am a employer with �_ 4. ❑ I am a general contractor and I Type of project(required): employees * have 6. New construction (full and/or part-time). hued 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 g, ❑ Demolition working for me in any capacity, employees and have workers' [No workers' comp. insurance comp. insurance.t 9• ❑ Building addition 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 1 l.❑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 P 3a.❑ I am a homeowner acting as a employees. [No workers' 13. Other general contractor(refer to#4) �----�---- comp. insurance required] i y applicant that checks box#1 must also&ll out the section below showing their workers'compcnsatioti poiic},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. tContractors 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 workerre comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job,site information. Ie) 'Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: �1C� 1 k Job Site Address: ,%SOU 9 T y �1 City/State/Zip: &4 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 file of up to$250:00 a day against the viplator. 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 Gerd pun the pains and penalties of perjury that the information provided above is true and correct. Si a Date: Phon #: Official use only. Do not write in this area, to be completed by city or tower officiaL City.or Town: Permit/Liceuse # Issuing Authority(circle one): L Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other ' f Contact Person: Phone#• From:Rogers&Gray InsuraE�].X: `` y To:+1 5087 7 85735 Fax: +15087785735 Page 2.of 2 0,,./3012015 10:04 AM CAPECOD-27 BDELAWRENCE '4�CO�RL7, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYYI 3130/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ), CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Rogers&Gray Insurance Agency,Inc, HONE Exc: IFAX Ac No: 877 816-21 S 6 434 Rte 134 ( ) South Dennis,MA 02660 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC u _ F INSURER A:Peerless Insurance Company-see LIBERTY MUTUAL INSURED INSURER B:SAFETY INSURANCE COMPANY 39454 Cape Cod Insulation, Inc. INSURER C:Endurance American Specialty Ins.Co. 18 Reardon Circle INSURERD:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth, MA 02664 INSURER E: INSURERF: 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. SR —- LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000, CLAIMS-MADE a OCCUR CBP8263063 04/01/2015 04/01l2016 PREMISES Eaoccunence $ 100,000{ - MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000I GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,0001,000I X POLICY jECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 B ANY AUTO TBD 04/01/2015 04/01/2016 BODILY INJURY(Per peison) $ 1 ALL OWNED X SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,0() C EXCESS LIAB CLAIMS-MADE EXC10006635000 04/0112015 04/01/2016 AGGREGATE $ DED I X I RETENTION$ 10,000 Aggregate $ 2,000,00 WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER D ANY PROPRIETOR/PARTNER/EXECUTIVE WCE00431900 06/30/2014 06/30/2015 E.L.EACH ACCIDENT $ 1,000,000, OFF]CERIMEMBER EXCLUDE D9 N❑ N/A _f (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ - 1,000,00 If yes,describe Under I DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 1,000,00 i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached if more space Is required) Workers Compensation includes Officers or Proprietors. Additional Insured status is provided under thh General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18 Reardon Circle ACCORDANCE WTH THE POLICY PROVISIONS. South Yarmouth, MA 02664 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD ' = Office of Consumer Affairs and Business,Regulation 10 Park Plaza - Suite 5170 -Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration; 153567_ Type: Private Corporation Expiration: 12/15/2016 Trg 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE `-----—- —==,-- SO. YARMOUTH, MA 02664 ==— i Update,Addi ess and return ca rd, Nim-k reason for ch;ui Address Renewal Eniployinent F. I,os( C:rirrl SCA 1 �:i. 20M-05/11 - � LJ/ze (Coo7[4,ra7z[ucn.�rf�n�C��C[dJa C�l�de�l•J � , .. - rrr Office of Consumer Affairs& Business Regulation License or registration valid for ii,dividul use only a before the expiration—date. Cf.,found return to: F),,)OME IMPROVEMENT CONTRACTOR ` 3567 Type; egistration: 15 Office of Consumer Affa u s aiid Business Regulation �� 10 Pari<PIgza -Suite 51,70 C� r� ;expiration; .12/15/201.6 Private Corporation. Boston,NTA 021 16 CAPE COD INSULATION, INC HENRY CASSIDY, 18 REARDON CIRCLE ��=—yam _ —• SO.YARMOUTH, MA 02664 Undersecretary „ . N valid wi ul sign -e • Mass tc;husell, - Department.ot 0ublic Sa(oly Board of Bulldtil Re ulatlo y g ns and Sf�ndard 'co list Snp.01-visor , License; cS•10098.8 ' - `HENRY,E CASSII� v q.8 SI-MD ROW WEST YARM0Tj- �t 0 70 � s /' Comn,issloner 1.1/11/20.15 � ' a . .� //�- F t.. / ��yA * � _ r V �j� �D�� y ,a ` + .. + 1 t` ..� P. � Federal ID#05.0405629 RI Contractor Registration No 8186 ` MA Contractor Registration No 120979 CT Contractor Registration No 620120. �' CONTRACT Page 1 i'ILC)GR�AM THIS CONTRACT IS ENTERED INTO BETWEEN RISE C LC-RCS ENGINEERING AND THE CUSTOMER FOR WORK AS DESCRIBED BELOW NE - DATE CLIENT a WORK ORDER 27)641-1255 0310312015 188921 00002 INC;STREET - Old Kings Road ING CITY•STATE,TIP flail. MA 02635 RIPTION fetal,rxccs.rur Icakaec. This work will be }our hnmc%%ill be left with a healthful level of We caulks.hams.weatherstripping and other d tiara-us and other unheated area(windows are tmner.a final bitmer door andror combustion door air qualit%. S 1.232.00 lulose added io(700)square feet ofopen attic i NOTE: SETBACKS MEASURED TO RIM J0I5T OF DECK w NO UGH n cn /"� N OAD m J I 95.38, Lo R=20.00' ° N A=34.08' T=22.8G' (yj I C) N I I 1 . I I O n/ uj O � > o 6 EXISTING EXIST, o u� DWELLING PORCH O U -----25-I' 6.5---- ) W ' --� LOT I G G 8137.4 S.F. - - -,- - - - -�__�6•_4, 4.5'1 - 109.68' DECK UNDER ., CONSTRUCTION BUILDING LOCATION PLAN FOR 43 IYANOUGH RD., HYANNI5, MA PREPARED FOR "°F"�'` HELEN VENTOURI5 02 tiG SCALE: DATE: DRAWN BY: 20' 04-0 I -20 15 TMW Nu 3 79 JOB NUMBER: REV1510N: 5hEEf NUMBER: CPP-2 RF�isT�¢� WELLER A550CIATE-5 P.O. BOX 417 CENTERVILLE, MA 02632 TELEPHONE: (508) 328-4692 EMAIL: trl5wellcr@gmad.com REGISTERED LAND SURVEYORS � ENVIRONMENTAL CONSULTANTS— 13 Traverse PC 4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 46 Map Parcel Application 0 0 Health Division Date Issued/f> —� Conservation Division Application Fee Planning Dept. Permit Fee ? Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Turdhn u.c I Village 1S Owner Me!q Address q3 17vaing' "jAW/ � Telephone 17ft-57939.. �p Permit Request 9w�V�Y0 411 C/1, ha why AU IC I&J41 o+�rMem Inc Denibr a rchk " �vr-w - Ne rpown c if N4 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 70,`'` b 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 7? Historic House: ❑Yes ❑ No On Old King�'s Highway❑Yesi ❑ No Basement Type: IQ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sgft) Number of Baths: Full: existing new Half: existing new r Number of Bedrooms: existing _new =� e- Total Room Count (not including baths): existing new First Floor Room Count M a� 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 5►►� wr�s �l�.> &Aaw.&t ,Telephone Number SO Address License# 7�g83 Ce-+e'"U, Le Qum— Home Improvement Contractor# 44 Email e6(, (&ea L S, cc iy Worker's Compensation # I B V 7.1 GI/y3_A1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ,4)hrd Oc ie_ C� SIGNATURE A DATE e FOR OFFICIAL USE ONLY w *APPLICATION# DATE ISSUED - MAP/PARCEL NO. r '" ADDRESS VILLAGE n OWNER d.. DATE OF INSPECTION: FOUNDATION �7odT0� o��8�d'�l�!'Y►�k. W#ro-# f FRAME ERl6xIyl INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL-6 PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING { DATE3CLOS'ED OUT AS$0GIATION PLAN NO. r e ae c,urnmunweaun of inassacausea s Department oflndustzalAcciden& Office of InvaWgations kvi 600 Washington Street r Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/.Clectriciam/Plumbers _Applicant Information Please Print Legibly Name(Business 0rganiration/IndMduaI): K A. " earsness+&, �►4 Gf Address: _il 44 fA C, IdaAl p 163� City/State/Zip: fl Phone Are you an employer?Check the appropriate box: Type of project(required): 1.,KI am a employes with ol— 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 partaer- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors bave 8. ❑Demolition working for me in any capacity, employees'and have workers' [No workers'comp.insurance camp,insurance.1 9. ❑Building addition• refined-] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required_]t c. 152, §1(4),and we have no employees.[No workers' 13. Other comp,insurance required_] *Any.applicautthat cbecks box#1 mast also M out the section below showing theirworkers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hue outside contactors must submit a new affidavit indicating such. �Contractms that check this box must attached an additional sheet showing the name of the sub-contractors andstz whether or not those entities have employees If the sub contractors have employees,they must provide their workers'core,policy number. I can an employer that is providing workers'compensaizon insurance for my employees. Below is the policy and job site informafiotL Insurance Company Name: ' M e r,G u I 2 U ► ,?.,R K S 6, . Policy.#or Self-ins.Lic.#: �y�2 / �--� Expiration Date: Job Site Address: N City/State/Zip: Attach a copy of the workers'compensa don policy declaration page(show-bag the policy n tuber and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can Iead to the imposition of criminal penalties of a tine 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 tine 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 DU for fimnaace coverage verification. I do hereby cerd u the paws andP anahles ofPejwY that the info n provided abo is true and correct - ate:ate: Phone#: Official use only. Do not write in this area to be completed by city or town official City or Town: s PermitlI.icense# 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 Mmsaclmsetts 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 mott. 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 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 ofpublic work until acceptable evidence of compliance with the insurrance requirements of this chapter have been presented to the contracting authority." Applicants PIease 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 numbers)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partriersbips(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 confizmation of ins,rra.,ce 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 peffiit/license applications in any given year,need only submit one affidavit indicating current policy information(if nevessary)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 Gommercial venture (Le. 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 caL The Department's address,talephone and fax number. The Gommouwealth of Massachusetts Department of Industrial AcUdmts Office,of kVC&t tions (500 Wasbbgtou Sttreet. , Boston,MA 02111 Tel.#f 17-727-4900 ext 406 or 1-07-MAS9 Revised 424-07 Fax 9 617-727-7749. Rightfax C1-1 9/24/2014 5:46: 26 AM PAGE 2/002 Fax Server DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE T. -tlFICATE 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 PRODUCER.OR D THE CERTIFICATE IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the arms 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: EASTERN INS GROUP LLC PHONE FAX 233 W CENTRAL STREET (A/C,No,Ext): (A/C,No): E-MAIL NATICK,MA 01760 ADDRESS: 22MLW INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA: AMERICAN ZURICH INSURANCE COMPANY EA BARSNESS&CO INC INSURER B: I INSURER C: INSURER D: 54 ANGUS WAY INSURER E: CENTERVILLE,MA 02632 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 ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MM\DD\YYYY) (MNADD\YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIALGENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE OCCUR. PREMISES(Ea occurrence) ED EXP(Any one person) $ ` PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE $ r_1 POLICY a PROJECT[:]LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINEDSINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY t $ (Per accident). NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) rl UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ LH WORKER'S COMPENSATION AND X WC STATUTORY OTHER EMPLOYER'S LIABILITY Y/N UB-9972L443-14 09/21/2014 09/21/2W5 I LIMITS ANY PROPERITORMARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000 (Mandatory in NH) It yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. ------------------ CERTIFICATE HOLDER CANCELLATION STEVE AND DEB REUMAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED 185 STONEY POINT RD. IN ACCORDANCE WITH THE POLICY PROVISIONS. - AUTHORIZED REPR A VE 1: BARNSTABLE,MA 02630 ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reserved. oFt"e ram, + BAMSPABM ' ,m� Town of Barnstable A�FD MA'S� Regulatory Services Richard V.Scali,Interim Director Building Division Thomas Perry,CBO - 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 ttyt 5 ,as Owner of the subject property hereby authorize Cfi &rs,YleSS ! N ess to act on my behalf, in all matters relative to work authorized by this building permit application for: n 0 C(1�N1S (Addr ss of Job) '7)71)Y Signature of Owner at 1% yPK7 9tAY•-is - Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. TAKEVRV MBuilding Changes\EXPRESS PERMIT\EXPRESS.doc Revised 061313 1 'PAassachusett, Departrr3extt of Putilac Safety $oard„crfBurldIm R ulataons:and„Standards: 9 Unrestricted.-Buildiogs-of any use,group which Gittlrtrurfatt Snptirta�ir z 3 x contain less than 35,000:cubic feet(9:9'1-m )of LFcerrss>ES o79883 enclosed space. ERIC A Bus, R 11NCSUS WASt:r GENTLRYII:LE 1VIA��' - �-� ... €xpiratiop Failure to.possess a current edition of"the:'Massachusetts ✓-. . D8/27f2015 :, State>B;ullding Code is cause for:revocatioa of this.liaense. Camriiissroner DPSlicensinginforination.visit: www,Mass.Gov/[)RS Office of Consumer Affairs and Business Regulation 10 Park Plaza -Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 14.1078 Type: Private Corporation ` Expiration: 1/6/2016 Tr# 247365 E.A. BARSNESS & CO., INC. ERIC BARSNESS 54 ANGUS WAY r: CENTERVILLE, MA 02632 Update Address and return card.Mark reason for change. Address Renewal ❑ Employment U Lost Card SCA 1 es 20M-05/11 • lJ/'l,B- (�Y'"I72ff1'talbr[�8C6��0��,C�J6[LCiLccJ6�`1 ffice of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: registration 14,1078 Type: Office of Consumer Affairs and Business Regulation • xpiration 1/6/2016 - Private Corporation 10 Park Plaza-Suite 5170 y� F Boston,MA 02116 E.A. BARSNESS&CO INC. f - ERIC BARSNESS 54 ANGUS WAY CENTERVILLE,MA 02632 Undersecretary . ersecretary Not valid without signature - N � 11'A ko o- N w NOV GH ROAD J Q 1 1 � 1 95 3,5, F o R=20.00' A=.34.08' Z. a T=22.86' m 1 Q NI 1 Q 1 1 1 O I. / °o EXISTING EXIST, o DWELLING PORCt1 m O 0) � u U ----�5. 1'---- W EXIST. -� LOT I G G 5, DECK 155" o 81 S 37.4 .F. _ LL 109.68' PROPOSED DECK EXPANSION ICI BUILDING LOCATION PLAN FOR 43 IYANOUGH RD., HYANN15, MA PREPARED FOR HELEN VENTOUR15 '► SCALE: DATE: DRAWN BY: I If = 20' 09-22-2014 TMW �Q�g� JOB NUMBER: PEV15ION: 511EET NUMBER: CPIp- WELLER * ASSOCIATES - P.O. BOX 417 CENTERVILLE, MA 02632 TELEPHONE: (505) 328-4692 EMAIL: trl5weller@gmall.com REGISTERED LAND SURVEYORS * ENVIRONMENTAL CONSULTANTS Traverse PC r - _ stt t7 t f _. , , F ..:_.. .. 1 S .......... �p ; t t s nR ny f W �. ....... � F .. ,. ., i , % R d e a f f f 3 i , s1 �. r y.Xly F , � l`�,Graf u-►� �, i I V� .. .. 1 r s + 4 t i 2 .,y , u 3 # - : "�r r < + 0 , i i za Y f ...,f „.,... ,, _ ... .f. ... 3 .. a -t z = t � Il,w f .. F f F 1 �r „•ri. t , f xv, i .......... i 3 ............. ............ .......... ........... A .:+ > a i ., 3 ................. ......... i } > R ® MEMBER REPORT Level,Floor.Flush Beam PASSED �,� 2 piece(s) 1 3/4,r x 14, 1.9E Microllam® LVL i Overall Length:15'11" f 0 -- --- - 0 15'4' All locations are measured from the outside face of left support(or left cantilever end).All dimensions are horizontal.;Drawing is Conceptual Design Results.. Actual i'Location"„ '.::Allowed,;, Result LDF, ,Load:Combination{Pattern).. ;._ System:Floor Member Reaction(Ibs) 4883 @ 2" 8881(3.50") Passed(55%) 1.0 D+1.0 L(All Spans) Member Type:Flush Beam Shear(Ibs) 3988 @ 1'5 1/2" 9310 Passed(43%) 1.00 1.0 D+1.0 L(All Spans) Building Use:Residential Moment(Ft-Ibs) 18624 @ 7'11 1/2" 24258 Passed(77%) 1.00 1.0 D+1.0 L(All Spans) Building Code:IBC Live Load Defl.(in) 0.426 @ 7'11 1/2" 0.519 Passed(L/438) -- 1.0 D+1.0 L(All Spans) Design Methodology:ASO Total Load Defl.(in) 0.581 @ 7'11 1/2" 0.779 Passed(L/322) 1.0 D+1.0 L(All Spans) Deflection criteria:LL(L/360)and TL(L/240). Bracing(Lu):All compression edges(top and bottom)must be braced at 7'11 1/2"o/c unless detailed otherwise.Proper attachment and positioning of lateral bracing is required to achieve member stability. Bearing. 3 Loads to Supports(Ibs)`.. SU OI tS Floor,: l. PP Total Available Required . Dead Total Accessones r Lrve; 1-Column-SPF 3.50" 3.50" 1.92" 1301 3581 4882 None 2-Column-SPF 3.50" 3.50" 1.92" 1301 3581 4882 None Tributary "Dead."::- Floor Live LOadS, , %Location, ;Width, (0.90)�,; w, (1.00),-_ Comments 1-Uniform(PLF) 0 to 15'11', N/A 150.0 450.0 Attic Loads 30/10 15' Weyerhaeuser Notea a xz ', (Z�SUSTAINABLE FORESTRY INmATIVE Weyerhaeuser warrants that the sizing of its products will be in accordance with Weyerhaeuser product design criteria and published design values. 1 Weyerhaeuser expressly disclaims any other warranties related to the software.Refer to current Weyerhaeuser literature for installation details. (www.woodbywy.com)Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,builder or framer is responsible to assure that this calculation is compatible with the overall project.Products manufactured at Weyerhaeuser facilities are third-party certified to sustainable forestry standards. The product application,input design loads,dimensions and support information have been provided by Forte Software Operator Forte Software Operator Job Notes 9/29/2014 3:38:00 PM J Andrew Shakliks 43 lyanough Rd Forte v4.6,Design Engine:V6.1.1.5 Mid-Cape Home Center Hyannis MA 43 lyanough.4fe (508)398-6071 ashakliks@midcape.net Page 2 Of 3 r•�F*D"R TE @ MEMBER REPORT Level,Floor:Flush Beam PA55EU h*ti IG 2 piece(s) 1 3/4" x 6" 1.9E Microllam® LVL Overall Length:6'8" t, 0 0 6.11. 0 All locations are measured from the outside face of left support(or left cantilever end).All dimensions are horizontal.;Drawing is Conceptual Design:Results ncivai@:Location , ;Allowed' `Result LDF Load:Combination(Pattern) System:Floor Member Reaction(Ibs) 2961 @ 2" 8881(3.50") Passed(33%) 1.0 D+0.75 L+0.75 Lr(All Spans) Member Type Flush Beam Shear(Ibs) 2258 @ 9 1/2 4988 Passed(45%) 1.25 1.0 D+0.75 L+0.75 Lr(All Spans) Building Use:Residential Moment(Ft-Ibs) 4454 @ 3'4" 6250 Passed(71%). 1.25 1.0 D+0.75 L+0.75 Lr(All Spans) Building Code:IBC Live Load Defl.(in) 0.157 @ 3'4" 0.211 Passed(L/485) 1.0 D+0.75 L+0.75 Lr(All Spans) Design Methodology:ASD Total Load Defl.(in) 0.294 @ 3'4" 0.317 Passed(L/258) 1.0 D+0.75 L+0.75 Lr(All Spans) Deflection criteria:LL(1-/360)and TL(L/240). Bracing(Lu):All compression edges(top and bottom)must be braced at 6'8"o/c unless detailed otherwise.Proper attachment and positioning of lateral bracing is required to achieve member stability. Resawn products must maintain manufacturing stamps. _. 6eanng:< Loads to supports(Ibs), SU OI tS Floor- ``Roof:' PP.. Total Available 4Required Dead Total Accessones _- Y � Live Live.... 1-Column-SPF 3.50" 3.50" 1.50" 1386 700 1400 3486 None 2-Column-SPF 3.50" 3.50" 1.50" 1386 700 1400 3486 None •Tributary. .':"Dead Floor Live `'Roof,Live toads Location.''. Widtfi x (0.90) =A;: (1.00) (non=snow:1.25) Comments 1-Uniform(PLF) 0 to 6'8" N/A 60.0 Bearing Wall Load M 60#PLF 2-Uniform(PLF) 0 to 6'B" N/A 70.0 210.0 Attic Load 30/10 7' 3-Uniform(PLF) 0 to 6'8" N/A 280.0 - 420.0 Roof Load 30/20 14 Weyerhaeuser Note' s (2�SUSTAINABLE FORESTRY INITIATIVE Weyerhaeuser warrants that the sizing of its products will be in accordance with Weyerhaeuser product design criteria and published design values. l Weyerhaeuser expressly disclaims any other warranties related to the software.Refer to current Weyerhaeuser literature for installation details. (www.woodbywy.com)Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,builder or framer is responsible to assure that this calculation is compatible with the overall project.Products manufactured at Weyerhaeuser facilities are third-party certified to sustainable forestry standards. The product application,input design loads,dimensions and support information have been provided by Forte Software Operator Forte Software Operator Job Notes 9/29/2014 3:38:00 PM J Andrew Shakliks 43 lyanough Rd Forte v4.6,Design Engine:V6.1.1.5 Mid-Cape Home Center Hyannis MA 43 lyanough.4te (508)398-6071 ashakliks@midcape.net Page 3 Of 3 q-z -/c oFtrq,,, Town of Barnstable *Permit# O © q 'a Expires Months fr�i issue date 3� ti �a e; E IT Regulatory Services Fe • snaxsTnare. �cb �2 t Richard V.Scali,Interim Director �EDMA� Building Division ®�N® BARIVSTABLB Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Q��Il Not Valid without Red X-Press Intprint � Map/parcel Number l / L1 Property Address / 3 L yoyi oi_h , _ Py Ah n Ls Residential Value of Work$ �06 10 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address (� 3 �� ' � ewlnt D�`a► Contractor's Name 151. A &rSn Mi c, Telephone Number 5y _�,��g 8� . Home Improvement Contractor License#(if applicable)_ Email: elt i G D&L bars h e SS, COM Construction Supervisor's License#(if applicable) D(Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance )- Insurance Company Name Am-eirscAm ZrT& Workman's Comp.Policy#_ 6 ZZ Lk 9 7141113 Copy of Insurance Compliance.Certificate must accompany each permit. Permit Request(check box) // - p "i�ier Re-roof(hurricane nailed)(stripping old shingles) All construction debris will betaken toAl'(Ce) U(s� ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side Replacement Windows/doors/sliders.U-Value j 30 (maximum.35)#of windows 33 #of doors:-3-_ ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,ctc. ***Note: Property Owner,must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction_ Supervisors License is requir SIGNATURE: T:\KEVIN D\Building Changes\EXPRESS PERM IT\EXPRESS.doc, Revised 061313 � e • BARNSTABIZ + "'A. Town of Barnstable pjED Mph A Regulatory Services Richard V.Scali,Interim Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 �vww.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 Hejeh VeVX40UVIi5 -, as Owncr of,the subject property hereby authorize C/'i rsr Cgs to act on my behalf, in all matters relative to work authorized by this building permit application for: 3 n ® j/Y'an14 s (Addr- ss of Job) Signature of Owner 6ad Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. • r T.:\KEVIN D\ i Bu Idin Chan es\EXP RESS PERMf'IlE� � XPRESS.doc Revised 061313 the C.ommorrivealth of Massaddrse is _.......... I)eparbrient of Industrial Acciderns Office of Investigi7fions 600 Washington Street , Boston,MA 02111 tt IPM rriasxgovlrlari Workers' Compensation Insurance davit: Builder s/ContractorslPlectricians/Pluin6ers Applicant Information / Please Print Lelibl Name(Busineseorgau zatior�7udi idua1) �a('s-nem Zrie, Address: �( ,tea Us VJ60 .� Phone 9- SOS-" c��yrsc�t�z�p. � Are you an employer'Check the appropriate boa:, of project(rewired): YPe LK I am a employer with 4_ '❑ I asu a general contractor and I employees(full.audlor part-time)..* have hired the sub-contractors b• ❑Neuu con tnxctian 2.❑ I am a sole proprietor or partner- listed on.the attached sheet., 7. Remodeling ship and have no employees „ These sub-conoractors hazre ' 8. ❑I7feemohtion working for me in t employees and have workers'a°Y caPac t3' 9. ❑Budding addition, [No workers'comp•insure comp.insuraiiee i ` 5_ ❑ We are a corporation arid.its 14:❑Electrical repairs or additians required-] 3•❑ I am a homeowner doing all work., officers have:exercised their 11.0 Plumbing:repairs or additions y right.of exeWtion per MGL myself o workeers'imp 12_❑Rocsfrepan insurance required.]1 c. 152,§l(4),and we have no employees-(No workers' 13.❑Other comp.insurance required.] •Any applicant that checks box#1 mast also fill out the section below showing their workers'compensation policy information- Homeowners wlm submit dais'af5dmit indicating dwy are doing all work.and then hire outside commctors mustsubmit a new affidn it indicating such Contractors that check this bore mast attached an additional sheet showing the name of the sub-contractors and:state whether or not those entities haveemployee'. If the subwcontractors.have'ei idey'ees,they i nsstp.mvid a their workers'comp.,policy number. I am an employer that is prm ding"Wkets compensridon insurance for my e..!nptnyees. Below is diepoliey and jab site nformatian Ame661.4tv Insurance Cain an Name: Z r'r- a f, G 6P yLC i �L $ Cf� � l.0. Policy#or Self-ins.Lic- :1p7.Z u B l/7,A 4 41y3 Expiration Bate: Job Site.address: Vfl K a ��• City/state zip: Attach a copy of the wor rs'compensation policy declaration page(shoving the policy nu her and eapitation date). Failure to secure.coverage as required under Sec tibn 25A of MGL c. 152 can lead to the imgasition stf criminal penalties of a' fine up to$1,500.00 an&or one-year imprisonment,as well as ci4^il penalties in the form of'a STOP WORK ORDER and a fine . of up to$250,00.a day against the joWoj. Be advised that a cagy'of this statesneut may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. do herel y eernfy render the pains andPell aldes cif perJeaty drat tit info rnzadora provided a bow,is ime acid correct sizo.ature. �, k Dat'' cl�� Official rese:only.'.M not writer in this:a area,to be completed by ciw or Mimi afe'pL City or 'own: _ 'Permit/License# Issuing Authority(circle one): L Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6Othher . Contact Person: ' Phone#. I - . _.. _._ n, — 1 ^Massachusetts i3epartment of Publae Safely ;80ard of Busitii'ng R�guiattarFsarrclrSt"c}ards; Unrestricted-Buildings,of`any use'group which Gott�truetrun ;gpehiit)r 3 Licer�s CSDT9w883': contain less than.35,000.cubic feet(9;9`l-m )of enclosed space. - 5'l E EKTERYII,LE 1GrA J Expiration Failure::to possess a current edition of the:Massachusetts Ganviiisssoei 08/27/20;15 State:B;uilding Code is,causefor:revocatwn of this license. For.DPS'�cen3ing mforma6on.visit: wwwaMass.Gov[DP3 S�\ a Office-of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration yam- Registration: 141078 Type: Private Corporation w Expiration: 1/6/2016 Trlk 247365 > � E.A. BARSNESS & CO., INC. ERIC BARSNESS 54 ANGUS WAY - CENTERVILLE, MA 02632 fi - Update Address and return card.Mark reason for change. 'Address D Renewal ❑ Employment Lost Card SCA 1 C: 20M-05/11 ViLG' (fC-7IzTlzfi/ftleClLLt�G`��CI::JCGCi"LltrG'L7J .- �. License or registration valid for individul use only ftice of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: { Registration 1g107g Type: Office of Consumer Affairs and Business Regulation Expiration 1/6/201(i Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 E.A.BARSNESS&CO INC,. ERIC BARSNESS 54 ANGUS WAY CENTERVILLE,MA 02632 Undersecretary Not valid without signature Rightfax N2-2 10/14/2013 9:24 :02 AM PAGE 3/004 Fax Server L AC& CERTIFICATE OF LIABILITY INSURANCE 10T14-2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: EASTERN INS GROUP LLC - PHONE FAX 233 WEST CENTRAL ST AIC No Ext: A/c No): E-MAIL NATICK.MA 01760 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:AMERICAN ZURICH INSURANCE COMPANY INSURED INSURER B: EA BARSNESS+GO INC INSURER C: 54 ANGUS WAY CENTERVILLE,MA 02632 INSURER O: INSURERE: 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 ADD SUB44rVO POLICY NUMBER MMM1DDPOLICfYV EFF MO LTR INSRMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED g PREMISES Ea occurrence CLAIMS-MADE OCCUR MED EXP(Any one person) S PERSONAL&ADV INJURY S GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP;OP AGG S RO- POLICY jECT LOC S AUTOMOBILE LIABILITY go denIt aMB NEED SINGLE LIMIT g ANY AUTO - BODILY INJURY(Per person) S ALL OWNED SCHEDULED S AUTOS AUTOS BODILY INJURY(Per accident) HIRED AUTOS NON-OWNED �20,"! d%Yt AMAGE S AUTOS acri en _ S UMBRELLA LUIB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I RETENTIONS S WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS LIABILITY YIN TORY LIMITS I ER ANY PROPRIETORIPARTNEIZEXECUTN� E.L.EACH AccIOENT $500,000 OFFICER!MEMBER EXCLUDED? I N I N/A 6ZZUB 09-21-2013 09-21-2014 (Mandatory in NH) _. 9972L443 EJ—DISEASE-EA EMPLOYEE $500,000 If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $500,000 . DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Addhlonal Remarks Schedule,If more apace Is required) CERTIFICATER CANCELLATION TOWN OF DENNIS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE 685 ROUTE 134 CANCELLED BEFORE THE EXPIRATION .DATE THEREOF, SOUTH DENNIS,MA02660 NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR12EDD REPRESENTATIVE f ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD . ............. Assessor's map and lot number ..... . ..............Sewage Permit number ...................... - TOWN OF BARNSTABLE I AMIT" L N"I 1639. am BUILDING INSPECTOR W/ APPLICATION FOR PERMIT TO .......0--l-l-�*,O#le***"""""""*******"*"",****"**,*""*................................................ TYPE OF CONSTRUCTION ...&049.13e........................................................................................................... ......... 4.Lfl..(xo�q...I 9M. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: .Location ........... .......jel-111 itz............................................................... ProposedUse ............................................................................................................................................................................. ZoningDistrict ..... ..........................................................Fire District .............................................................................. L j ,-- Name of Owner .................Address ................................................ Name of Builder .W.ATA ............. Z--4—....Address7A ..T/ .........)Yve..) ... . O Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................. ............... Exlerior ....................................................................................Roofing .................................................................................... Floors ......................... ............................................................Interior .................................................................................... Heating ..................................................................................Plumbing ....................................... Fireplace ..................................................................................Approximate. Cost cvoo ............ . ............................. .......... Definitive Plan Approved by Planning Board ---------------------------------19--------- Area ........... ........................ Diagram of Lot and Building with Dimensions Fee ... .................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH IN I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Na;me .. I... .. V...144..... . ......... � . ~ ' ` ` ' ' ' ^ � r Lafferty, G. F. 17711 deck May 2V 75 Date Completed ...i�A/`/. � PERMIT REFUSED ' ---------------------. lP � . ' � --.'..-----------`----------.. ' . . � " '------------------`------- , ' � ` .-------------.----------'—. � � - ............... ^ ' Approved ---------------- lg ^ ^ � . . , ^ � ---------------.----------- . � -----------.---------.---.~. . . ` . ` \ ` ' ^ - � Assessors map and lot number . ....� ..�.� .� /-P✓ � Sewage Permit number ..................... =..'?I e �<i rt. c • �,�.,,.' ,� ,� . ..................... M , , l,• ti *THE Toy° TOWN ®F B A R l�S'I`1-�A L E i i 11ASH9TODLE, i mum p MAY�, BUILDING INSPECTOR �F APPLICATION FOR PERMIT TO ......:...:� '. :. '`- / ,� TYPEOF CONSTRUCTION ....:......�.......�.�:............................................................................................................. ! ........... ................i i.....'... r...19r.. ..t TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...........� .... f��yi......f;t l.... ...R !.•,........................��.... ............ ......................... ................................... ProposedUse ............................................................................................................................................................................. ZoningDistrict ........ .............................................................Fire District .............................................................................. {{ ...... �Name of Owner i. P'.- , '� • .............Address ............................................ .......... ...]............................:............................/........................ Name of Builder ........... . .. ..I.......!...!......P�..:...........Address .d.........�...?..+........... ....... 7,L✓.. .././....!.. Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation ...................:.......................................................... Exierior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing ................................... . ..: ...................................... Fireplace ..................................................................................Approximate Cost Y A • ....................................................... I Definitive Plan Approved by Planning Board -----------_-------------------19________. f Area ....,." ..:.................. v'? � . Diagram of Lot and Building with Dimensions Fee `-� "'� SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 s v J 4 \` ( f , I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .......... - I i/ Lafferty, G. F. A=325-116 No .....17711. Permit for ....deck....................... ............................................................................... Location ....f&Ivanou h Road ....................1....................................... .........................klyann i ........................................ Owner G. F Lafferty ..................... Type of Construction ......frame Plot ............................ Lot ................................ Permit Granted ay 28 ....19 75 - ......... ......................... Date of Inspection ...................................19 Date Complete ......................................19 �P-ERMIIT REFUSED ............................... .................... 19 .................................... . .................................... ........................ ................. ............................... Approved ................................................. 19 l ; i I ; `60:;1 } I • ' I + ! I I I 1 � 1 ; i ! � t:. I. :.! '. }. .' ':1 I ' _,I. 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