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Home My WebLink About0534 LINCOLN ROAD EXTENSION ,j PC- ��M a� BARNSTABLE CAPE CO® MA �a e. .w, INSULATION sa�� a.... ` 7 141OEASS SEAMLESS SSMRSOASS SYSRNOW Ott. 1-800-696-6611 Town of Regulatory Services Building Division Address - Address 2 - Date: H— Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. 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 (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village 1 -P4, co 53q l','0c0(vJ pj. L,4-4 NJ( S Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) ( ) ( ) ( ) ( ) Slopes ( ) ( ) ( ) ( ) ( ) Floors ( ) ( ) ( ) ( ) ( ) Walls ( ) ( ) ( ) ( ) ( ) Sincerel my EZ'ssidyresident Cape Cod Insulation, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION O pp r ( Map ?--'Parcel Application- # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee LAC Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address �•i ��(r �- ✓ Village `s a Owner (A- Address Telephone 5(3 ` P mit Request �U�.U� - � 6 f�� .+b s Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No, Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new 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 woodloal stove' ❑Adis C3 No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: Q53 dsting �YnevPsize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: ' Zoning Board of Appeal7; N thorization ❑ Appeal # Recorded ❑ Commercial ❑Yes o If yes, site plan review # ' Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) U V`y (I'll � Name mvu Telephone Number tot �� '1� I -Z4 Address 4 License # to o?% Y U AO(0)YqHome Improvement Contractor# 661 Email Worker's Compensation # d U 5Z� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJ CTaILLBE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY cE ePPLICATION# -DATE ISSUED d MAP/PARCEL NO. ADDRESS VILLAGE . OWNER ' a DATE OF INSPECTION: 1 FOUNDATION nF + 1 1. • FRAME INSULATION ` FIREPLACE ELECTRICAL: ROUGH FINAL t l PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ` i. FINAL BUILDING D#F&CLOSED OUT t. AS—S90 ION PLAN NO. r� Massachusetts -Department-of public Safety ..:Board of Building Regulations . g g latrons and Standards Construction Superviscir License: CS-100988- HENRY E CASSUA 8 SHED ROW �. WEST YARMOU'rH 8 Expiration Commissioner 11/11/2015 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 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SO. YARMOUTH, MA 02664 "Update Address and return card.Mark reason for change. SCA 1 20M•05l11 Address Renewal Employment Lost Card +:0 ✓V/2e [QO/9U/nowtuea..GC1 c1, gQjjac1UJeM �\ Office of Consumer Affairs&Business Regulation License or registration valid for indivNul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 153567 Type: Office of Consumer Affairs and Business Regulation xpiration: :.12715/2b:16 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULATION:;;;INC" HENRY CASSIDY 18 REARDON CIRCLE— SO.YARMOUTH,MA 02664 Undersecretary N valid wi ut sign e �t The Commonwealth of Massachusetts Department of Industrial Accidents 4 W Office of Investigations a d 1 Congress Street, Suite 100 W= Boston,MA 02114-2017 p �o www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information fifi Please Print Le ibl Name (Business/Or z'zation/Individual): L{� Q, oAddress: 0 4m, VWmm City/State/Zip; �, l. � Phone #: l7 ✓�� Are you an employer? Check i4e appropriate box: general contractor and I Type of project(required): 1.521 am a employer with 4. ❑ I am a g employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp, insurance comp. insurance. $ 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.0 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 12.7 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13. Other comp, insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. - t Homeowners who submit thisWiidavit 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 A employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. j.� Insurance Company Name: ��' �� ( Policy#or Self-ins. Lic. #: 400 ; 0 1 Expiration Date: Job Site Address: ) City/State/Zip: )l Attach a copy of the wor ers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cert n r pains and penalties of perjury that the information provided above is�true and correct. Signature: { Date: 20 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#: } ny CAPECOD-27 KLIGETT CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) 61131213/2014 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(les)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 Ileu of such endorsement(s). RODUCER CONTACT g NAME: Barbara De Lawrence 0 Rte&Gray Insurance Agency,Inc. PHONE Guth Dennis,MA 02660 E-MAIL816-2156 ADDRESS: bdelawrence@rooersgray.com ' INSURER S AFFORDING COVERAGE NAIC# INSURER A:Peerless Insurance Company suRED INSURERS:COMMERCE INSURANCE COMPANY Cape Cod Insulation Inc INSURER C:Evanston Insurance Company 18 Reardon Circle INSURER 0:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth,MA 02664 INSURER E INSURER F 0 ERAGES CERTIFICATE NUMBER: REVISION NUMBER: T IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IN ACATED. 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. R TYPE OF INSURANCE POLICY NUMBER MM/LI Y POLICY EXP YY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE T OCCUR CBP8263063 64/01/2014 04/01/2015 PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 11000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X POLICY JE� LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT KEaaccidenl $ 1,000,000 ANY AUTO 14MMBCKVMK 04/01/2014 04/01/2015 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X AUTOSHIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAR CLAIMS-MADE XONJ463514 04/01/2014 04/01/2015 AGGREGATE $ DED X RETENTION$ 10,000 Aggregate $ 1,000,000 ORKER3 COMPENSATION PER OTH- ND EMPLOYERS'LIABILITY STATUTE ER NY PROPRIETOR/PARTNERIEXECUTIVE Y/N WCA00525904 06/30/2014 06/30/2015 E.L.EACH ACCIDENT $ 1,000,000 FFICER/MEMBER EXCLUDED? N/A Mandatory In and E.L.DISEASE•EA EMPLOYEE $ 1,000,000 f yes,describe under as, OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 SCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) rkers Compensation includes Officers or Proprietors, 1ltlonal Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. iR IFICATE HOLDER CANCELLATION 10 ;z MAC Housing Assistance 4 Lift Corporation Cape Cod HOME OWNER WEATHERIZATION WORK PERMIT&FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE THE APPLICANT HOME OWNER. �g i _ - I id¢'� ��' hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation ( herein after referred as "Agency" ) on the property located at: Vt The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather-stripping & caulking of windows and doors, insulation of attics, sidewalls & basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows. In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to the "Agency" its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves .the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. I have read the provisions of this agreement as listed and freely give my consent. ,............ i f Home Owner Home Owner email: I `Date:Agent: (signature) Date: y HAC approved Weat zzation Company: Adam T Inc Cape Save All Cape Energy Frontier Energy Solutions Alternative Weatherization Lohr Home Improvement Bu_ild_i_ nstruction Resolution Energy /` Cape Cod Insulation Tupper Construction ( APPLICANT INFORMATION �. (BUILDER OR HOMEOWNER) Name ��/ �� G� Y� t- c,. u Telephone Number 7 7,/- 2'7 9 / Address 111C4 t License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE 3 r s TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION}, z ;., Map �.7 2- 1 9— Parcel rApplicatiof # o�ol� a-S Health Division "Date Issued Conservation Division ;Appl,catiori Fee 05� Planning.Dept t 'Permit Fee`, Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address S 3 4- 9 l N C o ICI R D, E xT, Village ,; I I "5 Il�.�w�✓�`� J� Owner Pn t Cc in 0 e r c.6 Address 534 l IN: COIN IUD F_XT' Telephone C 5091 77 1 - :2 Z g Permit Request TQ bu[ la l2 x 18 Ex`reN S IGbi T4 a IST'I ar, r(-I Il 1 aG Room, Square feet: 1 st floor: existing proposed '2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater.Overlay Project Valuation 0® Construction Type t0 b Lot Size SA A - Grandfathered: ❑Yes ZKO If yes, attach supporting documentation. Dwelling Type: Single Family ;'CIS Two Family ❑ Multi-Family (# units) Age of Existing Structure Al,q�s=— Historic House: ❑Yes B17o On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other 50go Tu h.e Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing: Z new 0 Half: existing new Number of Bedrooms: 3 existing O new Total Room Count (not including baths): existing 57new First Floor Roo Count _ Heat Type and Fuel: Wtas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing li New Existing wood/coal stove""`. ❑As 9lo w Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ xisting `0 newT size_ Attached garage: ❑ existing ❑ new size _Shed: existing ❑ new size _ Other: a � w Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ %.n 1 n Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION - - - �� (BUILDER OR HOMEOWNER) Ngme_22Kig1D FY•eCe�l 010.e� Mill 0-On Telephone Number Cc Address lis o bo+l Pi License # 2 3 4L T Home Improvement Contractor# 154 936 Worker's Compensatign # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO r SIGNATU DATE - !�� fir ' FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE I OWNER DATE OF INSPECTION: f FOUNDATION 5c,,c,s cdwI1ka/09 ja- FRAME /� - - INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING r DATE CLOSED OUT ASSOCIATION PLAN NO. i oFt�r� Town of Barnstable o Regulatory Services ST" Thomas F.Geiler,Director Mass. 1639. ,0� Building Division ArFD MA'I A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION / ` 9 Please Print (DATE: JOB LOCATION: S-3 . f—�/lI G(,G lL .L'XT• ` /9 /t/lv�/ S numb r street village HOMEOWNER`[j/rf,�!rail c_'J�l /PLC f3 c5--- 7 71`2 7?/ name home phone# work phone# URRENT MAILING ADDRESS: 4 l/J/ C d L/V ytb k " a / city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Fe t rson(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requ' ments and that he/she will comply with said procedures and S}uiLementS. Y,r-- �df � er Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this.section(Section 109.1.1 Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor.,, Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is,a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\YvrPFILES\FORMS\homeexempt.DOC � l i a IME,ey�. Town of Barnstable Regulatory Services M i '� Thomas F. Geiler,Director 039. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, 2( d}- ?vyV, 4-Lft es Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) c« gnature co Owner Date 1-,;)Lj A) 4�� &-L-� Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION The Commonwealth of Massach usetts Department of Industrial Accidents Office of Investigations 600 Washington Street c Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Bus iness/Organization/lndividual): D/ Address: ,_�3 /AIG9 City/State/Zip: FR'/V if 1,5411V 19 1 Phone #: �0 �`7 71 c7.7 -7 Are you an employer. Check the appropriate bgfc: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. molition workingfor me in an capacity. employees and have workers' y9. �ilding addition No workers' comp. insurance comp. insurance.1 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 I LE] Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t C. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 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 workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ff)V y,+L c, Policy#or Self-ins. Lic.#: Jed Expiration Date: 1"V D 1 Job Site Address: J'J 77 1 NCO L AJ l� . 'L�C 7'• City/State/Zip: #tl M�9• OZ�D Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do her cer ' under the pains nd pe alti s of perju that the information provided above is true and correct. Si natur : ��. Date: �/3 0 0 Phone#: -�� ` 7 7 '— eZ 7 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service.of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a homeowner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, . please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia . a The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations' 600 Washington Street Boston, MA 02111 .� a• www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LefJbI Name(Business/Organization/Individual): MW_ MWI -Bma-e.,At t`►6 Address:S'® Vj ` O-e-4t 1 1 �-►�N� City/State/Zip: STEMS Adis 0. adC4g Phone.#: N 360 W 36 Are you an employer? Check the appropriatA Type of project(required): L❑ I am a employer with 4. a general contractor and I * eve hired the sub-contractors 6. ❑New construction mployees (full and/or part:tirne). ' I am a sole proprietor or'parhier-' listed on the attached sheet. T. Q Remodeling Ly ship and have no employees These sub-contractors have g, '(]Demolition working for me in any capacity. employees and have workers' 9 [ Building addition [No workers'-comp.-insurance comp. imurance.$ 5. 10.0Electrical repairs or additions required.] � [] We are a corporation and it s ' 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew 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 empioyees,they must provide their workers'comp.policy number. Iam an employer that is providing workers'compensation insurance for my employees Below is the policy andjob site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip 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 1-do her y cent under the ins and penalties of perjury that the information provided above is true and correct. Si a e: Date: Phone#: Offu ial 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 Phone#: Contact Person: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their.employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that"every state or local Iicensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for,the performance of public work until acceptable evidence of compliance,�sZth the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-conkactor(s)name(s),address(es)and.phone numbers) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have P ' employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials .Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town).".A copy of the affidavit.that has been officially stamped or marked by the city or town maybe 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 fo any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone-and fax number: The Commonwealth of Massachusetts Department of lndustri.al Accidents Office of InVestigatiM, 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia , Town of Barnstable P.°�T"Ergo Regulatory Services Thomas F. Geiler, Director * anaxsrABLe, + 63. � Building Division Arfp �° Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXIT ORDER DATE: LOCATION: `p � `-{' LI N C U 1� e � I UNDER THE PROVISIONS OF 780 CMR, THE STATE BUILDING CODE, SECTION 3400.5.1, YOU ARE HEREBY ORDERED TO IMMEDIATELY DISCONTINUE THE USE OF.THE CELLAR/BASEMENT AREA FOR SLEEPING PURPOSES. LOCAL INSPECTOR J SIGNATURE OF WCIPIENT ODEM DE SAIDA DATA: LOCALIDADE: DE ACORDO COM 0 PROVISORIO 780 CMR, CODIGO DE CONSTRUCAO DO ESTADO, PARAGRAFO 3400.5.1, VOCE ESTA ORDENADO DE DEIXAR DE USAR, IMEDIATAMENTE, A AREA DO PORAOBASEMENT PARA 0 PROPOSITO DE DORMIR. INSPECTOR LOCAL ASSINATURA DO RECIPIENTE ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR. ONE; AND TWO-FAMILY DETACIIED RESIDENTIAL*CONSTRUCTION (780 CMR 6X.00) Applicant Name: ��ArtY�.�17 (� Site Address: print Town: S Applicant Phone: 6 G Applicant Signature: Date of Application: NEW CONSTRUCTION: choose ZYNTE of the following two'o tions 790 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMZ'ONENT CRITERIA FOR NEW ONE- AND TWO-FAMILY BUILDINGS 'MINIMUM Ceiling or Slab QOption 1: Basement Fenestration exposed Wall Floor Wall Perimeter AFUE HSFF SE U-factor floors R Value R-Value R-Value R-Value R-Value and De th National Appliancc-acrgy R-10, Conservation Act(NAECA) .35 R-3 8 R-19 R-19 R-10 4 ft . 1997 as amended,minimums cattr as applirablr Note: This form is not required if you choose either of the two versions ofREScheck as listed below. 0 Option 2: RES,check Version 4.1.2 or later variant software e analysis must b completed 790 CMR 6107.3.2 REScheck—Web which can be accessed at htttp•//w MW ener>rYcodes Gov/rescheck/ ADDXX' OIVS.bRALT RAI'XOI4 .TO EXISTING B; UfLDI R 5 YEAJ12S OLb* *)Buildings under 5 years old must use option#1 or 42 in New Construction section above, Complete the following formula to determine the %o of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b _ a) ri Q --SF 100 x 46 +570 =J'4f .% of glazing b a (b) Glazing area equals _SF If lazin is_'�0%.use the chart below. If glating is > 40 % rocee,•d to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITER-A ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Ceiling and Slab Perimete ❑` Fenestration Exposed floors wall Floor Basement Wall R-Value lu U-factor R-Value R-Value R-vae R-Value and Depth .39 R-3 7 a R-13 • R-19 R-10 - R-10, 4 feel a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e. not com ressed over exterior walls, and includin an access o enin s). STJNROOM—An addition or alteration to an existing building/dwelling unit where the total 0 t�additiou. azing area of said addition exceeds 40% of the combined gross wall and ceiling area of the ote: Owner to -11 out Consurner Information Form found in A e-ndix 120.P 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STAN 5 3 4 I��►ss THE MASSACHUSETTS STATE BUIlDING CODE DARDS A�4 /"l10 b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: i. Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction,panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction,upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel.Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates,band joists, and girders shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment WHEN TM EDGE RESTS ON MANN-- --- ATS'ac. USE 8dNAaS i ATS°oA ----ir-----_--- - - ii 1 11 ii 1 � ~ 11 1 I 11 ~ 1 11 11 1 , 1 ^ 11 1 � 11 11 6 11 I 11 ll 11 1'1 I 11 11 u 1 11 11 11 1 � 11 11 1/ 11 1 11 11 d Y 11 11 1 11 ii 11 11 1 n 1 1 n u 1 w ii ll" 11 rll DOUBLlEDOE ••-�-�• - NAL'�SFACOVr>' 1 t , PwuE+ y 4 See Detail on Next Page Vertical and Horizontal Nailing I for Panel Attachment 1056 780 CMR-Seventh Edition 12/28/07 (Effective 1/1/08) 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDP .i iUlS CES 5 -- + C5 ' + tu + , IL � ' FRAMWG MEMBERS i� J i EDGE INfTFAMEDIATE �, ,i� i i � g fig• � 3•MIN. STAGGERED 34 MR NAIEPATTEAN Z f PANEL PANEL EDGE DOUBLE NAIL EDGE SPACING MAL Detail Vertical and Horizontal Nailing for Panel Attachment 12/28/07 (Effective 1/1/08) 780 CMR-Seventh Edition J 1057 14 Ile G o T' 44 140 � 43 35�� EX f5'r Q Co"C. U � F•gtlnwD .1 140 . 01 , t r v LOT Q Z 77f/S LOT /,S NOT i nl 7't-f E FLooD PL.f?.'N -Z 0"OG, O� C F1 f?E Co D, /tilC. L®t�4Trc�a/o K�RNNIS IvLvrr H. s siee'tey cPe'r«Y rsr,�r rsr� �i�.a��v� gp.L rssaa viAMA/ ie 404CA97'A'O 10 r co�v�o.e.s•s� m rs�� zav��vcs• . Aty—4,QWZ o.c 14l�./sbv ca�va9'�'vC�'�D. LOw ��LL Ems, !A!C . 1 0Fptis`S 1C 1 3 LIN64 q� 80 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS A7N l,J tj A .miCHELE APPENDICES ' ..CUDILO p NO.34774 dbearing Wall Connections STRUCTURAL Lateral(no.of 16d common nails) ......... Tables 7 �e n-Loadbearing Wall.Connections ( ) Lateral(no.of 16d common nails) ......... (Table 8) ......... .. ... . ....... . .. ` 4 i / Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9)^ Header Spans.. .......... ............ (Table 9) ...... ..... . .. ... Sill Plate Spans ....................... (Table 9) .......... .. .. _�j ft.C� in. s I _ Full Height Studs(no.of studs) ........... (Table 9) ............ .. ........... _ Non-Load Bearing Wall Openings(record largest opening but check all openingsAor compliance to Table 9) Header Spans...... ..................... (Table 9) ft�in. s 12' _ Sill Plate Spans.... ...... .... ........... (Table 9) .. ....... ... ..T ft E in. s 12" _ Full Height Studs(no.of studs) ........... (Table 9) .... . . .. . . . . .. . . ..... .. .. _ Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously' Minimum Building Dimension,W u Nominal Height of Tallest Opening .............. .. ..... .... . . ...I.. . . 6'8" _ Sheathing Type .. ..... .. ........ ..... (note 4) .... .... ...... .. . . ... .. .. _ Edge Nail Spacing ...... ............. (Table 10 or note 4 if less) .. ...... . in. Field Nail Spacing .... ............... (Table 10)......... ..... . ....... 2 in., Shear Connection(no.of 16d common nails)(Table 10) .. .......... � — Percent Full-Height Sheathing .......... (Table 10). . . ........ ... . ........ .Z 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)... ........ Maximum Building Dimension,L 1 t1 Nominal Height of Tallest Opening' . ............. . ....... ..4( !� 6'8" _ Sheathing Type ...... . ............... (note 4)........ ............. Edge Nail Spacing .... .. ............. (Table 1 I or note 4 if less) ......... Field Nail Spacing .... Table 11 ' P 8 ( )............... ....... -2:- Shear Connection(no.of 16d common nails)(Table 11) ............ _. .... ..... .. Percent Full-Height Sheathing .......... (Table 11)............ .............I % 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)........... Wall Cladding —' Rated for Wind Speed? ........................................ . ....... _ 5.1 ROOFS Roof framing member spans checked? (For Rafters use AWC Span Tool,see BBRS Website)L Roof Overhang.. . .. .... ...... ............ (Figure 19) ...... +ft s smaller of 2' or U3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors t f Uplift . .... .. ....... ........... .... (Table 12).......... . ..... ... . U=� Lateral ...... ...:... ............... (Table 12)................ ... . . L= 1L f Tf Shear.. ........ ... Table12 Ridge Strap Connections,t collar tie tf sed er page 21(Table}3).. ........... T plf _ Gable Rake Outlooker .. (Figure 20) �l./, , _ft 5 smaller of 2'or U2 _ Truss or Rafter Connections at Non-Loadbearing Walls / Proprietary Connectors Uplift ... . ... ... . .. .............. (Table14).... ..... ...... .... U=_lb. Lateral(no.of 16d common nails) ....... (Table 14).... ............... L= lb. T Roof Sheathing Type ...... .... (per 780 CMR 58.00 and 59. 0 Roof Sheathing Thickness .................. . .. .....Jr in z 7/16"WSP Roof Sheathing Fastening ..... (Table 2) Notes: 1. This checklist shall be met in.its entirety, excluding the specific exception noted in 2, to comply with the requirements of 780 CMR 5301.2.1.1 Item 1.If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Comer Stud Hold Downs per Figure 18a and Figure l8b 2. Exception:Opening heights of up to 8 ft,shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2-grade. 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing and Nail Spacing requirements 12/28/07 (Effective 1/l/08) 780 CMR-Seventh Edition 1055 kA OF SS9c .53 o� MICHELE 7 C R: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS I 1 Y-to ti t S � CUDILO T SSACHUSETTS STATE BUILDING CODE ° N0.34774 -A STRUCTURAL AWC Guide to Wood Construction in High Wind Areas;110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)' A Check 1.1 SCOPE Compliance Wind Speed(3-sec.gust) ........... .. .. .. .. .. .. .... ... ... ... ... ...... .. . . . 110 mph Wind Exposure Category . . ...... ..... ........ ... ...... .... .. . .... .. . .... . . . . .. .. B 1.2 APPLICABILITY Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story) stories s 2 stories _ Roof Pitch . .. ..... .. ... .. ... .. .. .. ...... (Fig 2) . . . . ... ...... ... .. . 6ZLZL s 12:12 Mean Roof Height . . . . ...... ... .. . ... ..... (Fig 2) . ...... . . .. .. . .... . ft s 33' — Building Width,W .. .. .. .. . . ..... .. .......(Fig 3) ....... .... .. . ..... 2 ft s 80' — Building Length.L .. ...... ... . ........ .. . (Fig 3) . ...... ... . .. ...... .ft s 80' — Building Aspect Ratio(L/W) .. .. .. . .. .. . ... (Fig 4) i s 3:1 _ Nominal Height of Tallest Opening' .. . . . .. ... (Fig 4) ... . . .... .. ..... .. .. b° s 6'8" _ 1.3 FRAMING CONNECTIONS General compliance with framing connections ... (Table 2) ....... ......... .. .. . ..... .. . _ 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete . .. ..... .. . ....... .... . .. . ........ .. .. . .... ... .. . . ... .. .. . . .. .. .. . _ Concret6Masonry . .. . .... .. .. ... ... . .. . .. ... ... .. ... .... .. . .. .. ..... ...... .. _ 2.2 ANCHORAGE TO FOUNDATION" %"Anchor Bolts imbedded or%"Proprietary Mechanical Anchors as an alternative�, � in concrete only Bolt Spacing-general .................. (Table 4) I �•' I�T. , N in. _ Bolt Spacing from end/joint of plate ...... (Fig 5) ........... . ... �in. s 6"- 12" _ Bolt Embedment-concrete.............. (Fig 5)...... ...... .. ......... .Z in. a 7" _ Bolt Embedment-masonry. .. ........... (Fig 5) ... .... .... ..... ... in. z 15" _ Plate Washer . .. ..... ................. (Fig 5) z 3"x 3"x t/4" 3.1 FLOORS — Floor framing member spans checked ....... .. (per 780 CMR 55.00) .... ................ Maximum Floor Opening Dimension........... (Fig 6) ................ ....(J ft s 12' Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6) .... .. . ...... Maximum Floor Joist Setbacks — Supporting Loadbearing Walls or Shearwall . (Fig 7) ....... . .... . .. . .. . . .. . =ft s d _ Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall . (Fig 8) .... ....... ..... ....... =ft s d _ Floor Bracing at Endwalls .................. (Fig 9) ......... .................... . . Floor Sheathing Type .... .................. (per 780 CMR 55.00) .. ........ ...... — Floor Sheathing Thickness .................. (per 780 CMR 55.00) .............. in. _ Floor Sheathing Fastening .................. (Table 2) d nails at-1 edge/Lin field _ 4.1 'WALLS Wall Height Loadbearing walls ................. .... (Fig 10 and Table 5) .. ......... ®ft s 10, _ Non-Loadbearing walls ......... . ......... (Fig 10 and Table 5) . ....... ft s 20' _ Wall Stud Spacing ..... ....... ........ (Fig 10 and Table 5) ....... ,. ..�in, s 24"o.c. _ Wall Story Offsets ......., . ............ (Figs 7&8) ..... ............ . =ft s d 4.2 EXTERIOR WALLS' Wood Studs Loadbearing walls ............ . ...... . (Table 5) ............2x l3 ft Q in, _ Non-Loadbearing walls .......... ....... (Table 5) ........ ....2x -11ft T in. Gable End Wall Bracing' — Full Height Endwall Studs ............... (Fig 10) . ................. ..��C..�a.. ...... _ WSP Attic Floor Length ....._.... ....... (Fig 11) ........... ........ L_ ft z W/3 _ ypcum Coilin »gth_(i. nog uoo (Fig 11) .. .......... .. �.J rl a 0.9W and 2 x 4 Continuous Lateral Brace®6 ft.o.c...(Fig 11).............................. or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 ft.spacing in end joist or truss bays ... . .... . ..... ............ ..... .. .. ........ . . .... . . ........ Double Top Plate — Splice Length... .. . ....... . ..... .. .... (Fig 13 and Table 6) .. . . .m i J'o .5f 7 ft _ Splice Connection(no.of 16d common nails)(Table 6) . .. . .... .. . .. . . ...1 1. 1054 780 CMR-Seventh Edition 12/28/07 (Effective 1/l/08) `pptHE Tp�� Town of Barnstable BA MAgl;.LE, ' Regulatory Services ti MASS. a, 1639. M Building Division pTfO Py A 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 'Inspection Correction Notice Type of Inspection f'�` C P Y GcJ V Location I L/NG LN �fl - Permit Number Owner 1 t t)6t�h e- �® Builder d w H One notice to remain on job site, one notice on file in Building Department. The following items need correcting: lJ l��l L-0 t- 70 C-00 ST 1e v CT- A CGOkb/N6_ 7-0 -nf C F14 i c_v 2 C-7 T-u C-0 V1 S7-2 v C-7- A C c o 2b/8 6-- 7-0 w r c u-t c µ C C-(c L(STT -rf 6-1 NEE�-GD GDA--& e C-ToKS P 0 E6-AEb Please call: 508-862-4038 for re-inspection. Inspected by Date r r ,N pp �yOeo & , - :00 F N R7 loop Ir = a t .• 77; F , S a p t v a • � t w i t i t 534 Lincoln Rd Ext, Hyannis 1 /19/11 .A._ 53� .L i nco n d �Ext;- Ya nn i s-.-..�-- - - 1 /19/11 11 3 _ y v �4 r— _ 4 :�"'5"'' -- '`y,,.•--',N,,.�".r `�� _ - � s� .�. � .•^."per , n "ter. " ,,p e w n y.r s• P yy �- •'w ... ...--.*..+e.-.. - _ —- a r IL 41 r ,;�, ,.. «.3's yr! y s.«' S r�`�' , •.�,• r• 3 ,4 JWFI v 1 �a . Nt w k r F 534 Lincoln Rd Ext 534 UnObIn . d Ext, H yan nis: 7 k p1 ti 96 4• � `i . � �^ �d d• � � � � a v 'C is . a cJ } w M ` fit. `1 �`�Cf � �-P} V,.•�� _ � ��a`` Q �' �7- k. e�p� .. '_�� '. � n�. '"` yr�.is '..r��s G � 0 d a _ d+" �' .� - • ^..- _ _ -�,'�.. 9 �1�..Q f-as._. ti_...r � _ - � � - � A ��• '_.�„'r"'_ ..�^"`.�..�._.-,..-="'.yam-*..-•'a'_-_.......��"��. � -- .. � '.s" r�;i� �j�o a f r , J r �rr.f ..r t, 0 j} Yam. X �,� �' ` `��.• .� s�' �Tt »_ =fir.... 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'i M-� k: 1K1Y,nw."� +A 4 '"L. �# .n.- ,•,� ,x + �y., f.��• ,a�' a~ ,�. • a x M f B SK-1 NEW 2x10 ® 16" O.C. 1 J N W (2)— 4>rM" LVL CO T. r 0 1 ih JL JL JL JL JL JL JL JL JL (2)-2x10 FLOOR JOIST A ADD: (2)—TIMBERLOK SCREWS x x 4" LONG 4,O i z STAGGERED IG• N ® 6" O.C. o v R ALONG �.`� r- �`' EXISTING ® " -H LEDGER :. ao 3 z EXISTING MAIN 2 —2x10 FLOOR J IST HOUSE NEW 200 z ® 16" O.C. NE (2) 13/a" 7Y4' VL X CON". J Bsim. Aj�1, ffqs SK-1 o�y�c y OHN sycL �Rll 12'—O"t EXISTING c e o.33 t�F01 S T C SS1ONAL EN�� FIRST FLOOR FRAMING PLAN SCALE: 1/4"=F-0" NOTES: 1. FIRST FLOOR DECK INSULATION BY CONTRACTOR, PROVIDE MIN. R19 AND AIR 8 BARRIER, SECURE INSULATION IN PLACE AND PROTECT EXTERIOR SIDE. 2. FINAL RIM ENCLOSURE BY CONTRACTOR TO PREVENT ACCESS FOR RODENTS. 3. ALL INTERIOR FACES OF EXTERIOR FRAME WALLS SHALL BE SHEATHED WITH 3' V THICK, APA RATED STRUCTURAL PLYWOOD WALL SHEATHING AS SPECIFIED a IN DETAIL "A". "ISSUED FOR CONSTRUCTION" Coastal Engineering Co.,Inc.©2011 ADDITION COASTAL PROJECT: DESIGN BY LJ GILMORE ENTERPRISES L.L.C. SK- SHEET DATE 12/28 2011 0— ENGINEERING 534 LINCOLN RD.EXTENSION HYANNIS MA TITLE: DRAWN BY LJ ICOMPANYINC CHECKED BY JAB 260 CmnbeRy Hwy.orle=,MA 02653 1 S T FLOOR FRAMING PLAN k 508.255.6511 Fax:508.255.6700 1 OF 5 SHEETS PROJECT NO. 07665.00 ADD 2x RAFTER TO FILL SPACE BETWEEN EXISTING ROOF RAFTER AT ADDTITION AND MAIN HOUSE WALL SHEATHING, PROVIDE 6" LONG TIMBERLOK SCREWS, w STAGGERED ® 8" O.C. TO CONNECT EXISTING ROOF RAFTER THROUGH NEW 2x TO EXISTING BUILDING SHEATHING AND WALL, TYP. EXIST. WINDOW HEADER TO REMAIN NEW 4x4 POST I I I AT EACH END, CONNECT VIA I I I SIMPSON EPC44 TO HEADER ® I I I CONNECT TOP PLATE TO EACH END. I I I INSIDE FACE OF WINDOW NAIL NEW HEADER VIA SIMPSON CS14 STRUCTURAL I I I COIL STRAP, NAIL W/ 10d PLYWOOD I I I NAILS AND PROVIDE MIN. 16" SHEATHING IN I I I END LENGTH ON EACH SIDE ADDIF ONE TO I I I OF SPLICE POINT. C OF COLUMN, TYP. I I I I I I Z X ``' o ;; NEW I I I (2)-1 74'x02" I I I LVL HEADER AT OPENING TO EXIST. LIVING ROOM I I I EXISTING I I I MAIN HOUSE I i I I I I I I I I I ADD 4x6 TIE RAFTERS IN (3) 2'-0"t 4'-0" 4'-0" 2'-0"t LOCATIONS (SPACING AS SHOWN) CONNECT EACH END W/ (21 SIMPSON HGA10KT TO TIE RAFTER 12'-O"t EXISTING AND PLATE/OR BEAM (PLACE ONE ON EACH SIDE OF TIE RAFTER). CONNECT VIA (4) SDS Y4" x 1Y2" TO TIE BEAM AND VIA (4) SDS Y4" x 3" ROOF FRAMING PLAN TO PLATE/ OR BEAM, TYP. 8, NOTES: SCALE: 1/4"=1'-0" 1. CONTRACTOR SHALL CONNECT EACH EXISTING ROOF RAFTER TO TOP PLATE/ 6 OR BEAM VIA SIMPSON H2.5 HURRICANE TIE (INSTALL ON INSIDE FACE OF a WALL) AND SIMPSON LS30, CONNECT TO TOP OF PLATE/ OR BEAM, TYP. �I "ISSUED FOR CONSTRUCTION" Coastal Engineering Co.,Inc.©2011 ADDITION COASTAL PROJECT: DESIGNBY LJ GILMORE ENTERPRISES, L.L.C. SK- 1 DATE 12/28/2011 ENGINEERING534 LINCOLNRD.EXTENSION HYANNIS MA 1 DRAWN BY LJ COMPANY,INC. SHEET TITLE: 260 Cranberry Hwy.Orleans,MA 02653 ROOF FRAMING PLAN CHECKED BY JAB w 508.255.6511 Fax:508.255.6700 1 2 OF 5 SHEETS I PROJECT NO. C 1766S.O 32" THICK APA RATED PLYWOOD SHEATHING, NAIL W/ 8d NAILS AT 4" O.C. AT ALL PANEL EDGES, 8" O.C. NAILING IN PANEL FIELD. TYP. ALL INTERIOR SIDES OF ADDITION WALLS. SIMPSON L90 ® EVERY FLOOR JOISTS, CONNECT W/ #9x1Y2" SD9 SIMPSON STRUCTURAL SCREWS, TYP. FULL DEPTH, SOLID 2x BLOCKING, TYP AT EVERY JOIST BAY AT SUPPORTS AND MID SPAN OF RAFTER, TYP. 3Y4" THICK APA RATED PLYWOOD FLOOR SHEATHING, NAIL W/ 10d COMMON NAILS 6" O.C. AT ALL PANEL EDGES, TYP. EXISTING WALL CONSTRUCTION AND EXISTING 2x10 FLOOR JOISTS ® 16" O.C. EXISTING CONNECTIONS TO ° REMAIN EXIST. 2x4 STUDS SIMPSON H2.5 CLIP ® EVERY FLOOR JOIST, TYP. P.T. 4x4 POST, TIMBERLOK SCREWS x 6" LONG IN (2) ROWS, NOTCH TO FIT SPACE EACH ROW ® 8" O.C., STAGGER ROWS. HEAD OF EXIST. ANCHOR BOLT AS NEEDED. (2)-7Y4" LVL BEAM X CONT. SIMPSON HTT4 HOLDDOWN, TYP ® ALL EXIST. o= SONOTUBE FDN'S, CONNECT W/ #10SDSx1YZ" M w LONG TO P.T. POST. P.T. 2x BLOCKING o w o CONNECT TO SONOTUBE VIA V DIA. ANCHOR ON FLAT ° ° ROD (F1556, GR.36) AND HILTI HY150 ICE a _ ADHESIVE, PROVIDE 10" MIN. EMBEDMENT DEPTH INTO CONCRETE AND MAINTAIN 3" MIN. EDGE 3" MIN. DISTANCE, TYP. HOLE PREPARATION FOR ANCHOR INTO CONCRETE PER MANUFACTURER'S (HILTI) SPECIFICATION. 3 8 SECTION & CONNECTION DTLs A SCALE: 1 =V-0" SK-1 Ui 3 � A� "ISSUED FOR CONSTRUCTION" Coastal Engineering Co.,Inc.©2011 PROJECT: ADDITION COASTAL DESIGN BY LJ ENGINEERING GILMORE ENTERPRISES, L.L.C. SK_ DATE 12 28/2011 534 LINCOLN RD.EXTENSION HYANNIS MA DRA WN BY LJ COMPANY,INC SHEET TITLE: 260 Cranberry Hwy.Orleans,MA 02653 SECTION&DETAILS CHECKED BY JAB 508.255.6511 Fax:508.255.6700 3 OF 5 SHEETS I PROJECT NO. C 17665.0 REFER TO DETAIL "A" FOR NEW -Y4' THICK PLYWOOD FLOOR SHEATHING AND NAILING. (2)-2x10 FLOOR JOIST, CONNECT PLIES W/ 10d 3'-0" t FNAILS @ 4" O.C. IN (2) ROWS, TYP. .a. �SIMPSON LUS28 FACE MOUNT HANGER ® 16" O.C., TYP NEW 2x10 ® 16" O.C. FLOOR JOISTS USE SPECIFIED TIMBERLOK SCREW IN ONE ROW WHERE ONLY ONE PLATE IS EXISTING. REFER TO DETAIL "A" FOR SIZE AND SPACING. REFER TO DETAIL "A" FOR ALL MEMBERS, CONNECTION ELEMENTS, AND ADDITIONAL COMPONENTS THAT SHALL BE ADDED TO THE EXISTING STRUCTURE. ,�/ : DRILL HOLE FOR ANCHOR BOLT AT ANGLE TO PROVIDE BETTER EDGE DISTANCE IN AREAS WITH I/ EXISTING 2X6 LOWER STUD WALL FRAMING, TYP. v U Q . EXISTING 2x6 KNEE WALL CONSTRUCTION h Q SECTION & CONNECTION DTLs B SCALE: 1"=V-0" SK-1 3 8 U 3 A� "ISSUED FOR CONSTRUCTION" Coastal Engineering Co.,Inc.Q 2011 ADDITION COASTAL PROJECT: DESIGN BY Li ENGINEERING GILMORE ENTERPRISES, L.L.C. SK- 1 DATE 12 28/2011 534 LINCOLN RD.EXTENSION HYANNIS MA 1 DRAWN BY Li COMPANY INC. SHEET TITLE: 260Cmnberry Hwy.Odeaas,MA02653 SECTION&DETAILS CHECKED BY JAB 508.255.6511 Fax:508.255.6700 4 OF 5 SHEETS I PROJECT NO. C 1766S.O GENERAL NOTES 1. ALL STRUCTURAL WORK SHALL CONFORM TO THESE PROJECT PLANS AND NOTES, INCLUDING THE FOLLOWING GOVERNING STANDARDS: A. THE MASSACHUSETTS STATE BUILDING CODE, 8TH EDITION (FOR ONE AND TWO FAMILY DWELLINGS), AND ALL OTHER AGENCIES HAVING JURISDICTION. A. THE NATIONAL DESIGN SPECIFICATION FOR WOOD CONSTRUCTION (NDS), LATEST EDITION. 2. THE CONTRACTOR SHALL PROVIDE TEMPORARY SHORING AND BRACING AND MAKE SAFE ALL FLOORS, ROOFS, WALLS AND ADJACENT PROPERTY AS PROJECT CONDITIONS REQUIRE. 3. ALL CONSTRUCTION IS TO CONFORM TO THE MASSACHUSETTS STATE BUILDING CODE AND ALL APPLICABLE PRODUCT AND DESIGN STANDARDS. ABSENCE OF SPECIFIC ITEMS FROM THESE DRAWINGS DOES NOT INFER THAT THE CONTRACTOR IS RELIEVED FROM THE STATUTORY CODE REQUIREMENTS. 4. ALL MATERIALS AND METHODS OF CONSTRUCTION SHALL CONFORM TO THE APPROVED RULES AND STANDARDS FOR MATERIALS, TESTS, AND REQUIREMENTS OF ACCEPTED ENGINEERING PRACTICE AS LISTED IN THE CURRENT MASSACHUSETTS STATE BUILDING CODE FOR 1 AND 2 FAMILY DWELLINGS. 5. THE CONTRACTOR SHALL VERIFY ALL DIMENSIONS AND CONDITIONS IN THE FIELD PRIOR TO COMMENCING WORK. ANY DISCREPANCY BETWEEN WHAT IS SHOWN ON THE DRAWING AND ACTUAL FIELD CONDITIONS SHALL BE REPORTED BACK TO THE ENGINEER IN WRITING BEFORE PROCEEDING WITH ANY WORK. 6. NOTIFY THE ENGINEER OF ANY ARCHITECTURAL MODIFICATION OR DIMENSION CHANGES THAT MAY AFFECT THE STRUCTURAL DESIGN. 7. CEC DOES NOT PROVIDE ANY VERIFICATION OR ENGINEERING ANALYSIS OF THE EXISTING SONOTUBE FOUNDATIONS, AS THESE HAVE BEEN PROVIDED BY OTHERS. IT IS ASSUMED FOR THE PURPOSE OF THESE CONSTRUCTION DRAWINGS THAT THE FOUNDATIONS HAVE BEEN CONSTRUCTED IN ACCORDANCE WITH THE ORIGINAL DESIGN DOCUMENTS PROVIDED BY MICHELE CUDILO, P.E., DATED 09-15-2009, (1) SHEET. SIZE 1107. WOOD FRAMING NOTES 1. ALL FRAMING LUMBER SHALL CONFORM TO THE LATEST EDITION OF THE AFPA "NATIONAL DESIGN SPECIFICATION FOR WOOD CONSTRUCTION", AND SUPPLEMENT "DESIGN VALUES FOR WOOD CONSTRUCTION", LATEST EDITION. MAXIMUM MOISTURE CONTENT SHALL BE 19%. 2. THE FRAMING LUMBER SHALL BE OF THE FOLLOWING MINIMUM GRADE AND SPECIES FOR THE SPECIFIED USE. ALL LUMBER SHALL BE GRADE STAMPED BY A RECOGNIZED GRADING AGENCY AND SHALL BE KILN DRY. ALL WOOD WALL FRAMING (STUDS, SILLS, PLATES, BRIDGING, BLOCKING ETC. SHALL BE 2x6 SPF#2. COLUMNS (WERE SPECIFIED) SHALL BE 44 SPF NO.2 OR SP NO.2 IF PRESSURE TREATED. 3. LUMBER WHICH IS SPLIT, CRACKED, NOTCHED OR OTHERWISE ALTERED OR DAMAGED SHALL BE IMMEDIATELY REJECTED AND NOT ALLOWED FOR USE, UNLESS OTHERWISE APPROVED IN WRITING BY THE STRUCTURAL ENGINEER. 4. ALL LAMINATED VENEER LUMBER (LVL) TO HAVE A MINIMUM ALLOWABLE BENDING STRESS (FB) OF 2,600 PSI. THE MINIMUM ALLOWABLE COMPRESSION STRESS (FC) PERPENDICULAR TO THE GRAIN SHALL BE 750 PSI. THE MINIMUM ALLOWABLE MODULUS OF ELASTICITY (E) SHALL BE 1,900,000 PSI. INSTALL LVL'S IN STRICT ACCORDANCE WITH THE MANUFACTURER'S INSTRUCTIONS. 5. ALL ENGINEERED LUMBER PRODUCTS SHALL BE AS MANUFACTURED BY THE TRUSS JOIST CORPORATION, BOISE CASCADE, LOUISIANA PACIFIC CORPORATION OR APPROVED EQUAL. 3 6. FOLLOW MANUFACTURERS' SPECIFICATIONS FOR ERECTION, INSTALLATION, AND PLACEMENT OF ENGINEERED LUMBER PRODUCTS. PENETRATIONS THROUGH ENGINEERED LUMBER PRODUCTS IS EXPRESSLY NOT PERMITTED WITHOUT PRIOR WRITTEN APPROVAL BY THE ENGINEER. $ 7. IN NO CASE SHALL JOISTS, RAFTERS, BEAMS, POSTS, STUDS OR ANY OTHER FRAMING MEMBER BE CUT, NOTCHED, DRILLED, OR OTHERWISE MODIFIED WITHOUT THE WRITTEN APPROVAL OF THE STRUCTURAL ENGINEER OR SPECIFIED ON THE DESIGN DRAWINGS. A� 8. ALL WOOD PANEL SHEATHING USED FOR WALLS AND, FLOORS SHALL BE APA RATED STRUCTURAL SHEATHING. f "ISSUED FOR CONSTRUCTION" Coastal Engineering Co.,Inc.@ 2011 ADDITION COASTAL PROJECT: DESIGN BY LJ ENGINEERING GILMORE ENTERPRISES, L.L.C. 1 DATE 12/28/2011 534 LINCOLNRD.EXTENSION HYANNIS MA SK- ,,Nc 1 DRAWN BY LJ COMPANY SHEET TITLE: 260Cranbeny Hwy.Orleam,MA02653 STRUCTURAL NOTES CHECKED BY JAB w 508.255.6511 Fax:508.255.6700 1 1 5 OF 5 SHEETS I PROJECT NO. C 1766S.O .- ..-. . . ... . July 15, 2009 Re: 534 Lincoln Rd Ext, Hyannis • Steve (508-360-0749) called to report an illegal bedroom in the basement of 534 Lincoln Rd Ext. • The caller is concerned that that there is no egress, no venting and a mold problem. • Claims owner is guilty of numerous illegal activities. • Male resident in basement has been there 1-2 yrs. • He accesses area by bulkhead. • There is no kitchen or bathroom downstairs. Owner is retired and home during the day. • Owner has 2 poodles and tenant has a shepherd. • Caller does not believe there are adequate smoke or CO detectors if any. • FHA by gas, Town of Barnstable �pf tHE 1py, ' do Regulatory Services Thomas F. Geiler, Director • BARNSTABLE, MASS. Building Division Argo rn�'�" Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.ba rnsta ble.maxs Office: 508-862-4038 Fax: 508-790-6230 EXIT ORDER DATE: � — �® LOCATION: UNDER THE PROVISIONS OF 780 CMR, THE STATE BUILDING CODE, SECTION 3400.5.1, YOU ARE HEREBY ORDERED TO IMMEDIATELY DISCONTINUE THE USE OF.THE CELLAR/BASEMENT AREA FOR SLEEPING PURPOSES. , LOCAL INSPECTOR SIGNATURE OF CIPIENT ODEM DE SAIDA DATA: f , LOCALIDADE: 4 �, DE ACORDO COM 0 PROVISORIO 780 CMR, CODIGO DE CONSTRUCAO DO. ESTADO, PARAGRAFO 3400.5.1, VOCE ESTA ORDENADO DE DEIXAR DE USAR, IMEDIATAMENTE, A AREA DO PORAOBASEMENT PARA 0 =f PROPOSITO DE DORMIR. _ INSPECTOR LOCAL ASSINATURA DO RECIPIENTE - i f TOWN OF BARNSTABLE Peimit No. .....2 t S,uIT..� i Building Inspector cash ------- 'Oo 9y_— �o OCCUPANCY PERMIT Bond _._ XX Al No building nor structure,shall be erected, and no land, building or structure shall be used for a new, different, changed, or, enlarged, use without a Building Permit therefor first having been obtained from tlie BuildingfInspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Eugene E. Duquette &' WiLf!;X E J ,Perron , Issued to Address c*out h Yexmonth Zot #43 534—_;6inocr1,n Rd. Ext. Hyannis,,_' 'Viring Inspector J _ Inspection date Plumbing IIEaspectoroc Inspection date Gas Inspector a'i"P��+�r: � Inspection date r�ao h-1- P— Engineering Department �� Inspection date '~, --� � THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. Building Inspector i 44 i /40. O / ' i X 143 i �j /7 soy 1 35 q - Ex,ST o Q COAJC. 0 N r-ouNo ,r 1 Q y V Lo-r 42 + 7-/-//S LoT' 15 /vo 7 IA-1 7-i9 nJ l3 D 2 S . THE FLo O D PC.f?i N 2 on/ CA C Fq P E Co D, i nJ C. LOGAT/O�/: H 5IAAJN/S !3E11,jG LoT' 4.3 /9-5 ;sHOA.,'Aj ON L. iVER�f7`H. G HINC�Y . 2 AVClCCOY Ti,/E SUTA.A/.L/6• �•1tQl d' 3NON/.V O.t/ TN/S OL.ocP" /S 40C.97'6'D ON 7-14/B yLtOci.VD o9a 3s✓O WA l N@!?BCW&/ A"D TNfiT /T aO�ES CO.VFOGti! TO 7"//C BY-LgN/S O.- T.4/E 7bN/A/ OF f3A.E,VSTABLE � I1//.�EfA./ CO.V3TBtlCTE Z7. /AJ C . /L?fi C @Q6•. Lq/l✓O St/@NCti�OQ r ,Assessor=s'map and lot number �.7�..'.,� ��! P/��j y�f G/i/J-4P 2ZP 0 �G7MEt0 Sewage Permit number ................... . ............. House number `5 > SEPTIC SYSTEM MW f NAM LE, . ................................................. ............... 3q. 9 INSTALLED IN COMP 1� TOWN- *OF BARNiS�gVW C®E AND .4 REGULATIONS BUILDING] INSPECTOR APPLICATION FOR PERMIT TO ..+.✓.UL4A0k...x.a'l.... .T.°&� Nf ............... TYPE OF CONSTRUCTION ........ ©0�....� Al+tGr................................................. ............................... "�' .. ex, 7 TO,THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according t0 00—the following information: Location .. ... ..... 14 .....1 . ...... ./4.A!N..1S M C3• �1�� .�X.l.. ................................................... ProposedUse ... .�.. .F!E N C E ..................................................................... .... ZoningDistrict ....... . ....I..............................................Fire District .............................................................................. EuC�N� -DUgvtyT' 4- Name of Owner,. !tFI�C,1� �....1... R ®. ...................Address ..at� N.a �.I.N...s..�.. Sd !?�Zho�JS a-,-66 Name of Builder �U!�iTl9.N...� l�iLpE S' �°<. ... ...Address J14.A! ILt P'.lit S T .....,5Q.. Nameof Architect ..................................................................Address .................................................................................... Lf Number of Rooms .............../..............................................Foundation .......Co` O�P...6�...q�.cnf................................ Exlerior ...... cs�.�..... .�.!14. .� ........................Roofing ......r S '�A LT �ll. �'6.. .�� ?............... .. ............ . .......... Floors Q� - Interior................................................... f ....�. i.. �.`.�ty.�....... ....N:�.. .�:..U.t+L. .. V�, -----Heating ....Ae7...'¢.2....................................:....................Plumbing ...........J`... .... ....................................................... y.� Ojk Fireplace .............. 4=..4�......................................................Approximate Cost .....� /.4�. ��...... ......................... Definitive Plan Approved by Planning Board -------------------------------19________. Area .........,!K .. .................... Diagram of Lot and Building with Dimensions Fee .. .. SUBJECT TO APPROVAL OF BOARD OF HEALTHY I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ... .......... .... ....... ..................... ...... 7T EUGENE E. DUQUETTE & WILFRED E. PERRON 22.9.5.6 Permit for ..One...S.tory�........ ... ..... .. .. ....... ...S.ing.le...Family. ...................Dwe11in5............. .... ....... ..... ............... Location ....Lot....#13...534...Lincoln...Rd.. Ext. .. .. .....•. .................Hyannis.......................................... ... .. ....... .. Owner Eu.gene I . ...E......Duquette. . . ...&...W.i.1-f red E. Perron ..... .... .. .. .. . .. .... ....... .. .. Type of Construction ...Frame.... .. .... ................................................................................ Plot ............................. Lot ............................. March 27, 81 Permit Granted. .......................................:19 .. Date of Inspection .................. 19 Date Complete ............. ........ PERMIT REFUSED T, -, ................. 0 ..... 19 ............... ..................................... .......... ................ ....................................................... < ................L41..... .................................................. ................... .............................................................. Approved.:... ............................... 19 . ............................................................................... ........... ................................................................. -2 - 2 V-e� Assessor's map and lot Tnumber Sewage Permit number t :/ .... d 0 Z i ti•✓ House number ro BARISTADLE,MA86 G i639 9� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ..::............ ........c................................................................................................... TYPE OF CONSTRUCTION ........ff�244 ' < ...........................19..`'�!.. 1• TO THE INSPECTOR OF BUILDINGS: The undersigned herebyapplies for a permit according to the �following information: Location .. l..-�! ... ..... /N.4C6.f.t .........."... .y. ...... 1 ! i . :: ..j.s. .`:.. ........... ............ ProposedUse .... !............................ ........................................................................................................ ......................... Zoning District .. / ..........................Fire District ....•....• Name of Owner .ul'L9 . .t ' r�( c�N xd// •� lF?,?/rv.s .........:........................Address ..;. ................................................... ..... .. r F r Name of Buildert ...Address . ..... ..... ... ....� Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ............... .................................................Foundation .......... i' Exterior ...... . ..... .!.: .$ ........................Roofing ...... : . t.'dc. ....... :: .:`.y. :?-- .............. Floors .................. ...........................................................Interior Heating .....'� ?...: .`. '1..........................................................Plumbing .......... '1 ..: ....................................................... Fireplace .............. � �..; ...:..................................................Approximate Cost ..... tf�.r� ..... �.......................... tl Definitive Plan Approved by Planning Board ________________________________19________ . Area .��`' Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ��G ....................................... � . A=217 2 ' EDGENE E. DDQDETTE 6 WI � No — parnmh for —.��e—Story�-- S ' le �w�l ~�� ' +�mx .��:�� ^--c� � � —.—= =`�.. ---.---- ----. Lot #43 534 Lincoln Rd. Ex-,'-- . Location --'-----.-------------- . Hyannis ^'---'----'^^^^~^~^^'-----------' Eugene E. Duquette & Wilfred E. Perron Owner .................................................... ' Type of Construction --Frame � ------------ --'---'—''--~—'—''—'------'-----' � � Plot ............................ Lot ----------' March 27, Ol Permit Granted -------------]P � Date of Inspection ------------lV Dote Completed ------------'l9 � PERMIT REFUSED ,____.,__,--.----..-----.. 19 - —'------^'~'—'—'—'-------'-----'' , ''—^'—`—'----'^^~^—'----^—^---^—' � ' -------'^^-'--^^~^^---- ' ..^—.:--/'''=--------'--'- Approved� ................................................ lg ' ----'---'---'--'`~'-----'—^^^--'~` -------'---^^—'^'---'--^^^^^^^^-^ | . ' 4VTown of Barnstable r� z CF THE�p� do Regulatory Services Thomas F. Geiler,Director * BARNSfABLE, Building Division z63q. iOrFn wv►'�°i Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6231 PERMIT# D� 119 (� FEE: $ C7 � SHED REGISTRATION 120 square feet or less Location of shed(address) Villag 7 71 7 9/ Property owner's name Telephone number v Q.- �j 0 o?z�J �; Size of She Map/Parcel# < Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required) 100 Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:042506 z- o7- 44 4 3 ±� /_7, 50/ 35�� EX/S T. 0 QCOAJe. d f40 . o / ' t v LOT 42 TN/S G.vT /S /d/O T i w �U,� t TA nJ O L d 2 5 . 7H6- FLOOD C7A CigRe COD, MAR. 2ya oe&A'tZ&AIC S: 66//u457 L.oT 43 onl i1N�'ttll'H. � f�/E6Cdy Gte'TlFY Ts-I�iT 9'��/E 8�/�L�t�t.l� � �•� !^ ,� 3s,.AC)�Wy ow rsVts ov 774W y- , aF.rroct va ~ sMo ww IWMA O" `atilt) 7-,WA07' t r �► �o� c©�✓�o�.�.s m r��r ro.vt�vc� � � �, .l�Y-L qNt F rAoP& 7tJH/il1 Qom' T PVA,Isti/ ca�,✓a r�c�c r�a. LOW ` /,JELL ee, IMC . O Cw*7: t �e�. Ls4titn ausrr+sfV-*Alt i Town of Barnstable Permit# Expires 6,x hfi m�usue dale )(_ PERMIT Regulatory Services Fee 0 Thomas F.Geiler,Director MAR 2.2 2006 Building Division TOWN OF BARNSTABLE Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY tor 4(3 Not Valid without Red X-Press Imprint Ma /parcel Number P , 7V[90 At -S Property Address [Residential Value of Work 3� p— Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address <-l 0. ► ��F Ci ,G Contractor's Naive q&ote_ DJ 44 4 Telephone Number ��-- Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 5zWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor am the Homeowner I have Worker's Compensation Insurance )l � }` Insurance Company Name �v �,wtpsl�cJ�- J;�s co Workman's Comp.Policy# (o L9 l Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) 2/Re-side e7,4_ Replacement Windows. U-Value © - 3 4 (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign P ty Owner Letter of Permission. /,jH,,me proveme ntr tors I icense is required. SIGNATURE: Q:Forms:expmtrg Revise071405 i R l Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registratio 126893 Expiration $13/2006 �Type Supplement Card i THE Home Depot At Home Servic FACHAEL BEDARfj "' 3200 COBS GALLERIA PKUUY"#20 �� ALTANTA, GA 30339 Administrator E { A aFSM�, Town of Barnstable �o regulatory Services ' $"aMA�1'E a Thomas F.Geiler,Director v� s63p. ,0�' ppE639 � Building Division. Torn Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property filer bust Complete and Sign This Section If Using A Builder I, ~Cto- G. Co ,as Owner of the subject property hereby authorize l�� to act on my behalf, in all matters relative to work authorized by this building permit application for.. L NC04U (Address of Job) Signature of Owner Date Aj, , Pnnt Name Q TORMS:OWNERPERMISSION The Commonwealth oj*Massachusetts Department of Industrial Accidents ®ice of Investigations 600 Washington Street Boston, M4 02111 wM ,.S� www.rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl Name (Business/Organization/Individual): Address: ,2g5s� &C'e's r N VV City/State/Zip: { a.,J .?�033 q Phone #: 3Z d 6 Aire you an employer? Check the-appropriate boa: 'Type of project(required): 1.ED I am a employer with ( O 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet t 7. ❑ Remodeling ship and have no employees These sub-contractors have &. ❑ Demolition working for me in any capacity. workers' comp,insurance. 9. ❑ Building addition [No workers' romp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself.[No workers' comp, c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. (No workers' r / 13.�Other comp.insurance required.] r� Jr 1 *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: vvr s t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Co Policy#or Self-ins.Lic. #: Expiration Date: _('— 0 Job Site Address: �3 L'1 P�c-o j � City/State/Zip: 41&4wI,s v 0 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$1,50Q.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fade of up to$250.06 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: Phone#; Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority (circle one): 1.Board of health 2.Building Department 3.City/TGWU Clerk a.Electrical inspector 5.Plumbing Inspector, �I 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership, association, corporation or other legal entity, or any two or more Of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the . receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation.insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this of idavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, IAA 02111 Tel. `617-727-4900 ext 406 or 1-577-MASSAFE r ax # 617-727-7749 Revised 5-26-05 V,-W-w.II12SS,cr0 uI cia I . MARSHIFI4�ATE'®F INSURANw.E CERTIFICATE NUMBER ATL-000915907-11 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS MARSH USA, INC. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE ATTN: BRENDA BOOKER (404)995-2594 POLICY,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE MAYA MCCLURE(404)995-3206 OR AFFORDED BY THE POLICIES DESCRIBED HEREIN. TAMI ROUSE(404)995-3430 FAX(404)760-5663 COMPANIES AFFORDING COVERAGE 3475 PIEDMONT ROAD,SUITE 1200 -- ATLANTA,GA 30305 CCMP.ANY '100492-IPUSA-GWA-03104 A STEADFAST INSURANCE COMPANY !NSUREO - - COMPANY THD AT-HOME SERVICES INC. B ZURICH AiMERICAN INSURANCE COMPANY I DBA THE HOME DEPOT AT-HOME SERVICES,INC. — HOME DEPOT USA, INC. COMPANY 2455 PACES FERRY ROAD NVI C NEW HAivIP S1 HIF''INS COMPANY BUILDING C-8 — ATLANTA,GA 30339 COMPANY D AMERICAN HOME ASSURANCE COMPANY COVERAGES Tkils certificate supersedes and,replaces any-previously issuetl ceh!ticateµfor the,pol cy penod"noted belDw 3 THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO - - POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIYY) DATE(MMIDDIYY) LIMITS A GENERAL LIABILITY IPR 3757 608-01 03/01/06 03/01/07 GENERAL AGGREGATE $ 4,000,000 X COMMERCIAL GENERAL LIABILITY 'LIMITS OF POLICY ARE EXCESS' PRODUCTS-COMP/OP AGG $ 4,000,000 CLAIMS MADE a OCCUR 'OF SIR:$1,000,000 PER OCC' PERSONAL&ADV INJURY $ 4,000,000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 4,000,000 FIRE DAMAGE(Any one tire) $ 1,000,000 MED EXP(Any one person) $ EXCLUDED B AUTOMOBILE LIABILITY BAP 2938863-03 ADS- 03/01/06 03/01/07 COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO ALL OWNED AUTOS BODILY INJURY $ - SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) X SELF-INSURED AUTO PROPERTY DAMAGE $ HYSICAL DAMAGE GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: ,r ae EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ G WORKERS COMPENSATION AND 6610998(AZ,ID,MD,VA) 03/01/06 03/01/07 X I WC STATU- OTH- { r r x r 1 C EMPLOYERS'LIABILITY TORY LIMITS ER C 6610995(ADS) 03/01/06 03/01/07 EL EACH ACCIDENT $ 1,000,000 G THE PROPRIETOR/ X PARTNERSIEXECUTIVE INCL 6611326(OR) 03/01/06 03/01/07 EL DISEASE-POLICY LIMIT $ 1,000,000 - E OFFICERS ARE: EXCL 6610999(NY,WI) 03/01/06 03/01/07 EL DISEASE-EACH EMPLOYEE $ 1,000,000 OTHER WORKERS E COMPENSATION CONTINUED 6610997(FL) 03/61/06 03/01/07 D 6610996(CA) 03/01/06 03/01/07 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESISPECIAL ITEMS CERTIFICATE HOLDER ^ CANCELI ATION SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL In DAYS WRITTEN NOTICE TO THE FOR INSURANCE PURPOSES ONLY .CERTIFICATE HOLDER NAMED HEREIN,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE,ITS AGENTS OR REPRESENTATIVES,OR THE ISSUER OF THIS CERTIFICATE. MARSH USA INC. BY: Walter Gilstrapi:1.t s fl � MM1(3/02) ) VALID AS OF 02/27/06 a � A DATEIMMIDDIYY) A®DJTIONAL INFORMATION 5 _£ ATLOQ091590711' 02�27/06 ^e .. .�✓lkf^,Sz ... -. u- ^,s:>..:.�A.u„ ,.""... zi-:US`. .. ,. '..4 _.....-9....aa,. , COMPANLES AFFORDING COVERAGE ?RDDUCER .' - I MARSH USA,INC. COMPANY " ATTN:BRENDA BOOKER (404)995-2594 E ILLINOIS NATIONAL INSURANCE CONIPANY MAYA MCCLURE(404)995-3206 OR TAMI ROUSE( 04)995-3430 FAX(404)760-5663 3475 PIEDMONT ROAD,SUITE 1200 COMPANY ATLANTA,GA 30305 f 100492-IPUSA•GWA-03/04 _ INSURED CCMPANY THD AT-HOME SERVICES INC. `G NATIONAL UNION FIRE INSURANCE COMPANY DBA THE HOME DEPOT AT-HOME SERVICES,INC. HOME DEPOT USA,INC. 2455 PACES FERRY ROAD NW COMPANY BUILDING C-8 ATLANTA,GA 30339 H ;.xT E XT x to _- :'a `-.�, .�,x, g" i CERTIFICATE HOLDER .... , . > a FOR INSURANCE PURPOSES ONLY MARSH USA INC.BY Walter Glstrap 3. 4 ,-a Av " Mar 10 06 09: 59p Danya Mahata 7743230034 p. 6 HOME IMPROVEMENT CONTRACT Sold,Furnished and Installed by: Bran'e?h Name: '�N Date: b THD At-Home Services,Inc. d/b/a The Home Depot At-Home Services 1 345A•Greenwood Street,Worcester,MA 01607 Branch Nutnber:J DD I Job Toll Free(800)657-5182; Fax: 508-756-2859 Federal ID#75-2698460 ME Lic#C 02439 RI Cont.Lic#16427 Z Z .C[ 1 S' 73 CT Lic#565522; MA Home Improvement Contractor Reg.#126993 Installation Address: �j J"1 V1 L►Li�1� F-a MQ�SrI( }{YR AyW QW I ity _ State Zip Purchase s: Last 4 Di 'ts o river's Lic.# Ea Mo/Yr: Work Phone: Home WAuo (AJ Home Address:SX7is (If different from Installation Address) City State Zip E-mail Address(to receive updates and promotions from The Home Depot):IJ� Proiect Information: I/We/You("Purchaser"),the owners of the property located at the above installation address,offer to contract with Home Depot U.S.A.,Inc.(" mot")to furnish, deliver and arrange for the installation of all materials as described on the attached Spec Sheet 4: f'tt''1 incorporated herein by reference and made a part hereof. Home Depot reserves the right to cancel this contract if,upon re-inspection of the job,Home Depot determines that it cannot perform its obligations due to a structural problem with the home,pricing error;or because work required to complete the job was not included in the Spec Sheet or Contract. DEPOSIT PAYMENT OPTIONS l (Sullied to fund votilication andlorcredil approval.) 1 CONTRACT AMOUNT S "O . Check,Cashiers Check or US Postal Service Money Outer F ( "udcpayablclo"1'IialiomeDepot). `LESS DEPOSIT S �I 917 2• Credit Card*andlor other payment options-Circle One Below Visa MasterCard Discover American Fxpn:ss BALANCE DUE •rhe home Improvement 1.,oan The home De x>I Credit Card ON COMPLETION $ Cl New Account 1611 xisting Account ., (Ill),&IIDCC ONLY) "Minimum 25%of Contract Amount due upon execution Available Credit:$G, (I1IL&HDCC ONLY) f this contruct. Acctl. __ _... _ _Exp.Date: Indicate Payment Method For Name as it appears on earn: k,fLOp'_�_I/C I Vir�(b_ BALANCE DUE ON COMPLETION: 'By my./our signature below,I/We agree to allow home Depot to charge the above referenced it card for t r�deposit.in aced. D6L�� Cardholder's Signature .' Date HIL or HDCC Authorization Codes Deposit Final Payment Purchaser agrees that, immediately upon satisfactory completion of the work,Purchaser will execute a Completion Certificate and pay any balance due. Purchaser,also agrees to be jointly and severally obligated and liable hereunder. Entire A2regiment: This agreement and its attachments, including any financing agreement, contain the complete agreement between the parties and can nq�be amended or modified unless in writing In a separate agreement signed by both parties. NOTICE TO PURCHASER Do not sign this contract before you read it. You are entitled to a completely filled-in copy of the contract at the time you sign. Keep it to protect your rights. Do not sign a Completion Certificate before. this project is complete. Law prohibits home re air* contractors from requesting or accepting a Completion Certificate signed by the owner prior to the actual completion of the work to be performed under the contract. You may cancel this transaction at any time prior to midnight of the third business day,after the date of this contract. See Notice of Cancellation for an explanation of this right. There will be a service charge equal to 25% of the contract amount if the job is cancelled by Purchaser AFTER the third business day. BY MY/OUR SIGNATURE BELOW,UWE AGREE TO BE BOUND BY THE TERMS OF THIS CONTRACT. GAVE ACKNOWLEDGE RECEIPT OF A COPY OF THIS CONTRACT AND TWO COMPLETED COPIES OF THE NOTICE OF CANCELLATION. BY MY/OUR SIGNATURE BELOW, I/WE UNDERSTAND THAT TILE AGREI:MI NT IS SUBJECT TO REVIEW OF MY�OUR CREDIT HISTORY AND I.fW AUTHORIZE HOME DEPOT TO VERIFY AND REVIEW MY/OUR CREDIT RECORD WITH AN INDEPENDENT CREDIT 4EEP91?I'ING AGENCY AND RELEASE 'THEM FROM ALL LIABILITY INCURRED FROM f �t �a Town of Barnstable *Permit# Expires 6 n onths from issue iWe Regulatory Services Fee — 00 Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner IT 200 Main Street,Hyannis,MA 02601 AUG 2 6 2005(�g) www.town.barnstable.ma.us Office: 508-862-4038 TOWN �R�STi6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY lNot Valid without Red X-Press Imprint lap/parcel Number 1 roperty Address 1- 1 n (z 7R y k lAt-s5diential Value of Work 1)1 0 Q 0 + 00 Minimum fee of$25.00 for work under$6000.00 )wner's Name&Address I CC'i-Z C i C J ;ontractor's Name 3 C, 1f\ 1' C GL l,, Telephone Number lome Improvement Contractor License#(if applicable) ;onstruction Supervisor's License#(if applicable) -lWorkman's Compensation Insurance Chec e: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance nsurance Company Name iVorkman's Comp.Policy# ,opy of Insurance Compliance Certificate must be on file. 'ermit Request(check box) ge'Re-roof(stripping old shingles) All construction debris will betaken to S Tg C16, 5 to+t`d✓1 ❑,Re-roof(not stripping. Going over existing layers of roof) -- ❑ Re-side } rs3 r, 001 ❑ Replacement Windows. U-Value (maximum.44) `* 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Cons ation,et ***Note: Property Owner must sign Property Owner Letter of Permission. Ho, a Imp ovement ontractors License is required. ;IGNATURE: , ):Forms:expmtrg .evise071405 Results Page 1 of 1 Home Improvement Contractor Look Up Enter Search terms separated by spaces. Search terms can be Town/City,Name, or License number Select Search type: r AND C) OR Seaich Search Results Reg. No. Applicant Street City State Zip Name Title Expirati —8.6—. _ �. _ 146 9 JOHN MCKAY— BIL-LERICA, N. - `MA O1&62 MC Y' O EWN R E 0� AVER .BILL � JOHN J MCKAY 45 103765 CONSTRUCTION STETSON Norwell MA 02061 McKay, Owner 7/9/20C CO. SHRINE John LN. McKAY- 7 GEROGE JOHNSON, 143121 JOHNSON , INC. ST WEBSTER MA 01570 MICHAEL OWNER 6/18/20� Total of 3 Records matched. Back to Home Page BBRS Privacy Statement http://db.state.ma.usibbrs/hic.pl 8/26/2005 The Commonwealth of Massachusetts Department of Industrial Accidents _ Office.of Investigations, * . A ' 600 Washington Street Boston,MA 02111 ' * www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers .nplicant Information Please Print Legibly game (Business/Organization/mvidual): ddiess: J �J y I I h lty/State/Zip: fA + S / �'I A Phone#: re you an employer? Check the-appropriate box:. Type of project(required): ] Zama•employer with 4. ❑ I am a general contractor and I 6 New construction employees (full and/or part-time).* have hired the sub-contractors ❑ a sole proprietor or partner- listed on the attached sheet $ 7. Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp.insurance. 9. ❑ Building addition [No workers' comp.insurance 5. ❑.We'are a corporation and its officers have exercised their 10.❑ Electrical repairs or.additions . required;] � . . I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself.[No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.]t employees. [No workers' camp.insurance required.] 13.[] Other y applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: N )meowners who submit this affidavit indicating they are doing all-work and then hire outside contractors must submit a new affidavit indicating such ntractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp:policy information. n an employer that isproviding workers'compensation insurance for my employees.'Below is thepolicy andjob site. brmation. - urance-Company Name: icy#or Self-ins.Lie.#: Expiration.Date:, i Site Address: City/State/Zip: tack a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). lure to.secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a e up to$1,SOO,.OU and/or one-year imprisonment, as well as.civil penalties in the form of a STOPVORK ORDER and a line ap to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to.the Office of . restigations of the DIA for insurance coverage verification. o hereby certify under th pains and penalties of perjury that the information provided above is true and correct. ature: Date:' one#: Ojjicial use only. Do not write in this area,to be completed by city or town official. iciaX City or Town: PermitlLicense# - 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#: f_ i rlGe.� P oil P 4-xv'Al 'All Pikml 14013 .'%re -A10-' . w 'Diaa MEM SM wt z5 "N L A4 Al w 14, f�Zl iini' Am� tfiel 'r YA 46 1W. N7 �Zk ks;*,:%T - I �:-� : V. ---q,�7f pro A .WO TM Pe d Effif R. M : , , ' - :.' .- �� S - � 1 �-�•-- ��- - -__ -�.. _.__ —_ a —_ �- �_ _._..._.. —"'__ d_ .—�-- —� r, m y J t [`ITET_ ��L ST I N Gs i z 1'I ` I �£ F Y i -. : ». A.:,- .�:..:.-. .. .._ -., �...'. �. �..„> .d:b..�+'� try. - mY3FF�3� �! 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