Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0160 MARSTON AVENUE
l ;o � ,�� ,t Commanwealth of Massachusetts- :� - S et Metal Permit ` Maparcel Date: Z2 errah# _.._. �,pp _�- MAY 1.7�2017. Fated Job-Cost:3 , , Peffiit Fee•$ Plans Submitted.: NO TOWN 0� BARN ea YES NO Business License# Applicant License# Business Ink- mn = Property Owner/job,Locatlon.In&anaiion.: Name: l) Name: A� Street n � �� '`r' Street 0, / � Cityfl own_ ' Cityfrown Telephone: � � Telepho 06 Photo LID.required/Copy of Photo.LD. attached: YES - NO inI4aP S 1 =1 c stacted.linense • ` Al t _ J 2�M-2 resticted'to clove ' 3-stories or less and commercial up-to 10;000 sq. f� 12-stories or less Residential: 1-2 fancy Multi-famtiy- condo/Townhouses Otiid. .Commercial: Office Retail Industrial Educational i • Fire Dept Approval Institufi _ Other - q I Square Footage:'under 10,0D0•sq.ft. over.10,000:sq.ft. Dumber of Stories: i Sheet metal-workto be completed: New"Work: Renovation: HVAC Metal Watershed Roofing. Kitchen Exhaust system Metal-Chimney/Vents AirBalancing Provide detailed description of work to be done: r INSURANCE COVERAGE: I have a current rmbIfty.insurance policy pr its.eguNalentwhich meets-the regtriremants of PL-L Ch.112 Yes o ❑ If you have checked yjm,:indicatte type-of cdverage'by checkng file appropriate box.below: i A Eiabitrty. Insurance policy Other type of indemnity ❑ Bond ❑ OWNEWS INSSURAHC4 INA11+ER:'1 am.aware•ftsat the licensee&es.•nof have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that m sigraitum on'this-permit applicatiorr:wares this nxtuimment. Check One On y O"er- ❑ Agent ❑ ' fSigrrafure of Owner or•Owr W--s Agent 13Y checking thit.bax❑,'Phereby cer*that all of the details and Information•I have submttfed(or entered)regarding this application are true.aod a=urate to the best of my knowiedge and'that'all sheet nistal work and instditatiorts•performed under the pem*issued,forfiris.application will be in compliance with all pertinent provisiori-of the Massachusefts'building Code and Chapter 112 of the General Laws. Duct inspection required prior ta"insuiatlori installaflon:YES NO • Protsress•j=ecfibns l Dais Comments Final Instiecfion Date Comments 7master of-Ucen e. 3Y r ❑Master-Restricted . C1ty/Town , ❑Joumeypetsolt'. Signature of Licensee . .❑Joumeypermn-Restricted Ucense:NunibW., . =ee Check-at www_rnass,9200 irspecEor Signature of Permit Apprevar . � lfb , w$washifffibM S~eet F 1 E g,MA d2 . '4�ar �mo� .Ir�s�r����-B�rlersf�"�gfr-a;rfizrs biers Iufa�cafFmu. n Piece�� _ Name fiify-{5 = Phoneme CJ lire ym ag ember?&e&t&apWopriatc btF= TgPe of pa olett(r am k❑ I am a employer via4_ El aorta gel car and I 6- ❑New��� r ,�{€�Iopees(fall a�dtorgart-iime�* ha�etire�S MY I am a sole proprietor orparbaer listed onthearmed sheet �- ��°a ' Them vab-oonIradars have 8- Demnlifi= shFg aad have no empics�ees �InYees aad have workrss' ❑ �g form in any capacity isn m � - .g �HuL�g a&difim j T4 'ctimP-* rrr�e 'comp. n 1 S: We am❑ a c apmrafi�maad ifs 10 0 F1es-Ecal repaie or additions 3_❑ I am.a how doing1all or, officers I�ve eased @sir 1��bmg n�asns or addsh s` €[No -=nP- � p�1 Q. I2 0 Rnofrepa= 157,§1(4yaudwehxmnoZI car effipla�ees_II<Tff `. camp-i,=rance rapiruLl w�np�gs�IE%t dmd s b=VI�sr finornt s betvar T I wn�s subrm2�is ¢ t5eya�ri�gaII��Yan�$�Im�tr ao zca�tm�.,sf$�ra�3 in =ZT, $�FcSe�cthis5a�mr�ststtac'hr�uca �;fi�•,•r�shtr�gt�ten�eaf$yen,*�n"h`�rhel3�ts�2S�sE�ifws�isva � ffi�Ivye� If�e sv�r-c��ashave�pIv�,8�egma�t p¢uvi3e fl�ix•w�'oomF•Po���� �axs are s�rmyeF fhr�tsFrfr}�ag t�o-rt+ers'•eanq�sr�satrn�}n�M�ca f ar rah*empFbpss.� SeTot�is Si�,g��c}*and jnb siLa i Inge C OMPanyName:-: PvFicy�ar Sel�i�Tip� - • Bate: _ Ielr site Bch z wpy Gf the-workers'conrpeasatwa paFicy decLu-atioa page(vhow sg thepo 3'1€monbes$mod hiaa �: FOMM to secnre caveage as roTd�nmder Se�SA 0€1�c M cm lead to.tfar i-Pr"bon of�atual of a AI*$L5U�andfor one-year" as wen as civl pemi ies m$�e fona of$STGF WGRI�O$DEB.aad a 5= a dsg a�st fhe vio $e$$vised.fl a c of st soagbe fatwarded fu$Le€7Sce of €�DIAforundo�Tcs F ¢t$ss pFx tctiaa prassrahave rs t=told"CwTect , Vq MOM# C ' F}} ctd�aril}:"Do suit terms in t{ri�area,tit be cautgleteri b}�a�ru MY JE or Town: +tlTeense a IssvingAnffinxity( r le one L Eaard of He,,ja?.lgd$g I3eg�+mt I CitoTinm Clerk 4.Eled cal Ea=ctur 5_Pft- ter 6.C kh!er - -C:sEtact per se.,- Moos th information an.d bkructions hfk achnsetts General Laws chapter 152 requires all employers to provide worker'compensation for their employees. Pursuant-to this sue, an errplayee is defined as¢_every person in the service of another under any contact ofhirc, express or implied, oral orwarien» An employer is defined as"aa individual,partnemhrp,association,corporation or other legal entity,or amy two or more of the foregoing engaged in a joint enbmTrrise,and including the legal representa&es of a deceased employer,•or the receiver or trustee of as individual,pariaeahip,association or btl=legal entity,employing cmpIoyees- However the owner of a dwelling house having not more than three apart n=ds and who resides therein,or the occupant of the . dwelling house of another who employs persons to do mai ateoance,construction or repair work on such dwelling house or an the grounds or building appurtenant them shall not bemnse of such employment be deemed to bean employer.» MGL chapter 152, §25C(6)also states thgt revery state or Iocal lire agency shall withhold the iss-aance or renewal of a license or permit to operate a business or to construct buildings in the corn monvwealth for arty applicant who figs not produced acceptable evidence of compliance with the inenrar,ce coverage required Additionally,MGL chapter 152, §25CM states'Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compli nce with the inRxarce' requirements of this cbaptea have been presented to the contracting anthority.- Applicants Please fill out the workers'compensation affidavit mmpletrly,by chug the boxes that apply to your situation and,if necessary,supply sub-contczntor{s)namme(s),address(es)and phone numbers)along with their cmtfficate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)withno employees other than the, members or partaers,are not requited to carry workers'compensation io� ce If an LLC or LLP does have " employees, a policy is required. Be advised that mis affidavit may be c-uT,mittrri to the Department of Industrial Accidents for confirmation of insurance ooveaage. Also be sure to sign and date the affidavit The affidavit sbould 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 gamt ons regarding me law or if your are required to obtain a workers' compcosatioa policy,please call me Department at the number listed below. Self-insured companies should enter their self-firma,ce license number on the appropriate lime. City or TOWM Officials Please be sum 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 Y wear the Office ofIn •ors to vestigatc has contact you re the applicant - Please 1'�g app Please be sure to fill in the pennit/license number which will be used as a ref rence number. In addition,an applicant that must submit multiple pemnit(licanse applutaiions a any givesr year.need o submit onea dave indicating g c. r7'nt policy is won(if necessary)and under"lob Site Address-the applicant should t�d� -,"all locations in (city or town)."A copy of the affidavit$athas beta officially stamped or markedby the city or town may be provided to the applicant as proof.that.a valid affidavit is on file far 51t=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. (Le,a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office,of Investigations would h7ce to than you in advance fur your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone and fax nwnbea-: as COMMM.�lth of Msssachvmt� Depait=at of dal AQc�dents BQODz Mai(2I 11 TrrI, 617 727-4-9-00 at406 or 1-&Tr-MALSA�� Revised 4-24-07 F=#6I7-727-7749 W W W. goVdia w �IHE Town of Barnstable Regulatory Services , Richard V.Scali,Director A. Building Division: Paul Roma,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 K-e— e— Vl.a ; as Owner of the subject property hereby authorize e a to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) . **Pool fences and alarms are the re onsibility of the a licant Pools are not to be filled or utilized befo e fence is installe d all final inspections are perfon ed and acce ted. S' of et S41 O?Apphcant ti e e l ` . Print Name Print Name I/1\✓ �' \�, •' _# ,. } is -- e - _ - s. 7� ' „Date Q:FORNIS:OWNERPERMISSIONPOOLS ix :OMMONWF. lLTk1 O�M cCHit '—1TS,..." oAla ol . } IT O KERS" " 7SSUES�p,._MF U OWINMEJOE S-E-PASTA �z� a IwA,�TEW NR€ST I;GTED SEAM.-F ULEARI( a PfM01�TFI; ItAQ2360 23�0 �� a z' r ;:ff a �7985��.� �'' rim=�.+cnac•....: ���- . • e OMMONWALTHOMHl3S.ETT 'I �� � • • • • � III � HEET IFIALMORKER rySUES�HE F(1LLINGGNSEkS A . AST lR UNRESTRICTED SEAi+�FAO LEARY y� PL''�yM013TM;M 02360 2390j 79 U412all 018; "53189 ' I , i !9. f Town of Barnstable. SHE Regulatory Services F Tp� o Richard V. Scali,Director '+ -Building Division sexivsxwBM M' Paul Roma,Building Commissioner �iDlFo 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax��-790-6230 Approved: _1X Fee: `3S Permit#: HOME OCCUPATION REGISTRATION Date: f ilia) 10_U1 � Name: (` L V—bCLV--a EY GI m Pit,h_ Phone#: SO 8 `0 W8' (Da 19 Address: (CjaU fyb_r S�-uy1 'Ay E J_s Village: R h Yl 1 S Name of Business: �V k Y_Ck Y�CI )Cl Vl (P��'1 Y a h ���u C-t't c;'Yl •• � Type of Business: 0i1 Yl GQ ar+ C)V1Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation' within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit.' • Such use occupies no more than 400 square feet of space. _ • There are no external alterations to the dwelling which are not customary in residential buildings',and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve-the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard ; • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to• exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. , 1,the undersigned,have read and agree with the above restrictions for my home occupation I am registering.- ' Applicant: LQa(GX' G1 -4 ( Date: Homeoc.doc Rev.06/20/16 ' YOU WISH TO OPEN A BUSINESS? For Your Information: . Business certificat s (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to.operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st Fl:, 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required bylaw.EM / DATE: I�-(! R 1 a 0 l4 Fill in please: M. APPLICANT'S YOUR NAME/S: ' n z BUSINESS YOUR' HOME ADDRESS: 160 tMa rS OVI f't I S 50(S (n - to k1f St 2 too TELEPHONE Home Telephone Number - - 0-0 ., � NAME OF CORPORATION: ari-.)CA rCA av-1 itDko r - NAME OF NEW BUSINESS TYPE OF BUSINESS Phy"t i n.Sf Ll t on c�vl ck Ay-t- IS THIS A HOME OCCUPATION? X YES NO cc ADDRESS OF BUSINESS l(jQ E -d, �� q)lm5 OZ U) MAP/PARCEL NUMBER D� (Assessing) , When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has be n infer d of any permit requirements that pertain to this type of business. DUST COMPLY WITH HOME OCCUPATION u ized Signature** RULES AND REGULATIONS. FAILURE TO COMMENTS: C �a��-� '� ' pLY MAY RESULT IN FINES. 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: �7 Town of Barnstable Building �Post:TMs CadoTha '�" �'� �� .uA"� rouedPlans�M s :lie R�eiam'ed�on�Job�and�thisCard Musbe�Ke t t�i is Visible From the Street pp u t p Permit p r m 7+ R r,Wherea Certificate ofxOccu �' Re uiretlsuch Bu�ld�n tsF�all Npt be �ccu ied�until a.F�nal;lns ection�has been�made �_ 1 �1 111j 1. Permit NO. B-17-412 Applicant Name: MALACHY THORNTON Approvals Date Issued: 03/09/2017 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 09/09/2017 Foundation: ` Residential Map/Lot 288-180 OON Zoning District: SPLIT Sheathing: Location: 160 UNIT 14 MARSTON AVENUE,HYANNIS r Contracb 1 ame MALACHYTHORNTON Framing:_ 1 - Owner on Record: COWPERTHWAITE,JANE. C01 ontractor License 138796 2 Address: 19.HOUND PACK CIRCLE Est P�pjpct Cost: $4,500.00 Chimney: EAST WALPOLE, MA 02032 . , r , Permit Fee: $85.00 Description: install new kitchen cabinets,change kitchen ceiling from cathedral to Insulation: Fee Paid: $85.00 flat A, � Olt � Date 3/9/2017 Final: Project Review Req: install new kitchen cabinets,change kitcheceilmg fromKPI! , cathedral to flat Plumbing/Gas a Rough Plumbing: ,Buildmg Official Final Plumbing: g: This permit shall be deemed abandoned and invalid unless the work authonzed1O ffiis permit is commenced within six months arft Vssuance. All work authorized by this permit shall conform to the approved appUcat�on and�the approved construction documents for which this permit has been granted. . Rough Gas: All construction,alterations and changes of use of any.building and structuresshaII in compliance with the local zon,g by laws and codes. Final Gas: This permit shall be displayed in a location_clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. x 3 Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the0,Buildmg and Fire Officials are provided on this.permit. Service: W Minimum of Five Call Inspections Required for All Construct' k: on or 1.Foundation or Footing ' r Rough: 2.Sheathing Inspection X .. r 3.All fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building,plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ," _-fOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel PP l/V A lication # 7 � Health Division Date Issued Conservation DivisionF� �� Application Fee Planning Dept. 20,E 'ram `�°� Permit Feed Date Definitive Plan Approved by Planning Board 'S? Historic - OKH _ Preservation/Hyannis Project Street Address I D D M4kS 7#/1 4 D E f f Village N y.NN 1 S Owner 0/E COOM4Wti11C AddressJ9 #00b PW C1kQC1&.k1hU'0te Telephone -7 8 1 2 S 4 O 4 f Permit Request INS•TAL' AIW KITCIICA/ CAB(1VGT9 006-C OyEy CC/IINA, tio� chiHtp�RC Tu FLU1 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District . W61ood Plain Groundwater Overlay Project Valuation 1500 06 Construction Type EMOOCL ' Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family a Two Family ❑ Multi-Family(# units) Age of Existing Structure S I Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout Other &&EMCA17 L171 C/7y AAEA Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 2-- new Half: existing new Number of Bedrooms: 2 existing _new Total Room Count (not including baths): existing S_ new First Floor Room Count Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other Central Air: AkYes ❑ No Fireplaces: Existing Yff New Existing wood/coal stove: ❑Yes ONo Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization 0 Appeal # Recorded ❑ Commercial ❑Yes .allo If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name M A LAC H V40O N 7O Al Telephone Number 208 7 2� d�r 7 Address 2 2 coNST,4Nu License # C-S , 62 4 15 3 W- Y amouiH AAA 0207 Home Improvement Contractor# 13 1?7 y b Email MALL-0 4 t 007AI AI L - Cohj Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO W-MAIN 4-4AIS P.Gk S'V 10 SIGNATURE DATE �s FEB- Z017 FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Official - Executive • •' Public • Safety im tag Mass.Go�HoFri-e-''State Agencies ass. .. L)emDetails a hic Information 9 p Full Name: MALACHY THORNTON Omer Name: icense Aaaress information City: West Yarmouth State: MA Zipcode: 02673 o nt : U 'ted Qtates icense inTormation License No: CS-084153 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 2/8/2017 Issue Date: Expiration Date: 1/18/2019 License Status: Active Today's Date: 2/15/2017 Secondary License Type: Doing Business As: tus Chan e R s License Re wal . Prerequisite InTormation No Prerequisite Information Close Window ©20.11mCommonwealth.of Massachusetts Site.Policies Contact Us lk l, _ = n � . ��ie�po-���rraorccacalC�a�C�/�la��ccc�c%aeCle '+ -Office of Consumer Affairs&Business Regulation License or registration valid for�ndividul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: , 138796 Type: Office of Consumer Affairs and Business Regulation , Expiration` 5/13/201] Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 =- e MALACHY THORNTAN ON ,- Y ` MALACHY THORNTON. � 32 CONSTAN_CE AVE j � W.YARMOUTH,MA 02673 ,Y Undersecretary o valid without signature , _ ,-..''-"`." ,'i•Y�Y'"'X.3'� ,�:.. ,� -. r ,s,* (k..,Ec tiY.Y;��c r.-.: a- '.'.{�#,-+"'174' .'?._ 'a_ - w -c ,...x cr" :.[.�: � -f1`.tt s;4., ,�.r�.. s ...,- �N ..3,r ^mom• ,reL.=�- try"iv - r at �iE. "?`��."'3 tfr h�T�; '�.xs�. S; . c>"0-,a�Y55:" ;S r ':r.'{G'-"sa 313'r „^e�'rri;.• ^7'i�„g.�.wlr'x L 4�.-'"�' lanR`k-ry ••tr$ rr ; w�_,.au,�t � - e%N- �� -� � �ct�.��+.�,��g�,� c-�f �•+Mr��•�� �r`�y ��'� �jr,`-y. �' :�""r' � �, �,`'� �j� �,�� ,�- k .t`e� - .`Fc .� _ a•Y -',- - ;C '�'\ 4-{t y.4 i� t..t4:, l}' ?Y 'ram^'"-u cam'! o-;Y 3Lf �F. ('ri' y�f�,9'..:.,Ks' i�`{5r..'#• 4 �'+� `y H I'�}.� F.. �'y '�zi'=i api,t'3'. ,w•r'"` i'Y oi,.'^zfw"$c:3� ..zE ,�-..-e -tgzi`.`" "t M1. SF �-,� fE{,ieS n 5 y„;.,x++ r43ya �,' y,T a it r `f.:`_tt c1}2S< •} 3 :'�'� '�C --a�� �'�>."s:s'��`a" "�S�.�i .�` sS '' s-:� ��"+'`��x PF FzC�,� �`�.�`;�d `"'` �`:oia�-~5 -"�tti�• '`'. n"Y-:.a�,,•� .��2--��Ea,+ •'G��E t- ,�_. -ce ;dhr=+;si^ "�" ..�'�`'+�- �'�• -":F} �'."t'� 'k {'5 rv. V ;cks U•-; "C .'.i n a.{'.s 1�Fv :.x-, fztir y: r z:l ',._r�s t st;J:- �z`� #u �;� 5'y,r.. "�frZri ?' �"�` fk f3"`"k'Y�3c.^->y- .:` c. r' '�•r, ,�.o-4:�'ti ,'- ' ;s?"k ti a �a e_.a z� per., Si3l c:r r" .-''. .ui `�`i' &�'-rts z;ussW. - ja y u w fat h�l w �-�: �,�:.. - � �5 � ��'"-:.-.p�*s' v�'�'arF-�� �'z. x `�''-�r ``5-['4. "'- r.Ji tx'xc='-.y-f`4. .at �'..,x'i:,- r'::avY _u' Y ,4G.:. r'y`�y,r-! iA 'a N z, �'�5..� pair�.4fi3 -�sa-�. -�>�4*' �.u�" 3,.e�,� ,+ K k s q'kc3 f i � � � ''fi��e.W'3; ,',�k�r,�'".�.-z�,•w. r3 NO r x:�'� �'.F. -��F,,.�,-�.a��C ��}� '�'iia ,3:3���k?a•�,x .:-s�-� t -a k it�.j` :.; �y�t t��,»�`*,�Z�ty �:°'�- y,*i�,e.�l.�"{�ro.,.,�;'�,i`��� � T,5 s >��,:�.s7ls'�jn�'w� a�.i.�+��-���-.`'�i��` 1�:�3•. - .� ,�� r� ��,- � 5(t. �,l�� �.p .. ,.�k - ,� a .s:, ,rJ.`�,,v k .f` a r'�r r-:.r�, €• �,,.a.�� �v+.,, yM. � �y�sY'� ?4 "� �t f Td .y 'rf:� t c� "�+.:�f'n^`F'£L�7� a arc y� �• � y'fr`P�v. �.d�r`"Si,7v��,tl��i��� ���''�y4, e� r a�n. `�.c�1 :x .+�.;=`��ww n��j r� � r ^x,�.c ,�y :<s' t.lti - � �t _ -._�,.� LL.. A i d t r�`rtz '� � s;��y x-� �•r[�f �`s�. "�sf F��k� sp '�� �'� ���. 'z �.xS,'uaA;,.s �`Z..� :r:-z! fi. '". .;,'M w..ac,'''z -' ., ."Y ';+.. ... A-gn'€,a�. ,1Lk,. .n„ ._,ae:•��r vim, �..±. fi4.R4,7',5:.:::`............ ..cF`.�G,x,.;t: '�+,c.�.`�#:���� rs_.,::--£3a "a"`'knv ..'`�•-'�'�.tiaS'_,.•,-.d . http://elicense.chs.state.ma.us/Verification/Details.aspx?agency_id=1&license_id=273099& 2115/17,8:20 AM Page 1of1 f dotloop signature verification:www.dotloop.com/my/verification/DL-219486325-2-1627 �SMEr Town of Barnstable g Regulatory Services WeSTAE'g, Richard V.Scali,Director a639 JbA Building Division FO � , 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, Jane Cowperthwaite ,as Owner of the subject property hereby authorize LMalachy Thornton to act on my behalf, in all matters relative to work authorized by this building permit application for: 160 Marston Ave,#14,Hyannis MA (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. d,do,p rifled LJQW- cPT-GM EST LJQW-MCPT-C3FR-NWSW Signature of Owner Signa of Applicant Jane Cowperthwaite Malachy Thornton Print Name Print Name 02/15/2017 Date The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information `f Please Print Legibly Name(Business/Organization/Individual): L AC I�7 Address: 3 2- CO O S7/ NUS AVE. W, City/State/ZipVI YA moklo 14010 Phone#: 3 N 2-770 Are you an employer?Check the appropriate bog: 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 g. Demolition workingfor me in an capacity. employees and have workers' Y P h' 9. Building addition [No workers'comp.insurance comp.insurance. r required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11. 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 It 1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or.Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one=year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify n er the pai and —alties ofperjury that the information provided above is true and correct SigLiature: �✓`l Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit[License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other +. Contact Person: Phone#: Y r ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION t t Map Parcel Permit# A Health Division u h16 Date Issued s Q QA oq o/6 Conservation Division / G `�P��iS; ococor-k 'y - Application Fee - - Piw�s s��P w l 1 Tax Collector Permit Fe? AO 4 -C-d Treasurer 4?e aC 3�G T E10 f:fJ3:y: 11MALLED IN WN7PLK;���, Planning Dept. V9llThi T17LE 5 Date Definitive Plan Approved by Planning Board ENIARONMENTAL CODE AN' TOWN REGULATlor,:- Historic-OKH Preservation/Hyannis &dOhm f #A/ Project Street Address Village Rum RAJ m�S Pa p—T Owner Trno M0C_C _tL Address 386 `31ue- ''otLL ?-%)o Che3Teg t!r Telephone �62 185� Permit Request mwx e5F Ek(Sf tCJ5 —sC+2eea--,Ct1 rN 2C4 aaD . c c e— To 13A --�rs QP_�e T� V�'10�l�+c. �Z 1�1�-1 f-�- /l\1 -�t�h; P$�Ce�tom.L /W1eJD,ULJ V!a5RAn'� Square feet:.1 st floor: existing 6 2. proposed 2nd floor: existing _ proposed Total new q& Zoning District flood Plain Groundwater Overlay Project Valuation$ 000 Construction Type, 000;0 rR P^5 Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 50� Historic House: ❑Yes )6,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 I new 2 b`a-L Half:existing new F� Number of Bedrooms: existing new -3 To«`- Total Room Count(not including baths): existing new Sr-. First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil Electric ❑Other C0 NU EeL70 NN '6 �F to(} Qy G-k-S Central Air: ❑Yes 4No Fireplaces: Existing ( New Existing wood/coal stove: ❑Yes *No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use .Proposed Use BUILDER INFORMATION Name �( � ej�L.ac.JS Telephone Number 7 6 j Address �C, e4-t N- 51 License# 1!)L40 S—f- ✓4 Home Improvement.Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ���S7-Ar-)'L-E SIGNATURE BATE O FOR OFFICIAL USE ONLY PERMIT NO. l - t I DATE ISSUED ;Srf j MAP/PARCEL NO. ADDRESS VILLAGE _ .r OWNER ^ ' t DATE OF INSPECTION: 1 f FOUNDATION �6 FRAME INSULATION S U 1 B FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH., FINAL, GAS: ROUGH FINAL FINAL BUILDING I N 6e- v DATE CLOSED OUT .I ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office 0110yesti nfaffs 600 Washington Street Boston,Mass. 02111 Workers' Cam ensation Insurance AIRdaNit name {-E 6t 20 5 location: 01110 city INS A-S R-e�-Ii-- ❑ I am a homeowner performing all work myself. ❑ I am a sole rgrietor and have no one worldn in ca achy 10,011, /%%%/G%%%/G/%%%%�//////%�G//% < I am an em I rovidin workers' compensation for my employees working on this job. ❑ Ty�P .............. ...::.r.n:tv:...Y..:...t:..,.:r.:......L:.}:r:}:::}}:::4;?•%<.}}:.:?::$::::.:h:;�::.::;::::::..,.,,.n.....r:J] .k. .�.\:.:::., ::.�:. .... ...........i........... ,v v:t .......,.....•..}.r::v..:.....h. ,...... .a:vh•..... .n....;•v:v.... ..t.,.....;::;.`,i';T$ n :.}.. •A•{::tn•?•i{.+•:2>i•:{ ... v•.;n...rnx.n.........:..:...}..v:}A}.:%.,.N...t..:.w:•.$.n....n.n..+....;/,..:•;;;,.:}%{•}•....v.,.r. 'J $:::::v{:+•:•`.•}$'{$n..... r. v.t..:......v..v....n... .:..:.r. h... .....r.........v.........n.....•::::r.....:v:v:.,+:n...v .;.. ::.; v.{;J v... Cv.; v..:rr. .....r.. ...:.... r. : ...3.. vY...... ...v.;; :..r..... r}:: .v y . .n.w..... rvr:. ...v.:.::.:•3, v. ..{{.n ...n...vr:: YS:t•v+::vnv:. ..,...::••. ;, v :?.{.. :.,: :. '}� {+y{__;:n .;,-1ti.`' rr^E$:v.::jY:: .v..: vE}+:.,•:]i,:yi:'?.:$$.`•}S;v•.n•.r. r 3,•vr,, :?:ij:i}::j$$:':v� $•.:}x�•:}::J: :+v' :r\•ay.;?} amen{;::>{•. � .. .. ..,.::. :}. ...: tr :,,. . ... ................................:.... n.::•::..:7:}% {•}}tv:•:}.v:.}}::C}'•} �:.:•T;{.;�{..u:r:r::v.•h•:••.}:.•'{:iv•:•:i3,}Fw.: :7.'vnv.. {v\......}n.t... ....................:n..... .:..v r. t r......:,......h\........:n.....r.. ...v`• {.r..... ...n,.t.:..+�.r vh•.v.�v..$+R{}%'i'iii$i•rrr::: '.}... ,nC+•a`r•:J.;�•.: \., 3 •:r.v:::.... ........ J•,.x..}v:•W/ x....vuv}.:.•}..:n.., :r.......... ..... .... :...r:xr.r.v.: .::va•t....y:,,,:,., 3 r.r .... ....... :.....r. .. ..... ....::.::.�::....,... .• :•.a•::: n••::::•.....,3..n r:::Sr,•:•. .:?io-::}3$:•:i{•;w:;;?}:::.::'Y.;•:{{.::�:�:�•:};27.:+ .,:?r}>..:r:n:::•.s%•.SJ:••::;SiY ..R,/..•:...:fF..a+.... a: }n; .v}Y{?v. J:Yjn :•}?n.• `C.i,R ...........: :.. ...:.. ....r• •.w:•...:::::::•.a.::.v\J ::•:?•:•;t,'.vv.`+.{•;:v +...S.v{.•.v}::r}.•. ..W;}y;`:}}{.}vn;:.}» .;UC:4<�•..:},vi:vn:?av v:)J.viry iv�l:i?}\{i:{fi r`.a`.$rr ;}}•• {3•o-Y ..T i•:an+ •:ti••{{:•}+'; .r .{••:? }T{:.;•..}, .w......2a}.}} ':?fS. .4.., ...i3'• .•h.. ?t3..r .$ti�.n v'�.`.,..�:$v<i •RR{J ...r {:•$Y}}:+.}•:?;}i .. n•nv .n..v......:•h R?n;.:::Ri..':»v}'ti...r v:iC. vr'.�•}$$.{:�i:}�.+.v:..}... w:. ..:......v.s.,..::. .r.:{{t??{ ..?•:::r ..... n,..r,r.t.... .n.n... •$rG.}: •.:C,{•h ..h..•?,.. •:v. jp� .. �y ........... .. C u. , r n... .. {" } '}ti;}•W�l�•�•'%`.v` :,: 0..r{' 5 Y 1 q { \ �f LL ZW Y} r ] h 3 \ \:Jr•Y•:{:;:}$}}Yr:.v $$$':•r}:?.. {..♦ ':vv: vv}..:•ur3:.., ::fi• {v� `T V ��? } p { h { .v'v::•. f t h ..... ..t ,... ...r ......::. ..\••:?w::••,,.....v:•.,••. .. v:.:::::?v:+• •.•.:i•..n.. .nr ..:{.:::v:C:;: r.. ...r... ...:..n+..r.nn.v...... ..... ..rn ............. ........ ...t ....r.....,.n .............,}v. ...,? .t 4r.{.C+. xC% ,.r.... ...........v.r. :v:...r }...r. v....:......... .. ..:r•. ...F..:. ......:... .......h....r... n• .v.......�.a..}n :.:�:v:::+: f.::. n..v ...../... n..}......F.,..r ......n.. ....... ..:. .: ..r...v.v...,.. ... .: n. n...v .4•... }}:kY;%A: .;4'In y,E .,.t,. ...w.a .°tJ +Y .? h:?}•.,r ::�t:;:;. ,4ryJ.. .:a.•:•vr:: .:;i }. h•: r..;• :r it11�e dllte` t)z >:$$ � ?� F�T}:•J:.::;.:.•r.}:.:...,r:..... .::.:•. t a sole proprietor,general contractor, or homeowner(circle one) and have hired the contractors listed below who have efollowin workers' co ensation Da es: 3 , },,m� .............F.... ..................:v.tr:x,,••..::.•.•.,v•:n•n:i}}}}}%{.}h+:a%•}}SS:a%3Y AhYR2:':{.vr,•:n•:3•;..:?it..%:i:<M1{i�$):<; +C;.+,:,�v:} {:•\,,... •,:,t,;t+•',•;`•�'• tL� t.............tn........,nr............vv•:}.....n..hn ......n...v.................v::vv::.v...nJ•. $... nn v» t...... R.::tiC>.\..v•\•.{<.. •1: :•+r:•avn t''•:;%{v.. .. ....... ........ v•Y..:,»•n...n.t n:v n..r:r, ...........n........:::•:n::::. vn.vn: n.. {n. v.,;...:........... • .....na•.. .:...:.x: .......rr:..}.. ,•:•:•r.................:... .:::....:::•.�:::...............::•:::�:..... ,••r:r}:?a:{•}:t•.:.,..,{{t;;a>{•..:. .;•3.:;;Y,;k;}}; :...ro.:.......r.,........:..,•..,.......}:...r. .9.........\..... : .. ............................ .. .................r....{... .:..:......: .37...:rt•:.....,•.;:.$;a:.tJ::•�" .h.: ...;\,tw ...Y....n... ......:.......:.......... .:.... .......... 4.................... ....n...• n...,,..............,..........J:. ,.... .......r n.n::•:•w.:nw:w::::: :":...: v..:\{.v.:.. •%•'l•.t:•:3.•$$$}; n... ,r:{^:r::-•::r::nJ•:••rny:•r ... n .,,,..},}, .: ..r.:::•:,,•.-n•:.J. ..F..., {•::3;.;;an.::x.v:7.v:nvnv.}:.}•.}}$'r,•}:.}}y;i{>L{•nv.{•::•.... .....t...::•n:••:•.vy 3.}$J +:n}Y:ivn•::•.a{v•:.v:•:J vv ,:.:.vvn .:..n.................+..• :4.T....`.•.....n... ,:.}i..:...Sr..v}i,,. $. ;.':\R: n'tit:h n{\'i..v a}n• r?3: •.Div.�::::T.tt:<•:+•:.:%•:......t•:nR>..:,$::4R..;:.,..},;.a..}.•T.•:4.:..,•.,•:::..}.,•:•:::::. „ .........r.... .,•::... .?• .. ..........rnn... .. n... Y .., ...............u..r.............t....r:.t�n•:a........... .........,. ,.{a..;;}...;r::.e.;{.;..:;.;•. ..}•. :,r�.; .\ n.. .•t....}..t,.a..............t........,...n...:..............t....... .... r.rn,.,.. r.... s?;".;:t.;•. ,:<:;$};$; ., ;at•: Y} #•n ;>>'{ r.tr?.. .t...:. ...........,.n•....r. ...{.. ....:........ ,...........t.,.......,..,... ..... . .. .•.. r:•.,.......... t.,•.\•...... .r .:r.::•':i � r>.•]•r{4`�•: ..o:::: .v\•T. .vh•:.:?•:•r .,x,:..:..:n ..yr.:.., ;....,\:Jx. t.,•.,:•:'•:n•w:::}:+J::•Y::::;:v,}•.;,, :2':y., :.�•:r} ......,;;:$$•.So-}}}.: .n... ..}..Y.w.:.n..:.vn....v}:r }.:::..r....,}n::•\::•}::....:.,;..v..... ...... , ...n.v...• .w:v .v r ..:n. .v..$.t.,}.. r...,....i :....r... :. fin............:. .......v.an ..:.... ,r:.,,......t.. ....x•..r::'• .. }::. }•.t .r..n n.:......:....... ...F....v.......k.a.h. hr,.. ...........t.. .. .. .........:v;...... h••......t.............h..\..?...n ..{n+ki.r �:::•.!?:•.,v;n.:.{v:.•:::}::•:\:•;v•;rv}.C+:.v:-:}::::::fr:Y.}yt;..nhv:::•n..::.:•.:::•'C•n•]?.v.v::.?•:n..............:n..... •,v..:.v::4.}T;{:•::::{•:}+:•n+}run{.:'iC:{•i:Y:ti•}:.v:v:.n:w:.} •rxsm .an .name::"::+•• '..:}•}}}:• t•:::.•{.:}..;.., ..» .nr..::+{rs}$Yi::•'ti:;'i:;•+::?;{:Si;•R:{i:;:k:::•$$$:::•$^.$$;y:�,� .vvn.n..»p. .......... ...... ................::..v...::.v...........i in•:::•xv+w:;v:::.V:::+::v vv}v:{?':...:....:r::•}•.i}}•v:r.y.{:.. ... .....}}.$...a•:ra+}tv:;}.:+.,:}...}. +;T•:n 74;{n... •r: ....... ........ ...n..»r...;:,..... •.•.r...,;:.r.,t•::::•r:r.:x.tr..:.$.v.3.•.:,.T::::::n:?•.:.:T.:t•n:r. t......•:•.:::i•::::......:::}}Lr...k�.;...., ...,..:....r.r...a,..,t;r; .}.;,•.i}..;};:.r:}}T•?}h ,r.}trr. ,y.a.r n fr.`.;};}; r.r :t•:.o-.»•:r:.. ..L \•+.,•n• ..T.. .;.?:n:.i ._.?........ ..]}..;;t;6,..r:. ..C. :.at,;.t.Y•n+. ;.i..:n:t:•:•t::.::.t:::.. .-r).n.S.. .•.. .k:::...}EY?th$:d{.r.{...... ;b.{S.f?r.Y.;.:$ti,.3: 6.,•. .}:•:✓.•}:... tr•+:•i:•:•{or•.:.. ..r..,.>�:?t... .t;{;:•:u#•%tY{tJ aa:aY{F:♦ ..;:v}: v.• ......i:.......:..An.....+,:.rY,.X... •vr.•::R$.. :•:i+.ii...... .h.v.•%•`.:vvx: \..: v..irr:.}:{Y::tr{• .{}:. ....vr .. ........ ....n• .v.....#r.n.}: .........:.h.....;....... .n{tCr:h}%?ifi:a;.}}}}r•.v:vh+:x.:$f:+'?{vi:'taifJ:3:{rr.;i^'•:a$:?:C:C:+'•rv::.x vn?a:+.v .}.::::}::}'v..:..�}.th+G••\v.•:•:::•v.• r.:n•x{;}•r..C}vr:w. ..::.:..:. ..{::•: ..{:+w::.•:rr.: :::::.Y::{v:�:+v: •n?•:]. v.a...$:.1 ::\•:.::hv,t }}...:a. ?itv. yi,..:i?•:: n3. .i:YF:. nf. ,S.v ..7.....Yvn?•;{•.:... v./.:Sh.....%{•}.{+.;YC....;..+, rL{.,aar}%t•::SYC; •$$:•+:'+ \4}%'}:•:�{iv$?.;;•v.•]'-N�rv$.v�-}rii++.:}';i�tJ. :. .}:r}::..: •+:3,......fY'r+t?�::S:i.`v'r'•v3:•.....>>t....n., ...,.............. . .. {}•:{$•v::.•: ....J.....v...:}$n. .Sr r�Jriv� .:.;.. ..�•.•:::.a., •}x. :,.i..$.::4':{:.}r}}{:;`Y${$$.,,+.i••it .::•h,:......:v•}•�.v•:Jv.;{:.•. .Y:: {:ifvv:•rS.G.v.w}%J .{ vl..r.+{v vn••:}.. r .,.:.:,•:2..:r: `:J?.fi t•+i:.}^}.vi•::C..t•.a$vhvi•r:?%}':.:{T:`:•{+$'::• .}. •:...: Y:i•:t:{:.;. ..L:••::..r.. -t.. .,h:•::}T. ...:2.. �. ....R•:,t%.r:+r:`{ Lw 4.:•{. .,...•,t {.:$:.: ..•::.:•• :•:r.;;..::•:.::•.4 ,..:.o.:+r>r•:Y•}:n:•rS:{,c• t::?5,;.:}tra..:.}„Y {•:.k•r}::...s2:,•:}• a;.?.:•....... ...•'•:.•:tr{..`..{i{{{.:}::'h:}{},C}i{?S:n::}�.v'.}:r}n x.?v7.}+:. .. ... .:•}••::ry.::........... .............. .;.........]%J{+:vp:+}v:::.}..,,%4$:'.:,{.•+:'•.\4Ji,J{i,{•Y•}•.:.:ti}.n..;ti..;.,v y}ip�:;{;{i••$>:�;:7 ............. ... ....:x:::w.::::•::n•....:.... .......,.. ..J.no-\S+ :'a77}' r. »\{:}::' v;t;{. ;h{a.{ 2...{•: ........ .. ,.... ........:... .:.......a..r....,.. :}.?:,;:c:;.::$S$•;};.,;•};.;•;.::;{;:y;J{}d':}:?,\.,'s;:•:}'Jr`:\d'4 rn.aQ:} ;{}}>}.3?.: +ti�w'}••titn�•:`�'�R>.::.r:••{` ..n••r.:•::•+�:•r.......•rr:i,:.r:.n...::.{••r.a•r:...r ,}s:.. .,:.,:•:.a,Sn::T..%.,:••.,a:d,.r...:.;,.. ,R:.} .Fr::�•::::, ,,.+.:tk..t•�}.i•+},+T}t•J• •o.:at..n.. .n.??Af•;;�:r o-,{{{>r•?i•:�Sxa;;?•,:•:y,�:Ya`,.:. n.et:. ,.'f}2;:;. :.r:%:+:•r:.,.t,,. .nta.,....:G.y,a;..r„ r.;}t+ 3.r m.3..;S..:rr .}...:{..,.;{;. {aq, $..,...:•rr•J:+.va,+�' .a*. :•S..:t a•v..,.•�'R;$a• }{...�b.:r..•.:fit..},,s,C:•n r::J. ,\r$•Y.,'•}r^^`t, .r.v .... rv': .,,}`+. h t•{ .:k •4::?r .•3•o-c{:,. .?€?,J{'a] a:t •:}r+ ::}.:J +.,<•.. •:{:Y. �;•:}$, x+::f•`. .Efi,'•}} ~,KR..hc:?.;�:7.4:•.. �.".Y..:}r+.i: .r..rf.••}:: .;7.. •:r Jr .r::..r.3o-`^c::....r .,%,»t•.;;;:•ii•}Ro-r ::;}{•}raY:$;3-:,+i�ftt•:;<•+r}r{•:.• r:{{.}{;;;•,,%.}%•: .:7:.. \• R••.'.. •$:a� a.. 'ir... .....r. f�........vY.+T,'y}•.n..t. ..{.,..?L•:.$. ..n..n...n•:... .tnr n;.}.. r...}.. .. } {••Y:\v.;.;Jv•.»;ST::"}++::.v}•:::'Q;�h,,?nv:%n}:j•;v,•Y •..Q.»:;.}}.,y..,}:}ii .r h...;n.;•:?'i:{C:: }xr ,,��ppr.i.r wSY'• .4:• :. •.:.xn .:'.h.}n.:r Ji:... .:•.}•t:.}}n.;.;..}:?nx....R•:•34 v.+.:3.}:Y%•::}:x+:•i+}•.}•.J.T:• ,.....;. .C.. }yy'.•..?•.. .r. .�:.F.. •:o:%t.r . :r`•+.+rn..b.:.... :$r::..•:...,7.v+•.:.:.♦ .{.;y:.,..:•.•. r.S:?:;.y.... ;;$,..n;.n.:{. r.>,.o-J{:Otis+ %;.{C'k,;2nX;.rns..$,>•{:T.Y�•: i.}}r;.:r:;,a•?.s:•> t•}%.n,;{...,.t,::::•;.';vY.+.:•,v:s,r ; ..:$,:J.•h',]R: •: •<.,r :nf:}.:•::Y.,2.,.< Rth .J. 1sv,:,*.;}. ..: .,...rr....,:�.:.. .. a... •`JAY•.:: A, ..,rE;RS;%auY:iJ t,,.. ?...t}.?a}J:`.... .....t :.t. .}}a.}:•`$::.t2•TJ::J.n•+{ C:fF.. .{xy{:.kr:•3Ch.::3;$:,�$N::;•n+:}:rf:,•xti.na::h}\•t:,>}...J:n,:,,a..-n.o-:;°?h.,,2�e a~o:i:•i.:'• ,<:::n{,t...t,.:h;c,..xr.{rF��•::•,.}.:,I..';,.{k.Y:?:{{.,},.;.:n•: t..:....{y.,:3} rra:. .tz.. ::h.r: ..T�.. �tOn ..t;:n • r....t...r..,r}`.:r.v}.•:.t,•.o::.6.J}:.,,.}..:.,..,.n:.,:•T:•h:::::.:Y...,. :r:•.t• .}:,.:, -:•:nx•...,•.�} .:.... .. .... .. ...........:.vnv:.:w:::nv::v:::.vWi}:...::}}x.r.vx;:in:v:;.ti.Y{.}•::C:{• :.. t........... .'•:.::{•]::•.;]h'{{J•:L Y-.C}ti}r?;.y:�;!.\�.t,}}: �•::i}n•. .................... ..............w:vv':•:.. .r.....:n• •v.••:.:n..:•.t:•} ... t:� •:v•.vr:•:w•....:.....t.;{:i.•v} :..,Yvv,,.;xvv rarir:J/.••,7•.v.\Av•:.v+{{•:v•}••,:....v:rx;{•.t :t•}.v.v::...Vv M+t. .i;}..{:W v"a.3..{v ..h{•.:{....:$:,Yr. \.. v.{.r..:.h• "tJ3\..;:.... {}.�%•}•}'•}•n:C:}{S%�:>.:%i:•: i•,•.v�{:.}}••}•:•$w} :•�0::;:.T.........a ,.f:.!.4:.•. :\{;r..:::! ..t:.,..n.,..n;, .r�r»,;.Y•:.:• ,K%Jn i•+•k. ••::q.::??i.:`•:?Y.,»... �•r:•..t..t "r:Y:s}S`••}:$:Y•:;{" a,J.n.: n n.. r•3•y. ...3:.tS:6<,o-y$..{•v}f�•,\:$:•.a .:•..p:.•}yt'r•Y. ..��•,t .'°.. '£.:L...... ':i�``}+'r•:h••:n f.} ...L #;,¢.4$}, r+r{•$:::{}':•9t•::.r.:::.•}•n?.%`;:'Srr•.:a'r`..`.•• ••{t»• .f$.: .,2....i. :.L,•.,• 1T..n.•:iJ ,3••.,na).r.r.. .:a:: .a.+�r:v-n•:S. n:}{.t,n.Sr:}%+•::>r,:. ..::�:?•: .3\.....a4:t;Jt•....?t•;:;;•}:TJ...•.+:.»t+t.+r•..L:3}h• aA•:.. ;:•r'.•} .'C ;�..{.•: n}.:$:$S:r: }F, ..:,rn�::}{{.r:. tt}}r,:. n•:"$,•:: n:a;+.;•::};.gin:{ ..\,:n....r.r ..�i.,]'c;:r;R.:24.,•.::r:{]..he}•{•^:": .�•:�d.'• .::.2•:{{$};'-�,-t:... �r .?J'?t•4:^:::i•}$%'>C: .rn .,c.:.r..,:•:;. J:....:•i:•:•h :•:•• r. :.:4...ax:•4v.,..}.iv: ..b q :^E :SY{.}•a•.•.h.•:,,F }{•}%.}y:.,7}+j }:♦-.,`:n.v hJ.}T^ ,\v.\d..,wt 'U3 k{•{..... ..}:.hvv .v:••Y:.y:. n'k A: .t•\.rn S:3.J R•:3r.0 v(v .{T.» .•iit••.SJ}`.o`ni$r: ..?.••r:{}•. kvo: :'ta+•. r.n\.a;.\... .o-.' ••.S:•.:•:•:.;• :'•+•iaRa:?...r]... .r.it:rE•. :,${ q:' .,«:..^.::+:.,::•r .::.t•n•:•-• nt.x,••r n t...J.v.,.�.}.:,ar.:n•; .Y »..{,�M...•.h..3.:.:t?Y}1....f.n r}r} EJ r....n.`.T�'.h.:..v. },;}:�:•.\....:�.fi ;4•»+•iY,1.:::r,?r'�.• t•`.::\ C�:�;. ..},. . . ... ..........:: .�..,•::{.;:$r.,. r>:$a:. +{•:•}::.,$.•2'n.}5:::•;t•::•R:•::$:.at\JrT::}:::�,.;,,{#rJ,3.t:, .:3:$;: b�i +;R2ii%G%:'iL}r:''C�:C?4��i{}r$Jv}�•::??;$.'"}?•`.::{Q$..!i . $.. %tiff;+:{::}::`;':•J$''Yl .} r.2h..•.?,., ::.{::,•:..+..f?•n E1,:yJye'• ...5:::::i::•3}::i•}..;..... ..:v. r +::�T.: E;•, ;�nan� ?. {.^{{{:?r n,�.:.};::.. .�v.v:• ........ .....:::�w.v:::::.v••...::•: m::?•: Ji::::?•.:.v:•:..vn:v•::v.. n..::S.:......n, JF.,•.av:Y't3hC:}'i:+J}}. .. ...m...+ r.C..........v:. ..? ,.n,.. v .n....t. ....a.,.n..:•::..viv..... .Fv. /...... ,n:..,v•:+}. .. ..... :. .;..r ...... ......Y•:h ...%r.......:...... .v.....:•.......n:•t......•.,R•:r.v x:•.•v.... .a{ .4 M{.}}• h;;$;.+{$.}; 4•nw:•]:•}+`h++:{n'S,h;,n.;•{•::•:C:•:}nii:70p..,+.}n.y'.' •.V..r. .CF\ .,{..r;{.}:. :.{........n- t?Y.• ..a r a:. ..h {•:}:t•}rY..,{.;.;:,}, .}.::.:.�::.. g. t�r... •....rr:•:•.�.,•::T::•:...............T•::::::}::::�•:::•:.. \t.•'ta}xi ....:.... S{..fit••:5::::J•.::•:.:•T �}•.;•.\•.•.-�:J,•Ra+:R{`e�i$C';�:�`:•,:< .i:Ji:•},:•..v....:Ch:...}...r:•v%}in3•.,S.@•... ./..v..$ ..f•.:•:h% \n•:::::::. ..?.n...:::}::v:.::::.•:•';ry:•?.Cv+7}T:v..v. r. .v: .,R::C$}: r. n.....r ... ..:r.....+:+v4 .:'•:r. to?v::v:....: ...... r rr...:....:... ,.,t...E.,.c .+n.....t..a...... .t.--•' .i•.:-�r}n.•r..+:••}::n} +� r.C...... ..:....h.. n... ...:.. ........v..r.n ..............n.:.....n........n...,n;'v:•:• nv ix•CY?t:•...v:•v .. .. tii{:\:? t%R:3 :4^v. .l{;:;:} ${�•T.... G..r...:h.v•....:.....A\:.n. :..}... r...n..`r.:...v•v:....,... .t....,t........:....v::}.... ..n...... .:.tt.., ,..{.r.. � ........ : ♦.. v7. YL .....n r.:. ..:. . ........ .... vn.. .n.nv.v-:'v.>.. .t{tiK::•:w:::. „%v•� .ih:;{'.v Y'}%{'{ t rJ. ll :.i..,.i:t �:,..r,.,},:.:y.r.r.. ,r. .r .;.:•�• ...o- .t+'r;.:u•>`J{tt•:•. Y•:ti}:• S.•::2... ':;:t;{;:\�.....2.,,+.Y.;,::u{,{;`.. 3'}::\..v.Q{`}'$'.Vi{:t:•.r :...v v.}$T..v:rt:..v...:...43.•}r•:43:�:{:•L.... r.;;.,vLC.C:.}•.1;:? ✓•:h:Yh'{'•,{',•."• ...t - ..:;..rr•...:.t.,c�..r.....r::f.,:.nit+rry�r��•...t.....:..:.....:r.....:.....: .:. :}.,;h....::. .,.r}:n,ah.:.\r't.{•::..:•:.h:•t+3y ...R+i+fi?,• a+?:;.io-?$::x >;::?:;}x\y,:.�f\•' Y•�'i�z: ::,}C?�v:'•;�:.:,�,�rJ3:\�%i1}:..,, .}+v.:.................... .:.•:•.v•:4.••:{., :i;.{•{r.}}v�{.,:::},•::$ : ,:\ -} rt r .r}.$':>'J,.}:•..: ...r•:fi.., a:h\.:.r.... :; ; .....+..?:•:n$ +5.kn,•.n..,•:.. <. •y;.:..:';;:.•.t•.r.:3:.n:;.;:.�>.}.}r{•:{•::•]::>`.}.:•:::::::::::s.:•.. .. .. .. and•iianie=::.:.........::.t,...:......... ................ ...........................:....::n,......... .......:•:f-.i.r:.v.• a n:n.,. t{r•:•:\+K;:'•i{.,,:{}:S:vTT tiC%%+'J•:$::}�+';?�•;r'4r•:h} ,4?ti.�,:;C:'t•.{,z Ti,'•�+C�}�•,},•, ................. ............:.t•.:•::::.:::............::•:::7:r::.h»,..�•:T.....T...4:.::^:::::}.•r,....r,•.a•:f•a,•.,:......,.:r....}}\::..n:.:}n?rx:.�•.,.::}•4r.Y:-}:::•fi;{...;+;t:yr$;;.:$R?},�• \•�; „w.;�;.�}�,�,ti;,a,} }:+•:7:: .,).. ..y.}n•.av .:Y\^.a}C.{dyt.,. .{$•n r..vP:.aty,.. ..;..:w.v v:nv::+ r:•.:•:: •r:iv:••:Q:::v:•:.v yr :n:•.: :.w•.::•r;}r:}:.,C:::::.:. .../.v .n. :......Mr:v: C .. ....::. .v.n...v....,v.......:...vd:'7:• ..::•..... .::.ir:•:n:C:?:•`.?v.::•. :C'•:{• rT}: v.C%.n :4a::y.};{{ .f... hT: 1 �$'H!^'•�t+.v......:: r... N .rn.n.r nn.•+v:$:•f.:t•.�v.�r•..»,{.....h:vv,...... .+..............,:r,?.:v;v....v.v...x....r.. ..n ..:.....:$:a`i:�}}r•:nv i• 4:•%J.. $:i'{.>r}i::{}:%•r..$}+t}:t:n R....S.•..n y4�Cv$, t3.rn.run.....r.v...:n'•..•. ....}.. ........v•..........t....n,r..,}..::v::... r.v:v...:. ...L,,•{v...:::......•....:::......: ..t�;nn;?iv{i::r, $x .h... ... .:... ...nn...•• , ........ .......:t•.... .,a.,....: t..n. .... t. .v..... � n•:h•.i::..., tr. ,:.r:++n•vn ..� %..];}..';:•^: {•}:E�:<v }:{tt:"•a:R: .rr .. ...t:• .r.•n +{•. {{..Li;3.x... ....:. .v:::;}:.+.•.........^., x��.v:}::...n•...... •.v.. ..... v �. »..:mn..:..: .. ....n..r...............:...v ........ ...nv..:n...vr^•n,v.,\v.:.. %:i•'i•:itiah;Vrnvnr:•.:. :•J.}i:}vti�${: :,vr ..h:$0:: ... .. L2.....Y ...............•;.E;u'y..:.xxn r.. .:•;•.v v.:•.........r......:.;.r...x:n......,..n... ...;...:.,»............x••..r ..n i.C.. v:<;:, {.�. {vtia�;'\hnxC, ..r....S+r,•r ..::..............: . : :.... \i......k.... .....,...t.4.... .:.... ,...... ...v..S...t ...... .Y.... t h•:.,• :i:\.,.3'i" �::�•:• ... ..,....... .,r, ........».,.,.. ..at , .,r.:t... :......,t.,. ..:.t...rr.......... ,........... v,. .....,• v:.,•..t.:,;:�; .].. ......7 .....n.r ..:.. .r.......t....., ...........rr..............:... ..,r.......•:•.......:..t..}nt:,;.:•a..•;}•$::•::: ..t.'2J.�:ti:2 :::}.,..:.<•:.v. .... ..;..,..Y.;..::•T}::•:.:.:.t ..;.'}..t?•nb.t•:::•\Jtn.Y.+.,n:..r::.� :..:. ..... :.:•JSnR '•..,:};:}.:;•.:•nr.....;........... .. ............ ......... .....:.n;.:.:}•;}}.::.: .. ,•:v:•;;........:J:{•}+:y,::::•$'S{%'::}:;:%{.^.{:KL},i:,l: •Y.t{v..'t:{'•, ............ .........:....... ..........n.........................,..,.n ry +•v:+:\tir}T:;:rti::riii:•:;a:ti;�• .i,:; ..i:... .:J'NYl•.. ....... ... ........n.... ...n:.r...........•• r ......n...,..,,. .v:.3:::nv v:n.•.:.•x.%:n.... .:`., ti:;r...v:••;:•`.C.v7::C $}.1+ . .}.r r.. .......v. x.. .. .....•.... ....r....:.... .+ ...:..... ......:. k:.:::..;..v}v.vT•::vv:W;•r..\•n!•;}J:C}':tJJ}!$�:•'.\.v}•:•:}::•.+{}•::nv•{:•.}` ... kn ....C........h.. .:...:.....t...r+....•.... .:.......:......•:.........n+,.......,...:.r.•;.. .,. .v.F +. n.'..\::•�: ,».{v.vt.,�}� v:4�{nun:: �...... ......:S..v.r.. .. _.. .... .......:v.. ..........::..r. .t.........r..n....,.n::?:.:v::}:••.v:n:•v:••:]::::.vv.\•....::n vvv�,•:T .v�iv{'�� y i\•.'v rig}:t }]r: ....v.. ..}..vn........fin.n•. h ..:. .. .:......v.v. .... ...vr n.n>...n..:..........nn...-.. .n...r..,.... .. ...........f..r i.,...+,;., .n..t...y:.. v::n••v'{4J{C. ..a .'�3\ ,'h.i{}::•{:�'....} . .rn..r... ..a::••n•..v.n.... ...rn./•...r.]�•.w...........:r.+:�:C.:...:.......r.........r.... .:::•:..:.. .........v).:r..............t:::x.. .t. }}:{ti•}3}`-:{:•.v.:i.:n..}; ..$},:++ is�+h+ .a7Ln� : :::rr?r•:.,.:tn:JS::::,tr::.,•r.:......••u: ......: ... ...}:}:::....... •.,.. I•.r .,..... na.h....... .•`.`a}> :;•>,,;S.tR:$:ta, .•$..}::C}:}$.+^ n .. ::.................... ... .:.'Srt:.t. ...v..r..:::.........t...., v::.•t:.�::t....,.:• ...:....{...:.}:n•:x.:•:h:., •:$z•`:: '}:tiEE•`.•:•h:.2s.. :•:$•:::}.Jn• .....,.. ....n•:;}•:;.�}kc,::?^..t.. ..:.t;.}n:•:.n.......... .:.,..::+::::::.::.Fh:...n. ...r :t{.,,.}:::•::.:.t.............. 1•>:•::.:C•}::::•:::.... ..: ......&..n:�:•,{t•r•:::•.. a. ......,tt•y7h•n•. .....,..;.....::..>.S .:.,..,.......r..:. ... :.t.;..n.:.. ..............r..:::.n+:• OII�:�.•. �•`;`•:�.., •.�}; ::ni: ;,�• ...v:»..;r...;.;f•:fn:..K.;,{.:{yr-.}.t'•...f�•r.•$:::$:•:::h•. :83::•x:::i.t::::..v:.:vY::.:vv3'Y{:,.:}}:;:.}•4:.n::?.vy:::::}:{...:•:::••....... � :.....::..... t...;C:.v n?.v.;}•rv?5.......ny:>•:r...:...i. $+.. ... ;,'�. }tJ:ti•: .tl..•:::n,....;::: ........... .... vvi}}:SC.•':r:.v:}":vr.r:»::;{::::::v:::••.; ti{$;;]it'v:ntJiiL';+:i0{iiCii't��Ti:ti;:$n•:•:v\}: }�•:•:n:t•.:;t .......... .........::::•::•:v:w:v::�•x:.v•w•v:v vY•rr}%i•v•rr:.:..v}}r:FJr.;•}2'L}.v.....fir:.v::i�{h:..:.::- .rn•.:::.?{•... .....vriwnvt,ti,•a•{:.:Ua:••.hvr::%•y{ ....................... ..... .::w• n.n.•w:....:.nn..... .rn.. .v 3,:.3:}r. ...nr}...,{......:+. .....:J:?w::a....,: :•:}+{}:' ::• .;�..\ r......n ..... v..v..i.,,x x•:�• .:.......n.....h.$hv...:v]....C.n.... .•:::. % ::.}, . r..n r .r.::: Y... ....h....... ,..........,.. ^}:......:.....v}m.:•y:vr•r.:n...r..;.;\..:'{+''i+ .. •... nv$::}'•v�;$:t{ti:;};$..:::•::�r.nk:�K,.n'L4{:J }.r%•:yit+:?Jn<.;h .F... ..aa. h r:f{ •rt•. .3.. •::h. {•};...{;r.: :.C]::•::•}A}•,;k•Ya:;' .v:•.». 5t. _ Y:#,:.}t•:•• rn....rp.•::..:....r:r.r.:.v::••R:}•::::::.:.{.,::.}::r.:;:{:..}.:•.�:•:}.:•h:??u-::•::n••:.�- ........... ...,�.t+:n.r•....w.,Q. \5h:{.v/n•.:�$$T`;{$. ..tJ3 h,r:+4 .•:v... :.T3,,{{t•W::h>ii:•:LST: t.r .}}.: ::}:: ,f}. ..:r::?•%;:�: } ?..:. .t. .s .5:::{/,;.. ..}.a:+7 :$:'{%k;c%;\{:•,Y•, .:SF, •.a..n {: }:R.. r;`:•YF.t•:, •T.an\:a::•S.\•a% h}.;r •n.:..• ..}::•:•:. ....... ;o-t•}:....t•:;:•. n..t.3:•`•,,v;... +.:., :a• ?}✓i .t. .${$R..:.v ..� • f., ,f .r1.. .:,•:.n:••{,••.+.t..............vv•.. :t:..:r..i. ...t.;.,.., .i,;.•{t,. .:h•. •:.t•:;. ,;,}..$......:e:+• :R•] .rx a;s•:a{;k;. .:'%.rf:•::n t..rr.r:>.,....t•..:3.. .t:...R. .....t..:. ..rr.ntn...n.... }r.�.+i.: .\„t•...n:•Th•. n.;}•:...,... •:.... `::•:v:: ;M+.c?}x.\.Y.. }3.•. J:::Jr.;{:•{.nr.,:.a ,'k;.v .{.%n.• Jo-:; \;{arras•:•:J::..y..Yn,+.•,•::•.;,....r. •.;ii:•:: %is?•• ,•:•�. ..a.•r ttk; ...{txraa•, ..i .:i..c:•.rRa..n•.i...:.: r.!n.x r•E:...+fir"•• .. .., .:•. n ••.:•r ,•::t%t' {:%'?t •. ..:...:J ..Xr:•.,3?•h ..��$`, ..: '?;.:$v:...tr.\....... .... {., ..t.,. ...}.,::..%n:a.•%.n}}::::.>.•\..{v.h,:•t{+.: •:.:.riR. Ik;t{,7,+:{.O'•7'i7:>.tiyYr�'',•{'r.. .. 7t .]lk::R..y.•:hv$:�h...hnvt:.::.a:•.{{v]+..+..;>.•::.v:F..;....n\L•.v....,:., ....... ; .rl,}+r.#i+]}-,2\y:r»;.Y.<..'k::'. t : } 2..:.,•:?:%T:n,'•.,,•h;;;3::::...,+,•+.•r,%E+..h, 011•'J'fF wnraace:ee.�n•Tr:..:?n::$..{:;::;.{.}::}:::YR}.��R,:••:>c,4::?::3%SS:t,;>:t4;i•.;.:{.::3:3:3.{�.37:�: .. . . /i Fan=to secure coverage as required mider Section 35A of MGL 152 csa lead to the imposition of criminal penalties of a fine up to SI,Bo0.o0 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me: I understmmd that s COPY of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby under the pains dpf eennalties ofpedwy that the information provided above is trap and eorred Si gnature Date CC) Plint ���, S . F-L L s phone# (saa) ��1 2��`________ official use only do not write in this area to be completed by city or town official city or town: pemdt/license# ❑BuIlding Department ❑Licensing Board [Icheckif immediate response is required ❑Se a Office _ ❑He alth lth Department contact person: Phone#; der---- Onised 9195 Pr/a Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer;or the receiver or g g gag association or other legal entity, employing employees. However the owner of a individual partnership, as g trustee of an mdi ,P P dweiling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of Hance construc tion or repair work on such dwelling house or on the grounds or another who employs persons to do mainte eP . building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or'renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. 4 Applicants .4 please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and 1:' supplying company names,address and phone numbers along with a certificate-of insurance as all affidavits may be 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 . Accidents. Should you have any questions regarding the"law"or if you being requested, not the Department of Industrial are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please wits may be returned o be sure to fill in the permit/hcense number which will be used as a ref erence number. The affidavits y t the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents gMce of lovestigatioas 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 . E Town of Barnstable . r�ti Regulatory Servides sAxrrsraei E, = Thomas F.Geiler,Director 1639. G 3�e,`0 Building Division F Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME Z,1PROVEMENT CONTRACTOR LAW W SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion; -improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: ?=A•J 24 A:r i sn Estimated Cost (0-6, O o s Address of Work: Owner's Name: � r CtAt,C¢�Ck J�►�� J\S Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 []Building not owner-occupied '[]Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: "* ©z_ rL,,0 3 . y� �14yy►E-s �. �F`L,L-c�w� � Date - Contractor Name Registration No. OR Date Owner's Name 71A CMR I+FP�� Txb1a JMIb(c*i tdbmu Huita n.v k metal xf +Fogy F`urli p�CtjptrYe F'a xaekx�a far one a Tw¢p'uait�' ' MrnrMvM 'Ficating/Caeling 1 AXtirit3M Gelling Will R 4,oar �sc F�CW Equiptacat EMQI'cncy C}Sazing Glaring k- R-value{ A vxlucr Aral(*/,) i],yalue� aCt ' p�sge �,.3761 to asap Hgtittg j3e�7tis nxY?' 6 . Noras�i 13 I9 11a � xnmu�i a.40 3$ 19 19 10 6 j {S A� RSZi� 4�q 3b 13 t5 � SO NIA NIA Narrnxl 10 6 .� Nannal . {SAFUE , 19 I5*h 0 35 i3 Z5 NIA NIA U la • {S AF[1E 3g; Y 3q ig Ig N1A Momsai 15VA O.iZ 13 15 NIA NamtaI Fl 191/1 03Z 31 23 NIA NIA 40 AFL]•1r Y ISyIL 0.42 3� 3 19 10 KAFLM 1 11% 0.42 1 ig to x iVA 0.30 30 1,A 1. ADDRESS OP PROPERTY ,7, -1 S , • gQVARE FOOTAGE OF ALL Ex'I'SR�OR V,rALLS; 5QVARE FOOTAGE 0P ALL GLAZING. D 3 � 3 P b h. °/a GLAZING AREA(0 DIV By#�): 5e@ Chart 8174Ye): I 51 S1LECT PACKAGE AA' HODS OIL I)STS ONC,amRGY RBQual COTE: OTHER M0��(OLVED ME'1?. Aga AVAILABLE, ASK US FOR THIS UxTORMATI03� BDGtSPECTOR APPROVAL: NO YES' 1 i , Q•faccns-�803035 Board of Building Regulations and Standards HOME IMVEMENT CONTRACTOR Reigistrat, 02827 �?Txpir on- 004 1' t FELLOVVS, BUILb °P !1\/CA T = dames fe"�lows 5 Mam; reety Nlashpik MA 02649 Ad nunistrator BOARD OF BUJI'.LDWO REGULATIONS pNSTRUCTiON SUPERVISOR *r;.License �y 04085 Numbers B 13 nrUt �`05 Tr.no: 7594 0 Rest ET:ed: ®0 JAIVIES.D FELLOVt y ST 5 MAIN AdCn�nistrator u MASHPEE, MA 02649 °FSHElp�, , Town of Barnstable Regulatory Services BARNSTAELF, i puss Thomas F.Geller,Director 1639. ���a Building Division �prFD MA'S Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 - Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I• � ``� � ,as Owner of the subject property s e hereby authorize Fe—)1 ups fIal l to act on my behalf,. in all matters relative to work authorized by this building permit application for: (Ivb NCa.�fi� l?we . (Address of Job)S61 40 c 11�29�a3 . tune of Owner Date ia4cock. Print Name Q:F0RMS:0VMMPERMMSI0N RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LNING SPACE � . square feet x$96/sq.foot= 6 plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq. , >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: x.0031= square feet x$961sq.foot= F STAND ALONE PERMITS Open Porch _x$30.00= (number) Deck —x$30.00= (number) Fireplace/Chimney —x$25.00= (number) Inground.Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocatiowmoving $150.00 (plus above if applicable) permit Fee �� S 0 projcosc L ATuglN ROPERYY LI r4E A, T BE ACCU TE STANDARD LEGEND NOTE:not all symbols will appear on a map GOLF COURSE FAIRWAY EDGE OF DECIDUOUS TREES EDGE OF BRUSH ORCHARD OR NURSERY. t V.....V.....v-!;' EDGE OF COWFEROUS TREES r MARSH AREA UN�� EDGE OF WATER DIRT ROAD DRIVEWAY PARKING LOT PAVED ROAD ------- DRAINAGE DITCH PATH/TRAM PARCEL LINE** MAP 326 MAP# i_„ U 1 ZS 0361 PARCEL NUMBER A HOUSE NUMBER L 2 FOOT CONTOUR LINE ��] - - 10 FOOT CONTOUR LINE V `',(u Elevation based on NGVD29 j ; 4.9 SPOT ELEVATION STONE WALL -X—X- FENCE BARNSTABLE CONS ERi� N - �—� RETAINING WALL RAIL ROAD TRACK STONE JETTY Pam ' SWIMMING POOL co ` - j,` PORCH/DECK '�--.___._„_._ R-y— ❑ BUILDING/STRUCTURE DUCK/PILK / HYDRANT q ti, oq e VALVE O MANHOLE o POST OFP FLAG POLE T O W N O F B A R N S T A B L E G E O G R A P H I C 1 N F O R M I A T 1 O N S Y S T E M S U N I T 0 SIGN ® STORM DRAIN M PRINTED SCAEE:IN FEET *NOTE:This map is an enlargement of a **NOTE:The parcel lines are only graphic representations DATA SOURCES:Planimetrics(man-made features)were interpreted from 1995 aerial photographs by The James 1"=I00'smle map and may NOT meet of pmpoq boundaries.They are not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD 0 UTILITY POLE ❑ TOWER w ° 0 15 30 National Map Accuracy Standards at this do not represent actual relationships to physical objects Corporation. Planimetrics,topography,and vegetation were mapped to meet National Map Accuracy Standards LIGHT POLE O ELECTRIC 80X : 1 INCH=30 FEET* enlarged style. on the map. at a scale of I"=100'. Parcel lines were digitized from FY2004 Town of Barnstable Assessor's tax maps. I�oc)�A TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Do Map Parcel _ Application# Health Division Conservation Division Permit# Tax Collector Date Issued © AI Treasurer - Application Fee Planning Dept. Permit Fee TJ i Zf Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village K3-n A S ® Owner 'rBp, apw h- Address Z7-8 RJZ T6117- Ba s _ QrLar-, UK 31fS"31 Telephone �� 3Vo "l 4-i 7 Permit Request Fn C-10 S 4e- rAdV r j �OuZC� b02l-t (�24,9 W tN b rLS Ic Square feet: 1st floor:existing (000 proposed 740 2nd floor:existing proposed 400 ,Total new Y Zoning District Flood Plain Groundwater Overlay i 'Project Valuation Lf' P0_0 Construction Type W0®D one .��® Grandfathered: ❑Yes ❑ No If yes attach supporting documentation. Lot Size �T'�- C� , _ Dwelling Type:.Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 4,0+ Historic House: ❑Yes *0 On Old King's Highway: ❑Yes 4No Basement Type: ❑Full Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 0Basement Unfinished Area(sq.ft) Number of Baths: Full:existing 2 new Half:existing new Number of Bedrooms: existing 3 new 0 Total Room Count(not including baths):existing 5, new ® First Floor Room Count -3 Heat Type and Fuel: PlIgGas ❑Oil ❑Electric ❑Other Central Air: ❑Yes WNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes too Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Elk Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 4 No If yes, site plan review# Current Use f i c,u Proposed Use & BUILDER INFORMATION Name w Telephone Number Rbs) ong •-%0!5c Address License#'_ 6qZ 1K9 yV 06ti P5 MA . oZi,_\kT Home Improvement Contractor# I 0 2'8z,7 Worker's Compensation# (A U c3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �? P_ > 3 Arli-am-Aaz_ SIGNATURE DATE �' Z t` i f' ' FOR OFFICIAL USE ONLY A 4 PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS' VILLAGE OWNER DATE OF INSPECTION:PP FOUNDATION FRAME PI<-� -& -o % INSULATION t d FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL { ' FINAL BUILDING d DATE CLOSED OUT t , f ASSOCIATION PLAN NO. ` > 1 , ' The Commonwealth of Massachusetts , Department of Industrial Accidents Office of Investigations - 600 Washington Street Boston,MA 02111' www.mass.gov/dia Workers''Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/ludividual):_fC—�r,j S 7I L-b i,cam, �Zri -Address: f VA A+N -S i ' City/State/Zip: PhoneA:_ � � Zq Are you an employer? Check the appropri?fmx: :Type of pioject(required). • b�I am a general contractor and I 1•�•I am a employer with�_ g 6• New construction . employees(full and/or part-time).*• , have hired the sub-contractors 2.❑ I am a hole proprietor or partner- listed on the attached sheet. 7. Remodeling ship,andhave no employees These sub-contractors have 8. ❑Demolition ivorking for me in any capacity. employees and have workers' 9 ❑Building addition , [No workers' comp,insurance comp,insurance$, required] 5 ❑ We are a corporation and its 10,❑•Blectrical repairs or additions officers have exercised their '3.❑ I am a homeowner doing ill-work . 11.[j Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL ; 12,❑Roof repairs . . insurance-required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other_ comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information, t Homeowners,who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must providb theiT workers'comp.pohdy 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: AKA J Policy#or Self-ins.Lic,#: K%J& v 981 XO ZZ 2.—0�, Expiration Date: Job Site Address:_I te-0 VAMPS 1Zf 0 S AVE City/State/Zip; rtdlvtt Py�%i Ylq , 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, ' I do hereby under the pains-and a alties of perjury that the information provided above is true and correct. Si Lure: G`'r Date: #: ' ( ? Z 6 — Phone Offtcial 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): A.Board of Health 2,Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ijAlt➢l�'dlilA.6,1Ui1 A.11�.l ill��l ��;�1�1�� • . 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." . AdditionaIly,MGL ehapter..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 • r Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-conti:actor(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 n=ber 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(ifnecessaty)and under"Job Site Address"the applicant should write"all-locations in (city'or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would Eke to thank you in advance for your cooperation and should you have-any questions, please'do not hesitate to give us a call. The Depa;tment's address,telephone-and fax number:. The COMMODwWth of Mmach=tts Depuimmt Of lade al Accidents Office of Investipflous 60f k Washington Sbd Boston ILIA 02111 • . TO. 617-727-000 ext 406 or 1-'877-MASSA.FF Fax#617-727-7749 Revised I1-22-06 www.ma;ss.&Wdia 1 V f 1 V a JLP&*A ALL.J wr a v Regulatory Services Geller Thomas F.. fARNb'TABs E.�, ,Director . WASS, s� s639- F�• Building Division. 'QED M1� Tom.Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.,b arnstabl e.m a.us 6ce: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME DUROVEMENT CONTRACTOR LAW -SUPPLEMENT TO PERMIT APPLICATION MGL a, 142A requites that the"reconstruction, alterations,renovatimi,repair,modernization, conversion, improvement;removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units.or to structures which'are adj scent to such residence or building be done by registered contractors,with certain exceptions,alOng with other requirements. Type of Work: 2 �� ^Estimated Cost m Address ofWork:L 1106 Owner's Name: � - -�- � i 0 Date of Application I hereby certify that: Registration is not required for the,following reason(s): ❑Work excluded by law OJob Under$1,000 OBuilding not owner-occupied ❑Owner pulling own permit Notice is bereby given that: OWnRS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER YIGL c.142A. SIGNED UNDER PENALTIES OF PERIM I hereby apply for a permit as the agent of the owner: Date Contractor ignature Registration No. OR Date. Owner's Signature Q yrp:Mes.fbr=-.homeaffidav Rev 060606 Table J5.2-11;(condaaed) Prescriptive Packages for One and Two-Family Redldentkal Bulldings"Aeated with"Amil Fuels MAXIMUM MINIMUM Glazing Glaring Ceiling Wall Floor Basement Slab Hesting/Cooling Arca'('/6) U-value, R-valuer R-value' R values Wall Perimeter Equipment Efficiency' Pachge R-value' R-value' 5701 to 6500 Heating Degree Days' Q 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Normal S 12% 0 50 38 13 1 19 10 6 WAI;ZJE T IS'l. 0.36 38 13 25 N/A N/A Nomtai U is% 0.46 38 19 i9 10 6 Normal V 15% 0.44 38 13 25 N/A N/A 85 AFUE W 15,16 OSl 30 19 19 ]0 6 8S AFUE X 18% 032 38 13 f N/A N/A NormalY 18% 0.42 38 19 N/A Wk Normal t 18% f 0.42 38 13 19 10 6 90 AFUE AA is% 0.50 30 19 19 IO 6 90AFUE 1. ADDRESS OF PROPERTY: 40 MA-45ratis U U, ; 14 AAA i5R.04- 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: i'S%? { 3. SQUARE FOOTAGE OF ALL GLAZING: 4. '/o.GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-080303 a 780 CMR Appendix J Footnotes to Fable A2.1b: i a doors skylights, and Glazing area is the ratio of-the area of the glazing assemblies (including sliding-glass basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expressed as a percentage.Up to 1%.of the total glazing area may be excluded from the U-value requirement. ••For example,3 ftiz of decorative glass may be excluded from a building design with 300 W of glazing area. =After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. s The ceiling.R-values do not assume a raised or oversized truss construction: If the insulation-achieves.�he full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 4 Wall R-values represent the sum.of the wall cavity.insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing,and interior drywall. For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-fame construction. The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet tk�e,ceiling requirements. 'The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as 'above-grade,-walls."Windows and sliding. glass doors of conditioned basements must be included with-the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece of heating a uipmef t,ormore,_thanLone piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the effciency,requirea by the selected package. 'For Heating Degree Day requirements ofthetl sest city or town see-Table J5.2.1a NOTES: a)Glazing areas and U-values are max1iniVni acceptable levels.Insulation R-values are minimum acceptable levels. R value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC.test procedure or taken from the door.U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply'.if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 12/21/06 THU 15:40 FAX 224 386 1956 BARBARA DELANO REALESTAT Ijoa2 Tovru of Barnstable Re for Services Who="".Oder,Director Btaldtg DiTidou - TomFem, SWIdWs Camudmiouer 200 Madt ftwo Ryumb,MA 02601 508.862-6038 Fit: 0�•790.6330 Property Owner Must Complete and Sim,This Section If Using A Builder r of ee,wbject prop qr,. ..,. ..,..• . .... hacbyauthOZ49 r °�� � �.�na I+�9 ,.to ca ,beh . in alt=ttexe xeietive to-work x t io=zaby*h buTading•pez -u icalion-for: AA (Addtta of Job) of met renCRAMDste ■/� r' - psiat Na= eoCk v 1 e Venru r'e Z® S10Vd 9NIciina SMO-73J � 596ZLLvees 6Z:Z2 900Z/Z-Z/ZT f i INKS Town of Barnstable a P Regulatory Services ail 9 saxiv S i e g Thomas F.Geiler,Director T,1' � �'Olfp NIA a`0 Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 4 Property. Owner Must Complete and Sign This Section If Using A Builder t as Hof-u-T3r j er-property. hereby authorize :�4,A AA , a�p p �� >s to act on my behalf, in all matters relative to work authorized by this building permit application for: ,V 0 V ' lJV • 4 • + (Address of Job) i Signature of Owner D t ICY-' ba�rG`- �CYI Print Name N Q:FORMS:OWNERPERMIS SION (.\ONS D OF gt)\t 0\p SUPS: f BOAR p�S j?, 8 :a L�cenSe G OQOgS be G� 0 Num r 6g53 � Tr,no 3 � g101200� ALLOW`"�•,�� ff;"1 � � 5ioner � i�pS p`MPND g E�kMA p29 MASHP ,• �-... 01/16/2007 02: 01 5084772969 FELLOWS BUILDING PAGE 03 . .The trommaxwedth Of majvacAuletts bepart`tnent of IndusNal Amhlents Offlae of 1� vmtfg.tntss 611E-1 WashMgggn Streel . ' 3�►�v.a�a�ss�.�o�+/dtaa . Werl rul"ConiPeusatloa WurAnce di-dt:]3utIders/Cotitractors/Elec'tZlc:iawtilult b,.r's Applicant WO N�=r(lBu�neselQrg�izet{ar,ll�clzvidusl): -wt�,�• "•.��:.�.. t�-•-.• .� -�• ^� City/statomp: & Are YOU an employer?Check the appropriate box. _ �4. � 1 aim a .Type of pso;ect(ragatred)' 1;❑I era a a lgyex with , gf=d oo toi.and I . l®y=(full and/or p timo�,� • .eve hired,&a sub-contmetore egr aonatraction 2. - a bOU,pioprielur or pattaer, listed on the"sattaoba d ahoot: 7. � la e=odaliag ++�� ..sehig aadba�e ns sssapYoyer.� These sub-crraaciors have B. 0 Demolition' *orking for me in say cepaaity, =Vloye4 and brave wo*ers° o w s°6w:anca oa+ .innzranco>�' 91 O Eualdin4 additioza � �• d ❑ e ars.e®orpoxatiaa.and its XO,�'�lea4zoa2.zepa3ts or adclitlons 3;n--x am-t mmo oquared� -aioiag a"Il=wort ;-_ ',a0cexe bAve oxeacaaod their 11;[,]l�l�riag xnpaixe'or adcl'ttzaaa dlf. o wri*are'ao xW Of Oiempticm.pea•MQL• i to tce.rtac�uired]t u,1 2,OI(��,tam we bane no13. Cam . c innu:anoo rom4rad.1 *MY irptimit Matct=e v box ftmoan%IN fill aut the scctivdbalmebowks ur,warkeu'cl., ,a uatm pcboYinfsrrm d=. 1:tomaP vncn.gvU eubmitthia WSdavit adfaaiig thoyam doingsa warkaa thOn IAM ouW10 onutrsox�rs mutttsubmitanew !d¢vIs$►dicatinY sroch. ;Castttotm Ihat eheak ffibbox must anaeW in addili641heet eLowi-tg the trsme alfhe Pub-eonttaaetm 44 ststo'Aatber ormat tbpaa eutidw}Rtig OTMIMp. lathe sub-coutma n halt MVI"acr,they roust prcrfdb WcAmn,comp,PON*7=ber, I ani an employer tAat ds pruvtidirtg ®rkers'caanpeKsutiox Grsurancr}or any e3r!appoye0s Ifalaw fs Eke poltgr wsd job stte �'ormdtt07c Tuguraace Company Na3: Pohoy#or Self-itm Lic,#: T - >�piz ntlorlDate; ��, job Site Ads:_ _ ___ rpl9taiig• Attach a copy of the rurkgrs' co4e�gsatina i0licyY deckers& page'(showing the policy cumber and exp 1rai sin 6 t®). 2aailurc,to aocute coverMo Eta xegafredamder S- fiction 25,k of M(3L c, 152 can lead tc the imposition of crimi-ani peaallti,za og e fine fig tb$1,SD�J,OQ and/or one-year i�'tpzisoraaeutn�-Nall�a�vi;poneltibe iuthe fom�of a STQg „QRriBR noel:�foie Of up to$250.00 L day egtnast tht<vis)I�toT, Be advised faaat @ a:opy of tl ss etatei �y ba fozwarded to tha d cc of In e ati of tha M o a cavern a erific tics, I'do hareb� cent(, +under afns•andpand ies DIP49PY 04 d th i Worinafion providad abaY4 is Prue and correc4. e S d 2,q 2,1 fft*14 use Only, Do Plot wT to in area,tbTe cahaF ete y or town i0frXid, , :Cite or'1'o�,•�_� �exrntfli�ictrr�•e# , Ys9taiag,A.uthor1%tj(circle one):' 1,3301rd BtW tbg bev artmmit I City/Town Clerk ¢,XlectriesI Inspector S.Plunablr,g Tuspectox Contest Person; _ Thone#; wY' ,r5,a F SME� Town of Barnstable ' Regulatory Services BAp.NsrABiXASS.MA33. Thomas F. Geiler,Director 9 �pr139. MP{01 Building Division - Tom Perry, CBO,Building Commissioner 200 Main Street, Hyannis,Na 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax; 508-790-6230 Building Permit Procedure for Residential Addition Or Remodel Or Dock Determine map and parcel number and enter it on application. ❑ Historic District Commission,200 Main Street, approval required prior to construction/demolition for any properties located in a Historic District: Old Kings Highway Historic District(north of the Mid Cape Highway) Hyannis Main Street Waterfront Historic District(See map for boundaries) Historic Preservation(if applicable). ❑ If ZBA relief(Special Permit or Variance is required for Project): []Copy of ZBA decision ❑Documentation proving that decision was recorded at the Registry of Deeds w/in one year of ZBA decision date ❑ Appr is from the following departments are required and can be obtained at 200 Main St.: =C'servation in Department (8:00—9:30 APri&3:30—4:30 PP,4 {as of March 2nd,2005} Department (8:00--9:30 AM &3:30—4:30 PM) Collector {can be obtained from Building Department) reasurer {can be obtained from Building Department) ❑ Permit must contain complete owner information, full description of project, correct square footage of project,valuation of project (must agree with Total Cost from Project Worksheet), building detail for Assessor's Office, complete builders information, including signature and date of application. ❑ 5 sets of reduced house plans measuring 11" x 17",scaled 1/4"= V & fully dimensionalized are required. Plans must include a foundation, cross section,framing schedule, insulation detail & floor plan showing location of smoke detectors (located with a Red IS'.) ****** IF USING ENGINEERED LUMBER AND/OR STRUCTURAL STEEL,ENGINEERI DATA MUST BE PROVIDED****** ❑ Plot plan or mortgage survey required for any addition. Home Improvement Contractor's Affidavit (� Workers Compensation Insurance Affidavit form must bezmittedfor any workers hired. In the ` ent the homeowner takes out the permit,subcontractors hired must supply this. Copy of Insurance mpliance Certificate must be on file. FL Energy Compliance Form ' Construction Supervisors Licen�&Home� Im rove ' omeowner icense Exemptim must be submitted igeneral or e project. Property owner must sign Property Owner Letter of Permission. ❑, A NON-REFUNDABLE Application Fee must be paid upon receipt of application number. All checks should be made out to the Town of Barnstable • eed Home Improvement License,no plot plan tfquired PIERS AND DOC a provemeut License. OWNER ULL sects requirin crane must comp etc the forms issued by the Aeronautics mission Q:forinYbldgperrnit/R addalt 101106 01/15/2007 02:01 5084772959 FELLOWS BUILDING PAGE 02 nigntrax ma►rtford 5/30/2008 12:14 PAGE 003102Z Fax Server . STPAUL TRAVELERS WORKERS COMPENSATION AND EMPLOYERS LIABIL11TY POLICY TYRE AR INFORMATION PAGE WC 00 00 01 { A) POLICY NUMBER: f 6X0-8$1X822-a-06) Btll�tilA.1, ON' ($KtJg-881X622-2-05j INSURER. THE TRAVELERS Ildl)2$MITY COMPANY NCCI CO CODE: 11347 INSURED: PRODUCER: FELLOWS, JAMS DSA FELLOWS DOWLING t 0 NEIL IN9.A4C BUILDING 6 HOME IMPROVXMWT 222 SIEST MAIN STMT 5 MAIN ST ? PO Box 1990 MURPF.E IRA 02649 HYMMI9' MA 02601 insured is AN INDIVIDUAL Omer work places and iden,ificaticn nr rnbers are shown in the scheduie(s) attached, 2. The pglir,y period i5 from CS-09-06 To 05-09-07 12:01 A-M, at the insured's marling address, 3. A. WORKERS COMPENSATION INSURANCE: part One of the policy applies to the Workers Cornpensatian Law of the state(s) I sted here; MA S. EMPLOYERS LIABILITY INSURANCE. Part Two of the policy applies to work ir,each state listed in item 3,A. the limits of ovr liability under Part Two are: Bodily injury by Accident: $ 100000 Each Accident ' Bodily injury by D!sease: $ 500000 Policy Limit Bodily njury by Disease; S . 100000 Each Employee 0. OTHER STATES INSURANCE: Part Three of the policy applies,o the states. It any, listed here, COVt6RAGl REPLACED BY ENIDOR3E6IiENT WC 2Q 03 06A D. This policy inclides these endorsements and schedules; SIX L!STINtG OF ZWORSDMATS - EXTENSION 01 INFO PAGE 4. The premium for this policy will be determined by our INan jals M Rules, Clessifications,.Rates and Rating Plans. All ragt;ired information Is subject to verification and Change by audit to be made U AlLLY. DATE OF ISSUE: 05-15-06 WC ST A99ICN: HA OFFICE, ORLA= IIr WS Ark 161 PRODUCER: DOWLING 4 o NXIL INS ACC 22LGR Triple 1-3/4" x 11.7/8"VERSA-LAM®2.0 3100 SP Floor Bearrl1F1302 BC CALC®9.3 Design Report-US 1 span 1.No cantilevers}0/12 slope Friday,January 05,200716:50 Build 057 File Name: BC CALL project Job Name: Unit 8 Description: F802 Address: 160 Marstons Ave Specifier: - City, State,Zip:, Ma Designer: Jim Fellows Customer. Company: Fellows Building and Home improvement Code reports. ESR-1040 Mise: 2nd floor girder 1 —� .. __...,.. 1i.00.00 go 81 LL 2188 ms LL 2168 lbs DL 1233 Ibs DL 1233 Ibs Total of Horimital Design Spans 17430.00 Co3ad Summary Live Dead snow Wind Roof Live Tag Deseri90n t..0ad Type Ref. Start _ End 100% go% 11.6% 133% 126% Trib, 1 Standard Load -� Unf.Area(psf) Left 00-00-00. 17-00-00 30 15 08-06-00 Controls Summary value %Ahowable 0umfion Load Case fBE 6ncatton Disclosure Pos. Moment 14451 V-Ibs 45,3% 1000/0 1 1 -Internal Completeness and accuracy of Input must End Shear 2975 Ibs 25.1% 100% 1 1 -Left be verlfled by anyone who would rely on Total Load Defl. U398(0.513') 60.4% 1 1 output as evidence of suitability for particular Live Load Deft. U624(0.327") 67.796 1 / application.Output here used on building Max Deft. 0;513 51,3% 1 code-accepted design properties and analysis methods,Installation of BOISE Span/Depth 17:2 n/a 1 engineered wood products must be in accordance with current Installation Guide Notes. and applicable building codes.To obtain InstDesign meets Code minimum 1J240 Total load deflection criteria. call( 00) Guide or ask questions,please g ( ) cell(80Q?232-078t3 before instaltetion. Design meets Code minimum(L1360)Live load deflection criteria. - Design meets arbitrary(1")Maximum load deflection criteria BC CALCO,BC FRAMERS,AJSTM Minimum bearing length for 80 is 1-1/2". ALUoISTO,8C RIM BOARD' Bci®, Minimum bearing length for B1 is 1-1/2": B015l:GLULAMTM SIMPLE FRAMING Entered/Displayed Horizontal Span Lengths)!n Clear Span+1/2 min. end bearing+ SYSTEMS,VERSA-LAMS,VERSA-RIM 112 intermediate bearing PLUSe VERSA-RIMS, VERSA-STRANDS,VERSA STUN are trademarks of Bok5e Wood Products,L.L.C. Connection Diagram g, C O O - a minimum=Z! o=7-70% b minimum=3" d-12 e minimum 3„ w .; :., .. ,;.. r`._.�G,N. ,: 41 sr. Fi +z-'+ y,Y. �f ,�� L-'q..:ut -.s C �f t, .:u4.xca•-- - , - Connectora stet 1�d t30>t Narl6- �., Page 1 of 1 j - Double 1-314" x 9-1/2" VERSA-LAM@ 2.0 310O SP Roof BeamIR801 SC CALC®9.3 Design Report-US 3 spans No cantilevers 10/i2 slope Build 057 Monday, January 16,2007 09;35 File Name- SC CALC Project Job Name: Harbor Villages unit 8 Description: R601 Address: 180 Marston Ave Specifier: City, State, Zip:Hyannisport, Ma Designer: Customer; Company: Code reports: ESR-1040 disc: ridge Beam i 12 I 1 oY Q9 v0 r 1&W00 � t31 92 � 93 AL 10D2 ft DL 1946 fbs OL 190 Ibs DL 1 Ibs SL 9599Ili SL Ib4 si 3920 Iba SL 1%9 The Tokll of Horiw tei Design Spans=37-00a O8d tt1i1818ar�1 Live I DOW SnM gYftad iRoa Lim TM Dew Load TyM Ref. start End top% i 00% 115% 1133tb 126% Trib. Standard Load Unf.Area(Pat) Left 00-00-00 37.00-00 } 15 25 10•04e00 �:Ofltd®{s�lAt1UFflaPy Value %AllowaW Duration t cam Sag Location .��..— Disclosure P08, Moment 8262 Fibs �>1 115% 193 1 -internal cornple:mness and accuracy of input must Neg, Moment -8243 ft-lbs 51.4% 1150A 1a6 1 -Right W vaffried by aMr a who geoid rely on End Shear 2247 Ibs 30.9% 115% 193 1 -Left output as erldence of sritabilfty,for paflicuw Cont.Shear 3236 Ibs 44.5% 115% 195 1 -Right i appliratlon.Outpui Rare based on building Total Load Defi. L1303(0.594") 59.4°/5 193 1 g coda acc ed sagn properties ana Live Load Defl. L1486(0.371") 49.4% 193 1 analsis rristho&ir"llstion of BOISE Total Neg. Deft 0.132" 17.6% 193 2 englneerao vrood products mist be in Max Dofl. a=wdastcs wilt►current installation Guide G.594" 59.4°�O 193 1 and Mplicable building cedes.To obtain Span/Depth 18.9 n/a 1 Installation Guick or ask questiors,please call(800)232.0768 before instaliatlon, tVfatss SC CALCO,BC FRAMERg,AJSTM Design meets Code minimum(L/18O)Total load deflection criteria, ALA 6p1S'*,lac RIM t3oastaT. 6GiC Design meets Code minimum(U240)Live load deflection criteri@, BOISE GLULAMTe,SIMPLE FRAMING Design meets arbitrary(1")Maximum,cad deflection criteria. l SYSTEK0,VERSA-LAMO,VERSA=RIM Minimum bearing length for BO is 1-112", PLUSS,VERSA-RIBS, Minimum bearing length for 81 is 3". VERSA-STRANDO,VERSA-STUDS orb Minimum bearing length for S2 is 3" trademarks of Boise Vvood PMducfs,L,i..C. Minimum bearing length for 83 is 1-1/211. Entered/Displayed Horizontal Span Length(s)=Clear Span 4 112 min,end bearing¢ 1./2 intermediate bearing Member Slope a 0,consider drainage, Conrtgt n Diagram i O i F ji� v a minimum=2" c a 5-112° b minimum=3" d=17' MVismbn ho no sfde loads. Connsctars are:led common Malls Page 1 of 1 t RESIDENTIAL BUILDING PERMIT FEES 'APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE _square feet x$96/sq.foot= 3 6 x.0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS.OF EXISTING SPACE (alf square feet x$64/.sq,foot=_ j�.o x .0041= 'L�3 plus from below'k;f applicable) GARAGES(att hed&detached) square feet x$32/sq,ft.= x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 sf 500 sf $35.00 >500 sf 750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS I Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney . x$25.00 (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25,00 Relocation/Moving $150.00 (plus above if applicable) , ,J, Projcost Permit Fee-- _ Rev:063004 �•� � .,F wt wt L ) a. f _ �'; , �'� •bpi �F #3`'�, �`� _^ ►•� � �� °A!` - as e..,�.. Th v 7 r I ON rfr } llp��e A s.�..� 1�`- - � "„t;�•;'�eil . sww'.�""'r�t�p'�..o..+=r;%��rc+.r Yl� ..r - '.ste a 1/ lot wn x b�{. �.•Jh'I/^ {��-r- •4� _ ,y'NaS.s S�j� r�! '•�: Sp~�1�1Y1 T. �+�"'a�., eri '-'4� I.' i � Vq��3 'cs �,F�wr��.' -"�^���i,c�:. 7'•��.1`� E/ � ,c" °4P�i'!'�ws.� L�a -t'« ir g r► (,.s<�ser.. .�'a.s,5c?1 J(°•t¢W '6a '4 +t ;Rt, $. : ,, ;,'•+y +rr��e� � F�.^��t-a 1,� t�,,e�,,.. W`fk!'� �,ty?.17NL .a �;/YY► yr .;mac rt. T��:�o-r,,,. !){1 11�� +�� .Y 1 IF,7'�",Ew�•" ''e""n a�` t "., "q+,',ti J ...r.i..._. c , 77 t it ac- ee6`i i .mom big Y i :w p;,y, ANY •`- ^ky. �'� ,- �'.'..�4.+ h� ra . C v.w tawL. x rAC s 7« +�f + 9-7.C 3s r. _ ' t ek '. F s i Al Ma+ANt : s 22 l�f e,..P', '. sr�-.,...•.�?�3 "^"'-fir' -r^s.„'i"g t .!°.. "»i �'- .�, '"" ;,r __ �'� .f 6',. � .`t` if�t•v3R ors} � � ��- •c r �.f,f�;�er 't!;�, /� ��,�� \.�de�"�.py�? l,,e.z t� 7 � �..,.yr''a"" I �'�i�Meiur� '.rrr,."'/'✓'"' „° �!. y • P t ron rf$� fLr v F r O�iit,ES. `?���°�'�F'�y < .�`r' -vc� a:�� °-�:,e„ alit'�z�,•a„ ^�'��y� 4' . .`r - ' .c. � aL.,f •�'srts�' 'ay k}.;� ��'�" � �C�. ��� sue'- � 1 �.y� ._ ;+ F ��C,F�y�� ...✓g.. � .,d"..y�; r (•�%5�*� � $ � yips r€. Pry"'' ���} "s,P,F. '.- �, n �" ��f '(fin i (` �V.(�t�i=•: 5.�,,,:t� y w.. Ir ow- Ins t''Svc sq lam.Ag R _ At • S4. +a ri op R� �t � .� '4 mow " 3 + v g` t `• �i; � + 'Q{ C•. � �;I _ 'fit"`v�c '�' �:F+. r�'& .siY t� Tt,.xciCl e _ 7 :v A. ;#r• �. �..N+�' �r .. it pit vl v 1 _ ti 4 r•^-� .. „�_fir•. rA t ` A �` > f7' r g rA �. 4t�': {•- .µme ��•T"'l •,� qqer - 1 r. M k ; T r 9 . O Re, ��Ip � eat��'""".�' � -1 't 1 - _ --°•„ '�V°a` ®' �® �."��°�°/ � m.. =.I/ � '�`„� fie•® ®��••.x-�- 0' ' �® � 60- dry , i f _ I ! _ I - '•� SAS?aM i�t to WA F19 )MI 'V aAl Aj as � 0 3 �51_liF�3Ef�o ROOF ,I y♦ _.......—___....-- _.. .,6 ,•., - u.as.c-_L�_..L.ar v 1~ ---- OWJXRM'.__Js.=�tl_7 AlClfliAU JO lsy�u�. LE ��'1�o:FC �C©''daGE= JZ$ - TOTAL la.5413jF$QUAIR-F FOOTAGE_ � C J$ BF i%i+LLa�ta MES OWAb - -' r--Qarovmr w,rain.we.r n p�aD/Do6.�o� l62o 001/ Te Ylb V 440 2 s ISt ISO r,w � � 1 •i U#JtT ; lam tF3o t�a �c��rN s AVZ cl- lei- Assessor's office(1st Floor): Assessor's map and lot number �'P 1 'W— 1 -0 v D 0/ QUO*7ME roe` Board of Health(3rd floor): (�� S � �.'.SYS'6' �! Sewa e,Permit number c�j + Engineering Department(3rd floor): 4 �0 o • f RAW iL SH LEC Mum �" 39. House number a `00 Definitive Plan Approved by Planning Board 19 ,pax d APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only YO°vimn0�s PPSOV OWN OF BARNSTABLE ft=14BC I L D I N G INSPECTOR -�L RERMfTwT TYPE OF CONSTRUCTION A s, TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �� �y .o ti't t..� �,V7 1-fA$Z T?fyeVS 4 V-0: y ,n//V 1 S r,,XT—, im,4 Proposed Use Zoning District Fire District Name of Owner t&k0,4e 4- Address Name of Builder Address Name of Architect —`� Address Number of Rooms Foundation �dNG LU Exterior Roofing L� Floors Interior +®/L 1�lti1��L Heating C- Plumbing / B A) £O W 0O Fireplace V", Approximate Cost Area AW 5J S Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name' u- Construction Supervisor's License BENGEN, BARBARA ADD � ,a.. No 3 3 0'51 Permit For DW .-fEL NG Frame .•, - Location -TMarstd)-,ns Av n Hyannis OfUlt Owner Barbara Ben en T e of Construction frame YP Plot Lot i Y • Permit Granted July 10 19 89 Date of Inspection 19 , Date Completed 19 PC • t-s • y 4 of 1W too to .•d Q7J(0?S TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 7 r'rq`"•' TF P RNSTAKplication # -� Health Division m Date Issued Conservation Division Application Fee Planning Dept. Permit Fee G Date Definitive Plan Approved by Planning Board 11VISION Historic - OKH Preservation/ Hyannis Project Street Address �O V`�1��6�c��► �! Gu h�i 1� Village �Amhh xOoI Owner 71aHe Address lq "0V t 1QVC < 11', •1�1T�,h Telephone -0 y qq Permit Request �2�o V e 3/9 f�� rn c lC Li I Q/�lh �1�oows ��Q,qC P S il �c9 J' 1h cta ti S il'e icsw P w�"1d�B Lo eC04-cad w �p1S� Ske S`oe -ee-�ract,( C�P���K� s iti a 12 eoQ�on�.s Square feet: 1 st floor: existing 7c�oproposed 2nd floor: existingproposed _Total new Zoning District Flood Plain Groundwater Overlay Project Valuationn y _Construction Type 'eM Lot Size / Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family C7 Two Family ❑ Multi-Family (# units) Age of Existing Structure S 6 Ic Historic House: ❑Yes g g &'No On Old King's Highway: ❑Yes 2'No Basement Type: ❑ Full e rawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) I/ Basement Unfinished Area (sq.ft) tl Number of Baths: Full: existing new Half: existing 1 new Number of Bedrooms: existing _n w a Total Room Count (not including baths): existing y new First Floor Room Count Ll Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other pq�A e Central Air: S"Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes B'IClo Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes W o If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name W M 14.yh �e Telephone Number O Address ,'j i��ti Y�t, tA yg%&h\ S License # C S-09 0 7'19 Home Improvement Contractor# 1 $ D O 8 Email Ver A Zx,►i, (\e- A Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE ''/ r�t���-� DATE f o2 1 !] I� T FOR OFFICIAL USE ONLY 4 APPLICATION# is I.p. D,.ATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: F FOUNDATION FRAME l INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH. FINAL GAS:r ROUGH' FINAL FINAL BUILDING DAT-CLOSED OUT j AS§OCIATION PLAN NO: DquatneW rfbz&it .Iccidets . ' - Fce•,�xf�t� �rs 0.Wm*hVvrr S6 eet starj,MI 02 wnru.� ga dia APP��- ��uipe�safInsca-an.�� avi��-mi�ciersf�agt�ar�r��tz�ciaaslP�uffi�ers Ii=t Infarmatian Please h� I�Tr7T7tP.. 1-T7fIfTSi�n��:Ov,,J � Y�,.'V� Address �7 c—Sj vg n VJ qm `s PA�a a Q&6Z cityfstat p-- x P K -5 vti Phonz 47 Are you an employer?Check the appragx late bG.. I3 Pe of Project ❑ I.am a employer wiry 4 E I ff getneral confactai ad I . []New Iayees{full RagOrpatt-#)* •�e ire the I am a soIe propiidar orparfner listed on the attached sheet 7- �rm�dP-f_ sbip and have naemployees These=b-aonractars ha ae S- ,ElInlitiau fnr ma in� emipinyees and fta�e wof$ers'��-�`- $ -•Q_ ❑Building addifion EIrr warms' comp_}u�rra,•,�e Comp-imsu a 10 electrical r or additions 1 5-.'❑ We:are a caiporaHcnaad its , -❑ epai .3-0 I am a homer doing i u wrnk offir;ers have esrr m-d thek 11-0 Plnmhiag repairs or addifiaa& try3el[Na quark='cep- xi�•of emeimpfion per MM I2-0 Rnaf repair 1 1 ,antic F>Hste tta' fitum-xncg required-]-F T��{?ii�r employees_[Na ' a comp-instr—ce mquire&j *Any aug fthatche:cksbos01=AF1aMouttheseciioab9owckowbig['hrirwo&m'co=safiaupoHrTi ma- ffomeowners?xhG to r isc�d-Yu"ma ya�dnm,=II �{ tb—hLeoati&-coanKtursnmc Submit sazrsigdndt�n^�sarlL : ZCOUtr&C=thst check this bas must at added m addi m d sheet shn•pzing tha bane of&a 6?.ds-=tw:b s and state whether,ocnotihnse e h ve ��J'�: Ff the snlr{n�dzas 1u-fie p nlir�c-�they ems[g=oti3e thy-worms'pomp.p uii�u;ffibez I am arz errzgImfx--r that is prmiffffg tt<ar&ers corrr nsatiazt insitrrufc$far=Y amiLayezcs. Betotr is fitepa&c}art d}ob L-Lff hi farYt afiatL FASTS mce GompmyName_' P-0Eay;ff OI�If IIIS:�iG� EXpimfivaDate Job§rim Addsesr -V © Cca'�'T['J CrEgiStat�ITg 141�i4 K(A{T('- Afiach z'opy of fhg wGrkers'campeusaiion pcylir.T. dedzratiou gage-(showing the paw nu=ber,and tm m taon lots): Failure to secm-e cq-v-etage as required under Secfrt SA of NIGL c. 152 caa lead to the impositim of criminal pea$fEies of-a fine up to. LUOIQD anafor one-yearimpaso ,as went as city Pt tfrR% s in ihe famm of s STOF WORK ORDER-aad a fmn- of up to$250-00 a day against the:violator. Be advised that a aTy oftbis statE�=zy be fa-warded ttF the Office of Investigations of ffie DIA for nre cat;•erage V'M:ffiCdjDn �ego FaRreb,J �.�P rcFrr�r t;`ra�irLs utict'gsntt�iss r furF Ifiatfhe i��vr-+ricdia-n yraxticled rrFirr��rs frue etnct cuFFs(� MOM 9- _ QYE�id ress rauT,, D? not wdhr in f ds area,fa bs caxrp eted by ct<ur farm fficinl ' Giiy or Town _ P rag cease . Iss�a��.ufharit�{mcIc ntie�: . - L ward-ef$ealfft 2.Binding Depar� a±yffa-vm CI=k'•4.Eleacical h spectar fi,Phm:bhig Easpector S.Other ; Contactl3ert<Qa: Flto-ut Massachmsdts General Laws chapter152 reqkes all emloyees to provide workers'compensation far their errplo' P tD this statote,an employee is defined as -_eve-T person in the service of another under any contract ofhire� ^ express or implied, aral or wd tco-" An mTTgya-is defined as'an individual,partaamhip,association,corporafidn or other Iegal entity, or any two or mare offat foregoing engage m d a7oi±enterpase,and molndmg the legal representat'tvrs of a deceased employer,-or the receiver or trIIstee of an individual,partneishig,association or other legal entity, employing employees. However the owner of a CLWe-U ag house having not more than three apartments and who resides fficreID,br the occupant of the dwelling house of another who ploys persons to do maintenance, construction.or repair work on such dwelling house or on the grounds or biding app rtrnant thereto shall not because of such employment be deemed to be-an employer." MGL chapter 152, §25C(6)also states tisat'every state or local fir-easing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct bnildings 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`Ncithex fhb 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 in su:rance 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 siination and,if necessary,supply alb-DO ntractar(s)name(s),addresses)and phone number(s)along with their cerdf cats-(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LL.P)verithno employees other than the members or partners,are not required to canny 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 ofinsurance beverage. Also be sure to sign and date the affidavit The affidavit should be mtnmed 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 lif 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 m srr�nce license number on the appropriate line. City or Town Officials Please be sui-e fist the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out is the event the Office of Investigations has to contact you regarding the applicant_ Please be sure to fiII in the peaaitdieense number which will be used as a reference number. In addition-an applicant that must submit multiple pennit/license applications in any given year,need only submit one affidavit indicafing current policy inform.ationl(if necessary)`and under"Job SitE Address'the applicant should wdte,'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 Me for future permits or licenses. A new affidavit must be Elled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial-emtgre (L e, a dog license or permit to bum leaves etx.)said person is 1�l OT regoired to complete this aiEdavZt The Office of Investigations would like;to thank you in advance for your cooperation and shouldyau have any questions, please do not hesitate to give us a call. 'Ihe Department's address;telephone and faxnuabe-. , ach CaD=aaww4a of Massachumts D-- �at of Ina a1A�deat ofcvau 6;00 W &ty--e-A fiastazi,MA 02111 TtrL A 617 727-49-�5 i�)±4-46 4r I-9 hLkS�A F=: 617-727- 4.� Revised 4--24-07 . . � E Tz Town of Barnstable Regulatory-Services quxrAM i g« Richard V.Scali,Director �A 1639 r� Y A Building Division Tom Perry,Building Commissioner ; 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 w Fax: 508-790.-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, as G� as Owner of the sub ect property J P P rty hereby authorize W I\G-v--A t to act on rnybehalf, in all matters relative to work authorized by this building permit application for.; 1 Coo w� ors- te e: a nls.,pc� v r - (Address of Job "Pool fences and alanns are the responsibility of the applicant.Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted: nature r. Signature of Applican tot-, A, 0/44 ��C wrll,4e,ll. Print Name g. Prn- Name s Date `Q:FORMS:OWNERPERMISSIONPOOLS Town of Barnstable Regulatory Services �oFe rrky,� Richard V.Scali,Director Building Division BARNST"LF Tom Berry,Building Commissioner Mass 200 Main Street, Hyannis,MA 02601 �E 't b►1tA www.town.barnstablema.us Office: 508-862-403 8 y Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone 7 CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINTTION.OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. _ The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner 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. t - HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,RuIes &ReguIations 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 Iicensed 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. QAWPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 isetts -Department of Public'Safety 3uilding Regulations and.Standards struction Supervisor {* -" * tis;a►aas�apun sense: CS-080779. L09ZO HW'SINNVkH /, L 3AINC]Nb'Al,4S Ll . TTT7 � q\U�$ all3Jl Wb IIIIM i-AA 02601 I = ,..11l3>i.Wb INI 1enplAlpul LIOZItfI_ uolaeJldx3 Expiration :adzl1 80 �:uol;ejsi6aa 051.1212015 2iOlOb211N00;1N3W3Ag21dWl 3WOH- ,ommissioner uoyeln8a ssauls r7aagJ'igmr unnsao0:3o o i _ s n; c; - idol use only ta 1 'd f r m d v setts.-Department of Public Safety License or reg►stration va lid 3uilding Regulations and Standards before the expiration date.If found return toulation uction Su ervisor " Office of Consumer Affairs and Business Reg str p. Suite 5170 ;ense:.CS-080779 10 Par. - ``��� '�!IS Boston,lVlA 02116, A IEI 17: i. 0z601 } sI Not valid without s Expiration ► ."" e 'r . .. 0511212015 ;ommissioner. ------------ .. - 1 eg D �X a f ' Commonwealth of Massachusetts Sheet Metal Permit Map Parcel OOL Date: Permit# 20r 9 o'6 g Estimated Job Cost: �. PERMITRESS Esti Permit Fee: $ DEC 17 2014 Plans Submitted: YES NO � Plans Reviewed: YES -NO WN OF BARNSTABLE -- Business License#q leo Applicant License# Business Information: Property Owner/Job Location Information: Name: U 6q� 4V/1 /vC Yame: J/-�1115 r �rI Street: f� Street`. .Q17�7 r r- �'� 16 / fr City/Town: I' 1 z 6� l&.®X(ovity/Town: Telephone: Telephone: Photo LD. required/Copy-of Photo I.D. attached: YES NO Staff Inifial J-1/M- - =estricted.license i J;-2/M-2-restricted to dwellin 3-stories or less and commercial up to 10,000 sq. ft./2-stories or less Residentiah 1-2 family Multi-family Condo/Townhouses Other j Commercial: Office Retail Industrial Educational Fire Dept Approval Institutional_ Other - Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. Number of Stories: Sheet metalwork to be completed: New Work: Renovation: HVAC Metal Watershed Roofing. Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: 2-- P u � T re I w Ri INSURANCE COVERAGE: i l I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L Ch.112 Yes No El I If you have checked YS& indic7tete type of coverage by checking the appropriate box below: A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Progress Inspections Date Comments Final.Inspection Date Comments I I i Type of License: 3y Master ritle ❑Master-Restricted 'ityTrown ❑Joumeyperson Signature of Licensee permit# ❑Joumeyperson-Restricted License Number:. =ee$ Check at www.mass.aovlcfal nspector Signature of Permit Approval ; s w Cara rio7[xmmh*off?fassachuse fs OA �e�rtr��t a��`arstrtr114ecidents _. 600 Washhigton Street Bastara,AM 02MI, www.mass.gm-ldia Warmers' Compensati€an lnsurance A#ftdavit:$nildersfContractors/E ectricianMumhers Applicant.Infermation, Please Pri t Ikeibly Nam o duxo_� zL4gc441 L�64 - _ L City/stateMp_ - one D Are yati an employer:'Ch the appropriate bay: 4_ I�:s confractor and i T�o#'t�l�(reqau•ed}_ ❑ I am a employer with l_ � 6- '❑New construction. ees fu11 andlor time. * havehim&the sub=contr$cfors. employees{ l ) listed on the attached sheet 7- ❑I�ndelizrg Z am a sole proprietor or partner- ship and have no employees These sub-ooaftwkrs have $_ ❑Demr}lition w for m e in any c .ci r_ ernplayees and.have workers' �� Y � � I 9- ❑$nilding addition [Na Workers'comp_in uTwice Cornp] in5uxaIIoe, 5-❑ We are a corporati�and its lfl_❑Electrical ical repairs or additions ❑ uierg _ $ u n. yv offims hnm exercised their 1I_.0 Plumbing repairs or additions Myself [No Workers'con3p- right•ofexrmplionperMGL 1 52, d.R e bmm no, �Roof repairsnmT,Ance regnued,l l � c-1 �I(�"an , employees_[No wnricers' 13_❑Other comp_MsurdnCe,required.-I... IAuysap5omtdutchedssboarInmstalsofDlovt the secticab9owckawfitgilteawrn3cess'core+ j Tin nry n�s5 olio sdmait this affidacif iniilratiitr taey are doing Rn xm&amd dipa hug is idc contracmrs mnsY slabos$a rt sad mit mpg sar&_ 'C-j---hscinrs thst rht lr this box mast sttarh+d M additional sheet shave-mg the nee of&e =d state whether mnot ihQse mattes have �.IQyees_ I�tT~e snit{o-ntnicfins haee empIo�s,m�must grav-ide th:ir wor>;ets'comg.petits n�nnber_ I am arz umployer ihatisgrm idiV workers'catrrpeusation insttrrutce far my engAtDy-em BeL?iv is the polio} arzdjob Sao i.��otmaiio� Insurance CorapanyN=e: . t . Pol r<y-4 of Self-ins- Expiration Date_ job site Address: Cityl°sta zip: Attach a copy-of the arorkers'compensation policy declaration page(showing the policy number and-) ation date). Failure to secure cmi rage as mquireduu-&T Section 25 A of MGL c.. 152 can lead to the imposition ofcriminal penalfres of a. fine np t I,5i34_Oa andlor one yearimprisonn�t,as well as civil penalties in the fbun of a STOP WORK ORDER-aad a fine DEng.to$ t7.0{l a against the violater_ Be advised that a copy of this statement maybe fnr�earded to:the Office,of Iin eSfSgiati of the DIA far 6e C[)-w-clage ver f cation- . .. __ ... _ ._. . _. _.... p ..._ -. _ .__.._.. .._._ . _.__ .__.._ . _ ._. . -. .__.. ...-. .....-- -- - -- - -- ._. .... . Ida here c exhfy ttmder s prd s I dpenaWes nfperYury thatthe inform a#ion prcnid8d rabm a is frtta and correct Siariature: Bate_ E)jEcial arse allfy. Da not w1 im in this area,to be completed by cij�y ar town of ciaL City or Town: PermitUcense ff E—iingAuthority(drde one): 1.803rd crf Health 2.Building Departmeat 3 Cityl o:,Ku Clerk 4.Electrical Inspector 5.Plumbing LL,4ie-tor 6,Other Contact Persan: Phane#: 6 - t Information and Instructions P�v Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an ernployee 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 airy two or more of the foregoing engaged in a joint enterprise,and including the Iegal 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." f 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 is 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 conts-act for the performance of public work until acceptable evidence of compliance-,Niu the ir-isuraace requirements of this chapter have been presented to the contrasting 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 employes 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 Departinent of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the af5davit .'I1ae 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 ob��-n a workers' compensation policy,please call the Department at the number listed below. Sell insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the a$davit is complete and printed legibly. The Depa ,gent has pro-ided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you retarding the applicant Please be sure to EM in the permit/license number which will be used as a reference number. In acd ition,as applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information (11 necessary) and under".lob 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 m1.st be gilled out each year.Where a home owner or citizen is obtaining a license or permit not related to any busil-ress or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidati;it 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: Tho eo=o-aw alth of Massachusttks. Department Gf hidustdal Accidents - Office Of xavestiotion's 600 Washington Sti-�t Boston,IAA 02111 Tel,9 617 727-49-W(�)ft 406 or I-W-7-I ASSA-FE Revised 4-24-07 Fax A 617-727-T/-49 W _rnas�ga���.ia _.dod reverirication: r-:,r..',:ao;-jp.r.::r.:!-acr,i�rii;cz:icer.;' t: 370cIM-_=; ; V y Town of Barnstable- Regulatory Sakes. . s 9Ehamas.R Gefler,Duector MA 6 Bud Tom Perry,Biutding Commissioner . 200 M4 n Street Hyanais,Ak 01601 ynew.€ w3L aras#a61e Erse us Office:. 508-8fi2-4038 Fax: 508-790=6230 PrGpe: Owner Mu Complete and Sign This Section Using- Builder aneC o erthwaite 1 - I., ..as-Qwnerpf the spbjectp _-roperL7 hereby authorize_-hl j�yi�ll{� � �C -PVC to act on inybehal in aR matters relative to monk pui aozizeld by.this building per-rajL F _ f H ! $P :(Address of job) i I ''Pool fences and alarms are the responsibility of t1se.applicant.. Pools are not to`be fined before fence is instated a ools are not to be utilized until all fi-►al inspections are pedo ed.and accept I eouoopp ea /� 736PM EST RLi B-WLVP-QLEPAM ( L Signawre of Owner of Applicant Jane Cowperthwaite 5� 1- i j Print Natne N*+—nt Name i F Date Q:Four-,fS:owr+rexPOUv]rssIorrnoor s i � 1 Along All Perfotions n e e • . ' h.. CQMMONWEALTHFold,Then h ra OF'IVIASACHfJSt�TTS kSHEEI �f�. JORKERS x �' x om , fpu ISSU,ESTHE� FOLLOWING LICENSE' ' r A A T R ,U S7R CT S t SEAN F "0 BLEARY r 3 fir' Z • e ,? ;FABYAN Rl7 Z�� . f . � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ,� L a Map Parcel 00 Permit# O Health Division �9�-t"/� ��/V � �/ Date Issued 3 a 0 3 Conservation Division F'313 oZ ®S 1>A ,0 D/ pom J. Application Fee aPe v 3/a iloS �� Tax Collector Permit Fee Treasurer SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENRONMENTAL CODE AND TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address 10 f eij A-v� Village Owner c.v Address 3�p C(-S 1� 11 Telephone Permit Request CSc� Dgck Square feet: 1st floor: existing 9661 proposed (O 2nd floor: existing proposed Total new ( 12 Zoning District Flood Plain Groundwater Overlay Project Valuation ?-0►6 a d Construction Type l,3c)!?© Eg,.4,,c- �a Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting dociumentatiom. ` n s Dwelling Type: Single Family �( Two Family ❑ Multi-Family(#units) co Age of Existing Structure g g Historic House: ❑Yeslo On Old King's Hig�i y: ❑leasU011 o Basement Type: ❑Full A, Crawl ❑Walkout ❑Other - v r Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) C71 Prn Number of Baths: Full: existing ( new Half: existing new Number of Bedrooms: existing_3 new 3 Total Room Count(not including baths):existing T new 5 First Floor Room Count Heat Type and Fuel: Gas 0 Oil ' ❑ Electric 0 Other ` Central Air: AYes ❑ No Fireplaces: Existing New 5 Existing wood/coal stove: ❑Yes ❑No` Detached garage:❑existing ❑new size- Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION t' Name AwLF_C Le4 Telephone Number Address License# 040 SS-8 Home Improvement Contractor# Worker's Compensation# LALLNSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO i�sj'_AURE J DATE 3 " 2-1 ' ° 5 FOR OFFICIAL USE ONLY PERMIT NO. 4 , p DATE ISSUED MAP/PARCEL-NO. ADDRESS VILLAGE OWNER i DATE OF INSPECTION: ` FOUNDATION' FRAME INSULATION FIREPLACE f 'r ELECTRICAL: ROUGH FINAL F PLUMBING: ROUGH f"' FINAL 0 0 GAS: ROUGE FINAL t FINAL BUILDING m® ra 50 F- Q M S 'DATE CLOSED OUT 3 N ASSOCIATION PLAN NO. a _- _ The Commonwealth of Massachusetts -- Department of Industrial Accidents .t 600 Washington Street Boston,Mass.' .02111 Workers' Co m ensation.Insurance Affidavit-General Businesses - • _Sni�'�Pi.e'.. :-•�t§°t9s,• - '.Sr,e""yF4`.rn`'�m.• f—'� � ,r � „_ � ::5�."�.FisLL1.. , address: S �►)A-CVIJ .,�j city /' 1,I �i ': state: / l� zip: c lR-1 vhone# l T / / �-�( work site loeatiori(full address): ❑ I am a sole proprietor and have no one Business Type, ❑Retail❑ Restaurant tai/Eating Establishment working in any capacity. ❑Office❑ Sales(•including Real Estate,Autos etc.)' ❑I am an em to er with em to ees(full& art time.): ❑Other / %%% %//011111%G/.aGi7%%%/%%%/////IJ////I////%�%%%%%%%%%%%%%%%�/%%%�/ I am an employer providing viorkers' compensation for my employees worldng on.this job:. 8,0 com v ari" •m v ine: 1A ' addre$$c i. ..T"'fir Y'i:'•r. ::i•^i•� - -K;.::i' city: AhOne. #: 7�^^ ..r: •. illStira1lCe.CU: r. y:•"�.X9 ." 011 #' :• J1.. �j I am a sole proprietor and.have hired the indepen ent contractors listed below who have the following workers' compensation polices: _ 4' . comDany'aarire= - _ :. , .mot i .. • ' — .. .. addresS. cil. ty •-[' tsfiorie'#.. insurance:cO.'. - - _ ��•o7i :#�� .ai:%: .5.<;; MM COnlpanY nffII1e:• > •:'fit Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a flne up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the fdim of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that It copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby ert under the pains an p naldes of perjury that the information provided above is Prue and correct: Si store Date' cj` �-O • O ' Print Phone � .�. 7 official use only do not write in this area to be completed by city of town official Lh . permittUcense# []Building Department -- — - - ❑Licensing Board diate response is required ❑Selectmen's Office ❑Health Department phone#; ❑Other - i Information and Instructions. General Laws ch ter 152 section 25 requires all employers.to provide workers' compensation for their.. _Massachusetts . aP :. employees. As quoted from the f'law", an employee is.defined as every person in the service'of another under any contract of hire, express or implied; the or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or mgre of the foregoing engaged in a�joint enferprise, and including the legal.representatives of a deceased,employer, or the receiver or trustee of an individual,partnership,. association or other legal entity, employing employees. However the owner of a dwelling house having-not more than three apartments and who resides therein, or the.occupant of the.dwelling house of.: another who.employs_persons to do.maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment.be deemed to be an employer. MGL chapter 152 section 25 also states that every. state�or local licensing agency.shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the.commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor.any.of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting . authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation.. Please supply company name, address.and phone numbers along with a certificate of insurance as all affidavits 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 returnedto 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 regardinethe"law"or if you are required to obtain a-workers."compensation policy,please call the.Department at the number listed;below. , City or Towns . Please be sure that the affidavit is complete andprinted 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 b;e used as a reference number. The.affidavits may.be.returned to the Department by mat?or FAX unless other'arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us.a ca1L... The Department's.address,telephone and fax number: The Commonwealth Of Massachusetts. Department of Industrial Accidents effice of leitesfipfts 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 ext:406 RE roe, Town of Barnstable Regulatory Services B, srnsr.r, Thomas F.Geiler,Director A 1 : ��� Building Division QED NIP' Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508462-4038 Permit no. Date - AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION - MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adj acent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Estimated Cost j 00 0 Type of Work Address of Work: D t v 6wner'sName; Date of Application: I hereby certify that: Registration is not required for the following reason(s): (]Work excluded by law []Job Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS FULLING THEIR OWN PERMIT OR DEALING WITHOVEAJtNT WORK DO NOT TJNREGISTERED CONTRACTORS FOR APPLICABLE HOME IlVIP GUARANTY FUND UNDERMGL E 142A. ACCESS TO THE ARBITRATION PROGRAM OR SIGNED UNDERPENALTIES OF PERJURY D I hereby apply for a permit as the agent of the owner: L: Registration No. Date Contractor Name OR Date Owner's Name gforms-.homeaffidav TQw. of.Barnstabl.e Re ato Services ry =Tomaer,-Director-' ���. M,• . on Division .. . .... ... .. ... . '0h�n r,Mr _ ... TonaPerry, Building COMMIssiOner 200 Main Street, Jy=is,.MA 02601 WWWAown barnstable.ma.us Office: 508-862-403 8 _ Fax: 508-790-6230 • ' Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property to act on mybe hereby authorize �alf, in all matters relative to work authorized by this bunding permit application for, (Address of job) 3 0 �Ignitu�reo er Date Print Name t . _ I - ° tQ X { � f.?' (p X g Cict 2'P - /�� r- .IC.I•+O�S r M114-4 nt 2 x io e�e�� 6� E- y (I& P - ., (jai' 0 I •{ Rai v'. (� , - *3 ;.. f �� t a At I 6r�L. --- ,-:.: C - - O �f •Er 6 d 14At t'W�G. FELLOWS BUILDING doB & HOME IMPROVEMENT SHEET NO. OF 5 Main Street CALCULATED BY DATE MASHIDEE, MASSACHUSETTS 02649 (508)477-5196 CHECKED BY DATE _'p 2V'm SCALE 'l 11 ! ' � � � r•� ® �� -y IL, kFE -T B ' ACC �� STANDARD LEGEND NOTE;not all symbols will appear on a map y` GOLF COURSE FAIRWAY EDGE OF DECIDUOUS TREES ^ EDGE OF BRUSH r ' ORCHARD OR NURSERY -- , ? t J J EDGE OF CONIFEROUS TREES i ...... u N`T, " 1 MARSH AREA L " EDGE OF WATER — —= DIRT ROAD DRIVEWAY PARKING LOT PAVED ROAD 1 r 1 DRAINAGE DITCH " ' f i ----- PATH/TRAIL ` f � ,f ""` " j PARCELLINE** MAP 326 MAP# 021 PARCEL NUMBER #367 HOUSE NUMBER 2 FOOT CONTOUR LINE 10 FOOT CONTOUR LINE Elevation ti based on NGVD29 — -` j - `,•�4.9 SPOT ELEVATION STONEWALL Ae { _X—X-- FENCE RETAINING WALL RAIL ROAD TRACK STONE JETTY SWIMMING POOL �-n,83r't,�� ;f'`''�'� 3;£ti r't �`" ' PORCH DECK s t r3r� r. 0 BUILDING STRUCTURE x t} 1 rf i ,a x, F} t ,�.y+�f sr r xk f x s -- k ¥3: 1B'-`_...__,_�.. _ ._._.-.__„•..._:,,�_1 ^` �!' • 'f i y„az ¥"t affix"47fi?fYl DOCK/PIER:. x,r Fti{ t4i'rr�t,•�}'�'ri s�# ;-�-p°;�+'as r. '.,._,,,._,,_.�. �•';`•`.,.,,,�� .,' HYDRANT i}g�^ati EP:C;t.2Yrt� t $ ttf r P5 K t n } VALVE O MANHOLE e , ..a ..:,,« :. ry }. x, - l PP tit --..3":`,'.,, a3 iKs s'x •„ Y,'�°`:a:„:.. 7{�i'a•, NSF ..d s z ...._...,a r .. ...., f ? a, '�•i:zu� 4' .r . r. a L r ,, er• , 1: r . t.., FLAG PO • .:....a....x._v,r.. k,-x x ,.. ,s, i:r; r,.. w o POST ;,...r:r•' ` s ,..'a, °?:u.,. fir._,..r^xX...sr es .. x ;�?r..ley .,s sc'N„{•r.. r,.,,a.,3.. x. £ $1 r• r ..:, .' yl, y:.,... t .'. l.. c ! ¥.. x. sy3 Si' 1.., 4 [].. . �xr xaix as u; T,.0:,•W N, 0,. F^. B, A R N S T A B L E G, E. O G R A P H 1 C 1 N F O R M A T 1 0 N , S Y S T ,E, .M. S U N 1' T a SIGN � STORM DRAIN k e PRINTED ME:IN FEET *NOTE:This mop is an enlargement of o **NOTE:The parcel lines are only graphic representations..DATA SOURCES: Plantmetrics(man-made features)were interpreted from1995 aerial photographs by The lames - v=100'scole map and may NOT meet of wooedv boundaries.Thev are not true locations. W.Sewall Comeanv.Taooaroahv and vegetation were interpreted from 1989 aerial ohotggraohs by GEOD o UTILITY POLE n TOWER I _ HOMECMPRO CONTRACTOR R 10282 tr /2/2006 - FELL WS BUI j I'P ►; dames a OWS 5 Main Stree _ - c Mashpee,MA 02649`' { - Administrator (Elie Pomvno�.wsea� o�,/�aQoac�e� .� . B,QARD OF BUiI�7MtNi3 REGt1LAT6QN- LFcense: Cy NSTRUCTION SUPERVISOR pJO ( 'S Tr. o: 7594.0 1Z. �± JAMES D F96L6" _�� 5 MAIN SIT G.Ee.«ol, g� ' 1. MASHiPEE ILIA 02649 `' yAd +mist: tot Assessor's office(,st Floor): 1XC4' 40 SEPTic Asse;,sor's mi*and lot number C. " ` ®O f9 GL_ BN�TALL®ST YSTEM Conservation �-� 3 Co Board of Health(3rd o : 93 MITI TITLE -NVIRONPAENTAL I zz so Sewage Permit number Engineering Department(3rd floor): �� �� �L*'•5�'y,°° �' �o �a° House number Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2W. P.M.only F. TOWN OF BARNSTABLE A4 J o ' BUILDING INSPECTOR APPLICATION FOR PERfiAIT TO Colu t-rA U c.71- -t)�c> TYPE OF CONSTRUCTION _ A`e sSu,Q L/'C�ATFaI t aft t2� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:/CIA Location �"�y r sro7"s 1U\fe UN i T If Proposed Use Zoning District Fire District Name of Owner -1-holnAs Address T30 x Name of Builder Sig 6-Q- Address Name of Architect N0 Rom- Address Number of Rooms Foundation 0 Exterior Roofing IE I Floors Interior Heating Plumbing Fireplace Approximate Cost Area 2-7-5 Diagram of Lot and Building with Dimensions Fee �11Rda OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License Y w GARRAHAN, THOMAS C. No" 35825 . Permit For BUILD DECK. .' Single Family Dwellin -Location Unit '.#1, RMarston#Avenue ' Hyanriisport j Ow !Thomas -C:' Ga'rrahan # 4 " Type of Construction' Frame - i i . Plot Lot Permit Granted 'April 3 0 , . 19 93 Date of Inspection 19 : 1 Date Completed w 19 111 y F t 1 J i i t w• " 1 i i 4 I t F 1 1 4 /.e7 I�•° 819' tr/ • i s Y 7 . �i Sc�dw�rl� frafoscj De.6k I� Arcf— 7-21/M3 a �-' a 3�a i�9 3 PiA , ( y t. n + 4 1� TOWN OF BARNSTABLE BUILDING DEPARTMENT " HOMEOWNER LICENSE EXEMPTIOP7 "''`•i"`'+ ¢ Please print. --------------=-- a A :r ,DATE •"� Ns 3.. .... Si>; xP ` JOB LOCATI NU r+ Number Street Address "HOMEOWNER" Section O Town S �� ��9/1R✓���N $ v Name _..------- - S 3 ' Home Phone Work Phone PRESENT MAILING ADDRESS , ,t City Town 'q ' State #zn The current z P. C.c exemption occupied dwellilude nption for "homeowners" was _ �+ Qs of six units or less andetoealllowtsuchchomeowwne kr�. engage. an individual for hire who does not the owner acts as su ervisor. Possess a license, Hers t° <� .. provided tat ; DEFINITION OF HOMEOWNER: `�'• _�xYPerson(s) who owns a Parcel of land on which he/she resides or " reside, on which there is ,is , or is intended to be intends' tQ':. g► attached or detached structures accessoryoto such family structures. ne to A person who constructs more than o h use and/or�.���` Period shall fe v not be considered a one home in a tshaiL r l :the .Building Official on a form acceptable Such "homeowner" shall SUb�¢w'� that 'he she shall be res onsible for all such work mit'., p ble to the Building Official building permit . (Section 109 , 1 erformed under the yS tt. Th8,' unders 'g "homeowner ';� State. 1 ned Her"Buildin assumes responsibility g Code and other a y for compliance with they t sF regulations. applicable codes, by-laws, rule3.. and. The undersigned s rt reigned "homeowner" �. Barnstable Buildin certifies that he/she understands requirements g Department m ' Town mum inspection procedures ands °f.;: HOMEOWNER'S SIGNATURE 43 APPROVAL OF BUII�DI?�G ----- 0F111C.I.AL Note Three famil required to Y dwellings 35 , 000 cubic r Contr`ol. Comply with State feet, or larger, will b Building Code Section 127 , 0 be Construction Y y; Y 1 NISC5' 4 j A HOME OWNER ' S EXEMPT Z O N The code states tha! perm Tin Elomr Y - ')Wller performing work for which a building, it is required riall be exem ; .. fron! the provisions of this section (Section 109 . 1 . 1 - 1- 1-cCnsir)y of Construction Supervisors) ; Home Owner en a es a P ) ; provided .thatiif: engages person ( s ) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assumin �v the..responsibilities of a supervisor ( see Appendix Q Rules : for'- Licensing Construction Supervisors , Section ?_ . 15 ) . Thisalackeoflat3.ons ! tt awareness often results in serious problems , particularly when the Home r` :Owner hires unlicensed persons . In this case our Board cannot proceed ,F against the unlicensed person as ;_l. :,_, ,i c� with licensed supervisor. The: :r" Home Owner acting as supervisor is u. t i mmat:ely responsible . To ensure that the Home Owner is 'f.uliy aware of leis/her res onsibi many communities rea':ire , as part of the permit application, that the1Home c4� Owner certify that h � ;she i.ndersi. .-On - the last page of. r the responsibilities of a supervisor. p 9 "11 ' s"e Focrr currently used by several towns. You may care to ame; and adopt s"�-h a form/certification for use in., our community. Y }r, art ti it j �y r z . ...ri J:t': N Regulatory Services Fee 9� SS Thomas F. ct Geiler,Direor - gcr)-c($' sA79•. �� " Building Division Peter F.Diliatteo, Building Connnissioner 367 Main Street, Hyannis,MA 02601w Office: 508-562--038 Fax: 508-790-62_0 ENPRESS PER1N111 APPLICATION - RESIDE 0 No: Yaiid widastr Aa X-Fuss ImPTiw PE Map:parcel Number 20 � �8/29 a®a17- -ye F E B 19 2002 r Properry Address A40 v ^ Residential Value Owner's Fame&:address .<<.v ..�1 �G�///y 5 lr � ��� Telephone.:�Iutaber 7� �� contractor's Name l�fG•�-r11-� Home improv,-Rent Conuactor licenses`(if applicable) Consuuction S73 upervisor's License_(if applicable) t ❑Work=,s Compensation Insurance Check one: I am a sole proprietor I am the Homeowtier Ijave Worker's Compensation Insurance Insurance Coatpany Warne rr Worlanaa's Comp-POlicy Permit Request(check box) Q Re-roof(stripping old shingles) Re-roof(not stripping. Going over =jst layers ofroon Q Re-side Q Replacement Windows. U Value ( ) Other(specify) .wherc required: luuL%ce of this pamit does not exetttpt conViiaace with other to"depamnent regulations.i.e.Historic.Consen 4tion.::c. Sieitattu Q:Fo rms:a xptntr&:rey-47060 l i ,17 i [10 of 2 CONSTRUCTION CONTROL Project Number: Contract No. 03-000-10-OHI, Engineer No. 8614341 Project Title: Area H-1 West Sewer Extension&Water Main Replacement Project Location- 160•Marston Avenue, Hyannis, Massachusetts Name of Building: Marston Avenue Pumping Station Nature of Project: Sewer and Pumping Station Construction In accordance with Section 116. of the Massachusetts State Building Code, I, Robert Butterworth , Registration No. 42518 am a licensed professional engineer in the State of Massachusetts. I hereby certify that to the best of my knowledge, information, and belief,the building was constructed in general conformance with the plans and specifications, and in my professional opinion, is in compliance with the Seventh Edition of the Massachusetts State Building Code. Entire Building rchitectural Structural chanica �%"OFMASS Fire Protection Electrical Other(Specify ROBERT GN 0 BUTTERWORTH a U No.42.518 (0 Seal SANITARY q� T�� `�� Ssio L Signature Subscribed and sworn to before me this s+h day of U�`I , 2012. Notary Public "( My Commission Expires 10 ' 2A ' 1 LAURA MUIR Notary Public $C=0WftXW&*&VA4LTN OF SACN{lSETTS My October 24.201MY Cwvftsion 144 es oap.12-07-12AO7 :34 RCVD C:\DOCUME—I\DLRUSS—I\LOCALS—I\Tenn&otes7A237C\Final Construction Affidavit-RB HlWest.docx r i 212 JUL 1 CONSTRUCTION CONTROL SF' 1fl='Sa Project Number: Contract No. 03-000-10-OH1; Engineer No 8614341 Project Title: Area H-1 West Sewer Extension& Water Main Replacement Project Location: 160 Marston Avenue, Hyannis Massachusetts Name of Building: Marston Avenue Pumping Station Nature of Project: Sewer and Pumping Station Construction In accordance with Section 116. of the Massachusetts State Building Code, I, Robert Butterworth , Registration No. 42518 am a licensed professional engineer in the State of Massachusetts. I hereby certify that to the best of my knowledge, information, and belief, the building was constructed in general conformance with the plans and specifications, and in my professional opinion, is in compliance with the Seventh Edition of the Massachusetts State Building Code. Entire Building rchitectural Structural chanica �HOFMgSs Fire Protection Electrical Other(Specify �A�R9cy OBERT GN p BUTTER WORTH mi v No.42.518 Z9 Seal SANITARY q�'o���/STtt��o`�� FSS/0 L�1G Signature Subscribed and sworn to before me this +h day of 52012. i NotaryPublic- My Commission Expires l0 ` 2A LAURA MUIR Notary OF MASSAMMMS W Cwwft on Eq*es October 24.2014 12-07-12AO7 :34 RCV CADOCUNffi—I\DLRUSS—ITOCALS—I\Temp\notes7A237C\Final Construction Affidavit-RB HI West.docx J I"E'er Town of Barnstable 0 Building Department - 200 Main Street t ASTABLE. * Hyannis, MA 02601 9 MASS. $ (508)i6gq. 862-4038 OD ,0 prFO MA'I A - Certificate of Occupancy Application Number: 201006342 CO Number: 20120095 Parcel ID: 28818000A. CO Issue Date: 07/20112 Location: 1-60 MARSTON AVENUE Zoning Classification: SPLIT ZONING Proposed Use: CONDOMINIUM Village: HYANNIS Gen Contractor: JOUDREY, KENNETH R Permit Type: ' CC00 CERTIFICATE OF OCCUPANCY COMM Comments: 57 Building Department. Signature �- Date Signed 1HE TOWN O F ARNSTABLE Building Application Ref: 201006342 BARNSTABLE, Issue Date: 11/30/10 Permit 9 MASS. �p 039• Applicant: JOUDREY,KENNETH R Permit Number: B 20102592 Proposed Use: CONDOMINIUM Expiration Date: 05/30/11 Location 160 MARSTON AVENUE Zoning District SPLTPermit'rype: NEW ACCESSORY STRUCTURE COMM Map Parcel 28818000A Permit Fee$ 547.00 Contractor JOUDREY,KENNETH R Village HYANNIS App Fee$ 150.00 License Num 80380 Est Construction Cost$ 0 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND CONSTRUCT A SEWER PUMP STATION.NON HABITABLE MECHAIN ICAIEBIS CARD MUST BE KEPT POSTED UNTIL FINAL BUILDING ENCLOSING A PUMP SYSTEM INSPECTION HAS BEEN MADE. WHERE A t CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH • Owner on Record: BARIGHT, RICHARD S 8i CARLEEN S BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: PO BOX 483 INSPECTION HAS BEEN MADE. TIVOLI, NY 12583 Application Entered by: DB Building Permit Issued By: THIS PERMIT CONVEYS NO..RIGHT TO OCCUPY ANY STREET;ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARIL ERMANENTLV. ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY.PERMITTED UNDER:THE BUILDING CODE,MUST BE APPROVED BY;1`HE JURISDICTION. STREET OR:ALLY.GRADES AS WELL•AS DEPTH AND LOCATION OF.PUBLIC'.SEWERS MAY;BE:OBTAINED FROM THE DEPARTMENT OF PUBLIC.WORKS. THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. - MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. - 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION: 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). d 0 v� f. n + BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 AN � � 2 2 ` � A G� �� '- 3 J Q 1 Heating Inspection Approvals Engineering Dept V j©� �. � Fire Dept 2 Board of Health Town of Barnstable r � Regulatory Services w s s"x`'STABLE „ ' « Thomas F. Geiler, Director 7y.t6 `0� '°rEo'3 A Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 October 6, 2011 Fall River Electrric Dana Johnston 74 Comeau St. Fall River, MA 02721 Re: 160 Marstons Avenue, Hyannisport, MA,,electrical permit# 201003211 Dear Mr. Johnston; Pursuant to MGL Ch. 143, §3L,the following violations and their respective code sections of the Massachusetts Electric Code were found at the Area H-1 West sewage pump station in Hyannis. 250.24(A)(1); Grounding electrode conductor must be connected to the grounded conductor terminal at the service disconnecting means. 25024(A)(5); Grounded conductor not to be connected to metal parts on the load side of the service disconnecting means.Notwithstanding 250.142(A)(1), the grounded conductor may not be reconnected to the equipment grounding conductor. 250.24(B); Main bonding jumper to connect the grounding electrode conductor and disconnecting means enclosure to the grounded conductor. 250.24(C); Grounded conductor to be brought to service disconnecting means and connected to the grounded conductor terminal. 230.66; Meter socket is not suitable as part of the service equipment with respect to. where the means of a main bonding jumper means is placed. 250.30(A)(1); Main bonding jumper for 208/120V system is located in multiple points within transformer and first distribution panel. 376.70, 250.86; Equipment-grounding terminal required in metal wireway: 110.3(B); Burndy KS17 only listed for(1)tap conductor 110.3(B); Greeves USA250-4 listed for(4) conductors, (1) conductorper port. s 1 a'. . Notwithstanding 376.56(A), the correct splice connector may require a larger trough. 404.3(A); Rotary switch in J-box to be mounted in a listed enclosure intended for device. 404.12, 250.86; Enclosure with rotary switch to be connected to grounding,electrode conductor. 314.15; Exterior Crouse-Hinds LBs not listed for wet location unless gaskets installed. 285.6. 110.3(B); GE THE series Type 2 SPD (TVSS) is not listed to have overcurrent protection in excess of 60A. UL has not tested this device with greater than 60A OCP, and therefore is not included in the listing. If you would like to discuss this further, or have any questions, please feel free to contact our offices and speak with William Amara the Inspector of Wires. Sincerely, AJ Pulley, Deputy Wiring Inspector Office 508-862-4089 C: William Amara, Wiring Inspector .Thomas Perry, Building Commissioner 2 COMPLETE •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse X `f ❑Addressee so that we can return the card to you. B. Received by(Printed Name) C. DiVe of iv ■ Attach.this card to the back of the mailpiece, Fri c Vqr V®q d or on the front if space permits. ' = D. Is delivery address different from item 1? 1. Article Addressed to: If YES,enter delivery address below: A No Vbte CLGCTK IC 3. tervice Type x: CeNfled Mail ❑Express Mail ❑Registered �etum Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7011 0470 i.00 01 i4 5 2 5 6'19 5 (Transfer from service labso = � PS:Form 3811 g February 2004 i a I ;D mestic Return Receipt 102595-02-M-1�540 ift4t ii I! i ii fi Ilii i iiifi! iri a I UNITED STATES POSTAL SERVICE First-Class Mail j Postage&Fees Paid J USPS Permit No.G-10 • Sender: Please print your name, address,,and ZIP+4 in this box • TOWN OF BARNSTAI3LB BUILD0110 DIVISION 200 MAIN ST. HYANNIS,MA 02601 /'v My STa N '_t /.c_ �M U.S. Postal'Se' ices. r " CERTIFIED MAILT,� RECEIPT (Domestic,Mail,Only; o.Insurance,Coverag_ rovided) IF,o7,dilivery,in'formation,visit our website_at,www.usps.con- ®® _ \ PS Fonn 3800,A7gus12006 See Reverse torrinstructions ' A Certified Mail Provides: a A mailing receipt m A unique identifier for your mailpiece a A record of delivery kept by the Postal Service for,two years Important Reminders: n Certified Mail may ONLY be combined with First-Class Mail®or Priority Maile. o Certlf!W Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. n For an additional fee,a Retum Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested'.To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement'Restricted-Delivery" o If a postmark on the Certified Mail receipt is desired,please present the art!- cle at the post office,for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with'postage and mail. IMPORTANT.Save this receipt and present it when making an inquiry. PS Forrn 3800;August 2006(Reverse)PSN 7530-02-000.9047 Gf Town of Barnstable Regulatory Services „ASS. g Thomas F. Geiler,Director 1°ten39. Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.m a.us Office: 508-862-4038 Fax: 508-790-6230 October 6, 2011 Fall River Electrric Dana Johnston 74 Comeau St. Fall River,MA 02721 Re: 160 Marstons Avenue, Hyannisport, MA, electrical permit# 201003211 Dear Mr. Johnston; Pursuant to MGL Ch. 1435 §3L,the following violations and their respective code sections of the Massachusetts Electric Code were found at the Area H-1 West sewage pump station in Hyannis. 250.24(A)(1); Grounding electrode conductor must be connected to the grounded conductor terminal at the service disconnecting means. 25024(A)(5); Grounded conductor not to be connected to metal parts on the load side of the service disconnecting means.Notwithstanding 250.142(A)(1),the grounded conductor may not be reconnected to the equipment grounding conductor. 250.24(B); Main bonding jumper to connect the grounding electrode conductor and disconnecting means enclosure to the grounded conductor. 250.24(C); Grounded conductor to be brought to service disconnecting means and connected to the grounded conductor terminal 230.66; Meter socket is not suitable as part of the service equipment with respect to where the means of a main bonding jumper means is placed. 250.30(A)(1); Main bonding jumper for 208/120V system is located in multiple points within transformer and first distribution panel. 376.70,250.86; Equipment grounding terminal required in metal�wireway. 110.3(B); Burndy KS 17 only listed for(1)tap conductor 110.3(B); Greeves USA250-4 listed for(4) conductors, (1) conductor per port. 1 Notwithstanding 376.56(A), the correct splice connector may require a larger'trough. 404.3(A); Rotary switch in J-box to be mounted in a listed enclosure intended for device. 404.12, 250.86; Enclosure with rotary switch to be connected to grounding electrode conductor. 314.15; Exterior Crouse-Hinds LBs not listed for wet location unless gaskets installed. 285.6. 110.3(B); GE THE series Type 2 SPD (TVSS) is not listed to have overcurrent protection in excess of 60A. UL has not tested this device with greater than 60A OCP, and therefore is not included in the listing. If you would like to discuss this further, or have any questions, please feel free to contact our offices and speak with William Amara the Inspector of Wires. Sincerel A P ley, Deputy Wiring Inspector Office 508-862-4089 C: William Amara, Wiring Inspector Thomas Perry, Building Commissioner 2 PROJECT NAME: 0 rn c`7� 0►�7 ADDRESS: �, L PERATIT# ZO to C-03`- Q). PERMIT DATE: M/P:- LARGE ROLLED PLANS ARE IN. BOA (. SLOT Data entered 'n MAPS program on: to � BY: t t r i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 4 8 Parcel ,� , DDI µApplication # Health Division Date Issued ` � 30 Conservation Division Application PlanningDept Permit Fee: Date Definitive;Plan Approved by Planning Board t Historic - OKH _Preservation/Hyannis ee Address Project Street Ad N IrPi�G-e s Village DD Owner ��u.K o Da�c a�1t �� Address 100 0, Telephone 5s0 g, g Co 6 qd Permit Request �eitsIPlncT Ol SrwGH Oyw►p . y�yt, vh . '1�/ert '�� �/• .�I�c�aw��aF Iklf` a"doSsK4 Q; 07vN• SYS N1 Square feet: 1 st floor: existing&Lproposed Znd floor: existing proposed N Total new Zoning District Flood Plain Groundwater:Overlay Project Valuation G� / D,od Construction Type 45ov, wlwovd 5kix ay Lod Size Grandfathered: D Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family :❑ Two Family ❑ Multi-Family (# units) Nl✓mcf Pa COX AV Cole)Q�. Age of Existing Structure Historic House: ❑Yes "❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout 1 (Other Ayeas,'l- W,i Ar11 Basement Finished Area (sq.ft.) /� 1�. Basement Unfinished Area(sq.ft) N. Number of Baths: Full: existing. & _ new &Pv c Half: existing e new A*,- Number of Bedrooms: Me e! existing —new Total Room Count (not including baths): existing Al.111. new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ;4 No Fireplaces: Existing**—New AA Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size — Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: moo$,- r Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # s ' a Current Use / A_ Proposed Use Pt APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ,... Name Rob ©v LO ?'hc. Telephone Number 9�7' q32- - 0630 ,0 0 � Address y 6rre,l GvQ,� �h 1C�! License # op_��S 90360 �A ,A r1wig �l 9 07-&Yr Home Improvement Contractor# Worker's Compensation # WON 0- /67/0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Apa lif 1; SIGNATURE DATE /J_P �. } FOR OFFICIAL USE ONLY APPLICATION# 4 i DATE ISSUED z MAP/PARCEL N0. ADDRESS w VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING S DATE CLOSED OUT ' ASSOCIATION PLAN NO.. == I Tke Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLyibly Name(Business/Organization/Individual): nJ I' G Address: rlA City/State/Zip: ►yui aw D LGY3- Phone.#: 927 8 ' i Are you an employer?Check the appropriate,box: Type of project(required): 1.PJ I am a �5 em to er with 0 4•� ' ;!am a general contractor and I p Y 6. ®New construction employees(full and/or part-tim.e).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' Y P h'• $ 9. Building addition [No workers' comp.insurance comp. insurance. 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 11.0 Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] . *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors 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. r _ Insurance Company Name: JO Ler 40�2 e w C' �KGI Cia 7aS eO° Policy#or Self-ins. Lic. #: C' � �YZ� Expiration Date:O Job Site Address: � �h H ke City/State/Zip: l l l e# Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). . Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under e p ins andpenalties of perjury that the information provided above is true and correct Signature:' Date: Phone#: Z 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-contractors)name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in__(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts . Department of Industrial Accidents (office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617--727-4900 ext 406 or 1-877-MASSAFE Revised 11-22-06 Fax# 617-727-7749 www.mass.gov/dia l , id pUSHE rog, Town of Barnstable �3' p Regulatory Services M 1 * BARN STABLE, yam, Thomas F.Geiler,Director 4i'°lFo;9,. 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 hP-4� Owner of the subject prope rty hereby authorize „� D. �� _ Tu C - to act on my behalf, in all matters relative to work authorized by this building permit application for: Awt 4th N`e (Address of Job) gkture r Date/ 1��8C/LT"�•,C��i/1�,NJip�siN 6'„C T 4,Y Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse.side. Q:FORMS:OWNERPERMISSION Town of Barnstable THE Tp�� Regulatory Services BARNSTABLE, Thomas F.Geiler,Director 9 MASS. 039. Building Division ATFD �p Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print 1 DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellln6 of six units or less-and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be a one or two-famil dwelling, attached or detached structures accessory to such use and/or farm structures. A Y ry 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 requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner 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 fotm/certification for use in your community. Q:forms:homeexempt. November 23, 2010 Barnstable Building Department Barnstable MA Subject: Building Permit for the Barnstable Sewer Department Area H-1 Construction Project# 03-000-10-01-11 To Whom It May Concern Please be advised that Kenneth Joudrey is employed by the Robert B Our Co., Inc in the capacity of Project Manager & Construction Supervisor. If there are any questions, please feel free to contact this office. Thank you Robert B Our Co., Inc Melanie Corso Office Manager 24 Great Western Road, P.O. Box 1539, Harwich, MA 02645 Tel:508-432-0530 Fax: 508-432-7057 Web:robertbourcom r - i IN Massachusetts- Dei)artment of Public Sa€eta- ` Board bf Bu.ifd n2. Regulation And Stiftdards r Gtu Supervisor r�ense license: CS 89380 obictedta; RO ,i.Ci=1VN`�Ti� 4 ' JI�DIEfY . A202 RLEAN ARWIC H, "RAM '# - C Qmuifsso "' TV 1 0986 f r i 7 Bond No.08930652 PERFORMANCE BOND ' KNOW ALL MEN AND WOMEN BY THESE PRESENT,THAT Robert B. Our.Company,. Inc., as principal,and Fidelity and Deposit Company of Maryland 1 as surety,are held and firmly bound unto the Town of Barnstable,Massachusetts,in the sum of Two Million Two Hundred Five Thousand Seven Hundred Seven Dollars ' and Ninety Three Cents ($2,205,707.93) lawful money of the United States of'America, to be paid to the Town of Barnstable, ' Massachusetts,for which payments,well and truly to be made,we bind ourselves,our respective heirs, executors, administrators,'sueeessors and assigns, jointly and severely, firmly by these presents. ' WHEREAS,the said principal has made a contract with the Town of Barnstable,Massachusetts, i bearing the date of January 15, ,2010,for the construction of H-1 West Sewer Extension and Water Main Replacement Project ' Now the condition of this obligation is s i g such that �f the principal shall well and truly keep and perform'all the undertakings,covenants,agreements,terms.and conditions of said contract on its part to be kept and performed during the original term of said contract any extensions thereof that may be granted by the Town of Barnstable,Hyannis,Massachusetts,with or without notice to the surety, and during the life of any guarantee required under the contract, and shall also well and I truly keep and perform all the undertakings;covenants,agreements,terms and conditions of any ' and all duly authorized modifications,alterations,changes or additions to said contract that may be hereafter made, notice to the surety of such modifications, alterations, changes or additions I being hereby waived,then this obligation shall become null and void;otherwise it shall remain in full force and virtue and the aforesaid.sum shall be paid to the Town of Barnstable as liquidated ' damage. 1N WITNESS WHEREOF we hereunto set our hands and seal this 5'th day of January , 2010. Seal Robert B.Our .o. nc. ,BY79' - Ch hllvQ.ht; our Pre bi'd.,4y Fidelit nd Depbsit Company of Mary4d Anne M.Higginbottom,Att rney-in-Fact 1 Bond No.08930652 PAYMENT BOND KNOWN ALL MEN AND WOMEN BY THESE PRESENT,THAT,Robert B. Our Company, ' Inc.,as principal,and Fidelity and Deposit Company of,Maryland as surety,are held and firmly bound unto the Town of Barnstable,Massachusetts in the sum of: ' Two Million Two'Hundred Five Thousand Seven Hundred Seven Dollars and Ninety Three Cents ' ($2,205,707.93) lawful money of the United State of America; to'be paid to the Town of Barnstable, Massachusetts,for.which payments,well and truly to be made,we bind ourselves,our respective heirs, executors, administrators, successors and assigns, jointly.and severally, firmly by these presents. WHEREAS,the said principal has made a contract with the Town of Barnstable, Massachusetts, ' bearing the date of January 15, 2010 for the construction.project: i H-1 West Sewer Extension and Water Main Replacement Project s t Now the condition of this obligation is such that if the principal shall pay for all labor performed or furnished and for all materials used or employed in said contract and in any and•all duly authorized modifications, alterations, extensions of time,changes or additions to said contract ' that may hereafter.be.made,notice to the surety of such modifications, alterations,extensions of time, changes or additions being hereby waived, the foregoing to include any other purpose or items set out in, and subject to, the provisions of Massachusetts General Laws, Chapter 30,. Section 39A, and Chapter 149, Section 29,,as amended, then_this obligation shall become null ' ' and void;otherwise it shall remain in full force and virtue. IN WITNESS THEREOF, we hereunto set our hands and seals this 15th day of lanuary ,2010 ' (Seal) Robert B.O Co. nc. By: ri5/vP be, ' Fidelit and Deposit Company of Maryland By: ' Anne M.Hlgginbottom,Atto a -in-Fact , i i 1 MAddressEdit Page 1 of 1 w r g BA045TA191 E %ASS. y � Logged In As: Monday, November 22 2010 Frank Schlegel Multiple Address Application Center Road System Reports Road System Another user has modified the record update cancelled Multiple Address Detail Map Parcel: 288 180 : OOA House Number: 158 House Letter: u� Road Name: MARSTON AVENUE Road Index: 0987 Village: 103- Hyannis Tenant: T.O.B. SEWER PUMP STATION Last updated: 11/22/2010 10:24:57 AM Update Delete Add Another http://issgl2/intranet/propdata/MAddiessEdit.aspx?ID=Add 11/22/2010 November 22, 2010 Town of Barnstable Building Department Barnstable, MA Subject: Building Permit for Sewer Project Contract NO. 03-000-10-01-11 Area H-1 West Attn Tom Perry— Building Commissioner Mr. Perry The Robert B our Co., Inc. has a contract with the Town of Barnstable to construct water and sewer facilities. Project H-1 West is a substantial project for water and sewer mains on Marston Ave, Greenwood St and other side roads. Included in the work is a small, 174 square foot, single story, sewer pump station located off Marston Avenue across from Knob Hill Rd. The value of the building itself is $60,110.00, which is just a small fraction of the cost of the overall project of$2, 205,707.93. Original Performance and Payment Bonds are attached to the executed Contract with the Town of Barnstable. Dale Saad is the project manager for the Town. A copy of the insurance certificate and bonds are attached hereto. Full plans & specifications were provided to the Building Department by the Engineer, Stearns &Wheler, 1545 lyannough Rd, Hyannis MA. Russ Kleekamp is the project manager for the engineer. He can be reached at 508-362- 5680. If there are any questions, please feel free to call. Thanks y Ken J drey Proj Thanks Man ger Robert B Our co., Inc Cc; Russ Kleekamp Dale Saad 24 Great Western Road, P.O. Box 1539, Harwich, MA 02645 Tel: 508-432-0530 Fax: 508-432-7057 Web:robertbourcom Barnstable H-1 West Pump Sta Building Costs Temp fencing 2700 Site prep 1200 Building foundation &floor slab 5110 Masonry Walls&Anchor Bolts - 9750 Waterproofing -800 roof trusses _ 900 ceiling carpentry r 850 ' exterior-plywood walls a 1100. roof sheathing &shingling - 7100 s.idewall shingling 4000 doors ,- 2800 fastners, sealants, insulation 1800 building trim 2500 Carpentry labor 13000 Painting 4500 -Miscellaneous 2000 Barnstable H-1 Building Costs .60110 y 1of1 ; j Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND fKNOW ALL MEN BY THESE PRESENTS:That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,a corporation of the State of Maryland,by WILLIAM J.MILLS,Vice President,and ERIC D.BARNES,Assistant Secretary, in pursuance of authority granted by Article VI,Section 2,of the By-Laws of said Company, are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date h e by nominate,constitute and appoint William L.LABBE,Anne M.HIGGINBOTTOM,Cathe ' C J.HORGAN and John J.FEITELBERG,all of Fall River,Massachusetts, dY'a ey-in-Fact,to make, execute,seal and deliver,for,and on its behalf as s i an 1 onds and undertakings,and the execution of such bonds or.undertak• p t 1 as binding upon said Company,as fully and amply,to all intents and had ctt and acknowledged by the regularly elected officers of the Company at i B re oper persons. This power of attorney revokes that issued on behalf of Joseph H. t AHAM,William L.LABBE,Regina M.MATHIEU,dated May 23, 2001. (? 0 The said Assistant 9 does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article VI, Section 2,of the By-Laws of said Company,and is now in force. 'I IN WITNESS WHEREOF, the said Vice-President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Seal of the said FIDELITY AND DEPOSIT.COMPANY OF MARYLAND, this 26th day of May, A.D.2005. 'I ATTEST: FIDELITY AND DEPOSIT COMPANY OF MARYLAND By: Eric D. Barnes Assistant Secretary William J. Mills Vice President ! State of Maryland 1 ss: City of Baltimore f On this 26th day of May, A.D. 2005, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, came WILLIAM J.MILLS,Vice President, and ERIC D. BARNES,Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers. described in and who executed the:preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn,severally and each for himself deposeth and saith,that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate-Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have'hereunto set my hand and affixed my Official Seal the day and year first above written. 0,0 I Maria D.A-damski. Notary Public My Commission Expires: July 8,2011. ' 11 i („ POA-F 063-2611 EXTRACT FROM BY-LAWS OF FIDELITY AND DEPOSIT COMPANY OF MARYLAND "Article VI, Section 2. The Chairman of the Board, or the President, or any Executive Vice-President,or any of the Senior Vice-Presidents or Vice-Presidents specially authorized so to do-by the Board-of Directors or by-the Executive Committee, _ shall have power,by and with the concurrence of the Secretary or anyone of the Assistant Secretaries, to appoint Resident Vice-Presidents, Assistant Vice7gresidents and Attorneys-in-Fact as the business of the Company may require, or to authorize any person or persons to execute on behalf of the Company any bonds, undertaking, recognizances, stipulations, policies, contracts, agreements, deeds, and releases and assignments of judgements, decrees, mortgages and instruments in the nature of mortgages,...and to affix the seal of the Company thereto." CERTIFICATE I,the undersigned,Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that the Vice-President who executed the said.Power of Attorney was one of the additional Vice-Presidents specially authorized by the Board of Directors to appoint any Attorney-in-Fact as provided in Article.VI, Section 2, of the By-Laws of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the ' Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the l Oth day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company, whether made heretofore of hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed." IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seal of the said Company, this I day of Assistant Secretary I I Client#: 123013 ROBERTBOUR U. CERTIFICATE OF LIABILITY INSURANCE 1108/2010"YYY) Hd THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HUB IntOfnatlonal New England ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 222 N9IIIIkOn Blvd HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Poll RIV@PI NIA 02722 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 000 230.2200 INSURERS AFFORDING COVERAGE NAIC# INIUR10 INSURER& Acadia Insurance Company 31325 Robert B.Our Co.,Inc. INSURER B: Continental Western Insurance C 10864 24 Great Western Road INSURERc: Firemen's Ins Co Washington DC 21784 P.O.BOX 1539 INSURER D: Harwich,MA 02645 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR R TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE IMMIDDNYYYI DATE(MM/DDIYYYYI LIMITS A GENERAL LIABILITY CPA130142818 12/01/2009 12/01/2010 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $250 000 CLAIMS MADE 7XOCCUR MRE E ED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2 ODO Q00 FEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AG G s2,000,000 POLICY PRO- JECT LOC C AUTOMOBILE LIABILITY MAA130144018 - 12/01/2009 12/01/2010 COMBINED SINGLE LIMIT $1,000,000 X ANY AUTO (Ea accident) ALL OWNED AUTOS _ BODILY INJURY SCHEDULED AUTOS (Per person) X HIRED AUTOS - BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO - OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESS/UMBRELLA LIABILITY CUA130142919 12/01/200.9 12/01/2010 EACH OCCURRENCE $1 O OOO OOO X OCCUR CLAIMS MADE AGGREGATE $1 O 000 000 DEDUCTIBLE _ g $ RETENTION $ $ B WORKERS COMPENSATION AND, WCA03167671 0- 01/01/2010 01/01/2011 X WcsrATu- o R EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT $5OO OOO QF�FICCER/M1MggEER EXCLUDED? N - (Mandatory m NH) - E.L.DISEASE-EA EMPLOYEE s500,000 If yes,describe under SPECIAL PROVISIONS below - _ E.L.DISEASE-POLICY LIMIT $500,000 C .OTHER Pollution CP08087906 12/01/09 12/01/10 $1,000,000 Each Occ f $1,0000,000 Aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Area H-1 West Sewer Extension&Water Main Replacement Project Town of Barnstable is named as Additional Insured as required by written contract I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable - - DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL -n. DAYS WRITTEN 230 South Street. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis, MA 02601 s IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED�IREEOtRESENTATInTIVE t�i� � ACORD 25(2009101)1 of 2 #S340469/M326864 © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NM001 ;7 r I IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. A statement on this certificate does not confer rights to the.certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer,and the certificate holder,nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. . x ACORD 25 2009/01 ( ) 2 of 2 #5340469/M326864 'THE?I Town of.Barnstable *Permit#, Reuu r. E Tres 6 months��®�, Cp. ,from.resue date t Services snxtvsrnst.>, t b 5 Fee . � : .� Thomas F. Geiler,Director 'Oren Mai°' Building Division � `"SS PERMIT Tom Perry.,CBO, Building Commissioner: 200:Main Street,Hyannis;MA 02601 C T 2010 .22 www.town.bamstable.ma.us Office: 508-862-4038 TCyWN_O AAjg�gVC � EXPRESS PERNHT APPLICAT I®N RESI1��1\TT'IA][, ONLY Not Valid without Red X-Press Imprint Map/parcel Number on /60 - Propert, Ad7res's- l' ll W nn1.g 0 Residential Value of Work �0 Minimum fee of S25.00 for work under$6000.00 O�;,ner's Name&Address Noo Worn mill &&�al 6errV F I AA' 76#7 Contractor's Name-Rd Mode 1ME � bna � _r Telephone NumbeO o Horne Improvement Contractor License (if applicable) Constriction Supervisor's,License 4.(if applicable)C.S 7 r(q F�Workman's Compensation Insurance Check one: ❑ I am a sole proprietor M' ❑ I.am,the Homeowner [�I have Worker's Compensation Insurance . Insurance Company Name I r A VC Workman's Comp.Policy# Cop`'of Insurance Compliance.Certificate must be on file. Permit Request(check boy:) ;Re-roof(stripping old shingles] _All constriction debris will be taken to' ��j Re-roof(not stripping. Going over existing lavers of,roof) ❑ Re-side ❑. Replacement Windows/doors/sliders.:U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other.town department regulations;i.e.Historic'Conservation etc. ***Note: Property Ow er must sign Property..Owner Letter of Permission. ., - 0 Y of e Home Improvement Contractors License is required.. SIGNATURE: C;llisers�decollik\Ap ata,Local\Microsoffk.Windows`,TemporaryInternet.FilestCOntenLOLItlOO1C\MY7,\TB41DEXP T) RESS:doc :_;,fi 1 nnr'ne �_ Consumer Affairs & , ss Regulation Ca License or registration valid for individul use only Office of Consumer Affairs&B sines Regulation g Y HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: . Registration:,,;406627 Type: Office of Consumer Affairs and Business Regulation TJOTHAN Expiration 7124/2012 Individual 10 Park Plaza-Suite 5170 Boston,MA0 16 M TYLER Jonathan Tyler \ :: ?; 67 Cranberry Lane B9x 80 4 - W Hyannisport, MA 0201 Undersecretary Not valid without signature iYlassarliusetls Department of Public Safety Board of Building R lations and Sxard trds i Constructiota Supervisor License �" License: CS 72579 f Restricted to- 60 1 " JONATHANM TYCER !i 2 LYNXH.OLM;CT HYANNIS, MA-02601 x Expiration: 1/4J2012 i ('ununissioner Tr--- 1.3117 Restricted to: 00 00- Unrestricted 1G-1.2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Refer to: WWW.Mass..Gov/DPS Office of ConsumerAffairs&Business Regulation License or registration.valid for individul use only - HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: "• Office of Consumer Affairs and Business Regulation Registration- 64032 Expirati_czti 11 Tr# 287856 10 Park Plaza-Suite 5170 _. ^�-; Boston,MA 021 Type P�va�wd_cation REMODELING ASSE-3�F]�TE (i JONATHAN TYtEFSM, •^�` 2 LYNXHOLM Cr6brl . HYANNIS,MA 0260 t Undersecretary ' / Not valid without signature a h VDAC TRAVELERS J' WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PACE WC 00 00 01 ( A) POLICY NUMBER: (7PJU13-0443N98-6-10) `RENEWAL OF (7PJUB-0443N98-6-09) INSURER: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA 1 NCCI CO CODE: 13579 INSURED: PRODUCER; REMODELING ASSOCIATES INC. BRYDEN & SULLIVAN INS AG 2 LYNXHOLM COURT 88 FLAMOUTH RD HYANNIS MA 02601 HYANNIS MA 02601 Insured is A CORPORATION Other work places and identification numbers are shown in the schedule(s) attached. 2. The policy period is from 05-02-10 to 05-02-11 12:01 A.M. at the insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part,One of the policy applies to the Workers Compensation Law of the state(s) listed here: MA B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: $ 100000 Each Accident °---- Bodily Injury by Disease: $ 500000 Policy Limit a= Bodily Injury by Disease: $ 100000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06A o� D. This policy includes these endorsements,and schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating „— Plans. All required information is subject to verification and change by audit to be made ANNUALLY. z DATE OF ISSUE: 03-29-10 WC f OV ST ASSIGN: MA OFFICE: DIRECT ASSIGNMENT 701 PRODUCER: BRYDEN & SULLIVAN INS AG 232MV 9EZ-9 S00/100d 966-1 b1f106LHS SIT RVAIIIIIS22GAUS-WOHE 5Z:6Z 0L,-03-60 OCT-13-2010 09 :01 AM RICHARD. HORNUDIANA. HORN 4076968739 P. 01 WAWUKJL MAKTown.of Barnstable w 'regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CHO Building Commisiionew 200 Main Stmot, 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 an a, 6-. 41orvt I, / Gy r ,___ ___ ✓,as Owner of the subiect property hereby authorize a Y`A ✓to act on my behalf, in all matters relative to work authorized by this building permit application for: x (Address of Job) iganature of Owner Date Print Name -2>l4'1 A. 6. +ta r-r, If Property Owner is applying for permit,pleasi complete the Homeowners License Exemption Form on the reverse side C:\Uecrtldeooilik%AppDatalLocellMiormoft\Windowt%Temporary intemet Filba\Content•Outlook\MY7NB41L TXPRFSS•doc Revised 100608 TOWN OF BARNSTABLESUILDING PERMIT APPLICATION.. Map a Parcel �' 0�o A Application#I e O c) Health Division Date Issued I 1 �� Conservation Division It �4oR o�c)h%I, �rm .Application Fee w' Tax Collector Permit Fee Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address_ fed Village / 6yr_�6 vd� Owner %'�cR. ,6� Address 4,5e5��3 Tvoli'; y i.z 3 Telephone 4''i*45= 757-.Z 7k) •i k Permit Request ;w G*e"l SNi%C1c�,� 3 d�,NQlws Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new o ckt� --is nct� Flood Plain Groundwater Overlay Project-_Valuation's/o 3oo, Construction Type .,_ Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 1�f Two Family ❑ Multi-Family(#units) Age of Existing Structure Zq_5_® Historic House: ❑Yes 4No On Old King's Highway: ❑Yes �a No Basement Type: ❑Full WrCrawl' ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new i Number of Bedrooms: existing new Total Room Count(not including baths):existing —7 new First-floor Room Count Heat Type and Fuel: ®'Gas ❑Oil ❑ Electric ❑Other Central Air: ©Yes ❑No Fireplaces: Existing New Existing wood/coal stove: O.es ._ ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: =t - G�r --. C- f Zoning-Board of Appeals Authorization ❑- Appeal#- --_ _- _- Recorded❑ I - ' Commercial ❑Yes ❑No If yes, site plan review# T , Current Use Proposed Use BUILDER INFORMATION Name ��tl��i �/�'rTla! Telephone Number Address / 7-0 License# CS 7 j!573 Home Improvement Contractor# /� ,0 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. k ADDRESS VILLAGE OWNER r- DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 1.! ' DATE CLOSED OUT "t a "' ASSOCIATION PLAN NO. ` The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d 600 Washington Street �< Boston,MA 02111' -wiww.mass.govldia. ' Workers'Compensation Insurance ffi Affidavit: Builders/Contractors/Electricians/Plumbers .. A_pplicant Information Please Print Legibly Name(Business/Organization/Individual): Address: O v4-A�S sue' City/State/Zip: a5 �rvl !1 o�ssc� • Phone 6c7 Are you an employer?Check the appropriate box: :Type of project(required):. 1.❑ I am a employer with 4. ]� I am a general contractor and I 6 New construction . employees(full and/or part-time).* • have hired the sub contractors listed on the sheet. 7. [ Remodeling 2.❑ I am a'sole proprietor or partner- These sub-contractors have ship and have no employees 8. ❑Demolition have workers' working for me i employees and h n any capacity. 9. ❑Building addition [No workers' comp.insurance comp.insurance.# 5 [] We are a corporation and its 10.❑Electrical repairs or additions . required.] officers have exercised their I LE]Plumbing repairs or additions ' .3.❑ I am a homeowner doing all-work . . myself.[No workers'comp. right of exemption per MGL 12,E]Roof repairs insurance.re uired t c. 152, §1(4),and we have no q ] employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners.who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the Sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site' information. Insurance Company Name: ' Policy#or Self-ins.Lic.#: Expiration Date: lob Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK.ORDER and a.fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the bIA for insurance coverage verification. I do hereby certify under the pains•and penalties of perjury that the information provided above is true'and correct. Zl-��3-9Si Date: - Signature — 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 r ' Phone#: Contact Person: Nov 13 07 10:25a Richard Baright 845-757-2400 p.1 r ti 'Town of Barnstable. Regulatory Services g . Thomas F.Geaer,Director. '"D a Building Dznslon rFnw•'� 7nmFerry,B--uM g Cbmmisri.oner t 200'Main Street, Hyannis,Mk 02601 ww-w.tort-m-b2r eable:ma.us Office:- 508-862-4036 Fax: 508-7916230 Propel Q-ner-Must Complete and S girk This Section, If If Using-A-Builder as �erof the subject property here authorize 1'�%l.i , i. � t by to art on my behalf, in-Z matters relative to work aut[orized bythis Building permit application for: , (.Address of Job) NOV,' !y, a00 -7 Signatuse of der Date Print Nam gropMs:Qwnt�x�i�lssrox_. To Whom it may concern: We the Harbor Village Condo Association hereby give permission to William Martin 111 ,permission to perform repair work on the#1 condominium at 160 Marston Ave Hyannisport, Ma Respectfully submitted by Linda Kurinskas Treasurer Date Nov.9,2007 160 Marston Ave 160 Marston Ave Condo Associoatiion Hyannisport,Ma.. Telephone#508 -930-4231 Meter#2350653 oF,HEh Town of Barnstable * w Department of Health,Safety,and Environmental Services sMWSTABLE, % MASS. i639•039. Conservation Division ♦0 �lfD uy s 200 Main Street,Hyannis MA 02601 Office: 508-862-4093 Robert W.Gatewood FAX: 508-778-2412 :. Conservation Administrator MINOR ACTIVITY REGISTRATION iir.s/ TEA'ri�N� y��— 757 2 Zo d Property Owner Telephone number /U Mailing address `�d h2lfT�vi�QlN� DV Project location Map/Parcel# Project description The following minor activities will be reviewed,'under Art.27,by Conservation staff instead of the Conservation Commission,as,long as they are constructed at least 60' from a wetland resource area or top of a coastal bank. * Pathways 4' in width * Fencing that does not create a barrier to wildlife movement,6"above grade * Conversion of lawns to decks,sheds,or patios that are accessory to single family homes,as long as: -house existed prior to August 7,1996 -alteration within the buffer zone is less then 250 sq.feet. -sedimentation and erosion controls are used during construction * Stonewalls(this does not include stonewalls for retaining wall purposes,grading and/or fill) Signature Efate _ l Reviewed by ate I _GIS Plan Attached(fee charged for plan) Q/WPFi les/Form/MinorAct ------------ 2U H � x 19.4 k \ « 3 a� ! CSC 17.51 x SIR 4 288180 ND � 6 #169 + Iwo � � J' �• � Y �"_.. � <v Xx� ✓f �.F 6.r`� � f � ���>� 3 it a x r s t r s Ar k LLx � Yt' �< � � '�' �u "`;. +��..-,N'"k.•,,e,. as i; • aw no w. ii T r� a- NOTE:PARCEL LINES MAY NOT BE ACCURATE. The DISCLAIMER:This map is for planning purposes only. it p�ra-I lines on this map are only graphic representations of may not be adequate for legal boundary determination or _ r v r •Sxi.•,w 3 Assessofs tax parcels. They are not true property, et regulatory Interpretation.This map tloes not represent an — --- 0 10 20 40 Fe yndarles anaccurateN� rat represent accurate relationships to on- e ph muntl survey. i physical objects an the map such as building locations. 1 inch equals 40 feet ✓�ie �anr�naruoeall� o��/�aaoac/auaefCa Board.of Building Regulations and Standards ` Construction Supervisor License L160,0se CS 79573 j� a 0 UPIMW 1 %5/2008. Tr# 1037 �I WILUAM MARTIN I(I� _ i=l 170 EVANS ST `! 5 OSTER, ILLS,MA 02655 r`•: Comm�ss�oner 4s h ME Town of Barnstable P` ILS "o Regulatory Services anxxsrwsi.e, - Thomas F. Geiler,Director MASS .039 Building Division 9 i639 `��' �'°�Ec n►ay Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-623( PERNIIT# OD�7 S `� FEE: $ SHED REGISTRATION 120 square feet or less /hi 5Yy/1J GP. I ,V�Svo Location of shed(address) Village /rr, A9/4/'57—e A/ ,f-uc L.� A556 . J�p� �� �✓ Property owner's name Telephone number --I , ;Zaillo Size of Shed Map/Parcel 4 . Sibiature Dat Hyannis Main Street Waterfront Historic District? � Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required) T Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITBIN THE JURLSDICTION 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 B"000-�_�'.'PVANIED BY A p�� PLOT PLAN forms-shedreg REV:042506 Map Page 1 of 1 c. Town of Barnstable Geographic Information System Parcel Viewer Custom Map Abutters Map Size Zoom Out E E M JE, ®fl fl nIn JPG Map: 288 4 c a Location: �s79 {, o Owner: a Q �. ;, �+ 0 t� `�� Q � '� Location In Map & Parce n .4 } v.M ,t Location n a Acreage 4 o Current Ow Bg s Mailing Addi Q a r a Extra Featur n t Out Building rr c �� Land Buildings Total Apprai CQJ !(Assessed V g Extra Featur 4 � rr#r�cckeur�d � 5'' Out Building rK;� �+���z �y�++ � � �. Land m Buildings Total Assess Set Scale 1" = 561 �' Aerial Photos' ' Copyright 2005 Town of Barnstable,MA All rights reserved.Send questions or comment: BarnstableMA VO.2.91 [Production] http://www.town.bamstable.ma.us/arcims/appgeoapp/map.aspx?propertyID=28818000A 9/17/2007 To Whom it may concern: We the Harbor Village Condo Association hereby give permission to William Martin 111 ,permission to reconstruct the water shed at 160 Marston Ave Hyannisport, Ma. Respectfully submitted by Linda Kurinskas Treasurer Date 9-,17-e7 . 1 a ry Ij V IA- w i . l corn- Z p - 20 irie�rdw l t��SG r i ."'c�✓� �, i //� _ _ i TOWN Of BARNSTABLE BUILDING PERMIT APPLICATION Map 18 Parcel f���©� Application#. 5 Health Division Date Issuedry l 0'1 Conservation Division Application-Fee 'q7 Tax Collector = Permit Fee w Treasurer Qi Planning Dept. lv Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address /Go /�srsi v Village Owner el�",l ��.���� Address Telephone Cl 7- 5Y fW- Permit Request �� a✓ may / lye Dti- �ly fivw�ue�.g ?�� 7 o f weg-k- 0 Ae 1 "lam` �-P7 _ fJfi�P� e 6 u Square feet: 1 st floor:existing proposed 2nd floor:existing proposed. Total new Zoning District Flood Plain Groundwater Overlay `Project Valuation; �`G o>.v Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family W/ Two Family ❑ Multi-Family(#units) P Age of Existing Structure Historic House: ❑Yes E(No On Old King's Highway: UlYes - ❑No Basement Type: ❑Full ❑fCrawl ❑Walkout ❑Other ?! Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing c,_,new Number of Bedrooms: existing new 3 Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil Electric ❑Other Central Air: ❑Yes td No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# _ Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use - Proposed Use BUILDER INFORMATION l` Name bnZZ44.14-07 Girl 14J..V7 Telephone Number 5_04�'� Aq5rt�az7 Address 1`70 License# <,.5_'7 5'7� B5� v« Gf-1 Home Improvement Contractor# /_�4c�7D Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �vcv,�1 ite�r9�/e SIGNATURE DATE �� �"0 7 FOR OFFICIAL USE ONLY APPLICATION# A DATE ISSUED 4 MAP/.PARCEL NO. I ADDRESS VILLAGE OWNER >x DATE OF INSPECTION: x FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r . FINAL BUILDING DATE CLOSED OUT' ASSOCIATION PLAN NO. t The Commonwealth of Massachusetts Department of Industrial Aecidents Office of Investigations - 600 Washington Street Boston,M4 021II , www.m ass.gov/dia Workers"Compensation Insurance.Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information Please Print Leeibly Name(Business/Organization/Individual): '0 •Address: ,17a City/State/Zip: �5i�'�/� �'�` Phone.#: �—�S�r�®� Are you an employer? Check the appropriate box: Type of project(required) 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction . 2. I am asole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an i employees and have workers' y capacity.� co insurance.$• 9• ❑Building addition [No workers' comp.insurance comp. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions '3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself: [No workers' comp. right df exemption per M6L 12.[_J Roof repairs insurance,required.]t c• 152, §1(4),and we have no employees. [No workers' A3.0 Other Ae4oz,,,5vz-a<✓ comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 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. lam an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site information. Jnsurance Company Name: Policy#or Self-ins.Lie.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date),. Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the bIA for insurance coverage verification. I do hereby certify and the pains•and penalties of perjury that the information provided above is true and correct: Sienature: Date: 49 ZO?--v Phone #: 5-0�� �!'`r —UU 2 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 CIerk 4,Electrical Inspector 5.PIumbing Inspector 6. Other Contact Person: Phone#: i Town-of Barnstable PLO • y`� ^ Regulatory Services - nafuyscnsL% 9 MAss Thomas F.Geller,Director 163 ► Building Division ED MA b Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax; 508-790-6230 Permit no. Date • AFFIDAVIT ROME EUTROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work:24'U get a /3jf C u � Estimated Cost-.5- rt y ,Address of Work: 160 1124-1-67-c 0-1 Owner's Name• ./ 3cvee_,y eZI Date of Application: 4P-J-d---d I hereby certify that Registration is not required for the following.reas on(s): (Work excluded by law []Job Under$1,000 []Building not owner-occupied ❑Owner.pulling own perrut Notice is hereby given that: OWNERS PULLING TB=OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MROYENIENT WORK DO NOT HAVE ACCESS.TO THE ARBITRATION PROGRAM OR GUARANTY FUND.UNDER MGL c.142A. SIGNED UNDER PENALTIES.OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name L p nd$t. /T Ur Regulations a ✓✓ cON.V cTOR Board of BuildiOVEMENT E tMpR NOM 134870 i Re9�strat�on �13Q12p0$ ExP�ra j'�dwidual lo AdruinistratOr Tz, 1, 170 E Rv�E,MA p2655 -- i ll! a�✓Glaaltcae ✓die-Vam�riortsuea Board of Building Regulations and Standards l Construction Supervisor License License: CS 79573 Expiration 12/5/2008 Tr# 1037 3' 00 J Restriction t WILLIAM MARTIN III 170 EVANS ST j OSTERVILLE,MA 02655* Commissioner i September 4,2007 To Whom It May Concern Town of Hyannis Hyannis,Ma. This is to advise that the Board of Managers at Harbor Village Condominium Association, 160 Marston Avenue,-Hyannis Port,Ma.,02647 give permission to William Martin to work on Unit 20"Merrow House' at Harbor Village. Thank you in this matter. Linda Kurinskas Treasurer t TOWN OF BARNSTABLE BUILDING PERMIT.APPLICATION . Map F Parcel_196o D `Application 4'� � Health Division Date Issued Conservation Division Application Fee Tax Collector Permit Fee Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 14 0 Village Ci.9,v�t5,oa�r� Owner Address Telephone Permit Request c s /Cfz/ /7 S Square feet: I st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay r—? 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 �= eat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other ; Zy Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/co'al stove: ❑Yes' ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑J new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: ' Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use ` BUILDER INFORMATION Name Telephone Number •s�- Address 1"1� dnv i5p-, F License# e�2 7 t§73 !&-fd_ O2U,�5-t5'_ Home Improvement Contractor#_�����0 j Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY r APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL a , FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. I i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia r Workers'' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibiy Name(Business/Organization/Individual):. ���i2. '>'T� -Address: 47d AZP_Vl 06 - s�- City/State/Zip: :P, Phone.#: i��:gS" = a�� Are you an employer? Check the appropriate box: Type of project(required):. 1.❑ I am a employer with 4. ❑ I am a general contractor and T mployees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction . 2.1�I am a'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance.#, required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.Z'Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' . .13.0 Other comp.insurance required.] , *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy.number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify utt4er the pains-and penalties of perjury that the information provided above is true and correct: Sienature: Date: dr— 1 Phone#: Official use only. Do not write in this area,to be completed by city ar town ofj71ciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I Informnation 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 mare 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( )states`Neither the co=onwealtla nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the romance 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-contiactor(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 member. 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 Sile Address"the applicant should write"all-locations in (city-or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves-etc.) said person is NOT required to complete this affidavit~ e to thank you in advance for our cooperation and should you have an questions, office of Investigations world hk y y q , The OffsY Y P please do not hesitate to give us a call. The Department's address,telephone-and fax number:. The Commonwcalth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washingtoli Street Roston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-NiASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gav/dia °fitMEray Town of Barnstable yP' Regulatory Services ' BAENM$M' ' Thomas F.Geller,Director 9. 6. 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 ABuilder I, Lt &alws 11 ,as Owmer of the subject property AK herby authorize to act on my behalf, in all matters relative to.work authorized by this bilding permit application for: . (Address of Job) lcc�> e"Al p ignature of 0w e"r Date Print Name Q YORMS:OWNERPERMISSION D �7 d Standards `nations an CTOR Board of Bn'Id CONTRA VEMENT H E 1MPR� OM 13487� Registration 8 113012p0 ExP!ration 1ndw1dual MARSIN 111 WI�UAM TIN 111 dm►nistrator NIILLIAM OSTE RV MII.LA D 170 EANSS 2655 ePnt9 A 9XI-VQO7L9YlO4l.!!/CiLLUL dL✓!�-cc6�p.Cftfl6p t .; Board of Building Regulations and Standards Construction Supervisor License License.: CS 79573 Birthdate 12/5/1935 I Ezpiratior 12/5/2008 Tr# 1037 t Restriction. 00 r WILLIAM MARTIN111 170 EVANS ST OSTERVILLE, MA 02655 Commissioner SEPT 4,2007 To Whom It May Concern: Town of Hyannis Hyannis,Ma. This is advise that the Board of Managers at Harbor Village Condominium Association,160 Marston Ave,Hyannis Port,Ma.02647 give permission to William Martin,to work on the Water Distribution shed,located on the property. Thank you in this matter. Linda Kurinskas Treasurer z • sJ• lit # `C �, Town of Barnstable *Permit Expires 6 months front issue date snRNsrto3ra.' .. . _.. Regulatorv. Services .... _. Fee.. a Director ° 9 ��� 1m�' ,,,•,,," _..,;_,Thomas:F.•Geller, : diia D g. ivision- =..���°�a ---• ..... ._ _. Perry, Building Commissioner .r_ 200 Mainfteet,•Hyannis,M.4 02601- m Office: 508-862-4038 MAY o � cu05 Fax: 508-790-6230- _ ' -EXPERIGIIT p�;Yt✓ ,;Y'1ZON REBID_ ENTIA vONLY.` BARNSTABLE Not Valid without Red X Press Imprint WN Ut ,v1a 1 aicel Number P P l� yhJS doe:,— ® z6 07 properly Address [�R side-atial Value of Work FOOO Minimum fee of$25.00 for work under$6000.00 / ' � CXo t;p you � �rJ (��2�4-!'ice-• Owner's Name&Address ('d f[ � �!/d Telephone Number E r �6Z-- Contractor's Name&j aT Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) I Or� a.n,8 Compensation Insurance 77��•� w Check one: ❑ I am a sole proprietor ❑ the Homeowner I have Worker's Compensation Insurance - Insurance Company Name S Workman's Comp.Policy Copy of Insurance Compliance Certificate:must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to r]Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side - [✓ Replacement Windows. U-Value = 5� (maximum.44) • x *Where required: Issuance of this perm ith it does not exempt compliance w other town department regulations,i.e.historic,Conservation,etc.. ***Note. •Property Owner must sign Property Owner Letter of Permission. ement Contractors License.is required. Signature Q:Forms: ., Revise063004 Board Of RmW-9 lteaoltd m and Statdtrda HOME IMPROVEMENT CONTRACTOR . Re�latsatllp� 12fi893 ' �:��t313�20pg TYP!=:'PPP &Mart Card THE HOMO DOW.A'-'- "we IUfARK AUDETTE 3200 COBB GALW:UA P4W#20 ALTANTA,GA 30339 "`� Admtahtrater a 1,ioense or rtgNmtlor valid for bdiviAlrl 8"only before the e:phlow date. If fond return to: Hoard of Banding Replatiom al:d SlU bdarda Qne Aa burton Place Rm 1301 Boston,Ma.02108 Not valid witimot signature a f i Town of Barnstable Regulatory Services Thomas F.Geller,Director 9� sees. ��• Building DIVISion TomYerry, Building Commissioner . 200 Main Street, $yams,MA 02601 wwW.town.barnstable;ma.us Fax: 508 790-6230 O fFice: 508-862-4038 Property Owner Must Complete and Sign This Section If Using ABuilder as Qwner of the subject property .to-act on mybeh4 . . hereby authorize in all niatters relative to work authorized by this building pemvt application for, • (pddress of Job} - i7-ate Date Sig'natuze of Owner Print T*�ame The Commonwealth of Massachusetts _ Department of Industrial Accidents Office oflnuesagations 600 Washington Street, 7 h Floor Boston,Mass. O2III Workers' Compensation Insurance Affidavit:Buildin lumbin /Electrical Contractors o ' name: �`�`r address• c_ S � �7 S7 oitV �.�/i� 5'��- state zip: L2164 rphone work site location(full address): /O� /`'t4� �7zV7 VZ 74L �� s ❑ I am a homeowner performing all work myself. Project Type: ❑New Construction[]Remodel ❑ I am a sole proprietor and have no one Working in any capacity. ❑Building Addition I ❑ I am an em loyer providing workers'compensation for my employees working on this job. y � r -. r ,r 4 � l.W.efo ;�c '�'++"� rs,s •,�rra�s{dyl,��s-..`tea.+, i.i h.,�r 4 Jm+sY � i X r u`t4.4 r> }. xc kx• n-,�2Fpr K . :1nS�tlTSIlC@'C ... :,.xtnT '''. .t....z�`+srf...:� ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers compensationpolices: calm ah �►aMe: �... 4 'Ai�`dress. ::•i � :-.::. . �, _...:!F �_. .:....,. .r .,.�.:' +;4'r:�{ui {.L.aw 1. ^-� '{ kttl^ 4. D116ne#- insuraneecco.. 1.. . olrc-#.:'. y rfimpanVnkl'�te - f + ' addre§s ..: �, z f r »hone# b. 7 vrsiirance'ct�. alic V. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me, I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby ceWnderapa'r andpenald of perjury that the information provided above is true and correctSignature Date > Q Print n e /''`�4��'1 (e Phone# ��� G 1 official use only do not write in this area to be completed by city or town official city or town: permittlicense# ElBuilding Department []Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revised Sept.2003) f Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",an employee is defined as every person in the service of another under any contract of hire,express or implied,oral or written. An employer is defined as an individual,partnership, association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants, Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. 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. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,7`h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext. 406 Engineering Dept.(3rdYoor) Map Parcel Permit# 215'� 6 House# 0 Date Issue Board of Health(3rdMTor)-(8:15 -9:30/ 1:00-4:30) Fee onservation Office (4th floor)(8:30- 9:30,/1:00-2:00) SEPTIC SYST UST BE Planning Dept.(1st flooi/School Admin. Bldg.) INSTALLED I ANCE Definitive an A oved by Planning Board 19 WIT � E6dVIRONME " "� AND' TOWN OF BARNSTABLE TOWN R� NS Building Permit Application Project ddress I 6 ���y�UC� Village .: l Owner ll Address Telephone 5 Permit Request c f 8if� First Floor 1 square feet Second Floor square feet Construction Type po s Estimated Project Cost $ Zoning,District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Zk'— Two Family ❑ Multi-Family(#units) Age of Existing Structure Q 125 Historic House ❑Yes ZPNC- On Old King's Highway ❑Yes @-Nar- Basement Type: ❑Full &Krawl ❑Walkout—`p Other Basement Finished Area(sq.ft.) '+� Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Exist ng 2— New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No - Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of A -Is Authorization ❑ Appeal# Recorded❑ Commercial es ❑No If yes, site plan review# - Current Use Proposed Use Builder Info ation _ Q Name Telephone Number Xddress License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE , v DATE BUILDING PERMIT Dl�NQFQvf..qp� YQs LLOWI G REASON(S) 9 FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE + OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUPH FINAL' , PLUMBING: t„= =,ROUGH!--. FINAL GAS: RO:u FINAL ' yM t ev FINAL BUILDING�..^ .�' . .. DATE CLOSED OUTS ASSOCIATION PLAN NO I r� $ HAIR? �i O 120 Great Western Road r (508)760-4500 P.O. Box 708 vU�p, ' `T Fax (508) 760-4930 South Dennis,MA 02660 Toll Free 1 (800)368-SHED D PRE 7433 58550 DEPARTMENT OF PUBLIC SAFETY 58550 ONE ASHBURTON PLACE, RH 1301 BOSTON,-*A 02108-1618 CONSTRUCTION SUPERVISOR LICENSE Number: Expires: Restricted To: iG MAY 1 J 1 6, JAMES D NCGRATH �` ..:� Detach bottom, fold , sign on PO BOX 708 � `back, and laminate license card. S DENNIS, KA 02660 Keep top for receipt and change of address notification. HOME IMPROVEMENT CONTRACTOR . Registration 109374 Type - INDIVIDUAL Expiration 09/11/98 PINE HARBOR BUILDING CO.,INC. 1AMES 0. McGRATH OX 708/120 GT:WESTERN RD PDm"siRATm S DENNIS MA 02660 i I , _ The Conr»ronwealt/t of Massachusetts 7M Department of Industrial Accidents Office OU17yestigdLions ` 600 Washington Street yr Boston, Mass. 02111 ' era-•.:,��: Workers' Compensation Insurance Affidavit i nnlicant`mforntatt05: '»- .�_ k °!7Please.:PRiI�TT•le�i}ilc�r: r,>_.} ,�;a;r �:- - _ name location: city phone n I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an emplo er providin2 workers"compensation for my employees working on this job. com any name: r r C1n address: r �► L1�1 `: W .. cI hone#: insurance co. olicv# 77 a_ I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: address: city: phone#: insurance co. policy company name address city phone Insurance co. policy# ,attach _ additions[sheet ff'n'ecessan ,;y_y r w• o =?r _.. .r. _ Failure to secure coverage as required under Section 25A of,MGL 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement mad'he forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under t psi//�n dlt erjury that the information provided above is true and correct. Signature Y, + 1 Date Print name Phone# -�oC[icial use oniv do not write in this area to be completed by city or town official -_\ t.: t-': city or town: permit/license# nBuilding Department ' C]Licensing Board Q cheek if immediate response is required OSelectmen's Office ❑Health Department contact person: phone a 0Othcr - f reoscd i%9c PIU- - j — 3 Ili Common ive'alth of Massachusetts r. T{ (_a Department of Industrial Accidents Offlce of lnVesUgations 600 Washington Street = Boston, Mass. 02111 Workers' Compensation Insurance Affidavit f nnlicanti'mforriiatton: :Ya � '' - �Mk:::t:7Please.:PRiNT�le�i}ilvrtt::•.-`�:'� ,�=-a:��:-�;b;.r -� -- � -��;......, i name: location: city phone I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity _ [D I am an emplo er providing workers' compensation for my employees working on this job. con any name � - L+fLn �: address -)n15 city: hone#: f ., 77 insurance co. �I 1 1 I 1' ry olicv# ')"t�aC - I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: address: city phone 9: insurance co. A policy# 77 company name address: city: phone 4: insurance co. policy# Attach additiona['sheef ff necessary:,..., icy ^ .�:• -F. - j�:y =rr _ �' Failure to secure coverage as required under Section 25A of ir1GL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one •ears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Fine ofS100.00 a day against me. 1 understand that a copy of this statement may he forwarded to the Office of Investigations of the DIA for coverage veriFicatit)n, l do hereby certify under t pai n att erjtiry that the information provided above is true and correct Signature i! Date Print name 1 Phone# �,(J 9� official use only do not write in this area to be completed by city or town official =_\ t.. city or town: permit license IY nBuilding Department «. C]Licensing Board Q check if immediate response is required OSclectmen's.Office 01-lealth Department contact person: phone K; f Other f Suggested Affidavit for Home Improvement Contractor Permit Application . For ofnce Use only NAME OF CITYII'OWN Permit No Date . AFFIDAVIT Home Improvement Contractor Law. Supplement to Permit Application MGLc.14ZA requires that the"reconstruction.alteration.renovation,repair,modernization,conversion,inprovement,removal,demolition, or construction of an addition to any pre-costing owner-occupied building containing,,;least one but not more than four dwelling units....or to structures which are adiacent to such residence or building"be done by registered contractors,with certain exceptions,along with other requirements. G Q � �L Type of Work: cc s "5 h'q� / Est. Cost✓ Address of Work v Owner Name'✓ Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law _Job under S 1,000 _Building not owner-occupied _Owner pulling own permit _Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as 7 Date Cantractor Narme Registration No. OR: V1 NJb� Notwithstanding the above notice, I hereby apply for a'permit as the owner of,the above property: Date Owncr Name CONSTRUCTION SUPERVISOR FORM PLEASE PRINT DATE JOB LOCATION PROPERTY OWNER - COITSTRUCTION SUPERVISOR eS 6 LICENSE NUMBER ' y5l PHONE 760-y ADDRESS La 5.fj c)n vs LICENSED DESIGNEE (IF ANY) 2 . 15 Responsibility of each license holder: 2 . 15 . 1 The license holder- shall be fully and co'mo1etely responsible for all work for which. he iS SuperVlSlna. He shall be responsible for seeing that all work is done pursuant to 'the State Building Code and the drawings as approved by the Building Official . - - 2 . 15 . 2 The license holder shall be responsible to supervi se the construction, reconstruction, alteration, repair, removal or demol-ition involving the structu_-a1 elements of builcinas anc. sprscpures only pursuant to the State Building Code and all- other a�pliCable Laws of the Commonwealth even though he, . the license holder, is not the permit holder but only a subcontractor or contractor to the permit holde*- :, 2 . 15 . 3 The license holder shall immediately notify the buildi nc o== cial in writing of the discovery of any violations which are covered by the building permit. 2 . 15 . 4 Any licensee who shall willfully violate Subs ect_ons. 2 . 15 . 1 , 2 . 15 . 2 or 2 . 15 . 3 or any other sections of theses rules and rec--slations and any procedures as amended, shall be subjec:,:: to revoc-=zion or suspension of the license by the Board. 2 . 16 All building permit applications. shall contain the name, S_cnature and license numbe': of the construction subervisor who 1s for supervise those engaged in construction, . reconstructi0 n,. alteration, repair, removal or demolit_on as regulated by Sec':on 109 . 1 . 1 of the Code an these rules and regulations . In the evenp that such licensee is no longer supervising said persons , the work sha l immediately cease until a I successor license holder is Suys�ituted on the records of the building debartm.ent. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with 'Section 109 . 1 . 1 of the State Building Code: I understand t' e c0nszruCtion inspection procedures and e Specific inspections as called for by the building official. - LICENSED CONSTRUCTION SUPERVISOR PLOT PLAN FOR LOT Indicate location of garage or,accessory building Additions with dashed lines------------- Sewerage disposal(Cesspool) well f7l ., I :•I ( (Lot,....................fr- rear) Abuttor'i Abutxor'sName Nave Lot # Lot/ Rear.Yard ....... .ft If Ibis is a C. If th is is u cc=neS lot, u - CC.-aei IOL, Z win M e lII d .7 'S1tC LC otbctied s . Size}=ram' HOUSE Sidcyard other rc,_t. Set Back ..... ft. (Lac....................ft. montage) \ /I (Name of street) / \ . Information / \ Supplied by — / Mark North Point I j i ASPi{A t-T j12 4i ,le v�2�7 I I I �IOiNG �p I , . Nil, fi 4 CoNCRE'r&. BLOCK' cso L.i D) <--- i P,NE '�oFv�4RD; ; cSTE PrL L Wonb 15 fiJ i-L ' 2�X N�� 2AF'TE7?S f 'Di rnGNSI oN14 4 �i.N� i ( i � axy e CrN Ur S► D w y ;TU P Pk ATE aL;oc.KING � � i "-n i qyq ix4" PdRLiOS i pl+ch - 22X lo'j �oo �STS �����'•� �� ��� Assessor's office(1st Floor): Assessor's map and lot num b _ o�TH Ir ro L _ SEPTIC SYSTEM &jU Conservation INSTALLED IN COMP Board of Health um3rd floor): WITH TITLE 5 sea,er ELZ Sewage Permit number ru• Engineering Department(3rd floor): ENVIRONMENTAL CO: ����' House number I" , 0 F`�� TUNN REGUL-A ION? Definitive Plan Approve(by Planning Board 19{ APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN , OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Y-` Location 0 f Proposed Use Zoning District Fire District Name of Owner-b. ks 400 Address a' Name of Builder n�r B Address Name of Architect Address Number of Rooms 4-1Foundation f 1 I OCIL— E:Kt�o � r Roofing Q-1 / Floor§, --J Interior Heating ec-:L Plumbing Fireplace Approximate Cost Area C� Diagram of Lot and Building with Dimensions Fee C�Cc.Q.Q�, j/Y ��/ J t 41 Ito pz>� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ' L Construction Supervisor's License� '�, N. BISHOP 34837 Permit For Repair Fire Damage �_ v Sing1Q Family y Dwelling :r° _ - �+ ;- ' ✓ - ' r Location 160 Marstons Avenue (Unit #5) f f � �Hvann spO'rt Owner. Y Na► Bishop Type of Construction Frame ' # _� IIU T Plot ; rj F7 kk Lot Febaruary 13 Permit Granted 19 9 2 Date of inspection - 19 r i } Date Completed 717z _ 19 - i , *' } S A � � i ', r r • • t ✓Assessor's office(1st Floor): Assessor's map and lot number � TwE s INSTALLED IN��®�� �e�� � h IlOnNt >o`1 w wR Aoard of Health( rd floor): WITH TITLE 5 ua,3.Tat, Sewage Permit number `' - WITH CODE AN .o N"& O engineering Department floor)! /�Q G J� e63q. .�o House number- � TOWN REGULATIONS esY&* Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2-.W P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO 7 G r 1�I M I la- TYPE OF CONSTRUCTION _ CO r .crtk'p-. �Ip e-19 9Z TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: — Location cr OL k v Proposed Use Lon, 1 �f 8 Zoning District Fire District Name of Owner I t Address I 1 W 1 J30{' Name of Builder eA A Address ox L'6 •9 l l Name of Architect Address II Number of Rooms Foundation (In n C�r _I Exterior Roofing N LA. Floors Interior Heating X/e_z51 Plumbing Fireplace �<, /s Approximate Cost 0oo — Area Diagram of Lot and Building with Dimensions Fee C;7C� to EX is �n`� 4oww 'P 7cri, 11 ? aH ql OCCUPANCY PERMITS REQUIRED.FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. d Name Construction Supervisor's Licensee/ (Y6 GARVEY, WILLIAM No 3,5011 permiffor BUILD PARTIAL CELLAR CONDOMINIUM ,Location'. Unit" #14 , 160 Marstons Ave. - 1 Hyannisport Owner. E "William: Garvey I Type of Construction Frame Plot 'Lot Permit Granted Apr ill' 2 8 ,_ --' 19 92 Date of Inspection { ,r /F" 19:I �. Date Completed 19. Cl 1 tI Y s ! �w t 1'. J L i N$ t f y r ' EXP ATION 3 \IIGJ�����1V� .�I Fi r 'i^d7 P; �t l9 Wt'i,�K. �5�q�}}'✓`'i7�,.� '9 qs l '}Ke �l�A} p�4 2 FAMILY BERGERONs r �kprySpX 579 `i `HAtI;ICR � 0263 C� PHOTO(BUSTING OPR ONLY) FEE 1 y-0•�D�.L ^5 ��.�f SIGNED BV LICENSEE�ANO OfF)�jALtY� , '!�t "5 �Y .&,�pMPEcI�dORIGNAYURE�OFT1�E COMMISSION R HEIGHT t + ;>,� LF�� . um l OTHERS RIGHT TNUMB PR�NT, EDA IN THIS ccUQ y tot r`T•^�Mr?:97•B1,429-a( ' 'h�-e� '1if�ra i��si �'�. 51,9 c' r,f"�'G e.��.r 'tr A Assessor's office(1 st Floor): Assessor's map and lot number 'w�� }�-SS _ LhT. Board of Health(3rd floor):Sewage Permit number • 'll�'a ql, AV, 71, er z Z BASd9'tA11LL, i Engineering Department(3rd floor): �� i ; �o rasa 163 House number `� cYAYd\®� Definitive Plan Approved by Planning Board . 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only y _ .-TOWN OF •BARNSTABLE ;.:. BUILDING INSPECTOR � cq- APP.I#GATIO R ERMIT TO k QArtil)� I V 1 f\I le TYPE OF CONSTRUCTION ��h ji la (?4 y N TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location AA-9oP, V t W_A_A 419 4-30 HA9_5140-S V E , Nt S reX , MA GAG y7 Proposed'Use RCS' b4E)v f f A_ - -Zoning District Fire District ;- Name of Owner t6daA:96 �1=�V(��� .Address ` Name of Builder 3 Address Name of Architect ' Address Number of Rooms J Foundation Exterior �Gb� Roofing Floors w 0 0 Y Interior Heating C,i. Gin 1 G- Plumbing Fireplace_ ✓ Approximate Cost 1 . Area Diagram of Lot and Building with Dimensions Fee %_ ewe .. +4 t ' t7 } i e 1 { rk ' 4 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS `- I hereby agree to conform to all the Rules and eRegulations of the,-Town of Barnstable regarding the above construction. � � ta— Name �:�n.✓Y� A-r�r Construction Supervisor's License BENGEN, BARBARA - A=288-180 . 00E ADD TO No 3 3 0 51 Permit For DWELLING Frame µ t _►- _, Location Marstons Ave. Hyannisport Owner Barbara Bengen Type of Construction frame Plot Lot Permit Granted July 10 1989 Date of Inspection 19 Date Completed 19 f % a-- .,'mpw—. Asses sor'srmap and lot number ........l.�...� ........�.� �� f ll THETO` P � Sewage Permit number ........................................................ Z BA"STADLE. i House number ........................................................................ :oo 1A 39 �0 �E0 MAY of, TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .................sz:�4d........................... ........................................................... TYPE OF CONSTRUCTION �v.....7......... TO THE INSPECTORJ2F BUILDINGS: The undersigned hereby a es for a permit according to the following informati n Locat' .a. .. . . .. .. 2. erns..........�.................................z ..?4t�-................................. ProposedUse ...................... ..... .... .. .............................. ZoningDistrict .................... . .. ......................... ...................Fire District ............ ........ ....................................................... Name of Owner . ... V�.�... ddress ................. ......................................... . Name of Builder .... ... Lc.....7; ��...............................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exterior .................(✓jd . ....................................................Roofing .................................................................................... Floors4V 111,74..................................................Interior .......... ......................................................................... Heating ........................Plumbin ............. Fireplace '- ............................Approximate Cost ...................................................... .................................................... ............... Definitive Plan Approved by Planning Board ________________________19 _______ . Area .../5....�.... .................... , ► .�.. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 16 K (�, OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ........ ...:........�..e.c�z.,;:�y4.�-...................... Construction Supervisor's License .....t do..b. ........... HARBOR VILLAGE NOMINEE TRUST I I T w. No 26398 Permit for .....Build Deck _r ......... .............. f_- e Single Farr4y..Dwellin:. r`.. ............... �®Mar'stons Ave:* Unit 17 Location .......... ......�.... ..... ........ _ x Hyan t nispor i ............................................................ .................. Owner ...Harbor,.Village. . ...Nominee..Trust .............. .. . .......... ........... . ............. r'^ .''Type of Construction ...:.Frame....... _ ...................................:............................................. ` lot ............................ Lot. ................................ "ermit Granted ...... ay...7.;. .................19 84 .M ' -Gate of Inspection ............................. ! ..Wig 19 is ^ate Completed � .�.A-.. 4.. g` � �• � �• . -� ti� • - - ram• 41 ssor s map and lot number ......,.....c.......... ....... PLO*THE tp�� ;,,age Permit number Z BABHSTABLE. i .:6, use number ........................................................................ M 6 Os 6 00 , 39• �0 'Fa MAI TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .................. . ...........�. �( ..................a......................................... TYPE OF CONSTRUCTION ................................. ...�`.� 7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information Locati'ognv.....N..........t.�...._.`............,............................................................................... ...::........1... :! !....................................... ProposedUse ............................... ...... ...........................................................................................................I......................... Zoning District :.............:......................................Fire District ........................................................ / Nameof Owner�.�1�r i 1 �t I� .........................�......�'`^Address ....................,.. M......... ................................................ Nameof Builder ... � . .................... .....................Address ..................................................... .. .................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation ............................................................................. 41777 Exterior .................. ....ja......................................................Roofing .................................................................................... 1. ......Floors .................!-<.!,.� ,........................................... .Interior ...................................................................... .......... HeatingR.............................................................Plumbing .................................................................................. Fireplace ..............."". ...^.......................................................Approximate Cost ..................................................................... 1 Definitive Plan Approved by Planning Board -----------____---------------19________. Area ... ......1�0.................. . Diagram of Lot and Building with Dimensions Fee x .. ................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH �r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ,.. „� ;�t1L p .�... 7..ra? :�- Construction Supervisor's License ......0&R-D HARBOR VILLAGE NOMINEE TRUST A=288-180-00 'PAmit for Build Deck �.I1g7.�..F 1?�Y..DwellinJ goo............. Location .Urlit. 17,..... ....Marston Ave. . ............... ...........................:..:....... Owner ..Harbor Village Nominee Trust Type of Construction ...Frame........................... ................................................................................ Plot ............................ Lot ............................... Permit Granted ..�..7r.........................19 84 .Date of Inspection ....................................19 Date Completed ......................................19 r 'y,•Y"`'♦ TOWN OF BARNSTABLE a - a Permit No. _ _.__----- sA"srr►X i Building Inspector Cash ---------------------- `6y9 r OCCUPANCY PERMIT Bond —__ Issued to t Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ...................................._..........__., 19......_.... .............. .................. ...................................................................... Building Inspector . . .. _ .-.. . . . . . . . .. ; . . . ..I�I.I�I II.�I.%..,'...I......I11;�'....�......�..�...:"..1.....i,.:.,..I.I.,..I...I..�.�I...-.........I II.�.�....I,I..III....:.I I....-�.:'...;."�-.._.'.::I.�...I I..-....—1.'.I..I�II..I��."�'I.I.:1-'II...I..'.-::.:�..I,�1I,�1..�"I..I'.I'.1��..-::I'I..1:�.:�1'.�I.I�I'..,�.I.�'.�..�:II.1...'�—�II.I II-._�I1�.—p....'.�....��..,.I..�:,�1-..J�I...�'I.�.I-.....-...I::-.I�.,.'�....4%.I,;..I..I.�...',—...-���I1.I..I"..11�...,.I.",:..'...I-.I.'..1..�'...I..�-.,.I�....—.I....:�..I...-I..�I:1I....�..-I-�.'....�1-I.I I,—-..�I I�:.—..'�..II.1..I.i.--I.-...�.-.I�I'._,.I-.�I..�,.,.+.�.�:.�'��.0 I.I."'.I::�I.I..I 1:."...��l I�I....II.I...�.I.:-I.l..I....._..�.I..1�,�%I:.,'.�I.I._1.�I.�II.I.,I1 1�I,.�1�II...,1..��II--I I...,I�...�,��.�..I1�.:.�....I'�I�..-:.I�.,.,t—�,I:-..1--:I��.,I..III I'.,I'.I,I.1��F.1.....-I.I;-,'-I 1.�.�.,:I.��-.'m'...I,.,.....i'..:....I::I..�..'r,.I'I...I:�'1,.,.�..I...�I..—I...�..I��.�i—.".-.I....-�'I�....,......,I..:I I,.I.:.....'+...,.1.,.II..-.1'-.-..I:I.�..".....:.�.,�I..:I.I...I.�.,I 1 II�.II.�....�I..�..�I..I-..-.'......�....I...I.I.:.:.'..-II I.�.�,...j..�I.,,.I.1.0�.1...:.I:I:...I 1..�.%L�..,�.��1.�......-I'...�.....I..1..1�I.1.,..1,...I�1�.I II—..'..,.'.I-I�-�.�.I.I-.i.-.-�II+.-'II..I.:�:....��I�....�".i-I..,...:�.-I-.....4'1,II�I��II..�....�-.I I.�.�..1 I1.�-..l.1.,I..-�.........��..I...."'I I1:I1�.I.".I%....1�I.II.II-I.�..�.1��...I.I�,1�...I.�.r.'.,.�I I...��........I.1..II�Im.....�I..-...-....�mI".:1'1�.1..I�..�....1.-...�,..'�I�.I...'.I.�......�:'.I.�I...��I...,�I.I.I-.'...I.��-..t.I..1'"I..I..�..I."...�'.�...1.�..(�.—�I..,I I...�.1.�.I.I II.I I.,1.i.1.I I.—..I I,..'.-.,�I.1 1 I'I"�.I'�.1p-..�I..-.—:-'. . • , ..F, : — :. -.-.I�..,..-I�I.��,B�--I---'..'.+.-.I.I..--.�I 1�I,.I.,O.I...�I....i 1.-..1...1'�..'I.�:�.I i.�...:I.'..I-."..'.::1I."1....,.I...�I.k I.I�I..�..-..':.,.s�--'.+l�II,...�,.F)I/..�..I�.I'I--i"..�...-.-I I.,...�...1..I.'-..:..�+,�..I,...�'1..%"..�..1(I : . .�'-�.I'1.I.'..-I,I�.-�.I I.--�.-1..,'-,.I"......I:_I.:..M�..�—E.,.mI1-,II�1...��.'I.�I-,�.-'_.�.�.:,I-,._:-...I.'.�.�I.....�,I1�.�,��.I.I I.�+.�I..:D.,..I.I.:.I..I..I�.--1..-.,/�-...I 1 I�I I.I,I 1...I�_...�I..,.....t._'..Il..I.o,:..'I..lI...-�:I�.I I.,�I..11i-...I",—.....�I-_.I,,.m1.1...1.1.I...-�.',.,,,1.:i...��L'"I 1'.II-�.......,11!.I_.I..'I..,l..I,1�'I.,�.f�!..'1I-J-,.I .��.:.''...--I.'�...�,...,I�,'*.I.'I,',�--—.I.--.I�...1_.'.'_.d.,..1.—..w...p.,'1 H-O�+4.-��..'.�:.��..I�'.._I1_.1—...-,,%.I'�.11..,.'I.I*1...�.�1I.-.1+4.I..I,,...��I1.I 1..'I:' .I I.,..I.:—I,I��t 1.I P.:I I'w,,.I..�.o'1��,-"!.'—f''��.-..,f:I�:�. •.k . . . . ) . ,. 1 ' R:REQUIREME N l. �_ AR LAW. EVEN. -: . R N -.:NEW. BEDROOMS W'1LL: TRDGGE (�AA.• . ... . . �. ,. .. - ; -FO . NA THE WHOLETHOUSE YOU MUST" . - � CCORDiNGLY AND,HAVE YOUR - . aI . , LECTRICIAN TAKE . PERMIT AT:THE FIRE DEPARTMENT. . . _ , . �; b.:�, .:SNiO. KE DETECTORS O.K. .- . .. I. . . . .. ; . . , . . . . -4 . - ARNSTABLE BUILDING DEPT . l �6,1,II.�.1 1 I.._I..z' - .' , II.�,,�LI�I�:.I',....I...'..�I.I 1-�-...:.�.1. - . —... -- . . . . IZ IG K — . : +�''i'. ✓.x. a 7 :. - _ - - . . - .. - _ .. -. I ' .: _ - - _ ". _ . . I I . ; . . .. _ - - . . . . . -__ .. .. - - / . _ n 1 _ _. . - " ____ . _ . _ ._... __ --' - .------- - ---II ...,_.--._..... _ ... __ .. - _ --- I. . r.._ . --- -- - . _ - w _ � I — r-1:1.� Y ., _ ---_._.., _ . . . --- - -- - . . -- -_ -• _ _ .. ., : - - - . . 1 ' 1 I . . - - -- - 1 -- LLr_— . I -" ' ` . — 1 . - . . 1 :: , .... .. I. ,..'.. .. Y .. 3. I .. . --�— — — — --— — — _ — .J. r . . _ - :, <.. t ,,, .... .. - '. - - . : i, 1. --., .... . . q �' . I I1 . _. - , ,, s . - 1 . , �� . '� . - - . : . I .. . A a . . • . . . t . : �/ . . _ . . . :� � Go C �, f � /�}v is �. . . . :. , . 1.1 . . . 1 - -_ . __ : _ - - . . . . . . . - . . .. - I. . . _ , _ . , . . - :.. . , . . . . .. . . . „ , . , , It. . . t . .. . :, , < . . . . . - , 1.s :„ 1. is fi' . . . . — . . : ' , I ' - " . _ % - . . `4 . , . . . r: .„ Y k . • -. w.. ,. , -. .. : _ I -. e - .. :. .. . -. :... .. - - : ... .. _ _ .. : -. _.( G 11 �/ �1 �1 . - r, ..,. , -., .. 'IF . _ 1. . - 1. - • _� .. - :_.. .. - ,. _. - �.I L t151. - o-- ._ _ _ _-- - . .I:�..�,�..,.�I.1:..,I.�..I. ,-,I p.. �I�-�.. ..1�...,1I.I-,�.l.1.I:I I ..-,...�.,. I..I. ....�.%.I.:-I ,—11�1.1,.I..,�.:�...��...�.I:..-�..I-,,.I ,��-.. ..�-.� ,1.�..- ��-..L..I m- ImI 11 :�.-,-eI".-��.�.I�A:'��. .I.I I..I p� ...-e...I.%,4.d..�-I, =.-,-''-. �.. ��I. I�... ,--.�)--....-.,.:�.--.I-.I-�.�.. -.1'.I I-.I.I�.1..��I..I I.: �.. II.��,.� ."�:1 I-� �,��.,..I...-.-I�1:.11—:I.1-�,�I,1..:II".--�,. .. -i I-I1..1 I..�I:.I I I-�.�.I-1 I..�.p,�.I.. �.,.:.,�. I.�I .�.-..��..1.��I. � 1,1 ;.".-�:,,I.. �.,.11..,..: . i�...1,zl�.. . Y'. .. �- G4 jj .. I. . -. - 4 3 .. .. - . .. .. - - , . : . . y. .:.. .. -_-...- -�—�� _ i - �_ ti --- ... ...--:: -- - I. I. I I . .. �I- � . . - ,. . = I.B . . - . . 11 � . � . I I .I. . I I I.,L .I. � � . d - 7 � � - .1- — I � I I -. 11 I I I - .. . I - ._ - . � I . �. - . 17 �11 I . � . 1, � ''. . I ., . L F I'll, , - . � . I I � . - ,�-I . I, , I � . , I .1 - . 11 .. - - I - ,;,� , �,: s - -.._--- -.--_-�-- , -.--. - _ ..- _ ,. .. _ I�.-u�.:�-1.--�.-q,.4..—---,—-..-.—,�--2:.:—11—II.. ...-...I,...-I�I.-I-�--�.---.-,,11.--..-�-a..,p I�d-.-m,.,...-d,.-..��.�II:11���-..L...1-.,--I...I:�0':'.-.-�I1.41.I.,.II..,1�1..9 2I�.�I I R,.:.I..r1I-.,,..�A..I--�—.-�I,.:k,.r II-r..I.1..-7,,II.6��-.�,.,-.1--,—�-�I I:--.I�-.....d1 4,I.-o d.-..��-,.r I I.I.r.,....�--7I-"I--..�-4I�...I.o'.�....I 11 I1.1 l..kII,II 6.I.I I.I..��:.I.I.�+�,.�$Ii,.�.4 j.1...I-4I%.�I,,�...:I.1 I-1 A�..I,1.�1.I.,�I-�.....:I.��.1�_1�.L m�1�..I:..1.i-I 1.,1 A�..1...1.I. .I.I.1�I.�....I"1-I�,-..--I�II I.I-,.I�...I..,�.-.-,..�I..,.....,..-dI.......:...I..I.:..1...�I-1-I:...�17�I�.w:.---.-..1.1-d.�.,.-:1:.�.�.,�,.�..II�...:.I.I"1 I-,I,11�i I I,�I I I..I 4..��1.,.,..I..I.I..d�I,1.%II�..�..�.I I,I II.I.�.—.�..�.I..-1 I.�4�.-�,-.���-1�I�I�-L-,—�:.I.I..I...-m...I.I I,.......-.,..I:..�.I..-II..II I�I.d II d I I..I I-�..-.-I-I-�.-.1 d......1�...I.1I,_.�I I.�d.....:..�..I:�e.�.I-.1 i.,.. .. ------ .--.- . {"I/ -- - - I \ - .. ..' - .. -- -- -- . . . . — . . . - , . . - - ,, . . ._ 1 1 I . ., ,. . 1 - , . , I .:._ 1. i ..- , b �: . . .!_ . . —.. -- — .�: , . . I. --I I -- - Y� . ,.�✓ i. �i ._.- .. 1- _ - 3 . - - .: - - . , ._ _ 1. . .. - _ :-, :. , - , ,'; :. .. , . - k . 77W - -. . . }. , r .. � , - - I . .. - . , . . r % -- r - - . 1 I � '. . . - - { �3 co e6e Di9-U rS ; . . . . . - . . . ; . - . ,:. _- . .:. � . , . . .. - _ r ' . _ . _ . . -- . . -- - . . .. . . . . . . �. .�I�.I".��i:..�I.�.�ZI I.�.P.�L,L1i!�;I.I�.I.I�I..-..I L I.'1'.1,-,.,,IIL-..��.I-I�.I�I.�.I�..'.L-L..I.,.,.L..�..._L-I:I.L..1L-.LIL..II.-II1�,�.I.II,��-.,.:I.'L,I...,,.I,.�.�-.�...-L...�.I.L',.IL L.L..I LI.I.,.I�.I."1.,:.,I�...I.�.I I.,L�.I.,I...�..L�I II-1.L..L.L%,I.....�I...I�II.L.I.L I...I'L:I.-L.II1.I,..I.'..L I....I�I.-,-�.......1'I.!..II-I..L..�IL.L,..LL.1.L L .. .-...'.I...,.IL.II.L LIII I I I.I,I.I L.I-I-.�I.I.,I..�..�..I..I...I.I.....I..L IL L,."I....-I...I 1.I..-I1,'�.L.......:.I,..�I"I.�II..:�.I L-..I I�..,.1:�I..I.I.I I I Q.�L.I..�I-I.I...I..-...I.[-,IL.-.�,II�......I IIL....�.�,-I�I-..1 I..�I.L,.,1,I II.I-I I...,....I:.L.-I.L,.,.I.�1II-,-..II.1 J.,.I,.L IL-I.,-.Io:.,I.1.��.I,L�.L�....:.I.I.!L I.-I"I..;...LI I,I..�I,---.I"�!�I..I.1.I.!..I-....!�...,,-t-I..aI�11�..L.,I....I I.1,...,..I I.I,,..�...I�,.�I...�..1..1..I.I..I:.".,..4 L L..II.".,LL....�I.I I..II,........L�.�-..I...�1.I..:L..1...I-I..1.II..I�L,.:I....I.".LI,.I..I....II I.�,......I%�I-.I.....-. .I-LL%I.I,V.�L��.I.�..I I 1.�II.o......g.1,,.'�'.t II'1 11.I..I.L-...I..L.-.I II...I._...L1 I I I,IL.-I.I,-;,.�L I�..I.�I....._.0.I1.�.:L....4-�I�:,I-i1�.I.1�"I�I.I.L..L-.,.I�I.:.I.�.I-.�.�..,.�..7.,...�:....-1 I.-..I..tw,..,-.�..,�I 1.._I.I,Q...L 1I I-...1-.-I.,.-,.....L.I..�I.-.L��,I,-..L..:..I.,I.I...I....II.#II,1'V-.1..',.�-..�L..I�I.I�.-�&�I�.-1I�.,I.I.1 I_�I.I.��1...L I,'II�.t.�I-I�.1.��.".I L,....IT..I�',�I�..I....;�I....."i�.,.0.II�:..,.I1..I.:,-I�,,j.�.�-..,-��11.-.�.�,I.I....�-L...,�...f L f L.,...,.i I.-,�.,.I..I.��,;:...I.��L.I,.:.LL;�.L.-....�..,L,I;,,':I1-:..I.-.I..L,L.I��.,.....I..I.-.I-,-II.��,:.II fLI..�,II0�i I II.II I�-.,.1...I.�I 1-.IIL.--.-.L..,,..,�.,�.-�.,-..��II,..:'I,.....I4.�-I,I=I�I.I I�.�I�.:.I,'.I.�-..=:.,.L%.I4 II:..,.'.�..�.III-,i.,.,,III�.LI r-..L,<�II'L.-..I:'.,.I..�-I.LI...L�L"...,-I..1.-.:.I�L..,-I..,.:j J-�-�..:�I-I-.�-.L....I:I�-,..,.-.-I..L,..I-I.,g I-1,.L I 1 L..II 1,'-'I�:j.:I...I�:",.'..I�I��.��.1�LI,��.I'.�..r.I I,.,L.I.�L-I.i1,'L-I.I.m�. L I I,I.�I..�I.I�-I.,:I-.I I,.I.�.I I�'.�...�.'.II.,I�I.�I--,I,L.I.:..i.'..,I.L.�..-I...L.-.'.I..I 1�-.�.I.I.L�..'I.�.�..I I.,.LI I..,...I.L-,.,I...L.....-...�L...1 III,I I..�*II-I.I'II.�I,-,I..,�.�-�..'-..L I.,.1..I.........iL-ILI1 I-II�.�..'I....L I....I I...I�I.IL.I'.I*..,....'.I......:,I I.,...-L I�..I..I....'....I.�.I.:�..,I.....,I-.....:I.III I I.I.I,.�........I.,.I,,1I�L�1 LLL I-II.I.L.I,-.'�.I�..-.....�.I...I..,....I,1I.I I II,1 I,'.1-'.,�I�I II1-1..,I 1..I,I..I.1�..�,.L.I-L'...I.II....,.-..L..IL�.....'�I.��....��.��I,I'..LI..I IL�...��IL....I N1..*...I1.....1..,I,,.........,-.I.�...�..I�..I.I*.�...,.l L.:.'1 I.....,..4 I..r.....L:.L..I..-�.�..._,i.�.I.--.-4.'..::.I.-�L-.I.I I.,�L...�1..I,L.,:.,I,-I.I.IL.I I I�I'...I:-.�LL�-�,I..L.l�-L,.I L-.I.�.-1 I:.I�II�...":.1L'..��I-L I..�..I"',I I�,.r"I 1..�..�I,I.,1,,1.:...,..I�I.I...I L.�.I..II.L.I.-I.I..I,'.1...,-.,I.�LL...,,..'...I.�I I..��I-I.1.�....,I�1 I..I.,-I-I,�..=L 1......II..I.I�.,.:I1 I.I�.I:'..i.�I 1...4I.I.L=L.�-I.II..1...;I�...4 I,...�I I.cII I.I�I.IL I I-...�I....�,':..t.-.L0.IL.:.,��,I..I...���.I-..1I.:��.�.IL�'��...�,.-L.%�.�'.�.1L:I.�I-1'.I...-,.,-,I-...Lr,��'IL..I�I:��I...',..--.II;�,_-..i'��,....i�.�-..,e I'II'-:-......,.�:4.1 1.I..I.�.1I.:..II Ii.''...�II I,.�L.II..'...I.....II.I�.1I I..'�L...I7..1I LL:.I-..1:,.w I.����.-.,.L I.1..I I,.L-,-�.O I.I-.LI.,..LI-IIIIA.�,I.,.I I..I:1.I,.,1I.1.,....1I....I.II I,.I.,I�.:...II-..�I..I r...I,I..i-..I.',1%.i;I.�.L.I,-"I.-I._...I.;.I�,Z....4...-.-..II..1 k.1.�.I.:.:.'...I...I.I�.�1.-IIj1I?L 4,�,:I?..,.I..��"I::-.II..4;.�1AI,-V�l�:'.I-,t,L4.I...�'.I.4_I..,.1 I.L-LI,.-.��,-I-...,,�I.,I.I.4...I..n1..�.....I I.I.,I-,..I-..I.I,1�-I.--.II'II.I,..I-,�.I�.I.,.�.1.I I 0.,I I.I,.:�_��..p 1 I�;,1�.Lff�.II�.1�.,1......I-L.I.,I I I,.,t . 3' ...�I...w..1q.....,,. . . . ;: :' : .,,.1,..,-..-I��i..I.L�..rI�.I 1.I-,..;I I�i.I�I�I,L�-..L I t.�-I,,L.L�1 w.L-:..--.L��.'',.,I�....�,'�,L�:"�.:..1....-I I�.I,,-�I I1 I I,-�...I:,,0..I II.�I I.1.I..I,,..L...,.,.-.1I,I..:�II.:1 I:-�.I,.,I.��-'�,.,�,-1:,�--;�L.II.LI.I.L...:;...I�LI.�I I I 1......I I...,I1.;II.,..�.*.I 1�.I',.;I.I.I,.�I.I1:I,i,,4L...,.I......,..��.-7�.:�II1�..I I:L.�I.:..I-'L I,.I...��,.:.....I...,�Ii.W I..�',.L-....L.�..I..I I.�:..�1.I 1-..-.-'%:I�I....':I��.,..L,.I I..I7.L-.I,..r I-�.I..%I...-.,.I,�I�I..,I."1�....,..I�I-.IIL�..�-..�'.I.I.-��.-L 1�I.1.,-_L1-.-I.L,I.'.-I..,L 1."�.:LL.I:I.l-..-.,I..�,.-�I I..,1�:,I...���I....I',.�.�I.,..-�;,:,L.,.I,.....'..'"..:,I..,�I.I I-.,.4I.,.I'',.L I...��,I:L IL.I'..I p�I.I..,".,..I..-I.�I.�.L.,..'-L.L�L.I II-_L I I��' ....1 I."...�II-,%.)��I...1��.I.�,.;.:�.L-...,,'',.,7-,.��II..LL.I.I.�,��I-�..I.,..:-:�II.I:I...I..1.,....-L.:1...��:1:��I.�I...,I,....-�:I'L,,�:I I....l�I'L..L.',...--*l I,.,'I.II,....I..�..,.!.�.�....1:,I..I:.�4',.,".I.�IL.I.I.�..,-..,I,,�I..L j,...-I.,�..a.:".'1......1..�.L...I I.�I..:�:�I.,,....,.I.....,..I'.I.-.,�L.;...:..,I'...I�L�I�.."-..I..I.,I�.-.-,..II.I.L.,,.:.f,I.:I...,..L.�.....I.,........-..L.��.,.,...,....1,:%1.I..I...,..I I.,....I I..I..I.�.1,.,:.�.-IIi:�I.I,.",.L....�L 1:1�.L...1.:%I.-I.�.�I�..1:-�,..,.i,L�I....I.1 I,.L�'.� . - . . . .I L-I I.,�F:'LI.:,L.I�....",L.-.I,.1..-I .I..I�I�.I--,I..I�-.;.1......�I..::....I III..I.I:I.Ia...:.�.I.�r..I..I.,1 I..I�;,.�,5...I.��,.L.I.'I.I,..-I.I.,LL.I..�I L.I�I.I-.�.,-.I. .. ,..i I�,I.�...-.I���I�I-A I,.'.,1�.�:.-4'��I I-.�1f.�..-��.,.,l.L I,..I.L.,I-...I.I.....I,I...I....,,,..1- ....II,�..b L.I�,,.IH....'I L�.k.�.,-�-*m.-.-I.;.r..I-I,....I�.,......L.I..-....��..I��i H..,,.....1IL L,,.7.,.L..I'�i I-.......I'�I,......J.I',,,..I,...-.....I'.11..:1 I"�..IWL..�..'.,.,.III.I.�.-. ....1I�II.*.,:'.I-,:I..�1...L.-��.I.�.;-,-lI,-�...LL.....I.-..IL.I.,1.:...,,.�...'I...-:-�.:�I,"�I�I,I-mL..'-.L��.JI.�.���.L f..�L..,. .-'._"-,.�,I.1�.I,�I.�:.1-.�-L,.:-...-,...-'.�.I 1.,.. �.*".II....'�:1.I,.L.�L.I..L I.,,...L.,:".,..-L E I II.L,.,�.;..�I,�,..��e.I7.II..-I��1.,,,i..1�1.:-.I,�...,.,,.I,.,r..,,.I,,��I�.,....�.,...N 1:L��-:.I�..I1 I..I..,.I..;-.-w...��.,I.,�..�r LI..:I,.-.L..I I,L I.�.LI-)I-I.-L,�-:.:,�I.IL.I..-,:�...�.�.I.,I.�L.�.I,.1.I..4I�I:-..-II:-1I...,��4*-.....I.,...'..�--%�,I,'c-.�.- I)�,.�'.,�II.I.,I�I,1.,�,.,1�1 II..I�.',..1...�.-L�....L...I...�.I I..1..,!I I..!��11iI1 I,"..L.�.I.I�--L%.I_.I I.�IL....'..I.I.1 L..;I.O..'..F..II-I.:�'L�. �,1.I.-�..I.,.L.:I.'I!'.'..I I.%�,",.1,�,.L.._.�'"�,�,1 II.., .L�-.-:..I.,.L,.�,a:.1�.�I......,�I I LI-%L,:I�i b,..-�"1.1..1.�4..:-�-..I I.,Q�%I'I.I.II.;.I�..,�I-�1,:,I�I�..::i�"--I-,.:.,L��-.-1-I r,L:L,,_-.-'�.I,L L,L I-%I1.I.,:.�1.L.I.-I�L..I.-,-�I L I.,I._wI.1.I.'�L I�II�.1,,�I:�II .I.��I.I4�.,...�I�,I..I.�L-I�L'..O�.,"I.I.�I.......1�I.IL,..I-.I/L.".I:1 I I.I...,�.I..�..I�.--".L�....I...�.�.-..1,.%L�..-:...��.-...-.,.L,.�..I....L.IL...II L.I-LI�I..-..,�.'LI.I,,.1 L.I..�.�..L I I II.L�1..'I L..1.LI.�'1 I;L 1,�,I:_.1'I-..,,...1,..:1�.:I'.,.I..1.I.'.�...�..I I,.L I�.,-.�.�,:L'L.��.-..'�.%'�,�L:1 I..I I I..L..-..1,-1�1�,I.�I1�.:.I-�;..��I.'.I.II�.:I��.-I:��,,-..1�.1�L 1�I.,�"...�..I.��I. I.I--L.,,�,....�I...1 I.1.�I..:.:1 L:..I,.I�,"11I.,.I.I_.I.,.,-'..�.,I.-I,I,:I*I L.�'-"..III'I�.:,.L.-,:L I.��..'..I: .�.I.-11.I._:,�'.I,I�.,I�.II:�1.L:.I.I.',.I....�.::..�.:II..�.I...i..II.1 I II-.,:-...I jI,.L I,,,.,..I%I_�LI�,..I:..I I I...LI,.,II�.,.-.,L I1I::......�.II.L.I.,.,II,.,:I,r.,�.I.:.1.1��.1 1 I�.,.,*-..IIL:1L1�.I 1,.�.L I..I.:.:.....I..I.,.'I 1��,IL.I�.�I,j�.�.I...dI�:I:'..I I.'.-i,.,I.I I.,.oL I.I.:l,-I 1IL.I:L...1.,-....I.�...I'.-I..g...I 1I L:..,.II....�I:'..,.1.I'...I I L I.I�',��IL�.:..I m..I..t�I�:'.,-....I.-.I�II�L.I I��.L�.,;I.,'.�.".,�`'....I�.I I I.....:�,L I.-�.,..,I,L..L�...�I,.�.,I,:. %.;�.,*..-I...�.-'�.-::7.L 1.-�L...'��.��,I�.-I.,-_I I4..L.�.L�.d�1I..,I.�-.....I-,�I��.L 1�.._.'I I.-I-,I..I,�'I:I i,.:.I'L.,.�I-I�I..:I�-�._'L II LI--,,.'1 L�1,.I1�..II.:".L--L,L.�I.�I�L�I.I.IL.o I. .....I.I,..�I.. F: > .. .,III�.I i I..,.LI:.-L,.II..��-..I(L..,.I....�.IIIL.."-!;.'-I L.I'.�L-LIL-IL L..;,,L.L:%...I.L"..II..I1 r .. r "„ - - - . ` :L I IL.I.�IL:,L/��.L',.. s - .: .. .. n _ : .: .. f ' r -.: ` ._ .. r _ ..--I I 1.I..�-I-I..'..,I.I..-L.....II..L. ,l.L��-I..��..-..��;II-I.....L.1I I I.I .. ".. .. . 'T: 'r',. .: .. : :., r ,, .a., .. : r 1' r Y , r r . r - .... .. e' . a. 's : is ...... _ r ,_ - _ : : :� .. .. - . ' -.: . 1 :. t. _ r. II .. ., - '�LFr - .. �� ... ... n:. - ::. . .. ' . . - . . . . �t314 r Ir ` I.L'%,.I I...�.�.�,-�'I..,L,I'...���..;I�II'4I.%....."y�.TLI-1,I.II,I�-..........!,.L.-�L.Ir f..��:��.,,I II-.,1,�-,I.,-I,.1.-I..--.I*'-=��..�.-L.:.L I.I-����.�.,T�I.I.-'.I I,.-I:L,..�.;..�...,-=��.I;�,.�.�,�.I..,�L,I.:,-..LI I-I.-,.I..:f�I�4.L.�L 1.,.I1.I I.....L�.a...,I�.....=...,,.�...I.,.,:..-,'.I II�.,�..L�4 L-..�.I'L.,.,I�,.I II I..=:'....L...�.�'...I�.:.L.L*'L II.I..�:,..I.I.L,1I...,...'I.=:1...:,.,,I.-.I�.--:I...�..,,.i;1�:,.-;�..,.*..:..I�....-".7.�.,.I',I,,4L.�,4=..:.I.,�.:.",.,..I,�.I...�"..I-1,,-...�-L'.-.�II..�.:.....,�I.I L-�I�j.,....l�I..=-'.,L:I,I'I'.' ..1,...�It-.,..I�I�.,..I�-�..��I .,.'.I.I..�I,.'L..-,L,...I.��It�14,:;,..I.,.-.1�II*,x�.,,.L..��.'.i..4.I I I I.I�.1,.I.,.-.I,.LI..�.I:.:....:..:I I�.I..��...,I.I I I.LII.�..,.-.�.L.-.,...I,i.L�r�1..I.,�.I.�...I;IL I..L'....-I-...,I.%..�..L.,�....2..I".�...".L:--,:.�,1 1..�,��.,:..',.I'.1 I.-".L,a,:�...r�L��..".I;,-,L-.I�-.��.._I...I...,.II,'-..,.I�L.�.�.-....Ir:,.z-,I:..L-�:I4..I-�-�'.I,'..�.I'--L..q�I I i,Im.I,:.i I_.:L;,-.�..�,�I.I'.I 1,.��.L,.�,I,'�I I..�,.�,'.I-.��4 I.*,.�-W.,-,,.�.I-:I.�..1.-....-....I�.I:�.LI.�.:�..,:�--I,�I,1.-.L-1,..p.'.II.�I`F 1.�..=I...1..,L��1 IL:.I I..,...I�1.I:I�,I L.�,��.I,..7...-I..,,I..:-�I.�-,....I.,;I.-':I�L�.,.1�..1...,,I'�.,I:..-LI._..�j.I.�[,.'.I IL;I1:�I..I�'.."�L II.I.' .L..L I.L..:..-L..4-I."L,.,�..,.I.I I�:I[I,.I.�...,,II,..I II.I,I'I....LI.I.It.�.I....-,,I�I:...L..L..:�.�.,�.:-,:.d I1.'.LI*4�.,I.:A,...�-',...,",z-�.-L.�.��,f..I,.,.V.�,�-L..,�-_....:I-II.,,I,I,-I,L�......I..L,,�L,,-.:I�I�..,,L.I I I.1-�.,,"I,..I�1�I.TI I,�I.I,",-I.I.1'�.L.j�I-...�..,�,.�L.L.1..L L.,,I.�.1�I...I..-...,".�.._.I.:�I.I,I I.I L I..�..-.,.1..�.�I......1..L L,�I:.....L..IL..1.1....:...�L I..I 1I I,�L...'�L..,.,.,w�f-.I,I.I..�.�L:-.:.I,I-..-.I.,,.II,!,.�.I L..I-I,1I,I.IL,Iz..I.I.L I.-.1,.�.-I�j:.,�.I1-L .' �.7 _- .. C^H _ O � . : r i� k: , {{ E M . . . .'... pay , . . ;_._ - - �. .•^ ; . . : . . . ! 4 . , . v s . 3 - .. . . . . .. i '. _ .. .. _ __ _ CFI D � ' - - _. . ._.. I - r� © 4- fit , . - - . .. -- - . . ., w ;Y- I, . _ ENo�>� rs��- uiL� . -f i s_ n _ 0 . I. : - - - -�� -Y ; . o kE h . . _I _ . . . . . : _N �- - - - f - -- . _ . . _ c - 0 I�r +j -- v� _ N _- -- _ - M . ` - L_I_a� WI Ncrw . �N� -p ' . J. .. It GLG� � Z . QL- ��� . , �i?E . . . r-- _ I. .. . . b I. . I .. . �.. r LL,.-...,.�.I,....I..,I m,I�,r�I.-...I�I I-..-...%�..II�I.I....w,I.�..�...,��...I.L,1...I.,...-1�I,..I.,I I I,I:...:.-...1 I.L.I..,..:.,:1�:.,..I�I.-.m..�.-:.'�.:I.,.FI L!I.I....�.,,�.I�.�..�I-..L�L.:I.,.".,��.,�.�..I.II..I.I,.LI.:*,.�VI1LL�.�...L I....._..,-..�.,�-,.,...�..,�...,:'.L.�,�I�,,.�..'o..,�I.I.r�1.:I...��...L,.-..-;..-,I I:...-I,.:�..L.�I II�w..II�_...II........L,.._......."�.I.I..-II,�oI 1.'I,:..�I II..II..L.III I:I.,..L-.I�.�I rt 1� L . . . . . _. .. . . Z p�� . r ? . . . I' . . . : . % . - s- -- _. ' _. ..�._- _. .�� ; _ +r11 -�-�' - ' .' . v . - -- - - . -1 - - . - - - - - - -- -- - - - . : . . . . . . A - . _F % . . , _` ti - - -. V, . . .. ; ;. ' a ., m ct' . . . . . r . p � : . 2 .p 2 . II . C 0GG- . Off. G..-__ _ _._ .. 0 . . . . . . . II �. . u a I. _ . __ __ . _ . _��, .._:. _. ._.: .- 11 . . . ' . .. . . . �I, . . . . , . . . . , . . . . . . . . . ' . . �. .. . . . '1) .. _ " r 1. .. a .. — I. .. '7 t �- - . - 1 . '..., .. . a .. r ., .3 µ f [�•tl. , , .. . . -. . < a. .- . .. - _ .. _ t .. - . . .. .,j : . - .. ... T t.....- .. u :' .. ': a...' , • - a _ h.: Ir , ..:-.. :• .. - ..- r, -. e .' . ,• - - -.• _ .: n • .� - .. . O a ,.-. v. ... -... ._ N I a .}.. , L :. K .. _ �, ��Q�4 - . _ .. .. _ .-. .. . - - :. - , . � t � - 6' - - _ �� . . . . . _ . � 7 1 , _.} . . . . I 1. . =. .. . . I . I . I I . I .. . -1� . �� _1. L' I .� r 1, . _ _. .. 1. % . . . . - f: . .. - . . IL I .. . . . 1: ri I = I i . �O� . . : . . 1. . . . . . , " - ,. ' .. . . . . . . . - . - , . I . . . . . A. :. . . ,SG f - . : t � 1 . . (� % ' M Lp p . . yam . . � . - . ,- . ,� •r , . 1 . - . . . . . . L. , . . \ ,e . . . .. - ,. .. .. . - Ga:c� l . . 6 . . . . . - s . . , . - _ t t „ 4. , „ r r r.: Y .. 4 A : e. 4 4k , rr y _ m r , • t , , e , , IIl77777 IL ti y : , ,v g A DE •#, _ _ I Lvv i ILOz � 5 rt i n# 7, s•. 1 " r , w c t x �I lii • t Y} 1 .m A t,w a P _ .c k I e. : , e ». a , F r 3. t , • , , 4 P ry , , , k , „ t , ` , - ti - e.' r - , 4^ e .. -. _ :. ,. .,.: :- . .�: ,�'x• ,. .,..'.. .. is .. :.: ,.' }} '. P .0 , . , _ a e . . . �_ _ r— . , . r t : . . , .. . . . _ : . -. ; .. . . . 1 . . G . . . I. . . I C : ,,:. . . . _ �} . f. 1. : . . . . . - . .. : . . - . . , . . . . ,: , . .'. . . . w , . . ; , , 1. p . , : . �:1 . . .. .., . . . : t tt w �1 . �0 . .. , �� . r . Z.I L✓L,� l= - - --- -- > , _ 1 -___ : , :, - — -- --- - , T R t _ � PL hIc»P I 'i :7 °'. - Y. . - D.L. . , ,. ,. . — .: . ..F 10 I _ -- • 3� a . 3` 1 . . .. - - . . Pf' . . , . , - '�- -+I YE v. '�.I61-.I�,(� . G ► i" : ' r ,. .. 1 , 'L- GAD �-� n - ,. .. N : _.. _' I s. N U L ." a. �'` P Y . . G . d_ l . ,: - 1 { . � . y 3� p. , _ . � 1 1 p ..: runs { 7 1 II _ , .. . - . . . . : 4 . __ ' . ,►�, p o . - :i 11 . .. _ _ , ..° -.. - ..r .. 'tl, 1 . . _. - J, 6 Fo . , . . . w s — . -: . .:_— . . . . . A , .. . . i' . - :.. - .. .r. - .._ _ - _ _, - _ - . t . `� } , . - . . . s - . : . , .. , , ry . ;, . ;.., . :. '..6 6 . I. . . . 6. � ': . � I I. . I. 6 . I . I _/ . . . , . `C . . . .. . - . . . . . - f . . � _. _ _ _ __. . . . _ _: . IMPORTANT ANY CONSTRUCTION THAT INCREASES LIVING SPACE BEYOND 1200 SQ. FT. PER LEVEL MAY REQUIRE THE INSTALLATION OF ADDITIONAL SMOKE DETECTORS. NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL CARBONMONOXIDEALARMS PERMIT DOES NOT SATISFY THIS REQUIREMENT. MUST BE INSTALLED PER MASSACHUSETTS BUILDING VODE 7-4 k. .. s I a c. s t . F: . r• ti 964 ~; 4 - f— _ ..o......_. .�.,. ...., _ ...._ ,..-. .—..».-. ..._. ...... _.-.. .-..._.. .�,.... � fit: s • Il t : g € - , k 77. v io 4 AX Pik 6 r i ' E e FSS' i j , e { _. cr t , u a r w 1 { 77 Tll u'r LW � . a h 9 s � o � , t .d - w_ / 61— i F f �Wo. 4 a { � 00 I TC1 - .� (���F,,'�� i ol ew 44 `c.. i : i E � s • B w 1 d 4`. .00 cw s i — 4 , a4 t I r _ r 'J `S F I s � , w u t I , I tk13�'i� z i I tv LVL 11. - C&IDp J p 31 VL LPL � IA91 14rs,r e F Lq i t s M ®� 14sr �81' LVL -- - �A ✓�� 'COCA** Irv. , v:nr.txr: •gym-:wrr�NYc4 A y�b•' �' ram.✓; �„�. t `,". �.` - �.. r�. 1 e E k CC 6 ` P i t w' I f f ) T^� 2 lip Ao �_ -w - - -- .. I e f \ ' y a.: S YJ a L e i O ra .. i \\ � � � " :. `� ..;�'i: ..... `.a�® � ,.:..A.*'M:.1�� •� ^;tom' •.:-.:1:c..,...14 ..-..m.. �t.,_..y_, �,�,.�,�: -`` : t , ;. X. �; I d,Aes -� J-Ae, 3G Yd w#!�.1 'S 1a 14 'W t"T 4 LCO,6 11ML. a >f l s. AAI� $ �tTC-1 -Sf-941Kws t-r 4e. HIEW 1&0, ®. 0, 1-40 T4ix A R a Prims eA A MIM: lit ®s151 SLe ` 1E2t tbT�NG R.A►�T1�� �����` ®��+ f_ OF 164TfL .100. *k►L . f 04 I i f IO t0 I�t. SST ��eL ► fj_ !D ado Z . �0' � � �� � �°� �� ct�S' a.c X!� t�L1�� AT ®t om aLgpeaq-jc�e— a.� e t..�1� 0Ttl a LCO • •� } ..4. 4wa RM wall F. Y ZJK �� 29 L, r w • a tied 8-�tZ W d,°�.A1..19.4C �°•^�r" .. OD /J • / ap Ib to OE 6 W R-YA r BUILDING DEPT o z FEB 15 2017 N m TOWN OF 13ARNSTA13LE W o 5 W" z m o XT \O y' X Av •tali/,La / /0 / ?. i � V r� ` � / � - ,�- /� ��'J ice• ; ++ A `� ��s � � ? '�< • � s > c•: � � + 1 ifs �'�c ; q ;. r, _ - _._.. (�,, - •-•,�� �;it \ /7 c � 39 S A VI � aa nn� ll — Ur p /l� / / 1��ST%C � /U� �IW � =` All 41 314S W4,Li� L Y of CA _ �`CC C//?A TE"L. Y OL"ice/C TS T/!E LAYOUT, L O T/ON UN/T NUMB�'R 74 US/Yam-, I pi L - �OTE',• �-�LL_ T/ES' TO X/S T//YG . Tc� COR/V�'R BO,q,40S. BU/L.O/NG CO�.ST�'!1-=T/O�/••; 4 t fl 2 eAlly W- of 1'zn,�i_ •s ";fit:- :: .' � 1 t_ a • �r- � \V i� cI S• 40 A. zg { � ''v ` : � � � ��� lj _ P' ,e e y r°`J'' � ``1 Q1�•!� llj'l, V . - -_> �- '._-...' �� // . 1/C �sue'•�� r / -s— V c o GEC G / /TZf'ATR/CK F/TZ 3/ S 1 / I 3✓ 1 / clef RT/F -7; a J L =_ /VOTE,• A.GL T/�--5 TO �"'X/S' T//YG BU/.� O//VG S ��4� _- . - Tc� CO,Q/y�:-,Q BO A.�'OS'. BU/L.p/NG CO�.S'T�C'l/ =T/O/y• - - r - - r i SET/T/O/1/ 104? _, 11