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Home My WebLink About0028 POINT LANE � �o �'nf� ��U� ?� \ r N � ` 1 �� l /A I V i 0� Town of Barnstable *Permit# Expirja oa ' .�. . Regulatory Services Pee Richard V.Scali,Director y" Building Division Tom Perry,C11O,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.townbarnstable.maus Office: 508462-403 8 Fax:508-790-6230 }PRESS PERmff APPLFCAnoN - RESIDENTrAL ONLY Nat Vaud wt*out Itedx--Press Fmprfut Map/parcel Numbea Property Address � O��1� �n thzonat-g . 1 Residential Value of Work$ I. �� 'Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 0'--o ' Y(�,J�;� (-J'/ Contractors Name Tel hone Number -'Home Improvement Contractor License 0(if applicable) ?_ 57 Email: Construction Supervisor's License#(if applicable) q XPRES' PERMIT Q Worlanan's Compensation Insurance m Check one: ❑ I am a sole proprietor ❑ I an the Homeowner C T 2 2015 Q Z have Worker's Compensation Insurance Insurance Company Name l,l✓-� Sf�� 1dtSt�Yrrs�rr!_ �EY, TOWN OF BARNSTARLE worla an's Comp_Policy# Copy of Insurance Compliance Certificate mist accompany each permit. Permit Re ps (check box) I jI'I Re roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to �d 4AU ilk ❑ roof(hurricane nailed)(not stripping. Going over eadsting layers of roof) Ro-side Q Replacemeut Wmdows/doors/sliders.U-Value (maxdmum.32)#of windows of doors: ❑ Smoke/Carbon Monoxide.detectors 4 floor plans marked with red S and inspections required. 'Separate Electrical&Fire Permits required. *Where required: Issuance ofthis peamit does act exempt compliance wit other tows dgw=cnt regulations,i.e.Hish c,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q\WFMES1F0Ma%w1dmg . Revised 040215 . r i 4 Dvaroffent qfrifirFrrstria1-4criderds Office 0flFirl?Md9afi0=. 600 Was rbigiort&&-eet Baston,M.02111 ' FViPIG-ma=g"..1dia Workers' C=Vensafiala.Insm-mceAffidavit BtilderslCuntra:ciurslElecfric=a dPhmahers ►�ica>, TzzfclirmafFan Please Print f eaffi j t Name .2ncirrP� Address_ 0 -j 1.55 H 1 CitISfatefip; �b u,dt �� fc 3 C`" Phaa 47�- Z2� 7 AL e you an employer?Cbeckthe appropriate bow Type of project(required)_ I_[II am a employer with f ❑I am a general cactcsr and l employers(full andforrpa-Time).* 'rav-ehiredgm sub-contractan d El I+ie�rcons&�cfio� 2,❑ I am a sole proprietor orpastaer- Usted va the attached street 7- ❑Rmodeliug ship and have no emplo5ees. _ Me m sub-cash'actors have g- ❑DemoliEfla -wod-Ing forme in any capacity- employees and aye wadoere INO urodmm,cczap.hmur nr-a_ comp-iasurance-1 9- ❑Bvikrg addition required-] 5. [] We we a-coaporalrran.and its 10,-[]Electucal repairs or adcREws 3.11 lama hameovmerdoingallwodc o$cers have exercised their ILE]Ph=biagrepaizsorad&fions Myself[No wo:d=' - resat of exeasgfi n per MGL 12[]Rnofregaus msurmceregu;*ad-1 i c_152,§I M and me have mo employees.[No wadnes$' comp_insurance zeguhm&] `.�iay s�rp€icuut;!B�tchedsl�os rl nm�also 511ouEttce sec@aube�mvshaRiag ihe'srwaxtces''canzpensatinapoT�yixcfnxmsuaa 'SnmeovrIIe who sabimt 3vs sx-fidacrn Mgr day axe do=.-zU wa&and diem Yme aut ads rsnmst submit a newa�dsrlt ma ic�n�such rC6190 ISff=chea tW5 boa must ztTeched as sdditirmal siaeet shouixig the xrzme of the sub ca�ctaxs•imd stye vrhedter araotthase�itiesha�� expia}•em Iftbp-mA-c tmctnmhzcemxgtojt-%tteymmstpzaidetheir uuriEEx5'c=p.paRcynmabez .Tam an emploFar ttiar#isgrat�idriir��oaxkerx'aam�rrsafiarr irrs�irance fvr�}*�rrPPo3�ess $elaly is tilcrpaiiuy ar�d jab�e frzformrition, ' IasuranceCampaayi'Iame: C-7tr64 vl - 'Policy-,'*'or Self-i-is-Zic-4 1`)()C qi : (O o { E,riEaffaDafe: Job She Address Citp/Stafe{ p: Ad2ch s copy of the zsorkere campensation.poliy dedaration page(shatviug the poRcy ntmaber and expiration date). Fal-lrzre to secwe coverage as req*ed.under Secticzt 25A of MGL m 152 caa lead to the Reposition of criminal penaldes of a ire up to$UOD CG andlar ozie eariznprisystmea as yell.as civil pe s.rm the fazm of a STOP WORK ORDERand a:rhe of ag to$250-00 a day against the viohdtx_ Be*&ised'fihat a copy of this sfi kment snag be*cwarded io the Cfm—ce of Imvesdgatzom ofthe DI&€or insurance coverage vesfcatiam- .I d'd Tw4by eartrfy w&ff the 'es and psnaWks arfyielmy tkaf fake [rue mid correct Off lord uss mily. Do net write f193 area,to be cmnpieted by city or town&jYk&T- Chy or Town: Per=ftT i,ceose;9 Lmming Anfhority(curle sne): L$oa:rd of$ealth 1 Bufffng Department 3.CAyf rumm Qerl; 4.Electriec21 Inspector S.Phmbmg lmspectar 6.Other Comtact Person: Mom ih I - 6 ISSUED 13Y 1 HIE STOCK INSURANCE CORIPA NY HE REIN CALLED THE COPAPA NY GRANITE STATE INSURANCE COMPANY 0103090-00 WC 009-93-0601 13102 -- 013-82-0915_50 - • PENNY VAN • FRASER CONFRUCTION, LLC AIG P.O. BOX 1845 COTUIT 02635-244 , MA 3 An AIG company EXECUTIVE OFFICES: SEE EXTENSION OF ITEM 1.OF THE INFORMATION PAGE- WC990610. 175 Water Street New York, NY 10038 I.D# 0001 0646 MA Ul#: KEATING GROUP INC THE WORKERS COMPENSATION AND EMPLOYERS 144 TURNPIKE ROAD LIABILITY POLICY INFORMATION PAGE SUITE 150 SOUTHBOROUGH. MA 0 2- 00 LIMITEDSLIABILITY COMPANY RENEUL`�Y NUMBER0 0601 OTHER WORKPLACES NOT SHOWN ABOVE SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE- WC990610 ITEM 2 POLICY PERI001201 A.M.standard time at the Insured's mailing add ress FROM 09/26/15 To 09/26/16 ITEM 3 A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here; MA B. Employers Liability Insurance: Part Two of the policy applies to the work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 500,000 each accident Bodily Injury by Disease $ 500,000, policy limit Bodily Injury by Disease $ 5001000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MD ME MI MN MO MS MT NC NE NH NJ NM NV NY OK OR PA RI SC SD TN TX UT VA VT WI WV D. This policy includes these endorsements and schedules: SEE EXTENSION OF ITEM 3.D. OF THE INFORMATION PAGE- WC990612 17EM4 The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Premium Basis Rate Per Estimated Classifications Coda Number Total Remuneration $1000E Re- Premium 0 Annual El3Year muncration 0Annual ❑3Year SEE EXTENSION OF ITEM 4. OF THE INFORMATION PAGE- WC7754 TAXESIASSESSMENTSISURCHARGES EXPENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) MINIMUM PREMIUM $500 MA TOTAL ESTIMATED ANNUAL PREMIUM If indicated below,interim adjustments of premium shall be made: 11 Semi-Annually El Quarteriy Monthly DEPOSITPREMIUM 08/25/15 PARSIPPANY 82 Issue Date Issuing Office Authorimd Representative WC 00 00 01A 39967(Redd CW 08) i ' f • Cris A�assaen::sa�s-7z�zrr-an?�� 30yid ar 3u=ldirc Ragu"aii. and Stan-oniv9 Covarvrsion Supcn•ieur DEAN C FRASER 104 T%INL Nvmw 1,A.m - EAST FALMOMM MAF:02-436 ia.-r::S;C:.e7 06107/2017 I Office ofCc3str�er a d3usz�e.s�?egr� a I'D-P9r-kPhza- Boston,NIm husefts 02116 •Home 1=prOVemee Ccntradarp-elai r '= Typec DBA pc crr 3/2ar=f it FRASEER COIFS 7 RUCTION CO. DEAN FRASM F.G.BOX 1845 COT OTi,MA 02635 Tspd3te:la'Rsesssa8:ezcrru�sd.l�a-lex�sattur r2�za� sse l - r osr: f-� d6x— Q P---4 [i T�taaioy.� t �a £aza BSicetCo+ --s as�b F fs&oa lzcmseos ae�iaYor�r�viaRTasear3y - HIZ COACTQp, bff*- aeexsaat- P.0&MZlPPMVMMU,-, Tf o_acz=z- 1V336 Type�ivaEaa;-3PaTeO'C7 93S lOPsxkR3zza_8acc5i�t� FP.�S=Ft CC�3STRUCLIOAI CO_ - ' BEAN R�AISRP. 2 ALMOL -L WA 02s&6 Ya�w•fi8svit5aat �xre Fraser Construction, LLC 31 Bowdoin Rd. Mashpee, MA 02649 "Y Email: info@fraserconstructioncapecod.com wWw.fraserconstructioncapecod.com FAX 1-508-428-0123/ PHONE 1-5087428-2292 HICL#112536 . CS#97668 RE-ROOFING PROPOSAL Date 8 20 2015 Name nthia-Baxter— i Q Email h c aol.com Phone 734-678-5619 Job Address // 28 Point Ln H annis MA �ovidfv , FRASER CONSTRUCTION hereby proposes to perform the following services in a ' neat, professional manner in accordance with the manufacturer's specifications and local building code. CertainTeed Shingle Options Good Better Best Shingles Landmark Landmark Pro Landmark TL Algae Resistant 10 years 15 years 15 years Wind WarrantY 130 MPH 130 MPH 130 MPH Weight/square 2401bs 260-2701bs 305lbs Shingle design Two-Piece Two-Piece Three-Piece Color Palate Standard Max Defmition Max Definition Valleys Closed cut Closed cut Open copper Investment 1 $4,800 $5,100 1 $7,200 * All above shingles quoted with CertainTeed 50 year non prorated 4-Star ' warranty _ Shingle Selection: Color V "B fiInitial: �67q Sidewall-Remove and Install 20 Sq. new white cedar RR shingles 9 Investment-$16,000 Initial *Please Contact solar company to disconnect hot water panels on rear dormer* Ironclad, Lowest Investment Guarantee Any contractor can price your roof for less by cutting corners and utilizing cheap materials and unskilled labor. It's important to know what is and isn't included in the roof you choose for your home. You don't want to be left with an inferior roof built by an untrained labor force. That's why Fraser Construction offers the Ironclad, Lowest Investment Guarantee. Not only do you receive a state-of-the-art roof built by highly skilled craftsmen, you also receive peace of mind knowing you obtained your roof for the lowest investment possible. If you later discover a comparable roof for less money than the one we constructed for your home, we will pay you the difference plus a $SO bonus. All we ask is the comparison be "apples-to-apples." "We have no quarrels with the man with lower prices,for he knows what his product is worth." PAYMENTS ARE DUE IMMEDIATELY AFTER JOB COMPLETION. 1/3 initial payment, remainder to be paid upon completion Payments accepted are: CASH - CHECK- MASTERCARD -VISA -AMERICAN EXPRESS * Any payments not immediately paid upon job completion will be charged 0.005%for every day after the given 5 day grace period upon day of job completion. * Please note that roof prices reflect removal of(1) layer of existing roof unless otherwise indicated in contract. If additional layer or layers are removed additional charges will be assessed. , Possible Extra -After the`shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$6.00 per panel including Materials 8s Labor. There are 6 Panels per sheet of plywood. Possible Extra-Any rotted or otherwise deteriorated trim boards,plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$75.00 per hour, plus 20% mark-up materials. FRASER CONSTRUCTION guarantees the labor for LIFETIME of roof. FRASER CONSTRUCTION guarantees the shingles against Blow-Offs for 15 years. Please note that all pricing is contingent upon current market pricing. If contract is not accepted within thirty days of date of proposal, change in price may occur due to deviation in material price. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. Work Permit- I4C P (Sign Name) give Fraser Construction permission to pull a work permit for the above work at _c�_.&'P.oi ru-F 2-A7V (Address) � vyf k? FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on, the above work, certificate available upon request. DATE OF ACCEPTANCE: hol,S. Homeowner Fraser Construction, LLC r a - I r = Town of Barnstable *Permit o Expires 6 the fr issue date . Regulatory Services Fee XmP ESS PERMIT Thomas F.Geiler,Director 2 �� AUG 17 2007 Building Division % d Tom Perry,CBO, Building Commissioner 4 q. TOWN OF BARNSTABLE 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us PIL Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ! Vn Property APO-64 ddress Residential Value of Work 6 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address at- 1� G Contractor's Name (� Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) . ❑Workman's Compensation Insurance Check one: (�I am a sole proprietor '❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name 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 ❑Re-roof(not stripping. Going over existing layers 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 Owner must sign Property Owner Letter of Permission. A copX of the Home Improvement Contractors License is required. SIGNATURE: QTorms:expmtrg Revise061306 'V 'V a f7 a s 1 O S N pJ a s x s 3 m I H a { O c 0 m 3 3 r Z 3 I m m Z r z 3 m m H G7 a m v - ti M 3 - H m I w OO Q7 3i m m 0 m I 3 Cn O a { O m a I • S O H O �I � Z m •• z •• o i `� m a cn z c I o o m � � � W 1 Z m O m r m rri � H ham^• 0o m o cn o c> ti w w w I � o c.o co co I o w w w I w o rn rn rn I cn i I I I I I tf` The Commonwealth of Massachusetts Department of Industrial Accidents IMI Office of Investigations . ' d 600 Washington Street 4 Boston,MA 02111 www.mass.gov/dia Workers" Compensation Insurance.Affidavit: Applicant Information Please riot Le 'bl Name (Business/Organization/Individual): . -Address: City/State/Zip: Phone.#: :2 Are you an employer? Check the appropriate box: -Type of project(required):, 1.El' 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 su.b-contractors 2.AI am a'sole proprietor or partner- listed on the'attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 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.Q Plumbing repairs or additions m sel£ o workers' co right of exemption per MGL y 12.[]Roof repairs t c. 152, §1(4),and we have no insurance required.] 13.❑ Other employees. [No workers' 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 sbowing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must providb their workers'comp.policy number. Iam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 0,, - Policy#or Self-ins.Lic.M Expiration Date: lob Site Address: 1A4A,, City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and iration 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 Investiwations of the DIA for insurance coverage verification. Ido hereby certify and thepains;and enalties of er'ury that the information provided above is true and correct Signature: Date: 7 0 1 _ Phone#: O Official use only. Do not write in this area,'tb 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/Towu CIerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: �oF ray Town of Barnstable. Regulatory Services ass $ Thomas F.Geller,Director TEa � Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder A-e as Owner of the subject property hereby authorize -IL- to act on my behalf, in all matters relative to work authorized by this bi ilding permit application for; (Address of Job) � 76 >1 (Xnature of Owner ate i i�� Y Print Name QFORMS:0-WNERPERMISS ION �3 a Town of Barnstable F1HE A ��° °�`�►°� Regulatory Services Thomas F.Geller,Director MAM Building Division FQ MP'� Tom Perry, g Buildin Commissioner . 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERM# �S 5��6 FEE: $ SHED REGISTRATION 120 square feet or less Location of shed(address) Village Property owner's name Telephone number K. f� C A2fe? -/70 Size of Shed Map/Parcel# ! Q N r 44 Silo" Date co Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District-Commission jurisdiction? Conservation Commission(signature is required) a a PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COAEMSSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN - f S 'OK DETECTORS NEW SMOKE DETECTOR REQUIREMENTS BARNSTA'LE BufLDfRfc DEEr. ARE NOW LAW.EVEN THE ADDITION OF A NEW BEDROOM WILL TRIGGER AN UPGRADE OF THE SMOKE DETECTORS FOR THE WHOLE HOUSE. YOU MUST PLAN ACCORDINGLY AND HAVE YOUR j PERMIT AT THE FIRE DEPA MENT. ' ASSE99'.RS MAP<'33 F'ARGFL 17o EYE ^1 W FLiN woK 9:P FAC i37 P �,/� d, =row � ✓ ' o � o & ol IT, y o Y o.� it rolion., ' Sll15PP IA � F w N m 111 �h " 1 II rn A��rTl �, � � i g D C .. V rn 6 ZO p �; M1d. A u�' (ll In 1 _' A6m f� n ^ � 9 ~6 N Z} �H i'Z s\ ` �.�-D � �.�� sue€ � � 1 .. :' �• ��°P f-n D A � Z 4,,� Y� ill 1 7 `�' Am m w o lac; O p P,V r. Y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION J' Map Parcel /70 'Permit Health Division 3 ��"5I'►)I "3� _ ^ �� bate Issued Conservation Division 7 a ° �Z " i V 2 rif 2 Application Fee Tax Collector Permit Feed ed Treasurer _ d SEPTIC SYSTEM MUST EE • - Planning Dept. )XISTALLED IN COMPL."CE Date Definitive Plan Approved b lanning Board WITH TITLE 5 i tl is l0 3 ENVIRO��MENTAL C®�E ANU '.Historic-OKH I'� Preservation/FTyannis `SOWN REGUU,01 NS Projf ect Street Address Village _ Owner e ddress Telephone -rQ -Permit Request G �- Square feet: 1 st floor: existing proposed Ca 2nd floor: existing proposed Total new G 5 O Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: O Yes ❑No If yes, attach supporting documentation. r . k Dwelling Type: Single Family Two Family O Multi-Family(#units) -3 Age of Existing Structure Historic House: 0 Yes No On Old King's Highway: , Yes ❑No Basement Type: XFuli' ❑Crawl ❑Walkout 0 Other .,,..Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) "Nur berof_Baths: Full:.existing CrV2g- new o Half: existing new -Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count � Heat Type and Fuel XGas O Oil ' ❑Electric 0 Other " Central Air: .0 Yes ❑No Fireplaces: Existing New Existing wood/coal stove: O Yes O No 'y Detached garage:O existing ❑new size Pool: 0 existing ❑new size Barn:Cl existing ❑new size Attached garage:O existing ❑new size Shed:O existing 0 new size Other: Zoning Board of Appeals Authorization 0 Appeal# Recorded 0 —Commercial`'O,Yes ❑No. If - ,yes site plan review,# ._� Current Use Proposed Use ' y BUILDER INFORMATION Nam e Telephone Number 5 ��- l/ �_ Address /1 License# .00 41 G Home Improvement Contractor# /0 i Worker's Compensation# .3/5-- 3/7340 —ORO-3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE //Z/_.� Lo FOR OFFICIAL USE ONLY PERMIT NO. • _ ' DATE ISSUED ;w MAP/PARCEL-NO. -� r ADRESS VILLAGE ,- t a OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION 0 A `T�/� t FIREPLACE ELECTRICAL: ROUGH FINAL. PLUMBING: ROUGH FINAL - + GAS: ROUGH' ; . FINAL FINAL BUILDING � Fn • DATE CLOSED OUT' : f ASSOCIATION PLAN NO. The Commonwealth of Massachusetts _ Department of Industrial Accidents �d office 811HI MS11921MIS 600 Washington Street ` Boston,Mass. 02111 Workers' Compensation-Insurance Affidavit ..�� t location /C r /' eG hone# .fit Q 7 2 ci .I am a homeowner performing all work myself. ' [] I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job n t xt�cu'i�'�N,§�•-"o'�i.7� zz .�. '.4�, ✓.�,""^ r�'..�k >✓n. ..r ,� S} - to ?�v'' a t a�,, 1�„�RaY' t..r�.r,u,,,'''' t �� .s�M �a'�,x �� .��3a. address +txP ra3 at C y' s t i F x� i # wY � i e stt}a 'q d -a"}�rty ...��.y �"-a'�p-..� ^,t'�L„1`,`�,s �t "�.. ;N r a s ?. c✓' 's ,7..��,�..�� ^i"'b � � 4 � � �' ana"� ,,p hone M [] 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 �t4rykr,�' vs t�,.c7r�, •�'t�,M-n t.P'"tys,..,.y� �§' �r:�+,a'�u }.yas�� „tea`' -as. _.,E s'r f �"�i i. ,, �.�, � a ,c� N '��-t i 3 r:..h_ry�+�{�.,t.�I'YsF.•�'� �k��1r��,c��X= _ `t--E. xr=s r 4L t,x„t.nR y U•a U,k�a's.;'fir d � ."�,y, acldre§s �x �G$Ji rYdZ� AS r Ir i a x K-t �4, i ri M—i�•� afrs � �S ��1'e fi ,^' r+'� rr t N� �. "`�._- -$v ur'X }x� t a k tc. � tz4.r .y ." a.;..+,_. i. .pw .t. xrayy� CIfY at rT�'t r✓xx S 44c S t rt uhOne f (.t.cluc a. .a.'tric-yg`c.xtz�ii2' �h�ti z• aylb ,..^,. h F r•#t v y >j'f> a t .,:. -�u< a,{v.• `S. -ra�•ri Sx + sw.r.;s2•, i �� r .'�.?'f" � �T .r t£�i } `zc, k r i tr s U � � :; red s.t � r X F� : �.^�"' a A �� a � x� -. 3�� •^:s j�a},c ,: y s_ s :, i x^A. a a�1.'� n a X a�r r R '`�a.`� `j.�sk�n�j ��' �t..:�,'",��t�t�".s��,rA^+Na 'l� fi'f.2".�-L34a�'+F 3'..:rs sP.l�"ri'�1.,_ iyt r u..Gt� c 1t. t 5} z �' 3 ,� �y, ?..1 T � ��S YR 3J'`v3} Y!'b�' i�s'wx'K'•t" 1�'i+. �. �addr'ess t> F f'+`� r: 1 �al u; ,i rfi '7 rsr � t�.1�k'.G b�a�.,,�5'�'' '�c�;r,- •syyai c, ka""a�_sk�+.a'' �,.��.N -''a�sP.�rJ$r>�-�5.�.•8�`'a C �r�i� � r .� r V4 ^ S LLB i ! 6 k§'l, Jj.,��ff�d .�7�'.x i>z �+?� t n..?'4,^ ,,Yy�` ��tY{^�.a'Po t �43 r. h �M ph00e••# "�'' ��L ;.,`-. `' ,.� 7 i' ¢.A 9 ...5.y F � "n h53 :.1:+1rr✓�,,� P 1 is # f L'f 1 a i t M 4 �� t"�9t' � 4 .iw } r4'�',{� 3 s � Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition oC 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 certify under thepains and penalties ofppeerjjuury that the information provided above is true and correct. Signature to!�� i��'�� Date Print name Phone# f e F G 2 official use only do not write in this area to be completed by city or town official city or town: permit/license# FlBuilding Department ❑Licensing Board check if immediate response is required []Selectmen's Office Health Department contact person: phone#; nOther t I I (revised 9/95 PIA) 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 and supplying company names, 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. Mail I 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 Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406 Town of Barnstable Regulatory Services B'�xxsr.+sr.E, Thomas F.Geller,Director MASS 9`bpr16;;�A � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no, Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied 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. i Type.of Work. ��1 Estimated Cost�OQ1_Tde7® Address of Work: Owner's Name: ,�G Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law []Job Under$1,000 OBuilding not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO TEE 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: D e ntractor Name Registration No. OR Date Owner's Name RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE d New Buildings;Additions $50.00 56, o Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSBEET NEW LIVING SPACE c o square feet x$96/sq.foot= T a 0 0 x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) GARAGES (attached&detached) square feet x$32/sq.ft. ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf-1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) . Deck x$30.00= (number) Fireplace/Chimney x$25,00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) �- Permit Fee Town of Barnstable Regulatory Services '" MAs& a Thomas F.Geiler,Director y rtnss. $ � E1.19;.� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-403 8 Fax:. 508-790-6230 Property Owner Must.Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized bythis building permit application for(address of job) tore of Owner /. Date Print Name Permit Number REScheck Compliance Certificate Checked By/Date Massachusetts Energy Code REScheckSoftware Version 3.5 Release lb Data filename: C:\Program Files\Check\REScheck\Mchugh.rck TITLE: Proposed addition for Mchugh residence CITY: Hyannis STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE: Other(Non-Electric Resistance) DATE: 11/11/03 DATE OF PLANS: October 8,2003 COMPANY INFORMATION: Art dolgoff Building/remodeling COMPLIANCE: Passes -Maximum UA= 148 Your Home UA= 145 2.0%Better Than Code(UA) - Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1: Flat Ceiling or Scissor Truss 650 30.0 0.0 23 Wall 1: Wood Frame, 16" o.c. 190 13.0 0.0 14 Window: TW2432: Wood Frame,Double Pane with Low-E 8 0.330 3 Window: TW2442: Wood Frame,Double Pane with Low-E 5 0.330 2 Door: 9 lite copy 1: Solid 8 0.660 5 Wall 2: Wood Frame, 16" o.c. 197 13.0 0.0 15 Window: A251: Wood Frame,Double Pane with Low-E 9 0.560 5 Window: TW2442 copy 3: Wood Frame,Double Pane with Low-E 5 0.330 2 Wall 3: Wood Frame, 16" o.c. 190 13.0 0.0 14 Window: TW2442 copy 2: Wood Frame,Double Pane with Low-E 5 0.330 2 Window: TW2442 copy 1: Wood Frame,Double Pane with Low-E 5 0.330 2 Door: 9 lite: Solid 8 0.660 5 Wall 4: Wood Frame, 16" o.c. 197 13.0 0.0 15 Window: CN235: Wood Frame,Double Pane with Low-E 13 0.560 7 Floor 1: All-Wood Joist/Truss:Over Unconditioned Space 650 19.0 0.0 31 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in REScheckVersion 3.5 Release lb (formerly MECchecl and to comply with the mandatory requirements listed in the RESchecklnspection Checklist. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design_ I Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date �� O r ,� e►� �UM Ike SUP \/dI�SOR i reense:� � ARaTHU,,R�r eD_'e0 e w A t'/,� NS�A ��E� MA� 668 q�d'_mMietrator. ��: it _ •is 6'!ee -�arninxo�zuea�i a��craaac�ucaet7` i Board of Building Regulations and Standards ` HOME IMPROVEMENT CONTRACTOR Registratirl�__Lp449S ---- Ei ----- , a�Exp�ron ' }5f1 �/2004 I. 'rPe PnV6te Corporation I ART DOLGOFF G 1" 1LDN, E1I 1 I Arth `' ur Dolgoff 19 McCormick Dry F i i W.Barnstable,MA 02668 �. d SMOKE DETECTORS O.K. • re: % �f5 ; .NEW SMOKE DETECTOR'REQUIREMENTS BARNSTABLE BI��LDiNG KEPT ARE•NOW LAW. EVEN THE ADDITION OF A NEW BEDROOM WILL TRIGGER AN UPGRADE OF THE SMOKE DETECTORS' �' "� * •;�.%' OR`THE WHOLE- HOUSE. YOU MUST PLAN ACCORDINGLY AND HAVE YOUR r to APPRePRIP 1. PERMIT AT THE FIRE DEPA MEW. A55E53,lIZ5 MA°,3.3 FPRlF1 i]o 77 ,J Door, 9 p FAaE/3 7 { flu � 1 A d r y / i : .. +� / ;• 's \ � .fin . l 1 �c moo. �_ /. N� � • s z � O 4� rn 9R f7j O� �i.- .. (y\ (yam e rn 3 c . L. - 4 -�` } .' \�\. �1�• D� � •"Cry �y T ca cl _ . fig • N m �^ pai �� v' G1 Z , U ti N D g O v FTI 0 9 t O m bn A � rn p O Arn s N Al O� y rn rn r11 h1 �� 0 2 V, a o z 70 rn Z C� rn y V o... 70 z Z � Arno � aI � oo r -1 P,t rn-rnaFTI _n rill V f (� \ ram\ �.. z Q 7Zw O W vl 1 I 1 rn rn = O O { �^ Z O \� L (� w � 1 ` (, \-ril rn U\ [� cn n b a A uZ 1 �J .'i�. T�Ti y 1 ,y N 6 A T I D I I I rn O �\rn N v ANDERSEN WINDOWS WITH SCREENS,x 'f . _ WINDOW SCHEDULE _ ' - - - IJUhibER 'pTY — FLOOR ;DESCRIPTION CODE _ �P03) \Wong+ a W00 -_- 1fi -- 1 j-DOUBLEHUNG - W01 j 1 'DBL CASEMENT LCN235R W02 -4 1 -;DOUBLE HUNG I TW2442 - 0O 1 AWNING A251 _ LAUNDRY 1 DOUBLE HUNG ITW2432 t � hz W03 2 „ H W04 j . . ' ...;._.• .. :_. :•`,; .. - ,. ,. '. ,. x .:'. + _ DOOR- SCHEDULE +NUMBER 'pTY •FLOOR ,CODE-- --- i e �wo3; 1 c O koos� BA - - D01 -' -1 j _ 2.6 X-6-6RH PASSAGE SET ' ,HIGH •+,' - .- - ::a �•. -,.a ;x :. 1 ."i. 11 2-8 X 6-8RH 9-LITE FIB.GLS.LOCKSET- I `� 1. -- BEDROOM .D02 003 '. 1 ` 1 _.... 3-0 X 6-8LH 9-LITE FIB G_LS.LOCKSET:- I •' •�� "X 11'-6" WIND WS D04 11 a 6 0 X 6-6 BIFOLD DOS` - 1... 1 _... 2 4 X 6.6RH PRIVACY m j •.,� CLOS`�oaj D06 _ ,1_ !1 .2-6 X 6-6 BIFOLD woi% o - - p D07 1 ¢. 1 2-6 X 6 8LH PASSAGE SET I `- h D DO8 1 5-O X"BIFOLD 1 W03 ....-... _ - POST r +. 35'-8,.' o POST' ` '�, oo., ,3/1-3/4"X 9-112"LVL CLOS. (-J �oIi OVER(FLUSH) SIT woo/ _ - - I, - - 25 XII13-6"R A FAMILY ROOM KITCHEN _ OPEN T _ w.0 INSTALL DOOR - ' 3 2' 4 1 4 READS UP , ~ wo3 loco woo 2' \wol �W3' ) BATH - _ - 16'-0' i. _ 2668 2666 2666 —D�__ LIVING ROOM . O - - , , A `F 25'-0" DINING ROOM .. _ REVISED 10/8/03 34: p r: R E DDITIO -: i HE MCHUGH RESIDENCE NC E 128 POINT LANE `. HYANNIS, MA. j K � „ ART DOLGOFF BUILDER 1 woo ) L.W._ - -' - '-- • BARNSTABLE, MA � `woo o0o woo �2woo 'r ,� w r f. •• t 8 5 11 �- „' �w I PLAN VIEW/1ST LEVEL I SHEET 1 3s'3., S LE 1 1 — . -- CA /4"— , r n }e 1 r F , hIle . ! ,ii Y art'!"• _ � �� '4 s v .: E,. - .x`.,.n i,h::.q f i '`u J r`..v ...,. .. '. ,. .. a,yr" r• ,t;.,,�£^! -... . ,} Yw :r ♦ o .. Y ; 20'DORMER IV wol Cwot ' ANDERSEN WINDOWS WITH SCREENS — WINDOW SCHEDULE —B _NUMBER OTY i FLOOR DESCRIPTION CODE WD q. — 2 — - I - p` DOUBLE HUNG�EXIST. W01 2 DOUBLE HUNG TW24310 r. S DOOR SCHEDULE -- HED/UNHE E ;NUMBER QTY FLOOR CODE UNFINIS ATED SPAC ~ 1D00 8 2 EXIST — ---- - _ fpp 1 2 2-6 X 6 6RH PASSAGE 1 v. �y DN li, Woo v woo �oo * FRAMED KNEEWALL EXIST. BATH JLJ ROOF OVER FAMILY ROOM q EXISTING EAVE SPACE BEDROOM woo, (000j o • . F , EXISTING \ BEDROOM. EXISTING s R OM - _ - z BED O boo t • J woo G .. skyit. ,. x• .4 J 0/8/03... - - - �., ', PROPOSEDADDITIONFOR.._ REVISED 1 r 10 r.:. )9/03 11/3/03 I THE RESIDENCE, 'E MCHUGH RESID E, , . - i 28 POINT LANE r ' I HYANNIS, MA ART.. BUILDER PLAN I W. BARNSTOABLE MA. __- VIEW/2 ND r LEVEL ; SHEET 2 I S SCALE 1/ = st diw •' r EXIST NEW - - • " ICI ... , - NJ - - r ',yam• ,� 25-3 1/2 INSTALL FND ANCHOR BOLTS 6 - .:OC AND 1-IN FROM ALL CORNERS y 6'CONC.FOUNDATION ——— — — ———— - r— —— ———————————————— ————— rr I' s ' 4"CONC,SLAB NOTE:BUILDER TO REMOVE EXISTING GREENHOUSE AND I I} BLOCK FOUNDATION IN AREA I I I •4 €. a OF NEW ADDITION V 0 8.0 T-11 1/2"r ' ' e SLAP NEW FOUNDATION ONTO I I .POCKET I I - • CORNER OF EXISTING 3-1/1".PIN I I • - — POCKET I :FOUNDATIONS WITH#5 REBAR - - r „ r : i L--J .A t• - - , - - 312X12 GIRDER - - [ I 1 —=1 OVER , I I ------ I I . _ � .. "' 30"X 30"X12"CONC PADS WITH • 3-1/2"LALLY COLUMNS OVER - - - CUT SIDES OF EXISTING •',`" - - OPENING DWN FLUSH WITH FULL BASEMENT _ m EMENT ` EXISTING CELLAR FLOOR - 0 STEP DOWN TO NEW SLAB . I - - WATER HEATER FOR ------------ SOLAR STORAGE 1 I FIE: ----- ---- ---- EXISTING BASEMENT 25.0" I I I I NUMBER fQTY CIODOW S DULE CHE HW FURNACE „-- I I T--1 I IVJ00 i 2 - .2817AN_DERSENBASEMENTWINDOW- - - 1 4----J _ ;P I HUG CLAIRE M� FOR , I PROPOSED N I I JOHN & _ e — —' 28 POINT LANE NNIS MA. " BUILDER I I ART DOLGOFF, J I_ I W. BARNSTABLE, MA I ----------- --------------- r: . i - ---�--------- 1 SHEET 3 } 36'-3" t FOUNDATION PLAN SCALE 1/4 --1' .{ - �` • - 1.: �- i .;y(I l ,V ..� •. Y ei 1i- {'ice � ,• 1 • , g,:. 'i.i e - ". .a,' A .F "'4'. f.4�.„-x•" _,n'.'F'a 1°k M , y m p its I� �� I ` � ` � , � - ��1. a ° •I I6 •\ I � i �i ,. l;:. A j .. � �• u 4 � �� 7 � M "�� i Sj x„...w h �I Cam, 'S:+ a � ,,. 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