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0013 PRAM ROAD
r 3 � r-� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Applicatie 4N. V Health Division Date Issued Conservation Division Application Fee 71 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project-Street Address 13 �&_Vy\, � Village Owner; • e, IL. �, rl�G(U.t.� Address Telephone Permit Reques t C&O Q'f0 I/L INA 1 (.411 (eme V e Ue_ `Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay, tProject Valuation 500, Construction Type -Lot Size Grandfathered: ❑Yes ❑ No If yes75attach supporting documentation. Dwelling Type: Single Family Li Two Family ❑ Multi-Family (# units) Age of Existing Structure (5 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: LdFull ❑ 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: -3 existing _new Total Room Count (not including baths): existing (0 new First Floor R©om Count Heat Type and Fuel: 6d Gas. ❑ Oil ❑ Electric ❑Other Central Air: O Yes ❑ No ' Fireplaces: Existing New Existing wood/coal stove:,]Ye§3❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑x ew tze_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: ' ,' j ° Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes LdNo If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name`"'�'�•.h e�+�cL l�I, /u����' Telep� -hon Number-----5� License # Home Improvement Contractor# Email Worker's Compensation # ALL.-CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE_ _ � �DATE�`"`'-.����7 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. f :F ADDRESS VILLAGE OWNER E DATE OF INSPECTION: a FOUNDATION FRAME INSULATION is FIREPLACE ? ELECTRICAL: ROUGH FINAL F PLUMBING: ROUGH FINAL R r GAS: ROUGH FINAL FINAL BUILDING DflT�f�CLOSED OUT,. °} AS_aQaATION PLAN NO. 4 P The Commonwealth ofMassachuseifs .'' " Department of IndustrialAccidents Office of Invesfigations 600 Washington Street Boston,MA 02111 www.mass gov/dia ' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumliers Applicant Information Please Print Legibly N C� 3II7e(Business/Organization/IndMdual): 6 t_Address:-/ 13 �j�a;tvl t't� City/State/Zip- Cln I �- M SS ,0oP/v0 Phone 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 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.msuranceJ , , required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3,1 I am a homeowner doing all work officers have exercised their l l.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no 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 showing the name of the sub-contractors and.statr whether or not these 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/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 under the pains twulpenalties of perjury that the information provided above is true and correct Phon#: ��c�' �L-� 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.EIectrical 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 m-a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call.the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line.* City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a 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. 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 lavestiptions 6W Washington Street. Boston,MA 02111 Tel,#617-727-4900 ext 406 or 1-877-MASSAFB Revised 424-07 Fax#617-727-7749. www mass.govfdia Town of Barnstable Regulatory Services of E TOYy� Richard V.Scali,Interim Director Building_Division a ASANCTART.F_ : Tom Perry,Building Commissioner _ 9� i634� ��� 200 Main Street, Hyannis,MA 02601 iDrfD Mai" www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6250 HOMEOWNER LICENSE EXEMPTION - � ^'' -r Please Print LDA'TE.^(- ':.. ' J JoTlorr - i 3 fWcl number �y7/ /AJ/� street village "HOMEOWNER":. :r1f l��Ct S"l i name me phone# work phone# ZCURR MAILING ADDRESS:__. � �iE1�/aC /)15 ado �oG1 cityAU wn state ,. zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who`does not possess a license;provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER 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 resdonsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsNlity 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 requipgments aad that he/she will comply with said procedures and requirements. rQuiur of Homeowmez_j Appioval of Building Official t 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'liomeowner 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 eommnnity`--- nanrorrr IIctFrlDAdcll,nilii;no nPrmit frnmciFXPRFCS-doc . i �1AE T Town of Barnstable Regulatory Services RAANST"XF, t sass. Richard V.Scali,Interim Director Building Division Tom Perry,Building Commissioner 200 Main Street;Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must omplete.and Sign This Sec on If Using A Builder as Qwnet of the subject ptopetty hereby authorize to act on my behalf, in all mattets telative to work authorized this building emiit /� a ess of Job) Pool fencese the responsibility of the applicant. Pools are not to be filbefore fence is installed and all final inspections ared accepted. Signatute of Own Signatute of Applicant Print Name Print Name Date = : . L�' �1 -Le_ O July 3,2007 Town of Barnstable Geographic Information System 01 �o11 22 r 268044 f SOP ti 268173 IF 5 j CQ 268189 #13 y #130 r 268045 #10 F. � � t #; 268053 °� 268046 z #26 0 18 Feet Map:268 Parcel:189 Selected Parcel 1N Ej DISCLAIMERS:This map is for planning purposes only. If is not adequate for legal 1l boundary determination or regulatory Interpretation. Enlargements beyond a scale of Owner:PADUCK,EDWARD A&L_EONA M Total Assessed Value:$325400 ,,y n irE 1'=100'may not meet established map accuracy standards. The parcel lines on this map Acreage:0.32 acres Abutters 5 Co-Owner: are only graphic representations of Assessors tax parcels. They are not true property - boundaries and do not represent accurate relationships to physical features on the map Location:13 PRAM ROAD Buffer �',••,. such as building locations. - 1 -- ='sue 'r zb'A�'•3 i` "� ^.� Sc7le reg .$99 and aboveNw Y �k '` ,� K x •hex z.""-" i�; •,ft��y���..�:.�" atT� "'� �_'I -^°" ��:e r.�k�" v� � e"��•` '� a. .'$ C nv` c�� "'i s save$12Q . tSALEt4'x42" AF.z Zo.a , t A, .v.,_ r�ieta(-frame pool•aa`o ,s`s -�a�/aWa�/1 i. v r �� ;�s l .t`` � '�'•� y,.i.�,�`,�„�-ea a:. rs•_ �i „r.><,c -tSeebelow � r- �7 M1?ti ? � -=t�k• y; . u, Y ��, '�- �a``--?51�v- "��-r:,�,;�^a'�",t:•� �aF �. �- ' detalis v, � �. �,,. - ,� -^.{� ✓ �- < s- . $1251 g "'+ -+�S _ '"+ �3E+'��s'.:�.•. 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Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village ����wv,=S , t''l o Z.(.o\ Owner p �v +L eovi a- V\, %N- Address 13�o Telephone f5cis `-15 Permit Request Or oaElu ri I a Square feet: 1 st floor:existing proposed 2nd floor:existing proposed zj Tofat.new co Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing 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 o Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use a�-�`t �- L4 BUILDER INFORMATION Name Telephone Number Ad'dresgs—�,_ (QQ 1rnGxC.Cx_,e- %_)&r Z\yc License# Home Improvement Contractor# Worker's Compensation# 01 HODQ`56to L40(o 1 o+ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO (SIGNATURE • DATE FOR OFFICIAL USE ONLY PFRMIT NO. DATE ISSUED MAP/PARCEL NO. s ADDRESS VILLAGE OWNER } s DATE OF INSPECTION: f FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. tt } J 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 Lezibly Name„(Business(Or�g"aiza on/Individ a): - Address: 4�0 A\c h _ YYI(4� 50 .. �56 City/State/Zips ��C- ' Phone.#: 4 Areyouu an'emp1`yer?-Check the appropriate-g Type of project(required):. 1.[ I am a employer with i a 4. ❑ I am a general contractor and I * have hired the sub-contractors 6. ❑New construction . employees (full and/or part-time). - 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 tY• �� 9. �Building addition [No workers' comp.insurance comp.insurance. required.] - 5. We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 11. Plumbin repairs or additions 3.❑ I am a homeowner doing all work ❑ g P 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 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/Zip:k�1 e-wv%.5, �"�p►B2 r 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 DIA for insurance coverage verification. I do hereby certi the pain nd penalties of perjury that the information provided above is true and correct .. �S a�—e -:r Date: — Phone#: �� (QLi (D 9 0 Official use only. Do not write in this area,to be completed by city or town ofj'lcial, 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#: S Information and Instructions Y Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two.or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented'to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. 'The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should wiite"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. 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 Acoidents Offlee of Investigati aaas 600 Washingtari Street Boston, MA 02111 Tel.4 617-727-4900 ext 406 or 1-877 IMASSAFE Revised 11-22-06 Fax 4 617-727-7749 www.mass.govldia Town of Barnstable. a _ ti Regulatory Services 9B '$ Thomas F.Geiler,Director `bATF%6 9. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-8 62-403 8 Fax: 5 08-790-623 0 Property Owner Must Complete and Sign This Section If USm* g A Builder I, lea px it> Wt �4�v ��—` , as Owner of the subject property hereby authorize —RV Ca ja2 C CA— to act on my behalf, in all matters relative to work authorized by this building permit application for; , (Address of Job) G Ci11 Signature off Date Print Name QF0PUMS:0 WrF—PPERMISSI0N e r t tf tr a t e of jftame dt CA REGISTERED ISSUED BY. Date treated or �6 04 APPLICATION AZTEC TENTS manufactured . CONCERN no. 490 ALASKA AVENUE e 0 TORRANCE,CA 90503 �2 r CAL CAB F 419.Oi (310)328-5060 $Et This is to certify that the materials described below hereof have been flame retardant treated(or are inher- ently nonflammable). ! FOR PARTY CAPE COD ADDRESS 660 AgACAR77f4/R,13L N!!. CITY POCASSET STATE MA, 02559 Certification is hereby made that (check "a"or"b") (a) The articles described below this certificate have been treated with a flame retardant chemical approved ' and registered by the State Fire Marshal and that the application of said chemical was done in confor- mance with the laws of the State of California and the Rules and Regulations of the State Fire Marshal. Name of chemical used....................-----------------------Chem.Reg.No..............._........ Meathod of application.....•............._....-..._..... ® (b) The articles described below hereof are made from a flame-resistant fabric or material registered and approved by the State Fire Marshal for such use;Fabric has been tested and passes NFPA701-96. Trade name of flame-resistant fabric or material used..-.___--_ ----.... --.-.- _..-.-.Reg.No....... � ._... The Flame Retardant Process Used MLZ NOT..-, Be Removed by Washing (will orwiH rv) z David Bradley Chuck Miller- President Naar OfApp;ealm w Produe6we Ssper t Trdt f Evil Please take this certificate of Flame Resistance to your local building department to attain a permit for the tent installation. Massachusetts State code requires a permit for all tent installations. Please be advised that a Dig Safe inspection is also required for all tent installations. In preparation for the inspection Dig Safe requires all sites to stake the tent area with white markings. Party Cape Cod will call you the week of your function to advise you of your inspection date. i itl'�CgUrtjP -g -Uj�A-NCE ��13AiF(N)+UL7LUYY1 —� First Cardinal�rp, ��THIS CERT!FIC: ---_-__-.' S% 1j47 ATE IS ISSU`:D Ad A M -71 E Cxr ---" L ish Am9rican olvd, ( " FORMATION ONLY AN17 00 Ai I cR Orm NY 1?110-D141 f CER7IF!✓yTr }iOLL;Er�. T RS NO RIGHTS UPON TME:AMEND, HIS CERTTFIOATE LDOES NOT A fE s✓ EXTEND OR ALTER Ti,E:,OIlFm GE A,FFORDEp EY OLlCIIwS BWLOW.INSUF{IEks A CFF RtDdNC CgV?rRq - rar<y C�ep6 Qvd,!tyr,, ! IriSURER^• 1v1A -- J1(.�ldC# 6$0 MW A that Blvtf. ?:«Retail Ar1� �r`-17 ,7�WG'Group Inc. PccaSs9t.,MA D2659 �iNSLIRRER^F�,� rNSURER D. COVERAGEfi — rHE➢OLlCIES OF RvSURANCE L!$1<0 9 ANVREG?IdiF,EM1ENT';RM AERTAI CC'NDI 1Cty OF ANY t 0 THE IP,SURED U.1MEtl ABOVE i CR—TM;-;OOLICY i'EI? NTF E INSURaNCEAFFC?RDj E?Y C<SVTRACT OR Orl iE1�DOCUMENT�><ITH RESAcCTiQ Y4t I!Cfi IS c GD 1rdDrC.47e'O,Plh7�417}iSTA yGITG Ar ''EC�y?E c TH_F'CLICII'S❑ SCR956C iEREiN I3 SURJECTTQ f;L(, R•FCATE f 7AY n liYll7S HGLjmI IV4YhL4VE BBeEN_RE7UCEA 711e TEF;lb1 3,EXC" r 8E S5U2r'QR�IAY J 9'Y FAIR CLAIIAS, L 310N3ANC CC�7CI'nGNg.OF I e va�K un FOLIG.E r an crlstzDATE Y !�PF_Or IW£IJR��N^.E Er:= 711'a DATE n eadERALLIA�ILt9Y r\UM1t>7>�1 + GLICYEAPI;p710y CAT2.tJkgl X _ CJM,!�iSFt.IAL GF.rv�AL L!AEILITY CLAWSMALE Q....JR ..FireDANIA�E(Apycme� ! P+CtT EXP{And oye ayraon+. -°�-�•---�—.-� • GcNL.rY=OREGPTELh�gl7iPpU�.�,PEq-�-? CF�d P,ALA -"" �---..�� PRO. A"i $ POLICY 6rcr JECT LGt: ••^`_4CDVC'S.-r;Ohr,F;;;P.4t;G g. RU,7pMOBILELW9i!.ITY --!-�-..'"_'-�•----��--�.__� "`�- ���-�-__-• I ! ANYAI•JTO +( 1` 1 CpMFiI;V�T• �� ALL FOULED AUTOS at!VG M19il - -NtaULEJ 4LR6S -- }++I WIREUAVY05 s I WDOILYPgjJ Ry -•+� 1 N6t1,Gi f�er Cr9ci; -�- c� 9CG. -� r PRoFg>.; .<^r 81LI:t - Pa'ecai -�_ Jf � arovauro _ AL'-0 ONLY-EA,hCCIpEfV7 E LIa3L!- 7Y y ___�� ; orHER THAN Osx�4 CLAIM�IyAO' E4CN U � $ ^y --.��..._.i. RE704TlOr7 L - "'�^•.�-_--I16•-----���.. �---•--.�._�_�- $IVJhs RA r3;:PELakllotj AND ETdPLOYB'RS DAE�UTy ANY'RoPn-ioEPJPARTN6F,.'f•?:FCL'71V@ ' I X; 1'VC51TS;j- OrH 1 � _,�•' i t�FF+CEc/�;ch:GE4F.tCLua;E� Yo4Yun�!T.a ;Fj>3a,det;itg urnar Nv f E,l,F4� .q WC DENT SpecLaLPRgV,c10N3bc;cw I JOD50CA�1Gi O1J Q7 i t�„'07 _ 1 fi 1 JOg fit.. aLcv I 500,OQa _ Fax#SOS-?9b E20 L=' nT ogv`Eai; .,:• co r: Y ra;rx,R;a reTN-rE� — ' tr O . rn 1 I (( t^FrATE R �^ _ . CttiA!ii•?5. ,1REp:;;.311>'?ER Lil1'E�-R: CANCFLt.f1T,0� -"----�---�- i � Ta+xn of E3a n�yle �`�-------- BLlildinQ Dept 15R�L�ANYQFTtf:A1:3p1,rc0-" 'j1cQLtL1ESBE+` 200 Main Streat THE �Y. .RATII�;vDATBTFiEFEi1 ANC LLEDBEFORE rnAfl �•� F,THEtSSUIVQIf4SUR5RVYILL.rNDEAVOftTO Hyannis,MA u2601 s�DAYSWRI77EN Nolq 2 T017fE CERTIFiCJATL-HGLUFR^Ikh1FT 11 iG i�'FY,BUT FAILURE C9•St e SHALLI V.PCSE,VO oAL�^,�>iaN�R RERI E8FIN1FA IVES. Uf?014 i�IE wsuRSR,T3 AG:NTS OR 1 REPREaEYVTATIV'ie5. Town of Barnstable Geographic Information System July 3,2007 r o< o� o� 268031 O #231 268190 #221 11-0 x`. l � V v s% 268189 913 4 i.^ s e x r! 4. 68174 4 i #130r_ +.r 26804 1-. #10 #21 (268175 r#_ti20 268053vha #181 268046 #26 0 8 Feet v � DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:268 Parcel:189 boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:PADUCK,EDWARD A&LEONA M Total Assessed Value:$325400 Selected Parcel 1"=100'may not meet established map accuracy standards. The parcel lines on this map :r e�„`S' are only graphic representations of Assessor's tax parcels. They are not We property Co-Owner: Acreage:0.32 acres Abutters `:` w—, E boundaries and do not represent accurate relationships to physical features on the map Location:13 PRAM ROAD such as building locations. Buffer /,•' �' R;. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map g Parcel Application# D (o aq Health Division Conservation Division Permit# Tax Collector Date Issued Treasurer Application Fee Planning Dept. Permit Fee 00 Date Definitive Plan Approved by Planning Board ®� Historic-OKH Preservation/Hyannis Project Street Address i 3�'`�`"'--1\2_L Village -�.��.,b•;� , YY1>a. Owner _F_,Dc,:+A-- v-CAA_ Address t Dr -7?_�, 1��� bV► Telephone 5 `�•- ��5 '-E �`� Permit Request X P / u \ 2 2c�a(A Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If es, attach supporting documentation. Y pp 9 Dwelling Type: Single Family d-" Two Family ❑ Multi-Family(#units) Age of Existing Structure ..3(c, 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: Z.Full:existing new Half:existing new Number of Bedrooms: existing 3 new Total Room Count(not including baths):existing S- new First Floor Room Count Heat Type and Fuel: & as ❑Oil ❑Electric ❑Other Cen%al Air: [Er Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:Erexisting ❑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 Address License# Home Improvement Contractor# Worker's Compensation# M ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. BATE ISSUED MAP/PARCEL NO. s ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ,P GAS: ROUGH FINAL FINAL BUILDING f DATE CLOSED OUT ASSOCIATION PLAN NO. 1- f 1 ne t,ommonweacrn uJ tnussucnua�eua Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mas&gov/dia Workers' Compensation Insurance Affidavit: Bluilders/Contractors/Electricians/Pluimmbers Awlicant Information Please Print Legibly Name (Business/organizationadividual):I A� Cr- �n� Address: �bo \n*\C- Alr\\\LLV v� City/State/Zip: P,>e_U-•re vV\A o 255 R Phone#: - 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 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 mein any capacity. workers' comp.insurance. 9. ❑ Building addition o workers' comp. insurance 5. ❑ We area corporation and its 10❑ Electrical repairs or additions quired.] officers have exercised their ep3. /eam a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 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 their workers'comp,policy information. I am an employer that is providing workers compensation insurance for my employees. Below is the policy ane8,p®b site information. Insurance Comp an Name: Y Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: } Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine 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 the pains andpenalties of perpuay that the information provided above is true and correct Signature• C CLt QP Date: Phone#: Official use only. Do not write in this area,to be completed by city or town officiai 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 inspec"Lcr 6. Other Contact Person: Phone#: l 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 orbuilding 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 crust 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 0r 1-077-MASSAFE Fax #1 617-727-7749 Revised 5-26-05 wwwmass.gov/dia �tl�r ��-�?�E:.�-i���?qs �: (Yr f-•_�f }:., f _¢ �F s-y � t` � � �aJ-a, � �.;��Y J .;� �.-i �.�..,� � - r' • shy .fir. 2 e a: �-r[ ,• r � r 1 • a� f .• �t a Y yr'''Cd�_�*t/�i.!';fv5,:�x�;'� i::. v ;�A x�� ��-�,' t,.��.'&�1�` ?.C?... Ir¢ � KY.'P'i �r x N_� �z -.fix a .� �1 � ':� s _! S°�-%:• ram!, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1 Map O ,Parcel. Permit# Health Division Date Issued Conservation Division Application Fee Tax Collector Permit Feed _ Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village ;!s 'i Owner Dcar,v A ,�MLAc- ddress Telephone SCO— �►�.v' � - Permit Reques d JSquare feet: 1 st flo r: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing 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_O Yes _❑No., If yes,site plan. review# Current Use, Proposed Use BUILDER INFORMATION 'Name- 5%o'Ar> � A-vzac��- Telephone Number S —1`��— U t Address k��Ya License# A 7_60 ► Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO li SIGNATURE 52 DATE �.t v FOR OFFICIAL USE ONLY r PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS 'VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL- f PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. O'D 4.1 M-4--_ it,_6 RbGtSTERED .,-tssuw BY Dote treated or APPLOTioN Academy Tent & Canvas Q _CONCERN_ i6 .manufoduieiJ • g 2910-.5 AlamedaStreet r F 337 Los An'ge-1es dcA' `.90058 23;4-.4060 `rail is'to-certify #hat the motrials described onfhe reverse stde hereof=have been flame retardant treated (or are inherently-nonflammable). f , FOti " ADDRESS �r�rit " ' CITY = STAB Certification is hereby ymade that•.(Ckeck "d! or "b''rJ n .(a) The articles described on the reverse side of.this Certificate hove been treatei!with aflame-retard'an#> L—� chemical appro� ed'and registe►ea by the State F re...fikorshcl- and that the appiication of said chemical' as done'in`conformance with the laws-of the State o. a fornia cry tfia Rules and Regulations of the State Fire Marshol Name of chemical used c No ....... Method= of application: ...: 'a (b) The articles described'on the reverse side.hereof are`made.from d flame--resistant fabric or.material Holstered and opFroved,by the State Fire Mar_sha:l foi ouch use XM Vi nyl... .Reg. No....F 337 . Trails name offlame-resistant fabric'or.mcteriaf.used:...... ......... ........ . The Flame .Retardant° Process .Used ...wlii Not Be Removed` by Washing (will or'wifl no j Tom Sha 'iro - President David Bradley By P Name of Applicatoror Production superintendent Title Please take-this certi-ficate of Ff e:-Resistance to yottr local buihding department to attain per;nit fdr the,:t�tit i°nStaiailt�Til. t SSaC11tiSeitS= State e'ode requires a Perini foraall tent instahlaf onS Please:be advised that a Dig Safe inspection is also required for'"all tent installations. In preparation forhe, nsectiopn Dig.Safe requires all sites to stake the tent area with white rna-rkings. Par.,ty Cape;Go.d will ea11-you the week of:your.func ion ao advise you of your ><nspection, 'a-At Town of Barnstable &wear 0 ?.2 3 4JW �6 - � iRglw 4 woa+i Yw Regulatory Services Fss s Theam F.QsGw,Director Beiidi0e Division Tom hK., it<WWi%Comrisdoner 200 MartaSwea, Hyw ads,MA 0260) PER %i Cfficc: 508-462-4038 OCT 1 7 2003 F"; 500-790.6230 I G feet Pew WIM*W A0i 1[-trfst 149p4as MAJ.pastel Number 0? 6 0 �S- g Pet+perty Addre.t �ssdaatir2 velar of W'orlt,,,��0_QD.,�_. ._�_ owner a�atae& CoatpacWt's?�aartp� Florae►reprovanwru Coaoacwr Licease as(f appLoblt)_ a'awstrvrooa Suparv►sor s Ltrcwre a(ii applicable)_, __ _..._.+_ _.....0 - _ QW urkMn'r Cua+pemtatbcsn l:N m a ce Cuck ors: 1 am a sole propriewl I am the HwnaowMar I We Workar's Coapsnaatio:Insurance 'nse:nece Company N Peredt Regiat(cbsck box) lJ Rc•teuf,slrppityi old du"ks) C]Rs.toof(riot statipp4. Gow4 ova txutia=layers of rwotl Q 1Re-aide (�Asplacarnsat Witidow•s, L�•Yalus 0•,�„_,_,fraruevruru s4j ,. Q Otbrr(speouY) •wAeta rn`wwre iroaww of ztiY pcvx»t eoer won erseip�.uA1'NY.Hot MtA o[F.er ipwe�4eyercKsn:r.r,►i�aaw.i�.FlirooYM;,Ge�ar.7ces,a«. Q:F4F M vows ati.►seef'91fot - j - ar 063—A-047 40-45 DH NFRC 6100 Renovations _ Double Hung Vinyl Argon/Low E SC NedmW Feemdnelpe SS Redttp Owed CERTIFIED •cos►�+uia�o.+°i'—'e� �'�'—`�'�U""'�,'' •For more rmw.em ed .rwrc wr db of wamAkrar0 • UFedor 0 . 3 Nate„ 0 . 2 0 . 4 ---- COMM ; ---�3':4 mmm mow Wk.. m tic prod to o � � :N�r�Inpeal.aeos�ea tar.tbrea ataren�rorurronotl corrWh IadapedAcPla"Mm w .. J s o.46 oaa. ail ,r w Order ,0:3367129010001 40199 gg D.na of BWWkg RWbdm mW ft..ftrde 1 128M ` • tt/3/ZC04 : � TMW "W cWW T ►iom.D@W AW*mme$wW*n CONRAD JOHNSON 3200 Cosa oALLEIMA PKW OU RLTANTA;GA 300U A dmimbWaftr —, Th a Common wealtl of Massachusetts j,�► Department of Industrial Accidents _ Office offnestigations - 600 Washington Street Boston, Mass. 02111. Workers' Compensation Insurance Affidavit PleaseiPRiNo'Ikle`'ilil � nn name: j�t�LlitW/�cZ ry t?X location: /`� S��'R in A4 city TT —4/Z/7 e r phone# S0tr 7 Z G q"w-* I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity, * "r I am an employer providing workers' compensation for my employees working on this job. company name: 1?&7 A 4ye & ' ,/ es � Ayr.= O' rA/ A—,0M e. address: Savo l b 4;iQ 1/Ge/' A /"/1 �Oy . city: aw • phone insurance co. Q1&?1 4 L— �jZs. eD• policy# 9 616 91 l y .b��:, ..:1 4a 1¢{7` RaL'...l1 tn,A '?l`Ly�F!(ay .R�'�l,(•' s.�. 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# �1lt �ai � fz' . .: e' Failure to secure coverage as required under Section 25A of jNICL 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 NVORK 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. /do hereby certify under Nie pains and pc' rlties of perjury that the information provided above is trite and correct. Signature Date Print name an/ON Od`&J012 Phone#V D 2r" Echeck ly do not write in this area to be completed by city or town official ; or permit/license# I-1Building Department (03 ❑Licensing Board mediate response is required - Selectmen's Oir❑ticalth Departmentn: phone#; nOther HOME IWROVE EGtNT INSTALLATION CONTRACT Branch Name: OJ Date: Z t 2�/.?j Sold,Furnished&Installed by The Home Depot Installed Sales 345A Greenwood Street,Worcester,MA 01607 Branch Number: Job#?' 60 116 Toll Free(800)657-5182; (508)756-6686; Fax:508-756-2859 Federal tD#75.2698460 ME Lic#C 02439 RI Cont.Uc#16427 CT Lic#565522 , 7 MA Home Improvement Contractor Reg.#126893 Installation Address: 4ycA /s " City State Zi E - Purchaser(s): Work Phone: ome Phone: 2-37 T NOTICE TO PURCHASER Do not sign this contract before you read it. You are entitled to a completely filled-in copy of the contract at the time you sign. Keep it to protect your rights. Do not sign any Completion Certificate or agreement stating that you are satisfied with the entire project before this project is complete. Law prohibits home repair contractors from requesting or accepting a Completion Certificate signed by the owner prior to the actual completion of the work to be performed under the contract. You may cancel this transaction at any time prior to midnight of the third business day after the date of this contract. See Notice of Cancellation for an explanation of this right. There will be a service charge equal to 25% of the contract amount if the job is cancelled by Purchaser AFTER the third business day. BY MY/OUR SIGNATURE BELOW,I/WE AGREE TO BE BOUND BY THE TERMS OF THIS CONTRACT. I/WE ACKNOWLEDGE RECEIPT OF A COPY OF THIS CONTRACT AND TWO COMPLETED COPIES OF THE NOTICE OF CANCELLATION. BY MY/OUR SIGNATURE BELOW, I/WE UNDERSTAND THAT THE AGREEMENT IS SUBJECT TO REVIEW OF MY/OUR CREDIT HISTORY AND VWE AUTHORIZE HOME DEPOT AND RMA HOME SERVICES,INC.,A HOME DEPOT AUTHORIZED CONTRACTOR, TO VERIFY AND REVIEW MY/OUR CREDIT RECORD WITH AN INDEPENDENT CREDIT REPORTING AGENCY AND RELEASE THEM FROM ALL LIABILITY INCURRED FROM INADVET OMISSIONS OR ERRORS. SUBMITTED BY: 1 y Uw �]� / ', Date: Vz7a03 Consult , ACCEPTED ,l ' � 'su" 1• t_� Date: - Homeowner Date: Homeowner NOTICE..ADDITIONAL TERMS,CONDITIONS AND WARRANTIES ARE STATED ON THE REVERSE SIDE AND ARE PART OF THIS CONTRACT White-Branch File Yellow-Customer Pink-Sales Consultant TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# l/ o -�P� Health Division � r`�St';riaPete Issued � � O �tP� �: Cons ation Division E A lication Fee 17. a, C � 1 A�1 g; � PP / Tax Collectors 61T2�:--3 �g �ermit Fee 5 Treasurer OAC SrRTIC SYS e E ZI Mi UST 6 S10 ``R° LLEC IN COMPLIANCE Planning Dept. VATH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONUENTAL CODE ANLTOWN REGUUTIONS Historic-OKH Preservation/Hyannis Project Street Address 13 Tr cc,,, L Village�a Owner tD t ArD AAv ctc Address 13�rcvh�� i u��Gv►n�s 5 (M�02�01 Telephone %-I Permit Request BOA)n i Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation V,wr> Construction Type J&5r-,mevA — Lot Size l ,k 46 Sfr Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0"' Two Family ❑ Multi-Family(#units) Age of Existing Structure �3 � Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: Ofull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing I new I Half: existing new Number of Bedrooms: existing -3 new Total Room Count(not including baths):existing new First Floor Room Count �o Heat Type and Fuel: Otas ❑Oil ❑ Electric ❑Other Central Air: I(Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 4�111a�62— FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. , ADDRESS' l,. VILLAGE } OWNER 1 DATE OF INSPECTION: FOUNDATION ; FRAME l'�2�'! 0 INSULATION .k v A/S 0 GK Q FIREPLACE ELECTRICAL: ROUGH FINAL 1 1 PLUMBING: ROUGH, FINAL GAS: ROUGH+ .�_ t FINAL FINAL BUILDING �: K 0 ' DATE CLOSED OUT . ASSOCIATION PLANNO.�i r„ 7 1 ° IKE t° Town of Barnstable Regulatory Services * i+xrisr BLE. ' Thomas F.Geiler,Director 9`bp,1639a 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. Type of Work: �`3�se vn �� �V 60 Vn— Estimated Cost 7,0t• Address of Work: I Tray" _l a a,� kA`1 a v►VN ; VY1 6-2-4ao 1 Owner's Name: �- uj afro A 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 NzOwner 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: Date Contractor Name Registration No. OR Date Owner's Name Q:forms:hcmeaffidav The Commonwealth of Massachusetts R.—_ , , Department of Industrial Accidents — Office ofieyesifgatiaas 600 Washington Street T Boston,Mass. 02111 Workers' Com ensation Insurance davit name -bLtsdi�i`� �t1(�u [✓ location- city I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one worlds m' ca acitp %��/�/%/%i"I i�%Y"11:2 din workers' co ensation for my employees working.on this job.:.{±±::}:.}}::.};;}}:.;}:.i:.::.:;::;:i<:::i:<.;>.::Y.;<:::<:;> I am an em 1 er ravi g mP..............:.::::................:..:. ............:.:.:.:.:.......:::.y::.y::::.:::::::::•:.y......::::.y::::::;......,.....................,:.n....,........:... . .......... .............. .:::::;::>:i;<<:::::::±:>::«;>:'{<:::ii::::<::i:>ii:r;:;;:::i::i>i:};«:Y;::<'.i:.:YY'.}}:•YY:.:;:}.:... ar an naafi i>`53'��' ?�:` ?'�`?` >`�::>t':<;S::�: r :::�:>;:: ;:<.;::::;?::'E:;::;:_;< t:;?::?+:: �.'•':�:�f:;:;>;:; ,;;. fix'::::p;::2::}};::::;::::.}:.:?:G:: ' '..}:.::.}:.:.:±•}:.Y:;.}::?.}}:.i;:.}:{{•:>::::r<;•:{.}rip........ .......:......: ...................... ...... ..::........:............. ..;: •gtidt�sS.. .. .. .....................::::::::::::::::ii:::::niY:Y:i?±^};w::.::::::::.::•}.�}:v:;:•:i:::::••:\•:•:vw:::::Y:iii:ti?.;{{;:,v,iit�•ri.:J}}Y}:iY:�Yi: f:idoY:•Y{:{i�i:t 1i '':e#s `"si '< cri% Eri>it •`: ti%<¢3c? �`^`•`•,`? ` : Q..Y a ``ali'cv t�sttrattice cff....:... :....... . ......... �/ ❑ I am a sole proprietor, general contractor, or homeowner(circle one and have hired the contractors listed below who have 'on olices: following work the ........... .......... 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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 author ity. Applicants 7 Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and company names, address and phone numbers along with a certificate of insurance as all affidavits maybe supplying P Y . 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 other arrangements have been made. unless oth Department b mail or FAX a�g the D Y ep 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 Investlgtions 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-490.0 eat. 406, 409 or 375 • .'I'al+Tr.i31••Ih� itoedl F'a� ' p�scripttre P:r3csty fardtsa sadTw--rx—albun Lm in . MUM wau Floor Bawmat a Fffia ~� g . GlasiagWILU Pam* Arss' ('/.� U-�Uir � atna� p=k. RO 5741 to 6560 Hrat�Drsx D 6 2{cr�asl 33 19 19 10 Q 1Z:4 0.44 3C 19 10 i5?.FVE A IZY: 0.5Z 1J ig to • �_ I _ 31 19 l9 to 6 >CSAFVE U I S'/. a.4 s 3i NIA wA !S AFVE 44 a. 31 t3 ; y IS/. 19 19 to Norsasi 15/. d31 30 WA NJA w '3i • X ,IEY. a�Z. . l3 � WATT1A 3i IV :. AFUS Y lE ' 0.41 13 14 to 9a AFUE x !3•/. . OAT 30 19 19 10 6 1, �DItE55 OF PROPERTY:. 2, SQUARE FOOTAGE OF ALL EXTEFSOR WALLS: �j�Jl OF ALL GLAMNG' S S' 3. SQUARE FOOTAGE • �.O #3 DNIDED BY#2): I S ' 4 GA GLAZING AREA( , ; CT PACKAGE(Q— AA-see chart above):' • 9;'SELF . ' • LVED METHODS OF D G ExER'GY REQ�gM�I'S ' rtOTE: 'OTHER MORE iNVO ARE AVAILABLE.•ASK US FOR TMS MOPI ATION. gCTILDING INSPECTOR APPROVAL: YES. q;tarms.f980303a , i Faotnote's to Table'J5.Z.lbf Glazing area is the ratio of the area of the glazing assemblies (including sliding-alas doors o t c gros, and basement windows ff located In walls that enclose conditioned space, bur excluding opaque doors) arcz. cxpres5pd as a percentage. Up to 1% of the total glazing area may be excluded,fram the U-Yalue requirement. For example,3 fci of decorative glass may be excluded from a building design with.300 fks•of glazing are 2 After January 1, 1999, glazing U-values'must be rested and docuaieated by the tnaaufaeturer in accordance with C durc, or'taken.from Table 11.5.3a. U-vaiucs are for Council (NFR the National* Fenestration Rating ) test P roce , whole units:'center-of-lass U-values cannot be used. 'rho ceiling R-Yalues do riot ass .11 ume a raised or oversized truss Rt��n�,athe-may y be substituted for R-38 insulation thickness, over the exterior walls without comprtw n, _ insulation and R-38 insulation may be substituted'for R49 insulation- Cmlrng R'��nrepresent must bee5 placed berwcen insulation plus insulating sheathing (if.used). For.ventilated ceilings,.insulatmg the conditioned space and'the ventilated portion of the.roof. sheathing (if used). Do not include Wall R-'Yalues rQprescrit the sum of the wall cavity insulation Plus uuulat-1 ent could be met EITHER exterior sidingx structural sheathing, and iaterior'drywall.For exaazple, an the thireqttitzm uuements 'apply to 'by R-19 cavity in 'OR'R-13'cavla u 1 �g apply° C c constructionP woad=frame or mass (concrete}masonry, g)wan construc;ti6ns,but do e The floor'requrrernents apply to floors•over unconditioned spaces (such as unconditioned erawlspaces,basements, or garages). Floors over outside air must meet the ceiling regttittmeats• erage depth less than 50%below grade must •6 Th e entire opaque portion of any individual basement wall with as av mc_: the same R-value requirement•as above-grade walls. Windows and sliding glass .doors of conditioned bcsements must be included with the other glazing. Has eraeut dears must meet the door LT-value requirement d_scribed in Note b. • The R-value requirements are for unheated slabs,Add an ad3zti onal R Z for heated slabs. to If the building utilizes electric resistance heating use compliance approach 3; en rthe equipmen 5. if you t with the 110iyest' than one piece-of hooting equipment or•more-than one piece of cooling et;uigm t, P efficiency must m cot or exceed the efficiency required by the selected Package- 'Far'14ceing•Degre6 Day requ=mdats of the closest city ortowu sew Table 352.1a _ NOTES,: a) Glazing areas and U-values are maximum acceptable•levels.Insulation R values are minimum acceptable revels. re R-value requirements are for insulation only and do not include structural ee 035 Door V-Yalues must be tested opaque doors in the building envelope must have a U-value no 1 m the door U-value b) GPaq the NFRC tut procedurc or taken fro and documented by the manufacturer ui•accordaa ce vnth . • 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 V-valucueg to determineha 5j compliance of the door.' one door may be excluded from this requirement(t y c) If a ceiling,wall, floor,basement wall,slab-edge,or riawi space wall component includes water than.or equal o different insulation levels, the component compiics if the ==_Weighted R, °rage R.value is gee q . alue requirement for that component Glazing or door components comply if the ars)-weighted,average U- the�R v q uircment(0,35 fordo ) value of all windows or doors is less than or equal to the U-value rrq _ 43 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE . New Buildings,Additions $50.00 _ Alterations/Renovations $25.00 S Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE 914 square feet x$64/sq.foot= x.0031= plus from below(if applicable) 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 8' O CD N O � 5 CD k The Town of .Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 )ffice: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: )Z W GZ JOB LOCATION: number street village "HOMEOWNER": Et;,W 7A r • �>a i��L�L -11 S—�(t`� '?7 S `Z G.o �C 2 3`� name home phone# work phone# CURRENT MA —ING 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. 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-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 minimilm inspection procedures and requirements and that he/she will comply with said procedures and requirements. SignM6re 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 fora/certification for use in your community. ,, �� � �. � �� �� ��- /� �� t �� f - � � M '� -�-�� � � , i , . � � Qy0p71ir_ y TOWN OF BARNSTABLE fob � O•w Z BARNSTABLE, i MASK 9 BUILDIH INSPECTOR APPLICATION FOR PERMIT TO AA TYPE OF CONSTRUCTION ............................. ..... �'.'..........Y..v....`f . :................ ... .....'. ................19...?.Z TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........�30` v�� oa. ....... ... (Vevltc............ '.� ...........:....... ProposedUse .....................................�Ta r...... ........ ............................................................ Zoning District ........... :.....................................................Fire District ..... .1.: ?iJ........................................ Name of Owner Cw.AC4 14...-f.LO/70: i!4zk4c.-k-...Address Nameof Builder ....................................................................Address .................................................................................... q Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ................. ..........Foundation C.6 C.r J�e I c Exterior ....... L !-Jvv�` .......................................................Roofing ........ .dJ ............................................ 3 Floorswoo� Interior......... .�.. ......�..8. .................................................. .................................................................... ............ Heating '.`. ''r...................................•........................Plumbing ................�i`?c'ft`a-`.........................................:...... Fireplace ............YL?!n`- ......................................................Approximate Cost ............ .........-e ............. old Definitive Plan Approved by Planning Board --------------_______"_______19 . ' Diagram of Lot and Building with Dimensions Fpc SUBJECT TO APPROVAL OF BOARD OF HEALTH .U:8 OU) m o d z z V) >� w :ix � > -::c 40 rod o,o , 0<�� z r o - CL dW I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. DD (e' Name .,EGG .. ......... `............ Pa6uck* Edward A. 6L Leona ' No - '- pa'nnkfo' --'t�oIbmo�e ��� � '---''-----''' __^.---,.___,,_.__,______,_,_____. Location .........I3-�razu..l�»ad____..____._ West HyannispIrt � —''-----'--.-.—..:''--..z..'-...---..—.-. Edward A.A° &: Leona Padpck � Owner —.---.--__.__.._...........__.__._ frame / Type of Construction ..................... ` —`--'--^`''--'--^—'----^`^---'-^'--- Pkt ............................ Lot ----------.. � � ' / � April 14 72 ) � Permit Granted ........................................ ' � \ � Dote of Inspection .......................... 19 ' / � ""'= C="p='=" ' . | � � PERMIT REFUSED ~ � . ---'------.--.----.------.. 19 ---^-----'^---^^~'—''^''`--'`—'—`--' �� | � | / ----'-'-'-------''--'----------'--'—'' --.--_—..'—'-----.-_-----.--.----... \ - ----.~—~..-....--....-,.~-'-.,..~---....- / Approved ................................................. 19 ________,___.___,,,,.__~,,,,_._. ^ | / ----''------^------~—^—^'`^``^`~^— � - - — k,isessor's map and lot numb %THE Sewage Permit number ........ .................................... yx STAILE, House number ......... 44- /" .....................................j...................... TOWN iOF BARN91,,r CODE • tAT101VS BUI'LDING INSPECTOR APPLICATIONFOR PERMIT TO .................................................. .............................................................. TYPEOF CONSTRUCTION ..................................................................................................................................... M. S......... ................191.9. TO THE INSPECTOR OF BUILDINGS: Th er.siqjned hereby applies for a permit according to the following information: qd .......................................................................... ProposedUse .......... LAJV-�........... .. .................................................................................................................................. ZoningDistrict .............. .........................................................Fire District .............................................................................. Name of Owner ...........�ciclress ..... ........................... Nameof Builder ..................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ............ .....................................................Foundation ........q........ ...... ................................. Exierior .........�.n--je.........................................................Roofing .......... ........................ ��>....................................................... Floors .......................................................................................interior ...... Heating ......... .. . .... . ......... ........ ........Plumbing .................................................................................. p Approximate Costc 9..7Fire ..............................................Definitive Plan Approved by Planning Board --------------------------------19--------- Area .......................................... Diagram of Lot and Building with Dimensions Fee ...........7.9 ....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 0 tAO all I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Q NameL I....................... .............................. Iadzok^ Edward A. ' 2l�A� 1�n� ^°^�^ --�- 4Le m dJw�TNo .�..�---.. Pennitfor .. ----... �^ys� -..,,---.---------..----------. . . . . 13 Pram Road Location --------------------_.. West ---~----.-----.---...--.-----.. ' I�bmazd /� � Iaaooa l� Pa�uo� Owner -.�----.��-�-------..�-----.. °^ | Type of Construction ----..�fame.................. . -----^---'----------'------' Plot ............................. Lot`---------- � Permit Granted .�6zu ]IL lg �� ---'--^' ----- ~ ' | Date of Inspection ....................................l9 Date C6mo��e6 ----�������.'---lP � ' . ' . � ' PERMIT REFUSED in / lV W C- . ............... ...JB ................................... . ~ ' ^ . - ........................................... ......................................... . . �n S -.. ----------. lg ' ^ --------.-----.-.-..---.----.. .^ --------.-----.-----.--.....-- Assessor's map and lot UTHE - Sewage Permit number ....... �J�°� ��� ' ` . House number ----,------�r._�./�x�/...................... . MAO& � | ' t639- | ������ ��� �� � � �� � � �� � � TOWN ��]� ������ |� �� �� �� ������ � ~ � BUILDING � 0N N N ��N �� INSPECTOR ��NNNN-NNN ���� �= == � ���� ° �� �� APPLICATION FOR PERMIT TO ........��................... ��z�...�)/�����.............................................................. � TYPE OF CONSTRUCTION -----------------__._____________.____.________ ; TO THE INSPECTOR OF BUILDINGS: � hereby | for o permit according ^o H`u following information: | . ' /Location ���-��.l ..—..kA. 1L��XlY3i.��^—..�-y����.�---------------------.--. u � Proposed Use .......... ------'--------------.---...--..-------------- Zoning District ------._---------------'Fino District -------------.--.---------.. . ^ Name of Owner � -L .��\ reo ....... —..—�l..l—.—..\\`i9\[�l\.��............ � ' u A _ Nome of Bui|6or ' —�..�^' ��-----------A66nss ------------.----.--...------.. ^ Nonm of Architect ----------------------A6dnss ---------------------------- � ^ T \ \ Number of Rooms ----\-----------------'Foun6ohun --.....�.���..—.. ..........----------- Exle,ior ---c�l`i�� -----------------.RnuGng ---���»\~' �l'--�`�'� -------.. v � . Floors -----�D—�!��-------------------..|ntevcv -- ....................................................... Hooting {��/� ( Lm �` `� �� ^ ' 4+� —`\ Plumbing ---'Y\---''---- � --`—'�3--'---' ''� -----==~-----------'--------'� � � Fireplace .............. ------------------Approximote [oo ........................... `� ' Definitive Plan Approved by Planning Board l9---- . Area --���r,�l—''���.---� Diagram of Lot and Building with Dimensions Foe ........... _______ SUBJECT TO APPROVAL OF BOARD OF HEALTH � ` � ' � . . , .�41 , , . . ' ^ � ^ � ' | .| hereby agree to conform to all the Rules and Regu|ohon's of the Town of Barnstable regarding the above � . construction. . Nome .{�v..�..!�.�—��...������ ---------.- ' ` U � - > S Paduck, Edward A. & Leona N. A=?68-189 No-' ....21282 Permit for add to dwelling Location 13 Pry Road ............ .............................. West �yannisport..................... Owner Edward A. & Leona N. Paduck ........... ................................. Type of Construction .............frame ........ . ............... Plot ................... . Lot ................................ Permit Granted .............May..10..............19 79 Date of Inspection .................................19 Date Completed ......................................19 (}PERMIT REFUSED ....................... r ........................ 19 t �. ....................................... ....................fir....`.................................................... . ...................................................... ...... ......................................................0........ .,� Approved ................................................ 19 . ............................................................................... ............................................................................... 1 I /L[ 1 O O O O M I O O O O QJ I N N N CD U N VJ O W 1� d ¢ N U H H W � O U W Z 1— LU W J W O W � m E c.0 I Cf] 1— H W O O I p Z VJ ¢ W � i p • W Z d K 4J p Z LL } ¢ p VJ E 1 d � W O W LO ¢ [a m N I W d O Z O 1 N! p J f-- I..L H W d W U Z Z W W E Z J Z LU W I E Z J E E LLJ O O } ¢ H I W E E S 1 ¢ ¢ d m N S p H 1 t1 ¢ ¢ U ¢ d d - I I f C t�7 Z�-- Town of Barnstable *Permit#0 2!1-ewl,P S; 3 Expires 6 onths from issue date Regulatory Services Fee MUF '96 X-PRESS PERMIT Thomas F.Geiler,Director AUG 3 0 2006 Building Division �� Tom Perry,CBO, Building Commissioner TOWN OF BARNSTABLE 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us 1 Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY ff ¢ Not Valid without Red X-Press Imprint lap/parcel Number roperty Address FK o residential Value of Work 5 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address ( 3 Prc (Z®,j ;ontractor's Nam Z & R 9np-- LC-a-5 Telephone Number &;�- l yn- lome Improvement Contractor License#(if applicable) CO i i ,onstractY rvisor s�icense fi{€appii blej �orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ k&m the Homeowner I have Worker's Compensation Insurance nsurance Company Name4-&4,,4P 6k 04— s Jdorkman's Comp.Policy# (0 C 10 ? ?�5- �opy of Insurance Compliance Certificate must be on file. ?emit 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) ❑ e-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 P oper ner Letter of Permission. A My of the Home Imp v ent on actors License is required. SIGNATURE: Q:Forms:expmtrg Revise061306 t ne c.ommunweairn uJ ivluYsuc:nuYect.Y Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 ' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Inform2tion Please Print Legibly Name (Business/organmation/lndividual): Address:,/- Q Ce,S �Q�- 0-0." A) Gt) City/State/Zip: A4LCu�_ Ib 363 Phone#: Fft 6S? Are ypu an employer? Check the appropriate boa: Type of project(required): 1.Egli am a employer with r 0 4• ❑ I am a general contractor and I 6. ❑New construction employees (fall'and/or part-time).* 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 8. [) Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5• ❑ We are a corporation and its ME] Electrical repairs or additions required.] officers have exercised their ep 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12,❑ of r airs insurance required.] t employees. [No workers' ) comp.insurance required.] 13 / Pg 05 *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: 1. t homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such t6ontractors that cbeck this box must attached an additional sheet showing the name of the sub-contrabtors and their workers'comp.policy inf6rznadon. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: &.�75kwe_, :17J.5 . Policy#or Self-ins.Lie. #: G� 10 ( 7 Expiration Date: -3 It? c> .Job Site Address:_ 13 PC-0,m Z,9,4-_t> City/State/Zip: QC./G/UCS 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 ertify der a pai d n Ities of perjury that the information provided above is true and correct, sign, Date: Phone#: Official use only. Igo not write in this area, to be completed by city or town official. j 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 H 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 orbuilding appurtenant thereto shall not because of such employment be deemed to be an employer." .MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or . renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es) and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(ILLC)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 Deparanent 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 pemuttlicensa applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in . (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof thata valid affidavit is on file for future permits or licenses. Anew 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. 1#1- 617-727-4900 ext 406 or 1-S77-MASSAFE ray 617-727-7749 'Revised 5-26-05 www.mzss.gov/m`a Town of Barnstable Regulatory Services vMSS. Thomas F.Geiler,Director 0.39. 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 A Builder I, ejm���--b as Owner of the subject property hereby authorize ki &awc to act on my behalf, J in all matters relative to work authorized by this building permit application for: 15 (Address of Job) Signature of Owner Date I�J g A' U� b � Print Name Q TO RM&O W NERP ERMIS S ION MARS! r "w CERTIFICATE NUMBER CE�TIFi��41'E OF iNI URANCE ATL-00091 590 7-1 1 �x PRODUCE - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS MARSH USA,INC. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE ATTN: BRENDA BOOKER (404)995-2594 POLICY.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE l MAYA MCCLURE(404)995-3206 OR AFFORDED SY THE POLICIES DESCRIBED HEREIN. TAiIi!ROUSE(404)995-3430 FAX(404)760-5663 1 3475 PIEDNIONTR' �D. SU!"" 1200 COMPANIES AFFORDING COVERAGE -- I P,TLA TA,GA 303i;;i CC?.IP.:,vY 10C492-IPUSA-GV'/A--03iO4 1, STE.eOFAST INS(.;RANCE C''?AFANY HD AT-HOME Sc 1 ICES IC 3 ZI RI•", a Ai'v1ERl ::=•,;`•1'VSUh C;E C 0 N1 P.A.i iv C;ERA THE HONIE DEPOT AT 'HOME SERVICES,INC. --. 'EDOT USA INC. •i „-0Ni PA,•I'• 2455 FACES FERRY ROAD I,.'! '[Nis CQ`ri"r',-',N"Y BUILDING C-3 — ---- ---- ATLANI-A,GA 30339 ? COMPANY D AMERICAN HOME ASSURANCE COMPAN'f COVERAGES x:` vThs certifeate supersedes and replaces any previously!slued ceR)ficate for thepolcy penod_noted t,elow THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MMIDOIYY) DATE(MMIDDIYY) - A GENERAL LIABILITY IPR 3757 608-01 03/01/06 03/01/07 GENERAL AGGREGATE $ 4,000,000 X COMMERCIAL GENERAL LIABILITY 'LIMITS OF POLICY.ARE EXCESS' PRODUCTS-COMP/OP AGG $ 4,000,000 CLAIMS MADE OCCUR 'OF SIR:$1,000,000 PER OCC' PERSONAL&ADV INJURY $ 4,000,000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 4,000,000 • - FIRE DAMAGE(Any one fire) $ 1,000,000 MED EXP(Any one person) $ EXCLUDED B AUTOMOBILE LIABILITY BAP 2938863-03 ADS - 03/01/06 03/01/07 COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO - ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNEDAUTOS (Per accident) X ELF-INSURED AUTO -HYSICAL DAMAGE PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ - AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ - G WORKERS COMPENSATION AND 6610998(AZ,ID,MD,VA) 03/01/06 03/01/07 X WC STA L TU- ER EMPLOYERS'LIABILITYTOR C 6610995(AOS) 03/01/06 03/01/07 EL EACH ACCIDENT $ 1,000,000 G THE PROPRIETORI X INCL 6611326(OR) 03/01/06 03/01/07 EL DISEASE-POLICY LIMIT $ 1,000,000 PARTNERS/EXECUTIVE E OFFICERS ARE: EXCL 6610999(NY,WI) 03/01/O6 03/01/07 EL DISEASE-EACH EMPLOYEE1$ 1.000,000 EOTHER WORKERS E COMPENSATION CONTINUED 6610997(FL) 03/01/06 03/01/07 D 6610996(CA) 03101/06 03/01/07 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESISPECIAL ITEMS CERTIFICATE HOLDERga ay . . €.�. r3 CANCELLATIONk .- SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,.. , THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL An DAYS WRITTEN,NOTICE TO THE FOR INSURANCE PURPOSES ONLY` CERTIFICATE HOLDER NAMED HEREIN,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER AFFORDING,COVERAGE,ITS AGENTS OR REPRESENTATIVES,OR THE ISSUER OF THIS CERTIFICATE. _ MARSH USA INC. BY: Walter Gilstrap .. :�..iLd • mm g � E VALID AS OF ,02/27/O6 a vs s .4- r �ry DATE(MMIDDIYR) :. DDI1'i3ON�4LINFORMATtONs �xATL0009159071c1 2/2/2 7/06 _ . . . COMPANIES AFFORDING COVERAGE PRODUCER : - MARSH USA,INC. CCMPANY ATTN:BRENDA BOOKER (404)995-2594 E ILLINOIS NATIONAL INSURANCE COMPANY MAYA MCCLURE(404)995-3206 OR TAMI ROUSE(404)995-3430 FAX(404)760-5663 3475 PIEDMONT ROAD,SUITE 1200 COMPANY ATLANTA,GA 30305 F 100492-IPUSA-GVVA-03I04 INSURED COMPANY THD AT-HOME SERVICES INC. G NATIONAL UNION FIRE INSURANCE COMPANY DBA.THE HOME DEPOT AT-HOME SERVICES,INC. HOME DEPOT USA,INC. 2455 PACES FERRY ROAD NSA/ CCNIPANY BUILDING C-8 ATLANTA,GA 30339 H CERTIFIGATE HOLDER FOR INSURANCE'PURPOSES ONLY MARSH USA INC.BY Walter Gllstrap5,5 Ll � ' mN .g � Board of Building Regulations and Standards License or registration valid'for.iudividul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration 126893 One Ashburton Place Rm 1301 Ex Craton p 8/3/2008 Boston,Ma.02108 Type Supplement Card THE Home Depot,At Home Seni'c NCHAEL B EDARD j 3200 COBB GALLERIA P'.KWY'#20 AtIANTA, GA 30339 Administrator Not valid ithout signature Danya Mahot 7743230034 p. 4 HOME IMPROVEMENT CONTRACT L Sold,Furnished and Installed by: Branch Name: S'li)A► Date: > L THD At-Home Services,Inc. d/b/a The Home Depot At-Home Services _ 345A Greenwood Street, Worcester,MA 01607 Branch Number: I T .lob#: Toll Free(800)657-5182; Fax: 508-756-2859 Federal[D l 75-2698460 ME:Lic 8 C 02439 RI Cont.Licfl 16427 CT Lic 11 565522; MA Home Improvomcnt Contractor Rcg.9126893 Installation Address: State Zip Purr. nscr s: Home Address: Si"�fli (If different from Installation.Address) City State Zip E-mail Address(to receive updates and promotions from The Home Depot)._N_&\ Project information: tj'We/You("Purchaser"),the owner,of the propetk Located at the adc1ress,olt�_r to contract with Home Depot U.S.A., Inc. ("home 1.)C )t"}to furnish, ilcliv�+r;tn i a :',1n � fo! ihk:in:;tai?ation of all materials as r described on the attached Spec Sheet#:�7 , ineorir,)ratcd h::r•�in h_�'rei-:rcnc<:and rn.)dc:a part hereof. Home Depot rL.semes the right to cancel'thi5 it ennnot perform its obli-111tions due to a structur'-, complete the Joh was not included in the Spee Siiee; a>;; >: ;=-':• B CONTRACT AMOUNT x NY�� *LES$ DEPOSIT $ L� •'! .::r.i aurl`: .:i,rr papn:.:nr or,u:ns-:'irr?c Gas. E:• 1 _—. ij sa Nia lei :,r` i>i::covcr A.m.:rican!`.ei:::s•: BALANCE DUE 2 l; G.,n,c Inn,,.rc trcn i:oan i`1...Ilnmc D.11 cell, ON COMPLETION J .N)C.-'ONLY) 'M;nitnum 25%of Contract Amount(Inc upon execu iota h + i'::40:^i:1e 'rCCr ;1O•(n.�_-- (i?Eir.die 11bCC ONLY) )f this contract. i 1 f i Indicate Payment Method For r1:,rn :et;t ahpcar;,n c;,rd: C�e�w-« 3t� r!?vLF __.._ BALANCE DUE ON COMPLETION: "'Rt,mv,;ou:signaturo holow,Uwe agree it,al low Home i1'cpot it,charge the above rof'crc cruiii card tix lie dcposa.t4'-:la?. It r relhotr�cc's Signature Date F HIL or HDCC Authorization Codes Deposit Final Pay ent Purchaser agrees that, immediately upon satisfactory completion of the work, Purchaser will execute a Completion Certificate and pay any balance due. Purchaser also agrees to be jointly and severally obligated and liable hereunder. Entire A reement: This agreement and its attachments, including any financing agreement, contain the complete agreement between t e parties and can not be amended or modified unless in writing in a separate agreement signed by both parties. NOTICE TO PURCHASER Do not silt this contract before you read it. You nr., crti:'h d!o r.corw)ft'iely`r.'..:-irt cols of Pete cainiraca::t the time you sign. Keep it to protect your rights. Do not sign a Comnlvior before this project LR complete. Law prohibits home repa g ir contractors from requesting or acceptin a Completion Certificate signe;l by the owner prior to th:.actual completion of the work to be performed under the contract. You may cancel this transaction at any time prior to midnight of the third !>usiness day:ifte:•the elate of this contract, See Notice of Cancellation for an explanation of this right. There will be ,i ser•vic ,cl;ar c e:%ual v; 25% of the contract amount if the job is cancelled by Purchaser AFTER the third husinrs day. BYMY?OUR SIGNATURE 136i..OW, 11"WI;AGRi:1iFOBEBODUGi ''''I':I'.';' riS'iN1;:?i .. : !Jl::',t"!. .-• I.;,( i<ru)��,1 ?::urr la_CFII l'Uh A C:OI'Y 01 "1'iIIS CONTRACT AND?'G✓O CO[v]Pi..!i l'i_i:i i i NO i, i;.,1i BY A4Y,`0Ui< SiGNATUItG PFLOW, UWE UNJX;1,S'1'ANI:; "?it ;; TIO: :'::ii'.li!?i'vi?iN !`; S11i;1Ii("i i i l !(IiViil'4V ?)P i•✓il'rCilll CRFDI7' HISTORY :1ND rl� ;1 E UTH0RIZI=- H E D OR'il?.i'r;f "CO " :iP i'.i 'I•;Vit %:r !`:'`r`ii:!;!•'. ;it il)I"I' '•?ECC)RI) �V!Tll AN iNl`I.I'P.NI)I.N'1' C Rr.DI i� l 'I'nR"i iNCi AC;17hlf'1 ;\Ni; i.i.IJI-11.1-''" INC'I iIZ1117r) I:Rt l"i