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Home My WebLink About0083 SCHOOL STREET P3 mt,14i* �- Pd d ras S {�f7M e S D� �7` ��C-1 Y•1 �fD(.�� A,- 0/15 r� f i I �� 1 ... ,. �-� -- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION RNSTABLE Map Oc Parcel ' " Application # /L5 0 !/in Health Division r ` ;A .,Date Issued Conservation Division Application Fee Planning Dept. -Permit Fee ,O D f \F7 3f , Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address c j Pr 563-toc)I Village ma fl y) L Owner rp 0 krvk-a-S l'o G. Address U�?2 • 5,- hoo I cS�• f•f �'I,ej/� Telephone 7 7 / -- Oft : Permit Request pe— a P 'l— 54-r-t P 2-e 59 0cf-cesa 1-1 k E 92K L,1 O Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0000 Construction Type SP ArraA-1.4— Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. &�( )-!� Dwelling Type: Single Family ❑ Two Family ❑ # units Age of Existing StrXull '��LJCrawl 2�0 Historic House: kYes ❑ No On Old King's Highway: ❑Yes &<o Basement Type: ❑Walkout ❑ Other N Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: (O existing —new Total Room Count (not including baths): existing ? hew First Floor Room Count Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes Alo Fireplaces: Existing J—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 AD eals Authorization ❑ Appeal # Recorded ❑ H Commercial Yes ❑ No If es, site Ian review# `` �� Y p Current Use �� t o&Lc Proposed Use /) A APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �!-1,&tip t°� ��(4�(1 Telephone Number Address ` 2 sG-�1D1� S e License # 05— �Y)b 1 :5 02-&0 / Home Improvement Contractor# Email 1 -gd-amsQ hou55 !q,ter-!a 1 , a5 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO _SIGNATURE `�/` G,� /�- /mot Lr rir DATE `4911 // '�. FOR OFFICIAL USE ONLY -' APPLICATION# DATE ISSUED n ' MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' } t ti YTw CommompmM ufMa—,inch= - Mice DOMMiagadaw ' 600 Wasskh;g#oir,treet $oslcrri,HA 02 wH.•rv.rxtFsxgr,�dur Worker:e CampensatwathmurauceA fidav&Emldeas/mastra:cinrs/ElectucianslPtumbers Apphrant Information � Please Print Le6bT� Name C�aslO�n� v�att�ry- ?V'Vl JD �kDf rw-s 1 DC, . i City/Stat&Zip= q AA a O Phanr-9: 5o'5—7 7 / — ® S$ 57 lire a-a an e;n Io er7 eck tyre ria b �c: p 4_ I atu confracEcir and i Type of grade (re gored= L❑ I am a employer with 6_ New r}n ,v az employees{full arfdlorpart-ime}* hovel iredtlre Listed on trio attached sheet T_ 0 Remodeling 2_❑ I am a sole proprietor or partner- h ship and have no employees sub-contractors have $_ ❑Dtindlitiou working forme in my capacity? employees and have workers' 9_ ❑B 'cog addition [90 workers, comp_ comp_incnrar Kx I Kegn+re'L] 5_❑ '%Te are a corporafioaand its 10-0 pl ecEcal repairs or additions. 3_❑ I am h.omeaumer doing an work officers ba-um exemsed their 1LO Plumbmgrepairs or additions my-self [No'4irdrlMM,comp: right ofexemptionperlY GL 110 Roof - c I-5Z§1(4).and wehneno lns7xarrc-t; 1T� 13_0 O(her employ-[Na workers' comp_memanrr_rtgaired.1 +ftxty sages$ut checks Dos—;I Est also fill otrt the sscfiva beTacv ck a SICII WO d�e6T rnz art paiicg $OIDPQ9fI1Hs[rlFp s�brIIit this af5dmff]t YFj they ace dam3z zff vu3c and rhea hire PAC couh8airrs nmst sdBnmt area€indsck hzd"lr tin sorb Mors ff=d c11eck this b=m st stta[hed sa addifi— sheet shotrmg the name of trio t mdslaiE trhether trnot ti sa a Ti.vs zmphTees_ if the salt-contmct=hire eabpIoy-ee-%they=st provide tbEar wmk--e&comp paLLy mM bez lam an fnsrmmce for my emptayem Hekty is fhe paEcy*andph site ir�fbrnr,ml`tu� r Insurance CompsnyN=e: Polite ff or-Self-ins- Expisatibn Date_ Job Site Address- CO/5tatelzip= Affach a copy of the cearkers'compensation poliLT declaratian page(shuwing the policy number and eqsatio-n:date). Faiinre to sty are.coverage as regaimd.nuder Section 25A of ItML c 152 can lead to the imposition of criminal peaahies of a fine up to S L-50D 00 and/or one-yeariapivunment,as wen as civil penalties in the farm of a STOP WORK:ORDIR and a fine ofup to�250-D-O a they against the violator- Be advised gmt a cep of this statement m3aytre fprwardad to the Off of lnvesfigations of the DIA for mince coverage vedffcalicrL I dri Iterei5�r c�xfy u�rdst/tic9spai�s anrl'pennIfies ufP�e'�u3Y i#tst$re uf�or-+riudiarnprat�icl�duhare a 6�ce anic!'c�arrsct Siffiatare-`�/��',t.l�J ��. , Date= to/ST,L� • (VEdot use anly. Da nat wntir in ffrfs area,ta.ba campL-W by city of tin offic&L City or Town: Ptit�icesYse# Ewing Aufhoaitg(drele omey L Baard of Health 2.Bu5ffmg Ilepm-buent &atyfrawa Qerk 4.Electrical inspector S.Plumbing I`xtslector .6.Other Cont*ct Perst,n- Phone#_ 6 �a Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 r • Property Owner Must Complete and Sign This Section If Using A Builder I, TJ -/4�"��Y A"D�'/ ,as Owner of the subject property hereby authorize . MA-P K P;QA-M S to act on my behalf, in all matters relative to work authorized by this building permit application for: 6c4hov 5E hnl (Address of Job) Signature o Print Name If Property Owner,is applying for permit,please complete the Homeowners License Exemption Form.on the ; reverse side. . QAWPM ESTORMS\building permit formslEXPRESS.doc Revised 061313 OFFICE OF THE SHERIFF = - ' BARNSTABLE COUNTY Upod The Commonwealth of Massachusetts .6000 Sheriff's Place,Bourne,MA 02532 r ♦� 508.563.4300 Fax:508.563.4574 BCSO@bsheriff.net ACCREDITED `, (/ sheriff James M.Cummings April 7, 2015 FOUNDED 1870 American Thomas Perry,Building Commissioner Correctional Association TOWN OF BARNSTABLE 200 Main Street Hyannis, MA 02601 � Dear Mr. Perry: I have been asked to provide a letter regarding workers compensation coverage for Commission on inmates in the custody of the Barnstable County Sheriff's Office who are erecting Accreditation of and dismantling tents for the Town of Barnstable. Rehabilitation Facilities These inmates are not paid wages for the services that they perform. They are providing a community service: They are not employees as a matter of Massachusetts law. They are not covered by worker's compensation insurance nor ,are they eligible to receive such. The Barnstable County Sheriff's Office itself is self-insured for its employees, the Community Service Officers,for worker's compensation purposes. Therefore, the Sheriff's Office does not maintain a worker's compensation policy. As an entity of the Commonwealth of Massachusetts, the Sheriff's Office is self-insured for all purposes. Please feel free to contact me if you have any questions in this regard. Verytrulyyours, Matthew urphy, Esquire = . Assistant Superintendent General CounselZZ �= /sdr c Enclosures " /NTE6/7/TY PBOffSS/ONAL/SM COMPASS/ON TMAFNOBK BARNSTABLE-BOURNE-BREWSTER- CHATHAM-DENNIS-EASTHAM-FALMOUTH-HARWICH MASHPEE-ORLEANS-PROVINCETOWN-SANDWICH-TRURO-WELLFLEET-YARMOUTH Massachusetts -Department of Public Safety Board of Building Regulations and Standards ? Unrestricted-Buildings of any use group Which " . Construc—Non JUr1eI V i-Or ; contain less than 35,000 cubic feet(991m)of License: CS-074295 � ' enclosed space. MARK R ADAM3 24 FASTBROOKjtD Iat W YARMOUTH MA S. �� ' Failure.to possess a current edition of the Massachusetts ��'�'�` ` Expiration State Building Code is cause for revocation of this license. Commissioner 03/01/2017 (. For DPS Licensing information visit: www.Mass.Gov/DPS , ��ie Cpanvniooacrsea��o�C�/</�acraac�cc�eC� . Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: e istration: 1 Type : Office of Consumer Affairs and Business Regulation 9 ";?," 2 10 Park Plaza-Suite 5170 I-xpirationt 5112/2101-7� Corporation Boston,MA 02116_> CHAMP HOMES INC�� MARK ADAMS 82 SCHOOL ST7:~----- HYANNIS,MA 02601 Undersecretary Not valid without signature RE-ROOFING/RESIDING/WINDOWS (COMMERCIAL) ❑ If located in OKH or Hyannis Historic District- Certificate of Appropriateness required unless same color/same materials specified on application ❑ Map/parcel number Approval Sign-offs from: ❑ Tax Collector. ❑ Treasurer #of squares of shingles or square footage of roof or sidewall to be shingled/sided Specify stripping old shingles or going over old roof. If going over ❑how many roof layers existing now what size are rafters. What is span. Owner's name & address roject valuation must be entered Builders Information Signature ❑ Workman's Compensation Insurance Affidavit State-form must be completed and.a copy of Insurance Compliance Certificate must be submitted. A copy of the Construction Supervisor license 's required. Effective March 1,2009 ❑ Check expiration date,no restrictions,. ❑ Permit fee$160.00;/I- i Property Owner must sign Property Owner Letter of Permission. Projects requiring the use of a.crane must complete the forms issued by the Aeronautics Commission q-forms/bldgpermitis/permitch=klists rev.070610 • "TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map —Parcel- / Permit# 2 Health Division C) Ok- Date Issu d �, o0 Conservation Division Fee Tax Collector Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 3 SG" 'O 6L_ 1 �Villages� 4,_ Ax, VIM �� C Own"r`3vLV4iR 1 �®v bz �C} ,-� SE Address &�3(_ :5 1 Telephone SCE `7 7 t 0 0 Permit Request �z:,6 1A!T Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay Construction Type�•T �nJ�� Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 6a/ Two Family ❑ Multi-Family(#units) k Age of Existing Structure GV iZ Historic House: Li Yes Flo On Old King's Highway: ❑Yes o , Basement Type: ❑Full trawl ❑Walkout ❑Other Basement Finished Area(sq.ft.). Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name � � fI \�� Telephone Number _'5�08 I Address License# 0 066, 143 ��/r4�'� �fY�r • Home Improvement Contractor# Worker's Compensation# AWC-'` CO 14! 30 1200 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE L Z — `s m f t FOR OFFICIAL USE ONLY PERMIT-NO. DATE ISSUED MAP/PARCEL NO. , ADDRESS r VILLAGE OWNER } DATE.OF INSPECTION: ; I FOUNDATION FRAME INSULATION FIREPLACE '+ ELECTRICAL: ROUGH FINAL : - PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. t P s. r 1 x �� ;�, �� E � w� ,{ � - �� ' �. .,,;1[ i �, s _ R �, .;, � l T{ 4 j r j If j E• ! r �StP' i I f °p THE r. The Town of Barnstable &-.RNSr"L& MASS. $ Regulatory Services 1679' � Thomas F. Geiler, Director, f0 Mp'i Building Division Peter F. DiMatteo, Building Commissioner 367 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: �ut LA TUV, z&6 NSA Estimated Cost © ` Address of Work: c,1A p(, a-A"VS . . Owner's Name Date of Application: ` ®l - I hereby certify thai. Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL a 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:fonns:Affidav:rev-070601 r i / 1 1 1• l 1-�T a•.uf=f•��f%�//3(a�f/Utuu/i��/;I/��'/!!/��//.c�G7//�. .%!%%/. �%: ,%��i�s;�%�� I i.3ti3s1✓./•ss/s;s s:',Ililils%. 1• ■ 11 . . .• . .11• I • /. •1 ••. •.UI 1 .11 walK«1 ////%/////////////////////%////////////////////i%/////////////////////////////////////i////////O////////Dili'/.zz///i r+r%i/i!/i is i//rr"/"'��r<+�ii•�+ri!riiii/iii//////////iii///////////////////////////////////////////////// n 1 .11.1• . n • •lu 1 ..•-. •nn✓-.1 .cn •n 11r n Iu• - ..11 _ u1 n •1 r• 11 1 r . 3 ;�i?•`.e" <aaa.e, �.. •.;i 'S :. -r„yv+`.^•, ..' y;;... $i'o)'43.`�'�o .§": o.. x� 11 t 1 :I11 •1 ••1•_1111 Ilrl• r/1 •1 1 1 _1 ' 1 . /1 . ••'11 ..�.� w•1111•tit �:1• •11 .. 1- •. i:xct: :.' ......_ .. ..: .T c; J.:..:...;::'�. ,13%ii5>�.i` '";iaiTCC<'J'a!::.SvYr'S2•k;JcMt:i;�i^:�ii::':�:^::.�F:y;.i�° A;^'.:\oiri�ta�t-*�..;e'�.>� ':?+-: :..T.?,S.b.',. .;T•i,Y .,;,Gel-. ..... 11 Ll pendocemso cltyort 4 T) •.111 ■ • Umensing Board 13sdecmcws Onke C3chakifinunedLefe response is required ■ contact Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers compensation forthrr emplovees. As quoted f rorn the "law", an employee is defined as every person in the service of another under any corgi o f hire. --xpress or implied, oral or written. An employer is defined as an individual.partnership, association, corporation or other legal ent#, or any two or more of ed in a joint enterprise,and including the i reseatatives of a deceased employer, or the rtccn er Or the-foregoing eaaag J rP g �� 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,orthe occupant ofthe dwelling house of another who employs persons to do maintenance, �etioa or repair work on such dwelling house or oa the grounds cr 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 locaUliceasiag 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,nezthathe commonwealth nor any of its political subdivisions shall eater==any cma=for the performance of public work==d acceptable evidence of compliance with the insurance requires ofthis chapter bave beta presented to the comracting authority. - ��17/��////%///%//%/////%//////////////////////////////%///////////////////////////////////////////////////iiiiiii/i//////////////////////////�� -Applicants on and Please fill in the workers' compensation affidavit completely,by cbeddo the.box that applies to your stun supply=g company names,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of kdul vial Accitim=far m�aition ofiasuraacx coverage. Also be sure to sign and t, date the affidavit The affidavit should be.retained to the city ort�ownthat the application for the permit or$case is bang requested,not the Departs=of Lxiusfaal Accidents. Should yam have any questions regarding the"law"or if you are required to obtain a workers' ccmpemsatiaa policy,please can the Departtaeat atthe mmbw listed below. / City or Towns Please be sure that the affidavit is complete and I legibly. The Departateat has provided a spa ce at the both of the affidavit for you to fill out in the event the Office of Iavestigatiams bas to contact you regarding the apPn== Please be sure to fill in the pezmWliccose number which will be use as d a reference nrimber. The affidavits may be r=nec t" the Department Y artment D b mail or FAX unless other arrangearmtr have be=n ade. The Office of Investigations would like to thank you is advance for you cooperation and should you have any questions. please do not hesitate to give us a call. Ell The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Ma of Imresduatioas 600 Washington street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 exL 406, 409 or 375 p (C '� ✓1;,'CJamrn�eanurva.�.� HOME IMPROVEMENT CONTRACTOR I �. Registration: 103757 I Expiration: 719102 Type: Private Corporatio �' 1 SPRINKLE HOME IMPROVEMENT,'. J! I Brad Sprinkle 199 Barnstable Rd. i ADMINISTRATOR Hyannis MA 02601 ( ae an�nnanurCpGCIL O�a/�p�I,UGP.CC6 BOARD OF BUILDING REGULATIONSs License: CONSTRUCTION SUPERVISOR Number. CS 006643 I { ?f Expires 10/08/2003 Tr.no: 6729 Restricted:;00 BRAD K SPRINKLE n 190 LOTHROPS LANE N W BARNSTABLE, MA 02668 Administrator y �A�N r RESIDENTIAL: SHEDS - POOLS —DECKS-OPEN PORCHES- GAZEBOS DETACHED GARAGES FEE VALUE WORKSHEET ACCESSORY STRUCTURES >120 sq.ft.(Sheds,detached garages,gazebos,etc.) . >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—USE NEW BUILDING PERMIT APPLICATION . DECKS _x$30.00= $ (Number) a PORCHES x$30.00= $ (Number) IN GROUND SWIMMING POOL $60.00 $ . ABOVE GROUND SWIMMING POOL $25.00 $ RELOCATION/MOVING $150.00 $ (Plus above fee if applicable) I PERMIT FEE $ Q:forms:dkcost E - eff:NMI POW T Hyannis Main Street Waterfront sT�B� Historic District Commission MAS& 039. ,,rFDY a 200 Main Street Hyannis,Massachusetts 02601 508-862-4665 FAX: 508-862-4725 AGENDA FOR PUBLIC HEARING To all persons deemed interested or affected by the Town of Bamstable's Hyannis Main Street Waterfront Historic District Commission Ordinance under Article LX of Chapter III of General Ordinances of the Town of Barnstable,you are hereby notified that a hearing will be held on the following applications for Certificate of Appropriateness and other types of applications or requests, if so named,in the basement Conference Room of the School Administration Building on 230 South Street,Hyannis,MA at 6:00 p.m on Wednesday,January 16,2002 Agenda Items: Paul Hebert/Champ House,83 School Street,Hyannis MA.(Map-Parcel 327=249),Rebuild rear stairway t ode co GO Hyannis Main Street Waterfront Historic District Commission ;'.i ,�'t—`" 230 South Street /� t,,''. .)o 1639. Se ri +-' ,^, `,'._.'_., '1,-, �gEo ' Hyannis,Massachusetts 02601 TEL: 508-8624665/FAX: 508-862-4725. :s I +; -c ffE 9 15 Application to Hyannis Main Street Waterfront Historic District Commission in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under M. G. L. Chapter 40C, The Historic Districts Act for proposed work as described below and on plans, drawings or photographs accompanying this application for: PLEASE CHECK ALL CATEGORIES THAT APPLY: L Exterior Building Construction: ❑ New Building ❑ Addition Alteration r Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Other fM& a 5' 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other 5. Parking Lot: ❑ New Building ❑ Addition ❑ Alteration (Please see the guidelines for explanation and requirements) TYPE OR PRINT LEGIBLY DATE ASSESSOR'S MAP NO. 6� 7 ASSESSOR'S LOT NO. APPLICANT u l/� j� T��j,�y/ /�� T,�EL. NO./74�0 2i'. 7,7 APPLICANT MAILING ADDRESSt /—Z L7�ISi 1js�• ADDRESS OF PROPOSED WORK�,� sd 11 / s /"-9 PROPERTY OWNER ��!.e LYZ—, ,e-- , 2"- TEL.NO. 3�tf5,-771 OWNER MAILING ADDRESS 4 FULL NAMES AND MAILING ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. This information is best obtained at the Town Assessor's Office. (Attach additional sheet if necessa AGENT OR CONTRACTOR�J2, ;d&/y �e h(p /gl TEL. NO. 1,> ADDRESS A9.17r, 6�2!L Zjf_ r &) m��D DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done, including detailed data on such architectural features as: foundation, chimney, siding, roofing, roof pitch, sash and doors,window and.door frames, trim, gutters- leaders, roofing and paint color,including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). dip �1 s s 0 ke� ;;Y ire , Signed Owner-Contractor-Agent SPACE BELOW LINE FOR COMMISSION USE Received by HMSWHDC Date FTA`��0'�a Time ncr ry A enna This Certificate is hereby allL- By TOWN OF BARNSTABLE Date �-- HISTORIC PRESERVATKAION. Signed INIPORTANT: If this Certificate is approved, approval is subject to the 20-day appeal period provided in the Ordinance. CONDITIONS OF APPROVAL: HYANNIS MAIN STREET WATERFRONT HISTORIC DISTRICT COMMISSION *** SPECIFICATION SHEET*** ADDRESS OF PROPOSED WORK J ��`� �j ✓ �� s`��'�!S /��,©�� FOUNDATION �)/��j2 e� SIDING TYPE // COLOR CHIMNEY TYPE/ Y Ze COLOR ROOF MATERIAL PITCH WINDOW �}/ 1A . COLOR TRIM COLOR DOORS ZA ° COLOR SHUTTERS GUTTERS ` DECK,e2&S ` O �v ci ho wy `` /4 rel1v1e 0 1,) A6--t `V e, GARAGE DOORS /y COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application,along with three copies each of the plot plan,landscape plan and elevation plans,when applicable. The Plot plan need not be"Certified",but should show all structures on the lot to scale. w u ;a _�.C21J C.��/__, tl �-,-�-- f mod- -- -r3 Z 7 - ✓��'- 17, a; z s � , z Y K3a J.;p s � - :,:�......_.._.......r....�...e,.__._ �.yv._,,. - - - - r,�•. - -. ....,,. ems:,. (- 3 i i a- i s T t �O r ►- YI 4 p; J e In 3.i 2 x r- • L' d c ]] L Riifu l,.1 t �r131 7r� -A All, 1, v off�J�1 F r. � C^`/it -} - 1 '1-'{,1 f �i{.ltl rY��lyr I�1d�4w�' ( �� ° •�7i{��11�4 f Y 7'.� � �' � �i - 3 ��'` 'r - 1 _l.xrif�J- � f� 7 1 f� 11 �`.T� 11. l Jh�'� � J { V'� � F�l !L� ♦I��.,ry - • �.. _ :t.tr �� .r_tL. .�.II S_ � _ �}�_a.fi z•.�,.,F` 'y��i. - :�KLGf .I .r f:�' i I)epartinent Hof�Iea nth Safety f y f f and tnvironn eritili,Services~ z {t ( 'r 'X>: � ��L +�fi't= r� +TJ'�•i 77� �r� 1 ��; N+C4�� .I., s� oy - t} a _� +.�57 � in �I.°�� r�i >, S.+Z:.� Y �., C '♦ i9,. BAMF 'ABLE;w t A9A�9. !�I i r x y 4 BUILDING DIVISION ` Y - BY ..y, G i,' � I�J.�..'r s4 yj'�r t j�.'Y,'� aC�-r3� { :i r ! 1ar.:'t y r '..rfi t �,4f�, a t�uf T ••� 4 y" r _ _ __ s �y 1: TOWN OF BARB ,r-SLE ICU-ILD:I;NG PEN.M.IT. Pt`zI CEL ID -27 24S CEOBASE Ii? 24302 J ADDRESS 83 SCHOOL STREET. } PHONE HYANN IS ZIP BLOCK LOT SIZE DEVELOPMENT DISTRICT HY . 5D236 DESCRIPTION REPLACE EXISTING .REAR STAIRS/DECK t R.t ."YPF BHISC TITLE, MISCFLF eOUS PERMIT { CONTRA SPRINKLE, BRAD Department of Health, Safety � � Ax � and Environmental Services TOTAL FEES: $67, i0 INEttr�y.. CONSTRUCTION COSTS $4,000.D0 - 7-53 MISC- 'NOT CODED ELSEWHERE 2 PRIVATE P-'4'> -Tik!*% BARNSPABM + 16 BUILDING DIVISION BY �--=1� -- ---r DATE ISSUED 02/21/2002 EXPIRATION DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET.ALLEY OR SIDEWALK OR ANY--PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- _CROACHMENTS ON PUBLIC,PROPERTY-NOT SPECIFICALLY PERMITTED,UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS -PERMIT DOES NOT RELEASE THE APPLICANT FROM-THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS\REQUIRED FOR ALL CONSTRUCTION WORK:, APPROVED PLANS MUST.BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE." 4.FINAL INSPECTION BEFORE OCCUPANCY. UILDING INSPECTION APPROVALS ` PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 4� 2 2 �,/rJ'li 'mil' -�s` n. j • 3F, 11-2i� 2 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL A WORK SHALL NOT PROCEED UNTIL PERMIT WILL 1 END VOID IF CON- INSPECTIONS INDICATE THE INSPECTOR HAS APPROVED THE STRUCTION WORK 1:-. RTED WITHIN SIX CARD CAN BE ARRANG VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEP TION. NOTED ABOVE. TION. . Y a a rx` 1 x r ' ,,28 C"E* SAVE .Weatherization 508-398-0398 December 14,2011 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits Dear Mr. Perry, This affidavit is to certify that all work completed for permit application #201104926, Status A, Parcel 327249 at 83 School Street,Hyannis,Permit type: RADD, and issued on 9/15/2011 has been inspected by a certified Building Performance Institute (BPI) Inspector. R-38 Cellulose insulation was added to the attic. R-18 and R-10 cellulose insulation was added to the attic slopes and floor..R-11 Fiberglass-batts were added to the open rafters,walls and kneewalls.All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel / Application # Cp 6) 6 Health Division Date Issued � Conservation Division Application Fee j Planning Dept. Permit Fee - ' L+Z) Date Definitive Plan Approved by Planning Board 1p Historic - OKH _ Preservation / Hyannis Project Street Address S.3 Se 6 o 1 6 4- Village H a-An is Owner 40 U'S i nq N Corp 0Mtlioh Address M e Telephone Permit Request A;e-- S,ea> 4++ e- a4a �1 eoc P1,f,.0[e-s w n A _o j�/ KA u in& 0,0V P C' i Yi C ra Yc�f�-j � 0 Yl ectY- Z u✓;47+ry 4 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation (qi a00 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:'Ll Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: 0 existing L new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: _ ,;; Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ w Commercial .IM-Yes -❑ No If yes, site plan review# _ ' -_ rn Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1111ui`� !'rGV I cJ1 S�� ' C t Skv'6 Telephone Number 5 U ` 3 98 " 0 M 9c / AddressC 1 rn G�bn VG License # :,Y, �6 YOLPMO %J114, 6 Home Improvement Contractor# � 6 "t ` Worker's Compensation # � 3 0 5 )t ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Yo-c'm e y-t r SIGNATURE DATE i t , = FOR OFFICIAL USE ONLY 4 APPLICATION# F. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER x' e' DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ICI DATE CLOSED OUT. ASSOCIATION PLAN NO. if ',C ,y The Commonwealth of Massachusetts . Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass gov/dia Warkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aunlicaut Information Please Print Legibly Name(Business/Organization/Individual): &C 14%s iC 131k C'.APC� Address: I -C, t ns-il►"i t3 &t-. City/State/Zip: YA9AosLI A N4ft 6VAgone#: r' .3 Are you an employer?Check the appropriate box: Type of project(required): 1.CK I am a employer with_�( 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors b. ❑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' insurance.- 9• ❑ Building addition . [No workers comp.coinp. insurance required.] 5. We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 12.❑ Roof repairs 4 insurance required.]' c. 152,§1(4),and we have no employees. [No workers' 13.® OthcrXASQtjA oo comp.insurance required.] "Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. *Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. teontractors 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:C(4A ZT 15 f 0S kA !VI CE Policy#or Self-ins.Lic.#: U3 C ) - qj 1 Expiration Date: Z ( I Job Site Address: City/State/Zip: 4_4CLAA Attach a copy of the workers'compensation policy declaration page(showing the policy numbJr 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 d enalties erjury that the information provided above is true and correct Signature: Date: Phone#: � Official use onliy. Do not write in this area,to be completed by riry or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.'Other Contact Person: Phone#: • CERTIFICATE OF LIABILITY INSURANCE DATE(MtliilDDrr'YYY) 11/1/2010 NIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements). PROOUCM NAME: Shannon Sperrazza Risk Strategies Company PHONE . (781)986-4400 NpI.,(701)963-4420 15 Pacella Park Drive ADDRESS:ssperrazza@risk-strategies.com Suite 240 PRGDUCER p0O18476 Randolph MA 02368 INSURER(S)AFFORDING COVERAGE i NAIC# INSURED INSURER A:Seneca Specialty Insurance CO r �—^ INSURER a-KeatingGroup Ins Services Michael McCluskey, DBA: Cape Save INSURERC:Chartis Insurance _ 7 C Huntington Ave INSURER D: INSURER E: South Yarmouth MA 02644 INSURERF: - ----._._-. COVERAGES CERTIFICATE NUMBER:CL1011132675 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS f CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. `s EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR i TYPE OF INSURANCE POUCY EFF i POLICY EXP LTR; POLICY NUMBER M/ O i MMIDONYYY ; LIMITS GENERAL LIABILITY ' EACH OCCURRENCE $ 1,000,000 R COMMERCIAL GENERAL LIABILITY DAMAGE ENTED PREMISES EEa occsar moo) $ 50,000 A i CLAfMSaMADE ; (:OCCUR 8AG100260B 10/16/2010'10/16/201I — { !,MED EXP(Any one person) $ _ 10,000 PERSONAL&ADV INJURY 1,000,000 r— }GENERAL AGGREGATE j$ 1,000,000 GEN L AGGREGATE LIMIT APPLIES PER: i PRODUCTS-COMPIOP AGG ;S 1,000,000 X _POLICY,' .^PRO- LOC i $ t AUTOMOBILE tJABILITY i COMBINED SINGLE LIMIT $ 1,000,000 I(Ea accident) ANY AUTO r208200 11/6/2010 ':11/6/20i1 ALL OWNED AUTOS I BODILY INJURY(Per person) S X SCHEDULED AUTOS { OB D LY INJURY(Per aCcidem)': PROPERTY DAMAGE X HIREDAUTOS I ;(Peraxkent) `$ !�X NO"WHED AUTOS j S i }e i X UMIMLLA LIAS 1 v V �f OCCUR EACH OCCURRENCE IS 1,OOO,DOO t7tCES8LIA8 CLAIMS-MADE� I ; :AGGREGATE z ;S 1,000,000 DEDUCTIBLE B RETENTION $ 023578601 10/26/2010 i0/16/2011 i $ 'WORKERS CCOMPENSATIO111 i Michael McClusk ! WCSTATU- ER AND EMPLOYERS LIABILITY YIN' I _____T_ORY LIMITS' ER ANY PROPRIETORIPARTNERIEXECUTIVE i +is excluded from coverage. - j OFFICERIMEMBER EXCLUDED? ;NIA i ' E.L.EACH ACCIDENT !$ 500,000 (Mans inl ` f9930951 10/21/2010;10/21/20" EL DISEASE-EAEMPLOYE6$ 5001000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 I ! e � ) i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Issued as evidence of insurance. Contractors-Executive Supervisors or Executive Superintendents. CERTIFICATE HOLDER CANCELLATION (508)790-2425 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Housing Assistance Carp ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Ruth 460 West Main Street AUTHORIZED REPRESENTATIVE Hyannis, MA 02601-3698 chael Christian/SMSa<: ...r._ :.... ACORD 26(2009M) 01988-2009 ACORD CORPORATION. All rights reserved. INS025(20f)!?09) The ACORD name and logo are registered marks of ACORD 460 West gain Street HOUS ING Hyannis, [,LA- 02601-3698 S S I S TANCE ENERGY & HOME REPAIR T (508) 790-7106 F (508) 790- ORL OR-ATION 2425 HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE: PL e-d hM-f Fly d-A z THEAPPLICANT HOMEOWNER. I Cf. 41 AJ_� hereby consent to and agreethat weatherization work may be done by the Weatherization Program of Housing Assistance Corporation ( herein after referred as "Agen n) on the property located at: Theweatherization work donewill be based on programmatic priorities and availability of funding and it may include all or some of thefollowing measures: Weather-stripping& caulking of windows and doors, insulation of attics, sidEwalls& basements, attic and other ventilation measure—sand possibly repiacement of badly deteriorated windows In consideration of the weatherization work to be done at my home I agree to the following: 1. 1 give permission to the"Agency" its agents and employees to`travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reservesthe right to inspect thefuel or utility bill for the weatherized unit on an ongoing basisfor no morethan five(5) years after theweatherization work is completed. have read the provisions of this aqwement as listed and freely give my consent. h Home Owner: (Sgnature) t r Date. Q I ` 1 Agent: (signature) Date. HAC approved Weatherization Company All Cape Energy, Cahber Building&Remodeling, Cape Cod Insulation, Q�apSave,j Creswell Construction, Frontier Energy Solutions, Lohr&Sons, Peter Smith, Resolution Energy, Rock Solid Construction CAPE SAVE Weatherization, 508-398-0398 August 22, 2010 To Whom it May Concern: William J. Mcauskey is an employee of Cape Save. He is authorized to negotiate contracts and building permits for our.company. Michael Mccluskey cape save—owner 9i9-593-5939 cell X Huntington Avenue,South Yarmouth,MA 02664 �—s O&Mlzn�� 91te ffice of Consumer Affai s and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 164432 Type: Supplement Card CAPE SAVE Expiration: 10/6/2011 WILLIAM MUCCLUSLEY 8201 S. HOURD CT CHAPEL HILL, NC 27516 Update Address and return card.Mark reason for change. OPS-CA1 0 50ta-04!04-G101216 J Address Renewal � Employment Lost Card .y. ��ie menn�tFue r, ,1 Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ._ expiration date. If found return to before the ex : - •-�HOME IMPROVEMENT CONTRACTOR P Office of Consumer Affairs and Business Regulation RegIstration: 164432 Type: 10 Park Plaza-Suite 5170 Expiration: 10/612011. Supplement Card Boston,MA 02116 CAPE SAVE WILLIAM MUCCLUSLEY 7C HUNTING AVE.. S.YARMOUTH,MA 02VA -` — Undersecretary Not valid wi 1 signature Ala%sachusetts- Department of Puhiic ti.�fety f >ard of Building Retoulation,:tntl Statnd:►rds Construction Supervisor Speciaity License License: CS St_ 102776 Restricted to: IC W(LUAM MC CLUSKY mot' 37 NAUSET ROAD : WEST YARMOUTH, MA 02673 r Expiration: 6/2812013 +•eHrii.vm.r Tr#: 102776 ` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map J Parcel' Application Health Division Date Issued Z l� Conservation Division Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis /��7/�o Project Street Address S3 Scher 1 . Village S4 IA-Y)n l5 f - Owner lk oo5 )cI 1�7v!, AC.L Coo%0. Address C oc) C`qAy)h 15 MA Telephone�3-ag — _ 71 (209 57 n Permit Request emO lii2�� t(`zV1�R— �C�p� OYl �,�� 1— ( on� 'Ex 1 5+1r1!n, :7E�k�-k r,00►YN Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1000,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 200 S Historic House: 'Yes ❑ No On Old King's Highway: ❑Yes L§ Flo Basement Type: & ull YC"rawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) XIA Basement Unfinished Area (sq.ft) Number of Baths: Full: existing_0 new IV A- Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new N.4 First Floor Room Count Heat Type and Fuel: V'Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes UWIN' o Fireplaces: Existing O New Existing wood/coal stove: ❑Yes [k<o 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 A Yes ❑ No If yes, site plan review# Current Use G o 4vo,5 i n Proposed Use AM APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name HA FtVAMS Telephone Number SC7g'3c1y —&/ ?� Address t-d45T f�' RCx�K -0 License # 7 �f 9-55� < 4 A GQM 00T14 0/14 . Home Improvement Contractor# 0.21 t7 3 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �L��G�z � DATE F { FOR OFFICIAL USE ONLY i APPLICATION# If DATE ISSUED t } MAR/PARCEL NO.. -_ ADDRESS. VILLAGE ' OWNER T r DATE OF INSPECTION: 4:•FOUNDATION FRAME INSULATION.-' , r FIREPLACE ELECTRICAL: ROUGH FINAL I� PLUMBING: ROUGH FINAL GAS: LeV -ROUGH ix '' -�`� FINAL l f DATE CLOSED OUT ASSOCIATION PLAN NO. l i The Commonwealth of Massaehusetts Department of Industrial Accidents I' Office"of Investigations ' 600 Washington Street t / Boston, AM 02111 www.tnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le,-ibly Nalne (Business/Organization/Individual): �►�'(,A t�K. YCs 51,44-8 Rec)0v4-r1�s Address: 'C City/State/Zip: tQ Otiwl O' 73Phone #; `79 Are you an employer? Check the appropriate box: Type of project(required): 1. ❑ l am a employer with 4 [] I am a general contractor,and.I 6: ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet. 7.* Remodeling 6,4-111 I` ship and have no employees These sub-contractors have g, ❑.Demolition working for me in an capacity, employees and have workers' g Y P Y 9. ❑Building addition [No workers' comp. insurance " comp. insurance) t required.] 5. [] We are a corporation and its 10.0Electrical repairs or additions officers have exercised their 11. Plumbing repairs or additions 3.❑ I am a homeowner doing all work ❑ g P myself. [No workers'comp, right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees.[No workers' 13.0 Other comp, insurance required.] "Any applicant that checks box-#I must also fill out the section below showing their workers'compensation policy information: I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name.of the sub-contractors and state whether or not those entities have employees. Ifthe 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 andjob site information Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-yea!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 thepains andpenaQlties ofperjury that the information provided Jabove is true and correct Si nature �LIJ �A Date: / ,�� 7//0 Phone M EEfusely.,(D only. Do.not write in this area, to be completed by city or town official n: Permit/License# hority(circle one); Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector son: Phone#: Information and Instructions ._ Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling.house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance. requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit,is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write "all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e, a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 " Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia pp THE Tp� 0 F • HARNSMBLE, MASS. 1639. Town of Bal-astable �� Regulatory Services Thomas F. G.eiler, Director Building .Division Thomas Perry, CBO Building Commissioner 200'Main Street, Hyannis,'MA 02601 www.town.birnstable.ma.us Office: 508-862-4038 Fax 508-790-6230 Property Owner must Complete and Sign This Section Zf,Using A Builde et � T as Owner of the subject property hereby authorize ./7 al /� y1oCJ/� �4/ti�-S to.act.on my behalf, in all matters relative to work authorized by this budding permit application for: (Address of job) Signature of Owner. Date Print Name Ff Property Owner is applying for permit, please complete the Homeowners License Exempfion Form on the reverse side. QAWPFILMFORMSIbuilding permit formslEXPRESS.doc �F Reyi.e,d 072110 1t�ro� Town of Barnstable Regulatory Services " i3Aj#STAst�, toss. Thomas F. Ceiler, Director $ 16 : ° Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.ba rnsta b le.rn i.its Office: 518-86274038 Fax: 508-790-6230 --------------------------- HOMEOWNER LICENSE FXEMPTION Pleasc Print DATE: JOB LOCATION: number street village "HOMEOWNCR" name home phone N work phone N CURRENT MAILNG ADDRFSS: 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-yearperiod shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building.Official, that he/she shall be responsible for all such work performed under the building permit (Section 109,1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures.and requirements. Signature of Homeown.cr Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control, t . fIOMEOWNER'S EXEAfPTION '* i 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 ofconstruction 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 ofa supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.IS) 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 ofa Supervisor. On the last page of this issue is a form currently used by several towns. You,may care t amend and mi adopt such a fo /certiFication for use in your community. Q:WPFILESIFORMSIbuilding permit formslEXPRESS.doc Revised 072110 Massachusetts Department of Environmental Protection ■ �J Bureau of Waste Prevention o Air Quality 1100118328 B W P A Q 06 Decal Number Notification Prior to Construction or Demolition Important: A. Applicability When fillingou.t forms on the computer,use only the tab key A Construction or Demolition operation of an industrial, commercial, or institutional building, or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection alirsor-do not use the return (DEP), Bureau of Waste Prevention -Air Quality Control Regulations 310 C M R 7.09. Notification of key. Construction or Demolition operations is required under 310 CMR 7.09 (2)ten (10) days prior to any work being performed. The following information is required pursuant to 310 CM 7.09. r� B. General Project Description� ptn o 1. a. Is this facility fee exempt- city,town, district, municipal housing authority, owner-occupied Instructions residence of four units or less? ❑Yes ✓❑ No 1.All sections of b. Provide blanket decal number if applicable: this form must be Blanket Decal Number completed in order to comply with the 2. Facility Information: Department of HOUSING FOR ALL CORPORATION Environmental Protection a. Name notification 183 SCHOOL STREET requirements of b.Address 310 CMR 7.09 H annis IMA 102601 c.City/Town d.State e.Zip Code (508) 771-0885 f.Telephone Number(area code and extension) . E-mail Address(optional) 2,007 1 2 h.Size of Facility in Square Feet i.Numberof Floors j. Was the facility built prior to 1980? ✓❑ Yes ❑ No k. Describe the current or prior use of the facility: GROUP HOUSING _ 1. Is the-facility-a residential facility? ✓❑ Yes ❑ No m. If yes, how many units? 1 �o Number of Units 3. Facility Owner: �N HOUSING-FOR ALL CORPORATION �o a. Name �0 182 SCHOOL STREET b.Address HYANNIS IMA 1 102601 �tD c.Citv/Town d.State e.Zip Code �o (508) 771-0885 f.Teleohone Number(area code and extension) a.E-mail Address(ootional) d PAULHEBERT �Q h.Onsite Manager Name ■ ag06.doc•10/02 BWP AQ 06•Page 1 of 3 ■ Massachusetts Department of Environmental Protection 1 Bureau of Waste Prevention • Air Quality 000118328 B W P A Q 06 Decal Number Notification Prior to Construction or Demolition General Statement:If Description B. General Projectp 1(cont. asbestos is found during a 4. General Contractor: Construction or Demolition IMARK R.ADAMS 1 A & B RENOVATIONS operation,all responsible parties a. Name must comply with 124 FAST BROOK ROAD 310 CMR 7.00, b.Address 7.15,and Chapter of WEST YARMOUTH MA 02673 Cha General Laws of c.City/Town d.State e.Zip Code the Commonwealth. (508) 394.6179 pmadams24@comcast.net This would include,but would not be f.Telephone Number(area code and extension) Q. E-mail Address(optional) limited to,filing an MARK ADAMS asbestos removal h.On-site Manager Name notification with the Department and/or a notice of release/threatof release of C. General Construction or Demolition Description hazardous substance to the t. Construction or demolition contractor: Department,if applicable. MARK R.ADAMS 1 A & B RENOVATIONS a.Name 24 FAST BROOK RD. b.Address WEST YARMOUTH 102673 c.City/Town d.State e.Zip Code (508) 394.6179 pmadams24@comcast.net f.Telephone Number(area code and extension) g. E-mail Address(optional) MARK ADAMS h.On-site Manager Name 2. On-Site Supervisor: MARK ADAMS On-Site Supervisor Name 3. Is the entire facility to be demolished? E] Yes EJ No �N =0 4. Describe the area(s)to be demolished: �0 ONE SMALL INTERIOR BATH, 30 SQUARE FEET �N �O �0 5. Ifthis is construction project,describe the building(s)oraddition(s)to be constructed: �0 INTERIOR BATH ROOM REMODEL �0 �d �Q ag06.doc•10102- BWP AQ 06•Page 2 of 3 0 Massachusetts Department of Environmental Protection ■ LF�J Bureau of Waste Prevention • Air Quality 1100118328 B W P A Q 06 Decal Number Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.) 6. a. If this is a demolition project,were the structure(s) surveyed for the presence of asbestos containing material (ACM)? ❑ Yes Z] No If yes, who conducted the survey? b.S rvevor Name c.Division of Occupational Safety Certification Number 7. Construction or Demolition: 01/0112011 01/1412011 a.Start Date(mmidd/yyyy) b. End Date(mm/dd/yyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding ❑ paving ❑ wetting ❑ shrouding b. If other, please specify: ❑ covering ✓❑ other ISEALING WORK AREA AND COVERING 9. For Emergency Demolition Operations, who is the DEP official who evaluated the emergency? a.Name of DEP Official b.Title c.Date mm/ddlyyyy of Authorization d.DEP Waiver Number D..Certification "' I certify that I have examined the MARK R.ADAMS �o above and that to the best of my a. Print Name _o knowledge it is true and complete. IMARK R.ADAMS The signature below subjects the b.Authorized Signature =N signer to the general statutes JOWNER 1 CONSTRUCTION SUPERVISOR �o regarding a false and misleading c. osi ion ite �o statement(s). A & B RENOVATIONS d. Representing 12/17/2010 �(D e. Date (mm/ddlyyyy) �O -a _Q 1 aq 10/02 BWP AQ 06•Page 3 of 3 1♦ eDEP -MassDEP's OnlineFiling System Page 1 of 1 MassDEP Home.I Contact Feedback .I Tour I Privacy Policy -MassDEP's Online FilingSystem Usemame:ABMARK Nickname:MARKA i My eDEPI Formstml My ProfileO Help Receipt Fccm Simatkue Payment Receipt Summary/Receipt e print receipt Exit Your submission is complete.Thank you for using DEP's online reporting system.You can select"My eDEP"to see a list of your transactions. DEP Transaction ID:356113 Date and Time Submitted:12/17/2010 2:37:18 PM Other Email: Form Name:AQ 06-Construction/Demolition Notification Payment Information DEP code:51502 Date:12/1 7/201 0 2:35:34 PM Amount($):85 Payment Detail:ADAMS MARK--AccountType--AccountNumber****3735 ConfirmationNumber. Contractor Contractor Number Name Address,, Supervisor -Project Monitor Lab My eDEP MassDEP Home J Contact I Feedback J Tour J Privacy Policy -MassDEP's Online Filing System ver.9.9.9.00 2010 MassDEP https://edep.dep.mass.gov/Pages/PrintR=ipt.aspx 12/17/20.1.0 Town of Bainstable Building Department - 200 Main Street ^B Hyannis, MA 02601 MASS 1639. , (508) 862-4038 ArFD��A f Certificate 0 Occupancy Application Number: 20063930 - CO Number: 20070006 Parcel ID: 327249 CO Issue Date: 01117/07 Location: 83 SCHOOL STREET Zoning Classification: MEDICAL SERVICES DISTRICT Proposed Use: RESIDENTIAL Village: HYANNIS Gen Contractor: BAYSIDE BUILDING, INC Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: — � f -7 0 -7 Building Department Signature Date Signed a INI tssachusetts- Department of Puhlic SafetN - Board of Building Regulations and Standards Construction Supervisor License License:"cS 74295 Restricted.to: 00 MARK R ADAMS 24 FASTBROOK RD r 'F W YARMOUTH, MA 02673 --�- �� Expiration: 3/1/2011 ('onunissiuner . Tr#: 12553 ., _._.✓�ie T�o7i�reo�teu•..`. _,,_�_`�a4aC�c�iu0e�-V.Office of Consumer Affair&B�iness Regulation HOME IMPROVEMENT CONTRACTOR Registration: -135899 Type: Expiration: -5E1E7%2012 DBA A+ ENOVATIONEV�- MARK ADAMS � 24 FA STBROOK R13� }1}. W.YARMOUTH, MA �— J Undersecretary V x 9K e � :77 >a�' 114 4 y; ,' x A� " �° a°°��u!Q License or registration valid for individul use onl O y Office of Consumer Affairs&B si s Regulation; ! HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration:_, -1.35899 Type: . Office of Consumer Affairs and Business Regulation Expiration 5l1=7/2012 DBA 10 Park Plaza-Suite 5170 �es Boston-MA 02116 A+ ENOVATIO;NS � r l z PJIARK ADAMS f �E 24 FASTBROOK RD`` �r _ V1f.YARMOUTH,MA 02673 Undersecretary Not.valid without signature e TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map- <34 Parcel C�I/q Application# � Health Division oW� Conservation Division Permit# Tax Collector Date Issued `2 p G' Treasurer Application Fee (/ Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address ��CN�aG- S :' f t1 ; l jr--"`" , Village 4.1 Owner idd-5IAIa P—Q&dLL CaR1?, Address �'� .5�46G 5� NY19Av,1lS Telephone 5 i' 7-91 " j' Permit Request 7)1r/w/7ld/V a/— �'f1 '�(� a9� Gd t6'57,41U-1C1X Ulf Zfo .x Z C&E 4/17r`i/ Fb 815iFi4�X17:-- %A,04C 6 6e ble6aA /3 79�7-t6� Square feet: 1 st floor:existing _ proposed dL 2nd floor:existing o proposed 500 Total new l/ y Zoning District Flood Plain Groundwater Overlay f' Project Valuation $/6 . W o Construction Type 4�)@O b r-k'4 171E Lot Size '0 QlO Grandfathered ❑Yes CAo If yes, attach supporting documentation. " Dwelling Type: Single Family 01 Two Family ❑ Multi-Family(#units) Age of Existing Structure PEW Historic House: ❑Yes Vl o On Old King's Highway: ❑Yes W<o Basement Type: Wfull ❑Crawl ❑Walkout• ❑Other Basement Finished Area(sq.ft.) �oa�� Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new 3 Half:existing new Number of Bedrooms: existing O new y Total Room.Count(not including baths):existing new First Floor Room Count 3 Heat Type and Fuel: &Gas . ❑Oil O Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New_ Existing wood/coal stove: O Yes GYI�o Detached garage:❑.existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size_ Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: ' fY t C, c; 2� l� Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ �� w70 Commercial ❑Yes Ct�'N0 If yes,site plan review# ;, > Current Use Proposed Use e95 /JeN BUILDER INFORMATION Name- 6AY5/M 13 y 1Lb-/A-6" ! Al C Telephone Number 277 (1 Val Address A 10. 60'x 9 License# 005,6 / A17YA V lL&, A41A. „4QO2.Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 157Eo�b k1IC6F SIGNATURE C - DATE Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division w BMWSTA13U, 9� `0$ Tom Perry,Building Commissioner iOTFo Mpv° 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fa�rrj 508-790-6230 Approved: ;1 Fee: _ Permit#: y,5 HOME OCCUPATION REGISTRATION Date: 3 Name: Phone#: Address<ts r C k o a l 5' Village: �n 11 I5 Name of Business:5DeC 1 o A`Z P_0 SeF✓`o e S Type of Business: /1 e f /�(Of `�P 11C'--e Map/Lot 3a rZ a � � INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: �� - • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within ' that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,' odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • ' If the Customary Home Occupation is listed or advertised as a business,the street address shall not be, included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersign@d, v - ad and agree with the above restrictions for my home occupation I am registering. ant•ApplicA Date: Homeoc.doc Rev.5/30/03 TO ALL NEW BUSINESS OWNERS DATE: , Fill in please: , x YOUR NAME: I(�opmas' lice APPLICANT'S YOUR HOME.ADDRESS: �S Sc hoc S s w BUSINESS ,` F/.taut vt �s ✓t-{ a�Coc�� y �S-39 TELEPHONE Telephone Number Home ' NAME OF NEW BUSINESS PG t a �' TYPE OF BUSINESS IS THIS A HOME OCCUPATION?AYES �NO Have you been given approval from the buildin division? YES NO'� '� MAP/PARCEL NUMBER ADDRESS OF BUSINESS S c �c When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of: 4 Barnstable: This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed below,you may apply for a business certificate at the Town Clerk's Office (Ist floor.-Town Hall) or if you get the business certificate first you MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) and you will find the following offices _ 4 c - 1. BUILDING COMMISSIONER'S FICE `- This individual has b n informed f y permit requirements that pertain to this type of business. - €x uthorize Signature** COMMENTS: �r 2. BOARD OF H ALT b" This individual ha be n infor of he pe i requir is that pertain to this type of business u orized ignatur COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business., Authorized Signature** a COMMENTS:' Business certificates (cost$30.00 for 4 years). A business certificate ONLY.REGI 11 STERS YOUR NAME in;the town (which you must do by-M.G.L. -it does not give you permission to operate-you must get that through completion of the processes from the various�departmentsinvolved., Ty` d S l **S/GN/F/ESAPPROVAL FORA BUS/NESS CERTIFICATE ONL Y. Il pp 1yHggE The Town ®f Barnstable P� p. BARNSTABLE. • Department of Health Safety and Environmental Services MASS. 039. �0 pTFD MA'S s. Building Division . 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location ' sCl L�L— Permit Number Owner Builder One notice to remain on job site,one notice on file in Building Department. The following items need correcting: 6 X /- O y[5 k 5P19-NN&t1 7 F HAX 5JPJ*q 5 T-A I P--S 7V C ® J C — C e— ® kt Please call: 508-8�6j2-4038 for re-inspection. Inspected by `d Date f (o TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map (34 Parcel 0��1 Application# 6 0d / I Health Division s 2 00 99 3() I Conservation Division D) 11 Permit# Tax Collector Date Issued Treasurer Application Fee 7(/ Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address , Village Oq � Owner tiD(f5IA/d E�)��LL C'(,g8 Address -5G1fhf1_ 57 Telephone SAD 77/ " 6 Permit Request 7�rMd'L/'TAQA/ Or f1 G'A��6� 4AO CJ t1t57XaC7-,`DA/ GC 4 24 'X G Y' -� 3 Fv� i3rzs Square feet: 1st floor:existing to proposed (�2Y 2nd floor:existing 0 proposed 500 Total new Zoning District 13 Flood Plain Groundwater Overlay Project Valuation 46 A 7. 90Y Construction Type wOO b f44IVE Lot Size %0. 06 ` Grandfathered: ❑Yes olio If yes, attach supporting documentation. Dwelling Type: Single Family 0' Two Family ❑ Multi-Family(#units) Age of Existing Structure PEW Historic House: ❑Yes Vk On Old King's Highway: ❑Yes id<o Basement Type: Wfull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) &:zq 91 Basement Unfinished Area(sq.ft) Number of Baths: Full:existing 0 new Half:existing new Number of Bedrooms: existing D new Total Room Count(not including baths):existing D new -7 First Floor Room Count 3 Heat Type and Fuel: Sr/Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing 0 New _ Existing wood/coal stove: ❑Yes ' o Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: n c7 "`: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ N Commercial ❑Yes Cta1Vo If yes,site plan review# ca Current Use Proposed Use BUILDER INFORMATION 5` vim. �`fl /0Z+ oZ Name ,�,3/4Y5/M i3 y 1Gb/AJ6'0 ! VC Telephone Number -771— tow Address A a License# 005-6 y5' C�N7YA V lLL-F'g IWA• M-026132 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO � .�/�6Ul.G L-�i✓� ��-- SIGNATURE DATE �U�/7/0,6 FOR OFFICIAL USE ONLY ' PERMIT.NO. DATE ISSUED MAP/PARCEL NO.' ADDRESS VILLAGE i ' OWNER t DATE OF INSPECTION: i 1 1 FOUNDATION 1 L l 6 6 ' FRAME �L — S �•1� � l �'_ �a-ca �v �- off INSULATION FIREPLACE 4 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL i r FINAL BUILDING DATE CLOSED OUT ? ASSOCIATION PLAN NO. ' r i BC -J PM I� I � xis/✓ - _ 3 itii_ II � �� `4 �.. ` ,w:s .,. Y � ,� `---a�� .._.. --. , — -• . a �. ,. � .. � � r ,�i �� `. � "l .e ._ � ,_. �� `. ... w... z ° a �� i �� e x a iJ1� e a ,. c _ S !i ' i. 5.w }� I 1 � � ` �± � � � i � a ." ` cw �� Y ��f � .. BO1SE, Triple 1-3/4" x 9-1/2"' VERSA-LAM® 2.0 3100 SP Floor Beam\FB01 BC CALC® .3 Design Report-US 1 span No cantilevers 0/12 slope Thursday, November 02, 2006 12:54 Build 057 File Name: BC CALC Project Job Name: Cottage Description: BASEMENT Address: 83 School Street F Specifier: City, State,Zip: Hyannis, MA Designer: Joe Madera Customer: Champ Homes Company: Shepley Wood Products Code reports: ESR-1040 Misc: ta a` 12-04-00 BO,3-1/2" 131,3-1/2" LL 2960 Ibs LL 2960 Ibs DL 1197 lbs DL 1197 Ibs Total Horizontal Product Length=12-04-00 Load Summary Live Dead Snow Wind Roof Live Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% Trib. 1 Standard Load Unf.Area(psf) Left 00-00-00 12-04-00 40 15 12-00-00 Controls Summary Value %Allowable Duration Load Case Span Location Disclosure Pos. Moment 11881 ft-Ibs 56.7% 100% 1 1 -Internal Completeness and accuracy of input must End Shear 3426 Ibs 36.2% 100% 1 1 -Left be verified by anyone who would rely on Total Load Defl. U354(0.402") 67.7% 1 1 output as evidence of suitability for Live Load Defl. U498 (0.286") 72.3% 1 1 particular application.Output here based 0.4 02" 40.2% 1 1 on building code-accepted design Max Defl. Span/Depth 0.40 n 1 properties and analysis methods. P P Installation of BOISE engineered wood products must be in accordance with %Allow %Allow current Installation Guide and applicable Bearing Supports Dim.(L x M Value Support Member Material building codes.To obtain Installation Guide BO Post 3-1/2"x 3-1/2" 4157 Ibs 46.8% 45.2% Spruce-Pine-Fir ask questions,please call (8 B1 Post 3-1/2"x 3-1/2" 4157 Ibs 46.8% 45.2% Spruce-Pine-Fir 00)232-0788 before installation. BC CALC®, BC FRAMER®,AJSTM', • Cautions ALLJOISTO,BC RIM BOARD- BCI®, BOISE GLULAM- SIMPLE FRAMING Member is not fully supported at post BO. A connector is required at this bearing. SYSTEM®,VERSA-LAM®,VERSA-RIM Column at Bearing BO analyzed for bearing only,column analysis has not been performed. PLUS®,VERSA-RIM®, Member is not fully supported at post B1. A connector is required at this bearing. VERSA-STRAND®,VERSA-STUD®are Column at Bearing B1 analyzed for bearing only,column analysis has not been performed. trademarks of Boise wood Products, L.L.C. Notes Design meets Code minimum(U240)Total load deflection criteria. Design meets Code minimum(U360) Live load deflection criteria. Design meets arbitrary(1") Maximum load deflection criteria. Connection Diagram tb d a o o c e 0 0 0 a minimum=2" c=5-1/2" b minimum= 3" d= 12" e minimum=3" Member has no side loads. Connectors are: 16d Common Nails Page 1 of 1 BOISE- Triple 1-3/4" x 9-1/2" VERSA-LAM® 2.0 3100 SP Floor Beam1F1302 BC CALCOA.3 Design Report-US 1 span.1 No cantilevers 1 0/12 slope Thursday, November 02, 2006 12:54 Build 057 File Name: BC CALC Project Job Name: Cottage Description: SECOND FLOOR Address: 83 School Street Specifier: City, State,Zip: Hyannis, MA Designer: Joe Madera Customer: Champ Homes Company: Shepley Wood Products Code reports: ESR-1040 Misc: 12-04-00 BO,3-1/2" 61,3-1/2" LL 2960 Ibs LL 2960 Ibs DL 827 Ibs DL 827 Ibs Total Horizontal Product Length=12-04-00 Load Summary Live Dead Snow Wind Roof Live Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% Trib. 1 Standard Load Unf.Area(psf) Left 00-00-00 12-04-00 40 10 12-00-00 Controls Summary Value %Allowable Duration Load Case Span Location Disclosure Pos. Moment 10823 ft-Ibs 51.7% 100% 1 1 -Internal Completeness and accuracy of input must End Shear 3121 Ibs 32.9% 100% 1 1 -Left be verified by anyone who would rely on Total Load Defl. U389(0.366") 61.7% 1 1 output as evidence of suitability for Live Load Defl. U498 (0.286") 72.3% 1 1 particular application.Output here based Max Defl. 0.366" 36.6% 1 1 on building code-accepted design Span/Depth 15.0 n/a 1 properties and analysis methods. p P Installation of BOISE engineered wood products must be in accordance with %Allow %Allow current Installation Guide and applicable Bearing Supports Dim.(L x W) Value Support Member Material building codes.To obtain Installation Guide BO Post 3-1/2"x 3-1/2" 3787 Ibs 42.6% 41.2% Spruce-Pine-Fir (8 ask questions,please call B1 Post 3-1/2"x 3-1/2" 3787 Ibs 42.6% 41.2% Spruce-Pine-Fir 00)232-0788 before installation. BC CALCO,BC FRAMER®,AJS-, Cautions ALLJOISTO, BC RIM BOARD- BCI®, BOISE GLULAMT"^ SIMPLE FRAMING Member is not fully supported at post BO. A connector is required at this bearing. SYSTEM®,VERSA-LAM®,VERSA-RIM Column at Bearing BO analyzed for bearing only, column analysis has not been performed. PLUS®,VERSA-RIM®, Member is not fully supported at post B1. A connector is required at this bearing. VERSA-STRAND®,VERSA-STUD®are Column at Bearing B1 analyzed for bearing only, column analysis has not been performed. trademarks of Boise Wood Products, L.L.C. Notes Design meets Code minimum(U240)Total load deflection criteria. Design meets Code minimum(U360) Live load deflection criteria. Design meets arbitrary(1") Maximum load deflection criteria. Connection Diagram b d a • • • 7 177 o o c e 0 0 0 a minimum=2" c= 5-1/2" b minimum=3" d= 12" e minimum= 3" Nailing schedule applies to both sides of the member. Member has no side loads. Connectors are: 16d Common Nails Page 1 of 1 d z", ( 2- - 4 4- rr r A-9 ffl4 C-0 V l� COMMONWEALTH OF'MASSACHUSETTS . . . o ••. . mom 0 .. t 1C1 . NN ' AS A Rse J0U IStUES.THIS LICENSE TO ROBRfi Fifi �'A1` ICK; ° 17 CARDINAL ROA6 + M:A- 02563= 331 .` SANDWICH l i Ql/SVO 9�9�0 N ],$758 E HARRY ASHLEY PLUMBING & HEATING 35 FULLER'S MARSH RD. COTUIT, MA: 102635 M. P. .8061 428-5875 J ' Xv,"k4, . x ' -- - •---- rn r"Ill i n WH i tK 5Y 5 i tM 508 790 1313 P.01/01 da Department of Public Works 47 Old Yarmouth RdL 326 Water Suppiy Division P.O.Box Hy .MA � Z annf��MA. � 02801.03ft NAM T'EU 500-775-OM .6 h Hyannis Water System Operations FAR:50e-"0-1313 October 19, 2006 Town of Barnstable Building Inspector Town Hall Hyannis,MA 02601 RE: Service# Garage @ 83 School Street . Dear Sir: Please be advised that there is no water service to the garage at#83 School Street. The owner has informed us of plans to demolish the building. Sincerely, ayne Starck Hyannis Water System WNW*~•ti Ndchu k TOTAL P.01 OCT 19,2006 04;05P 508 790 1313 page 1 ,p Ed Marshall From: "Linda Bradstreet'<btohope@yahoo.com> To: "Ed Marshall" <marshall.e@comcast.net> Cc: "Paul Hebert' <hfac@champhouse.org> Sent: Thursday, October 19, 2006 9:25 AM Subject: Demolition-October 24th Ed, Paul called with the Dig Safe Ticket #20064207346. No work is to begin until 8:00 a.m. on Tuesday, October 24th. Paul will call you directly about the letters from the plumber and electrician. He is confident that the Building Department will be more than satisfied with Dig Safe coming out and you will not have any problems getting the permits needed. Even though there is no electricity or heat in the building, there still could be other lines around that area that need to be protected. Better to be safe than sorry. Linda Do you Yahoo!? Get on board. You're invited to try the new Yahoo! Mail Beta. r 10/19/2006 Client#: 15273 2BAYSIDEBU ACORD� CERTIFICATE OF LIABILITY INSURANCE 10119/ot°°"Y"Y' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 222 West Main St.PO Box 1990 Hyannis,MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Acadia Insurance Bayside Building,Inc.and INSURER B: Fireman's Companies Bayside Design&Remodeling,Inc. INSURERC: PO BOX 95 INSURER D: Centerville,MA 02632 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE MM DD/YY DATE MM/DD/YY A GENERAL LIABILITY CPA007340914 01/01/06 01/01/07 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTPREMISES(Ea occEDrencel $250 OOO CLAIMS MADE 51 OCCUR - _ MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1 000 000 X OCP GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY PRO LOC JECT B AUTOMOBILE LIABILITY MAA130145414 01/01/06 01/01/07 COMBINED SINGLE LIMIT $1,000,000 ANY AUTO (Ea accident) ALL OWNED AUTOS - BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) X Drive Other Car PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY - AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY - EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION AND WCA007340614 01/01/06 01/01/07 1 TORY WC STATU- OTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT Is500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS JOB:Champ House,83 School St., Hyannis, MA.02601 Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable, Building DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL _ 10_ DAYS WRITTEN Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 200 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Hyannis,MA 02601 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001108)1 of 3 #44889 NS2 © ACORD CORPORATION 1988 S IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer,and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. f ACORD 25S(2001/08) 2 of 3 #44889 DESCRIPTIONS (Continued from' Page.1a) coverage provided by the policy provisions. AMS 25.3(2001/08) 3 of 3 #44889 b Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111'. `'4 Y•' www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electridans/Plumbers kpplicant Information Please Print Legibly ame (Business/organization/individual): ��"��> 1 Bo lzl /y ( I AIC ddress: ity/State/Zip: (FAIW 2i IUF Phone#:_ 77/—:/j 0 ,re you an employer? Check the-'appropriate box: Z*Ype of Droject(required): ❑ I am a employer with 4, []'I am a general contractor and I 6• Tew construction employees(full•and/or part-time)-* _ have hired the sub-contractors[] 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: g• Building addition [No workers' comp.insurance 5• ❑ We'are.a corporation and its 10.❑ Electrical r airs or.additions required.]-------— ——- ❑ I am a homeowner doing all work right of exemption per MGL mm PIumbing 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.] ,y applicant that checks box#1 must also 511 out the section below.showing their workers'compensation policy information omeowners who submitthis affidavit indicating they are doing all work end then hire outside contractors must submit anew affidavit indicating such ntractors that check this box must attached as additions]sheet showing the name of the sub-contractors and their workers'comp,policy information. . m an employer that is providing workers'compensation insurance for my employees.'Below is the policy and job site brmation. urance Company Name: 1�(d4 ��✓� --� �� d dcy#or Self-ins.Lie.#: 66 3- to 6 — l® Expiration Date: ka 2 Site Address: S3 •SGJ V ,5 r City/State/Zip: {yi4 it4/6 (/Y/ 'ach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). lure to.secure coverage as required under Section 2SA of MGL c. 152 can lead to the imposition of criminal penalties of a e 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 ip to$250.00 a day against the violator. Be advised that a copy of this statemmf maybe forwarded to the Office of estigations of the DIA for insurance coverage verification. hereby certifyu der the p sand penalties of perjury that the information provided above is and correct. nature:. Date: ,ne#:. Official use only. Do not write in this area,to be completed by city or town offcc* City or Town: Permit/License# . Issuing Authority(circle one): L.Board of Health L.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector i. Other �ontact Person: Phone#: Town of Barnstable Regulatory Services 9 `NSTABM MASS �; Thomas F.Geiler,Director �'OEED Mai p�0 Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1 i, ��k dt k � a T 011 t7 F/q C , as Owner of the subject property hereby authorize 0-c S I de- D U l l d i K 1 to act on my behalf, in all matters relative to work authorized by this building permit application for: 8 3 Sc lu,-0 / S f 1 0�1�S �f e 0 (Address of Job) l a//6 16 C Signature cW Owner 1 Date i0 K Print Name Q:FORM&OWNERPERMISSION i MAScheck COMPLIANCE REPORT I, Massachusetts Energy Code ( Permit # MAScheck Software Version 2.01 Checked by/Date CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 10-17-2006 DATE OF PLANS: 6/20/2006 TITLE: 83 SCHOOL STREET COTTAGE PROJECT INFORMATION: CHAMP HOUSE - HOUSING FOR ALL CORP COMPANY INFORMATION: BAYSIDE BUILDING, INC. COMPLIANCE: PASSES Required UA = 224 Your Home = 207 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 624 38.0 0.0 19 WALLS: Metal Frame, 24" O.C. 1542 19.0 0.0 135 GLAZING: Windows or Doors 120 0.350 42 GLAZING: Skylights 10 0.400 4 DOORS 21 0.350 7 ------------------------------------------------------------------------ COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date v MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software 'Version 2.01 83 SCHOOL STREET COTTAGE DATE: 10,17-2006 Bldg. 1 Dept. 1 Use CEILINGS: [ ] 1. R-38 Comments/Location WALLS: [ ] 1. Metal Frame, 24" O.C. , R-19 Comments/Location WINDOWS AND GLASS DOORS: ( ] 1. U-value: 0.35 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location SKYLIGHTS: [ ] 1. U-value: 0.4 For skylights without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: [ ] 1. U-value: 0.35 Comments/Location AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures shall meet one of. the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: [ ] Required on the warm-in-winter side of. all non-vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] Ducts shall be insulated per Table J4.4.7.1. DUCT CONSTRUCTION: [ ] All accessible joints, seams, and connections of supply and return ductwork located outside conditione d space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. [ ] SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless .over 20% of the heating energy is from non-depletable sources: Pool pumps require a time clock. [ ] HVAC PIPING INSULATION: HVAC piping.conveying fluids above 120 F or chilled fluids below 55' F must be insulated to the following levels (in.) : I PIPE SIZES, (in.) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-411 Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 Low temperature 120-200 0.5 1.0 1.0 1.5 Steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant below 40 1.0 1.0 1.5 1.5 i [ ] CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in.) : PIPE SIZES (in.) NON-CIRCULATING CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F) : RUNOUTS 0-111 0-1.2511 1.5-2.0" 2.0+" 170-180. 0.5 1.0. 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only) ----=-------------------- f _ s RESIDENTIAL BUILDING PERMIT FEES • APPLICATION FEE New Buildings $100.00 0 Residential Addition $50.00 Alterations/Renovations $50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE � c square feet x$96/sq.foot=_16 7, d a x .0041= 6 �` I plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0041= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck �_x$30.00= �d• O( (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 Projcost Rev:063004 BOARD OF BUILDING REGULATIONS +; _+ License: CONSTRUCTION SUPERVISOR i Number: CS 005645 Expires 04/19/2008 Tr.no: 21766 • ` . r st t � Restricted 00 BRIAN T DACEY } PO BOX 95 �� /f 1 CENTERVILLE, MA 02632 Commissioner Q -- --- Q r n r r � r r n r r r October 17th, 2006 r� Western Surety Companyr r r � n r r LICENSE AND PERMIT BOND n r n r n r r KNOW ALL PERSONS BY THESE PRESENTS: Bond No. 14901650, r n r n r 5 Thatwe, Bayside Building, Inc. n r n r n of the village of Centerville State of Massachusetts as Principal, n and WESTERN SURETY COMPANY, a corporation duly licensed to do surety business in the State of n Massachusetts as Surety, are held and firmly bound unto the Town of Barnstable,Building Inspector , State of Massachusetts as Obligee,in the penal sum of Three Hundred Forty-Four and 00/100 .DOLLARS ( $344.00 ) lawful money of the United States, to be paid to the Obligee, for which payment well and truly to be made, we bind ourselves and our legal representatives, firmly by these presents. THE CONDITION OF THE ABOVE OBLIGATION IS SUCH, That whereas, the Principal has been licensed General Contractor- 83'School Street, Hyannis, MA 02601 by the Obligee. NOW THEREFORE, if the Principal shall faithfully perform the duties and in all things comply with the laws and ordinances, including all amendments thereto, pertaining to the license or permit applied for, then this obligation to be void, otherwise to remain in full force and effect until October 17th 2007 unless renewed by Continuation Certificate. This bond may be terminated at any time by the Surety upon sending notice in writing, by First Class U.S.Mail, to the Obligee and to the Principal at the address last known to the Surety, and at the expiration �tc�ae of th t ��4.ays from the mailing of said notice, this bond shall ipso facto terminate and the Surety shfih reitl5trr�. glieved from any liability for any acts or omissions of the Principal subsequent to said dad . e number of years this bond shall continue in force, the number of claims made a s bo ; athe number of premiums which shall be payable or paid, the Surety's total limit of 1bT ty shall not b4 ulative from year to year or period to period, and in no event shall the Surety's total r li i y o laf exceed the amount set forth above. Any revision of the bond amount shall not be r r cu r `a��r;Od��3u�06618�� Dated this 17th day of October 2006 r r n r n r r - . Bayside Bui 'ng, Inc. r CORPORATE 9 r Principal r r I r r r r Principal r . n "Countersigned(where required) WE S T E SJUE T COMPANY n r n r n r B,/ By 9 Resident Agent Pa . T.Bruflat,SeAor Vice President Form 532-2-2006 r n r r r n r n ACKNOWLEDGMENT OF SURETY STATE OF SOUTH DAKOTA ss (Corporate Officer) COUNTY OF MINNEHAHA On this 17th day of October 2006, before me,the undersigned officer, personally appeared Paul T.Bruflat who acknowledged himself to be the aforesaid officer of WESTERN SURETY COMPANY, a corporation,and that he as such officer,being authorized so to do,executed the foregoing instrument for the purposes therein contained, by signing the name of the corporation by himself as such officer. IN+ '� SbF� F�ObF�;�kave hereunto set my hand and official seal. S. PETRIK p NOTARY PUBLIC SEAL s J�SOUTH DAKOTA o�c a tart'Pubhc-South Dakota �bbbbbbbbb4bbbbbbbbbbbbb} My Commission Expires August 11,2010 ACKNOWLEDGMENT OF PRINCIPAL STATE OF ss (Individual or Partners) COUNTY OF On this day of before me personally appeared known to me to be the individual _described in and who executed the foregoing instrument and acknowledged to me that—he—executed the same. My commission expires Notary Public ACKNOWLEDGMENT OF PRINCIPAL STATE OF (Corporate Officer) COUNTY OF ss On this day of before me personally appeared who acknowledged himself/herself to be the of a corporation,and that he/she as such officer being authorized so to do,executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himself/herself as such officer. My commission expires Notary Public O W U o a Z A a a O o c Z z a o > .� ° 0 a 0 n w Western Surety Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That WESTERN SURETY COMPANY, a corporation organized and existing under the laws of the State of South Dakota, and authorized and licensed to do business in the States of Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, and the United States of America,does hereby make,constitute and appoint Paul T. Bruflat of Sioux Falls State of South Dakota its regularly elected Senior Vice President as Attorney-in-Fact,with full power and authority hereby conferred upon him to sign, execute, acknowledge and deliver for and on its behalf as Surety and as its act and deed,the following bond: L & P Bond, Signed - General Contractor- 83 One School Street, Hyannis, MA 02601 bond with bond number 14901650 for Bayside Building, Inc. as Principal in the penalty amount not to exceed: $ 344.00 Western Surety Company further certifies that the following is a true and exact copy of Section 7 of the by-laws of Western Surety Company duly adopted and now in force,to-wit: Section 7. All bonds,policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary,Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys-in-Fact or agents who shall have authority to issue bonds, policies,or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds,policies,undertakings,Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by its Senior Vice President with the corporate seal affixed this 17th day of October 2006 ATTEST WEST /BURET COMPANY By G.� L.Nelson,Assistant Secretary Paul T.Bruflat enior Vice President 0 STATE OF SOUTH DAKOTA COUNTY OF MINNEHAHA ss tp On this 17th day of October 2006 before me,a Notary Public,personally appeared Paul T. Bruflat and L. Nelson who,being by me duly sworn,acknowledged that they signed the above Power of Attorney as Senior Vice President and Assistant Secretary, respectively, of the said WESTERN SURETY COMPANY, and acknowledged said instrument to be the voluntary act and deed of said Corporation. +��,Sb��Sss�,4a�yaaaowygti��+ r D. KRELL aSE L NOTARY PUBLIC(SEAL IS a SOUTH DAKOTA s 4yhyyyh�,a��aby�hy��h��a.+ Notary Public My Commission Expires November 30,2006 os Form F1975-3-2006 �aN rr .� Subcontractors Insurance Certificates As of 5/16/2005 Sub Contractor General Liability Workers Comp 2005 Status A Concrete Answer 06/28/03 06/28/05 08/27/03 08/27/05 508-420-1997 OK Concrete work Airtech 7/25/03 07/25/05 9/19/03 9/20/05 508-945-2466 OK Copper All Cape Garage Door 6/1/03 6/1/05 6/l/03 6/1/05 508-398-2757 OK Garage doors Aluminum Products of Cape 8/15/03 08/15/05 8/15/03 8115105 508-394-8546 OK Storms, screens, gutters American Floors 3/4/03 03/04/06 508-362-6400 OK Oak floors Brian Tracey Arne Excavating & Paving 7/14/04 7/14/05 7/30/04 I 7/30/05 508-748-2060 OK Excavation James Arne Assurance Excavation Inc 08/01/03 08/01/05 11/20/03 12/24/05 508-771-7410 OK Excavation Res. Mamt Res. N/lamt Jeff Brown Atlantic Kitchen and Bath 04/01/05 04/01/06 04/01/05 04/01/06 Bob Gluskin OK ATC Ceiling Systems 8/8/02 8/8/05 10/3/03 10/3/05 508-420-2053 OK Suspended ceilings Alan Conlon Averinos. Anthony 7/20/03 04/06/05 7/20/03 7/25/05 508-362-2762 Requested new GL certificate Tile Baltic Security 5/6/03 5/6/05 508-833-0996 Has exemption from state for worker's Alarms comp insurance. Requested gl certificate Pale 1 5/16oi5 i Baxter Inc 8/1/03 8/1/05 10/6/03 10/6/05 508-775-0375 OK Frame Labor Baxter,Nye & Holmgren 01/25/04 1/27/06 8/20/04 8/20/06 508-428-9131 OK Engineers Bayside Electrical Contr. 10/05/04 10/05/05 08/18/04 08/18/05 508-771-7270 OK ECectric%an Bortolotti Construction 3/7/03 3/7/06 3/7/03 3/7/06 508-771-9399 OK Fill, loam Boston Closet Co 11/16/04 11/16/05 11/16/04 11/16/05 Moe Delaney OK BSC Group 01/01/04 01/01/06 01/01/04 01/01/06 508-778-8919 OK Survey ors Budden , Robert W. l/1/04 1/1/05 2/20/03 2/15/05 508-775-3988 Requested updated certificates ` Oak floors Cabral's Masonry 11/10/04 11/10/05 8/20/04 8/20/05 Michael Cabral OK Campbell, William 8/26/04 8/26/05 7/13/04 7/13/05 508-790-3517 OK Painter c:508-367-1238 Cape Cod Closet Systems, 06/30/04 06/30/05 06/30/04 06/30/05 508-888-4376 OK Mattes, Ronald J. Closets Cape Cod Concrete Pumping 1/l/04 09/01/05 9/l/03 9/l/05 508-420-2800 OK Cape Cod Fireplace Shop 4/5/03 4/5/04 11/30/03 11/30/03 508-775-2511 Requested updated certificates Gas log Cape Golf Construction, 4/22/04 4/22/06 4/11/04 4/11/06 508-362-3005 OK Tom Kennedy Excavation Carpet Barn Inc 111105 l/l/06 111105 1/l/06 508-548-1443 OK Carpets Central Vacuum House 12/01/04 12/01/05 12/01/04 12/01/05 508-420-5622 OK Div of EF Winslow Plumb & cl: 508-826-0029 Heating Inc Eric Branzetti Central Vacuum Chaves, Robert 08/13/04 08/13/05 12/17/04 12/17/05 508-362-9929 OK ECectrician City Crane 07/29/04 07/29/05 08/10/04 08/10/05 OK Frame Labor Clancy, John 07/01/04 " 07/01/05 10/01/04 10/01/05 508-477-3266 OK Allason Contractor Page 2 5/16/05 Costa, Christopher 1/22/04 1/22/06 ProfLiab:5/23/04 Prof Liab:5/23/05 508-548-6424 OK Omni Environmental on,�i:2/21/03 omni:2/21/06 Systems Engineers Coy's Brook, Inc 4/24/04 4/24/06 9/21/04 9/21/05 508-394-8442 OK Landscape Creswell Siding 5/19/03 5/19/05 4/19/03 - 4/19/05 508-775-4285 OK Siding Steve Creswell Cunningham Construction 1/31/04 1/31105 Requested updated certificates Siding Dartmouth Pools & Spas 111105 1/1/06 1/1/67 1/l/06 508-998-7100, OK Pools and spas 'Davids Building & Remodel 111105 1/1/06 6/14/04 6/14/05 508-428-4154 OK Interior trim Dave Vankleek Dave Schafer Drew Electric 1/21/04 08/28/05 8/28/04 8/28/05 508-778-0723 OK Electric Duffley, Michael 4/l/04 4/l/05 4/8/04 4/8/05 C:508-737-6474 Requested updated certificates Framer Eaton Construction 11/30/04 11/30/05 12/04/04 12/04/05 Randy Eaton OK Foundation painting Fucillo Construction Inc 10/20/04 10/20/05 10/23/04 10/23/05 508-540-2821. OK concrete GAF Engineering 09/01/04 09/01/05 07/22/04 07/22/05 OK engineering .Gardner Concrete Forms 05/01/04 05/01/06 05/01/04 05/01/06 508-759-5630 OK foundations Govoni Land Services 5/31/03 5/31/05 07/04/03 09/20/05 508-400-2111 OK Lot ctearing Peter Govoni Hill Construction 4/29/04 4/29/06 8/14/04 8/14/06 508-888-8154 OK David Hill _'ramin contractor Horsley Witten Group Inc 12/13/04 12/13/05 05/01/04 05/01/05 Requested updated certificate . Engineering In Place/DM Design 01/20/04 01/20/06 02/18/04 02/18/06 OK J & J Concrete 7/13/04 7/13/0 01/01/05 01/01/06 508-457-1131 OK Foundations Page 3 5/16/05 JAG Cleaning Corp, 5/7/04 5/7/05 08/25/04 8/25/05 508-477-7497 Requested updated certificate M&M Cleaning Cleaning Jalbert,Ned 04/15/15 4/15/06 508-836-9999 Requested updated certificate James Construction 07/11/04 07/11/05 Johnson, Steven 04/25/04 04/05/06 04/25/04 04/05/06 OK Framer Joyce Landscaping 11/15/04 11/15/05 04/07/04 04/07/05 Chris Joyce Requested updated certificate Kitchen Appliance Mart and 8/12/04 8/12/05 111105 1/1/06 508-771-2221x4 OK Electronics Appliances 4/ 4 02/04/06 10/07/04 10/07/05 OK Kitchen and Bath Designs 02/0 0 Unlimited Kitchen,Creations 3/30/04 3/30/05 01/22/04 1/22/05 508-775-5311 Requested updated certificates Cabinets L & M Glass Co, Inc 5/1/04 . 5/l/06 5/1/04 5/l/06 508-778-6888 OK Mirrors, shower doors Lauder, Jeffrey R. 12/09/04 12/9/05 508-420-0538 OK Bobcat 221-1046 LHS Construction Inc 4/l/04 4/l/06 4/1/04 4/1/06 508-564-7877 OK 4/ 7/06 774 219-1012 OK O 1/09/04 O 1/09/06 0-1/07/04 0 0 MacDonald Concrete Finishing MAP Insulation Co, Inc 3/1/04_ 10/1/06 Umbrella: 508-888-3599 OK American Building Systems 3/1/04 3/1/06 Peter Taylor Insulation 8/1/04 8/1/05 Meagher Construction 6/19/04 06/19/05 06/23/04 6/23/05 508-726-3202 OK ' Framer RA Mitchell 18/04/04 01/04/05 01/01/05 01/01/06 OK Generators Morse, Richard W. Sr. 3/10/04 3/10/06 7/30/04 7/30/05 508-888-8489 OK Cellar floors MTF Custom Finish 3/5/04 3/5/06 3/5/04 3/5/06 508-888-3075 OK Interior trim Mike Fitzpatrick Northern Sealcoatina Inc 7/l/04 01/22/06 4/1/04 4/l/06 508-398-9474 OK Driveways (paving)v Omni Environmental 01/22/05 01/22/06 02/21/04 02/21/05 Matt Costa OK Systems Page 4 5/16/05 rr Septic Design/Testing Pride Flooring, 6/13/04 6/13/05 6/15/04 6/15/05 508-420-8727 OK FCoor InstaCCation Pro Fence 3/26/04 3/26/06 3/26/04 3/26/06 5087394-4800 OK Custom Fencing R& H Construction, Inc 2/15/04 2/15/06 12/21/04 12/31/05 508-540-9074 OK Excavation Race, D Michael l l/l/04 07/30/05 8/6/04, 8/6/05 508-759-9794 OK Race Framing y Framer Reed, Mel 7/21/04 7/21/05 7/21/04 7/21/04 508-775-1616 OK Sheetrock Scannell, D.A. Well Drilling 9/12/04 9/12/05 09/20/04 9/20/05 508-477-2811 OK , Wells Seaside Alarm 0025/05 02/25/06 02/10/05 02/10/06 OK Sethares, Mark 6/16/04 6/16/05 .6/16/04 6/14/05 508-548-050.7 OK Foundation Shaw Woodworking 04/19/05 04/19/06 02/24/05 02/24/06 Jim Shaw OK Cabinet Maker v Stewart Painting 07/29/04 07/29/05 07/15/04 07/15/05 Sheldon Stewart OK Terra Nova Marble & 7/l/04 7/1/05 7/l/04 7/1/05 800-570-1526 OK Granite Triple Crown Construction 07/30/04 07/30/05 12/12/04 12/12/05 508-833-6500 OK trim Kevin Fitzpatrick Weller& Assoc 08/15/04 08/15/05. 508-7.75-0735 OK Engineers Whiteley, W. Vernon 10/01/04 10/01/05. 10/3/04 10/3/05 508-945-1100 OK Plumbing & heating Server/Subs and Vendors/Certificates of Insurance 2002.doc Page 5 5/16/05 Town of Barnstable Building Department - 200 Main Street STAB . * Hyannis, MA 02601 MASS. 9�A 16:9. . (508) 862-4038 rFo nna�s Certif icate of Occupancy Application Number: 20063930 CO Number: 20070006 Parcel ID: 327249 CO Issue Date: 01/17/07 Location: 83 SCHOOL STREET Zoning Classification: MEDICAL SERVICES DISTRICT Proposed Use: RESIDENTIAL Village: HYANNIS Gen Contractor: BAYSIDE BUILDING, INC Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: Building Department Signature Date Signed f\ TOWN OF. BARNSTABLEBuilding Application Ref: 20063930 Permi * BaRxPTABLE, Issue Date: 11/03/06 t 9 M SS. �ArFC . p�� Applicant: BAYSIDE BUILDING,INC Permit Number: B 20061661 Proposed Use: RESIDENTIAL Expiration Date: 05/03/07 Location 83 SCHOOL STREET Zoning District MS Permit Type: REBUILD HOUSE AFTER TEARDOWN Map Parcel 327249 Permit Fee$ 688.01 Contractor BAYSIDE BUILDING,INC Village HYANNIS App Fee$ 100.00 License Num 005645 Est Construction Cost$ 167,808 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND REBUILD SINGLE FAMILY HOME THIS CARD MUST BE KEPT POSTED UNTIL FINAL AFTER TEARDOWN OF ACCESSORY STRUCTURE INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: HOUSING FOR ALL, CORPORATION BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 82 SCHOOL ST INSPECTION HAS BEEN MADE. HYANNIS, MA 02601 Application Entered by: PR Building Permit Issued By: THIS PERMIT CONyEYS I(O ItIGHT'i'0 OCCUPT'`ANY STREET,�LLYAORY`SID�VALK„OR�ANY PAST THEREOF�ETTHER TEIvfPORARILY OR PERMANENTLY; ENCROAGHEMENTS�ON PUBLIC PROPERTY�NOT SPECIFICALLY PERMITTED UNDER TIDE BTJILDIIVG CODE,MUST BE APPROVED BY THE JURISDICTION, STREET ORALLY GIRADES�AS WELLrP:S DEP3'H AND LOCATION OP P>^7BLIC$EWERS MAYBE OBTATNED FROM':THE DEPARwTMENT OF PUBLIC WORKS THE�ISSU�INCE OF THIS PERMIT DOES NOT RELEA5I�THE APPLICANT.FROM THEYCONDI'ITONS`OF A�APPLICABLE SUBDMSION RESTRICTIONS t MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2,ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS• WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1�� `��• 1 QG( /C �� V © � 2 -`(0-4) (� - ��, 577�IfLS i' ^�� y��p�:.,�, 2 3 //� �j�� 1 Heating Inspection Approvals Engineering Dept t t77 D Fire Dept ! 2 Board of Health n TOWN OF BARNSTABLE BUILDING.PERMIT,.,APPLICATION- Map- "'Applicaticin # Parcel':"' Health bivisi6n 0 14 D Date Issued Ct a 3 ' ati Fe Conservation Divisib n -Ap plic on .'Perffiit Fee Planning'Dept. D Definitive,Plan Approved b Planning Board Date p y Historic -'OKH Preservation Hyannis Project Street Address 73 Sir-In cc> I Village y ign n 15 . MA Owner AC2bS ('VVfl Po R A-(f-, &IORP Address o c) WY)L.5 AA Telephone '5V9 - '77/-�010V3' Permit Request —TV _BQ t tel A- 144dd P IqAmP 4- I-Aw"I n9i Square feet: 1 st floor: existing 7490 proposed NA- 2nd floor: existing q00 proposed 444 Total new NA Zoning District Flood Plain Groundwater Overlay Project Valuation -1 5t2b. Construction Type Lot Size 10 2- Grandfathered: J Yes Ll No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family Ll Multi-Family (# units) Age of Existing Structure q-V0 (tr Historic House: V<es Ll No On Old King's Highway: Ll Yes &<0 Basement Type: gr'Full LJ Crawl LJ Walkout LJ Other Basement Finished Area(sq.ft.) 0 Basement Unfinished Area (sc6ft) -4 Number of Baths: Full: existing new NA Half: existing n e,,% F4 r" Number of Bedrooms: (10 existing —new 444 Total Room Count (not including baths): existing newer_First Floor Roo Count Heat Type and Fuel: B/Gas Ll Oil El Electric LJ Other Central Air: (0/No Fireplaces: Existing LJ Yes NewN,4 Existing wood/c al stovek-U YG U/No Detached garage: LJ existing Ll new size—Pool: Q existing U new sizeAlA Barn: LJ existing L] new sizeA114 Attached garage: Ll existing LJ'new sizeV4 Shed: U existing L3 new size#AOther: Zoning Board of Appeals Authorization U Appeal # Recorded Ll Commercial U/Yes LJ No If yes, site plan review# Current Use Roos i nq up Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ftm—W R. APA45 Telephone Number Address 0114 FA-�Ebeook 941 License # 1Ar6W-A ilM - 0 46 Z& Home Improvement Contractor# . Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE 74 7 FOR OFFICIAL USE ONLY APPLICATION# OATE ISSUED MAP/PARCEL NO. r s` -.ADDRESS VILLAGE OWNER .DATE OF INSPECTION: l w FOUNDATION FRAME ^ INSULATION �r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH i FINAL FINAL BUILDING lviam y DATE CLOSED OUT , ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / Please Print Legibly Name(Business/Organization/Individual): �LvC A A-ens Address:__04 *57-be co 12,J ' . vein . City/State/Zip: p 2-673 Phone.#: �509 — 39V` 61? Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with . 4. ❑ I am a general contractor and I 6. ❑New construction 2.dmployees(full and/or part-tim.e).* have hired the sub-contractors i am a sole proprietor or'partner-' listed on the'attached sheet. T. 0 Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in an capacity. employees and have workers' g Y p h'• $ 9. ❑Building addition [No workers'.comp..insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑R f 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insutance 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 crimirial penalties of a fine tip to$1,500,00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct 01 Signature:! arZle Date: �,I'`/D Phone Official use only. Do not write in this area, tb be completed by city or town official .City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Flealth 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector. 6. Other Contact Person: Phone#: ' Information an Instructions d 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 of 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 staie'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 Frith 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-contiactor(s)name(s),address(es)and.phone number(s) along with their certificate(s)of insurance. Limited Liability Companies.(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has,to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where'a home owner or citizen is obtaining a license or permit not related 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 Investigations. 600 Washington Street Boston,MA 02111 ' Te1. #617-727-4900 ext 406 or 1-877-MA.SSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia d w ' t IKME Town of Barnstable Regulatory Services vn"R'MSTAB, � Thomas F.Geiler,Director 019. 16 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 Ov laser Must Complete and Sign This Section If Using A Builder as Owner of the subject ro e l P P rtY. hereby authorize to act on my behalf, m all matters relative to work authorized by this building permit application for. hl--J Se-4 0ca � ��Ar is (Address of job) Signature of Owner ate e- LT11CtW,-A.JJ' Print Name If Pro eejjy Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q_F0 RMS:O WNERPERMISSION of z"e.roif. Town of Barnstable " Regulatory Services STAB Thomas F. Geiler,Director RARNLF- MASS. Lbs� ,0�� Building Division PrED MAC A Tom Perry,Building Commissioner 200 Maili.Street, Hyannis,MA.02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 a01«OWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING'ADDRESS: city/tovrn state rip 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 Persons)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) Tide undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies thathe/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hues 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 respombilitiu,many communities require,as part of the permit application, that the homeowner certify that heshe understands the rtspo=bilities of a Supervisor. On the last page of this issue is a.form currently used by several towns. You may care t amcnd.and adopt such a fomr/certification for use in your community. Q:forms:homccxempt N 4 158.81- 4� o �? o Ios• '" CONCRETE W (09 FOUNDATION EXISTING O 04 BUILDING [ti O � 'd- OT 2 l9 10.1 5F 1G7.00' DOE JOB #04-148 FOUNDATION PLOT PLAN FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT ONLY PREPARED FOR: LOCATION 83 SCHOOL STREET HYANNIS, MA CHAMP HOUSE SCALE 1' _ 30' DATE "NOVEMBER 2. 2000 REFERENCE _ REFERENCE: DEED BOOK 14273 PACE 302 ASSESSOR'S MAP 327 PARCEL 249, �'��jti10F4'�sA:.. HEREBY CERTIFY THAT THE STRUGTURE o� DANIEL u SHOWN ON THIS PLAN IS LOCATED ON THE n m{, GROUND AS SHOWN HEREON. OJALA C 0 40 rn fax '.508 962-9880 q ��I() � All, �? eering, inc. I,yLO down cape to ss __ rt CIVIL ENGINEERS LAND SURVEYORS DATE PEG. LAND SURVEYOR q3f man St. yamth ma 02675 �1as achusctts- Depa -tmcnt(if Public Safcch Board of Building- Re-ulatioris and Standards Construction Supervisor License License: CS 74295 Restricted to: 00 i MARK R ADAMS 24 FASTBROOK RD W YARMOUTH, MA 02673 �- - Expiration: 3/1/2011 (ummissioner Tr#: 12553 � 1 :'fi � r c � fi. � -W:> r 1 �� Hyannis Main Street Waterfront z M Historic District Commission BAPOW"RM ' 200 Main Street MAss. Hyannis,Massachusetts 02601 TEL: 508-862-4665/FAX: 508-862-4725 Application to Hyannis Main Street Waterfront Historic District Commission in the Town of Barnstable for a --CERTIFICATE-OF_ARPROPRIAT.ENESS_ Application is hereby made, in triplicate, for the issuance of a Gertificate of Appropriateness under M. G. L. Chapter 40C, The Historic Districts Act for proposed work as described below and on plans, drawings or photographs accompanying this application for: PLEASE CHECK ALL CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building ❑ Addition ❑ Alteration Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑' 3. Signs or Billboards: El New sign El Existing sign Rep inting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole Other CO �Pnlg 5. Parking Lot: ❑ New Building ❑ Addition ❑ Alteration (Please see the guidelines for explanation and requirements) TYPE OR PRINT LEGIBLY DATE $ C; ASSESSOR'S MAP NO. '3 j;t 7 ASSESSOR'S PARCEL NO. APPLICANT V�1 cS—k I c'�A�Y1 S TEL.NO. ,�6$ W—G/7 7 APPLICANT MAILING ADDRESS 9L( CA S-CgRZ A R� W-4AFQ.00041• 0AA-02473 ADDRESS OF PROPOSED WORK 75 c�N� 5T ttE4t�1V115 MA PROPERTY OWNER 40051f o COJ- 1�rLj, r . TEL.NO. . 0%-77/—P, F5 OWNER MAILING ADDRESS 5C hyQ( FULL NAMES AND MAILING ADDRESSES OF ABUTTING OWNERS. Include name of adjacent yawners across any public street or way. This information is best obta a *11k,P Tn., ' + e, ach additional sheet if necessary). AUG 2 Uun i ►0f- 0 i � 4k9�1a Q� TOWN OF BARNSTABLf CAA 3-10 P VQ ,'DQ kI k, HISTORIC PRESEP— ^T -�� AGENT OR CONTRACTOR IH A f-k`� TEL.NO. ADDRESS `'1 �A��,�I 6 r'o o qA�1�11®U�'h 4 DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done, including detailed data on such architectural features as: foundation, chimney, siding, roofing, roof pitch, sash and doors,window and door frames, trim, gutters - leaders,roofing and paint color, including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet,if necessary). l)1, �Vp¢( c�at y— pi�" Pro fw44. 'Z x tv" PM 550,re A- W tk�N 9%'ey Pro" t1 e_vm Pos►Te- -ro(7, Vq E.D ArP"PnQ" L Signed 11 /-�� Owner- ontractorCeit 'CIRCLE ONE) SPACE BELOW LINE FOR COMMISSION USE Rece vedr� IVISVHDC_m. Date D E C EJ WJ E This Certificate is hereby Tim . A U G. 2 1 , O Date, By TOWN E n A n,,,�Y.� LE Signe HISTORIC PRESERVATION IMPORTANT:If this Certificate is approved,approval is subject to the 20-day appeal period provided in the Ordinance. CONDITIONS OF APPROVAL: HYANNIS MAIN STREET WATERFRONT HISTORIC DISTRICT COMMISSION ***SPECIFICATION SHEET*** ADDRESS OF PROPOSED WORK D33 Le, "Asa,31.5 iMA• FOUNDATION SIDING TYPE A 1 A COLOR CHIMNEY TYPE__A COLOR ROOF MATERIAL &] A COLOR PITCH N WINDOW N A COLOR TRIM COLOR A)A+Q y-,>- DOORS IMP COLOR SHUTTERS . N A GUTTERS DECK Nro ce 1SAVen G ff CD M 1p�>5 C'Y De-CAS t Y� GARAGE DOORS COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application,along with three copies each of the plot plan,landscape plan and elevation plans,when applicable.The Plot plan need not be"Certified",but should show all structures on the lotto scale. p E C E Hi AUG. 2 1 .2009 OVIED TOWN OF BARNSTABLE HISTORIC PRESERVATION q 1 N 4 158.81' 4� 0 o 10.5. o '9 Ems, CONCRETE W OFOUNDATION W EXISTING 0 Q4 BUILDING [� • O i✓j l9 10.1 5F I O th 107.00. n � W E fF AUG_ 2 1 :2009 ' 'VLLJ%: -1 lrlh0 F BARNSTABLE HISTORIC WN� PRESERVATION DCE JOB #04-148 FOUNDATION PL 0 T PLAN FOR THE PURPOSE .OF OBTAINING A BUILDING PERMIT ONLY PREPARED FOR LOCATION = 83 SCHOOL STREET HYANNIS, MA CHAMP HOUSE SCALE : 1" 30' DATE : NOVEMBER -2. 2000 REFERENCE REFERENCE: DEED BOOK 14273 PAGE 302 .,, ASSESSOR'S MAP 327 PARCEL 249 ��,"_`'F A' s`' I HEREBY CERTIFY THAT THE STRUCTUREYu`' Uf1NILL �y , SHOWN ON THI5 PLAN 15 LOCATED ON THE GROUND AS SHOWN HEREON. OJALA n off 506-362-4541 C fax 508 3c2-":Im j PIo. 109C10 J down cape engineering. inc. CIVIL ENGINEERS i`L------- — LAND 5URVEYORs DATE REG. LAND; 5URVEYOR 93 min st ya-mth ma 02675 I '- •��•-��:- r Iwo �s 'a Ow �- p -j..i i"" _ � '' 3Y�=j y� - y:b- v 9 �7aG-•� �z':. ji. no ask - `_ Tw WNW L iT9/!r I � d- Z� .�'�' 1 •y`. tE " D AU G 2 1 ,2009 TOWN OF BARNSTABLE HISTORIC PRESERVOON 7-f4 5-1 r---� - - �affA. its w, IF -.r ♦ - [ e k -'gam _ .a•. n _.y. ,�. .�:� ter"_, .f,� i,; j 'A 40 ,v , A t i _ __ ifs• �_ � _ .. - � r s � . t i T ' AUG 2 12009 TOWN OF BARNSTABLE HISTORIC PRESERVATION r , { ti41 Lg4 _ t a N 158.81' o o CONCRETE OFOUNDATION W EXISTING 04 BUILDING io.i1`o 5F O O 167.00' DGE JOB #04-148 FOUNDATION PL 0 T PLAN FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT ONLY PREPARED FOR LOCATION 83 SCHOOL STREET HYANNIS, MA CHAMP HOUSE SCALE : 1' = 30' DATE : NOVEMBER 2. 2000 REFERENCE REFERENCE: DEED BOOK 14273 PACE 302 r ^ ASSESSOR'S MAP 327 . PARCEL 249 jNOF1' S�G�� I HEREBY CERTIFY THAT THE STRUCTURE �o`� UANIEL cy SHOWN ON THIS PLAN 15 LOCATED ON THE A GROUND AS SHOWN HEREON. Off _-3r.2-4541 OJALA fn P. 508 362-9B80 ` q��0.4098O v 0F\rJ down cape engineering. inc. y CIVIL ENGINEERS LAND SURVEYORS 93 mah st ywmouth ma 02675 DATE REG. LAND SURVEYOR C., O `' L, [so co V�- f ,r a CH�qf� MP HOUSE "Places Hope, Built on Faith" ,Serving Adolescents.& Adults The First Champ House Established 1996. 82 School Street Hyannis, MA 02601 508-771-0885 Npzl c2,0�a o 0 aZ PA, r. C � 4 Champ House•Jamie Ready Youth Home• The Children's Home CHAMP House is a multi-generational group home program of the Housing For All Coporation(HFAC),a charitable 501 (C)(3)tax-deductible organization registered with the Massachusetts Attorney General's Office(Account#23602).Please call to learn more about us and to discuss how you can remember the Housing For All Corporation in your will and the tax saving benefits of Charitable Remainder Trusts and Annuities. . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map��Parcel OZ v� Permit# Health Division Date Issued Conservation Division ES,/�.�, ,0 ®,� Application Fee Tax Collector Permit Fee .�5—e Treasurer ��— o(L Planning Dept. C� G Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 83 S c—k v o L S T7 Village Owner D v S o`V9 A Address o SC-.00 S ✓�e7` yrg�P✓s, Telephone 0 V_ f 7/—(� 8�S �4 0 60 Permit Request —/ 54 le s — 3 CyWks Square feet: 1st floor: existing 0 0 prbpo ed 2nd floor: existing oo proposed Total new Zoning District PR_D Flood Plain A10 Groundwater Overlay A10 ,� ® oI moo 0 Project Valuation �� Construction Type Cr/crd 5�i� 1 — J YP Lot Size 0(4 o4o S9 Fr Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) �ti'o✓� �/� Age of Existing Structure A9ot Historic House: ❑Yes C AIo On Old King's Highway: O Yes NO Basement Type: ❑Full ❑Crawl ❑Walkout VOther /"i9'x %/f C Basement Finished Area(sq.ft.) �/q 0/ Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new .r Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count /,rd a4_Je Dear Heat Type and Fuel: )(Gas ❑Oil O Electric ❑Other Central Air: ❑Yes P(No Fireplaces: Existing New Existing wood/coal stave: ❑YQS #,No Detached garage.Aexisting ❑new size Pool:O existing ❑new size Barn:❑existin ❑nev'A�'size - c Attached garage:❑existing ❑new size Shed:❑existing O new size Other: C' v� ut Zoning Board of Appeals Authorization ElAppeal# Recorded❑ � M Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use _ rn BUILDER INFORMATION Name �4✓I !7`�f7�r�7j&,I Telephone Number So �' 7 l`-D�PS Address &- Saoo i`S License# Home Improvement Contractor# Worker's Compensation# a.3 U13— ks-q x/,�1y 9-ok ALL CONSTRUCTION M!S RESULTIN FROM THIS PROJECT WILL BETAKEN TO SIGNATURE �_. DATE — e�— FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. CJ rJ ja ?Y j ADDRES } 1 � �" �1 j ;�• VILLAGE f � v OWNER DATE OF INSPECTION: "ti FOUNDATION FRAME INSULATION i �✓ ^. FIREPLACE ! ,/ ELECTRICAL: ROUGH FINAL _ r PLUMBING: ROUGH FINAL r i r 3 GAS: ROUGH FINAL-^ FINAL BUILDING ,z ` DATE CLOSED OUT L t ASSOCIATION PLAN NO.- ; �r i ---- OPFnATION:- C,-PNEUMATIC ❑ ELECIMC U IIYDnAULIC --- -- -.r1F_ING SUPERVISED - --_ 0 YES - ONO--'ETECTING MEDIA SUPERVISED? YES _ 0 NO -- DOES THE VALVE OPERATE FnOM THE MANUAL TRIP AND/On REMOTE CON1n01-? YES O NO DELUGE & IS 11IFnE AN ACCESSIBLE FACII.IIY IN EACII CInGUIT rOn TESTING? YES 0 NO PREACTION IF NO, EXPLAIN: VALVES Does each circuit operate Does each circuit Maximum time to MAKE MODEL supervision loss alarm? operate valve release? operate release _ _ _ _ YES NO -YES -_ NO --- MIN, (--•-SEG. --- HYDROSTATIC:Hydrostatic tests shall be rondo at not less than 200 psi 113.6 bars) for two hours or 50 psi 13.4 barsl above static pen.^.suer. in excass of 150 psi 110.:1 bars) for two hours, 0ifterontial dry-pipe valve clappnes shall be left open during last to prevent i TEST damage. All nbovnprotind pipir,q leakapn shall he stopped. DESCRIPTION PNEUMATIC:Establish 40 psi 12.7 bars) air preseron and measure rhnp which shall not exceed 1.1/2 psi 10.1 barsl in 24 hours. Test "'" pressvrr and measure air ressure drop which shall not exceed 1.1/2 psi 10.1 bars)in plessuae tanks et normal watnr level and air p 24 hnurs. ` --_.__...... IF NO. STATE FIEASON ALL PIPING Ilyl)n0STATICALLY TESTED AT PSI rnn Iles. UnY rIrING PNFUMATICALLY IES1EU? (6'+*/S F rt FOUIPMENT OrEIIATE,; movElILY? I - (JNO --- -- - _. - ------- -- ---- DRAIN FADING OF GAGE LOCA'IFU NrAF1 WATFn-SU!'rtY TEST rIPF: nES1UUAL rnESSURE WITH VALVE IN TEST PIPE TESTS TEST � PSI OPEN WIDE ---- - �[ -- -"- -- - rSl 1lndergrouml n+nlns find tenet h+r,nnnecUoos In system risers shall bn Ilosho 1 helorrt ronunr-tlor+madn to sprinkler pipinq. EXPLAIN VrnirIEU OY COPY OF THE FORM NUMBFn n5R? ( XFS ( I NO O f I tEn FLIISIIF.0 BY INSTALLEn OF UNUFn(TnOUND 51'nINKLER PIPING? S L.j NO -.--_-.-_ _ _--- -. _ NUMOEn REMOVED _.-. _BLANK NUMnFn USED LOCATIONS TESTING GASKETS - ._-_ r- f..... WELDED mrING. (J YES ........... .....r r'�..y ---�---•-- •-- -- --- - - - '- ---= -•--- . '`4, IF YES'::... ------ -------- w UO Y011 CERTIFY AS THE SrnINKLEn CONTrACTOrt TIIAT WELI)IN(; r'nOf:FOtIfIES COMPLY Wlill ..,M _.. .�_�YFS s (_)Nn i TIIE nEQ0lnFMENTS OF"AT-LFAST AWS 010.9. LEVEL An-37 DO YOU CEnTIFY TIIAT TIIE WELDING.WAS,PERFCnMED'BY WEI.OFI"- fB11ALIrIEU.IN.COMPLIANCE [__],YES_ r3 NO WELDING Will[THE REOUInEMENT9 2 .OF AT-LEAST AWS D19.'LEVEL An-3? = DO YOU CERTIFY THAT WF.LI)INr,WAS (:AnnIFO OUT IN COMPLIANCE WITII A UOCIIMFNIED QUALITY- j-•- l CONTROI. PROCFDLIRE TO INSUnF TIIAT AI.L U I S C S A I I E nF.1TIIEVEU O . TIIAT ar'ENIN5 IN P I r I N 0 µV' ArtF- SMOOTII. TIIAT SLAT ANU OTIIFn wFI.DINrT r1r:SIU11F Ar1F nrMOVFU, AND MAT INTERNAL ( I YES DIANIFIFnS OF rirIN(T AnF NOT rENFTnA1FU? - _-- _ O � yS N HYDRAULIC NAMErLAIE rnOVIOEII? DATA IF NO. EXPLAIN: NAMEPLATE -- -- -- —-- ---- -- _ _ DATE LEFT IN SFn`✓IMF WI'tll AL1. CONTf101.VALVES OPL•N: y -..._._... REMARKS NAME Or INSTALI.IN( CONIT1Af TOn _ I . - ..TESTS WITNESSED BY — ---- - ------ SIGNATURES I<T O IiTCO�"VNEtt 1 ran l S p 1% i•; 1'r DATE... r - FortINSTALI_�NG CONTPACTOrl ISrgnedl TITLF u= 77 AUUHIONAL EXI LANATION AND NOTES: CONTRACTOR'S MATERIAL & TEST CERTIFICATE FOR ABOVEGROUND PIPING r: Additional copies of this form are Loss Provemlon Puhliretlons -Training Resourea Center available fo insyreds from: Factory Mutual Engineering end Research, 1 151 Boston-Providence Turnpike, P.O. Box 9102,Norvvond MA 02062 PROCEDURE: --- ------------- ------- — - Upon completion of work,inspection and tests shall ho made by the contrar.tor's representative and witnessed by an owner's representative. All defects shall be corrected and system left in service hofore contractor's personnel finally leave the job. A certificate shill he filled oUt and signed by both ropresmitativos. Copies shall he prepared for approving authorities,owners and contractor. It is understood the owner's representatives signature in no way projurficos Any claim against the contractor for faulty material,poor workmanship, or failure to comply with approving authority's requirements or local ordinances. PnOPF.RTY NAME. ' ( --------.._..--------- - GATE - --- rnorEUUREss�---w'"� -- - A _- - - — - -- - ACCEPTED BY APF'nOVING AUTIIOnITY'(S)NAMES r -- a PLANS � �^c_ p_C_C_�:) �Jc.1 INSTALLA ION CONFORMS TO ACCErTEO PLANS - ES ��NO F-0UIPMF.NT USED IS ArrnOVEU (IF N0, SrATE DEVIATIONS RF.LOW) S [ NO IIAs PERSON IN CTIAnGE OF FInE EouirMENT BEEN INSTnUCTED AS To LOCArION OF CONTROL YFS NO VALVES AND TIIF CAnF AND MAINTENANCE Or TIIIS NEW EOUIPMF,NT? IF NO, FXI'LAIN: INSTRUCTIONS' .._-._._._. --- ------ - -- - -- - ..- ---- -- ---- -------- ---- .-...... HAVE rnrIES OF ArrnOPMATE INSTRUCTIONS ANU CAnE AND MAINTENANCE CIIAnTS nEEN J;1 YES NO LEFT ON rnFMISES? IF NO. EX('LAIN: surrLIES RUILDINCS -- -= - - -- - --- - - -- - -- LOCATION OF SYSTEM -_ S-zi Sl MAKE _ - -MODEL- YEAR OF ORIFICE SIZE QUANTITY TEMPERATURE MANUFACTUnE RATING --._...--'-----...........--------. ..------- Lq SPRINKLERS ( O(n � U: `---....__..... .__`% r`t^[ r`y...._. PIPE CONFORMS TO --�15 ,__-C\1Al STANOAni) (a ES NO PIPE AND FITTINGS CnNFU(iM TO �^ STANDA(10 � S ONO FITTINGS ---'- --.. -....... .�. ._. ...._... IF NO. EXPLAIN: ----- -- -----...--..---- ---------.-._............_..._.............. _....-- ALARM ALARM DEVICE MAXIMUM TIME TO OPERATE THROUGH TEST PIPE VALVE OR TYPE MAKE MODEL MIN. SEC. FLOW INDICATOR DRY VALVE - Q.O.D. MAKE MODEL SERIAI NUMBER MAKE MODEL SERIAL NUMBER Time Wa1Pr.TIME TO TRIP Y_ WATER ... .. _ .__AIR .... .. . TRIP POINT AIR --- Alnrm Opeietod Reached Test DRY PIPE rTHRU TEST'PIPE PRESSURE` PRESSURE PRESSURE Properly outlet ' OPERATING MIN, SEC. PSI PSI _rSI MIN_ -- SEC..- -- MIN. SEC: -TEST_ WITHOUT - -- ----- ---- —-O.O.D. WITH --- -— --- - -- IF NO, EXPLAIN: BSA 11.941FMnC rnINTFO IN USA ------------ s �r ' 33 ir. A. z.i �! # F 7 4 li dS -f d :'1•�+fi i. Opp \tom ; \`cy ps U b 9 Qj 11 n �� • � �� r C a � p� � � yea yi �2O F t 0�3n a Nn At TP 14 ra IL 14( WFI- - `r+�'��e � ._c �S� � �� .,o.,... & Z{Tc•• ewooa. � �� U� � N dl ��4a} t t j NOTICE N NOTICE W TO a TO EMPLOYEES EMPLOYEES The Commonwealth of . Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I (we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ROYAL INSURANCE COMPANY OF AMERICA ----------------------------------------------------------=------- NAME OF INSURANCE COMPANY ONE TOWER SQUARE HARTFORD, CT 06183 ------------------------------------------------------------------ ADDRESS OF INSURANCE COMPANY (6R23UB-859X164-9-02) 04-04-02 TO 04-04-03 ------------------------------------------------------------------ POLICY NUMBER EFFECTIVE DATES INSURANCE PROFESSIONALS 100 CHARLTON RD — STURBRIDGE MA 01566 ' ---- ------------------------------- NAME OF INSURANCE AGENT ADDRESS PHONE i HOUSING FOR ALL CORP 82 SCHOOL STREET HYANNIS _— MA 02601 EMPLOYER----------------------------ADDRESS------------------------------- Paul Hebert 04-04--02 __ ___ EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE N MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First.Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the Cape Cod Hospital , 2.7 Park St . , Hyannis , MA NAM ----E-OF--- HO-SPITAL----------------A-DDRESS---------------------------------------- TO BE POSTED BY EMPLOYER ROYAL& 018635 W20PIH95 —� SUNALLIANCE Information and Instructions _ Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied,,oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner.of a . �. dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who h_ as not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the' commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. �.. . Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation,nd supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"of f.you are regmred,fo obtain a workers' compensation policy,please callthe 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 flue 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 permrr/hcense number which will be used as a reference number. The'affidavits maybe returned�t�+.,. the Department l;y mail or FAX unless other arrangements have been made The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, . please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts -Department of Industrial Accidents Ofece of lovesUnUous 600 Washington Street -.., Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 _ --� The Commonwealth of Massachusetts Department of Industrial Accidents _= Office efinrestigatiens . 600 Washington Street 3 Boston,Mass. 02111 `r--� Workers' Compensation Insurance Affidavit name: 0 V S 'N �M CG v� u Jj e�er 1 /v/ ., location d SC40U city A,�/y "S phone# St 7 ❑ I am a homeowner performing all work myself. ❑ Iamasolzro n5or and have no one workin in ca acity I am an em 1 r raviding workers' compensation for my employees working on this job...............:.....•:...... P.°ye... P XX .. address.......... :.:..........::..:.:::.;; ::.;':..::::::::::.:;.;;::.::::... . ::.::::::...;:.;:. ::..:;:.: :. . h.:. ;;:..: i ...: . .. . : ::.::::..::. � ..:.... . .::..... ....... . .. .. .. ..........::::.::::. : .::. :: �.,. ... .. :::......: :. .::: ::::.... ..:..:.:.::::... :.:::::.:.::.:::::: .. ..... ..... . .: .::.. .. :.:. :::: .. ,:.. :::::::...::::.:::.:::::::::::::.::::::::::::. .... ::...:..:::::::: � : .:: : a:::::.::: . .:..:. ..:...........................::. 1t1St11`anee:.co.; ;:.::.::::::::::::::::::::::::.:.: :::::.:.:............................... ❑ I.am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have i:... . the followin workers' compensation polices:...:. ........:....:::::::::.:.:::::::::::::::.::.:::::::::::.::::.::::::.:::..;': :<.::.:.;;.,:•>::::.::.::::.::._;:<..;::.:.:;:: g.........................::::::::.::.::.::::::.:........:.::::.::::::::::::.:::..:......................:.::::: :::::::::::::::::.:::::::::::.:::.:..:.:......:.........:........:..............................::.:::::.:.::::::: cone'an.<:nam ..... ::::ii::i:Gj:i+:ii:'vi:v;:�:iL?: :+::isiii'::;1:?:i`v:v:4i:fi:it>.:i;::?!::<2;..:......iii?':'::'?;...... ..... i:;%:..;::J::•ii:•i:?i•i:i}:: :•iviiii}i:<.;};:4ii::4:v:::::::::•. •iiii::4;ii}i}:v}: •:}iiii: 'r:•:}i:tvhi:,�:•:is?i:•:: .... .. ... ..... .... ..............................................................:.... .:.:.............................................:.:...................................:•:::r::i:.�::.._::::.:-:::.:::::'::;::::::::::::::.�::.•::::::-•..•:::::: ........... ...................................:......................:n:.....................................................:..:................. . ...$::Gi::�.';;?�::>i:<;;�i•r.2>:>iiir.':yi iiii:t:;i i:;::•` 'r:,ii: � �>:�:}�ii:�iiii:;i::Ji::i;:i;i;;;;:i%:Ytii iiiii:::ii:::iiii i i:.•'t;:iiii ii:bi:6i5i::iiiiiiii::is�i::�;::;.'•i::::ifi:%�:i i4;%i::�ii:>isc:;f7;??�:.^,::::::Y:iiiii:;;•::;a:•:•`.::::;?:::4?::.:.::`?,•ikf?: ad�i�es •:: 4i:< ?�i:ii::::::{vx.•.:;.y.: :i:%L:ii:•:4:i�::?:i:::><::::::ii:C'�:::::1i::::!ii::ii:i:•ii;.i;:<ti9i:•}iii:{ii.i:i:::Li:::�iiiiiiii:ii'-ii;•iii}iiii:�iCi:i::i:::'?i:iiiiii:�:ii::ii::):i: ::r:::iii:ti>ii::.:�i iF::':•:>:: ;::.�.:•:: X. 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X. :':;:•: hone.#:::;;:';;:::;:;:. VN v:Z•ry ............. ........................... iII511Y'AIII:e:.0 .... f. uired under Section ZSA of MGL 152 can lead to the imposition of criminal penalties of a fine up.to s1,500.00 and/or Failure to secure coverage as rej one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification _.__....._. ..___.....L.dherebYcerd -and-P- nalties-of- e 1•ur that-the-information rovidedabove_is_trLue_ond_correct__._.... _fy nderthe ains Signature _ 4LIDate Print name Phone# � official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑checkif immediate response is required ❑Selechnen'9 Office _❑Hhealt Department contact person: phone#; ❑Other (revised 9/95 PW �'� �� l �J��. - �� - O�11..+ ✓ ' � � `mil 1 v� �X ! Ti vi C C— c .. 5C- L, l� _ e `1E 1��1UD � .. 3o \��"' TD I f i 0 �xt5Ttv1 5 . — 67 15'�i t a �xk> i n - - wail S�n1�. Cpf�V�� cal TU g t a Y,6 SAT 00 T\ ai�3 w�S WA�-S +- PA e-r-tTj CW 5 - q _ J Lu 00 pdp 1 400-mor..." Do iwdm AUG. 2 1 ,2009 TOWN OF BARNSTABLE HISTORIC PRESERVATION g`3 t E Corp. 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' \ItNYL I t i GN E Xti 00 s _ . v N A( I Q i _ 1 � --- c� !r7 X 2�{ fCm r _: _. _ p,lq 1`- c9 = i _ f \p I , f 1 i _ y I �o �, moo; ��QM 2 r r'° Uy�l �� ? � , coi cat�pc—T Ay - _ D pp �ni�LL c --- S_N p�( ASx�--� -t�0� 1 a t -Q 0 - _ 67D0 -�--- cJ 80 Al "` o! m 12- x-1q'-2` -_ x 1.. t m U 12 US cp x iz � I : I I � O q _ S , I � T - s _ RO :_4 _ i I 1 r — ; I --- �--�-- , �' ... �,_ 1 ", SKY`L1•� _ _ i � _ NT _ 1 o -- --- 5 t I _ ' 1 .,n I �, t n I i t3gR L J � � Y ; � n � _w �7 { 1 ( [y Q L� _ ` 3 I I � -r TYP. o� -N SMOKE QTEC REVIEW°ram L. e va_ FLA �OCtNPN Wq U�IFiNi541 D - jt ce)0- v —rl Co 0 iz� ARNSTABLE BUILDING I�Ef'T. , D ; CARBON MONOXIDE ALARMS MUST BE INSTALLED PER MFt :av'II;pa��-r L-AN _�tiEST Z MASSACHUSETTS BUILDING CODE FIRE DEPARTMENT i.aTE u BOTH SIGNATURES ARE Rf lLrt�,EGR�r,co ,� R, - L ` f i ✓ ✓ G~ 1.-�/ - - _._�.. __.. _ _. - - _ c Cr V E�.- DRAWN BY SCALE '"� APPROVED BY: DATE: 0a REVISED AKRO ASSOCIATES ARCHITECTS 310 Barnstable Road, Hyannis, MA ' 02601 i or 3 tel. 508-778-6060 fax 508-778-2558 DRAWING NUMBER Steven M. Shuman, RA Alice L. Oberdorf, RA a613 Ix 4� FK1t_�E rjl� ---pF-C--yr p, -��5�� I ix rlei_tf__ 1 - _ - t Ix tZ fA5 c7. IA , �2 - x { -I I ' A-F02= -- - - fi - r I k T 3a�8 cF T e -� s _ RA AcE w�Nn GLG. e- -L- r} It-�LI VI L -y' �.fg 294.6 v SCALE: APPROVED BY: DRAWN BY ��j T'1 �F) DATE: 7- '-06, REVISED AKRO ASSOCIATES ARCHITECTS - 310 Barnstable Road Hyannis MA 02601 ' , � a � tel. 508-778-6060 fax 508-778-2558 DRAWING NUMBER Steven M. Shuman, RA Alice L. Oberdorf, RA - -- -- - --_--- -