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0040 SIXTH AVENUE (HYANNIS)
yD,Sir�hlve ® Complete items 1,2,and 3. A. Signature ■ Print your name and address on,the reverse X `"� ❑Agent so that we can return the card to you. .--' � ❑Addressee ■ Attach this card to the back of the mailpiece, B• Received by(Printed Name) C. Date of Delivery or on the front if space permits. 1. Article Addressed to: D. Is delive ddress�lifferent•from�it"cm ? ❑Yes If YES, ter d�liGery address below: �❑No G��f/n.2_c_m1V J✓n��� /�5��► >3 �. �� JUL 0 r 2016 (I"I'III I"I I'I I I I I I II I'II I II I II I'II II'lll'll 3. Service ah 0 ,.,❑❑Prjority Mail Express® S i ❑Adult Signature 7 {1 ��O'Registered MailTM El Adult Signature Restno liver!'fl Registered Mail Restricted 9590 8403 0521 5173 2831 56 >�eertified Mail® Delivery ❑Certified Mail Restricted Delivery Return Receipt for El Collect on Delivery Merchandise 2..Article Number(Transfer from service iabe0 ❑Collect on Delivery Restricted Delivery Signature ConfirmationTM a e-I' I l ,+ " ! .3 nsured Mail ❑Signature Confirmation. ;�,7 015 10 6 4'i0 V 0 0 0 5i i 8 4 8:9 1 s8 4 3 O: i nsured Mail Restricted Delivery Restricted Delivery ver$500) Ps Form 3811,April 2015 PSN 7530 02-000 9053 Domestic Return Receipt z. I UNITED STATESFWAESIERVICE First-Class Mail Postage&Fees Paid 4 -77 JUL -:16 USPS di 7l Permit No.G-10 I • Sender: Please print your name, address, and ZIP+4®in this box" TOWN OF ADIVIS DIVISION BUILDING 200 MAIN ST. HYANNIS,MA 02601 d I USPS TRACKING# I I I I 9590 141 5 1t it gal tly6+}il��jf,►(,�Itit,it,tliE'�dtj �f �C3 �. • �m ICO a" R cD Certified Mail Fee CO $ C31,60 Extra Services&Fees(check box,add tee as appmpnate) LrI ❑Return Receipt(hardcopy) $ c C3 ❑Return Receipt(electronic) $ Post p ❑Certified Mail Restricted Delivery $ tPj Ht% 0 ❑Adult Signature Required ,. $ t%1 ., [-]Adult Signature Restricted Delivery$ _ b. � Postage -a $ "fy p Total Postage and Fees Ln $ Sent To � Street andApt.No.,or Pb Box No. City,State,ZIP+4® ----------------------�- i OWN Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service- Restricted delivery service,which provides for a specified period. delivery to the addressee specified byname,or to the addressee's authorized agent Important Reminders. Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(not Rrst-Clasp Mail®,First-Class Package Service®, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specified ■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent: with CerbTied Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage:automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on - ■For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. Ps Form 3800,April 2015(Reverse)PSN 7530-02.000.9047 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �-y� Parcel 13 Application # ,�(� r 3I f Health Division Date Issued J013 1116 Conservation Division Application Fee Planning Dept.. Permit Feed Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis girt-1-L s Project Street Address �� V Village W Owner /2) - -A w At r - Address 13 QPw v;&-w N"H , Telephone D� � SO,57— Permit Request A a i l cy= )-Pry tL Pa. Square feet: 1 st floor: existing .72aroposed n 2nd floor: existing proposed_Total new n Zoning District Flood Plain Groundwater Overlay Project Valuation 49M 00 Construction Type Lot Size Grandfathered: 3.�` S ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure &0 -- Historic House: ❑Yes O<o On Old King's Highway: ❑Yes gkllo Basement Type: ❑ Full yawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) ® Basement Unfinished Area (sq.ft) Number of Baths: Full: existing_ new n Half: existing new Number of Bedrooms: Z existing aew Total Room Count (not including baths): existing new First Floor Room Count $� Heat Type and Fu el: as ❑ Oil ❑ Electric ❑Other Central Air: es ❑ No Fireplaces: Existing_ New 4;;' Existing wood/coal stove: ❑Yes AINo Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: BUILDING DEPT. Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ OCT 19 2016 Commercial ❑Yes fi"o If yes, site plan review# Current Use Proposed Use TOWN OF BARNSTABLE APPLICANT INFORMATION (BUILDER OR HOMEOWNER) - Name ss lb-Qt.%-1'' wrx)l bh Telephone Number "gos i Address G, :11'3 License # r �'7 c lyr;11S, IW4 . Q;*1+Z Home Improvement Contractor# ))`) 9 9) Email UL t9)t A P Worker's.Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO_T'Q�rrh/ SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED _rMAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r ,� T��cfs�errt�,� �Tcb3�rACl�i�e� Office off' af�aru.. 600 Wk%b rig#mt Street Base,MA 02HI •. k�t�xuma�gaP��ia . Wurke& CumpensathuInsurmce Af Edavit Bmldex-Jf�unh ecbrir-i�n �' *___.Zieis AppiicmE#Iafamptigu Please Prfid Eie�r"b�y Tame �-Ga�,n.D-�1 ►.�b Cit Are YOU au englayer?Checkthe appropriate I&= Type of project(reTmkedDr- I.❑ I am a employer veitbr - 4. ❑I zm a ge=—A confrmctmr and I 6_ ❑New oms mceir n empkyees(fal,adfor pa * 1mve lied me sub-cos acts 2.b'I am a sole etmr or Tisfed r �e at�rbed:sheet 7- ❑�6 g NF�iFa. 1 These sob-caa�€cactas�have and have no empl�ees s 9- ❑Detnnlifiou frma i a �l a-dhave worms' waling, agY . 9. a 1Np g irrcesar,re �- rmitioff 16- E1echiad �-1 '• . 5. ❑ We are a t�rpaiafifln.a�ifs ❑ repaus or a,dditeaus. afucers hm exercised fizeir ' 3111 am bQmeo�er dairfg all�odc 1L❑Plumbingrepaiss or$ddztions my-self[No vas'o=p- rigbt of exe per MO-c�tca�trt+ ]7❑�af*�T*� tnTP7FF7fTT�dj i Q M.11(4).andweloveno _�-ZZ - emplaye [NowAme u_❑{?ther c=qxin� ] `dap appfi6�st cbedsbos OR, ales ffiathe sec�oab�iaw �d�eatvar7ceis'm¢ap�•m++;••poycgx ¢rm 1 ��raasr�idaea` g$�ep>aa�,�tsc�c�d�haea»tie'tecooamst3v5mitaaezvs�d�mdi�sac'b.. .• ' 'Ca�stTsst Wk1]&Uaa m=attadred zasddiii®al siieei s5nx�gtheaamsof the sob ca�c6�ssmd sh�ea Rho otaatfhase eei rshs� employee�7fthesuh-ta�aaas7�e�oF��Y�1�•idet�> '�P•F�3'amahez. , am ara eoipIa sr t7iatis praurdirg tvcrkers'camperesadaft utsrirarecs nr my eacglaS� Berg is ilia pazi y a job s� IasmanFeComgangName: _ - . • 'Foaq¢or f-i Iic. r}aDafe: job 9de Addre Cifg tafel - AEtarh a copy of the snarl ere compeusatiompolicp decEm atiait;page(showing the policy mmEber and espii stioa d ate)- Faihne to se=e cawmage as required under S=tmn 25A of MGI a 1P can lead to the imposil of rximinai peualtePs of a fine up to$L 5OD OQ andfor one-yewimp�ssmm2eoi;as wi li as civil p-19- a fhe faun of a STOP WORK ORDERand a ftme of up to$250M a drg against the violAnn Be advised fhaf a copy of this zbkmmt maybe fmvarded fa the Office of luvesttatioms of 9m DIA.for hsutmm coverage ved&a1 iQn Ida her4o&y cedWader tImpidns qdpPutNff4qfperjzuy flirt t ie u farma6bx pent&d abom is true and correct Ord use wz]D&,Do aot write in Ms area,€a be compLeted by taffy artatFn a,;jjiciat City or Taws: t:nse Issuing gnffio-rity(dr&one): L BmA of I3•e2Ith 'T leg Department 3.6iy1rosea Omk 4.Eledriod Fnspec w S.PI�hiag hMPCCWF Cantact Persaa: Phone 9- 6 �/ `•= -/1\A SIR 1 G .\.■/[� Y..11�•. 1 �■/1■ ••�h t. rl .- ■- ••.l.1rR roan r1 Yl.•I• itt d t rlln • r • -•r •rh•■ it i/ • :1■.r•� .1..i .It r•nl. r • ■n • . �.u • •:r ■am-• _ .n n u• n■r rr.■ n�.h nrr .Y■wrn•■ rn •• _n u■ n •n^ -r a■nt n _n• ••• . ■■•1 - .• 1/ - \1■1 -in■F ■LA- JI■ n P■■I■: i/ - .) �.�■lr■•w • •� K �• :ann ■•r ■l i■ •r • ■ t ■�- • :1. .t.■ •I■ ■.■ \\rR■tlr -A�•wY.■•■l. ■1 •■\� -_ :i.111 • �.I.1\ •' .1: �f1.n \•rr- i••• •� ll •r'• • - ■ 1 ■.' /■• ■-•t■• 1• n.1 - ■/.■. 11. .r.:1 n.:r■Il :■1■ •'/+• Y■ n u ti■■ n •• " • Vat.-.21 • n- .• - 1 n• ■•■A- • •t•■•.i ••t• �■•n r• I�ih.1. 1■ .• .■-f nitot.n r •n f ■r■■1 ■I - ■-t1 •'■■. .l■ rl / .•• 1111� ••■A" • •oil t/ J •/1•• \7 •It /.1- -t■■•1 •-t/JII .r - n ■ 1 •. ■r.r./■ - • • .t i51t.■ ■•1.r•1 ■ l��■■�t .■ I" -tt �ftn • tea. 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AWC Guide to Wood Construction in High Wind Areas:110_mph.Wind Zone Massachusetts Checklist for Compliance(790 ChIR 5301.2.1.I)1 • Q Chek 1.1 SCOPE Compliance Wind Speed(3-sec.gust).._............................... ..... ........•...................................._ ........... .110 mph Wind Exposure Category . .._......................................................... — 1.2 APPLICABIL r7Y Number of Stories ....................._......... ................. .. :. ..(Fig 2)........ .............. stories 5 2 stories _ RoofPitch ....._............................................................. .(Fig 2) 512:12 ..... ......... ......... Mean Roof Height ................................... = Building Width,W. .. ..........__.... ........._.... ....(Fig 3). . ................._....._....... ... _ft 5 80' Building Length,L'.............................................................(Fig 3)...:........._...... ... ................:.. _ft s 80, Building Aspect Ratio(UW) ..................._..........................(Fig 4).....:..........................._............... 5 3:1 Nominal Height of Tallest Opening? ....... (Fig 4):.................................................. 5 6'8 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2).:....................................................._....... 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete................... .... ............ ........................................... .............. ConcreteMason ....................................................._.....:........................_............:.......:.......:.._Masonry• ...... 22 ANCHORAGE TO FOUNDATION 5/B'Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only :. Bolt Spacing-general............................................(fable 4). .. in. Bolt Spacing from endroint of plate .(Fig 5).......I........._........... in.5 6'-12. Bolt Embedment-concrete.........................................(Fig _ Bolt Embedment-masonry.........:..............................:(Fig 5)........................................_.. in.Z 15' Plate Washer......................................................... (Fig 5)............... ..............................Z 3'x 3"x V4' — 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 55).................................... Maximum Floor Opening Dimension_................................(Flg 6)............................ ' ft 512'or L/2 or W/2 _ Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6).................................... Maximum Floor Joist Setbacks — Supporting Loadbearing Walls or Shearwall::............ Maximum Cantilevered Floor Joists Supporting Loadbearing Wails or Shearwali.......`.........(Fig 8)...................... ............................ ft 5 d Floor Bracing at Flydwalls...... .....................................:(Fig 9):. :............... — ... _ Floor Sheathing Type ..........................................................(per 780 CMR Chapter 55).................. _........... _ Floor Sheathing Thickness.........:........__..c.... ...........(per 780 CMR Chapter 55)..............:........ in. _ Floor Sheathing Fastening.................................................(Table 2).._d nails at in edge/_in field 4.1 WALLS • ;. . . ; Wall Height Loadbearihg walls........... .. (Fig 10 and Table 5)........_......._......,_ft 510, ....._ Non-Loadbearing walls A� - (Fig 10 and Table 5 _ft 5 20' Wail Stud Sparing i4.. .....(Fig 10 and Table 5 in.5 24"o.c. ._.... — Wall Story Offsets .............. ......(Figs 7&8)..............._.:.. _aft 5 d — 42 EXTERIOR WALLS r " Wood Studs Loadbearing wails................. ...............................(Table 5)..............................2x_-_ft_in. Non-Loadbearing walls....................................... ........(fable 5).............................. in. Gable End Wall Bracing Full Height Endwall Studs............................................(Fig 10).................._...................... ._...._.............:... WSP Attic Floor Length.. _......................(Fig 11)........................................ —ft>W/3 Gypsum Ceiling Length(if WSP.not used)......._..........(Fig 11)......................:..... _.------ _.:._ft 2 0,9W ' 2 x 4 Continuous Lateral Brace @ 6 fL o.c...(Fig 11)...:..............:.................................. Double Top Plate Splice Length ..........................................................(Fig 13 and Table 6) ....... .-------- It Splice Connection(no.of 16d common nails)..............(Table 6).........:................................_............. f , AWC Guide to Wood Construction in Hight tend Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(7s0 CMR 5301.2.1.1)t Loadbearing Wall Connections Lateral(no.of endnalled 16d common nails)..._.........(Table T).._......................_............................ Non-Loadbearing Wall Connections Lateral(no.of endnaled 16d common nals).._...__.....(fable 8)................_............................._..... Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans .................»...............................:...(Table 9)........_......................_ft_in.s 11' Sill Plate Spans ..................................................(Table 9).............................._ft_In.!;I V Full Height Studs (no.of studs).. .. ......._......... _._. (Table 9)........................................................ Non-Load Bearing Wag Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans.............._.............................................(Table 9)................................_ft_In.512' Sill Plate Spans............................................._.............(fable 9)................. ......... ft_in.512' .... Full Height Studs(no.of studs)............ .............__...(fable 9).............................................. ...... Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously" Minimum Building Dimension,W Nominal Height of Tallest Opening2 ................................._...._..........................._..........._5 6'ir SheathingType................_............................(note 4)...................................................................................... Edge Nag Spacing..................................__..(fable 10 or note 4 if less)........................ in. Field Nail Spacing.........................................(Table 10)....................._..................I.... in. Shear Connection(no.•of 16d common nails)(Table 10)_..._............................................... Percent Full-Height Sheathing...........:... (Table 10)_...._............................................. % _ 5%Additional Sheathing for Wag with Opening>6'8'(Design Concepts).............. ... [Maximum Building Dimension,L Nominal Hei hi of Tallest O enin .............................................................._<6'8• _ SheathingType................................_......._..(note 4).................................................... Edge Nag Spacing...................._...................(Table 11 or note 4 If less).....,.................. in. Feld Nag Spacing...._...................................(Table 11)...................................... ........ ... in. Shear Connection(no.of 16d common nails)(Table 11)........................................................ Percent Full-Height Sheathing.......................(Table 11)........................_. 5%Additional Sheathing for Wall with Opening>6'8'(Design Concepts)..................... Wag Cladding Ratedfor Wind Speed?............._....................................................................................._................_... 5.1 ROOFS Roof framing member spans checked?..............._......(For Rafters use AWC Span Tool,see BBRS Website) _ Roof Overhang .................. ............................. (Figure 19)............. ft s smaller of 2'or U3 _ Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12)...............................__.._ . .U= plf _ Lateral......._...................................(Table 12).....•......._..............................L= Of _ .................(Table 12)..........._................. _ Shear..................... - P Ridge Strap Connections,If collar ties not used per page 21..... able 13 ..............................T= pif Gable.Rake Oubooker...............................:.........(Figure 20).............. ft s smaller of 2'or U2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift................................................(Table 14).............._...........................U= iti. Lateral(no.of 16d common nails)...(Table 14)................................ ...:..L= Ib. _— Roof Sheathing Type..................................................(per 780 CMR Chapters 58 and 59)............ .. RoofSheathing Thickness................................_........................................................ ' in.a TI16'WSP Roof Sheathing Fastening............................_............(Table 2)........ ..............._................_..._. Notes: 1. This chest must be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of T80 CMR 5301.21:1 Item 1.If the checklist Is met in its entirety then the following metal straps and hold downs are not required per ft WFCM 110 mph Guide. a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per'Figure IT e. Comer Stud Hold Downs per Figure 18a. 2. Exception:Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2•in.nominal thickness.pressure treated#2-grade. r -K ` AFVC Grade fo i-P`bod Cor7n5'uc:6orf art f{ia�h ;run-dArecrs:IfO M-prx fY WdZoae Massachusetfs Cheek fog- CampUMCe PRO a• From Tables 1 D and 11 and iocafion of wag shaaihing and Blunting A.s adRafloi de&nTdne Perto=tA Fur(-Height• Sheaffiing and NA Sgating b. W=d Structnal Panels shall be minlraum thidrness❑f7116'and be installed as fbDDwx - - L Panels shall be insf abed�oft 9=g1h ass parallel tg sfsrris. I M horimr W job is sM otstr aver and be;naiad in frlanmg. M. On side s3nty mmst gin,panels sham be attached b botbm plates and top.inember of file double -.-- — P - _ — ---- ---- .--- - --- __---- --- _Onhuo.sbrycciish aSonr shatlbe20a t0JhdlapmeMber-of-the.upper double#op-- --- ph a and b band joist at botfnm of panel-Upper afta of lower pane!shaA be made to band joist and lowerattadrmant Made to.lovrestpbte atfirstoarframirag. ' v. Hori nn:W narl spacing at dodia tDp plains, lard joists,and girders shalt-be a dDishle row aP 6d staggered at 3 inches on tangy per 5graes batm:Verntal and Horimrrfal hlaff ng for Panel Aifat hrnent S. Glaiing prob! [a)new house onccdmnfaladd cxn—required ifprnje if i mrle orciosertct shore(genera y,svufh of Rte.ZB ornar1h of Rta 6) b)vertid addffian—Mtragffid unless them is wt'rsive rwmrADn io fhe fi st1nor . c)mplammentiMciD as—needs energy rrorrsarvation compGaric;Drily(chap 93) E.Wood Frame Canst uation Manual OWCli/j for 110 MPH, E.xpusirm 9 maybe obtainedfrorn the American Wood Caunrsl (AWb)webs ' • •/ r3x�-rs�,r � - tt�td r� -ATE 1L f - it tl� t• � Q � it 11 _ =t it - � � l • cr CL XL m R t t tt -Pd 1 XL: tt pp a ILZ 1 • .S 1i it ju l i IF r, 3`1d1V bJkE:S�+ per- 1`� ,rS- ... 1 � rrxrra�i:tktr�FSPRC24&t�.SL See Ball ?ri Rwd Page _ .lrerbd and HIIrizDrrlal NmTmg - for Panel Aftari mmt ` V G3I xnd I'fm im trial I�fail"mq - fnr NI Aflachmarif _ . r �"E Town of Barnstable Regulatory Services Bn81HSTi,B�S, ; , a AB& Richard V. Scab,Director n,ua Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I C ► ll 'y%'- --- ,as Owner of the subject property hereby authorize y1 to act on my behalf, in all matters relative to work authorized by this building permit application for: • / F A dress o Job) **Pool fences'and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final .inspections are performed and accepted. S' tore-of 6w&r Signature of Applicant Print Name Print Name Date. QYORMS:OWNERPERMISSIONPOOLS Town of Barnstable Regulatory Services o�TM� Richard V.Scali,Director f Building Division spat AM t Paul Roma,Building Commissioner ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": - name home phone 11 work phone# CURRENT MAILING ADDRESS: cityhown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A,person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for,all such work performed-under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall-act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing.Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. r x ; Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 Massachusetts -Department of Public Safety Board of Building Regulations and Standards ,l 11111t1 LI l'LII'l1I 1,ISlir'1 (]L G IT`211i111� License: CSFA-057394 o • ROBERT G WADI 735 Old BarnstablE R e� East Falmouth M 1 S JI1141\J Expiration Commissioner 06/02/2017 e"jeff� nse or registration valid for individul use only Lice . Office of Consumer Affairs&Business Regulation If found return to: n before the expiration d Regulation IiOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and`Business Type: 10 Park Plaza-Suite 5170 y' ttiRegistration: :141991 DBA Boston,MA.02116 y�Expiration-.--3%3/2018.. HARBORSIDE REMODELING, ROBERT WALSHt/t/� 250 CAPTAIN CROSBY ROAD {_ y '' Not valid without signature 'CENTERVILLE,MA 0263'1 Undersecretary y a� w 44 t. r r. r * 1 Parcel Detail Page 1 of 5 HE 107 MASb 04 Logged to As: Tuesday,:July 5 2016 Parcel Detail . PArc..i_,.LQokup Parcel Info _ __. .._._____. ._, __._.._._._..__ __....._.."._ ..............__.__._ Parcel ID[246-136 � Developer Lot SLOTS 447&449 - Location 40 SIXTH AVENUE(,i /A Pri Frontage j�80 -7 _. - sec Road aMAPLE WAY <� Sec Frontage 1100 n Village HHyyan Fire District HYANNIS Town sewer exists at this address<NO ( Road Index i 1492 1 . Asbuilt Septic Scan: k 2461361 Interactive Map " I Owner Info _ Owner YBUNKER^.,.0 PETER&EI� owner ..., streets 52 GLENVIEW DRIVE l street2I. oty�HUDSON: w.�,...,.,_. ..�.I state H <..�. zlP 03051 <,�., ,r..,.�.,,,..:, ,�.,,,,�,.»...•,m.,.Po,....�� Country Land Info ......... _ ......._.. ......... _ ............ ......_.... .... ............ _...... Acres 0 185 .. useSingle Fam MDL-01 ..,,,,,,� zoning!RB ,,,. ,., rlghbd0109 Topography!Level Road!Paved Utilities Septic,Gas,Public Water I Location Construction Info ._.. ................. .......................... .....__......... Building 1 of 1 � Year i Roo !Gable/Hi f ext''Wood Shin le Bull[^ ., 1951 i Struct. p Wall+ g Living AC Area 750 Roof�As h/F GIs/Cm J Type !None Area Cover� p p Type? Style a ch wat Plywood Panel RoBed,Fj2Bedrooms N J Model Residential 1 Flo� Hardwood« R omsFull-0 Half Grade Average Type,!Hot Air Rooms$4 Rooms Stories>1 Story Heat GaS Found Blk/Pour Ft s _ 1, „, Fuel: _ adon g Gross Area 1210 V/ w Permit History C►,�f Insp ... /� Issue Date Purpose .. Permit# Amount Date Comments 6/30/2016 11/23/2015 New Roof 201508045 $5,200 12:00:00 REROOF RESIDENTIAL AM http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=17218 7/5/2016 Parcel Detail Page 2 of 5 9/20/2012 New Windows 201205806 $5,500 6/30/2013 REPLC WINDS .31 U 12:00:00 VALUE AM 6/30/2010 REPL 3/2/2010 New Windows 201000886 $4,500 12:00-00 AM WINDOWS,SLIDER,RESIDE 12/4/2008 8/22/2008 Remodel 200804493 $4,500 12:00:00 BATH REMODEL AM 1/1/2002 4/19/2001 New Roof 52868 $3,700 12:00:00 AM Visit History....... ... .......... ......... _.. _........_ ........ Date Who Purpose 9/11/2014 12:00:00 AM Susan Ricci Cycl lnsp Comp . 3/18/2010 12:00:00 AM Paul,Talbot Drive by inspection only 3/18/2010 12:00:00 AM Paul Talbot Drive by inspection only 12/4/2008 12:00:00 AM Mike Keating Bldg Permit Completed 8/14/2008 12:00:00 AM Michele Arigo In Office Review 7/19/2007. 12:00:00 AM Jeannette, Kirwan In Office Review 7/9/2003 12:00:00 AM Paul Talbot Meas/Est 3/19/2002 12:00:00 AM. Martin Flynn'. Drive by inspection only 7/28/1999 12:00:00 AM Donna Dacey Meas/Listed-Interior Access Sales History . Line Sate Date Owner Book/Page Sale Price 1 7/20/2012 BUNKER, C PETER & ELAINE M 26515/1 $1 2 6/23/1966 OBRIEN, WILLIAM A 1339/376 $0 Assessment History......... .. . ........ .. ..... Save Year Building XF Value OB Value Land Value Total Parcel ValueValue 1 2016 $54,400 $.9,700 $1,100 $240,400 $305,600 2 2015 $62,1.00 $10,600 $1,000 $225,100 $298,800 3 2014 $58,000 $10,600 . $1,000 $225,100 $294,700 4 2013 $58,000 $10,600 $1,100 $225,100 $294,800 5 2012 $58,000 $10,000 $900 $225,100 $294,000 6 2011 $74,000 $3,000 $600 $225,100 $302,700 7 2010 $74,700 $3,000 $700 $230,000 $308,400 8 2009 $73,800 $2,400 $300 $235,400 $311,900 9 2008 - $85,900 $2,400 $300 $266,200 $354,800 11 2007 $85,600 $2,400 $800 $294200 $382,700 12 2006 $79,200 $2,400 $300 $282,900 $364,800 13 2005 $75,200 $2,300 $300 $143,700 $221,500 14 - 2004 $66,200 $2,500' $300 $143,700 ~$212,700 15 2003 $52,600 $2,500 $300 $62,900 $118,300 http://issgl2./intranet/propdata/ParcelDetail.aspx?ID-17218 7/5/20I6 Parcel Detail Page 3 of 5 16 2002 $50,100 $2,300 .$300 $62,900 $115,600 17 2001 $50,100 $2,300 $300 ' $62.900 $115,600 18 2000 $38,500 $2,300 $200 $41,300 $82,300 19 1999 $40,900 $2,200 $0 $41,300 $84,400 20 1998 $40,900 $2,200 $0 $41,300 $84,400 21 1997 $39,600 $0 $0 $53,100 $92,700 22 1996 $39,600 "$0 $0 $53,100 $92,700 23 1995 $39,600 $0 $0 $53,100 $92,700 24 1994 $41,300 $0 $0 $47,800 $89,100 25 1993 $41,300 $0 $0 $47,800 $89,100 26 1992+ $46,900 $0 $0 $53,100 $100,000 27 1991 $52,200 $0 $0 $64,900 $117,100 28 1990 $52,200 $0 $0 $64,900 ' $117,100 29 1989 $52,200 $0 $0 $64,900 $117,100 30 1988 $35,500 $0 $0 $24,800 $60,300 31 1987 $35,500 $0 $0 $24,800 $60,300 32 1986 $35,500 $0 $0 $24,800 $60,300 Photos 75 zAS WMMa E j yt�ta http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=17218 7/5/2016. Parcel Detail f' Page 4 of 5 9 r T l t yIN8�08� F Ale A Ik ( � d y.a s x � Y �� 3' t u t http:Hissgl2/intranet/propdata/ParcelDetail.aspx?ID=17218 7/5/2016 Parcel Detail Page 5 of 5 v r j £ va f, • http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=17218 7/512016J. Town of Barnstable iilln reet°-A rouedtiPlans<Must be;Retamed on Job and th-is r Gad. u Mst be Kept��61 ' Post ThisCard So Thatit is Visible From t e pp ■AILKt2Y'ABiI, W , rt 3. �,'.. • AS Posted Until Final Inspect�on,Has Been Made =� ¢ " ;Burld�n shall Not be O.ccw ae`d un#fl a%Final Ins ectaon�has beenmacJe Permit Where F Permit No. B-16-1943 Applicant Name: BUNKER,' C PETER& ELAINE M Map/Lot: 246-136 Current Use: Zoning District: RB Date Issued: .07/28/2016 - Permit Type: Shed-Residential-200 sfand under Expiration Date: 01/28/2017 Contractor Name: Location: 40SIXTH AVENUE(HYANNIS), HYANNIS Est Project Cost: $0.00 Contractor License: Owner on Record: BUNKER,C PETER&:ELAINE M _ Y PermitFee� $35.00 Address: 13 GLENVIEW DRIVE - f Fee Paid � � $35.00 HUDSON, NH 03051 Date. may.. 0 7/28/2016 ,. Xo Description: •8x14 Shed - Project Review Req ; 8x14 Shed g Building Official k Xa�b tl a�� 'r. This permit shall be deemed abandoned and invalid unless the workaathonzed by this;permrt s�commenced within six months after issuance. All work authorized by this permit shall conform to the approved application,and the approved construction documents four which this permit has been granted. All construction,alterations and changes of use of any building and structuresshall beiicomphanee''withthe lI cal zornng by laws=and codes. This permit shall be displayed in a location clearly visible from access street o`r,road and shall be maintained open for public inspectron for the entire duration of the work until the completion of the same. M � The Certificate of Occupancy will not be issued until all applicable signatures by the Building and fire Officials are provided on this permit.. Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing 2.Sheathing Inspection 15 3.All Fireplaces must be inspected at the throat level before firest fluelning is installed z 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) ( , 6.Insulation 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed untifthe Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 6 Town of Barnstable Regulatory Services BUILDING BBPT Richard V.Scali,Interim Director AM ' Building Division JUL 11 ��� h Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 TOWN OF BAHNSTABLB www.town.barnstable.ma:us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# �` lU ~ �✓ FEE: $ v� SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less `4 o' ' ki d, i Location of shed(address) N Village By ?6-yc-T S1 " Q R.- Property owner's name Telephone number / Size of Shed Map/Parcel jz/ Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old I{ing's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: 1F YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:110413 JLL-11-2016 09:37A FROM:KP REMODELING 15084202163 -M:16038829456 P.1/1 Tawas of Barnstable s Regulatory SeMms Mebsra V.5esfi,M69W ` wilding 0vidon Tom Perry,Bum =e-F 200 Main Mat,Ryarmck MA 02601 www townJmrWtWe.m 10 offico: 5084W 4038 Fax: 5o8-990-6230 F.topetty Owner Must Complete and Sign This Section sin A BURAe,r i ,as Owner of the subjeet property hereby aud�orize to anti on my bchalf, .in aU mamM raladve to work authoa=d by this build permit application for (,lea of Job) **Pool fence'► and alarms ate the respoUSibility of the applicant. Pools are not to be Wed or u fized bcfmc fence is instaBcd and all final inspections are performed and accepted. *gnmrc of 0W= S40==of 9>Q B(.drylttrllr' �C2� PAu Name Print Nam 024 Client#:9580 2KPRE DATE(MMIDDNYYY) ,,AOORD. CERTIFICATE OF LIABILITY INSURANCE 1 7/11/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(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 endomement(s). PRODUCER CONTACT NAME: Dowling&O'Neil Insurance Ag P"°NE 508 775-1620 FAx 5087781218 AIC,No,Ert: ac,No 973 lyannough Rd,PO Box 1990 E-MAIL ADDRESS: Hyannis,MA 02601 INSURER(S)AFFORDING COVERAGE NAIC# 508 775-1620 INSURER A:Penn-America Insurance Company INSURED INSURERB:Associated Employers Insurance Kenneth Perry D/B/A INSURER C K.P.Remodeling&Construction INSURER D 19 Guildford Road INSURER E Centerville,MA 02632 INSURER F COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL UB POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD MMIDD A GENERAL LU161tJTY PAC7108843 3/04/2016 0310412017 EACH OCCURRENCE $1,000,000 PREMISES X COMMERCIAL GENERAL LIABILITY Prrence $50,000 CLAIMS-MADE �OCCUR MED EXP(Any one person) $5,000 X BUPD Ded:500 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $1,000,000 POLICY PRO- M LOC $ JECT AUTOMOBILE LIABILITY CEOs BIINED SINGLE LIMB $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ anti ti" EXCESS LIAB CLAIMS-MADE AGGREGATE $ `- DED RETENTION$ $ r B WORKERS COMPENSATION WCC50050054502016A 0611312016 0611312017 X WC STLA S °TH ER AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/DCECUTIVE Y/N - E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE s500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) **Workers Comp Information** Voluntary Compensation Proprietors/Partners/Executive Officers/Members Excluded:Kenneth Perry,Sole Proprietor Insurance coverage is limited to the terms,conditions,exclusions,other (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Town Of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Bldg.Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE 01988-2010 ACORD CORPORATION.All rights reserved ACORD 25(2010105) 1 of 2 The ACORD name and logo are registered marks of ACORD #S173553IM173552 CBD Town of Barnstable Geographic Information System July 8,2016 246193 _ 246144 #32 #33 1,94 ` 246132 #36 - G � 246136 . #40 246143 #41 �ppLE{NI9Y r 246183 #59 246128 .246169 #52 #53 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal I Map:_246 Parcel:136 = - boundary determination or regulatory interpretation. Enlargements beyond a scale of $eI6C1ed P8rC61 1"=100'may not meet established map accuracy standards. The parcel lines on this map Owner:BUNKER,C PETER&ELAINE M Total Assessed Value:$305600 are only graphic representations of Assessors tax parcels.They are not true property Co-owner. Acreage:0.18 acres Abutters boundaries and do not represent accurate relationships to physical features on the map' Location:40 SIXTH AVENUE(HYANNIS) such as building locations. - - Buffer Town of Barnstable oF�+E r Regulatory Services Richard V. Scali,Director w aszAB , : Building Division BARNSTABLE MAW ewxsTe e•cv nnu t"conm•x uars 1639. Thomas Perry, CBQ � t6J9.2°I.0 EDAAOr� Building Commissioner 200 Main Street, Hyannis,MA 02601 www.t ow n.b a rn s to b l e.m a m a Office: 508-862-4038 Fax: 508-790-6230 July 5, 2016 Peter C. Bunker Re: 40 Sixth Avenue Elaine M. Bunker Hyannis,VA 02601 13 Glenview Drive Map 246 Parcel: 136 Hudson, NH 03051 Dear Property Owners, This letter will serve as a notice of violation on your property. A shed was installed on your property without the proper paperwork as required by the Massachusetts State Building Code 780 CMR and/or the Regulations of the Town of Barnstable. Please contact the Building Department office to begin the process to bring your property into compliance within 14 business days of the receipt of this letter. Failure to comply may lead to fines and additional fees. Sincerely, k Robert McKechnie ` Local Inspector Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 robert.mckechnie@town.barnstable.ma.us i lZ- Z-- i S o� Town of Barnstable *Permit#.Z6I,56 �S FApires 6 months from issue date K Regulatory Services Fee M a • RUMSPABM • 1 �MASS. Richard V.Scali,Director 039. Ep Mpl Building DIVIS110111 Tom Perry,CBO,Building CexififflEss 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us' NOV 2 3 2015 Office: 508-8624038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - Aftf 1V _ Not Valid without Red X-Press Imprint Map/parcel Number 2 ^��(.((J . Property Address ❑Residential Value of Work$ ,0 8 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address d, Ere, O f Contractor's Name i� Telephone Number Home Improvement Contractor License#(if applicable) Email: a �� Construction Supervisor's License#(if applicable) , ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance %surance Comnanv Name. Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will betaken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.-U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of ome ovement Contractors License&Construction,Supervisors License is requir SIGNATURE: C:\Users\Decollik\AppData\Local\Microsoft\ ► ���s\Content.0utiook\2PIOIDHR\EXPRESS.doc Revised 040215 NOUi�19-2015 03:33P FROM:KP REMODELING 15084202163 TO:16038829456 P.1 Town of Barnstable Regulatory Services KAM g Richud V.Sulk Diiettor F •`� Building Division Tons Perry,Bonding commissioner 200 Main Sheet,Hymmis.MA 02601 www town.barnstsbtL=.ns 'Office: 508-862-4038 'Fax: 508-790-6 0 t'xoPAY Owner Must Complete and Sigm-This Section --Builder LAINE 9ttNKER 4 Z � ,as 6wner of the subject PropertY hereby authorize Rrnooeuao - to act on my behalf, f in all matters relative to work authorized by this building pemik application for: ;i AVENUE wFST WANNIS PORT (Addm&s of job) "Pool fences anti alarms are the responmbility of the applicant: Pools , are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Sigtta of Owner lg6auire of Ap t PM . Print Name Prnt Name •U'" C_'vPK'1.W t.: .:. -y NOCJ-19-2515 03:21P FROM:KP REMODELING 15084202163 TO:16038829456 -P. + 6 5 { K. P. REMODLING&CONSTRUCTION. ;A: 19 Gulidford centerWlle:MA. Kennetho. Perry owner cs#078820 DDRESS ICE HOUSE.JOB 40 6TH AVENUE QUEST 1 YANNIS PORT OB DESCRIPTION EPLACE RAKE BOARD REMOVE 13.5 SO ROOF SHINGLES AND INSTALL NEW 3 TAB GRAY FROST UP AND TAKE THE OLD SHINGLES TO DUMP + , TERIALS ' XSX14 PRIME PINE P8,00 XBX14 PRIME PINE pe.00 115 SQ SHINGLES 41 bdI gray frost xt 25 year $1,327,00 bdi 3tarters $109.00 $23_.00 rolls ice water barrier - - - -- --- — -- ---- ; Min n - vent pipe flashing $15.00 pc drip edge white 194.00 box gal 11/4 roof coil nail �W.00 roll$Cobra vent :. SQ8.00 ump fee 3395.00 abor p old roof 13 sq 95 per sp i $1,235.00 abor to inStaN new Hoof 13 sq_ 115 ps�r sq abor to replace trim board 5.00 rmit fee $100.00 " ` Eal due 2p9.00 f Client#:95aO 2KPRE UA I t(MM/UU/YYYY) CORD. CERTIFICATE OF LIABILITY INSURANCE 11/23/2015 IS 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 endorsement(s). PKODUCLK CONTACT NAME: Dowling&O'Neil Insurance Ag PHONE -1620 FAX 5087781218 508 775 (AIC,Nu,Exl►: fAIC,No): 973 lyannough Rd, PO Box 1990 L-MAIL ADDRESS: Hyannis, MA 02601 ;- INSURERIS)AFFORDING COVERAGE NAIC 8 508 775-1620 INsuHtK A:Associated Employers Insurance INSURED INSURER B Kenneth Perry D/B/A . INSUK tH C:. ' K.P. Remodeling&Construction INSURERD: 19 Guildford Road INSUKhK h: Centerville, MA 02632 INSURER F COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. LIMIT& SHOWN MAY HAVE BEEN REDUCED-BY PAID CLAIMS. tNSK TYPE OF INSURANCE AUU UHK POLICY tFF POLICY LxP LIK INSR WVD POLICY NUMBER (MM/uD/YYYY) (MWDD/YYYY) LIMITS GtNtKAL LIAHILI I Y - FAC'H I 1 OCCI IKKFNCF COMMERCIAL GENERAL LIABILITY DAMAGE T^RENTED — PKFMI;;F;; Fa nrrnrmnrr. $ CI AIM;-MAIIF I OCCI IK MI-I)FXP(Any nnc prrsnn) $ PI•KSONAI R AIIV IN.IIIKY $ GENERALAGGREGATE $ hF .I ACirikl-GA 1 F•I IMI I APPI IFS PFK: PKOUI ICIS-(OMP/CIF Aar $ POLICY F JECPKCI- LOC $ AU I OMOHIL6 LIAHILI I Y - COMHINHI SINa1 F I IMI I (Eu ecuJeul) $ ANY AUTO - BODILY INJUnY Irtn pt>luw) $ ALL OWNED SCHEDULED ' HOIIII Y IN.II IKY(P rr irrlArnl) At I I CIS At 110,; NC1N X)W NF I) PR OPER I Y"Am AGI- HIRED AUTOS All I O;R r.,eu aJenl $ UMBRELLA LIAR OCCUR EACH OCCA IKKFNCF $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ LIED RETENTION $ WORKERS COMPENSATION wK AiA OTH- AND 6MPLOY6KSLIAtlILI IY ANY PKOPKIF IOK/PAK I NFK/Fx I-Ci111 IVF YIN - E.L.EACH ACCIDENT $100000 OFFICER/MEMBER EXCLUDED? Y N/A (Mand.lory In NH) - .I-J.I11;,FARF-FA FMPI OYFI- $100 000 If veu,douwibe veldt" I+SCKIPI ION bF OPFKAI IONS hnlnw E.L.DISEASE-POLICY LIMIT $500,000 DESCRIP I ION OF OPERA I IONS/LOCA I IONS/VhHICLES(Altaah ACOKU 101,Addhlonal Kamarks Schadula,If more spaca Is raqulrad) RR Workers Comp Information=` Voluntary Compensation Proprietors/Partners/Executive Officerfa/Members Excluded:Kenneth Perry,Sole Proprietor 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 Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Bldg. Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis, MA 02601 AUIHOKIZEDREPRESENIAIIVh c11988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/06) 1 of 2 The ACORD name and logo are registered marks of ACORD #S161230/M161229 CBD The Co►nn►onevealth of Massachusetts Deparhnent ofInduslrial Accidents Office ofInvestigado►►s 600 Washington Street Boston,MA 02111 wtvrn►nass gov/dia Workers' Compensation Insurance Affidavit: B®lders/Contractors!Electrician/Plumbers Applicant Information Please Print 'bl Name(musiness/organizafiawhdiqudy Address: City/Statdzip: Phone# 4�;_O O �Q 3 Arc you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 1 4. ❑ I am a.general contractor and I 6_ ❑New coi stnretion. employees(full and/or part-time)_* have hired the subcontractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g_ ❑Demolition for me in an capacity., employees and have have �v°rking y 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 1 L❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12A Roof repam insurance required.]T c. 152,§1(4),and we have no ] employees-[No workers' 13.❑Other comp.insurance required-] *Any applicant that checks bos#1 mms<also fill out the section below showing their workers'compensation polies information. T HomEwwnws who submit this affidavit indicatmg they are doing all wont and&w hire outside contractors least submit anew affidavit indicating such.. Contractors dint check this boa must attached m addition- sheet showing the name of the sub-cantracmrs and statE whether or not those emities;bate employees. If the subcontractors haee Employees,they must provide their worters'comp.policy number - lam ere employer that is providing workers'coretpeitm on ieesuranee for sty etupliol em Below is dte polity and job sita information. Insurance Company Name: Policy A or Self-ins.Lic.ft: Expiration Date: Job Site Address: e ' ^n City/State/Zip: MN Attach a copy of the workers'compensation policy declaratio page(showing the policy number and expiration date). Failure to sectere 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 imprisons mt,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 ieuumce coverage verifcation- I do hereby certi render thepainp 's of per�eery drat the information protdded abot1e is true and correct: Si true: Date: J� Phone#: 3"a--i- 3 Official use only. Do not write in this area,to be completed by city or h"un officiaL City or Town: PermidUcense# Lssuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Iown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other :J ` � . CL U U) n � d � F' a wo a0 Co U C \IFN a\.p `tt p 0. W ++ Z p� O _ U F- a) x 1N0 Z i ZN olii , W NI N t ai O O J (1 Vv U o J c Z=U' i.- YU Z O O (L) X a � .J WW, W i— W` j Z r 0)? 1W W' ® ZrZ i � .W. � • Y i1.; Construction Supervisor ----- Restricted to: Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit: WWW.MASS.GOV/DPS _._.. -._ License or registration valid for individul_use only 'before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation JO-Park Plaza-Suite.5170 ` Boston,Mrs:02116 .Not valid withou e f PERMIT Town of Barnstable *Permit# Expires 6 'Ms from rss�ue date Regulatory Services Fee BARNcr MAW 0 2012 i6� Thomas F.Geiler,Director A TOWN OF SARNSTABLE. Building Division om Perry,CBO, Building Commissioner . 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION" - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 7N 1i D f : Property Address C) lO4� f�Xj W e'S MY A'S c3 � rn A' Residential Value of Work Mnimum fee of$35.00 for work under$6000.00 Owner's Name&Address XA3 oloi Contractor's Name 1� �' Telephone Number J � � 0 Home Improvement Contractor License#(if applicable) 3a ^12 , 1 4� Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: El I am a sole proprietor ❑ I am-the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp:Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed).(not stripping. Going over existing layers of roof) ❑ Re-side #of doors Replacement Windows/doors/sliders:U-Value A (maximum.35)#of windows 9 - *Where required; Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter.of Permission. A copy of the Ho rovement Contractors License&Construction Supervisors License is required. SIGNATURE: C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet es\Content.Oudook\DDV87AAZ\EXPRESS.doc Revised 072110 fIiassachu setts, -Department-of Public Safctl Board of Building Refg emulations and Standards Construction Supervisor License.: License: cs. '76820. KENNETH O PERRY-19 GUILDFORD ROAD.• s CENTERVILLE,'MA 02632 r Expiration: 8/28/2013 Tr#: 3806 . t .Y Oftrce.of Coirsmner Affar dsinesnl° t.-ens or: reg�st:atrmi ;li rfOME IMPROVEME JT CONTRACTOR :before the expiration date. If founddfori r�pdul use oily Registration 132282 `. turn to ' Expiration: 12/21%2012 Type { Office of Consumer Affairs and Business'lkebu:ation' i DBA I 10 Park Plaza-Suite 5170 K P 'EMODELING+ ~; Boston;MA 02116 I V 3 : KENNETH PERRY t '? 1. 19 GUILU0RD RD ;f � CentErville MA 02632` � � g •--�— �; - ' Undersecretary i a Not valid wr attire I The Commonwealth of Massadiuselis Department.of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 ►viinnutass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print 'bl Name(Bussiness/Organization/indivi ): Q `� � �s-Address: L)��ii- n _ City/State/Zip: 6ty� V\ -e NN VK Phone#: ��� C'� Are you an employer?Check the appropriate box: Type of project(required): 1.D1 I am a employer with A 4. ❑ I am a general contractor and I employees(full and/or part-time)-* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g_ ❑Demolition working for me in any capacity. employees and have workers' g ❑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 1 L❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12_❑Roof repairs insurance required.]i c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required_] *Any applicant that checks bon#1 ttmst also fill out the section below showing their workers'compensation policy information 1 Homeowners who submit this affida qt indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. +Contractors that check this bon must attached an additional sheet showing the name of the sub-comractors 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 at employer that is providing workers'compensation.insurance for my employees. BeIoty is the policy and job site information. Insurance Company Name: aa 1 Policy#or Self-ins.Lic.#: �. ��d � d U' Expiration 1 Job Site Address: k0it, Ippee City/State/Zip: Attach a copy of the workers'compensation policy declaration (showing the policy number and expirati n 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. 1 do hereby erhfy under the pains t p to a perjury that the information provided above is trite and correct Si tore: Date: d / Phone M Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 f Client#:9580 2KPRE ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 08/(MMIDD 2 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(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 endorsement(s). PRODUCER CONTACT NAME: Dowling&O'Neil PHONE 508 775-1620 FAX Insurance Agency a ANe Ext: ac,No): 5087781218 IL ADDRESS: 973 lyannough Rd., PO Box 1990 INSURER(S)AFFORDING COVERAGE NAIC# Hyannis,MA 02601 INSURER A:Western World INSURED Kenneth Perry D/B/A INSURER B:Associated Employers Insurance K.P.Remodeling&Construction INSURER C 19 Guildford Road INSURERD: Centerville,MA 02632 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ INSR TYPE OF INSURANCE _ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD MM/DD/YYYY A GENERAL LIABILITY NPP8014991 3/04/2012 03/04/2013 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea o.0 ence $50,000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $5 OOO X BI/PDDed:500 PERSONAL&ADVINJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $1,000,000 POLICY PRO LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SC AUTOS HEDULED AUTOS: v BODILY INJURY(Per accident) $_ ,� g" I '"r 1 NON-OWNED , PROPERTY DAMAGE HIRED_AUTOS AUTOS 4 ( r' Per accident UMBRELLA LIAB m OCCUR EACH OCCURRENCE- $ - t EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY WCC5OO5450012012 6/13/2012 06/13/201 X WC STATU- OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $100 000 OFFICER/MEMBER EXCLUDED? � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Kenneth Perry is excluded from the workers compensation policy. 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 coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION - 71 Town of Barnstable. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, -NOTICE WILL BE DELIVERED IN 3 Bldg.Dept., I ACCORDANCE WITH THE POLICY PROVISIONS. - 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S99589/M99587 LS1 �n+e i s • BARNSrABLL • 9 A, Town of Barnstable " Regulatory Services Thomas F.Geiler,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 Property Owner Must Complete and Sign This Section If Using A Builder nk LA-o as Owner of the ero subject l P p rtY hereby authorize he.Yh(dG(I m q-- to act on my behalf, in all matters relative to work authorized by this building'permit application for: (Address of Job) t Si ture of Owner 6ate lCi►^,� Mks✓ Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. I C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 aY o 000 jD . Town of Barnstable Permit# r Alla Expires the a date . Regulatory Services Fee f BA 2010 Thomas F. Geiler,Director � Building Division h'IVsrA t3L , Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.baristable.ma.us Office: 508-862-4038 Fax EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X=Press Imprint Map/parcel Number Property Address L 0 5 /�X l P �• ❑Residential Value of Work SUM) Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 47 Contractor's Name h r Telephone Number �"l) Home Improvement Contractor License#(if applicable) I U t Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑.I am a sole proprietor. „ .. ❑ I am the Homeowner ® I have Worker's Compensation Insurance Insurance Company Name i T� Workman's Comp.Policy,# c o Q ( ©® Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) \ Re-side 'SL #of doors Replacement Windows/doors/sliders.U-Value �1�J`°N (maximum.44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations;i.e.Historic;Conservation,etc. ***Note:, Property Owner must sign Property Owner Letter of Permission. A copy ofthe Home Improvement Contractors License&Construction Supervisors License is required. : , , SIGNATURE: C:\Users\decollik\AppData\Local\Microsoft\Windows\Tempo Interne Files\Cont Outlook\4STGU5QO\EXPRESS.doc Revised 090809 u g y r { is t �r .ka tf I 4 .A j. III Ii : - _ ". E otk 'N��� '. t ,,' 9 T k U I ir, asp 4 �II I - HOME IMPROVEMENT CONTP2AGTOI2 [Massachusetts- Depai tmcnt of Public Sut'et� :.. �T Reg and Standards i y " Registration 132282., Board of Buildi.n. �f .,.Construction Supervisor License . J Expiratidif 12V21/2010 Tr# 278840 License .CS 76820 �= - _ Tyke DMA) ReSfricted to OOt , y K P REMODELI - ait KENNETH PERRY' --M a' KENNETH O,PERRY 19 GUILDFORD RD 19 GUILDFORD ROAD Centerville MA 02632�'4 CENTERVILL:E MA102632 ' Administrator .�� Expiration: 8/28/2011; yµVy 1 rti A +k Tr#: 1362 (om..N iuncr � 4l ^^ ,rf ; J opU POTS Puu S or[r�?I aausotZ�.0 cuo 'flgo aso In lar Puno� 4win;;'a�Ict trol•+ng,- I sob. P!�!Pu!ao�P!ln�gP uo!;g;;pl!nBJo p UO uor;u� .dxa t, a og .. )sJ�qa�-to asu,f� _ L .+ Massachuutts-.Dc p:ii tmcnt:of PublicrS:►fctv Board of Building Regulations and'Standards Construction Supervisor License License: Cs.N 76820 �: Y Restricted to 00 KENNETH O:'PERRY .. 19 GUILDFORD ROAD ' CENTERVILLE, MA 02632 ` Expiration: 8/281201 T Tr#: 1362 commissioner GlentAl:9880 2KPRE D. CERTIFICATE OF LIABILITY INSURANCI11/1 9 IROOUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ?owling&C'Nell Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE >�ency HOLDER,THIS CERTIFICATE DOES NOT AMEND,MEND OR ALTERT44E COVERAGE AFFORDED BY THE POLICIES BELOW. 173 lyannough Rd., PO Box 1990 lyannls,NIA 02501 INSURERS AFFORDING COVERAGE NAIC 9 4SURED INSURER A; Western World Kenneth Perry DIS1A INSURER B: Associated Em to ersS Insurance K.P.Remodeling&Constructtion INSURER C 19 Guildford Road INSURER D; Centerville,NBA 02632 INSURER E. :OVERAGES 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 CONDMONS OF SUCH ` POLICIES.AGGREGATE LINTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. In IL ME TYPE OF INSURANCE POLICY NUTABER POLICY—RAMLa ffilla Y RATS LIMITS s GEMMUL LIABILITW NPP1203292 03104109 03104/10 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIARILITY DAMAGE TO RENTED S5 00 CLAM MADE ®OCCUR MED E%P 0" } S5 000 X BI1PD Ded:500 PERSONA.t1 ADV INJURY 51.000.m GENERAL AGGREGATE $a 00a 000 GENt AGGREGATE uMrr APPuEs PER PRDDUM•COMPtOP AGG $1 000 000 POLICY JggjPRE LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea aft} ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (p-P-) S HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS I az tml} r PROPERTY DAMAGE i s (PW ecddem) GARAGE LIABILITY AUTO ONLY-EAACCIDENT $ ANY AUTO OTHER THAN EA ACC $ r AUTO ONLY: ADO i EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ®CLAIMS MADE A93GAFGATE 5 g .. DEDU6TISLE S RETENTION 9 WORKERS coMPEIIS$ATm AND WCC5005450012009 00113/09 06113110 X OR eTATY LIME oTH- I ANY PRDPRIseO I LIABILITYTaRrPAInNEIVEXEctrrnrE E.L.EACH ACCIDENT $100 000 OFFICERNEMSER ExCWDED? YES EL.OISEASE-EA EMPLOYEE $100 000 S tf_yea deep a u E.L.DISEASE.POLICY LIMIT $500 000 OTHER IESCR1FnON OF OPERATION$I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORBEIpENT I SPECIAL PROVISIONS fenneth Perry Is excluded from the workers compensation policy. nsurance coverage Is limited to the terms,conditions,exclusions,ether Imitations and endorsements. Nothing contained in the certificate of nsurance shall be deemed to have altered,waived,or extended the See Attaciaed Descrlpdons$ 'IfMEME HOLDER CANCELLATION SHOULD ANY OF THE ABWM WSCRIBEO MACIES OF CANCELLM 613FORR THE EXPIRATION Craig Lyons DMTMMEW,WEMMGMUIIERVM.LEMMAVO$kTOMAM 4(k DAYa WRrrrEN PO Box 411 NOT=To THE CERrtmATE ROLOEA NAMED TO THE LEFT,WT FAILURE TO 00 SO SHALL West Hytannisport,MA 02672 WOO*NO OSLIGAMON OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIEJ D PRESE91TATINE WORD 25(20.01/08)1 of 3 OSS324141V.59004 L.S1 a ACORO CORPORATION 1988 t Tire Corrrmotrmea th-of assachimems �► r77�in�rrt��f`�T;r�e�ra�a�rta�l.����-�,r�'���.ts Of "OfInvestigation:s Workers' Compensation insurance.. fides-vit.:BuilrtersiCentractoi sITlechicilus`Plui tiers 4policaut Information Please Pt nt Legibb n Name am-^es,-"Orgy =4 Address: ��1 c ' ' it,rr�'State ziv: U3 lz� is c�—=-ate Are you an employer?Check the appropriate box. TYPe ofproject;(required: 4. l am a =�ener i t act and 3 1. .aiu a ei^,YL�I�>er i f ❑ ❑Ne. c ,t_tictiin emplcyee-ffi.l anctorpaa•t f Y .`� ha, hxed±e�rub-ccmtractc s =.❑ I ai:Y a sale ro}rietcr,r.car er-- li.te�i ren�e anached sheet. �Remcdelinff ship and ba a zc eruplo__ees Thee sub-contractor,ha;e G. F1 Ueme ition for me in�n cava 3r-. e l ,tee,and 3Y3ye;workers Ei41l�li xe a clvitiou (No cike ,-comp irl,tuaace = ' Mace: resltured:- : ❑ •..e are a corporation acd As El E .L..1.tezau,o_ a,�cli-ici_s .❑ I am a ticr_Yez:.•flee dcii:7 a_l-1,tl f�icers ha se eszr:iseci thei `1_❑PlILTI:i:ze i PaU, ci ac1�ti•:Y nay_elf. o o:l.er ca:L . r alit cf.ex tion per MGI. insurance z tired: - 15- §1 E4,.a a e t:�no zits:�,i=e . t.�r ar _?.❑otEie. — cmip..iaulmuce regtrired.] *.z�}a p i:;i€ i: :its',• =Y 3Ya.t sL= 511 on:L.e se_ozi 6eE:�r Eton :yes* :er_'tau pet�a_e=petit-info c coa. - cmco,s,?.,,1•.to x5A:,s_r ima:stts-�zr am cloias S11 Weirs r_�L: €s Lre c tine tra_x►_z art ;u:mi a rox afi_cic::,_r mdi_aru_ :i:u -ti.,€rx=:a=;:"sa€�e_3 z)r>`rs>";,r:•.aacY.tw;z,,c:dr,as.=�et:si-z._ae rLFc..�:?o'3se:::=iLLc€; :r._>�iudse�:eztff?=s=1zi€uo.e°-u._c_e ir�:� ?:VU501?E:. Y`cl'Ea�+,-�oSCB:[0:��:L;.:EEL tv•'E?S,.:cY_'+:[r7:"a[�i0's liL_L_=`iC1Ei :iLp.;�t61C1'�'TA:C�Ei. Irrrr apt empki'ertlrat f=_providhig o-varkers',:compensaarfoia fusurancefor rrtY errij lows. Below is Me}rolici'widjob sift n r,�r.r°rl r a ri c�rr. Aitr•�._mice f~oinl�an Z Polo:--ow Self-ins.Lic.r: a+U cc 400 aO3q Espuatior_Date4ae-i A ?ovt4 a -s(- ) V e *Acjr-State,zip: Attach a copy of file%vo irk ers'compe sation policy declaration page f%owing the policy miluber and expiration date. ailure to secs:e c eraze as regu red u_ciff Sec ti on A of 1_1 _-mil lead to-Le itupe=_st:ctr of criinirm1 pea'siL iej�•f0. fire up to S1.5-0:01)ard`cr me-.:ear irnprisonmeri.as wel.a_zi::il pen l-des in tile fdai of a STO?WORK ORDER and a fine of up t.3'_+0.vu a Fiat <$3ia--t ILe vi hitor. Be a61, d that 3 1 ztip_-cf ili,s ateraent ma-, be Ruwa rded tc the O.:f ce<f 1westi TI-INY, fthe DU fcr i:Y_iu<=nce ci,--.•e ge, rificatio:Y. I do her.bi're'rrf ,abider rLhepnins and t m0i o , _1, altar the fifft�ration pro%Me d above as true and Correct �hLi_e=� [)ffaefrrl rise oar?r. Ipo raorii'rfre:rtr this nre<n, to be completed bt'tr'rt`ortetwrr ajcerrl t_im.or'To.s-n: PeY YnitLireYtse r t Is�uiYt Authoritv(circleone): i 1.Board of Health _.Buildilg Department '.Oity,Toxm Clerk 4.Electrical lYrrpertor .FItunbing IYt,peerGY i 6.Other Contact Person, Phones: 6 MRR-2-EO1® 0'3=O7R FROi'1:YP F&NIMELDGAL Town 3 t 6f Barnstable Regulatory Services _ .v. �,� nmmms re"j,CW ?t70 Muir%voc9. Hyumis,MA 02601 offira; 506 2-403'g Pelt; ?0-Q3O ]Pro► eny Owmr Must CompLete and Sign This IfUsingAbuMer g0 bat ,as e of su$'�ct P A Y .VV n h m. by authorize o act on my behalf, in all zmatt m relative to wodk autM6VA by Ns hUikIiII9VC=it application f0t., 5iature Of der LJLY) Print Name hr is mpPly Ibr rm Mom twomptimat Famn on dw my Ream 090H09 TOWN OF BARNSTABLE.,BUILDING PERMIT APPLICATION Map Parcel -" Application # 0(3 Health Division 3- /'SS 6 yt - , Z� Date Issued Conservation'Division Application r r. Planning Dept. Permit Fee Date Definitive Plan Approved.by Planning Board Historic'- OKH Preservation/ Hyannis Project Stre et eet Address Village W� 2ST 'iI!,Y\M�(5 (J65 fi PqN © chi Owner �Z<z C,,Q (,j am a A YR\R, Address L tW I t Q J 3 Telephone o "�®�'�ba '[� ,� .Q'3 dS Permit Request liYO STI " 6 " A-U , Square feet: 1 st floor: existing lm%posed 2nd floor: existing proposed _Total newv Zoning District Flood Plain Groundwater Overlay Project Valuation 00 Construction Type i"IyV_1__ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single FamilN Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes\IS, No On Old King's Highway: ❑Yes\&No Basement Type: ❑ Full \151 Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) ear Number of Baths: Full: existing . new Half: existing new Number of Bedrooms: 01 existing ew, f Total Room Count (not including baths): existing LA —new First Floor RWrn Count O Heat Type and Fuel Gas ❑ Oil ❑ Electric ❑Other p Central Air: ❑Yes No Fireplaces: Existing—!—New Existing wood/(oal stove: ❑Yes ® No rya "l Detached garage: ❑ existing ❑ new size—Pool: existing ❑ new size _ Barn: ❑ isting 0 new' size_ 4. Attached garage: ❑ existing U new size _Shed��W existing new size _ Other: Zoning Board of Appeals Authorization 0 Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current-Use _- _. - —_ -r _ . �t —Proposed Use— APPLICANT INFORMATION (BUILDER R HOMEOWNER) Name Telephone Number 015De) L4ao z I Address 1 Q i ` 4� LV D License# C S :7 a Do rn+a-vi 4z� I " 'A ® API Home Improvement Contractor# Worker's Compensation # C'4 P7I LE ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C4SSECL/c \11N 30 DMPST SIGNATURE _ �'' ATE Y 'i w - FOR OFFICIAL USE ONLY `r APPLICATION# � 7 DATE ISSUED MAP/PARCEL NO. A ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ' ,i FRAME o P� y '4 INSULATION �o FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL t FINAL BUILDING + r DATE CLOSED OUT ASSOCIATION PLAN NO. ° The Commonwealth of Massacnuseirs \ Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, AL4 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Build ers/Contractors(Electricians%Plumbers A licant Info�rma.tion Please Print Legibly N e (Busio s/ c5 dmclual): y. GO ED END 9D�D Ad l�re55: City/State/Zip: �Phone.#: its re you an employer? Check the appropriate box. Type of project(required): 1 I am a employer with 4• ❑ 1 am a general contractor and 1 6 ❑Hew construction employees(full and/or part-tins).* bavc hired the Sub-contractors 2❑ I am a sole proprietor or parbanr- listed on the attached sheet. 7. ❑Remodeling ship and have no employers These sub-contactors bavo 9. ❑Demolition working for me employees and have workers'in any capacity. 9. ❑Building. addition • . comp.insuranee.i [Now n� orkers' rani. i „ranco refit �] S. ❑ We a= a corporation and its 10_0 Electrical repass or additions 3.El lam.a homeowner doing all work officers have exercised their 11:❑Plumbing repairs or additions myself. [No workers' comp_ right of exemption per MGL 12.0 Roof repairs insurance rc t c. 152, §1(4), and we have no �] employees. [No workers' 13.❑Other comp.insurance required.] *Any applimrrt 11W ehecl5 box#1 murt also full out ffie scetiou below Showing their y M_kCn'compensa9on policy information. t Eiomeownws who submit this affidavit indicating tbey arc doing all work and than hire outside wntmc'tom must wbrrnt a new affidavit indicating such. rCvntractors that ebeek this box must attached an additional sbrct sbowing the name of the sub- o ftautm and stain whether or not,thDSd entitits bava employees, if the sub-contractors have miploycaa,thry must providb their workers'comp.polity number. I am an employer that is providing workers'compensation insurance for my employees. ffalm-wa the poUcy and job site information 1mmrancc Company Name: policy#or Sclf--ins.Lie.#: Expiration Date: Job Site Address: S 1�1�1^ �� V�- ��PrA�^r(l��s ( ��ity/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 r rirnir al penalties of a fine uip to $1,500.00 and/or one-year imprisonment; as well as civil pcnaltit;s in thr form of a STOP WORK ORDER and.a fine of up to$250.00 a day against the violator. Bc advised that a copy of this statcmerit may bo forwarded to the Office of J]IYCsti ations of thr DIA for' inincc covers e verification. I do hereby •erfzf ruder the pains•and pen Qfper'ury that the inform.adon provided above rs true and correct. ! •� � Date: �� � t��• store: U Phone# official use only. Ao not write to this area, tb be completed by city'or town ofj`4:W City or Town: Permit/License# Zsstung 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#: Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: Pursuant to this statute, an employee is dcfincd 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,partacrship, association, corporation or other legal entity, or any two or more of the foregoing.engaged in a joint enterprise, and including the legal represcntatives of a dcccasrd employer, or the receiver or iruatee of an individual,Partnership, association or other legal entity, employing employees. Flowcverthe owner of a dwelling house having not more than tbroe 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 tha 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 cornmonwealth for any applicant Who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL ohapter 152, §25C(7) states`Neither the commonwealth nor any of its political subdivisions shall cater into any contract for the performance of public work until acceptable cvidcncc of compliance with the insurance requiremr,nis of this chapter have been presented to the contracting authority. ELpplieants please fill out the workers' compensation affidavit completely, by checking the boxes that apply to.your situation and, it 3eccssary,supply,sob-contractors)name(s),addresses) and phone numbers) along with their cerdEca c. of nsun mce. Limited Liability Companies(LLC) or Limited Liability Partnerships (LLP)with no-employees other than the nembers or partners, arc not required to carry workers' compensation in�Trance. If an LLC or LT does have :mployecs, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial lccidents for confmnation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should or returned to the city or town that the application for thn permit or license is bring rcqucstcd., not the Department of ndustrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' ompensaEon policy,please call the Drpartment at the number listed below. Self-insured companies should enter their clf-insuranro license number on the appropriate line. 1ty or Tower Officials Icase be sure that the affidavit is complete and printed legibly, The Department has provided a space at the bottom f the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant lease be sure to fill in the permnit/liccnse number which will be used as a reference number. in'a.dditian, an applicant ,at must submit multiple permit/liccnse applications in any givrn year,need only submit onr al5davit indicating current olicy information(if necessary) and under"Job Site Address" the applicant should write"all locations in or wn)."A copy of the Lf5davit that has been officially stamped or marked by the city or town may be provided to the rplicant as proof that a valid affidavit is on Or,for Rifiirc permits or licenses. A new affidavit must be filled out each :ar.Wh.ero a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture .e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit re Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, ease do not hesitate to give us a call e DcpaTtment's address, tcicphone•and fax number. Tha C6mmanwWth of Massachusetts Dq)ai:tment of kdustcial Accidents Office of Iuvestig-at ans 6PO washingtan Sixeet Banton, MA 02111 TO. # 617-727-4.90.0 ext 40b o-r 1-M-MASSAFB Fax# (517-727-77491 d 11-22-06 www.ma.ss.gov/dia i I EROY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- A.Nn TWO-FAMILY DETACHED RESIDENTIAL'CONSTRUCTION (780 CMR 61,00) Applicant Narne; Site Address: Print Town: Applicant Phone: Applicant Signature: __ e Date of Application: NEW CONSTRUCTION: choose ONEVf the ?bllowing two options) 730 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE AND-TWO-FAMILY 13TJILDINGS MAXIMUM- MINIMUM Ceiling or Easement Slab -0 tion 1: Fenestration exposed Wall Floor Perimeter U-factor floors. R-Value R-Value Wall R-Value AFUE I�SPF SB1sR R-Value R-Value and Depth National Appllance.Energy` 35 R-38 R=19 R=19 R-10 R"10, Conscrvnlion Act(NAECA)of . 4 ft. 1981 as amended,minimums or rLNCef fly fl Ilcat)1L Note: This form is not required if you choose either of the'two versions of REScheck.as,listed below. ❑ Option 2: �. REScheck Version 4.1.2 or later variant software analysis must-be completed (780 CMR-6107;3.2 �. REScheck--Web which can be accessed at http://www.cncrgycodes,goy/reschecld' DpZTIO1vS=0n'-A:z,'' -IONS:TO'.EX1STING�.BCT�[S�DIlVGS'OVER5;YF.A IRS OLD 'Buildings under 5 years old must use option#1 or#2 in New Construction section above; . complete the following formula to determine the % of glazing; (a) Gross Wall & Ceiling Area equals LForjffinula: 1.00 x b_ a), % of glazing (b) Glazing area equals SF a lazing is':5 401o.use'.thc chart below., If.,g'laziri is>-:40'`% proceed to "SUNROOM" section 780 CMR TABLE 6101,3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIA-L BUILDINGS 7rExposed MINIMUM iling and Slab Perimeter Wall. Floor Basement Wall R-Value floors R-Value R-value R-Value-Value and De th'-3 7 a R-13 R-19 R-10 R-10, 4 feet R-30 ceiling`insulation may be used in place of.R-37 ifthe ins achieves the full R-value over the entire ceiling area(i.e. not compressed over exterior iYalls, and including any access openings).' SUNROOM—An addition or alteration to an existing buildink/dwelling unit Where the total El glazing area of said addition exceeds 40%o of the combined gross wall and peiling area of the addition. Note:. Owner to fill out'Consumer Information Form found in Appendix 120,P .oF Er° - Town of Barnstable a ReguIa to ry Services vQ' ABM HAS& Thomas F. Geiler, Director o i639 °rFo►,+a�a - Building Division Tom Perry, Building Commissioner, 200 Main Street, Hyannis, MA 02601 www.town.barnsta ble.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the'subject property hereby authorize ��� ` com5 fLUcTi pQ to act on ray behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Signature of Owner Date e-f�e; vy� -�,f Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on tEc reverse side. Town of Barnstable NSF'pFTHE T y �` •' , Regulatory Services . Y usxszws Thomas F. CCeiler,Director MASS. 16Tq ��� Building Division pjFD �� Tom Perry,Building Commissioner . 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us face: 508-962-4038 Fax: 508-790-6230 HOhZEOwNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number sticet village , -HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state iip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on'which he/she resides or intends to reside, on which there is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with'said procedures and requirements. Signature of Homeowner Approval of Building Official 7 Note: •Three-family dwellings containing 35,000 cubic'feet or larger will be required,to comply wttl ;the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that "Any homeowner perfomring work for which a building permit is required shall be exempt from the provisions f this section(Section 109.1..1 -Licensing of construction Supervisors);provided that if the homeowner engages a p=on(s)for hire to do such cork,that such Homeowner shall act as supervisor:" Many homeowners who use this exemption aie unaware that they are assuming the msponsibilitics of a supervisor(see Appendix Q, .u)cs&Regulations for Licensing Construction Supervisors,Section 2AS) This lack of awarcncss often results in serious problems,particularly 'hen the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would tihth a licensed ipervisor. The homeowner acting as Supervisor is ultimately responsible. To ensum that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, at the homeownr certify that he/she tmdcrstands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by Ycral towns. You may care t amend and adopt such a form/certification for use in your community. I V8/21/2008 Time:. 11:30 AM TO: Q 9,15087906230 Page: 001 Client#: 9580 2KPRE D. CERTIFICATE OF LIABILITY INSURANCE 08/21/08°""YY' THIS CERTIFICATE IS ISSUED AS 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. 973 lyannough Rd., PO Box 1990 Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Associated Employers Insurance Compa Kenneth Perry D/B/A INSURERB: K.P. Remodeling &Construction INSURER C: . 19 Guildford Road 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. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSR DATE MM/DD DATE MM/DD/YY GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY - DPREAMAGE TO RENTED - MISES Ea occurrence $ CLAIMS MADE OCCUR MED EXP(Any one person) $ - PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY F1 PRO-. El LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS - BODILY INJURY - SCHEDULED AUTOS (Per person) $ HIRED AUTOS • BODILY INJURY $ _ NON-OWNED AUTOS (Per accident) - - 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 - - M $ RETENTION $ - $ A WORKERS COMPENSATION AND WCC5005450012008 06/13/08 06/13/09 X WC STATU- OTH- EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? YES E.L.DISEASE-EA EMPLOYEE $100,000 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 ; 4 Kenneth Perry is excluded from coverage under the workers compensation policy. Insurance coverage is limited to the terms,conditions,exclusions,other �, CIA �:3c, 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 EFORE THt EXPIRATION Town of Barnstable Bldg Div. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN Attu:Tom Perry-Commissioner NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FA RETO DO SO SHALL 200 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY;KKWD UPON THE INSURER,ITS AGENTS OR Hyannis, MA 02601 REPRESENTATIVES. . AUTHORIZED! VPRESE NTATIVE rn ACORD 25(2001/08)1 of 3 #53189 JMH o ACORD CORPORATION 1988 . ,� � ✓/ze �a7remioouuecz/,C�z o�../�aaaaclreaelta � '��. Board of Building'Regulations and Standards L 7 License or registration valid for mdt✓idul use only, HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registrat�on132282 Board of Building Regulations and Standards, i One Ashburton Place Rm 1301 Expiiation 12/21/2008 Tr# 124628 n ,e Boston Ma.02108 Type DBA �.. K.P.REMODELING'` KEN TH.PERRY . . j 1:9 GUILDFORD RD. 4✓' -- - Centerville,MA 02632 Administrator Not valid awitho t e - j � � i Board of Building Regt lations'and Standards f Construction Supervisor License x License CS 76820 Y i Bteth�date 8/,'28/1965 •_. .�•I ' fiExpiration _8/28L2009 Tr# 2373 Restriction�-001, I KENNETH O PERRY ,> l 19 GUICDFORD ROAD CENTERVILLE MA 02632j s Co mmiss►oner m, OT F.upuaj 6 months from usyr c;u a' o -kpch ,,Br,, Regulatory Services Fee 9 t& �e�' Thomas F.Geiler,Director j � Building Division .� Elbert C Ulshoeffer,Jr. Buihiirig Commissioner Hyannis,MA 02601 W 367 Main Street, Hy c,, Office: 508-862-4038 J Fax: 508-790-6230 ti 1.2 - EXPRESS PERK=APPLICATION �Fe Not Valid without Red X-Press Imprint �1y;I V Mapiparcel Number Property // Address Residential OR 17 Commercial Value of Work Owner's Name&Address rcl, - ------------ Contractor's Name .I/L S' Telephone Numbef �3��� Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 's Compensation Insurance Check one: s I am a sole proprietor �av I the Homeowner e Worker's Compensation Insurance Insurance Company Name � ZZ Workman s Comp.Policy# Permit Request(check box) ` [g Rs:rd6{(stripping old shingles) Re-roof(not stripping. Going over existing layers of roof) Re-side Replacement Windows. U-Value (maxumm•44) Other(specify) •WheL14m ance of this permit does not exempt compliance with other town department regulations,i.e.Historic.Conservation.etc. Sign ature expmtrg Cf C Expire 6 months romissue ale .� `/ t�rrszes�e. : Regulatory Services Fee 9 16 e� Thomas F.Geller,Director ►A1 Building Division Elbert C.Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601w �4=',� Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERNIIT APPLICATION OMB Not Valid without Red X-Press Imprint Map/parcel Number Property Address 76 Residential OR 17 Commercial — Value of Work 3 hA Owner's Name&Address Telephone Number+ Contractor's Name 1/C �' 4 A Home Improvement Contractor License#(if applicable) /7 Construction Supervisor's License#4(if applicable), f�1 's Compensation Insurance Check one: {° ' I am a sole proprietor I the Homeowner ave Worker's Compensation Insurance ,•'" ; - 6. Insurance Company Name ` `r 'r Workman's Comp. Policy# Permit Request(check box) ' «E r1 R�,rd6f(stripping old shingles)'• �] Re-roof(not stripping."Going over existing layers of roof) �. Re-side Replacement Windows.-.U-Value (aim=.44) Other(specify) •Whe wired.,Issuance of this permit does not exempt compliance with other town department regulations,i.e:Histanc.Conse>ti'anon.etc. Signa ture expmtrg i i j I i I NOTES o�. LEGEND 1. DATUM IS NAVD88T�_ 99— EXISTING CONTOUR m 2. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO X ss.l BE USED FOR LOT LINE STAKING OR ANY OTHER EXIST. SPOT ELEV. PURPOSE. To ey o [99]— PROPOSED CONTOUR 3. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING _D 198 4) PROPOSED SPOT EL. DIGSAFE (1-888-344-7233) AND VERIFYING THE Croi ville Beach Rd. LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES g mdh TH1 PRIOR TO COMMENCEMENT OF WORK. '' _ 01 TEST HOLE k 4. EXISTING SEPTIC LOCATION PER TIE—CARD ON FILE � • Lo s a WITH TOWN. SLOPE OF GROUND UTILITY POLE ros FIRE HYDRANT Q NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING Nantucket Sound LOCUS MAP v v v SCALE 1"=2000't ASSESSORS MAP 246 PARCEL 136 LOCUS IS WITHIN FEMA FLOOD ZONE X (AREA OF ,MINIMAL FLOOD HAZARD) AS SHOWN ON COMMUNITY PANEL #25001CO564J 25 DATED 7/16/2014 x jO0 00 o w ` ZONING SUMMARY 4„W / r BENCHMARK: S7g 4 �,y� �`,\-; o ZONING DISTRICT: RB RESIDENTIAL DISTRICT BOUND DISC —a� SHED O =24.3' NAVD88 MIN. LOT SIZE 43,560 S.F. �O.p' N MIN. LOT FRONTAGE 20' • MIN. LOT WIDTH 100' H MIN. FRONT SETBACK 20' EXISTING r\ PERGOLA MIN. SIDE SETBACK 1 O% DWELLING TOP r �' MIN. REAR SETBACK 10' FNDN EL.= ♦^ ,'�% 36.7 �� 25.98' ����� \ MAX. BUILDING HEIGHT 30' PATIO��� LO LOT 449 OWNER OF RECORD .� � 26 Q _ a , �► 1 7,952t S.F. Z PETER & ELAINE BUNKER ° D 0 o � s �•rYPJ 13 GLENVIEW DRIVE ` �� 1 Ex j. sErBAc _ HUDSON, NH n1 •N N � 01 GR VEWAY c Q� 0 4.99 s� X 2s REFERENCES _ x R N x DEED BOOK 26515 PAGE 1 PLAN BOOK 109 PAGE 49 LE WAY MAP 0 � SITE PLAN OF 40 SIXTH AVE i HYANNIS, MA PREPARED FOR ELAINE BUNKER HOFA4, sq , DATE: JULY 1, 2021 l � c � 0o DANIEL A yG\ off 508-362-4541 OJT�A 1 fox 508-362-9880 v u:'✓ q No.40980 d o- owncape.com � qNo S�R���° dowo cope engineering, lac. ID ! civil engineers Scale: l"= 20' _ ,-L i.- land surveyors 939 Main Street ( R to 6A) 0 10 20 30 40 50 FEET. DATE DANIEL A. OJALA, P.E., P.L.S! YARMOUTHPORT MA 02675 DICE #,2 1- ' 78 21-178 BUNKER.DWG EA W _ s