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0149 SIXTH AVENUE (HYANNIS)
Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 12/3/18 Brian Florence CBO Town of Barnstable Building Division a�" 200 Main St. Hyannis,MA 02601 RE: Insulation Permit 18-3593. Dear Mr. Florence: This affidavit is to certify that all work completed for 149 Sixth Ave,Hyannis has been,inspected by a third party Certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey A Town of Barnstable a 7q �WPos"ttF'Th�P i il`r"tdFifii,naSc�oa;l t-T+"Ien h`osa ft eO�ctc ti�csiou�U naPi q'asH`ain�ba cls�e.�'aB 1Fser oeRRnem M t�ah.ai�rede eSdsxt��;r seuecst h�A BAiu P;"t�Il?d`r+or�an v se dsh�Pal�ha�n^N.`�so`�Mt bu#se s tO-bcec`:�uRpeit e.�ad`i n"r ue'nd''t+iorla�'na�%3JF"-o.ina beaal nInd;^si„pthe��c,s�t,C io'�a n�dh�aMsb ubset:e.';�b n�e"mKae�dt'?"-t s Building i's,Ca • Permit o .163 BARKSTA eensCrP e Permit No. B-18-3593 Applicant Name: William McCluskey Approvals Date Issued: 10/31/2018 Current Use' Structure Permit Type: Building-Insulation-Residential Expiration Date: ' 04/30/2019 Foundation: Location: 149 SIXTH AVENUE(HYANNIS),HYANNIS gMap/Lot: 245 076 Zoning District: RB Sheathing: Owner on Record: Raymond Beattieg Contractor Narne WILLIAM J MCCLUSKEY Framing: 1 Address: 149.Sixth Avenue Contractor License: CSSL-102776 2 Hyannis,MA 02601 °..; ,Est Protect Cost: $5,000.00 Chimney: Description: Add 275 sq ft of R-10 rigid insulation to the crawlspace Ad'd 390 sc jPermit Fee: $85.00 Insulation: ft of R-19 fiberglass,and 390 sq ft of R-10 rigid fnsulationito the Fee Paid;` $85.00 attic.Air seal the attic plane and basement with expanding foam. Final: General weatherization. Date 10/31/2018 Project Review Req: signed installers certificate required to'cl&6e 0ermit / Plumbing/Gas /� Rough Plumbing: ��..a Building Official Final Plumbing: Rough Gas: Final Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after=.issuance. All work authorized by this permit shall conform to the approved applicat onand tie-,"approved construction documents for�which this permit has been granted. Electrical All construction,alterations and changes of use of any building and structures$shallbe in complianceAwith the local zoning by lbws and codes. This permit shall be displayed in a location clearly visible from access street orroad and shall 6e'maintained open for public inspection for the entire duration of the Service: work until the completion of the same. , w ` Rough: 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: Final: 1.Foundation or Footing 2.Sheathing Inspection Low Voltage Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Health 7.Final Inspection before Occupancy Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Fire Department Work shall not proceed until the Inspector has approved the various stages of construction. , Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A).. �,�]n Tr Barnstable q�pF THE Town n O1 • BARNSTABLE. Regulatory Services TSMASS. g. Eu Nu;+6. Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location /7� Permit Number o2 e) /m Owner���G7 Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: / 717 sOc�-7�v JN,A O " 12ST hor V S /1YC 6- A I� 'y0 � E 17, / - 5 3 Ate. �� Y-mac%r�'��-rlcA)-s' 1 ,17V —7 1A 7r-q� °err. u C�q 7'/0-IJ A", Please call: 508-86246$ for re-inspection. Inspected by Date �� M C K E N 211 E June 23,2011 ENGINEERING CONSULTANTS Mr' Dennis O. Casto 56u rat dw arvannmeaw C/O Casto Construction Co. P.O. Box#571 South Chatham, MA 02659 (508)292-5084' Re: Bearing Wall Replacement Beam, 149 6t Ave,HyannisPort Dear Mr. Casto, After a site visit and calculations,I have concluded the new beam stretching from the stairs to the back kitchen wall can either be a W 8x24 beam or(4) 1-3/4"x 14" Microllam LVLS. The W 8x24 steel beam could run flush with the floor joist. The(4) 1-3/4"x 14" x Microllam LVL,S would match the header height and would be a less expensive option.- Both options have been calculated with full live load for the possible future addition of a second-story dormer. The footing required for both beam options is a 24"x 24"x 12"under the interior posts. L . 4 If you have any questions,feel free to contact me. - tt#OF Y Sincerely, CIVIL 0.39C?�g ark A. McKe TO- Pres., McKenzie s nsultants,Inc. h ' ,* . "d 1279 Millstone Road Brewster,MA 02631 t 774.353.2144 1774.353.2142 www.mckengineers.com �w i r !1 cs1 ' � 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION s aal � 0(456D Map Parcel : 0 l e Application # Health Division Date Issued Conservation Division_ ApplicatioA Planning Dept. , Permit Fee 2 Date Definitive Plan,Approved,by Planning Board Historic - OKH — Preservation /Hyannis Project Street Address h6a, tt Ag , Village C Owner5lilVA'fDr(� C,19� V �' _Address 5 M�}II Sr" Telephone_$/• N34) -cZq �� 111•$ �D.� •30x �txir�tcn,N► /4 Permit Request A ' � b A MtS w /S r�: _JS/ ihP�►#uM���'tl� ., �� hint Cate, W1W fLr r Z�pma 6%,galf-fe Mod 1:51ah- A.,41 *VW hfow,1,4 wgJl nDAVew AVSf tvi Nta10&fih gsptO*#- Square feet: 1 stMoor: existing_1Q31proposed 103g_ nd floor: existing proposed 10Zg _Total rr Zoning District Flood Plain_ Groundwater Overlay Project Valuation S3400 _Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family W/ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full W C;rawI ❑Walkout ❑ Other Basement Finished Area.(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 3 existing _new Total Room Count (not including baths): existing "t new First Floor Room Count Heat Type and Fuel: dGas ❑ Oil UI Electric ❑ Other -_=2 CD Central Air: ❑Yes o Fireplaces: Existing New _� Existing wood/coal stove: ❑-Yes t&No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn"❑:existing'U new size_ Attached garage: ❑existing ❑ new size —Shed:Id-existing ❑ new size Other E X a:N 48.a x Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial _ ❑ Yes H-Wo---,If-yes,-site plan-review-# r Current Use __1?c5 re , 5 V µW*.V Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Z� , Telephone Number 7S01•a a/g Address �.� .� •�-� License # 5 9 Home Improvement Contractor# Worker's Compensation # 6Z2� II ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 5t3 x w�� v l^Ju,arcr,� IQo� SIGNATURE DATE FOR.OFFICIAL USE ONLY APPLICATION# , DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE k OWNER DATE OF INSPECTION: FOUNDATIONjf,. „ .R Alp FRAME /OOf rr ��tHtrB INSULATION. FIREPLACE ELECTRICAL: ROUGH FINAL- ' _ } PLUMBING: ROUGH FINAL -GAS:-,.-.- - ROUGH FINAL _ 'r FINAL BUILDING " DATE CLOSED OUT ; r ASSOCIATION PLAN,NO. - Town- of Barnstable : Regulatory Seryices �LftH3i'AgC., ks,iss , ` Thomas F. Geiler, llirector =e;yq� l0� Building Division Thomas ferry;CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601' www.town.b arnsta b l e.ina.us Office( 508-862-4038 Fzx: 508-790-623C FLAN PE L r ' Owner: C V` 1 Map/Parcel: Project Address lz �q & Builder s L'�-� The following iteriis were,noted on reviewing: r Reviewed by:_ -C Date: '�r s The Commonwealth of Massachusetts { Department of Industrial Accidents fOffice of Investigations DO Washington Street- i- Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information " r — -- '—zse P rint Le>3ibty Je Name: Stello Construction Company �! Name (Business/Organization/I;, d- ','-- I" - . Location:-310.Commerce Park — r Address: I City: South Chatham, MA 02659 City/State/Zip: . Telephone; 508-432-2218 . . Are you an employer?Check the appropriate box:(?< Type of project(required): am a employer with 4. am a general contractor and I employees full and/or art-time .* ave hired the sub-c 6 0 New construction ( P ) ontractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet t 7 Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity.. workers' comp. insurance. 9. Building addition. [No workers' comp, insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3,❑ I am a homeowner doing all work 'right of exemption per MGL 11..0 Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t. employees. [No workers' comp. msurancerequired.] 13.❑ Other ;Any applicant that checks box 91 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information Insurance Company Name I - -- - - - ---- -- - ------------ --------�_� ---___ Insurance'CO:-Zurich American------`----_ Policy#or Self-ins.Lic. #•_ Policy#: 6ZZUB-921X2744402_ Job Site Address:. J f Q�lt.�- 4 '�tT�C<' rSwrvZi 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. I S2 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification.' I do hereby c 119'under the d penafties of perjury that the information provided above is true and correct 6 S i attire: a..4v/ G - Date: Phone F only. Do notwrite in this area,to be completed by city or town official n: Permit/License# hority(circle one): Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector on: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the.commonwea.lth nor any of its political subdivisions shall enter inio any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractors) name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no em ployees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is-being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number Iisted below. Self-insured-companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that'the affidavit is complete and printed.legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/Iicense number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavii hziicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proofthat a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would Irke to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The-Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street R stoa,MA 02111 Tel. # 617-727-4900 ext 406 or 1-977-MASSAFE Revised 5-26-05 Fax 4 617-727-7 749 www.ma.ss..gov/dia AAe Office of Consumer Affairs&B smess Regulation I�I HOME IMPROVEMENT CONTRACTOR 4. Registration i-J,03537 Type: _ Expiration. -7/812012 DBA RO ERT,K.STELLO.-CONSTUCTICSNe I Robert.•Stello ,� '310 COMMERCE PARK- S.Chatham;MA 0265�, u. Undersecretary I Massachusetts- Department of Public Safety Board of.Building Regulations and Standards Construction Supervisor License License: CS '15M bra �• ' ROBERT K T STELLO-- PO BOX 776�g 'S CHATHAM;"MN"02659' ice` Expiration: 6FJ 2012. Commissioner Tr#: 27911 /ie -�onznzoncuet�l�./z o�,:/�caaatzcl Office of Consumer Affairs&B siness Re ulation License or registration valid for individul use only g r HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: lk Registration: s1�03537 Type: �, Offce of Consumer Affairs and Business Regulation Expiration 718l2012 DBA 10 Park Plaza-Suite 5170 ^-� Boston,MA 02116 ROBERT K. STELLO CONS UCTI10N I Robert Stello 310 COMMERCE S. Chatham; MA 0265J„ Undersecretar - Not valid without signature 1 Y1 h vt w►5A Oki�1 ep o u 0[S� ��oor l�a��5- K��c�t t��.�±v�_��n.� �cr� 3 �2 w !15 P to Pt 9 .� n Z"� E foo r Z $ c Coon Vie+ � � �- ^ �+ ' , • E• ' r n • � �_ rc , �: �. - 4 i • • � � � .� .. a ^'t � • - <x i f p.: ;�` * i 4 .. e � ,j '� + �z,t � _a' � � Y' ' �_ a � y # � a - ,a z� HME Tr " Town of Barnstable • Regulatory Services f HA RN�r'l RT-� F Thomas F.Geiler,Director B>uia- w ing Division Tom Perry,Building Commissioner 200 Ma n street, Hyannis,MA 02601 www.town.barnstable ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder` I' t as Owner of the subject pe hereby authorize. -- to act on rap behalf, in all matters relative to work-authorized by this:building permit application for. 1 J At /fJ14�S O/ (Address Job) k Signature of Owner ate rtt A& PriIIt Name If Property Owner is applying for permit lease complete Homeowners License Exemption Form on•the re P e the verse side. Q:F0 RMS:0 VJNF,"ERMISSION r oFTKE Town of Barnstable Regulatory Services aAxxsrAsr s, Thomas F. Geiler,Director MASS. g 1639. Building Division Tom Perry, Building Commissioner 200 Mairi-Street;._Hyannis,MA_02601- WWWAown.barastable.ma us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTTON Please Print DATE: JOB LOCATION: number street . village . "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town states r- zip elide The current exemption for `homeowners was extended to include owner-occiiuied dweUsn�of siz'uuits ar Iess and to allow hDmeowncis tolcngagc an individual forfhire whordoes not possess Inc e'» rovided that the owner acts as SUT)Cr•ylsoI. ac° x l s s..'1�•ri ` S.�. .,.� ".. .,ter. ` DEFI711Z-ION OF HOMEOWNER Persons)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable.to the Bunlding;Ofncial that he/she shall be responsible for 0 such work perfaimed under the bunlditntr permit ( ec on 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 Buildin&Dcpa:ftmcnt; min;mnm inspection procedures and requirements and that he/she will comply with said prpcedtires`+anci; requirements. Signature of Homeowner k 5 �:\4 u • Approval of Building Official ` $ �_ "r Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the States Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that: "Any bomeownc perfornning work for which a brn1ding pemvt is required shaD be exempt from the provisions of this section.prction ID9.1.1 -Uccnsiirg of construction Supcnisors);provided that if the homoo-vvner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Z-11y homcownczs who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rides&Regulations for Licensing Crmst uction Supervisors,Section 2.15) This lack of awareness bft=results in sa-ious problems,particularly when the homeowner hires unlicensed persons. In.this case,our Board cannot procee d against the unlicensed person as it hrould with a licensed Supervisor. The:horbrowncr acting as Supervisor is ultimately responsible. To ensum that the bomeowner is fully zware of his/her respo=brlidcs,many communitiu require,as part of the permit application, that the homwwncr certify that he/she undarstands the resp=btlitia of a Supervisor. On the last page of this issue is a form=n-ently used by several towns. You may can t amend and adopt such a fmTri/eertification for use in your community. Q:forms:homrcxcmpt b0'd _1d101 ACORD. CERTIFICATE OF LIABILITY INSURANCE DarzB/zo11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES N07 AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THm CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN 714F_ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT-,If the certificate holder is an ADDITIONAL INSURED,the poticy(ies)must be endorsed. It SUBROGATION IS WAIVED,subject to the terms and eanditionS of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the certiticate holder in lieu of such erdorsement(s). PRODUCER CONTACT NAME: PHONE I-AX MARK T VOKEY US AGOY (At,No,EXt): FAX (AIC,Ne): 28 VILLAGE LANDING E-MAIL ADDRESS: PO BOX 12.47 PRODUCER WEST CIIATH00A.MA 02669 CUSTOMER 10 a: 232NJ INSURER(S)AFFORDING COVERAGE NAIL if INSURED INSURER A: ANIERICAN ZURICH INSURANCE CONMA.W INSURER B: S 1'ELLO C ONSTRUC noi,4 EN`F_"R1SFS INC, INSURER C: INSURER D: PO BOX 776 INSURER E; SOUTH CHAM'1M,MA 02659 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS ISTo cF.RnFY THAT THE POLICIES OF INSURANCE LISTED 9ELOW HAVE BEEN ISSUEDTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOOINDICATED. NOYWITHSTANDING 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 PIE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - - INSR AODLSUPR POLICY EFF DATE POLICY EXP DATE TYPE OF INSURANCE POLICY NUMBER IMMIDD%YYYY) (MM%DDIYYrf) LIMITS LTP INSR WVD GCNERAL LIABILITY EACH OCCURRENCE 3 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED CLAIMS MADE OCCUR. PREMISES(Ear�occlurence) II MED EXP(Anyone person) 3 i.x, PERSONAL A&ADVI INJURY g GCN'L AGGREGATE LIMIT APPLIES PER! GENERAL AGGREGATE POLICY PROJECT LOC PRODUCTS-66I4ICP AGG AUTOMOBILF I IARIUTY COMBINED SINGLE $ ANY AUTO LIMIT(Ea acddent)' ALL OWNED AUTOS BODILY INJURY SCHEDULE AUTOS (Per permn) Co HIRED AUTOS BODILYINJURY S' (Per acrklant) NON-OWNED AUTOS PROPERTY DAMAGE S)" (Per accide(:t) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAS CLAIMS-MADE AGGREGATE $ DEDUCTIBLE - $ RETENTION $ $ WC STATUTORY LIMITS OTHER WORKER'S COMPENSATION AND EMPLOYER'S LIABILITY YIN US-921)(2744-11 OPY0112011 09/012012 E.L.EACH ACCIDENT $ 1.000,000 ANY PROPFRITORrPARTNFRiSXECUTIVE N E,L,DISEASE-EA EMPLOYEE 3 1.000,000 OFFICEWMEMPER EXCLUDED? tManda:oryin Nq F,L,'DISEASE•POLICY LIMIT $ 1.000.000 V YOC.d-In0o vAcrx DF-.SCRIPTION Or TERAT'IONS Lwow DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESiRESTRICTIONSr'SPECIAL ITEMS THIS}Uc7'LAUES ANY PRIOR '1'0-im CERTIFICATE Houm AFFECTING WOR1¢RS COMP COVERAGE. 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 ACCORDANCE 700 MAIN STKEBT WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 11YANNIS,MA 02601 W A Bolinder ACORD 2S(2009109) T 19W2009 ACORD CORPORATION. All rights reserved. b0'd 8926SVGBOS QN30ld 'SN I J 3>10n '1 Xi UW SS:80 T T0z-9Z—onu HE tu Regulatory Services lARNSrABLE. # �t —$ v MASS. g Thomas F. Geiler, Director Am 10 37 n►A�a,� B01ding Division Tom Perry, Building Commissioner. 200 Main Street,Hyannis, MA 02601 ' www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF WITHDRAWAL OF LICENSED CONSTRUCTION SUPERVISOR FROM PROJECT A-c ? ),J i7` Construction,Supervisor'License # C> l C) 66 hereby certify that I am no longer the Construction Supervisor listed on the application for the project under construction as authorized by building permit S 1(p ) I ` k l / 6� �� , issued to (property address) '-� ^I �l \�CI S on I also certify that on ( 7 , 201 .( ,d notified the property owner, that the, project under construction must cease until'a successor licensed Construction Supervisor, is submitted on the records of the Building Division. a : CENSE HOLDER DATE q/forms/newcontr - reference R-5 780 CMR rev:110410; t: HE x Regulatory.Services, TOWS! OF BARNST BLE w t3AxxsrABM, y MASS. Thomas F.Geiler, Director i639 7 1I JU -� �� IQ: 37 Tfnn,,A�a Building Division Tom Perry, Building Commissioner . 200 Main Street,Hyannis, MA 02601 www.town.barnstable.ma.us DIVISION Office: 508-862-4038 Fax: 508-190-6230 NOTICE TO THE BUILDING DIVISION OF WITHDRAWAL OF LICENSED CONSTRUCTION SUPERVISOR FROM PROJECT dot 71`1 a , Construction Supervisor License # C 5 731 hereby certify that I am no longer the Construction Supervisor listed on the application for-the project under construction as authorized by.;building permit # 9 o I I o 2 6 Z, issued to (property address) nj A f s on , 201L. I also certify that on �7 f 11 , 201 I ;f I notified the property owner, that the project under construction,must cease until'a successor licensed.Construction.Supervisor, is submitted on the records of the Building Division. y� LI NSE HOLDER DATE q/forms/newcontr,, reference R-5 780 CMR 'rev`1)0410 k TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 7 Parcel V Application # Health Division � Date Issued Conservation Division Application Fee Planning Dept. Permit Fee I � Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Villages Owner C54-Cti. C/�-L!�-cd TT-i Address .7��i �-eA✓�Y2i Telephone 7 ( 30 3 j , �o Permit Request U LA-tj p y{ �TrC � �i��.��T� -f- rCril I A- OnXyl Square feet: 1 st floor: existing - proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Roo aril Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood-koal stovCLJ Yg ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing O�new' ize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 0 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Uhme W1 Telephone Number _ _,56 Z4 3 na 5- Address 1`� ok!C Vt(W 57 License# S 7 355 � OA 2 T p Home Improvement Contractor# 13 Zz35 A,=rl -f-� S- Worker's Compensation # VUY, (,-601T S) '� al Zvt�N ALL CONSTRUCTION D77 RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE "r FOR OFFICIAL USE ONLY ;.. APPLICATION# y DATE ISSUED MAP/PARCEL NO. y 'P ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION 't FRAME INSULATION i . FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. R t N The Commonwealth of Massachusetts �i Department of Industrial Accidents t ;, . Office of Investigations 600 Washington Street Boston;MA 02111 e www.mass gov/dia Workers' Compensation Insurance Affidavit:`Builders/Contractors/Electrician's/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: / / O(e/Y,4 �'f City/State/Zip: CWE'y in'V Phone #: 0 CoC3Y Are you an employer?Check the appropriate box: Type of project(required): I I am a employer with �,�a. 4. ❑ I am:a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired;the sub-contractors 2.❑ I am a sole proprietor or partner-, listed on the attached sheet.t 7• ❑ Remodeling ship and have no employees These sub-contractors have S. ❑ Demolition working for me in any capacity. workers' comp. insurance. g ❑ Building addition [No workers'comp. insurance 5. ❑ We are a' corporation and its. ❑ required.] -� officers have 10 Electrical repairs or.additions ' . exercised their , 3.❑ I am a homeowner doing all work - ` right of exemption per MGL I l.❑ Plumbing..repairs or additions myself. [No workers' comp. c. 152,'§1(4),and we have no 12.❑ Roof repairs insurance required:]t. employees;[No workers' 13.❑ Other comp. insurance required.]- *Any applicant that checks box#I'must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they am doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name ofthe sub-contractors and their workers'comp.policy'information. ' I am an employer that is providing workers'compensation insurance for my,employees. -Below is the policy and job site information. Insurance Company Name: A�- �-fVs Policy#or G9 Self-ins. Lic.#: VC S"/C/0 Via(/( Expiration Date: ' Job Site Address: f ( � � � 1/`e City/State/Zip: �S 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. l52 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 advisedthat dcopy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi d t pains and pena hies`of perjury that the info rmiation provided above is true and correct. Signature: Date: G^l Phone#: Official use only. Do not write in this area,to be completed by.city or town official` City or Town: 'Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Towh Clerk 4. Electrical Inspector 5.Plumbing.Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do inainteriance, constructiori-or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and,-if necessary,supply sub-contractor(s)name(s),address(es)and phone nurnber(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured-companies should enter their self-insurance license number on the appropriate line. City or Town Officials t r. Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit'indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone and fax number: The-Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-977-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mass.gov/dia I b3/n8/7b11 18:53 5088217684 FEND DELEADING PAGE 03 • CERTIFICATE OF LIABILITY INSURANCE °"'� Y� ' otr�ino�i Wai C5TSFSOl1'E IS lia AS I tiii—or xwommo LON MIZZ Am emnum KO MGM YPON 17tR CCWSPrCR= Rimot. "IS C@M=vICa= oohs IM AW%1RjW=Vnjr OR Mti®TiVnr A WW, t41=t{ItD oft A6TE8 M cOM.N a"" MMD By Teo ?O7L>) = Nzw. UIS =KVZfICAu OF 33PSVRAM=DOW NOR CMSSISIITR A COSTRU2 BLSTStE>ts tab ISNtRM9 1M2V=R(3), ammimmo nEPR85m=TIVE OH PA na=, An T)t8 C88SIPSCA12 umr-EI. - 3MORTARR: If ttae oerttrioake bo it. an AMXTXCIMZ IIi6V M, the aelieymbo) must be endorsed. it SOBAoo=on I8 vuaman, STIb)OCL t0 the tettas and ocaft ms Of the 9011M COMIn nelltiee MY reQeire an endarxl ut. A Statseat Oa thla certificate does net acofer rAgAto to the Certificate holden- in lien of asah mdo>esemo,It(y), atG == nNVAcr Farrell Rackl.uned InrairanCe SAM: taan Agency LyC (Arc.No.ant) Na✓c su): 8 O Son 509 Tmmton, MA 027BO tPatara:w_ aattuota,.maata,o caveeam .aAP t Kaw Haslmwnd Deleaeiitig 6 Coa6txttatioa Inc A.I I.M. Mituai Inaura ft coAMURa. 19 Orchard Street rPtvttN C: Berkley, MA 02779 swamp Pr tawea t. rNaota„R COVEItAOBS CRRRIFICA?E NUMM; REVISION NUMER., YY FEE'INS POLICIES Or 1lumulce 1.11M saw OEM im INa„rn To TW xKNEBW RAIL®10011 HE Tffi POLICY sizzon smic TED.. NOI1rrTHMMMIM MM 11MWIMaS(T, um a)t umWaIOn or AMr OwntACI OR O'ZEER DOCUW=r WIN HrYSRCR r0'NM=VMS Gz;pTIPICASD Isar RE ISSU®OR am FMAIM, TW 3NAL tASIM AFSONDIra MY WW VOLICPtS MCRIA® Is 509E TO ALL Sae SF10®, 6WWRIOMS AM CMZVIOMS Of 6VCM POLICILLS. LBWS NWW IMT IMPS OEM RECIAM D RY PAID CLLW. +� PeLm INs POLICY Em y � .ts Truc OF IRSORAaCM EOLZi.7 IIONBIIt atvae/eM w�/+wn . SEVERAL LIABILITY _ ZArx Oacmu/o, 6 ❑co"RocIAL UL4Y311u.LwYJfrr OaNM4 ro efPrOC aaNntaN(te.am,ssmwl � ❑atLA1Na NNfIL ❑Oee1a, _ rmsaaL A AM trosNT GWWL Ar4MWT3 I.LOT APKJN Uu ie6e11.AOmtmrt C ❑IOLTCY ❑aBARCTALTZMANLEEZ OLOc - oa009trs-Ltty/oP Aac ! , P Doer®error=Lffie P _ ' El--A� LIABILITY �.ft, ❑a,a.warp Nn" POOALT DATOaT(PPP PRN o 6 ❑sr emun AMOS ArOTgV tKiwlllN soli lt, f ❑OUQO AOTOa PAOPIM PAN= o,e:.mrna! 6 QNttr.QOnD AUfOO ❑ P ❑ttCLOP LYI1a �ttrnln 71NL paOatQ 0 aOtORCTDLB P ❑KrrMr01 � . ! TIORi�CO10)LYSATSOM aa- AID MQXC=LIABILM s®rms a. IUD IAOBRIITOB/PARINERS/ Cs. ¢N71 aOriptteT A BXMTIVE OFFICERS ARE ! 1,000,000 ® incl ❑ exci 6005�514012010 09/19/2010 09/18/2011 ■.L. Pru=.7"arw3= P 1,000,000 e.,. rrtnz_rA moAora t. 1,000,000 em®Nq/sstautr:a w wvar:orc aN raonarA: y •. CERTI=CATB HOLDER - CJu"MI AMON CITY OF BOSTOR . - SHOULD AMY O$TW ABOVE Mtsoum BOLscmo RE cw=Lm 8ErO8!ow 26 CE1(VRAI, AVE - EMIDATIOW W= T)mRRoz, vnt=WILL 33E OELIPERED AT ACO MITa Txc POLICY FPOVI8I4MS. MDR WJK, MR, 02236 massacnusetts- mpartment of runuC 'MIM .Board of Buildimi Re�,ulations and Standards Construction Supervisor License License: CS 73952 JOHN H HAMMOND .. fix. 19 ORCHARD STREET 9 BERKLEY, MA 02779 Expiration:,6/28/2012 ('unmiisiuner` Tr#: 28624 C�arrNna� ✓� - License or registration valid for individul use only i G Office:of Consumer Affairs&B mess Regulauu4. before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Office of C66suiner Affairs and Business Regulation Registration: , 132238 Type' 10 Park Plaza-Suite 5170 Expiration :12/13/2012 Individual Boston,lVlA 02116 I == . . J H.HAMMOND ,.:1M+' JOHN HAMMOND, y r 19 ORCHARD T BERKLEY,MA 02779 Undersecretary Not va thout signature i The Commonwealth of Massachusetts William Francis Galvin- Public.Browse and Search Page 1 of 2 ; - The Commonwealth of Massachusetts j : William Francis Galvin Secretary of the Commonwealth,Corporations Division One Ashburton Place, 17th floor Boston,MA 02108-1512 rat �o!`�� Telephone:(617)727-9640 HAMMOND DELEADING AND CONSTRUCTION, INC. Summary Screen Q Help with this form m �A Re nest a, ertlficate The exact name of the Domestic Profit Corporation: HAMMOND DELEADING AND CONSTRUCTION; INC. Entity Type: Domestic Profit Corporation Identification Number: 000847817. Date of Organization in Massachusetts: 09/01/2003 . Current Fiscal Month/Day: 12/31 The location of its principal office: No. and Street: 19 ORCHARD STREET City or Town: BERKLEY State: NIA 'Zip: 02179` Country: USA If the business entity is organized wholly to do business outside Massachusetts,the location•of that office: No. and Street: City or Town: State: Zip: Country:,. Name and address of the Registered Agent: Name: JOHN H. HAMMOND No. and Street: 19 ORCHARD ST. City or Town; BERKLEY- State:MA Zip: 02779 Country: USA The officers and all of-the directors of the corporation: . Title Individual Name Address(no,PO Box). Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term PRESIDENT JOHN H.HAMMOND' ,, 19 ORCHARD STREET ' BERKLEY,MA 02779 USA TREASURER JOHN H.HAMMOND• 19 ORCHARD STREET +w BERKLEY,MA 02779 USA:;; SECRETARY JOHN H.HAMMOND �19 ORCHARD STREET BERKLEY,MA 02779 USA VICE PRESIDENT KAMM MEEHAN 90 CUTTER HILL ROAD ARLINGTON,MA 02474 USA' q .. DIRECTOR JOHN H.HAMMOND 19 ORCHARD STREET• �• BERKLEY,MA 02779 USA http://corp.sec.state'.ma.us/core/corpsearc h/Corp SearchSummary.asp?ReadFromDB=True... 5/20/2011 The Commonwealth of Massachusetts William Francis Galvin Public Browse.and Search Page 2 of 2 business entity stock is publicly traded: Y` The total number of shares and par value, if any,of each class of stock which the business entity is authorized to issue: A Par Value Per-Share Total Authorized by Articles ' Total Issued ' Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding Num of Shares Total Par Value Num of Shares CNP $0.00600 200,000 $0.00 20,600 Consent Manufacturer Confidential Data Does Not Require Annual.Report Partnership X Resident Agent X For Profit Merger Allowed Select a type of filing from below toview this business entity filings: ALL FILINGS Ili Administrative Dissolution Annual Report Application For Revival Articles of Amendment Comments ©2001-2011 Commonwealth of Massachusetts All Rights Reserved Help hgp:Hcorp.sec:state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... 5/20/2011 v i oF� T ti Town of Barnstable � � � ermtt# o Regulatory Services EYpifes6mo,trlrsjromlesrre dY .. . C jLe saRvsr�Br�. Fee � ttnnss. Thomas F. Geiler, Director, ` $��ce1 NIA A Building Division Di Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprin! Map/parcel Nurnber Property Address v•.ff- _ Residential Value of Work C) Minimum fee of$35.00 for work under$6000.00 Owner's Name & Address Contractor's Name_ c�1�as' tkM Al Oz:}7 Telephone Number Home Improvement Contractor License#(if applicable) / 3 Z,13 Construction Supervisor's License#(if applicable)._ C 5 7 (5 �cr jWorkman's Compensation Insurance .°�"'� p IT Check one: ❑ I am a sole proprietor s` f,Y +a; ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance TOWNDF BARNSTABLE Insurance Company Name Workman's Comp. Policy# `/ tip( C 6 Cp(�� j_ C-) Copy of Insurance Compliance Certificate must accompany each permit. Permit Request (check box) D—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) �e-side — , 7• #of doors ❑ Replacement Windows/doors/sliders. U-Value , (maximum .35)# 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 of the Rome Improvement Contractors License & Construction Su required. pervisors License is IGNATURE: \WPHLESTORMS\building permit forms\EXPRESS.doC evised 072110 a The C'®tterttaniv 11fie ofMass husefis Depffmaa aflivedusnial Accident -- GE of An, Boston,-VA 02111 tt-K,#r.Ma&r gav1elaaa Workers' Compensation Insurance davit: derslCantractorsMectr ciansITEumbers Auupl cant Information . Please,Print Lees itlol*� Name t2stigsesslGng tianrladh}idsrll: N Anil r'1 O->D ID c2IE-7A 0-F—, Ad& : 19 Qc- rtaD i CitSy/Stat Mp-- r L!7' M 04- POD Are;you an ermployvr?Check the app epriate box: Type ofproject ,�,� 4. I am a general eoatractos and I � ( +�'e��� 1.t11 1 am a,employer wii /O ❑ G- ❑New constnwtion. employees(full andlor part-tie)-" havehired d2e sub-contractors 2.❑ 1 am,a sole proprietor or partner listed on the attad ed;Beet. 7- E4 Remodeling ship and have no employees. ThM, sib-contractors have g_ ❑Deawlition. evodring for me,in any capacity- employees and-have workers' � ❑Building addition. [No worfmrs'comp-insurance: comp.inm ce.I req eed..] 5• ❑ e.area coiporatian.and.its IG.0 Electrical regains or addition 3.❑ I am a homeowner doing all work officers have exercised their 18:.0 Plumbing repairs or additions. myself..[No workers'camp.. right of exemption per-MGL. 12.0 Roofrepai. insurance repined.]1 e. 15Z§1(44),and we have no employees-[No w-c+rkers' 13.0 Other coup.inswauee required-] 'Any apphtma that cnecI3lox=1 tastat at_=o fill.am the sectson bekw showing 91tek wwkets"compa ncra pabcyinfortnaioa. I I-omeamcners who mbro t this:d fidavit b&mdxg they age doing su wv&ana ttien b to outside cmumors mast submit:a new affidavit inidiicatiag s =Cantractors fan dwA this box mast attached at:addWong sheet sliou--ing the acme of the sab-contruton and stare whether oz not those eoeltigs sure emplo}eec. I€tte sti ¢nnactors lane eruplo ess,they mro tmxavide their wwken'camp..p =mbet F armn an emr pkw tW esp ! nw 'mra Vensff dam fttsru=ce f r my ewpkyan RdaW is tke pate audjab sib esmlorr:tratierr�, Iassrtsanee:Comparr;Name: �,1U 1'u 4-L- 5 Policy#or Self-ins. Lic_#: V k' Co 0 l t 1 `t o i Z®l i F ieatiorx lame_ l I AA A- Job Site.Addtms: pity*fStateMp: Attach a copy of the workers'compensation policy decl'aratiorn.page(shams the policy number and epiration datel. Failmre:to secure coverage:as required under Sect on.2.5A of MGL c. 8:52 can lead to the imapo4sition of criminal Penalties of a fuse up to B,5Q0 GG anWor apse-year imprisonment,as evell ay civilPenraTties im the:fbrmv of a STOP PORK ORDER d a fine of up to$2-50- 0 a day against:the,violator. Be,advised that:a:copy of Aiis statement may be forwarded to the Office of Iacestigatioms of the:DU for insurance coverage-,wiffcation. I do hereby cae)' ?rnrader trre dins-arret'prnahks.o p appasy that the ermfom add npro 4ded above is lane and e6eirect S' tmrec: hate: Phtrne t?ffif®l rasa onJL% Do not wMe in tk&area,to be cotrThved by city or ttvn a ecia City,or Town: Permit/License L'Mmrng nthorsty(circle t ne): 1.Board of Health 2.Building Department Jti CityMown Clerk 44.Electrical Inspectdr S.Prhrahing Inspector d.Other Contact Peirsow. Phone# ujf udf:zull 18:53 50BB2176B4 HAMMOND DELEADING PAGE 03 CERTIFICATE Uh LIABILM INSURANCE [7101/3i°noiiY� 28IS C�SFIf71TE IS Elm bE ALAaTl'ii or In69Ap;Dop ONL7 Am caguz S NO I XGM UM "m c ffwxdmm EOTaEk. WE CsnTxrx== Dots RIOT AP'MIgN1mux Olt iiQA mmy m=. mmm OR imum 2E.L COMMSM APP'OMD03D W 2Ei P=== MUM. 4MIE CnWZriCA2t OF =aTshm DOES NOT C00321TM A COM Ms Mmms 2Ni x88=ws SA7viiitP), AVMIMSED DiPiB.TEiTA m OB PRfmOCLR, mm mz COWZF PATE iolT:Dpat. muca r. if the oe.Rulamt. b.2demill. m AIDI'SiOIpL mmiD, tba VeLiey(Saa) rust be andoreed. sf SUBROr.A=Or La wwww. anDlact to Um tern and co�nditlois of CDe valley, eertm Delleies mw requl=an ead=sa nt, A atatUWbt OR MR "LlUfleate does net aa■few FightP to tan Certificate bolder in lien of anoh andP>:c■so,■t(n), Farrell Backlund insurance ■rls Agency cy Lw IAIe.r. Mgt): - IA/c so): P O BOX 509 :-NL=.: Taunton, IA 02780 COWV M M. Drovllw ie■euota/anaroao cook: ■LtV� Hammond Deleading 6 Construction Inc '• ■A:A.X.M. mit ual Indura ee co IlpraPR., 19 O=ehard Street Berkley, L0! 02779 iemlgA., . ftntaa)I u rnoese., COVERAEMS CERTIFICATE PUN=; 3MVXSICN IWU►BER- IMS S TO CPR Pr MAT TW P=WrZS or 11ai0P.U=LIBMD NtlLOV GAVE pppttar I=WD TD Tam Immm aA11®APOM rOR 2W POLI r P-= DD)ICArED. NOTwnmrmmzw ANT rsmareAm, %m OR camirlm)as ANr own%=OR O'mi DOLmr tamp JWSR=I'TO Mim TM M QR mnmTD Kw ru isum oR mx PERTAT)T, 7W 3NNA)ATTCB ASW=D NT TW VOLWWM DC==MM IS ELT TO ALL ZZ MMU, M=V&ze WW NAVE'9 VEOVCM NY PAID su AMo0ND1ZICNS OP 10tl[POLIC3t. LAWS rIDMi rr.�ye. P m or DeORwCE Io T OOLIG7 ear p zcr (ITeGt ■■V■a■■■fo /+Em7.DaITs _ real COMM Q i aCAPORODu V uft m •. - " oaocs ro A■eeso ❑❑eL%%w Uh= ❑ORlr1 reoe■a41...e.+as ? E3 OW Pr OYMMM i AM Ira7R' GW L ArdaIOP11TP LD2T%PMJU lk. - .. OomcYL mtoat i pPOUCY [19AWMT[lot nAOator/-NIP/W r10C P L IL ase■rm craps Lme pare.I .T'yam AOOSLT XOMY(poll Pa■aU S pcueen M AV)VO owns rllnwipu N■■I.AtI i .. perere AM# _ rAePponr eAMree Qea..o.ee aVr00 - .. ars■..■..,■) - i AAa1OLV®ereG' i - ❑tlCLagl LYIr■ CLAM Nw IiOGPOArr A [:IVAA4TaLs - ❑KKtITZa, : ' t10RIWtA COIppInnlA.T'IOlp P AM WIFZC=LIA0mm 'sa■aa as s IlIB pAOPRZEI'ONPhiTNEPS/ A PXECaITIVE OFFICERS ARE P-L. CUMZ=Dw i 1,000,000 ® incl. excl 4601,514012O10 e.L. oresaz.roua anla P 1,000,000 09/19/2010 09/1S/2011 e_L ar■as-Got,aonaa: r»W.. ■ 1,000,000 calmrn/■walvrrq er Wnar:e■a C=R=jri7'iC&TS HOLDER CANC3UZA 'IGK CITT OF 80STOM W WW ANT C9 T)C ABOVE DkiCRIDED BO wnM gE CAz=tED emnw"m 2aS CRfjjp iL AvE CWTVATMV W= TOMM, BOX=W= BE DM7EIM IN ACOO NIIN Itr . . rMIL7 p7AMIONA. e IiYDE PARIG. Nk 02136 vres:rm ev■rrmaw viassacnusetts- vepartment or runtic �)wety r Board of Building Re�*ulations and Standards Construction Supervisor License License: CS 73952 JOHN H HAMMOND , 19 ORCHARD STREET BERKLEY; MA 02779 Expiration: .6/28/2012 . Commissioner Tr#: 28624 ✓1e �� ✓�• License or registration valid for individul use only Office of Consumer Affairs&B%iness Regulanw. HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: . Registration >IMPROVEMENT Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Expiration. A2113/2012 Individual Boston,MA 02116 J H. HAMMO..HD ' L JOHN HAMMOND 19 ORCHARD ST. BERKLEY,MA 027 ' thout signature Un sr t The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 1 of 2 The Commonwealth of Massachusetts Will Francis Galvin Secretary of the Commonwealth,Corporations Division a s One Ashburton Place, 17th floor Boston,MA 02108-1512 Telephone: (617)727-9640 HAMMOND DELEADING AND CONSTRUCTION, INC. Summary Screen Q Help with this form ;��,z��j�equest�a Gerttficate�� , The exact name of the Domestic Profit Corporation: HAMMOND DELEADING AND CONSTRUCTION. INC. Entity Type: Domestic Profit Corporation - Identification Number: 000847817 1 Date of Organization in Massachusetts: 09/01/2003 Current Fiscal Month/Day: 12/31 The location of its principal office: No. and Street: 19 ORCHARD STREET City or Town: BERKLEY State:MA Zip: 02779 Country: USA If the business entity is organized wholly to do business outside Massachusetts,the location of that office: No. and Street: City or Town: State: Zip: Country: Name and address of the Registered Agent: Name: JOHN H.HAMMOND No. and Street: 19 ORCHARD ST. City or Town: BERKLEY State:MA Zip: 02779 Country: USA The officers and all of the directors of the corporation: Title Individual Name Address(no Po Box) Expiration First,Middle,Last,Suffix. Address,City or Town,State,Zip Code of Term PRESIDENT JOHN H.HAMMOND 19 ORCHARD STREET BERKLEY,MA 02779 USA" TREASURER JOHN H.HAMMOND 19 ORCHARD STREET BERKLEY,MA 02779 USA SECRETARY JOHN H.HAMMOND 19 ORCHARD STREET BERKLEY,MA 02779 USA VICE PRESIDENT KAMM MEEHAN 90 CUTTER HILL ROAD ARLINGTON,MA 02474 USA DIRECTOR JOHN H.HAMMOND 19 ORCHARD STREET BERKLEY,MA 02779 USA http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... 5/20/2011 i The'Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search , Page 2 of 2 i business entity stock is publicly traded: The total number of shares and par value, if any,of each class of stock which the business entity is authorized to issue: Par Value Per Share 'Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding Num of Shares Total Par Value Num of Shares CNP $0.00000 200,000 $0.00 20,000 Consent Manufacturer _ Confidential Data Does Not Require Annual Report Partnership X Resident Agent X For Profit Merger Allowed Select a type of filing from below to view this business entity filings: ALL FILINGS IFS.j Administrative Dissolution Annual Report Application For Revival Articles of Amendment f tliy'Ys 90 z'� r Vlew Fl n- ,,r� tYyR F I w=Search y� »Y.f_:�S f.+a„`•,v._ ...t'�F;:PA 1 F'�''• L'v......�..J+...ec .fz .�Sa" Comments O 2001-2011 Commonwealth of Massachusetts ? All Rights Reserved Helo http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True..: 5/20/2011 639. Town of Barnstable Regulafory Services Thomas F.Geiler,Director Building Division Thomass Perry,CBO . Building Commissioner.. 200 Main Street, Hyannis,MA 02601 www.town.ba'rnstable.ma.us Office; 508-862-4038 Fax: 508-790-6230 Property ORmer.Must Complete and Sign This Section ' If Using A Builder n (_ �Q ��I,�� l� ,as'Owner of the subject property . Ct�rlrylord PGrol t�`�i hereby authorize.. d` � l'1)n5Y�CAYlto act on my behalf, in all matters relative to work authorized by this building permit application-for. (Address of Job) Signs a of Owner Date Print tafme r If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the r reverse side. { 1, C:\Users\decollik\AppData\Local\Microsoii\Windows\Temporary Intemet Files\ContentOutlook\DDV87AAZ\EXPRESS.doc , Revised 072110 a SEPTIC SYSTEM MUST BE Assessor's map and lot 'number .1:..1..1..�. ...6: ... ..:;1 } INSTALLED I^1 COMPLIANCE <, WITH ARTICLE it STATE SANITARY CODE AID TOWN Sewage Permit number .......... �I�Nc_A . .... PF TIQNS �Qy�FTNET��o .` TOWN OF BARNSTABLE Z MAUST4DLE, c=; I o, "6a — BUILDING = INSPECTOR 'Ep ypY p• C' t • 15 APPLICATION FOR PERMIT TO ........................................................¢ �A �z .. r`z. 'T ntC....... ............... r: TYPE OF CONSTRUCTION ...... F???": .6. ........................................................................................................ ............. f ...g............19.... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following �i`nfformation: Location .........4.9.4..... .`r'AF1t...... .oi .•...! J ... a.:............:................................................. ProposedUse .......,.fl ri 5 l'i7 He i.................................. ................ ...................... ........ ...........:......................... ZoningDistrict ....`.�.j2, 13................................................................Fire District .............................................................................. i Name of Owner ....!:.} �t ..... � v .Address ..... .... ............................ j......�r.............a.S�!� ................ .�. ........ Name of Builder ...J.Z. a.+?.?. .... : :* ..................Address .:vim? 1eS„l�!�...rry �i�KTrzti�iL Name of Architect .....................I..........Address .................................................................................... Number of Rooms ........I............................ .Foundation A �?�i.: .`i.. ��w!,��o� ............................. ........... ................. ........................... Exterior .........(. :?Ah... .? ,rc4 L.zS.................................Roofing ..... ....................................................... Floors �-vkC era .'.. ..............................................:...Interior ......1"o-hr(.. .` ..:..........:......................................... .................... Heating1.gvt. .—)...................:.......................................Plumbing ..........`...er.. .. .. ................................................... Fireplace ...........1.�4.b.:..............................................................Approximate Cost ........4.i .�:.:'.......................................... Definitive Plan Approved by Planning Board _______________________ ------19--------. Area ... ............................. S� Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH t I M_ I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regardiria the above construction. ' Name .. ... ...... .......... ..:............... Neeven, Roy No -................. Permit for ......remove ..p.o.rch.... ...... . .... . ...... and add to dwelling� ................................................................................ Location ..........494 Sixth Avenue....................................................... West Hyannisport ............................................................................... Owner ............R......oy....Neeven............................................ Type of Construction ..........frame ............... ................ ............................................................................... ti Plot ............................ Lot ................................ Permit Granted ..........June............17...................19 77 Date of Inspection .....................................19 Date Completed ..........ZL/.~...............19.... ........ PERMIT-REFUSED ................................................................. 19 ............................................................................... ...................................... ........................................ ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... Assessor's map and lot number ...... ......:`....�.^.. Sewage Permit number ...... ��QyoFY►+Ero�y� TOWN OF BARNSTABLE Z MARNSTSDLE. i "b BUILDING INSPECTOR o 1 MPY p'' ff, APPLICATION FOR PERMIT TO ....... .-:n!:(.�� �o r t-t c .................... TYPE OF CONSTRUCTION ........FR�A*-t�- ............................................................................................................................. r ..........:.�t tiS. .....g............19.7 .?. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for[�a permit according to the following information: Location . . ! � L t!.� l �Y rcNrSvrz I �JA d. a............. ..................... ............... .......................................................................... • Proposed Use .......... . '.5.1„-)17c ....:...................................................................................................................................... Zoning District ........ F7............................................................Fire District .............................................................................. Name of Owner 1-`i .. Imo. F F u r-'aN..........................Address .�.��.. ar , . �c� .� n �,>>s- -::. .� .:..............7... ........./.. ................. . J Name of Builder 47 ..Address ���'r•,,s �_> 1 E wa r-r, r,T-,u, 7 f `1A Nameof Architect ...................:: ........................................Address ...............'"............................................................:.... Number of Rooms .Foundation ' � Exierior .......... !.�... 1-1 1",-. I;«.3 'Roofing .....!`!. .'.+:'..ct.A:. ....................................................... ......... .............................. .i' Floors ( K ' � 'Y Interior r n** --(, 4� ............................................................................ I ............................................ .................................... Heating .....�..�f..t...... ...........................................................Plumbing Fr'c rc ................................................................................ y Fireplace ..........!.......................................................................Approximate Cost ........ .. C:............................................ Definitive Plan Approved by Planning Board ________________________________19________ . Area ... ..c'►n..�...................... / Diagram of Lot and Building with Dimensions Fee �'............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH —J� l i� IZ'•L" � �i F77C µ 1 ]171-1c-vc 1, 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. JJ(, f Name ........................................ ................................. Neeven, Roy A=245-76 [ 19308 remove por4h No ................. Permit for .................................... and add to dwelling ............................................................................... Location I 4"I ..Si. . .. xth Avenue .............. West Hyannisport ............................................................................... Owner Roy Neeven ................................................................... Type of Construction frame ..................................................................:............. Plot ............................ Lot ................................ Permit Granted ........June..17...............19 77 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED .......................... ....... ...... 19 ............................................................................... Approved ................................................ 19 ............................................................................... Y ............................................................................... - A2 EXIST. DECK CA EXIST. . o in CRAWLSPACE -NEW P.T.6.6 POST.USE SIMPSON ABUSE POST BASE - wNEW 30'x 3T x 42 —— —-� BATH CONCRETE FOOTING \ r 1 - -I- REMOD. pb O EXIST. ———EXIST.GIRT ©--——————L_.!_ - BEDROOM --FF b i KITCHEN o o , . � NEW 3 f 3 ---------- w § SUNROOM -- ----- - _ .- - ✓ - - hcW 4 x6 POST UKaER TI-111S END OF NEW BEAM CLOS. NEW 6 z 6 POSTS UNDER THIS END OF NEV BEAM USE SIMPSON ACE5 CAP UP USE SIMPSON ACES CAP O EXIST.CONCRETE - _ - - _ . BLOCK FOUNDATION _ - - WALLS TO REIAA;N - - ' REMOD. LIVING © EXIST. : A BEDROOM A2 - - FOUNDATION PLAN - NOTES: --- — b 1.) CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS &DIMENSIONS 1N THE FIELD ,q 2.) CONTRACTOR TO VERIFY ALL INTERIOR&EXTERIOR MATERIALS, Ax DETAILS,&FINISHES IN THE FIELD WITH OWNER 3.) ROUGH OPENING HEAD HEIGHT OF WINDOWS AT 17s a 3ca FIRST FLOOR TO MATCH EXISTING 4.) ALL CONSTRUCTION TO CONFORM TO 780 CMR MASSACHUSETTS , I OO R PLAN STATE BUILDING CODE-8TH EDITION&IRC2009 FIRST FL (— 5.) 110 MPH EXPOSURE 8 WIND ZONE Q SMOKE DETECTOR s•) ALL LVL LUMBER/BEAMS TO 13E 1.9e U480 LOAD ©CARBON MONOXIDE DETECTOR 7.) FOLLOW ALL MANUFACTURER'S SPECIFICATIONS FOR INSTALLATION OF ALL SIMPSON COMPONENTS 8.) ALL CONCRETE USED FOR FOUNDATION WALLS,FOOTINGS&SLABS TO BE 3000 PSI LEGEND: 9•) VERIFY ALL PLUMBING&ELECTRICAL DETAILS W/OWNERS ON THE SITE DURING FRAMING CONSTRUCTION 0 EXISTING WALLS - CONSTRUCTION TO BE REMOVED 10.)TIMBER FRAMING TO BE SPRUCE/PINE/FIR NO.2 GRADE --� 11 J INSTALL NEW BATT INSULATION AT WALLS&CEILINGS WHERE OPENED EMI NEW CONSTRUCTION UP TO REPAIR WATER DAMAGED AREAS ERRORS OR OM `BE?*TanES ARE FO•JDCVv SCALE : DRAWING NOEaF-< -:COTUIT BAY DESIGN. LLc NEW REMODELING FOR: AESE CRAV6 R RIDSTAi° tH} •C ALLE.E RES ir51 E_B CR TIE COY�E:T`Q. 1/4tr 43 BREWSTER ROAD ;1„.ES=DpAA,WS,FOr SS7W.ma� C00.•NEr:OES vlT ouT I clwliN1,rE MASHPEE MA. 02649 SALVATORE CALAUTTI RESIDENCE ��5 r_RC°MYER °R°.•,u DATE _Sc Gce.rPAN r S AR Sv.ELY FGA 1FW:/5F PH. (508)274-1166 8/23/2011 8 Al 149 SIXTH AVE. WEST HYANNISPORT MA �o,'SEr'T° T� ° �� aTM= FAX (50 ) 539-9402 JTECIJRALCOa RI° ,PQOTEC� 1 A 42.-6. - 0 EXIST. BATH r. a O EXIST. Os LOFT © ' CLOS. oK EXIST. LOFT - - EXIST. .. . ATTIC ' NEW 2.65 INSTALL - - WHERE OPEN EXIST,-",' EXIST- @12'o.c. RAFTERS 7 .c. a BATH1-' LOFT t. . - - ;T 6' EXIST.2.ifs(c�17 o-C: - EXIST.2.Ss @ 1Z cc. - SECOND FLOOR PLAN .. NEW END POSTS UNDER - EXIST.2x 4lJAll5 THIS END END OF NEW BEAM . - - .. USE SIMPSON ACEG CAP. REMOD. REMOD. -KITCHEN LIVING I EXIST.2 x Ss 0 17 o.c. EXIST.2 x B's 17 o-c. - - EXIST.CONC.BLOCK - - L FOUNDATION WILS _ NEW P-T-6 x 6 POST,USE �SIMPSON ABUSS POST BASE A NEW 37x Wx 11' : CONCRETE FOOTING - - -- A SECTION @ KITCHEN/LIVING a2 n oEs:c�RsrucsEncTwroiFafr SCALE : DRAWING NO-: I ? �� COTUIT BAY DESIGN, LLC NEW REMODELING FOR. ERRC45C-..OV 54ptS A4E FQlt[)C" i'CSE RUC y _ ..0 3E R-SPC1ZF5 E FCR THE M11- 1/4` 43 BREWSTER ROAD NTESE°" MASHPEE ,MA. 02649 w•..•r1ROFA` E unm Gss SALVATORE CALAUTTI RESIDENCE G_5!3MROF 0."t-RE SMCR Fogy \5 DATE : IA2 PH. (508)) 274-1166 .Y-ESE ZavA SREWP STKI i-E SE 8/23/2011 FAX 50$ 539-9402 �F TME 4E-.ArV.Z!R, S �. ( 149 SIXTH AVE. WEST HYANNISPORT, MA w5E 04?Y.l-' RE tP'cSM1E Y(V^•Sv w1:sErr:cF rrE oEse��e�wR c� aac«recTuzv x?vRic�^rac:�c-.x �+4 i 42,_T_ 92'-0" a — -a0 y0 21 I --. ' 1_ � � ,°...�,.,• .ref �' � '1 ,�lr.� eV ....... - 44 remove partitions r r rem/In s `��° tci`�ar-�� � reconfigure area under I - ,, �_,p ;: •,, .. -��,� ^�i� �,.� �� I stair utilizing-max. headroom for new closet t remove existing chimney \ I } I remove existing �p door: ` - — —'---- remove existing c _ s door lD � p' add bay windows ° F0 ' 2 acme: 194�1