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Home My WebLink About0021 WACHUSETT AVENUE �� (,�a �� _. -- - - - _ w_ �� r-- - �� I r .�� ' � ll7 i /� 1 � �� ti g PROJECT. /1, NAME: F'rP, I- ADDRESS: Cl�_kV%,L5 PERMIT# oaf l Owl CU PERMIT DATE: �� 1 MiP: LARGE ROLLED PLANS ARE IN: BOX ( 2= SLOT - Data entered in MAPS program on:, L 11 c BY: - q/wpfiles/forms/archive _ J' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel / 3 q Application #Ji`lbf- L O Health Division Date Issued/e'er 9—/` Conservation Division Application Fee Planning Dept. Permit Fee t? �� r Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village Owner Address a I h Me 11L)5cd Telephone lC� Permit Request 1&-00(/e4TL &20 pu 5&e�ov0 rzyzw, &VCR S 1&0101A4 Square feet: 1 st floor: existing4S72 propose s/ 2nd floor: existing// 9 proposed� Total new �✓ Zoning District R 1= Flood Plain Groundwater Overlay _ Project Valuation WAt5 Construction Type Rc:51410W Lot Size��/S� Grandfathered: des ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Ua' Two Family ❑ Multi-Family ((## units) Age of Existing Structure Historic House: ❑ Uk Yes o On Old King's Highway: ❑Yes "lo /I Basement Type: Full UeCrawl ❑ Walkout ❑ Other CI Basement Finished Area (sq.ft.) D Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new 0 Half: existing / new 8 Number of Bedrooms: existing D new Total Room Count (not including baths): existing It new First Floor Room Count Heat Type and Fuel: dGas ❑ Oil ❑ Electric ❑ Other Central Air: ®Yes ❑ No Fireplaces: Existing d New 0 Existing wood/coal stove: ❑Yes UIRQo Detached garage: ❑ existing . ❑ new size—Pool: ❑ existing siz Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing Vew sizaWhed: ❑ existing ❑ new size _ Other: a Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes M No If yes, site plan review# Current Use �<o�,c�rAL Proposed Use / <4 k6V, f APPLICANT INFORMATION -F A (BUILDER OR HOMEOWNER) v Name �%�C� �UfG,O/iY�' Cow Telephone Number #Ca 2— Address MAW Sx— Bct 12 License # eS- ehg' T/� 074 , OR43_3 Home Improvement Contractor# 1111706 Worker's Compensation # We-876710/i ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �5// FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ` ADDRESS VILLAGE E OWNER 1 . DATE OF INSPECTION: ;FOUNDATIONiuik-11L:'V� t,;. 4,IDAJ! ± FRAME ,s INSULATIONa FIREPLACE ET ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 'a FINAL BUILDING I' DATE CLOSED OUT ASSOCIATION PLAN NO. " He CommonyawUh of-Vassachuseffs Departrttent ofhulrrsttzal Accidents - Office o,f bwesttgrrt�ons 600 Washhigtmn Sirreet f Boston,Al 02111 Worketrs' CampensationInsuranceAffitdavit:Builders/Contractors/ElectricianMumbers Applicant Infarmation Please Print Legibly Name(B+rime�l ft izntionllndividuaI): Gable, ` ( � ' f C n G L�p� r l'.7 Address-. �W I 9a 1 n S &x i z- J City/State/Zip: ' YW `Z/r 33 Phone 47 d gs-q 4 t2 400 Are you an employer?Check the ap::ropriate box: Type of project(required): 4. I stn a camtractor and I III � I ��' '�" L krI am a employer with—�2 ❑ 6 employees(full and/or part-time)_* havehiredthe sub ctors _ ❑Near oanstnretion 2_❑ I am a sole proprietor or partner- listed on the attached sheet, 7_ [�4 Remodeling ship and have no employees These v3b-contractors have a_ 9 Demolitioa w for me many capacity. employees and have workers' working Y 4_ ❑Building addition [No Workers'comap_ �insurance Comp- �1 required 5_.❑ QTe are a corporatian and its 10_.❑Mectrical repairs or additions � officers have exercised their I I_ Plumbing repairs or additions I❑ I am a hameawner doing all work ❑ g P , ar right of exemption per MGL € o w leers' _ 12_. Roof mySeS [N �mP ❑ repairs insurance required.]l c_152,§1(4),and we Purim-no �p10y�_[No workers, 13_❑Other comp_insurance requtred_j; 'Arty appbcant that checks boa€1 toast also fill out the section beiaw showing Their workers'compensation policy 3nfbrmatinm T Homeowners Wb.submit this affidavit Trim cstirrg they axe doing s11 ZtU k and then hire outside contra rocs most submit a amr affidavit mdicstin saaL tc_Wt mcmrs that chea this box must attached an additional sheet showing the name of the sash-co ova and state whether ormot those entities Have employees. Ifthe sulr-contssctors have employees,they must provide their workers'comp.policy avmbez_ I am an employer tltat is prm dding it orke-s'conrperissrrtin.n irtsrtrarice f or my emp7nyess BeLow is thepaTic}and job site in formatiom Insurance Company Name: T.12e t^'25 S `� i'1. Policy#-or Self--ins_Uc_#: . WO, 8767011 Expiration Date: 0 --C1 A Job Site Address: a I �t�Gt @ �u 5,z`J `"1 � �y� City/Stat 0p: !a n 11�st Atrtach.a copy of the workers'compensation policy declaration page(shoving the policy number Anal expsatr 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[me-year imgrisamnent,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator_ Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA far insurance coverage verification_ I do hereby eerhfy under thapainiand enaIties afpe uty that the information prosided abase is true and correct Sitmature: a Bate: Phone#: J UC%" J Z_ Official use on[y. IM not tvrite in this area,to be completed by city or town o,f�'ciaL City or Town:. Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CitylFawn Clerk 4.EIectrical Enspector S.Plumbing inspector 6.Other Contact Person: 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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 IocaI 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 auy applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), addresses)and phone number(s)along with their cerrificatc(s)of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no cm.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 iasu=ce coverage. Also be sure to sign and date the affidavit. 77ie affidavit shou_id be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be are 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 permi/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/licerise 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 Massachusttts Department of Industrial Aoeidents 4ffce of kvestigations 600 Wasbz gtaa Street Boston=MA 02111 Tel.A 617-727-45M W 406 or 1-$77-MASWE Revised 4-24-07 Fax# 617-727-7 749 www.mass-gavldia GABL850 OP ID: EA DATE(MMIDD/YYYY) CERTIFICATE. OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Sullivan,Garrity&Donnelly NAME: - - — PHONE 10 0 Institute R (A/c No._Ezt) 508-754 1767 — - (N9,No). 508-754-1885 101nstitute Rd a-MAIL ------ Worcester, — - MA 01609 _ADDRESS INSURER(S),AFFORDING COVERAGE -�_ — NAIC p INSURER A PeerlesS_Insurance.Company_ _ — j24198 _ INSURED Gable Building Corp. INSURERS. - Attn: Debra Askew ---- PO BOX 390 INSURER C: i. Chatham, MA 02633 INSURER D: INSURER E: s— INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR.OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR i IN%-SUBRj POLICY EFF I POLICY EXP L7R TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYYI I MM/DD/YYYY i LIMITS A I X COMMERCIAL GENERAL LIABILITY ± 11II ;EACH OCCURRENCE.. j$ 1,000,000 CLAIMS-MADE I OCCUR CBP9702220 03/24/2014 03/24/2015-I3AMAGET NTS— ORE ' 1 PREMISES Ea occurrence $ 100,000 I L I - ( 'MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY$ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY j i PE LOC 1 f PRODUCTS-COMP/OP AG G $ 2,000,000 i '•: OTHER. AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT I $ 1,000,000 I I(Ea accident) A !ANY AUTO ; BA1075489 03/24/2014 03I24/2015! BODILY INJURY,Per person) I$ ALL OWNED 1 X SCHEDULED I - AUTOS AUTOS j ! BODILY INJURY(Per accident)j$ X HIRED AUTOS X NON-OWNED V. PROPERTY DAMAGE $ - - AUTOS { I I Per accident) i I$ UMBRELLA LIAB I OCCUR - i EACH OCCURRENCE $ EXCESS LIAB i1_LAIMS-MAD EI i� AGGREGATE $ DED !RETENTION$ $ WORKERS COMPENSATION - PT' AND EMPLOYERS'LIABILITY Y/N i i i ' STATUTE �_.. A A.NY PROPRIETOR/PARTNER/EXECUTIVE ? WC8767011 � 03/29/2014�0 3129/2 01 5 E.L.EACH ACCIDENT $ 500,00 OFFICER/AdEPdBER EXCLUDED? (N/A' i,_-----------------.---..-�._ _..---..--------- (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE,$ 500,000 If yes,describe under I. I __—____.__— DESCRIPTION OF OPERATIONS below 1 j E.L.DISEASE-POLICY LIMIT $ w 500,000 I I I I i f DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached if more space is required) Contractors executive supervisor CERTIFICATE HOLDER CANCELLATION TDEQUIP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TD Bank N.A. ISAOA/ATIMA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2059 Springdale Road . . k Cherry Hill, NJ 08003 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD IKE Town of Barnstable • RARMASM • Growth Management Department 9`bArF 39. Barnstable Historical Commission www.town.barnstable.ma.us/historicalcommis'sion Jo Anne Miller Buntich,Director COMMISSION MEMBERS: Marylou Fair,Administrative Assistant Laurie Young,Chair Nancy Clark,Vice Chair Marilyn Fifield,Clerk George Jessop,AIA 2014 OCT 24 AM11:56. Nancy Shoemaker Len Gobeil Ted Wurzburg Paul Arnold,Alternate BARN1TABLE TOWN CLERK DECISION Summary: Demolition Delay Not Imposed Pursuant to Chapter 112 Historic Properties, Section 112-3 F Applicant/Property Owner: Farley& Elizabeth Lewis Subject Property: 21 Wachusett Avenue, Hyannis, Assessor's Map/Parcel: 2871139 Hearing Date: October 21, 2014 Pursuant to the Barnstable Historical Commission Chair's determination on September 30, 2014 a duly advertised and noticed public hearing was held on October 21, 2014 to determine whether the significant building identified as the single family dwelling on this property is preferably preserved and whether demolition delay would be imposed for the partial demolition of the dwelling on the parcel addressed as 21 Wachusett Avenue, Hyannis. After review and consideration of public testimony, application and record file, the Commission by a unanimous vote, found that in accordance with Chapter 112-F the demolition of the portions of the single family dwelling are not preferably preserved significant buildings. The portions of the single family dwelling to be demolished are identified in plans submitted by Brown, Lindquist, Fenuccio& Raber Architects, Inc. dated August 28, 2014 and are attached to this decision. In accordance with Chapter 112-3 F, the Commission determined by a unanimous vote that the demolition of the portions of the single family dwelling would not be detrimental to the historical, cultural or architectural heritage or resources of the Town. ' LGL(Mrl.Qi Y&V-gig. October 23, 2014 i Laurie Young, Chair 'Date 200 Main Street,Hyannis,MA 02601 (o)508-862-4786(f)1508-862-4784 367 Main Street,Hyannis,MA 02601 (o)508-862-4678(f)508-8624782 ' iu From: 10/22/2014 15:59 #659 P.001/001 u"`�A A B L - E DBUILDING CORP. 1291 Main Street—Chatham, MA 02633 Te1.508--945-4002 Fax.508-945-4004 ate: 10/22/14 To: Whom It Maij Concern From: .Tames E Gable �Re: . Michael Squier H To Whom It.May' Concern: This letter is to confirm that Michael Squier is an employee of Gable Building Corp and is in fact covered under the company's Worker's Comp Policy(WC 8767011). Sincerely, ames E Gable President Gable Building Corp I - - REScheck Software Version 4.6.0 Compliance Certificate Project Additions & Alterations to Lewis Residence Energy Code: 2012 IECC Location: Hyannis,Massachusetts Construction Type: Single-family. Project Type: Addition Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 21 Wachusett Ave. Liz Lewis Rich Fenuccio Hyannisport, MA 02601 21 Wachusett Ave. BLFR Architects, Inc. Hyannisport, MA 02601 203 Willow St Suite A Yarmouthport,MA 02675 508-362-8382 MENEM Compliance: 3.9%Better Than Code Maximum UA: 308 Your UA: 296 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies Floor 1: All-Wood Joist/Truss:Over Unconditioned Space 929 30.0 0.0 0.033 31 Wall 1: Wood Frame, 16" o.c. 2,292 20.0 0.0 0.059 113 Window 1:Wood Frame:Double Pane with Low-E 282 0.300 85 Door 1: Glass 100 0.320 32 Ceiling 1: Cathedral Ceiling 1,302 49.0 0.0 0.022 28 Skylight 1:Wood Frame:Double Pane with Low-E 24 0.280 7 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculation submitted with the permit application.The proposed building has b desig ed to meet the 2012 IECC requirements•in RESchec ersion nd to comply, ith the mandatory requirements list e R c Inspection hecklist. Name t5q e v Date No. 7789 YARMOUTHPORT, J OF Project Title: Additions &Alterations to Lewis Residence Report date: 09/03/14 Data filename: H:\_Current.Projects\Residential\Lewis Residence (Liz &Farley)\Lewis 21 Wachusett Page 1 of 1 Sve.rck I ` CONSULTING STRUCTURAL ENGINEER, INC. 53 Knox Trail, Suite 201 978-461-6100 Acton, MA 01720 www.cse=ma.com September 4, 2014 Kathryn Giardi, LEED A.P. Brown Lindquist Fenuccio & Raber Architects, Inc. 203 Willow Street - Suite A Yarmouthport, MA 02675 Kathryn(a)-capearchitects.com RE: Structural Review Additions &Alterations to the Lewis Residence 21 Wachusett Avenue Hyannisport, MA Dear Ms. Giardi: Consulting Structural Engineer Inc. (CSE) is pleased to submit this letter confirming our structural review of the additions and alterations to the single family residence at the referenced project location. We reviewed the structural drawings entitled Additions & Alterations to the Lewis Residence, numbered SO.1 through S1.5, and dated August 28, 2014 as prepared by BLF&R Architects, Inc. To the best of our knowledge and belief, the structural systems defined on the referenced drawings satisfy the relevant requirements of the International Residential Code (IRC), 2009 as amended by the Massachusetts State Building Code for 1&2 Family Dwellings, 81h ed. (MBSC). The structure has.been evaluated for Exposure C in a 110 MPH wind zone in accordance with the Wood Frame Construction Manual for One- and Two Family Dwellings (WFCM) as permitted in IRC R301.2.1.1. Thank you for the opportunity to support you with this structural review. If you would like to discuss this project further or have any questions please feel free to contact the undersigned Sincerely, ` 'WALSH STRUGIURAL " 46077 Brian A. Walsh, P.E. Consulting Structural Engineer, Inc. �mETti Town of Barnstable Regulatory Services t • 9 swxx &9. E Richard V.Scali,Director i63 a Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 -- www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner$f the subject property hereby authorize/� '.X/��/.(1�0 to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job Pool fences and alams 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. 'A� � Signature of Owner Si a e of,Applic o-- .Print Name Print Name Date Q:FORMS:OPJNI RPERMISSIO'NTP00LS - _ I r Town of Barnstable s Regulatory Services -,THE roty� Richard V_Scali,Director f Building Division * snrcxsT"M Tom Perry,Building Commissioner nuss v� 1639- �� 200 Main Street, Hyannis,MA 02601 ATEn tM'I a www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEWTION Pease Print DATE: _ JOB LOCATION: - number street r village "HOMEOVJIJER": - name home phone# work phone# CUT,RENTT MAILING ADDRESS: city/town state rip code The current exemption for"homeowners'was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,Rrovided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Parsons)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. Sip.,Fture of Homeowner Approval ofBuildingOfficial Note: Three-family dwellings containing35,000 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,RuIes &Regulations for Licensing Construction Supervisors,Section 2.1S) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor_ The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:IVJPFILES\FORMSIbuilding permit fbTms\EXPRESS.doc Revised 061313 Massachusett,-, -Department of Public Safety Board of Building Regulations and Standards Construction Supen-isor - License: CS-051830 MICHAEL K SQUIER 582 BAY LN ' i ' CENTERVILLE MA R632 �.•G... ,lJ . " "' Expiration Commissioner 02/03/2016 7/. �omvrnoouoea/C� o�'' ,�iizsac�ivaello Office of C(insumer A&:rs&Rdsi;e;s Regu�ation gjHOME IMPROVEMENT CONTRACTOR Registration: Re 9 111006 Type: \, Expiration: 1 111 812 01 4 Private Corporati SQUIER CONSTRUCTION, INC. MICHAEL SQUIER 582 BAY LN' CENTERV!Li_E, MA 02632 Undersecretary HOLD? D - 0 103.22 BY DEED ,�. ^ OO 32a 9.5'iv N 31 S v CHIMNEK CD S ,^^ N V/ m 21.5 s h 13.5 h 9 ± p 101 m 7.5 --� 03 iD 0 D1 I D UUD NOTE:SHAPE OF LOT SCALED'FROM _ ASSESSSORS MAP A.M. 287/139 16xl8 Krr"OtJ m m rn z 150:00 BY DEED 1 C m 0 co m o C.B. held NOTE: RECOMMEND, INSTRUMENT SURVEY NOTE: PRE-EXISTING NONCONFORMING ESIONE: RF—I FLOOD ZONE:C THIS,_ M0R A'GE S r4'<' PLAN IS FOR TOWN: BANK USE ONLY !ANN�SPORT REGISTRY OWNER: MADELAW ISE B. LEW - - , .DEED REF: _1429_313 BUYER: nOATE: 10-15-88 PLAN REF: A.M. 287- SCALE: 1 `- 30' shawne .Y certi y t at t e u1 inS \-gyp Of on this plan is located on �� YANKED SURv * 'he �„g�ound as shown .and it �o� � COI�ISULLTANTS osition does PAUtA. `'� 70 RASPBERRY .LANE . confora to the o 4} _ 8 law setback requirement . of MEnrrHEW BARNSTABLE MARSTONS MILLS - es not lie within the special �A9g`ESS1o�P� MASS 02648 hazard area 'as shown on qH� SURVFy�� flood ap dated ' This Plan not made f er rom an instrument Y . 'lot to be i'thew, RPLS survey , 47I8 _ used for fcnccs . ctc yJ Town of Barnstable - *Permit# Expires 6 months from issue ate Regulatory Services Fce Thomas F.Geiler,Director Building Division Tom 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 13 c1 Property Address , _ residential Value of Work .50 v Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name F/i 6a�t. �t�p Telephone Number.J�"O�'-y��" 9 4)- Home Improvement Contractor License#'(if applicable)_ I 2 IS 3�P Construction Supervisor's License#(if applicable) C Cf O [&Workman's Compensation Insurance Checl one: � e " -f' . ❑ I am a sole proprietor a �`_;< N R_ ❑ I am the Homeowner 0,I have Worker's Compensation Insurance J A N 2 Z 010 Insurance Company Name I - Il k/) FOVOI OF L ARNSTABL Workman's Comp.Policy# _ LL 2 — 03 L/ t N',5, Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) C�,Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission: A copy of the Home Improvement Contractors License is required. SIGNATURE: Q:Forms:expmtrg Revise06.1306 t_ I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1. 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): FA o_� LC, Address: 1 City/State/Zip: j�LLt,L� `y1� bo'�635 Phone #: 569—YO-9 1 ,42ol?- gA Are you an employer? Check the appropriate box: Type of project(required): 1 aI am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.1 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 I I.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#:44 0" Job Site Address: O� W -0_A_tt . City/State/Zip: �V v9— Attach a copy of the workers' compensation policy declaration page(showing the policy num er and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cep the nd pe Mes of perjury that the information provided above is true and correct Sip-nature: Date: Phone#: UQ Yoe 6 ' o�7`� 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 M i r u "� �:• s ✓fce ��`br8,1r%o�zcu ��✓�/�a�raE�':. i I . k !Board ofBmidieg Regula4ions and Stan�l.ards; . " 1 Construction Superv.isort.icense ` s License CS 97668 Expiration �n/2p11 Tr# 97668 N. u 46 Restnction OA DEAN FRASER 104-7WINN'-VIEW LANE EAST FALMOUTH,MA:02536- Commissioner`"' Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ;;4 Regist(i&O; 112536 Board of Building Regulations and Standards 'Wt� =3`/23/2011 Tr# 281021 One Ashburton Place Rm 1301 �` Boston,Ma.02108 Type: Dt#/ FRASER CONSTRUCTION CD. DEAN FRASER 104 TWINN VIEW[SANEC. f� E FALMOUTH,MA 02536 y Administrator Not re ne! noar o u r One Ashburton Place m Room 1301 Boston. Massachusetts 02108 Home Im-provement-C61a9ractor Registraf.on Registration: 112536 Type: DBA Expiration: 3/23/2011 Tr# 281021 FRASER CONSTRUCTION CO. DEAN FRASER P.O. SOX 1845 COTUIT, MA 02635 Update Address and return card.Marls reason for change. Address Renewal Employment Lost Card Al 0 40M-08/0B-DBSLIF0RMC/�108212008 tu` R,3.ghtFax C2-2 9/29/2009 5 : 35:22 AM PAGE 2/002 Fax Server ACORD. CERTIFICATE OF INSURANCE DATE(MM1DD\VY) 09-29-09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE WISE fir.QUINN INS AGCY IN HOLDER- THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 449 PLEASANT ST ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE BROCKTON,MA 02301 COMPANY 24WCB A HAR'ITORD GROUP INSURED COMPANY B FRASER CONSTRUC'nON LLC COMPANY P.O.BOX 1845 C COTUIT,MA 02635 COMPANY D COVERAGE THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALLTHETERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIYY) DATE LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL PRODUCTS-COMPIOP AGO. $ CLAIMS MADE OCCUR. PERSONAL&&ADV.INJURY $ OWNER'S&&CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ MED.EXPENSE(Any one person) $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY(Per Person) $ SCHEDULE AUTOS BODILY INJURY(Per Accident) $ HIRED AUTOS PROPERTY DAMAGE $ NON-OWNED AUTOS GARAGE LIABILITY ANY AUTOS AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGREGATE $ EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ WORKER'S COMPENSATION AND A EMPOLYEWS LIABILITY UB-0341 M556-09 09-26-09 09-26-10 STATUTORY LIMITS X THE PROPRIETORI EACH ACCIDENT $ 500,000 PARTNERS/EXECUTIVE INCL DISEASE-POLICY LIMIT $ 500,000 OFFICERS ARE: X EXCL DISEASE-EACH EMPLOYEE $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLEWRESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER APFECTWO WORX2R.S COMP COVERAGE'. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE FRASER CONSTRUCTION LLC EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TOTHE LEFT,BUT PO BOX 1845 FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY HIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. COTUIT,MA 02635 AUTHORIZED REPRESENTATIVE ACORD 2&5(3193) Ramani flyer Fraser CONSTRUCTIONConstruction, LLC P.O. Boy: 1845, Cotuit MA. 02635 Email: faser constructionQverizon net www.fraserroofng.com FAX 1-508-428-0123 508�428-2292 MCL#112536 CS#97668 RE-ROOFING PROPOSAL DATE: September 11, 2009 NAME: Liz Lewis PHONE: 508-775-9168 MAIL ADDRESS: P O Box 417 Hyannis Port, MA 02647 JOB ADDRESS: 21 Wachusett Ave. Hyannis Port, MA ]EMAIL: lizlewis a,comcast.net FRASER CONSTRUCTION hereby proposes to perform the following services in a neat and professional like manner and in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. Supply and Install - CERTAINTEED LANDMARK /WOODSCAPE AR 30: 30 - Year Warranty, 5 year Sure Start Protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi- Layered, Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10 Year Warranty against ALGAE Containment. 5 year 110 mph wind- resistance warranty with six nails in common bond area, Fraser construction includes six nails in common bond area at NO additional cost. See actual warranty for specific details and limitations. Color: to match Burnt Sienna PRICE- $2,500 Initial Ell Price is to reroof the towe J`' Supply & Install - CertainTeed Winter - Guard: (ice & water shield) Waterproof Underlayment System (3ft. on eves and valleys, 18" on rakes, walls, and skylights) ICE & SNOW ENTIRE AREA Supply & Install - 8" Aluminum Drip Edge with existing soffit vents or Smart Vent Supply & Install - Aluminum & Neoprene Soil Pipe Flashing Supply & Install- Ridge Vent - Shingle Vent II (as recommended by CertainTeed) �� Clean & Remove - Debris from work area daily. J ' NO MONEY DOWN - NO Payment at the start or part way thru Payments accepted are: CASH - CHECK- MASTERCARD -VISA-AMERICAN EXPRESS *Any payments not made within 30 days of completion will be charged 1.5%for every 30 days the payment is late. Possible Extra-After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$6.00 per panel including Materials 8s Labor. There are 6 Panels per sheet of plywood. Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$60.00 per hour, plus 1 S% mark-up materials FRASER CONSTRUCTION Warranties the labor for 12 years FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. CERTAINTEED Warranties the shingles and labor 100% through the Sure Start Warranty duration. CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the Sure Start Warranty depending on the shingle that was purchased. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: • 9 omen-rner Fraser C®nstruc�ion, LLC g• gam, y Town of Barnstable *Permit Expires onths from issue date Regulatory Services FeeY co Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PEIZIVIIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 17� g (39 Property Address �J tn� �tJ �— C�Y�,�b_ UZJt1 1 � [residential Value of Work 1 G. Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address a Contractor's Name F- 0.a mac, . Telephone Number J S'_ Home Improvement Contractor License#(if applicable) o�5 3 . Construction Supervisor's License#(if applicable) [�Workman's Compensation Insurance Checl one: ❑ I am a sole proprietor X—PRESS PERMIT ❑ 1 am the Homeowner AUG 6 Z008 . Z,I have Worker's Compensation Insurance Insurance Company Name T 1 T,OWN OF BARNSTABLE Workman's Comp.Policy# 5 J O L 35 6 o Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) [&Re-roof(stripping old shingles) All construction debris will be taken to Z,tl_ ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders. U-Value (maximum.44) *where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Histonc;Conservatign,etc. c�5 *-**Note: Property Owner must sign Property Owner.Letter of Permission. . A copy of the Home Improvement Contractors License is required. SIGNATURE: n Q:Forms:expmtrg Revise061306 The Commonwealth of Massachusetts s _ Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 IF www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): FRF�S M CQ A)�T rZ_U_C t 10 A-) Address: 'Po City/State/Zip: Pm- QZ 3,_�Phone #: _! 'D 0 — `�o� � ^o�2 off- Are you an employer?Check the appropriate box: Type of project(required): 1.Z am a employer with__?�, 4. ❑ I am a general contractor and I employees(full and/or part-time). * have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition workingfor me in an capacity. employees and have workers' � y p tY comp. insurance.t 9. ❑ Building addition [No workers comp. insurance p'required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.4Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number: I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. ' I Insurance Company Name: 11�� 7'7-{�R7\—F-y g- C) Policy#or Self-ins.Lic.#: D g S L S 5S0 Expiration Date: ' 02 ' Q 8 Job Site Address: Cq_1 �.t�CYC.G �`-u-� City/State/Zip: +/ Attach a copy of the workers' compensation policy declaration page(showing-the policy num r and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as'civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi er the airs and ties of perjury that the information provided above is true and correct Signature: �J Date: Phone M J�O a �oZ 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#:' H®me n Alassachuse DEAN F �SE TRUCTl® egletMtlon: 77253E j BOX 1845 N co.C® tray on T 'V �ITB MA ®2e 008 T1 72782 � Q D�`r+A1 d'S 60M-0.5/OB-pGg.}g� _• - 601Z -- VPdate �bMeg C3ra 13®�®fjm,, ° `-- — -- ❑ �d � e®at for Chan., 110lwa Im. and�a aat ❑ Card ed�rvkllz r c®f� �R LfeeAae #teg: 12538 beff., regbt,,ti,,Vad for tm B® teQU dates e �� oQs r 727s2ot�t �d �; DEAN FRaseRMuCrl .° �j ® �,®6 4558 Rr 28 Corulr,Mq L63.5 - i I i .r..:::•:: ::�^}:•:r:;:}:?�J:�,?J}:ram}:;•:4:h};{::;rJ •Yi'3.•Jv+� :::• ..::J; .. v: vv .. .{'j:�i?}':tijv:•:titi3 ii{:;S::�S?:� :;isis�:4J:�:�Si::P?J?:4:4YJ?Yiw.vnv:x:::q J��+t'}}I�' J•' '- -' : '};:;;J.}::i+:v;;_'iJ:i.''-iw;::i?'?iiY.�'.:?:;4J:? i:�:Y�:i::ti:::r}i:�:{ .....,+ �.��•,...... (S.•'•.U�. •: :: ..r..::. r .. 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FY Y.}•.;;v+GS.vWI-h.Y•.: Ac:' . THIS IS TO :'':; :,\Y';ti•yq ;;..••f+...;,L,k!r:S,>^.;'%:Y: :.k.�_,. : ?? ::f�rii C<.2n 'w3!y:2n J �. Y •`J+<r'<K}::%yyf:;:' K?4• ;.:Gv'.:::..,c;.;:'.:J•:•t r CERTIFY THAT THE POLICI INDICATED, NOTWITHSTAND ES OF INSURANCE LISTED BELOW .>v..,�..;•. :•,.a..,k::."�.`JY��.cv�iY:.x,•:;r�N:: � +.�✓,r�,�,�Y'•�,;n�?r•;�:;:�•x,5�. 'K'•��^Eck:>>�;•:�•..``�"'`-%;._`€»::;,. HAVE BEEN ISSUED TO THE INSURED NAMED .i. .. FOR THE POLICY ING ANY VrPERIOD rr< 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE LTR POLICY NUMBEq POLICY EFFECTIVE POLICY EXPIRATION GENERAL LIABILITY DATE(MMMI AYA) DATE(FAMIDDAVV) UNITS COMMERCIAL GENERAL UA131UTY GENERAL AGGREGATE $ ' PRODUCTS-COMP/OP AGG. CLAIMS MADE a OCCUR, $ OWNER'S&CONTRACTOR'S PROT• PERSONAL 8hADV.INJURY EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) AUTOMOBILE LIABILITY MED.EXPENSE(Any one person) $ ANY AUTO COMBINED SINGLE ALL OWNED AUTOS LIMIT $ SCHEDULED AUTOS BODILY INJURY HIRED AUTOS (Per Person) $ NON-OWNED AUTOS BODILY INJURY (PerAccldent) $ GARAGE LIABILITY PROPERTY DAMAGE $ ANY AUTO AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: ?:s•'':ti°?:""':#?{ %;c:`::'s`.:: •J;ri::J.:tti. EACH ACCIDENT $ EXCESS LIABILITY AGGREGATE UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ A WORKER'S COMPENSATION AND EMPLOYER'S LIABILITY (6560U6-0850L35-5-07) : :- '••'. I 09-26-07 09-26-08 STATUTORY LIMITS THE PROPRIETOR/ PARTNERB/E EACH ACCIDENT)(ECUTTVE INCL $..^. OFFICERS ARE: X EXCL DISEASE-POLICY LIMIT OTHEq DISEASE-EACH EMPLOYEE I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS I i THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE I ...... �1• &dE .....-•>: :::>':::r;;':::-::is:::; ::>.:::::>.:?::: :?<.::::.Y;:oJi:::.r..::.:::.r.::...... .... CATE :::.::�:::::.Y;?:;:::•.�::.;r•?Y ::.r.�� `.::::.v:::.:.:;.:•:_.:.::.>;:;:::::::?,•?:��:.:::::i:-i?•:::-::•;?::;:•:::::::::s:±:;:>.J'.:::r::.J:.;•:::.:::+..:.......... 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AUTHORIZED REPRESENTA t.... !se4N..J:;.;:•?:::??:c;;.?;.:.;.;:;;...., 'r:''':;:�S:J:�t'�':r:�'::�:;:;:::�::�:�::;:;:::;;Y'•.::y`::�i::::%;:�J:;�::Y':'�::�:�:;�i:;:•>Y:?::•T:;:.: THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) m A- 7��-C&,L- DATA T 1 aser C on structionl LLB. � ' ,LSTRUCTION n Home Im roveln L'e l License #11256 • P.O. Box 1845, Cotuit MA. 02635 . / 508-428-2292 Email: fraser constructioKii!verizon.net www%fi•aserrooling.com FAX 1-508-428-0123 WORK PROPOSAL DATE: May 1, 2008 NAME: Liz Lewis PHONE; 508-775-9168 MAIL ADDRESS: P O Box 417 Hyannis Port, MA 02647 JOB ADDRESS: 21 Wachusett Ave. Hyannis Port, MA EMAIL: 1 izf ex-N-i s(cr)colljcast.nct FRASER CONSTRUCTION hereby and professional like u� Y proposes to perform the follovvin specifications and local building dodgy accordance uri g Se1"VICeS In pCrlt -Remove � �e manufacturer's and Haul alvay all of the old -Re-nail all plywood sheathingroofirt as needed g material Su I and Install _ CEIiTAINTEED Extra Hen 5 Year Sure Start Protection ANDMARB i Based AsplI Weight, Self Sealing ' CLASS A FIRE ODSCAPE AR 30. 30 _ a Full Ip ye t S�gle wj C7, Multi - LaYered l ►TED, Year New En Architectural S �+ Resistant ! resistance warranty 'ag st gland s Exclusive ER�CE le, Fiber ' I s. nails - arty or 5 LGPZ; Conte COPP RA glass �n eoinnton Year 80 �Ph wind_ r'n1ent. 5 Year °gyp MIC Stones tvth spe c details and Iimbitationonct rea, for es3stance Ph wind_ an additional cost. S erranty available actin with ' Color: RV-y,�" S� wa antY for PARTIAL RE_ROOF I, Su 1 SCE- $i,800 (4sg) Initial Instal] - CertainTeed waterproof Zr nter_ Cuard: 0ce Valle „ nderlaymen r s t & Valleys, watehield Sq 1 , I8 on rakes, walls,Yst skyIi on eves and Install _Roofer's Select gh ts) Su b.Y Certa' vaderlayrn pa mTeed1 eat Per 1 Install - 8„AIu (as recommended Su 1 Instal] rainvl Drip Edge OCteaa � Air Vent Ridge Vent (as reco oDe - n D 1nended ri .Deb from work wo ' area daily, by CertainTeed) Z d 8916-5LL-809 91mal 41egezge BZ6 L0 90 8Z AeIN i <-� T 24" Royals !a? 8" TTW on side connecting asphalt roof PRICE- $3,750 Initial (1( Sheet of Copper PRICE- $150 Initial NO MONEY DOWN -NO Payment at the start or part way thru Payments accepted are: CASH - CHECK- MASTERCARD -VISA - AMERICAN EXPRESS *Any payments not made within 30 days of completion will be charged 1.5%for every 30 days the payment is late. Possible Extra -After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed,this would be charged for as an extra at the rate of$4.00 per panel including Materials 8& Labor. There are 6 Panels per sheet of plywood. Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$55.00 per hour, plus materials, plus 15% overhead mark-up on total extras. FRASER CONSTRUCTION Warranties the labor for 12 vears FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. CERTAINTEED Warranties the shingles and labor 100% through the Sure Start Warranty duration. CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the Sure Start Warranty depending on the shingle that was purchased. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: omeowaer Frase on n, LLC tA lU P,P 6'd - 9966-SLL-905 siMa� y�egezge sZ1,10 80 8Z L Town of Barnstable MAM. Growth Management Department BARNSTABLE s639• �� Barnstable Historical Commission OMArA wvvw.town.barnstable.ma.us/historicalcommission Jo Anne Miller Buntich,Director Marylou Fair,Administrative Assistant COMMISSION MEMBERS: Laurie Young,Interim Chair ; ., r-- �- George Jessop,AIA ;{ Marilyn Fifield,Clerk Nancy Clark Nancy Shoemaker Len Gobeil rt, ; �� -. Ted Wurzburg __; _ : P'; Paul Arnold,Alternate September 30,2014 Re: Intent to Demolish Portion of Single Family Home 21 Wachusett Avenue, Hyannis, MA Map 287, Parcel 139 - Richard Fenuccio Brown 'Llnd uist Fenuccio& Raber Architects, q c tects, Inc. 203 Willow Street/Suite A Yarmouth Port, MA 02675 Ann Quirk,Town Clerk •� � _ $ 367 Main Street, Hyannis, MA 02601 Thomas Perry, Building Commissioner 200 Main Street, Hyannis MA 02601 Pursuant to the attached decision, please be advised that the Barnstable Historical Commission will hold a public hearing on this matter on October 21,2014 at 4:00pm,367 Main Street, Hyannis,2nd Floor, Selectmen's Conference Room. This public hearing will be advertised,notices sent to abutters and a notice form will be posted on the building or other visible site on the property-The applicant is responsible for advertising and mailing costs associated with the pubic hearing. Please contact Marylou Fair at 508.362.4787 or Marylou.fair@town.barnstable.ma.us for processing information. Sincerely, Laurie K.Young , J Laurie K.Young,Chair p 200 Main Street,Hyannis,MA 02601 (o)508-862-4786(f)508-862-4784 367 Main Street,Hyannis,MA 02601 (o)508-862-4678(f)508-862-4782 i Town of Barnstable BARNS'TABLE MAS�AS^S.B Growth Management Department 1659. s`� Barnstable Historical Commission FO IV1Ar www.town.bamstable.ma.us/historicalcommission Jo Anne Miller Buntich, Director COMMISSION MEMBERS: Marylou Fair,Administrative Assistant Laurie Young,Acting ChairNice Chair George Jessop,AIA Marilyn Fifield,Clerk Nancy Clark Nancy Shoemaker Len Gobeil Ted Wurzburg Paul Arnold,Alternate —r.. 10.1 , Ja,r Chapter 112 Historic Properties, Section 112-3 D. DETERMINATION of SIGNIFICANT BUILDING t 21 Wachusett Avenue, Hyannis Map 287/Parcel 139 Pursuant to Intent to Demolish Portion of Existing Single Family Home The Barnstable Historical Commission received a Notice of Intent to Demolish application for this address stamped by the Town Clerk on September 26, 2014. This structure, located at 21 Wachusett Avenue, Hyannis, MA is a contributing building in the Hyannisport National Register Historic District and is architecturally significant in terms of period and style of the neighborhood. In accordance with Chapters 112-2 and 112-3(D), Barnstable Historical Commission Chair has determined that this structure is a significant building. 200 Main Street,Hyannis,MA 02601 (o)508-862-4786(f)508-862-4784 367 Main Street,Hyannis,MA 02601 (o)508-862-4678(f)508-862-4782 Town of Barnstable pQ L y , Ga431( th Manageme,"A Departreerif_ 70111 .Tit 26 M, � kf;�Gri;� ;IDI C Te00�:.i SacrostahBe Historical Commission NOTOCE OF UN`I ENT TO DEE-MOLISH A SIB"KOFOCAH7 p lea W`�law .a06r�l�' Date of Application 9/2 5/2 01 4 Full Demotion 16artial Demolition Building Address: 21 Wachusett Ave: Number street Hyannisport 02601 .. Assessor's.Map# 287 Assessor's Parcel# 139 Village ZIP Property Owner. Farley & Elizabeth Lewis .508-280-5921 Name Phone# Property Owner Mailing Address.(if different than building address) Property Owner e-mail address: lizlewis@comcast.net / .farlewis@comcast.net Contractor[Agent: Brown Lindquist Fenuccio & Raber Architects, Inc. Contractor/Agent Mailing Address: 203 Willow St. Suite A Yarmouthport, MA 02675 Contractor/Agent Contact Name and Phone#: Richard P. FenuQcio _508-362-8382 Name Phone:g Contractor/Agent Contact e-mail address: rick@capearchitects.corn Detail of.Demolition Proposed: Demolition & reconstruction of the 2 story 1961 addition Existing 1930's windmill to remain as is. Type of New Construction Proposed: . TWO story wood frame construction in same footprint as existing (on north side) along with a new garage on the west side & small 2 story addtion on the south side. Provide information below to assist the Commission in making the required determination regarding the status of the Building in accordance with Article.1, § 112 Year built: 1930 Additions Year Built: 1961 , 1989, 1997 1s the Buildi `g listed on the National Register of Historic Places or is the building located in a National Register District? No Yes lzwf A� t - Property Owner/Agen Signature May,2014 PF �,> Town of Barnstable *Permit too f�6s • Regulatory Services Expires nthsj)omissuedate MAW 039. Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY jSq2 Not Valid without Red X-Press Imprint Map/parcel Number 'w V I �J Property Address a V 1 a - ,!4 4&4 Ave H y Ca n n l�5 e j r T to d e (0 f + 0 residential Value of Work$ �, � Minimum fee of$35.00 for work under$6000.00 . Owner's Name&Address 4W Q L e yu i 5 M 9- Contractor's Name l Telephone Number 0S !77-9-- Home Improvement Contractor License#(if applicable) 11 d q 77 Email: Construction Supervisor's License#(if applicable) 3 3 r. ❑Workman's Compensation Insurance X-PRESS PERMIT Check one: ❑ I am a sole proprietor �I am the Homeowner 'JUL 2.9 2013 I have Worker's Compensation Insurance Insurance Company Name Lb0WItno �i/t�( � TOWN OF BARNSIABLE Workman's Comp.Policy#kfCM s0007 3301 A j A 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 ❑ e-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#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 the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: 1 QAWPFILESTORMS\building permit forms RESS.doc. Revised 061313 the Commammakr of Massachusetts Arent of In&EsV iid Acme office Girin estigadons 600 Washington Street B03torr,MA 02111 wwmmamgov1dia Worlmrs'Ctsmpensation Insurance Affidavit BmiderslCoia slPlnmber-s AppliraIIt Iuferma#ion Please Print Lzibiv Name 1 ` (),a lylplt) d Perm Dot Address: J O S Hv►-s e skv JP city/stg& : v II f A j2A 4-- S�� —7I -3`70J Are u'an employer?Check the appropriate box: Type of;project(required): L. I am a employer with + 4. ❑ 1 am.a general contractor and.I - 1 full an&or * have hired the 6. ❑ ew�. employees( ' pattrtime). 2.❑ I am a sole proprietor or partner listed on the attached sheet. T Remodeling ship and have no employees. These sub-contractors have 8. ❑Demolition working for me in any capacity. employes and have workers' (No workers' comp.insurance comp.msuranoe.X 9- ❑Building addition required-] 5. El We are a corporation and its ME]Electrical repairs or additions offidmrs have exercised dwir.3_❑ I ama homeowner tl!daing all work 11.❑Plumbingrepairs or sdditiom myself [No workers'camp. right ofwon per MGL 12.❑Roof repairs insurance d.]T c. 152, §1(4),and we have no employees.[No workers' 13.❑Others d de w w 11 comp.insurance required.] 'piny apphcant that checks hook#1 nmst a1w fill out the section below Showing then Votes'camopensation policy ink matim 11ameawn�ets who subamt this affidnir m&cating they are doing all work and then hoe oatsi&contemn— subunit a new affidavit indicating such_ �Contractor:that check this ben must attached as additional sheet showing the nacre of the snb-c�and state whether or not those entities have employees. If the stab-cant<actots]we employees,they must provide their workers'comp•policy number. I arc an employer that is providitrg worken'.conwerusation insurance for tray enrpiuyVe& Below is the policy Brad job site informatiom Insurance Company Name: (NaOn,1 Policy 4 or Self ins_Lic_-AA f lilt/ S00 b /31 0 r o-V►dX Expiration Date: )A 1?✓ Job Site Address: NN )S r City/State zip: Attach a copy of the workers'compensation policy ration page(showing the policy number ank expiration date). � Failure to secure coverage as required.under Section 25A of MGL c 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,.as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250-00 a day against the violator. Be advised that`s copy of this statement may be forwarded to the Office,of Investigations of the DIA for insurance coverage verification. I do hemby ramify under the p ns W penalties ofprdury that the information provided above is bw and correct St Date: Phone# Official use only. Do not write in this area,to be completed by city or Mum a ffi at City or?own: Perumt/Licentse 4 Issuing Authority(circle one): L Board of Health 2.Budding Department 3.Citylrown Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone�• „ 6 OFVE .. Town of Barnstable Regulatory'Services MASS �, Thomas F.Geiler,Director Building'Division Tom Perry,Building Commissioner - '200 Main Street,'Hyannis,MA 02601 �. www.town.barnstable.ma as Office: .508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I �'P�2cxy �.Cixl"l s as Owner of the subject property hereby authorize ►�i/l to act on mp behalf, in all matters relative to work authorized by this building pexmit 0A WkWvsE-1 AVE,- }-IYAt Q s A , Mk 02.E4�+ (Address of 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' tune_aLbwner Signature of A cant fly of Print Name Print Name Date QFORMS:OWNERPERMISSIONPOOLS 62012 Town of Barnstable Regulatory Services Thomas F.Geiler,Director 6 16 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building-permit.it. (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 pr du c�eres and requirements and that he/she will comply with said procedures and requirements. JAII I Al in Si ) of Ho o er / 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 lacy of aw, ness often results in serious problems,particularly when the homeowner hires unlicensed"persons.. In this case;our Boacannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. ` To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decoUDc\AppData\Local\Microsoft\Rrindows\Temporary Internet Files\ContentOutlook\QRE6ZUBNO,TRFSS.doc Revised 053012 u t o. ruaii,.vas �y 'Board,of Building Regulations and Standards Construction SuperN isor 1 & 2 FamiIN License: CSFA-048338 ` NIICHAEL J DSA&GELO 105 HORSESiOE,LA - y CENTERVII LE]VIA ;02632 -r r Expiration Commissioner 01/22/20.14 ��e �poawnzaazcoea�a��/�,caaoa�uaeC�; ..,:-. . ...._.. _...__ . ------- .. ..-- - VOffice of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the.expiration date. If found return to: egistration: 112977 Type: Office of Consumer Affairs and Business Regulation 'Expiration:`.5/7Individual 10 Park Plaza-Suite 5170 7y .", MICHAEL J DANGEL O = Boston,MA 02116,, - - MICHAEL DANGELO E I 105 HORSESHOE LN CENTERVILLE, MA 026321 ` Undersecretary Not valid w' out signature 9 n t Client#: 3860 2DANGELOMI DATE(MMlDD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 12/27/2012 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). CONTACT 'RODUCER NAME: fowling &O'Neil PHONE 508 775-1620 FAX No), 5087781218 A/C N0 ., nsurance Agency EMAIL t ADDRESS: -__ —�---� 373 lyannough Rd., PO Box 1990 INSURER(S)AFFORDING COVERAGE i NAIC» -lyannis, MA 02601 — _ INSURER A:Associated Employers InsuranceM�� URER'dN SUREDT L - . — Michael J. Dangelo Building IINNSURERC: _— &Remodeling,Inc. I IIaSURER D --105 Horseshoe Lane I INSU� RER E Centerville, MA 02632 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: HE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO T 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. NSR ADDL SUB — POLICY EFF POLICY EXP _ LIMITS — TR TYPE OF INSURANCE INSR WV POLICY NUMBER MMIDD/YY� MMIDD/YYYY GENERAL LIABILITY EACH OCCURRENCE — $ -- DAMAI FETO RENTED PREMI S Ea occurrence _ _� COMMERCIAL GENERAL LIABILITY I MED EXP(Any one person)_ $ CLAIMS MADE OCCUR I PERSONAL&ADV INJURY $ _ --� �GENERALAGGREGATE — $ PRODUCTS-COMP/OP AGG $ — GEN'L AGGREGATE LIMIT APPLIES PER: $ PRO- LOC _POLICY JECT COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $_------�----- I BODILY INJURY(Per person) $_—_ ANY AUTO BODILY INJURY(Per accident) $ I ALL OWNED SCHEDULED I I AUTOS AUTOS PROPERTY DAMAGE $ —'— NON-OWNED Per accident --- 1 HIRED AUTOS AUTOS $ --- --j---"---'-- _ EACH OCCURRENCE $ — —_ I I UMBRELLA LIAR OCCUR AGGREGATE $ EXCESS LIAB _ CLAIMS-MADE -----$----- I DED RETENTION$� — .—_--- WC STATU- OTH- �— A WORKERS COMPENSATION WCC5006733012012 12/19/2012I1 211 912 0 1 X RYLIMI,TsT ->� _-- AND EMPLOYERS'LIABILITY Y� •E.L.EACH ACCIDENT $100__ ,000_-- 1 ANY PROPRIETOR/PARTNER/EXECUTIVE�Y YIN I OFFICER/MEMBER EXCLUDED? U NIA A E.L.DISEASE_EA EMPLOYEE $100 000 ;Mandatory in NH) If yes,describe under — E.L.DISEASE-POLICY LIMIT L$500,000 — DESCRIPTION OF OPERATIONS below -- --- -"— DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space is required) Michael Dangelo 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 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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 LS1 #S104759/M104758 Town of Barnstable *Permit# (4e; Expires 6 mondis from issue date Regulatory Services Fee l Loci Mwvsrnet.e, : Thomas K Geiler,Director IL t659. ,�g Building Division Tom 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 I� <� Property AddressV- �1t U.S'�' �e • �/C�•/I n s 6�` ti Residential Value of Work �� , �f� Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address GL -y U_)j$ Contractor's Name_ o C6'Q d`tCt hA-C— 440 �r's Z17C Telephone Number Home Improvement Contractor License#(if applicable) _ D/Workman's Compensation Insurance X-PRESS IT Check one: ❑ I am a sole proprietor FEB 8 2008 El Ham the Homeowner I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name e946,41 t L �JJLCI✓ //SLL/"Lt 12e � �?� /�[/ Workman's Comp.Policy Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old,shingles) All construction debris will be taken to. ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re- ide � S Replacement Windows/doors/sliders.U-Value � maximum *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 Home Improvement Contractors License is required. SIGNATURE: CUIU2 7�'PC'bs'l� rit 1 al.e Q:Forms:buildingpennits/express Revised 123107 Town of Barnstable BARIMAS 039. Regulatory Services zas� ,0 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 as Owner of the subject property hereby authorize 3 r Ulm i�l�l U`eX-� ULto act on my behalf, ,Sle6— 1R1-%-1Cs0 in all matters relative to work authorized by this building permit application for: Ct (Address of Job) U, Idll Sign of O er Date Print Name Q:Fortwbuildingpermits/express Revised 123107 f I. ,� Board of Building Regulations and Standards lls Construction Supervisor License License: CS 83280 Expiration: 11/29/2010 Tr# 5313 Restriction: 00 SEAM J ROYCROFT 65 EBEN SMITH RD CENTERVILLE.MA 02632 Commissioner f ✓1re U�omrn4�uueal�f• a �/j�aua�uaella Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR F-E = Registration: 141225 Expiration: 1/22/2010 Tr# 262207 Type: Private Corporation ROYCROFT&KUEHNE BUILDERS, INC. Sean Roycroft 65 Eben Smith Road , -` Centerville,MA 02632 Administrator GRANITE STATE INSURANCE COMPANY 71337-0000 WC 447-03-14 13102 - ---- o� -- 3-66-0807-00 PENNSYLVAN I A ROYCROFT M KUEHNE BUILDERS INC.65 EBEN SMITH ROAD Member Companies of CENTERVI LLE, MA 02632-0000 American International Group EXECUTIVE OFFICES: 70 PINE STREET, NEW VORK, N.Y. 10270 SEE NAME AND ADDRESS SCHEDULE - WC990610 I.D# MA UI '•a. ..- mr SOUTHEASTERN INSURANCE AGENCY WORKERS COMPENSATION AND EMPLOYERS 641 MAIN ST LIABILITY POLICY INFORMATION PAGE HYANN I S, MA 026o 1-5403 INSURED IS PREVIOUS POLICY NUMBER CORPORATION RENEWAL 004392269 OTHER WORKPLACES NOT SHOWN ABOVE:SEE NAME AND ADDRESS SCHEDULE - wc9go6lo ITEM 2 POLICY PERIOD 12:01 A.M.standard time at the insured's mailing address FROM o8/06/07 TO 08/06/08 REM 3 A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to the work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 100,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: SEE ENDORSEMENT - WC200306A REM 4 The premium for this policy will be determined by our Manuals of Rules, Classifications. Rates and Rating Plans. All information required below is subject to verification and change by audit. Estimated Total Rate Per Estimated Classifications Code Number ❑Remuneration Premium munerat on X Annual 3 Year X Annual 11 3 Year SEE EXTENSION OF INFORMATION PAGE - WC7754 TAXES/ASSESSMENTS/SURCHARGES $124 EXPENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) $284 MA MINIMUM PREMIUM $500 MA TOTAL ESTIMATED PREMIUM $2,550 If indicated below,interim adjustments of premium shall be made: ElSemi-Annually 11 Quarterly Monthly DEPOSIT PREMIUM ENDORSEMENTS(FORM NUMBER) SEE ATTACHED FORM SCHEDULE - WC990612 08/30/07 ASSIGNED RISK 66 Issue Date Issuing Office Authorized Represent hre INC 00 00 01 39967 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 .� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / Please Print Legibly Name(Business/Organization/Individual): (�U��!'L f�. �G� �`� S Address: 4:�5 A�h" 5m 4k 17©ad ei.&�rd'V/14fl 2 6 3 City/State/Zip: Phone.#:— �3 6 — 6 d2 Are you an employer?Check the appropriate bog: Type of project(required): 2 I 1. am a employer with 3 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.El I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. employees and have workers' Y P tY• � 9. ❑Building addition [No workers'comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its- 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. - t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. ' ,�tl Insurance Company Name: ��'L -E� V— Policy#or Self-ins.Li/c.#: ,, q �/� Expiration Date: Job Site Address: gw �OAL' S`e //`11�`�� City/State/Zip: M OJ_ Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine ' of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance covers a verification. I do hereby c fy un er a in and penalties of perjury that the information provided above is true Caand correct Si ature• Date: d�v Phone#: 17q "t 3 6' 6 — 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#: 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 representative's of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a'business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited LiabilityCo anies LLC or Limited Liability Partnerships LLP with no employees other than the � ( ) h' P ( ) members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a,s ace 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: ti The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 11-22-06 Fax#617-727-7749 www.masss.gov/dia C-A 3 oFT Town of Barnstable *Permit# S 6 X_ / Expires 6 months from issue date Regulatory Services Fee • Thomas F.Geiler,Director ��ED MP't a Building Division Tom Perry, Building Commissioner PERMIT 200 Main Street, Hyannis,MA 02601 S Office: 508-862-4038 Fax: 508-790-6230 AuG 17 2094 EXPRESS PEPMT APPLICATION - RESIDENTIAL ONLY STABLE Q"� Not Valid without Red X--Press Imprint F BAR N dap/parcel Number C-y O ` I 'roperty Address a &G10 S-e—+t- nL.< ''.Residential Value of Work OZ90 Minimum fee of$25.00 for work under$6000.00 )wner's Name&Address v9 L S►�-tntiJ2 :ontractor's Name �c,�n ��t.c �-. Telephone Number_ �'2 a S ,D Tome Improvement Contractor License#(if applicable) / ,S construction Supervisor's License#(if applicable) MWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ElI am the Homeowner ❑ I have Worker's Compensation Insurance n nsurance Company Name f r� ' Workman's Comp.Policy# 79 Y X b 5 l :opy of Insurance Compliance Certificate must be on file. 'ermit Request(check box) TM Re-roof(stripping old shingles) All construction debris will be taken tom ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. ome rovement Contracto s License is required >ignature 2Torms:expmtrg Fraser Construction Roofing & Siding Specialists Payable immediately upon completion NO MONEY DOWN- NO Payment at the start or part way thru Payments accepted are: CASH - CHECK- MASTERCARD -VISA-AMERICAN EXPRESS * f completion will be charged 1 '/z%for every 30 days Any payments not made within 30 days o p g �Y the payment is late. Possible Extra.-After the shingles are removed from the roof, we will life one sheet of plywood to make sure that the insulation be not up against the plywood sheathing so that ventilation cannot occur from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$4.00 per panel including Materials & Labor. There are 6 Panels per sheet of plywood. Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$40.00 per hour, plus materials, plus 20%overhead mark-up on total extras. FRASER CONSTRUCTION Warranties the shingles and labor for 10 years. FRASER CONSTRUCTION Warranties the shingles against Blow-Offs,for 10 years. ' A CERTAINTEED Warranties the shingles and labor 100%for the first 5 years, and then on a pro rated basis for 30 years total if the shingles become defective. CERTAINTEED Warranties the shingles to be ALGAE resistant for a full 10 years. , Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tomado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION: Carries Workman's Compensation and Public Liability Insurance on the above work. DATE OF ACCEPTANCR: SUBMITTED BY: lQ,G1/l� truction q.00wner Fraser Cons t Board of B � wilding Regulations HOME IIWPROVEMENT and Standards Registr,43 \ CONTRACTOR Licen,, } °q 1=12536 befort P" I 005 Board ERASER C A rY.Rea DB;q One DEAN p ONSTgtIQ'V`co _; Bostot, BASER 71 TARRAGON CIR` .. COTUIT,MA 02635. `administrator Assessor's office (1st floor): �THET Assessor's map,and lot number ......:� .7:..... Mme Syr"MVO IRE Board of Health (3rd floor): G 71�t? 4 ��''""" ° ED IN COMPUL , 'E fO Sewage Permit number ....:... ^. .0�., a .?.............. 47H TITLE 2 MARBSTODLE, MMa. y Engirieering, Department (3rd floor): ;, C01 'oo +639• 0� House number . .. .................... 7�ji�VN RE6ULATI06 `'ao"pY°'� Definitive Plan Approved by Planning Board __ _____________________ 9 APPLICATIONS ,PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only, TOWN ,OF BLLARNSTABLE L BUIDING -INSPECTOR APPLICATION FOR PERMIT TO .... R E 1 ��I(�l 2..... ......................................... ... TYPE OF CONSTRUCTION .' WOOD.... ........... Sq l U1�t �11.1.a-................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... .. .......::&C..H... ......A.V..t .;......".(.6-. p�1�-` f ..1."Il...'........................ Proposed' Use . fit . � �—..............&1-7;�-.!Ilk-111.!. .....�........02M?Oom .................................. ... i� - Zoning District ........................................................................Fire District N(` �s Name of Owner M :.. .�..1d?. 1- :.L ......:.............Address Name of Builder vO� M ®1V Cry.....................Address .: .....1.�...OI .F-. Tl�..!..�. -Name of Architect .:...... /�..... wo.. . ...,........Address .... ......... Number of Rooms ..............�) ................................... ......Foundation N L . Exterior ...............wOO.p.... ..................................................Roofing ......... :. ................. .... ..... Floors ...................W- D.....................................:.............Interior ....ll—!..........l,N..!"1LL........................................... 6-4� Heating ........................A..,,..pp......................................................Plumbing .........................................................::....................... p 4vv .. .....Approximate Cost .. .�.... .OD.�........................Fire lace ...................... ... ................................................. Areay ................ Diagram of Lot and Building with Dimensions Fee Js. . OD OCCUPANCY PERMITS REOUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. A... ... . L. Construction Supe visor's License ..D3`�....q.� LEWIS, M. B. MRS . Build Addition No :'.1.25.3.6. ..Permit for .................................... Single Family Dwelling .......................................................... Location -�" 21 Wachusetts. Avenue....•• ' Hy.anxispat.............................. Owner ....M'..... ...... .�Y� i.S..............`.................. -^ -, ^� T Constr '; >- _ • _ �_... , � '�' t ' f . Type of. uc ti on ......F.r.ame....................... 4, Ploi! � ......... .. . , Lot' ....... .. ......... j -r •� �'� t � December 0• �'. 88 Permit Granted ......19 Date of inspection ................. Date 'Completed .. . r / 1 q 7 4 f^ • '± fA Z IN CIF► � C _ _. ♦ .._._.. __ 5iF _ _ _. Assessor's office •Ost floor): • CF THE TO Assessor's map and lot number ............ .............Zv.`✓.........C..�._, Board of Health Ord floor): 'Sewage Permit number ....:... �Sf.'.7�!. ..� ............. 1 >i BAHd9'fADLL, i Engineering Department (3rd floor): '�o N IL �+ Housenumber ........................................................................ OYaYa�e Definitive Plan Approved by Planning Board --------------------------------19-------- . APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN 'OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO rPkQ L y.............�....� �!N.�........................................... 1. TYPE OF CONSTRUCTION �,IUt�t�� .. .........K �SJ��I k! ..�.. .Er.........---19. TO THE INSPECTOR OF BUILDINGS: / The undersigned hereby applies jf1or a permit according to the following information: j�-�� Location ...... . .........v`r.#.r-H...U.S.;TT......./,'-'.�VE#......H��N IU E 5... !..�!` !....r.....'••••!.�.................... .... Proposed Use 4 .� .�— ................!r � /� ....................... R........... ....l.1. ................................... Zoning District ............. .......................!...............................Fire District ................. f// ��, Nameof Owner 1.� /....................Address .................................................................................... Name of Builder .:✓. .H............M PN C .;,.....................Address J. ... —�.5 .�....Xu. l C!„t.+r... ................... Name of Architect .. . ./. .... �"�:�KWOO...........Address ...Vgl.,..f��4+�.�•�.....1�?�r.�.. t"�. .. ....... ................... ,Number of Rooms ..............1...........................I....................Foundation ...0 ............... -0 G��T� ..................................................... Exterior ................{/v0o. .............;..................................Roofing ........... � ......................................................... Floors ..................W®D.................................................Interior .....-D.:.1.......w ........................................ 1 Heating ..................................................................................Plumbing ................................................. ... ..................... Fireplace ......................^^...,,...�.. .................................... Approximate Iv Cost Area .... "r.. ........... Diagram of Lot and Building with Dimensions � , Fee Q � ......:......... C? � . . 1 � I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. NameX Construction Supervisors License ... ..........t II LEWIS, M. B. MRS . —287-139 Addition BuVd Addition No ... Permit for .........i............... ........ .aincrle Family..P��q;L�.ing......... ..... ............................ ..... Location ... . ..........Avenue ........... .......................... ........................ Owner ....... L eXi s.............................. ..... .. . .. Type of Construction .......FrAMP...................... e�l .................... ..... ....... Plot ..............j....... Lot ................................ Permit Granted .......D.e.q.e.mb.e.r...3.0.,..Ig 88 Date of Inspection ....................................19 Date Completed ......................................19 A N I 00 eq RICHARD P. FENUCCIO A.I.A. j N 1 1 � t•1 O i 1 FENUCCIO & PEEL A.I.A. ARCHITECTS 0 923 MAIN STREET, YARMOUTHPORT, MA 02675 r ' FENUCCIO & PEEL A. I. A. ARCHITECTS 923 MAIN STREET, RTE. 6A YARMOUTHPORT, MASSACHUSETTS 0 5 Tel: (508) 36.2-8382 Fax: (508) 36 -2�/ 14 November 1996 Mr. Ralph Crossen,Building Commissioner Town of Barnstable 367 Main Street Hyannis, MA. 023601 RE: Proposed Addition to the Lewis Residence 21 Wachusett Street, W. Hyannisport Dear Mr. Crossen: This letter is intended only as confirmation of my conversation today with Louise from your department. We are designing a small kitchen addition to the subject property and wanted to confirm that.no special variance from the Board of Appeals would be required even though the existing house is within 10' of the North and East property lines. Our addition(see attached sketch)is proposed towards the West side and will be in compliance with all side and rear yard zoning setback requirements. We are also working.under the assumption that a new site survey plan will not be required and information contained on the attached plan by Yankee Survey Consultants will be adequate for design and permitting purposes. Please contact our office as soon as possible if any of the above assumptions are incorrect. Thank you for your assistance. Sincerely, Fenuccio&Peel A.I.A. Architects Richard P. Fenuccio enc.: 10/15/88 Site Plan cc: Farley&Elizabeth Lewis RPF/mm The Connitflttft•calth of:4tascachusctts ! - 1•=w Department of Industrial Accidents _ tJiOffice oflttyestlgatlotrs rx �i\ ' =r•==+ 6110 !I?ashlar tutr Street Boston. Afars. 02111 `-• Workers' Compensation Insurance Affidavit at�jlic•tnt information'•• Please PRINTlediil owner Lewis , Elizabeth & Farley 0 locition• 21 Wachusett Avenue Cin• Hyannisport, MA nhnnc# 508-775-9168 I am a homeowner performing all work myself. [•I I am a sole proprietor and have no one working= in any capacity • �-!.. .Mwy. �.•w..»..«w�.+'.1N�..�.�[T.w.wr+l�"/�•^_ _ ��...�w��.�•.�.�-....�.w-..•.w.`�..wr"r`� j I am an emplover providing workers' compensation for my employees working on this job. anuminv, name, OHC, Inc dba The HouSp rnm==ny •addrr«. 60 Benjamin Franklin Way, Hyannis MA 02601 ( location) city•P 0 Box 1166, Barnstable, MA 02630 (ma; 11 nhnnc#• 509-771-0303 • in�ur�ncccn TIG Premier Insurance Co nolievif WCN80418309 I am a sole proprietor, general contractor• or homeowner circle one) and have hired the contractors listed below who � the following workers compensation polices: comn•rny n•arnc• •acicirrsc• cin nhnnc 0- .n , .i incnr•ancr cn Holley cmmnnn.• n•amr• •tddresc- rity nhnnc#• insurance ro neiicv d •Attachaddid'nalshcetifneeessa7.+.:.r' •:��y.�:�•;_.�..�. .-•..,r: -►w.• ,..,..vs .:.�.-: a.•.•..«.�.... Fsriiurc to secure coveraee as required under Section 25A of 111GL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.UU andiL unc+cars'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a dar against me. 1 understand that COPY of Misstatement may be fo varded to the Oflice of Investigations of the DIA for coverage verification. 1 r10 herebt•cr ift•under the ins and penalties of perjury Ilia'the information prorvded above is true and correct. Sianaturr Date 3/2 7/9 7 Printnamc Phone* 508-771-0303 '•ofrrc� ia�se unly du not write in this area to be compacted by city or town oifcial Y+ city or town• permit/lleense# r1guilding Department ( auccesing hoard L t Encicetmens Officr Check if imrnrdiatc response is required ► __ _ r'tllcalllt Department �` Information and Instructions Massachusetts General Laws chapter 152 section 15 requires all employers to provide workers' ct►inpensation employees. As quoted from the "law". an enrploree is defined as every person in the service of another under contract of hire, express or implied. oral or written. An rnrpinrer is defined as an individual. partnership, association. corporation or other legal entity, or any two the forcgoin , engaged in a joint enterprise,and including the legal representatives of a deceased employer.-or receiver or tnistee of an individual , partnership. association or other legal entity, employing employees. Nowt owner of a dwelling house having not more than three apartments and who resides therein. or the occupant of t. dwclling house of another who employs persons to do maintenance, construction or repair work on such dwell or on the ;,;rounds or building appurtenant thereto shall not because of such employment be deemed to be an en MGL chatter 152 section =5 also states that every state or local licensing agency shall witltltold the issuance rencival of a license or permit to operate a business or to construct buildings in the commonwealth for ar applicant who has not produced acceptable evidence of compliance with the insurance coverage required Addi,ionally, 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 ch. been presented to tlhe contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situatioi supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. 71 affidavit should be returned to tile city or town that tlhe 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 re to obtain a workers' compensation policy. please call the Department at the number listed below. Cin- or ro��ns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at tine boi tlhe affidavit for you to fill out in the event the Office of Investigations has to contact you regarding tine applicant be sure to fill in the permittlicense number which will be used as a reference number. The affidavits may be rety the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any qc. please do not hesitate to ;,give us a call. ` Tlhe Department-'s address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of 1nvesdgations 600 Washington Street Boston. Ma. 02111 ti °FTME 14 . � The Town of Barnstable 9� 16.19. 10�' Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date 3/27/97 AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. TypeofWork: addition for kitchen Est.Cost $60,000 Address of Work: 21 Wachusett Avenue, Hyanni sport, MA Owner's Name Elizabeth & Farley Lewis Date of Permit Application: 3/2 7/9 7 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF RJURY I hereby apply for a pe ZG g t ner: 3/27/97 J f ldstein 100932 Date Contractor Name Registration No. OR Date Owner's Name Proposed Addition to the Lewis Residence 21 Wachusett Avenue » , �EPEO Ali • Y P M p W H a11111S O MAQp,UL Architects: I Fenudcio&Peel AIA Architects tx No.7789 Pt 923 Main Street Yarmouthport,M,A �0 NA ME POR' �Fq �ayPy. YI eTHOF�A • 1 e erm..tw walw.+r — 'SM PLAN 1".=20'-0" . . Note:Info madon an this plan was takes from a pL"prcpeRd by _ _ Yankee Survey CmmhaaM Mmstws Mills,dined IN IS/88 N�WJ.oI9' IMO 467/179 Ph _o ' YrY�10. `r•Io(w OURN.1.� ' + e•tr l0• w ' W°o< 1 ilia•r,IY OL. Nh•b,'✓Z.i Y d v. 1 r Id wa IMh i •.,o. o. ---aww+sw IPwt1R wr d• p�,p• FOUNDA•IION PLAN IW V-0" ' rA 1', le�•O•� V•LR - ... s _ --� M_�MLM�LO�W�.K 1.OYrYY.I.IN eos YLi.6 I �'•Mlo'W-1'nw r1�T.�mH�. r t0 eTf ".eUML.N exrer. GNINIL M. nev ' Pt..Y.s+KML 1• Yr.rI.p. ILL NLLVM .Toall I. OW. � YJTLHIN ❑ � AI 11•�.p• Yl h.1►v�•Yucr. • D � r � I ri=11Wti+1'i - 11AM � nl • •0 II 1I I � � tx wt.pLcrlal N �'aNINa wfn �i� 1 - �p � �L7`e'n*ny.Jl•• ' Ip.wrL. - -I I1❑Is'L.•• , 6 0 t" �o•H..c,+c. Ht a.w nsr..L�.c 1 � II Q Q Q I CROSS SECTION A-A •1/2 = 1'-0" n I:TIi ciVi r-711L o-are..v Lv`ie-n t2 FLOOR PLAN 1/4" = 1'-0" wre.w� µ., e.6; W-o ✓•J t..dlvw. Nil !'•d N'-e Trp• nx R� Eor,w ra✓.L.no - xaT rncnJcrl..l Gw.4r'4,LneN -- - I.s�swrll�eG�H,w,LtM. ,x w,.LL ♦s+ ax to rsrc C I✓a. 17'•(f WINDOW SCHEDULE _ea_o.e ii .. - .. Tq•ar L'Lrn ' 4H•L. MWL.V/•LTUHLwi Wlr Pa+rN G1lNWM RIP•ViMrj ... - A M.xee'++eN [M•Mr Wtrr +'•I'x e'•oye oxL1oN {eLxVfe t>KK.RIr.NNLbJ 2-Il/F•yVL'I.w !-IYM Y/a w.r•O•S T v I6rM . {el."VfII EwM Mqa Nr,H.Jr.,oN rl/N Mi�Mle I/i•orxLy�,LL�LrL/. . E p.evrleN wwHLwr crrt I'•BYs r a'•oj's' nyr wlr rwruh.a i I4rcrleN -191"14A aYP — J V • flLr ow.M1. F M+r. Ule+r, U» 1'•oyE.y►yL.• nrlr H'ML�wlr.I w:1 Lw fyYffw rLxNa. eQ Le" (A {.Ny. /nL•LT. U'9 'l�•O�!rt i•eY0 "Fly ro IJory: a.1. NWwf.y TV M W'.t cLa,s• N'M Hhte IC[V bt'.LM ILJ I!1 z.[xw ewc.+.'+.� n.L n.. ' tno•6 It•ot•. 1)( 2no•a Ir rw •. CROSS SECTION B-B IR" 1' Q ' (E ki7._.L*ynrP /iaveeoarx,nvJ vPROPOSED ADDITIONTOTNF.LEWIS RF,SIDENCE 21WACHUSFTTAVENUE, W.HYANNISPORT,.MA. FFNU('.CIO k PF.F.I.AIA ARCHITECTS l 4x¢ per ry +x uYaw-m T' ya-io �No rr r.�er CAP rI6 FiQ a r,h r4/ I I/Zx 1��2 ha- a�-�r• ty oP Z 5(�Rf �xjoK-0;lo S'�aeap�dLiiL.Tf CUTS - PxKr, ~irIDN "YotN✓ F �AF� pAPTop - IX8 5GFi1r r i O'wooe Eox 6AY eayoNd PAIL, 4511vas, I 1)(+ TwM -T(p• I WG ye-Iir1r.1.E5 � 6,aI0.T-O MoTU-1 Ex• . heo �H Ixb nWp GAP r s FRONT ELEVATION 1/4" = V — 0" NOTICE ~' NOTICE TO � `� , Y-= > TO EMPLOYEES - ~' EMPLOYEES The Commonwealth of Massachusetts DEPI RTME?NT OR IIN?DU,;TRLAT ACCIDENTS, 600 Washington Street, Boston, 1lassachus-etts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I (we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: TIG PREMIER INSURANCE COMPANY NAME OF LYSUFL� CE COMPA.YY ADMINISTRATIVE OFFICE IRVING, TX 75039 ADDRESS OF LYSTJTR.aYCE COMPANY WCN80418309 5/3/96-97 POLICY NUMBER EFFECTIVE DATES LINER INSURANCE AGENCY, INC. 535 BOYLSTON STREET BOSTON, MA 02116 (617)266-7600 NAh1E OF INSURANCE AGENT ADDRESS PHONE THE HOUSE COMPANY, INC. DBA O.H.C. , INC. PO BOX 1166 BARNSTABLE, MA 02630 EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE MEDICAL TREATMENT The abc-.a named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish -dequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the ser- vices -)rovided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER G7 a &I + HOME IMPROVEMENT CONTRACTORS REGISTRATION j Board of Building Regulations and Standards ) One Ashburton Place — Room 1301 Boston , Massachusetts 02108 HOME." IMPROVEMENT tCONTRACT;OR L Registration•-100932 Expiration 06/24/98 Type — PRIVATE CORPORATION T� o�✓lwctiu �i HOME IMPROVEMENT CONTRACTOR Registration 100932 OHC -NC .. DBA/ THE HOUSE COMPANY Type - PRIVATE CORPORATION Jeffrey Goldstein i Expiration 06/24/98 60 Ben Franklin Way Hyannis MA 02601 OHC INC. DBA/ THE HOUSE CO*- ! Jeffrey Goldstein t kO Ben Franklin Way ADMINISTRATOR Hyannis MA 02601 ! I Nile � 45 � "y .: DEPARTMENT OF PUBLIC S.AsET 564c ONE ASHBURTON PLACE , RR 1301 j BOSTON ,,;PtA. 02108-1.618 CONSTRUCTION SUPERVISOR LICENSE Numl�r: Expires: �- Restricted To: 00 JEFFREY GOLDSTEIN "� ' Detach bottciu, told sign, on PO BX 1166 zpa` p bG T:, and laminate license rd. BARNSTABLE , MA 02630 Krrep, top for receipt and cllanqe ., of cldress notification. Restricted To; 40 . RtgTMENT OF PUBLIC SAFETY 4 5 e 4 8 CORSPfl,ICw—SUPE_RVISOKICENSE 00 - None Eusber, Expires: 1G - 1 & 2 Family Homes Rest I.Pted To: •-00 Failure to possess a current ?da on of th? +n �t Massachusetts State Buiilding Code JEP?flBY GOLDSTEIN is cause for revocation of this license. QO BB 1166 } BARNSTABLE, MA .02630 Engineering Dept: (3rd floor) Map 2 Parcel l39 Permit# y 21 '7 �p House# 2 ate Issued 7 ' 3 '1:2 oard of ATeealth(3rd floor)-(8:15 -9:30/1:00-4:30). ��. r,-6Fee f?6 - dZ/ � Conservation Office.(4th floor)(8:30-9:30/1:00-2:00) Fl-annirfgDet (- srft m r c oo_�Ad_min�-AB g� SEPT*ATIONS UST BE .. INSTAPUANCE i Approa .: y -n 19 � a�:. ENVIR ODE AND TOWN OF BARNSTABLE TO Building Permit.Application Projec ddress 21 Wachusett Avenue, Hvannisport , MA Village Hvannisport Owner Elizabeth & Farley Lewis Address same Telephone 508-775-9168 Permit Request Wood frame addition for kitchen e3:pansion. 6 ,r First Floor 336 square feet Second Floor square feet Construction Type wood frame Estimated Proj ect Cost $ 6 0,0 0 0 Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ® Two Family ❑ Multi-Family(#units) Age of Existing Structure 10 0 y r s+ Historic House ❑Yes Zj No On Old King's Highway ❑Yes CjNo Basement Type: ❑Full 0 Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 3 New 0 Half: Existing 0 New No.of Bedrooms: Existing 3 New 0 Total Room Count(not including baths): Existing 6 New 1 First Floor Room Count 4 Heat Type and Fuel: ❑Gas )❑Oil ❑Electric ❑Other Central Air ❑Yes ®No Fireplaces:Existing 1 New 0 Existing wood/coal stove ❑Yes Xj No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) Xj None ❑Shed(size) " ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes Xj No If yes, site plan review# - Current Use Proposed Use Builder Information Name The House Company (Jeff Goldstein)Telephone Number 508-771-0303 Address 60 Ben Franklin Warr License# CS O42406 Hyannis, MA 02601 Home Improvement Contractor# 10 0 9 3 2 Worker's Compensation# WCN80418309 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Town of Bar table Landfill SIGNATURE _%�44DATE 3/2 7/9 7 BUILDING P R EN D FOR THE FOLLOWING REASON(S) ? �� p FOR OFFICIAL USE ONLY PERMIT NO. = I DATE ISSUED MAP/PARCEL NO. i ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION , FRAME 744-92 INSULATION 7-9-/2 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING% ROUGH FINAL GAS: f �..6UGk a- FINAL zz R FINAL BUILDINGZY DATE CLOSED RA. ASSOCIATION 'L NQ e�x E -- �. ADDITIONS :&ALTERATIONS TO THE LEV1/lS RESIpENCE 21 V1/ACHUSETT AVE . HYANNISPOT, IVIA 0 ,IMI, _ M1 _l Y .. P. \� r - " % - ' V , ATTENTION: Pv1ASSACHUSETTS LAW REQUIRES IN CARBON MONOXIDE DETECTORS IN . ALL RESIDENTIAL -=-� ..,. _.,_��_ _�i .._. ._ _. . I. _ . _... _. __...I. ♦ r/ f ram. ,a6€I — — m 1� R E:FIRE ALARM n .IT► �..> P E - - ^ OF ...;1 .._. x,*s', I ., I, �.. ,,.x-, .,, fl Si:-- 11' J�Px:L.� I;, - ; .I__..:_. CO DETECT ACCORDANCE ,<) .:.._:� , � ..: ro- ��, �� ORS IN � c._. IN viR 31.00 WILL - VERIFIED FRIOR TO SIGNING THE _ — - THC BUILDING PERMIT ARCHITECTS _ BROWN LINDQUIST FENUCCIO&. RABER ARCHITECTS, INC. r. - 20 � No. 7,�39 3 WILLOW STREET SUITE A,YARMOUTHPORT,MA 02675 O YARMOUTHPORT, J TEL. (508)362-8382 FAX.(508)362-2828 y�6 AAA �Gr WWW.CAPEARCHITECTS.COM gC.TH 0 F M FSS - CONSULTING STRUCTURAL ENGINEER < CONSULTING CI L EER CSE CONSULTING STRUCTURAL ENGINEERS, INC, - BAXTER NYE ENGINEERING & SURVEYING .; CARBpNMONOXIDEALARMS 53 KNOX TRAIL,SUITE 201 ACTON, MA 01,720 78 NORTH;STREET,.3RD FLOOR, HYANNIS,'MA 02601 USA QE k.Ey,�iTAII,ED PER TEL./FAX' 978)461 6100 TEL, (508)771- FAX(508)771 M. A, ( 7502 0 7622 �� . WWW.CSE-MA,COM WWW.BAXTER NYE.COM 1 to GE , o i NERAL CONTRACTOR GABLE BUILDING CORPORATION 1291 MAIN STREET,PO BOX 390,CHATHAM,MA 02633" TEL,c5os)945=4002 SMOKE DETECTORS REVIEWED o WWW.GABLEBUILDING.COMAl s BARNSTABLE B ILDING DEPT. DATE 5 p I 5 ": BUILDING PERMIT SET FIRE DEPARTMENT DATE . BOTH SIGNATURES ARE REQUIRED FOR PEIWITING m August 28, 2014 mo L ° " - flx I -- --- 4V71 E'/+ - - — 0 V En: Gc % 13'-10' , 22'-10 31-I 34•' CO o �ruRourH A OF - - � N NEW ADDITION NEW ADDITICN IXLSTI G , n. ♦ v. —— LRAVA.PALE 31— NEW MUOROGM '——— NEW GARAGE .. C .NEW CRAWL SPACE :' � � -——— _ w 4 r _ I P -- p YIALL FOR GARAGE W � U15nNG BULKNEAO CRA"I SFALE 52 - I I _ wNLRETE WPIl EX.FULL BASEMENT EX.CRAWL SPACE CRAWL SPACE EEC . ,. : •. I .. _: I: �. - SIAB ON GRAD 10 I - .. I CRAWL SPACE wNCREre WAu- ' a Y z o`d I' Ljj zg RAVA.SPACE ' wNCR£(E YIPll' I .. I -I' FASTING sTFEL NftV IJ DIAM,wNLRE2 O - 1 I flER WR NEW FN(RY RLOF - - C/). w.. - .. 0 \/ - - EX.CRAWL SPACE NEW LIVING ROAM . IEW .. O ADDITION -' � N MUOROOM.'. Q Lu w � P W (/) Lu .NEW GARAGE Q Z - C`' CLLJ .. - I..-. .. _ 5TEMWWMNON — - - - - 60 utED aonuG I .NEW CRAWL SPACE i F 0 _ mN Q .N V .. .. 3 RWW NON x _ RETE PIER, .. A3.1 rum TITLE: PROPOSED .• \ - _ N ' ._ d: i.. . II� ':eoutED P<enNG ca• - . .\ - I BASEMENT PLAN - �— ? — -— —— : .. .,Iawvre+D „?. '. .NEW FULL HEIGHT DATE ISSUED: IIASEME wNCRE(E 4IALL. .. _ _ .. REVISIONS August l �. � .. se,zoi a . w yTEELwWMN ON - m O UM Fa h wuc �I NEW CMWILSPACE NW NEGNT PROPOSED BASEMENT PLAN 1 I =_...`.. wxcREre _ �1'/^II 1 -011 } DRAWN BY:: :. Author DRAWL NPN TN05TORIES ADPTION ' Alto - q AN - PROPOSED AOgTION ' �.. � � - .. I'-B I/4'. IO-5 I12' � I'd I/a•. - ._. �. � � � _ _ _ � L J. . 7789 a OUTiiPOR c — .. I m wlmoPENsnELv�PrgvE ,. - RMCK rpsu: r i , ..... _ i z 4 1J E ——— b A3.1 2'-2 1/4' 4'O� 4'-II G OOMi - - Uf1UfY BWS 1 9! 104 -_.................... .BWINDG4� MPIIOGPNf b . m WIDIxG �� C. . I i I ! i eOJBBIb STOOP W R�" MOO V� EXISTING LAUNDRY ,I .. I .._... ................. E - - (144m as 53 ^ . P I .. wlnEPD UP � O IXISIING FAMILY .- i . u 3 I t� - m �UD ROOM i GE 0 107 EXISTING PANMY _ .3= Eg FAMILY ROO I - OU . � - � .. •'� - I I ADD 0 116 /,•' - I 18, 3'-2 I/2' 2'-2 I/4' � 4'-0' 4'-I I'J4 '-b I COxCf,ETE 5100 . i 'NEW MNNC-0NRT ____ _______ sT6 - - f11Ci FLOOR OF IX6nNGTnRESnOww - - - _ - e i YnxOMR1'i0 OF 0' -- ..i:i :. ONE P.r. . _ r-I v,a•-r MaoGux - . z r:"aliPRe we cou MN b : -F— . IXLSBNG 5f ' .. - 'i. •� z! PATIO :.. ' ENnDsuRE vn fvc ea=E cas _ I i DINING ROOM _ I t27 ROOF PROVE 122 LU I . . SKVPGE OCOS FOR � U � �ti L . P,B13E YME IOCATgN /i P O ` .. ' - - lu �ROOF ABDVELy _ F— ., __-- :-__-_-.-- _---_ gam:_. .3• - _� . Ciw�) Lv .. 20' � O LU co Imo/ o- VNG vFMING I _ m - . ET�nNG oar gPCR wai ro aE¢e-eula : - . - scrumis Aeove - - .Z ` f amF eICGE uNE . .'_-. -. . � � .. I� - .. ::: ! � .... I • .-. -vnm NwrEcuu tuvPc-Eo awNG X Q. 2 olBdounoN . IBTCWNERBUB)N.I.c. C\ ..- I I LNING ROOM a Ii - - - - --- - a - - up I ===fp , -2'- I O'10' 2' n TITLE: N, Wi.WOOD BASE,CAP 103 - . ----. -.-_—_ - PROPOSED rT.E�T.O0 HOOD - 'A2T wUT D :�...., .. .. ___ e. - -PERGOLA PROVE 2. _ BEDW - - - FIRST FLOOR �. PLAN . L---� .. - 1.' I I. CLOSET O. r W3 'BEDROOM#1. d: DATE ISSUED: . August 28,2014 - (2)sTuos .. I ` d REVISIONS 102 (3)mD5 I m _ a I OF - NONlG.6EA_CE_ - ._ 1 HR RATED WALL .. zo-o• FACE OF ADJACENT .. DRAWN BY: 8KG - — - --- - -STRUCTURE- - - s ''. DRAWING NO.: ` First Floor Plan A _ I g «.. D ARC ex F ENGc L . .. ... .. _ : .'.. . . ... . �'s'-all• �• z /z _ FTFOH OF BEOOM - - - mow CEIUNG .. _ O YARMOUTHPORT,. Jh y MA g g SSP NeV/hFna.i ENINGlFS.. C r E ®. - I i:f �r STRUCNNREWVu _l L- •. 1 4. M1 i� '- A3.f ..' 6 F f NEY/q r FOOT 10-3 2.-3. 2.-3.. m Wrtr-INs vnm ease OFFICE ... / ..� I IL a-I �. r .. - i : >✓ r - OA.imB PND OPEN - _ z U. Tn. I 208 I '' i"' AFPLY NEW CLOSEP CELL!AGUTAIWN I i .. - - ! .. M'T .i r— xiw IN Wa1 AND CEI:JNG .-. U. �.... n .. � .' :- INeraLaD xoM me INreeroROF � ::.:: - �me nnNDNULL•. "t : riv6Roove BOARDS RarlPLE ...::: liir li oN ... ..... a WIN - 4TH FLOOR SIRING U BEDROOM P TOP - - I M O.5.T i I — II : - 205 H r: �~Ly t � I ii! I i' LL I' - i - - N ._ _ i f-?II - - - f1 I II 3SNvS II U' I I - I 1 - Z A7.4 !4 Z - I I _ i. it I I 6 L— I o ' . � � __ "'! �,•�! ..'---� -.. _o .: .: .; 'al �-5.- t.: '!-'<^.Ilv lzi" `7."�, i rilr'_'' z � i :; ., f" 3 Fxisiing FIAT IJ 1 ! .. -1 UNFlNISHED ATTIC a < 112 I2/12 : _ _ _ _ - '--I -1 L" .. '-i — ! :-;NEW FIAT ROOF TO Z I 1 MATCH FXISTING I L I' O i i — Fourth Floor Plan112 II _ 1-- 11 711 x ! - ..A _ W TO TOn 204 ND FL SnNG AREA - PAT:.NtP.fPaR KOND FLCOR Or' .._ .: +/'1a-0%t/-B 1J _ _ _ w .. FAETDIG'1VWDMILL'AS w Q ry RESULT OF BE Di.AND `.- - _ ' BATNRNM R 11APOIC AND.&1 OF - - - �� 1 �. LU LU LLJ IJ Vw N ! 1 Q i-. i Uz i ® I I r = - r � NEw ASFrwv BnitY-Is U. A3.1 1 I .. .. d !-" I Q I ,IILEPROPOSED - N SECOND, THIRD, r . _r WILT-IN OPEN SnEWINFIN EAVE - �'. FOURTH FLOOR 4TRIR � �' F CEIGUEST g:. __ . ROOM , O PLANS, i - I t3I sTvos ISSUED: August 28,2014, .DATE ISSU .. PAren a aEPaR rmRe FtCOR of \,® - 3RD FL CL.:. �._. .. s A79 a REVISIONS�Z—-NOMILL•AS—I— .. BATH A RE LILT OF NEW W!NDOIY 2DaU110N AND R81ALE WATER � 3RD FL SKIING AREA I _ - _ yr I 1 s-ion a_ 3RD FL CL m - Ern ' —_ - ----' ---'— pdslinq - s House a` I(I�� A3.1 ;>xE A =a'uGars FAce OF An IW - DRAWN BY: - . -sfiLCNRE KG ...za-o• - - DRAWING NO.: .. . !, 2 Third Floor Plan 1 Second Floor Plan a�: Foundation Certification in' Barn'stable, MA Address 21 WACHUSETT AVENUE Prepared For FARLEY & ELIZABETH LEWIS Assessor's Map: 287 Lot: 139 Baxter Nye Engineering & Surveying Community Panel Number 250001 0568 J. DATED 7/16/14 Registered Professional F.I.R.M. Map Zones: X (un—shaded) Engineers and Land Surveyors Plan Reference: Plan Book 574 Page 31 78_North Street, 3rd Floor. Deed Book 6510 Page 259 Hyannis, MA 02601 Phone — (508) 771-7502 Fax - (508)-771-7622 Owner: FARLEY & ELIZABETH LEWIS Job Number. 2013-074 Scale : 1 20' Date : 01-12-2015 " _ ATCHLIN WACHUSEff AVENUE .MIS _ — I= Mae u -& �/Im M OnRBIon40NAon S I i 86*08#00, 26. c � �o � c zk 42 •-•� �==iu �O � z p RNa nj ayyR. . (W p) In MATCH LINE _ agaRa ^ `� w thqj S 87*55'15" E 60.00' w S 4 • • c 8 5 8 2 5" y 49.86+ _ ASSESSOR'S MAP c� 20.0 p�SO- 147 PARCEL 139 � ,188f S.F. OR ,� ►� ° -Ak Z 0.33f ACRES �g m 0 T.O.F. EL. 27.8 1.0 5.5' 6.5' Q p o o N �ci • v,.b W W �oFo 5.5 �� as X O O Q co O p die ww�o to w� EXISTING OR �o co FOUNDATION o 0 12.5' N DATE TION N 11.3' / ts,,* 01/12/15 vp RKNN,�� 11.3' 26.0' ° il� I N §�� P y$ic cp O " �2 13.9' �tia V m O �b N 78'5629- W N�p� P� � B ?54E A�A04ale EJ 1 CERTIFY THAT TO,THE BEST OF MY KNOWLEDGE THE EXISTING STRUCTURES SHOWN HEREON IS IN COMPLIANCE WITH THE BARNSTABLE ZONING ORDINANCE, IS LOCATED IN RELATION TO THE Q�P MONUMENTS SHOWN AND IS NOT LOCATED WITHIN A SPECIAL FLOOD HAZARD AREA. .�� SS�^ ' o'' SHANE THIS PLAN IS NOT TO BE RECORDED.NOR IS IT TO. BE "USED TO ESTABLISH PROPERTY.LINES. M. MALLON Ca No.48637 REGISTERED PROFESSIONAL LAND SURVEYOR N BAXTER NYE ENGINEERING & SURVEYING DATE TOWN OF BARNSTABLE' r' In. is f x11ISF