Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0361 BAY LANE
.. :. .... .. .... a }� a 9 r v t r ' a I 1 � c t� OD ��A� :� OF RsAE CAPE C ,L, - INSULATION , 116/R OLASS HAM LISS SPRAY,OAM SURVINRIO RATTS - OUTTIRS INSULATION CRILINOS 1-80.0-696-6611, D IV1 Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 r r Date: Dear Building Inspector Please accept this Affidavit,as.documentation that Cape Cod:Insulation, Inc, performed & completed the insulation and weatheriza4ion'work at the property listed below, Cape Cod Insulation did this in accordance to the specifications listed on the building permit application, All work has been inspected by a certified Building Performance Institute '(BPI) inspector, All work preformed meets or exceeds Federal &.State Requirements, i Property Owner Property Address Village Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) ( (a[ ) ( ) ) Slopes ( ) ( ) ( ) ( ) ( ) Floors ` Walls ( ) ( ) ( ) ( ) ( ) �iv,er W0r k J��✓)rOr 1e0l y Sincerely 2Hry E ssi z; President Ins ation,Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION "fi g," OF B Map Parcel �V N°° = NT'� j- Application 0 Health Division I '+ 'j Date IssuedAle— Conservation Division Application Planning Dept. Y,�.�,.�� Permit Fee Date Definitive Plan Approved by Planning Board ' Historic - OKH _ Preservation / Hyannis Project Street Address P, x 19 we Village Owner j?,,a Address Telephone (_�8 77/ Permit Request G '� ,l�T� �7 Z G;r1/u/G 5-0 /1ZY'_ 25 e0�G Of Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuations g 4,4_Construction Type /��J�✓ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes R No On Old King's Highway: ❑"Yes XNo Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning o g Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �Wer /icy�, / gyp Telephone Number �� 77-s�/Z—/ Address ,LE License # �•��r�/2 Tlti Home Improvement Contractor# 43 SSG 7 Email Worker's Compensation vl,�lL�DD 319e/ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE t C C FOR OFFICIAL USE ONLY y1 APPLICATION# DATE ISSUED f' MAP/PARCEL NO. ADDRESS VILLAGE OWNER T `? DATE OF INSPECTION: FOUNDATION FRAME INSULATION Ir FIREPLACE I r ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ` GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Adobe Document Cloud Electronic Signature Service and Digital E-signature Solution'—E-signature and Digital Signature System 8/27/1S,1:27 PM .Town of HarnsOhle' ° Regulatory Ser ices 'Richard V.Srali,nirertor _ .. Ruildin Division Tom Perry,Building Commissioner 200 Main Street,tiy'mis,SSA 02601= . - . . e'rrw.to%Tr.b2rnst261c.ma.us . Office: 508-862-4038, Fax: $08; 90-6230.. Property Ovnicr'A1tut Completc and Sign't'his Section Tf Using A Kuilder: Dr.Joseph Asiaf 1, as(`?aauof the subject V.oopcity, heccby audn:vc I �� to act ull inybc'nnil, us all matters rclativc to. -rkautbotized by this bad ng permit application for. 361 Bay Lane Centerville,MA'02632 _ . —op-&—ssofJoti)_ ' ooLfenco;and alarms are the respomsibluj of the applicant.Pool; are not to be Mod c r utiliz'�d before,fence is installed and all final ' 1115PeCuuus are.petfurwcd and accepted.- c ttrz acr 8i;manue of Applicant 1` --f'1— -S - -�- .Print Name� Pint Nacre • Dare ,l f;+ � ��� _ r . QfORtd5�0'k7:F�PFIMISSW1aetX)Lti ._�'�('^ (-•,. �f" t'iCt fC ,�.# ; Start SEP `201 Click here to sign , _ x } 1 agree to the'ferms of Use and'C'onsumer Di§closure of this document https://thlelsch.echoslgn.com/`public/esignRsid=CBFCIBAA2AAAiLbl...KtzAcQUChA4_afeCpeDyvT0228c33odarjmsON3T6BACekm5VnQIRHxD2f0A•& Page 2 of # Mass,u;Ivusr:Ct:a •.t)6par4ni%rtt:of P.ublic.Safety. ..:Eoard'of Building 130gulations and Standards Construction Supervisor License; CS-100988 HENRY E CASSH}V 8 SHED ROW WEST YARMOUfiH i ✓• ''''" Expiration Commissioner 11/11/2015 Office of Consumer Affairs and'Buslness Regulation 10 Park Plaza - Suite 5170 Boston,.Massachusetts 02116 Home Improvement Cbi ;tr `Ctor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION; INC HENRY CASSIDY 18 REARDON CIRCLE r..; SO. YARMOUTH, MA 02664 Update Address and return card,Mark reason for change, sCA 1 ti 20M•05/11 Address ❑ Renewal Employment Lost Card .. ._.. _. . (OT14e cpar���zooacuea�G�a�C�/�/Caoeac�cwell� Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENTCONTRACTOR before the expiration date. If found return to: eglstration: -.133567 Type: Office of Consumer Affairs and Business Regulation j xpiration ;:-1:21:1:5/2Q:1.6 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116, CAPE COD INSULATI'QN:;;_INC' :` . HENRY CASSIDY 18 REARDON CIRCLE'..,.. S0.YARMOUTH, MA 02664 Undersecretary N valid wi ut sign e The Commonwealth of Massachusetts Department of Industrial Accidents Off ice of Investigations ons € I 600 Washington Street r' Boston,,MA 02111' www.mass.govMa /i orV kers' Compensation Insurance Affidavit; Builders/Contractors/Electricians/Plumbers ` licant Information `` =A Please.Print Legibly Name (Business/Organization/Individual): Address: �' � City/State/Zip: VA, b ' 'Phone #: 11 1,5 �9 Are you an employer? Check th appropriate box; Type of project (required),. l. ,I am a employer with ��> 4, ❑.•I am a general contractor and 1, 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 These sub-contractors have ship and have no employees 8. ❑ Demolition working for me in any capacity. employees.and have workers' comp. insurance. 9• ❑ Building addition [No workers' comp. insurance required,) 5. ❑ We are a corporation and its 10•0 Electrical repairs officers have exercised their or additions 3.❑ I am a homeowner doing all work; _ � 1 1,❑ Plumbing repair's or additions self,m ' right of exemption per MGL Y �o workers comp, � 12.7 Roof repairs insurance required.] t e. 152,'§1(4), and we have no employees• [No workers' 13. 'Other p ' comp, insurance required,] Any applicant that checks box 91 must also fill out the section below showing their workers'compensation policy information t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attachbd 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 polley and job site information. p' Insurance Company Name: '� i� >� U •'',)kV Av Policy # or Self-ins, Lic• #: G 00 Expiration Date: 1 Job Site Address:Zz�i ;6�. City/State/Zip; Attach a copy of the workers' compensation policy declaration page (showing'the policy number and expiration date).. Failure to secure coverage as required under Section 25A of MGL c, 152 can lead to the imposition of criminal penalties of a fine up to $1,506.00 and/or one-year irrhprisonment, 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 Investijzations of the DIA for insuraw coverage verification, I do hereby certify d the pai an penalties of perjury that the information provided above is true and correct, Si nature: Date: Phone#: Sdt� .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); 11 Board of Health 2, Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector. 6. Other CAPECOD-27 BDELAWRENCE CERTIFICATE OF LIABILITY INSURANCE' DA6 'MMI°°/YYYY) 6l3012015 XE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS T OES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE,COVERAGE AFFORDED BY THE POLICIES /MIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE 'A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED �ITATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, jMNT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must be endorsed, If SUBROGATION IS WAIVED,subject to ,arms and conditions of the policy,certain policies may require an endorsement, A statement on this certificate does not confer rights to the 'idificate holder In lieu of such endorsement(s). r�ODUCER CONTACT `o ors&Gray Insurance Agency,Inc. PHONE j434 Rte 134 we a� N.:(877)816-2156 South Dennis, MA 02660 E-MAIL ADDRESS: INSURER(SJ AFFORDING COVERAGE NAIC N INSURER A:Peerless Insurance Company-see LIBERTYMUTUAL INSURED INSURERS:ATLANTIC CHARTER INSURANCE GROUP Cape Cod Insulation,Inc, INSURER C: 18 Reardon Circle INSURER°: South Yarmouth,MA 02664 INSURER E; INSURER F t 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY M IC YEEF MM DOmYY LIMITS. A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE a OCCUR CBP8263063 EACH OCCURRENCE . $ 1,000,000 0410912015 04/01I2046 PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ _ ' 5,000 PERSONAL&ADVINJURY $ :. 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO• GENERAL AGGREGATE $ 2,000,000 X POLICY JECT LOCG OTHER: PRODUCTS-COMPIOPAGG $ 2,000,000 AUTOMOBILE LIABILITY -- COMBINED INGLE LI IT - ANY AUTO n Ea a $ccidenl ALL OWNED SCHEDULED BODILY INJURY(Per person) $ AUTOS AUTOS BODILY INJURY(Per accident) $ HIREDAUTOS NON-OWNED AUTOS Pe�PERTYacciden OAMAGE $ UMBRELLA LIA6 $OCCUR EXCESS LIAB CLAIMS-MADE EACH OCCURRENCE $ DED RETENTION$ AGGREGATE $ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY PER OTH- YIN STATUTE ER _ B ANYCER/MEMBERIPARTNDRIEXECUTIVE ;WCE00431901. 0613012015 06/3012016 E.L.EACH ACCIDENT $ 11000,000 OFFICER/MEMBER EXCLUDED? a N I A (Mandatory In NH) It yes,describe under E.L.DISEASE•EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (CORD 101,Additional Remarks Schedule;may be attached If more space Is required) Workers Compensation includes Officers or Proprikors, Additional Insured status Is provided under the General Liability and Auto Lability when required by written contract or agreement with the Certificate Holder, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18 Reardon Circle ACCORDANCE I WITH THE POLICY PROVISIONS,� SONS, South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ' 6 � ©1988-2014 ACORD CORPORATION, All rights reserved, ACORD 25(2014/01) The ACORD name and'logo are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 18 l Parcel 60 1 Permit# 6 1 7 Health Division 'G --1 &f l Date Issued Conservation Division lollI&W2- Application Fee91R�5_/ 00, Tax Collector . _ O&A (ZI Permit Fee 1 Treasurer t V 1/0 Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 361 Eau �4-Am_ Village CPva fiQR u Il�2 l� I�} / - Owner as 1 A-F Address 36 80 ti ,e C *0 , wVya vl/lt9 Telephone Permit Request .rs:6f,,,r C'me"a&.= 3 toy y 4.e/ ir�la<c Square feet: 1 st floor: Ai ing 'y PO proposed _4 6 2nd floor: existing proposed _ �eL Total new_X Zoning District Flood Plain Groundwater Overlay Project Valuation 4V Construction Type - 10 F Lot Size qV 1 Ho Grandfathered: ❑Yes 2lo If yes, attach supporting documentation. Dwelling Type: Single Family GY Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes UWo On Old King's Highway: Cl Yes OlTa-- Basement Type: ❑Full drawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 3 new Half: existing new Number of Bedrooms: existing_ new 710 Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas 36il ❑ Electric ❑Other Central Air: ems, ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes �o Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage: sting ❑new size Shed:❑existing ❑new size . Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ®'I�lo If yes,site plan review# Current Use Proposed Use BUILDER.INFORMATION Name ' `R,t ff , G�oal�A� �D• Telephone Numbers_.�` '�= Address 0 6. ,&wg License# 06a eIV3 YOp trS A r -e lc/ I4- 02O5U Home Improvement Contractor# hpo y-p y Worker's Compensation# 4� (7C20/6 7/ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY PEINIT NO. DATE ISSUED MAP/PARCEL NO...", ' ADDRESS - VILLAGE OWNER yi � - •_ ," �` . j � I I � L f + to — S •. • . DATE OF INSPECTION: j FOUNDATION "~ FRAME O F INSULATION 6 1, 1 Z 12--v FIREPLACE :1 ELECTRICAL: ROUGH FINAL`_.. f PLUMBING: ROUGH FINAL GAS: ROUGH FINAL �- FINAL BUILDING r ± DATE CLOSED OUT - J '1 Y r ASSOCIATION PLAN NO. °FtHE loy, Town of Barnstable Regulatory Services MUMSTASLE, + Thomas F.Geiler,Director NAM 9�'ple a � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. �1 Type of Work: �, �/ d� Estimated Cost �4 wa, %!2 G ��n Address of Work: 3 61 Q �" 'f Owner's Name: C�Mn iM2S /'I5 Date of Application: ��L - 1 hereby certify that: Registration is not required for the following reasou(s): []Work excluded by law ❑Job Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PEST OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT �D DER HAVE ACCESS 142A. ACCESS TO THE ARBITRATION PROGRAM OR SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: .�. J 06a OZ Registration No.'` Date Contrac or OR ate Owner's_vas, The Commonwealth of Massachusetts Department of Industrial Accidents _-_ - Office oflnyestl9adaAVs . - 600 Washington Street Boston, Mass. 02111 �3 Workers' Com ensation Insurance davit name: •'. • hone# aC] •I am a homeowner parfornling all work myself [] I am a sole r rietor and have no one workiin. in ////// Qz% i%ee%s ensatz my ems ww •$v; akarY workers p Y { r•,•ri. ^ !at,v 3:. x) er_ IOYl ^2iKK4.:'ZrC {,�4°:i: i e l g,. n to}:t »'•.Yt::?:3 }•,h idr,:w:a r ,:.., .�vv$;^F i :{ 3. 2:3T } <r: $, .,{'•b t'^:;.•3?S v I am an m� op '•?4. :tLi .},�:::Y•f•.'•..k: o;i•{. ~a^,.$•;: :::St .;..m•:>r,.r.�.:f: .K•L•;{t•,\} :iSr.;.. ?2. ?;..Yh',.d5';}'l .. .•}. ':.:;ti;?$:t::.{:.s,•..:.t•+'•:ia,t. :.{,.! ..$.. ,:?w'#'4} ', .s.: •.Ga3}k:i:$3i:'• 3::^•.a$3i•. {t4+s y J.£•:, ��'. : :.;:$}. Vr.. 4^' •r<,. :<. 4ri:i: 3 :aY r..• K.,,,a 't�2S:$_?�,c:2.n,rr.•r.. {-.•,�.4.t n n:if;vy'•:rw:t;^,?..l �Y, r.Y.:•:c ?�.Y4a .•i.;t$.�' •}•:� :}}S.L: �v'.,',';v'Yr:L4a}r{r .,Y...:rfi ;.hK•v.v.:{4:<L$ $>�i: iii•:v�$?,r.$••}'••.:a::F•iY ,v4•:. '...{:{{v:xavv,x,:r ,:�}4.: ''•'4:Sy. �: x .S.•i~Gh}: .::;'n;K:41rY}ir'^fLf:.,a 1Gfir.;,.Y.K.},t4 iati:Y,i:•SK?$r.:t{.: ,^]• r :`:.cYx}?tis:4x5:::}c•.:.: y��;{, ::},,:)^±.;S}`.kS..• Sw:r .!•k.,.:4 tt, .a.r ,. a?$}}:$'Jrrvr•N{:•:::n,...:-T•.. S•kl+:•f«:• :,;;;::•,:a•:-:t.:,.:�::y .: .::.•:4:........ ,, x:.-. .>',. .}.. . .;�' GJJ2-:.:}.., ,.t.$.32}jGo„pr•{•. ,v;R''•<' {{. :>,�$gc •,'•:3$'{,?a.•L r•,>,tx.•':rq��r°c'}:#Y$'�k,.+\`•:2{ { •, G;.,.•:r<fi.N r,•:: }fir..,?L..: 'GY•i E':%:Y.,+.:k: .ar,.n •Sry ry,n.S:}:•:2,•2?{:•., •av,. t'rSr•'4 k,::tw,;:+k';., .t?j2•, •'�rTn r..•r-:« •+3r..',� :.}.�!:n SII•3n$III "..w•L:• :'<:Yil.3•:..�:::: '`?:$'<iS�.�• ,,.4:.}'v.•.,abn. ,S r.S,:;:i!;••. ra S:»•+`:.{v';. !S$•wyti'}''< .{.:�k:;`�.3.}, rr3.,«5,,. •,c wn{«o-..�i•`• .x 'COIIf fr:r:^,v.{:'«:��',•:'.tix44tiST'Y f. .}.v,.4.v.�:s...v�3,`.^ ;Y.: ,(,.r,:..;vY:'• •:,:;e{e::}t,3{•'{::} '.?:} 2'...{ :.: :ALto;' .. Ems x; 4y?,.;�{.yh•: '.'•?.•:?+$}',rZ ..,r.Y...,.h.}, 3:...: •,.. 2Sy.. ,,..,.}• ..r ,:.}.:t}•'Sc..hF'}:l »K{i.• C}`C:R{4',•art: ..R2:5± •Lw �. ,� p,,, `#•}. .;2k.4 . �•s 4 ..;;.-•t:•Y,:L:^?•�{$••`: •:?'�knrr..•.:,::•. ;>.:•f.•{rr •}., :,}. .�Y...r.0,, {.::,.}}...:C.:v ).. ,;.ti:r.:{3,,.••?.::t�i..,.•:n �t :2rr y��� ;}'rir::.. $��...J.. ,.x.. :x ....A..:•..'»^'R,..4?W,c�....-,...w. +',. 3. ..�?rta••i:::,.,:.�~x'', fi;4 k : f..; s •:;w'�S;yc{:it•v:•�';?.3:•WrS,'.fYr^`,.•.5'tyr;:}k .,y$�t:. x•::;�:{aS?•rT i.. : ,, .,.;$Y+c;�?i:L`a ..3u.}.. }c ;:a.. :�:. "S:t;:;:$»a!••Y :�r,;:z�E •i'•X; ., •:.� .:}. •>: ?$?, "•{ }. ::rr{.{ T_32�:v'.?#2:#Y~{'R. .•r.:...}:••;!,+ ;i•Y v: -•r;.}e:52.;:$?ry""%:�Y•;':' _ ;:,a•• •r .,4:. .v,.�<:R:::. ,:r...t N•r• ' ,GYM'•;:.,t;'L.cTex.•'.•.n+.}.:.... .:.:a:Y;r;•:.a::,:,G:t' v<•:. -:Y. 2:Y•`.:.iC.,.: .:;a}.;.,.,•. :.:h C'}.:..Y�--`%�}^•r,•'.4:�•:.a; •$,li ::},:Yrl.•.,;e•::•:a••:•:..• :.re. 'j�'` :..ax.. ..r:• K;t'ta,C525:4•^r•2 $$vG2n•' ,`.vr`.•`hi„Y,< .y .• .:#e:} :,;.:•,, .{;,.,>.a.. •:�:${ic$y��#;f.:,±^•.•t?SiFi::,•k•.-iY,•r }?.� :..Sd :,.?}}�::•;.}::e.h h,• •L fir.:, l� .. :�:•. .t}. `i•:p;< -'�reSS`22}$ }•:K.v- �xx:`. •2:3r •'•{ik;.3•a:�c:`..C,...:#} }ii :wi. #� .n�• ad;:r•r.;Ys.G 3�� ;:?2:x:$t:�$G•' .:r.'q.''�•vJ ra•.•'6�:K i'•r.:ha,• {�' :�:5r., `C:;.h., ,E.' ,:Y�•• 'tb?c:;?. i:: '•�;�:• ,sor}.y K �,a..G•..� {•$}??'.i7:•#b. .,+,. .:iv3{.+:• `•:'•a•.N•::Y.•'}'.'^»•r 4.4,rr, .3 ••}r.h<•hY...�`an•M'..;•.:.v, '^{:?{::Fr3<Y•r.$.�:.`� :{>OEM,.�+:'; n•}" :Y.?$$' ,}r.:-, •rC• c$,t`s 2. ,:.n r: .:G J}'Ln ,J r.3:.hi :{: 'r. .. �}.S•:�„6:: `^'r'•,'c'2,. ..!;2,,;::t'<'.'•' .,y..{f.`,,{? ,:-ri. •a2:' :~:•i:t'3,Year.''if• K;.y.,�S.S• ,:.tt 't` }..,, 2'N '}.:L`L•,. •.}•,$...st ^. {C' r'` .�;>."r+.3., .,X.a �i _ r.ah..{,, ;'•}'•:ti•' }Y'•'u:{,S,K:,F•:: .}.i.}229r::.:G•`•:`•:2?::a• i ae: ;;;' .tr .K{.w;,• '.?.::,:.i•32•,•t 4`�s"^•::;•.`.'•:.:.lt••�. h.{»a:•4^,••:vib'•:tY::. 7;}a`•'w'.C•4' ••.X: "•'CMC,,'LT:4.;, h�}�•$%\6.<:t :.S yi+y �A.',:{#;•.,C''#...}~�Y';•ti:•�,•'G}r�.},{:...' :C•'}'.YL: $,'•S`'�.r.4,'• `}n', .,c... YrYi:, • :;y;'`: h,•' !: :;J.,�t'2?.`2; N»+•ak $k, K •rY.{;•.}':tw:;,;.{.T.•:ifZ}:{ ,} •wr r s.`.• "•?$e$`#:;::,:.#:• .2.e ,a :.:+.:>x •t..3.}..r::`ff x• ;:i¢2{ .2" }•S $•. 's?, iCl•..i.t.,. o" '.'.^ •,d}...,;w{:#:3`?:},`,:;2Ji;.•ris; y`lOEM kY..;y. ,y:a;•r s+}:;;,+:: i?;;s$ ••i`s.T. .t.,k..y• :, K. +.�.,ri, :2,•;.';ck.r :.' S fi r • i; . f{.:{{•+f$9`. •.a..• 6r•:h.. mom .oS:r:r•.r,�,•f, r.v.3,t•2:YiS. :'ti';• x: :..L.:2•... •.. .{a..::'t•t•:•:3:f;r` .:.r¢, :a?,.'gi�":i3•.}•r�:'.3:^`�'}• .S}.: i�#..,{i,:;C•:r.t;.,, ,.;s.4'r. ,.•,,.2:. .<. •::•�, '.'• •.?a&};2?}:,r,•{. :.}Y•{yam•}• •y`;.•.t.:. 2• .f.• ':#',:;G?e;•.'•::2:k{^::aY:•. ,:;i3:3e:}4 YYy{,'a•3.v.}?.3:vrx4 : .:'•'•' :: •.;#•;{,,:v•-•::v�:: ::^;�: 'L :t :•L. y}i?.::Y•. v. r i •'iREM .v a sole proprietor, general contractor, or homeowner(circle one) and have lured the contractors listed below who ❑ I o .. Lav8 aIIl p j. ••4` _ ::_ .,.,�w,.;,}•,s${....}g ar gK;:,l>},:xa+rn;t#s:•;•?,p}::,:coy,•, ;�;�•,�•' �5, :N,,,Y• ilaY 1� a ation,�77olices: v,:LL.}:fi av„. <4Lv` ,}�:` y :L6. {. ;if irir Nsr" S workers comp �r,Y:ay:.y:.ri::::;•`.:3<?;Y.{.,dy :2:ar`;:r.•?;•:.;;.{:r.,:;.}•:.t:£Sv;'}}}<a: .,?#•-;iY.St:{.Y.Yi; xak•3:xte `po- :� 4$•> thefollowill .K ::$tt:$µxit.,;r:a Yr»{•4,{.:k?:•:;:•S}YY..S,:4}`•:a}r•.,� ?aih!{• :}}.uGx4?:{.h${t}• fiSN'.c d ::.YfY:: .:nq Gc•d:,,t r ft�} 4}:. •T:a.:: r.;J;x$;i,/ {:•.,^ '..Y/.$ $}x^r .,rTk•:!r 2,Y n:a} :v}«; }Jt:..a?t:}!•• , ' .'-+Y.•r 3rC-}\v''•:} »..�., n •,•':v. n tC}:t• .v LY{^:v. ..0: "•v 4:.}±„ . nn v '.•i:h :^wwi aay} ..aX+ .,{r..:4�•„':•y,': {{. .. . :.x?? v.�: t•.ti: {..::i l {. :N 2.. v^,%i,.} y:.Y r:;•: M. :...r..n.: .,...:r:n....,•:, ....•,�#.:.... ..?•4N }' :+T...n. •${$,•:,`r'••}•:q;::?!: ..F2:b,.Y .:L•::k....4 rr}. Y'C+'ir ::>wr:�, I ..•,..:. ,}. ..f•r. ..x:•:•}+ .�Y}}Y::.: /••:. . "f... .r..:at :C:}4Y,•,':x..,: .$�ifi:•':,t.}<3:{. a:.:.{:!•.:,,,t... ,•yriL2 .s;:Y.:: 32;.}•r,:..t x{.:;: .,•2:.•. ,t::v`,:;. r..'.:^::br.+ •:2tac.•. ,:::•n L•Tkh:. a..... : '•;r.:}'y:w;.y. K^;2. nSS:.{ •r .. .r{!,:4:'v:•Y...::.{+t,:,h'}.r...-. :.r..,.;•{.:'$�'r;$.4. .{3..{ .hvi•:i^.:.• .r:i�' :.r'S:,Yk ::.,r.. .n r.r.... ..r•,.{..t4...- :.:. `rnn.. :...:.p, �. .,. ,...T...r..,..>:.,. ..$.. : .4 .,. ,r.., :.,....r.,...4,.....:: .. .»y.,;:�.'• •x{?'}}t,<.:: '},:Fi:':Y%�Y'',:g'rt.•,i3c'is`•?}:$r$�•.i -2 ?3�.�,{ ,. .;r.x.{••,YLa•:r.{;r...}:.::::.::4 a ,.:.};rr;•:?'R;:s k}r•. nS:<"`: '?"l;Tc:Y,.#2 ,r..:r5:•::.K.4: ••u,?:-,h;2}y:$$$•::r;... ,s{...i....' #,.:fi:�}•Yr.i., b+'i•,2' :.;,.,. .'%c<'2:k• r::.:3•a}}4K2:?2•:yr.$�`it�.. i+•:Q•. P.':r.>:{r`•:ri{.Yr!.. ki';rn'L 2L.!v:rr v:<5.,,3•::y.: 22.?n}::htiw:$2;;.:a:.A.K¢'`vS' iK gti.`E1Atl2 ;r, -:2• r :?., rT .}•3'?:•.r:$+{,;:}:••r{:3}}•4.-xai'::h`2•'YJ4o2ar 4 v:8? i � ..n:.+Yf K::}. ^a :ti•:.; ..q. x ;a. S,; :a :.; .........:.,•:,-.J,:•wt;r::tta»}.•}:,;.r::. .:?. a2;<%• R::'.t.:3•:::•Y••{#,,}., .s'$:., :}}5•r3}r`4.a.. '4;�•i'$�'a v.•4"'::• v$ ,,.#., 9,r�G.$ ..,,,,: ,:,;?•: •,w:•rr.,.,•r:.•r......:a..::.•:::.i;aciTr3i .drY.C''•�'.,Y,`:r..:,Y-.• >.},}; ..•.,r:}3'?2T..3`•:,. �, ,.. ;»r:4`k.,:,. ,.''?�°'i. •.a9:..•,�'r a. rv{•Y.;}:'fi::fi:!v.h x.:rr.}} Y}.. •}'d:•.wai•4e..�.:.Ya..v. :'r: `•AO.:3.:3»c3'•a :425.; fi ^TC•:':$2f 5`•6:y� �{:<.',�3':Yn:+k$xk'{-{�'::�'r�::i.}r.�a3 :. '' . ,.:,.....,•........... n yx:•:wa.:.yL,.!;..3,.:.;•{,}..L••.:}Yr•.::.}r.:r,,:.;�:Tn...f.{.:'.{.?:a T.4,Kv..a«r!..•}.,::,:F T.£.Y•5fy..;!r:i{:r:l.:k:....:::..:.!r:.Y•}$.,....,r«,•...ya.......,.� 'Ii:�'v{•:�Ypa•ONN 4tik•n7{22...:.:{.•.T..# vdWP &;- ?..",.•y;..'h;;."�'i�2•Q j•``'b',•i!.y.•t••.:d'a}.x'$C#.,}t"G::.},.•.,;r`Y.a•:YeSJi•::t•,i Y^{}•�4:.a^rY•?..:.?1.a..•..v:c.}..'.;\r}:�h.4:a:ri{^:.:..{.r}.•hr..}.l,.r•Y.:.,l•f.;1�.}.t6''h•':.�:v:rLv•r.'.}z.:,.{;•:v;.}•;a:..Y•.t,'>..>::,fhy}!.•<{.::.}r.:;x:;l}.,,::'•..::?¢i::v•Y,Y:.,::,.:.vT}.;}Lv.}cr..:.,..::.};:?..•tk.T.YT:.r„.A Glr'�,h•.Sra,.{}tt;.k<,i,L,:::i2:?t•wiy.S{;�{}:f::?;rf:.:�b}'l`:{.,fikrS:n+.:::}}.:::,•i::;!.7,a,:kv#3y K}.:.::L.dr..^r....:'..}:[:.;:;.%,:'J.i,};+s{s..ia:2c i4•'o•.7i3,'.•r i.'Avu ya.4 r.»•±,::.i••:.•:: 4::o r:}�..,a}.};:'h'�.y..r.iv•:•3..}yn.;a.•.:i::•r•l.�r.fi�'s.;v:{C.Y>;4a.'<r•,"�+'>:y.n C..rK:SY!cr.�}.dxdyd.$:,S?±r�l•:{'K.$C.:o':O.!hY.',a•;a`.�.�u.,.`i�;-Y.'i,`-..v t±tZ cYs:;•t:..uHw•••Qa.`r o•r'':'•;;`ct•'.'a;.ao.r••r,;,c;Y'•::±lt::v O#'.Y,:a?»�y:r'.'.4naY,et}.k}'y•r:.ia#w:'ta:'i4 hYw-a{:;,.:yr?2xaq>'t.fix'x«�:a;g'2w:>:,:S}?N.+„•tit.}.at}i}''�.{Srn�n^',Y•,;.S?,,:`:`;:.A:$,'ti:•.'.•}+r,:,:r!.r:ha{1ax"3•':«eo`Y..t2'�;Gy^"firf•.3Y, �r,q'•ef'.d'•.••'.i;''•r12�;�S`<%;::..;':,.w�.T.#y}vt•;s^i'�'a .,•'2•±:S s: - .. $$; ,..r•r:.•:i:,xt ..,a:r •t'•Y .«.:;..y;n?:..:.,.•...+,.:,:r;T.:.,:.";$:;;v.,?Cx.: :y;5:}Y.OY v•;:r,};4;0!> ,•}A .:ta. y:S{ ac,`f.T r4T. S •:•,G3,.:...:.3... ..}.:,...a7a4.' �!•8'• • •ar.: x};r.n.;r,:K,Yr.` .y:x.v �z S a.�.: ,;.r4.�.;. iaa.:..rx�:•r}xa., Kr •x;�;r, <::�t..„�'•:, ,'•�:-.W.,:,Y,"32. fi�. '::�. •:}'�• r. $ ... ••.3r h.. } .. r .... .v,r.;:x•;.;li?4:::}rcY.,•.a°+`-:0-:. '$r•.,. ,.•Y?^r.,•:a::a::.:rr..a.' r]',r,3 T•?,:.h•:..,3t•,;:,.}:;R<}.,,'E•:a<:h OIl.E�s: .?{Lr•a r. .;n.'•}}:0:2.•3,•:a:Y''.:o}: 4!,3r5'••?A?:}`;3 �'v:.#�}:•:•:::x.,:•..,}:&.{.�n•.,.t Ja•L:.Sr.,•. .} •4}..�{or::.:.:.fiZr},.x.::r,:}Yr..::.ry:;.:•„ , .,,.- �}.{{'`�::.-}... '• 4••" Ls� 4Y }# ...b.:r ..v. :.2^'-::Yi"J'. ,.}.»ar;r: ..:h.,...-..}.k.}.r.>:,.$:{:4... .•s..• :.K. .a�.,inr,:,•'c.x:Nfa?Y;:,{;3.{.rik.:.:h.yc;.. :',,y.'.;4�r' >:!.»4,;;' 4r.: :}r,R{.,•{.;,. .;},.: .ri!.. .}•tr.•-:• r{Nt ^,?a; •.,•';r. #4,\aS };�:}; yQ• h..•-.�w,h .;;3.t •., ...., .. S. .;$,....... ...:.::. •.•r.::...::t•�•;,$«„•,••:yY•' ,.Y`.?{yr.:.rY„c:'•#}:,, ,.. .$�,;,;.F,;r ^.:J?r}f,;?:::,••:�: a:K..rg.. :.;.}•- ,'}�'`,;,• .'.^•..�;2•'j .�{:YT$.:x}+�Y -:t;5 <. .G.'•.t.hLK# .;`a,4•�;rxr.;'r, ..stc:<...Yr.rrr;•:{?.nv:3R. r ':.{'J.•±$'Y?hY,,..:�?.•{.;2.?6 :rirv.. .rrnr•...: J.:. .$tLS,`.}.,ir`c`r.::..,3`ti'�. ,i.4a;•�t .dr{xi,�in''••a,:x•,'•;:2 x'!5 •' Y,:.tf�:r".,'. •^$•''�i .«.rn.,:.......... .......,:.•:::..•r:i{.,Y:y;:.,it.Kv%°'ttr:2c`•;Riis`,•'.?;v :•Y{ ::y:r:,,.t 7'a rv.v} y'.Y<'•::r-rv.Carr•;•4a• w, :'2.!r,, 2•}a,•c}{<y � r4}:,. ".�.v v.,n•.:. .,!4{..2-T;•S.:•:•rr..,:.»:•T,':r;f is{','.3•r0?fi4:y^ ..'Ce ,rrvw'.: Y, ,`•t' ,,. .FrkY+7:s:v{;'•;S}:ritr i4;?,i.'axe:AIL::n3i-�•.'•Y*%+�.','•o'r,.,;: v : :•« <} S.:.v: ..:^.:r,. n}• .:y:t•4�'.:}.:$f. a} .42 2•:n+;tttx.?'�.r a3 L• L. .. 'h{} �'v nr.S4a.« n,t. :;:;'"ir•:•.a,•.::t'yi':••.`o•'•r:•:Jfi�;..ir.^.sw' f.<.:ri�i:?`,:',•:•,`.,•',r :•::'y:•:?,. ;�.!r.. aS••3 .c;';apL •},y^'•'�i. �y. L�v,6.:f••°i,.` ..:E�J ',f!n$:!,cc>$:^,.3;.•r.}}aT$.}�'•�r/:rtick%...�,./' ,� y :;, r.'' S Y..;r.:Cc,`. ^ ' � 3. ;. .,,F FF�;,a'aC ?�N.i•:• .•fidfo--,r:.::.,•fi•.{er3±Y�-.•.c�?•..: �'•t ar,S. 1. } ryy r:^ 'w r,'i;yr>i3 S�yaa' ?},:; {\:`;:}'t::r+:n;:}�F,#5 :4.`{;t:+ir:+r.•.:s':;.ar:S`:r 0 � .� }ilkY,w}rfv .'"ifa}:$n:T iv}:v��X<$�'r'-'S'it}: ��'}?W.{ir,Y.f}iwf+.$i:•:Y4}: .:i1•i'.. . •• a :::•.i::v..•.:'�.. `G;{;�r{:M:•{f4^�:•?%,$R-rn } 2•<;t.`•r. \K. .$•�:iNhbx'Si:,v°:4Ur.::ry:•.'•::...»'..•.ry•....�f•..:e;;.•,.yr:..r.•.�:....:...:.$3•2{;.�;:r:..:I.:.'..:r..;LY t..,:,C::r oii.3!.;/f.e.,.}$:.,.::a,en}:L2r.rx3;,.C..,,•}i'•.ra.:•{0:..%r:•:.,}r:YRr•.a;.$t?:.Y.r}..}$v•:T..2::uT:{.^n Jv a.Y<l.:...�..:n.%.Fs.o.••...;.•`,.Y.....:.•f.:•:Y.Yf:,..r?.r�,r/.•r.aw,n:.i h.:sc 3.•;.••::,:wJ`.?.,:}.r•.,.4,:"-:r.T.lr:.r.'i.:^..,,.r.•-;..}:u3.•9.,<-..},h.y¢G$,,.sf:.9..:/{.}•,•:..':-r::•,...0?r h$a?},.Y.y.?{.,.}.:»:.$C..e::.x.C.4•.iS:^r:p.t.•:Sf}:.}i,..:'f};:.vw..Y•.hh k:W.•}:a',.`{'}Tw.:....•2.r.::..,.r.::.;r.{':+3+:.i$,:t:•.:$:.:.:.:•:n}Y3y{..r•.:}am:.•ra}^:,•.v...C.Y•a.•,N+.:,.l t.:}:.nr:•i^,:;..,:r e::•Y:::.':fL.}:,�.?T;,•:q'•2.s Yti{ry i.;:.;t}:{5:•v4.+••}{:;::3r$N.gT.)i:$5..,K}:••xrfr'.:..;rr•h•.•:.„:}.•.4;:.:Yv.•.:..r.:•}.}}{!.iY:Y.:,?a.,..::.;;.?:.t.:<:'.a t.•.;a}r.24•r}..N..,}:..,k.r,4:;:+•:iY,...$G.•:0".::,:u}.,.{c`rf<»:.:..c{{':•.#icn:;.}:Sav^.,y.;,.h t:.rYr{Yrn•,,#::.:.2r 3i:;2),.•,.::ti,:fi,:t;...4:{h yc?•'...i},+�r,.%;}..{':.ir.:.:a 3vyr<r,3axe..y::4;r,:r:•,;,rrT;.:..tic+:xt.r,4$:s.•#,..•v!y4 t•.:•.::::}?£�,a.'.r•;.,;{?•,;;.:k,•.t.,•wa..•:;a..."c,,.•:1.a•{}.C..;:.,';2:nitu.•.•:..y,.2:•:.•ri.#'.:F}+.$;•:•.:}•hY':•::}t.%.�..,:Y ,'vr:.cLr.;`:.C}n:$y}',.,%}4.!.r,,?c•;r:::.t.<•.f;Tn',::.C.t 3•Y.:;•_F.3•Y:;{r};r•.::y:N\^p.:v2h.Y}•'<.:. .?:}5•;•••`.';r•.?,:.i'$,';,s:•,�n'rL;:. :,;?c:'• 5?�G'wr$:.t••}T::?i3.'h:h.?...:•��.+s.r'L":nx'.rxY?}..i�}a a-.La�}:..;y r,7:;v:'.n v:',.a.i'{�.:.{.{$'`'{.`:t•b:;•.'.r.,4x}.:a,Y;.•.iv;.};3'....c:2 s2x.,.{,:2}.{rv.J}.:;v.;.,:#<,e.;::.,;;2#x,.B�s}:.':{:.'i+.:,hi•4•t.}{:r^Y�••a..r4: c.2,S•-:::.Tf.'y,'r,,a.,'E,!•{.,••,`.'s:,Y.:.'n.`h,.y.:^}�•N.,,w'`.fe.}:g w t.e;r.'.?^ya<.'•v.ry Y:r,.i.»}{ai.,,�.hr::h.rrY.,.•:':2'+.;.,•ra'K.�Y:}`w$.i^:�,:t:�,'•.a'.7:.h}�,,^,'x4{.Y.+i.c:`>Sa,2:•;t},..;2x.:n.i,.T:{.a'::..i}.•'...:4Lfi.'F`'�-•:'.vr:`:,{?}.•••y:':$J$• ,i:;:.2<hCar••:•{:•}�:.,r.v!.3:•.t;.a.:.?...42,2...F::v,:..i`;2r{x,•}C.T.}#:$a?i}`}•:.vr�.:a•.:,.�:,.!..'.•,;.?.{'lGi'?'a'a•},?F.Yi},{:::•,:{• :•..^•.''.}:G•;n t•,:r..#'E 2}.:'••"::•.r$::;:r!.`.;.':•K.rfK.':,s•,:}.}S y,'.a«-�{�rK:..Yr.,:}'.}-.;••.Y,.h•2:•:',i•:.Yk^;:;..;..!:n.x a{}...•;!•"Y J�.5•7`A`F{{'<a`..r:h{+#•yf'••{:,.:?r.;v?�;•r,.r.i�`•�.;Y trr:�:r:?..;,ha.:;•,,,33u x ' 2,•,,.,x r,.�},e:n.Jv$.�.'..>al.{:Yrw5,?f•,n$:v}?::.!r'3•,:?n .:.t�.:}.vM•tS ivn:•y `;Ss{•?¢'}..'{}i:.;•'j.y'v;;c.;;•}'vw '}S :: ± �:}�•r^ Y.a }T :y.#+:�;v:t a rnw NY b7:>)r ;N �$::$ ,` } •. r ...::...,{,.,...a::nr.. ..r•:.r:4.,Y...,r.-,.,,..;}:... .i:i.{'.:... ::;.}.....::.:....ny:n..n:.�5.a....q. :T.,......a:}.:.:•.:,nr":.a.,•T.✓.•r..r•::i:::•:,.::.ah.:..rr..... , •. .•:: ... ..N.. ....:. :..r.r-.......x r..x.....a}. ..n..,ry•. .v.r....'•..Yr... .......:•;;?. ^..V^' hi::.y•y.:{4T.+,;2{Yl'.:Yi$\:}.:ii•//ria'i i Sl�•,^.',i.j;'.t}•i:...:4`•... v,.. .:Jrv..,.xv,.•::::L..•:.:. $..rv: .:. .;a..v.. er••. ...:::r.,..:},?:;..:::{1,....:..::;+ '4L:'•.2Y.':` Y'•QT,::Y} n,:.h .:.?,}:.....rynv.,•••{.....,:.,..r...::. (:v}}tv+., .{• •.'.�;}.:, .».1.;•..y ...a:... ...,..:r........... ..... ... ...rv}..........:::2..4::.::. :'i:in i•:J'v vtifi$f.. '!ir.. v .. .v. .. ...Y ....: r.. .r .t ...... ...•:::-.{,.;.;..;,;.3•.:•:::• .r»:::r:�.,.::.}:r:r.S:r::}}::•::.c2•n-.:;,r.+.;;,.<}'$Y:t:•r:ra s•:Y.;•••-::.:••?'!:.,•:?•. :y.,;r..;24;••` F}:. r.:F:•: r :... ..^ ..... ........ .:.v:•:•',... ...:.v: .. ..>v:•:�,•:r:.:::..5. ,,,r..:.f.•:.:v:..:::•: ,-r;:.;•;.,r. t r.}•r - ................. ....... ..n.^ ..,.... .............. ;,{`.•}..wv,n..:• ,. r.'.:;•};:,}•.},}}Y}}?.w•.}:•v}}Y••Y.;^, ,S:{•.{:':4?•'•:?:C'}i:?iv:•:tiry:44S.}/,.r•. {4,3'?.1�{:k'� - Q.S�i.......... ............-..:.;• ........::•....f.:::..r..nvnL.....v•:...::r`...:r.:-.r.....rr.{r..^,,n.•:...,.:::..», ..lan. . r... ....... .5... ... ........ .....: ..x.,. .. ..•....}::::, ....}«.;,'r.;n,^.,r. :wi,'a}}'rv}.SKa^,:,{yi}'v:::}J,:,l{r'^?irri#F,.a;:{t:;Y,:t .xSi}.;:ti•}Lr{•` :++,C#::; ...,N,.r.::•:.. .;{...{.;;•:?•.}r..,...}.:.::..vv,......{v^..•,. .:h r. :{;.,,,,.Z :.:v:T•{Snrnx.•.....;^.v?v.v•.:....4:.h:v.>•...i:Y.$JSJn•:}. hCi•: ........;., n.....r.. r. .. rv:, },:•..r.. .... :...:.n.v n.-w:n.xn.«::•: ..::.:v,...:^ ,v:vi:::•:•:v C.:.:n'i...:•h.:. ..r.i.....}. •:r....n::•.4..:::••;i}.t3:iii+}:•$•;x.• r... ...... ..... .,. n...:.♦ :^...:. .,... ...:T. r ...2.:v;.d.v••.•v;nNY:r:. ,...;,{•{. ..r}} .... :...., .i.... -.,. / ... -. ...r.. .x.•.v((:::..;•:::.}Y'.n ... ,...}vr.. ... -.Y:}r}'{;:•v:w.. <'•:• y}� y� .h:?.n3?:,{`v;}:C{,}Y{m ...:n...:.:...^...a.., ..: n n•}.r:...,. ...r,.... ,.f..r.. ..1.,:.: n•:..a..}::.... .: r.J-.w,i,... 1.,:•^.....:.::•:+' hoti�: .•. :...: . $r.4..r........,.,...v..err...n r. ..t.. ...?.}.v...,M• ...r .....Y...r ....Ci C. ..:. ..!•3i•v:::;}.. .. :". .;}'�� •F.},::Y;•YY.v+i{t'?f::^{ r..... .. .:... .:•.....-...,..»...y...Y...{. ..., :•,...r.. ..t.:.a.}.:...f. .,::r.....{.:........r. ,.....-..... .yi!a+>}Y•.. ..{...:' {�•:$c•,$i,+';3#;�FIY•{0." ...,,.i,,.,.3:r.,...+1.•:.. C...:: r.::•«.T.•: ,.:. J•.,...:• ......nr ..x:a.:..f.:.r.r....:.{:3::..:_..:... .. ..... .......:.�.:.. ,r..,.Nt$:rf.5i}...;,. •..a.u:•:}..;..n:/,.`•4• .: •:. I 1 n.3..:nv.v,r..:.:. :r.S<v+.{{. •r. ..:,•: :YA..:2v.TS'ar:hv.¢.,:}:vx.•r...::::......... -....:..: ......v::v•„ ,r. ....ss..Y..!!Ni$$y',%?:i$#$>.: ::i2•r a$}. ../.:$r`'.;L2•:+v:S {Y.; 4,.,r•}k• inn{.,:.•:a v•• v:: .:.,Y.•�-.+.rxh• :rfv: '^:••?•.:,..:r•:;{,..........r.. ... ... ,.; ..n.- :4 ,:iCx. r3r• n;ia•v.?,: ry••N:•Y:v$}l'.^.:hr•a.;"}::;C... Y-- �. :.::,...Y..,:3 4.,:,.:.$ ^,_ .:3.;?:.a.}a:l.r. ....,... :!4nrGa �j•,( Y. frry.3: $.. i.t.: :•}{i:? }M; ..t•:!r•vrr}ry•iv'?:4:2Y:;Y :�•., ..{,Y.N :a.ir:,+ryrn - S I.v•«..Kr...,f+ ...2:^..}}:..1......r.r.. •...pvr.•.•:.......:• ,n r...v;,-•, .,};:� .::':r .. ..a...: :.... •:.:r 4:a;y•rr;v{{h:c.{;.:, iy:t'g;^.': :.;r,.•, `},• .;,.}..fls,G;3;?;;r;2•:.g.�. .. ..,::........... ........ ;. .,:..N:t•..rT:p•...r..::.......:,.:.,.., ....,. „.:....rr:«•::,. .,.. ...r.,u.:. rn�'.}., ..C:,^• ;:.:.. . .:.x.:a.. .. .: :.. .... .. ........}.:. ..r::.:•:.::..h:.....^.•::,••:»: v. •'.r ..,r.:•.E'-.Y^•..:.. ....i• :::?$•aY•.,..,f':- •''3 y„#�r:Yr•::.ir..'rc::;::.}S$;ti.:..::;:? .,:ti..`::{k';:%{.': ......vx•.v:.^xk.:,.N..{rr...,..,...v.^::.^,h..:.ivv.....nv;:,••w:r r. iv....}..... r r...:;2:'' K r ..4e �..+.r}... \T.,. .{ h;' ;l{..: .0 .....«v.:...r:.....v.r:..$ .v:$:..Iry..::: .,rr av ....r..•....::!,v•...}:.v:....r.::.:Y. :�.^•..i.{,:,- r:« .,}T ro....:.?....ry...,:•...-.{,. .r..... ..j i...i.r...G.. }.....}:....,:........r .,..:..r.-v:••Y}fiT':T-${:'v`{•r.• :Y'i #•y;#T2:A+'w • };;''r'J.-v 2•:i1'tv}•:`{..:..vi'1r,i.:.>•..:a::•: •rr:•::..}:{.r:^..::::t:•:.:;:•::.} :rr::4?•:.::.;.:•:.,;...;}. .:.n.::r.}..:}..r....:.r:!,:{:,$vG,. :r.�-r.••}ate...,-:r.•,K ,.a#o:.••r�3` ,:.:}:;:.}Y•..r.......... vry{:•:•lrr•xr}:•;.•.�:4.n :;..4.N'ra.l'1..4::-!:v.+r<.hY•rr�. {{,- w:.:.;:>. ,.....<.{.t<:•.:• :.{;.•:<"i•�O�E.s� ..:;::,.;::^:;!:!v•.PR,;.u:'iJ,.Y:{•.»'$!Nv{rr$:::x;.. .,,i\x^'r.•.'+•,,{.,-{:.}..::.v},L.:.:•:.v. :v}�i:i' {'r,.:.:.v,:+}•r:.f.4 ,.v;}r::x;a}.4 "2Nv,;%,i,..Yr.::$.•:?{:'••,..�-;{.v{rTY.:n:Y.•}; .' /. >~r:N�r.}:err:{.,:,.y?;:::�:....:..:.f.:^•...:.::...,... :l aYaare ...., enalties of a ftnenp to$1,500.f}0 and/or Failure to secure coverage v regttired ender Section lSA bf MGL 152 caytlead to the imposi,a fine cf s foal p ^ rJsonrnent�'yd1 as dull penalties in the form of a STOY WORK ORDM and a fine mcationOU a dap against me I mtdersGmd that a' one years'imp ed a the Office of Investigations of the DIA for cc ierag Y copy of Otis statementauy be forward `> _ - vveisltv�au d..c oire c't I do kereby-eertifyun�erthepaires curd persalties-of-perjurythat,the-info rmiation-prauided�tb Date �t7��hZ - -. Signature - �pl-�3�/- 77a7 • .��• .. �....'�• All tat name do not write in this area to be completed by city or town omdal ofjIcw Use Only [{Btuding Department perntitfliceme# QLicenring Board dty or town: ❑Selo rLej's Offir cantELct person: �` . , r Information and Instructions for Massachusetts General Laws chapter�152 section 25 zequires all defined employersersonPm the servicerovide eof another under nany aorrhact employees. As quoted from the `laweir , an employee is rYP. , 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 Job 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 ham 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 repaird to be an emplo work on such yer. house or on the grounds or building appurtenant thereto shall not because of such employment be de p ye1; MGL chapter*152 section 25 also states that every state or local licensing�ge cam���for an he,a u licaat who has of a license or permit.to operate a business or to construct buildings to Y PP 1,11.., 6r the' not produced acceptable evidence'of compli o enter into any co�rthe insurance rage actfor thelperfounaaceoo public w rkuatil commonwealth-nor any of its PCIrttcal subdivisions acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority- Applicants Please fill in the workers' compensation affidavit completely,by checking-die box that certificate of insurance as lies all affidavrts_may be pply�g oompany names, address and phone numbers along with • ed to the Depaztment.of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and �n submitt date the affidavit. T7oe•affidavit should be retumed to the city or town that the application for the permit of license is artn of Industrial Accidents. Should you have any questions regarding the'law'oz if yQu being requested, not the Dep ber listed obtain a workers' cpmpensatioitpoliay,please cZl die Dep afthe num below:: aie requlred,tb r / City or Towns .� Please be sate that the affidavit is complete and printed legibly. The Department has provided the applicant.e at he Pleas 6_ e lease it for you to fill out inthe event the Office of Investigations has to contact youregardingr af ein�irmztjlicense nu�nbei whichwillbe us_d a's a reference num�ei.�'1�ie affidavits maye're _tF?•.. be sure toeiit `email or FAX other arrangements Have been made: the Departm . y.,�„ ,. ., estigations would like to thank you in advance for you cooperation and should you have any�uestions. . The Office of Inv s ,.. •.,, s. J;. .. _� _. .. - please do not hesitate to give us'a call. The Departments address,telephone and fax number. ,:�,,,.. .. The"Commonwealth Of Massachusetts _Department of Industrial Accidents amce of 1nvesilgatlalls 600 Washington Street Boston,Ma. 02111 fax ff: (617) 727-7749 _ _r 5084570649 OCT-17-2062 11:04 FALMOUTH LUMBER 5084570649 P.01iO4 MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2-01 Checked by/Date CITY: Barnstable STATE: Massachuse-tCs HDD: 6137 CONSTRUCTION TYPE: I or 2 Family, Detached HEATING SYSTEM TYKE: Other (Non-Electric Resistance) DATE: 10-17-2002 DATE OF PLANS: 10/17/2002 PROJECT INFORMATION: 361 BAY LANE CENTERVILLE COMPANY INFORMATION: CHILTON DEVELOPMENT COMPLIANCE: PASSES Required UA = 304 You..r. Horne = 243 Area or Cavity Cont- Glazing/Door Perimeter R-Value R-Value U-Value UA ---------- -- - ..--------------------------------- __-___-- -- 1.7 CEILINGS 0 WALLS: wood Frame, 16" O.C. 1804 13-0 0.0 148 GLAZING: Windows or Doors 156 0.340 53 FLOORS: Over Unconditioned Space 496 19.0 0.0 24 I•TVAC EQUIPMENT: Furnace, 84.0 AFUE ------------------------------------------------------ ------------------------ COMPLIANCE STATZMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate,. has been determined using the applicable Standard T)osign Conditions found in the Code- Thcc HVAC equipment selected to heat or cool the building shall be no greater than 12596 of the design load as specified in Sections 780CMR 1310 and J4. Guilder/Designer Date d RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 �S• Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/BENOVATIONS OF EXISTING SPACE p y 10 square feet x$64/sq.foot= 3 60 x.0031= -`7 •;22, plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x .0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= � (number) Inground Swimming Pool $60.00 Swimming Above Ground Sw g Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) . Permit Fee molcost BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number;.CS: 062443 w- tpires 66/13/208�Tr.no: 10499 es r c ad To,- RANDY BERN _ 50 ROSSUM RUN ...aa DUXBURY, MA 02332 Administrator 91te R Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston. Mass setts 02108 Home Improvement=µ ontractor Registration Registration: 120484 Type: Private Corporation Expiration: 1/9/04 CHILTON DEVELOPMENT CO INC , RANDY BERN PO BOX 534/ 130 CLAY PIT RD MARSHFIELD, MA 02050 Update Address and return card.Mark reason for change. CI Address n Renewal n Employment 7 Lost Card 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: • Registration '�720484 Board of Building Regulations and Standards + One Ashburton Place Rm 1301 _ Expiration ;.119j04 Boston,Ma.02108 Typre Private Corporation CHILTON DEVELO`PMiTiVT CO INC RANDY BERN PO BOX 534/130 CLAY MARSHFIELD, MA 02050 Administrator Not valid without signature 4, 2' 6' 8'-6" 1 '- 11r 81 T axldot e7 e a{ ` �=tl s Proposed !Mpirovomehi s ChRtor Deve � o m6) nt c d m ca n yDa sco, � e = 1 / 4 361 :B a y Lore 10 / 1 � 8 41-1 10 L J 30'=8 1/2. . Chlltcn Deve* � d meat C c rn air D a � .e P y scale 1 / 4 36. 1 Bay. Lane 10 1 1 / d . 1 �7ul ow Mt Nunn By - am �� f _ _ RIMENOW win EM �� -sa- �' r --� :� �:.'-�`-.F-�._w�;�k.'�.-�...ra:.�.�§_ �=r �'f"�:..��-4`��p"-*''- _�`.��'__�•�_�--,.->6.-_ �-��-'�- - `.':was: a 1 PH { � Imin r i . WIN. i f ' `oFt►+E T o� The Town of Barnstable _ f Y BARNSTABLE.g Department of Health Safety and Environmental Services MASS. f6yy' �0 prfD 39- Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection P Location I ,V4 10 Permit Number 3-3 d Owner � AS l'A t Builder C H One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: L \�Q RIJae.7 o 6' r C;4-e-c Please call: 508-790-6227 for r�eein1spection. Inspected by Date I;-` Z13—C TNE iq The Town of Barnstable BARN STABLE Department of Health Safety and Environmental Services , �EDMA�b Building Division 367.Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Location ,,GzM 11 Permit Number Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: r � �`►r�..:.�-�'(a art. n,�01, P oT,V\,* 4Pf fit.,z Please call: 508-790-6227 for reeinspection. Inspected by — ,�-G�,.�...� Date � � � 7 ,,Ass_ssot's Office(1st floor) Map / _'Parcel U / Permit# 3 3� Conservation Office(4th floor)(8:30-9:30/ 1:00-2:00). �. Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) '"' �1��' �`Fee, o—_6 Engineering Dept. (3rd,floor) House# 3(a I 0� �Ne r p SEPTIC SY T BE INSTALLED IAPICC 19 NVIRONME TOWN OF BARNSTABLE TMV19 R,2GU r,ti T, Building Permit Application Projec a Address 3(p Villagey ,LLa p ' Owner AS 1 Lt 3&56—PH I\ . R�l� Address Telephone 506, —7 Permit Request 'First Floor s a square feet Second Floor k square feet f r" Estimated Project Cost $ ®t�. Dy'D, f Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family :i/ Two Family Multi-Family Age of Existing Structure Basement.Type: Finished Historic House Unfinished Old King's Highway Number of Baths 3 ( -Z No.of Bedrooms Total Room Count(not including baths) '7 First Floor Heat Type and Fuel„_( �(L_ _ Central Air ,p L Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Cy i+!LTbt4 D�(t �ry C=Jvw(,�� Telephone Number (o)�Z Address - P 6 13�X � - License# ©6'Z Z Aa2,s5('j Home Improvement Contractor# r Z D O L Worker's Compensation# (,J 6-P 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 SIGNATURE I DATE lU BUILDING P I DENIED FOR TH&OLLOWING REASON(S) FOR OFFICIAL USE ONLY kRMIT NO. 1336� DATE ISSUED MAP/PARCEL NO. VILLAGE 6 ! t ' + � Y' • ADDRESS + , OWNER .� 4 a ► i ' ' - r � k � -' A DATE OF.INSPECTIA.: FOUNDATION FRAME t ; INSULATION 1 FIREPLACE ELECTRICAL: ROUGH FINAL r _ 4 PLUMBING: OUGH FINAL - 1 tr GAS: _ ( He FINAL + 1 { FINAL BUILDING T DATE CLOSED OUT tr f f r i ASSOCIATION PLA NO. Bs 1 ■■.I ■■■ . �— --� I�'swill.III = ■i� ■■ ■i■ Q j jl ■■■: oiml ■ �o �Y—� �o� � � � � - .. = � u.a.!..!ui..ui■.!■!■I� I�I■ICI■I■:■I■I■I■■I�■.� � • I I ww�wr dr■-11w\ sour.=�rrau ■iw.w.www�rr.w-r.► i�ruurmuwr-rrrwrr: - t�uuu irw■iwiiuuwsrr-r-ram= \w_ • �mmwmrwrraruwr■rwrrwwwrMw v.► i■.w�.www.wwrwwwwmwrw■w.w �.r■ i■rms-rrwwr■urr■wsrwrw■rrnow �■r iroww - rw■w■. v rwrm ore: --- --- ■wu s�i■rii■urz �iiwo. ■wrr SIN ■rrr ■/ �i�l�l■ /'J rme _ ��■� ■�■ie■� ■���! ■wrm . un C urn uuun— rwrr i ai�ri ■i■!■ ■111! �iiww�o �!r■ �I/■ ww■ �■ ■_I■i■I■ ;wu zwwnrr!//i1 !■I/I�I�I■ /1111� MEMNO■ ■i■ie�� ...■ -■ IMUM room.. ro-ro■o u.rwww-■ �o ■oi■ ■rr■ ■� �I■ICI■ ://�i rn ururr /'/11 �I�I■ICI■ /IIi/I urrw rumm�ow ,.�I� ■■I■■'■ ■�_II�' r■rrworw—m IL emu II®1 �I I ur urrlwr� mom son■w.-.w.■ �o■r-rrwmal�irr ■���� urr ■I■.■I■ 1.1';■rI Iwwrmru ■/1 ■IIi■itl■ 11111 uum �r-w�rm■N ■i� ■�■I■■I■ ■II■ �-rww.w_ :��=����.■�_ ■■.r��I i I .rrmrwrrr- -swwruw\� -�� r� r- w '��011 �■Ii■�■:■i IJ�II . nr■mwwww-Nrwuwrwurmwwurrmrrumr■■r -- - r way.arrr�rwrrrr-rwr■wr■awwwrwwirrr■ �,�,i - w��wrr'w�r�rwwwrwnwrrwwrrwwarwurrr rrrwr�ww�wwrwwrwrlirllwwr■r■M■■1��1■/ 1■■■1■■■r■IIfII■■■■/111■■■1/■■Y■I■■■/11■■■! rrnmlwwrrrwur _ �: � �r� IuwYr ■rwr■ — ..`� y mlrwrrrmrrrror - son ■■—■rrr e rwr�l or:r mmao i �C, nwwrurwr■wrrz ■rr Iworrwrrl N�ri�Aii �rwwr mrww' � ' I 'r�� urrurruwrrr �� �ieeie ��' u■: arrow.■ ■rrY� lrlr wrME f ' i �` ■rrrYiwruuw mow G■■rruw mrrwrYrrww rrwwi rmr uww� "a; c S ° zrruuurrrrw 11 ■I■I■I■ 11 ■w■: rwrrrow■ owl mom rr♦.wll�'�Ir �wwr', �' •Y` \� mwrw■wrrrrr■wl ■rr wwrwrwr ■w1.Y.rr.Y M I■rrG' -■r•�1 s ei �/. ` `I w�';�>`�t't,v',,, rwuruurrmrw 1■_ ■�e�■■ L/ rw■: IwrrrrMI i�irrr ■iww■n mYrwr�■■��www �ia�...y�/ :I . ;''6 ♦ ■w■wr■rormrr■ -i n■ Irrrrwrrr wr■rwwwwwrmrw� wwwuruwruw 1� ■I■■■I:Ii Ern ■wrr-u■ ', I I mrwnrwrtrwm ■wrrrr�mrrmrrw iys' ''.. i��<y��t�4 sa i.', wrrw . �wu�iirr -- -r�iiinrirzwiIiO■ Irrl■r.uuur//� \>°v < . S y ■-rwvouwuuwrmworamarrr■ rwurrrm rw■wrwrwmrw ■wwwrouroruw iy�<r > z < 9wrr-wwrurrwwwr+wrrrmworro■: mrrrrwo wwrrronwr■w `- wrumwrrrnrruww� :�>frwrmwrrir wwrr■r�■r� � v�■■wuw■n■r� .wrwwurwwuy I�L l--■Nw- arrr -fir �rmIrrarmuuwwq- — __ /m w.zfriwavr w.w��wr.rr .�w- -is sr�r_■+�I �ww-. .�� mil' #,����!..... - - -- — s- wNN�i :'.',11',I■I■11■ ill a .w..o..wwww.wus..v�..o. . �srwNNo\wwllwNNn•Ir•\I ��'�.......��.�w.w�w..»:� - _ N•nNNrN.wr.rwr\N•r•\v w.��.Mw.w. ww...w o. I'•Ni�u\N\M�•�� •rw�.w_mwu=wwioiiwwiwiwi NNIrm.W% KNEW ON .tee ��: �Zwwtw�rsww�.�wrr���•N�mwer�ova wwwi: ■00_ u�u so mNwwwlM.�wwlR%mt=M ■■l o.w......ww.au.wo.v.�w.ws.w-o.o.. /�;?. .....�rww..e.�w.wN. ■.uowwww�.w�wwww.uw�.�r.wwur..o •r;:. mi') ..wL....w.a .w..ww.ww..w.n...n ✓:.G: �waowwa�wsww. MMMM.rwwl.Mwu.www.w www w iw . Wr�N.ww . 'Lha: � .ww.wwa..www.rww....�.vrma—MESmmumm yell ruwrNw pP1 10ie .r.w.Iww.1.w0O�.wwwf�rrww.lrrrr.rlN \uww\wlwNwNwN\W ww�11w1u�NwNwr1 ww�= wwwwoww IMIS... wwwra�u.w.wwwwswaww�.w•w.�...�.�wwwww u ■ww.1....M�_.I.Iw.1�=�.Iw1�-���-w.l ww�y..wwwwwwwl. � u W w.�uwwwu....w.ww.0�.wwww.wuw w...o.wN�..ww.�. 10 no rL 4'_p, 'L'.O' SCREEh15 9-0- -g',O W%LtooWXIJT. Gx6 POSTS lr O - SCREEN UTILITY o ROOM N O O n SL A8 oN GRADE7 4 FiEMOVEEXIST. DOOFINAY WALL. A00NEW _M1CR0•LAM BEAM W D O Q O s MODE WALL -. - OVEPa EW J y KI - w NZTCPaO LAM W EAM F BCra � STEEL $1=aM Afb0�6 N Rr/ALLO rvtslPslr O N REMOVE EX15T1NC�-- CHIMNEY QGLOS T• - -. _.I • MOTES REMc.T/E CLIPPED CORNER TRIM.ADD �,ALL CONSTRUCTION SHALL 0E IN CONFOP,M- Z-gA1J50M5 P. ANCE w/THE MA55ACHUSE'Cf3 STA.T6 GARAGE OOOPSS BUI%-oIr.1Cq CODE ♦ ALL LOCAL T-ow,4 CODES. _ 2.ALL OIMENSlOwS SNAI-L BE VEAIFIEO W T-ks CONTAAGTOF, PRIOR TO THE STAgT OF COw15TAUCTION. 3�1NDICATES EXISTING Ep, SED &,omITION TO 1 A BA`tFIRST FLOOR PLANTE�V4.'v00' ST F�.00P, PLAI.I OAAwN w Owq 1.10 A•M.M I GN N I s'-w OATS 2-9G 4. 'o II I �I I is is l O I j it I II'I r i . ............. NEW DOORWaY =. �' �Zg0.Y Ca,Lttty it MOVE C LO SET t W A_�OV EPA O I O :FAMILY � o .R OOM - wAt_I�t I r.1 c�a WALK-I�l ct.q _ p CD9,_3„ 5, 1 3„ I p OPEt.1 To O O BELOW II �f11 � 4 V AN1TY -� _...-- ------- i -..._. _ T tJ a TO 15% SEt_ECTEO - - � ITTII I; (II I'; tii'I�:I. IE{jt Ii:' I:I I:I © 0® 1J OTES I.-..ALL cow5TP.0 TtOAI SHALL @>ETN CC"- FORMARiCE W TF4E MASSACHU5ETS5 STATE OUILO�NC� CO E i ALL LOCA.\--row t.l CODES, EXISTII! 16'-0" 12'-O� 12'-O" 4-ALL CtMENSIONS SµAt_t_6EVEgtFtEo 9Y THECC��ENEF�AL COt-aTP,AC'Tgq PRtOPa.TOT�1E $TAA`T- OF CO�13TP,t.1GT101.1. 24'-O" 9�INDICATES eX15TINCj r , P90POSED A.00ITION! Ta ASIAF RESIDENCE S E COtJ� FLOOR P L AI`l CEtdT gvlL EµMA. SCXL.S '/4". 1 LO" SECOND FLOOR PLAN oAAwN »Y owG do A.M.MICt-1NtEw1GZ 9 G _J I RIOC�E vENT II O" I IL 12 PsI 50A.R0 '1 i2 �K IO RA.FTr-vSs C ---- 'Lx 8 C 61LIU GG —14- y2"Cox SH�CATNIN� — � Irt ASPHALT SHINGLE$ �, b� 12� Lv.4 S-rjo5@IG"aG IrL r2° COX SuEATLAIt--ICj _ \rL RA7TER5 G1G"0.c. 14 2 x tO Jot5T3 @ IG"C.C. !rl-�4 2x6 CEILIN� JOISTS@IG" ' ASPv,nLT 5�-111J�LE5 2x4 KNEE wALL 51r0 SUBFLOOR O IA L 5 (I 2x"10 FLOOPaJOISTS�IG" - 12'-O" S�UOS V'L�CC7X Sµ`;ATH1N� __ P,EMOvE ExIST•—�I I S-2Y 12 WALL FLOOR J IS-I•S TO MA_Tr"N STrSL 6EAM BEAM. X\STIN BE`tONp (�N O N V-4 4 '-Y Co>i6 GxG Ex15TINCj i tx6 S\LL APT. POST POST I T\ON c4 1-1I�,i W'r-rq. _- SCALE - j i DOOR SCHEDULE CODE QLIAPI. SIZE TYPE OESIqN REMARKS p 1 5 2=G"x G'-G" \-I INCHED GPALIEL,.WOOO S ECT I ON p E T 1 V-O'x G'-G° 1-11NgF-0 C.PAr.tEL,WOOM $GALS : 1/e�4;II-O° -3 IPR. 2'-G"x G'-G" B I PARz1NCq G PANEL,WOOD 4 2 2'-8°x G'•®" H INCacD G PAh1EL�5TL- „ Y.IOTES 5 1 3'-O x 6 -8" HINqEO SCREEN 1. ALL CONSTRUGTIOtJ 5�-1A�.L gE IN•CONFOP�tJIQNCE W IT+d THE MASS AGNu 52 RS STpTe OUiLOING CODE Q ALL LOCAL TOWN CODES. W INOOW SCI-1E0LIL,E 2.ALL DIMENSIONS SHALL 8E vERIFt�O g`t TuE CONTRACTOR PRIOR TO THE START OF CON- STRU CODE QUAN. GLASS SIZE ROt1q1.1OPLiCq. CATALOG 1,4umaER F�EMt.RKS A 1 - .j8oxZ1�� RIVGO 32�24-60Co -TRLlEO\v\OEO B 2 - "LVx49" R\VCO 20/20. 404 PROP05E0 ACDITICN TL7 C 1 - 30"x 49' RwCo eL+4/'LO-GOCo A51 AF F3E'S10ENGE 561 6A.`t LANE D R\vCO 44310-4-4-04 CENTERVILLE�Mla- E 1 - 1'-g°,,4'-5" R\VCO 54.4-IL - 4-404 SEGTIOtJS SCidEDUIE F 1 - C'-S"x 4'-5 R\VCO 44VL- 4- 404 ORAwN gY OwCq,NO- G 4-'-5 RI1/CO 5 5044 - 4 A.M-N1ICHNIiWICL H IL - 30"x 55" P,IvGo 241'L4'-Goa LATE 2-qG l r� Randy S. Bern ' - 617-834-7727 President 508-539-2621 Fax 617-837-1989 Chilton Development Company, Inc. Post Office Box 534, Marshfield, Ma 02050 �• - The Conzinot t'ealth oJAfassachusetrs . Dcpartntcnt oJ Industrial Accidents -4 i' . a` 600 Washbig n y ri Street; �, Boston,Mass. 02111 Workers' Compensation Insurance AlTtdavit AFMIlc—nf nfennarin'ni ' Please PRi1VT 1` 1 «•-rr•-• name: location- 64 FTeau I LLAS- VVN A— nhnne#4Q,3=?71--8S67 I am a homeowner performing all wort:myself. - I am.a sole proprietor and have no one working in any capacity Yam an employer providing workers' compensation for my employees working on this job. comply name: .4I.L � �>f�Pi/11�"rt C�✓�^(�r�►�I � l ,f1 address: gyp• 2:�4 4— _ cih•: M,624Prti:Dcr T !. -AA— 0,6C10 nhnne#: c.1i 7 r' 5 2i-7 insurance ce. JS�� G.�,U�.'� I�S�fLd�Gt' R01ItS•# ,�5 C�/�o��DOS Z. 1 am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: _ company nnmc• address• citv: nhone#: insurance rn policy# l.'=::'�"..' N'.T�"' — '._ �+erne✓...4:.� ';Z:��r'?���",—_- -- ------•���'t'�%�!�ef.7Z!R���'L'r�"y7..A443?S!AY`�_?R ctimn Inv name: address- city: phone#: inseMnrp rn o�lia# :Attach addiddi2l'sheet if nice i y�:••�}: Y:� :mot'_ +�!�`.:- '��w" ';,�, fairelu to secure coverage as required under Section 25A of 51GL 152 can lead to the imposition of criminal penalties of a fine up to SI.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of S100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Ofrcc of Investigations of the DIA for coverage veriffeation. I do herebt•cerrifj•un the pairs and enalties of peryuq•that the infotmmtion pnndded above is true and clotted Signature ate / Print name B Phone#j�'�—-,`N3 4---7-7 ofl-Jcial use only do not write in this area to be completed by city or town official city or town: permit/license# rnBuilding Department (3Liceasing Board ' check if immediate response is required OSelectmen's Once C311ealth Department " contact person: phone#; nOther Im•ued9195 PJA) Information and Instructions Massachusct'ts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an emplityee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An empinyer is defined as an individual, partnership,association. corporation or other .L-gal entity, or any two or more of the fore=oin enga-ed 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 dwellin= 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 1.52 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the in coverage required. Additionally.neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. - r. lei.♦. 77 .. - ... .. • .:.;. ... ... - :!. fw'+••f.:fi, �.a: .MCµ ne[:•.•`_ Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and 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. 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. - � ,,.. .-...ter,..... .1'.•.... .. ..... . :.......T r.r ».'. .•.lY ii/.�j h...��.r.b.:J�w x�r .�',�{,U��•^T t.w'i`,]S� .� •'�+sX%ry"�-�'��5: y City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to 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 questions, please do not hesitate to give us a call. _ . Tom • p a.c. _ � �_ ..: ..r.�..-r-: . .. . :.Yi•..�•`.:.:ar•. • -s .wci.•.«•6u.Y ,.ui- rw.:•:.» The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations ... 600 Washington Street _ — Boston,Ma. 02111 fax#: (617) 727-7749 -. phone#: (617) 7274900 ext. 406, 409 or 375 . . : The Town of Barnstable ' erg De artment of Health Safety and Environmental Services 1659. `° p Building Division 367 Main Street,Hyannis MA 02601 Ralph Office: 509-790-6227 Building Commissioner Faye 508 775-3344 For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,,removal, demolition, or construction of an addition to any pre-odsdug owner 0ecepred building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: Ap=�_-Ts, �� Est.Cost DL D dd Address of Work: ' �3 1 73 `e Law Ovmer.Name: S Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law Job under S1,000 Building not Omer-occupied Owner pulling own permit Notice is hereby given that: CONTRACTORS OWNERS PULLING THEIR OWN PERMIT OR DEALING wrm UNREGIST ERED FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hcrcby apply for a permit as the agent of the owner. Contractor name Registration No Date . OR ' Date Owners name Z, COMMONWEALTH - — ' OF DEPARTMENT OF PUBLIC SAFETY ONE ASHBORTON PLACE " MASSACHUSETTS BOS TON,MA 02108 EXPIRATION DATE LICENSE 06/13/1997 CONSTR. SUPERVISOR CAUTION RESTRICTIONS EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST 00 0 05/11/1994 062443 THEFT, PUT RIGHT THUMB PRINT IN APPROPRIATE o >° BOX ON LICENSE. RANDY BERN 5 Z 50 POSSUM RUN BLASTING OPERATORS PHOTO(BLASTING OPR ONLY) m m MUST INCLUDE PHOTO. FEE: DUXBURY MA 02332 �2 L3(L.. NOT VAUD UNTIL SIGN LICENSEE AND OFFICIALLY HEIGHT: STAMPED-OR - _ _ c`c i Ci�� THIS DOCUMENT MUST BE _ f CARRIEDONTHEPERSONOF - « SIGN NAME IN FULL THE HOLDER WHEN EN SIGNATURE OF LICE OTHERS SIGNATURE LINE 'OTHERS :'_. 1(AE PRINT GAGEDINTHISOCCUPATION. ,7 —�DDR[IU�pLLTu I HOME IMPROVEMENT CONTRACTOR Registration 120484 Type - PRIVATE CORPORATION Expiration 01/09/98 CHILTON DEVELOPMENT CO INC' RANDY S. BERN G� tal 50 POSSUM RUN ADMINISTRATOR DUXBURY MA 02332 I 3s edge of water Q'V 715 ' � a / �� "•— /� d line_ wetland �// 1 Q�m 01 O c / - - 8 - -- -- ---- \ 0 C \; PROPOSE[ 1 / --- `10_ ADDITION • / I I ' Patio ' shed z ' 1 1/2 STORY Stone patio. � / / CAPE . Garage : . • - / � / Finish Floor=12.35 000 L=264.13 Assessor's map and lot number .f4.7��......�49,../............. AL /l C�THE t0 Sewage Permit number ... �fr .•A . ....... . .. 3 1 I rIL E House number TOWN OF B A R N S TA-B REGULATIONS BUILDING' INSPECTOR ,,- APPLICATION FOR` PERMIT TO ...IM...... ..�........ ,G�he ..r!'a� ..................................................... TYPE OF CONSTRUCTION ...... ......................................... Cl . TO THE INSPECTOR OF BUILDINGS:The undersigned hereby applies for a permit according to the following information: - I Location ... .%............ .......t : ...... ..... ..................................................... ProposedUse ............................................................................................................................................................................. Zoning District .....�ce1 l4 ...........................Fire District ..... %F+®. .' ... f ,. . ....: ,; &°!✓�ZL: � Name of Owner ....A�. f/L..........*1e. ;r.s.1•�✓I�o%�,/d�.....Address .... �.<.........1���.�f'�C:....�.eF........ 014 Name of Builder .... .... �� � .�!.........�/.1A-1A1............Address .......���`:�'��''°�.�e��... .Name of Architect .................................................................. e - Address ......................:............................................................. Numberof Rooms ....... .................................................Foundation ........................................:.........................:........... Exierior .......................................Roofing .....fKgA-11.%1-7...................................................: Floors O.O.P ....................Interior ... '( ............................................... Pleatin g ..�.:�6.;i'I�.�......., ....:....................................Plumbing ......G(.�e�/.�............................................................. Fireplace .......A11 .M.E..........................................................Approximate Cost S© ........ .11:............... ./................................ Definitive Plan Approved by Planning Board ________________________________19________. Area all.0... ............. Diagram of Lot and Building with Dimensions Fee `�.°. ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH ft e lrfl. Room -t'"aVau$�,�' A S®V F- �.tl• ,- I ,r i a I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regar ing the above construction. a/ -- -- r Name".:- -. .o............:..:...........:........:...................... HUTCHINSON, PAUL No ... ... Permit for Dw .................................................. Location ......-1,61..Bay..Lan.9................................ ...........................Centerville.............:.............. ...... . .... .............. Owner .....Pa-ul.-Hutchinson............................ Type,of Construction ...Frame............................ .. ................................................................................ Plot ......................... Lot ..................... ............ l Kermit Granted ..........ja)Wary..1.8 .......19 80 Date of Inspection ..... .... .............19 Date Completed ................... ....1958) PERMIT REFUSED .... 19 ................ ........ .... . . ................................ ......... . . . ............ . ..... t , ...... ...... .... ..... ... ....... ....... . . . . ................................................ : f ` Appr .................................. 19 5 .......... ................................ co V . .. ............ ............. ............ r , ZZ4 TOWN OF BARNSTABLE PermitNo. -------------------------------- 1 ,mn.,c ; Building Inspector raaCash ------------------------- g OCCUPANCY PERMIT Bond _---- "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ...................................................._, 19......_ _ ..................................................................._._M......_......._._.. _. .._._._ Building Inspector TOWN OF BARNSTABLE "LOCATION ,7 [ SEWAGE #_ VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME 6z PHONE NO. ,4A 13 e—'e G`/ SEPTIC TANK CAPACITY 16 a--d LEACHING FACILITY.-(type) ��o ���1/�• (size) NO. OF BEDROOMS 3 PRIVATE WELL OR PUBW WATER BUILDER OR OWNER �,;,, ,y r DATE PERMIT ISSUED: DATE' COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No`- i�oal r . X2. r � '. / r .01 IN 2.6 y , 3.1 1 1 / 6.2 . yo�7REtp�° TOWN OF BARNSTABLE Z BAUSMULE, i "6 9 0 q BUILDING �NSPEPTOR � PY Ar• APPLICATION FOR PERMIT TO ...�...... .. ... ✓I..... . ...t............ ..... .............. ........................ .......... TYPE OF CONSTRUCTION C3Co 1......2 . ..�G�?:.R.)....... ... ... .. ..... ..... .. . l�f ....... .............19...1.� TO THE INSPECTOR OF BUILDINGS: The undersigned hereb4alies fo permit ac rding to the following information: Location ........ ........ ... ... ... ....................... .................................................................................. ProposedUse ............................ . ...... .. . ........................ ................................................................................................. ZoningDistrict ........ ...............................................................Fire District ... ......................................................................... Nameof Owne .. -... .:.......................... ......... .....Address ..................................................................................... Name of Builder ......... /�i72 ..................................Address .................................................................................... Nameof Architect ...................................................................Address ................................................117. ................................. Numberof Rooms ..................................................................Foundation .......................... .......... ........................................ Exterior ............ ..... .... ............................................................Roofing ........... ...................................................................... Floors .....................��....................................................Interior .....................-�..................................................... Heating ...............................:..................................................Plumbing ................................................. ................ ............... Fireplace ........Approximate Cost �..... ,,,, Difinitive Plan Approved by Planning Board --------------------------------19--------. Diagram of Lot and Building with Dimensions i L/ q l ,e hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Molloy, William & Stella DEC 31 1971 13 �... Permit for , add greenhouse No ............. ...................... to single family dwelling Location 361 Bay Lane .. ............................................. Centerville ............................................................................... Owner ............ illiam & Stella Molloy .... ...... i Type of Construction .....fre�glass } . ............................. Plot ............................ Lot ................................ Permit Granted ..March 1...................... 19 Date of Inspection ...... - ....... ........19 /r Date Completed ....................19 PERMIT REFUSED ................................................................ 19 t ............................................................................... 1 ................................................................................ y ............................................................................... ............................................................................... Approved ... 1 ................ 19 V3**O"'* .. ................. ................I.......................... ........ I