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0007 BAYBERRY LANE
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I I ' 0,�!�i "," ,;i`0 WE �,��i,' , , ", ,� , _�� _�,, ,� , ,.:!!I' �I 0,�i l �i*!-"".""�,�"",;""�'I",",; .�"!Aif',x-� �,,�ili,NillIvIl�;���,�,,,��.',.-��",?�.,��:��!."�����!�,,,._,�i,."".,�,�,�,;�,,,�.�,,,;,',,"..�.,,,'-,,';�',,i�,,,�':��,�����,���i�,,�,�,,���-,�!,?,����".,���'ll,��-�,'�l".�'���;,�i'l�",,e, Qj�tIA'..�,"Al";�", -. 'i!,i,2�.,Ii!,�,`� � ,,;,: W� ',?"',i,,i�,�,, -�,.�,.�,�..,�l,,,,,,,,-,,��,��""",,;!",,-."�-!',t-",-", ,,��,�,,,�,.,,,,��:"l , � ,��,i,�i,,�;';4���,"i�,,:�,;�'!�, .,I 41"" 4 ,,,�,''-�, , ,�l 'i'�, � ". . ltt::Iixttiuti�0 ,�,*,,', ,, ,, - .,��.,�";"�!.,�,�-.�.,,,.,i�i���,.,, , its , ' ' Town of Barnstable Build in . � In a wuvsrn�u� ? Post This Card So That it.is Visible From the Street-Approved Plans Must be:Retamed onJob and this Card Must`be Kept 'd" Posted Until Final lnspection"Has Been Made ��gY11 ib;p ♦ 1 Ill liJll Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final,lnspectiorf has been made' Permit No. B-20-826 Applicant Name: Craig Orn Approvals Date Issued: 03/25/2020 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 09/25/2020 Foundation: Location: 7 BAYBERRY LANE,CENTERVILLE Map/Lot 190427 Zoning District: RC Sheathing: Owner on Record: GAYE, LISA 1&TENNEY,FRANCES M Contractor Name:' SUNRUN INSTALLATION SERVICES Framing: 1 INC. Address: 7 BAYBERRY LANE 2 --.,Contractor License: 180120 CENTERVILLE, MA 02632 Chimney: Description: Installation of an interconnected rooftop PV system.34(310w) Est Project Cost: $20,026.00 i Insulation: Panels 10.54 KW DC 'Permit Fe.e: $ 152.13 Project Review Req: Fee Paid` $ 152.13 Final: Date:`' 3/25/2020 Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved applicationand the'approved construction documents#or which this permit has been granted. l Final Gas: e in compliance with the local zo All construction,alterations and changes of use of any building and structures shall be in and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open forpublic inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and'Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing - - -- - 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Ern�L s�✓'T Town of Barnstable Building I?OStThIS.Card So T:hatrt:'�s Vis�bleF..rom�:the;Street 3A roved.PlansMustrbe Reta►ned on Job.and this Caid Must,be Kept • RARI AM& • 'i '�:'. .';. ` ` ` •�� ... -'' � 'e ` t pp +.4 5 m : n.. �y � ',&��• a N:: ` ; 14M& ;P,osted>Unt�t Eln�al;lns' `ection Has Beeri Mader - „e r ° Where avCer ifica "lredsuch`Buildm 'shallNotbe.©ccu �edkuntil.a�Final Ins ection has:beenmade x Permit a of Occupancy is Requ � g Permit No. B-20-541 Applicant Name: HOME WORKS ENERGY INC. Approvals Date issued: 02/21/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 08/21/2020 Foundation: Location: 7 BAYBERRY LANE,CENTERVILLE Map/Lot 190-127 Zoning District: RC Sheathing: Owner on Record: GAYE, LISAJ&TENNEY, FRANCES M `4 Contractor Name HOME WORKS ENERGY INC. Framing: 1 Address: 7 BAYBERRY LANE Contractor,License e 181138 2 CENTERVILLE, MA 02632 Est Project Cost: $3,982.00 Chimney: Description: Insulation/weatherization PermitFe"e: $35.00 � a s , Insulation: Project Review Req: Fee Paid ` $35.00 �F Final: Date 2/21/2020 Plumbing/Gas Rough Plumbing: m Build g Official Final Plumbing:. This permit shall be deemed abandoned and invalid unless the work author ied by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved applicant on and the"-approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and st uOures:shall be in compliance with the local zone g kiy laws anted codes. t: , Final Gas: This permit shall be displayed in a location clearly visible from access street or road'and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. x Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials arellp ided on thispermit. Minimum of Five Cali Inspections Required for All Construction Work ; Service: 1.Foundation or Footing 5 �� Rough: 2.Sheathing Inspection 1 All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (asset forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT i zSDI! 04TKE Application number.:...... . ...o....-......................... 7 Fee ....:�rJ... ......... ................................................. MASS �,� Building Inspectors Initials. ................................. DateIssued....�j�I.�......................................... Map/Parcel....... .......C:2 ........... !`C TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION SCANNED PROPERTY INFORMATION Address of Project: 7 Bayberry Lane NUMBER STREET VILLAGE Owner's Name: Lisa Gaye Phone Number 508-790-2794 Email Address: lisagaye7@comcast.com Cell Phone Number Project cost $ 3982 Check one I/sidential yes Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK 0 Siding D Windows (no header change)# Insulation/Weatherization 0 Doors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name HomeW'orks Energy.:;..:, �..t t Home Improvement Contractors Registration (if applicable) # 181138 (attach copy) Construction Supervisor's License# 103832 (attach copy) Email of Contractor lea.anthony@homeworksenergy.com phone number 781-305-3319 ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER ............................................................ *For Tents Only' Date Tent(s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. F Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location (s) of each tent T-10 O If/ood is being served at your event please obtain a Health Department approval between the hours il1[� 1 °of k'00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model /I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. f SCANNED FEB 2 4 2020 PLAN VIEW Name: (motSal �jqv�¢� Site ID: Sq(Q Finished Sq. Ft: Z,ZC) Phone: Year of House: Electric Acct#: Address: u 1--h #of Floors { Gas Acct#:- C�rv'1�1Q unit a: #Occupants: Z Housing Type? DUCTWORK INSPECTION Ducts Insulated?I] Duct Linear Duct Square Ft. - - Duct Air Sealing Hours y- t Duct Insulation Duct Ins on Removal - -•-- - — - BASEMENT INSPECTION " Existing Spec'ing Ln/Sq.Ft. - Bsmt Wall AG Crawl Ceiling Crawl Rim Joist Bsmt RJ w/Sill Co cr.rtr? -r �7R^an.id�estr Bsmt RJ NO Sill _�-•-- — Vapor Barrier ,—•--sgft.I Bsmt Door I'YM Blower Door? WALLS&GARAGE Drill Location? L- qt Pao i�td2y�y,� Siding Ceil.Height Existing Spec'ing S .Ft. Framing Exterior Wall 1 VlfA S'e AA 1, a x 4 x CA Balloon latfor Exterior Wall 2 x---�ac------Ballaerr/•P{atfor-m Overhang Garage Wall 1�-JLk�0,W7 x Lj x r-.13alloontlaffoTT Garage Ceiling I v3 wC, _ DO,(- CAS �r 3 Insulation Removal ------- Sgft. Sweeps: WX Stripping:Y WORK SPEC'D BUT NOT CONTRACTED OAD BLOCKSPRESENT� MANDATORY) Attic Basement/Crawls ace Other: K&T Y Moisture Y N Combustion Sft Y AA Kneewall Overhan Gara a Asbestos Y Mold>100 sq.ft -Y/ CO Detector Missing Y Ductwork Exterior Walls - Vermiculite Y Structl Concerns Y 'N thee:- Notes for Lead Vendor/Work Not Contracted: - - S i KW WALL AND KW FLOOR Blind Spec? OR KW SLOPE AND GABLE END Blind Spec? Why? Why? A ING EXISTINGP I T FRAMING . EXISTING SPEVING SQ.FT. WALL l X SLOPE x x FLOOR X X �' GABLE x x ACCESS x TRANS x x TRANS X X _ ,-� r� y t.. l; IC ATTIC t SLOPE X X r� SLOPS, EXISTING ING7 EXISTING VENTING? , ' ..��*�` EXISTING PIPES? - KW Venting Vent BF: 9 F,lose Damming Sheathing Attess liemp Access .w+' - xW Venting Vent BFTemp Access n 2 10 v x r ' 3' I s; bR i5 0 11�v s Ci o 4tgt _ _ `"`""v "„r,r^.�.�.��...„�.�>.w,•e...+ �,Zpo`� �L�011k »'iS.t��o� _�SQ �- -- � t0>rrivt� •..- �w 3,,� � �`-�---s....._�... �._...p � P d�� `V o.\\ S��f �av�le.c� e���ny r ab " _ w Ctrs t h�` SQA r CU CrG1+ or) 7rinn�k t^rU5 GO aid. ✓'Q C40v* Uc �p�� awl ig cdk��ri:aiol �� ce44rata irlS r1?r��),� of Sc V S Zvts�ct}Ialsa� of Lb GVS C'L DC \'U'ev(-.Il 0"Ck owk `°grt (��:CY w,11 0'rjj L©�Gi'kr�l :vew�s Cx?> oa fU K �2t i 200 V4n�' C x t=1 MtA'+n4i?"�1 CZ�C �/ � �(, - nor yr?vs�l:•:c -- Insulated Watt X x Aec'd Ight O��'7Ins.Hose 8F Vent BF BFv Chim.O Damming 12"Roof V t 12AV rn� X :� Air Handler IAH Temp Access i• Pull Down DS Hatch;] Wall Hatch tt/•Door o j 8"Roof Vent(SR!) J. `j L7wl'� x A x ATTIC 1 Blind Spec? 0 X ATTIC 2 Blind Spec? P� X(ts.a(z rv) Existing Spec'ing 5q ft Existing Spec'ing q ft 33. Unfloored r! tt l) L O e Trusses Cross Batting Floored ' FloOred Mixed Insulation Du ork >6"Loose None Cath Sloe --_.., Cath Sloe _ Walls N5 Nf— "F�4 4-Qo\ r Walls Access II 4 W C Access VentingI Propavents Vent BF I BF Hose Damming- Venting Pr avents Vent BF BF Ho Dammin { c LOG XL WHF Box 12rQVCxt1 x5 " " '( 1 �lbdl :U TelppAccess: { cl �( xt { CL Sheathing Access:= R.L:Covers: 14LSq.Fti 300 (Exist:NFA Venting)_._(Needed tJ 300=__(Exist.NFA Venting) _(Needed p Existin Venting? NFAVenting) ? NFA Venting)- oof Type:L—J /fs t _ l _ g g ExistingVentin yiA t a f .f`ri' t j r �✓� / fi �� '` r�/ri✓i✓.r�✓i.�o>✓-�i;lr r• ,rim-itz�fif :�rff.�• Office of consumer Affairs and Business Regulation im Washington Street Suite 710 Boston,Massachusetts 021IS tame Improvement Contractor Registration Type C0rPbw0(IF1 t�egistraiton-. 18 1 13a . HOA.EUtORKS ENERGY.INC. Exprraticn. LYll4id'2U29 'o'1 STATION LANDING STE 1S4 - MEDFORD,t_IA o215.5 � Updnta:.Addroz*and RoWe Card: - ONice of taa..Me$Affa,ra A3usia.cn ReOutealon- - - - HOME 1Pn PR,OVEMENT CONTRACTOR Registration valid for individual use ardp - TYP-Con nraEgn belnre Use dxPirati:n tluta•If round return io: Raaudraiior. pvniratien - tHHca ofronsumer Atdairs and BUSIMSS Ragutotion "1911:}d 93t7L!t0?; 10DO Washfrpo strecl•stalls 710 tiOME WOWS Eh ERGY.10C 8oatenMNtt2?t - - - - h1AXVEG0E8ERG - 101 STP,TjQN I1+NGIMG STE 1,0 .F~-. _ - - MIILVORD.4%.131'.5 valid without signatureilndersr�.giai}: - r r Commonweeilth 01 Massachusetts r Construction Supti vmar Specialty t, ',')• DivsyiOf, of Prntes5ixs,,�1 �rcei;:sitr�? Board 0 Suildino Regulations arTr Stand trr s 1 stfieted ta: ��Tt7$tteit:tirnn•SCp��Jtscar Spt:c3alty CSSL4C-Insuiatiort Contractor CSSL-103832 1 i, eipiras-,1011312021 i SCOT?VEGGEBERG 8 COVINGTO14 ST t#1 BOSTON MA',Q2123 e� kb J �s Failure to possess a cui Oition of the Massachusetts State Building Code is c or revocation of this,license. Commissio t �t�4t 7t�.��t�*d� --- For infarmafivar about this license Call(617)727-3200 or,visit www.mass.govidpi i The Commonwealth of Massachusetts F 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): HOlneworks Energy Address: 101 Station Landing Ste 110 City/State/Zip:Medford MA 02155 Phone #:(781) 305-3319 x5007 Are you an employer?Check the appropriate box:1.92 1 am a employer with 200 4. ❑ lam a general contractor and I Type of project(required):❑New construction employees(full and/or part-time).* have hired the sub-contractors 6. 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.* 9. ❑ Building addition 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 12.0 Roof repairs insurance required.] ' c. 152, §1(4),and we have no Weatherization employees.[No workers' 13.❑ Other comp. insurance required.] . *Any applicant that checks box#I must also till out the section below showing their workers'compensation policy information. If 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: Safety Indemnity Insurance Company Policy#or Self-ins.Lic.#:4001017 Expiration Date:1/1/2021 Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Sign ture: Date Phone#:(781) 305-3319 x5007 / wxpermitting@homeworksenergy.com 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#: --�� HOMEENE-01 LLARIVIERE ' ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE 2 19/20V 19 / 9/2019 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 have ADDITIONAL INSURED provisions or 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 Lisa Lariviere NAME: Foster Sullivan Insurance Group,LLC 163 Main Street (A/C,No PHONE,Ext):(978)686-2266 301 (AA/c,No):(978)686-6410 North Andover,MA 01845 ADDRIESS:certificates@fostersullivangroup.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Homeland Insurance Company NY 34452 INSURED INSURER B:SafetyIndemnity Insurance Company 33618 Homeworks Energy Inc. INSURERC:NH Employers Insurance Company 13083 Homeworks IIC LLC 101 Station Landing Suite 110 INSURER D: Medford,MA 02155 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER IMMIDDIYYYYI (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �X OCCUR 7930060660002 4/1/2019 4/1/2020 DAMAGE TO RENTED 500,000 PREMISES Ea occu rence $ MED EXP(Any oneperson) $ 1 O,000 ' PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - GENERAL AGGREGATE $ 2,000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ ANY AUTO 6244378 4/1/2019 4/1/2020 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY INJURY Per accident $ X HIRIT X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ $ A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 X EXCESS LAB CLAIMS-MADE 7930060660002 4/1/2019 4/1/2020 AGGREGATE $ 2,000,006 DED I X I RETENTION$ 0 - $ C WORKERS COMPENSATION _ - X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN ECC-600-4001017-2020A 1/1/2020 1/1/2021 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Evidence Only I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Homeworks EnergyInc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 101Station Landing Ste 110 Medford,MA 02155 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and BLtsieless.Regulati©n 1000 Washington Street-Suite 71"0 Boston,Massachusetts 02118 Home tmprovemenLContractor Registration . 'Tppy f,;grtitxtlfian- - f�egtstrationt 1$1138 HOf4lE WORKS EME'RGY.IMC: Expiration, M?J'2021 109 STATION LAN[)ING S f E 1'�D - MEDFORD,MA.02155 - . - - Update Addm=and Roiurn Card. - - - - QHice of CnM1..MW Affairs 8 Bu9inacg RC➢LL19iM!I', R YGbiiOn v➢716 fbtlndlvidu➢1 vs-anlp' "MAP RA"0VErAENTC0NMACT0R �9i' -. TYM Ccvoor M before aE a expirbNon a➢to+if frond return iw Rbaiitr➢iloc IrRf— 0f oorCo nsumcr Af(Mrs arid.Susln➢ss RegWMion - 181138. a3f71/2Q2% I ➢aW"hQ%M�Strosl•Su1i0710 HOME WCRKS CN FMGVY(NC Boob➢,M IV f121 t. - r OX VEGGEBER. ,� 101 STATION LANDING.SSE 110 - o valid without.signature NILDFURDAN^?[55. iJndBi'SrXX51gry' - - Commonwealth t5i Massachusetts r Construction Suts'k:visor Specialty ti�.s 01viSrJtw bf Prf�.tgSSif�fT:311 �iCEnSc1r@ - Board of Huildfiltg Regulations and Standards: Restricted to! Csartsirur,7inp"S�p�rJi�i� lTi r 5pSpecialty } CSSL4C-Insulation Contractor tU5�1 -143tl32 6cpires:1011312021 SCOTT VEGGEBERG 6 COVINGTON 5T if1 ys_+ BOSTON MA 02127 t a0: , Failure to possess a cart lition of the Massachusetts State Building Code is c. .-1r revocation of thisticense. For informaliwt about this license . Call(617)727-3200 or visit www.mass.govldpl 1 Ov u , 4 ' Q To whom it may concern, Scott Veggeberg is a current employee of Homeworks Energy Inc. and operates under our insurance policy. Policy numbers that Scott is covered by are as follows: Commercial General Liability: 793006065002 Automobile Liability: 6244378 Umbrella Liability: 79.30060660002 Workers Compensation and Employers' Liability:ECC-600-4001017-2020A All HomeWorks Energy permits are pulled under his CSL license. The insurance provider is AIM Mutual Insurance Company. If you have any questions or concerns please contact Director of Weatherization Adam David Glenn at 774-365-2446 or adam.slenn(@homeworksenergy_com. Thank You, Adam David Glenn - Director of Weatherization HomeWorks Energy. Insulation/Air Sealing Permit Authorization Specialist: Ben Wollman Company: HomeWorks Energy �n Email: benjamin.wollman@homeworkse Address: 101 Station Landing HomeWOficS Cell: 508-292-2630 Medford, Ma 02155 rr.rgy,Inc Phone: 781-305-3319 Customer: Lisa Gaye Address: 7 Bayberry Ln Email: lisagaye7@comcast.net Barnstable, MA 02632 Site ID: 3967273 Phone: 508-790-2794 I, the owner of the property identified above hereby authorize HomeWorks Energy Inc., or their Partner to act on my behalf in obtaining any building permit that maybe required to perform insulation and/or Weatherization work on my property and all matters related to the work authorized by said permit if one is obtained. Any related permit application cost will come at no additional charge provided that the agreed Weatherization work is completed. In the event that a permit is pulled on your home for insulation and/or weatherization work,you may required uired to have a p final inspection scheduled and performed on the work by the building inspector in your town. If this case relates to your job,you will be notified by HomeWorks Energy that an inspection is necessary and you will be given the proper steps on how to complete this process to close out your permit. Email Customer Signature: Date: 1/31/2020 Lisa Gaye f Proposal Terms Customer: Lisa Gaye Specialist: Ben Wollman � Site ID: 3967273 Date: . 1/31/2020 HomeWorks • NOTICE CONCERNING SPONSORSHIP:Customer understands and acknowledges that HomeWorks Energy is not an agent,vendor or sub-vendor of the sponsoring Utility with respect to the installation of any energy efficiency measures. In the event of the failure of any energy conservation device to perform as expected,Customer agrees that Customer's sole recourse is to Contractor and not to Clear Result or to the Utility.The Utility and its operating companies shall not maintain, remove or perform any work whatsoever on the energy conservation measures installed. Customer understands and acknowledges that its participation in the MassSave Home Energy Services Program is voluntary and that it has consented for Contractor to install the propose energy conservation measures.Customer agrees that it shall not hold Clear Result,the Utility,their affiliates or operating companies liable for Contractor's failure to perform its obligations under this agreement,for failure of the energy conservation measures to function, for any damage to Customer's Premises caused by Contractor or for any and all damages to property or injury to persons caused by the energy conservation measures • ENERGY BENEFITS:The sponsoring Utility is entitled to 100%of the energy benefits associated with all Energy Conservation Measures,excluding the value of energy cost savings by the customer,but including all rights to all associated ISO-NE Energy,Capacity and Reserves Products.HomeWorks Energy agrees to provide the Utility with such further documentation as the Utility may request to confirm the Utility's ownership of such benefits and products. • CLEAN UP OF THE WORK AREA:Weatherization projects can generate dust, some of which may contain traces of lead. The Contractor agrees to follow Lead-Safe Guidelines and to make reasonable efforts to control dust and other mess through the draping of cabinets and furniture with plastic, hanging plastic sheet walls,and cleaning floors of dust and any paint spatter. However,the Contractor will not leave the interior white glove clean. Outside work areas will be left broom clean and all debris and trash removed.The Homeowner should be aware however that minor amounts of cellulose and wood chips--which are harmless and biodegradable-maybe left on the ground. The Contractor agrees to be conscientious about picking up nails and other fasteners,but Homeowner should also be prepared for the occasional fastener that escapes contractor's notice. • CUSTOMER INFORMATION ➢Storage Removal: ❑Perimeter of the Basement ❑Attic ❑Knee Wall ❑Crawl Space ❑ Interior Walls Notes: **If the storage is not removed,HomeWorks Energy will charge$0.53/square foot of storage to move it. ➢Wall Insulation:There is a chance your walls may crack due to the pressure that is required to achieve.a dense pack.If your walls crack,we will hire a plasterer to plaster over the cracked area.You will be responsible for repainting. Please review and sign the wall disclosure form. ➢Insulation Removal:Insulation must be removed from the following locations: *If it is not done,HomeWorks will charge$1.26/square foot for the removal ➢Parking Permits:If the energy specialist or operations manager determines that a parking permit is required for installation and if you do not have a pre-existing solution,we will procure one and add the cost to your invoice. ➢Bath Fan Venting:Installing a hose and flapper to an existing bath fan may increase noise levels due to proper venting procedures. ➢Exposed Pipes:If the energy specialist finds pipes that may be exposed to cold weather,leaving pipes outside the thermal envelope may cause them to freeze. The auditor will recommend a solution to the best of their ability,however,HomeWorks Energy will not be held responsible for any damage caused due to frozen pipes. • DEPOSIT: A$50.00 deposit may be required when signing this document.It is completely refundable until the weatherization work is scheduled. The remaining customer copay it is due in its entirety upon completion of the weatherization work. • DISPUTE RESOLUTION:The Contractor and the Homeowner hereby,agree in advance that in the event the Contractor has a dispute concerning this contract, the Contractor may submit the dispute to a.private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the Consumer shall be required to submit to such arbitration as provided in Massachusetts General Laws, Chapter 142A.The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the Contractor. The Homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Customer Signature: Date: 1/31/2020 Lisa Gaye Auditor Signature: Date: 1/31/2020. Ben Wollman • Page 1 of 2 r / - p �-- noble mass save Energy, Inc PARTNER 101 Station Landing Ste 110•Medford,MA 021SS (781)305-3319 ext.120 Customer Name:Lisa Gaye Email:Not provided Phone:508-790-2794 Premise Address:7 Bayberry Ln,Barnstable,MA 02632 Mailing Address:7 Bayberry Ln,Barnstable,MA 02632 Project ID:3977284 Date:Jan.31,2020 Job Description Measure Description Location Quantity Unit Total Cost Customer Cost AIR SEALING Other 8 hr $640.00 $0.00 WEATHERSTRIP DOOR &ADD SWEEP Other 3 each $240.00 $0.00 ATTIC FLAT-9"OPEN R-33 CELLULOSE Other 762 SF $1,143.00 $285.76 KNEEWALL: FG BATT+2" RIGID BOARD Other 53 SF $278.25 $69.56 PULL-DOWN STAIRIHERMADOME, BUILT-UP Other 1 each $237.65 $59.41 12" X 18"WOOD GABLE VENT Other 2 each $247.00 $61.75 12" MUSHROOM ROOF VENT Other 1 each $120.75 $30.19 8" ROOF VENT Other 1 each $87.15 $21.79 VENTILATION CHUTES Other 58 each $202.42 $50.60 INSULATED BATH EXHAUST HOSE Other 1 each $60.00 $15.00 Total Contractor Price and Payment Schedule HomeWorks Energy, Inc.agrees to perform the above described work,furnishing the material and labor specified for the listed total price. Payment of the balance ofthecustomer contribution is expected upon completion of the work. Customer Signature: _ Date: ozil oi2o2o Customer Phone: Specialist Signature: tiy —Date: 02/10/2020 ----� �1-- -- — LIMITED TIME OFFER: The prices and incentives in this contract are subject to change in accordance with the sponsoring utility MassSave Home Services Program offers. Proposals can be sent to:inbox@HomeWorksEnergy.com Page 2 of 2 r O nHomeWorks - mass save � C Energy, Inc PARTNER 101 Station Landing Ste 110,Medford,MA 02155 (781)305-3319 ext.120 Customer Name:Lisa Gaye Email:Not provided Phone:508-790-2794 Premise Address:7 Bayberry Ln,Barnstable,MA 02632 Mailing Address:7 Bayberry Ln,Barnstable,MA 02632 C Project ID:3977284 Date:Jan.31,2020 ATTIC DAMMING- R-38 FIBERGLASS Other 100 SF $246.00 $61.50 Project Total $3,502.22 Weatherization incentive ($1,966.66) Pre-Weatherization barrier incentive ($250.00) Air sealing incentive ($880.00) Total Program Incentive $3,096.66 Customer Total $405.56 I Total Contractor Price and Payment Schedule HomeWorks Energy, Inc.agrees to perform the above described work,furnishing the material and labor specified for the listed total price. Payment of the balance of the customer contribution is expected upon completion.of the work. 02/10/2020 Customer Signature: � Date: _ Customer Phone: Specialist Signature: L _Date: 02/10/2020 LIMITED TIME OFFER: The prices and incentives in this contract are subject to change in accordance with the sponsoring utility MassSave Home Services Program offers. Proposais can be sent to:lnbox@HomeWorksEnergy.com I Project Summary Name: Lisa Gaye HomeWorks Energy,Inc. �O Phone: 508-790-2794 101 Station Landing Gn Email: lisagaye7@comcast.net Medford,Ma 02155 H01TI2W0(N Site ID: - 3967273 7 81 305 3319 `nei9Y,Inc MASS SAVE Cost Incentive Air Sealing $880.00 $880.00 Weatherization $2,622.22 $1,966.67 Duct Sealing 1$0.00 $0.00 Duct Insulation $0.00 $0.00 MASS SAVE REBATES Incentive Preweatherization Barrier $0.00 IC Rated Lights $0.00 tDryer Vent $0.00 ,Attic Floor Removal $250.00 t Rebates may only be applied as reimbursement of your cost to the Contractor for services rendered. ++BEYOND MASS SAVE QTY Cost Floor-Relocate Flooring In Attic[Create a Flooring stack in attic] 150 $126.00 Floor-Pull Up Flooring and Reinstall 150 $165.00 Storage Moving 1-way(minimum 100 sgft) 120 $63.60 Storage Moving 2-way(minimum 50 sgft) 120 $126.00 Total BMS Costs $480.60 t+Additional listed work may be a requirement of the insulation proposal. HomeWorks will only remove those line items if completed prior to install date.All work performed beyond Mass Save carries no incentive.Attic Floor Removal rebates may only be applied if HomeWorks Energy completes the flooring removal. SUMMARY Cost Incentive Mass Save $3,502.22 + Beyond Mass Save $480.60 TOTAL PROJECT $3,982.82 $3,096.67 Total Copay $886.16 Customer Deposit Applied $50.00 FINAL COPAY. (due on completion of work) $836.16 HomeWorks Energy, Inca agrees to perform the above summarized work (Mass Save & Beyond Mass Save), furnishing the material and labor specified for the contract price(Total Project).All work is subject to change,and homeowner's approval is required for completion of any and all work. Preferred Day of Week for Insulation Install• - Customer: Date: 1/31/2020 Lisa Gaye Specialist: Date: 1/31/2020 Ben Wollman benjamin.wollman@homeworksenergy.com - 508-292-2630 v.18 „ . Town of Barnstable Build i a Post This Card So That it isi.Visible.From'the Street Approved Plans Must be,Retamed on Job antl;this Card Must be Kept tA81V�'CA9L6. • .. m r k .r 7 -R., y w,'' '`^�; �w 3 r- a ” Posted Until:Final Inspection Has Been Made ;- yam aso a, ' ".,i•° a aired such Builtlin shall•Not'beAccu ied}until a,F,nal Inspection has been made f Per mi a, Where a'Certificate of Occupancy,is#R q . . _rt fic. A p .� .. r Permit No. 8-20-340 Applicant Name: Jason Couto Approvals .Date issued: 02/18/2020 Current Use: Structure Permit Type: `Building-Addition/Alteration-Residential Expiration Date: 08/18/2020 Foundation: Location: 7 BAYBERRY LANE,CENTERVILLE Map/Lot 190-127 Zoning District: RC Sheathing:. Owner on Record: GAYE,tISA i&TENNEY,PRANCES M i Contractor,N me ,Jason O Couto Framing: 1 Address: 7 BAYBERRY LANE ° ntractor License: CS 096628 Co 2 Centerville, Massachusetts 02632 Est Protect Cost: $.17;399:00 Chimney: Description: Strip and re-roof 22 squares Permit F e: $138.73 remove and replace 4 windows and one sliding glass door Insulation: Fee Paid: $138.73 2/18/2020 Final: Project Review Req:'• �- ` � �✓ �y_ Plumbing/Gas i Rough Plumbing: ui rn icia This permit shall be deemed abandoned and invalid unless the work authorized by this permit`is commenced within six mTyonths after iss anL�. Final Plumbing: All work authorized by this permit shall conform to the approved application and the,approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning try-la ws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or-road and shall be maintained open for public inspection for the entire duration of the work until the completion of.the same. '-° Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures 6ythe Building and Fire.Officialsare p ovided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing ` Service: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue;Im_mg is mstalleda = Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: S.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy �. Low Voltage Rough: Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund"(as set forth in IV1GL c.142A). Final: Building plans are to be available on site Fire-Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: ONE-?T► Fv»4Z c. sC'.s- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION p Parcel Application# 01 t . Health Division /�. bate Issued+ d Conservation Division ��J Application Fe ' ) Tax Collector Permit Fee 3a • fYJ Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address L 1VE Village Owner ����T��� � Address Telephone 14- 508- 7 V U _ 9'7 9 7"/ a) ,S_®,f -79O "_CYO 1- 0-20k Permit Request ?t4 l d,9'4 ® de-c,4 on 1%O 64R_ Square feet: 1st floor:exi ing Q proposed 2nd floor:existing proposed Total new cn Zoning District"' Flood Plain Groundwater Overlay cc Project Valuation 100--00 Construction Type W00d Lot Sizes CD..,. Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. i> Dwell ing_TyperziSingle Family Two Family ❑ Multi-Family(#units) Age of Ezisting'Structure' Historic House: ❑Yes No On Old King's Highway: ❑Yes 0 No Basement Type: Full ❑Crawl ❑Walkout ❑Other z7 Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) `tl s1 _' €�', Number of Baths: Full:existing r new Half:existing 0 � new-' Number of Bedrooms: existing C2 new 0 Total Room Count(not including baths):existing new 0 First Floor Room Cou t Heat Type and Fuel: Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes XNo Fireplaces: Existing / New 0 Existing wood/coal stove: kYes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage)(existing ❑new size Shed:❑existing ❑new size Other: Zoning-Board of-Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑YesNo If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name.. Telephone Numb r J�0 '7 O -c?797� dress� /� 1�� CAI License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE D 0 O7 1 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL N0. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 4, 'w N I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations . d 600 Washington Street Boston,MA 02111 www.mass.gav/din Workers"Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibiy / Name (Business/Organization/Individual):. Address: me— City/State/Zip: IVA o OL Phone.#: 56S- 790"O7 9 Are you an employer? Check the appropriate box: Type of project(required):. 1.❑ I am a employer with 4. ❑ I am a general contractor and I . 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 8. ❑Demolition working for me in any capacity. employees and have workers' co insurance.$' 9• ❑Building addition [No workers' comp. insurance �• t equired.] 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 . 152, � 12.❑Roof repairs insurance required.]t c i §1(4) and we have no 13.❑ Other employees. [No workers' comp. insurance required.] . `'Any applicant that checks box#1 must also fin 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 providb their workers'comp.policynumber. I am an employer that is providing workers'compensation insurance for my employees. Below is-the policy and job site information. r Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Inv ti ations of the DIA for insurance coverage verification. o h 're by certify:ender t,epains andpenalties ofperjur},that the information provided above is true and correct: Si ature: ei Date: #:Phone ; Yl�f ��� ""'d 79 V Official use only. Do not write in this area,tb be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of 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 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." IvmGL chapter 152, §25C(6)also states that"every state or local Iicensing agency shall withhold the issuance or s renewal of a license or permit to'operate a business or to construct buildings in the commonwealth for any ce it the insurance covers a re uired." applicant who has not produced acceptable evidence of complian wi h g q PP 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-contiactor(s)name(s), address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies*(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required, Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. 'The affidavit should be returned to the city or town that the application for the-permit or license is being requested,not the Department of industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate-line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all•locations in (city-or town)."A copy of the affidavit that has been officially stamped or marked by the city or town 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 fo 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 Massaehusettts Doparttment of Industrial Accidents Office of Investigations 600 Washingtoii Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax 4 617-727-7749 Revised 11-22-06 www.mass.gov/dia f E,p Town-of Barnstable Regulatory Services sAxrrsrABr•Eti F Thomas F.Geiler,Director .9 MASS. . t6 � Building Division • ��IED MA'S� • Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax; 508-790-6230 Permit no. Date AFMAVIT HOME MROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion, •improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Q G� Estimated Cos ,kddress of Work: -7 4. u kL.m, C T �� Owner's Nerve: f I,5o ('-Q V� Date of Application: D /911 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 FIBuilding not owner-occupied Owner pulling own pemut Notice is hereby given that: OWNERS FULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE AREnRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES.OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR c D ate Owner's Name Q:fa m lomeaindav All wood Pressure treated All ' 2 x 8 except decking 2 ea. 3/8" x 6" Lag (5/4 x 6) and girder�(2 x 8) screws Typ. 5 places 8„ I.-- -- -- 4x4 . posts Typ. r7 15 -10" Deck height not to exceed 30" oFtMl r Town of Barnstable Regulatory Services * BARNSPABLE, Thomas F.Geiler,Director y MASS. 1639' �0'g 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 (� -'7 Please Print DATE: [� '^% 0 / JOB LOCATION:_ ! ��\113 Egg Y �N�- &?R& number street �-7 �7(� / village �7J(� „HOMEOWNER":_ L�S G{�y — / 9U "� / 7 `1 name �7 home phone# work phone# / CURRENT MAILING ADDRESS: j��� ( o n e- ��.d,-1 erVI 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 (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 ndersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department imum inspection procedures and requirements and that he/she will comply with said procedures and requirements. � I Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code'states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page 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:forms:homeexempt P ,w ....... .. 114 t 40 14j OP II I certify that thin prppe y in located In Fior d'Ha zard ZorA C (out- side the 300 yeat inlood) as ident-lk ied ' by the Department bf Housing and Urbar; Development (HUD) . PLAN -NCF- 9. I aertifv tp Cope Cbd Ctop,l�enk tmd its rot€e inS.CO. THE LOCATION OFTHE ORIGINAL OWEi UNG that there are no uiSible encroa hwahts : RONEITHERWA IN MPI MCE or es menu ezc t a saa�n and that this SHOWN i G BYLAWS :k CFfWT W09N, CONOr VOTED (WtTK plan was prepared under iny ir►medi s .e �ESPMT TO HORIZONTAL 0100ENSIONAL euverv—1 aion. tR1rt'IRFUENTS L1RLY),OR EXEMPT FPIDIl �Vyta#�1LAv't'lC`N &a'MFORCEWUN 1`AC�T//pION UNDE'Fs�'�1H�.G¢L, } s.''�-�rq � G°.elsi,�"'—r�',c°`Y"� �✓�:'' t?7`F3ER1�dI fiF l�ttat�n na c.rsiatu u r a cn.x TOTS P.02 ` Y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �- "` `'�~ ',t;g;r:Applcaton# — ?3{- tu Health Division 3 h:a �? ;,;�j; j r. n Conservation Division I--- Permit# "1. k Tax CollectorTMia S � f3ats-Iss - Treasurer F Application Fee t- ` 2 Planning Dept. �7 1 Permit Fee —¢Z Date Definitive Plan Approved by Planning Board LIMITED TO'_�EXISTING2 #OF BEDROOM S'EPTIC SYSTEM (� vHistoric-OKH Preservation/Hyannis - �` On —�— Project Street Address Village C 1�' 'l� 'ir' �/ oLl � A, Owner Address . 41 Telephone �� 81 7 9 " L 4 p i Permit Request` c e , Vxol UU 6 'r-, lzer,� / ;. - i ,Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay r. 000. t<; . Project Valuation Construction Type t Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) V1' A e of Existing Structure g g /9 _ Historic House: ❑Yes No On Old King's Highway: ❑Yes o Basement Type: Vull ❑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 ''��// New ff �No .Fireplaces: Existing a Existing wood/coal stove: I�Yes ❑No 4, Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage: existing ❑new size 12)(12 Shed:dxisting ❑new sizel�Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes V No If yes,site plan review# Current Use Proposed Use — BUILDER INFORMATION Name-6-UY Telephone Number 2130 Address ( e,y1, License# Home Improvement Contractor#_ a t C n) Worker's Compensation# 4S/ _200 7(.�`1 40120 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO' �! }i0�1/Y1 L SIGNATURE DATE O FOR OFFICIAL USE ONLY,' PERMI NO. DATE ISSUED ' 'MAP/PARCEL'NO.' ADDRESS i VILLAGE r OWNER w DATE OF INSPECTION: FOUNDATION 04 FRAME INSULATION (j �� fx FIREPLACE I+ ELECTRICAL: ROUGH `„ FINAL tz IV, , - PLUMBING: ROUGH FINAL GAS: ROUGH s OLI FINAL FINAL BUILDING . � I ' t) 0 - N tr DATE CLOSED OUT C3 m ASSOCIATION PLAN NO. ti r t Board of Buildin egulations One Ashburton P?ace, ism 1301 Bo - stop M ,�_2108 1 618 :.License: CONSTRUCTION SUPERVISOR LICENSE a Birthdate• 12/11/1962 Number. CS :' . - .d56192 .::Expires t2/11/200 � Restricted To: 1G t t41 �€ ` K 5J GUY L RUFO �� 10 OLD TOWN RD HYANNIS, MA 02601 no: 6410.0 Keep top for.receipt and cFlartO�of address natdica6on A7 $`301N 09704 Csi0i2�S - DV o. g e ��iOns an tan One Ashburton Place - Room 1301 Boston. Massa chusetts se_ tts 02108 Home Imps:ovement C°ontractor Re ' - _ Registration: 119952 TYPe: Individual Expiration: 9/24/2007 GUY L. RUFO GUY RUFO 10 OLD TOWN RD. HYANNIS, MA 02601 £� Update Address and return card.Mark reason for:change. 3� cA n Address wal. ❑Employment Lost Card � Rene t s, 5oA�A4/04 G'M1s .. - 0.Out Departr�tent of_ tcafey One Ashburton Pfiace, ' 3 Boston MfJ218 -License: HOISTING�NGIN �`-"" Number: HE 07 37. Expires:l2/11/20�16 -- _ c 13cer1seQ�ISU CONUPER�tSOS2 �lun�liber� 3)56i92 GUY L RUFO w MOM 10 OLD TG.WWNj 1iYANNIS, MA 02b0I 0--ir . r Restnste�d 1 y s �► GUY L RUF-0 �� x K 10 OLD 1 OURD �CAl.$ SOM-0 04G10121s I _ 1 4*+ 1- 1 � W do 3Z� i I-AD,04 Y cartify that this property is located In Flood;Hazard Zone C (out- aide the $OJ ye flood) as identl- i.ed by the Departine of Housr�,x and 5rbar. Development (HUD) . Date i!T �. L7 /r1" CCRTI FI t D PLOT PLAN L(ICAT?ONV ,4� 40, SCALE . .�'��3c�' .: DATE!*e.e7/ff7 Rrg. PLIXN REt=E ICNcc 1 t� • ,['oi%!f-�. ,�'�c''r�"��S- . .�O Jam'-��-•.- - I' Z oerti fy to Cape Gbd loop.Bonk and its=itle ins.co. THE LDCATION OFTHE ORIGINAL OWELI.ING that there are no 'Visible Ancr qc' chment�7 SHOWN HEREON,EITHER WAS 1N COMPLIANCE or oa s:nerite e7CC 'fit ELF, shown and that this WITH THE LOCAL APPLICABLE ZONIAfe SrLAWS ik EFFECT WIfEN, coNbTRUCTED (WITH Plan was prepared under mar :i_1nmedi.ate RESPECT TO HORIZONTAL DIMENSIDNAL superv+eion, REOUIREMENTS ONLY),OR EXFMPT FROII VIOLATION ENFORCEUUNT ACTION UNDER M.G.L, TITLE VI I,CHAPTER 40A, SEC'ON 7,UNLESS � OTHER101519 Nnrrn me aijAwu utocna TOTAL P.02 ptZNElQ 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.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 to a on my behalf, in all matters relative to ork authorized by this building permit application for: LJCc Yt e- �e y)leYYd l e AAA._ 02 6::�3 Z (Address of Job) Signature of Owner Date Print Name C QTORMS:OWNERPERMISSION • y . Table JS.Z.ib(C"I f oua) •�pMIX rush• ' ptnerigfns P:ekxEti�far has aad Z'ira-F�Raideat�l Hniidia�p Sn3sd�d • MJIXfMUM 1�7MMiTM . � •Heaaa;lCoaiitig . g Gelling Wdl Floor .Baxmmi eter kd1mmd Mdeic .titi�ag - Amr II011s2 R-value: It�ntuei R ia(ues R-y4uW A. T , �° .• . 3701 to Bd00 Hestin DegreR Da . . MAWS 1Z1� 0�2 3 a I9 19 10 t2'l� 0.30 I 3 '19 10 �. T— ---tb!l� 38 13 2S IAA _ IA ------ • a, r �g 19 t9 I0 asx asz.. 30 . 19' 19 it95 ara�l . I8l a3Z '"'ZS NIA NIA osnui X � Y .:1•sy�-.� aai•. 3E 19� � WA NIA 3a 13 I9' 10 0 y ,• .18'li a.aZ 8 . AA . 18�� osa ao 19 19 to u ' 1.-ADDRESS OF PRQPERT'Y; ;• •a . Ak, V� ' OF ALL k�'I'EAIOR�'AL'L'S:; - .. �.� �,.�•— ' a, ; QvAAE FQoTAE �,•. 3. SQvim FOOTAGE.OF ALL'atAZINGI: ' a. 4. �o C}LAZZN4 AREA(#3 DIVIDED BY#�2): 5, SELECT PACKAQE(Q AA•sea that ai:ove): f ' .. NdTE: ©' }4C gjOLYED METHODS OF DETER G ENER.CiY REQL'IIEMEKTS , ARE AVAILABLE, ASK US FOR THIS Ug0?,MATION,. . BL1IIrDB�G INSFECTOR APPROVAL: YES; NO a ti q-iarrns-BSG3D3a . r RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE - New Buildings $100.0.0 Residential Addition $50.00 AlteratiomiRenovations $50.00 Change of Contractor/Builder $25,00 FEE VALUE WOMHEET -NEW LIMG SPACE square feet%$96/sq,foot= - x.0041= plus frombelow(if applicable) ALTERATIONSaMNOVATIONS OF EXISTING SPACE square feet x$64/sq,foot- x.0041= plus frombelow(if applicable) . QARAGES'(attached&detached) square feet x$321sq,ft,= x.0041= ACCESSORY STRUCTURE>120 sq.ft.. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 . >750 sf-1000 sf 75.00 >1000 of-1500 sf 100.00 >1500 sf-Same as new building peanit~ square feet%$96/%foot- x,0041= STAND ALONE PERMITS Open Pqrch x$30,00 s- (number) Deck %$30.00= (number) Fireplace/Chimney x$25.00 (number) Lo-ye round S*immtng T ool $64A4 GroundSwimmingPool $25.00 locationli4loving $150,40 us above if applicable) 9' J Permit Fee � ��• f °F�►,E,°,,, Town of Barnstable Regulatory Services BAMMBM ' Thomas F.Geiler,Director , 9 Mass. g Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax: 508-7.90-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion, -improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other - requirements. Type of Work: _Estimated Cost Address of Work: Owner's Name:. C _I Date of Application: 3 0 I hereby certify that: Registration is not required for the following reason(s): y . OWork 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 PERJURY I hereby apply for a permit as the agAnt of the o Dat ontractor ame Registration o. OR Date Owner's Name Q:fonw1omeaffidav �� .�� � .� +� �. s_. � e � ;�, i �,� 1'' ">N ' i v�e � • 'vl �t I r M}y '�0`.i .. 1 - - Z-4 "E AOwq, TOWN OF BARNSTABLE Permit# MASSACHUSETTS 292,2.7 BARNSTAEI Date: MASS. 9 i639. �iOrEp Mpl A SOLID FUEL STOVE PERMIT Fee: Z� ,dp Owner: (� 1 S N T 6 Phone: Address: ��— (�P Y I�l� Q(Z�r L4i�j(%VWage: Approved by: -Date: Date: �L s Stove A. New Used B. TC/Rad�iawnt irculating w � Y C. Manu acturer I.ab No. D. Model No. r Chimney A. New (:)Jx�istinf s, date of last cleaning _ B. Flue Size L 6olzx Orr(LvL, C. Are other appliances attached to flue? ".W D. Pre-Fab type--and Manufacturer Masonry/lined UI111Iled Hearth A. Materials B. Sub Floor construction Installer �\ Address Phone Location of Instillation (V T l La,rr � CJ?C 'Polaroid Photo Necesswy *This constitutes an ollicial stove pennit after inspection and approval by Building Inspector ME T rO'`ti TOWN OF BARNSTABLE Permit# MASSACHUSETTS 29 75- BARNSTASLE, Date: MASS. �Ar 163 9. a SOLID FUEL STOVE PERMIT Fee: r ED MA �i1 Doi-Li 790 - pia 7 Owner: LI S A GAyE- Phone: tir tZ_ 7q6 - 07gY Address: -7 8cLu be rr j to n _ Village: Approved by: Date: 1 96) li 2-+ Stove A. New Used B. Type/Radiant Circulating C. Manufacturer Lab No. ' D. Model No. Chimney `� A. New Existing/if yes, date of last cleaning g_ 7 B. Flue Size C. Are other appliances attached to flue? NO D. Pre-Fab type and Manufacturer E. Masonry/lined Unlined Hearth $riG)< A. Materials - B. Sub Floor construction Installer Address 1f6? 6�re&:f /01 At& -0V, ",a5kfu— Phone e..f 1 7 - <3 1W � ��j le .=��-�T Location of Installation 7 L� ( ►� " 1 'Polaroid Photo Necessary "*77us constitutes an official stove pennit,-dterinspection and approval by Budding Inspector The Town of Barnstable*�134(�;- ° Department of Health, Safety and Environmental Services NAM 1 Building Division 367 Main Shut,Hyannis MA 02601 Office: 508-790-6227 Ralph MCrossen Fax: SOS 790-6230 Building Commissioner Home Occupation Registration Date: Name: t�(�G �/ phone#: 790 ` 97 Address: �7 be-rn� La o vM" Gh4ry I Ile Type of Business: C�� f MaPA= l qd INTENT: R is the inrem of this section to allow the residents of the Town of Bazastable to operate a home occupation within single family dweMEV6 subject to the provisions of Section 4-1A of the Z do ordinance,provided that the activity shall not be discamble from outside the dweMuug: there steal be no increase in noise or odes;no visual alteration to the premises wbkh would anything other than a residential use;no increase in traffic above normal residential volumes;and no i is rase in air or groundwater politiaL After re&ttadm with the Building Inspector,a customary home occupation steal be permitted as of right subject to the Wowing conditions: • The activity is carried an by the permanent resident of a single family residential dwelling wait,located within that dwelt mit. • Such use occupies no more than 400 square feet of space. • 'Kure are no extermi alterations to the dweRingwhich are not customary in residential buildings,and there is no outside evidence of suer use. • No traffic win be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,deci ical disnurbaaoe,heat,glaree,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met an the same lot containing the Customary Home Occupation,and not within the regtmzd fmat yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pwkatp truck not to exceed one ton capamy,and one trarl w not to exceed 20 feet in length and not to exceed 4 tires,parked an the same lot comtainmgthe Customary Home 0avpation. • No sign shall be displayed inditatmg the Custoznray Howe Occupation. • ff the Customary Home Occupation is listed or advertised as a business,the strea address steal not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent residem of the dwelling unit. L the undersigned,have read and agree with the above restrictions for my home occupation I am registering. ' Applica=- h � Hate: HcmeocAw I _r l_l —( I —Y I. I , I T T fZI(� N r ALE Vt\T1b1J ��112 VAMDN) IMPQRTANT— UPGRADE REIN!°° "_ STATE BUILDING CODE REQUIRES THE UPv u - SMOKE DETECTORS FOR THE ENTIRE DWELLINS C3N[:OR MORE SLEEPING AREAS ARE ADDED OR NM: A SEPAFMM PEW IS REDUJRED r INSTALLATION OF SMOKE DETECTORS-THE F V P€kwT�SATISFY THIS REQUIREMEN SMOKE DETEC,I' ks R,' 4NED _ -r 4 rt- I R B BuIL�1 ,G DEFT. DATE LI Intl r� r i L1LI T FIDE DEPAI TI;�E T DA.TE I T BOTH SIGNATURE'S ARE PE:JWRE�FOR PFRMITTING �ie0 aV T SCALE: APPROVED CV: DRAWN BY aa— DATE: a-a:i-Q� REVISED . 5i-Al2-0N ht,A-LONE— -t]N-iJ!•A n1 77 Sr-//7V • ' DRAWING NUMBFA tB]2L AIWIFD OR MO.t11001 CIEgpiRlRf• _ ,., - S"�LONG,•.-.WA-LLS. G, D ._.._ t�x�sr NEtJ D D N�Eti1 5 t 413 v + TILeU o O Q Show P� O OrT .O,.VE/z .4TG a /d W 883L-^k G�TJ k IToN-E NcWd�(ob O NFw waL�f NFto Caw 3rrrzoo. •t # � F. 7 _ I a• a i a�(ob AO.LT G lJ /J \O 2S N&W r1Ew U L ZA� GCL LAI ! a fy`r.. .. o 9 c _f135/ Q � .. I-� WINDOW- 0, oQ�... XISt7 NCB I V/N( (L,pp t 'D — O a.t/ya w�AZz-Y - ovE,e 'a ram_ OPT- 5 I-OPat TOLL • S7arz.,N G -0' A)Eto _ E 1517A) FZ,00R -!CIA L) ACV/,5><D 1 Ab-/rJ ADD l776>nJ ljGA t.5YO, / /�", 7:`OV1,)D }-72.OA) 101—A-A) O�a�� M sov, ,— 1N7t2roK DOOL PA 6 GF r. Io,15ULA�'lUrU SrD/u�C� —�OD� s µIO G S _axy fUEK - 6U. 2 y P Lt� .- _ : S_N.VT7-tE2j �i2:0oar /_yla..-f-. �J�rIJTE•2 'I7RtP ta.,D.G16;�- .. Y /X s_, GJr.dDow TR_rM._.. LV.L, RID ECS> s LUM.4 iZ.yr12 ,/PEGS m RA_ T�P_-.I. �l6"04- yoL/D �c�� w6 y � - • v�z:p r y . , _ , AIAT6 H p L cos e _1. FAN.' % - so _ k —`�4, Nazi a x 7 � • - � _ - W �4, �a tV�L N 1 O � Y g �3 " r &'sve �t. GcuC--rtVAI LFDUND4T7neV a �xcsT- x8 � 6"oc 50Lin g�aG y-0`/�/h.F/ 8.:'CO.UG. CUfiG�j , _. V//(o. JC 8 CON " 1 ELoLJ ID O" !O -D` ./3 o?X6 P T. 5!,Lt_-.Wl S-EAL a„ ays r . _ a x . OD=fOG1 "OR . aOLT f r , s w 3.0"x 301,. -- A'AA 1 A)C �£ G-noAj- GiCA-C��y / C� Tyo� r_ ---Num/�♦=i2--._ CEO �� _ . �/G a C-. _._A351 • . - 7._ , is