Loading...
HomeMy WebLinkAbout0105 BEECHWOOD ROAD fit. �t , { '�`w. ��u��A`� aP ,gyp, • ay � a v a � i• A W't ,. ..te, n E of " a rn. 7 'e C w *i ..a4s:"� ...:ii}`3: .„�i �.:..a. -,.;..sf�fi'.'s,;:, "..i., _;. �' . :..T,,•., ,.:..,li "�" �j' - .;7t?'b ,.:... t.-. '�i�,r 7 aY..,, r � y ..,r,�` �_d_��• _ '.�t�' ',ate.. ••g;,,r..}d.�'�'�'_ �}y, �^ a. � a� •a..1 St. i..:. a: �, .. 1a Gr .v. - v4 , 'A .u. 4;'f 5 -y�tr R. y'i4°'', Yf .ram .%� l �4� Y .x,v. ..n� � 4 OWN t A , t ' 1!. '. Jan 29 2021 12:50PM Tupper Construction Co. 5087785010 page 2 TUPPER CO NSTRUCTION CO. LLc 546A Higgins Crowell Rd,WEST YARMOUTH,MA 02673 PHONE: 508-778-0111 FAX: 508-778-5010 EMAIL:admin@tupperco.com Date: 42A�� Town of Barnstable Building Inspector 200 Main Street Hyannis, MA 02601 (508) 790-6230 fax Re: Insulation Permit at 1" Permit # R -1-0 -���3 �✓ Issued On Z� This affidavit is to certify that all work completed for the above permit application has been inspected by a certified Building Performance Institute (BPI) inspector. All work performed meets or exceeds Federal and State requirements. Sincerely, r ,I i Richard Tupper License # CS-69058 Vv Application number.... .... ..... � BUILDING T DEP Fee .... ................. ....................................... _ KMW = NOV Z 2019 Building Inspectors Initials..... OWN OF ggRNsrq Date Issued.:. .. ... ....1......................... - BLE _ 0 3 S Map/Parcel..... .�................................................. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATliERIZATION PROPERTY INFORMATION Address of Project: AIr l9eec AW 0.0 i TPiui f� ER. TREET VILLAGE Owner's Name: i anal o a Phone Number__ Email Address: /foa"• 6N Cell Phone Number Project cost$ 600. 66 Check one Residential � Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize F6,W to make application for uil 'ng rmit in accor an with 780 CMR Owner Signature: Date:�1.Zd Zl9 TYPE OF WORK ❑ Siding ❑ Windows (no header change)# ❑ Insulation/Weatherization ❑ 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 / yn Lone l� CONTRACTOR'S INFORMATION t Contractor's name 1 C /7 r�/C/ Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor r 6 o6in Phone number ALL PROPERTIES THAT WAVE iTRUCfURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN n.eftrna.r vim.. M&IOrr/lnrw►w. wnnn^Iiwi nrr^nr w non&w.rPA.. nr.e-r88rn c.' L APPLICATION.NUMBER:........................................................... 1 *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. 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 Fuel source being used LP tank 20 lbs. or>Yes No ,if yes, a gas permit is required. Natural Gas Yes No_______:, if yes,a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-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 r 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. I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly 1 Name(Business/Organization/Individual): Address: /6.0 igeerA Wood 91J• , City/State/Zip: (,;!:�17I& IkIle 4W, d 2 _?2 Phone#:' 509 27 y-7S7(� 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 1 6. ❑New construction employees(full and/or part-time).* have hived the sub-contractors 2.EL I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an capacity. employees and have workers' y p �'• # 9. ❑.Building addition . [No workers'comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10..❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.�Roof repairs insurance required.]t c. 152,§1(4),and we have no 13.❑Other employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new,affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the 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. am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:_ Policy#or Self-ins.Lic.#: 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 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 u r th pai and penalties of perjury that the information provided above is true and correct Si afore: Date: Phone#: Official use only. Do not write in this area, to be completed by city or town ofciaL City or Town: Permit/License# Issuing Authority(circle one): F 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,coristiuction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone 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 in by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts , Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.gov/dia — � l.Utl itI WIIWCg111 VI ivla aba.tu'Gta� -Division of of Professional.Licensure _ ' ..F o..�..�of R.,j tul D tatinnc anri Cfanriarric C5 Ofi39d1 r�pires_ i 1111i'2 R. Nk ------------- RICH ARD P FOCARTY Rti � w. 105 BEECHWOOD RD; " a CENTERVILLE M 63 A 022 Commissioner �/r{iF frs�l7l73LPL1PPEtCIllt1E Ld.}`QGPr:;;3f/ClcrfJel%:s office of consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE,Individual before the expiration date. tf found retuin to. Re9lstrMlon. Expiration office of Consumer Affairs and Business Regulaftri 02127/2020 One Ashburton Place-Suite 1301. RICHARD FOGARTY ' Boston,MA 02108 fy % r r9f RICHARD P.FOGARTY'. '� CGj`—` �G'� ;•rfgi 4' fO5 BEECHWOOD RD Not valid witholJ igrtatgl* CENTERVILLE,MA 021332 Undersecretary Town of Barnstable Building Post7h�s Card So;That;it�s,VisibleFrom theStreet A roved:Plans Must be Retained on Job„andyth�s Gard'Must be'Ke t a , P M" Posted Until'FInalInspection�Has•:Been°.;Made s639 ° Where a Certificateof Occu anc. �s Re aired such Buldm shall Not::be Occu ied until a Final Inspect�onzhas been matle Permit iijlt ,n-- Permit No. B-18-538 Applicant Name: RICHARD FOGARTY Approvals Date Issued: 02/23/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 08/23/2018 Foundation: .Location: 105 BEECHWOOD ROAD,CENTERVILLE ( Map/Lot 252 035 � Zoning District: RD-1 Sheathing: Owner on Record: FOGARTY RICHARD P � Contractor Name RICHARD FOGARTY Framing: 1 ' " Address: 105 BEECHWOOD ROADContractor License 130373 2 OR- CENTERVILLE, MA 02632 Est Project Cost: $4,500.00 Chimney: Description: REPLACE WINDOWS(9) .30 UVALUE&1 DOOR' Permit fee: $35.00 Insulation: Project Review Req: Fee Paitl ` $35.00_` Final: h <Date 2/23/2018 Plumbing/Gas Rough Plumbing: -' Building Official final Plumbing: Mk., " W M �� Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. g All work authorized by this permit shall conform to the approved appl cat on and the approved construction documents fo-r49" h this permit has been granted. 3 Final Gas: All construction,alterations and changes of use of any building and structures shall{be in compliance with the local zoning�by laws and codes. This permit shall be displayed in a location clearly visible from access street or road a d shall be maintained open for�publicIinspection for the entire duration of the "Al work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Buildingianci F;ire Officials a e proTded on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work:' Rough: 1.Foundation or Footing �,r.. .. ... - 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 c Town of Barnstable *Permit# -Zf Fx�gy�res 6 months from issue date Building Department Fee .-4 S, ,na,,rsr,,B , « Brian Florence,CBO ,m$ Building Commissioner �ArfD MAr A 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number c 6 07 - a 3 S nn Property Address /dam I3ee_CAcJo©j Kd• &w1eli Ae WAlf 026.?2 R Residential Value of Work$ y�60.. -Co -Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address iL,chaf-d �o4ar fN r Contractor's Name � ChRt'Ct ,zn�a 4,6 Telephone Number ,SOB -21y Home Improvement Contractor License#(if applicable)_ Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: I am a sole proprietor �'��2 ❑ I am the Homeowner 1 1 0�® ❑ I have Worker's Compensation Insurance �UR,I � � Insurance Company Name RNSTABL Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ® Replacement Windows/doors/sliders.U-Value 6,.?O (maximum.32)#'of windows #of doors: *Where required:Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is equired. SIGNATURE: QAWHILESTORNISMPRESS2017 The ColFnmomvealth ofMassadjusetfr De,�rartineti!t cr,f�ntrrsfrial Acciderr�s - l ffwe i wesagadens 600 Washington Street Boston,CIA 02111 wrvtu ma-mgm1dia , Workers' CcimpensafranInsurauceAffidavit:Buildex-JC,antractiirsMec6r cians!Plumbers Applicant Informatran Please Print> bly Address: /6S- , ea i ld 061 CitY1Sta&Zi! &n'�e%y/11e Id, 6Z d.s 2 Phasic--a--- S-0 2`7Y- I.-3&/ 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 6. ❑Newemployees(Rd andfor part-limed* 'have!tired the sub-cosatractoss consfruction 2.1 I am a sole proprietor orpartuer- 'listed on the attached sheet 7- 0 Remodeling ship and have no.employees These sub-contractors have g.:❑Demolition wodkng for me in any capacity- employes and have wows' [No wosloers'comp.uasurance comp.insurance l 9. ❑Building addition required-] 5. ❑ We are a corporation and its 10❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 L❑Pltmtbing repairs or additions Mys,eM[No WOkers'comp- 'right of exemption per MGL 1ry_❑Roof r epairs insurance re uired]F �2,§e1(�wodoe versa 13.21 Other G�i4,idf� aloal to o worms' . cam-insuramm required-]. • Any WBcs�faccbedc b=flum also M cut the sectioabeLawshmdugdLekvialereca�panatinnpoTuyinfa�d=- fi Homeoaraers who submit this dfidavir kac.tmg they axe doing ollwak and thenbim outside contmctmcmnst submit anew afftdavk mdicazina such. ZCantxactoxs*=check d&b=mast stmched sa.additinna2 sheet shauiog the nmue of the s&-comuachus and state whether or w those ea iueshsv employees.It:the sub-can hate employees,dLey nmstpiuvdde their worker'comp.policy numheL I am art slrrpIay�sr fleatis pratddirrg workers'coa peresrn�a�rt instirartca�'nr Axs*enrpfayaees Se[biv is f tepaUcy and joh site inf ornzafiom Insurance Company fame: Policy#or Self-ins-I.ic. Expiration Bate: Job Site Addse= Citg/Stat'e/Z.p: Attach a copy of the work-ere compensationpolicy declaration page(sheering the policy number and expiration bate). Failure to swum coverage as r+equired.under Section 25A of MGL a M can lead to the imposition of criminal penalties of a fine up to$1,540:00 and/or one-year imprisonme k as well as civil peualties.in the form of a STOP WORK ORDERand a fine of up to$250-00 a day against the violator. Be ad dsed That a copy of this statement may be fixvm&d to the Office of Itavestigations ofthe DIA for iasmzmce coverage+vedfics#icn- f da kensby 'satdgr the!poets and psraaTfixs a.�pat j ary flat fide infor�sxcdimrprmt rl�d ubawrs true and correct Sit tature: Date- 1 2/ / Phone it 511 22Y--7,r--n1 tVEdat use only. Do not wri a in dds area,fa be coinpWad by city arton-n aficiat City or Town- PerndtUcense# Issuing Authority(ch*de one): 1.Board of Health 2.Building Department 3.Cltyirosera Clerk 4.Electrical Inapt ctor 5.Plumhh g Inspector 6.Other Contact Person Phone-P.- 6 ' 4 hafarmatian and Instructions Massachusetts CT&=-,l Laws chapter 152 rmpirw all employees to provide wogs'compensation for their employees. Pursuantto this stye,an ez7Ioyee is defined as.`�_evmy person in fine service of another under any contact ofhire, express or in¢plied,oral or wii ten." Air emplaym-is d:cfned as"an iadbidnA partammh�p associaii&A corporation or other legal entity,or any two or more of the foregoing engaged is a joint enterprise,andinclndmg the legal representatives of a deceased employer,or the receiver or trustee of an individual,pa timzbip,association or other legal entity,employing employees. However the owner of a dwelling house having not more fhan three apartments and who ressides therein,or th o octet of the - dwm jmg house of ano9zer who employs pmsons to do mai�aace,construction or repair work on such dwelling house or on fie grounds or building app rte:nantthereto shaRnotbwanse of such employmentbe deemedto be an employer:' MGL cbapter 152,§25C(6)also states fiat"every sfafe or local licensing agency shall withhold the issuance or renewal of a licen a or permit to operate a bWkess or to construct buildings in the corumonwealth for any applicant who has not produced acceptable evidence of cduupUanm with the insurance coverage require(L" Additionally.MCM chapter 152, §25dM states"Neither th r-commonwealth nor ray of i tS political subdivisions shalt enter into any contract for the performance ofpnblic womic until acceptable evidence of compliance with the insarat,ce. rem mmnents of this chapter.have beta preseute:d to the contracting authority." AppHc Please fill out the workers'compensation affidavit completely,by chectang the boxes that apply to your situation and,if necessary,supply sub-c°ntractOr(s)n2a*s), addresses)and Phone Tn— er(s)along with their certificates)of filmn7a•nce. LmmitedLiabilityCompan' (LLC)or Limited Liabm7ityPaitn=sbips(LLP)with no employees other.than the members or partner are not required to casy workers'compensation insurance- If an LLC or LLP does hale empIoyees,a policy is rued. Be advised that this affidavit maybe submftt�d to the Department of Industrial Accidents fbr confirmation of insm=c- a coverage. Also be sure to sign and date the affidavit. The affidavit should be-rstomed to the city or town that:the application for the permit or license is being regnest uL not the Deparbnmf of Ln.fT trial AcaLdenfs. Shouldyou have any questons regarding the law or ifyou are reguo ed to obtain a workers' compe:nsatiou policy,please call the Deparfiner±at the number listed below. Self-insured con3panies should eater then self-insurance license number on the appropriate line. City or Town Officials t � Please be sane that the affidavit is complete and prkibf :d legmlbly. The Departiaent has provided a space at the bottom of the affidavit for you to fill out in time event the Office of lnvestigations has to coact you regarding the applicant_ Please be sure to f M in the pen mi license number which will be used as a reference number_ In addition,an applicant fat must submit multiple pennitlIicense applitalions in any given year,need.only submit one affidavit indicating cazrmt policy information.t`if necessary)and under"Job Site Address"the applicant should write"all locations in ( S'or town)_"A copy of the a$davk fmat has bey officially stomped or marked by the;city or t owa maybe provided to the ' applicant as proof thmat a valid affidavit is on file for fotore'pe=jp or Hc=es. Anew affidavitmust be filled out each year.'¢Where a homeowner or citizen is obtaining a license or permit not related to any bnsineass or commercial vtni (Le. a dog license or permit to Immm leaves etc.)said person is NOT reqaired to complete thus affidavit: The Office of Investigations would like to lmank you in adv-aoco for your cooperation and should you have any questions, please do not hesitate to give us a call. The Ileparlmmfs addross,ftlephone and fax mnnber: Departmmt of liidiiddat Aocideents =Ce of Xuvezgi iO.= Bastm�MA 0�11I T614 617-727-4900 ci t 4€6 Qr I-977-MASSAFE Fax 9 617` 27 7749 Revised 4-24-07 ..ma.s! � �pFTHE r Town of.Barnstable °* Building Department 9 M& Brian Florence,CBO Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.maxs 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 act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant~ Pools , are not to be filled or utilized before fence is installed and all final inspections are performed and accepted.- Signature of Owner Signature of Applicant Print Name Print Name Date Q:PORMS:OWNERPERMLSSIONPOOLS Rev:10/17 Town of Barnstable pFtHE, A Building Department f '' os Brian Florence CBO STAB Building Commissioner BAMM MALS& ,0 200 Main Street, Hyannis,MA 02601 ptFp .th www.town.barnstable.ma.us 4 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: /14, A&A W G v d le nu er street village "HOMEOWNER": C U Qr name /home phone#p work phone# CURRENT MAILING ADDRESS: lO r b Pc®C/7Gd 013q� 1��. any/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 undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection.procedures and requirements and that he/she will comply with said procedures and requir eats Z 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 to amend and adopt such a form/certification for use in your community. r f Permit Ntimber C' '01114pliance Report fin ' ' --- Prl CCh e c &' rrttvvare c rsInr, 3.2 t<dlems " 1s hL C� �ke�!B�ir!`It;iti�. TIT Lp:- N��•Bath , CITY-Ba"m<;atwle STATE �assachtt4ctis .s '3 F1Dd # a G,i 7 com'mu,CTIOIV ITPE 1 or 2 family, De,,achl d 1 MA' ING SYSTEM.Ti E:C>tJ>evr Ctw*rsw l trlc' �M n� f - OAT DATE QF Pl hI M O.V 1/200 c PROJECT I�iFC7RM��l��sN. ,Jmnes ChristianTV A 74 Beachwood Road Centerville,M4. �Zb3 t • �" x„ ; ".OWANY INFORKATION: s �f Mi[ e l�otsri'Ci stuns c3ltilder 387Phiri me { Cent&villi; i` A, 02632 � ® . No Its, o iLiaChcc by Cruse Corgi Insulaticsn 31ti 4 , COMPLIANCE'..'.r Passes Ytsur 14o'me? ?3' i 23".3% kt r Than.Cede , Geeing Arar,r Cavity Coot- or Doll �Ci"1Rt14��i �V 4 + � 'l q'. dC�IY ?l {y Cr fling l: Plat Ceili6l; 10.0 Wall,1: Wood Frame, l.C}i���;� �a- 13.0 0.0 15 Window 1: Wood,l,Far�e,Double Parse miith Law,.'' � 6.340 2 Floor I: All.Vood o1stl is�,:6ver U*nconditio6ted Spiwe. 72 19,0 0,0 3 COMP.1JA'Na.s'rA+.` EMENT- The proposS d building clMi"W deVZTIbeu he a is consistent With t,ie l) ldigg lj plans,.specifications-, `I'11e xsrollas€d bzrildirg has been,deaigined tm rrleet tkq,Mass'aehusetts-Energy Ccxie.requ=tet ents ri Rr1ECcheck Wnsion 3,2 Release Ia. k- i =Che heatin�t(oad,for t9�ls l�uilctliig, and the�c�nfirt l�>a 'Tf pprr�pr+rrtt,lams been determined using the applicable Standard Design[Condit ionf,fi&nd,in the(rode, .The,F'iV,�,Gegrsipmerrt selected to-beat t�i°conl the building slifill -be no gre t r th nr 1 So of the design_inat�ins;specifWe r bons 7$OC114R 131(l and.14.�1, i .._ - E a y -ten - . FR i t t., its' sty a'Rt i . Pc the;building,playas or.?pcc il�c.�t.ions; m �, .�1lCt trli3al�4a9�6'afi�: r`' E J I'.; D acts shall be insWated per,'rably 14.4:7.1. „ I .t'baae$�'aaaas�r�Bio�ta: _ f ,• rz'�ce5sil5te,t©ir><ts Seam:; rrd ccitttte�~tic i; of supply zrsd ream ttut:t err# lortttea c�ctis`ae conditioned s0444.irt%:luu'ing'sttad l~ayS rrr joist cavitiesJspares used w transport air, shalt t sealed o,14 tnastio$yid_fibrous lLackitap;Ispe cnst&lkd.acc:ording to the ManActurer's irstallol,Ony t instructions, Mash tape may orn tted where grips are kw than 1/8-inch. Duct tape.is not perrnitted Th F1'�Ar . stcm run rovide s�..mean? l'rr l i ci - ''r � f �. 1'► p �.il p�,alr Afi'i�`+'+�@�Cy3t�rY14 u?a T glhperaaVre`C;ontracis, u3[ I { rheribsfiits a+€:regtr'itrd far eaclr s ara,L'.-3VAC systcm, A manual or automatic mons'to ".s 'par4i allyretst ic�t r stout otl K.➢te.hegriatp atidlor cooling L-inut to eacti zone or floor shall be providdd. I Heating n'd Cooling Equipmeatt Sizing; Okttpatt cF aclt `'c�ffihahrstingl6v+,li g s7rst a is not rate? than !W5%�oct;rs design. load as spcciried In Sect oeis 7R4t;tsrilPo 131 ;and 34.4. "f 'S;,"3rciaiss�n�dot a,'l✓'ai�tt•�wstraaa6r, . • .1. ln�ttlti.te i. c dktirg Jn t water pipes io the'lewls bi Table 1: *: J Al)haatac?simim-'ming txvts must have an ora;od heater swit.�lt and rewire a cover unk'ss order 20% ul;tlze:larr ting emn—gy is otti non-depletabie,sour . Fool purrnps regtrire a'tstnc cicrc k. 4 ,fleoatinly-aaa;<al€'cooing Piping txasaalta,tion. ?. 14VAC pipitsg o-onveyi4g fluids ah6v h20 of c'hillet fluids�wtic v 55°F crust be ins"dated to they f levels in'aide 2, 41 4' a fit } FROM I lr,.'i.. .2l_1012 i iy:=#. fi('`I F' i 4 !. r 44h8e^�+,Y'Jt 4 lW�l9tl',\,.�r•V.3 $aY'' �'\ Code lvCl Cc}rc'cTc i�ftwvsre ?l; rsaprw 12. Release l�, ' l'l"1 LE"Neww' iwal UsIc II t n, ,1: Flat Ceilin or 863s rc'i niss, R-:30 0 r-avi`ly Insulation. _Lar�rnenis` - r � ; �. 1 � alt I•P��'Jc�od_l"rrsrn�;, :16d rr t,.4�1 -1.:1:U cavil+rh,.claft�i� 1 j `,� ; 1. W4endo' , 1: Wood Frame, lrlOOle PRfle with Low-C,U-f8 !or. ),340 For wvindoi vs wvithiota is, led v-fpctors, descVr be.futures: #Paves_ Fr`nmeType Thm. naj Lr ak? y C �orttnertts� Floras v Tloor 1: All-Wad doist/Truss,.,Cvc.a unconditioned Spam, R-19 0 cavity insulsiiorl , 1 _CJt�ICt£13is: Doiler i , l;? 7 ARJE or higher j �`l�lwc:.�'i�S;vl'odt�i ivuln�r • Air Leakgg t,: E. ) .loin(.s;penetrations,,and all other su�.1' openi s ;s sin the?�uiidirrg'nvelr jse tlt�lt Pins sorrrcss c�at; leakage r;must bi:sealed. ( ] '06n ibsl:alied in the buildini etavelalrr.,r".sel lightin� Gi'xtlares �. '�laall"�FeT ring�>f!lte in9lawita;�te�r��exrza�tfi;° ;. 1. 'f'ypa lt.;'rat d;niarn factur,�d vviib no'f)cnetratioor �tw n the ,rssicfe csf the recessed fixfuri t ;P } arid f'g CaVI v'nntl seal�l or;gasket to pr vent stir ICal- ge i:?tcr Ilse uracartrlit tined s ac;e° j2. T e 1C.rated. in accordance with,Standard ASTJM F 283,with no more than 2.0 efin(0.9.14 I. I'ht)tsir movoment Frain tl'Se the conditioned space to the"ailing cavi y. The lighting fdt•3arc I Shill.have li t n tested at 75 Rk�fy't57 lhs/fU presscr<.difEece�c�and slia!E ize labeled. Cgll1l'4'oni.the worin41..­'Visater sire of ait nor, wv ntcd framed ceilirrge,waits, and flvors. . ( µ l' atcs ials aiar�ictuiprrrW..must Yee eactrfied so that complielice can berdeteiTnined, S 1 =�3nittal ul'er ra�Arsuais far ill`arsiatle he*ing and cwling,equipmen,t and service water hearing r equ rI%at"TnAIWbO'provided.; r . I,. ] lrisu_at orr R-values,gjazin9 heRting equipment efficieticy rrrust be clearly marked nor FROf'I r - �' FF. ��!_. I_�f'rt (a 2(,-j2 CIS.:r441 Pt �q c� f^.�'trrtaae rss illisnalglia n Tbkkrrersjbj=CirmialimigIdig:Wale;P4pe.v, �:3eal�d�Na�t�r � ��erGui�#t€�,.��� n�D.. Cic��..l�r! nt,�s�r►tD�.���.` r Cc sty %ta!", U' A0" 4 '7CI,l 3; 15 , D.Q J.� 2.0 DrDt��DC1D 01 MA a litb' .. 7ixH�s : . � 0�n�� r:� JtaFlor fi7 �r ss ` IIVA,C Pipes. _n!D 1:,ry `9y��9 v5 ttue_�. ),1— rl��?y4 a"FSi C 1 25""��r!t nitY 41 id�uj" z ..- T.�vs�l�rosN�:r�T.'['c�t�p�t`�tur�� �Cl•2��' �..4 D,� 3.;s 2,d Stospi Cc+raiD jo� xs 3a�e w te'r). i1 t I.d� 1.0 I.S zo 4ituidi` �st� .;�a^ iylzrnt� s�., CD.S e�, U.75 i,�?E x- nd �. 33e-t m 40 1.,C1 3.0 3. 1.5 Von, �:,. y�e'��T"3�~�p�� �'�'LmtR���c�tn�;l�ep�t'tr�►��G[)sP CM6�.> i9 . 7 ' Bate v . .. ... to a i , a ; v . F(7- 7-Aj � � �� L-v 1 � � � r I p `� A uc2�r S f? Z I � � � � . �� i l i' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma . oz ;5 Parcel 6 Permit# 0 n ' ' I Health Division D � `' af_ Date Issued 2 V _ ��. ✓ V Conservation Division Z// 0 ( Application Fee Tax Collector �� �/vr��� Permit FZ, L �. ` - 7 PEC "Y"T EIM MUST BE Treasurer ._ ''.�, ;*� IYSTALLED IN COMPLIANCE Planning Dept. / VMPT TITLE i Date Definitive Plan Approved by Planning Board EMMMINMENTAL CODE AND 01AFN P GU LAP T10N3 Historic-OKH Preservation/Hyannis Project Street A seec 0 'a 7 �� Village .4/I a IN. U 1 Owner A,AA 1 it t 1- % 4 Address 722 3 4/1�S C w iTzeh &A P Telephone Q f/ y/- 4• / zl ✓— &2 Permit Request 0 u a 4 � + X 1 Z ' ,�1 A J 3 A_X 1, A 0 e) •�•� � / g c tr To LJV Square feet: 1st floor: existing 100 proposed 7 Z 2nd floor: existing C?� proposed Z Total new Zoning District Flood Plain Groundwater Overlay Project Valuation %), 400 Construction Type 6u 0 o � Lot Size / /' Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ff*"' Two Family ❑ Multi-Family(#units) Age of Existing Structure 2 0 y'(\)' Historic House: ❑Yes &No On Old King's Highway: ❑Yes 4EY'IGo Basement Type: & ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 0 Basement Unfinished Area(sq.ft) 166 Number of Baths: Full: existing new I Half:existing new Number of Bedrooms: existing Z new Total Room Count(not including baths): existing � new First Floor Room Count S Heat Type and Fuel: 26as ❑Oil ❑ Electric ❑Other Central Air: ❑Yes O'No Fireplaces: Existing New Existing wood/coal stove: ❑Yes Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:21rexisting ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use - 1 BUILDER INFORMATION p Name M � ��-�` Telephone Number ®q� Address 7�'6 ) ?H (titi P Y f ( <-N e License# o S+ �- �✓ � Lyt (f Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE f /�✓2��� FOR OFFICIAL USE ONLY PERMIT NO. .. I DATE ISSUED - - � - J MAP/PARCEL NO. ti ADDRESS-- VILLAGE ') OWNER _r DATE OF INSPECTION: • - FOUNDATION FRAME \ p 3 �' INSULATION - l FIREPLACE z ELECTRICAL: ROUGH FINAL.--' :) PLUMBING: ROUGH FINALS- - } GAS: ROUGH) k FINAL'S ` FINAL BUILDING, 77 . DATE CLOSED OUT( ASSOCIATION PLAN::NO,: <, f, ,r t . . The Commonwealth of Massachusetts Department of Industrial Accidents t - Office of/nYes 9,911ans t' 600 Washington Street - - Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name M l' A location: e# cityhon ❑ I am a homeowner performing all work myself. Qm a sole r netor and have no one worki>1 in ca achy u workers' co ensaton .. :name:::::': :;::: ...;...:... ...... tom ::.:........... ..:: :i ?>::: Y::;ii:;;;::Y:!:::i:<:?:%Y;:;?Fi:::i:::L:•i:;;:;:Yi;:::;?::�;:i ":ti:i:i::Yi:: ;;•;;..Y:':Y::;: ...::.. ansttranc / ❑ I am a sole proprieto w eneral contract94or homeowner(circle one)and have hired the contractors listed below who have the following workers' 'on ohces: ....::. .... ..... ...... ........:;.Y:::;:.:.... ...............::.:YYY:::::>::»: ....::............ l Y! n awe to anv >i 1 S 4 a � >! -::!.};YYY:.;�.;Y:�•>:::::.�:.}:•::;::;::...::........:....:•:::.. 'oa .. } YH:... y 't 4� Ax ..::..:.:.. iy::;>:•}•Y:•Y:•}':';YYY:;;Y}::!-Y:•YY-.,y;�::.::.:v�}:: .........:.......... ............:. ;..Y:•Y::Y:•:;�::•i:•YY:•::i•::•::SS;:r::%�:; :•>YY::'::�: :�``':�::.:':"`:',:::'::°'<.:::•".:.•:�::::.�:::��..:..`..;i:.:.:::,:!•:•YY•.;•n::•:•:•••Y•:•Y••Y•Y-•:;..;. ::::::::::::::::::::.::::.::.;:.;:.YY:.Y;:•.....:.:::::::.�:::::.:::::.:;-;•Y:�;:;.}Y}Y:.Y:.Y:Y;YYY:.»»::;:�»>:::::::::.�::::.::::._::::::•Y:... .,:., ..:,..::,:.:. ........:........ ...........-::.: ............:.....:........... ..........:::YYY}• YY:4Y:ffi•}Y:4:•Y:4Y:ii: ::(Stitt?"ii'i!:i{i;Y:�+' 1y SL'.•[•,-'.•'ij'':<v?!y::::: ......::::: .......::..:.............::::..... :. ... ......:...:.:...........:::::::::::::ii:Yl•Y:•'•:::iYK:iivY:•is:i>:::i::{:i:::::?:i'Y::Y:!.::;�}iY:ii:i}`:::::: Q� liuuraaCe:CIY��:�»» '� ;:< >%:Y:•Y:!;»:,:::<•:<•>Y:..�,::::.:�:;::::.::,:,.,•,.::.,.::,.,.:...... . .. gaffme to.... coverage a,required wider Section ZSA of MGL 152 can lead to the imposition of critninsl pensltles of a tine IIP to S1,300 00 and/or one years'imprisonment as well a,duff penalties in the form of a STOP WORK ORDER and a Sue of 5100.00 s day against ma I understand that a copy of this statement may be forwarded to the Office of Investigation o[the DIA for coverage verification I do hereby certify under the pains and penalties of perjury that the information provided above is true and eorred Signature Date cc s Print name Ak Phone# ONNNOMM official we only do not write in this area to be completed by city or town official permittlicense 0 ❑Baffling Department m) city or town: ❑Licensing Board required ❑Selectmen's Office ❑checkif immediate response i9 q ❑Health Department phone#; ❑Other contact person: (revised 9/95 PJA � II Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied,oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 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 insurance 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. a 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 along with a certificate of insurance 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`Uw"or if you are required to obtain'a workers' compensation policy,please call the Department at the number listed below. 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 p11:i license number which will.be used as a reference number. The affidavits may be miuriR to the Department bymail 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. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents omee of lavestlgsuons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 Town of Barnstable Regulatory Services AM Thomas F.Geiler,Director 94,l i639. g Buildin Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 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: 4 0 o 1 i o°^' Estimated Cost i Address of Work:—!y w� C 1✓ n Owner's Name: S AA- -e Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Con acto ame Registration No. OR Date Owner's Name Q:forms:homeaffidav RESIDENTIAL BUILDING PERMU FEES . APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE _square feet x$96/sq.foot= (, f 7-t x.0031= 2 plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq. , >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >150 sf- 1000 sf 75.00 >1000 sf- 1500 sf .100.00 >1500 sf-Same as new building permit: square feet x$961sq.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 Above Ground Swimming Pool $25.00 Relocation/Moving S150.00 (plus above if applicable) Permit Fee ■ ■■■■ ■ ■���■■■■■ ■■■ ■ ■■■ ■■ ■■■ ■ ■ ■■ ■ ■■■■■■ ■ ■■ ■�■■■ ■■ ■■■■ ■■ ■ ►%■ ■■■■■ ■■■■■■�'■ NEE ■■■ ■ ■■■■■ rat■■■ ■■■■■ ■■■ MINE ■ ■ ■ ■ ■■■■■■ 1!■■■■■■�'�.■ ■■■■■■■■■ ■■■■ I ■ ■■■ ■■■ ■■■■in■■ ■ ■■■■■MEN. �,■� ■o ■ ■■■G ON ■■■■■■ ■®�■■■■■ . L� l�!■■■■■w �■ ■■ ■■■■■■■■ ■■■■■■ NEE ■ ■ ■■■'■■I I r■■■■■■ MllllMMlMMMMM NEON ■■ ■■■/ ■ ■■■■ ■■ � ls■■■■■ ■■■ ■■■■■■NONE■0�" ■■■ : ■■■F ME ®!i Iii■■■111111015■■■ ■■■■■■■■■■■r/ ■ ■���l ■ 1111,01 MENEM w■■■ mini■■■■MIM ■ MEN ■ ■ ■T�■■■■ ■■■■■■■■■■■■■ ■■►a�■■■■■■■■■MINES■■■■ ■■ ■■■ ■ Mail ■ :■■ ■■ ■®■■■■ ■■■ ■■ ■■■■■ NINON ■■■■■ ■■■MEN ■ No SIEMENS ! !!■ ■■■■■ ■■ i . L■■■ ■■■■■ ■ ■■■■■■u■n PENN! ■ ■■■■■■■■r■■■■■■■ ■ I■■l ■ ■■0 on ■�■■■■■ ■■■lLco■■ ism■; ■ !!■ ■ ■ ■■■■■■■ ,� ■ ■morrow■ ■■L■■IIJ, ■ ■ ■■ ■■■■■■ ■■■■■■ "own ■■■_.■■E■■■■■ ■ ■ ,■ ■■ ■■■■ ■■■li■► ■■■■■■■ ■■■■■■■■� ■ NEE■■■■' ' !■■■■■■ ■■ ■■■■■■■■■■, !■■■■■■■ ■■■ ■■ ■■■■■!. ■ !!: ■�! ■■■■ li1�■�■ ■ ■■■■■■■■ ■■■ ■■■■■ ■ ■' ■ ■! ■■■' ■■ ■■■ ■■■■■■ ■■ ■■■■■■■■ IN No ■■■■■ ■E ■■ f ■■■ ■ ■■ ■■ ■■ ■ ■■ ■■ ■ ■ ONE ■ ■ ■■MEMO ■■ ■ ■ ■■■ ■■ ■■■■■■■ ■■ ■M11MENINE■■ ■ ■■ ■ ■ ■■■ ■ i t i v i i . ✓_ pp ,le L�arivnaoyuuPr�l d��,G is%ua�� ~k a Board Of Building Re aulations and Standards I HOME IMPROVEMENT CONTRACTOR w; Registration: 111859 Expiration: 11/12/03 Type: DBA MICHAEL RENZI CONSTRUCTION MICHAEL RENZI 387 PHINNEY'S LN GENTERVILLE, MA 02632 AdmillistratO 072 ✓ 9"[�ryII7�Y�tdytUlP.GLGCIG 6�J✓ C1k1lLU6Q .11 } BOARD OF BUILDING REGULATIONS 'I License CONSTRUCTION SUPERVISOR i i. Number CS 058266 - +' Birthdate 01/30f1953 r Expires 01/30f2004 Tr.no: 13512 , i,,,,,� Restricted 1 G": a MICHAEL J RENZI'` 387,'PHI NNEYS LN' CENTERVILLE, MA 0263'` ° Administrator ;t Oc't 17 02. 12: 46P r CorneStn Title 508 7576793 p. 1 ' OCT-10-2002 11:59 RENEY MORAN TIVNAN T .5098532913 'R.0I%01 RENEY, 1MORAN 4 TIVNAN, INC, MORTGAGE INSPECTION PLAN REGISTERED LAND SURVEYORS NAME JAM T. CHRISTIAN 33 BURNCOA"STREET to WORCESTER, MA 0�,G05-;81 1 LOCATION 74 BEECHWOOD ROAD � 505-552-5203 ;PMONE) o 508-853-25 13 (FAX)) C NTERVILLE MA _ 508-653-b3G4 (FAX2) SCALE 1 " = 30 DATE 10-9-02 9 RMT.INC@VERIZON-NET (EMAiQ 6v REGISTRY BARNSTA.BLE arm WaAlpmr � D!1.=UPON DDCUmwokNQv MV0E0. It"M ED WFAWPf- PUW 9DOIc/PyW N AIEN15■FAF YAbE w Mf AIONTAOf MD BUNGING S SNOMN ON MIS 1fDAf6tpe N ft .w 0UA NT ALL M��[EASt]Ai1t15 AAE SMOn"AND THERE#A ND v0A*4 WE c0m1f NO f►rF a 2aWNC RWaUNDNATS mwpDWC STTNCNM TO PR BYRDN/G(S)+WE NOT Mfl1aN 11� . UK wrx"(104m OTNAIN',sf,NOTED a oRATRNG ee j E%VAL A0a0►Ivmq^m^ mx rvD wP: QR bfl�t'L6ND � P'ODtS bAIMEYIAYS. . NoaTrDNs.TNIS N�Naec 5C STD 8-19-85 f�mar'crow��'R " STWP m. OR TO PLANS TD S*vm IAwU of THE STRoETIflKlS)SNorN NFRfDN oMDR r69W WAD aDW W K04 W VAE Na IN COYPLiIWO[IpM EOCAL iONNID T'+OOAA 1 POF 1q/UNE amc? !S NOT WCUA T ACCUPME.UUM OIFINWW KAWS NoK Acn mfvmm*oA Is EKVAW FMW 00%ArOW W10kiUM „`�H OF y MUED By N O 4W/w A vWr.4L CWMM SUR►cr 13 Oma UNDTA . n CA iTI1F YD. CMAP. SEC. 7.UNIESS (C�' PERPdi M,PRE= UVARONS CAWOT Df MfON MM, OIlIERRISe fRDlpp• TgIS CE7N1iTCAlIOh IS NQM- .�`� GEO1% �+ NI ABOIE"Im" dTIONS AAE M�OC•IM n¢Ii Tq ^�INE1aI04A110N PAamD[0 IS AO WTE AND GNAT THE MWVRE. EQWARp p=W014 ACCUPATQr WGTEO IN AGATM TO Wr No 15158 y r I 1!o.00 t 1 I House Te (Or>1r153 jjj I i J� GARgc � r\ � -----� 110.00 — � BEECHWOOD ROAD Wy Sri BY:CORNEWONE TITQUM seawces TTA4T9(TfA [EY d�� - TOTAL P.01 I