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0120 BLUE WATER DRIVE
I"kwAl P1 14, JVM210001 OWN* 16,0..;� �v www Nm k A%Al is 1 RAN 17 "g P,��VO; . A,� D -P I KU" W Vk, MEN& aNk "gffi, � yj is A WE- �zc �g K W�l IPNM��Ie,��, ��ign vz, eu tow ru R, g, A�,OE�1X "wqqyqy, two Nusgun a Qf, 'Wll�., I HW� 7 11Y gzqa EL": 44 a SAW g- ijg A'E�RR� 5 m ,,AIM,', a ",CIA �Nkl��"--q �jt tq� H.WL�-6-0- 5, ARTMV, RV� xj M? U�+SRNSU;'fAT u "WR �,1611� N, F1�4. 0 i;�I PINAR RU�5 M11 .1V ein "R 0 , P , vi xry M., 1 MR 2P N IN K �g 51 i, rt, its wwu 'PT: �"u --w 0", A 'W Pn`2,1111,1111tU q--goo- - 7t M. Opp gy 5p 401 R,$ WN , 2,� Ek k gp g X-A A, KORVAR g� "OV g ti .04 n "'a 2'jvl�M'N qffl� 0 `0- R Ak-12vilit""', A. J"j, kY01 'a 5s �i wT A, j AFf "41 . vzg gemaya tx ON 7, jg R% f x V 30"'M �KKAI low A W 0010. �L� �`��� � k { f Town of Barnstable Building �'` -; 'bra,�:.� -.. �''.,. .,`�. %'." ��`;,� .,� r -fie" c uF � � k' ..,:.�-`# ..,^,� vs«� � �r3 •.• s� :� r a. ,. r Permswiuvsrw Post This Cad So That+t s Visible=Fromthe Street Approved Plans,Must be Retained on>Job and this Card Mustbe Kept ,•,,,, b" 'Posted Until Final,Inspection HasBeen Made n :, ' W,.here a Certificate ofOccu a,nc. is RequiredsuchBw�ldm shall Not be Occur, �ed,untilza Fiaal:lns ection has been made ,:! . ,..:...�:.x�.*�m«. �..., "v"�,»�:�< Permit No. B-18-1312 Applicant Name: J SCOTT CIMENO Approvals Date Issued: 06/05/2018 Current Use: Structure Permit Type: Building-Detached Accessory Structure- Expiration,Date: 12/05/2018 Foundation: Residential Map/Lot- 253-024-XO.2 Zoning District: RD-1 Sheathing: Location: 120 BLUE WATER DRIVE,CENTERVILLE Contractor Name: CIMCO CONSTRUCTION INC. Framing: 1yJ�5, Tc,. Owner on Record: RILEY, KEVIN R&CAROL R `Contractor License 161550 2 Address: 120 BLUE WATER DR � Est Project Cost: $60,000.00 Chimney: CENTERVILLE, MA 02632 P6rmlt Fee: $406.00 Description: Construct 24x24 Garage w/storage space above See Atta hed w Insulation: Fee Paid:;` $406.00 Plans. (Attached by Open Deck). A � Date ` 6/5/2018 Final: Project Review Req: ATTACHED GARAGE UNFINISHED SPACEABO�/E � � T :. �-_ Plumbing/Gas 3' YC ✓� ` Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorzed by this permit is commenced within six months imssuance. Rough Gas: All work authorized by this permit shall conform to the approved application and�Yhe approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structuresshall be in with the local zonmgby laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street orroad,and shall be maintained open forpubl c mspectn for the entire duration of the work until the completion of the same. ¢f ' Electrical Service: The Certificate of Occupancy will not be issued until all applicable signatures by theBuildmg and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing „� � - ., .. Rough: 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 7.Final Inspection before Occupancy Low Voltage Final: 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" (asset forth in MGL c.142A). Fire Department Building plans are to be available on site Final: o All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Fpemnnift ationNumber� d• (.� • . ..!,a....... ......... BAE1�i6TABLL. f Fee. ` ►✓ ,•• u•. 0@ierFee. l 16 9. Total Fee Paid. ' TOWN OF BARNSTABLE Permit Approval by.. on . � V i BUILDING PERMIT APPLICATION Section 1 Owner's Information and Project Location l�A�WPRTEh— Village am& 1'-1 ri Project AddressI� Owners Name 10.E Owners Legal Address �LV1�lNla' }� [ l V City Stated �n�r�►�`lPZlo 2^�0 Owners Cell 114-S E-mail Section 2—Use of Structure P: . ❑ Commercial Structure over 35,000 cubic feet Use Group 't ❑ Commercial Structure under=35,000 cubic feet L g' Single/Two Family Dwelling Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use `❑ Finish Basement El Family/Amnesty ElFire Alarm ElDemo/(entire structure) A artment fl Sprinkler System Rebuild El Deck P 6 Addition ❑ Retaining wall ❑ Solar ❑ Renovation �,�. ❑ Pool ❑ Insulation Other—Specify Section 4-Work Description S� 2`t X2 A L oS w� a1 ��drd r 4 �' i act Tmciated:2J9l201 S i Application Number.................................................... i Section•5 Detail Cost of Proposed Construction Square Footage of Project 464 Age of Structure Dig Safe Number #Of Bedrooms Existing Total# Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method MA Checklist ❑.WFCM Checklist E'Design Section 6—Project Specifics iris Oil Tank Storage Smoke oke Detectors l� " 0 0 O Plumbing ❑ Gas Fire Suppression ❑ Heating System- Masonry Chimney ❑Add/relocate bedroom Water Supply Q'Public • ❑ Private Sewage Disposal ❑ Municipal '2On Site Historic District ❑ Hyannis Historic District E] Old Kings Highway Debris Disposal Facility: H\'\J)DL.f'60 Qk) I am using a crane ❑ Yes BNo Section 7-Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes 0 No Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft.`I3q Total Frontage Percentage of Lot Coverage ' #of Dwelling Units (on site) Setbacks Front Yard Required 30 Proposed 93 e. k Rear Yard Requited,L Proposed rl 1 4'ei t Side Yard Requu dk.l Proposed Has this property had relief from the Zoning Board in the pastT ❑ Yes I € ' = Last undated.2/9m i s Application Number........................................... Section 9-,.Construction Supervisor Name &-A-N a Telephone Number 53 3 Address U. P�b x 15 &A- CRY !iAaYYUA,6 State PW10,z Zip 62- License Number 042Ct 57 License Type Expiration Date Contractors Email T c7 SGobl,,I CoMcasT- 46-C Cell# 6-09. 3 33. 1533. 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 require CMR and the Town of Barnstable.Attach a copy of your license. Signature ` L Date Section-10—Home Improvement Contractor -_-- Name aoisl Telephone Number « 3 Address 0-d. BOX fjb4- City S4GAw+g1Gts' StatelM A. Zip Q ZS611 Registration Number t b I S5Z Expiration Date Zz, uo. 20 Ids 5' I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation re CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 —Home Owners License Exemption Home Owners 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 SIGNATURE Signature Date 4 Print Name Sc(ITT Um's (1j Telephone �• t 1 _ ep Number SZ 333 l533 E-mail permit to: -rba-J 6 U i I de u(s Co m ST E r T e..F.....i..ae.i.11 In M1n1 0 Section 12 —Department Sign-Offs Health Department ❑ Zoning Board(if required) .❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ ' y. _ r Conservation Ir For commercial work,pl ease take your plans directly to the fire department for approval Section 13—Owner's Authorization I as Owner of the subject property hereby J authorize Sc=�1 � P j C0 to act on-my behalf, in all a permit application for: matters relative to work authorized by this building p pp . 026vz-- ' (Address of job) l Si ature of Owners date - Print Name 9 • 1 j i i - i y J f A = Last undated:2/92018 II I Lauzon, Jeffrey From: Lauzon,Jeffrey Sent: Friday, May 18, 2018 4:49 PM To: 'toscobuilders@comcast.net' Cc: Lauzon,Jeffrey Subject: ViewPermit, Permit No:TB-18-1312 Applicant, Please be advised the above application h een reviewed and the following is needed: 1) Engineering needed for Ivls. ' 2) The construction documents show conflicting information with the application and need clarification. Please contact the building department as soon as possible to resolve the above.Thank you. Jeffrey Lauzon Chief Local Inspector (508) 862-4034 ieffrey.lauzon town.barnstable.ma.us 4 9 ®Boise cascade Triple 1-3/4".x 18" VERSA-LAM® 2.0 3100 SP Floor Beam\F1301 Dry 11 span I No cantilevers 10/12 slope May 25, 2018 08:30:38 BC CALC®Design Report Build 6536 File Name: BC CALC Project Job Name: Riley Residence Description: Designs\FBO1 Address: 120 Blue Water Road Specifier: City, State, Zip: Centerville, MA Designer: Customer: CIMCO Company: Code reports: ESR-1040 Misc: v 24-00-00 BO B1 Total Horizontal Product Length=24-00-00 Reaction Summary(Down/Uplift) (Ibs) Bearing Live Dead Snow Wind Roof Live BO; 3-1/2" 5,760/0 1,768/0 B1, 3-1/2 5,760/0 1,768/0 Live Dead Snow Wind Roof Live Trib. Load Summary Tag Description Load Type Ref. Start End 100% 90% 115% 160% 125% 1 Floor Load Unf. Area (lb/ft"2) L 00-00-00 24-00-00 40 10 12-00-00 Controls Summary Value %Allowable Duration Case Location Pos. Moment 43,462 ft-Ibs 62.1% 100% 1 12-00-00 End Shear 6,404 Ibs 35.7% 100% 1 01709-08 Total Load Defl. U332 (0.85") 72.2% n/a 1 12-00-00 Live Load Deft U435 (0.65") 82.8% n/a 2 12-00-00 Max Defl. 0.85" 85% n/a 1 12-00-00 .Span/Depth 15.7 n/a. n/a 0 00-00-00 %Allow %Allow Bearing Supports Dim.(L x W). Value Support Member Material BO Post 3-1/2"x 3-1/2" 7,528 Ibs n/a 81.9% Unspecified B1 Post 3-1/2"x 3-1/2" 7,528 Ibs n/a 81.9% Unspecified Cautions Member is not fully supported at post BO. A connector is required at this bearing. Member is not fully supported at post B1. A connector is required at this bearing. Notes Design meets Code minimum (L/240)Total load deflection criteria. Design meets Code minimum (L/360) Live load deflection criteria. Design meets arbitrary(1") Maximum Total load deflection criteria. Calculations assume member is fully braced. BC CALC®analysis is based on IBC 2009. Design based on Dry Service Condition. Fastener Manufacturer:Simpson Strong-Tie, Inc: Page 1 of 2 i Boise Cascade Triple 1-3/4" x 18" VERSA-LAM® 2.0 3100 SP Floor Beam1F1301 Dry. 1 span No cantilevers 1 0/12 slope May 25, 2018 08:30:38 BC CALCO Design Report Build 6536 File Name: BC CALC Project Job Name: Riley Residence Description: Designs\FB01 Address: 120 Blue Water Road Specifier: City, State, Zip: Centerville, MA Designer: Customer: CIMCO Company: Code reports: ESR-1040 Misc: Connection Diagram Disclosure t�I b - d Completeness and accuracy of input must L� be verified by anyone who would rely on a output as evidence of suitability for • • . particular application.Output here based on building code-accepted design properties and analysis methods. • i• • Installation of Boise Cascade engineered wood products must be in accordance with current Installation Guide and applicable building codes.To obtain Installation Guide or ask questions,please call a minimum = 1-1/2"c= 1.5" (800)232-0788 before installation. b minimum =6" d=24" e minimum — 1 BC CALCO,BC FRAMERS,AJSTM' ALLJOISTO,BC RIM BOARDT"',BC10, Install Screws with screw heads in the loaded ply. BOISE GLULAM- SIMPLE FRAMING Member has no side loads. SYSTEMO,VERSA-LAM@,VERSA-RIM Connectors are: SDW22500 V SE,VERSA-RIME, ERSA-STRAND@,VERSA-STUDS are trademarks of Boise Cascade Wood Products L.L.C. yiassachuseits Deoariment of?uhlic Ssfety *:. Bbard of Bwadi.na Regulations and Standarac License: CS-042957 Construction Supervisor J SCOTT CIMENO PO BOX 664 SAGAMORE MA 02561 =.t ' Expiration: Commissioner 09/20/2018 constructioh Supervisor Restricted to: Unrestricted-Buildings of any use group which contain ..less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit: WWW-MASS.GOV/DPS + ,per a6ac/auae.G�r- tt Oc�su�:Fs A airs&Bu$iaess'ne5sl=iior i HOME INU ROVEMENT CONTRACTOR .Yoe: Corporation P� sfration Expiration ~ 10/26/2018 Cimco Constru #ii3 1ne. J.Scott Cimere . ?7 Yearling Run` .=:zt` �Z Bourne,NI _. Undersecretar,r LOT 15 9 N,� 2 fro13 8 LOT 14 o N 43917 S.F. o o+`s cp_ cp ADS Zw 0 L LT, �. OQLo _ N LOT 34 r w Qj72 13o'Q S?6. 1,45„y� BLUE 1 8 19 - 3-1 INITIAL ISSUE PAL THIS PLAN IS NEITHER INTENDED N0.1 DATE I DESCRIPTION eY FOR, NOR SHALL IT BE USED FOR AS-BUILT FOUNDATION_ PLAN-LOT 14 MORTGAGE LOAN PURPOSES. BLUE WATER DRIVE BARNS.TABLE, .MASSAC.HUSETTS. os M� FOR p� DENNIS STAR CONSTRUCTION' SCALE 1" 801 JOB_NO- 1257/1257PER �� _ — I CERTIFY- THAT THt FOUNDATION 80 SHOWN ON THIS PLAN IS LOC TD : 160 Lehr ^ ON THE GR INDI \ \\ o% f 8 19 93 "� LEVY, ELDREDGE & WAGNER ASSOCIATES INC. /_ / ^fie`=' Rif.R1= TANIISY'.APR ASS PIAkM 1AIM SIlRVMIN :t ne uommonweattn of massacnuserrs Department of IndustrialAecidents Of of Investigations 600 Washington Street -" Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit:Buz.ders/Contractors/Electrieians/Plumbers Applicant hformation QiblY �i Please PrintLe Name(Business/oro nizaiion/Ind 1.ividual): 1,Mr-.I, Cof\C 9ticTeril'i INCH' Address: P� �jC g5�A SA 6 A PA a� City/State/Zip: O W MA Phone#: Are you an employer?Check the appropriate bow Type of project(required): 1.❑ I am a e to er with 4. I am a general contractor and I mP Y 6. 0 New construction _ employees(fulland/or part-time).* have,hired the sob-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, E]Demolition working for me in any capacity. employees and have workers' 9. agog addition [No workers'comp.insurance P.insUzance,T required.] 5. We area corporation and its 10.[]Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I1.❑Plumbing repairs or additions myself:[No workers' comp. right of exemption per MGL 12.0 Roofmpairs insurance re d t c. 152, §1(4),and we have no 4�e ] employees.[No workers' 13.❑Other comp.insurance required_] *Airy applicant that checks box#1 mnst also fill out the section below showing their workers'compensation poky information. t Homeownors who submit this affidavit indicating they are doing all work and then Lure outside contractors must submit a new affidavit indicating such. �Conbactors that check this boxmust attached an additional sheet showing the name of the sub-coutractors and stye vyhctbcr 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 far nv 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 fain 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 e pains and penalties of perjury thaf the information provided above is true and correct Si afore: Phone#: pffzcial use only. Do not write in this area,to be completed by city or town officiaL City or Town: PernnitMicense# Lssuing Authority(circle one): 1.Board of Health 2,Building D epartmeat 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector. 6.Other Contact Person: Phone#: I LOT 15 i �o 9w� 568�52 � �6Fi 8 � r LOT 1.4• $N 43917 S.F. o cA Z-W: Ln { s �. lfl UI41 -LOT 34 t� 2,2i9 ��O 72 13 ,16 �'4 0 WATER DRIVE BLUE 1 '18/19/931 INITIAL ISSUE PAL THIS PLAN IS NEITHER INTENDED N0.1 DATE I DESCRIPTION BY FOR, NOR SHALL IT BL USED FOR AS-BUILT FOUNDATION PLAN-LOT 14 MORTGAGE LOAN PURPOSES. BLUE WATER DRIVE .: . _ BARNSTABLE, MASSACHUSETTS FOR DENNIS "STAR CONSTRUCTION ® CAUL"A. � . SCALE: 1" ,80' _._ .JOB N0. 125.7 1257PER I CERTIFY THAT 'THE FOUNDATION LElr,: A 0 80 160 SHOWN ON THIS PLAN IS LOCATED v No. IOr.I7 I-- ON THE GR _ I.NDI J � 8/19/93 LEVY, ELDREDGE "i WAGNER ASSOCIATES INC. e � RRG@IM LAt3 T.APR A PlIXO C' [AHil SUHVRY IK a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map '� Parcel a ' ems- P�ld5 Use Vis•` Permit# Health Division ate Issued ( o Conservation Division Fee Tax Collector SIC SYSTEM MUST EE Treasure s- 1�� "��sLE® IN COMPLIANCE Planning Dept. WITH TITLE 5 ENVIIRONIA0ENTAL CODE AND Date Defi6itive Plan Approved by Planning Board EGULff1ON Historic-OKH' Preservation/Hyannis Project Str et'Address C� � r � Village a C&AIrl= Owner ` (X-j Address ! iv le (,"L4 iVe f 5, 6'oi Telephone '7 Permit Reques 5�v4 �1! . ®O6�- /�/ d� 610 �6ftf_ No Square feet: floor:existing 104 proposed J �U 2nd floor: existing proposed Total new f �D Valuation 0j Zoning District Flood Plain Groundwater Overlay. Construction Type I1,c) )n F4j86A Q__ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure PSG Historic House: ❑Yes Pu On Old King's Highway: ❑Yes a-RIO Basement Type: & ull ❑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 ©�j 1Z, first Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑existing ❑new size Pool:❑existing, ❑new size Barn:❑existing ❑new size Attached garage:Cl existing ❑new size Shed:❑existing ❑new size Other: 5J►- 006M I y ►V Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number S 6 (,o Address 3 Yj S� Vj v�� License# G 0 S C-e,v--I z-v'v �.�� VkA V'� b 3 Home Improvement Contractor# . C� Worker's Compensation# ALL CONSTRUCTION DEBRI RESULTING FROM THIS PROJECTi WILL BETAKEN TO SIGNATURE DATE �� �� FOR OFFICIAL USE ONLY IT NO. ,zt n _ DATE ISSUED MAP/PARCEI:NO. ADDRESS ,VILLAGE OWNER DATE OF•INSPECTIONg FOUNDATION <•j - , FRAME INSULATION FIREPLACE` ,F ELECTRICAL: - ROUGH FINAL PLUMBING:'• ROUGH FINAL' a GAS: ROUGH: FINAL to : -= - t FINAL BUILDING ' r.. Jr r DATE CLOSED OUT ,*t ASSOCIATION PLAN NO. - ' . u r� .� •'1,�: The Town of Barnstable i - r BARNSrABLE. • . $ - Regulatory Services 'OrED nw't° Thomas F. Geiler, Director. Building Division Elbert Ulshoeffer, Building Commissioner 367 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. 4 Type of Work: /a/Y alp k4'j o`a` r Estimated Cost Address of Work: /lz U1?( 61'9. Owner's Name: At,v; 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 ag ;It he owner:oU � /, O 5�i� Dav V Contract r fiame Registration No. OR Date Owner's Name q:forms:Affidav i ►� , . , , . , l /amasoep / // ii // // „ b y. MEMERIM. „ t ----- // //%/%///////////////////////////////////////// ///%////////////////i�i�///ii��/////////i�///////////////////i�//////i�ii%/////////////////////////////%%///////%//�/%//%///�/%%/// , : , • MMM rt ti ILL— , . • W- O4). t; i, ■ : „i. CjLlccmsing Board ■ • .• - ■ 1, C3jjvdthDepWbnMot ■ • phone 0; ;: 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 appur==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 eater into any contract for the performance of public work until ;acceptable evidence of compliance with the insurance requires of this chapter have been presented to the contracting authority. y ,applicants fi y� b the box that lies to situation and g'lease fill in the workers' compensation affidavit cample;telya Y �P Yam' tplYIDg company names,address and phone numbers along with a certificate of insurance as all affidavits may be �Fs -submitted to the Department of Industrial Accidents for confi>mation of insnraacx coverage. Also be sure to sign and .date the affidavit. The affidavit should be r+cmed to the city or town that the application for the permit or license is ;.being requested,not the Department of Industrial Accide�. Should.you have any questions regarding the`law"or if you are required to obtain a workers' cca pemsation 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 pei iiiit ei number which will be used as a referencinii ei r. The affidavits may be rettriiR o the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would Ile to thank you in advance for you cooperation and should you have any.questions. please do not hesitate to give us a call. MjEs address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents 0mce of UNOSUoedoos 600 Washington street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 f ESTIMA TED PROJECT COST WORKSHEET LIVING SPACE / Value construction KCD square feet X$115/sq. foot d d es-� (high end ) J -o—� � , (above average construction) square feet X$96/sq. foot= (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) square feet X.$25/sq. foot= PORCH square feet X$20/sq. foot= DECK square feet X$15/sq. foot= OTHER square feet X$??/sq. foot Total Estimated Project Value LOT 15 w LOT 14 ' 2 o 43917 S.F. 0 O ul N00. m �+ rl . O hhhllt - W Lr Co- � 4 LOT 34 m z�9' J .00 ATER DRIVE 1 8 19 93 INITIAL ISSUE P, THIS PLAN IS NEITHER INTENDED No. DATE DESCRIPTION e FOR, NOR SHALL IT BE USED FOR AS=-BUILT FOUNDATION PLAN-LOT 14 MORTGAGE LOAN PURPOSES. BLUE WATIN ER DRIVE BARNSTABLE, MASSACHUSETTS FOR DENNIS STAR CONSTRUCTION %' a4 SCALE: 1" = 80' JOB NO, 1257 1257P 1 CERTIFY THAT THE FOUNDATION Jan PAUL A 0 80 160 SHOWN ON THIS PLAN IS C TED ON THE I iC T D. LEVY, ELDREDGE & WAGNER ASSOCIATES INC. 8/19/93 ` plMM LAND SORVErOR >? BIG= (MAPS ARLrtQPECt'S I ( 1 4-4- 1. It i � .�...�....�-___ I � ; I � Cr���l`ems . ► � � - s _ FT f rL' 1 t i 1 .. i i. • 7T J. -:E7 Ti- r fT 1 I1:jj 14 boA 17 t V i { F t r ' 77 1 i , _rY Y . � . .i-�. j-- _t I r • r � 1 , r - ( , �. 't _ �— ' 'A41 ' 1 -�--t---�--;--i J I I— � k — — �S — I f 1 r }— iV � 1 • e - _ y HONE IMPROVEMENT CONTRACTOR Registration: 103218 Expiration: 07/06/2002 Type: OBA APPLETON CONSTRUCTION P!�ter Appleton "11 Baird Nay ADMINISTRATOR Centerville NA 02632 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 005414 Ar Birthdats: 06/08/1954 Expires:06/08/2002 Tr.no: 25981 Restricted To: 00 PETER J APPLETON 37 BAIRD WAY administrator CENTERVILLE, MA 02632 LOT 15 I S ,166 ah LOT 14 ? o 43917 S.F. U; N o IWI bZ oy � l 7,71 . 4> N oYp 45•4 LOT 34 c 49.5' C� 22.9 072 130 OS16.51'45"W WATER DRIVE BLUE 1 8/19 93 SSUE PAL THIS PLAN IS NEITHER INTENDED No. INITIAL I DATE DESCRIPTION BY FOR, NOR SHALL IT BE USED FOR AS—BUILT FOUNDATION PLAN-LOT 14 MORTGAGE LOAN PURPOSES. BLUE WATER DRIVE 'N BARNSTABLE, MASSACHUSETTS , �b4J y DENNIS STAR FOR CONSTRUCTION MAUL A 4-n SCALE: 1" = 80' JOB NO. 1257/1257PER I CERTIFY THAT THE FOUNDATION LEVY p 80 160 SHOWN ON THIS PLAN IS LOC T D �, ON THE IREG INDI T �Io. in�?� - �'S\� o ram/ 8/19/93 <� �_�_r LEVY, ELDREDGE & WAGNER ASSOCIATES INC. DATE ED LAND SURVEYOR ENGINEERS LANDSCAPE ARMFECTS PLANNERS LAND SURVEYORS 586 STRAWBERRY HILL RD. CENTERVILLE, MA 02632 DEPARTMENT OF PUBLIC SAFETY COMMONWEALTH 1010 COMMONWEALTH AVE. OF i BOSTON,MASS.02215 A ENCLOSE CHECK OR MONEY ORDER MASSACHUSETTS L I1=EN`-E FOR REQUIRED FEE, i?4/ ,t?!1'?'=,5 =a_NSTR. UfEkVT'_aiF; EXPIRATION DATE MADE PAYABLE TO ° EFFECTIVE DATE LIC-NO. ° s � "COMMISSIONER OF PUBLIC SAFETY" RESTRICTIONS �� i)�i]'7t 11 ' 1 & f=AM I LY HC Ih1E':i c 0 ?•�/i?1' 1 ' ' (DO NOT SEND CASH). _IAI_I_JLIE N MI_IR I N ? I _= _:; 0(- BEAR'_�E WAY + _ HYANN I-S MA <i t,c_?1 PHOTO(BUSTING OPR ONLY) FEE: NOT VAI_ UNT4 SIGNED BY LICENSEE AND OFFICIALLY ' HOT V-'_�HEIGHT: sr MPE OR SIGNATURE OF THE COMMISSIONER i SIGN NAME IN FULL-ABOVE SIGNATURE LINE THIS DOCUMENT MUST BE NATURE,OF LICENS If ,EE CARRIED ON THE PERSON OF THE MOLDER WHEN ENGAG-I OTHERS-RIGHT THUMB PRINT ED IN.THIS OCCUPATION. APPRC AUIH. 20OM-2.87.81429 I - l . \ t _`;"�: � _ •� }c:-cf� ..j����,"w �Ca' ♦�; hi., � }a v� ��Yrg C�;y: r. ����.'9�'M'`� �r c c.i�"�' 4 r QF 7M( TOWN OF BARNSTABLE 36108 - .Permit No.. BUILDING DEPARTMENT ($1,000.00) I ""'� I TOWN OFFICE BUILDING Cash Tto�►r+ HYANNIS.MASS.02601 Bond ................ . CERTIFICATE OF USE AND OCCUPANCY Issued to Jacques{ Morin Address Lot #14, 120 Blue Water Drive ;Centerville, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD' THIS PERMIT WILL NOT BE VALID, AND.THE BUILDING'SHALL,NOT BE.OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY 'COMPLIANCE WITH TOWN' REQUIREMENTS AND IN ACCORDANCE:WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. November..1.?�..:. 19...:.9 3........ Building Inspector THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) pAtA PMIT t ASIZ7SSORS PAP_CET No. CONTINUATION OF ROAD BOND The unders4L--ne,-� ' ow-,ierlcoTltrac"Or hereby agree to.mainc-tin t,'LE--;= road band in force until the following wor'K ita=s ara c--=Ietad to the Satis-Eact-zon of the L Enzineer-_:ng Sect--on of the Depar=ent of Public wars: .1 c Z. a"d seed sliculders as sac-,- as x Cj (p in nam= e, 0 IN dARNSTABLE, MASSACHUSETTS , BUILDING PERMIT 10ATE• AUyUst'� 19, 1g 93 PERMIT NO. jI��PLICANT GWllQI: ADDRESS Listed Below #05770 IND.) (STREET) (CONTR'S LICENSE) i3uilu Dwc111I1 ( 1 ) STORY - 51ng e ranlil �. DWellind!uMBER OF PERMIT TO ` l go WELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) COL Tj lY F: 1=0 LS1U11 I,,ia t r DrI'yir�, Conti ry ilia ZONING kJ--1 _ (NQ.1 ^ (STREET) - DI- STRICT BETWEEN AND n T1 (CROSS STREET)' ' (CROSS STREET) SUBDIVISION LOT LOT BLOCK E E� BUILDING Is TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION. YPE) REMARKS: SetJi L3E # 93^420 A Jacque Morin ($1, 000. 00) AREA OR VOLUME .028- s I-,! -f t, ESTIMATED COST ,$ FEE PERMIT s 162. 2 - ,(CUBIC/SQUARE FEET) e - OWNER Jac : ues !`lorirl I C f'dr6C 7c.i h...�jn11ls •. .,; BUILDING DE PT ADDRESS. 1 By THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,,'ALLEY OR SIDEWALK OR ANY PART .THEREOF, EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS.ON PUBLIC PROPERTY, NOT PERMITTED PERMITTED UNDER THE BUILDING CODE; MUST BE AP- PROVED BY THE .JURISDICTION, STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS,MAY BE OBTAINED �. FROM THE DEPARTMENT-OF PUBLIC WORKS: THE .ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE C.O.N:DiTION5- r ; OF ANY APPLICABLE SUBDIVISION RESTRICTIONS-. a - - MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE° INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ` ALL CONSTRUCTION WORK: ELECTRICAL,' PLUMBING AND I, FOUNDATIONS OR FOOTINGS, MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. ' 2. 'PRIOR TO COVERING STRUCTURAL QUIREO,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBE RS(RE ADO TO LATH). FINAL INSPECTION HAS BEEN MADE. 3, F;N AL INSPECTION BEFOREE • ' OCCUPANCY. - POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS I . J 2 2 / • �� �� 9 3„ k HEATIN 1 PECTION APPROVALS ENGINEERING DEP�AT TME �. . RD OF HEA TH ��• OTHER �� SITE PLAN REVIEW APPROVAL CFO WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!L L BECOME NULL AND VOID IF CONSTRUCTIONINSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF OR WRITTEN WORK IS NOT STARTED WITHIN SIX MONTHS OF GATE THE ARRANGED FOR BY TELEPHONE CONSTRUCTION. I PERMIT IS ISSUED AS NOTED ABOVE, NOTIFICATION. _- - d: Exhibit A - Plans no 7 0 �IQ-P xz� Rmc ® ^ a:ie crnu wrsouns [�L—/ �7 •r ro yumcx IRCMf 6N.i10�1 qlT ('� "�. lul v u 00 0�0 ono i, 7t+Ts li,u n�ovEb RIGHT SIDE._ro•LE EVATION -fD Rt�hf AS SHow/i - suac.v. Bi W� BACK To BE Fu«y bOKM•EiCEb W Q 0 O ® ~ +30 W JEEDI Q Lo k oWc w,ti Zaoz z ocOQ 00> LEFT SIDE ELEVATION REAR ELEVATION K'lTc(+Eu [{LSEM Eh{t SNEET NUNBER� sc+12"w•.r-o• PILE NAME. 92117A1 --------------- 1� • T'-2' 7-2- WINDOW SCHEDULE KEY QTY.I DESORFIION ROUGM OPENNG mm/m n RLMARKS o A 2 .O a cASCM[M 1'-0 Y2•v 5'-0 V2' MRRS51 c=1 NIIfR fCR1Y5fIEID C O 0 1 GASCISIR 2'-O""x 5'-0 Vz• YCOtSa LLI W1tRC RRMASMna = DECK Y ® c 1 TRf12 CA51K HT G'-0 3/5•x 54-0 Y2' MORSp L]V wnrtc rC wsnn0. J Q © D I CRUET., G'-0—x 5'-2 5/4 —RSCN cTLS Vr1RfC fCRMASnnn N . ® L I OLIAGCO 2—V2•+2--0 V2' W0O 0 S l N P r 2 GRf1LTOf 4•-0 5/D'•2-2 5/4' A RWN LTc2 In2fC RRMASnnD Z . • Y G 5 Do—MIIG 2'-G'x 4•-R6 nSR 2424 Q FAMILY q n s r1LTURCnA.rLAMQRS 8-.4'�- w[sn[ m o J 1 cRaCTOP 4'-Y.2'-T' MOOtSp acm w1RfC RRnA5nn0 O ROOM b = ' R 1 .-.-G lLLON S-0•.4'-4 nS 2424-2 ¢7� L 1 cAxrvrt z•-0 ve•.5--0-ai ArmcRsoa cu wlmc RRn45n1!ID I .. i n s rILT1JiC c-0 5/e•.5•-0.ve 1IUICRSCN cP55 vn5rz P[RMASnM I °I If .` ' n 2 Awranc wc no r-0 5/e•.z•-0 5/e' ArmcRscn Au lm RRrast+ 4 j DINING ® ., —G c'-0�/e R z•-0 5/e uoo o act wm TC rcRn.SMno I�1 I(�LJ11T1I /J� �td1 41 MASTER I•{• p SR TS 31 3/1•v SG' mu Vs 2 BEDROOM EB SW=NED. eTCT•,CA CpS�� g�fir' ANY f/4 . - --- ---- Q�v, a DOOR 5GHEDULE O -fir` O -I KEY CITY. DCSc?vTION RODUt OPENNG MfR./MODEL RCMARKS 5 12'-2 f/2' G-T 5/4' p STAR V TO F•!m•U(pepµ/ Cf 1 1 ]'O'v G'S' 11IfC 3,_2 ST—I K2 II IuI lu111 IL lul lul II © iiBRMeC oV' = 1 2'e'v G'e'St[n fRC COL[ 2'-]O Y4'.G'-10' STAItR RI Q O r_-_- GARAGC I Y I? 5 1 G'v x G'e'SIIDOI G'-0 5/1'.G'-10 T/e' 1NDLR5Ln fS O O 1 0®0 `� ; l 4.O'.T-0'OVCReKAO 9'i'.r-0• 41 LMC DOOR 6 NOR•+ROvmC 5%e' I WY+I-R11 11 UWN TIl rR2 GODC GTP.SD. } uo5CT 1 r LULT GA%%Ln O TALL LOro]ON I - E c 1 2'c'x G'G'6PYHL 2'-e VW.c'-P _ Y 1 I a.W. VWT LRrR LAV. •�• G R GC CK T 4 2.1•.G'G•WA 2•-c Ye•.G•-9' IV e z z'o•.c'c•wards A2'-2 ro•.cc•gran O GARAGE 3 w 5 Cw.a,"LeanMASTER -------- 0 u = ry x c'cI/e.c•a• q BATH FOYER 2.-0.I KITCHEN o O (Do cola to I n a v ® D I p �> O O q o r-0• ra [-3, 4•-5• s'-c• 1•<• 4'{• s-t 5•-to• c-0• u•-0• c•-0• I z ' - cLATMCORAI - FIRST FLOOR PL r-I 5 1• I.•-,a 5 4• v-]a 5/e• -0 T,e• rYm sca1C•v.•-r-0• - eaom + . WMt.-Iv bE I ® T.V. .. (Web TO NertG; tunn�ovcwrRo me W ei BEDROOM DEN ROOM 5� 5A"Sm o9 ~ � a w 'U'-1 5/4' I U•-to I/4' BEDROOM ? , , Y a, ® Ear cvu•Lw I- •+3 N . . ROLL eun AeoV[ --- ^ �\ I O . O tL a A ua It O O 1 1 Q ---\ I E BATH P O i w ,i ---- — i I F12casMea I Q OG ACLCss %_ I Full I W U) soma O § o Pw%"I( oom U R ?L*y MEAT., I m Z i I Z core ro q AL ZS9 i I O z _ I ® i corvt TO mow cSTORArp 5rFyyp-Ty.� •. ® j SKEET NUMBER. SECOND FLOOR PLAN u— - 5C .V4•-1'-0' - FILE NAME. 92113A2 I 1 m �FP X Z� OOC� xorz.c.c..rdHD.T1ON A 4 cartnwus RIXL vcnr � ��J�J I inn q,;R COMTRAGTOR ro V[Rrr Q F7 � L� [WanswMs or xa a Ttt1C4 et1D-0KR �-r . IOGATIONS Or S"It.S 7/ u f —,v T TYRGAL Roar GpiSTRUCTION -------------- ; q ATTIC V2 ft-OOD WEAT�:s a @ i T/F-- :3 RAITCRS AT TG'OLlr 0-TROPON \O i O m[OWL STTRAIOAM NSLLATWN4 TO r W W 0¢OP WALL TrPGti°'LOi1CRRC WALL I. +�. MAMTAN KNTMG AT rAK AIm SLOMIT d Q ICR eLCO L' OM 1C'.e'GOMf.U0U5 • l• b - MSLLATLO CLLrIG5TtOVor GCNAUdIs tlA1WC/O -.COMC m IOOIML ♦S RCO SOTff Oro e¢r otoTcr cool uoasnvrt-IN14 FULL BASEMENT .1 . TO.G. 2.10'..1 TG' co• co• c•o• ro• co- co• -c'•o• ,. � - rn+cu crrerwR wuL cansrRUGTwn Iwi> °1 r 1 r 1 -I r -1 r 1 r -1 "` TT'{• Rm COIAR ca♦reoue5 AT.•TO 9 z ^T' _ ^Q' 1. S LAV. DINING RM. WAY—CM [LCV♦TIONOM."l S -- -�-�- +--� -I—'---}• -+---�- -- W SIX AIt L:M15N2 RATNCR L_J L_J _J L J L_J L_J r,1 g L C1]3. 0 J r CTV.) 1 F 3 vx�Ipexwss nsuiian osi m. ao•.To•core.ca.rAo L J ve•nr.san —axro AIm r 0 TO I STS g GARAGE x.To'..e u•o<. x.ao•.eo Tc•o<. .� Q C4'COMC.SLAB W/ I Q S)a.TO-1 x a G r Tm 5LL eI W.wnlrtfPJ1 To I G v.•re[RCLss MSIL m. OKRI¢AO DOORS) •' �\. N eAxrcxr CRrIG FULL BASEMENT r'� w I uur•ca iw xm-rum sTm F-- 4. L i J a•:GONG.SLAB Q' I♦O I I L J lG'R e'COW.LONG.rOOTHO �0 STA,tT Ir_ MOP WAIL rw V/ •: r-v �3-j L---J J r I T_ <<kg LIK.IOUTITO A- { T{ T{ { GRO55 SECTION W sue♦rar e'ON IG'T[ _ wn.'c"ariA"c.r�oomc° - scar.vv-r-o• FOUNDATION PLAN Z 00 z j scAar 1/4'.V O' O Z oc Q . 00_ SHEET NUMBER, PILE NAME. 9289A3 a Assessor's office(1st Floor)* �iu Assessor's map and lot mbe ' S 3 "" 1012 f r .rd fq� o< /�B�}' r�iC—, p� P44f,` ®ti von THE Tp`i Conservation . - 1 !: •1I�®�� � i ew Board of Health(3rd floor): _ Sewage Permit number, �3 s / • Engineering Department(3rd floor): c House riumber /,gyp ,CUE ZZUe.2ia?/vr Definitive Plan Approved by Planning Board / 19 � APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1.00-2:00 P.M.only TOWN . OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO / r TYPE OF CONSTRUCTION TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following informati Location Ala l-(/ I ! 7-" p P Proposed Use , i1,� Zoning District bat Fire District f ✓ACQ vE$ 174aeeW Name of Owner *96- Address 54—/ham' Name of Builder,�CauES Al. Address OO Name of Architect � . t� A Address Number of Rooms / Foundation trA. .1/�a@TE� Exterior L'/. ��+r�/�' Roofing AS14 X*/ Floors l Interior Heating Plumbing �- Fireplace /e EAML4_vZ A!0042 Approximate Cost Area -� Diagram of Lot and Building with Dimensions FeeU � �P D©• �10 L11 r " OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..,Construction Supervisor's License MORIN, JACQUES y No 3610i3 permit For 1 z STORY Single Family Dwelling jq Location Lot #14, 120 Blue Water Drive --' ` Centervillel + ;� Owner. Jacques Morin Type of Construction Frame 15. Y Plot Lot Permit Granted August 19 , 19,,9 3 Date of Inspection 19 j teCo pe d ` � �� 19. e � +L r Town I Barnstable *Permit# `70) � Expires 6 months from issue date R6gulat ry Services Fee Thomas F.G iler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONTLY Not Valid without Red X-Press Imprint ap/parcel Number Pesident dess 1/ j�1/�ial Value of Work Minimum fee of$25.00 for work under$.6000.00 ;mer's Name&Address t -/%P Clow )ntractor's Name Telephone Number l ome Improvement Contractor License#(if applicable)-- 17 _f---S ems- 5nsauctions * ls-hizerrse-#--i app3i=b,1e) ]Worlmzan's Compensation Insurance. PERMIT Check one: ❑ I am a sole proprietor APR 3 0 2007 ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance TOWN C EARNSTABLE surance Company Name A t/y' y V.5 orkman's Comp,Policy# 7 9-�n lR `J A(8 Q,-7—�► spy of Insurance Compliance Certificate must be on file. :rmit Request(check box) be.eRe-roof(stripping old shines) All construction debris will be taken to :. ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town departm�gs, oric,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission, "'"---- of e Improvement.Contractors License is recuired. iGNATURE: Forms:expmtrg Mse061306 j The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111' wtvw.mass.govldia ' Workers''Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plumbers A licant Information /p .Please Print Legibly Name(Business/Organization/Individual): . ' rs L, V Address k 1T 52LAIe.t'f' City/State/Zip: Y v i�1 e _ Phone.#: Are you an employer?Check the appropriate bo . :Type of project(required):. 1.❑ I am a employer with 4. I am a general contractor and I 6. []New construction . employees(full and/or part-time).* have hired the sub-contractors • listed on the-attached sheet. 7. ❑Remodeling 2.❑ I am a'sole proprietor or partner- These sub-contractors have ship and have no employees 8. ❑Demolition employe and have workers' ' working for me in any capacity. $. 9, []Building addition [No workers' comp.insurance comp,insurance. 10.❑tlectrical repairs or additions required.] 5. We are a corporation and its 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 ] to o workers' 13.❑ Other_ employees, (N comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f Homeowners.who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the yub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.polidy number. _ram an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site' information. Insurance Company Name: v f Policy#or Self-ins.Lic.#: �. � s�/9�!^d Expiration Date: / lob Site Address: �� U��� ✓✓�/ Fes'' City/State/Zip: , _ KR� 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 b e forwarded to the Office of Investigations of the DIA for insurance coverage verification. 7do hereby certify the nd of perjury that the information provided above ' true d correct. Si tore: Date: _ Phone#: Official use only. Do not write in this area, to.be completed by.city or town official. City or Town: Termit/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 mstructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as "an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a-deceased employer, or the receiver or trustee-of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shalt 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 producedacceptable 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-ofcompl mce with:tlie insurance requirements of this chapter have been presenteddto the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)nanie(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies'(LLP 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 requireu 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- ne. 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 permitllicense number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to brim 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 ofMassac-husetts Pepar memt of ladustdal Accidents Offlce of Inver lgaidon 60Q Washin tofi Street . Boston,MA 0.2111 Tel.##617-727 4900 ext 406 or 147 MASSAFB Fa}e##617-727-7749 Revised 11-22.06 W Mas&gOV/din I 1 �owTNsropy : TOWn of Barnstable Regulatory Services a • sYAMAte' Thomas F.Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-62.30 Property Owner Must Complete and Sign This Section If Using ABuilder 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) Signature of Owner Date Print Name . O:rGR�!S:O i�T_�R?bF.N�I55IO2r' ACORD CERTIFICATE OF LIABILITY INSURANCE DATE I fwm 104/09/1007 PRODUCER THIS C F IS ISSUED AS A MATTER OF INFORMATION SCHLEGEL INSUPJWCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 34 NAIN ST HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. WEST. YAR1r OM, NA 02673 INSURERS AFFORDING COVERAGE NAIC# esmom INSURER a NORTHLAND INSURANCE Paul Buckmiller INSURER B:TRAVELERS IDEA BUCRMILLER ROOFING INSUKR C: INSURER D: Hyannis, MA 02601 INSURERE: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR *am TYPE OF INSURANCE w POLICY mmullEA DATEDATE PRUDDAM LOUTS A 009MALLIABUTY CP46SS9503 05/15/2006 05/15/2007 EACHOCCIIRRENCE $1,000,000 8 CMUM c AL GENERAL LIASILIiY PREIISES(Ea ole—) $50,000 MAW MADE_ ®_OCGUR_.___ (Any aye psmn) S-EXCLUDED PERSONALgA6VMMY $1,000,000 GENERALAGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: _ PRODUCTS-COMPAWAW s2,000,000 POLICY � LOC AUTOMOBILE LIABOM COMBINED SINGLE LIMB ANY AUTO ga aow" $ AM OWNEDAUTOS BODILY INJURY S SCHEDULED AUTOS (Per PermM HM AUTOS BODILY INJURY 8 NONAWNED AUTOS (w scad O PROPERTY DAMAGE S leer acddeM) GARABE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AM. S EXCESWASRE"LUIBUM EACH OCCIAtRENCE s OCCUR ❑MAW MADE AGGREGATE $ E DEDUCTIBLE S I E RETENTION s $ WDAKERSCOMPENSATIONAM 7PJM-743OA7-06 04/11/2007 04/11/2006 X&APLOV TORy LIMITS OETR B ANYPRO RI TOPPLIABILTr E.L.EACH ACCIDENT $100,000 ANYPRDPwEroR+Pa� -- OFFICERRMEMBER EXCUMNIM E.L DISEASE=£AEIMUIPILOYEE-— E.L DISEASE-POLICY LIMIT s 500,000 OTHER DESCRIPTION OF OPERATIONS I LACATIONS I VEHICLES I SXCUMM ADDS BY ERDOMMMa I SPECIAL MW"S ONS PAUL BUC11sfILLER IS EBCLDDED rRON HIS IIrOR1C m COMPENSATION .ERT09CATE HOLDER CANCELLATION GREY Ni COREY $RD= ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EIBMRATION 1694 FAIMDUTH RD DATE THEREOF. THE ISSUING mumm VALL ENDEAvOR To MAIL 21 DAYS WRnTa MNY'EMLLB, NA' 02632 NOTICE TO THE CERTiHCATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE HO OBLIGATION OR LMIBIUTY OF UPON THE INSURER, ITS AGENTS OR REPRESENTA . aUTHoeQED REPRES kCORD 25(200 =) G ACORD CORPORATION 1228 -_- ----- ✓fze �oomva�.uaeall/ a��aaaa`�ivae�.6 Board of Building Regulations and Standards License or registration valid for individul use only HOME IMpi?OVEMENT CONTRACTOR before the expiration date. If found return to: a" n Board of Building Regulations and Standards Registration,,,�36066 x p�rati n / One Ashburton Place Rm 1301 k, -- i Boston;Ma.02108 COREY&CORE�Y OM MPR VEMENTS CHARLES CORE 1684 FALMOUTH CENTERVILLE, MA 02632 Deputy Administrator valid without signature . r f .. - ✓�te ZJO�I➢7/I720i/ZL!/6�j� O�i/(//,pQd�tll4C`�4 . BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR - Number' CS, 002881 gjrt`hdate %02/14%143 E�xpirs; !� /14/?008 Tr. no: 19666 ReetSicted•''A00�r,:r` CHARLES E 1694 FALMOUTH RD#115 CENTRERVILLE MA 02632 �� Commissioner L CORE' y COREY Tb� : 1694 Falmouth Rd. #115, Centerville, MA 02632 .A. N. 6 LE ` I P ® April 17, 2006 L, CAROL RILEY 120 BLUEWATER DRIVE CENTERVILLE, MA 02632 Phone: 1-508-362-4432 COREY & COREY hereby proposes to perform the following services in a neat and professional manner and in accordance with the manufacturers specifications and local building codes. Remove and Haul Away All of the Old Asphalt Roofing Shingles. Supply and Install Missing Skylight Step Flashing,Pad Out the Roof Change of Pitch Behind the Garage and Rear Addition, Do Whatever is Necessary to make the Valley and Corner at the Meeting of the Main House and Rear Addition Watertight. Supply and Install CERTAINTEED LANDMARK AR 30: 30 YEAR WARRANTY, 10 YEAR SURE START PROTECTION, CLASS A FIRE RATED, ALGAE RESISTANT, 245 POUND HEAVY WEIGHT, SELF-SEALING, 90 MPH WIND WARRANTY (with Hurricane/Storm Nailing-6 Nails per Shingle), MULTI-LAYERED, LAMINATED ARCHITECTURAL STYLE, FIBERGLASS BASED ASPHALT SHINGLE with COPPER/CERAMIC STONES with a FULL 10 YEAR WARRANTY Ag,624ST LGAE CO 'I MINENT COLOR:_ rLc/tJ�E Supply and Install CERTAINTEED WINTER-GUARD (lee& Water Shield )WATERPROOF UNDERLAYMENT SYSTEM on Roof Eaves, Valleys, Under the Step Flashing on the Skylights, Chimney and Gable Walls and 100% Total Coverage on the Shallow Pitched West End Addition Roof. Supply.and Install HICK'S VENTILATED ALUMINUM DRIP EDGE on West End Addition Eave. Supply and Install ALPHAPROTECTOR-SUL SYNTHETIC UNDERLAYMENT MEMBRANE http://www.nermarnroducts com/onlinefonw/alphaurotector vdff Supply and Install SMART VENT RIDGE VENT SYSTEM on the House & Garage Ridges and West End Addition Wall. http://Www.dcipToducts.com/btml/smartridge.htm Supply and Install COPPED& NEOPRENE SOH,PIPE FLASHINGS Clean and Remove Debris from work area after job is completed. TOTAL INVESTMENT, S 149250.00 Payable immediately upon completion. REAR ADDITION- POSSIBLE EXTRA: After the Shingles are removed from the root we will lift one sheet of plywood to make sure that the insulation is not up against the plywood sheathing. This would prevent air from traveling from the Eaves to the Ridge. If it is, VENTILATION PANELS will be installed by Removing the Plywood Sheathing, Installing the Panels, Turning the Plywood over and then Re-installing the Plywood. If needed, this would be done and charged for as an Extra at $ 500.00 includingMaterials Labor. and POSSIBLE EXTRA CARPENTRY: Any Rotted or Otherwise Deteriorated Trim Boards,Plywood Sheathing,Missing Metal Flashing, Side Walling or Any Other Carpentry Needing Replacement will be done and charged for as an Extra: Materials Plus 20% and Labor at the Rate of$50.00 per Hour. PAYMENT SCHEDULE A Deposit of One Half is due at the Signing of this Roof Proposal and the Final Payment for the Balance is Due Immediately Upon Completion. WORK SCHEDULE: All Roof Work is Normally Scheduled for Completion Within 30 Days of Acceptance and Receipt ' of Deposit providing the Materials are Available. Please Make Checks Payable to: CHARLES COREY COEY & COREY Warranties the Shingles and Labor for 10 years. CERTAINTEED Warranties the shingles and labor 100% for the First 10 Fears and then on a pro-rated basis for 30 Years Total if the shingles becomes defective. CERTAINTEED Warrants the Shingles up to a 90 MPH WIND WARRANTY, CERTAINTEED Warrants the Shingles to be Algae Resistant for a Fall 10 Years. Any alteration or deviation from above specifications,will be executed only upon written orders and will become an extra charge,over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire,tornado,and other necessary insurance upon the above work.. This proposal may be withdrawn by us if not accepted within thirty days. COEY & COREY carries Workman's Compens tion and Public Liability Insurance on the above work DATE OF ACCEPTANCE: ACCEPTED BY: SUBMITTED BY: CAROB. RAEY C COREY HOMEOWNER C 0 N C.) X 2� fO 2 A CC"CLAPBOARMS t •4-TO WEATHER TYr. - j - ® PROM O.LVATR711 ONLY E El o0 .00 � o ❑❑❑❑ S+ k g = f TO WEATHER TTP.we a at FRONT ELEVATION REAR ELEVATRXRS A ti A W W SCALE-1/4 -T-0 RIGHT SIDE ELEVATION 4 - SCALE.1/4'-i'-0' o= U W fi t U) w a 0 luTll ❑ ❑ < < ®®® 0 W w Q AMU 00 LEFT SIDE. ELEVATION REAR ELEVATION SHEET "UMBER, .. SCALE.I%4'*1'-0' � _ �� SCALE-1/4'-1'-0' .. FILE =1ME. 92113A/ i V JN�n N cQ co O � { r-z• 4-0• a s• OTC•G.C. TOl 0 ... OONTMOUS ROCC VCNT CONTRACTOR TO CRdT VrRfYN O ..p C ry rTTO4l 51D-oVCR � :ounoNs a soNAnncs o .j ''•~ � 12 , no ` r — 1 s. . 1 _ I TTPGAL ROOF CDNSTF=TlCY4 • --------- ! I "\• ATTIC - ARCrMCTS A5PNALT 5NNCLES/ - - I Q 1/2•PLYWOOD Sn!ATNNcn■0 > - %(HCRClA5s HSLL RAFTERS AT I�OZ TROVOC"%OPCRVQ/T' Z OR COWL-sTTRA(OAN H5LIADM TO LDROr WALL T PGAL 0'CONCR C WALL • I ui MANTMI VCNTNc AT EAVES AND SLOPED a i .. 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Lu.0 Rs ❑wZ FAMILY nCTR./ e'-s• 4-4• .-srrc a CRCLTOP Rnsn_.DROOM 4 uoeDeTcx2Q K L N ' L0 w-SHL 2424-2 <mf'.1 v c_sn-_w 2-0 3/e'x s'-0 3/e NCYRSLN C19 w rm PCRn45rrLD 1 I n 1 MTLRL' c-0 3/e•x 5'-0 3/D ANY-RSEN Cr-" wraR P7tlf45ttGLD I I e•-s. _ n z awrac zo s/e•x 2•-0 s/a er�zs[N au x+m r•.nuSrrLD (7 n 11 .. 4 LIVING , DINING m r 1 A%MG- 6-0 3/e•z 2'-0 s/e MMSM ul wnTC r-z•usneLD MASTER u i R p 2.� n a 3 sKTLKrTs m 3/4 x x vamvs-2 BEDROOM 1-77—" 4 ----------- i M� M� lz-2 1/2• G-1 3/t• s STAR Le TO 1- . i ! STORalc1 ovac I z r-_-- cARAu_ Q 3 I Q © - - - Nor_. M GT s5D. I Z 41 1 w,wc-N 1 u ' orL �— AT ALL GC cm.eD. }' 1 1 clOSCT 1 r_Te STSTOI O AT eR M 14 1 �w PLT CIAW LAV. I cARa¢.um - Er v T De JIO .mule ea+rR. uvne SPpC_S a MASTER O ®a ---� GARAGE © a W _ --� 2. y BATS FOYER :-0.I KITCHEN 4 i Q q i h o W a COe--N TO 1 r 80 , . Z _ 4 4.{• 4•{• 3-10• O G"-0• - I FIRST FLOOR PLAN r-1 a/4• 14•-10 3/e 3-lo s/e• a"-0 1/e' eaNe Dune fair m 81 RR 5C.4_.v4'.1.q•. 3-Lowl l2C Or CacKCT In ® I I ® I wLpOvrX'mOvoc W a BEDROO L—J L—J 5�%s AS on Q ` CCr1 TO MOWS I - lt'-1 3/4' BEDROOM —j,-- Q BALCONY © i Q Q rf a C3n4•LVL Rxc ecw.aovc 1--- o \\ i •1v Q m Da \ I to 1D 30 Lft Il � � ; Q ; \\\ lW Q rJJ -n- BATH 4i. �. uoX ---- -----�� , IQ a n r ss� l _I corL TO r oo.w, I 1 1 Z Wit► - - ". -- .r -, a=`: .._ ''. - ... -"•��+-s•tTc',�5[��.tsuare 1P-1• m r-z• I z WINDOW SCHEDULE !—� IC7 am D=SORPTION ROUGH OPENNG MrR./Moom" R-IMARCS A 2 DOL0.L cA$&f 4'-0 V2•x 7-0 V2' Y0 0 '5 01 Cgs w m rLRaasndD v ® e 1 cASL.`�Jff 2'-0 e'x W-0 V2' Weu'm= W n rimug[1D I DGGK c + Tzm!cAscrew G'-0 s/e•x V-0 V2 Meow cae w rL rRrwsnsLo 20 © w D 1 cRG-'T°r G•-0 S/e•x s-z 3/4AMMSM GTGI W"T-rDLn 5MGLD Q J j m ® L 1 c9cuToOCTAGON 2'-0 V2'x 2•-0 1/2• DROWAMMS GT F I r z uxeur°' a•o ve•x z--z sra• amnesa eiez wraT=rLze+asM..to N N Q G s DOUBLE 16M0 T'-G':4'-5• wcsnt"2424 I FAMILY ' 'q FCT1xL/D rLAN n. eRS e�-s x/' r vset m e m n " m n y J 1 I LLC /•-4 x 2•-r A DOP•.°t G= Y&IT:PLRMASMGLD .j o Op .L MLMG MlLL1Jt/ S-0'x s'-q 7 if DOOM O � K a wLSP2G 212h2 v 11 v - "I I / L z �rr z•-0 ve•x s-°s/e umLRSLN css x*arl r:Rnns'r_,n t=7 I i. 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BEDROOM L_J �_J smmesAs2'Ov Q~ u-1 va I co 1T°o V41 o n. u;-0• \ i O BEDROOMo {. s © BALCONY © Q Q - - \r-Q Or c31:a'LVL . N p xDtc SCAM Aaovc1--- \ I U) • 7~ O \' I } W . 10 10 a Lea 11 O I 1 \ I J e� < aeeva --- BA t WALK r� ---- ------ I IQ OG \ TM 4 I /i Q _ Access co.-N To reM^ A scvn o t 4 1 / zco corrnw O q ra�eaes / R O Q OO > ® I COMM TO eaow csTORA°1 / STORAGE ELT BE SHEET N M R U SECOND FLOOR PLAN - sc"..Va•-1•-0•. FILE NAME. i LOT 15 rn LOT 14 z 43917 S.F. w N O+lP 0p. Ul N � cJ. a r ••{} s On . d �+ Lo N iIUf1 U! 4 LOT 34 'C � 45. o 22 g' � kk J N V, \ N 0121 WATER Dg,IVE Y BLUE 1 8 19 93 INITIAL ISSUE PAL~ THIS PLAN IS NEITHER INTENDED N0. DATE I DESCRIPTION BY FOR, NOR SHALL IT BE USED FOR AS BUILT FOUNDATION PLAN—LOT 14 MORTGAGE LOAN PURPOSES. BLUE WATER DRIVE A `'`'` BARNSTABLE, MASSACHUSETTS DENNIS STAR FOR CONSTRUCTION SCALE: 1" = 80'1 JOB NO. 1257/1257PER I CERTIFY THAT THE FOUNDATION - SHOWN ON THIS PLAN IS C TED ""-f�P�Ut.A. \ ,ya`f, o so 160 ON THE I IC T D. r v, 8/19/93 �. '',.°t < . „'. LEVY, ELDREDGE & WAGNER, ASSOCIATES INC. DATE RE YERED LAND SURVEY ENGINEERS LANDSCAPE ARCf r0S PLANNERS LAND SURVEYORS -- >" 586 STRAWBERRY HILL RD. CENTERVILLE, MA 0263? �s3- oa 4, � �7y6� " 2-5-9- o2�- Xo Assessor's office(1st Floor): . Assessor's map and lot numb a��3 } i201WIL.S� Conservation(4th Floor): `� _ �� �' i SEPTIC SYS,-E °w Board of Health(3rd floor a INSTALL 4{ - E�111I Co >e act Sewage Permit number n - WITH TITLE 16 Engineering Department(3rd floor): ENVIRONMENTAL House number ENVIRONMEN 9AL C® Definitive Plan Approved by Planning Board 4?Lbcgl APPLICATIONS PROCESSED 8:30-9:30 A.M.'and 1`00-2:00 P.M.only- TOWN " OV xBARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO � _ f) TYPE OF CONSTRUCTION 19 � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according -- to the following information: Location ✓ � ��c;'�t�� st c�1 > ( . a /�" Proposed Use / G7Zf7/ � Zoning District � Fire District Name of Owner [� /, /��7f�/V 7�(_fr�/ � Address Name of Builder 4?yf:�- �V Address li �:S/Z5- Name of Architect U/� %� �`�?�1� � 1 tVO Address APW;�?1.� G Number of Rooms !L41Foundation Exterior S�ii Roofing 47-1-4 ✓/ Floors �; � 1� r�� ®err Interior . Heating Plumbing f h _ r Fireplaces Approximate Cost Area Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstabl egarding the above construction. Name �N Constr ion Siipervisor's License 4 � i i �a 2/28/95 ~$ 253.024.X01 & 253.024.X02 No Permit For Location 120 Blue Water Drive Centerville Owner' Kevin & Carol Rileylei ; Type of Construction i Plot Lot a Permit Granted 19" F i Date of Inspection: j Frame r. 19 t Insulation ���'�'� 19 1 Fireplace 19 '" F Date Completed 19 ' c Cosa o� ass '` 3 i y J DEI?AIZ.-NMN r OF LNDUSTRIArIir,ACCIDENlS " 600 WASHINGTON S�R= jame5 Gampoec BOSTON, MASSACHUSMS 02111 _or:;n-ssione- WORKERS' COMPENSATION INSURANCE AFFIDAVIT l r //.P z,c (licensee/permiacc)With a principal place of business/residence at: (C.Lty/ auJZip) do hereby certify, under the pains and penalties of perjury,that: () 1 am an employer providing the following workers' compensation coverage for my employees working on this job. Insurance Company Policy Number O 1 am a sole proprietor and have no one working for me. ( am a sole proprietor, general contractor or homeowner (circle one) and have hind the contractors listed bcl( who have the following workers' compensation insurance-politics: C- C - z-/ o 3934/3 Namc of Conrraactor Insu=9c Company/Policy.Number Name of Contraor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number Q 1 am a homeowner performing all the work myself. NOTE.Plcuc 6c aware twat wbilc bomco:Nncrs wbo employ persons to des maintenance,construction or repair work oa a dwcliinc of not more 6xn trcc units in vwicb the borcowncr also resides or oa the grounds appurtenant tbcrcto arc not generally considered to be er•olovcrs under the a'orkcrs' Compesatioo Ace(CL C 152.sect. 1(5)),application by a homeowner for a license or permit may MCC--cc the kcal status of in employer under the Workers'Compensation Act co,-r ct t a s;::c:acr.;will be forwz:ccd to &,c ✓cna:r c.L of Indus;ria Accidents' OFriee of Insurance for coverage C1 scc,-:C W�C:..QC:3 rCcui.cL undo cc:",2 .' 'O-�ICi� L CSr.lea0 LO�L9e 7rnpOSlLIOn O. CT11T.L'] CG.^.sl •.-C o7 : rl nC IV- - (j:..&or impruorrn=.t or up to one ve::and c%-,j pcn:::Ks in the form of:Stop Work Order anC fine of S 100.00. d ag- r.. Me. < � Sicncd this av of o�7 % � , 19 % LIC=!:.:P. �:ccrsorl n.rml..V. t i COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY '� F.<F_r.-�tziaCssrg r�carr��B OF ONE ASHBORTON PLACE S.—D"cui0,9np MASSACHUSETTS BOSTON,MA 02108 COaa for ra>oca¢ioa of this/ic�Mae. LICENSE CAUTION EXPIRATION DATE. d CONSTR. .SUPERVISOR ! 0 6/1 7/1995 � EFFECTIVE DATE LIC—NO. FOR PROTECTION AGAINST . RESTRICTIONS -� a � � I THEFT, PUT'RIGHT THUMB = 6/30/1993 a49055 PRINT IN APPROPRIATE E to - BOX ON LICENSE. fD a�9ARK A WENZ.EL i� 45 W H I D A H W AY BLASTING OPERATORS SS 4 033-44--4363 ([[(Z CENTERVIiLLE IAA MUST INCLUDE PHOTO. €m i PHOTO(BLASTING OPR ONUS FyEE,ryry �?,, - { wi.�/.J - NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY I HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONERi1. '•-`ti ID. . DOB THIS DOCUMENT MUST 8E51 SIGN NAME'IN FULL ABOVE-SIGNATURE,UNE CARRIEDONTHEPERSONOF. �J +� SIGNATUR FU SEE THE HOLDER WHEN EN-� �q OTHERS-RIGHT THUMB PRINT GAGED IN THISOCCUPATION.i ER - ?5 :T:7rr a 6'.y fw t q '.f Y�.:_' ;y...� -:ramY+s f c Sze 3 `.ue,.x:. .:i M`#„ ' x°,.' sPta=, k F.-�. r In l._.1 `x✓ y�sfr. ae wf°` 1T?; f � i-'S`..` �, -''x--r ._.�,, �`S4'°%�w.*-':� evy, M1 ,K{^a* @i:.• *r'e�-'[. ra .Ta..2 .e s.,L Ilk' r � ,x TORSREG:ISTRAT:ION 'I 'ME NT CONTRAC s w ;� '_ a :'HOME--,,,,IMPROVE si i }• a � „tt l :. R .. r ! z n" 11-f u;latx.Ons-sand,5tandards 2 Yw t �I 2_ P.l.a.ce .:::- '3.One-"Ashby n - -' fs h x�, +a .�, J- ,..�,eb"^'Y''4_+. 2y�:.,.,.._/J•CJ+aE.1t_t Q2�0 �`Y ra+ o, `' _ r`, �rr ��. i �S .a`�.- Jy 'c ;}.�. „+ F e ,.. s"'.5:.i. •'9'.ta pv yAi Yµ � �i1 ?ie x. ;g, ..,L,„ h.. � _•q 'i r ,+.it ^2 }= >.K t^ „� r"-r :e ;z,._...*� '. $', .:.m gl :� -" ;'." "kt':a ...,.� Wiz ''=W�.;t o�. - -�4a�Y _ �y Nk ".'r° gym, ENTEONTRACT,Oft _ 4 � K � ,„ 'HOM IMPROVEM gip, . ,� .� . w,o� Of115f�96 � ' r � ��. < 1 144285t mExp�ratz, em - � y� Reg.zstraTiot ,R .', � n �F � gx AEON h> a "` :- _ .: EINPROVEHENI GONjRACIORr .T .: yPRLVATE" CORP,ORS � r HOME r1 �' - YPS "� -wa+`n: wB. �. °�,-:'•a a1 :-a.r .r. xM" ti'�x f.�3- r.rdiP"' q''; t ^vC + +.. a+�'"bt-tic; i:' r brr �s eg "stratlo I e P.RIiIAjECOR , ,. i' Yp ;, y alnc Wenzel :FraminJ ; -...w .x�`' AN �,.ly E; �a enZel .y� *tea zs I,�w .t �ta:,w c� ? €da S Mar, .A,a W � t xF. ���tz � t �� � � ;� ,. c f`5 fi ,r. t. j �' .. i. ' �} `;s : ..'^' as+ ; 4 F » • 45 Whii_dah WaY. x � 3 f : s Wenzel Pram, Inc:ru t, .n .f` -'43" +-,,-, qzH.s x »�`Aa' " k Y£'-1'd�° .c tervi lle MA 02632� 7� � n` Y parkAWenze� z 4 `t7 t G .F ? I *' -S�'-Fa +t .+, '- ,irk' �• • p ,p K ^ I e n ..r '� .` �hrdah61ay ,µ ,k,; fi t o- s � <i I ADMINI TOR%ka All � CenteXvrilaMA}02 I IKE The Town,:' owri of°Barnstable 169. 0�' Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax:. 508-775-3344 t . �3 t Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement, removal, demolition, or construction of an addition to any pre-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: Est.Cost Address of Work:_ /,2 O �E Owner Name: 4 E1/�/ Date of Permit 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 a-,� r r ()%timer 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 o«-ner: Date Contractor name Registration No. OR Date Owner's name __ I