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0256 BUCKSKIN PATH
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ORR, U Y il;#144%g,�, v ------------ TOWN OF BARNSTABLE BUILDING PERMIT A;PPLIC,ATION Map ParcelJ Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. 9� �� Permit Fee Date Definitive Plan Approved by Planning Boa` q� Historic - OKH _ Preservation / Hy nisi 1 Yj(Mid( l T Project Street Address *75 G VbQ QV S l� Village Q."e �.�iLX.r, Owner -V;z a 1r+E✓ Address S G Telephone �� -7 (p q Permit Request Square feet: 1 st floor: existing Itcro proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Jam'Ile— Construction Type STI LA4_ 4� Lot Size - Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure ® Historic House: ❑Yes 4No On Old King's Highway: ❑Yes No Basement Type: (*Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: —new Total Room Count (not including baths): existing L new First Floor Room Count Heat Type and Fuel: 0 Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes N 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:'o existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes A No If yes, site plan review# Current Use iveV,iTA Proposed Use Si. APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name � 0 S � i ` PC Telephone Number �b� �7-7 4=1 Address `�®TC l License # ?&RY�S f�16' 0 2-6 'J D Home Improvement Contractor# Email !S�rk_TEETL° B0IL-0424cs cc-IiJ4SNA-QJ0w`'1 Worker's Compensation # '^ ALL CONSTRUCTION DEBRIS RESULTING F THIS PROJECT WILL BE TAKEN TO --To SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL i' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. a I I �FE�f,�££ZF�#'�FLf#P.flt �`�ff�F1Y�*P.� • -Ak- JEyFtff 4517 L �CLTIITE '. �FfFS 699 Wad6Vt 7S&i BaS&z;-4fA QM Wurlmrs, CmapenSa� ce Tmdzyfb RuffilE'r•sdCum±rzctC€tS G �ers QL 3fFi�rE F.easaPrfid .N Are you as eng9ayer?`.Cfitcktb.aappragiiafehc= � Type nfLrAleet�L�4. 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AWC Guide to Wood Construcfdan in High Wind A eas::110 mph,Mrrd Iona q - Matssachtnsetts Checklist for Comp1iaace(790 cl+1R53Gj2.]:t)' • � .. �C�1 crzeck Camplisncq 1.1 SCOPE WindSpeed(3-sec,gust)........ _.. -__._._.. ........._..... ......._.......-_................._..__... _...110 mph Wind Exposure Calegory_ _._...._._._... :._.... ...... _._... 12 APPLICABILITY Number of ._........ 2)... ......_._. stories 5 2 sfnries RoofPitch ...._.____......_.._.__......�.. _......-. .(Fg 2)......•_---__-..•__..._._._., 512:12 Mean Roof•Height _. . _._.. ._:.__.__..::_... .._._. _.._.Fig 2)'-_. ___...._.�._.�..._. ft 5 33' Building Widfh,W.__.`_.-___�___._. ..-�__...(Fig 3}._...._.. __..._.._._ ft 5 8D' Building Length,L ................_..-_..._..._........__:__.(Fig 3). __._ -.....__.._.__.. ft 580' Building Aspect Ratio(LJW) ___...:..._.._ 4).-..................___._._...._..._.r" <-3:1 Nominal Height of Tallest Opening2.......... .:.:.�:.:.__;(Fig 4). .:._:.:...._mac... .:. 5 6'8' r- ' 1:3 FRAMING CONNECTIONS General compliance with framing connections.. ._..._-_.......(fable 2)............_...... 2-1 FOUNDATIO-N Foundation Walls meeting requirements of 780 CMR 504.1 Concrete......................................_....................................................... :._.,---__..:......_..._.._.. Concretd-Masonry_,.................................. .............._....._.........--............:._..:_...._.. _..._.. . . 22 ANCHOR4GETO FOUNDATION1.3 5/B'AncharBolts imbedded or 51B'Proprietary Mechanical Anchors as an arternaiive in concrete only Bolt Spacmg-general ...... ..__..(Table 4)._:........_.........._. -. in. Bolt Spacing frorn•endrIarnt of plate ____......__.(Fig 5)^._.__:_:_.._...... _.. in.5 6'-12' Bolt Embedment-conaeie._...._.---^.__.._.__..__..(Fig Bolt Embedment-masonry._............�..._,�r:_:_-•(Fig 5)._ _:.. ..._...____-.. in.z 15' Plate Washer.-._ _. _.:........_.. .. ._(Fig 5)__.._..... _.._ 3'x.3'x l'. 3.1 FLOORS Floor fiamfng member spans checked ....._.. :._..:..........:(per 730 CMR Chapter 55)............... ::................ . Maximum Floor Opening Dimension__._-.._.:_. (Fig 6)...._._............-_.,_ fts I or L12 or,W/2 Full Height Wall Studs at Floor.Openings less than 2'from Exterior Wall(Fig 6)........................... _....::_._ Maximum F•loorJoist Setbacks Supporting Loadbearing Walls or Shearwall........ (Fig 7)._ __:.._: :.:..._...:..__.._..._.—ft 5 d Maximum Cantilevered Floor Joists Supporting L.oadbearing Walls or 5hearwall...._..........(Fig B).............._._.____..__.._..... ft 5 d Floor Bracing atEndwalls.. ........... :.__ .(Fig 9)...._........... ........:...:....:,... Floor Sheathing Type _..._........................._.................(per 780 CMR Chapter Floor Sheathing Thickness (p __._. __:_• ....-..___....._�_....... .-..___ er 780 CMR Chapter 55).__..........._. in. Floor SheathingFastenin able 2 -. d nails at in edge g------_.......r,.....__.,..._...._. (T ) _ 9 /_in field' .- 4.1 WALLS _ Wall Height ' Loadbe:ar ng (Fig 10 and Table-5)......__...._.._ ft 51.0' Non-Laadbearing walls._ _.._..:...:_..:..:..,. .....:_ ,(Fig 10 and Table 6)..._........_..........._ft 5 20' Wall Sfvd Spadhg _ .(Fig 10 and Table 5), _ in.5 24'o.c. Wall Story O rFsets ,:_ _.............. .._: ..:_.(Figs T B) ._.. ..__.... _...... .. _ ft 5 d 4.2 EXi EMOR 1NALL53 - Wood Studs r _ Loadbearing wails_.. _ _ ........ _..(Table 5).. ....... ZX _ft in. - Non-Lcadbearing walls ......_ ,..(Table 5). _ -Zx -_ft_in, Cable End well Bracing Full Heigh{Endwall Studs" ...... _. _ ............._...._.. ............ WSP Attic Floor Length..:: _.. .� (Fig If) ft>W/3 Pypsurn Gelling Length(ri WSP not used)... _ ,(Fig 11).__.._............... _ft;0 9W, -.2 x4 Continuous l_aferal Brace G_6 fL o.ri_(Fig 11). ......_'...... _.. Double Top Plate Splice Length ................. .......(Fig 13 and-Table 6)_... _ (t Splice Corinection(no:of 16d comriion na'ils)_ ,_._,(f"able AWC Guide fo Wood Consf UCdQn ur NO K'ad Areas:110 Wh Wind Zatte Massachusetts CheckIistfor Compfance po'Cxiz 53o l-2.1.1)r Loadbeauing Wall Connections Lateral(no,of endnailed 16d common nails).......—gable T)-_.__-._.__--_____-_- ...-___.... Non-Loadbearing Wall Connections Lateral(no,ofendnarTed 16d common nails).�:_._-__(Table 8)__...... Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans _ �_ __...- ..._. .-.- --_ .(fable 9) ___ ... �........_. Sill Plate Spans _____ ____ ___ . .(Table 9), !_ .._ ..... _..._ _ft_In.s 11' Full Height Studs(no.of studs)_ _ — Non-Load Bearing Wag Openings(record largest opening but check all openings for compliance to Table 9) Header Spans:_.. _____».... _. - __ ..._,. _ .(Table 9)-----_...... _ft_in.5 iZ' Siff Plate Spans. __._ .....___ __(Table 9)_,__„_____._--_,_ ft_in.S 12" _ Full Height Studs(rio.of studs)-------(Table 9)_.,_-_,_-_,_,___..._-_.,-...__-_____..._.__ — EA--dor Wall Sheathing to Resist Upi'dt and Shear Simultaneously+ Mnirnum Building Dimension,W Nominal Height ol'Tallest openingz ., .... ....._ _ _ .__..- ...-.-. . -........... Sheathing Type. _. __.. __._.._. __ (note 4)..__....__....._ ..... — Edge Nafl Spacing (Table 10 or note 4 if less)___... in, -. Feld Nall Sparing ___.._ .. ...... (Table 10)-...... - ----- in. — Shear Coin nection(no..of 16d common els (fable 10)--- -Percent _ Full-Haight Sheaffifng — ° > (Design �Co ce is __ 8'~Des n n - ...-- .___a wiftr Opening 6 lg P )------ — 6/°Additional Sheathing for W g p 9 ( _ - Dime $ion L Maximum Building. n � NomihalHeightofTallestOpenin __.._ ........ ..............._...................... _... { Sheathing Type-------(note Edge Nag Spacing...... . -___._.. :..(fable ll ornote4If ILSS)._..... _"._.._. in. Feld Nall Spacing._-__.___.,,-.._._..._..._..(fable 11). ...-.�-._._..__._..:�.__._- fin. Shear Cohnec ion(no.of 16d common nails)(fable 1 �.__ .- ---- • -_--• _= Percent Full-Helghtsheathing____.-•-•._-_.__.._.(Table I1)__- -- ....... ._...... ._.. - 5%Additional Sheathing for Wall with Opening>6'8"(Oeslgn Concepts)• •••_- Wall Cladding Ratedfor Wind Speed7...._-._.------•-......._. _ _..._ _....._.___..._--. -.- • _ __... 5.1 ROOFS Roof framing member spans checked? (Far Rafters use AWC Span Tool,see BBRS Webstfe) Roof Overhang -...-_...... ...... ..:.... ...._.....:.... (Figure 19)....,._.. _ft5 smaller ofZ'orLI3 Truss or Rafter Connections atLoadbearing Walls Proprietary Connectors Upilft-__-.________--._.-_.__.....____._ (Table 12)......... . .. ._ _..__._.._U _Of Lateral __.._ .__....__.___........(I-able 12)._._..._. _. _..._ ...._.._ ..L- pif Shear---.----.---.(fable 12),...Y_ ____...._..._r_5=_Plf -- Ridge Strap Connections,if collar ties not used per page 21___,(Table 13). ...._-_,,,__-...,_,T= plf _ Cable.Rake Outiooker...__._ ............................. (Figure 20). ........._.-.fts smaller of2'orL12 Truss or Rafter Connections at Non--oadbeadng Walls Proprietary Connectors Uplift_.._..._...:_ ..__.._.__.__.._.._(fabiel4)...._ Lateral(no.of ISd common nails)-.(Table 14)........................_..,+_.. Roof Sheathing Type._ -...._-.._._ ,_ ..._._ ._....(per M CMR Chapters 58 and 59).'................. — Roof Sheathing Thick ess in.2:7116,WSP Roof Sheathing Fastening _.....__ ....._..___. _-(rabla2)___. _. ._.._......__ _._ Notes: 1, This checidist must be met in ifs entirety,excluding the specific exception noted in 2,in comply.with the requirements of T80 CMR 53012-1.1 Item 1.If the checklist Is met in its enfirety then the fogowing metal straps and hold downs'ars not required per be WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. .20 Gaga Straps per Figure 11 c. Uplift Straps per Figure 14 d. • All Straps per Figure 1T e. Comai Stud Hold Downs par Figure Iaa-, 2- Exception:Opening heights of up to 8 fft_shall be permitted when 514 is added to.the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shag be a minimum 2 in.nominal thickness,pressure treated#Z-grade. Fry—��•1�.. '.� _ l � . �4Fli qrficte fa f`aDr CDnnS-urhDrt rsr F �fr; 14reRs_ £ZD � n Zvf�D,a1z - - r Y m(:hTi&e:tf3 Chadliat for CDMp'HanGe pQ cn-f:-�3@t2:1s)` alp d and sh' and 1�& �Q def znirre 1= Fury ram► a From T I f �f and fo�nn aft all. g�P I 9 SFr ►g and 147 Ong regf - - b. •Wnad Sfrudurai fans shall be niuiwIIn ffiidaie�cif7fi 5 and be iialled as fbigmys L . J?ands shall be a2sfaNed wr dram�ams pamn4 fn sivrf . I Al h !Dims-Ball D=mrf,-r and bE�naned to fimn mlq_ uL Dn single sft3iy mrts idml r�pane&shall ba of died In baBnm plafas and fnp.lnp-- r Df$te d❑nbld: fan F%nsfnry=mcirr Lrfinj7�.t�m pai]Ric 4=4-tr F,� �5�$�Efpp rt[e�M-.a-$etlppar rbrihfa#aft—• - plaL-and b band jorst at bofbm of panel.Uppe1-affar r* of bwar pair!shall be rnada in band joM and lDwaraffazhnerit madam fn]Dwa�t pEh�at nrst So6rf m!g. v. Flnr¢mrrfall rra'l sfr=g of drnb�-by pWE!g,Land Ioi-L-,and phk=shalf-ba a dou5le Tote rsf ad - st�dt 3 inches on mrd per ftvru s baFDw--VE6ml arnd km mr�al NmTi g fnr Fmeel A -.a ent, 5' Gfaz g.pmtf r-5 rt a)'naw bD=a orharimrtfal inn—regtrirLd Wprajeifls I mile errimsesia shara(genea4y.&Dffh of . Rfe.ZS or norgi of Rf;6} b)vwfical add-man—nat regffhd`M-&SZs thM-B k e - Ti-ljt won Sn lba fast•ffMr• �}r=ph:emertwMd=w —needs MMW C:DnsMafian cattipZaiM COY(Chap M) , E Laad Fr am e Cansiivcffin gar>ual( Chh}for id MPF{,E. l�B past may be Qbfau tedfrom'fi-m ArneriE-,rt Virnod CDuga1 (AWb) - - -xru"=_ _ u u _ • �i ik _1 - . - _ Lr Lr _ I Q 4 L cr F- i ri �> i r t L > t LL YID i i - ` Lr Ii - - - it It F LV .cL LI L • . ❑❑ - -S is 1 � - I E . PAVE- S DEW . -Vi rlfu3f and HDTimtrfalfGrTng >�T VaW And I-fmfm�Nar�'mg'• -. . fDr FtLeI Alnl� ..Town of Barnstable F Regulatory Services t u�ANh-P�HT� r - �� Richard V.5ca14 Director Building Division Paul Roma,Building Commissioner 200 Main Street Hyannis,MA 02601 www.towmbarnsfable.ma.us - Office: 508-862-403 8 Fax: 598-790-6230 Pieoperty Owner Must Coinplete and Sign This SectiOri : = If Using A Builder as Owner of the subject ptopettp herebT anthw ze S'�'���.1 _S �)i, ��C to act on my behalf; " in aU iaattets telative to wotk authorized by this building pernnit application for... �LL (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools .r are not to be filled or utilized before fence is installed And all final . inspections are performed and accepted. e A Owner . - Signatate cant - &e�p 44 e.M' 13 REE- Ptint Name Ptint Name ktziL-'3 7,0 �� t Date Q:FORUE-.DWN=M:gMSIONPOOI S Regulatory Services _ u Richard V.SczA Director �,. Building Division Paul Roma,Building Commissioner XAM No Main Street, Hyanm- MA 02601 s6f4• t r++d~ www.tc)wu barustable..ma.us Office: 508-86211038 Fair: 509-790-6230 HOMEOwNERLICENSE Effi!HMON plcaie Print ' DATE JOB LOCATION: street numbrr Fi02vIE(JWI�R": home phony# work pbone# name CURRENT MAILINGADDRE4S: citp/ivwn std zip mdo The current exemption for"homeowners'was extended to include owner-occaykd.dweTlm as of silt ups 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- pEFlNITION of HOMEOWNER Persons)who owns a parcel ofland on which he/she resides or intends to reside,on which there is,or is intended iD be,a one or two-family dwelling,attached or detached structures accessory to such use andlor fain shmctares. A '. person who constructs more than one home is a two-year period shall not be,considered a homeowner..Such "homeowner"shall submit to the Budding Official on a form acceptable to the Budding Official,thathe/she shall be recponsi`ble for all such work performed under the building permit (Section 109.1.1) The undersigned"IlomeOwnef'asses responsili i�ty for compliance with the State Building Code and offer applicable codes,bylaws,Tales and regulations. The undersigned"homeownee'ceTiifies that he/she understands the Town of Bamstable Binding Department minimum inspection procedures and rec=rements and that he/she will comply with said procedures and requirements. sigpah re ofHomwwncr Approval ofBui7ding Official Note: Three-family dwellings containing 35,000 cubic feet or larger wM be required to comply with the - State Budding Code Section 12TO Construction Control HOAMOWNE s XX12d TION The Code states that: "Any homeowner performing work for which a building permit is required . us of this section(Section 10911-Licensing of construction Supervisors); shall be exempt from the provisio 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) rious problems,particularly when the homeowner hires unlicensed This lack of awareness often results in se 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 for .1certifiCatiDa for use in your community. .. � r I 1 . �� ��D, _ dap � . � � . , . �� � . �. ,. ��h .. o .� . , ; � _ . _ � . SOV i arrW101.7rraetrll/ W//l ac/u el! Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR p Registrations 1.00390 Type: Expiration.�6/16120:18 Individual STURGIS ST.PETER r Sturgis St.Peter 65 Cindy lane!P O Box 372 r Barnstable;MA 02630 Undersecretary { a License or registration valid for individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 . Boston,ldlA 02116 Not v id with t signature f Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-014501 Construction Supervisor � t t t., r> —• STURGIS ST.PETER �:r,. rr.r• # P.O.BOX 372 , BARNSTABLE MA 02630 CA--- Expiration: ' Commissioner 08/23/2017 R ' z o�VE�7 Town of Barnstable *permit# � ti O )�rpires anttrs from issue date Regulatory Services Fee -� • STAB°LE, S� � PoYiFIT Thomas F. Geiler,Director PR 2. 7 Building Division �/129�1i Jam' ITEm Perry, CBO, Budding Commissioner `OV1/N OF BARNSTAB v 200 Main Street, Hyannis, MA 02601 _ www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508=790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY , Not Volitl witlrout Red X-Press Imprint Map/parcel Number Property Address M"Residential Value of Work a-0 Minimum fee of S35.00 for work under S6006.00 Owner's Name &Address T fZL` Contractor's Name ���P_@ GAP , Telephone Number %7— till Home Improvement Contractor License#(if applicable) 10 g C� Construction Supervisor's License#(if applicable) 21rorkman's Compensation Insurance Check one: ❑ I am a sole proprietor h1/111h am the Homeowner ave Worker's Compensation Insurance Insurance Company Names S Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(eheck box). ❑ Re-roof(stripping old shingles) All construction debris will be taken to Re-.roof(not stripping: Going over existing layers of roof) #of doors Replacement Windows/doors/sliders. U=Value .0 3 0 (maximum .44)#of windows 3 *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 a Improvement Contractors License & Construction Supervisors License is req uir SIGNATURE: L. Q:\WPFILESTCWMMMS\buildine permit fornu\EXPRESS.dOC f y ✓�ze Vam�yea�rruecz`C�z o� %uzaa�tofuael 1 Office Of.Consumer Affairs fi Business Regula.i oii _ y License or re UgHOWgistration valid for mdrvidul use on IMPROVEMENT CONTRACTOR !• before the expiration date. If found return to: f Registration 100503 Office of Consumer Affairs and Business Re ulatio, 1 Ex ira`ti Type'. 10 P g i" P on 6/19/2012 ark Plaza=Suite 5170 SupplemenCjy�:rd Boston,MA 02116 G CAREFREE HOMES ZINC ' DANA PICKUP I239 Huttleston ave ^ i Fairhaven, MA 02719 _ { Undersecretary r _Not valid wit out signa o;,,.achus(ttti_ Dcp Wtrrient of Public Stitch � Board of Buildin'j Rcwlations an(1 St.[ndards.;. q Construction.Supervisor 'License ` + License: CS 95228 Restricted to: 00. DANA PICKUP 19 HAMLET STREET. g FAIRHAVEN, q MA 02719 i • •i , (utnmiss�unc EXPiration: 3/22/2012 -------- Tr#: 18680 - f l , I s Client#:33723 CAREF y4COTlD.M CERTIFICATE OF LIABILITY INSURANCE FDgAITOE 6/10D1YYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Herlihy Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 51 Pullman Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Worcester,MA 01606 508 756-5159 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Interguard Insurance Company Care Free Homes Inc INSURERB: General Casualty Insurance Companies 239 Huttleston Avenue INSURER C: Fairhaven,MA 02719 INSURER D: INSURER E: 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 INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE MM/DD DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE OCCUR MED EXP(Any one person) $ PERSONAL$ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- JECT LOC B AUTOMOBILE LIABILITY CBA08168.10 07/01/10 07/01/11 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $1,000;000 ALL OWNED AUTOS BODILY INJURY $ • X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY X NON-OWNED AUTOS (Per accident)RY $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY EA ACCIDENT $ ANY AUTO , OTHER THAN EA ACC $ AUTO ONLY:' qGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR FI CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATIONAND CAWC134097 09/01/10 09/01/11 X WCSTAT U- OTH- EMPLOYERS'LIABILITY DRY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1 000,000 Oyes,describe and EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1 000,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION r ;. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ' Town of Barnstable,Bldg Dept DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3n . DAYS WRITTEN 367 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO$O SHALL 'Barnstable,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR;' } a REPRESENTATIVES. !§ AUTHORIZED REPRESENTATIVE -J 4 w • ... ` ACORD 25(2001/68)1 of 2 #M42357 PB2 ©.ACORD CORPORATION 1988 54 N M " The comnioi x3ealllt of Massachusetts Deparimetit of Industrial Accidents Office of Investigations ' 600 Washington Street Boston;MA 02111 www.mass.gov%dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers 1'. Applicant Information �. Please Print Legibly Name(Business/Organization/Individual): Address: 77- °1` S ' - City/Sta %Zip: Phone#: Are y an employer?Check the appropriate bog: Type of project(required): 1. I am a em Toyer with .4. Q I am a general contractor and I employ (full and/or part-time). have hired the sub-contractors ti: ❑Ne construction 2.❑ I am a sol proprietor or partner-' . listed on the attached sheet: 7: odeling These sub-contractors have ship and have no employees 8. ❑Demolition � . working for me in any capacity. employees and have workers' 9 guild addition [No workers'comp.insurance comp.insurance t Q required.] 5. Q We are a corporation and its 10.0 Electrical repairs or additions 3.Q 1 am a homeowner doing all work . officers have exercised their 11.Q Plumbing repairs or additions: myself.[No workers'comp.. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4);and we have no employees.[No workers 13.❑Other i comp.insurance required.] AI *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 3 t Homeowners who submit this affidavit indicating they are doing all work and then hire outside conwractors must submit a new affidavit indicating such $Contractors that check this box must attached an additional sheet showing the nine of the subcontractors and.state whether or not those entities have + employees. if the sub-contractors have employees,they must provide their workers'coup.policy number. I am an cnrployer that It providing orers'compensation insurance for my employees. Below is thepolicy andjob site information: Insurance Company Name: Al Policy#or Self-ins.Lic: Expiration Date: l Job Site Address: 2.S�' v c K t O City/State/Zip: Y j . Attach tt 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 fine up to$1,5M.00 and/or one-year imprisonment,a§well as civil penalties in the form of a STOP WORK ORDER and a fine a �ti of up to$250.00 a day.against the violator: Be advised that a.' - of this statement may be forwarded to the Office of r y Invesle, coverageI do itniler,theand p alti " jpe'` " that the injorinbtion provided above ist eandcorreci: Si s ate: 2 . Pho # Official use only. Do not write in this area,to be'completed by city or town official City or Town: Permit/License# f Issuing Authority(circle one): 1.Board of Health 2:Building Department 3.City/Town Clerk 4.]Electrical Inspector 5.Plumbing Inspector 6.Other. � . . Contact Person-: Phone#• OFFICE: (508)997-1111 ;; MA. Builders Lic. #021330 FAX'(508) 997-1297 C A R.E FREE Home Improvement TOLL FREE: 1-800-407-1111 QmeS InC. Contractor's License WEBSITE: #100503 MA. www.carefreehomescompany.corn 239 HUTTLESTON AVE.(FIT 6)• FAIRHAVEN, MA 02719 #15179 R.I. NAMEGAL /I DATE ADDRESS g�,$'-y A�l-e GL6ziP C 0 a& 5 Z- ADDRESS OF JOB tL� / TELS CJ JOB DESCRIPTION nxg ns-L--. (/�/ 6 9 J_S- Gli�f71 r e r Cr c. � Q W / < IJ v/3 L L0 w S7-iP!i� Ole-le [aJe7 /7-7 &e_X-77f e!5_-A G6,- ^�O 'atl` L rV /4/9/,Dc5 S G`D/2,G - , C'��2 ti /tf r �. ,,-elcnZ c&/ /�DY /'Z w� wL x t y � fa,t_1"<7C CP /t7l x , I/0n Scheduled Start / Scheduled Completion A. Replacement of missing or rotted lumber is not included unless specified. B.All start&completion dates are approximate and could change due to weather conditions. C.Stripping of roof includes removal of up to two(2)layers of shin e , ac iditional layer to be charged @0 ft2. D. Replacement of rotted roof boards/plywood to be charged @ ('— N E. Exisiting chimnet(lashings will be reused;replacement, if necessary, is not included. F. Care Free Homes, Inc.is not responsible for mold/mildew conditions that are pre-existing or result from leaks not brought to the attention of C.F.H., Inc. promptly. The Company hereby proposes to furnish labor and material to complete the above work for the amount herein. Fulfillment of this order is contingent;however, upon the want of strikes,fires,and any natural disasters,the ability to obtain materials,or any other conditions beyond the control of th11 e C , Cost of Project$ 7191212 PAYMENT TERMS Date 1. You,the Owner may cancel transaction at any time prior to midnight of the third business day after the date of this transaction. 2. You,the Owners agree to pay any and all expenses incurred by Care Free Homes, Inc. in collecting money due under this contract and enforcing the terms of this contract, including but not limited to, reasonable attorney's fees, interest and court costs. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES CARE FR HOMES, INC. AC TED: Buyer acknowledges Owner: Z_ By receipt of fully completed copy of this Areement Owner: All contractors and subcontractors shall be registered by the director and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Director, Home Improvement Contractor Registration One Ashburton Place, Room 1301 Boston, MA 02108 Tel. (617)727-8598 1 Assessor's office(1st Floor): ° e yS7. Assessor's map and lot number 9341 D 1�'` INSTALLED co W, i, Board of Health(3rd floor): Wwill�p Sewage.Permit number 4"RONAN ENTAL Engineering De artment 3rd floor 9 9 P ( 9. House number '��u }o• Definitive Plan Approved by Planning&ard APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only OWN . OF BARNSTABLE IW ILDING INSPECTOR i00W-Efi c 1 1 ►Cliff so ►J 6-Of 1711.1►cJ t +v1 . 1 'TYPE OF CONSTRUCTION i Z/L� 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora permit according to the following information: Location- (� 4 C.I�.S�LI r�� cy—:,it3 ��- Proposed UseC>Sc17 Zoning District 1 d �� Fire District, c' Name of Owner ® Address 46?sc Name of Builder 's Ogj:,'Ls `�-� 1� Address —601C iV Name of Architect �� Address Number of Rooms i Foundation Exterior Roofing Floors Interior Heating VC-99pt) 4, 0 A iS Plumbing Fireplace ��+ Approximate Cost lo Area Diagram of Lot and Building with Dimensions Fee I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the ab ve con u 'on. Construction Supervisor's License to(`��� HEMBREE, FRED Now Permit For AD I T I ON x �r Sinale Family > ael.: r r ► + Location 2 56 Buck - -P • i -I CentervillAll Owner' yFr6d Hembau t. Type of Construction Fra Plot Lot = <, k December 30 92 Permit.Granted ► 19 Date of Inspection f 19 Date Completed /9 19 '_ rn r 8 c O I aQ �a I, I c_»_------- i i I f � �/ee t��ealDi o�,�aaaor/euaeQa I HOME IMPROVEMENT CONTRACTOR., Regis#ration 108821 I TYPe INDIVIDUAL I Expiration @6/23/?4 Stanley E. St. Peter 5 Main Street, Box 54 ADMINISTRATOR _.... .4tRb l e $A 07E30 f Assessor's tmap.and 'lot number :..: .(:'.�..- p, IiGL//e C� L . s �./,_ Gr .. �. rid Se-wage•-Permit number ... ..4Cr..!?,�j t........,f Z. yofTHEro�� TOWN OF'.- BA,RNSTABLE Z B9HH9T11DLE, i _ � ' o AY01.1 : t=' n UUI��LDING INSPECTOR APPLICATION FOR PERMIT TO ...........................................................................:..................:. ............................... TYPE OF .CONSTRUCTION .......... . s�.,ln.,1 ... .. ..... :............................... .......... .... f1 19....... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............ j...... G � r�•.r• . 1...... �, .//.......... ,1 .. fly `„�i ............................... ProposedUse ................. ©.}. .. !...................................................................................................................................... ZoningDistrict ........................................................................Fire. District ................................................. Name of Owner .... .. .61 ../..:7.11 VI.�.Y...Y.. ........Address Name of Builder .. . ...b�..l.......J.. .... /. . 1 .... &........Address ....AQl....- ��' �►� e Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ......................... ......................................Foundation ........ ,.. .?9 0 Exterior .........:..........................................................................Roofing ......:... ........................................ Floors ........................................................................ .............Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost .... ....z. ..... .. .....................:............. .. J Definitive Plan Approved by Planning Board ________________________________19________. Area v S'................................ Diagram ofLot and Building with Dimensions Fee � SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstab a regarding the above construction. Name : ............... Hembree, Fred . ' ^�~ ' ' ~-- 17131 ' add porch to No .............. Permit for .................................... single family dwelling ...-------------..--------.���... � ' 256 Patb ~ Location ---.—.��������----------.. . , . ` Centerville .—~...----------.----------.. ~ - ' . Owner --.�red.. ................................ --- -----. ^ Tvpo.-ofConstpuction --..f r.a.me.---..---.. .................... Plot --....................... Lot ---'-------. ' ^ . ^ � Perm Granted �4 ' � Duha of.|n�pecio'n ------------lg � ' ^ � -.Date~ Completed .-J�. --]g � ' � . ' . � PERMIT REFUSED ... .---.��----...--.------ 19 . . .------.—.--~.�.-.----------... - . - --~^^^--^------~-^--------^--' ` . ` . . . . . � . —._.----._..+.~.--..---.--~—.--,... -.`—�-------..--.....--..~.~—~.'—. ' . ~ . . ^ � —'.'—.. lQ Approved-- -----------' � -------------.---..—~---.---. . ~ . . -------------------.—..."--..— . ` ^ U - � , ' � f• {{ _ r _ .. 9 � , i s 1• � � 1 `.� , `_•`1 - ' ems' /��,.L.jl(l'_..�.. t I� • Y Vu 4 - y t r hill 77, ool V 4 _ a � 1. !. .. �. 21 moo" oz ! �w GutT2'� r . . - � t - ,�.:.�T._. •fad. i� `t;�I' •�\ — - � '«�`�,.+rG•l+ — � _ / - /�; � A t - ,z Y 'r. , , ry l r. Assessors map, and lot number ...... .../ ''1 �.*. .. ......... �G'p �f 0 f=7'- - rye Sewage Permit number ...5. .:.ht../.+!. ......... .,f.!.._�.�. .. . FTMEtO�yo� TOWN OF BARNSTABLE L BASHSTADLE, i "ASL 6 9 BUILDING INSPECTOR E YPY a' APPLICATION FOR PERMIT TO ................................. TYPE OF CONSTRUCTION ..........., ,?.,r.�'.......�............................................................................................ ..............`................................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: / Location ............... -......1....!.h��f.�.. ! ,/ ..... f/,L.r� ........ .. ............................... ProposedUse .................��p. ..�:! ...................................................................................................................................... ..................Fire District .............................................................................. Zoning District ..............................(...f.............[....... Name of Owner !�� ..../..`.:f�.�?�.,l).Y....?'..�---.........Address .;�F.5.. ...... ;sil �s/r�; •,a /.•.,<`� {� Name of Builder .......!!).,/.. �� i.'11 �` .... !f .......Address %..... .......!'�.. Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ���'''� l........................ .........................................Foundation ......_......................................................................... .'�� 1' .rJ..�........................................... Exterior ............................................................................. Roofing ............. �.../.. Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..............................Approximate Cost ` Definitive Plan Approved by Planning Board ________________________________19________. AreA ..... .4. Diagram of Lot and Building with Dimensions Fee 7� !....... SUBJECT TO APPROVAL OF BOARD OF HEALTH ,{ I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. r Name.... .... du Hembree, Fred No ...17131„_ Permit for ...add porch to sin le famil dwellin Location ..........256 Buckskin Path ................................................ Centerville ............................................................................... Owner Fred Hembree Type of Construction ......frame ........................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ..........Jua.e••1D...............19 74 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... yof7HETo�° TOWN OF BAR.NSTABLE i BARNSTABLE, i .p�"b 9 B YAr BUILDING INSPECTOR Op� � s APPLICATION FOR PERMIT TO ....... ........................... TYPEOF CONSTRUCTION .............:.... .. ........ .. ..................................................... .......................................... ...��..... TO THE INSPECTOR OF •BUIL'DINGS: ;'. t The undersigned hereby pplies.for a per accordin o the following, information: Location ....... . .........� .. ........................... ..... } ..+ ........ .. ProposedUse .. ..... .. .......... ....... ... . .............................................. Fire District ......... Zoning District ...................... .................... ......................... Name of Ow er .......Address .. ... .... ... .. 0....... ......J ,3G Nameof Builder ......... ..................`...................!.... .............Address .................................................................................... Name of Architect ...... ................... .... . .Address Numberof Roo ..................................................................Foundation Q........:.:.........,.........:....... 9 Exterior .... ... .... ..........................................Roofing ] ........ .. ................. Floors ....................Interior ...... .. ... .. ......... Heating ...�"------�...,�.�.......... ....... ........................Plumbing ...... ................................. Fireplace ...:. ...... ...................................Approximate Cost o.z.. .. Definitive Plan Approved by Pla g Board ---------_______-----------19 Diagram of Lot,and Building with Dimensions f SUBJECT TO APPROVAL OF BOARD OF HEALTH CA14, 1 f^p U x "J Qb O "all w a®Ld to j 0" to Y r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable arding the above construction. Name .......................7...... ...��. ......,I.... ...................... _ SMQLL` }LA14 E. ^ No, .- Permit for 000'. ............... ' ` .......................... - 66P . Location ..... .......................... / Centerville _,—.-_--',..,'="=`==^-----------. � . Owner 'JQLan,E�_Sm.aII.................................... � � Type of Construction ����y� —. --------,. � | > -----^—'--^---'~--------'----'' Plot -----..—.—. Loi .—�9-------. � | . | � | ' v' 2�� 7� Permit Granted �q2������-------]g � Date of Inspection .................... . —lV ^ ' � /* / ' | � | � PERMIT REFUSED / | ` � _____.._----...---------.. lA ^ / ..---.---.—.----.-----....-----. � | ' � ^—_---_...---.----..~..~..—..---.— � .-----.--.----^~'^'----^—~—'---'` ~ � ^ .-------~.—.~...----..—..-.—....— / __-------------. lg [Approved _______._________~,,,___..__,_ . . -----------------_—.—.—........ ^ ) ` ^ . . 8 ' .