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Home My WebLink About0031 CEDAR POINT CIRCLE �ni ' j�� d j� , „Y y,- •rtC'YrKlrrt u +lt';3St: 4 1.s,{,1 .�d7• hi. �. r.� 4`,. .. " � r �� ?: r.. +.^;•+K r." .'ft'_i!A% r -,.:•�tr'�#YC. M .i t,-.'r:ti "`5'.� ..-s;+{Na[r rn_t.:l'f�47.7! .. ,.a,.,�� +d.�� k $ _3.t _ F��}��.I y� .jl[kFT�"�r �{.-kti��{�4��,y�[s 4r •' �• � �I��1f�d� S§ir tl! '�3 .. ° � AA e..t,�Kx�t.,. ta��a 1 t '•. ,. R { p { �'��!`��t_,.�1•�s�� i'��n 1 E.��l�lt�r°►^it��ri� �F��R�- r�'� � M �0 ° a e r ° a . n' p I a l ° 4a o � I ° I T , � U f a C=-DAIR POINT C �RC�.fe Lly" 3 i L 7% OF II RICHARD BAXTER r4o.24048 r , lilt a Ta C A✓rAFq tr 14 Z. Wit'4, TZ-/,AT 7-,A� S,�/4Wit/yE.eEO.C/COtil dL YS W/22V SCA L G— / �®f Z .A TE 2- 7'"/,i.1-- S14OZ7X A,4/Z:;'SETBA Cl--::: ,�Eglii.2E�-lE�vrS o� T,Z/,, 7ow�VDF AIvv A_T /t/v 1 L crr J_ ,Cac.4 TEv W/Ty/,/ TyE Ti�11S ocX,41t//S A4517- 6ASE"O 0,�,45-ETS Syo1,�/y S,Sbtit� yoT' 8� /lO. �.� /C,�/7" -,I GU p�f.�,j � : ;,�i,• C:; N L-ERT V/E1k,--Z- de 00 114 )S` WP p Foul Prr �y�pos - - -Z8CM - >. 01 20 41 ' .. s � b or h � ICU Town of Barnstable *Permit l Expires 6 r nt i r m issue Regulatory Services Fee HA MABIA 9�MASS. b3 Richard V.Scali,Director �,� Mld Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY C Not Valid without Red X-Press Imprint Map/parcel Number p - ire Properly Address �jF1_�'L.I, 6 (:(.�, U/Residential Value of Work$�8_5 a 0T7 Minimum fee of$35.00 for work under$6000,00 Owner's Name&Address LIM Contractor's Name Telephone Number Lj U�' y' � — l l 0 Home Improvement Contractor License#(if applicable) PS Email- Construction Supervisor's License#(if applicable) Wworkman's Compensation Insurance Check one: ks - ❑ I am a sole proprietor Vam the Homeowner 4V 1 I have Worker's Compensation Insurance '0I ! 26 Insurance Company Name kirf 0 f 8Aqa ',II n G t� l Workman's Comp.Policy# � `f-S too (,� . 16 L'P(�. Copy of Insurance Compliance Certificate must accompany each permit. .Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ -roof(hurricane nailed)(not stripping. Going over existing layers of roof) [VRe-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red and inspections required. Separate Electrical&Fire Permits required. *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. copy of the Ho provement Contractors License&Construction Supervisors License is r quired. SIGNATURE: 0 C:\Users\Decollik\AppData\L,ocalWicrosoft\Windows\Temporary Internet Files\Content.0ut1ook\2PIOIDHR\EXPRESS.doe Revised 040215 The Corriigiarrivealth n,f A#assachuseets i Peppr waq o,f industrial Aicidepts ©.,fie of ITl'Vk'Stigafrgnl � 600 Washington Street Barton,MA 02111 . fvrtrw.rtias�govldia Workers' Compensation liiiurince.Affidavit Bmlders/Contractors/EEIecttici;insfPlumbegs Applicant Informatilon , . I . ., Please Print Le6bty Address: City/StateJZip �Q�(U[�f(i, 1�� l'�5�� Phone# Gb . d Are you an employer?Chec appro_prrate Doi: I T}je of protect(r�ymred): i I am a employer with 4 I am a general contractor and I etoploy-ees(full and/or past-tom)_• have hired the sub-ontractois d ery cons uctxo 2_E I am a sole proprietor of partner listed on'the attached sheet. 7. [ emodehng and h ave These. . .utr or ah�'e 8. 2e—o�h tion w . andhavew6d6ers' yc c - - - 9. ❑Bnildmg asldehOi [No arkers'cosrip erestzauce comF- nsivaucc l d:i 5 IVe are a.corporation aver its t -�I cal repaus or a—Ow . 3 Q I am a homeowner doing all work officers have exercised their. l t�❑Pi�beng repates or addition. myse1£ oworkers comp txg pfexemp onpe lVLGL 12_DRoof [N ..regatta: +n races f"� - -c 152 §1(4),addwehaveQo - - - __ 13c❑Other . . . employees [No workers .. , comp: nslmaneuiied '"I, agpti a�that clhetks has RI»s3 alro fill ant see�rni below sl°omag t$s nro¢iceis'caaspeaiset%aa gohcp infnn oti Aoaieoivaeas*]!b sabmif["kis affidat rt i cstntg ih .sae . ia4 aIl war$aad t$en Ira.ant a caarrscFuas nin5t sn$nut a nsiv s�dasit indicatieU finch ii rGoatiactaas ffi#chEck this bra must attaaa an additine�I sheets$ the name of d2e vkb-emrtraconis�d statewls.th P not thane eii rt hice emg_Men.,If the suite contraefges hsee pIn�s,!�?y raise pior�de thfir aAws'comp:,policy nu mmbir. I filn rita etnpinyer tDtafis prop g workers'con pensrition insarmice for riy en3Ptiryee� BeIots is.tepAy and jnb sale .".1 ormatioii. Insurance Company Nam: Polite or Self ins.I ac.# �L Y ()c�- �} �1 u2 .�.t uahon I1ate - . . . 7. - t�. . . _. Job Site Address= 3 l: c� f�(l1 l rC� : . City/scat ziP Attach a CDpy of the work ers'tompensatron policy declaration page(showing the policy number and a prrat on date). . Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of cruninal penalties of a fine up to$1,56U_00 and/or one year itrdpiisoent,as well as civil penalties ifle fozm of a STOP WORK ORDER and a fine of up to S256.00 a day agsinst the vrol�ttar. Be advised that a copy of this.statement maybe forwarded to the O&ce.of Investigations of the DIA for insurance coverage verification. it that the in orenatipn prm�rde-d a- T o In and correct I�a hereby cet7i an the pains a penalties of pert ry f Sitntatiire: _Bate.- ,. `17..- . Phone,4: D;,jicidt arse o1ily Dv Iw* f ivrite to this area.to be cviripleted by city or mpn gffl gat City or Town: . . . . .- . . . Permit/Lice-we A .;. Issuing Anthalgty(circle ore): 1 Board of Health-3.Bmltting Ihepa rtmeat 3.City/Tgwn Clerk 4.Electrical Inspector .Plumbing&n senor 6.Other Contact Persow. : Aone _ ..,. _-.-:_ 6 x s a ys�� 1.0 t �. NA 6AAie 46» Town o Barnstable Regulatory Services Richard V.Scall,Director Building Division' . Thomas Perry,CEO Building Commissioner 200 Main Street, Hyannis,MA 02601 invw.town.barnstable.ma.us ` Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder r as Owner of the subject property, hereby authoc7ze c ; to act on my behalf, in all matters relative to work authorized b thisbuilding by ulldin g permit application for: (Address of Job) /ggnaturc of Date Rdnt Name I1'Property Owner fs applying for pe reverse side. rmit,please corliplete the Homeowners License Exemption Form on the C•lUs'`sOeroU&L4ppDatalt,ocaM9icrosoft11y;11d01451Temporary lntemet FileslContent.OuAookl2Plpl ' Revised O�14215 bliRl�XPR):SS.doc , Office ofCosumerAffairs&Business Regulatione License or registration b valid for individual use only — HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 151882 i Type: Office of Consumer Affairs and Business Regulation _ 10 Park Plaza-Suite 5170 y Expiration :71:1 3%2018 Private:CorpoFation SCOTT E CROSBY BU[LDER IN.0 Boston,MA 02116 SCOTT CROSBY 1112 MAIN ST UNIT#7 OSTEP,VILLE,MA 02655 Undersecretary Not valid without signature • a i E Massachusetts Department of Public Safety 19 Board of Building Regulations and Standards License: CS-043556 Construction Supervisor SCOTT E CROSBY 62 CROSBY CIR , ;r OSTERVILLE MA 0265,5. Expiration: Commissioner 12/13/2018 ACORL® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/°DYYYY) 11/16/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO;RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Germani Insurance Agency PHCC o Ext (508)428-9194 A/c No: (508)428-3068 908 Main Street AB DRESS: certs@germaniinsurance.com INSURERS AFFORDING COVERAGE NAIC# Osterville MA 02655 INSURER A: SAFETY INS CO INSURED INSURER B: Hartford - Scott E.Crosby Builder,Inc. INSURER C: 1112 Main St.Unit 7 INSURER D: Osterville,MA 02655 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE.BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE;AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLISUBRI TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDY EFF MM DDPOLICY EXP LTR LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE I^I OCCUR PREM SES(E.occurMIE TO rence) $ MED EXP(Any one person) $ A BMA0022636 10/12/2017 10/12/2018 PERSONAL a ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - GENERAL AGGREGATE $ 2,000,000 POLICY 0 PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000.000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED AUTOS ONLY AUTOS 3953278 09/07/2017 09/07/2018 BODILY INJURY(Per accident) $ X HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ A EXCESS LIAB HCLAIMS-MADE CM00001805 10/12/2017 10/12/2018 AGGREGATE! $ 2,000,000 DIED I I RETENTION$ $ WORKERS COMPENSATION X I STATUTE ERH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 B OFFICERIMEMBER EXCLUDED? N/ N/A 6S60UB4727P23817 06/23/2017 06/23/2018 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) i Workers Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance).The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION ! SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Scott E.Crosby Builder,Inc. 1112 Main St.Unit 7 AUTHORIZED REPRESENTATIVE Osterville,MA 02655 Fax: Email: ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks Of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ` Map Parcel // �- �D'�' Permit# Health Divisions �/ Date Issued h� �- Conservation Division � I Fee 3 7, Tax Collector �C��o%y SEPTIC SYSTEM M a �� / INSTALLED IN COMPLIAI'6C1 Treasurer o2' WITH TITLE 5 f ENVIR®NNiEIdTAL CODE AND Planning Dept. TOWN REGULATIONS Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis ry Project Street Address A-� PUiAfr G C f Village Q&✓/VWJ LAA-C 7.5-2 5 -M 119 Owner 7DAAW 1,C�.' AA-C^-rW 4"� � 'VA VAddress N-fA 5*A,42S E 144, -. OLb Y Telephone `0-7, (off 7 5 Permit Request ENV X cS7��/b /M'Jk y /&M 1/1 Q�`h�f /'-cy" ins &0-46 C V4_(� Ar' /,;AA Slf �.�. Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type UAW P Lot Size Grandfathered: ❑Yes ❑No. If yes,attach supporting documentation. Dwelling Type: Single Family M-' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes 3_Iq On Old King's Highway: ❑Yes ❑No Basement Type: OFull ❑Crawl O'Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 2 new Half:existing new Number of Bedrooms: existing 3 new 0 . Total Room Count(not including baths): existing 6 new First Floor Room Count 7 ' Fyn Heat Type and Fuel: ❑Gas fil Oil - ❑Electric ❑Other Central Air: ❑Yes KNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ,Eff!No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage: existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 1$6 No If yes,site plan review# Current Used Proposed Use S D 1 BUILDER INFORMATION Name ✓t-A KF K i� SfOrd rr Telephone Number 36 2-' 7 Address /;7-�. �dX ,b License'# Z�Z� Home Improvement Contractor# Worker's Compensation# UJ GV ZUO-Q �3b ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY " PERMIT NO. DATE ISSUED r MAP/PARCEL NO. , ADDRESS VILLAGE ' OWNER DATE OF INSPECTION - ! 3 1 FOUNDATION + FRAME - $ INSULATION v FIREPLACE• � .:.. t...-� ,- y. ,` _ 4 `y , ... f r- 4 ELECTRICAL: ROUGH FINAL': PLUMBING: ROUGH" FINAL GAS: ROUGH'S `' `-- FINAL FINAL BUILDING _ y 1p DATE CLOSED'OUT ASSOCIATION-PLAN NO. --- -_ - The Commonwealth of Massachusetts �_: Department of Industrial Accidents Olfice 01/nsestigations i� _� _ '�' 600-Washington Street ''� J Boston Mass. 02111 Workers' Compensation insuranceAffidavit ��TI1�Ftar��iiaii�a i o��/��;�iiiar ,,,,,,, „ e�[nEf✓��",,... name: location: city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole pro rietor and have no one working in any capacity ® I am an employer providing workers' compensation for my employees working on this job. comnanv name: Sl QJ QJ I lQZS. JVC ... .. address: n^A . ' �^ F city: �!, .1 ,SN��l�s Li ! phone#: insurance co. CA-VJ pnlicv# LJ C�2-U0 O L(3 ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the follo«zng workers' compensation polices: comnanv name* - address• city: phone#- insurnnce co. olicv# :;:....: ... company name. i address: city phone#� insurance co. olicv# %///%/%%%% Failure to secure coverage as requited under Section 25A of MGL 152 can lead to the imposition of crbninal penalties of a tine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S 100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification 1 do hereby certify the ns d penalties of perjury that the information provided above is true and correct Signature ,J Date Z ` �-SS - Print name 1 K& /((4 1�,O Phone# 6 1-" 7� Y-7 ofncial use only do not write in this area to be completed by city or town official city or town: permit/license# Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other ([evuea 9i95 PJA) e 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 cow 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 recelve c: 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 buildingappurtenant thereto shall not because of such employment be deemed PP �p ym to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewL of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. . XXXXXXI Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the`law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the peiinit/license number which will be used as a reference number. The affidavits may be reduned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents office of levesugauOns 600 Washington Street Boston Ma . 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 k�* .s � :t:Rtf'o � 108zS S►A€ QI�PUR9101t RNSTRBLk-BUILDERS INC�O �tiSfABlE NR Q68 �� :. �'1ze �o,.rmauuea/ o�✓ aaaclu.,etGr E F DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Nu�ber Expires: — Rest cteQ TQ:1 11 MICHAEt L KINGST0N = M' 41101"loW 11 POPPLE BOTTOM RD SANDWICH, NA 02563 The Town of Barnstable BAMMANZ : 9 �m Department of Health Safety and Environmental Services Eon'' Building Division 367 Main Street,Hyannis MA 02601 , Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building'Commissioner 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: 0 5A-1a- Estimated Cost Address of Work: UQ 41t. !f O I YT CA VLCA- Q&)TWA Z tkll�-- Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law E]Job Under S1,000 Building not owner-occupied [30wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR Date Owner's Name t . q:fb ms:Affidav V2o, ;,5L 6�Qµ S!77 i 9' �,ILI 4/',AX'j 7: C64 .......... 7 Le�U4'.I- Afl, t! OVA 0 iA :jt64A4DV ........... fl I 06"A [T At6 SHE �A 17- r------ 77-I f %61 ZA�AY "M-444 161) F7 H—J.- lsol r. usry yv L"O 44-b- A.LAA i 1 LAI. I I I I I I. i '_ I I ) I I I .I I 1'FTI' W4- A& 31" IT_J 77- O 30 two hit. SHEET NO. �J�OF . I ^ATE i _SCALE 77-1 I , I I �-- I I J i I — r -- - i 1 - I 1 s UAj STpl2 V,41L7W 7-0 UP rx W I,� Coo�A'G�. Cuti�� S✓yj _ 1�9 ...._-..: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ?` Parcel A 31 �d Permit# yF'�)1111TABLER tIi � Health Dvisiorla r eDate Issued I - 9 -D Conservation Division fLOZ 05 & 0--Ai�%M24 PM (: 08 Application Fee . Tax Collector Permit Fee 7. Treasurer ��--- I Z (.2 'D Z ��„ 111=1 u f 0 Fre SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENMRONMENTAL CODE ARSE Historic-OKH N Preservation/Hyannis /J TOW4 REODUTIONS Project Street Address QFJ4 P O W f_ � (:�f.�CJL Village @(�� Z I 1NklkC� �4 �`? — Owner PA �' address ?I Telephone _7 5 0 1 Permit Request A�o L—LS,i� E i s j Ai rb 10 UW �,_MkJQ_ 4190", -n, xa-2 E x 3 X `I'" Square feet: 1 st floor: existing proposed 3`ll? 2nd floor: existing proposed Total new Z ning District Flood Plain Groundwater Overlay roject Valuation Construction Type W(3s�0 R�E_ Lot Size .2 �-C S Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family L�t' Two Family ❑ Multi-Family(#units) Age of Existing Structure �7 + ` Af Historic House: ❑Yes o On Old King's Highway: ❑Yes 21N0 Basement Type: mull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 2— new Half:existing new Number of Bedrooms: existing 3 new -�r- Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: 0 es ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes o Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size A_�Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes If yes,site plan review# Current Use S Uq�UR- -Aq441 L/4 Proposed Use NJ CAN—,m BUILDER INFORMATION Name I �!v 5"; Telephone Number Sb% , 3 6 2 1 �q 7 Address Q W�S`i �AIWS -A�ut 6U I w0 S License# 1023 2 Z 1 ,,Ar 6 A- Home Improvement Contractor# A Z0 `YS QU G�, Worker's Compensation# U ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ON , S cric_ OJOSl A SIGNATURE A DATE FOR OFFICIAL USE ONLY PERMIT-NO. - DATE•ISSUED MAP/PARCEL-NO. ADDRESS- - VILLAGE - OWNER DATE OF•INSPECIFION: , FOUNDATION x Z- o F FRAME L _ , ..- 1 INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r - PLUMBING: ROUGH FINAL!` ' GAS: ROUGH` FINAL , FINAL BUILDING DATE CLOSED OUT - ASSOCIATION PLAN NO.17. .` t f so t� QZ POINT lie t `7O fjLr t� n P�o�os&o of .� SA I _ (V �, 5 a� II LO6.4T/O,,C/ CE'n �,"1.0/<t AT lie i / E Y T/-IAT T,4/ I`vuNvn Tia�1 ,� I W/V 170Ele'501116 11-1OL YS W/22V T./,/�,S-ioE,C/,vim ANO SE'TBA Gk .�E'QUi.2E�-lE�c/TS of T�/6 �"otti�t/aF 4=l -AA1 ,2E, E.0 E•UG'E- � a cA Wiry/1t/ ;EAXT.E.2E NYE /it/C. T///S O,C,.4.�//S .t/oT_BASEO av Ate!/ ,2E'G/STE.2E0 ,L��l� SU.2Y�Ya�� /it/ST,2U�/E.t/T,5'U,2j/E}�f' T.him USTE,2ti/,C,L�'� MASS. 0•�.�5'E'T,S Syot�/�f!Shbv�� .t/aT B� � U.SE� T� r t �°FZHE T� Town of Barnstable Regulatory Services * sexr►sTnstE, ' Thomas F.Geiler,Director asnss. 163; �°� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW + SUPPLEMENT TO PERMIYAPPLICATION + MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: 4/) rTl�� t 0 Estimated.Cost 5 V o O Address of Work: ` J Owner's Name: . UAi\)1'J F_ Date of Application: I hereby certify that: Registration is not required for the following reason(s): t MWork 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 p as the a ent of the owner: Date Contractor Name Registration No. OR Date Owner's Name ` Q:fomis:homeaffiday. ' lj -1 �k {oamxmoncueald/e a�,/ aaaac/ivaekd BOARD OF BU:IL-DING REGULATIONS LicenseSTRUCTION SUPERVISOR - �� - Number 023212 • � 04 Tr.no: 20267 d R6 `reed i MICHAEL L KIN 9 GREAT HILL RDA SANDWICH, MA 02563 _ Administrator 7/. P IBoard of Building Regulations and Standards HOME tUPORO.-�VE-M',ENT CONTRACTOR � Re ,s�tr 0878 04 j MR r rt te Corporation WEST BARNSTA I, WCHAEL KINGS- 1170 RT.6A/P0 BOA • 5 D`�t� WEST BARNSTABLE,MA 02668 Administrator 1 I `ppiHE►p�� The Town of Barnstable BARNnAB�E. _ Department of Health Safety and Environmental Services v q_% m i639' �0 p�EO Mp+p Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: J-O4N,ro- /�e- Map/Parcel: �-a��//3 Project Address:31 CLOW2PQ Ili T CI/F. Cr-,A'Mrz- Builder: —e y The following items were noted on reviewing: ` n rii O s-&- ��-r�21 J45�GLOW2 '�10 kc. T - /%Y-rZ-T"a4 We)V A- 1/LrT4 I-X�s i/�/�. �aa �/�/D t7D /Y/��"�. 1p-.y 7— Reviewed by: Date: ©- 9S :buildin :forms:review Client#: 12900 2WBARNBU ACORDTM' CERTIFICATE OF LIABILITY INSURANCE /02°"'""' PR�OUCER, b THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dolling&O' Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 222 West Main St. PO Box 1990 Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Zurich Insurance Company USB West Barnstable Builders, Inc. INSURERB: Associated Employers Insurance Compa P.O. Box 516 INSURER C: West Barnstable, MA 02668-1124 INSURERD: 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 NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE MM/DD/YY DATE MM/DD/YY LIMITS A GENERAL LIABILITY SCP37338572 01/24/02 01/24/03 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence)en $50 000 CLAIMS MADE D OCCUR MED EXP(Any one person) $1 O 000 X PC Ded:250 PERSONAL&ADV INJURY $1 000 000 X OCP GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident)' $ v ALL OWNED AUTOS ..._ .....,,__..a. „,,,. " - ''• .`. ."". •"` ` '""""""'""" -�-BODILY INJURY 4 y _. ' SCHEDULED AUTOS r... .. __.. ,v., _ (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHERTHAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE - AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND WCC5002701012002 06/11/02 06/11/03 WCS T MTAIT E TU- OTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $100,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Operations performed by the named insured subject to policy conditions and exclusions. r � ; CERTIFICATE HOLDER # CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED-BEFORE THE EXPIRATION, •JoAnne McAteer DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR.TO MAIL 'In DAYS WRITTEN 31 Cedar Point Cr - NOTICE TO THE.CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Centerville, MA 02632 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE j ACORD 25(2001/08) 1 of 2 #28647 LG - 0 ACORD CORPORATION 1988 rx i, t{ I MAScheck COMPLIANCE REPORT I I Massachusetts Energy code I Permit MAScheck Software Version 2.01 I I I I Checked by/Date I I I CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 12-24-2002 TITLE: West Barnstable Builders PROJECT INFORMATION: McAteer Residence 31 Cedar Pt Centerville, MA COMPANY INFORMATION: All Cape Insulation & Supply Inc. P.O. Box 645 E. Dennis, MA 02641 (COMPLIANCE:PLIANCE: PASSES_ Required UA = 85 , .A_ Your-Home = 85) Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA CEILINGS 340 38.0 0.0 10 WALLS: Wood Frame, 16" O.C. 375 13.0 0.0 31 GLAZING: Windows or Doors 106 0.330 35 FLOORS: Over Unconditioned Space 340 38.0 0.0 9 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipme emsn selected to heat or cool the building shall be no greater than 12; f the ' n load as specified in Sections 780CMR 1310 and Jj .4 lam// -03 Builder/Designer !/ Date / l! I ` MAScheck INSPECTION•CHECKLIST Massachusetts,Energy'Code MAScheck Software Version 2.01 West Barnstable Builders DATE: 12-24-2002 Bldg. l Dept. l Use I I ' I CEILINGS: [ ] I 1. R-38 I Comments/Location I I WALLS: [ ] I 1. Wood Frame, 16" O.C., R-13 I Comments/Location I I WINDOWS AND GLASS DOORS: ( l I 1. U-value: 0.33 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location I I FLOORS: [ ] I 1. Over Unconditioned Space, R-38 i Comments/Location I I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 283, with no i more than 2.0 cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: [ ] I Required on the warm-in-winter side of all non-vented framed I ceilings, walls, and floors. I I MATERIALS IDENTIFICATION: ( I i Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R-values and glazing U-values must be clearly I marked on the building plans or specifications. I I DUCT INSULATION: [ ] I Ducts shall be insulated per Table J4.4.7.1. I 1 I DU,T CONSTRUCTION: All accessible joints, seams, and connections of supply and return I ductwo.rk located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. I I TEMPERATURE CONTROLS: [ J I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: ( J I Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified I in Sections 780CMR 1310 and J4.4. I ( l I SWIMMING POOLS: I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I [ ] I HVAC PIPING INSULATION: I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in.) : I I PIPE SIZES (in.) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-l" 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 I Low temperature 120-200 0.5 1.0 1.0 1.5 I Steam condensate any 1.0 1.0 1.5 2.0 I COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 I [ J i CIRCULATING HOT WATER SYSTEMS: I Insulate circulating hot water pipes to the following levels (in.) : i I PIPE SIZES (in.) i NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS I HEATED WATER TEMP (F) : RUNOUTS 0-l" I 0-1.25" 1.5-2.0" 2.0+" I 170-180 0.5 I 1.0 1.5 2.0 I 140-160 0.5 1 0.5 1.0 1.5 1 100-130 0.5 I 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only)------------------------- 0 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 v/Alterations/Renovadons $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET Alf NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE 310 square feet x$64/sq.foot= x .0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft. r� >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x .0031= STAND ALONE PERMITS Open Porch x$30.00= (number) L�ck � x$30.00= �� •QL ' De (number) Fireplace/Chimney x$25.00= (number) � Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) f ` " - Permit Fee °7, -4.b pro;cost 116" The Commonwealth of Massachusetts ��- ,Department of Industrial Accidents _ - Office efloyestl98Uans• - 600 Washington Street Boston, Mass. 02111 Workers' Com ensation Insurance Affidavit VIM/ / / location: . ci all work mpsel£ ❑ •I am a homeowner performing c aci ❑ I am a sole =o rietos and have no one Wozldn in Y %//%//%//%/%/%%/��/%%%/%�/%i%%/e%%5%W%%...... goon//this%b%//%%%%/%////%////%/////�l% ensation-for my em oy $ com ,v.•r.:,•. •<+v:n.{{rlr;;{r:;•.,?t} ., y011��,Kll ovidinv worker P, .P4i.:> :{ :,:,.I I g :{:Yi>:;:3!;T'•v:r{ �`•fi%}l '.'•'G+":i�7it J'••'tK+•y:;$v.;{%• S..ti�:'}',};'?an e `r J__- • }am `..... .. r r �•}.1.,.,.<;. ,•.:4Yn•..#:::a}{.......; .... :....n...• }{;,• •:•i::•'•.•i n"'.;•,:}. r4{:;•}... r•:4'r.+4t%?,+,;v} } .t.':r.:• ::::5•f.;:iY:4:{r•v.:..:Ix:X•}:yx.};{•: { v'+'::," r. :. . ....... ....:. ....x....... w... ...•,,• .<. ,., .:.:.��.,rn •.:`•..•:.::...4.. . a}•. •Cfi^:..n.. ..•r:.,::+... y:...}.. ... iT. .} . .v. �:,ar}..:.••:•,.•••..t•• r:•:}'yY ..,Y;.....t•n...x'•?.'•viY .an$ :,k, �a6 ,...,.,n.. ? .. �p......4, {{,..:..v,.• ... ,:, : .. ..4 C:.}+• r .. ..,.: ..,'+•?' }, ,.{v 4:`t: ..}..4. n.T.. f....:. n��•,•.• •:.22� n}. xk: {4...N. .4.:rp $III ?r:4 v:: -t ?:ti:•f :.f•:+, :%n...2•t••.�r :K;+•'t• ,ar .}t•$f'•t { ?!{ sI1.3 t1 ,�!�}•.r^YJ:3:s$:.. :.?; r,a a . . ?; .. :4 r...,,a 4..ni....7:;r:,..4?`.c4•:s..+ ...... -:•:r{..::. t••:.+•n!:•r.r•.vA::.. 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Fyflure to secure eoveraLe su ngedander Section Z5A of MGL 15Z canlaad the imposition of Cxisninalp enelties of a$ne np to 51�'00.00 an or ►AT4y iIii risoiuneat as well as CiYii penalties in the form Of ati n" th K O S r A I Le cation.00 a dap againstma Imtdersfsmd tk�it a' . OM y P entmx be forwarded to the Office of In hL ; copy of this statem . , _. nue_is.�cu-e_ais3-caire� . ndeTthe�ains aredpenalties-of-perjury that-the-information providedab Y I da hereby� Date P �2 707 Signature Pfioae# priat name \"Iv J do not write in this area to be completed by dty ar town oi&dal aMcwuseOnly - (3B-andingDepaztment ' peanitllicense# ❑LicensingBoard City or town: ❑.setectn•_t�s OMC. cantact person: Information and Instructions ir vlassachusetts General Laws chapter�152 section 25 red e as evs an employers erson iv.the serviceeof another underanoy oentract As_quoted from tl�e `law , an employee is rY P . :7n - _. ... _...._. _ ).fh rere, express or ixrrplie oralor an individual, partnership, association, corporation or other legal entity, or any two or more of An employer is defined as 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 .. dwellin house having not more thanthree apartments and who zesides therein;•or the.occupant of the dwelling house of ' gconstruction ,. . another who employs persons to do maintenance, constru ion aexnrtbe deemed to be andwe low house or on grounds or appurtenant thereto'shall not because of such emp yin employer. building MGL chapter 152 section 25 also states that every state o.r canstructocal buildingsing agency shall withhold in the commonwealth for any applicant who has of a license or permitIo operate a business or not produced acceptable evidence'of compliance with the insurance coact for theverage 1perfoArsnance o pubyj li woz until commonwealth•nor any of its political subdivisions shall:enter y acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority : .. r.• %/%%/ %E/%/Wj/'// Applicants ; Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and' ly�g company names, address and phone numbers along with a certificate of insurance as all affidavits may be • PP arbmeut•of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and ' submitted to the Dep date the affidavit. The affidavit Should returned to the city or town that the application far the permit oY license is Industrial Accidents• Should you have any questions regarding the'Ia e'o „if yQu e�,g a uested,not the Deparment of In at'ih number listed below:. b r q ed,to obtaia.a workers' compensation polioy,please calY the Depaitmerit e aie requir =: City or Towns lete and rioted legibly. The Department has provided a space at the bottom o. Please be sure that the affidavit rs comp P ding the applicant. Please to fill out in the event the Office of Investigations has to contact you regarding _ , affidavit for you , ._ .. da may e' ne�—to'. ,r r— bei whichwill beused as a re£ereilce numb'er,�'TTie off nits �'be'r besnie.tofillizi e•PeanrFlhcen'seriu�n :;. _. . ' 'email r FAX unles s other arrangements have been made. -ti ezitb or the Departm „ , Y.,;:,.,• _W..: 7• .. .. � •. d should ouhave an estiona, . • ce of In would like to thank you in advance for you cooperation an The Offs Y •` please do not hesitate to 1.give us'a call. NMI 111G T(.�D ��, tel hone and fax number. ep s�address, + ep .� .,•,. . ., •;.:.•, ,.. ,� .r,. ;..••" •,• - The'Commonwealth Of Massachusetts Department of Industrial Accidents ' '" s 1 atlans t11C . . 600 Washinb on Street Boston,Ma. 02111 , far A: (617) 727-7749 02/01/2003. 12:18 FAX 508 240 1464 The Schrocks C�O1 ' 45 Starlight Lane �. JI�MES C. SCHR®CK, P.E. Eestham, MA 02642 CIVIL & STRUCTURAL ENGINEERING Phone (508) 240-2535 Fax (508) 240-1464 jimr7a jimschrock.com FAX TRANSMISSION 8 PAGES TOTAL 1-28-03 To: Jack Rhynd Barnstable Building Inspector Fax ( 508) 790-6230 From: Jim Schrock Re: McAteer Residence Attached are the structural calculations for the McAteer Residence. Please call me if any further questions arise. Thank you. 02/01/2003 12:18 FAX 508 240 1464 The. Schroci;s 002 (30-7 + t o9'(8. 32 ` - Z� = 1'13 0 F-T LZs Z t 5-1 V rhr4k,- l74,8 + �2G� - 4- Co �lo� 4�-t4 �i �^ f� ES-i�C�hp� �,Ad►�CIC.- sS.J�i` �Q%-JN- �04 1-3 CM..jT*F17— LoA3n, z . 7*7 Q�r 33O(12d)� )CMO.t Z(4$51)) 3(ia.0�� 11 �`--Low 01 ST kl4•J GF..J� � �Ac.� r r 1 ov..�- �2 �?K t Q (30-1 LL * I Clot DL) _- 416 :d: —tZ ANY 'S11r,f60,J T-O-Q-- 1Y1GX K [Jit.4. tJoAAc James C.Schrock, PE °"T 45 Starllght Lane `OOZI vw4iecr Eastham,MA 02642 ph(500)240.253S +" 14i1�T��3L BLS t0 C..� MUT fx(506)240-1484 CUExr ' ! Isahroek®eapeeod.net W�T �{�TJe,)lttiAl3� Cl�1ttD��.T �'� 02.01%2003 12:18 FAX 508 240 1464 The Schrock,s 1jn03 QOOF �O �SF ��r►:- MO ►c. . 10 psF 57 !.5 PsG �5 psF 7,57 17 ti 5s P� i 5 PLF fkp 40 PSc Lt. 6o PsF LL io PSF PL vV 10��7t, i� ZZ6 -I>1.. 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Schrock, PE 45 Stgrllght Lane >Awecr E80thum,MA 02642 ph(508)240.2535 M C-A•'-F-9- Qz S o to Fi..1 C.0 S+wr Tx(N@)240-1464 CUMT Jschnxk®capecoQ.neR WEST- 02i01i2003 12:18 FAX 508 240 1464 The Sr_.hror-.ks 1604 - M a.►,.J ��.'i�E� �C—�4r-� �E S1 G n� P � . � �'asc �P�sC.�i G Lo&),- = Zzr. PLF *Pet.,E.D t 24- P,x 5Ekp Z�50 PcF 'DL 6�) i R 65 W Las > S, '�E2.�/d c� t_F�J� � -- H�o.►s= .��t�..,� �lG> (�� <,Z 8�® xfc` 4- 5 3�4- (1,74 xlo') ZS) DES[afrelOM James C. Schrock, PE 64T! I 45 StarlIgM Lane 10 iAd1ECT ph(5 ) MA 022563452 535 nn &�� ph(508)240.T585 9 y�C. l Dam-3 Cz snEr► tY(508)240-1464 Jschrock®capecod.net 02/01,12003 12:18 FAX 508 240 1464 1` ^ The Schrocks [ J05 ^)o Zriz>i.j6 I.-, Foci-"..>G �OJuj DE )�C59ED E7E.'i'Y.1E '4�� 1� �-tal v.,.,a T:��nL. g James C. Schrock, PE 45 Starlight Lane DRWECT 102642 ph(508) ph(508)240.2535 i ' 1G 1 Ca EJ.,)Cia saw he(506)240-1464 ischruck6capewd.net 02/01/2003 12:18 FAX 508 240 1464 The. Srhror_..ks z 06 �V x�o �c..ww.J '� O Q x `� 5 aS �- , ►'I E f James C. Schrock, PE PAR 45 Sta►Ight Lane PROJECT Eastham,MA02642 h Mc S-T�JLg►O��X,� weer p (sas)xa¢2sas fa(508)240.1464 cum ` Ja�hrOCk®C9p000d.f19t ��+/�� 2.�SC�A.at� 1-acJ1�F�„� l y ' y 1 f 02/01/2003 12:18 FAX 508 240 1464 The Schrocks Z 07 L.►i E• Lo kb o.j As 0 ��. ,rags o� l�.a•., � 14it 4° � I� Lo� L,.E L� o�.J 4q'-A Zs ff 475 P,= A-TT,C- 190 P� Iq' ►OPT = I°9o �,� —Se Lr- tn1T -a!g P� LVL (i S1 555, = �-r4, ir,G �s 431 IS3 Pr LZ5 - o K 1.-74( r/ 4 / .43,1 �7 5 QE c. .�cl a'7�'t;psd �c 3 i. l�-7s A MVE James C. Schrock, PE .� I 455tarllghtLane VNQ)Ec'.T Z Eastham,MA 02642 ph(508)240-2535 1 � f-i ��•t �T tx(508)240.1464 �®cnrocic®cepecod.net �„��„�T plilte,)�i Ate.��5 I 02/01/2003 12:18 FAX 508 240 1404 _ The Schrocks 5z. 14 la' 4 �i A . cc Cas .7. „v 'ak', 4 2"Pg ; •:"a. i 1svlPSoaJ CBS fie,•S�s�a James C. Schrock, PE aTE 45 StAhight lane 7ASIEC7 1�/L 1/� Easthem,MA 02042 ph(500)24fr2535 fx(508)240-1454 GUM )echrockftspesod.net � :ST �®►J?�� "i lE ><7�J 1�Dt^J 5 t AS.s� ,E tQPst` LL w A`' Tlc— _ (?Jo S--tmA.6e� i Lo LkO L ig i p,_,-, 19p P� f ur— ryl 4-31 )33 s m fMx 3�i St 5s5) = 4-�, �bS �- Cz�s 43, f 3 Pr LZS C z1 4 �74.. _- Q 4 ��. z 1291 �40 384 t.�j xtoo)( 11,0 cl o5 t �.43 7$0�� n 3i. i,7s �E.u'�-•SG Descmvraw James C.Schrock, PE OAS +�Caca� PPoc� .y zj 45 Seeirtllght Lan® ao/ � Easth®m,MA 02642 M ('�— ph(S08)240-2535 I Z)E JC. PRET Tx(508)240•1464 cuewr —-- Jachrock®cape+coo.net t - F 4 F ' k k / � a 0 k It �£N s ] , I CC �t It L 1 ,. �f f • f. f g r £ lyfS. Y: 311 CBS 3„ W, 0 2"PBS : z < 0. s hl: MoABU /� 5l ►1 s /�� ' NB �Lsyr w �j Co�yw,.J CAP CBS Cowrr,,� g ASE Gl�wa�1� �J\�PSorJ C�S `o� �►�►SH DESCRIPTION - DATE - James C. Schrock, PE 45 Starlight Lane PROJECT 1��Z�(pZ Eastham,MA 02642 sNEET �- ph(508)240-2535 fx(508)240-1464 "T , 1 jschrockfcapecod.net W E.ST A.t2�S'�48c.E, g�J 1lD�QS I JIB — — — — — — — — — — — — — — — — — — , �z 0 \= la I� W Z =34'=0"-NEW ADDITION r' 4' DIA. CONCRETE FOOTING 11 1V'—DIA SONOTUBE"PIER -----�- I 1' 8" "10�-8 -10 -8'l 1, 34' First Floor & Deck Addition 48" Pier Location Plan OF/Nq McAteer Residence JAMES C. SCHROCK, P.E. 45 Starlight Lane 0 SCHROCK 31 Cedar Point Circle Eastham, MA 02642 STRUCTURAL Centerville, Ma ph (508)240-2535 NO.43113 fx (508) 240-1464 A9o,�9�GIST �Q Sketch S K — 2 jim@jimschrock.com �S�oNA1. 10-29-02 TOWN OFrBARNSTABLE BUILDING PERMIT APPLICATION Map 0 Parcel j 3 60 YI Application # Health Division �O � V�V✓� ! T �� OF �ik�,�I�ST�� Date Issued y � Conservation Division z+` =` `' ` j Application Fee - Planning Dept. Permit Fee �J5'00 Date Definitive Plan Approved by Planning Board - Historic - OKH _ Preservation/ Hyannis Project Street Address 31 C.G,b Aez- Village C.aKPr 5A;,J Owner J© ONME Mc-0. Address P O (3 oy, -7 l t Telephone S® J b Q S`s`b 7 Permit Request 'I)ew c) 01: 1 M-rc1-4.ko VU D 411 m A be Srdwc- r QoLa I NS,.J w G cs IN /Uea itu 6,46AL-La: ��G C (A l�Oc1e�. C7►4AA6,=� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation' V$—M Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family X Two Family ❑ Multi-Family(# units) Age of Existing Structure 3( -1dL Historic House: ❑Yes *o 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: �.13 existing _new Total Room Count (not including baths): existing -7 new First Floor Room Count Heat Type and Fuel: ❑ Gas )(Oil ❑ Electric ❑Other Central Air: ❑Yes '*No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage- existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name W I'a W_ 1"p Telephone Number V&- `?6 0 t 21 Address /aQ Pykg� 5 i License # i��( ► P ��r2 �.�N SGh��e�rs Home Improvement Contractor# /0?7 0) Worker's Compensation # ALL CONSTRUCTION.DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO POSA SIGNATURE DATE ;I 'r FOR OFFICIAL USE ONLY 1 'E APPLICATION# # DATE ISSUED r MAP/PARCEL NO. ;r 'ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME _ INSULATION E FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL-. FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Restoration Services?Inc: Fire, Smoke,Soot,Water Damage&Mold Remediation'Services Cleaning Deodorization Reconstruction , Specializing in Fire Restoration' - All Work Guaranteed Access, Authorization and. Direct=Payment Request Form N I (we) authorize WHALEN' RESTORATION SERVICES to perform work as per estimate at property located at 31 Cedar Point Circle, .Centerville, MA 02632 to repair damage.caused by wager on As owner(s) of this property, I (we) understand' that 1 (we) must authorize•.this'work. I:(we) hereby authorize WHALEN RESTORATION .SERVICES toe,perform -this work and accept responsibility for payment upon completion. (we) authorize and direct my Insurance Company usAA Policy No. 01097494291A , to make payments directly to WHALEN RESTORATION- SERVICES, Insurance Claim Specialists, for doing this work.and.to that extent I'(we) assign the benefits applicable to this loss to WHALEN RESTORATION SERVICES: (we) acknowledge receipt of a copy hereof: s 01 o°I�I6 OWNER DATED • SIGNED 'OWNER WHALEN RE TORATION REP. SIGNED 22 American Way,South Dennis,MA 02660' Phone:(508)760-1911 Fax: (508)760-9995 • 1-800-244-2598 E-Mail:restore@whalemestorations.com Web Page:http://wWw.whatenrestorati6ns.com OFFICE.COPY=WHITE— CUSTOMER CUSTOMER COPY=YELLOW c u The Commonwealth of Massa h sefts " .Department of Indsistrial Acchients Office of Investigations• l Congress Street,Suite,144 - / Boston,MA 02114 2017 www.inassgov/dia Workers' Compensation Insurance Affidavits Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Letibly, Name(Business/OrganizatioW[ndividuai): Whalen Restoration Services - Address: 22 American Way City/State/Zip: South Dennis, mA 02660 Phone#: 508 760 1911 Are you an employer?Check the appropriate box: Type of project(required): 1.F1 I am a employer with 2 5 '4. ❑ 1 am a general contractor and_I 6, rl 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 employees and have workers' working for me in any capacity. 9. (]Building addition comp,insurance:$ [No workers comp:insurance 10.0]Electrical repairs or additions required:] <, y5. [] We are a corporation and its. 3,El I am a homeowner doing all work officers have exercised their 11.❑PIumbing repairs or additions [No workers'comp. myself. right of exemption per MGL 12,❑ goof repairs ' insurance required.]t c. 152,§1(4),and we have no 13•[]Other employees.[No workers' comp.insurance required.] •Any applicant that checks box#1 must also fill out tho section below showing their workers'compensation policy information. a t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. if the sub-eantmetors have employees,they must provide their workers comp.policy number. lam an employer that:is providing workers'compensation insurance for my employees, Beldw is the policy and Job site inforination. Insurance Company Name: nsur'ance Company UB-5B894542-15 4/1/16. Policy#or Self-ins:.Lic. Expiration Dater Job Site Address: -S l G c b Ar Pa%su'�e City/State/Zip: C eN c� 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' iine.upao$1,509 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,agattlst the vtolaCor. Be:advised that a copy of this statement.may be forwarded Co the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerft under the' sins attd enalttes o er u .that the in or►natlon provided above is.true and correct: it ';Sisnatiire. , Official use only. Do not rvYlte its this area,to be completed by city &o or wn off ciar: Cttyor Torn PermitlLicense Issuing Authority(t ircle one) ° 1 Board of Health 2 Building Department 3 `City/Town Clerk 4:Electrical Inspector 5.Plumbing Inspector~ 6.Other - _ Contact Person - < Phone.#: Massachusetts -Department of Public Safety L-J/ee U�e•i�ro�eo�uvealt�a��/ljt{�Jrcc�tc�e�- Board of Building Regulations and Standards Office of Consumer Affairs&Business Regulation Construction SupervisorF(7"� t — ,POME IMPROVEMENT CONTRACTOR License: CS-074928 "Registration: Type: Expiration:_7/30/2'617 Private Corporation WHJAAM WHAL9N `- 122 POND STREKT y Whalen Restoration;Services Inc BREWSTER MX70263 •. � William Whalen 22 American Way Expiration p South Dennis,MA 02660` Commissioner 08110/2016 Undersecretary Unr6stricted-Buildings of any use group which` ' ,I- •.,: Tnv contain less than 35 000 cubic feef(991m3)of i License or registration valid for individul u`se'only" before the expiration date. If found return to: enclosed space. + ,> , to.'! t I Office of Consumer Affairs and Business Regulation f n 10 Park Plaza-Suite 5170 Boston,MA 02116 - Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS Not valid without signature J e Unrestricted-Buildings of any use group which contain less than 35,000 cubic fed(991M )of License or registration valid for individul use only J . r before the expiration date. If found return to: enclosed space. ,, Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 Failure to possess a current edition of the Massachusetts _ State Building Code is cause for revocation of this license. For Day Llcensing information visit: VV'' Mass.Gov/DPS Not valid without signature . . l I _ --13'2"----i._ 1T 6' y .Attic Space r -Bedroom Over garage* . _ ai . 00 Removal of carpeting and lower sheetrock in these areas due to water damage 4. 16'9' , .r ITY Garage Area 31 Cedar Point Circle 24'8" 94 00 K Rooml N 4 CII Removal of garage ceiling and several walls needed in these area due to water damage Scale:V8" = l'0" _ -- miurorl nea-ratut, mnla rRmteur L:ertit 15:31 01/12/16 ET Pq 3-4 ® Client#:245206 WHALENREST P1liORM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIY" THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must be endorsed.if SUBROGATION IS WAIVED,subject to the terns and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s), PRODUCER C HUB International New England ON . CT John Powers , 205 Orleans Road al:NoExl:508-945-7866 AA No: 866.323-0182 AI� North Chatham,MA 02650 ADtGMDRESS: 508 945.0446 INSURERS AFFORDING COVERAGE NAIC N INSURED INBURERA:Arballa Protection Ins Co. Whalen Restoration Services Inc.; wsuRERa: Whalen Services Inc, INSURERC: 22 American Way INSURER D South Dennis,MA D2660 INSURERS: — INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES..LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. R lT TYPE OFiNSURANCE ADDLSUB PO IC EFF PO C�EXP S CY NUMBER D ' POLE _ MM MMMlIfYYYV LIMITS A GENERAL ugeallY 10200,16678 4/01/2015 04/01/201 EAGH occuRRENCE si 000 000 COMMERCIAL GENERAL LIABILITY D 1 T RENTED �RMEe�I§ S Eaoccunence $100,000 CLAIMS-MADE OCCUR MED EXP(An oneperson) s5 000 „ PERSONAL SADVINJURY $1000000 GENERAL AGGREGATE 52 000 000. GF.NI.AGGREGATE LIMIT APPLIES PER: - - "-' •— PRO• PRODUCTS•COMPIOP AGO S POLICY E T LOC 9 q AUTOMOBILE LIABILITY 1020016678 4/0112015 0410i/201 COAIBINEDSINGLELIMIT 1,000,000 a Scldonrf AN OVINEAUTO BODILY INJURY(Per person) $ ALL OVJNEO X SCHEDULED AUTOS AUTOS BODILY INJURY(Per acvdonq S X NIREDAUTOS X AUTOSNON-O ?JED PROPERTY DAMAGE AUTOS JECr en s A UMBRELLLIAD OCCUR 4600055368 - 4/01/2015 04/01/201 EACH OCCURRENCE S1 OOO OOO ' EXCESSCLAIMS•MADES1 O00 000 AGGREGATEDED ION 510000 _ WORKERS COMPENSATION S' AND EMPLOYERS'LIABILITY WC STATU. OTN- ER TORYLIMITS OFFICEFUMEMBEREXCLUUEU7 ECUTIVE� NIA E.L.EACH ACCIDENT $ (Mandatory in NH( If os.doscI"under 4 E.L.DISEASE•EA EMPLOYEE S DESCRIPTION OF OPERATIONS below E.L.DISEASE«POLICY LIMIT s DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Altach ACORD 101,AddiIM-1 Remarks Schedule,If more space is required) Project Address: 31 Cedar Point Circle,Centerville,MA 02632 , CERTIFICATE HOLDER CANCELLATION Jo Anno McAtoor SHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 31 Cedar point Circle THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVEREO IN , ACCORDANCE WITH THE POLICY PROVISIONS. Centerville,MA 02632 AUTHORIZED REPRESENTATIVE m 1908.2010 ACORD CORPORATION,All rights reserved. ACORD 25(2010105) 1 Df 1 The ACORD name and logo are registered marks of ACORD reca��nsa�/M�aan�� . Tenn,) •, . ._.- ..----._..... ........„v„wv� moo,ti n ;> 15:31 01/12/16 ET Pg 4-4 AC R®® CERTIFICATE=OF LIABILITY INSURANCE DATE(MMIODIYYYY) =REPRESENTATIVE 0111212016 CATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANd CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES S CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: It the c11111 c l l; holder is an App1710NA1 INSURED,the poltcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain poIICiDs may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In IIBu of such endorsements, PRODUCER CONTACT HUB INTERNATIONAL NEW ENGLAND I-LC NAM Theresa Cahalane_Norkus PAt,HONE 508 945 0446 FAx IF :MAIL -- - ` 600 LONGWATER DRIVE ADD RESS•_lheresa.Cahalanenork@hubintern_atronal,Com _ NORWELL . -7 - _INSURERIS)AFFORDINO COVERAGE - NAICp MA 02081 INSURED _ INSURER A:.ACE AME_RICAN INSURANCE '0, - � -. •.22667 � WHALEN RESTORATION SERVICES INC IN3uRER0: INSURER C: - _ — 22 AMERICAN WAY INSURER 0:'------------ SOUTH DENNIS INSURER E: MA 02660 INSunER COVERAGES r _ CERTIFICATE NUMBER: 23668 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUR DENAISION M D ABOVEB OR THE POLICY PERIOD INDICATED. NOTWlTHSTANDlNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS,„ EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. /Nan oD 0 R L R TYPE OF INSURANCE MM ICY trP POLICY E COMMERCIAL GENERAL LIABILITY POLICY NUMBER - LIMITS CLAIMS-MADE Q OCCUR, EACH OCCURRENCE g R PR MIS SJEaoeeurrenwlNIA S MEO EXP(Any one person) $ GEN'LAGGREGATE LIMIT APPLIES PER: PERSONAL BADV INJURY $ POLICY JECT LOC ' GENERAL'AGGREGATE OTHER: PRODUCTS-COMPIOP AGG S AUTOMOBILE LIABILITY $ COMBINED SINGLE LIAIIT S ANY AUTO � Eae Ida Il ALL OWNED SCHEDULED BODILY INJURY(Per person) g AUTOS AUTOS HIREDAUTOS NON-OWNED, a - BODILY INJURY(Per accident) $ -- AUTOS PROPERTY DAMAGE Jr Per aoddeni $ UMBRELLALIAe S _ OCCUR - EXCESS LIAb L CLAIMS-MADE N/A '` EACH OCCURRENCE.• g M1 OED RETENTIONS AGGREGATE $ WORKERS COMPENSATION a $ AND EMPLOYERS'LIABILITY X PER 07H• ANYPROPRIETORIpARTNER/EXECUTIVE YIN - a STATUTE E A (MandatoOFFICERIry In NH) NIA NIA NIA 6S62UB5B89454216 EL EACH ACCIDENT 1MandatorytnNH} 04/01/2016 04/01/2616 S 1,000000 Uyea, IPTION under s. E.L.DISEASE-EA EMPLOYE S 1,000,000 DESCRIPTION OF OPERATIONS below ° - � �' E.L.DM....-POLICYUMR.' S 1,000,000 NIA DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(ACORD 101;Addlllonal RemarkrSchedut0.may bo attached If more space is required)' r' Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization Is given to pay claims for benefits to employees in states other than Massachusetts tf the insured hues,or has hired!hose employees outside of Massachusetts: This certificate of insurance shows the policy in force on the date that lhls cerlificale was Issued(unless the expiration date on the above policy precedes the issue date of this certificate of Insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at WvAv.mass.gov/hvdtworkers•compensallon/inv6stigationst. CERTIFICATE HOLDER r ` CANCELLATION` SHOULD ANY OF THE A80VE DESCRIBED POL < THE EXPIRATION DATE THEREOF, NOTICE I WILL BE CDEL�VEREOORN .IO Annt? McAteer ACCORDANCE WITH THE POLICY PROVISIONS, , 31 Cedar Polnl Circle AUTHORIZEO REPRESENTATIVE CenlervUle ' CLy% MA' 02632 Dante)M,Cro!r By,CPCU,Vice President—Residual Market—WCRIBMA ACORD 25(201001) ©1988-2014 ACORD CORPORATION, All rights reserved. The ACORD name and logo are registered marks of ACORD 13'2° � w � i Attic.Space Bedroom Over garage q s 'gY, __.._,. _-_Yw 8Y Removal of carpeting and lower sheetrock in these areas due to water damage Bedroom 3 ti 16Y 9 1T 5„ r? 00 Y Garage Area 31 Cedar Point Circle TOWN OF BAIMSTABL 24'8 'im 9: P ! Y Rooml: ,, N r I Removal of garage ceiling and several walls needed' in these�area due to water damage ' t Scale:1/8" = 1'0" TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map o1 � L� Parcel 00 '"�� Application # Health Division (7,336 9 Date Issued �./�� uV✓'J AV— Conservation Division Application Fee Planning Dept. �`'� � � � Permit Fee I Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis (T�0 IGIMA�L Project Street Address 3 C6"DAi2 Pot s4—f , C- i� + Village C i NT%XX V,l Owner .�o A IWN Address PO 6 0°J• 7 a , C G-NTz►2u c 'ar Telephone 5 0&- 3 60 Yi9-6, Permit Request 1-0 MC-70(,Acl� Sete-TaLOC4< c+ AAS Auj ravSvL, T-,4" r G- &AKAeC AuA Q044&".wA AC uc g r,.4e, 6A*eatom, AI( owr,5rtjcnn— tvo Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 8 66 Construction Type o�tSe Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure -3 rL Historic House: ❑Yes LANo On Old King's Highway: ❑Yes XNo Basement Type: 11 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: �J existing _new Total Room Count (not including baths): existing --new First Floor Room Count Heat Type and Fuel: ❑ Gas YLOil ❑ Electric ❑ Other Central Air: WYes ❑ No . Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: 0 existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use /0 /® Proposed Use APPLICANT INFORMATION - (BUILDER OR HOMEOWNER) Name (JJ►0`A►P_t kjgcb&5 Telephone Number 1 -7 It Address t l a, Pcy-4 5C Z yrujs—r 1 License # C, - 6 7 S/5! �► �" _ U=i'kA LC5 N CZEs��o vy s��v+c.c�� Home Improvement Contractor# 1019 d 1V V Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIIGNATURE t_hn-li U3 DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. I, ADDRESS VILLAGE OWNER DATE OF INSPECTION: -- r �µ INSULATIONgG*10,`C,a,rtT,y FIREPLACE I' ELECTRICAL: ROUGH FINAL - J I is PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING: '+ DATE CLOSED OUT E ASSOCIATION PLAN NO. y' 1 tl 0 The Commonwealth of Massachusetts Deparhtent of Industrial Accidents Officeof Investigations l Congress Street,Suite,]DO Boston,MA 021142017 www mas&gov/dia. Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/]Plumbers Applicant Information ]Please Print Legibly Name(Business/Organization/Individuai): Whalen Restoration` Services, Address: 22 American Way City/State/Zip: South Dennis, mA 02660 Phone#: 508 760 1911- Are you an employer?Check the appropriate box; Type of project(required):, 1.® I am a employer with 2 5 4. Q I am a general contractor and I b Q New construction employees(full and/or part-time).* - have hired the sub-contractors t, listed on the attached sheet. 7.,Q'Remodeling 2.0 I am a:sole,proprietor or partner- These sub-contractors have ship and have no employees 8.' [)Demolition working for me in any capacity. employees and have workers' 9. Q Building addition [No workers'comp.insurance comp,insurance t 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its ❑ 3 Q-I am a homeowner doing all work officers have exercised their I1.Q Plumbing repairs or additions myself.[No workers'comp., right of exemption per MGL 12.E] Roof repairs insurance required-]t c. 152,§1(4),and we have no ' employees.[No workers' 13.Q Other comp.insurance required.] *Any applicant that checks box#1 must also'fill out tho section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such, 3Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name. Ace American Insurance Co any Policy#or Self-ins.Lic.#_ UB-5B894542-15 Expiration Date: 4/1/16 c L b f3 2, �f r(1l— C' t o City/State/Zip: C C Job Site Address: - 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 nment,:as well as civil.penalties in the-form.of.4 STOP WORK ORDER and a fine fine up to$1;SOp.00 and/or one year unpriso of up to$256;6O.a day against°the violator. Be:advised that a copy of this staberneat.may be forwarded to the Office of nvestigahons:oflhe DIA for insurance coverage venfication I do hereb cert�fv nde`r the gins dnd enaltles o er ie that fire in ormd, n provided above is,true and correct _ Sit?nature. hone.r ®� ?.: O Official use only Do not fvpite in'this area,to be cottipleted by city`or town ojficiad City br ToSt • � Permit/License# issuing Autlianty(circle one) A .Board of Iealth.;2 Building Department 3 City/Town Clerk 4:Electrical Inspector 5,Plumbing Ynspecttir b�Other _ Confact Pelson Phone#' ��® DATE(MMIDDIYYYY) A CC) CERTIFICATE OF LIABILITY INSURANCE 01/12/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements). PRODUCER CONTACT NAME: Theresa Cahalane-Norkus HUB INTERNATIONAL NEW ENGLAND LLC PHONE ; 508945-0446 FA(.INo): ADDRESS; theresa.cahalanenork@hubintemational.com 600 LONGWATER DRIVE INSURERS AFFORDING COVERAGE NAIC A NORWELL MA 02061 INSURER A: ACE AMERICAN INSURANCE CO 22667 INSURED INSURER B: WHALEN RESTORATION SERVICES INC INSURERC: INSURER D: 22 AMERICAN WAY INSURER E: SOUTH DENNIS MA 02660 INSURERF: COVERAGES CERTIFICATE NUMBER: 23615 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENT CLAIMS-MADE MOCCUR PREMISES iEa occu cote $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JEC PROT ❑LOC PRODUCTS-COMP/OP AGG $ OTHER: A COMBINED SINGLE LIMIT AUTOMOBILE LIABILITYaccident) $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTYDAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ tXED CESS LIAR HCLAIMS-MADE N/A AGGREGATE $ RETENTION$ $ PER WORKERS COMPENSATION X STATUTE I I ERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBEREXCLUDED? I NIA1 NIA NIA 6S62UB5B89454215 04/01/2015 04/01/2016 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS , ,,�, _"., �;._,,, E:L DISEASE-POLIGY,LIMIT: $HK1,00.0;000,_ tielow' N/A DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensationrinvestigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Jo Anne McAteer ACCORDANCE WITH THE POLICY PROVISIONS. 31 Cedar Point Circle AUTHORIZED REPRESENTATIVE , Centerville MA 02632 Daniel M.Cr—'�ey,CPCU,Vice President—Residual Market—WCRIBMA I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Client#: 245206 WHALENREST DATE(MM/DO/YYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE TE(MMMON 1112/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMEAC John Powers HUB International New England °N 7 -323-4182-945- 866 /acri tt;508 ac No; 866 265 Orleans Road E-MAIL ADDRESS: North Chatham,MA 02650 INSURER(S)AFFORDING COVERAGE NAIC p 508 945-0446 INSURER A:Arbella Protection Ins Co. INSURED INSURER B: Whalen Restoration Services Inc.; Whalen Services Inc. INSURER c INSURER D: 22 American Way INSURER E South Dennis, MA 02660 INSURER F COVERAGES _r � CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE NSR WVD .POLICY NUMBER MM/LDIDY MMIDDY� LIMITS A GENERAL LIABILITY 1020016678 4/01/2015 04/01/2016 EACH OCCURRENCE $1000 000 COMMERCIAL GENERAL LIABILITY PREMISES Ea occur ence $100 000 CLAIMS-MADE DOCCUR \ MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1,000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 'POLICY PRO-JECT LOC $ A AUTOMOBILE LIABILITY 1020016678 4/01/2015 04/01/201 EaaacidenISINGLELIMIT 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY TnDAMAGE $ AUTOS $ A UMBRELLA LIAB OCCUR 4600055369 4/01/2015 04/01/2016 EACH OCCURRENCE $1 000 000 hDXECE ESS LIAB HCLAIMS-MADE AGGREGATE $1 000,000 I X RETENTION$10000 $ WORKERS COMPENSATION TO Y I IMITTU- OERT AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,ddis66be under ,-.- `.: DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Project Address: 31 Cedar Point Circle,Centerville, MA 02632 CERTIFICATE HOLDER CANCELLATION Jo Anne McAteer SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 31 Cedar Point Circle ACCORDANCE WITH THE POLICY PROVISIONS, Centerville,MA 02632 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05). 1 of 1 The ACORD name and logo are registered marks of ACORD ,!lC153ndZ91M1 RRn199 Trnm Restoration Services Inc. Fire, Smoke,Soot,Water Damage&Mold Remediation Services Cleaning Deodorization Reconstruction Specializing in Fire Restoration - All Work,Guaranteed Access, Authorization and Direct Payment Request Form I (we) authorize WHALEN RESTORATION SERVICES.to perform work as per estimate at property located at 31 Cedar Point Circle, Centerville, MA ,02632 —r- to repair damage caused by water on, 1t9/-16 As owner(s) of this property, I (we) understand that I (we) must authorize this work. 1 (we) hereby authorize WHALEN RESTORATION SERVICES to perform this work and accept responsibility for payment upon completion. I (we) authorize and direct my Insurance Company uSAA Policy No. 01097494291A , to make payments directly 'to WHALEN RESTORATION SERVICES, Insurance Claim Specialists, for doing this work and to that extent I (we) assign the benefits applicable to this loss to WHALEN RESTORATION SERVICES. (we) acknowledge receipt of a copy hereof: of�OgIIb OWNER DATED SIGNED 036; fot1 OWNER WHALEN RE TORATION REP. SIGNED 22 American Way, South Dennis',MA 02660 Phone: (508)760-1911 Fax: (508)760-9995 • 1-800-244-2598 •E-Mail:restore@whalenrestorations.com whalenrestorations.com Web Page: http://www.whalenrestorations.com OFFICE COPY=WHITE CUSTOMER COPY=YELLOW 1, Massachusetts -Department of Public Safety ( n �✓! ��/C 1([�%IklILOICfCiCCF�C�O� �CCfi:itLC�[ISC�J' Board of Sullding`Regvlations and Standards _ Office of Consumer Affairs&Business Regulation Construction Supervisor ' S 40ME IMPROVEMENT=NTRACTOR License:CS474928 �e-: Registration 129244 Type: Expiration 7/30/2017 Private Corporatio+ 122 POND STREET '? t Whalen Restoratio'Se Inc BREWSTER MA70263 - r William Whalen 22 American Way �. a A, 1 Expiration., SoutFf Dennis,MA 02660 — Commissioner 0811012016, -Undersecretary. UnrLsstricted-Buildings of any use group w}uch contain less than 35,000 cubic'feet(99Iin3)of, :� License or registration valid for individul'use only before the expiration date. If found return to }Y>' enclosed space. F• Uftice of Consumer Affairs and Business Regulation =v. 10 Park Plaza-Suite 5170 Boston,MA 02116 A..,1'- - r r Failure to possess a current edition of the;Massachusetts �- • `4 '��"� �-" .« } T"`+� °`� �}o.� -cur State Building Code is cause for revocation of this license. «"-'' Not valid without signature For DPS Licensing information visit: www.Mass.Gov/DP5 ' • z XT ts;} �xv r> r Y n.'.C: ff` .i x � ,:ya a,, .c,'A %.'� .. Y�`•Y � 4y�:: _ Unrdstricted-Buildings of any use,group which an contain less th 35,000 cubic feet(991m3)of License or registration valid for individul use only •, x before the expiration date. If found return to: enclosed space.p s} Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Not valid without signature For DP5 ucensinglnformationvisit www-Mass.Gov/DPs, „ l S l l Garage Area 31 Cedar Point Circle � 1+ 24 8" _ 24 i SU t r� I Garage.` Noo N I r,t Rep acement of insulation walls and ceilings (A/r Scale:1/8" = l'0" r' 13'2,,. � - 12.6„ t Attic Spade' Bedroom Over garage 7 1. . 4'7. 3' tairi 3 2" a ' Replacement of lower sheetrock walls,base trim,insulation,carpet and pad in this room above the garage Bedroom 1T 5" Garage Area 31 Cedar Point Circle 24'8" 24 — — -- - 5 Garage 1 Rep acement of insulation walls and ceilings (r IScale:1/8" = 1'0" 13'2" 12,6I, Atric Space ' Bedroom Over garage 1 4 7' Y i• N: 4'8,I , I Replacement of lower sheetrock walls,base trim,insulation,carpet and pad in this room above the garage } Bedroom � k pi 3 y ` 16'9" O� �: Y` V 3� Garage Area 31 Cedar Point Circle �r 24,8„ 24' — ii , it sn i .. -. 00 'Garage N I Rep acement of insulation walls and ceilings In Scale:1/8" = l'0" Amc Space '^ Bedroom Over garage 7'-1' 4,7pfau „ 3, i 0 4'8 00 --8' 10" t C 1 S M 'M Replacement of lower sheetrock walls,base trim,insulation,carpet and pad t in this room above the garage Bedroom E 17�5„ i 1 Garage Area 31 Cedar Point Circle 24'8" 24 - - :SD - Garage N � i i I $ 5 Rep acement of insulation walls and ceilings I Scale:1/8" = 1'0" I 13'2" s Attic Space Bedroom Over garage y 7 1 .. 4' O p :.1 3p s '. h R Replacement of lower sheetrock walls,base trim,insulation,carpet and pad in this room above the garage Bedroom :I Town of Barnstable Building Post'Th�s Card So That it is.Visible From the Street ApprovedPlans'Must be Retained on Job and this.Card Must be Kept + BARP13PA81F w Y„h .v .•, g % Posted Until Final Inspection Has Been Made Permit. WY here a.Certificate,of Occupaari y�Js Required such Building sFiall Not be,Occupled`until F I Ian pect on has been made jjl Permit NO. B-16-629 Applicant Name: MARCANTONIO,THERESA M'&VINCENT P Map/Lot: 171-030 Date Issued: 04/01/2016 Current Use:. Zoning District: RC Permit Type: Addition/Alteration-Residential Expiration Date: 10/01/2016 Contractor Name: Location: 212 BUCKSKIN PATH,CENTERVILLE Est.,Project Cost: $15,000.00 Contractor License: Owner on Record: MARCANTONIO,THERESA M&VINCENT P Permit Fee $ 126.50 Address: 212 BUCKSKIN PATH Fee Paid $ 126.50 CENTERVILLE, MA 02632 'Date:� � 4/1/2016 a . . . Description: convert existing one car garage to family room Xi P " Project Review Req Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced,within six months after issuance. All work authorized by this permit shall conform to the approved applicatiorrandthe approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall begin compliance<with"the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street orroad a`nd shall be maintained open for.public inspection for the entire duration of the work until the completion of the same. - The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed a .Y.L 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection,:- 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation „ . .., 7.Final Inspection before Occupancy 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. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 9228 Parcel )l 3 Oo`1 - Application Health Division Date Issued t 1 Conservation Division Application Fee Planning Dept. Permit Fee ' Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis (/ Project-'Stre"et=Address R51V4 cl f-d-e, cVill71- ag l 1 �-,"� 3 Owner=`- , ?C,t h - S� MC Address 31 U�QLZ= Telephone.,-J- 5-6 T- 290 `"93 2 3 Permit_Request..- _ _ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project-Val_. uatio` (-TD Construction Type i 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 ❑ No 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: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood coal stove:"-^❑Yes';-] No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: -'i c -toning Board of Appeals Authorization ❑ Appeal # Recorded ❑ LD .v Commercial ❑Yes ❑ No If yes, site plan review# rill Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) _ -- - Name �� YVI�1� elephomNumber 91� 3 95 Addre s—` r 0, DX R -t'U ro , AA-' b2lo�6 Home-,lmprovernent--Contractor Worker's Compensation # �� , W O 960 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �+ �j SODS CLt - SIGNATURE DATE ;r FOR OFFICIAL USE ONLY ' APPLICATION# DATE ISSUED MAP/PARCEL NO. ti ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION l FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED,OUT x ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents 4s Office of Inves6kations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers T A Iicant Information Please Print Le 'bI , kv Name (Bnsiness/Or nization/IndividEml): ,t ' Address: eQ 13o> (o,33 City/State/�Zip:�C t,�`� i� d X—66 Phone#:' Are you an employer?Check the appropriate box: [[ �� 4. [] I am a general contractor and I Type of project(required): . 1. I am a employer with i �L' �" employees(full and/or part-time).* have hired the sub-contractors 6. ❑New constriction 2."0 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' [No workers'"comp. insurance comp.in�,a„Ce.# 9. ❑Building addition required.] 5:[] We,are a corporation and its 10.El Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12 Roof insurance required .]t c. 152, §1(4), and we have no repairs employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information, t Homeowners who submit this affidavit indicating they aro doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If flee sub-contractors have employees,they must provide their workers'comp.policy number, I am an employer that is providing workers'compensation insurance for my employees, Below is the policy andjob site information. Insurance Company Name: Policy#or Self-ins.Lic. � LIU Expiration Date: 'nD V a c� 1 Z Job Site Address:__ City/State/Zip: 6 �//L NA. j�.2k 3� Attach a copy of the workers compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties"of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the.form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby ce under the p and penalties of perjury that the information provided above is true and correct Si tore: � , L Date: Phone#: 7� 0 `,G� 3 L only. Do not write in this area to be completed by city or town off ciaL n: PermitUcense# hority(circle one): Health 2.Building Department_3. City/Town own Clerk 4.Electrical Inspector 5.Plumbing Inspector . son: Phone#: DATE(MMIDDIYYYY) =SRO® CERTIFICATE OF LIABILITY INSURANCE 9/15/2011 ,CIS CERt1NFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON.THE CERTIFICATE HOLDER. THIS ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR'ALTER THE COVERAGE AFFORDED BY THE POLICIES �ELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. /IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policypes)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER NAME COUNTY INSURANCE AGENCY INC HONE 9 -8415 ACo 774 ao No ) NEx : ) 123 .Sylvan St E-MAIL s:[] ADDRE Danvers, MA• 01923 INSURMIS) AFFORDING COVERAGE NAICE INSURER A:COMMerCe Ins. Co. INSURED Building Performance Contracting,:LLC INSURER B:Essex Ins. Co. INSURER C:Atlantic Charter 50 Sunset Dr INSURER D Beverly, Ma 01915 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED,ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF-ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INBR TYPE OF INSURANCE AouL suSIR P LC�M LIMITS POLICY EXP LTR INSR IWD POLICY NUMBER MMIDD MMIDD GENERAL LIABILITY EACH OCCURRENCE s 1 000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurtence $ 50,000 CLAIMS-MADE Fx_�OCCUR MED EXP(Arty one person) $ 1,000 B 3DE9441 11/19/2010 11/19/2011 PERSONAL BADVINJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 1,000,000 POLICY E T LOC $ AUTOMOBILE LIABILITY Ea accident $ 1,000,000 ANYAUTO 3983 2/2/2011 2/2/2012 BODILY INJURY(Per person) $ ">�ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ A AUTOS x AUTOS , P PERDAMAGE HIRED AUTOS AUTOS P Rer accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMBS ER ANY PROPRIETORIPARiNER/D�CUi1VE YIN 11/23/10 il/23/11• NIA - EL EACH ACCIDENT $^ 500,000 C OFFICERNMER(Mandatory EXCLUDED? WCV.00939900 EL DISEASE-EAEMPLo $ 500,000 {Me,Matory In NH) IfEas esclibeunder D ESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION Town of Harwich SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Building Dept. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 732 Main St ACCORDANCE WITH THE POLICY PROVISIONS. Harwich, Ma 02645 AUTHORIZED RESENTATIVE AeZ 0 1 988-201 0 ACORD CORPORATION. I)rights reserved. ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD �/ee i�oa�a�na�uuea a Iaicense or registration valid for individal use o Office of CtWwmter Affairs&B ess Regulation only HOME PAPROVEMENT CONTRACTOR before the expiration date. R found return to: Regishation: .4462715 Type: Office of Consumer Affairs and Business Regulation Expiration: Z56W3 lndividuid 10 Park Plaza-Suite 5170 Boston,MA 02116 { 9JEMOIND ��22 t� JOSH EMOND 50 SUWSET DRIVEa_ BEVERLY,MA 01915 -F=" budersecretu7 Not valid wiWoutsigna6are �- .. x y W s c itT ZJ Q �^_ 10 10 W m > r L = O 76 x �► Ulul J m- W Z W Q � y. OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at 31 Cep Po lnk Cir. (Property Address) (Properly Address) hereby authorize anC (Subcontractor an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. Owner'seftnattire Date Y Building Performance Contracting,LLC Nauset Insulation P.O.Box 1044 N. Eastham,MA 02651 Phone(774)316.4464 Fax(774)316.4462 Date RE: Insulation Permits Dear Mr Perry, This affidavit is to certify that all work completed for the insulation work at I � � has been inspected by a certified Building Performance Institute(BPI) Inspector.All work performed meets or exceeds Federal and State requirements. Respectfully, s mond C . i . 1 ! JOB ✓l.'�v/V�[ l-" /1-1 l../_/\ �• ,- rr 9NEET NO. OF _ .. - Y V- _ � i • I I � � -- � -- �-u5 IS w � rI � CALCULATED PTE -_ . I I' K1 z►1�/`� � p ll IL-� 1 � ALCU 8Y •�'.I/ O CHECKED BY iA\ 4_- DATE_ SCALE I sc� IVil I >� Cr;£CCYa� — CTIFCLfd _ C �1G�- . j I i I I I - -- -I --- --- — --I- I I �- I T /940 __ _1� I 1 1 3 I I I I —�-iEx sns�vf7d G D L a IF I I I I t- �— �'— —� I I I ITo - -b- 0 - I I, i Illlil I a , ITjr -17 iI ' -- --- I I I I , t I , I , -I I i- 3!o. <'Al uN6 9� - Jus 94E _ OF �+ �11 rG it - Y- - I /I I I i I I I 1 !.. i -- - i 17 I I T I ! I I-17 II I I I I I I I I I . ! ._ _,._..uv_f 1. 1 .i I I ! I i � I I I �fi PAN ! I I I _I ..! . I I FT- I I i I I i I ! I i �r - - - -- - - - �I - I I I. , I i 1 I ! - I I SHEET NO. CALCULATED BY-. - DPTE CHECKED BY DATE-_- /)� I ' I I SCPLEL-_�_ _-_- 1 i I rr---- i I ! — yi j� I I I i d ur NOFA 777 q a7t x Y�11L I1171 I o � _ i - I I _� i I '__i___r_I i TT� • I I I PL �Ii > , I. I I—T-- - _I I I L j ! I I � I I !�;__ i _�_ i I I I :, ! I ►_ I I I I I,� ��1 I I I � i. L. I � i ��I I I I I I' . NELJ cz -- I -- I 1 I I I I I. I I I I Ij i : LLB---- — ---- - - I • - I I i _ I I f I � _ - - ' : : I , - I i c — I. NFL: /aDprT7 cn1 9suC Assessor's map and lot'number '�1'..��.`.-.Q `� SEPTIC SYSTEM MUST BE cFTHETO INSTALLED IN COMPLIANCE 6�P�' �`♦� Sewage Permit number ....................�-..YS.4 WITH TITLE 5 Z / "E7�?f9l�ONMEN AL CODE AND �BAHB98Ta LE, House number ., ..J.I................................................:........ ,•, �o,,�t639. TOW ' TOWN OF BARNSTABLE BUILDING ' INSPECTOR APPLICATION FOR PERMIT TO ... ..�-?d . ... ....... .......... ....'.. ..V-f!m,\-A TYPE OF CONSTRUCTION ........ ........l..e 1.�..................................................................... ..�. .....�Q ..............19 �l•• TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit a rding to the following information: e Location )�07 _ y S, LProposed Use1 . ....................................... :,.............................................................. ZoningDistrict ........... ... ...C...,...........................................Fire Qistrict ;.....•;t................................................................. Name of Owner l.Q.k-NO... 1�J t�1�. . ............Address .................................................................................... Name of Builder >.J...V� ddress ....A`..� � C•�.J�• Fps s Name of Architect .....Address Number of Rooms .............. ...........................................Foundation 1.41...... ...... . ... Exierior ......... ...Roofing ..... V ............................................ ........................................................................ Floors �AMIF-=...cFh . '...............................Interior ................................................ Heating ...1 .� J.....�j�....... �.� .....................Plumbing ..��.....!i� s. Fireplace ^��J. ...................Approximate. Cost .....!. .. ..j..0.�. ................r.. .................... ......................................Definitive Plan Approved by Planning Board-��-- GG ....(. .U.. ...:�.. ------19Q_l--. Area ......... r Oa Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 1� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the T of Barnstable regarding the above construction. Name .... .. . ... Construction Supervisor's License ..�b.............. ..... MAHER, JOHN No ...2�302.. Permit for ...9!7 .StPXY............ r- Single F ...................ami.1y..Dwellixig..................... t _ s Location ... t.. ,......31..C4edar..P.oir t..Oirale Rterv.l le....................... 3 c- Owner ....John, .r'�c12. ....................................... ' Type of Construction ....Tram.......................... ..........'.................................................................... Plot .. .................... Lot ................................ t� Permit-Granted .....June.14., ....... ....:19 85 Date of Inspection 19 Date Completed . ' " �.=:=.:�, �..�• = „��''.•,Y^�7: ',. fic'"'.A. x '' �» y'�':-§.' 4s-�*.,-'Y�.m- s 7V�r; '�", *t F ?. r TM'* TOWN 'OF BARITST"LE Permit 28024- 'No t .�, Bwldsng Inspector ». f Cash — Y OCCUPANCY PERIviiT Bond i f Issued'to John Maher Address ^J Lot 43* 31 Cedar Point Circle; Centerville Wiring.Inspector � 6f� � Inspection;date/ • r � *�v Plumbing Inspector ` Inspection date /1V,�; , Gas Inspector /Aci .•,ih ' Inspection date �+ Engineering Department y.+` -�,• Inspeotiori date w Board of.Health `�' � ��✓ ,4t'' ~ Inspection..date:,_ V 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.. ................................... .......... 19 .zz"�� /Z",/- ----------------------- Building inspector,-- :: .= � •.. _,.r '..,'. ,,,X }� f�,z,,.il i�,t;�!' .. .'"+,.FF'�c..F-�°F.�. :"',-�...r.,.�.' 19'r "" .� `.�A �. ",..;�Y _ j.k d"';�.�,w r ,St;+e ::�,,.: ;1 TOWN OF BARNSTABLE BUILDING DEPARTMENT sARIST IM : TOWN OFFICE BUILDING rua � °b .39 HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: i An Occupancy Permit has been issued for the building authorized by BuildingPermit �$........ ... ... -„. ........................................................................ ........._........................................................... issued to .....2Y[1...h Y...... 1 .... 3f...e'e r O!..:°v.TOr...........'...„e- J Please release the performance bond. ID, c�Y - + i Assessor's map and lot number � ,%� l��-.1/ ,--%�%�5'� �pf 1N F TD Q �♦ Sewage Permit number .................... ��r��-.1J.�?. ..�Z!!� Z 33AWSTABLE, i House number .....-:.;.... 1.........:............................................ y� MAM p� a p 1639. `e0 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... :: :::.: ..... Z,\ ;`�,y).. }.... ..a .:4 ... ; 1i....: TYPE OF CONSTRUCTION ...... ?........ ...............{-`t`r 1 . ..................................................................... ..............r................................19'{ ..) TO THE INSPECTOR OF BUILDINGS: ;k The undersigned hereby applies for a permit according to the following information: Location .9..:.. ..`. �. ;t ...:(-4��. t�� C i �r }.i.........(.�, 1 � . ....::...• ..`:....`. Y ,\.J. .!... ............... . ................ ......... _ .. . Proposed Use ... ................................................... I�� "a` L 1 ' Zoning District .....................Fire District ............ Name of Owner . .;��., � \\, .............Address .................................................................................... Name of Builder .. ` .-Address � �. ... ... �.. ... Nameof Architect ...................................................................Address ...:................................................................................ Number of Rooms ...........................................Foundation rlr.lfe �. Exterior .........� :.. :::.......... ............ . ....................Roofing ... .5��S4 C. `7.:................................................. .( �- i> : .Interior �=\ Floors 1 -' ........:.:........ .............................................................. Heating :............................. ......A........:..................................Plumbing ...-'^�................ ,.a............................................ Fireplace ' � ...................Approximate. Cost ............... u• 4 Definitive Plan Approved by Planning Board/_4- ke'___ ---------19rJ l_ Area ..:..................................... __. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 4 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the To of Barnstable regarding the above construction. ? �11 Name ...... Construction Supervisor's License { MMM, JOHN A=228-113-004 No .28024..... Permit for ..Q1e.5t.QXY.............. Single ly..j).w .............. ....................... Location JP!...4-x.....31,..(7edar..P0j-at.-Cixc1e .................. .................................... Owner ...q.Q.h11..M.P11er......................................... Type of Construction ...Fram............................ ................................................................................ Plot ............................ Lot ................................ ........ .... Permit Grant"ed ......!Tune....14..................19 85 Date of Inspection ....................................19 Date Completed ......................................19 w O •, y EXISTING 2x8@ 1 6 ROOF RAF I�E R b�, M INSTALL 2x6@1 6 KNEEWALL TO SUPPORT NEW RAFTERS "�� d Y o 0 0 V V2•- W a (� Q � c ` w' WQrV `tTR!� L x1 6" MICROLAM HEADER r _ Of Lo co Lo a : t188 SPAN_'AND 16' SPAN' ~��a Qom° �' � a o NJ-NIy3" BEARING EACH END w F EACH SECTION OF BEAM) ui ,�T Q III-1 I I-1 -1 .. lul -11 =1 -1 -1 2 x 8@ 1 6 RAFTERS 1'6"__ DIAMETER I 'R� 38.E FIBERGLASS INSULATION = SONOTUBE PIER z ~ 3"CLEAR FOUR 2 2x6 @16 STUDS EL-SHAPED JOIST HANGER I I 2x10C,1 6 REBAR i i CEILING JOIST ER1-=9? FIBERGLASS INSULATION 16"x44" 900# RATING i � � 3 JOIST HArjGER 4" DECKING 300# RMING (2x1'0 @ -12" SPACING CAST FOOTING I '�,_ PRESSURE TREATED JOISTS --4' DIAMETER AGAINST SOIL �_,.- NEW QU.,4)- 2x6 COLUMN- 9EYOND _ PIER FOUNDATION DETAIL ; .O 4.0 1 /2 1 ,-0„ , 54"x`f 14" PRESSURE TREATED PARALLAM BEAM 4 HANGER R38 FI03ERGLASS 500# INSO.LtATION SIMPSON CC66 COLUMN CAP v � v NOTES RATING? Ir 'BLO-CKING� 0 '� �; 2X vSLEEP CBETWEEN 1" 1„ --- � -RS R 54 x54 PRESSURE TREATED 1 PARALLAM -COLUMNS,AND BEAMS „- --- -� JOISTS. PARALLAM COLUMN v SHALL BE PRESSURE TREATED TO 1 6 SPAC G 1 1 '-6" MAX SPACING LO 60 PCF. NEW 2x10 JOISTS SHALL -_-_- == LJ III III I'. ! III III;III =i 1- M O BE PRESSURE TREATED TO .40. PCF. 2- FOOTINGS SHALL BE HAND SIMPSON CBS66 COLUMN BASE 'EXCAVATED AND CAST WITH HAND- L BATCHED CONCRETE AGAINST SOIL HAND-=DUG-PIER FOUNDATION EL SHOWN. 3-FOOTING DESIGN ASSUMES A SOIL I BEARING CAPACITY OF 1 /2 TSF. EXISTING , � �4 , „ 4-ALL WORK SHALL CONFORM TO THE , -0___ 4 -0 MASSACHUSETTS STATE BUILDING FIROOR DECK ADDITION SCALE CODE. AID DI" •10N AS NOTED TYPICAL SECTION DATE 10-23-02 1 /4"= 1 '-0" DRAVING N0, SK-1