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0175 FIVE CORNERS ROAD
R 7 _ F ue y e o d i Tom` -�° �� �� 5��� T''' �v�- • � m� � �_t l��D ��`f�2.21�VlS�S��e.�On/j YOU WISH TO OPEN A BUSINESS? LF For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you ar must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: „! Fill 'n please: APPLICANT'S YOUR NAME/S: e ems{ 10 �t BUSINESS YOUR HOME ADDRESS: ✓ LA i rii�l Iris C d i y:?LEA 2 TELEPHONE # Home Telep one Number �•• ;z.,i1'.'J�.,l .SJ Goa• NAME OF CORPORATION: NAME OF NEW BUSINESS S -- TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESS. A— P/PARCEL NUMBER /lo o 7 (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of i the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth This form is intended to assist you in obtaining Barnstable. h Y 9 Y Y . e in this town. and licenses required to legally operate our business Rd. & Main Street) to make sure you have the appropriate permits q g y p _ y . 1. BUILDING COM 4binfarm 'S OFFI MUST COMPLY WITH HOME OCCUPATION This individu I f an p mit eq 're Brit that pertain to this type of business.RULES AND REGULATIONS. FAILURE TO COMPLY MAY RESULT IN FINES. e n ture* —� OMMENTS. 0 41 %i i 2. BOARD OF H LTH This individual has been informed of the permit requirements that pertain to this type of business: Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business: Authorized Signature** " COMMENTS: i own of Barnstable Op1HE rqy Regulatory Services Richard V.Scali;Director Building Division 16 . 39. �' Tom Perry,Building Commissioner 9� a6;p �0 ''rEn► _a 200 Main Street,Hyannis,MA 02601 www.town.barustable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: �O J s �� � C� 4 • Name: Phone#• ( —77 A Address: I (-fl —village: • Name of Business: �Q11, LC Type of Business: , Map/Lot. b — 0 7 D INTENT. It is the intent of this section to allow the re ' ents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling. there shall be no increase in noise or odor,no visual.alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials, exp nals,in excess of. normal household quantities. • Any need for parking generated by such'use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment • There are no commercial vehicles related to the Customary Home Occupation,other than one van dr one pickup trick not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. •. No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling I,the undersigned,have d and agree "oveons for my home occupation I am registering., Applicant: Date: Homeoc.doc Rev.11111 TOWN bF BARNSTABLE BUILDING„PERMIT APPLICATION Map- Parcel 0 Application # � � nn Health Division D IJ �` Date Issued Conservation Division FAQ L ,l! Application 6 RECV Planning Dept'. By Permit Fee Date Definitive Plan Approved by Planning Board ;�1 r✓ir►1�'u- ST Historic - OKH Preservation/ Hyannis Project Street Address / 7 S F1 ut God D Village C C Pl TC R_V Owner C'S A I G S H C-VE R Address I'7 S FIfZ�_atrvE:WS PLO Telephone 8/ 33 Q Y r17.4 T v PICAO 1 Permit Request Pem6ye muJrn,m be=�l.T- md4rri Ps@ 1,A4 ,OCCAeaxiC41n5 tuc 11in 1i0,5 room fo a-Y o new rn-Mr or doer, 24?Mode s/,eefi-. •.k , rg,Qcq QrLn/ fe gfxl6erl�WJ?LS 4n Rao, Fr%3 mad a Flees- 4s,9 PXH IQP6"opJCZnTT9P. a a A owsu/afefo R 1% 0%-9-6,11n,"i Siieetr'oetk and 4r-,ni. Square feet: 1 st floor: existing/proposed l;a 2nd floor: existing proposed AA Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 8 5 Construction Type Lot Size ® e 36 k_R Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ®� Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes Flo On Old King's Highway: ❑Yeso Basement Type: eFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) / roc) Number of Baths: Full: existing / new f Half: existing new Number of Bedrooms: 2 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 U 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 /71qtr K U n Telephone Number Z?a t Y-5-9/ Address I C o n n e rvi a ra w License# fo'16 7 G We sf Yar mol-)4-h IT o a6 7 '3 Home Improvement Contractor# 16 7�?6'/ Email MULL w RaoF h1Al L ,C6M Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO &,,c-1'- h le durmp SIGNATURE DATE l� FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER . DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. f ?Tie Conzinornrealth af-Vassachusetts Deparkrrel t ofrkdrrstrialAcciderrts 0—ce of 1ri�.- tigatiorrs 600 Wasiaington Street ; I—N- Baston,CIA 0211I• �l�rvtwnrrissg�fdin Workers' CumpensaiionInsuraaiczAffidavit:Brill.den/ContracturstEIectri;cianslPlumhers AppEcant Inkir atian Please Print Le ibly Name CBuss�e�,�, miu iana&idaa1): M A f- K M V L c:i N Address:_ ' C-0 N MF-f"A2 A- `V AY City/StattlZ Y A R M C 7-q Af A-0--A)73haao ate_as r-�s Are you an erVloyer?Check the appropriate box: Type of project(req d)c - 4 I am a general contractor and I I.L^�1 am a employee uritb. a �employees(full andlor part-time).* Have]sired the sub-contmctors G_ New consizucfiou 2_❑ I.am a sole propne=tor orpartner Tisfed on the attached sheet ?_ ❑Remodeling slop and bane no employees. These sib-contractors have g_ ❑Demolition worlring fbr e.in,any capadty employees and have workers' [No❑o erg' comp.insurance comp.insurance,1 g. 0 Building additiooa rewired I 5. ❑ We.are a cmporation and its 10❑Electrical repairs tar additions 3.❑ 1.am.a homeoumer doing all work officers have exEirdsed their 11_❑Flumbingrepairs or additions o workers' fight of exemption per MGL �' � �F- r 12_❑Ii.06fregatfS c.I52 §I(4k and we have no �n�,tx-a„�ereq=-e ,� employees.[No workers' 13.❑other comp.insurance required.], •flay apyBcLut&xtchedrsbox Pl mast also Uoutthe sectionbelawshns ng theawozT Ee ca®pensatiaapaHryinformatiaIL Homeownem who submit this of uLmrir indficzdng they arx doinz allwat sad then Iure outside contractorsnmst submit a new2mdaVk iadica�sacs_ ZOontractorsA&ctieckihis box mast attached ate additional shin sh6wmi gthaauneof the sub-cwt wAos-snd strife whether ornotthose eafitfesbive emp9oyees 1fthesabtaatmctorshaveempIoyeer,they mvseprc id then workers'•r_omp.policy number_ I aim an employer that&prmiding workers'eangw.madan inmiraace-for ary ffeIaiv is file policy toed job Sue hiformatiars InsurancecornpanyName: z t/K.' 'Policy 4 or Self-ins..UC.k_ _ Expiza nDate: Job Tite Address: j7 i 1 U.6 C'_0Ra0dZE CD ' City/statel: C d/•�tilE'!/��-�G "/yJ'4 Attach a copy of the workers'compeusationpolicy declaration page(sh -ning the policy number and respiration date). Failure to secure coverage as.req*ed.under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to$1,50OA0 andrar on 6-yes r imprisonment,as well as chril penalties.in the A=of a STOP WORK ORDER and.a Em of up to$25t1_00 a day against the-violator. Be adidsed that a copy of this statement maybe forwarded to the Office of Imrestrgations of the DI for insurance coti erage mrifscatioa Ida Hereby c&fi,njrder thin prmis and p nabYes ofpedaty 8ratt7re ieafornzat'iorr pratirled a.bmv is bare wid carrect Signature_ Date- c2- Phone i€ �d � d`I 9 S 9 OfjSdd use arrry: Da oat errite in this-area,to be compleW by city artoirn offidal City or To-nu. PermitUcense4 Issuing Authority(circle one): 1.Boas-d of Health, 2.Buff ding Department 3.Ciql Town Qerb 4.Electrical Fnspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions M,c Irusetts General Laws chapter I52 requires all employers to provide workers'compensation for their employees. p this she,an employee is defined as."-.every person in the service of another ruder any cotract of hie, express or implied oral or wri� An err1pIvyer 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 Iegal represcata&cs of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling horse having not more than three aparlmeats and who resides therein,or the occupant of the- house of another who employs pions to do maintenance,construction or repair work on such dwelling house orO tl�the grotmds or bniZdmg apgurEenaatthem shaR notbecanse of such employment be deemedto be an employes." MGL chapter 152,§25C(6)also states that"every state,or local licensing agency shall withhold fhe issuance or renewal of a license or permit to operate a busumess or to construct bnfidiags in the commGnwealth for any applicant Who has not produced acceptable evidence of compliance with the iIIsnrance coverage required_" Additionally,MGL chapter 152,§25C(7)states'Neither the eommoawe-alth nor any ofits political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with.the fi occur ce:. rrmz nmm ents of this chapter have Been presented to the contracting anihodtY." Applicants PIease ffll o�c± the worker' compensation affidavit completely,by checking sae boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone numbers) along with their cer ff icate(s)of ncrmancB. LmmitedLiability Companies(LLC)or LimitedFiability-Pazttamsbips(LLP)with no employees other than the members or partners,are not mquimd to catty wormers'compensation insurance. If an LLC or LLP does have empIoyees, a policy is required. B e advised that this afrdayh maybe submitted to the Department of Industrial Accidents for confirmation of fi mian ce coverage. Also be sure to sign and date�d[e affidavit- The affidavit should be retumed to iho city or town that the application for the permit or license is b eing requested,not the Department of n a • `Accide ss_ Should you have a-ay questions reg�ding thae law or ifyou are req= to obtain a workers' cornpensationpoliey,please call tht-Department atth.en=berlistedbeIow. Self-fimued companies should enter their self-i sara ce license number on the appropriate line. City or Town Of-cials Please be soz e that the affidavit is complete and pried legibly. The Department has provided a space at the bottom of tine affidavit for you to fill out in the event the Office of -avestigations has to contact you regarding the applicant Please be sure to fill in thepennitllicense nwnber which will be used as areference number. In addition,an applicant that must m"bmt multiplepennit/license applications in any givenyear,need only submit one affidavit indicating dent policy information(ifnecessary)and under"Tob Site Address"tie applicant should write II"all locations (city or town)_'A copy of-the•affidavitthathas been officially stamped or marked bythe city or town maybe provided to the • applicant as proofthat a valid affidavit is on file for fatm permits or licenses A new affidavit must be filled out each year.'Whero a home owner or citizen is obtaining a ture license or ptr itnot related to any business or commercial ven Cie. a dog license or permit to bum leaves etc.)said person is NOT rcgcdxrdto complete this affidavit The Office of Investigafions would lake to thank you in advance for your cooperation and shaddyou have any questions, please do not hesitate to give us a call The Department's address,telephone and faemmmber. Tire CGm=MmweeaY*of Mans nb -F—tf;s - D:epaitnmt of Iadustzzal AccUeu:t, f��e ref�gve�g�tio� . CQ4 TWtan Sit I Tf,-L 4 617 727-•gRg cxt 4,06 or 1-977-M 4&VA Fax 617 727 7749 R Pised 424-07 w Mass.gavldia A FCC rlicide to Waad Consfmc#orr zn 1Yje'Ji end Areas:110 inph T-YYnd Zo;ze Massachusetts Checklist for Compliance (780 C144Iz 301•?1.1)' - ' C1rcc-k - . Caapllan= 1.1 SCOPE. __ .tiD m h Wind Speed{3-sm gust)-- ..____._________.__.. _...� ___--_:-_ _ • P Wind Exposure Category___ B Wind Expasure Category..:.............Engineering Required For Entire Project .....................................0 • 12 APPUCABlLtiY -Number of Stories(a roof which exceeds B in 12 sigpe shall be considered a story)' stories s 2 dories Ftaof Fitch .r.--.. -_.___: _.-�.._.._.__(Fig 2) _-__�_-_-------- -1212 < - Mean Roof Height -- ----_ __ ._...._.-_ _____(Fig 2}-.__--___--._._._._._ __ft 5'33' Building Width,W.__._.- _-- -_--_---(Fig 3)-_- _-- ---•--- _ft 5 BQ' Buldng Length,L _.______ _-___.-._---- _ ---fig 3)— -- -•-- ---- —ft s BD, Building Aspect Ratio(LMr) 4)-- ___--- - s 3.1 Nominal Height of Tallest Dpeningz�------ 12 FRAMING CONNECTIONS General compliance with framirig c nnecfians_...__._-.(Table 2)_ ...--•-:---__-----_-___:_-• 21 FOUNDATION . Founda:5on Walls meeting req mments of 78D CMR 54D4.1 Concr __..... -•-•----•----•------------------------------------------ --------- - ------ -----•-- -...---•- --- ' ---- - Concrete Masonry....... 22 ANCHORAGETO FOUNDATIDNIA 518"Anchor Bolts�imbedded or 5/8'Proprietary MechanicJI Anchors as an abrhative in concrete only BDIt Spacing-general -------- .(Table 4)------r..___. in. Bolt Spacing from erndTD!nt of plate Bolt Embedment-concrete_-_-- -(Fig 5)..- _-___ - in. 7" Boat Embedment-masonry-..._-_-.-_-..-.. ___(Fg 5)--_ __ _.._---- in-?:15" Plate Washer-,-,--- -----(Fig 5)---- -- -r?3`x 3'x 3.1 FLOORS Flcorrraming memberspans ched E!4 -_-_- —(per 7BD CMR Chapter S$)--•---:----_-- — Maximum Floor Opening aimensiDn Fug Height Wag Studs at Floor Openings less:than 27 from Exterior Wall(Fig 6)....................................... Ma�FloorJolst Setbacks Suppoiling Laadbeam' g Wairs or Shear wall______(F!g Maximum Canfilevered Floor Joists. Supporting Laadbearing Walls or5hean�ra[! -: (Fig 8}__________•-_--�_-- _. —ft s d _ •Floor.Bmcing at Endwalls_.._•--------- -.--------=(Flig 9}_ __-._-.• - --• Floor Sheathing Type _.__ .._(per7B0 CMR:Crhapfer 55)___-_�_ Floor Sheathing Thickness -(per 730 CMR C:hapiar 55)....._-- in- Floor Sheathing Fasterrmg ...... _(fable 2)_ d nails of in edge/—in field. , 4.1 WALLS Wall Height r Laacibearing tsialls..M ___-- •... _(Fg 1fl and Table 5)___ .—ft s1D' Non4_Dadbeaiing walls_ ___ (Fig 10 and Table 5).------_._-__ft-s 21Y Wag Stud Spacing -•-- - -.= - •------Pg 10 and Table 5)________-_!n_s 24'a.r- Wag story Ofirsefs ' .__ - ----- ------____(Figs 7&B)- _- .___ —ft s d ' 42 !E Z OR:WALLS' Wood Studs - - Laadbearirrg'h%ralls_ __ ___....__... ..... - hbn-Laad�earing walls__-_._.- Gable End Wall Bracing t — Full HeightEndwall Studs WSP Atria Floor Length --Fig 11)_ .___._.__ - ft�:WY3 'Gypsum Carling Length(if WSP not used)_. ._...__(Fig 11) and 2 x4 C:onfirruous Lateral Brava 9 6 ft o_c_-[Fig 11�-_------------------------ ---� ' or t x 3=Tmg finring strips @ 16'spacing•min.with 2 x 4 Mocking @ 4 ft.sparing in end joist or truss bays Double Tap Plate - &price Length r_..r -__ (Fig 13.and Table e) Splcm GDmac:gpn(no:of 15d common narls)'� ATVC Guide to f-KOad COtrstrurdan III j�1gf1 [YI-n ArEUS. II a Mph Wrnd ZOM-f ' Massachusetts Checklist for Compliance(rso cmRs301.Zt_r)i Loadbearing Wall Conn coons Lateral (no.of 16d common Waifs)_-- .____—.-(Tables 7) -_.------- Non-Laadbearing Wall Connections Lateral(no.of 16d common nails)-- -.._—(Table 8) -------- Load Bearing Wall Openings(record largest opening but check all openings for coliipfrance to Table 9) Header Spans _.____ .-_ --_-...___.(Table 9).._�_.____�..- _fit—in.S if, Sill Plate Spans (Table 9)__ .—_._.. _._ _ft—in._<11, Full Height Studs (no. of sfuds)____- -.__(fable ._-.- NM-Load.gearing Wag Openings(record largest opening but check all openings for compliance to Table 9) in_512' • Sill Plate Spans.._._--- " _-.(Table'9)._ --.- —ft—in.512' Fug Height Studs(no_of studs) .(Table 9)-----___--._._ Edarior Walt Sheathing to Resist Up(dt and Sheaf Sirnulthnbously4 _ Wwilmum Buildng Dimension,W - Nominal Height of Tallest OpeningZ Sheathing Type-- - -_.—._-_-___(note 4�-------�---------..__ Edge Nail Spacing____. _—(Table 10 or note 4 if less)-_________ fn Freld Nall Spacing -..._,. _ _ -.(Table 10)-_—_-- ---- in. Shear Connection (no_of 16d common nails)(fable 10).-_.__ -__-_.__.____ ____-.--__ PercentFulhHeightSheathing--_--_-_.-(Table 5%Additional Sheathing for Wall with Opening>SW(Design Concepts)_______.__. Maximum Building Dimension,L Nominal Height of Tallest Opening?___.___--------------------------------------------------- --!56'B_ ` Sheathing Type------- _--- ---(note 4) Edge Nall_Spacing_--._ —_ --(Table 11 or note 4 if ___ __--- in. 1 Feld Nail Spacing _(Table 11)______-____—_-_-_-. __- in. Shear Connection(no.of 16d common nails)(Table 11)-..__� Percent Full-Height Sheathing— (Table 11)_ 5`Y Additional Sheathing for Wall with'Opening?•SY(Design Concepts)_.-__.__ Wall Cladding Rated for Wind Speed? 5-1 ROOFS Roof framing member-spans checked?____.-. .(For Rafters use AWC Span Tool,see RBRS Websrte) RDaf Overhang ft s smaller of 2'or U3 Truss or Rafter Connections at Laadbeadng Waft = Proprietary Connectors - Uplift__.__------•--- —.(Table 12)___ _-._ ___--U= plf Lateral _.._-(Table 12)_� - P ff Shear._ _-- _w Ridge Strap Connections,if collar yes not used per page 21__. (Table 13)____._-,--_-.-__--T= plf Gable Rake Outlooker---._-.___ (Figure 20) .___--- 11 s smaller of 2'or LPL Truss or Rafter Connections at Non-Laadbearing Wags - Praprietsry Connectors - Upitlt—.-:.__.- _.--- .(Table 14)--- ------ ---U= lb. Lateral(no_of 16d common nails)_.(Table 14)------_-------______.�--- ---_L= . lb. Roof Sheathing Type—_____.;_- __- _-(per7B0 CMR Chapi>rrs 53 and 59)............. , Roof'Sheafhing Thickness in?71161 WSP Roof Sheaifiirrg Fastening-_..____.—.-._---•-__(fable 2) — Nofes: This checklist shag be met in its entirety,excluding the specific exception noted in 2, to comply with the requirements of TBD CMR5301.2.1.1 Item 1. if the chec)dfst is met in it entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 2b Gage Straps per Figure i 1 c_ uplift Straps per Figure 14 d_ All Straps per Figure 17 e- Comer Stud Hold Downs per Figure 1Ba and Figure 1Bb 2 'Exc:option:Opening heights of'up fo B fL shall be permitted when 5%is added to the percent fuMeight sheathing ukearients shdwn in Tables 1 D and 11. ' 3. The botinm sill plate in e)±&ior wags shag be a minimum 2 in.nominal thickness pressure trees#2-gr2ide. • -iFN .. - -AFVC Gu de fo Wood Corrctractiorr im Ili h 11,iizdAreas. I10 rrtpk J7'VdZoaze Massachusetts Checklist for CompiialLCe(780 CrARS3,012 i_I)' 4. a: From Tables ID and 11 and location of wail shimthing and Sui7ding Aspect Ratio,determine Perr.> FUf!-Height Sheathing and Mail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7116'and be installed as follows L Panels shall be installed Vd strength aids parallel to studs. F 11. All horizontal joints shall occur over and be nalled to framing. tit_ Dn single slnfy construction,panels shall be attached to bottom plates and top inembe:r of the double tap plate- iv. Dn two story construction,upper panels shalt be attached'to the top member of the upper double top plate and to band joist at bottom of panel Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first fidorfmming. V. Horznntal nafl spacing at double top phries, band joists,and girders shall-be a double row of Bd staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment 5. G[Edng protection:a)*new house or horizontal addition—required if pplect'is 1 mule or closerto shore(generally,south of Me.28 or norfh of Rte:6) b)vertical adCMDn—not rBquti'ed uriless there is w••tenslve renoYafion to fhe first ffoor c)replarinentwiridows—needs eriergyconservafion rump6ahce only(chap 93) S.Wood Frame Construction Manual(WFCM)for 110 MPH, Exposure S maybe obtainedfrom the Americ2in Wood Council (AWb)website. / 1SrIERTI'm 1=r-tES73ON 1LL�sdr.th�L� . ATE'n= ttl t. • it it t c �Qo l tt tl•o t i t E. - 1 ' I II • t Q t is r t t t it i t n t7 i I_. t •m tt v� t t _ t9d ' +u ., I ' t t a I r r ,�•c.a.nv��� WEPWEDLIZEE t 1' o It Itp �t ,t — t t t �'lriCi • �ot19iE�� � STAGGERED _ fitAS�S�JEGkJG NAX.PAT EFU PANS- PAW— r - -� TF=E Ao=.EbL4lL®GESPAGFiMMTAI.. , See Datiff on Next Page -Vertical and HDtvmrilal Mailing DetEill - Veriigl ar�d Hotizanu Nailing • for Panel Alta chment for Panel Attachment . Town of Barnstable RegWatory Sergiees ' F Sit StNCTIT1rF i 9 WA CM �. R.ich2rd V.Sc4 Director }� Building l?iYision tom Perry,EmIdmg Commissioner 200 Main S =4 Hy=3j, MA 02601 wwW townbarnstable rm us Office: 508-8624038. - Fa= 508-790-6230 PropeAy Owner Must Complete and Sign This Section If Using ABuilder I, C as OwIIer of the subject property l�rebyat�horize /l1 �� II(���- / j.� to act on mybebaY, In aR.=2t b==kEve to woik andioazed by-d=bml&3g permit application for. = Z3' . 1i0& Ce fq c P,SAtT,!F-P—v (A&f=s of Job) _ -Poolfences and alarms are the responsjil'17 of the applicant:Pools are not to be filled or uhiized before fence is installed and all final ' inspections_are pedomed and accepted -a- —D SI .of Owner . S of Applicant A,4,e K A oe-Z-/4 Print 14aine Puuat Name off_.f� / �, - • - Bate•. - Town.of Barnstable . Regulato rg,,$erQiceS of r Mr-h-rd V.ScaFi,Director 0 BuTding Division 'Tom.Perry,Building Commiceipnw ICAMMtia 200 Main Sftw4. Hymms,MA 02601 ��MAC wt4TcY_town�barncfaRj�m_a__IIS Office_ 508-96Z-4038 Fay 508-79Q-6230 • B:0IMWNMI cx=ExElaTZON • PlersePrint JOB LOCAIIO Z-- s � C MRMgT'MAMn,iGADDRESS: _ City/ftn- nP c6de The current exemption for`_homeowners"eras exfendc-dto include owmer oce�ied&Wt--Mn.es of silt emits or less and to aIIoW homeownms to engage an mdMdual for hn ewho does notpossess a license,ptgdded tbatthc awner acts as supervisor_ DEFR-glION OFECOMEOWNM P eson(s)Who opens a parcel of land oa which he/she resides or mfends to reside, on Which there is,or is intended to be,a one or two- 5mdy dWelling attached or&tarhed structures accessory to such use and/or fa=sf cacti es_ Apmson who consfmcts more than one ho=in a two-year period shall notbe c,nsidcr id ahomeown= Such-homeownce.shah submitfn tl=Bm'lding Official on a form acccpiahletotheBurldmgOffiaial,tbatbe/shnshaIlber�sponsiibIeforaIlsockwarkperfvrmcd�dertizebmldm�vc� (SeLtioa 109.L1) The=&Zigaed`.,ioiaeownce as==respons�ilhy far cnmpliance_w�tbe St,Bmlding Code and other applicable codes, bylaws,roles and resolution. - Ile undcoigaed`homaovmee certifies thathashj5'u dentuads the Town ofBamsiabIr,BmMing Depaiim=t Mkill=inspection proaodnres and regniremenfs andthat he/she wM comply with said procedures and reqirMmeEds. • SigaamraofHomco�ncr - - . APpraval ofBm7d"m9Officbl • Note_ Three family dwellings containing 35,000 cubic feet or larger wMbe requiredto comply whhtho State BmIding Code Section W.0 Coni.&lxnctioa Conan/- HGMM0WN=,S Ecaa=d The Code sus that 'Any homeowner performing workfor which a bui-Idhg permit is required shall be exempt from the provisions of this section(Section 109-LI-Licensing of eonsfracfiont S¢gerd=S);provided that if the h.omeowaer engages a person&)for hire to do such work,that such Homeowner shall act as s¢pervisor:I Mauy,homeowners who use ffiis exemption are unaware-that they are assn�g Elie responsr�iT�of a supervisor ' (sea AppendbC Q+Rules&Regulations for Limusing Construction SIIperPisors,Sermon 2.15) This Lack of awareness often results in serious problems,parficularly When flie homeowner him nnDicensed persons. In this rase,our Board cannot proeee:d against the unlicensed person as it would with a fic�nsed Supervisor_ The homeflwner acting as Supervisor is uW=trly responsible. To ensure that fhe homeowner is fully aware of his/her respoasrmmdes,many communities require,as part of fhe permit appIic�nn, that the homeowner certify that he/she unders(ands the responsr�iffiies of a Supervisor. On$ie Iastpage of this issue is a form carrewdy used by scieral towns_ You map 0 re t amend and adopt such a form.1certi[Iration for use in Your Community— Q.41PFIT�SlF08MStbm7dim�P� �Fs RRFce�� Revised 061313 ' �1 ® CERTIFICATE OF LIABILITY INSURANCETW&JQM DATE(MM/DD/YYYY) l TIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS rconik ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. IS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE 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 and endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s. PRODUCER CONTACT NAME: r MARGARET J GRASSI INS PHONE FAX 1188 MAIN STREET (AIC,No,Ext): (A/C,No):• E-MAIL W WAREHAM,MA 02576 ADDRESS: 7282M INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: AMERICAN ZURICH INSURANCE COMPANY MULLIN ROOFING AND SIDING INC INSURER B: INSURER C: INSURER D: 7 CONNEMARA WAY INSURER E: W YARMOUTH,MA 02673 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 ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) LIMITS GENERAL LIABILITY CH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR. PREMISES TO RENTED $ ES(Ea occurrence) MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 0 PROJECT F__1 LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND X WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-9F464748-16 01/13/2016 01/13/2017 LIMITS ANY PROPERITOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ 100,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under ? DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIRESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. r CERTIFICATE HOLDER. CANCELLATION TOWN OF YARMOUTH- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 7 CONNEMARA WAY BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPR TAy WEST YARMOUTH,MA 02673 ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reserved. EXIST gq - 175ZN �1VECArv�E6gS 6�ar�4, �►r ��I�, DK 14 AS 12 121 `32 x �Ft E i q i � t � xrcfa � o BAS .� o r� 61 2GAR .170' ' u 9,a sf O DINING �5�1Me71 6 B�t� QIZZ gLlf® O 0 jryl q 4� d 0 04t1, ��r ProPoSED - 1-75 &YOTO L. mew ij," et.1 poop.. ZI[ F-c.,eo 14t<d.A 3. N"d VOOI : 2zQfr�agt��Fcade.� 9 4)ct 0 be iPjSr,IAfej -id (Zao _ , �j. (c, &e-FGooR i O p v ISo14fi2� r o � ¢ W :DO 141 raw POOR. kv lV boo 0 sE Pit -C -aLA9 E ` ►J ID f a i 4A Cl LV it DI NI�NGt�t �I pk-fo 4 cam,+' Massachusetts Department of Public.Safety • Board of Building Regulations and Standards a _ License CS 104076 Construpti ", -FSor MARK M MULLIN- '`� Y 7 CONNEMARA WAX WEST YARMOUIH ' ( �M lam. Expiration: Commissioner 09107/2017 . Construction Supervisor Restricted to: Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. T Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license.- e DPS Licensing information visit: WWW.MASS.GOV/DPS e�parrunaaouuealC�z ��aaaaclyewel . s e .. Office of.Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR istrattog 1f7281 Type. WI! ira4gn 8fgl�ad6 DB4 MULLIN ROOFING ARU-Sl II�G r MARK MULLIN 7 CONNEMARA WAY r W..YARMOUTH MA U2673:- 'Undersecretary License or registration valid for mdividul use only } , ,before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 Not valid without signature HEIATLOK010.0 - a s �° 2.1 Company Name Cape Cod Insulation i Phone Number 508-775-1214 Applicator Name oy� 2 Installation Date Jobsite Address 175 Five Corners Rd. Centerville Ma. A-Side Lot #'s f¢ 6' 00��� Permit Number B-Side Lot #'s � f , o o o �ojjMdam AMIYU&MIN ftFL Walls: 311 R-21 450 Attic o o U@W ,j www.Demilec.com cO DEMiLEC rya TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION r f�r� Map ' u Parcel U�b Application# Health Division �Ur�b/ Date Issued Conservation Division JA� o�A� - Application Fee Planning Dept. TpWAI '282of6 Permit Fee Date Definitive Plan Approved by Planning Board �F�A � Historic - OKH _ Preservation / Hyannis Ae�F Project eet A dressy L e Villa ( ✓fk 9 Owner t�aqvtev Address Telephone 74 f Permit Request VDU i �11V ` 41 - I 0a d �A GOI� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project.Valuation 7iJ4 0 Construction Typed 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: 0 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 0 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 )6o If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name1),ovu Telephone Number Address �$ l/' License# Home Improvement Contractor# 66-7 Email �l I P, cad 04U4 h 0/1 Worker's Compensation #' 6i0 YX ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WI L BE TAKEN TO SIGNATURE DATE j FOR OFFICIAL USE ONLY c � APPLICATION # r DATE ISSUED MAP/ PARCEL NO. „ADDRESS VILLAGE t OWNER DATE OF INSPECTION: FOUNDATION FRAME a INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. �j Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-100988 Construction Supervisor x HENRY E CASSIDY ,' 8 SHED ROW• WEST YARMOUjH 2q Expiration: Commissioner 11/11/2017 1 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 1 211 5/2 0 1 6 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY — - 18 REARDON CIRCLE SO, YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. I :5 20M-05n1 Address Renewal ❑ Employment Lost Card /ee ...._....__. ........................_...._.. . ao�r�raooacae«lC/ �L✓ruroaa/udeCtd \ -Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 1:53567 Type: Office of Consumer Affairs and Business Regulation ij�v_ xpiratlon: :::--1:21.;1:6/20:1.6 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 PE COD INSULATi1ON:,.INC NRY CASSIDY REARDON CIRCLE` g YARMOUTH, MA 02664 Undersecretary qNvalld wi 6signe I lie Uommonwealth of Massachusetts Department of Industrial Accidents j Office of Investigations _- ^ 600 Washington Street }A, Boston MA 02111 ,, wivw,mass,gov/dta Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organizatiorvindividual); "1 TIN .. Address; J) �Glliv �j �tRYIAA, City/State/Zip; i P' Phone #; � W ` '�r,� • ) tYv Are you an employer? Check tb• appropriate box; I. ,l am a employer with ' 4. 7 1 am a general contractor and I Type of project (required): employees(full and/or art-time ,* have hired the sub-cont ew construction p ) ractors 6. Q,N ruction 2,❑ 1 am a sole proprietor or partner- listed on the attached sheet, 7. 7 Remodeling ship and have no employees These sub-contractors have working for me in any capacity, employees and have workers' ' 8' Demolition (No workers' comp, insurance comp, insurance.t 9. ❑ Building addition required.) 5. 7 We are a corporation and its 10,❑ Electrical repairs or additions 3,❑ I am a homeowner doing al I work officers have exercised their myself, (No workers' comp, right of exemption per MGL l I'❑ Plumbing repairs or additions insurance required.) f C. 152, §l(4), and we have no 12,❑ Roof repairs employees, (No workers' 13• Other ' - comp. insurance required,) *Any applicant that checks box bl must also fill out the section below showing their workers' compensation policy information, r Homeowners who submit this afd:avit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attaphed an additional sheet showing the name of the sub-conq•actors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers' comp, policy number. I am an employer that is providing workers' compensation insurance for my employees, Below is the policy and job sr.'te nfp,rmalion , r Insurance Company Name; Policy # or Self-ins, Lic• j Expiration Date: I 1 Job Site Address City/State/Zi ; lw Attach a copy of the w6KOrs' coriipensation 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�nprisonment, as well as civil penalties in the for n 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 insura covera e verification. I do hereby certify, d the pat an penalties ofperjury that the Information provide above s true and correct,���� Si nature; c� Date: Phone#, Offscial use only, Do not write In this area, to be completed by city or town offciu l. City or Town: Permit/License # Issuing Authority (circle one): 1, Board of Health 2, Building Department 3, City/Town Clerk 4, Electrical Inspector 5, Plumbing Inspector 6. Other Contact Person; n� L. CAPECOD-27 BDELAWRENCE 7613012016 CERTIFICATE OF LIABILITY INSURANCE TE(MMIDDfYYYY) ,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 pbiicy(les)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 Irf lieu of such endorsement(s)• PRODUCER CONTACT NAME: Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 A/c E t; /vc No:(877)816-2166 South Dennis,MA 02660 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Peerless Insurance Company-see LIBERTY MUTUAL INSURED INSURERB:ATLANTIC CHARTER INSURANCE GROUP Cape Cod Insulation,Inc. INSURER C: 18 Reardon Circle INSURERD: South Yarmouth,MA 02664 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 HEF EIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I SR TYPE OF INSURANCE OLSUBR POLICY NUMBER MMIDDIIYEYYY MM/DD�YY LIMITS LTR A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE a OCCUR CBP8263063 04101/2015 04/01I2016 PREMISES Ea occurrence $ 100,000 MEDEXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:k GENERAL AGGREGATE $ 2,000,000 X POLICY❑jECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: I $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER � B ANY PROPRIETOR/PARTNER/EXECUTIVE YN/A WCE00431901 06/3012015. 06/3012016 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 (,yes;describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (AC(3RD 101,Additional Remarks Schedule,may be attached It more space Is required) Workers Compensation includes Officers or Proprietors. Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18 Reardon Circle ACCORDANCE WITH THE POLICY PROVISIONS. South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ©1988.2014 ACORD CORPORATION, All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Permit Authorization ' mass save Form rM.21 ,�G thn CONTRACTOR Site ID: S00050139711 Customer: CRAIG SCHEUEK' I, CRAIG SCHEUER ,owner of the property located at: (Owner's Name,printed) 175 Five Corners Rd CENTERVILLE (Property Street Address) (City) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. Owner's Signature: Date: •e��e��eeeee�e�ees�e�eeeeeeeesee��ee�eeeeeeeeeeeeeeeeeee��eere�eeeee• FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Participating Contractor — Date Of'O Conservation.Services Group • S0 Washington Street,Suite 3000 • Westborough,MA 01S81 • 1800-480-7472 For Office Use Only Rev.102015 8 � A� Ne r- v TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2� Parcel Application # Health Division Date Issued 2 Conservation Division Application Fee Planning Dept. Permit Fee J Po Date Definitive Plan Approved by Planning Board Historic - OKH — Preservation / Hyannis Project Street Address ��� Village Owner L - �� �\ Address Telephone Permit Request � ���(\� 1�}�{ ( ex� Ioc Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project ValuaticnIFF Construction Type 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 0iother 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_ 3 Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:�I �— 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 �� ` Telephone Number Address . ll;� License # Home Improvement Contractor# v Worker's Compensation # r ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROOJ�CT WILL BE TAKEN TO SIGNATURE DATE W4 k FOR OFFICIAL USE ONLY " APPLICATION# DATE ISSUED V r r= MAP/PARCEL NO. i f, ADDRESS VILLAGE OWNER DATE OF INSPECTION: xF=.FOUNDATI.ON;}��������;�; s-�;,��,r.,�,;,f•, f FRAME w INSULATION w FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH t FINAL GAS: ROUGH FINAL r r FINAL BUILDING. -" DATE CLOSED OUT F, ASSOCIATION:,PLAN NO. �RMp�R: ass.save i $;rFinei::iunuglt'n,)cq:3Y`Iflriga^(.y - - • 1 PERMITT I -7 A.. owner of the property located at: si (Owner's Name, printed) Od (Property Street Address) (Cityrrown) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. Owner's Signature Al� r Date FOR CSG OFFICE USE ONLY 1 Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Participating Contractor Date Rev. 12132011 ' r i The Commonwealth of Massachusetts Department of Indw&ialAccideftis r Office of Investigations w 1 Congress Street,Suite 100 Boston,MA 02114-2017 " www mass.gov1&a Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): TUPPER CONSTRUCTION Address:546A HIGGINS CROWELL RD City/State/Zip:WEST YARMOUTH MA 02673 Phone 4:508-778-0111 Are you an employer?Check the appropriate box: 'Type of project(required): 1. I am a employer with 10 4: 0 1 am a general contractor and 1 6. ❑New construction employees(full and/or part-time).*' have hired the sub-contractors 2. .1 am a so]e.proprietor or partner- listed on the attached sheet. 7. Q Remodeling shipand have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' insurance.- - 9. ❑Building addition coin [No workers' comp.insurance P• required.] 5. We are a corporation and its 10.[Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c.152,§1(4),and we have no VVEATHERIZATION employees. [No workers' 13.❑� Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing then workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new a Ilidavit indicating such. " :Contractors that check this box must attached an additional tronal sheet sh �'o ving the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my empkvees•.Below is the policy and job site information. Insurance Company Name:AEIC ' Policy,#or Self--ins. Lic.#:WCC5005593012015A Expiration Date:1013/16 Job Site Address: 69 Fox Run - City/State/Zip: Centerville, MA 02632-3673 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as,required tinder Section 25A of MOL 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 qb e coverage verification. I do hereby certify der th pains an penalties of perjury that the information provided above is true and correct Si nature: Date: 1/13/16 Phoneff: 508-778-0111 Official use only.. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical inspector S.Plumbing Inspector 6.Other Contact Person: Phone#' r ACORO® DATE(MMIDDIYYYY) �� CERTIFICATE OF LIABILITY INSURANCE 12/1/2015 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 - CONTACT Lora FitzGerald. NAME: Southeastern Insurance Agency, Inc. PHONE (508)997-6061 AIC FAX No (508)990-2731 PHONE No.Ext} 439 State Rd. E-MAIL DDRESS:lfitz@southeasternins.com a A P.O. BOX 79398 INSURERS AFFORDING COVERAGE NAIC q North Dartmouth MA 02747 INSURER Arbella Protection Insurance 141360 INSURED - INSURER B Boston Insur'anco Brokerage Inc Tupper Construction Co LLC INSURERC: 546A Biggins Crowell Road INSURER0: INSURER E- West Yarmouth MAS 02673 INSURERF: �. COVERAGES CERTIFICATE NUMBER2015-2016-1 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 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. ILTR TYPE OF INSURANCE ADDL UBR POLICY NUMBER I MD POLICY EFF MMIDD EXP LIMITS R COMMERCIAL GENERAL LIABILITY - r I EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED A CLAIMS-MADE OCCUR - PREMISES Ea occurrence E S 100,000 9520045208 11/1/2015 11/1/2016 MED EXP(Any one person) I S 5,000 PERSONAL&AIN INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 ' ❑ PRO- 7 LOC , X POLICY JECT - - PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER: Is AUTOMOBILE LIABILITY - - - -COMBINED(EaSINGLE.LIMIT �S '1,000;000 ' ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED AUTOS R AUTOS 1020009389 12/1/2015 12/1/2016 BODILY INJURY(per accident))S R HIRED AUTOS R -NON-OWNED i PROPERTY DAMAGE ,$ 1 AUTOSPeracddent Uninsured motorist BI split limit $ 250,000 UMBRELLA LIAR �_I OCCUR - EACH OCCURRENCE $ A EXCESS L[AB I I CLAIMS-MADE AGGREGATE S DED RETENTION$ 14600058368 11/1/2015 1171/2016 $ WORKERS COMPENSATION I P R TH- AND EMPLOYERS'LIABILITY - STATUTE ER ANY PROPRIETORIPARTNER/EXECUTIVE YIN .. OFFICERIMEMBER EXCLUDED? _ ❑N 1 A .E.L.EACH ACCIDENT _' $ 1,000,000 B (Mandatory in NH) WCC5005593012015A �.10/3/2015 10J3/203fi E.a_.DISEASE-EA EMPLOYE $ 11000,000 . If yes,describe under DESCRIPTION OF OPERATIONS below. E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) - - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For informational purposes Only THE EXPIRATION DATE THEREOF; NOTICE WILL BE DELIVERED IN Tupper Construction CO.,LLC ACCORDANCE WITH THE POLICY PROVISIONS. 546A Higgins Crowell Road W Yarmouth, MA 02673 AUTHORIZED REPRESENTATIVE Lora FitzGerald/MEM ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD I NS025 i2cuoi i r - C� i ✓d ���1'� l s f� a &t, 0'f� Office of Consumer Affairs and Business Regulation. 10 Park Plaza- Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 178434 Type: LLC Expiration: 4116t2016 Tr# 251075 TUPPER CONSTRUCTION CO, LLC. RICHARD TUPPER 79 6 MID-TECH DR. --"W. YARMOUTH,MA 02673 'Update Address and return card.Mark reason for change: Address ;`; Renewal Employment Lost Card 8CA i a 20M-Gal l — r<�>ie Yt.�,r,�iai�u_�rr/fir cf"Jlr.:;arinr/lr Office af.Gnstiromer Affairs&Business Regulation before or re•istrattion valid for iDdividul use only :j�oxpiegiM E IMPROVEMENTCONTRACTORbefore the ezp' data (f found return to: stra0.: 178434 Type: Office of C ffairs and Business.Regulation ration: 41i612t}16 LLC 10 Pa aza-Su' }5170 � sc� Str ,11-IA02114 jr TUPPER CONSTRUCTION CO,LLC. f I J i ) � t r RICHARD TUPPER 79 B MID-TECH DR. W.YARMOUTH,MA 02673 Undersecretary Tla tthout signature M;jssacbui;stts Oe r;r,an or Pubic Sa erg 3UILDiNG PERFORMANCE INSTITUTE, INC Boam o4 'd., Reau zt.c,^.s asd i07 Hermes Road,Suits 210 `GiNie+iu,i,ii SU�?c Ti,++,'e _ Svid[r,NY 12020 - License- CS4690M (87iy274-1274 wmr.bpi-org Richard S Tupper_ 546 A H�ns Crc*ell Bjw&d West Yarmouth 1VL4 ram, Richard Tupper Bpi IM:WA.C840 commissione, i 12J3112016 �, -c•; - ZScEnyFriiFSIDE 79rr_:fu:�i Gtia%:'i�-n�:, Unrestricted-Buildings of any use group Wbicll Contain less than 35.00.0 cubic fed(99ln 3)of �I paa�siCNatr>S,•��,ATc.I, _xPirxs:an 7n enclosW space. Building Analyst Professional 5IM2018 Failure to Possess a current edit*n of the Ntassachusetts State Building Code is cause for revocation of this license. For DPSllcensinginformationvisit: www.mms GovjoPs !BUILDING PERFORMANCE INSTITUTE, INC TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map `�V Parcel Application Health Division Date Issued Conservation Division Application F . V NJ Planning Dept, Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address / '7 5� F1 UE e-,0RpE R S 12D Village C16 MT-F:iZ vi LC-G Owner Address /7 V" Fl da c_oRA1z5kS Ro., Telephone 33 Permit Request BUILD n/&r.J -Da C)c --0 KbPLACE Ex l,T%/A G 0 c0C Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �5V O Construction Type 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 2 new Pr Half: existing new Number of Bedrooms: 3 existing eF new Total Room Count (not including baths): existing :3M) new S,4inG 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= �N Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ g }; -0 Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use Y " 4 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) - Name M+f-jk M U-4,, , Telephone Number Address ''7 CO Knfr MARA (,v A `/ License # r 041076 7— '� i'' 00-rd '4 0,)62 Home Improvement Contractor# Email 6N\ULz 1I1_1 Worker's Compensation # `ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1�,AIZOSq -- buMR3 'EP,, SIGNATURE ✓� �?�� DATE t FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: ► FOUNDATION �� S�N� 1III? IS � p FRAME C66D' qut /G INSULATION ! ISO FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING J Zit DATE CLOSED OUT ASSOCIATION PLAN NO. 77ze Corr niorrivealth of Massrrclrrmetts Repax•aavitce, rndustWalAcciderds f�,f-ce o,f fi vestrgadg= 600 Washington Street , Baston,M4 02111 ' imp'kf?nias—sgovIdia Workers' Campensatian Insurance Affidavit Builder-s/£:ontrartursJEIectricians/Plumbers Applicant InformatiGn Please Print f eadb .Name�1LSQ���an1Z34ionFfnd n �I- //(�41�i� rn U��/�� Address:- -7 C OXI AJ E 002.4 city/statelzip_ Lem. H M IN --X3 Monet' Are you an employer?Check the appropriate box: Type of project(required).: 1_�am a employer u7tb�_ 4 ❑I am a beuetal contractor and I ype p ] full and/or part-time).* have hired.the sub-contractors 6. ❑New construction ' employees� P }-- �_ Reaaodelin Z.❑ I.am a sole proprietor or partner- listed outhe attached sheet. ❑ g These sub-contractors have slip and lunge no employees. 8. ❑Demolition wotIcing for me in any capacity. employees and have workers' 9. E]Building addition [Na workers'camp-incUMM5 comp-insurana-0 required-] 5. ❑ Ne area corporation and its ltl_❑Electrical repairs nor additions 3.❑ I am.a homeoumer doing all work• officers have:exercised their 11-❑Plumbing repairs or additions.' sod€ o workers right of exemption per 11 iGI �' � 'gip- 12.[1 R-oofrepairs insurance required.]i c.152, §I(e},andwehaveno employees-[No workers' 13-❑Other ` comp_insurance required.] *Any applicantd mtchec3s box 91 must also fill out the sectionbelowshowingthe¢woiserecompensatanpolicyitfbnnzd0nL t Homeowners who submit dlii.ar5dmir m&cztmg they are doing all wa3c and diem hire outside contractors must submit a new affidavit indicating McIi IC'antrsctors That rhea this boot must attached an additiaaal sheet shoeing the more of the sub-cantr=taTs and state whether ar not those entities have employees.Ifthesub-cantractveshave employees,they=atpmuide their uvrken'mTnp.palicy aumber_ lam an erripIoy�trr f7tatispraxzdur �urrrk¢rs'cranspertsrrl�irrt itssrirarrce for xr}*¢nrptayes 8e£aev is fiT�¢patiry and job srte� hiformafiom Insurance Company Name: Z'U'R l C K Podicp or S+rlf isle_Lie: (� Z U a� .S9 c �o` -�� Expiration Date: //-/�9_- Job Site Address: 176-- r_WV�e-O R A)��'/2p City/S tat elzip: C�✓��R V l �L� ti'IA Attach a copy of the workers'compensation policy declaration page(shoWM9 the policy number and espiraiion 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$1,50a oa ana.,'or one-ye-arimprisosmieut,as we11 as civil penalties.in the form of a STOP WORK ORDER and s fine of up to$250-00 a day against the violator. Be adidsed that a copy of this statement maybe forwarded to the Office of ' Istvest gations.of the DIA.for insurance coyet'a a yerifrcation. I do£iemby cexlif}r tinder the pains �azidpenaYes of g'urp that tlte informafiou prarrrled abmv is 6=and correct Sim tune. /l� d�f�.�' -. Bate: Phone g. �`08 oZ�( g OB al use mi£y. Da mat write in this area,to be calnpietesd by city artamn oficiaL City or Ton'u: PermitlLicense# Issuing Authority(cu.-cIe one): I.Board of Health 2.Buil ng Department 3.Q.tyfTorn Clerk d:Electrical Inspector S.Plumbing Inspectcir 6.Other Contact Person: .., Phone it: -- — - 6 Laformation and, Instrncfions Miecarhrusefts Geheral Laws chapter 152 regi-es all employers to provide waH[ers'compensadDu for tbeg employees_ pursu�tto this stye,an=pLyne is defined as"_.every person in the service of another uader any contract ofhire, express or implied,oral or writfnn." An,77TIayB is defrned as-anndividual,parinersbip,association,carporation or otter IegaI entity,or any two or mare in.a-out e,and including the legal representatives of a deceased employe,or the of the foregoing engaged J �P� _ _ 0 other I enti employing e loyees- However the or trustee of an individual,partnership,association r. er legal ty,euip Y� mP receiver P erch,P owner of a.dweIIiag horse baving not more than three aparfmmts and.-Who resides therein,or the occapant of the - dwelling house of ano$er who employs peisans to do maintenance,construction or repair work on such dweIing house or on the grounds or building appintemsnt thereto shag not becanse of such employment be deemed to be an employer." MGL chapter 152,§25C(6 also states that"every state or local licensing agency shall withhold the issuance or renewal of a Iicerise or permit to operate a business or to construct buildings to the commonwealth for any e insur2nce,coveXa e required:' ' t who has not produced acceptable evidence of compliancE with the g qn a Iican w p P PP - Additionally,MOL chapter 152, §25C(7)states"Neither the comman�vealth nor any of its p olitical subdivisions shall enter into any contract for the performance ofpublic wont until acceptable evidence of compliance wifh the inmumce._ requirements of this chapter have been presented to the contracting airfhoiity:"Applicants Please fill obt the,wodcers' compensation affidavit completely,by checking e- boxes that apply to your situation and,if e o 1h their certrfi c s of necessary,supply sub-contactor(0)name(s), address(es)and phone numb r(s) along vri �() inzance. Limited Liability Companies(I.LC)or Limited Liability-Partnerships(LLP)with.no employees other than the members or par tiers,are not required to carry workers'compensation ns rance. If an LLC or LLP does have employees,a policy is required. B e advised that this a$daYrt maybe submitfr;d to the Department of Industrial Accidents for confirmation ofin�oe coverage_ Also be sure to sign and date the affidavit The affidavit should be retrmmed to the city or town that the application for the permit or license is being requested,not the Department of Tnriri s Accidents. Shouldyon have any questions regarding the law or ifyou are required to obtain a workers' compensation policy,please call the.Deparfinent at the number listed below siaed Self-io companies should enter their s elf-i-j sj=ce Iiceose number an the appropriate line. City or Town Of Facials Please be sure that the affidavit is complete and printed legibly. The Deparlmenthas provided a.space at the bottom of the affidavit for you to fM out in.tte event the Office ofIuvestigations has to contactyon regarding the applicant. Please be sure to fill n the pemitllicense mrinber which will be used as a reference number. In addition,an applicant that must submit multiple pennitlLicensa applications is any given year,need only submit one affidavit iadira�g current policy bafbrniatian(if necessary)and under"Job Site Address" i�ie applicant should Wr, "all locations n (�'or town)_"A copy of the-affidavit that has been officially stamped or marked by the city or town maybe provided to the ' applicant as proof that a valid affidavit is on file for fitore permits or licenses A new affidavit must be filed out each year.Where a homeowner or citizen is obtaining a license or permit not related to any business or commercial venttz<e (i.e. a dog license or permit to bum Ieaves etc.)said person is NOT rtTiir d to complete this affidavit The Office of Investigations would Ike to thank you is advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone and fax number: The C�o.MmM tbL of Massachu&ttbl. ' Daparbnent of ludusfiiak Accidents ace of ve gkf�a> �Q4tQu Sit Tf,-i:#617727-494G ixt 406 or i-�� Fax#627-727 7M Revised 4-24-07 maQ��c�a A1YC Guide to Wood Coizstwzdo.Tr L7 H4,-714 end Areas:110 xtph WfadZom-- Massachusetts Checklist for Camp anc:e (790 CKR 301 [.L)l .. - C�mp[iancc 1.1 SCOPE. lVlnd Spetpd{3-sea' 110 mph Viand Exposure Caiegary__-___._ ---------•-----------___-__~_._�-�B Wind Exposure Gatagory..:.............Engineering Requirad For Entire Praject----------------------------------._C . 12 APPLICABILITY . - ' -Number ofSbbdes(a roofwhirh axceeds B in 12 slope shall be considered a story) stories 52 stories Roof Frizh -(Fig 2) ---•--- ---- <_1212 Mean Roof Height —f{ s'KT Building Width,W___•-•-----=------------_--_--(Fg 3)--_- Buiid'utg Lengffi,L -----•------------ -- --(Fig 3) _ Bulding Aspect Ratio(LU) -•-=Z 4)-------------_—_- -s 3.1 Nominal Height of Tallest Dpening __-.-__•--__-.---(Fig 4) 12 FRATA.[ G; CONNECTIONS General compliance wlh framing conn6c&ris_ .-__-:-(Table 2)________-:--_--------------�.__.-. 21 FOUNDATION Foundation Walls meeting requirements of 780(.-;MR 5434-1 Conte--------•------ ...................................__ -- - _. --`- Concretp-Masonry.-•- --------=-- --- -- ------ ------ -- ----=- 22 ANCHORAGE TD FDUNDAT[D]41t3 5J8'Anr-har Bons*imbedded or SIB`Proprietary Mechanical Anchors as an alterhaffve in concrate anfy Bolt Spacing-general----------------------------------.{Table 4) __-__-____ - in- Bolt Spacuig from androint of plate---" . _(Fig 5)-_____�---___ Batt Embedment-concrete_,. - --_-(Fg 5)._-:------------;___-- in.->7" Bolt Embedment-masonry--.-, ,-.:_-----•--(F►9 5)-=-_----_--------.. in_>15" Kate Washer__---_—_--- ------•__(Fig 5}-- _-- -- 3`x 3"x tl�" 3.1 FLOORS Floor•frarning member spans (Per 130 CMR Chapter 55)------ _-- Maximum Floor Opening Pimerrsion-- ft<-1 Z FuA Height Wall Studs at Floor Openings less than Z'from Exterior Wall(Fig 6)-------------------------------------- Maximum F1oorJo1st Setbacks SuppDMngLaadbaaringWafCsorShewn all-----'-(Fig 7).___-__.____.----------_-_ftSd Ma)dmum CanfleveredFloorJoists, Su Lead ppcatng bearing Walls orShearwall--- (Fig B)--------------=---------=--- fts d FloorEracing at F:ndwaIls-:___---._:_---------------(Fg 9)__ Floor Sheathing Type :-----___-- -----._. _---_(pet 7BD GMR Gfiapter 55)------,-----__---- Floor Sheaththing Thickness (per TBD GMR Chapter 5.9 Floor&heatNng Fastening------------___'___--_-. _._.(fab[e 2)__d nails at 'in edge/_in field 4_t WALLS , Wan Height ` L.aadbaarkq wafts = ___. __._ -(Fig 10 and Table 5) _ _ft 51 D' Non 4L ad1>mdng walls ----(Fig 10 and Table 5) -_ -__ ft s 2[r Wall Stied Spacing 10 and Table 5) _[n 5 W a•d: Wall S1gry Offsets --_--- {Figs 7 8)=-- -__--- $ c d , 4-2 Ln-EPJoRWAL& Wood Studs Crradbearih vra[ls --.fix -n ft , in. hlorz-Laadbeating�ra[[s.__�- _--_------- {Table S)---- --•--•---_2x ft in_ Gable End v►rafl Bracing Fufl Heidht Endwall 5fuds..._ W -Ai3c Hoor Length ___._ -(Fig 11} - _ ft LW/3 [gypsum Ceiling Length Cif WSP oat used) _-._,(Fig 11) ----- -- _ft z 0-9W - and 2 x4 Continuous Lateral Brace @ 6 fit o.c._(Rg 1 _................x • or'i x 3 ceiling furring strips @ 16`spacing-min t�i 2 x 4 MDi--an' g @ 4 ft spacing in end Joist or bays - Double Trip Flafi� r i . Sprk--e Length -- -(Fig 13.and Table 5)�- --•--- fr Spftr�a Connection(no.of 16d common nails) 4 FVC guide to f-Food Carfstrucfian irc lIigfr FYZnd Areas: 110,arpft err d Zone ' Massacliuseffs Checklist for Comp.jaace(rso Giv1R53ol.?1-1)I Laadbearing Wall Connec5ons - Nan-Laadbearing Wall Cones ions Lateral(no_of 16d common na lsj--_ _—(Tpbfe ------ Load Bearing Wag Openings(record largest opening but chat is all openings for cDTripGance to Table 9) Header Spars _--_------- - -----(Table 9)—:._._ _ft_in-`11t Sill Plate Spans —_—_ —_. ---(Table 9)____—,----_--_-_ft—nn.�5 11 FL A Height Studs (no. of-sfuds)-- --_(Table Non-Load Bearing Wall Openings (record largest opening btrt check all openings for compriance to Table 9) Header Spans--------_—_.----._--__:--_--__Ci"abfe 9)____-__-- --- f_in.512` Silt Plate Spans__-_ __(Table 9)__-- — _ft_in_51Z Fuf!Height Studs(no_of studs)----- _(Table 9) ---------___--- -----•- E�rior Walt Sheathing tD Resist Upfa't and Shear Simuftaneously4 Minimum Budding Dimension, W Z ----- -- - —�6'B hloaninalHeight ofTalle$tOpening ...--•_-----------_----------- Sheathing Type------ ' —_------(note 4)----------------.-- Edge Nail Spacing --_--_- --.(Table,10 or note 4 if less)---------____-- m Feld Nail Spacing-_--- _--- ----(Table 10)__—__________--- — in- Shear Connection (no_of 16d common nails)(Table 10)___—_�--- =--- ----- Percent Full-Height Sheathing__--------(Table 1D)___—.___—_______.--------•-_'�� 5%Additional Sheathing fDr Wall with Opening>Val(Design Concepts),_—_-____—__ Ma)dmurn BuRfi ng Dimension,L NornirA Height of Tallest 0 enin Sheathing rYPe------^------_(note 4)------ -------.--- Ed e Nail Spacing _-- able 11 or note 4 if less)--------___-- in_ Feld Nail Spacing---___ —_—=(Table 11), —_— in- Shear Connection(no_ of 16d commm nails)(t-able 11)______ Percerit FuMeight Sheathing—_ (Table 11)_— 5%Addrdonal Sheathing for Wall vvrh'Opening>68'(Design Concepts)-----_----•- Watt Cladding Rated for Wind Spy?---- -— ---- -- -- — -- ---- S_1 FLOOFS - RnDf framing member spans chedced7-- _(For Rafters rise AWC Span TD_OL see BBRS Website) Roof Overhang -__----_--- ------(Figure 19) --------_ft s smaller of 2'or L13 Truss or Rafter Connectii;ns at Loadbeadng Walls Proprietary Connectors ; ---- .(Table 12)----_—__ —w U= plf 'Lateral__--___------------(Table 12)_ - ----—L= Pff Shear-------— --- --—gable 12}-- - --- — P�. Ridge Strap CDnnecSDns,if collar ties not used per page 21__- (Table T= plf Gable Rake Otlfjooker___._.____..__—.______-----(Figure 2D) •_---•—__ftssmallerO_f2`orLIZ Truss Or Raft Cannecfions at Non,[_uadbeking Walls Proprietary Connectors _— —.(Table i4)_-- -- U= lb. Lateral(no_of 16d common nails)_.(Tables 14)-----------------------------------_f _ lb. . Roof Sheathing TYpe___ _-----_(per 78D CMR Chapters 5a and 59)............ - Roof`Shea',thing Thickness mess__--_-- — --_— — _in_-:7116'WSP Roof Sheathing Fastening—_--- __(Table 2)--_---:---- --- — NDteS: - - - -f. This Est shall be met in its entirety,excluding the spedffC exception noted in 2,to comply wrfth the raquirements of 760 CMR-530121.1 Item 1. ff the checldist is met in rls enn2fy than the following metal straps and hold downs ara not required per the WFCM 110 mph Guide: - - a_ Sfz:�e!Straps per Figure 5 b. 2D Gage Straps per Figure 11 W - - c UpFi t Straps per Fgura 14 qL Ali Straps per Figure 17 e_ Comer Stud Hold Downs per Figure 1Ba and F►gure 1Bb _ 2- 'Exception:Opening heights ofup to 8 ft shall be perms when 5%is added fD the percent full-fieight sheathing nacli.Aht mis shown in Tables I and 11_ a- The bDilnm sib platy in exterior walls shall be a minimum 2 in_nominal thickness pressure t-eated#2_72ia e_ ` ATVC Guide for Wood Carrvirua dare iirl-iig7tr IrindAreas_ I10,7zpfr JY1_-z1d 70ae ` Massachusetts CheckJist for Compda*nCa(790 CNTIR53.61 I:1)4. a_ From Tables 10 and 11 and Iocaf5Dn of WaU sh'eatiling and Building Aspect R flo,determine Perc&nt Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels sEral►be minimum thidmess of 7116'and be installed as follDw_— L Panels shalt be installed With strength axis parallel to stuns. Ti. AU hor3mntal joints shall occl.u-over and be nailed to flaming. M. On single stoty mnstriiL—b n,panels shall be attached to bottom plates and top Member of the double top plate. fit. On tvm story construction,upper panels shaft be attached to the top member of the upper double top plate and b band joist at bottom of panel Upper attachment of lover panel shall be made to band joist and lover attachment made to lDWeSt plate at first floor framing. v. Horizontal nail spacing at double top plates, band joists,and girders shall-be a double Folk of Bd staggered ilt 3 inches on center pf r figures betovr:Vertical.and Horizontal Naff ng for Panel Attachment 5_ Glazing protedi=a)'nevt house or horizontal addition—required if prnject'is 1 mile or dosarto shore(generally,south of Rte.ZB or north of Rte_6) b)vertical add_rf 6—not requlred unless there is extensive renovadon to the first floor c)repiacesnentivMdovrs—needs energyconservat Dn compGari�Dnfy(chap 93) fi-1Nood Frain e Consruucbon Manual(WFCM)for I ID MPH, Exposure B maybe obtained from the American Wood Council (AWb)wabsite, ' =. T [15ESd r.VtiL� - tl a! If 1 • .,,1 It 1.� ,t _ is 1 K 11 r r L 1 Ia tt rl, rI H' F -'�<' ,• r 4 r U , , , ti rr I rIf I n < < .a ir u is tt PZ - i 1 EDGE l— . tic t t If It r r L I [ t rr �t r�rx ten c I ` STAGGERED 3`RdYd • €�A>F.:S�hct�1G + ". t � t�tLPR71H3t1 � PAHEL - PX1 _. — _ ''-� >r�� . ." � QQtIef�bL4fL13�GEs?AGLY>iDt_IAL - • See Dala11 on hlexf Pagt:. -Vertical and HDrizflrrtal}wiling QetL r. - � V=rilr�i Arid Hotiz-cnial Naiiirg.' ' - far Panel Attachmnt.> fblr Panel Aiiacl-Lmerit p b . MULLIN ROOFING & SIDING INC. CONSTRUCTION CONTRACT • This Construction Contract (the "Contract") is made and entered into as of 10-14-15 (Date), by and between Craig Scheuer (Name, hereinafter called the "Customer") and Mark M. Mullin, DBA Mullin;;;' Roofing and Siding, Inc. having its principal office at 7 Connemara Way, W. Yarmouth MA 02673 (hereafter called the "Contractor"). T Property Location: 175 Five corners rd. Centerville, MA In consideration of the mutual promises hereafter set forth and intending to be bound hereby, the parties hereto agree as follows:_ Contractor's Obligations. Contractor shall complete the following Project herein described in and shall provide supervision necessary to commence and finish the Project expeditiously, in a workmanlike manner, in accordance with the "all applicable codes, laws ordinances, rules, regulations and orders. Remove exisiting roofing while protecting the home and landscape. Nail down any loose roof decking to ensure a solid roof deck. Install ice and water shield on all eaves, valleys, around pipes that penetrate the roof, and around the chimney. Install Diamond Deck-roofing underlayment by Certainteed over the remaining roof deck. Install Swift Start starter shingles on all eave and roof edges. Install Landmark Pro roofing shingles by Certainteed to factory specifications. The color of the roof is to be &,ANT S1eN1Y*- After completion of'yod0toof I' . will register your roof with Certainteed for the four star Sure Start warranty. Install Typar Dome wrap over the exterior walls. All seams will be taped with Typar tape. Install new.grade A white r shingles using galvanized staples and nails for finished co rses stall new four inch cedar g g g P . , , . exposure primed red cedar clap boards on the front of the houssrng�s ,tnless steel als. Install new white seamless gutters and downspouts. Remove and replan the fascia; ord on the left side of the house with composite trim. Remove and replace all oflhe!:Akes a'id cornerboards on the house with composite trim using stainless steel fasteners. Red ';ce the trim under the sliding doors using composite trim. Repair garage siding where thee` are holes in the siding from woodpeckers. Install a new Thermatru fiberglass garage entry d`.: r. Build `n.ew=deck on=the.backzof the house using pressure=treated-lumber=for-framing�and_,iecking with, a,,step=around=the�entireideck� Remove and replace the trim to the left of the entryway. Remove and replace all of the ear boards with composite trim. Install trim around the sliding doors. Install new composite trim around two existing windows. Remove--g-ar_age-do_or;frameiin, -the -d=install new double-ca es mentwmdow=in=gar-age�wall.alnstall an awning window in the far bedroom. Install a single casement in the bathroom. Install a double casement window in back bedroom. Install ten foot double mulled casement windovon each side of one stationary window. Install four single hung 50 series windows in the garage, all other windows to be installed will be Anderson 400 series windows.All waste assocoiated with.this project will be disposed of properly by contractor. /6h�e_=4T . In consideration of the performance by Contractor of its duties and obligations, stomer shall pay to.contractor the sum of '$32,775 aOwner shall pay the contractor 50% of the contract sum upon signing the ntract,20% upon completion of roof and trim, and the remaining 30% upon completion of the contract work. actor's Res onsibili . Contractor is an independent contractor for all Work to be Contr p tunder the performed hereunder. The detailed manner and method of erfo midoing n Work shall Work undebth s Contract control of the Contracte Contractor's employees employeesontractor p shall be and remain th r shall supervise and direct the Work, using its best skills. a. The Contracto Contractor shall be responsible for initiating, maintaining and supervising all safety Job Safe . precautions in connection with the Work. Permitsary forFees and Notices. The Contractor shall secure and pay for all permits and roper execution and governmental fees, licenses and inspections neces shall bettheppr perty of the Customer and completion of the Work. Such permits and licenses shall be delivered to the Customer upon request. The Contractor o sl an'd orderstof any public comply with all applicable codes, laws, ordinances, rules, reg authority in connection with the performance of the Work and the Contractor's obligations hereunder. Insurance. Con tra acknowledges and agrees that Customer or Owner shall not be obli ated to carry any insurance in connection with the Work for the benefit of the Contractor. 9 Contractor's Insurance. Contractor shall at all times maintain entdneces ary keep in full f rce able forand effect the at its expense, any and all insurance coverage which is prud , . protection of the interests of Contractor. Contractor shall furnish to Customer certificates of insurance for the following types of insurance. a. Commercial General Liability Insurance; b. Workers':Compensation Insurance to cover full liability under the Workers' Compensation Laws. 'ect: This project will be started by October 19 20157 and will be completed W IPpay$150 - Timina by of prof P r, Contractor this is not completed by the er da each day that goes over the completion date/Only exception would be if we lose more . Y �O�han five days due to weather. v�G ►Ir1 IN WITNESS WHEREOF, the part ies hereto have executed this Contract as of the day and year first above written. Contractor Company Custom By: By: Mark Mullin, Mullin Roofing& Siding, Inc. Print: Craig Scheuer 7 Connemara Way, W.Yarmouth MA 02673 508 2218591 l� �� L��• 7� ����.:�;: ?� / ' � �°wr� "'� � � � x �jj� �� ` �' � �,� `� ? %� T � ��e 4 � ': w � �Y�'�i � 'lK` .�<`- - �4 k t� 7� &r .`v,' �y 3 �a t�•� h � �, .. >�-: :� � � _, �. d q� 1 �� Ps �� 1 DATE(MMIDD`YYYY) - �►coRo f"EkTIFICATE OF LIABILITY INSURANCE 5%11, CONFERS NO RIGHTS i15 THIS RIFICATE IS ISSUED AS A MATTER.OF INFORMATION ONLY E E D OR ALTER THE COVERAGE AFFORDED ABY THE PO C ETE HOLDER. IS CERT�FIC'ATE-QOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, O_ Ll�(u. THIS'CERTIFlCATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE;ISSUING INSURERS , AUTHORIZED ,FEpR NTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. to IMPORTANT: If the ifofthe policy,certain policies rllaNALlySequED�ari endolrsement A statement on this certificate does not conferDr�ights totthe the terms and conditions . certificate holder in lieu of such endorsemen s I CONTACT � NAME: FAX -1 07 _ PRODUCER A enc PHONE 508 295-2007 / No; (506) z91 7 ' In Y / � • J Gr assi si B Margaret E-rnaL insOcomcast.net 1188 Main Street AODREss: debm - - v .. COVERAGE NAIC# West Wareham, MA 02576 INSURE- S AFFORDING O INSLiriERA:.Atlantic Casualty Insurance Co INSURERS:Zurich Insurance - INSURED Mark M Mullin INsuREftc: 7 Connemara Way :,' INSURERD: k I .. West Yarmouth, MA 02673 t 4 INSURERS: tIRER F.. . . ' REVISION NUMBER: COVERAGESNSURED CERTIFICATE NUMBER: k • ' ISSUED RESPECT TO WHICH THIS THIS ATED.CNOTWITHSTANDING ANYIREQUIREMENTNTERM OR CONDITIO1 ` >siN CONTRACTO OR OTHER DOCUMENT 1NITH FOR THE POLICY PERIOD N INDIC ,g ..THE POLICIES CERTIFICATE MAY BE ISSUED OP'SUACH POLIAIN THE INSURANCE CIES.LIMITS SHOWN MAY HAVE BE I..I . UC.: BY PAID CLADESCRiIMS BED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CON Po" FF POU.CY EXP uMTs AODL SUER .POLICY NU NEER Mlmlly NMIDD/YYW ILTR IT TYPE OF INSURANCE D f 2/2E/15,� 2/26Z-i6. EACHOCCURRENCE $ 1,000,000 i - GENERALLIABILITY L117OO2`080 - , _� . 'DAMAGETORENTED A e $ 100,000 COMMERCIAL GENE PAL LIABILITY '. ME EXP(Anyone person) $ 5,000 CLAIMS-MADE �OCCUR PERSONAL'&ADV INJURY $ 1,b00,000 4 r �t GENERAL' GREGATE' $ 2 OOO:'OOO PRODU COMPIOP AGG $ 1 0 0 0 0 0 0 GENLAGGREGATELIMhTAPPLIES�ER"' PRO- LOC, ) tm C cGnt51NGLE LIMIT pOLICY �_ { � �4AUTOMOSILELIABLLITY �•' ) .. , � - BODILY INJORY(Periperson) f : i r BODILY INJUR`(-(1�e'accldant) t ANY AUTO ¢ « SCHEDULED AUI'ELOW D a. AUTOS .�"7r - • .PROPERT AMA YDGE _ TOS NON-OWNED ',' HIRED AUTOS AUTOS s x _ -.i ` hr..` ,EACH OCCURRENCE, : AB LI OCCUR LLA 'OCC RE $ y. ft tip'?i ` �UM1m'8, �A<. .t;.. AGGREGATE pcCES$�LIAB S' <,. CLAIMS-MADE -DEp `'^.'RETENTIONS ,_ 11/18/14 11/18/15 WCSTATU- OTH- i W. B_ 6,5'COMPENSATION 6ZZUB-2E59306-8-14 $ 100 '000 Y, ,bEMPLOYERS'LIABILITY YIN E.L.EACH ACO CE Nr J1'PROPRIETOR/PARTNER/EXECUTNE -77 N/A EMPLOY EE 100'.0:0 0 r� ,OFFICER/MEMBER EX JCLLDED7 E.L.DISEASE-EA ,.$ (Mandatory mNH) ! � 5.'00 000 If yes,describe under -. ;. E L.DISEASE-POLICY LIMIT''$ �. .DESCRIPTION OF OPERATIONS belowk,, •'' "�� ti 04 i DEScRIPTIONOFOPERATIONS/LOCATIONS/VEHICLES (AttachACORD101,AdditlonalRerte,keSchedule,Ifmorespacelsregdred) LN Ar K _ - ^^, . Massachusetts Department of Public Safety � Board of Building Regulations and Standards `�ILI License: CS-104076 ` Construction''Su•Pervisor MARK M MULLIN 7 cONNEMARA WEST YARMOU7H M _ Expiration: 0910712017 Commissioner ' - �lze ipoaninzoavcuea�Cli a��aaoac�ic�eGt�, Office of.Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR gistratioq 1f7281 Type: xpirahan 8J.3,QJ2016 PBA MULLIN ROOFING ANC?SI[SflG MARK MULLIN 7 CONNEMARA WAY W...YARMOUTM MAU2673-1 Undersecretary, • only valid for individul use istration return to: License or regiration date. If found a ulation before the eM) ' ffalrs'a'd Business R $ Office of Consumer A aza-suite 5170 j. lOParkMA02116 _ Boston, t s ' nature u g Not valid wrtho r . 0 1 do� ce u(c�o Ids � �� , "��-�;` � �� ����� � � ����.� -x 5� �,.� ,r r 3fi � � � � ,� �� � � 4. ;�„ ` � � � � � � Ax � ��� Yam..� � ..3: ..e:r�'.,.>. 3: .,','�� .. �. ' i ;�+dN� 7 5'cop-rc5" Ax. o-/A a- I ' I UO ` I /IT i r s AC- 1 X d T(715T S ►(o C� •L • _ I"f}l o .CA K TD t� w L�1 y l f 7x L J2.T2�f I N.G fl ` i/ won7Z�f fir.' r= /V A (1 f i v/1`�1 Ass'essor's offioe (1st floor): E T Assessor's map 07® ,and lot number ....... ..... Q FNl �" o� Board of Health (3rd floor): o Sewage Permit number ....... � :. ?..e:O L BAE39TADLE, S Engineering Department (3rd floor): oo 16}9-. e� House number ...............................�.0. ..�... ........ � ' i° a` 0 ypV APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only, TOWN OF BAR.NSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... '. .�.. .......1. ......?<... LV......19. .�' .5?"... ... .. ........................ TYPEOF CONSTRUCTION ..................................................................................................................................... , .......................0.r- d2. -..19..U..-t TO THE INSPECTOR OF BUILDINGS: The undersigned �� hereby applies for a permit according to the following information: Location ... l..l.... � . .�.. . ....r... �.c_..................................................... I '1-3 _. Proposed Use `�' .......................... .................................. . ................ ...................................................... ..............................................Fire District Zoning District .............. :.... .............................................................................. Name of Owner ....... Qi.1�. ..1.5.... .�......... .�.\1+.�q dress ........A. ..... .A. . .............................................. I; Name of Builder �;�. . �S;�.N.S. .� .C�.�.4..1�.... �.. Addres ..l..1GG, .Qi�4.���>..4.1�.,....... Q4S.�. ..tC1�� Nameof Archite t ............`....................................................Address ..................................................................................... Number of Rooms Foundation uv S 1 CoNe�C� � .............................................. ....... . .................... .. . ExIerior� \ •1�i1 ..1.\N (.Z—.x.1.. ...\.131�..(!".....................Roofing 0.4 .—<.. .\�.F..S�....97. .1�4.w.4T s Floors � ..................................................................Interior .......... . —' Heating .............. ...................................................Plumbing Fireplace p ..................................................................................Approximate Cost ............�..1..�.�. .....F.�:.v..............A...... Definitive Plan Approved by Planning Board __________________________ _ ...... S, r - ----�9-------- . Area. ........... .......... ® Diagram of Lot and Building with Dimensions Fee . �.O .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....... ... ... ........ ... ............... Construction Supervisors License �.�......................... MAGUIRE, FRANCILS J. No .3.10.0 3... Permit for Build Garaqe .... ..... ................................... r to Accesso Dwelling. j.......... ............................Y.......................... ..... Location ..........17 5.....Five Corners Road .. ............................................... Centerville ............................................................................... Francis J. MaGuire Owner .................................................................... Type of Construction .....Fr.arne............................. ....... .......................................................................... Plot ............................ Lot ................................ Permit Granted .......jLy...1.74.............19 8 7 Date of Inspection .............................. 19 Date Completed ........... ...... ...........19p? A-� 7 oF.►,E„ Town of Barnstable *Permit# fret nths from issue date Regulatory Services ;p ,0- * snnivsTneL& Richard V.Scali,Director ��A, . .row ill 9 zo Building DivisionI/OF�/ 15 Ner Tom Perry,CBO,Building Commissioner � 200.Main Street,Hyannis,MA 02601 g`q / c www.town.barnstable.ma.us ` Office: 508-862-4038 Fax: 508-790-6230" is EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X--Press Imprint Map/parcel Number �-°- �, n Property Address / 7 J /`�U�i C©Q K�'p�J C AtTF R U 1 L-�_E ❑Residential ` Value of Work$ � � 000 Minimum fee of$35.00 for work under$6000.00 4', Owner's Name&Address F 6 C O G RS C LLC— Contractor's Name Telephone Number �'O .2 a Home Improvement Contractor License#(if applicable) lj q & Email: Construction Supervisor's License#(if applicable) 16 7,2F Vorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I-am the Homeowner [✓ l have Worker's Compensation Insurance Insurance Company'Name Z UJZ (C Workman's Comp.Policy# t{i Z Z Q1 2 E 9 3 06 6 -SLY Copy of Insurance Compliance Certificate must accompany each permit. ' Permit Request(check box) 8�Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 8 01lossApclli ps'TEP, ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) RX -side Replacement Windows/doors/sliders.U-Value y0U(maximum.32)#of windows J— 1 r. #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S 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. ' A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIOl DHR\EXPRESS.doc Revised 040215 The Commonrswealth of Massachwaffs Department of Industrial Accidents 09we of Investigations ' 600 Washington Street , Boston,MA 02111 tvr nnmass.govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electiicians/Plumbers' Applicant Information Please Print Lembix .`.. Name(Budness/orgmiaatiewbdivianal)_ /��� K U Address: -7 C 0 L LMA P—4 (A/ A y City/State/Zip: RAJ , TAP YY1 0- L�` /'�114 Pho e S-d 8 9o)l Y�91 Are you an employer?Check the appropriate boa: 'Type of project e 1.0 - 4. I am a general contractor and I 3'Pe P ] ( ���� I am a employer with V— ❑ g 6. ❑New construction employees(full and/or part-time).: have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7_ ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition workingfor me in capacity. employees and have worms' �Y � ky- . ' I - 9. ❑Building addition [No workers'comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its ME]Electrical repairs or additions. 3.❑ I am a homeowner doing all work officers have exercised their • 11.❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]I c. 152,§1(4) and we have no employees-(No workers' 13.❑Other comp.insurance required.) *Any applicant that checks box#1 mot also fill out the section below showing their workers'compensation policy information. 1 Homeowners who submit this atTidacdt indicating they are doing all work and than hire outside contractors most submit a new affidavit indicating such koutructors that check this turn must attached,art additional sheet showing the name of the sub-coamutors and state whether air act those entities have employees. If the sob-coutractors have employees,they tmrst provide their workers'comp.policy number. I ant an employer that is providing workers'eonipeitsadon insurance for my employees. Below is Here policy and job site information Insurance Company Name: Policy#or Self-ins.Lie. F—IYExpiration Date: Job Site Address: 1`7 City/State/Zip:Cr=;X,9�E-P-(J/LL C J41 f- C).-Ig '7S 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 S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a Sae of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify nnder the pains mud penalties of perjury that Hhe information provided above is tore and correct Signature: Date: /D 9-15— Phone#' L pZ. Official rise only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: AC40 CERTIFICATE OF LIABILITY INSURANCE °A�`M"'°°"�"'") 5/11/15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement($). PRODUCER CONTACT NAME: Margaret J Grassi Ins Agency PHONE FAX 1188 Main Street BEN 508) 295-2007 N (508) 291-1707 ADDRESS: debm" ins@ comcast.net AIL West Wareham, MA 02576 INSURERS)AFFORDING COVERAGE NAIC# INSURER A r Atlantic CasualtV Insurance Co INSURED INSURERB:Zurich Insurance Mark M Mullin INSURERC: 7 Connemara Way INSURER D: .. West Yarmouth, MA, 02673 1NSURERE: 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 AWL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER M/DD/Y MN/DDIYYYY LIMITS A GENERALLIABILITY L117002080 2/26/15 2/26/16 EACH OCCURRENCE $ 1,000,000 COMMERCIALGENERALLIABILITY DAMAGE TORENTEDPREMISES(Ea occurrence) $ 100,000 CLAIMS-MADE OCCUR ME EXP(Arty one person) $ 5,000 PERSONAL&ADV INJURY, $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER PRODUCTS-CO MP/OP AGG $ 1,000,000 POLICY PRO- LOC $ AUTOMOBILELIABIUTY - COMBINED�SINGLE LIMIT(Eaaccide $ ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS _AUTOS aracddent UMBRELLALIAB OCCUR EACHOCCURRENCE $ EXCESSLLAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ ... ' $ B WORKERS COMPENSATION 6ZZUB-2E59306-8-14 1i/18/1a 11/18/15 WCSTATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTNE YIN E.L.EACH ACCIDENT $ ZOO 000 OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 100,000 If yyes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,irmore space is required) 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.. AUTHORED REPRESENTATIVE Debra Martin ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: MULLINROOFING@ GMAIL.COM Massachusetts - Department of Public Safety Board of Building 9 Re ulations ind Standards : Construction Supervisor._ License CS.t04076 Al , �, MARK M MULLLjV Y. 7 CONNEMARA WAY ' West Yarmouth MA 02fr7 Expiration Commisssio'nner` 09/07/2015 - . �6 -riznrluiea�l�o,�C•�/Gla:r9ac�u�c/% Office of Consumer Aflairs&Busiriess Regulation License or registration valid for individul use only _ OME IMPROVEMENT CONTRACTOR before the expiration date. If found return.to: gistrajtlon 7281 . �_ Type; Office-of Consumer Affaics acid Business Regulation xP!.raBea 8f072016 pBA, r 10 Park Plaza-Suite 5170 MULLIN ROOFING ANQ SI[ll`h(G ? Boston,MA 02116 a a MARK MULLIN " 7 CgNNEMARA WAY Y W,YARMOUTH,MA t)2673 Undersecretary Not valid without signature MULLIN ROOFING & SIDING INC. ` CONSTRUCTION CONTRACT . This Construction Contract (the "Contract") is made and entered into as of 10-14=15 (Date), by and � between_ Craig Scheuer (Name, hereinafter called the "Customer") and Mark M. Mullin, DBA Mullinx,z Roofing and Siding, Inc. having its principal office at 7 Connemara Way, W. Yarmouth MA 02673 (hereafter called the "Contractor'). _ Property Location: 175 Five corners rd. Centerville, MA 1 In consideration of the mutual promises hereafter set forth and intending to be bound hereby, the parties hereto agree as follows: Contractor's Obligations. Contractor shall complete the following Project herein described in and shall provide supervision necessary to commence and finish the Project expeditiously, in a workmanlike manner, in accordance with the "all applicable codes, laws ordinances, rules, regulations and orders. ' Remove exisiting roofing while protecting the home and landscape. Nail down any-,loose roof decking to ensure a solid roof deck. Install ice and water shield on all eaves, valleys, around pipes that penetrate the roof, and around the chimney. Install Diamond Deck roofing underlayment by Certainteed over the remaining roof deck. Install Swift Start starter shingles on all eave and roof edges. Install Landmark Pro roofing shingles by Certainteed to factory specifications. The color of the roof is to be mow;Siv-N1Y*. After completion of yodfl,?roof will register your roof.with Certainteed for the four star Sure Start warranty. Install Typar'A me ' " wrap over the exterior walls. All seams will be taped with Typar tape. Install new grade A white _. .; cedar shingles using galvanized staples and nails for finished co rses. stall new four inch exposure primed red cedar clap boards on the front of the hous siri-stainless steel q;0jls. . ,,.. r Install new white seamless gutters and downspouts. Remove and rep"la, the fascia o. �rd on ` the left side of the house with composite trim. Remove and replace all ohe'�rakes id . cornerboards on the house with composite trim using stainless steel fasteners. Replace the trim under the sliding doors using composite trim. Repair garage siding where thg7 are holes in the siding from woodpeckers. Install a new Thermatru fiberglass garage entry,dAr. Build new deck on the, back of the house using pressure treated lumber for framing and}decking with. a step around the entire deck. Remove and replace the trim to:the left of the entryway. Remove and replace all of the' ear boards with composite trim. Install trim around.Ahe sliding doors. Install new composite trim around two existing windows. (Remove garagefdoor, frame in the opening, and install new double casement window in garage wall. Install an awning window in the far bedroom. Install a single casement in the bathroom: Install a double casement window in back bedroom. Install ten foot double mulled casement wndo "on each side of one stationary window. Install four single hung 50 series windows in the garage, all other windows '. to be installed will be Anderson 400 series windows. All waste assocoiated with this project will be disposed-of properly by contractor. I v Contract Sum. In consideration of the performance by Contractor of its duties and obligations, hereunder, Customer shall pay to contractor the sum of '$32,775 Payment schedule: Owner shall pay the contractor 50% of the contract sum upon signing the contract,20% upon completion of roof and trim, and the remaining 30% upon completion of the contract work. Contractor's Responsibility. Contractor is an independent contractor for all Work to be performed hereunder. The detailed manner and method of doing the Work shall be under the . control of the Contractor.All employees of the Contractor performing Work under this Contract' ' shall be and remain the Contractor's employees. a. The Contractor shall supervise and direct the Work, using its best skills. Job Safety. Contractor shall be responsible for initiating, maintaining and supervising all safety precautions in connection with the Work. Permits. Fees and Notices. The Contractor shall secure and pay for all permits and governmental fees, licenses and inspections necessary for the proper execution and completion of the Work. Such permits and licenses shall be the property of the Customer and shall be delivered to the Customer upon request. The Contractor shall give all notices and comply with all applicable codes, laws, ordinances, rules, regulations and orders of any public authority in connection with the performance of the Work and the.Contractor's obligations hereunder. Insurance. Contractor-acknowledges and agrees that Customer or Owner shall not be obligated to carry any insurance in connection with the Work for the benefit of the Contractor. Contractor's Insurance. Contractor shall at all times maintain and keep in full force and effect, at its expense, any and all insurance coverage which is prudent, necessary or desirable for the protection of the interests of Contractor. Contractor shall furnish to Customer certificates of insurance for the following types of insurance. a. Commercial General Liability Insurance; b. Workers' Compensation Insurance-to cover full liability under the Workers' Compensation Laws. ` Timing of project: This project will be started by October 19 2015, and will be completed by' ire 2 this is not completed by the er, Contractor will pay $150 er day each day that goes over the completion.date�Only exception would be if we lose more than five days due to weather. IN WITNESS WHEREOF, the parties hereto have executed this Contract as of the day and year first above written. Custom 'Contractor Company By: By: - Print: Craig Scheuer- Mark Mullin, Mullin Roofing & Siding, Inc. 7 Connemara Way, W. Yarmouth'MA 02673 508 2218591 Address: 175 Five corners rd. Centerville MA • , Date: 10-14-15 : .Date: 10-14-15 Phone number: 781-330-9418 License No. CSL# 104076 HIC# 167281 Email address:.ces0007@hotmail.66m Email address: mullinroofing@gmail.com .. tit •9 + .. }- �,. �. tJ.L r P6 SP rFs state me uIx s(�:.Fuan)�I Pta'ct irp.a a� Y..d iW4 ar a.f 5 W y� sir ...... 'rtir W 3 rj Kl' \ tx.•a y 6' f ks s ensee Detail .. .. l" r f mo ra hic_li formatta Q n v � r ull me; " �. M RKMMULLItJ -..._............--- --- --... A l� y w� er Name: ress: se. a'�t r ...............-_--..._..........................____._..._...._....... _....................._...._ ✓ c � � duress;!::. 1NeM Yarmouth mate MA Jnx ipcode: 02673; jiX3a SKgw;,. ;'�+fyF d e ffa oUnt_. U ed -fates ------ ------ .—._ _....... 5X y tense No: 7 LIC"Se Type: Construction Supervisor Professfan:� Building Licenses Date of Last Renewal: 9/1612015 �\ Issue Date? irauon Date: W7/2617 r F Icense.Status. Active Today's Date: 10/:1912015 �=�r ecandary License: b y� y R , ngBusInenAs:� � ` atus Cha e: Uc se Rene I. - Y_ ' 00 �erequtst rma .o..]--._. . -..._.._.._..._._.........---------- ----- Intormalfon.... s� v1IqrInIInPP A \� — ......0 cmentum _ z wWFn a 2011 Commonwealth of Massachusetts Slte Policies Contact USa R7;%�� 'AX �� d '+'57 QO� 0 'C1 q El Parcel Detail Page 1 of 3 Logged in As: Parcel Detail �Monday,October 19 2015 Parcel Lookup Parcel Info . ----Parcel ID 168 0 Developer Lot'LOT 12 ........ n� a Location175 FIVE CORNERS R Pri Frontage 201 Sec Road , Sec Frontage ,. « Village CENTERVILLE ) Fire District C-O-MM a Town sewer exists at this address jNo ) Road Index 0545 ,y. Asbuilt Septic Scan: ` , 168070_1 Interactive Map 168070_2 Owner Info Owner MAGUIRE, FRANCIS J E `Co- o1ooSCUER,HE 'CRAIG E Owner a streets 11 JONATHAN LANE l Screetz ,« city SANDWICHa.>. state MA -� zip 02563-2104 Country l „s Land Info ......... Acres IO.36 use Single Fam MDL 01 zoning RC �)Nghbd 0106 � M�) Topography 115vel YF.� I Road Utilities kSeptic,Gas Public Water Location • Construction Info Building i of 1 Year 1971 Roof Gable/Hi � exr"Vertical Sidin Built Struct p .Wall Living Root � tic e-1aArea Cover � Type R ,I Style Ranch wan.Drywall Rooms3 Bedrooms Model�Resldential Floor Carpet R oms 1Full-1 Half Grade Average TYPe HotAWater a Total`6 ROOms--J Rooms s 1 St0 Heat G I Found- tories as Typical „ ry Fuel J atio Gross 3068. _. Area Permit History Issue Date Purpose Permit# Amount Insp Date Comments 6/1/1992 New Roof B35128 $1,600 1/15/1993 12:00:00 AM CE REROOF 7/1/1987 Addition B31003 $9,875 1/15/1988 12:00:00 AM CE GARAGE t. History......._..................:........_..................-................................__...._._... http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=10981 10/19/2015 Assessor's office p(1st Floor)* n �� B � THE Assessor's ma and lot number I o `pi r01 Conservation `�v w� ♦w Board of Health,(3rd floor): >; sstsruc Sewage Permit number � rua Engineering Department(3rd floor): �o o639. `pa° House number Ito ar'r r Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2-W P.M.only TOWN OF , BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION JynP IS 19 2 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location /7-7 s A(- Proposed Use R0 Zoning District ' Fire District Name of Owner E r1 C 1 5 / 'G V V l'�, Address Name of Builder 4-V IW n C1 Pc.r�S Address (1 VAIrPo(�7/-� Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost Area Alto AreA e t+A,-,; Diagram of Lot and Building with Dimensions Fee I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re arding the above construction. Name Construction Supervisor's License MCGUIRE, FRANCIS No '151 Permit For RE-ROOF Single family dwelling Location �� � Five Corners Rd. r Centerville _ Owner. Francis McGuire Type of Construction R Plot Lot Permit Granted June 15 1992 ; Date of Inspection 19 Date Completed 19 i 1 AWI � 1 ,y r� 3 z 7 J-- y�F?NEr��♦ TOWN OF BARNSTABLE i BJ,HB9T1►BLS, i 6 9 BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...f../Y! ..7:Ze e.k,.� '�� s% ? ................. TYPE OF CONSTRUCTION ......... � .. ! .............. ......................................................... C. a..................19.�Q. TO THE INSPECTOR OF BUILDINGS: The undersigned _ hereby applies fora permit according to the following°information: Location ... ! �,. �! ........ /.Y..$t...(.-. !l!l20!� ... .... c:Z..l .............. ProposedUse ........................................................................................................ - ZoningDistrict ........................................................................Fire District . C .. .....:..4,✓.�. ............ . .. .......... Name of Owner - . �1 '4POtr �C.;C ..Address �:►t �fit' f.... ....... Name of Builder C- ' ...... .....Address Nameof Architect ........�y�. a ? !....................................Address ................................................................ ..............,..... Number of Rooms .... ................................................Foundation !?:' .....,. .. ....,.. . / g� &e- Exterior Roofing .. . ........ ...................................................... Floors ........ ... d .. ........................................................Interior ......:. ... !. ti �c'`e'U............................................ ..... Heating rx .� W �7 ...... ........................Plumbing ..... ,.... ......r.................... ..... �I-�` ....... V 64 Fireplace ....&r�............................................................Approximate Cost .../ .. .. ................................ Diagram of Lot and Building with Dimensions �/yQ /1 Uj 10 d LU i�f O < J Cn O m - 4VMme, lA 9 G 0 0 zQ ,� m ►- V Q < o � � �G� 6 LL. :D w LL. w rL O Q 2 o }: >- < LU O _1 w ::D c~n Ui W }tV) Q ter L1J o � D- V w F-- _U a 4 Ce !� LLI E, HQz: Q >66001 Ix CY. I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. a 0 Name Normest Development Corp. 06C 31 191U No ....�325„ 'Permit for ...,.one story,.....,... single famil��dt1e11in ........................ - Locationt......Five Corners Road ....... ..................................... ....................Cgntq:l v q................................. Owner .........Normest Development„Corp, Type of Construction .............;C.:r4;C.:r4MQ................. ................................................................................ Plot ............................ Lot ........ ................. Permit Granted ........A3A&P: „17............19 70 Date of Inspection ..:.........../............vv..........19 Date Completed .... .. ........197� PERMIT REFUSED .r` ................ ... ..................................... 19 ............................................................................... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ...............................................................................