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0027 LONG BEACH ROAD
T ,6 " c/) D Q-O I Ac, IVE i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ® Parcel Tit!! t F BARNSTABLE Application # Bv Health Division `` i '''.' j ;'_;'; c: ('o Date Issued I-Z'l f s d Conservation Division Application Fee /d4 Planning Dept. a 9 E Permit Fee �� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village ��e�S J JC Owner�ac-L qL -b C6, - �� 0 kkca Address Z� Telephone Permit Request V-�� 4F c.r ,6 r4 �GW-` � U) Lu-ci z Ua,6_� !t__ '-LW 9 - Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new -- Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type �r5�-�` Lot Size 6 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure 8? a' Historic House: Yes No On Old Kin ' Highway: Yes ❑ No ��T ❑ ❑ 9 s Hi9 ❑ Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial s ❑ No If yes, site plan review# Current Use "J.-C. C C u- Proposed Use R.��-c� C Lu L APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 4. t3• Abrr'is .�)n .Xnc. Telephone Number -'o 9- Yak /165 Address/3k 05-ervI Ile,- West.&t-n6taLk -got License # 616 95l ery -e, A A Oa Home Improvement Contractor# /0,ZQJ f Email Worker's Compensation # /_S q_ 05� _f_ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # a DATE ISSUED MAP/ PARCEL NO. y ADDRESS VILLAGE OWNER t' DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. i "t A 'arrrrrsorrtve �x'�i Oda pf lrest�dx ro b deoft,UA 01111 N=M En Norris&SOA,Inc, RniLd kAre yaa 44 OMP10700 Check the a6ppropriloo I ' ( TM u(O"J"t(roq rl); =,a Omplarn With " ,� S 4M o r1 i po1Zf ttr Md 1 l� aa y"i'=Aud/of Portwl o)L haalva!�ftd to M-44ttwas 6. a Now 00twft tdn 2,Q X asit o sale;=;rlabr of partner, U00d'aa dad wuhad'uhak 7° M Marra odours aWp quad barn 40 plara� Thtio�tib-ogfld' otiot"3 hpa I. �rbrdng lbx rha In my nApacit7, mployean aaad WI-w ri ' Yo wGCl{seg'o0riv.WA=AQ7 0012P. (rM=40,N �4 13 itW4YMEF labCt 1 carpond atn laid W i O.0 2144 daal rt*IW ar ad&*V 3.[] r am a hazneawmor-d*IzW all work afters h yt Ourplud didt1I Z n4m6a ropdaox sddadaras taY3011 CNa TarkM°aaMP, right Ceaa mption pn N IL I^-r haumda MvinL,�' W� l �q ���r=4 WO hAW, 10 dnE(a at+w 4) " a a it tit�a+aYa�tea �kl nua alna 94 414 M 00040 WOW 4tirtFvtta dim 'Saa�maa�an I ' 00°ipt'aqu« r G�amgr1gY amp wtKd ar rt fiat to rt#fdAV tGl49A tO Jl am dt at JO A,w mk as Then=gIAtq*aAtt�t�a0 M t��sR,a�,llt 41w a#�6 ui, kft owtw 00rintt�ilaM~ #lam k!dull►box atuda aRtaahad aAt add tone!4114 edkttro AVI d"Olwd $AO*I di aid ytOP4 WggAIV ar gWk'd�µo talktaA Iipa =1:41& VMS ftb-ft uUtm I va nmplaKaa� Ihay avtt�M**Ochr Wailaara°eoaq�,paliay ailo#ltaa � 1 1 ..�•alWr'H Sob ShO Ad4ross; 27 Long Beach Road �Ik l t i J Zhu: Centerville,MA ,{�,y��a�AO Jg�yy,COV'y,�oL,�"Iry�d Workart°enttpaMsa�i��pQl��r dioalurffi�Con page(shawin the�a4hgay lars�h� ailp u �ea. �1�7ii4 KL hLf}1'd7'61b9�i'M Q�y�dr�M '�M.Kyl M ' yJ� bmda as �a n L d.1S2 aa�.iaad that imp�asitiot off'od P001`ras at taste uct t��it��LtlM ia�ctoaMy:�r �G3�1IaaXi'� as Woi�a,�Ci��r$1 padsxld��lh�� ts�o,�����4���'� ��snc�siin9 , of UP to 450-00 al by age the VIOWar. 30 ad ud amt a>,coVy of thi's statdrnat yP ho arda�O to tho Ofte of �VaAdPOOV4 of U DIA for i =anet auw '' t t asY I 1 . �' d►h l r i i aKS� �1tdp- a-.-- 1br rrr,�°or OUR prav�dsd aWo and aarrau�, i ' " f 12-29-16 �� 'H'�L�NM.MTWMIW4wMM�'MII�NWNIINLWWN.MtWNPYYWWYY1Wy.yy�,yyN f 0r fhd oil a(p. A3 not riWAV In 011,1MA id be e0trrp1'ow by do of josm aa, aYad , �1i6a city spy W 1�1 I�W1791A4 'WYVIYYNVI.I.NW.�nw.w.rwlm.ww �„���..�_._ yy//yyyyyy aa,,..'',�,, �(}�L,j�'�L y� IaCf%�t� tCCd� ' ��IIA��/�{ �1'AIyi�YIYO.L eYwNNWpIWYOWlo.�1 -yAawl.IdiYlrl ..�-..ii:kwlwkTrl,+.n.wq{i'WWI'Nw4NY ty Ctlreje one)-, 'p14 BOOM ol"004th I hull vtog D.loart*aTo 3,at;;7M)YA Clone 4.Z't O W'1194 alai W Ri V�"LF6VNNI,NwwryNy�„•.., Pheoe#I �T'L'^'n�M�h.+WM I !"��—�N"�^ IYnxwfl•T1Mlw+M+wi.+MrwW11MtlY1,MWbMnwrMtwawNL.n '1�M,1111L11.YW114«Yy11kMWA1VYM1 �y�l',IIA NYy11Y1L, 1 .Aw ty �J7.•G G���Zri�2-ryY2Ll��CGI�� Q ��� CG;�JG�'�C�2%GG�•C'i — ,i Office of Consumer Affairs and B siness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 102014 Type: Private Corporation Expiration: 6/30/2018 Tr# 288022 ERNEST B. NORRIS & SON INC Craig Ashworth 138 Osterville W. Barnstable rd. Osterville, MA 02655 Update Address and return card.Nlark reason for change. SCA 1 LS 20M-05H 1 Address ❑ Renewal ❑ Employment Lost Card /c ony affairs ss egulation !� License or registration valid for individual use only �,• Office of Consumer�.ffairs Sc Bus' regulation g -- HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return t6: Um Re istration: :"9 102014 Type; Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Expiration;. 6/30/2018 Private Corporationy, Boston,MA 02116 ERNEST B. NORRIS&`SON'If?JCi _ Craig Ashworth .: •� 138 Osterville W. Barnstable rd: �- Osterville, MA 02655 Undersecretary Not valid without signature a Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-015851 Construction Supervisor CRAIG N ASHWORTH 138 OST W BARNSTABLE-'`1'1. OSTERVILLE MA 02.6 r Expiration: Commissioner 09/28/2017 °,*I E Town of Barnstable. Regulatory Services * BAMSTABLE, _ y nrnas Thomas F. Geller,Director pQ,,,ota Building Division _-.__..__........... Tom.Perry---Building.Commissioner 200 Main Street Hyannis, MA 02601 www.town.barnstable •ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder . John R Lake, Building Chairman , as Owner of the subject property hereby authorize E. B. Norris & Son. Inc. to act on my behalf, in all matters relative to work authorized by this building permit application for: . 27 Long Beach Road, Centerville,MA `ddr s of Job) 12-29-16 Signature of Owner Date John R. Lake, Building Chairman for Beach Club of Craigville, INC. Print Name iClient#: 646400 2NORRISEB ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) 08/24/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed.IF SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Dowling&O' Neil Insurance Ag arAl INEAX A/C N. Ext:508 775-1620 AIc No): 5087781218 973 lyannough Rd, PO Box 1990 E-MAIL Hyannis, MA 02601 ADDRESS: 508 775-1620 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Employers Mutual Casualty Compa INSURED INSURER B: E.B. Norris&Son,Inc. 138 Osterville-West Barnstable Road INSURER C: Osterville, MA 02655 INSURER 0: 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 CONTRACTOR 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, LTRR TYPE OF INSURANCE NS WVD POLICY NUMBER UBR MMIODNYYY MMIOONYYY LIMITS A GENERAL LIABILITY 5D46954 05/03/2016 05/03/2017 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PRt+AISES Ea occurrence $100 000 CLAIMS.MADE 7 OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERALAGGREGATE $2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY PRO PRODUCTS-COMP/OPAGG $2,000,000 JECT LOC $ 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 HIRED.AUTOS AUTOS Per accident $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS.MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS LIABILITY 5H46954 05103/2016 05/03/201 C X W STATU- OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $500 000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L,DISEASE-EA EMPLOYEE $500 000 If yes,describe under DESCRIPTION OF OPERATIONS below. E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of Insurance shall be deemed to have altered,waived, or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE ©1988-201 D ACORD CORPORATION.All rights reserved.. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S175842IM175841 LS1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 72DP Parcel D& Application # Health Division Date Issued /-/7—i 7 f � Conservation Division Application Fee /0 G Planning Dept. Permit'Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis / Project Street Address I� Village C, 9 J t� Vfl Owners C u�i c�3 Address Telephone �- 7. P C (3 S p Permit Request R ze- q- �Q_c (e �C,_ tl vks b ¢. f l C,o� ` S 5�i "mod C �0. r� 5 �T � � S � 0C� e-c-LS -�, 136 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District gg Flood Plain r Groundwater Overlay Project Valuation�Db COD Construction Type Lot Size .2- Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure g E` 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 BUI DJNGErPT Total Room Count (not including baths): existing new First Fl�oorlRo�,o�m Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other TOW&,,0P C Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal,stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use -C-� Proposed Use APPLICANT INFORMATION _ - - (BUILDER OR HOMEOWNER) Name L=. 6. Norris -4- _5n -Inc. Telephone Number .5Dg- I I L.5 Address 13,w Stervi I� - sj Aaxn5 (e 6./License # C 5- G15 E,51 _0 5teo-v, Ile /� /-� o alvzs Home Improvement Contractor# /o P-of 4 Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO PG 0_) Z - Z1 - / SIGNATURE --DATE `�' FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE r' Owr'IER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL INAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. o4t E Town of Barnstable. Regulatory Services �cr. BAMSMELM 1 HAM �, Thomas F. Geller,Director p zs3s~ - Building Division ___.._.._.. Tom.Perry---Building.Commissioner 200 Main Street Hyannis, MA 02601 www.town.barnstable •ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1. John R Lake, Building Chairman , as Owner of the subject property hereby authorize E. B. Norris & Son, Inc. to act on my behalf, in all matters relative to work authorized by this building permit application for: 27 Long Beach Road, Centerville,MA dr s of Job) 12-29-16 Signature of Owner Date John R. Lake, Building Chairman for Beach Club of Craigville, INC. Print Name I t Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-015851 Construction Supervisor CRAIG N ASHWORTH 138 OST W BARNSTABLE_ :`y, OSTERVILLE MA 026$5• yuri Tf (� CA— Expiration: Commissioner 09128/2017 s A t:` 211 Office of Consumer Affairs and B siness Regulation � G/p 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 102014 Type: Private Corporation = = Expiration: 6/30/2018 Tr# 288022 ERNEST B. NORRIS & SON INC Craig Ashworth 138 Osterville W. Barnstable rd. Osterville, MA 02655 - Update Address and return card.Mark reason for change. []SCA 1 t5 20M-05/11 Address 0 Renewal Employment ❑ Lost Card Office ofGo/nC's uVmerl ffai rs x rB/C/u sP�cnsss-r(eIgu la!t/iLo6n:iPlr!1 License or registration valid for individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 102014 Type: Office of Consumer Affairs and Business Regulation Ex iration; 6/30l20.18 Private Corporation 10 Park Plaza-Suite 5170 '7 p p Boston,MA 02116 ERNEST B. N 0 R R I S Craig Ashworth •� 138 Osterville W. Sarnstable rd. _ Osterville,MA 02655 Undersecretary Not valid without signal re t I i e ° It..•�Nd YM'IA°°Fii4wli 7ti'� �!'/ IANII�I WIl.f1•i�IJ�Gii)f O 4� xrrve d'4O WWA01 '�rw wo rkrin, COMPOUSado>a ` � a4r4 a/t � arrliadivttlV ); U Norrla&$wt, Dm i38 paitaty lle)). Barut Abla load low- MA i � to l � r pe arwil7e, 0205 Ar:3 YDO 44 amployerr?ph"k the approosge I qyj TM urf'p ��?(r��tc ; 1, 1 mm.a OrglOyln with�, �5 14m; ds`fmi rotor ad 1 qmPIQym W a ndlor hua kw to sukofitwm 6. 0 Now muftaft X am a IOlapxapc mtOr or partner, " Hold'on tbo 7, M ReaooM tg ahlp ad havo rya omplayog Theis StlawcPA tall hive t 6d&g 1tr 66 ta Vjagp ;f Impldyael Izd uawarwork l EN'o wacksm'oar*taga camp, Itm=Q0 1 3, � a a a�rlaty row + Ltd w 1 tlfl 214owmal rq or adatA 3. I are a 1aame mer-dolztd All work afters hy momllod dlelr pat �iug ropAiN ar�dda�ama myaalt NO IN L t2, bowl a marr loft a I mployagsY(No wwkqml 1 �dao r �aaz�,�l cagti��m�r+r �) tom . �aK�c6. '• 1 ",only aaud t, a box it fa"alto fig uuck 6'uayt� v auw�o alimi�wlaz�cm 'Saamn +a�Alltc�y#>�� xtian«t x0ftoman who p 'WI x1�YWfg ta�OU0#t M 1�C2wq 4 w wk dz then him Rµtu►40 AB M jOug•w+*�1e a na�Y a�awiw OQFJU OWX*Sd bax IAVU R t Nd 44 441912"11 N1l0"show►irm 60 unsam of ft�G}� Rq��d alto WhOAW ww"14 aaw"lave 0210yft IftUm+sob4orzutm IMV4 nmptoKaa�,they M10$=**00jr wvgow4 pwo av�,�11a�at►a��a t°tea as � s.l, kP + arr l ; ,} `�Fra n��rls��r ,ara»r.�eresr��'grt a"�►wr;��acir�br ernp�'w,pa�& .�+�� �C�"��lly�l�°' ���,_ - ° '�, a —>r,..-.,� ..�._._-_,•.,...�..� 8���7��1�1t��RRi>�t ��-,.�,,..,, lob VO Adclk'eao: 27 Lon Beach Road �l yb to J l a Centerville, A Adak a OVY of At w orlra>rg°empouggog DQUOY d oglamon laagt(Shawfal the 1aOMY member slid ID lrAtloa doo). J aa�v�a U rt�casi=dar>Se�=28A�►fMOL a.152 oaaIced to the�hpaaflfta ard4ar-im p��tle�of a �t>5 up to ht,�4+���0 dlarstpaMye��:rp>rtam ��, as wa;i��,�otvlt�a�►,a3���the l� ern h`�pla�c��x'w'C�l�h��cl a i�te ; of up to$250.00 a dAy ttgm'�A the violator, 11e advzeed ftt a COPY Of this Itatamaty he hard toSao� l° wee ' as o the 1 14 l +r a e Cov gl�"#04dom do ha +o aiam�rra dr AIP4 091 ►NO 12-29-16 MYWYu'p'P,fl^^gTAYM�rkMlWhFE.uxW,XwMwe+a{Y1•hby'�°••,••4"�+a.i.ao orr(p. Do not IWO In t i afmao 1w hor��rrr�rtoidd by MY nw 16ft 6, 'a1ad ' yy��ppg spy,W v�W�y� 1 iw y Yo u I6 O' µ4^",��I�unNroxwwP�u+mu..+m�.�ya^1.N5+a nww•.,.Mnanw��� Et�IlfK.vli'�� -. • ' ��r rHrw r� 'harpy l>roleez one),- ��line nl"1(�e�tla �.13ra1' ng I��'Oasa�u�C �.���;w�`1i'e �'ltrria °tM l�lale�rrleaail��I��d;Ak>r(8� g.ttltaam�blyd�1]t1�I+Ag� Ylr(iY�♦�YW W RiF��7d°M'�,�I�NMNVI�1 •u �����,4� fl`q RMYnfli..,xu.ua.yuY.u.uN."4WNn.n r "rv"°'N+r°�py�,� f •. Client#: 646400 2NORRISEB 1-14, bATE(MM/DDmYY) ,AOORDTM CERTIFICATE OF LIABILITY INSURANCE 08/24/2016 THIS CERTIFICATE IS ISSUED AS A MATLER 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 NAME: Dowling&O' Neil Insurance Ag arc°N a EXt;508 775-1620 Arc No; 5087781218 973 lyannough Rd, PO Box 1990 E-MAIL Hyannis,MA 02601 ADDRESS: 508 775-1620 INSURERS AFFORDING COVERAGE NAIC Et INSURER A:Employers Mutual Casualty Compa INSURED � E.B. Norris&Son,Inc. INSURER B: 138 Osterville-West Barnstable Road INSURER C: Osterville, MA 02655 INSURER D: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE Ns WV0 POLICY NUMBER MMIDiONYYY MMIDIONYYY LIMITS A GENERAL LIABILITY 5D46954 05/03/2016 05/0312017 EACHOCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $100 000 CLAIMS-MADE a OCCUR MED EXP(Any one arson) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS-COMM13AGG $2,000,000 POLICY 7 PRO LOC $ 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 HIRED.AUTOS AUTOS Per accident $ $ UMBRELLALIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION 5H46954 05103/2016 05J03/201 X WC STATU- OTH• AND EMPLOYERS'LIABILITY YIN T ANY PROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $SOO OOO UDED7 OFFICER/MEMBEREXCL NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE,$ 10 000 If yes,describe under ' DESCRIPTION OF OPERATIONS below• E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more apace Is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of Insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. ' Hyannis, MA 02601 f AUTHORIZED REPRES ENTATIVE ! ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S175842IM175841 LS1 Project Name: JR(k --t Ind wt Address: �rrWl k Permit#: _5q Permit Date:__& . �%��I� Mip:___,2 b D�__ LARGE ROLLED PLANS ARE-IN: BOX: 3� SLOT: Date entered in MAPS program on: By air Oh Consulting -StructlarAl Engineer Centerville, Massachusetts 02632-1979•(508)771-•7601 •Fax(508)771-,7163 mcudilo@comcast.net June 08,2016 Town of Barnstable Building Department 200 Main St. Hyannis,MA 02601 Attention: Mr.Thomas Perry Building Commissioner RE: Maintenance of]Exits,Massachusetts,.Stat'e.Building(erode The Beach Club,27 Long Beach Rd.,Centerville,MA Dear Mr.Perry, Please be advised that the above captioned project has been inspected on June 1,2016,and again on June 08,2016 to review repairs completed. This office has inspected all exterior bridges,-steel or wooden stairways, fire escapes and egress balconies for structural integrity.and safety,and finds them adequate,as amended. I trust that the above addresses your heeds at the present ti_;nie. Should you have any-question on any of the above, please do not hesitate to call. Sincerely, PPE < is ele Cudil /2016-pc o, -n Qc; jqy e Flvnn �kOFMgSS9cy CD MICHELE G� CUDILO. Q STRUCTURAL No 34774 r o Q e�J 9FOISIEP �FSSlONAI� . ... ._. n ?3-'. _"'i i. + -;,, r 1 "=:a:;� 4,7 f C..i r.•�..�ryr 13.. _. .. 't .�..,. iti'' ., fit .. " y .. . ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel b l lIi Application # d�l U �� Health Division Date Issued 4 Conservation Division Application Fee LV Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address Village lk—, 0 �)6 2� Owner C f1b Address_ » eo r.� It Telephone_ S-0% 7720 94c 0 Permit Request S uare feet: 1 st floor: existing 2nd floor: existing r Total n w q g g p oposed � e Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attachsupporting aocur,r ntation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) C) Age of Existing Structure Historic House: ❑Yes 211 No On Old King,s;Highway:,°❑Ye`se allo Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Others Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) , g C� ¢-0 Number of Baths: Full: existing new Half: existing ' new`0 Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas' ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 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 - : yLc� Telephone Number Address License# CS 617 6� M46 MY�- Home Improvement Contractor# vUd Email Worker's Compensation # &y�Do4006o 1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE r FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED k MAP/PARCEL NO. f 1 ADDRESS VILLAGE OWNER C I DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH I FINAL L C PLUMBING: ROUGH FINAL t GAS: ROUGH FINAL FINAL BUILDING t t DATECLOSED OUT r ASS-O 'ION PLAN NO. r: x l • ,f he Corn�rzo.2�ivealth —.-. of MgEsachzi, setts Department of Industrial Accidents, D,,1f ce of kivestigatzons 600 Washinkton Street .Boston,v A 021,l R.. ` WYt V;.n2aSS.g ov%din Worker's cornpensaolz Insurance' ffidavit:Builder s/Contractors/E7ectrciams/Pltimbers _4.ppucant Infoi-mation Please Print Legibly. Name (Business/Organizauon/Individual): � �1 f � el Address: t101 City/State/Zzp: Are you an employer?Check the appropriate box: Type of project•(required): 1- LJ i am a employer with 4•�'I a a general contractor and 1 have 1'6. ���^�--•��� employees(full and/or ,zrt-tine'.* lured the sub-c - 0 New corgis'action . P� 1 o�tractors listed on 7. Remodeling2. The t,-cd itieet# !am a sole proprietor or partnership These sub-contracto>s have 8• ❑Demolition ' and have no employees working for employees and have work=,comp. 9. L__J Building addition mein any capacity.[No workers' insurance.t comp insurance required.] 5. 'We are a corporation and its I�•a Electrical repairs or additions officers have exercised their ri&L of 11-.F Plumbing repairs or additions 3 1 am ahomeowner doing all work exemption per NlGL c.152§(�),and 12. hoof repairs myself.NO workers'comp. we have no emgIayees,[No workers' • insurance required.]11 13 Othe comp.insurance Tegi,-ed.] Q +Any applicant that checks aox r:l mast also yl}our itie scedon belo•N snowing their w�kers'.comperrtior policy itioaiiaDot:. 't Homeowners who subinir this zffidavit indicating they am do!ng aU work and then hire or,[sid contractors mutt SL+boric P new afrldavir indicaing S leh $Contractors tbia—,to check this box must attach au addirovi oral sheaf showing the name of the sub-contractors and state,whriber or not those entities have=p}oyaes,3f f" the sub coazxctors havep}oYees they nit;st provide their;iorkcrs'comp•Policy number. I ana an employer that is providing worlcers,co"Weniation Lnnzrance for my employees.BeIoty is the policy and job site irzfortrcation J a Ins pGn.lInsurance Con? any Narse: Policy T or Sel ins.Lice WC,-V 0 . Expi'a�on Date:�� // � • Job Site Address: l' CitylState zip., ter/ Elttach a copy of£3>e workers'compensatia polies declaration a e showin the obey number and r'ailure to secure cov Qa as r page( g p exppena n s of& "etas, egLitt:d Corder Se:tioa 25A of MGI,c.I52 can lead m the itaposton of criminal penalties of a ford up to$1500.00 and'ar one-year impdsoamenr,as well es civil penalties in the form of a STOP WORK ORDER siid a fine of un to$2_0.00 a Bay against c to violator:Be advised that a copy of this statement may be forwarded to the Office o 7.nvestigations of the DIA for insurance coverage v;.rmcadOn- 1 do hereby certify the 't enaiies of perjury that the information�try�ided above is true and correct. Signature:: _ Date: Phone#. 02 --------------- official use only,Do not.lw ite.in this area,to be comple:ed by city or town off ci¢I City or Town: Permit/License n Issuing Authority(circle one): f t 1.Board of Health 3.Buildinb]fit pa 6.Other rtment 3.Citp/Town Clerk 4.Electrical I�pector S.Plumbing Inspector Contact Person: ` Phane??: FRASCON-01 PAAS �- CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDfYYYYI THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOf LDER.I E THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pOlicAies)must beendorsed. 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 certifiFRIver, t hlder in lieu of such endorsement(s). 508 676-0309 CONTACT ce Agency,Inc. NAME: Ashle P81Va ac No Ext': 508-676-0309 127 d (.Arc,No): 508-324-9147 720 ADDRESS:APaiva Viveirosinsurance.com - IN AFFORDING COVERAGE NAIC N IN A:Granite`-State Insurance CO INSURED . Fraser Construction LLC+ PO BOX 1845 INSURER B: , ti � INSURER C: ; Cotuit, MA 02635 INSURER D 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 CONTRACTOR 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 LTR TYPE OF INSURANCE SU IN SIR WVD POLICY NUMBER C L EXP GENERAL LIABILITY - MIDD MM1DD LIMITS EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY r ce $ CLAIMS-MADE �OCCUR PREMISES(Ea occurren • MED EXP(Any one person)' $ PERSONAL&ADV NL IRY $ GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 1 PRO- LOC PRODUCTS-COMPIOP.AGG $ AUTOMOBILE LIABILITY $ ANY AUTO Ea accident 1 1UMI $ ALL OWNED SCHEDULED BODILYINJURY(PerOrson) $ AUTOS AUTOS LOWNED BODILYINJURY(Perawdent) $ HIRED AUTOS AUTOS $ Per accident A AMA GE OCCUR EXCESS LIAR EACH OCCURRENCE $ , CLAIMSMADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY WC STATU. OTH- A ANY PROPRIETOR YIN TORYLIMRS ER OFFIC WC009930601 9/26/2013 9/26/2014 (MandaRIMENI3EREXC�UDEDo ❑ NIA t ,e E.L.EACHACCIOENT $ 500,000 (Mandatory In NH) 4 a yes.describe under � E.L.DISEASE-EA EMPLOYEE $ 500,1 000 DESCRIPTION OF OPERATIONS below r E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attael7 ACORD 101,Additional Remarks Sche(jule,if more space is required) CERTIFICATE HOLDER CANCELLATION ''SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable Building Division THE EXPIRATION DATE THEREOF. NOTICE'WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis_,MA 02601- AUTHORIZED REPRESENTATIVE ACORD 25 2010/05 O 1988-2010 ACORD CORPORATION. All rights reserved. ) The ACORD name'and logo are registered marks of ACORD , ' 0 mnsaeilusetts oec nftment of Public Safety I Board of Building Regnlitinns anct Standards, - I Cnnstructlnn Sahrrsisnr , `- r i t icense: Cs oa7688 Dim bYAN CFRAS>�Y2 ` t„fM1 , r - - 104 T'�VAVN VIiaW ,3 . EAST' lT��A°� tri i ` } ` ,i ns r_xi,)iration 06/07/2015 Cummissiaier V I 1/3 initial payment, remainder to be paid upon completion Payments accepted are: CASH- CHECK-MASTERCARD -VISA- AMERICAN EXPRESS *Any payments not immediately paid upon job completion will be charged 0.005%for every day after the given 5 day grace period upon day of job completion. Possible Extra -Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$75.00 per hour, plus 20% mark-up materials. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workmaa's Compensation and Public. Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: 1 Fraser Construction, LLC., 7 .. t. - ..*� qt '1 <+ ,t •.. , �,� ,�y v,�,.+.`c+ � r 4'k" t i t IN gai a t r ��•� iY' ri.F `� �t' r '' x " ;�r} '� 4 g Y� { *c� "*'� 1 r� ti{;r r�#. . a �y,��r S'" �'Tv r' '��97.��� Y�Y. �+"�v '�"�'� � � � �ttA ��� �a�$4"'�"a x 5. Y.: •�r s t a � # pb+j`xi�.�# ��6" - g� y �.�. A•u{5, Ors �R� : } � 'Pr �,}�` ���i �9. C�'�w��4�� S � �� �1� �}e %�' ��T � *� � ',.:�M1.. .AAA�Y;I `3 � � �, � L �� ,i}A+{s,k „�' � � � 5 k' �P.,*�, t a '.;•tea 74 a 5 C� s a a .� � r r"»> ? ,mow'Ses �� �t�`+#�i.,� 3`rs. .`•ak,J}i � r ) ,c `.'v,„` _ s t dt ys s 9e°�t,: a � � ���' � r��a� 1 i t as r•.� y'q" ��'�' ^,� _ •r'. aa.� r �� #�'T'�' �'� ?� i+�'' -1�s}��gy rt �;�� �t,,9 a r�s•t#�: �, � tsz ��.e�a., t 4 . a a g. s , Mass. Corporations, external master page Page 1 of 2 b Corporations Division Business Entity Summary ID Number: 043157481 Request certificate 11 i New search Summary for: BEACH CLUB OF CRAIGVILLE, INC., THE The exact name of the Domestic Profit Corporation: BEACH CLUB OF CRAIGVILLE, INC., THE Merged with CRAIGVILLE BEACH TRUST,THE on 08-17-1992 Entity type: Domestic Profit Corporation Identification Number: 043157481 Old ID Number: 000395380 Date of Organization in Massachusetts: Date of Revival: 03-05-1999 05-21-1992 Date of Involuntary Dissolution: 08-31- Last date certain: 1998 Current Fiscal Month/Day: 10/31 Previous Fiscal Month/Day: 01/01 The location of the Principal Office: Address: 27 LONG BEACH ROAD, P. 0. BOX 297 City or town, State, Zip code,. CENTERVILLE, MA 02632 USA Country: The name and address of the Registered Agent: Name: LAURA BOUCHER Address: 27 LONG BEACH ROAD City or town, State, Zip code, CENTERVILLE, MA 02632 USA Country: The Officers and Directors of the Corporation: Title Individual Name Address PRESIDENT RICHARD T. COLMAN MR. _ 941 SEA VIEW AVENUE OSTERVILLE, MA 02655 USA TREASURER GRANT'PATTISON MR. 1094 BUMPS RIVER ROAD CENTERVILLE, MA 02632 USA SECRETARY CATHERINE,O. BUCKLEY MRS. 200 UNION STREET NORFOLK, MA 02056 USA VICE PRESIDENT IRA STEPANIAN MR. 175 BAYBERRY LANE OSTERVILLE, MA 02655 USA http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.a.:. 4/1 2014 Mass. Corporations, external master page:. Page 2 of 2 DIRECTOR RICHARD T. COLMAN MR. 941 SEA VIEW AVENUE OSTERVILLE, MA 102655 USA Business entity stock is publicly traded: r The total number of shares and the par value, if any, of each class of stock which this business entity is authorized to issue: Total Authorized Total issued and Class of Stock Par value per share outstanding No. of shares Total par No.of shares value CNP $ 0.00 200,000 $ 0.00 852 F Confidential . FA Merger Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS I J1 Administrative Dissolution Annual Report Application For Revival Articles of Amendment j w.1:_I__ _L View filings Comments or notes associated with this business entity: New search .http:Hc' orp.sec..state.ma.us/CorpWeb/CorpSearch/CorpSummary.a .., 4/1/2014 Mass. Corporations, external master page Page 1 of 1 '.s?l William Francis Galvin � az .` Secretaryofthe Commonwealth • of Massachusetts Corporations Division Business Entity Summary ID Number: 043157481 Request certificate I New search Summary for: BEACH CLUB OF CRAIGVILLE, INC., THE The exact name of the Domestic Profit Corporation: BEACH CLUB OF CRAIGVILLE, INC., THE Merged with CRAIGVILLE BEACH TRUST, THE on 08-17-1992 Entity type: Domestic Profit Corporation Identification Number: 043157481 Old ID Number: 000395380 Date of Organization in Massachusetts: Date of Revival: 03-05-1999 05-21-1992 Date of Involuntary Dissolution: 08-31- Last date certain: 1998 Current Fiscal Month/Day: 10/31 Previous Fiscal Month/Day: 01/01 The location of the Principal Office: - Address: 27 LONG BEACH ROAD, P. 0. BOX 297 City or town, State, Zip code, CENTERVILLE, MA 02632 USA Country: The name and address of the Registered Agent: Name: LAURA BOUCHER Address: 27 LONG BEACH ROAD City or town, State, Zip code, CENTERVILLE, MA 02632 USA Country: The Officers and Directors of the Corporation: Title Individual Name Address PRESIDENT RICHARD T. COLMAN MR. 941 SEA VIEW AVENUE OSTERVILLE, MA 02655 USA TREASURER GRANT PATTISON MR. 1094 BUMPS RIVER ROAD CENTERVILLE,— MA 02632 USA SECRETARY CATHERINE 0. BUCKLEY MRS. 200 UNION STREET NORFOLK, MA 02056 USA http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.a.. 4/1/2014 LLY April 1,2014 RE: The Beach Club, 27 Long Beach Road, Centerville, MA We have hired Fraser Construction, LLC to remove existing flat roof on small room (Craigville Beach side) and replace with rubber membrane. Regards, C) Richard T Colman t ,o J Jr- President, The Beach Club w " " TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION j ^ Map _ Parcel Applications Health`Division ' Date Issued Conservation Division Application Fee Planning Dept. , Permit Fee 53. Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address Z"7 Z_cAj&! L-5 2r 4C cY Z. Village C..��T— 2 01 1_C. �o Owner e C I_u a, Address C"bN .D &cI r. ir/R va 3� Telephone 7? Permit Request f�� /�� <JA 2 ,►2l 12 jS, -X '5 UxJC-12 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District - Flood Plain Groundwater Overlay Project Valuation A7-•704f)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 141 2-7 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes 0'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 Roo Coin Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stoke: 4�bs ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size — Barn ❑existineRL] near size— Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size — Other '` ` 7 s o 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 ZZ� Address �� 5:7)X l S License # 7 C -7— G��i� Z�'�S Home Improvement Contractor# �� `� co Worker's Compensation # ,"�G 0�n9cl' _�506 o ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE Z FOR OFFICIAL USE ONLY i APPLICATION# -DATE ISSUED t t _ MAP/PARCEL NO. •. ADDRESS VILLAGE OWNER r 's DATE OF INSPECTION: - FOUNDATION ` FRAME ` ..' INSULATION, .' '. `. FIREPLACE �s ELECTRICAL: ROUGH FINAL 4 PLUMBING: ROUGH FINAL i -GAS:, ROUGH.,. Y FINAL .y ;FINAL BUILDINGt — DATE CLOSED OUT s ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 wwr.mass.gov/din Workers' Compensation Insurance Affidavit: Buflders/Contractors/EIectricians/Plumbers Applicant Information Please Print Legibly Name (Business/oWmzation/Indmdnat): ¢•5 � —� ,,. Address: City/State/Zip: Phone#: 8 t/Z, zZ� Are you an employer? Check the appropriate box: Type of project(required}: . 1.�am a e to er with 4. I mm a general con mp y '� ❑ g tractor and I employees(full and/or part-time).* have hired the sub-contractors 6 ❑New construction 2.❑ I am a sole proprietor listed on the attache p p r or partner- d sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. Demolition working for me_in any capacity. employees and have workers' 9. Building addition [No workers' comp.insurance comp,insumce.t ❑ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' camp. right of exemption per MGL 12. Roof repairs insurance required]t c. 152, §1(4), and we have no ❑ employees. [No workers' 13.0 Other, comp.insurance required.] *Any applicant that checks box 91 must.also fill out the section below showing their workers'compensation policy information. t Flomoowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. Contactors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employers. 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 site information. I Insurance Company Name: <_ OA- /o 4 J C_ Policy#or Self-ins.Lic.#_ u�G d0/'J?50(:�0p/ Expiration Date: (d Zot Z Job Site Zx*,-)c 13_ e_*<_4 /L)-:,-> Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be-advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I:dohereby c nd apains and penalties of perjury that the information provided abov istr andcorrectSe: Date: Phone#: ® Official use only. Do not write in this area to be completed by city or town official City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 1 City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector fi.Other Contact Person: Phone#: FRASCON-01 MOSU ��® ®¢ DATE(MM/DD/YYYY) �- CERTIFICATE OF, LIABILITY INSURANCE 4r5r2o�z PRODUCER (508)676-0309 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Viveiros Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 375 Airport Road °HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Fall River,MA 02720 ALTER THE COVERAGE AFFORDED BY THE POLICIES�BELOW. INSURERS AFFORDING COVERAGE - NAIC# INSURED Fraser Construction LLC INSURER A.National Union Fire Insurance Company P.O.Box 1845 INSURER B: Cotuit, MA 02635- INSURER C: INSURER D: INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR-THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY.PAID CLAIMS: INSR ADDT 'N POLICYEF IMMIDCTIVE POLICY EXPIRATION IMM/DDIYYYYI .LIMITS TR RD P INSURANCE - POLICY NUMBER GENERAL LIABILITY - - EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE I PREMISES Eaoccurence $ CLAIMS MADE OCCUR MED EXP(Any one person) $ +r PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER:' - PRODUCTS-COMP/OP AGG $ POLICY PRO-JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO - (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULEDAUTOS. .. (Per person) HIRED AUTOS BODILY INJURY $ , NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $f " (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY - - ,EACH OCCURRENCE ' $ OCCUR EI CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE - $ RETENTION $ $ WORKERS COMPENSATION X. WC STATU- OTiT AND EMPLOYERS'LIABILITY - TO Y LIMITS ER - - A ANY PROPRIETOR/PARTNER/EXECUTIVEY®WCOO9930601 ,•9/26/2011 9/26/2012 E.L.EACH ACCIDENT $ - - 500,000 OFFICER/MEMBER BER EXCLUDED? _- (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes•describe under 500 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ ,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE BOLDER'. CANCELLATION - - - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION y- DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN OVVn Of Barnstable NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Building DIVISIon IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 200 Main St REPRESENTATIVES. Hyannis, MA 02601- AUTHORIZEDREPRESENTATIVE ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD - . am M.issachu' U Board of Building Regulations and Standards C6nstructi6n Sup rvisor License Lic erise:;.CS. 97668 .; DEAN F12ASER - . 104 TWWN VIEW:.LANE 1. EAST FALMOUTFl MA 02536 "Expiration:. 617/2013. : �.. ., <pmm C' iawoncr Tr#' IBM k Alm -ComwevInaww" Azamm '40e Office of Consumer Affairs and usiness Regulation 10 Park Plaza- Suite 5170 Boston, Massachetts 02116 Home Improvement Contrtor Registration Registration: . 112536 ' Type::. DBA Expiration: 3/23/2013 Tr# 209024 FRASER CONSTRUCTION CO. DEAN FRASER P.O. BOX 1845 COTUIT, MA 02635 Update Address and return card.Mark reason for change. [J.Address Renewal 7 Employment Q Lost Card DPS-CA1 0 50M-(W04-Q101216 - �,,,�� '���t. - � - OificeTtleoeua�m'er .,ma nea va-fion� License or.registration.valid for individul use only HOME IMPROVEMENT CONTRACTOR: before the expiration date. If found return to: Registration: 112536 Type: Office of Consumer Affairs and Business Regulation Expiration•. 31230013 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 F R CONSTRU&ION CO:'' 7 DEAN ERASER j � .. log 104 TWINN VIEW ANE � 3� E FALMOUTH,MA a636 Undersecretary of va r It ut s' re,' I x Any deviation or alteration from above specification will be executed upon written 4 'orders and will become an extra charge over'arid above the estimate: All agreements contingent upon strikes, accidents or delays are,beyond our control. Owner should .carry fire, tornado and other necessary.insurance upon the above work.. We, if not .` accepted within thirty days may withdraw this proposal.. FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public rt Liability Insurance on the above work, certificate available upon request.k' _ DATE OF ACCEPTANCE e .5"R. ' H®me®wner Fray r Construction,, LLC- a ! For conagauny use only ,Datte Received Date Started: Date Completed Job^estimate Dean/Mike # o s ares: - Billed .f � 1Vlaterial ordered Extras Paid - Available Discounts r It i 1 , s f 1v M l F ' 4x ti � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Mapc Parcel ' Application # ail f Health Division Date Issued O (ca t Z Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board �k 101,s1►Z Historic - OKH Preservation / Hyannis v Project Str et Ad ress 4 Village �r Owner 0 Address Telephone Permit Request n Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatis, 0SO Construction Typbz .i Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes Z No On Old King's Highway: ❑Yes i/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 Couunt Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes;❑ Nod Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing new size Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER-OR HOMEOWNER) Name Telephone Number Address License # -43��qJ i IT Home Improvement Contractor# Worker's Compensation # ALL ' O TRUCTION DEBRIS RES ULT11G FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR - DATE t FOR OFFICIAL USE ONLY _ APPLICATION# DATEISSUED ` MAP/PARCEL N0. { ADDRESS VILLAGE OWNER ` t F DATE OF INSPECTION: I FOUNDATION 7 FRAME INSULATION FIREPLACE ;S ELECTRICAL: ROUGH FINAL { i PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING a, DATE CLOSED OUT . ASSOCIATION PLAN NO. bepartment of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 - Uf - WWI :mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le •bl Name(Business/Organizadc)n/IndividuaI) Address: City/State/Zip: ./L : Phone.#:---5`� � � Are you an employer? Check the appropriate boz: Type of proj ect'(requireti):• 1.❑ I am a employer with 4. I am a general contractor and I employees(full and/or part time). * have hired the sub-contractors 6. ❑New construction . I am a•sole proprietor or partner- listed on the•athazhed sheet' 7. El Remodeling and have no employees These sub-contracim have ' 8. Demolition wo=king forme in any capacity: employees and have workers' -9. [[Building addition [No workers' comp.insurance, comp.m.surance- required) 5. 0 We,are a corporation and its 10.❑Electiicalsepairs 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 , 12.0 Roof r ai36A Iasi ce required.]t c. 152, §1(4),and we have no employees. [No workers' 1.DLDther ' comp.insurance required] *Any applicant that checks box#1 must also 0 out the section below.showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they arc doing all work and then him outside contractors must submit anew affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contactois and state whether or not those entities have employees- If the sub-contractors have employccs,they must provide their workers'comp.policy number. 'I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy andjob site information Insurance Company Name: Policy#or Self-ins,Lic.#: Expiration Date: - Job Site Address: City/Statdap: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure,to secure coverage as mguired under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of fine up to $1,500.00 and/or one-year imprisonment,'as•well as civil penalties in the farm 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 statr merif maybe,forwarded to the Office of Invest* of the D for insurance covers. e verification. I do-he by un ns•and en al ' of p 'ur that the information provided above is ue ect Si ature:. = Date: Phone Offccw use only. Do not write in this area,to be completed by city or town official- .City or Town: Permitlhicense# _ . Issuing-Authority(circle one): .1,+Board of Health 2.Building Department 3. City/Town Clerk .4.Electrical Inspector 5:Plumbing Inspector 6. Other Contact Person: Phone#: . I Mass ichuseas- Department:ot Puhtic.SafetN- Board 01;'.Building= Rc�ua�tinnti ind Standards Go:nstruetion Supervisor'License License: Cs 73395 { PETER J KENNEDY 444 MISTIC DR MARSTONS'M.ILLS, MA 02648 �y Expiration: 1 1/21201 2 C..onmi issionej Tr#: 4777 I - ' Town of Barnstable ` Regulatory Services t r uxxsres Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-796-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, �e 'J� 1' t „as C of the subject property-r- _ J P P rtY hereby authorize PET el) ) E: p" to act on mybelalf, in all matters relative to work authorized by this building permit application for: n _ (Address of Job) - -7 5-6,1 / 6- 10 S' ' e f z M 6,L Date- Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:F0 RMS:0 WNERPERMIS510N Town of Barnstable Regulatory Services sAitNSUBLE, ; Thomas F. Geiler,Director Building Division PIED µA{k Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number i strcot village f "HOMEOWNER': I name ? home phone# f work phone# CURRENT MAILING ADDRESS: i ? /f r city/town // state zip code f / The current exemption for"homeowners,'was extended to include o er-oecu red dwellings of six units or less and to allow homeowners to engage an individual for hire who does no possess a license,provided that the owner acts as supervisor. DEFITTTITON OF EOMEOWNER Person(s)who owns a parcel of land on w 'ch he/she resides oi&i nds to reside, on which there is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period.ihall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on.a.forrn;acceptable to the Building Official, that he/she shall be responsible for all such work pr,rforrned undAr the buildin ` 'ermit. (Section l o9.1.1) The undersigned"homeowner"assumes responsibility fo o'mpliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that.he/shq under-stands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and , requirements. s Signature of Homeowner >f I° Approval of Building Official !f 1 t o t 1 Note: Three-family dwellings containing 3S0 00'pubic feet or larger will be required to -omply with the State Building Code Section 127.0 Construction Control. HO'&O WNEWS,EXEMPTION .7he Code states that: "Any homeowner perfonTung work for which a building permit is required shall be exempt from the provisions of this Section(Section 109.1.1 -Licensing of construction Supervisors);pr'ovidcd that if the homoowna engages a persons)for bite to do such work,that such Homeowner shall act as supervisor. I P/r I Many homeowners who use this exemption are u nawan that thcylarc assuring the responsibilities of a supervisor(see Appendix Q. Rules&Rcgvlations for Licensing Construction Superosdh,Section 2.15) This lack of awareness often results in serious problems,particularly when the hDmeOWDcr hires unlicensed persons. In,this case,our Board cannot"procecd against the unlicensed person as it Mould with a licensed Supervisar. The homeowner acting as Supervisor isjultirrrztcly responsible. To ensure that the homeowner is fully aware oilhis/ha resportstbilitirs,many communities require,as part of the permit application, that the homcowncr certify that hc/she understands the responsibiliti.cs of a Suervi psor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/ccrtification for use in your community. Q:forTns:homccxcmpt r Peter Kennedy 444 Mistic Drive Marstons Mills, MA 02648 , (508) 280-5641 Bob Lewis Centerville Beach Club Long Beach Road Centerville, MA September 26, 2012 Description Qty Rate Total Miebec pre stained shingles 17 320.00 5,440.00 Dump Fee(charged by estimated ton, minimum of 2 tons) 3 190.00 570.00 Side Wall Installation 17 220.00 3,740.00 Permits included Total estimate $9;750.00 Thank you. Peter Xennedy TOWN OF BARMSTABLE 70"If MNJ.3 N 12: 57 MICHELE CUDILO, P. . Consulting Structural Engineer Centerville,Massachusetts 02632-1979•(508)771-7601 •Falo'@8),-,L7�1,,:-71Z3-m-c—uai7ro@comcast.net June 10,2011 Town of Barnstable Building Department 200 Main St. Hyannis,MA 02601 Attention: Mr.Thomas Perry Building Commissioner RE: Maintenance of Exits,Massachusetts State Building Code The Beach Club,27 Long Beach Rol:Centerville,MA Dear Mr.Perry, Please be advised that the above captioned project has been inspected on June 06,2011 and again on June 10,2011 to review repairs completed. This office has inspected all exterior bridges,steel or wooden stairways,fire escapes and egress balconies for structural integrity and safety,and finds them adequate,as amended. I trust that the above addresses your needs at the present time. Should you have any question on any of the above, please do not hesitate to call. S' cerely, Cudilo, .E. / TH of ;,'�i�chele S 11-103 �s cc: C. Orlorff WC 9°y O CumLo G N m o.^4774 ST RU„TURAL o 9Fr.SrERE� ' - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ('� l Permit# �, / /,� Health Division Date Issued Conservation Division FeeP) Tax Collector Treasurer U Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address ? h oAJ 67- 6 e—ac- 2 ( GL...(ti� . Village 1. eo �-e r V i 19 Owner k3,M C,k ClYb 6-F ( riVQ Ville- Address � z( 5217 Ce��eryi'l le Telephone 608' - ��� �, EYA_ �l m4ca('0 k Permit Request re roo FI A-T robs e r rnern h ra n y_ t kip Square feet: 1st floor: existing proposed 2n floor: existing proposed =. Total-,new _. V n A- b ow Zoning District Flood Plain Groundwater.Overlay ' Construction Type — , Lot Size Grandfathered: ElYes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: Cl Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn: ❑existing ❑new size Attached garage: ❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial'A Yes ❑No If yes, site plan review# Current Use oi�I°G vl��g(,h l,�Ub Proposed Use U. BUILDER INFORMATION Name ao t CGx�eav � Telephone Number 7 7 Address lom /"I Cf I►1 License# 10,30 S 0 S1ery i 1'P AA- 02�O S 5 Home Improvement Contractor# 0 . / Workers Compensation V�7 W16 I0d ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO M064\ LA _ U J SIGNAT RE 'n . 4 T- —7 DATE 161151 v FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED t , MAP/PARCEL NO. G ADDRESS VILLAGE 'r OWNER- DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING h I Yt^ t yw DATE CLOSED OUT �x ASSOCIATION PLAN NO. '' t The Commonwealth of Massachusetts Page 10 of 10 !! Department of Industrial Accidents M i Office of Investigations ' 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print L egibly Name(Business/Organization/Individual): Ply L— S C 2 z e a u l+ Address: JC)-�> J_n of l n s� City/State/Zip: 0 5 T,e1^V I t �e M AO2(o S S Phone#: Are you an employer?Check the appropriate box: 'type of project(required): I am a employer with 12 4. [] I am a general contractor,and I 6. n New construction employees(full and/or part-time).* have hired the sub-contractors 7.2.❑ I am a sole proprietor or partner- listed on the attached sheet.x 8. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. Building addition [No workers' comp.insurance 5.. ❑ We are a corporation and its 10.0 Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 1 L[J Plumbing repairs or additions myself.[No workers' comp.. c. 152, §1(4),and we have no 12,[R Roof repairs insurance required.]t employees.[No workers' 13.0 Other comp.insurance required.] •Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information: I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: V 1J l�Oq sz ( ALDI Expiration Date: L-) U Job Site Address:!;) City/State/Zip: C Q;� f \\�P�mA 62 Attach a copy of the workers'co ensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Si a e Date: A)6 -7 Phone#: 8 Official use only. Do not write in this area,to be completed by city or town offwiat 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: Phone#: Property Owner Must Complete & Sign This Form If Using a Roofer / Builder. I (print) �� C�' as Owner Agent of the subject property hereby authorizes Paul J. Cazeault & Sons Roofin_g Inc. to act on my behalf, in all matters relative to work authorized by this building permit application for.- Address of Job .Zo A Signature of Owner Mailing Address of Owner Telephone# O Date (Please return this form to Cazeault roofing along with your signed contract; It is needed for us to obtain the building permit required by your town, to complete your roofing project, thank you) fax#508-420-4555 ® r® os al. ,Main Street Osterville,MA 02655 (508)428-1177 Fax:(508)420-4555 www.cazcault.com The Beach Club Attn: Bob WL on Post Office _ _.. 297 DATE ESTIMATE NO. Centerville, . 02632 S0/1/2007 3862 S 1 ` y Phone�# Estimated by: i 4zgaos� Per Description of work to be perfromed j Tota l Remove existing flat roofing system. Install V'polyiso insulation. Install .060 Carlisle sure-seal rubber membrane, fully adhered. ' Flash all curbs, pipes, posts and other penetrations in accordance with manufactures specification I Install .032 aluminum flashing on perimeter edges. Replace side wall with white cedar shingles (prestained--double di All roofing related rubbish to be removed from premise. peed) (� Provide manufactures 10 year warranty I'd p Coat roof with Hypolon (gray) E t. : I _— - e _ = ' do Building gaBoar Re i and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Registration: 103714 Type: Private Corporation PAUL J. CAZEAULT & SONS', INC. Expiration: 7/9/2008 Paul Caieault --• 1031 MAIN ST OSTERVILLE, MA 02658 \ Update Address and return card.111:11-1c reason for change. 's-0At 0 5oon-05/06-PCo490 I.-.I Address Renewal I I,mp m loycnt Lust('arcl L. .� 67' -ic a»incaowin o0✓ avaccc�ivaella Board of Building Regulations and Standards ' License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration(late. If found return to: Registration: 103714 Board of Building Regulations and Standards Expiration: 7/9/2008 One Ashburton Place Ito 1301 Type: Private Corporation Boston,Ma.02108 DAUL J.CAZEAULT-'&SONS,:INC, 'aul Cazeault 1031 MAIN ST JSTERVILLE, MA 02658 Deputy Administrator �- Not valid without signatt e` Boar o ui mg egulat'ons an tan�ar One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Construction Supervisor License License CS: 26325 Restriction: 00 Birthdate: 10/20/1959 Expiration: 10/20/2009 Tr# 6311 PAUL J CAZEAULT 1031 MAIN ST _.._ OSTERVILLE, MA 02655 Update Address and return card.Mark reason for change. oPS-CA1 co 5OM-07/07-PC8490 _..__..___...... .-._. �] Address Renewal [ .Lost Card _F. Board of Building Regulation and Standards Construction Supervisor License License: CS 26325 Birthdate:"`10/20/1959 a f„ Explratlon 10/20/2009 Tr# 6311 Restriotton 00 f: PAUL,J CAZEAULT':` 1031 MAIN ST OSTERVILLE,MA 02655 Commissioner _.-._ ...-• -- - Pages 003• .103 RightFax H1-2 8/24/2007. 1 :21:48 PM PAGE 003/003 FaX server ACORD. CERTIFICATE OF INSURANCE DATE(MMIDDIYY) 08-N-07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO R]OHTS UPON THE CERTIFICATE DOWLING g O'NEIL INS AGC HOLDER. TH13 CERTIFICATE DOES NOT AMEND,EXTEND OR 973 TYANNOU014 ROAD 2ND FL ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 1990 COMPANIES AFFORDING COVERAGE HYANNIS,MA 02601 COMPANY 22LGR A TRAVMEP-S DIRECT ASSIGNMENT INSURED COMPANY ' 13 PAUL J CAZEAULT&SONS INC. COMPANY 1031 MAIN STREET C OSTERVILLE.MA 02655 COMPANY D COVERAGE THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE MR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQURONIENT,TBRH OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECY TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERIM,EXCLUSIONS AND CONDITIONS OF SUCH POLIC0, LINM SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POUCYGPP pOLICYEXp LTR TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIYY) DATE(MMIDDIYY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE S COMMERCIAL OENMRAL LIABILITY PRODUCTS-COMP/OP AGO, 3 CLAIMS MADE OCCUR. PERSONAL B8 ADV,INJURY 3 OWNER'S da CONTRACTORS PROT. EACH OCCURRENCE 3 FIRE DAMAGE(Any one fire) 3 AUTOMOIi1LE LIABILITY rs MED.EXPENSE(Anyone peon) 3 ANY AUTO COMBINED SINGLE LIMIT 3 ALL OWNED AUTOS BODILY INJURY(Par Pelson) $ SCHEDULE AUTOS BODILY INJURY(PerAcddenl) $ HIRED AUTOS PROPERTY DAMAGE 3 NON-OWNED AUTOS GARAGE LIABILITY / ANY AUTOS AUTO ONLY.EA ACCIDENT S OTHER THAN AUTO ONLY: EACH ACCIDENT S AGREGATE S EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE S OTHER THAN UMBRELLA FORM AGGREGATE $ WORKER%COMPENSATION AND A IEMPOLYER'SLIABILITY UB•0095564A-07 08-10.07 08.10-08 STATUTORY LIMITS X THE PROPRIETOR/ EACH ACCIDENT ' $ 100,000 PARTNERS/EXECUTIVE X "INCL DISEASE-POLICY LIMIT $ 500,000 OFFICERS ARE EXCL DISEASE-EACH EMPLOYEE S 100,000 I OTHER DESCRIPTION OF OPERATIONS(LOCATIONSNENICLESIRESTRICT10h$tSPGCIAL ITEMS THIS REPLACES ANY PRIORCERTI ICATE ISSMD TO nM'CMU-I HCAIB HOLDER AFFECTING WORKERS CObe COVERAGE, CERTIFICATE MOLDER CANCELLATION -HOLDER--------_"-'^"---- SHOULD ANY OFTHE ABOVE DESCRIBED P(XICIES BE CMCELtED BEFORE THE EI(PIRATION DATE THEREOF,THE ISSUING COMPANY WILL EHOEAVOR TOMAIL 10 1., DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BJT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO 013LIGATION OR LIABILITY OF ANY WND UPON THE COMPANY,ITS A'SENT$OR REPRESENTATIVES. AUTHORIZED RBPRESFNTATIVE Charles J Clark MICHELE C. TUDOR, P.E. Consulting Structural Engineer 123 Cottonwood Lane•Centerville,Massachusetts 02632-1979•(508)771-7601 •Fax(508)771-7163 mctudor@comcast.net May 17,2006 Town of Barnstable Building Department 200 Main St. Hyannis,MA 02601 Attention: Mr.Thomas Perry Building Commissioner RE: Section 1028 Maintenance of Exits,Mass.Bldg.Code 6th Edition The-Beach-Club;Centerville,MVO Dear Mr.Perry, Please be advised that the above captioned project has been inspected on April 20,2006 and again on May 11th and 17t`,2006 to review repairs completed. This office has inspected all exterior bridges,steel or wooden stairways,fire escapes and egress balconies for structural integrity and safety,and finds them adequate,as amended. I trust that the above addresses your needs at the present time. Should you have any question on any of the above, please do not hesitate to call. S' rely Michele C.Tudor,P. w /2006-78 cc: B.Watson > (H0F MASS c MICH-LE C. Gn � TUDOR 0 No.34774 v STRULFURAL ey ISTE-�4,.`� a �FTHE L4 lZ 1 IV� ach r + The Town of Barnstable � L1RNSfABLE, • MAS& ��� Department of Health Safety and Environmental Services 1659n. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner May 24,2000 The Beach Club PO Box 297 Centerville,MA 02632 Re: Sleeping Quarters on Second Floor CEASE&DESIST To Whom It.May Concern: This letter is in response to an inspection that was made on May 24,2000 of the Beach Club building located on Long Beach Road in Centerville. In that inspection it was discovered that there is approximately six(6)people sleeping on the second floor. Because of the age of the building,lack of safe egress out in case of an emergency,and other building code issues,this is an accident waiting to happen. This must stoX immediately. If you should have any questions regarding this issue,feel free to contact this office. Sincerely, cr Tom Perry Building Inspector TP/sc 'a rN"r- Cu✓ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map PG ' Parcel e,'2/ A, Permit# _!�p Health Division Qe Date Issued I 12D 00 Conservation Division - Fee Tax Collector. , - .: " . /ad r Treasur SEPTIC SYSTEM p� INSTALLED IN COMPLIAV Planning Dept. WITH TITLES Date Definitive Plan Approved by Planning Board /U NVIRONMENTAL CODE AND TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address 9"7 I—O N C- B E A C VA 0 P�-D 4c Village CeN i F-R V I L-1-_ Owner 714C `PEERCl4 C-L-L58 Address ? 0 'rZ>®k aq 1 A-1 L-Db4& FvcN f3l Telephone - __---_-'_7 `7-1> 6-1 11 C1=t-3 t ER V t-L 111I1 10--xG3a-Oa9`7 Permit Request OT7 L K t T o4 c tJ , R�t�LL�C�YY1�NT �T' K L-rc"-EI. 1 Eqv 11p m'Et17-- F►0 t5lA FL-oes fZ5 WA LL-4, 1 LC-1 L 10.1 G-. C-LEC_T-R1 CFI L� ` l-u m E>i&J� 4+60 K u'p S 5F>R1 AJ K L1=R FuE L0(fW-I 10^t T-0 ACDvS-ncC,-L- CC--)LA 14C,- Square feet: 1st floor: existing proposed 2nd floor:existing proposed Total new P4 0k4E Estimated Project Cost� � ��'eJ Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0 Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑ Full 0 Crawl O 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: .0 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 0 new size Barn:0 existing ❑new size 9 g 9 9 9 Attached garage:❑existing ❑new size Shed:0 existing ❑new size Other: Zoning Board 2es Appeals Authorization ❑ Appeal# Recorded❑ ercial Comm ❑No If p ,es site Ian review# Y Current Use C%-k3?) Proposed Use BUILDER INFORMATION Name CR-1 s i A L 'PHE L{O?ME tl f CQR.F Telephone Number Lf6 t - 9 4- L Address 16a5 'PL-31Ai [=teL > S7f License#4�5- 6 MA J®141 t S•T0 t l T. C aq 1 y Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE _. o� �`� � i r -DATE — F - 31 — ® c> FOR OFFICIAL USE ONLY _ Ili ~PERMIT NO.. ✓ ' L/ ' i DATE ISSUED MAP/PARCEL NO. . � ADDRESS VILLAGE-� OWNER 40 ,7 DATE OF INSPECTION: _ FOUNDATION t FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH} . FINAL PLUMBING: ROUGH.. Z � FINAL ._ � � � yr' , _ .. . GAS: ROUGH) �,; FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PIAN NO. rlE, i _ , The Commonwealth of Massachusetts Department of Industrial Accidents �J17, = OlBcs olhresti9stioas 600 Washington Street } Boston,Mass. 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I understand that a one years,imprisonment as well as dvli penaltla to the form of a STOP copy of this statement may be forwarded to the OMco oflaveadgEdowof the DIA for coverage vetilicatim the sots and efP�'"the information Presided above is true and correct I do hereby certify P P Date c/o _/ 7 — Signature . . --..._._ . Phone# Print name oflidal we only do not write in this area to be completed by city or townillci oal perntit/lleensetl []Building Deparonent city or town• Olicensing Board Osdectmen's Oilice ❑check if immediate response is regorged []Health Department phone#, ❑Other contact person: (sewed 9195 P1lU Information and Instructions ` all to to provide workers' compensation for their Massachusetts General Laws chapter,1 a section 25 requires employers contract quoted from���w„����y�is as every person in the service of another under any employees. As , of hire, express or implied, oral or written. defined pip,association, corporation or other legal entity, or any two or more of An employ representatives of a deceased employer, or the receiver or the foregoing engaged`in a joint enterprise,and including the legal association or other legal entity, employing employees. However the owner of a trustee of an individual,partnership, who resides therein, or the occupant of the dwelling house of dwelling house having not more than three apartments air work on such dwelling house or on the grounds or another who employs.persons to do maintenance,succonh a uctzon or rep building appurtenant o shall not because of sack employment be deemed to be an employer. state or local licensing agency shall withhold the issuance or renewal MGL chapter 152 section 25 also states that every in the commonwealth for any applicant who has of a license or permit to operate a business or to construct bindingsthe not produced acceptable.evidence of compliance with the insurance coveragrequire�d� public c wo until P shall enter into any contract P commonwealth nor any of its political subdivisions requirements of this r haVe been presented to the contracting acceptable evidence of compliance with the msarance authority. Applicants compensation,affidavit camp,by checlang the box that applies to your situation and Please fill in the workers' co®p with a certificate�;*,�„��as all affidavits maybe address and phone numbers alaog - supplying company names, ofmsurance coverage. Also be sure to sign and submitted to the Department of Industrial Accidents for confilmatim licatian for the emut or license is date the affidavit The affidavit should be rem to the ch9 or town that the app P not the Department of Industirial Accidents. ShMM you have any questions regarding the"law"or if you being requested, lease call the Department at the number listed below. are required to obtain a workers cnmP=sation po�9�P City or Towns ` is lobe and printed legc�ly. The Department has provided a space at the bottom of the Please be sure that the affidavit comp has to taunt You regarding the applicant. Please affidavit for you to fill out in the event the Office of Investigations number. The affidavits may be reformed t^ be sure to fill in the pe®it/ikme member vA&hwMbe used as a reference the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would ble to thar<k you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. FEAM E M M The Department's address,telephone and fax member. The Commonwealth Of Massachusetts Department of Industrial Accidents Otllce of investloatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 OCT-17-2000 TUE 04119 PM BEACON MUTUAL INS ---YX NO. 401088644E2 P, 02 The I3cacon Mutual Insurance CCn,lp ttly w Mutual Onc Beacon Centre ��e� 1~ Insurance co, 'Warwick,RI.02886-1373 (401)325-2667 Fax(401) 825-2855 CLRTIRCATE OF WORKERS' C:OMPFNSATION AND E.NIPLOYIi RS'LIABILITY INSURANCl j 4 c:HRTII'iCATE IIOLDER INSURED The Bench Cinb Crgviile MA Crystal Uey Corp Attn;John II Garvey 68 Chine Way 1024 Plainfield Street.JyhnSton)RI 029I9 a,yterviue,MA 02655 Thiti t.ertilicate is issued tiv a IMAter of informa,ien only and confers nori_hts upon the cktr0icate holder. This certificate:'does not amend,extend or alter t1le COVMV afforded by the policy below t I i �a,�'✓"r V e. P fit J a.��;t Y»�d+a,1, 1)i2i Y�' vrti- n, 'a''R•—'n'r 77 . ti:' 4 of q �tk�7'v7'+7'9."a.,iT"�,"'R"r"'T' --r• (g,!,N rkaRMc u? ''It is is tll a:I'lify ihM Plici-of i'Viumilce Usi d below hzvc beer,c ..,sued the insured n;n,ted ub(ivo for thf,policy period inch atcd. Nu(witlis(andin�flry rtquinmcnt,[Can or eondiGnn of art'con} tl'ac(ur6t11vr document with respect to wIlic:h th,,ccru;;cntc muy ho issutd or ,aay Ire lain,the insurance al7brdcd by the polieios dl w ibed h Kwn is suh�cct,o all tcrnts,exclusiuns,anj conJiuons of such pohc'los. a•1 t .. x W Yrr,Q` .C1tlu Ft Ir ti+.rr 451,1i' Q 1G' r�3 "'t I�l'yr{�- 'f"t '"-�--� - •T'x '^i. ff/' q. a., dttfi ,..uuvY2 )IYl1�tbIYwlyt r' i sy. r aG twvs ti1l(1T$Ol I'ABf)A1, Workora'Co.npeaisation I 26992 10/12/00 10r12.f0I .• .V. . ; J J Stutuloty berlurits required b7 t.)e Fl edo Wilmd And I Workers'Cotnpcm,vtiion Law Entpiny'cr;'I_irthility i $,tUO OU{1 Each rcpide t $'IOQ!U00 hnlicy Liiril by disulso 5500,000 Such emp2oycc by disease llnscriptinn ot'op!:r;,rinn/lucatiolts ��, , 11,11 ,` n 6 rMINOR, 771,171, r' kf k-7 i . " Sy baw �n4ts.rf u.•,..;„t„�Y�1i�.,�1aS� .hh!r`tNl',i�:b..�U �ew�l,e`:�r- ytr�'�n, Ak L:i, : !pi . Should the shove policy b�c n flat befor,•the exP iMfioh dsllg theivof,The Beacc,n Mutual It) urnr,ce C,ornp ny Will nuii _ dttvA writiel notice to the certi ieutc holder named kcrcin by regular mj41. AU1110aii.9d)ZUltraeCitlilhV4 I `— �1 Date 1):sucd(,A M I)EINY)/10/17/00 RRCIXI?k OI�REC'ORn Duxbu,y do Ray Ins Agency 11d Box 170M8 Smith(-told, R102417 I - I — CERT1F!CA1 E 1101 )CP, PH a o -9 1 Fn t 5 73 x 7, FR FTI 69 F n r-n �q y 1?7 T I 1- 13 ---------- ---------- rn lv Fn z FTI r-n -0 m i > 0 z Zn(n 0 0 m >�sr Edward F. Barry Health Inspector FPO MARTIN MacNEELY Town of Bar nstable CERTIFIED FIRE INSPECTOR B"";s"sB1Ea: 1926 Department of Health,Safety& � `e rEo�,u,�.•CENTERVILLE-OSTERVILLE-MARSTONS MILLS Environmental Services FIRE DEPARTMENT HEALTH DIVISION Office Hours: 367 Main Street,Hyannis,MA 02601 1875 Route 28 f 8:00-9:30 a.m.Daily TEL:(508)862-4645 Fax:5 -790- 0-2380 Centerville, I f Daily 1:00-2:00 p.m. FAX(508)790-6304 i Fax: 508-790-2385 MA 02632 �- DONALD A.DENNIS r dvanced Vice President ire 1707 Purchase St. rotection New Bedford,MA 02740 I. ( Complete Inst.of Rest.Kitchen Exhaust Systems and ANSUL®Fire Systems. 1 C) 15 MA,RI&CT Area v / (508)993-4080 (508)993-2313(Fax) Page 1 of 1 John H Garvey From: "Steve Lombardi"<cdcorp@tiac.net> To: "John H Garvey" Sent: Tuesday, November 14, 2000 3:37 PM Subject: Building Permit John, Can you find out what the building department is looking for to complete your application. I have spoken to Advanced Fire, who has spoken with the building inspector,and was told they did not have to apply for any permit from the building department. All his paperwork is in order at the fire department. I would like a framing inspection this week so that we can cover the area around the hood Steve 11/15/00 = A TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Jf INS .Permit Health Division y .. �s� � �. �� Date Issued Conservation Division TOWN RE--G-11" Feed Tax Collector 7 t F �P 7�c f Treasurer L�n�,(�" � ...��( 4z, Planning Dept. , Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project StreetAddress,�-7t Long Beach Road / ,Village Centerville - Owner The Beach club Address :Long Beach Road , Centerville Telephone 428-0184 - Jb4n .Permit Request Work — Sepiace entireoo f ;, JV • �U r Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new Estimated Project Cost $30 ,000 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. - .Dwelling Type:. Single Family 0 iTwo Family •❑ Multi-Family(#units) Age of Existing Structure Historic House: 0 Yes 0 No "`. On Old King's Highway: , O Yes . 0 No, Basement Type: ❑Full '0 Crawl ❑Walkout 0 Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) N ,- F um 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 . r Heat Type and Fuel ❑Gas 0 Oil ❑ Electric, ❑Other Central Air: ❑Yes O No Fireplaces: Existing New Existing wood/coal stove: 0 Yes ❑No Detached garage:O existing ❑new size' Pool:0 existing 0 new size Barn:O existing 0 new size Attached garage:O existing O new size" Shed:O existing ❑new size'. Other: Zoning Board of Appeals Authorization .❑ Appeal# Recorded❑ ` Commercia 6Z .-0 No If yes,site plan review# ' Current Use Proposed Use BUILDER INFORMATION Name E.J. Jaxtimer, Builder, Inc. Telephone Number 778-491.1 Address 48 Rosary Lane , Hyannis License# 0.03251 Home Improvement Contractor# 1 1 o6og Worker's Compensation# WC97-695028 ALL CONSTRUCTION DEBRI ESULTING FROM THIS PROJECT WILL BE TAKEN TO ~ Macomv,Wlnumpster " SIGNATURE DATE _ 5 r t FOR OFFICIAL•USE ONLY PERMIT NO. _ •' - I c i ' DATE ISSOED MAP PARCEL NO. ADDRESS - VILLAGE . OWNER ' + •rr 4 DATE OF INSPECTION: .FOUNDATION • FRAME, _- � t r .;.3 - �° � .- , - - ', � '; 1 `' .. • • s .INSULATION g c r - k • ' - t FIREPLACE ¢ p r� E '";, `` � � • (' t _ `; •• f. - ELECTRICAL: ROUGH FINAL= f r' PLUMBING: t ROUGH' FINAL' GAS: ROUGH :.FINAL FINAL BUILDING { t DATE CLOSED OUT r ASSOCIATION PLAN NO. 4 • _ 1 s __ The Commonwealth of Massachusetts Zi..... . n< _ -_ Department of Industrial Accidents - `-. office offnrestfgatiofts 600 Washington Street Boston Mass. 02111 Workers' Compensation Insurance Affidavit name: E. J. Jaxtimer, Builder, Inc. location: 48. Rosary Lane city Hyannis MA 02601 phone# (508)778-4911 ❑ I am a homeowner performing all work myself. ❑ I am a sole ro rietor and have no one workin in any ca acity ''/////NOME////%////%////%////%%%%%/��/G%% %/// % ❑x I am an employer providing workers' compensation for my employees working on this job. company name:. E. J. Jaxtimer; Bu 1'der, `Tnc.> address. 48 Rosary Li3ne city, Hyannis > MA 02601 shone#: (gnR�77A alai i .. _ insurance co. Eastern Casualt olicv# — 0/1 / ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: comaanv name: address: city. phone#. : insuranee.;co. ohcv#cutnaany name. .....:.:::.. wx address' city- ;phone#. i:. _... .... x. inanraneeMco.: Failure to secure coverage as required under Section 25A of MGI:152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certify under pains and penalties of perjury that the information provided above is true and correct Signature Date Print name E. .J. Jaxtimer Phone# (508)778-4911 official use only do not write in this area to be completed by city or town official 1,`cityor;:town• permit/license# []Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other Oevised 9195 PIA) • a r Assessor's office(1 st Floor):, Assessor's map and lot number6n Conservation(4th Floor): Board of Health(3rd floor): r • • Sewage Permit number sMnct ' Engineering Department(3rd floor): c0, i610'`\,�► House number I Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN ' OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO '`'_ s4 ','5`Z TYPE OF CONSTRUCTION �✓ � Z r 1 7C' [ f/ 19 • TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following ///information: Location t y lOh< 4"��� ��1 �s•� �-G�d' 8 Proposed Use Zoning District Fire District A1 l Ge�6 r"hL 1ja)° 27 C4* 1-f 6 a�i�2 E'lh o2�'c3Z Name of Owner Address Name of Builder �y �G' `-- �' Address bay QW- 0skewc;A mac`' aze Name of Architect Address J Number of Rooms Foundation Exterior Roofing ASJ4 al i S �r is .t Floors Interior �1�r Heating r t/ Plumbing Fireplace I 114 Approximate Cost Area 42/'eA Diagram of Lot and Building with Dimensions Fee L�Q 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 s Construction Siipervisor's License c� THE BEACH CLUB, INC. { x No 9-6fr83- Permit For RESHINGLE ROOF Location-1-• Long Beach Road Centerville Owner The Beach Club, Inc Type of Construction ; Plot Lot Permit Granted May 6 19 94 Date of Inspection: Frame 19 Insulation 19; Fireplace 19 Date Completed 19 r ` COMMONWEALTH OF MASSACHUSBTTS DEFAR"I'MENI'OF INDUSTRIAboACCIDENIS _ 600 WASHINGTON STREET lames.: Car-tDoei: BOSTON, MASSACHUSETTS 02111 cor•nasione' WORKERS' COMPENSATION INSURANCE AFFIDAVIT I� (licensee/permittee) with a principal place of business/residence at: (Gty/StlmmZ ) do hereby certify, under the pains and penalties of perjury,that•. H11-am an employer providing the following workers' compensation coverage for my employees working on this job. Insurance Company Policy Number (J I am a sole proprietor and have no one working for me. ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation insurance policies: Name of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number Dame of Contractor Insurance Company/Policy Number 0 I am a homeowner performing all the work myself. NOTE-Please be aware that while homeowners who employ persons to do maintenance,construction or repair wort,on a dweiiing of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto are not generally considered to be employers under the Workers' Compensation Act(GL C 152,sect. 10)),application by a homeowner for a license or.permit may evidence the legal sutus of an employer under the Workers' Compensation Act. I understand that:copy of this sutcment will be forwarccd to the Department of Industrial Accidents' Ofnee of lnsumncc for coverage vcr.nc::ion and t^a:i:iiurc to sccurc coverage as reouirec under-Sccnon 25A'of'v1GL 152 can iead to the imposition of criminal penalucs consisdnQ of a fine of up to S1500.00 and/or imprisonr..cnt of up to one year and civu penaities in the form of a Stop Work Order and a fine of S 100.00 a day against mc. / Signed this � day of 19 :ccasor;Pcrm::.o: r. z ✓!2� �Cz��Z�7'2%Q�IYLL(1E?cz�f�YL HOME IMPROVEMENT CONTRACTORS REGISTRATION � ° Board of. Building Regulations and Standard One Ashburton Place Room 1301 Boston, Massachusetts 02108 HOME IMPROVEMENT CONTRACTOR - Registration 100023 Expiration 06/08/B-# Type INDIVIDUAL Bill Croston Bill Croston 51 . Suomi Rd Hyannis MA 02601 COMMONWEALTH '"aossssacerront DEPARTMENT OF PUBLIC SAFETY ,saaara�t7aStatsBaticr'r® OF 'ONE ASHBORTON PLACE ^is cow"for revocation ' MASSACHUSETTS BOSTON,MA 02108 LICENSE CAUTION EXPIRATION DATE �. CONSTRO SUPERVISOR 04/25/1996 `6 FOR PROTECTION AGAINST RESTRICTIONS EFFECTIVE DATE LIC-NO. THEFT, PUT RIGHT THUMB NONE 0 6/30/1993 014112 PRINT IN APPROPRIATE ° BOX ON LICENSE. WILLIAM W CROSTON SS tt 025-50-605801 S1 SUOMI R� a BLASTING OPERATORS H YA N N I S CIA 02601 Z MUST INCLUDE PHOTO. m m PHOTO(BLASTING OPR ONLY) FIf 0 be. 0 - NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY _ HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER DOB: 04/25/19 56 THIS DOCUMENT MUST BE'CAR t « SIGN NAME IN FULL ABOVE SIGNATURE LINE THE HOLD TH WHEN NOF SIGNATURE OF LICENSEE THE HOLDER WHEN EN- � - OTHERS-RIGHT THUMB PRINT GAGED IN THISOCCUPATION. TONER f, T -- --._ - - - ,t - -- --- -.- _-- - - _ e Assessor's office(1st Floor): Assessor's map ay lob numbe X Conservation — SEPTIC SYSTEM MUST BE Board of Health(3rd floor): INSTALLED IN COMPLIANCE Sewage Permit number WITH TITLE S = DA877T�DL � rua Engineering Department rd floor): ENVIRnmrra .qT'kr House number r- 'tp Yal► Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO / 1, a Ie.U. W�r�U a�✓s rn c d- TYPE OF CONSTRUCTION _ r/5� c,wJ (,�/� ✓+u y .r, J 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according/to the following information: Location Proposed Use i0 •�dd z �l �✓ Zoning District Fire District G Name of Owner z �J i C ly 6 v h G. Address /"• G �G� Z 5� �Z �-�����z vu�, Name of Builder r'3 C y^y Address !/ o�- / 3 U S !� L�Z /� c_ Name of Architect Address Number of Rooms / A Foundation p-t c.+�s �p �Iz p'2 S Exterior 'L�v"" s 4 Roofing A 514 Floors �i 00�lic vt' µ�vr 0aL Interior !/h ��y �S�� ���h t �✓ �oa�n.a�� Heating I�JGHZ Plumbing Fireplace /' p Approximate Cost � � c'0 Area,//���h Diagram of Lot and Building with Dimensions Fe �j�®� Z5 n f � t 't cd W OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License 0/y �� Z THE BEACH CLUB, INC. i No 34937 Permit For REPLACE WINDOWS Beach Club - . Locatioo &-"Long Beach Road A '' - ,Centerville t . ; The Beach -Club, Inc,. � � . '^• � i ��� � •,� k � ` . Owner Type of Construction Frame «'. Plot '.Lot Permit Granted April 3 , 19" 92 { _t I i Date of Inspection q 19 - Date Co[rtpleted.:�/ 1,9 ' a SL ' HELICAL PIER NOTE£ •; _s i I. HCUGI FIEF DESIGN SHALL CONFORM TO APPLICABLE REQUIREMENTSER REFERENCED or THE MASSACHUSETTS PAUL F.WEBER j/•} ,': i""""••+.., "'.A r, - _ - BUILDING CODE AND APPLICABLE OR TESTING A Of OTHER FERRENCED DOCUMENTS. . AS -AYERIGM SOCIETY FOR TESTING AND MATERIALS i ASTM A5 8/A SBM--STRUCTURAL=EL- w 5 PORTION OF BOWED IN CMU FOUNDATION WALL ASTY AM-'PIPE.STEEL BUCK AND HOT-DIPPED.ZINC-COATED WELDED AND SEAMLESS' ARCHITECT,LLC. , ..�- `A yyl •'�' ASTY AISS--ZINC COATING(NOT-DIP)ON INCH AND STEEL HARDWARE- 1•-B- (_P) �. 2 - 12' ACI 701 --SPECIFICATIONS FOR STRUCTURAL CONCRETE FOR BUILDINGS- I 2. DESIGN NCl/GL PILE SYSTEM TO SUPPORT LOADS AS INDICATED ON DRAWINGS AND OUTLINE IN THIS SECTION. SUBMIT CDR APPROVAL BY THE ENGINEER THE HELICAL PILE DESIGN CALCULATIONS AND , `L OMER PERTINENT AA TI BEFORE COMMENCING PILE INSTALLATION. APPROVAL Of SUBMITTALS DOES 449 Thames Street NOT BELIEVE CONTRACTOR OF RESPONSIBILITY FOR PERFORMING THE PILE INSTALLATION IN N WITH CONTRACT DOCUMENTS.ASTALLE cc port, 2 2 ,, _ 0.. . F NU ACNRER AMINIMUM 9 YEARS A n J. INSTALLER SHALL BE CERTIFIED By HELICAL FILE MA WITH 1' • - }f +r -F� •f J n ___r'S'�+ -..__..:4' _ 'S'P+... 'S-P+ _ I'L is_. 'S'�+ __...'i -.. .'f' 'Y _.. .'S' ..._. `._ ___L :......__.. EXPERIENCE IN TYPE Of DESIGN AND CONSTRUCTION SPECIFIED IN THIS SECTION AND ABLE TO Newport,.RI 02840 - c a• e' e s _ N EXPERIENCE Tel:401.849.3390 .„ +� +`t INFMCONSTRUCTION PROVIDING SPECIFIED IIN 7UPERINTENDNR OR FOREMAN CMSURNG 4LICNESUPERV BST 5 YEARS ILL CONSTRUCTIONC PRESENT AT Fax:401.849.3397 P 7S SITE DESIGN PILE CONSTRUCTION. J d F i . r _n .•�.._ - - ,,,-.,- _ _ _ .». __.. ..,.i 1. ASSAC ES TO BE OEfCRYIN[0 AND STAMPED BY AN ENGINEER REGISTERED IN THE STATE Or SETTS. TO B S. INSTALLER 70 CONFIRM ETHATNSURE SRC REQUIREMENTS ARE APPLICABLE AR ENSURE PROPER GUARA AND TIMELY • „V. TAs' _ r2�O• INSTAL{ATION AND TO ENSURE RCOUIREYCNTS FOR APPIICABLE WARRAMTI'OR GUARANTEE CAN BE WWW,ptwarchitect.com SATISFIED,SUBMIT TO ARCHITECT WRITTEN CONFIRMATION FROM APPLICABLE INSTALLER. FAILURE i0 :•�"¢ C 1l - SUBMIT WRITTEN CONFIRMATION AND SUBSEQUENT INSTALLATION WILL BE ASSUMED TO INDICATE CONDITIONS ARE ACCEPTABLE TO INSTALLER. Q B. ACCURATELY LOCATE EACH PILE PER DESIGN DOCUMENTS By MEANS OF SURVEY.DO NOT EXCEED/ . DESIGN LOCATION.INCHES LATERAL DEVIATION FROM CENTER Of PILE c I 7. PILES IMPROPERLY INSTALLED BECAUSE Of YISLOCAnON.YISWGNYEM,OR FAILURE 10 MEET OTHER SPECIFIED DESIF,N/INSTALLATION CWTERM ARE NOT ACCEPTABLE. ABANDON REJECTED PILES AND INSTALL ADDITIONAL FILES AS REQUIRED, A PILE INSTALLER RECORDS-MAINTAIN DAILY RECORD OT ALL'OATA PERTINENT TO INSTALLATION OF , DING THE GINIMM'PILE NUMBER.DATE OF MSTALLAT(OK HELICAL PLATE DIAMETER. PIER SHAFT USIZ.P�ELENGTHH.TORDUr READINGS DURING 1MWALLATINt ESCRIPnON ANY - L - UNUSUAL OCCUR DU LE p B. INSTALLATION CONTRACTOR TO PRODUCE AS-BUILT DRAWING AFTER COMPLETION OF PILE INSTALLATION - 01 IDENTIFYING ACTUAL LOCATIONS OF HELICAL PIERS,PIER DIAMETER.AND PIER LEMON AND DEVIATION' . FORM INDICATED LOCATIONS y ZJr r' S _ YJ FQOS� QOZ� QOSt ''' w l�1 Z1 lb� \6� lbl 0- T - `pS 1 t OS� Z1 OZ� ♦1p l 1p .. 'I I R QO Z d Q Z 0 I m l m l m 1 m 1 m W 3 W W ? _ FIO �O ry0 y0 EO y m pI m .y01 m Gr01 m .,r0 W FJZJI�' W ZJ�' W ZJ� W/41P ♦ � ♦ ', � � 1 E)FLUSX S E)FLUSH Z E)FLUSH aS S OS Z OS EFU E)FLUSHFRAMED JOISTS Q FRAMED JOISTS FRAMED JOISTS QQ Q FRAMED JOISTS Q FRAMED JOISTSj.'l l l i l t E)FLUS O Liu �. E)FLUS , (E)FLU S (E)FLUSH E)FLU FRAMED GISTS rr FRAMED J ISTS J FAO FRAMED ISTS p FRAMED J01 FRAMED GISTS SJ���I .? Ii�1, F•C•I GUS �n 1 HANGER O S S S Z BG Is G H1 �,'- - I+`:. __._ .._ ,._r _ •7} 9� WOLN PA_ LLAM .. __ _ ( � ���� lbl� \���. • Lfl� 161� G� _ _ - f� 3}xB} WOLM. PARALlAM _ - 0 4 _ d ce cn -'-.ems. gJ Q �n- _.L��� BJ�f� .`+�- F JT �.� �i^ 'lc �,. �a^ti c I �� ~� t e L^ BEAM TYPO 4 y \/ J p[g[ t_;+!'!L (E)JOIST 2x10 TO ABUT LVL'S. ' W W SHIM GAP IF NECESSARY NOTE: e)i. v'Oi _ PILES SPACED WITHIN 9 { '+ - O _ x m !Z: R(E)"SILL ALLOWABLE LIMITS TO BE'�'-" _ _�1` BATTERED TO ACHIEVE PROPER SPACING HIGH GRADE A .,,_. ---_--____• �V �• ,+Lf�IY : pPR1Yd► '"•��G6 ALONG ENTIRE LVL FLIT 2x10x3"-O-TIMBERLOI _ E)RAFTER -WOL PAAWM.-- ' \. NINGI/PLAN # I,II _ UNDERPIN .f LENGTH OF WALL EACH EXISTING JOIST G --- . .,r �i IO•xIO-PL W/ (B-SPACING, 2-EDGE a��6 Y' - ' h5/8'lHRUBOLTS DISTANCE) _ Q� IL CMU OWALL g t DESIGN INTENT: , ,d;o�✓.L,'w�'% 4 i �' E 1 J 2- LVL HEADER THE INTENT OF THIS DESIGN IS TO STABILIZE THE _lL III,.IA �• REAR WALL AGAINST ANY FURTHER SETTLEMENT. i �� �; (70 BE VERIFIED IN - - THIS WILL ALLOW FOR NEW WINDOWS AND DOORS 'a FINAL CONDITION - �- / ) TO Bf HUNG PROPERLY. NOTE THAT THIS REPAIR DOES NOT ADDRESS THE FOUNDATIONS FOR THE - � INTERIOR POSTS. THEREFORE. THE FUTURE SS I PERFORMANCE OF THE FLOOR WILL STILL BE _ WEBB STRUCTURAL SERVICES INC. _ F TO BE UNKNOWN AFTER THE REPAIRS ARE PERFORMED. n 5 _ ti NEW - - Daniel Webb P.E. j, _ f�/ THIS REPAIR ALSO ADDRESSES THE BOWING IN 670 rWn Street CMU Reading"MA 01867 F { ADERS .OF THE BUILDTING WALL AT THE FRONT PORTION 781 779-1330 lxi` P"-: .y G� GUS E)2.JOIST - L 1- a7, FOR PERMIT PARALLAM HANGER I 8 DesalPron: BFA (E)BEA U 1 Ix T ECHNO PILE WITH LEGEND m UNDERPINNING e ET EENACK NON AND C GROUT BRACKET t oem+ssued: 0, BETWEEN H55 AND CM WALL I OW=BEARING WALL E; FVP=FLAT VALLEY PATE p 6� AS NOTED c u EPLACE CU OUT (E)=EXISTING �S���O �y 1131 swe POTION SLAB :.•� .. - \rG 8�' ^� XISTI SLAB APPROXIMATE (1-MI V.I.F.) GROUND w SURFACE FOUNDATION UNDERPINNING a� 02016-PAUI WEBER ARCHITER.LLC S a I: C , e FNUMBER OF STUDS IF APPLICABLE „ h TIGHTLY COMPACT BACKFlLL SOIL P3_26 h e CONIC. 12•DEEP . Y2-x�10-PL CONE. FOOTING .1 I SIZE OF SND OR DIMENSION OF SOLID PO o / a-s/B-rxs• L u EMBED. EPDXY , - POLUMN.-LICK,VC-VERSA ANCHORS W TYPE OF PoST: e / COLUMN, LC-LALLY COLUMN, �7 S2 LEVELING NUT FOUNDATION REP R _ u AND GROUT sw.:v*-ra - SECTION LLOW STRUCTURAL e 0 HELICAL PIER NOTES: z 1. HELICAL PER DESIGN SHALL CONFORM TO APPLICABLE REQUIREMENTS OF THE MASSACHUSETTS BUILDING CODE AND APPLICABLE REQUIREMENTS OF OTHER REFERENCED DOCUMENTS. ASTM — AMERICAN SOCIETY FOR TESTING AND MATERIALS PAUL F. WEBER PORTION OF BOWED IN CMU FOUNDATION WALL ASTM A36/A 36M — "STRUCTURAL STEEL" ASTM A53 — PIPE, STEEL, BLACK AND HOT—DIPPED, ZINC—COATED WELDED AND SEAMLESS" ARCHITECT, LLC. ASTM A153 — "ZINC COATING (HOT—DIP) ON IRON AND STEEL HARDWARE" € 1 '-6" 4'-0" (TYP) 2 12„ ACI 301 — "SPECIFICATIONS FOR STRUCTURAL CONCRETE FOR BUILDINGS" 2. DESIGN HELICAL PILE SYSTEM TO SUPPORT LOADS AS INDICATED ON DRAWINGS AND OUTLINE IN THIS SECTION. SUBMIT FOR APPROVAL BY THE ENGINEER THE HELICAL PILE DESIGN CALCULATIONS AND OTHER PERTINENT DATA BEFORE COMMENCING PILE INSTALLATION. APPROVAL OF SUBMITTALS DOES r r—7 r—-i r—, r—, r—� NOT RELIEVE CONTRACTOR OF RESPONSIBILITY FOR PERFORMING THE PILE INSTALLATION IN 449 Thames Street IInn, I IIM , I I An, I ACCORDANCE WITH CONTRACT DOCUMENTS. Suite 202 3 ARS EXPERIENCE ININSTALLER LTYPE OFL BE R DESIGN TIFIED BAND ECONSTRUCTION LICAL PILE NSPECIFIED R W INTH S SECITH A ITION AND ANIMUM 5 BLE TO Newport, RI 02840 DEMONSTRATE SUFFICENT COMPETENT PERSONNEL TO COMPLETE SPECIFIED CONSTRUCTION. CAPABLE oil s 6 s �' Tel: 401.849.3390 + +� +�, +� + +�, +� +� OF PROVIDING JOB SUPERINTENDENT OR FOREMAN WITH AT LEAST 5 YEARS CONSTRUCTION EXPERIENCE +�� + + + + + + + Fax: 401.849.3397 p A � IN CONSTRUCTION SPECIFIED IN THIS SECTION AND ENSURING SUCH SUPERVISION WILL BE PRESENT AT SITE DURING PILE CONSTRUCTION. 4. PILE DESIGN CAPACITIES TO BE DETERMINED AND STAMPED BY AN ENGINEER REGISTERED IN THE STATE OF MASSACHUSETTS. 5. INSTALLER TO CONFIRM THAT SITE CONDITIONS ARE ACCEPTABLE TO ENSURE PROPER AND TIMELY INSTALLATION TO SATISFIED, SUBMIT TO ARCHITECT WRITTEN NCONFIRMAT CONFIRMATION APPLICABLE INSTALLER. FAILURE TOwww•pfwarchitect.com SUBMIT WRITTEN CONFIRMATION AND SUBSEQUENT INSTALLATION WILL BE ASSUMED TO INDICATE CONDITIONS ARE ACCEPTABLE TO INSTALLER. Q� 6. ACCURATELY LOCATE EACH PILE PER DESIGN DOCUMENTS BY MEANS OF SURVEY. DO NOT EXCEED 4 �F1 INCHES LATERAL DEVIATION FROM CENTER OF PILE DESIGN LOCATION. 7. PILES IMPROPERLY INSTALLED BECAUSE OF MISLOCATION, MISALIGNMENT, OR FAILURE TO MEET OTHER SPECIFIED DESIGN/INSTALLATION CRITERIA ARE NOT ACCEPTABLE. ABANDON REJECTED PILES AND INSTALL ADDITIONAL PILES AS REQUIRED. 8. PILE INSTALLER RECORDS — MAINTAIN DAILY RECORD OF ALL DATA PERTINENT TO INSTALLATION OF PILES, INCLUDING THE FOLLOWING: PILE NUMBER, DATE OF INSTALLATION, HELICAL PLATE DIAMETER, PIER SHAFT SIZE, PILE LENGTH, TORQUE READINGS DURING INSTALLATION, DESCRIPTION OF ANY UNUSUAL OCCURRENCES DURING PILE CONSTRUCTION. 9. INSTALLATION CONTRACTOR TO PRODUCE AS—BUILT DRAWING AFTER COMPLETION OF PILE INSTALLATION IDENTIFYING ACTUAL LOCATIONS OF HELICAL PIERS, PIER DIAMETER, AND PIER LENGTH AND DEVIATION 5J 1 FORM INDICATEDr LOCATIONS. �JH 5J�• QoQ0c, Qo �01 �Ol �01 Q05� 9 05� I i Z W m ��01 m �01 m 01 m �01 m �0 m �01 �01 cc, �01 (E) FLUSH 05� (E) FLUSH 05� (E) FLUSH 0 0 0�'� 0�'� 0�'� 0�'� (E) FLUSH 0�'� (E) FLUSH n FRAMED JOISTS Q FRAMED JOISTS Q FRAMED JOISTS Q Q Q Q Q Q FRAMED JOISTS Q FRAMED JOISTS F� IV/ E E FLUSH �%E) E FLUSH (E) FLUSH E) FLU H FAMED OISTS O FRAMED SJOISTS F01 FRAMED JOISTS FRAMED JOIS S o1 FRAMED JOISTS 01 GU S HANGER G � 0� 0 007� 0 O 31"x9j" WOLM. PAR LLAM (TYP) \�0�� Q 01 Q Cc1 Q OG� 'Oi J L AEG/�Oi 3�"x9�" WOLM. PARALLAM Q��G J L JI J L (�v ` ` \ `O/�< J L G v \\ \�0X� + F Atn AF Atn G Ate` Ace` 0 AF W E) BEAM (TYP) � o 9 (E) JOIST 2x 10 TO ABUT LVL'S, SHIM GAP IF NECESSARY NOTE:PILES SPACED WITHIN 'Oi�FC `9� ''+� AiO�c� ALLOWABLE LIMITS TO BE F F O E SILL ^IN BATTERED To ACHIEVE ® PROPER SPACING HIGH GRADE �PRP� � G �`�`� UNDERPINNING 2-1 i� LWL ON FLAT O -4,� 32 O ALONG ENTIRE E) RAFTER A%��'.f- L 3""x PLAN Scale: 1/8" = V-0" LENGTH N WALL 2x10x3 0 TIMBERLOk F 9 WOL . PARALLAM J F. EACH EXISTING JOIST %2"x10"x10"PL W/ (6„SPACING, 2" EDGE 4-5/8" THRUBOLTS DISTANCE) 1F,0%y CM BOWE WAL� I I /�F /<<" c DESIGN INTENT: p��H OF �4S ® HE THE INTENT OF THIS DESIGN IS TO STABILIZE T DANIELW. 2-9�"LVL HEADER a I 0 (To BE VERIFIED IN REAR WALL AGAINST ANY FURTHER SETTLEMENT. STR RAIL y Job#: THIS WILL ALLOW FOR NEW WINDOWS AND DOORS 0752 p "' ® o FINAL CONDITION) TO BE HUNG PROPERLY. NOTE THAT THIS REPAIR F Revision: DOES NOT ADDRESS THE FOUNDATIONS FOR THE NAL INTERIOR POSTS. THEREFORE, THE FUTURE HSS PERFORMANCE OF THE FLOOR WILL STILL BE 17 TO BE UNKNOWN AFTER THE REPAIRS ARE PERFORMED. WEBB STRUCTURAL SERVICES, INC. JEW Daniel Webb P.E. THIS REPAIR ALSO ADDRESSES THE BOWING IN 670 Main Street 4DERS CMU FOUNDATION WALL AT THE FRONT PORTION Reading, MA 01867 HGUS of THE BUILDING I I (E) 2x JOIST (781)-779-1330 Phase: FOR PERMIT PARALLAM HANGER BEAM (E) BEAM Description: II II TECHNO PILE WITH UNDERPINNING LEGE �1�1 DRYPACK NON—SHRINK GROUT U BRACKET Date Issued: 01.13.17 BETWEEN HSS AND CMU WALL BW = BEARING WALL REPLACE CUT OUT FVP = FLAT VALLEY PLATE 0�G�,�0�F�' 1 ,� �, Scale: AS NOTED I � PORTION SLAB (E) = EXISTING EXISTING SLAB APPROXIMATE (4" MIN, V.I.F.) GROUND SURFACE— 1 FOUNDATION UNDERPINNING F� O 2016 - PAUL WEBER ARCHITECT, LLc X X Scale:3/4"=P-0" TIGHTLY COMPACT NUMBER OF STUDS IF APPLICABLE BACKFILL SOIL P3-26 %2"x10"x10"P L 8"x18"x12" DEEP 4-5/8"Ox5" CONC. FOOTING SIZE OF STUD OR DIMENSION OF SOLID POST EMBED. EPDXY TYPE OF POST: P—POST,J—JACK,VC—VERSA ® ANCHORS W/ COLUMN, LC—LALLY COLUMN, LEVELING NUT (�FOUNDATION REPAIR sEcrloN AND GROUT Scale:3/4"=1'-0" HSS—HOLLOW STRUCTURAL 0 0