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i1�?,ta. December 9,2020 at 11:03 AM
< Town of Barnstable - Regarding your permit• B-20-2997 ate..
t Town of Barnstable Building
y t Post This Card SoThat K is Visible From the Street Approved Plana Must be Retained on lob aad this Card Must be Kept Poster
>' UutB Final Inspection Has Been Made d e r ,r t °F"t
Where a CertiNcate of Occupancy k required sudt Bultdir shall Not be Ocwpled ulnil a Fine!inspection lies been made ry Permit
Permit No. B-20-2997 Applicant Name: KENNEY BUILDERS INC. royals
Date issued: 11/06/2020 Current Use: Structure
Permit Type: Building-Detached Accessory Structure- Expiration Date: 05/06/2021 Foundation:
Residential Map/lot 208.034 Zoning District: RD-1 Sheathing:
Location: SS OLD STAGE ROAD,CENTERVILLE i Contractor Name' CHRISTOPHER T KENNEY framing: 1
Owner on Record; COCHRANE,1 BRUCE&JANET H ' _ ° "
:: COntractor license CS-001895
z., 2
Address: 26 FIELDSTONE LN
Est Project Cost: $50,000.00 Chimney:
NATICK,MA 01760 Permft Fee: $355.00
Description: new uunattached garage-three car and storage room above Insulation:
Fee Paid: $355.00
Project Review Req: Certified as-bulk survey required before frame ^ Date 11/6/2020 Final:
engineering calucation for steel beam required at or before ir" /
frame. x //7 t )h/ Plumbing/Gas
UNFINISHED STORAGE ABOVE.SEPERATE PERMITTD
t = Rough Plumbing:
RECtU1RE0 TO FINISH. Building Official Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance.
All work authorized by this permit snail conform to the approved application and the approved construction documents foc:which this permit has been granted. Rough Gas:
All construction,alterations and changes of use of any building and stniittures ihalibe in compliance with the local zoning hydaws and codes.
This permit shall be displayed in a location dearly visible from access street or road and shag be maintained open for public Inspection for the entire duration of Final Gas:
the work until the completion of the same.
III a'
Sent from my Phone
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Notes• steel girder beams (3 typ.):
If floor joists are flush framed to steel beam,
provide 1/2" clear gap above steel top flange W 16x31 (max. 28'-0" span, :ASTM A992) Cochrane Garage]3ui
to accommodate shrinkage of floor joists. Provide 5 1/4"x5 1/4" Versa-Lam (1.7) 2650 posts, or equal min. floor joists
required (assuming steel g e s s ppo:
Provide solid blocking w/bearing support on q ( 9
g engineered posts in strength. DL=15psf, � ���'''
interior face of bottom flange of steel beam at 1 " 1 1,
Provide steel tab plate: 0-6 XO-3 x1/4 thickness, welded
124"o.c. (min.);through bolt via. 1/2"dia. LL=50psf, and max. 1�aAgt5e R.
ASTM A307, Gr."A"through bolts @16" o.c. via. 3/16 fillet weld t bottom
a. e o oom flange of W-flange beam
g15ft clear span are: C 11t >�aL
staggered, typ. provide washers on each adjacent to each post. Connect each tab plate via. (2)- No.50602
face, typ. Simpson SDWS wood screws x 411 long to the engineered
2X10's @ 12" o.c., � �FG,ST
If floor joists are supported atop the steel 11 see calc. sheet for
� wood post, typ. Screws shall have min. 2 end distance on
girders, provide a 2x nailer, 2X blocking post, and be centered on the post's vertical axis. hanger information. 12 11/202
between joists along girder supports, and
connect floor joists @ 24"o.c. via. Simpson
"H2.5A" clips, alternate sides on steel beam,
for lateral support of steel beams
1 1
1 a
'i •
1
1 , -
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cam,_. �I ,
1
� T' s Y:�tv�'�� 17., q:PLC:
M... .. t / bl•taN P.f '.O',HCM.
r .Ct.145.(�A.__O,M• ....�rc,�)..._A'(�y�jp ''
1 �
y
f 1 full depth solid 2X ,
blocking at mid span,
. I W 4,2- � arL _ typ. each bay
1 .. ( C -0r tom•. r260 ,G4F7'c.-'iSiP�l...y
�al aILr Q /�•% I , rto ._i .. o i1d7y.. GOMG ...MAjL9
� r 2 Ic S.dtt'C� t:Q. .::: I°, ... ' /y' ,.[e' f l � `of -'1.>"4 -keY Y�!--•_ — .
_ 5...�tl.:q: C'ma¢�z? Collc Ir:ult/_t3e-e
0.
teel Girder beams @ 2nd floor level PLAN (not to scale, schematic only)
TOTE: INGHOUSE has not reviewed or designed any other information of this a Mash _ t
INGHOUSE,PC ?. r rolect, other than steel girder beams and their supports, as well as the typical nt�• n ma/l/ng: P.O.Box 182 ..:5.5 vUh '-� p E- u.0,,....: �!22-tCB2.✓I LLO._
nd floor joist size. Other building related design is provided by others, and ,5 ,MAD2649 ,-
JGHOUSE excludes any liability for items not specifically indicated by our 9b° 18steepemmo Street
2 �z�
Mashpee Commons DON�1 a� 40�/R�]!/Tgj,
Mashpee,MA 02699 j'�(�,{,, !1 j�ValU �ttj� ^�
.dmarked notes on this sheet. structural design phone: 508-221-2980a�n sraralDulGiiigD1U,gwr
S ingenuity emv0: tensenCla lnaho e[
Profs
web• www.lnahouse.netDox8,17
... .
Ba Yumonlh,MA 02681
: .. 18881199:8198
INGHOUSE 12/09/2020 Cochrane Garage Bldg Steel Girders&2nd floorjoists'(ING20148) Page 1 of 1
2nd floor,Floor:Joist
1 piece(s)2 x 10 Spruce-Pine-Fir No.1/No.2 @ 12"OC
Overall Length:15'7"
+
0 0
15'
a o
All locations are measured from the outside face of left support(or left cantilever end).All dimensions are horizontal.
Design'ResUlts. Actual tda Location Allowed' +,yResult 1 LDF Load.ComMnation(PatEern)
System:Floor
Member Reaction(Ibs) 488 @ 3 1/2" 956(1.50") Passed(51%) -- 1.0 D+1.0 L(All Spans) Member Type:joist
Building Use:Residential
Shear(Ibs) 437 @ 1'3/4" 1249 Passed(35%) 1.00 1.0 D+1.0 L(All Spans) Building Code:IBC 2015
Moment(Ft-Ibs) 1828 @ 7'9 1/2" 1973 Passed(93%) 1.00 1.0 D+1.0 L(All Spans) Design Methodology:ASD
Live Load Defl.(in) 0.411 @ 79 1/2" 0.500 Passed(L/438) -- 1.0 D+1.0 L(All Spans)
Total Load Defl.(in) 0.535 @ 79 1/2" 0.750 Passed(L/337) 1.0 D+1.0 L(All Spans)
TJ-Prol-Rating N/A N/A N/A N/A
•Deflection criteria:LL(L/360)and TL(L/240).
•Allowed moment does not reflect the adjustment for the beam stability factor.
•A 15%increase in the moment capacity has been added to account for repetitive member usage.
•Applicable calculations are based on NDS.
•No composite action between deck and joist was considered in analysis.
x r Beanng Lem + Loads to SuPPo►1s Obs) �n4 " :
• a # ;
Supports Total Available Required Dead Floor Live
t � T I�
r
ota Accessones
1-Hanger on 9 1/4"SPF beam 3.50" Hanger' 1.50" 117 390 507 See note'
2-Hanger on 9 1/4"SPF beam 3.50" Hanger' 1.50" 117 390 507 See note'
•At hanger supports,the Total Bearing dimension is equal to the width of the material that is supporting the hanger
•'See Connector grid below for additional information and/or requirements.
Lateral Bract Moog Intervals Comments s f
r a ," „E�; e,curr .L .7is. .act ce �
Top Edge(Lu) 3'7"o/c
Bottom Edge(Lu) 15'o/c
-Maximum allowable bracing intervals based on applied load.
Connector.Sim son Strom Tie If
Support .w ;Model .r, Seat Length , Top Fasteners ";#Face Fastenerst Merribei Fasterie_cs Accessones w
1-Face Mount Hanger LUS28 1.75" N/A 6-10dxi.5 3-10d
2-Face Mount Hanger LUS28 1.75" N/A 6-10dx1.5 3-10d
•Refer to manufacturer notes and instructions for proper installation and use of all connectors.
w g Dead. Floor Live
46
Vertical load Locabon(Side) spanrrg (0 90) (1 00) Comments
uF' Sa
1-Uniform(PSF) 0 to 15'7" 12" 15.0 50.0 Default Load
We erhaeuser NotesN,, . ` ,`•:
Weyerhaeuser warrants that the sizing of its products will be in accordance with Weyerhaeuser product design criteria and published design values.Weyerhaeuser expressly disclaims any other warranties
related to the software.Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,builder or framer is
responsible to assure that this calculation is compatible with the overall project.Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Products manufactured at
Weyerhaeuser facilities are third-party certified to sustainable forestry standards.Weyerhaeuser Engineered Lumber Products have been evaluated by ICC-ES under evaluation reports ESR-1153 and ESR-1387
and/or tested in accordance with applicable ASTM standards.For current code evaluation reports,Weyerhaeuser product literature and installation details refer to
www.weyerhaeuser.com/woodproducts/document-library.
The product application,input design loads,dimensions and support information have been provided by ForteWEB Software Operator
ForteWES Software Operator Sob Notes 12/9/2020 9:28:30 PM UTC
Lars Jensen
INCHOUSE PC ForteWEB 0.1, Engine:V8.1.5.1,Data:V8.0.1.0
Town of Barnstable
aae^ ^z'...... �°w rx �".... •. .. ., `r° , f t n:r H Y
f Post ThisBuAding
Card So?hat rt is'Visible From;the Street Approved;Plans,Must be Retained on Job andahis.Eard Mustwbe�Kept
Posted Until'Final Inspection Has$Been MadePermit
Where Cert ficate.of Occupanc�yas Requred,Tsuch BItlmg shall Not:bcc�upiedun#ilaFna�l Inspectionhas4been made k
Permit NO. B-19-2864 Applicant Name: COCHRANE,J BRUCE&JANET H Ap
provals
Date Issued- 09/05/2019 Current Use: Structure
Permit Type: Building Shed-Residential 200 sf and under Expiration Date: 03/05/2020 Foundation:
Location: 55 OLD STAGE ROAD,CENTERVILLE Map/Lot 208-034 Zoning District: RD-1 Sheathing:
Owner on Record: COCHRANE,J BRUCE&JANET N �' Contractor Name*a t Framing: 1.
Contractor License:
Address: 26 FIELDSTONE LN a 2
Est Project Cost: $0.00
NATICK, MA 01760 Chimney:
Description: 10x16 shed 4, rt Permit Fee: $35.00
Insulation:
9 Fee Paid ' $35.00
Project Review Req: SHED REGISTRATION 160 SF A: Final:
Date 9/5/2019
. >
� � � �� ��,��.�d�r- :.: Plumbing/Gas
M
Rough Plumbing:
Building Official
Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authored,by this permit is commenced within,six,
p6pths�after�issuance.
All work authorized by this permit shall conform to the approved applidatton AJ&the approved construction documents;for whicJ1his permit has been granted. Rough Gas:
All construction,alterations and changes of use of any building and stead" iesshallllb6 in compliance with the local zoning by lawszand codes.
This permit shall be displayed in a location clearly visible from access street or roa�d�nd shall be maintained open for pubic nspec o for the entire duration of the Final Gas:
' F T
work until the completion of the same.
-` �r� �� Electrical
The Certificate of Occupancywill not be issued until all applicable signatures by the Bwldihg and=Fire Officials are provided on thiei ,s permit.
;
Minimum of Five Call Inspections Required for All Construction Work ",'� £ ,4 zW Service:
1.Foundation or Footing
Rough:
2.Sheathing Inspection w
3.All Fireplaces must be inspected at the throat level before firest flue Llining is installed
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final:
5.Prior to Covering Structural Members(Frame Inspection)
6.Insulation Low Voltage Rough:
7.Final Inspection before Occupancy
Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanigal Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Health
"Persons contracting with unregistered contractors do not have access to the guaranty fund (as set forth in MGL c.142A). Final:
Building plans are to be available on site Fire Department
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final:
ToNvn-of Barnstable
(}' Tl
Building Department Services
THE ip�
Brian Florence, CBO
uxxsrescE, : Building Commissioner
�PrE.7�`�� 200 Main Street, Hyannis,MA 02601
wfvw.town.barnstable.ma us
Office: 508-862-4038 Fag: 508-790-6230
PERMIT# 6y1 1 296.y : $35.00
SIM REGISTRATION
RESIDENTIAL ONLY
200 square feet or Iess
s c G � V ),
Location of sh (address) Village
operty owner's name Telephone number
Size of Shed Map/Parcel# x
' 4..
s.a G.
C>
Q � ~
Date
Hyannis Main Street Waterfront Historic District? W
Old Kings Highway Historic District Commission jurisdiction?
You must file with Old King's Highway
Conservation Commission(signature is required)
Sign off hours for Conservation 8:00-9:30&3:304:30
PLEASE NOTE: IF YOU ARE WTrBE[N THE JURISDICTION OF ANY OF THE ABOVE
CommiSSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEZ.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.
TMS FORM MUST U ACCOMPANIED BY A
PLOYPLAN
Q-fims-sbe&eg °bl'!� q � t�J REV:08/6/17 340 '
' b lop '" Legend
Parcels
Boundary
own
Railroad Tracks
Buildings
�} +. 208038001 � VJ Approx.Building
#T$ t 2060
€13$02; Buildings
Painted Lines
Parking Lots
E'.; Paved
i2�$Q Unpaved
2€�$137 Driveways
I #326 Y
i fs1- - F --.' Paved
y ` " .rid Sw3 Unpaved
4 62 " 2{3$ �k1t1 2 Roads
'� - 0 Paved Road
#356 Unpaved Road
Bridge
IM Paved Median
1&0 E Streams
' Marsh
vL Water Bodies
208040
2. 034
55 v
1$$1I6::
#12 - 'f'
s }
r
I _ r
08030
t #141 208t152
tE 20$144 '� 2QBU33l .352
#31`
#.37 t
E
i 20 042
364
#62.
200031 208156 2Q3.
$$ -
�•
........:.....:....._...............
Map printed on: 9/3/2019 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit
adequate for legal boundary determination or representations of Assessor's tax parcels.They are
Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA 026o1
!O 83 167 0 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 5o8-862-4624
reflect current conditions,and may contain such as building locations.
�, Approx.Scale: 1 inch= 83 feet cartographic errors or omissions. gis@town.barnstable.ma.us
Town of Barnstable � *Permit#��` `
J m Expires 6 nths rorn issue date
Regulatory Services Fee C
Thomas F. Geiler,Director
Building Division I b12 11?_
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town,bamstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
EXPRESS PERAUT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
ap/parcel Number
operty Address J ��d/ s qS'� � C--e
I Residential Value of Work Q D Minimum fee of$25.00 for work under$6000.00
Nner's Name&Address ' �i e e—
v
yntractor's Name)) j, it P PL<1�.- h/ / ifJ n: e�/ Telephone Number .�O - -7 7,- ,3 7
ome Improvement Contractor License#(if applicable) to
i
's- ' table) �ci--ram✓-^v�-
11W-orkman's Compensation Insurance. -PRESS PERMIT
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner OCT ;8 2012
❑-T-h—ave Worker's Compensation Insurance
surance Company Name S A /iG✓` C. BARN 3TABLE
orkman's Comp.Policy# w
opy of Insurance Compliance Certificate must be on file.
smut Request(check box)
Z�Re-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
0Re-side
❑ Replacement Windows doors/sliders. U-Value (maximum.44)
*Where required: lssuance.of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Pro Owner must sign Property Owner Letter of Permission.
y of the Home ImprovemegContractors License is required.
GNA
For=:expmtrg
;vise061306
_ The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
' d 600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insuranlce Affidavit: Builders/Contractors/Electricians/Plum' hers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): . GIJ/f A.,C?¢ . p y e /r �' ,
Address: O C
City/State/Zip: . �T/}P O v/�� A 0 Phone.#: 3S 5 T�3-c��9.5
Are yo3Lan employer?Check the appropriate box: ' Type of project(required):,
1. I am a employer with 4• ❑ I am a general contractor and I r'
employees(full and/or part-time).
* have hired the sub contractors 6. El New construction .
2.❑ I am a sole proprietor or partner- listed on the'attached sheet.r 7. []Remodeling
shipand have no employees These sub-contractors have
8. [�Demolition
working for me in any capacity. employees and have workers'
com insurance t' 9. ❑Building addition
[No workers' comp.insurance P•
required.] 5• ❑ We are a corporation and its 10.0 Electrical repairs or additions
3..❑ I am a homeowner doingall work officers have exercised their
11.❑Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL. .
12.❑Roof repairs
insurance required.]t -c. 152,§1(4), and we have no I�
employees. [No workers' 13.❑ 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 anew affidavit indicating such.
$Contractors that check-.this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees: If 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. 1� %
Insurance Company Name: e .O
Polic #or Self-ins,Lic.#: Ki Ci 4 //
Y Expiration Date:
Job Site Address: 0J s f li Ci /State P
tY /Zi p:_�,.
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
I ao hereby erz�ti r the pains and p naltces erjury that the information provided above is ue and correct. {
SiMaurgDate: a
Phone#: .`a� �� —7"f 63 7 26
Official use.only. Do not write in this area, to be completed by city or town offcciat
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#•
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide worker 'compensation for their employees.
Pursuant to te,an employee is defined as"...every person in the service o another under any contract of hire,
express or.implied,o or written."
An employer is defined as ` n individual,partnership,association,corporation other legal entity,or any two or more
of the foregoing engaged in 'oint enterprise, and including the legal represen tives of a deceased employer,or the
re iv tLusee a lndi ' al Uartnershi association or other le al enti el
loving employees. However the
owner of a dwelling house havin not more than three apartments and who r ides therein;or the occupant of the
dwelling house of another who e loys persons to do maintenance,constru lion or repair work on such dwelling house
or on the grounds or building app nant thereto shall not because of such employment be deemed to bean employer."
MGL chapter 152, §25C(6)also states t"every state or local licensi agency shall withhold the issuance or
renewal of a license or permit to'opera a business or to construct uildings in the commonwealth for any
applicant who has not produced:accepta a evidence of complianc with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)sta s`Neither the commo ealth nor any of its political subdivisions shall
enter into any contract for:the performance of blic work until-acce table evidence of compliance with the insurance
requirements.of this chapter have been presente o the contracting uthority."
Applicants
Please fill out the workers' compensation affidavit cc letely, checking the boxes that apply to your situation and,if
necessary,supply sub-conti-actor(s)name(s),address(es) d ph ne number(s) along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited is ty Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers' cc anon insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit y be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be s r to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the pe t. ..license is being requested,not the Department of
Industrial Accidents.' Should you have any questions regard' g the w or if you are required to obtain a workers'
compensation policy,please call the Department at the num er listed elow. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete'and printed le ly. The Dep ent has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of vestigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which be used as a referee number. In addition, an applicant
that must submit multiple permit/license applications in given year,need only�submit one affidavit indicating current
policy information(if necessary)and under"Job Site Ad ess" the applicant shoul write"all locations in (city or
town).":A copy of the affidavit that has been officially st ped or marked by the ci or town may be provided to the
applicant as proof that a valid affidavit is on file for futur permits or licenses Anew ffidavit.must be filled out each
year.Where a home owner or citizen is obtaining a licens or permit not related to any iness.or commercial venture
(i.e. a dog license or permit to bum leaves etc.)said perso is NOT required to complete affidavit.
The Office of Investigations would lrke to thank you in a ante for your cooperation and sh uld you have any questions,f
please do not hesitate to give us a call.
Department's address tele hone-and fax number:
The Departm p
The Commouwt alth of Massachusetts
Depaziaent of dustial A.eczclents
Office of nvestigations
600 Was ` gtQii Street
Boston, 02111
Tel.##617-727-4900 ext. 06 or 1-977-MASSAFE
Fax#617-727-7749
.Revised 11-22-06
www.mass.pv/dia
i
Town of Barnstable
" Regulatory Services
BMUMABLE,
9 ass g Thomas F.Geiler,Director
AlfD MAC p' Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
www-to wn,b arnstable.ma.us
Office: 5 08-862-403 8
Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
as Owner of the subject property
P m'
hereby authorize '
" ')ti to act on my behalf,
in all matters relative to work authorized by this building permit application for; .
04 1&0 ta,u I tle
(Address of J )
Signature of Owner Date
Print Name
QTORn4S:O NTERPERMISSION
Workers Compensation and Employers Liability
Insurance Policy
I N S U R A N C iE Polic `Number Policy Period
Y From _ .Ta
C O M P A N Y WC 0113.246 01/26/2012 01/26/2013
C 12 01 A.M.Standard Time at the mailing address
26255 American Drive of the insured as stated herein
. Renewal Of' Transaction
Southfield, MI 48034-6112
WC 0113246 Policy Declaration
1: Named lnsiared and Mai ing Address ': -.Agent
LAWRENCE K. KENNEY COCHRANE & PORTER INSURANCE
100 SULLIVAN RD AGENCY INC
WEST YARMOUTH MA 02673-3544 981 WORCESTER STREET
WELLESLEY MA 02482
UNEMPLOYMENT ID# CARRIER# FEIN# Risk ID# Entity of Insured
24562 105287178 INDIVIDUAL
Other Workplaces Not Shown Above:
2. The Policy Period is from 01/2 6/2 012 to 01/2 6/2 013 12:01 a.m. Standard Time at the Insured's mailing address.
3. A. Workers Compensation Insurance: Part ONE of the policy applies to the Workers Compensation Law of the states
listed here: MA
B. Employers Liability Insurance: Part TWO of the policy applies to work in each state listed in Item 3A.
The limits of our liability under Part TWO are:
Bodily Injury by Accident $ 100, 000 each accident
Bodily Injury by Disease $ 500, 000 policy limit
Bodily Injury by Disease $ 100,000 each employee
C. Other States Insurance: Part THREE of the policy applies to the states, if any, listed here: All states except North Dakota,
Ohio, Washington, West Virginia, Wyoming, and states designated in item 3.A. above.
D. This policy includes these endorsements and schedules: See attached schedule
4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates, and Rating Plans.
All information required below is subject to verification and change by audit.
Assessments and Taxes SEE EXTENSION OF INFORMATION PAGE
MA 5986
If the premium is paid on an installment basis, a$5.00 per payment charge applies.
Total Estimated Annual Premium $ 20, 328
Expense Constant $ 338
Minimum Premium $ 5oc Premium Discount $ - 618
❑This is a Three Year Fixed Rate Policy
Deposit Premium $ 21, 314
Premium Adjustment Period: ® Annual; ❑ Semiannual; ❑ Quarterly; ❑ Monthly
Countersigned this Day of
Issued Date: 12/14/2 011 Authorized Representative
Issuing Office
wr:nnnnnstca »fr,ei INS17RFD COPY
Unrestricted-Buildings of any use group which Massachusetts-Department of Public Safety
contain less than 35,000 cubic feet(991M )of Board of Building Regulations and Standards
enclosed space. Construction Super%,isur
License CS-005609
LAWRENCE*kiNNEY
100 SULLIVdiN RD ?�
W YARMOiTII MA 02673 T
Failure to possess a current edition of the Massachusetts I ±f
State Building Code is cause for revocation of this license.
For DPSLicensing information visit: www.Mass.Gov/DPSExpirationCommissioner
03/08/2014
registration valid for individul use only.
before the expiration date.. If found return to: Office of Consumer Affairs&Business Regulation::
Office of Consumer Affairs and Business Regulation OME IMPROVEMENT CONTRACTOR
i 10 Park`Plaza-Suite 5170 —
_ egistratton: 101413 Type:
Boston, MA 02116
xpieatton x 16/25/2014, Individual
t a
LAWRENCE K.KENNEY r
}
Lawrence .Kenney r
x
100 Sullivan Road;
Not vhd without s!g'nature
1 ,W Yarmouth Mi4:02673 Undersecretar f :
3 r€
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SEM SUMM.— MUST BE
Assessor's office(1st Floor):
Assessor's map and lot number 0 O � 4*fNE TO o
Board of Health I floor):
Sewage Permit number Zo EMROM,M , eODE
®
BAMST&BLE i
Engineering Department(3rd floo 5S ��S .noN,,: raaa
House number 1639- \e�
Definitive Plan Approved by Planning Board 19 �Ea M0 rr
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 AG 49niLl l Ae-5S,!A!w htal Awn="Ij
TYPE OF CONSTRUCTIONpO�f
19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location old 5114AK-7 RI G�nvdlfc
Proposed Use 6 ,M
Zoning District Fire District
Name of Owner Address t5 e5r Cc,—
Name of Builder Vr Address r l+lil�t
Name of Architect Address
Number of Rooms Foundation
Exterior Roofing C2100�0144 -,,I*/:
v
Floors Interior 11
Heating ��lllll! &4 Plumbing ge5c.-
Fireplace z:-,A, 1 im1 Approximate Cost
Area L/C/
Diagram of Lot and Building with Dimensions Fee 0 Ul
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
COCHRANE, VIRGINIA S . y�
No 3308.6 Permit For Remodel & Renovate
Single Family Dwelling
Location 55 Old Stage Road
Centerville
+ r Owner Virginia S. Coc-hranP "
;. Type of Construction Frame
,.> 7
` Plot Lot
Permit Granted J.u1y -201 19 89
Date of Inspection 19
Date Completed 19
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LOQ0055 OLD STAGE ROAD CTY]10 TDSJ 300 CO EYj 126624
----MAILING ADDRESS------- FCA]1011 Pecs joo YR]oo PARENTI 0
COCHRANE, VIRGINIA S MAPJ AREAj54AA JVj24SSII MTOJOOOO
45 LONGWOOD AVE #504 SPlj SP2j SF 31
UTIJ UT21 1 .20 SO FT] 2016
BROOKLINE MA 02146 AYBjl972 EYBJ1975 OBSJ CONSTj
0000 LAND 168000 imp 135200 OTHER
LEGAL DESCRIPTION---- TRUE MET 303200 REA CLASSIFIED .
#LANLr) I 16S000 ASO LND 16SO00 ASO IMP 135200 ASO OTH
#BLDO(S)-CARD-1 1 135,200 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE
#PL 55 OLD STAGE RFC CENT TAX EXEMPT
#RR 1174 0182 •RESIDENT2 303200 303201) 303200
OPEN SPACE
COMMERCIAL
INDUSTRIAL
EXEMPTIONS
SALE]091SS PRICEj ORB ISSS01169 AFDJ
LAST ACTIVITY]07125108 PCRJY
FROM
yFMs Virginia S. .Cochrane
TOWN OF EiARNET14BLE
BUILDING DEPARTMENT
55 Old Stage Road 367 MAIN STREET HYANNIS,MA 02601
Phone:775-1120
Centerville,, MA 02632 I
SUBJECT: -J
FOLD„EFW 55 Old Stage Rd. , Centerville (Permit # '33086)
DATE ,
12111/89 MESSAGE
Please contact this office about the above referenced permit.
Richa - R. Bearse , Inspector
SIGNED,
GATE
REPLY
i
SIGNED -
- s
LN87-RMIRECIPIENT:RETAIN WHITE COPY,RETURN PINK COPY
SENDER:SNAP OUT YELLOW-COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT.